HomeMy WebLinkAbout11-15-13 1505610143
REV-1500 EX 162-11)
PA Department of Revenue pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes aaeU* + ro aew.ea County code Year File Numbar
PO BOX.280601 INHERITANCE TAX RETURN 21
Harrisburg,PA 17128-0601 RESIDENT DECEDENT 13 0506
ENTER DECEDENT INFORMATION BELOW
04 19 2013 05 19 1915
Decedent's Last Name Suffix Decedent's First Name
MILLER MI
AUDREX B
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
M(
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1, Original Return ❑ 2. Supplemental Return ❑
3. Remainder Return(Date of Death
Prior to 12-13-82)
❑ 4 Limited Estate ❑ qa,Future Interest compromise i�"�
(data W death after 12.12-62) 5, Federal Estate Tax Return Required
IJ
6_ Decadent Died Testate 7 Dacedent Maintarzd ativag Frust
(Affa;h Copy orwaq ❑ (Attain Copy orirtul) _.._ 8. Total Number of Safe Deposit Boxes
❑ 9. Litigation Proceeds Received ❑ 10.benveet P?a �j�te dif�Dae f Death ❑ 11,Election to tax under Sec.91131A)
(Attach Schedule 0)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
WM D SCHRACK III ESQ 717 432 .9733
MISTER OOyi�WILIa Ug ONLY
First Line of Address S CI)
rn rn
124 W HARRISBURG STREET M cl PEI °
v o 0
Second Line of Address
O "-n
c M
City or Post Office State ZIP Code "I' DA'�E FIL F-
State
DILLSBURG PA 170191268
Correspondent's e-mail address: SChraCklaw@Comcast.net
Under true, "OF hat i have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true, r i of pre other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATURFILING RETURN DATE
Donn Jerre Miller
ApURESS
1011 Bra town Road. Dillsburg, PA 17019
SIGNATURE OF PREP ER T RFPRESE ATtVE DATE Wm. D. Schrack III Esq. Ce,
ADDRESS
124 W. Harrisburg Street, Ditlsburg,PA 17019-1268
Side 1
1505610143 1505610143
�3
J 1505610243
REV-1500 EX
RECAPITULATION
i. Real Estate(Schedule A)....................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................. 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 1 , 033 , 759 . 85
6. Jointly Owned Property(Schedule F) 11 Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous NLf nn,-Probate Property 54 , 481 . 16
(Schedule G) Separate Billing Requested............ 7, 58 , 065 . 0 6
8. Total Gross Assets(total Lines i through 7)...............................
8. 1, 146, 306. 07
9. Funeral Expenses and Administrative Costs(Schedule H)............ 20 , 098 . 66
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10. 1 , 000 . 87
11. Total Deductions(total Lines 9 and 10)................................................................
11. 21, 099 . 53
12. Net Value of Estate(Line 8 minus Line 11)...- . ...... . ... .........
12. 1 , 125,206. 54
13. Charitable and Governmental 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 , 125 ,206 . 54
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X .00 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 1 , 125,206. 54 16. 50 , 634 . 29
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 00 1s. 0 . 00
19. TAX DUE................................................................................................................ 19. 50 , 634 . 29
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
L Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21-13-0506
Decedent's Complete Address:
DECEDENT'S NAME
_ Miller,Audrey B.
STREET ADDRESS
Bethany Village, 5225 Wilson Lane
CITY i=� STATE '
Mechanicsburg PA ZIP 17050
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 50,634.28
2. Credits/Payments
A. Prior Payments 45,000.00
B. Discount 2,368.42
Total Credits(A +B) (2) 47,368.42
3. Interest (3)
4, if Line 2 is greater than Line 1 +Line 3,enter the 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) 3,265.87
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 the use or income of the property transferred:...................................................................-.......... ❑
b, retain the right to designate who shall use the property transferred or its income;............-..._...............
c. retain a reversionary interest;or.................._....._...........................................-......_......................
......_. x
d. receive the promise for life of either payments,benefits or care?_......................................................... i x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?_......... ................. .............. ............... ........ ❑
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑
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 QUESTIONSIS YES,YOU MUST COMPLETE SCHEDULE O 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 for the use of the surviving
spouse is 3 percent(72 P.S-§9116(a)(1.1)(i)].
For dates of death on or after January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
172 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 disclosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000,
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent(72 P.S.§9116(a)(1.2)],
•The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
(72 P.S.§9116(a)(1)].
•The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent(72 P.S.§9116(a)(13)]. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1508 EX.(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Miller,Audrey B. 21-13-0506
Include the proceeds of litigation and the dale the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Wells Fargo Securities Account#5644.4685 1,033,759.85
TOTAL(Also enter on Line 5, Recapitulation) 1,033,759.85
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
st"4609 EX.101.10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Miller,Audrey B. _ 21-13-0506 _
If an asset was made joint within one yearof the decedent's data of death,it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Donn Jerre Miller P. O. Box 705 Child
Dillsburg, PA 17019
B. Patricia M. Miller Apt 2124,5225 Wilson Lane Daughter-in-Law
Mechanicsburg, PA 17055-6666
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY o DATE of DEATH
ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT /n Of
NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR DATE O DEATH DECD�S DECEDENTS INTEREST
TENANT JOINT JOINTLY-HELD REAL ESTATE. ALUE Of ASSE INTEREST
1 A 08/10/2006 Fulton Bank, N.A.-CD #064-0332706 15.000.00 50.000% 7,500.00
2 B 08/1012006 Fulton Bank,N.A.-CD #064.0332710 15,000.00 50.000% 7,500.00
3 A 08/10/2006 PNC Bank,N.A.-account#5140043363 36,687.24 50.000% 18,343.62
4 A 08/10/2006 Sovereign Bank-CD #1685553347 42,275.07 50.000% 21,137.54
TOTAL(Also enter on Line 6, Recapitulation) 54481.16
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule F(Rev.01-10)
Rev-1510 EX+(0a-09)
SCHEDULE G
pennsylvania
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
Miller Audrey B. FILE NUMBER
21-13-0506
This schedule must be completed and filed M the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY °c of DecDs
NUMBER INCLUDE NAME OF TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH EXCLUSION TAXABLE
THE DATE OF TRANSFER, ATTACK A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 John Hancock Annuity Contract#860010 53.554.63 53,554.63
2 Wells Fargo IRA Account#5644.4683 4,510.43 4,510.43
TOTAL(Also enter on Line 7, Recapitulation) 58,065.06
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA•1500 Schedule G(Rev.08-09)
REV-1511 EX.(10.09(
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Miller,Audrey B. 21-13-0506
Decedent's debts must be reported on Schedule 1.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s)attached 12,187.50
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip-
Year(s)Commission Paid
2. Attornev's Fees Wm. D.Schrack III Esq. 3,500.00
3, Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant to Decedent
4. Probate Fees 863.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 3,547.66
See continuation schedule(s)attached
TOTAL(Also enter on line 9, Recapitulation) 20,098.66
Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Miller, Audrey B. 21-13-0506
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Exoenses
1 Bethany Village(Memorial Service catering) 858.20
2 Hotel Edison (post-burial luncheon) 192.62
3 Northumberland Memorial Park(grave marker) 395.00
4 Parthemore Funeral Home 10,741.68
H-A 12,187.50
Other Administrative Costs
'5 Bethany Village(additional 1 month fee to process items) 2,149.66
6 Clerk of Orphans'Court-Release filing fee 5.00
7 Cumberland Law Journal -estate advertisement 75.00
8 Fed-Ex charges incurred in transporting Miller Estate documents from originating office to 57.12
our office on behalf of Executor
9 Miscellaneous expenses incurred during administration(postage,copies,faxes,etc.) 35.00
10 Register of Wills-Inheritance Tax Return filing fee 10.00
11 Reserve for future administrative expenses 1,000.00
12 Sovereign Bank-fee for Estate Valuation Report 20.00
13 The Patriot-News Co-estate advertisement 123.38
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Miller, Audrey B. 21-13-0506
ITEM
NUMBER DESCRIPTION AMOUNT
14 Wells Fargo Advisors-fee for Estate Valuation Report 72.50
H-B7 3,547.66
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev 4512 EX-(12.08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Miller,Audrey B. 21-13-0506
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION! OF DEATH
1 Bethany Village(pro-rated final monthly fee) 987.87
2 Verizon(final telephone bill) 13.00
TOTAL(Also enter on Line 10,Recapitulation) 1,000.87
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12.08)
REV-1513 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Miller, Audrey B. 21-13-0506
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
O List mstCO 5
I TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
Donn Jerre Miller Son 1,125,206.54
1011 Braggtown Road
Post Office Box 705
Total 1,125,206.54
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. 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
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev. 01-10)
r
�I
LAST WILL AND TESTAMENT
II OF
AUDREY B. MILLER
ii
itI, AUDREY B. MILLER, a resident of Cumberland County,
� Pennsylvania, being of sound and disposing mind, declare this to
I be my Last Will and Testament, hereby revoking any Will or
Testament previously made by me.
FIRST: I direct that all my just debts and burial expenses
be paid as soon as practicable after my death.
i
SECOND: I give, devise and bequeath my entire estate of
every nature and wherever situate to my son, DONN JERRE MILLER. j
THIRD: In the event that my son, DONN JERRE MILLER,
predeceases me, I give, devise and bequeath the residue of my
i estate of every nature and wherever situate to my daughter-in-
/X law, PATRICIA M. MILLER.
FOURTH: In the event that both my son, DONN JERRE MILLER,
W I and my daughter-in-law, PATRICIA M. MILLER, predecease me, I
J ' ( give, devise and bequeath the residue of my estate and every
nature and wherever situate to my granddaughters, LAURI CHRISTINA
_ SALVAS and LEANNE COLLEEN LAYNE, each to take an equal share .
FIFTH: I appoint my son, DONN JERRE MILLER, as Executor of
w this Last Will and Testament . If my son, DONN JERRE MILLER,
`J I predeceases me or is for any reason unable or unwilling to act as
my Executor, I appoint my daughter-in-law, PATRICIA M. MILLER, as
Executrix of this Last Will and Testament .
li SIXTH: The interests of the beneficiaries hereunder shall
not be subject to anticipation or to voluntary or involuntary
alienation.
SEVENTH: I direct that my Executor have all the powers not
prohibited by law, including but not limited to the power to
sell, mortgage, lease or convey any real or personal property
which I may own at the time of my death. I direct that my
Executor not be required to enter security in any jurisdiction in
which he may be required to act .
EIGHTH: I direct that any and all taxes, expenses, costs
and fees connected with the administration of my estate be paid
Page 1 of 3 Pages
I �
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Ii from the residue of my estate to the extent possible.
it
NINTH: In the event any legatee or devisee named in this
Will dies under such circumstances that there is not sufficient
evidence to determine whether such legatee or devisee survived
me, I direct such legatee or devisee shall be presumed to have
predeceased me and I devise and bequeath the gift in favor of the
legatee or devisee to such persons and in such manner and in such
I proportion as set for in this Will for distribution if the
legatee or devisee predeceased me .
I sign this Last Will and Testament in the presence of the
f; witnesses who have signed below on this ` .+ da y of
1997 . '< 9
j AUDREY B.; MILLER
ill AUDREY B. MILLER, requested that we witness the execution of
this instrument . In our presence she acknowledged that this
111 instrument was her Last Will and Testament . In her presence, and
in the presence of each other, we signed below on this day
i of 1997 .
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add ess
acitiress
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address v` /
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Page 2 of 3 Pages
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STATE OF PENNSYLVANIA
'' s s .
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COUNTY OF CUMBERLAND
ii
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We, (hi;S .ne. /J,e(Rr� and Ju )' /_. '��. : and JJ
y
the witnesses whose na s are signed to the foregoing instrument
being duly qualified according to law, depose and say that we
were present and saw the Testatrix sign and execute this Will as
!i her last Will and Testament; that she signed it willingly and
it that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and
j; sight of the Testatrix signed the Will as witnesses and to the
best of our knowledge, the Testatrix was at the time 18 or more
I years of age, of sound mind and under no constraint or undue
influence .
is
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Sworn to and Subscribed
I before me this . `,/n,lday of
1997 .
i
ivo .ary Public
I
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(SEAT,)
� V 1 : ,ry Public
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Page 3 of 3 Pages
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Estate Valuation
Audrey B. Miller
Date of Death: 04/16/2013 Estate of: Audrey B. Miller
Valuation Date: 04/16/2013 Account: 5644-4665 Individual
Processing Date: 05/24/2013 Report Type: Date of Death
Number of Securities: 30
File ID: Miller, Audrey B. 5644-4685
Shares Security Mean and/or Security Div and Int
Identifier or Par Description High/Ask Low/Hid Adjustments Value Accruals
1) CASH 42288.42 CASH/HANK DEPOSIT SWEEP 42,288.18
Accrual 0.24
2) OOIOIJ106 17 THE ACT CORPORATION
COM
New York Stock Exchange
04/16/2013 44.58000 42.75000 H/L
43.665000 742.31
3) 00206R102 7091 AT&T INC
cam
New York Stock Exchange
04/16/2013 - 36.28000 37.92000 H/L
Div: 0.95 Ex: 04/08 Aec: 04/10 Pay: 05/01/13 38.100000 270,167.10 3,190.95
4) 00142CB47 10146.978 AIM INVT SECS PIS
INVSC US GV A
Mutual Fund (as quoted by NASDAQ)
04/16/2013 9.25000 Mkt
9.250000 93,859.55
Daily Div. Accrual as of 09/16/2013 - 92.00
5) 013904305 171 ALCATEL-LUCENT
SPONSORED AIR
New York Stock Exchange
04/16/2013 1.43000 1.40000 H/L
1.415000 241.97
6) 15189T107 1378 CENTERPOINT ENERGY INC
COM
New York Stock Exchange
04/16/2013 23.86000 23.54000 H/L
23.700000 32,658.60
1) 2003ONJOI 495 COMCAST CORP NEW
CL A
The NASDAQ Stock Market LLC
04/16/2013 41.63000 41.24000 H/L
Div: 0.195 Ex: 04/01 Rao: 09/03 Pay: 04/24/13 41.435000 20,510.33 96.53
8) G2554F113 35 COVIDIEN PLC
SHS
New York Stock Exchange
04/16/2013 66.82000 66.00000 H/L
Div: 0.26 Ex: 04/02 R 66.4100DO 2,324.35 ec: 04/04 Pay: 05/03/13 9.10
9) 3016IN101 1782 EXELON CORP
COM
New York Stock Exchange
04/16/2013 36.01000 35.65000 H/L
35.830000 63,849.06
10) 302310102 1056 EXXON MOBIL CORP
COM
New York Stock Exchange
04/1612013 - 87.23000 86.08500 H/L
86.657500 91,510.32
11) 450737101 126 IBERDROLA SA
SPON ADR
Other OTC
04/16/2013 20.28000 20.03000 H/L
20.155000 2,539.53
Page 1
This report was produced with EstateVal, a product of Estate valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.3.1)
Date of Death: 04/16/2013 Estate of: Audrey B. Miller
Valuation Date: 04/16/2013 Account: 5644-4685 Individual
Processing Date: 05/24/2013 Report Type: Date of Death
Number of Securities: 30
File ID: Miller, Audrey D. 5644-4665
Shares Security Mean and/or Security Div and Int
Identifier or Par Description High/Ask Low/Bid Adjustments Value Accruals
12) 4613IM106 292 INVESCO TR INVT GRADE MUNS
COM
New York Stock Exchange
04/16/2013 14.89000 14.80000 H/L
14.845000 4,334.74
Div: 0.083 Ex: 09/09 Rod: 04/11 Pay: 09/30/13 24.24
13) 46132X109 501 INVESCO PA VALUE MUN INCOME TR
COM
New York Stock Exchange
04/16/2013 14.78600 14.67010 H/L
Div: 0.075 Ex: 04/09 Rec: 04/11 Pay: 04/30/13 14.728050 7,378.75 37.58
14) 502161102 49 LSI CORPORATION
COM
New York Stock Exchange
04/16/2013 16.46000 6.26000 H/L
6.360000 311.64
15) 552939100 2000 MPS GOVT MIS INCOME TR
SH BEN INT
New York Stock Exchange
04/16/2013 6.58000 6.55000 H/L
6.565000
Div: 0.040340 Ex: 04/16 Rec: 04118 Pay: 04/30/13 + 0.040340
6.605340 13,210.68
16) 62886E108 84 NCR CORP NEW
COM
New York Stock Exchange
04/16/2013 27.52000 27.06000 H/L
27.290000 2,292.36
17) 629377508 132 NRG ENERGY INC
COM NEW
New York Stock Exchange
04/16/2013 26.82000 26.45000 H/L
26.635000 3,515.82
18) 648018109 1248.189 NEW PERSPECTIVE FD INC
COM
Mutual Fund (as quoted by NASDAQ)
04/16/2013 33.35000 Mkt
33.350000 41,627,10
19) 6935IT106 2906 PPL CORP
COM
New York Stock Exchange
04/16/2013 31.91500 31.37000 H/L
31.642500 91,953.11
20) H6169Q106 6 PENTAIR LTD
SHS
New York Stock Exchange
04/16/2013 52.53000 51.32000 H/L
51.925000 415.40
21) 713291102 6462 PEPCO HOLDINGS INC
COM
New York Stock Exchange
04/16/2013 . 21.77000 21.39000 H/L
21.580000 139,449.96
22) 744573106 670 PUBLIC SVC ENTERPRISE GROUP
COM
New York Stock Exchange
04/16/2013 35.11000 34.50000 H/L
34.805006 23,319.35
Page 2
This report was produced with EstateVal, a product of Estate Valuations 6 Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com, (Revision 7.3.1)
Date of Death: 04/16/2013 Estate of: Audrey B. Miller
Valuation Date: 04/16/2013 Account: 5644-4685 Individual
Processing Date: 05/24/2013 Report Type: Date of Death
Number of Securities: 30
File ID: Miller, Audrey B. 5644-4685
Shares Security Mean and/or Security Div and Int
Identifier or Par Description High/Ask Low/Bid Adjustments Value Accruals
23) 746853100 1400 PUTNAM PREMIER INCOME TR
SH BEN INT
New York Stock Exchange
04/16/2013 5.55000 5.52000 H/L
5.535000 7,749.00
24) 767754104 120 RITE AID CORP
COM
New York Stock Exchange
04/16/2013 2.28900 2.18000 H/L
2.234500 268.14
25) 631661101 816.507 SMALLCAP WORLD 6T) ,INC .
COM
Mutual Fund (as quoted by NASDAQ)
04/16/2013 43.23000 Mkt
43.230000 35,297.60
26) H84969104 35 TE CONNECTIVITY LTD
REG SHS _
New York Stock Exchange
04/16/2013 41.40000 40.52000 H/L
40.960000 1,433.60
27) 68076W103 84 TERADATA CORP DEL
COM
New York Stock Exchange
04/16/2013 54.94000 54.08000 H/L
54.510000 4,578.84
28) H89128104 35 TYCO INTERNATIONAL LTD
SHE
New York Stock Exchange
04/16/2013 31.70800 31.38000 H/L
31.544000 1,104.04
29) 939330106 909.655 WASHINGTON MUT INVS FO INC
COM
Mutual Fund (as quoted by NASDAQ)
04/16/2013 34.27000 Mt
34.270000 31,173.88
30) 70884BI41 5 PENNSYLVANIA INSD BUNS INCOME
UT SER 85 M
Miscellaneous
04/16/2013 - 40.66000 A/B
40.660000 203.30
Int: 0.12 Ex: 04/08 Per: 04/10 Pay: 04/25/13 0.60
Total Value:
$1,030,308.61
Total Accrual: $3,451.24
Total: $1,033,759.85
Page 3
This report was produced with EstateVal, a product of Estate Valuations d Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.3.1)
Date of Death: 04/16/2013 Estate of: Audrey R. ,Miller
Valuation Date: 04/16/2013 Account: 5644-4685 Individual
Processing Date: 05/24/2013 Report Type: Date of Death
Number of Securities: 30
File ID: Miller, Audrey B. 5644-4685
Portfolio $ndnotes
IMPORTANT INFORMATION ABOUT THE ESTATE VALUATION REPORT
The information in this Estate Valuation Report (referenced below as the Report) is based on the Estate valuation
Worksheet provided to us by the Financial Advisor requesting the Report. We have not used client statements, internal
accounting data, or any other resources to independently verify the identity or quantity of securities held, the date of
death, or the alternate valuation date, if applicable.
The Report may include assets that you currently hold away from our firm, which may or may not be identified as being held
away. Information on assets held away from Wells Fargo Advisors was provided by you and may not be covered by SIPC.
Weiss Fargo Advisors makes no representation with respect to accuracy of information on outside holdings.
In most cases, we use Estate Val, a valuation and pricing program, to provide information on the value of securities on
the requested date. Estate Val software is provided by Estate Valuations b Pricing Systems, Inc., (EVP), a third-party
vendor unrelated to Wells Fargo Advisors, The pricing and valuations generated by EVP are derived from sources it
believes to be reliable, but the accuracy and completeness of this information is not guaranteed.
Depending on how the Report will be used, the pricing generated by EVP for some securities may warrant additional
consideration. Users may want to supplement or adjust the values provided for certain types of securities. For example:
- Brokered certificates of Deposit, and certain bonds, may possess a death put feature. EVP provides a value whack does
not account For the possibility that a successor owner may be able to put the security back to the issuer at par, upon the
death of the original owner.
- Treasury Inflation Protection Securities (TIPS) are often not identified as such in the Report, so the inflation factor
may not be reflected in the value and accrued interest shown.
- variable rate auction securities may be reported by EVP at par, without reflecting accrued interest or market
conditions. Other types of variable rate securities may not reflect accrued interest.
- Accrued dividends are not reflected for mutual funds with daily dividend accruals.
The databases used by EVP do not encompass all markets or types of investments. For example, Estate Val does not provide
valuation data on investments such as annuities, equity options, limited partnerships, or managed futures funds, among
others. If the Financial Advisor is able to obtain pricing or valuation data from other sources with respect to such
investments, we may include that data in the Report for informational and convenience purposes. We will identify such
investments in the Report. We do not audit or independently verify the data provided to us, and make no representations
as to the accuracy or completeness of information provided to us by others,
This Report does not in any way supersede the information contained in client statements and trade confirmations, which
are the official record of account positions and activity.
We make no representations that the information contained in this Report is suitable for any particular purpose, it is
the responsibility of the client, together with his Or'her' tax and legal advisors, to determine the appropriate
information to include on any tax return, inventory, or other accounting.
Pace'4
This report was produced with Estateval, a product of Estate Valuations 6 Pricing Systems, Inc. If you have questions,
please contact EVP Systems at {818) 313-6300 or wvv.ovpsy.,ca,, (Revision 7.3.1)
/
FultonBank
LISTENING IS JUST THE BEGINNING
May 217 2013
Law Office of Wm D Schrack III
124 West Harrisburg St
Dillsbum, PA 17019
Dear Mr. Schrack,
RE: Audrey B Miller, deceased 4/19/2013
In response to your recent inquiry concerning the accounts maintained in the name of
the decedent, please be advised that the following accounts were open at the date of death:
DATE OF DEAT14 ACC
CD# BALANCE INT RATE OPEN ROLL OVER MATURITY
064-0332706 15000.00 23.40 2.71 2/9/10 N/A 4/9/14
(titled jointly always with Donn J. Miller)
064-0332710 15000.00 23.40 . 2.71 2/9/10 N/A 4/9/14
(titled jointly always with Patricia M.Miller)
If you should have any further questions, please do not hesitate to contact me at 717-327-2497.
Very truly ,
/yours.,
\J April Blillett
Credit Confirmation Processor
.s '�j3C,t iV
1.800.FULTON.4 fultonbank.com
Fulton Mink,N.A.Membe,FDIC. Member o the Fulon Rwncial Family.
May. 23 2013 11 : 31AM PNC Bank Na. 5462 P. 1!1
PNC
D lay 23, 2013
William D Sch ack III Esq.
124 L Harrisburg St
Dillsburg, PA 17019-2365
RE: Audrey B Miller
SSN: 178-10-9883
DOD: 04-19-2013
Dear Mr, Schraek:
In response to your request for Date of Death (DOD)balances for the customer noted above,our
records show the following:
Checking Account
Account# 5140043363 Established: 08-10-2006
AUDREY B MILLER
DOitiN fE RE MILLET:
DOD balance: $ 36,68724 +0.12 accrued interest
hiterest paid 01-01-2013 thrit 04-19-2013 $ 0.45 Y"TD
Please note that this office provides date of death balances for deposit accounts(IRAs, CDs, Checking and
Savings). We do not process any financial transactions or provide statements. if you need assistance with
any of these items,please call 1-888-PNC-BANK(1-888-762-2265)or stop by your local YNC Bank branch
office.
Sincerely,
(�
National Financial Services Center
PNC Bank-,N.A.
A4eraber FDIC
This message is intended for the use of the individual or entity to which it is ctdldressed arid angy
contain information that is privileged, corlf dential artd exempt ftom disclosure under rxpplicable law,
ffthe reader of this message is not the intended recipient or the emplayee or agent respai7sib1e for
deliverbW thin nussage to the intended recipient,you are herebv notified that any dissemination.
distribution or eopvil,q gl'this communications is strictlyprohibited !fyou hone received This
Communication in error,please notfly rne. immedialeki,by reply or by telephone at 800-762-17,75 and
immediately destroy this faxed ddoctnnent.
Page I of 1
Sovereign Bank
ESTATE OF Audrey B. Miller
SOCIAL SECURITY #: 178-10-9883
DATE OF DEATH: April 19, 2013
Account#: 1685553347 Type: Time Deposit Open date: 2/24/2011
In the name of: Audrey B. Miller or Donn J. Miller
Date of Death Balance: $42,275.07
Int.(YTD) from 1/1/2013 to 3/31/2013 $308.92
Accrued interest to date of death: $75.49
Otherinfo:
Page 1 of 1
John Hancock Life Insurance Company(U.S.A.) r,
John Hancock Annuities Service Center
27 Dry0ock Avenue STE 3,Boston,MA 02210-2382 rhe futum is yours
Mailing Address:PC Box 55444,Boston,MA 02205-5444
(800)344-1029
w jhannui6es.com
August 31,2012
Audrey B Miller
5225 Wilson Ln, Apt 2124
Mechanicsburg,PA 17055
Contract Number 860010
Settlement Certificate
Dear Ms.Audrey B Miller,
We have received and processed your request authorizing us to annuitize your Venture contract. If you
have not received it already,soon you will be receiving your first payment representing your annuirized
income stream. Please review the following factors that have determined your monthly payout amount.
Be sure to let us know of any discrepancies.
Individual receiving Income/Gender: Audrey B Miller,(Female)
Co-Individual(s)receiving income/Gender: Donn Jerre Miller,(Male)
Date of birth of annuitant: 05119/1915
Date of birth of co-annuitant 07/31/1944
Name of Bank receiving income: PNC BANK
ABA Number: 031312738
Bank Account Number: 5140043363
Annuitization Option: Joint Life and 100%Survivor
Contract Value to ammitize: $53,554.63
Monthly Fixed Payout: $281,88
Exclusion Ratio:" 25.1%
The monthly payable amount is what you receive through an annuitization option called Joint Life and
100%Survivor. if the word Life is included in the option this means you will receive this monthly payment
------ -- ----for-the rest-of your life and-for the life of the co-annuitant.In order to receive your payments in a timely manner,please inform us of any changes in your mailing
address or in your banking information if you are receiving your payments electronically via direct deposit
to your bank account.
If you have any questions about this letter or wish to inform us of an address change,please call us at 800-
344-1029. Our Client Services Representatives are available on weekdays from 8:00 am to 6:00 pm EST.
Sincerely,
John Hancock Annuity Services
^Percentage of guaranteed income that would be non-taxable(excludable from income).
Life Insurance,annuities,Including getup annuities are pmdwts Issued by John Hancock Life Insurance Company(U.S.A.)-,Bloomfield Hills,MI 'not
licensed in New York
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ORFHANS' COURT
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LAW OFFICE OF
Wm. D. SCHRACK III
124 WEST HARRISBURG STREET
DILLSBURG, PA 17019-1268
Telephone 717-432-9733 e-mail:
Telefax 717-432-1053 Schracklaw @comcast.net
November 14, 2013
M
0 M o
Register of Wills _ cl Cn °a
Cumberland County Courthouse a r --j rn
rzm cn MM
1 Courthouse Square cn � p o
Carlisle, PA 17013-3387 o n o -n -n
C-> C> n '� �. n
RE: Estate of Audrey B. Miller - m
FILE #: 21-13-0506 N
To Whom It May Concern:
You will find enclosed herewith two copies of a "Resident Decedent Inheritance
Tax Return", filed on behalf of the Executor of the Last Will and Testament of Audrey B.
Miller. Affixed to the Return is the Executor's check for the sum of $3,265.87, which
represents the balance of the tax liability shown on the Return.
Also enclosed is a cover page stamped "COPY", which I ask be time-stamped and
returned to me with the filing receipt.
Sincerel
WM. D. SCHRACK III
WDS/jsg
enc.