HomeMy WebLinkAbout02-11-15 J 1505610105
REV-1500 EX(02-11)(FI)
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania
Bureau of Individual Taxes .....`.... �,E County Code Year File Number
ERITANCE TAX RETURN
PO BOX 28o6o1 INHI I I ( ��
Harrisburg,PA 17128-0601 RESIDENT DECEDENT `-�
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08/21/2014 05/28/1917
Decedent's Last Name Suffix Decedent's First Name MI
Miller Howard . F
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix 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
OD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of will) (Attach Copy of Trust.)
C=:) 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 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
Geoffrey G Miller (717)243-0924 F 70
(-r- r-ri
REGISTER^O ILLS USE-ONLY
r 'I: '7 n t S) C 7
First Line of Address t,- £.J
38 N Dickinson Schl Rd - c) �' 17,
Second Line of Address ; -TI
C.D r rr1
DATE FILED r
City or Post Office State ZIP Code
C ) '77
Carlisle Pa 17015
Correspondent's e-mail address:geospiad@comcast.net
Under penalties of perl'u fare that I have examined ' turn,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct angAmpe.Declaration of preparapo6ther,,Oan the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE O E N RESPONSIB FOR `kETURN DTE
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REP ESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Howard F Miller
RECAPITULATION
1. Real Estate(Schedule A). ............................................ 1. 0.00
2. Stocks and Bonds(Schedule B) ....................................... 2. 0.00
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. 219,306.17
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 23,840.58
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested........ 7. 0.00
8. Total Gross Assets(total Lines 1 through 7)............................. 8. 243,146.75
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 7,789.09
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............... 10. 264.00
11. Total Deductions(total Lines 9 and 10)................................. 11. 8,053.09
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 235,093.66
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. 235,093.66
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- 15.
16. Amount of Line 14 taxable
at lineal rate X.0 4 16. 235,093.66
17. Amount of Line 14 taxable
at sibling rate X.12 17.
18. Amount of Line 14 taxableat collateral rate X.15 18.
19. TAX DUE......................................................... 19. 9,403.75
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Side 2
L 1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Howard Franklin Miller Jr.
STREETADDRESS
134 N Dickinson Schl Rd.
CITY STATE ZIP
Carlisle Pa 17015
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 9,403.75
2. Credits/Payments
A.Prior Payments
B.Discount
Total Credits(A+B) (2)
3. Interest
(3)
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 9,403.75
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.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income............................................ ❑ 0
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?.............................................................................................................. ❑
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 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 transferto 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.
REV-1502 EX+ (12-12)
pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Howard Franklin Miller Jr. 21-14-0822
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts,
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1 Parcel#08-11-0292-001 Dickinson Twp Cumberland Co Pa.(2014 Market Based Assessment) 0.00
$862,500.00 Real Estate Deeded to:Howard F.Miller and Marguerite E.Miller(Deceased),
Huntley H.Miller,Geoffrey G Miller,Renee M Andwood,and Keren M Blackbird.
Value At Time Of Death-Refer to Farm Bill Act 85
TOTAL(Also enter on Line 1, Recapitulation.) $ 0.00
If more space is needed,use additional sheets of paper of the same size.
REV-1197(5-13)
pennsylvania SCHEDULE AU
DEPARTMENT OF REVENUE AG RICU LTU RAL USE
BUREAU OF INDMDUAL TAXES
INHERITANCE TAX DMSION EXEMPTIONS
PO BOX 28o6o1
HARRISBURG PA i7128-o6o1
ESTATE OF: Howard Franklin Miller Jr. FILE NUMBER: 20-14-0822
Use this schedule to report real estate for which you claim an exemption from inheritance tax under the"Farmland - Other"
Exemption (72 P.S. § 9111(s.1)) or the "Business of Agriculture" Exemption (72 P.S. § 9111(s)). Check the box below next
to the exemption you are claiming (select only one):
Business of Agriculture Exemption ❑ Farmland - Other Exemption
Complete Parts 1 and 2 of this form. Agricultural Conservation Easement; Agricultural
Reserve; Agricultural Commodity; Agricultural Use
Property; or Forest Reserve (Definitions on back of
form). Complete Part 1 and check the applicable
category on the back of this form.
Attach a written statement explaining in detail how the real estate qualifies for the claimed exemption. In addition, if you
are claiming an exemption for any structure affixed to the real estate, identify the structure and explain in detail how each
structure qualifies for the claimed exemption. Structures affixed to the real estate that do not qualify for an exemption must
be valued and reported on Schedule A to the Inheritance Tax Return. Please also attach all supporting documents with the
written statement, including the county assessment card. Failure to provide this information may result in a denial of the
claimed exemption or a delay in processing your return.
PART 1: PROPERTY INFORMATION
Property Parcel Identification Number: 08-11-0292-001
Percentage of Parcel Exempted: 33.33%
Date of Death value under 72 P.S. § 9121: 287471.25
Physical Location: 134 N.Dickinson Schl. Rd. Carlisle Cumberland
STREET ADDRESS(DO NOT REPORT P.O.BOX) CITY COUNTY
PART 2: OWNER(S)'S INFORMATION
Provide the name and mailing address of all transferees of the real estate listed above (attach additional sheets if necessary):
Huntley H Miller Son Geoffrey G Miller Son
OWNER NAME RELATIONSHIP TO DECEDENT OWNER NAME RELATIONSHIP TO DECEDENT
42 N Dickinson Schl Rd 38 N Dickinson Schl Rd
MAILING ADDRESS MAILING ADDRESS
Carlisle Pa 17015 Carlisle Pa 17015
CITY STATE ZIP CITY STATE ZIP
Renee M Andwood Daughter Karen M Blackbird Daughter
OWNER NAME RELATIONSHIP TO 75ECEDENT OWNER NAME RELATIONSHIP TO DECEDENT
44 Wellesley Dr 40 Pheasant Court
MAILING ADDRESS MAILING ADDRESS
Bedford NH 03110 Elizabethtown Pa 17022
CITY STATE ZIP CITY STATE ZIP
Farmland - Other Exemption Categories and Definitions:
If claiming the"Farmland - Other" exemption, indicate the category below the real estate identified on this form
qualifies:
❑ Agricultural Commodity - Any and all plant and animal products, including Christmas trees
produced in Pennsylvania for commercial purposes.
❑ Agricultural Conservation Easement - An interest in land, less than fee simple, which interest
represents the right to prevent the development or improvement of a parcel for any purpose
other than agricultural production. The easement may be granted by the owner of the fee
simple to any third party or to the Commonwealth, to a county governing body, or to a unit
of local government. It shall be granted in perpetuity as the equivalent of covenants running
with the land. The exercise or failure to exercise any right granted by the easement shall not be
deemed to be management or control of activities at the site for purposes of enforcement of
the act of October 18, 1988 (RL 756, No. 108), known as the"Hazardous Sites Cleanup Act"
❑ Agricultural Reserve - Noncommercial open space lands used for outdoor recreation or the
enjoyment of scenic or natural beauty and open to the public for such use, without charge or
fee, on a nondiscriminatory basis.
❑ Agricultural Use Property - Land used for the purpose of producing an agricultural commodity
or devoted to and meeting the requirements and qualifications for payments or other
compensation pursuant to a soil conservation program under an agreement with an agency of
the federal government.
❑ Forest Reserve - Land of 10 acres or more, that is stocked by forest trees of any size and
capable of producing timber or other wood products.
Business of Agriculture Exemption - Annual Certification
To maintain the "Business of Agriculture" exemption, each member of the same family who has inherited real
estate for which the business of agriculture exemption was claimed is required to certify to the department that
the real estate still qualifies for the "Business of Agriculture Exemption"for a period of seven years beyond the
decedent's date of death. If during the seven-year post-death period the real estate ceases to be used in the
business of agriculture at any point or does not generate a minimum of $2,000 of gross income in any year, the
owner(s) must notify the department within 30 days of such occurrence and will be liable for inheritance tax
in the amount that would have been paid on the fair market value of the real estate as of the date of the
decedent's death, plus interest. The department will supply the owners with the annual certification form.
f L
REV-i508 EX+(o8-i2)
r
r pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Howard Franklin Miller Jr. 21-14-0822
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
rrEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Citizens Bank 665 N East St.Carlisle Pa 17013 PH 717.243.5311
Acct#6100731553 Howard F Miller and marguerite E.Miller(Deceased-6-25-2011) 30,286.54
2. M&T Bank Stonehedge Square,Carlisle Pa 17013
Acct#15004210919097 Howard F.Miller 188,419.63
3. 1976 Ford 112 Tn Pickup Truck VIN#F15YEC52301 Sold 10.10-2014 500.00
4, 1988 Pequea Utility Trl(Farm Use)VIN#1PQUS1019JG122391 Transferred to family member 100.00
Note:All personal property disposed of prior to 2012.Howard Miller lived with family members
two years prior to death.
TOTAL(Also enter on Line 5,Recapitulation) $ 219,306.17
If more space is needed,use additional sheets of paper of the same size.
REV-i5og EX+(oi-io)
pennsytvania SCHEDULE.F
doDEPARTMENT OF REVENUE
INHERITANCE TAX RETURN 30INTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Howard Franklin Miller Jr. 20-14-0822
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)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A•Huntley H.Miller 42 N.Dickinson Schl. Rd.Carlisle Pa. 17015 Son
Geoffrey G Miller 38 N. Dickinson School Rd.Carlisle Pa. 17015
8'Huntley H.Miller 42 N. Dickinson Schl. Rd.Carlisle Pa. 17015 Son
Geoffrey G. Miller 38 N. Dickinson Schl. Rd.Carlisle Pa. 17015 Son
Renee M Andwood 44 Wellesley Dr.Bedford N.H.03110 Daughter
Karen M. Blackbird 40 Pheasant Ct.Elizabethtown Pa. 17022 Daughter
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 02/08112 M&T Bank StoneHedge Sq.Carlisle Pa.17013
Acct#000009856467452 40,976.75 33 13,658.93
Acct#0150044225781639 30,545.70 33 10,181.65
2. B. 08/18/08 Parcel#08-11-0292-001 862,500.00 33 0.00
Value at Date of Death:Refer Farm Bill Act 85 Schedule AU Attached
TOTAL(Also enter on Line 6, Recapitulation) $ 23,840.58
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (08-13)
iV"pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Howard Franklin Miller Jr. 20-14-0822
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Hollinger Funerl Home Crematory 2,225.49
2. Death Date Inscription 219.00
Memorial Services Expenses 284.00
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: 1,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.) 3,500.00
Claimant Geoffrey G Miller
street Address 38 N Dickinson Schl Rd
city Carlisle state Pa zip 17015
Relationship of Claimant to Decedent Son
4. Probate Fees: 560.60
S. Accountant Fees:
6. Tax Return PreparerFees:
7.
TOTAL(Also enter on Line 9,Recapitulation) $ 7,789.09
If more space is needed,use additional sheets of paper of the same size.
REV-1512 EX+(12-12)
pennsytvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES &LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Howard Franklin Miller Jr. 20-14-0822
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. LifeWays Missiah Walnut Bottom Rd Carlisle Pa 17013(daycare expenses) 61.00
2. Mass General Physicans Org.P.O.Box Boston Mass.02241-3864 129.00
3. 2014 Federal Income Tax 74.00
4. Pa State Income Tax Est.Refund 308.00 0.00
5. Local Income Tax Dickinson Twp Cumberland County Pa.Est Payments$563.39 0.00
TOTAL(Also enter on Line 10, Recapitulation) $ 264.00
If more space is needed,insert additional sheets of the same size.
LIST OF ATTACHMENTS
1.Short Certificate 20-14-0822
2. Deed for Parcel#08-11-0292-001
3. 2014 Cumberland County Assessment for Parcel#08-11-0292-001
4. Proof or Publications and Notifications
5.Bank Statement Citizens Bank
6. Bank Statements M &T Bank and related corresponce
7. MV4-ST Disposition of titled vehicles
8.Outstanding Debt paid after Death
1
COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE
COUNTY OF CUMBERLAND
of curt'
I, LISA M. GRAYSON, ESQ.
CRegister
� for the Probate of Wills and Granting
V D Letters of Administration in and for
CUMBERLAND County., do hereby certify that on
" the 3rd day of September, Two Thousand and
1750 Fourteen,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
estate of HOWARD F MILLER late of DICKINSON TOWNSHIP
(First,Middle,Last)
in said county, deceased, to GEOFFREY G MILLER and
(First,Middle,Last)
HUNTLEY H MILLER
(First,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 4th day of December
Two Thousand and Fourteen.
File No. 2014- 00822
PA File No. 21- 14- 0822
Date of Death 812112014
S. S. #
Register s
c
Deputy
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
Tax ID No.
DEED
MADE THE day of in the year of our Lord two thousand eight(2008)
BETWEEN HOWARD F. MILLER and MARGUERITE E. MILLER,his wife,of
Carlisle, Pennsylvania,
GRANTORS
and GEOFFREY G. MILLER,a single man of Carlisle, Pennsylvania,HUNTLEY H.
MILLER, a married man of Carlisle, Pennsylvania,RENEE E. ANDWOOD,a married woman
of Bedford,New Hampshire,KAREN M. BLACKBIRD,a married woman of Elizabethtown,
Pennsylvania, HOWARD F. MILLER and MARGUERITE E. MILLER, his wife, of Carlisle,
Pennsylvania,
GRANTEES
WITNESSETH,that in consideration of One Dollar($1.00), in hand paid,the receipt whereof
is hereby acknowledged, the said Grantors do hereby grant and convey to the said Grantees,their
heirs and assigns as joint tenants with the right of survivorship:
ALL THAT CERTAIN tract of land situate in Dickinson Township, Cumberland County,
Pennsylvania, Lot No. 1 on the Final Subdivision Plan of Howard F. Miller and Marguerite E.
Miller, recorded in the Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania,in Plan Book 35,Page 75,the same being numbered as more particularly described as
follows:
BEGINNING at an iron pin at the southeast corner of Lot No. 1 and Lot No. 3 of the
aforementioned Subdivision Plan;thence along Lot No. 1,Lot No.3 and lands now or formerly of
Paul J. Hoover and The Carlisle School District, South 17 degrees East 4,112.16 feet to a point;
thence along Lot No. 1 and lands now or formerly of David Lillich, Jr., South 73 degrees West
1,398.00 feet to a point;thence along Lot No. 1 and lands now or formerly of George M.Heckman,
North 21 degrees 35 minutes West 3,392.00 feet to a point;thence along Lot No. 1 and lands now or
formerly of Charles Nickel, North 44 degrees 30 minutes East 1206.11 feet to a point; thence
continuing along Lot No. 1 and Lot No.2,South 45 degrees 30 minutes East 150.00 feet to a point;
thence continuing along Lot No. I and Lot No. 2,North 44 degrees 30 minutes East 600,00 feet to
the point and place of BEGINNING.
CONTAINING 134.262 acres more or less.
BEING a part of the same premises conveyed by Harry F.Brougher and Sarah E.Brougher,by Deed
dated April 1, 1957,and recorded on April 1, 1957,in the Office of the Recorder of Deeds in and for
Cumberland County in Record Book S,Volume 17,Page 270,to Howard F.Miller and Marguerite
E. Miller, Grantors herein.
THIS IS A NON-TAXABLE transfer for Pennsylvania transfer tax purposes from father
and mother to father and mother and children,
11/14/2014 11:43:39 AM CUMBERLAND COUNTY Inst.#200829557-Page 1 of 4
f
IN WITNESS WHEREOF. the said Grantors have hereunto set their hands and seals the day
and year First above written.
SI E , EAL D 1 T DELIVERED
T -1 PRI: :N F
Huntley 1I. i iller. PO 1,M gue fie E. Miller
Yp
V Q _
Geo re G ill r. PO for Howard F. Miller
C'OMMONW'EALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
ON THIS, the day of_ 2008, before me, the
undersigned officer,personally appeared Huntley FI.M ller, POA for Marguerite E. Miller,
known to me (or satisfactorily proven) to be the persons whose names are subscribed to the
within instrument. and acknowledged that they executed the same for the purposes therein
contained.
IN WITNESS WHEREOF, 1 hereunto set my hand and official seal.
CAiAt,18lE "MY��
KW CJM N AM..pOWMry Robin L. StalVer,Notary Public
�'��A+r►2f.2010
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
ON THIS, the / I day of_ 2008, before me, the
undersigned officer, personally appeared Geoffrey G. MOA for Howard F. Miller, known
to me (or satisfactorily proven) to be the persons whose names are subscribed to the within
instrument, and acknowledged that they executed the same for the purposes therein contained.
.IN WITNESS WHEREOF, I hereunto set my hand and official seal.
NiOrAft an - - ";�
ttowtanf y haft
bi
tio � Ron L. Starner, otary Public
�� �CONY
foto
11/14/2014 11:43:39 AM CUMBERLAND COUNTY Inst.#200829557-Page 2 of 4
I do hereby certify that the precise residence and complete post office address of the within-
named Grantee(s) is:
ck Pa / a2,P+ s ��
56 r 1k,,hSV• 13
Date:-41 le,
Attornev for
11/14/2014 11:43:39 AM CUMBERLAND COUNTY Inst.#200829557-Page 3 of 4
ROBERT P. ZIEGLER
RECORDER OF DEEDS J.
CUMBERLAND COUNTY
1 COURTHOUSE SQUARE ' `
CARLISLE, PA 1701.3
l
717-240-6370
Instrument Number-200829557
Recorded On 8/29/2008 At 3:10:08 PM *Total Pages- 4
*Instrument Type-DEED
Invoice Number-28073 User ID-MBL
*Grantor-MILLER,HOWARD F
*Grantee-MILLER,GEOFFREY G
*Customer-PAUL BRADFORD ORR
FEES
STATE WRIT TAX $0.50 Certification Page
STATE JCS/ACCESS TO $10.00
JUSTICE DO NOT DETACH
RECORDING FEES - $13.50
RECORDER OF DEEDS
AFFORDABLE HOUSING $11.50 This page is now part
COUNTY ARCHIVES FEE $2.00 of this legal document.
ROD ARCHIVES FEE $3.00
CARLISLE AREA SCHOOL $0.00
DISTRICT
DICKINSON TOWNSHIP $0.00
TOTAL PAID $40.50
I Certify this to be recorded
in Cumberland County PA
Gg ct,`,ys
c°+ � � �� �.
RECORDER Of D DS
P7
t�s0
*-Information denoted by an asterisk may change during
the verification process and may not be reflected on this page.
0010OG
111IIIIIIIIIIIIIIIIIIIIII
11/14/2014 11:43:39 AM CUMBERLAND COUNTY Inst.#200829557-Page 4 of 4
Cumberland County Assessment Office Cumberland County Board of Assessment Appeals
One Courthouse Square Room 107 George A. DeMartyn
Carlisle, PA 17013 Kristin Lehman
(717) 240-6350 Lloyd W. Bucher
John G. French, Solicitor
Hours: 8:00am to 4:30pm Bonnie M. Mahoney, Chief Assessor
Parcel Identifier:
MILLER, GEOFFREY G 08-11-0292-001.
& HUNTLEY H MILLER
134 N DICKINSON SCHOOL ROAD MAILING DATE: AUGUST 28, 2014
CARLISLE PA 17015 APPEAL DEADLINE: OCTOBER 07, 2014
CHANGE OF ASSESSMENT NOTICE - THIS IS NOT A TAX BILL
This is a notice of a change in assessed valuation of an approved Clean and Green parcel.
REASON FOR CHANGE: 40 - PA DEPT OF AG C&G REVISED RATES
The new value is based on "use value" changes from the "PA Department of Agriculture" and
MAY not reflect recent transfers of land, new construction, or alterations to structures.
RIGHT TO FORMAL APPEAL: If you disagree with the values, tax status, or C&G status on this
notice, you may file a formal appeal with the Board of Assessment Appeals, in writing,
within 40 days of the date of this notice. Appeals must be postmarked or received at the
address above by the deadline.
FUTURE TAX BILLING BASIS EFFECTIVE: 01/01/2015 for County/Manic
07/01/2015 for School
OLD NEW
ASSESSMENT I 340,000 351,800
TAX STATUS Taxable Taxable PROPERTY DESCRIPTION
C&G STATUS Approved Approved
Homestead Approved Munic. : 08 - DICKINSON TOWNSHIP
School: 3 - CARLISLE AREA SD
MARKET-BASED ASSESSMENT Control Number: 08000764
Password for free Web Access: CUKTJBKJ
OLD NEW (My Property at courthouseOnline.com/pa-cu-ao)
Land 643,100 643, 100
Improvements 219,400 219,400
TOTAL 862,500 862,500
Property Location:
100% of Market Value at 2010 Base Year Rates. 134 N DICKINSON SCHOOL ROAD
CLEAN AND GREEN (C&G) ASSESSMENT LAND APPROX 134 ACRES
OLD NEW Land Size: 134.26 acres
Land 120,600 132, 400
Improvements 219, 400 219,400
TOTAL 340,000 351,800 Property Type: A
Residential (10+ Acres)
Land value based on rates provided by the State.
CHANGE OF TAX BASIS - NET CHANGE Cumberland County Commissioners
Barbara Cross
COUNTY/MUNIC SCHOOL Jim Hertzler
Land 11,800 11,800 Gary Eichelberger
Improvements 0 0
TOTAL 11,800 11,800
Effects Future Billing Cycles Only
(notc_allL] ORIGINAL
AND c G
�assocu.�°
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
Tele: (717)249-3166 Fax:(717)249-2663
October 17, 2014
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Geoffrey G. Miller
RE: Howard F. Miller Estate
Legal advertisements must be received by Friday Noon. All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on following dates:
October 3, October 10, and October 17, 2014
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 75.00
-------------
Total Amount Due $ 0.00
Becky H. Morgenthal, Executive Director
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587,approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA :
SS.
COUNTY OF CUMBERLAND
Lisa Marie Coyne,Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952,been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
October 3, October 10, and October 17, 2014
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time,place and character of publication are true.
—5isa Marie Coyne,Yditor
SWORN TO AND SUBSCRIBED before me this
17 da of October, 2014
C
Miller,Howard F.,decd. Notary
Late of Dickinson Township.
Executors: Geoffrey G. Miller and
Huntley H. Miller.
Attorney: Paul Bradford Orr, Es-
quire, 50 E. High street, cariisle,
PA 17013, NOTARIAL SEAL
DEBORAH A COLLINS
Notary Public
CARLISLE BORO.,CUMBERLAND:CNTYMy Commission Expires Apr 28,
CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a)
REGISTER OF WILLS
COUNT z',PEN-IN SYLVANIA
Name of Decedent:
Date ofDcath: File Number:
Date Letters Granted:__
To the Register:
I certify that Notice of Estate Administration required by Pa. O.C.Rule 5.6(a)of the Orphans' Court
rve
Rules was 2 on or mailed to the following beneficiaries of the above-captioned estate on
_Name: Address:
- ----- A_Ixls
more space is needed, attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa. O.C.Rule 5.6(a)except:
Deve ALL(
Sign
At6-o,'0fP( son Filidg 1161F61
Capacity: 06personalRepresentative Cl Counsel
Ame,of Pep-Soil filing this I-on,I
A rid
,;
eZ1
Telephone
PROOF OF PUBLICATION
State of Pennsylvania,County of Cumberland
Cathy Clark,Advertising Director,of The Sentinel,of the County and State aforesaid,
being duly sworn,deposes and says that THE SENTINEL,a newspaper of general
circulation in the Borough of Carlisle,County and State aforesaid,was established
December 13th, 1881,since which date THE SENTINEL has been regularly issued in said
County,and that the printed notice or publication attached hereto is exactly the same as
was printed and published in the regular editions and issues of
September 26,2014 and October 3, 2014 and October 10,2014.
COPY OF NOTICE OF PUBLICATION
Affiant further deposes that he/she is not
CO-EXECUTOR'S NOTICE interested in the subject matter of the
Letters Testamentary on the Estate of HOWARD F.MILLER,late of the aforesaid notice or advertisement,and that
Township of Dickinson,Cumberland County,Pennsylvania,deceased,
have been granted to the undersigned. all allegations in the foregoing statement as
All persons knowing themselves to be indebted to said Estate will make
payment immediately and those having claims will present them for to time,place and character of publication
setuemedt.
Geoffrey G.Miller,Co-Executror a true.
Huntley H.Miller,Co-Executor
38 North Dickinson School Road
Carlisle,PA 17016 / J`
Sworn to and subscribed before me this
gra �,ol�
N tary Public
My commission expires:
CQMMQNMAL1141 OF PENNSYLVANIA
Notarial Seal
Bethany M.Holtry,Notary Public
Carlisle Boro,Cumberland County
My Commission Expires Sept.26,2015
The Sentinel HUNTLEY MILLER AD NUMBER PAGE NO.
w w w.c u m b e r I i n k.c o m 42 NORTH DICKINSON SCHOOL 434449 1 of 1
CARLISLE,PA 17015
Pi BILL DATE SALESPERSON
717-243-9546 _ 10/10/14 _ wolfc_ _
CedSf E SHMP NSSURG PE RY COUNN _.
_ START DATE STOP DATE
09/26/14 10/10/14
AD NUMBER I AD DESCRIPTION CLASS I LINES
434449 CO-EXECUTOR'S NOTICE LETTERS TESTA 10 PUBLIC NOTICES 1 26 * 2 cols
Publication Insertions Rate Net Amount Gross Amount
3 THE SENTINEL-LEGAL 3 LGL $138.06
TOTAL AD CHARGE $138.06
3 MOBILE SITE MOB2 $3.00
3 PROOF OF PUBLICATION 01PRF $7.00
PREVIOUSLY PAID ($148.06)
Purchase Order Est. H.F.Millerr $0.00 $0.00
Lee Enterprises no longer accepts credit card payments sent via e-mail.
Emails containing credit card numbers will be blocked. Please use the coupon
below to send credit card payment to our lockbox. THE SENTINEL
You may also send the coupon to a secure fax at 319-291-4014. c/o LEE NEWSPAPERS
Thank you for advertising with The Sentinel! Deadline for PO BOX 540
in-column legal ads is 4:00 p.m.two business days prior to WATERLOO IA 50704-0540
date of insertion. For questions,call (717)240-7130.
Return this portion with your payment Legal
THE SENTINEL _ Check# _Credit Card Ad Number i 434449
c/o LEE NEWSPAPERS
im—,
i vi — _ nrgeg Billing Date 10/10!14
PO BOX 540
WATERLOO IA 50704-0540 Acct#: ' ; i Amount Due $ .00
Exp.Date: Amount IiI
Name on credit card Enclosed '$
Signature
Please make checks payable to: THE SENTINEL
'168THE SENTINEL
HUNTLEY MILLER c/o LEE NEWSPAPERS
42 NORTH DICKINSON SCHOOL PO BOX 742548
CARLISLE, PA 17015 CINCINNATI OH 45274-2548
IIIIIIIIIllll!,VIII11l l l l l l'I I I'1',II„`�n�u�n��n�,�u,��
21540200000004344490000000000000000000000000000003
' ' Ciflz ns Banff Circle Gold
� �-$ooa73-7373 Account Statement
PO Box 7000 i�
Call Citizens'special,dedicated Gold
ROP-450InCustomer service tine any time for account
Providence 8102940 information,current rates,and answers to OF 4
your questions.
Beginning August 06, 2014
through September 04, 2014
AB 01 006682 73846 B 25 A Contents
Ii�iII�IIE .I����i111�tIl�irllltEt�rt�i��I11���1�It��iItI�I1tiI Summary Page I
HOWARD F MILLER Checking Page 2
38 N DICKINSON SCHOOL RD
CARLISLE.PA 17015-9611 Check Images Page 4
Circle Gold Summary U S 2 5 9 3 1
Account Account Number Balance Balance HOWARD F MILLER
Last statement This statement MARGUERITE E MILLER
DEPOSIT BALANCE
Checking Circle Gotd Checking wJInterest
XXXXXXXI55-3
Circle Gold Checking w/Interest XXXXXXX155-3 32,512.40 33,602.90
n Total Deposit Balance
�— 33,602.90
Total Relationship Balance
�'j 33,602.90
11,19
Owe'
S Bank2.804.773.7373 Account Statement
CA Citizens special,dedicated Gold
Customer service tine any time for account
information,current rates,and ans'arers to OF 4
your questions.
Beginning August 06, 2014
through September 04, 2014
Checking
SUMMARY HOWARD F MILLER
Balance Calculation Balance MARGUERITE E MILLER
Circle Gold Checking w/Interest
Previous Balance 32,512.40 Average Daily Balance 31,425.56 XXXXXXX155-3
Checks 912.50 -
Withdrawals & Debits 1,313.62 -
Interest
Deposits &Credits 3,316.36 + Current Interest Rate .01%
Interest Paid .26 + Annual Percentage Yield Famed .01%
Current Balance 33,602.90 = Number of Days Interest famed 30
Interest Eamed .26
Interest Paid this Year 4.28
You can waive the monthly maintenance fee of$20.00 by maintaining a monthly combined balance
of$20,000.
Your monthly combined balance used to qualify this statement period is: $31,663
Your next statement period will end on October 03, 2014.
Previous Balance
TRANSACTION DETAILS 32,512.40
Checks"There is a break in check sequence
Check# Amount Date Check# Amount Date
2969 250.00 08/06 3451 375.00 08/21
3450* 287.50 08/14
Total Checks
912.50
Withdrawats&Debits
ATM/Purchases
Date Amount Description
08/15 6.95 6753 Dbt Purchase - 269800 Family Home Medicacartiste PA
08/15 15.67 6753 POS Debit-301646 CVS 01646 Carlisle PA
08/20 500.00 6753 ATM Cash -000000 5 Eastgate Drive Carlisle PA
Other Withdrawals&Debits
Date Amount Description
08/13 200.00 Gotfview Respite Visiting A 140813 Howard Miller
08/20 591.00 Messiah Lifecomm Statements 140820 571281
Total withdrawals&Debits
313.62
posits&Credits --
Date Amount Description
09/02 2,743.36 US Treasur 312 Xxciv Sery 09011�A1452�0680A
04j03 573.00 SSA Treas10 Xx c Sec 090314�� r ^ Total Deposits&Credits
(\'!•'/�—..-_ 3,316.36
Interest
Date Amount Description
09/04 .26 Interest
Total Interest Paid
.26
Current Balance
33,602.90
• wmiber FDIC 0 Equal Fbusina Lender
LCALL: (800)724-2440 ACCOUNT TYPE
MYCHOiCE PREMIUM CHECKING
00 0 04331M NM 017
ACCOUNT NUMBER I STATEMENT PERIOD
9864363701
000001319 FIDS1549DO1710101410 07 000000 p SEP.10-OCT.10,2014
ESTATE OF HOWARD FRANKLIN MILLER JR BEGINNING BALANCE $0.00
GEOFFREY G MILLER, EXEC DEPOSITS&CREDITS 243,373.05
HUNTLEY H MILLER, EXEC LESS CHECKS&DEBITS 83,298.50
38 NORTH DICKINSON SCHOOL RD INTEREST 8.09
CARLISLE PA 17015 LESS SERVICE CHARGES 0.00
-ENDING BALANCE,- $160,082.64
INTEREST EARNED FOR STATEMENT PERIOD $8.09 MT HOLLY SPRINGS
VfTEREST PAID YEAR TO DATE $8.09
ACCOUNT SUMMARY
BEGINMNG DEPOSITS&OTHER CHECKS PAID OTHER DEBITS CURRENT ENDING
BALANCE CREDITS(+) INTEREST PD I BALANCE,
NO. I AMOUNT NO. AMOUNT NO. AMOUNT
$0.00 6 $243,373-05 10 $83,293-55 1 $4.95 $8.091 $160,082.64
ACCOUNT ACTIVITY
POSTWG TRANSACTION DESCRIPTION DEPOSITS&OTHER WITHDRAWALS& DAILY
DATE CREDITS t OTHER DEBITS I-) BALANCE
00110,P2014 BEGINNING BAtANCE $0.00
09t1012014 DEPOSIT $188,419.63
0911012014 DEPOSIT 284.00 4"4**A fK4'�
0911012014 CHECK NUMBER 0098 $284.00 188,419.63
0911912014 DEPOSIT 30,286.54 Cirt3ton" 13AAX 218,706,17
09114/2014 DEPOSIT 23,840.58 )s4cr Jj,,U Accf%J
09/24/2014 CHECK NUMBER 0101 2,225.49 240,321.26
09/2512014 CHECK NUMBER 0103 61.00 240,260.26
09r26!2014 CHECK NUMBER 0104 500.00 239,760.26
09129/2014 CHECK NUMBER 0108 20,000.00 219.760.26
09/30/2014 CHECK NUMBER 0107 20,000.00
09130/2014 CHECK NUMBER 0109 75.00
09/30/2014 CHECK NUMBER 0110 148.06 199,5371.20
10/01/2014 CHECK NUMBER 0106 20,000.00 179,537.20
10/07/2014 DEPOSIT 537.35
10/07/2014 CHECK NUMBER 0105 20,000.00 160,074.55
10/10/2014 WAIVE ADD-ON FEE:CHKS/SAFE DEPOSIT BOX 4.95
10/10/2014 INTEREST PAYMENT 8.09
10/10/2014 M&T ADD-ON FEE:CHKS/SAFE DEPOSIT BOX 4.95 160,002.64
1 ENDING BALANCE $160,082.64
PAGE 1 OF 2
.008 Wl 2)
MM&T IMPORTANT NOTICE
Manufacturers and Traders Trust Company
02/08/1> �2N�
HOWARD F MILLER
134 NORTH DICKINSON SCHOOL RD
CARLISLE PA 17013
Dear HOWARD F MILLER
We have processed your request to update the address information on your M&T account(s) to the
following:
42 NORTH DICKINSON SCHOOL RD
CARLISLE PA 17015
If you have any questions regarding this change, please call the M&T Telephone Banking
Center at 1-800-724-2440.
Thank you for banking with M&T .
Sincerely,
Michael N Tkaydek
Michael N Trayder
M&T Telephone Banking Center
Note: This update was made in accordance with a request we received to complete a permanent or temporary
change of address for your account or to send a duplicate statement or interest check to an alternate address.
" M&T Bank acts as a servicer for M&T Bank,National Association Accounts
EAVIX : I m
STATEMENT PERIOD
AUG.09-SEP.08,2014
00 0 04345M NM 017
1 000005031 FIDS1549D01709081409 02 000000 P
HOWARD F MILLER
GEOFFREY G MILLER t
HUNTLEY H MILLER
38 NORTH DICKINSON SCHOOL RD 1
CARLISLE PA 17015
SELECTED ACCOUNT SUMMARY
ACCOUNT ACCOUNT INTEREST EARNED MATURITY ENDING
TYPE NUMBER YEAR-T -D TE DATE BALANCE
MYCHOICE PREMIUM CHECKING 000009656467452 8.18 39,204.50
POWER MONEY MARKET 015004225781639 17.79 30,545.70
TOTAL DEPOSITS 69,750.20
M
ACCOUNT HOWARD F MILLER
MYCHOICE PREMIUM CHECKING TITLE GEOFFREY G MILLER
0
r
ACCOUNT NO. 9856467452 STONEHEDGE
y INTEREST EARNED FOR STATEMENT PERIOD $0.34
a
LL
N
o ACCOUNT SUMMARY
BEGINNING DEPOSITS&OTHER CHECKS PAID OTHER DEBITS(-) CURRENT ENDING
9 BALANCE CREDITS + INTEREST PD BALANQE
NO. AMOUNT NO. I MOUNT NO. A-MOUNT
$42,004.71 1 $4.95 4 $2,270.92 4 $534.58 $0.34 $39,204.5(
ACCOUNT ACTIVITY
POSTING DEPOSITS&OTHER WITHDRAWALS& DAILY
DA TRANSACTION DESCRIPTION CREDITS OJHER DEBIT - BALANCE
08/09/2014 BEGINNING BALANCE $42,004.71
08/14/2014 CHECK NUMBER 0185 $100.00 41,904.71
08/15/2014 Met-Ed CHECK PYMT 000000000000190 34.65 41,870.06
08/21/2014 CHECK NUMBER 0189 893.41 40,976.65
08/22/2014 CHECK NUMBER 0188 717.01 40,259.6
09/02/2014 AUT020NE PURCHASE 192 CARL PA 127.19 40,132.45
09/04/2014 SUBURBANPROPANE2 CHECK PYMT 000000000000191 367.79 39,764.66
09/05/2014 CHECK NUMBER 0193 560.50 39,204.16
09/08/2014 WAIVE ADD-ON FEE:CHKS/SAFE DEPOSIT BOX $4.95
09/08/2014 INTEREST PAYMENT 0.34
09/08/2014 M&T ADD-ON FEE:CHKS/SAFE DEPOSIT BOX 4.95 39,204.50
ENDING BALANCE I 1 1 $39,204.50
PAGE 1 OF 2
STATEMENT PERIOD
AUG.09-SEP.08,2014
HOWARD F MILLER
GEOFFREY G MILLER
CHECKS PAID SUMMARY
CHECK NO. DATE AMOUNT CHECK NO. DATE AMOUNT CHECK NO. DATE AMOUN'
185 08/14/14 100,00 188' 08122/14 717.01 189 08/21/14 893.
193' 09/05/14 580.50
ANNUAL PERCENTAGE YIELD EARNED=0.00%
WE WOULD LIKE TO INTRODUCE THE M&T BANK OPINIONS PANEL,AN EXCITING RESEARCH
COMMUNITY OF M&T BANK CUSTOMERS LIKE YOU.
AS A PANEL MEMBER,YOU WILL HAVE OPPORTUNITIES TO PARTICIPATE IN VARIOUS SURVEYS
TO HELP US IMPROVE OUR SERVICES.TO SEE IF YOU QUALIFY TO BECOME A PANEL MEMBER,
VISIT WWW.MTB.COM/PANEL TO COMPLETE A PANEL QUALIFICATION SURVEY.
AFTER YOU COMPLETE THE SURVEY,YOU WILL HAVE AN OPPORTUNITY TO ENTER A
SWEEPSTAKES FOR A CHANCE TO WIN ONE OF FIVE$200 PRIZES,EVEN IF YOU DO NOT
QUALIFY TO JOIN THE PANEL.
a
N POWER MONEY MARKET ACCOUNT HOWARD F MILLER
TITLE GEOFFREY G MILLER
N
O
ACCOUNT NO. 15004225781639 STONEHEDGE
INTEREST EARNED FOR STATEMENT PERIOD $1.29
0
ACCOUNT SUMMARY
SEGINNING DEPOSITS&OTHER WITHDRAWALS& CURRENT ENDING
ALA EREDI + OTHER DEBITS - -........INTEREST P D SALAN
N MO AMOUff
$30,544.40 0 $0.00 0 $0.00 $1.30 $30,545.70
ACCOUNT ACTIVITY
POSTING DEPOSITS&OTHER WITHDRAWALS& DAILY
DATE TRANSACTION DESCRIPTION CREDIT + 03 ER DEBITS - BALANCE
08/09/2014 BEGINNING BALANCE $30,544.40
09/08/2014 INTEREST PAYMENT $1.30 30,545.70
ENDING BALANCE $30,545.70
ANNUAL PERCENTAGE YIELD EARNED=0.04%
PAGE 2 OF 2
M&T Bank
FOR INQUIRIES CALL: (800)724-2440 �� ACCOUNT TYPE
M&T MARKET ADVANTAGE
00 0 04345M NM 017
ACCOUNT NUMBER STATEMENT PERIOD
000002965 FIDS1549D01708281408 02 000000
P 15004210919097 MAY.29-AUG.28,2014
1 HOWARD F MILLER BEGINNING BALANCE $188,403.53
S ' 38 NORTH DICKINSON SCHOOL RD DEPOSITS&CREDITS 0.00
CARLISLE PA 17015 LESS CHECKS&DEBITS 0.00
INTEREST 14.25
:(ESS':SERVICE CHAR699.': 0.00
EI+�DING BALANCE '; , $188,417.78
INTEREST EARNED FOR STATEMENT PERIOD $14.24 STONEHEDGE
INTEREST PAID YEAR TO DATE $37.79
ACCOUNT SUMMARY
BEGINNING DEPOSITS&OTHER WITHDRAWALS& CURRENT ENDING
BALANCE CREDITS + THE8 DEBITS - INTEREST PAID BALANCE
NO. I AM UNT NO. I AMOUNT
$188,403.53 0 $0.00 0 $0.00 $14.25 $188,417.78
i ACCOUNT ACTIVITY
POSTINGDEPOSITS&OTHER WITHDRAWALS& DAILY
DATE TRANSACTION DESCRIPTION CREDITS + OTHER DEBITS - BALANCE
05/29/2014 BEGINNING BALANCE $188,403.53 ..
S 06/27/2014 INTEREST PAYMENT $4.64 188,408.17
x 07/28/2014 INTEREST PAYMENT 4.80 188,412.97
0
08/28/2014 INTEREST PAYMENT 4.81 188,417.78
ENDING BALANCE $188,417.78
m
0
4 ANNUAL PERCENTAGE Y!ELD EARNED=0.02%
N
PAGE 1 OF 1
L008(6/12)
M&T Bank
FOR INQUIRIES CALL: (800)724-2440 ACCOUNT TYPE
M&T MARKET ADVANTAGE
00 0 04345M NM 017
ACCOUNT NUMBER STATEMENT PERIOD
000001661 FIDS1549D01711281411 06 000000
P 15004210919097 AUG.29-NOV.28,2014
HOWARD F MILLER
BEGINNING BALANCE $188,417.78
' 38 NORTH DICKINSON SCHOOL RD DEPOSITS&CREDITS 0.00
CARLISLE PA 17015 LESS CHECKS&DEBITS 188,419.63
INTEREST 1.85
LESS SERVICE CHARGES 0.00
ENP INO'S A . $0.00
INTEREST EARNED FOR STATEMENT PERIOD $1.85 STONEHEDGE
INTEREST PAID YEAR TO DATE $39.64
ACCOUNT SUMMARY
BEGINNING DEPOSITS&OTHER WITHDRAWALS& CURRENT ENDING
BALANCE REDITS + OTHER DEBITS - INTEREST PAID BALANCE
NO. AMOUNT NO. AMOUNT
$188,417.78 01, $0.00 1F $188,419.63 $1.85 $0.00
ACCOUNT ACTIVITY
POSTING TRANSACTION DESCRIPTION DEPOSITS&OTHER WITHDRAWALS& DAILY
DATE CREDITS + OTHER DEBITS BALANCE
08/29/2014 BEGINNWG BALANCE $188,417.78
09/10/2014 INTEREST PAYMENT $1.85
09/10/2014 CLOSEOUT $188,419.63 0.00
ENDING BALANCE 0.0
ANNUAL PERCENTAGE YIELD EARNED=0.02%
WE WOULD LIKE TO INTRODUCE THE M&T BANK OPINIONS PANEL,AN EXCITING RESEARCH
COMMUNITY OF M&T BANK CUSTOMERS LIKE YOU.
AS A PANEL MEMBER,YOU WILL HAVE OPPORTUNITIES TO PARTICIPATE IN VARIOUS SURVEYS
TO HELP US IMPROVE OUR SERVICES.TO SEE IF YOU QUALIFY TO BECOME A PANEL MEMBER,
VISIT WWW.MTB.COM/PANEL TO COMPLETE A PANEL QUALIFICATION SURVEY.
AFTER YOU COMPLETE THE SURVEY,YOU WILL HAVE AN OPPORTUNITY TO ENTER A
SWEEPSTAKES FOR A CHANCE TO WIN ONE OF FIVE$200 PRIZES,EVEN IF YOU DO NOT
QUALIFY TO JOIN THE PANEL.
PAGE 1 OF 1
LOOS(6112)
No. B -135518
A. PA TITLE NUMBER(AS SHOWN ONATTACHED TITLE) MAKE OF VEHICLE MODEL YEAR
PURCHASE PRICE
197(9 (See Note on Reverse.) ` S
rW C VEHICLE IDENTIFICATION NUMBER CONDITION
O GOOD ,FAIR O POOR LESS TRADE-IN
LAST NAME JOR FULL BUSINESS NAME) FIRST NAME MIDDLE NAME
//e J O g TAXABLE AMOUNT _
y CO-SELLER /
r �Q/� `j,(�/j!r 1.SALES TAX DUE
X s%(.oe),X»(.07)OR
C LAST NAME(OR FULL BUSINESS NAME) FIRST NAME MIDDLE AME PA OUPHOTO iD# DATE OF BIRTH X moll} 2
�- // c j f OR BUS.ID# *(See Note on Revere..)
s j_X1 /)1(�C S ISAA AI JA M e 4 'I I J 69 1" y 1 7 73 REASON CODE(must
O CO-PURCHASER LAST NAME FIRST NAME MIDDLE AME PA DUPHOTO ID# DATE OF BIRTH be a number from 1 to
23or0
18.FIRST - 18.SECOND.
STREETASSIGNMENT, ASSIGNMENT
o EXEMPTION NO. EXEMPTION NO.
14
its Oc,✓:. rnetit lava '
2. TITLE FEE v�I
CITY STATE ZIP CODE DATE PURCHASED
EDI
PURCHASED REFER TO COUNTY CODES
C tG;r k 5 IS,1-A M I �Aj2qjj i G f(! LISTING ON REVERSE SIDE
7 OF YELLOW COPY 3. LIEN FEE
D LAST NAME(OR FULL BUSINESS NAME) FIRST NAME MIDDLE NAME PA DUPHOTO ID# DATE OF BIRTH
OR BUS.ID#
4. REGISTRATION OR
CO-PUR HAS R LAST NAME FIRST NAME MIDDLE NAME PA DL/PHOTO ID# GATE OF BIRTH PROCESSING FEE
w FEE EXEMPT NUMBER
AS ASSIGNED BY THE
DEPARTMENT
CK
r
OUNTY CODE S. DUPLICATE REG,
0 r FEE NO.OF
CARDS_`
CITY STATE ZIP CODE DATE ACQUIRED/
PURCHASED REFER TO COUNTY CODES 6. TRANSFER FEE
LISTING ON REVERSE SIDE
OF YELLOW COPY
E. MAKE OF VEHICLE VEHICLE IDENTIFICATION NUMBER T. INCREASE FEE
u90
MODEL YEARBODY TYPE(CP,TK,ETC.) CONDITION 8. REPLACEMENT FEE
O GOOD 0 FAIR O POOR
TOTAL PAID
F. L7 PLATE TO BE ISSUED BY TRANSFER OF PREVIOUSLY ISSUED PLATE (ADD t THRU A)
DEPARTMENT(PROOF OF 0 TRANSFER&RENEWAL OF PLATE
INSURANCE MUST BE 0 TRANSFER&REPLACEMENT OF PLATE 11.GRAND TOTAL SEND ONE CHECK INATTACHED.
O EXCHANGEPLATETO BE O TRANSFER OF PLATE&REPLACEMENT OF STICKER (ADD 9&10) THIS AMOUNT Lc ! r
ISSUED BY DEPARTMENT
0 TEMPORARY PLATE ISSUED PLATE NO. - REASON FOR REPLACEMENT
BY FULL AGENT(Note:This O LOST O DEFACED 0 STOLEN O NEVER RECEIVED(Lost in Mail)
ppC� plate will expire 80 days from EXPIRES Month J Year NOTE: If"NEVER RECEIVED'block IS checked,applicant must complete Form MV-44.
r0 date of issuance.) TRANSFERRED FROM TITLE NO. VIN
7-?,1e 7
- SNATURE OF PERSON FROM O SIGN HERE RELATION IP TO APPLICANT
TEMP.PLATE NO PLATE IS BEING TRANSFERRED(IF
4 OTHER THAN APPLICANT
VEHICLE PURCHASED WEIGHT VWR 4. UNLADEN WE GHT REQ.REG.GROgS WT. GROSS B.Wt
INFORMATION IF APPLICABLE V INCLUDING LOAD r 7 IF APPL{CABLE
}N$ NC COMPANY N M POLICY NO.(OR U C Y� POLICY EFFECTI E t D�E Y EXPIRATION
14
01- O ATTACH BINDER �L G f�'Z� L � l7 DATE
I CERTIFY THAT ON MONTH 11^ DAY f4 YEAR ISSUINgGAGE(,IT(PRINT NAME) AGENT NO.
ISSUING I HAVE CHECKED TO DETERMINE THAT THE VEHICLE IS INSURED ANDi'` ►}r'► -!Jv
AGENT ISSUED TEMPORARY REGISTRATION TO THE ABOVE APPLICANT,IN
INFORMATION COMPLIANCE WITH ALL APPLICABLE PROVISIONS OF THE VEHICLE ISSUING AGENT SIGNATU TELEPHONE NO.
CODEAND DEPARTMENTREGULATIONS. [ O Ic7i7w,/3
IIWE CERTIFY THAT IIWE HAVE EXAMINED AND SIGNED THIS APPLICATION AFTER ITS COMPLETION.I _ FURTHER CERTIFY THAT ALL STATEMENTS HEREIN ARE TRUE AND CORRECT AND
MAKE APPLICATION FOR CERTIFICATE OF TITLE FOR THE VEHICLE DESCRIBED IN SECTION A.IF ANY VXEMPTION IS CLAIMED,THE PURCHASER FURTHER CERTIFIES THAT HE/SHE IS
AUTHORIZED TO CLAIM THIS EXEMPTION.INYE ACKNOWLEDGE THAT IIWE MAY LOSE MY/OUR OPERATING PRIVILEGE(S)OR VEHICLE REGISTRATION FOR FAILURE TO MAINTAIN FINANCIAL
RESPONSIBILITY ON THE CURRENTLY REGISTERED VEHICLE FOR THE PERIOD OF REGISTRATION.VWE ACKNOWLEDGE THAT UWE MAY BE SUBJECT TO A FINE NOT EXCEEDING$5,000 ANC
aaa IMPRISONMENT OF NOT MORE THAN TWO EARS FOR Y FALSE STATEMENT THAT IIWE MAKE ON THIS APPLICATION.
IST Sign ur Purch r or uthorized Sign Telephone No.
-ASSIGN.
MENT atureof Co-Purchaser of Authori igner (IS�1 Z' i y
r� L+
2ND Signature of Second Purchaser or Authorized Signer Telephone No.
ASSIGN-
MENT Signature Of o- urchaser e of AuthorizedSigner ( )
H. z NOTE: IF A CO-PURCHASER OTHER THAN YOUR SPOUSE IS LISTED AND YOU WANT THE TITLE TO BE LISTED AS"JOINT TENANTS WITH RIGHT OF SURVIVORSHIP"(ON DEATH OF ONE
C
OWNER,TITLE GOES TO SURVIVING OWNER.)CHECK HERE 0. OTHERWISE,THE TITLE WILL BE ISSUED AS'TENANTS IN COMMON"(ON DEATH OF ONE OWNER,INTEREST OF DECEA
OWNER GOES TO HIS/HER HEIRS OR ESTATE.)
NOTE: IF THE VEHICLE IS TO BE USED ASA DAILY RENTAL OR LEASED VEHICLE,CHECK THIS BLOCK 0. IF BLOCK IS CHECKED.COMPLETE AND ATTACH FORM MV-1L.
MESSENGER NO.
1.BUREAU OF MOTOR VEEHIr.1 1=5'
No. B735547
PA TITLE NUMBER(AS SHOWN ON ATTACHED TITLE) MAKE OF VEHICLE MODEL YEAR
` + �IF PURCHASE PRICE
U,N LI)G L."710 Sry C� fi� L f a ? (See Nota on Reverse.)
C Q t
z VEHICLE IDENTIFICATION NUMBER CONDITION
te
1173& O GOOD O FAIR )I POOR LESS TRADE-IN
B.Iz LAST NAME(O LILL BUSINESS NAME) FIRST NAME MIDDLE NAME
Lu it I'1G�,_ d +� TAXABLE AMOUNT
tu CO-SE ( tt
r ( G.+ Er'n.s :7'E_ ';, t. SALES TAX DUE
X 6%(.06),X 7%(.07)OR
`" LAST NAME 10)FULL BUSINESS NAME) FIRST NAME MIDDLE NAME PA DWPHOTO ID# DATE OF BIRTH Xa%(.0S) -
OR BUS.ID# y '+t(See NMe on Rovgso.)
f t 3r1 f�•. ! rIC..+� `mat i;` '(/"f j 11A. EXEMPTION
REASON CODE(must
CO-PURCHASER LAST NAME FIRST NAME MIDDLE NAME PA DL/PHOTO ID# DATE OF BIRTH -.be a number From 1 to
2 w _ 23or0
16.FIRST 118.SECOND
- ASSIGNMENT ASSIGNMENT
STREET r COUNTY CODE EXEMPTION NO. EXEMPTION NO.
2.TITLE FEE Ly
CITY STATE ZIP CODE DATE ACQUIRED/ _ 'w/ "
PU HASE REFER 70 COUNTY CODES
,. LISTING ON REVERSE SIDE
OF YELLOW COPY 3.LIEN FEE -
D LAST NAME(OR FULL BUSINESS NAME) FIRST NAME MIDDLE NAME PA OUPHOTO IDN DATE OF BIRTH
OR BUS.ID#
b. REGISTRATION OR
PROCESSING FEE
F
CO-PURCHASER LAST NAME FIRST NAME MIDDLE NAME PA DL/PHOTO 109 DATE OF BIRTH --
W FEE EXEMPT NUMBER
_ AS ASSIGNED BY THE
DEPARTMENT
STREET COUNTY CODE
rr a S. DUPLICATE REG.
FEE NO.OF
NCARDS-„_. .
CITY STATE ZIP CODEJ DATE ACQUIRED/
PURCHASED REFER 7O COUNTY CODES 6. TRANSFER FEE
LISTING ON REVERSE SIDE
OF YELLOW COPY
E. MAKE OF VEHICLE VEHICLE IDENTIFICATION NUMBER T.INCREASE FEE
lu Q
luWg
a MODEL YEAR BODY TYPE(CP,TK,ETC.) CONDITION
h &. REPLACEMENT FEE
0 GOOD D FAIR O POOR
TOTAL PAID $• 10.
C7 PLATE TO BE ISSUED BY 'TRANSFER OF PREVIOUSLY ISSUED PLATE (ADD 1 THRU&) J i,..+
DEPARTMENT(PROOF OF O TRANSFER&RENEWAL OF PLATE
INSURANCE MUST BEd TRANSFER&REPLACEMENT OF PLATE 11.GRAND TOTAL SEND ONE CHECK IN
4/S
ATTACHED.) (ADD$&10) THIS AMOUNT -'>7
I G!
C? EXCHANGE PLATE TO BE O TRANSFER OF PLATE&REPLACEMENT OF STICKER
ISSUED BY DEPARTMENT PLATE NO ,. REASON FOR REPLACEMENT
C.7 TEMPORARY PLATE ISSUED Q LOST O DEFACED C)STOLEN O NEVER RECEIVED(Lost M Mail)
BY FULL AGENT(Note:Thist .
aa plate will expire 90 days from EXPIRES Month '"'�. Year t NOTE: If*NEVER RECEIVED'block is chocked,applicant must complete Form MV-44.
O=, date of Issuance.) - - - -
u.0 TRANSFERRED FROM TITLE NO.
Q 9 SIGNATURE OF PERSON FROM WHOM SIGN HERg,- R TIO SHIP TO APPLICANT
w TEMP.PLATE NO. PLATE IS BEING TRANSFERRED(IF ,x' - /�,,�;,,�
a ff OTHER THAN APPLICANT
a UNL �EJ, tiTNLIGrLASC"VEHTNHFSEDWLIGHTay� INCLUDING
r � Css GO B.WTINFOCMIOABLE) F IE .
INSURANCE COMPANY NAME POLICY NO.(OR POLICY EFFECTIVE POLICY E)(P-IBATION
ATTACH BINDER) DATE DATE
I CERTIFY THAT ON MONTH DAY '` YEA -t ISSUING AGENT(PRINT NA AGE +, pry
ISSUING I HAVE CHECKED TO DETERMINE THAT THE VEHICLE IS INSURED AND 1 f I JT/9 �D I�'r"Y'�`r C/ t) #.
AGENT ISSUED TEMPORARY REGISTRATION TO THE ABOVE APPLICANT,IN TELEPHONE NO
ISSUING AG SIGNA .
INFORMATION COMPLIANCE WITH ALL APPLICABLEPROVI510NSOF7HEVEHtCLE
CODE AND DEPARTMENT REGULATIONS.
G. [ME CERTIFY THAT IANE HAVE EXAMINED AND SIGNED THIS APPLICATION AFTER ITS COMPLETION.VUVE FURTHER CERTIFY THAT ALL STATEMENTS HEREIN ARE TRUE AND CORRECT AND
MAKE APPLICATION FOR CERTIFICATE OF TITLE FOR THE VEHICLE DESCRIBED IN SECTION,A..IF ANY EXEMPTION IS CLAIMED,THE PURCHASER FURTHER CERTIFIES THAT HE/SHE IS
_ AUTHORIZED TO CLAIM THIS EXEMPTION.IANE ACKNOWLEDGE THAT IN; MAY. OSE Uk OPERATING PRIVILEGE(S)OR VEHICLE REGISTRATION FOR FAILURE TO MAINTAIN FINANCIAL
Z RESPONSIBILITY ON THE CURRENTLY REGISTERED VEHICLE FOR THE PE IOD F ISTRATION.i KNOWLEDGE THAT IAVE MAY BE SUBJECT TOA FINE NOT EXCEEDING$5,000 AND
O IMPRISONMENT OF NOT MORE THAN TWO YEARS FOR ANY FALSE STAT E BANE O APPLICATION.
t IST Signature of first Purchaser or Authorized Signer Telephone No,
ASSIGN, (�J7
MENT Signature of Ca PurchaserlTiile of Authorized Stgnar
ur
tl
2ND Signature of Second Purchaser or Authorized Signer Telephone No.
ASSIGN-ASSIGN-
MENT gnature o u aser e o ut or- igner ( )
H., NOTE:NOTE: IF A CO-PURCHASER OTHER THAN YOUR SPOUSE IS LISTED AND YOU WANT THE TITLE TO BE LISTED AS'JOINT TENANTS WITH RIGHT OF SURVIVORSHIP'(ON DEATH OF ONE
z u+F OWNER,TITLE GOES TO SURVIVING OWNER.) CHECK HERE O. OTHERWISE,THE TITLE WILL BE ISSUED AS-TENANTS IN COMMON-(ON DEATH OF ONE OWNER,INTEREST OF DECEASI
E OWNER GOES TO HISIHER HEIRS OR ESTATE.)
a NOTE: IF THE VEHICLE IS TO BE USED ASA DAILY RENTAL OR LEASED VEHICLE,CHECK THIS BLOCK O. IF BLOCK IS CHECKED,COMPLETE AND ATTACH FORM MV-1L.
Z
MESSENGER NO.
3.APPLICANT'S COPY f TEMPORARY REGISTRATION(VALID FOR 90 DAYS)
MASSACHUSETTS GENERAL PATIENT NAME. ACCOUNT No.'
II l PHYSICIANS ORGANIZATION HOWARD F MILLER 5104377
P.O. Box 3864 AMOUNT aUE AMOUNT PAID DUE 13ATE BILL I
Boston, MA 02241-3864 129.00 11/24/2014 11/03/
to na; YO-11f biN OrNax;.a;;l,r,n O,c::;rOnie check or a credit card,
plots-y0 to;:_r�,halicntretc;r;�i„mg
t,•lake checks;,;}•ab c co'MASSACHUSEI TS GENERAL PHYSICIANS ORGANIZATION
To contact Customer Service,please ca11617.726.2040.
HOWARD F MILLER 3372
44 WELLESLEY DRIVE Mass. General Physicians Org., Inc.
BEDFORD,NH 03110-4531 P.O. Box 3864
l�rNlilul��l����I��d���llllllill�i��l��1�w���l�li�l�I���I� Boston, MA 02241-3864
7 5104377010300012900
BILLING ID: 510437701
PATIENI"NAME: HOWARD F MILLER ACCOUNT NUMBER: 5104377 PAGE
DESCRIPTIONOF
ADJUSTMENTS 0
05/15/2014 ULTRASOUND PELVIS BILL PROVIDER 129.00
SACKNOFF MD,RI
VISIT PROVIDER
AMORNSIRIPANIT
06/02/2014 MEDICARE PAYMENT 0.00
SERVICES NOT COVERED
06/23/2014 AETNA/US HEALTHCARE PAYMENT t 0.00
NON-COVERED CHARGES i
J
I
f
t
i
r !
s
The MGPO has not received a response from your insurer for some/all of
these services. Please send payment to the MGPO and obtain reimburseme t
from your insurer per the policy on the back of this istatement
(Section II-Insurance information) .
I
11/03/2014 129.00 0.00 too
yFt MESSIAH
Form P8=
ewa sLfy, Q
G
ADULT DAY
100 MT.ALLEN DRIVE,MECHANICSBURG,PA 17055 ID#-- I UNIT STMT. DATE
571281 08131/2014
NAME(S)
GEOFFREY MILLER HOWARD MILLER
38 N. DICKINSON ROAD
CARLISE, PA 17015 TOTAL AMOUNT DUE $61.00
DATE DUE 09/30/2014
*13'0 NOT PAW.-Total .amount due will be electroni ally withdrawn from your bank account on 912212014. 'DONOTPAY,
DATE DESCRIPTION RATE Days/ CHARGES CREDITS BALANCE
U
00/00/00 Balance Forward PRIVATE 591.0
08/20/14 PAYMENT RECEIVED -THANK YOUI 591.00 0.0
09/04/14 PVT LEVEL 2 -CARLISLE 61.00 61.0
Amount Billed to PRIVATE 61.0
U� �l
ire
Please contact our office to inquire about our electronic funds transfer program. This Page 1
eliminates the need for you to send us a check each month for your statement balance.
ID# CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT DUE
571281 61.00 0.00 0.00 0.00 0.00 $61.00
NAME HOWARD MILLER Form Ps-&
Please make check payable to Messiah Lifeways COMMUNITY SUPPORT SERVICES/ADC.
A 1%finance charge may be assessed if balance is not paid by the due date.
f you have questions or concerns about your statement,please address them directly to Fiscal Services at(717)790-822