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HomeMy WebLinkAbout03-0989PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate o.f Patricia A. Miller also known as Social Security No. 192304~6 To: Register of Wills for the Deceased. County of Cumberland in the Commonwealth of Pennsylvama The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decedent was domiciled at death in CumberlanqJ County, Pennsylvania, with h .~r last family or principal residence at 375 Claremont Drive. Middlesex Township. Cumberland County. PA (list street, number, Twp. or Boro.) Decedent, then 69 years of age, died 11/13/01 at Claremont Nursine & Rehab. Center. Middlesex Township. Cumberland County. PA Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ $ $ $ Petitioner the following spouse (if any) and heirs: Name Kay Miller Edward Miller Frank Miller (Deceased 5/14/9)) after a proper search ha ~ Sifter l~rother Brg[h~r ascertained that decedent left no will and was survived by Relationship Residence 1012 s. Market Street Mechanic¢~urg PA 17Q~ 125 W. Main Street Mechanicsburg PA 17055 THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. J " 500 N. Third Street, 12th Floor ~' Harrisbure ~' Roenald D. Butler PA 17101 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF Cumberland The petitioner(s) above-named swear(s) or affn-m(s) that the statements in the foregoing petition are tree and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subs. zr[bed t' ~ b~ore me this, ~ da- of No. ~5~/- FXS' ' qiCa? Estate of Patricia A. Miller , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW aa::_ / , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that ~ ~-~'~ {g ~ ~ ,Tleg.~ is/are entitled to Letters of A ~d~hnistration, and in accord with such £mding, Letters of Administration are hereby granted in the estate of Pgtricia A. Miller FEES Letters of Administration ...... Short Certificates ( ) ...... Renunciation ............ (~_3O TOTAL Filed j.~,D_~.-.~[-. ~ .. Benjamin J. Butler ~1948 A~O~EY (Sup. Ct. I.D. No.) 500 N. ~ird S~eet, 12th Floor ~g~sbur~ PA 17101 ADD'SS 717.236.1485 PHONE Register of Wills of Cumberland County, Pennsylvania Estate of Patrician, r,, Miller also known as RENUNCIATION No. ,, Deceased The undersigned, Ka7 Miller - Sister (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters o~ Admimsication be issued to konald D. Butler Witness her hand this /¢/¢') dayOf N°vember 1012 S. Market Street Mechanicsburg 2003 (Signature) (Address) PA 17055 of (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed befere me this day of Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 Register of Wills of Cumberland County, Pennsylvania RENUNCIATION Estate of Patricia A Miller also known as , Deceased NO. The undersigned, Edward Miller - Brother (Relationship) (Capacity) the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters oi Admini:,,.rati,m be issued to yon~id U. Butler Witness her hand this ~ ~ ~ day of November 2003 (Signature) 125 W. Main Street Mechanicsburg PA 17055 (Address) of (Signature) (Address) (Signature) (Address) Sworn to or affirmed and subscribed r>efore me tills day of Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 .. . Register of Wills of Cumberland County, Pennsylvania CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Patricia A. Milkr Date of Death: 11/13/01 Will No. Adm. No. 2003-90989 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 12/4/03 : Name Kay Miller c/o Susan Janis Edward Miller Estate of Frank Miller c/o Ronald D. Butler, Administrator Address 1012 S. Market Street Mcqhanie~l~qrg 125 W, Main Street M¢~l~gni¢~berg 500 N. Third Street, 12th Floor PA 17975 PA 170~ PA 17101 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: 12/4/0,3 (Signature) r Name: Beniamin J. Butler Address: 500 N. Third Street. P.O. BoM 1004 Harrisbur~ pA Telephone (717) 236148~s 171o$-1904 Capacity: X Personal Representative Counsel for Personal Representative REV-1500 EX + (6-O0) uJ =uc Z LU r',, Z o uJ o z z COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAt Miller, Patric/a, A. DATE OF DEATH (MM-DD-Year) I 1/13/200l REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IDATE OF BIRTH (MM-DD-Year) 02/28/! 94 ] (iF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 2 1 - 0 3 0 9 8 9 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER I 9 2 -3 0 -4 2 3 6 THIS RETURN MUST RE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ['-~1. Original Return F']4. Limited Estate r~6. Decedent Died Testate (Attach cop), of Will) E~9. Litigation Proceeds Received Et2. Supplemental Return Et 4a. Future Interest Compromise (dateofdeath after 12-12-82) E~]7. Decedent Maintained a Living Trust (Attach copyofTrust) "-] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ] 3. Remainder Return (dateofdeathpriorto 12-13-82) Et5, Federal Estate Tax Return Required O 8. Total Number of Safe Deposit Boxes Et11, Election to tax under Sec. 9113(A) {Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Benjamin J. Buffer 500 N. Third Street FIRM NAME (If Applicable) Butler Law Firm P.O. Box 1004 TELEPHONE NUMBER 17.230.1485 Hamsburg 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14 Net Value Subject to Tax (Line 12 minus Line 13) :~;~7s.oo C) © 17108-1004 OFFICIAL USE ONLY (8) 6,983.65 (11) (12) (13) (14) 2~375.00 6~983.65 -4,608.65 -4,608.65 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20 X ~ (15) X ~ (16) X .12 (17) X .15 (18) (19) ] ' · ' ' '0[ ,' ' ti[ ~N ' ' [ ~1 ! , ~N O? '',' ! ~N 0.00 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < , Decedent's Complete Address: STREET ADDRESS 375 Claremont Drive CITY Carlisle ISTATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount $0.00 $0.00 $0.00 $o.oo SO.O0 Interest/Penalty if applicable D. Interest E. Penalty (I) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT $0.00 $0.00 $0.00 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; ........................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ........................................[] [] c. retain a reversionary interest; or ...................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer properly 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? ....................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF P~ON RES~I)N,~IrL~ FOB FILING RETURN . D~TE 500 N. Third Street, P.O. Box 1004 Harrisburg ADDRESS 500 N. Third StreW, P.O. Box 1004 PA 17108-1004 DATE Hamsbur~, PA 17108-1004 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [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 4.5%, 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 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502EX '*(1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Miller, Patricia, A. 21 03 0989 All real property owned solely or as a tenant in common must be reported at fair market value. Fair 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 facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF BEATH 1. $2,375.00 1/4 interest in property at 720 S. Frederick Street, Mechanicsburg Borough, Cumberland County, Pennsylvania based on appraisal - see attached TOTAL (Aisc enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) 2,375.00 REV 1503 EX - (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS&BONDS ESTATE OF Miller, Patricia, A. FILE NUMBER 21 03 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION TOTAL (Also enter on line 2, Recapitulation) 0989 VALUE AT DATE OF DEATH (If more space is needed, insert additional sheets of the same size) GOMMONWEALTH OF PENNSYLVANIA INHERITANOE TAX RETURN RESIDENT DEOEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Miller, Patricia, A. 21 03 0989 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with the right of survivorshi ~ must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION TOTAL (Also enter on line 5, Recapitulation (If more space is needed, insert additional sheets of the same size) VALUEAT DATE OF DEATH COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Miller, Patricia, A. 21 03 0989 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. C JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number, Altach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-15105X+(1 97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Miller, Patricia, A. 21 03 0989 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is, es. DESCRIPTION OF PROPERTY % OF ITEM INCLUDETHE NAME OFTHETRANSFEREE. THEIR RELATIONSHIPTO DECEDENTAND THE DATE OFTRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE N U MB E R ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST OF APPUCABLEI 1. Public School Employees' Retirement System - Non-Taxable Death Benefit Beneficiary: Kay E. Miller TOTAL (Also enter on line 7, Recapitulation) $ (If more space ~s needed, insert additional sheets of the same size) REV1511~X+/1'97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Miller, Patricia, A. FILE NUMBER 21 05 Debts of decedent must be reported on Schedule I. 0989 ITEM NUMBER DESCRIPTION FUNERAL EXPENSES: Malpezzi Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees Butler Law Firm (Insolvent Estate - No Fees Collected) Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address city Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal - Estate Advertising The Sentinel - Estate Advertising Cumberland County Register of Wills - Filing Fees State Zip TOTAL (Aisc enter on line 9, Recapitulation) $ AMOUNT $6,694.50 $51.00 $75.00 $143.15 $20.0O 6,983.65 (If more space is needed, inse~ additional sheets of the same size) REV-1512 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Miller, Patricia, A. FILE NUMBER 21 03 O989 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Commonwealth of Pennsylvania/Department of Public Welfare - Class 3 Claim (20 Pa. C.S.A. 3392(3)) - $23,651.01 ***listed for infbrmational purposes only*** Commonwealth of Pennsylvania/Department of Public Welfare - Class 6 Claim (20 Pa. C.S.A. 3392(6)) - $51,059.80 ***listed for intbrmational purposes only*** TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insed additional sheets of the same size) AMOUNT REV-leI3 EX + (9-nm COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Miller, Pstricia, A. NUMBER I. 1. II. 1. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1.2)] Insolvent Estate FILE NUMBER 21 03 O989 AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Insolvent Estate TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Insolvent Estate Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Patricia A. Miller also known as , Deceased NO. 21 03 0989 Date of Death 11/13/01 Social Security No 192-30-4236 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Beniamin J. Butler I.D. No.: 81948 Ronald D. Butler Address: 500 N Third Street, P.O. Box 1004 Dated Harrisburg PA 17108-1004 Telephone: 717.236.1485 Real Estate Description 1/4 interest m property at 720 S. Frederick Street, Mechanicsburg Borough, Cumberland County, PA based on appraisal - see attached (Attach Additional Sheets if necessary) Total Value O© ~ ;T? ,'. ,:'~:~,375.00 $2,375.00 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. RW*4 BUREAU OF /NDTV/DUAL TAXES TNHERITANCE TAX DIVIS~LON DEPT. Z80601 HARRTSBURG, PA 17128-0601 BENJAMIN J BUTLER BUTLER LAW FIRM PO BOX 1004 ~ HBG PA 17108 COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOT/CE OF /NHERZTANCE TAX APPRA/SEHENT, ALLONANCE OR D/SALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF DATE OF DEATH FZLE NUHBER ACN REV-iSgi? EX AFP (0].-03) 04-05-2004 HILLER PATRICIA A 11-15-2001 21 05-0989 CUHBERLAND 101 Amount Remitted r HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS L/NE ~ RETAZN LONER PORT/ON FOR YOUR RECORDS ~ DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF HILLER PATRICIA A FZLE NO. 21 05-0989 ACM 101 DATE 04-05-2004 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Tnterest (Schedule C) ($) ~. Hortgages/Notas Receivable (Schedule D) (~) E. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G)~ (7) 8. Tote1 Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expanses/Ad.. Costs/Hisc. Expanses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 11. Total Deductions 12. Nat Value of Tax Ra~urn 15. 1~. Charitable/Governmanta! Bequests; Non-elected 9115 Trusts (Schedule J) Nat Value of Estate Subject to Tax 2/$75.00 .00 .00 .00 .00 .00 .00 (8) 6,985.65 .O0 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. NOTE: Z,$75.00 (11) 6.98~3.65 (T2) 4,608.65- (Ts) . O0 (~4) 4,608.65- Zf an assessnent Nas lssued previously, lines 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. 18 and 19 will ASSESSHENT OF TAX: 15. Amount of Line 1~ at Spousal rata 16. Amount of L/ne lr* taxable at Lineal/Class A rate 17. Aeount of Line 1~ at Sibling rata 18. Amount of Line lr~ taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYHENT RECE/PT DzsCOUNT DATE NUMBER TNTEREST/PEN PAZD (- TF PAID AFTER DATE TNDICATED, SEE REVERSE FOR CALCULATTON OF ADDITZONAL INTEREST. (25), .00 x O0 = .00 (26). .00 x 045= .00 (17). . O0 x 12 = . O0 (lB). . O0 x 15 = . O0 (19)= . O0 AHOUNT PAZD TOTAL TAX CREDZT .00 BALANCE OF TAX DUEI .00 ZNTEREST AND PEN. .00 TOTAL DUE . O0 ( TF TOTAL DUE TS LESS THAN $1, NO PAYHENT TS RE{)UTRED. TF TOTAL DUE TS REFLECTED AS A 'CREDTT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THTS FORH FOR /NSTRUCTTONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 198Z -- if any future interest in t~e estate is transferred in possession or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coeeonaealth hereby expressly reserves the rlght to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rata on any such future interest. To fulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act 23 of 2000. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your paymant to the Register of Hills printad on the revarsa side. --Hake chack or money ordar payable to: REGISTER OF NILES, AGENT A refund of a tax credit, which was not raquastad on the Tax Raturn, amy be raquasted by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special 24-hour ansaering service for forms ordering: 1-800-362-ZOS0; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (incLuding discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ze-10Z1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within throe (3) calendar months after the decadent's death, a five percent (BX) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the toter of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated et a daily rate of .000164. All taxes ehich became delinquent on and after January 1, 198Z will bear interest at a rate ahich will vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .0005~8 ~)'~-1991 11Z .O00SOX ~ 9X .000247 1983 16X .000438 199Z 9Z .000247 ZOOT 6Z .000164 1984 11Z .000301 1993-1994 7X .00019Z 2003 5Z .000137 198S 13Z .000356 1995-1998 9Z .000247 2004 ~Z .000110 1986 lOT .000Z74 1999 7Z .00019Z 1987 lOT .000Z74 2000 7Z .OO019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. _ _ _ _ -. SVPf'LEMEiJ~aL INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA ~ SS COUNTY OF CUMBERLAND File Number 21 03 09819 Personal Representative(s) of the Estate of Patricia A. Miller deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assetslwherever situate and all of the real estate in the Commonwealth of Pennsylvania of said 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 out$ide of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- tory are true and correct. I understand that false state- Ronald D. Butler ments herein are made subject to the penalties of I 18 Pa. C.S. § 4904 relating to unsworn falsification to ~ authorities. Attorney -- (Name) Benjamin J. Butler (Supreme Court LD. 1'~0.) 81948 (Address) 500 N. Third Street, P.O. Box 1004 Harrisburg ! PA 17108-1004 (Telephone) 717.236.1485 DATE OF DEATH LAST RESIDENCE DECEDE TS SOC. SEC. NO. 375 Claremont Drive 11/13/01 Carlisle PA 17013 192-30- 236 FIGURES MUST BE TOTALED Miscellaneous: The Prudential Life Insurance Company of America -Policy No. 25331098 Beneficiary: Estate (Attach additional sheets as needed) [VOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.,S. § 3301(b)) Form RW-09 rev. !0.!3.06 ~~! 8,331.42 ca ~~ ~ r ~;~ ,' . ~,:~ ~ r ~~<~~ .~ f V '~ ~ ~ ti~~. _ ~ 8,331.42 incline the value of each _, - L . ___ 500 North Third Street Tel: 717.236.1485 Twelfth Floor Fax: 717.236.7777 Harrisburg, PA 17101 lawyers~butlerlawfirrn.com Mailing Address: Post Office Box 1004 Harrisburg, PA 17108.1004 July 28, 2010 Ronald D. Butler Jana Butler Toole Benjamin J. Butler ~ M. ~~,. Register of Wills Cumberland County Courthouse ', 1 Courthouse Square ', Room 102 Carlisle, PA 17013 Re: Estate of Patncla A. Miller File 2003-00989 Dear Sir or Madam: I have enclosed an original and one copy of a Supplemental Inventory for the above referenced estate. I have also enclosed a check for $15.00 made payable to the Register of Wills for the filing fee. Please time stamp the enclosed copy and return it to me in the enclosed self-addressed stamped envelope. Very truly yours, Benjamin J. Butler BJB/mot Enclosures I ~ ~! ~ ~ 7 O i ~ ~o I c... _ ,sr :- , ~~c7 ~ rJ ~ ~ ~ C > ~ ~~ I _ N r ~'_ Cf'S ~ ~ T`F '~ r? C~ "T'f s .. ~~! ~ ~ ~ ~ _ :~~ b ~,. t.~ } 's r , ^l