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HomeMy WebLinkAbout09-01-09 (4)1505607120 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 0 8 113 0 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 172 O1 6563 10 18 2008 Decedent's Last Name Suffix Decedent's First Name MI BUTTORFF LOUISE S (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~~, 1. Original Return ~_~ 4. Limited Estate n ~ y g Decedent Died Testate ^ L ~ (Attach Copy of Will) 9. Litigation Proceeds Received J MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4a. Future interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Trust) 1 p Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number RICHARD W. STEWART (717) 7~1 45~ Firm Name (If Applicable) ~_ ~ JOHNSON DUFFIE REGISTERt~USE~ILY `J_ ~,~ I ~~~ f~'1 I ~~ First line of address ~ =t=J 301 MARKET ST. Second line of address PO BOX 109 City or Post Office LEMOYNE State 21P Code ' PA 17043-0109 ~L~J~ __ ty ~~ -~ N .r~- DATE FILED Correspondent's a-mail address: Under penalties of perjury, I declare 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 complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLF~FpR FILING RETURN f)ATF Karalee B Ameel 73 Oak Drive, Doylestown, PA 18901 SIGNATURE OF PREPARER OTHER THAN REPR ENTATIVE DATE ~~~ /h/~~~~ RICHARD W. STEWART $,~3j~6S ADDRESS - ` 301 Market St., Lemoyne, PA 17043-0109 Side 1 1505607120 1505607120 PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF I FILE NUMBER Buttorff, Louise S 21-08-1130 Under penalties of perjury, I declare 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 complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature #2 Name Address1 Address2 City, State, Zip Barbara B Taylor 1248 Downwood Manor Date Morgantown, WV 26508 ~ ~ 09 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-08-1130 Louise S Buttorff STREET ADDRESS 219 Haldeman Avenue ITY New Cumberland Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable p. Interest E. Penalty 0.00 0.00 150.52 STATE PA I 17070 (1) 22,791.83 Total Credits (A + B + C) Total Interest/Penalty (D + E) 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 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. (2) 0.00 (3) 150.52 (4) (5) 22,942.35 (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 2 2 , 9 4 2.3 5 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................~ ~ I x J b. retain the right to designate who shall use the property transferred or its income :.................................... [~ (x j c. retain a reversionary interest; or ...............................................................................................................~' d. receive the promise for life of either payments, benefits or care? ..............................................................~i x~, 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .....................................................................................................................u ~ I 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... [Jx 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................~ f IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, 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. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (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 zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (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. §9116 (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. RBV-1502 E7t+ (8.88) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Buttorff, Louise S 21-08-1130 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 wilting seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointlyowned with right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Residence -located at 219 Haldeman Avenue, Borough of New Cumberland, 234,000.00 Cumberland County, Pennsylvania. Contracted Sales Price. A copy of the Settlement Sheet is attached to this Return. TOTAL (Also enter on Line 1, Recapitulation) ~ 234,000.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-7500 Schedule A (Rev. 6-98) rcev-i aus tx+ la-aal SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Buttorff, Louise S 21-08-1130 All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 002116208 30 shares of AT8tT - Com ~ Valued using Estate Val 23.11 693.30 Valuation System and is attached to this Return as an Exhibit 2 077853109 12 shares of Bell Atlantic Corp - Com ~ Valued using 27.71970 332.64 Estate Val Valuation System and is attached to this Return as an Exhibit. $ 077853109 42 shares of Bell Atlantic Corp (Verizon) -Com - 27.719700 1,164.23 Valued using Estate Val Valuation System and is attached to this Return as an Exhibit 4 20030N101 27 shares of Comcast -Com -Valued using Estate Val 15.915 429.71 Valuation System and is attached to this Return as an Exhibit. 5 783876103 8 shares of SBC Communications Inc -Com -- Valued 25.905 207.24 using Estate Val Valuation System and is attached to this Return as an Exhibit 6 845333103 12 shares of Southwestern Bell Corp -Com -Valued 25.905 310.86 using Estate Val Valution System and is attached to this Return as an Exhibit 7 928577107 26 shares of Vodafone Airtouch PLC - Adr Sponsored 20.0375 520.98 Valued using Estate Val Valuation System and is attached to this Return as an Exhibit. TOTAL (Also enter on Line 2, Recapitulation) 3,658.96 (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 B (Rev. 6-98) R@V-7505 EX+ (g-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF (FILE NUMBER Buttorff, Louise S 21-08-1130 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with the right of survivorship must be disclosed on schedule F. i I clvl I VALUE AT DATE NUMBER DESCRIPTION OF DEATH Volkswagon Jetta -Sale Price Miscellaneous Household Goods Department Stores National Bank -Refund on Account Edward Jones -Reimbursement of Bank fee Internal Revenue Service - 2008 Personal Income Tax Return Refund Refund Reimbursement for County Taxes -Reimbursed during settlement for Residence. A copy of the Settlement Sheet is attached. United Healthcare Insurance Company -Refund on Account 1,100.00 2,750.00 9.00 10.00 58.00 1.82 285.20 212.92 TOTAL (Also enter on Line 5, Recapitulation) I 4,426.94 (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-1509 EX+ (B-98) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Buttorff, Louise S 21-08-1130 If an suet was made joint within one year of the decedent's data of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Karalee B Ameel 73 Oak Drive Daughter Doylestown, PA 18901 B. Barbara Taylor 1248 Downwood Manor Daughter Morgantown, WV 26508 C. JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH ALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A, B 8/28/1964 MS:T Bank Checking Account No. 2.470.62 33.333% 823.54 18896987 -Date of Death Letter Valuing Account is attached to this Return as an Exhibit TOTAL (Also enter on Line 6, Recapitulation) I 823.54 (If more space is needed, additional pages of the same size) 1 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1570 EX+ (8-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Buttorff, Louise S 21-08-1130 This schedule must be completed and filed rf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER DESC I INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (IF APPLICABLE) TAXABLE VALUE 1 Metlife Annuity Account No. 007026947MA - 184,289.72 184,289.72 Valued at Date of Death and is attached as as Exhibit to this Return 2 Metlife Annuity Account No. 550085911AB - 91,646.31 91,646.31 Valued at Date of Death and is attached as as Exhibit to this Return 3 Edward Jones Account No. 377-03934-1-5 - 28,228.39 28,228.39 Securities and Mutual Fund Account; Transfer on Death Account to Barbara Taylor and Karalee Ameel, Daughters. Date of Death Valuation is attached to this Return as an Exhibit TOTAL (Also enter on Line 7, Recapitulation) 304,164.42 (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 G (Rev. 6-98) REV-1151 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & IN RESIDENTDF EDENTR" ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Buttorff, Louise S 21-08-1130 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION NUMBER AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Johnson Duffie 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 23,000.82 7,800.00 4. Probate Fees 460.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 100.00 7. Other Administrative Costs 3,654.50 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 35,015.32 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Buttorff, Louise S 21-08-1130 ITEM NUMBER DESCRIPTION AMOUNT Funeral Expenses 1 Gingrich Memorial 5,000.00 2 Gingrich Memorials - Gravemarker 1,000.00 3 Musselman Funeral Home and Cremation Services, Inc. 10,741.32 4 Musselman Funeral Home and Cremation Services, Inc. 5,000.00 5 Two Gal's Catering 1,259.50 H-A Subtotal 23,000.82 Other Administrative Costs 6 Casey Johnson -Yard Work @ Residence 170.00 7 Cumberland County Register of Wills Office -Filing Fees for Inheritance Tax Return 30.00 and Inventory 8 George R. Ulsh, R8L Appraisal Associates 275.00 9 Know Swett Terminte and Pest Services 1,272.00 10 M8T Bank Deluxe Checks 17.75 11 M8~T Bank Estate Checking Account No. Ending 2656 -Bank Fee for Return of 10.00 Check 12 Maintanence of Residence by Jason Shober -Painting and Carpet Removal at 500.00 Residence to Ready for Sale Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued =STATE OF (FILE NUMBER Buttorff, Louise S 21-08-1130 ITEM DESCRIPTION AMOUNT NUMBER 13 Mrs. Barb Kelly -Watching the Decedent's Residence 815.00 14 Reserves for Additional Costs and Expenses 15 The Cumberland Law Journal - Notice of Estate Administration 16 The Patriot News Co. - Notice of Estate Administration H-B7 Subtotal 300.00 75.00 189.75 3,654.50 Coovright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98 Rev-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OFFILE NUMBER Buttorff, Louise S 27-08-1130 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Check No. 1002 28.41 2 Internal Revenue Service 144.12 3 Montour Oil 256.91 4 New Cumberland Borough 101.55 5 PA American Water -Payment on Account No. 24-0620413-7 29.24 6 PA American Water 10.88 7 PA American Water 28.66 8 Pennsylvania Power & Light -Utility Company -Payment on Account No. 133.53 33410-85008 9 Robin Gasperetti, Tax Collector -Personal Tax 9.80 10 Robin Gasperetti, Tax Collector - 2009 Real Estate Taxes 832.78 11 Settlement Charges -for the sale of the Decedent's Residence. A copy of the 3,322.50 Settlement Sheet is attached to this Return 12 Stone LaFaver & Shekfetski -Attorney Fees 675.00 TOTAL (Also enter on Line 10, Recapitulation) I 5,573.38 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS (If more space is needed, additional pages of the same size) Coovriraht (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) KCV-113 C1C+ (9-VV~ SCHEDULE J COM NHERITANCE~TAXRENURNANIA BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER GULLOf~T, ~ou~se ~ 21-08-1 130 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) Do Not List Trustee s I ' TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Karalee B Ameel Daughter 1/2 of Estate 73 Oak Drive Doylestown, PA 18901 2 Barbara B Taylor Daughter 1l2 of Estate 1248 Downwood Manor Morgantown, WV 26508 Total Enter dollar amounts for distributions shown above on lines 15 through 18, as approp riate, on Rev 1500 cov er 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) ESTATE OFLOUISE S. BUTTORFF SCHEDULE OF EXHIBITS EXHIBITA Copy ohf'Decedent's Last Will and Testament signed and dated on the 16` day of January, 2004. EXHIBIT B Settlement Sheet for Decedent's Residence located at 219 Haldeman Avenue, New Cumberland, Pa on August 28, 2009. EXHIBIT C Estate Val Valuation of Stocks EXHIBIT D M&T Bank Date of Death Valuation Letter EXHIBIT E Metlife Annuity Date of Death Valuation Letter EXHIBIT F Edward Jones Date of Death Valuation Letter EXHIBIT G Verification of Request and Acceptance of Extension of Filing Inheritance Tax Return from Pennsylvania Department of Revenue. .a~nc~~ 3 t .,. .. - u ~ ...... ' ,_ ,._ ~YS AT LAfAt F~• }~ n~. ~LANI1, PA' 2?QJ© r 1 4 , k' ~ A i{ t Y $ 7 4 { ~h~ ;~ -'.~'~EY ':r.: ~- r n ~~ b -2~ -~. i l .-F ~~ ~ - . LAST WILL AND TESTAMENT -'?'r ;~ '' - , _`' OF . - :r~ r: .~- - ~ ; -;;-; LOUISE BUTTORFF ~-.,`-~~-~ -~ `_-'<;-; J T _ 1~ __ t. -rJ ~ N - .~ t O N ` I, LGUISE BUTTGRFF, of the Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I direct that my Co-Executrices hereinafter named shall pay all my just debts and funeral expenses as soon as conveniently may be done after my decease from the residue of my estate. ITEM II: I devise and bequeath all the rest, residue and remain- der of my estate, of every nature and wherever situate, to my daugh- ters, BARBARA ~ TAYLOR and KARALEE B. AMEEL, or to their issue, per 3. stirpes. ITEM III: I appoint my Co-E~cecutrices and their successors guardian of any property which passes, either under this will or otherwise, to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the I i right of any fiduciary in its discretion to distribute a snare w:-~~ere i pO~~~,sle to the m~ncr or to another for the mirror's benefit. Su~.~h ~I guardi ~ snali ha~.e Lne po:~~er to use r~r.cipal s :•~~' 1 s :~ f , j p ~ 1 a iii ~G e rcm i ~~7 --T? T-J t'_m°_ Cr ti"?e i:iynCr~ 3 .. 'ppOrt an'.t educatl~~n l,iriCl~_~d~ng C~J? 1 , ~~~e 'i education, both graduate and undergraduate} without regard to his or her parent's ability to pro~ride for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. {~ ITEM IV: I appoint my daughters, BARBARA ~~. TAYLOR and KARALEE B. AMEEL, Co-Executrices of this my last will. ITEM V: No fiduciary acting hereunder shall be required to post bond or enter security for the faithful performance of her duties in any jurisdiction. IN WITNESS WHEREOF, I, LOUISE BUTTORFF, have hereunto set my hand and seal this ~ day of Z 2004. LOUISE BUTTOR F ,- ~~ SIGNED, SEALED, PUBLISHED and DECLARED by LOUISE BUT'TOR.FF, the Testatrix above named, as and for her Last 6~lill and Testament, and in the preS?.iCe cf US, W~"'i0 at her request, In %er preser:ce :.nd in the ::>reSel'iCe Of ,aC' Other, ha'Te sll~scribed Cllr T'iameS as :ait!^aeSSeS. ~~ ~~~C~.:' \ ~.-. ~-- _ c ~Vl~'~ S5 ~- ?ddreSS -..~ - - a. Settlement Statement U.S. Department of Housing and Urban Development ~ ~r OMB Approval No. 2502-0265 8. T pe of Loan 1. ^ FHA 2. ^ FmHA 3. ^Conv. Unins. s. Fse Number 7. Loan Number B, m°nDa9e u,s°rarKa case Nw,~ber 4. ^ VA .5. ^Conv. Ins. 09-228 C, Note: This form is famished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside Dosing; they are shown here for informational purposes and not included in the totals. 1.Oa B °_e5. eN;- a~ D. Name and Address of Borrower E Name end Address M sells >r,' ~ t0l{l`£eK1~0C~ F. Name and AtlMass or larxfer Kirby J. Baer Barbara 8. Taylor, Co-Executrix Provident Funding Group, Inc. Karalee B. Amee(, Co-Executrix iSAOA ATIMA 101 Sunset Drive 219 Haldeman Avenue 350 Sentry Parkway, Ste. 220, Bldg, 610 Garlisle PA 17013 New Cumberland PA 17070 Blue Bell PA 19422 c. Property Locauon H. f>el9emerrt Atav,t Melanie Waiz Scaringi, 219 Haldeman Avenue Scarin i & Scarin i P.C. Pie ~ Sedlement L Settlement Date New Cumberland PA 17070 2000 Linglestown Road, Suite 106 8/28/2009 Lar slodc Harrisburg PA 17110 Dkbursemenl Date 8/28/2009 J. Summary of Borrower's Transaotlon ~ K. Summary of Seller's Transac8on 100. Gross Amount true From Borrower ern r..... em..,...a n... r., c..n.. 101. Contract sates price 234 000.00 sot. Contract sales ce 234 000.00 102 Personal 402. Personal 103. Settlement cha es to bonowar fine 1400 1 O 906.78 403. 104. A raisalCC Fee to PFG Inc 4.50P0C 404. 105. 405. Ad ustments for items aid seller in advance Ad'ustments for ftems ald seller in advance 106. Ci flown faxes to 406. C /tam taxes to 107. coun taxes 8/28/200, 12/31/2009 285.20 ao7. coun taxes 8/28/2009012/31/2009 285.20 108. Assessments to 408. Assessments to 109. to 409, to 110, to 410. to 111. to 41 t. to ii2. to 412 to 113. to 413. to 714, to 414, to 115. l0 415. to 120. Gross Amourrt Due From Borrower 245,191.98 420. Gross Amount Due 7o Seiler 234,285.20 Tnn_ IImnrmts Paid Rv f)r In Rnhalf of Rnrrnwer . ..- ...,- ~.,..., .~ _ _ .__ 201. De sR or earnest more ~ 2,5DO.OO 501. 6ccess de it see Instructions 202. Pdnd 1 amount of new loan 6 502. Settlement cha es to seller line 1400 2 840.00 203. Existin loans taken sub to 503. Existin loan s taken sub to 2oa. Provident Fundin Grou Inc. 174 000.00 soa. P of first mo a eloan 205. 505. P of second mo a loan 206. 506, 207. 507. 208. 508. 209. 5pg, Ad ustmants for hems un aid salter Ad ustments for ftems un altl seller 210. C (town taxes to 510. C /town taxes to 211. Court taxes ~ 517. Court taxes b 212. Assessments to 512 Assessments to 213. School Tax 7/1/2009 }° 8128!2009 258.31 513. School Tax 7/1/2009 tD 8/28/2009 258.31 214. Sewer 1/1/2009 t° 8/28/2009 154.82 s14. Sewer 1/1/2009 ro 8/28/2009 154.82 215. Trash 4/1!2009 to 8/28/2009 69.37 s1s. Trash 4/1 /2009 to 8/28/2009 69.37 216, to 516. to 217, to 517. to 21 B, to 51 B. t0 219, tO 519. to 220, Totat Paid aylFOreorrower 176,982.50 520. Total Reduction Amount Dua Seller 3,322.50 3ne_ Cash At SMHaman} Fmmrfe Rnn•nwar snn r..l. er c.ttr.,...,a r..rc....., c.n.. 301. Gross Amount due from borrower IMe 120 245 191.98 601. Gross amount due to serer Ire 420 234 285.20 30z Less amount id Iror boraA~er ire 220 176 982.50 602 Less reductions in amt due seller ire 520 3 322.50 303. Crib Q From ^ To Borrower 6$,209.48 603. Cash ®To ^ From Seller 230,962.70 SUBSTITUTE FORM 1099 SELLER STATEMENT The infortnatron contained in Blocks E, G, H, and J and on Nne 407 (or, 9ne 403 and 404) is important tax iMOrmation entl is being famished to the Internal Revenue Service. If you are required to file a return, a negligence penalty w other sanction will be imposed on you H this item is required to be reported and the IRS delertnines that it has not been reported. N this real estate is your prinrtipal residence, file Forth 2119, Sale or Exchange of Pnndpai Residence, for any pain, with your Income tax return; for other transactions, rwmplete the app)kable parts of Forth 4797, Form 6232 and/or Schedule D, Forth 1040). You are required to provide U1e Settlement Agent (named above) with your correct taxpayer Identficafion number. Ii you do not provide the SetflemeM Agent with your correct taxpayer identification number, you maybe subject to dull or criminal penalties imposed by law. Under panalfies of per)ury, I certify that the number shown on this statement Is my cortect taxpayer idertM~n number. {Sellers Signature) L Settlement 700. Total Sal to 234,000.00 %= U.UU paid From paid From Bortower's Seller's Funds At Funds At - Settlement Settlement 703. Commission id at Set0ement 7oa Yield Adjustment Credit to LeTort Mortgage Group Inc. 1 % ($1740 POC) o,,... ,.a,,.a .. o...~ ... _.,....____.. -.._. ---.. 601. Loan on ination Fee % to LeTort Mt . G .Inc. 2 587.50 602 Loan Discount °~^ 803, raisal Fee to Provident Fundin Grou Inc. $150 POC Boa Cred'RReport to LeTort Mort a e Grou Inc. $25 POC 805. Lenders Ins ~on Fee 606 Mortgage Insurance Applicetron Fee to 607. Assum 'on Fee eoe. Tax Service Fee to Provident Fundin Grou Inc. 60.00 ao9. Wire Fee to Provident Fundin Grou Inc. 17.00 e1D. Processin Fee to LeTort Mort a e Grou Inc. 750.00 e, 1. Administration fee to Provident Fundin Grou Inc. 795.00 e1z. Administration Fee to LeTort Mo a e Grou Inc. 20.00 6, 3. MERS Fee to Provident Funding Group, Inc. _ 6.95 901. Interest from 8/28/2009 to 8131 /2009 s 24.17 ~ da 96.68 902. Mort a e Insurance Premium for months to 903. Hazard Insurance Premium for rs ~ 904. B t0 aos Hazard Insurance Premium for 1 year to Gunn Mowery {$396.00 POC t o01. Hazard insurance _ 3 ^ months S 33.00 er month 99.00 1002. Mort a e insurance 1 months S r month 1003. C' pro taxes 1 month S month 1004. Coun o faze; 7 months S 35.55 r month 248.85 loos. Annual assessments 1 months S r month tool. School Tax 3 month 138.23 r month 414.69 1007. 1 moot S r rtanth 1 Doh. Aa°re°ate Acmuntine Adjustment __ _ -142-20 1101. Settlement or dosin fee to 1102. Abstradort@lesearch to Harve P. Murra Jr. 143.00 1103. Title examination to 1104. Title insurance binder to 1705. Document re aretion to 1106. Nota fees to Cash 10.00 5.00 1107. Attom s fees to Scarin i & Scarin i P.C. roved Attorne s 647.75 Includes above items numbers: for First American Title Insurance Com an 11oe, rue inwrence for owner and lender to John R. Lhota P.C. A ant for First American 746.00 Includes above items numbers: Tltle Ir1SUranCe Com an 1109. Lenders covers e S 1110. Ownefs covers S 1111. Brio down and Record fee to Harve P. Murra Jr. 20.00 1112. Endorsements 100 300 900 & 710 to John R. Lhota P.C. A ant for First American 200.00 ,,,3. Closing Services Letter to First American Title Insurance Com an 35.00 1201. Recording fees: DeeA s 44.50 Mo a S 64:50 ;Releases S 109.00 1202. Ci Icoun tax/stam :Deed S 2,340.00 ; e S 2340.00 1203. State taxlstam s: Deed S 2340.00 ; a e S 2340.00 ,2oa. UPI Certification Fee to Cumberland Co. Rec. of Deeds- $10 r recorded document 20.00 12DS. 1301. Su to 1302. Pest inspection remed w Know Swett Termite Pest Services $1 272 POC b Salle 1303. Tax Certification Fee to Robin Gas eretti Tax Collector 10.00 1304. 2009/2010 School Real Estate Taxes to Robin Gas eretti Tax Collector 1 625.56 ,3os. American Home Shield - 1 ear -Contract No. 91539072 495.00 1306. Ovemi ht fee to Scarin i & Scarin i P.C. 35.00 1307. Flood Fee to to Provident Fundin Grou ,Inc. 12.00 13oe. A raisal Technolo & Mana ement Fee to ProvidentFundin Grou Inc. $50 POC 1400. Total Settlement Charges (enter on lines 103, Seetlon J and 502, Se°tlon K) 1 9 6.78 2840.00 (:tK I Ih ILA I I V N I have cerefulty reviewed the HU0.1 Settlement Statement and to the best of my knowledge end belief, tt is a true and ate s tame II receipts and disbursements on my account or try me in thi~nsadion. I further certify that 1 have received a copy of the HU0.1 Settlement S e Seller Borrower Barbara B. T lor, Co- ecutrix I y • B Seller Bortower ralee B. Ameel, Co-Executrix To the b t of my knowledge the HUD-1 Settlement Statement which I have prepared is a true and acwrete account of the funds which were received and have been or will be disb ea by the u0dersig s art o e settler0ent of this transaction. ~ ~ r~ ~~ Settlement Agent Sy(' Date Melan a Walz Scaringi, ~ingi 8 Scaring .C. WARNING: It is a crime to knowingly make false statements to the Uniled States on this or any other similar form. Penahies upon conviction ran include a fine and imprisonment For details see: TAIe 16 U.S. Code Section 1001 and Secion 1 D1 D. _ us oouerxaorr rrdvnw orece: rw awaxs Estate Valuation Date of Death: 10/18/2008 Estate of: BUTTORFF, Estate of Louise Valuation Date: 10/18/2008 Account: 15965-1 Processing Date : 08/31/2009 Report Type: Date of Death Number of Securities: 12 File ID: BUTTORFF Shares Security Mean and/or Div and Int Security or Par Description Hig h/Ask Low/Bid Adjustments Accruals Value 1) 92 VERIZON COMMUNICATIONS INC (077853109) COM New York Stock Exchange 10/17/2008 28.99000 26.18000 H/L 10/20/2008 29.09000 27.21880 H/L 27.719700 1,169.23 Div: 0.46 Ex: 10/06/2008 Rec: 10/10/2008 Pay: 11/03/2008 19.32 2) 26 BELLSOUTH CORP (079860102) COM New York Stock Exchange 12/29/2006 47.82000 97.00000 H/L 47.410000 NJA Last price available on 12/29/2006 3) 12 VERIZON COMMUNICATIONS INC (077853109) COM New York Stock Exchange 10{17/2008 28.49000 26.18000 H/L 10/20/2008 29.09000 27.21880 H/L 27.719700 332.69 Div: 0.46 Ex: 10/08/2008 Rec: 1011012008 Pay: 11/03!2006 5.52 4I 12 AT&T INC (895333103) COM New York Stock Exchange 10/17/2008 26.75000 29.50000 H/L 10/20/2008 27.08000 25.29000 H/L 25.905000 310.86 Div: 0.4 Ex: 10/08/2008 Rec: 10/10/2008 Pay: 11/03/2008 4.80 5) 12 MEDIAONE GROUP INC (58490J109) COM Other OTC 06/19/2000 66.61250 66.93750 H/L 66.625000 N/A Last price available on 06/19/2000 6) 8 AMERITECH CORP NEW (030954101) COM New York Stock Exchange 10/08/1999 69.25000 66.43750 H/L 67.843750 N/A Last price available on 10/08/1999 7) 26 VODAFONE GROUP PLC NEW (928577107) SPONS ADR NEW New York Stock Exchange 10/17/2008 20.91000 19.15000 H/L 10/20/2008 20.58000 19.51000 H/L 20.037500 520.98 8) 12 NYNEX CORP (670768100) COM New York Stock Exchange 08/19/1997 58.43750 56.93750 H/L 57,687500 NIA Last price available on 06/19/1997 9) B AT6T INC (783876103) COM New York Stock Exchange 10117/2008 26.75000 24.50000 H/L 10/20/2008 27.08000 25.29000 H/L 25.905000 207.24 Div: 0.9 Ex: 10/08/2006 Rec: 10(10/2008 Pay: 11/03! 2008 3.20 Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.1) )ate of Death: 10/18/2008 Estate of: BUTTORFF, Estate of Louise valuation Date: 10/18/2008 Account: 15465-1 ?rocessing Date: 08/31/2009 Report Type: Date of Death Number of Securities: 12 File ID: BUTTORFF Shares Security Mean and/or Div and Int Security or Par Description High/Ask Low/Sid Adjustments Accruals Value 11) 3 U S WEST INC NEW (912889102} COM New York Stock Exchange 06/30/2000 87.93750 83.50000 H/L 85.968750 Last price available on 06/30/2000 12) 30 AT&T INC (002116208) SR NT 6.375 New York Stock Exchange 10/17/2008 23.15000 22.53000 H/L 10/20/2008 23.96000 22.80000 H/L 23.110000 13) 27 COMCAST CORP NEW (20030N101) CL A NASDAQ - Industrial 10/17/2008 17.88000 19.59000 H/L 10/20/2008 15.97000 15.22000 H/L 15.915000 Div: 0.0625 Ex: 10/06/2008 Rec: 10/08/2008 Pay: 10/29/2008 1.69 Total Value: Total Accrual: Total: $3,693.49 534.53 N/A 693.30 929.71 $3,658.96 Page 2 this report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.1.1) O 1VI8TBallk 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 434-2955 December 24, 2008 Law Offices Johnson Duffie 301 Market Street P.O. Box 109 Lemoyne, Pennsylvania 1'7043-0109 Re: Estate of Louise S. Buttorf, f Social Security.• 172-01-6563 Date of Death: October 18, 2008 Dear Sir or Madam: Per your inquiry dated December 16, 2008, 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 Account Number Ownership (Names o~ Opening Date Balance on Date of Death Accrued Interest Total 2. Type of Account Box Number/Location Ownership (Names o~ Opening Date Checking Account 18896987 Karalee BAmeel, Joint Owner* Louise S Bottorff, Joint Owner* Barbara B Taylor, Joint Owner* 8/28/64 $ 2,470.48 $ 0.14 - ---------------------------------------------- $ 2, 470.62 Safe Deposit Box 0001620/ West Shore Plaza Louise S Buttorff"` Karalee B Ameel, Co-Owner* 1/1/50 * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures andlor reimbursement of funds, eta, please contact our West Shore Plaza Office # 717-255-2271. Sincerely, ~.Y ~' ~2~ 2~~ Tracie Haze Adjustment Services 309 3rd Sveet #7, t~ew Cumberland, PA 17070 Tei (777) 920-0679 ~ Fax (7t7) 92Q-0636 jwain~metiife.com Gerald L. Waln, ~trrcx Financial L~dviser . Financial Services Representative Registered Representative investment Adviser Representative Graduate, Smai1 Business {Marketing Pcogrdm Dates of Death Balat~.ces, Louise S. Buttarff Accaur~t #: 55008541~AB- $9x, 6g6.3Z Account #: oo7o2b947N~ $x84 289.7 Meflife Metropolitan L'rfC Irtsu~ance Company (ML1U, Nero Yoflc, NV 101fi6. Securities and investment advisory Services offered by Mett.ifd $e4urities, inc. (M51) (FINRA/S1PC), a registered i0vC5Uilent adviser. MUC and MSI ete' affdSatec ~' -, ~' c to .. off ~ D ~ O rn cn ? w~ m ~~ ~~ p p ~ 3 c~ i dam„ a7 N C ~„ o n ~ W o' ~ o~ 3 m G -°' m o 4 ~ m ~ N ~ coo ~ T ~' ~ S. ~ ~ ~ ~ °'. _, C7 C1 -~ o N N ... m0 Q- ~ ~ .,,,, c N t9 C 3 O o Q ~ 3 ~ N ~, ~ o~~ H m m o~ ~ a ~. Q. •~ ~ ..~ ~, a m c`r ~ .. cn uoi c„ N '~ ~ ~ N ~ ~ O D P~ O tD N N N ~ W 1 C2 t7/1 ~ ~ ~ ~ ~ O ~ ~? N O~ ~ '~ ~~ ~ 0 0 O O N CO"~, ~ ~ O. fl- CX1 n ~ ~ ~ ~ ~ C7 ~ '~ W O CD ~ O a ~. 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N ~ ~ ~ C C7 ~. ~ v y C (n N N N 4J n ~ ~ ,s ~ Q a IV j O m ~ ~ ~ ~ ~ Z K ~ _ A~ ~ ~.« Q. !~ ~ffl ~ffl ~ffl ~fA Iffl W ~A ~ ~ A C D ~ O ~ A U7 O ~ C ~~ ~ 3 c ~' 3a a~ ~~ ~~ m O Q n S Q f~ ~ Q ~ fD ~ t11 .. ~ O Q ~ O ~~ ~ ~ vi ~ O Q" C ~ ~ Q ^' C 3 ~ O C ~ ~ ~ ~~ O N N ~ tD '~ O (Q Al ~ ~ N O pp n ~ O ..a Q ~ t* ,. (D CD n ~ .. ~ O ~ 3 ~ W ~ .~. ~~ Q ~ n ~ O N N ~ (~D Q ~ ~ _. < 7 Q fD ~p ? ~ fD 7 ~« ~ ~ _ !n .. ~-* O R ¢1 ~ (Q n O C "~* O ~ n ~~ _(=D ~ v w N Q O X tiKAN'1'I/ll '1~P,MPLATE Dana L. Wieseman From: Kristee K. Myers Sent: Friday, July 17, 2009 3:48 PM To: Dana L. Wieseman Subject: FW: Louise S. Buttorff, Est. D -this came into the general firm inbox -it's yours, correct? K From: RV, Inheritance Tax Extension [mailto:RA-InheritanceTaxExt@state.pa.us] Sent: Friday, July 17, 2009 3:43 PM To: MAIL Cc: 'gfarner@ccpa.net' Subject: Louise S. Buttorff, Est. o~~~la~r~~r~r o~ ~~v~~;u The following message is being sent from an unmonitored account. Please do not reply. Re: Estate of Louise S. Buttorff File Number 2108-1130 Dear Sir or Madam: Page 1 of 2 This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before 01/18/10. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. We now offer you the option to request your extension request via a-mail. Please use the following a-mail address: RA-InheritanceTaxExt state.pa.us. Please contact me with any questions or concerns at 717-787-8327. Sincerely, Claudia Maffei, Supervisor Document Processing Unit Inheritance Tax Division -~n ~i~nnn X GRANTED TEMPLATE Page 2 of 2 Please do not reply to this email. This mailbox is not monitored and you will not receive a response. Far assistance, visit us on the web at www.revenue.state.pa.us or cal{ us at 717-787-8327 The information transmitted is intended only for the person or entity to whom it is addressed and may contain confidential and/or privileged material. Any use of this information other than by the intended recipient is prohibited. you receive this message in error, please send a reply a-mail to the sender and delete the material from any and all computers.