The URL can be used to link to this page

Home My WebLink About07-07-14 (3) 1505611185 REV-1500 EX(02-11)(FI) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes PO BOX 280601 INHERITANCE TAX RETURN 21 14 0384 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 04042014 09271923 Decedent's Last Name Suffix Decedent's First Name MI MILLER JANET C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW ❑ 1. Original Return ❑ 2. Supplemental Return ❑ 3. Remainder Return(Date of Death Prior to 12-13-82) ❑ 4. Limited Estate ❑ 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Required death after 12-12-82) 6. Decedent Died Testate ❑ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) ❑ 9. Litigation Proceeds Received ❑ 10. Spousal Poverty Credit(Date of Death ❑ 11. Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number TIMOTHY M . FINNERTY-i ESQ . 717-237-5394 REGISTER WILLS USE 0dlY �l O L. First Line of Address 1 j l70-TJ C J tj Sf?f= _� 100 PINE STREET -T' Second Line of Address 3 PO BOX 1166 Fri City of Post Office State ZIP Code E FILED 7 CD GR HARRISBURG PA 171081166 CorrespondenYS e-mail address: TFINNERTY@MWN - COM Under penalties of perjury, I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete. claration of preparer other than the personal representative is based on all information of which preparer has any knowledge. —� RE F PE R P Si OR FILING RETURN DAT AD ESS ^ oZ 91 NI N DRIVE MECHANICSBURG, PA 17055 E OF�AN REPRESENTATIVE DAT Al PO BOX 1166 HARRISBURG, PA 17108-1166 PLEASE USE ORIGINAL FORM ONLY Side t 1505611185 OM4647 3,000 1505611185 U 1505611285 REV-1500 EX(F I) Decedent's Social Security Number Decedenfs Name: MILLER JANET C RECAPITULATION 1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 0 - 00 2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . 2 4171205 - 64 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C), , . . . 3. 0 • 00 4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . 4. 0 • 00 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) . . . . . 5, 271404 • 45 6. Jointly Owned Properly(Schedule F) ❑ Separate Billing Requested . . . . 6. 501318 - 50 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedule G) ❑ Separate Billing Requested . . . . 7. 4 7 1 4 35 • 27 8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . 8. 542,363 • 86 9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . 9, 141694 . 04 10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule I) . , , , , , . . . 10. 91754 • 21 11. Total Deductions(total Lines 9 and 10). . . . . . . . . . . . . . . . . . . . . 11. 24 n 4 4 8 • 25 12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . 12 5171915 • 61 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J). . . . . . . . . . . . . . . . 13. 81403 • 24 14. Net Value Subject to Tax(Line 12 minus Line 13) . 14. 5091 512 - 37 TAX CALCULATION -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.0 0 0 . 00 15. 0 . 00 16. Amount of Line 14 taxable at lineal rate X.oLIJ5 4671496 -18 16. 21.037 . 33 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 421016 - 18 18. 61302 - 43 19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 271339 . 76 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 1505611285 1505611285 OM4648 3.000 REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: 21 14 0384 DECEDENT'S NAME MILLER JANET C STREET ADDRESS CUMBERLAND 5225 WILSON LANE CITY STATE ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due(Page 2, Line 19) (1) 27,339 . 76 2. Credits/Payments A. Prior Payments D • D D B. Discount 11366 - 99 Total Credits(A+B) (2) 11366 - 99 3. Interest (3) 0 . 00 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2,Line 20 to request a refund. (4) 0 . 00 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 251972 - 77 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 . . . . . . . . . . . . . . . . . . . . . . . . 1:1 b. retain the right to designate who shall use the property transferred or its income . . . . . . . . . . 1:1 c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments,benefits or care? . . . . . . . . . . . . . . . . . . ❑ 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑X 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . KI ❑ 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 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the 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 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)(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. OM4671 2.000 REV-1503 EX-(612) pennsylvania SCHEDULE B DEPARTMENT OF REVENUE INHERITANCE TAX RETURN STOCKS & BONDS RESIDENT DECEDENT ESTATE OF FILE NUMBER JANET C. MILLER 21 14 0384 All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH f. 83 Shares MetLife 4,449.22 THE DECEDENT HELD THE FOLLOWING ASSETS IN A WELLS FARGO BROKERAGE ACCOUNT; SEE ATTACHED VALUATION INFORMATION: 2 800 Shares AT&T 28,552.00 3 1,000 Shares Aegon NV 7.25% 25,780.00 4 170 Shares Chevron Corporation 20,258. 90 5 865 Shares GE Cap Corp 4.875% 20,483.20 6 300 Shares General Electric Company 7,858.50 Dividend accrued on 4/4/2014 66.00 7 1,000 Shares Frontier Communications 5,615.00 8 2,211.538 Shares IVY Municipal High Class A 11,124.04 9 1,231.803 Shares IVY Funds High Income Fund A 10,778.28 10 5,950.433 Shares IVY Funds High Income Fund B 52,066.29 11 250 Shares Johnson & Johnson 24,712.50 12 900 Shares DB Cont Cap Tr 6.55% Pfd 23,323.50 Total from continuation schedules . . . . . 182,138.21 TOTAL (Also enter on Line 2,Recapitulation) $ 417,205. 64 2w4696 2.000 If more space is needed,insert additional sheets of the same size Estate of: JANET C. MILLER 21 14 0384 Schedule B (Page 2) Item Value at Date No. Description of Death 13 3,400 Shares Nuveen Quality Preferred Inc Fund 3 28,543.00 14 1,465 Shares Blackrock Credit Alloc Income 19,909.35 15 8,978.768 Shares Prudential Invt 15 High Yield B 52,076.85 16 675 Shares Qwest Corp. 6.125% Pfd 14,974.88 17 700 Shares Verizon Communications 33,708.50 18 2,475 Shares Western Asset High Inc. 14,788.13 19 Wells Fargo Money Market 18,137.50 Total (Carry forward to main schedule) 182,138.21 REV-1505 EX-(M12) pennsylvania SCHEDULE E CEPARTNE rOFREVENUE CASH, BANK DEPOSITS & MISC. RESs)EMOEECE ENrNRN PERSONAL PROPERTY ESTATE OF: - FILE NUMBER: JANET C. MILLER 21 14 0384 Include the proceeds of litigation and the date the proceeds were received bythe estate. All property jointly owned with right of sumbionship must be disclosed on Schedule F. REM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PNC Bank Checking Account No. 50-0097-7818 24,551.26 see attached bank letter Interest accrued to 4/4/2014 0.19 2 U.S. Treasury - Estimated Refund re 2014 individual income tax return 775.00 3 1996 Chrysler Cirrus 2,078.00 Valued per Kelley Blue Book TOTAL(Also enter on line 5,Recapitulation) $ 27,404.45 2w45AO 2.0110 If more space Is needed,use additional sheets of paper of the same she. REV-1509 EX.(01-10) pennsylvania SCHEDULE F DEPARTMENT OF N.UE INxERITANCE TAX RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JANET C. MILLER 21 14 0384 If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G SURVIVING JOINT TENANT(S)NAIv1F{S) ADDRESS RELATIONSHIP TO DECEDENT A Phillips, Judy L 906 Nixon Drive, Mechanicsburg, P 17055 Daughter B Simms, Cheryl P 12509 W. Modesto Drive, Litchfield Park, A2 85340 Daughter JOINTLY OWNED PROPERTY: fi1�7 =ER DATE % DATE OF DEATH FOR J"N WDE DESCR PIIONOF P AND 6ANNN DATEOFDEATH INLWDEINM1ECf NUMER ATTACH DEED FOR 9ONI(LCGWMEAL ESTATE, 1AR DINTEREST VAWEOF NUtv8Ff2 TENANT JOINT mENnrrwa xur.BEx.nTrncx oEEOra�axnv HELD REAL ESTATE, VALUE OF ASSET INTEREST DECEDENTS INTEREST 1 B Susquehanna Conference, Account No. 2-11888 Certificates 50,000.00 50.0000 25,000.00 Certificates held between decedent and Cheryl P. Simms. Certificates pass to surviving joint owner. See attached letter Interest accrued to 4/4/2014 318.49 159.25 2 A Susquehanna Conference, Account No. 2-11889, Certificates 50,000.00 50.0000 25,000.00 Certificates held between decedent and Judy L. Phillips. Certificates pass to surviving joint owner. See attached letter Interest accrued to 4/4/2014 318.49 159.25 TOTAL (Also enter on Line 6, Recapitulation) E 50,318.50 9W46AE 2.000 If more space is needed, use additional sheets of paper of the same size. REV-1510 EX+(08-09) pennsylvania SCHEDULE G DEPARTMENT OFREVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER JANET C. MILLER 21 14 0384 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM INDIDETIENAAEOFTIETRANSFEREE,TreiR RELATIONSHP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE NUMBEF TFE DATE OF TRANSFER ATTAaiADORY OF TIE DEED FOR REAL ESTATE VALUEOFASSET INTEREST IFAPPUCABLE VALUE 1. MetLife Total Control Account, No. 4053727541 5,616.47 100.0000 0.00 5,616.47 Designated beneficiary of account was decedent's granddaughter, Jana L. Simms. See attached copy of March 31, 2014 statement Interest accrued to 4/4/2014 0.92 100.0000 0.92 2 Western S Southern Life Annuity, Contract No. W0020183119 41,817.88 100.0000 0.00 41,817.88 Beneficiaries of annuity are decedent's daughters, Judy Phillips and Cheryl Simms. See attached copy of account statement dated April 2, 2014 TOTAL(Also enter on line 7,Recapitulation)$ 47 435.27 If more space is needed,use additional sheets of paper of the same size. 9W46AF 2 000 REV-1511 EX+(0&13) pennsylvania SCHEDULE H DEPART WOFREVINUE FUNERAL EXPENSES AND NHERTANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER JANET C. MILLER 2114 0384 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERALEXPENSES: 1. Malpezzi Funeral Home 6,096.52 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: 2. Attorney Fees: McNees Wallace & Nurick LLC (estimated) 7,500.00 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: 518.50 5. Accountant Fees: 6. Tax Return Preparer Fees: 221.00 7. 1 Cumberland Law Journal Legal Advertising 75.00 2 Journal Multimedia Legal Advertising 158.00 Total from continuation schedules . . . . . . . . . 125.02 TOTAL(Also enter on Line 9,Recapitulation) $ 14,694.04 3W46AC 2,000 If more space is needed,use additional sheets of paper of the same size. Estate of: JANET C. MILLER 21 14 0384 Schedule H Part 7 (Page 2) 3 McNees Wallace & Nurick LLC Costs Advanced as follows: Duplicating $17.20 Postage 7.82 25.02 4 McNees Wallace & Nurick LLC Reserve for closing costs re duplicating, postage, etc. 100.00 Total (Carry forward to main schedule) 125.02 REV-1512 EX t(12-12) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENTDEGEOENT ESTATE OF FILE NUMBER JANET C. MILLER 21 14 0384 Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreim burled medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. West Shore EMS Balance Due 240. 95 2 Camp Hill Fire Company Emergency Transport 1,217.25 3 Omnicare of King of Prussia Balance Due 51.42 4 Bethany Village at Home Balance Due 170.50 5 Medicine Shoppe Drug Charges 41.97 6 Bethany Village Final Nursing Home Charges 7,064.20 7 Pennsylvania State Employees Retirement System Partial Reimbursement of April 2014 pension payment decedent not entitled to (payment deposited to decedent's account prior to her death) 816. 92 8 PA Department of Revenue Tax Due (estimated) re 2014 Pennsylvania individual income tax return 151.00 TOTAL(Also enter on Line 10,Recapitulation) $ 9,754.21 2w46AH 2.000 If more space is needed, insert additional sheets of the same size. REV-1513 EX,( SCHEDULE J penns nsylvania EPA ENTOF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: JANET C. MILLER 21 14 0384 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Truste (s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outnghl spousal dishibutions and transfers under Sec.9116(a)(1.2).] 1. Judy L. Phillips 906 Nixon Drive Mechanicsburg, PA 17055 Western & Southern Life Annuity, Contract No. W0020183119 Inventory Value: 20,908.94 Susquehanna Conference, Account No. 2-11889, Certificates Inventory Value: 25,000.00 Accrued: 159.24 34% of Residue: 142,855.03 Daughter 188,923.21 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF 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: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 See Attached 1 TOTAL OF PART It-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 8,403.24 9W46Al 2,00D If more space is needed,use additional sheets of paper of the same size. Estate of: JANET C. MILLER 21 14 0384 Schedule J Part 1 (Page 2) Item No. Description Relation Amount 2 Cheryl P. Simms 12509 W. Modesto Drive Litchfield Park, AZ 85340 Western 6 Southern Life Annuity, Contract No. W0020183119 Inventory Value: 20,908.94 Susquehanna Conference, Account No. 2-11888 Certificates Inventory Value: 25,000.00 Accrued: 159:24 34% of Residue: 142,855.03 Daughter 188,923.21 3 Jana L. Simms 3723 Bailey Road Yorkville, IL 60560 MetLife Total Control Account, No. 4053727541 Inventory Value: 5,616.47 Accrued: 0.92 20% of Residue to Jana L. Simms 3723 Bailey Road Yorkville, IL 60560: 84,032.37 Granddaughter 89,649.76 4 Karolyn Kay Rodkey 514 Thomas Road Camp Hill, PA 17011 10% of Residue: 42,016.18 None 42,016.18 Estate of: JANET C. MILLER 21 14 0384 Schedule J Part 2B (Page 1) Item No. Description Amount 1 First United Methodist Church 135 W. Simpson Street Mechanicsburg, PA 17055 1% of Residue: 4,201. 62 4,201. 62 2 Asbury Foundation Bethany Care Assurance Fund 201 Russell Avenue Gaithersburg, MD 20877 18 of Residue: 4,201.62 4,201. 62 ESTATE OF JANET C . MILLER NO . 21 - 14-0384 COPY - SHORT CERTIFICATE AND WILL DATED APRIL 29 , 2002 COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE COUNTY OF CUMBERLAND I, LISA M. GRAYSON, ESQ. Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 22nd day of April, Two Thousand and Fourteen, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of JANET C MILLER late of LOWER ALLEN TOWNSHIP (Firs(,Middk,lash a/k/a JANET COO VER PHILLIPS MILLER in said county, deceased, to JUDY PHILLIPS (Firs[Middle,Last) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 22nd day of April Two Thousand and Fourteen. File No. 2014- 00384 PA File No. 21- 14- 0384 Date of Death 410412014 S.S. # Hetrister Ut lis � a U putt'l NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, JANET C. MILLER, a resident of Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I I declare that I am married to NORWOOD E. MILLER, and that I have a daughter, CHERYL P. SIMMS, a daughter, JUDY L. PHILLIPS, a granddaughter, JANA L. SIMMS, and my husband's niece, KAROLYN KAY RODKEY. II I direct that all my just debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath all my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment to my husband, NORWOOD E. MILLER, provided that he survives me by thirty (30) days. V If my husband, NORWOOD E. MILLER, shall predecease or fail to survive me by thirty (30) days, I give, devise and bequeath all of my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment, as follows: A. One percent to the First United Methodist Church in Mechanicsburg, Pennsylvania. B. One percent to Bethany Care Assurance Fund. C. Ten percent to my husband's niece, KAROLYN KAY RODKEY, per stirpes. D. Twenty percent to my granddaughter, JANA L. SIMMS, per stirpes. E. Thirty-four percent to my daughter, CHERYL P. SIMMS, per stimes. F. Thirty-four percent to my daughter, JUDY L. PHILLIPS, per stirpes. VI I nominate, constitute and appoint my husband, NORWOOD E. MILLER, as Executor of this LAST WILL, to serve without bond. If my husband is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my daughter, JUDY L. PHILLIPS, as Executrix of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, JANET C. MILLER, have set my hand to this LAST WILL this 2C 7 day of 2002. JANET C. MILLER Signed, sealed, published and declared by the above-named JANET C. MILLER, as and for her Last Will and Testament, in the presence o��s, who, at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. �G ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND I, JANET C. MILLER, Testatrix, 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 as my free and voluntary act for the purposes therein expressed. JA&FT C. MILLER Sworn or affirmed to and acknowledged before me by JANET C. MILLER, Testatrix, this Vl- day of Qpr 12002.// c[/ Notary Public Notarial Seel Diana M.Smith,Notary Public Mechanicsburg Boro,Cumbanand County ' fdy Cornmissicn Expire=_June 22,2004 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND we, M(4rrcf 12. IJa IlrrS /l and 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 Testatrix sign and execute the instrument as her LAST/WILL, that JANET C. MILLER signed willingly and that she executed it as er free and voluntary act for the purposes therein expressed; that each of u -m the hearing and sight of the Testatrix signed the Will as witnesses; and that the best of our knowledge, the Testatrix was at the time 18 ye az of age or mo-e, of sound mind and under no constraint or undue influence. / Sworn or affirmed to and acknowledged before me this Z 9�'K day of 017,91111 2002. Ck Notary Public Notanal Seal Diann N,.Smith,Notary Public Mechanicsburg Boro,cuabodand County My Commission Expires June 22,2004 ESTATE OF JANET C . MILLER NO . 21 - 14-0384 COPY - WELLS FARGO ACCOUNT INFORMATION Weds Fargo Advisors,LLC 1250 Broadcasting Road Suite 100 ® Wyomissing,PA 19610 Office:610-376-1700 Fax:610/478-1352 Toll Free:800-288-2437 May 16, 2014 Judy L. Phillips 906 Nixon Drive Mechanicsburg, PA 17055 RE: Estate of Janet C. Miller Dear Judy: I have enclosed a date of death valuation for A/C #6818-7625. If I can provide additional information, please let me know. I had worked with Janet since 1986, and I thought of her as a friend. I miss her. You have my sincere sympathy. Very ttruully/your/s, Eleanor S. Collins Senior Vice President-Investment Officer Enclosure Together we'll go far Member FINRA/SIPC 40J__ - v CWo _ co N N �t 30o A � � pVpA A (otjp � � OOpy OD d c fD � O Cn -I CC n O O O A W U7 p 0 (n O p O M _ 0 o m e W W W OD ''f. 0 n < 3 7 o m C N I p I co C W O T CD M S N � o w m 1 N N d n < j 7 CD O Q° 3 S N ° 0 N N 0 � (D C7 N T T 7� - CD C7 < O -� (D N J a�, N CD j ^' 7 p CD O O C C C CD N O < O d SD C) o d � � a 'o �. nmC) 7 z � o A Do pC) gocn m 0 0 o v p C CD 0 N a m CD c0 3 = 'O N fD m ,P my � � L � CLZ 7 37 ? c 0 � � Cn N N O CD o d M. CNn D � O 7 7 O 7. o W v ° a a ^ 0°�, o can ' o o C) d o A << s n 7 ,.� O o d O U ° O o an d to W 0 p. T T T W C=/1 7 '�I'1 7 0 aaD ,< m � m W � 0 WD T c y O� � N 0 3 W 0 3 n J d . = � = xz1 m < m � ° c o �" N � oo � ooD ZlmooXT tr O = m X x O 3 y .* x ^� `-D = CD 0 w < A N N CD N N i N W = m Co (n W N U7 W W Ut CD co W Cn Cn W W CD Cn U7 < a a n CO W N W m A CO W .I v O V A p J co W S n w m O Cn M O A N -I W Cn Cn W O O W Cn A W o Co E N p CD 0 0 0 Q Cn V N Cn W co (n W W W CT CT Cn W W (n m _ H •.< m CD CD W Cn W W W V V O M O Cn Cn v Cn m m N O A -I m N Ut Cn W W CO W CO N O N 0. 0 J � O x J Cn W N Cn W W Cn W W W m U7 m W CO Cn Cn S1 J m 0 Co Oo Cn A CD W -I V :-O CA N) 0) V 61 = m w W m CO O Co O N Cn Cn M W N O W I W Co J C N CS d O = N A W A N Co W W A N O -+ Cn V O O Cn W W 0 a -I W V Co O CO Cn W -I O V 1 m W A N V Cn - a- 5 a W O -I v O m N -+ m -I N N m W Ut W Cn W CD 3 m m -I O N W m Co O W N m W A 0 0 W W O N V F N O O N W W O O Cn N N O O O N CO O O Cn .O+• C71 O Cn Cn (n O O O CO W A 0 0 0 0 O O O x o A O 3 m to CD N 0 rn m O .y. m <D C7 m 0 d W go C. 7 0 0 m@ O O 0 0 3 o Q 0 M CD CD CD A O OD m >• a W Cn N N N U7 s N N N N s 1 0 a N N W N N CO W W A N O -+ CTt -I 0 0 Ut CO Oo O co m W W V Co O CD U7 W J O -4 m CD A N V Cn < (n m 3 - O O --• v v O m N m -1 N N N W Cn CO Cn W N N -1 W O N W m CD O Co N m Co A O m W W O N -I O O - O) °= N O O N W W O O U7 N N O O O N CD O O Cn O o N U7 O Cn Cn Cn 0 0 O W 00 A 0 0 CD O 0 O O -4 Cn ESTATE OF JANET ... C . MILLER NO . 21 ,= 14 =0384 COPY - PNC BANK ACCOUNT INFORMATION Jun. 4. 2014 9: 27AM PNC Bank No. 4393 P. 1 P l:'il Q June 4,2014 Linda M Eshehnan, PA. C.P. McNees Wallace &Nurick LLC 100 Pine Street PO Box 1166 Harrisburg PA 17108-1166 RE: Janet C Miller S SN: DOD: 04-04-2014 Dear Ms. Eshelman: In response to your request for Date of Death(DOD)balances for the customer noted above,our records show the following: Checking Account Account# 5000977818 Established: 04-08-1997 JANET C MILLER DOD balance: S 24,551.26 +0.19 accrued interest interest paid 01-01-2014 thru 04-04-2014 $ 0.67 YTD 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 PNC Bank branch office. Sincerely, National Financial Services Center PNC Bank,N.A. Member FDIC This message is intendedfor the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering this message to the intended recipient,you are hereby notified that ahy dissemination, distribution or copying of this communications is strictlyprohibited If you have received this communication in error,please notify me immediately by reply or by telephone at 800-762-1775 and immediately destroy this faxed document. Page 1 of 1 ESTATE OF JANET C . MILLER NO . 21 - 14-0384 COPY - SUSQUEHANNA CONFERENCE CERTIFICATE HOLDINGS SUSQUEHANNA CONFERENCE A PENNSYLVANIA CONFERENCE OF THE UNITED METHODIST CHURCH 303 MULBERRY DRIVE• P.O. BOX 2053• MECHANICSBURG, PA 17055-2053•TELEPHONE(717)766-5275 June 4, 2014 Ms. Linda M Eshelman McNees Wallace &Nurick LLc PO Box 1166 Harrisburg, PA 17108-1166 RE: Estate of Janet C Miller Dear Ms. Eshelman: In response to your request,this letter provides a summary of accounts 2-11888 and 2-11889 the Estate of Janet C Miller. The principal balance in account 2-11888 the Estate of Janet C Miller or Cheryl P Simms, at the time of Janet's death on April 4, 2014, was $50,000 and included CD's 15352 and 15950. The principal balance in account 2-11889 the Estate of Janet C Miller or Judy L Phillips, at the time of Janet's death on April 4, 2014, was $50,000 and included CD's 14145, 14196 and 15951. - Interest earned as of the time of Janet's death for the period of November 1, 2013 to April 4, 2014 was $318.49 per each account. In June, an interest payment of$435.61 will be disbursed to the account names shown above for each account. If you should have further questions, please contact me at 717-766-5275, extension 5. Sincerely, � a Sue Ellen Adams Administrative Accounting Assistant COUNCIL ON FINANCE AND ADMINISTRATION ESTATE OF JANET C . MILLER NO . 21 - 14 -0384 COPY - METLIFE CONTROL ACCOUNT STATEMENT Total Control Account' Account No. 4053727541 Statement Period From 1/01/14 To 3/31/14 Page 1 of 1 5H-0850x-TCA1PC05 JANET MILLER Customer Service: (800) 638-7283 906 NIXON DRIVE MECHANICSBURG PA 17055-4046 Beneficiary Election Recorded as of 1110712007 If you want current information about your Total Control Account, you can use our automated phone system to obtain your Account balance, interest rate, transaction activity, and more. Just call 800-638-7283, and the friendly easy-to-use system can help you to get the information you need, day or night, seven days a week. TCA SETTLEMENT OPTION EFFECTIVE ANNUAL YIELD 1.50% AS OF 03131114 Account Summary BegInning Balance $5,595.77 Interest $20.70 Ending Balance! $5,616.47 %Year TO Date:Interest $20.70 Year To Date Federal Tax WRhheld ! $0.00 Transaction Details Trans Date pctivHy Draff No Descripliae Amaunt LN 1131 Interest $7.13 2/28 Interest $6.44 3/31 Interest $7.13 fi The Total Control Account Settlement Option ('TCA") is offered by Metropolitan Life Insurance Company, New York, NY 10166 ("MetLife") and certain of its affiliated companies, listed below. MetLife may from time to time also make TCA administrative services available to customers of and beneficiaries of policies issued by unaffiliated insurers in connection with administrative services it provides to such unaffiliated insurers, in all cases, administrative services in connection with the TCA, other than banking services, are provided by MetLife. This statement is your record of activities for your TCA for the statement period shown. The statement also shows the effective annual yield of your account as of the end of the period shown. "Effective annual yield" refers to the annualized rate of interest in effect after compounding, assuming that all your principal and interest remain in the account at that interest rate for one year.The yield on the TCA Settlement Option may change weekly. In addition, certain information regarding any Total Control Account Guaranteed Interest Certificate Option ("GIC') you have selected may be reflected on this statement, In addition to examining your Account statement so that you may know your Account balance, you should also examine your Account statement promptly for any unauthorized drafts that may have been written against your Account. It is your responsibility to review your statement for any discrepancies including any unauthorized transactions. You have 60 days to report these discrepancies to this office. If you feel that a draft which is listed on your statement is not yours, please call us immediately. In case of errors, or if you have inquiries about your statement or account, please call 800-638-7283. Callers with a Telecommunications Device for the Deaf (TDD) may call 800-229-3037. Written inquiries may be sent to: MetLife, Total Control Account° P.O. Box 6300, Scranton, PA 18505-6300. - JU4-Q Ctat.** 0 To add or change beneficiaries on your Total Control Account, you may download the TCA Beneficiary Designation Form by visiting www metlife com. Near the bottom of the metlife.com home page, under Service, click on the link: Download a Form. On the MetLife Forms page, click on:Total Control Account. Then, under TCA- Beneficiary Designation Form, click on: PDF version. You also may request a TCA Beneficiary Designation form by calling us at 800-638-7283, and using our automated phone system to request the form: Select"Access My Account Information,"and then select"Add or Change Beneficiary." PLEASE NOTE: Executors, personal representatives, guardians, conservators, trusts, and minors who are Accountholders generally may not designate beneficiaries. MetLife Family of Companies Metropolitan Life Insurance Company New England Life Insurance Company General American Life Insurance Company Metropolitan Tower Life Insurance Company MetLife Investors USA Insurance Company First MetLife Investors insurance Company MetLife Insurance Company of Connecticut Total Control Account is a registered service mark of MetLife. RECONCILIATION OF ACCOUNT STATEMENT ENDING BALANCE Balance shown on this statement $ ADD Transfers in not credited, e.g., from GIC option (if any) + $ _ and additional proceeds 1 SUBTRACT Drafts and other debits outstanding, e.g., transfers to - $ — 0 other settlement options, automatic withdrawals, etc. BALANCE This should agree with the balance in your records after you add interest credited and deduct any special service charges shown on this statement. ESTATE OF JANET C . MILLER NO . 21 - 14-0384 COPY - WESTERN & SOUTHERN LIFE ANNUITY STATEMENT Western & Southern Life Single Premium Deferred Annuity A member of Western&Southern financial Group @ * Prepared on 04/02/2014 Page 7 of 1 Owner JANET C MILLER 906 Nixon or Uourbun Southern Life appreciates —_ your business. Mechanicsburg PA 17055-4046 — Annuitant JANET C MILLER Contract Number W0020183119 Contract Date 04/02/2004 — Contract Type NON-QUALIFIED — Issued by Western-Southern Life Assurance Company *** INFORMATION ABOUT YOUR CONTRACT _ > Total interest earned during any contract year will be impacted by any withdrawals, including systematic withdrawals, from the contract during that year. For example, if you select the systematic withdrawal plan, the interest you receive will be less than the amount indicated by the effective annual interest rate because interest is being paid out rather than accumulated. SUMMARY OF ACTIVITY 04/02/2013 through 04/01/2014 Beginning Contract Value $ 40,957,75 Plus Interest Credited` 860.13 fess Systematic Withdrawals .00 Partial Withdrawals .00 Surrender Charges .00 Ending Contract Value 41,817.88 Surrender Value' 41,817.88 The effective annual interest rate for the contract year indicated above was 2.10% and is 2.00% for the current year. The guaranteed minimum effective interest rate for the fife of the contract is 2.00%. '* Amount available after deducting any applicable charges if you cancel your contract. For further information about your MultiRate Annuity ANNUITY OPERATIONS contract, including interest rates, contact your sales Western-Southern Life Assurance Company representative or call Annuity Operations. PO Box 2918 Cincinnati, Ohio 45201-2918 1-800-926-1702 Customer Service Hours: Monday -Thursday, 8 a.m.to 6 p.m., Eastern time Friday, 8 a.m.to 5 p.m., Eastern time `IDS2002J` 076