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Home My WebLink About03-1078 PETITION FOR PROBATE and GRANT OF LETTERS Estate of Elizabeth K. Miller No. _~.1- ~5- I0]? also known as To: Register of Wills for the SociaISecurity No. 205-09-96~2 Deceased. County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut or named in the last wilt of the above decedent, dated May 1, 1989 and codicil(s) dated none (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 2108 Cedar Run Drive, Unit 305, Camp Hill, PA 17011 (Iisi street, number and muncipality) Deccnde~:, then 83 years of age, died December 20, 2003 Except as follows, decedent did not marry, was not divorced and did n°fftha-ve a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: ~ o.12 (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (lf not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $"5-0~ OOO.~ situated as follows: ~1,1_07 CgOhR ROW 13RIt/E, ~lL~'/%/ Too,rt./5; !-.l lltg] C/gt~P /JILL) p~ 1 7011 ' WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~"~ 510 Porsha Terrace ~~ o ~ Camp Hill, PA 17011 ~o OATH OF PERSONAL REPRESENTATIVE COMMONWEAIATH OF PENNSYLVANIA COUNTY OF _k.[~ec~~._.~ ~_. f ss The pe,:itiouer(s) above-immed swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or af~irnle_d and subscribed ,/~//.-/~/ bef~e me this ~(,.~-¢.._~ day of ~ ' - .~~%~_ogOster~ , ~ l-~ No. 'fl, I- D~- 1~3q~ Estate of Elizabeth K. Miller , Deceased DECREE OF PROBATE AND GRANT OF LETTERS ~ .~ _ 2004_, in consideration of the petition on AND NOW the reverse side her~f, satisfactory proof having been presented before me, 1T IS DECREED that the instrument(s) dated May 1, 1989 described therein be admitted to probate and filed of record as the last will of Elizabeth K. Miller ; and Letters are hereby granted to Ronald ?. Frank FEES Terrence J. Kerwin, Esq. 29922 Probate, Letters, Etc .......... Short Certificates( ) .......... $ ,~L,.~k_ ATTORNEY (Sup. Ct. I.D. No.) Renunciation ~.kvtro...~ ...... $ ~,CK) 27 North Front Street, Harrisburg, PA 17101 ,,XO~O $ [ID - ~.2c~ ADDRESS TOTAL __ $~'~'°° (717) 238-4765 Filed ./~.'..~. J.-..O..~. ..................... PHONE REGISTER OF WILLS OF ctn, m~ COUNTY OATH OF SUBSCRIBING WITNESS Joseph D. Kerwin and Terrence J. Kerwin codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that Joseph D. Kerw±n and Terrence J. Kerwin present and saw Elizabeth K. Miller the testat r~w , sign the same and that. Terr~ncaJ°se~h D.j.KerwinKerwinand signed as a wit. n~s atthe Sworn°therrequest of testatr iXsubscribingto or affirmedWitness(es))'andin h ttleirpresence and (in t~e presence ot-each other) (i.~~ ¢/of thesubscribed before Joseph D. Kerwin -fi~=~/~ me this 29th day of (Name December ~ -19 2003 27 North Front St., It~arr sburg, PA 17101 7~ ~"'-~ (Address) Register Terrence J. Kerwin Notarial Seal 27 North Front St., Harr±sburg, PA 17101 Nancy J. Ligon. Notary Public ,.W~hington Twp., Dauphin County (Address) REGISTER OF WILLS OF cOUNTy OATH OF ~RIBING WITNESS '_ ~~ d~s~ ' (each) a subscriber~ng duly qualifie e(s) and say(s) that ____ famish the signature of ~ , ...... ~ _ codicil testat___ of (~e subscribing witnesse-'~9.~ the will presented h~ith and ~ codicil that _ _ believes the signature~he handwriting of SwoUnd subscribed before me this _ day of ~ (Name) 19_____ Register (Name) (Address) This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~~ ~/~ Local Registrar P 9 81 2 4 g 8 g 2003 No. ~ Date ,,5 t44 Rev. 1/91 COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF H -'ALTH · VITAL RECORDS CERTIFICATE OF DEATH . //29-165 (Coroner) ST~rE FILE NUMBER ~4AME OF DECEDENT (F~rs% M~dle. La.~) ISEX [~OC,AL SECURITY NUMi3ER DA~E OF DEATH (Mordh, Day, Year) ,. Elizabeth Miller I" Fema]"13' 205-09-9642 4. December 20, 2003 83 ~uly 16,1920 7.Harrisbttr§ Pa I~.''~"'[] Cumberland Lower Allen I- 2108 Cedar Run Drive ~ ~'~"~'~I~~'~k'W~"~c' ~nistrative ~ Na~ ~CE~NT'S MNLI~ AD.ESS ~r~. ~. m~, Zip ~) ~CEDENT'S p~ 2108 Ced~ ~ Dri~ (~U~RES~E~"'~'i~, ,~,.S,.,. ~" ~.~ ~,~.,~.~ T~ A] ]~n ~ Hill, Pa 17011 j~.~.~) '~'~"' -..D ~..~,~.o,. __~, ~HE~'~ (F¢~..~. ~) ,~. ~.~. ~rl~d ~"~P~ ,.. ~ Koh~n Eliza~th Keller ~na~d ~ank INF~M~T'S MAILI~ A~ESS (S~, C~, $~le, E~ C~) 011654-L ~neral 7:00 A.u. December 20, 2003 ,~m~e~i.~,,)~ · Probable Pancreatic Cancer ,~ ~ ~) mST d ~ ~ ~S ~ NO ~ I Accident ~ Pe~ng tnvest~at~ ~ 130"' 13~. M. 3 To~,o~.~,~m.o.~.,~.~,~.,~,.~o~...~.).~.~,....,~ ........................ ~ 3~0. 13~". Decembe~ 22, 2003 NAME AND ADD~ OF PER~ WHO C~P~ED CAU~ · MED~AL~AMINE~R~ER [It~27)Ty~orPrint H~chae[ ~. Ro~S~ Co~one~ ~n~r~"th*b~N~xam~i~na~/~rinve~ti~t~n~nmy~p~ni~n~deat~cu"~att~time~date~nd~c~ anddueto~ecau~s ~~ated... , ,d ~. 6375 ~aseho~e Road, Su~e .......................... Hechan~csbu~s, ~a. 17050 ELIZABETH K. HILLER I, ELIZABETH K. MILLER, of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make and publish this, my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Executor to pay all my legally enforceable debts, funeral expenses, administration expenses and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. I further direct that my funeral arrangements be handled through the Neumyer Funeral Home and I be burried with my late husband, John A. Miller at Ft. Indiantown Gap National Cemetary, Section 12D, Grave 843. SECOND: I give, devise and bequeath the sum of $2,000.00 to my grandson, JASON M. FRANK, and I further direct that said $2,000.00 be placed in account no. 05-533726 which is an account that I have maintained for JASON M. FRANK at Harris Savings and Loan Association. In the event JASON M. FRANK would predecease me, I direct that this bequest be made to JESSICA L. FRANK in account no. 05-534393. THIRD: I give, devise and bequeath the sum of $2,000.00 to my grandaughter, JESSICA L. FRANK, and I further direct that said $2,000.00 be placed in account no. 05-534393 which is an account that I have maintained for JESSICA L. FRANK at Harris Savings and Loan Association. In the event JESSICA L. FRANK would predecease me, I direct that this bequest be made to JASON M. FRANK in account no. 05-533726. EL~FZABETH K. MILLER FOURTH: I give, devise and bequeath all the rest, residue and remainder of my property, be it real, personal and mixed, whatsoever or wheresoever the same may be situate at the time of my death to my son, RONALD P. FRANK. FIFTH: I nominate, constitute and appoint my son, RONALD P. FRANK, as Executor of this, my Last Will and Testament. I further direct that my within named Executor shall not be required to post bond to act in said capacity. IN WITNESS WHEREOF, I, ELIZABETH K. MILLER, have hereunto set my hand and seal to this, my Last Will and Testament, this ~.~ day of , A.D., SIGNED, SEALED, PUBLISHED : and DECLARED by the above- : named Testatrix, ELIZABETH K. : MILLER, as and for her Last : Will and Testament, in the : presence of us, who at her : request and in the presence : of each other, have hereunto : s~jt our names as witnesses: : , ~ : SEAL ReSiding a~/ ' - ~ ' : EL]~ZABETH K. MILLER FY'. ff'~ g ht'/ : Page 2 of 2 Pages ' EL]~ZA~BETH If,' MILLER KERWIN AND KERWiN AttORNEYS aT LAW SUITE SOl, 1OO CHESTNUT STREET HARRISBURG, PA. 17101 (717) 238-4765 IN THE COURT OF COMMON PLEAS,CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION ..'DC ~? ESTATE OF ~ ) Register's # ~1-03-1078 ELIZABETH K MILLER Deceased) 'i~ CLAIM To the Clerk of the Orphans' Court Division : Index and make proper entry in your official records of the claim of CITIBANK(SOUTH DAKOTA)NA in the amount of 430.30 against the estate of the above-named decedent. This claim is filed under Section 3532 (b) (2) PEF Code, 20 Pa. C.S. ss. 3532 (b) f (2) . The said decedent, whose last known residence was at 2108 CEDAR RUN DR UNIT #305 CAMP HILL PA 17011 Written notice of this claim was given to RONALD P FRANK 510 PORSHA TERR CAMP HILL PA 17001 oi~bruary 24, 2004 SHAWN HARMER ,manager of Citicorp Credit Services, Inc. USA under limited power of attorney for CITIBANK(SOUTH DAKOTA)NA 7930 NW 110TM ST KANSAS CITY, MO 64153 (Claimant's Address) Account #(s) 5491130381949528 AT T YourAT&TUnhersa/Card St_a_~_ement Page 1 of 3 November 20 - December 22, 2003 How To Reach Us Account Online: www.universalcard,com ELIZABETH K MILLER Customer Service: 1 800 423-4343 or write Account 5491 1303 8194 9528 Cardmember Services, PO Box 44167 Jacksonville, FL 32231-4167 Calling Card 9571331723 + PIN No Annual Fee/Platinum Card IMPORTANT NOTICE OF CHANGE IN TERMS Minimum Payment Due ........................................... $20.00 Please see the enclosed Notice of Change in Due Date~ ............................................... January 12, 2004 Terms to Your Card Agreement for *Payment must be received by 1:00 pm 10cai time on the payment due date. important information regarding changes Credit Line ............................................................. $8,300.00 to your Card Agreement. 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The Bose Wave Radio/CD Ddivers Lifelike Sound! Yet it's small and simple to use. Your satisfaction is guaranteed and shipping is free. To order call 1-800-491-2073 Ext. TB981. This offer is brought to you by Media Syndication Global. Payment Record Amount Paid: Date Paid: Check Number: Please follow payment Instructions for Account Number New Balance Enter Amount Enclosed 5491 1303 8194 9528 01112104 $630.30 $20.00 *if yOu provide I about your acca[mt. We may also use about producls and services you State Zip Home phone B~siness phone ( ) 47S HC o0 A I AR7050511 Make check payable to: AT&T Universal Card h,,llh,,llh,,,,,Ih,.lll,,,h h,lh.h,,,llh,hlh,,,,hll IIh.,h,.hlh,II .... Ih,h,h,,hh,,Ihh,l,lh,I ELIZABETH K HILLER 2108 CEDAR RUN DR AT&T UNIVERSAL CARD PO BOX 8214 UNIT 305 SOUTH HACKENSACK NJ 07606-8214 CAHP HILL PA 17011-7681 Ihhl,,lllllh,h,lll,hlhlh,lhlllh,hhhllhhlhhlhl 54911303819495280000020000000630304 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Elizabeth K. Miller Date of Death: December 20, 2003 Estate Proceedings No.: 2003-01078 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of tl~Orphans Court Rules was served on or mailed to the following beneficiaries of the above~aptioned estate on January 5, 2004. Name: Address: Ronald P. Frank 510 Porsha Terrace Camp Hill, PA 17011 Jason M. Frank 510 Porsha Terrace Camp Hill, PA 17011 Jessica L. Frank 510 Porsha Terrace Camp Hill, PA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE Date: January 5, 2004 ~~.~ ~/~ J SignatUre: f~f, ENCE J. KERWIN, ESQUIRE Address: 8245 Route 209 Elizabethville, PA 17023 Telephone: (717) 362-3215 Capacity: Personal Representative X Counsel for Personal Representative D:\PJW~EST'~MILLER-E. 56N KERWIN O KERWIN ATI~ORNEYS AT LAW 4245 ROUTE 209 GOVERNORS' ROW PATRICK E. KERW1N (1913-1987) ELIZABETI-IViLLE, PA 17023 27 NORTH FRONT STREET HARRISBURG, PA 17101 (717) 362-3215 GREGORY M. KERWIN - GMK~Ke, winlawfi~m.com (717) 896-9089 (717) 238-4765 TERRENCE J. KERWIN- KK@Ke~dvdawfirra.com FAX (717) 362-4459 FAX (717) 238-8455 JOSEPH D. KERWIN- JDK~Kenddawfirm.com E-maih kkl@eplx.net HOLLY McCLURE KERW1N - KK@Kerwlnlawfirm.com Please Reply To: C~ ELIZABETHVILLE OFFICE ~ HARRISBURG OFFICE September 17, 2004 Office of the Register of Wills Cumberland County Courthouse ~ ~;~: One Courthouse Square Carlisle, PA 17013 RE: Estate of Elizabeth K. Miller Estate No. 2003-01078 Dear Register of Wills: Please find enclosed herewith a check in the amount of $1,200.00 for payment toward the inheritance tax due in the above-referenced estate. I have enclosed a self-addressed, stamped envelope for return of the receipt to me. Thank you for your kind assistance. Very truly yours, TERra'CE J'. KERWlN TJK:clw Enclosures D:\CLW\LETXCUMBER.REG COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11 96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004405 KERWIN TERRENCE J ESQ E. MAIN STREET RR01 Bo× ESTATE INFORMATION: ss' FILE NUMBER: 2103- 1078 DECEDENT NAME: MILLER ELI; DATE OF PAYMENT: 09/20/200 POSTMARK DATE: 09/17/200~ COUNTY: CUMBERL~ DATE OF DEATH: 12/20/20( REMARKS: '- SEAL = Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Miller, Elizabeth K. No. 21 - 03 - 01078 also known as Date of Death 12/20/2003 , Deceased Social Security No. 205-09-9642 Ronald P. Frank The 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 located 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 the Decedent owned no real estate outside of 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 are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unswom falsification to authorities. Personal Representative Attorney: Terrence J. Kerwin, Esq. Signature: X ~1~_ ~~_~ Ronald P. Frank I.D. No.: 29922 Signature: Signature: Address: 4245 Route 209 Address: 510 Porsha Terrace Elizabethville, PA 17023-9765 CampHill, PA 17011 Telephone: 717/362-3215 Telephone: (717) 763-4302 Dated: .!C' ~'- -0 ~ Personal Property 112 Shares Waypoint stock, net proceeds amounting to $2,922.60. 2,922.60 Multi-Financial Securities Corp. - Account #3KZ-287313 10,656.89 1995 Buick Skylark Sedan 750.00 Household Items 500.00 Waypoint Bank - Certificate of Deposit #1066225787 6,923.36 :: ~f~tal Personal Property $21,752.85 Register of Wills of Cumberland County, Pennsylvania INVENTORY continued Estate of Miller, Elizabeth K. No. 21 - 03 - 01078 also known as Date of Death 12/20/2003 , Deceased Social Security No. 205-09-9642 Real Estate Real property located at 2108 Cedar Run Drive #305, Camp Hill, Lower Allen Township, 14,174.36 Cumberland County, sold on July 1, 2004, with net proceeds in the amount of $14,174.36. See copy of settlement sheets attached which reflects a mortgage payoff, real estate transfer tax, and pro-rated real estate taxes. Total Real Estate $14,174.36 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG, PA 17128-0601 September 28, 2004 Telephone (717) 787-3930 FAX (717) 772-0412 Kerwin & Kerwin Attorneys At Law 4245 Route 209 Elizabethville, PA 17023 Re: Estate of Elizabeth K. Miller File Number 2103-107~ Dear Sir/Madma: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before 03/27/05. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely., Claudia Maffei, Su ~ni D I~ r ocument Processin t Inheritance Tax Division KERWIN & KERWIN ATTORNEYS AT LAW 4245 ROUTE 209 ELIZABETHVII.lE, PA 11023 (717) 362-3215 (111) 896.9089 FAX (111) 362.4459 E.m;lil, kkl@~pix.net GOVERNORS' ROW 27 NORTH FRONT STREET HARRISBURG, FA 11101 (717) 238.4765 FAX (117) 238.8455 PATRICK E. KERWIN (1913.1987) GREGORYM. KERwIN. GMK@~.~ TERRENCE J. KERWIN . KK@KerwirJilwfil'tn.com JOSEPH D. KERWIN . JDK@K.n.in\.wIinn~m HOLLY McCLURE KERWIN. KK@Ke..ruJawtinn.com pll!02#fI R..ply To: Cl EllZABETHVILLE OFFICE a HARRISBURG OFFICE October 6, 2004 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 ~- ".. ... \. ~ S (f\ ::$ _. ,~ i g .'~ :::J -~, ~, Re: Estate of Elizabeth Williams No. 2003-01078 c.., C--,j ..... I ctl Dear Register of Wills: :g I""J "j Please fmd enclosed herewith for fIling an original and two (2) copies of an t;heritance Tax Return and Cumberland County Inventory. Also enclosed is a check in the amount of $614.25 for payment of the balance of inheritance tax due. Also enclosed is a check payable to the Register of Wills in the amount of $15.00 for the filing fee. I have enclosed a self-addressed, stamped envelope for the return of the clocked-in copies and Receipt to me. Thank you for your kind assistance. Very truly yours, ~/):J/~. TERRE~J. KERWIN TJK:pjw Enclosures d:/pjw/let/cumb-reg.est u.V_,.U'I_ . REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OOMMONWEALl'1i OF PI:NNSVlVANIA OEPARTM~T OF REVENUE OEP'L26OIIOl HA.'lRJSBUFlCl,PA 17\211.011)1 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Miller. Elizabeth K. ~ z w o w " :'l DATE OF DEATH (MM-QO-YEARI OATE OF 6lRTH {MM..oo..YEAR} 12/20/2003 07/1611920 (IF ,l..PF'LlCABlE} SUR'JI'-I1NG SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) w ~ ",:!!'2 ldh Offjij ~ 1 Original Retum 0 4. Limited Estate 18I 6. Decedent Died Testate (Atl8ch copy olWm) 0 9. Litigation Proceeds Received 4a. FJJl.u~ l!1terest ComprcrMl) (dale oj OIlalh IIIlei' 12-12-82) 7. Decedent Maintained a Uving Trust {Attach copy 01 TrusI) 10. Spousal Poverty Credit (dale 01 dealh bfllwee!1 1-'. -1- 2. Supple menial Return o o o OFFICIAL USE ONl '( FILE NUMBER 21 03 01078 C NTYC E YEAR N M EA SOCIAL SECURITY NUMBER 205-09-9642 THIS RETURN MUST BE FllEO IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3. Remainder Relum (date 01 dlath prior to 12.13-82) o 5. Federal Estate Tax Retum Required 8. Total Number ot Safe Deposi160XMi o 11.Election to tax under Sec. 9113(A) (AnechSch 0) .~ II ,..i~ISECTlOtlI ,. Ji'. AME Terrence J. Kerwin. Esq. lAM NAME (If applicable) Kerwin & Kerwin . ri'PO COMPlETE MAIUNQ ADDRESS ELEPHQNE NUMBER 717/362-3215 4245 Route 209 Elizabethville. P A 17023-9765 1. Real Estate (Schedule A) 2. Stocks a.nd Bonds (Schedule B) (1) (2) (3) (4) (5) (6) (7) 3. Closely Held Corporation. Partnership or Sole-Proprietorship ~ 3 ~ " ~ 4. Mortgages & Noles Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Scl1edule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Intar.Vivos Transfers & Miscellaneous Nan.probate Property (Schedule G or L) 8. Total Grols Allell (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Dabls of Decedent, Mortgage liabilities, & Liens (Schedule I) (10) , ,. Total Deductions (total Lines 9 & 10) 12. Net Valu. ot Estate (Line 8 mInus Line 11) 14.174.36) , 2.922.60(. ... None None 18,830.25 1.914.16 7,789.09 5,339.34 13. Charitable and Governmental Bequ8sts/Sec9113 TTusts for whlch an electlon to tax has not been made (Schedule J) 14. NetVarue SubJect to Tax (Une 12 mInus line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLiCABLE RATES 15. Amount of Una 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) ~ ~ ~ " ~ x .00 16. Amount of Line 14 taxable at lineal rate 40,291.12 x .045 17.Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Copyrighl2.000 form software only The Lackner Group, Inc, x .12 x .15 OFFIC!Al USiF!Nl Y g -"('! R --< I CO -I"') I'.') ~j 0\ I.., ".~ (81 45.630.46 (11) 5,339.34 40.291.12 (12) (13) (14) 40.291.12 (15) (16) 1.813.10 (17) (18) (19) 1.813.10 !t lii'l Form REV.1500 ex (Rev. 6..QO) D&cedenl's Complete Address: STREET ADDRESS 2108 Cedar Run Drive CITY Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount I STATE PA I ZIP 17011 (1) 1,813.10 1,200.00 Total Credits (A + 6 + C) (2) 1,200.00 1.15 3. InteresVPenally if applicable D. Interest E. Penalty TotallnleresVPenalty (D + E) 4. Jf Una 2 is greater than Una 1 + Una 3. enter Ihe difference. This is the OVERPAYMENT. ChecK box on Page 1 Line 20 to requ..t. r.fund 5. If Una 1 + Line 3 Is greater than Line 2, enter the difference. This is the TAX DUE. A. Enler the interest on the tax due. B. Enter the total of Una 5 + 5A This is the BALANCE DUE. (3) 1.15 (4) (5) 614.25 (SA) (56) 614.25 Make Check Payable to: REGISTER OF WILLS, AGENT _.Ymmllnlll~lIIIlrrllll".lIIlr'-"'-"""""""..::J"IlIJI._IIIIIIMII__11II1 "~I1lIl'--"~~ PLEASe ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X. IN THE APPROPRIATE BLOCKS ~ i 1. Old decedent make a transfer and: a. reta\nthe use or income oftha property .ransferred;.......... ...,................................................................... b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary lnterest; or. ,... ......, .......... .................................................................. ...... .................... d. receive the promise torUfe of either payments, benefits or car67.............................................................. 2. If death occurred after December 12, 1982. did decedent transfer property within one year of death without receiving adequate consideration? ................................................................"'...m...........",'............., ................. 3. Did decedent own an "in trust for" or payable upon death bank account or security at hls or her death?......... 4. Did decedent own an Individual Retirement Account. annuity, or other non-probate property which contains a beneficiary designatIon?,...., ,... ... .... ,.. ..... ,..... ........................................................... ............................ o ~ o 181 o ~ 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 perj.l'y. I declare Ihllt I halle el<amiled lh15 relum, Including accompanying tch8dules and sWtements, and to thll beat of my kl10Wledgll and belief, It Ii true. correct and compjal6. Declal'liltion of Pf\lpurer other th.in the per9ataf regresentalive is bailed on allrnOl111811OO of \Iotllch preparw Nil anv knowledQEl. SIGNATURE OF PERSON RESPONS\aL.E FOR F\l.\NI3 RE'T\JRN ADDRESS DATE Ro P.Fr 510 Porsha Terrace Camp Hill, FA 17011 GNA.TUFtE OF PERSON RESPONSIBl..E FOR FlUNG RETURN AOCRESS ADORESS DATE 4245 Route 209 Elizabethville, P A 17023-9765 /0 For dates of d th on Of after July 1, 1994 and before January 1,1995, the tax rate ImpOSed on the net varue of transfers to or for the use of the surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (I)). Far dales of ooath on or after January 1. 1995, \:he tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.8. ~9116 (a) (1.1) (ii)). The statute does not exernot a transfer lo a surviving spouse from tax, and the stalutory requirements for disclosure of assets and filing a tax relum are stlll applicable even if the swvlvlng spouse \s the only beneficlary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased chUd 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 00 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. 99116 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. S9116 (a) (1.3)]. A sibling Is defined, under Section 9102, as an individual who has at least one parent in cammon with the decadent, whether by blood or adoption. *' SCHEDULE A REAL ESTATE COMMOHW€ALTH OF I'ENHSYLVNlIA INHEFlrTANCETAX RETURN RfSlcENTceceCENT ESTATE OF Miller, Elizabeth K. FILE NUMBER 21 - 03 - 01078 All real property owned sOlely or as atenentln 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 wilnng selier, neither being compelled to buy or seli, both having reasonable knowledge of the relevant lacts, Real property which Is Jointly-owned wllh right of survivorship must be dloclosed on schedute F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 14.174.36 Real property located at2108 Cedar Run Drive #305, Camp Hill, Lower Allen Township, Cwnberland County, sold on July I, 2004, with net proceeds in the amount of $14,174.36. See copy of settlement sheets attached which reflects a mortgage payoff, real estate transfer tax, and pro-rated real estate taxes. TOTAL (Also enter on Line 1, Recepltulallon) 14,174.36 A. Settlement statement US. D<!p"nmcnt ,If HII'Il$ing llnd Urban D~\"dnp!1lO:m O~lB No. ~~a~.o~(,.s U. Type of L,l~n DFHA 2.0fmHA 3.&JCllnv. Unins. 4. OVA 5.0CQnv. 1M 6, II<!Number 7. L(1arl NUlllb~r S. Innpge nl, Cll~e Number 55.2 33331903 C TJli~ form j~ furnished ~s a strttement IIf actual sd!lemcnl to:;l!.. Amounls paid te and by Ih~ ~elllem<!nl aj;enl are ~h(l\\"n lIerm mark~d (IJ"~) were p.,id "ul~ide IIle tln:,in~: nleY ale ~l1l1wn rn( infnrm'lli"nal r\Jrpn~e.< ;Inrl :1r~ Il"r in,luded ;n 1111011.< [). N~111e Rn<t Ad(lre~~ nll.lorrower I t. N;;me ',11'10 Aodre5S ot :seller , ~. ,\'a~ "nd Addre~~ 01 lender Mithae181eugh Elizabethk.H1l1erEstate Ccr.-'"lI~rce B~nk (. lOD Se.,ate Avenue Calllp H111. PA 17011 (j Pr"fl.rty LO(';ltj"n 'r\.Sel\lemcmA~ent Davi d J. Ldnl~ 2108 Cedar Run Dr;ve #305 Y1aceul:Selllemem .SelrlernenlvRIl:: Camp Hi 11 , Penl'\sy1v...t\i~ Cumberldnd County 2157 Harket 5treet 07101/2004 C6IIp Hill P#o. 17an J, SU/<'lMARYOF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TR...l,NSACT1Of'!: 100 GROSS AMOUNT DUE fROM BORROWER '00. GRDSS AMOUm DUE TO SELLER 101. COl1lrlu;(saltsprico: 51,000.00 0101. CnntraclUltspri,e 51,000.00 102 Pcnnnalllloperty 402 Personalp.n'?efty 103. StHI~menl d\lIrJ;es fO llorrowef(line 1400) 2 .50B.~O 40J 104 010..1. 105. 40j. AdjuSlnlllnlS for ileffiS pllid by sell",r irl advance Ad)umnenlS for ittm~ paid by ~el1er in ~d"ftrl'e 106. CirY/I<lWn!n~s I, '" Cil)'llnwnt;lxes " 107, COtJnlYlaxCS 07/01/2001b 12/J1/2004 126.11 407, Counryt.u;es 07/(}1I201)4. 12/31/2004 126.11 108. Asse~smenfs " 408. Assessments " 109 409. 110 410. III 411. 112 412 120 GROSS AMOUNT DUE fROM BORROWER 53,6J5.01 420. GROSS A~IOUi'o'T DUE TO SELLER 51.126.11 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER '00. REDUCTIONS IN AMOUJ'I,'T DUE TO SELLER 10\ Dew,silorearnestrnoney 2,500.00 50!. E~'ce.lS deposi(f~te Instrul.'tions' 202 Pri~~'ipal amuunl nfnew lllan(s) 40.800.00 50~. Settte~nll.'I1l\r~e~ to ~eUeriline 1400: 726.00 203 ExiSlin.,; lll~n()) raken subject to 30J. EXiHing Illar'l'-~'I laken ~ub.iett t(\ 20' jO~. P~}'off lIf firs! morr~a,\:e Inan 36.204.7:' 20' jQj. PIIY<;Iff ~1f $<;:c<;lru3 moT1p~e 101m 206 "". overnight Waypoint p:Jyoff 21.00 207 ~O7. 20' 50S. 209 '09. Adju~lments Cnr ilem.~ unpaid hy $<;:llef Acl.iu~rITlo:'n!.< f(lf il~nl~ unp~j4 by ~eller 210. CilylllJwnlllWS 10 510. Cilylto,'.-n l:\xe~ '0 211 Cuul1ly ta~cs " ..sIt. COllnlY taxt:~ '" 212 AssessffiCilll '" jl~. As~e5MneOls '" 213 513. '" ~14. 21' 51~. 216. jiG. 217. .517. 21S >IS 2\9 j19. 220 TOTAL PAID BY/FOR BORROWER 4:l,)00.00 520. TOTAL REDUCTION A~IOUNT DUE SELLER 36.951.75 300 CASH AT SETTLEMENT FROMITO BORROWER '00 CASH AT SETTLEMfl\'T TO/FROM SELLER )01 Gross8mou/ll dl.le from borrowcr(line 120) 53.635.(11 60t. Gtan l\lt\l.'\UI'I\ ~u-e II' sd\el.:\ine 410) 51.126.11 3112 Les~ amnunl paid by/for bQuower(line 120) 43,300.00) '02 Lt~s redu"lion amount due ~eller(line 520) , 36,951.75) 303. CASH((I] fROM){DTO) BORROWER 10,335.01 603. CASH{D TO',':O FRml) SELLER 14.174_36 Tile inrorlTlllrion contained in Dlod:s E. G. H and I and en lille 401 or. if lint.'. <lOt i, ~M\:f\$ked. lincs 403 <l{111 ~O~ is impollllnl tax in(nrmation and is bein& t"urnis/R-d to Ihe Int~mal R~Ye~ue Service. H"~'l>U ue required l\l file,t renJrn, a nr~ligen~'e ~ell~lh' or olher $;\:Jl.'lion wiIJ be imposed on you if lhj~ item i~ required to be reperted ~I\d (he IRS d<:lefl11ine~ lh~1 ir has (lor bccn repClrled. HUD.] SETTLEr>IEl\T STATE.'<IENT (I. B!.,i""":tll S"hWMC 1.~~(I-M5.fl~0(1 WARNING: II isa ,rime [U !;Iluwingly ma!;e falso:c statements. lull\e Uniled Sl~\<:~ lln lhi~ ur ~ny other similar form. Pen~Hies upon 'onyi~tion ~'an iill:ludc R fine and lmprisonn'k!nt. for details .'lee: Title 18 U,S. Code Section 1001 &. 1010 SETTLEMENT STATEMENT PAGE 2 L. SETILEMENT CHARGES PAID fROM PAID FROM 700. TOTALSALES/BROKER'S COMMISSION based oaplk<: S Sl.CCIi.OO @ <;;'""S BORROWER'S SELLER'S DiV1Si'ln OfC\lmrnissi"n (line 7(0) as fn1lOW5: FUNDS AT FUNDS AT 701. , " SETILEM Em SETTLEMENT 702. S " i03. Conunis~ionpaid at Settlement "/04. SOO ITEMS PAYABLE IN CONNECTlON, WITH LOAN EOI. LtMn Origioation Fee % SOl LollnDiSCOI.lnl -;% SO). Appuisill Fee f, to 804. CredifReport " SO, ~nder'~ Inspel,;(ionPee '06. M"rq;ll.l;'= lnmfll= App\il;a\iol\ F<:'C " S07 AssulllpfionFee 80S. Canllerce.taxservicefee 15.IlQ li09. COIIIlerce doc prep fee 250.00 810. Geotrac floodcert 5.00 %11. lJnishipper . courier fee 25.00 '00 ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANcE 901. tnt~restfrQm Q7/01/ZQ041c. (}7'~ln~<l@S 1.080000 Iday 219.58 902. M"rtgagelnsuranl;~Prcmiumfor month.<l!f1 903. HlI1.ud Jnsurance Premium for )'eanlo 904. 905. 100<> RESERVES DEpOsrrE.DwITH LENDER 1001. Hou:ardinsurance months@$ permonlh 1002 Mllrtgagcinsuranco: ffi(}ntll~@S ptrlT\Qnlh 1003 Cityprnpertyraxes monthS@S p~r month 1004. CllUntyproperrytaxcs mondl~ @ S 20 97 per monfM 100.5. Annual ass~ssmenfs monthS@S 50 14 per I110tlth 1006. monlhs@$ per month 100'1. mnmhs@S per month 1008. ..ggre9ate adjustment 1100. TITLE CHARGES 1101. S"'flle~ntorclo$ingfec to law Offices of O~vid J. LanZa 1102. Al.l~lrlldorti(lese:lrch I" nO) Titleel;aminalion " law Offil::es orOavidJ. Lanu 1104. Tille jn~uUnl;ebinder ,,, 1105 Docurrx:ntprepuatlon '" lllW<Jff"\u!s of OAvid J. Lanza 1106. Notlryfec$ '" cash 10,00 5.00 1107, AlforncY'sfces " lawOfficl!s of DavidJ. L4l"\ld (includes.brtveitcJTt5Numl1ers: ) 1108. TitJein$Urllncc '" law Offices of David J. Lanza 764.75 (illcludes lIb!;)"e items Num~rs: ) !lO9 Lender'seoveu!:c$ 40,800.00 COTIfIIerce 1110. Qwnet'lcoVeraj;eS Sl,OQIl,OQ Blood, 1111 Closing Servh::e Letter 3; DO lllZ. BonnieH111er. taxcert S.DO lID. 80nnie Hiller. 2004.05 school t" 589.57 1200. GOVERNMENT RECORDrNG AND TRANSFER CHARGES l'WI. R~I;of<ling (<:1:5: Dterl$ :18.50 :Mortg~~.:S 58.50 ; Fl..:Io:~se~ S 107.00 1202 CII)'/cmlnty l&x/$tllmp~: D.:edS 510.00 :Mort,!;llgeS 510.00 1203. Stalelax/sta.mp~: DeedS 510.00 ;Mort!).a:;eS 510.00 1104. recordass1gl'1l1el1tofrents 17.00 1205. 1100. ADDITIONAL SETILSMENT CHARGES 1)01. Survey " 1302. Pes/ insllectlort " 1303. Cedilr Run Condo Assoc - ,uy ~ juneassessment 205.QO 1)04, 130S. "00 TOTAL SETTLEMENT CHARGES (cnter on line 10J. Section J Jnd line .502. Section K' 2.508.90 n6.QQ ""'.$. iaet !:r !.tate Elorrow<:n ::;~li"rs The HUD-I SdllemcntS!Ucm<::l1t whilh 1 h"~'e ?~epM~<! is" IT\!<: ~r,rI a~curale m:Cllunt of this transal,;lion In nnllrdl\nte with this Sl8leme:t j A 5t"ulement Ag~nt DaVld ~ ffiza J ha\'e cau~ed or will caust Ihe funds 10 be di~bur~ed July ~, 2004 lJar( . SCHEDULE B STOCKS & BONDS COMMONWEAL,... Of PENNSnVNtIA INHERITANOE TAX RIm.IRPl RESIOE;NT OECEOen ESTATE OF Miller, Elizabeth K. FILE NUMBER 21 - 03 - 01078 All property Jolntly-owned with right of survivorship must be disclosed on Sch.dule F. ITEM I DESCRIPTION I UNIT VALUE VALUE AT DATE OF NUMBER DEATH 1 112 Shares Waypoint stock, net proceeds amounting to $2,922.60. 2,922.60 I TOTAL (Also ent.r on line 2, Recapitulation) 2,922.60 ....- .:I.I...'1:fo!'I:Iu....'II:/:l.J....::I...j:I:r:H",...I:lrf~'...ihlmllllr:flf...r.lll~.'r'l-y,Y....'T.T:l;j';J',T.~H~fffiOlt~"u ~~::'.~'llIlrrll1'l<'9.II.,;...II.]""~: ,1. ,..,.. ;',.;,:- , cOMMERCE BANK J'OELAWARE;N,A: .-~":';_:: : ,-,1-',,, . ",I." "62:101 311 Janney Montgomery Scott LLe '180.1>Ma~ke,t Street,Phlladelphia,PA19103-1_615 .. _. ,,'; ,....,.. " jr0S{2922;dbls!,.q~!'"tt~ ':. -', . ,',,' '-'-", ,'-',' . VQID,...:a:FtE~'.S,lxMClN'rHs c~~nG!@.7i3332 PAY TO THE ORDER'OF , DATE. ",122104'. ' ".1'" , -,,::,.,,> .:<....,.', ',.::'..,',./.:.., .....2922,60: : . - .. PAY'$' EST OF ELlzABETHK'MllwER RONALD P FRANK-EXEC CIO TERRENCE J<KERWIN-ATTY '4245 ROUTE 209 ELlZABETHVILLE PA 17023 JAN~EY ,~ONT~OMER7 SCOTT LtC ~fi.TJ:,;..:.z;;. .- !"{JODe O?l,3~,;~2.i!~:/I.;p ~)l,l,D_ 0 -7,(;\,:, ,'~.(5 ,,,9I;%q 2::t~o~~r!:, !,; "",,'r.. .~.h~::a.~"I:lI. :a"'~"""'"'' I~".' ...""......... ."'1I00,..'".n..,J.",."" ....,I.,.... ,"~"". "'" . ,,';.... ,.~'. JANNEY MONTGOMERY scon l.l.e PLEASE 08'AC,", BEfORE DepOSITING DEBIT ACCOUNT I'UAPQSE: SU07-5893-2255-1 WAYPOINT FINL CORP 73332 3/22/04 2922.60 ****2922.60 . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COM"'O~EALTH OF PENNSYlVANIA INHEAITNlCETAX RfTURN f\ESlOEN1" DECEDENT ESTATE OF Miller, Elizabeth K. I FILE NUMBER 21 - 03 - 01078 Include the proceeds of liligation 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 NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 10,656.89 Multi-Financial Securities Corp. - Account #3KZ-287313 2 1995 Buick Skylark Sedan 750.00 3 Household Items 500.00 4 Waypoint Bank - Certificate of Deposit #1066225787 6,923.36 TOTAL (Also enter on Line 5, Recapitulation) 18,830.25 ~ Multi-Financial HC".'TUI co..our.o.. 1290~olldway De:nver, co 80202 (303)+46-8400 AOCIOOooooo~a~7C3n05llP Imllln,IIl",~"111'lln'I.I.II,II'II"'III'"IIIIII,,.I,1I ELIZABETH K MILLER CIf JASON FRANK UGMA/PA 2108 CEDAR RUN DRlVE UNIT 305 CAMP HILL PA 17011-7-481 YDllr FlIMdaI Co..tlaIt DONALD E YOST (717) 975-0509 Asset Allocation MutuillFunds Cash aooCash Eauivaleots Ac.mlnt T obi V~.. Lasl P.nH 10,657.03 -0.14 $10,656," VoIoo rhisp,lfod 10,739.92 -12.64 $10,117.11 AOOOOOOOOO~l~I'c:srI05DP YOUR Brt:lkerage Account Account Number: 31CZ-285754 Slil<menl P..locI: 01/01/>004.01/30/2004 Period Beginning Account Value: $ 10.656.89 Period Ending Account Value: $10.717.28 P,n.1It "a.adiD. 10"" "" ""'" Your Accounl is 100% invested In Mutual Funds. Cloo,i"9~~ PenhIug- ;:::IM~c.~""f". PAA-02-ROlL PlICI.1 of~ o....r..""ne"",",u,JerooyCily,l<l<rw.loneyOlJ99 ........w;_lIIII,m~!W'l......~......_UL = = !!!ii ~ "'" = -= ~ = - == E! - -= -= !;!i '* SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEAl.TH OF PEr..tlSYLVANIA lNHEArTANCE TAX RETURN RESlOENT DECEDENT ESTATE OF Miller, Elizabeth K. I FILE NUMBER 21-03 -01078 If an asset wes made joint wIthin one yeer of the daceden!'. dele of deeth, It must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME A Ronald P. Frank ADDRESS RELATIONSHIP TO DECEDENT 510 Porsha Terrace CampHill,PA 1701\ Son JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include nama of financial Institution and bank account number DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT r similar identifying number. Attach deed for Jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST estate. 1 A 09/22/1992 Savings Account #1060001 138 2,046,23 50% 1,023.12 Waypoint Bank 2 A 02/25/1992 Checking Account #1000005586 1,782.08 500/. 891.04 Waypoint Bank , I TOTAL (A1ao enter on line 6, Recapitulation) 1,914.16 COMMONWEALTH OF PEN~SVlVANIA DEPARTMENT OF REVENUE BUREAU Of INnt~IOUAl iAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0501 - IN~ORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 03-1078 04115511 04-09-2004 UY-liH U ~f~ (G'-aDl EST. OF ELIZABETH K MILLER 5.5. NO, 205-09-9642 DATE OF DEATH 12-20-2003 COUNTY CUMBERLAND TYPE OF ACCOUNT 1iI SAVIHGS o CHECKING o TRUST o CERTIF. RONALD P FRANK 510 PORSHA TER CAMP HIll PA 17011-1266 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAY POINT BANK hn provided ttle Depertlllilnt with thu inforlUltion 1htlild billow which hllS lJaan used in caleulating tha pot8ntial tax dua. Their records IndlcBtD that at thD death of thD above decedant, YQU wlilre " joint ownar/benefI~iary of this aeeount. If you faDl thIs lnformatlon Is incorrRct, p1.es. obtain wrltt.n correctIon from the financIal instItutIon, ettech a copy to this form and return it to the above addro55. This account I~ texabl8 10 eocord8neg wIth t~a InharItancu Tax laws of th. Com~onwe81th of pgnn$ylv~nle. Questions ~BY bg Bn!wgred by callIni (7l?) 787-83Z7. COMPLETE PART 1 BELOW" " " SEE RI;:VERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1060001138 Date 09-22-1992 Es1:.bl1sh.e To insur& proper credit to your account, two (2) copi.s of this noticB ~ust acco~Plny your p~Yment to the Register of Wills. M9ka cheek paY.blg to: "ReiIstar of WIlls, Ag8nt... [CHECK ] ONE BLOCK ONLY Account BalancB 2, 046 . 23 Per-ce.nt Ttlx:able X 50.000 Amount Subject to Tax 1,023.12 Tax Rt!lte X .15 Pohntial Tax Due 153. 'i 7 PART TAXPAYER RESPONSE [TI ll'ill";'lIr"'j""""""'''''''''''''."''''''"''''''''''';'~';''""""'"","'i,"''''''''''.~"'''",,; "'I"...."''''''",,'''''"''''..,~''''''""'''''''';.......j''_''"iiII'.'"'~''';"'''.,'''..""""""""",." ,.",,", ~!;.\~~'i~~~~~fr\\~~~!#~~if:'~~::~:~~!j~~i~i~~~ili~'~:~i~1~ik~~m!~~I~i!~~,,,\,~!:i:~~~:!~~i~~;~i!llir~~i;~~~!ii~~~!m~i~~!9.ii~jmu.J~~firffi~:it~~~:~i!~i~~i~Jiffi~~!~j~t:i~tfrlWm: A. c=J The above infar~tlan ~nd tax ~ue Is corrlilct. 1. You /IIay choOSII to remdt pi!l)/1'II8nt to tha Register of Wills with two eopiQs of this noticliI to obtain a discount or avoId intllrlllllt, or ~ou rna~ eheck box "A" IInd return thIs notlce to th.. Regist.r of Wills and an offici~l ass~~smBnt will be issued by the PA Departm9nt of RlilvenUII. 8. ~ The abovg aS$lIt has beliln or will bD rlilpoded end tax pdd with the ~~S'y~anI8. Innari.tunca Tax return )Alto t)tl filed bi the d&C&Cllnt's rnprUlilntative. r~tt<iZi)~~ 4.s-% c. c=J The IIbovn information Is Incorrgct and/or debts and dllduoticns ~QrQ ~~id b~ ~Olj. You must complate PA~T Q~ ~nd/or PART ~ below. NOTE: If tax payments IIrB mad. within three (3) months of the dQcadQ"t's data of daath, you .ay deduct a 5% discount of the tax due. Any InherltenclI tllX dUD wIll bliloome delinqulilnt nIne (9) ~onth~ eftllr the date of death. PART o DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please stata your relationship to decedent: PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established Z. Acco~n~ Balance ~. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate B. Tsx Due TAX ON JOINT/TRUST ACCOUNTS OF 1 2 3 4 S . 7 8 x x PAYEE DESCRIPTION AMOUNT PAID ;1 I $ t TOTAL (Enter on Line 5 of Tax Computa~1Dn) Under penalties of perjury, I declare that the COMplete to the best of My knowledge end ~ ~fW'A""JJff)(b~.IIl2fi#L. f.ct$ I have reportBd above are true, car-r-Bet and HOME ( ) W~~K__ <?/)),RJ..?'c--'I76 S , fl_-oq COMHOMWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF IHD!V!DU~l TAXES OEPT. Zl'J1I6111 HARRISBURG, PA 17128-0601 - INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 03-1078 04115510 04-09-2004 U:Y.15U E. "~ (~'-OOI EST. OF ELIZABETH K MIllER 5.5. NO. 205-09-9642 DATE OF DEATH 12-20-2003 COUNTY CUMBERLAND TYPE OF AccounT o SAVINOS IXJ CHECKINO o TRUST o CERTIF. RonALD P FRANK 510 PORSHA TER CAMP HILL PA 17011-1266 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAY POINT BANK hu pf"C1vidllld ttllll Olllpllrtunt with thllil il'lfcrllllilUo'n listed bllllow whIch hu bllilRn uud in c~lculating the potenti~l t~K due. Their rucords indic~tlll that 8t the death of thlll abOve dllloedent~ you were ~ joint own~r/b.n.fici8ry of this account. If you fIll this infor~8tion is incorr.ct~ plRaSIlI obtain writtlliln cor-r.ction fjO~ the fin.noi8l institution, attach 8 eOpy to thi~ form and rlliltur"n it to thlll above addresl. This account is ta~abl. tn aceorduncg with the InhlllritaMce Tax Law~ of the Co~~onw881tn ~f P~n~~~JvBni~. Cue$t!oo~ ~e~ b~ ~n~w~~p~ by ~~l'i~g (7171 1a7-83~7. COMPLETE PART 1 BELOW Account No. 1000005586 .. .. .. SEE n.h Est:abl1st,"ld REVERSE SIDE FOR 02-25-1992 FI~ING AND PAYMENT INSTRUCTIONS PA~T [1J 1,782.08 50.000 891.04 .15 133.66 TAXPAVER RESPONSE \!I\~~,~~~~~l!\i~'~:m,!!!l~!~iii~~~~jfr:~I~~~lJjil~~t'[~NiL~~~~'~~1l!1i~~~1r~~;,:"i::~~,~!~~!'II~~~~im!~~~,\1!~~~i~~ltit;~,~~I:~! A. 0 Th. 1!I00\llil InformeUOI1 lllnd t_ due Is l;:orreC\. 1. ~ou may chcosllI to rBMlt pay_ant to tho Rl!Igi$t.r" of Wills with two copillls of this neticQ to obtain II di,count or avoId ,intllilrest, or you lIey OI'Hlck: box "A" l!Ind r"Dturn tnis notIce to the RClgistqr of Will' Dnd 8n Qffiel.l .5$&~~m~nt will be iS~l!Id by the PA DePllr"tment of RllIvenue. B. M'Thil Dbov., l'Isset has oOlln or will 0& rOlpof"ted !lind, tfJ!5.;f;eid ."'ith~))1" PUMsylllanl.e Inheritancl! Ta)( return to bll filad by ttle ollcedllnt's repr"asanhtive. Rd0~.J;..eJ 4. ~~ c. c=J The eOOVil informatIon is incor"reet end/or dabts end deductions ~e~. peId b~ you. You must complete PART ~ end/or" PART ~ below. Account Balance Percent Taxable Amount Subject to Tax F.~ate Potential Tax Due K To Insur"Q proper credit to your account, two tl) copies of this notice ~ust llccompany YOUr" ppY~ent to the Register of Wills. Hake ChMCk pilYllbh to: "Register of Wills, Agent". x NOTE: If ta~ paymlllnts are mad8 within three C3) months of th~ d.ead~t.s data gf Death, you may oeducf a 5% discount of the tax due. AMY JnhRr"itanca tax due wiil become delin~ulllnt nina (~) months after the data of death. Tax [CHECK ] ONE BLOCK ONLY If you indicate a different tax rat., please state YOUr r81a~lonship to decedent: PART o DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART @) TAX RETURN - COMPUTATION LINE 1. Date Established 2. AccQynt Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts end Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF 1 2 3 4 5 6 7 8 x TAX ON JOINT/TRUST ACCOUNTS x PAYEE DESCRIPTION AMOUNT PAID I $ =1 l TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury} I declare that the complete to the best of my knowledge and belief. 1~)t~/l4~j:47$ facts I have reported abo~e are tru.~ correct and HOME WORK ( ) _(7/1 )~};r-7'7bL;-' ,,~h/ou '* SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY COMMONWEALTH Of PENNSYLVANIA INHERiTANCETAA RETIJAN RESIDENT DECEDENT ESTATE OF Miller, Elizabeth K. FILE NUMBER 21 - 03 - 01078 This schedule must be completed and filed If the answer to any of auestlons 1 throu"h 4 on "a"e 2 Is ves. ITEM DESCRIPTION OF PROPERTY OAT" OF DEATH %OF l\"ld\lde the name of \he lransfllffl$. their relatJ~ to decedent and the dBtl oItransfer DECO'S ""CLUSION TAXABLE VALUE NUMBER Altach 8 GOpy of ~& deed for real Mlale. VALUE OF ASSET INTEREST (IF APPLICABLE) I Waypoint Bank (Elizabeth K. Miller ITF Jessica L. Frank, 1,303.38 1,303.38 gtanddaughter) Savings Account #0505534393 2 Waypoint Bank (Elizabeth K. Miller lTF Jason M. Frank, 72 1.88 721.88 grandson) Savings Account #0505533726 3 Waypoint Bank - Certificate of Deposit (IIF Jessica L. 616.88 616.88 Frank, granddaughter) Account #1000012984 4 Waypoint Bank - Certificate of Deposit (ITF Jessica L. 3,235.49 3,235.49 Frank, granddaughter) 1064259466 5 Waypoint Bank - Certificate of Deposit (IIF Jessica L. 647.29 647.29 Frank, granddaughter) Account #1000008885 6 Waypoint Bank - Certificate of Deposit (IIF Jason M. 647.2~ 647.29 Frank, grandson) Account #100008886 7 Waypoint Bank - Certificate of Deposit (IIF Jason M. 616.88 616.88 Frank, grandson) Account #1000012985 I TOTAL (Also enter on line T, Recapitulation) 7,789.09 t"WaYRRi!lJ P.O. Box 1711. l-tarrlsburg. P.nnsylviilnllll 17105-1711 MQI1'\berFOIC COMBINED STATEMENT DATE 1-31-04 [LllABErH K HILLER TRUSTEE JESSIe' , fR'."'. BENEFIC 2108 cr:'R RUI! DR APT 305 CAMP P' PA011-7481 011-1689 LOOKING TO EARN MOREl OUR CERTIFICATE OF DEPOSIT SPECIALS ARE HARD TO BEAT' VISfT YOUR LOCAL BRANCH OR CALL US AT 1-866-WAYPOINT FOR DETAILS. - - - .YOUR ACCOUNTS WITH US- - - - - - - - - - - - * ACCOUNT NBR BALANCE 505534393 1.303.38 1000008885 .000 647 29 I 000~.Q064dj~~~~~~'~~6. 88 ":::<..,"~_,>" :.':..', ','<'~~_: :,:,-:.':'-'i" " ,,',;,,'. ~,.:, :._,.-:_:,w_~'\ 1 0 6 4~~~i~'6'6'i. ,>. .0'.00 1>. '3 .23 5 . 49 ," ~ '. ,-" . *". - . - - . - --YOUR DEPOSI SAVERS ADVAN 60-119 MONTH Matures on 48.59 MONTH CE Matures on 48.59 MONTH C Matures on .Total of Your ':,?-~;. ,'" PREVIOUS BALAN DEPOSITS WITHDRAWALS CHARGES INTEREST ENDING BALANCE 5.8030 4 ACCOUNT TYPE OF 505534393 SAVER'S .16 .00 00 .00 .22 1.303 38 . . . . . . .INTEREST SUMMARY. - INTEREST EARNED FROM 12/31/03 TO 1/31/04 D.'.YS IN PERIOD INTEREST EARNED ANNUAL PERCENTAGE YIELD EARNED INTEREST PAID THIS YEAR INTEREST WITHHELD THIS YEAR * . . . . . - . . - - . . - TRANSACTION SUMMARY. TRANSACTION OEPOSITS/ DATE DESCRIPTION CREDITS liDS TRA~SFER FROM CHECKING 25.00 1/31 lNTEREST PAYMENT .22 . . 31 .22 .20 % .22 .00 * CHECKS! DEBITS BALANCE 1303 16 1303.38 THANK YOU FOR BANK1NG AT wAYPOINT 8ANK POO-502 (8102) CustomEr ServiCE Toil-FreE 1-866-WAYPOINT (1-866-929-7646) . In York Area 717/815-4500 www.waypolntbank.com "I WayJ:tqint P.O. Box 1711. Harrisburg, Pennsylvania 17105-1711 Member FDIC COMBINED STATEMENT DATE 1-31-04 ELIZABETH K MILLER TRUSTEE JASON M FRANK BENEFIC 2108 CEDAR RUN DR APT 305 CAMP HILL PA 17011-7431 011-2688 LOOKING TO EARN MORE' OUR CERTIFICATE OF DEPOSIT SPECIALS ARE HARD TO BEAT' VISIT YOUR LOCAL BRANCH OR CALL US AT j-866-WAYPOINT FOR DETAILS. * - - - - - - - - - - - - YOUR --YOUR DEPOSITS-- SAVER'S ADVANTAGE 60- 119 MONTH CERTIFICATE Matures on B-11-08 . 48 - ~~t~~~IH o~ERT~~6j~~*~&tJ' - Tot a I of Your Oepos 1t$;... ACCOUNTS WITH US- . - . - . - ACCOUNT NBR 505533726 1000008886 .000 1 0 0 0 9*3i~,R:u..;,::;.;.E 0 . . . . . * BALANCE 721.8B 647.29 .88 1,98605 " ;,.: ':';';;'.~-. " ACCOUNT TYPE OF ACCOUNT 505533726 SAVER'S ADVANTIIG,E',/;r: 1:.',',,'-.,. ...... _._ .. ----------------------------~-~---------~-------------------~~-------------- PREVIOUS BALANCE OEPOSlTS WITHDRAWALS CHARGES INTEREST ENDING BALANCE }.::I,': ;:::t,":, <..; , -}~ 696 .76 25.00 .00 .00 .12 .88 ','",,),-'} - iinEREST SUMMARY - - INTEREST EARNED FROM 12/31/03 TO 1/31/04 DAYS IN PERIOD INTEREST EARI~ED ANNUAL PERCE:TAGE YIELD EARNEO INTEREST PA:, THIS YEAR INTEREST Wl-',HELO THIS YEAR * - - - - - . . - - - - . - TRANSACTION SUMMARY- TRANSACTION DEPOSITS/ DATE DESCRIPTION CREOITS 110S TRANSFER FROM CHECKING 25.00 1/31 INTEREST PAYMENT .12 * - * 31 .12 .20 % .12 00 * CHECKS/ DEB I TS BALANCE 721.76 721.88 THANK YOU FOR BANKING AT WAYPOINT BANK Customer Service Toll-Free 1-866-WAYPOINT (1-866-929-7646) . In York Area 717/815-4500 www.waypolntbank.com POD-502(1lI02) V1Way~qi!lJ p.o. Box 1711, Harrisburg, PlI!nnsylVllnla 17105-1711 Member FDIC COMBINED STATEMENT DATE 1-25-04 RONALD P FRANK OR ELIZABETH K M]LLER 510 PORSHA TER CAMP HILL PA 17011-1266 012.801 LOOKING TO EARN MORE? OUR CERTIFICATE OF DEPOSIT SPECIALS ARE HARD TO BEATI VISIT YOUR LOCAL BRANCH OR CALL US AT ]-B66-WAYPOINT FOR DETAILS. *. - - . . . . -~OUR ACCOUNTS WITH US- - - - - - - ACCOUNT NBR 1060D01138 1000005586 - - - - . * --YOUR DEPOSITS-- SAVER'S ADVANTAGE FOCUS FiFTY BALANCE 00 3.125.67 '3\.:125.67 -Total of Your Depo ACCOUNT TYPE OF ACCOUNT 1000005586 FOCUS FIFTY 'j';' AV.IRAGE .BALANCE ,'2,981.07 PREVIOUS BALANCE DEPOSITS WITHDRAWAL 5 CHARGES INTEREST ENOING BALANCE 1,557,42 4,23767 2.669,80 .00 .38 3.125.67 * - - . - . - - - - - - -t.HTIRtSt SUMMAR Y - - INTEREST EARNED FROM 1I.1'25103'.,1'0 1/25/04 DA~S IN PERIOD ..< , INTEREST EARNED ANNUAL PERCENTAGE YIELD EARNED INTEREST PAID THIS YEAR INTEREST WITHHELD THIS YEAR * .' - - . - - . - - - , TRANSACTION SUMMARY- TRANSACTION DEPOSITSI DATE DESCRIPTION CREDITS ]2/30 CHECK 2493 12/30 CHECK 2495 1/02 ELECTRONIC TRANSACTION US TREASuR~ 312 CIVIL SERV 1/02 ELECTRONIC TRANSACTION US TREASJRY 312 CIVIL SERV 1/02 CHECK 2496 1/05 TRANSFER TO SAVINGS ]/05 iRANSFER TO SAVINGS 1/05 CHECK 2497 li06 CHECK 2499 1/06 CHECK 2498 * 31 ,38 .15 Z .38 00 * 1112 00 64000 CHECKS I DEBITS 25.00 22.80 BALANCE 1532.42 1509.62 2621.62 3261.62 3103.73 3078.73 3053.73 2825.73 2425.73 2312.85 CONTINUED ON NEXT PAGE 157.89 25.00 25.00 228,00 400.00 112.88 Customer Service Toll-Free 1-866-WAYPOINT (1-866-929-7646)' In York Area 717/815-4500 www.waypolntbank.com POp.502 (8102) '* SCHEDULEH FUNERAl.. EXPENSES & ADMIItSTRA11VE COSTS COMMONWEALTH OF" PE'NNSYL.VANIA INHERITANCE TAARETUAN. RESIDENT OEcE09T ESTATE OF Miller, Elizabeth K. I FILE NUMBER 21 - 03 - 01078 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES, I Deissler's Flowers. funeral flowers 112.88 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I ErN Number of Personal Representative(s): Street Address City Stat. - Zip Year(s) Commission paid 2. Attorney's Fees Kerwin & Kerwin -- Terrence J. Kerwin, Esq. 1,875.00 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 10 Decedent .. Probate Fees Register of Wills 228.00 5. I Accountant's Fees 6. Tax Return Preparer's Fees Ritter - 2003 Income Tax Returns 100.00 7. Other Administrative Costs I Citicorp Credit Services ~ account payable 630.30 2 Register of Wills - Short Certificates 12.00 Total of Continuation Schedule!s) 2,381.16 TOTAL (Also ..nt..r on IIn.. 9, Recapitulation) 5,339.34 *' SchedI.E H Fl.rleraI Expel SB & AdJ. Mrali.e Costs CXlI"Ilhled GOMMON'NEAI.TH OF PENNSYLVANIA INHERITANCE l,ll)l. RETURN RESIDeNT OEce:OENT ESTATE OF Miller, Elizabeth K. FILE NUMBER 21 - 03 - 01078 3 Register of Wills - filing fee Inheritance Tax Return and Inventory 25.00 4 Quality Cleaners - account payable 5 JC Penney - account payable 6 Fara Family Tire - account payable 7 FHB - account payable 8 CCFCA - account payable 9 MSHMC Physicians Group - account payable 10 Capital One - account payable II Boscov's. account payable 12 Verizon. telephone bill 13 PPL - electric bill 14 Comeast - cable bill 15 Karl Schubert - trash 16 2108 Condo Association 17 Waypoint - loan payment 18 Waypoint - loan payment 19 Closing costs. e.g. Releases. postage, copies 22.00 157.89 315.49 97.42 60.00 15.00 100.00 70.98 80.25 253.19 79.28 110.00 103.00 438.33 438.33 15.00 Page 2 of Schedule H REV:1513 EX+ (NO) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECeDENT ESTATE OF Miller, Elizabeth K. I FILE NUMBER 21 - 03 - 01078 ~..- RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME ANO ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE -.--- I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Jason M. Frank Grandson 2,000.00 510 Porsha Terrace Camp Hill, P A 17011 2 Jessica L. Frank Granddaughter 2,000.00 510 Porsha Terrace CampHilI,PA 17011 3 Ronald P. Frank Son 100% residue 510 Porsha Terrace CampHilI,PA 17011 I I Enter dollar amounts fordistrlbutions shown above on lines 15 through 18. as appropriate. on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET llInst ~illl1no mcstllmcnt nf ELIZABETH K. MILLER I, ELIzABETH K. MILLER, of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, 00 make ana publish this, my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. FIRST: I direct my hereinafter named Executor to pay all my legally enforceable debts, funeral expenses, administration expenses and inheritance, estate. succession or excise taxes, which I owe or may become due on account of my death, as Soon as may be convenient after my decease. I further direct that my funeral arrangements be handled through the Neurnyer Funeral Home and I be burried with my late husband, John A. Miller at Ft. Indiantown Gap National Cemetary, Section 12D,Grave 843. SECOND: I give, devise and bequeath the sum of $2,000.00 to my grandson, JASON M. FRANK, and r further direct that said $2,000.00 be placed in account no. 05-533726 which is an account that I have maintained for JASON M. PRAN~ at Harris Savings and Loan Association. In the event JASON M. FRANK would predecease mel I direct that this bequest be made to JESSICA L. FRANK in account no. 05-534393. THIRD: I give, devise and bequeath the sum of $2,000.00 to my grandaughter, JESSICA L. FRANK, and I further direct that said $2,000.00 be placed in account no. 05-534393 which is an account that I have maintained for JESSICA L. FRANK at Harris Savings and Loan Association.In the event JESSICA L. PRANX would predecease me, I direct that this bequest be made to JASON M. FRANK in account no. 05-533726. Page 1 of 2 Pages '"d .~ ~/ ./ -, .. C'-~: l,-'-t'L-' A. fK"'~.(.I1.,,- EL ABETH K. MILLER (SEAL) FOUR'l'H: I give, devise and bequeath all the rest, residue and remainder of my property, be it real, personal and mixed, whatsoever or wheresoever the same may be situate at the time of my death to my son. RONALD P. FRANK. FIFTH: I nominate, constitute and appoint my son, RONALD P. FRANK, as E~ecutor of this, my Last Will and Testament. r further direct that my within named Executor shall not be required to post bond to act in said capacity. IN WITNESS WHEREOF, I, ELIZABETH K. MILLER, have hereunto set my hand and seal to this, my Last Will and Testament, this ~~. day of ')"ti...-f /91'9 A.D., / SIGNED, SEALED, PUBLISHED and DECLARED by the above- named Testatrix, ELIZABETH K. MILLER, as and for her Last Will and Testament, in the presence of us, who at her request and in the presence of each other, have hereunto s t our names as witnesses: ~ C1'i. . 1989. ~~,...L.?....L k 7J4-Ct:~ EL AEETH K. MILLER ISEFo.L) Page 2 of 2 Pages COM~QNWEAli'rl OF F'ENN5'r'lVAN1A OfPA,'lTMENT OF REVENUE 8UREAU OF INDIVIDUAl TAXES DEPr. 280601 HARRISBURG. f>A 17128.0601 REV.1162 EXi11.96} RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KERWIN TERRENCE J ESQ E. MAIN STREET RR01 BOX 566 ELlZABETHVILLE, PA 17023-9765 .Uh___ fold ESTATE INFORMATION: SSN: 205-09-9642 FILE NUMBER: 2103-1078 DECEDENT NAME: MILLER ELIZABETH K DATE OF PAYMENT: 09/20/2004 POSTMARK DATE: 09/17/2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/20/2003 NO. CD 004405 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,200.00 , I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#148 SEAL INITIALS: JA RECEIVED BY: TAXPAYER $1,200,00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BJREAU OF INDIVIDUAL TAXES DEPT.2S0S01 HARRISBURG, PA 17128.0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECeiPT KERWIN TERRENCE J ESO E. MAIN STREET RR01 BOX 566 ELlZABETHVILLE, PA 17023-9765 .___n__ lold -- ESTATE INFORMATION: SSN: 205-09-9642 FILE NUMBER: 2103-1078 DECEDENT NAME: MILLER ELIZABETH K , 10/08/2004 DATE OF PAYMENT: POSTMARK DATE: 10/07/2004 COUNTY: CUMBERLAND DATE OF DEATH: 12}20}2003 NO. CD 004481 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $614.25 I I I I I I I I TOTAL AMOUNT PAID: $614.25 REMARKS: CHECK# 150 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~ J r . ",..J;- , i I . : ! . : ~ I I ! . I 1 ~ i . ! j f t ~ . i . ! . FLAT RArE POSTAGE REGAIIDiEsS OF WEIGHT DOMESTIC USE ONLY FOR PICKUP CALL 1-800-222-1811 iiif 111111 u.$"",el!StfIGE ElIZAllEH>>YLLE.PA oc~c~ . ..;::::'= HOW ro USE: ~ 1. COMPl..ErEAOORESSLABEL~ KERWIN" KERWIN TyperJIprintrl/qlllrwlmum Attorneys at law .atruaand~1nfoImIt/on Incuatomcorblock(whltearN) 4246 Rollle 209 OI:OI'1tee1(1fprovided). ElizabethviUs, PA 17023 2 i rn .2. PAYMENT MErHOO IlEGIS1'EIl OJ' VlLLS -~ AlffxpollllgltornM,.._ID_ CQlBERlAlID COOIITI' COUITBOUSl!: , /ndicafedklllPlW/lgllthandc:omr. 1 COUB.'l'BOUSE SQDAU :,,," i CULISLI. PA 11013 .i' t;,., ~ [ad 3. ArrACHLABEL(lfprrwIdfIdJ ~ Remo\IIIlmeItJecIt.Jr,gllld~ o""'ClIlI/tImer~bIock_ ~ ..,..- I ... PLACE LABEL HERE ... ~ . COHMONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES ZNHER~TANCE TAX D~VISION NOTICE OF INHERITANCE TAX po BOX ZB060I APPRAZSEHENT, ALLONANCE OR DZSALLONANCE HARRISBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX ,EV-X~4? EX AFP (09-04) DATE 12-15-200q ESTATE OF MILLER ELIZABETH K DATE OF DEATH 12-20-2005 FILE NUMBER 21 03-1078 TERRENCE J KERNIN ESQ ACN 101 KERWIN S KERWIN Amount Remitted q2~5 RTE 209 ELIZABETHVILLE PA~';i7Oz$ HAKE CHECK PAYADLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 170Z3 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MILLER ELIZABETH K FILE NO. 21 03-1078 ACN 101 DATE 12-13-200q TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 1~17~.36 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 2z922.60 credit to your account, $. Closely Held Stock/Partnarsh/p Interest (Schedule C) ($) .00 subait the upper portion q. Mortgages/Notes Rece/vable (Schedule D) (q) .00 of th/s fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) ($) 18z8~0 .Z5 tax payment. 6. Jolntly Owned Property (Schedule F) (6) 1;91q.16 7. Transfers (Schedule G) (7) 7z789.09 8. Total Assets (8) q5,630.q6 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/H/sc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) .00 11. Tote1 Daduct/ons (11) 12. Net Value of Tax Re~urn (12) q0,291.12 15. Charitable/Governaental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Nat Value of Estate Subject to Tax (lq) qO,Z91.12 NOTE: If an assessment ,as lssued previously, lines lq, 15 and/or 16, 17, 18 and 19 ~111 reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rata (1S) .00 X O0 = .00 16. Amount of Line lq taxable at Lineal/Class A rata (16). qO,Z91.12 X Oq5 = 1,813.10 17. Amount of Line lq at Sibling rata (17). .00 X 12 = .00 18. Amount of L/ne lq taxable at Collateral/Class B rata (18). .00 X 15 = .00 19. Principal Tax Due (19)= 1,813.10 TAX CREDITS: PAYMENT RECEIPT DISCOUNT AMOUNT PAID DATE NUMBER /NTEREST/PEN PAID (-) 09-17-200q CDOOqqO5 .00 1,200.00 lO-07-ZOOq CD00qq81 1.15- 61q.25 TOTAL TAX CREDIT 1,813.10 BALANCE OF TAX DUEI .00 INTEREST AND PEN. . TOTAL DUE . §0 ZF pAID AFTER DATE IND/CATED, SEE REVERSE ( ZF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REi~UIRED. FOR CALCULATTON OF ADDTTTONAL TNTEREST. TF TOTAL DUE IS REFLECTED AS A "CREDTT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS. STATUS REPORT UNDER RULE 6.12 Name of Decedent: ELIZABETH K. MILLER Date of Death: December 20, 2003 Estate No.: 2003-01078 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1.State whether administration of the estate is complete: Yes X No~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. ( if any) for the personal representatives' account is · c. Did the personal representative state an account informally to the parties in interest? Yes X No~ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. '~--, Datee~ecember 21, 2004 n~amre~ ~~x~ CD - -- TD ;'];: i._-. ex.. cD c.> f--. TERRENCE J. KERWIN, ESQUIRE !-~i:! i:i.' ~ ~.~ _cc... 4245 ROUTE 209 ,-' .... ~ :~74 ;::' ELIZABETHVILLE, PA 17023 ' ' ' ~ '- .'2.5 _1.2 :, ::-> ~ ~ .... --'~ c~Q~ (717) 362-3215 o.~ Capacity: Personal Representative X Counsel for Personal Representative Estate No. 2003-01078 KNOW ALL MEN BY THESE PRESENTS, that I, RONALD P. FRANK, of 510 Porsha Terrace, Camp Hill, Pennsylvania, do hereby acknowledge that I have received from Ronald P. Frank, Executor of the Estate of Elizabeth K. Miller, late of Lower Allen Township, County of Cumberland and Commonwealth of Pennsylvania, one-dollar ($1.00) and other valuable consideration in full settlement of any claim or claims that I may have by, under and because of the Will of the late Elizabeth K. Miller. AND, THEREFORE, I, RONALD P. FRANK, intending to be legally bound hereby, do, by these presents, release, quit-claim and discharge Ronald P. Frank, as Executor of the Estate of Elizabeth K. Miller, deceased, and, his heirs and assigns, of and from all actions, claims and demands whatsoever, related to the administration of this Estate. I, RONALD P. FRANK, have been duly advised of my right to have Ronald P. Frank, Executor, file with the Orphans' Court Division of the Court of Common Pleas of Cumberland County an Accounting of the services he has rendered, and I do hereby specifically waive my right to have such an Accounting prepared and presented to the Court. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this '5[ 5q' day of T)_ .~c~. ~ 2004. WITNESS: RONALD P. FRANK TERRENCE J. KERWIN D:/laUesmte/release. EKM HOLLY MCCLURE KERWIN ATTORNEYS AT LAW