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HomeMy WebLinkAbout07-10-80 r REV-449 (8-78) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF FIELD OPERATIONS . 7- /tJ- ,?O 21-78-314 ........ RESIDENT DECEDENT COUNTY OF CUMBERLAND IMPORTANT: This return must be completed in detail and filed in duplicate, with all attached, with the Register of Wills of the County where decedent resided; Return is due within nine months after date of death, unless an extension is granted by the Secretary of Re'lenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) Late of Cumberland } AFFIDAVIT OF EXECUTOR County H~~ IN THE MATTER OF THE EST A TE OF T. A. MILLER (STATE FULL NAME OF DECEDENT) State of Pennsylvania Cumberland } ." rix ExecutxlOC County of Administrator Beatrice M. Claus of the estote of the above.named decedent being duly sworn, depose and say June (MONTH) Home and address of attorney or } other authorized repres.entative to whom 011 correspondence should be moiled. (DAY) (YEAR) testate leaving a last will, copy of which is hereto attached. } !lOI: Decedent died 2 19 78 James R. Hurner, Attorney 1 W. High St., Carlisle, FA 17013 That as such Executrix deponent is familiar with the affairs of said estate and the property constituting (EX ECU TO R'ADMINI ST RA TOR) the assets thereof and their fair market value. That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the exception of the following: - . , RELATIONSHIP OF JOINT HOLLlERS TO DECEDENT That the contents of said safe deposit box or boxes are itemized under Schedules wi th the exception of the following, for the reasons hereinafter set forth: R of this return, That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the columns provided therefore the assessed valuation of -each of said parcels, the estimated market value thereof as of date of death of decedent. That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death; all moneys left by the decedent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interest thereon,' if any, down to the last interest day prior to decedent's death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de- cedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States, or any state, or political subdivision thereof, or of any foreign country, which are owned at the time of death; all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, carriages, automobiles, boats, and any and all other personal chattels of whatsoever kind or nature, left by decedent, together with the fRirly estimated market value thereof; all bonds and mortgages held by decedent and'of all claims due and owing decedent at the time of death, and all promis sory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's death and other investment securities owned by the decedent at the time of death, with the market value there- of at such time. In the case of securities of close or family corpcrations, the values reported are as far as possible substantiated by financial statements of the corporations, showing the assets and liabilities thereof as of the date of death. The schedule also sets forth the interest of decedent at the time of death in any co-partnership or business, and in support of the value of such interest there is annexed to said schedule, financial statements showing the assets and liabilities of said co-partnership or lmsiness. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business, its location, and such other facts pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted. It should also set forth in itemized form, together with the fair market value thereof, any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein and in the case of transfers of property, real or personal, within two years of decedent's death, in contemplation of decedent's death, or intended to take effect in possession or enjoyment at or after death, said schedule sets forth the nature and value of such property, to whom transferred, the relationship of the transferees to the decedent, the proportionate share received by each transferee and all other facts of a pertinent nature regarding said transfers. In the case of transfers intended to take effect in possession or enjoyment at or after death, there is also attached to the schedule a co~y of the deed, trust agreement or other instrument creating the trust. Ther'~ is also set forth in said schedule a list of all property, real and personal, with its value, which passes at decedent's death by virtue of the exercise by decedent, either individually, or jointly with another, or any power of appoint- ment vested in decedent, either individually or jointly, by the will, deed, or other instrument of another, with a copy of the instrument creating such power attached to the schedule. That Schedule 0 attached hereto and made part hereof sets forth the names and addresses of all persons beneficially interested in this estate,. at the time of decedent's death, the nature of their res- pective interests, their relationship, if any, to the decedent, together with the ages at the time of decedent's death of all minors, annuitantS and beneficiaries for life under decedent's Will. It also contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary. That Schedule E attached hereto and made 'a part hereof sets forth all property, real and per- sonal, owned by the decedent jointly with another or others, including intangible, standing in the name of the decedent and others, plus the d~te and place of record of instruments effecting the vestiture of real estate and the date of acquisition of personalty, plus the name, address and relationship, if any, of co-owners to the decedent. That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid; family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence of the death of the decedent; debts and claims owing and unpaid at time of death; taxes accrued chargeable,for period prior to decedent's death (except those allowed under Section 651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga- tions, if any. It is agreed that the fiduciary will present ppoof of said claimed obligations upon re- quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that the amount of tax assessed can be reassessed in accordance therewith. , That the totals of the appropriate columns in Schedules "A", "B", We", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this ......27:L.......,.... /, ~/ J/t' ...................................~...................... day of. ................::J..H:fte: ..... ;-:::)1..... 19...8..0.... jf Ii /; . ~Y,?J,/I/ ...~t...d.L~~.....,;;!/~.c:..~,~,;~................. TARY PURtle Ex9ires July 14, 1981 Cumberland County /) ~ 3 ~r;g // '. . .../.()",&... .... ..~.~.............. ..... ..... ....((6;:::::?..........._......._... (Ezecu.tor-AdminiatTator ) .....~~.~.v.!:~...................G.S.....Ma.in....S.t...........................-..-.-.. (Street Number) ....yjJ1.~.1.g,.nd...,......O'n.t.ar..io..........LOR2C.O'...................... (City or Town 4M St4te) NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word "None", and in case the assets include rare and unlisted securities, securities of close or family corporations or an interest in any co-partnership or business, that the data and statements required illlder the paragraph above relating to Schedule "B" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above-directed. RC C.34 (4.73) COMMONWEAtTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" REAL PROPERTY * Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Property held by the decedent as tenant in common with another or ather, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property held as joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.") The real property located In the Commonwealth of Pennsylvania should be described by lot and block number, street and street number, together with a general description of the property, with a reference to the record of the conveyance by which the decedent took title; If a farm state number of a- cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are to be listed on Schedule "F" and must not b. deducted from this schedule. (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH 1. (A) House and lot of ground No. 531 N. Pitt St., Carlisle, Cumberland Co., Pa., lot 25' X 95' and improved with a brick dwelling. (B) Lot of ground adjoining (A) above, vacant, and fronting 56' on N. Pitt St. and 100' on "B" Street. Prior deed recorded in 15 "A" 154. Both tracts sold as a unit 1/29/79 and assessed together. Sale price $22,500.00 ~*'r:t 4090.00'/ 2.House and lot of ground No. 631 Factory St. Carlisle, Cumberland County, Pa. Lot 25' x 60'. Prior deed recorded 23 "BII"' 480. Sold 12/5/78. Sale price $8500.00H;f}av!fMtJV2760.00V 3. House and lot of ground No. 155 W. North St., Carlisle, Cumberland County, Pa. Lot 24' x 114'. See deed recorded" 23 "A" 567. Sale price $7000.00. Sold~J(s.C 3240.00y' , 9/ 2 7 / 7 9 . .,.-11/ 4. Tract of land, 7 Acres, N. Middleton Twp., Cumberland County, Pa., improved with frame dwelling and other outbuildings, Prior deed recorded in 19 "C" 497. So11.";7'"..... d 4'1 4970.00'/ 5/30/80. Sale price $25,000.00~f'" y Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. (2) ESTIMA TED MARKET VALUE 22,500.00'[/ 8,500.00,1/ ./ 7 , 000. 0 O~ 25,000.00IV (3) DEPARTMENT VALUATION CAUTION (Do not write In this space) 63000.00/ [:f,C'H,(C , 7 ".~' -'t:7' \ ... RCCO-:3,s . COMMONWEALTH OF PENNSYLVANIA TRANS}~R INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY . I I NS1'RUCTlONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time of his death. Property owned by the decedent jointly with another or others must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta- tive tl'USt accounts, must be listed, despite the fact that they are not of the administered estate. Tangible personal property should be listed f'irst (e. g. jewelry, wearing apparel, household goods, and f'urnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank, stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay- able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed estate of or income from any property held in trust under the will or agreement of another, even though located outside of the State, at the time of" death, should be listed in this schedule. I tern No. 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ITEM List and describe fully 1 2 Personal property sold at public sale Cottage on leased ground, Evangelical Camp Grove, Herndon, Jackson Twp., Northumber- land Co., PA Assessed value $450.00 Contents Bal. due on agreement of sale of land in Jackson Twp., Perry Co., PA sold 10/ /73 to Wade W. Killinger et ux, deed dated 5/1/79. Purchase price fully paid prior to death of decedent 6/2/78, tax appor- tionment only due ACF Brill motor home, non-operational 1972 Cadillac Cpo Title C23671201 Indian Jewelry & artifacts, per appraisal Coin collection, per appraisals Com. Nat1. Bk., Ck. acct. 182-203255-1 Com. Nat1. Bk., Save acct. 18-0021063-3 Int. to 6/2/78 CVS&L, Acct. #160925 incl. into 8.09 CVS&L, Acct. #154180 incl. into 5.75 Farmers Tr. Co., Ck. Acct. 1-25816-5 Farmers Tr. Co., Ck. Acct. 2-0602-4 CCNB Bank, Save Acct. #076-028984-3 Deerfie1d Beach St. Bk. Ck. #306-287-7 First Fed. S & L of Hbg. S/A#06-14-37293-6 First Fed. S&L of Broward, #5-18086-5-09 Mid Penn Bank, #301-959-3 Northern Central Ban~, Ck. Acct. 208-852-4 Northern Central Bank, Save Acct. 35831-7 PNP Bank Card 4261 360 127 918 Credit Texaco Canada Inc., Trav. Cd.9211228912 Cr . U.S. Series E Bonds, list attached 6 She Cumbo Valley Co-Op. Assn. Pfd. 10.00 Metropolitan Life Ins. Co. Proc.#6975196C Prudential Life Ins. Co., Proc.#20 061 172 Prudential Life Ins. Co., Proc.#091333199 VA Ins., Proc. Pol. #V 17539 VA Ins., Proc. Pol. #V 6006583 15 She Herdon Camp Meeting Assn. 3 4 UNIT ESTIMATED VALUE MARKET VALUE 6,477.10 1,800.00 1,800.00 19.10 700.00 1,500.00 , 9,586.00 (6 , 572 . 05) 871.43 244.54 .07 371. 87 264.31 174.08 23.71 28.13 8.72 (318.64) 84.79 34.09 395.55 82.81 12.08 101. 82 5,043.46 60.00 1,730.79 22,439.79 610.26 1,696.25 1 , 773 . 8 ~, (5.00/ DEPARTMENT VALUATION (Do not write in thi s space) (, .s-7.3, O~ .$1'1, .(p J' 75:oc / ) 3 L/ __5 <Jel. 7.5 'if 75 7?~o 3,1.95 {/tJ .15 /~o./O 55:1tJ /?'75 I/S-,oo L/ 7J!,0 0 ;<:;-~::! . c?S /60 .~3CJ , ( :,c; ~ I , I ? 9 o JJ /1 I " I - , -, }(1 )i) ,,- i../ - \-.-' / .. , . .! J..r ,.. . . / .. l ~,. /'~/" I.' i) 'f (.' I ,"- ..... J !. . '.. ~ / /I},/j.l/) l.t" (/ / ! Ie. .. '- ..J J ../ . /"\.,..,. r- .-") ) . ~ 'l ~,") (> '- , " .., ,-," ,. .., .. ~". , "( l." . ;." ,( ".-' ........ ( -~' ,-. t ~ :') - / \. Ii!.:. i \ /ell/ L /./ ! . /',1 1- . /,/ I //7?(,1.5 ~ t'-/77./CJ ? /} /-- .' . .__j::. ,./ .~). L" _i' /'/:~ ; 4'.. .' -..... 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INDIAN ARTIFACTS AND JEWELRY Klagetoth all wool blanket or rug Rio Grande design Wide Ruins design Pueblo weaving Grande Canyon floor Klagetoth Alligator design Jerronga design, all wool Buckle Ballo 2 silver beads @ 30.00 1 silver bead 1 liquid silver 1 stone turquoise 1 shell Turquoise and shell Olive shell fetish crab bracelet silver and turquoise squash 1 coral squash 1 corn and silver pendant butterfly squash Belt Rain dance Silver and turquoise belt Watch and Bracelet 1 ring 1 Shrine ring 3 Shrine pins Necklace Silver chain Necklace Silver chain 10 liquid silver @ 5.00 5 pin shell @ 15.00 1 silver turquoise 1 silver turquoise nuggets Bracelets 3 @ 40.00 Bracelets 4 @ 25.00 Bracelet 1 Bracelet 1 2 Key rings @ 15.00 4 ear rings @ 10.00 14 rings @ 15.00 13 rings @ 20.00 14 rings @ 25.00 1 ring 2 rings @ 10.00 3 rings @ 30.00 1 ring 1 ring 1 ring , $90.00 90.00 190.00 275.00 200.00 150.00 300.00 60.00 75.00 90.00 35.00 20.00 60.00 45.00 35.00 175.00 250.00 250.00 350.00 3000.00 800.00 1200.00 50.00 50.00 120.00 25.00 25.00 50.00 75.00 40.00 45.00 120.00 100.00 40.00 35.00 30.00 40.00 210.00 156.00 350.00 45.00 20.00 90.00 35.00 40.00 55.00 9586.00 \ 1857 1855 lS5? 1893 1901-3 1882...cC ..,,....., ~ .J..)' .1..;> 1912 1913 1923 1898 1945 1945 1955 1959 1959 1929 1862 1905 1908 1915 1967 Type 1 'rype 2 Type 3 Liberty He~.d Liberty i-Ie~d Libert-,! Head Liberty Head Indian He;lc Indian Head Ir.dian Head Saint Gaudens 1 Pesos 2 Pesos 2~ Pesos 5 Pesos 10 Pesos 20 Pesos SO Pesos u.S. Type 3 1. S ' Z ' overe1.zn 1 Sovereign 1 Sovereign 1 Sovereign u.s. GOLD PLASTIC CASE $1 Dollar Gold $1 Dollar Gold $ 1 Dollar Gold $3 Dollar Gold $2J;- Dollar Gold $ 5 Dollar Gold ~'l() Dollar uold $20 Dollar Gold tr,2~ Dolh.r'l-old $5 Dollar :}old $10 Dolh.r Gold $20 Dollar Gold 1-lEXIC A1~ GOLD PLASTIC CASE Gold Piece Gold Piece Gold Piece Gold Piece Gold Piece Gold Piece Gold Piece ~ Uncircvli.ted Plugged & Polished (good) UncirculR.ted TTncircuhted Very Fine Extra Fine Uncirculated About Unciro Umrircu.lated Ver;r Fine About Uncirculated Uncirculated Uncirculated Uncirculated Uncirc ulol.ted Uncirculated UI:.circu-lated Ui.'lcirculated Uncircul<il.ted INDIVIDUAL GOLD PIECES IN gARDBOARD 2 x 2 1 Dollar Gold ENGLISH EdwOl.rd 7t.h Ed\vard 7th George 5th Elizabeth ?nd " Plugged & Soldered ( Good) Very Fine Fine-Soldered on Clasp Uncirculated Uncirculated .' $250000 75.00 250000 $1100000 $ 90000 $ 90.00 :$ 175000 $ 725.00 $ 150000 :j) goo 00 ~ 190000 $ 30.5.00 $ 10000 $ 12050 $ 15060 $ 31. 20 $ 62.40 :$ 118.3.5 $ 284.00 $ 2.5.00 $ 38000 $ 20000 $ 48.00 $ 48.00 , '( .. . '. .. -2- FRANCE DATE 1865 5 France Napoleon 3rd Uncirculated Restrike $ 65.00 1867 10 Francs Napoleon 3rd Uncirculated Restrike $ 55..00 1868 20 Fr.mcs N..poleon 3rd Uncircul;ilted Restrike '" 55.00 y 1859 50 Fr.mcs Napoleon 3rd U~circula.ted Restrike $ 275.00 1869 100 Fromc8 Napoleon 3rd Uncircula.ted Restrike $ 460000 1935 20 Fromcs Napoleon 3rd Uncirculated $ 60.00 EUNGARE' 1880 1 D\1c~t Res tri..l{e Proof .... 50000 0.1> lR92 20 Korona. Restrike Uncirculated :p 65000 1906 10 Korona About Uncirculated $ 45.00 1778 1 Ducat Liechtenstein Restrike/Uncir. :j) 15000 CHILE - 1947 100 Cien Pesos Extr_ Fine ~, 75000 oj) AUSTRIA 1892 4 Florin Uncircu.lated $ 15.00 1915 1 Ducat Uncircuhted $ 20000 1915 4 DU.cat Uncirculated $ 25.00 PERSIA-IRAN 1339 t POl.hlen Restrike Uncirculated ct. 45000 'V 1909-1925 1/5 Toman Uncirculate6. $ 30.00 1909-1925 t Toman Uncircbllated .... 3'000 .:j) 1905-1925 1 Tom.... Uncirculated $ 50000 NETEERLA1\TD-EAST INDIA 1928 1 Ducat Uncirc1J.lated $ 25000 GERHANY 1905 20 Mark Uncirculated $ 135.00 . . " " . III f"' '" " . , ; , -3- DATE DOMINICP.N RE?TTBLIC 1955 30 Pesos Uncirc'lAlated $ 75000 TURKEY 19f;6 250 Piastres Uncirculated $ 60.00 QUA TEI1.ALli 1864 4 Reales Uncirc~lated $ 45000 '\ .' , '. Mr James R.Humer Farmers Trust Building One West High Street Carlisle,Penna 17013 U.S.A. STANLEY GIBBONS CURRENCY LIMITED MEDAL DEPARTMENT 17 Piccadilly Arcade London SW1 Y 6NL Tel: 01-493 5082 Telex: 28883 -and London WC2R OLX Tel: 01-836 8444 Telex: 28883 28th November 1979 Dear Sir, I have been asked to write to you by Tim Crisler concerning the medal which you wish to identify and value. This is an unofficial GOLD medallion comemmorating the Coronation of Edward V11. It's only value is that of it's gold content, approximately ~300. I trust this information will be of help to you. Yours sincerely, f\. J ~ Nimrod Dix CHAIRMAN: H. O. haser DIRECTORS: Colin Narbeth David Millar David Whatley Registered Address 391 Strand. London WC2R OLX Registered No. 993183 London Cables: C/o Telex 28883 t : i-I ;" "l " ~:..\) G','~-;}' \:,~ , ,.., ~"J 3~: ~~~ ~ ) .; ~l(;;'~ J2 .~~a Mr James R.Humer Attorney at Law Farmers Trust Building One ~est High Street Carlisle Penna.17013 U.S.A. , . Commonwealth 1\ National Bank/" " V-,. ", ..~ July 17, 1978 James R. Humer Farmers Trust Building One West High Street Carlisle, Pa. 17013 Re: Estate of Dr. T.A. Miller Dear Mr. Humer: In reply to your recent letter dated June 23, 1978 on the above estate, the following accounts are listed below as of June 2, 1978: Checking Account - #182-203255-1 $871.43 Opened - January 5, 1976 Savings Account - #18-0021063-3 $244.54 Opened - Accrued Interest - $.07 June 20, 1975 The above accounts are in Dr. T.A. Miller's name only. If you have any questions, please feel free to contact us. Very truly yours, { !- ..... ( ~ / , , / / // '~, /' r. /' / ; Robert Ta1a1ai Assistant Vice President and Credit Officer RT/cg The Commonwealth National Bank, 10 South Market Square, Harrisburg, Pa, 17108 (717) 564.9500 . ., ~! ;~-" .I "' ""CUMBERlAND ~LLEY ~1N<75 AND LOiN ASSOCI~TION 16 West High Street. Carlisle. Pennsylvania 17013 249-2525 August 3, 1978 James R. Humer Attorney At Law Farmers Trust Building One West High St. Carlisle, PA 17013 RE: Dr. T. A. Miller Date of Death: June 2, 1978 Dear Mr. Humer: Please find listed below the balances and accrued interest on the two savings accounts held by the deceased as of June 2, 1978: #160925 #154180 Balance --------------$363.78 Balance --------------$258.56 Accrued Interest ----- 8.09 Accrued Interest ----- 5.75 Total ---------$371.87 Total ---------$264.31 If additional information is needed, please contact this office. Very truly yours, !J~{ pt}{4 Richard L. Kuntz Bookkeeping Dept. ~ FARMERS TRUST COMPANY CARLISLE, PENNSYLVANIA Date June ?7, 1978 James Rn Humer One West High Strppt Carl i ~l P, PA 1 701 q Re: Estate of Dr. Tn An Miller Date of Death .Tunp 2, lq7R Dear Mr n Humer In answer to your request concerning accounts owned, either separately or jointly, by the above referenced decedent and the balance in each account .as of the date of death, we have checked our records and are submitting the following information in duplicate. We suggest that you file one of these letters attached to the Pennsylvania Inven- tory forms (RCC) to substantiate the balance you report. Note that we have shown the correct registration for each account. Also, interest accrued to the date of death, if any, is listed as a separate figure. Very truly yours, FARMERS TRUST COMPANY @ib<:LtJ3~cvr7." '-V Olive Bolinger Supervisor Bookkeeping Dept. Balance in Acct. #1-25816-5 $174.08 $ 23.71 Balance in Acct. #2-0602-4 (Tamec Riding Club) DB/db .~>> /~ ~~n r"""""""" f'.~? \..~ lJ ~ '1 ..C:;,J MAIN OFFICE 331 BRIDGE STREET NEW CUMIJERLAND PENNSYLVANIA 17070 (717/230.()041 CCNU DANI<-. N.A. D^TE AUGUST 24,1978 JAllliS R RUMER ATTORNEY AT LAW FARMERS TRUST BUILDING ONE ~~T HIGH STREE~ CARLISLE,PE~rr~. 17013 RE: !STJ.TE OF Dt. T.. }.. }rTITEH GENTLEMEN: The following is a list of accounts that we have in our bank. TYP~ OF ACCT. ACCOUNT NO. OPEN DATE DUE DATE BALANCE ACCR. INT. SAVINGS 076-028984-3 ~uv.66 $28.13 DORMA.NT*NO INTEREST NAMES ON THE ABOVE ACCOUNT If we can be of further assistance, do not hesitate to write. Very truly yours, b6vt97 );;?~ Dorothy Morrette Savings Department Head DEEHFIELD BEACH STATE BANK . ,,' ,.. ,.. ,.. MEMBER FDIC 225 SOUTH FEDERAL HIGHWAY, DEERFIELD BEACH, FLORIDA 33441 TELEPHONE (305) 428-3000 RICHARD R. MONTGOMERY VICE PRESIDENT AND CASHIER July 6, 1978 Mr. James R. Humer Farmers Trust Building 1 West High Street Carlisle, Penna. 17013 Re: Estate of Dr. T. A. Miller Checking Account No. 306-287-7 Dear Sir: In reply to your letter of June 23, 1978, be advised that the balance in the reference account as at June 2, 1978, was $8.72. If we can be of further assistance, please do not hesitate to advise. Yours truly, .~ I ~, /) If, - ~'.'ltW. f \!1?---' Richard R.' Mon~omery Vice President and CAshier RRM/pef : I ' rJ / : I..;, ~. , ,; ( Savings & Loan Association of Harrisburg June 27, 1978 James R. Humer Attorney at Law Farmers Trust Building One West High Street Carlisle, PA 17013 Re: Estate of Dr. T. A. ~liller Account #614-37293-6 Dear Mr. Humer: The above account is the only one Dr. Miller had with our association. The balance in the account at date of death was $311.84. Accrued earnings to date of death were $2.84 making the available bclance $314.68. Enclosed is a withdrawal slip for use by the Executrix in collecting the funds. We also require9to close the account, a short certificate neming the Executrix. Sincerely, ~.,.;, k4.0~ Lois 1'1. Coover Assistant Vice Fresident Dee: jrh 234 i'-JORTH SECOND STREET. P. O. BOX 1111 . HARRISBURG, PA 17108 . (717) 232.6661 .:~f[Fee1 FIRST FEDERAL B OF BROWARD flPST July 13, 1978 James R. Humer, Attorney at Law Farmers Trust Building One West High street Carlisle, Pennsylvania 17013 Re: Estate of Dr. T. A. Miller Our Account No. 5-18086-5-09 Dear Mr. Humer: According to our records, we find only the above account open at this date. It is a single account in the name of Dr. T. A. Miller. The balance at the date of death June 2, 1978 was $84.78 which inaluded interest through May 31, 1978. Interest from June 1 to June 2, 1978 would have been $.01. We are enclosing a withdrawal slip for use by the Executrix; but in addition to the signed withdrawal, we will need a death certificate and a letter of testamentary both with raised seals in order to complete the transaction. We will also need the passbooko Upon receipt of the above named items, we will give this matter our immediate attention. Sincerely, - \-~ ) u7-- ;( 6,-: > L/{l . /J C A ~ ( c f_. Kathleen O. Bissell Savings Officer KO:a/cak Enclosure FIRST FEDERAL SAVINGS AND LOAN ASSOCIATION OF BROWARD COUNTY 1000 South Federal Highway. Deerfield Beach. Florida 33441 . Telephone (305) 427-8200 ~ LEND!!" JAMES R. RUMER ATTORNEY AT LAW FARMERS TRUST BUILDING ONE WEST HIGH STREET CARLISLE, PENNA. 17013 (717) 243-a831 June 23, 1978 Mid Penn Bank 349 Union St. Mi11ersburg, PA17061 In Re: Estate of Dr. T. A. Miller Date of Death - June 2, 1978 Account No. 301-959-3 Gentlemen: I am the attorney for the above estate and request from you a certification over the signature of an authorized officer of your institution stating the balance in the above accountt or accounts as of the date of the decedent's death including interest to the date of death if credited. I would expect to furnish a copy of your letter to the Pennsylvania Inheritance Tax Appraiser for taxation purposes. If there are other accounts in your institution in the name of the above decedent, I would appreciate similar information with respect to them. In the case of a savings account, I would also appreciate a withdrawal slip for use by the Executrix in collecting the assets of the estate. Thank you very much for your helpfulness. ~ery truly yours, " '- /-' '/ I \ ,/ ....-yrl-i/.1- ?\ . (-.;.-c -'-7 ......'-.-'_"''\....., .~- /James R. Humer i,r:? G'_ JRH : sa / / Balance in his account as of 6-2-78 $34.09 ' 'yy].J-t t.-.~..A )..'"I.......j J.;..u . "C (~~,~v Mid Penn Bank Dalmatia, Fa. 17017 ,"'"","."'". rth i,; ~'.~ : "4. ~'~'<';.:W no ern ! central bank '1(,~ Q.O (lA Sunbury, Pennsylvania 17801 286-6751. Fort Augusto 286-7136. Northumberland 473-3593 June 30, 1978 James R. Humer, Esq. Farmers Trust Building One West High Street Carlisle, Pa. 17013 Re: Estate of Dr. T. A. Miller Dear Mr. Humer: Your letter of June 23 was received regarding the above. Please be advised that Dr. Miller, at the time of his death, had a balance of $395.55 in his checking account #208-852-4. His savings account #35831-7 had a balance of $82.06 with accrued interest of $.75 as of that date. In accordance with your request we enclose a savings withdrawal slip which we have not filled in the amount since savings accounts accrue daily. In the event the Executrix plans to close the account, please have her sign the withdrawal slip and we will complete the total balance at the time that the account is closed. If you have any further questions in this matter please advise. At the time of forwarding the withdrawal slip we would also ap- preciate receiving a copy of the short certificate for our file. Sincerely yours, / / (.l~) / _,. / j. ." ',f (\. "- - -)()>; ).-... _/ -.~ George A. Park Vice President GA~:psm Encl. .) ~.) re..:':!:: . t.~ tor' A '" ~ r"cl.~O [.'.-: II! , VI.'~" PN'B BAN~ CARD 51' A TEMENT Please detucff. and.ret(/rn this par, t,on with your remittance payable to Philadelphia National Bank. Do not remit cash. 0.00 0.00 06/14/78 0.00 4261 360 127 918 $ Plea:ie indicate amount paiq I I MINIMUM PAYMENT DUE PAST DUE AMOUNT PAYMENT DUE DATE NEW BALANCE ACCOUNT NUMBER INDICATE NAME AND. OR ADDRESS CHANGE(S) BELOW. ~ ~ A MILLER PO BOX 377 HERNDON PA 17830 ~ I 426136012791800000000000000 ACCOUNT NUMBER CREDIT LIMIT AVAILABLE CREDIT DAYS IN MUNG CYClE BILLING DATE PAYMENT DUE DATE MINIMUM PAYMENT DUE 4261 360 127 918 500 500 30 05/18/78 06/14/78 0.00 REFERENCE NUMBER CHARGES, PAYMENTS AND CREDITS SINCE LAST STATEMENT 401042507000068 REDIT BALANCE REVERSAL PHILA PA AMOUNT 12 8 I I I I I I I I I I I CREDITS I I I I I I I I I I I I I ! I .L....-./ P.AYMENTS NEW BALANCE A FINANCE CHARGE will not be charged for new purchases recorded on this statement if there is no Previous Balance for either Purchases or Cash Advances (after deduction of Payments and Credits) on the Billing Date shown below, and the amount of the New Balance 'is paid in full within 25 days of the Billing Date (i.e., on or before the Payment Due Date,) '. AN AMOUNT FOLLOWED BY A MINUS (-) IS A CREDIT OR A CREDIT BALANCE UNLESS OTHERWISE INDICATED, WE Of fiNANCE CHARGE ~.., 18.I..AMIRlCARO.! E.:;..", 'C' ,~. :~ Pf:llAOm::iA NATlOiiAL BU;K [n;;: Cl.nD STATEf.'.nlT ( 111-. ;:;':r_:~\'l,n?: :~''H~' ;. .' .'.' ..---....-.. \~~_!UiODIC WES (' 170:: 1:' 77 NOTICE: See Reverse Side for important Information. 9211228912 0000000000000 4000010182 'ACCOUNTfcOMPn:' ~'EXACO CANADA INC. BOX/CP 1400 DON MillS, ONTARIO M3C 2T9 4021 ESTATE OF T A MILLER C/O J R HUMER ATT. AT 1 WEST HIGH ST CARLISLE PENNA USA 170 13 DATE 12/01/78 LAW AMOUNT DUE 101.82- MONT ANT 00 000 DIRECT INOUIRIES TO ADRESSER LES OUESTIONS A H D MANSON (416) 443-7887 RETURN THIS PART WITH YOUR PAYMENT/REPLY RETOURNER CE COUPON AVEC VOTRE REMISE/REPONSE Dear Customer: We wish to thank you for your recent communication, and advise that our cheque covering the refund you request will'be mailed to you shortly, under separate cover. -,' We sincerely regret any inconvenience caused. Yours truly, TRAVEL CARD MARKETING cI'EXAC(') C~ANADA INC STATEMENT ACCOMPANYING CHEQUE RELEVE: ACCOMPAGNANT LE CHEQUE 5.57 (7-781 R I NO. 06457 8 ,: Refund of overpayment on Travel card account # 92 112 2891 2 $ 101.82 NOTICE THE ATT ACHED CHEQUE IS TENDERED IN FULL PA YMENT OF ITEMS STATED ABOVE. IF CORRECT DETACH CHEOUE. OTHERWISE RETURN BOTH CHEQUE AND STATEMENT. . AVIS CE CHEQUE COUVRE LE PAIEMENT TOTAL DES ARTICLES INO/OUES CI.OESSUS. 51 TOUT EST EN REGLE. OETACHER LE CHEQUE. SINON. RETOURNER LE CHE~UE ET LE RELEvt . . . . . U.S. SERIES "E" BONDS Mrs. E1izaheth C. Miller Cd e c e a sed 2/1/71) or Dr. Thomas A. Miller 25.00 Q 1 007 431 851 E 11/51 55.09 25.00 Q 1 008 674 380 E 12/51 55.76 50.00 L 231 358 656 E 1/52 108.26 50.00 L 231 259 553 E 1/52 108.26 50.00 L 237 289 375 E 6/52 108.10 50.00 L 237 291 660 E 6/52 108.10 50.00 L 237 472 965 E 7/52 108.10 50.00 L 237 474 906 E 7/52 108.10 50.00 L 237 751 738 E 8/52 108.10 50.00 L 251 899 006 E 8/52 108.10 50.00 L 251 901 180 F. 8/52 108.10 25.00 Q 1 051 400 051 E 8/52 54.05 50.00 L 272 253 996 E 10/53 105.50 50.00 L 272 555 150 E 11/53 102.44 50.00 L 550 861 879 E 10/60 83.54 50.00 L 550 864 685 E 10/60 83.54 50.00 L 571 041 583 E 11/61 81.58 50.00 L 571 044 459 E 11/61 81.58 50.00 L 594 200 583 E 10/62 78.02 50.00 L 594 204 102 E 11/62 78.02 50.00 L 596 027 692 E 11/62 78.02 50.00 L 596 031 646 E 12/62 78.32 50.00 L 597 101 289 E 12/62 78.32 50.00 L 597 104 931 E 1/63 78.32 50.00 L 600 273 687 E 1/63 78.32 50.00 L 600 277 299 E 2/63 78.32 50.00 L 603 896 015 E 2/63 78.32 50.00 L 606 810 241 E 3/63 78.52 50.00 L 603 899 994 E 3/63 78.52 50.00 L 603 903 567 E 3/63 78.52 50.00 L 606 814 083 E 4/63 76.22 50.00 L 607 554 840 F. 4/63 76.22 50.00 L 607 650 648 E 5/63 76.22 50.00 L 607 654 502 E 5/63 76.22 50.00 L 611 248 083 E 6/63 76.80 50.00 L 611 251 839 E 6/63 76.80 50.00 L 611 915 789 E 7/63 76.80 50.00 L 611 919 651 E 7/63 76.80 50.00 L 614 668 379 E 8/63 76.80 50.00 L 614 680 296 E 8/63 76.80 50.00 L 615 464 975 E 8/63 76.80 50.00 L 615 543 844 E 9/63 76.98 50.00 L 634 098 717 E 7/64 73.68 50.00 L 634 084 892 E 7/64 73.68 50.00 L 640 511 930 E 8/64 73.68 50.00 L 636 618 369 E 8/64 73.68 50.00 L 636 662 092 r 8/64 73.68 50.00 L 640 637 727 E 9/64 73.86 50.00 L 640 921 434 E 9/64 73.86 50.00 L 642 996 217 E 10/64 71.70 50.00 L 643 001 590 E 10/64 71.70 50.00 L 645 233 332 E 11/64 71.70 50.00 L 645 237 170 E 11/64 71.70 50.00 L 647 197 803 E 12/64 72.14 50.00 L 647 201 764 E 12/64 72.14 50.00 L 649 236 470 E 1/65 72.14 50.00 L 649 241 052 E 1/65 72.14 50.00 L 649 244 739 E 1/65 72.14 50.00 L 655 327 954 E 5/65 70.22 50.00 L 656 551 503 E 5/65 70.22 50.00 L 658 615 085 E 6/65 70.62 50.00 L 658 618 855 E 6/65 70.62 50.00 L 750 919 355 F 12/68 62.86 5043.46 , ." Lnetropolitan Life Insurance Company 609 C-545-SC (9-74) . . : , 1-2 210 " . 6... ,.. _ w . -.......--,...... Mideastern Head Offic, 500 Schoolhouse Rd. Johnstown, P,. 15916. THOMAS A Tr:\'1 rr.rnnl DEATH CLAIM H .0./0.0. No. 597 A..nc, Check Number No. 2502 98882 80~ 83ir056er 00697519l Suffix Date u.. Code C 8-31-78 253 Pay to the Order of: BEATRICE M CLAUS EXTRX ULWT OF THOMAS A MILLER, DECEASED $*1730*79 To The Chase Manhattan Bank, N,A. 33 East 23rd Street, New York, N. Y. II' 2 50 2 11 B B B 2 III I: 0 2 .0 II' 0 0 0 21: M-/.4 00 2 "' :}'" 0 0 bOg . III ~.t~ PItllll.1'l\t 1M 1)t6I1lI'U r'..,. ".1'. .' ,l~ .,~.,t I. '" . " .. ' ..~.1 .' t. f-r . .t.,.....L...,., The PrudenilallnsuriJnce ComJ1any of America Central Atlantic Home Office. Fort Washington, Pi!. 19034 General Account 24 CA 015 5 8 6 G",lfO odnk ....UADI'.....A,... :; Pay To Thl' ;-Jldcr Dote rsEPTEMBERb, 1978 Ot: BEATRICE M CLAUS EXECUTRIX** Exactly r*********128Dollars 64cenls $*****128.64 J) () ..:: "1 o Insured I THOMAS A MILLER Policy 120 061 172 .... o Sem To ;- bLATH.I CE-M-'CLA'lis EXECUTRIX :~ C/O JAMES R HUMER 1 ~l HIGH STREET I CARLISLE PA 17013 , IS$Ul:u '" 'E""~l"';':"t- GF I.lt ,r li) h~l:hlfU f n'.... - -, "/ 1/ )I,,~'-';.-I"',- LJidL~~L'~__ , ----.-_. _. =~--r. ~ '-===_.:.:::::.:~ -~-~ ~;, :;:~_ - ~- ~?~~~<~:2i~:~_~~~,--J ....-P. ,.,.... ;:.fP.... -- -4 ...,'" II- 0 . 5 5 B b II- I: 0 ~ . 0 III 0 0 0 ~ I: 2 III g . ~ B 0 L, III ~ i r-.I' Pr""'l' "1':11 In~,tJr(lnC(1 Compnnv ot AmnrlCit .,'1,,' I; J\'d"nlh HUn'H' uflle!: ....,':.1 OIIIL(! Ud)o. :380, FOlt Wa-.:;tll'l{JltHl. p,: i,,;i:i.. 2~CA 668:5 L~ 2 MI'llun (j'ill;'-. r-." A P111:...hlJlQil I'd ; SE P-Ol-1978 ?ay r $- I-X--HUNDR-E-O-iENAND26T1-0-0-0-0llAR-S*-- I , l>i..ft. -L ____._ _ __ _ _ Amount/S***610.26* I I L:: r. o To the r - ..---. Ord\!r Of I BEATRICE M CLAUS EXECUTRIX OF* 1THOMAS A MILLE~* *** Insured Policy No. 41 188475 T MILLER 091333199 1404 0608342 Q _ -:~;....--r';~,,:, --=..-~~ ~:,;.:.-:~~--'~:, ..--."..,-- -. .. -~ _! ....---: .-:;:-:.. ~--':-~-"----~ :~:\..._.... .~.. ~------"''-'-~:~~-''._''''--'----~''''~ _.... ~-----' 1 .---".- "..- -- .. "-~.-' ....... , , - .... . III b b B :} L, 2 III I: 0 L, :} 0 II. 0 0 2 b I: o 0 3 III 5 g b 7 ul \ . ~...'" ~ Address W Sri 'ilL' PmdentJal The Prudential Insurance Company of America Central Atlantic Home Office Post Office Box 631. Fort Washmgton. Pa. 190342 Kl4 7 b F 0 51 b ** b 15 MIll Check number D240 0179376 I Statement of I I dENEFIT Name of insured Policy number Date THOtoiAS A f'1! LlE K 2, :.; b 1 172 AUG 2 LlJ :., ~ -/c INCLUDED AMOUNTS $1b.....,1. .n.. 5.447.74 31.,1.20 ]'26.G3 1'11.5'1 FAC~ AI~IOUf\jT OF I,\iSUi{Ai'\Cc P~IO-U~ AuDITiUNAl IN~UKANC~ TE~Ml~ATlGN DIVI~~ND peST MJRTE~ DIVlu~NO PR~MIUM AJ~USTM~~T c. c. ), f b . b '-I 333.15 ~M0U~T OF THIS PAYhE~T li'JTt:KEST A,"ldui'. T Of CHECK $C:2. 439.7'1 IF THE Df~fAS(O JAS NAM~D AS btNEfICIAkY UN eTHER IN~URANCl, A NEW nENEfICIA~Y Srl~UlJ dE DtSlGNATEO ~ITriuuT DELAY. UNITc-l} SrATi:;) suCIAl SECURiTY IlR CANAUIAI'~ SLClt.l INSUKA,'.C;:: bl.::i\i....rll.::. ,'uW Al::.u rlE uuE. ~O~ INFORMATION, CONTACT THE APPkUPkIATE AGENCY IN YGU~ l~L~llTY. ('.' I<.!. '0' :~I - 'co: il:;: 'cr-; 10 L. , PlrASF DETACH "Hi:CK dEFORE CAS.dNv Ai\iU KeEP THIS STATEMENT FUR YUUK KI.:~LJ''-'" ~. ,. . ! r ""-'; pr' ~ ,..~\ ,.,", _..-~ ~;..# ~'. ...,'" j. ..:.-:;~' [' i ,'" __ :: ....--...-- .~_....- The PrudentIal Insurance Con1pany of AI1H!rICil C""I,,,I Allilf,IIC Home OffIce. Fort Waslllf)(Jton. p" 1 9034 40 CA 01 7 9 378 FIl:,1 1"'IlII',\!I\ tll',j ILlIl' I\^ J'iU!.I<I,'lphld. f',1 JATc AUl1 ~ ,~ " ..,J /~ PAY Hi TMb ri<.IJt:R I)f dEAlldCE M CLAU~ lXi:Cul,dX ul- T h,),1Ij A S A I\;; ILL;:: r{ * ,,:,** EXACflY **::<*rvh:...TY r...ll TrlljUS~j"u FUiJl\ HUi.~i"lJ Tnl"TY**** ::y.>;<**;Hi-lE DUllAKS Ai...J 7c, Ctl...TS-'r..;c~,~, Ii C' .-: * .....-! .:. . 4 ..J -.. " <f n: PUlley ~', ~, c., ;:, t..:J.lJ 1-/2 Guu .:. u'-i74 C/l) I"IANAl~C'< , ,j .s rl III 0 ~ ? g :1 ? B III I: 0 j ~ 0 "' 0 0 0 21: =(/' ~~t::,- :-=-- ict~ -' P -!~l- \.. "... - (A.:.n - ~ =.::-~. ~;: ~7 a. p -j. . ":~~:~:"'-rr~C~~r"1"'f.'\~~ ~,..... AUDIT !~M.J^GER o ? ? 1I',~t.~D'I"ib-il. 1'0 1(. '. I": ~ \ , ..... " . VETERANS ADMINISTRATION INSURANCE AWARD ST ATEMENT - GOVERNMENT LIFE INSURANCE INSURANCE FILE NUMBER PAYEE POLICY NUMBER TYPE OF PAYMENT CLAIM NUMBER F V 1 75 39 1 V 17539 PRINCIPAL BENEFICIARY AblARD XC 131f141f72 Always show the above identifying numbers when corresponding with the Veterans Administration re- garding your claim. . BEATRICE M CLAUS EXEC EST OF THOMAS A MILLER P 0 BO X 2 CARLISLE PA 17013 Please send all correspondence including change of address to the office shown below. Keep this document with your other personal records. Veterans Administration Center BOX BD79 PHILADELPHIA PA 19101 SEPT 17 1978 AMOUNT OF THIS INSURANCE POLICY ADO ITIONAL YOUR SHARE INSURANCE (PAID-UP) AMOUNT OF THIS IN- SURANCE AWARD * PREMUvI REF'lNl DIVIDEND DIV. INTEREST TOTAL DISABILITY PAYMENTS DUE OTHER 1,661. 5 PLUS ADDITIONS ADDITIONS ~ 31f. 0 PREMIUM DUE LIEN LIEN INTEREST PRIOR PAYMENTS TOTAL DISABILITY OVERPAYMENTS 34.80 LESS DEDUCTIONS DEDUCTIONS ~ THE TREASURY DEPARTMENT WILL SEND YOU A CHECK FOR THIS AMOUNT 1,69k.25 *THIS IS A ONE SUM PAYMENT. VA FORM 4-5851, APR 1973 SUPERSEDES VA FORM 24- 5851. MARCH 1967. WHICH WILL NOT BE USED PAYEE , VETERANS ADMINISTRATION INSURANCE AWARD STATEMENT - GOVERNMENT LIFE INSURANCE INSURANCE FILE NUMBER PAYEE POLICY NUMBER TYPE OF PAYMENT CLAIM NUMBER F V 1 75 39 1 V 6006583 PRINCIPAL BENEFICIARY AWARD XC 1341~"'72 Always show the above identifying numbers when corresponding with the Veterans Administration re- garding your claim. . BEATRICE M CLAUS EXEC EST Of THOMAS A MILLER POBOX 2 CARLISLE PA 17013 Please send all correspondence including change of address to the office shown below. Keep this document with your other personal records. Veterans Administration Center SOX 8079 PHILADELPHIA PA 19101 SEPT 17 1978 AMOUNT OF TH IS INSURANCE POLICY ADDITIONAL YOUR SHARE INSURANCE (PAID-UP) AMOUNT OF THIS IN- SURANCE AW ARD * PREMILM REF'lNl DIVIDEND DIV. INTEREST TOTAL DISABILITY PAYMENTS DUE OTHER ADDITIONS ~ PREMIUM DUE LIEN LIEN INTEREST PRIOR PAYMENTS TOTAL DISABILITY OVERPAYMENTS DEDUCTIONS ~ THE TREASURY DEPARTMENT WILL SEND YOU A CHECK FOR THIS AMOUNT *THIS IS A ONE SUM PAYMENT. .' RCC- % L'l)MMlr\VVl:'AL~']{ lW l'E\'N~YIYj\NI!I. T'tA\~F~'i~ I:\FF:IUTl>\'CF TAX SCHEDULE "e" T J\ \N c.: F1;~ns i,ESlnE'IT nFCEnl~\T (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without receiv ing 11 valuable ar.d adequate consideration therefor? (Answer yes or no) No (2) Did rtecedent, within two years of death, transfer property from himself to himself and another or (,t hers (includi ng a spouse) in j oint ownership? (Answer yes 0 I' no) No (3) If the answer to (1) or (2) above is in the aff'irmatj-ve state: (a) Age of decedent at time of transfer NLA (b) State of decedent's heal th at time of making the transfer. (Note 1). (c) Cause of decedent's death. (Note 1). (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no) No (a) Was there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition? (Answer y'es or no) No (b) What was the transferee's age at time of decedent's death? NI A (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a) The possession or enjo.~ent of or the right to income from the property transferred? (Answer yes or no) NO (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) No (0) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others N/A . (7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor? (Answer yes or no) Nn (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserved power to al tel', amend, or revoke, or which COllld revert to decedent under terms of transfer or by operation of law? (Answer yes or no) No (9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no) Nn NOTE 1: The answers to these questions should be supporterl by affidavit by the atterHUng physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transferred, it's fair market value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based. NOTE 3: List applicable property below in manner in which provided in Scherlules A, B, or E. ITEM DESCRIPTION MARKET VALUE (Es tima ted) DEPT. VALUATION (Dept. Only) None Insert this totr!l opposite "Transfers", Schedule "C" in the "As Reported" colunm on the] ast page of this return. IV 6-'it~-, ~-9;1r: ;, .~ , : '. 3lLasl 3~t1Iill altO cr~slantPltt I, T. A. MILLER, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my last will and testament, and revoke all wills which I have previously made. I I give and devise my farm with the improvements thereon erected, situated in North Middleton Township, Cumberland County, Pennsrlvania, known as Tamec Farms, unto Bethel AME Zion Church, Shiloh Baptist Church, and West Street AME Zion Church, all of Carlisle, Pennsylvania, as tenants in common, in fee simple, upon the condition that the said property shall never be sold or encumbere or become subject to the lien of unpaid real property taxes, municipa or similar assessments, and upon violation of this condition all righ , title and interest of the devisees previously named shall cease and determine, and title to said premises shall thereupon vest automatic- ally and without action of my executor, to the Township of North Middleton, to be used upon the following conditions upon vesting of title in the Township: A. That it shall be devoted forever to public recreational use, with preference given to local horse shows so far as practicable. B. That it shall forever bear the name and be known as Tamec Farms. C. That a stone marker, similar to that erected on the Carlisle Public Square for Jim Thorpe, be erected and inscribed to explain for future generations the origi of the name Tamec, an acronym composed of T.A.M. for Dr. T. A. Miller, and E.C. for his wife, Elizabeth C. Miller, and the year of my death. II I direct George Ebener Realtor and my executor to sell my residence at No. 531 North Pitt Street, Carlisle, Cumberland County, Pennsylvania, at public or private sale as it deems best, and the net proceeds therefrom to be held in perpetual trust by the First United Methodist Church, Carlisle, Pennsylvania, or its successor, 'I \ , r iI .. . the income to be paid to said church and to be used to provide colored covers for the church bulletins, said bulletins to bear the notation, "This bulletin is given to the church community in memory of Dr. and Mrs. T. A. Miller", to provide artificial flowers for the graves of my wife and myself eight times yearly on Easter, Memorial Day, Mother's Day, Father's Day, July 4, Labor Day, Thanksgiving and Christmas and having our grave marker cleaned every five years. Any remaining annual proceeds shall be spent as the church decides. III I give, devise and bequeath my cottage at Evangelical Camp Grove, Herndon, Northumberland County, Pennsylvania, and its contents to Beatrice M. Claus of 6S Main Street, Vineland, Ontario, Canada, for and during the term of her natural life, or so long as she continues to use and enjoy the same, and upon her death, or upon her written declaration of discontinuance of use, I give, devise and bequeath the same to the Seibert Evangelical Congregation I Church or its successor, for the express use of each pastor of said church or its successor church, during the pastor's tenure at the church. The church shall, at its own expense, provide and install a bronze plaque in full view where the present Dr. T. A. Miller bronze plaque is located, the new plaque to read "Donated to the Seibert Evangelical Congregational Church by Dr. and Mrs. T. A. Miller" and to include the dates of our death. IV I give and bequeath my fifteen shares of stock ln the Herndon Camp Meeting Association unto the Seibert Evangelical Congregational Church or its successor, absolutely, but all voting rights and privileges of said stock shall be vested in and exercised by the pastor of said church at that time. V I give and bequeath the sum of Two Thousand ($2,000.00) Dollars unto the Seibert Evangelical Congregational Church, Herndon, Northumberland County, Pennsylvania, in perpetual trust, the net income therefrom to be used for maintenance of my cottage at Evangelical Camp Grove, Herndon, Pennsylvania, devised by paragraph III of this will. ...~ 1 '1' t . II t t. VI I direct George Ebener, Realtor and my executor to sell my properties Nos. 155 West North Street and 631 North Factory Street~ Carlisle, Pennsylvania, and the contents thereof, and my mountain land situated in Henry's Valley, Jackson Township, Perry County, Pennsylvania, at either public or private sale and to add the proceeds therefrom to my residuary estate. VII I give and bequeath my coin collection, my India jewelry and Indian artifacts to the Cumberland County Historical Association absolutely and request that the same be displayed in the Hamilton Library, North Pitt Street, Carlisle, Pennsylvania, and bear a visible plaque stating "From Dr. T. A. Miller Estate." This plaque shall be added to the display within six months of my demise or the collection shall be sold at public sale and added to my residue. VIII I give and bequeath my motor home to Eloise Goodhart of Walnut Bottom, Pennsylvania. IX I give and bequeath any automobiles which I may own at the time of my decease, together with all insurance thereon, to Beatrice M. Claus. X I give and bequeath the sum of One Thousand ($1,000.00) Dollars to my wife's al;1nt, Thelma Neiles, of' Carlisle, Pennsylvania, if she shall survive me. XI I give and bequeath the sum of One Thousand ($1,000.00) Dollars to the Carlisle Band, Carlisle, Pennsylvania. XII I give and bequeath the sum of One Thousand ($1,000.00) Dollars to the following named individuals in the following order: Bryon Claus, Vineland, Canada Brenda McKenzie, Vineland, Canada Beatrice Claus, Vineland, Canada Vaughn Reid, Newville, Pennsylvania Dr. N. L. Plank, Carlisle, Pennsylvania William Wolfe, Carlisle, Pennsylvania Bob Dubrinski, Vine land Canada William C. Albertson, Jr., Bloomsburg, Pennsylvania Rev. I. Ray Berrian, Martinsburg, Pennsylvania Rev. Cecil Brown, Stayner, Canada Dr. C. H. Sharbaugh, Bethlehem, Pennsylvania Sam Watson, Jr., Carlisle, Pennsylvania Joan Shaver, Irvington, New Jersey Glenn Lytle, C;rlisle, Pennsylvania Rev. F. E. Remaly, Carlisle, Pennsylvania C. Richard Stover, Carlisle, Pennsylvania Heber Trometer, Herndon, Pennsylvania ( , . . , ." . ii, a . Edward Zierold, Weirton, West Virginia Rev. C. M. Beam, Herndon Camp Grove, Herndon, Bill Gamber, Orlando, Florida Rev. Wayne Good, Zepher, Canada Pauline Klucker, Duncannon, Pennsylvania Gloria Weaver, Carlisle, Pennsylvania James A. Miller, Fayetteville, North Carolina Mildred Albertson, Bloomsburg, Pennsylvania. I I pennSYIVanil I direct my executor to sell at either public or private sale all real and personal property not otherwise disposed of XIII by this will, and to add the same to my residuary estate. XIV I direct that my funeral shall be conducted by G. Book Roth, Funeral Director, if living, otherwise by the Ewing Brothers Funeral Home. XV I give One Hundred ($100.00) Dollars to each of th following named Shrine Temples for the Shriners Hospitals for cripple children: Rameses, Toronto Zembo, Harrisburg Mahi, Miami XVI All the rest, residue and remainder of my estate, I give and bequeath in equal shares per capita, to PTL Club, Charlott North Carolina, Jerry Foldwell's Bible College, Lynchburg, Virginia, Herndon Evangelical Camp Grove and Seibert Evangelical Church, Pennsylvania, all ln memory of Dr. and Mrs. T. A. Miller. XVII I appoint Beatrice M. Claus, Vineland, Ontario, Canada, as the Executrix of this Will. In the event that she pre de- ceases me, then I appoint Farmers Trust Company of Carlisle, Pennsylvania, as Executor of this Will. I have hereunto set my hand and seal IN WITNESS WHEREOF, da y 0 f "'711- .c&;~ () 1978. (\ ' '\ \\ !\ ~\\ 1\ ) I ,.-- '\; V . \i \) \. \j ( , I (SJi L) this ~ ~~. I I \ I !Signed, scaled, published and ueclared Iby T. A. Miller, testator above named, as and for his last will and testament, written on four sheets of paper, in our presence, who, in his presence, at his request, and in the presence of each other have hereunto subscribed our names as att~sti,nJ witnesses: 'J (/ _ ~ .<',- ,_ . /-r). . "'_ __{ '." , (' ..' '..: C..:' ."t-/ /" . , "- ',-~-- ,If /;,'1j/pJ~ ~-v-i , 4 ,.. ~ REV-4513 (!l'.1'<!)" . COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELA TIONSHIP I (State full names and addresses of all who (Kstep-children or SUR VIV ED DATE INTEREST OF have an interest, vested, contingent or other- ilIegi tima te children DECEDENT OF BENEFICIARY wise, in estate) are involved, set STATE YES BIRTH IN ESTATE forth this fact.) OR NO Beatrice M. Claus Wife Yes 6-8-19 1/2 eSTate Box 155, Vineland, Ontario, Canada LOR-2CC Bethel AME Zion Church - -- - - - - -- 1 Shiloh Baptist Church - -- - - - - -- ] 117 T::Jmp.C'. F::JTm West Street AME Zion Church - -- - - - - - - ] Carlisle PA 17013 First United Methodist Chure h--- - - - - - - /2 531 N. Pitt St. Carlisle, PA 17013 EvanQ"elical Camn Grove - - - - -- - - - 12 rnt-t-~cre (, content Herndon PA 17830 Seibert Evangelical Congre- - -- - - - - -- /2 Herndon Camp Mtg. gational Church, Herndon, FA 17830 As sn. shares + 1000. Cumbo Co. Historical Assn. - -- - -- - - - h/7 rnin rnllprt-inn F.. Carlisle PA 17013 Tnc'li~n .Tp.wplrv pTr Eloise Goodhart Not related Yes N/A \K_..._~ Hnmp. Walnut Bottom, PA 17266 Thelma Neiles Wife's Aunt Yes N/::J 17 n-F lonn nn c'arlis1e, PA 17013 r.arlisle R::Jnd - -- _. -- - - I? n-F lonn nn 25 named individuals Brother & Non- YP.S N/A /7 nf lnnn.oo each relatives 3 Shr ine Temnles for Shriner 's Hospitals - -- _. -- ./2 of 100.00 each PTL Club - -- - -- _. -- ./4 residue Charlotte. N.C. Jerry Falwell's Bible ColleQe - -- - -- - -- 1/4 rp.sic'lllp. LvnchburQ". VA Herndon EvanQelical Camp - _.- - -- - - - ./4 residue Sp.ihp.rt EvanQ"elical Church - _.- - -- - -- /4 residue Herndon. PA s Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE None "i ... ..)I:.... . REV-454 (4-79) COMMONWEAL TH OF PENNSYLVANIA BUREAU OF EXAMINATION INHERITANCE TAX SECTION SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRUCTIONS: This schedule must disclose all property, real and personal, owned b the decedent 'ointl with another or others, including intangibles, standing in the name of the decedent and others. List real estate irst, as entireties, or joint tenants, giving brief description, as indicated under Schedule "A," plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of state real estate value in estate valuation colu!lln. Personal property should be listed as in Schedule "8," plus da te of acquisition, and the name, address and relationship (if any) of co-owners to the decedent. Description of Property, Date of Acquisition, Name Unit Percentage Es tate DEPARTMENT VALUATION Address and Relationship of Co-Owners, and Place Value Share Valuation (OFFICIAL USE ONLY) of Record of Instrument, where Real Estate. 8 ~ I~ ~ Value of Value of ~ ~ Entire Decedent's ~ ~ Property Interes t None INane Insert this total opposite uJointly Owned Property," Schedule uE" N 6-JL(J in the "As Re orted" column on the last a e of this return. ...~f( p p g / ,- " . .. . REV.IlIS FO+ (ll-SO) *' " Commonwealth of Pennsylvania Department of Revenue BUREAU OF FIELD OPERATIONS P.O. Box 2970 Harrisburg. PA. 17105 NOTICE OF FILING OF APPRAISEMENT IN YOUR REPLY PLEASE REFER TO Investigation Division Beatrice M. Claus 65 Main Street Vine1and, Ontario LOR2CO RE: Estate of County of File No. T. A. Miller Cumberland 21-78-0314 Dear Mrs. C1aur: You are hereby notified that the origin::!l appraisement in the estate of T. A. Miller has been filed in the office of the Register of Wills of Cumberland County on August 20 , 198L. Said appraisement reflects the following valuations: Real Estate Personal Property Jointly Owned Transfers Total 63,000.00 64,897.28 None None $12 T, 897 .28 As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable. As to any tax that remains unpaid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by this notice may object thereto within sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961,72 P.S. 2485-1001, P.L. 373. Date August 20, 1980 Signed P~A1"u'O./ tr/.t'Jld~f// Ti tl e Chief Appraiser NOTE: This is not a bill. . ,. , . INHERITANCE TAX SUMMARY SHEET . REV-484 EX+ (3-80) (BUREAU USE 0Nl~Y) File Number 21-78-0314 Estate Name MILLER, T. A. -_.- Date of Death 06/02/78 Socinl Security Number ~~ ----------- --. ~---- ---- "--------.- REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Cumberland , Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing retum at the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E" Dated: August 20, 1980 P /..0'..11 / A'lA'.J(a Hd ./ INHERITANCE TAX APPRAISER ADJUSTMENTS REMAINDE R APPRAISEMENT 1 CODE INVENTORY VALUE AS APPRAISED CODE (HARRISBURG USE ONLY) Real Property (Schedule A) $ 63,000 00 00+ 92+ Personal Property (Schedule B) 64,897 28 10+ Joint.Held Property (Schedu)e E) None 20+ Transfers (Schedule C) None 30+ TOT AL GROSS ASSETS 127,897 28 Less Debts and Deductions 40- 93- (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or RATE FACTOR PRINCIPLE VALUE CODE annuities. . . . . . . . . . . . . . - - 1 FOR USE OF REGISTER ONLY CODE COMPU,TATlON OF TAX T ax on $ -. 6% $ T ax on $ 15% $ Tax on $ $ T ax on $ $ T ax on $ $ Exemptions Total Estate TOTAL TAX $ INTEREST FROM TO $ BALANCE $ Less Credits DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT $ + $ - $ = $ + - :;: BALANCE $ INTEREST FROM TO $ BALANCE DUE S . .. .. .- .> REV.457 (1-80) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT ., .. INHERITANCE TAX APPRAISEMENT Estate of MILLER, T. A. File No. 21-78-0314 County Cumberland Date of Death 06/02/78 In the event thet any future interest in this estate is transferred in po.....ion or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for yeers, the Commonwealth hereby expr_ly reserves the right to appraise and a..... transfer inheritance texesat the lawful collateral rate on any such future interest. PROPERTY REPORTED BY THE ESTATE DEPARTMENT'S APPRAISED VALUE 1. TOTAL REAL PROPERTY - SCHEDULE "A" 63,000.00 2. TOTAL PERSONAL PROPERTY - SCHEDULE liB" 64,897.28 3. TOTAL TRANSFERS - SCHEDULE "C" None . 4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE liE" None TOTAL REPORTED PROPERTY 127,897.28 PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH TOTAL UNREPORTED PROPERTY None TOTAL GROSS ASSETS 127,897.28 LIFE ESTATE OR ANNUITY CALCULATION I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day with the Register of Wills. 1/J..ILIY./O / IflrJl"d ./ APPRAISER 08/20/80 DATE