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Home My WebLink About01-0513 Estate of ELIZABETH MAE MILLER also known as ELIZABETH CORNMAN MILLER Social Security No. 203-10-5040 PETITION FOR PROBATE & GRANT OF LETTERS No. 21-01- J..I"- 0 f...::51j To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania , deceased. The Petition of the undersigned respectfully represents that: Your Petitioner, who is 18 years of age or older and the Executor named in the Last Will of the above decedent dated March 18 .1997, and codicils dated none .19----=. The Executor named none died Renunciations for none attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 24 Grove Road. Carlisle. Lower Frankford Township Decedent, then M.- years of age, died Mav 21 .2001, at 24 Grove Road. Carlisle. PA 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: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: 24 Grove Road. Carlisle. PA 17013 $5.000.00 $ $ $50.000.00 WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Signature(s) and Residence(s) of Petitioner(s): a~~ A1~ Charles Ha ry ~ 9835 East Mary Drive Tucson. AZ 85730 520-298-0618 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND 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 representative of the above decedent, petitioner(s) will well and truly administer the estate a~ to law. _ Sworn to or affirmed and subscribed ~~~ J A?'r'~ before me this 29th day of 2001. C '~ Charles Harry Miller /~ -;l33-S No. 21-01- 513 Estate of ELIZABETH MAE MILLER a/k/a ELIZABETH CORNMAN MILLER , deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, Mav 31 st. 2001, 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 March 18. 1997 described therein be admitted to probate and filed of record as the Last Will of Elizabeth Mae Miller a/kJa Elizabeth Cornman Miller ; and Letters Testamentarv are hereby granted to Charles Harry Miller WIN MCK. NIG~UGHES ~~. Ro er. in. Esquire (06282) ATTaR (Sup. Ct. I.D. No.) FEES Probate, Letters, Etc. . . . . . . . $ 115.00 Short Certificates( -2- ) . . . . $ 6.00 Renunciation(s) ........... $ JCP ...... . . . . . . . . . . . . . . $ 5.00 Other Will Paqes (-2-) .... $ 6.00 TOTAL: .... $ 132.00 Filed May. 3~S_tl, 20.01........... 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717 -249-2353 PHONE CALL ATTORNEY ROGER B. IRWIN 'r> '7~: ,,'<::(:. This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 7401984 No. 21-2001-51:3 'g.._~. ~~~~ Local Registrar MAY 2 2 2001 Date Hl05.143 Aft. 2117 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH STAlE F'l.E :>lUMBER SOCIAL SECUR'1'l' NUM8€R ~T 1fT II( NAME OF D1!CEDEIfT IF.... ..._. .., I. Elizabeth Cornman Miller SEX aFemale s. 203 - 10 2001 UNDER 1 YEAR -- 0..,. UNDER I OM -1- 8111THI'lACE (CIy _ PI...cE Of' DEIll"H fC/>fdl Dr'Oof"'" - _ ...,,"""""" on.- _I SlaIe co FCOtql CcunlrYl HOSPITAL: Carlisle, PA .......0 .,. Ie. FAClLlTV If......" (M ....~. _...... and numbef. ~,O llkI - "'on. --." ,.,..0 :"'-===01 MOTHER'S NAME (1'.... _. -. Sufname) It. Mabel Adams INFOAMANT'S MAIUNO ADDRESS lSlt... 0t,Ib0n. SIaIe, ZCl Code) . 9835 EastMa Drive, Tucson AZ 85730 PlACE OF OISPOSITION. _ oI~. C,........., lOCRlON - CilyITown. St.I.. ZlpCooe 01 OI/lef "'- ... Cumberland DECEDEIfT'S USUAL OCCUPRION ~_-::~O:='::~""'r '''..~.. PA 1711. Cumberland .. "1. : 0 (.) (' M. U. If. MftT I: E_IM _. .......Ot~wIlictl_l". "8th. Do natenlerllle _at dying, ouch ucardiaCOt rnp;r.lCIty ,"HI. _'" helltlt.iIur.. LiaI"'" _ _ Clfl_..... ;f1 t7 fl1 (p'/,~ C, It ~.. /""'IJ DUE 1'0 lOA AS A CONSEOUENCE OF): M 1,)';' V..J ;.r,../ , "v ;V ~ 1';- I "'" [ :. ct. WERE AUlOl'SY FINDlHGS ~ PAIOIl1O COMP\.ETlOH OF CAUSE OF DEATH? DUE 10 lOA AS A CONSEQUENCE OF}: DUE 10 COA 10S A CONSEOUENCE OF}: MAHNER OF DEATH ORE OF IN.IURY (.........Dey.-) ~ White SURVlVlNO SPOuSE I"..... ___...",.. _TA~ STATUS._ No.... Men_. WldooooecI. ~~1Iy) 14. Widowed IS. 17c.il...__.. Lower Frankford "'P. QIy- Ill. Carlisle PA 1701 Hoffman-R<?th Funeral Home , ApprlIIlimat. '-- l- andclNlll I l PART R: OIlIer Iic;\niIlcant condlliaN............1O _. buI lllll rnuIllno on'" ~_oo-in IWn'I. TIME OF INJUflY INJURY Ill" WORK? DESCAJee HCNi INJUAY ClCCl.JRAiD. Suicide o CclukIIlIlt bot c1et.rmONd o o o ~(OF INJURY. AI""""'. Ia,m. st.... taclClty. otllc. M. -.g. 1lC. l$pecolv\ _. _ D IfaD -- Hclm_ I'eftdin9 ~Ian - _ 0 No~ _ 0 No 0 ... - CIIlT....'o- ClI'iy..... "C8ITM'YlNG PMYlIlClAN(Ph_ c~ __ d _ _..- gn-..c_II.. prcnaunr:ecl de.1II ana c""'lllM8<l"em 231 llo..._.....,--......____to....clUM(.'.ncIm..,...,..._............................................. . 8. 'PROHOUNCIHQ AND CEltTlI'YlNO /ltfYSICIAN ~ bClIII P<onautlOn\l_.ond c;IrllfyonglO.,..... 01 aeallll llo..._.....,_twIecIp......"'_.,..._.da..._plece..""_"'...c.uMI.'_m.n.......,.IIcI......................... . -.OICAL DAIIlNEAICORONEA On _ Mflof ...mi...ton .nd/or Inv..lIg"lon.ln my opinion. dnlll occurred ."he 11m.. d.le. and pl.ce..ncl due 10 1M c.use(.'.ncl __ U ".ted.. . . . .... . .. . . .. " .. . .... . .... . . .. ... . ... . .... . .... . .. . . . . . .. . ... .. .... . .. .... ...... .. .. ..... ., . .. 31.. REGISTRAR'S $IGNATUM AND NU)l . ,,~ I~~ l~\ cl 33. 1iIN! \1. ~1 ~. tGn.at mill nn~ UJe.atnment of I, ELIZABETH MAE MILLER, of 24 Grove Road, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot in Westminister Cemetery, Carlisle, Cumberland County, Pennsylvania. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my children, Beverly Jean Williams, Patricia Lou King, Annette Frances Lawyer, Sondra Lee Chronister, and Charles Harry Miller, in five equal shares, per stirpes, to share and share alike. FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my children, Beverly Jean Williams, Patricia Lou King, Annette Frances Lawyer, Sondra Lee Chronister, and Charles Harry Miller, in five equal shares, per stirpes, to share and share alike. SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto my children, Beverly Jean Williams, Patricia Lou King, Annette Frances Lawyer, Sondra Lee Chronister, and Charles Harry Miller, i~ five equal shares, per stirpes, to share and share alike. SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. EIGHTH. I hereby nominate, constitute and appoint my son, Charles Harry Miller, as Executor of this my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of Charles Harry Miller, I nominate, constitute and appoint Patricia Lou King and Annette Frances Lawyer as Co-Executrix of this my Last Will and Testament. I hereby relieve my Executor from the necessity of posting security in connection with his duties, as such, in any jurisdiction in which he may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize ,.. . 0( . my Executor, in his absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. NINTH. I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two typewritten pages this tt~y of March, 1997. ~ rY4 /'YWdJ Jr7;~~ ELIZABETH MAE MILLER Signed, sealed, published and declared by the above named Testatrix ELIZABETH MAE MILLER as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. \M~~0~ fJrv-t~ <if'. COMMONWEALTH OF PENNSYLVANIA SSe COUNTY OF CUMBERLAND I, ELIZABETH MAE MILLER, Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. (431.1 ~tf.~ ~ ~ ELIZABETH MAE MILLER Sworn or affirmed to and acknowledged before me, by _~ ELIZABETH MAE MILLER this/i',raay of March, 1997. NOTARIAL SEAL VELDA M. SEASE, Notary Public Shippensburg Boro, Cumberland County, Pa. My Commission Expires April 16, 1998 t/uy~~~ Notary Public COMMONWEALTH OF PENNSYLVANIA SSe COUNTY OF CUMBERLAND We, /)Ji/l,'t4t\ A. DlA-hC;t~ and (Vi\t-l.e;... L. ~-rr- the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Elizabeth Mae Miller sign and execute the instrument as her Last Will; that Elizabeth Mae Miller signed willingly and that Elizabeth Mae Miller executed as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at that time eighteen (18) r more years of age, of sound mind and under no constraint or undue influence. ~ Sworn or affirmed to and subscribed before me by WI' lli"'-/JA. t+. ()v..AC~v- and CVV\ t).; ~ L. bo-.r r , witnesses, this /~t1iay of March, 1997. ()-dh.Ai~ Notary Public ~?~ NOTARIAL SEAL VELDA M. SEASE, Notary Public Shippensburg Boro, Cumberland County, Pa My Commission Expires Apr~ 16, 1998 c CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ELIZABETH M. MILLER Date of Death: May 21. 2001 Estate No.: 21-01-0513 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 23.2001 . Name Address Beverly J. Williams Patricia L. King Sandra L. Chronister Annette F. Lawyer Charles H. Miller 12 North Washington Street. Shiopensburg. PA 1725/7 P.O. Box 673. Carlisle. P A 17013 699 Mohawk Road. Newville. FA 17241 24 Grove Road. Carlisle. P A 17013 9835 East Mary Drive. Tucson. AZ 85730 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none. 07/23/01 /?>"L Date: & HUGHES Name Roger B. Irwin. ESQuire Address 60 West Pomfret Street Carlisle. P A 17013 Telephone (717) 249-2353 Capacity: Personal Representative x Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 _nn___ fold ESTATE INFORMATION: SSN: 203-10-5040 FILE NUMBER: 21-2001- 0513 DECEDENT NAME: MILLER ELIZABETH MAE DA TE OF PAYMENT: 08/21/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: OS/21/2001 NO. CD 000182 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,000.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ROGER B IRWIN ESQUIRE CHECK#18135 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS $3,000.00 MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 _h_n__ fold ESTATE INFORMATION: SSN: 203-10-5040 FILE NUMBER: 21 - 2001 - 051 3 DECEDENT NAME: MILLER ELIZABETH MAE DA TE OF PAYMENT: 10/29/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: OS/21/2001 NO. CD 000456 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $524.02 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ROGER B IRWIN ESQUIRE CHECK#18006 SEAL INITIALS: DO RECEIVED BY: $524.02 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS STATE OF ARIZONA COUNTY OF l J ss: Charles H. Miller being duly ~lJnrn according to law, deposes and says that he ; ~ f"hp Executor of the Estate of Elizabeth M. Miller late of _~Qw_er_Jl'~~kt<rr_(t_'I'9wnshiR____ , Cumberland County, Pa., deceased and that the within is an inventory made by him -, the said Executor of the entire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. \1. and subscribed before me, Dcr. 20 H \ LLE12- ,2001 U~(w Executor . Administrator .) Sworn 9835 East Mary Drive Tucson, AZ 85730 OFFICIAL MARICELA M. SUAREZ Address NOTARY PUBLIC - ARIZONA PIMA COUNTY " My Comm. Expires A~ 31, 2004 May 2001 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional a$~ets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. cu f..I u:l >- -0 'r-i ~ to- W CD ;::l rs Oft C"') ~ e:::: to- p:: Itl tT' w c( Q) to Ea - 0.. to- ~ u ~ 1.1') 0 0 Vl H Q) CD 0 W w H C 0' .. :;-~ I J: e:::: H lIlS !:l .... 0.. EE-I - to- ...J U. ~ a.. 'r-i 0 Z Itl ...J c( 0 .1 a.. ~ O::I: I u. :1:0 - LLJ 0 c( w ~l >. > 0::: H c(H N Z +- f2 Z 0 C ::I: c :::II Vl Z E-I 0 ~ u 0 0::: ~ U ::E: Z w c( ~ ~ f..I 0.. < -0 cu Z N c 00 H H Itl 0 ~ HI '+- &: p:: ~' 0 Q) H I ..0 " ~ I Q) E +- CD 0 I Itl :::II 0 I ...J U u: III E. - ~nventory of the real and personal estate of ELIZABETH M. MILLER deceased 24 Grove Road, Lower Frankford Township, Carlisle, Cumberland County 100,000 00 Miscellaneous personal property Cash on hand 5,608 50 1,959 89 TOTAL: $107,568 39 E. - \la- :2~3- s- REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USEONL Y REV- 1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R 0 E E S N T FILE NUMBER o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF AEVENUE OEPT.280601 HARRISBURG, PA 17128~0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Miller Elizabeth M. DATE OF DEATH (MM-OD-YEAR] SOCIAL SECURITY NUMBER 203-10-5040 THIS RETURN MUST BE FILED!" DUPLICATE WITH THE 21-01-0513 YEAR NUMBER COUNTY CODE DATE OF BIRTH (MM-DD-YEAR) OS/21/2001 12 23/1912 IF APPLICABLE) SURVIVING SOUSE'S NI>.ME LAST, FIRST, AND MIDDLE IN\ IAL, REGISTER OF WILLS SOCIAL SECURITY NUMBER X 1. Original Return 4. Limited Estate X 6. Decedent Died Testate 2. Supplemental Return 4a. Future Interest Compromise (date of death after \2-12-82) 1. Decedent Maintained a Living Trust (Attach copy of Trust) 3. date of death . Remainder Return prior to 12-13-B2} S. Feder...! Es1a1e Tax fle1urn Required 8. Total Number of Safe Deposit Boxes {Attach copy of Will) D 9. litigation Proceeds Received D 10. Spousal Poverty Credit 0 11. Election to tax under Sec, 9113(A) (date of death between 12~31-91 and 1-1-95) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE & CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Ro er B. Irwin Es . FIRM NAME (If Applicable) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 R E C A P I T U L A T I o N 717 249-2353 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Recell/able (Schedule D) S. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or Ll 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts 01 Decedent, Mortgage Liabilities, & Liens (Schedule l) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (line 12 minus Line 13) (8) 107,568.39 (11) 25,748.25 (12) 81,820.14 (13) (1~) 81,820.14 (1) (2) (3) 100,000.00 None None OFFICIAL USE ONLY (~) (5) None 7,568.39 (6) None None 19,130.59 6,617.66 C o M T P A ~ X A T I o N SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, ortransfers under Sec. 9116(a)( 1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 'l::l-I"'CKH"'lI,*)fYc:l~~I!.,*'I!.!f:!il!lE!.f!'1 >>BESURE 1'() A!lsWElI ALL x .0 0 (15) 0.00 81,820.14 X 045 (16) 3,681.91 X .12 (17) 0.00 X .15 (18) 0.00 (19) 3,681. 91 Copyright (c) 2000 form software only The LaCKner Group, Inc. Form REV-1500 EX (Rev. 6~00) (00-9 ""H) X3 ~1-^31:1 w'o, '::lUf 'clnoiO ieu.l!'~el <141 AftJO aiE'MHOS W.lO~ 0002 (j) 1/.(o!JAdo:) 'uo!Jdope JO poolq Aq Jl34194M '~uape:>ap all! 41!M UOUJUJO:> U! lU9Jed auo lsealle seLl 04M lenp!^!pu! ue 5e 'ZO~6 L10!paS Japun 'pau!!ap s! 6U!lq!s V '[(€'~)(e)9~ ~6 'S'd 2L] %2~ S! s6U!IQ!S S,luape:>ap 941!O asn 941101 JO 01 sJaJsUeJllo anl'e^ tau 1341 uo pasodw( aiel xel 941 "[(~)(e)9~~6S"d u] ((n)9~ ~6 'S"d ZL U! palau 51:!' lda:>xa '%SP 5! 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JO} JO OJ slaJsUeJI JO anje^ Jau all! uo pasodw] aIel xe! aLII 'S66 ~ '~ AJenuer aJOlaq pue v66 ~ '~ ,.(Inr Jaije JO uo p 10 sau~p 10.::1 (TOLT va 'aTsTT~~3 ----------------------------------------------------- 4aa~4S 4a~JlliOa 4sa~ 09 31'10 S3H~OH '9 lH~I.N)loW NIMH I 3^11VIN3S3t;1d3t;1NVH1t;13HlOt;l3t;1Vd3t;1d::103t;1n1VNOIS 0(L58 ZV 'uosonl 31va - - - - - - - - - - - - - - - - - - - - - - - - - - - -: ~-~;~~:w: ~s:~~-~~~~- - - "Hnm D"IlI' HO~::tifZ:t!ZDIS 'a6paIMOU'I ^ue sel./ JaJedaJd I./~II./M ~o UOI~elJJJO~Ullle uo paseq Sj a^,~e~uasaJdaJ leUOSJ9d al./l uel./~ Jal./~o JaJedaJd ~o UO!lUl!pao 'alaldlJJo~ pue l~aJJO~ 'ann S! I! 'J9!1&q pua a6p9IMOU.lj ku J.O Iseq al./~ 01 pue 'slu8We1e1S' pue salnpe4~S' .6u!kJedwlX)~ 6u,pn/:>>J1 'UJn}9J SlI./} pau/wl!xQ 9Ae4 ! lel./l.IJI!!~ap ! 'AlnfJad J.o sallJl!uad lapUn [K] [K] [K] o o o ~~ lO'vl5 00'0 lO'vl5 00'0 00'0 kJeU8d '3 IS8J91UI .0 61qe:>!ldde I! Al/eu8dIlS8J8JU/ .t 6S'L5T'( (Z) (:! + \3 + V ) Slip.,:! ,.,01 68'L5T 00'000'( luno::>S!O .0 sluauJAed JO!Jd "S ~!peQ 4J9^Od lesnods ."1 sluaw,.(2dfSllpaJ:) .Z (6~ aun ~ a62d) ana x21 .~ :SI!P9JO pue sJUaWAed xeol T6'T89'( (I) nOLT I va I aTsTT~~3 dl2 31VlS All:! P"Oll a^o~:) vl SS3<lOOV 133<llS :SS'UPPV aJaldwD:) s,Juapa:>ac REV-1502 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Elizabeth M. Miller SS# 203-10-5040 OS/21/2001 21-01-0513 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 which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE DESCRIPTION NUMBER OF DEATH 1 24 Grove Road, Lower Frankford Township, Cumberland Co. 100,000.00 SCHEDULE A REAL ESTATE TOTAL (Also enter on line 1, Recapitulation) $ 100,000.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETA:X RETURN RESIDENT DECEDENT ESTATE OF Elizabeth M. Miller SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SSff 203-10-5040 OS/21/2001 FILE NUMBER 21-01-0513 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 Cash on hand DESCRIPTION VALUE AT DATE OF DEATH 1,959.89 2 Personal property sold 5,608.50 TOTAL (Also enter on line 5, Recapitulation) $ 7,568.39 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1511 EX +(1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Elizabeth M. Miller SSfj 203-10-5040 OS/21/2001 Debts of decedent must be reported on Schedule I. FILE NUMBER 21-01-0513 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1 Hoffman-Roth Funeral Home 5,439.50 B. ADMINISTRATIVE 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 Zip - Year(s) Commission Paid: 2. Attorney's Fees IRWIN McKNIGHT & HUGHES 5,200.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant Patricia Y. King Street Address 24 Grove Road City Carlisle State PA Zip 17013 Relationship of Claimant to Decedent daughter 4. Probate Fees Register of Wills 132.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Cumberland Law Journal - estate notice publication 75.00 2 Recorder of Deeds - transfer stamps 1,000.00 3 Register of Wills - filing fee 25.00 4 Rowe's Auction Service - commissions 3,668.50 5 The Sentinel - Legal - estate notice publication 90.59 TOTAL (Also enter on line 9, Recapitulation) $ 19,130.59 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-1512 EX +(1-97) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS COM MONWEAL TH OF PEN N5YL VANIA INHERITANCET/J\)( RETURN RESIDENT DECEDENT ESTATE OF Elizabeth M. Miller FILE NUMBER 21-01-0513 SSfl 203-10-5040 OS/21/2001 Include unreimbursed medical expenses. ITEM NUMBER 1 Adams Electric 10 11 12 13 DESCRIPTION AMOUNT 141. 67 2 Carlisle Hospital 792.00 3 Carlisle Imaging Assoc. 29.00 4 Family Home Health 19.99 5 Masland Associates 200.42 6 Masland Associates 53.62 7 Mellon Bank, installment loan - (1/2 value) 4,853.58 8 Penn Rehab Assoc. 58.26 9 RWC Corporation 38.78 Sprint Telephone 99.68 SW Barrett Real Estate 250.00 Tanner Home & Energy 22.08 Waste Management 58.58 TOTAL (Also enter on line 10, Recapitulation) S 6,617.66 (If more space is needed, insert additional sheets of the same size) Copyright (cl 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Elizabeth M. Miller NUMBER I. SSif 203-10-5040 OS/21/2001 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(aXl.2)] Sandra L. Chronister 699 Mohawk Road Newville, PA 17241 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Daughter Daughter Son Daughter FILE NUMBER 21-01-0513 AMOUNT OR SHARE OF ESTATE 1/5 remainder 1/5 remainder 1/5 remainder 1/5 remainder 1/5 remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 1a, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 2 Patricia L. King P.o. Box 673 Carlisle, PA 17013 TOTAL OF PART 11- ENTER TOTAL NON- TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. 3 Annette F. Lawyer 740 South West Street Carlisle, PA 17013 4 Charles H. Miller 9835 E. Mary Drive Tucson, AZ 85730 5 Beverly J. Williams 12 N. Washington St. Shippensburg, PA 17257 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 Form REV-1513 EX (Rev. 9-00) 14nnt mill ntt~ w.cntnm.cttt of I, ELIZABETH MAE MILLER, of24 Grove Road, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all other wills and codicils heretofore made by me. FIRST. I direct that all my just debts and funeral expenses be paid from my estate as soon after my death as practically and conveniently may be done. SECOND. I direct that my remains be interred within my family's burial plot in Westminister Cemetery, Carlisle, Cumberland County, Pennsylvania. THIRD. I authorize my personal representative to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my grave. FOURTH. I give, devise and bequeath any and all tangible personal property owned by me at the time of my death unto my children, Beverly Jean Williams, Patricia Lou King, Annette Frances Lawyer, Sondra Lee Chronister, and Charles Harry Miller, in five equal shares, per stirpes, to share and share alike. FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of my death, unto my children, Beverly Jean Williams, Patricia Lou King, Annette Frances Lawyer, Sondra Lee Chronister, and Charles Harry Miller, in five equal shares, per stirpes, to share and share alike. SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate unto my children, Beverly Jean Williams, Patricia Lou King, Annette Frances Lawyer, Sondra Lee Chronister, and Ch::rles Harry Miller, in five equcl shares, per stirpes, to share and share alike. SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed upon my estate passing under my will or otherwise, shall be paid out of the principal of my residuary estate. EIGHTH. I hereby nominate, constitute and appoint my son, Charles Harry Miller, as Executor of this my Last Will and Testament. In the event of renunciation, death, resignation or inability to act for any reason whatsoever of Charles Harry Miller, I nominate, constitute and appoint Patricia Lou King and Annette Frances Lawyer as Co-Executrix of this my Last Will and Testament. I hereby relieve my Executor from the necessity of posting security in connection with his duties, as such, in any jurisdiction in which he may be called upon to act insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize my Executor, in his absolute discretion, to retain in the form received, and to sell either at public or private sale any real or personal property owned by me at the time of my death. NINTH. I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two typewritten pages thistGtttay of March, 1997. IPf} , LA-i., r.~!!~ It /7/v(.L-f. 711.1 {le~ ELIZABETH MAE MILLER Signed, sealed, published and declared by the above named Testatrix ELIZABETH MAE MILLER as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. \AJ\ ~\fd-uvV~JC~ ~C7 /J ~ .~ . ;q COMMONWEALTH OF PENNSYLVANIA SS. COUNTY OF CUMBERLAND I, ELIZABETH MAE MILLER, Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ([IV) 11 ~ if, ~ '}J"-/--~ )y~t f;,<-- ELIZABETH MAE MILLER Sworn or affirmed to and acknowledged before me, by t. ELIZABETH MAE MILLER this 1ft ilay of March, 1997. NOTARIALSEAL VELDA M. SEASE. Notnry Public Shippsnsburg Boro, Cumberland County, Pa. My Commission Expiros Aprj~9f!9 tdLdtJJ)(JS~ Notary Public COMMONWEALTH OF PENNSYLV AN/A SS. COUNTY OF CUMBERLAND We, {jJiI1i'&Y>< if. [)"LI'C"~ and C'f"t-{,;" L.bv-rr the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Elizabeth Mae Miller sign and execute the instrument as her Last Will; that Elizabeth Mae Miller signed willingly and that Elizabeth Mae Miller executed as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at that time eighteen (18) r more years of age, of sound mind and under no constraint or undue influence. \.J" ~ ~YI~ Sworn or affirmed to and subscribed before me by lu,' II i ..../lA 1'0. [)"''''~... '" and C".,tJ"" L. f)",rr , witnesses, thislli't1Jay of March, 1997. V-dhAi J;t1AJL- Notary Public NOTARIAL S8\L ~ VELDA M. SEIISE. Notary P,.lJlic Shippensburg Bora, Cumberland County. p,,, My Commission Expires Ap\'it 16. 1~"3 'A. Settlement Statement U.S. Department 01 Houf;ing and Urban Development ~ ,r 8. Type of Loan 1. D FHA OMS No. 2502-0265 2. D FmHA 4. D VA 5. D Conv. Ins. C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "p.a.c." were paid outside of closing; they are shown here for Infonnational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWeR: DANIEL L PEl PER . .'. . .... . . . 420KERRSVILLt~6AO. CARLISLE, PENNSYLVANIA 17013 . ESTATE OF ELIZABETH M. MILLER 24 GROVE ROAD. CARLISLE. PENNSYLVANIA 17013 F1 RST UNITED MORTGAGE SERV I~ES, INC. ... .... . 4931 CARLISLE PIKE, MECHANICSBURG, PA 17050 3. D Conv. Unins File Number peiper Loan Number 0176511105 Mortgage Insurance Case Number F. NAME AND ADDRESS OF LENDE;R: G. PROPERTY 24 GROVE ROAO LOCATION: CARLISLE. PA 17013 H. SEffiEME;NT AGENT: PLACE OF SEmEMENT: (TIN - 23.1438531) IRWIN, MCKNIGHT & HUGHES . GO WEST PO/'IfRET STREET, CARLISLE, PA. 11013. I. SETTLEMENT DATE: September 12. 2001 J. SUMMARY OF BORROWER'S TRANSACTION 100. GROSS AMOUNT DUE;.fflOM BORROWER: 106. Clt)l/tQ"wt'l tll)!:" 107. County tax8S 108.-A.$$fSlfmentll 109. SUMMARY OF SELLER'S TRANSACTION . OUNTDUEi, "SEtteR:,,,.,.., 10', COl'llraOI U!1l8 prlce 102. Personal property 103, Setllllm$nl Cha'rges lo,borrowet: (from line 1401') 100,000.00 104. 105. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ,4;0$;-':.'. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: -40$:-:'QI,yitQwl(:j"~)(f.' 407. County taxaa . '"o~;::'A._..~'iim:iii~t.)--::"': 409. 69.30 110. SCHOOL 91201T063002 811.89 SCHOOL 9120lT063002 811.89 111. 411. '1'2, 120. GROSS AMOUNT DUE FROM BORROWER: 104,368.08 420. GROSS AMOUNT DUE TO SELLER: 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER' 500, . REDUCTIONS. IN AMOUNT DUlnO.SELLEfil: 201. Deposit or earnest money 10 ,000.00 !SOl, Exca'l depOllt (...lnlllructlonl) 202.'Prlnclpal amount of new loan(s) 90-,#_'0,00 .,0,'0 s6i.::;iJ.~I~~.A'i:.d~lGij~rt~':iell.((~J~'::1:40~) 100,881.19 - 210. City/lawn taxes 21,., COunty- taul 212. Assessments to 03. ExistIng loan(8) takan 8ubJect to S... P"," ot ","."'.".... ,...MELLON BANK 0100.152-1 505. Payol! 01 second mortgage 10anMEMBERS 1ST 136078#2 soe. 3,031.00 203. Existing loan(s) taken sublect to 204. 205. 9,073.83 10,881. 99 20e. 207. 208~ 209. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: to 510. City/town tax8I sh. ~illY:_fa*. ': to t~ 10 512. AU8nmentl 10 21a 214. 5'13. 514. 215; 216. 217. 218. il!19.. 220. TOTAL PAID BY/FOR BORROWER: 300. CASH AT SETTLEMENT FAOMrrO BORROWER: 301. Gross amount due from borrower line 120) 3Q2.Less amount aid b Ifor borrowerOlne220) 303. CASH (E]FROM) ( 0 TO) BORROWER: 10 0 , 00 0 . 0 0 520. TOTAL REDUCTIONS IN AMOUNT DUE SELLER: 500. .. CASHATSEmEMENT'TOIFROM SeLLER: 104,368.08601 Gross a nt due to seller line 420) 10 0 0.0 0; 00 60Z,liess'redlJct'.tlSi "afile; due.sdh# (l i ne.. 520 4 , 368 . 08 603. CASH ( ~TO) (0 FROM) SELLER: HUD-1 (3-86) - RESPA, HB 4305.2 22,986.82 ~OO,BB~.~9 22 986.82 77,894.37 PAGE 1 ~(R!lV.3/86) 1.. SETTLEMENT 700. TOTAL SALES/BROKER'S COMMISSION OMB No. 2502-0265 BASED ON PRICE $ @ % . PAID FROM BORROWER'S FUNDS AT SffiLEMENT P AID FROM SELLER'S FUNDS AT SETTLEMENT DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: 701. 10 702. to 703. Commission' 'al ':at settl.ment 704. 800. ITEMS PAYABLE IN CONNECTION WITH LOAN: 8 1'. lailfl' od 1/1.tlon,I.. 802. Loan discount 86~. 'A fa!' al'-fee',IO: 804. Credit r. Oft to: 80 .. Utndttr'iS I "ction 'fee % % FUMS rUMS . 100.00 50.00 P.O.C. Mort a . lnsuraf\ce a licatlon I.. 10 a06. 7. 808. 809. 810. 8U. 900. ITEMS REQUIRED BY L NDER T BE PAID IN ADVAN Q01,lnler'esl from 9 12 01 to 10 , OVERNIGHT MAIL FUMS CREDIT PROCES ING .FEE FUMS COMMITMENT FEE SOVEREIGN BANK E: 1 01 ]. . 1 .. 338.43 902. Morl a e Insurance rtlmlum tor 903. Hitard In;uranC& remlum fOf' 904. Flood Insurance remlum for '05. 1000. RESERVES DEPOSITED WITH LENDER: 3 1 mos. to i.; 'h:l rs. to BELMONT BRANDT & KNOL 225.001'.0.C. 100. "" a seu 1006, Flood In urance 1007. SCHOOL 1008. " monlhs'@,$ months @ $ monlhs (ii$ months @ $ monlhQ.:@:S monlhs @ $ numlha '@ :$ months@$ Escrow Ad.ustment 7 18.75 po< mon" per month plitr"frio,;ib 19.27 p.r month p.r.-frlond; per month 85.04 pOI.".'" per month 34 tOOl, H 4:'ard ln$uranee '002. Mort a "insur nce 100$. Cll ro erl l:iCe 1004. Count ro ert taxes 4 A re ate Accountin 1100. TITLE CHARGES: 1101. Settlement or closin fes to 11.0:1', Abstract or 1llle'search to 1103. Tille examination 10 1104. ntla'lnauranee "Indar 10 1105. Document re aralion 10 1 Hle.' Notar lites to 1107. Attorney's fees to includes abo...e Ilems Numbers: ,,,e. T1I'. 'n"ranee 10 STEWART TITlE GUARANTY CO {nclud~8'above Items Numb.,s 110l' 1102" n03.'1104: 1105 :-:110T' 1108 FUMS R B IRWIN ES 200.00 8.00 '" n ' veta e- 1109. lend.r's Cover a e "". ENDORSEMENTS 1 00,300.900 l1l2. CPL STEWART TlTLE GUARANTY Co 1113. 1200. GOVERNMENT RE ORDING AND TRANSFER CHARGES: 1201~ Al.tcordl" 188s: Dud 25.50 .'Morl _ '. 45.5,0 <,A.re_.u 1202. Cil coul"ll taxstam s: De.d 1 000.00 . Mort Ii e 1203.S1atetalfstams: baed 1,000.'00 'Mritt'a'a '204. ASS I GNMENT OF MTG 1205. 1300 ADDITIONAL SETTLEMENT CHARGES' 71.00 1 000.00 1 000.00 14.00 1301, 8ur...e"1O .', ..... ,. " ',. 1302 Pest ins eel Ion to 130~. " ", .. < '. .'" ,., ,'.. . 1304. 2 % COMMISSION TO ROWES ANTIOUES REAl. EST 2 000.00 ~30S. OVERNIGfIT MAIL (3\ .' ,'. "., '., .. 23 50 31. 00 1306. ~3<i7 '" , " ,. '..' ',' "..,.... .'.""""'." . . 1400. TOTAL SETTLEMENT CHARGES 3,486.89 3,031.00 I /la...e carefully re"'lewed the HUD-l Settlemenl Slalemllnl and 10 the bllsl of my knowiedge iwd bellor. II IS a lrue and aCcurale slatement 01 all reCelpls and dlsbursem&nts mad& on my account or by me in lhls transaction. J further cllttlly Ihal I ha.... tsc(j(...ed ;!. copy 0\ \\'\1) HUO-' Se\\lemenl Sla1emenl. ESTAIE OF ELlZABElH M. MILLER ///;' Borrower: ) J:. .~.-:~ DANIELIL. PEIPER Date: 9/1 "/01 Sellel Of .... Agel'll: 0"" 9/12/01 Borrower: Dale: Seller or Agent: Date: The HUO-l Selllllment Slalllmenl which I ha"'ll prllpared is a !lue and acculJte account or IIlls lransaclioll. with lhl!:i !:it_tement. I ha...& caused or will t.au~a Iha lunds to ba disbursed ,n aCCordance Date: /?~ "3.dL ESOUIRE D",,9/12/01 Settlemllnl A'Jtlnt: rIGGER B. ~WI WARNING: II Is a crima to knowingly make lalse stitemllnls 10 lhll tJnitild Slal.a on lhlll 01 any ,lB.,., similar rorm. P al.'." men1- For details S811: Tille 18 U.S. Code Seclion 1001 and Sllctlon 1010 upon con...ictlon C.1f1 InCludll a IlI'\e and impdSQ(\ ~ /6-;:2J~ ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX Recoroe,', Reh1i~~tt; r \~e of ')'/H!s DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-10-2001 MILLER 05-21-2001 21 01-0513 CUMBERLAND 101 .01 ole 17 P12 :03 ROGER B IRWIN ESQ IRWIN ETAL 60 W POMFRET ST Clerk~i CARLISLE ~antDiD;B3u PA *' REY-1547 EX AFP (12-00) ELIZABETH M Allount Rellitted 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 ~ REY=is4j-iif-AFP--ri'2-:olir-No'T-ici--OF-'rtiRiififlNCE-'T-AX-A-PPRAisiirENT~--ALi-owlN-CE-CrR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MILLER ELIZABETH M FILE NO. 21 01-0513 ACN 101 DATE 12-10-2001 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. Hortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property {Schedule EJ 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) S. Total Assets CHANGED Cl) (2J (3) (4) (S) (6) (7) 100.000.00 .00 .00 .00 7.568.39 .00 .00 (S) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 19,130.59 6.617.66 Cll) Cl2) Cl3) Cl4) (9) ClO) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 107,568.39 '1i.748 21i 81,820.14 .00 81,820.14 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: IS. 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 IS. Allount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: Cl5) .00 X 00 = .00 Cl6J 81,820.14 X 045 = 3,681.91 Cl7) .00 X 12 = .00 ClS) .00 X 15 = .00 Cl9)= 3,681.91 PAYHENT ReCEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 08-21-2001 CDOOO182 157.89 3,000.00 10-29-2001 CDOO0456 .00 524.02 TOTAL TAX CREDIT 3,681.91 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) {}; v STATUS REPORT UNDER RULE 6.12 Name of Decedent: ELIZABETH MAE MILLER Date of Death: May 21. 2001 No. 21-01-0513 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: -L Yes _ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a fmal account with the Court? Yes ~ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? x Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 9/9/02 c"-J IRWIN, Mc T & HUGHES Roger B. Irwin. Esquire Name (please type or print) 60 West Pomfret Street Address Carlisle. P A 17013 City, State, Zip (717) 249-2353 Telephone Number x Personal Representative Counsel for Personal Representative Capacity: