HomeMy WebLinkAbout04-0905Estate of
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Sadie E. Miller No. ~l--~-q05
, Deceased Social Security No. 218- 32- 9471
P. Bruce Austensen
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or named in the last Will of
the Decedent, dated 11/01/2001 and codicil(s) dated None
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.t.a.; d.b.n.c.t,a; 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:
I Name '~ ~
Relationship
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
I
County, PennsY!vania with ~her last family
or principal residence at 61 Country View Estates, Newvtlle, PA 17241 ~o
(list street, number, and municipality)
Decedent, then 70 years of age, died 06/03/2004 at Gettysbur¢ Hospital, Gettysbur¢, PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal prope~'y
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of reaJ estate in Pennsylvania
$ 20,000.00
situated as follows:
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:
Si atur
~c~ ~ Typed or printed name and residence
¢"~-~ i~- ./ ./ J / P. Bruce Austensen
227 Street, Reisterstown, MD 21136
' ] ~._ ~.7--'t-*~/~ ~L~;~Cz~/ Main
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the know[edge and belief of Petitioner(s) and that, as personal repre~e.~tative(s) of
the Decedent, Petitioner(s)will well and truly administer the esta!~e.~ag~or~g to law. /~.~
Sworn to or affirmed and subscribed ~'~~
P. Bruce Austensen
before me this ~ ~day of
Estate of Sadie E. Miller Deceased
Social Security No: 218- 32 - 9471 Date of Death: 06/03/2004
AND NOW, 0 ~'~"O~3J~. ~.~ '
consideration
of ~he Petition on the reverse side hereon, satisfactou proof havin~ been presented before
IT IS DECREED that LePers ~ Testamenta~ ~ Of Administration (c.ta4 d.b.n.c.ta4 pendente I~e; durante absentia; durante minoritate)
are hereby granted to P. Bruce Austensen
in the above estate and that the instrument(s) dated 11/01/2001
described in the Petition be admitted to probate and filed of record as the last Wili of Decedent.
Letters ........... $5(~) · (--~ ~ ~~ ~L'/~'~L~ A'- [-
Register of Wills
Short Certificate(s) ..... $ C><OZ'/ ' ~)~)~~ ~/.ix~.~l~/y~ Attorney:
I.D. No: 34358
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( ) .... $
Codicil ........... $
JCP Fee .......... $ 1~, Ob
Cuthrie Nonemaker Yingst & Mart
Address: 40 York Street
Hanover, PA 17331
Telephone: 717/632-5315
Inventory .......... $
Other ........... $
TOTAL .........
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSysterns, Inc,
Form RW-1 (1991)
Estate of
aJso known as
Register of Wills of ^d=s County, Pennsylvania
OATH OF SUBSCRIBING WITNESS
Sadie E. Miller No~l- O~ -qO~
, Deceased
(each) a subscribing witness to the ~ codicil(s) ~ will(s) presented herewith, (each) being dub/qualified according to law
depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as
a witness at the request of Testator(rix) in his/her/their presence and r~ in the presence of each other [] in the presence of the
other subscribing witness(es).
(Signature)
(Address)
(Signature)
13923 Hanover Pike
Reisterstown, MD 21136
Sworn to or affirmed and subscribed
before me this c,~ day
N~ta~ ~u bile /
My Commission Expires:
(S[gnature ~nd seal of Nota~ or other official
quallfl~ to administer ~ths. Show date of
exp;ration of Norse's comm~sslo,.)
(Address)
KATHLEEN INCAPRERA
NOTARY PUBMC
BALTIMORE CO~ MD
NOTE:
To be taken by officer authorized to administer oaths.
Please have present the original or copy of instrument(s)
at time of notarization.
Prepared by the Pennsylvania Bar Association
Copyright(c) 1996 formsoftware only CPSystems. lnc. Forrn~RW-2 (1991)
Estate of
also known as
Register of Wills of ^,~s County, Pennsylvania
OATH OF SUBSCRIBING WITNESS
Sadie E.
, Deceased
Robert S. Knatz, Jr.
(each) a subscribing witness to the [] codicil(s) [] will(s) presented herewith, (each) being duly qualified according to law
depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as
a witness at the request of Testator(rix) in his/her/their presence and [] in the presence of each other [] in the presence of the
other subscribing witness(es).
(Signaturd) Robert'S. K6a~z, Jr~
227 Main Street
Reisterstown, MD 21136
(Address)
(Signature)
Sworn to or affirmed and subscribed
i ~fore me this ~ ~'~ day
Notary Public
(Address)
NOTE:
To be taken by officer authorized to administer oaths.
Please have present the original or copy of instrument(s)
at time of motarization.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #I~W-2 (1991)
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or pho~ograph.
Fee for this certificate, $2.00
P 102857,33
No.
Local Registra~
JUL
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
Sadie E. Miller
70 ~ arc
~ Adams Gettysburg Bo . Gettysbur~ Hospital
~,. Westminster,MD 21157 ,m.~ Carroll '~ ~7~.~ ~ Westminster .~
~'s~h~oma sGrimsley ~TM <F'' '"
,~ ,, ~nh~ ~eth Ellis
~ .............. ~I Country View Estates Newville PA 1724:
~ ~ DIJune 7, 2004 Bake VSew Hemor~al Park Sykesv~lle HD 2~784
· -' . 1~SLLle s ~.H. 34 ~aple Ave.
~ ~-~- I~.~) I I .... PA 17340
LAST WILL AND TESTAMEN?
OF
SADIE E. MILLER
I, SADIE E. MILLER, of Carroll Countv, State of Marv]and,
being of sound and disposinq mind, memorv and understanding, do
make, publish and dec]are this as mv Last Will and Testament,
herebv revoking anv and all other Wills and Testamentarv
Dispositions bv me at anv time heretofore made.
ITEM ONE
I direct mv Persona] Representstive, heretnafter~named~~ to
pay all mv just debts, funeral expenses and other ad~nistrstion
expenses of mv estate as soon as oossib]e afte~!mv de~th, wl:~hout
the necessitv of the prior or subsequent approval of the Orohans
Court or of anv other Court as to the amounts thereof, and or
without regard to anv limits prescribed bv ]~w.
I further direct that all estate, inheritance and succession
taxes which shall become pavab]e bv reason of mv death, shall be
paid out of the principa~ of mv estate, without seeking reim-
bursement from or charging anv person therefore. Mv Persona]
Representative, in his discretion shall have the right to
litigate, compromise or settle any such taxes, and a~v action
taken bv mv said Persona] Representative with respect thereto,
including deposits made to secure the pavments thereof, shall be
conclusive on al] persons.
ITEM TWO
I herebv give, devise and bequeath all the rest, residue ~nd
remainder of mv estate and propertv of whatsoever kind, nature,
character and description, real, persona] and mixed, however
acquired and wheresoever situated, of which I mav die seized or
possessed, or in which I mav have ~n interest, or over which I
mav have power of appointment or testamentarv disposition to mv
three children, BRENDA LEE VARNER, PATRICIA ANN MILLER and
FRANCIS LEE MILLER, share and share alike, per stripes, EXCEPTING
that I specifical]v give, devise and begueath mv 2001 Ford Focus
automobile to mv daughter, BRENDA LEE VARNER and all mv jewelrv
to mv granddaughter, MICHELLE RENEE LYNN VARNER.
ITEM THREE
I do herebv nominate, constitute and appoint P. BRUCE
AUSTENSENto be the Persona] Representative of this mv Last Will
and Testament, and as I have entire confidence in mv said
Persona] Representative, I request that he be excused from the
necessity of giving bond for the faithful performance of his
duties, further than shall be required bv law to secure the
pavments of all debts, assessments and taxes properlv chargeable
upon my estate after mv death.
ITEM FOUR
I do hereby give and confer upon mv Personal
the right, authorization and power to do anv and
Representative
all things
necessarv for the comp]ete administration
the power:
A. To distribute anv part of mv estate to anv minor
who mav be entitled to such distribution.
B. To sell, lease, mortgage, exchange or
of all or anv part of the propertv belonging
of mv estate, including
children
otherwise dispose
to mv estate, rea],
personal and mixed, at a public or private sale, and to make,
execute and deliver proper deeds, convev~nces, leases, mortgages,
and transfers or dispositions.
C. To compromise and settle all c]aims, charges and demands
against or in favor of mv estate.
O. To divide in kind for the purpose of administering and
settling mv estate, or to sell for the purpose of division to the
PAGE TWO OF THREE PAGES
extent that such exercise is appropriate or advisable.
E. To vote at ail stockholder meetings either in person or
by proxy the stock of any corporation which may be owned by mv
estate, without application to or necessity of obtaining the
prior or subsequent approval of the Orphans Court or
Court in the exercise of this power.
IN TESTIMONY WHEREOF, Witness mv hand and seal this
of anv other
SIGNED, SEALED, PUBLISHED AND DECLARED bv SADIE E. MILLER,
the above named testatrix, as and for her Last Wi]] and Testament
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 thereto.
WITNESS:
PAGE THREE OF THREE PAGES
In the Estate of:
Sadie Miller
Estate NO. ~.~ I- Oq
Date October 12, 2004
CLAIM AGAINST DECEDENT'S ESTATE
The claimant certifies that there is due and owing by the decedent in accordance
with the attached statement of account or other basis for the claim the sum of
$ 7,375.00 (plus interest of 1% per month) per contract
I solemnly affirm under the penalties of perjury that the contents of the foregoing
claim are true to the best of my knowledge, information, and belief.
Haight Funeral Home & Chapel, P.A.
$1gnllute of ~llllmln! or pl~ofl M]lhMIzed to mike
verlRcmllone on beh. lt of tlelment
Brian L. Haight, V.P.
Name Ind TIIle ol P~-sofl 81gnlng Clllm
FILED:
PO Box 195, Sykesville, MD 21784
Addr~.
(410)-795-1400
r~,
Tellphoni~NumbM' ~-~
RECORDED:
Claims Dockel Liber Folio
InMnJcllons:
1. This Iorm may be filed with Ihe Register of Wills upon paymenl of the filing lee provided by law, A
copy must also be sent to the personal represenlative by the claimant.
2. If a claim is nol yet due, indicale Ihe date when it will become due. If a claim is conlingent, indicale
the nature of the contingency. If a claim is secured, describe Ihe security.
RW ~1
CERTIFICATION OF NOTICE UNDER RULE 5.7
Name of Decedent:
Date of Death:
Will No.
SADIE E. MILLER
JUNE3,2004
2104-0905
To the Register:
I certify that notice of beneficial interest required by Rule 5.7 of the Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate on
/
Name Address
Brenda L. Varner
Patricia A. Miller
Francis L. Miller
Michelle R. L. Varner
61 Country View Estates, Newville, PA 17241
10 Betty Place, Finksburg, MD 21048
10 Stuart Circle, Hanover, PA 17331
61 Country View Estates, Newville, PA 17241
Notice has now been given to all persons entitled thereto under Rule 5.7 except:
NONE
J~s T. Yingst, ~squ
qDuthfie, Nonemaker, Yingst & Hart
40 York Street
Hanover, PA17331
(717)632-5315
BALOGH BECKER, LTD.
JAMES A. BA~OGH - MN
G~RY W. BECKER - DC, FL, IL, MN, WI*
"CREDITOR*S RIGHTS SPECIALIST
AMERICAN J~OARD OF CERTIFICATION
CHELSEA A. WHITLEY - MN, WI
ANGELA M. HORN - MN
MICHAEL D. JOHNSON - MN
MARY ELLEN WEEMAN - KS, MN, MO
THERSlA O. LEE - MN
CHAD J. BOUNSKE - MN
STEVEN M. TOMS - MN
MICHAEL L. MCCAIN - MN
JOHN E. OLCHEFSKE - MN
JASON R. EOSTER - MN
MEAGAN M. PROBST - MN
MICHAEL J. DOUGHERTY - MN
MICHAEL D. BOLINSKE - MN, OR
REGISTER OF WILLS
A1-FORNEYS AT LAW
SEND ALL WRITTEN REPLIES TO:
4150 OLSON MEMORIAL HIGHWAY, SUITE 200
MINNEAPOLIS, MINNESOTA 55422-4811
TELEPHONE 763-852-8440
FAX 763-852-8499
TOLL-FREE 866-234-0513
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE, #102
CARLISLE, PA 17013
64 E. BROADWAY ROAD
SUITE ] 75
TEMPE, AZ 85282
DIANA THEOS - AZ, CO
SANDRA TANG - AZ, CA
OF COUNSEL:
LITOW LAW OFFICES, P.C.
(iOWA)
LUSTIG, GLASER & WILSON, P.C.
(MASSACHUS E3TS)
11/10/04
Re: In the Estate of
Probate Case No. 21-2004-0905 P"~
Social Security No: 218329471
Last known residence: 61 COUNTRY VIEW NEWVILLE, PA 17241 .~.~
Our Client: CITICORP CREDIT SERVICES INC.
Account Number: 5424180304833830
Amount of Debt: $ 7317.83
SADIE E MILLER
Dear Sir or Madam:
Enclosed please find a Creditor's claim to be filed in the record with the above-referenced Estate.
Please return a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you
for your assistance. If you have any questions or if this is a duplicate claim, please call our firm toll free at 1-
866-234-0513
Cordially,
Balogh Becket, Ltd.
Attorneys at Law
Enclosures
A check for $5.00 for the filing fee.
cc: Attorney for Estate
Personal Representative
This letter is an attempt to collect a debt and any information obtained will be used for that purpose. This
letter is from a debt collector.
5145 11/8/2004 1219356
COMMONWEALTH OF PENNSYLVANZA
NO TICE OF CLAIM
COURT OF COMMON PLEAS
OF CUMBERLAND .COUNTY
ORPHANS' COURT DXVXSXON
Xn Re: The E.tate of:
SADIE E MILLER
Deceased
Court File No: 21-2004-0905
TO: THE CLERK OF THE ORPHANS' COURT DXVXSXON:
Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate,
Estates, and Fiduciaries Code, 20 PA.C.S.A. §3532(b)(2)
CITICORP CREDIT SERVICES INC.
:~) Claimant's name:
C/O BALOGH BECKER LTD, 4150 OLSON MEMORIAL
2) Claimant's address: HWY #200
MINNEAPOLIS, MN 55422
866-234-0513
3) Creditor listed below is the owner and holder of a claim in the amount:'df
$ 7317.83
4) The facts upon which this claim is based:
This claim is based on an account for credit evidenced by the attached
Affidavit of Account Stated.
5) Decedent's address: 61 COUNTRY VIEW NEWVILLE, PA 17241
6) Date of Death: 06/03/04
7) That the claim arose prior to the death of the decedent on or about
8) That the claim is secured by.
On behalf of the claimant, I do solemnly declare and affirm under the penalties of
perjury that they Information and representations made hewn are true and correct
to the best of my knowledge, information an.,,~Pl~f. / /
Dated.. tl-tt,-Oh
Che~aea A. Whitley/Angela M. Horn/Mary E~en~an/Chad Bolinske/Thersia Lee, Attorney-in-Fact
Written notice of claim was given to Personal Representative and/or his/her counsel
as stated below:
P BRUCE AUSTENSEN
Name
227 MAiN ST
Address
REISTERSTOWN, MD 21136
City/State/~ip ~ ,
Date notice~ m~iled
IN RE ESTATE OF: SADIE E MILLER
AFFIDAVIT OF ACCOUNT
The undersigned, being first duly swom deposes and states the follows:
1. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit.
Your Affiant has reviewed the account records of the Claimant with respect to the
decedent. Your Affiant is familiar with these records and accounts and reviews them as a
regular part of his/her duties.
The Decedent purchased merchandise in the amount of $ 7317.83
account namber 5424180304833830
evidenced by
The unpaid balance does not include any post-death late payment charges, accrued
interest, collection costs or attorney's fees.
Further your affiant sayeth not
BALOGH ~LT~
By: --:: ......~ ~
One of its attorneys:
Chelsea A. Whitley _ Angela M. Horn
Michael D. Johnson ~¢~ary Ellen Weeman__
Thersia O. Lee / Chad J. Bolinske
4150 Olson Memorial Highway, Suite 200
Minneapolis, MN 55422-4811
Subscribed and sworn before me
This /c~. day of '~J. ,2004
NOTARY PUBIJC - MINNESOTA ~
- -- HI~NNEPIN COUNTY ~
My UOmmmaion Expires Jan. 31, 2~o08~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAt!Si4ffi.jED OCFiCE ijC NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISIDN,' ,-- '. " ,APPRAISEMENT, ALLOlIANCE OR DISALLOllANCE
PD BDX Z80,01 '--' _ OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
*'
REV-1548 EX AFP (06-05)
20D5 !,UG 12 Pi,; I: 09
DATE 08-15-2005
ESTATE OF MILLER SADIE E
DATE OF DEATH 06-03-2004
FILE NUMBER 21 04-0905
COUNTY CUMBERLAND
SSN'DC 218-32-9471
ACN 04132837
APPEAL DATE: 10-14-2005
(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
CLE::'< C:C
Of?-'
BRENDA ct.YARNER"
61 COUNTRYYIEW ESTATES
NEWVILLE PA 17241
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -
REV=is4S-EX-AFP-loj=OSl--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HEL~ OR TRUST ASSETS
DATE 08-15-2005
ESTATE OF MILLER
SADIE
E DATE OF DEATH 06-03-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-0905
TAX RETURN WAS:
S.S/D.C. NO. 218-32-9471
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
04132837
FINANCIAL INSTITUTION: ORRSTOWN BANK
ACCOUNT NO.
106002057
TYPE OF ACCOUNT: ()SAVINGS IX) CHECKING (>TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 05-07-2001
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
541.77
0.500
270.89
.00
270.89
.45
12.19
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:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 08-23~2005 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 12.19
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .29
TOTAL DUE 12.48
N IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. N
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRJ, YDU HAY BE DUE A REFUND.
--- --............. "'T'ftoe nle' T"T~ ~nDM FnR INSTRUCTIONS. )
~~
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF 'NDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
September 22, 2005
Telephone
717-787-6670
James T. Yingst, Esq.
40 York St.
Hanover, Pa. 17331
Dear Mr. Yingst:
Re: Estate of Sadie E. Miller
File Number 2104-0905
RK.
The Department has been advised that the above-referenced estate is
presently involved in litigation. The Department will SUspend further activity on this estate until
September 22,2006. You are required to notify the Department when the status changes or the
extension date expires.
If you have any questions, please contact me at (717-787-6670).
co
,~ -
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I OffiCiAL USE ONLY
'FILE NUMBER
i .il 04 0905
I COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
REV-1500 EX + (6-00)
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i DECEDENT S NAME (LAST, FIRST, AND MIDDLE INITIAL)
I Miller, Sadie E.
FTE OF DEATH (MM-DD-YEAR) :' DATE OF BIRTH (MM-DD-YEAR)
06-03-2004 03-12-1934
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
218-32-9471
I
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o
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o
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
~ 1. Original Return
D 4. limited Estate
o 6. Decedent Died Testate (Attach
copy of Will)
D 9. Litigation Proceeds Received
o
D
D
D
o 11.Election to tax under Sec. 9113(A) (Attach Sch 0)
2. Supplemental Return
3, Remainder Return (date of death prior to 12-13-82)
4a. Future Interest Compromise (date of death
after 12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Povertyt Credit (date of death between
. 12-31-91 and 1-1-95)
5. Federal Estate Tax Return Required
8, Total Number of Safe Deposit Boxes
......................
...................
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James T. Yingst, Esquire I
FIRM NAME (If applicable) I
Gut h r ie, Non e m a k e r, Y i n g s t & Hart i 40 Yo r k S t r e e t
I Hanover, PA 17331
I TELEPHONE NUMBER I
I,
717-632-5315 i
1 . Real Estate (Schedule A) (1 ) None
2. Stocks and Bonds (Schedule B) (2) None
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 95,084.08
(Schedule E)
2 6. Jointly Owned Property (Schedule F) (6) 270.89
0 D Separate Billing Requested
~
< 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None
..J
:) (Schedule G or L) D Separate Billing Requested
I-
0: 8. Total Gross Assets (total Lines 1-7)
<
u 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 20,983.59
w
"
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11,586.12
11. Total Deductions (total Lines 9 & 1 0)
12. Net Value of Estate (Line 8 minus Line 11)
I~OFF!ClACVSE ONL\ I
: ) ~
I :.' I
~ t~~' _l~
. ',' 'I
:.................................................................
(8)
95,354.97
(11 )
32,569.71
62,785.26
0.00
(12)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not
been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
62,785.26
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
2 or transfers under Sec. 9116(a)(1.2)
0
~ 16. Amount of Line 14 taxable at lineal rate 62,785.26 x .045 (16)
::
:)
a. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
:E
0
u 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18)
x x
~ 19. Tax Due
(19)
0.00
2,825.34
0.00
0.00
2,825.34
20.0
::::::::::::::::::\::::;::::::\::::::;:::::;. .:::::::::<::::::::::::::::<m/:}~::ij$:jijRi@Q:AN~Wgfl:AtWQij~~ijj9N.ij:9ij:ij$&Ri$:jjpij:Aijttij~iji9ii~ijij}~@::fmrr}}:\ ..
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Copyright 2002 form software only The Lackner Group, Inc.
Fonn REV-1500 EX (Rev.~
Decedent's Complete Address:
STREET ADDRESS
61 Country View Estates
CITY Newville
I STATE PA
IZIP 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
2,825.34
0.00
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
150.92
Total Interest/Penalty (0 + E)
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
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(3) 150.92
(4)
(5) 2,976.26
(SA)
(58) 2,976.26
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
o 0
D ~
o ~
o 0
o 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. D 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?................................. ....... ......... ...................................................................... 0 0
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 f 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 RESP NSIBLE FOR FILING RETURN ADDRESS
P ce Austens
1. 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;.........................................
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?....................... .................................................................. ................................
Yes
DATE
227 Main Street
Reisterstown, MD 21136
3/3/oc
DATE
ADDRESS
ADDRESS
3/ j/O b
DATE
40 York Street
Hanover, PA 17331
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. 39116 (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. 39116 (a) (1.1) (ij)]. 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. 39116 (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.
39116 1.2) [72 P.S. 39116 (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. 39116 (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.
Rev-H508 EX+ (6-98)
W,.
. (
i
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Miller, Sadie E.
FILE NUMBER
21-04-0905
ESTATE OF
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 DESCRIPTION
VALUE AT DATE
OF DEATH
1 Net proceeds from survival action - P. Bruce Austensen, Executor of the Estate of
Sadie Miller v. Penny Monforte, Adams County Court of Common Pleas, No.
05-5-1423 (settlement check dated 01/19/06)
83.170.89
2 Prudential Insurance Company - reimbursement for collision auto damage
7.331.24
3 Prudential Insurance Company - personal injury protection payment
3.763.34
4 Orrstown Bank Checking Account #106002184
406.64
5 Prudential Insurance Company - refund of deductible
250.00
6 United American Insurance - refund
161.97
7 Per Item Two of Will regarding all jewelry specifically devised to granddaughter,
Michelle Renee Lynn Varner - all jewelry was given away during decedent's lifetime
more than one year prior to date of death
0.00
TOTAL (Also enter on Line 5, Recapitulation)
95.084.08
(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)
Rev-1509 EX+ (6-98) . ~
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL V-OWNED PROPERTY
Miller, Sadie E.
FILE NUMBER
21-04-0905
ESTATE OF
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
A. Brenda Lee Varner
ADDRESS
RELATIONSHIP TO DECEDENT
61 Country View Estates
Newville, PA 17241
Daughter
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
LETTER DATE
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENTS INTEREST
JOINTLY-HELD REAL ESTATE.
1 A 5/7/2001 Orrstown Bank Checking Account 541 .77 50.0000/0 270.89
#106002057
TOTAL (Also enter on Line 6, Recapitulation) 270.89
(If more space is needed I additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule F (Rev. 6-98)
REV-1151 EX+(12-99)
.'''.
, .
, I
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Miller, Sadie E.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-04-0905
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
7,375.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
P. Bruce Austensen
Social Security Number(s) / EIN Number of Personal Representative(s):
214-32-7815
City
Year(s) Commission paid
Street Address 227 Main Street
Reisterstown
State MD Zip 21136
2006
4,760.00
2.
Attorney's Fees
James T. Yingst, Esquire
4,760.00
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Brenda Lee Varner
Street Address 61 Country View Estates
City Newville State PA Zip 17241
Relationship of Claimant to Decedent Daughter
3,500.00
4.
Probate Fees
250.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
338.59
TOTAL (Also enter on line 9, Recapitulation)
20,983.59
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
~
~
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Miller, Sadie E.
FILE NUMBER
21-04-0905
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Haight Funeral Home - funeral service
7.375.00
Subtotal
7.375.00
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
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Miller, Sadie E.
FILE NUMBER
21-04-0905
ITEM
NUMBER DESCRIPTION AMOUNT
1 Chart One - medical records 43.28
2 Cumberland Law Journal - estate notice 75.00
3 Little's Funeral Home - death certificates 54.00
4 Register of Wills, Cumberland County - filing fee 30.00
5 The Sentinel Legal - estate notice 136.31
Subtotal
338.59
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
~
~
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Miller, Sadie E.
FILE NUMBER
21-04-0905
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Bon Ton - account balance at death
VALUE AT DATE
OF DEATH
466.01
2 Citicorp (Balough Becker, L TO) - account balance due at death
7,317.83
3 Gettysburg Diagnostic Imaging - unreimbused medical expense
24.00
4 Gettysburg Fire Department - unreimbursed ambulance expense
400.00
5 Gettysburg Hospital - unreimbused medical expense
175.25
6 Lowe's - account balance due at death
2.177.36
7 Orrstown Bank Checking Account #106002184 - checks cleared post-death
1.025.67
TOTAL (Also enter on Line 10, Recapitulation)
11 ,586.12
(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)
SCHEDULE ..
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Sadie E. Miller 218-32-9471 06/03/2004
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
1 Francis Lee Miller Son 1/3 residue 0.00
10 Stuart Circle
Hanover,PA 17331
2 Patricia Ann Miller Daughter 1/3 resid ue 0.00
10 Betty Place
Finksburg, MD 21048
3 Brenda Lee Varner Daughter 1/3 residue, plus 0.00
61 Country View Estates insurance collision
Newville, PA 17241 damages in lieu of
2001 Ford Focus
automobile
4 Michelle Renee Lynn Varner Granddaughter All jewelry 0.00
61 Country View Estates
Newville, PA 17241
Total
1
~oo
,...../ ~ ,'-"';;
ORRSTOWN BANK
October 20,2004
TO: law Offices of
Guthrie, Nonemaker, Yingst & Hart
40 York Street
Hanover, PA 17331
FROM: Timothea Moose
Cust. Servo Op.
P.O. BOX 250
SHIPPENSBURG PA 17257-0250
RE: ESTATE OF Sadie E Miller
DATE OF DEATH: June 3,2004
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOllOWING ACCOUNTS WITH ORRSTOWN BANK:
(1) CHECKING ACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
106002184 Sadie E Miller 8/22/01 406.64
106002057 Sadie E Miller 5/7/01 541.77
Brenda L Varner
(2) SAVINGS ACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
(3) CERTIFICATES OF DEPOSIT
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
P.O. BOX 250
SHIPPENSBURG, PA 17257
.
TEL. (717) 532-6114
L l\ S '1' NIL L j\ 1'1 \) T g S T}\ N E H'1'
.________t_....___..-----
OF
g~~I~_~~~~;n
T, S 1\ 0 lEE. ~1 ILL E R, 0 feCi r r 01 1 Co U n tv, S t: a 1:: e 0 fT.' a ': v 1 and ,
be 1. n q 0 f S Q U n d ::If I d d -L '3 P /) r~ i \l q l'fll n d, It) E' f(l 0 r v .:.l n dun d e r s t: and t n q, d /)
rr FJ k e, I? u b 1 ish and c1 E' C 1 iJ r. E' t h t s a S f11 v L -3 <3 t w i. 1 1 3 n cJ T E' S t -3 III I? nt,
herebY t:"l?vol~ tng any Gncl ;;l11 other: \'Ji 11s and 'l'E'sta1l10nt::n:v
Disoosltions bv ll1E' (JI: ;;Jnv tirlle heretoforE' lnade.
. I
1'1' En or.JE
I d t. I;' e c t Hl V P E' r son J 1 H P P r ~? '3 (' \ 1 t .) l: l v (', \ I 4-: t E' t n ~ f t (' r n a Ill'? 1,1, t 0
p. ;:I V -3 11m v jus t deb t s, ( u n (' r ~l 1 f:> X t? ens e g C1 n dot her: a r1 rn In 1. ~; I: r i) t i Q n
e"{H'nSE?S or: mv E'st~)t.E' -3G soon as ?08~i.ble after mv ol?3th, \"1.thoul:
the n E' C f~ S g t tv 0 f I: h (~ P l~ 1. 0 t: (> r ~5 u b ('~ "q u e n I: -:J 0 P \." Q V ? 1 0 f t h (> 0 \~ r) I J ;:i n s
COU(t or of any other Court as to the amounts thereof, 9nd or
w t I: h 0 U t r l? q -3 r c1 t 0 a n v 1 t 111 t t '3 I? ( (;) S C ( 1. b r::> d b v 1::l \'J .
I further dir!?cl: tl1at all esl;;\I.:p" tnhE'l.:'lt:;lnce and sUCCpc:>slon
t~n{I?S which shall b(?C01/lP 9avr.Jb'le bv rf:'-3Sr)\l or ll1V cll?at~"\, '3\1;;111 be
? ~ l d 0 U toE t h '? P t" 1. n c i l? :=J 1 0 f TI1 V E' S tat l?', \y t tho u t s P, E' Ie t T'l q rei. T(l-
b I J t' G e Tn E' n t fro III 0 r c h a r q 1 11 q a q II per son thE' r f' E 0 r E' .
Hv Personal
I-<pt:Hf?sentativE', in his di.screl:loll shall have> t:hl? rtqht to
1 l t i. q () t (>, co TI'? r 0 rrd. s e 0 r S ~ 1: t 1 (> :] 11 V S L1 C h t a i{ E' S, B n c1 a n V -3 C t l 0 n
t ~ k E' n b v {[IV '3 C) i. ,:1 P E' r u em::.J 1 R E' \::n: E' C.3 P. n t r) l tv e '1:1 t t h res p E' C t t h p r (? to,
lncludtng dr??osi.ts l(lade.> to '3ecurp I:h~ ?:JV1llpnls thet:'E'of, shall Uf?
con c , u s 1. v E' 0 n :;1 -\ 1 1;> E' (" yon s .
:r 'rm.1 'J'~'10
I h E' r E' b V q t v (J, cl (' v L '5 l:? () n (.1 Iy: qUE' ? t 11 .) 1 1 t h t? r: est, ( P S 1. d u r.> :J n (1
rs~r[1:dnller of 1[lV eej I:.::! I:.;, :Ind ~,)"-()PC'rl:v or' wl1ul:CJ()f."vP'~ kl.nd, 11::'lt:urr,
c h Q t :J C t l? ran c1 des c r. t p t 1. 0 n, r ',> ~J 1, l?~? r s () 11 ~ 'I -3 n d HI l X f? c1, how P. V C ('
acquired and wh~resoeve( situated, of which I mav di~ seiz~d or
p 0 S <3 e r;; s E' (1, 0 r to \oJ h i. chI ll1;;J V h a v e ani. n t E' r E' s t, 0 r 0 \! ~ (" \.J t 1 i c h .r
TfI 8 'I h;::} V E> pOW \? ( 0 f ;:H::> \? 0 1 n t 'l1 E' n t () ': t. est: :J 111 E' n i: =) r V c1 i. \3 P (y,] 1. t 1. 0 n t (J m v
(~ ,c ten t t h a I: <J U c h l? J{ C' r c 1. s p 1. s ,;) ? P (' 01;' l: i. :3 t E' 0 r. a d v 1 s a b 1 e .
E. '1'0 vat'? 3t all stockholder meetinqs eithl?'C in Df?l'Son or
b v p (' 0 ){ v I: hE'S toe k 0 f () n vCr) ': P 0 r d t ton It; h i. c h ITP) V b p t) iI!t 1 f? d b v rn v
E' S I: 3 l: l?, W t tho uta p!? 1 tea t i. 0 n too r n e C' (? S G 1. I: v 0 fob t: a l n t n q t h (?
l? l." tor 0 (' 6 1.1 b '3 l' que n tal? I,) t: 0 V .'3 1 <) E thE' 0 r ph .J n G C 0 U '( t \) r 0 f -3 n v 0 \: h e t.'
Court in the exe~ctge of this ~owpr.
I N rr E S rr I M () N Y ~v II E H COP', t \I l t n e S S lJ'V h a n C ~ n d '3 P.J 1 t: his
._.__t_""__ D........_f.__-_d ~ v (7
w! _ _.. 0 f .___!.~7.!?:]~!.~~y~~.~~....12 0 0'1 .
r'<~c RC.~Jl. _Jr.:~"-j~~)~r-ll.;;flL:;-..._._. - '..--
-:ll\ 0 ll~ h. l'-1 r ,J L I J H
SIGNED, SEAL8D, PUBLISHED AND DECLARED bv SAOI~ E. MILLER,
thE:"' abovE' nameu testatrlx, ;;IS <3nd for hpr L9sl.:. Will and Tpst.?ITlpnl:
l nth e p t (:' S en CE'O f US, VI h 0, Q l: 11 err .;>q u (' s 1.:, i. n her 9 r p s (? nee .'3 n (1
l nth t? l? res e n c !? 0 r: ~ a c h 0 l: 111? r 1.1;) V E' sub s c r l bed 0 u t:' n a Ill!? S a s
wltn~ss~s thereto.
~'lI'rNESS :
.--/;:1 /- f ( .- 'l..- Q /1
N A H E L{i{vJ-:Q_J.{LL.!'4_-};:::=
l\ DOn 8 S S ,;} 1 ( ?/&~J^t/,;d
a ,.-'--'--.----~-:-~'-.--- -.-::-
.L{i2?!lfi2f0::t:}J14_'1:.Lt1~
l'J 1\ r-] E~:::.~~0J::~r _.~._.Jd:Sk;L.:'~~ ~C~
^ 0 l) H E S s.~~i~~::.~~r;;?(t:::?,y__&".:~
.d32<d~~~~~r~')~~~:~~ ~::?!"L7('
P 1\ G E rp H R E: E: 0 F l' H R E r~ P 1\ G E S
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
AUSTENSEN P BRUCE
227 MAIN STREET
REISTERSTOWN, MD 21136
nnnn fold
ESTATE INFORMATION: SSN: 218-32-9471
FILE NUMBER: 2104-0905
DECEDENT NAME: MILLER SADIE E
DATE OF PAYMENT: 03/07/2006
POSTMARK DATE: 03/06/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/03/2004
NO. CD 006408
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,976.26
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$2,976.26
REMARKS:
CHECK# 1001
SEAL
INITIALS: MG
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
)
J
.. ,
Register of Wills, Cumberland County, Pennsylvania
INVENTORY
J Deceased
No. 21-04-0905
Date of Death 06/03/2004
Social Security No. 218-32-9471
Estate of Sadie E. Miller
also known as
P. Bruce Austensen
The 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 real estate located 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 the Decedent owned no real estate outside of the Commonwealth of
Pennsylvania except that which appears in a memorandum at the end of this Inventory. IlWe verify that the statements
made in this Inventory are true and correct. IlWe understand that false statements herein are made subject to the
penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities.
1.0. No.:
34358
Attorney:
James T. Yingst, Esquire
Signature:
Signature:
Firm: Guthrie, Nonemaker, Yingst & Hart
Address: 40 York Street
Hanover, PA 17331
Telephone: 717-632-5315
Address: 227 Main Street
Reisterstown, MD 21136
Telephone: 410-833-2250
Dated:
,3h~
, '
Personal Property
Cash.................................................................................................. ..
Pe rso na I Prope rty .............................................................................
Stoc ks/Listed.....................................................................................
Stoc ks/Closely Held.........................................................................
Bonds.................................................................................................
Partnerships and Sole Proprietorships ........................................
Mortgages and Notes Receivable....................... .................... .......
All Othe r Property.............................................................................
95,084.08
0.00
Total Pe rso na I Property...........................................
95,084.08
....,.}
T ota I Rea I Pro pe rty ........ ...........................................
Total Personal and Real Property........................... r" :'::::::::::::.::::::::':::~~~I~~I::;:I
Total Out-of-State Real Property............................
.-
t#
., .,
Register of Wills, Cumberland County, Pennsylvania
INVENTORY
Estate of
Sadie E. Miller
No.
21-04-0905
also known as
I Deceased
Date of Death 06/03/2004
Social Security No. 218-32-9471
Cash
Net proceeds from survival action - P. Bruce Austensen, Executor of the Estate
of Sadie Miller v. Penny Monforte, Adams County Court of Common Pleas, No.
05-5-1423 (settlement check dated 01/19/06)
83.170.89
Orrstown Bank Checking Account #106002184
406.64
Prudential Insurance Company - reimbursement for collision auto damage
7.331.24
Prudential Insurance Company - refund of deductible
250.00
Prudential Insurance Company - personal injury protection payment
3.763.34
United American Insurance - refund
161.97
Total Cash
95.084.08
Personal Property
Per Item Two of Will regarding all jewelry specifically devised to granddaughter,
Michelle Renee Lynn Varner - all jewelry was given away during decedent's
lifetime more than one year prior to date of death
0.00
Total Personal Property
0.00
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
95.084.08
I
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV.1162 EXI11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
AUSTENSEN P BRUCE
227 MAIN STREET
REISTERSTOWN, MD 21136
------.- fold
ESTATE INFORMATION: SSN: 218-32-9471
FILE NUMBER: 2104-0905
DECEDENT NAME: MILLER SADIE E
DATE OF PAYMENT: 05/05/2006
POSTMARK DATE: 05/04/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/03/2004
NO. CD 006661
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1.62
,
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1011
SEAL
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
$1.62
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
LAW OFFICES OF
GUTHRIE, NONEMAKER, YINGST & HART
40 YORK STREET
HANOVER, PENNSYLVANIA 17331
RALPH E. RUDISILL 0888-1954)
HAROLD B. RUDISILl 0898-1969)
LOUIS T. GUTHRIE
KEITH R. NONEMAKER
MATTHEW L. GUTHRIE
JAMES T. YINGST
OJ. HART (PA. MD)
TELEPHONE (717) 632-5315
FAX (717) 632-5734
Writer's E~mail jamesy@gnyh.com
May 3,2006
Cumberland County Courthouse
~Register of 'Alills
One Courthouse Square
Carlisle, P A 17013
Re: Estate of Sadie E. Miller
File No. 21-04-0905
Dear Sir or Madam:
Please find enclosed a check in the amount of$1.62 and a copy of the notice of inheritance
tax due in the above referenced estate.
Also enclosed is the status report indicating the administration of the estate is now complete.
Please return a stamped copy of this status report for my records. A return envelope is provided.
Thank you.
Sincerely,
GUTHRIE, NONEMAKER,
YINGST & HART
/ ~~
~~'/
/; James T. Yingst, squire . ..
1/
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04-24-2006
MILLER
06-03-2004
21 04-0905
CUMBERLAND
101
APPEAL DATE: 06-23-2006
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REv:is47-Ex-AFP-C03:osj-NoTIcE-OF-INHERITANCE-TAX-APPRAISEMENT:-ALLOWANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
SADIE E FILE NO. 21 04-0905 ACN 101
aUREAU OF INDIVIDUA( iilJCi$ED OFf:iCE
INHERITANCE TAX DIVISION
'D BOX 280601 ! . c
iARRISBURG PA 17128-0601 .
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
2006 APR 24 PH 3: 59
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CLERK OF
ORPHAN'S COURT
JAMES T ~W{'f)\.E\S:Q) CO, PA
GUTHRIE ETAL
40 YORK ST
HANOVER
PA 17331
ESTATE OF
MILLER
REV-15~7 EX AFP (06-05)
SADIE
E
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
DATE 04-24-2006
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS.
.00 X 00 = .00
62.785.26 X 045 = 2.825.34
.00 X 12 = .00
.00 X 15 = .00
(19)= 2,825.34
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
95.084.08
270.89
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
20.983.59
11 .586.12
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
95,354.97
32.569 71
62.785.26
.00
62,785.26
.
rlun!:1'I "....".., . (+J AMOUNT PAID
DATE I NUMBER INTEREST/PEN PAID (-)
03-06-2006 -/CD006408 150.92- 2,976.26
BALANCE OF UNPAID INTEREST/PENALTY AS OF 03-07-2006 TOTAL TAX CREDIT 2,825.34
BALANCE OF TAX DUE .00
INTEREST AND PEN. 1.62
TOTAL DUE 1.62
~ IF PAID AFTER DATE INDICATED. 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 DU~~
.. nr-r-......... ....-- --..---- ---- -- ----- --
Cumberland County - Register Of Wills
One Courthouse Square
Carlislel PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
YINGST JAMES T
40 YORK STREET
HANOVER I PA 17331
RE: Estate of MILLER SADIE E
File Number: 2004-00905
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES I NO. 103
SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsell within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/03/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report I please disregarc
this notice.
SincerelYI
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Pprsanal Renresentative(s)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
AUSTENSEN P BRUCE
227 MAIN STREET
REISTERSTOWN, MD 21136
RE: Estate of MILLER SADIE E
File Number: 2004-00905
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 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:
6/03/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
,~~) .~/h(,~1
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
::c: File
Counsel
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
JAMES T
GUTHRIE
40 YORK
HANOVER
YINGST ESQ
HAL
ST
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-30-2006
MILLER
06-03-2004
21 04-0905
CUMBERLAND
101
SADIE
E
Amount Remitted
PA 17331
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 form 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 SADIE E FILE NO.21 04-0905 ACN 101 DATE 05-30-2006
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: 04-24-2006
PRINCIPAL TAX DUE: 2,825.34
PAYMENTS (TAX CREDITS):
PAYMENT RECEl PT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-06-2006 CD006408 150.92- 2,976.26
05-04-2006 CD006661 1.62- 1. 62
TOTAL TAX CREDIT 2,825.34
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
lE IF PAID AFTER THIS DATE, SEE REVERSE
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
.,
. '\
(' '.~ i
~
).. ,',",.! '
" \,,,\; ~ /
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAUgf-iiiiiIVIDUAL TAXES
INHERITANCE TAX DIVISION
:IIn Rn~ 2806.01
HARRI5BUK~ ~A ~r~~o-uou~
INHJ:.RITANCJ:. TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
REV-1604 EX AFP (03-05)
BRENDA L VARNER
61 COUNTRYVIEW ESTATES
NEWVILLE PA 17241
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
04-20-2006
MILLER
06-03-2004
21 04-0905
CUMBERLAND
218-32-9471
04132837
SADIE
E
Amount Remitted
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 DR TRUST ASSETS --
DATE 04-20-2006
ESTATE OF MILLER
SADIE
E DATE OF DEATH 06-03-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-0905
ADJUSTMENT BASED ON:
S.S/D.C. NO. 218-32-9471
ADMINISTRATIVE CORRECTION
JOINT DR TRUST ASSET INFORMATION
ACN
04132837
FINANCIAL INSTITUTION: ORRSTOWN BANK
ACCOUNT NO.
106002057
TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 05-07-2001
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
.45
.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.~HOWN AB~VE.
MAKE CHECK OR MONEY ORDER PAYAaL!
TO: "REGISTER OF WILLS, :AGENT..i'~
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
\....'-.-.\
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. 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"
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
.00
.00
.00
.00
(CR),
REGISTER OF WILLS
Cumberland County, Pennsylvania
Supreme Court Orphans' Court Rule 6.12
Status Report by Personal Representative
Name of Decedent:
Sadie E. Miller
Date of Death:
06/03/2004
Will Number:
21-04-0905
dministration Number:
21-04-0905
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to
completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete.
3. If the answer to NO.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No X
b. The separate Orphans' Court No. (if any) for the personal representative's account is:
c. Did the personal representative state an account informally to the parties in interest:
Yes X No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may
be filed with the Clerk of Orphans' Court and may be attached to this report.
Date:
') /1//-:: f..
7 ~-=.i
.~A' /[,/7,/\ or7 / - _~f;j..f
Sign~ure . 7
Name: James T. Yingst, Esquire
Address: 40 York Street
h j' -1 ,'lr
1 '-I 1 c_
Hanover, PA 17331
Telephone: 717-632-5315
Capacity:
Personal Representative
X Counsel for Personal Representative
-'-; ''-,./
Register ofWiHs of Cumberland County
STATUS REPORTGTNDEl\RULE 6.12
Name of Decedent: S ~ J I ~ [.. n1.. \ \ \-er
Date of Death: Jv... (\e. 0 '3 z.. GO '{-
(
Estate No.: :) 1- 0 t{ - 0 q 0 ~~
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ns No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the person~epresentative file a final account with the Court?
Yes 0 No J2S
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes ~ No 0 .
Date: J u.. '" e..
c. Copies of receipts, releases, joinders and approval offonnal or infonnal
accounts maybe filed with the Clerk of the Orphans' Court and may be
attached to this report. /';2 .-;? a. 7 ~
'J 72 OOb C I ~J-j~ ~~~~J
I
Signature
'"'=' @< lA c.-e:. (/ \A S1eV\ j. c V\.
t .
C~l
(
Name .. a-r-
d: J- 7 rn c;L,..." ..J~~e I
~ e, sf'e. { .rTo-.A lit VIA D 2.... (( 'J (,
Address
t ~
1.-/ J (j - g '] J .. 2. 2 s- 0
Telephone No.
Capacity: M Personal Representative
o Counsel for personal representative
L