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HomeMy WebLinkAbout11-05-10 (3)I 15D5610140 REV-1500 EX ~°'_'°' OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN 2 1 1 0 0 2 5 4 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 9 5 1 6 3 1 4 2 0 3 0 6 2 0 1 0 0 6 3 0 1 9 2 3 Decedent's Last Name Suffix Decedent's Firs t Name MI M I L L E R E L E A N O R W (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 WIl'H THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) Q 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number G E R A L D J S H E K L E T S K I E S Q 7 1 7 7~1~~4 ?~ 3 5 _ _,_ --- -- -_ _ _--- -~-~ ~'- --- - ~ _ REGISTER-~~ USE~fILY , ~ , First line of address ~ "~~ ~'~' =~ ~ ~;~4 ~ , 4 1 4 B R I D G E S T ~' ~-- .;T7 _` ~ r Second line of addre ss ~ .~ `~~~ ~: =~j ~;:~ P 0 B O X E ~ ~'; ~'~~ City or Post Office State ZIP Code DATE 1=1LED N E W C U M B E R L A N D P A 1 7 0? 0 Correspondent's a-mail address: g s h e k l e t s k i a s t o n e l a w• n e t Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SI ATURE OF PER N RE ONSIBL FOR FILING RETURN D~4T v , A DRESS LINDA M• CUSHNER 110 HARRISON DR NEW CUMBERLAND PA 17070 SIGNAT EP THAN DATE - - '~ g ~~~ ADDRESS GERALD J. SHEKLETSKI ESQ• 414 BRIDGE ST•, NEW CUMBERLAND PA 17070 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 150561,01,40 J J 1505610240 REV-1500 EX Decedent's Name: ELEANOR W • MILLER Decedent's Social Security Number 1, 9 5 1, E~ 3 1 4 2 RECAPITULATION 1. Real Estate (Schedule A) ......................................... .. 1. • 2. Stocks and Bonds Schedule B 2. 2 :L 9 6 . 7 1 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. • 4. Mortgages and Notes Receivable (Schedule D) ........................ .. 4. • 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5. 2 1, 5 5 0 7 5 2 6. Jointl Owned Pro ert Schedule F y p y ( ) ^ Separate Billing Requested ..... .. 6. 2 3 `~ 6 0. 5 5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ..... .. 7. I, 9 6 .3 ~ 2 . 0 8 8. Total Gross Assets (total Lines 1 through 7) ......................... .. 8. 4 0 7 `~ 9 6 . 8 6 9. Funeral Expenses and Administrative Costs (Schedule H) ............ ...... 9• 1 6 5 9 4 . 7 7 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ...... 10. 0 • 0 0 11. Total Deductions (total Lines 9 and 10) ......................... ...... 11. 1 6 5 9 4 . 7 7 12. Net Value of Estate (Line 8 minus Line 11) ...................... ...... 12. 4 2 1, 4 0 2 . 0 9 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. 4 2 L 4 0 2 0 9 TAX CALCULATION -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 .0 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 4 2 1 4 0 2 0 9 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 1 g. 19. TAX DUE .................. ........................... .. ..... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0. 0 0 1, 8 9 6 3. 0 9 0. 0 0 0. 0 0 1, 8 9 6 ~• 0 9 Side 2 1505610240 1,50561,0240 J REV-1500 EX Page 3 File Number Decedent's Complete Address: 21, 1, 0 0 2 5 4 DECEDENT'S NAME ELEANOR W. MILLER STREET ADDRESS 1,1,0 HARRISON DR ____ _ ___ CITY STATE ZIP NEW CUMBERLAND iPA 11,7070 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B, Discount 3, Interest 4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval 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. Total Credits (A + B) (2) (3) (~) (5) Make check payable to: REGISTER OF W1LLS, AGENT 18,963.09 0.00 0.00 18, 963.09 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 : ................................................................. ..... ~ ^ 0 b. retain the right to designate who shall use the property transferred or its income; .......................... ..... ^ 0 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 0 without receiving adequate consideration? .................................................................................. h? " " ..... ^ ^ .... or payable-upon-death bank account or security at his or her deat in trust for 3. Did decedent own an ..... 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. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 21 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 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 4.5 percent, except as Hated 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 percent [72 P.S. §9116(a)(1,3)]. A sibling is defined, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS L- ESTATE OF FILE NUMBER ELEANOR W• MILLER 21 10 []254 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 24 SHARES ALCATEL-LUCENT COMMON STOCK 81.48 3/5/10 VAL UE-$3.40 + 3/8/10 VALUE-3.39 = $6.79/2 = $3.395 PER SHARE X 24 = $81.48 2• 53 SHARES METLIFE, INC• COMMON STOCK 2,115.23 3/5/10 VAL UE-$38.92 + 3/8/10 VALUE-X40.90 = $79.82/2 = $39.91 PER SHARE X 53 = ~ 2,115.23 TOTAL (Also enter on line 2, Recapitulation) I S 2 ,19 6 • 71 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDVLE E ~+ COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER ELEANOR W• MILLER 21 1,D 0254 Include the proceeds of litigation and the date the proceeds were received by the estate. All propertyjointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. M&T BANK CHECKING ACCOUNT NUMBER 60743204 55,560.56 2- M&T BANK SAVINGS ACCOUNT NUMBER 15004222178996 100,D43.26 3• M&T BANK CERTIFICATE OF DEPOSIT ACCOUNT NUMBER 14,587.13 31003913915624 4• WACHOVIA BANK PROPERTY TAX REBATE 500•DO 5• METRO BANK SAVINGS ACCOUNT NUMBER 6270611,20 5,654.11 6• FIDELITY INVESTMENT ACCOUNT Z46-737488 36,115.88 7• HEALTH INSURANCE PREMIUM REFUND 1,630.92 8• VERIZON - MONTHLY PENSION PAYMENT 161.52 9• LEFFLER ENERGY PREPAID FUEL REFUND 705.14 1D- HOMEOWNERS INSURANCE REFUND 549.00 TOTAL (Also enter on line 5, Recapitu{ation} ~ ~ 215 , 5 0 7. 5 2 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (01-10) pennsyivania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: ELEANOR W• MILLER 21 10 0254 If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A.LINDA M• CUSHNER 110 HARRISON DRIVE DAUGHTER NEW CUMBERLAND, PA 17070 s. BRENDA M• SWARTZ 171D CREEK VISTA DRIVE DAUGHTER NEW CUMBERLAND, PA 1?070 c 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 DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTERESI 1, A. B. 4104 BELCO COMMUNITY CREDIT UNION 1,454.50 33.33 484•?8 SAVINGS ACCOUNT 062930 2• A•B• 4/04 BELCO COMMUNITY CREDIT UNION 2,957.59 33.33 985.76 CHECKING ACCOUNT 0000629303 3• A•B• 2005 BELCO COMMUNITY CREDIT UNION 65,521.02 33.33 21,838.16 CERTIFICATE OF DEPOSIT NUMBER 3258? 4• A•B• 8/06 8? SHARES VODAPHONE GROUP PLC 1„955.76 33.33 651.85 COMMON STOCK 3/5/10 VALUE-$22.4? PER SHARE 3/8/10 VALUE-X22.49 PER SHARE X22.47 + $22.49 =X44.96/2=$22.48 X22.48 PER SHARE X 87 = $1,955.76 TOTAL (Also enter on Line 6, Recapitulation), ~ 2 3 , 9 6 D • 5 5 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+ (08-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER ELEANOR W• MILLER 21 1,D 0254 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM NUMBER DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE 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 ~. METLIFE ANNUITY CONTRACT NUMBER 0300 32,356.24 1,00.00 32,356.24 6941,3~1A TRANSFEREES-LINDA M • CUSHNER AND BRENDA M•SWARTZ-DAUGHTERS 2 - CUNA ANNUITY CLAIM #1,00325022 163, 975.84 ],00 •00 63, 975.84 TRANSFEREES - LINDA r'I- CUSHNER AND BRENDA SWARTZ, FORMERLY BRENDA SNELL, DAUGHTERS TOTAL (Also enter on Line 7, Recapitulation), $ 1, 9 6 , 3 3 2 • 0 8 If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERALEXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER ELEANOR W• MILLER 21 L0 0254 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MUSSELMAN FUNERAL HOME, INC • 7, 567.1,2 324 HUMMEL AVENUE, LEMOYNE, PA 1,7043-01,37 B, ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name{s) of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: 2, Attorney Fees: STONE LAFAVER & SHEKLETSKI 4,000.00 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.) Claimant Street Address 4 5. 6. 7, 8• 9• 1, 0 1, 7, • 12• L3• 1, 4 L5• 1, 6 • ], 7 • City State ZIP Relationship of Claimant to Decedent Probate Fees: LETTERS TESTAMENTARY Accountant Fees: Tax Return Preparer Fees: ROLLING GREEN CEMETERY COMPANY BETHANY SKILLED NURSING CARE HAMPDEN PHYSICIANS BONNIE MILLER, TAX COLLECTOR, PERSONAL INCOME TAX PPL ELECTRIC JOHN UHLINGER - MINISTER/FUNERAL SERVICE CONTINUING CARE MEDICAL SERVICE PENNSYLVANIA AMERICAN WATER FUNERAL LUNCHEON GINGRICH MEMORIALS FILING FEES-INHERITANCE TAX RETURN($1,5)AND INVENTORY t $1,5 ) 498.50 1„ 395.00 1„798.50 1, 3.71, 9.80 28.52 1,00 •00 305.62 17.69 390.31 1,90.00 30.00 TOTAL (Also enter on Line 9, Recapitulation) $ 1, 6 , 5 9 4 • 7 7 If more space is needed, use additional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent ELEANOR W. MILLER 21 10 0254 Decedent's Name Page 1 File Number Schedule H -Funeral Expenses & Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 18• RESERVE FOR CLOSING EXPENSES 250.00 SUBTOTAL SCHEDULE H-B7 1 2 5 0. 0 0 REV-1513 EX+ (01-1 d) pennsyfvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: ELEANO K W • rIlLLEht cy .uu uc~-~ RELATIONSHIP TO DECEDENT AMOUNT OR SNARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE j TAXABLE DISTRIBUTIONS (Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).) 1 LINDA M • CUSHNER * (SEE BELOW) Lineal 112 SCHED. F, ITEM . 110 HARRISON DRIVE 1,2,3,AND 4, and 1/ NEW CUMBERLAND, PA 17070 SCHED. G, ITEMS 1 2• BRENDA M• SWARTZ** (SEE BELOW) Lineal AND 2. 1/2 OF RESUI 1710 CREEK VISTA DRIVE NEW CUMBERLAND, PA 17070 1/2 SCHED. F, ITEM 1,2,3, AND 4, AND l * LINDA M . CUSHNER WAS KNOWN AS SCHED. G, ITEMS 1 LINDA M • HAWKE PRIOR TO MARRYING ,AND 2. 1/2 OF RESII **BRENDA M• SWARTZ WAS KNOWN AS BRENDA E• MILLER PRIOR TO MARRYING ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. jl. NON-TAXABLE DISTRIBUTfONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET, ~ 2 UE /2 UE If more space is needed, use additional sheets of paper of the same size. ?rrtst 3~fi11 ttn~ (~leskrxmrnt I, ELEANOR W. MILLER, of the Borough of Camp Hill, Cum- Berland County, Pennsylvania, make, publish and declare this to be my Last Will and Testament, hereby revoking and making void any and all former Wills by me at any time heretofore made. 1. I direct the payment of my just debts and funeral expenses as soon after my death as may be convenient to my Executor hereinafter named. 2. All the rest, residue and remainder of my estate, I give, devise and bequeath unto my husband, Richard H, t-~iller, if he survives me. 3. Should my husband, Richard H. Miller, fail to sur- wive me, I give, devise and bequeath my estate unto my daugh- ters, Linda bi. Hawke and Brenda E. Miller, share and share alike. 4. I name, constitute and appoint my husband, Richard H. Miller, to be the Executor of this, my Will. Should my said husband fail to survive me, or fail for any reason to complete the administration of my estate, I appoint my daugh- ters, Linda M. Hawke and Brenda E. Miller, to be the Execu- trices in his stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this "~~, day of ,,,/~1 , 1976. ~~ ,.. _ Eleanor W. Miller ~;_ u lJ_~ ', Signed, sealed, published and declared by the above- named Testatrix, 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, have hereunto subscribed our a~ames as witnesses . N ' °. ~--- ~ .~ `~ ri ~. .. t ". i.:~.. i .. ~Y G ~U ' C ~; ~ RECT REGISTRATION TRANSACTION ADVICE Company Nam CATEL-LUCENT Security Description: ADR CUSIP Number: 013904305 Account Registration: Depositary: The Bank of New York Depositary Account Number: 0038622338 ELEANOR W MILLER Telephone Number: 1-888-582••3686 2935 COLUMBIA AVEiIUE CAMP HYLL PA 17011-5219 Transaction Date: 02J26J07 Transaction Description: EXCHANGE ENTITLEMENT Transaction Advice Number: DRS 00549168 Transaction Shares: 24 , DRS Current Balance: Retain this Advice as a record of your ownership of the above security. ~ FdLD AND DETACH HERE ~ ~ FOLD ANC DETACH HEfiE ~ SALE REQUEST FORM - (SEE REVERSE SIDE FOR ENTRY INSTRUCTIONS) ADSs will be sold subject to the terms and conditions detailed in the Global BuyDIRECT~" Plan for Alcatel-Lucent ADS holders, which are also referenced in the enclosed Direct Registration pamphlet. By signing below I/We agree to the Terms and Conditions outlined in the Global BuyDIRECTs"' Plan, which is administered by The Bank of New York, with respect to any sales by me/us. Box #2 ~ Sell my Direct Registration ADSs: Box ;f*1 ~ Change my address ~~ ^ - Mark this box and complete on reverse side. (Indicate number of whole ADSs) Q;~ All ADSs (chEack here) All RMwib mrq M Signature Signature Date Daytime Telephone No. tiMrd w •11 tplsE~N ( ) owMet PLEASE MAKE NO MARKINGS BELOW THIS DOTTED LINE 3460 1014 0038622338 5 00000000001 Hi, ferry Sign Out Ne(p Upgrade to Safer IE8 Yahoo! Mail ~~~~ ~~~ ~~ ~ ~ ~ ~ ~ ~ ~ Web Search ~~ Search Dow j- 0.15% Nasdaq ~ 0.65% HOME INVESTING NEWS & OPINION PERSONAL FINANCE MY PORTFOLIOS TECH TICKER ~~~~~ ~~ GET QUOTES Finance Search Wed. Jul 21, 2010, 11 26AM EDT - iJ.S. Markets ciase in 4hrs 34mins Alcatel-Lucent (ALU) At 11:10AM EDT: 2.60 ~ 0.04 (1.52°io~ C ~ ~ ~ ail ,~~ ~~Rrrt E r C7~1~ TitADES z ~ F ~ ~ ~ brt? DAYS / ~ : ~ ` i• _ ~ E~kTRADE SECURITIES LLC -- - - - .. Historical Prices Get Historical Prices for: GO SET DATE RANGE AdChoices ~::v::~ Daily Eg. Jan 1, Start Date: Mar 5 2010 zoio ~ :;Weekly End Date: Mar - 8 2010 ~'._ :~ Monthly ~- _ ;~ Dividends Only Get Prices First ~ Previous ~ Next ~ Last PRICES Date Open High Low Close Volume C ose* Mar 8, 2010 3.41 3.42 3.38 3.39 14,223,100 3.39 Mar 5, 2010 3.36 3.42 3.34 3.40 20,091,900 3.40 * Close price adjusted for dividends and splits. First (Previous ~ Next (Last ~ ~ ~+~ ~C~ O l~ . `~~"~ Download to Sareadsheet " . Copyright ©2010 Yahoo! Inc. A11 rights reserved. Privacy Policy -About Our Ads -Terms of Service - CopyrighUlP Policy -Send FeedbacEc -Yahoo! News Network Quotes delayed, except where indicated otherwise. Delay times are 15 mine for NASDAQ, NYS[= and Amex. See also delay times For other exchanges. Quotes f ~ ~ MetLife Statement of Tru t In s terests February, 2000 At the time MetLife demutualizes, you will be allocated shares of MetLife, Inc. Common Stock, which will be held for you in the MetLife Policyholder Trust. The number of Trust Interests you own is equal to the number of shares of Metlife, lnc. Common Stock held for you in the Trust. This Statement of Trust Interests tells you how many Trust Interests you will own at the time Metlife demutualizes (in other words, how many shares of Metlife, Inc. Common Stock will be allocated to you and held for you in the Trust). If you want to buy more shares of Metlife, Inc. Common Stock to be held for you in the Trust, you should use the form printed below to submit a Purchase Instruction. You are only eligible to purchase additional shares if you are being allocated less than 1,000 shares. Stock can be purchased through the Purcha:e and Sale Program on the first trading day following the 90th day after the date MetLife'a demutualization becomes effective. Purchase Instructions received before the purchase program begins will not be processed until the commencement of the purchase program. If you want to sell the shares of Metlife, Inc. Common Stock held for you in the Trust, you should use the form printed on the reverse side of this page to submit a Sell Instruction. Stock held In the trust can be sold after the IPO distribution is completed, which should be no more than 30 days after the plan effective date. Sell Instructions received before the sale program begins will not be processed until the commencement of the sale program. All such purchases and sales wilt be on a commission free basis. AUTO if*l'ltl~~~~~~~ 5-DiCiT 17ooi Please be sure the correct address a ears in ELEANOR M MILLER ~ pp 2935 coLU1R3IA AVE v the window of the envelope if you are CAM!' NILL PA 1011-5219 submitting a Purchase ar Sale Instruction. The attached instruction card identifies the I"'ill"'ll1""..11"'11'1'1...1.1ll,lllll"..Illllll"I'I'I correct address for each type of transaction. LL4 N59694 PLEASE RETAIN FOR YOUR RECOFi08 Name ELEANOR M MILLER Retain this number for Investor ID secs 99e3 92b3 future reference Number of Trust Interests s3 Sequence Number Meosi7944• PLEASE READ THE IMPORTANT INFORMATION ON THE BACK OF THIS FORM AND iN THE ENCLOSED BROCHURE Use ONLY if a transaction is requested. Unless you wish to initiate a transaction, no action is required. PURCHASE INSTRUCTION 8065 9903 9253 Change of address: (See reverse side to SELL) ELEANOR M MILLER ChaseMellon Shareholder Services PO Box 382200 Pittsburgh PA 15250-8200 I~l~ Illl~l~~ll~I~l~IIII...I~~I~lllllll~~lllll~il~l~fll~ll~llll 02 Please be sure this address appears in the envelope window for Purchases ONLY! 0000101 102 806599039253 7 Slonatufe: (it address being Ghana ) Make check, to U.S. dollar:, payable to: MetLife Purchase Program Amount Enclosed Minimum investment $250.00 (except as described in the enclosed brochure) l 14 YCa~A4 Hi, ferry Sign Out Heip Upgrade to Safer IE8 Yahoo! Mail Search Web Search ~~ ~~~~ Dow ~- 0.21% Nasdaq ~' 0.74% HOME lNVE5TING NEWS & OPINION PERSONAL FINANCE MY PORTFOLIOS TECH TICKER ~~~ w..._..___.~ GET QUOTES Finance Search Wed, Ji~l 21, 2010, 1 1 34AM EDT - U.S. Markeits close in 4hrs 26mins MetLife, Inc. (MET) at ~~:19AM EDT: 37.96 • 0.15 (o.ao~lo} TRACE "~" ~ , ~~ >~ ^~- , ~ ~ - lid aMl~l~~rlRwi~ ~: ~~~ ~~E E 6U OAYS ~ ~C7~5 ~'~ ~~3 f - ~ • E*TRADE SECURITIES LLO ~'~~~ w Historical Prices Get Historical Prices for: GO SET DATE RANGE ~:o:~ Daily Start Date: Mar 5 2000 2010an 1, ,-_ ;Weekly End Date: Mar ~ 8 2010 ~~ _..` Monthly ~~ _ ~~ Dividends Only Get Prices First ~ Previous ~ Next ~ Last PRICES Date Open High Low Close Volume C ose` Mar 8, 2010 40.65 41.06 40.04 40.90 15,602,600 40.90 Mar 5, 2010 38.31 39.04 38.13 38.92 7,082,200 38.92 Mar 4, 2010 36.93 38.18 36.83 38.11 9,054,800 38.11 Mar 3, 2010 36.88 37.02 36.62 36.75 3,832,700 36.75 Mar 2, 2010 36.63 36.91 36.35 36.79 4,529,700 36.79 Mar 1, 2010 36.51 37.30 36.26 36.54 5,319,900 36.54 Feb 26, 2010 35.89 36.61 35.41 36.39 9,668,700 36.39 Feb 25, 2010 35.20 35.87 34.82 35.84 8,377,300 35.84 Feb 24, 2010 34.79 35.65 34.63 35.59 5,668,200 35.59 Feb 23, 2010 35.21 35.39 34.37 34.84 7,503,800 34.84 Feb 22, 2010 35.12 35.43 34.91 35.27 6,372,700 35.27 Feb 19, 2010 34.70 35.24 34.46 35.03 7,754,400 35.03 Feb 18, 2010 34.74 35.03 34.74 34.85 6,383,900 34.85 Feb 17, 2010 35.23 35.37 34.73 34.87 6,088,500 34.87 Feb 16, 2010 35.07 35.23 34.46 35.06 6,902,900 35.06 Feb 12, 2010 34.12 34.71 33.70 34.64 7,606,100 34.64 Feb 11, 2010 34.70 34.77 34.31 34.54 6,843,800 34.54 Feb 10, 2010 35.10 35.30 34.53 34.93 7,349,800 34.93 Feb 9, 2010 34.00 35.73 33.40 35.15 16,339,700 35.15 Feb 8, 2010 34.61 34.65 33.60 33.64 6,369,200 33.64 Feb 5, 2010 35.03 35.35 33.57 34.68 10,360,600 34.68 Feb 4, 2010 35.13 35.36 34.33 34.73 13,309,300 34.73 AdChaices ^_.~.... SALE ~~l''~I'~~" During our Madet Year End Sales Event, get alt that and a great deal. ,~a AVI , p~~ 499 Mitchell Road, Millsboro, DE 19966 Adjustment Services Stone, LaFaver & Shekletski Attorneys At Law 414 Bridge Street POBoxE New Cumberland, PA 17070 Re: Estate of Eleanor W Miller Social Security: 195-16-3142 Date of Death: March 6, 2010 Phone 888-502-4349 F ax (302) 934-2955 July 14, 2010 Dear Sir or Madam: Per your inquiry on June 30, 2010, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownership (Names o, fl Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Checking 60743204 Eleanor W Miller 04lZ8/77 , $55,559.04 , $ 1.52 $55,560.56 Savings 15004222178996 Eleanor W Miller 02!18/10 $100,004.10 $ 39.16 __ __ _ _ _ _ $100,043.26 ' 't r ~ 3. Type of Account Accouftt Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Certificate of Deposit 31003913915624 Eleanor W Miller OS/18/99 $14,587.13 $ 19.13 $14,587.13 For further account information, closures and/or reimbursement of funds please call the West Shore Plaza Office at #717-731-1730. We were unable to locate any safe deposit box for the above-mentioned decedent. 'This letter does not include any accounts in which the deceased may have been listed as Power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement Since ly, Suzanne M Kimble Adjustment Services ~~ '"' w O ~ ,*+ "~. p r d ~ ~ i 7" L~ .t r ~ 4 ~S a 7' ., .. ,~ ~j~i ~°` ~~ 1~ `',' ~ u1 ;Q f- t 4 ~` +~ i ~ i ~. ~~ 0 0 1.~ • ~{ - ., ,.: ~ ,. ~ :; ~'' ° _ `~ rta~ :: w N • ...» 0 • © o- O r- r ~ ,ar $ ~ -~ ~ ~ a ~ ~ - o ~ w ~ ' ~ ;~ c ~ ac a = s o ~ ~ ~' ~ ~~ ~ = "' •' ~ oc UD o 2 s t ~ ~ ~ d. d Z c$ ~ t~~+ ,S ~ o u`;! Z c W ••: 0 ~ g-~~ WO~z 7 O u. ~„' ~, Or O , ~ ~ ~ Qi°~.e~ o ~ ~ ~. ~ 0 0 *~340 'HETRO BANK 3801 Paxton Street Harrisburg • PA • 17111 myMetrobank.com 888.937.0004 Stone LaFaver & Shekletski 414 Bridge St PO Box E New Cumberland, PA 17070 RE: Estate of: Eleanor W. Miller Tax Identification Number: 195-16-3142 Date of Death: March 6, 2010 To Whom It May Concern: July 1, 2010 This letter is in reference to decedent account information you requested for the individual fisted above. We are able to provide the following: Account Type: Savings Account Number: 627061120 Date Opened: 7/22/2008 Primary Owner: Eleanor W. Miller Date of Death Balance: $5,654.11 Please feel free to contact me at (717) 412-6105 if I may be of further assistance. Sincerely, L~y~~ Cindy Shultz Support Associate/Deposit Services Metro Bank July 02, 2010 Jennifer A Mearkle C/O Stone LaFaver & Shekletski 414 Bridge St PO Box E New Cumberland, PA 17070 Dear Jennifer A Mearkle: We are responding to your request for information regarding Eleanor Witman Miller's Fidelity Investments account(s). All information in the enclosed valuation report(s) is (are) based on assets in the Fidelity account(s) as of the date indicated on the report(s). Valuation information is provided through a third party valuation service provider. Fidelity does not warranty the accuracy of this information for any particular purpose, nor does Fidelity provide legal or tax advice. Consult with an attorney or tax professional regarding any specific legal or tax situation. We hope this information is helpful. If you have any questions about account holdings or need instructions on how to transfer the ownership of the accounts, please visit us at Fidelity.com and search under "Change Account Registration" or call us at 800-544-0003. Fidelity Inheritor Services Representatives are available Monday through Friday from 8:00 a.m. to 6:30 p.m. Eastern time. Sincerely, Carla Goins Fidelity Investments Account Re--Registration Services Representative Our file: W 144982-25JUN 10 DDODCNFM 531298.1.0 cn -- -- -- cD a rrt ~ rt O Cp O Cr.1 cn N • r-t, '~ ~~ ~~ t~ '~ ~v ~ ~ co `~ a m d a n~ darn w W ¢* m ~a rn ~ ~ ~ o J N . .. 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T~ b O (D ~. n ~- ~ ~ • H ~ C m ~ o N h-h O crt M ~ ~ Z O C (n 'r} ~A N H h-' - (D ~-] d1 CD h ~ ~ ~ ~ p i CD ~.] ~ C ~ O lD w O (D O H t-fi •• J h j C7 ~ O F--' CZ c.J n r-r ct ~ ~ ~t !-~ w cn CD n ~Ca rj '~ a N- N- a~ N• O ~ ~ O w Ul ~. w ~ ~ a~ CD ~ C N - , R' ,r~ ~ ~ v, .• a ~ .. w ,p w r, { f a CD c> rn ~-' h--~ n a ("t N a f-~ >/ a N- O ~~ ri 0 to O "~ CD ~ N Q' (D £ Cl ~'- O ~ ~ ~ CZ ~ ~ ~ Cr] ~ G G b ~ ~ ~ K tfi ~ ~~ U1 ~ C7 ~ O ~' r-h cn W ~ ~' ~L'3 W ~ ~ ~ ~ l~ W ~ O ~ N O ~ t-' rt~„~, ~- d T11 ~~ ~b K 'j ~n +,. n ~ Y' .-- ~ ~ ~ tt7 ~~ N- [n cn ~ H o ~ ~ n -J ~ H N r+'+ K O t,'. ro (4 t17 C'~ t~• d G ~ ~ o ~ n ~ N ~ ~' o ~ ~* ~-3 -- C!y r, . ~-r, a ~ ° ~ ~ ~ d w~ ~, ~~rn w ~~ ~~ ~~~ . n G ~ ~ . ~ .. ~ ~ ~ ~ o a .. • cs` d c~ ~ n G tD cp c~ o °, rn W O N E 0 n ~ w ~~~ ~~ ~ ~ j N ~ n ~ ~ ~ p ~ rC N ~'' ~ ~ ~ ~ t--' G N ~ ~ N~ W p0Y` (':t O ~ O ~ ~ O 00 F~ ~ ~ ~ ~ ~ ' ~ O ~ ~` ° H a w --- tT1 y, x W ~-- ,~ ~ N -' A~ '~ ~ ~~-- , ~ tI] N O ~ 1-~ F-' o `Z+ C7 C r ~-- o ~.o N O W W ~P ~... o W G rn r-' -,.. a N rP O F-' -' ~.,• ~ d ~' N N '`~ ~ U.1 J w 7~' N ~ p O O a ~ O ~ ~_ N N ~ ~ ~ N ¢~ F-' N -~ ~ Q Q h-' p O O O ~ ~ O ~ ° xx r~ ~~ ~ ~, ~~ ~ ~ p' O ~ O ~ ~ ~ (D O o n ~~ C1 ~ ~ ~ ~ "d ~ .. ri Z p .. ~ ~ ~ N Fes-' ~ ~'' '~' ~ CD ~-r5 ~ 1 ,~- ro ro ~ ~ o ~~- w ~ " j J + ~ ~ .. ~ ~ ~ d cnd~~. u-+ N G cn ~ ~ ~ J N ~ ri ~ ~ P~ ~ 0 ¢, ~ ~ ` ~,. W ~ }.,, . ~ Y - :~ t/} `P t mac: rn ~ (~D Q, t~-' $ ~'' ;.~ ~ .. ~ ~ rn ~,, N cx~ ~ rn ~' F-' ri ~ O N W W ~ N ~"` COMMUNITY CREDIT UNION STONE LAFAVER & SHEKLETSKI Attorneys At Law 414 Bridge Street Post Office Box E New Cumberland, Pa. 17070 February 19, 2010 Re: Estate of Eleanor W. Miller S.S. 195-16-3142 Attention Jennifer Mearkle: Here is the information for the above referenced account. There were no other account for Eleanor W. Miller. If you need any further information, please call me at 717 720 6414. Sincerely, Yvonne Jam Finance Department DECEDENT ESTATE INFORMATION 1. Name(s) in which the account was held: ELEANOR W MILLER Joint Owners Linda M. Cushner and Brenda M. Swartz 4/14/2004 2. Account number: C U ~~ a .-3O ~ 62930 3. Balance as of date of death: $69,933.11 Balance Accrued Dividends YTD Dividends Opened Regular Savings: S1 $1,454.50 $0.00 $1.18 6123/1995 Christmas Club: S2 Whatver Club: S3 Checking: S4 $2,957.59 $0.15 $0.15 11!4/2002 Money Market: S6 ~. D o 5r Certificates: Balance Accrued Dividends Certficate Number YTD Dividends $65,521.02 $154.02 32587 $455.88 $ $ 4. Date the account was initiated: CD prior to 2005 5. Name(s) in which Safe Deposit Box was held: ~-- 6. Date the box was initially rented: 7. Branch address at which the box is located: 8. Loan Information: Balance Accrued Interest Per Diem Int A. Unsecured Loans: L14 Classic Visa Card B. Secured Loans: C. Mortgage Loans: $ $ $ $ $ $ $ $ 9. Miscellaneous: /~a~~~~S DIRECT REGISTRATION TRANSACTION ADVICE ~~~ Narne: VODAFONE GROUP PLC Transfer Agent: Thy Bank o~ Nl~w York ~~~ Description: LEVEL II - NEW ADR Transfer AgentAocount Number: 0004414397 CUSIP Number. 92a57W209 Telephone Number: 1-800-233-5601 Transaction Date: oa~2aios Aooount Registration: ELEANOR w MILLER i LINDA M CUfNNER ; Transaction Description: ~ SNARE CONSOLIDATION fRENDA M lYARTZ JT TEN Transaction Advice Number. DRS 00656146 2lis COLUMtiTA AVE 87.0000 CAMP N1LL PA 17011-521! Trans~e-ction Shares: DRS Current Balance: e 7. o 0 0 0 BROKER/~DEAL,ER INFORNAAI'ION Name: Participant Number: Customer Account Number: Ratifn thla Advky p • rocOrd ott your owrwrshlp o1 ttw above tecurttlus. ~ FQLD AND DETACH HERE ~ ~ POLDANOD~~"a ~ DRS 00656146 TRAN8ACTION REQUEST FORY -PLEASE KEEP THIS FORM FOA FUTURE REST (SEE REVERSE SIDE FQA PROPER ENTRY M1STAtJ~.'T10N3)0 0 (~ tart,. a urtiticate from rtry pirect Registration stare position ~ 1--- i__ (Pkise ctaose one optbn onh-)~ ! ~ ~ Issue Uiirect Registration stares M piece d the atdched certititiccated shares<s): f ~ ---r--~ r-_r--T---t-- ~~ ~,.~«.~.., ~ ~,~•~ ~____~ ! ~(Indicite number of whole stares) Please erw~+ss your GsliAcaiae{s>. _~.____ __ r'~'~ --___;Charlge trry address -Mirk this box N1d CO~tlplete tf-e Otfler slde Of fOmt. I _ - -- Mrl w ~ ' sue. ~ Sgrgdure T o.i. osPlm. TMephon. qo. _L. ~ _ ~ ~ _ ._ __. MAKE NO MARKINCiB BELOW TN13 00'T'TED UNE Hi, ferry Sign Qut Help Upgrade to Safer IE8 Yahoo! Mail 5e~rch " ~~~,„~'~~~~, ~ ~ ~ ~'~ ~ ~,,, ~ Web Search Dow ~ 0.25°lo Nasdaq ~ 0.75% HOME INVESTING NEWS & OPINION PERSONAL FINANCE MY PORTFOLIOS TECH TICKER ._.___._.r~ GET QUOTES Finance Search Wed, Jul 21, 2010, 11:17'AM EDT - U.S. Marice~ts close in 4hrs 43mins Vodafone Group plc (VOD) ~~~~a E~kTRAD SECURITIES LLC Historical Prices SET DATE RANGE Start Date: Mar 5 End Date: Mar ~ 8 At 11:02AM EDT: iZZ.34 "~`' 0.17 (0.77%) " ~' .'95 t r Y + Get Historical Prices for: GO ~o> Daily 2010 Eg. )an 1, ;; - :; Weekl zolo _. Y 2010 ~" _ .~ Monthly ~" _ :~ Dividends Only Get Prices AdChoices ~~M~ i~r~~~~~ m~~r ~~_~°~~: SALES ~~~~~ First ~ Previous ~ Next ~ Last PRICES Date Open High Low Close Volume C ose" Mar 8, 2010 22.45 22.54 22.33 22.49 5,208,800 21.59 Mar 5, 2010 22.19 22.55 22.12 22.47 5,096,800 21.57 * Close price adjusted for dividends and splits. First ~ Previous ~ Next ~ Last '~' Download to Spreadsheet Copyright Jl_010 Yahoo! !nc. Alf rights reserved. Privacy Policy -About Our Ads -Terms of Service - CopYrightllP Policy -Send Feedback - '>'ahoo! News Network Cluotes delayed, except where indicated otherwise. (Delay times are 15 miss for NASDAQ, NY5C and Amex. See also delay times for other exchanges. Quotes Metropolitan Life Insurance Company P.o. sox 10342 Des Moines IA 50306-0342 MetLife July 2, 2010 GERALD J SHEKLETSKI ATTORNEY AT LAW POBOXE NEW CUMBERLAND PA 17070 RE: METROPOLITAN LIFE INSURANCE COMPANY CONTRACT 030 069 413 MA DECEASED ELEANOR MILLER Dear Mr. Shekletski: This is in response to your request for a Statement of Values for the above annuity contract. As requested, the values are enclosed. If you have any questions, please contact your representative or call our Customer Service Center at 1-800-638-7732 Monday through Friday between 9:00 a.m. and 6:00 p.m., ET. Sincerely, Connie S Brown MetLife Annuity Operations and Services Metropolitan Life Insurance Company P.O. Box 10342 Des Moines IA 50306-0342 Statement of Value of Annuity Contract MetLife 1. Name and address of Insurance Company Metropolitan Life Insurance Company, One Madison Avenue, New York, NY 10010 2. Name of Annuitant 3. Date of Annuitant's Death 4. Annuitant's Social Sec. No. ELEANOR MILLER 3/6/2010 19516 3142 5. Contract Number 6. Type of Annuity 7. Date of Issue 030 069 413 MA DEFERRED 8/6/1987 8. Owner's Name 9. Assignee's Name 10. Date Assigned (Attach copy of Application) (Attach copy of assignment) ELEANOR MILLER N/A N/A 11. Name(s) of Beneficiary(ies) LINDA M CUSHNER BRENDA M SWARTZ 12. Description of Contract NON QUALIFIED 13. Value of annuity contract on date of death of Annuitant . This represents the death benefit as follows: Accumulation Value on Date of Death $32,356.24 Cost Basis/Return of Payments $32,519.56 Interest $22,519.56 Total Payout $10, 000.00 14. How payable: One Sum See Remarks 15. Remarks CLAIM PAID PAID BY APRIL 27, 2010 The undersi ned hereb certifies that this statement sets forth true and correct information. 16. Date of Certification Signature Title July 2, 2010 ~ .s' ~~orr~ Annuity Representative -Post Issue Processing CUN ~ STATEMENT OF VALUES Claim # 100325022 Insured: Eleanor W Miller BENEFITS Amount of Insurance or Annuity ....... Term Insurance Additions ................. Accidental Death Benefit .................. Paid-Up Additions ............................. $163, 570.58 $o. 00 $o.oo $o.oo Dividend Accumulations ................... $0.00 Interest on Accumulations ' .............. $0.00 Regular Dividend .............................. $0.00 Termination Dividend ........................ $0.00 Policy: 000060125651 Type: ANNUITY DEDUCTIONS Policy Loan ....................................... $0.00 Interest on Policy Loan ..................... $0.00 Premium ........................................... $0.00 Miscellaneous Deductions................ $0.00 Total Deductions ............................ ;0.00 SUMMARY Premium Refund ............................... $0.00 NET BENEFIT.................................. ;163 570.58 Advance Premium Deposit $0.00 INTEREST'* ..................................... i445.2g Interest on Advance Premiums ........ $0.00 Miscellaneous Benefit ....................... TOTAL BENEFIT........................ 6163,975.84 Total Benefits .................................. ;163,570.58 ' Interest on accumulations while the policy was in effect will be reported to the policyowner on Form 1099-I. "Interest on net benefit is reportable as taxable interest to the beneficiary(ies). SETTLEMENT BENEFICIARY: Ms Linda M Cushner Benefit: $81, 785.29 **' Taxab/e Interest: Federal Withholding: $0.00 "*"'' Taxable Income: State Withholding: $0.00 Paid to Assignee: $0.00 Net Payment: $81, 785.29 Left at Interest -Supplemental Contract- 5 Year Deferral $0.00 $0.00 Special Remarks: SETTLEMENT BENEFICIARY: Ms Brenda Snell Benefit: Federal Withholding: State Withholding: Paid to Assignee: $81, 785.29 $3,178.53 $0.00 $0.00 Net Payment: $79,012.02 Special Remarks: By Check "** Taxable /nter~est: "**' Taxable income: 3SR "' Interest amount reportable on Form 1099-t as taxable interest to the beneficiary(ies). "" Amount of distribution that will be reported as income to the beneficiary(ies) an Form 1099-R. Printed: 4l20t2010 Form Ot-3448 $405.26 $31, 785.29