HomeMy WebLinkAbout07-16-79
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Inventory of the reol and personal estate of
SARA G. MILLER
deceased.
Real Property
None
Personal Property
1.
2.
3.
4.
5.
6.
7.
Account 002-00-04009 at State Capital Savings & Loan
Association, Date of death balance plus accrued interest
Certificate of Deposit at Dauphin Deposit Bank and Trust
Comparty, No. 14-03-724767, Date of death balance plus
accrued interest
Certificate of Deposit at Dauphin Deposit Bank and Trust
Company, No. 14-03-725661, balance plus accrued interest
24 shares common United Telecommunications, Inc. at
$19.50 per share
Miscellaneous clothing and jewelry, including 2 fur coats
Medicare reimbursement
Blue Shield 65 Special reimbursement
5,805 63
7,091 78
4,069 03
I
468100
1,500 00
107 76
26 94
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OFeUMliR' . fiB ~ 55:
William E. Miller, Jr.
being duly sworn according to law, deposes and says that he is Executor
of the Estate of Sara G. Miller, deceased
late of East Pennsboro Township , Cumberland County, Pa., deceased and that the
within is an inventory made by William E. Miller , J~ ., the said Executor
of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
~y;o
,
~ Jj 197<1
i~~~r'N~'~/~
My ~ Comminion Exjlire5 M.::nh 1.1, 1933
HillriJburQ, PA Dauol;in CC'jJ;:lV
......------~~-" ._.~~
- /
Executor .~Hii"iC,_/
William E. Miller~;"
208 Walnut Street
P. O. Box 1226 ,/
Harrisburg, PA 17108
and subscribed before me,
Address
Date of Death
18
October
1978
Day
Month
Vear
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
0.
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RCC-33 (4-73).
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
,;;;)/_/7/, (, /6
'* 1/11/11
RESIDENT DECEDENT
COUNTY OF
CUMBERLAND
IMPORTANT,
This return must be completed in detail and filed in duplicate, with all attached, with the Register .of Wills .of the
County where decedent resided; Return is due within nine months after date .of death, unless an extension is granted
by the Secretary .of Re'otenue. (Section 703 .of the Inheritance and Estate Tax Act of 1961.)
Late of
Cumberland
} AFFIDAVIT OF
EXECUTOR
~BR
County
IN THE MATTER OF THE ESTATE OF
Sara G. Miller
(STATE FULL NAME OF DECEDENT)
State af
Pennsylvania
} ss,
Caunty of Dauphin
William E.
Administrator
Miller, Jr.
Execut.or
of the estate of the above-nomed decedent being duly sworn, depose
and say
(MONTH)
Nome and address of attorney or }
other authori:r.ed representative to whom
all correspondence should be mailed.
(DAY)
, 19~{~estote leaving a lost will, copy of which is hereto attached.}
(YEAR) Intestate
Decedent died
October 18
William E. Miller, Jr., 208 Walnut Street, P. O.
Box 1226, Harrisburq, PA 17108
That as such Executor deponent is familiar with the affairs of said estate and the property constituting
(EXECUTO R-ADMINISTRA TOR)
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A S.~FE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDEN T
Husband and wife
mmo al
10 South Market
Harrisburq, PA
S uare
17108
That the contents of said safe deposit box or boxes are itemized under Schedules
with the exception. of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property
wheresover situated owned by the decedent at the time of death; all moneys left by the decedent at the time of
death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons
giving also separately the accrued interest thereon, if any, down to the last interest day priM to decedent's
death in the case of savings.'banks,. and to the .date of decedent's death in all other cases; all bonds, postal
savings, treasury certificates or notes and other evidence of indebtedness of the United States to the de-
cedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States,
or any state, or political subdivision thereof, or of any foreign country, which are owned at the time of death;
all wearing apparel, jewelry, silverware, pictures, books, works of art, household furniture, horses, carriages,
automobiles, boats, and any and all other personal chattels of whatsoever. kind or nature, left by decedent,
together with the fairly estimated market value thereof; all bonds and mortgages held by decedent and of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair,market value be
less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all mo~eys
payable to the estate from life insurance policies carried by decedent; all annuity and endowment contracts
the proceeds of which were payable upon the death of the decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of decedent's
death and other investment securities owned by the decedent at the time of death, with the.market value there-
of at such time.
In the case of securities of close or family corporations, the values reported are as far as
possible substantiated by financial statements of the corporations, showing the assets and liabilities
thereof as of the date of death. The schedule also sets forth the interest of decedent at the time of
death in any co-partnership or business, and in support of the value of such interest there is annexed to
said schedule, financial statements showing the assets and liabilities of said co-partnership or husiness.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted. It should also set forth in itemized f'orm, together with the rair market value
thereof, any other property owned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof' sets forth a true answer to each inquiry
contained therein and in the case of transf'ers of property, real or personal, within two years of decedent's
death, in contemplation of' decedent's death, or intended to take effect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of' such property, to whom transferred, the
relationship of the transferees to the decedent, the proportionate share received by each transferee and
all other facts of a pertinent nature regarding said transfers. In the case of transfers intended to
take effect in possession or enjoyment at or after death, there is also attached to the schedule a co~y
of the deed, trust agreement or other instrument creating the trust. Therl'~ is also set forth in said
schedule a list of all property, real and personal, with its value, which passes at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power of appoint-
ment vested in decedent, either individually or jointly, by the will, deed, or other instrwnent of another,
with a copy of the instrument creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially interested in this estate at the time of decedent's death, the nature of their res-
pective interests, their relationship, if' any, to the decedent, together with the ages at the time of
decedent's death of all minors, annuitants and beneficiaries for life under decedent's Will. It also
contains a statement showing which of the beneficiaries named in the decedent's will, it any, died prior
to decedent, the dates of their death, their issue, and the relationship of' such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the name
of the decedent and others, plus the date and place of record of' instruments ef':fecting the vesti ture of
real estate and the date of acquisition of personalty, plus the name, address and relationship, if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed f'or and on behalf of this decedent's estate, including fUneral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fUdiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decedent; debts and claims owing and unpairl at time of'
death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section
651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A", "B", "e", "E", and "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this .................................
.............Jd{h r. day of . ,~... .....", 19.1.7.
.i~Ho~~r~ . . ..............
.., ~ bpir.. IW<h 14. I'm
....... " o_n c_
-~~- c=-
.----
."'(E~~;;i;;:Ad;;;i;;~t;~t;;r........."........._....,.......
208 Walnut Street "
...............................................................~...............................................................,.
(Street Numb",,)
Harrisburg, P 17108
..........................................................................................
(City en' Town and State)
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None", ~nd in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data and statements requirerl under the paragraph above relating to Schedule "B" are attached. Also make
certain that column #1 in the "Summary" has been properly completed as above-directed.
RCC-34 (4-78) .
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DEt:I!DENT
SCHEDULE "A"
REAL PROPERTY
*
Real property in Pennsylvania, with statement of mortgoge encumbrances upon each parcel at death of dece-
dent. Property held by the decedent os tenant in common with another or other, should be identified
os to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held os joint tenants with right of surviorship or tenancy by entireties should be reported on Schedule "E.")
Th. real property located In the Commonwealth of Penh.,dvanla should b. (1) (2) 131
de.crlbed by lot and block number, .tr..t and .tr..t numb.r. tog.ther with DEPARTMENT
a general d..crlptlon of the property, with a r.f.rence to the record of the ASSESSED VALUE VALUA TION
conveyance I:ty which the decedent took title; If a farm .tate number of a- FaR VEAR OF ESTIMA TED CAUTION
cre.; 01.0 .tatement of mortgage encumbrance. upon each parcel at death
of decedent. Taxe., a.....menta, accrued Intere.t on mortgage., etc.,are DECEDENT'S MARKET VALUE (Do not write
ta be lI.ted on Schedule uF" and mu.t not he deducted from thl. .chedule. DEATH In thl. space)
None ^/1H1-( /
Insert this total opposite "real property", Schedule "A" in the X X X X X
.. As Reported" column on the lost page of this return.
N",1'Ul-'
ffr-/
RESIDENT DECEDENT
SCHEDULE "Bn
PERSONAL PROPERTY
'*
RCC -35
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangIble personal property owned individually
by the decedent, at the time of' his death. Property owned by the decedent jointly with another or others
must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but
payable at death to another or others, including but not limited to P.O.D. U. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the fact that they are not of' the administered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certiricates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or f'iduciary in said capacity, partnership interests, interest in anyundistributed
estate or or income rrom any property held in trust under the will or agreement or another, even though
located outside or the State, at the time of' death, should be listed in this schedule.
Item
No.
/f}.
f
fl.h5
\ \3
'4
ITEM
List and describe fUlly
UNIT
VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
ESTIMATED
lIARKEf VALUE
1
Miscellaneous clothing and jewelry,
including two fur coats
[./
1,500.00 '
Account 002-00-04009 at State Capital
Savings & Loan Association, date of
death balance plus accrued interest
V
5,805.63....-
Certificate of Deposit at Dauphin
Deposit Bank and Trust Company, No. 14-
03-725661, balance plus accrued interest
V
4,069.03/
Certificate of Deposit at Dauphin Deposit
Bank and Trust Company, No. 14-03-724767
~
7,091.78-
5
24 shares common United Telecommunica-
tions, Inc. at $19.50 per share
.L9.50
468.00""
107.76/
26.94./
6
Medicare reimbursement
7
Blue Shield 65 Special reimbursement
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of' this return.
x X
19 0 10<1. I~
)
RCC-36
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "c"
TRANSFEIlS
'*
RESIDENT DECEDENT
(1) Did decedent, within two years of'death, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) No
(2) Did decedent, within two years of' death, transfer property from himself' to himself and another or
others (including a spouse) in joint ownership? (Answer yes or no) No
(3) If' the answer to (1) or (2) above 1s in the affirmative state:
(a) Age of' decedent at time of' transfer
(b) State of decedent's heal th at time of' making the transt'er. (Note 1).
(c) Cause of' decedent's death. (Note 1).
(4) Did decedent, in his I1f'etime, make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no)-HQ.._
(a) Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition? (Answer yes or no)
(b) What was the transferee's age at time of decedent's death?
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor ,under which transf'eror expressly or impliedly reserves for his life or any period which does
not in f'act end bef'ore his death:
(a) The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no) No
(b) The right to designate the persons who shall possess or enjoy the property transf'erred or
income therefrom? (Answer yes or no) NO
(6) If the answer to (5) (b) above is in the af'f'irmative, state whether the right was reserved in decedent
alone or othf>rs
(7) Did decedent in his lifetime make a transf'er, the consideration for which was transferee's promise to
pay income tn or fOl. Lhe l:enefit of care of' transferor? (Answer yes or no) No
(8) Did decedent, at a.ny time, transfer property, the beneficial enjoyment of which was subject to change,
because of a reserveli power to alter, amend, or revoke, or which could revert to decedent under terms
of transf'er or by operation of law? (Answer yes or no) No
(9) If the anSwer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the benef'iciary reserved in the decedent alone or the decedent and others?
(Answer yes or no) No
NOTE 1: The answers to these questions should be supported by aff'idavit by the attending physician as
well as a copy of the death certificate.
NOTE 2: If answer to any of' the above questions is yes, set forth below a description of the property
transferred, it's fair market value at date of' death, dates of transfers and to whom transferred, with
relationship of transf'erees to decedent, if any. Submit copy of any trust deed or instrument, if trans-
rers are claimed to be non-taxable, also submit detailed statement of' racts on which said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM
DESCRIPT ION
MARKET VALUE
(Es tIrns tad)
DEPT. VALUATION
(Dept. Only)
NMIl-J
Insert this total opposite "Transfers", Schedule "e" in the
WAs Reported" column on the last page of this return.
~j
~
RE V:,,453 ,(s..1t)
COMIIONWEALTH OF PENNSYLVANIA
TRANSFER INHEIUTANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP
(State full names and addresses of all who (If step-d>i1dreD or SURVIVED DATE INTEREST OF
have an interest, vested, contingent or othel'" illegitimate children DECEDENT OF BENEFICIARY
wise, in estate) are involved, set STATE YES BIRTH IN ESTATE
forth this fact.) OR NO
William E. Miller
561 Brentwater Road
Camp Hill, PA 17011 Husband Yes of aqe residue
Tri-County Branch, None Yes n/a $1,000
Pennsylvania Association
for the Blind
2336 North Third St.
.
Harrisburg, PA 17110
Deponent further says that a!l the above-named beneficiaries are I iving at thi s time except below:
NAME
DATE OF DEATH
RESIDENCE
RCC-38
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
'*
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This scherlule must disclose all property, real and personal, owned by the decedent jointly
wi th another or others, including intangibles, standing in the name of' the decedent and others. List
real estate f'irst, as entireties, or joint tenants, giving brief' description, as indicated tmder Schedule
"A", plus the date and place of record of' instrument ef'f'ecting vestiture, but do not include entireties
or out of' state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus date of acquisition, and the name, address and relationship (if' any) of co-owners to
the dece;lent.
Description of Property, Date of" Acquisition, Name Unit percentage Estate
Address and Relationship of' Co-Owners, and Place Value Share Valuation
of' Record of' Instrument where Real Estate.
DEPARTIlENT VALUATION
CAUTION-Do not Write
In This Snace.
~
><X:
<<<<
><X:
:x <X
:x <X
X:&:K
,(}O
X6<:X<X~
Value of'
Entire
Property
Value of'
Decedent's
Interest
Real Property
Residence numbered 561 Brentwater Rd.
East Pennsboro Township, Cumberland
County, titled in names of William E.
Miller ("WEM") and decedent Sara G.
Miller ("SGM")
Personal Property
1. Checking Account 64-310240 at
National Central Bank in names of
WEM and SGM. Date of death balance
$1,985.72.
2. Savings Account 002-20-10622 at
State Capital Savings and Loan
Association in names of WEM and SGM.
Date of death balance plus accrued
interest $17,249.34.
3. Certificate of Deposit 4-09-
109829 at Harrisburg Savings Associa-
tion in names of WEM and SGM. Date
of Death balance plus accrued interest
$20,455.05.
ND-t1.t)
Insert this total opposite "Jointly Owned Property", Schedule nEn
in the" As Reported" column on the last page of' this return.
f\U t'1.C I
r;-fu'
RCC- 3 (1-/39)
l:APPLlCATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFE~ INHERITANCE TAX
(Act of May 28, 1956, P L. 1757, and Act of June 15, 1961,
P.L. 373, os amended)
~,~~.~
f.:...'f. ',~-/ '.'\
...{ '.;tljlJ.!~,)i,
~?'~~2~~,(,;~
-9~'.
CGMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVEt"WE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed for the approval
of on exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of the property
described below:
1. Bureau File #
c;:: 1-
/-;)J/'~ 6/' {.;
2. Date of Deoth ~:tober 18,
1978
3. Date of Approva I
4. Name of Decedent
Sara G. Miller
5. The Commonwealth's appraised value of the property for which on exemption is claimed is $ 1,000.00
(Note: Where the property is other thon a specified amount of cash, the exemption cannot be approved until the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of Hil;l' document authorizing the transfer, unless
such material has been previously filed.
WILL fl;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If other, .exploin)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME
Tri-County Branch, Pennsylvania Association for the Blind
ADDRESS
2336 North Third Street, Harrisburg, PA
l7110
8. certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
.,'--~..
-;7
~/.....
William E. Miller, Jr.
----
Signature of Applicant ___-
?
Address of Applicant
P. O. Box 1226, H~isburg, PA
17108
Off" " I T" I Executor
ICla Ite__ .
Dote
July f;J 1979
This form must be completed in triplicote and all three copies delivered to the Register of Wills for the County in which the deced~nt
resided, or in which letters were issued for 0 non-resident decedent's estate. If the decedent was a non..resident of Pennsylvania and
letters were not issued by 0 Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of County Collections,
Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po.
Do not write below this line ~ For Official Use Only
Referred to Bureau Headquarters
Approved 0
For Secretary of Revenue
Denied' 0
(Signature of Register of Wills)
(lnitiols of Register of Wills)
(Authorized Signoture)
(County)
RItHARD ~ ANOrnlll
REGISTER OF WillS
,CUl',.jf)ffiLAND CO'J1i
(County)
(Title)
(Date of Approval)
(Dote of Referrol)
(Dote of Action)
* See reverse side for reasons
'1- lit -~,
MUST BE FILED IN TRIPLICATE
This section will be compl eted by Bureau Headquarters only when the application for exemption has been denied.
Date:
The application for exemption contained on the face of this form has been denied because
Note: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days after
the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable
Pennsylvania Inheritance and Estate Tax Acts.
Form RC C .10
OP'FICE OF T"'E
REGI8TER OF WILLS
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STATEMENT OF DEBTS
AND DEDUCTIONS
DATE OF FILING APPIltAISEMIINT nUn. -=3 J rq Yl Cf DATE 0" DEATH October 18, 1978
DATE NO. 01" NAME 0111' P'AYEE REMARU AMOUNT
VOUCMIiJII
Register of Wills Letters Testa. & Short Cert 38 00
Cumberland Law Journal Advertising Letters 18 00
West Shore Times Advertising Letters 16 75
Schleisner's Account balance 162 10
W. Orville Kimmel FuMgllllh Funeral Services 2,260 30
William E. Miller Family Exemption 2,000 00
National Central Bank Checkbook charges 5 64
Register of Wills Filing fees 9 00
United Missouri Bank Lost certificate 'd b~~d 13 59
J.n emnJ.
/
William E. Miller, Jr. Executors fee 1,200 00
Keefer, Wood, Allen & Rahc Attorney's fee 300 00
Closing costs Estimated 75 00
.
I
ESTATE OF
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ev (
Sara G. Miller
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DEDUCTIONS ALLOWED IN
(."C)9!,3J
THE SUM OF ............ $.
DATE ..,19_llf??
O~ Cumberland
COUNTY
AND AGENT OP THIE COtflMONW....LTH
LMEOF R~~r Ppnn~hnrn Tnwn~hip
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Dauphin
I, william E. Miller. Jr.
MY kNOWLEDGE AND SELIEP', THE POREGOING I. A .JUaT AND TRU IE SrATEMIENT OP'
AQMINISTR"'TION SUBMl'nED TO THE ESTA,TE OP Sara G. Miller
IN....RITANCE TAX PURPO....
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toIUlEaV caRTIN. THAT. TO THE SEaT 0'"
DaTa, P'UHatAL OPENSIES AND EXPEN." OPO
"'SC&Ae&D. Aa DEDUCTIONS P'OR
..CRIBED .....ORE ME THI. / 3~
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"'AY Of'
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WillJ.am
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E. lhller,
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eWOftN
CL. S.)
Jr...; Executor
KItlIlyt c. 1IolIinger. Hotaty Publi:
M. C_ bpim "rdr 14. 198J
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