HomeMy WebLinkAbout07-12-13 -� REV-1500E"`°Z„' 1505610143
'� OFFICIAL USE ONLY
PA Department of Revenue pennsylvania co�my cma rear Fue N�moer
Bureau of Individual Taxes �EP�a*ME�*��AE�E��E
Po aox2eoso� INHERITANCE TAX RETURN 2 1 12 12 7 9
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
� ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date ot Birth
10 15 2012 07 11 1929
DecedenYs Last Name Suffix DecedenPs First Name � MI
MILLER JAMES W
(If Applicable)Enter Surviving Spouse's Informatfon Below
Spouse's Last Name Suffx Spouse's First Name MI
Spouse's Social Security Number '
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� t. Original Relum ❑ 2. Supplemental Retum � 3.Remainder Retum(Date of Death
Pnorto 12-13-82)
� 4. Limited Estate � 4g.FuWra Interest Compmmise � 5. Fetleral Estate Tax Return Required
(date ol death aker 12-12-82) '
6 Decetlent Oietl Testate � Decetlent Main�ainetl e Living Tms� � e. Total Number of Safe Deposit Bozes
� (Attacn Copy of Wili) � (A�tach Capy af Tivst)
❑ 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � 11.Election to tax under Sec 9113(A)
behveen 12-31-91 and LL95) (AtlaCh SChedule O)
CORRESPONDEN7-7HIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFI�EN7IAL TAX INFORMA710N SHOULO BE DIREC7E0 TO:
Name Daytime Telephone Number
WILLIAM C CRAMER 717 264 3711
c� � �
REGI�[E�F WILI.S`USE�iLd
¢� � � c�
m = c, �' v; z
First Line of Address � � � � � m
14 NORTH MAIN STREET ST � cn � N ^`� �-'
' � o c
Second Line of Adtlress
C7 O � � '�1 "/i
. 'r; .� ... TY
'�J C F--+ '��' C7
. a7
—DATE FIL�6 ;— rn
City or Post Offce State ZIP Code ..
CHAMBERSBURG PA 17201 W �
correspondent�se-maiiaddress: W�Iliamcramer@embarqmail.com
Under penalties of perjury,I aeclare thaf I have examined this reNrn,inclutling aaompanying schedules and statemenis,and to ihe best of my knowledge an0 belief,
it is true,cortect an0 complete.Declaration of preparer other than the personal representative is based on all inlormation of which preparer�as any knowled9e.
SIG T RE OF PERSON RES ONSIBIE FOR FILING RETURN OATE
� ��/�J Karen Sue Hudson '7�/p,/3
nooRess
92 Hillside , echanic rg, PA 17105
SIGNA URE OTHER R SENTATIVE pqi
� William C Cramer f�
A E55
14 North Main Street, Ste.414, Chambersburg, PA 17201
Side 1
� 1505610143 1505610143 ��
1 1505610243
�J
REV-1500 EX
. DecedenCs Social Securiry Number
oeceaem'sNeme. MILLER� JAMES W.
RECAPITULATION
1: Real Estate(Schedule A)......_........................._......_............................................... 1. 9 2 , 2 8 8 . 0 0
2. Stocks and Bonds(Schedule B)..............................................__............................. 2.
3. �Closely Held Coryoration,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Modgages&Notes Receivable(Schedule D).......................................................... 4.
5� Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 4 5 , 6 6 4 . 6 7
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............. 7.
8. Tofal Gross Assets(total Lines t through 7).......................................................... 8. 1 3 7 , 9 5 2 . 6 7
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 2 2 , 2 8 5 . 5 6
10. Debts of Decedent,Mort9age Liabilities and Liens(Schedule q............................. 10. 5 , 3 0 3 . 2 2
11. Total Deductions(total Lines 9 and 10).................................................................. 11. 2 7 , 5 8 8 . 7 8
12. Net Value of EsWte(Line 8 minus Line 11)............................................................. 12. 1 1 O , 3 6 3 . 8 9
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13.
�
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 1 1 0 , 3 6 3 . 8 9
TAX COMPUTATlON-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal taz rate,or �
transfers under Sec.9116
(a)(L2)X .00 15.
16. Amount of Line 14 taxable
at�inea�rate X Oa5 110 � 3 6 3 . 8 9 �s. 4 � 9 6 6 . 3 B
17. Amount o(Line 14 taxable
at sibling rate X ,12 ���
'18. Amount of Line 14 tazable
at collateral rate X .15 t8�
19. TAX DUE................................................................................................................... 19. 4 , 9 6 6 . 3 8
20. FILL IN THE OVAL IF YOU ARE RE�UESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
L 1505610243 1505610243 J
� REV-1500 EX Page 3 File Number 27 - 1 2 - 1 279
DecedenYs Complete Address:
Miller, James W.
STREET ADDRESS
510 West Main Street
CITY STATE ZIP
Walnut Bottom PA 17266
Tax Payments and Credits:
t. TaxDue(Page2,Line19) � (�) 4,966.38
2. Credits/Payments
A. PriorPayments 4,500.00
e. Discount 236.84
TotalCredits(A +g) (2) 4,7$s.84
3. Interest ' (3) 0.00
4. If Line 2 is greater than Line 1 +Line 3,enter lhe difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 2 2 9.54
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 No
a. retain ihe use or income of the property iransferred;._............................................................................... � �
b. relain the right to designate who shall use the property iransferred or its inwme:............................_...... ❑ �
c. relain a reversionary interest:or.................................................................................................................. � x
d. receive the promise tor life of either payments,benefits or care?......................................................._..._ � x
2. If death occurred aker Dec. 12, 1982, did decedent transfer property within one year of death without
receivin9 adequate consideration?..............................................................................................._..._................. ❑ � . -
3. Did decedent own an"in trust for" or payable upon death bank account or securiry at his or her death?......... � �x
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?...................................................................................................................... ❑ ��
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or tor the use of the surviving
spouse is 3 percent[72 P.S.§9116(a)(7.1)(i)j.
For dates of death on or after January 1, 7995,the tax rate imposed on the net value of transfers to or for the use of ihe surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disdosure of
assets and filing a tax reiurn are still applicable even it the surviving spouse is lhe only 6enefciary.
For dates of death on or after July 1,2000:
•The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a naturel parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(12)].
•The tax rate imposed on the net value of transfers to or for the use ot the decedenPS lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)].
•The tax rete imposed on the net value of lransfers lo or for the use of the decedenfs siblings is�2 percent p2 P.S. 9116 a)(1.3). A
sibling is defned under Section 9102,as an individual who has at least one parent in common wRh the decedent,w ether y bloo or adoption.
�j pennsylvania
��y DEPARTMENTpFREVENUE SCHEDULE A
INHERITANCETA%RETURN REAL ES7ATE
RESIOENT DECEOEN�
FILE NUMBER
ESTATE OF Miller, James W. 21 - �2 - 127s
All real property owned solely or as a tenant in common must be reForted at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a wilfing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant tacts.Real property which is�ofntty-owned witfi right of survivorship must be disclosed on
schedule F.
, AHach a copy of the settlement sheet if the properry has been sold.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Single family residence situate at 510 West Main Street, Walnut Bottom, Cumberland County, 90,000.00
Pennsylvania, as more particularly described in Cumberland County Deed Book 120, Page 101,
sold at public auction for the gross proceeds of$90,000.00. Settlement was hetd on May 24,
2013. See, Exhibit A attached
2 Single cemetery plot, originally owned by decedenPs spouse and passing to decedent upon her 2,288.00
demise but not used for decedeM's intermeM, situate in the"old section" of Westminster
Cemetery, Carlisle, Pennsylvania. Valuation based upon information received from Cemetery
administrator. Executrix intends to either seli the plot at or below the appraised value or donate
the piot if unable to be sold.
TOTAL(Also enter on Line 1, Recapitulation) 92,288.00
r,�; pennsylvania SCHEDULE E
�y� DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC.
INHERITANCE TAX RETURN f
ResioeNTOECEOeNT PERSONAL PROPERTY
FILE NUMBER
ESTATE OF Miller, James W. 2� - �z - �z�s
Include lhe proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 Checking account#103006333 maintained with Orrstown Bank in decedenPs name alone, 15,084.64
including interest accrued through date of death. See, Exhibit B attached
2 Savings account#727970 maintained with Orrstown Bank in decedenYs name alone, including 1,069.08
interest accrued through date of death. See, Exhibit B attached
3 Certificate of Deposit#4000033480 maintained with Orrstown Bank in decedenYs name alone, 4,373.07
including interest accrued through date of death. See, Exhibit B attached
4 Gross proceeds from personal property sold at public auction held by Wayne Myers Auction 5,448.00
Service. See, Exhibit C attached (personal property of beneficiaries also sold at this public
auction; the gross proceeds of beneficiary's personal property is deducted from the gross
estate proceeds)
5 Winchester Model 12, #136538, shotgun. See, Exhibit D attached 200.00
6 Gross proceeds from sale of 2008 Honda Accord. See Kelley Blue Book value and copy of 14,500.00
cashier's check attached as Exhibit E
7 Grandfather clock. See appraisal of The Clock Doctor attached as Exhibit F 250.00
8 1998 Chevrolet 1500 truck, as valued per Kelley Blue Book. See, Exhibit G attached 3,025.00
9 Pro rata distribution of real estate taxes due from purchasers of decedenYs real estate. See, 382.13
Exhibit A attached
10 DecedenYs entitlement to 2012 Federal income tax refund (based upon return filed; refund not 1,276.00
received at the time this inheritance tax return is filed)
11 Refund from Kuhn Communications 17.75
12 Refund from Nationwide Insurance, for unused homeowner's insurance premium 39.00
TOTAL(Also enter on Line 5, Recapitulation) 45,664.67
REV-06H E%�(10.OB�
,�� , pennsylvania SCHEDIAFH
� DEPARTMENTOFREVENUE ��` S`�D
RESI�ENT�ECEDENT URN A��,�w���
MLA�111'UJ 1 fW
FILE NUMBER
ESTATE OF Miller, James W. 21 - 12 - 1279
DecedenPs debts must be reported on Schedule I
ITEM
NUMBER FUNERAL EXPENSES: DESCRIPTION AMOUNT
A. 1 Fogelsanger-Bricker Funeral Home, Inc., for funeral service 4,672.07
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Karen Sue Hudson 3,000.00
Streetnddress 92 Hillside Road
Ciry Mechanicsburg s�ate PA zip 17105
Year(s)Commission Paid 2013
2. Altorney's Fees William C. Cramer, Esq. 5,518.00
3. Family Exemption: (It decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent �
a. Pronate Fees Cumberland County Register of Wills 353.50
s. Accountant's Fees Darlene Kelly, CPA, for fiduciary return 500.00
6. Tax Return Preparer's Fees �8�71BS D. PIV011k8, CPA, for decedenYs final income tax 175.00
7, OtherAdministrativeCosls
1 Cumberland County Legal Journal, for estate advertising 75.00
TOTAL(Also enter on line 9, Recapitulation) 22,285.56
Sdice`d,�ule H
COMMONWEA�THOFPENNSYLVRNIA F� • �
INHERITANCETA%RETURN ���C���
FESIDEM�ECEDENT '
ESTATE OF Miller, James W. FILE NUMBER
21_12 - 1279
2 The Sentinel, for estate advertising 240.19
3 Wayne Myers Auction Service, for auctioneer's commission and costs on sale of 2,352.00
personal property(auctioneer's commission not included on items sold for
beneficiaries)
4 PP&L Electric, for electric service supplied to decedenYs home from date of death 364.10
through date of sale of real estate
5 Leffler Energy, for home heating oil supplied to decedenPs home from date of death 1,565.94
through date of sale of real estate
6 Cumberland County Recorder of Deeds, for one (1%) percent transfer tax regarding 900.00
sale of real esetate
7 Donna Brobst, Tax Collector, for 2013 county real estate taxes 346.58
8 Rodger Conrad, for removal of garbage following public auction 175.00
9 Karen S. Hudson, for reimbursement of expenses incurred as executrix, including, 198.18
stamps, printer cartridges, vehicle registrations, auto trader, insurance payment
10 Wayne Myers Auction Service, for auctioneer's commission on sale of real estate 1,800.00
11 The Clock Doctor, for appraisal of grandfather clock 50.00
Page 2 of Schedule H
�"j,� pennsylvania SCHEDULE I
��� OEPARTMENTOFREVENUE DEBTS OF DECEDENT MORTGAGE
INHERITANCE TAX RETURN �
RESIUENTOECEOENT LIABILITIES & LIENS
FILE NUMBER
ESTATE OF Miller, James W. 2� - �2 - t27s
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM DESCfiIPTION AMOUNT
NUMBER
1 Nationwide Insurance, for insurance on Honda automobile 94.52
2 MCI, for decedenYs finai telephone bill 42.09
3 Honda Financial Services, for payoff of Honda automobile loan 4,307.04
4 Bobby Rahal Honda, for repairs and detailing of Honda automobile 240.62
5 Southampton Township, for decedenPs final garbage removal 45.21
6 Nationwide Insurance, for insurance on truck 168.53
7 Nationwide Insurance, for insurance on Chevrolet automobile 43.30
8 University of Pennsylvania, Department of Neurosurgery, for decedenYs final medical bill 361.91
- TOTAL(Also enter on Line 10, Recapitulation) 5,303.22
REV467J E%t(01�10)
^�]�?]-,�, pennsylvania SCHEDULE J
�\�I DEPARTMENTOFREVENUE
��"' BENEFICIARIES
INHERITANCE TA%RETURN
RESIDENT DECEDENT
ESTATE OF MII�Bf, Jen18S W. FILE NUMBER
21 - 12 - 1279
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Words) ($$$)
RECEIV ING PROPERTY oo No�uet Truetee�e�
I� TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transters
under SeC.9116(a)(1.2)]
1 Nicole Michele Grant Granddaughter 6,000.00
2051 Sandpiper Pt, NE#103
Grand Rapids, MI 49505
2 Stephen Lawrence Miller Son 20 gauge
111 Julia Drive Winchester shotgun
Royce City, TX 75189 and one-half of
remaining net estate
3 Karen Sue Grant Hudson Daughter Grandfather clock
92 Hillside Road and one-half of
Mechanicsburg, PA 17050 remaining net estate
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET O.00
REGISTER OF WILLS Certificate of Gr�nt of Letters
CU�II3ERLAND COUNTY, PENNSYLVANIA
. .,-•�--�
�-�� � �-� No. 21-12-1279 PA No. 21-12-1279
J GSTATE OF.lames W. Miller
� i
�j a/k/a:
�
� < Late Of: South Newton Townshin, Cumberlmid Counry, Deceased
� �/ Social Security No. 159-24-9108
� ;.
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WHEREAS, on the 7th day of December, 2012, the instrument dated
September 19, 2011, was admitted to probate as the Last Will of James W. Miller, late of
South Newton Township, who died on the 15th day of October, 2012, and
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, [, Glenda Farner Strasbaugh, Register of Wills in and for the County of
Cumberland, in the Commonwealth of Pennsylvania, hereby certify that I have this day
granted Letters Testamentary to Karen Sue Hudson, AKA Karen Sue Gra�t who who
duly qualified as Executrix and who agreed to administer tl�e estate according to law, all
of which fully appears of record in my office at Carlisle, Pennsylvania.
[N TESTIMONY �VHEREOF, I have hereunto set my hand and affixed [he seal of my oftice
the 7th day of Deccmber, 2012.
r�,�r�c1c� .�c�n-�, -�y� ,�a tx�a���1,
' Register of GVrlls
����Ylk� �.P �i�r� ���S�C�yv �
Deputy
**NOTE** ALL N.9��/ESfi/�OVF fiPPE.4R (FT2ST, ,t4IDD/.E, GAS'TJ
LAST WILL AND TESTAMENT
OF
JAMES W. NIILLER
Dated: September 19, 2011
Prepared by:
Captain Jessica E. Guise
22 Ashbum Drive ^-'
Cazlisle Barracks, Pennsylvania 17013 � o ^' � m
717 245 4940 m s � � � Q
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LAST W[LL AND TESTA�IF.NT
OF
JAMES W. MILLER
I, James W. Nliller, a resident of the Commonwealth o£ Pennsylvania, make,
publish and declaze this to be my Last Will and Testament, revoking all wills and codicils at any
time heretofore made by me. I am retired from the military service of the United States.
FIRST: I direct that the expenses of my last illness and funeral, the expenses of
the administration of my estate, and all estate, inheritance and similaz taxes payable with respect
to property included in my estate, whether or not passing under this will, and any interest or
penalties thereon, shall be paid out of my residuary estate, without apportionment and wi[h no
right of reimbursement from any recipient of any such property.
SECOND: It is my desire that, upon my death, my body be cremated with fult
military honors.
THIRD: I give the items of tangible personal property ]isted below, if owned by
me at the time of my death, as follows:
My 20 gauge Winchester pump model 12 shotgun to my son Stephen Lawrence
Miller;
My grandfather clock to my daughter Karen Sue Grant.
All other tangible personal property is given as hereafter provided with respect to
my residuary estate.
FOURTH: I give the sum of Six Thousand Dollars ($6,000.00) to my
granddaughter Nicole Michele Grant, if she survives me. ,
FIFTH: I give all the rest, residue and remainder of r.� property and estate, both
real and personal, of whatever kind and wherever located, that I oevn or to which I shall be in any
manner entitled at the time of my death (collectively referred to as my "residuary estate"), as
follows:
(a) In substantially equal shares to those of my daughter Karen Sue Grant and
my son Stephen Lawrence Miller who survive me and to the issue who survive
me of those of my children who shall not survive me, per stirpes.
��ti� `��
_ . _
(b) If no issue of mine survives me, my residuary estate shall be paid and
distributed to the American Cancer Society.
SIXTH: If any property of my estate vests in absolute ownership in a minor or
incompetent, my Executor, at any time and without court authorization, may: distribute the
whofe or any part of such property to the beneficiazy; or use the whole or any part for the health,
education, maintenance and support of the beneficiary; or distribute the whole or any part to a
guazdian, committee or other legal representative of the beneficiary, or to a custodian for the
beneficiary under any gifts to minors or transfers to minors act, or to the person or persons with
whom the beneficiazy resides. Evidence of any such distribution or the receipt therefor executed
by the person to whom the distribution is made shall be a full discharge of my Executor from any
liability with respect thereto, even though my Executor may be such person. If such beneficiary
is a minor, my Executor may defer the distribution of the whole or any part of such property until
the beneficiary attains the age of eighteen (18) years, and may hold the same as a separate fund
for the beneficiazy with all of the powers described in Artide EIGHTH hereo£ If the
beneficiary dies before attaining said age, any balance shall be paid and distributed to the estate
of the beneficiary.
SEVENTH: I appoint my daughter Karen Sue Grant to be my Executor. If
Kazen Sue Grant shall fail to qualify for any reason as my Executor, or having qualified shall die,
resign or cease to act for any reason as my Executor, I appoint my son Stephen Lawrence Mil(er
as my Executor. I direct that no Executor shall be required to file or furnish any bond, surety or
other security in any jurisdiction.
EIGHTH: I grant to my Executor all powers conferred on esecutors under the
Pennsylvania Probate, Estates and Fiduciazies Code, as amended, or any successor thereto, and
all powers conferred upon executors wherever my Executor may act. I also grant to my
Executor power to retain, sell at public or private sale, exchange, grant options ori, invest and
reinvest, and otherwise deal with any kind of property, rea] or personal, for cash or on credit; to
borrow money and encumber or pledge any property to secure loans; to exercise all powers of an
absolute owner of property; to compromise and release claims with or without consideration; and
to employ attorneys, accountants and other persons for services or advice. The term "Executor"
wherever used herein shall mean the executors, executor, executrix or administrator in office
from time to time.
NINTH: I direct that for purposes of this wi(1 a beneficiary shall be deemed to
predecease me unless such beneficiary survives me by more than thirty days. The terms "child"
and "children° as used in this will indude only the child and children of the person designated,
but not any adopted child and chi(dren of such person. The term "issue" includes only the
children and other issue of the person designated, but not any adopted or step children or issue of
such person. The terms "child," "children° and "issue" of the Testator sha(I not include any
stepchiid of the Testator.
TENTH: [ have served in the Armed Forces of the United States. I therefore
request that my Execuror make appropriate inquiries to ascertain whether there are any benefits
to which I, my dependents or my heirs may be entitled by virhie of any military affiliation. I
2
t > , l-v�n
specifically request that my Executor consult with a retired affairs officer at the nearest military
instaliation, the DepaRment of Veterans Affairs, and the Social Security Administration.
This document was prepared under the authority of 10 U.S.C. §1044 and
implementing military regu(ations and instructions, by CPT Jessica E. Guise, who is licensed to
practice law in Pennsylvania.
IN WITNESS WHEREOF, I, James W. Miller, sign my name and publish and
declaze this instrument as my last will and testament this I9th day of September, 2011. .
i' , �
James W. Miller
The foregoing instrument was signed, published and decfared by James W. Miller,
the above-named Testator, to be his last will and testament in our presence, all being present at
the same time, and we, at his request and in his presence and in the presence of each other, have
subscribed our names as witnesses on the date above written.
� ��� �
having an address at
LGYI.JI�� /d�
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having an address at
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ACKNOWLEDG�IENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA, COUNTY OF 1�. ¢� • • , ss.
We, the Testator and the witnesses, whose names are signed to the attached or
foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that
the Testator, James W. Miller, signed and executed said instrument as his last wifl and testament
in the presence and hearing of the witnesses, and that he stated that said instrument was his last
will and testament, and that he had signed willingly, and that he executed it as his free and
voluntary act and deed for the purposes therein espressed, and that each of the witnesses at the
request of the Testator, in the presence and hearing of the Testator and each other, signed the cvill
as witness, and that to the best of his or her knowledge the Testator was at the time at least
eighteen years of age or emancipated, of sound mind and under no constraint, duress, fraud or
undue influence.
�
James W. Miller
Testator
i •
print: De'�iSG $ �BY
Witness
. A
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nt: I� �h �
Witness
Subscribed, sworn to and acknowledged beFore me by the said James W. Milier,
Testator, and subscribed and sworn to before me by the above-named witnesses, this 19th day of
September, 2011.
�
Notary P ic
My commission expires on
COMM NWEALTH OF PENNSriVAN1A
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A Tradition of ExceUence
January ]0,2013
William C. Cramer Attorney At Law
14 North Main Street, Suite 414
Chambersburg, PA 172�1
Faz: 2640554
Re: Estate of James W.Mi(ler
Social Security Number
Date of Death 10/15/2012
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HpD'Tf;g
FOLLOWING ACCOUNTS WiTH ORRSTOWN BANK:
CHECKING�iCCOUNT
Account No: 103006333
Account Type- 50+Intetest Checking
Date Opened- 4/7/2006
Joint Account(name/date)- No
$���- $15,084.49
Accrued Interest- $0.15
SAVINGSACCOUNf
Account No: 727970
Account Type- Statement Savings
Date Opened- 12/30/1988
Joint Account(name/date)- No
B��Ce- $1,069.01
Accrued Interest- $0.07
2fi95 Philadelphla Av�nXR�t_C}iambersburg, PA ll201
t fipitS
CERTIFICATE OF DEPpSll
Account No.- 4000033480
Account Type- 120 Month Growth CD— [rrevocable Burial Fund
Date Opened- 6/25/2009
Joint Account(nameJdate)- No
Halance- $4,365.05
Accrued Interest- $8A2 ,
Best Regazds,
�
J 1 R. WorthingtonU�
Deposit Processuag Clerk
Exhibit B
FINAL
SETTLEMENT
SELLER NAM W / !�Y,C�_�'_�tl.� DATE OF SALE � v � 'J�-
ADDRES _�Ld1� PHONE �� �j�_-
°�� ZIP / 7�lF� � --
LOCATION OF SALE �v`' --
r,I' �7�/� .�.�r- r/
AUCTIONEER W��Y(�-t //Gr3.fo /r a� 7 U � PHONE ^ �
� �.!':` �''.. fi ,i��? �-+.1_ ";� r. ,-..;: �,,,.,. -n /Ba � �
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PROFESSIQNAL FEE ���� �� ,�����"�' � �o�lS��w" ���Gy �7p
AUCTIONEE_fj�� - ''��� /rn r"" LA� �� `{ o �� S`
v�lr� Co�il�/�
,S�,� �fU.!/'*� / �/ /�
f0 (J2J/Qa.�, I�LERK 3 - S.utl � G/�� Cf���HE� s Sa yU, Sc
�o-o-i-o
�/G JL�/LL.�t•�` �SHIER $ 7'�� OTHER RECEIPTS
OTHER EXPENSES $
� $ 6�� $ —
l�S�� � s-2'�?•.v� s -
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� �' $ ��J� �
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..__ "_—.� _. . _ .. . . . . _ . _ . . . . _ . . _
/ �
� .0�� / $_ /�c� TOTAI REGEIPTS $_ �� ��'�—�' _
/ \ $�1Av�� tE55T01ALEXPENSES $��d � �tv._.
ra 1
/�L�i V�S✓U ' ` �--__ ,
� fOTAI EXPENSES _ $���?•Q� �lET PROCEE05 PAYABLE TO SELLER $ .7 V � 7' � y j
I (or we�, the se{ler, accept �his seHiement and acknowledge receipt of the above specified net proceeds
from fhe aucfion of my yoods and propery sold on the above date. I accept all responsibiliry for providing
merchanta6le tide to all goods, and property sold, ond for delivery of tide lo Ihe purchaser
i
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Exhibit D
2008 Honda Accord EX-L Sedan 4D 1'rade In Values-Kelley Blue Book Pa e 1 of 3
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YourBlueBook°Value •._:,:,�:-,:�_.�r:.. ,�:.�..::... .........
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��""'� New Cars You Might Uke
Cars for Sale Get a Used Car Report " ' " ='
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2C09::cnie Acr.rno Get Me Inlamatlm You NeoC an 7Ns
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Exhibit E
ORIGINAL CII[CN HAS fviULtIPLE SECURIfV FfAI1117ES. 1'111NfFD ON CIIEA�IICAL HtiAC71V[ IONFR FUti[ PAPf°q�yFF ffACK f'01i DETAILS
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untitled attachment 00004
7o whom it may concern:
Appraisal for grandfather clock for the estate �ames w. Miller:
rhe clock is about 7 feet tall made from a kit with a German made movement. rhe
clock was assembled in a home shop with limited skill . The weight shells and the
case show usage. i would guess it was a Mason and sullivan kit.
rhe value of the clock is $250.00.
yours truly'
Mervin Brubaker
Page 1
Exhibit F
Untitled attachment 00007
Qualifications: Member of the National qssociation of watch and clock collectors for
33 years.
involved in antique and modern clock repair and
restoration for 33 years.
Page 1
Exhibit F
Kelley E31ue f3ook Page I of2
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Exhibit G
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