HomeMy WebLinkAbout01-0681
Estate of Evel yn M. Mill er
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
No. ~-Ol- Otoil
To:
Social Security No.
. Deceased.
197-10-134?
Register of Wills for the
County of r. 11 m h p r 1 ::I n n in the
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 executn r named
in the last will of the above decedent, dated Au g us t 11 , 19~
and codicil(s) dated Will names decedent's husband.. Arthur F. Miller. as
Executor. He predeceased her. dying on M~rch lS, 19R5 Will names
n::lllph;n nppoq;r R::Ink ::Inn 'T'rllqr Com.p::lny ::Ie: h;e: ~11ccessor AllfirstTrust
Company of Pennsylv3n1~~M ~. 18 BUCCQB80r to D3uphin Dcpooit.
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cum be rIa n d
her last family or principal residence at 8 0 1 Nor t h
of r.~rl i Rl p. r.lImhprl ::Inn r.ollnry. PA
(list street, number and muncipality)
County, Pennsylvania, with
Hanover Strept. Rorollgh
Decendent, then 9 1 years of age, died J u n e 2 7 ,xli ? 00 1 ,
at r. h 11 r rho fr;o n Horn P, r. ::I r 1 ; e: 1 p J 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:
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 reat estate in Pennsylvania
situated as follows:
$ gO,OOO
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters t est am e n tar y
theron.
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
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Tomas E. Markin, Vice President
Allfirst Trust
2 West High Street
r.~rliRlp. PA 17011
OATH OF. PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA l ss
COUNTY OF CUMBERLAND J
lit - l4-G ~
No.Q!J-'Of-O&~1
Estate of
EVELYN M. MILLER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW TnT y iD ~~. 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 All g 111=1 t 1 1, 1 q R 0
described therein be admitted to probate and filed of record as the last will of
Evelyn M. Miller
and Letters T est a ill e n tar y
are hereby granted to All fir s t T r u s t Co ill pan y 0 f Pen n s y 1 van i a, N. A .
Zu[),DO
Probate, Letters, Etc. ......... $ . 0
. Cf 0
Short Certlficates(Z" '_' . . . . . . " $ .
Ren.-iatieni~~ :~
TOTAL _ $ ,
Filed . .~'-I.1O.t MU/............
FEES
D~l~ F ahygh~rt~ Jr
AITORNEY (Sup. Ct. I.D. No.) 19373
35 East High Street, Suite 203
ADDRESS Car 1 i s 1 e, PAl 7 0 1 3
(717) 241-4311
PHONE
['his is to certify that the information here given is correctly copied fron: an original certificate of death dul~ filed with me as
Local Regisrrar. 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.
No.
t2rc.,. / c:g ~-r
Loca Registrar
Fee for this certificate, $2.00
p
7431010
JUN 2 9 20m
Date
a Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT (Firs, Middle. Last)
1.
SEX
2. Female
STI\I'E fiLE NUMBER
SOCIAL SECURITY NUMBER
3. 197 10 - 1342
DATE OF OE1J"H (Month. Day. Year)
4. June 27,01
CUmberland
Carlisle
BIRTHPLACE (Cily end PLACE OF DEATH (Check only one - _ instrUCIions OIl oIhel side)
Slate or Foreign Counlty) HOSPITAL: OTHER:
Inpatient 0 ER/Oulpelient 0 OOA 0 NUI8l~
19107. Fairfiel ... Home
FACILITY NAME (" not inelilution. give 8ll'eet end number)
=ifylO
5. 91
COUNTY OF DER'H
UNDER 1 DAY
HouI8 . Mlnulee
i
lb.
Ie
DECEDENT'S USUAL OCCUPoV'ION
(G1.e kind 01 WOII< done durinIl most
cx:Jn~ Ih; do not use relired.) Miller's Market
A 11a. lIb.
DECEDENT'S UAlUNG ADDRESS (Street. CilyflOwn, State, Zip Code)
801 North Hanover Street
Carlisle, Pa 17013
DECEDENT'S
ACTUAL
RESIDENCE
(See in8ll'uctions
on othe< side)
WAS DECEDENT EVER IN
U.S. ARMED FORCES'!
Yea 0 NoXJ
Pa
MARITAL STnlJS - Married
Never Married. WIdowed,
Divorced (Specify)
14. Widowe<i
17e.O Yes. decedentllved I..
twp
Cumberland
Old
dececlent
live In a
township?
('.ATl ;!::lp
citylboro
17a. Stale
11.
FIUHER'S NAME (First. Middle, Last)
1.. Harry E. Rose
INFOR~~vmrler
17b. c<'un
Removal from Stale 0
ou
~
\ :
d.
WERE AlIlOPSY FINDINGS
,4MtdLABLE PmOR 10
COMPLETION OF CAUSE
OF oe.<crH?
DUE 10 (OR AS A CONSEQUENCE OF):
MANNER OF DEATH
OIUE OF INJURY
(Month. Day, 'IlIar)
TIME Of' INJURY
INJURY AT WORK? DESCRIBE HCMIINJURY OCCURRED
Natural
,er
o
o
Homicide
Yea 0
No 0
Suicide
Pending 1_1gaI1on
Could not be delermlned
o
o
o PlACE OF lNJUftV . At home, farm, ....... factory, olllca M.
bulktlng, etc. (Specify)
308.
Yes 0 Nod<f
Accidenl
2Ib.
CERTIFIIR (Check only one)
.CERTll'Y1NG Pt4YSlCIAN (Physician ce<1IIying cause 01 delllh when anoIhel physician haS pronounced death and completed Item 23)
To the beat 01 lilY kIIowIecIge. claathocc:urqcI due la theca-<a) and me......... NIed. .. . ............,...... ............. . ..... . ..........
21.
l~/,~/,/I
~
o.ue SKJNEb~'Y' q;
PRACTICE
303 N. BALTIMORE AVE.
MLHQU y ~~NGUA 11M-Ii
.PAONOUNClNQ AND CERTIFYING PHYSICIAN (Physiclan bolh pronouncing d....1h and certdyirlQ 10 cause 01 death)
To the beat 01 lilY kIIowIecIge. death occ:urrad althellllle. dale. and~, and due la the cauaa(a) and _.. alalec1.. . . . . . . . . . . . . . . . . . . . . . . . .
"MEDICAL EXAMINER/CORONER
On the buIa ot eaamlnatlon lIrlCIIor Investlg8tlon. In my opinion, death occurred .t the time, date, and place. and due to the eauae(a) and
__alated..........,.............,........................................................................ .
31a.
REGISTAAR'S SlGNRURE AND NUMBER
o
34.
,
LAST WILL AND TESTAMENT
OF
EVELYN M. MILLER
I, EVELYN M. MILLER of the Borough of Camp Hill, Cumberland
County, Pennsylvania, declare this to be my Last Will and
Testament, hereby revoking any will previously made by me.
I - I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
II - I devise and bequeath all of my estate of whatever
nature and wherever situate unto my husband, Arthur F. Miller.
III - Should my said husband predecease me, then I
devise and bequeath my said estate in four equal shares as
follows:
A. One share to my son, Charles W. Miller, if
living, and if not, to his issue;
B. One share to my son, Richard F. Miller, if
living, and if not, to his issue;
C. One share to the issue of my deceased son,
James R. Miller;
D. One share to my daughter, Kathryn E. Zink, if
living, and in which event, her share shall be charged with the
advancement of $30,000 for funds which I have used in the pur-
chase of a home at 406 Herman Avenue, Lemoyne, PA for her, and
which is held by her and my husband and I as joint tenants with
right of survivorship, and which will have survived to her at
the time of my death if she outlives me. If she predeceases me,
then I devise and bequeath her share to her issue and if the
said house has survived to me by virtue of her prior death, then
the foregoing charge for the $30,000 advancement is hereby
eliminated.
IV - ~. appoint Dauphin Deposit Bank and Trust Company,
ARNOLD, SLIKE & BAYLEY
ATIORNEYS AT LAW
Lemoyne, Pennsylvania, guardian of any property which passes
either under this will or otherwise to a minor and with respect
to which I am authorized to appoint a guardian and have not
CAMP HILL. PENNSYLVANLA 17011
ct ~ -';n/ /11- 711 dL. A.)
Page I
ARNOLD, SURE & BAYLEY
ATIORNEYS AT lAW
CAMP HILL. PENNSYLVANIA 17011
otherwise specifically done so. Such guardian shall have the
power to u~e principal as well as income from time to time for
the minor's support and education (including college education,
both graduate and undergraduate) without regard to his or her
parent's ability to provide for such support and education, or
to make payment for these purposes, without further responsi-
bility, to the minor or to the minor's parent or to any person
taking care of the minor.
v - I appoint my husband, Arthur F. Miller, Executor
of this, my Last Will and Testament. Should my said husband
fail to qualify or cease to act as such, then I appoint the said
Dauphin Deposit Bank and Trust Company to act in this capacity.
Neither of my personal representatives shall be required to post
bond in this or any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on
this, the / I t'i day of ~ ' 1980.
~ .
~7n 7r;Jb)
- ~ M. Miller
(SEAL)
Signed, sealed, published and declared by EVELYN M. MILLER, Tes-
tatrix therein named, on this and one (1) other sheet of paper
as and for her Last Will and Testament in our presence, who, in
her presence, at her request and in the presence of each other,
have hereunto subscribed our names as attesting witnesses.
j'/'y }'~'~'<'" Vi/ /) ", ..-
l f1 ( I L- 0[. vl./ ./ /:,. /// u... " '--{:-<-.--'
Name
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./ ,~.// / //- /.,' ._7 ,7
a . ~ .' (/: '-,LC ,</ " /~'/
Ad~r~s~ /" .'
Cf~.-Jd ~
Name
~h.t J.J~" ~
, Address
Page 2
1
COMMONWEALTH OF PENNSYLVANIA)
SSe
COUNTY
OF.
CUMBERLAND)
I, EVELYN M. MILLER , the testatrix whose name is signed
to the attached or foregoing instrument, having been duly quali-
fied according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it will-
ingly; 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//~
EVELYN M. MILLER, the testatrix this t, day
of *- UM....I~, 19 80 .
~4 ~ ~.ti.~
Ndtary Public
Thelma S J~ r .
. /!I.C,,~fJj':n. N'Jt~ p .
My Comllli~~f-,n ': . ry ubl,(
, tlClr"s"
c'mp Hill, PA .' N~' J, J984
Cumberiand County.
COMMONWEALTH OF PENNSYLVANIA)
SSe
COUNTY
OF
CUMBERLAND)
WE, the undersigned,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose arid
say that we were present and saw the testatrix sign and execute
the instrument as her Last Will; that EVELYN M. MILLER
signed willingly and that EVELYN M. MILLER executed it
as her free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testatrixsigned
the will as witnesses; 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.
C./:,", ._,' i I
""~ ,n 1 / ( (
Co'. . _I ( or _ -._ . ).1.
/,(1)
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I.. / (:' '- LZ,,?
~~-~
RNOlD. SlIKE & BAYlEY
ATTORNEYS AT LAW
2109 MARKET STRE ET
AMP HILL, PENNSYlVANIA 1/011
Sworn to and subscribed before me
this if d day of ~ ' 1980
~c/ ~ ~k~
Notary Public
Thelma S. McCausfin, Notary Publir
My Commission Expirc:s Jtl.y 1, 1984
Camp Hill, PA Cumber:and County
c
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Evelyn M. Myers
Date of Death: June 27, 2001
Estate No. 21-01-681
To the Register:
I certify that notice of estate administration required by Rule
5.6(a) of the Orphans' Court Rules was served on or mailed to the
following beneficiaries of the above-captioned estate on
July 23, 2001
Name
Address
Richard F. Miller
106 Rolo Court
Mechanicsburg, PA 17055
Susan Lacheney
5730 County Road 926
Nevada, TX 75173
Craig Turner
437 Second Street
West Fairview, PA
Evelyn L. Maze
285 Bishop Drive
Gainesville, FL 32607
Ronald Turner
1437 Apple Circle, Apt 188
Mechanicsburg, PA 17055
Rule
Notice has now been given to all persons entitled thereto under
5. :~:: ::~e::Ol N/A ~r %lJ
Dale F. Shughart, Jr.
35 East High Street, Suite 203
Carlisle, PA 17013 .
Telephone (717) 241-4311
Date:
Capacity:
Personal Representative Counsel
for personal representative
IMPORTANT NOTJ:CB
NOTzeB OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL
RECEIVE ANY MONEY OR PROPBRTY PROM
THIS ESTATE OR OTHERWISE
Whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive any money
or property will be determined by the intestacy laws of
Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Evelyn M. Myers, deceased,
Estate No. 21-01-681
TO: Richard F. Miller
106 Rolo Court
Mechanicsburg, Pa 17055
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below.
The Decedent Evelyn M. Myers, died on the 27th day of June,
2001, at Carlisle, Cumberland County, Pennsylvania.
The Decedent died testate.
The personal representative of the Decedent is:
Allfirst Trust Company of Pennsylvania, N.A.
2 West High Street
Carlisle, PA 17013
(717) 240-G711
The will has been filed with the office of the Register of
Wills of Cumberland County. 1 Courthouse Square, Carlisle, PA
17013. Phone No. 717-240-6345.
A copy of the Will or Petition may be obtained by contacting
:::e~eg::::r2:~ :~::s and ~~~.dUPlication.
Attorney Supreme Court I.D. #19373
35 East High Street, Suite 203
Carlisle, PA 17013
Telephone (717) 241-4311
Capacity: Counsel for personal representative
IMPORTANT KOTICH
NOTICB OJ' ESTATE ADJaNISTRATZON
THI:S NOTICE DOBS NOT MBAH THAT YOU WILL
RECEIVE ANY MONBY OR PROPERTY PROM
THIS ESTATE OR OTHERWiSE
Whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive any money
or property will be determined by the intestacy laws of
Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Evelyn M. Myers, deceased,
Estate No. 21-01-681
TO: Susan Lacheney
5730 County Road 926
Nevada, TX 75173
please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below.
The Decedent Evelyn M. Myers, died on the 27th day of June,
2001, at Carlisle, Cumberland County, Pennsylvania.
The Decedent died testate.
The personal representative of the Decedent is:
Allfirst Trust Company of Pennsylvania, N.A.
2 West High Street
Carlisle, PA 17013
(717) 240-6711
The will has been filed with the Office of the Register of
Wills of Cumberland County. 1 Courthouse Square, Carlisle, PA
17013. Phone No. 717-240-6345.
A copy of the Will or Petition may be obtained by contacting
the Register of Wills and paying the~a~rgeB fO, ~lication.
Date: July 23. 2001 @ \-> ~/_
ale F. v~'u9hart, r.
Attorney Supreme Court I.D. #19373
35 East High Street, Suite 203
Carlisle, PA 17013
Telephone (717) 241-4311
Capacity: Counsel for personal representative
IMPORTANT NOTICI:
NOTICI OF BSTATE ADMINISTRATION
THJ:S NOTICB DOBS NOT KBAN THAT YOU WILL
RBCBIVB ANY MONBY OR PROPERTY FROM
THIS BSTATE OR OTHERWISE
Whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive any money
or property will be determined by the intestacy laws of
Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Evelyn M. Myers, deceased,
Estate No. 21-01-681
TO: Craig Turner
437 Second Street
West Fairview, PA 17025
please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below.
The Decedent Evelyn M. Myers, died on the 27th day of June,
2001, at Carlisle, Cumberland County, Pennsylvania.
The Decedent died testate.
The personal representative of the Decedent is:
Allfirst Trust Company of Pennsylvania, N.A.
2 West High Street '
Carlisle, PA 17013
(717) 240-6711
The will has been filed with the Office of the Register of
Wills of Cumberland County. 1 Courthouse Square, Carlisle, PA
17013. Phone No. 717-240-6345.
A copy of the Will or Petition may be obtained by contacting
the Register of Wills and paying the charges fo duplication.
,./'
hugh t
Attorney Supreme our I.D. #19373
35 East High Street, Suite 203
Carlisle, PA 17013
Telephone (717) 241-4311
Counsel for personal representative
Date: July 23, 2001
Capacity:
DlPORTAN'l' HOTICB
HOTICB OF BSTAT. ADIIIHIS'l'RATIOH
THIS HOTIeB DOBS HOT JIBA.N THAT YOU W:ILL
RBCBIVB ANY KODY OR PROp_aT'!' FROII
THIS BSTAT. OR OTHBRWISlI
Whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive any money
or property will be determined by the intestacy laws of
Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Evelyn M. Myers, deceased,
Estate No. 21-01-681
TO: Evelyn L. Maze
285 Bishop Drive
Gainesville, FL 32607
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below.
The Decedent Evelyn M. Myers, died on the 27th day of June,
2001, at Carlisle, Cumberland County, Pennsylvania.
The Decedent died testate.
The personal representative of the Decedent is:
Allfirst Trust Company of Pennsylvania, N.A.
2 West High Street
Carlisle, PA 17013
(717) 240-6711
The will haa been filed with the Office of the Register of
Wills of Cumberland County. 1 Co~rthouse Square, Carlisle, PA
17013. Phone No. 717-240-6345.
A copy of the Will or Petition may be obtained by contacting
the Register of Wills and paying the charges fo duplication.
,/
Dale F. S ugha ,ar.
Attorney Supreme Court I.D. #19373
35 East High Street, Suite 203
Carlisle, PA 17013
Telephone (717) 241-4311
Counsel for personal representative
Date: July 23, 2001
Capacity:
.
DlPORTAN'l' RO'l'ICB
NOTICE 0., :SSTAft ADJIIHISTRA'1'IOR
THIS NO'l'ICB DOBS HOT IIBAH THAT YOU 1fJ:LL
RBeBIVB ANY KORBY OR PROPBRTY "ROX
THIS BSTA'l'B OR OTHBRWIS.
whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive any money
or property will be determined by the intestacy laws of
Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Evelyn M. Myers, deceased,
Estate No. 21-01-681
TO: Ronald Turner
1437 Apple Circle, Apt 188
Mechanicsburg, PA 17055
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below.
The Decedent Evelyn M. Myers, died on the 27th day of June,
2001, at Carlisle, CUmberland County, Pennsylvania.
The Decedent died testate.
The personal representative of the Decedent is:
Allfirst Trust Company of Pennsylvania, N.A.
2 West High Street
Carlisle, PA 17013
(717) 240-6711
The will has been filed with the Office of the Register of
Wille of Cumberland County. 1 Courthouse Square, Carlisle, PA
17013. Phone No. 717-240-6345.
A copy of the Will or Petition may be obtained by contacting
the Register of Wills and paying the charg for duplication.
.,/
Date: July 23, 2001
,
ug
Attorney Sup 1.0. #19373
35 Bast High Street, Suite 203
Carlisle, PA 17013
Telephone (717) 241-4311
Counsel for personal representative
Capacity:
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA
ORPHANS' COURT DIVISION
bl -6~ f
NO. 21-_-~
FIRST AND FINAL ACCOUNT
FOR THE ESTATE OF
EVELYN M. MILLER
AN INCOMPETENT PERSON
STATED BY RICHARD F. MILLER
SURVIVING GUARDIAN
Date of Guardian's
Receipt of Funds:
October 31, 1997
Account stated for the
Period:
October 31, 1997 to
June 27, 2001
Purpose of Account: Richard F. Miller, Surviving Guardian, offers
this Account to acquaint interested parties with the transactions
that have occurred during the administration of the guardian
estate.
The Account also indicates the proposed distribution of the Estate.
It is important that the Account be carefully examined. Requests
for addi tional information or questions or obj ections can be
discussed with:
Dale F. Shughart, Jr.
35 East High Street, Suite 203
Carlisle, PA 17013
Attorney for Richard F. Miller,
Surviving Guardian
(717) 241-4311
SUMMARY OF ACCOUNT AND INDEX
Principal
Receipts, personal property... ...... ...... ......... ...... 2
Receipts, real property .................................. 2
Principal Gains and/or (Losses) ...... ............... ..... 3
Income
Receipts
3,4
Disbursements
Principal and Income, combined .. ..... .... ...... .......... 4
Combined Balance for Distribution ... ...... .......... ..... 5
Reserve for Final Disbursements
5
Assets on Hand for Distribution
5
Schedule of Proposed Distributions... .... ..... ...... ..... 6
PRINCIPAL RECEIPTS
Personal Property
1. PNC Bank, checking account #51-4004-3283
(Per bank statement 11/3/97)
13,345.25
2 .
Harris Savings, C.D.
Principal
Accrued interest
(per 12/31/97 deposit)
47,000.00
276.69
47,276.69
3. Household goods, furnishings
and furniture (based upon net
proceeds from auction sale) .
1,906.75
Total Personal Property Receipts -
62,528.69
Real Property
Land and residential and store building
located at 2164-2166 Market Street, Camp Hill,
PA, value based upon actual sale price, approved
by Court Order dated 1/19/99.
. 160,000.00
Total Principal Receipts -
222,528.69
-2-
PRINCIPAL GAINS AND/OR (LOSSES)
1/19/99 - Tax Prorations on sale of real estate.
RECEIPTS OF INCOME
1997
PNC, checking account #51-4004-3283
(11/4/97 - 12/31/97)
Rent received from Charles Miller (12/97)
Social Security (12/97)
1998
PNC, checking account #51-4004-3283
(1/1/98 - 12/31/98)
Social Security
(Jan - Dec $727/mo.)
1999
PNC, checking account #51-4004-3283
(1/1/99-3/12/99)
Pennsylvania State Bank, checking account #1020855
(2/19/99-12/31/99)
Pennsylvania State Bank, savings account #26013359
(2/19/99-12/31/99)
Social Security
(Jan-Dec $735/mo.)
2000
Pennsylvania State Bank, checking account #1020855
(1/1/00-12/31/00)
Pennsylvania State Bank, savings account #26013359
(1/1/00-12/31/00)
Pennsylvania State Bank, C.D. #40266
(8/1/00-12/31/00)
Social Security
(Jan-Dec $754/mo.)
-3-
602.85
15.19
500.00
711.00
1,226.19
557.00
8,724.00
9,281.00
58.34
251.41
6,265.11
8,820.00
15,394.86
219.81
5,588.45
690.76
9,048.00
15,547.02
2001
Pennsylvania State Bank, checking account #1020855
1/1/01-6/20/01
Pennsylvania State Bank, savings account #26013359
1//1/01 - 6/20/01
Pennsylvania State Bank, C.D. #40266
1/1/01 - 7/9/01
Social Security
(Jan-June $778/mo.)
Total Income November 1997 - June 2001.
Combined Receipts of Principal and Income.
DISBURSEMENTS OF PRINCIPAL AND INCOME
CHURCH OF GOD HOME
Cost of care 11/14/97 - 6/29/01
PharMeica, medicine
11/97 - 12/98
Brockie Pharmatech, medicine
12/98 - 6/01
Rutherford Insurance, medical insurance
11/97 - 6/01
RSR, real estate appraisal
11/18/98
Johnson, Duffie, Stewart & Weidner
1/99 - legal fees and costs
H & R Block, preparing Income Tax Returns.
Richard and Charles Miller, reimburse
out of pocket expenses.
Remaining balance of Principal
and Income before final Disbursements.
-4-
183.17
1,372.86
1,238.39
4,668.00
7,462.42
48,911.49
272,043.03
162,914.65
806.59
1,991.09
8,800.00
1,600.00
5,961.50
200.00
84.68
182,358.51
89,684.52
Reserve for Final Distributions
Register of Wills, filing fees
500.00
Dale F. Shughart, Jr., preparation
of Account
1,500.00
Total reserve -
2,000.00
Remaininq Balance for Distribution
Principal
Income
80,222.10
7,462.42
Combined Balance for Distribution.
87,684.52
Assets on Hand for Distribution 7/9/01.
Balance in Pennsylvania State Bank
Checking Account #10120855.
15,326.10
Balance in Pennsylvania State Bank
Savings Account #26013359.
42,429.27
Balance in Pennsylvania State Bank
C.D. #40266.
31,929.15
89,684.52
-5-
SCHEDULE OF PROPOSED DISTRIBUTION
Richard F. Miller, Surviving Guardian of the
Estate of Evelyn M. Miller, an incapacitated person,
being duly notified by Allfirst Trust Company of
Pennsylvania, N.A., 2 West High Street, Carlisle,
PA, that the Register of Wills in and for
Cumberland County, Pennsylvania, has appointed
Allfirst Trust Company of Pennsylvania, N.A.,
Executor of the Estate of Evelyn M. Miller,
deceased, in proceedings docketed to Estate No.
21-2001-0681, the entire balance of principal
and income on hand is to be distributed to
Allfirst Trust Company of Pennsylvania, N.A.,
Executor, Estate of Evelyn M. Miller, deceased.
Principal
Cash
Income, cash
Combined Balance
-6-
80,222.10
7,462.42
87,684.52
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
Richard F. Miller, Guardian of the Estate of Evelyn M. Miller,
an incapacitated person, hereby declares under oath that he has
fully and faithfully discharged the duties of his office; that the
foregoing First and Final Account and Schedule of Distribution is
true and correct and fully discloses all significant transactions
occurring during the accounting pe~~ ;
- Richard F.~
me,
, 2001.
NOTNULIIAL
80NNII L COYLI. NOTARY PUBLIC
BORO ()II CMUIU. Ct*IIRLAND COUNTY
MY COM___.....a OCTOBER 17 2002
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-01-0681
ESTATE OF EVELYN M. MILLER, DECEASED
------------------------------------
------------------------------------
FIRST AND FINAL ACCOUNT OF
Allfirst Trust Company of Pennsylvania, N.A., Executor
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
Date of Death: June 27, 2001
Date of Executor's Appointment: July 20, 2001
Date of First Advertisement of Letters: July 26, 2001
Accounting for the period: June 27, 2001 to
May 8, 2002
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
Purpose of Account: Allfirst Trust Company of Pennsylvania, N.A., Executor,
offers this account to acquaint interested parties with the transactions that
have occurred during this administration.
It is important that the account be carefully examined. Requests for
additional information or questions or objections can be discussed with:
Allfirst Trust Company of Pennsylvania, N.A.
8 West High Street
Carlisle, PA 17013
(717) 240-6707
OR
Dale F. Shughart Jr., Esquire
35 E. High Street, Suite 203
Carlisle, PA 17013
SUMMARY OF ACCOUNT
Estate of Evelyn M. Miller, Deceased
For Period of 06/27/2001 through 05/08/2002
Page
Current
Value
Proposed Distributions
to Beneficiaries
12
77,024.57 77,024.57
PRINCIPAL
Receipts:
Per Inventory Filed 3
Subseq Prn Receipts 3
Net Gain (or Loss) on Sales
or Other Disposition
4
Less Disbursements:
Debts of Decedent 5
Funeral Expenses 5
Administration Expenses 5-6
Federal and State Taxes 6
Reserves 6
5,508.46
4,910.00
2,259.79
8,800.00
12,024.28
Balance before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
7
For Information:
Investments Made
Changes in Investment Holdings 8
INCOME
Receipts:
This Account
9
Net Gain (or Loss) on Sales
or Other Disposition
Less Disbursements
10
Balance Before Distribution
Distributions to Beneficiaries
Income Balance on Hand
11
Investments Made
Changes in Investment Holdings
COMBINED BALANCE ON HAND
11
2
Fiduciary
Acquisition
Value
103,242.41
5,536.50
0.00
108,778.91
33,502.53
75,276.38
0.00
75,276.38
1,855.61
0.00
1,855.61
107.42
1,748.19
0.00
1,748.19
77,024.57
---------------
---------------
RECEIPTS OF PRINCIPAL
Assets as per Inventory filed:
CASH:
06/27/01
Church of God Home - Refund
06/27/01
Pennsylvania State Bank
Checking Account #10120855 -
accrued interest
06/27/01
Pennsylvania State Bank
Checking Account #10120855 -
date of death balance
06/27/01
Pennsylvania State Bank
Certificate of Deposit #40266
- accrued interest
06/27/01
Pennsylvania State Bank
Certificate of Deposit #40266
- date of death balance
06/27/01
Pennsylvania State Bank
Savings Account #26013359 -
date of death balance
06/27/01
Pennsylvania State Bank
Savings Account #26013359 -
accrued interest
06/27/01
Prudential Financial Policy
#502706523 - Life insurance
proceeds
06/27/01
Rutherford Insurance Agency -
medical insurance
reimbursement
SUBSEQUENT PRINCIPAL RECEIPTS:
04/18/02
Commonwealth of Pennsylvania -
reimbursement of PA
Inheritance Tax
4,753.54
5.21
10,326.10
162.63
31,748.45
53,429.27
24.24
2,578.78
214.19
5,536.50
TOTAL RECEIPTS OF PRINCIPAL...............
3
Fiduciary
Acquisition
Value
103,242.41
5,536.50
108,778.91
--------------
--------------
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL
Gain
12/31/01
Pennsylvania State Bank
Certificate of Deposit #40266
Net Proceeds
Fid. Acq. Value
31,748.45
31,748.45
0.00
TOTAL GAINS AND LOSSES/PRINCIPAL........ ...
0.00
LESS LOSS.............................
0.00
NET GAIN OR LOSS. . . . . . . . . . . . . . . . . . . . . . . . . . .
0.00
4
Loss
0.00
09/06/01
09/06/01
12/31/01
09/06/01
08/06/01
08/28/01
09/13/01
12/31/01
12/31/01
02/12/02
DISBURSEMENTS OF PRINCIPAL
DEBTS OF DECEDENT
Brockie Pharmacy - medical
expense
Johnson, Duffie, Stewart &
Weidner - Successor Co
Guardian Fee Evelyn Miller
Church of God Horne - nursing
home expense
122.96
385.50
5,000.00
TOTAL DEBTS OF DECEDENT. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FUNERAL EXPENSES
Myers Harner Funeral Horne
Inc. - funeral expense
4,910.00
TOTAL FUNERAL EXPENSES............ ... ... ... .........
ADMINISTRATION EXPENSES
Dale F. Shughart, Jr.,
Esquire - Probate filing fee
reimbursement
Pennsylvania Vital Records -
death certificate for Arthur
Franklin Miller
Dale F. Shughart, Jr.,
Esquire - Reimburse for cost
of advertisement and proof of
publication, The Sentinel and
Cumberland Law Journal
Cumberland County Register of
wills - account filing fees
Dale F. Shughart, Jr.,
Esquire - account preparation
fee - guardianship
Cumberland County Register of
wills - filing PA
Inheritance Tax and Inventory
and $35.00 additional probate
costs
5
224.00
3.00
181.79
113.00
1,500.00
63.00
5,508.46
4,910.00
04/18/02
09/26/01
Boyer & Ritter, CPAs -
accountant fees
175.00
TOTAL ADMINISTRATION EXPENSES. . . . . . . . . . . . . . . . . . . . . . .
FEDERAL AND STATE TAXES
Cumberland County Register of
Wills, Agent - prepayment of
PA Inheritance Tax
8,800.00
TOTAL FEDERAL AND STATE TAXES........ .............. .
RESERVES
Allfirst Trust Company of PA,
N.A. - Executor's Fee
5,162.14
Cumberland County Register of
Wills - filing fees for
first and final account
300.00
Dale F. Shughart, Jr.,
Esquire - Attorney fee
6,162.14
Fiduciary Income Tax
400.00
TOTAL RESERVES
TOTAL DISBURSEMENTS OF PRINCIPAL..... . . . . . . . . . . . . . . .
6
2,259.79
8,800.00
12,024.28
33,502.53
--------------
--------------
# Units Description
PRINCIPAL BALANCE ON HAND
Current Value
or as Noted
Ark Money Market Portfolio
75,276.38
75,276.38 75,276.38
75,276.38
Fiduciary
Acquisition
Value
--------------- ---------------
--------------- ---------------
7
CHANGES IN INVESTMENT HOLDINGS - PRINCIPAL
Cost
Pennsylvania State Bank Certificate
of Deposit #40266
06/27/01
12/31/01
inventoried
sold
31,748.45
(31,748.45)
0.00
8
RECEIPTS OF INCOME
INTEREST
Ark Money Market Portfolio
08/01/01
09/04/01
10/01/01
11/01/01
12/03/01
01/02/02
02/01/02
03/01/02
04/01/02
05/01/02
2.41
14.05
180.33
175.30
149.12
140.09
134.37
117.85
122.21
122.06
Pennsylvania State Bank Checking
Account #10120855
12/31/01
02/19/02
48.52
18.47
Pennsylvania State Bank Certificate of
Deposit #40266
12/31/01
Pennsylvania State Bank Savings Account
#26013359
12/31/01
Prudential Financial Policy #502706523
10/22/01
post mortem interest
TOTAL INTEREST INCOME.....................
TOTAL RECEIPTS OF INCOME..................
9
1,157.79
66.99
377.56
230.02
23.25
1,855.61
--------------
--------------
1,855.61
--------------
--------------
05/08/02
DISBURSEMENTS OF INCOME
Allfirst Trust Company of PA,
N.A. - commission on income
107.42
TOTAL DISBURSEMENTS OF INCOME..................
107.42
10
# Units
Description
INCOME BALANCE ON HAND
Current Value
or as Noted
Ark Money Market Portfolio
1,748.19
1,748.19 1,748.19
1,748.19
Description
Principal
Income
Fiduciary
Acquisition
Value
--------------- ---------------
--------------- ---------------
COMBINED BALANCE ON HAND
Current Value
or as Noted
75,276.38
1,748.19
Fiduciary
Acquisition
Value
75,276.38
77,024.57 77,024.57
1,748.19
-------------- -------------
-------------- -------------
11
PROPOSED DISTRIBUTIONS TO BENEFICIARIES
Richard F. Miller
Distribution of 1/3 share, in
accordance with IIIB of the
Last will an Testament
Susan Lacheney
Distribution of one half of
1/3 share, in accordance with
IIIC of the Last will an
Testament
Evelyn L. Maze
Distribution of one half of
1/3 share, in accordance with
IIIC of the Last will an
Testament
Craig Turner
Distribution of one half of
1/3 share, in accordance with
IIID of the Last Will an
Testament
Less 1/2 share of advancement
See calculation attached as EXHIBIT A
Ronald Turner
Distribution of one half of
1/3 share, in accordance with
IIID of the Last will an
Testament
Less 1/2 share of advancement
See calculation attached as EXHIBIT A
12
Current Value
or as Noted
35,674.86
Fiduciary
Acquisition
Value
35,674.86
35,674.86 35,674.86
17,837.43
17,837.43
17,837.43 17,837.43
17,837.43
17,837.43
17,837.43 17,837.43
17,837.43
-15,000.00
2,837.43
17,837.43
-15,000.00
2,837.43
17,837.43 17,837.43
2,837.42
-15,000.00 -15,000.00
2,837.42
77,024.57
77,024.57
AFFIDAVIT
Allfirst Trust Company of Pennsylvania, N.A., Executor under the Last
will and Testament of EVELYN M. MILLER, deceased, hereby declares under oath
that it has fully and faithfully discharged the duties of its office; that the
foregoing Account is true and correct and fully discloses all significant
transactions occurring during the accounting period; that all known claims
against the estate have been paid in full; that, to its knowledge, there are no
claims now outstanding against the Estate; that all taxes presently due from the
Estate have been paid; and that more than four months have elapsed since the
first complete advertisement of the granting of letters in this estate.
Subscribed and sworn to
before me this /3 day
of ---JYJ 91= , 2002.
G~J~ L, KJ1..~
Notary ublJ.c
Notarial Seal
Gwendolyn E. Killian, Notary Public
Carlisle Boro. Cumberland County
My Commission Expires Nov. 22. 2004
Member. Pennsylvania Association of Notaries
13
REQUEST FOR DISTRIBUTION
Accountant requests that distribution be determined by the Court in
accordance with the petition for Distribution to be offered in evidence at
the audit of this account.
n~ of Pennsylvania, N.A., Executor
ent
14
EXHIBIT A
Adjustment Calculation For Advancement
As Per Article III.D. of the
Last will and Testament of Evelyn M. Miller
Balance for Distribution
77,024.57
Advancement
30,000.00
Adjusted Balance
107,024.57
Beneficiary Share Adjusted Advancement Net Balance
Balance For Distribution
--------------- ---------- ----------- ----------------
Richard E. Miller 1/3 35,674.86 .00 35,674.86
Susan Lacheney 1/6 17,837.43 .00 17,837.43
Evelyn L. Maze 1/6 17,837.43 .00 17,837.43
Craig Turner 1/6 17,837.43 (15,000.00) 2,837.43
Ronald Turner 1/6 17,837.42 (15,000.00) 2,837.42
---------- ---------- ---------
107,024.57 30,000.00 77,024.57
---------- --------- ---------
---------- --------- ---------
...
~
Register of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of Evelyn M. Miller
No. 21-01-0681
Date of Death 06/27/2001
also known as
,Deceased Social Security No. 197 -10 -1342
Allfirst Trust Company of PA, NA,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative
Name of
Attorney:
Dale ~ Shughart, Jr., Esquire
Signature:
I.D. No.:
19373
Signature:
Address:
35 East High Street
Address:
8 West High Street
Carlisle, PA 17013
Carlisle, PA 17013
Telephone: 717/241-4311
Telephone: 717/240-6707
Dated:
Description
Value
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total:
309,727.23
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems,lnc.
Form ##RW-7 (1992)
INVENTORY
Estate of:
Date of Death:
County:
Evelyn M. Miller
06/27/2001
Cumberland
CASH:
Church of God Home - Refund
4,753.54
Pennsylvania State Bank
Checking Account #10120855 -
Date of Death Balance
Accrued Interest
10,326.10
5.21
Pennsylvania State Bank
Certificate of Deposit
#40266 - Date of Death Balance
Accrued Interest
31,748.45
162.63
Pennsylvania State Bank
Savings Account #26013359 -
Date of Death Balance
Accrued Interest
53,429.27
24.24
Prudential Financial Policy
#502706523 - Life Insurance
Proceeds
2,578.78
Rutherford Insurance Agency -
Medical Insurance
Reimbursement
214.19
103,242.41
TOTAL RECEIPTS OF PRINCIPAL....... ... .....
103,242.41
----------------
----------------
1
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
ALLFIRST TRUST
2 WEST HIGH STREET
CARLISLE, PA 17013
n__n__ fold
ESTATE INFORMATION: SSN: 197-10-1342
FILE NUMBER: 21 - 2001 - 0681
DECEDENT NAME: MILLER EVELYN M
DA TE OF PAYMENT: 09/27/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/27/2001
NO. CD 000322
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $8,800.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: ALLFIRST TRUST
CHECK# 20243518
SEAL
INITIALS: DO
RECEIVED BY:
REGISTER OF WILLS
$8,800.00
MARY C. LEWIS
REGISTER OF WILLS
\., /6' -C)/ij' ~ -3
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY~U07 EX AFP U1-02)
.02 r1AY -3 1\11 :21
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-15-2002
MILLER
06-27-2001
21 01-0681
CUMBERLAND
101
EVELYN
M
THOMAS E MORKIN
ALLFIRST TRST CO OF PA
8 W HIGH ST l;,..;
CAR LIS L E (P~I'!li-7;O 13
AMount ReMitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subMit the upper portion of this forM with your tax paYMent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R'Ev=i6'ifj-ix--AFP--(Cfl-::Ozl-------...--iNHER'i'i'-ANCE-i"if-STATEMENi-OF-"Ccouiif--...---------------- -----
ESTATE OF MILLER EVELYN M FILE NO. 21 01-0681 ACN 101 DATE 04-15-2002
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-01-2002
P R I NC I PAL TAX DUE: ...._.-.......__.........._..-........-..-...._...-..........-...........-........-............-.............-......-.........................-...........-..-..........-.........-................
3,435.26
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-27-2001 CDOO0322 171.76 8,800.00
03-26-2002 REFUND .00 5,536.50-
TOTAL TAX CREDIT 3,435.26
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l
" /i'---t2~C~:3
\, BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT I AllOWANCE OR DISAllOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
Rec,
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
P12 :410UNTY
ACN
04-01-2002
MILLER
06-27-2001
21 01-0681
CUMBERLAND
101
THOMAS E MORKIN
ALLFIRST TRST CO OF PA
8 W HIGH ST
CARLISLE
.02
APH -1
*'
REV-1547 EX AFP lOl-02)
EVELYN
M
Allount Rellitted
Cic)i,"
PA 170t~anb(.i
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=is4-j-iifAFP--(cff:02i--NCffici-OF--rNHiifiTANCi-yAx-jrpPRAIsiirENT~--Ar.iowAi'-ci-irR-----------------
. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER EVELYN M FILE NO. 21 01-0681 ACN 101 DATE 04-01-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
100.663.63
.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/Governllentel Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
18/816.07
5.508.46
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account I
subllit the upper portion
of this forll with your
tax paYllent.
100/663.63
24.324 53
76/339.10
.00
76/339.10
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of abb returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of line 14 at Spousal rate
16. A_ount of line 14 taxable at lineal/Class A rate
17. AlIOunt of line 14 at Sibling rate
18. Allount of line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
(15) .00 X 00 = .00
(16) 76/339.10 X 045 = 3/435.26
(17) .00 X 12 = .00
(18) .00 X 15 = .00
(19)= 3/435.26
TAX CREDITS:
.-nlnlOn. "IO~IO'" . II (+ J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-27-2001 CDOO0322 171.76 8/800.00
TOTAL TAX CREDIT 8/971.76
BALANCE OF TAX DUE 5/536.50CR
INTEREST AND PEN. .00
TOTAL DUE 5/536.50CR
· IF PAID AFTER DATE INDICATED I 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 "CREDI'" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
J
,."
STATUS REPORT UNDER RULE 6.12
Name ofDecedent: E V e..hl VI M) YV\ / 11 f IL.
,
Date, of Death: 5<< (1 'L -z, 7; ;);:Dr} J
fdli,.~CI ~ 2-1 - 0 1- 6, cr/ 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 ~ No 0
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 final account with the Court?
Yes .x No 0
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? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the rphans' Court
and may be attached to this report.
Date: M-l/63
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Telephone No.
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OFFICIAL USE ONLY
REV~ 1500 EX + (6-00)
"
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNTY CODe YEAR
SOCIAL SECURITY NUMBER
197-10-1342
THIS RETURN MUST BE ALED IN OUPUCATE WITH THE
FILE NUMBER
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. Pit. 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Miller Eve1
DATE OF DEATH (MM-OD-YEAR)
NUMBER
21-01-0681
DATE OF BIRTH (MM-OD-YEAR)
06/27/2001 06/01/1910
IF APPLlCABL SURVIVING SPOUSE'S NAME LAS, FIRST, AN MIDDLE INl IAl)
REGISTER OF WILLS
SOCIALS CUR1TYNUM EA
X 1. Original Return
4. Limited Estate
X 6. Decedent Died Testate
2.
40.
3 date at death
. RemaInder Return prIor to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
(Attach copy of WIll)
o 9. litigation Proceeds Received
Supplemental Return
Future Interest Compromise (date of death after 12412-82)
7. Decedent Maintained a LIving Trust
(Attach copy of Trust)
o
010. Spousal Poverty Credit 0 11. Electfonto tax under Sec. 9113(A)
(date of death between 12.31-91 and 141-95) (Attach Sch 0)
THIS SECTION MI:JST'BECOMPlEl'E1li. Au.:, CORRESPOHDENCE& C08FIDENTlAbTAr.INf<llilMATION\Si'li:llItDSEDIREClE1U:O:; ,
NAME COMPLETE MAILING ADDRESS
Thomas E. Markin
FIRM NAME (If Applicable)
A1lfirst Trust Com an of PA, NA
TELEPHONE NUMBER
8 West High Street
Carlisle, PA 17013
R
E
C
A
P
I
T
U
L
A
T
I
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation. Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule 0)
5. 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 L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage liabilities. & Liens (Schedule I) (10)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Governmental Bequests/Sec 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)
76,339.10
(1)
(2)
(3)
NN '?3't,
Cltl~,
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N
OFFICIAL USE ONLY
:0
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rn
CD
(4)
(5)
Nohe
100,663.63
-
VI
-0
(6)
None
-
Norie
0:'
(8)
100,663.63
18,816.07
5,508.46
(11)
(12)
(13)
24.324.53
76,339.10
(14)
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES
15. Amount of line 14 taxable at the spousal tax
rate. or transfers under Sec. 9116(aX1.2)
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. X . CHECKHEllEIFYOll,ARl!il'lE!:lUIii$1:INll:A,IlE'UNO;Ol'AN;'IlVEllPAYliIliNll.
> > BE SURETO ANSWER ALL QUESTIONS ON REVERseSlDEAND1T~1lEc:itECitiItfA~lt1(;::; i, 1 ~,l " ?l;\,;", ;,:
x ,0 0 (15) 0.00
76,339.10 X ,045 (16) 3,435.26
X .12 (17) 0.00
X .15 (18) 0.00
(19) 3,435.26
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
801 North Hanover Street
CITY I STATE I ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
Z. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
3,435.26
8,800.00
171.76
Total Credits ( A + B + C) (2)
8,971.76
3. Interest/Penalty if applicable
Q. Interest
E. Penalty
',"" !!i!!HW
ji!ji'i'i;iiii:
Total Interest/Penalty ( D + E) (3)
4. It 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)
5. If Line 1 -+- Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (S)
A. Enter the interest on the tax dUe. (SA)
B. Enter the total of Line S + SA. This is the BALANCE DUE. (SB)
Make Check Payable 10: REGISTER OF WILLS1. AGENT
:::::::::::::;,.!ii!i:!:!!i!;;j.::!!!!!!!:fi.::::':::':;:~::::::.::_..,....,..",.:::::::'!:!::!i!:!!!!!!:::j!!!::.:i::i::::'::::::.,':":~'::"::::::::'::~.,::::,::::j!::::':::,:",:,:~::::::i':':::::::
:::!!!ii!:::::;:!::::::::::::,,:';;;;;!::f.:;::_.!!i!),.i~!iiiiiiiii:i;;:::::::!:::::::._i:::::~,.::;;:;:.:!i!!i!!!!:i!:i:!ii!:!!.,::!:!!!!:iii!ji!i;;ii
pLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and; Yes No
a. retain the use or income of the property transferred; . ~ ~:
b. retain the right to designate who shall use the property transferred ar 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, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an "jn trust fo( or payable upon death bank account or security at his
or her death? .
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
5,536.50
0.00
0.00
0.00
o
o
o
[]]
[]]
[]]
Under peniloltles oi perjury, \ dec.\ilITe that \ have examined this return, including accompanyIng schedules and statements, and to the best of my knowledge and belief, it Is true,
correct and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge.
SlGNATUREOFP ~SONFlESPONSrBLEFORFILlNGRETURN Allfirst Trust Compa.ny of PA, NA
j, 9('. . Lh ~/), ___a._~~_S.1;_?},.I~"'__S.1;,~_".1;____________________________
,1" 1/: /.///~ I/d/~~ -' ,/jJ Carlisle, PA 17013
IGNATUREOFPREPAAEROTHE . REPRE);; ATIVE Dale F. Shughart, Jr.
~ - - -~ir f-{; ~~~~ P~~'i;-6i3 ?_'O~ !'~- - ~Q!- - - - -- - - - - - -- - --
DATE
c2j-5/O~
DATE
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 P.S. 9116 (a) (1.1) (i)].
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 surviving spouse is 0'%
[72 P.S. 9116 (a) (1.1) (jj)J. 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 child is 0% (72 P.S. 9116 (a) (1.2)~
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aX1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)}. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent. whether by blood or adoption.
Copyrlght (e) lOOO form software only The Lackner Group,lnc.. Form REV-150D EX (Rev, 6~OO)
REV-1508 EX +(1-97)
,
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Evelyn M. Miller SS# 197-10-1342 06/27/2001 21-01-0681
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
Church of God Home
DESCRIPTION
Refund
VALUE AT DATE
OF DEATH
4,753.54
2
Pennsylvania State
Death Balance
Accrued Interest
Bank Checking Account #10120855 - Date of
10,326.10
5.21
3
Pennsylvania State
Death Balance
Accrued Interest
Bank Certificate of Deposit #40266 - Date of
31,748.45
162.63
4
Pennsylvania State
Balance
Accrued Interest
Bank Savings Account #26013359 - Date of Deatr
53,429.27
24.24
5
Rutherford Insurance Agency - Medical Insurance Reimbursement
214.19
TOTAL (Also onler on I;ne 5. Roc.pit";.I;on) $ 100,663.63
(If more space is needed, insert additional sheets of the same size)
CopyrIght (c) 1996 form software only CPSystems, 1m:. Form REV-1508 EX (Rev. 1-97)
REV-1511 EX +(1~91)
.tOMMONWEALTH OF PENNSYLVANIA
INHERITANCETAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Evelyn M. Miller
SSjf 197-10-1342
06/27/2001
FILE NUMBER
21-01-0681
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
B.
7.
~ 1
. 2
J
.3
J
J 4
AMOUNT
DESCRIPTION
1
FUNERAL EXPENSES:
Myers Harner Funeral Home, Inc. - Funeral Expense
4,910.00
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) A11first Trust Company of PA, NA
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 8 West High Street
City Carlisle State PA Zip 17013
5,162.14
Year(s) Commission Paid:
2.
3.
Attornels Fees Dale F. Shughart, Jr., Esquire
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
6,162.14
City
Relationship of Claimant to Oecedent
State
Zip
4.
Probate Fees
Register of Wills
259.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
Other Administrative Costs
Cumberland County Register of Wills - Guardianship Account Filing
Fees (Paid from Guardianship Account)
113.00
Cumberland County Register of Wills - Filing Inventory and
Inheritance Tax Return
25.00
Dale F. Shughart, Jr., Esquire - Reimbursement for Cost of
Advertising and Proof of Publication in The Sentinel and
Cumberland Law Journal
181.79
Dale F. Shughart, Jr., Esquire - Reimbursement for Guardianship
Account Preparation Fee (Paid from Guardianship Account)
1,500.00
Total of Continuation Schedu1e(s)
503.00
TOTAL (Also enter on line 9, Recacitulationl $ 18,816.07
(If more space is needed, insert additional sheets of the same size)
CopyrIght (c) 1996 form software only CPSystelT'lS, Inc. Farm REV- 151 1 EX (Rev. '.97)
Estate of: Evelyn M. Miller
Soc See #: 197-10-1342
Date of Death: 06/27/2001
Continuation of Schedule H-B4
(Probate Fees)
Item
IF
Description
Amount
1
Dale F. Shughart, Jr., Esquire - Reimbursement for Probate Filing
Fee
224.00
2
Reserve for Additional Probate Fees
35.00
259.00
Estate of: Evelyn M. Miller
Soc Sec #: 197-10-1342
Date of Death: 06/27/2001
Continuation of Schedule H-B7
(Other Administrative Costs)
Item
If
Description
Amount
Ii 5
Pennsylvania Vital Records - 1 Death Certificate for Arthur
Franklin Miller
3.00
6
Reserve for Filing Fees and Final Tax Returns
500.00
503.00
REV-1512 EX ..'(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Evelyn M. Miller
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SSfl 197-10-1342
06/27/2001
FILE NUMBER
21-01-0681
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Brockie Pharmatech
DESCRIPTION
Prescription Expense
AMOUNT
122.96
2 Church of God Home
Convalescent Home Expense
5,000.00
3
Johnson, Duffie, Stewart & Weidner - Attorney's Fee
385.50
TOTAL (Also enter on line 10, Recapitulation) $ 5,508.46
(If more space IS needed, insert additional sheets of the same size)
CopyrIght (c) 1996 form software only CPSysterns, Inc. Form REV-1512 EX (Rev. 1~97)
REV~ 1513 EX + (9~OO)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Evelvn M. Miller
SSfF 197-10-1342
06/2712001
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and
transfers under Sec. 91 16(a}(1.2)]
RELA IIONSHIP TO DEqqENT
Do Not List Trustee(s)
1
Susan Lacheney
5730 County Road 926
Nevada, TX 75173
Grandchild
2
Evelyn L. Maze
285 Bishop Drive
Gainesville, FL 32607
Grandchild
3
Richard F. Miller
106 Rolo Court
Mechanicsburg, PA 17055
Son
4
Craig Turner
437 Second Street
West Fairview, PA 17025
Grandchild
FILE NUMBER
21-01-0681
AMOUN ~ OR SHARe
OF ESTATE
1/6 Share
of Residue
1/6 Share
of Residue
1/3 Share
of Residue
1/6 Share
of Residue
Adjusted for
Advancement
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - 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.
0.00
Form REV-1513 EX (Rev. 9-00)
Estate of: Evelyn M. Miller
Sac Sec If: 197-10-1342
Date of Death: 06/27/2001
Continuation of Schedule J, Part I
(Taxable Bequests)
Item
II
Name and Address of Beneficiary
Relationship
Amount or
Share of Estate
5
Ronald Turner
1437 Apple Circle,
Mechanicsburg, PA
Grandchild
1/6 Share
of Residue
Adjusted for
Advancement
Apt 188
17055
An"ot,p, SUIIE &: BAYLP.:T
.IITTI'M",",' .IITUW
_..~..S'OS'O.....
'....III1....~.S'O.._...._
LAST WILL AND TESTAMENT
OF
EVELYN M. MILLER
I, EVELYN M. MILLER of the Borough of Camp Hill, Cumberland
County, Pennsylvania, declare this to be my Last Will and
Testament, hereby revoking any will previously made by me.
I - I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
"
II - I devise and bequeath all of my estate of whatever
nature and wherever situate unto my husband, Arthur F. Miller.
III - Should my said husband predecease me, then I
devise and bequeath my said estate in four equal shares as
follows:
A. One share to my son, Charles W. Miller, ..,
~.
living, and if not, to his issue;
B. One share to my son, Richard F. Miller. if
living, and if not, to his issue;
C. One share to the issue of my deceased son,
James R. Miller;
D. One share to my daughter. Kathryn E. Zink, if
living, and in which event, her share shall be charged with the
advancement of $30,000 for funds which I have used in the pur-
chase of a home at 406 Herman Avenue, Lemoyne, PA f0r her, and
which is held by her and my husband and I as joint ~enants with
right of survivorship, and which will have survived to her at
the time of my death if she outlives me. If she predeceases me,
then I devise and bequeath her share to her issue and if the
said house has survived to me by virtue of her prio~ death, then
the foregoing charge for the $30,000 advancement is hereby
eliminated.
IV - I appoint Dauphin Deposit Bank and Trust Company,
Lemoyne, Pennsylvania. guardian of any property whi=h passes
either under this will or otherwise to a minor and with respect
to which I am authorized to appoint a guardian and have not
d;~ (~,........""rY1. 7J'1 dL. A..J Page I
otherwise specifically done so. Such guardian shall have the
power to u~e principal as well as income from time to time for
the minor's support and education (including college education,
both graduate and undergraduate) without regard to his or her
parent's ability to provide for such support and education, or
to make payment for these purposes, without further responsi-
bility, to the minor or to the minor's parent or to any person
taking care of the minor.
v - I appoint my husband, Arthur F. Miller, Executor
of this, my Last Will and Testament. Should my said husband
fail to qualify or cease to act as such, then I appoint the said
Dauphin Deposit Bank and Trust Company to act in this capacity.
Neither of my personal representatives shall be required to post
bond in this or any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on
this, the / /1':1 day of ~".# , 1980.
% '
.u7rJ 7l2-,/..t~/'
. ~ M. Miller
(SEAL)
Signed, sealed, published and declared by EVELYN M. MILLER, Tes-
tatrix therein named, on this and one (1) other sheet of paper
as and for her Last Will and Testament in our presence, who, in
her presence, at her request and in the presence of each other,
have hereunto subscribed our names as attesting witnesses.
\ . '.
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Name
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Adaress
Cf' -:t! C:4... qjz'
c~-rt).J~i PF
, Address
ol"n. SUll2 S. BAYl.r;Y
AT'I'ORHIn'IAT LA_
_.........y.u..
',."...L...._.U......,'_
Page 2
COMMONWEALTH OF PENNSYLVANIA)
55.
COUNTY
OF'
CUMBERLAND)
t, EVELYN M. MILLER ,the testatrix whose name is signed
to the attached or foregoing instrument, having been duly quali-
fied according to law, do hereby acknowledge that I signed and
executed the instrument as my Last will; that I signed it will-
ingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and
EVELYN M. MILLER,
of ~ UM.J~, 19~.
acknowledged before me, b'J/'~
the testatrix this day
~d ~ ct"..~
N tary Public
Thelm. S " r .
. ",.c,.1(lsl'n N f
My Cornnai~:i(', .. :. ~ .1ry Publ;c
C'lI'"""!l ,.
Clmp Hill PA ' .(/!Y 1. 1984
. Cumberi'nd Cotmly
COMMONWEALTH OF PENNSYLVANIA)
55.
COUNTY
OF
CUMBERLAND)
WE, the undersigned,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, de depose ar.d
say that we were present and saw the testatrix sign and execute
the instrument as her Last Will; that EVELYN M. MILLER
signed willingly and that EVELYN M. MILLER executed it
as her free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testat rix signed
the will as witnesses: and that to the best of our kr.owledge the
testatrix was at that time 18 or more years of age, of sound mind
and under no constraint or undue influence.
C/__Ii!
/) :;" ( ,', , ({ J
'/.1,7 ,")
L ; - . -! (....(--~
~ Lk. -sse
Sworn to and subscribed before me
1:1 ~
this /1 ' day of , 1980
W. SlIKE & BAYLEY
nORNfYS AT LAW
l09MMl(fTSlItfEf
flU. PfNNSYlVAIIA 11011
~;/ ), ~:u t
Notary PuI:>l.J.C
Thelm. S. M<Cau.fi., Nol.ry Pubfit
My CornmiS'Sion EJqliN!s Jtt.y I. 1984