HomeMy WebLinkAbout01-0120
Estate of NO;e.MA
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
No. :1../- (5 1- I 20
To:
~. (v(' Ll-E.fL..
Register of Wills for the
, Deceased. County of c..UM.?>{3Z1..-A).11 in the
Social Security No. I t:1 f -I (p -/ () q('l Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executf'o j ~
in the last will of the above decedent, dated
and codicil(s) dated A vl V'3+ 1/ 1Cf71
named
,19_
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in CJfY\.bp....rlt'>.~ County, Pennsylvania, with
her last family or principal residence at c;..,Z 2..- V ~ <=) ~ c- fZ~~
EAST PENNSRORO TWP. ~AO'(c.,..' r~... I ::our
(list street, number and muncipality)
Decendent, then
at ENOLA P A
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
77
years of age, died
IfiR/O(
.
, 19
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
/, D 6 D
$
$
$
$
-0-
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters ~S+c. ~)
(testamentary; adm{nistration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA I ss
COUNTY OF Y.J'J.L ~ . J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
~~~~.
/If;-yfl- (,
Sworn to or affirmed and
before me tl}.is- '2--(p ~
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This is to certifY that the information here given is correctly copied fro~ an original certificate of death dul~ filed with
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filll1g.
me as
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~~d~
Fee for this certificate, $2.00
p
7174213
JAN 0 8 2001
Date
143 Aev, 2187
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT (FirM, MidcIe. u.)
..
AGE (L..1li<1Mey)
UHOEA' YEAR
- ~
NO/l.ma S.
UNDEIl , IIIll'
-1-
ftli.lle/l.
ORE OF IIIRTH
(MonIh, ~, _,
BIRTHPL.ACE (COy_
Stale or FOIIlgr'i Counuy)
SWE FILE NUMBER
SEX SOCIAL SECURITY NU"'BER DIiTE OF DEliTH ''''onIh, Ca,. '_I
J. Female 3.198 - 16 -1030 .. 1/6/01
Pt.ACE OF DEATH (Check onIv ooe ... lnatructlOOS 00 othef w;ie)
HOSPITAL: OTHER:
,_ 0 EAlOuIpotienl 0 DCA 0 ~ 0 ~,O
79 Yro.
'Pa
COUNTY OF DEIiTH
922 Valley
... cnola, 'Pa
FRHEA'S NAME (Fll'st. Middle. Last)
...
INFORMANT'S NAME (T,pelPrinIl
S-t.
17025
A/l.nold
17b.
Did
-
~in.
C/Jmbp//l ann 1oWnIhlp? '7d.o :':",,"=,,=ol
MOTHER'S NAME (First, Middle, Maiden Surname)
... cmi.ly Shewan
INFOR"'ANT'S MAlUNO AIlIlRESS (SIreol. Cit>i/lOwn. Slate, z;P CaMI
2 . 922 Valle S-t., cnola, 'Pa 17025
PlACE OF DISPOSITION. N..... ol CemoIory. Cr_ LOCRlON . City/1\Jwn. SIMe. ;z-'" ~
or Other ptac.
MARITAl SWUS. Married
N_Montod. -.
~(Spocdy)
,.. Wi.dow
'7c.lX! .....__in Caod-t
RACE ._,-..-. WhiI.. ....
(Spac.Iy)
10. WhLte
SURVIVING SPOUSE
(II wH. give tnaICMrl nwne)
Cumbe/l.land
1c.C.
'Pennodbo/l.o ~922 Valle St.,
KINO Of BUSINESS/INDUSTRY 'MS DECEDENT EVER IN
US. ARMEDFORCES7
....0 NoI8l
'Pa
17.. Stat.
'I.
'Pennodbo/l.o
.....
-
Shephe/l.d
N.
oanne ftli.LLe/l.
METHOD OF DISPOSITION
s..n.XJl' Cr_1on 0 _vol 'rom SIal. 0
0Ih0r (Speedy'
an 10 2001
LICENSE NU...BER
22b.F. D. 011897 L
To the b.- 01 my know.... death occurred at the lme, dat. and pIactI Slale(t
(Signeture and Tillie)
21C.
Hol
C/l.Oodod Cemete/l.
NAME AND AOORESSOF FN;lUTY
22C.Sulli.van F.H. ,51N.
LICENSE NU"'BER
2'd. Ha/l./l.i.od bu/l.
'Pa
cnola 'P
J3a.
TIME OF DEliTH OIiTE PRONOUNCED DEAD (Month, Do" _,
24. 6:10 'P. ....25. 1/6/01
27. MAT I: Enter 1M di....... tnjurles or compHc:aliOna which caused lhe dealh. 00 not enter 1M mc:JCM of Uying, such IS cardiac or reapiralOry arrest shock or hearl laMe.
U. onty one ell.... on HCh lintl.
21.
'-.-
l=--=
I
I J~ (nO
PART II:
OIIlorsign___......-.a 10 _.....
noI mulling in..... und8ItyIng cawe g;.,.n in PART I.
..
~~c.....c. o.rc..i nC
OUE 10 (OR AS A CONSEOUENCE Of):
""""--
lb.
e.
d
DUE 10 (OR AS A CONSEOUENCE OF):
OUE 10 (OR AS A CONSEOUENCE Of):
WERE AU10PSY FINDINGS MANNER Of DEATH
-.....eu: PRIOR 10
COUPLImONIY CAUSE ~ 0
OF llEArH7 ...... Homicide
-- P.-.g "'-;gat1On 0
Nolt _0 NoD - 0 Coukt not be delenniMd 0
0IiTE OF INJURY
(""""'.0&,._'
TIME OF INJURY
INJURY liT WORK? DESCRIBE HOW INJURY OCCURRED.
.... 0 NoD
....
~/Pi,~/I
v'kJ)
__ Jib.
ClllTIFIIR ICh_ _ onel
.c&Jn1PV1NQ PHYSICIAN (Physoan certJfying cause of death when anOCher physician has pronounced death ana canp6eled tlem 23)
To........otmyknowledge....aU1occurredclueto....cauM(.)andmannerHIllat8'CI.... ...,...,...,.........,."...".............
H.
PlACE IY INJURY. AI hom.. Iann. _. fOClOfy._
_Ole. (Spocol,)
_.
.PAONOIINClNO AND-CEATWVINQ PHYSIaAN (PhYSICI8n bath pronouncll1g deaIh and certlfyll'lQ 10 cause 01 dealh)
Totne a..totm.,knowledge. deathoccUf'f'eldallhe time. dllte, and pI~. and due to theClluM(.) and mann......tal8d. , ,.......................
.MEDlCAl EXAMINER/CORONER
On the.... oI..amfnatkK\ .neIIOf' inv.allgation. In my opinion. de.th occurr.d at the time. dat.. .nd pi..... and due to th. uuM(a) and
manner.. stated.. .. . ... .. .... .. .. .. ..... . . .. .......... .. . .. .... ......... ..... . .. . . ........, .......... ... , ..... ...
31.. ,.
REGI
o
21-01-120
LAST WILL AND TESTAMENT
OF
NORMA S. MILLER
I, NORMA S. MILLER, now of 922 Valley Street, Enola,
Cumberland County, Pennsylvania, declare this to be my Last will
and revoke any Will or Codicil previously made by me.
ITEM I: I direct that all expenses of my last illness
including my gravemarker and perpetual care shall be paid from my
residuary estate as soon as practicable after my decease as part
of the expense of the administration of my estate.
ITEM II: I devise and bequeath all of my estate of
every nature and wherever situate to my daughter, N. JOANNE
MILLER, providing that she shall survive me by thirty (30) days.
ITEM III: Should my daughter, N. JOANNE MILLER,
predecease me or die on or before the thirtieth (30th) day
following death, I devise and bequeath all of my estate of every
nature and wherever situate in equal shares, share and share
alike, to my brother and my two sisters, or the survivors of
them:
(a) EDWARD V. SHEPHERD, now of 5 Forest View Drive,
RR #1, O'Fallon, Missouri, 63366;
(b) SHIRLEY DOLSON, now of 2460 Heron Terrace,
#E101, Clearwater, Florida, 34622; and
(c) JEAN S. SNELL, now of 351 Oak Drive, New
Cumberland, Pennsylvania, 17070.
ITEM IV: In writing this Will, I acknowledge my son,
DONALD P. MILLER, however, I make no devise or bequest to him,
understanding the unequal distribution between my children which
will result from this.
ITEM V: I appoint my daughter, N. JOANNE MILLER,
Executrix of this, my Last will. In the event that my daughter,
N. JOANNE MILLER, fails to qualify or is unable to serve as
Executrix of this, my Last Will, I appoint HARRISBURG BELCO
FEDERAL CREDIT UNION, or its successor as Executor of this, my
Last will. In the event that the HARRISBURG BELCO FEDERAL CREDIT
UNION, or its successors, does not have the authority to act in
its corporate capacity as Executor of this, my Last Will, then I
appoint the MANAGER of the HARRISBURG BELCO FEDERAL CREDIT UNION,
in his capacity as MANAGER, or his designee, as Executor of this,
my Last Will.
IN
{5 t- day of
WITNESS WHEREOF, I have hereunto set my hand this
~ ' 1991.
N~ ~(~~LLl )/) ~~4t)
The preceding instrument, consisting of this and two
(2) other typewritten pages, identified by the signature of the
Testatrix, NORMA S. MILLER was on the day and date thereof
signed, published and declared by NORMA S. MILLER, the Testatrix
therein named, as and for her Last Will, in the presence of us,
who, at her request and in her presence and in the presence of
each other, have subscribed our names as witnesses hereto.
/8iLP~
of ~rq.
~'~,~zI/J. ~Itt<
of
I:h J~ A..>J t7A!cG~
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF DAUPHIN
I, NORMA S. MILLER, the 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; and that I signed it
willingly and as my free and voluntary act for the purposes
therein expressed.
Sworn to or affirmed and acknowledged before me by
NORMA S. MILLER, Testatrix, this I~f- day of , 1991.
"""<'d/~JI?L ~:
NO.J::.. S. MILLER
th~\-~t-
)/1 ~.J
(^~jj~
Not ry Publl.c " ."'
NOT ARIAl SEAL
CYNTHIA LOU MYERS, Notary Public
Harrisburg, Dauphin County, Pa. "
My Commission Expires Sept. 7, 199~1
COMMONWEALTH OF PENNSYLVANIA
55.
COUNTY OF DAUPHIN
WE, the undersigned witnesses, whose names are signed
to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw
the Testatrix, sign and execute the instrument as her free and
voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the Testatrix
signed the will as a witness; and that to the best of our
knowledge, the Testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
Sworn to or affirmed and subscribed before me by the
undersigned witnesses, this "I s.t- day of ~~~ , 1991.
~~-
witness
--
SgA\(4l$.~r({\
Wl.tness
~
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Not ry Public. ·
NOT ARIJ\!. SEAt
CYNTfHA (011' MYERS, Notary PubliC
HarrisDurg, Dauphin County, pa.
MV Commission Expires Sepf. ;, 1992
No. 21-01-120
Estate of NORMA S. MILLER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JANUARY 29, 2001 1~, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated AUGUST 1, 1991
described therein be admitted to probate and filed of record as the last will of
NORMA S. MILLER
and Letters TESTAMENTARY
are hereby granted to N. JOANNE MILLER
'-rrn/)o fl. You/th f?- (] . J1C~~JJ~f~
Register of Wills
FEES
Probate, Letters, Etc. ......... $ 18. 00
Short Certificates( 5) . . . . . . . . .. $ 15.00
~ EXTRA. .P.GS. .4. .. $ 12. 00
JCP $ 5.00
TOTAL _ $ 50.00
Filed . :1.1WVM~. f~." .?9.o.~ . .......... ...
ATTORNEY (Sup. Ct. J.D. No.)
ADDRESS
PHONE
MAILED LETTERS AND ORDERS TO ATTORNEY
1-29-01
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612 Status Report scnJest
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Norma S. Miller
Date of Death: January 6, 2001
Will No.:
2001-00120
Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X
No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: Not Applicable
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes
No
X
b.
The separate Orphans' Court No. (if any) for the personal representative's
account is: NA
c.
Did the personal representative state an account informally to the parties in
interest?
Yes X No
d.
Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report. ~ VI
B ce l~t:::
Nicholas & Foreman PC
4409 N. Front Street
Harrisburg, PA 17110-1709
(717) 236-9391
Supreme Court ID No. 21193
Capacity: Attorney for Estate
Date: Apri12, 2001
-
\ /6 -c206 ~-tb
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
Si
(/
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
BRUCE D FOREMAN ESQ
NICHOLAS & FOREMAN
4409 N FRONT ST
HBG
P A Ul'l.O
04-23-2001
MILLER
01-06-2001
21 01-0120
CUMBERLAND
101
/
Allount Rellitted
REY-1647 EX AFP 112-001
NORMA
S
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE __ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifiv=i5'4j-EX-AFP-n'2=ocff-NCfficE--OF-YNHEifiTANCi-TAX-APPRAisEMENT-,--ALrOWANCi-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER NORMA S FILE NO. 21 01-0120 ACN 101 DATE 04-23-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. JointlY Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts
14. Net Value of Estate Subject to Tax
NOTE:
RECEIPT
NUMBER
AA478170
DISCOUNT (+)
INTEREST/PEN PAID (-)
10.73
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
CHANGED
.00
15,109.55
.00
.00
9,303.68
.00
.00
(8)
7,115.00
12.527.47
(11)
(12)
(13)
(14)
(Schedule J)
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
24,413.23
lQ.647 47
4,770.76
.00
4,770.76
214.68
.00
.00
.00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate
16. Allount of Line 14 taxable at Lineal/Class A rate
17. Allount of Line 14 at Sibling rate
18. Allount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
03 19-2001
(15) .00 X 00 = .00
(16) 4,770..6 X 045 = 214.68
(17) .00 X 12 = .00
(18) .00 X 15 = .00
(19)= 214.68
AMOUNT PAID
203.95
F
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
OFFICIAL USE ONLY
IGo - ;2oC,-~
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FILE NUMBER
621 0\ 1010
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
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COUNTY CODE
YEAR
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DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INITIAL)
MILLER NORMA S.
DATE OF DEATH (MM-DD-YEAR)
01-06-2001
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
198 -
16 -1030
DATE OF BIRTH (MM-DD-YEAR)
06-05-1921
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[i] 1, Original Return
D4,LirnitedEstate
D 6, Decedent Died Testate (Attach copy 01 Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust {Attach copy 01 Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
D 3. Remainder Return (date of death prior to 12.13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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NAME
Bruce D Foreman
FIRM NAME (II Appticable)
Es uire
COMPLETE MAILING ADDRESS
4409 North Front Street
TELEPHONE NUMBER
Harrisburg.! .PA
17110
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(1)
(2)
(3)
(4)
(5)
OFFICIAL USE ONLY
$15,109.55
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. JoinUy Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1)
(9)
(10)
7,115.00
12.527.47
9,101 6B
(6)
(7)
(8)
$24,413.23
11. Total Deductions (total Lines 9 & 10)
(11)
(12)
(13)
1Q h.d? .47
12. Net Value of Estate (Line 8 rninus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (ScheduleJ)
4,770.76
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
4.770.76
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a}(1.2)
x.O_ (15)
x.O_ (16) 214.68
x .12 (17)
x .15 (18)
(19) 214.68
16. Amount of Line 14 taxable at lineal rate
4.770.76
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
200
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
STATE
PI'.
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
$10 71
(2)
Total Credits (A+ B + C)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
ZIP17025
$214.68
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5) 203.95
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5B)
203.95
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes
o
o
uO
...0
o
.0
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;.. ...................................m..
b. retain the right to designate who shall use the property transferred or its income;.. ...........................
c. retain a reversionary interest; or ............................. ....................
d. receive the promise for life of either payments, benefits or care?", .............................................
2. If death occurred after December 12, 1962, 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? ............................ .......................... ..................
No
W
IX]
IX]
IX]
IX]
IX]
.......0 IiJ
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
Urlder perlalties of perjury, I declare that I have examined this retum, including accompanyirlg scl1edules and statements, and to the best of my knowledge and belief, it is true, correct
and complete.
Declaration of preparer other lhan the personal representative is based on all information of which preparer has any knowledge.
DATE
3-07-Dl
17110-1709
North Front street. Harrisburq. PI'.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS 99116 (a) (1.1) (i)].
For dates of dealh on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)).
The statute does not exemot 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the chiid is 0% [72 P.S. 99116(a)(1.2)).
The tax rate imposed on the net value oflransfers to or for the use of the decedent's lineal benelciaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The lax rate imposed on the net vaiue of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(I.3)). A sibling is delned, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
LAST WILL AND TESTAMENT
OF
NORMA S. MILLER
I, NORMA S. MILLER, now of 922 Valley street, Enola,
Cumberland County, Pennsylvania, declare this to be my Last will
and revoke any will or Codicil previously made by me.
ITEM I: I direct that all expenses of my last illness
including my gravemarker and perpetual care shall be paid from my
residuary estate as soon as practicable after my decease as part
of the expense of the administration of my estate.
ITEM II: I devise and bequeath all of my estate of
every nature and wherever situate to my daughter, N. JOANNE
MILLER, providing that she shall survive me by thirty (30) days.
ITEM III: Should my daughter, N. JOANNE MILLER,
predecease me or die on or before the thirtieth (30th) day
following death, I devise and bequeath all of my estate of every
nature and wherever situate in equal shares, share and share
alike, to my brother and my two sisters, or the survivors of
them:
I
I
I
(a) EDWARD V. SHEPHERD, now of 5 Forest View Drive,
RR #1, O'Fallon, Missouri, 63366;
(b) SHIRLEY DOLSON, now of 2460 Heron Terrace,
#E10l, Clearwater, Florida, 34622; and
(c) JEAN S. SNELL, now of 351 Oak Drive, New
Cumberland, Pennsylvania, 17070.
ITEM IV: In writing this Will, I acknowledge my son,
DONALD P. MILLER, however, I make no devise or bequest to him,
'. .
_'"'____._'_...c..__.-~__'"___^~_~__.,_"~_"_~.,__;.;.._"__'__'~"'__'_.,;.;_"'__
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understanding the unequal
will result from this.
distribution between my children which
----~~---- r
ITEM V: I appoint my daughter, N. JOANNE MILLER,
Executrix of this, my Last Will. In the event that my daughter,
N. JOANNE MILLER, fails to qualify or is unable to serve as
Executrix of this, my Last Will, I appoint HARRISBURG BELCO
FEDERAL CREDIT UNION, or its successor as Executor of this, my
Last will. In the event that the HARRISBURG BELCO FEDERAL CREDIT
UNION, or its successors, does not have the authority to act in
its corporate capacity as Executor of this, my Last Will, then I
appoint the MANAGER of the HARRISBURG BELCO FEDERAL CREDIT UNION,
in his capacity as MANAGER, or his designee, as Executor of this
,
my Last Will.
I S I- day
IN WITNESS WHEREOF, I have hereunto set my hand this
of '~'-'1v,-<lt-, 1991-
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NORMA S. MILLER
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The preceding instrument, consisting of this and two
(2) other typewritten pages, identified by the signature of the
Testatrix, NORMA S. MILLER was on the day and date thereof
signed, published and declared by NORMA S. MILLER, the Testatrix
therein named, as and for her Last Will, in the presence of us,
who, at her request and in her presence and in the presence of
each other, have subscribed our names as witnesses hereto.
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
ss.
COUNTY OF DAUPHIN
I, NORMA S. MILLER, the 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; and that I signed it
willingly and as my free and voluntary act for the purposes
therein expressed.
Sworn to or affirmed and acknowledged before me by
NORMA S. MILLER, Testatrix, this \ S+- day of ffv\.!tFl-Q./t- , 1991.
/ct/~l / ?<- ,..:;; )/I~~C'4~)
NORMA S. MILLER
NOTARL4l SEAL \
CYNTHIA LOU MYERS, Notary Public I
Harrisburg, Dauphin County, Pa.
My Commission Expi res Sept. 7, 199~1
-""'. _~"',''!'l!<.~'>#>..'_.: m ".~~.",,,"",,,,!,:, ');;,"',~'""""",~O!'l',~::!'i'.,,,~"i"(_",.'gIi -. _".,..l:l._ __.
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COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF DAUPHIN
WE, the undersigned witnesses, whose names are signed
to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw
the Testatrix, sign and execute the instrument as her free and
voluntary act for the purposes therein expressed; that each
sUbscribing witness in the hearing and sight of the Testatrix
signed the will as a witness; and that to the best of our
knowledge, the Testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
Sworn to or affirmed and subscribed before
undersigned witnesses, this I <;1- day of ......;:~\9<1-''-,:J-
.'......;)
me by the
, 1991.
f31{M:h~ ~
Witness v
-
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tV\0-\ \,--1 Vt.U.: .
W~tness
'j /'
ft'OTAR!!'.t SEAL
CYNTHIA COtl' MYERS. Notary publie
Harrl'zl~'Jrg, Daupnin County, Pa.
MV' CQmmis~ion Expires Sepf. 1, 199''2
_..::2.",.'....,~"...::~,~:;:.:;;~~~~'''''..
REV.1503 EX + (1-97)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
II~HERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Norma S. Miller
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUM8ER
FILE NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
u.s. Savings Bonds
2.
MFS Investment Management
$1,838.48
$813.04
3.
Main stay Investements
12,458.03
TOTAL (Also enter on line 2, Recapitulation) $ 1 ~ i '(. cJ 9 . 5 5
(If more space is needed, insert additional sheets of the same size)
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Interest Reporting Form ~:: :,:
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Uw lnwl"'ft&l ~ s.rricf ror t.U YMrW_ ,
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. rw,...' .nt:,4dreu:tPl.ut print or t,-.p.lfciblyl
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7 ~J.:,; ~ I~Y ,Sr
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luwrest Earned $-1.. ~ 2 5.!1.B
TazplQ'er' I"~r otPenoo Bed.ee..... Boad.z
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1R-3V. ~.-> ~... PD..
,', REGULATORY REPORTING UNIT COpy
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Investment Summary
INVESTMENT MANAGEMENT
We invented the mutual fund@
Year-to-Date Statement
January 1, 2000 to December 29, 2000
Page 1 of 3
NORMA S MILLER
922 VALLEY ST
ENOLA PA 17025-1541
009662
Dealer
NYLlFE SECURITIES INC
(ADDITIONAL COpy TO NYLlFE)
PO BOX 2465
HARRISBURG PA 17105-2465
Rep Name SCARAZZO
Rep Number 28466
Dealer Branch 00105311V39
1",111",111,,,,,1,1,1,1,,,,11,1,1,,1,,1,,,11,,1,1,,1,111,,,1
Your Account at a Glance
Beginning Value 01/01/2000
Additions
Withdrawals
Change in Value
*Ending Value 12/29/2000
$874.62
$0.00
$0.00
-$61. 58
$813.04
Account Analysis
.
Personal Accounts
Shares
Price Per
X Share
= Value
Earnings /1:,.
Dividends Capital Gains
MFS High Income Fund-A
0018/03550606526
NORMA S MILLER
Total
194.043
$4.19
$813.04
$87.13
$0.00
$813.04
Historical Summary
Summary of activity from January 1, 1990 to present
Fundi Year
Account Number Opened Additions
WIthdrawals
Earnings
Dividends Capital Gains
Personal Accounts
aiFS High Income Funcl~A
G018i03550606526 Pra 1990
$0.00
$0.00
$550.77
~n nn
..........-
*Additions include purchases, transfers and exchanges into accounts. Withdrawals include redemptions, transfers and exchanges out of accounts.
appreciation or depreciation of the investment plus reinvested dividend and capital gain distributions.
Account Retirement Plan
Services Services
1-800-225-2606 1-800-637-1255
8AM-8PMET 8AM-6PMET
Change in Value reflects the
Web site
www.mfs.com
Visit Account Access
Automated
Information
1-800-MFS- TALK
24 Hours a Day
515669
CPl. 000152957
"'FS.."~21CO'.2'l94J900~,28984.l8984.CNS"'FSOLlNV"'F"'__......CPI.".0.,000162967
Year-to-Date Statement
January 1, 2000 to December 29, 2000
Page 2 of 3
Account Activity
MFS account information 24 hours a day
Get online information from MFS Access at WWW.mfS.com. For account
information by telephone, call1-800-MFS-TALK (1-800-637-8255).
Personal Accounts
MFS High Income Fund-A
0018/03550606526
Price
Date
01/31/2000
02/29/2000
03/31/2000
04/2B/2\lOO
05/31/2000
06/30/2000
07/31/2000
08/31/2000
09/29/2000
10/31/2000
11/30/2000
12/29/2000
Activity
Dollar Price Shares this Total
Amount Per Share Transaction Shares Owned
175.274
$7.07 $4.95 1.42B 176 .702
$7.00 $4.9B 1.406 17B.l0B
$7.13 $4.90 1. 455 179.563
$7.20 $4.85 1.485 181.048
$7.17 $4.73 1.516 182.564
$7.24 $4.76 1.521 184.085
$7.19 $4.74 1.517 lB5.602
$7 .40 $4.71 1.571 187.173
$7.45 $4.61 1.616 188.789
$7.44 $4.40 1.691 190.4BO
$7 .46 $4.14 1.802 192.282
$7.3B $4.19 1.761 194.043
194.043
Beginning Share Balance
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Income Reinvested
Ending Share Balance
In January 01 next year, you will receive further information as to the Federal tax status of all distributions paid during the current year.
As agent for the dealer designated by you, MFS Service Center, Inc. (MFSC) as transfer agent confirms this transaction in yoor account.
In this connection, MFS Fund Distributors \ loe., as distributor for tl\e MFS Funds, sold tMm tt} your dealer as principal.
MFS__.62100..~ 1 ~"19006.~II!1l16.~'9116.CNSMFSO' .INVMFM......"CPI ._____OOD' 62961
Cf'1.UU0152967
.
.......
-
.......
-
-
-
-
II MamStay Investments
NORMA S MILLER
I Portfolio Summaryl
Your Total Portfolio Value
as of 03/3112000
$12,897.66
If yoo received a year-end bonus or
raise, MainStay can help you put "the
money you worked to earn" to work for
you. Ask your investment professional
about adding to your Investments or
diversifying your portfolio.
Portfolio Activity Summary
Investment Accounts
MAINSTAY TAX FREE BOND FUND B
Investment Account Subtotal
Total Portfolio
MCS.,.'fi210_, 100~444005.05B61.25'.9_CN5MKS01.INVMMC........MKS....".200fiO&816
Slatement Period
01/01/2000 to 03/31/2000
Page 1 of 2
Quarterly Investor Statement
......................................................................................................
Your Investment JOSEPH V MINNICI . Client Services 1-800-624-6782
Professional NYLlFE SECURITIES INC. . On the Web www.malnstayinv.com
AOD'L COPY TO: NY LIFE
3401 NORTH FRONT ST 1ST FLOOR
HARRISBURG PA 17110-1462
Your Portfolio Allocation
Value on
12/31/1999
$12,488,03
$12,488.03
$12,488.03
Illustrates the portions of your Investment based on asset type.
Asset Type
II'i:I 100% Income Funds
100% Tax Free Bond B
Value on
12131/1999
Change
In Value'
Value on
03/31/2000
$12,488.03
$12,488.03
$12,897.66
$12,897.66
$409.63
$409.63
'Reflects the Impact of share appreciation or depreciation, as well as additional fund purchases (less sales charges paid, if
applicable), redemptions, and reinvested dividends and distributions, if any,
Value on
03/31/2000
$12,897.66
$12,897.66
Change In
Value"
% of
Portfolio
$409,63
$409.63
$409.63
100%
100%
$12,897.66
100%
509406
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lll'6L8'~ ~OP'9 S6'S$ 09'SP$ 8980' IS3^NI3l:l 3~O::lNI
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REV.1506 EX + (1.91)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
N()rm.::l S MillAr
Include the proceeds of I~igation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Belco Community Credit Union Acct. #055770
one-half of account jointly owned with daughter
VALUE AT DATE
OF DEATH
$1,303.68
2.
1997 Buick
8,000.00
TOTAL (Also enteron line 5, Recapitulation) $9,303.68
(If more space IS needed, insert additional sheets of the same size)
r
B.r?-L"....O,
{_L '1v
~Comm/riCC 10 QuaM}' Ser..fCe
HARRISBURG SEIIVlCE TeLEl'HQNE NO: . . . . '-7 I 7-Zl.BELCO
LANCASTER SERVICE TeLE~HONE NO: . _ . 1.717-aaa.I1' 6
CAMP HIll.. SERVICE TeLEPHONE NO: _ _ . _ ,-7'7-72Q-SZ3D
PINNACLE HEALTH SERVCCE TELEPHONE NO:. 1-717-ZlHI301
GETlYS!lURO 5 ERVICE TELEPHONE NO: . 1-717 -:l'l7 -3474
TOLL FREE TE:.EPHOIlE J.:UMBERS:
TcdFrea.
i3el~e Au-:.ornal.~d SEI"l(:O:OS_
\'Vet) Sile . .
BELCO COMMU~ITY CREDIT UNION
r~ArN OFFICE
403 N. 2nd Street . P.O_ Box 82 . Harrisburg, PA 17108
BRANCH OFFlCES
354 N. PnroeStr~et.. SU;le 12.0 " P.O. 8:;))(1026 .. Laf1cas~;'!r. PA 17606
:;.sea TrinC::9 R-?ad .. cawnp Hill. PA 17011
205 S. Flonl S1~,e!lt '. P.O~ ~O~ 8100 . HalriS:!:)u~, PA 17105
S785. "\lIc-ntm".n e,ulevard .. H.-:.rrisburg.?A :11 J2
127Q FaiTf.ala R<>4a . S>A1' 105 . Ge~.buro. PA 173,;
201 GOO(l Dr::v~ .. uncasl.r. PA 17603
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.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Norma S. Miller
FilE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. John C. Sullivan Funeral Home $6,465.00
B. AOMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative {s}
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State lip
Yea~s) Commission Paid:
2. Attorney Fees - Nicholas & Foreman 600.00
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State lip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 50.00
5. Accountanfs Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $7,115.00
(If more space is needed, insert additional sheets of the same size)
JAN-22-01 MON 10:33 AM
FAX NO,
5T A TEMEI'<T
p, 02/15
~Dl1n or. j;ulliU8111lfUllmd 1\ome
111 N. [NO.." CRIYI!
ENOL A., PA. 17025
PHONE 731-11400
JaIl. 16, 2001
:!o(]f/Jte M,UJ.M
922 Valle!/- SUe"-:!;
f-no).a, I'a 17025
196_
T ota). ~.xp".nAe4"
Paym~n~ ~Qcp~ved:
1/16/01
Ba).ancQ
$6465.00
- $1939.50
$"525,50
:JOM
'P./.QUAQ c.a.U i.f. y.ou need omj.tJUng..
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Register Of Wills
Hanover and High Streee
Carlisle, PA 17013
Receipt Date
Receipt Time
Receipt No.
1/30/2001
13:02:15
1024471
MILLER NORMA S
File Number 2001-00120
Remarks NICHOLAS AND FOREMANPC
CW
Transaction Description
PETITION FOR PROBA
SHORT CERTIFICATE
EXTRA PAGES
JCP FEE
Distribution Of Receipt ------------------------
Payment Amount Payee Name
18.00
15.00
12.00
5.00
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
Check# 12486
Total Received.........
$50.00
$50.00
REV.1S12 EX.(1.97)
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
ESTATE OF
Norma S. Miller
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
Verizon
$
AMOUNT
17.70
DESCRIPTION
2.
AT&T
25.73
3.
PPL
129.00
4.
AgWay Energy
346.24
5.
Comcast
2B.37
6.
Note to Belco Community Credit Union
2,726.57
7.
Car Loan to Belco Community Credit union
9,253.B6
TOTAL (Also enter on line 10, Recapllulatlon) $ 1 2 I 527 . 47
(If more space \s needed, insert additional sheets of the same size)
,JAN-22-01 MON 10:33 AM
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Your AT&T Statement
Ikccmber 30, 20110
lIBWNCJrM
11J915D2D256SQ101,l C 490~1^f110 27~B29'A6g9GO
1...111",111"..,\,1,1,1,..,11,1,1"1"1,,,11,,1,1,,1,111.,,I
NORMA 5 MILLEfl
922 VALLEY 5T
ENOlA PA 11025-1541
Summary of durgc,
rreviou~ bal;}nce "...
Paymenl received - Th,1nk you ....,...
AT&. T Lona Uislance Services
A I&T WlUldNol.' S.tvica______
.. ..__... ....__ ...28.62
.......7.6.62
....... ......10.42
. ..............14.95
T01:al amount uue
Dale due
$25.37
January 26, 2001
r, Uq/l b
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CUSIO,".' # 711 732-9794
Pagp. 1 oj 5
Custome, Service: 1 888288-9050
Texl Pllone (TTY): 1 800833-3232
~-;. EXLraII\Xlral
Win a trip 10 the A T& T sponsored
RosF.t Bowl Game in 2002. Visit
~ A TS T site and enler now!
Continued..
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Total (nun /.a.\'ll1i1t
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Billing Details
1I"\",,ro n" or nee 21, 2000
p, 05/15
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Current Charges
Charges ror . I'I'L lJ'I'II.lTmS
R.e~j.dCllli;'il RMc: RS for Nov 21 - Dee :!ol
Dislrihulion Char~e:
CUSl<lIHC1' ('h;lrgc
1[)(J KWH iI! J.i9f,)OOtl!Jc pc, KWH
(,()O KWH ill 1.59401lllooc pcr KWH
1,1fJO KWH ill 1. 172t1tXJOOc pcr KWH
'1'(<lllSI)l is.''iiOIl' Ch.lrgc:
3.0(,1) KWH i11lJ,377000(X)~ pcr KWH
Tr~ltlsi.ti(.)n Chil[gl:~
100 KWH ill 1. 7fJ8()OOIIO"I"~' KWH
6lJ1I KWIl ," 1.594l100UO" pcr KWll
~,160 KWII al L473000UO~ pC< KWH
(Jcllcralion Char!.:..c:
(::'Igaclt~ and Encrs;..f
::lXJ KWIInt 4.M~6000UO~ per KWlI
6UO KWH "I 4.13ROODOOc pcr KWH
1.160 KWH al 3.118C\UllOOOCp"r KWII
!'A T"x Ad.ill.'fI11Cllt Snn'hilf~c nf{U}50000UO%
TOf"II'!'1. lJ'I1UTlF~ Charge"
Your Budgel PI:m Amollnt
^lllOR1"tlc'lliU'l)ay!ui:lllQl"~I"'l{ gi",2001..
Ac~otlnL UalHnce
647
3.59
C),50
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11.54
3.60
9.56
33.19
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$ I 29.1If)
General
Information
Nc~l u1l'lcr
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Jan 1.1
We bilh.'d you
Yl)u-u~ed
At'h.:r lhi:'i payment, YO\lr hlH.t~l i.".i hl:!hind
Blldgl.'t SUI\\I1I:IrY
Sl,~6.',OO
1.491.15
-- 511H:15
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Summary Page
lIalancc a. or ncc 21, 20011
$0.00
Char'l;~s:
'h)lall>I'L UTILl'lIFS Clla'~"s
'I'nl,1I Chal'l!ocs
AlllnllmUc 1111I J'aymcliloi'Jitll1S1'ZOOl
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$ 12~O()
$ 129,00
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$ 12900
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IOn Dee 2t AClUal . 52885
------ ---_.>>--- Nov :2J A-ctu:1l 49825
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TCI1If1l;t:Hurc '131' J2F
KW 11'<, Day 5S 102
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20 lIs< Mo.I" ~
hn 1999 - l)\:c ]999 16W5 134.
(> .1:111 :!OOO . Dee 2000 20764 1730
1).1 FMAMJ J ASliN})
li)\)l) MOll1hs 2000
. _________. ____.-___ .__ ___ ...___ . ..___ _____,..__nu___ .__...______" _ _________h_~________...____..__.,_.'~___n_.'.__.u.__...___._
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JHI~-cc-UI nUN IU;jj Hn
r AX NO,
p, 07/15
IONTHL.Y STATEMENT - 11/15/00 THROUGH 12/14/00
1'11>~1" NORMA MILLER
40.DAY II~~ -- DF.~r.~;;-~~':i
REtJfous 8Al.(NC
'ZiZ VAllEY RD
':~_r:!~ry_ ri~NJ[~~~~~ =e~:~"
ENOLA PA
TAX"MOUK!S ~iRTA~
3lArE l ~~ ''X1~ O.I:E BU\.IW
AMOUNT CHAAGr:D
em. C:1EOtiEO (CR.)
.~- 2ZS.6i---
2/05
2/11
2 FUEL OIL )50.60 1.2"0
AVHENT THANK YOU
nS,63
75.00CR
211~
CHEDUlEU BUDGE
AYt1ENT DUE DAT
PAYt1fHT
0110'11 1
751"
..____,_~____.L__ t. _
r-LEASE PAY M:COAOrN(J TO TEAM:; TO "VOID- F1NI\NCE CHAAG~ on LATE CUAHCE
--"'~iNA.NCE.Ct1^~(i""IiA~[_M[:TH(lD'."~---'w--> -.-"---.-' -.'...
iNANcF r.:IIAIII.C-i'iATEs' -'''CO .r--' ... _:1 (Nl:~~ - - ','p' AY"fNT~D._-~".E.-E ,~ ,,', .JS--,--oo ..,.
1<1NHrlYr'm()lw;'!Alt.'1 "~~h~';-,,;-,t~~7(:~(lr, ACTUAL .", ""'"' 3"'6.2'"
.NN\!AL .'CrlCH_MO. 11M l -, ~~~7r~~T~~~''''~;~'~';.~'~1>I
1IN1MIIMCllfl.f'\Gf_... ." __,~5JL__ r ~
.' AGWAY ENERGY PRODUCTS
. 530 e HQRTH Sf
CARLIsLE PA 17tl-l3~2.:!& ~~i,r~~.;}~~;;,;::;~~~,~'~::"~~"~:~"~i~"'f~~J~,";~rll" --",,-
-!!!~NE.. ?!:?-2"!:!!S8. __ _L02a04.6S "<~~~".;,~'""~"
PT1101 {fit'V 'I'Jf!l
RHA"", 'OR "fOUR lA~ RECORDS
AGWAV ENERGY PRODUCTS
JHWa-UJ nUN JU'j~ Hn
~.,
J@omcast
3800 Trindlo Rd., Suit<> D
F CIlJIlP Hill, P A 17011
Account Name:-
NOlma S Miller
Service Addrc.s:
922 VaUey St
BilliJ>gDat..;
Dc~elIlbor 21,2000
Account Number;
049370S-01
C\l.to~er ~J"Vill'ol
'l17.b40-8900
T.l('pl,ont'o H01111''9
24 Hourn I' D4y
7DIIYlIGWIl'"k
Bnw.ncQ
atBiI1in~
$0.00
H1X NO,
Current
Chnrges
$27.48
Feel'i&
TA1eli
Tot,,}
Alnount nU4l
$0.B9
1mNKYOU FOR PAYING YO(ffi BILL ON' TIME. Y DIU' prompt atcantion jfl o.ppr.d..ted. A '2.00 Jd. ("J.,atge
willloo .pplif'd Qnly ",b..n. payment h recflived I) do,.. ~It yo\l1' Payment ~ Do"". For y_r COo.".ni.Mt, ""I
nQW dCtfIpt n'sulllf 11Id, au~1it .Ollt~ credit eo.rd P~.ut.. direct d~bit (ZipCh,6ek.l Gl'ld MAC for p6)'11lentfl.
a.lnDeOl
U/21
121\1
Curreut ChlU1lea:
12(2)-1/20
T...... _nd: Fear,-
~l-1/20
lZI21-1I20
Prc:v/OUd'Dfll..~.,.. """"" ......., '" n..'."..... .28.37
PIl}'UUUlt.-TiuU<You .............,."..,..... I....'., .28.31 CR
n.laat.ce tlt Billi.ng Dat.e ..... .... ...... ...........,.. ... .......5
ServjCllfl
Sa.u.dQrd.. .
Uuic... .
. ...... .........,.., '...."..,."...,.,., .1$.12
..... ,.,.,.............,. ....,. .'s,76
Toyl Cv,lTtd:lot Cliars.....I. ,.,.....,.,. "" "'" I' I... I"' '...... S
FCCR6lf\l1at.orylo'ee........... ,...... ..,... .0.04
Fraachi~ FfHl.. ............. '" ,..",.... ,..,...... .O.8S
Tobl}.....&T.._ n-._...... ............... I..... .... ,........,...
V.V IlClIOUDt 'lri11 bo c:L.1u'Wod on lIOllIOt.
DONOTPAY~AtrrDMATlCD!:DUCTION ...... .......................,.. 28.37
Effcctivt' JlIn. 1,20&1, WIVE, Cl\lal)VlUwill be. dd.d ta your euLle liDeup.
rCl)nu..lu,,, IIlltl"...ity: tMTPENNtUtO:nO TO'WNfiUJ? at a ENOLA DR tNOt..4,l'A 17025 CUJD' J'ADoI.2G
p, 08/15
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$28.37
0.00
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,AX NU.
P. 15/15
FEDERAL 'rnU'rH-IN-LENDING PISCLOSURE STATEMENT
APPLlCATlON#: MillER 7HIlljO
G-."-_~"-~Rl)rrow(:r! -~-_._.-:~ lO^N i: 7197~OMI.l"
N JOil/H11) Mlll cr DCleO Community CrcdH Union
No/mil S r':lllrr J50.:J Trlndle ROild
Camp Hill, PA 17011.4463
[Properly
922 Va II ey Strrf't. 922 Valley Street
[110 i d I'll 17 02 ~ [no]". f'A 17025
~. - -
l 0 lOll ~ (j
---Itemizmion or Amman Financed
29.9DO.OO (e}Totillamountflnilllced_ $_ 29.900.00 (e)
24,716.1.1 (el P~y-nfi !lelco [,C.U
24.746.,:} (e) Total amount paId to others
THE FIRST PAYMENT FOR Vo.lR
FIXED flArE tu:m-TmM"LOAI'l
FOR: 29,900,00
AT; ?250000t
WHlrH WILL P^Y OFF IN 72 I'AVM[NTS
IS Bll!.lK(N DCl\.IN AS FOll()"jS.
PRlNCIPi\l ~/on INTEREST
InSl,lrilllCC
513.36(c)
C.OO(c)
O.OOCC)
O.OOrel
MortgaSlI:? Insurance
Taxes
Other
TOTAl PAYMENT
a.tlI./ill)
:-.!'l 'Jhfi")
L_.___
lOAN ,,:nrlr
29.9011.00(e)
~!!A~ l'~^fiiJf AmllllllC!l'in.1need Tor.IDl'P-J"lfIo,!il~
. Clrn'J'AGE CID.lm, 'lIot.........rc'..... ,..........,,.,..,u.....
lU"Tr-- l"".h,.,t'~.,.....t"" poi1l ,r,,,,,," ""..,..,.,.
ThcJ"II",..".,,,., ~"'h.lt. oIL''''''''''''l''I<I>oU,ol.:<!
'fij;;c;;:~"''''"t''',/" ....<ocdil.-...ill<'*,.,...
...,.",I,t,,,.
7_?~O' (e) I 7,062.15 (,) . 29,90tJ.OO(e) I 35,%2 15 <0'
__ 'H'~"_ -~.. Y our PaYlll~rtt Schedule Will Be: - ...
11 pa)tirll!nts monttlly of S 513.36 (el b;;\JiOl\irw) NOvellb~ _20, 1m Ie!
1 payn!ellt of S S13.59/e) <lUll? on October 21): 21JIJs~(e
,,-~ - ----.
~ccufi ty ITltefl')~t YOu are giving a tecUflty lnterest illl,.he property lOClltcd at
9~2 Villll!Y Street. (!'lolll. -P^ l?O25.
lilt€' Ch~rge; H pllylllent IS 15 cl~ys- late. you. ,,111 be. t;barged !i.nooo, or thQ P4}'1'lI{'o1t.
Prl!lJaYlnent: It yuu payoff e.lrly. you will not have-taSllY a-pt'/\illty.
If you [lay off e~r1y. YOU will not be entit eel to a rl!rund of part of the fin~nce charge.
AsslIltif,ltlOfl" SOJnE'OllC IlllY'ing YOllr home Cllnnot assull.e the remainder of t.he l~ort!Jd9l!
un Lhe .origind 1 t~'l"llIS
11\15 Olilltjat1on: w1l1 I'IOT ha...e a drm\1nd feuure
In~uml1ee: You may ol>r~m PTOfle"I)' '1l~lImtt(:f (rum BnyOhe yotl''''~ne dIn/ i$ ~~~erL,l>lt to) Lendet.
See YOLlr conlNel documellltro,.:my ~itianll. infurrtr.ttiOIt;ltltl\ttI\tMtf";tyttlefll. defiltl4, I>>If rc'luifcl.lICp:lymenlin run bdort: the Ichedlllcll d~l~.
P/CJ'l~Ylllcnc rcf"l'lQ-i alld pen~tl\e~_
~-"._---".
cP.."".."",,,,,...
.._~ - - -.. .... -
I {We) tMchy R~i:llowlc(Me rccciving a completcu COllY or Ul!.J di;clll.~Ur".
OiIte__I_'_
-i"i. ";oanro\: ~tl (ler-
Norma- 5-, ~11ii-i:~r
TRUE AND EXACT COpy
'-'- VI "Ull IV'..}..} nIl
rnt\ I~U.
nELCO COMMUNITY CREDIT UNION
DATE: IOfO 1/99
NAME:
ADDRESS,
N
J.
H111er
9-n Va-I ~ey Street, Enola. PA 17025
RIC:
92 2 1J tl \ I ~ y 5 l r eel. E no 1 a
PA 17 025
De"
J.
MIllcor:
We arc pleased that your reCt'll! loan application has been given a !'!I.vorable iDihl rcvitw. UELCO Community
Ctedit Union llgrces to make a lIome Equity loan SCCUl"ed by the captioned property, subjcct to the attept3.11Ce
Of the fallowing felmS "lid clmdilion.~:
tOANAMOlJN'f: S?~..9-00.01l
NOTE INTERI~ST RATE, , 2 S
nntM: 72
YOllr loan mi\Y be given final approv:ll if:
1. Your propc-rty issufliciently vall1cu. 10 colbtcl1\lize iliis loan:
2. YDur prop~rty search illdicalc$ no other liens which would illlt'rfcr with lhe Pfopt-'f lecording lIlld
pos.itioning oftbe lien for tltis lo.m and
3. All atllt'I' rn('tor", which we review nfE' ~tCtj)tllhle,
Mease SUulIIillhe following information-wnich l1-as lK:CIl nmk.cd with lU'I kX" on Of be((ITC ~~~en t 0
l.lEED
__ 1998 YEAR EN!,) MORTGAGE STA TEMllNT
___ 1999 County and 1998 _0_ Most rCCcllt pnystub & W2$ for cllch npplic:JJll
SclllJOl Talt Receipts (if notesc.rowcd)
X_ Copy of Fire/F'fDlld _ S150 _ I~Circle One)
IllSUfitIlCC Policy Dec. Page ' At>plitMi~'
___ Copies-Gf M.Y hills.wbi;.cOIlSOlidalcd &lor ~slitnates for Home Improverru::nts,
Om ilJ1Jlraiscr will be ~'nll{m;ting you 10 ani\ngc 3. mutual time 10 appnli:ie yom property, In lhe interim, please
arrange for your h;J'Iilnl insura.nce lUlu Bont! hlsunmce, if required. policy to he submitted to the Morteage
Otp;JrllUCI1( prior to your S-l;1dcttJe1K date'. (.'oV('rncc in 1111 JllDOODf.l'Ql101flO.MUit'JlS nC;Jin$1 YOUT l'ropeny or 80%
nl'thepropcny villl.lC, whidlCVC:f is grc.ltcr, is rL"quired. Please be advised lhat BELCO Community Cl'edit Union
win pl.ace hnl.anl Of Hood jn~uram:c ag"In.~l yom I"rOpcny if your coverac:u is (:l\llcclled, ar later required for any
rcl\SOllllfter SCllkll'ICot, and alljJrem.illl1l$ will beadllcd {O your ttOl11C~J.ollll.
I'rovklcu. tll:\t ull of [he iufornmlion checked above is submitted to the ~ilgC Department, UTI 01' blllore (he
date jmlkatC;11 above, yom loan WilllJeSCl'Uf' for seulemrnl. Shouruyoull,live any question, rcgardingyour
Ilome E'lUiIY 1,(I:'In, or if I can he of ,my assistance, please ktJ ftee 10 COlUnct our Mortgage DC\lal1mcnt al
720.6280.
Sincndy,
~~4JO\~NX~
1'. ]j/l':l
....~ v. .."" 'V'"" ''''
rnf\ nu,
r, 14/ I~
10fiJl/99
MILLER 719)40
GOOD FAITH ESTIMATE
IHCOCO/'ll1'(lnilyCreditUlliOrl
"h~ inrml1mliOlllll()~id~,1 hdolY rdl~~u ellilllales ollht ~h:I1~~$1I1111 yClll arc 1i~~ly "J hlCllr ~I dli! 1ell!cmcl1l or your ID~11 The fed 'ill~\l are
eSlill\,lI~S .Ih~ a~II,;,1 dtar~CllllllY 00 I1Ulrc Ilr len. Y"u. H~II5;\~~!"" may nol hwnlve ~ rce rm e~cry i1'111Ii~lc>.l.
Tt>r l1unl\l~n li~lCd besi..k lhc tlljll1:uc~ "~llcral1y COHC5polld Il} lhe: IlUll1l>.;reJ lincs clll1raluedin1tre IIUD.1 or IlUD.IA SculenlCIII SI~I'lllcnl
wloieJl.)'tm--"';I~bc rr<;ci.'(il\& ~l ~enJcnlcn' 'fhe IIUD.J or 1JUD.IA Sc\!lcn~'U SI~rC'ntlll will .dlllW YOIJ lhc ftClual C011 for ilcfl\l Jlolid ~l
,,,ak~,lU.
IIUp.tllA T~.llil:;
105
1201
AMilllm:
~~24,7"6.41 (e-}
!IEM
l'ay;-OCf Q.Cl.Ctl ConU'rlullity C:.U. 1f71'J740MI-L5
\
111.00 {el
ReQordlllfj fee to the Recorder of Deed5 of Cumberlanrl
COltrlty \:.0 record the role~~e or sat:infaetion OC Qxitrting
Inortg<.l9~ to Belco C.C.U. (you will nQed to pay thls f(!Q
,:It time, of sel;tlement).
Reconling fee to t:h~ Recorder of Deeds of Cumberland
County to l:ecDrtl the new mortq,:lge to Deleo C.C.U. (YOIl
w~ll nc~ La pay this fea at time of aettlcment).
1201
,
2'3.50 (n)
'\'h~~t Cr.li11l~IC: ~r~ rr<l~~lctllll.lrl"~n[ 19 lite R~;l' Enille SClllemenl Procrdu~1 ^C:l of 1974, a~ Mwmdl'd (RESI'A). Addilion~llllroJr!'ll:\liun
can be loJml<lltllh~ IIIJD Spcci~llllfom"ljlo)l\ Jhlt,~l~l. whkb ls 10 tl<: I'rov)d~...1 Il) yOIl II)' )'0111 morll::lllll lIrok1:r IIr 1~l1dcr. it YOLlr npplicl'liol1 il
III purehu. f'1:,iJlll1lr.1I fl'illlll\7pcl'1y ,w<<,u...Ufllkr wilt t;jkc ~ rlUt1ian:mlhtrPf01lW~.
c=C!ltilntlte
l'ntt>Mr~u:
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922 Valley Street. [nalll. p^ 17025
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Norma S. Miller
FILE NUMBER
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. N. Joanne Miller
922 Valley Street
Enola, PA 17025
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
Daughter
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)