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95-0168
HI~S.A05 REV 9-86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Regiseraz. The original certificate will be forwarded to the State Vital Records Office for permanent filing. Wf~RNING: it is iHegai to replicate' Ehis copy ny pttiotost~t ar photograph. pee for this certi#icate; ~2.tt0 ~~ ~• ~~. Local `Registrar 2872525 ~~.~ 'ise~ No. Date rte0S,1~S Ra., x~aT COMMONY/EARTH OfPEMNSYRYANIA • DEPARTMENT Of HEALTH • VITAL f1ECOR05 CEFITIFlC11TE OF DEATH MNT 3TQE FILE `LUMBER VENT MA~DK DE~OEN IE~t. MlaBte.lal SE% SOGeAI SECURMVNUMEEA D+aE dP DEATN;rAOnn per: -earl ~ E.A ~_ AitriT•av T . M 11 or a. Fezsle a. 191 - 26 - 6847 A. March 1. 1995 iUl EyaraalA 1 IRIDGAtOM 0 DFM N iWLACE (t'irrb tlF 06AEN(prarF anN aw-vee »rtuamaaramar seNa MnrEea ~ Der. NouB = ~MOrNn:Op. ~aat) 3raw a•aapnCatam G3TMER 80 Y~ 1 10-14-1914 7 Carlisle, Pa '"^"""^ EWOi"°"""O DO"^ .^ ~~ D}I'f, OF DEATN (a na.4eNUOR,yw a%an artlnaner YM M9/AANG AawrtanenaiM. EIaA. Wrdea. a¢: TYOF ' E~ommunity raaC~xr«.wae:errcaean . 1 Cumberland S. Middleton Twp Cumberland Crossings Retirement ~'~~^•~ +, White AL %N7D Y VYAS UOEM EYEAW E. SERLS• 9l1RVMwG SPUe~9E e ,w arorR Nato BUr~,amOM U.S.AaME0 i0RCE97 N•vNMbN.tl,M~wq, /M W,prvarnYDn netnii Dlrvrl~OtSOa~.Yi D M O~ a wo.aaeO MM: as eaCUw raFraa) e lover Arranger ++ Flower Shop +_ ""^ "°®x + m,n i e''as~~ + Widow ~ DCCEDEN*sMM^+a uw~se ts~w. rew~or•^.xn.. a,cm.+ DEeEDE"rs Pa S Middleton 1h d YM aaca0ln awa Cumberland Crossings Ret . Coma . . era. UAl 17a. Sen. Dkl ~~ ~~+ Carlisle PA 17013 man.r.ea. Cumberland + per ~ +~ , d .:. oaYlesro. e» NEHEa3 NAME rgnr. Matw. tart MOTNER'S NAME c~+x. eaBOa. eAtianSarrq~nai Frank Maore Sue E. Heiser Jane Chro~n stet 8bi W Louther~t. Ca lisle. Pa 17013 OF •N.madcrnwry.cnenawY LaC •OM7u.n•. .zocoa. er.+r e.aR,sraa^ A.rrwrr ameBTna^ Dar. ear, aOaew PMc• 'Dewnaa~ D""'!~"'~"'e'~ ^ 3-3-1995 Westminster Cemeter N. Midd eton Tw Pa ,,. E AESUDN LICENSENUMEEA NAME AND O , man- Ot unera ome 012748-L 19 N. Hanover S . Carlisle Pa .17013 ' aateataaravrr+wABx+%rar0 anew dnr tnanlaa¢a.OeaeA axurwa MeM eutr.emaanB O6ea wnaa. tICEN ENUMBEA {i1l~faenaPla /~a1 B•aaMB•neaMdaarab Yltl 7Bq .DaY.laatl tMl/Y ¢a.rfadAaalA. twma aanrW~erpwaoM EarBan.An panflungseaP%A T E N OEID{eAa'a.. DaY, Meal DASE ABED ME E%AMWE Rt o~ a . t„ ~. M ~.. RTI: Eawm.OiN.M-~rM~/eMa oOmD•~niaru WYC~eJew.EtlM aNtn. Do roe.w«eM rma atlWg,aUesau a~Mdt>~Ynnn..MM atone LMip.. iApyNnen. /AAT at dAr.iyYetlYt OE~Yp1. n.VEluNgbOUTA. bA t]A dM/OM.Cr1cWIM..CP PrY. IMearrY aBlavaP ~be1MYWrpaf alY WWN//F1Baa1Y-Qi.rIw PANE/1. e aANI rq OaW 1MBIEDIA7E CAl1EE (F~nr : ~ J ~ ~ / I WE IOR ASACON3EUUENCE t7Er $.prINMWywCQ1YWN0eN D Era, ee n.a.er. ( . DuE tD LOA ASACONSEUUENCE Ot-1: I iI~dMwo+r.r f e j EwYe4etw atiaaa f DUE t0 tDA AS A CONSEDUENCEEJFy e rBawq noW+r lMT l ANAU+DPEY AU'EpP'EY PEi0E/09 MANNEA DP OEITN OIEE GPINJURY TIME ©F aUUf1Y MJUA7 AYIDRK7 DESCRIBE fIQYIII,R/AYDCCVRAEO. >FEErOR1/fiD9 AWRAB6E PiE011 W ~ NaMM I..`f Momkta ^ (MOr~, DaY• taarr wa ^ NB O ' Ad'ItlaM ^ variaxq a...eepnla. O M rw. ^ rb rw ^ wo ~~ srYCM. ^ DauaR•eI>•aataamRw ^ . PtAfS:DSINJlAev.NlraaN.nam.nrw,eaceary.dBe» lDCA1+DNgtew.Grirta.R,Setati aawalno, n¢. RP•aM xBS, zs, aa. aBr. WETIPeEAeCnact a+r a+n " 9 AND tetIE OF GEAt1i1ER ~ •cb1TgY+11a}N7ErpAU 1>firarw+eenMma causadww+.abr ananer MYSicwn nea aonw.rwo cream a~acm+aaeeo nem Tar / ' ~ ~~~~ ~ ... Ta Bw ban N rwy krewNOga. a+•m•o¢wne so. eer aw eaewlaHne manner as aenw.... ... _ ................. ............. _ , . .v--~G~ G .iN L lrDENSE W "OQ[ .Yw1. ' •MONOUECU1o,uro cERTMnND PNYBInAN IPegx cam mt%cwcx~y awm erounAp^amcaua•aaaanl te+n.s.namY-te.wE•.awaa«wnsnauxm..aw.nwPl«..aoadwwa.cu..~q.+a.mei+....n.na ........................ ^ ~ .- + • / G7 ~ f' ~'^ + ~ 2 `T S ~2,~AO ~ vEatgNrrNO ~oP c~t , ee c 'Oaal~ WEE~ex mrasnyatlore, N mY eWMa•. tlaNA xeuvae a B+a ama, dan, anB Wave, crew eNato Bra a.u.slsl crew at s ^ ~ LL Y i3 e ~+^ h aA $ S i' L~'tEr I R k . mrMar h at .................................................................................................. a aie.. ~. ~ ~~C / ~.~.` .~ S(T~AAA• Se0 R ~ ~ ~~ ~ ~ ~ DMor%n. Dav. eani .t rc r- r C~~E ~• cj ` \~S :3~ n. ~0.~11C Q~. . a•. r PETITION FOR PROBATE and GRANT OF LETTERS Estate of Audrey T, Miller No. also known as To: Deceased. Socia! Security No. 191-26-6847 21-95- Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rites named in the last will of the above decedent, dated February 24 , 19~$_ and codicil{s) dated none (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 1 T.nngerlpr~a3t., Carlisle, PA 17013 (list street, number and muncipality) Decendent, then 8U years of age, died March 1, , 19 95 , at 1 Longsdorf WaY, Carlisle, Pa. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never ad}udicated incompetent: no eXCeQtions Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) A11 personal property $ unestimated (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: none WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. N U C N 'O n .~ v Shirley L. Miller 3912 Van Buren NE ha A1bu~ueraTle. NM 87110 ~, ~, ~ o Jane M. Chronister 861 W. Louther St. (':ArlislP~ PA 17013 ~s G m OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 ~~ 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 knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before mMarich 95 of 19 Mary C. Lewis, Register a ~o NO. 21-95- Estate of Audrey T. Miller ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW 19 95 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated February 24, 1988 described therein be admitted to probate and filed of record as the last will of Audrey T Miller - -- ; and Letters Testamentar are hereby granted to Shirley L. Miller and Jane M. Chronister. Register of Wills FEES Probate, Letters, Etc.......... $ Short Certificates( ) .......... $ Renunciation ................ $ $ TOTAL $ Filed ................................... Frey and Tiley By Robert M. Frey #06274 ATTORNEY (Sup. Ct. I.D. No.) 5 S. Hanover St., Carlisle, PA 17013 ADDRESS 717-243-5838 PHONE REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Robert M. Frey and Krista King ~ca~~acilx (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that they were present and saw Audrey T. Miller , the testat rix ,sign the same and that they signed as a witness at the request of testa rt ix in hgr presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of March. 1995 Mary C. Lewis, Register Robert M. Frey (Name) 5 S. Hanover St., Carlisle, PA 17013 (Address) rista Kiftg (Name) 924 Burr Avenue, Carlisle, PA 17013 (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of , codicil testat of (one of the subscribing witnesses to) the will presented herewith and codicil that believes the signature on the will is in the handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19 !Name) (Address) Register (Name) (Address) 4 LAST WILL AND TESTAMENT dF AUDREY T. MILLER I, AUDREY T. MILLER, of 132 Glendale Street in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executrices to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral service to be conducted by Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsylvania, and that my body be interred beside that of my 'husband, Carroll G. Miller, on our burial lot. in Westminster• Cemetery located in North Middleton Township, Cumberland County, Pennsylvania. 2. I give and bequeath the sum of One Hundred Fifty Thousand ($150,000.00) Dollars to be divided equally between my two daughters., Shirley L. Miller, of Albuquerque, New Mexico, and Jane M. Chronister, of North Middleton Township, Cumberland County, Pennsylvania, provided each of them shall survive me by a period of ninety (90) days, but should either of them fail to so survive me, then the share such deceased daughter of mine would have received shall pass to such of her issue as shall survive me by a period of ninety (90) days, per stirpes, and if there be no such issue, the same shall lapse and be added to the share of the other daughter. 3. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: (a) I give and bequeath the sum of Six Thousand ($6,000.00) Dollars to be divided equally among the three children of my daughter, Jane M. Chronister, their heirs and assigns, provided each of them shall survive me by a period of ninety (90) days, but should any of her three children fail to so survive me, then the share such deceased child of hers would have received shall ~•~;' lapse and be added to the shares of her other children, ~'>> per stirpes. The three children of my daughter, Jane +' M. Chronister, are: Kevin Chronister, Laurie Chronister ~? and Brett Chronister. r.~, `'~~ (b) The balance or remainder thereof I give, devise and bequeath in equal shares to my two daughters, Shirley %~~ L. Miller and Jane M. Chronister, their heirs and assigns, provided each of them shall survive me by a period of 1~ ninety (90) days, but should either of them fail to ~j so survive me, then the share such deceased daughter o$ mine would have received shall pass to such of her issue as shall survive me by a period of ninety {90) -' days, per stirpes, and if there be no such issue, the ~~..~ same shall lapse and be added to the share of my other ,~ daughter. 4. I hereby nominate, constitute and appoint my two Page 1 of 2 pages daughters, Shirley L. Miller and Jane M. Chronister, or either of them,- as Co-Executrices of this my Last Will and Testament, and I further direct that. neither of them shall be required to post any bond to secure the faithful performance of her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on two (2) pages, this 24th day of February 1988. ._./ ~e c/~ ~-P-~C~ ( sEAL ) Audrey T. filler Signed, sealed, published and declared by Audrey T. Miller, the Testatrix above-named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. /~~ ~, ~' ~ J~ o-- ~_ Page 2 of 2 pages __ _. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Audrey T. Miller Date o f Death : March 1, 1995 Will No. To the Register: Admin . No . 21-95-168 I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court °Rules was served on or mailed to ttie following beneficiaries of the above-captioned estate on March 14, 1995 Name Address Shirley L. Miller, 3912 VanBuren NE, Albuquergue. NM 87110 Jane M. Chronister. 861 W. Lowther Street. Carlisle~PA 17013 Kevin Chronister. 232 North College Street. Carlisle PA 17013 Laurie Chronister, R.D.1, Box 468, Pisgah State Road, Shermans Dale, PA 17090 Brett Chronister. 186 Victoria Lane, Wyomissing. PA 19610 Notice has now been given to all persons entitled thereto under Rule 5 . 6 (a) except no exceptions. Date : March 14. 1995 Signature Name Robert M. Frey Address 5 S. Hanover Street Carlisle. PA 17013 Telephoned 71'~ 243-5838 Capacity: Personal Representative X Counsel for personal representative REV-t soo Ex+. (7.94) ~, FOR DATES OF DEATH AFTER 12(31191 CHECK HERE INHERITANCE TAX RETURN P ^ OVERTY CREDIT l5 CLAIMED RESIDENT DECEDENT FILE NUMBER _. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (TO BE FILED IN DUPLICATE ~/ ~ ~- ~~ DEPT. 280601 WITH REGISTER OF WILLS] HARRISBURG, PA 17128-0601 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS MILLER, AUDREY T. 1 Longsdorf Way W SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH Carlisle, PA 17013 1.91.26-6847 Mar. 1, 1995 Oct. 19, 1914 Cumberland ~o~M p (IF APPlICA9lE) SURVIVING SPOUSE'S NAME (UST, FIRST AND MIDDLE INITIAL( SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) N/A ~++ ®1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return Ye,n (for dates of death prior to 12-13-82) W a~ ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required ~ s ° (for dates of death aher 12-12-82) a00 ®b. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach copy of Trust) ,- .. .. ._ ~. _ •_ __ - . -.c.. _ y = NAME COMPLETE MAID G ADD ES ~= Frey and Tiley 5 South Hanover Street ~~ TELEPHONE NUMBER Carlisle, PA 17013 ( 717) 243 5838 z 0 a W S 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line B minus Line 11) 13. Charitable and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 1. Real Estate (Schedule A) (1 ) 2. Stocks and Bonds (Schedule B) (2 ) 3. Closely Held Stock/Parinership Interest (Schedule C) (3 ) 4. Mortgages and Notes Receivable (Schedule D) (4 ) 5. Cash, Bank Deposits $ Miscellaneous Personal Property (5) 263, 212.08 {Schedule E) b. Jointly Owned Property {Schedule F) (b ) 7. Transfers (Schedule G) (Schedule L) { 7 } 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscelloneous (9) 16 + 005.66 Expenses (Schedule H) 10 Debts Mortgage Liabilities Liens (Schedule I) (101 (B) 263.212.08 (11) 16, 005.66 (12) 247, 206.42 (13) (ta) 247, 206.42 z 0 c r- d 0 v a r 15. Spousal Transfers (for dotes of death after b-30-94) See Instructions for Applicable Percentage on Reverse (15~ Side. (Include values from Schedule K or Schedule M.) 16. Amount of Line 14 taxable at b% rate (lb) (Include values from Schedule K or Schedule M.) 17. Amount of Line 14 taxable at 15% rata (1T, (Include values from Schedule K or Schedule M,) 18. Principal tax due (Add tax from Linea 15, 16 and 17.) 247.206.42 19. Credits Spousal Poverty Credit Prior Payments Discount Interest + + 741.62 20. If Line 19 is greater than Line 18, enter the difference on Lins 20. This is the OVERPAYMENT. ~^ 21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. A. Enter the interest on the balance due on Line 21A. B. Enter the total of Line 21 and 21A on Line 21B. This is the BALANCE DUE. Make Check Payable fo: Register of Wills, Agent C4- ~ r: ~+t~~~ -rvC~7~. Under peMalties of perjury, I declare that it is true, correct and complete. I declare based on all information of which prepay x. __ x .ob = 14, 832.39 x .15 = {tB) 14,832.39 (19) 741.62 (20) (2t) 14, 090.77 (21 A) (21 B) 14, 090.77 return, including accompanying schedules and statements, and to thi c been reported at true market volue. Declaration of preparer other 861 W. Louther St., Carlisle, PA 17013 ~f my knowledge and belief, ie personal representative is DATE May 31, 1995 DATE May 31, 1995 ' REV-150YEX+(2-87) SCHEQULE E CASH, BANK DEPOSITS AND COMMONWEALTH OF PENNSYLVANIA M{SCELLANEOUS INNERITANGE TAX RETURN PERSONAL PROPERTY Please Print or T e YP RESIDENT DEGEDENT ESTATE OF FILE NUMBER AUDREY T. MILLER 21-95-168 (All property j ointly-owned with the Right of Survivorship mu:t be disclosed on Schedule F) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Balance Farmers Trust Company checking account #9-28213 78,939.88 Accrued interest to March 1, 1995 110.17 2. Balance Farmers Trust Company savings account #1-383292 56, 820.56 Accrued interest to March 1, 1995 4.36 3. Balance Farmers Trust Company C/D #55726 50,000.00 Accrued interest to March 1, 1995 16.44- 4. Balance Farmers Trust Company C/D #67153 50, 000.00 Accrued interest to March 1, 1995 65.75 5. Balance Farmers Trust Company C/D #72489 5, 000.00 Accrued interest to March 1, 1995 •82 6. Balance Farmers Trust Company C/D #75944 5, 000.00 Accrued interest to March 1, 1995 3.82 7. Balance Farmers Trust Company C/D #78142 5,000.00 Accrued interest to March 1, 1995 3.56 8. Balance Farmers Trust Company C/D #80770 5,000.00 Accrued interest to March 1, 1995 10.41 9. Balance Farmers Trust Company C/D #95631 5,000.00 Accrued interest to March 1, 1995 1.58 10. Cash 32.73 11. Social Security check for February 1,052.00 12. 1984 Buick Sedan 1,100.00 13 Misc. personal property in decedent's room in nursing home 50.00 TOTAL (Also enter on line 5,_ Recapitulation) I $ 263, 212.08 (Attach additional B'h" x 11" sheets if more spoce is needed.) Fa~ERs • TYZUST March 20, 1995 Frey & Til.ey 5 South Hanover St Carlisle, PA 1701.3 Re: Estate of Audrey T Miller SSN 191-26-6847 Datp of Death: March 1, 1995 Dear Mr. Frey: In answer to your request concerning accounts owned, either separately ar jointly, by the above referenced decedent and the balance in each account as of the date of death, we have checked our records and are submitting the following information in duplicate. 1X~e suggest that you file one of these letters attached to the Pennsylvania Inventory forms (RCC) to substantiate the balance you report. Note that we have shown the correct registration for each account. Also, interest accrued to the elate of death, if any, is listed as a separate figure. Checking account 114-28213 was arigi.rially opened 9;'1,'67 ar before. The account was titled Audrey T Miller with Jane Chronister as Power of Attorney. The balance as of 3j 1/95 was $78,939.88 plus $110.17 accrued interest for a total of $79,050.05. The account was a N~~~' .Account earning 2.10 interest at the tine of death. Savings account 111-383292 was originally opened 12!31;'93. The account was titled Audrey T Mi l ler with Jane Chronister as Power of Attorney. The balance as of 3J1J95 Jas $56,820.56 p1L~s $4.36 accrued .interest for a fatal of $56,524.92. The account was a statement savings account earning 2.80` interest at the time of death. We da have a Safe Deposit Box at our Main Office 11132. The box is in Audrey T Miller's name with Jane Chronister as Power of Attorney. We have n<.> record of a safe deposit box in the deceased narrre. Sincerel ti~ . FARRdERS TRUST CO~.~PAN~' ~~~~~1m~_ ~~®r1~e Supervisor One West High Street P.O. Box 220 Carlisle, Pennsylvania 17013 (717) 243-3212 F1~-~;MERS TRUST One West High Street PO Box 220 Carlisle, Pennsylvania 17013 March 24, 1995 Date Frey & Tiley 5 S. Hanover St. Carlisle, PA 17013 Re• Estate of~ Audrey T. Miller 191-26-6847 Date of Death 3/ 1 /9 5 j>edr Mr . Frei In answer to your request concerning accounts owned, either separately or jointly, by the above referenced decedent and the balance in each account as of the date of death, we have checked our records and are submitting the following information in duplicate. We suggest that you file one of these letters attached to the Pennsylvanis lnvsn- tory forms (RCC) to substantiate the balance you report. Note that we have shown the correct cegistration for each account. Also, interest accrued to the date of death, if any, is listed as a separate figure. Very truly yours, r Doris Goodhart CD/IRA dept. Certificate 55726 was opened 8/27/84. The value as of 3/1/95 was $50,016.44. Certificate 67153 was opened 3/14/86. The DOD value was $50,065.75. Certificate 72489 was opened 8/31/87. The DOD value was $5,000.82. Certificate 75944 was opened 8/22/88., The DOD value was $5,003.82. Certificate 78142 was opened 1/24/89. The DOD value was $5.003.56. Certificate 80770 was opened 7/10/89. The DOD value was $5,010.41. Certificate 95631 was opened 2/27/91. The DOD value was $5,001.58. All of these certificates are registered to Audrey T. Miller. REV-1511 Ex+ (7.88) SCHEDULE H t FUNERAL EXPENSES, COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS AND INHERITANCE TAX RETURN MISCELLANEOUS EXPENSES Please Print or Type RESIDENT DECEDENT ESTATE OF FILE NUMBER AUDREY T. MILLER 21-95-168 ITEM DESCRIPTION NUMBER A. Funeral.Expenses: 1. Hoffman-Roth Funeral Home, funeral services AMOUNT 3,537.90 B. Administrative Coats: 1. Personal Representative Commissions _ _ 0.00 Social Security Number of Personal Representative: Year Commissions paid 2. Attorney Fees 10, 896.36 3. Family Exemption 0.00 Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code 4. Probate Fees 284.00 C. Miscellaneous Expenses: 1. Cumberland Law Journal, advertising Letters 40.00 2. The Sentinel, advertising Letters 72.20 3. Care Apothecary, account 387.65 4. Darlene L. Moyer, Tax Collector, 1995 personal income taxes 9.90 5. Carlisle Imaging Associates, account 29.61 b. PA Department of Revenue, 1994 personal income taxes 174.54 7. Internal Revenue Service, 1994 personal income taxes 115.00 8. Care Apothecary, account 11.62 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of same size.) SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PAGE 2 ESTATE OF AUDREY T. MILLER FILE NUMBER 21-95-168 ITEM DESCRIPTION AMOUNT NUMBER 9. Belvedere Medical Corp., account 10. Carlisle Imaging Associates, account 11. PA Department of Transportation, automobile title transfer 12. ATS Medical Services, Inc., account 13. Cumberland Crossings, final nursing home bill 14. Register of Wills, filing Pa. Inheritance Tax Return 15. Reserve to prepare and pay 1995 income tax returns 16. Notary Public fee 17. Reserve to file Account ii 30.36 20.00 19.00 125.58 30.94 15.00 100.00 6.00 100.00 16,005.66 REV-1513 EX+ (2-87) ~, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAx RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER AUDREY T. MILLER 21-95-168 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxable Bequests: ~. Shirley L. Miller Daughter $75,000.00 plus., 3912 Van Buren NE 1/2 of residue of e Albuquerque, NM 87110 2. Jane. M. Chronister Daughter $75,000.00 plus 861 W. Louther Street 1/2 of residue of e Carlisle, PA 17013 3. Kevin Chronister Grandson $2,000.00 232 North College St. Carlisle, PA 17013 4. Laurie Chronister Granddaughter $2,000.00 R. D. 1, Box 468 Pisgah State Road Shermans Dale, PA 17090 5. Brett Chronister Grandson $2,000.00 186 Victoria Lane Wyomissing, PA 19610 ITEM NAME AND ADDRESS OF BENEFICIARY AMOUNT OR NUMBER SHARE OF ESTATE B. Charitable and Governmental Bequests: ~ ~ NONE state state TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on Vine 13, Recapitulation) I$ (If more space is needed, insert additional sheets of some size) REV.a85 E%r (1.92) a COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 SAFE DEPOSIT BOX INVENTORY Please Print or T MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE ~ / FILE NUMBER J's- o i b~ SOCIAL SECURITY OR DEATH CERTIFICATE NUMBER j ~ c Z~-~ v~~ • DECEDENT'S NAME (LAST, FIRST, MIDDLE) (~~~.~-< ClJtt ~ ~ i i - DATE Of DEATH ~ " 1 ~' ci S ADDRESS OF DEcCEDENT (STREET) /- (CITY) (STATE) (ZIP CODE) ~i.7 C~-t.' ~ ~ ~J~-~ 1. ra~-f" (C J L-- ~ ~- 1 ~ ~ 1 .~ NAME AND ADDRESS OF RSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) (STREET ADDRESS) (CITY) (STATE) (ZIP CODE) NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAME) (RELATIONSHIP) (STREET ADDRESS) _ (CITY) (STATE) (ZIP CODE) ~~v ( ~ Lcl/ ~ ~ j C ra-r~-~ fJ ~ PGA r 7 6 % ~ b. (NAME) (RELATIONSWIP) (STREET ADDRESS) (CITY) (STATE) (ZIP CODE) c. (NAME) (RELATIONSHIP) (STREET ADDRESS) (CITI~ (STATE) (ZIP CODE) NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAM~~ _ ~~~71 !?sl.-o ~ i[ ~ ~ (STREET ADDRESS) r- (CITY) (STATE) (ZIP CODE) ~ NAM OF PERSON MAKING LAST ENTRY DATE AND TIME OF LAST ENTRY DATE OF CONTRACT TO RENT BOX NUMBER OF BOX TITLE UNDER WHICH BOX IS REGISTERED NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) b. (NAME) (STREET ADDRESS) ( STREET ADDRESS) (CITY) (STATE) (ZIP CODE) (CITY) (STATE) (ZIP CODE) NAME AND TITLE OF EMPLOYE TAKING THE INVENTORY WAS A WILL IN THE BOX? ^YES ^NO If yes, a. Dare of will: b. Name and address of personal reprosenfative, if named in the will (NAME) (STREET ADDRESS) (CITY) (STATE) (ZIP CODE) c. Name and address of oHorney, if any (NAME) (STREET ADDRESS) (CITY) (STATE) (ZIP CODE) Page _~_ of ~ soFE DEPOSfT BOX INVENTORY INSTRUCTIONS {1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. {3) Obligations of U. S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM NO. ITEM DESCRIPTION ~ ~ 1 ,~C12.¢, 1 ci ~ t{ gu rGk 3 ~ 3 (aS t 3 ~ 2~c ~ A ud ; F. 1 ' , ~~ l CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. PERSON RECEIVING COPY OF SAFE DEPOSIT 80X INVENTORY: SIGNATURE SIGNA PRINT NAME PRINT E AND CHECK APPROPRIATE BO BELOW: PRINT TITLE CHECK APPROPRIATE BOX: ^Executorltrix) ^Administratorltrix) ^Estate Representative ^ Joint owner of safe deposit box NOTE: Attach additional 8tls" x 11" sheet (s) if necessary or use duplicates of rnls page or corm. O V ~ ~ r L N C`L "~ ~ ~ Q ~z SLR `" W 1 ~ r N ~ "'~ I~ W ~ ~ , a ~ ti. W 7 ~ y ~ '~ ~+~ ~ ~ 1 ~ ~~ ~ ~ W. ~ a r L- N ~ Q ~ ~ ~ M ~ -•. cu 4 Z W ~ O ~, . ~ r ti ~ O v. m ~ (~'~ ~ F ~ ~ ~ N r4 ~ ~ ~' Z ~ ~ C ` ~ ~.,, C ~ m~ ` ~ W u ~ 2 -. ~ ~ ` S ~ ~ t '.. `` 4 ~ ~ ~ ~. 1 t o ~~ ~ ~ ~ ~ U ~ ~ c ~ \ 4 ~~ Z O Z °~ n W ~ 1 ~a~d ~ O rN ~ ~ ~ ~ .; U Y. J W W ~ `~ afom '~..J ~{ ~ u '-~~ W ~ N Z b OL J P. ~' a ~p Z 'L Z '~ ~~ „ v ~ fj ~ r !J d ° ~ r7 J O v wK ~Q. ~ ~ s Z 4 O ; ~ ~~ ~ 7 ~ ~ ~ ~"'~ ~ ~n p °- Z o ~~ w FIRST AND FINAL ACCOUNT OF SHIRLEY L. MILLER AND JANE M. CHRONISTER, EXECUTRICES OF THE LAST WILL AND TESTAMENT OF AUDREY T. MILLER, LATE OF SOUTH MIDDLETON TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED DATE OF DEATH: LETTERS TESTAMENTARY ADVERTISED: March 1, 1995 CUMBERLAND LAW JOURNAL - March 24, 31, and April 7, 1995 ESTATE FILE NO. THE SENTINEL 21-95-168 March 18, 25, and April 1, 1995 PRINCIPAL RECEIVED 1995 Mar. 2 Cash 32.73 3 Social Security check for February 1,052.00 6 Balance Farmers Trust Company checking account #4-28213 78, 939.88 Accrued interest to March 1, 1995 110.17 6 Balance Farmers Trust Company savings account #1-383292 56,820.56 Accrued interest to March 1, 1995 4.36 6 Farmers Trust Company Certificate of Deposit #55726 50,000.00 Accrued interest to March 1, 1995 16.44 6 Farmers Trust Company Certificate of Deposit #67153 50, 000.00 Accrued interest to March 1, 1995 65.75 6 Farmers Trust Company Certificate of Deposit #72489 5, 000.00 Accrued interest to March 1, 1995 .82 6 Farmers Trust Company Certificate of Deposit #75944 5, 000.00 Accrued interest to March 1, 1995 3. $2 6 Farmers Trust Company Certificate of Deposit #78142 5, 000.00 Accrued interest to March 1, 1995 3.56 6 Farmers Trust Company Certificate of Deposit #80770 5, 000.00 Accrued interest to March 1, 1995 10.41 6 Farmers Trust Company Certificate of Deposit #95632 5,000.00 Accrued interest to March 1, 1995 1.58 6 1984 Buick Sedan automobile 1,100.00 6 Misc. personal property in decedent's room in nursing home 50.00 TOTAL PRINCIPAL RECEIVED 263, 212.08 -1- INCOME RECEIVED 1995 Mar. 5 Interest, Farmers Trust Company checking account #4-28213 18.35 10 Interest, Farmers Trust Company C/D #80770 4.93 14 Interest, Farmers Trust Company C/D #67153 56.97 27 Interest on Estate NOW account 97.77 Apr. 27 Interest on Estate NOW account 136.48 May 27 Interest on Estate NOW account 139.32 June 1 Interest, Farmers Trust Company savings account #1-383292 and C/Ds from March 31 to June 1, 1995 2,116.57 TOTAL INCOME RECEIVED 2, 570.39 DISBURSEMENTS 1995 Mar. 6 Register of Wills, Letters Testamentary and 2 short certificates 284.00 8 Cumberland Law Journal, advertising Letters 40.00 8 Care Apothecary, account 387.65 17 Darlene L. Nloyer, Tax Collector, 1995 personal taxes 9.90 17 Carlisle Imaging Associates, account 9.61 22 PA Department of Revenue, 1994 personal income taxes 174.54 22 Internal Revenue Service, 1994 personal income taxes 115.00 29 Hoffman-Roth Funeral Home, funeral services 3, 537.90 29 Care Apothecary, account 11.62 29 Belvedere Medical Corporation, account 30.36 Apr. 18 Carlisle Imaging Associates, account 20.00 19 PA Department of Transportation, title transfer 19.00 19 ATS Medical Services, Inc., account 125.58 19 Cumberland Crossings, final patient account 30.94 May 2 The Sentinel, advertising Letters 72.20 -2- May 31 Register of Wills, PA Transfer Inheritance Tax 14, 090.77 31 Register of Wills, filing Pa. Inheritance Tax Return 15.00 Reserve to prepare and pay 1995 income tax returns 100.00 Notary Public fee 6.00 Frey and Tiley, Attorney's fee 10, 896.36 Reserve to file Account 100.00 TOTAL DLSBURSEMENTS 30, 076.43 RECAPITULATION Total Principal Received 263, 212.08 Total Income Received 2, 570.39 Total Receipts 265, 782.47 Less Total Disbursements - 30, 076.43 Balance for Distribution 235, 706.04 PROPOSED SCHEDULE OF DISTRIBUTION BALANCE FOR DISTRIBUTION 235, 706.04 TO: Kevin Chronister 232 North College Street Carlisle, PA 17013 Bequest in Paragraph 3(a) of Decedent's Will 2, 000.00 TO: Laurie Chronister R. D. 1, Box 468 Pisgah State Road Shermans Dale, PA 17090 Bequest' in Paragraph 3(a) of Decedent's Will 2, 000.00 TO: Brett Chronister 186 Victoria Lane Wyomissing, PA 19610 Bequest in Paragraph 3(a) of Decedent's Will 2, 000.00 TO: Shirle~J L. Miller 3912 Van Buren NE Albuquerque, NM 87110 Bequest in Paragraph 2 of Decedent's Will One-half residue of estate: One-half of personal property, in kind Balance for distribution 75,000.00 575.00 39,278.02 39,853.02 TO: Jane M. Chronister 861 W. Louther Street Carlisle, PA 17013 Bequest in Paragraph 2 of Decedent's Will One-half residue of estate: One-half of personal property, in kind Balance for distribution 75,000.00 575.00 39,278.02 39,853.02 235,706.04 STATE OF NEW MEXICO ) SS.: COUNTY O F ~(~ ) Before me, the undersigned officer, personally appeared Shirley L. Miller, one of the Executrices of the Last Will and Testament of Audrey T. Miller, Deceased, who, being duly sworn according to law, deposes and says that the foregoing First and Final Account and Proposed Schedule of Distribution are true and correct to the best of her knowledge, information ant k~elief. ,, Shirley L. Mi r' Sworn to and subscribed before me this 1~~ day of June, 1995. 11 a / 9q COMNIONWEALTH OF PENNSYLVANIA ) SS.. COUNTY OF CUMBERLAND ) Before me, the undersigned officer, personally appeared Jane M. Chronister, one of the Executrices of the Last Will and Testament of Audrey T. Miller, Deceased, who, being duly sworn according to law, deposes and says that the foregoing First and Final Account and Proposed Schedule of Distribution are true and correct to the best of her knowledge, information and belief. Jane ~hronister L Sworn to and subscribed before me this ~~~ day of June, 1995. r NOTARIAL SEAL KRISTA KING, NOTARY PUBLIC CARLISLE, CUMBERLAND COUNTY PA MY COMMIS810N EXPIRES JUNE 27,1998 LAST WILL AND TESTAMENT OF AUDREY T. MILLER I, AUDREY T. MILLER, of 132 Glendale Street in the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time lleretof ore made . 1. I direct my hereinafter named Executrices to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. I direct that my funeral service to be conducted by Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsylvania, and that my body be interred beside that of my 'husband,' Carroll G. Miller, on our burial lot in Westminster• Cemetery. located in North Middleton Township, Cumberland County, Pennsylvania. 2. I give and bequeath the sum of One Hundred Fifty Thousand ($150,000.00) Dollars to be divided equally between my two daughters., Shirley L. Miller, of Albuquerque, New Mexico, and Jane M. Chronister, of North Middleton Township, Cumberland County, Pennsylvania, provided each of them shall survive me by a period of ninety (90) days, but should either of them fail to so survive me, then the share such deceased daughter of mine would have received shall pass to such of her issue as shall survive me by a period of ninety (90) days, per stirpes, and if there be no such issue, the same shall lapse and be added to the share of the other .daughter. 3. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: (a) I give and bequeath the sum of Six Thousand ($6,000.00) Dollars to be divided equally among the three children of my daughter, Jane M. Chronister, their heirs and assigns, provided each of them shall survive me by a period of ninety (90) days, but should any of her three children fail to so survive me, then the share --~ such deceased child of hers would have received shall ~..~; lapse and be added to the shares of her other children, ~;~ per stirpes. The three children of my daughter, Jane ~ ~tJ M. Chronister,- are: Kevin Chronister, Laurie Chronister and Brett Chronister. C ~~ r~ ~ ~ ~ (b) The balance or remainder thereof I give, devise J ~ and bequeath in equal shares to my two daughters, Shirley L Miller d J M Ch i . an ane . ron ster, their heirs and assigns, provided each. of them shall survive me by a period of ~~ ninety (90) days, but should either of them fail to ~' '~ so survive me, then the -share such deceased daughter `~ ' o$. mine would have received shall pass to such of her ia issue as shall survive me by a period of ninety (90) ~~ days; per stirpes, and if there be no such issue, the ~,.,~ same shall lapse and be added to the share of my other ~...~ ~ daughter. 4. I hereby nominate, constitute and appoint my two Page 1 of 2 page daughters, Shirley- L. Miller and Jane M. Chronister, or either of them, as Co-Executrices of this my Last Will and Testament, •and •I further direct that neither of them shall be required to post any bond to secure the faithful performance of her •duti~s in the Commonwealth of Pennsylvania or in any .other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament, written on two (2) pages, this 24th day of February , 1988. ~/ ,, /~ e CJ ~C-~~~ ( SEAL ) Audrey T. filler Signed, sealed, published and declared by Audrey T. Miller, the Testatrix above-named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses.. vim.., ~~, Page 2 of 2 pages CO~Ul~TY 4E ~CUM,BERLA~ID ~~ OCT 10 19 95 I, Mary C. Lewis, Register for Prgbate of, Wills and granting Letters of Administration for the County of Cumberland, in the Commonwealth of Penns} Ivania, do hereby certify the foregoing to be true and accurate copies of the FIRST AND FINAL ACCOUNT OF SHIRLEY L.MILI,ER AND JANE M. CHRONISTER, EXECUTRICES OF THE ESTATE OF AUDRI~Y T. MILLER, LATE OF, SOUTH MIDDLETON TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED. as the same were passed and advertised and remain on file and of record in this office. IN TESTIMONY WHEREOF, I have hereunto set my hand and official seal the date above. t E Mary C. L is, Register of Wills NOW TO WIT,0~1019~_ , came into Court_$I~RT.EV I,. MILLER AND JANE M CHRONISTER. EXECUTRICES and presented an account and statement of proposed distrubution, which were examined, passed, approved, and confirmed with a balance in his hands of $ 2 3 5 , 7 0 6.0 4 and the accountant was directed tp distribute said balance in accordance with the statement of distribution filed. / '~ ~. Mary ewis, Clerk of he Orphans Court COMMONWEALTH rJF PENNSYLVANIA COUNTY OF CUMBERLAND )} ss I, Mary C. Lewis, Clerk of the Orphans' Court., in and for said County, do hereby certify the foregoing to be a true copy of the account and statement of proposed distribution of SxTRrFV L MILLER AND JANE M.CHRONISTER~~xEC'UTRICES as full and entire as the same remain on file and record in this office. IN TESTIMONY WHEREOF, I have hereunto set my hand and official seal at Carlisle, this 10th day of ~.C.TOB •u 1995. ~.~.--, , ar .Lewis, Clerk f the Orphans Court .7 _ ~ .~,~~ ~ ~ 3;:: ~ I Syr i ~ t:.+ ~'~ t f ~ :° ~~.. ~~ Y ~ n i~, t , - ~- ~ ^y, f {~ ~ / t~~ACCOUnt Confirmed absolutely and distribution decreed in accordance with proposed ~ched- taie Of distrib(u~~tion herewith.( By the n m c 3 m Q y ~ O ~ t~ T ~~m~ °c~ ~OC~ <.~ =~r ~~ ~~~ v_' N ,' go n°°~ ~"°~ ~ d ' ~ ('~ U7 ~ H ~ ~d ~, ~ n ~ ~ , ~ d , ~ 0 ~ ~ ~ ~ ~ ~ ~ '~ x d to x ~ ~ z ~' •• d "~"+ ~ d ~ r z ~ ~ ~ =] "~ ,,.~ Y C ~ ~ 5C r ~ y ,mac ~ ~ 'd ° O tai ~ n ~ y --+ ~ nH~ '~ ~ ~~ n ~ Y~O O ~ n~~ H ~. ~x ~z~ ~ r+ t~! O ro ~ "'~ ~ .~ ~ ~ ~„ O No.AA O47$25 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Rev.,,es Ex L.9.1 OFFlCIAt RECEIPT s PENNSYLVANIA INHERITANCE AND ESTATE TAX RECEIVED FROM: FREY ROPERT M 5 S HAIVOVER STREET CARLISLE PA 17013 FOLD HERE ESTATE INFORMATION: © FILE NUMBER 21-1995-0168 SSN 19'1-2b-6847 © NAME OF DECEDENT (LAST) (FIRST) (MI) MI L R AUDREY T DATE OF PAYMENT © POSTMAR E COUNTY -` A DATE OF DEATH KtMAKKS 3ANE M CHRONISTER SEAL CHECK# 118 TAXPAYER a ACN ASSESSMENT CONTROL AMOUNT NUMBER ~1 , . FOLD fiEf TOTAL AMOUNT PAID ~ 7 tt 090 77 P8 RECEIVED BY ~. SIGNA ~~~~~h~ MARY C. LEWIS /~ REGISTER OF WILLS REV-1547 EX AFP (12-941 c01WONMEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX ACN 101 BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPT'. 280601 OF DEDUCTIONS AND ASSESSMENT OF TAX wusRlsauses, PA 1~1za-oeol DATE 09-04-95 ESTATE OF FILE N0. - DATE OF DEATH 03-01-95 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF HILLS. MAKE CHECK PAYABLE TO °REGISTER OF HILLS, ACENT^ REMIT PAYMENT T0: FREY 8 TILEY 5 S HANOVER ST CARLISLE PA 17013 CUT ALONG THIS LINE - RETAIN ---------------------------------------------- DCrf- 7 P.~a7 f'Y Bi°B f 7 3-O6Z WflSTf~G AC TA:Y REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Aaount Rewitted LOWER PORTION FOR YOUR RECORDS t .DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MILLER AUDREY T FILE N0. 21 95-0168 ACN 101 DATE 09-04-95 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ]CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rpl Estate (Schedule A) (1) .00 2. Stocks end Bonds (Schedule B) (2l .00 3. Closely F(eid Stoek/Partnership Interest (Schedule C) (3) .00 4. MortGages/Notes Receivable (SeMdule D) (4) .00 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 263,21 2.08 6. Jointly ONned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 263,212.08 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Atd. Costs/Misc. Expenses (Schedule H) (9) 16,005.66 10. Debts/Mort~ Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) 16.005.66 12. Net Valw of Tax Return (12) 247,206.42 13. Charitable/Governaental Segwsts (ScMehile J) (13) .00 14. Net Valw of Estate Subiect to Tax (14) 247,206.42 NO'(E: I~ an assess(~ent was issued previously,.lie:es ik, 18 and~cR 16, 37 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Aaount of Line 14 at Spousal rate (15) .0 0 X .03_ .00 16. Awount of Line 14 taxable at Lineal/Class A rate (16) 247,206.42 X .06. 14,832.39 17. Aaount of Line 14 taxable at Collateral/Class 8 rate (17) .00 X .15. .00 18. Principal Tax Dw (ig) 14,832.39 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE N(A78ER INTEREST (-) A~+T PAID 05-31-95 AA047825 741.62 14,090.77 TOTAL TAX CREDIT 14,832.39 BALANCE OF TAX DUE .00 INTEREST .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN •1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ^CREDIT° (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1547 EX AFP (12-94) COMMONHEALTH OF PEl81SYLVANIA DEPARTMENT OF REVENUE BUREAU OF IImIVIDUAI TAXES DEPT. 280601 NOTICE OF INHERITANCE TAX ACN 1 O1 APPRAISEMENT, ALLOWANCE OR DISALLONANCE HARRISeuac, PA 171z8 0601 OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 09-04-95 ESTATE OF MILLER AUDREY I FILE N0. cl y~-utoa DATE OF DEATH 03-01-95 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO ^REGISTER OF WILLS, AGENT^ REMIT PAYMENT T0: FREY & TILEY REGISTER OF WILLS 5 S HANOVER ST CUMBERLAND CO COURT HOUSE CARLISLE PA 17013 CARLISLE, PA 17013 Amount Rawitted CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 -------------------------------------- ----------------------------------------------------------------------- REV-1547 EX AFP f12-943 NOTICE OF INHERITANCE TAX APPRAiSEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MILLER AUDREY T FILE N0. 21 95-0168 ACN 101 DATE 09-04-95 TAX RETURN WAS: (X) ACCEPTED AS FILER ( )CHANGED 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. MortyaDes/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Mise. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule 6) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTIONS: 9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) lo. Debts/Mortpape Lisbilities/Lians (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Goverrwntal Begwsts (Schedule Jl 14. Het Value of Estate Subject to Tax (i) .00 (2) .00 c3) .00 (4) . 00 (5) 263,212.08 (6) .00 (7) .00 (B) 263,212.08 (4) 16, 005.66 (10) .00_ (il) 16.005.66 ci2) 247,206.42 (13) . 00 (14) 247,205.42 NOTE: If an ass(assoent was issued previously, lines 14, iS a~dior 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: . 00 X . 03_ . 00 15. Aaount of Line 14 at Spousal rate (15) 16. Aaount of Line 14 taxable at Lineal/Class A rate (16) 247,206.42 X .06. 14,832.39 17. Aaount of Line 14 taxable at Collateral/Class 8 rate (17) •0 0 X .1 5. .0 0 D l T (ig) 14,832.39 18. ue ax Principa rwv reerrre. PAYMENT PATE RECEIPT NUMBER DISCOUNT (;) INTEREST (-) AMOUNT PAID 05-31-95 AA047825 741.62 14,090.77 TOTAL TAX CREDIT 14,832.39 BALANCE OF TAX DUE .00 INTEREST .00 TOTAL DUE .00 +~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN !1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A '•CREDIT^ (CR), YW MAY SE DUE • RFFIAJA. SFF REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.12 Name of Decedent: Audrey T. Miller Date of Death: March 1, 1995 Wi 11 No . - Admin . No . 21-95-168 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-~capkioned 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 X No 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 . d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date : Oct. 18, 1995 ~ ~ ~- Signature Robert M. Frey Name (Please type or print 5 S. Hanover St., Carlisle, PA 17013 Address ( 717 ) 243-5838 Tel. No. (MAH:rmf/AM3) Capacity: Personal Representative X Counsel for personal representative STATUS REPORT UNDER RULE 6.12 Name of Decedent : Audrev Miller Date of Death: March 1. 1995 Will No. Admin . No . 21-95-168 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 X No 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 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date : April 8, 1998 0/~~'~`"~ ~" ~_ Signature Robert M. Frey Name (Please type or print) 5 S. Hanover St., Carlisle, PA 17013 Address ~; ( 717) 243-5838 -..- ~_f Te 1 . No . Capacity: Personal Representative X Counsel for personal representative (MAH:rmf/AM3)