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HomeMy WebLinkAbout03-21-121505610143 REV-1 SOO ~"°'-'°' OFFICIAL USE ONLY PA Department of Revenue Pennsylvania cour~y coos rear File NumDSr Buroau of Individual Taxes 0BQ1BfO"~"~"'~ PO 80x.280601 INHERITANCE TAX RETURN 21 11 0781 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Stlcial Security Number Date of Death Date of Birth r ~~` ~ ~- S~w~ 07 05 2011 05 20 1923 Decedent's Last Name Suffix Dtaoedent's First Name MI MITTEN HARRY F (If Applicable) Enter Surviving Spouse's IrlforrnaUon Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW t. Original Realm ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior b 12-13-82) 4. Limited Estate ~ qa, Future Irserea Compromise ~ 5. Federal Estate Tax Relm Required (aeteoraaetnener z-tz-ez> ® g. Dscadsrrt Died Testate ~ T. Decade~t~ta Living Trwt 2 8. Total Number Of Sate Deposit Boxes (Attaeh Copy d WNp l~~tte~~ 9. Lklgadon Proceeds Received ~ 10. ~1~x ~_de~) death ~ t t. Eledwn to tax under Sec. 9113(A) (Attach Bch. O) CORRESPONDENT - THI8 SECTION aN13T BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number SUSAN E LEDERER 717 652 7323 First Iine of address 5011 LOCUST LANE Second Iine of addross CNy or Poet Office State ZIP Code HARRISBURG PA 17109 REGISTER LLS USt' -ONLY ~ _~ ~ C . ` i ' Y ~ ~ ,- ~~ . . -~ ~ -1 ~ .. ~ `' D FILED tJ's iti'~ f'F7 C`'. =~=+ coirrspondenre.-mall addraas: Susan(d~ledererlaw.com Under penaltles of pttrju I declare tthhaatt I have examined this return, inGudina aocornparrying schedules and stetxrlenta, and Eo the best of my knowledge and belief, k is true, correct and . Dedaratlon of proparer other than the personal representative is based on all information of which preparer hea any knowledge. 8278 Baring Knoll Drive, Harrfsburta. PA 17111 SIGNATURE OF PREPARER OTHER TFIAN REPRESENTATNE DATE Susan E. Lederer 5011 Locust Lane, Harrisburg, PA 17108 Side 1 1505610143 1505610143 REV-1500 EX osaasrn~sNana: Mitten, Harry F. Decedent's Social Security Number RECAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 2. Stodca and Bonds (Schedule B) ............................................................................. 2. 3. Cbsely Held Corporatbn, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 7. Inter-Vivos Transfers 8 Miscellaneous t~oq Probate Property (Schedule G) u Separate Billing Requested............ 7. 8. Total Groas AssMs (total Lines 1-7) ..................................................................... 8. 11,605.58 7,139.17 18,744.75 9. Funeral Expenses & Administrative Costs (Schedule H) ..................................... .. 9. 1 O , 37 5.8 9 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................ .. 10. 1 , 1 O 6.98 11. Total Dsduetlons (total Lines 9 & 10) ................................................................. .. 11. 11 , 482.87 12. Net Value of Estate (Line 8 minus Line 11) ........................................................ .. 12. 7 , 2 61.88 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............................................. .. 13. 14. Net Value SubJect to Tax (Line 12 minus Lina 13) ............................................. .. 14. 7 , 2 61.8 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of tine 14 taxabb at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable '7 2 61.8 8 16. at lineal rate X .045 ~ 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 . 0 0 18. 19. Tax Due .................................................... ............................................................. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 1505610243 1505610243 1505610243 0.00 326.78 0.00 0.00 326.78 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-0781 DECEDENTS NAME Mitten, Harry F. STREET ADDRESS 180 Conodoguinet Estates CITY Nevwille STATE PA ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPaymeMs A. Prior Payments B. Discount 0.00 3. Interest 4. If Line 2 is greater then Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a refund g, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 326.78 0.00 (5) 326.78 Make Check Pa able to: REGISTER OF WILLS AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :............................................................................... x b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................................................................................................... x d. receive the promise for life of either payments, benefits or care? ............................................................ x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... ^x ^ 3. Did decedent own an "in trust for' or payable upon death bank account or severity at his or her death?....... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary desgnetion? .................................................................................................................. ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTION313 YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of trensfere to or for the use of the surviving spouse is 3 percent [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 percent [72 P.S. §9116 (a) (1.1) (ii)J. 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 evenrf the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: . The tax rete imposed on the net value of transfers from a deceased child 21 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 percent [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 percent, 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 trensfers to or for the use of the decedent's siblings is 12 percent p2 P.S. §9116 (a) (1.3)]. A sibling is defined under Sedlon 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. (1) Total Credits (A + B) (2) (3) (4) Rw-1608 t_)r+ (6.96) SCHEDULE E CASH, BANK DEPOSITS, 8t MISC. PERSONAL PROPERTY coetetow~A~TN of PENN9YWANIA INMERRANCE TAX N6TUFtN RE81DEHr nECEDENT ESTATE OF FILE NUMBER Mitten, Henry F. 21-11-0781 Include the proceeds a iitgWbn and the date the proceeds were reeeived DY the estate. All property jointly-ovmsdwtth the rlyht asurvlvorshlp must W dbeloaad on sehsduN F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Savings Account No. 235228-00, held at Members 1st Federal Credit Union, titled to Harry F. 346.10 Mitten (60.01 accrued interest) 2 Checking Account No. 235228-11, held at Members 1st Federal Credit Union, titled to Harry F 2,037.97 Mitten 3 Check from Highmark (refund of health insurance premium) 157.77 4 Check from Gulf OII Limited Partnership (refund) 249.97 5 Check from Aero Energy (refund of natural gas service) 352.90 8 Check from The Sentinel (refund of subscription) 68.12 7 Check from Central Penn Auto Club (refund of membership) 58.25 8 Check from Kemper Insurance (refund of trailer lot rental) 185.00 9 Check from Kemper Insurance (refund of auto insurance premium) 33.00 10 1990 Oldsmobile Cutlass, titled to Harry F. Mitten (cash sale -sale and ownership 300.00 documentation not available) 11 1984 GMC truck, titled to Harry F. Mitten (cash sale -sale and ownership documentation not 300.00 available) 12 1990 Derose trailer, titled to Harry F. and Evelyn M. Mitten (died May 10, 2004) (sale price - 8,000.00 copy of check not available) 13 Rowe'a Auction Service (proceeds from personal property auction 827.50 14 Check from US Treasury (personal income tax refund -documentation not available) 345.00 Total of Continuation Schedule See attached page TOTAL (Also enter on Line 5, Recapitulation) 11,605.58 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software onty The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. B-g8) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMAONVYEALTH OF GENNBYLVANU\ INHERITANCE TAX RETURN continued RE910ENT DECECENT ESTATE OF FILE NUMBER Mitten, Harry F. _ 21-11-0781 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule E (Rev. 6-98) Rw-1610 EX~ (title) SCHEDULE G INTER-VIVOS TRANSFERS 8k MISC. NON-PROBATE PROPERTY co~aaoranE~L1H of vataurLVnnw er+Fnrru~ca TAx RBIURH r~oEtrr oeceoeRr ESTATE OF (FILE NUMBER Mitten, Harry F. 21-11-0781 Thb actroduN must W kwmpbtsd and filed r the answer to any of questions 1 thraph 4 an O,e reveres side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESCRIPTION OF PROPERTY TI I E DATES OAF TROAFNSFRERSAEI ~EFI A COPY ~ THOS DEED FOR ORF%ESTnTE. DATE OF DEATH VALUE OF ASSET %OF DECD'S t~REST EXCLUSroH (IF APPLICABLE) TAXABLE VALUE 1 IRA Account No. 35004200305412, held at MST Bank, 3,657.88 100.000% 3,657.88 Harry F. Mitten, owner, Harry Lee Mitten, Mildred Estrada, Bonnie Lou Hess, beneficiaries (;25.08 accrued interest) 2 Savings Account No. 5000970488, held at PNC Bank, 1,382.07 100.000% 1,382.07 titled to Harty F. Mfttan and Harry L. Mitten (account made joint on 05/01/2011, within a yearof death) (;0.01 accrued interest) 3 Savings Account No. 2581902851028, held at PSECU, 5,098.22 100.000% 3,~•~ 2,099.22 titled to Harry F. Mitten and Harry L. Mitten (account was made joint on 04N2H1, within a yearof death) (;0.28 accrued interest) TOTAL (Also enter on Line 7, Recapitulation) 7,138.17 (rc more space is needed, additlonal papas of the same size) Copyright (c) 2002 form software onty The Lackner Group, Inc. Forrn PA-1500 Schedule G (Rev. 6-98) REV•1761 EXa (10-06) c nNw SCHEDULE H FUNERAL EXPENSES ~ \DMINISTRATIVE COSTS ESTATE OF FILE NUMBER Mitten, Harry F. 21-11-0781 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT A, FUNERAL EXPENSES: See continuation schedule(s) attached ~ 9,092.64 B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Reprosentative(s) Street Address City State Zio Year/s) Commission paid Waived p, Attomev's Fees Law Offices of Susan E. Lederer (estimate) 500.00 3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zio Relationship of Claimant to Decedent a. Probate Fees Cumberland County Register of Wills 135.50 5. Accountant's Fees 6. Tax Retum Proparor's Fees DeVid WeaV@r 50.00 7. Other Administrative Costs 587.75 See continuation schedule(s) attached TOTAL (Also enter on line 8, Recapitulation) 10,375.89 Copyright (c) 2009 form software only The Lackner Group, Inc. Fonn PA-1600 Schedule H (Rev. 10-06) -.~. 1 ~_. __-._.....,, ,. ~CMEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Mitten, Hany F. 21-11-0781 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Roman Funeral Home 9.092.64 H-A 9,092.64 2 Other Administrative Cosffi Rowe's Auction Service (auctioneer's commission) 289.62 3 Cumberland County Register of Wills (filing fees - PA Inheritance Tax Re~rn and Inventory) 30.00 4 U.S. Postal Service (certified mail fees) 10.74 5 Adams Electric (electric service -July) 27.00 6 Walmart (new truck battery) 50.85 7 The Sentinel (legal advertising) 189.54 H-B7 587.75 Copyright (c) 2002 Corm aotiware only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rsv1612 Ex+ (12~) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, ~ LIENS coraw~wkln of verxisn.vu~ i~rr~ r~x aenxw ~acerrt oeceoerrr ESTATE OF FILE NUMBER Mitten, Hany F. 21-11-0781 R.a~ a.na iaw~.a M sN ase~a.nt pior to a..m mn nmraW uap.a n tM a.a d dsaM. mauarw aenlmtwn~d n,.aiw.~.». ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Loan Recount No. 235228-02, held at Members 1st Federal Credit Union, titled to Harry F. 457.41 Mitten 2 Adams Electric (electric service -June) 87.00 3 Century Link (phone service -June) 84.42 4 Shelby Winter, Tax Collector (real estate taxes) 60.36 5 Maaland Associates (medical bill) 18.72 6 Aero Energy (natural gas -June) 290.40 7 HTBT (phone and tv service in hospital) 4.00 8 GMCC (mobile home insurance) 80.00 9 Pharmacy bill 8.88 10 Gulf Oil (heating bill) 25.01 TOTAL (Also enter on Line 10, Recapitulation) I 1,106.98 (If more apace is needed, additional pages of the same size) Copyright (c) 2009 form software ony The Lackner Group, Inc. Forth PA-1600 Schedule I (Rev. 12-08) REV-1613 8X• (11-0!) SCHEDULE J 60A"'~~°~~""'" BENEFICIARIES ESTATE OF ~ FILE NUMBER Mitten Ha F. 21-11-07 81 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE OUNT OF ESTATE NUMBER PERSONlSI RECEIVING PROPERTY DECEDENT (Words) (53S) I TAXABLE DISTRIBUTIONS [incude outright spousal • diatnbuhons, and transfers under Sec. 911 a 1.2 1 M[Idred Estrada Daughter 113 of residue; 1,260.19 181 C.M.E. 1/3 of IRA (Sch. Newville, PA 17241 G, Item 1) 2 Bonnie L. Hess Daughter 1!3 of residue; 1,260.19 3328 Rock Hollow Road 1l3 of IRA (Sch. Loysville, PA 17047 G, Item 1) 3 Harry L. Mitten Son i!3 of residue; 4,741.50 6278 Spring Knoll Drive 1/3 of IRA (Sch. Harrisburg, PA 17111 G, Item 1); Jt. accts on Sch. G Total 7,261.88 Enter dollar amo nts for distributions shown above on lines 15 thro h 18 on Rev 150 0 cover sheet as a riate. NON-TAXABLE DISTRIBUTKNS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI Copyright (c) 2009 form softwaro only The Lackner Group, Inc. Form PA-1b00 Schedub J (Rev. 11-08) ..:~ n ~.: r'^ -- y~ c D~r Last Will and Testament ~~~ ' of ~~~' Harry F. Mitten ~~ ,, I, HARRY F. MI"fTEN, of 181 CME, Newville, Lower Frankfard Township, ~ Cumberland County, Pennsylvania, 1'1241, being of sound and disposing mind, memory ind understanding, do make, publish and declare this to be my Last Will and Testament, ~ hereby revoking and making void all previous Wills and Codicils heretofore made by me. FIRST I order and direct my personal representative hereinafter named to pay all of my debts, expenses of my last illness, funeral expenses, including my grave marker and ~ perpetual care, and expenses involved or connected with the administration of my estate, as soon after my death as is reasonably as possible. However, my personal representative need not accelerate and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more advantageous to retain or renew and pay as they become due and payable. SECOND I give, devise and bequeath all the rest, residue and remainder of my estate to be divided as equally as practicable among my children, HARRY L. MITTEN; ~ MILDRED D. ESTRADA, and BONNIE L. HESS, per stirpes. THIRD I order and direct that any estate, inheritance or similar tax due as a result of m; death with respect to any property passing as a result of my death, shall be paid from thi residue of my Estate before its division into shazes and prior to distribution as an expense of administration and that no part of the taxes should be prorated or apportioned amon the persons or beneficiaries receiving the taxable property. It is my express intention the all inheritance taxes imposed as a result of my death be paid from the residue of my estate m C;> ~- ; ~- ~_..; (T~ ~; 7 4_-i ( 1 ~_Y X11 c°. ~_ ~, cn 1 ihether or not the property passes under my Last Will and Testament. My personal ;,presentatives shall have full power and authority to pay, compromise or settle any such axes at anytime whether with respect to present or future interests. FORTH I hereby authorize and empower my Executor hereinafter named to sell all of the ~eal property and any or all of the personal property not specifically bequeathed herein, which I may own or to which I am entitled at the time of my death, in the sole discretion ~f my Executor at private or public sale, with or without an Order of Court, at such time or times and upon such terms as the said Executor shall deem proper for the best interests of my estate or of my beneficiaries, thereby converting the same to cash. I further authorize and empower my said Executor to execute, acknowledge and deliver all proper writings and deeds of conveyance and transfer thereof. FIFTH I nominate, constitute and appoint my son, HARRY L. MITTEN, as executor of this my Last Will and Testament. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. 1N WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament which consists of two (2) pages to each of which I have affixed my signature, this '~~ day of _ , 2010. rte. ,^ Harry F. Mitten " 2 Signed, sealed published and declared by the above-named HARRY F. MITTEN s and for his Last Will and Testament, in the presence of us and each of us, who, at his equest and in his presence and in the presence of each other, have hereunto subscribed ~ rur names as witnesses thereto the day and yeaz last above written. ~lJ~R.~,ce.~ I " • Ltc,} ~~ C2~Q~4,/ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . SS COUNTY OF CUMBERLAND I, HARRY F. MITTEN, the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. HARRY F. MITTEN Swom or affirmed and acknowledged before me by HARRY F. MITTEN, the testator, this $~ day of ~2. , 2010. r~ E-~.: William 1. Cmibb, Esquire PA Attorney ID 72661 3 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ~OUNTY OF CUMBERLAND SS WE, ~nn~~ S ~+~lt~_ ,and I~Al2~/ S, ~EG~r', the witnesses whose names are attached to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testator sign and execute the instrument as his Last Will; that he signed willingly and executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the Last Will and Testament as a witness; and that to the best of our knowledge the testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~ • (seal) ___-_ i~ ~_ (seal) Sworn or affirmed and subscribed before me by~n,.~ ~ G'`,a~~ and ~~~~/ ~• ^t~witnesses, this gam` day of~°/C.Z , ZO10. ~ ~J~K 4a~ William L. Grubb, Esquire PA Attorney ID 72661 4 st MEMBERS 1't FEDERAL CREDTT UNION REGULAR SAVINGS ACCOUNT: Account Number/Suffuc 235228-00 Date Account Established 09/09/2003 Principal Balance at Date of Death $346.09 Accrued Interest to Date of Death $.01 Total Principal and Accrued Interest $346.10 Name of Joint Owner - - None CHECKING ACCOUNT: Account Number/SufNx 235228-11 D-ate Account Established 09/09/2003 Principal Balance at Date of Death $2,032.97 Acuued Interest to Date of Deeth $.00 Total Principal and Accrued Interest $2,032.97 Name of Joint Owner None LOAN ACCOUNT: Account NumbeNSuffix Date Opened Principal Balance at Date of Death Loan Type Interest Rate Name of Co-Borrower "Loan does not have life coverage. 235228-02* 03121/2008 $457.41 Unsecured/Contractual Pledge of Shares 8.40% None M B RS 1~ F ERAL C DIT U~~~~jj ~~ +` y ~~'l le A. Kline ~~ •"'~ Lending Insurance Support Specialist November 22, 2011 Estate of: Harry F. Mitten Date of Death: 07105/2011 Soefal Security Number. 188-12-5087 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org ~ c Nv~wc. Date: 07/26/2011 Gross payment amount Net payment amount This Month 157.77 157.77 0360543 00 C~ROSS~ING BL partnership No. 1023733 FRAMINGHAM, MA 01702 DATE: 2S-JUL-11 VENDOR NAME HARRY F MITTEN VENDOR NO. 1049 6 071311 13-JiTL-11 6438 GULF CARD REFUND 0.00 249.97 PLEASE DETACH AND RETAIN THIS STATEMENT AS YOUR RECORD OF PAYMENT. ~~~ •!p" 0 • 0 Q 24 9.97 __ _ Mid-Atlantic COOOeratlVB Solutions. Inc. A!h/a Aarn Fnamv Yendoc ID -- Name - Payment Number Check Date Check Number R149850 HARRY F MITTEN PMT00000031925 08/18/2011 32005 Invoice'Number, : Date ' :'' '. ..:Amount Amount Paid ._ Discount ' NetAmount Paid aast~ut 09/79!2077 $352.90 $352.90 $0.00 $352.90 ... ~ - ccitvcK NO: 2720752 .. , :..` 7!28!2011 $**"******68.12 ..:_. _ - :' r~K,.y~Niwhsw .: ~. ~~..~N t Y { Sf~~~~~~ x .' OD 68:.12 C ~ .. i:i~~^. !^ FKSr.'uiquities c8ll (563) 383 2128 Detach gad rein this statement before: depositingcheck _ REMOVE DOCUMENT ALONG TIi1S PERFORATION ~:~ ~~. . ~;~ Y .f:. 1 .~ }. l Y .. 'a _. C: ,:. ,_r~_ ~- N0. e• Rl .. NT IF'-379298 ~S~NfL~EFt~I-I IF' F.CF'UND "' S.~. E3tIO9:.J ~JL~S.c^':i 'b IA Td: Hh1f;F;Y F' MITTE~t TOTAL: I}ISTL'. ~~~~c~c~~~of>.c5 •J _ _ _ _. JOHN D. WALTER ,. ~~.u*"' - 105 Ca,tisle Road #^~~~...~C+~+l~~~:~ • ~'t?=s.~ ~. T`~.... ~,~,:.~„~'+ti~. Newv+3le, PR 17241-~40t} ~ ~.+,,,.,, '~•.:...~''~~ ..~ ., €~: ~ E:~s~ : ~€~5.~.. ~~'~:- DES ;~"....'-. rr~'°"`~..; , .. ~~,'~ ~ oa USA FIRST-CLASS . ... XT t7B • 1*i•8£i .1. ! i J.I--.04 •OF3,f C 6:T7D SPRZ~kG KT~iOL.I. DF2 HARRISBU;aG`' AA i7'S1i-BQ43 E1C: i7iii4©S37Q *19iS-178v8'C '!~'~i`'i~'i~~as~ I,,,)I),,,I,,,)i,,,)I.,,I),Il„I,,I~I,i,,,,ll,),,,I1„lil„ _ ___ -- A UNIT RIN BUSINESS ' Date: 08-23-11 MILLER 1N5 ASSOC INC 79 BROOK W000 AVE CARLISLE PA 17013 z aooua ox a eooml oaooao i HARRY F MITTEN Unitrin Auto and Home Insurance Company CME #181 Policy Number: CV999432 NEWVILLE PA 17241 PERSONAL AUTOMOBILE POLICY ~~ ~~ Reason for Refund: CANCELLED~~~1U.t, If you have any questions please contact your agent at 717-243-44@0 a c c c c __ ....... .. ~ 5 c'~.z~~ l;, f , I ~,.,., r ~ I~OWE'S AUCTIQN S~l~.VICE (RH 79L) ,,; ,.~ _, 2605 Raitner Highway • Carlisle, PA 17015 $ill Rowe (AU 1538L) 249-1978 215-1044 574-1008 .Dave Rowe (AU 2295L) Auction Is Action -Call "Rowe" For Satisfaction ' - SELLERS NAME ~`,~ ~i ~tti ~ IyI + ~'FAl DATE ~ _ } ~ '" ~'~ ADDRESS ~ 7O Sn.LI N`, to ~ ~ ~~~ PHONE ~5~- 41092 OTHER ~i4Aa +~ ~ u ti, F~i4 ~ ?1 ~~ AUCTIONEER ~% ~ ~' AUCTION DATE/LOCATION 'T ~2r°~" CLERK DESCRIPTION OF MERCHANDISE Ij~ h `"' ~^ L.iti- ~ ~ Q 4 i L T- ~- n x/L- /~,(~j___~~-[ y^, ~vCS ,~~ ~ ~-,d.~ 5 - t~ ~a ~--vf~-n• C„1~~4.n_C.s.~ Y~n~~~ i.•lo~ _ .] tic-1.~. • 1~ l ~ pct ~.dn..~,..~., c }~ )c.-L:"_ !}~ 4.c, > S ( 4f, R. ~ . n--~~~~ f~.~ i~..:cFy_ G n .~..i7<~. ~ 1 l c.F. - ~ '.'~, ,~ic:.~ c-'~ 3S ~a t:~5 S ,N~ ....~ v..~ n..~ s~ -- ~-- Z .~L-.~.. c.rt 5 .,acs ~ c_d~,'~ S A~..y I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen- tative ofthe merchandise, goods and or property and have good title and the right to sell and that they are free from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of title to the purchaser. I agree to hold harmless the Auctioneers against any claims of the nature referred to in this agreem ~. A CTION SIGNATURE SELLERS SIGNATURE s~ _ Total Sales (Clerking Tickets Attached) $ `~ 1" 1 Less Sale Expense: (p L ~ ~ % Commission Auctioneer $:~~~"'~'"~~ % Commission Clerks S ~'~.,~,,,.~'~~~ ' .OTHER: ~n TOTAL SALE EXPENSE DEDUCTED S SELLERS NET $ ~ ~ ~ p ~rs~ 499 Ivtitchell Road, Millsboro, DE 19966 Adjustment Services Harry L Mitten 181 Conodoguinet Mobile Est Newville, PA 17241-9492 Re: Estate of Harry F Mitten Social Security: 188-12-5067 Date of Death: July 5 2011 Phone 888-502.4349 F ax (302)934-2955 November 23, 201 ~-~-~-. ~ Dear Sir or Madam: Per your inquiry on November 16, 2011, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Account Number Ownership (Names ofl Opening Date Balance on Date of Death Accrued /merest Totai lndividuat Retirement Aecotrnt 35004200305412 Harry F Mitten Harry Lee Mitten (Beneficiary) Mildred Estrada (Beneficiary) Bonnie Lau Hess (Benficiary) 06/13/00 $3.632.80 $ 25.08 $3, 657.88 _ . Por any additional information on the shove accounts, including ownership and any changes, closures and/or reimbursement of funds, please call the Stonehedge Office atf{'t17.24(I-4524. We were unable to locate any safe deposit boz for the above-mentioned decedent This letter does not include any accounts in which the deceased may have been listed as power of Attorney, Custodian of Uniform Transfers, Representative Payee, or Trustee under a Written Agreement Sincerely, Tammy Spencer Adjustment Services ~~~~ G, 1 ~~--, :~ ~,.~¢ ~~ LEA~lNG THE'WAY January 10, 2012 Harry L Mitten 6278 Spring Knoll Dr Harrisburg, PA 17111 RE: Name: Harry F Mitten SSN:188-12-5067 DOD: 07-05-2011 Dear Mr. Mitten: In response to your request for Date of Death (DOD) balances for the customer noted above, our records show the following: Savings Account Account #5000970499 Established: 12-02-1996 HARRY F MITTEN HARRY LEE MITTEN DOD balance: $1,382.06+0.01 accrued interest Interest paid 01-01-2011 thru 07-05-2011$0.05 YTD Please note that this office provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings). We do not process any financial transactions 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. Sincerely, National Financial Services Center PNC Bank, N.A. Member FDIC Page 1 of 2 PSEL~k y ~~.~,~ ~, I~~, ~ 11/29/2011 Ham L. Mitten 6278 Spring Knoll Dr. Harrisburg, PA 171 I 1 Re: HARRY F MITTEN, Deceased. PSECU Reference # 2581902851028 Dear Mr. Mitten: The above referenced person has an account with PSECU which was opened on 4/11/11. The Share accounts were ,jointly held by HARRY F MITTEN and HARRY L MITTEN. HARRY L MITTEN was added as a joint owner on 4/12/11. The following are the Date of Death Balances for HARRY F MITTEN's account with PSECU: Account Date of Death Balances Interest- July I-5 Savings (S1) $5,098.94 $ p,2g The account has been closed If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237-7328, press 6, extension 3120. incerely, ndy F e Member Service Representative PSECU Pennsylvania State Employees Credit Union 1 Credit Union Ptace, P.0. Box 67013, Harrisburg, PA 17106-7013 • 800.237.7328 • »psecu.com THIS CREDIT UNION IS FEDERALLY INSURED BYTHE NATIONAL CREDIT UNION ADMINISTRATION. EQUAL OPPORTUNITY LENDER. <g r~ ~u1~ yy ~~~ $ o~ rr~ ; y 0 N ,'~~' ,~ r v...~ .~ ,:w .~, - .~. N V N ._ LL. r~ ~lalS~;TF ~i= Wfl,la~ 201't MAR ~ i ~M 11 : . C~K r~ a~ ` vim.,':, i r' ~'t ~ `~. ~' ,~ ,~ ` M ~ s ~~ ~ _ d V , ,~ ? "~6 a t Q _~ ' ~r r~ 4. ~ ~~ /` Cr ~/ C~ ,~