The URL can be used to link to this page

Home My WebLink About11-30-07 (3) REV.1500 EX + (~OO) .... Z W C W o W C COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) MILLER DATE OF DEATH (MM-DD-Year) JOHN REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE: ONLY FILE NUMBER 2 1 -07 0 8 3 6 'COUNri'COoE -YEAA- - - NUMBER- - SOCIAL SECURITY NUMBER R. DATE OF BIRTH (MM-DD-Year) 1 86- 3 4 - 2 1 8 3 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 09/03/2007 09/20/1943 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) W to. ~ ~Ul u~~ w&u :z:~9 U~1lI c( [Xl 1. Original Return o 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received SOCIAL SECURITY NUMBER o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12.12.82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1.1.95) o 3. Remainder Return (date of deat/l prior to 12.13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) to. Z W Q Z o lL Ul W ~ ~ o U ''rHlSSE(:T10NMIJS1SECOMPLE1ED.'ALL.CORRESPONDENCE.AND'CONFIDENJ1AL' TAX IN f:ORMATION SHOULD BE 'DIRECTED TO: NAME COMPLETE MAILING ADDRESS ROGER B. IRWIN ESQUIRE 60 WEST POMFRET STREET FIRM NAME (If Applicable) IRWIN & McKNIGHT TELEPHONE NUMBER 717 249-2353 CARLISLE PA 17013 z o ~ ::::>> .... 0: <C o w a:: z o i= <C .... ::::>> Q. :E o o ~ 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or. Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 457.73 OFFICIAL USE ONLY I"-..) = ~ 13,864.79 -..., C) 'X'J :'120 . f--- 51,396.181 en 00 :::0 rn C) C) ::::0 C-) rTl C--:J o '-;""1 ~~1 C') "._ rTl (.J .-) (~) -.) (.,) C> r ~ \ , ::-:; /':"';' -':.J -'T1 --..,',~ 10,998.60 r,) (8) 76,717.30 2,812.64 384.51 (11) (12) (13) 3,197.15 73,520.15 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 73,520.15 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 0.00 X _(15) 0.00 0.00 X _(16) 0.00 0.00 X .12 (17) 0.00 73,520.15 X .15 (18) 11 ,028.02 (19) 11 ,028.02 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20. D . . . , ... > >'BESURE TO ANSWER All QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < CITY CARLISLE STATE PA ZIP 17013 Decedent's Com lete Address: STREET ADDRESS 345 E. LOUTHER STREET Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 11,028.02 551.40 Total Credits (A + B + C) (2) 551.40 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( 0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check AGENT 0.00 0.00 10,476.62 10,476.62 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; ........................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00 c. retain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?... ..... ..... ......... .... ... ....... ... ...... ........... ........... .......... ..... ............ 0 00 3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 00 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I have examined this return, includinQ accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILlNG~N DATE ADD~.~TH~S~~ \ \ \ ~R:/ OJ CARLISLE PA 17013 SIGNATURE OF PREPARER OT DATE II 1-':1/07 ADDRESS 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 3% [72 P,S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a trans!'3r 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 bene.ficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)]. The t~ rate imposes on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate iJ1lPoGed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an indiVidual who has at least one parent in common With the decedent, whether by blood or adoption. REV-1503 EX + (6-98) .W COMMONWEALTH OF PENNSYLVANIA , INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF MILLER JOHN R FILE NUMBER 21 07 0836 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION OPPENHEIMER MAIN STREET FUND CLASS A ACCOUNT #700 7009056217 MSIGX VALUE AT DATE OF DEATH 13,864.79 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 13,864.79 REV-1508 EX + (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER JOHN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER R. 21 07 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 0836 ITEM NUMBER 1. DESCRIPTION RaC DAIN RAUSCHER CASH AND MONEY MARKET ACCOUNT TMGX 186.430 X $1.00 PERSONAL PROPERTY 2. VALUE AT DATE OF DEATH 207.73 250.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 457.73 REV-1509 EX + (6-98) .w SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER JOHN R. FILE NUMBER 21 07 0836 If an asset was made joint within one year of the decedent's date of death. it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. GLORIA S. GILBERT 345 E LOUTHER STREET CARLISLE, PA 17013 FRIEND 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 NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER An ACH DEED FOR JOINTL Y.HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1- A. . ORRSTOWN BANK 5,940.41 50. 2,970.21 SAVINGS ACCOUNT #706001446 2. A. COMMERCE BANK - 50+ CHECKING #513153148 2,441 .93 50. 1,220.97 50+ CHECKING #513153148 3. A. ORRSTOWN BANK 5,220.99 50. 2,610.50 CHECKING ACCOUNT #417130 4. A. SOVEREIGN BANK 8,393.84 50. 4,196.92 CHECKING ACCOUNT #2891037197 TOTAL (Also enter on line 6, Recapitulation) $ 10998.60 (If more space is needed. insert additional sheets of the same size) REV-1510 EX... ~6-98) .W SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER JOHN R. FILE NUMBER 21 07 0836 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 ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER. ATTACH A COP"! OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE (IF APPliCABLE) 1. RBC DAIN RAUSCHER-US EQUITIES RETIREMENT ACCT 65.24 100. 65.24 HKN INC. 7 SHARES @ $9.32 = $65.24 2. RBC DAIN RAUSCHER-US EQUITIES RETIREMENT ACCT 4,538.28 100. 4,538.28 INTEL CORP 177 SHARES @ $25.64 = $4,538.28 3. RBC DAIN RAUSCHER-US EQUITIES RETIREMENT ACCT 24,578.40 100. 24,578.40 PENN NATL GAMING INC. 418 SHARES @ $58.80 = $24,578.40 4. PRUDENTIAL/AMERICAN SKANDIA MARKETING, INC. 17,731.81 100. 17,731.81 CONTRACT #000421805 5. AMERICAN FUNDS - CB&T CUST IRA #63754151 4,482.45 100. 4,482.45 WASHINGTON MUTUAL INVESTORS FUND-A TOTAL (Also enter on line 7 Recapitulation) $ 51 396.18 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + ('12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISlRA liVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER JOHN R. 21 FILE NUMBER 07 Debts of decedent must be reported on Schedule I. 0836 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. CREMATION SOCIETY OF HARRISBURG B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. AttomeyFees IRWIN & McKNIGHT 2,000.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS 102.00 5. Accountanfs Fees 6. Tax Retum Preparer's Fees PATRICIA A. ROSENDALE, CPA 350.00 7. REGISTER OF WILLS - FILING FEE 30.00 8. CUMBERLAND LAW JOURNAL - ESTATE NOTICE 75.00 9. THE SENTINEL - ESTATE NOTICE 150.64 10. NOTARY FEES 15.00 11. DEATH CERTIFICATES 90.00 TOTAL (Also enter on line 9, Recapitulation) $ 2812.64 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) '. SCHEDULE. DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MILLER JOHN R. 21 07 0836 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. KINETIC IMAGING - MEDICAL VALUE AT DATE OF DEATH 17,83 2. CARLISLE REGIONAL MEDICAL CENTER - MEDICAL 250.00 3. MARTINSBURG VA MEDICAL CENTER - MEDICAL 48.00 4. DREW STOKEN, MD - MEDICAL 17.21 5. MOFFIT HEART AND VASCULAR GROUP - MEDICAL 11.34 6. PINKER AND ASSOCIATES - MEDICAL 17 .45 7. WILLIAM PHELAN, MD - MEDICAL 22.68 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 384.51 '''''~'''''''I* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF t.AIIII=Q NUMBER 1. JOHN SCHEDULE J BENEFICIARIES R NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1. GLORIA S. GILBERT 345 E. LOUTHER STREET CARLISLE, PA 17013 FILE NUMBER 21 n7 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Collateral ()R~R AMOUNT OR SHARE OF ESTATE REMAINDER 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 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT of John R. Miller I, JOHN R. MILLER, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my Executrix to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I specifically give and bequeath the following items to SAMUEL G. GILBERT: a. the drop leaf table; b. the set of antique dishes; c. the wash stand; d. two (2) chests; and e. the wooden wardrobe. 3. All the rest, residue, and remainder of my estate of every nature and wherever situate, I give and bequeath to my friend, GLORIA S. GILBERT. If she has predeceased me, then I give and bequeath all the rest and remainder of my estate to my daughter, VICKI L. FLICKINGER. 4. I nominate and appoint GLORIA S. GILBERT to be the Executrix of this my Last Will and Testament; she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint VICKI L. FLICKINGER as substitute Executrix, also to serve as such without bond, with the same powers as are given herein to my Executrix. 5. My Executix may, at her discretion, comproffilse claims, borrow money, retain property for such length of time as she may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as she may deem proper; and invest estate property and income without restriction to legal investments. 6. I hereby suggest that my personal representative retain the serVIces of Irwin & McKnight as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this j.$ day of May, 2006. ,~I:!_ B mum ' (SEAL) (/ JOHN R. lVlILLER 2 Signed, sealed, published and declared by JOHN R. MILLER, the above-named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other have subscribed our names as witnesses hereto. ~~-GK~X ~fA ~f-- JI. .'Ljl-1tJd~ .,,r ~ 3 ACKNOWLEDGMENT AND AFFIDA VIT WE, JOHN R. MILLER, MARTHA L. NOEL and SHARON L. SCHW ALJ.\;I, the Testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament, that he had signed willingly, that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as a witness and that to the best of their knowledge the Testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. ~/2-~ Y JOHN R. J.\;IILLER '-21(-CU~ X1i:m MARTftA L. NO ~_ _ ;;- /} / /1 cL--l.t:')-( / . Y /1 /c..a /,,7.1 n( . SHARON L. SCHW ALJ.\;I COMMONWEAL TH OF PENNSYL VANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by JOHN R. J.\;IILLER, the Testator herein, and subscribed and sworn to before me by MARTHA L. NOEL and SHARON L. ~~ SCHWALM, witnesses, this ~ day of May, 2006. A.~ tary Public COMMONW ALTH OF PENNSYLVANIA i/ Notarial Seal Roger B. Irwin, Notary Public Carlisle Boro. Cumberland County My Commission Expires Oct 3, 2008 Member. Pennsylvania Association or Notaries 4 ~ OppenheimerFunds<J W The Right Way to Invest Account Statement Statemllllt Period: January 81, ZH7 - June 31, 2tt7 Page 1 of 1 AV []], 003824 1107641::301 AuSDGT 111.111...111,"11111,111,111.1.1.1,1111.11,...1..1.1.1,1,1111 JOHN R MILLER 345 E lOUTHER ST CARUSlE PA 17013-2530 Your Financial Advisor. BARBARA BISTLINE AMERICAN GENERAl SECURITIES INC 301 S HANOVER ST CARlISlE. PA 17013-3933 (717) 249-4441 '.; ;:;iTotal Account Value .et..... Yalue on June 38, 2Ifl1 . . :i:Mark8t Value 00 March 30. 2007 :~;Chanoe since last statement r,-5,",',> $1f,237.93 $13.nZ.60 $465.33 o Visit us onOntl at www.oppenheimerfunds.com .-. ~ 24-hour automatld mvlcs: 1-8OO-CAU-oPP (225-5677) .~eimer Main Street Fund Class A . . ~ Num/Jfr 700 7009056217 :. :. Accu.nt Rlfistration JOHN R MILLER :. ,ftplifSJIII/JOI MSIGX ,,~ CIbJgory Cae ':";,',.,,<>:xcL/: > -:"" ::~" -)~_:_'~' 'z/<:ti .:_/~~ '.'.....111. Transaction Detail .' "n.lIt' ... '!!!I ;;_i;~>:_" '-/';'- , ~;01/O9101 ,02/12/UJ .' , O3It1Irf1 :,,'. 0N10I07 :: u51tQI07 " , 08I12J07 Value on June 30, 2007 Market Value SharfS {)wnld Share PrlCtl $14,237.93 327.384 $43.49 TIWJSEtJan DescliptiOll Redemptioo Redemption Redemption Redemption Redemptioo Redemptioo Dol.... SIIar8 ,.... Eilcling AmDunt Prfce ~ SIIar8 8lII:mce $140.00 $40.53 -3.454 344 . 099 $140.00 $41 . 15 -3.402 340.697 $140.00 $40 .41 -3.464 337.233 $140.00 $41. 69 -3.358 333.875 $140.00 $43.02 -3.254 330.621 $140.00 $43.25 -3.237 327 .384 ;)~::~~i<-":'f~:"~~~ ':';;::!:":',,' '.> ;:.~.Dlt. Account Summary ~\!!!!!. .. .~~1f07 Uarbt Value $14,131.50 AdditfOllS + $0.00 WlIIIdrlIRIs - $840.00 Cll8gein VIIIueIEMDIllfs + $946.43 UIIrffet Value 011 J.... 30. 2l107 = $14.237.93 \:;'.',:_jfy'\'''r~'~ AIIrFuDds lIews for mUne document delivery NOW and we'll send you an e-mail whenever account statements. confirmations and, tax fams are available. Just log in to .~msfm-'- 1)oJe-- ~ ~ Va,(~ . ~\3\t01 \ 3\ ~~~11 g :--------- _~. c- >>, ~'i^"-'- ;'0 _.;);c._', ,,,,,,"" _??oo1 * ~ ORRSTOWN BANK A Tradition of Excellence September 13, 2007 77 East King Street P.O. Box 250 Shippensburg, PA 17257 TO: Roger B Irwin 60 W Pomfret St Carlisle, PA 17013-3222 FROM: Andrew G Ott Branch Executive Officer 22 S Hanover St Carlisle, PA 17013 RE: ESTATE OF JOHN R MILLER DATE OF DEATH: September 3,2007 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE FOllOWING ACCOUNTS WITH ORRSTOWN BANK: CHECKING ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 417130 GLORIA S GILBERT 09/02/1997 5,220.33 + .66 = 5.220.99 JOHN MILLER SAVINGS ACCOUNTS ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 706001446 GLORIA S GIBLERT 03/04/2002 5,934.52 + 5.89 = 5,940.41 JOHN MILLER CERTIFICATES OF DEPOSIT ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST 11',............._.~ ~ ..1;.".'..." ..--... ~. September 14, 2007 Commerce eBank ~rE~Ii:UWOC~ SE? 1 5 2007 Irwin & McKnight Roger B. Irwin 60 West Pomfret Street Carlisle, PA 17013-3222 IE. -.ir;ul- ,~' ~_ .-... "t.J.. '-' ....J. RE: Estate of: John R Miller Tax Identification Number: 186-34-2183 Date of Death: September 03, 2007 Dear Sirs: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: 50+ Checking Account Number: 513153148 . Date Opened: March 30,2000 Primary Owner: Gloria S Gilbert Secondary Owner: John R Miller Date of Death Balance: $2,441.93 Accrued Interest: $0.24 Please feel free to contact me at (717) 412-6124 if I may be offurther assistance. Sincerely, /) .. 17 /7. -.-ftJ. <-: ""32) ~ jI CLA:::l>---L- Billie M Ware Research Associate Commerce Bank/Harrisburg Commerce Bank I Harrisburg. N.A. PO Box 4999 3801 Paxton Street Harrisburg. PA 17111-0999 commercepc.com @ A;~~i~;~IF~~ds. PO Box 2560 Norfolk VA 23501-2560 Quarterly Statement September 28, 2007 Page 1 of 2 FP 01 lbSb79 18bS4 H SS8 A 11111111111111111111111111111,11111111111111111111111111111111 CB&T CUST IRA!SEP JOHN R MILLER!DEC'D 345 E LOUTHER ST CARLISLE PA 17013-2530 Your financial adviser POWELL (717) 258-0751 FINANCIAL NETWORK INVESTMENT CORPORATION 43A BROOKWOOD AVE CARLISLE PA 17015-9126 New account-login alternative ........................................................................................................... Have you been looking for another way to log in to your accounts? Now you can create a custom user name for online account access at americanfunds. com. This new login option offers a convenient alternative for accessing your accounts on our website. For more account infonnation Annual fee . Call your financial adviser . Automated information and selVices Website - americanfunds. com American FundsLine '" - 800/325-3590 . Personal assistance - 8 a.m. to 8 p.m. Eastern time M-F Shareholder Services - 800/421 -0180 ......................................................................................................... A $10 annual fee will be deducted in December from traditional IRAs, Coverdell IRAs, Roth IRAs, SIMPLE IRAs, 403(b)s, 457s, money-purchase plans, profit-sharing plans and 529 accounts .If yol.! prefer to pay by check, we must receive it by December 7. Quarterly summary (July 1 - September 28, 2007) ..............-.................................................................................................................................................................................................................... Reinvested Change in Value on dividends and account Value on Ending ......................... ......... ............. ............ .........~~:r.~!............:.........~~~~~~q.~~....~....E~f.!~~~.~~!.~.~......:. ......~!!~~:.~~~!~.. ..... ..:(.:........~~.~~.~.............. ........~~~~~~..... ...~.~~:.~.~~!~.'!.I!.~. Washington Mutual Investors Fund-A Account # ~541.n $4,403.26 SO.OO $21.31 SO. 00 $57.88 $4,482.45 118.961 ......-....................................................................................................................................................................................................................... Year-to-date dividends and capital gains Short-term Long.term ................................................................. ...........................~I!.~.~.~!!!.L.........f~!!~..! ......... ......... ....... .....~!~!~~~~~...........................~~I!.!~~!.f!~!~~........................ ....E.~p.!!~~.~~f!.l.~ Washington Mutual Investors Fund-A 63754151 01 $62.45 $0.00 so.oo Beneficiary infonnation ....................................................................................................................................................................................................................... .. ..... ....... ................................... '" .... ...................................... ~.~!:.~~~~.~..... .... !.:.if!!~:t... .................. .... .................. .......................:... E~!!!!!!~ ~'!.~.... .................... .............................. . CBa:T CUST IRA/SEP JOHN II MlLLERlDEC'D 63754151 GLORIA GILBERT VICKIE MILLER To update and read important legal information about your beneficiary designations, please go to americanfunds. com/beneficiary 11111111111111111111111111111111111 7 , 1 2 0 A.fS.....U14G1<.Hr.u.1OK.03901.03901.CNSAFS(l1.IN\lMCR.. ....AF1.......ot5110469/SITE102 71122looQOI The right choice for the long term1l> @ American Funds. Quarterly Statement September 28, 2007 Page 2 of 2 Year-to-date history ....................................................................................................................................................................................................................... Washington Mutual Investors Fund - Class A Account # 63754151 Fund # 01 Symbol AWSHX Trade date Description Dollar amount Dividends and capital gains reinvested Per-share average cost: Not available 'please see back of statement) ...............................................................................................................................................................................................................u.............................................................. 01/01/07 Beginning balance $5,158.93 $34.86 147.990 02/15/07 Normal Distribution -$1,100.00 $35.80 -30.726 117.264 03/23/07 Income Dividend 0.17 $19.93 $35.39 0.563 117 .827 06/22/07 Income Dividend 0.18 $21 .21 $37.10 0.572 118.399 09/21/07 Income Dividend 0.18 $21.31 $37.89 0.562 118.961 09/28/07 Ending balance $4,482.45 $37.68 118.961 Shere pric e Sheres transacted Share balance /1111111111111111111111111111111111 7 9 2 1 0 AFS..-22250-.05U663006.03102.03902.CNSAFSO I.INVMCR .....AF 1.......0156104Cii/SI1E 102 71122100002 * t1 ~ '"-' -g~; ~~ " :! ~ 't 8 ~ < = - = - 55 - == !!!!!!!!!! iIiiiii iIiiiii - !!!!!!! iIiiiii = - iIiiiii = - iIiiiii - = iiiiii == I- Z ::::> o () () ~ I- Z W ~ W ce:: 0::1- wW --.lce:: -I --.l ~~ 0::::0 z> In 02 -, - ~ - ",' -- '~ '- -- .-t """-j" " ~ " ~ ;:j :; c; ~ :J "l ~ ~ -j ~ ~~ :;;"- ~ 3 \j.;g ~-t " ~ "- " 'j""':j ...:::: ~ -z;? - " ..c "- ;, ... c g gj ..c '- "5~ ~ E ~~ "8 ::: ..:''3 g:::' %-'~ '...; ;:::r::; -; :; g '" '\j"'::: -~ ~ ~ n -:J -:: ~ ";:~ t:: .:s:; '3 ]~] '0 - '" '- - "l g'~ - ""' ~~ '01! ~~ - "- -5t. ~'"2 ':j ~ .-~ ::: ~:::: ~~ "'- '" "l El-, '" " ~ ;e '--<l 3~ -c::: ~ ~ $ ~'~ 3 :=: q ~~ .5 ~ :;i p ""'-' ::0", ~ C ~2 --"" " Q... ~ ':::l ;-,] s ... ..J c:( I- lIJ C I- lIJ tn tn c:( :; j ..3 t c '::: e 2 tl () :i <:5'?> '" ~~ 0 .~ ~ ] ~~ .J ~] ~ -;.g ~ ~~ j * ~ ...---. " ~ " ~ ..c ;:; 2- ~ B .~ ~ S' ~ ...:: :-;; ';;1 -s ~ ~ ~ '3 3 ] ~ t:i ~ a:: c( :E )0- w :z; o :E o :z; c( ::J: en c( u w , ~ o (.) ~ C !;: 1-", Z:> "'.... ~.. ",> 1-1- ""... ti~ ",.e :J~ o ;; '" '" lL ...'" Z:J ....... "''''' "'> :Jl- 0'" ::w:: Q: ~ ...... "'U x- a:'" .elL ~ ~ 0 ;:: (YJ Z I'- ~! r-... Cl ~ .... o 1O ::e >- .. z o ;:: lL a: o en '" a (YJI q r-.. <FJ. (YJ .;- U) <Xl ...... w- (YJ I'- r-.. o C\I .yt o o o ..-. .yt + X C9 :?: f-- :?: :?: f-- > o C9 (/) ::J ~ o <( 0:: <( :?: <( f- l"'l " " o N ~ I- I.LI ~ a:: c( :E >- I.LI Z o :E o z c( ::J: en c( u ..J c( I- o I- en w E ::> CI I.LI en ::> CILI ~~'i ~!i ;::- ",... ...< :J Z Z .. C' w'" ~'" ....0 .e... "'z "'- Z.. :JCl I- '" o \) I- ... Z t:;1LI ",3 "'< <> :E ...'" .....0 ::w::- a:a: ..lL ~ ~ ;:: Z .. :> CJ ... o 1O :E ... '" Z o t a: \) z ~l ~ ~ z <( z m ..-. .;- U) - o ..... .-;1 ~I o o o r-.. z ~ :r: l) z co I <.0 ,m , ..... - v q (YJ N (YJ "?" U) N o o m '<t - N C\I ..... ,..... lO v - I 0' U) <Xl lO N - o o o ,..... I'- o f-- Z (L 0:: o U -' W f-- Z U'l , \0 oi " ~ m (YJ <Xl N lO o N - U'l l"'l .n o N ci N ~ t'-. m ('I) N N '<t o oi' ~ -' .;- .-< v - U) (YJ o ,..... ~ .;- N - " " ... ... ('I) oi' N ~ o N q m lD - o o o <Xl .;- z z w (L o z fn C9 I.LI z i= :2: ::> <( CI C9 I.LI -' en !;;( ::> z ....I Z <( Z I- w 0 (LII- HKN: Historical Prices for HKN INC. - Yahoo! Finance Page 1 of2 YahoWeldllll1'ejlllWhcttes41!f,1Stgn Out HelD "hHOO!,FINANCE Dow ~ 1.07% Nasdaq ~ 1.49% Wed, Nov 21, 2007, 11:35AM ET - U.S. Markets close in 4hrs 25mins. ( GET QUOTeS J Symbol Lookup Finance Search ^- '--""'_'_~"^'___'wm'._u~_, '_m"_"__"'_Uh_~m_A'^__"''''m~.mm. _. ,~___ HKN, Inc. (HKN) At 11:08AM ET: 8.37 "'0.16 (1.88%) o r'dde Smarter I FldIIll~ ~ ~ ?;;~ ,,""'& ~w. E*TRADE FINANCIAL' Historical Prices Get Historical Prices for: [GO) SET DATE RANGE ADVERTISEMENT 31-Aug-07 9.36 9.45 9.30 9.32 21,700 9.32 End Date: 31 2007 Eg. Jan 1, 2003 @Daily o Weekly Monthly () Dividends Only Start Date: 31 2007 Get Prices First I Prey I Next I Last PRICES Date Open High Low Close Volume Adj Close. . Close price adjusted for dividends and splits. First I Prev I Next I Last '~ f, Download To Spreadsheet S1 6iliL!o PortfQtiQ '().' Set ~ B E1MiL1o a Friend Get Historical Prices for Another Symbol: ~ Svmbol Lookuj2 . Stock Screener . Mergers & Acquisitions . SQ!@ Copyright@ 2007 Yahoo! Inc. All rights reserved. Privacy Pollc)!' - lli!lIfl-?-9.LQ!ill'i9.e - !;;QpyrigtlJllJ:. PoIic;;.y http://finance.yahoo.com/q/hp?s=HKN &a=07 &b=31 &c=2007 &d=07 &e=31 &f-=2007 &g=d 11/21/2007 INTC: Historical Prices for INTEL CP - Yahoo! Finance Page 1 01'2 YahoWeld;/iIl'ejltlA:lhcI1'8sill1!f.;1Stgn Out Help 'h.HOOl FINANCE Dow .... 0.98% Nasdaq'" 1.39% Wed, Nov 21,2007, 11:36AM ET - U.S. Markets close in 4hrs 24mins. ( GEr QUOTl!S J, Symbol Lookup Finance Search __m__'_'~_"_~____"m"~"'.____'_'__A__~,_,,_ "__U__W"_'___~'m~'______~ Intel Corp. (INTC) J[DAM&RITRAD& , Transfer today and get upt9$3(.(Q OTrade Smarter ,S FIdtIIlq ;< 0 -~~ '" "","""21-"" "'Ar' 100 FREE TfW)ES At 1l:21AM ET: 24.66 ... 0.86 (3.37%) E*irUlDE S"curiti.u Historical Prices Get Historical Prices for: (GOI SET DATE RANGE ADVERTISEMENT End Date: 2007 Eg. Jan 1, 2003 (!! Daily Weekly Monthly () Dividends Only Start Date: 2007 Get Prices First I Prey I Next I Last PRICES Date Open High Low . Close Adj Close. 25.75 56,843,900 25.64 Volume 31-Aug-07 25.56 25.80 25.53 . Close price adjusted for dividends and splits. First I Prey I Next I Last A Download To Spreadsheet 8,1l.J1dJQYortfolio '';'' Set Alert G Email to a Friend Get Historical Prices for Another Symbol: ~ Svmbol Lookup . Stock Screener . Mergers & Acquisitions . SQ1lN Copyright@ 2007 Yahoo! Inc. All rights reserved. E'.rivacv P~!i0' - Terms of Se_lYice - ~_QPvriQhtllE'J:)gli0' http://finance.yahoo.comlqlhp?s=INTC&a=07&b=31&c=2007&d=07&e=31&f=2007 &g... 11/21/2007 PENN: Historical Prices for PENN NATL GAMING 1- Yahoo! Finance YahoWeldifill1~!ltlMlhc:thlost41!M9tgn Out Help ~HOO!,> FINANCE Dow ... 1.02% Nasdaq'" 1.36% Page 1 of2 Wed, Nov 21, 2007, 11:38AM ET . U.S. Markets close in 4hrs 22mins. GIrr QUOTES Symbol Lookup Finance Search Penn National Gaming Inc. (PENN) rtD "UmtAD. 'Transfer today and get up tQ$~~OC! OTrade Smarter .s FIdIIIl" ,,~ %W~""~'VWc~ 100 FREE TRADES E,*U..DE $lII!curitilf$ Get Historical Prices for: jGol Historical Prices SET DATE RANGE Start Date: Eg. Jan 1, 2003 (~ Daily Weekly Monthly CJ Dividends Only 31 2007 2007 End Date: 31 Get Prices First I Prev I Next I Last PRICES Date Open High Low Close Volume Adj Close> 31-Aug-07 58.70 59.00 58.41 58.80 682,600 58.80 . Close price adjusted for dividends and splits. First I Prev I Next I Last #i Download To Spreadsheet kiJ Md to P.QftfQ\jQ '0: Set Alert ':;J l:.maIllit a Friend ADVERTISEMENT SIMt SOC n_ .' ~dst; Biscuits Taste the tradition · Rollover to learn more ~ Svmbol Lookup . Splits Get Historical Prices for Another Symbol: . Stock Screener . Merqers & Acquisitions Copyright@ 2007 Yahoollnc. All rights reserved, Privacy Policy - Terms of Service - ~htllP Policy http://finance.yahoo.comlq/hp?s=PENN&a=07&b=31&c=2007&d=07&e=31&f=2007&...11/21/2007 8 Prudential Prudential Annuities A Division of Prudential Financial. Inc. P.O. Box 7960 Philadelphia, PA 19176 (800) 752-6342 TTY (800) 654-7637 www.americanskandia.prudential.com October 31, 2007 IRWIN & MCKNIGHT A TTN ROGER B IRWIN WEST POMFRET PROFESSIONAL BUILDING 60 WEST POMFRET STREET CARLISLE PA 17013 COi"~~~d~~ "n r Con ~",~t~~~~~t1lJ.! ". !J 1'-<, ! ..: ~.' ii Dear Mr. Irwin: IGHT Thank you for submitting the required documentation to release information to your office regarding John R. Miller's above referenced annuity contract. John R. Miller was the sole owner and annuitant of this nonqualified annuity, which was established on March 15, 2000. We did not receive or process an ownership change on this annuity within one year prior to the date of death (September 3, 2007). This annuity is Mr. Miller's only contract with us and it was not closed within one year prior to the date of death. Furthermore, this annuity does not earn interest because the contract value was invested in variable sub- accounts. The date of death value was $17,731.81, which is as of September 4,2007, for September 3,2007 was a holiday. If you have questions, please contact our Annuity Service Center at (800) 752-6342. Representatives are available to assist you Monday through Thursday between 8:00 a.m. and 7:00 p.m., and Friday between 8:00 a.m. and 6:00 p.m. Eastern Time. 7.T~l /~y0 ~nne~ Senior Customer Service Representative Registered Representative American Skandia Marketing, Inc. A Prudential Financial Company One Corporate Drive Shelton, CT 06484-0883 Annuities are issued by Pruco Life Insurance Company or Pruco Life Insurance Company of New Jersey (in New York only) (both located at 213 Washington Street, Newark, NJ 07102), or by American Skandia Life Assurance Corporation, I Corporate Drive, Shelton, CT 06484. Prudential Investment Management Services LLC (located at 3 Gateway Center, Newark, NJ 07102) distributes variable annuities issued by Pruco Life Insurance Company and Pruco Life Insurance Company of New Jersey, and American Skandia Marketing, Incorporated (located at 1 Corporate Drive, Shelton, CT 06484) distributes variable annuities issued by American Skandia Life Assurance Corporation. Each such company is an indirect subsidiary of Prudential Financial, Inc. --~""-=<'--~.~~~~'lJo&."---" _-Sovereign Bank , .. !; , Fax 'rom: Paulo J5fe('~kh J I /;;).<:;pl 0 > Tel -6f+n', ~Gte.rr ~ J1 of! I De_ Fax JIIInIIIeJ'; d'-{q -1.-30'1 Phone~ Total No. vi....... Including Ccrnr: ~ ........ Phone Number. RI: JoA 11 ~ /J1N!er SendeI's Fax Number. [J UJ8ent o For Review o P.... Conunent . 0 PIeMe R..-, ), , ...:.... 921 Cavalry Rd Carlisle PA 17013 (717)243-8868 and fax (717)243-8927 Mail Code 169-169 "This fax fJleSS8g8 contains info11flsllon which may be confidenttal and ptM7eged. u~s JIOU 8n1 III" addreS$/NJ (or authoIized to rec&AIe Ibr!he addte$$lNl), you may not use, copy Of dsdose 10 atl)'OIl6 the messlJge Or any information contained in the message. If you hiwtJ received the message in emJ(, please adlise the SIInder and destJOy the message. Thank you. ~nn iTnnl'Jl ~ Page: 1 Document Name: untitled Demand Deposit Display History 6017 11/20/07 DDerST Acct 2891037197 Request ALLTRANS Alpha key MILLEJR.14 Last stmt 10/19/07 S --Daten 1t 08/29/07 '* 08/31/07 * 08/31/07 '* 09/04/07 * 09/04/07 .,. 09/04/07 '* 09/05/07 '* 09/05/07 _l___,. ----Description----- -SERIAL NBR- DAILY BALANCE DEPOSIT DAILY BALANCE eRR CARD PUR 772284 COUNTRYB COUNTRYBUTC CARLISLE PA VETERANS AFFAIRS 635 PAYMENT 070831 0635 DAILY BALANCE MRP HEALTH CARE PREMIUM 0854486611 DAILY BALANCE -Reference- 06661106280 89900000000 00077900000 00077900000 ------Amount------ 7,940.37 500.00 8,440.37 (31. 53) (15.00) 8,393.84 (133.25) 8,260.59 DDDHISTREQ DDDHISTBAL DDDMAIN DDDACCT DDDINT THERE IS ADDITIONAL INFORMATION BEFORE AND AFTER-THIS PAGE. GN20000I03 COMMAND ==::::> F2=Retrieve F3=Exit F7=Backward F8=Forward F4=CRFwindow >:00/>:00171 Date: 11(21(2007 Time: 4:49:50 PM ?age: 1 Document Name: untltled )DDHIST .~-"'-~__'-~__'IO:.""'~~"~/.1.lI\~~- DEMAND DEPOSIT DISPLAY HISTORY 6017 11/23/07 Acct 2891037197 Request ALL TRANS A .-------------------------------2RF WINDOW-------------------------------. : JOHN R MI~LER Alpha-key MILLEJR.14 S 1 GLORIA S GILBERT TIN 186-34-2183 * : 345 E LOUTHER ST Birth date 09/20/1943 * : CARLISLE PA 17013-2530 Horne phone 717-249-7016 * : Work phone 000-000-0000 * I I * I I * I I * I I * I I * I I * I I * I I * I I * I I I I -------Account Holders-------- ,JO~IN R rlILLER GLORIA S GILBERT --Acct ReI-- PRIMARY CO-HOLDER -----Demand Depos~t----- Branch 0289 Area 0289 Offlcer Class 30001 -------------------Customer Ccmments------------------- -Emp- --Date-- (NO COMMENTS ON FILE FOR THIS CUSTOMER.) o c F3=Ex:..t Date: 11/26/2007 Time: 8:38;39 AM .. "'A I_""/'IM I 0 0) 3 o 3 3} o o I 0 : 0 : 0 : 3 : 3 : T : 04 I I I I m'