HomeMy WebLinkAbout01-0658
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of
also known as
Charles G Miller
No.
To:
21-01-658
Register of Wills for the
/69 A ,Deceased. County of Cumberland in the
.1 -Ill -..~.l::J
Social Security No. Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or 01ger an the executrix
in the last will of the above decedent, dated Od"o.,br?Y 'i;
and codicil(s) dated OcLoL~y 4, 2eae f<f.t
named
,* ZtYfJ
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
County, Pennsylvania, with
ROad. Carlisle. Ph 17@13
h ; ~
Decendent, then 83 years of age, died , ~ 21111111
at Carlisle Regional Medical Centerc
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 prob~le~ was not the victim of a killing and was never adjudicated
incompetent: #0 eX Le"/77a/V'S
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 PenqsJjvania' /. ./ $
situated as follows; :311> -9'.r/q ~a; C~)'//.{/~/'&...I1Cn
S)(JO(!J.t!tJ
7Sjt(}O .f:lJ
WHEREFORE, petitioner(s) respectfullt: re~uest(s{ the probate of the last will and codicil(s)
presented herewith and the grant of letters estamen ary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
'"
~
<!)
u
c:
<1)
~3
<1)l-o
c.::g
-00
c;:"=:
roo.;:::
~<1)
~Il<
<1)<+.
:::;0
OJ
c:
OIl
Vi
~~~
3 . 41~ . I
C1.1l..L~f;;J C1.1I..Lf;;J
f6
23111 Halsema Road North
Jacksonville, FL 3222111
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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ~~--: t/.. ~ ~/ / /J ~
befOLe IDe this 9th day of nlce~ ?anlel ~
JULY 1921111111 :;
- ;:
~
~
.:1' .~_./
~~1
r\
No 21-01-658
.
Estate of
Charles G. Miller
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JULY 11 W...MtiU....., 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 October 4, 2@@@
described therein be admitted to probate and filed of record as the last will of
Charles G..Miller
and Letters Testamentary
are hereby granted to Janice L. Dan i e 1
~uy(!jt!.:P4{,~~.J ft'.I' .I A-<~
gister of Wills
JCP
$ 200.00
$
................ $
$ 5.00
TOTAL _ $ 223.00
.JULY. .9 , . 2QO 1. . . . . . . . . . . . . . . . . . . .
1~:88
up. Ct. J.D. No.)
t Street
17@13
16453
FEES
Probate, Letters, Etc. .........
Short Certificates( )..........
x-pages
Renunciation
ADDRESS
717-243-@123
Filed
PHONE
HlOS.805 REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
p
7402705
No.
21-01-658
~--~. ~~&..~
Local Registrar
JUN 2 9 2001
Date
Hl05.14.JArt_ 2Ja1
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
IT
"
<
NAME OF DECEDENT (Fit". Mick:Ie.l....1
SEX
.. Male
'.
Charles G. Miller
STAll F'lE ~UM8EA
SOCIAl. SECURITY NUMBER
3. 716 - 09
June 28, 2001
AGE (laSl' a.m-o.y)
UNDER 1 ytAR
......". Days
UNDER 1 DAY
HoI.n Min""..
BIRTHPlACE ~C4y and PlACE Of: DEATH tCP>eck OJ'IV I)(\e' 'iM 'r\SlrU<:loOnt 00 otf"et ,...\
SlI:'e Of Fcr&lgtl Country} HOSPITAl.:
Carlisle,PA ,........XJ
7. ...
F",CFlrt'V NAME (11 "'OI.nst.futlQl"l. 0'''''' SI'", and numDefI
:=.,,0
3Ob. M.
PlACE OF INJURY. AI hOme. farm, stteet,lactor" office
building, tu:.lSpec:rfvl
a.. 2'b. zti. 30..
a:RTIP'IER ,Ct'!eck My onel
.CERTIFYING PHYSICIAN (Phy5lOltl'l cerllfytng eauwol dealtl..,.t\e(laf\Olhet pI'IV$lC.an has pronounced death &nO compjeled Ilem 231
To tht.... of my kt'tOW~. de.th occufTe'd due to". cau..(.. and m.aM4f.. stated. . . . . . . . . . . . . . . . . . , . . . .
83 v"
5.
COUNTY OF OERH
::)1 '_
Carlisle
Cumberland
Ie.
PA
P<IND oF BUSINESS/lNDUS1RY
DECEDENT'S USUAL OCCUP1J1OH
t~:o,.~II~~~::~:r
nO. De ut Sheriff
DECEOENT'S MAIUNG ADDRESS (Sb'''. CityfTown.~. ZIOCooe\
3115 Spring Rd.
Carlisle, PA 17013
Government
OE.CEOENt'S
ACTUAL
RESloE:NCE
,...""""""'"
Of'lotrlefSldeI
17.. &.'e
Cumberland
,..
J"ATME".S NAME IFirst, M~. last)
II. Ha es 1. Miller
INFORMANTS NAME (T J'S*P,inl)
... Janice Daniel
METHOD OF OISPO$JTK)N
BuMtKJ C'."..lionO ~frofnSla1eO
Of'"
..,..
I ·
t '
d.
DUE 10 (OR AS A CONSEQUENCE 0Fl:
DUE 10 lOA AS A CONSEOUE NeE OF):
WERE AUTOPSY FINDINGS IIotANNEA OF OEATH
~v.6\.E PRIOA 10 ~
COMP\.ETION OIF CAUSE 0
OF DEn"'? ,...."'., HomiCide
lice...... P.nding lnvnIigatlon 0
N.~ v.. 0 No 0 s..oc... 0 Coutd not DrI ~-,",med 0
DATE OF INJURY
lMonrh. Day, Yearl
.PftOHOUHCIHG ANO CEATIFYIHO PHv$fCIAM 1~l3n bolt1 ;>1:ylOUf\Cll'''g oeath and cer1dVIl'IQ10 caUO-A of dealt'll
To tM besl ot my kl'O~r.Jt'I, dealt! occu,red at b dme, dale. and piKe. and d...elo the c:ause(.) and manne,.. stated.
"MEDtCAl EXAMINER/CORONER
On Itle ba.is of e.aminatlon .nd/or investlgolliotl. in my opinion. duth occurred at the time, date, and place, and due to Ihe cause(s) and
",antler.. stated..
3".
REGISTRAR'S SIGNAtURE AND NU
~. ~eu..~
~\ ~I\ I()I
RACE. Amenca.n tndian, 8laclll,. Whtl:e. *.
'_I
10.
White
SUAVMN(3 Sf'OUSE
(II ...... QI\"I ma.o.tn nMWl
...
--
MIrU
_7
MARITAL STATUS. Marn.d
Never Man*,. ~,
-""""''VI
14. Widowed
!7C.DD _.__'" Middlesex
_.
eiIly~.
>I.
I Approximate
I~~n
: onM'l and death
.
: 2,.W/...'-
pART": Othersignincatllc:ondltiona~lOdealh,bIA
not rH4,IIhng in 1M undeIfVing cauM ~ in PJ\RT I.
tIME OF INJURY
INJURY /if WORK? QESCRl8E H(JYt 1NJUf\'( OCCURAEO.
_ 0 NoD
CATE StONED lMonIn. Day. 'INrI
"'-9 aoo\
\
21-01-658
LAST WILL AND TEST AMENT
OF
CHARLES G. MILLER
I, CHARLES G. MILLER, of 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 all other wills and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my
grave marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I give, devise and bequeath the residue of my estate, of every
nature and wherever situate, to my stepdaughter, JANICE L. DANIEL providing she shall
survive me by thirty (30) days. Should my stepdaughter, JANICE L. DANIEL, predecease me
or die on or before the thirtieth day following my death, I give, devise and bequeath the residue
of my estate, of every nature and wherever situate, to her issue, per stirpes, living on the thirty-
first day following my death.
THIRD: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary
estate as a part of the expense of the administration of my estate.
FOURTH: I nominate, constitute and appoint, JANICE L. DANIEL,
Executrix of this my Last Will and Testament.
FIFTH: I direct my Executrix and her successors shall not be required to
give bond for the faithful performance of their duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and T~ent, consisting of two (2) typewritten pages, each identified by my signature, this
. Y day of October, 2000.
..-
i:~~d..o 11 /n~d~JL
Charles G. Miller
(SEAL)
Signed, sealed, published and declared by the above-named Testator, CHARLES G.
MILLER, as and for his Last Will and Testament, in the presence of us, who, at his request, in
his sight and presence, and in the sight and presence of each other, have hereunto subscribed our
names as witnesses.
COMMONWEAL TH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
I, CHARLES G. MILLER, Testator, 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 Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by CHARLES G. MILLER, the
. -{I]
Testator, this 'I day of October, 2000.
NOTARIAL SEAL
SHEllY SEXTON, NOTARY PUBLIC
CARLISLE BORC, CUMBERLANO COUNTY
MY COMMISSION tX?\RES~PRIL 26, 200~
M ber Pennsylv,,-'':' f., .~M:~'.iiJt1 01 ~~l\~l~
em, __.'_' ..-._
(SEAL)
AFFIDA VIT
COMMONWEAL TH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
We, RONALD E. JOHNSON and -'-;;YLO,( ? 1-!lvDf<E t-/./,- , 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 Testator sign and execute the instrument
as his Last Will and Testament; that Charles G. Miller, signed willingly and that he executed it
as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and
sight of the Testator signed the Will as wItnesses; and that to the best of our knowledge the
Testator was at that time 18 or more years of age, of sound mind and under no constraint or
undue influence.
Sworn or affirmed to and subscribed to before me by RONA E. JOHNSON and
~y L () iL P t-l.v f)K.ty\.(~ , witnesses is 7' d 0 ct ber,2000.
NOTARIAL SEAL
SHELLY SEXTON, NOTARY PUBLIC
CARLISLE BORO, CU1-l,CERlAND COUNT'(
MY COMMISSION Ei\rlik2 AP~IL 26,2003
b Pennsylva:'!;\ ,t,~.".riaIIOn of Notaries
~:~~~_..~__~_. '0" .~._..-'_.
(SEAL)
(SEAL)
Name of Decedent:
Date of Death:
Will No:
To the Register:
.~
CERTIFICATION OF NOTICE UNDER RULES 5.6(a)
Charles G. Miller
June 28, 2001
21-01-0658
I certify that notice of beneficial interest required by Rule 5.6(a) ofthe Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on July 16, 2001:
Janice L. Daniel
230 Halsema Road North
Jacksonville, FL 32220
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: No exceptions.
Date: July 16,2001
Ronald . hn on, Esquire
78 We omfret Street
Carli e,PA 17013
Phone: 717-243-0123
Capacity: Counsel for personal representatives
FORM 93 - O. C. DIVISION
IN THE COURT OF COMMON PLEAS
OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
OF
}
}
}
}
}
}
No. 21-01-658 of 2001
IN RE: ESTATE
CHARLES G MILLER
(Deceased)
CLAIM
To the Clerk of Orphans court Division:
Index and make proper entry in your official records of the claim of ADV ANT AGE
RECEIV ABLE SOLUTIONS for HOUSEHOLD CREDIT SERVICES (Claimant),
account # 5407070003955441/716094915/5407070002843119, in the amount of
$3,921.83 against the estate of the above named decedent.
This claim is filed under Section 732 (b) (2) of the Fiduciaries Act of 1949 as amended.
The said decedent, who resided at 230 HALSEMA RD N, JACKSONVILLE, FL
32220-1606, died on June 28,2001.
Written notice of this claim was given to ~ jttJ11 Ct.. DlLvJlel} a60 ~Isem(i f1i
N) J lA-W ant> i /I.e r L 3 :).~. (Personal representative, if any, or counsel).
SePtember 17
, 2001
~~ K ltJ~
(Claimant)
ADV ANT AGE RECEIVABLE SOLUTIONS
1941 SOUTH 42ND STREET SUITE 380-25
PO BOX 6618
OMAHA, NE 68106-0618
800-999-3778
(Claimant's Address)
CLIENT: UNION PRIVILEGE-PC/O
ACCOUNT: 55516998
PACKET:
CLI REF#~ 5407070003955441
REASON: DO-ACTIVE
STATUS: ACTIVE STATUS
More. . .
J . :~~~~TION ]
~~~~~; ~~:~~~~~~NLI L~~~ :
PHONE TYPE: HOMPHN
PREFIX: RESP: PRMRSP
N AREA CODE: ~
ADDRESS TYPE: PRMHOM
STREET: 230 HALSEMA RD
FIRST NAME: CHARLES
PREFIX: 243
MIDDLE NAME: G
NUMBER: 2490
LAST NAME: MILLER
EXTENSION:
EXTENDED:
ANSWER CODE:
SUFFIX: SSN: 716094915
L CODE: MATL CALL CODE: CAT ,T.
EXTENDED:
CITY: LTACKSONVTT ,T ,F.
STATE: FL
ZIP CODE: 32/.20 1606
COUNTRY: US MAl
~ J~ bJ; BrAN::-1 I
C T STATISTICS
CURRE~~~~~C : 3921.83000 UST~D
00 LISTING BALANCE: 3921.83000
PROMISED PAYMENTS: 0.00000 PRINCIPAL
00 LOCAL LISTING BALANC 0.00000
ADJUSTMENTS
I r--
BALANCE:
0.000
PAYMENTS:
0.000
More. . .
ACTIVITY:
IN THE COURT OF COMMON PLEAS, CUMBERLAND COUNTY
PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF
CHARLES G MILLER
)
) Register's #
Deceased) c5<1-Ot -(PSi
CLAIM
To the Clerk of the Orphans' Court Division:
Index and make proper entry in your official records of the
claim of Citibank (South Dakota) N.A. in the amount of $2,675.92
against the estate of the above-named decedent. This claim is
filed under Section 3532 (b) (2) PEF Code, 20 Pa. C.S. ss. 3532
(b) (2).
The said decedent, whose last known residence was at 3115
SPRING RD CARLISLE PA 170138713
Wri tten notice of this claim was given to JANICE DANIEL,
Executor, 230 HALSEMA RD NORTH, JACKSONVILLE, FL 322200000 on August 21,
2001.
(cla2~~ t1~
Shawn Harmer, Manager of Citicorp Credit Services, Inc.
under limited power of attorney for Citibank (South Dakota)
N.A.
7930 NW 110 Street,
Kansas City, MO 64153
(Claimant's Address)
0811 6/200 1-76
Acct. #542.H80476611956
$2675.92
fA
SITE: KC
TM:6350 ACID:
08/01/01
KCB6014
22:54:55
. v". .......
.................................................
CHARLES G MILLER
3115 SPRING RD
CARLISLE
17013-8713000
CITI CARDS
P.O. BOX 8114
S HACKENSACK. NJ
07606 -8114
PA
Citi~ Driver's Edge~
Platinum Select~ Card
for Customer Service, call or write
1-800-967-8500
Account Number
5424 1804 7661 1956
Payment must be receIved by 1:00 pm local tIme on 08/14/2001
To r.-t bllllnq errors. write
to thts addrns: ".lJJnQ will
not preserve your rlqhts.
BOX 6500
SIOUX fALLS, SO
57117
statement/Closing Date
07/20/2001
Available Credit Line Cash Advance Limit Available Cash Limit
$0 $10600 $0
Amount Over Purch/Adv
Credit Line Past Due Minimum Due
. $0.00 + $54.00 + $55.00 =
i$i!i"fifiWfWIif.1l4t.bMiJ_t!i!(f1B1@.MttlBli@tljjm\W';jl@!;;;;lltlVftystlICiLtifslllfRili!iI{;%\'\;!jj;@il!jiHijij'ijiliil;i!i%)\\1jl@!jliillL"
7/20 lATE FEE - JUN PAYMENT PAST DUE
66 0000. .. .
7/20 AOVANCES*FINANCE CHARGE*PERIOOIC RATE
84 0000
7/20 PURCHASES*FINANCE CHARGE*PERIOOIC
84 0000
7/20 PURCHASES*fINANCE CHARGE*PERIOOIC
84 0000
Total Credit Line
$13900
New Balance
$2675.92
RATE
RATE
Minimum Amount Due
$109.00
. ..' ....I\1WiAl!iOiji1t!1!1iljl;'ill.
29.00
0000000 0
24.49
0000000 0
5.85
0000000 0
11.41
0000000 0
The Annual Percentage Rate on your account may
increase due to one of the fol owing reasons
stated in your Card Agreement with us: if YOll
fail to make a payment to us or any other
creditor when due, you exceed your credit line
or you make a payment to us that is not honored
by your bank.
Account Summary Previous (+) Purchases & (-) Payments & (+) FINANCE (=) New
Balance Advances Credits CHARGE Balance
PURCHASES $1,126.71 $29.00 $0.00 $17.26 $1,172.97
ADVANCES $1,478.46 $0.00 $0.00 $24.49 $1,502.95
TOTAL $2,605.17 $29.00 $0.00 $41.75 $2,675.92
Days This Bf III ng PerIOd: 30
Rate Summary Balance Sublect to Periodic Nominal ANNUAL PERCENTAGE
finance Charge Rate APR RATE
PURCHASES
Standard Purch $433.98 0.04493%(0) 16.400% 16.400%
Purch/Adv
thru 01/20/1993 $701. 05 o .05425M D) 19.800% 19.800%
ADVANCES $1,490.26 0.05477%(0) 19.990% 19.990%
PLEASE REfER TO THE REYERSE SIDE Of THE ORIGINAL STATEMENT fOR PAYMENT INfORMATION.
Make check or money order payable in U.S. dollars on a U.S. bank to Clll Cards. Include account number on check or money order. No cash please.
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
JOHNSON RONALD E
78 WEST POMFRET STREET
CARLISLE, PA 17013
______u fold
ESTATE INFORMATION: SSN: 71 6-09-491 5
FILE NUMBER: 21-2001- 0658
DECEDENT NAME: MILLER CHARLES G
DATE OF PAYMENT: 11/13/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/28/2001
NO. CD 000514
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,017.01
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,017.01
REMARKS: RONALD JOHNSON ESQUIRE
CHECK# 121
SEAL
INITIALS: AC
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500 INHERITANCE FILE NUMBER
DEPARTMENT OF REVENUE DEPT.
280601 HARRISBURG, PA 17128-0601 TAX RETURN RESIDENT DECEDENT 21-01-0658
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
f- Charles G. Miller 716-09-4915
z
w DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY) THIS MUST BE FILED IN DUPLICATE
C
w June 28, 2001 January 4, 1918 WITH THE REGISTER OF WILLS
(,)
w (IF APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER
C N/A I
w :J 1. Original Return o 2. Supplemental Return D 3. Remainder Return
'"
~t:U) :J 4. Limited Estate 0 0
u"'" 4a. Future interest Compromise 5. Fed. Est. Tax Return Req'd
w"-u
IOO ~ 6. Decedent Died Testate o 7. Decedent had Living Trust 0
u"'~ 8. Total number of SOB's
,,-'" - -
"- I 9. Lit'g'tion Proceeds Rec'd n 10. Spousal Poverty Credit n 11. Election to tax wI Sec. 9113(A)
'"
f- tlli!MllWmIQtl:Ji!_jj!!latl!pll!gli't;WMMMlill!illlQlllm@!!lIiijpJlj{jOO!l$g!lft@tt;M<iill!ffi.~Mi!il@ijit~HdHdddkii
z NAME: COMPLETE MAILING ADDRESS:
w
0
z Ronald E. Johnson, Esquire
0 Ronald E. Johnson, Esq.
"- FIRM NAME:
<IJ
w Andrews & Johnson Andrews & Johnson
'"
'" TELEPHONE NUMBER 78 W. Pomfret St.
0
u 717243-0123 Carlisle, PA 17013
1. Real Estate (Schedule A) (1) $77,500.00 OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B) (2) $0.00
3.Closely Held Corporation, Partnership or Sole-Prop. (3)
4. Mortgages & Notes Receivable (Schedule D) (4) $0.00
Z 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) (5) $3,032.40
0 $0.00
i= 6. Jointly Owned Property (Schedule F) (6)
<( D Separate Billing Requested
....I
=> 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. (7)
f-
a: 8. Total Gross Assets (total lines 1.7) (8) $80,532.40
<( 9. Funeral Expenses & Administration Costs (Sch H) (9) $17,370.51
(,)
w 10. Debts of Decedent, Mortgage liabilities, & Liens (10) $40,561.77
D::
11. Total Deductions (total lines 9& 10) (11) $57,932.28
12. Net Value of Estate (Line 8 minus Line 11) (12) $22,600.12
13. Charitable and Governmental Bequests/Sec 9113 Trusts
for which an election to tax has not been made (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) $22,600.12
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z 15. Amnt of Line 14 taxable at the spousal rate,
0
!;1 or transfers under Sec.9116(a)(1.2) x.O_ (15) $0.00
f- 16. Amount of Line 14 taxable at lineal rate $22,600.12 $1,017.01
:;) x.045 (16)
..
:;; 17. Amount of Line 14 taxable at sibling rate $0 x.12 (17) $0.00
0 $0
" 18. Amount of Line 14 taxable at collateral rate x.15 (18) $0.00
><
;:: 19. Tax Due (19) $1,017.01
20 n CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
...........w. .......w. ..-.-.............. ... ...,....,. .. ... .................ww.w.ww..,..,... ...... ..........................w......
......_.,.....................................w......,....w..
/6-c2#,g-~
.................,.....,w...,.
........w.......w.w_...
..,.....,w..........,w_.....
........w.w..............
!:~~$t;M}jj'!ll~!W.Q:i\l!lliWI;11l1:l!~W9V$$)tl{j1!l1l'$NI!!W'II;~'$!!l!!iili!i!..WJ'l!(9HII;$til\l1!l'tflWr@@::,,/;,iii;<,
,Decedent's ComDlete Address:
STREET ADDRESS
3115 Spring Road
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discounts
(1)
Total Credits (A+B+C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
TotallnleresUPenlalty (D+E)
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
(3)
(4)
5
(5)
(5A)
(56)
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check to: REGISTER OF
AGENT
$1,017.01
$0.00
$0.00
$1,017.01
$1,017.01
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Did decedent make a transfer and" yes no
a retain the use or income of the property transferred
b retain the right to designate who shall use the property transerred or its income
c retain a reversionary interest: or
d retain the promise for life of either payments or care?
2 If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?
3 Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary disignation?
D
D
D
D
D
D
D
~
~
~
~
~
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompal1yil1g schedules and statemel1ts, al1d to the best of my kl10wledge al1d belief, it is true,
correct and complete
For dates of death 011 or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value oftral1sfers to or for the use of the survivil1g spouse is 3% [72P,S Sec,
9116(a)(1, 1)(1)]
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivil1g spouse is 0% [72 P,S Sec,9116(a)(11)(ii)]
The statute does not exempt a transfer to a surviving spouse from t ax, and the statulory requirements for disclosure of assets and fil ing a tax return are still applicable evel1 if
the surviving spouse is the
ol1lybeneficiary
FordatesoldeathonorafterJuly1,2000
The tax rate imposed on the l1et value of transfers fmm a deseased child twenty-one years of age or younger at death to orfor the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. Sec. 9116(a}(1 ,2}]
The tax rate imposed on the l1et value of transfers to orforthe use of the decedent's lil1eal bel1eficiaries is 45%, except as noted in 72 P.S, Sec. 9116(1,2) [72 PS, Sec,9116(a)(1)
The tax rate imposed on the l1et value of transfers to orforthe use of the decedent's siblil1gs is 12% [72 P.S Sec,9116{a)(1,3)], A sibling is defined, ul1der Section 9102, as 0111
individual who has at least one parel1t il1 common with the decedent, whether by blood or adoption.
LAST WILL AND TESTAMENT
OF
CHARLES G. MILLER
I, CHARLES G. MILLER, ofCwnberland 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 all other wills and codicils heretofore made by me.
FIRST: I direct that all my just debts and funeral expenses, including my
grave marker, shall be paid from the assets of my estate as soon as practicable after my decease.
SECOND: I give, devise and bequeath the residue of my estate, of every
nature and wherever situate, to my stepdaughter, JANICE L. DANIEL providing she shall
survive me by thirty (30) days. Should my stepdaughter, JANICE L. DANIEL, predecease me
or die on or before the thirtieth day following my death, I give, devise and bequeath the residue
of my estate, of every nature and wherever situate, to her issue, per stirpes, living on the thirty-
first day following my death.
THIRD: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary
estate as a part of the expense of the administration of my estate.
FOURTH: I nominate, constitute and appoint, JANICE L. DANIEL,
Executrix of this my Last Will and Testament.
FIFTH: I direct my Executrix and her successors shall not be required to
give bond for the faithful performance of their duties in this or any other jurisdiction.
"
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and T~ment, consisting oftwo (2) typewritten pages, each identified by my signature, this
y day of October, 2000.
~
('.Ju.'hd.u .1J M ~~_
Charles G. Miller
(SEAL)
Signed, sealed, published and declared by the above-named Testator, CHARLES G.
MILLER, as and for his Last Will and Testament, in the presence of us, who, at his request, in
his sight and presence, and in the sight and presence of each other, have hereunto subscribed our
names as witnesses.
COMMONWEALTH OF PENNSYL VANIA )
: SS.
COUNTY OF CUMBERLAND )
I, CHARLES G. MILLER, Testator, 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 Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by CHARLES G. MILLER, the
Testator, this /f"IJ, day of October, 2000.
NOTARIAL SEAL
SHELLY SEXTON, NOTARY PU8L1C
CARLISLE BORO, CUMBERLANO COUNTY
MY COMMISSION (!(PIRES APRIL 26, 2003
Member, Pennsyl\,:\_~~~~C:!HOn ot Notaries
(SEAL)
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
We, RONALD E. JOHNSON and --r;;YLotC P rlrV DRE W( , 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 Testator sign and execute the instrument
as his Last Will and Testament; that Charles G. Miller, signed willingly and that he executed it
as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and
sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the
Testator was at that time 18 or more years of age, of sound mind and under no constraint or
undue influence.
. Sworn or affirmed to and subscribed to before me by RONA E. JOHNSON and
.-r;; Y L 0 Ii!- P 1'-1 :Vj)I2.cYV.s , witnesses is f d 0 ct ber, 2000.
NOTARIAL SEAL
SHELLY SEXTON. NOTARY PUBLIC
CARLISLE BORO, Cutl.CERLANO COUNTY
MY COMMISSION miRES APRIL 26, 2003
Member, Pennsylvania A,,"'la~1 Notaries
(SEAL)
(SEAL)
SCHEDULE A
REAL ESTATE
ESTATE OF
FILE NUMBER
Charles G. Miller
21-01-0658
(Property jointly-owned with Right of Survivorship must he disclosed on Schedule F) All real estate should be repol1ed at fair
market value with is detined a~ the price at which property would be exchanged between a willing huyer and a willing
seller, neither being compelled to sell, both having reasonable knowledge orthe relevant facts.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
ALL THAT CERTAIN tract of land with the improvements
thereon erected situate on Spring Road in Middlesex
Township, Cumberland County, Pennsylvania and being
known and numbered as 3115 Spring Road, Carlisle, P A 17013
(See Deed Book P, Volume 34, Page 931)
Thelma H. Miller died October 21, 1994 thus vesting full
fee simple title in the decedent.
Property sold (see settlement statement attached)
$77,500.00
TOTAL (also on line I, Recapitulation)
$77,500.00
A. U.S. DEPAATMENT OF HOUSING and URBAN DEVELOPMENT OMB No. 2602.0265
\ SETTLEMENT 8T A TEMENT , TlTLEPRO
. SECURED LAND LaiS8fptlnt
TRANSFERS, INC. B. TYPE OF LOAN
5006 East Trindle Road 1.( ) FHA 2. r (FMHA 3. r J CONV. UNlNS.
Suite 203 4. [ ]VA 5. rlj:CONV.INS.
Mechanlcsburg, PA 17055 6. FILE NUMBER: T 7. LOAN NUMBER:
502928 50097119
Phone: (717) 591-8500 FAX: (717) 591-8506 8. MORT. INS. CASE NO.:
15,l1B337
C. NOTE: This form is furnished to give you a statement of actual settlemer.\t costs. Amounts paid to and by the settlement agent are shown. Items marked
"(p,D.C.)' were paid outside the closing; they are shown here for informational purposes and are not included in Ihe totals.
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME.AND ADDRESS OF ~ENDER:
Dana L. Hannan Charles Guy Miller Waypoint Bank
Estate
101 S. GEORGE STREET
YORK PA 17401
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT DATE:
3115 Spring Road Secured Land Transfers, Inc. 09/25/01
Middlesex TOWNSHIP PLACE OF SETTLEMENT:
CUMBERLAND County 106B Harrisburg Pike, Carlisle, PA 17013
.'
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLE.R'S TJ:tANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER <DO. GROSS AMOUNT DUE TO SELLER
101. Contract sales price 7/500.00 401,Con\rac\ sales price 77500.00
102. Personal property 402.Personal property
103. Settlement charges to borrower (line 14QO) 4993.4b 403.
104. 404.
iOS. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller In advance
1{)6. CltylT own tax 10 1I06.CityfTown tax 10
107. County tax 09/25-/011012/31/01 47.57 1107, County tax 09/25/011012/31/01 47.57
108. Assessments 10 o108.Asses$ments 10
109. School 09/25/011006130r02 4B5.82 409. School 09/25/011006/3 0/02 485.8:.!
110, 10 410. 10
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 83026.85 '20.GROSS AMOUNT DUE TO SELLER 78033.39
200 AMOUNTS PAID BY OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. Deposit or earnest money 1000.00 sOl.Excess deposit (see instructions)
202. Principal amount of new loan(s) 75150.00 502.Settlement charges to seller (line 1400) 7799.98
203. Existing loan(s) taken subject to 503.Existing loan(s) taken SUbject to
2011. 5011. Payoff of First Mortgage Loan
Gene R. & Clair H. Myers 20000.00
20S 50s.Payoff of Second Mortgage Loan
206 IS) - (B) C.LOSlng Costs :.!325.00 506. IS} - (B) Closlng Costs 2325.00
207. 507
208. FHLB 4522.00 508
209. 509.
Adjustments ior items unpaid by seller Adjustments for items unpaid by seller
210. CltylTown tax 10 510.CflyfTown tax 10
211. Counly tax 10 51\.County tax 10
212. Assessments 10 512.Assessments 10
213. School 10 513. school 10
21-1. SIll.
215. 515.
216. 516.
211. 511.
218. 518.
219. 519,
220 TOTAL PAID BY/FOR BORROWER 82997.00 520. TOTAL REDUCTION AMOUNT DUE SELLER . 30124.98
300. CASH AT SETTLEMENT FROM OR TO BORROWER 6oo.C/l.SH AT SETTLEMENT TO OR FROM SELLER
301. Gross amounl due from borrower (line 120) 83026.85 SOl.Gross amount due 10 seller (line 420) 78033.39
302. Less amount paid by/for borrower (line 220) 82997.00 602.Less reduction amount due seller (line 520) 30124.98
303 CASH (IX] FROM) (I ) TO) BORROWER 29.85 w3.CASH (00 TO) ([ J FROM) SELLER 47908.41
Buyer or Borrower's Signature
Seller's Signature
HUD-1 Rev. 51B6
- - __.. __on _d ---- - -----.-...-..---- --_._------~,----~----- ~.--PAn5 FRO.~--~-ID.FROM
L. SETTLEMENT CHARGES 502928
700. TOTAL SALES/BROKER'S COMMISSION based on price $ 77500.00 6.0 BORROWER'S SELLER'S
FUNDS AT FUNDS AT
Division of Commission (line 700) as follows: Total: $4,650.00 ....
701. $ 2300.00 to Jack Gauohen Realtor ERA ...
702. $ 2350.00 to B-H Aqencv
703. Commission paid at Settlement 4650.00
704. Trans Fee Jack Gau-ohen Realtor ERA I 100.001
eoo. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Origination Fee %
802. Loan Discount 2.375 % Wavpoint Bank 1784.81
803. Appraisal Fee to Steven Barrett
804. Credit Raport to
805. Lenders Inspection Fee
806, Mortgag~ Inswance Application Fee 10
B07. Assumption F8e
80a. Doc preo Wavoo~nt Bank 290.00
809. Tax Serv WavDoint Bank 75.00
810. Underwr~te Wavpoint Bank 100.00
811. CourierFee WavDoint Bank 16.00
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest from 09/25/01 to09/30/01 @$ 13. 83/day 82.98
902, Mortgage Insurance Premium for mO.to
903. Hazard Insurance Premium for lyrs. to Erie Insurance ($217.POC)
904. APD1~c Fee yrs. to Wavpoint Bank ($325. POC)
905. Flood Cert WavDoint Bank 16.00
000. RESERVES DEPOStTED WITH LENDER FOR
001. Hazard Insurance 2 mo.@$ 18.08 Imo. 36.16
002. Mortgage Insurance mo.@$ Imo.
003. CitylTown tax mo.@$ Imo.
004. Counly tax 7 mo.@$ 14.92 Imo. 104.44
006. Assessments mO.@$ Imo.
008. School Tax 3 mO.@$ 53.16 {mo. 159.48
007. mO.@$ {mo.
008. Aqqreqate mo.@$ Imo. -41.66
100. TITLE CIjARGES
101. Settlement or closing fee to
102, Abstract or title search 10
t03, Title examination to
104, Title insurance binder to
105. Document preparation to
106. Notary fees to Cash 8.00
107. Altorney's fees to Ronald Johnson, Esq (POC) ~"
(includes above items No.:) 1105 'm ':;:', ."
'. ~"
108. Title Insurance to Secured Land Transfers 846.75
(includes above Items No :) Ends: 100/300/900
109. Lender's coverage $ 75,150
110. Owner's coverage $ 77,500
111. Ml/ICPL Secured Land Transfers 46.00 11.00
112.2001SchTax Nancv R. She~blev, TIC 637.86
113.2001CntvTx Nancv R. Sheiblev, TIC 196.90
200. GOVERNMENT RECORDING AND TRANSFER CHARGES
201. Recording fees: Deed $ 25.50 Mortgage $ 53.50 Misc. $ 25.50 104.50
202. Citylcounty tax/stamps: Deed $ 775.00Martgage$\ 775.00
1203. State tax/stamps: Deed $ 775.00Mortgage$ " 775.00
204. Rec Sat Recorder of Deeds 14.00
205. WtrTreat Blacks Water Conditioninq 880.22
300. ADDITtONAL SETTLEMENT CHARGES
301. Survey . to
302, Pest Inspection to Homechek, Inc. 30.00
303. Wtr IRdn/Hm Homechek, Inc. 440.00
304. Septic Peck's Se6tic Serv~ce 20.00 240.00
305. Home Wrntv HSA Home Warranty 395.00
400. TOTAL SETTLEMENT CHARGES (enter on lines 103 and 502, Secl10ns J and K) 4993.46 7799.98
parUes ~gree thaI no liabilily is assumed by Selll~ment Agent lor the accuracy of intormallon furnished by others as shown on the HUD-1 Sell1ement Statement. Settlement Agent hereby
expressly
reserves Ihe righl to deposit any amounls collected lor disbursemanlln an Interest bearing account In a Federally Insured instilulion and \0 cradil any inlaresf so earned 10 ils own
lJccount as addilionsl
compensalion lor ils services in this Iransaction
HUD CERTIFICATION OF PUYERS AND SELLERS
1 have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowfedge and belief, it is a true and accurate statem
made on my account by me in this transaction. , further certify that I have received a copy ollhe HUD- t Settlement Statement.
{j;:;a. A ~. ~~.A A AJ
I all recelpls and disbursements
Puyer or Borrower's Signature
BlJyer'. Address &. Phone:
used or will cause lhe lunds 10 be disbursed in accordQnce wiltJ this slatefJ'lenl.
. ')-5 2a01
Data
\0 Ihe Unlled Slates on Ihls or any similar lorm. Pe
10
II . . . I ,. d.1 F d'"
1 as upon conVIctIon can lOG ude a me an Jrnpflsonmenl. or a 81 s see
I'lUD-l Rev. 5/86
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Charles G. Miller
21-01-0658
(All property jointly-owned with Right of Survivorship must be disclosed on Schedule F)
ITEM DESCRIPTION
NUMBER
VALUE AT DATE
OF DEATH
Checking account no: 5140188167-PNC Bank (See letter attached)
$1,119.70
2
Commonwealth of Pennsylvania-real estate tax rebate
$156.20
3
Allstate Ins. CO.-automobile insurance refund
$102.06
4
Blue Cross/Blue Shield-medical iusurance refund
$121.05
5
1989 Chevrolt Cavalier automobile - sale price
$500.00
(,
Misc. Household goods, furniture and personal property
$500.00
7
Dana L.Hannan-reimbursement for real estate taxes paid in advance
(see settlement statement attached to Schedule A)
$533.39
TOTAL (also on line 5, Recapitulation)
$3,032.40
PNC Bank
PNC Bank
180 NOBLE BLVD
CARLISLE, PA 17013
Phone: 717-243-0034
FAX: 717.243.3520
email: marlies.trimbur@pncbank.com
Monday, July 23, 2001
Andrews & Johnson
Attorneys at Law
78 West Pomfret Street
Carlisle, P A 17013
Dear Ronald Johnson,
This letter is in reference to your letter of July 16th regarding Charles G. Miller
deed.
The type of account is a regular checking account,
The account number is 5140188167.
The only name on the account is Charles G, Miller.
The date of death balance as of June 28th, 2001 was $1,119.70.
Please do not hesitate to call if you have any questions.
Sincerely,
/J(fid:. /I.~
Marlies Trimbur
Branch Service Manager
I .,
\il
1,1 ~\,:
i \
'I,'
,u' ,
L~'"
iJl.. 2 5 (,I
. r--'
;'\\'
! II
~ ! : I'
, "
';',
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE OF
FILE NUMBER
21-01-0658
Charles G. Miller
(AJI property jointly-owned with Right of Survivorship must be disclosed on Schedule F)
ITEM DESCRIPTION
NUMBER
AMOUNT
A
$1,26250
2
B.
2
3
4
C.
2
3
4
5
6
7
8
9
Funeral Expenses:
Hoffman-Roth Funeral Home-funeral expense
Cumberland Valley Memorial Gardens-grave opening
Administrative Costs:
Personal Representive Commissions
Social Security Number of Personal Representative:
Attorney fees to Andrews & Johnson
Family Exemption
Claimant Relationship:
Address of Claimant at decedent's death:
Street:
State & Zip
City
Propate Fees to Register of Wills
Miscellaneous Expenses:
Patriot News-advertise letters
Cumberland Law Journal - advertise letters
Sprint-telephone bill
Sprint -telephone bill
Comcast cable-final TV cable bill
Sprint-telephone bill
Mobile Oil-final gas card bill
PP&L-electric bill
B-H Agency Realtors -real estate commission paid upon the sale of real estate
(see settlement statement attached to Schedule A)
$815.00
$4,000.00
$223.00
$203.22
$75.00
$37.42
$39.86
$7.90
$40.70
$1.50
$20.75
$2,350.00
10 Jack Gaughen Realtors - real estate conunission paid upon the sale of real $2,300.00
estate (see settlement statement attached to Schedule A)
II Nancy R. Shiebley, Tax Collector-school real estate $637.86
(see settlement statement attached to Schedule A)
12 Nancy R. Shiebley, Tax Collector-county real estate $196.90
(see settlement statement attached to Schedule A)
13 Recorder of Deeds - I % transfer tax (see settlement statement - Schedule A) $775.00
14 Recorder of Deeds - recording fee for satisfaction piecc $14.00
(see settlement statement attached to Schedule A)
15 Black's Water Conditioning-water treatment incurred upon sale of home $880.22
(see settlement statement attached to Schedule A)
1(, Peck's Septic Service - septic inspection and pumping incurred upon $240.00
sale of home (see settlement statement attached to Schedule A)
17 HSA home warranty (see settlement statement attached to Schedule A) $395.00
18 Dana L. Hannan - sellers assistance to buyer upon the sale of 3115 Spring $2,325.00
Road, Carlisle, P A 17013 (see settlement statement attached to Schedule A)
19 Andrews & Johnson - reimbursement for ovemight mail expense $14.(,8
20 Register of Wills-Pennsylvania Inheritance Tax -filing fee $15.00
21 Reserve for closing and accounting fees $500.00
TOTAL (also on line 9, Recapitulation) $17,370.51
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
FILE NUMBER
ESTATE OF
Charles G. Miller
21-01-0568
ITEM
NUMBER
AMOUNT
DESCRlPTION
I
Mobil Oil Company - ontstanding credit card bill
$44.28
2
3
4
5
6
7
8
9
]0
II
]2
\3
]4
PP&L - outstanding electric bill
$67.31
Sprint - outstanding telephone bill
$50.46
Comcast Cable - outstanding cable TV bill
$43.73
PP&L - outstanding electric bill
$48.02
MBNA - mastercard acet no: 54909990 18454867-oustanding credit card debt
$2,727.08
MBNA-visa acct no:4264299017075483-outstanding credit card debt
$2,860.66
AFM mastercard acct no:5407-0700-0395-554]-outstanding credit card debt
$3,921.83
Citibank visa acct no: 5424180476611956-outstanding credit card debt
$2,605.17
WalMart credit card acct no: 6032207420923385-outstanding credit card debt
$2,477.46
Chase Visa acct no: 41020064900081 13-outstanding credit card debt
$3,058.37
Chase Advantange Credit acct no:2155130947-outstanding credit card debt
$2,388.40
Gene R. and Clair H. Myers - balance due on outstanding mortgage
dated June 15, 1990 secured by 3115 Spring Road, Carlisle PA 17013
(see settlement sheet attached to Schedule A)
$20,000.00
Dr. Brazell - outstanding medical bill
$269.00
TOTAL (also on line 10, Recapitulation)
$40,561.77
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE
NUMBER OF ESTATE
1 Janice L. Daniel
23() Halsema Road North step-daughter 1O()%
Jacksonville, FL 3222()
Charles G Miller
21-01-0658
ITEM NAME AND ADDRESS OF BENEFICIARY
NUMBER
AMOUNT OR SHARE
OF ESTATE
B. Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation)
$()
'~:",~ "i:;":~"
;.?w
..i a:
a:
6
t(;fv
STATUS REPORT UNDER RULE 6.12
Name of Decedent: C~ dJ" k,.r g, 10/ ,/It-r
Date of Death: (;-dY.{) I
Will No.: '<1- '<&)1 - 6S' / 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 ~ether administration of the estate is complete:
Yes LA No 0
2. lfthe 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 final 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 ~resentative stati1an ac,:~~~t ~f~} to the parties
in interest? Yes JKJ No 0 r{)J!.fdlUJl ~. W~
c. cop~1~cetl1r~~~tit~ approval of formal or
informal accounts may be filed with the Clerk of the Orphans'
and may be attached to this repo
Date: ~~lj
UI
N
N
a:
N;/M~ffe)'- #.
(cJ,i;/~ i: #- / 7/1 U
Address
~C/!- tJ/Z-5
Telephone No.
l"-
N
~
:z::
;r;2
"!J
,':\
..0
~E
,,) -
.56
Capacity: 0 Personal Representative
~ounsel for personal representative
p
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/07/2003
DANIEL JANICE L
230 HALSEMA ROAD NORTH
JACKSONVILLE, FL 32220
RE: Estate of MILLER CHARLES G
File Number: 2001-00658
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 6/28/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc:
JFile
Counsel
Judge
\ / t, - c:1//'..;3--6'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
RecorG,
ReqiE.I\\!
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
of DATE
ESTATE OF
DATE OF DEATH
P FILE NUMBER
3 :1 :eOUNTY
ACN
.02
JAN 18
RONALD E JOHNSON ESQ
ANDREWS & JOHNSON Clerk
78 W POMFRET ST r,umbeiC-,,'
CARLISLE PA 17013 .""..
un
, PA
01-14-2002
MILLER
06-28-2001
21 01-0658
CUMBERLAND
101
'*
REY-15~7 EX AFP 112-001
CHARLES G
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 ~
REV=isirj-ExAFP-ci'2-=ooY-NoYicE--oF-YNHEifiTANci-YAx-AppRAisEMENy-,--AL1-owANci-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER CHARLES G FILE NO. 21 01-0658 ACN 101 DATE 01-14-2002
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)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
77,500.00
.00
.00
.00
3,032.40
.00
.00
(8)
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/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
NOTE:
(9)
(10)
17,370.51
40.561. 77
(1lJ
(12)
(13)
(14)
.00 X
22,600.12 X
.00 X
.00 X
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
80,532.40
57.932 28
22,600.12
.00
22,600.12
00 =
045 =
12 =
15 =
.00
1, 017 . 01
.00
.00
1,017.01
(19)=
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-13-2001 CDOO0514 .00 1,017.01
TOTAL TAX CREDIT 1,017.01
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 PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A R~~UND_ see REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)