HomeMy WebLinkAbout04-1031 PETITION FOR PROBATE and GRANT OF LETTERS
~T,.vf~,feoS' Samcul CarrollMiller, Jr. NO. ti-t14 iO31
also known as To:
Register of Wills for thc
o Decea~d. County of Cumberland in the
Social Security No. !8v-1/,-7rmz~ Commonwealth of Pennsylvania
The petition of thc undersigned re.spectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the exguLor named
in the last wil of the above decedent, dated ~ [ 29 / 03 19
and cod e (s) dated " '
Decendent was domiciled at death in Cumberland County, Pennsylvania with
~last family ornrincinaLr, esidence at Bol-h~nv V±llaee, 5255 Wilson Lane
±csburg, Pg. 17055 '" '
(llst street, number and muneipality9
Deeendent, theh84 __ years of age, died October 21, 2004 ,~..
Except aa follows, decedent did not marry, was not divorced and did not have a child born or adopted
.after execution of the will offer*d for probate; was not the victim of a killing and was never adjudicated
incompetent:
E~cendent 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 Pennsylvarda
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
pre~ented herewith and the grant of letters.. Testamentary
th~ron. (tmtamentary; administration c,t.a.: administration d.b.n-c,t.a.)
OATH OF'PERSONAL P SENTATIVE
CO~ONWEAL~ OF PENNSYLVAN~
COUNTY OF ~H ~Ct~D f ~
The ~tinoner(s) abov~named sw~r(s) or affirm(s) ~at the s[at~en[s in the foregoing p~tion ~e
true and eo~r~t to the b~tof the know edge ~d b~ief of ~fioner(s) ~d that ~ ~sOnal r~r~en-
tative(~) of the above d~edent ~tioner0) ~11 well an~truly ad~ni*ter the ~ta~ccordi~ to law,
before me this .... ILTH da,,o~ [ [' /~ I 1/? I/il1 ~/)[~
Estate Of SAMUEL CARROLL MILLER, JR. , Deceased
DECP~EE OF PROBATE AND G~NT OF LET~RS
~, ~ co~id~a~on of the petition on
~e ~verse side hereo~, sa~isf~o~ proof havin~ been ~r~ented before
d~c~b~ ther~n be a~t~ to probate ~d ~fl~ of recor~ ~ the l~t ~j] of
~d L~tt~ta Testamentary ;
are hereby ~ted to , ~iL~ ~ ~ I$~l~ ~
A~OR~y (Sup, Ct. I-D. No.)
114 South St., Harrisburg, PA 17101
ADD~S
PHO~
CERTIFICATE OF DEATH
25 ~ jj',]¥t. John s ~emetery)~,, Camp Hill PA 17011
LAST WILL AND TESTAMENT
OF
SAMUEL C. MILLER, JR.
1, Samuel C. Miller, Jr., of Lower Allen Township (Cumberland County), Pennsylvania,
make this my Will. I revoke all my prior Wills and Codicils.
I am married to Elizabeth J. Miller ("my wife"). I have four children living on the date of
execution of this Will, SAMUEL C. MILLER, Ill, of Alexandria, VA; LINDA M WAGNER,
DEBRA M. LATSHA and JOHN R. MILLER, all of Lewisberry, PA. I have four grandchildren
living on the date of execution of this Will, ALL1SON L. WAGNER, ADRIE~ L. WAGNER,
LANCE E. MILLER, all of Lewisberry, PA and EMILY M. MILLER of Alexandria, VA.
Article I, Distribution of My Estate.
A. Tangible Personal Property.
( 1 ) I give my tangible personal properb, to my wife if she survives me.
(2) If my wife does not sup~'ive me, my Executor shall divide my tangible
personal property, into two shares. The first share shall consist of all tangible personal property my
Executor may deem appropriate for distribution to my children in kind, and I give this share equally
to my children. The second share shall consist of the balance of my tangible personal property, and
my Executor shall sell this share and add the net proceeds to my residuary, estate.
B. Principal Residence. I give all my interest in my principal residence, including all
adjoining real property and related casualty insurance, to my wife if she survives me. This gift
includes any interest in a condominium or cooperative apartment if it is my principal residence at
my death.
C. Residue of Estate. If my wife survives me, my Executor shall divide the residue of
my real and personal estate including my interests in all stocks, bonds and bank deposits into the
Marital Share and the Credit Trust as directed in Article IV. If my wile does not survive me, all the
residue shall constitute the Credit Trust. l give the Marital Share to my wife outright, t give the
Credit Trust to my Trustee to be administered as directed in Article II.
Article II. Credit Trust
A. Durin~ My Wife's Lifetime. My Trustee shall pay the net income of the Credit Trust
to my wife during her lifetime in quarterly or more frequent installments and may pay to her as
much of the principal as my Trustee may deem necessary for her support and health.
B. Upon Survivor's Death. Upon the death of the survivor of my wife and me, my
Trustee shall distribute the principal and any undistributed income of the Credit Trust to my then
living lineal descendants, as follows: one fifth is given to each of my children, SAMUEL C.
MILLER, III, LINDA M. WAGNER, DEBRA M. LATSHA and JOHN R. MILLER, (or in the event
the child predeceases the survivor of my wife and 1, to that child's heirs). The remaining one fifth
part is to be divided equally among all my living lineal descendent grandchildren; provided, the
share that would pass to any grandchild of mine who has not reached age twenty-one shall be
retained in a separate trust to be administered as directed in the following paragraphs.
( 1 ) Grandchild's Separate Trust. My Trustee may pay to or for the benefit of the
grandchild as much of the income and principal as my Trustee may deem necessary' for the
grandchild's support, health and education (including higher education).
(2) Termination of Grandchild's Trust. When the grandchild reaches age twenty-
one, my Trustee shall distribute the remaining principal and any undistributed income of the trust
to the grandchild. If the grandchild dies before reaching that age, my Trustee shall distribute the
principal and any undistributed income to the grandchild's then living lineal descendants, per
stirpes, or if there are none, to my then living lineal descendants, per stirpes; provided, the share that
would pass to any other grandchild of mine who has not reached age twenty-one shall be added to
such grandchild's separate trust.
Article IIL Interests I/esting in Certain Beneficiaries. Whenever any interest in my estate or
any trust hereunder vests in a beneficiary under the age of txventy-one, it shall be administered
pursuant to either paragraph A or paragraph B below.
A. Vested Interests Retained in Trust. My Executor may distribute such interest to my
Trustee, to be held in trust, or my Trustee may continue to hold such interest in trust. In either case,
my Trustee may pay to or for the benefit of the beneficiary as much of the net income or principal
of the trust as my Trustee may deem necessary for the beneficiary's support, health and education
(including higher education). When the beneficiary reaches age twenty-one, my Trustee shall
distribute the trust assets to the beneficiary, if the beneficiary dies before reaching that age, my
Trustee shall distribute the trust assets to the beneficiary's estate.
B. Distribution to Custodian. My Executor or my Trustee may also distribute the
beneficiary's interest to a custodian under the Uniform Transfers to Minors Act (21).
C. Vesting Not Postponed. The provisions of this Article shall not postpone vesting of
any interest in the beneficiary.
Article IV. Di~,ision into Credit Trust and Marital Share.
A. Division of Residue. If my wife survives me my Executor shall divide the principal
of the residue of my estate into the Credit Trust and the Marital Share in the manner described in
this Article.
B. Credit Trust Fractional Share. The Credit Trust shall consist of a fractional share of
the residue. The numerator of the fraction shall equal the largest value of the residue that can pass
free of federal estate tax by reason of the unified credit and the credit for state death taxes (to the
extent the use of such credit does not increase state death taxes) allowable to my estate, after
reduction by reason of(l) my adjusted taxable gifts, (2) other dispositions of property included in
my gross estate for which no marital, charitable or other deduction is allowed in computing my
federal estate tax and (3) administration expenses and other charges to principal that are not claimed
and allowed as federal estate tax deductions. The denominator of the fraction shall equal the value
of the residue based upon values as finally determined for federal estate tax purposes.
C. Marital Share Fractional Share. The Marital Share shall consist of the remaining
fractional share of the residue.
D. Tax Elections. Any portion of the Marital Share tbr which the marital deduction is
not allowed in computing my federal estate tax by reason of a qualified disclaimer shall not be
deemed "other dispositions of property" under clause (2) of paragraph B. I realize that the
fractional shares of the Credit Trust and Marital Share may otherwise be affected by the exercise
of certain tax elections.
E. Assets Not Subject to Division. My Executor shall segregate and add to the Credit
Trust all assets that are not included in my gross estate, and such assets shall not be subject to the
fractional division described in this Article.
F. Allocation of Assets. My Executor shall not allocate to the Marital Share any
property or proceeds of property that cannot qualify }bt the marital deduction. To the extent
possible, my Executor shall not allocate to the Marital Share any assets upon which a fbreign death
tax is payable. In other respects my Executor may allocate assets as my Executor may deem to be
in the best interests of the beneficiaries, valuing each asset on the date of allocation.
G. Allocation of Income. Income earned on the residue before the division (and income
on assets used to make the payments under Article V) shall retain its character as income and shall
be allocated in the same fractions. Income earned on assets that are not included in my gross estate
shall retain its character as income in the Credit Trust.
Article V. Debts, Tt~¥es and Other Charges
A. Debts and Funeral Expenses. My Executor shall pay or provide for the payment of
my debts and the expenses of my funeral and burial (including the cost of a headstone or marker).
My Executor shall not seek contribution from my wife on our joint debts. However, if my wife
wishes to retain any residence or other real property subject to a mortgage or similar indebtedness,
my Executor may elect not to pay the indebtedness.
B. Taxes. My Executor shall pay or provide for the payment of all estate, inheritance
and similar taxes payable by reason of my death, including taxes on assets not passing under this
Will and interest on taxes. Except as otherwise provided with respect to certain disclaimed
property, the taxes and interest shall be paid as a cost of administering my estate and without ap-
portionment.
Article VI. Fiduciaries.
A. Executors and Trustees. I name my son SAMUEL C. MILLER, 1tl to be my
Executor and my Trustee. If he fails to qualify or ceases to serve, I name my son JOHN R. M1LLER
to be my Executor and my Trustee. 1 request that no security be required of my Executor or my
Trustee. I direct that my Trustee shall not be required to file annual accounts with any court as
otherwise required by the laws of Pennsylvania or any other jurisdiction.
B. Compensation. Any individual serving as Executor or Trustee shall be entitled to
receive reasonable compensation for fiduciary' services.
C Fiduciary_ Powers. I give my Executor and Trustee the following powers, which are
to be construed in the broadest manner consistent with the validity and with their duties as
fiduciaries. I give the powers stated here in addition to those granted by law and I give them to
fiduciaries who succeed the fiduciaries I have appointed.
a. To retain any and all of the assets of my estate, real or personal, without
regard to any principle of diversification or risk.
b. To invest in all forms of property, including stocks, common trust thnds and
mortgage investments, without restriction to investments authorized for Pennsylvania fiduciaries,
as they deem proper without regard to any principle of diversification or risk.
c. To sell at public or private sate, to exchange or to lease, for any period of
time, any real or personal property and to give options tbr sale, exchanges or leases, tbr such prices
and upon such terms or conditions as they deem proper.
d. To allocate receipts and expenses to principal income or partly to each as they
from time to time think proper.
e. To borrow money from any person or institution, and to mortgage or pledge
any or all real or personal property as my Executor or Trustee, in their sole discretion shall choose,
without regard for the dispositive provisions of this instrument.
f. To register securities in street name or in the name ora nominee or in such
manner that title shall pass by delive~ and to vote, in person or by proxy, securities held hereunder
and in such connection to delegate discretionary powers.
g. 'Fo compromise any claim or controversy.
h. To choose the optional valuation date for federal estate tax purposes.
i. To exercise any law-given option to treat administrative expenses either as
income or as estate tax deductions, without regard to whether the expenses were paid from principal
or income.
j. To exercise any law-given option to pay death taxes in installments, the
payment of interest due on such installments to be a charge against principal.
To make distribution in cash and in kind, and in such manner as they may
determine, and at valuation finally to be fixed by them.
D. Funding of Marital Share. in funding the Marital Share, my Executor shall not
exercise any power in a manner that would infringe upon any legal requirement for the allowance
of the marital deduction.
E. Merger. My Trustee may merge or consolidate for administrative purposes any trust
under my Will with any other trust made by me or my wife having the same Trustee and
substantially the same dispositive provisions.
F. Termination of Small Trusts. If at any time the size of any trust under my Will is so
small that, in the opinion of my Trustee other than any income beneficiary.' of the trust, the trust is
uneconomical to administer, my Trustee may terminate the trust and distribute the assets among the
persons then authorized to receive trust income in such shares as my Trustee may deem appropriate.
G. Allocation of Assets. Assets allocated to one trust or share may' be of diflkrent
character or have different income tax bases than assets allocated to another trust or share.
H. Fiduciary Discretion. The powers and discretion granted to my Executor and my
Trustee are exercisable only in a fiduciary capacity and may not be used to enlarge or shift any
beneficial interest except as an incidental consequence of the discharge of fiduciary duties. My
Trustee may make discretionary payments to the beneficiaries of any trust in unequal shares and
may, but shall not be required to, consider other resources available to an_,/' beneficiary.. My
Executor and my Trustee may make tax elections without regard to the relative interests of any
beneficiaries and may, but shall not be required to, make equitable adjustments among beneficiaries.
Restrictions on Individual Trustees. No individual serving as Trustee shall have a
voice in any discretionary, decision to distribute income or principal of any trust in order to discharge
a legal obligation of the individual or for the individual's pecuniary, benefit unless necessary for the
individual's support or health.
Article VII. Miscellaneous Prm,isions.
A Spendthrift Provisions. To the extent permitted by law, the principal and income
of any trust shall not be liable for the debts of any beneficiary or subject to alienation or anticipation
by a beneficiaD,, except as other provided.
B. Survivorship. I shall be deemed to have survived my wife if we die simultaneously
or if, in the opinion of my Executor, there is no sufficient evidence we have died otherwise than
simultaneously.
C. Disclaimer. Any beneficiary, or the legal representative of any deceased beneficiary.
shall have the right, within the time prescribed by law, to disclaim any benefit or power under my
Will. All or any fractional part of the Marital Share disclaimed by or on behalf of my wife shall be
added to the Credit Trust. My wife shall have the same interest in such added property, as she has
in the other property in the Credit Trust (unless she also disclaims her interest in the Credit Trust).
Any additional estate or inheritance taxes attributable to any disclaimer of the Marital Share or other
property qualif~ving for the marital deduction shall be paid from the disclaimed properb,. The taxes
attributable to any disclaimer shall be the difference between (1) the actual taxes payable at my
death and(2) the taxes that would be payable if the disclaimer ~vere not made.
E. Takers in Default. If at any time there is no living beneficiary, designated to receive
the assets of my estate or any trust under my Will, my Executor or Trustee shall distribute the assets
(1) one-half to the persons who would be my distributees under the laws of Pennsylvania then in
effect if 1 had then died without a Will, unmarried and o~vning the assets and (2) one-half to the
persons who would be my wife's distributees under the laws of Pennsylvania then in effect if she
had then died without a Will, unmarried and owning the assets.
F, Construction of Terms. Where appropriate to the context, pronouns or other terms
expressed in one number and gender shall be deemed to include the other number and genders. Tax
related terms shall be construed in the context of the federal revenue laws in effect at my death.
G. Governing Law. This Will shall be construed in conformity with the law of the
Common~vealth of Pennsylvania.
IN WITNESS WHEREOF, 1, Samuel C. Miller, Jr., hereunto set my hand and seat this Day
of ,2003.
SAMUEL C. MILLER, JR.
Signed, sealed, published and declared by the above named SAMUEL C. MILLER, JR. to
be his Last Will and Testament, in the presence of us, who at his request, in his presence and in the
presence of each other have hereunto subscribed our names as witnesses.
* * *ACKNOWLEDGMENT* * *
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF 1~.-~,<- -
I, Samuel C. Miller, Jr., TESTATOR, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Wilk that I signed it willingly; and that I signed it as my free and
voluntary' act for the purposes therein expressed.
Sworn or affinne~d before me, a Notary Public, thisZ'~)ay of
(Official Ca~pa~. of Officer)
* * * * AFFIDAVIT * * * *
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF i,~--;,- -
the witnesses whose names are si~ed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw the Testator si~ and execute the
instrument as his Last Will; that he si~ed ~villingly and thru he executed it as his free and voluntao~
act tbr the purpose therein expressed; that each of us in the hearing and sign of the Testator si~ed
the Will as witnesses; and that to the best of our knowledge the Testator, Samuel C. Miller, Jr., was
at that time 18 or more years of age, of sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by witnesses, thisl day of
2003.
/ Witness
oo~' (Official Capaci~of Officer)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 02/01/2005
BICKLEY L REX
121 SOUTH STREET
HARRISBURG, PA 17101
RE: Estate of MILLER SAMUEL CARROLL JR
File Number: 2004-01031
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 02/22/2005
Your prompt attention to this matter will be appreciated.
Thank You.
r~
GLENDA FARNER S~B~
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Judge
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 02/01/2005
MILLER SAMUEL C III
3901 PlCARDY COURT
ALEXANDRIA, VA 22309
RE: Estate of MILLER SAMUEL CARROLL JR
File Number: 2004-01031
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 02/22/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
/f:;/!:;;::r
Clerk of the Orphans' Court
cc: File
Counsel
Judge
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
J,-.
Name of Decedent: Samuel C. Miller.Yf
Date of Death: October 3 L 2004
Will No. 21-04-1031
Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the
Orphans' Court Ru1es was served on or mailed to the following beneficiaries of the above-captioned estate
on November 15. 2004
Name
Address
SEE ATTACHED
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None
Date:
2-/10/0)
I ,
Name Samuel C. Miller. ,X JIT
Address 3901 Picardv Court.
C:1
Alexandria . VA 22300
Telephone {{J~ }C(q <;9 5"'(
Capacity:
X Personal Representative
Counsel for personal representative
U'
ATTACHMENT TO CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name
Address
Elizabeth W. Miller
c/o John R. Miller
825 Siddonsburg Road
Lewisberry, PA 17339
John R. & E. Lance Miller
825 Siddonsburg Road
Lewisberry, PA 17339
Linda, Allison and
Adrienne Wagner
800 Siddonsburg Road
Lewisberry, PA 17339
Debra M. Latsha
827 Siddonsburg Road
Lewisberry, PA 17339
Samuel C. & Emily M. Miller 3901 Picardy Court
Alexandria, VA 22309
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005583
MILLER SAMUEL C III
3901 PICARDY COURT
ALEXANDRIA, VA 22309
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
_nn___ fold
101
$48,713.00
ESTATE INFORMATION:
SSN:
187-14-7084
DECEDENT NAME:
2104-1031
MILLER SAMUEL CARROLL JR
FILE NUMBER:
DATE OF DEATH:
07/18/2005
07/13/2005
CUMBERLAND
10/21/2004
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY:
TOTAL AMOUNT PAID:
$48,713.00
REMARKS:
CHECK#1006
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
':1':' ,)
RI:V-1500 E.X (r "0)
,
t
)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21-04-1031
COUNTY CODE
YEAR
NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
I-
Z
LU
C
LU
CJ
LU
C
SAMUEL C MILLER. JR.
DATE OF DEATH (MM-DD-YEAR)
137-14-7084
DATE OF BIRTH (MM-DD-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
10/21/2004 10/25/1919
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
W
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Woo
"0:..1
u....
..
"
03. Remainder Return (date ofdealh prlor 1012-13-82)
05. Federal Estate Tax Return Required
ELIZABETH J MILLER
o 1. Original Return 0 2. Supplemental Return
o 4 Limited Estate 04a.
o 6. Decedent Died Testate (Attach copy of Will) 0 7. Decedent Maintained a Living Trust (Attach copy of Trust) 0 8. Total Number of Safe Deposit Boxes
o 9. Litigation Proceeds Received 010. Spousal Poverty Credil (date ofclealh between 12-31-91 and 1-1-95) 011. Election to tax under Sec. 9113(A) (Attach Sch 0)
!tA!$.$~fIQijMQ$ttl~qQM!wl;TI;R;AP#~Ql:m$$PQ~~~Ngg~p<<9f.!mQ!;IDj!#~t,iQ(~~fQRMif~QN$.ijQqt~tl~~~g]~QXQ@
NAME
Future Interest Compromise (date of death after 12-12-82)
I-
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LU
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LU
II:
II:
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CJ
LORRAINE R. NAGY
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
2331 MARKET ST
CAMP HILL, PA 17011
KERN AND COMPANY, PC
TELEPHONE NUMBER
717 -763-0888
OFFICIAL USE ONLY
1. Real Estate (Schedule A)
(1)
o
1.412,632
o
c;~
, i--Cj
~: \--
--;-1
'---'-1
c:>
:::~~
c,:,:)
cIl
2. Stocks and Bonds (Schedule B)
(2)
(3) NONE
(4)
o
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
20,379
o
(J
--n
-\)
(5)
(6)
-'J
'1
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6. Jointly Owned Property (Schedule F)
Dseparate Billing Requested
C:.
(JI
7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property
(Schedule G or L)
(7)
5,922
8 TOTAL GROSS ASSETS (total Lines 1-7)
(8)
1,438,933
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
16,009
7,564
10. Debts of Decedent, Mortgage liabilities, & Liens (Schedule I) :10)
11. TOTAL DEDUCTIONS (total Lines 9 & 10) (11)
23,573
1,415,360
o
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)
(12)
(13)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
1,415,360
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate ,or transfers under Sec.9116 (a)(1.2) 332,857 X .00 (15) 0
Z
0
;::: 1,082,503 .045 48,713
~ 16 Amount of Line 14 taxable at lineal rate X (16)
::>
"-
:;; 17. Amount of Line 14 taxable at sibling rate X .12 (17) 0
0
CJ
)(
<( 16. Amount of Line 14 taxable at collateral rate X .15 (18) 0
I-
19. Tax Due (19) 48,713
20. ~ !:i~~~.I~~~~!lffiociU!_a~i~~~i~il~I'iiiti~~!~ijl~~I~~~i~~~M~~mii
~~.j$QR$rQANivmRAijWQQmQN$9NR$~$i$jQ.ANQRjQHjQKM\~TH*~?
217
.Deced-ent's Com lete Address:
STRr,ET ADDRESS
18 CLEMSON DR
SAMUEL C MillER, JR.
137-14-7084
CITY
CAMP Hill
STATE
PA
ZIP
17011
Tax Payments and Credits:
1.
2.
Tax Due (Page 1 Line 19)
Credits/Payments
A. Spousal Poverty Credit
S. Prior Payments
C. Discount
(1)
48.713
Total Credits (A + B + C) (2)
o
3. InteresVPenalty if applicable
D. Interest
E Penalty
TotallnteresVPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5 If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check AGENT
o
o
48,713
48,713
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1.
Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b retain the right to designate who shall use the property transferred or its income;
Yes
D
D
D
D
D
D
No
[R]
[R]
[R]
[R]
[R]
[R]
c, retain a reversionary interest; or
2.
d receive the promise for life of either payments, benefits or care?
If death occurred after December 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
3.
4.
Did decedent own an Individual Retirement Account, annuity or other nan-probate property which
contains a beneficiary designation?
D
[R]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
A If'}c. '- cl "'I "
REPRESENTATIVE
VCI,.
2- L 30 }
DATE
6"
KERN AND COMPANY, PC 2331 MARKET ST. CAMP Hill. PA 17011
For dates of death on or after July 1, 1994 and before January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the survivinn <>M""" ,~ ~Ol
[72 P.S. Section 9116 (a)(1.1 Hi)].
NflPD
f A tis7
For d<ltes of death on or after January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are
the surviving spouse is the only beneficiary
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural pare
or a stepparent of the child is 0%[72 P .S. Section 9116(a)(1.2)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 as noted in 72 P.S. Section 911
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.$. Section 9116(a)(1.3)] .A sibling is defined, under Section 9102, as an
Individual who has at least one parent in common with the decedent. whether by blood or adoption.
I 217 ..
REV-1503 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
SAMUEL C MillER, JR.
FILE NUMBER
21-04-1031
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5.
DESCRIPTION
VALUE AT DATE
OF DEATH
1,320,550
42,090
18,664
16,685
14,643
38,500 SH ALLIED IRISH @ 34.30/SH
1,500 SH COMCAST @ 28.06/SH
1,786 SH DELMONTE @ 10.45/SH
500 SH GENERAL ELECTRIC @ 33.37/SH
300 SH EXXON MOBil @ 48.81/SH
TOTAL (Also enter on line 2 Recanitulation !I;
(If more space is needed, insert additional sheets of the same size)
1412632
217
REI,15G8 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SAMUEL C MillER, JR.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-04-1031
Include the proceeds of litigation and the date the proceeds were received by the estate.
All orooertv iointlv-owned with rinht of survivorshio must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
CASH - E- TRADE BROKERAGE ACCOUNT, ACCT # 6730-3783
VALUE AT DATE
OF DEATH
20,379
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
20,379
217
, REV-151r,EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
SAMUEL C MillER. JR.
21-04-1031
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NA.ME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DE CD'S EXCLUSION TAXABLE
NUMBER TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE} VALUE
1. HEALTH INSURANCE/MEDICAL REFUNDS 2,922 100.00% 2,922
2. AUTOMOBllE-1988 CADilLAC BROUGHAM 1,975 100.00% 1,975
3. MISC. PERSONAL POSSESSIONS 1,025 100.00% 1,025
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL (Also enter on line 7 Recapitulation) $ 5922
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
(If more space IS needed, Insert additional sheets of the same size)
217 ,
REV-15111iX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
SAMUEL C MillER, JR.
21-04-1031
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. MYERS FUNERAL HOME 7,938
2. FUNERAL RECEPTION - HOSSES RESTAURANT 265
3. TOMBSTONE ENGRAVING. JAMES R. GINGRICH MEMORIALS 140
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (5)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees 1 ,460
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 935
5. Accountant's Fees 5,093
6. Tax Return Preparer's Fees
7. PUBLICATION COSTS 178
TOTAL (Also enter on line 9 Recaoitulation' $ 16 009
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03) 217
,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SAMUEL C MillER, JR.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FilE NUMBER
21-04-1031
Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
1.
2.
3.
4.
5.
DESCRIPTION
BETHANY VillAGE-MEDICAL EXPENSE PAID AFTER DEATH
lATSHA-MEDICAl EXPENSE PAID AFTER DEATH
ALERT PHARMACY-MEDICAL EXPENSE PAID AFTER DEATH
MID PENN UROLOGY-MEDICAL EXPENSE PAID AFTER DEATH
MOFFITT-MEDICAL EXPENSE PAID AFTER DEATH
VALUE AT DATE
OF DEATH
6,990
16
528
20
10
TOTAL (Also enteron line 10 RecaDitulationl $
(If more space is needed, insert additional sheets of the same size)
7,564
217.
, REV-1Sn EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
21-04-1031
SAMUEL C MillER JR
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
L TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec, 9116 (a) (1,2)]
1 ELIZABETH J, MillER, C/O JOHN R, MillER, 825 SIDDONSBURG SPOUSE 332,857
2 SAMUEL C. MillER, III, 3901 PICARDY CT, ALEXANDRIA, VA 2230! SON 216,501
3 LINDA M, WAGNER, 800 SIDDONSBURG RD" lEWISBERY, PA 1nDAUGHTER 216,501
4 DEBRA M. LATSHA, 827 SIDDONSBURG RD, lEWISBERRY, PA 17 DAUGHTER 216)501
5, JOHN R. MillER, 825 SIDDONSBURG RD" lEWISBERRY, PA 173 SON 21 ~501
6. lANCE E, MillER, 825 SIDDONSBURG RD., lEWISBERRY, PA 17 GRANDSON 54)125
7. ALLISON l. WAGNER, 800 SIDDONSBURG RD., lEWISBERRY, PA GRANDDAUGHTER 54P5
8, ADRIENNE l WAGNER, 800 SIDDONSBURG RD" lEWISBERRY, P GRANDDAUGHTER 54)125
9. EMilY M, MillER, 3901 PICARDY CT. ALEXANDRIA, VA 22309 GRANDDAUGHTER 54,125
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
217.
'REV.1514.EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
Check Box 4 on REV-1500 Cover Sheet
FILE NUMBER
ESTATE OF
SAMUEL C MILLER. JR. 21-04-1031
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89,
actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99,
and in Aleph Volume for dates of death from 5-1-99 and thereafter.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
[ill Will D Intervivos Deed of Trust D Other
LIFE ESTATE INTEREST CALCULATION
- .
;I,'i, ,'" 't "I j
'0 I,'., ~',i,' ;, >'t':; ~ {I" J 0] 0 ~"l~ 1 ; ,~
., ~ M ~ _ _~ _ ~ ~ ~~ - " ~I " ~ ~ " ' ,<' "
ELIZABETH J. MILLER
11/14/1920
84
[K] Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
1. Value of fund from which life estate is payable ......................................... $
2. Actuarial factor per appropriate table .. ('. ~.~-?5"~) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest table rate- 031/2% 06% 010% [RlVariableRate 4.4%
3. Value of life estate (Line 1 multiplied by Line 2) ...................................... $
1 ,412.360
0.2336
329,857
ANNUITY INTEREST CALCULATION
';" "~'" - --,~ j '"' I ,(::: ',(f~~~'l"'-'(";~ ,,"~ -",~ I'. '1 "I ,':; "
~ "' '~~:\,'{~4" \'" l~ I' ~ J ~ f' 1f0t' .~,' '" 1t,r' ;:- )1 :)(*
J., J."'-"'N _ ~ ~ '" _ ^ ~:^ ' ,'1~ ~,):I~~L~' I~,., _,1, i,'; ~ >,' '- '\ -
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
o Life or 0 Term of Years
1. Value of fund from which annuity is payable ........................................... $
2. Check appropriate block below and enter corresponding (number) .........................
Frequency of payout - OWeekly (52) OBi-weekly (26) DMonthly (12)
OQuarterly (4) OSemi-annually (2) DAnnually (1) OOther ( )
3. Amount of payout per period ....................................................... $
4. Aggregate annual payment, Line 2 multiplied by Line 3 ..................................
5. Annuity Factor (see instructions)
Interest table rate - 031/2% 06% 010% OVariable Rate %
6. Adjustment Factor (see instructions) .................................................
7. Value of annuity -If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at
end of period, calculation is: Line 4 x Line 5 x Line 6 ................................... $
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3 .................................................. $
o
o
0.0000
o
o
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through
G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13 and 15 through 18.
(If more space is needed, insert additional sheets of the same size)
217 ,
. REV-1649'EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 0
ELECTION UNDER SEC.9113(A)
(SPOUSAL DISTRIBUTIONS)
ESTATE OF FILE NUMBER
SAMUEL C MILLER, JR. 21-04-1031
Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act
If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust.
This election applies to the TESTAMENTARY TRUST UIW SAMUEL CARROLL MILLETrust (marital, residual A, B, By-pass, Unified Credit, etc,),
If a trust or similar arrangement meets the requirements of Section 9113{A), and:
a. The trust or similar arrangement is listed on Schedule 0, and
b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0,
then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar
property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative
shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar
arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement.
Part A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the
decedent's survivin souse under a Section 9113 A trust or similar arran emen!.
Description Value
38,500 SHARES ALLIED IRISH @ 34,30/SH, NET OF ALLOWABLE DEDUCTIONS
1,296,977
1,500 SHARES COMCAST @ 28.06/SH
42,090
1,786 SHARES DELMONTE@ 10.45/SH
18,664
500 SHARES GENERAL ELECTRIC @ 33.37/SH
16,685
300 SHARS EXXON MOBILE @48.81/SH
14,643
CASH-E-TRADE BROKERAGE ACCOUNT
20,379
HEALTH INSURANCE/MEDICAL REFUNDS
2,922
Part A Total $
1,412,360
Part B: Enter the description and value of all interests included in Part A for which the Section 9113(A) election to tax is being made,
Description Value
38,500 SHARES ALLIED IRISH @ 34.30/SH, NET OF ALLOWABLE DEDUCTIONS
994,068
1,500 SHARES COMCAST @ 28.06/SH
32,260
1,786 SHARES DELMONTE @ 10.45/SH
14,305
500 SHARES GENERAL ELECTRIC @ 33.37/SH
12,788
300 SHARS EXXON MOBILE @ 48,81/SH
11,223
CASH-E-TRADE BROKERAGE ACCOUNT
15,619
HEALTH INSURANCE/MEDICAL REFUNDS
2,240
Part B Total $
1,082,503
(If more space is needed, insert additional sheets of the same size)
This is ,to certify that the information here given is correctly copied from an original certificate of death du~y. filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanen.~ hlmg.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
wJl1?~
Fee for this certificate, $2.00
Local Registrar
p
10667798
tnC! t<Sl "~~ a 6" I ~O<' Lj.
Datc
H\O':);4.HI.... 2J~7 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT Of HEALTH" VITAL RECORDS
CERTIFICATE OF DEATH
-~l'l,pnINT
84
Carroll
UNDEA I YEAR
........ 0...
Miller,
LINDER 1 DAY
Hour. ! U.....l_
sex
.. Ma 1 e
S'A,TEF'LENUM8eFl
SOCIAL SeCURITY ~UMBEfI
D""EOfUEAJHM~-O.", ~;,------
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..Samliel
....GEIL.$I0"ll'>Cavl
'.Ul7 - 14
.. 10-21-2004
,.
BlRTtiPLA.CE le.ly ana PlACe Of' OEATH {CllecJo O<I/y Of>a __",oj''-'''hO... on 01"" j/>Ulll
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COUNT"'fOfOEATH
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-
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.
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OIJE TO (OA AS... CONSEQUENCE 01'):
".
IAppro_lmal.
~inI_~1'I
:om<<anclae&In
:
PART II:
[ :
DUIE 10100 AS "'CONSEOUENCE 00:
,..0
..rI'
IolANHEA 01 DEATH/
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Aeeidlol'lt D
Suic~ 0
OArE Of IN,JUAY
lMonInD~y.~)
TIME OF INJURY
INJURY ,;r 'o\OAl(?
OESCFIIBf: HOW IN.JUAY OCCLJRREO
weRE AUTOPSY FINDINGS
~LA8Ll PRIOR 10
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To tha booal..1 my llnowl.-!Qe, death occun.a d.....IO Ih. cau...,.) and mi""""" .lI'ed
. PRONOUNCING AND CERTIfYING PHYSIC'AN (Phy$C1iI'l borh ",onou'--'::'no;IllHlO a(l(l Cef\I!y'"O 10 cause DI [le~'hl
To Ina beal 01 "'., 111\0...1.-.:111', a.aln occur," al!ha Urn., d.oo'., .r>d pl.c.,;lfId au. 10 th. cauu(a) and man".r n ....,a<1
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-- /::.. /L-.'i_
LAST WILL AND TESTAMENT
OF
SAMUEL C. MILLER, JR.
I, Samuel C. Miller, Jr, of Lower Allen Township (Cumberland County), Pennsylvania,
make this my Will. I revoke all my prior Wills and Codicils.
1 am married to Elizabeth 1 Miller ("my wife"). I have four children living on the date of
execution of this Will, SAMUEL C. MILLER, III, of Alexandria, VA; LINDA M. WAGNER,
DEBRA M LATSHA and JOHN R. MILLER, all of Lewisberry, PA. I have four grandchildren
living on the date of execution of this Will, ALLISON L WAGNER, ADRIENNE L WAGNER,
LANCE E. MILLER, all of Lewis berry, PA and EMILY M. MILLER of Alexandria, VA.
Article I.
Distribution of My Estate.
A.
Tangible Personal Property.
(l) I give my tangible personal property to my wife if she survives me.
(2) If my wife does not survive me, my Executor shall divide my tangible
personal property into two shares. The first share shall consist of all tangible personal property my
Executor may deem appropriate for distribution to my children in kind, and I give this share equally
to my children The second share shall consist of the balance of my tangible personal property, and
my Executor shall sell this share and add the net proceeds to my residuary estate.
B. Princioal Residence. I give all my interest in my principal residence, including all
adjoining real property and related casualty insurance, to my wife if she survives me. This gift
includes any interest in a condominium or cooperative apartment ifit is my principal residence at
my death
C. Residue of Estate, Ifmy wife survives me, my Executor shall divide the residue of
my real and personal estate including my interests in all stocks, bonds and bank deposits into the
Marital Share and the Credit Trust as directed in Article IV, Ifmy wife does not survive me, al1 the
residue shall constitute the Credit Trust I give the Marital Share to my wife outright I give the
Credit Trust to my Trustee to be administered as directed in Article II.
A rticIe II.
Credit Trust
During My Wife's Lifetime, My Trustee shall pay the net income of the Credit Trust
A
to my wife during her lifetime in quarterly or more frequent installments and may pay to her as
much of the principal as my Trustee may deem necessary for her support and health,
B, Upon Survivor's Death, Upon the death of the survivor of my wife and me, my
Trustee shall distribute the principal and any undistributed income of the Credit Trust to my then
living lineal descendants, as follows: one fifth is given to each of my children, SAMUEL C
MILLER, III, LINDA M, WAGNER, DEBRA M, LA TSHA and JOHN R MILLER, (or in the event
the child predeceases the survivor of my wife and I, to that child's heirs), The remaining one fifth
part is to be divided equally among all my living lineal descendent grandchildren; provided, the
share that would pass to any grandchild of mine who has not reached age twenty-one shall be
retained in a separate trust to be administered as directed in the following paragraphs,
(1) Grandchild's Separate Trust My Trustee may pay to or for the benefit of the
grandchild as much of the income and principal as my Trustee may deem necessary for the
grandchild's support, health and education (including higher education)
(2) Termination of Grandchild' s Trust, When the grandchild reaches age twenty-
, ,
one, my Trustee shall distribute the remaining principal and any undistributed income of the trust
to the grandchild If the grandchild dies before reaching that age, my Trustee shall distribute the
principal and any undistributed income to the grandchild's then living lineal descendants, per
stirpes, or ifthere are none, to my then living lineal descendants, per stirpes; provided, the share that
would pass to any other grandchild of mine who has not reached age twenty-one shall be added to
such grandchild's separate trust
Article m. Interests Vesting in Certain Beneficiaries. Whenever any interest in my estate or
any trust hereunder vests in a beneficiary under the age of twenty-one, it shall be administered
pursuant to either paragraph A or paragraph B below.
A Vested Interests Retained in Trust My Executor may distribute such interest to my
Trustee, to be held in trust, or my Trustee may continue to hold such interest in trust. In either case,
my Trustee may pay to or for the benefit of the beneficiary as much of the net income or principal
of the trust as my Trustee may deem necessary for the beneficiary's support, health and education
(including higher education). When the beneficiary reaches age twenty-one, my Trustee shall
distribute the trust assets to the beneficiary. if the beneficiary dies before reaching that age, my
Trustee shall distribute the trust assets to the beneficiary's estate.
B. Distribution to Custodian My Executor or my Trustee may also distribute the
beneficiary's interest to a custodian under the Uniform Transfers to Minors Act (21).
C. Vesting Not Postponed. The provisions of this Article shall not postpone vesting of
any interest in the beneficiary.
, .
Article IV. Division into Credit Trust and Marital Share.
A. Division of Residue. If my wife survives me my Executor shall divide the principal
of the residue of my estate into the Credit Trust and the Marital Share in the manner described in
this Article
B. Credit Trust Fractional Share. The Credit Trust shall consist of a fractional share of
the residue. The numerator ofthe fraction shall equal the largest value of the residue that can pass
free of federal estate tax by reason of the unified credit and the credit for state death taxes (to the
extent the use of such credit does not increase state death taxes) allowable to my estate, after
reduction by reason of (l) my adjusted taxable gifts, (2) other dispositions of property included in
my gross estate for which no marital, charitable or other deduction is allowed in computing my
federal estate tax and (3) administration expenses and other charges to principal that are not claimed
and allowed as federal estate tax deductions. The denominator of the fraction shall equal the value
of the residue based upon values as finally determined for federal estate tax purposes.
C. Marital Share Fractional Share. The Marital Share shall consist of the remaining
fractional share of the residue.
D. Tax Elections. Any portion of the Marital Share for which the marital deduction is
not allowed in computing my federal estate tax by reason of a qualified disclaimer shall not be
deemed "other dispositions of property" under clause (2) of paragraph B. I realize that the
fractional shares of the Credit Trust and Marital Share may otherwise be affected by the exercise
of certain tax elections.
E. Assets Not Subiect to Division. My Executor shall segregate and add to the Credit
, I
Trust all assets that are not included in my gross estate, and such assets shall not be subject to the
fractional division described in this Article.
F. Allocation of Assets. My Executor shall not allocate to the Marital Share any
property or proceeds of property that cannot qualify for the marital deduction. To the extent
possible, my Executor shall not allocate to the Marital Share any assets upon which a foreign death
tax is payable. In other respects my Executor may allocate assets as my Executor may deem to be
in the best interests of the beneficiaries, valuing each asset on the date of allocation.
G Allocation ofIncome. Income earned on the residue before the division (and income
on assets used to make the payments under Article V) shall retain its character as income and shall
be allocated in the same fractions. Income earned on assets that are not included in my gross estate
shall retain its character as income in the Credit Trust.
Article V.
Debts, Taxes and Other Charges
A Debts and Funeral Expenses. My Executor shall payor provide for the payment of
my debts and the expenses of my funeral and burial (including the cost of a headstone or marker)
My Executor shall not seek contribution from my wife on our joint debts. However, ifmy wife
wishes to retain any residence or other real property subject to a mortgage or similar indebtedness,
my Executor may elect not to pay the indebtedness.
B. Taxes. My Executor shall payor provide for the payment of all estate, inheritance
and similar taxes payable by reason of my death, including taxes on assets not passing under this
Will and interest on taxes. Except as otherwise provided with respect to certain disclaimed
property, the taxes and interest shall be paid as a cost of administering my estate and without ap-
)
.)
I .
, .
portionment.
Article VI. Fiduciaries.
A Executors and Trustees. I name my son SAMUEL C. MILLER, III to be my
Executor and my Trustee. lfhe fails to qualify or ceases to serve, I name my son JOHN R. .MILLER
to be my Executor and my Trustee. I request that no security be required of my Executor or my
Trustee. I direct that my Trustee shall not be required to file annual accounts with any court as
otherwise required by the laws of Pennsylvania or any other jurisdiction.
E. Compensation Any individual serving as Executor or Trustee shall be entitled to
receive reasonable compensation for fiduciary services.
C. Fiduciary Powers. I give my Executor and Trustee the following powers, which are
to be construed in the broadest manner consistent with the validity and with their duties as
fiduciaries. I give the powers stated here in addition to those granted by law and I give them to
fiduciaries who succeed the fiduciaries I have appointed.
a. To retain any and all of the assets of my estate, real or personal, without
regard to any principle of diversification or risk.
b. To invest in all forms of property, including stocks, connnon trust funds and
mortgage investments, without restriction to investments authorized for Pennsylvania fiduciaries,
as they deem proper without regard to any principle of diversification or risk.
c. To sell at public or private sale, to exchange or to lease, for any period of
time, any real or personal property and to give options for sale, exchanges or leases, for such prices
and upon such terms or conditions as they deem proper.
,,' .
~
"
d. To allocate receipts and expenses to principal income or partly to each as they
from time to time think proper
e. To borrow money from any person or institution, and to mortgage or pledge
any or all real or personal property as my Executor or Trustee, in their sole discretion shall choose,
without regard for the dispositive provisions of this instrument.
f. To register securities in street name or in the name of a nominee or in such
manner that title shall pass by delivery and to vote, in person or by proxy, securities held hereunder
and in such connection to delegate discretionary powers.
g To compromise any claim or controversy.
h. To choose the optional valuation date for federal estate tax purposes
I. To exercise any law-given option to treat administrative expenses eIther as
income or as estate tax deductions, without regard to whether the expenses were paid from principal
or Income.
J. To exercise any law-given option to pay death taxes in installments, the
payment of interest due on such installments to be a charge against principal.
k. To make distribution in cash and in kind, and in such manner as they may
determine, and at valuation finally to be fixed by them.
D. Funding of Marital Share. In funding the Marital Share, my Executor shall not
exercise any power in a manner that would infringe upon any legal requirement for the allowance
of the marital deduction.
E. Merger. My Trustee may merge or consolidate for administrative purposes any trust
)
J
" It
under my Will with any other trust made by me or my wife having the same Trustee and
substantially the same dispositive provisions.
F Termination of Small Trusts If at any time the size of any trust under my Will is so
small that, in the opinion of my Trustee other than any income beneficiary of the trust, the trust is
uneconomical to administer, my Trustee may terminate the trust and distribute the assets among the
persons then authorized to receive trust income in such shares as my Trustee may deem appropriate
G. Allocation of Assets, Assets allocated to one trust or share may be of different
character or have different income tax bases than assets allocated to another trust or share.
B. Fiduciary Discretion. The powers and discretion granted to my Executor and my
Trustee are exercisable only in a fiduciary capacity and may not be used to enlarge or shift any
beneficial interest except as an incidental consequence of the discharge of fiduciary duties. My
Trustee may make discretionary payments to the beneficiaries of any trust in unequal shares and
may, but shall not be required to, consider other resources available to any beneficiary. My
Executor and my Trustee may make tax elections without regard to the relative interests of any
beneficiaries and may, but shall not be required to, make equitable adjustments among beneficiaries.
I. Restrictions on Individual Trustees. No individual serving as Trustee shall have a
voice in any discretionary decision to distribute income or principal of any trust in order to discharge
a legal obligation of the individual or for the individual's pecuniary benefit unless necessary for the
individual's support or health.
Article VII. Miscellaneous Provisions.
A. Spendthrift Provisions. To the extent permitted by law, the principal and income
.,~... j
~
(
of any trust shall not be liable for the debts of any beneficiary or subject to alienation or anticipation
by a beneficiary, except as other provided.
B. Survivorship. I shall be deemed to have survived my wife if we die simultaneously
or if, in the opinion of my Executor, there is no sufficient evidence we have died otherwise than
simultaneously.
C. Disclaimer. Any beneficiary or the legal representative of any deceased beneficiary
shall have the right, within the time prescribed by law, to disclaim any benefit or power under my
Will. All or any fractional part of the Marital Share disclaimed by or on behalf of my wife shall be
added to the Credit Trust. My wife shall have the same interest in such added property as she has
in the other property in the Credit Trust (unless she also disclaims her interest in the Credit Trust).
Any additional estate or inheritance taxes attributable to any disclaimer ofthe Marital Share or other
property qualifying for the marital deduction shall be paid from the disclaimed property The taxes
attributable to any disclaimer shall be the difference between (1) the actual taxes payable at my
death and(2) the taxes that would be payable if the disclaimer were not made.
E. Takers in Default. If at any time there is no living beneficiary designated to receive
the assets of my estate or any trust under my Will, my Executor or Trustee shall distribute the assets
(1) one-half to the persons who would be my distributees under the laws of Pennsylvania then in
effect if I had then died without a Will, unmarried and owning the assets and (2) one-half to the
persons who would be my wife's distributees under the laws of Pennsylvania then in effect if she
had then died without a Will, unmarried and owning the assets.
F Construction of Terms. Where appropriate to the context, pronouns or other terms
"... '
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~
expressed in one number and gender shall be deemed to include the other number and genders. Tax
related terms shall be construed in the context of the federal revenue laws in effect at my death.
G Governing Law This Will shall be construed in conformity with the law of the
Commonwealth of Pennsylvania.
IN WITNESS WHEREOF, I, Samuel C. Miller, Jr., hereunto set my hand and seal this Day
of
,2003.
// I C. ,1;
/()A/}1) /Lu.l ,'h-L<--t'Lt'L. f~'
SAMUEL C. MILLER, JR
Signed, sealed, published and declared by the above named SAMUEL C. MILLER, JR to
be his Last Will and Testament, in the presence of us, who at his request, in his presence and in the
presence of each other have hereunto subscribed our names as witnesses.
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***ACKNOWLEDGMENT***
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~<. _/,L... -
c
SS
I, Samuel C. Miller, Jr, TESTA TOR, whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
'^'7
* * * * AFFIDAVIT * * * *
COMMONWEALTH OF PENNSYL V ANlA
COUNTY OF i1<"J'''-
a Notary Public, thi?4tay of
~J&1 M r..- rh~?- {I\--
SS:
We
the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw the Testator sign and execute the
instrument as his Last Will; that he 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 sign of the Testator signed
the Will as witnesses; and that to the best of our knowledge the Testator, Samuel C. Miller, Jr., was
at that time 18 or more years of age, of sound mind and under no constraint or undue influence.
.;,1
Sworn or affirmed to and subscribed to before me by witnesses, this~ day of v<.}
2003.
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7000 1670 0012 2267 0285
10-03-2005
MILLER JR
10-21-2004
21 04-1031
CUMBERLAND
101
APPEAL DATE: 12-02-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REV:is47-EX-AFP-io3:0si-NOTicE-OF-iNHERiTANCE-TAX-APPRAisEMENT~-ALLOWANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
SAMUEL C FILE NO. 21 04-1031 ACN 101
,;- C-', .~", :-.[',r-n
BUREAU OF INDIVIDUAL "TAl(5,' i ..
INHERITANCE TAX DIVISION " ".
PO BOX 280601
HARRISBURG PA 1712B-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NDTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
I"
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
_'1
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'?: 25
LORRAINeR NAGY
KERN 8 CO
2331 MARKET ST
CAMP HILL
PA 17011
ESTATE OF
MILLER JR
REV-1547 EX AFP [06-05)
SAMUEL
C
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
DATE 10-03-2005
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
11)
(2)
(3)
(4)
(5)
(6)
(n
.00
1.412,632.00
.00
.00
20.379.00
.00
5,922.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
lID}
16,009.00
7.564.00
(11)
112)
113}
114}
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
1,438,933.00
23.573 nn
1,415,360.00
.00
1,415,360.00
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of Ahh returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousel rate (IS)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
332,857.00 X 00 = .00
1,082,503.00 X 045 = 48,713.00
.00 X 12 = .00
.00 X 15 = .00
119)= 48,713.00
rAYnl:NI I'lI:LI:.Lr. {+} AMOUNT PAID
DATE ... NUMBER INTEREST/PEN PAID (-)
07 13-2005 CD005583 .00 48,713.00
TOTAL TAX CREDIT 48,713.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
RK.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR}, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.}
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTIC..E.J),F ~TERMINATION AND
n'-('(\G~t$S~lltN:r.' OF PENNSYLVANIA
rc,."~ :ESTA'tE:TAX BASED ON FEDERAL
....... . ESTATE TAX RETURN
REV-483 EX AFP (06-05)
2D:~~
.,
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, ,:.U
DATE 10-03-2005
ESTATE OF MILLER JR SAMUEL C
DATE OF DEATH 10-21-2004
FILE NUMBER 21 04-1031
COUNTY CUMBERLAND
ACN 201
APPEAL DATE: 12-02-2005
(See reverse side under Objections)
Amount Remitted I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
LORRAINE R NAGY
KERN 8 CO
2331 MARKET ST
CAMP HILL
PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR FILES +-
------------------------------------------------------------------------------------------
REV-483 EX AFP (03-05) .. NOTICE OF DETERMINATION AND ASSESSMENT
'-- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ..
ESTATE OF MILLER JR
SAMUEL
C FILE NO.21 04-1031
ACN 201
DATE 10-03-2005
ESTATE TAX DETERMINATION
I. Credit For State Death Taxes as Verified
.00
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
48.713.00
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
48.713.00
5. Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
-IF PAID AFTER THIS DATE. SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
()r1
.
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Samuel Carroll Miller, Jr.
Date of Death:
10/21/04
Estate No.:
\0~'"
File No. 2004-01-031---Pa. File 21-04-1031
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 a~istration of the estate is complete:
Yes 0 No W .
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete: June 2006
3. If the answer to No. J is Yes, state the following:
a." Did the personal representative file a final account with the Court?
Yes 0 No 0
b. The separate Orphans' Court No. (ifany) for tbe personal representative's
account is:
c. Did the personal representative state an account infonnally to the parties in
interest? Yes 0 No 0
c. Copies ofrec:eipts, releases, joinders and approval offormal or infannal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: &Ill. 7(oIJ
:i~?
Name
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,:--,
114 South St., Harrisburg, PA 17101
Address
717 -234-0577
Telephone No.
Capacity; gf Persona] Representative
o Counsel for personal representative
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NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
CLOSING LETTER
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
REY-736 EX lFP (0'-05'
PA 17011
01-16-2006
MILLER JR
10-21-2004
21 04-1031
CUMBERLAND
202
APPEAL DATE: 03-17-2006
(See reverse side under Objections)
Amount Remitted I
MAKE CHECK PAYABLE AND
SAMUEL
C
LORRAINE R NAGY
KERN & CO
2331 MARKET ST
CAMP HILL
I
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR FILES +-
REV:73&--EX--AFP-Toi:.-02i-----.-i-NCfffcE--OFt-DETE-RHii,fAfioN-AirD-AS-SES.~fMEN,._----------------------- - ----
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER ..
ESTATE OF MILLER JR
SAMUEL
C FILE NO.21 04-1031
ACN 202
DATE 01-16-2006
ESTATE TAX DETERMINATION
1. Credit For State Death Taxes as Verified
.00
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
48,713.00
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
48,713.00
5. Pennsylvania Estate Tax Due
.00
6. Amount of Pennsylvania Estate Tax Previously Assessed
Based on Federal Estate Tax Return
.00
7. Additional Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. . 00
TOTAL DUE .00
-IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED ^t
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE \<J'
DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
In Re: Estate of
MILLER SAMUEL CARR
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 2004-01031
;:2
NOTICE OF FAILURE TO FILE STATUS REPORT
Personal Representative: l\IILI,ER SAMUEL C III
:::r~ .',
Counsel for Personal Representative: BICKLEY L REX
t.,,';
C-,"J
Date of Decedent's Death: 10/21/2004
The Orphans' Court record indicates that neither the above named personal representative
nor the above named counsel for the personal representative have filed with the Register o~'\Viils
or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme
Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court
Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report.
If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of
such delinquency and the undersigned will requests that a Court conduct a hearing to detelmine
whether sanctions should be imposed upon the delinquent personal representative or counsel for
the delinquent personal representative.
Date:
10/31/2007
e1/i' ( L
,',. ~7""-
Y . I 7:~
.J.~.
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
1 '\
In Re: Estate of
MILLER SAMUEL CARR
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 2004-01031
NOTICE OF FAILURE TO FILE STATUS REPORT
C)
'-~cJ
-'~
, ,
Personal Representative: MILLER SAMUEL C ITI
Counsel for Personal Representative: BICKLEY L REX
Date of Decedent's Death: 10/21/2004
The Orphans' Court record indicates that neither the above named personal representative
nor the above named counsel for the personal representative have filed with the Register of Wills
or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme
Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court
Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report.
If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of
such delinquency and the undersigned will requests that a Court conduct a hearing to determine
whether sanctions shaull;! be imposed upon the delinquent personal representative or counsel for
the delinquent personal representative.
~ij ~., &" /J
6/" ," .' . .~./ ,
,f ~t~.dilt. 'L t"t.I~f't",:.L/..." }A~e.
, ;!' ..
Date:
10/31/2007
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
~, -J
~:",')
...-.'.";
C.,
Pa. D.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF
CUMBERLAND
COUNTY, PENNSYLVANIA
Name of Decedent:
SAMUEL CARR MILLER
Date of Death:
10/21/04
File Number:
2004-01031
Pursuant to Pa. O.c. Rule 6.12, 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: . . . . . . . . . , . . . . . . . . .. 0 Yes I&J No
2. IUhe answer is No, state when the personal representative
reasonably believes that the administration will be complete:
6-12 months
3. If the answer to No.1 is YES, state the following:
a. Did the personal representative file a final account with the Court? . . . . . ., DYes
DNa
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? .................,............. DYes
DNa
d. Copies ofreceipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and m y be attached to this report.
Dole 1//.1 ( , ]
. ( I
Capacity:
Personal Representative 0 C01.illSel
'J .
..~. -..
1.. Rpx R;('kl"y, E5q
Nome of PerSOll Filing Ihl's Form
114 South St.
Address
HArrisburg. PA 17101
717 -234-0577
Telephone
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Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF CUMBERLAND
COUNTY, PENNSYL VANIA
Name of Decedent: SAMUEL CARR MILLER
Date of Death: 10/21/04
File Number: 2004-01031
Pursuant to Pa. O.C. Rule 6.12, 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: . . . . . . . . . . . . . . . . . . .. III Yes 0 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? . . . . . .. DYes I2JNo
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? ............................... IZJYes DNo
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and may be attached to this report.
Date November 7, 2007
Capacity:
L. Rex BIckley, Esq.
Name of Person Filing this Form
I2JCounsel
114 South St.
I,)
Address
Harrisburg, P A 171 0 1
717-234-0577
o E: : ~.~ !: I f ,-
..; L.'
Telephone
Form RW-IO rev. 10.13.06
4