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HomeMy WebLinkAbout03-0345Register of,Wills.of York County,. Pennsylvania PETITION FOR GRANT OF LETTERS. Estate of ANNA PAULINE MIT,T,k'~R also known as NO. , Deceased Social Security No. 165-20-1386 Petitioner(~) who !s/.a~.~ 18 years of age or older, app.(les) for: (COMPLETE A OR"B" BELOW) [~ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execute decedent, dated and codicil(s) dated named in the last Will of the ( State relevant circumstances, e.g. renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: [~ B. Grant of Letters of Administration Petitioner(~ after a proper search has/have (if any) and heirs: Name (d.b.n.c.t.a.; pendente lite; durante absentia; durante rninontate) ascertained that Decedent left no Will and was survived by the following spouse Relationship Residence David R. Mi l ler son (COMPLETE IN ALL CASES:) Attach additional sheets if necessary 2601 Yale Avenue C,~m~ Hill, PA 17011 Decedent was domiciled at death in Ctr/lber ] an.d County, Pennsylvania, witllN3~ther last family or principal residence at 323 North Street. Boiliruz Sorin~rs. PA (Boilin~ Snrin~s Borons,h3 (list stree-t, n~mber,'~nd municipality) ..... Decedent, then 80 years of age, died ~arch 25 ,2003 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: single-fami ly residence at 323 North Street, ,at Boilin~ Snrin~s. - (£ocatio~) $ 5,000.00 $ PA 17007 $ $ 50,000.00 Boiling Springs, PA 17007 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with 'this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence snace/VVllls PetGrant LtJ2001 David R. Miller 2§01 Yale Avenue Ca?p, Hill, PA 17011 ", Oath. of perso6al RePresbhtative Commonwealth of pennsyv a . I ani County of York The Petitioner(~) above-named swear(s) Or afffirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief or Petitioner¢~ and that, as personal representative~ of the Decedent, Petitionf~ will well and truly administer the estate acco to law. Sworn to or affirmed and subscribed '~~ DAVID R. MILLER before me this ~day of 20 Donna M. Otto, lsCor the Register DA~). utv No. 21-2003-345 Estate of ~ PAU~I~ MII,I,~. Deceased Social Security No.: 165 20 - ~386 Date of Death: March 25, 2003 AND NOW, Apri 1 21st ,20 03 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary :1~ Of Administration d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate are hereby granted to DAYfI) R. MIT,f,A~R in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ............ $. 115.00 Short Certificate(s) .(~.~ 6.00 Renunciation ....... $ Affidavits ( ) .... ... $. Extra Pages ( ) .....$ Codicil ............ $ JCP Fee ........... $ 10. O0 Inventory ...........$ Automation Fee ..... $. Other .............. $ TOTAL ........ $. 131.00 Address: Telephone: P. O, Box 310 Dillsburg, PA 717-432-9733 17019-0310 Mailed letters to administratrix on 4/21/03 snace/WillsPetGranttt/2001 his is to certify that the information here given is correctly copied fi-om an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent f~ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. . ~~ ~ Registrar Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENI OF HEAL?H · VITAL RECORDS CERTIFICATE OF DEATH ,. Anna Pauline Miller l, Female ]. 165 _ 20 _ 1386 l, March 25, 2003 s. I ~ I ] Ik- I~- le. ' ' I~. o~k~h~~ , Own Home i ~ ~ /~t~] ~ I o~ i ,u=,,,a~m I ~ ~' / ~'~ 1~ 2~'5.~ ~dowed 323 North Street J~[~E 17,.~.......... ' Boiling Springs, PA 17007 I Cumberland Robert Hampton ~om~..s.~,~,~...~.J..~,s~,~.~ Sara Beaver David R. Miller ~g ~e,~amp ~ Pa. 17011 ~J ' ' Mar 28, 2003 Mt. Zion Cemete~ I Carlisle, Pa. 17013 ~ FD-014318-L ~ Myem Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa ~7055 · . I15o ~ -~5-o~ .. La' 21-2003-345 IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT M~AN THAT YOU WILL RECEIV~ ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTheRWISE. Whether you will receive any money or property will be determined wholly or partly by the decedent's Will. If the decedent died without a Will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA In re: THE ESTATE OF: ANNA PAULINE MILLER ESTATE NO. 2103-0345 To: DAVID R. MILLER Please take note: The Decedent, ANNA PAULINE MILLER, died on the 25th day of March, 2003, at 323 North Street, Monroe Township, Cumberland County, Pennsylvania. The personal representative of the Decedent is: DAVID R. MILLER 2601 Yale Avenue Camp Hill, PA 17011 (717) 761-4344 The Decedent died Intestate (without a Will). A Petition for the Grant of Letters of Administration was filed with the office of the Register of Wills. Register of Wills of Cumberland County 1 CourthOuse Square Carlisle, Pennsylvania 17013 (717) 697-0371 A copy of the Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. · . SCH~-ri~, I ,~S~UIR~ 124 West Harrisbur~ Street P.O. Box 310 Dillsburg, PA 17019 (717) 432-9733 Counsel for Personal Representative SCHRACK & LINSENBACH LAW OFFICES 124 W. HARRISBURG ST. P.O. BOX 310 DILLSBURG, PA 17019-0310 PHONE (717) 432-9733 FAX (717) 432-1053 WM. D. SCHRACK III BRIAN C. LINSENBACH August 5, 2003 Register of Wills of Cumberland County Cumberland County Court House Carlisle, PA 17013 Re: D/D: File #: SS #: Estate ofAnna Pauline Miiler March 25,2003 20 03-00345 165-20-1386 Ladies: You will find enclosed in this mailing the following: A. The original and one copy of a Resident Decedent Inheritance Tax Return, executed by the Executor and by me; B. A "COPY" of the face sheet of the Return; and C. The original and one copy of the Status Report, required by Rule 6.12. Please accept the Return as presented, time stamp the face page "COPY", and return it to me. Please also accept the Status Report, and return to me a time stamped copy of that Report. Attached to the bottom of this letter, to facilitate the transaction, you will find Executor's checks as follows: Check #212, payable to the Register of Wills, Agent, for the sum of $4,421.45, reflecting the calculated Pennsylvania Inheritance Tax liability; and Check #213,payable to the Register of Wills, for the sum of$15.00, that is the filing fee required for processing the Return. I enclose a self-addressed, stamped envelope by which I request that you return to me the face page of the REV- 1500, the Status Report, and the appropriate receipts. Thank you for your attention to this request. WDS/jsg enc. Sincerely, Wm. D. Schrack ~I SCHRACK & LINSENBACH LAW OFFICES CERTIFICATION OF NOTICE UNDER RULE 5.6(a} Name of Decedent: Date of Death: Estate No. ANNA PAULINE MILLER MARCH 25, 2003 2103-0345 To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiary of the above-captioned estate on April 28, 2003. .,Name DAVID R. MILLER Ad&ess 2601 Yale Avenue Camp Hill, PA 17011 Notice has now been given to all persons' entitled thereto under Rule 5.6(a) except none. WM. D. SCHRACK, IH, ESQUIRE 124 West Harrisburg Street P.O. Box 310 Dillsburg, PA 17019 (717) 432-9733 Counsel for the personal representative CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No. ANNA PAULINE MILLER MARCH 25, 2003 2103-0345 To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiary of the above-captioned estate on April 28, 2003. Name Address DAVID R. MILLER 2601 Yale Avenue Camp Hill, PA 17011 Notice has now been given to all persons' entitled thereto under Rule 5.6(a) except none. WM. D. SCHRACK, III, ESQUIRE 124 West Harrisburg Street P.O. Box 310 Dillsburg, PA 17019 (717) 432-9733 Counsel for the personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003346 MILLER DAVID R 2601 YALE AVENUE CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 165-20-1386 FILE NUMBER: 2103-0345 DECEDENT NAME: MILLER ANNA PAULINE DATE OF PAYMENT: 12/19/2003 POSTMARK DATE: 12/18/2003 COUNTY: CUMBERLAND DATE OF DEATH: 03/25/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,421.45 TOTAL AMOUNT PAID: $4,421.45 REMARKS: DAVID R MILLER SEAL CHECK# 212 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 - REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Miller Anna Pauline DATE OF DEATH (MM-D~YEAR) I DATE OF BIRTH (MM-DD-YEAR) 03~/~C) 03 ] 06/29/1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 2003-00345 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 165-20-1386 REGISTER OF WILLS SOCIAL SECURITYNUMBER 1. Odginal Retum 2. Supplemental Retum 3. Remainder Retum pn C A mP La 4. Limited Estate . ~la~)l~r~z[~t'~ Compromise (date of death after 12-12 5. Federal Estate Tax Return HEPA P ,n C° 6. Decedent Died Testate BeqeiJedt Maintained a Living Trust 8. Total Number of Safe DaDo C R ~ ['~ (Attach copy of Will) (~fftec~:ssopy of Trust) KOl~sK 9. Litigation Proceeds Received~-----J 10. Spousal Poverty Credit r~ 11. Election to tax under Sec. 9 ~d;8~f death between 12-31-91 and 1-1-95) (Attach Sch O) C O R R E S R E C A P I T U L A T I O N C O M T I O NAME Wm. D. Schrack III Esq. FIRM NAME (if Applicable) Wm. D. Schrack, III Esquire TELEPHONE NUMBER 717/432- 9733 COMPLETEMAILINGADDRESS 124 W. Harrisburg Street Post Office Box 310 Dillsburg, PA 17019-0310 1Real Estate (Schedule A) (1) 2Stocks and Bonds (Schedule B) (2) 3Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4Mortgages & Notes Receivable (Schedule D) (4) 5Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6Jointly Owned Property (Schedule F) (6) [~eparate Billing Requested 7inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8.Total Gross Assets (total Lines 1-7) 9Funeral Expenses & Administrative Costs (Schedule H) (9) liZ)ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11Total Deductions (total Lines 9 & 10) la, let Value of Estate (Line 8 minus Line 11) 105,92~rQ0 NOne None None 5,935.33 None None 12,962.87 640.00 13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) l~let Value Subject to Tax (Line 12 minus Line 13) (8) (11) (12) (13) (14) OFFICIAL USE ONLY 111,857.33 13~602.87 98,254.46 98,254.46 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 150,rnount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16Cu'nount of Line 14 taxable at lineal rate 17Amount of Line 14 taxable at sibling rate 18~,mount of Line 14 taxable at collateral rate l~rax Due 98,254.46 x .0 0 (15) 0.00 x .0 45 (18) 4,421.45 x .12 (17) 0.00 x .15 (18) 0.00 (19) 4,421.45 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00) Decedent's Complete Address: ;TREET ADDRESS 323 North Street CITY Boilin8 Sprinss STATE ZIP ?A 17007 Tax Payments and Credits: 1.Tax Due (Page I Line 19) 2Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Total Credits ( A + B + C ) (2) 4,421.45 3Jnterest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4Jf Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ......................... r'~ ~ 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? ................... 2if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ [~ ~] 3Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. F-'I ~ 4Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ~ F-~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 0.00 0.00 0.00 4,421.45 0.00 4,421.45 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my kno~edge and belief, it is tr~e, correct and complete. Declaration of preparer other than the personal representative is based on all information of vYnich preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETU.~,I Dav i d R. Mi 11 er , '- V6i7 ......................... SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Wm. D. Schrack, III Esquire ~ ~ ~ -- 124 W Harrisburg Street .... For dttes of det~ on or t~er July 1, 1994 ~nd before dtnut~ 1, 1995, ~e t~ r~ta iB~s¢ on the net v~lue of trtnsfeB to or for ~e use of the su~iving s~use is 3% [72 P.8. 9116 (t) (1.1) (i)]. For dttes of death on or a~er danuaw 1, 1995, ~e ~ rata i~s~ on the net vtlue of tansfers to or for the use of the subbing s~use is 0% IT2 P.S. 9116 (~) (1.1) (ii)). The stttute doe~ not exempt t transfer to t sullying s~use from t~, a.d ~e s~t.to~ requimmen~ for disolosure Cf ~ssets and filing t ~ return ~re still appliotble even ~ ~e s.~ivi.g s~.se is the only For dttes of det~ on or t~er duly 1,2~: ~e ~ rate i~s~ on ~e net vtlue of ttnsfe~ fro~ a d~ets~ child ~en~-one yetB of t~ or younger tt det~ to or for ~e use of t n~turel perent, an ~ptbe Brent, or I stapperent of ~e ohild is ~% [72 R.8. 9116 (t) (1.2)]. ~e t~ rate im~s~ on the net value of transfers to or for the use of ~e d~ent's linal bene~oi~des is 4,5%, exoept ~s not~ in T2 P.S. 9116(1.2) [72 P.S. 9~ ~6(a)(1)]. The ~x rate im~s~ on the net value of tmnsfe~ to or for the use of ~e d~eent's siblings is 12% [~2 P.~. 9116(t)(1.3)]. A sibling is define, under Section 9102, ts tn individual ~ho has tt letst one ptrent in oom~on with the d~ent, ~he~er by blo~ or tdoption. Copydghl (c) 28~ fo~ ~o~wa~ only ~e Leckner 6roup, Inc. D A T e A T E REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna Pauline Miller SS~/ SCHEDULE A REAL ESTATE 165-20-1386 03/25/2003 FILENUMBER 2003-00345 All real property owned solely or as a tenant in common must be repo~ted at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with ri~lht of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Sale of property at 323 North Street, Boiling Springs, PA 17007 (Monroe Township, Cumberland County) for $119,000.00, minus expenses (SEE HUD-l) TOTAL (Also enter on line 1, Recapitulation) VALUE AT DATE OF DEATH 105,922.00 $ 105,922.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software o~ly CPSystems, Inc. Form REV-1502 EX (Rev. 1-97) 4660 Trlndle Road - Suite 101 ' ~.1JF~ ' · , 50436~ 232447 ; ::::::' :' a. Mo~. iNS. C~E C. NOTE. ] I,s h)m~ ~s lump,hud lo 9~vu ~u a statement ol acluM seUl~t costs. ~nls paid Io ~d by lhe settlement agent ~e ~. Items ma~ed '{p o c )' wu~u pa~d outside Ihe cbsing; Ihey mo st~ here !~ ~lo[malional purposes and are ~t included in Ihe totals. D NAME A~ ~)ll[ :;5 (Jr ilOllltOWi R E. NAME ~D ~ OF SELLER: F ~E ~D ADD~ ~ ~N~R: KELLY M. BARNIIART ~NA P. MILLER ESTATE ~ERIC~ BRO~RS CO~UIT 323 NORT~ STREET LIBERTY ~ SETTLEMENT SERVICES INC 08/19/03 MONROE ']'OWNS~ ~ [ P, ~Ac~ o~ CUMBERLAND COUNTY, PA. C-21 WA~ 3803 CEDAR AVE. C~P HILL PA J. SUMMAHY OF BORROWER'S TRAN~CTION: ~ SUMMARY OF SELLER'S TR~ON: I~. GROSS ~OUN; DUE FROM BORROWER 4~.GROSS ~OU~ DUETO SELLER tot Cont;acl salus price [[~000.00 401.~tracl sales price [[9000.00 m2. Personnl properly 4~.Per~nal prope~y 103 SnUlomonl (.ha;~us tn t)r~r~owe~ (li~m 14~) ~ ~ 0 ~. ~ 8 403. 104 404. A(l~uslmonts I0; iloms pa~d by seller in advance Ad~uslments for items paid by seller in a~ce 2? 08/T9/03,o 0G/30/04 757.58 ~. 08/~9/03~o06/30/04 75T.58 ..?.SEWER U/[~-9/30,. 94.92 ~o.S~R 8/[9-9/30~o 94.92 ,~o C,IOSSAMOUtlT uuE FROM OOn,O~a 123754 . 58 4~.GROSS AMOU~ DUETO S~L~ 119947.90 m~ AMOUNTS PAID BY OR IN BEIIALF OF BoRnowER ~.REDU~ONS IN AMOU~ DUETO S~L~ ~Ol. Del)OSil or ontr.~sl ,~ey 2 0 0 0.00 ~.Excess de,sit (see hstmclions) ~; Prmcipal ~1 BI new loan(s) 9 52 0 0.0 0 5oz.~lllemenl char~es lo seller (line 14~) 10 52 5.9 0 ~ rxmlm9 ~3,gs) Inkun 5ublect Io ~3.Existin~ ~an(s) laken subiecl 1o m, ~.Pa~ff of First MoAgage Lo~ . 20~. ~.Pa~ff of Se~d Me,gage Loan ~,~. CLOSING COSTS BY SELLER 3500.00 ~.C~SING COSTS FOR B~ER 3500.00 A(lluSImu~ls lot dams u~q~a,d b~ seller Ad~stments for ilems unpaid by seller . ~lO (%tv/To~ la= 1o 510, City~o~ ~x lo ~,1 C,.nily 13x In Sll.C~ntylax to · ~o TOTAL ?klO DY~Ofl 0OflflOWER [00700.00 5~.TOT~ REOU~ON ~U~ DUE ~R, ~ [~02~.~0 ~ CA~4 AT ~LEME/4% FROM OR TO D~IROWER ~.~ AT ~ TO OR FROM ~ I p~ . . . . ~l.(;russafg~d~td~hmnbnffowut(I,ml~) 123754.58 ~t.Or~s a~t ~e to seller (li~e 4~) 119947.90 3o~ t,)ss ~,t I)a,(~ t)y~m t;o,fowof (I,,o ?~) 10 0 7 0 0.0 0 ~.Less rod~t~ a~t due seller (line 5~} 14 02 5.90 ~.CASH(I3FROa) (! ITO) aO~eOWE~ 23054.58 ~.C~H([ZTO) ~ ] FRO~SE~ ~05922 ~00 ~'OMMISS~OHI~Iledonp~'IClS ' ~ ~;119000.00:~' 6.5 FiliGree, o! C(~,,,,%~, (t~i. ?u0) as morrows: Total L<':~i~,''~ ~ 5.00 FUND." %~K$~'~ 7735.00 ,o~ C-21 .: W~J~AK"ASSOC .-- ~"~¥%'RANS. FEE WA~K/W~TZ t2 5.00 ~I~S PAYABLE IN CO~ECTION ~H LOAN ~- L~,, Or,ginm,~ Fuo · ~:~,~7735%- 00 '~e~i.-125 '; 00 l ~03; ^l)r-a,sal I.o, to 804~ Cfoclil Ropoll Io ~05; Londors Inspucl~O~l Feu $275 POC A DV.RES.MTG. 9.50 POC ADV.RES.MTG. 806~ COMMI1M£N[ I IrE AMERICAN BROKERS CONDUIT .480.00 8o7. ]Ax su~wc[ t t Ii AMERICAN BROKERS CONDUIT ~ 75.00 8o8. FLOOD tIAZ^tlt) li:[: AMERICAN BROKERS CONDUIT t 15. 809.[tROKEttPH{MlUM ' $1785 AM.BROKER TO ADVANceD RESIDENTIAL MTG ADVANCED RESIDENTIAL MTG. 810. PROC£S.%IN(; FEE 250.00 811. [r]ROKEI{ FEE I)OO ITEMS iIEOUIIILD [IY LENDER 10 lIE PAID IN Al)VANCE 30. 901. tmu,esl ho,,, 0~/19/03 m0l~/31/03 <~$ 15.2 l/day mo. to ly, s. to $339 POC 901. yrs. Io 197'67t 000. RESERVES DEPOSITED WITH LENDER FOR 1001. I'la/;ltd Insurance 3 1hi) US 28 . 25 /~. I B4 . 7~ ~ lax rT~ ~ $ /mO. ,~ax 7 ,,,o uS 21.22 /mo I 148.54.. ~.SCHOOL 2 ,,o e& 71.66 l, no. ~ 143.32~ I~?. .~ ~ $ /mo. ~ ~. AGG. ADJ. ,,~ ~ ~ /mo. ~ - 134.35 ~ [ ~. ~E CHARGES 101..~elflen'lent IO2. ;d)$1 r acl I~. lille insurance I~, ~umerd I)te~[)ar:ll~ I0 I - ' · '- , laus lo CASH (uIcludos al.~vu d*..nt',, lgo ) 1~. rmllu Insurance to LIBERTY ~D SE~.SERV. (includ,~ ab,mo ,toms No ) 300 ~ 8. 1 m I~J. I.m.fer's cuvo,;,,/u S 95 / 2 00 119,000 953.75 1110. Ow~*er's COV,.a~)e $ mI. END. LIBERTY LAND S~TT.SERV. nlz [NS.CLOS. STEWART TITLE GUARANTY 13. 1200o GOVERNMENT RECORDING AND TRANSFER CHARGES ZOt Rocordi,,gfo, s. Deod$ 38. 50 Mo,gageS 64.50 [)ODd S 1190 . 00Morlgage $ 1203. Stale lax/elan,ps. D.ed S 1190.00 Mod~age S 204. Misc. S 1300. ADDITIONAL SEI~LEMENT CIIARGES 100.00 35 1190. - .- 1190 I301. TEHM/I/VGLI./IiOM[ INSt~O "l 1~2 '03 ;;CHOO[ IAXI 5 ~3. HOME WARR. :K~. SEWER 305. $330 POC HOMESPEC (BUYER)[ MARY MURRAY HMS MONROE TWP.AUTH. 400, TOTAL .~ell LEMENT CHARGES {onlm un ~,mS 103 and 502. 5oc6on$ J and K) 3806.68t HUD CERTIFICATION OF BUYERS AND SELLERS I havocarufullyfovlowud Iho ilUD-I f~ltlumcnl 5talomonl &nd lo lbo boslof myknowtodge and boiler, It lea Iruo and accutalo statemenlofidltecolpts and disbursements ;. !'i': :' '-:' & Pm .... REV-1508 EX ~ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna Pauline Miller SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER SS# 165-20-1386 03/25/2003 2003-00345 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 2 Copyright (c) 1996 form software only CPSystems, Inc. PNC Bank - checking account #5070082534 Household contents TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 5,188.83 746.50 $ 5,935.33 Form REV-1508 EX (Rev. 1-97) ' ' ..... 412 ?6El 3458 PNCBAN< June27,2003 Wm D. Schrack, III 124 W. Harrisburg Street P.O. Box 310 DiIlsburg, PA 17019-0310 Estate of Anna Pauline Miller, deceased SSN: 165-20-1386 DOD: 3/25/2003 Dear Mr. Schrack: In response ~ your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5070082534 ANNA P MILLER DOD balance: $5,188.63 + $.20 accrued int~'est Established 03/31/1966 Please note that this office only provides date of death balances for deposit accounts (IR.As, CDs, Checld.g and Savings accounts). We do not process any financial transactions or provide statements. If you nced assistance with any of these items, please call 1-8$8-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office, Sincerely, Rachelle Wells 1-800-762.1775 P7-PFSC-04-F 500 first Ave. Pittsburgh PA 15219 Member FDIC WD~TABLE &:CHAIRS:" ELECTRIC STOVE STOVE'(OLD)' ': METAL' CART ' MICROWAVE MICROWAVE CART CABINET DISHES BOWLS 2o. ool DRYER UPRIGHT FREEZER 2 PC LIVING ROOM surl 10.00 15.00 75.00 TOASTER 1.00 REFRIGERATOR 30.00 UTILITY CABINET 2.00 WASHER 30.00 HUTCH WD CHAIR 15.00 15.00 DOUBLE BED 2 ~ 10.00 EACH SINGLE BED 2 ~ 8.00 EACH TABLE W/CHAIRS WASHSTAND 20.00 CABINET 'ZOO LIGHTS 2.00 FLOOR MODEL'IV 10.00 HALL TREES 2 ~ 10.00 EACH SWEEPERS FULL SIZE BED 20.00 16.00 75.00 50.00 20.00 8.00 i 50.00 DRESSER 35.00 METAL WARDROBE 8.00 MIRROR ; 1.00 LIGHTS 0.50 WALL STAND TABLE i 4.00 WINDOW FAN .4.00 TOTAL .- 746,50 REVo1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX REllJRN RESIDENT DECEDENT ESTATE OF Anna Pauline Miller SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS SS# 165-20-1386 03/25/2003 Debts of decedent must be reported on Schedule I. FILE NUMBER 2003 -00345 ITEM NUMBER 2 Bo 1 2 3 4 5 6 DESCRIPTION :UNERAL EXPENSES: Gingr tch Memorials Myers Funeral Home engrave monument ~DMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attomey'sFees Wm. D. Schrack, III Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address C~ty Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Carlisle Sentinel Clerk of Courts Cumberland Law Journal Decker Surveying - set State Zip_ - estate advertisement Release estate advertisement markers, etc. to prepare property for sale property Hardy Auction Service - appraisal of contents Home Depot - materials for repairs prior to sale of Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recarnit-I~tion) (If more space is needed, insert add~ sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. AMOUNT 145.00 7,373.60 3,250.00 131.00 95.27 10.00 75.00 1,080.00 20.00 41.00 742.00 12,962.87 Form REV-1511 EX (Rev. 1-97) Estate of: Anna Pauline Miller Soc Sec #: 165-20-1386 · Date of Death: 03/25/2003 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description Amount 9 10 11 Metropolitan Edison - electric service during period of administration Miscellaneous expense (photocopies, postage, etc.) Register of Wills - filing fee Reserve for future administrative expense SICO Oil oil delivery/maintenance prior to sale of property 140.00 25.00 15.00 100.00 462.00 742.00 REV-1512 EX + (1-97) COMM~EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna Pauline Miller SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SS# 165-20-1386 03/25/2003 FILENUMBER 2003-00345 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 6 Comcast cable service Mary Murray, Tax Collector Monroe Township Municipal Authority - balance due on sewer bill Sprint - telephone service Walnut Bottom Radiology Yellow Breeches Clinic TOTAL (AJso enter on line 10, Recapit,:letior~_ ) (If more space is needed, insert additional sheets of the same size) 7.00 266.00 213.00 62.00 67.00 25.00 $ 640.00 Copyright (c) 1996 form software only CPS)stems, Inc. Form REV-1512 EX (Rev. 1-g7) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna Pauline Miller SS~ NUMBER II. SCHEDULE J BENEFICIARIES 165-20-1386 03/25/2003 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfem under Sec. 9116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) David R. Miller 2601 Yale Avenue Camp Hill, PA 17011 Son FILE NUMBER 2003-00345 AMOUNT OR SHARE OF ESTATE residuary estate ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18T AS APPROPRIATE~ ON REV 1500 COVER SHEET ~ION-TAXABLE DISTRIBUTIONS: ~.. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0 . 00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) STATUS REPORT UNDER RULE 6.12 Name of Decedent: ANNA PAULINE MTII F~ Date of Death: 03/25/2003 Will No. Admin. No. 2103-00345 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 xx No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes__ No xx 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 xx No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: 12/05/2003 ~O~~ (~, ~ Signature DAVID R MILLER Name (Please type or print) 2602 Yale Avenue Camp Hi]]. PA 17011 Address 717 ) 761-4344 Tel. No. Capacity: xx P~rsonal Representative (MAH:rmf/AM3) . __Counsel for personal representative IN RE: THE ESTATE OF : ANNA PAULINE MILLER : LATE OF MONROE TOWNSHIP : CUMBERLAND COUNTY, PENNSYLVANIA : THE COURT OF COMMON PLEAS CUMBERLAND CO., PENNSYLVANIA ORPHANS' COURT DIVISION NO. 2103-0345 RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, as beneficiary and heir of ANNA PAULINE MILLER, late of Monroe Township, Cumberland County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive a distribution as total satisfaction and payment of my interest in the Estate of ANNA PAULINE MILLER. I desire that the shares of the Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Administrator to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Administrator, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration of the Estate or of any other act, matter, cause, or thing whatsoever from the beginning of the world to the date of these presents. INTENDING to be legally bound~hereby, I have hereunto set my hand and seal this /2~ day of p_~-f~., 2003. DAVID R MILLER, Administrator Witness BUREAU OF TNDTVZDUAL TAXES TNHERTTANCE TAX DZVTSTON DEPT. 180601 HARRISBURG, PA 17118-0601 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX NH D SCHRACK III ESQ 124 N HARRISBURG ST PO BOX 510 DILLSBURG ~::'~ ..... '2f DATE ~ ; ~! ~/illS ESTATE OF DATE OF DEATH FZLE NUMBER '04 FEB 27 P 1:01COUNTY ACN PA 170~t~lT~b~r!A.q~ 00., PA 02-24-2004 HILLER 05-25-2005 21 05-0545 CUNBERLAND 101 Amount Rem/~ad ANNA P HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-15~7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HILLER ANNA P FILE NO. 21 03-0545 ACN 101 DATE 02-24-2004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE INTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Raal Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) ($) fi. Not,gages/No,as Receivable (Schedule D) (~) $. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assa~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/M~sc. Expanses (Schedule H) (9)' 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deduct/ohs 12. Net Value of Tax Return 105z922 O0 O0 O0 O0 5z935.35 O0 O0 (8) 12,962.87 640.00 NOTE: To insure proper credit to your account, submit the upper portion of ~his form w/th your ~ax payment. 15. 1~. NOTE: ASSESSMENT OF TAX: 16. Amoun~ of Line lq at Spousal rata 16. Amount of L~na :Lq taxable a~ Lineal/Class A ra~a 17. Amount: of Line lq a~ Sibling rata 18. Amoun~ of Line lq ~axabla at Collateral/Class B ra~a 19. Principal Tax Due TAX CREDITS PAYNENT RECEIY I DISCOUNT (+) DATE NUNBER INTEREST/PEN PAID (-) 12-18-200:5 CD005:546 . O0 111,857.33 (11) 1~. 60218"/ (la) 98,254.46 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (1:5) Net Value of Estate Subject to Tax (1~) Zf an assessment ~as issued previously, 1/nes 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. .00 98,254.46 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 18 and 19 ~ill TOTAL TAX CREDIT 4,421.45 BALANCE OF TAX DUEI .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS RE~UIRED. IF TOTAL DUE IS REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR /NSTRUCTZONS.) ~ 4,421 ANOUNT PAID (1.;) .00 X DO = .00 (16) 98,254.46 X 045 = (17) .00 x 1Z = .00 (18) .00 X 15 : .00 (19)-- 4,421.45 RESERVATION: PURPOSE OF NOT[CE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 1E, 1982 -- if any future interest in tho 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 2160 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 9140), Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISiS). Applications are available at the Office of the Register of #i118, any of the 25 Revenue District Offices, or by calling the special 24-hour ansaering service for fores ordering: 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-B00-447-50Z0 (TT only). Any party in interest not satisfied with tho appraisement, alloaance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. 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. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the data of death, to the data of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6X) percent per annum calculated at a daily rata of .000164. All taxes mhich became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year ts calendar year with that rate announced by the PA Department cf Revenue. The applicable interest rates for 19BZ through ZOOS are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Yea.~r Rate Factor 198Z ZOZ . 000546 1987 97. . 000Z47 1999 7Z . 000192 1983 167. .000438 1988-1991 llZ .OOOSO1 ZOO0 8Z .OOOZ19 1984 112 . 000501 1992 92 . 000247 2001 97. . 000247 1985 152 .000556 1995-1994 72 .000192 2OOZ 62 .000164 1986 lOX .000274 1995-1998 92 .000247 2005 52 .000157 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must bm calculated.