Loading...
HomeMy WebLinkAbout11-14-07 (3) --.J 15056041147 REV -1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX.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 RESIDENT DECEDENT 2 1 0 7 0831 Date of Birth 187164395 08222007 12181923 MILLER KATHRYN MI E 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 OVALS BELOW o 1. Original Return o 4. Limited Estate 9. Litigation Proceeds Received 0 2. Supplemental Return 0 3. Remainder Return (date of death prior to 12-13-82) D 4a. Future Interest Compromise D 5. Federal Estate Tax Retum Required (date of death after 12-12-82) 0 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) D 1 0 Spousal Poverty Credit (date of death D 11. Election to tax under Sec. 9113(A) . between 12-31-91 and 1-1-95) (Attach Sch. 0) [gJ o 6. Decedent Died Testate (Attach Copy of Will) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D. BOGAR 717737~61 Firm Name (If Applicable) BOGAR & HIPP LAW OFFICES ", REGISTER OF W1LL~ USE 'ONL Y First line of address ONE WEST MAIN STREET -", ; Second line of address DATE FILED City or Post Office SHIREMANSTOWN State PA ZIP Code 17011 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGN R OF PERSON RES NSI FOR FILING RETURN 0 TE Patricia A. Peterson /1 ADDRESS James D. Bogar II hiremanstown, PA 17011 Side 1 L 15056041147 15056041147 --.J ~ 15056042148 REV-1500 EX Decedent's Name: Kath ryn E. 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)............................................................. 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J)................................................. 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, of transfers under Sec. 9116 (a)(1.2) X .00 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 447,493.90 16. 0.00 17. 0.00 18. 19. Tax Due..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 Decedent's Social Security Number 187164395 25,031.84 186,325.58 61,966.48 182,287.82 455,611.72 7,710.06 407.76 8,117.82 447,493.90 447,493.90 0.00 20,137.23 0.00 0.00 20,137.23 D 15056042148 ~ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-0831 DECEDENT'S NAME Kathryn E. Miller STREET ADDRESS 5225 Wilson lane CITY I STATE IZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 1,006.86 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) (58) Make Check Payable to: REGISTER OF WILLS, AGENT 20,137.23 1,006.86 19,130.37 19,130.37 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;.................................................................................. b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary interest; or.......................................................................................................... ........ d. receive the promise for life of either payments, benefits or care?.............................................................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?...................................................................................................................... Yes D D D D No [!] [!] ~ [!] [!] D D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?................................................... .................................................................. D [!] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (a) (1.1) (Ii)]. 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. 99116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS COMMONV\nW.TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Miller, Kathryn E. FILE NUMBER 21-07-0831 ESTATE OF All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 Series EE U.S. Savings Bonds - 31 Bonds - date of 25.031.84 death values determined per attached Savings Bond Calculator - total price $8,900.00; total value $25,031.84; total interest $16.131.84 TOTAL (Also enter on Line 2, Recapitulation) 25.031.84 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) ::T ....,. ....,. -0 ::::: $2 $2 $2 ;.... @ ~ '" C '"-t '-< 0- ~f ("') ;' lJq o <: -- to n -- en to n '"d ::l. ("') ('P \0 -- --.J -- tv o o --.J ~o ~" ow WLn N~ W'CO N" WW mm mim 8iO 0 0 0 ooo~oo ~~p O~~i~i~~~~ ~.~.~.~ ~ ~ ~~~W~~N.NLn ~'N'~~~~~~ o COO..~ ~ ~ ~i~~'''.'Ln.Ln Ln.Ln'll1 " 0\ W W W W W Ln N:NN~ ~ ~ ~~~.CO'Ln'Ln~"'''CO W ~" " " CO CO 0\ 0\ 00\ Ln Ln Ln Ln LnLnW:" "0\0\1l1 0 "0\0\,,, COCO" W ~,~ Ln Ln Ln Ln'LnLn''''~~ CO CO ~ " ~ W'W'CO NN:~ W'NIN~ ~ ~ ~'~'~I~O\ O\~ ~,~ ~IO WW~~~" :OiW~ 0 0 0 0 ~~'W," CON NN CO~ ~I~'" ~ILnCO OiCO~ CO " 0\ Ln ~WlCO'~ "'O\.Ln:CO N ~ W.~,,~O~ m1mm m m m mmimimm'mm m m mmmm m,m,mm m:mmm m m mmmim:mimm m m m m:mm.mmmm m m m m m m m m .m 'm m :m m m m m m m 'm m .m m m m 'm m 'm .m im m m m m m 'm m 'm 'm m m m m m im m im m m m m I : ~.' ,':' I . ~~ ' ~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~ N LnLn OLn LnLnLnLn LnILnNLn'LnOO~Ln:oooiooo 0 00 000 0000:000010,01000.0001000 0 00 0'00 0000 0000 000000'00:000 0 OO:~iO:oooooooio!oo~~OOiO~i~i~OOO ~ ~ ~WNN~O\O\O\O\'~~'W'WiO\'~'~~~~O:O~N~Ln ~ ~ __~~~~~~~~~~~~~~~~~~~~~~~~w~ ~;0i~i~'~!0'~'~~i~.~i~!~i~j~j~~~;~,'~i~:~,~'~i~ ~ ; COiCOCOiCO'COCO COCOCOiCOCOiCOlCOiCOCOCOCOCOiCO~i~,~~~i~ _~;~!~!~O\O\ O\;~_~J~J~J~J~J~;~.".~!~~~_~!~!~N NN , , , , , .' --', , O'O~ OOi~~I~~oioioiol~ ~~O oiO~I~:~ OO~ ~1~INN~NNNN'~~'~I~iN~~~~I~oo,~N~~ .......,...............:.......:...............'.......~~I.......~........:.......:.......:.......:~'.......:.......I.......i.......:.......:.......'.......:.............. NINNiNiNiNN,NNiNiNiN:NiN'NN'NNiNNiNiNN.NN 0010:0:000100:0:0.0:0.000:00:010:00000 OOOOOOO'OOO:OiO'OiOOOOOiO,OiOiOIOO,o ,,~l~l~l~J~J~_~.~j~l~j~l~l~l~_~l~l~,~l~l~l":"COCO" J: : : . i'l, , ' " " i , ii, ' " ,I 1 1 : . 1 w." o,oi~o:o:ooooio:OiO:OiO~'~'OOiO~:~~ooo ~ - ~IWIN'NI~IO\IO\O\O\I~:~:W:W:O\~~I~~I~OIO'~'N~'Ln C = .......~.......~~~~~~~~~~~~~~~~~~~~~~~w NiNiNiNNNNNN,NINiNN:NNNNNiN'NiNNN.N'N ~- olo:oioooO.O'OOIO,OIO:OOOiOO:OO:ooo-o'o< ~~i~,~~:~~:~:~i~:~:~!~'~-~~~~i~iNN:NNN:N LnLnLnILnIO\iO\-O\!O\:O\O\iO\i"i"i""I"'COCO'CO:~!~:~NN,N ~ u.v," ""'~ -i:' H""<~' ~ K~ <1 ~ .... -t' '''".~'''' ~ ".,-." ~ ~ ..,>><-~" "!" ~..~;- ~~""r.~" "i' .-<-.."" ~ ~"";~"'~-~"i'''' '.' + ""-. ~ """'~, '"' ".<< ''':1 ~ ....~".. ""~i:,,," .,..,.~ ~"_,.~ ~ ".,... ~..",,~ ~ ~ ~~~~~~~~~~~~~~~~ ~~~~~~~~~~ ~ NN'LniNNN N N:N:Ni~NiNiLn Ln~iN,Ln:LnLnLnLnLnLn ::!, ~ O'LnLn:O LnLnLn LnLn:Ln'Ln,O'LnLnO Oll1Ln,OO,OO,OOO n c OO'OiO 010 0 OOlo:o'oio:o Ooooio:oiOIOIOIO'O CD ~ . ..... . . . . . '. .. '. . .. . .. .. " .. I. '.. ... "' 00010000 00:0010:0 0'000010000000 o 000 0 00 0 00:0'0'00 0 0000:0:00000 ,;~ '. " ~'" ,- ,. .;, ~"., -";,.. '"' .~ ~, ',. ~~~~~~~~~~~~~~~~ ~~~~~~*~ NLn Ln'N Ln'LnLnLn:LniLn:LnI~,~:~'COCOi~-~'CO'O\ 0\,0\ 0\0\.0\ N ~"i~ " LnLnLn Lnl~:~":~:~ 0\ 0\ COO:~O\O\O\O\O\~ ~:~~ ~~~~i~~i~i~i~i~i~~ ~ ~ ~:~:~ ~i~i~~I~ ~ 0 0\0\ O\~~~~:O\,O\i~lCOCOO OLn O\INIO\ 0\,0\0\ 0\ CO .~ 0 0 00100 ?~l~iO:NiO:OO O.~.~_~l?~l?~~.~l?_ ~:~~.~~ ~ ~ ~ ~'~~ ~,~ ~,~'~:~ ~:~I~'~~~~~ 000:0000 0 00.0 0 0 0 0 0 000000'000 0000 OiO 0 0000'000'0000000 0000 ~ ~ ~ ~ ~ ~ ~ ~ ~i~ ~'~~~~~ ~ ~i~~i~ ~'~ ~'~ ., ," *. ~~~~~~~ .*.~..~.~.~.~.~~~.~~~~~~~ woo 00 "-I 00 0000 0000 '-I '" NO'l O'lWW....O'lW........................ !Io.l,J:o.t-J....t-JOOOO\O\O"-I\O\OO'lO\WUt....O\O\O\O\O\,J:o. IOOWWW"-l"-l "-1"-1"""" \0"-1 "-I CO CO...."-IUt "-1"-1 "-1"-1 "-I,J:o. ::'0 ',0\ 0\ 0\ ~ ~ ~ ~ ,0\0\ j... Co Coo 0 U, 0\ t.J0\ 0\ 0\0\ 0\ Co ,J:o. 00 0 00 0 0 00 0 t-J 0 0 0 0 !Io.l 0 00 0 0,0 0 0 t'J:J 0 U'l :I CD C. ~ fI) iii' -I =l; .... co 0 r+ I ~ l>> W 0 .... 0 "0 U'l 0 '"f CD 0 r:;- '"f ..... 0 CD iii' w ~ .... C CD = 0 3 :J> nZ n CD '"f >< C ~ W ~ = ~ CD '"f CD ~ ~ ~ ::a~ w CD ~'"f CD CD ~ ~ < OJ C CD 2: o ~ tD -I NO LnS' o W< ~O.I CO- ~; n n (J GI DJ ~ - () n - = c n ~ - C ....,. QJ ('P f"'t' - 0- 0 DJ < ., ,... ~ " t1) t: tIl Q. ('P fI) 0 < ....., C -< - DJ f"'t' 0 fI) - c C '"-t ..... '"d 0 t1) ~ ., "'0 " 0 ('P '"-t tIl .... en C. -< ~ <: tIl 0 :i" 3 lJq c '" "C ., to f"'t' -. 0 0 "'C ;:i 0- :I DJ ---- '" 0 'tJ '-" GI t1) f"'t' ., tIl 0 (/) 00 DJ ........ < JIoJ -. 0 ~ 0 ~ " (I) C:I 0 ~ Q. ,......, (Il "'" -I ~o ~.... 0\0.1 ~~ w= ~~ CO'"f ~tD ~ .... -< -I '=' 0\1-1 ~::l 0~ ~CD N'"f It; U'I ~ '"d ~ lJq ("P f-' o ....., [,,-, J ~ Z\~~\\~ ):l', . 'i'\~'\:Z:\Z t;;. "\ Q.. ',9.-.9.- S;C \~'iii' Cll .~ 115 '. (/I 0-\(/1 \o:-~ ~ \UJ \.ro-,.O- 0- \3 \\6''' ~.o..... , 0''8- ''(0 ,... '.::5"'0' ' ~ \-.\<.... ... \'8- \3 ' ~\Cll\Cll\ 5:~ \'8-\ (/I. . _..,.... ~'70 '. '(;\Cll ... ,~ \ Cll,o' . (/I '.-' ,...,~\ 33 () ~ ~ rl ..... o o ...0 ::i ~ o -:l O\gQ ~ ~""~ -.J\~UJ tv .tv,l).O UJ.....I-'" 0 1-"'1-'" ~~,O CP cp.U) tv\tvtv ~ ~N o . 0\ ~ U'\ U"I U) \0;0\ tv 00 N U'\\UJ~ oN N rn.rnrnrn .rnm rn.~ rnrn .rn~ ~\~~ ~ .~Wl 'Z o .... ~ III *\,l,J'r ,**** U'\\ I-'" '..1-'" . tv tv ...NO 0';00.00' 0\,0,00 00 0'0',0 0'..0'0 tv . -.J \0 -.J -.J.I.O '.-- j......... ',-- ',-- ',-- \........ 1-"'\1-"',1-"".1-'" .1-"".1-" \0 \.\0 \\0\0\01.0 CP\r:/)'cpCP cpr:/) . U'\ .. U'\ .... U"I '. U'\ ~; u:' 0\0.0....0.0\0 -' ',N \1-'" '\0.1-"'1-"'1.0 -, ,-- ','-- :--- ',......... -- """'-. o .\tv \.tv ,N ,N ,.N'N .... '.0 \0 '.0 ,.0.0..0 '!,.....o.o..o.o 0..0 U\.r:/)\cp-.Jcp cp'~ ....,... ............y...... o -t ~. " """.0\0".0.0 0...0 ~,tv \ -.J \0 -.J -.J 1.0 o '.;3 ;~;3;3 ;3 '"No ~..o'o'oo.o . 0....1-"'\1-'" 1-""1-'" .1-"'1-'" ~..~~~_,:-,:,..':-':'.~'u:' . () e- O ~ ~ o p.. .c. e- ~ o ....... ~ o ~ '"'d ~ ~ fJ) ~ ..... ~ {JQ rJ> to g ,e: e- "",' . .'. . 0\\ \.. ". '., ****** ""'\0\\1-'" '.1-'" ,tv.tv '.,N ~,o'.I-"'I-""UJ'UJ.tv polo. (jI ',r:/) " ~ . (jI '. (jI . \0 Cf,)..'r:/)",o.~ 0 '.o,'~ ,;.o'oNO 0 ~ ",.".,.,.., , ~ ,,'<' . ., ~\~.~ ~ ~.~ 0\00'0 00 0.0.0.000 ~\~~ ~.~ .g. ~ U\.1J'r.1J'r.1J'r*.1J'r.1J'r o Ct)"'" ,polo ~ ~ ~ ~\J\O\O\~~~ polo 0\ '.. Ct) ,;. 0\ 0\ \D ~ b,)O ~O 0 ',;. ,;.oOt-JOO';' / SERIES EE ~ r , / ~ERIES EE j' SERIES EE w:..et _- & wt_- _-~ '0 _- : I n ~~~Q!f~ AT THE MATURITY HEREOF WILL PAY ~~~!!~~~~ 205-09-6343 Harry F. Miller 348 Park Avenue New Cumberland, Pa. 17070 OR Kathryn E. Miller 187-16-4395 lltlS IOND IS ISSUEDUNOEfI A ANDISSUlJECT'rnTKETE UIEI'I'TY IONDACT.ASAIIENOED, no ON THE ...ex HEREOF. DUA/lTMENTOFTHE TIIEASUIl'" WASHINGTON :t~.,0~ Harry F. Miller 205 09 6343 348 Park Ave. New Cumberland, Fa.. 17070 OR: Kathryn E. Miller 187 16 4395 DErAllTMENTOF THETIlEASUlty WASHINGTON ~::~,0~ THIS 10ND IS ISSUED UNDlR .o.NOISSUIJfCTTOTHETEII UT~~~~~'H~II~:~DlD. Harry F. Miller 348 Fark Ave. New Cumberland Pa. 17070 OR Kathryn E. Miller OUAIITMEUTOFntETIIEJoSUflY W1<SHINGTON :t~,~=6~ THIS 10NO IS IssueD UNDER AUTH ANDISSUBJECTTO,THETER ;~~~Il6: :;~:g'H~~:.NDED. ISSUE DATE WHICH IS THE FIRST DAY OF FEE 1985 -(MONT~~::::: :..-rvEA"Rl-- " ".:..c~"n SCJn~(1 ?.{\,~' \ , ' t ISSUING AGENT'S \ ~ ~ 0 n ry l'a'R~ ; r 't u C~INtl ST~p"".; '--~ , , , , , \J\~,;r~~ .__r: ._...---~- 07 342095 EE .D J~v__J~85______ I MoNSFH } _ _ _ _ t YE:AR_I,"",," , .. "- ~ 1klni, ~~7 , , : I SSUlNG AGENT'S \ jUb~~~~ , MeW' Cwn3~>>' 'If C84 142 663 EE Sept 30 1985 ___________J______ (MONTH) _--_ tYEARI - - " 7(.. ~ i;-' 'r.~~. ~i1-,~- }~~~ : I SSUlNG AGENT'S \ 's: r l!lA"..,G ,,;r.Jtil~ ,c.r , y; ...""- , , ' " ",.I' ~.~~~~~,t~ C93 002 424 EE /' SE]PlIES EE SE:&IES EE j HarryF. Miller 348 Park Ave. New Cumberland, Fa. 17070 OR: Kathryn E. Miller 187 16 4395 TttlS 80ND IS ISSUED UNDEII AND lSSlJIJECTTO THE T UIE""" SONO ACT. ASAMENDED. ON THE IACIlHEIIEOF. OEI'ARTM~~~iN~RiASUJlY ~,,~t0<<- July 1985 -(MONfH~::::: ...-rvEAR-) -- t;;i<{S Bank, N'~ , , , , : I SSUING AGENTS \ iU' () 1 iQQE:: v\ Lo..~G ~~i:J' , , , , , , New '(:U,;j~~RI.t.NZ'; p~ R22184 500 EE ~ HARRY F. MILLER 205-09-6343 348 Park Ave., New Cumberland, PA 17070 or KATHRYN E. MILLER 187-16-4395 DEP,,"TM~~:N~IIEASUIIY ~l0<<- THJSI':::I~S=g,.UT~~~ET OUIlEIITY 100000ACT.ASAMlNDEO. "'TEOON THE IACKHEIIEOf. ~~~~~t~ AT THE MATURITY HEREOF WIl.L PAY ~~l!!.~~~~~1M..'fii~ Harry F. Miller 205-09-6343 348 Fark Ave. New Cumberland Fa. 17070 OR Kathryn E. Miller I I (~}j7lD~'~ ~~ ~ C1~il%.ltlr1S ~~ ~ DE'ARTMENT OF TllE TIIEASURY ~ WASl-iINGTON . J~\~4'\--~'!I~r:?m?"'D;-lOl":?T.(IA"""Ol'l?,",?O?~'O'1l0"'O""?,,"O"OF.;''''?''l?..~<;no!lO'!lDmD~'?I':D'''ile'':''\'~"'OO':n_".l1r':?"""I>DFlo~nM"'O(!lO'S?"'O"D~O!'llO~?"D"_ ... _,..," ,. ~,t0<<- TflISIOND1SI5SUfDUNDfIlAUTH ANDISSU8JECTTOTHETEII lIIlEIITYIONO.lcr.llS_fNOfD. TiD ON THE .....ell: HERf.O~ JULY 1985 -tMoNTH1-: ::: -t-vEARJ-- t~NB BanlC;'~A , , , (J ur'(j AilOO5 \ CA.TING STAMP """,,,,,,,,~. j R22184502 EE I ~ Sept 1985 ct)~~:B i~f~[ ~V~~RJ - - , , , :~ V-p ISSUING ~GJ;:. ~.T'S ' vc.: :3 0 18B5 ; \ CATINO STAMi'" J , W:' , ~~~~ r;>n;' ..,. -CJ '''_~' R24 032 322 EE ,.. ...~., "C'l ~ 0'\(1 '" ",r... "'~~ .", '" ",". o. D.... n~ ... .. '" '" '" ~n" "'~.. '" ,,"'..... '"' J':~" ..~,..~ "'" /' J/ Harry F. Miller 205-09-6343 348 Park Ave. New Cumberland Fa. 17070 OR Kathryn E. Miller -'Mop_e~t - J..2~5 _ _ __ TH...... _ _ _'.. ~ YEAR) , , , c~.~~43'A ~~4~..ttf~"7'~"-~" : I SaVING AGENT's \ ;S~p oA,"'N~19~5 ,: "\,J ~~ -~ / , , - - -,~-~~15: 1'<\ .~~. ~~........--.~ SERIES EE ~L~4.- THISIOIIID1SISSueDUNDERALSTHO MlDISSUBJECTTOTHET DLlIEIITYIONOAcr,ASAMENDIEO. AnD OHTHE.4Cll: HEIlEOF. R 2 4 032 323 EE DEl'....IITM~~~:N~~REAS\JIIY / Harry F. Miller 348 Park Ave. New Cumberland, Fa. 205-09-6343 . i i .~::.: -(MONTH~::: ::..-rYEAR1-- I I i ! I I i I Mar. 1985 17070 ~ i!Cliiii. N.l.. , ISSUING AGENT'a- " OR Kathryn E. Miller f , , ~,2G9rJ98S , f " ,," -~~t\;;q>.(:.. 187-16-4395 SERrES EE fil Tl4lSllONDISISSUEDUNDER ANDI$$UlI.lECTTOTHE o LlII,"" BOND ACT, AS _lNOED, STATED ON THE....(:I( KEJliOF. 07 351873 EE DE'.untENT OF THE 1lI1EASU1IV WASHING1QN ~?..04.- / ~~~~~ AT THE MATURITY HEREOF WILL PAY ~~~RtS\ Harry F. Miller 205-09-6343 348 Park Av-enue New Cumberland, Fa. 17070 OR Kathryn E. Miller 187-16-4395 _'-:F,;:S~_ )..985______ t....ON"'i"H;_ _ _ _ _, ~YE:AAI t-":~:':2' 3.~H~~:[v ~i,~ , , , , I ISSUING AGENT'6 \ r'*l_:<-',_ _, .-;. I .[-,.= i.; " " .jOQ5-' t I......U ~ , ;00. r \ CATING STAMP / , , ~~~~~~~~~~f' I SERIES EE T1USIlONDISlSSUEDU~DI!F1 AHDISSU8.1fCTTOTHETE ~j 1Ja- M8 209 238 EE LllfnTY IOND ACT.,o,s AMENDED. TlOOlOTHi81toCltHEREOf OU41lTM~~."N~REA5tJR" " / Ii -J J' i >F f.~~~~"'~f~..",!Jr,,}~~_.,."_ //. I / /i Kathryn E.M:tl1er - 187-16-4395 " ~ ..~ ~.'::,,-:>,,:,/ .:::..1Db'~:"~"'4. '::~ ~ R3h83l938EE il %il ,~i - . . . ~ . '. . ."-" - ".' ','" ,-.,... , .-.._'_:-~"'.'...L:.'_.'." .:::;.:~- ~', ...___ ~ .----.,~, i);.~ ;~.~i ,"'i;f~: ;j:~;0~;i;:.,:;;i'~,;:'.::i,,;: ;if.l;<' ,~~:,;. '.;i!.~~::~~';S''''i''>: ,;; '!~~c'_~'.~.'~.;;,.;!:;;::-~;:;.~::~'':: ;-i,~,':_ ?L- .#j?~ /.iwr,f""I/.Jllir';;"os"'.'.I o 0 :1 7 rB 3 7g :i rB II~ I:OOOOCJOOO 73:05 . / J "'~~~~~~~~~1"..~~~~i:~~~J~~;~~;{;IB::1i~11~~{t~~t~~i~~~1~~#~~~j#~1lJ~~~1~ti\~*~~\If:~~ S? ~ b ? ... II- v/ ~-_._-------"- ----T--- ,,/ II' / v / V // J / ,// '" .F,~17'r70 ._____._ 'U'." _ - ----.-----. _..---- '-P'.- _.". ,. ,. , :KA THRyj\ij'f:: ,,1:[ U:..ER ~-M-O';;D4"3.;;.1' S3'.;.314-fE 002-51106"-+' Rt. ---c~:~,ri,=~- - M Y-3l b 3 3 ]LfEE,;f !:OOOO CiJOOO 70:0 7 8 0 0 ~ 3 7 b 3 3l ~ ~ IIi ,1.'f;~!l';~7!?f!W;~~i\<;&:flr.~fi'I,"t::~r:::~k~fl';f}:n.:.fy:,f>:l\f.f'r.!W!'f'oIif;":~i!<...'l';t'IJ~fY.fo:li. / V '~~~~~s~]~~~ '~~ '._' FR<?M__I.S~Ur:;-'P~~T.E",;~;,: ". :'~~.~_':._-! '-11' '199.1:""1 . F.R:e-' P-ili~'11 1=.1 S,C AGr lj~r\, : I'" :: J ~ ISSUING AGE~:r'S:: _ \- :.'':: D~t 10 :1991':.- f \ . :::D~;JN_G STAMP _ /'~; :':>,:,<;~~iL;~:! 18}' ~ ~~~:--'>~ c-~M ~3j-}8f~r9E -.'- '- .,.'. . ~DD~3? 78.7 711'," , "-:':-":.' .'~, ',----.<".. 'i,"',..,' ."-,.,"_' ":,-"",'-,,'''.':'-.'' .-, ?':;{i-'~-~:t.,.:~:;/ : ,"-~ .\~..i. .....", ~ - :"'~-, i'" / ,~/ J i~~5 ~-5 ~t"8 8 2 -1,,~iji~022-~ ... CD 3"'~u51 7 O'"p '-~- R~ _A~ ~ -~-----,--- --- ~~J;~~ :__~_'7_ OOO~ 3as 2 ~ SOli' .;-i;~ff.,r.;~~-ij-jI)-J~';Ij;ftini"~<r/.'";r,,;Pt;ii;f;,;f,;':.:;iiii~',,:~';.;l\-:};,ii~'71i~rii};:ll';r,.,"~;=:::;,"I;, "11';1;;f';r.-;~-';;.-~~;i;:;~-,:.;~~~f(,r,^~;il-',~';~ jfr.~~1~ii,f'jj;~;I~; - -. / ../ Rev-1508 EX+ (6-98) ,*' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Miller, Kathryn E. FILE NUMBER 21-07 -0831 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolnlly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Bethany Village - refund VALUE AT DATE OF DEATH 1,250.00 2 Members 1st - Certificate of Deposit No. 239804-52 - date of death balance $16,260.29; accrued interest $49.40 16,309.69 3 PNC Bank - Certificate of Deposit No. 31500250711 - date of death balance $22,220.27; accrued interest $0.00 22.220.27 4 PNC Bank - Certificate of Deposit No. 31500257915 - date of death balance $11,081.51; accrued interest $1.50 11.083.01 5 PNC Bank - Certificate of Deposit No. 31600261721 - date of death balance $16,574.40; accrued interest $26.92 16.601.32 6 PNC Bank - Certificate of Deposit No. 31600290662 - date of death balance $46,081.99; accrued interest $118.50 46.200.49 7 PNC Bank - Certificate of Deposit No. 31900230149 - date of death balance $38,609.14; accrued interest $20.69 38.629.83 8 PNC Checking Account No. 5140043443 - date of death balance $2,513.37; accrued interest $0.29 2.513.66 9 PNC Savings Account No. 5003783736 - date of death balance $31,072.27; accrued interest $45.04 31.117.31 10 Personal Property - Sold at Private Sale 400.00 TOTAL (Also enter on Line 5, Recapitulation) 186.325.58 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established fvlt MEMBERS 1st FEDERAL CREDIT UNION 239804-00 12/31/2003 $63.54 $.04 $63.58 Patricia Peterson 12/31/2003 239804-05 07/26/2007 $10,001.08 $11.39 $10,012.47 Patricia Peterson 07/26/2007 239804-40 02/15/2007* $22,353.35 $64.18 $22,417.53 Patricia Peterson 02/15/2007 239804-42 02/23/2004 $33,139.57 $84.08 $33,223.65 Patricia Peterson 02123/2004 *Rollover from certificate 239804-45, originally established 08/16/2004. CERTIFICA TES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-51 09/27/2006* $33,818.00 $102.73 $33,920.73 Patricia Peterson 09/27/2006 239804.52 10/10/2006** $16,260.29 $49.40 $16,309.69 None *Rollover from certificate 239804-46, originally established 09/27/2004. **Rollover from certificate 239804-47, originally established 11/08/2005. CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-53 05/15/2007* $34,209.23 $98.21 $34,307.44 Patricia Peterson 05/15/2007 239804.54 07/05/2007 $34,028.06 $100.43 $34,128.49 Patricia Peterson 07/05/2007 *Rollover from certificate 239804-48, originally established 06/15/2006. 5000 Louise Drive . Po. Box 40 . Mechanicsburg, Pennsylvania 17055 . (800) 283-2328 . www.memberslst.org CERTIFICA TES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-55 07/30/2007* $18,184.93 $53.67 $18,238.60 Patricia Peterson 07/30/2007 *Rollover from certificate 239804-50, originally established 08/30/2006. Estate of: Kathryn E. Miller Date of Death: August 22, 2007 Social Security Number: 187-16-4395 ~BERS 1~:IkRALrm~ Dani~ Insurance Services Specialist October 2, 2007 G PNCBAN< October 10, 2001 James D. Bogar Attorney at Law One West Main Street Shiremanstown, P A 17011 RE: Estate of Kathryn E. Miller, deceased SSN: 187.16-4395 000: 8/2212007 Dear Mr. Bogar: In response to your request for Date of Death balanoes for the customer noted above~ our records show the following: CertWtates of Deposit Account #31900230149 KATIIRYN E MILLER DaD balance: $38,609.14 + $20.69 accrued interest Account #31500250711 K.A THRYN E MILLER DaD balance: $22,22017 + $0.00 accrued interest Account #31500257915 KATHRYN E MlLLER DaD balance: $11j081.51 + $1.50 accrued interest Account #31600261721 KATIIRYN E MILLER DOD balance: $16,574.40 + $26.91 accrued interest Account #31600290662 KATHRYNE MILLER DOD balance: $46,081.99 + $118.50 accrued interest Checking Account Account #5140043443 KATHRYN E :MJLLER DOD balance: $2j513.37 + $.29 accrued interest Page 1 of2 Established 06/1&/2002 Established OS/21/2002 Established 03/21/2005 Established 05/10/2005 Established 05/03/2006 Established 04/01/1958 Savings Account Account #5003783736 Established 12/24/2002 KATHRYN E :MILLER DODbalance: $31,072.27 + $45.04 accrtJed interest Please note that this office only provides date of death balances for deposit accounts (IRAsl CDS; Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please oalll-888-PNC-BANK (l.gg8-762-Z265) or stop by your local PNC Bank branoh office. Sincerely, &\~~ Rachelle Wells 1-800-762.1775 P1-PFSC-04-F . 500 first Ave. Pittsburgb.PA 15219 Page 2 of2 Member FDIC Rev-1509 EX+ (6-98) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Miller, Kathryn E. FILE NUMBER 21-07-0831 ESTATE OF If an asset was made joint within one year of the decedenfs date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A. Patricia A. Peterson ADDRESS RELATIONSHIP TO DECEDENT 2 Ash Drive Mechanicsburg, PA 17050 Daughter B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT . MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENTS INTEREST JOINTLY-HELD REAL ESTATE. 1 A 12/31/2003 Member's 1st - Savings Account No. 63.58 50.000% 31.79 239804-00 - date of death balance 63.54; accrued interest $0.04 2 A 8/16/2004 Members 1st - Certificate of Deposit No. 22.417.53 50.000% 11.208.77 239804-40 - date of death balance $22,353.35; accrued interest $64.18; rollover from certificate 239804-45 established 8/16/04 3 A 2123/2004 Members 1st - Certificate of Deposit No. 33.223.65 50.000% 16.611.83 239804-42 - date of death balance $33,139.57; accrued interest $84.08 4 A 9/27/2004 Members 1st - Certificate of Deposit No. 33.920.73 50.000% 16.960.37 239804-51 - date of death balance $33,818.00; accrued interest $102.73; rollover from certificate 239804-46 originally established 9/27/04 5 A 6/15/2006 Members 1st - Certificate of Deposit No. 34.307.44 50.000% 17.153.72 239804-53 - date of death balance $34,209.23; accrued interest $98.21; rollover from certificate 239804-48 established 6/15/06 Total of Continuation Schedule :>ee attached page TOTAL (Also enter on Line 6, Recapitulation) 61.966.48 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established fvl~ MEMBERS 1st FEDERAL CREDIT UNION 239804-00 12/31/2003 $63.54 $.04 $63.58 Patricia Peterson 12/31/2003 239804-05 07/26/2007 $10,001.08 $11.39 $10,012.47 Patricia Peterson 07/26/2007 239804-40 02/15/2007' $22,353.35 $64.18 $22,417.53 Patricia Peterson 02/15/2007 239804-42 02/23/2004 $33,139.57 $84.08 $33,223.65 Patricia Peterson 02/23/2004 'Rollover from certificate 239804-45, originally established 08/16/2004. CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-51 09/27/2006' $33,818.00 $102.73 $33,920.73 Patricia Peterson 09/27/2006 239804-52 10/10/2006" $16,260.29 $49.40 $16,309.69 None 'Rollover from certificate 239804-46, originally established 09/27/2004. "Rollover from certificate 239804-47, originally established 11/08/2005. CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-53 05/15/2007' $34,209.23 $98.21 $34,307.44 Patricia Peterson 05/15/2007 239804-54 07/05/2007 $34,028.06 $100.43 $34,128.49 Patricia Peterson 07/05/2007 'Rollover from certificate 239804-48, originally established 06/15/2006. 5000 Louise Drive . Po. Box 40 . Mechanicsburg, Pennsylvania 17055 . (800) 283-2328 . www.members1st.org CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-55 07/30/2007* $18,184.93 $53.67 $18,238.60 Patricia Peterson 07/30/2007 *Rollover from certificate 239804-50, originally established 08/30/2006. Estate of: Kathryn E. Miller Date of Death: August 22, 2007 Social Security Number: 187-16-4395 &BERS 1" :rr;:Lrrn~ DaniQ-W- Insurance Services Specialist October 2, 2007 Rev.1510 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, Kathryn E. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-07-0831 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. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1 Members 1st - Certificate of Deposit No. 34.128.49 3.000.00 31.128.49 239804-54 - date of death balance $34,028.06; accrued interest $100.43. "(AN EXEMPTION IN THE AMOUNT OF $3,000 IS CLAIMED IN ACCORDANCE WITH THE PROVISIONS OF THE INHERITANCE AND ESTATE TAX ACT, BEING 72 P.S. SECTION 9108(c) AND 72 P.S. SECTION 9107(c)(3)) 2 Members 1st - Certificate of Deposit No. 18.238.60 18.238.60 239804-55 - date of death balance $18,184.93; accrued interest $53.67; rollover from certificate 239804-50 established 08/30/2006 3 Members 1st - Savings Account No. 239804-05 - 10.012.47 10.012.47 date of death balance $10,001.08; accrued interest $11.39 4 DWS Scudder Account No. 20784825 - DWS 60.012.25 60.012.25 Balanced Fund-S. This is a transfer on death account which passed in equal shares to Patricia A. Peterson and Jacqueline L. Miller, daughters of Decedent, Kathryn E. Miller, upon her death. 5 DWS Scudder Account No. 20784825 - DWS 62.896.01 62.896.01 Capital Growth Fund-S. This was a transfer on death account which passed, in equal shares, to Patricia A. Peterson and Jacqueline L. Miller, daughters of Decedent, Kathryn E. Miller upon her death. TOTAL (Also enter on Line 7, Recapitulation) 182.287.82 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule G (Rev. 6-98) REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established fvl~ MEMBERS 1st FEDERAL CREDIT UNION 239804-00 12/31/2003 $63.54 $.04 $63.58 Patricia Peterson 12/31/2003 239804-05 07/26/2007 $10,001.08 $11.39 $10,012.47 Patricia Peterson 07/26/2007 239804-40 02/15/2007" $22,353.35 $64.18 $22,417.53 Patricia Peterson 02/15/2007 239804-42 02/23/2004 $33,139.57 $84.08 $33,223.65 Patricia Peterson 02/23/2004 "Rollover from certificate 239804-45, originally established 08/16/2004. CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-51 09/27/2006" $33,818.00 $102.73 $33,920.73 Patricia Peterson 09/27/2006 239804-52 10/10/2006" $16,260.29 $49.40 $16,309.69 None "Rollover from certificate 239804-46, originally established 09/27/2004. ""Rollover from certificate 239804-47, originally established 11/08/2005. CERTIFICATES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-53 05/15/2007" $34,209.23 $98.21 $34,307.44 Patricia Peterson 05/15/2007 239804-54 07/05/2007 $34,028.06 $100.43 $34,128.49 Patricia Peterson 07/05/2007 "Rollover from certificate 239804-48, originally established 06/15/2006. 5000 Louise Drive . Po. Box 40 · Mechanicsburg, Pennsylvania 17055 . (800) 283-2328 . www.members1st.org CERTIFICA TES OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest to Date of Death Name of Joint Owner Date Joint Ownership Established 239804-55 07/30/2007* $18,184.93 $53.67 $18,238.60 Patricia Peterson 07/30/2007 *Rollover from certificate 239804-50, originally established 08/30/2006. Estate of: Kathryn E. Miller Date of Death: August 22, 2007 Social Security Number: 187-16-4395 ~BERS 1~:U:Lrm~ ~QW Insurance Services Specialist October 2, 2007 P.O. Box 219151 Kansas City MO 64121-9151 1-800-728-3337 C9~!! ---.. October 2,2007 Patricia A Peterson 2 Ash Drive Mechanicsburg P A 17050 Inquiry #: Fund: Account #: 20784825 DWS Balanced-Fund-S- 04295049717 Dear Patricia Peterson: I am writing in response to your recent letter regarding the DWS Scudder account referenced above. Please accept our condolences on the passing of Kathryn E. Miller. Below I have provided the number of shares, share prices, and dollar values of the funds in this account as of August 22, 2007. Fund Name (S Class) Number of Shares Share Price Dollar Value DWS Balanced Fund-S 6,098.806 $9.84 $60,012.25 DWS Capital Growth Fund-S 1,176.506 $53.46 $62,896.01 If you have any questions, please contact our Shareholder Services Department at (800) 728-3337. OUf representatives will be happy to assist you Monday through Friday, 8:00 a.m. to 5:00 p.m. Central Time. Sincerely, ~~ Josh Yates Lead Mutual Fund Representative REV-1151 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Miller, Kathryn E. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07-0831 ESTATE OF ITEM I DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 162.06 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Bogar & Hipp Law Offices 5,330.00 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 368.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,850.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 7,710.06 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) SCHEDULE H.A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Miller, Kathryn E. FILE NUMBER 21-07-0831 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Bethany Village - memorial services 60.00 2 Parthemore Funeral Home - remainder of funeral bill due 102.06 Subtotal 162.06 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1S00 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6098) SCHEDULE H.B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, Kathryn E. FILE NUMBER 21-07-0831 ITEM NUMBER 1 DESCRIPTION RESERVES: - Cost to conclude administration of Estate including filing fee for PA Inheritance Tax Return, Inventory and First and Final Account; preparation of Personal and Fiduciary Income Tax Returns AMOUNT 1.850.00 Subtotal 1.850.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H.B7 (Rev. 6-98) Rev-1512 EX+ (6-98) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAl. TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Miller, Kathryn E. FILE NUMBER 21-07-0831 ESTATE OF Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Millenium Pahrmacy Services, Inc. - miscellaneous pharmacy expenses VALUE AT DATE OF DEATH 12.60 2 Millenium Pharmacy System, Inc. - prescription drugs 108.32 3 Mobile X-Ray Imaging, Inc. - medical bill 17.84 4 Pennsylvania Department of Revenue - estimated Pennsylvania Income Tax payment 140.00 5 United States Treasury - estimated Federal Income Tax payment 129.00 TOTAL (Also enter on Line 10, Recapitulation) 407.76 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV.1513 EX+ (9-'10) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Miller, Kathryn E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal aistributions, and transfers under Sec. 9116(a)(1.2)] Peter F. Chamberlain 1647 Briarcliff Road, N.E., Unit 7 Atlanta, GA 30306 Grandson RELATIONSHIP TO DECEDENT Do Not List Trustee(s) I. Jacqueline L. Miller 4611 Gann Crossing Smyrna, GA 30082 Daughter Patricia A. Peterson 2 Ash Drive Mechanicsburg, PA 17050 Daughter Andrew B. Shearer 1625 Shenandoah Court Allentown, PA 18104 Grandson FILE NUMBER 21-07-0831 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) Ten percent of rest, residue and remainder Forty percent of rest, residue and remainder Forty percent of rest, residue and remainder Ten percent of rest, residue and remainder Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Form PA-1500 Schedule J (Rev. 6-98) .. LAST WILL AND TESTAMENT OF KATHRYN E. MILLER I, KATHRYN E. MILLER, of Mechanicsburg, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my husband, HARRY F. MILLER, provided he survives me by sixty (60) days. SECOND: Should my husband, HARRY F. MILLER, predecease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, as follows: (A) Forty (40%) percent thereof to my daughter, PATRICIA A. PETERSON, provided, however, that should she predecease me, then to her issue per stirpes by representation. (B) Forty (40%) percent thereof to my daughter, JACQUELINE L. MILLER, provided, however, that should she predecease me, then to her issue per stirpes by representation. (C) Ten (10%) percent thereof to my grandson, ~~DREW B. SHEARER, provided, however, that should he predecease me, then to my daughter, PATRICIA A. PETERSON. (D) Ten (10%) percent thereof to my grandson, PETER F. CP~BERLAIN, provided, however, that should he predecease me, then to my daughter, JACQUELINE L. MILLER. THIRD: Should any of my grandchildren not have attained the age of twenty-four (24) years at the time for distribution to him, I give, devise and bequeath the share of each such grandchild to my hereinafter named Trustee or Trustees, IN SEPARATE TRUSTS, to hold, manage, invest and reinvest the shares so received, and to use and apply from time to time such portion of income and principal for the said grandchild's post- high school education (including college, trade school or other similar training or education), as my Trustee or Trustees, in their sole discretion, deem advisable. The Trustee or Trustees, in exercising their discretionary authority with respect to the payment of income or principal of the within Trust to my grandchildren, shall take into consideration any income or other resources available to my grandchildren from sources outside this Trust. Any income or principal not so applied shall be dis- tributed to each grandchild when he attains the age of twenty- four (24) years. In the event any of my grandchildren die prior to the termination of the Trust established herein for their benefit, the interest of my grandchild in said Trust shall cease with any income and principal being divided evenly between or among that deceased grandchild's brothers and sisters or the separate trusts established hereunder for their benefit and, in the absence of any brothers and sisters, to my other grandchil- dren in equal shares. FOURTH: In addition to all powers granted to them by law and by other provisions of this Will, I give the fiduciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give 2 options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege glven by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax laws. :---- -, (8) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order to pay debts, taxes, or estate or trust administration expenses, to protect or improve any property held under my will, and for investment purposes. (I) To select a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise --... "- "'....... 3 any other rights which they may have under the plan, in whatever manner they consider advisable. FIFTH: I nominate and appoint my daughters, PATRICIA A. PETERSON and JACQUELINE L. MILLER, as Co-Trustees of the hereinabove described Trusts, who shall serve without bond and shall receive fair and reasonable compensation. SIXTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of the principal of my residuary estate. SEVENTH: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. EIGHTH: I nominate and appoint my daughter, PATRICIA A. PETERSON, Executrix of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said PATRICIA A. PETERSON, I nominate and appoint my daughter, JACQUELINE L. MILLER, Executrix of this, my Last Will and Testament. I direct that my Executrix, Trustee or Co-Trustees and their successors, shall not be required to post security or a bond for the performance of their duti~s in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this "':)---\h day of 2002. t --(. L -- 'r-'...~ ..-,:..-\ ---.- J / I / ." ..' _,.-J.""! /'i.: / I!" / ' ..' " ~ .'" ~~.!,.. (SEAL) - KATHRYN E. MILLER 4 Signedt sealedt published and declared by the above- named Testatrix as and for her Last will and Testament in our presencet whot at her request, in her presence and in the presence of each othert have hereunto subscribed our names as attesting witnesses. /---.. fJ // } ' .\ j, ., .I .I.... ( j fl'10.,{-/;( -,,-d..i-t,; j 1 ...A./":~ L.-- /J \., Address ----r=> . . ~ ,,('; -genii u d. LJJLt-la"r}t-D Address 5