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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 ?/ ~{/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 '! / ~07 ,/) /- .<-<:'~ , <C-':L :r:;,~ -.:;"-:> 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?/ (, _ '1 ", '. \ .' f . I'.,' / I - //'\ ' ( L . i\oli'ry Pub c NOT,lI,RIAL SEAt YI'Qt: JV .S. (>~ES8RG, H'J~rJ\)ubljc H . r.... ;: (,:' i; .'., ,-, (" "."""'0_("'''' 1 (, "! ~ ~"i\ --, J ',.._.1, '..'-, """:":"'';''~'~;'{J _r..,..:t~t ' '. l'\' - - . ',~.. - " l ,"v . ....., ....... .... ;"V . 0 C"O ' b-~ ~~ :~;--~;.':~~';;::~-~~'~.,.~.~~,~,,,~~.~2~~~~~ 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 ~V~.(f{fL1 I:\ (jJlf,i t8m Notary Public./ .",-- , ',-..,.." I \I'E1'IDY,s. CijEm;'RG. ijla~1 Pl!blic c','rr 1\l'e'l 1"'0' ["~,),,,""(j CO""'~ -.' . ',. r,., ,; , ..' , . '.. ,,'i..'''' ." ,.! ~ "Jl. t~/;'.! C"'r':;.':"li'::<,,~ :('0""0 2(1/'. !>.,.,'r:',..::,,"""'-' " :~:;:.~.l,~.,~ 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 i - ~ -' ~ ~ \ .-!\ i~\ 'iiit~ ... ::>0 t;: '69 ~ 4- , ti~\ ti .-! i '5i\l ~~ .1E 'i~i\t.i 4-azP$ 0.-- :::; : -: :::; i - - :s - :s : - :s -: - :s -; :::; : - -:: - - :::; -; - - 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 I I I I I I I I TOTAL AMOUNT PAID: $2.20 REMARKS: CHECK# 0478 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS D("n'1,",rn I'\(ClI'( nC ,,, I . ,-,,; 1<,) " .~ i <'" '., ,q_V,-, -'-" ~~, '-'-- .....~.. ('; I'" ", 20D5 SE? -1 Pi'i 12: 51 i'= C~" , , 'I ~ (~.'~" ; , \~ ~~ ~ ~~~ ~t ~ t \v -- \ () lJJ I o ~ ! /~'" ~ 1 ; , 1..::,-, .~ r" 'C\ " 'T):Oj \ ' - ~~l .. \, ,'/' \ I (. ~ ~ ~ ',': ! ': \ " . \ " ,\ \ , , . , .;l. ::::' .... '~. ,". ~ II" , CI c n~l! -t !sh :l> 110<""''"' r- .. -<c :J ~N" m....l> g~o II: ZNr- ,,"'... ~ O....r- '00 r- m >'"";!to-t ! l>IIlZ ~ "Z " " . .... ~ "... l> N ~< , .. <... -t ~ E~ m III ::: i~ .... ... 3: > ..... X r- '" r- .. m ." '" l> ... ... 0 N \II 0> t-."J ...... C) -, ... CI '.,) i=:I,~J 0 ,0 ' " l;~-tI ., Z .:u ,) t:lZ ''':'J ;1 ~...ft3 ~) ",0 .- H,"~ 'VZ i-, r-i!!i J>:E .I -." -< ",:- ",'" J' :s: ,". .,' \.~ -tJ> rn ,,>-. zr :'l >~ -0 ,..~. .. 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C- o 0 ~ 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 .