HomeMy WebLinkAbout03-0543Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Doris J. Miller
also known as
, Deceased
Richard S. Ma~aro
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
Social Security No. 177-24-5181
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or
the Decedent, dated 06/16/2003 and codicil(s) dated None
named in the last Will of
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
(c.ta.; d.b.n.c.ta; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
J Name Relationship Residence
Allen Miller, Sr.
Marlin L. Ensel
Brandon I. Ensel
Tiffany J. Ensel
(COMPLETE IN ALL CASES:)
Decedent was domiciled at death in
Ison
son-in-law
grandson
~randdaushter
AttachaddRionalsheetsifnecessary.
Cumberland
IWest Fairview, PA
328 3rd Street, West Fairview
328 3rd Street, West Fairview
328 3rd Street, West Fairview
County, Pennsylvania with his/her last family
or principal residence at 328 Third Street, West Fairview, West Fairview, PA 17053
Decedent, then 71 years of age, died 06/16/2003
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
(list street, number, and municipality)
at Harrisburg Hospital, PA
(Location)
$
$
70,000.00
situated as follows: 328 3rd Street, West Fairview
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:
I Si~lnature Typed or printed name and residence
~J~~,j RichardS. Magaro
705 Tower Road, Enola, PA 17025
-- ' p y he Pennsylvania Bar Association
Copyright (¢) 1~8 fo~m software only GPSystems, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitionerls) 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 Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed Richard S. Magaro /
before me this lstday of
JULY, 2003
...... ~o/the/Re~i~ter ", ~
No. 21-03-0543
Estate of Doris J. Miller
Social Security No: 177-24-5181
AND NOW. JULY 2,
Date of Death: 06/16/2003
Deceased
2003 , in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters E~ Testamentary ~ Of Administration
(c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Richard S. Magaro
in the above estate and that the instrument(s) dated 06/16/2003
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
Letters
FEES
Short Certificate(s).. ~. · $
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( 6 ) .... $
Codicil ......... $
JCP Fee ......... $
115.do
15.00
' - / ~ i/Register of Wills-
Attorney: Michael L. Bangs
I.D. No: '41263 t;~ :"3
18.00 Addressoc~ ,~3~72 ,South 18th Street
' qfiF fO.
Camp Hill, PA 17011
10. O0 Telephone:: '717/730:
Inventory .......... $
Other ......... $
TOTAL ........ $ 158.00 MAILED TO ATTORNEY JULY 3,
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc.
2003
Form RW-1 (1991)
I05 g05 REV 9/86
Tibia is to certifY, ti~at the information here given is correctly copied from an original certificate of death duly filed with me as
lx,cal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fec for this certificate, $2.00
No.
Local Registrar
Date
Rev 2,'87
71
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
UNO~R 1 YEAR
OCCUPAZIO~
Housewife
O~CED~NT'S MAILING ADORE SS ~,e~t. C~y/Tow~. ~lale. Zq~ Codei JI:i~CEDENT'$
ACTUAL
328 3rd Street ,E~,~
West Fairview, Pa ~,~,
Moss S. Wilder
Marlin Engel
est Falrvlew t ,
IM- ~ '*~ cG~ Iu'"'~- P~° Rm. ac ' ] wnlce
I'. I,o.
KIND~ ~SINES~N~STRy J U.S. ~MEOF~ES? [ IS~9~
J"' '-- I-. '~'~'u k 0,~s,, ,. Widow ,,.
-..m,. Pennsylvania ~ ,,~.~ m.~, East Pennsboro
,~. ~.. Cumberland
J". Marqaret Hammon
[~. ~ 3rd St., West Fairview, Pa
J~,. East Hbg Crematery L, Hbg,Pa
June 18, 2003
F.D.011897-L
,~ullivan FH, 51 N. Enola Dr~ Enola,Pa
,t intmv~ b~lv, m~n O(ha~ stgniflcam c~ con~mg to d~ath, bul
~ ~ AN A~SY |WERE ,',UmPS*V ~=~NmNGS
COMPLETION OF CAUSE
FREDERJCKSEN OUTFr CENTEg
2(325 TECHNOLOGY PAR~WAY
J:IL£D{Mo,,xh my ved, i ' ' I ! ' NICSBURG PA
21-03-0543
21-03-0543
I, DORIS J. MILLER, of 328 Third Street, West Fairview, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death, whether on property passing under this will or
otherwise, shall be paid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, jewelry, and all
other articles of household and personal use, equipment and ornament, together with all
insurance thereon and relating thereto, to my son-in-law, MARLIN L. ENGEL, provided he
survives my death by thirty (30) days. If he fails to survive my death by thirty (30) days, then his
share shall be divided evenly between my grandson, Brandon I. Engel and my granddaughter,
Tiffany J. Engel.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of my
possessions and estate of every nature and wherever situate, to be divided as follows:
A. Fifty (50%) percent to my son, ALLEN MILLER, SR., provided he
survives my death by thirty (30) days. In the event that he predeceases me or fails
to survive my death by thirty (30) days, then his fifty (50%) percent share shall be
divided evenly among my son-in-law, Marlin L. Engel, my grandson Brandon I.
Engel, and my granddaughter, Tiffany J. Engel, or the survivor of them who shall
survive my death by thirty (30) days.
B. Fifty (50%) percent to be divided evenly among my son-in-law, Marlin
L. Engel, my grandson Brandon I. Engel, and my granddaughter, Tiffany J. Engel,
or the survivor of them who shall survive my death by thirty (30) days.
C. It is my specific desire that my son-in-law Marlin L. Engel get the first
option to purchase the real estate which I own at 328 Third Street, West Fairview,
for its fair market value as determined by my Executor. He shall make that option
to purchase the real estate within sixty (60) days of my death. Until he makes that
option to purchase the real estate, he and my grandchildren shall remain in the
residence without the necessity to pay rent, but shall be required to pay all utility
charges incurred for the residence.
ITEM IV. Should any of my heirs entitled to a share of my estate not have attained the
age of twenty-five (25) years at the time for distribution to him or her, I devise and bequeath the
share of such heirs to my hereinafter named trustee, IN SEPARATE TRUSTS, to hold, manage,
invest, and re-invest, the shares so received, and the accumulation of income thereon, and to use
and apply from time to time such portion of income and principal thereof as my trustee thinks
proper for the comfortable support, maintenance, health, welfare, and education of the heirs or to
make payment for such purposes, without further responsibility, directly to such heir, or directly
to any person taking care of such heir. Any principal or income not so applied shall be
2
distributed to such heir when he or she attains the age of twenty-five (25) years, or if he or she
dies prior thereto, to his or her personal representative.
ITEM V. I appoint SHELLY J. HENNINGER trustee of the trust or trusts created by
this my last will. In addition to the other powers and authorities granted to my trustee by
Pennsylvania Law and by the preceding paragraph of this my last will, I hereby give my trustee
the following special powers and authorities:
A. To retain any or all of the assets of my estate, real or personal
(including any stock or securities of any corporate fiduciaries), without any regard
to any principle of diversification, risk, or productivity;
B. To invest and re-invest in all forms of property without restriction to
investments authorized for Pennsylvania Fiduciaries, as my trustee deems proper,
without regard to any principle of diversification, risk or productivity;
C. To sell at public or private sale, to exchange or to lease, for any period
of time, any real or personal property and to give options for sales, exchanges, or
leases, for such prices and upon such terms or conditions as my trustee deems
proper and in the best interest of the beneficiary or beneficiaries of said trusts;
D. To allocate receipts and expenses to principal or income or partly to
each as my trustee from time to time deems proper in its sole discretion;
E. To compromise any claim or controversy;
F. To exercise any option, right, or privilege granted in insurance policies
or in any other investments;
G. My trustee may accumulate the income from this trust during the term
thereof but may, from time to time, distribute from current income or from
accumulated income or from principal such amounts as my trustee, in its sole
discretion, deems advisable for the education, welfare, and comfort of the trust
beneficiary.
ITEM VI. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM VII. I appoint RICHARD S. MAGARO Executor of this my last will.
ITEM VIII. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, I hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy;
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by them; to
invest in all forms of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or diversification;
to retain any or all assets of my estate, real or personal, without regard to any principle of risk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time,
any real or personal property and to give options for sales, exchanges, or leases, for such prices
4
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
deem proper in their sole discretion.
ITEM IX. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this
,2003.
DORIS J. MILLER
day of
5
The preceding instrument, consisting of this and FIVE other typewritten pages, each
identified by the signature of the testatrix was on the date thereof signed, published, and declared
by DORIS J. MILLER, the testatrix therein named, as and for her last will, in the presence of us,
who at her request, in her presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
(SS:
)
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed. ~
DORIS J. MILLER
Sworn 9r affirmed to and acknowledged
before ~ne by the test t~Lr~ named above
t~fiis/[~ day ofj "'~ ~.~ ~.ff/' , 200~,
COMMONWEALTH OF PE~SYLVANIA
Sw6j'n or affirmed to.and, acknowledged
b " '
ef6~¢]~e/thi~ ,~ / //7~/'~'.,(da of
--~.-d-~- ' k .B ~ ,2003.
)
(SS:
)
COUNTY OF CUMBERLAND
WE,i~j~,~j~._&/,.,O...~ and S~ojtO~ ~,[q~lOd~F , thewitn~es,sesw~hffse
names are signed to the attached or foregoing instrumen[, being duly q~alified according to law, do
depose and say that we were present and saw the testatrix sign and execute the instrument as her last will;
that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to
the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and
under no constraint or undue influence.
Notary Public
7
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No.:
To the Register:
DORIS J. MILLER
JUNE 16, 2003
21-03-0543
Admin. No:
I certify that notice of beneficial interest (estate administration) required by Rule 5.6(a)
of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the
above-captioned estate on July 8, 2003:
NAME
Allen Miller, Sr.
Marlin L. Engel
Brandon I. Engel
Tiffany J. Engel
ADDRESS
323 State Street, West Fairview, PA 17025
328 Third Street, West Fairview, PA 17025
328 Third Street, West Fairview, PA 17025
328 Third Street, West Fairview, PA 17025
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none.
Capacity:
Signature ~_~ ~/~M~?/5~f~/
Michael L. Bangs, Attome~ja~-Law
302 South 18th Street
Camp Hill, PA 1701
(717) 730-7310
Counsel for Personal Representative
BUREAU OF ZNDTVIDUAL TAXES
TNHERTTANCE TAX DTVTSTON
DEPT. :*80601
HARRISBURG, PA 17128-0601
ALLEN HILLER
$28 SRD ST
WEST FAIRVIEW
PA 17025
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTXCE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOXNTLY HELD OR TRUST ASSETS
REV-1GI:i8 EX AFP (OX-OS)
DATE 08-$0-200~
ESTATE OF HILLER DORIS
DATE OF DEATH 06-16-Z005
FILE NUHBER
COUNTY c'_U~RLAN~)~
SSN/DC
HAKE CHECK PAYAB[~AN~ ~IT PAYHENT TO:
REGISTER OF
CUHSERLAND
CARLISLE, PA 17015
CUT ALONG THIS LINE
~ RETAXN LONER PORTXON FOR YOUR RECORDS
REV-X548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-50-200~
ESTATE OF HILLER
DORIS
J DATE OF DEATH 06-16-2005 COUNTY CUMBERLAND
FILE NO. 21 05-05~3 S.S/D.C. NO. 177-2~-5181 ACN 0313~985
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOZNT OR TRUST ASSET XNFORHATZON
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO.
900026691
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 09-0q-1996
Accoun~ Balance
Percen~ Taxable X 0.500
Amoun~ Subjec~ ~o Tax 2~1.51
Debts and Deductions - .00
Taxable Amoun~ 2~1.51
Tax Ra~e X .15
Tax Due 56.20
TAX CREDITS:
~82.62 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYHENT TO THE
REGISTER OF HILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
**REGISTER OF HILLS, AGENT.**
PAYHENT
DATE
RECEIPT
NUHBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 09-07-200~
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORH
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
/NTEREST AND PEN.
TOTAL DUE
.00
56.20
.70
36.90
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE 1S LESS THAN $1, NO PAYHENT IS REQUIRED.
[F TOTAL DUE IS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
PURPOSE OF
NOTICE:
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 25 of 2000. (7Z P.S.
Section 91qO).
PAYNENT:
REFUND (CR}:
OBJECTIONS:
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on tho
reverse side.
-- Make check or money order payable to: REGISTER OF WILLS, AGENT.
A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISiS). Applications are available at the Office of
the Register of Wills, any of the 23 Revenue District Offices or by calling the special Z~-hour answering service
for forms ordering: 1-800-362-Z050; services for taxpayers with special hearing and or speaking needs:
1-800-~q7-3OZO (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice amy object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZSIOZ1, Harrisburg, PA 171ZS-lOZ1, OR
--electing to have tho matter determined at the 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. Z&0601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6SOS. See page S of tho 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 (3) calendar months after the decedent's death, a five percent (5Z)
discount of the tax paid is allowed.
The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat
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 tiaa 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 date of death, to the date of payment. Taxes which became detinquent before January 1, 198Z
bear interest at the rate of six (6X) percent per annum calculated at a daily rate af .OO016q.
All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue.
The applicable
interest rates for 1982 through gOOq are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .0005~8 1988-1991 llZ .000301 ZOO1 9Z .O00Zq7
1983 16Z .000q38 199Z 9Z .O00Zq7 ZOOZ 6Z .000Z19
198q XIZ .000301 1993-199q 7Z .00019Z ZO0$ SZ .0001~7
1985 13Z .000356 1995-1998 9Z .OOOZq7 ZOOq qZ .000110
1986 XOZ .000ZTq 1999 72 .O0019Z
1987 9g .O00Zq7 ZOO0 8Z .000Z19
--Interest is calculated as fallows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DBLTNI;IUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15] days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest sust be calculated.
BUREAU OF ZNDTVTDUAL TAXES
TNHERTTANCE TAX DXVZSXON
DEPT. Z80601
HARRTSBURG, PA 17128-0601
ALLEN MILLER
528 3RD ST
WEST FAIRVIEW
PA 17025
CONNONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTXCE OF XNHERXTANCE TAX
APPRAXSEHENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCT/OHS, AND ASSESSHENT OF TAX ON
JOXNTL¥ HELD OR TRUST ASSETS
REV-XSI~O EX AFP (OX-OS)
DATE 08-30-200~
ESTATE OF HILLER DORIS J
DATE OF DEATH 06,=~1~_**-Z003
FZLE NUMBER 21~-05R~ ~.~. :~
COUNTY CUI~B~R LAN]~ r L~
17~*..'~_ 51, ~
SSN/DC
ACH 0~'5~98~
Amou~~ Remi**~d
REGISTER OF ~L::Ls
CARLISLE, PA 1701~
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-15~8 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DXSALLONANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOXNTLY HELD OR TRUST ASSETS
DATE 08-30-200~
ESTATE OF HILLER
DORIS J DATE OF DEATH 06-16-2003 COUNTY CUMBERLAND
FILE NO. 21 03-05~3 S.S/D.C. NO. 177-2~-5181 ACN 0313~98~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: NAYPOINT BANK
ACCOUNT NO. 920028273
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 11-02-1996
Accoun~ Balance
Percent Taxable ~ 0.500
Amoun~ Sub~ec~ ~o Tax 189.37
Debts and Deduc~/ons - .00
Taxable Amoun~ 189.37
Tax Ra~e X .15
Tax Due 28.~1
TAX CREDTTS:
378.7~ NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
NTEREST IS CHARGED THROUGH 09-07-200~
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
~ALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ZF pATD AFTER THTS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REI~U/RED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
.00
28.~1
.55
28.96
PURPOSE OF
NOTICE:
To fulfilL the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S.
Section 9140).
PAYHENT:
REFUND
ODJECTIONS:
ADH/N-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NILLS, AGENT.
A refund of a tax credit, ahich mas not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ID[S). Applications arm avaiLable at the Office of
the Register of Hills, any of the Z5 Revenue District Offices or by calling the special Z4-hour answering service
for forms ordering: 1-800-561-Z050~ services for taxpayers with special hearing and or speaking needs:
1-800-447-5010 (TT only).
Any party in interest not satisfied with the appraisement, alloaance, or disalloaance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty [60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZalOZ1, Harrisburg, PA 17[18-1021, OR
--electing to have the matter determined at the 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. 180601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z)
discount of the tax paid is allowed.
The 15Z 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
free the date of death, to the date of payment. Taxes which became delinquent before January l, 1981
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164.
A11 taxes which became delinquent on or after January 1, 1982 wiZI bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue.
The applicable
interest rates for 198Z through 2004 ara:
Interest DaiXy Interest Daily Xnterest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198'"~ ZOZ .000548 198"--'--8-199l 112 .000501 200'"~ 92 .000247
1983 lSZ .000458 1992 92 .000247 2002 61 .000219
1984 llZ .000501 1995-1994 7Z .O00lgz 2003 52 .000157
1985 132 .000356 1995-199& 9Z .000247 2004 41 .OOOXXO
1986 lOZ .000274 1999 72 .000192
1987 92 .000147 ZOOO 82 .000Z19
--Interest is calculated as follows:
ZNTEREST= BALANCE OF TAX UNpATD X NUMBER OF DAYS DELXN~IUBNT X DATLy XNTERBST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
Register of Wills of
County, Pennsylvania
INVENTORY
Estate of Doris J. Miller
No. 21- 03 - 0543
also known as
Date of Death 06/16/2003
,Deceased Social Security No. 177 - 24 - 5181
Richard S. Magaro,
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 Teal estate 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 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 AVe verify that the statements made in this Inventory are true and correct. I/'Ne understand that false statements herein
ate made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
Michael L, Ban~s
Personal Representative
,/ J f? ~~
Signature, /~. //;:<7""~' .<
Richard S. Magar""
10. No.'
41263
Signature:
Address:
429 South 18th Street
Address:
705 Tower Road
Camp Hill, PA 17011
Eno1a, PA 17025
Telephone, 717/730 - 7310
Telephone, 717/732 - 6969
2 ~- -sc <)
Dated:
Description
Value
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total:
33,675.96
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the PennsylvanIa Bar Association
copyright (c) 1996 form software only CPSystems, Inc.
Form ilRW-7 (1992)
Estate of:
Date of Death:
County:
INVENTORY
Doris J. Miller
06/16/2003
Perry
CASH:
Cash on Hand
337.00
Revenue Department Refund
500.00
837.00
REAL ESTATE/PA:
328 Third Street, West
Fairview
32,838.96
32,838.96
TOTAL RECEIPTS OF PRINCIPAL.. ... ... .......
33,675.96
-1-
OFFICIAL USE ONLY
REV-1500 EX + (6-00) REV-1500
INHERITANCE TAX RETURN FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA 21-03-0543
DEPARTMENT OF REVENUE RESIDENT DECEDENT
DEPT. 280601
HARRISBURG, PA 17128-0601 COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
D Miller Doris J. 177-24-5181
E
C DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM DO YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
E
lJ 06/16/2003 02/29/1932 REGISTER OF WILLS
E IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
N
T
.1- 1. Original Return 2. Supplemental Return B 3. Remainder Return (date of death
- prior to 12-13-82)
CAPB X 4. Limited Estate - 40. Future Interest Compromise (date of death after 12-12-82) 5. Federal Estate Tax Return Required
HpRL
EplO 6. Decedent Died Testate - 7. Decedent Maintained a Livil1<J Trust 8. Total Number of Safe Deposit Boxes
- -
CRAC (AttaCh copy of Will) (AttaCh copy of Trust)
KOTK 0 9. 010. 0 11. Election to tax under Sec. 91131A)
ES Litigation Proceeds Received SpousOlI Poverty Credit
(dOlte of death between 12-31 91 and 1-1-95) (Attach Sch 0)
'l'H1$,$e.ej:lQN,IilI.lStijE<:()MPI..~Il.,,,~I;'<:QI'lI'l"$~f>III)ENPg:~:<:6NFII)I;N'1'1"I..T#,lC:Im-OI'IMA...IQ"$f{()I!~I)IlI;"!Qll'lgCTtD;r(),
p NAME COMPLETE MAILING ADDRESS
C
0 0 Michael L. Bangs
R N FIRM NAME (If Applicable) 429 South 18th
R D Street
E E Camp Hill , PA 17011
N
S T TELEPHONE NUMBER
717/730-7310
1. Real Estate (Schedule A) (1) 32,838.96 OFFICIAL USE ONL Y
2. Stocks and Bonds (Schedule B) (2) None
3. Closely Held Corporation, Partnership or (3) None
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4) None
R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 837.00
E (Schedule E)
C
A 6. Jointly Owned Property (Schedule F) (6) 430.68
p 0 Separate BilHng Requested
I
T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None
U
L (Schedule G or L)
A Total Gross Assets (total Lines 1-7) (8) 34,106.64
T 8.
I 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 9,771.69
0
N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 698.79
11. Total Deductions (total Lines 9 & 10) (11) 10,470.48
12. Net Value of Estate (Line 8 minus Line 11) (12) 23,636.16
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 23,636.16
C SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
0
M
P 15. Amount of Line 14 taxable at the spousal tax
T U
A T rate, or transfers under Sec. 9116(a)(1,2) X 0 0 (15) 0.00
X A 16. Amount of Line 14 taxable at lineal rate 23,636.16 X 0 45 (16) 1,063.63
T
I 17. Amount of Line 14 taxable at sibling rate X .12 (17) 0.00
0
N 18. Amount of Line 14 taxable at collateral rate X .15 (18) 0.00
19. Tax Due (19) 1,063.63
20. n 1':P!'iI!<:K!'il;ijI;Jfl(lil\J,,~ijl!j:\l;q\JI;$'t!N$:*,!!l!fI!Ntj~fMlIilV$:I\~*,)'lo!gN'1',i1
> > BE SURE TO ANSWER ALl. QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH < <
Copyright (c) 2000 form software only T he Lackner Group, Inc.
Form REV-1S00 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
328 Third Street
CITY I STATE I ZIP
Marysville PA 17053
Tax Payments and Credits:
1. Tax Due (Page lUne 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
1,063.63
Total Credits ( A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
T otallnterest/Penalty ( 0 -+ E ) (3)
4. If 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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This;s 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. (58)
Make Check Payable to: REGISTER OF WillS, AGENT
0.00
0.00
1,063.63
33.93
1,097.56
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN
1.
"Xl!
IN THE APPROPRIATE BLOCKS
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; ,
e. retain a reversionary interest; or ,
d. receive the promise for life of either payments, benefits or care?
2. \f death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? '
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death?
4. Did decedent own an Individual Retirement Account annuity, or other non-probate 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.
Yes No
~~
o
o
o
[]]
[]]
[]]
Under penalties of perjury, I declare tllat Illave examined tllis return, including accompanying sclledules and statements, and to tile best of my knowledg~ and belief, it is true.
correct and complete. Declaration of preparer otller than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
/'
(
Richard S. Magaro
705 Tower Road
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - - - - -
Eno1a, FA 17025
Michael L. Bangs
429 South 18th Street
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - -
earn Hill PA 17011
DATE
U;/J
> C')
DATE
J. J O\~
For dates of death on or after July 1, 1994 and before January', 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) Oi)]. The statute does not exempt a transfer to a surviving spouse from tax. and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S, 9116(1.2)
[72 P.S. 9116(a)(1)J
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 120jQ [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an Individual who has at least one parent in common with the decedent. whether by blood or adoption,
Copyright (e) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
REV 1502EX+(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESJDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Doris J. Miller
55i! 177-24-5181
06/16/2003
FILE NUMBER
21-03-0543
All real property owned solely or as a tenant in common must be reported 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
knowledQe of the relevant facts. Real property which is jointly-owned with right of surVivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
DESCRIPTION
NUMBER OF DEATH
1 328 Third Street, West Fairview 32,838.96
Property was sold on January 21, 2005, see copy of settlement
sheet attached. The delay in selling the property was as a
result of an encroachment dispute that was resolved sufficiently
to permit the property to be sold.
TOTAL (Also enter on line 1, Recapitulation) $ 32,838.96
(If more space is needed, insert additional sheets of the same size)
Copyright (cl 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
0 NO. 2502-0265 1r
, 8. TYPE OF lOAN
1DFHA 20Frr.HA 3 ;~CONV UNINS ... ',VA :; 'JC?NV '''IS
DEPARTMENT OF HOUSING & URBAN DEVELOPMENT ~I
U.S. , FilE NUMBER \7 LOAN NUMBER ~-
SETTLEMENT ST A TI:MENT 20D41200::.4COL 1("),')0157~S8
0 MORTGAGE INS CASE hUMBt':R
C t\JOTE rhls form IS !urmslled to give YOII a statement of actual setrlemenl cosrs Amoun!s p<lld (0 amf I)y lire Sr"INemenl agent are shovm
Items marked '"(POCj"were paId outside /he clOSing: Ihey are shown here for in/anna/lonal purposes fH1C1 are Ilot rncluded In the /0!8IS
:V\)O '200412()()~c.r~ P~ll!;>OO~ I ~OO~',C.:;JUI"
0 NAME AND ,ADDRESS OF BORROWER E. NAME AND ADDRESS 0'" SELLER IF NAME ANO I\OORESS OF lENDER
/olilrlir l. Engel Estaleof OOflSJ Millerand I New Century Mortgage Corp
328 Thl'd S',reel Richard S, Magaro, Executor I ~30 '",'om B,,'"'' C,e",. 3,d "00'
Wes\Falrvlew,PA 17025 K:lng Of PruSsia, PA 19406
G PROPERTY LOCA TION H SETTlEMENT AGENT 020-04.8725 I SET7LEMEN- DAT[
328 Tfj;,d Streel Colonial Setllement SerVice"
VVes! "'airview, PA 17025 J<inuary21 2005
CumberlandCOlJniy PenrlSylvar,'a PLA,CE OF SETTLEMENT i
3800 Markel Street I
Camp >-1111 PA 17011 i
J SUMMARY OF BORROWER'S TRANSACTION K SUMMARY OF SELLER'S TRAI\'SACT!O~l
100 GROSS AMOUNT DUE FROM BORROWER: 400 GROSS AMOUNT DUE TO SELLER
>01 COr1lra<:\ Sales Price 35,00000 401 CCHllract Sales Pnce ~5,QCQ 00
102 PerSOl1al Pro en 402 PersonarPro en
103 Settlement CharQes 10 Borrower Line 14QO 5,8S562 403
104 Pa of/Mon a e 404
105 Payoff Mortoage 405
Ad'ustments For Items Paid 8 Sellermadvance Ad uslmenls For lIems PBJd B' Seiier'nadv[ll)te
lG5 LocaliSchoolTtlxes 10 400 locallSchoolTaxes 10
107 Court Taxes 10 "7 Count Taxes 10
'00 School Taxes 01/22105 10 07/01105 416.77 400 School Taxes 01122/05 10 07!QliC5 ~ 16 77
109 409
11<:' '10
111 411
112 412
'20 G,<WSS AMOUNT OUE~ROM BORROWER 4130239 420 GROSS AMOUNT DUE TO SELLER 35.41677
200 AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201 De os it or earnest mone 501 Excess De OSlt See Inslructiors
2C2 Or,ncip211 Amount of New Loan s 50,22000 502 Settlement C/'lar es to Seller Line 1400 2,5:3524
203 EXIstin loans taken Sub eCI \0 503 Existin loan s)laken subect 10
20' 504 ~ayoflol firslMortgage
205 505 Pa offofseconcl Mort a e
206 506
207 507
208 508
209 509 -.-----
Aciruslrnenls For items Un Elld B Seiier Ad VSlmenl.s .For Irems Un air! By Seller
210 LocallSclloolTaxes 10 510 Local/School Taxes "
211 CounlyTaxes 01101/05 10 01122105 , 12.57 511 Counly T;lxes 01/01105 " 01/22105 1257
212 SchOOl Taxes 10 512 School Taxes 10
21) 513
2" 514
215 515
216 516
217 517 -
21[\ 518
2'9 519
220 rOTAL PAID BYIFOR BORROWER 50,232.57 520 TOTAL REDUCTION AMOUNT DUE. SEI..LER 2,57781
300. CASH AT SETTLEMENT FROMITO BORROWER: 600 CASH AT SETTLEMENT TOfFROM SELLER.
3C1 Gross Amou'lt Due From Borrower line 120) 41,30239 601 Gross A1110un( Que To SeNer (Une 420 3541677
302 less Amounl Paid ByWor Borrower (line 220 ,( 50.23257) 602 Less Reduclions Due Seller (ltne 520) , 257781
30J C;ASH( FROM) ( X TO! BORROWER 8,93018 6D3 CASH( l( TQ)( FROM) SELLER . 3283805
MB
""
-!1e ~nderslpned hereby 3tknowledge recelpl of a completed copy of pages 1&2 of thiS slatement & any aHachments referred:O herein
BOf'owel
/~ / /1
/ '-C"., ,,,"
tl0 A/ '7'/ / /V'-J~/r..I""'
arlnLEngpl /'
Seiier
;;/
700,
TOTAL COMMISSION Based on Price
OI'/lslOO of Commlss,'on (Ime 700 as Follows
S :0
S Ie
COI'lI ','5510n Paid a~ Settlemenl
L. SETTLEMENT CHARGES
@! "10
70;
702
703
70!'
800_ ITEMS PAYABLE IN CONNECTION WITH LOAN
801 Loan Ori inalion Fee 3.0000 % to UnIled Mort a e Network
802 _08" Discount % to New Century Mortgage Corporal Ion
B03 AppraIsal Fee to ROberl80lash
8-]4 DOCdmenl Prep Fee to New Century Mortgage CorporatIOn
805 Flood Ce1if'cation Fee 10 New Centu Mortgage Corporation
SCG ;:JroceS,,1n Fee 10 New Cenlu. Mort a e Cor orallon
8D7 Tax Service Fee 10 New Cenlury Mortgage Corporat:on
805 lil1derNf:ting Fee 10 United Mortgage Network
8G9 Underwriting Fee to New Century Mortgage CorPO'atlor
~?cessingFee . :0 United Mortgage Network
8",1 v,eld Spreac Premium to United Mort a e Network
900 ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
90c InlerestFrom 01r21/05 to 02101/05 @ $
902 Mort age Insurance P'emlum for months 10
803 Hazard Insurance Premtl;rr.lor 10 ears toDelp Insurance Services
g"
Ie
,
PQC S:.OOt.4:JL
{day
11days
%'1
90~
1000 RESERVES DEPOSITED WITH LENDER
'001 Hazara Insural1ce 2000 months , 36.500er month
'002 Vorta etnsu'ance months S " month
1003 LocallSchoolTaxes months , " month
10C4 Coul1tvTaxes 1000 monlhs S 1821-o-er month
lOC5 School Taxes 8.000 months @ I 72 03 per monlh
1006 month$ @ I per 'nonth
FJO"( monlhs " month
-1.00P, A " ale Ad ustrr,enl months $ " month
1100. TITLE CHARGES
to Colorllal Setllemenl Services
10 Colonial Settlemenl SerV1CeS
"
"
to Colonial Selllement ServIces
to COlonial SettlementSelVlces
10
110' :ransportallon Fee
1102 Se1v,ce Rendered Fee
"03 "tle Examination
11 O~ Title Ins'Jla1ce BlrJder
,',05 Dccume.1t Pre aralion
1106 Nola fees
"07 Atlor1ey's Fees
"ncludesabovel/emnvmbers
_11G8 Tllle',nSurai1ce
l.I1cludes above Ireml1(lmbers
1109 Lel'der's Coverage
'",10 Owner's Coverage
',11, ALTA Endorsements
1112 C~L
1113
1114 ExpressOvernightFee
1115 Wire Fee
~ 116 Closing Protection Letter Fee
1117 Tax Ce1 Fee
1118
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
120., Recording Fees Deed $ 3850; Mortgage S 74.50 Releases S
1202 Cit iCount T~xlSlam s Deed 35000 Mort a e
. 203 Slate TaxlStam s Revenue Starn s 35000 Mort a e
1204 A.ssi nment Recordln Fee Colonial Recordln Account
1205 Recorrtln ServIce Fee \0 Colonial Setllament Recordln Account
^Her 5 00 PM
'Net Documents:
to Colonial SettlemenlServices
S 50,22000
S 35,00000
to Colonial Settlement Services
\0 Stewart Title Guaranly Company
100f300!8 ~
,
10 Colonial Selllement Serv,ces
to Colonial Setllement Services
ColonialSeltlemenl Services
I
Conve ance Fee
1300. ADDITIONAL SETTLEMENT CHARGES
1301 Survev to
1302 Pest Ins ection to
1303
<304
1305 See addit'ldlsb exhibit 10
1400. TOTAL SETTLEMENT CHARGES Enteron Lines 103. Section J and 502, Section Kl
n" 'iq",,'q peg. 1 01 ",,' 'lal~'l1cI11. I~O "g,'"10"6,' oU<"_edq~ r~""'pl O!" compIM><1 "OpV c' p.q., n' 1"'.< two ,'090 "316rr,en,
-~"'/./ ~ .,~
/;:f?.;,..-C-t:~ I (~~
;;'--Colonial Settlement Services
. Se\ltemenlAgen\
Certified 10 b.-a Iruecopy
.,.ORf'o._\~r;5 - -1-
1
~AI[) ;qo,,^
""": 1.~O't
^,':s:."
f..,
CLT~'. ,. !"I'h.
c .~;, .
-~-
1506,6C
._._ 27500;
30COO
, ~ 20;
10000
C8 00
25000
3000C
49500
79261
43[\ DO
7300
18,21
576.24
-31Ce,g
10000!
750C
1200
56475
-
15000
]:'00
17,00
1500'
11::'00
17S.0C
17500
'75GO
.,',:JC
4500
2184:i
588 5 E 2 ~
~.2 15 24
2.56524
,. F)(MI,[\Q".~(;:'ll 17ao"?",".~'<r;:)'
ADDITIONAL DISBURSEMENTS EXHIBIT'
Borrower: Marlin L. Engel
Seller: Estate of Dons J Miller and Richard S Magaro. Executor
lender: New Century Mortgage Corp
Settlement Agent: Colonial Settlement Services
(717)731-0360
Place of Settlement: 3800 Market Street
Camp Hill. PA 17011
Settlement Date: January 21,2005
Property Location: 328 Third Street
West Fairview, PA 17025
Cumberland County. Pennsylvania
PAYEE/DESCRIPTION
NOTE/REF NO
BORROWER
SELLER
Cumberland County Tax Claims Office
Delinquent Taxes Due
ColOnial Settlement Services Escrow
2005 Municipal/County Due
2,21524
45-17-1044-129
2';845
45-17-1044-129
Total Additional Disbursements shown on Line 1305
$
218.45
s
2,215.24
/'
4/'
/.
_.~
"
(20041 20054COL,PFDI20Q<l12C054CCL:' 1,,:
REV-1508 EX + (1 -97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Doris J. Miller
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
SSll 177-24-5181
06/16/2003
FILE NUMBER
21-03-0543
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 Cash on Hand
DESCRIPTION
VALUE AT DATE
OF DEATH
337.00
2
Revenue Department Refund
500.00
TOTAL (Also enter on line 5, Recapitulation) $ 837.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150B EX (Rev. 1-97)
REV -1509 EX + (1-97)
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Doris J. Miller
SSfI 177-24-5181
06/16/2003
FILE NUMBER
21-03-0543
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
RELATIONSHIP TO DECEDENT
A.
Allen Miller, Sr.
ADDRESS
323 Third Street
West Fairview, PA 17025
B.
c.
Son
JOINTLY -OWNED PROPERTY,
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank DATE OF DEATH DECO'S VALUE OF
account number or simflar identifying number.
NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A 09/04/96 Waypoint Bank - Checking 482.62 50.00% 241. 31
Account
Joint with Allen Miller
(son)
2 A 11/02/96 Waypoint Bank - Savings 378.74 50.00% 189.37
Account
Joint with Allen Miller
(son)
TOTAL (Also enter on line 6, Recapitulation) $ 430.68
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1509 EX (Rev. 1-97)
07/22/2003
BANGS LAW OFFICE
302 S 18TH ST
CAMP HILL PA 17011
VlWay~qi!'Kt
lOOK FOR US. WE'll GET YOU THERE.
The information which you requested on the account(s) ofDORRlS J MILLER
(Social Security Number 177-24-5181) is/are as follows:
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
900026691
CHECKING
09/04/96
482.61
.01
482.62
Balance at Date of
Death
Account Ownersbip JTO
Name of Joint ALLEN
Owner, if any MILLER
Date Ownersbip 09/04/96
Was Established
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner, if any
Date Ownership
Was Established
Additional
Information
Requested
920028273
SAVINGS
11/02/96
378.72
.02
378.74
JTO
ALLEN
MILLER
11/02/96
Sj{~~I::~/
~"10~~
SENIOR SERVICES REP.
RO. 80x 1711. HARRISBURG. PENNSYlVANIA 17105-1711
Toll Free 1-866-WAYPOINT (1-866-929-7646) . IN YORKAAEA 717/815-4500 . www.wauDointbank.com
REV 1511 EX + (1-97)
ESTATE OF
Doris J. Miller
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
SSfI 177-24-5181
06/16/2003
FILE NUMBER
21-03-0543
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1
FUNERAL EXPENSES,
Sullivan Funeral Home
865.00
B.
,.
ADMINISTRATIVE 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:
2.
3.
Attorney's Fees
Michael L. Bangs
(If decedent's address is not the same as claimant's, attach explanation)
8,500.00
Family Exemption:
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills
158.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Cumberland Law Journal
75.00
2
The Sentinel
98.69
3
Central Penn Appraisals, Inc.
75.00
TOTAL (Also enter on line 9, Recapitulation) $ 9,771.69
(\f more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV-1S12 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Doris J. Miller
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
5511 177-24-5181
06/16/2003
FILE NUMBER
21-03-0543
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Expense
DESCRIPTION
AMOUNT
112.76
Pinnacle Health
2
Expense
Blair Credit Card
5.16
3
Expense
Discover Card
580.87
TOTAL (Also enter on line 10, Recapitulation) $ 698.79
(If more space is needed. insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev_ 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Dor is J. Miller
SSfI 177-24-5181
06/16/2003
FILE NUMBER
21-03-0543
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONls) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a){l.2)]
1 Allen Miller, Sr. Son 50% of Estate
2 Marlin Engel Son- in-Law 16.6% of Estate
3 Brandon Engel Grandson 16.7% of Estate
4 Tiffany Engel Granddaughter 16.7% of Estate
ENTER DOLLAR AMTS FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON- TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 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 $ 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)
6)j{/j
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~{/jJ 9fdJk}';
1, DORIS J, :YIILLER, of328 Third Street, West Fairview, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will previously made by n~c.
ITEM I. I direct that all my just debts and funeral expenses, including my gravcmarKer
and all expenses of my last illness, and any and all taxes and assessments imposed by any
governmental body as a result of my death, whether on property passing under this wiil or
otherwise, shall be pilid from my residuary estate as soon as practicable after my decease as a
part of the expense of the administration of my estate.
ITEM II. I give and bequeath all of my household goods, automobiles, Jewelry, and ail
other articles of household and personal use, equipment and ornament, together with all
insurance thereon and relating thereto, to my son-in-law, MARLIN L ENGEL, provided r.e
SJr\wes my death by thirty (30) days. Ifhe fails to survive my death by thirty (30) days, then im
si1are shall be divided evenly between my grandson, Brandon L Engel and my granddaughter.
1i ffany J Engel.
ITEM III. I give, devise, and bequeath all the rest, residue, and remainder of m\
possessions and estate of every nature and wherever situate, to be divided as follows:
A. Fifty (50%) percent to my son, ALLEN MILLER, SR, provided he
survives my death by thirty (30) days, In the event that he predeceases me or fails
to survive my death by thirty (30) days, then his fifty (50%) percent share shall be
divided evenly among my son-in-law, Marlin L. Engel, my grandson Brandon 1.
Engel, and my granddaughter, Tiffany J. Engel, or the survivor of them who shall
survive my dcath by thirty (30) days.
B. Fifty (50%) percent to be divided evenly among my son-in-law, Marlin
L. Engel, my grandson Brandon 1. Engel, and my granddaughter, Tiffany J. Engel,
or the survivor of them who shall survive my death by thirty (30) days.
C. It is my specific desire that my son-in-law Marlin L. Engel get the first
option to purchase the real estate which I own at 328 Third Street, West Fairview.
for its fair market value as determined by my Executor. He shall make that option
to purchase the real estate within sixty (60) days of my death. Until he makes that
option to purchase the real estate, he and my grandchildren shall remain in the
residence without the necessity to pay rent, but shall be required to pay all utility
charges incurred for the residence.
ITEM IV. Should any of my heirs entitled to a share of my estate not have attained the
age of twenty-five (25) years at the time for distribution to him or her, I devise and bequeath the
share of such heirs to my hereinafter named trustee, IN SEP ARA TE TRUSTS, to hold, manage.
invest, and re-invest, the shares so received, and the accumulation of income thereon, and to use
and apply from time to time such portion of income and principal thereof as my trustee thinks
proper for the comfortable support, maintenance, health, welfare, and education of the heirs or to
make payment for such purposes, without further responsibility, directly to such heir, or directly
to any person taking care of such heir. Any principal or income not so applied shall be
2
d:stributed to such heir when he or she attains the age of twenty-five (25) years, or ifhe or she
dies prior thereto, to his or her personal representative.
ITEM V. I appoint SHELLY J. HENNINGER trustee of the trust or trusts created by
this my last will. In addition to the other powers and authorities granted to my trustee by
Pennsylvania Law and by the preceding paragraph of this my last will, I hereby give my trustee
the following special powers and authorities:
A. To retain any or all of the assets of my estate, real or personal
(including any stock or securities of any corporate fiduciaries), without any regard
to any principle of diversification, risk, or productivity;
B. To invest and re-invest in all forms of property without restriction to
investments authorized for Pennsylvania Fiduciaries, as my trustee deems proper,
without regard to any principle of diversification, risk or productivity;
C. To sell at public or private sale, to exchange or to lease, for any period
of time, any real or personal property and to give options for sales, exchanges, or
leases, for such prices and upon such terms or conditions as my trustee deems
. proper and in the best interest of the beneficiary or beneficiaries of said trusts;
D. To allocate receipts and expenses to principal or income or pal1ly to
each as my trustee from time to time deems proper in its sole discretion;
E. To compromise any claim or controversy;
F. To exercise any option, right, or privilege granted in insurance policies
or in any other investments;
3
G. My trustee may accumulate the income from this trust during the term
thereof but may, from time to time, distribute from current income or from
accumulated income or from principal such amounts as my trustee, in its sole
discretion, deems advisable for the education, welfare, and comfort of the trust
beneflciary.
ITEM VI. All of the interests of the beneficiaries hereunder shall not be subj ect to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any execution or
attachment.
ITEM VII. I appoint RICHARD S. MAGARO Executor of this my last will.
ITEM VIII. In addition to the other powers and authorities granted to my personal
representatives by Pennsylvania law and by the other terms and provisions of this will, J hereby
give to my personal representatives the following powers and authorities effective without court
approval and until actual distribution of all property: to compromise any claim or controversy:
to make distribution in cash or in kind, or partly in cash and partly in kind, and in such manner as
my personal representatives may determine and at valuations finally to be fixed by tbem, to
invest in all fom1s of property, including any stock or other securities in any corporate fiduciary
or its successor without restriction to investments authorized for Pennsylvania fiduciaries, as my
personal representatives deem proper, without regard to any principle of risk or dlversification:
to retain any or all assets of my estate, real or personal, without regard to any principle of rISk or
diversification; to sell at public or private sale, to exchange, or to lease for any period of time.
an\' real or personal property and to give options for sales, exchanges, or leases, for such prices
4
and upon such terms or conditions as my personal representatives deem proper; and to allocate
receipts and expenses to principal or income or partly to each as my personal representatives
dcem proper in their sole discretion,
ITEM IX. I direct that my personal representatives and fiduciaries shall not be required
to give bond for the faithful performance of their duties in any jurisdiction,
IN WITNESS WHEREOF, I have hereunto set my hand this
,
dc/~-\
I b 11,
dav of
,2003,
(:,
DORIS j, MILLER
'! /
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5
The preceding instrument, consisting of this and FIVE other typewritten pages, each
idcr,tified by the signature of the testatrix was on the date thereof signed, published, and declared
by DORIS 1. MILLER, the testatrix therein named, as and for her last will, in the presence of us.
who at her request. in her presence, and in the presence of each other, have subscribed our names
as witnesses hereto.
6
COMMONWEALTH OF PENNSYLVANIA
)
( SS:
)
COlJNTY OF CUMBERLAND
The undersigncd, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that I signed and
exccuted the foregoing instrument as my last will, that I signed it willingly; and that I Signed It as :ny free
and voluntary act for the purposes therein expressed. ,
.~
J
/},"'n ....
. ,-/~) r
'-, ,_.,l....
DORIS J. MILLER
Sworn 9r affirmed to and acknowledged
bdcre.rn.e by the t..ejt, !ci~ named above
\fml (t., day of' .~ I' ,2003._
I 1 l?/ (, _
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
wE.l1 ,J/,~I L&/v~0 and
names are signed to the attached or foregoing instrume , being duly alified according to law, do
d'cpose and say that we were present and saw the testatrix sign and execute thc instrument as her last wtll.
that she signed it willingly and that she executed it as her free and voluntary act for the purposes therein
'''pressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and that to
the best of our knowledge, the testatrix was at that time 18 or more years of age, of sound mind, and
ullder no constraint or undue influence.
)
( SS:
)
, the witnesses \vhose
,
Swom or affirmed to and knowledged
bcf6~e hi / day of
. U~. . ,2003.
~-1 i 'I) n /~ II ~ I
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7
BAN6S LAW OFFICE
429 SOUTH 18TII STREET
CAMP HILL, PA 17011
E-mail: mikebangs@verizon.net
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
WILLIAM E. MILLER, JR.
Of Counsel
February 4. 2005
Glenda Farner Strasbaugh. Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle. PA 17013
RE: Estate of Doris J Miller
File No 21-03-0543
Dear Mrs. Strasbaugh:
Enclosed is a check in the amount of$30.00 together with the original and one copy of the
Pennsylvania Inheritance Tax Return and the original Inventory. Please file these documents
accordingly and return a paid receipt to us in the enclosed. stamped, pre-addressed envelope.
r Very truly yours.
/,
r
,
\,
Michael L. Bangs
\VSC
Enclosure
BAN6S LAW OFFICE
429 SOUTH 18TH STREET
CAMP HILL, PA 17011
E-mail: mikebamrs@Verizon.net
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
WILLIAM E. MILLER, JR.
Of Counsel
February 3, 2005
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
RE: Estate of Doris J Miller
File No. 21-03-0543
C~)
co
Dear Mrs. Strasbaugh:
I enclose the following documents for filing as a part of the above-referenced estate:
I. The original and one copy of the Pennsylvania Inheritance Tax Return together
with a check in the amount of$I,097.56 which pays the tax shown to be due;
2. An original Inventory; and
3. A check in the amount of $30.00 to pay the filing fee for these documents.
Please file these documents and return a paid receipt to me in the enclosed, stamped, pre-addressed
envelope. If you require anything further, please contact me directly.
IV7V:;~
~ichael L. Bangs
wsc
Enclosures
cc: Mr. Richard S. Magaro
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BANGS MICHAEL L
429 S. 18TH STREET
CAMP HILL, PA 17011
_____u_ fOld
ESTATE INFORMATION: SSN; 177-24-5181
FILE NUMBER: 2103-0543
DECEDENT NAME: MILLER DORIS J
DATE OF PAYMENT: 02/04/2005
POSTMARK DATE: 02/04/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 06/16/2003
NO. CD 004914
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,097.56
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,097.56
REMARKS:
CHECK# 0096
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
BUREAU OF INDIVIDUAL '-TA'{E$"-
INHERITANCE TAX DIVISION -
PD BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
*'
REV-1604 EX AFP (03-05)
rr 1 :~: L~
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN.lDC
ACN
04-14-2005
MILLER
06-16-2003
21 03-0543
CUMBERLAND
177-24-5181
03134983
Allount Rellitted
DORIS
J
ALLEN 0,Qi(LER
328 3RD ST-
WEST FAIRVIEW PA 17025
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ....
................................................................................................................
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 04-14-2005
ESTATE OF MILLER
DORIS
J DATE OF DEATH 06-16-2003
COUNTY
CUMBERLAND
FILE NO. 21 03-0543
ADJUSTMENT BASED ON:
S.S/D.C. NO. 177-24-5181
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
03134983
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO. 900026691
TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 09-04-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.15
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE 00
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"' (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
~--L
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
._ _ RECORD ADJUSTMENT
JOI"TLY HELD OR TRUST ASSETS
'*
REV-1604 EX AFP (03-05)
~) ~)
H: ~)it
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN.lDC
ACN
04-14-2005
MILLER
06-16-2003
21 03-0543
CUMBERLAND
177-24-5181
03134984
Allount Rellitted
DORIS
J
n~"-
ALLEN MIL~t~
328 3RD ST
WEST FAIRVIEW PA 17025
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ....
................................................................................................................
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 04-14-2005
ESTATE OF MILLER
DORIS
J DATE OF DEATH 06-16-2003
COUNTY
CUMBERLAND
FILE NO. 21 03-0543
ADJUSTMENT BASED ON:
S.S/D.C. NO. 177-24-5181
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
03134984
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO. 920028273
TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 11-02-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.15
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE I nn
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "'CREDIT"' (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
0.--::,""-
REV-1470 EX (6-88)
*
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
FILE NUMBER
REVIEWED BY
ACN
2103-0543
03134983,84
DORIS MILLER
SCHEDULE ITEM
NO.
EXPLANATION OF CHANGES
The above referenced ACN has been reduced to zero, as this account was reported on the
probate return.
PaQe 1
BAN6S LAW OFFICE
429 SOUTH 18TH STREET
CAMPHILL,PA 17011
E-mail: mikebangs(ii)verizon.net
PHONE: 717-730-7310
FAX: 717-730-7374
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
WILLIAM E. MILLER, JR.
Of Counsel
April 27, 2005
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
RE: Estate of Doris J Miller
File No. 21-03-0543
t"<)
Dear Mrs. Strasbaugh:
Enclosed please find a copy of a Notice of Inheritance Tax Appraisement together with a check in
the amount of $5.1 0 to pay the balance shown to be due. Kindly return a paid receipt to me in the
enclosed, stamped, pre-addressed envelope.
Thank you.
rvery truly yours,
I ~ ^v/1
~i;hael ~' Bong,
wsc
Enclosures
cc: Mr. Richard S. Magaro
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTIC~ Qf ~~H~RITANCETAX
APPRAISEHENT, ALLOWANCE~6R:DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX ZB0601
HARRISBURG PA 171ZB-0601
DATE
ESTAn5Qi:
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-18-2005
MILLER
06-16-2003
21 03-0543
CUMBERLAND
101
MICHAEL L BANGS
429 S 18TH ST
CAMP HILL
PA 17011
*
REV-1547 EX AFP (03-05)
DORIS
J
Anount Reni Ued
CHANGED
(1)
(2)
(3)
('i)
(5)
(6)
(7)
32,838.96
.00
.00
.00
837.00
430.68
.00
(8)
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ft!V-~l;"'"fi.~.m~'1f!'.mfYl!t.w.!MftitrrJtm!r.M.AWJtAW!~~.~~WJtm!r.llrt'."'.......... ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER DORIS J FILE NO. 21 03-0543 ACN 101 DATE 04-18-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Estate (Schedule A)
2. Stocks end Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
'i. Hortgeges/Notes Receiveble (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Trensfers (Schedule G)
8. Totel Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgege Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedula J)
1'1. Nat Velue of Estate Subject to Tax
(9)
(10)
9,771.69
NOTE: To insure proper
credit to your account}
subnit the upper portion
of this forn with your
tax paynent.
34,106.64
10 470 48
23,636.16
.00
23,636.16
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~i9ures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Lina 1'1 at Spousal rate (15)
16. Anount of Line 1'1 taxable et Lineal/Class A rete (16)
17. Anount of Line 1'1 at Sibling rate (17)
18. Anount of Line 1'1 taxable at Colleteral/Class B rete (18)
19. Principal Tax Due
.00 X 00 = .00
23,636.16 X 045 = 1,063.63
.00 X 12 = .00
.00 X 15 = .00
(19)= 1,063.63
698.79
Ill)
(12)
(13)
11'1)
TAX CREDITS:
rI"n~"' ,+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
02-04-2005 CD004914 33.93- 1,097.56
BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-05-2005 TOTAL TAX CREDIT 1,063.63
BALANCE OF TAX DUE .00
INTEREST AND PEN. 5.10
TOTAL DUE 5.10
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. S~~ REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BANGS MICHAEL L
429 S. 18TH STREET
CAMP HILL, PA 17011
____nn fOld
ESTATE INFORMATION: SSN: 177-24-5181
FILE NUMBER: 2103-0543
DECEDENT NAME: MILLER DORIS J
DATE OF PAYMENT: 04/28/2005
POSTMARK DATE: 04/27/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 06/16/2003
NO. CD 005265
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $5.10
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$5.10
REMARKS:
CHECK# 0097
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/18/2005
BANGS MICHAEL L
429 S. 18TH STREET
CAMP HILL, PA 17011
RE: Estate of MILLER DORIS J
File Number: 2003-00543
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.1, for decedents dying on or after
July 1, 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:
6/16/2005
Your prompt attention to this matter will be appreciated.
Thank You.
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
~
BUREAU OF INDIVlDUALTAllES,"
INHERITANCE TAX DIVISION
PO BOX Z8060l
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
I r,
IJ
1.8
Lf
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
MICHAEL L .QP;~\\:'
rrit,!- .
429 S 18TK"ST
CAMP HILL PA 17011
*'
REV-16D7 EX AFP (03-05)
05-31-2005
MILLER
06-16-2003
21 03-0543
CUMBERLAND
101
A.GUlt R_itt.d
DORIS
J
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
................................................................................................................
REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF MILLER DORIS J FILE NO.21 03-0543 ACN 101 DATE 05-31-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SunKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTEO INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-18-2005
PAYMENTS (TAX CREDITS):
PRINCIPAL TAX DUE: 1,063.63
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-04-2005 CD004914 33.93- 1,097.56
04-27-2005 CD005265 5.10- 5.10
TOTAL TAX CREDIT 1,063.63
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
,L
_S>
BANGS LAW OFFICE
429 SOUTH 18TH STREET
CAMP HILL, PA 17011
E-mail: mikebangslWverizon.net
PHONE: 717-730-7310
FAX: 717-730-7374
WILLIAM E. MILLER, JR.
Of Counsel
MICHAEL L. BANGS, Attorney-at-Law
WENDY S. CHESBRO, Paralegal
June 17, 2005
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
RE: Estate of Doris J Miller
File No. 21-03-0543
Dear Mrs. Strasbaugh:
Enclosed you will find the following documents for filing as a part ofthe above-referenced estate:
1. Four (4) Receipts and Releases;
2. A check in the amount of $20 to pay the filing fee for those documents; and
3. A Final Status Report Form.
Please file these documents accordingly and return a paid receipt to me in the enclosed, stamped,
pre-addressed envelope.
The administration of this estate is now concluded and you should mark your records accordingly.
If you have any questions or require anything further, please contact me directly.
t7 trW.y yours,
V\/l/"-
Michael L. Bangs
wsc
c
Enclosures
cc: Mr. Richard S. Magaro
INRE:
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-03-0543
i'-,,)
ESTATE OF
DORIS J. MILLER,
Deceased
RECEIPT AND RELEASE
BRANDON 1. ENGEL, a minor, being a beneficiary under the Estate of Doris J.Miller,
deceased, does hereby:
4>~
1. State and acknowledge that he is a minor and this Receipt and Release is being
executed by his Trustee appointed under the Last Will of Doris J. Miller, Shelley J. Henninger;
2. Waive the filing of an Account or Schedule of Distribution by the personal
representative of the Estate;
3. Acknowledge that he has received all sums of money and/or personal property to
which he is entitled as a beneficiary of the Estate of Doris J. Miller;
4. To the extent of said distribution, release Richard S. Magaro, Executor, of the Estate
of Doris J. Miller, and his heirs and personal representatives, from all liabilities, whether due to
his negligence or otherwise, which he may have by reason of his administration of the Estate;
5. Agree to refund to the Estate and to the said Richard S. Magaro, Executor, any portion
of the distribution to which he is not properly entitled, and, to the extent of said distribution, to
indemnify him and the Estate for claims made against him and to reimburse him and the Estate
all expenses and costs incurred in connection with any such claim; and
6. Declare that this instrument shall be legally binding upon him, his personal
representatives, and assigns.
\7'
IN WITNESS WHEREOF, I have hereunto set my hand and seal this Iv k day of
{y~
, 2005 as Trustee for Brandon 1. Engel.
~~
BRANDON 1. ENGEL, a minor
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
/ ~ 'r7
On this, the / v day of I ~ ,2005, before me, the
undersigned officer, personally appeared SHE EY J. HENNINGER, Trustee for BRANDON 1.
ENGEL, a minor, known to me (or satisfactorily proven) to be the person whose name is
subscribed to the within instrument and acknowledged that (s)he executed same for the purposes
therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
,%Lt1
rotary Public
////~J
I
COMMONWEALTH OF PENNSYLVANIA
I' NoIarIaI Seal
Tm M. Robertson. Notary PubIlc '
I East Pennsboro Twp.. Clmberfand County
; My Commission ExpIres Nov. 15.2007
"",""H ;:>Annsvlvania Association Of Notaries
-
.,.,.,,~._"""""-
._'.~'
I
INRE:
ESTATE OF
DORIS J. MILLER,
Deceased
RECEIPT AND RELEASE
TIFF ANY J. ENGEL, a minor, being a beneficiary under the Estate of Doris J. Miller,_
deceased, does hereby:
.""
...;::--,
1. State and acknowledge that she is a minor and this Receipt and Release is being
executed by her Trustee appointed under the Last Will of Doris J. Miller, Shelley J. Henninger;
2. Waive the filing of an Account or Schedule of Distribution by the personal
representative of the Estate;
3. Acknowledge that she has received all sums of money and/or personal property to
which she is entitled as a beneficiary of the Estate of Doris J. Miller;
4. To the extent of said distribution, release Richard S. Magaro, Executor, of the Estate
of Doris J. Miller, and his heirs and personal representatives, from all liabilities, whether due to
his negligence or otherwise, which he may have by reason of his administration of the Estate;
5. Agree to refund to the Estate and to the said Richard S. Magaro, Executor, any portion
of the distribution to which she is not properly entitled, and, to the extent of said distribution, to
indemnify him and the Estate for claims made against him and to reimburse him and the Estate
all expenses and costs incurred in connection with any such claim; and
6. Declare that this instrument shall be legally binding upon her, her personal
representatives, and assigns.
\J'
I
K
IN WITNESS WHEREOF, I have hereunto set my hand and seal this /& day of
t17!J-
,2005 as Trustee for Tiffany J. Engel.
~j~~
TIFFANY J. ENGEL
(SEAL)
COMMONWEAL TH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
On this, the 1(; "'^- day of t71~ ,2005, before me, the
undersigned officer, personally appeared SH EY J. HENNINGER, Trustee for TIFFANY J.
ENGEL, a minor, known to me (or satisfactorily proven) to be the person whose name is
subscribed to the within instrument and acknowledged that (s)he executed same for the purposes
therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
~wJ~Yl~~)
~otary Public
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Tina M. Robel1sOn. Notary PubliC
East PennsbOro Twp., Coo\bertaod Caunty
My CommIssiOn expires Nov. 15, 2007
Member, Pennsylvania Association Of Notatles
ESTATE OF
DORIS J. MILLER,
Deceased
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
) ORPHANS' COURT DIVISION
)
) NO. 21-03-0543
INRE:
RECEIPT AND RELEASE
I, ALLEN MILLER, SR., the undersigned, being a beneficiary under the Estate of Doris
(,::,1
~::..
J. Miller, deceased, do hereby:
1. State and acknowledge that I am an adult individual;
2. Waive the filing of an Account or Schedule of Distribution by the personal
representative ofthe Estate;
3. Acknowledge that I have received all sums of money and/or personal property to
which I am entitled as a beneficiary of the Estate of Doris J. Miller;
4. To the extent of said distribution, release Richard S. Magaro, Executor, of the Estate
of Doris J. Miller, and his heirs and personal representatives, from all liabilities, whether due to
his negligence or otherwise, which he may have by reason of his administration of the Estate;
5. Agree to refund to the Estate and to the said Richard S. Magaro, Executor, any portion
of the distribution to which I am not properly entitled, and, to the extent of said distribution, to
indemnify him and the Estate for claims made against him and to reimburse him and the Estate
all expenses and costs incurred in connection with any such claim; and
6. Declare that this instrument shall be legally binding upon me, my personal
representatives, and assigns.
\)..
IN WITNESS WHEREOF, I have hereunto set my hand and seal this (" ~day of
0\~
,2005.
~ f/;!f' ,~
EMIL , SR.'--/
(SEAL)
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
On this, the U; ~ day of ~~ ' 2005, before me, the
undersigned officer, personally appeared ALLEN ILLER, SR., known to me (or satIsfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that (s )he executed same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
_ ~ ~ /?l '4'----d}-
Fary Public
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Tina M. RoberlsOn. Notary PubliC
East Penns/JOIO Twp., Qrnbelland County
My CommiSSIOn expres Nov. 15.2007
Member, Pennsl/lI/anla Association Of Notaries
,/.
INRE:
) IN THE COURT OF COMMON PLEAS OF
) CUMBERLAND COUNTY,
) PENNSYLVANIA
)
)
)
)
ORPHANS' COURT DIVISION
r ......1
ESTATE OF
DORIS J. MILLER,
Deceased
NO. 21-03-0543
RECEIPT AND RELEASE
I, MARLIN L. ENGEL, the undersigned, being a beneficiary under the Estate of Doris J.
Miller, deceased, do hereby:
1. State and acknowledge that I am an adult individual;
2. Waive the filing of an Account or Schedule of Distribution by the personal
representative of the Estate;
3. Acknowledge that I have received all sums of money and/or personal property to
which I am entitled as a beneficiary of the Estate of Doris J. Miller;
4. To the extent of said distribution, release Richard S. Magaro, Executor, of the Estate
of Doris J. Miller, and his heirs and personal representatives, from all liabilities, whether due to
his negligence or otherwise, which he may have by reason of his administration of the Estate;
5. Agree to refund to the Estate and to the said Richard S. Magaro, Executor, any portion
of the distribution to which I am not properly entitled, and, to the extent of said distribution, to
indemnify him and the Estate for claims made against him and to reimburse him and the Estate
all expenses and costs incurred in connection with any such claim; and
6. Declare that this instrument shall be legally binding upon me, my personal
representatives, and assigns.
J-
~". --.-'''"'---..-....-''... ",.,- ..
". .. .
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 1 Go d"'""- day of
Mt-'J
,2005.
Jl?-~<l dt T 'J'~EAL)
ARLIN L. ENGEL
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF CUMBERLAND )
On this, the I (p ~ day of (1 c.. it ' 2005, before me, the
undersigned officer, personally appeared MAR IN L. ENGEL known to me (or satisfactorily
proven) to be the person whose name is subscribed to the within instrument and acknowledged
that (s )he executed same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
dU//);utJ L
Notary Public
NOTARIAL SEAL
Donald Wood, Jr., Notary Public
W. Fairview 80ro
Cumberland County
My Coml'Tlleslon txoires Oct. 17, 2006
\ \\1 U
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAl.. T I>.XES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MILLER ALLEN
323 STATE STREET
ENOLA, PA 17025
_nn~n told
ESTATE INFORMATION: 55N: 177-24-5181
FILE NUMBER: 2103-0543
DECEDENT NAME: MILLER DORIS J
DATE OF PAYMENT: 08/10/2005
POSTMARK DATE: 07/30/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 06/16/2003
NO. CD 005672
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05134084 I $36.20
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$36.20
REMARKS: A E MILLER
CHECK#0461
INITIALS: VZ
RECEIVED BY:
SEAL
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
".r:er)!";1 ED C(FIOE OF
..". l~N~1':."ATlNO: NonCE
. TAXPAYER RESPONSE
IEY-lS4 9
FILE NO. 21 03-0543
ACN 05134084
DATE 07-21-2005
0\ ::DV r,-:
V,"":,,.; ;,\ ',-' ,
ene:' i.'_i,I'C' ;'-""1
'1',1",--:,'.., ,--' ,
CI ,. .
-",
TYPE OF ACCOUNT
EST. OF DORIS J "ILLER 0 SAVINSS
Iii. s. NO. 177-214-5181 IX] CHECKING
Dll:rE OF DEATH 06,-16-2003 0 TRUST
COUNTY CUMBE~LAND 0 CERTIF.
R~"IT PAY"ENT AND FORMS TO:
REGISTtR OF WILLS
CUMBER AND CO COURT HOUSE
CARLIS E, PA 17013
ALLEN
323 STATE
ENOLA
MILLER
ST
PA 17025
SOVEREIGN BAt<< has provided the 08partHnt with the infol'1lation listed belCJw which hilS bHn used in
calculatinG the potential tl!lx due. Their rec ords indicate that .t the death of the above decedllll1t'4u were 8 joint own..../beneficiary of
this account. If YOU fol 1tlls info.....Uon is lnco...rect, please obtain writtllll1 car...ection fr~ the f l'*1Ci.l institution, atblch a copy
to this fo.... and return it to the above addr.ss. This account is taxable in accordanc_ with the I ritance Tak LaMS of the C~onwealth
of Pennsylwnia. Questions ny be answered by ealling (717) 7-87-&ZU~-----,-- -- - -- -- ----,
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS'
Account No. 0921709056 Data 09-04-1996
Established
x
482.61
50.000
241. 31
.15
36.20
TAXPAYER RESPONSE
To insure p......r c....di t to your ItCCClU1t, two
(2) copies o~ this notice .ust accOllpany your
palfllent to '*"' Rqlster of Wills. Nake check
payable to: -megister of Wills, Agent"'.
NOTE: If taJ paYllents are .ade within three
(3) .anths oil the decedent.s date af dnth,
YOU bY t a !:IX discount of the tax due.
Any inheribl . blx due will bllCO.. deUnquent
ninlll (9).on s after the cf8te of death.
Account Balance
Percant Taxable
A.ount Subjec:t to
Tax Rat.
Potentiel Tax Due
x
Tax
A.
[CHECK ]
ONE
BLOCK
ONLY
B. [] The above asset has been or will be reported and tax paid Nith the Perinsylvania Inheritanc. Tax return
ta be f-illlld by the d.cedlJnt's representative. i
c. 0 The abOve infa....ation is incor....ct and/or dtllbts and deductions were p~id by you.
You .ust C08Plete PART ~ and/or PART ~ below.
x
If you indicate a different taM rat., please state ~our
relationship to cMcedent:
PART
[!]
TAX RETURN - COMPUTATION
LXNE 1. Dat. Established
2. Account Balance
3. Perctlnt Tax8lble
4. Mount Subiect to Tax
5. Debts end IleclucUons
6. AllDUnt Taxable
7. Tax Rat.
8. Tax Du.
OF TAX ON ~OINT/TRUST ACCOUNTS
1
2
3
4
5
6
7 X
8
PART
[!]
DATE PAID
,
'.
I
TOTAL CEnter on Line 5 of Tax CoIIputaUon .
Under penal tie. of IHIrjur~, I decl.r. thllt the facts I Mve reported abov ara t......, cor....ct 8Ild
PAYEE
DESCRIPTION
AMOUNT PAID
complete to the best of my knowledge and beli.f.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
DATE
TAXPAYER SIGNATURE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
Per-nor,::!! C:rPr-E (1c
BUREAU OF INDIVlDO~v:r:Wlij ., ,'J ,,' NOTICE OF INHERITANCE TAX
IHHERIUNCE UX nI'lsl"':~," u~ ',' APPRAISEHENT I ALLOlIANCE OR DISALLOIIAHCE
PO lOX '80601 ',,' , 'OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTL V HELD OR TRUST ASSETS
*'
REV-1548 EX AFP (16-05)
ZU05 srp -2 Pfi 12: 07
PA 17025
DATE 09-05-2005
ESTATE OF MILLER DORIS J
DATE OF DEATH 06-16-2003
FILE NUMBER 21 03-0543
COUNTY CUMBERLAND
SSM/DC 177-24-5181
ACN 05134084
APPEAL DATE: 11-04-2005
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
c,c, '
r-I
ALLEN 0, MILLER
323 STATE ST
ENOLA
CLEF(
"
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -
REY=is4S-EX-AFP-r03=OSj--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF
DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 09-05-2005
ESTATE OF MILLER
DORIS
J DATE OF DEATH 06-16-2003
COUNTY
CUMBERLAND
FILE NO. 21 03-0543
TAX RETURN WAS:
S.S/D.C. NO. 177-24-5181
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05134084
FINANCIAL INSTITUTION: SOVEREIGN BANK
ACCOUNT NO.
0921709056
TYPE DF ACCOUNT: ()SAVINGS 0<) CHECKING (>TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 09-04-1996
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
482.61
0.500
241.31
.00
241.31
.15
36.20
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
RREGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-30-2005 " CD005672 .00 36.20
BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-31-2005 TOTAL TAX CREDIT 36.20
BALANCE OF TAX DUE .00
INTEREST AND PEN. 2.20
TOTAL DUE 2.20
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l
~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-11B2 EX(l1-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MILLER ALLEN
323 STATE ST
ENOLA, PA 17025
n~n_n fold
ESTATE INFORMATION: SSN: 177-24-5181
FILE NUMBER: 2103-0543
DECEDENT NAME: MILLER DORIS J
DATE OF PAYMENT: 09/07/2005
POSTMARK DATE: 09/06/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 06/16/2003
NO. CD 005774
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05134084 I $2.20
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TOTAL AMOUNT PAID:
$2.20
REMARKS:
CHECK# 0478
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
r,r['r': ttNHERITANCE TAX
U\, 'StATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
...~ ,t
\: 2 \
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-26-2005
MILLER
06-16-2003
21 03-0543
CUMBERLAND
05134084
DORIS
J
ALLEN MILLER
323 STATE ST
ENOLA PA 17025
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
CUT ALONG THIS LINE
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
---------------------------------------------------------------------------
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF MILLER DORIS J FILE NO.21 03-0543 ACN 05134084 DATE 09-26-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-05-2005
PRINCIPAL TAX DUE: 36.20
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-30-2005 CD005672 .00 36.20
09-06-2005 CD005774 2.20- 2.20
TOTAL TAX CREDIT 36.20
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
eM
.