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HomeMy WebLinkAbout06-02-08s 15056041147 REV-'1500 Ex (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 7 0117 3 PO 80X.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 166 O1 0162 11 24 2007 11 08 197L1 Decedent's Last Name Suffer Decedent's First Narne MI REMPER CHARLOTTE M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's Social Security Number THIS RETUI FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Retum ~ 2. Supplemental Retum 4. Limfted Estate ^ qa, Future Interest Compromise (date of death after 12-12-82) a g Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received Spouse's First Name MI 2N MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 3. Remainder Retum (date of death prior to 12-13-82) ^ 5. Federal Estate Tax Retum Required ^ ~ Decedent Maintained a Living Trust (Attach Copy of Trust) ~ D Spousal Poverty Credit ((date of death ^ between 121-9t and f-1-95) ~ 8. Total Number of Safe Deposit Boxes ^ 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number BRUCE C BANRENSTEIN 71.7 843 0961 Firm Name (If Applicable) MANIFOLD & B ANK E N S T E I N RIEGISTER OF WILLS USE ONLY First fine of address C7 ~ 4 8 SOUTH DUKE STREET .~c-O ° -~~, { •^~ Second line of address ern- _ ~ t7't 1 i tV , 7 .. ~~ C/a ~ ~ D City or Post Office State ZIP Code -t..t _ YORK PA 17 4 O 1 _~, ?~ _~ ~ _ ~^ :a •• ~___ : F't , 'r' ~f Correspondent's a-mail address: ' Under penalties of perjury, I declare that I have examined this return, inGuding accompanying schedules and statements,, and to the best of my knowledge and belief, correct and complete. DeGaration of preparer other than the personal representative Is based on ail information of which preparer has any knowledge. it is true , SIGNATURE OF~n1PE//RSON RESPONSIBLE FOR FILING RETURN DATE ~ S~ ~~ n ILL ~ Y/il,'l.~ia~ Slr., _DONALD L MILLER SR. „Z, 7 og ADDRESS ` 240 EAST LOCUST LANE, York, PA 17406 SI TURE OF PREP ER OT N REPRESENTATIVE DATE ,7~*~te„ ~ L___.:~ BRUCE C BANKENSTEIN s /l J/v~ ADDRESS 48 SOUTH DUKE STREET, York, PA 174012 Side 1 L 15056041147 15056041147 PA Inheritance Tax Return Signature of Additional Fiduciaries I KEMPER, CHARLOTTE M 121-07-01 MBER I I Under penalties of perjury, I declare that I have examined this return, including accompanying schedulers and statements, and to the best of my I 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 #2 Name Address1 Address2 City, State, Zip Date AL 719 PINETOWN ROAD PA 17339 51z~1?~~ ^ r t REV-1500 EX 15056042148 oecaa~,rs Name: C H A R L O T T E M K E M P E R RECAPITULATION 1. Real Estate (Schedule A) ..................................................................................... 1. 2. Stocks and Bonds (Schedule B} ...........................................................__............. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages & Notes Receivable (Schedule D} .............................__........................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E} .............. 5. 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested............ 7, 8. Total Gross Assets (total Lines 1-7) ................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ............................._........ 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................... 10. 11. Total Deductions (total Lines 9 & 10} ................................................................. 11. 12. Net Value of Estate (Line 8 minus Line 11) ........................................................... 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................._............... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13} .............................._......... ...... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X .00 0 . 0 0 15. 16. Amount of Line 14 taxable 9 9 $ 5 5 0 4 16 at lineal rate X .045 , . 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. t 8. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 19. Tax Due ..............................__............................__.... ........................__.............. ..... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 15056042148 Side 2 Decedent's Social Security Number 166 O1 0162 104,000.00 16,498.29 7,605.39 128,103.68 27,126.90 1,121.74 28,248.64 99,855.04 99,855.04 0.00 4,493.48 0.00 0.00 4,493.48 15056042148 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-0'1173 DECEDENTS NAME CHARLOTTE M KEMPER STREET ADDRESS 46 ERFORD ROAD CITY Camp Hill STAI"E PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit g, Prior Payments C. Discount 3. Interest/Penalty if applicable p, Interest E. Penalty 3,000.00 157.89 Total Credits (A + B + C) (1) 4,493.48 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theDVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (2) 3,157.89 (3) (4) (5) 1,335.59 (5A) (56) 1, 3 3 5.5 9 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :................................ ............................................. ^ a b. retain the right to dry ignate who shall use the property transfenred or its income :............................... c. retain a reversions interest; or ........................................................................................................... d. receive the promise for life of either payments, benefits or care? .............................._.......................... ^ a 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................__............................_...................... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death.?....... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................................ ^ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE (i AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §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 zero (0) percent p2 P.S. §9116 (a) (1.1) (ii)j. The statutedoes not exemota transfer to a surviving spouse from tax, and the statutory requirements for disGosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §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-1502 FJ(+ (8-98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 All real property owned solely or as a tenant In common must be reported at fair market valu6eir market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fads. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. (Ir more space Is neetletl, atltlitional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) ' RAv-1508 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 Include the proceeds or litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 FRONTIER CITIZENS TELECOMMUNICATIONS -REFUND 10.50 2 FULTON BANK -CHECKING ACCOUNT #0002-83568 -See Bank Letter Attached 7,283.58 3 GOLDEN LIVING CENTER -NURSING HOME REFUND 1,487.85 4 M Sz T BANK -CERTIFICATE OF DEPOSIT # 031003914480436 (JOINT OWNER - 2,161.25 RANDY L. MILLER IS DECEASED, 12109/05) -See Bank Letter Attached 5 SCHOOL TAX PROBATIONS -FROM SALE OF REAL ESTATE 129.60 6 VERIZON -REFUND 0.01 7 1978 PHOENIX AUTOMOBILE -SOLD AT PUBLIC AUCTION -See Statement 425.00 Attached 8 HOUSEHOLD GOODS - SOLD AT PUBLIC AUCTION -See Statement Attached 5,000.50 TOTAL (Also enter on Line 5, Recapitulation) I 16,498.29 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) R4v-1509 E,(+ (6-98) COMMON4NEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 H an auet was made Joint within one year of the decedenYa date o} death, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. TONYA L MILLER now LANTZ 719 PINETOWN ROAD Granddaughter Lewisberry, PA 17339 B. TAMMY L MILLER now MOMMA 835 WYNNEWOOD ROAD Granddaughter Camp Hill, PA 17011 C. KERRY L MILLER 8 HUMMELL AVENUE, APT. B Grandson Camp Hill, PA 17011 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOIN TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALOE OF ASSE e~ OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 G ~ ~~ ~~g FULTON BANK -SAVINGS ACCOUNT 2,243.22 50.000% 1,121.61 #4485-35933 -See Bank Letter Attached 2 B 5/1/1995 M Si T BANK -CERTIFICATE OF 2,1fi~1.25 50.000% 1,080.63 DEPOSIT # 031003914480444 -See Bank Letter Attached 3 C 5/1/1995 M & T BANK -CERTIFICATE OF 2,161.25 50.000% 1,080.63 DEPOSIT # 031003914480452 -See Bank Letter Attached 4 D 5/1/1995 M 8 T BANK -CERTIFICATE OF 2,161.25 50.000% 1,080.63 DEPOSIT # 031003914480460 -See Bank Letter Attached 5 A 5/1/1995 M 8t T BANK -CERTIFICATE OF 2,161.25 50.000% 1,080.63 DEPOSIT # 031003914480478 -See Bank Letter Attached 6 D 5/1/1995 M 8 T BANK -CERTIFICATE OF 2,161.25 50.000% 1,080.63 DEPOSIT # 031003914480486 -See Bank Letter Attached Total of Continuation Schedule ee attached page TOTAL (Also enter on Line 6, Recapitulation) I 7,605.39 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) ^ Rev-1509 EX+ (6-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT continued ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY DESCRIPTION OF PROPERTY ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH % OF DATE OF DEATH NUMBER FOR JOIN MADE NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR ALUE OF ASSE DECD'S VALUE OF TENANT JOINT JOINTLY-HELD REAL ESTATE. INTEREST DECEDENTS INTEREST 7 g 5/1/1995 M & T BANK -CERTIFICATE OF 2,161.25 50.000% 1,080.63 DEPOSIT # 031003914480494 -See Bank Letter Attached TOTAL (Also enter on Line 6, Recapitulation) ~ 7,605.39 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) CONTINUATION OF SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF CHARLOTTE M. KEMPER SURVIVING JOINT TENANTlS) NAME D. TODD L. MILLER E. MALISSA MILLER now SHETRON F. MARK A. MILLER G. DONALD L. MILLER, SR ADDRESS FILE NO. 21-07-01173 329 GARRISTON ROAD YORK HAVEN, PA 17370 1701A PETERS MOUNTAIN DAUPHIN, PA 17018 901 BRANDY AVENUE NEW CUMBERLAND, PA 17070 240 EAST LOCUST LANE YORK, PA. 17 4 0 6 RELATIONSHIP TO DECEDENT GRANDSON GRANDDAUGHTER GRANDSON SON REV-1151 EX+~12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached ~ 8,388.43 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 719 Pinetown Road DONALD L MILLER SR. TONYA L LANTZ Lewisberry, PA 1 733 Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 240 EAST LOCUST LANE City York State PA Zip 17406 Year(s) Commission paid 2008 5,970.00 See continuation schedule(s) attached 2. Attorney's Fees MANIFOLD 8< BANKENSTEIN 5,970.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip _ Relationship of Claimant to Decedent 4. Probate Fees 362.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Other Administrative Costs 6,436.47 TOTAL (Also enter on line 9, Recapitulation) 27,126.90 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) R9ty-7502 E)(+ (6-98) SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 Copyright (c) 2002 form software only The Lackner Group, Inc. (Form PA-1500 Schedule H-A (Rev. 6-98) F~ev-7502 EX+ (6-98) SCHEDULE H-B1 PERSONAL REPRESENTATIVE'S COMMISSIONS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF - (FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B1 (Rev. 6-98) R!v-1502 EX+ (6-98) SCHEDULE H-B2 ATTORNEY'S FEES continued COMMONWEALTH OF PENNSYLVANW INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF- _ _ __ __ _-_ FILE NUMBER __ KEMPER, CHARLOTTE M 21-07-01173 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B2 (Rev. 6-98) IYev-1502 EX+ (6-98) SCHEDULE H-B4 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 ITEM NUMBER DESCRIPTION AMOUNT 1 REGISTER OF WILLS -LETTERS OF ADMINISTRATION FILING FEES 260.00 2 REGISTER OF WILLS -WILL FEE 15.00 3 REGISTER OF WILLS -SHORT CERTIFICATES 12.00 4 REGISTER OF WILLS -RENUNCIATION FILING FEE 30.00 5 REGISTER OF WILLS - JCP FEE 10.00 6 REGISTER OF WILLS -AUTOMATION FEE 5.00 7 REGISTER OF WILLS -INHERITANCE TAX RETURN FILING FEE 15.00 8 REGISTER OF WILLS -INVENTORY FILING FEE 15.00 Subtotal ~ 362.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-64 (Rev. 6-98) ' Rev-1802 EX+ (8-98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN continued RESIDENT DECEDENT ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 ITEM NUMBER DESCRIPTION AMOUNT 1 CUMBERLAND COUNTY BAR ASSOCIATION -ESTATE ADVERTISING EXPENSE 75.00 2 LINDA PARRISH -NOTARY FEES FROM SALE OF REAL ESTATE 14.00 3 MARC ROBERTS -REIMBURSEMENT FOR TAX CERTIFICATION FOR SALE OF 20.00 REAL ESTATE 4 NEVIN B. RENTZEL -AUCTIONEER'S FEES FOR SALE OF HOUSEHOLD GOODS 1,966.35 5 NEVIN B. RENTZEL -AUCTIONEER'S FEES FOR SALE OF CAR 42.50 6 NEVIN RENTZEL -AUCTIONEER'S EXPENSE FOR SALE OF REAL ESTATE 3,120.00 7 RECORDER OF DEEDS -REALTY TRANSFER TAX EXPENSE FROM SALE OF REAL 1,040.00 ESTATE 8 THE SENTINEL -ESTATE ADVERTISING EXPENSE 158.62 Subtotal I 6,436.47 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-01173 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 DEBRA S. POPP, TAX COLLECTOR - 2008 COUNTY AND TOWNSHIP TAXES ON 130.25 BOTH REAL ESTATE PARCELS ($392.51) LESS PROBATIONS FROM ;SETTLEMENT ($262.26) 2 DOLAN OIL SERVICE -HEATING OIL EXPENSE 254.93 3 EAGLE ROLL OFF SERVICES -GARBAGE REMOVAL 55.18 4 ERIE INSURANCE GROUP -HOMEOWNER'S INSURANCE 343.00 5 GOLDSBORO E.L.H.P. -REFUSE AND ELECTRIC UTILITY EXPENSE 166.53 6 GOLDSBORO MUNICIPAL AUTHORITY -SEWER EXPENSE 160.49 7 VERIZON -UTILITY EXPENSE 11.36 - TOTAL (Also enter on Line 10, Recapitulation) I 1,121.74 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1573 EX+ (9-00) SCHEDULE J COM RNANIA ERET N ~ITA T C BENEFICIARIES NHE R AN CE TAX U RESIDENT DECEDENT ESTATE OF FILE NUMBER KEMPER, CHARLOTTE M 21-07-0 1173 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHAF2E OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not List Trustee s (Words) ($$$) I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. ~116(a)(1.2)] 1 TONYA L LANTZ Granddaughter 118 :SHARE OF 719 PINETOWN ROAD REMAINDER Lewisberry, PA 17339 2 AMANDA MILLER Great-granddaug 1/8 :SHARE OF 5 BUNKER LANE hter REMAINDER Etters, PA 17319 3 DONALD L MILLER SR Son 118 ;SHARE OF 240 EAST LOCUST LANE REMAINDER York, PA 17406 4 KERRY LEE MILLER Grandson 1/8 SHARE OF 8 HUMMEL AVENUE REMAINDER APT. B Camp Hill, PA 17011 5 MARK ALLEN MILLER Grandson 1/8 SHARE OF 901 BRANDY AVENUE REMAINDER New Cumberland, PA 17070 See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er sheet II. NON-TAXABLE DISTRIBUTIONS: _ A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) SCHEDULE J BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: CHARLOTTE M KEMPER 11/24/2007 166-01-0162 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 TAMMY LYNN MILLER now MUMMA 835 WYNNEWOOD ROAD Camp Hill, PA 17011 Granddaughter 1/8 SHARE OF REMAINDER 7 TODD LOREN MILLER 329 GARRISTON ROAD York Haven, PA 17370 8 MALISSA KAY MILLER now SHETRON 1701A PETERS MOUNTAIN DAUPHIlJ, PA 17018 Grandson Granddaughter 1/8 SHARIE OF REMAINDER 118 SHARE OF RF~IAINDI~2 Total 1 LAST WILL AND TESTAMENT OF CHARLOTTE M. KEMPER I, Charlotte M. Kemper, of York County, Pennsylvania, being of sound and disposing mind, memory and understanding and considering the uncertainty of life, do therefore make, publish and declare this to be my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments or writings in the nature thereof by me at any tame heretofore made. FIRST: I direct the payment out of my estate of the LAW OFFICES AMNIFOLD, LINEBAUGH 8 BAN KF.NSTEIN K, FENNSYLYANIA expenses of my last illness if any, my funeral expenses, and my j ust debts, the same to be paid out of my estate by my Executor hereinafter named, as soon as conveniently may be after my demise. SECOND: I give, devise and bequeath all of the rest, residue and remainder of my estate and property, real, personal or mixed, of whatsoever nature and character and wheresoever situate, of which I may die seized or possessed, or to which I am in any sway entitled at the time of my death, or over which I have any power of testamentary disposition unto my husband, Lester E. Kemper, if my spouse survives me by thirty (3Ci) days. ~ THIRD: In the event my spouse predeceases me or does iot survive me by thirty (30) days, I give, devise and bequeath X11 the rest, residue and remainder of my estate to the following, _n equal shares, share and share alike, or their issue per ~~8 ~~ . ( SEAL ) Charlotte M. Kemper -1- i stirpes, to wit: A. Randy Lee Miller; B. Tammy Lynn Miller; C. Kerry Lee Miller; D. Tonya Lorraine Miller; E. Todd Loren Miller; F. Malissa Kay Miller; G. Mark Allen Miller; and H. Donald L. Miller, Sr. FOURTH: I direct, empower and authorize my hereinafter named Executor, at his sole discretion, to Nell and convert into cash, any or all of my estate whether real or personal, wheresoever situate and whatsoever kind, which I may own or possess. FIFTH: I nominate, constitute and appoint Hugh D. Manifold to be the Executor of this my Last W=ill and Testament. SIXTH: I direct and request that any fiduciary under this my Last Will and Testament, shall not ]be required to enter bond or security of any nature whatsoever in any jurisdiction in which Such fiduciary may act. IN WITNESS WHEREOF, I have hereunto set my name and affixed my seal to this my Last Will and Testament which consists of three ( 3 ) pages this ~~~~ day of 1987 . LAW OFFICES ~~/( Ir/`4~ J P ( DEAL ) MANIFOLD, LINEBAUGH Charljj of/te M. Kemper/ & BANKFNSTEIN S S u / /~ ~ J t~ ~ /~J ~„~ IK, PENNSYLVANIA tt' I iG/' ! ~` -2- SIGNED, sealed, published and declared by the above- named Testator as and for the said Testator's Last Will and Testament in the presence of us who have hereunto subscribed our names at the Testator's request as witnesses thereto, in the presence of the said Testator and of each other. r LAW OFFICES MANIFOLD, LINEBAUGH & BANKFNSTEIN RK. PENNSYLVANIA -3- 65-000-01-75 241 South York Street 65-000-01-0021 Railroad Street THIS DEED MADE this ~~day of ~ ~ ~ , in the year Two Thousand Eight (2008), BETWEEN DONALD L. MII,LER, SR. and TONYA L. LANT~~, Executors of the ESTATE OF CHARLOTTE Ni. KEMPER, Late of Cumberland County, Pennsylvani a GRANTOR DAVID E. SCHLOSSER and GLENN E;. SCHLOSSER, of York County, Pennsylvania GRANTEE WITIVESSEI'H, that in consideration of One Hundred Four Thousand and 00/100----------------- -------------------------------------------($104, 000.00)----------------------------•-------------DOLLARS in hand paid, the receipt whereof is hereby acknowledged, the said Grantor, for Grantor, Grantor's heirs, personal representatives, successors, and assigns, hereby grants acid conveys to the said Grantee, Grantee's heirs, personal representatives, successors, and assigns, Parcel 65-000-01-007 - 241 .South York Street ALL that parcel of land situate in the Borough of Goldsboro, York County, Pennsylvania, bounded and described as follows: BEGINNING at a point on the east side of South York Street a distance of one hundred (100) feet north of the line between lands now or formerly of Malvin W. Brothers and Elizabeth S. Brothers and 1 land now or formerly of Lester A. Schlosser and Ella Schlosser and extending thence along the east side of said South York Street, North one and three-eights (1 3/8) degrees East, a distance of fifty (50) feet to a point; thence extending along land now or formerly of Florence Stough, formerly Emma L. Idail, North eighty- six and three-fourths (86 3/4) degrees East, a distance of one hundred fifty (150) feet to a point; thence extending along a twenty (20) feet wide alley, South one and three-eighths (1 3/8) degrees West, a distance of fifty (50) feet to a point; thence extending along other land now or formerly of Lester A. Schlosser and Ella Schlosser, South eighty-six and three-fourths (86 3/4) degrees West, a distance of one hundred fifty (150) feet to South York Street and the place of BEGINNING. UNDER AND SUBJECT, NEVERTHELESS to the express conditions and restrictions that not more than one single dwelling house shall at any time hereafter be erected on said premises and no dwelling house shall be erected the cost of which shall be less than $2,500.00; and no obnoxious or unsanitary out-building shall be erected or maintained on the premises; and no into:iicating liquors of any kind shall ever be manufactured or sold on the premises. IT BEING the same premises which Lester A. Schlosser and Ella Schlosser, husband and wife, by their Deed dated March 31, 1948, and recorded in the Office of the Recorder of Deeds in and for York County, Pennsylvania, in Deed Book 33-5, Page 4:Z2, granted and conveyed unto Lester E. Kemper and Charlotte M. Kemper, husband and wife, and the said Lester E. Kemper predeceased Charlotte M. Kemper, full title to said premises automatically thereupon vested in Charlotte M. Kemper, who died testate on NovE~mber 24, 2007, leaving her Last Will and Testamentary which was :probated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, to file No. 21-07-1173, pursuant to which Letters of Administration, C.T.A. were issued by the Cumberland County Register of Wills unto Donald L. Miller, Sr. and 'Ponya L. Lantz, Administrators of the Estate of Charlotte M. Kemper, Grantor herein. Parcel 65-000-01-0021 - Railroad Street TRACT 1• ALL that certain parcel of land, situate in the Borough of Goldsboro, in the County of York and State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the eastern side of a proposed public alley 2 twenty (20) feet wide, said alley lying between South York Street and the right-of-way of the Northern Central Ra:ilroad, and said point of Beginning being North seven and three--fourths (7 3/4) degrees East, a distance of fifty hundred fifty (550) feet from the northeastern corner made by the intersection of said alley with Newberry Street, and said point of Beginning being a continuation of the southern property line of other property now or formerly of the Grantees herein, which other property adjoins the western side of said alley; extending thence from said point of Beginning, along the eastern side of said alley, North seven and three-fourths (7 3/4) degrees East, a distance of fifty (50) feet to a point at lands now or formerly of Lester A. Schlosser and Ella Schlosser, of which the land hereby conveyed was a part; thence along said land now or formerly of Lester A. Schlosser and Ella Schlosser, South eighty-seven and three-fourths (87 3/4) degrees Ea:>t, a distance of one hundred thirty-eight (138) feet, more or les~~, to a point on the line of right-of-way of the Northern Central railroad; thence along said right-of-way of the Northern Central Railroad, South one-half ('~) degree West, a distance of fifty (50) feet to a point at land now or formerly of Lester A. Schlosser and Ella Schlosser, about to be conveyed to Wilbert H. Weirich and Norma I. Weirich; thence along said land about to be conveyed to Wilber H. Weirich and Norma I. Weirich, North eighty-seven and three-fourths (87 3/4) degrees West, a distance of one hundred and forty-:Four (144) feet, more or less, to a point on the eastern side o:f said proposed public alley, the place of BEGINNING. IT BEING the same premises which Lester A. Schlosser and Ella Schlosser, husband and wife, by their Deed dated December 14, 1953, and recorded in the Office of the Recorder of Deeds in and for York County, Pennsylvania, in Deed Book 38-I, Page 1~i4, granted and conveyed unto Lester E. Kemper and Charlotte M. Kemper, husband and wife, and the said Lester E. Kemper predeceased Charlotte M. Kemper, full title to said premises automatically thereupon vested in Charlotte M. Kemper, who died testate on November 24, 2007, leaving her Last Will and Testamentary which was ~grobated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, to file No. 21-07-1173, pursuant to which Letters of Administration, C.T.A. were issued by the Cumberland County Register of Wills unto Donald L. Miller, Sr. and ~Ponya L. Lantz, Administrators of the Estate of Charlotte M. Kemper, Grantor herein. TRACT NO. 2: ALL that certain parcel of land, situate in the Borouch of Goldsboro, in the County of York and State of Pennsy:Lvania, bounded and described as follows, to wit: 3 BEGINNING at a point on the eastern side of a proposed public alley twenty (20) feet wide, at the northwestern corner of land formerly of this tract, now or formerly of Lester E. Kemper and Charlotte M. Kemper, said alley lying between South York Street and the right- of-way of the Northern Central Railroad, and said point of Beginning being North seven and three-fourths (7 3/'4) degrees East, a distance of six hundred (600) feet from the northeastern corner made by the intersection of said alley with Newberry Street, and said point of Beginning being a continuation of the northern property line of other property now or formerly of Lester E. Kemper and Charlotte M. Kemper, which other property adjoins the western side of said alley; extending thence from said point of Beginning, along the eastern side of said alley, North seven a:nd three-fourths (7 3/4) degrees East, a distance of fifty (50) feet to a point at lands now or formerly of Lester A. Schlosser and Ella Schlosser; thence along said land now or formerly of Lester A. Schlosser and Ella Schlosser, South eighty-seven and three-fourths (87 3/4) degrees East, a distance of one hundred thirty-four (134) feet, more or less, to a point on the line of right:-of-way of the Northern Central Railroad; thence along said right-of-way of the Northern Central Railroad, South one-half (1/2) degree West, a distance of fifty (50) feet to a point at land notir or formerly of Lester E. Kemper and Charlotte M. Kemper; thence along said last mentioned land, North eighty-seven and three-fourths (87 3/4) degrees West, a distance of one hundred thirty-eight (138) feet, more or less, to a point on the eastern side of_ said proposed public alley, the place of BEGINNING. IT BEING the same premises which Lester A. Schlosser and Ella Schlosser, husband and wife, by their Deed dated ;august 8, 1957, 1948, and recorded in the Office of the Recorder of Deeds in and for York County, Pennsylvania, in Deed Book 49-Z, Paige 157, granted and conveyed unto Lester E. Kemper and Charlotte M. Kemper, husband and wife, and the said Lester E. Kemper predeceasE~d Charlotte M. Kemper, full title to said premises automatically thereupon vested in Charlotte M. Kemper, who died testate on November 24, 2007, leaving her Last Will and Testamentary which was X>robated in the Office of the Register of Wills in and for Cumberland County, Pennsylvania, to file No. 21-07-1173, pursuant to which Letters of Administration, C.T.A. were issued by the Cumberland County Register of Wills unto Donald L. Miller, Sr. and 'I'onya L. Lantz, Administrators of the Estate of Charlotte M. Kemper, Grantor herein. A1YD the said Grantor Will Warrant Specially the property hereby conveyer: IN WITNESS WHEREOF, the said Grantor has hereunto set the hand and seal of Grantor the day 4 and year fast above written. Signed, Sealed and Delivered in the presence of ESTATE OF CHARLOTTE M. KEMPER By: (SEAL) D nald L. Miller, Sr.,, Executor By: ~ (SEAL) o a L. Lantz, Executor I hereby certify that the precise residence of the grantee herein is cis follows: Attorney or Agent for Grantee COMMONWEALTH OF PENNSYLVANIA COUNTY OF YORK On this, the day of May, 2008, before me, a Notary Public, tide undersigned officer, personally appeared Donald L. Miller, Sr. and Tonya L. Lantz, Executors of the Estate of Charlotte M. Kemper, Deceased, who are known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purpose therein contained IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. Notary Public My Commission Expires: 5 ~. 4 1. ® P))A 2.~ PmFSA 3.~ Cmv. Urine. 6. Pile Number 7. Loan Number 8. Mortgage Ire. Case Number a.~ vn s.~ cmv. Ina. SCHLOSSER241 C. This form ie famished ae a statement of actual settlement coats. Amounts paid to and by the settlement agent are shown. Itame marked (p.o.c) were paid outside the cloeiag; they are ehowa for infoxmatiaaal puzpoese and are not included in totals. D. Name and Addreee of Borrower H. Name and Addree• of Seller F. Name and Addraes of Leader David E. Schlosser Charlotte M. Kemper Natio):lal City Mortgage Glenn E. Schlosser Estate a Division of National 33 North Main Street C/o Bruce Bankenstein City ]3ank Manchester, PA 17345 48 South Duke Street 3232 ]Vewmark Drive York, PA 17401 Miamisburg, OH 45342 A. SettlemeIIt Statement U.B. Dspartmest of Hmeing aRd Vrban Development OMH No. 250T-0265 H. Type of Loan G. Property Locatlm 241 South York Street Etters, PA 17319 Goldsboro Borough, York County Marc Roberts, Esquire Place of settlement 149 East Market Street York, PA 17401 I. Settlement Date 05/06/08 J. BONMXRY. DP apR6OWERt6 TH7tN3ACTYq'Zii;:,,,, ... : ... -; ,. tG ": $I)l1J4AIi8 pp.9$LL712'8 TRANSACTIf?N: :: .:. 100. GROSS AMRUtri! DE?k ~ $.4k~R9;........:; : '. £ iCQ~„ ~1G$sT+l~?t~:.h9~ "Ce: eISF,4~F. - :~. . 101, Cc4stract salsa price 104,000.00 401. Cmtract sales price 104,000.00 102. Perecsal property 401. Peremal property 103. Settlement charges to borrower line 1400) 5,666.88 403. 104. 404. 105. 405. Adjuetmeate for items paid by seller is advance Adjuetmeste for items pald by seller is advance 106. City/town taxes 05/06/08 to 12/31/08 41.41 406, City/town taxes OS/O6/OB to 12/31/08 41.41 107. County taxes 05/06/08 to 12/71/08 220.85 407. County taxes 05/06/08 to 12/31/08 220.85 108. Assesamente OS/O6/OB to 06/30/08 129.60 408. Aceeaememte 05/06/08 to 06/30/08 129.60 109. Sewer 5/6-6/30/08 69.51 409. Sewer 5/6-6/30/08 69.51 110. 410. 111. 411. 112 412 120. 'GR08S AH6V}Yt DUk YRdM H41RRbiYEI ~ ~~ 110,128.25 t: d. '6'Rb~3 AH0Y3NT SIDE TO SEE,LH7z -~ 104,961.37 xoo. AMOUNTa PAID ~Y DR 4?.::~.#~#d',. ,~ $?!'f~= ~4, ..it~Dtrci°tbNt#.~.7u+Rtttr#" DI~.:CO B~.LLE9 201. Deposit or earnest mmey 10,400.00 501. Hxcaes depoelt(see Instru<:tims) 202. Principal amount of new loan(s) 103,184.00 502. Battlement charges to sel7.er(line 1400) 4,416.22 203. Sxieting loan(s) taken eubj set to 503. Existing loan (e) taken euk>j sct to 205, 504. Payoff of first mortgage 7.000 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. Adj ustmants for items unpaid by seller Adjuetmeste for items 'unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to 212. Aseeesments to 512. Aseasamenta to 213. 513. 214. 511. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. :; -220 TOTAL PAID flY1PD$ D:ORR4P($R -: ~~ G~.... ~ 113,584.00 6.cG. T ,EW.~~:%CTJ.vJ: A::WUNT DUB .s$LLER 4,416.22 300. C.48pAT 88'FTLBMBNT PR4'df/T41 > ~~ 600. CAHH AT yg'1'fI.EMENT .TO/PROt4,SHLLER 301. Grose amont due from borrower(liae 120) 110,128.15 601. Grose amount due to sell e:c(line 4201 104,461.37 302. Leee amount paid by/for borrower(line 220) ( 113,584.00 ) 602. Lss• reductlm amount due seller (line 520) ( 4,416.20 ) 303. CA.9H-(~ F'AOM) E~% IY3) ,Htlxa.C)VER'. 3, 455.75 603. CASH (® TR) (© i•ROM) SELI,EFY 100, 045.15 Ths informatim emtained is Slmka H, G, H sad I and m l:iae 401(or, if line 401 ie asterisked, lines 403 and 4041 i^ important tax informatics and ie being furnished to the Internal Revenue Service. If you are required to file a zetura, a negligence penalty or other eanctim will be imposed m you if this il:em ie requited to be reported and the IRH detaxmissa that i[ hoe not been reported. NUD-1 9HTTLSNBNT 9TATHMENT ® Computer Services sad Consultants 1-703-665-0800 WARNING: It ie a crime to knowingly make false etatemeate to the United states SETTLF'sMENT STATEMENT on this or any other ^imilar form. Penalties upon conviction can include a fine PAGE 2 and imprisonment. Por details see: Title 19 U.B. Code 9ectlan 1001 R 1010. L. ~SSTTi:~MENl' CHA1iOi?s ~ - "' ~ PAID FROM PAID FROM 104,000.00 • 3.04 $ ],130.00 700. TOTAL eAL83/HROEER'9 COMMISSION based on price $ BORROWER'S 9ELLBR'9 Divisim of commission (line 700) ae Follows: FUHI13 AT FUNDS AT 701. $ 3,170.00 to Nevin B. Raatsel Auotioneei SETTLEMENT 9HTTLEMENT 702. $ to 703. commission paid at settlement 3.].70.00 704. ' 900. :ZTEN9 PRYASLBSI27-; tX127N$~}'ZO,N'W1TH IRAN ~~ 901. Loan Origiaatlcn Pee 1.000 OR National city Baak 1,016.60 802. Loan Diseoimt 1.00001 National City Baak --1,031.84 803. Appraisal Fsa 375.00 to Network Appraisal 9exvloes 375.00 904. Credit Report 9.70 to CeC/Bquifax 9.70 BoS. Lender's Inapectim Pee 806. Mortgage Insurance Application Pae to 907. Assumption Fea 909. Loan Prooessiaq !se to National City Baak 175.00 809. Uaderwzitiaq Fea to National City Hank 100.00 810. Flood Cart Fe. to FIS Flood eervia•s 5.00 811. .;: .. :. - ~' ~9oD ITID~13 88QV3&EC! HY .SE'k1D8H T)~1 gB ,:kRIfl IN ADSFRIykS,~~:',~<::r .~. .... ". 901. Interest from OS/Ofi/OB to 06/01/09 •$ 16.61000 /day 431:96 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for 1 years to Erie Ins. POC $439 904. FHA One Tima YIP to FRA 1,524.90 905. 1000 RE888Q8S DSPCi:BZ'~ iilTit. LENDER. ~: ;..' s...;,. ,. ~. ..,:_: ~ : ~ ,'' .' 1001. Hazard insurance 3 months • $ 36.58 psz mcath 73.16 1001. Mortgage insurance i months • $ 47.17 per month 47.17 1003. City property terse 5 months • $ 5.37 per month 16.35 1004. County property taxes 5 months • $ 78.11 psx month 140.55 1005. Annual assasaments menthe • $ per month 1006. Bahool tax 11 months • $ 70.]4 per month 777.64 1007. months • $ par maath 1009. Aggregate Aoot. Adj. months • $ per month --310.04 1100 ~.: TETLL* C(iAaY(i~3 1101. Settlement oz closiagfee to 1101. Abstract or title search to 1103. Title examination to 1104. Tills insurance binder to 1105. Document preparation to 1106. Notary fees to Linda Parrish ~ 14.00 14.00 1107. Attorney's fees to Maro Robert^ 700.00 (includes above items Numbers: ) 1108. Title iasuranca to Nara Roberts, Agent for CLTI 790.88 (includes above lteme Numbers: Reissue Rate ) 1109. Lender's coverage $ 103,184.00 1110. Genet's coverage $ 10{,000.00 1111. Ead. 100/300/900 350.00 1112. Closing 9atvio• Letter 35.00 1113. Nara Rob•zts, dooument rstzievel 50.00 1100.. ~ o0y$RNMSNT' 3LG °4D,..RD'f,Ni}-.RN~D, q'gA17$p~t, ~XF~H'..."...... a ....., .:. :.:... -. 1101. Recording fees: Deed $ 46.00 :Mortgage $ 60.00 ;8eleaess $ lOfi.00 1202. City/county tax/stamps: Deed $ 1,040.00 ;Mortgage $ 1,040.00 1203. State tax/stamps: Deed $ 1,040.00 ;MOZtgaga $ 1,040.00 1204. 1205. .. 1300 ApDI'1'IQNAL 3STT~I,Y,N$N'1 /,~k'SR~i9E.;.__. .. ~ . 1301. Survey to 1302. Peet inepectlon to 1303. Nero Roberts, aouri•r fee 10.00 1304. Yaro Roberts, rsimbuzssmant tax oertif. 70.00 1305. ooldeboro ELB4P, final Eleotria/truh ~ 77.2 ~~ ~ ~~ ~ ~ ~ 1400 .:. roxnv SSI'TLaMHNT :CHA12G88?;t •nG6r ian line::. 1P3p B~c.CiaZ,~fi~ 1ud iiite soz, 9ectioia tSi 5,666.88 4.416.21 CERTIFICATION I have c vlly reviewed the HUD-1 settlement Statement and to the beat of my )mowledgs and bali.sf, it ie a true and accurate statement of 11 re t dieb sensate made on my account ox by ms in this tzansactloa. I further certify that I have received a copy t DD- t em.nt. C://A~" l oT'L-' M. E /N~/1~Ert ~ l v E. Bahlosser h otts Y. Kemper Eslt~ate Horr ere Olann E. eahlossar SBe late /~f}/h ~J/ls ~~ V Tha HOD-1 9ettlsmeat Staten c I have prepared is a true sad accurate account of this t cacti ~. I have caused or will cause the funds to bs d' i a ord with this statement. Yay 6, 1008 Settlement Agent a Roberts, Esquire Date Pl~ttanBank LISTENING. January 11, 2008 Manifold & Bankenstein 48 South Duke Street York, Pennsylvania 17401 Dear Mr. Bankenstein: RE: Charlotte M. Kemper, a/k/a Charlotte Marie Kemper, deceased November 24, 2007 In response to your recent inquiry concerning the accounts maintained in the name of the decedent, please be advised that the following accounts were open at the date of death: Checking # 0002-83568, open 8/11/1989, date of death balance $7,283.58 (any accrued interest ($ .24) would not have been payable had the account been closed on the date of death) Donald L. Miller, Sr. as Power of Attorney. Savings # 4485-35933, open 1/1/1979, date of death balance $2,243.22 plus accrued interest $4.56, joint with Donald L,. Miller, Sr. If you should have any further questions, please do not hesitate to contact me at (717) 291-2437. Very truly yours Karen D. Hilllegas Credit Inquiry Processor .. .. .I l~~'J~.~Fi~~~'F~Ei~~.~~3 ra e: ~i:~r£S ~t'fe,i.. _ .m..~'?:~ ;1~ +; in i~:.e:...~ 'r ire ar;~:~wr t;a _i, i~'t ~` >r c 3 ¢ I t ! ~ b } 1~ ^.i'CiS : °R.....,# e`~~% Ei;ii'!. p'4 b"oc•:;nri r i'3~J .~i.. : <°,j~ ifs ~ ~C t ,_ . ~ 7 ~{ h4rFj ryw`?3 ies~[~ ~lY:rc i{~ ~..~i. ~s...:+{''?~ S~ ,.'._li,yi` ~; t1 ~i.i~<~• :AL ~: P O Box 4887 ~ Lancaster, PA 17604 Ptiilt~i Bank :,,,~.:,,,o=„~~~STEti~N~. fultonbank.com ~ 1-800-FULTON-4 I • ©M~ ~~ 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302)934-2955 January 8, 2008 Manifold & Bankenstein Attorneys At Law 48 South Duke Street York, Pennsylvania 17401-1454 Re: Estate of Charlotte MKemper Social Security: 166-O1-0162 Date of Death: November 24, 2007 Dear Sir or Madam: Per your inquiry dated January 03, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Certificate of Deposit Account Number 031003914480436 Ownership (Names ofi Charlotte MKemper Randy L Miller Opening Date OS/01/9S Closed 01/04/08 Balance on Date of Death $2,156.16 Accrued Interest $ 5.09 Total $2,161.25 2. Type of Account Cert~cate of Deposit Account Number 031003914480444 Ownership (Names o, fl Charlotte MKemper Tammy L Mumma Opening Date OS/01/9S Balance on Date of Death $2,156.16 Accrued Interest $ S. 09 Total $2,161.25 i . 3. Type of Account Certificate of Deposit Account Number 031003914480452 Ownership (Names o~ CharlotteMKemper Kerry L Miller Opening Date OS/Ol/9S Balance on Date of Death $2,156.16 Accrued Interest $ 5.09 Total $2,161.25----------- ---------------------------- 4. 7~pe ofAccount Cert~cate of Deposit Account Number 031003914480460 Ownership (Names o~ Charlotte MKemper Todd L Miller Opening Date OS/01/95 Balance on Date of Death $2,156.16 Accrued Interest $ 5.09 Total ------------------------------------------------------ $2,161.25 5. TypeofAccount Cert~cateofDeposit Account Number 031003914480478 Ownership (Names o~ Charlotte MKemper Torrya L Miller Opening Date 05/01/95 Balance on Date of Death $2,156.16 Accrued Interest $ S. 09 Total ----------------------------------------------------------- $2,161.25 i.. . 6. Type ofAccount Certificate of Deposit Account Number 031003914480486 Ownership (Names o~ CharlotteMKemper Malissa K Miller Opening Date 05/01/95 Balance on Date of Death $2,156.16 Accrued Interest $ 5.09 Total $2,161.25-------------~- 7. 7j~pe ofAccount Certificate of Deposit Account Number 031003914480494 Ownership (Names o~ Charlotte MKemper MarkA Miller Opening Date 05/01/95 Balance on Date of Death $2,156.16 Accrued Interest $ 5.09 ------------------------------- Total $2,161.25 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the Fairview Office # 717-938-1829 Sincerely, ~~~~~ Nancy Clagett Records Management i. ~ ~ h~lE1~Ih1 H. REI'JTZEL, AUCTIDI'+IEER B00 iVORh1A1V ROAD, YORK, PA 17406 RHOIWE : 717-843-67'3 WWW. REIVTZELAUCTIOIVS. CDI++1 03/24/08 - - CONSIGNOR 5TATEMENT - - CONSIGNOR NUMBER : 248 NAME :CHARLOTTE M. KEMPER E5TATE DONALD HILLER 240 EA5T LOCUST LANE YORK, PA 17406 {1171 848-2317 PAGE 13 AUCTION NUMBER :080322 PROD ITM INV UNIT TOTAL CDMMIS5ION 5ELLER'S RE5ERVE CODE ND. ITEM DESCRIPTION ----- NO. QTY PRICE RRICE ANDUNT NET ANDUNT AMOUNT BIDDER ~ AN 446 HAND PLOW 1 1.00 1.00 15% .I5 .85 .00 85 AN 447 BA5KET FULL DF BLADES 1 1.00 L 00 15% .15 .85 .00 55 AN 448 FOLDING BED 1 4.00 4.00 15% .60 3.40 .00 Is'1 AN 449 WHEELBARROW 1 4.00 4.00 15% .60 3.40 .00 133 AN 450 WOODEN EXT LADDER 1 7.00 7.00 15% 1.05 5.35 .00 69 AN 451 ELEC ED~R 1 1.00 1.00 15% .15 .85 .00 131 AN 452 6A5 CAN 1 1.00 1.00 15% .15 .85 .00 105 AN 453 PUSH MOWER I 8.00 8.00 15% 1.20 b.80 .00 64 AN 454 PU5H MAR/GRASS CATCHER 1 15.00 15.00 15% 2.25 12.75 .00 89 AN 455 2 FLOWER ~T5 1 17.00 17.00 15% 2.55 14.45 .00 118 AN 45b CLOCK 1 6.00 6.00 15% .90 5.10 .00 105 TOTAL 6RDS5 SALE AMOUfi~T ACTUAL SALES TOTAL LE5S CQMMISSIDN ADVERTISING SALE PREP-25 1/2 HR5 @ f12.5@ 5, @00.50 5, 000.50 750.20 897.4@ 318.75 ~IPLETED : YE5 ND TOTAL NET PRDCEED5 TOTAL ITEMS: 455 TOTAL DUE TD 5ELLER NOTE :THANKS FDR CONSIGNING WITH US. = BIDDER DF THIS ITEM I5 DN ACC(XJNT. 3,034.15 3,034.15 1 ~ ~ h1EVI1V B. REIVTZEL, AUGTICihdEER ExOi~ hIORMAIV ROAD, YORK, RA 174~6~ RHdIVE : 717-@43-679 WWW. REIVTZELAUCT I CJhIS. COt~'i 03/24/08 - -CONSIGNOR STATEMENT - - PAGE 1 CONSIGNOR NUP4BER : 247 AUCTION NUMBER :080322 NAME :CHARLOTTE M. KEMPER ESTATE DONALD NILLER 240 EAST LOCUST LANE YORK, PA 17406 !7171 848-2si7 PROD ITM INV UNIT TOTAL COMMI85IDN SELLER'S RESERVE CODE ND. ----- ITEM DESCRIPTION - NO. QTY PRICE PRICE AMOUNT NET FM40LRYT AMOUNT BIDDER ~ AN 366 78 PHOENIX CAR 1 425.E 425.00 10% 42.50 382.50 .~ 131 TOTAL GROSS SALE AMOt){VT ACTUAL SALE5 TOTAL LESS COMMISSION 425. ~ 425.00 42.50 CIN4PLETED : YE5 NO TOTAL NET RROCEEDS TOTAL ITEMS: i TOTAL DUE TD SELLER NOTE :THANKS FOR CIIVSIGNING WITH US. 382.50 382.50 ~~,,~~ ,~ ~~ r ~~ l :~ ~~~~ ~¢ << . ~,Fd '°~ z ~~ .? Y{~ ~ ._.i Q u ~ " s ~' ~,. •~ o ~ c? ~~ t.=~ ` S ~ - N 1 it ` Q u.s ~_ i-` , ~--- c ,,. c ~ .- C- : •- Z J U t.~ ~ ~k _ ~ i.. t 0 ~~ g c•+ v Ul O ~ ~ ~ ~ ~ ~ ~ ~ S-a O z O U N ~ ~~ FLi ~ ~ fLS r--d H ~ ~ try ° ~ ~ o ~ z U ~ p W ~ O '~ ~~ ~ ~ a ~ ', o2j U ~' Q d +~ ~ ~ u~ U' au A~ a ~ m _ ~ ~ -~ cn ~~ ~ ~ ~ ~ ~ ~~ a U ~~ z °° 0 H t INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland DONALD L MILLER SR. and TONYA L LANTZ r ; ,k _ ~ =~~ i tr:.. , ~... _ COON 0~8 JU~IN`LYAt~'~N~ CLERK 0~ Fite Number 21-07-011 iQR~~~ COUP; Personal Representative(s) of the Estate of CHARLOTTE M KEMPER deceased, depose(s) and say(s), that the items appearing in the following inventory include all of 1;he personal assets wherever situate and all of the real estate In the Commonwealth of Pennsylvania of saki Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at thle end of this inventory. I verify that the statements made in this Inven- ~ ~ ~~ ~ ~~~~ `~~ tory are true and correct. I understand that false state- Y ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unswom falsification to authorities. ~, Attorney - (Name) (Firm) (Address) (Telephone) BRUCE C BANKENSTEIN MANIFOLD S BANKENSTEIN 48 SOUTH DUKE STREET, York, PA 17401 717-843-0961 (Supreme Court l.D. No.) 27025 DATE OF DEATH LAST RESIDENCE 46 EXFORD ROAD DECEDENTS SOC. SEC. NO. 11/24/2007 Camp Hill, PA 17011 166-01-0162 FIGURES MUST BE TOTALED Personal Property Cash ............................................................................................... Personal Property ......................................................................... Stocks/Listed ................................................................................. Stocks/Closely Held ...................................................................... Bonds ............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ......................................................................... Total Personal Property ......................................... Total Real Property ................................................ 104,000.00 Total Personal and Real Property ......................... NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b)) 11,072.79 5,425.50 16,498.29 Form RW-09 Rey. ~a>~-zoos r ~ REGISTER OF WILLS OF INVENTORY CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } SS File Number 21-07-01173 DATE OF DEATH LAST RESIDENCE 46 EXFORD ROAD DECEDENTS SOC. SEC. NO. 11/24/2007 Camp Hill, PA 17011 166-01-0162 Cash FRONTIER CITIZENS TELECOMMUNICATIONS -REFUND FULTON BANK -CHECKING ACCOUNT #0002-83568 GOLDEN LIVING CENTER -NURSING HOME REFUND M 8 T BANK -CERTIFICATE OF DEPOSIT # 031003914480436 (JOINT OWNER - RANDY L. MILLER IS DECEASED, 12/09/05) SCHOOL TAX PROBATIONS -FROM SALE OF REAL ESTATE VERIZON -REFUND Total Cash Personal Proaerty 1978 PHOENIX AUTOMOBILE -SOLD AT PUBLIC AUCTION HOUSEHOLD GOODS -SOLD AT PUBLIC AUCTION Total Personal Property Real Estate REAL ESTATE - 241 SOUTH YORK STREET, GOLDSBORO BOROUGH, YORK COUNTY, PENNSYLVANIA, AS SOLD 05/06/2008 Total Real Estate 10.50 7,283.58 1,487.85 2.161.25 129.60 0.01 11,0 425.00 5,000.50 5,425.50 104,000.00 104,000.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 120,498.29 MANIFOLD & BANKENSTEIN Legal Counselor 48 South Duke Street York, Pennsylvania 17401-1454 Telephone (717) 843-0961 Telefax (717) 843-0699 Bruce C. Bankenstein May 27, 2008 Register of Wills/Orphans' Court Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Charlotte M. Kemper Will No. 2107-1173 Our File No. 7224-1 Dear Register of Wills/Orphan's Court: Enclosed please find the following: Hugh D. Manifold 1968-2001 1. Original and one (1) copy of the Inheritance Tax Return. Please file the same. An additional front page i~: enclosed for you to clock-in and return to my office. 2. Original Inventory plus a copy of the front page. Kindly file the same and clock-in the front page and return to my office. 3. Estate check #114 in the amount of $270.00 for the additional filing fees. 4. Estate check #115 for the additional inheritance tax due. Please file the necessary documents and return the time- stamped front page copies and receipt in the enclosed return envelope. Very truly yours, MANIFOLD & BANKENS7'EIN Bruce C. Bankenstein BCB:blo Enclosures cc: Donald L. Miller, Sr., Executor Tonya L. Lantz, Executor