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Home My WebLink About02-1123PETIT~O~F~R PROBATE Estate of Paul Ems- Miller also known as Deceased. Social Security No. 174-07-1949 and GRANT OF LETTERS No. ?_l-~a- I~a3 -- To: Register of Wills for the County of C_t~mY~r1 and 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 ri x named in the last will of the above decedent, dated netol~r ~ , 19$x_ and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in (`»mharl and County, Pennsylvania, with h~.G last family or principal residence at any ~~P~~ e+-roAt lisle, PA (list street, number and muncipality) Decendent, then 90 years of age, died November 23 , ,~9t 2002 _, at art isl P Rpt~i nnal Mr~di c-al (`PntPr, Carl i G1 a, Pa _ Except as follows, decedent did not marry, was not divorced and dtd not have a chtld born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ ~_~, nnn 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. . C-~-, ~~ ~_.. _. ~__ ~ y- QfZ_ w ~~~~ w .. ~v rx ~, -o 0 c ': cd •.^. ~a ~ ~, 7 ~ G b0 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss 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 esta rding to law. Sworn to or affirmed and subscribed ~D ~' ~~' l° ~' before me this ~ i:h day of GECEMBFR 2002 ~jx ~Q,t,,,~ ~ ~~ gister 00 A >; ego in No. ~!-Oa.- 11/x3 Estate of PAi;L E MILLER Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW DECEMBER 10 2002 xl~~_, 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_ 10 - 2 -1 g g g ~> described therein be admitted to probate and filed of record as the last will of PAUL E MILLER and Letters TESTAMENTARY are hereby granted to OERTRUDE FOOTE FEES Probate, Letters, Etc.......... ~ J`~.00 Short Certificates( ) ..... , , , . , ~ l S . 0 0 ~eaP ~ io . o0 TOTAL $ . 00 1 Register of Will ~(~ _ ATTORNEY (Sup. Ct. I_D. No.) ADDRESS Filed . ~p2. -. /.O -.Q,2,~ ~- PHONE ~~~ .. This is ro certif, r at the inforr~~ation here given is correctly copieL~ ~re~rn an original certificate of deaf i1. ~t1,~ fire,,: ~~•a~ li,e :,s Luca; RLt>i~r±-ar. h11e ol-i+~in:bl c~:ritlcate wilt br forwarded to the ti_.itc~ ~'I~ai Kecords Office for pc~n;al,.~;~t ti~,n,~. WAR1~!lv~: !t is illegal to duplicate this copy by photostat or photograph. „,-„ '~ ~ ;, Fe° d.,: this c~~rifc,•~..~~.Ui) ~e~~~,~jHOFp~/f • ~ C~~C~~~~ ,' - ~ +~~ ~~ :/~ _ (o~a'r Zt .gal' Y^ of ~ a ~{ ~~ a~3 ~ ~I F ~p F~ ~~~' =_ .-,,; J 87®4128 ~,,.q~~---~~~ Gov 2~ 2002 - ------ - -- -- ~.., ENT,,,,,,,, tit.,. ( M105.1 U Rev. ?le7 RINT VENT INK ~~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT IFng. Mb«e.lml ~ ~~-~- ~ SE% SOCIAL SELURITV NUMBER V~ DATE OF DEATH ~Memn, Day.'Aw1 ,. PAIdL E M11.L~Q :. j~ a. I"2N - Off' - 19Lf a 3 • I i oZ ' AGE IUS Bvtnasyl UNOERIYEM UNDERIDAY ORE OF BIRTH BtRTHPUCE (Gty and PLACE OF DERHIChck axy one-xw M>trucwr.s on0a!ar seal MpnM • Dana Ib«s . Monroe ~ ~'!' Carnyl iMOntn. , karl SMNdFa HOSPITAL: OTHER: Pit ~ h ~s ur Na.mq^ ~~^ ^ ~ Q Ym. (~' I ~ e n n a 9 Inpat»nt ^ ENOlnpn»m DDA ^ Hon.. bI s e. 7. ... COVNT'OF OERH CITY. BORO. i\VP OF DERH FACILITY NAME pl nel ursolulpn, S>we ftreel aria nrnoer~ WAS CEDENT OF HISPANIC DRKiIN7 RACE-Amwican lna»rt elan, NTNe.arc, Cumberland Carlisle ~ ~ ++•~•^EYKSP•MYCuMn. IS°°`"1'1 M. ~ Pe.rm wue..le. .Whit e , ». k. ee. 4f ~ C n s, te• DECEDENT'S VSUAL QCCUPRKIN KIND OF BUSINE55/INDUSTRV WAS DECEDENT EVERM DECEDENT'SEWCRION MARITAL STRUS-Manisa Sl1RVIVINCi gpp,l$E IGiva kvW m w«k aona Nr+q rroY U.S. ARMED FORCEST n Can NwN Marti W, WmowM, III'Mla pM rnFOMr rwral . d waking M•: ao rid uas r M.l ENmarnary/Sauneary C«Nes Ohareaa tSeecMl Brewery M• ~•^ m+~ borer L - d +•«S 11e . „~ a " ,a Wi 11 ' ower ts a to oECEDENT'9 MAKINLi ADDRESS (SlraaL CiryTrown, sla». LP Looel 403 "F" Street . DECEDENT'S e o n s v a n l a ACTUAL +T•'~„• Y ow ,7e.^Yw a.c.e.ntw.am , n.v RESIDENCE aseaaam Carlisle, Penna. 17013 ~ ~'°"° Cumberland •^~• Carlisle 1e ~~ mvmanip7 ,Td ~ ~a FRHER'S NAME (Piro. Mq«e Laal) ,,. Frederick Miller MOTHER'S NAME (Fig. Mitlak. M rSur 1 ~~ f"°~rriza~eth Hyers ~ORMANi•s NAM~,(rypamr.Nl l7ertrude D. Foote '~"~"`"•~"• I~°~"~•+~~"w"°S°t=ee ar isle; Penns lvania 17013 y METNOOOF DISPOSITK)N I ~ ^ ^ . DRE OF DISPOSITION (Memo D•y lbarl PLACE OF pSPOSl710N-Noma a Camnary, Crwrlalay a OIMr PMu LOCRpN • Ciry/m.n, Sm.. ZpCoW Bunts My ~Y Cramnbn Ramov4 hen Stria ^ ~«~ I+ . , vember 29,2002 Queen of Heaven Bridgeville, Penna. . au ate. :7e. me. ' SIGNRUR FUNERAL SER LKENS OR PERSON ACTING SUCH „~ Ord ~, LK.ENSEN ME ILpDAWi~SS OF F/~KJTV ne `l~~'$219-L wing ~jro ers : arlisoYe, Peann°sygvaniag7 13 tea<aily v~nan canoy»q n•I Mi»W M time al dam io Mal «my krow»egs, °aam occunee at tM tirl», rIM• W pace statart. a aria Tq» LICENSE NUMBER DRE SIGNED ' army «eatn. (/AaMI Day. Marl aa.. aw. sae. Same 2a-ae mtwl M rbniplalW ey TIME OF DERH ORE PRONOUNCED DEAD (M«rn, Day, Marl WAS CASE REFERRED TO MEDICAL EXAMINER/CORONERT • persm wro pr•rmum:r wam. YN Ns^ I I I Z 3 I O Z 2f ~ 4 M a3 . . . 10. a7. PART I: EMV n» o»eaaaa, k+Ar»a a canpacations whits uuaeOlM uatn. 0• n•1 anlar 1M mo0a •I eyinS, srrc+l ae nr«ac a reepiratery arrant. aMat a Mart »»ra. r AppmaYnMa PART S: Omar aigrallcam Lorlal0err m ~•~^~ Oealll• ~ L'M aNy aria urAm on aacn lino . ;~ t ~ rlol mrNlalE in S»uManyYgeaw poen vn PART I. IMYEpATE CADS! (Fuel I ~° .. aC,k~-e' v>1~,~c d,a I~ ~~4.~rJn. I 3 rs. DUE TO IOR AS A COHSE ENCE OF}. SapArmYylM mt6aena D a •^K »s0irtpm iemma»N DUE 10 (OR ASACONSEWENCE OFl: I esusa. Einar UNDERLYIND ; CAUSE IOwaaaa r7ay c - nN er.eea awrNS DUE 70108 AS A CON$EOUENCE OFI: I rssaNq n eeasll LAST a. • VMS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DERH ORE OFINJURY TIME OFINJURY INJURY RyPORKT DESCRIBE 110W INJURY OCCURRED. PERFORMEDT AMVLABLE PRIOR 70 (Mann. Day. Mar) COMPLETION OF CAUSE 1~ aDERM NNUrtl ~I /b Kie ^ m a YYa ^ NO ^ ' ^ A<ciMm PaMirrE lrnwallgatbn ^ ~t YM ^ NS vJ Yw ^ No ^ Samba ^ Cats na M MtarmineA ^ PUCE OF ttUURY -M Imma hrm graaL lacto o1BCa M LOCRION T lB G . , ry. ry ew. y rwn. S1ate1 7k 2110. af. ~ ale.ISPac+yl aa. CERTIFIER tCt»q aey oriel 'CEIITIFYINO PHYSICIAN(Pnyf.uan umryvg taussa uM when anansr Pnvscun nos pr«quriGee ~~an aria canpetw Sam 2a1 SIGNRURE ANO TITLE OF CERTIFIER Te em e..e of mY krow»aW. wan oatrree era m tM uuaa(a1 one manner p stetW ..................................................... ^ a70. /1? /v1 • 'M10NOIMCIND AND CERTIFYttNI PHYSICIAN (Pnyston eon aaavnc ug seam aria caMyvq mosueadlxaml LICENSE NUMBER ORE SgNEDIMOT, Day. Marl .. ~ Tn dm heel a mT knewMage, aaatn a«urrw n na dine, ante. aria qac•, and au• m the eauwpl aria manmr as Mn,q ......................... . Q 1H.~ I ~ ? - a+e. ale. 1 3 0 NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE H 'MEDICAL O(AMINER/CORONER (Sam 271 TygaPdnl WILLIRM 7>'~T`'~I C~.Nls R'EG' M[•p Ltr?C On Ilts Gals el a:sminHbn and/oF Investlgatbn, In mY oplnbn, dears octurrad st the time, date, aria pleas, and d e to the douse(s) and ~ (. p/hE1cC~ STe~eT ^ marine. as etaLad ............................................................................... ~ ................. 7 r.. C,}L'~LL$ LE PH I7 O ( 3 az. REGISTRAR'S SIGNRURE ANDN I A ~w c~ ~ OREFILEOIMOmn. Day, 1 ~ ' . .. ~. a.. 1 ov , a 1 abr.3a- LAST WILL AND ~ OP' PAUL E. MIIiEI.t ~~ I, PAUL E. MILLER, a legal resident of the Borough of Carlisle, C~nberland County, Pennsylvania, being of sound and disposing mind, memo and understanding, do hereb make ~' Last Will and Testament hereb revo~ll~ and declare this as and for my , Y king all other wills and codicils heretofore made by me. ~~: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as p~acticabie afr_er my decease. I direct that I be buried in Grave No. 8, I,~t 6, Block 21, of the Queen of Heaven Cemetery, peters Township, Washington County, Pennsylvania. SEQO~ID: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the ac~ninistration of my estate, ~D: I devise and bequeath the sum of Fifteen Thousand ($15,000.00) Dollars, in equal shares, to the grandchildren of Gertrude Foote. FUA2~i: I devise and bequeath the residue of my estate, of every nature and wherever situate, to Gertrude Foote, provided she shall survive me by thirty (30) days. Should Gertrude Foote predecease me or die on or before the thirtieth (30th) day following my death, I devise and bequeath the residue of my estate, of every nature and wherever situate, to her grandchildren, equally. FIF~I: I direct that the share of residue of any beneficiary under the age of 21 years shall be held, IN TRUST, however, by LARRY E. FOOTE, as Trustee, to hold said share for the benefit of each said beneficiary under the age of 21, upon the following teams and conditions: A. To pay the income and so much of the principal as may, in the sole discretion of my Trustee, be necessary for the ~~~nce, support, medical expenses and education of each beneficiary. B. The amount to be paid for the benefit of any of said beneficiaries shall be determined from time to time by the need of each of said beneficiaries, and the amounts and times of said payments shall be determined by such need. The said payments may be made by my Trustee directly to each of the said beneficiaries, or to such of them as may be, in the sole opinion of my Trustee, of such age and ability to handle properly the funds so paid to such beneficiary, or may be made QOAMZONWEAI,TH OF PEl~1NSYLUANIA SS. OOUN'I'Y OF CiJNlBERL,AND ~ I, PAUL E. MILLER, Testator, whose name is signed to the attached or foregoing instnmlent, having been duly qualified accorciinq to law, do hereby acl~owledge that I signed acid executed the inGt~nt as mY Last Will; that I signed it willingly; acid that I signed it as my free and voluntary act for the purposes tt-ierein expressed. Sworn or affirmed to and ac3mawledged before me by PAUL E. Mlr,r~~z, the Testator, this day of ~ ~~ ~,~„ 1989. C,j~c~~ ~ -~ (SEAL) Tes r Paul E. Miller~~ No a LC~6~.~ (SEAL) tary Pub -~~. A~~~~.I, NOTARIAL SEAL SHIRLEY W. AHLERS, NOTARY PUBLIC CX)NIMONWEAI,'Ig~ OF PENNSYLUAN.LA CARLISLE BORO., CUMBERLAND COUNTY, PA ) MY COMMISSION EXPIRES JULY 14, 1993 SS. OOUNIY OF CUM~ftLAIVD ~ We, EDl~RD L. SQiORPP and ~p 6~ ~ f /~, ~k~'C ~ the witnesses whose names are signed to the attached or foregoing inctnmtent, being duly qualified accon-~ing to law, do depose acid say that we were present and saw Testator sign and execute the inStrlIIttellt aS his Last Will; that Paul W. Miller signed willingly and that he executed it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our l~owledge the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed and subscribed to before me by EDWARD SCHORPP and /20 6 H ,~ t R h'/aa /~ ,witnesses, this~day of 19x9. SEAL) SEAL) .-.~j~/ 7 4-/~ ~~~ (SEAL) V NOTARIAL SEAL SHIRLEY 1Y. AHEERS, NOTARY PUBLIC CARLISLE BORO.. CUMBERLANDf COUNTY. PA MY COMMISStON EXPIRES JULY 14, 1993 by my said Trustee directly to the person having the custody and care of any of the said beneficiaries, or may be made by my said Trustee directly to any institution entitled to such payment by reason of services rendered or to be rendered to any of the said beneficiaries. C. To pay the acctunulated incxAne and principal then remaining in his hands to the said beneficiaries, upon each beneficiary's attaining the age of 21 years. D. Any and all payment or payments of any stun or sums, whether in cash or in kind, and whether for principal or incoarie, payable to said beneficiaries, shall be made upon the sole receipt of the respec,-tive beneficiary to wham the payment is made, and free from anticipation, alienation, assignment, attachment and pledge, and free frarn control by the creditors of ary such be.-ieficiary. All snares of principal and income herein given shall be free from anticipation, assignment, pledge or obligation of any beneficiary, and shall not be subject to any execution or attachment. S]~IH: I nominate, constitute and appoint GEEY1'R[JDE FC)OTE , Executrix of this, my Last Will and Testament. Irt the event of the renunciation, death, resignation or inability to act for any reason whatsoever of the said GE~JDE FCO'I'E, I nom_is~ate, constitute and appoint LARRY E. F~00'I~, Executor of this, my Last Will and Testament. I hereby relieve my Executrix or her successor frarn the necessity of posting security in connection with their duties as such in any jurisdiction in which they may be called upon to act, insofar as I am able by law so to do. 7N Wr.~.S i~ff~tDOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two ype itten pages, each of which bears my signattare, this ~~`'° day of ct~~" ~ ~s'~"~ 1989 . C~~f" ~ /y~~ca~SEAL> Paul E. Miller Signed, sealed, pub]_ished and declared by the above-named Testator, Paul E. Miller, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ~~Q~~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Paul E. Miller Date of Death: November 23, 2002 21-02-1123 Will No. Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 12-7-02 Name 403 "F" Street, Carlisle, PA Shaun R. Foote ~ 78 Nelson Drive, Carlisle, PA Larry E. Foote, Jr. 78 Nelson Drive, Carlisle, PA Gertrude D. Foote Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 2-4-03 Address Signature Name C`,artn~r3a 11_ Fnnt.a Address 403 "F" Street Carlisle, PA Telephone 717) 243-1415 Capacity: X _ Personal Representati~~e __---(~~xuisel f~~r E,er~~,n<tl rei~re~~ntnii~~e IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WII.,L RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND. CARLISLE, PA In re Estate of Paul E. Miller ,deceased, Estate No. 21-02-1123 (Name and Address) TO: Shaun R. Foote 78 Nelson Drive, Carlisle, PA Larry E. Foote, Jr. 78 Nelson Drive, Carlisle, PA Gertrude D. Foote 403 "F" Street, Carlisle, PA Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent Paul E. Miller day of November 2002 , at Cumberland County, Pennsylvania. X The Decedent died testate (with a Will); or The Decedent died intestate (without a Will). The personal representative of the Decedent is (name, address and telephone number). Gertrude D. Foote 403 "F" Street died on the 23rd Carlisle, PA [f the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No.717-240-6345 A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the ch-a/rages for duplication. Date: 12-7-02 Signature;,~,Q~~.~'Fc?- SLY , ~o Name (print) Gertrude D. Foote Address 403 "F" Street Carlisle, PA Telephone (717 243-1415 Capacity: Personal Representative X Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002132 FOOTE LARRY 35 EAST HIGH STREET CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 174-07-1949 FILE NUMBER: 2102-1 123 DECEDENT NAME: MILLER PAUL E DATE OF PAYMENT: 02/05/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /23/2002 REMARKS: LARRY E FOOTE CHECK# 97 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $26,1 17.28 TOTAL AMOUNT PAID: INITIALS: AC RECEIVED BY: DONNA M. OTTO REV-1162 EX111-96) 526,1 17.28 DEPUTY REGISTER OF WILLS REGISTER OF WILLS ~V-\5OQHI6-OO) . , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY / '..... / - FILE NUMBER INHERITANCE TAX RETURN RESIDENT DECEDENT ~L - ..Q,.J/ COUNTY CODE YEAR _...LL~~ NUMBER .... Z W C W o W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Paul E. Miller DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 11-23-02 10-06-12 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) THIS RETURN MUST BE ALED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER 174 07 1949 w ,.., "'~'" l.>"'" w"l.> ",00 l.>...... .." .. .. [!] 1. Original Return o 4. limited Estate o 6. Decedent Died Testate (Attach copy 01 WJII) D 9. litigation Proceeds Received o 3. Remainder Return (daI1IoIdeath prior 10 12-13-82) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. ElecIion to tax under Sec. 9113(A) r"""'SohOI o 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12.a2) D 7. Decedent Maintained a living Trust (AttachcopyofTrusl) D 10. Spousal Poverty Credit (date of deaItl between 12-31-91 and 1-1-95) ,.., Z W C Z o .. '" w .. .. o l.> NAME COMPLETE MAILING ADDRESS 35 E. High Street SUite 101 Carlisle, 'PA 17013 Lar E. Foote FIRM NAME ("_bIo, TELEPHONE NUMBER (717) 249-2758 z o 5 :J .... ii: <C o w It: (1) N.A. OFFICIAL USE ONLY (2) N.A. (3) N.A. (4) N.A. (5) $185,500.65 (6) N.A. (7) 5,202.50 (8) $190,703.15 (9) '1,424.00 (10) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (Schedule G or L) 8. Total Gross Assell (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debls of Deoe<ient, Mortgage L~bilities, & Liens (Schedule I) 11. Total Deduellons (Iotal Lines 9& 10) 12. Net Value of Estate (line 8 minus line 11) 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) (11) 7,424.00 (12) 183,279.15 (13) (14) 183,279.15 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I-' :J ll.. ~ o o ~ 15. Amount of Line 14 taxable at the spousal tax: rale, or transfers under Sec. 9116 (a)(1.2) x.o_ (15) x.o_ (16) x .12 (17) x.15 (18) 27.491.87 (19) 27.491.87 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 183,279.15 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ ~(~.., , ,,: : Decedent's Complete Address: STREET ADDRESS . " 403 "F" Street CITY Carlisle . I STATE PA I ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page Hine 19) 2. Credits/Payments A, Spousal Poverty Credit B. Prior Payments C, Discount 1. 374.09 3. interesUPenaity if applicable D. Interest E, Penalty (1) 27,491. 87 Total Credits (A+ B + C) (2) 1,374.09 Totai InteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This Is the OVERPAYMENT. Check box on Pagel Line 20 to reque.t a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 26,117.28 A, Enter the Interest on the tax due. (5A) B. Enter the total of Line 5 + 5A This is the BALANCE DUE. (5B) 26,117.28 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;"""""."."""".""""""""""".""""""""".""""""""."""" 0 , b. retain the ri9ht to designate who shail use the property transferred or its income; """"""""."""""""."""",," 0 c. retein a reversionary interest: or""""""""""""""."""""""."",,,,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,.,,.,,,,,,,,,""',,"'"'''' """"" 0 d. receive the promise for life of either payments, benefits or care? "".".""..."""""""."""""""""""""""".,,",,. 0 2. If death occurred after December 12, 1982, did decedent transfar property within one year of death without receiving adequate consideration? """"."""""""."""""""""""""""""""""""""".".""""""...,,.,,""""" 0 3, Did decedent own an "in trust fo~ or peyabie upon death bank account or security at his or her death? ."""""." 0 4. Did decedent own an Individual Retirement Acoount, annuity, or other non-probate property which contains a beneficiary designation? """""".""""""""""""""""."""""".""""""""""."""",,.,,"""""""."""""" ~ No ~ IX] IX] IX] ~ 29 o 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 pe~ury, I declare that I have examined this return, Including accompanying schedules and statements, and 10 the besl of my knowledge and belief, it Is true, correct and complete. Declaration of preparer other than the personal representative Is based on alllnlormatlon of which preparer has any knowledge. SIGdRE OF PERSON RESPONSIBLE FOR FILING RETURN ,(DDRES~ -? T.:'l, II" tio /0, ..;z~ 403 "F" Street, Carlisle, PA 17013 SIGNATURE OF REPARER OTHER THAN PRESENTATIVE 35 E,.'Jli,g-g'c,Street, SUite 101, Carlisle, PA 17013 DATE 2-4-03 DATE 2-4- 3 ..r" For dates of death on or aftar July 1, 1994 and before January 1, 1995, the tax rate imposad on the net value of transfers to or for the use of the survivin9 spouse is 3% [72 P.S. ~9116 (a) (1.1) (I)J. For dates of death on or after January 1, 1995, the tax rate Imposed on the net value of transfers to or for the use of the survivin9 spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii) The statute does not exemot 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 the surviving spouse is the only beneficlery. For dates of death on or after Juiy 1, 2000: The tex 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 paren or a stepparent of the child is 0% [72 P.S. ~9116(a)(I.2)J. 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 a. noted In 72 P.S. ~9116(1.2) [72 P,S. ~9116(a)(1)], The tax rate imposed on the net vaiue of transfers to or for the use of the decedenf. siblings i. 12% [72 P.S. 59116(e)(1.3)1. A siblln9 Is defined, under Section 9102, as al Indivlduai who has at ieast one perent in common with the decedent, whether by biood or adoption. """"'1':1. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Paul E. Miller SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FilE NUMBER 2002-01123 Include the proceeds of litigation and.the date the proceeds were received by the estate. All property jointly-owned with the right of 5uNivorship must be disclosed on Schedule F, ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. DESCRIPTION VALUE AT DATE OF DEATH $ 5,576.04 64,956.28 70,930.16 12,350.60 5,167.53 16,520.04 10,000.00 Certificate of deposit Certificate of deposit Certificate of deposit Certificate of deposit Certificate of deposit Checking account 2000 BuiCk automobile TOTAL (Also enter on line 5, Recapitulation) $ 185,500.65 (If more space is needed, insen additional sheets of the same size) ""'''c;'''''''~. .,~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Paul E. Miller SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 2002-01123 This schedule must be ccmpleted ana filed If the answer \0 any of questions 1 through 4 on the revefSe side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE -mE NAME O~ THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE OATE OF TFt'.NSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPV OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST IFAPPUCABL~\ 1. Annuity (cashed in) !5,202.50 100% 5,202.50 TOTAL (Also enler on line 7, Recapitulalion) $ 5,202.50 (If more space is needed, insert additional sheets of the same size) 'W"""i'~i. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Paul E. Miller FILE NUMBER 2002-01123 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Professional services, casket and vault. 7,008.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Secunty Numbe~s) I EIN Number of Personal Representative(s) Street Address City State Zip Yea~s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Street Address City Stale Zip Relationship of Claimant to Decedent 4. Probate Fees 281,00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 135.00 7. 0 -- TOTAL (Aiso enter on line 9, Recapitulation) S 7,424.00 (If more space is needed, insert additional sheets of the same size) ~'1513EX.{1.s7)~. ..~ COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN SlDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(a) OF ESTATE 1. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. ~UtI R. Foote Friend $7,500.00 8 Nelson Drive Carlisle, PA 17013 2. Larry E. Foote, Jr. Friend $7,500.00 78 Nelson Drive ~ Carlisle, PA 17013 3. Gertrude D. Foote Conq>anion Remainder of estat 1/r 403 "F" Street Carlisle, PA 17013 ENTER OOUAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 17. AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- TAXABlE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRiBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ Paul E. Miller 2002-01123 e (If more space is needed, insert additional sheets of the same size) BUREAU OF INDIVIDUAL TAXES TNHERTTAHCE TAX DZVTSTON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 CONHONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS, AND &SSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-IG48 EX AFP C01-0S) GERTRUDE ~05 F ST CARLISLE D FO0~ FEB 20 ~I1~ :22 (:, ~¢.P,A 17o15=17,~rt ,,,,,,,.,~,,-:.,..,' _: Co., PA DATE 02-2~-200~ ESTATE OF HILLER PAUL DATE OF DEATH 11-23-2002 FZLE NUNDER 21 02-11Z3 COUNTY CUHBERLAND SSN/DC 17~-07-19~9 ACN 03111950 Amount Remitted I HAKE CHECK PAYABLE AND REHIT PAYHEHT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 E CUT ALONG THIS LINE ~'- RETAIN LONER PORTION FOR YOUR RECORDS REV-1548 EX AFP NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOHANCE OR DISALLO#ANCE OF DEDUCTIONS, AND ASSESSNENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE OZ-Z~-ZO0~ ESTATE OF HILLER PAUL E DATE OF DEATH 11-23-2002 COUNTY CUHBERLAND FILE NO. 21 02-1123 S.S/D.C. NO. 17~-07-19~9 ACN 03111950 TAX RETURN WAS: eX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORNATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE ACCOUNT NO. 800000021~7Z07 TYPE OF ACCOUNT: ¢ ) SAVINGS ( ) CHECKING ( ) TRUST ¢ ~ TIHE CERTIFICATE DATE ESTABLISHED 05-08-2000 Account Balance 15,971.25 Percent Taxable X 0.500 Amount Subject to Tax 7,985.63 Debts and Deductions - .00 Taxable Amount 7,985.63 Tax Rate X .15 Tax Due 1,197.8~ TAX CREDZTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS NOTICE HITH YOUR TAX PAYHENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO= "REGISTER OF HILLS, AGENT." PAYHENT RECEIPT DISCOUNT ¢+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 0~-10-2005 CD002~11 .00 1,197.8~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDTTZONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" { CR}, YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORN FOR INSTRUCTIONS. 1,197.8~ .00 .0O .0O STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: /! Will No.: '2./---~tO :7~J/] ~ Admin. No.: 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 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 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 J~ No [--] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. D at e:/z~ -~Z~.~ ~ ~/t~t~ f ~-~t~ Sign[tu~,~/ Name Address Telephone No. Capacity: ~5Personal Representative [-] Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: FOOTE GERTRUDE 403 F STREET CARLISLE, PA 17013 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: ~~4-0~-1949 FILE NUMBER: 2102-1 123 DECEDENT NAME: MILLER PAUL E DATE OF PAYMENT: 03/07/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /23/2002 REV-1162 EX(11-96) N0. CD 002261 ACN ASSESSMENT AMOUNT CONTROL NUMBER 03104522 ~ 5443.52 TOTAL AMOUNT PAID: REMARKS: GERTRUDE D FOOTE CHECK#102 SEAL INITIALS: AC RECEIVED BY: DONNA M. OTTO 5443.52 DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INFORMATION NOT I C E BUREAU OF INDIVIDUAL TAXES AN D DEPT. 280601 TAXPAYER RESPONSE HARRISBURG, PA 17128-6601 REV-1543 EX RFP (V9-00) FILE N0. 21 02-1123 ACN 03104522 DATE 02-21-2003 TYPE OF ACCOUNT EST. OF PAUL E MILLER ®SAVINGS S.S. N0. 174-07-1949 ^ CHECKING DATE OF DEATH 11-23-2002 ^ TRUST COUNTY CUMBERLAND ^ CERTIF. REMIT PAYMENT AND FORMS T0: GERTRUDE FOOTE REGISTER OF WILLS 403 F ST CUMBERLAND CO COURT HOUSE CARLISLE PA 17013 CARLISLE, PA 17013 YIAYPOINT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling 1117) 787-di27. COMPLETE PART 1 BELOW * * ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1760009100 Date 02-16-2000 To insure Proper credit to your account, two Established C2) copies of this notice must accompany your Account Balance 5 913.54 Payment to the Register of Wills. Make check , payable to: ^Register of Wills, Agent^. Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to TaX 2, 956.77 (3) months of the decedent's date of death, T9X Rate X , lrj you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 443.52 nine (9) months after the date of death. PART TAXPAYER RESPONSE ....~~~~...~r~.... ......................................................................................:.::::::::::::.............................................................................................................:::::::::::::::::::.._:...................................... A. The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, ar you may check box ^A^ and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N LY to be filed by the decedent's representative. C. ^ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART 2^ and/or PART 3^ below. P T If ou indicate a different tax rate, Please state your ::::~:,~;;;:~:;:;:;;;;;;;~;;~~;;, _; :: :::~~~~~.'~. :: ~~~~~ ~ ~ ~ relationship to decedent: TAX RE _ TURN COMPUTATION OF TAX • ACCOUNTS RUST ON JO .~`#~_.,... LINE 1. Date Established 1 ~::::: €s~ €~'~~~~~~~~~ii~~;~ ~~ ~ iii i~ ;;°°~=_ ~~~~~~ 2. Account Balance 2 s€~ ~€s~s _i~~EE~'•.~s~si: `SE~EE~iEE~ ~~ ~~~~s_~;~~~~~;s_;s ;€ 3. Percent Taxable 3 X '~~~€(i"~~':.~s?iii:i_~s'=~~~~~~~~ii€_€€~~ ~~€!~€!~i~si~i~~~~~ii~s~~€=€ .... 4. Amount Subject to Tax 4 `" ~~ 5. Debts and Deductions 5 - ';t~'si~€=~ii~~~i~i~€~_~€~€€~€~~~€~:~is~~~ ~i~i~ii i i:s?s • 6 . Amount Taxable 6 : .:::: 7. Tax Rate 7 X 8 . Tax Due 8 ~:•::: ~::::: ~~ ~ ~ ~' ......................................... . PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my know~lye-dge and belief. HOME C 717 ) Z~~~1~/~~ ~~ ,~ ~e-~-~~ WORK (7-7 ) y'E3~242b ~~y.'2_? ~~ owvro CTGIJATIIDF TELEPHONE NUMBER DATE /?` l~~ /Dam COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-obol NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% RFP coi-o3~ DATE 03-17-2003 ESTATE OF MILLER PAUL E DATE OF DEATH 11-23-2002 FILE NUMBER 21 02-1123 COUNTY CUMBERLAND LARRY E FOOTE ACN 101 STE 101 Anount Remitted 35 E HIGH ST CARLISLE PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP (01-031 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MILLER PAUL E FILE N0. 21 02-1123 ACN 101 DATE 03-17-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1l .00 2. Stocks and Bonds (Schedule B) (2) .00 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 4. Mortgages/Notes Receivable (Schedule D) (4) .00 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 185, 500 .65 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7l 5,202.50 8 Total Assets (8) NOTE: To insure proper credit to your account, submit the upper portion of this fore with your tax payment. 190,703.15 APPROVED DEDUCTIONS AND EXEMPTIONS: 7,424.00 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions (11) 7.424.00 12. Net Value of Tax Return (12l 183,279.15 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) [13) .0 0 14 Net Value of Estate Subject to Tax (14) 183,279.15 . NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount ofi Line 14 at Spousal rate (15) • 00 X 00 = . 00 16. Anount of Line 14 taxable at Lineal/Class A rate (16) • 00 X 045 = . 00 17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00 18. Amount ofi Line 14 taxable at Collateral/Class B rate (18) 183,279.15 X 15 = 27,491.87 Principal Tax Due 19 [19)= 27 491.87 ~ . Twv nnrn*TC~. . DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 02-05-2003 CD002132 1,374.59 26,117.28 TOTAL TAX CREDIT 27,491.87 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ^ IF PAID AFTER DATE INDICATED, SEE REVERSE [ IF TOTAL DUE IS LESS THAN 51, 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 FDR INSTRUCTIONS.) / 7-/~~ ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INFORMATION NOT I C E BUREAU OF INDIVIDUAL TAXES AN D DEPT. 286601 HARRISBURG, PA 171z6-6601 TAX PAYER R E S PO N S E REV-1543 EX RFP (09-00) FILE N0. 21 02-1123 ACN 03111950 DATE 03-21-2003 TYPE OF ACCOUNT EST. OF PAUL E MILLER ^ SAVINGS S.S. N0. 174-07-1949 ^ CHECKING DATE OF DEATH 11-23-2002 ^ TRUST COUNTY CUMBERLAND Q CERTIF. -- REMIT PAYMENT AND FORMS T0: GERTRUDE D FOOTE REGISTER OF WILLS 403 F ST CUMBERLAND CO COURT HOUSE CARLISLE PA 170..13-1348 CARLISLE, PA 17013 ALLFIRST FINANCIAL SERVICE has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW ~ * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 80000002147207 Date 05-08-2000 To insure proper credit to your account, two Established (2) copies of this notice must accompany your Account Balance 15 971 .25 Payment to the Register of Wills. Make check , payable to: "Register of Wills, Agent°. Percent Taxable X 50.000 NOTE: If tax payments are made within three Anount Subject to Tax 7,985.63 (3) months of the decedent's date of death, Tax Rate X , lj you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 1 , 197.84 nine (9) months after the date of death. PART TAXPAYER RESPONSE A. ^ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box ^A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 CK B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N LY to be filed by the decedent's representative. C. ^ The above information is incorrect and/ar debts and deductions were paid by you. Yau must complete PART 2^ and/or PART 3^ below. PART If you indicate a different tax rate, please state your `.?'.".?:: ~~~~~~~~ ~ ~~~~ relationship to decedent: `'""""'" TAX E R ~ ACCOUNTS TURN - COMPUTATION OF TAX ON JOINT TRUST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -:...:..,...,~~ ::::::::::::::::::::::::::::::::~::::::::::~:~::::::::::::::::::::~:::-::::::::::::~:::::~:::~~~::::::::~::-::::::::::::::::::::::: _!#~~~:~::~::~:::::~:::::::::::~ :::::::::::::::::::::::::.::.:::::::. ::::.::~::_:~:::: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LINE 1. ablished 1 Date Est €~€~~~°~ __`~~€_i€€_s€isis~€€~_~~€s€~€i~ ~~~~i~'€=`€€_='€~€€ ~~~~~~~~ 2 . Balance 2 Account ;•: ~ :::: €€€~~~~~~~~~~~~€=~~'•.~€~~€s'•.~~~~~':•':•~'~s~s~':•~~~~~€ ~~ 3. X Percent Taxabl ~~ ~~ 4. to Tax 4 Anount Subject s~~~#~~~~~~~~!~!~~~'•.~~~~?s~s~ ss[~s~~~~i s~~~~s?~_ics=?_=`=~s?'f'=s!i '`` ``' "~ € 5. ions 5 Debts and Deduct ~:::~~:~ ~'~€€~€~€~~€` ~~~~''~€~~s~s~s~~s~~~s~~~~~~~~`~~'~€~~~~i~€'°~'~€~"s ~~~~~~ 6 . 6 Amount Taxable ~::~::;• ~ iii ~~Es~?€!=~i=!~ ~~~~~~~ ~ ~ €~€=s`s~=i= s~i`i~`'~~ ~i€~ ~~ 7. X Tax Rate ~~~~'` . 8 ~s 8 Tax Due ......................................................................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . =~€~s~€~~~:;: PART DEBTS AND DEDUCTIONS CLAIMED 0 - DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of ny knowledge and belief. HOME C ) WORK ( ) TAYDAVCD crr_unTnoG TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: FOOTE GERTRUDE 403 F STREET CARLISLE, PA 17013 fold ACN ASSESSMENT CONTROL NUMBER AMOUNT 031 1 1950 ~ 51,197.84 ESTATE INFORMATION: ssN: i~4-o~-is4s FILE NUMBER: 2102-1 123 DECEDENT NAME: MILLER PAUL E DATE OF PAYMENT: 04/10/2003 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 1 1 / 23/ 2002 TOTAL AMOUNT PAID: REMARKS: GERTRUDE D FOOTE SEAL CHECK# 859 INITIALS: JA RECEIVED BY: DONNA M. OTTO 51,197.84 DEPUTY REGISTER OF WILLS PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT DUPLICATE REV-1162 EXI11-96) N0. CD 00241 1 REGISTER OF WILLS ~,`~ ~~~_ ~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 17I2a-o6ol APPRAISENENT ALLONANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 E% RFP (01-03) DATE 05-12-2003 ESTATE OF MILLER PAUL E DATE OF DEATH 11-23-2002 FILE NUMBER 21 02-1123 COUNTY CUMBERLAND SSN/DC 174-07-1949 GERTRUDE FOOTE ACN 03104522 403 F ST Amount Remitted CARLISLE PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1548 EX AFP CO1-03~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-12-2003 ESTATE OF MILLER PAUL E DATE OF DEATH 11-23-2002 COUNTY CUMBERLAND FILE N0. 21 02-1123 S.S/D.C. N0. 174-07-1949 ACN 03104522 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT N0. 1760009100 TYPE OF ACCOUNT: C ~ SAVINGS C ) CHECKING C ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 02-16-2000 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due 5,913.54 X 0.500 2,956.77 .00 2,956.77 X .15 443.52 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 T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 03-07-2003 CD002261 .00 443.52 TOTAL TAX CREDIT 443.52 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. rG rnrei ntlE is REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND.