HomeMy WebLinkAbout03-0489 ETZWEILER AND ASSOCIATES
ATTORNEYS-AT-LAW
105 NORTH FRONT STREET
HARRISBURG, PA 17101 2 West Main Street
Earl Richard Etzweiler (717) 234-5600 Elizabethville, PA 17023
Christian S. Daghir ..... (717) 362-8395
HALIFAX LINE
(717) 896-373 7 225 Market Street
Millersburg, PA 17061
Fax Line: (717) 234-5610 (717) 692-2519
June 5, 2003
Register of Wills Sent via fax and regular mail
Cumberland County Courthouse (717) 240-7797
Hanover and High Streets
Harrisburg, PA 17013
RE: Estate of Homer E. St. Sing a/k/a Homer E. Saint Sing, a/k/a
H. Eugene St. Sing - Deceased 06/04/2003
(Informal Caveat)
Dear Sir or Madam:
Please find enclosed a copy of what we believe to be the Last Will and Testament of
Homer E. St. Sing a/k/a Homer E. Saint Sing, a/k/a H. Eugene St. Sing.
We are requesting at this time that you do not probate any other document that may be
presented as the Last Will and Testament of Homer E. St. Sing a/k/a Homer E. Saint Sing, a/k/a
H. Eugene St. Sing, Deceased, who died on June 4, 2003. Mr. St. Sing had in the past thirty (30)
days become a resident of Dauphin County having taken up residency at the Frey Village Nursing
Home, located at 1020 N. Union Street, Middletown, Pennsylvania, but just prior to that time had
lived in a home which he owned in Cumberland County. We are therefore unsure as to which
County someone might attempt to take out letters.
If any other Will is presented for probate, we would request that 'this office be contacted
immediately.
We are making this request on behalf of our client, Susan J. Foulke, now known as,
Susan J. Neifert, who is one of the two children of Homer E. St. Sing a/k/a Homer E. Saint Sing,
a/k/a H. Eugene St. Sing.
Sincerely,
Earl Richard Etzweiler
ERE:haf
Enclosure
'Etzweiler and Associates
105 North Front ,._ [reet ~..: ....... '
Harrisburg, PA 17101
.> ~ Register of Wills
,:~ '- Cumberland County Courthouse
....c~ ~::~ Hanover and High Streets
. ~ Harrisburg, PA 17013
V. I direct that no bond be required by my fiduciaries for the faithful
performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I, HOMER E. ST. SING, herewith set my hand to this
my Last Will and Testament, typewritten on two (2) sheets of paper, including
the attestation clause and signatures of witnesses, this ~O~-"day of
!
,,~; ':?"~'".~..~?..~ ( SEAL )
HOMER E. ST. SING
Signed by Homer E. St. Sing, by him dec~gred to be his Last Will and
Testament in our presence, who have hereunto subscribed our names as witnesses
in his presence and at his request, this ~O~- day of ~~;w~ ~ ,
1985.
- 2 -
COMMONWEALTH OF PENNSYLVANIA .-
.' SS:
COUNTY OF LEBANON .'
I, HOMER E. ST. SING, testator, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge
that I signed and executed the instrument as my Last Will and Testament; that
I signed it willingly; and that I signed it as my free and voluntary act for
the purposes therein expressed.
SWORN or affirmed to and acknowledged before me, by HOMER E. ST. SING, the
testator, this ~O~ 'day of ~~ ~ , 1985.
HOMER E. ST. SING
(SEAL) NOTARY PUBLIC
CHARLENE R. KREIDER, Notary Public
Palmyre, Lebenon Co., Pa.
My Commission Expires June 1, 1987
-3-
COMMONWEALTH oF PENNSYLVANIA :
'. SS'.
COUNTY OF LEBANON :
whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw the
testator sign and execute the instrument as his Last Will and Testament; that
he signed willingly and that he executed it as, his free and voluntary act for
the purposes therein expressed; that each of us~in the sight and hearing of
the testator signed the Will as witnesses; and that to the best of our know-
ledge the testator was at that time eighteen (18) or more years of age, of
sound mind and under no constraint or undue influence.
SWORN to or affirmed before me this ~O~-~ day of ~~ ~,
1985.
WITNESS
WITNESS
(SEAL) NOTARY PUBLIC
CHARLENE R. KREIDER, Nota~ Public
Palmyra, Lebanon Co., Pa.
My Cammi~ion Expires June 1, 1957
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also known ~ ~ ~ No. -
To:
Register of Wills for the
Deceased. County of C,~'l~ in the
Social Security No. ~q ~ "I ~ - ~ ~ ~ ~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who ~/are 18 years of age or older, applff for letters of administration
on the estate of
(d.b.n.; pendeme lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in ~~ [~ County, Penn~ylva~a, with
h I~ last familyorprincipalresidenceat IqOI Le~oK ~r~t; ~ ~'ili ~ 1701/
(list street, number and municipality)
Decendent, then ~ ~ years of age, died ~q,~ ~, ~, ~ ~ , ~
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $ ~3~ O~
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not dOmiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ i~0~
situated as follows: tqOt Le~o~ 5~ro*~ ~ ~d/i ~ 17ot~'
Petitioner '~ after a proper search ha4¢ ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
~'~Lf~I ~. 17097
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
~.~ ~.)~ .ff)'el'~'a"4-t/knso{ 110 ~c~ ~e,~
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF
J
The petitioner(s) above-named 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
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this [~'_~A-V~ day of
~ ORegister
' 0
No..~1- 03
Estate of /~,,~r Evct~< ~+, ~t~o , Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ,,~x c~ ~ ~ I '~/3/) ~ }6.__, in consideration of the petition on
the reverse side hereof~satisfactory proof having been presg~nted before me, ,
IT IS DECREED that--~~ ,~. ~_~. ~Lt~, 0-~-,_.),_ ~..n'-~.t~. ~. ")Q~ ,},' ad-
is/are entitled to Letters of Adminisl~ration, and in accord with such fin~ling, LettErs of Administration
are hereby granted t~ (~ U
in the estate of ~o'~-x.~ ~_~_ ~,~qr_ ~ ~
- ~ Register of Witls ~ [3 ~
FEES
Letters of Administration .....
Short Certificates( ) .......... $~ ATTORNEY (Sup. Ct. I.D. No.)
Renunciation ................ $
. ADDRESS
TOTAL ~ $~
Filed .~ :1~ :.0~ ......... A.D.
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
I,ocal 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.
f ~, ~ Local Registrar
P 9 2 6 6 1 t3 4 ~5~~';,,~ J U N 0 7 2003
No. ~ Date
COMMONWEALTH OF PENNSYLVANIA o DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
Hcm~r Euaene St. S~no "Male 3'196 -- 14 --1269 "June 4.2003
' ~ ,~h 16,2 ~ Willi~ ~"'~ ~"'"'~
,. ~uph~ ,. ~leto~[,. ~y Village [~.~.v~o,~ ...... [,.. ~ite
,,..~c~nist ,,~. ~ch Na~ ~t J,,. '-- ,~. 12 ~ ~ (' '~*~ Wid~
1901 ~ox Strut ,~s,~
,,. ~ ~ll,Pa 17011 ~m""o'~ ,~.c~.~ ~rland '~*"~ ~'~
,,,. ~e St. Sin9 ,, Ve~a ~ttis
~H~S~SlT~N ~. 717 ~!~ie ~e ~dd]et~,Pa 17057
.... .......
,,~ O1,,~3~el 9, 2003
/
~ ~~~~ ~ J,2b. 011654-L L~o~-H~or ~neral ~ In~ ~?~aS~
/ ~ 'S CASE REFERRED ~MEDICAL E~MINE~R?
manner aa Ital~ .................................. ' · , , ( ) and
Zg: Z ct ~ [ Nfl,r` ~0.
COURTHOUSE, CARLISLI~, PA 17013 I~,RY C. LEWI,~
Register of Wills &
Clerk of thc Orphans' Cour~
JERRY R. DUlq'FIE, ESQ.
Solicitor
TO:
Date: 06-13-2003
TODAY I SPOKE TO THE SECRETARY OF RICHARD EARL ETZWEILER, ESQ.
TO LET THEM KNOW THAT THE TWO SISTERS CAME IN TO PROBATE THE
ESTATE OF THEIR FATHER HOMER EUGENE ST. SING. THEY HAVE
DECIDED TO TAKE OUT LETTERS OF ADMINISTRATION.
JACQUELYN A AUST
06-13-2003
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Homer Euqene St. Sinq
Date of Death: June 4, 2003
Will No. Admin. No. 2003-00489
To the Register:
I certify that notice of (beneficial interest) 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 June 20, 2003 .
Name Address
Donna J. Keefer, 717 Melanie Lane, Middletown, PA 17057
Susan J. Neifert, 170 Beacon Drive, Harrisburg, PA 17112
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE
Date: June 20, 2003
Name David C. Miller, Jr.
Address 1846 Bonnie Blue Lane
Middletown, PA 17057
Telephone( ) 717-329-8533
Capacity: __ Personal Representative
X Counsel for personal representative
IN THE MATTER OF THE ESTATE · IN THE COURT OF COMMON PLEAS
OF HOMER EUGENE ST. SING, ' CUMBERLAND COUNTY, PENNSYLVANIA
DECEASED · ORPHANS' COURT DIVISION
· NO. 00489 YEAR 2003
PETITION FOR LEAVE TO PURCHASE REAl, ESTATE
.BY PERSONAl, REPRESENTATIVE
TO THE HONORABLE, THE JUDGE OF SAID COURT,
The Petition of Susan J. Neifert, Co-Administrator of the above entitled estate,
respectfully represents:
1. That HOMER EUGENE ST. SING died intestate on June 4, 2003, a resident
of Camp Hill Borough, Cumberland County, Pennsylvania, leaving no Last Will and Testament.
Letters of Administration were issued on June 16, 2003 by the Office of the Register of Wills in
and for Cumberland County, to the decedent's daughters and heirs, Donna J. Keefer and Susan J.
Neifert.
2. At the time of his death, HOMER EUGENE ST. SING owned premises
situated in Camp Hill Borough, Cumberland County, Pennsylvania, known as 1901 Lenox Street,
Camp Hill, Pennsylvania, 1701 ! and having said Deed recorded in Cumberland County Record
Book 1-24, Page 104.
3. The heirs to the property, Donna J. Keefer and Susan J. Neifert, have agreed
that the property has a value of Ninety Thousand Dollars ($90,000.00) based upon discussions
with two independent real estate agents.
4. Donna J. Keefer, the other heir of the aforesaid property, has no desire or
interest in the purchase of said property.
$. The Petitioner, who is a Co-Administrator of the Estate of HOMER EUGENE
ST. SING, is agreeable to purchase the hereinafter described property for the sum of Ninety
Thousand Dollars ($90,000.00) with the new deed for the same to be placed in the name of the
Petitioner, Susan J. Neifert.
6. The property which Petitioner desires to purchase is described as follows, and a
copy of the Deed for said property is attached as Exhibit "A":
ALL THAT CERTAIN tract or lot of land formerly situate in the Township of East
Pennsboro, now in the Borough of Camp Hill, Cumberland County, Pennsylvania, and known as
Lot No. 187 on Plan of Lots of arnsourg Gardens" which plan is recorded in the Recorder's
Office in and for said Cumberland County, in Plan Book #1, page 86, said lot being more
particularly bounded and described as follows, to wit:
Lot No. 187 bounded Northerly by Lenox Street, forty-four and eighty-eight one
hundredths (44.88) feet; Eastemly by Exeter Street (now North Nineteenth Street) eighty and two
one hundredths (80.02) feet; Southerly by Lot #239 on said plan forty-six and eighty-four one
hundredth (46.84) feet; Westerly by Lot 188 on said plan eighty (80) feet.
Together with the fee to the streets and ways shown on said plan insofar as the said party
of the first part has the right so to convey the same, subject to the rights of all of said lot owners
to make use of said streets and ways as more particularly set forth and subject to the restrictions
more particularly set forth in the hereinafter recited deeds and prior deeds in the chains of title to
said lots.
HAVING thereon erected an aluminum ranch type dwelling known and numbered as 1901
Lenox Street.
BEING the same premises which Lloyd R. Eichelberger and Barbara A. Eichelberger, his
wife, by Deed dated October 7, 1971 and recorded in the Cumberland County Recorder's Office
in Deed Book 1-24, Page 104, granted and conveyed unto H. Eugene St. Sing and Geraldine H.
St. Sing, his wife, with the said Geraldine H. St. Sing having died August 9, 1985 leaving to
survive H. Eugene St. Sing, deceased herein.
7. There are no liens against the above-described real estate.
8. Known debts and expenses, administrative costs, inheritance tax, federal estate
tax (if any) and devises and bequests will be paid from the proceeds of the sale of the real estate,
which is the only significant source of funds for the estate.
9. Petitioner was not required to enter any bond to serve as Co-Administrator of
this estate.
10. Petitioner proposes to purchase the above-described real estate for the sum of
Ninety Thousand Dollars ($90,000.00) in accordance with Section 3356 of the Probate, Estate
and Fiduciaries Code, 20 PA. C.S.A. 3356.
11. The other heir of the aforesaid estate, Donna J. Keefer, is in accord with the
request of Petitioner as evidenced by the Consent of said heir which is attached hereto and made a
part hereof, and is marked Exhibit "B."
WHEREFORE, your Petitioner prays that your Honorable Court issue an Order
for Petitioner, Susan J. Neifert, to purchase the within described real estate for the consideration
of Ninety Thousand Dollars ($90,000.00), and that the Clerk of Orphans' Court Division of the
Court of Common Pleas, Cumberland County, Pennsylvania, be authorized to execute and deliver
a deed conveying the within described premises to Petitioner, Susan J. Neifert.
COMMONWEALTH OF PENNSYLVANIA )
,-,t -ss
COUNTY OF4~MI~ix~. )
Before me, a Notary Public, this lq.__.n-~lay of July, 2003, personally appeared Susan
J. Neifert, known to me, being duly sworn according to law, deposed and said that the facts set
forth in the foregoing Petition are true and correct to the best of her knowledge, information and
belief.
Notary Publi~
~ NOTARIAL SEAL~"I'~
UUURTNEY S V~r'~' .... !
~ ' ",-'m ~otary ~ublic
uerry Twp., Dauphin County
Commission Expires March
RECOROER OF
OUMBERLA~IO COUNTY
'~. ~,~ ol ~ ~~
T~s,sd N~, Ha~drrd smd Seventy-one (1971)
~P~I~PPII L~ R. EIC~L~RGER and ~ A. EIC~LBE~ER, his ~ife, of
R.D. ~1, Dillsburg, Pennsylvania, Grantors and Parties o~ ~he First Part,
-AND -
H. EUCE~ ST. SI~ and CE~I~ H. ST. SI~, his ~ife, of ~lllersburg,
Pennsylvania, Grantees and parties
...................... r (:~ 23,000.00)
Doll,rs, /,w/al money o~ t~ U~ted St~/#s o/ A~tc,~, s~vll ~nd truly p,id by 1~ s~d ~4rt tee~/ Ihs s~coad
have
grant~, ~ar~ined,
slien, en/eo~, releate, tony., a~ c~firm un~ t~ J~ld p~rl ~e8 of l~e ~erond
~[[ T~T CERTAIN tract or lo: o[ land fomerly situate tn ~he Township o~ Eas~
Pennsboro, n~ in the Borough of Camp H~ll, Cumberland County, Pennsylvania,
and known as Lo~ No. 187 on Plan of Lo~s of "Harrisburg Gardens" ~htch plan la
recorded in the Recorder~s Office in and for said Cumberland County, ~n Plan Book
i~l, page 86, said !o~ being more Particularly bounded and described aa follows,
Lo~ No. 187 bounded Northerly by Lenox Street, forty-four and eighty-eight one
hundredths (44.88) feet; Easterly by Exeter Street (no~ North Nineteenth Street)
' eighty and C~o one hundredths (80.02) feet; 8outherly by Lot t~239 on said plan forty-
six and eighty-four one hundredths (~6.8~) ~ee~; ~esterly by Lot 188 on sa~d plan.
eighty (80) feet.
Together ~tth the fee to the streets and ~ays aho~n on said plan insofar as the
said party o~ the first part has the right so to convey the same, subject co the
rights of all o~ said lo~ o~ners to mke use of said streets and ~ays as more
cularly se~ [orth and subject to the restrictions ~re Particularly set ~orCh in the
hereina:ter recited deeds and prior deeds in the chains o~ ~i~le ~ said lo~s.
~VINO thereon e'rected an alumin~ ranch type d~elling known and numbered as
1901 Lennox Street.
BEING the same premises ~hich Ntlltam ~. Dodson, jr. and June H. Dodson~.his
~ife and Jacques D. Heyers and Jane S. Heyers, his ~ife, by Deed da:ed January 1~,
1971 and recorded in the C~berland County Recorder'a Office in Deed Book
Volume 23, Page 13, granted and conveyed un:o. Lloyd R.. Eichelberger~ one of the
Grantors herein.
104 EXHIBIT "A"
,, For further re£erence o~' title see Schedule of Diatrib~t on in the Estate of
, ~11~. TH~ ~D Parties of the Fl~st Part, their
Parties o[ the First ParC, their
mt~e~ to to be, ~1~ tg~rten~ncet, snto t~
or ~rs~s w~ms~t.er. Itw]~ly dalming or lo cldim /be Mine or any part l~ereo/,
I~i tnJ wgl, by t~e ~re~ent~. WARRANT AND FOREVER DEFEND
~nto tel their
Signed, ~aled and Deliver~ Barbara A. ~i~h~-ig~~ ........... (SEAL)
in the Pr~ence of ................................................................................. (SEAL)
................... ' ................................................................................
~il ,
COU~T~ O~ ....~..~ ................. ~ ~: ,
"? ...................... :.---.:-...~..:..~.~~ ..... ~.~.~..,, ........~ t,,,,~
o~ce,. ~,,on,I]7 ,p~,red ..~loyd R. Sichelberger and ~'~'~-'~'-"~T .........
............................ ; ............................... X.~.T.~'~ ~- ~chel~ergor, his ~ j
............................................... .. ~4..~,_~,,.~. .
........ rxr~t~t I~
'
~2~2~T~ ............................................... ~.....~.~ ~~
............ : ...................................... ~... ~( /~ .' ........................................... ~'~
. ~ .... . .............. ~.~......~ ...................
.......................... ~;;~.~;..~;:~..~ .......
, ~ j
I I~O~OgG~i OF C,~UP HILL
.~MMONWEALTH OF PENNSYLVANIA
COUNt, ~
~JJllt~ ,U)) ~,~ ~,~ Stol oJ O~:t, t~h .............
~oo~ 24P~[ 106
CONSENT
I, Donna J. Keefer, of 717 Melanie Lane, Middletown, PA 17057, being the other
residuary heir of the Estate of Homer Eugene St. Sing, do hereby consent to Susan J. Neifert, of
170 Beacon Drive, Harrisburg, Pennsylvania 17112, purchasing the property situated in Camp
Hill Borough, Cumberland County, Pennsylvania, as more particularly described as 1901 Lenox
Street, Camp Hill, Pennsylvania, 17011 and having said Deed recorded in Cumberland County
Record Book 1-24, Page 104 for the sum of Ninety Thousand Dollars ($90,000.00).
IN WITNESS WHEREOF, the said Donna J. Keefer has hereunto set her hand
and seal this/q..__.~day of July, 2003.
DonnaFJ. k/ee~
COMMONWEALTH OF PENNSYLVANIA ) -- ~otam~ ~¢,~
Samantha Keefe~. '~,~tary Public
' SS UPlI~r AIl~n Twp., Cum~rl~nd Co~m~
COUNTY OF CUMBERLAND ) My co~a~io~ m,,i,o. ,~ :~]. 2oo~
Before me, a Notary Public, this ]q~ day of July, 2003, personally appeared Donna J.
Keefer, known to me (or satisfactorily prov--en) to be the person whose name is subscribed to the
within instrument, and acknowledged that they executed the same for the purpose therein
contained.
Notary Public
EXHIBIT "B"
IN THE MATTER OF THE ESTATE · IN THE COURT OF COMMON PLEAS
OF HOMER EUGENE ST. SING, ' CUMBERLAND COUNTY, PENNSYLVANIA
DECEASED
· ORPHANS' COURT DIVISION
· NO. 00489 YEAR 2003
CERTIFICATE OF SERVICE
I, David C. Miller, Jr., Esquire, certify that I served the Petition for Leave to Purchase
RealEstate by PersonalRepresentative upon the individuals named below by placing a copy of
the Petition in the United States Postal Service Mail, First Class Postage, addressed as follows:
Earl Richard Etzweiler, Esquire Donna J. Keefer, Co-Administratrix
105 North Front Street
Harrisburg, PA 17101 717 Melanie Lane
Counsel for Co-Administratrix Middletown, PA 17057
Susan J. Neifert
avRI'~. Miller, Jr., Esq~e'
1846 Bonnie Blue Lane
Middletown, PA 17057
Supreme Court I.D. # 36504
717-329-8533
Counsel for the Estate of Homer Eugene St. Sing
IN THE MATTER OF THE ESTATE 'IN THE COURT OF COMMON PLEAS
OF HOMER EUGENE ST. SING, 'CUMBERLAND COUNTY, PENNSYLVANIA
DECEASED ·ORPHANS' COURT DIVISION
·NO. 00489 YEAR 2003
ORDER
~ day of 2003, upon consideration of the within
Petition of Susan J. Neifert, it is hereby ordered and ed that Susan J. Neifert is authorized to
purchase the real estate as described in the within Petition for the sum of Ninety Thousand
($90,000.00), and that the Clerk of Orphans' Court Division of the Court of Common Pleas,
Cumberland County, Pennsylvania, is authorized to execute and deliver a deed to Susan J. Neifert
for said real estate.
-U.'p . .,. ,d
co.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EX(11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128~601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 002968
SUSAN J NEIFERT &
DONNA J KEEFER
717 MELANIE LANE
MIDDLETOWN, PA 17057
ACH
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 ~3,850.00
ESTATE INFORMATION: SSN: 196-14-1269
FILE NUMBER: 2103- 0489
DECEDENT NAME: ST SING HOMER EUGENE
DATE OF PAYMENT: 09/03/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/04/2003
TOTAL AMOUNT PAID: $3,850.00
REMARKS: DONNAJ KEEFERAND
SUSAN J NEIFERT
CHECK# 0098
INITIALS: SK
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EX(11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003153
MILLER DAVID C JR, ESQ.
1846 BONNIE BLUE LANE
MIDDLETOWN, PA 17057
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 $60.69
ESTATE INFORMATION: SSN: 196-14-1269
FILE NUMBER: 2103-0489
DECEDENT NAME: ST SING HOMER EUGENE
DATE OF PAYMENT: 10/21/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/04/2003
TOTAL AMOUNT PAID: $60.69
REMARKS: DONNA J KEEFER&SUSAN J
NEIFERT C/O DAVID C MILLER JR
CHECK#0100
INITIALS: SK
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX + (~-00)
REV-1500 OFFICIAL USE ONLY
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN "LE.UMBER
DEPT. 280601
HARRISBURG, PA17128-0601 RESIDENT DECEDENT 2 1-0 3 0 0 4 8 9
DECEDEN'r's NAME (LAST, FIRST, AND MIDDLE INITiAl
~ SOCIAL SECURITY NUMBER
Z Homer erie
uJ 1 9 6-1 4-1 2 6 9
i"'t DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD.Year)
[l.J THIS RETURN MUST BE FILED IN DUPLICATE W~TH THE
(.1 06/04/2003 03/16/1921 REGISTER OF WILLS
~ (IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ - _
~. [] 1. Original Return [] 2. Supplemental Return
v ~.~ [] 3. Remainder Return (dateofdeathpd~t~ 12-13-82)
Oi~ J--'l 4. Limited Estate ['--~ 4a. Fulura Interest Compromise (dat~ of dea~ a~ ,2.12.92) [] 5. Federal Estate Tax Return Required
Mo [~] 6. Decedent Died Testate (^tac~ ~y of yaM) [] 7. Decedent Maintained a Living Trust (A,a~ copy of Trust) ~ 8. Total Number of Safe Deposit Boxes
< [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date ~deah bet~,~e, ~2-31-gl and 1.~-~) [] 11. Election to tax under Sec. 9113(A) (^~ta~h Sch O)
NAME SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
= David C. Miller Jr. I 1846 Bonnie Blue Lane
~o FIRM NAME (IfApplicable)
,,- Law Office of David C. Miller, Jr.
~' l Middletown, PA 17057
o TELEPHONE NUMBER
~ 7-329-8533
1. Real Estate (Schedule A) (1) 90~000.00 1 OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B) (2) 1,64~6
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 2,554.84
Z (Schedule E)
O 6. Jointiy Owned Property (Schedule F) (6) 8~377.80
~: [] Separate Billing Requested :'
:::) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properb/ (7) 164.80
I'- (Schedule G or L)
~ 8. Total Gross Assets (total Lines 1-7)
~ (8) 102~740.10
14,1 9. Funeral Expenses & Administrative Costs (Schedule H)
13:: (9) 9,049.53
10. Debts of Decedent, Mortgage Uabilities, & Uens (Schedule I) (10) 2~212.43
11. Total Deductions (total Unes 9 & 10) (11) 1 1 ~261.9R
12. Net Value of Estate (Line 8 minus Une 11) (12) 91 ~478.14
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Une 12 minus Une 13) (14) 9~
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) X., (15)
~ 16. Amount of Une14 taxable at lineal rate 91,478.14 X .045 (16) 4,116.5;:)
O~ 17. Amount of Une 14 taxable at sibling rate X . 12 (17)
X(~ 18. Amount of Line 14 taxable at collateral rate X . 15 (18)
~ 19. Tax Due (19)
20. [-'-J
>> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND REC~HECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
1901 Lenox Street
C~TY
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments (1) _ 4~116.52
A. Spousal Poverty Credit
B. Prior Payments 3,850.00
C. Discount 205.83
3. Interest/Penalty if applicable Total Credits (A + B + C ) (2) 4,055.83
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 60.69
A. Enter the interest on the tax due.
(SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 60.69
Make Check Payable to: REGISTER OF WILL& AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... [] []
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 car ?
2. f death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate cons derat on?
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 des ~nat on?
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 eccornpanyino scbedu s and statements, and to the best of rny ' edge a be' f it is true correct and complete
, , .
ADDRESS - ~l. 7...Mel~r~. Lane / '9~1L;n~ *tr',t' ~
Middletown..~._PA 1 7057
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% F2 P.S. §9116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirement~ 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) F2 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% 172 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + (6-98)
ESTATE OF
FILE NUMBER
St. Sina. Homer Euaene210300489
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 properly 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 prope~y which is jointly.owned with right of survivorship must be disc!_n~ed on Schedule F.
iTEM
NUMBER DESCRIPTION VALUE AT DATE
1. 1901 Lenox Street, Camp Hill, PA 17011 OF DEATH
90,000.00
TOTAL (Also enter on line 1, R~apitulation) $ 90,O00.O(J
(If more space is needed, insert additional sheets of the same size)
IN THE MATTER OF THE ESTATE · IN THE COURT OF COMMON PLEAS
OF HOMER EUGENE ST. SING, · CUMBERLAND COUNTY, PENNSYLVANIA
DECEASED : ORPHANS' COURT DIVISION
· NO. 00489 YEAR 2003
SALES AGREEMENT FOR PURCtlAS~OF REAL ESTATE BY PERSONAl,
REPRESENTATIVE
1. Homer Eugene St. Sing died intestate on June 4, 2003, a resident of' Camp Hill
Borough, Cumberland County, Pennsylvania. Letters of Administration were issued on June 16,
2003 by the Office of the Register of Wills in and for Cumberland County, to the decedent's
daughters and heirs, Donna J. Keefer and Susan J. Neifert.
2. At the time of his death, Homer Eugene St. Sing owned premises situated in Camp Hill
Borough, known as 1901 Lenox Street, Camp Hill, Cumberland County Pennsylvania, 17011.
The Deed is recorded in Cumberland County Record Book 1-24, Page 104.
3. The Co-Administratrixes of the Estate, Donna J. Keefer and Susan J. Neifert, have
agreed that the property has a value of Ninety Thousand Dollars ($90,000.00) and that the
property would be sold to Susan J. Neifert for that amount.
4. Susan J. Neifert has petitioned the Court of Common Pleas, Cumberland County,
Pennsylvania for an Order in accordance with Section 3356 of the Probate, Estate and Fiduciaries
Code, 20 PA. C.S.A. 3356, approving her purchase of the property as a Co-Administratrix of the
Estate of Homer Eugene St. Sing, with the new deed for the same to be placed in the name of
Susan J. Neifert.
5. There are no liens against the above-described real estate.
6. Ihis Agreement of Sales has been executed by Donna J. Keefer and Susan J. Neifert as
Co-AdmJnistratrixes of the Estate of Homer Eugene St. Sing, sellers, and Susan J. Neifert,
individually and on her own behalf as purchaser.
Sellers: . ~ ;? '? . t .,
Donna J. Kee~,, C~>-~dl~istra~rix
Stl"safi j. C~. arninistratrix
IN THE MATTER OF THE ESTATE ·IN THE COURT OF COMMON PLEAS
OF HOMER EUGENE ST. S1NG, 'CUMBERLAND COUNTY, PENNSYLVANIA
DECEASED ·ORPHANS' COURT DIVISION
·NO. 00489 YEAR 2003
ORDE___RR
AND NOW, this 2.[ ``-%-[
~ day of .-~L. 2003, upon consideration of the within
Petition of Susan J. Neifert, it is hereby ordered and decreed that Susan J. Neifert is authorized to
purchase the real estate as described in the within Petition for the sum of Ninety Thousand
($90,000.00), and that the Clerk of Orphans' Court Division of the Court of Common Pleas,
Cumberland County, Pennsylvania, is authorized to execute and deliver a deed to Susan J. Neifert
for said real estate.
A TRUE COPy' FROM RECORD
In Testimony Wherof. I hereunto
set my hand and the seal
of said Court at Carl
~, This 2 Z ..,_ . ~ isle, PA
.... ,u ~n~
coM ~ I SCHEDULE B I
NMOHNE~IEATALNTcHEOTF~ERNENTSuYRLNVAN~I STOCKS & BONDS I
ESTATE OF FILE NUMBER
St. Sing. Homer Eugene 21 03 00489
All property jointly-owned with dght of survivorship must be di_ec.lo_s~ on Schedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. 46 Shares of HARSCO stock valued at $35.71 per share as of the DOD 1,642.66
TOTAL (Also enter on line 2, Recapitulation) $ 1 ~642.61:;
(If mom space is needed, insert addilional sheets of the same size)
! H 58879
COMMON STOCK COMMON STOCK
THIS CERTIF1FSTHAT -
CUSIP q15864 10 7
~fl 0§8879 HOI~ER E ST *ZNG '
TC 70G0~01
HD~EEOOOO ***'10.******
FU~L-PA~D AND NON-ASSESSABLE SHARES Or ~E PAR YALUE OF O~E DOLOR AND ~EH~-F~ CE~5 (SL~51 EACH O~ THE COMHON STOCa OF
THE CHASE MANH~N ~ANK
COMMON STOCK COMMON STOCK
~NCORPORAT£D UND[R THE: lAWS
THISCERTIFIESTflAT cusip 4~5864 ~0 7
0~8
LH 0699987
HO~EEO000
***i
COMMON STOCK COMMON STOCK
INCORPORATED UNDER THE LAWS
THISC£RTIFIESIHAT CUSZP q.~S&b4 'LO ?
H 0964,60 HI]~ER E ST SIW6
~' 0131 1901 LENOX ~REET
9SO 000025 CRMP HILL Pa 17011--3728
ISTHE OWNER OF
FULL-RAID AND NON'ASSESSABLE SHARES OF THE PAR VALUE OF ONE DOLLAR AND TWENTY-FIVE CENTS ($L~.S) EACH OF THE COMMON STOCK OF
02114/97
COM /~ I SCHEDULE E I
MONWEALTH OF PENNSYLVANIA ICASH, BANK DEPOSITS, & MISC. I
INHERITANCE TAX RETURN I ~"~m,m~ w~m-m~.~-m.~,~.~,
ESTATE OF
FILE NUMBER,
St. Sino. Homer Euoeq~ 21 03 00489
A.l~dude ~e.p[~s of li~a~? an~ E~ date Ee pr~s w~e re~ved by ~e ~tate.
. pm~ joimly~wn~ wire ~ght m su~ivomnip must ~ disclos~ on ~ch~ule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
1. Cash on hand OF D~TH
29.00
2. Household items sold at auction
1,464.00
3. Jewelry
84.20
4. Coin collection
103.90
5. Medcohealth refund
19.16
6. HARSCO stock dividend
12.O8
7. Clothing
325.00
8. Miscellaneous household items.
500.00
9. Currency - Old $1.00 Bill
17.5O
TOTAL (Also enter on line 5, Recapitulation) $ 2~554.8,1
(If mom space is needed, insert addilional sheets of ~he same size)
BELLOS
Diamond Center
Colonial Park Mail
HARRISBURG, PENNSYLVANIA 17109
(717) GS2-8~S
01~, STATE, ZIP
I I I
REGEI~D BY
~ ~ KEEP THIS )R REFERENCE
5805
medcohealth::~-
100 Parsons Pond Drive, Mail Stop F1-3 REFUND OF MAIL SERVICE CREDIT BALANCE
Franklin Lakes, New Jersey 07417-2603
Medco Health Solutions, Inc. iili!!iiiiiii~i~!!~i!!!!~~i iiiilN~~ii XXXXXg0_0095871304390
i~C~!iiN~iii 08/07/03 2650830
O-E-650830-(X) 1-01-01
EUGENE ST SING
1901 LENOX ST
CAMP HILL, PA 1701 1 3728
Dear Member:
Attached is a refund of the credit balance left on your Mail Service Benefit Account. Please
deposit or cash this check promptly.
To prevent credits on your account in the future, you may choose to utilize our Credit Card ----
Autocharge Program. For further information or questions, please contact Customer
Service at 800-447-7856.
Thank You.
~ JPM°rgan Chase 2650830 ;
medcohea Ith sy,~u~, N~w'York
5701 East Hillsborough Avenue. Tampa, FL ~10
50-937
213
VOID AFTER 1 BO DAYS
PAY ]~1']~1'~ AND *********************************************************
TO THE
oao~a OF EUGENE ST SING
1901 I.I~IOX ST
CAMP l~rl J:
Authorized Signatu~
"' E)r-, c;o,°, ~,01~' m==O E) &=,0q3?qm: r:,O &',,P,,,,D 5D 8
I, IMPORTANT TAX INFORMATION DATE
ISSUE 08/15/2003
HARSCO CORPORATION COM $1.25 PV TAX iDENTIFICATION NUMBER I
P.O. BOX 3314 ,o. OF SHARES OWNED
SOUTH HACKENSACK, NJ 07606-1914 46 ACCOUNT KEY
CURRENT DIVIDEND DIVIDEND PAID Y.T.D. STSING---HOMEE0000
$12.08 $36.24
Please detach and retain this form ~or
TAX WITHHELD TAX WITHHELD Y.T.D. your records. Total dividends paid to
you during this calendar year will be
3300 1038 $0.00 $0.00 rep .... d to ,,, .... I , ...... Service.
* * * Fast, Smart & Easy * * *
Get your shareholder information on-line via a secured Internet site:
Information Available Transactions Available
· Account detail · Change your address
· Certificate history · Consent to view proxy material on-line
· Book entry history · Request certificate issued from book entry shares
· Dividend check history · Request a dividend check replacement
· Tax information Form 1099 · Request a duplicate Form 1099
· Historical stock price information · Dividend payment election
· And more ·
Visit us on the web at:
www. melloninvestor.com 00~.2~0-4,~B64,0
Click on Investor ServiceDirect '"' and
follow the easy instructions to establish I,,,lll,,,lll,,,,,,Ih,,Ih,lhh,h,l,ll.,hll,,,,,,lll,l,,I
a PIN and you're on your way. HOMER E ST SING
1901 LENOX STREET
CAMP HILL PA 17011-3728
Or contact us at: 1-800-526-0801
NAME AND ADDRESS AS IT, APPEARS IN OUR RECORDS
0000066
I~ HARSCo~:CORPORATION ~::: . .~ ....
lB
J~l "'~::' ' . :::::ii' '.:.i:.~ ...." CHECK ;NO*.::'3~001:038
..::':' :: :.:': ':~ ':~:" ~ 07/15~ ! COM$1 25 PV · ': :. i 0262500 08/15~0~
~ .: % ::: . ·' ' '. PAYABLE A~ ~.. ~SE M~AN"B~N~;'~YRACUSE '. :. '" :
llJ ';; ·: " ':YH~ '~s~ ~X~A~A. dANK. NEW ~ORK:' '
" 4158~10
I _
~ PAY TO THE HOMER E ST SING
lj ORDER OF 1901 LENOX S~EET ' '.
.: : CAMP HILL PA. 1701 1-3728 . PAY
ACCOUNT KEY ~ STSlNG-~OMEE0000 AUTHORIZED SIGNATURE
I I
~ I SCHEDULE F I
c ° M ~""~ '~ AT~c"EO~ E~"E"~S~ A N ~ r JOINTLY-OWNED PROPERTY I
ESTATE OF FlEE NUMBER
St. Sin_a. Homer Eugene 21 03 00489
ff an asset waa made joint within one year of the decedent's data of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Donna J. Keefer 717 Melanie Lane Daughter
Middletown, PA 17057
c
JOINTLY-OWNED PROPERTY:
L~EI~ DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDEN'r's INTERES
1. A. 3/15/01 PNCBANK Checking Account #5140062943 16,755.60 50. 8,377.8(;
TOTAL (Also enter on line 6, Recapitulation)
(If mom soace i.~ n~l~ ine,~r~ ~I~;~;M~, ~eets of the same size) 8~377.80
PNCBAN(
July 7, 2003
David C Miller, Jr.
scp
Attorney at Law
1846 Bonnie Blue Ln
Middletown, PA 17057
RE: Estate of Homer E St Sing (Deceased)
SSN: 196-14-1269
DOD: 06-04-2003
Dear Mr. Miller:
In response to your request for Date of Death balances for the customer noted
above, our records show the following:
Checking Account
Account#5140062943 Established 03-15-2001
HOMER E ST SING
DONNA J KEEFER
DOD balance: $16,755.60 Non interest bearing account
Please note that this office only provides date of death balances for deposit
accounts (IRAs, CDs, Checking and Savings accounts). We do not process any
financial transactions or provide statements. If you need assistance with any of
these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local
PNC Bank branch office.
Sincerely,
Erica L Schlegel
PNC Decedent Reporting
Firstside Center
500 First Ave, 4th Fl CIF
Pittsburgh PA 15219-3128
1-800-762-1775 Member FDIC
REV-1510 EX + (6-98)
ESTATE OF
..~ FILE NUMBER
21 4
This schedule must be completed and filed if the answer to any of questions 1 throu h 4 o~ the reverse side of the REV-1500 COVER SHEET is yes.
ITEM DESCRIPTION OF PROPERTY
INCLUD~ THE NAM~ OF THE ~ANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
NUMBER THE DA'I~ OF TRANSFER. A'r]'ACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH % OF DECD'I EXCLUSION TAXABLE
VALUE OF ASSET INTEREST (~F~O~.~c^a~) VALUE
1. Federal Employees' Group Life Insurance Benefit 4,500.00 100. 4,500.00 0.00
2. Civil Service Retirement System Lump Sum Death Benefit 164.t 100. 164.80
TOTAL (Also enter on line 7 Recapitulatior $ 164.80
(If more space is needed, insert addi§onal sheets of the same size)
U,S. Off,ce oF Personnel Management
Retirement Programs
Retirement O~erat~ons Center
O.~C~A~ ~US~N~SS
PENALTY FOR PRIVATE USE, $300
FORWARDING SERVICE REQUESTED
DONNA d KEEFER
717 MELANIE LANE
MIDDLETOWN PA 17057
FINAL STATEMENT OF LUMP SUN! DEATH BENEFIT PAYMENT
You are entitled to a lump sum payment because of the death of a former employee Th s payment, shown in Block 5. covers
only benefits due from the Civil Service Retirement and Disability Fund and consists of any unused contributions the former
employee made to the Fund or any accrued annuity payable at the time of his or her death, or the Basic Employee Death Benefit
payable to a surviving spouse under the Federal Employees Retirement System.
1. Name of Deceased Federal Employee r~ 2. Claim Number .~ 3. Date of Birth i4. Date
ST SING HOMER CSF 2827005 03/16/21 ; 09/29/03
5. YOU Will Receive a Lump Sum Payment Fo 6. To Be Sent By I7. Interest Ilncluded in Item 5) , 8.Tax Withheld
164.80 I 10/13/03 $ NONE i$ NONE
9. Remarks
THIS PAYMENT TS TO BE DIVIDED BETWREN
YOU AND SUSAN.
THIS IS NOT PART OF THE ESTATE
;-~' See reverse side for important information.
REV-1511 EX+ (12-99)
ESTATE OF
FILE NUMBER
St. Sina. Homer Euaene 21 03 00489
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES: AMOUNT
1. Myers-Harner Funeral Home, Inc
5,175.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) 0.00
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees David C. Miller, Jr. Supreme Court I.D. #36504 3,077.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Filing Fee: $263.00; Petition Fee: $17.00; Short Certificates: $12.00 472.53
Publication Fees: Cumberland Law Journal: $75.00; The Sentinel: $105.53
5. Accountant's Fees
6, Tax Return Preparers Fees
7. Donation of Clothing to Goodwill
325.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size) 9,049.5:
MYERS-HARNER FUNERAL HOME, INC.
1903 MARKET STREET
P.O. BOX 291 ROBERT H. HARNER
CAMP HILL, PENNSYLVANIA 1701 I SUPERVISOR
LOCALLY OWNED AND TELEPHONE
OPERATED 717-7~7-9961
June 11, 2003
Mrs. Donna Keefer
717 Melanie Lane
Middletown PA 17057
Services for Hon~r Eugene St. Sing
June 9, 2003
Charges for Services Selected $ 3,375.00
Professional Services
Use of Facilities
Automotive Equipment
$ 3,375.00
Charges for Merchandise Selected
Casket
$ 1,450.00
Cash k~vanced
Newspaper Notice/Local $ 67.00
Certified Gopies 24.00
Flowers 159.00
$ 250.0O
Total:
$ 5,075.00
Received check # 5381 (06/05/2003)
- 5,108.00
Refund check # 3509 mailed (06/11/2003) $ 33.00
33.00
-- 0 --
Minister Honorarium Due (Not on Original Contract) (06/25/2003) $ 100.00
RECEIPT FOR PAYMENT
Cumberland County - Re~ister Of Wills Receipt Date 6/16/2003
Hanover and High Street Receipt Time 14:38:33
Carlisle, PA 17013 Receipt No. 1033154
ST SING HOMER EUGENE
File Number 2003-00489
Remarks DAVID C MILL~JR, ESQ.
JA
........................ Distribution Of Receipt ........................
Transaction Description Payment Amount Payee Name
LETTERS ADM ISSUED 235.00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 18.00 CUMBERLAND COUNTY GENERAL FUN
JCP FEE 10.00 BUREAU OF RECEIPTS & CNTR M.D
Cash ~63.00
Total Received ......... 63 00
RECEIPT FOR PAYMENT
Cumberland County - Orphans Court Receipt Date 7/15/2003
Hanover and Hiqh Street Receipt Time 13:17:37
Carlisle, PA I7013 Receipt No. 1022163
ST SING EUGENE
File Number 2003-00489
Remarks DAVID C MILLER JR, ESQ
AC '
........................ Distribution Of Receipt ........................
Transaction Description Payment Amount Payee Name
PETITION 12 00 CUMBERLAND COUNTY GENERAL FUN
ORDER ·
3.00 CUMBERLAND COUNTY GENERAL FUN
CERTIFIED COPIES 2.00 CUMBERLAND COUNTY GENERAL FUN
Check# 1053 ~7.00
Total Received ......... 7 00
RECEIPT FOR PAYMENT
Cumberland County - Reqister Of Wills Receipt Date 7/30/2003
Hanover and Hiqh Street Receipt Time 10:23:15
Carlisle, PA I7013
Receipt No. 1033583
ST SING HOMER EUGENE
File Number 2003-00489
Remarks D MILLER
VZ
........................ Distribution Of Receipt ........................
Transaction Description Payment Amount Payee Name
SHORT CERTIFICATE 12.00 CUMBERLAND COUNTY GENERAL FUN
Check# 1061 ~12.00
Total Received ......... 12 00
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
JULY 18, 2003
Cumberland Law Journal is published every Friday by the Cumberland County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal notices.
TO:
David C. Miller, Jr., ESQUIRE
RE:
Homer Eugene St. Sing, ESTATE
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on following dates:
JULY 4, 11, 18, 2003
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment Received $ 75.00
Total Amount Due $ 0.00
Payment received JULY 1, 2003
by Becky H. Morgenthal/Executiv~rector
~ RETAIN THIS PORTION FOR YOUR RECORDS
TflE SENTINEL - LEC~ ~
P.O. BOX 130, CARLISLE, PA 17013 DAVID C. MILLER
~ ~ SA,ES~--~ ~ ~
246335 J 10 PUBLIC NOTICES c31
~~ 07/09/03 29
NOTICE LETTERS OF ADMINISTRATION IN ~~
~ 06/25/03 07/09/03
INSERTI---'~-~,' r~'-'~RATE -- '--'--'-"~"~""~OUNT GROSS AMOUNT
3 THE SENTINEL - LEGAL 3 99 18
TOTAL AD CHARGE ·
99.18
3 PROOF OF PUBLICATION 01PRF 6.35
DAYS RUN
PURCHASE ORDER
Homer St. Sing PAY THIS AMOUNT 105.53 126.64*
* A~ER 08/08/03
MESSAGE:
Thank you for advertising with The Sentinel.
Deadlines for in-column legal advertisements: Monday is Friday at
11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon;
Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday
is Thursday at 12 Noon.
If you have any questions regarding your Legal bill please call
Lori Saylor 243-2611 ext. 201
Fax your legals to 243-3754, attention Lori Saylor
You can also EMAIL your legal to Classified ads: ads@cumberlink.com.
Please send a cover letter including your name and address as an attachment
DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT
THE SENTINEL - LEGAL
P.O. BOX 130, CARLISLE PA 1701_~ Homer St. S±ng
246335 I PUBLIC NOTICES __ 07/09/03
~~ 06/25/03
~ TE_LEPHO~ GROSS AMOUNT OF
NOTICE LETTERS OF ADMINISTRATION IN 07/09/03 717-329-85331DUE AFTER 08/08/03
126.64
TOTAL AMOUNT DUE
105.53
DAVID C. MILLER ENTERAMOUNTENCLOSED
1846 BONNIE BLUE LANE
MIDDLETOWN, PA 17057
20200000002463350000000000000001266400000105535
11:01 FA,'( 3623325
~1Ol
Goodwill Industries o,
AN AFFILIAT~ OF KEYSTONE C, OODWILL ~U~,
P.O. BOX31~ · ll~D~D~ ~' ~~'3~
~SB~, PA ITl~
CITY ~ . ..,
__ Fu~rru~
~SCE,~Aa'~bus
THE DONOR/U~RESPONSIBLE FOR ASSIGNING VALUE TO ~A~S.
ESTI V~E~ S $ ~ )
CUSTOMER COPY
Goodwill Industries o, 0~,~P~.~s~v~ ~o.
AN AFFIIJATE OF K~3YSTONE C-OODWILL ~UST~ES, ~C. /
P.O. BOX 3~ · 1150 ~OD~LL D~ [ ~CB~ ~0.
g ~H~epa.org or ~.~epa.org [ :~ / z 7
DATE LOCATION ~
A~ENDANT8 INITIALS
ZIP CODE
E-MAIL ADDRE~
CLOTHING
FURNITURE
MISCELLANEOUS
THE DONOR IS RESPONSIBLE FOR ASSIGNING VALUE TO DONATIONS.
GOODWILL HAS RNISHED GOODS OR SERVICES TO THE DONOR IN EXCHANGE
FOR THIS CONTRII~TION.
"A copy of the official registration and financial information for Goodwill Industries of
Central Pennsylvania, Incorporated may be obtained from the Pennsvlvania Department
of State by calling toll free within Pennsylvania, 1-(800)-732-0999. R~gistration does not
imply endorsement.
WE THANK YOU FOR YOUR TAX DEDUCTIBLE DONATION THAT PROVIDES VOCATIONAL TRAINING
OPPORTUNITIES FOR PERSONS WITH DISABILITIES AND OTHER SPECIAL NEEDS.
CUSTOa,!E~, CO~Y
I SCHEDULE I I
COMMONWEALTH OF PENNSYLVANIA J DEBTSOFDECEDENT,
INHERITANCE TAX RETURN
ESTATE OF
FILE NUMBER
St. Sina. Homer Eua~n~ 21 03 00489
Include unreimbursed m~ical expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1. Lebanon VFW - Fort Indiantown Gap Military Service 50.00
2. Country Oven Restaurant - Wake
305.82
3. Frey Village Nursing Home
1,480.02
4. Frey Village Nursing Home
177.00
5. Verizon Telephone Company 19.59
6. Marilyn Swart - Landscaping charge for tan bark at personal residence 60.00
7. Mary Haring - cleaning and refuse removal charges for personal residence 120.00
TOTAL (Also enter on line 10, Recapitulation)$
(If more space is needed, insert additional sheets of lhe same size) 2~212.4;';
FREY VILLAGE ~/~'~ ACCOUNTS RECEIVABLE STATEMENT
1020 NORTH UNION STREET Statement Date: 05131/2003
MIDDLETOWN PA 17057-2199
Balance Due: 1,480.02
HOMER ST. SING
cio DONNA KEEFER
717 MELANIE LANE
MIDDLETOWN PA 17057
Account Number: 1991
Balance Forward: 0.00
05/14/2003 - 05/14/2003 Blood Glucose Finger Stick 1.00 4.00 4.00
05/14/2003 - 05/14/2003 02 CANNULA (SOFT TIPS) W/TUBI 1.00 0.80 4.80
05/14/2003 - 05/14/2003 OT Self care mgmt 1.00 59.22 64.02
05/14/2003 - 05/21/2003 R&B Private Pay Nursing 8.00 1,416.00 1,480.02
TOTAL: 1,480.02 0.00 1,480.02
"REY VILLAGE: HOMER ST. SING 1991
FREY VILLAGE ACCOUNTS RECEIVABLE STATEMENT
1020 NORTH UNION STREET Statement Date: 07/31/2003
MIDDLETOWN PA 17057-2199
Balance Due: 177.00
HOMER ST. SING
c/o DONNA KEEFER
717 MELANIE LANE
MIDDLETOWN PA 17057
Account Number: 1991
Balance Forward: 0.00
06/03/2003 - 06/03/2003 R&B Private Pay Nursing 1.00 177.00 177.00
TOTAL: 177.00 0.00 177.00
FREY VILLAGE: HOMER ST. SING 1991
09/16/03 16:00 FAX 3623325 ~03
Page 1 of I
Check #2152
._ ht~ps://intemctapps ! .psecu.com/kiosk/check!ma~e.asp?POSTDATE--0g/22/2003&CHEC... 9/16/.2003
REV-1513 EX + (g-nnl
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
St. Sino. -Iomer Eugerle 21 03 00489
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE
[. TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Donna J. Keefer Daughter 50%
717 Melanie Lane
Middletown, PA 17057
2. Susan J. Neifert Daughter 50%
1901 Lenox Street
Camp Hill, PA 17011
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
11. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART l] - 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)
[/ M I L L E R, J R.
DAVI 1)
c.
Attorney at Law
December 19, 2003
Register of Wills
Cumberland County Court House
Carlisle, PA 17103
RE: Estate of Homer Eugene St. Sing
Date of Death: 06-04-.2003
File Number: 21 03-0489
Dear Sir or Madam:
Enclosed please find a copy of the letter I received from the Department of Revenue
accepting the tax return as filed in the above-captioned matter. An additional payment of $3.20 was
calculated by the Department and I have enclosed that payment with this letter.
Please contact me if you have any questions regarding the letter from the Department of
Revenue or the enclosed payment. Thank you for your cooperation.
Respectfully,
David C. Miller, Jr.
Enclosure: Copy of Department of Revenue Letter dated 12-15-03
1846 Bonnie Blue Lane * Middletown, PA 17057 * Phone: 717-329-85.'53 * Fax: 717-9:39-2798 · E-mail: DavidCMi lerLaw(a~aol.com
BUREAU OF ZNDZVZDUAL TAXES COHNONNEALTH OF PENNSYLVANIA
INHERITANCE TAX DIVISION DEPARTHENT OF REVENUE
DEPT. 280601
HARRISBURG, PA I?IZB-O6Ol NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
DATE 22-15-2005
ESTATE OF STSING HONER E
DATE OF DEATH 06-0q-2005
FILE NUHBER 21 05-0q89
DAVID C HILLER J'~" :' ~ *' COUNTY CUHBERLAND
D C HILLER JR LAW OFC ACN i01
18~6 BONNIE BLUE LN ~ Amount Rem/fred
HIDDLETOWN ~PA 17057
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWE
........................................ R PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTICE b-~* ~'~H~-~N~-~ ~%'~' ~P~A'~E~' ~OWA-E~ OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF STSING HONER E FILE NO. 21 0~-0~89 ACN 101 DATE 12-15-2005
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
(1)_ 90/000.00 NOTE: To /nsure proper
2. Stocks and Bonds (Schedule B) (2) 1~6~2.66 cred/t to your account~
$. Closely Held Stock/Partnership Interest (Schedule C) ($) .00 subm/t the upper port/on
~. Nortgages/Notes Receivable (Schedule D) (~) .00 of this form ~ith your
$. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) (5). 2155~.8q ~ax payment.
6. Jointly O~ned Property (Schedule F) (6) 8~577.80
7. Transfers (Schedule G)
8. Total Assets (7) 16q.80
(s) 102,7fi0.10
APPROVED DEDUCTZONS AND EXEHPTIONS:
9. Funeral Expenses/Adm. Costs/N/sc. Expenses (Schedule H) (9) 9,0~9.55
10. Debts/Nortgage Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Net Value of Tax Return (11) 11.261.96
(zz) 91,q78.1fi
15. Char/table/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) O0
1~, Net Value of Estate SubSec~ to Tax ·
91,~78.1~
NOTE: I~ an assessment was issued Dreviously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX= -'
15. Amount of Line 1~ at Spousal rate
(is) .00 x O0 = .00
26. Amount of L/ne lq taxable at L/heel/Class A rate (16)~ 91,q78.1q X Oq5 q,116.52
17. Amount of Line lq at Sibling rate =
(17) .00 x 12 = .00
18. Amount of L/ne lq taxable at Collateral/Class B rate (18) O0 X 15
19. Princ/pal Tax Due · = .00
~I~'L"L~ (19)= q,116.52
DATE
NUMBER INTEREST/PEN PAID
CDO A.0u.T .A D
0-21-2005 CD005155 202'6-~---~5~
.00 __' 60.69
PAYMENT MUS' BE HADE BY 05-Oq-ZOOq~.
~ANCE OF TAX DUE{ 5.20
XNTEREST AND PEN. I .00
TOTAL DUE I 5.20
~ 1F PAID AFTER DATE INDICATED~ SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYMENT ZS RE~UZRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR)~ YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCT/ONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EX(11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT· 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003356
MILLER DAVID C JR, ESQ.
1846 BONNIE BLUE LANE
MIDDLETOWN, PA 17057
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 $3.20
ESTATE INFORMATION: SSN: 196-14-1269
FILE NUMBER: 2103-0489
DECEDENT NAME: ST SING HOMER EUGENE
DATE OF PAYMENT: 12/22/2003
POSTMARK DATE: 12/19/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 06/04/2003
TOTAL AMOUNT PAID: $3.20
· REMARKS:
CHECK//1128
INITIALS: AC
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
~ BUREAU OF [NDZVZDUAL TAXES CONMON#EALTH OF PENNSYLVANIA
ZNHERZTANCE TAX DZVZSZON DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 171Z8-0601 NOTICE OF /NHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
RE¥-1547 EX 4FP (01-05)
DATE 12-15-2005
ESTATE OF STSING HOMER E
DATE OF DEATH 06-04-2005
FILE NUMBER 21 05-0489
DAVID C MILLER JR 'I: :. :,,. COUNTY CUMBERLAND
D C MILLER JR LAW OFC ACN 101
1846 BONNZE BLUE LN ~ = Amoun~ Ree/~ed
MIDDLETOWN PA 17057'
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
REV 1547 EX AFP (01 03) NOTICE OF INHERITANCE TAX APPRAZSENENTF-~'~'~'~- .................
ESTATE OF DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
STSING HOMER E FILE NO. 21 05-0q89 ACN 101 DATE 12-15-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE ~NTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a*e (Schedule A)
(1) 90/000.00 NOTE: To insure proper
2. S~ocks and Bonds (Schedule B) (2)_ lz64~.66 cred~ ~o your account,
$. Closely Held S~ock/Per~nership Zn~eres~ (Schedule C) ($) .00 submi~ ~he upper portion
q. Hor~gages/No~es Receivable (Schedule D) (fi) .00 of ~his fore wi~h your
$. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) ($). ~1554.84 tax payment.
6. Jointly Owned Proper~y (Schedule F) (6) 8;$77.80
7. Transfers (Schedule G)
8. To'al Asse*s (7) 164.80
(B) 102,740.10
APPROVED DEDUCTZONS AND EXEMPTZONS:
9. Funeral Expenses/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 9,0q9.55
lO. Debts/Mortgage Liabilities/Liens (Schedule I) (10)
Il. To*al Deductions
12. Ne~ Value of Tax Re~urn (11) ]].76]-9~
(12) 91,478.14
15. CharA*able/Governmen,el Bequests; Non-elec*ed 9115 Trusts (Schedule J) (15) .00
1~. Ne~ Value of Es*a~e Sub~ec* ~o Tax
91,478.14
NOTE: Z~ an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 #ill
re~Zect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Aeoun~ of Line 1~ at Spousal ra~e (15). .00 X O0 = .00
16. Aeoun* of L/ne lfi ~exeble a* Lineal/Class A re~e (16). 91,478.14 X 045 4,116.52
17. Aeoun~ of L/ne lfi e~ S1blAng re*e =
(17). .00 X 1Z = .00
lB. Amount of Line 1~ taxable at Collaleral/Class B rate (18)_ O0 X 15
19. Principal Tax Due ' = .00
4,116.52
DATE
NUHBER INTEREST/PEN PA/D (-) ANOUNT~
0-21-2005 CD005155 .00
PAYMENT HUS' BE MADE BY 0~-04-2004~. TOTAL~ 4,115.$2
BALANCE OF TAX DUE
INTEREST AND PEN. I .00
TOTAL DUE I 3.20
~ ZF PAZD AFTER DATE ZNDZCATED~ SEE REVERSE ( [F TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED.
FOR CALCULATION OF ADD[TZONAL ZNTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.)
RESERVATION: Estates of decedents dying on or before December 1Z, 19az -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such futura interest.
PURPOSE OF
HOT%CE: To fulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S.
Section
pAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS15). Applications are available at the Office
of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-SOZ-ZOSO; services for taxpayers with special hearing and / or
speaking needs: 1-860-~7-50Z0 (TT only).
OBJECTIONS: 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. ZBlOZ1, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing 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.
DISCOUNT: If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (BI) discount of
the tax paid is allowed.
PENALTY: The 1SI tax amnesty non-participation penalty is computed on the total 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 would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine (g) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of
six (6Z) percent par annum calculated at a daily rata of .000161. All taxes which became delinquent an and after
January 1, 19BI will bear interest at a rata which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO3 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Yea.__r Rate Factor Yea___r Rate Factor
198Z ZOZ .OO05qB 1987 9Z .O00Zq7 1999 7Z .00019Z
1985 16g .000~3B 1988-1991 llZ .O0030X Z000 8Z .000Zlg
198q llg .000301 1992 9g .0002q7 ZOOl 92 .O00Z~7
1985 13Z .000356 1995-199~ 72 .O0019Z ZOOZ 6Z .O0016q
1986 lOX .O0027~ 1995-1998 92 .O00Z~7 2005 5Z .000137
--Interest is calculated as follows:
XNTEREST= BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY XNTBREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) 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.
BUREAU OF ZNDZVZDUAL TAXES COMMONNEALTH OF PENNSYLVANZA
ZNHERITANCE TAX DIVISION DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 17ZZ8-060! ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
KEV-1607 EX ~FP (01-03)
DATE 01-26-2004
ESTATE OF STSING HOMER
DATE OF DEATH 06-04-2005
FZLE NUHBER 21 05-0489
DAVID C MILLER JR COUNTY CUMBERLAND
D C MILLER JR LAN OFC ACM 101
1846 BONNIE BLUE LN ~ Amount Reeitted
MIDDLETONN PA 17057
MAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit to your account, subeit the upper port/on of this fore with your tax payeent.
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS
~-£~-'~--~-~-(01-03) ~ ~NHERZTANCE TAX STATEMENT OF ACCOUNT
ESTATE OF STSING HOHER E FZLE NO. Z1 05-0489 ACN 101
DATE
THZS STATEMENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELON
ZS A SUMMARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE,
A PROJECTED ZNTEREST FZGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-15-2005
PRiNCiPAL TAX DUE:
........................................................................................................................................................................................................................... 4,116.52
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT ~ DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
09-05-2005 CDOOZ968 202.63 3,850.00
10-Z1-2005 CD003155 .00 60.69
12-19-2005 CD00~$56 .00 5.Z0
TOTAL TAX CREDZT
4,116.52
BALANCE OF TAX DUE .00
*rNTEREST AND PEN. .00
TF PA'rD AFTER THZS DATE, SEE REVERSE TOTAL DUE . O0
STDE FOR CALCULATZON OF ADD*rT*rONAL ZNTEREST.
'rF TOTAL DUE 'rs LESS THAN $1,
NO PAYMENT 'rS RE~)U'rRED.
'rF TOTAL DUE 'rS REFLECTED AS A "CREDZT,. (CR),
YOU NAY BE DUE A REFUND. SEE REVERSE S'rDE OF TH'rS FORM FOR 'rNSTRUCT'rONS. }
PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-l)13). Applications are available at
the Office of the Register of Wills, any of the Z3 Revenue District Offices or from the Department's Zq-hour
answering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or
speaking needs: 1-800-qq7-3ogo (TT onlY).
REPLY TO: guastions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZB060I, Harrisburg, PA ITIZB-060l, phone
(717) 787-6505.
DISCOUNT: If any tax due is paid within throo (5) calendar months aftor the dacedsnt's death, a five parcont (SI) discount
of the tax paid is allowed.
PENALTY: The iSg tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period.
INTEREST: Interest is chargod beginning with first day of delinquency, or nine (9) months and one (1) day from the data of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent par annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and after
January I, 19BZ will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 19BI through Z005 are:
Interest Daily Interest Daily lntsrest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .000548 1987 9Z . OOOZq7 1999 7Z . O00XgZ
1983 16Z .O00q3B 1988-1991 llT. .000301 ZOO0 8Z .O00ZI9
1984 11Z .000301 199Z 9Z .000Z47 2001 9Z .000Z47
1985 I~Z .000356 1993-1994 77. .00019Z ZOOZ 6Z .000164
1986 10X .000Z74 1995-1998 9X .000Z47 ZOO3 5Z .000137
--Interest is calculated as follows:
I'NTEREST = BALANCE OF TAX UNPAID X NUtlBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issuod after the tax becomos dolinquont will reflect an interost calculation to fifteen (15) days
boyond the data of the assossmont. If payaont is mado after the interest computation date sho~n on the
Notice, additional interest must be calculated-
~i~
WILL I
OF
HOMER E. ST. SING ~'~ ~'
I, the undersigned, HOMER E. ST. SING, a/k/a HOMER E. SAINT SING and H.
EUGENE ST. SING, presently of the BoroUgh of Camp Hill, County of Cumberland,
Commonwealth of Pennsylvania, being of sound mind and disposing memory, do
hereby make, publish and declare this to be my Last Will and Testament,
hereby revoking any and all prior Wills and Codicils made by me.
I. I direct that all my just debts and f~eral expenses, including the
cost of a headstone and the inscription thereon, be paid from the assets of my
estate as soon as practicable after my demise.
II. I direct that all estate, inheritance and succession taxes that may
be assessed in consequence of my death, of whatsoever nature and by whatsoever
jurisdiction imposed, shall be paid out of the principal of my general estate
to the same effect as if taxes were expenses of administration and all
property includable'in my taxable estate whether or not passing under this
will shall be free and clear thereof.
III. All the rest, residue and remainder of my estate, of whatsoever
nature and wheresoever situate, including property over which I hold a power
of appointment, I devise and bequeath unto my two (2) daughters, Donna J.
Keefer and Susan J. Foulke, both of the County of Dauphin, Commonwealth of
Pennsylvania. Should either of them predecease me, her share shall pass unto
her ~ssue per stirpes. If said child leaves no issue, that share shall pass
unto my other daughter or her issue per stirpes.
IV. I appoint my two (2) daughters, Donna J. Keefer and Susan J. Foulke,
Co-Executrixes, or the survivor of them sole Executrix, of this my Will.
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
es,ate oS ./4or, er 0 No. 05-
also known as To:
Register of Wills for the
Deceased. County of ~,:~,'la~ _ in the
Social Security No.. ~ ~ '- I ~ - ~ ~ ~ ~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who ~/are 18 years of age or older, app~ for letters of administration
(d.b.n.; pendente lite; durante absentia; durante minoritate) O~ the estate of
the above decedent.
Decendent was domiciled at death in ~'~ ~i ~ ~ County, Pennsylva~a, with
h I~ lastfamilyorprincipalresidenceat. 1901 Le~og ~r~t~ ~p ~'ll~ ~ I~_011
(list street, number and municipality)
Decendent, then ~ years of age, aiea ~e, ~, ~
Decendent at death owned prope~y with estimated values as folllows:
(If domiciled in Pa.) All personal property $_ &~ 0~
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania
· · $_ i~,0~
situated as follows: ~ ~r~~.
Petitioner_s; after a proper search ha~< ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~, ,~ c~x~r~. ~-
The petitioner(s) above-named 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
representative(s) of the above decedent petitioner(s) will well and
truly adminisier the estate according to law. ~~ ,,~.~~
Sworn to or affirmed and subscribed
before me this I~ dayof
~.~~ ~eglster
No. ~QI- t~3-ql~q
Estate of ~,~w< E~< 6+, ~,t4~ , Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ,.~x mO ~ ka . 2/9/) ~ ~.~, in consideration of the petition on
' · e
the reverse side hereof, satisfactory proof havtng been presr~nted before m , , .
IT IS DECREED that-~~ ,q', t~' uA~'' 0-,, ~l_ ~-~x~ ~. _Q"/o~
is/are entitled to Letters of Administration, and in accord with such finYling, Letters o~ Administratio~
are herebygrantedto~~ ~ ~ ~
in the estate of Q~o-,c'cx.~ ~%0,~,~_ xc~_. ~
Register of Wills
FEES
Letters of Administration ..... $~ {~)g~Z~:3 ~-~, ~t'~bL~'q~ ~' -
Short Certificates( ) .......... $~ ATTORNEY (Sup. Ct. LD. No.)
Renunciation ................ $ [~ q ~ ~~ ~OC~ ~'
~ $ ]0,00 t ~' ADDRESS
TOTAL . $~~ ~ ~ ~ ~ ~. ITOS'V
Filed .~rj~:.O~ ......... A.D. ~ --
Tlais is to certify that the information here given is correctly copied from an original certificate of death duly riled with me as
I.ocal Registrar. The original certificate will be forwarded to the State Vital Records Of'rice for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
,,,," ~,: Local Registrar
P 9 2 6 6 1 6 4 ~~ JUN 0 ? 2003
No. ~ Date
COMMONWEALTH OF PENNSYLVANIA o DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
~-AME O~ DECEDENT (Fir~ MJ(~le, Laa) STALE FILE NUMBER
~. 82 v,. ~h 16,2 Wil!i~
DECE~'S USUAL ~U~N KIND ~ SUS/NES~/NDUSTRy '
"---- L
~NI'~ ~tlmG ~ (~, C~g~n, ~m. Zip C~) 3E~EDENT'S
~90~ ~OX Strut ~S~OE~E
"- ~ ~,Pa 17011 ........ ~
~NF~T'S .~ ~p,.) I,. Ve~a ~ttis
~. ~nna K~fer
717 ~l~ie L~e ~dO!et~,Pa 17057
~'m~ ~ ~ ~,~a~e 9, 2003 ·
"
Zg: Z ~ E i. Nt"I? £0.
Caunt~ af Cumlnr~nb
COURTHOUSE, CARLISLE, PA 17013 MARY C. LEWIS
Register of Wills &
Clerk of the Orphans' Couff
JERRY IL DUFFIE, ESQ.
Solicitor
TO:
_~1 o ~- ~41~,~ Date: 06-13-2003
TODAY I SPOKE TO THE SECRETARY OF RICHARD EARL ETZWEILER, ESQ.
TO LET THEM KNOW THAT THE TWO SISTERS CAME IN TO PROBATE THE
ESTATE OF THEIR FATHER HOMER EUGENE ST. SING. THEY HAVE
DECIDED TO TAKE OUT LETTERS OF ADMINISTRATION.
JACQUELYN A AUST
06-13-2003
CERTIFICATION OF NOTICE UNDER RULE 5.6(a}
Name of Decedent: Homer Euqene St. Sinq
Date of Death: June 4, 2003
Will No. Admin. No. 2003-00489
To the Register:
1 certify that notice of (beneficial interest) 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 June 20, 2003 ·
Name Address
Donna J. Keefer, 717 Melanie Lane, Middletown, PA 17057
Susan J. Neifert, 170 Beacon Drive, Harrisburg, PA 17112
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE
Date: June 20, 2003
Signature C&___>'~'-7( {,,~ ~ ,.. t (¢'
Name David C. Miller, Jr.
Address 1846 Bonnie Blue Lane
Middletown, PA 17057
Telephone( ) 717-329-8533
Capacity: ~ Personal Representative
X .Counsel for personal representative
I) A V I I) C. M I L L 15 1¢., J
.~ttorlle, tit ]~all~
May 19, 2004
Register of Wills
Cumberland County Court House
Carlisle, PA 17103
RE: Estate of Homer Eugene St. Sing
Date of Death: 06-04-2003
File Number: 21- 2003-0489
Dear Sir or Madam:
Enclosed please find an original and two copies of a Supplemental Inheritance Tax Return
for filing in the above captioned matter. Would you please file the original and one copy, and time
stamp the additional copy and return it to me in the envelope provided. I have also included a check
made payable to the Register of Wills, Agent, in the amount of $67.93, regarding payment of the
taxes that are due.
Should you have any questions pertaining to the enclosures, please contact me. Thank you
for your cooperation.
Respectfully,
David C. Miller, Jr.
DCM/Imb
Enclosure: Supplemental Inheritance Tax Retum (Original + 2 copies)
Check # 1224 - "Register of Wills, Agent" - $67.93
Return Envelope, Postage Paid
1846 Bonnie Blue Lane · Middletown, PA 17057 · Phone: 717-329-853.3 · Fax: 717-939-2798 · E-mail: DavidCMillerLaw(a>aol.com
REV-1500 EX + (~-0~)
REV-1500
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER
DEPT. 280601
HARR,SBURG, PA1,128 01 RESIDENT DECEDENT 2 - 0 3 0 0 4 8 9
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL SOCIAL SECURITY NUMBER
z St. Sing, Homer Eugene 1 9 6- I 4- 1 2 6 9
~ DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD-Year) THIS RETURN BUST BE FILED IN DIJPMCATE ~I'H THE
I
o 06/0412003 ~ 03/1611921 REGISTER OF WILLS
III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~-"' O 1.0riginalRetum [] 2. SupplementalRetum J-"l 3. RemainderRetum (dateofdealfll~Ol'to12-13-82)
~"' O 4. Limited Estate r-'l 4a. FuturelntorestCompromise(da~eofdeahaf~r12-12-82) 'l"-I 5. Federal Estate Tax Retum Required
"'o~
,.,~ ['" ,,,"I O 6. Decedent Died Testate (Attach copy of Wi,) r-'l 7. Decedent Maintained a Living Trust (^t~ach copy (~ Trust) t 8. Total Number of Safe Deposit Boxes
< [] 9. LitigatJon Proceeds Received [] 10. SpousalPovertyCredit(dateofdeahbetween12-31-91and1_l.951 O 11. EleclJon to tax under Sec. O113(A)l^tachSchO)
~_ THIS SECTION IllUST BE COII~PIJ= I ~.z~. ALL CORRESPONDENCE AND CONFIDEN'nAL TAX INFORII. ATION SHOULD BE DIRECTED TO:
z NAME
,,, COMPLETE MAILING ADDRESS
z David C. Miller, Jr. 1846 Bonnie Blue Lane
0
a. FIRM NAME (If Al~ica~e)
~, Law Office of David C. Miller~ Jr. Middletown, PA 17057
o TELEPHONE NUMBER
717-329-8533
1. Real Estate (Schedule A) (1) 0.00
2. Stocks and Bonds (Schedule B) (2) 0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Morlgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) 1,554.00
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) 0.00
~[, F-'] Separate Billing Requested
.-I 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) O. 00
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) (8) 1,554.00
9. Funeral Expenses & Administrative Costs (Schedule H) (9) 55.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 0.00
11. Total Deductions (total Lines 9 & 10) (11) 55.00
12. Net Value of Estate (Line 8 minus Line 11) (12) 1 ~499.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 1,499.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at I~e spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) O. O0 X (15) O. Of)
16. Amount of Line 14 taxable at lineal rate 1,499.00 x .045 (16) 67.4f~
17. Amount of Line14 taxable at sibling rate 0.00 X .12 (17) 0.00
18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00
19. Tax Due
(19) 67.46
20.
Decedent's Complete Address:
STREET ADDRESS
1901 Lenox Street
CITY
Camp Hill Ii STATE PA IizIP 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 67.46
2. Credits/Payments
A. Spousal Poverty Credit
B. Pdor Payments
C. Discount
Total Credits ( A + B + C ) (2) 0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 67.46
A. Enter the interest on the tax due. (5A) 0.47
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5BI 67.93
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... [] []
b. retain the dght to designate who shall use the property transferred or its income; ........................................ [] []
c. retain a reversionary interest; or ...................................................................................................... [] []
d. receive the promise for life of ether payments, benefits or care? ............................................................. [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate cons derat on?
3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ................. [] []
4. Did decedent own an individual Retirement Account, annuity, or other non-probate property which
conta ns a beneficiary designation? ....................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUS'I' 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 statemen~ and to the best of my knowled e and belief it is true correct
Declaration of preparer other than the personal representative is based o~ all informalion of which preoarer has any ~;;[_.~...,~.,,~ g , , and complete.
SIGNAT,,~E OF PERSON RF.,8*P~NSIBL;E FOR FILING RETURN r '/ri' ...... /~) ~/~ /? / ' -AT-
AI~DRESS ..... x,-'...- // ,... ,/ z/.v,/~
///Me~ame Lane ~ 1901 Lenox Stree..g,~
Middletown, PA 17057 Camp Hill, PA 17011 L/
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS 1846 Bonnie Blue Lane
Middletown, PA 17057
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) (iii.
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)].
REV-1508 EX + (6-98)
'~ SCHEDULE E
coM~o.w~L~, oF PE..s~.v^.~ CASH, BANK DEPOSITS, & MISC.
...E..^.cE ~.E~u.. PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
St. Sing. Homer Eugene 21 03 00489
Include the proceeds of lilJgafion and the date the proceeds were received by the estate.
All property jointly-owned with rigM of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Federal Income Tax Return Refund 1,554.00
TOTAL (Also enter on line 5, Recapitulation) $ 1 .~54 I3R
REV-1511 EX + (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
,..E. TA.CE TM.ETU.. ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUBBER
St. Sina. Homer Eugene 21 03 00489
Debts of decedent must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representa~ve(s)
Street Address
C~y State Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedenfs address is not We same as claimant's, attach explanation)
Claimant
Slmet Address
C~ State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees Federal, State & Local Tax Returns for Tax Year 55.00
Ending December 31, 2003
7.
TOTAL (Also enter on line 9, Recapitulation $ 55.00
REV-1513 EX +
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
St. Sing. -Iomer Eugene 21 03 00489
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY De Not List Tmstee~s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [indude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Donna J. Keefer Lineal 0.50
717 Melanie Lane
Middletown, PA 17057
2. Susan J. Neifert Lineal 0.50
1901 Lenox Street
Camp Hill, PA 17011
Collateral
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-90)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003973
MILLER DAVID C JR, ESQ.
1846 BONNIE BLUE LANE
MIDDLETOWN, PA 17057
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..........
101 $67.93
ESTATE INFORMATION: SSN.' 196-14-1269
FILE NUMBER: 2103-0489
DECEDENT NAME: ST SING HOMER EUGENE
DATE OF PAYMENT: 05/25/2004
POSTMARK DATE: 05/1 9/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 06/04/2003
TOTAL AMOUNT PAID: $67.93
REMARKS:
CHECK# 1224
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
U.S. POSTAGE
PAID
AMOUNT MIDDLETONN,PR
17057
.... E ....rE, $1 29 M~Y 19.'04
~osr~ ~wc~ 0 O 019933- 15
~ 17!hR
0000
h.llh.h.lllh,,,,Ih h,hl
Law Office of David C. Miller, Jr.
1846 Bonnie Blue Lane
Middletown, PA I~057
Register of Wills
Cumberland County Court House
Carlisle, PA ~ / 70L5
INVENTORY
Estate of St. Sin.q, Homer Euqene No. 21 03 00489
also known as Date of Death 6/4/2003
, Deceased Social Security No. 196141269
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/VVe understand that false statements herein made are subject to the
penalties of 18 Pa. C.$. Section 4904 relating to unswom falsification to authorities.
Personal Representative:
Name of
Attorney: David C. Miller, Jr. Donna J. Keefer
LD. No.: 36504 Susan J. Neifert
Address: 1846 Bonnie Blue Lane Dated May 7, 2004
Middletown PA 17057
Telephone: 717-329-8533
Description
46 Shares of HARSCO stock valued at $35.71 per share as of the DOD ~~' 1,642.66
Cash on hand
29.00
Household items sold at auction 1,464.00
Jewelry
84.20
Coin collection
103.90
Medcohealth refund
19.16
Total
(Attach Additional Sheets if necessary) 95, 916.30
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personas representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
st. Sing, Homer Eugene 21 03 00489
Page 1
Description of Inventory
Description Value
HARSCO stock dividend 12.08
Clothing 325.00
Miscellaneous household items. 500.00
Currency - Old $1.00 Bill 17.50
Real Estate - 1901 Lenox Street, Camp Hill, PA 17011 90,000.00
Civil Service Payment 164.80
Federal Income Tax Refund 1,554.00
Subtota~ $ 92,573.3t~;
Grand Total $ .ct.~ .cI1R Ri3
COMMONWEALTH OF PENNSYLVANIA ~k~
BUREAU OF INDIVIDUAL TAXES DEPARTNENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE 07-05-2004
ESTATE OF STSING HOMER E
DATE OF DEATH 06-04-Z005
FILE NUMBER 21 05-0489
· ~! GOUNTY CUMBERLAND
DAVID C MILLER JR 'L~/., ~,u~.
ACN 101
D C MILLER JR LAW OFC
1846 BONNIE BLUE LN Amount: Remit'ted
MIDDLETOWN PA 17057:
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LINE I~> RETAZN LOWER PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01'03} NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF STSIN6 HOMER E FILE NO. 21 05-0489 ACN 101 DATE 07-05-2004
TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF.
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
1. Real Este*e (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) .00 credi~ to your account,
:3. Closely Held Stock~Partnership Interest (Schedule C) (:3) . O0 submit ~he upper per*ion
~. Mortgages/Notes Receivable (Schedule D) (~} .00 of this form with your
$. Cash/Bank Deposits/Hisc. Personal Proper*y (Schedule E) ($) I ;554.00 tax paynen*.
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 1,554.00
APPROVED DEDUCTTONS AND EXEMPTZONS:
9. Funeral Expenses/Ada. Costs~Misc. Expenses (Schedule H) (9) 55.00
10. Debts/Mortgage Liebili~cies/Liens (Schedule [) (10) .00
11. Total Deductions (11) ~;. 00
12. Not Value of Tax Return (12) 1,499.00
1:3. Charitable/Governmental Bequests; Non-elected 911:3 Trusts (Schedule J} (15) .00
1~. Net Value of Es4:a~:e Subjec~ to Tax (1~) 92,977.14
NOTE: zf an assessment ~as issued previously, llnes 14, 15 and/or 16, 17, 18 and :19 ~ill
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
1.6. Amoun~ of Line lq at Spouse1 rate (1.;) .00 X 00 : .00
16. Aeount of Line lq taxable a~ Lineal/Class A rate (16). 92,977.14 x 045 = 4,18:3.98
17. Amount of Line 1~ at Sibling rate (17). .00 x 12 = .00
16. Amount of Line lfi taxable at Collateral/Class B re*e (18) .00 X 15 : .00
19. Principal Tax Duo (19)= 4,18:3.98
TAX CREDITS:
PAYH~NT RECEIPT DTSCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PA:ID
09-05-200:3 CD002968 202.65 :3,850. O0
10-21-200:3 CD003153 . O0 60.69
12-19-200:3 CD00:3:356 . O0 :3.20
05-19-2004 CD00:397:3 .47- 67.9:3
TOTAL TAX CREDIT I 4,18:3.98
BALANCE OF TAX DUE .00
INTEREST AND PEN. .09
TOTAL DUE .09
~ ZF PAID AFTER DATE ZNDZCATED~ SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYHENT ZS REi)UZRED.
FOR CALCULATION OF ADDZTZONAL INTEREST. IF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.
RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Comaoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. [TI P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of NiIls printed on the reverse side.
--Make check or money order payable to: REGISTER OF #ILLS, AGENT
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, say be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office
of the Register of Wills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour
answering service for fores ordering: 1-800-56Z-lOS0; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disalloaance of deductions, or assessment
of tax Eincluding discount or interest] as shown on this Notice must object within sixty [60} days of receipt of
this Notice by:
--eritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes~ ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg, PA ITIZe-060I
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.
DISCOUNT: If any tax due is paid within three (5) calendar months after the decedant's death, a five percent (5X) discount of
the tax paid is allowed.
PENALTY: The 15X tax amnesty non-participation penalty is computed on the total 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 would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning eith first day of delinquency, or nine (9) months and Dna (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .000164. AIl taxes which became delinquent on and after
January l, 198Z will bear interest at a rata which will vary free calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2004 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ZOZ .000548 198~-1991 11Z .000301 ~ 9Z .0002~7
1983 16Z .O004~B 1992 9Z .000Z47 ZOOZ 62 .000164
1984 11Z .000301 1995-1994 7Z .00019Z 2003 5Z .000137
1985 13Z .000356 1995-1998 92 .000247 ZOO4 4Z .000110
1986 102 ,000274 1999 72 .00019Z
1987 IOZ .000Z74 2000 72 .00019Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBBR 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 oust be calculated.
FIRST AND FINAL ACCOUNT OF
Donna J. Keefer, Co-Administratrix
Susan J. Neifert, Co-Administratrix
For
ESTATE OF Homer Eugene St. Sing
Date of Death: June 4, 2003
Date of Co-Administratrixes' Appointment: June 16, 2003
Final Date of First Publication: July 18, 2003
Accounting for the Period: June 16, 2003 to July 31, 2004
Purpose of Account: Donna J. Keefer and Susan J. Neifert, Co-Administratrixes, otter
this account to acquaint interested parties with the transactions that have occurred during their
administration. The account also indicates the proposed distribution of the estate.
It is important that the account be carefully examined. Requests for additional
information or questions or objections can be discussed with:
David C. Miller, Jr., Esquire Donna J. Keefer Susan J. Neifert
Counsel for the Estate Administratrix Administratrix
1846 Bonnie Blue Lane 717 Melanie Lane 1019 Lenox Street
Middletown, PA 17057 Middletown, PA 17057 Camp Hill, PA 1701
717-329-8533 717-939-8963 717- 737-1213
SUMMARY OF ACCOUNT
(Continued on Page 3, 4 & 5)
Donna J. Keefer and Susan J. Neifert, Co-Administratrixes of the Estate of Homer
Eugene St. Sing, deceased, hereby declare under oath, that they have fully and faithfully
discharged the duties of their office; that the forgoing First and Final Account is true and correct
and fully discloses all significant transactions occurring during the accounting period; that all
known claims against the estate have been paid in full; that, to their knowledge, there are no
claims now outstanding against the Estate; and that all taxes presently due from the estate have
been paid.
Donna J. Keef~, Co-~d~nistratrix
Subscribed and sworn to by Dpnna J.
Keefer, before me this
Nc~-y Pfff~ic S~n/tture
' NOTARIAL SEAL
KATHY K. SEMIC, Notary Public
Lower Swatara Twp., Dauphin County
My Commission Expires March 3, 2007
Subscribed and sworn to by Susan J. $~san'J.'N:,
Neifert, before me this
day of .)L'~--I ,2004
Notary Public Signature
ML~ Commissiun Excre, s Dec 30 2006
SUMMARY OF ACCOUNT
Principal:
Receipts: $108,034.09
Less Distributions:
Debts of Decedent -$2,497.79
Funeral Expenses -$5,208.00
Administration Expenses -$689.53
Federal and State Taxes $0.00
Fees and Commissions -$3,077.00
Subtotal: -$11,372.32
Balance before Distribution: $96,661.77
RECEIPTS OF PRINCIPAL
Assets Listed in Inventory
8/6/2003 Real Estate $90,018.53
Tangible Personal Property:
112612003 HARSCO Dividend $12.08
1/26/2003 Old $1.00 Bill $17.50
7/7/2003 Cash on Hand $29.00
818/2003 Household Items Sold at Auction $960.00
8/2912003 Jewelry $84.20
9~3~2003 Stock - HARSCO (48 shares) $1,642.66
913/2003 Household Items Sold at Auction $504.00
10/7/2003 Civil Service Payment $164.80
1/26/2004 Coin Collection $103.90
1/2612004 Medcohealth Refund Check $19.16
4/15/2004 Federal Tax Refund $1,554.00
Subtotal of Tangible Personal Property $5,091.30
Bills paid from Joint Account:
6/5/2003 Funeral Bill Payment from Joint Account $5,108.00
6~9~2003 Lebanon VFW - FiG Military Service $50.00
6~9~2003 Country Oven Restaurant - Wake $305.82
6/1212003 Frey Village Nursing Home $1,480.02
6/1212003 Marilyn Swartz - Landscaping $60.00
6112/2003 Verizon $19.59
9/8/2003 Frey Village Nursing Home $177.00
10/2512003 Holy Spirit Hospital $4.00
Subtotal of Bills Paid from Joint Account: $7,204.43
Other:
6/11/2003 Myers Funeral Home $33.00
6/25/2003 Cumberland County $100.00
7/212003 Comcast Cable $1.33
7/14/2003 Cash $199.08
11/13/2003 M&T Investment Group $63.40
Subtotal of Other: $396.81
Payments from Beneficiaries:
8/12/2003 Donna J. Keefer $736.51
8/12/2003 Susan J. Neifert $736.51
9/2/2003 Donna J. Keefer $1,925.00
912/2003 Susan J. Neifert $1,925.00
Subtotal of Payments from Beneficiaries $5,323.02
Total of Principal: $108,034.09
DISBURSEMENTS OF PRINCIPAL
Debts of Decedent:
6/9/2003 Lebanon VFW - FIG Military Service $50.00
6/9/2003 Country Oven Restaurant - Wake $365.82
6/12/2003 Frey Village Nursing Home $1,480.02
611212003 Marilyn Swarlz - Landscaping $60.00
6/12/2003 Verizon $19.59
7121/2003 PPL $117.00
8/6/2003 PPL $83.80
8/6/2003 PAWC $26.56
8114/2003 Mary Haring - Cleaning & Hauling $120.00
9~8~2003 Frey Village Nursing Home $177.00
10126/2003 Holy Spirit Hospital $4.00
3/6/2004 Tax Preparation Fee $55.00
Subtotal of Debts of Decedent: $2,497.79
Funeral Expenses:
6/512003 Myers-Hamer Funeral Home, Inc. $5,108.00
7/21/2003 Myers-Hamer Funeral Home, Inc. $100.00
Subtotal for Funeral Expenses: $5,208.00
Administration Expenses:
817/2003 Probate Costs & Filing Fees $292.00
8/14/2003 Publication Fee - CLJ $75.00
9/24/2003 Publication Fee - Sentinel $105.53
7113/2004 Filing Fee - Inventory $13.00
7/23/2004 Final Accounting Filing Fee $104.00
Subtotal of Administration Expenses: $589.53
Federal and State Taxes
9/25/2003 PA Department of Revenue $3,850.00
1012612003 PA Department of Revenue $60.69
12/16/2003 PA Department of Revenue $3.20
5~26~2004 PA Department of Revenue $67.93
Subtotal of Federal and State Taxes $3,981.82
Fees and Commissions
8/12/2004 Law Office of David C. Miller, Jr. Paid $1,000.49
10/17/2004 Law Office of David C. Miller, Jr. Paid $1,038.24
Law Office of David C. Miller, Jr. Unpaid $1,038.27
Subtotal of Legal Fees $3,077.00
Total of Disbursements: $15,354.14
Balance for Distribution: $92,679.95
STATEMENT OF PROPOSED DISTRIBUTION
Balance for Distribution: $92,679.95
Prior Distribution of Principal to Beneficiary
8111/2003 Partial Distribution #1 -$80,000.00
8/11/2003 Partial Distribution #2 -$10,000.00
9/312003 Partial Distribution - Stock -$1,642.66
10/712003 Partial Distribution - Pension Payment -$164.80
Subtotal of Prior Distributions: -$91,807.46
Remaining Balance for Distribution: $872.49
Bank Balance: Wednesday, June 30, 2004 $2,218.89
Payment to David C. Miller, Jr. - Fees -$1,038.27
Payment to David C. Miller, Jr. - Taxes -$3.20
Payment to David C. Miller, Jr. - Taxes -$67.93
Payment to David C. Miller, Jr. - Filing Fees -$13.00
Payment to David C. Miller, Jr. - Filing Fees -$104.00
Payment to Susan Neifert - Mary Haring -$120.00
Bank Balance After Payments: $872.49
1/2 Balance to Donna J. Keefer $436.24 $436.24
1/2 Balance to Susan J. Neifert $436.25 $436,25
IN RE: ESTATE OF HOMI~.R IN ~ COURT OF COM~ iON PLEAS
EUGENE ST. SING, DECEASED CUMBERLAND COUNTY.
PENNSYLVANIA
ORPHANS' COURT DIVI~ [ON
NO. 2003-00489 PA N 21-03-0489
FIRST AND FINAL ACCOUNTING
I hereby certify that writtan notice of the filing of this Account, and of the date, time ar ~ place when the
same will be presented to tho Court for confirmation and the last day to file written obje :fions to said
Account, has been given to every unpaid claimant and to every other person known to ~ ~e accountant to
have or claim an interest in the estate as creditor, beneficiary, heir or next of kin.
I hereby certify that wriuen notice of the filing of this Statement of Proposed Distributi n, and of the date,
time and place when the same will be presented to the Court for confirmation and the la ~t day to file written
objections to said Statement of Proposed Distribution, has been given to every unpaid c] ~Jmant and to every
other person known to the accountant to have or claim an interest in the astute as creditc beneficiary, heir
or next ofkln. A copy of said Statement was included with the notice.
David C. Miller, Jr.
1846 Bonnie Blue Lane
Middletown, PA 17057
Counsel for the Homer E lgene St.
Sing, Deceased
FIRST AND FINAL ACCOUNT
I hereby c~mify that wtilten notice of the min~ of fltis A-'count, and of fl~e data, time and place whan tha
sam~ will b~ l~umt~d to th~ Court for confirmati(m and tho last day ta fil~ writtan objcctiom ~ ~d
~ ~ ~ giv~l to e~ Impaid ¢]almaqt alld to ~ve~ other p~oB klloWll to that aceotmtalR to
have or claim an interast in the es~te as credi~r, baneficia~, heir or next ofki~
I here, by c~tify that ~ notice of the filing of this Statement of Proposed Distributio~ and of~he data,
time end place when the same will be presented to the Court for confirmation end the last day to file writtan
objectians to said Statement of Proposal D~o~, has been given to ewry ~ ¢lainmm and to ~vory
other pe~on known to tho accoumant to have or claim an interest in the estate as creditor, benzflclary, Mir
or ne~ ofl~ A copy of said Statement was included wi~h the notice.
1846 Banni~ Blu~ Lan~
Middlatowa, PA 17057
Counsel for the Homor Euganz St.
--d oistri~3utlo~
STATUS REPORT UNDER RULE 6.12
Name of Decedent: H0m~r Euoene St. Sino
Date of Death: ~i/4/2003
Will No Admin. No. 21-2003-00489
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, ! 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 .9 Yes X No ~
b. The separate Orphans' Court No. (if any ) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest ? Yes No X
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.
Date' 10,7,2004 (~~~ j~
Signature
David C. Miller. Jr.
Name (Please type or print )
1846 Bonnie Blue Lane
Middletown PA 17Q~7
Address
( 717 ) -3298533
Tel. No.
Capacity: ~ Personal Representative
Counsel for personal
representative