HomeMy WebLinkAbout05-21-08
~
15056041147
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX.280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
'.
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 7
0874
Date of Birth
176 32 5059
09 19 2007
09 25 1929
Decedent's Last Name
Suffix
Decedent's First Name
MI
SHELTON
JAMES
w
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
SHELTON
RUTH
H
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
l~] 1. Original Return
n
'----"
2. Supplemental Return
1~
~i
4. Limited Estate
"
I I
~J
4a. Future Interest Compromise
(date or death after 12-12-82)
u
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
o
[Xi
1--;
9. Litigation Proceeds Received
o
1',
7 Decedent Maintained a Livmg Trust
. (Attach Copy of Trust)
8. Total Number of Safe Deposit Boxes
6. Decedent Died Testate
(Attach Copy of Will)
10 Spousal Poverty Credit (date of death
. between 12-31-91 and 1-1-95)
r--l
I
L--1
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JAMES D, HUGHES ESQ, 717 249 6333
Firm Name (If Applicable)
SALZMANN HUGHES PC
PA
ZIP Code
17015
. I"-..;)
REGISTER @WILLS US~NL Y
"C. 0 =
':;~ ~
.) "1;: ,Q -<
j,'~~~ N
b'''''') ;:0..
~'_ '1 __
:u ~
ONTE1=ILED 9
J~
First '.ine of address
354 ALEXANDER SPRING ROAD,
Second line of address
City or Post Office State
CARLISLE
o
Correspondent's e-mail address:
Under penalties of perjury, I declar that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it IS true, correct and comp te. Dec ration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG TURE OF PERSON S SIB OR FILING RETURN OA TE
James W. Shelton Jr.
\~
22405
James D. Hughes Esq.
er Spring Road, Suite 1, Carlisle, PA 17015
Side 1
L
15056041147
15056041147
~
.~
.-..J
15056042148
REV-1500 EX
Decedent's Name: Jam es W. S h alto n
RECAPITULATION
1. Real Estate (Schedule A).............................................................. ........................... 1.
2. Stocks and Bonds (Schedule 8)............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule 0).......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................
6. Jointly Owned Property (Schedule F) LJ Separate Billing Requested............. 6.
7.. Inter-Vivos Transfers & Miscellaneous NSln-Probate Property
(Schedule G) 0 Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7).......................................................................
9.
9. Funeral Expenses & Administrative Costs (Schedule H)..........................................
10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I)................................ 10.
11. Total Deductions (total lines 9 & 10)...................................................................... 11.
12. Net Value of Estate (line 8 minus line 11)..........................................,........:........: 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J)................................................. 13.
14.. Net Value Subject to Tax (line 12 minus line 13)................................................. 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers uflder Sec. 9116
(a)(1.2) X ~
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
109,874.30
15.
0', 00
16.
o 00
17.
o 00
18.
19. Tax Due..................................................................................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
~~
~
d
Q~
~
-Z
Side 2
L
15056042148
Decedent's Social Security Number
176 32 5059
5.
114,696.30
8.
114,696.30
-~~-,-_._.-
4,822.00
4 822.00
1 0 9 8 7 4 ,.3 0
109,87430
o 00
,0 00
o 00
o 00
o 00
D
15056042148
.-..J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
James W. Shelton
STREET A5[5RE~SS--~---~-~~---~-----'--'----- -.--.-~ ~
24 Parsonage Street
f----. --.- ~---- .-
File Number 21-07 -08 74
-- iSTATE
I
'~i1P
CITY
Newville
PA
17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 0.00
0.00
Total Credits (A + B + C)
(2) 0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
B. Enter the total of Line 5 + 5A This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(5B)
0.00
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A Enter the interest on the tax due.
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS-BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
!7(
IZr
'7:
~
LJ 0'
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... D 12<1
4. ~~~t~~~:~e~~~;rci:~1 ~~~~~~::,~t~~~.~.~.~.t .~~~~~~~:. ~ ~~~~t:.'. .~~. ~t~~r. .n.o.n.~~r~~~t~. ~~~.~.~.~:. .~~ i~~............. .... 0 '$
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred:..................................................................................
b. retain the right to designate who shall use the property transferred or 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?.. ................... ........ ......... ............... ................ .... ....................... ......................
Yes
,--.
U
II
o
[J
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 three (3) percent [72 P.S. 99116 (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 zero
(0) percent [72 P.S. 99116 (a) (1.1) (ii)l. The statute does not exempt 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 zero (0) percent [72 P.S. 99116 (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 four and one-half (4.5) percent,
except as noted in 72 P.S. 99116 1.2) [72 P.S. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [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.1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Shelton, James W. .
FILE NUMBER
21-07 -0874
ESTATE OF
Include the proceeds of Illigatron and Ihe dale the proceeds were received by the eSlate
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Farmers National Bank - checking account
VALUE AT DATE
OF DEATH
10,001.48
2 USAA - member #000463714
104.694.82
TOTAL (Also enter on Line 5, Recapitulation)
114,696.30
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV.1151 EX+ (12-99)
~.
~
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shelton, James W.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-07 -087 4
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State Zip
2.
Attorney's Fees
SALZMANN HUGHES PC
1,000.00
3.
Family Exemption: (I~ decedent's address is not the same as claimant's, attach explanation)
Claimant Ruth H. Shelton
Street Address 24 Parsonage Street
City Newville
Relationship of Claimant to Decedent
3,500.00
State
Spouse
PA
Zip
17241
4.
Probate Fees
302.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Cost~
Register of Wills
20.00
TOTAL (Also enter on line 9, Recapitulation)
4,822.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
REV-1513 EX+ (9-00)
.
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER.
Shelton, James W.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-07-0874
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Ruth H. Shelton
24 Parsonage Street
Newville, PA 17241
Spouse
109,874.30
Total 109,874.30
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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
LAST WILL AND TEST AMENT
OF
JAMES W. SHELTON
I, JAMES W. SHELTON, ..a resident of the Commonwealth of Pennsylvania, make,
publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any time
heretofore made by me. I am retired from the military service of the United States.
FIRST: I direct that the expenses of my last illness and funeral, the expenses of the
administration of my estate, and all estate, inheritance and similar taxes payable with respect to property
included in my estate, whether or not passing under this will, and any interest or penalties thereon, shall
be paid out of my residuary estate, without apportionment and with no right of reimbursement from any
recipient of any such property (including reimbursement under Section 2207B of the Internal Revenue
Code).
SECOND: I give all real estate owned by me at the time of my death, and all rights that I
have under any related insurance policies, to my wife RUTH H. SHELTON, if she survives me.
THIRD: If my wife does not survive me, I give the sum of Ten Thousand Dollars
($10,000.00) to the BIG SPRINGS PRESBYTERIAN CHURCH, Newville, Pennsylvania.
FOURTH: If my wife does not survive me, I give the sum of Ten Thousand Dollars
($10,000.00) to the JOHN GRAHAM LIBRARY, Newville, Pennsylvania.
FIFTH: I give all the rest, residue and remainder of my property and estate, both teal
and personal, of whatever kind and wherever located, that I own or to which I shall be in any manner
entitled at the time of my death (collectively referred to as my "residuary estate"), as follows:
(a) If my wife RUTH H. SHELTON survives me, to my wife outright.
(b) If my wife does not survive me, then to my son my son JAMES W. SHELTON, Jr. if
he survives me, or if he does not survive me to any then living issue of my son, ~
stirpes.
(c) If my wife does not survive me and there shall be no issue of mine then living, my
residuary estate shall be paid and distributed to the BIG SPRINGS PRESB YTERIAN
CHURCH, Newville, Pennsylvania.
SIXTH: If any property of my estate vests in absolute ownership in a minor or
incompetent, my Executor, at any time and without court authorization, may: distribute the whole or any
part of such property to the beneficiary; or use the whole or any part for the health, education,
maintenance and support of the beneficiary; or distribute the whole or any part to a guardian, committee
or other legal representative of the beneficiary, or to a custodian for the beneficiary under any gifts to
minors or transfers to minors act, or to the person or persons with whom the beneficiary resides.
Evidence of any such distribution or the receipt therefor executed by the person to whom the distribution
d ~-
. '.~
;:.~ ~[ .
is made shall be a full discharge of my Executor from any liability with respect thereto. even though my
Executor may be such person. If such beneficiary is a minor. my Executor may defer the distribution of
the whole or any part of such property until the beneficiary attains the age of eighteen (18) years, and may
hold the same as a separate fund for the beneficiary with all of the powers described in Article EIGHTH
hereof. If the beneficiary dies before attaining said age, any balance shall be paid and distributed to the
estate of the beneficiary.
SEVENTH: I appoint my son JAl\-fES W. SHELTON, Jr. to be my Executor. I direct
that no Executor shall be required to file or furnish any bond, surety or other security in any jurisdiction.
EIGHTH: - I grant to my Executor all powers conferred on executors under the
Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and all powers
conferred upon executors wherever my Executor may act. I also grant to my Executor power to retain,
sell at public or private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any
kind of property, real or personal, for cash or on credit; to borrow money and encumber or pledge any
property to secure loans; to pay any legacy or distribute, divide or partition property in cash or in kind, or
partly in kind, and to allocate different kinds of property, disproportionate amounts of property and
undivided interests in property among any parts, funds or shares, and to determine the fair valuation of the
property so allocated, with or without regard to tax basis; to determine what property shall receive basis
increases pursuant to Section 1022(b) and (c) of the Internal Revenue Code and the amount of such
increases and to make such determinations without regard to any duty of impartiality as between different
beneficiaries; to exercise all powers of an absolute owner of property; to compromise and release claims
with or without consideration; and to employ attorneys, accountants and other persons for services or
advice. The term "Executor" wherever used herein shall mean the executors, executor, executrix or
administrator in office from time to time.
NINTH: I direct "that" for ptirposesof this will a beneficiary shall be deemed to
predecease me unless such beneficiary survives me by more than thirty days.
TENTH: I have served in the Armed Forces of the United States. I therefore request
that my Executor make appropriate inquiries to ascertain whether there are any benefits to which I, my
dependents or my heirs may be entitled by vir.tue of any military affiliation. I specifically request that my
Executor consult with a retired affairs officer at the nearest military installation, the Department of
Veterans Affairs, and the Social Security Administration.
This document was prepared under the authority of 10 USe. S 1044 and implementing
military regulations and instructions, by Captain Joseph Krill, United States Army, who is licensed to
practice law in the State of Pennsylvania.
IN WITNESS WHEREOF, I, JAMES~zJ:IELTOf'l'r sign my name and publish and
declare this instrument as my last will and testament this r day of L,ti<.{({ 4.1 ,2006.
J
/~
The foregoing instrument was signed, published and declared by JAMES W. SHELTON,
the above-named Testator, to be his last will and testament in our presence, all being present at the same
2
time, and we, at his request and in his presence and in the presence of each other, have subscribed our
names as witnesses on the date above written.
-dd~ ~l(}z.
v
ha ving an address at
f, ,j ",
L..UA_-{ f} ~Q
l
~t.~
lit-
7613
ha ving an address at
-7f~~tJ
/7tJ.J/-
3
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYL V Ai,{IA, COUNTY OF ClTMBERLAND, ss.
We, the Testator and the witnesses, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator,
JAi\1ES W. SHELTON, signed and executed said instrument as his last will and testament in the presence
and hearing of the witnesses, and that he had signed willingly, and that he executed it as his free and
voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the request of
the Testator, in the presence and hearing of the Testator and each other, signed the will as witness, and
that to the best of his or her knowledge the Testator was at the time at least eighteen years of age or
emancipated, of sound mind and under no constraint, duress, fraud or undue influence.
~ iJ--M4~-'
t/' JAMES W. SHELTON
. Testator
.--r!if~ /~_El~
pnnt: ES;>eL ~C:.c
Witness
~a~
pfint: ;ep)')Q .tI~ C)~ Z
Witness
Subscribed, sworn to and acknowledged before me by the said JAMES W. SHY;TON,
T~ator, and subscribed and sworn to before me by the above-named witnesses, this ~ day of
(j,f. OLI./Z.r , 2006. ("
f / # ,
c- //,/ .,~.
i Nary Public .
My commission expires on /f}:Z<-j. F-t. ;LOD'1
COlvIMON'vVEALTh OF PENNSYL.VANiA
I Notarial Seal
I Betty S. Kistler, NolalY Public
1 ':":u1isle 80m, Cumberland Countv
:'vly Ccmmissicn Expires May 14, 26.J9
I
i
I
;\1~':Hnber. Pennsvlvan1;3 A'S$ociati,; "jf Nctafie~;
. <k ,:-\~
... .....;;..;Ii.
~- ,:;.- (1~
\.\\'~ 1.1
'\
~
USAA@
/
t...... '.\\ .i
~) 7
^~\f ,/"
V /
//
,.
Quarterly Investment Statement
July 1 to September 30, 2007
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
= Your life: Easier
-
-
-
-
-
-
-
-
-
-
-
-
-
-
E Portfolio su nrnClrY
-
-
:'~9t~.i:iIIR~~~E':~a JEf~t
-
-
-
-
-
-
-
-
-
-
= Totaiportfoiio value
= September 30, 2007
-
-
-
-
-
- . .
:j~IJI.~Jj)il
-
-
= Unrealized gain/Uoss)
- ... ._.m....
= .....--::=:.:..::
= Gainl (loss) on your currentyortfoliois only informational
= and should not be used fO~=}axi~'portiiig. '::-;;;::'--':=-;"'=:'::"
-
-
-
-
_ ""'''__'''.__n
= j;g1iil::::'-
-........'.'..."..',..'.'..........
-
-
-
-
-
-
= Large Cap Stocks
-
-
_ Total portfolio value
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
DM3477 /0169 ]
~ES VV 5HELTO~
24PAR50NAGE 5T
NEVVVILLE PA 172, -1314'
Your usaacom has been
three sections. My Accc
Advice and Planning. YOL
latest details on service:
finances and use plannir-
3designedtosimplifyyournlife. "In
1tS. . ProdUcts "and. Ser'iiices::=jOd.. :
;ari/'nanagir:your. accoUots;:::geCthe
10anllf1[~.:~r.~~~t oJ!E!':S.i::~. C!,:::....
tools.. og on...to....y..c-.----"':-7'.----
Portfolio value
June 30. 2007
Earnings
Change in market value
HO.3 ;:4,lS;51
,. 'E)5 !.9~
1 ;21();32
::.::",~~~m:~I-:
......... . ...,...
--$104;694-::'82--
. '., :1it..~-==..:~::.:,:."
':*.::;:'=---:::'
urt-::"':::':'::
~~_ _.u~_~_ _,_.
.. . -:rr:- --:-:-:=:.
':::=$-1 t;706: 96
',Value on %:'01
September.30,.2007::portfolio
$104.694.82.:=100;QO"
$104, 694 ;82=10(j~(j6%
USAA Investment
Management COmpany
P.O. Box 659453
San Antonio. TX 78265'
www.usaacom
C~.~Q.mer service
U~.M Touchlin~
800-531-84'
800-531-87.
EST OF JAMES . WSHELTON::=
Member number 000463714 Member since 1959--
Next steps Jnuncenaiiitimes
Wondering' how: market ':Vo latiITty:: may affectVou;:':current
. investment plan?' Get an:as~CilloC41tion recommenaation and
'.clearguidance.. for. your In\lestlmJnt.'portfolkcl/'o/lLUSAA
Portfolio Planner. Find it'i1tusaacom; c1ick:~'Products and
Services; then:lrivestmen~ .__._._.m... , --- ---.
. "..oo~
$90,00
$60.00
.".:
2003
....~
..............~- - ... ..-
---.-._-~_.... . --- . - -,-
~ - - - '_or
.11.
, 2004 .... .':'~2005
2006
2007
Annualized total'return::'
.<,"'.m 18. 449
The total return is. the annualized percentage cNilge in the v
of your portfolio:.':
'--r
Large Cap StoCka.
.,
~ FARMERS NATIONAL BANK
OF NEWVILLE
October 11, 2007
James D. Hughes, Esquire
Salzmann Hughes, P.C.
354 Alexander Spring Road, Suite 1
Carlisle, PA 17015
RE: Estate of James W. Shelton
Dear Mr. Hughes:
Mr. Shelton had a checking account with this bank which was joint
with Ruth H. Shelton and was opened October 12, 1976. The balance as
of September 19 was $15,574.25 plus $1.77 accrued interest.
Mr. Shelton also had a checking account in his name alone which
was opened December 29, 1978 and had a date of death balance of $10,001.48
plus $1.33 accrued interest.
l~ t;( BCl-:;~ 1 ':::,(-) ,
p~ 1 -: 2'-11 <J C~~ 1!"~ ~'76-;c~ i 2.
04/29/2008 11.27 FAX 703 255 7963
DECEDENT ACCOUNTS
ltJ 002/002
NAVY FEDERAL CREDIT UNIONs
Dear Jacqueline
DATe (MO,. CAY,YR.)
04/29/08
AcCess NO.
1660799
SHARE SAVINGS NO.
0644875007
NfCUiM GRAM
ThiS NFCU GRAM is used instead of a typed letter so that we may expedite the settlement of
James W Shelton '$ Navy Federalill account(s).
o Please complete, sign and return the following:
o Membership Application (NFCU 97) 0 Checking~ Reorder Form (NFCU 2247)
o Estate Account Application (NFCU 40S) .
o Other
o The following document(s) are required to continue the process of Closing the account(s):
o Death Certificate 0 DD1300!Casuillty Report 0 Estate (Executor) papers
o Affidavit 0 Court Documents/Letters of Administration
o Other
o We are returning the
o
for your records.
o
o Our lien has been released on the following vehicle(s} and we are.enclosing the Certificate(s) ofTiUe.
Make: Model: Yea r:
VIN: Title No.:
Make: Model: Year:
VIN: Title No.:
o is listed as the beneficiary on the above share savings and!or
IRA account and is entitled to the Life Savings Insurance benefit; however, we are unable to locate this
person. Please advise uS of hislher mailing address and telephone number, or any other information that
will assist us in locating this individual.
The U.S. Treasury! has!have submitted a Notice of Reclamation in the
amount of $ for
o The full amount has been withdrawn from the account and will be returned to the agency.
o There are insufficient funds in the account to satisfy the Reclamation. Please contact our office at the
number listed below.
o A copy of the notice is enclosed.
~ Per your request the date of death balance for Mr.Shelton Is $131,241.64 with Ruth Shelton as the joint owner.
Thank you
Should you have any questions, pleasEiI call the Decedent Accounts Settlement Section at 1-800-883-3323, or
locally in metro Washington DC at 703-255-7363, weekdays 8:00 am and 4:30 pm Eastern time, Monday tkrough Friday.
NAVY FEDERAL CREDIT UNION
Starr Weston X48029
NFCU 3,9 PC 14-07)
C..ynght C) 21101 N.", Fodoro'
DASS COpy