HomeMy WebLinkAbout11-29-05 (2)REV•1500 EX + (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
~ ~ DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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OFFICIAL IL~SE ONLY
FILE NUMBER
21
2005 0395
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Millington, John Thomas 204-30-6762
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
04-19-2005 10-21-1910 REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITV NUMBER
w 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82)
H
x ~ x
w a V
~ 4. Limited Estate ~ 4a. Future Interest Compromise (date of death after ~ 5. Federal Estate Tax Return Required
12-12-82)
v a m ~ 6. Decedent Died Testate (Attach ~ 7. Decedent Maintained a Living Trust (Attach 0 8. Total Number of Safe Deposit Boxes
R copy of WII) copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit
12 31-91 and 1-1-95
(date of death between ~ 11. Election to tax under Sec. 9113 A Attach Sch o
~ ) ( )
- - --
THIS SECTION MUST BE CO~PLETED. ALL CORRESPONDENCE AND CONFID _ _ - -
ENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
z NAME
- - -
COMPLETE MAILING ADDRESS
Z Wm
D
Schrack III
.
.
y FIRMNAME(Ifapplipble) 124 W. HarrlSbUrg .Street
P. O. Box 310
v TELEPHONE NUMBER Dillsburg, PA 17019-0310
717-432-9733
1. Real Estate (Schedule A) (1) None -;OFFICIALESE ON~.Y
2. Stocks and Bonds (Schedule B) (2) 3,626.41 -~
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) N O n e -
..,
4. Mortgages & Notes Receivable (Schedule D) ,
(4) `'~~ -'
None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 337
667.87
-
(Schedule E) ,
-
zo 6. Jointly Owned Property (Schedule F) (6) N O n e
i= ^ Separate Billing Requested r
,, ' --'
g 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ,
(7) None '~
F (Schedule G or L) ~ Separate Billing Requested
Q 8. Total Gross Assets (total Lines 1-7) (8) 341 294.28
w g. Funeral Expenses & Administrative Costs (Schedule H) (9) 42 154.94
'
~
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 2,095.43
11. Total Deductions (total Lines 9 & 10) (11) 44,250.37
12. Net Value of Estate (Line 8 minus Line 11) (12) 297,043.91
13. Charitable and Governmental Bequests/Sec 9113 Trusts for wh ich an election to tax has (13) 0.00
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 297,043.91
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, -0.00 x .00 (15) 0.00
or transfers under Sec. 9116(a)(1.2) ---
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0
a 1ti.Amount of Line 14 taxable at lineal rate 291 ,350.65 x .045 (16) 1 3,1 10.78
E-
a 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) 0.00
O
x
18. Amount of Line 14 taxable at collateral rate
5, 693.26 x .15 (18) 853.99
a
~
19. Tax Due
(19) 13,964.77
BE SURE TO ANSVSI~ ALL QUESTIONS ON REVERSE SI~E AND RECHECK MATH «
Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00;
Decedent's Complete Address:
STREET ADDRESS
Country Meadows
4833 E. Trindle Road - #512
CITY Mechanicsburg
STATE pq ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 13,964.77
2. Credits/Payments ---
A. Spousal Poverty Credit
B. Prior Payments 12,900.00
C. Discount 678.95
Total Credits (A + B + C) (2) 13, 578.95
3. Interest/Penalty if applicable --
p. Interest
E. Penalty
Total Interest/Pe~~
(D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference ~
. Thic I~ ~~ - $~`d ~ (4)
Check box on Page 1 Line ..~~~C~v,+ -
5. If Line 1 + Line 3 is greater than Line 2, enter the differs:
~ ~ ~~ ~~
(5) 385.82
A. Enter the interest on the tax due. ~ -~ (5A)
B. Enter the total of Line 5 + 5A. This is theBALAI ~~~~ (56) 385.82
Make Check Payable to: F
y/~ _
PLEASE ANSWER THE FOLLOWING QUE: _ ..,~ s~PPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
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 :............................... ^
x
c. retain a reversionary interest; or ..............................__............................_.............................................. ^
d. receive the promise for life of either payments, benefits or care? ........................
.................................. ^
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .............................................................. ^
3. Did decedent own an "in trust fol" 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
.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and
complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DA
Rath M f`larlr
870 Crandon Way
Mechanicsburg, PA 17050
FOR
DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE
Wm. D c c 124 W. Harrisburg Street
Dillsburg, PA 17019-0301
,. _ _
__
,
, - - - _
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`. ...M~~' .. -
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes 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)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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.
A W aL41~~b~]NQINT10H~d)
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OF
JOHN THOMAS MILLINGTON
BE IT REMEMBERED, that I, JOHN THOMAS MII.LINGTON, of 4833 E. Trindle
Road, Mechanicsburg, Hampden Township, Cumberland County, Pennsylvania, being of sound mind,
memory and understanding, do make, publish and declare this as and for my Last W i1I and Testament,
hereby revoking and making null and void any and all Wills and Testaments and writings in the nature
thereof by me at any time heretofore made.
ITEM 1: I direct that my hereinafter named Executrix pay all my just debts, my funeral
expenses, and the expenses of the administration of my estate. With this direction, I authorize and
empower my Executrix to expend for my funeral expenses and interment such amounts as she may
consider necessary and proper, without regard to any limit that may be prescribed by a court of law.
ITEM 2: I direct my Executrix to pay all inheritance, estate, succession, and legacy taxes
of whatsoever nature and kind, to which my estate, or the transfer of any property passing hereunder
or otherwise passing by reason of my demise, maybe subject, and to charge such taxes against my
residuary estate. It is my intention that none of the aforesaid taxes, either federal or state, on any
property required to be included in my gross estate, under the provisions of any state or federal law
now in force or hereafter enacted, shall be prorated among the persons interested in my estate to
whom such property is or maybe transferred or to whom any benefit accrues.
ITEM 3: I give and bequeath the portions of my estate as hereinafter enumerated, in the
order enumerated:
A. Two percent (2%) unto my dear friend, DORA MEGONNELL;
B. Ten percent (10%) unto my grandson, BRIAN R CLARK;
C. Ten percent (10%) unto my grandson, STEVEN M. CLARK;
D. Twenty percent (20%) unto my son and daughter-in-law, JOHN THOMAS
MILLINGTON, JR and RUTH L. MILLINGTON;
E. Ten percent (10%) unto my son-in-law, RICHARD P. CLARK.
ITEM 4: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed, including property over which I have a
power of appointment, I give, devise and bequeath unto my daughter, BETH M. CLARK,
absolutely.
ITEM 5: I nominate, constitute and appoint my daughter, BETH M. CLARK, as
Executrix of this my Last Will and Testament.
ITEM 6: I direct that my hereinbefore named Executrix shall not be required to give
bond for the faithful performance of her duties in this or any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of
ed Zooo.
1 ~~~~~
J HN THOMAS MII.LINGTON
The preceding instrument, consisting of this and one (1) other typewritten page, was on the
day and date thereof signed, sealed, published, and declared by the Testator herein named, as and for
his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the
presence of each other, have subscribed our names as witnesses hereto.
C ~" ~"7 Y X OF ~
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF YORK
and
~/Z1- ~ /
We, JOHN THOMA LINGTON, ~"~i ~~, ~~z~ •/
~¢, ,
`ter ~Z~ ~~ G~~~J the Testator and the witnesses,
respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn,
do hereby declare to the undersigned authority that the Testator signed and executed the instrument
as his Last Will and Testament, and that he signed willingly, and that he executed it as his free and
voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and
hearing of the Testator signed the Will as witnesses, and that to the best of their knowledge, the
Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint
or undue influence.
~~,
THOMAS MIIrLINGTON
SWORN TO AND SUBSCRIBED
Notarial Seal
Janefi S. Gore, Notary Public
Dillsburg Boro, York County
My Commission Expires Oct. 2~, 2002
AAemher "ennsyNaniaASSOCia~onotNotaries
BEFORE ME THIS Z.~j~.~DAY
Rev-1503 EX+ (8.98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Millington, John Thomas 21-05-0395
Ail property Jointty-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER CUSIP
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE
OF DEATH
1 Prudential Financial -Proceeds of sale of 57 shares 3,626.41
common stock
TOTAL (Also enter on Line 2, Recapitulation) 3,626.41
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98)
RETAIN THIS INFORMATION FOR YOUR RECORDS.
r ~t~.~l •®ic~al rartsacti tterrtt
0001381840
JOHN T MILLINGTON SR
355 S SPORTING HILL RD STE 63
MECHANICSBURG PA 17050
NUMBER OF SHARES CREDITED S ~ ~~
~ 7.0000
TRANSFERAQENTACCOUNT NUMBER
143 316S
CUSIP NUMBER
714320 lU 2
"~"""""""~""~"-"""~ ~"~ """" PIN/PASSWORD • PLEASE KEEP CONFIDENTIAL
010001433168 ~ c- f~~ ~l
~ }y 6Cc, 7l/
January 2002
We're pleased to welcome you as a near stockholder of Prudential Financial, Inc.
On December 18, 2001, Prudential completed its conversion from a mutual company to a stock company. As part of our
conversion, we are issuing stock to eligible o~~mers of the company. This includes anyone who owned an eligible policy
or annuity contract as of December 15, 2000. You have received the numUer of shares listed above. Compensation for all
of your policies eligible for stock is included in this statement.
This does not affect your insurance policy or annuity in any way.
Stock ownership is a benefit of holding an eligible policy or contract. It does not replace your policy or contract, or
change your benefits, cash values, eligibility for policy dividends or guarantees. You do not have to give anything up to
receive stock.
Iioiv your allotment of shares was determined.
Company actuaries and external advisors developed a plan for dividing the value of Prudential amoua its owners.
Factors such as the type of life, annuity or health policy or contract you owned, the face value, and how long you owned
it determined how many shares you received.
Your shares are registered on the boobs of Prudential Financial, Inc.
Prudential has engaged EquiServe Trust Company, N.A., a provider of shareholder services, to hold your shares at no
cost to you. A stock certificate is not required to continue holding your shares in book-entry form. The enclosed brochure
explains how to hold shares, transfer or sell shares, or obtain a stock certificate, tluough EquiSetve. Note: If you would
like EquiServe to continue holding your shares at no cost, no action is required.
A commission-free sales and purchases program will be available far certain shareholders in the future.
To participate, you must own 99 shares or fewer and hold your shares in book-entry form as they are riow. See back for
more infonuation.
`Vhat you should do now.
1) Keep this statement for your records.
2) Read the enclosed brochure for information on how you can hold, transfer or sell your sl>aares tlu-ou~h EgttiServe's
" Sales Facility, or obtain a stock certificate.
SEE BACK FOR ADDITIONAL INFORMATION.
A
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UI~S~I479S~ Call 1-800-305-9404 weekdays from 8:00 a.m. to 7:00 p.m. (ET). For hearing impaired, call 1-800-619-2837.
Or visit prudential.equiserve.com
Rev-1508 FJC+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF (FILE NUMBER
Millington, John Thomas 21-05-0395
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property )ointlyowned with the right of survNorehlp must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1 ComCast Cable -refund 64.65
2 Country Meadows -refund 3,050.00
3 Patriot News -subscription refund 95.85
4 Pennsylvania State Bank - CD#50209 44,458.17
5 Pennsylvania State Bank - CD#50211 110,978.18
6 PNC Bank, N.A. - CD#31100257029 10,067.64
7 PNC Bank, N.A. - CD#31300213419 15,333.05
8 PNC Bank, N.A. - CD#31500215885 44,820.49
9 PNC Bank, N.A. - CD#31500255971 46,311.97
10 PNC Bank, N.A. - CD#31900195433 55,244.84
11 PNC Bank, N.A. - ckg acct #5140043961 7,243.03
TOTAL (Also enter on Line 5, Recapitulation) I 337,667.87
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
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JUN-13-2005 22 08 PNCBANK
~ PIVCBAIV<
June 14, 2005
Wm. D. Scbrack, III
124 W. Harrisburg ST.
P.O_ $ox 310
Dillsburg, PA 17019-0310
RE: Estate of J. Thomas Millington, (Deceased)
SSN; 204-30-6762
DOD: 04/19/2005
Dear: Mr. Schrack
412 768 3458 P.01
In response to hour request for Date of Death balances for the customer noted above, out
records shove the following:
Certificate of Deposit
Account # 31900195433 Established 08/04/2000
v, 7 T1iOMAS MILLINGTON SR
DOD balance: $54,503.44 + $109.58 accrued interest
Account # 31300213419 Established 07/01/2001
J THOMAS MILLINGTON SR
DOD balance: $15,127.56 + $39.17 accrued irnerest
Account # 31500215885 Established 08/03/2001
J THOMAS MILLINGTON SR
DOD balance: $44,329.21 + $76.76 acxrued ir~tere:.at
Account # 31500255971 Established 02/23/2005
• J THOMAS MII.LINGTON SR
DOD balance: $46,161.28 + $150.69 accrued interest
Account # 31100257029 Established 02/23/2005
J THOMAS MII.LINGTON SR
DOD balance: 510,016.19 + $38,41 accrued interest
Checking Account
Account # 5140043961 Established 01/01/1978
J THOMAS MILLIlVGTON SR IvID
DOD balance: T>3,273.28 + $0.16 accrued interest
JUN-13-2005 2208 PNCBANK
412 768 3458 P. 02
Please note that this office only provides date of death balances for deposit accounts
(kRAs, CDs, Checking and Savings accounts). 'We do not process any financial
transect3ons or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
SinceLely,
Jessica Scheller
1-500-762-1775
k?7-PFSC-04-F
500 first Ave.
Pittsburgh PA 15219 Membor FDIC
TOTAL P. 02
REV-1151 EX+ (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Millington, John Thomas 21-05-0395
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A, FUNERAL EXPENSES:
See continuation schedule(s) attached ~ 8,537.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Beth M. Clark
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 870 Crandon Way
city Mechanicsburg state PA zip 17050
Year(s) Commission paid 2005 12,930.00
2. Attorney's Fees Wm. D. Schrack III 7,500.00
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 406.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. ~ Other Administrative Costs ~ 12,781.94
TOTAL (Also enter on line 9, Recapitulation) I 42,154.94
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev1502 EX+ (6-98)
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Millington, John Thomas 21-05-0395
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA continued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Millington, John Thomas 21-05-0395
ITEM
NUMBER
DESCRIPTION
AMOUNT
1 Clerk of Orphans' Court -Release filing fee 20.00
2 Cumberland Law Journal -estate advertisement 75.00
3 Miscellaneous expenses (photocopies, postage, Notary fees, etc.) 50.00
4 Patriot News -estate advertisement 119.94
5 PNC Bank, N.A. -cancelled check fee 2.00
6 Register of Wills -filing fee 15.00
7 Reserve for future administrative expense 500.00
8 Reserve for future federal and state income tax liability 12,000.00
Subtotal
12,781.94
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-67 (Rev. 6-98)
Rev7512 EX+16.98)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
Millington, John Thomas 21-05-0395
Include unreimbursed medical expenses.
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (g-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF
Millinn+nn I..hr. Th..w.....
FILE NUMBER
.........~....., ...,........,...ate Z1-05-0 395
NUMBER NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO
DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
Do Not Llst Trusteels (N/ords) ($$$)
I. TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
1 Beth M. Clark Daughter residuary
870 Crandon Way estate
Mechanicsburg, PA 17050
2 Brian R. Clark Grandchild 10% of estate
42912 Via Veneto Way
Ashburn, VA 20148
3 Richard P. Clark Son-in-Law 10% of estate
870 Grandon Way
Mechanicsburg, PA 17050
4 Steven M. Clark Grandchild 10% of estate
45533 Clear Spring Terrace
Sterling, VA 20165
5 Dora Megonnell Friend 2% of estate
12 Cedarhurst Lane
Camp Hill, PA 17011
See continuation schedule attached Continuation
Total
Enter dollar amounts for distributions shown above on lines 1 5 through 18, as appropri ate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0 00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
John Thomas Millington 204-30-6762 04/19/2005
Item Name and Address of Person(s) Share of Estate
Number Receiving Property Relationship (Words)
6 J. Thomas Millington, Jr. Son 10% of estate
7895 Dusty Lane
Somis, CA 93066
7 Ruth L. Millington Daughter-in-Law 10%
7895 Dusty Lane
Somis, CA 93066
Amount of Estate
($$$)