HomeMy WebLinkAbout03-0197PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of
also known as
THOMAS L. MILLER
Decease&
Social Security No. 430-96-5570
No. a~ I.~i._~" t{¥1
To: Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner, who is 18 years of age or older applies for letters of administration [d.b.n.;
pendente lite; durante absentia; durante minoritate] on the estate of the above decedent.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or
principal residence at 1654 Newville Road, Carlisle, West Pennsboro Township
(list street, number and municipality)
Decedent, then 52 years of age, died January 31, 2003, at Hershey Medical Center, Hershey,
PA.
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: [None]
$ unestimated
$
Petitioner after a proper search has ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
Tim Miller Son
Lorrie Sandridge Daughter
P.O. Box 681, Salem, AR 72576
P.O. Box 161, Mammoth Spring, AR 72554
THEREFORE, petitioner respectfully requests the grant of letters of administration in the
appropriate form to the undersigned, a Renunciation hav~ .been fil~)by Tim Miller.
/Lo r~ e- ~a-r~dri g~l~"' .... P.O. Box 161
Mammoth Springs, AR 72554
(870) 625-1335
OATH OF PERSONAL REPRESENTATIVE
STATE OF ARKANSAS
COUNTY OF FULTON
)
: SS.
)
The petitioner above-named swears or affirms that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner and that as personal representative
of the above decedent, petitioner will well and truly admini~i~r the e~state.~aqcording to !aw.
Sworn to or affirmed and subscribed /~.//[/Qf/
before me this l <~ day of ///Lord; S-ar~c~r~dgev Ov'
(R~.g]ster/Clerk
Estate of THOMAS L. MILLER, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW, ~r~,.~\~ ~- , ~2,(~ in consideration of the petition on the
reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that Lorrie Sandridge is entitled to Letters of Administration, and in accord with such
finding, Letters of Administration [d.b.n.; pendente lite; durante absentia; durante minoritate] are hereby
granted to Lome Sandridge in the estate of Thomas L. Miller.
Will Book #:'~ ~-'1
Page
FEES
Letters of Administration
Short Certificates( )
Renunciation
TOTAL
Filed..~..r..~-.5...7..,~...c~.. ,.3. ............. A.D.
~-~-o~
"RegisterofWil~is t! tJ i~~f
Carl C. Risch, Esquire (75901)
ATTORNEY (Sup. Ct. I.D. No.)
MARTSON DEARDORFF WILLIAMS & OTTO
10 East High Street
Carlisle, PA 17013
(717) 243-3341
F:hnlLES~dDATAFILEXESTATES\ 10820-I. let t ers. adminkqtration
RENUNCIATION
In Re Estate of THOMAS L. MILLER, deceased.
To the Register of Wills of Cumberland County, Pennsylvania.
The undersigned Tim Miller, son of the above decedent, hereby renounces the right to
administer the estate and respectfully asks that Letters of Administration be issued to Lorrie
Sandridge.
WITNESS my hand this ~--,.~day of ~ZT'~. ~ ff , ~___~.
~ Mil~er -?
P.O. Box 681
Salem, AR 72576
PENNSYLVANIA NATIONAL
MUTUAL CASUALTY INSURANCE COMPANY
Harrisburg, Pennsylvania
In the Matter of the Estate of: Thomas L. Miller
KNOW ALL MEN BY THESE PRESENTS, that Lorrie Sandridge
we,
as Administrator of the Estate of Thomas L. Miller
and Pennsylvania National Mutual Casualty Insurance Company, a Pennsylvania Corporation, of Harrisburg,
Pennsylvania, as Surety, are held and firmly bound unto Commonwealth of Pennsylvania
the
in the full and just sum of Fifty Thousand and No/100 ......................................................... DOLLARS,
($ 50~000. ) for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors,,
administrators, successors and assigns, jointly and severally, firmly by these presents.
Sealed with our seals, and dated this 3rd day of March, 2003.
WHEREAS,
administrator
Lorrie Sandridge
of the estate of
, has been, or is about to be, appointed
Thomas L. Miller
, by the Orphans' Court of
Cumberland County.
NOW, THEREFORE, the condition of this obligation is such, that if the
said
Lorrie Sandridge
Administrator
shall well and truly discharge the duties of said trust according to law, then this obligation
is void, otherwise to remain in full force and effect.
Form 78-168
PENNSYLVANIA NATIONAL MUTUAL
CASUALTY INSURANCE COMPANY
PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY
Harrisburg, Pennsylvania
POWER OF ATTORNEY
Know All Men By these Presents, That PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, a
corporation of the Commonwealth of Pennsylvania, does hereby make, constitute and appoint
PATRICIA K. ARBEGAST, DAVID W. HOPCRAFT AND JEFFREY L. SCOTT, ALL OF CARLISLE,
PENNSYLVANIA (EACH)
its true and lawful Attorney(s)-in-Fact to make, execute, seal and deliver for and on its behalf as surety as its act and deed:
ANY AND ALL BONDS AND UNDERTAKINGS PROVIDED THE AMOUNT OF NO ONE BOND OR UNDERTAKING
EXCEEDS THE SUM OF SEVEN HUNDRED FIFTY THOUSAND DOLLARS ($750,000.00) ........................................
ALL POWER AND AUTHORITY HEREBY CONFERRED SHALL HEREBY EXPIRE AND TERMINATE WITHOUT
AT MIDNIGHT OF THE 30TM DAY OF SEPTEMBER 2005, AS RESPECTS EXECUTION SUBSEQUENT THERETO.
And the execution of such bonds in pursuance of these presents shall be as binding upon said Company as fully and amply, to all
intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its
office in Harrisburg Pennsylvania, in their own proper persons.
This appointment is made by and under the authorization of a resolution adopted by the Board of Directors of the Company on
October 24, 1973 at Harrisburg, Pennsylvania, which resolution is shown on the reverse side hereof and is now in full force an,
In Witness Whereof: PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY has caused these
presents to be signed and its corporate seal to be affixed on SEPTEMBER 18, 2002
PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE C(
Kenneth R. Shutts, Executive Vice-President, Secretary & General el
Commonwealth of Pennsylvania, County of Dauphin - ss:
On SEPTEMBER 18, 2002, before me appeared Kenneth R. Shutts to me personally known, who being by me duly sworn, did
that he resides in the Commonwealth of Pennsylvania, that he is Executive Vice-President, Secretary & General Counsel of
PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, That he is the individual described in and wh,
executed the preceding instrument, and that the seal affixed on said instrument is the corporate seal of said Company, and that said
instrument was signed and sealed on behalf of said Company by authority and direction of said Company, and the said office
acknowledged said instrument to be the free act and deed of said Company.
Commonwealth of Pennsylvania, County of Dauphin- ss:
Notary Public
Notarial Seal
Jacqueline A. Ellis, Notary Public
City Of Harrisburg, Dauphin County
My Commission Expires Dec. 19, 2005
Member, Pennsylvania Association of Notaries
I, Michael F. Greet, Vice President, Surety & Fidelity of the PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSI
COMPANY, a corporation of the Commonwealth of Pennsylvania, do hereby certify that the above and foregoing is a true and
copy of a Power of Attorney, executed by the said Company, which is still in full force and effect.
/
In Witness Whereof, I have hereunto set my hand and affixed the corporate se~jff'~said/Com, pany2on--~Igc,~i'~c.h , 3, 2003
~~Vi'~J~/ ~/~"~ s _Zd, S~u~e v~~~ ~t ~~r~a
,MPOFITANT NOTICE: This border most be FLIED in color, l* it is not Fl/. __d~cesn~t~f/ri~S~ copy. T Code 717-255-6870. ~,~
78-190 (Rev 05/02)
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jo saog, aoa.~G jo pa~o[t oq~ _gq po~dopu
NIOI&FI'IOS~lt
WELTMAN, WEINBERG & REIS CO., L.P.A.
ATTORNEYS AT LAW
175 South Third Street, Suite 900
Columbus, Ohio 43215-5177
614.801.2710
800.325.9965
614.801.2604 (fax)
www.weltman.com
MOUNT HOLLY, NJ
609.914.0437
PHILADELPHIA, PA
215.599.1500
PITTSBURGH, PA
412.434.7955
CINCINNATI, OH
513.723.2200
CLEVELAND, OH
216.685.1000
DETROIT, MI
248.362.6100
Register Of Wills
One Courthouse Square
Carlisle, PA 17013
October 6, 2003
RE: Estate of Thomas Miller
CLAIM OF: Household Credit Services
OUR FILE NO.: 03201608
Dear Sir or Madam:
This law firm represents Household Credit Services in connection with its claim which we wish to file on our client's
behalf into the estate of Thomas Miller, deceased. Enclosed is our check in the amount of $5.00 which we
understand is the filing fee for this claim.
Our client's claim is based upon its account number 5407912600042927 in the amount of $568.98. Included with
this letter is the claim form which we wish to present to this court and which we are forwarding to the attorney and/or
fiduciary of this estate.
It would be appreciated if all correspondence and disbursements with respect to this matter be forwarded to our
office and to the attention of the undersigned. Additionally, it would be appreciated if any notices of any hearings
also be forwarded to the undersigned. Thank you for your cooperation in this matter.
This law firm is a debt collector attempting to collect this debt for our client and any information obtained will be
used for that purpose.
~!ly~ ..
Attor~ :y at Law
AJR:tde
CC: Lorrie Sandridge, Personal Representative and Carl C Risch, Esquire
Enclosure
FORM 93-O.C. DIVISION
IN THE COURT OF CO/V~ON PLEAS
OF
Cumber[and COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: ESTATE
OF
Thomas Miller
(Deceased)
CLAIM
To the Clerk of Orphans' Court Division:
No: 2103197
Index and make proper entry in your officiat record of ctaim of Household Credit
Services(Ctaimant) Acct. No.: 5407912600042927
in the amount of S568.98 against the estate of the above named decedent. This
ctaim is fi[ed under section 732 (b) (2) of the Fiduciaries Act of 1949 as amended.
The said decedent, who resided at 1654 Newvitte Rd, Carliste, PA 17013, died
on January 21, 2003.
Written notice of this ctaim was given to Lorrie San,~ge, Persona[ Representative
and Car[ C Risch, Esquire on October 6th_, 2003
AJien J. Reis,/Attorn~y at Law
175 South THird Street,
Columbus, OH 43215
1-800-325-9965 wwr # 03201608
REV -~5ao SX + (6-Ob~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17126-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
C)FFiC!AL USE ONLY
FILE NUMBER
21 03 00197
COUNTY CODE YEAR NUMBER
LU
z
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
MILLER, THOMAS L.
SOCIAL SECURITY NUMBER
430-96-5570
DATE Of DEATH (MM-DD-YEAR) DATE Of BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
01/31/2003 03/22/1950 REGISTER OF WILLS
F APPLICABLE) SURViViNG SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Retum (date of death prior to 12-13-82)
[] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after [] 5. Federal Estate Tax Return Required
12-12-82)
[] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 0 8. Total Number of Safe Deposit Boxes
of WilO copy of Trust)
[] 9. Litigation Proceeds Received [] 10. Spousal Povedy Credit (date of death between [] 1 l~Election to tax under Sec. 9113(A) (Attach Sch O)
12-3t-91 and 1-1-95)
COMPLETE MAILING ADDRESS
qAME
Carl C. Risch, Esquire
(8)
:IRM NAME (If applicable)
Martson DeardorffWilliams & Otto
'ELEPHONE NUMBER
717/243-3341
Ten East High Street
Carlisle, PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
None
None
-0-
None
16,578.97
None
None
12,460.73
41,765.27
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
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)
(11)
OFFiCIAl_ LJSE ONLY
(12)
(13)
(14)
16,578.97
54,226.00
insolvent
x .00 (15)
16. Amount of Line 14 taxable at lineal rate x ,045 (16)
17.Amount of Line 14 taxable at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
20. []
I~JS' 0~ ~EVERSE SIDE Ai~ID.R~C ~CK:I~AT" <¢
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
ISTREET ADDRESS
CITY
1654 Newville Road
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
STATE PA
zip 17013
(1)
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 I + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 1 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. (5) 0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0,0 0
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 right to designate who shall use the property transferred or its income; .................................... [=.J ~
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? ....................................................................................................................... [] []
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 propertywhich
contains a beneficiary designation? ...................................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSOfl~RESPONSIBLE FOR FILING RETURN ADDRESS DATE
~"rrie Sa~dridg4 ,~ /~, · /
~IG~UfiED~ P/RSCWRESP~SIBLE ~ff~ RETURN ADDRESS DATE
P.O. Box 161
Mamoth Spring, AR 72554
SIGNATURE OF EREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE
Carl C ?iI~ Ten East High Street
Carlisle, PA 17013
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116 (a) (1.2)]-
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116
1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Decedent's Complete Address:
STREET ADDRESS 1654 Newville Road
CITY Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
zip 17013
STATE PA
(1)
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. (4)
Check box on Page 1 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. (5) 0.00
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 0.0 0
Make Check Payable to: REGISTER OF WILLS, AGENT
IIIIIIIIIII III I II
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 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? ....................................................................................................................... [] []
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
contains a beneficiary designation? ...................................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
Lorrie Sandridge P.O. BOX 161
Mam0th Spring, AR 72554
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS
Carl C. Risch
Ten East High Street
Carlisle, p.a/ 17013
DA7 /
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116
1.2) [72 P.S. {}9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {}9116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP or
SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER
MILLER, THOMAS L. 21 - 03 - 00197
Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the
decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM DESCRIPTION VALUE A-F DATE OF
NUMBER DEATH
i T.L. Miller Tracking, Inc., no value (see attached financial statement) 0.00
TOTAL (Also enter on Line 3, Recapitulation) 0.00
F:\FILESkDATAFILEkESTATES\ 10820-1. INTX.C
Created: 9/24/03 5:25PM
Revised: 10/10/03 9:IOAM
T.L. MILLER TRUCKING, INC.
FINANCIAL STATEMENT
ASSETS:
01/31/03
04/11/03
07/07/O3
Allfirst Bank, checking account # 09902-1927-0, balance
Proceeds of sale of 1996 Peterbilt truck tractor
State of New York, Highway Use Tax refund
Total Assets
EXPENSES PAID:
O2/03/03
02/11/03
03/10/03
04/09/03
04/16/03
05/01/03
05/01/03
05/01/03
05/01/03
05/01/03
05/01/03
05/01/03
05/02/03
05/27/03
06/10/03
06/19/03
07/09/03
08/19/03
09/02/03
09/02/03
09/02/03
09/02/03
09/02/03
09/02/03
Reserved
ATM withdrawal posted
Allfirst Bank, service fee
Allfirst Bank, service fee
Allfirst Bank, service fee
Clarke American, checks
Owner Operator Services, Inc., 4th quarter fuel tax services
Federal Express, payment on account
Sprint, payment on account
Smith Elliot Kearns & co., accounting fees
Cohick & Associates, tax preparation, quarterly returns
US Treasury, Form 941,1st quarter 2001 tax
US Treasury, Form 941 2nd quarter 2001 tax, interest and penalty
Martson Deardorff Williams & Otto, attorneys fees
State of Arkansas, Ad Volorem Tax
Owner Operator Services, Inc., payment on account of insurance
US Treasury, Form 941 1st quarter 2001, interest and penalty
PA Unemployment Compensation Fund, tax
Cohick & Associates, 2002 tax preparation
PA Dept. of Revenue, IYTA fuel tax payment 12/31/02
PA Dept. of Revenue, IFTA fuel tax payment 09/30/02
NY Comm. of Taxation and Finance, Hghwy Use Tax 10/01/02-12/31/02
NM Taxation and Revenue, tax 07/01/02-09/30/02
NM Taxation and Revenue, tax 10/01/02-12/31/02
US Treasury, Unemployment Compensation tax for 2002
Filing fees and attorney fees for dissolution of corporation
Total Expenses Paid:
ASSETS:
EXPENSES:
278.51
15,000.00
2.00
15,280.51
270.00
19.00
12.03
13.08
8.50
120.00
166.22
35.93
1,850.00
150.00
758.50
4,627.84
3,250.00
48.77
1,777.37
68.83
24.06
800.00
250.37
338.57
22.92
133.47
88.83
70.02
376.20
15,280.51
15,280.51
-15,280.51
BALANCE ON HAND: 0.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
ESTATE OF FILE NUMBER
MILLER, THOMAS 21 - 03 - 00197
Name of Corporation T.L. Miller Trucking, Inc.
Address P.O. Box 202
City New Kingston State PA
2. Federal Employer I.D. Number 25-1825529
3. Type of Business Service
State of Incorporation PA
Date of Incorporation 1/1/1999
Zip Code 17072 Total Number of Shareholders 1
Business Reporting Year Calendar
Product/Service Over the road trucking
TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE
STOCK Voting/Non-Voting SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK
Common Voting 1,000 00.00 1,000 $0.00
Preferred
Provide all rights and restrictions pertaining to each class of stock
5. Was the decedent employed by the Corporation? [] Yes [] No
If yes, Position President/Secretary/Treasurer Annual Salary $28,800.00 Time Devoted to Business Full-Time
6. Was the Corporation indebted to the decedent? [] Yes [] No
If yes, provide amount of indebtedness
7. Was there life insurance payable to the corporation upon the death of the decedent? [] Yes [] No
If yes, Cash Surrender Value Net proceeds payable
Owner of the policy
8. Did the decedent sell or transfer stock of this company within one year prior to death or within two years if the date of death was prior to 12-31-827
[] Yes [] No If yes, [] Transfer [] Sale Number of Shares
Transferee or Purchaser Consideration Date
Attach a separate sheet for additional transfers and/or sales.
9. Was there a written shareholder's agreement in effect at the time of the decedent's death? [] Yes [] No
If yes, provide a copy of the agreement.
10. Was the decedent's stock sold? [] Yes [] No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedent's death? [] Yes [] No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships? [] Yes [] No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been
secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
SCHEDULE C-1
RE: Information to be submitted with schedule:
Ao
B.
C.
D.
E.
F.
See attached Financial Statement; stock has no value.
Attached as available
No real estate was owned by corporation.
Decedent was only stockholder.
Decedent was only officer and salary is shown on Schedule C-1
No dividends were paid.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MILLER, THOMAS L.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 - 03-00197
Include the,~roceeds of litigation and the date the proceeds were received by the estate. Ail property jointly-owned with the right of
survivorshtp must be disclosed on schedule F.
ITEM
NUMBER
1
2
3
4
5
6
7
8
9
10
11
DESCRIPTION
Allfirst Bank, checking account # 09503-2302-2
Bank of the Ozarks, checking account #8540829, payable on death to Tim Miller, son
1997 Model 2804 Sportsman Camper Trailer, actual sale price
1981 Harley-Davidson motorcycle, actual sale price
1991 Utility Trailer, actual sale price
1980 Peterbuilt tractor, model 135, wrecked, no value
State Farm Insurance, refund, motorcycle insurance
State Farm Insurance, refund, camper insurance
PA Department of Revenue, refund, 2001 individual income taxes
Magistrate Court, Torrance County, NM, bond refund
West Shore Tax Bureau, tax refund
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
45.12
85.75
6,5OO.O0
4,500.00
5,000.00
0.00
7.15
70.23
304.28
54.00
12.44
16,578.97
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MILLER, THOMAS L.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21 - 0:3 - 00197
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
1
2
3
Bo
DESCRIPTION
FUNERAL EXPENSES:
Hoffman-Roth Funeral Home, Carlisle, PA
Lorrie Sandridge, reimbursement for Cox-Blevins Funeral Home, AR, services
Lorrie Sandridge, funeral expenses
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
Attorney's Fees Maztson Dcardorff Williams & Otto (estimated)
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees Cumberland County Register of Wills
Zip
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Hopcraft, Hockley & O'Donnell Insurance, Bond
The Sentinel, advertising letters testamentary
AMOUNT
4,326.50
2,625.00
437.00
4,000.00
82.00
260.00
91.85
Total of Continuation Schedule(s) 638.38
TOTAL (Also enter on line 9, Recapitulation) 12,460.73
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedule H
Funeral Expenses &
.N~'~in~ Costs corfinued
ESTATE OF FILE NUMBER
MILLER, THOMAS L. 21 - 03 - 00197
4
5
6
7
8
Cumberland Law Journal, advertising letters testamentary
Register of Wills, short certificates
UPS, overnight mailing
Sollenberger's Messenger Service, duplicate title for trailer
Register of Wills, filing fee, inheritance tax return
Reserved for additional fees for filing Account and dissolution of corporation
75.00
12.00
5.98
35.40
10.00
500.00
Page 2 of Schedule H
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
MILLER, THOMAS L. 21 - 03 - 00197
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1
2
3
4
5
6
7
8
9
10
11
Fulton Bank, secured loan #255-1084535, balance due on date of death
Joyce Coggins, balance due on promissory note dated 10/17/1977
Mazel Miller, outstanding alimony due pursuant to separation agreement
US Treasury, personal income tax, interest and penalty, 12/31/1997-12/31/1999
PA Department of Revenue, 1999 personal income tax due
Cross County Bank credit card account #4227-0973-4255-8553, account payable
Household Credit Services, account #5407-9126-0004-2927
Carlisle Digestive Disease Associates, LTD, account payable
Hershey Medical Center, account payable
Verizon Wireless, account payable
Satellite Radio, account payable
4,770.42
5,885.30
7,500.00
18,788.93
1,598.00
1,301.00
568.98
7.00
6.00
1,279.70
59.94
TOTAL (Also enter on Line 10, Recapitulation) 41,765.27
REV-1513 EX+ (9.00) ~
SCHEDULE J
COU~ONWEA~TH O~ PENNS¥~VAN,A BEN EFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MILLER, THOMAS L. 21 - 03 - 00197
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE
Do Not List Trusten(~)
[. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 No taxable bequests as all assets will be used to discharge debts 0.00
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
F:~FILES~DATAFILE\ES TATES\ 10820-1 .account formal
INRE:
ESTATE OF THOMAS L. MILLER,
DECEASED
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
:
: ORPHANS' COURT DIVISION
: NO. 2003-0197
FIRST AND FINAL ACCOUNT OF LORRIE SANDRIDGE,
ADMINISTRATRIX OF THE ESTATE OF THOMAS L.MILLER,
LATE OF WEST PENNSBORO TOWNSHIP,
CUMBERLAND COUNTY, PENNSYLVANIA
Date of Death:
Letters of Administration Granted:
Letters of Administration Advertised:
Sentinel -
Cumberland Law Journal -
Account Stated to
January 31, 2003
March 5, 2003
May 14, 21 & 28, 2003
May 23, 30 & June 6, 2003
January 20, 2004
SUMMARY
PRINCIPAL
Receipts
Less Disbursements
Principal Balance Remaining
INCOME
Receipts
Less Disbursements
Income Balance Remaining
COMBINED BALANCE REMAINING
$ 16,493.22
$ -16,493.22
$ 0.00
$ o.oo
$ 0.00
$ 0.00
$ 0.00
PRINCIPAL RECEIPTS
Proceeds from dissolution of insolvent business, T. L. Miller Trucking, Inc.,
of which Estate is sole shareholder
Allfirst Bank, checking account # 09503-2302-2, closing balance
1997 Model 2804 Sportsman Camper Trailer, actual sale price
$ 0.00
$ 45.12
$ 6,500.0O
-1-
1981 Harley-Davidson motorcycle, actual sale price
1991 Utility Trailer, actual sale price
1980 Peterbuilt tractor, model 135, wrecked, no value
State Farm Insurance, refund, motorcycle insurance
State Farm Insurance, refund, camper insurance
PA Department of Revenue, refund, 2001 individual income taxes
Magistrate Court, Torrance County, NM, bond refund
West Shore Tax Bureau, tax refund
TOTAL PRINCIPAL RECEIPTS:
$
$
$
$
$
$
$
$
4,500.00
5,000.00
0.00
7.15
70.23
304.28
54.00
12.44
16,493.22
PRINCIPAL DISBURSEMENTS
Hoffman-Roth Funeral Home, Carlisle, PA
Lorrie Sandridge, reimbursement for Cox-Blevins Funeral Home,
Arizona burial services
Lon'ie Sandridge, funeral expenses
Hopcraft Hockley & O'Donnell Insurance, Administratrix's bond
Fulton Bank, balance due on secured loan # 255-1084535
Hershey Medical Center
Carlisle Digestive Disease Associates, LTD
Reserved for future disbursement: Martson Deardorff Williams & Otto,
disbursements advanced
Register of Wills, probate fee 77.00
Register of Wills, additional probate fee 5.00
Sollenberger's Messenger Service, duplicate trailer title 35.40
UPS, delivery of loan payoff 5.98
Cumberland Law Journal, advt. Letters of Administration 75.00
The Sentinel, advt. Letters of Administration 91.85
Register of Wills, short certificates 12.00
Register of Wills, filing fee, Inheritance Tax 10.00
Register of Wills, estimated filing fee, First and Final Account 104.00
4,326.50
2,625.00
437.00
260.00
4,829.05
6.00
7.00
416.23
-2-
Reserved for future disbursement: Martson Deardorff Williams & Otto,
attorneys fees
Estimated attorneys fees based on hourly rates: 5,200.00
Discount due to insufficient funds in estate: 1,613.56
TOTAL PRINCIPAL DISBURSEMENTS:
3,586.44
16,493.22
None
INCOME RECEIPTS
0.00
None
INCOME DISBURSEMENTS
0.00
UNPAID CREDITORS
U.S. Treasury, personal income tax, interest and penalty,
tax period ending 12/31/1999, balance as of 12/20/03' $
U.S. Treasury, personal income tax, interest and penalty, tax period ending
12/31/2002, balance as of 12/20/03' $
PA Department of Revenue, interest and penalty through 5/17/02 on 1999
personal income tax* $
PA Department of Revenue, 2002 personal income tax, penalty and
interest through 10/31/03' $
Cross County Bank, credit card account # 4227-0973-4255-8553* $
Household Credit Services, account # 5407-9126-0004-2927* $
Verizon Wireless, account #603432913-00001 * $
Satellite Radio, account #1-33982993' $
Joyce Coggins, balance due on promissory note dated 10/17/1977 $
Mazel Miller, outstanding alimony due pursuant to separation agreement $
TOTAL UNPAID CREDITORS: $
* Copies of claims are attached hereto as Exhibits
19,286.07
2,155.17
67.71
754.85
1,301.00
568.98
1,279.70
59.94
5,885.30
7,500.00
38,858.72
-3-
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND )
Lorrie Sandridge, Administratrix of the Estate of Thomas L. Miller, being duly sworn
according to law, deposes and says that she has fully and faithfully discharged the duties of her
office; that the foregoing First and Final Account is true and correct to the best of her knowledge and
belief based on the information available to her, and that the Grant of Letters of Administration and
the first complete advertisement thereof occurred more than four (4) months before the filing of the
Account.
l~orr{e Sandfidge, Admi~]strat~ik-' J*
Sworn and subscribed to before me this
~3 day of ._~~ , c9~t9c/.
Notary Public
STATEMENT OF PROPOSED DISTRIBUTION
No payments will be made to unpaid creditors nor will any distribution be made in this estate
due to insufficient funds and the estate being insolvent.
~or~i-~' S~d~]ge, Admi~istratrix ]'
Department of the Treasury
Internal Revenue Service
P.O. BOX 57
BENSALEM, PA. 19020 '
THOMAS MILLER
LORRIE SANDRID6E ADM
10 E HICH ST
CARLISLE PA 17015-5015108
Date:
DEC. 20,
Taxpayer Identifyi~tg Nilmber:
650-96-5570 Z O0
Caller ID:
Contact Telephone Number:
TOLL FREE: 1-800-829-5903
BEST TIME TO CALL:
8:00 AM TO 6:50 PM
MONDAY THRU FRIDAY
27800~,
SBW
Reminder Notice
We are required by law to remind you periodically in writing about your overdue tax. The amount
you owe is shown on the backofthis letter.
You do not need to coutact us about this letter if you are working with us to resolve your account.
l'{owevCr, please call tl~e teleph¢)ne number listed above if you:
· have unanswere'd questions about the overdue taxes.
· wrote or called us more than 30 days ago and have not received a reply.
If you have NOT been working with us to resolve your account, please read the rest of this letter
carefi~lly. Then, based upon your situation, take the action listed m either Step I or Step 2.
S ~ c I.Li~
Send us the thll payment if you agree with the anlount you owe shown Oll the back of this letter and
have no questions. Make your check or money order payable to United States Treasmy. Write your
social secmity number or employer identification number and the tax year on your l)ayment. Send
your payment m the enclosed envelope with a copy of this letter.
Call the telephone l]Ul]]ber listed above if you:
· believe the overdue tax is incorrect or have other questions.
· are unable to pay your overdue taxes m flfil. Be ready to tell us what your monthly income anti
expenses are so we can help you arrange a payment plan.
This office is authorized to take enforcement action to collect the amount you owe. This can include
taking your property, or rights to property, such as wages bank accounts, real estate or automobiles.
We may also file a Notice of Federal Tax Lmn without giving you advance notice. A lien is public
notice to your creditors that the government has a right to your interests m your current assets and
assets you acquire alter we file a lien. This can afl, ct your ability to obtain credit. To avoid possible
enfi)rcement actions, we must hear flora you within 1 0 clays fi'om the date of this notice.
[~llCIOSllreS '
Copy of this letter
Envelope
II IIII IIIIIIIIII III11 IIIII
*430965570103'
Larry Leder
Operations Manager, Automated Collection System
Exhibit Letter 3228 (Rev. 01-2002)(LT-39)
Account Summary THO.AS mLLE.
Type I Period~' ,! I Late Payment
of Tax Ending Assessed Balance Accrued Interest Penalty Total
1040 12-51-1999 $ 12,644.48 ~; :5,579.70 ~ 5,061.89 ~ 19,286.07
10~0 12-~1-2002 $ 2,087.51 ~ 19.76 ~ ~8.10 ~ 2,155.17
Total Amount ~e 21
Type ol Tax Period Ending Name of Return
Exhibit
Department of the Treasury -- Internal Revenue Service
1008
Form 668 (Y)(c)
(Rev. October 2000)
Area: I Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
lien Unit Phone: (800) 829-3903 151268504
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penakJes)
have been assessed against the following-named ~axpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien Jn favor of the United States on all property and rights to
property belonging to this ~axpayer for the amount of these taxes, and
additional penalties, interest, and cosLs that may accrue.
Name of Taxpayer THOMAS L MILLER DECD
Residence 10 E HIGH ST
CARLISLE, PA 17013-3015
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Kind of Tax
(a)
For Optional Use by Recording Office
· This Notice of Federal Tax Lien has
been filed as a matter of public record.
IRS will continue to charge penalty and
interest until you satisfy the amount
you owe,
Contact the Area Office Collection
Function for information on the amount
you must pay before we can release
this lien.
See the back of this page for an expla-
nation of your Administrative Appeal
rights.
1040
Place of Filing
Tax Period
Ending
(b)
12/31/2002
Identifying Number
(c)
430-96-5570
Prothonotary
Cumberland County
Carlisle, PA 17013
Date of
Assessment
(d)
10/13/2003
Last Day for
Refiling
(e)
11/12/2013
Total
Unpaid Balance
of Assessment
(f)
2087.31
$ 2087.31
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 13th dayof January, 2004
Signature~7? I
, Title
..... " ' ~ ~ .... ~ ?. ~,~ ACS 23-00-0008
for L LEDE ~_.2},..,,~,.>~ ~''~ ~;'~/~/~, ~ :, ,.,'~ (800) 829-3903
(.OT~: Ce.i~i~ate o~ o.~er .othor~d b~ ,.~ to t~e .~[~e~t ~ ~ot es~ti., to t~ ~iait~ o~ Noti~ or F.0~, T.x ,ie~
Rev. RuL 71-466, 1971 - 2 C.B. 409)
Pa~ 3 -Taxpayer's Copy Form 668(Y)(c) (Rev. 10-00)
CAT. NO 60025X
BUREAU OF INDIVIDUAL TAXES
DEPT. 280q32
HARRISBURG, PA 17128-0q32
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
ASSESSMENT
REV-S6qC EX AFP {S-SD
THOMAS L MILLER
BOX 202
NEW KINGSTOWN
PA 17072
lB.
1C.
2.
3.
q..
.SA.
6.
7.
B.
9.
10.
11.
13.
lq.
16&17
18.
19.
20B.
22.
DATE OF NOTICE: MAY 17 2002
SOCIAL SEC. NUM: 430-96-5570
TAX YEAR: 1999
ASSESSMENT: 096021
BALANCE(S) DUE FOR YOUR ACCOUNT AS OF MAY 27 2002
~ BALANCE INCLUDES ESTIMATED TAX UNDERPAYMEIV~T-PENALT¥?
ONE" PAID ~BALA"~
L PEN/ADD .00 .00 ' "~
U/EST PEN 67.71 .OO 67.71
LEGAL .00 .00 .00
TNTEREST .00 .00 .00
TAX/RFD 1.S98.00 1.S98.00 .00
PLUS OTHER TAX YEAR(S) LIABTLTTZES ~~L~
TOTAL DUE NON
PLEASE PAY THIS AMOUNT USING THE DETACHABLE LOW
YOUR 1999 TAX RETURN WAS PROCESSED AS FOLLOWS. SEE
ORO~S COMPENSATION ..........................
SCHEDULE UE EXPENSES ........................
COMPENSATION ................................
TNTEREST (SCHEDULE A) .......................
DIVIDENDS (SCHEDULE B) ......................
NET TNCOME OR LOSS ..........................
TAXABLE SALE - GAIN OR LOSS .................
CAPITAL GAIN EXCLUSION ......................
RENTS, ROYALTIES, PATENTS, COPYRIGHTS .......
ESTATES AND TRUSTS (SCHEDULE J) .............
GAMBLING. AND LOTTERY NINNINGS ...............
GROSS TAXABLE ZNCOHE (ADD LINES
CONTRIBUTIONS TO HEDZCAL SAVINGS ............
NET PA TAXABLE INCOME(LINE 9 MINUS LINE 10).
TAX LZABTLZTY (MULTIPLY LINE 11 BY .02800)..
TAX NTTHHELD (FROM N2'S) ....................
CREDIT FROM PREVIOUS TAX YEAR ...............
ESTIMATED TAX g EXTENSION PAYMENTS ..........
TAX NZTHHELD AS REPORTED ON NRK-! ...........
TOTAL CREDITS (ADD LINES 1.S-18) .............
NUMBER OF DEPENDENTS ........................
TAX FORGIVENESS CREDIT ......................
OUT STATE CREDIT (SCHEDULE G) ...............
2q-27.CREDZTS (LINES 2q-27) .......................
28. TOTAL CREDITS (ADD LINES lq,19,ZOC-Z.S) .....
29. TAX DUE (LINE 13 MINUS 26) ..................
OVERPAYMENT (LINE 26 MINUS 13) ..............
REFUNDED.
33-$7.TOTAL DONATIONS (LINES 33-$7) ............
CALCULATIONS BELOW.
YOUR FIGURES
2~,000.00
.00
2q,O00.O0
72.00
.00
q6,.S36.00
10,q70.00
O0
O0
O0
O0
81,078 O0
O0
81,078 O0
2,270.00
672.00
.00
.00
.00
.00
0
.00
.00
.00
672.00
1,.S98.00
.00
.00
.00
.00
OUR FIGURES
Z~,O00.O0
.00
2q,O00.O0
72.00
.00
q6,.S36.00
10,470.00
.00
.00
.00
.00
81,078.00
.00
81,078.00
2,270.00
672.00
.00
.00
.00
.00
0
.00
.00
.00
672.00
1,598.00
.00
.00
.00
.00
SEE REVERSE SIDE FOR MORE INFORMATION
DETACH AT PERFORATION
[-
PIT
BUREAU OF /NDZVIDUAL TAXES
PERSONAL INCOME TAX
REV-$6qC
TAXPAYER NAME:
NOTICE DATE~ ......
SOCIAL SEC. NUM:
TAX YEAR:
THOMAS L MILLER
MAY 17 2002
q30-96-5570
1999
PAYMENT AMOUNT:
100
HAKE CHECK OR HONEY ORDER PAYABLE TO: "PA DEPT. OF REVENUE".
DO NOT NRTTE TN THIS SPACE
30018343096557000049199912310000000000067718
Exhibit
BUREAU OF INDIVIDUAL TAXES
DEPT. 280q$1
HARRISBURG, PA 17128-0q31
COMMONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
BILLING NOTICE
REV-36qC EX AFP [$-01)
THOMAS L MILLER
10 E HIGH ST
CARLISLE
PA 17015
DATE OF NOTICE: OCT 51 2003
SOCIAL SEC. NUN: 430-96-5570
TAX YEAR: 2002
ASSESSMENT:
BALANCE(S) DUE FOR YOUR ACCOUNT AS OF NOV 10 2003
~ BALANCE INCLUDES ESTIMATED TAX UNDERPAYMEN. T~
OWED PAID ~_~;~
U PEN/ADD 35.95 . O0
EST PNLTY 22.q6 . O0 22 .q6
LEGAL .00 .00 .00
INTEREST 19. qq . O0 19 .qq
TAX/RFD 679. O0 . O0 679. O0
PLUS OTHER TAX YEAR(S) LIABILITIES ~~-~
TOTAL DUE NOW
PLEASE PAY THIS AMOUNT USING THE OETACHABLE~C~BI:IPOI~-14ELOW
YOUR 2002 TAX RETURN WAS PROCESSED AS FOLLONS.
YOUR FIGURES
GROSS COMPENSATION .......................... ~,~Oq. O0
SCHEDULE UE EXPENSES ........................ 1,2q~.00
COMPENSATION ................................ 3,160.00
INTEREST (SCHEDULE A) ....................... 93.00
DIVIDENDS (SCHEDULE B) ....................... O0
NET INCOME OR LOSS .......................... 25,$93.00
TAXABLE SALE - GAIN OR LOSS .................. O0
CAPITAL GAIN EXCLUSION ....................... O0
RENTS, ROYALTIES, PATENTS, COPYRIGHTS ........ O0
ESTATES AND TRUSTS (SCHEDULE d) .............. O0
GAMBLING AND LOTTERY WINNINGS ................ O0
GROSS TAXABLE INCOME (ADD LINES 1C,2-5,6-8). 28,6q6.00
CONTRIBUTIONS TO MEDICAL SAVINGS ............. O0
NET PA TAXABLE INCOME(LINE 9 MINUS LINE 10). 28,6q6.00
TAX LIABILITY (MULTIPLY LINE 11 BY .02800).. 802.00
TAX #ITHHELD (FROM W2'S) .................... 123.00
CREDIT FROM PREVIOUS TAX YEAR ................ O0
ESTIMATED TAX & EXTENSION PAYMENTS ........... O0
TAX WITHHELD AS REPORTED ON NRK-1 ............ O0
TOTAL CREDITS (ADD LINES lq-17) .............. O0
NUMBER OF DEPENDENTS ........................ 0
TAX FORGIVENESS CREDIT ....................... O0
RESIDENT CREDIT (SCHEDULE G) ................. O0
CREDITS (SCHEDULE OC) ........................ O0
TOTAL CREDITS (ADD LINES 13,18,21-23) ...... 123.00
TAX DUE (LINE 12 MINUS 2q) .................. 679.00
PENALTIES AND INTEREST ...................... 51.00
OVERPAYMENT (LINE 2q MINUS 12) ............... O0
REFUNDED ..................................... O0
CREDITED TO NEXT YEARS ESTIMATED TAX ......... O0
TOTAL DONATIONS (LINES 51-35) ............. O0
lA.
lB.
1C.
2.
3.
5.
SA.
6.
7.
8.
9.
10.
11.
12.
13.
lq.
15&16
17.
18.
19B.
21.
22.
23.
2~.
25.
28.
29.
30.
31-35.
OUR FIGURES
q,qO~.O0
1,2q~.00
3~160.00
93.00
.00
25,393.00
.00
.00
.00
.00
.00
28,6~6.00
.00
28,6q6.00
802.00
123.00
.00
.00
.00
.00
0
o00
.00
.00
123.00
679.00
.00
.00
.00
SEE REVERSE SIDE FOR MORE INFORMATION
DETACH AT PERFORATION
PIT
BUREAU OF INDIVIDUAL TAXES
PERSONAL INCOME TAX
REV-36~C
TAXPAYER NAME:
NOTICE DATE: .....
SOCIAL SEC. NUM:
TAX YEAR:
100
THOMAS L MILLER
OCT 31 2003
q30-96-5570
2002
PAYMENT AMOUNT:
MAKE CHECK OR MONEY ORDER PAYABLE TO: "PA DEPT. OF REVENUE".
DO NOT WRITE IN THIS SPACE
30018343096557000049200212310000000000754852
Exhibit
IN THE MATTER OF
ESTATE OF:
THOMAS L MILLER
STATE OF PENNSYLVANIA
IN THE ORPHAN'S COURT
OF CUMBERLAND COUNTY
ESTATE#: 21-03-0197
DATE OF DEATH: 01/31/03
STATEMENT OF CLAIM
1. The creditor, Cross Country Bank, certifies that there is due and owing by THOMAS L MILLER, deceased, the sum
of ONE THOUSAND THREE HUNDRED ONE DOLLARS AND NO CENTS ($1,301.00).
2. The nature of the claim is a VISA CARD account 4227097342558553, which was established in 12/02/99.
3. The name and address of the claimant is: Cross Country Bank, 50 Applied Card Way, Glen Mills, PA 19342.
4. The name and address of the claimant's agent is: Jennifer L. Strehlein, Estate Recoveries, Inc., P. O. Box 24566,
Baltimore, Maryland 21214.
5. This claim is not contingent and is not secured by any liens or judgments.
6. This claim is not based on any one instrument. Said balance has accrued since the account was established.
On behalf of Cross Country Bank, creditor, I do solemnly declare and affirm under the penalties of perjury that the
information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made
diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to
the affiant have been allowed.
P.O. Box 24566
Baltimore, Maryland 21214
(410) 444-8022
Baltimore City, Maryland:
IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal this August 04, 2003.
My Commission Expires: October 11, 2006.
FORM 93-O.C. DIVISION
IN RE: ESTATE
OF
Thomas Miller
(Deceased)
IN THE COURT OF COMMON PLEAS
OF
Cumberland COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
To the Clerk of Orphans' Court Division:
CLAIM
No: 2103197
Index and make proper entry in your official record of claim of Household Credit
Services(Claimant) Acct. No.' 5407912600042927
in the amount of $568.98 against the estate of the above named decedent. This
claim is filed under section 732 (b) (2) of the Fiduciaries Act of 1949 as amended.
The said decedent, who resided at 1654 Newville Rd, Carlisle, PA 17013, died
on January 21, 2003.
Written notice of this claim was given to Lorrie SanCr.~ge, Personal Representative
and Carl C Risch, Esquire on October 6th, 2003
Rel-'~,/~(ttorngy at Law
Allen
J.
175 South Third Street,
Columbus, OH 43215
1-800-325-9965 wwr # 03201608
Exhibit
700 CRANBERRY WOODS DR. ,
CRANBERRY TWP., PA 16066 '
Page: 1 of 8
Account Number ..................... 603432913-00001
Invoice Number .......................0421398610
Billing Date .............................. March 15, 2003
100022302 AV 0.503AUTO T6 8 3915A 17013-7400 I 345 0318CNPA
h,,lll.olll,,..ll,,ll,I.,l,l,,lll,,,ll,.,I,l,,I.,ll.l,I
THOMAS L MILLER
1654 NEWVILLE RD
CARLISLE PA 17013-7400
Previous Balance 873.32
Balance Forward 1,279.09
Current Charges* .61
'*includes Lale Fee... 12.19
Total Amount $1,279.70 I
· Includes prorate (parlial month). Explanation on page 2.
** Late Fee amount is included in total Current Charges amount.
Simplify your account management. Dial #BAL + SEND to obtain
your account balance or to make a payment. Dial #MIN + SEND
to hear the estimated number of minutes used. Both calls are
airlime free.
Just a reminder*** Our records indicate your account is
now past due. If payment has been mailed, please
disregard this notice.
View and pay your bill online. Visit us on our web site at verizonwireless.com
Call Customer Service toll free at 1-800-922-0204 (or '611 from your wireless phone).
Please see reverse side for a description of our charges and the correspondence address.
CUSTOMER ACCOUNT NO:
INVOICE NO:
BILLING DATE:
Please detach here and return this portion with your payment
0421398610
March 15, 2003
THOMAS L MILLER
1654 NEWVILLE RD
CARLISLE PA 17013-7400
BALANCE FORWARD 1,279.09
CURRENT CHARGES .61
PAYMENT DUE IMMEDIATELY ! $1,279.70
MAKE CHECK PAYABLE TO
VERIZON WIRELESS
PO BOX 17464
BALTIMORE, MD 21297-1464
h,l,l,,,ll,,I,II,h,l,,,I,,,ll,l,,I,II,,,I,,I,h,II
Account or user address change? If yes, please check box and see reverse side.
D42139861001060343291~'~10000000610001279705
SATELLITE
RADIO
April 07, 2003
64~591 A 1 0001 Ol 01204010-01 00292 A
TOM MILLER
PO BOX 202
NEW KINGSTOWN,
PA 17O72-O2O2
Re: Account # 1-33982993
Dear Tom Miller:
We value you as our customer and pride ourselves on providing you with 100 channels of Amazing
Radio.
To ensure uninterrupted programming, XM needs to receive payment in the amount of $59.94 for
your past due balance.: Please 'send your payment along with the remittance slip below in the
envelope enclosed For your convenience, one time credit card payments can also be made through
our Listener Care Center at 1-800-852-9696.
If payment has been sent prior to the receipt of this notice, please accept our apology and disregard
this letter.
Thank you
XM Listener Care
Please fold along pedoration, detach and return this portion with your payment
SATELLITE
RADIO
www.xmradio.com
(800) 852-9696
00000293 ~i~591 A I 0001 Oi 01204010-01 ~ A
ACCOUNT AMOUNT PAYMENT
Date Due
NUMBER DUE ENCLOSED
IMMEDIATELY 1-33982993 $59.94
--1 Check here if address or phone changes or payment
by credit card is provided on the back side of this form.
Tom Miller
PO Box 202
New Kingstown, PA 17072-0202
Please indicate amount enclosed.
Do not send cash.
Make check or money order payable to: XM Satellite Radio Inc.
XM Satellite Radio
P.O. Box 79500
Baltimore, MD 21279-0500
Exhibit
000000000000000000001,-33ct&~'=1300000005~t'=14&
36917
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 2003-0197
IN RE: ESTATE OF
THOMAS L. MILLER, DECEASED,
LATE OFWEST PENNSBOROTOWNSHIP,
CUMBERLAND COLRX5~, PENNSYLVANIA
FIRST AND FINAL ACCOUNTAND
STATEMENT OF PROPOSED DISTRIBUTION
LORRIE SANDRIDGE, ADMINISTRATRIX
OF THE ESTATE OF THOMAS L. MILLER
MA~S ,~' OTTO
IN[-ORMATION ADVICI: ADVOCAC~~
ATTORNEYS ~X~ COUNSELLORS AT LAW
TEN E^ST H~GH STREE~r
C^RLlSLE, PENNSYLYANIA 17013
TELEPHONE (717) 243-3341
~, ~ ,~~L~~t
absolutely and distribution decreed
in accordance with propoaed ached°
~l® o! dlatrlbutton herewltl~. B~
F:\FILES\DATAF1LE\ESTATES\ 10820-1 .notice.¢ert
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Thomas L. Miller
Date of Death:
File No.
January 31, 2003
21-03-0197
To the Register:
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on or
about May 7, 2003.
Ms. Lorrie Sandridge
P.O. Box 161
Mammoth Spring, AR 72554
Mr. Tim Miller
P.O. Box 681
Salem, AR 72576
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A
Date: May 7, 2003
Signature
Name
Carl C. Risch, Esquire
MARTSON DEARDORFF WILLIAMS & OTTO
Ten East High Street
Carlisle, PA 17013
(717) 243-3341
Attorneys for Personal Representative
IN THE MATTER OF
ESTATE OF:
THOMAS L MILLER
STATE OF PENNSYLVANIA
IN THE ORPHAN'S COURT
OF CUMBERLAND COUNTY
ESTATE#: 21-03-0197
DATE OF DEATH: 01/31/03
STATEMENT OF CLAIM
1. The creditor, Cross Country Bank, certifies that there is due and owing by THOMAS L MILLER, deceased, the sum
of ONE THOUSAND THREE HUNDRED ONE DOLLARS AND NO CENTS ($1,301.00).
2. The nature of the claim is a VISA CARD account 4227097342558553, which was established in 12/02/99.
3. The name and address of the claimant is: Cross Country Bank, 50 Applied Card Way, Glen Mills, PA 19342.
4. The name and address of the claimant's agent is: Jennifer L. Strehlein, Estate Recoveries, Inc., P. O. Box 24566,
Baltimore, Maryland 21214.
5. This claim is not contingent and is not secured by any liens or judgments.
6. This claim is not based on any one instrument. Said balance has accrued since the account was established.
On behalf of Cross Country Bank, creditor, I do solemnly declare and affirm under the penalties of perjury that the
information in the foregoing claim is true and correct to the best of my knowledge, information and belief. I have made
diligent inquiry and examination, and I believe the claim is just and all legal offsets, payments, and credits made known to
the affiant have been allowed.
jE ,N~kR L/i~].REHLEiN
Esta"~e Recoveries, Inc.
P.O. Box 24566
Baltimore, Maryland 21214
(410) 444-8022
Baltimore City, Maryland:
IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal this August 04, 2003.
My Commission Expires: October 11, 2006.
~f',,, SHANNON K. HEIM, Notary Public
'-..:~,.g ::.~ c ...'
ttttlllllllt%%'~
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
File No. 21-03-0197
Estate of Thomas L Miller
I I I
, Deceased
NOTICE OF CLAIM by .W, NNIFER L. gTREHI,EIN: AGENT FOR CRC}gR C(}IINTRV BANK
Filed Pursuant to Section 3532 (b) (2) of the Probate, Estate,
and Fiduciary Code, 20 Pa. C.S.A §3532 (b) (2) .
To the Clerk of the Orphans' Court Division:
Enter the claim o JENNIFER 1,_ gTREttI,EIN: AGENT FOR (?RORR COIINTRY BANK
(Claimant)
in the amount of $1,301.00 ~ against the above entitled
estate. The Decedent, who resided at
Carlisle, PA 17013-7400
(City)
Pennsylvania, died on Jan.ary 'I1; 2tiff3
1654 Newville Road
(Street Address)
, Cumberland
Written notice
County,
of said claim was given to l,nri gandridge
(Personal Representative, or
If known to claimant, at P. O. Box 161
his Counsel)
Mammoth Spring, AR 72554
(Address)
.on August 04.. 2003
(Date)
~,A/{dA~ d l~/_/~/_.~_~Jd..' ,Claimant
Post Office Box 24566~ Baltimore~ Maryland 21214
(Address)
Claimant's Counsel:
(Address)
COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
ORPHAN'S COURT D1VISON
NO. 21-03-0197
ESTATE OF: THOMAS L MILLER
deceased.
Notice of Claim by CROSS COUNTRY BANK
~ed pursuant to Section
3532Co) (2) of the
PEF Code.
Jennifer L. Strehlein, Agent
ESTATE RECOVERIES, INC.
P.O. Box 24566
Baltimore, Maryland 21214
(410) 444-8022
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DZV]STOH
DEPT. 180601
HARRISBURG) PA 17118-0601
CARL C RISCH ESQ
HARTSON ETAL
10 E HIGH ST
CARLISLE
CONHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
PA 1701~
DATE 01-05-200~
ESTATE OF HILLER
DATE OF DEATH 01-$1-2005
FILE NUHBER 21 05-0197
COUNTY CUHBERLAND
ACN 101
I Amoun~ Rami~ad
REV-15~I7 EX AFP (01-03)
THOHAS L
MAKE CHECK PAYABLE AND REMZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG TH]:S LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOT]:CE OF ZNHER]:TANCE TAX APPRA:ZSENENT, ALLOWANCE OR
DZSALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF HILLER THOHAS L F]:LE NO. 21 0:3-0197 ACN 101 DATE 01-05-200R
TAX RETURN NAS: (X} ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~narsh/p Zn~aras~ (Schedule C) ($)
~. Not,gages/No,es RecaAvable (Schedule D) (~)
5. Cash/Bank Depos/~s/Mlsc. Personal Proper~y (Schedule E) ($)
6. Jointly Owned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Assets
APPROVED DEDUCTZONS AND EXEHPTZONS:
9 Funeral Expanses/Ada. Costs/H/sc. Expanses (Schedule H) (9)
10 Dab~s/Nor~gaga L/abAli~/as/Lians (Schedule 1)
11 To,al Deductions
12 Na~ Value of Tax Ra~urn
16~578.97
.00
.00 NOTE: To Ansura proper
.00 crad/~ ~o your account,
.00 submA* ~ha upper portion
.00 of ~h/s form wASh your
~ax payment.
.00
(10)
(8)
12,~60.75
15
NOTE:
ASSESSHENT OF TAX.'
15. Amoun{ of LAne lfi a{ Spousal re~e
16. Amoun'l: of Line 1~ {axabla a{ L/neal/Class A ra*a
17. Amoun{ of L/ne 1~ a~ SAbl/ng re~a
18. Amoun~ of Line 1~ ~axabla a~ Collateral/Class B ra~a
19. Pr/nc/pal Tax Due
TAX CRED]:TS-'
PAYMENT RECETpT DTSCOUNT
DATE NUNBER TNTEREST/PEN PA'rD (-)
16,578.97
c~1,765.27
(11) 54.226. §O
(12) $7,6~7.03-
Char/~abla/Govarnmen{al Baquas{s; Non-alec{ad 9115 Trusts (Schedule J) (15) .00
Na~ Value of Es~a*a Sub,ac* ~o Tax (lq) $7,6R7.03-
]:f an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
1F PA/D AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(15) .00 x O0 = .00
(16) .00 x 0~5= .00
(17) .00 x 12 = .00
(18) .00 x 15 = .00
(19)= . O0
ANOUNT PAID
TOTAL TAX CRED]:T I .00
BALANCE OF TAX DUEl .
INTEREST AND PEN. .00
TOTAL DUE . O0
( ]:F TOTAL DUE TS LESS THAN $1~ NO PAYNENT TS REi~UZRED.
ZF TOTAL DUE 1S REFLECTED AS A "CRED/T' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTTONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND ICR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on ar before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section zlqo of the /nheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S.
Section 9140).
Detach the top partion 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 #/LLS, AGENT
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-1315). Applications ara available at the Office
of the Register of NJlls, any of the 25 Revenue District Offices, or by calling the special Iq-hour
answering service for fores ordering: 1-800-56Z-2050~ services for taxpayers with special hearing and / or
speaking needs: l-DOO-qq7-SOZO iTT only).
Any party in interest not satisfied with the appraisement, allowance, or disalloaance of deductions, or assessment
of tax lincluding discount or interest} as shown on this Notice must object within sixty 160} days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZDIOZ1, Harrisburg, PA 17128-IOZIj OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. gD06Ol, Harrisburg, PA 17128-0601
Phone I717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
The 1SI tax amnesty non-participation penalty is computed an the total of the tax end 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 is charged beginning with 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 I, 198Z bear interest at the rate of
six (DX) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which ail1 vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOS are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .000548 1987 9Z .OOOZ47 1999 72 .00019Z
1983 162 .000q58 1988-1991 112 .OOO301 ZOO0 8Z .000Z19
198q llZ .000501 199Z 9Z .000Z47 ZOO1 9Z .000Z47
1985 15Z .000556 1993-1994 7Z .000192 200Z 6Z .O0016q
1986 IOZ .O00ZTq 1995-1996 9Z .O00247 ZOO5 5Z ,000157
--Interest is calculated as folloas:
INTEREST -- BALANCE OF TAX UNPAID
X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen IlS) days
beyond the date of the assessment. If payment is made after the interest computation data shown on the
Notice, additional interest must be calculated.
REGISTER OF WILLS OF CUMBERLAND COUNTY
STATUS REPORT UNDER RULE 6.12
(For Resident Decedents Dying After July 1, 1992)
Name of Decedent: THOMAS L. MILLER
Date of Death:
January31,2003
FileNo.' 21-03-0197
Social Security No.: 430-96-5570
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect
to completion of the administration of the above-captioned estate:
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:
Did the personal representative file a final account with the Court?
Yes x No
The separate Orphans' Court No. (if any)for the personal
representative's account is:
Did the personal representative state an account informally to the parties in
interest?
Yes No x
Date:,: 3/9/04 .~.
,Z3
F:X. FILESkDATAF1LE\ESTATES\ 1082'0~..~P
Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk~~urt and may be attached to this report.
.~' :i.:: Signature: ~ ~
:' Name: Cad C. Risch, Esquire
Address: MARTSON DEARDORFF WILLIAMS & OTTO
Ten East High Street
Carlisle, PA 17013
(717) 243-3341
Counsel for personal representative