HomeMy WebLinkAbout04-1171
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ~~') ...."" ~" G..:.-\ov No. d I - 0 'I - //7/
also known as To':
, Deceased. Register of Wills ff/ th~ rd... in the
County of Lv(}') e, Cl
Social Security No. \"\\-1...0 -0(,- ClO Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut named
in the last will of the above decedent, dated ,19_
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in c.. u_ 'c.\oo\..~_ County, Pennsylvania, with
h e..v- last family or principal residence at '-..\.&..""\. ~ 5u~_ ""~~~
"
(list street, number and muncipality)
Decendent. then 'lot years of age, di~ ~~. \ l\ , ~ '2cro<<+- ,
at L-~~\~ c;: u ,,'" ~,"",,,,
Except as foHows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows: $ t ~ .c..-o.-
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ t t 1. c;: Cr oa. 0-.
situated as follows: ~~ C """"'__ '\....'Y' ~) ""\
~ ~v.a-. Q
l C(~C( 0
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF'PERSONAL REPRESENTATIVE
COMMONWEALT! OF pt.NrSY~ANIA } ss
COUNTY OF 1I VYl yet" .
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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No. J }- 0 if - //7 /
E .~ /~( ~ r~ t<. C(Jr~ , Deceased
sbte (h DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW lJH tUn &..r d;)."'..{ 'R~' in consideration of the petition on
the reverse side hereof, satisfactory proof having beejPrejnted before me,
IT IS DECREED that the instrumem(s) dated II ;{ I qq'j
described therein be admitted to probate and filed of ;ecor~ as the last will of
, I ( G ,
and Letters
are hereby granted to
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FEES R'g"'" of WHo r~ .~ '^--
Probate, Letters, Etc. ......... $
Short Certificates( ).......... $ ATTORNEY (Sup. Ct. I.D. No.)
Renunciation ................ $
$ ADDRESS
TOTAL _ $
Filed ....................................
PHONE
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H105.112 REI' 8/88 WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR
(FEE FOR THIS TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
CERTIFICATE $2(0) COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
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Name of Decedent Barbara R. Gorton
F':rsl Middle Last
Female 171-20-9600 December 14, 2004
Sex Social Security No, Date of Death
Date of Birth Oct. 13, 1925 Birthplace New Providence, PA
Place of Death He a 1 t h South Cumberland Mechanicsburg Pennsylvania
Far;i1ity Name County City. Borough or Township
White Office Mgr. (Mfg.) No
Race.. Occupation Armed Forces? (Yes or No)
Widowed Decedent's 435 Chambers Way, West Grove, PA 19390
Marital Status Mailing Address
~jun;be' Strept City or Town Slate
Informant Fred A. Gorton Funeral Director Nathan Ray
Name and Address of Urich Funeral Home, Inc., 305 W. Front St. , Lewisberry, PA
Funeral Establishment Be a v e r
I J:'A 17339
I InteNal Between
Part I: Immediate Cause I Onset and Death
I
I
(a) Chronic Obstructive Pulmonary Disease I
I
I
Aspiration Pneumonia I
(b) I
I
Infection I
(c) Urinary Tract I
I
I
Bandemia Infection I
(d) I
I
Part II: Other Significant Conditions I
I
I
MannE~r of Death Describe how injury occurred:
Natural tjx Homicide 0
Accident 0 Pending Investigation 0
Suicide 0 Could not be Determined 0
Name and Title of Certfier Dominic Mirarchi, D. o.
108 Lowther St. Lemoyne, PA 17043 (M.D., D.O., Coroner, ME)
Address
This is to certify that the information here given is correctly copied from an original certificate
of death duly filed with me as Local Registrar. The original certificate will be forwarded to the
State Vital Records Office for permanent f~
December 16, 2004 a s t 0 ","CI/'O 7313
D8\P Recel-'ed by LOl'ell Reqislr;J' Street Address City, Borough, Township
. .
LAST WILL AND TESTAMENT
OF
BARBARA R. GORTON
I, BARBARA R. GORTON, of 435 Chambers Way, West Grove,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking all other Wills and
Codicils previously made by me.
ITEM I: I direct the payment of all my just debts,
expenses of my last illness, funeral expenses, perpetual care of
my burial lot, suitable marker for my grave and the costs of
administrating my estate from my estate as soon after my death as
conveniently may be done.
ITEM II: I give, devise and bequeath all the rest,
residue and remainder of my property, real, personal or mixed,
tangible or intangible, of whatsoever nature and wheresoever
located and all property to which I may be entitled or over which
I may have any power of disposition or appointment and whether
acquired during or after my lifetime to FRED A. GORTON and PHYLLIS
GORTON BERGLUND, my two children, absolutely share and share alike
and in event either of them are not then living then her share to
go to his or her children then living, otherwise to ~ surv~ing
-0'_ 0 ..c- ::0
. ~-:o 0 Fgg
Chlld. ..,g-q rTl G) .
:TJ ;:;!; p n rj) :T.J
ITEM III. I direct that any and all taxes ~~ m~ b~-!J 23
assessed in consequence of my death, including all ,~~itagce~:3J
. :::0 ,.." <- ')
.~:J --l N!= n~l
Estate and Transfer Taxes imposed upon my estate pass!ng und~ my)C)
C) .,
will or otherwise, shall be paid out of the principal of my
.
residuary estate as a part of the expense of the administration of
my estate.
ITEM IV: I authorize and empower my personal
representative and/or said Trustee representative may deem proper,
all debts and claims owed by or to me or my Estate; to sell, lease
or exchange at public or private sale or in such manner, at such
prices, and upon such terms of credit or otherwise, as my personal
representative or said Trustee may deem proper, all or any part of
my property, real or personal; to execute, acknowledge and deliver
instruments of conveyance, including deeds in fee simple; to borrow
money for the purpose of paying estate, inheritance or other taxes
which are required to be paid and to secure any such loan by pledge
or mortgage of all or any part of my property and to execute the
necessary instruments to carry out such powers; to distribute my
estate in kind or partly in money or partly in kind, and to
determine the fair value at which any property so distributed in
kind shall be received by the distributees; to conduct any business
in which I have an interest at the time of my decease, for such
period as my personal representative may deem proper, power to
borrow money and pledge assets of the business and the power to do
all other acts that I, in my lifetime could have done, to delegate
such power to any partner, manager or employee without liability
for any loss occurring therein and to organize a corporation to
carryon said business as capital to such corporation and accept
stock in the corporation in lieu thereof and hold such stock for
the uses of this my Will, and to vote said stock or sell the same
as to my personal representative may seem best; to retain all
stocks, assets, bonds and investments owned by me without being
confined to what is known as legal investments; to execute any
options to purchase, to apply for stocks, bonds or other
investments, to purchase or otherwise acquire real estate and to
execute the same powers thereover as hereinbefore provided, to
retain indefinitely any part of my assets, real or personal, which
is or may become unproductive or to make sale thereof; to pay
carrying charges and expenses of the property out of other
principal or income of my estate; to invest and reinvest in all
forms of property without restriction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to
the principle of diversification or risk; to exercise any law-given
option to treat administrative expenses either as income tax or as
estate tax deductions, without regard to whether the expenses were
paid from principal or income. The powers herein conferred shall
be to my named personal representative and said Trustee and all
successors thereto and shall be in addition and not in limitation
of other powers conferred on said fiduciaries.
Any and all payment or payments of any sum or sums,
whether in cash or in kind and whether for principal or income,
payable to any beneficiary shall be made upon the sole receipt of
the respective beneficiary to whom the payment is made, and free
from anticipation, alienation, assignment, attachment, and pledge
and free from control by the creditors of any such beneficiary.
All shares of principal and income hereby given shall be free from
anticipation, assignment, pledge or obligation of the beneficiaries
and any of them and shall not be subject to any execution or
attachment, levy or sequestration or other claims of the creditors
of said beneficiaries or any of them.
ITEM V: All shares of principal and income hereby given
shall be free from anticipation, assignment, pledge or obligation
of the beneficiaries and any of them and shall not be subject to
any execution or attachment, levy or sequestration or other claims
of the creditors of said beneficiaries or any of them.
ITEM VI: I nominate, constitute and appoint my son, FRED
A. GORTON, as sole Executor of this my Last will and Testament,
to serve without bond. In the event of the renunciation, death,
resignation, refusal or inability of my son to act for any reason
whatsoever I nominate, constitute and appoint my daughter, PHYLLIS
GORTON BERGLUND, as sole executrix of this my Last will and
Testament to serve without bond.
IN WITNESS WHEREOF, I, BARBARA R. GORTON, have, to this my
will and Testament, set my hand and seal this dnd day
of ~~ , 199L .
I3J~ Q. h(l~ (SEAL)
BARBARA R. GORTON
Signed, sealed, published and decla~d by BARB~~TO~ the
above-named Testatrix, on the ~ n day of () 0 ,
1995 , as and for her Last will and Testament in the presence of
us, who, in her presence and in the presence of each other have,
er request, subscribed our names as witnesses hereto.
~J~ residing at 10 v r:r~~,.~ (2A.-
M,,-,j t Gf'tJ ~, <-/ ~"
~QQu\ p<,-\~ residing at lr;~'~~'
Name
.
COMMONWEALTH OF PENNSYLVANIA )
0~ ) SS:
COUNTY OF )
We, the undersigned, the Testatrix and the witnesses,
respectively, whose names are signed to the foregoing instrument,
being first duly sworn and qualified according to law, do hereby
declare to the undersigned authority that we were present and saw
the Testatrix sign and execute the instrument as her Will, and that
she had signed willingly and that she executed it as her free and
voluntary act for the purposes therein expressed, and that each of
the witnesses, in the presence and hearing of the Testatrix, signed
the will as witnesses and that to the best of their knowledge the
Testatrix was at that time eighteen (18) years of age or older, of
sound mind and under no constraint or undue influence; and I, the
said Testatrix, do hereby acknowledge that I signed and executed
the instrument as my Last will and Testament, that I signed it
willingly, and that I signed it as my free and voluntary act for
the purposes therein expressed.
t-A-a.lJ~
Testatrix
) p. ~~~
) ~
'..J .' -7
Wltness
~ JeaXl El~
l efore me t~
, 199 .
My
Notarial Seal
oraida Cabrera, Notary Public
vondale Boro, Chester County
y Commission Expires Nov. 4, 1996
M91l'lber, Pennsylvania Association of Notaries
Marjorie A. Wevodau First
Glenda Farner Strasbaugh Deputy
Register of Wills
and
Clerk of Orphans' Court Kirk. S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240,6345
FAX (717)240,7797
I INVOICE I
Bill To: InvoiceNo: 175
Invoice Date: 01-20,05
TA TITLE Estate of: BARBARA RVIH GORTON
105 SOVIH HIGH ST Estate No: 21- 2004,1171
3RD FLOOR JA
WESTCRESTER, PA 19380
Qty Fee Description Fee Total
7 PHOTOCOPIES 0.50 $3.50
1 CERTIFIED COpy 5,00 $5.00
Total: $8.50
.
d1ecks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you. .
(;OMMONWEAlTH OF PENNSYLVANIA REV,1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004951
GORTON FRED A
1407 LETCHWORTH ROAD
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
_____n_ fold ---------- --------
101 I $ 30,000.00
ESTATE INFORMATION: SSN: 171-20-9600 I
FILE NUMBER: 2104-1171 I
DECEDENT NAME: GORTON BARBARA RUTH I
DATE OF PAYMENT: 02/16/2005 I
POSTMARK DATE: 02/16/2005 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 12/14/2004 I
I
TOTAL AMOUNT PAID: $ 30,000.00
REMARKS: FRED A GORTON
CHECK# 114
INITIALS: RSK
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: 6 All' \0""",0. Q.~ @.~
Date of Death: t'l..\. 1L{ l O~
.
Will No. 0-.Do~{-) ~\l \ Admin. No. '2-~ ~ 0 ~ - WI'
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the fltt.\\~ benef~ciaries of the above-captioned estate on
Name Address
(J\-\.'t \\~ G.-. ~ \":>e",", \UIV~ 6 cr; lfCo ""J b'Vt ~ ~w
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Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: '7- \ 1< \0\ ~ .9..-.."-
Signature
('.,1 Name ~ (',..,.~~
-
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Telephone M7l 1?7-<iS-'2-~
Capacity:~ Personal Representative
Counsel for personal
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June 16,2005
To Whom It May Concern:
Please find enclosed a check in the amount of$12,975.00 as Final Payment for
Inheritance Taxes for the Estate of Barbara Ruth Gorton, File No. 2104-1171 filed in
Cumberland County, Pennsylvania. Please let me know if I can be of any further
assistance.
Sincerely,
t. {)J ~ ljllUL/
Erica L. Werner
FLT216-346
. 0--. .~
, R.,_'
'..
FIRST LAND TRANSFER, LLC
Oaklunds Corporote Center
100 Campbell Blvd" Suite 106
[xtun, PA 1934]
610.363.4304 rux: 61 CU63,4384
COMMONWEALTH OF PENNSYLVANIA REV.1162 EX{11.96)
D~AATMENT OF REVENUE
. BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT NO. CD 004951
GORTON FRED A
1407 LETCHWORTH ROAD
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
up...__ lulu .---~....- -~ --_..-
101 I $30,000.00
ESTATE INFORMATION: SSN: 171-20-9600 I
FILE NUMBER: 2104-1171 I
DECEDENT NAME: GORTON BARBARA RUTH I
DATE OF PAYMENT: 02/16/2005 I
POSTMARK DATE: 02/16/2005 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 12/14/2004 I
I
TOTAL AMOUNT PAID: $30,000.00
REMARKS: FRED A GORTON
CHECK# 114
INITIALS: RSK
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005486
GORTON FRED A
1407 LETCHWORTH ROAD
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold ------~--- --------
101 I $12,975.00
ESTATE INFORMATION: SSN: 171,20,9600 I
FILE NUMBER: 2104-1171 I
DECEDENT NAME: GORTON BARBARA RUTH I
DA TE OF PAYMENT: 06/27/2005 I
POSTMARK DATE: 06/1 6/2005 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 12/14/2004 I
I
TOTAL AMOUNT PAID: $12,975.00
REMARKS:
CHECK# 216
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
--
REV.l5reEX (6.{){)) REV-1500
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER
DEPT 280601 --eU-~f -L dRJ..L _
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT
COUNTY CODE YEAR
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITI SOCIAL SECURITY NUMBER
i-
Z .
W THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W REGISTER OF WILLS
U
W SOCIAL SECURITY NUMBER
C - -
w ~riginalReturn o 2. Supplemental Return o 3. Remainder Return (date ofdeatn prior 10 12.13-82)
>-
:x:::!:(I) o 4. Limited Estate o 4a. Future Interest Compromise (date of death after 12-12-821 o 5. Federal Estate Tax Return Required
<.>"':<
w"<'>
:roo o 6. Decedent Died Testate (AlIeen copy 0: Will) o 7. Decedent Maintained a Living Trust (Attach copy 01 TruSl) 8. Total Number of Safe Deposit Boxes
<.>"'--'
..'" -
.. o 9, Litigation Proceeds Received o 10. Spousal Poverty Credit (dale of deal" between 12-31.91 and J.1.95) o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
0(
>- THIS SECTION MUST BE COMPLETED, All CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
z COMPLETE MAILING ADDRESS
w NAME
0 If'/) 7 L€7CN&f.JOR TH RO;fl)
z
0
.. FIRM NAME (IfApDlicable)
"'
W
'"
'"
0
<.>
1. Real Estate (Schedule A) (1) /11/ 757. 77
2. Stocks and Bonds (Schedule B) (2) <ii1. 3tJ 3. 9 'I
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0
4. Mortgages & Noles Receivable (Schedule D) (4) 0
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) ~31 .=;1.7~..;2.3 ,
.
Z (Schedule E) i
0 6. Jointly Owned Property (Schedule F) (6)
S o Separate Billing Requested
::l 7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (7)
I- (Schedule G or l)
ii: 8. Total Gross Assets (tolal Lines 1-7) (8) 7(JI, 337. 9~
c(
u 411, 3 PO, 90
w 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
It: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions ((otal Lines 9 & 10) (11) &(1. 39(}.?O
12. Net Value of Estate (Line 8 minus Line 11) (12) t.S9. 9~ (; q
13 Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) <:)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus line 13) (14) (..51. 9'17. 0 ~
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Z 15 Amount of Line 14 taxable at the spousal tax
0 0"'(15)
!;( rate, or transfers under See, 9116 (a)(t.2)
X,O~(16) .;l~ Ii 97.~:;J.....
I-' 16 Amount of Line 14 taxable at lineal rale
::l
Q. t7. Amount of Line 14 taxable at sibling rate x .12 (17)
:!E
0 18, Amount of Line 14 taxable at collateral rate x .15 (18)
U 19 Tax Due (19) ~9, t. '17. Gt..::1..
><
~ 20
> > BE SURE TO ANSWER All QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
CITY I
Tax Payments and Credits: A~ t, 9 ~ G.;L
1 Tax Due (Page 1 Line 19) (1)
2. CreditslPayments
A, Spousal Poverty Credit ~~: ~~ ~
B, Prior Paymenls
C. Discount 31, ~8't: 39
Tolal Credits (A + B + C) (2)
3 InleresVPenaity if applicable
0, Inlerest
E, Penaity 0
Totai InteresVPenalty ( D + E ) (3)
4 If Line 2 is greater than Line 1 + Line 3, enter the difference, This is the OVERPAYMENT, 1,71/10.77
Check box on Page 1 Line 20 to request a refund (4)
5, If Line 1 + Line 3 is greater than Line 2, enler Ihe difference, This is the TAX DUE, (5)
A, Enter the interest on the tax due. (5A)
B, Enter the tolal of Line 5 + 5A, This is the BALANCE DUE, (5B)
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 Ihe use or income of the property transferred;,.. ,........,..,....,..,..,.. ..,..,..,..,....,.. ............................,.......,.. 0 W
b. retain the right to designate who shall use the property transferred or ils income; ............,..,..,................,........ 0 @"
c, retain a reversionary interest; or.., ..,......,..... ..,.......,..,..,..,...... ..,........, ..........,.. ........,....,......,..,......,..,............ 0 ~
d, receive the promise for life of either payments, benefits or care?.... ........ ,....,..,............. ....,....,...... ,....,.......... 0
2, if death occurred after December 12, 1982, did decedent transfer property wilhin one year of death
wilhout receiving adequate consideration? ......,....,..,..,..,....,..,..........,....,....,.... ,....,..,....,......,............... ..,.... ,........' 0 [W'
3 Did decedenl own an "in trust for" or payable upon dealh bank account or security at his or her death? ..,.. ........ 0 [jY
4, Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ~
contains a beneficiary designation? 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.
Und" ponalties ,I peoo~, I deola" .at I h,,' "amieod thi, ,,10m, incloding "",mpanying "h,"oles and ,lal,mont" and to the best ,! my 'n,wtedge and beliel, it i, twe, "'ITee! and ",mplete,
DeclaratiOrl of preparer otner than tne personal representative is base donallinformationofwnichpreparernasanyknowledge.
SIGNATURE OF PERS~ FO~~ RE~\.. DATE
~
ADDRESS Ra4-DJ (!..tJ./1?~ I/IL" PII17ol1
1(~7 ) ;'7'"~l+bJ(jI2.7"Jf
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE , DATE
ADDRESS
For dates of death on or after Juiy 1, 1994 and before January 1, 1995, the tax rate imposed on the net vaiue oftransfers to or for Ihe use ofthe surviving spouse is 3%
[72 P,S, 99116 (al (1.1) (ill,
For dates of death on or after January 1, 1995, the tax rate Imposed on the nel value of transfers 10 or for Ihe use of the survivin9 spouse is 0% [72 P,S. 99116 (a) (1.1) (ii)],
The statute does not exemot a Iransfer to a surviving spouse from lax, and the statutory requirements for disclosure of assets and fiiing 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 chiid twenty-one years of age or younger at dealh to or for the use of a nalural parent, an adoptive parent,
or a slepparent of Ihe child is 0% [72 PS. 99116(a)(1.2)].
The tax rate imposed on Ihe net value of Iransfers 10 orfor the use of the decedent's iineal beneficiaries is 45%, excepl as noted in 72 PI. \9116(1.2) [72 PS 99116(a)(1 Il
The tax rale imposed on tile net value of Iransfers to or for Ihe use of Ihe decedent's siblings is 12% [72 PS 99116(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. 16'9. SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Go .
All real property owned solely or as a tena t in common mus 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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 PR.(}PE~-ry A-r ~35" t.HAm&c~S W/ly
WEST G/l.()V6 PI/- IQ3Qo I.S ~
I I 7 7 \.: IAJtH..G-
PAm Il-y "Ii "Ii .\
f',I4tIVCt+ rrd":Je.t ~dT/ /f}(, 7S7. 77
'5 OL 1) (),(/ I/o.. 7!():5'" (s6i!!' A-r"~IfED)
TOTAL (Also enter on line " Recapitulation) $
(If more space is needed, insert additional sheets 01 the same size)
RE"~""(''''. SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
G()RTO.lt/' 8ARIYlRA-R. .;J,/~1/-1171
,
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1, L.M lZa..v '-rv FV,#'[>5 .:J I 1':1, ~ I
d. I
CQ,///-r,4S :J.t:). got:)O .ea(
3. U. S. AG-Elf/c y Stfc.vA.,lrIEs /9,3 ?/I, 90
~.
In IIrth4J.. FVA/1J'S :l...7, t>.;zo. ~ ;4.
I
I
,
i
~tg.3~3.9'1
REV.,...".,,.,,. SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
(yt:>r< rt:>A/, ~~A.B,4R..4 R.. ,51./-0tf-1/71
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1- L.=G& /lttSOAl tASH 84t."fIl/CE 9/<J,S'O
:1.. tVAcH4Vllt (},1.()SIA.J6- 8AUfNCa 4c1,P~' 13
3. AL.L STArt: )RA II,S~3. 70
'f. US, 1,f",€/lSi/R.Y B,u- q, <6~9, (j (
5. SUN 1-1 Ft' F/tVAtf/t:: 11fL- /(J/I, '~~.(j3
(,. SUN '-(F~ FI/fI/lNCf,4t.. /1' I 77~, '-f
i. H/tj,TFM1.)) L.IFJi ~7. t"S~ c:; ;l..
"8. W A<:./HN J A ttJITHDR/fWIU.. PA./(jP' 7d De:A-711 ::1 0 ,t)~(j, () CJ
I
TOML (Also enier on line 5, Recapitulation) I $
(If more soace is needed. insert additional sheets of the same size)
AEV-1511 EX+ (12~99) .
~i!- SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GOIl.7~A/, J1JA~~,q R./l R. 011-0'1-11 7/
,
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1,
5e:RVI~e$ ~(1~,0~
fYl A-(~.J(E R.
<:1 0 0 . Ot)
N07"ES. ~rc.
so~,oa
B, ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name 01 Personal Representative{s) F/l..eD
Social Security Number(s)/EIN Number of Personal Representative(s %
Street Address J"i1J7 J r-rC:H4tJ~T# ~ n.
City CAB!' !lU..L State M Zip /70/1
.
Year(s) Commission Paid: 35; () (.,,~.. '10
2, Attorney Fees 6S-0.00
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 330.00
5. Accountant's Fees C
6. Tax Return Preparer's Fees 5t>.OO
7,
TOTAL (Also enter on line 9, Recapitulation) I $ 1(/, 39/), ftJ
(If more space is needed, insert additional sheets of the same size)
REV,1513 EX+ 19,00)
*' SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
G-~ fC -It:) fl'-
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONIS) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 la) 11.2)J
" F RE.D Gol..-rd/ll Self) S-o~
I ~d 7 Le-rc/twoR..rH ~~
CAmp If/~~, PI1 /7d 1/
,;1.. PWfl...LIS Ge>I(T~1II ])III/&-I-I ~ I< S~~
(15"( to ac...,.H ftyp; 5 I.N
I
5tR {Tl..1ii U/A 9g 1:1(.
I
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
"
Nlfi
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
/lJbA.J~
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
.
A, U, ~, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 8, TVPE OF LOAN
SETTLEMENT STATEMENT
I. o FHA 2. 0 FMHA 3. 0 CONY. UNINS.
First Land Transfer, LLC 4. OVA 5.OCONV.INS.
100 Campbell Boulevard
Exton, Pennsylvania 1934 I 6. File Number 7. Loan Number:
FLT216'346 17129730/117129730 I
610')63-4304 fax: 610,363,4384 8. Mortgagelns,ClISeNo
C. NOTE Thlsform "JUrm,h,d 10 gIVe you a stat'm'nt of actual mtl,ment cosls, Amounls paid 10 and by Ihe sell/emenl ag'nt are ,how.. Items marked
.a.c.) were aid outside the closin . The are shown here or in ormational ur oses and are not included in the totals.
D. Borrower: Kathleen R Cleveland
E, Seller: Fred A, Gorton, Executor of the Estate of Barbara R, Gorton, deceased
JP Morgan Chase Bank N,A,
F, Lender: Five Valley Square
Blue Bell, Pennsylvania 19422
435 Chambers Way
G, Property: West Grove, Chester County, Pennsylvania 19390
London Grove Township
Chester County, Pennsylvania
H. Settlement Agent: First Land Transfer, LLC
Place of Settlement: 100 Campbell Boulevard, Exton, Pennsylvania 19341 Chester County
L Settlement Date: January 27, 2005
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 195,000,00 40 I. Contract Sales Price 195,000,00
102, Personal Property 402, Personal Property
103, Settlement Charges to Borrower (line 1400) 7,032.32 403,
Adjustments for Items Paid I>r Seller in Advance: Adjustments for Items Paid by Seller in Advance:
106, City / Town Taxes 406, City / Town Taxes
107, County / Parisb Taxes 407, County / Parish Taxes
108, Assessments 408, Assessments
109, School Taxes Jan 27, 2005 thru Jun 30, 2005 1,009.44 409, School Taxes Jan 27, 2005 thru Jun 30, 2005 1,009.44
110, Sewer Rents 410, Sewer Rents
111. Trasb 411. Trash
112, Association Dues 412. Association Dues
120. Gross Amount Due from Borrower: 203,041.76 420. Gross Amount Due to Seller: 196,009,44
200. Amounts Paid I>y, or in Behalf of Borrower: 500. Reductions in Amonnt Due to Seller:
201. Deposit! Earnest Money 8,000,25 + 501. Excess DepOSIt (see instructions)
202, Principal Amount of New Loan 156,000,00 502, Settlement Cbarges to Seller (Line 1400) 29,075,80
203, Existing Loan(s) 503, Existing Loan(s)
204. Borrowers' Closing Funds 504, Payoff of First Mortgage to
205, 505, Payoff of Second Mortgllge to
206, 506, Purchase Money Mortgage to
Adjustments for Items U'!J>llid I>y,Seller: AdJustments for Items Unpaid by Seller:
210, City / Town Taxes Jan I, 2005 thru Jan 26, 9,60 510 City / Town Taxes Jan I, 2005 thru Jan 26, 9,60
2005 , 2005
21 I. County / Parish Taxes Jan 1,2005 thru Jan 26, 24.27 511 County / Parish Taxes Jan 1,2005 thru Jan 26, 24,27
2005 , 2005
212. Assessments 512, Assessments
213, School Taxes 513, School Taxes
220, Total Paid by / for Borrower: 164,034.12 520, Total Reductions in Amount Due Seller: 29,109.67
300. Cash at Settlement from / to Borrower: 600. Cash at Settlement to / from Seller:
301. Gross Amount due from Borrower (line 120) 203,041.76 601. Gross Amount due to Seller (line 420) 196,009.44
302, Less Amount Paid by/for Borrower (line 220) 164,034,12 602 Less Reductions Amount due Seller (line 29,109,67
' 520)
303, Cash From Borrower: $39,007.64 603. Cash To Seller: $166,899.77
I'"
I 1 't-
1 have "",efully ,eviewed the HUD-l Settlement Statement aud to the best of my knowledge and belief, it is a true and accurate statement of all 'Cceipts and
disbursements made on my account or by me in this transaction. I further certifY that I have received a copy ofHUD-I Settlement Statement.
Borrowe,'1{dAlUA/ (~ ~& J /ll\ c--. \ ~ '\
'-.,,_.-,--- ".,,,-,..- ,,-, --~,.".+ -
T.A. Title Insurance Company
Pile No, FL T216-346
Commitment No, KS05055
Date: 01127/2005
ESCROW AGREEMENT
Premises: 435 Chambers Way, London Grove Township, Chester County, Pennsylvania
Settlement Officer/Agent: Erica L. Werner
To: T.A. Title Insurance Company
The undersigned parties hereby request the swn of $13,000.00 be held from settlement for the following
purpose(s), viz, (explain in detail):
Payment of Pennsylvania Inheritance Taxes
In the event your insurance is imperiled, you are hereby authorized to use any or the entire sum retained to
protect your insurance, The undersigned hereby agree to indemnify and save you harmless,
Upon fulfillment of the above conditions, which are to be approved, in writing, by First Land TransfertrA
Title Insurance Company (not a Company employee if it relates to a repair item) you are authorized to pay the
above stated swns to Estate of Barbara R. Gorton without interest,
The above conditions are to be fulfilled on or before May 31, 2005. In the event this is not accomplished by said
date, the funds are to be disbursed as follows: (explain fully)
Payment to be made in full to Pennsylvania Inheritance Tax Division
In the event of a dispute over distribution of the escrowed funds, T,A, Title Insurance Company, upon
consideration of the facts in the particular case and without liability on their part, is authorized to continue to
hold said funds, pending resolution of the dispute, or to pay the funds into Court, IfT,A, Title Insurance
Company interpleads the funds into Court, it is entitled to be reimbursed from the fund for reasonable attorney's
fees and costs it incurs in that action,
In the event the amount retained is not sufficient, the undersigned will, upon demand, deposit the additional
amount necessary.
Escrow Agreement ~
Page 1 of2 mITIAL INITIAL
R1I/03
WACHOVIA
Deposit Account Close Confirmation (Debit)
WACHOVIA BANK, NA
Date Customer Name(s) and Address Taxpayer 10 Number
01/03/2005 BARBARA R GORTON 5171209600
FRED A GORTON POA
435 CHAMBERS WAY
WEST GROVE PA 193901301
ACCOUNT NUMBER: 3000023250232
Available Balance $40,026,71
+ Accrued Int : $1.42
, Fed WIHd Due: $0,00
'Admin Fee: $0,00
- Outstanding Db : $0,00
- Closing Fee: $0,00
--------------
Paid To Customer: $40,028,13
566596 CUSTOMER COpy
DoD (2.-!liIO(:l Account Statement
- LEGe Legg Mason Wood Walker, Inc.
M~New York stockEx~:f1<nge, fncJMerrt:Jer SIPC
- MASON P~~~~D
Page: I
Account: 363-04362
- F,A.: RL4
December 31, 2004
- 334557
- Last Statement
November 30, 2004 BARBARA GORTON
435 CHAMBERS WAY
WEST GROVE FA 19390-1301
YlHff_Finalfd'atAdVis()t
RICHARD A LYBARGER
LEGG MASON WOOD WALKER INC 111I11I.111I111,1.11111111111111111.11111I11111111111,1111.,.1
214 SENATE AVENUE
PO BOX 8853
CAMP HILL PA 17001-8853
(717) 730-3610 (800) 433-8186
Account Vain"
Cash Balance 918.50 This Month Y car to Date
LM Equity Funds 21,142.61 Legg Mason Mutual Funds
Equities 20,800.61 CASH RESERVE
US Agency Securities 19,339.90 TRUST
MUhwl Funds 27,020.82 Dividends 0.00 2.53
Annuities 203,606.36
Other Income
Appr4XiTllat~..VaJlle Dividends 322.48 1,864.80
Interest 86.25 662.02
This Statement 292,828.80 L T Capital Gains 444.90 444.90
Last Statement 285,809.49 Cash in Lieu 0.00 4.57
Ttjtal..ln~Qrne 853.63 2,978.82
You may have purchased lllutllal funds, annuities. limited
pal1nerships or other investments whieh arc not reported as Taxable Income 408.73 2,529.35
positions on this slatement. If so, you will receive periodic Other Distributions 444.90 449.47
statements directly frOIll the fund, insurance company or
partnership.
Cash Balance SUQuljary
Cash
Opening Balance 780.45
Closing Balance 918.50
Incoll1eActivity
Date Transaction Quantity Description Price Amount
12/06 DIVIDEND NICHOLAS-APPLEGATE CONVERTIBLE $43.19
INCOME FD II
CASH DIV ON
373.56600 SHS
REC 11/12/04 PAY 12/01/04
12/06 REINVESTMENT 2.753 NICHOLAS-APPLEGATE CONVERTIBLE 43.19
INCOME FD II
REIN @ 15.6900
REC 11/12/04 PAY 12/01/04
12/10 DIVIDEND CHEVRONTEXACO CORP 51.20
CASH DIV ON 128 SHS
REC 11/18/04 PAY 12/10/04
Statement Continued on Reverse Side
See Enclosed Brokerage Account Statement Disclosure For Important Information
LMCOO1 334557 m 1,592,308ZBA 1101/02/05;13:27 RS 363-04362 RL4 292,828.80 Der;ember31, 200 tor
Account Statement
LEGG Legg Mason Wood Walker, Inc.
MASON P~~~~D Member New Yolk StJxi<. Exr:h<nge, fncJMember SIPC
Page: 2
Account: 363-04362
F,A,: RL4
December 31, 2004
BARBARA GORTON
Date Transaction Quantity Description Price Amount
12/14 L/T CAP GAIN **CAPITAL INCOME BUILDER FUND $444.90
CLASS A
L/T CAPITAL GAIN
RECORD 12/10/04 PAY 12/13/04
L/T CAP RATE $ 0.900
12/14 DIVIDEND **CAPITAL INCOME BUILDER FUND 227.49
CLASS A
RECORD 12/10/04 PAY 12/13/04
12/14 REINVESTMENT 4.399 **CAPITAL INCOME BUILDER FUND 227.49-
CLASS A
REINVEST PRICE $ 51.71
12/14 REINVESTMENT 8.604 **CAPITAL INCOME BUILDER FUND 444.90-
CLASS A
REINVEST PRICE $ 51.71
12/15 INTEREST FEDERAL HOME LOAN MTG CORP 41.67
DUE 07/15/2019 5.000
REG INT ON 10000 BND
REC 11 30/04 PAY 12 15/04
12/15 INTEREST FEDERAL HOME LOAN MTG CORP 44.58
DUE 08/15/2024 5.350
REG INT ON 10000 BND
REC 11/30/04 PAY 12/15/04
12/31 DIVIDEND WESTERN ASSET/CLAYMORE U S .60
TREAS INFLATION PROTECTED SECS
FUND 2
CASH DIV ON
1.86944 SHS
REC 12/15/04 PAY 12/31/04
Portfolio Summary
Securities prices lIsed in your pOl1folio summary arc obtained from outside services and their accuracy cannot be guaranteed. These values arc
provided as a general guide hul in some cases may not reflect the actual market price. If an exact price is needed, contact your Financial Advisor.
Legg Mason Equity Funds
Shares Description Price Market Value
03 73 324.124 **LEGG MASON VALUE TRUST 65.23 $21,142.51
OPENING SHARES 324.124
PRICE $61.49
MARKET VALUE: $19,930.38
Market Value of Legg Mason Equity Funds $21,142.61
7.2% of Portfolio
Equities
n Estimated --
Annual Current
Quantity Description Price Market Value Income Yield
53,o~ 128 CHEVRONTEXACO CORP 52.51 $6,721.28 204.80 3.0%
15;, </-'f 376.319 NICHOLAS-APPLEGATE CONVERTIBLE 15.82 5,953.36 722.91 12.1%
41,0 INCOME FD II
200 VERIZON COMMUNICATIONS 40.51 8,102.00 308.00 3.8%
Statement Continued on Next Page
LMCOO1 274 1,592.309ZBA 1101102/05;13:27 RS363-04362RL4N1A Nof
Account statement
- LEGG Legg Mason Wood Walker, Inc.
Mf'f'1Ur New York stockEx.cJwnge,fnc.lMentJer SIPC
- MASON P~~!~D
Page: 3
- Account: 363-04362
F,A,: RL4
December 31, 2004
- BARBARA GORTON
Portfolio SUll1ll1l1fY(CllOtinued)
Equities -~ Estimated
--
Annual Current
Quantity Description Price Market Value Income Yield
[.1.90 1.869 WESTERN ASSET/CLAYMORE U S 12.82 23.97 $1.54 6.4%
TREAS INFLATION PROTECTED SEes
FUND 2
Market Value of Equities $20,800.61 $1,237.25 5.9%
7.] % of Portfolio
US Agency Securities
h Estimated --
Annual Current
Quantity Description Price Market Value Income Yield
9foJXJ 10,000 FEDERAL HOME LOAN MTG CORP 96.067 $9,606.70 $500.00 5.2%
INTEREST FROM DATE 07/17/03
DATED DATE 07/14/03
DUE 07/15/2019 S.OOG%-
10,000 FEDERAL HOME LOAN MTG CORP 97.332 9,733.20 535.00 5.4%
q1.0D INTEREST FROM DATE 08/26/04
DATED DATE 08/23/04
PAR CALL 08/15/2008
DUE 08/15/2024 5.350%
Market Value of US Agency Securities $19,339.90 $1, 035.00 5.3%
6.fi% of Portfolio
Mutual Funds (Mutual fund share balances may not reflect recent activity.)
h Estimated h
Annual Current
Quantity Description Price Market Value Income Yield
,./
52,(& 507.338 **CAPITAL INCOME BUILDER FUND 53.26 $27,020.82 $920.82 3.4%
CLASS A
Market Value of Mutual Funds $27,020.82 $920.82 3.4%
9.3% of Portfolio
Annuities (Annuity policies arc mailed to you sh0l11y after the initial purchase and arc not held by Lcgg Mason or protected by SIPe.
Policy values arc provided for informational pUrposes only based on infonnation received from the insurance carriers and may
not reneel current values. Ownership of your annuity policy may differ from the registration of your Legg Mason account.)
Description Market Value Sub Value Date Reported
HARTFORD $47,458.01 12/30/04
HARTFORD LIFE INS CO INS
POLICY #710138983
FUND ALLOCATIONS;
DIVIDEND & GROWTH FUND 12,199 _ 96
STOCK FUND 8,782.83
CAPITAL APPRECIATION FUND 16,976.24
INDEX FUND 9,498.98
Statement Continued on Reverse Side
lMCOO1 214 1,592.310ZBA 1101/02/05;13:21 RS 363-04362 RL4 NIA Nof
.
Account Statement
LEGe Legg Mason Wood Walker, Inc.
Merme, NINf YOik Stxxk EYJ:h1'Y1ge, fnclMember SJPC
MASON P~~~~D
Page: 4
Account: 363-04362
F,A,: RL4
December 31, 2004
BARBARA GORTON
I'Ol'tfolio Summary
Annuities (Annuity policies <lre mailed to you ShOJi!y after the initial purchase and <lfe not held by Lcgg Mason 0]" protected by SIPe.
Policy vnlucs arc provided for infollnalionaJ pUrposes only based on information received from the insurance carriers and may
not reflect current values. Ownership of your annuity policy may differ from the registration of your Lcgg Mason account.)
Description Market Value Sub Value Date Reported
SUNLIFE u.s. 4518 51,352.62 12/29/04
SUN LIFE ASSURN CO CDA U S _
POLICY #507507500005196
FUND ALLOCATIONS;
TOTAL RETURN SERIES 51,352.62
SUNLIFE U.S. 4518 104,795.73 12/29/04
SUN LIFE ASSURN CO CDA US INS
POLICY #903603600009149
FUND ALLOCATIONS:
MFS/SUN LIFE SERIES TRUST TOTA 104,795.73
Market Value of Annuities $203,606.36
69.8% of Portfolio
AccQunt Instructions
Investment Objectives
Investment objectives for your account are shown below. [f you have any questions concerning these objectives, or wish to
change them, please contact your Financial Advisor.
I. Income 2. Long term growth
Delivery Instructions
Securities in your account will be held by Legg Mason for your benefit.
Cash balances will be held in your account.
IMPORTANT REGULATORY MESSAGE:
Legg Mason Wood Walker, Incorporated ("LMWW") is subject to the requirements of thc Securities and Exchange
Commission's Uniform Net Capital Rule ("Rule 15c3-1 ") and the rules of the securities exchanges of which it is a member.
LMWW has elected to use the alternative method of computing net capital permitted by Rule 15c3~ I, which requires that it
maintain minimum net capital of two percent of aggregate debits, as defined. Ncw York Stock Exchange rules stipulate
that a mcmber organization may not expand its business, equity capital may not be withdrawn, nor may cash dividends bc
paid if resulting net capital would fall below specified levels. At October 31, 2004, LMWW had net capital, as defined,
of $320,712,000, which exceedcd the required net capifal of $24,408,000.
^ copy of LMWW's consolidated statement of financial condition may be obtained at no cost, by accessing our website
at www.leggmasoll.com or by calling us toll-free 1-877-534-4627.
* - - - - - - - - - - - - - - - - - - - - - - - - - - - -- End of Statement For Account 363-04362 - - - -. - - - - - - - - - - - - . - - - - - - - - - - - *
LMCOO1 274 1,592.311 Z8A 1101102/05; 13:27 RS 363-04362RL4 N1A NofY
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
FRED GORTON
1407 LETCHWORTH RD
CAMP HILL PA 17011
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTAtE OF
DATE OF DEATH
FILE NO.
COUNTY
ACN
REV.1547 EX (06.a5) PC
11-07 -2005
GORTON
12-14-2004
21 04-1171
Cumberland
101
BARBARA
R
Appeal Date: 01-06-2006
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
Register of Wills
Cumberland County Courthouse
Carlisle, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
. - REv~154i EX -(ifEi-osfpc - - - - - - - - - - - - - -NoticE - ,iF -IN~iERif ANCE- TAX AP-PRAis-EME-NT-, - A-LL.OWA~{CE- OR - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
GORTON BARBARA R FILE NO. 2104-1171 ACN 101
TAX RETURN WAS: ([gJ) ACCEPTED AS FILED (D) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
ESTATE OF
DATE 11-07-2005
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/ Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 41,390.90
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 0.00
11. Total Deductions (11) 41,390.90
12. NetValueofTaxReturn (12) 659,947.04
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 0.00
14. Net Value of Estate Subject to Tax (14) 659,947.04
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16,17 and 18 will reflect figures
that include the total of ALL returns assessed to date.
(1 )
(2)
(3)
(4)
(5)
(6)
(7)
181,757.77
88,303.94
0.00
0.00
431,276.23
0.00
0.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
701,337.94
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 taxable at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
(15) 0.00 X .00 0.00
(16) 659,947.04 X .045 29,697.62
(17) 0.00 X .12 0.00
(18) 0.00 X .15 0.00
(19) 29,697.62
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID H
02-16-2005 CD004951 1 ,484.88 30,000.00
06-16-2005 CD005486 0.00 12,975.00
TOTAL TAX CREDIT 44,459.88
BALANCE OF TAX DUE 14,762.26 CR
INTEREST 0.00
TOTAL DUE 14,762.26 CR
*
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
It..
(U'
BUREAU OF INDIVIDUtct:rUJlE$',
INHERITANCE TAX DIVIlilDIt,'_:',;., ..'
PO BOX 280601 .
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
r r-'. 16
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-28-2005
GORTON
12-14-2004
21 04-1171
CUMBERLAND
101
BARBARA
R
FRED GORTON
1407 LETCHWORTH RD
CAMP HILL PA 17011
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
---------------------------------------------------------------------------
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF GORTON BARBARA R FILE NO.21 04-1171 ACN 101 DATE 11-28-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-19-2005
PRINCIPAL TAX DUE: 29,697.62
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-16-2005 CD004951 1,484.88 30,000.00
06-16-2005 CD005486 .00 12,975.00
11-10-2005 REFUND .00 14,762.26-
TOTAL TAX CREDIT 29,697.62
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
If IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
pj(
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 11/30/2006
GORTON FRED A
1407 LETCHWORTH ROAD
CAMP HILL, PA 17011
RE: Estate of GORTON BARBARA RUTH
File Number: 2004-01171
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 12/14/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Pa. D.C. Rule 6.12 STATUS REPORT
R.:hGISTJ;;R. OF WILLS or ('...... ---l-. <'>-l ",,~.l.. COUNTY, PENNSYLVANIA
Name of Decedent:
6.~ 1.:Jy.\~{\
\ --2J ''i \ O~
R. Gc.~~
Date of Death:
File Number: 'J-oD"-{ - 0 \ \" \
Pursuant to Pa. O.c. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. ~Yes 0 No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
3. If the answer to No.1 is YES, state the following:
a. Did the personal representative file a final account with the Court? . . . . . " 0 Yes ~ No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? ............................... ~Yes 0 No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and may be attached to this report.
Date
~"2-\c. \~
~'" ~'-
Signature of Person Filing this Form
Capacity: ~sonaI Representative
o Counsel
Name of Person Filing this Form
t="""~ Go... -\0.)
(y\
'-._ ,_,~.J pJ
c 1',".;1'" '0
",'\J\{I"-l-'~lU. :
'...., . 1'-/
jf- \ ;i~'l'\
-,,) I,l.:! J
l'iUl G2--\c\,\ Ck"'=\\A ~
Address
L ,,~....Q lr\. ~ \ \, {J t:\ \to\ \
\
-'\ \L - \"), - ~~ "+-0
Telephone
98 :6 ~IV 9- J30 900l
(; '~'i{~\i i ~j-l (J:rl~..l"("i~H
Form Rw!ZrJ JeJ!.,:11XJ,3,VJ.1J:uc<'hJ_'-'
~
BUREAU OF INDIVI~t((~'XEl>i
INHERITANCE TAX DIVISION} _ . ....
PO BOX 280601 .
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
7 r (- [" ". 1 6
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-28-2005
GORTON
12-14-2004
21 04-1171
CUMBERLAND
101
BARBARA
R
FRED GORTON
1407 LETCHWORTH RD
CAMP HILL PA 17011
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF GORTON BARBARA R FILE NO.21 04-1171 ACN 101 DATE 11-28-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-19-2005
PRINCIPAL TAX DUE: 29,697.62
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-16-2005 CD004951 1,484.88 30,000.00
06-16-2005 CD005486 .00 12,975.00
11-10-2005 REFUND .00 14,762.26-
TOTAL TAX CREDIT 29,697.62
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
If IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
r<K