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Home My WebLink About02-0636JRD/June 30, 1992/17858 JUL l 200 In Re: Estate of Deanna E. Miller Late of East Pennsboro Township Estate No.: 2002-636 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-Deanna E. Miller NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Robin J. Parker Counsel for Personal Representative: Bruce J. Warshawsky, Esquire Date of Decedent's Death: 06/10/02 Date of Delinquency Notice: 07/14/04 The undersigned, Glenda Famer-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a heating to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Distribution: Date: 07/14/04 ~ Glenda Famer Strasbaugh Clerk of the Orphans' Court onal Representative ~C~nsel for Personal Representative i/Estate File A heating is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the heating date, the hearing will automatically be cancelled.~:~ Name of Decedent: Date of Death: Will No.: _STATUS REPORT UNDER RULE 6.12 Admin. No.: _~=_0_~L - 0 } Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether admini~on of the estate is complete: Yes [~ No ~ - 2. If the answer is No, state when the personal representative that the administration will be complete: bin ~.,~,,,~ _ reasonably believes 3. If the answer to No. 1 is Yes, state the following: ~ O~,/ss- ' - ' Did the personal representative file a final account with the Court? Yes _ No [] The separate Orphans' Court No. (if any) for the personal representative's account is: Co Co pate: _~¥ Did the personal representative state an account informally to the parties in interest? Yes []] No Copies of receipts, releases, j oinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Name ~-,, e_~ Address ~1~- ol ~0o- O~y 7 o Telephone No. Capacity: 1--] Personal Representative [~ounsel for personal representative IN RE: ESTATE OF DEANNA MILLER, : IN THE COURT OF COMMON PLEAS OF B YROBIN J. PARKER, AD MINIS TRA TRIX Decedent's SSN: 206-70-1755 Date of Death: 06/10/2002 CUMBERLAND COUNTY, PENNSYL VA]VIA ORPHANS' COURT DIVISION DOCKET NO. 21-02-636 TO: REGISTER OF WILLS AND CLERK OF ORPHANS' COURT PRAECIPE TO ENTER APPEARANCE/CHANGE OF ADDRESS AND LA W FIRM AFFILIA TION OF COUNSEL Bruce J. Warshawsky, Esquire has changed his law firm affiliation and address and will continue to represent Administratrix of the Estate of Deanna Miller, Robin J. Parker, in the above captioned action. Please kindly enter the appearance of Bruce J. Warshawsky, Esquire and the Law Firm of Cunningham and Chernicoff,, P.C., on behalf of Administratrix of the Estate of Deanna Miller, Robin J. Parker, in the above captioned action. CUNNINGHAM & CHERNICOFF, P.C. Br~'~e ~. I~arshawsff~y, Esquire PA Supreme Court ID# 58799 CUNN1NGHAM & CHERNICOFF, P.C. 2320 N. Second. St. Harrisburg, PA 17110 Mailing Address: P.O. Box 60457 Harrisburg, PA 17106-0457 (717) 238-8187 Attorneys for Administratrix, Robin J. Parker PRAECIPE TO WITHDRA W APPEARANCE Kindly withdraw the appearance of Metzger, Wickersham, Knauss & Erb, P.C. on behalf of Robin J. Parker, Administrator of the Estate of Deanna E. Miller, in the above captioned action. Dated: METZGER, WICKERSHAM, KNA USS & ERB, P.C. Steven Pt'Miner, Esquire P.4 Supreme Court ID# 38901 Met~ger, Wickersham, Knauss & Erb, P.C. 3211 N. Front. St. Harrisburg, P.4 17110 (717) 238-8187 CERTIFICATE OF SERVICE I, Julieanne Ametrano, Legal Secretary for the law office of Cunningham & Chemicoff, P.C., do hereby certify that a tree and correct copy &the Praecipe to Withdraw Appearance/Enter Appearance in the above-captioned matter was sent first class U.S. Mail, First Class Mail, postage prepaid on this date, to the following: Steven P. Miner, Esquire METZGER, WICKERSHAM, KNAUSS & ERB, P.C. 3211 North Front Street Harrisburg, PA 17110 Date: C~AM & CHER~IICOFF, P.C. / / Julieanne Ametrano 2320 North Second Street P.O. Box 60457 Harrisburg, PA 17110 (717)238-6570 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/03/2005 WARSHAWSKY BRUCE J ESQ CUNNINGHAM AND CHERNICOFF P.C. PO BOX 60457 HARRISBURG, PA 17110-0457 RE: Estate of MILLER DEANNA E File Number: 2002-00636 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/10/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~F~~~ REGISTER OF WILLS cc: File Personal Representative(s) Judge o PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of _DtaYlV\r( E .iV1d ley' also known as No. ---.21 - 02- (03 tb To: Register of Wills for the { County of {U""'~b" in the Commonwealth of Pennsylvania Deceased. Social Security No. ~O(,,- -'0 - ( 7.')':;,- The petition of the undersigned respectfully represents that: Your petitioner(s), whofuYare 18 years of age or older, appl l'eS for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in eM b.e/ lane! County, Pennsyl~ania, with >11 hell'"' last family or principal residence at t.J ve d t. /C1~d L':UIP ,GtJT~"/J (];..."H,//. .f1rr (list street, number and municipality) . ,i/O'J,.. I years of age, died , ( Ju 10 Decendent, then at 1/ Decendent at death owned property with estimated values as folllows: (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: $ $ $ $ o 00 0'00 o . or) 0, 00 Petitioner_ after a proper search h~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: ame (lrjtb.r e/ II !l-elationship WI () (1-, e-r- ev ,<,d ''" t:J':;Ptf nOJS" p/,. ...d ,l'flI70d5' THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. " 'or u " " ~3 "" ",g -00 1::".0 ce"';:: -" ~o. "~ 00 " " ~ Ui tL1 PJL /2061n J'. rJt:vk.ev- r"q;). r/ll),,-t sr. (__n(-r(:t>A~''''''') /IV." rr fil.i/i/,4../ TWf". E...o/'1 pj4, I ?oJ, '" ''i-'fi-LI OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF C (hJ4 b-t/{I1/dJ } ss:t. o r......J c_ c. r-- ~ N The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. ~.~.;JJL rZo 10,/1 . fi r kif ~ ~ ~ " ~ ;:I - os = "" iJ5 Sworn to or affi\'2'~ and subscribed r before me this T day of j) t];~ tl .~~ Register L Estate of No. 21-(J2- (a~lo ~tl"'Y1C( E' Ih/I/ev , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW JULY 15, 2002 W_. in consideration of the petition on the reverse side hereof, satisfactory proof havins been presented before me, IT IS DECREED that Po hi/) (. tJa,ru-,,- is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration 12 0 '" I ...., <. . /Jar /!:.e.-.-- /!((I/1 '1~ e. ;/hI 'I(~ are hereby granted to in the estate of gi"er~ll; C?~~ FEES Letters of Administration $ 18.00 Short Certificates( ~.......... $ 15.00 Renunciation ................ $ s nn jcp $~ TOTAL _ $1J3:00 Filed .... J:] ::-.~002. .... A.D. 19_ mailed to atty 7-15-2002 f]Y'i/(~5.GLb/J4Ck.v.f7- - ::; t791 ATTORNEY (Sup. Ct. I.D. No.) If h; l'/1y/eslo~;?d, Ikr,r{ 5~JJ1?I/O ADDRESS -j {I - d-S~- fS;-OO PHONE ""\ This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar.' The original certificate will be forwarded 1:0 the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. Date a~... fie v~L t-,.. ~.d_ ~'..~ r ..,';_ ';-'.' /- Local Registrar r/.... (J ~ee for this certificate, $2.00 JUN 1 2 2002 )5.144 Rev, 1/91 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (Coroner) NAME Of oeCEOENT (FilSI. ModdIe. Last) 1. Deanna E. Miller '" 2. Female STIJE FILE NUMBER SOCIAL SECURITY NUMBER ,.206-70-1755 DATE Of DEATH IM""ltl, Day, \"eatl .. June 10, 2002 UNOER1 YEAR MoM'" DaY" UNDER 1 OAY Hoo,. MInuIH OATEOF81RTH (Mool/l,Day.'fila,) PLACEOfDEATH(ct,,,,,k"';y'~'e ""''','''UCIK,,,,,,,,, other ""lei IiOSPlTAl Inpat",M~ EA/Oulpau.n1D ... FACtLITVNAME(U,KJI".81iluhon,II''''st'....la''dnumboKl BlRTHPLACE(C~ya'oc.! S!aloorfou.,I.I"eou"oy) I(INDOfBUSINE ......S DECEDENT EVER IN U.S. AAMEDFDRCES1 v..D NoKJ OTHER ~::QO R.llidllnctoO =IY) 0 ..4/12/1984 CITY. BORO. TWP OF DEATH Derry Twp. 7.CampHi 11, Pa. k. Hershey Medical Center RACE 'Am.rican lnellan, Black. Whita, .te (Specify) White ". 4 Richland Lane 1..CampHill, Pa. 17011 FRHER'S NAME (F"Sl, Middle, Lalli) 11. Robert S. Miller lNFORMANTS NAME (T yJ>>'Prln~ Robin J. Parker DECEDENT'S .'''''''- RESIDENCE (S&e'''SUUClI<#>S ooolller_l 171. Slata Pa. "" clecedenl ~........ lOWnahlp1 17drJ ~~h=alnl~~ot MOTHER'S NAME (F,..!. M..r~, M..don Su,,,..mel l' Robin J. Balash 1NfORMANT'S MAlUN(>AOOflESS(Sl,,,,,,, C~:i.rTown, SIaIe. z,pCOOe) 4 Richland Lane campHill, Pa. 17011 PLACE Of DISPOSITION. NlmeofC_..y, C'lmalory LOCATION -CityfTown. State, Zip Code mOth_Place MAAITALSTATUS.MoIrriad N....'M..n.d.WkIowed. D1VOfced(Spec~y) 14 Never Married 1. 17C.~ Ya.,deceden1lill8d.... East Pennsboro SURVtvlNG SPOUSE (Ilwile, (jOvernai<lll" name) ". ~, 17b.Counl Cumberland "'~. Ramovalf,oonSllll.D o 14. 2002 Chestnut Grove Cemetery ". NAME AND ADDRESS Of FACILITY uc.Richardson F.H.EnolaDr.Enola,Pa.17025 LICENSE NUMBER DATESIG-NED (Monlh,Day,V""'j Marysville, Pa. ,. 17053 LICENSE NUMBER ,,,. FD012774-L u..bNlolmykoowledQe.delllhO<X:l.lrred.tlMli.....dlll..ndplace.l&led {SlgnatuI.'ndT1llel "'. TIME OF DEATH DATE PRONOUNCED DEA (MOnlh, Day, Yea') ". 9:40 p.m. "". June 10, 2002 27. MAT I: EnI..the ........lnju...orc:ompliclltions wh.;:tu'.....dlhedallh. 00 rKllanlltfU>lll'JlOdeoldyinQ, aucII"Q1'~" or.atpilatOl)/."H1. ahOCkOl hurt !allu,.. Lialonly_~..onHChliM. alb. 23<:. ......S CASE REFERRED TO MEDICAl E)(AMINERICOAONER1 VaaIXl NoD Multiple tratuna DUE lOjOA ASACONSEQUENCE Of} MVA CUE 10 (OA AS A CONSEQUENCE OF): ". :Appro.lrnllle ,1N.....a1bel_n lonaelanddealh ! PART II: DIM, ."""lant condilionl contributIng to deMh. bul oot..aultinginl... unde,IVlng ca.....Qi..... In PART I , DUE TO (OA AS ACONSEOUENCE OF)' , WERE AUTOPSY fiNDINGS IUlIlABl.EPRlORlO COMPLETION OF CAUSE OFDEATH1 MANNER OF DE.AJH DATEOF1NJURV (Moolh,Day,Yearj T1MEOf'lNJURY INJURYATWOfII(? DESCRIBE HOW INJURY OCCURRED Nalu,a1 o I\J o HOI'ncidoo o o ~ o PLACE Of INJURY .AI home. !arm. 'ImI, !ac1orv. office :--.:""'rllf"'!!'t Locust Point Rd. May 30, 2002 8:18 p.m. ,.. 0 "iD ejected from vehicle ...0 ,,0 """. P.nd'nglnWlt'llfltio" 2... 21b. CERT"'ER (Checl< only one) 'CERTIFYING PHYllIClAH 1PhySicjan ,*Myin~ cause <>4 <lealll "'tier, """""" r!>Y&ic"''' I..., (;o'OII<JU,",,,,J d....,I, and cornplOOldlle'" 23) TO_....I..."'r~,dNth_......:IIiueoIO__.....).nclmlll'l.........._.. "'- a. Couldnolbtl.x.t..mlned S 'PRONOUMClNG AHD CERTIf'YINQ PHYSICIAN IPhy""''''' to~h P''-'''O'-''lC"'II ""alh and c",lily""J lu ,,-,,<,,,, or 'klalhl To lhebMIoflllr knowlHfoI, dulh _....-.del_lime. clabo, .nclpIace, and due 10 _ca..M(.lancl.............U1_.. SlGNATUREANDTlT DUb. LlCE~SENUMBE DATES DIM'-"1lh.[);oY,'"-1 [] ",. "June 11, 2002 ~AME ANDADDAESS OF PEASO~ WHOCOMPlEiEDcAlISEOFOEATH IIM,,;>I)Trpe"'P~1 Graham ;). Hetrick, Coroner 'IJ'J ,,1271 S. 28th St.. Harrisburg, PA 17111 ."2-- 1:,(,/"", /,/1 RENUNCIATION 2 \.02-(031.0 The undersigned D.t/1V1V\ct t - fV11'/1~ CUM ~~ I CC.r?O\ (206u+ ~. 1Ylt'1 /~r- deceased. In Re Estate of To the Register of Wills of County, Pennsylvania. of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters 0.[: A-d/V1 /111~frn-A'O^ '{<Obi'/') J. /tiv!L-fAr be issued to WITNESS hand this I J 1t.. day of y> { '-t- ')-" (9 J.... .,,- ,~_. f.w-t -i;~8na~~ 48 c;-O wood !CI."cI.. ~ . I?" 0 J c(, f' /I- II 0 J..r::- (Address) (Signature) (Address) (Signature) t.,; p (Address) (/ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Deanna E. Miller Date of Death: June 10. 2002 Will No. Admin.No. 2002 - 00636 To the Register: I certity that notice of beneficial interest required by Rule 5.6(a) ofthe Orphan's Court Rules was served on or mailed to the following beneficiaries of the above- captioned estate on July 29. 2002 Name Address Robin J. Parker Robert S. Miller 692 Front Street. Enola. P A 17025 4850 Woodland Drive. Enola PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: July 29, 2002 ruce J. Warsha 1820 Linglestown Road Harrisburg, P A 17110 (717) 232-8500 Capacity: _ Personal Representative ---K- Counsel for Personal Representative . RW-35 .' IN RE: ESTATE OF DEANNA MILLER, BY ROBIN J. PARKER, ADMINISTRATRIX IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Decedent's SSN: 206-70-1755 Date of Death: 07/13/2002 DOCKET NO. 21-02-636 PRAECIPE To: REGISTER OF WILLS and CLERK, ORPHANS' COURT Please kindly note that my address and law firm affiliation have changed, and that I am continuing my representation of the Administratrix of the Estate of Deanna Miller, Robin J. Parker, in connection with this pen4!,ng case. (") - c:c "...1 (lJ .~\, Ci (I' ..... .~." :;) "'1) \:-' ID <DC: a: ...., N >- ~ METZGER, WICKERSHAM, KNAUSS & ERB, P.C. f3 ,ij , .Q t:: >; <U= .:.5u /;' / , re. m""_, E, , Supreme Court Id No.5 9 3211 North Front Stree Harrisburg, PA 17110-0300 (717) 238-8187 Attorney for Estate of Deanna Miller, Robin J. Parker, Administratrix Date: ~/J&IOJ Document #: 262021.1 280905-1 Register of Wills of Cumberland County Name of Decedent: STATUS REPORT UNDER RULE 6.12 D -e CI. t\ /I C{ E' (J/I ( rt e.,/ 0-10 - dooL J-v 0 d- --00(03 <n Date of Death: Estate No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether arl~iFation of the estate is complete: Yes 0 No 1B' 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: /tv t] v! r ~ I f 1".00 r 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 Date: c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be ~ ~ attached to this report. ~ /J ~ ____________. >MOI_ ff:~ Name _ C0~!'~~O lJotiJnb~"nJ~~ Address --t-t:v'J.A-':::> t1 cU:f\ 'P A i III L; -i I -, ~.-., r) ," >--l I / - ()I___X:"",>-Wu . 0 Telephone No. Capacity: 0 Personal Representative iJ?founsel for personal representative (' -~ , I I I (" JtEV-15011EX.~1 I!! ~~U) ".,,' wi!;8 1i",~ .... !l . OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 02 COUNTY C DE YEAR SOCIAL SECURITY NUMBER 00636 NUMBER COMMCINWEAL TH OF PENNSYlVANIA DEPARTMENT OF REVeNUE DEPT. 280001 HARRISBURG, PA 17126-01301 ... Z W C W " l!l DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Miller, Deanna E. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 206-70-1755 THIS RETURN MUST BE FILED IN DUPUCATE WIlli THE REGISTER OF WILLS SOCIAl SECURITY NUMBER 181 ,. OriginaJ Return o o 181 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintainecl a Uving Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31. 1an 1.'-95 , o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11.Election to tax under Sec. 9113(A){AttactJSdJ 0) ME .;'" Bruce J. Warshawsky wZ 55 ~ IRM NAME (If applicable) ~ ~ Cunningham & Chernicoff ElEPHQNE NUMBER 717/238-6570 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship i!i !:i ~ F ~ " w '" 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. JoinUy Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 06/10/2002 04/12/1984 3. Remainder Return (dale of death prior to 12-13-82) (IF APPUCABlE) SURVIVING SPOUSE'S NAME ( lAST, FIRST AND MIDDLE INITIAL) 4. Limited Estate 6. Decedent Diecl Testate (Attach copy of Wilt) 9. Litigation Proceeds Received 12. Net Value of Estate (Line 8 minus Line 11) 2320 North Second Street Hamsburg, PAl 7110 (1) None (2) None (3) None (4) None (5) 61,117.29 (6) None (7) None OFFICIAL USE ONLY "" = or~;J ~, n " ~~r] . d:J -,-0 - ~ i .- - ,.Tl J = ~i:'j~ '<:j(~ ; ,c;~ ::-X") "-::J . irn _:~ CJ <- c: {'.- f'., ...0 (8) -ry --, I '1 3:61,J:I'1~i III (9) (10) ~~ 7,097.82 D 01 -'" -1-1 (11) 7,097.82 54,019.47 (12) 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) (13) (14) 54,019.47 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of line 14 taxable at the spousal tax rate, 54,019.47 x .00 (15) or transfers under Sec. 9116(a)(1.2) Z 16.Amount of Line 14 taxable at lineal rate x .045 (16) c ~ => (17) .. 17. Amount of Line 14 taxable at sibling rate x .12 i!j " S 18. Amount of Une 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0.00 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0.00 20. 0 _..lIl\1lliBlJljll!llWl!l. Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Dece~ent's Complete Address: STREET ADDRESS 4 Richland Lane CITY ISTATE PA I ZIP 17011 Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) 3. InterestfPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) 4. If Une 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1) 0.00 (2) 0.00 (3) 0.00 (4) (5) 0.00 (5A) (5B) 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred:.................................................................................. b. retain the right to designate who shall use the property transferred or its income;........,........................... c. retain a reversionary interest; or.............................,...............................................,... ...............,................. d. receive the promise for life of either payments, benefits or care?.............................................................. 2. If death occurred after December 12. 1982, did decedent transfer property within one year of death without receivin9 adequate consideration? ...............,..............................................".....................,.........................,....... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 4. Old decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................,.................................................................................... Yes No ~ I o 181 o 181 o 181 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 115B Bungalow Rd. Enola, P A 17025 SJGNATURE OF PERSON ADDRESS ADDRESS 2320 North Second Street Harrisburg, PA 17110 DATE 7-f'7-C'Y DATE For dates of death on or after July 1.199 d 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)J. 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 exemDta 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 decadenfs siblings is 12% [72 P.S. 99116 (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. . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Miller, Deanna E. I FILE NUMBER 21 - 02 - 00636 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 61,117.29 Litigation Proceeds for Cwnberland County, Docket # 03-2098 TOTAL (Also enter on Line 5, Recapitulation) 61,117.29 *' SCHEDULEH FI..ItERAL. EXPENSES & ADMNSTRAT\VE COSIS COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDCNT OECEDENT ESTATE OF Miller, Deanna E. I FILE NUMBER 21 - 02 - 00636 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: I Richardson Fumeral Home 4,625.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Cunningham & Chernicoff -- Bruce J. Warshawsky 2,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 43.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs I Legali\dvertising 179.82 2 Reserve for Costs 250.00 TOTAL (Also enter on line 9, Recapitulation) 7,097.82 REV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, Deanna E. I FILE NUMBER 21 - 02 - 00636 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY "_ ~:?EDENT OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) I Robert J. Miller Father of Minor 8,000.00 4850 Woodland Dr. Decedent Enola, PA 17025 2 Robin J. Parker Mother of Minor Remainder of Estate 521 Stale St. Decedent 2nd Fir. Apt. WestFairview,PA 17025 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 11_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET REV.1513 EX+ (9-00) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Miller, Deanna E. I FILE NUMBER 21 - 02 - 00636 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE I. TAXABLE DISTRIBUTIONS (indude outright spousal distributions) 1 Robert J. Miller Father of Minor 8,000.00 4850 Woodland Dr. Decedent Enola, P A 17025 2 Robin J. Parker Mother of Minor !Remainder of Estate 115B Bungalow Rd. Decedent Enola P A 17025 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 \I - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Bureau of Individual T_ PO Box 280801 Harrisburg, PA 17128-0801 COMMONWEALTH OF PENNSi.._VAN1A DEPARTlIIENT OF REVENUE . Telephone: 717-787-1794 Fex: 717-783-3467 Ern8i1: hmcdtntDrB8t1ltR DB UI May 23, 2005 David H. Rosenberg, Esq. 1300 Linglestown Rd. Harrisburg. P A 17)] 0 Re: Estate ilfDeanna Miller File Number: 2102-0636 Date of Death: 6110/04 Court Number: Cumberland County No. 03-2098 Dear Mr. Rosenberg: The Department of Revenue received a letter concerning the Petition for Approval of Settlement Claim to be filed on behalf of the above-referenced Estate in regard to a wrongful death and survival action. h was forwarded to this Bureau for the Commonwealtb's approval of the allocation of the proceeds paid to settle the actions. Pursuant to the letter, the 18-year-old-decedent died as a result of a motor vehicle accident The 'heirs to the decedent's estIIte ate her parents. n.."'lfwe, any proceeds paid to settle the survival action would pass to the decedent's parents and would be subjectto a zero percent inheritance tax rate. 72 P.S. ~9116(aXl.2). Accordingly, regardless of the allocation of the subject proceeds, there would be no .inheritance tax consequences. Please be advised that based upon these facts and for inheritance tax purposes only, this Department has no objection 10 the proposed allocation of the gross proceeds of this action, $ 420,000 to the wrongful death claim and $ 105,000 to the survival claim. Proceeds ofa survival action, are an asset included in the decedent's estIIte and, although subject to the imposition of a zero percent inheritance tax rate in this instance, they must be reported on decedent's Pennsylvania inheritance tax return. 42 Pa.C.S.A. ~8302; 72 P.S. ~~9106, 9107. Costs and fees must be deducted in the same percentages as the proceeds are allocated. In re Estate of Merrvman. 669 A.2d 1059 (pa. Cmwlth. 1995). I trust that this letter is a sufficient representation of the Department's position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending the hearing regarding it Please contact me if you or the Court has any questions or requires anything additional from this Bureau. Finally, the approval of this allocation is limited to this estate and does not reflect the position that the Department may take in any other proposed distribution of proceeds of a wrongful death 1 survival action. Sincerely, ~t,UC(2~ Holly A. McClintock. Trust Valuation Specia:list Inheritance Tax Division Bureau ofJndividual Tues ~~,-~--.,..,.: ,----~ :: i i'l I ' - - : l\, "':. (Ri~hardson Juneral geome, c!Jnc. 29 SOllTH ENOLA DRIVE ENOLA, PA 17025 (717) i32.0587 MICHAEL G. MURRAY SUPERVISOR STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED Charges arc only for those items tbat you sclcclell or that arc required. If we are required by law or by a Ctmeler) or cremator}' to use any items, we will explain in writing below. Uyou selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay for embalming. You do nOI have to pay for embalming you did nOI approve if you selected arrangemems such as a direct cremation or immediate: burial. 1f we charged for embalming, we .!ill explain why below. For th.S.rvlc. of fJec-/7'laJ 11'1:/1(:',.- Dat.ofD.ath . hlo,"! /0. J "'~;L. Charg.to. 0/'17 /?,rk~r t,//?:</,/Gn.1' /".,,,. Cc.~~ .'of IJ".t10/1 Name Address City State A, CHARGE FOR SERVICES SELECTED. Olher clothing 1. PROFESSIONAL SERVICES . , . Services. of Funeral Dir.ctor/Stalf .. . . · ~t ~~.' ~ I Embalmmg ....................... .. O,h.r preparalion of body .- .- ......- Cremalion urn . . . . . . . . . .. . . . (Descriplion) OTHER (Funeral Home) Immediate Burial. . ... . .. . . . . . . ... '_ OirectCrcmalion................. '_ .- SUB-TOTAL OF SPECIAL CHARGES .. . . . . . . . . . . . . .. C ._ D. CASH ADVANCED .' OpcningGrave ................... SU.B.TOTAL Of FAciLITwiEQuiPMENr ~ . . . . A2 .itL ov Cem.lery Equipmen'. . . . ...... . . .. .==: Lo'andD.ed.................... ._ 3. AUTOMOTIVE EQUIPMENT Newspaper Notices-Local ..... . . .. . V.hicle '0 transf.r r.mains 10 Funeral HOIOfijc> " Newspaper Notices-Out.of.'own.... .~ L"t;. ....1<..&/ Local........................... .~Q Telepbone& Telegrams ............_ Hearse (Cask., Coach) 1;).') J~ Air/arc......................... ._ Local..... ...... ............ .... .----=-. Clergy/Mass Offering.............. ./1)() ,0" Limousine Pallbearers. . . .. .. . ..' . . . . . . . . . .. '_ Local........................... ._ Certified Copies of the Death ''It;-GO Family:car " Certificate ....;..........:......I~ Local............................ 1_ Police Escorl .-r;....'("..........- Flower car or floral disposition Flowers... . 'T.4 ."!1.'. 'dr-. . . . . . .. ...::::::....- . Local........................... ._ VaultServiceCharge..............._ Lead car/clergy car .- Local. ......... ..... ..... ....... ._ :- Car for pallbearers . - Local............................_ .- Out oC ,own rtansporratlon ......... ._ . - , :- oJ SUB-TOTAL OF ADVANCES...........~..... D .);;1.0.()() SUB-TOTAL Of.AUTOMOTlVE EQUIPMENT........ A3 . 5"<," w. charg. you for our services in obtaining, . ..' (specify cas/) advances tbar are marked-up) , ,. TOTAL OF PROFESSIONAL SERVICES, fACILITIES AND AUTOMOTIVE '. ~9~~~: ...... .,'~:..::.................... A B. ~~W">~p.~~~r.~.~~~loI (DcscrIJll1on) q r . J ~ : oi OiC::;' ,Me;! - ". d-f~ ,-r, " < Other Rec ptaclc:................. ._ i (Description) '. ;,OuI.r bUrlalcontaincr.e~-u:~'!"'Z?dll' .0 (.J ..j:, (Dcscrlf~ /~qu-,t:I.. c;...~ J'" ~ ;"::i~ ,I, a" /- -rf!"~ ~ . SUB-TOTAL 0; 'PRofESsiONAL SEiivl~~.. .. AI .; 7'-K. t/v 2. FACIUTlES AND SERVICES Use of faciliues and servic.s for~ r ::! S"<l . <ioJ vl.wing (ViSltation/Wak.).),....... ._ Use of faciliues and ,ervices ~ 9S" ,J oJ for funeral ceremony ............ ._ Use oC faciliues and services for MemorialServ!c. ................_ Use of .quipm.nt and ,.rvlces for gravcslde service............. ._ O,h.r use of facilities .- I- .- TOTAL MERCHANDISE SELECTED. . . . . . . . . . . . . . . C. SPECIAL CHARGES, I . Forwarding of remains to ... B.~';.J .- (Funeral Hom.) Receiving of remains from .- (,e) ) . -::J.7/1',.~ :.SUMMARY OF CHARGES A: ProCessional Services, Facilities and .=~:::::' .~d A.utom.otlve......... .?/ (~. Q ~ 8, Merchandise..................... Jf Go 0" . C:Spccial Charges ...................~ tJ" . Df Cash Advances........ .'.......... ._- .....,_:;" TOTAL OF ALL SECTIONS........................ ._ . :::.: PAID AT TIME OF OR PRIOR TO '~I,ARRANGEMENTS................................ .-m--r~-. 0" ,L. BALANCE DUE.................................. .-=.= ',: ,~'.!,;:.,. . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Harrisburg District Office; Lobby, Strawberry Square, Harrisburg, P A 17128-0 101 Phone: (717) 783-1405 FAX: (717) 783-4447 Web: www.revenue.state.pa.us JULY 19,2004 ESTATE OF: EANNA E. MILLER DATE OF DEATH: 06-10-2002 FILE NUMBER: 21 02-0636/2004-24 (Please remit top portion with your payment) ------------------~---~------------------_._------- BURCEJ. WARSHAWSKY' 3211 N FRONT STREET PO BOX 5300 HARRISBURG, P A 17110 Dear BURCE J. W ARSHA WSKY: A review of our records has disclosed that you are responsible for the settlement of the above estate, or that you represent the responsible party. This is to advise you that the above estate is in a delinquent status. According to our records, as of this date, the estate still is not settled. The Inheritance and Estate Tax Act, mandates the filing of a tax return and payment of all outstanding liabilities by a personal representative of the estate or a transferee within nine months of the decedent's death. The Department's records show that this estate remains open because: AN INHERITANCE TAX RETURN HAS NOT BEEN FILED. Ifthe return has been filed it is important that you contact us immediately. If this estate was opened for the purpose of a lawsuit, please contact this office in writing with the term and docket number of the lawsuit so that we may postpone any further action. We are extending a thirty day courtesy period from the date of this letter to permit you to file the return. If you fail to do so, the Department of Revenue will make a formal demand on you or your client and, if necessary, institute legal action. lA Sinc S). ~~~ SIn Jose~ ce I ~ Area erations Director/Central Region . .~-----j ;U~2 ~:,;~\ -~_..--------' MAKE CHECKS PAYABLE TO: REGISTER OF WILLS. AGENT Any questions regarding this estate, please CONTACT: BRIAN BEAM (717) 783-1405 / /' RECEIVED JUN 01 2005f ROBIN J. PARKER, Administratrix of the Estate of DEANNA E. MILLER, Deceased, Plaintiff . : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 03-2098 v. JESSICA FREEDMAN and JACK R. ANDERSON, III, Defendants : CIVIL ACTION - LAW AND NOW, this 304 ORDER OF COURT day of ~ , 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that: 1. The above parties may compromise the action set forth in the Petition to Approve Settlement of Wrongful Death and Survival Actions for the principal sum of $525,000.00. 2. Robin J. Parker,Administratrix ofthe Estate of Deanna E. Miller, Deceased, is authorized to distribute the monies in this action as follows: a. Authorize the payment of counsel fees in the amount of $210,000.00 and costs in the amount of $7,413.55 to Handler, Henning & Rosenberg, LLP, from the funds due; b. Authorize the paymentto the Estate Administrator for Attorneys fees and expenses in the amount of $2,000.00 to Bruce J. Warshawsky, Esq.; and c. Direct distribution of the remaining net proceeds of the settlement as follows: i. To the Petitioner for the wrongful death action, in the amount of $244,469.16; ii. To the Estate of Deanna.E. Miller, for the survival action in the amount of $61,117.29; Hi. The allocation of the Settlement of 80% to the Wrongful Death Action and 20% to the Survival Action as approved by the Department of Revenue and; iv. The payment of $40,000 to Robert Miller representing his total interests in the Wrongful Death & Survival Settlement is approved. BYT J. fRUE COPY FROM RECORD In Testimony whereof, I here unto set my hand and the seal of said ~ CittisIe Pa. This 3'"7-1/. at ~. ',,*,.s' . J. ;IJ.I. ~ PlultlOllCllllY . Register of Wills of Cumberland County, Pennsylvania INVENTORY , Deceased No. 21 - 02 - 00636 Dale of Death 6/10/2002 Social Security No. 206-70-1755 Estate of Miller, Deanna E. also known as Robin J. Parker The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Attorney: Bruce J. Warshawsky Personal Represen7l j! AI Signature: -J, <.JL--- binJ. P er Signature: I.D. No.: 58799 Signature: Address: 2320 North Second Street Harrisburg, P A 1711 0 Address: 115B Bungalow Rd. Enola, P A 17025 Telephone: 717/238-6570 Telephone: 717-732-1418 Dated: 7/1 9/ (6 Personal Property Litigation Proceeds for Cumberland County, Docket # 03-2098 61,117.29 Total Personal Property $61,117.29 ..:: c::> u_^ C~i c- , LU _: t~ ~~- u_ (~) c: UJ o a:::. o C) L'-.J L.C" ~ :E: I-L u- C) ~/ r.~ V' N LL!"~- -.J U ~;~ =:) ~ 8~:..; ~ u = ~ (Attach additional sheets if necessary) Total Personal Property and Real Estate $61,117.29 10-18-2005 MILLER 06-10-2002 21 02-0636 CUMBERLAND 101 APPEAL DATE: 12-17-2005 ( See reverse side under Objections) Amount Remitted[ ] MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 PYr_~~p~p_r~l~_~l~~______~___~~r~!~_~p~~~_~p~r!p~_fP~_!PY~_~~~P~P~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DEANNA E FILE NO. 21 02-0636 ACN 101 nr-r", .''1 ~ ,'"\ ~;"'; BUREAU OF INDIVIDUAb'TAXES . INHERITANCE TAX DIVISIO~ PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ?'. - - !;~"I.. ~ ! ,) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN BRUCE JWARSHAWSKY CUNNINGHAM & CHERNICOF 2320 N 2ND ST HBG PA 17110 ESTATE OF MILLER TAX RETURN WAS: (X J ACCEPTED AS FILED J CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AJ 2. Stocks and Bonds (Schedule BJ 3. Closely Held Stock/Partnership Interest (Schedule CJ 4. Hortgages/Notes Receivable (Schedule DJ S. Cash/Bank Deposits/Hisc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule FJ 7. Transfers (Schedule GJ 8. Total Assets nJ (2J (3J (4J (sJ (6J (7J .00 .00 .00 .00 61.117.29 .00 .00 (8J APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule HJ 10. Debts/Hortgage Liabilities/Liens (Schedule IJ 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule JJ 14. Net Value of Estate Subject to Tax (9J nOJ 7.097.82 .00 nlJ n2J n3J n4J NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (lsJ 16. Amount of Line 14 taxable at Lineal/Class A rate (16J 17. Amount of Line 14 at Sibling rate (17J 18. Amount of Line 14 taxable at Collateral/Class B rate (18J 19. Principal Tax Due TAX CREDITS. - REV-1547 EX AFP (06-05) DEANNA E DATE 10-18-2005 NOTE: To insure proper credit to your account. submit the Upper portion of this form with your tax payment. 61.117.29 7.097 8? 54.019.47 .00 54.019.47 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. . .. 1 ,.,,,.., "....".., , I+T AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-J TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 54.019.47 X 00 = .00 X 045 = .00x12= .00 X 15 = n9J= · IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. ^~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ. YOU HAY BE DUE\<S' A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.J JORDAN D. CUNNINGHAM ROBERT E. CHERNICOFF MARC W. WITZIG BRUCE J. WARSHAWSKY JOHN M. HYAMS KELLY M. KNIGHT CUNNINGHAM & CHERNICOFF, P.C. ATTORNEYS AT LAW P.O. BOX 60457 HARRISBURG, PENNSYLVANIA 17106-0457 HERSHEY TELEPHONE (717) 534-2833 IRS NO. 23-2274135 TELEPHONE (717) 238-6570 FAX (717) 238-4809 Street Address: 2320 N. 2nd Street Harrisburg, PA 17110 Writer's Direct Email: biw(Ql,ccIawPc.com November 1, 2005 Register of Wills County of Cumberland One Courthouse Square Carlisle, P A 17013 RE: Estate of Deanne E. Miller File No: 605204 Dear Sir or Madam: Attached find an original and four (4) copies of the Status Report Under Rule 6.12 in in the above referenced matter. I ask that you return the copies to my attention in the self- addressed envelope provided. Should you have any questions, please do not hesitate to contact me. Very truly yours, ~HAM & CHERNICOFF, P.c. Bruce J. w2~!: BJW/ja AttaSnnents . cc - Robin Parker . f:\Ho~JW\HHR\PMii:LER\Ll10105.wPD ...-.' , STATUS REPORT UNDER RULE 6.12 Name of Decedent Date of Death Will No. Deanna Miller 6/1 0/2002 Admin No. 21-02-636 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No. 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. Ifthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal ::unIS roa; ;/JI1~;fu fue Clerk of fue # Court ~:ibe a_hoo 10 tills report. /~ SIgnature Name Bruce J. Warshawsky. Esquire Address 2320 North Second Street P.O. Box 60457 _-:t' Harrisburg. PA 17106-0457 L_j " C,~) j" LLi C)" c::__ 1,t,..1 C~) Ci L! Ii r'".." f 0: I~_- = ~-,-?! t:~; \ ~,'..~ 1'. < ~ ~ "F:\HO~\D~~~R\612FORM.WPD C---.j 1--- Telephone (717) 238-6570 L_ '- Capacity: Personal Representative X Counsel for Personal Representative ('-J I V-l:- APPROVAL OF ACCOUNT, RELEASE AND INDEMNIFICATION ESTATE OF DEANNA E. MILLER, DECEASED THIS AGREEMENT is made this ~~f'^ day of 00~~ 2005, by and among Robin J. Parker, Administratrix (the "Administratrix"), and Robin J. Parker and Robert S. Miller, beneficiaries and heirs ("Beneficiaries") of the late DEANNA E. MILLER ("the Decedent"). The Beneficiaries desire that the administration of Decedent's estate be terminated and that the Estate be distributed without the expense, delay and formality of a court accounting. The Beneficiaries, by executing this Agreement, agree to the proposed distribution as set forth in this document. The Administratrix of the Estate is willing to consent to such a distribution upon receipt of a proper release and indemnification, which it is the purpose of this document to provide. In consideration of the willingness of the Administratrix to make distribution without the formality of a court accounting and agreeing to be legally bound hereby, the undersigned individually and on behalf of their heirs, personal representatives, successors and assigns have entered into this Agreement. 1. Decedent died on June 10, 2002, and her estate is in probate, Letters of Administration having been duly granted to the Administratrix by the Register of Wills of Dauphin County on July 15, 2002. The Administratrix has proceeded with the administration of the estate in accordance with the provisions of Pennsylvania Statutes, and more specifically, 20 Pa.C.S.I0l, et. seq. 2. At the time of Decedent's death, her entire estate consisted of the net proceeds of a Survival Action in the amount of $61,117.29 obtained in litigation docketed to 03-2098 in Cumberland County, Pennsylvania entitled: Robin J. Parker. Administratrix of the Estate of Deanna E. Miller. Deceased v. Jessica Freedman and Jack R. Anderson. III (the "Litigation") and (the net proceeds of the Survival Action shall be referred to as the "Probate Assets"). In addition, the Litigation also generated net proceeds for a Wrongful Death Action in the amount of $244,469.16. By Order of Court dated June 3, 2005 in the Litigation (attached hereto as Exhibit "A"), the Cumberland County Court approved: (1) a global Settlement in the amount of $525,000.00; (2) payment of the Litigation counsel fees and costs of $217,413.55 (inclusive of initial Probate Fees and Legal Advertising costs); (3) payment of the counsel fees and costs for Estate Administration of $2,000.00; (4) allocation of the Settlement as 80% for Wrongful Death and 20% for the Survival Action; and (5) the payment of $40,000.00, (allocated as $32,000 for Wrongful Death and $8,000 for Survival as per the Court Order in the Litigation) to Robert S. Miller, receipt of which Robert S. Miller acknowledges, representing his total interests in the Wrongful Death & Survival Settlement (based upon a May 2, 2005 Agreement executed by Robin J. Parker and Robert S. Miller attached hereto as Exhibit "B" and which was presented to the Court in the Litigation as Exhibit "H" attached to a Petition to Settle Wrongful Death and Survival Actions filed on or about May 23, 2005). Robin J. Parker was paid (1) the remainder of the Wrongful Death proceeds ($212,469.16), from which she, solely, paid additional attorneys fees (for prior Litigation counsel) in the amount of $10,279.15, a net amount of $202,190.01; and (2) the remainder of the Survival Action Proceeds ($53,117.29), from which she, solely, paid counsel fees and costs for Estate Administration of $127.00 (Additional Probate Fees), a net amount of $52,990.29, from which she, solely, paid for the Decedent's funeral in the amount of$4,625.00. 12. This Agreement may be executed in multiple counterparts, and, when so executed, shall be binding upon all of the parties and their respective heirs, next-of-kin, personal representatives and assigns. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written. BENE rJL~ Robin J. P rker Kn~.~.t, ___ Robert S. Miller . STATE OF PENNSYLVANIA COUNTY OF Lu >'Y\ b~r Ie...... J. On this, the ;)... '7 ~ day of Dc..- Iv k r ,2005, before me the undersigned Notary Public, personally appeared Robert S. Miller, who, known to me, or satisfactorily proven, acknowledged that he executed the foregoing instrument for the purposes therein contained. : ss lJ\A.L IY7 N tary Public M Commission Expires: COMMONWEAUH vI-- 2ENNSYLVAI'llr, Notarial Seal Tina M. RoberV'Y.I, Notary Public East Pennsboro TWIJ., Cumberland County My CommiSSion Expirf;S Nov. 15,2007 Member. Pennsylvania Association Of Notaries F:\HOME\BJW\HHRIDMILLERIFAMSET. WPD STATE OF PENNSYLVANIA COUNTY OF Cuwvh~r'C<.-.-. d 9t-... On this, the c2. '1 day of () c.- +n h~ r ,2005, before me the undersigned Notary Public, personally appeared Robin J. Parker, who, known to me, or satisfactorily proven, acknowledged that she executed the foregoing instrument for the purposes therein contained. : ss set my hand and official seal. COMMONWEALTH OF PENNSYLVAi'....-. Notarial Seal Tina M. Robertson, Notary Public East Pennsboro Twp., Cumbertand County My Commission Expires Nov. 15, 2007 Member. Pennsylvania Association Of Notaries