HomeMy WebLinkAbout02-26-07 (2)
REV- 1500 EX (~-OOl
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 06
0517
COUNTY CODE YEAR
NUMBER
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DECEDENT'S NAME (LAST, FiRST, AND MIDDLE INITIAL)
CATHERINE B. BUTT
! SOCIAL SECURITY NUMBER
! 175-34-8256
----t-..~.- .--... ~.
i THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
j REGISTER OF WillS
.....1..-.._.._._ "_'_'_'
SOCiAL SECURITY NUMBER
DATE OF DEATH (MM.DD.YEAR) ! DATE OF BIRTH (MM-DD.YEAR)
OS/27/2006 i 04/24/1928
--"_._-"-"~--~---"._-"-_._. _._--~.. "--
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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~ 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of WHI)
o 9. Litigation Proceeds Received
o 3. Remainder Return (date 01 death poor to 12.13.82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AttachSch O)
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of dealh after 12.12-821
o 7. Decedent Maintained a living Trust (Attach copy 01 Trus!)
o 10. Spousal Poverty Credit (date of death between 12.31.91 and '+95)
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NAME
LINDA A. CLOTFELTER, ESQUIRE'
FIRM NAME (lfApplicabi;j--'-' ~
LAW FIRM OF LINDA A. CLOTFELTER
TELEPHONE NUMBER "--.--,------" "--.--- --_.-.."---
(717) 796-1930
COMPLETE MAILING ADDRESS
5021 E. TRINDLE ROAD, SUITE 100
MECHANICSBURG, PA 17050
(1)
(2)
(3)
(4)
(5)
149,000.00
232,548.72
0.00
0.00
162,199.60
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or SoIe.Proprietorship
4. Mortgages & Notes Receivable (Schedule O)
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
(Schedule G or l)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
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)
39,582.65
554,567.54
0.00
.i
"
(6)
0.00
(7)
50,401.87
L _'\
594,150.19
(9)
(8)
37,960.70
1,621.95
(11)
(12)
(13)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
554,567.54
seE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See 9116 (a)(1.2)
x .0
(15) 0.00
(16) 24,955.54
(17) 0.00
(18) 0.00
(19) 24,955.54
16. Amount of Line 14 taxable at lineal rate
_g94,5pL~. xO ~9
17. Amount of Line 14 taxable at sibling rate
x .12
18. Amount of Line 14 taxable at collateral rate
x .15
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
~
Decedent's Complete Address:
STREET ADDRESS
101 APRIL DRIVE
~__.._n___~__ ___.__~_._..____.._..__.~___.___~_.....__~__
CITY CAMP HILL
STATE
PA
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17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
24,955.54
22,500.00
-_.._----_.'_..._..._._~-
1,184'.?t
Total Credits ( A + 8 + C ) (2)
23,684.21
3. Interest/Penalty if applicable
D. Interest
E. Penalty
A. Enter the interest on the tax due.
(SA)
0.00
0.00
1,271.33
0.00
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
1,271.33
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Ves No
a. retain the use or income of the property transferred;....................... .................... ............................................ 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................... 0 [i]
c. retain a reversionary interest; or.......................................................................................................................... 0 [i]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [!]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.............. 0 [i)
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 lil
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 penalbes of perjury. I declare that I have examined this retum, 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.
~~~UiJIt~~ Ri:t)~:lp~G RETURN P')Ul Ai,ut~~~
ADDRE~~ rrL~(f\.~. AJUdL E ~t))A,../__
13709 Stafford Dr. Thurmond, MD 21788 301 Cameo Drive, Fayetteville, PA 17222
. _...~_____ _.. "_____..____ .__._n____. m...___.._ ... ~._---_..-_._... .-.-.--.....
SIGNA ~;;;;::J111+. P~ESENT:~I~~
DDR SS
5 E. Trindle'3o~~, SIlJt~_~OO,~~~banj.~~~lJr!;l~.~_~!9~9_.
?ATE /
d 1~3/ () 7_
DATE
JI~Jia1
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS 39116 (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. g9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent. an adoptive parent.
or a stepparent of the child is 0% [72 P.S. 39116(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. S9116(1.2) [72 P.S. S9116(a)(1 )].
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. s9116(a)(1.3)]. 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.
REV-1502 EX... (6-98)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CATHERINE B. BUTT
FILE NUMBER
21-06~0517
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Personal Residence - Tax Parcel No. 01.21-0275.085
VALUE AT DATE
OF DEATH
149,000.00
101 April Drive, Camp Hill, Cumberland County, PA 17011
Deed Book 20, Page 429 - By operation of law title passed to decedent as the surviving spouse
Upon her husband, Ralph B. Butt's death April 25, 2006
Value at date of death $149,000.00 (sold to third party 8/31/2006 for $149,000.00)
See HUD-1 for sale 8/3112006 attached
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
149,000.00
r;- I::S. I r f""'C V. LV/",\,...
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.~FHA 2.0FmHA 3.0CONV. UNINS. 4.DVA 5.DcONV. INS.
6. FILE NUMBER: 17. LOAN NUMBER:
SETTLEMENT STATEMENT 06.505 8570607034
8. MORTGAGE INS CASE NUMBER: OLD MORTGAGE INS CASE NUMBER:
6.00%/F/886.31 MO
C NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to end by the settlement agent are shown.
Items marked "[POC)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1,0 Ji9tl (SWEENEY.WA TSON.PFDI06-505I24)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Shannon A. Watson and Estate of Catherine Butt SLM Financial Corp.
Brian C. Sweeney 6000 Commerce Parkway
101 April Drive MOUnt Laurel, NJ 08054
Camp Hill, PA 17011
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 68-0510988 I. SETTLEMENT DATE:
101 April Drive Community Land Transfer, LLC
Camp Hill, PA 17011 August 31, 2006
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
2331 Market Street
Camp Hill, PA 17011
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract Sales Price 149,000.00 401. Contract Sales Price 149,000.00
102. Personal Prooertv 402. Personal ProDertv
103. Settlement Charces to Borrower (Line 1400) 7,592.51 403.
104. 404.
105. 405.
Adiustments For Items Paid Bv Seller in advance Adiustments For Items Paid Bv Seller in advance
106. CitvlTown Taxes to 406. CitvlTown Taxes to
107. CountvTaxes 08/31/06 to 01/01/07 141.05 407. County-Taxes 08/31/06 to 01/01/07 141.05
108. School Taxes 08/31/06 to 07/01/07 1 045.50 408. School Taxes 08/31106 to 07/01/07 1,045.50
109. Sewer 08/31/06 to 01/01/07 56.82 409. Sewer 08131/06 to 01/01/07 56.82
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 157,835.88 420. GROSS AMOUNT DUE TO SE:LLER 150,243.37
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deoosit or eamest money 2,000.00 501. Excess Denosit ISee Instructions'
202. Principal AmOunt of New Loan!s) 147,829.00 502. Settlement Charaes to Sellerlline 1400\u 13,004.29
203. Existing loan(s) taken subiect to 503. Existina loan(s) taken subiect to
204. 504. Payoff of first Mortgage
205. 505. Pavoff of second Mortoaoe
206. 506.
207. 507. (Deposit disb. as oroceeds)
208. 508.
209. 509.
Adiustments For Items Unpaid By Seller Ad;ustments For Items Unoaid Bv Seller
210. CitvlTown Taxes to 510. CitvlTown Taxes to
211. County Taxes to 511. County-Taxes to
212. School Taxes to 512. School Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BYIFOR BORROWER 149,829.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 13,004.29
300. CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower lLine 1201 157,835.88 601. Gross Amount Due To Seller (Line 420\ 150,243.37
302. Less Amount Paid By/For Borrower (Une 220) ( 149,829.00) 602. Less Reductions Due Seller (Line 520) ( 13,004.29
303. CASH ( X FROM) ( TO) BORROWER 8,006.88 603. CASH ( X TO) ( FROM) SELLER 137,239.08
The undersigned hereby acknowledge receipt of a completed copy of pages 1 &2 of this statement & any attachments referred to herein.
Seller
Estate of Catherine Butt
BY)5v~ ~ 11~ J2j~~
Ii .4 . 7 ,(~-A;".,. ,7z"
.i,UI.f.Llv.f..!' (. ,/ . 7'.", '"'-1 i r Q,...
-.. --.. ---
700. TOTAL COMMISSION Based on Price $ @ % 8.940.00 PAID FROM PAID FRDM
Division of Commission (line 700) as Follows: BORROWER'S SELLER'S
701. $ 4,495.00 to REJMAX REALTY ASSOCIA res FUNDS AT FUNDS AT
702. $ 4.445.00 to THE HOMESTeAD GROUP, INC. SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement 8.940.00
704. to
800. ITEMS PAYABLE IN CONNECTION WITH lOAN ,
801. Loan Oriaination Fee 0.9852 % to SLM Financial Corodba Sallie Mae Mta. 1 ,456.45
802. Loan Discount % to
803. Appraisal Fee to Donald Steele POC:B300.00
804. Credit Report to Credco 16.50
80S. Lender's Inspection Fee to
806. Morloage Ins. ADD. Fee to
807. Assumption Fee to
808. Commitment Fee - to SLM Financial Corp dba Sallie Mae Mtg. POC B $25.00 75.00
809. Flood Cert Fee to First American Flood Data Services 13.50
810. AUS DU to SLM Financial Corp. dba Sallie Mae Mtg. 30.00
811. PA Housing Auth. Fee to PHFA 300.00
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 08/31/06 to 09/01/06 -@ $ 24.300660/day ( 1 days 6.0000%) 24.30
902. Mortgage Insurance Premium for months to HUD 2.184.68
903. Hazard Insurance Premium for 1.0 years to Christian-Baker ComDanv 425.00
904'.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 2.000 months $ 35.42 Der month 70.84
1002. Mortoaoe Insurance months $ Der month
1003. CitvITown Taxes months $ oer month
1004. CounlYTaxes 6.000 months $ 34.18 oer month 205.08
1005. School Taxes 2.000 months @ $ 102.52 per month 205.04
1006. months Ilil $ Der month
1007. months fl!} !I; Mr month
1008. Aaoreoate Adiustment months @ $ Der month -136.69
1100. TITLE CHARGES
1101. Settlement or Closino Fee to
1102. Abstract or Title Search to
1103. Tille Examination to
1104. Title Insurance Binder to
1105. Electronic Document Prep. to Communitv Land Transfer, LLC 50.00
1106. Closino Service Letter to Communitv Land Transfer, LLC 35.00
1107. Attorney's Fees to
!includes above item numbers: I
1108. Tille Insurance to COMMUNITY LAND TRANSFER CRA Rate 827.81
(includes above item numbers:! 1 02, 1103 & 1104 )
1109. Lender's Coverage $ 147,829.00
1110. Owner's Coverage $ 149,000.00 827.81
1111. Endorsements 100, 300, 8.1 to Community Land Transfer, LLC 150.00
1112. Notary Fee to Community Land Transfer 10.00
1113. Notary Fee to Commun-ity Land Transfer 500
1114.
1115.
1116. Transaction Fee to RElMAX Realty Associates 125.00
1117. 2006-2007 School Taxes to JanetL. Miller, Tax Collector 1,255.29
1118. Sewer Fees to Borough of Camp Hill 85.00
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 39.50; Mortgage $ 53.50; Releases $ 93.00
1202. CiIY/Countv TaxlStamDs: Deed 1,490.00' Mortaaae 1,490.00
1203. State Tax/Stamps: Deed 1 490.00; Mortoaoe 1,490.00
1204. Recording for Assianment to Cumb"r1and Counlv Ret'./Ifder of n-ds 27.00
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302. Pest Inspection to Bower's Pest Control 40.00
1303. Home Warranty te First American Heme Bwers Protection 399.00
1304. Tax Cert to RElMAX ReaItv- 5.00
1305. Radon Mitigation System to ARS 700.00
1400. TOTAL SETTLEMENT CHARGES IEnter on Lines 103, Section J and 502. Section Kl 7[ 7,592.51 13,00429
By signing page 1 of this stalemenl. the signalones acknoWledge receipt ar a completed copy of page 2 of this ""'" pege statement ,11L---
Communi Land Trarnl'fer'1.LC
ty
Settlement Agent
Certified to be a true copy.
REV-1503 EX+ (6-98)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CATHERINE B. BUTT
FILE NUMBER
21-06-0517
All properly jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
8430 Shares of Common Stock of Tyco International, L TO
VALUE AT DATE
OF DEATH
231,487.80
Date of death value: $27.46 per share
2.
14 Shares of Common Stock of Prudential Financial account number 593-7580
1,060.92
Date of death value: $75.78 per share
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
232,548.72
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Date Requested OS/27/06
The date reqiJ6'ste,j is not available.
The previous trarjing day is OS/25/06
Closing P(ce $27.46
Volume 3!544,900
Spill l....dJusiJnBnt Facto; t1
Open $27.37
Day's rHgh $27 .47'
DayilS Low $27.-16
NOTE: The Closing Pdce. Day's High, Da/s Low, and Day's VQliJm~ have been adjusted to 0.CO):jntj~y ~tr?G
and/or divid€ndi;} v.:h1ch may have occurred .for HHs se~~urlty since the date shown above. Tt16 ACti.i21 Pric,:.:. no:::
spiits or dividends. The Spiit Adjustment FoReroI' is a cumulativ'S facior \I.ihlch er;c~rsubt€5 aj: splits :::inc~.~ ~he caif
above.
The dosing pdce a.bove is r;ot 'l€'CBs.sarliy indicative of future price performance
'f) 20Q4~2006 Tyco tnternat:cna;! Ltd, AH Rights Reserved
l-{PJ_n? l Care6($ 1 q~m,'f,#~L~!.~.1 ~~i.tqj-.:h~p. T?.f.(r?.;~...qLl!_~.$
http://investors. tyeo .com/phoenix.zh tInl ? c= 112348&p=ir\)J_~sto<:ldoo kup& t= HistQuote
10/13/2006
Prudential {~, Financial
Transaction Statement
IMPORTANT INFORMATION ABOUT YOUR ACCOUNT
0001364989
CATHERINE BUTT
101 APRIL DR
CAMP HILL PA 17011
NUMBER OF SHARES CREDITED
14.0000
TRANSFER AGENT ACCOUNT rWMBER
593 7580
1111111111111111111111111111
CUSIP NUMBER
744320102
010005937580
PIN/PASSWORD. PLEASE KEEP COrlFIDEIlTlAL
4296 5597
January 2002
We're pleased to welcome you as a new stockholder of Prudential Financial, Inc.
On December 18, 2001, Pmdential completed its conversion fi"om a mutual company to a stock company. As part of our
conversion, we are issuing stock to eligible owners of the company. This includes anyone who o\vned an eligible policy
or annuity contract as of December 15, 2000. You have received the number of shares listed above. Compensation for all
of your policies eligible for stock is included in this statement.
This does not affect your insurance policy or annuity in any way.
Stock o\'11ership is a benefit of holding an eligible policy or contract. It does not replace your policy or contract, or
change your benefits, cash values, eligibility for policy dividends or guarantees. You do not have to give anything up to
receive stock.
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How your allotment of shares was determined.
Company actuaries and extemal advisors developed a plan for dividing the value of Prudential among its owners.
Factors such as the type oflife, annuity or health policy or contract you owned, the face value, and how long you owned
it determined how many shares you received.
Your shares are registered on the books of Pm de ntia I Financial, Inc.
Prudential has engaged EquiServe Trust Company, N.A., a provider of shareholder services, to hold your shares at no
cost to you. A stock certificate is not required to continue holding your shares in book-entry foml. The enclosed brochure
explains how to hold shares, transfer or sell shares, or obtain a stock certificate, through EquiServe. Note: If you would
like EquiServe to continue holding your shares at no cost, no action is required.
A commission-free sales and purchases program will be available for certain shareholders in the future.
To participate, you must own 99 shares or fewer and hold yom shares in book-entry fonn as they are now. See back for
more infonnation.
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What YOU should do now.
1) Keep this statement for your records.
2) Read the enclosed brochure for inlonnation on how you can hold, transfer or sell your shares through EquiServe's
Sales Facility, or obtain a stock certificate.
SEE BACK FOR AODrnONAL INFORMATION.
Que$tions? Call 1-800-305-9404 weekdays from 8:00 a.m. to 7:00 p.m. (ET). For hearing impaired, call 1-800-619-2837.
Or vi<;:it nrudential.equiserve.com
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pnvacy and Business Integrity Terms and Conj,tiors
... ro 1-'4 """ II"'\AAr
REV-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CATHERINE B. BUTT
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-06-0517
ITEM
NUMBER DESCRIPTION
1. Miscellaneous Household Goods and Furnishings sold at public auction including 1993 Buick LeSabre
Custom Sedan VIN 1 G4HP53L9PH544652 (sold for $3,700.00)
Total gross proceeds of auction: $9,061.00
2. Investment account number 16463932 with Raymond James Financial Services, Inc.
Date of death value: $50,104.23
3. Checking account number 18889468 with M&T Bank
Date of death value: $48,027.11
Interest accrued: $1.44
4. Certificate of Deposit number 031003914577027 with M&T Bank
Date of death value: $ 5000.00
Interest accrued: $5.82
5. Certificate of Deposit number 24-740-205-2167287 with Wachovia Bank, NA
Date of death value: $ 50,000.00
Interest accrued: $141,56
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
9,061.00
50,104.23
48,028.55
5,005.82
50,000.00
162,199.60
CLAUDE C. WOLft & A))UlIAI t)
AUCTIONEERS & APPRAISERS
FAMILY OWNED SINCE 1910
2009 LINCOLN STREET · CAMP HILL, PA 17011
717-737-0734
Public Auction for Estate of Catherine B. Butt
Date July 22, 2006
Address 101 April Drive, Camp Hill. PA 17011
Auction Gross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,061 .00
EXPENSES
Shoppers Guide Adv. & Sale Bills $306.20. . . .97. 5%. $
Patriot News Adv. ...... $54..4B.auto$.4.7...67... 97.5%.
Paxton Herald Adv. .............. $222..40. . . 97.5%
other Mv. ......................................................................
Other Mv.. ........................................................................
Other Adv.. ........................................................................
Sign for Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
state Fumigation Tags .... .......... ..... ......
Registration Numbers .. . . . . . . . . . . . . . . . . . . . . . . . .
Ten t/ Tarp .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Mi sc . Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Clerks at $ 65.00 each. $260..0.0. . . .97.5%
4 Runners at $ 65.00 each. .$260..0.0.. . .97.5%
La})or Sale preparation
Labor
Labor
Labor
Personal Items Fee at 10 % .. . . . .. . .. .. .. .. ..
Total Expenses for Auction ...... ......... ......
Real Estate Gross. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Real Estate Fee at
% (Due at Settlement) .
298.50
100.88
210.10
25.00
10.00
10.00
75.00
253.50
253.50
166.00
906 .10
. . . $ 2,308.58
\ ') \) 0~ ;..{)
\JV " \\.' \.../ L0l\ i...-J\'c,)?'~t v\...
c-----.) \
Auctioneer or Cashier:
~ '
I .I .
~ \ I htA-yl~4-1~
Approved by:
$ 9,061.00
2,308.58
6,752.42
N/A
6,752.42
Auction Gross
Expenses
Net
Checks
Owed ~by Auctioneer
PI M&fBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
October 13,2006
Law Firm of
Linda A Clotfelter
5021 East Trindle Road, Suite 100
Mechanicsbnrg, Pennsylvania 17050
Re: Estate if: Catherine Butt
Social Security: 175-34-8256
Date of Death: Mav 27.2006
Dear Sir or Madam:
Per your inquiry dated October 7, 2006, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
18889468
Ownership (Names of)
Catherine Butt *
Ralph B Butt Jr *
Opening Date
08/28/64 Closed 09115/06
Balance on Date of Death
$48,027.11
Accrued Interest
$
1.44
Total
$48,028.55
2.
Type of Account
Certificate of Deposit
Account Number
031003914577027
Ownership (Names of)
C.atherine Butt *
Opening Date
08/18/97 Closed 06/12/06
Balance on Date of Death
$5,000.00
Accrued Interest
$ 5.82
Total
$5,005.82
._ .' ._~." .. ____..~_~_.____.._~_y_...._..___...._ ,,~_..___. ""'~H'__" ~~
Please be advised, there was no safe deposit box found for the above decedent * For further account information,
regarding ownership, closures and/or reimbursement of funds, etc., please call the West Shore Plaza Office # 717-
255-2271.
Sincerely,
/$4.f~,C2~7
/
Nancy Clagett
Records Management
.
WAcmJv.rA
ReftnllCe ID: 17'95631
Wachovia Bank. N.A.
Balance Confirmation ServiCll:s
POBox 40028
Roanoke, VA 24022.7313
October 22, 2006
LINDA A CLm'FELTER LAW FIRM
5021 EAST TRINDLE ROAD SUllE 100
MECHANICSBURG, PA 17050
SUBJECT: Verification / Confirmation of Aa:ount and Balance Information provided for:
Customer: CATIII.IUNJ: B BllTl' (SSN# 17S-34-8256)
Date of Death; May 27, 2006
DeuoIit AttOllllt lDformati08
Ao:couct
Type
A/;:rounl
Number
om ofDo:ath
Ball11l1:C
Awrage
Ba1u>co*
IllIte MaIwil.y lDtIn5t A=ucd YTD om
Opened Oat.: Rile Intenst 1_ Paid Closed
CERTIFICATE OF DEl'OSIT 241402052167287
LEGAL Tm..E: RALPH B BUrr
CATHER.INl: B BUIT
CLOSING BALANCE: $501011.50
$50.000.00
1121f2005
$14U6
$513.44 6f23!2006
CERTIFICATE OF DBPOSIT 2474020'2190366
LEGAL TITLE: RALPH B BUrr
CA1HERlNE B BUrr
CLOSING BALANCE: 530016.03
$0.00
2f18l2OO'
412412006
* Due to systlImlimitaticms. \\Ill l:III mIy provide a twclvc IIIllIIIb a~ baIam:e 011 tIl:poQhxy &OOOIlIIIs.
REV-1510 EX+ (6-98)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
CATHERINE B. BUTT
FILE NUMBER
21-06-0517
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A copy OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1. Aetna Life Insurance Company Joint Life Annuity Contract No. GA-443 270.14 100 270.14
Upon spouse, Ralph B. Butt, Jr's. death, payments to Catherine Butt
Payments 25% of $1,080.55 per month, but Catherine Butt died 5/27/06
Only one payment received for $270.14
2. Allstate Life Insurance Company Annuity number GA 17633671 50,131.73 100 50,131.73
Date of death value $50,131.73
3. Death Benefit of (ING Benefits) Reliastar Life Insurance Policy No. 5,000.00 0.00
62941-3-GA T on the life of Ralph Butt, Jr. payable to decedent
4. Death benefit of Prudential Life Insurance Policy No. 40224011 on the life of
Catherine Butt. BeneficiaryfTransferee: Margaret McGoarty, sister
5,662.10
0.00
TOTAL (Also enter on line 7 Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
50,401.87
1:qt:D
PO Box 3608
Harrisburg, PA 7 7705-3608
USA
Electronics
Natalie Quigley
HR Benefits
M S16I-33
Phone: 717-810-4.905
Fax: 717-810-4.966
E-mail naquigle@tycoelectronics.com
Phone: 777-564-0700
wwwtycoelecrromcs,com
June 12,2006
Catherine Butt
101 April Dr
Camp Hill, PA 17011
Dear Mrs. Butt:
I am sorry to hear of Ralph's death and wish to extend my condolences to you and your family.
I would like to inform you of the benefits payable to you as the Joint Annuitant and beneficiary of Ralph
Butt Jr. Since Ralph elected the 25% Joint and Survivor option for his monthly pension benefits, 25% of
his monthly payments will continue to you for the remainder of your lifetime. The gross monthly amount
of your benefit will be $ 270.13 per month from Aetna.
You will bc eligible to receive payments effective May 1, 2006; however, these payments will
temporarily be put on hold until the claim is filed with Aetna. Once we receive the information requested
below, we will process the claim and the payments will be made payable to you, effective May 1, 2006,
reflecting your Federal income tax withholding election.
As a retiree Ralph was covered with a life insurance policy under the Tyco International (US) Inc. Basic
Term Life Insurance Plan; therefore, you will receive a $5,000 life insurance benefit. This is a non-
taxable benefit.
In order to file the claims for the above-mentioned benefits, I will need you to supply me with the
following information:
1. One original death certificate for Ralph B Butt Jr
2. A copy of your marriage certificate
3. A copy of your Social Security Number
4. ING Death Claim form - Please complete, sign, and return with other requested paperwork.
(enclosed)
5. Form W-4P - Please complete this form indicating the withholding you wish for your monthly
pension payments. (enclosed)
6. Aetna Direct Deposit Authorization Form - (optional) if you would like your monthly payments
directly deposited into your bank account, please complete this form and return it with the remainder
of the forms. (Enclosed)
tqCD
Electronics
J y<..;u CI':!(;U UI 11I..,3 l...,.Vff../VI t3UVII
PO Box 360.8
Harrisburg, PA T 7 705-360.8
USA
Phone 17 7-564-0 TOO
~,tvcoe~Clfon0scom
Please return the above-mentioned forms to Tyco Electronics, Mail Stop: 161-33, P.O. Box 3608,
Harrisburg, PA 17105-3608. Tfyou have any questions, please feel free to contact me at 717-810-4905.
Sincerely,
'",--:: l ~-+--::; 1
!; / /j'l.!J ~ .
fl' OuJ-V..J.5-
,
Natalie Quigley
HR Benefits
. 1
/' b
t, 1, J / j 11(},C/
\""y"'.../.Jv'-./-l Ii
(; U
~
Allstate.
AII_t. Ute Insunnce Company
PO Box 94260
Palatine IL 60094-4260
Telephone: 1-800-755-5275
Fax: l.e66-628.1006
CATHERINE BUll
101 APRIL DRIVE
CAMP HilL PA 17011-4904
JUM 26. 2006
.;;~~. ~'i'~;;,:~.<~:~~~.~~t,,~'~~~~t;:;;'i~.;'r;;'::':~:~,:
STEPHEN J LANDERSMAN
M & T SECURITIES. INC.
380S TRINDLE ROAD
CAMP HILL PA 17011-43,37
(717}737-2308
Allstate. Performance PIU$ #OA17633871
As you requested, we have processed the following withdrawal. Your withdrawal has been el8ctronically transferred
according to your instructions.
Withdrawal Information:
Remaining Annuity Value as of 06I26f06
11'5.70
$125.70
$50,006.03
$50,131.73
S125.70 .
Gross Annuity Value u of 06126106
Gross Witbdrawal Amount
Electronic Transfer AmOl.ln1
As required, the taxable amount of this distribution will be reported to the Internal Revenue Service on Farm 1099R. A
copy of this form will be mailed to you by January 31 01 the next year. Please retain this information for your financial
and tax records.
If you have any questions about this transactiOn, please contact your representative. or call 1-800-755-5275. We value
our relationship with you and look forward to continuing k> help you achieve your long-term financial goals.
_..-- -.'
4_____.__ .--...--
---- ..-. :.-:,:::.-,..._-_._-'..~~
-
X26X01WONOl
A......,It'zp.I01.,.,.,~'...-
nl7la
Prudential ~ Financial
Customer Service lfffice -
po. Box 70174
Philadelphia, PA 19176
(800)496-1035
www.prudential.com
Linda Martin
13709 Strafford Dr
Thurmont, MD 21788
Insured: Catherine Butt
Policy Number: 40224011
September 27, 2006
Dear Linda Martin:
I am writing to let you know that we have received your notification regarding the death of Catherine
Butt. Please accept our sincere condolences for your loss. In order to process the claim as quickly as
possible, I need your assistance.
I want to begin by confirming that the policy names Ralph B Butt Jr as primary beneficiary.
Because Ralph B Butt Jr died before Catherine Butt the death benefit proceeds on policy number
40224011 are payable to Margaret McGroaty as contingent beneficiary.
Enclosed is important documentation related to the claim. Please have the beneficiary (or the
appropriate party) complete, sign, and date any documents where information is requested. If changes
are needed to any of the pre-filled information in these documents, the person signing them should
make the correction and place his or her initials next to it. Finally, return all the items listed below to
us in the enclosed reply envelope. Please note that any documents sent to us become part of the
claim file and cannot be returned.
. A Life Insurance Death Benefits Claim Form. Please be sure that the section titled Tax
Certification is completed, and the form is signed and dated in the section titled Signature.
. An original death certificate issued by the state in which Catherine Butt passed away, or a copy
that has been certified and includes the raised seal of that state. To prevent a delay in
handling, the death certificate should include the cause or manner of death. Please note that
we require only one death certificate to process all of the claims for this policy.
. An original death certificate issued by the state in which Ralph B Butt Jr passed away, or a
copy that has been certified and includes the raised seal of that state. Please note that we
require only one death certificate to process all of the claims for this policy.
. The insurance policy, if it is available and does not provide family coverage.
If you have any questions or would like more information, please call our customer service office at
(800) 496-1035 and refer to reference number WN18ZDYW. We are available Monday through
Friday between 8:00 a.m. and 9:00 p.rn. Eastern time. You can also reach us on Saturdays between
8:00 a.m. and 3:00 p.m. Eastern time.
'.' . ~ '" iN 1f'<~ .. 11
niuentl~'li V~ 1i HlanCUU.
p 00 950 0
CATHERINE BUTT
101 APRIL DR
CAMP HILL PA 17011-4904
This is your annual dividend notice.
We are pleased to tell you that a dividend of $31.02 will be credited to
your life insurance contract 40 224 011 on Mar 28, 2006. This will be
used to provide paid-up additional insurance protection.
Your Prudential policy provides valuable insurance protection. We
also want you to know that:
The dividend credited to your policy on Mar 28, 2006 is $31.02.
Next year's annual premium will be $27.70.
Your cash value will continue its guaranteed increase. Any dividends
will be earned based on our future experience.
On Mar 28, 2006, the (Net) Death Benefit of your contract will be
$5,662.10.
On Mar 28, 2006, the Guaranteed Cash Value of your contract will be
$779.00 and the (Net) Cash Value will be $4,798.62.
Thank you for insuring with The Prudential.
o 20200 YI
Dividend Notice
(This is Not a Bill)
Dividend Date: Mar 28, 2006
Contract Number 40 224 011
Insured: CATHERINE BUTT
DIVIDEND INFORMATION
Current Dividend $ 31. 02
PUA Dividend.... $183.78
Total Dividend $214.80
Paid.Up Additional Insurance Protection
""(see other side for additional information)
Amount Added This Year $249.13
Total Paid-Up Add' Ins $4662.10
For assistance, please call our Customer Service
Office at (800) 778-2255. You may also write us at
the address listed below or visit us at
www.prudential.com.
Customer Service Office
PO Box 7390
Philadelphia, PA 19176
Do We Have
Your Correct Address?
If the address shown is not correct, please
call our Customer Service Office at the number
listed above.
REV-1511 EX+ (12-99)_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-06-0517
ESTATE OF
CATHERINE B. BUTT
ITEM
NUMBER
A.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Monahan Funeral Home, Inc., Gettysburg, Pennsylvania - Funeral Expenses
Cordor Memorials - Expense for grave marker and inscription
9,546.50
1,443.00
8. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative{s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
Attorney Fees
5,872.04
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State
.Zip
Relationship of Claimant to Decedent
4.
Probate Fees
620.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Cumberland Law Joumal - Estate Advertisement
The Patriot News - Estate Advertisement
75.00
246.24
15.00
20.00
2,340.00
36.04
8.
9.
Register of Wills, Cumberland County - Filing Fee for PA Inheritance Tax Return
Orphan's Court, Cumberland County - Filing Fee for Family Settlement Agreement
Dan White's Plumbing, Heating & AC - Bill for plumbing repairs at residence
Virgil Hartman - Reimbursement for bill paid to Duty's Lock Service for repairs to residence
10.
11.
12.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
20,213.82
SCHEDULE H (continued)
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
13. Eric Paull- Lawn maintenance bills pending sale of residence
14. J.R. Hossman - Home repairs pending sale of residence
15. UGI - Gas bills for residence pending sale
16. Diane Hixon - Reimbursement for funeral luncheon expense
17. Camp Hill Borough - Sewer bill for residence pending sale
18. P A American Water Company - Water bills for residence
19. PP & L - Electric bills for residence pending sale
20. Linda Martin - Reimbursement for expenses of Executrix (mileage $597.64, Meals
$86.43, toll calls $8.10)
21. Dianne Hixon - Reimbursement for expenses of Executrix (mileage $561.59, Meals
$73.14,to11 calls $21.60)
22. Linda A. Clotfelter, Esquire - Reimbursement of fees for additional short certificates
23. Claude C. Wolfe & Associates - Expenses for public auction of estate personal property
24. Prudential Financial, Inc. - Transaction fees for sale of stock
25. The Homestead Group, Inc. - Realtors commission for sale of residence
26. RE/MAX Realty Associates - Realtors commission for sale of residence, transaction
fee, and tax certification fee
27. Community Land Transfer - Notary fees for sale of residence
28. ARS - Fee for radon mitigation system
29. Janet L. Miller, Tax Collector - School taxes due for residence ($1,255.29 -
reimbursement of $1,045.50)
30. Camp Hill Borough - Sewer bill for residence paid at settlement ($85.00 -
reimbursement of $56.82)
31. Recorder of Deeds, Cumberland County - Transfer tax for sale of residence
32. First American Home Buyers Protection - Home warranty fee paid at settlement for
residence
TOTAL (page 2)
TOTAL (Page 1)
300.00
1,031.00
312.67
249.00
85.00
51.40
127.64
692.17
656.33
8.00
2,308.58
23.12
4,445.00
4,625.00
5.00
700.00
209.79
28.18
1,490.00
399.00
17,746.88
20.213.82
TOTAL SCHEDULE H $37,960.70
REV.1512 EX+ (12-{)3) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
CATHERINE B. BUTT
FILE NUMBER
21-06-0517
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
M&T Visa - Credit card bill
640.47
2.
UGI Utilities - Gas bill
113.00
3.
AT & T . Telephone bill
41.78
4.
BP Amoco - Credit card bill
12.00
5.
Verizon - Telephone bill
30.04
6.
Penn Waste - Trash bill
42.63
7.
Trugreen Chemlawn - Lawn service bill
37.10
8.
PP & L - Electric bill
47.71
9.
Comcast - Cable television bill
47.85
10.
PA American Water - Water bill
47.62
11.
Linda A. Clotfelter, Esquire - Bill for professional services and expenses prior to date of death
561.75
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,621.95
REV.1513 EX+ (9-00) *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
CATHERINE B. BUTT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)]
1. Linda M. Martin, 13709 Stafford Drive, Thurmont, MD 21788
FILE NUMBER
21-06-0517
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
step-daughter 50.00
2.
Dianne E. Hixon, 301 Cameo Drive, Fayetteville, PA 17222
step-daughter
50.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE. ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
NONE.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
NONE.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(ff more space is needed. insert additional sheets of the same size)
0.00
LAST WILL AND TESTAMENT
I, Cathrine Butt, of Cumberland County, Pennsylvania, declare this my
Last Will and her,eby revoke all prior Wills and writings in the nature thereof
by me at any time heretofore made.
Item 1: I direct that my personal representative pay all the legal obli-
gations of my estate, funeral expenses and the costs of administration of my
estate as soon after my death as practicable.
Item 2: I give my tangible personal property, together with any existing
insurance policies thereon, to my husband, Ralph B. Butt, Jr., if he survives
me by thirty (30) days; otherwise, to my two daughters, Linda Mae Cipriani and
Diane Shupshinskas, if they are living on the thirty-first (31st) day after
my death to be divided between them in accordance with any memorandum I may
leave or, in the absence of any memorandum or as to items not covered by such
memorandum, then to be divided among them as they shall agree. Should there
be no agreement, I direct that a private auction sale of such tangible personal
property, including my automobiles, household goods and furnishings, furniture,
and personal effects of like nature shall be arranged as promptly as possible,
such private auction to be limited to my said daughters; any of such items
not disposed of at such private auction shall thereafter be disposed of by
public sale or in such other manner as my personal representatives shall
select; all of such sale proceeds shall form a part of the residue of my
estate hereinafter disposed of.
Item 3: I give the residue of my estate of whatever nature and wherever
situate to my husband, Ralph B. Butt, Jr., if he survives me by thirty (30)
days. Should he predecease me or die on or before the thirtieth (30th) day
following my death, I give said residue to my two daughters, Linda Mae Cipri.an:i
and Diane Shupshinskas, share and share alike, or to their issue per stirpes
living on the thirty-first (31st) day following my death.
Item 4: I appoint my husband, Ralph B. Butt, Jr., as personal representa-
tive of this my Last Will and Testament. If he predeceases me, fails to qualify
or ceases to so act, I appoint my two daughters, Linda Mae Cip~ and Diane
Shupshinskas, as personal representatives of this my Will. No personal
representative shall be required to furnish bond.
IN WITNESS WHEREOF, I, Cathrine Butt, have to this my Last Will and Testa-
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Cathrine Butt
day of
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. 1 982 .
ment, containing two (2) typewritten pages. set my hand and seal this iJ;iK
SIGNED. SEALED. PUBLISHED and DE-
CLARED by the above named testatrix.
Cathrine Butt. as and for her Will.
in the presence of us. who. at her
request, in her presence, and in
the presence of each other have
hereunto subscribed our names as
witnesses in attestation hereof.
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