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Home My WebLink About12-15-09 (2)i ?~~ 15056D7120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code near File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.28oso1 2 1 0 9 10 0 3 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 209 12 9137 09 22 2009 07 30 1921 Decedent's Last Name Suffix Decedent's First Name MI MILLER HELEN E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X^ 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ qa, Future Interest Compromise ~ 5. Federal Estate lax Retum Required (date of death after 12-12-82) 8. Decedent Died Testate ~ 7• (ptta dteCopy of Trni,~stj living Tn,st ], 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) 9. Litigation Proceeds Received ~ 10. spousal Poverty Credit (date of death ~ 11, Election to tax under Sec. 9113(A) between 12-31- 1 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIO SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAMES D. BOGAR 717 737 8761 Firm Name (If Applicable) BOGAR & HIPP LAW OFFICES First line of address ONE WEST MAIN STREET Second line of address City or Post Office SHIREMANSTOWN State ZIP Code PA 17011 correspondent'se-mail address: Jbogar@bogarlaw.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statement: ft is true, correct and complete. Declaration of preparer other than the personal representative Is based on all infortnatiol Joy M. Hamsher 1325 Oak Lane, New Cumberland, PA 17070 v PL.EASI3 NOTE: DUE TO AN EI,I;CIRONIC MALFUNCTION WITH 'I"IbiECLC)CK -THE CLOCK DA'I'S ON 1'I IIS DOCUMF,N'I' IS 12 HOURS BEHIND TI IF. ACT'U.~1I,'I'IME. --R13GIS'ITR OF l`TLIS/C1.HRK OF ORPHANS' CRT tiz/~4/ny SIGNATU O PREPARER OTHER THAN REPRESENTATIVE DATE ~~~ ~~~~_ James D. Bogar i Z ~ ~ ~~~.L9 I ADDRESS ~ V One West Main Street, Shiremanstown, PA 17011 Side 1 REGISIF WILLS~E ONLY ~^ `° a v r- ~ ~ rn X ~ ~.t rte-, - :~+~ : ~ ~~~r-- ~ - ; r~;Y- ... n t cn ~ CJ! ~ 'a r.V = 's= E'" ~ DATE F(L£tJ' I';:~ ,. •~ ~ 1505607120 1505607120 J wear r PA Inheritance Tax Return Signature of Additional Flduciariss I MOlar~lielen E. FO..E NUMBER Z9-09-1003 I 11~1dar panaltles of pspry,l dsdlaro wet I here armed thb iebm, indudinp aooompenying schedules and stetemanla. and m tlas beat of my I ofp~eparer ties any knoeAed~e. and oon~le6e. Dedaallon of preperec oQ1er tltan the personal ra{xeseraatlre is based ~ a0 i~tonwtlon slgnaturo ~ N,~ addnssi IWdross2 ~Y+ ~, ~P Yr ~V ~ ~~>~ - a cow l.sne Cape Yyr Court How.. Nd oE210 Z ~ 1~ `1 ~.~ J 1505607220 REV-1500 EX Decedent's Social Security Number oe~aaant~s name: Helen E. Miller 2 0 9 12 9 13 7 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 6 0, 4 9 4. 9 9 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages i~ Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 7 , 8 9 2 . 1 3 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 9 0 , 9 0 3 . 0 1 7. Inter-Vivos Transfers 8~ Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7, 14 2 , 8 1 5 . 0 8 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 3 0 2, 1 0 5. 2 1 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 14 , 8 7 6 . 4 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 14 , 8 7 6 . 4 9 12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 2 8 7 , 2 2 8 . 7 2 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ................................................. 14. 2 8 7 , 2 2 8 . 7 2 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0 . 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 2 8 7, 2 2 8. 7 2 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. .0.00 12,925.29 0.00 0.00 12,925.29 Side 2 15056D7220 1505607220 t'Y REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-1003 DECEDENT'S NAME Helen E. Miller STREET ADDRESS 1325 Oak Lane CITY New Cumberland STATE PA ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. lnterest/Penalty if applicable p, Interest E. Penalty 646.26 Total Credits (A + B + C) (1) 12,925.29 (2) 646.26 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A, Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) 12,279.03 (5A) (56> 12,279.03 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 :.................................................................................. ^ ^x b. retain the right to designate who shall use the property transferred or its income :.................................... ^ ^x c. retain a reversionary interest; or .................................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? .............................................................. ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ ^x 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... ^x ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [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 zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ~~ REV-485 EX+ (9-0D) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 SAFE DEPOSIT BOX INVENTORY Please Print or Type MUST 8E COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE FILE NUMBER SOCIAL SECURITY OR D EATH CERTIFICATE NUMEiER 209-12-9137 DECEDENT'S NAME (LAST, FIRST, MIDDLE) DATE OF DEATH Miller, Helen E. 9/22/2009 ADDRESS OF DECEDENT (STREET) (CITY) (STATE) (ZIP CODE) 1325 Oak Lane New Cumberland PA 17070 NAME ANO ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) James D. Bogar, Esquire (STREET NAME) (CITY) (STATE) (ZIP CODE) One West Main Street Shiremanstown PA 17011 NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAME) (RELATIONSHIP) Joy M. Hamsher daughter (STREET NAME) (CITY) (STATE) (ZIP CODE) 1325 Oak Lane NEw Cumberland PA 17070 b. (NAME) (RELATIONSHIP) (STREET NAME} (CITY) {STATE) (ZIP CODE) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) (STATE) (Ztp CODE) NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) PNC Bank (STREET NAME) (CITY) (STATE) (ZIP CODE) 331 Bridge Street New Cumberland PA 17070 ! NAME OF PERSON MAKING LAST ENTRY `-~_ Vw-~ ~'~ DATE AND TIME OF LAST ENTRY ~, __ ,,pp vi l~ t~~ t ~'~ct ' ' .s ~l , .. . ~ 1 ~ ~C ~' . DATE OF CONTRACT TO NT BOX NUMBER OF BOX ~ TITLE UNDER WHICH BOX IS REQUESTED ~ 4 Z 41 87 4 4 5B ~E~-, F !Le' ` ~, C~~ '-jF~ ~ . wr, j NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) b. (NAME) (STREET ADDRESS) (STREET ADDRESS) 435 Q~~ ~ 3ZS G~~-~. ~~.- (CITY) ~~ll ~~ ~~ (SST^ATE) (ZIP CODE) i ? U?~ (~L ~~ ~ (CITY) / (STATE) ~ ~ (ZIP CODE) ~~ C f.t.'~t.ftiet Nye ~ ~ 7"l.~ts ~ NAME AND TITLE OF EMP LOYEE TAKING THE NVENTORY I (' ~ L WAS A WILL IN THE BOX? ^ YES ~, NO If yes, a. Date of will: b. Name and address of personal representative, if named in the will (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE} c. Name and address of attorney, if any (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) -.. y SAFE DEPOSIT BOX INVENTORY Page of ~NSTRUGTIONS (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrantor other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. {3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (S) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. {6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. {8) Atl other contents. ITEM NO. ITEM DESCRIPTION ~~~~ ~ {'v~tAf I CERTIFY UNDER PENALTY OF PERJURY THATTHE AEtOVE RECORD !S CORRECT AND OMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF, PERSON RECEIVING COPY OF SAFE DEPOSIT BOX INVENTORY: SIGNATURE } h SIGN RE , PRINT NAME jj ~~ ~~~~ C t l.~Cl ' J ~ PRI NAM AND CHECK APPROPRIATE BOX BELOW: {+~ ~~ . ~~ S Ci7` PRINTTiTLE ~'~~~ { 4 Y ~'~'~~ ~'tt -r~ `t M ~ j ~ ~; ~'~ DATE ~ ~ ` ~ Cl~rt CHECKAPPROPRIA BOX: ,~Executor(trix) ~ Administrator(trix) ~ Estate Representative ~ Joint owner of safe deposit bax -.inTF• attacCa additional 8'h" x 11" sheet(s) if necessary or use duplicates of this page of form. _, Rev-1503 EX+(~g$j SCHEDULE B STOCKS ~ BONDS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Miller, Helen E. 21-09-1003 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATi-I 1 PNC Investments - BLACKROCK FDS (091928374) - 11,801.45 Mutual Fund 2 PNC Investments - BLACKROCK MULTI ST MUN SER 48,693.54 TR (092531755) -Mutual Fund TOTAL (Also enter on Line 2, Recapitulation) 60,494.99 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) ~~ PNC INVESTMENTS Member FINRA and SIPC October 19, 2009 James D. Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 RE: Estate of Helen E. Miller SS #209-12-9137 Date of Death: Sept. 22, 2009 Dear Attorney Bogar: In reply to your request for a date of death value for Helen E. Miller, PNC Investment Account 6134-7323, please find enclosed the valuation and, copies of statements for August 2009 and September 2009. If you have any other questions, please do not hesitate to contactrne at 717-730-2289. Sincerely, ~~ Todd Perry Vice President Financial Advisor TP/ho Enclosures PNC Investments LLC Member of The PNC Financial Services Group 4242 Carlisle Pike Camp Hill Pennsylvania 17011 vvww.pnc.com ~ •~fay]cue\xatue Importantlnvestorlnformation: Securities and brokerage services are provided by PNC Investments LLC, member FINRA and SIPC. •Nu Bank Guaranu:e Annuities and other insurance products are offered by PNC Insurance Services LLC, a licensed insurance agency. ESTATE OF HELEN E. MILLER ACCOUNT #6134-7323 (DOD VALUATION 22 SEPTEMBER 2009} The information provided in this report is believed to be reliable, but its accuracy cannot be guaranteed. A mean price is calculated as an average of the high and low on the valuation date when available. If these prices are not avai table, such as on weekends or holidays, the mean price is the inverselyweighted average of the high and low on the nearest trading dates before and after, when these prices are available within one week of the valuation date. If actual trades are not available, the nearest bid and ask prices are substituted. Note that securities traded on the Toronto Exchange are in Canadian dollars. If an equity is ex-dividend for a cash distribution on or before the valuation date but is of record after the valuation date, the dividend is included in the valuation report and is added to the security's value.. This is reported as an adjusted value on the report. If the date of death is on or after the record date and the dividend is payable after that date, the accrued dividend is listed separately on the report and added to the portfolio's total value. Prices for which daily updates are not available arepriced according to a Corporate Pricing Cycle. These pricing dates occur on the fast business day of the week, and the last business day of the month, unless the end of the week update falls within three business days or less, of the end-of-month update. Prepared 13 October 2009 Estate Valuation Date of Death: 09/22/2009 Estate of: Helen E. Miller Valuation Date: 09/22/2009 Account: 6134-7323 Processing Date: 10/13/2009 Report Type: Date of Death Number of Securities: 4 File ID: MILLER,HELENE Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Bid Adjustments Accruals Value 1) 1136.941 BLACKROCK FDS (091928374) GV INCM INVS A Mutual Fund (as quoted by NASDAQ) 09/22/2009 10.38000 Mkt 10.380000 11,801.45 2) 4467.297 BLACRROCK MULTI ST MUN SER TR (09253A755) PA MUNI BD A Mutual Fund (as quoted by NASDAQ) 09/22/2009 10.90000 Mkt 10.900000 48,693.54 3) 142615.08 MetLife Annuity (591567708) Contract 940163159 PNC 09/22/2009 1.ODODO 1.00000 1.0 000 00 142 , 815.08 4) 5573 Cash (SVPOl) MMF PNC 09/22/2009 1.00000 1.00000 1. D OOO OD 5 , 573.00 Total Value: Total Accrual: Total: $208,883.07 $208,883.07 $0.00 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (816} 313-6300 or www.evpsys.com. 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CA ~"i on~-i c~i~-aim D 69 A_ O Cv 0 EA V_ N A ~I p D O n v (D ~ __ a '~ ~. ,~• ° m b -i D r rb + --~ .~ ~ ~ <• O D ~ u, y ' -i rn ~+ N ~ ~ o ~ a 7 ~ 0 N ~ ~ Z ,, N Z C m D v 7 `G O -1 n D m n f3 c a r ~ m ~ z ~ ~ ~ ~ v ~ f , '~ ~` 1 ~ ~1t r~- !D r ~ N. ~_ W /`~ ~ O w ~ 0 N ~' o r„ o v1 m ~, ~ (0 ~ ~ 0 -~ o~ Rev-1508 FJIt (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Miller, Helen E. 21-09-1003 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with the right of survivorship must tre disclosed on schedule F. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) PNC INVESTMENTS Member FINRA and SIPC October 19, 2009 James D. Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 RE: Estate of Helen E. Miller SS #209-12-9137 Date of Death: Sept. 22, 2009 Dear Attorney Bogar: In reply to your request for a date of death value for Helen E. Miller, PNC Investment Account 6134-7323, please find enclosed the valuation and copies of statements for August 2009 and September 2009. If you have any other questions, please do not hesitate to contact me at 717-730-2289. Sincerely, Todd Perry Vice President Financial Advisor TP/ho Enclosures PNC Investments LLC Member of The PNC Financial Services Group 4242 Carlisle Pike Camp Hill Pennsylvania 17011 www.pnc.com •~tay I.cue Value ' •Nul3ankGuarencee Important Irnestorlnfomlation:Securities and brokerage services are provid ed by PNC Investments LLC, member FINRA and SIPC. Annuities and other insurance products are offered by PNC Insurance ServicesLLC, a licensed insurance agency. ESTATE OF HELEN E. MILLER ACCOUNT #6134-7323 (DOD VALUATION 22 SEPTEMBER 2009} The information provided in this report is believed to be reliable, but its accuracy cannot be guaranteed. A mean price is calculated as an average of the high and low on the valuation date when available. If these prices are not avai lab le, such as on weekends or holidays, the mean price is the inversely weighted average of the high and low on the nearest trading dates before and after, when these prices are available within one week of the valuation date. if actual trades are not available, the nearest bid and ask prices are substituted. Note that securities traded on the Toronto Exchange are in Canadian dollars. If an equity is ex-dividend for a cash distribution on or before the valuation date but is of record after the valuation date, the dividend is included in the valuation report and is added to the security's value. This is reported as an adjusted value on the report. If the date of death is on or after the record date and the dividend is payable after that date, the accrued dividend is listed separate{y on the report and added tothe portfolio's total value. Prices for which daily updates are not available are priced according to a Corporate Pricing Cycle. These pricing dates occur on the last business day of the week, and the last business day of the month, unless the end of the week update falls within three business days or less, of the end-of-month update. Prepared 13 October 2009 Estate Valuation Date of Death: 09/22/2009 Valuation Date: 09/22/2009 Processing Date: 10/13/2009 Shares Security or Par Description High/Ask Low/Bid 1) 1136.941 BLACRROCR FDS (091928374) GV TNCM INVS A Mutual Fund (as quoted by NASDAQ) 09/22/2009 2) 4467.297 BLACRROCR MULTI ST MUN 5ER TR (09253A755) PA MUNI BD A Mutual Fund (as quoted by NASDAQ) 09/22/2009 3) 142815.08 MetLife Annuity (591567708) Contract 940163159 PNC 09/22/2009 4) 5573 Cash (EVPO1) MMF PNC 09/22/2009 Total Value: Total Accrual: Total: $208,883.07 Estate of: Helen E. Miller Account: 6134-7323 Report Type: Date of Death Number of Securities: 4 File ID: MILLER,HELENE Mean andjor Div and Int Security Adjus*_ments Accruals Value 10.38000 Mkt 10.3 800 00 11, 801.45 10.90000 Mkt 10.9 000 00 4 8 , b 93.54 1.00000 1.00000 1.00000 1.00000 1.000000 142,815.08 1 .0000 OD 5 , 573.00 $208,883.07 $0.00 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. 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SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Joy M. Hamsher B. Cindy M. Evans C. 1325 Oak Lane Daughter New Cumberland, PA 17070 9 Conover Lane Daughter Cape May Court House, NJ 08210 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 A, B 1/29/2008 New Cumberland Federal Credit Union - 369.16 33.333% 123.05 Savings Account (S1) 2 A, B 1/29/2008 New Cumberland Federal Credit Union - 9.499.15 33.333% 3,166.38 Checking (S4) 3 A, B 1/29/2008 New Cumberland Federal Credit Union - 23,430.50 33.333% 7,810.17 Certificate of Deposit (CD3) 4 A, B 1/29/2008 New Cumberland Federal Credit Union - 35,217.48 33.333% 11,739.16 Certificate of Deposit (CD4) 5 A, B 1/29/2008 New Cumberland Federal Credit Union - 54,575.55 33.333% 18,191.85 Certificate of Deposit (CD5) 6 A, B 1/28/2008 New Cumberland Federal Credit Union - 54,769.92 33.333% 18,256.64 Certificate of Deposit (CD6) 7 A, B 1/29/2008 New Cumberland Federal Credit Union - 22,247.29 33.333% 7,415.76 Certificate of Deposit (CD7) 8 A, B 1/29/2008 New Cumberland Federal Credit Union - 22.247.29 33.333% 7,415.76 Certificate of Deposit (CD8) Total of Continuation Schedule ee attached page TOTAL (Also enter on Line 6, Recapitulation) I 90,903.01 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-^1500 Schedule F (Rev. 6-98) New Cumberland k'ederal Credit Univz~ Your Commurcify Credit Urzio~x P,D. Box 653, New Cumberland., PA 17070-0658 Phone: (717) 774-7706. 1-R00-716-2328 • Fax: (717) 774-7996 • Web: «~ti~'w.ncfcuvnline,org october z 7, zoa9 James D. Bogar Attorney at Law One West Main Street Shirmanstow~z~, PA 17011 RF: Estatte of Helen E. Mill.ez Dear Mr. Bogax, Pursuant tv your letter dated October 26, 2009, in regards to Estate of Helen E. Miller the informatioa~ is as follows: Account Nun7,ber: 7409 Owzaer(s) on Account: Helen E.1VTxllez' Joy G. Hamsher added 01/29!08 Ciritdy M. Evans added 01/29/08 Date acct opened: 10/25/1977 Date of Deatlx Balantces: S 1 (Savings) $ 369.16 S4 (Gheckiug) $ 9,499.15 CD3 $23,430.50 CD4 $35,217.48 CD5 $54,575.55 . CD6 $54,769.92 CD7 $22,182.3 8 CD8 $22,182.3 8 CD9 $32,861.94 DOD'1'axableDiti-idends: $ 5,1,87.95 YTD Taxable Dif-idends: $ 5,796.94 If you need aztything addid.onal itx zegards tv this information, please feel free tv contact zzte directly. Sincerely, ? ~ ,~ ~~ ~t^ , . Barbza J. Wrigll~~ Branch Manager + r N~ +LtlnaB~[ttv,-n F~:~[>~:~:u. C:HmI°r UM1I[~It '~nur Cc~mrrrunity ~rr'~ '~nr~ E't"I E3c~k €~zt3, Velti~ ~unil~erlancl, ('A ~ ~t~'~~~t 1-~3•i16r2~2~3 * et~e~t~anr.n~f~u~r~~ne~.~r HELEN E MILLER C/0 ANTHONY EVANS 9 CONOVER LANE CAPE MAY COURT NJ 08210-1467 STATEMENT OF ACCOUNT 1 OCT. 22 ELEC. RATE SEMINAR. OCT 23,24 ENTERPRISE CAR SALE-RATE LOW AS 4.49%. WIN TICKET TO NFL/SUPER BOWL STOP BY OR CALL FOR DETAILS! 08210-146709 ACLQLWTZJLIMBER JOY G. HAMSHER CINDY M. EVANS NaACraN EFFECTIVE DESCFZIPTION. AMOUNT- FINANCE FEES/ oAts DATE - _. _ CHARGE FINE 0901 PREVIOUS BALANCE S1-PRIMARY SHARES 0930 DIVIDEND THE ANNUAL PERCENTAGE YIELD EARNED IS 0.50. 0930 NEW BALANCE DIVIDEND IS CALCULATE USING A DAILY BALANCE METHOD. 0901 PREVIOUS BALANCE S4-SHARE DRAFTS 0923 'TRANSFER 090930 0923 TRANSFER 077350 0930 .DIVIDEND THE ANNUAL PERCENTAGE YIELD EARNED IS 0.25 0930 NEW BALANCE DIVIDEND IS CALCULATE USING AN AVERAGE DAILY BALANCE METHO 15 -316638' -316638' 160 0901 PREVIOUS BALANCE CERTIFICATE 3 0930 CERTIFICATE EARNINGS 60.08 6008' THE!ANNUAL PERCENTAGE YIELD EARNED IS 3.17. 0930. ;NEW BALANCE (MATURES 012110)3.120% Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases 0901 PREVIOUS BALANCE CERTIFICATE 4 0930 CERTIFICATE EARNINGS 94.36 9436' THE ANNUAL PERCENTAGE YIELD EARNED IS 3.31. 0930 'NEW BALANCE (MATURES 072110)3.260% Your current Member Rewards level-is DIAMOrFD =.~rhich entitles You to a 0.4 increase over and above our base rate on future CD purchases. 09.01 PREVIOUS BALANCE CERTIFICATE 5 0930 CERTIFICATE EARNINGS 91.51 9151 THE'ANNUAL PERCENTAGE YIELD EARNED IS 2.06. 0930 NEW BALANCE (MATURES 061310)2.040% Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases. 0901 PREVIOUS BALANCE CERTIFICATE 6 0930 CERTIFICATE EARNINGS 144.50 14450 **CONTINUED** SOCIAL SECURITY STATEMENT PERIOD F~~~109-09300 s .'BALANCE 36916 36931 36931 9499'x5 6332:77 316639 316799 316799 2343050 2349058 2349058 3521748 3531184 3531184 5457555 5466706 5466706 5476992 5491442 1l~~ ~~~ IfYf011~ Ntw~w ~C:TnraaE~t.~ISn FE€aElLil. GREUI7' I1I~PIir~h' I~~~rur C~a~rrmur~:"t~~ Crept ~~nt' Box. ~~8, '~er~ Cunil.rlC~nd, ~A I ~t~7~:St~ 1-Bl~t~a716-~~?S * r~r~+r~ra.ra~k~ctOnlne.Or HELEN E MILLER C/0 ANTHONY EVANS 9 CONOVER LANE CAPE MAY COURT NJ 08210-1467 STATEMENT OF ACCOUNT 2 OCT. 22 ELEC. RATE SEMINAR. OCT 23,24 ENTERPRISE CAR SALE-RATE LOW AS 4.49%. WIN TICKET TO NFL/SUPER BOWL STOP BY OR CALL FOR DETAILS! JOY G. HAMSHER CINDY M. EVANS esecrrow EFF&CTTVE - ,. FINANCE ue~s .DATE DESCRIPTIONS AMOUNT CHARGE THE ANNUAL PERCENTAGE YIELD EARNED IS 3.26. 0930 NEW BALANCE (MATURES 121309)3.210% Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases. AC,COIJNT Ni.IMBER SOCIAL SECURITY STATEMENT PERIOD F~~~10909300~ ~~` BALANCE FINES 5491442 0901 PREVIOUS BALANCE CERTIFICATE 7 0930 'CERTIFICATE EARNINGS 64.91 6491 THE ANNUAL PERCENTAGE YIELD EARNED IS 3.62. 0930 NEW BALANCE (MATURES 061310)3.560% Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases. 0901 PREVIOUS BALANCE CERTIFICATE 8 0930 CERTIFICATE EARNINGS 64.91 6491 THE ..ANNUAL PERCENTAGE YIELD EARNED IS 3.62. 0930 NEW BALANCE (MATURES 061310)3.560% Your current Member Rewards level is DIAMOND which entitles: you to a 0.4 increase over and above our base rate on future CD 'purchases. 0901 PREVIOUS BALANCE CERTIFICATE 9 0930 CERTIFICATE EARNINGS 86.70 8670. THE ANNUAL PERCENTAGE YIELD EARNED IS 3.26. 0930 NEW BALANCE (MATURES 121309)3.210% Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases,. 2218238 2224729 2224729 2218238 2224729 2224729 32861'94 32948:64 32948!64 5796.67 0.00 ~ r rl£W[CJGARERE.~T+IFl P~E]IRJIi. E:QEI}I3' i1NIEiE'4 ~c~~~r C'n~a~rr~rar~it~r C~dzt `~~rr~~rz f'Ca [fox ~~$, ~le~v Curnl.rl~l~d, ~d~ t <<U~C~-d~b5k~ 7 =8f~C1•i 7 G~"~ ~2~i * tiv~~tn1.n~€cc~c~n~rne.t~r STATEMENT OF ACCOUNT 1 SPREAD THE WORD! 4.74% NEW/USED CAR 60 MO 5.74% HOME EQUITY TO 120 MO 6.90% VISA FOR MORE INFO WWW.NCFCUONLINE.ORG 08210-146709 ACCQ~L~ITiI[IMBER HELEN E MILLER JOY G. HAMSHER C/0 ANTHONY EVANS CINDY M. EVANS SOCIALSECURITY 9 CONOVER LANE CAPE MAY COURT NJ 0 8 210 -14 6 7 STATEMENT PERIOD F~~~10908310~ NEwCTION EFFECTIVE - FINANCE FEES/ °"~ DATE DESCRIPTION' AMOUNT CHARGE...-FINES BALANCE- 0801 .PREVIOUS BALANCE S1-PRIMARY SHARES 36900 0831' DIVIDEND 16 36916 THE ANNUAL PERCENTAGE YIELD EARNED IS 0.51. 0831 NEW BALANCE DIVIDEND IS CALCULATE 36916 USING A DAILY BALANCE METHOD. 0801 PREVIOUS BALANCE S4-SHARE DRAFTS 949713 0831 ..DIVIDEND 202 949915 THE ANNUAL PERCENTAGE YIELD EARNED IS 0.25. 0831. NEW BALANCE DIVIDEND IS CALCULATE 949915 USING AN AVERAGE DAILY BALANCE METHO 0801 .PREVIOUS BALANCE CERTIFICATE 3 23368'.58 0831 'CERTIFICATE EARNINGS 61.92 6192 23430'.50 THE ANNUAL PERCENTAGE YIELD EARNED IS 3.17. 0831 ,NEW BALANCE (MATURES 012110)3.120% 2343050 Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD :purchases. 0801 PREVIOUS BALANCE CERTIFICATE 4 3512024 0831 CERTIFICATE EARNINGS 97.24 9724. 3521748 THE ANNUAL PERCENTAGE YIELD EARNED IS 3.31. 0831 .NEW BALANCE (MATURES 072110)3.260% 3521748 Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases. 0801 PREVIOUS BALANCE CERTIFICATE 5 5448116 0831 CERTIFICATE EARNINGS 94.39 9439 5457555 THE ANNUAL PERCENTAGE YIELD EARNED IS 2.06. 0831 NEW BALANCE (MATURES 061310)2.040% 5457555 Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD :purchases. 0801 PREVIOUS BALANCE CERTIFICATE 6 5462101 0831 CERTIFICATE EARNINGS 148.91 14891 5476992 **CONTINUED** ' w~~~~1~~IMi1~iw~M~ Rwa ~. lYlEi~ {:il[~iRLRF.A1r°Fl P'EC]Q4AAt: GREIIi'a' i3l~C?t °7fc~ur C'am~zru~tt~ Crct ~'n F'O f3ox ~~~,, '~+~~,v Cur3ilrl~7i~€1, I',~ t itt'(~-~~5~3 '1-8E~C~-71E~-~~.28 +~ ti~~t~tir~~.nc~c.uc~nlrl~.c~r HELEN E MILLER C/0 ANTHONY EVANS 9 CONOVER LANE CAPE MAY COURT NJ 08210-1467 STATEMENT OF ACCOUNT 2 SPREAD THE WORD! 4.74% NEW/USED CAR 60 MO 5.74s HOME EQUITY TO 120 MO 6.90% VISA FOR MORE INFO WWW.NCFCUONLINE.ORG JOY G. HAMSHER CINDY M. EVANS ACLQCI.j`IT Nj]MBER SOCIAL SECURITY STATEMENT PERIOD F(~~~10908310~ Ns•cnoN wra PINAxcE ~ESr F.PPFECI7VE DArE DESCRIPTION ~.... AMOUNT CHARGE. FINES BALANCE' THE ANNUAL PERCENTAGE YIELD EARNED IS 3.26. 0831 NEW BALANCE (MATURES 121309)3..210% 5476992 Your current Member-Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases;. 0801 PREVIOUS BALANCE CERTIFICATE 7 2211551 0831 ..CERTIFICATE EARNINGS 66.87 66.87. 2218238 THE ANNUAL PERCENTAGE YIELD EARNED IS 3.62. 0831 NEW BALANCE (MATURES 061310)3.560% 2218238 Your current Member Rewards level is DIAMOND which entitles you to a 0.4 increase over and above our base rate on future CD purchases. 0801 PREVIOUS BALANCE CERTIFICATE 8 2211551 0831 CERTIFICATE EARNINGS 66.87 66:87 2218238 THE ANNUAL PERCENTAGE YIELD EARNED IS 3.62. 0831 NEW BALANCE (MATURES 061310)3.560s 2218238 Your current Member Rewards level is DIAMOND which entitles you to' a 0.4 increase over and above our base rate on future CD purchases. 0801 'PREVIOUS BALANCE CERTIFICATE 9 3277259 0831 CERTIFICATE EARNINGS 89.35 8935 32861.94 THE ANNUAL PERCENTAGE YIELD EARNED IS 3.26. 0831 NEW BALANCE (MATURES 121309)3.210% 32861'94 Your current Member Rewards level is DIAMOND which entitles; you to a 0.4 increase over and above our base rate on future CD 'purchases. 5187.95 0.00 ~4 LEliDIt1G Trig WAY ' November 5, 2009 James D Bogar, Esq. One Viz Main St Shiremanstown, PA 1701 i RE: Helen E Miller SSN:209-1Z-9137 DOD: 09-22-2'009 Dear Mr. Bogar; In response to your request ~oz Date of Death (DOD) balances for the customer noted a_bave, our records show the fvIlowing: C[tecking Account Account # 5140043339 Established: 01-01-1978 HELEN E MILLER JOY G HAMSHER CIl~TDY M EVANS DOD balance: $ 15,175.81 + 0,39 accrued interest Interest paid O l -01-2009 thru~ 09-22-2009 S 17.75 YTD Savings Account Accaunt # 5001143823 ~ Established; 10-Z1-1997 HELEN E MII,LER ' JOY G HAMSI-lER . CINDY M EVANS~ DOD balance: S 1,314.50 + 0.07 accrued interest Interest paid Ol'-01-2009 thin 09-22-2009 $ 1.43 YTD Investment Account - ' The decedent maintained Investment Accaunt 61347323. Por further information, you may call the Brokerage Department at 1-800-762-6111. Page 1 of 2 Safe Deposit Boa The decedent maintained safe deposit box 445B HELEN EMILL-ER - 7~Y G HAMSHER GINDY M EVANS Located at: New Cumberland Branch . 331 Bridge 5t New Cumberland, P.4 17070 (71'7) 774-2982 Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings). We do not prnceas any financial transactions ar provide statements, If you need assistance tivith any of these items, please call 1-E88 PNGBANK (1-888-76Z-Z26S) yr stop by your lots! PNC Bank branch o$ice. Sincerely, . National Financial Services Center PNC Bank, N.A. Member FDIC Page 2 of 2 Rev-1510 EX+ (698) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Miller, Helen E. 21-09-1003 This schedule must be completed and filed'rf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DE CRIPTION F PROPERTY INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 PNC Investments - MetLife Annuity (59156T708); 142,815.08 142,815.08 Joy M. Hamsher and Cindy M. Evans are the named beneficiaries of this account. TOTAL (Also enter on Line 7, Recapitulation) I 142,815.08 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule G (Rev. 6-98) R_ ~ PNC INVESTMENTS Member FINRA and sIPC October 19, 2009 James D. Bogar Attorney At Law One West Main Street Shiremanstown, PA 17011 RE: Estate of Helen E. Miller SS #209-12-9137 Date of Death: Sept. 22, 2009 Dear Attorney Bogar: In reply to your request for a date of death value for Helen E. Miller, PNC Investment Account 6134-7323, please find enclosed the valuation and copies of statements for August 2009 and September 2009. If you have any other questions, please do not hesitate to contactrne at 717-730-2289. Sincerely, Todd Perry Vice President Financial Advisor TP/ho Enclosures PNC Investments LLC Member of The PNC Financial Services Group 4242 Carlisle Pike Camp Hill Pennsylvania 17011 vvww.pnc.com •~1tay Lose Value ' •No Bank Guarantee lmportantlrrvestorlnformation:Securities and brokerage services are provided by PNC Investments LLC, member FINRA and SIPC. Annuities and other insurance products are offered by PNC Insurance Services LLC, a licensed insurance agency. r. ~ ESTATE OF HELEN E. MILLER ACCOUNT #6134-7323 (DOD VALUATION 22 SEPTEMBER 2009) The information provided in this report is believed to be reliable, but its accuracy cannot be guaranteed. A mean price is calculated as an average of the high and low on the valuation date when available. If these prices are not available, such as on weekends or holidays, the mean price is the inversely weighted average of the high and low on the nearest trading dates before and after, when these prices are available within one week of the valuation date. If actual trades are not available, the nearest bid and ask prices are substituted. Note that securities traded on the Toronto Exchange are in Canadian dollars. If an equity is ex-dividend for a cash distribution on or before the valuation date but is of record after the valuation date, the dividend is included in the valuation report and is added to the security's value. This is reported as an adjusted value on the report. If the date of death is on or after the record date and the dividend is payable after that date, the accrued dividend is listed separately on the report and added to the portfolio's total value. Prices for which daily updates are not available are priced according to a Corporate Pricing Cycle. These pricing dates occur on the fast business day of the week, and the last business day of the month, unless the end of the week update falls within three business days or less, of the end-of-month update. ared 13 October 2009 A Estate Valuation Date of Death: 09/22/2009 Valuation Date: 09/22/2009 Processing Date: 10/13/2009 Shares Security or Par Description High/Ask Low/Bid 1) 1136.941 BLACKROCR FDS (091928374) GV INCM INVS A Mutual Fund (as quoted by NASDAQ) 09/22/2009 2) 4467.297 BLACRROCR MULTI ST MUN SER TR (09253A755) PA MUNI BD A Mutual Fund (as quoted by NASDAQ) 09/22/2009 3) 142815.06 MetLife Annuity (591567708) Contract 940163159 PNC 09/22/2009 4) 5573 Cdsh (SVPO1) MMF PNC 09/22/2009 Total Value: Total Accrual: Total: $208,883.07 Estate of: Helen E. Miller Account: 6134-7323 Report Type: Date of Death Number of Securities: 4 File ID: MILLER,HELENE Mean and/or Div and Int Security Adjustments Accruals Value 10.38000 Mkt 10.380000 11,801.45 10.90000 Mkt 10.900000 46,693.54 1.00000 1.00000 1.00000 1.00000 1.000000 142,815.08 1.000000 5,573.00 $208,883.07 $0.00 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818} 313-6300 or www.evpsys.com. (Revision 7.0.4) ti ~~ ,o <^• n= p y ry s ~tt ~o ~~ A ~ n 3 ~+. ~ o ~ 'h' fw4 ~ S c A ~` n ° ^ N _ ~ .. o ~~ ~~ x ~ ~ rn { r m n 3 K A °~, f> ,~ A o _- a R g ~ . n n a 3 $`' ~ a ~ ~ ~"°' F, . ~ a~ ' < ham ? N L T n~Z e SX7 0 q N n ~ ~ n ., ~ A O ~' y rn n ^ N '~•~ t"' M ~ n n n t. e Z n ~ n ~ _ ~ b n ~ n ~ ~ 0 -.1 ~ ~ ~ W 3 mh ra Z m ~_ ~ f.. •t r m c N d1 ~ , i, a Z ~ -o 'fl ~ G ~ ~ ~ o o y~ m ~ ~ _ -} ~ ' ^ C. N ~ • O a r 01 r+ O O p+ "~ n Z _ ~ (9 O O O 3 ~ O ~p n. 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N '~ ~ h W N ~~v W C Q II~VVi ~~ 0 r /1 \~~ D1 ~ ~ ay 0 rn REV-1151 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ApMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Miller, Helen E. 21-09-1003 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name(s) of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Bogar 8~ Hipp Law Offices 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 7,575.00 5,250.00 4. Probate Fees 189.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1,862.49 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 14,876.49 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) .: SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Miller, Helen E. 21-09-1003 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Stone 8~ Murray Funeral Home -funeral bill 7,575.00 H-A Subtotal 7,575.00 Other Administrative Costs 2 Pharmerica -final pharmacy bill 73.39 3 PNC Bank -outstanding check for pharmacy supplies as of date of death 289.10 4 RESERVES: -Costs to conclude administration of Estate, including filing of PA 1,500.00 Inheritance Tax Return and Inventory; Accounting; 2009 Personal Income Tax Returns and Fiduciary Income Tax Returns H-B7 subtotal 1,862.49 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-15!00 Schedule H (Rev. 6-98) s ~ V ., REV-1513 EX+ (11.08) SCHEDULE J COMMO A"IA BENEFICIARIES ERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Miller, Helen E. 21-09-10 03 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$) Do Not Llat Trus s I~ TAXABLE DISTRIBUTIONS [nclude outright spousal ib i d t f di str ons, an rans ers ut under Sec. 9116(a)(1.2)] Cindy M. Evans Daughter One-half of 9 Conover Lane rest, residue Cape May Court House, NJ 08210 and remainder Joy M. Hamsher Daughter One-half of 1325 Oak Lane rest, residue New Cumberland, PA 17070 and remainder Total Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 150 0 cover sheet, as appro priate, II NON-TAXABLE DISTRIBUTIONS: ~ A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I 0.00 .~ Copyright {c) 2009 form software only The Lackner Group, Inc. Form PA-15b0 Schedule J (Rev. 11-OS) ,. I, HELEN E. MILLER, a resident of the Borough of New Cumberland, Cumberland County, Pennsyl~a nia, being of sound and disposing mind and memory, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all Wills by me at any time heretofore made. ITEM I. I direct that all my just debts and funeral expenses by paid as soon after my decease as gray be found convenient. ITEM II. All the rest, residue and remainder of my estate, real or personal, which I may own or have the power to dispose of at the time of my death, I give, devise and bequeath unto my husband, Charles W. Miller. ITEM III. In the event my husband, Charles W. Miller, shall predecease me, I give, devise and bequeath my entire estate, real or personal, in equal shares, unto my children, Joy M. Hamsher and Cindy M. Evans, If either of my said children shall predecease me, her share shall go to her surviving issue, if any, in equal shares, otherwise to my surviving child. ITEM IV. I hereby nominate, constitute and appoint my husband, Charles W. Miller, Executor of this my Last Will and Testament, with full power in his discretion to do any and all things necessary for the complete administration of my estate, with full power to sell at public or private sale and without order of court, any real or personal property belonging to my estate, and to compound, compromise or otherwise to settle or adjust any and all claims, charges, debts and demands whatsoever against or in favor of my estate as fully as I could do if living. In the event that my said husband, shall predecease me, I hereby nominate, constitute and appoint my daughters, Soy M. Hamsher and Cindy M. Evans, Executrices with full powers as set forth above. IN WITNESS WHEREOF, ~ have hereunto set my hand and seal to this, my Last Will and Testament, this 3~ day of A. D. , 1978, L3~i~~Q~ (SEAL) Signed, sealed, published and declared by the above-named Helen E. Miller, as and for her Last Will and Testament in the presence of us, who, at her request, in her presence and in the presence of each other, we believing her to be of sound and disposing mind and memory, have hereunto subscribed our names as witnesses this 3/ day of , A. D., 1978. -- ~Z~~_ t u~'-'rut__ ~.