HomeMy WebLinkAbout09-21-05 (2)
RE\I.~5~ EX -\- (6-00)
OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128.0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I-
Z
W
C
W
(J
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Bushon Lotta,H
DATE OF DEATH (MM-DD-Year)
FILE NUMBER
21 -0 5 0 022
COONTYCODE --YEAr- - - NUMBER- -
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
1 98- 3 6 - 4 1 0 5
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
12/24/2004 6/21/1897
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
w
....
l.:~(/)
ull:l.:
wc..u
J: 00
" ll:...J
~c..1Il
c..
<(
SOCIAL SECURITY NUMBER
[R] 1. Original Return
o 4. Limited Estate
[Xl 6. Decedent Died Testate (AllachcopyoIWill)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale 01 dealh after 12-12-82)
o 7. Decedent Maintained a Living Trust (Allach copy 01 Trusl)
o 10. Spousal Poverty Credit (daleoldealh between 12-31.91 and 1-1-95)
o 3. Remainder Return (daleoldeathpr~rloI2-13-82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A)lAllach Soh 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
David H. Stone Es uire 414 Bridge Street
FIRM NAME (If Applicable)
Stone LaFaver & Shekletski
TELEPHONE NUMBER
717-774-7435 New Cumberland PA 17070
~ OFFICIAL USE ONLY
z
o
i=
<(
...J
::l
I-
a..
<(
(J
w
c::
z
o
i=
<(
I-
::l
a..
~
o
(J
X
<(
I-
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter.Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
....
z
w
c
z
o
Q.
(/)
w
0:
0:
o
U
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
0.00 .
(,"'1
"
171,171.61
(. ~,
__.1
i
~
I
--.-.1
173,073.06
15,928.61
89.97
(11)
(12)
(13)
16,018.58
157,054.48
14. Net Value Subjectto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
157,054.48
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1 .2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
0.00 X _(15) 0.00
157,054.48 X .045 (16) 7,067.45
0.00 X 12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 7,067.45
20. []
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's ComPlete ress:
STREET ADDRESS
100 Mt. Allen Drive
CITY I STATE I ZIP
Mechanicsburg PA 17055-
Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payrnents
A. Spousal Poverty Credit
B. Prior Payments
C, Discount
(1)
7,067.45
7.000.00
368.42
Total Credits (A + S + C )
(2)
7,368.42
3,
Interest/Penalty if applicable
D. Interest
E, Penalty
(3)
0.00
5,
Total Interest/Penalty ( 0 + E)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX DUE. (5)
A, Enter the interest on the tax due, (SA)
S, Enter the total of Line 5 + SA. This is the BALANCE DUE. (5S)
Make Check Payable to: REGISTER OF WILLS, AGENT
300_97
0.00
4,
0.00
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
ND
!Xl
!Xl
!Xl
!Xl
1. Did decedent make a transfer and: Yes
a, retain the use or income of the property transferred; .."."..".............."........................................"".... 0
b, retain the right to designate who shali use the property transferred or its income; .................................""... 0
c, retain a reversionary interest; or ..........................."""..............................................................""... 0
d, receive the promise for life of either payrnents, benefits or care? ........................................................"". 0
2, If death occurred after Decernber 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?......,...,...,...,.......,.."..,....,...,......,...,..."...........,...,....,...,..."...... 0
3, Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0
4, Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designatiDn? ."....,......,...,...,...,...,.......,..."...,..,...,...,......."..........,....".......,....,..... !Xl
IZI
IZI
o
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, 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 wtlich preparer has any knowledge.
"'"^'" '" "'''P~ ""'""'''~'''u'"
fj(.C&/?; <<~ -
ADD SS 2613 Talbot Road
Itimore
PRE
, DATE
(/-/9-0~
SIG
MD 21216
DATE
,2.\, <>y
PA 17070
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P,S. 99116 (a) (1.1) (ilJ,
For dates of death on or after January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1,1) (ii)].
The statute does not exernot a transfer to a surviving spouse from tax, and the statutory requlrernents for disclosure of assets and filing a tax return are stili applicable even if
the surviving spouse is the only beneficiary,
For dates of death on or after July 1, 2000:
The tax rate irnposed on the net value of transfers frorn a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S, 99116(a)(1,2)J,
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72 P.S. 99116(1,2) [72 P,S. 99116(a)(1)J,
The tax rate irnposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P,S, 99116(a)(1 ,3)J, A sibling is defined, under Section 9102, as an
IndiVidual who has at/east one parent in cornman with the decedent, whether by blood or adoption,
REV-1,,08 EX + (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Bushona Lotta H
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 05
Include the proceeds of litigation and the date the proceeds were received by the estate,
All property jointly-owned with fight of survivorship must be disclosed on Schedule F.
0022
ITEM
NUMBER
1.
DESCRIPTION
M& T Bank-Checking Acct. #18845002
VALUE AT DATE
OF DEATH
1,901.45
TOTAL (Also enter on line 5. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1.901.45
REV-~509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL Y.OWNED PROPERTY
ESTATE OF
Bushona Lotta H
FILE NUMBER
21 05
0022
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G,
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A Judith A. Bushong
2613 Talbot Road
Baltimore, MD 21216
Daughter
B
c
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE DF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE, VALUE OF ASSET INTEREST DECEDENT'SINTERES
1. A. 1991 Merrill Lynch-Account No. 872-33865 joint wlJudith A 342,343.21 50. 171,171.61
Bushong-value on various securities $342,343.21
TOTAL (Also enter on line 6. Recapitulation) $ 171.171.61
T
(If more space IS needed, Insert additional sheets of the same size)
REV-1511 EX + (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Bushong Lotta. H
FILE NUMBER
21
05
0022
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
1. Myers-Harner Funeral Home-funeral expenses 7,965.00
2. Charles Evans Cemetery-services rendered 550.00
B, ADMINISTRATIVE COSTS:
1, Personal Representative's Cornmissions
Narne of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees David H. Stone, Esquire 4,326.00
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 and short cert 76.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Cumberland Law Journal-advertising grant of letters 75.00
8. The Patriot News Co.-advertising grant of letters 113.61
9. US Treasury-est. tax payment for 2004 900.00
10. PA Dept. of Revenue-est. tax payment for 2004 650.00
11. US Treasury-payment on dec. 2004 income tax 437.00
12. PA Dept. of Revenue-payment on dec. 2004 income tax 636.00
13. Reserve for closing expenses 200.00
TOTAL (Also enter on line 9, Recapitulation) $ 15,928.61
(If more space is needed, Insert additional sheets of the same size)
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Bushona Lotta H
FILE NUMBER
21
05
0022
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Messiah Village-final bill
VALUE AT DATE
OF DEATH
89.97
TOTAL (Also enter on line 10, Recapitulation) $
(If rnore space IS needed, insert additional sheets of the same size)
89.97
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Bushona Lotta H
SCHEDULE J
BENEFICIARIES
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
See, 9116 (a) (1.2)]
FILE NUMBER
?1 Of;
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
0022
AMOUNT OR SHARE
OF ESTATE
1.
Judith L. Bushong
2613 Talbot Road
Baltimore, MD 21216
Lineal
157,054.48
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
1.
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - 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)
LAW OFFICES
JON F. LAFAVER
.917 THIRD STREET
NEW CUMBERLAND.PA
~ i
LAST WILL AND TESTAMENT
OF
LOTTA H. BUSHONG
1
'I
')
;\
,
il
q
i!county, Pennsylvania, being of sound mind, memory and understanding,
II
lido hereby make, publish and declare this as and for my Last Will
I
111.and Testament hereby revoking and making void any and all other
wills by me at any time heretofore made.
I
I
I
I
\
imy just debts and funeral expenses as soon as conveniently may be
,I
Ildone after my decease.
'I
Ii
I!
II
Ilreal, personal or mixed, and wheresoever situate, I hereby give,
II devise and bequeath unto my daughter, JUDITH L. BUSHONG. If my
"
Isaid daughter, Judith L. Bushong, does not survive me, then I
I
ihereby give, devise and bequeath my entire estate as follows:
I
.1
I
I B. One-half (~) unto JOHN H. SHOTT, III, in trust, never-
'I
Ii theless, for my granddaughter, MELISSA L. CHENOWITH, to be held by
limy said Trustee and invested and reinvested for the welfare,
"
iI
'!maintenance, support and comfort of my granddaughter, MELISSA L.
!CHENOWITH.
I, LOTTA H. BUSHONG, of Upper Allen Township, Cumberland
1.
I direct that my Executrix hereinafter named shall pay all
II.
All the rest, residue and remainder of my estate, whether
A.
One-half (~) unto my granddaughter, JENNIFER B. GOSS.
My Trustee shall pay all the net income from this share
liunto Melissa L. Chenowith in installments, at least semi-annually.
j'
liMy Trustee may invade the principal of this trust when, in his. sole
.1
I:
Page one of six Pages
LAW OFFICES
JON F. LAFAVER
317 THIRD STREET
NEW CUMBERLAND, PA
discretion, such invasion is necessary and proper to accomplish the
purposes of this trust. In determining whether principal should be
'iinvaded, my Trustee shall take into account the resources of
'(
Melissa L. Chenowith known to the Trustee. I specifically authorize
if
i:invasion of the principal for maj or medical expenses.
:i
ii
Ii Upon the death of Melissa L. Chenowith, this trust
,;
I!shall terminate and my Trustee shall distribute the principal and
Ii
'I
lany accumulated income to the issue of Melissa L. Chenowith, if any,
Ii
liin equal shares per stirpes. If Melissa L. Chenowith is not
It
oj
I~urvived by issue, then unto JENNIFER B. GOSS, or if she is not
'1,
illiving, then unto her issue in equal shares per stirpes.
"
Ii
I~ III
" .
i'
'i
ii TRUSTEE'S POWERS: My Trustee shall have the following
\1
Ipowers in addition
lid' .
L ~scret~on:
"
\f
"
i!
F
,I
I'
iI
11
Ii
Ii
I!
iI
I!
II
I[
11
I'
.,
to those given by law to be executed in his sole
A.
To retain any real or personal property which may at
any time form part of the trust.
B.
To invest in any real or personal property without
restriction to legal investments.
C.
To purchase investments at premiums; to charge premiums
to income or principal, or partly to each.
D.
To subscribe for stocks, bonds or other investments;
to join in any plan of lease, mortgage, merger,
consolidation, exchange, reorganization, foreclosure
or voting trust and to deposit securities thereunder;
and generally to exercise all the rights of security
holders of any corporation.
II
H
I ~
1\:
I'
i ~
,
E. To repair, alter, improve or lease, for any period
of time, any real or personal property and to give
options for leases.
F. To sell at public or private sale, for cash or credit,
with or without security, to exchange or to partition
any real or personal property and to give options for
sales or exchanges.
Page two of six Pages
LAW OFFICES
JON F. LAFAVER
ii
il
l!
H
n
Ii
Ii
!j
Ii
Ii
Ii
"
Ii
I
"
Ii
I
I
I,
i'
Ihecomes distributable to a
"
:!
:1
"
:;
"
i;
iI
Ii
'I
II
\1
p
!I
Ii
Ii
p
Ii
I:
'i
II
ii
It
j ~
G. To borrow money from any person, including Trustee,
and to mortgage or pledge any real or personal property.
H. To compromise claims.
I. To make distributions in kind.
J. To exercise all power, authority and discretion given
by this Instrument of Trust, after the termination
of any trust created herein until the same is fully
distributed.
K. To purchase and hold investments in the name of a nominee.
L. To employ, in his discretion, legal counsel, and such
other agents and servants as he may deem necessary in
the administration of the trust estate, and of paying
expenses of such employment out of the income or
principal of the trust estate as he may determine and
deem best.
M. To collect and receive the income of the trust estate
and to pay therefrom all lawful taxes, including income
taxes, charges and other expenses properly incident
to the management of this trust, and to compromise
any and all claims arising in connection herewith.
N.
In making any division or distribution of the trust
estate herein provided for, the Trustee shall have
full power, authority and discretion to make such
division or distribution, and to determine of what
each shall consist, whether cash or securities, or
other property, or combinations thereof, and the
respective valuations thereof; and the judgment of
the Trustee as to the value and nature of the property
so to be divided, apportioned or paid over shall be
final.
IV.
MINORITY PROVISION:
Any share of this trust estate which
minor shall be held in trust by Trustee
iiduring minority. Trustee shall apply such amounts of income and
"
"
!principal as he, in his sole discretion, deems proper for the
I
support, education and welfare of such minor and shall accumulate
317 THIRD STREET
NEW CUMBERUlND. PA;any unexpended balance of income. Such amounts may be applied
Page three of six Pages
~
~\l
L.AW OFFICES
JON F. LAFAVER
317 THIRD STREET
NEW CUMBERLAND, PA
directly or may be paid to the person with whom such minor resides
i
or who has the care of or control of such minor, without the
i'
~ntervention of a Guardian.
Trustee shall not be obliged to
:!supervise or inquire into the application of such amounts by such
person, and the receipt of such person shall be a complete release
11
IOf Trustee. Should the share of a minor, in the sole opinion
;i
i1
!pf Trustee, be or become too small to warrant continuing such
U
!fund in trust, or should its administration be or become impractical
;i
It
lior any other reason, Trustee, in his sole discretion, may pay such
II
!ishare, absolutely, to the parent or other person maintaining said
Ii
ibinor or may deposit such share in the minor's name in a savings
I:
I~ccount in a savings institution of his choosing, payable to the
"
I:
iminor at majority.
p
i\
V.
!;
"
DISABILITY PROVISION: If any beneficiary is, in the
P
i
F
iFpinion of the Trustee, mentally or physically incapacitated,
Ii
Imy Trustee may apply such funds for his medical care as my Trustee,
I:
If
11n his sole discretion, shall deem appropriate, directly to doctors
Ii
I
ipr medical institutions without the intervention of a Guardian.
II
'I
Ii
If
it
I~he principal of this trust any property which at any time may
Ii
I'
ibe given to the Trustee by myself or by any other person, by Deed,
VI.
RIGHT TO ADD TO TRUST:
Trustee shall receive and add to
i~ill or in any other manner.
VII.
PROTECTIVE PROVISION: All principal and income shall,
Page four of six Pages
LAW OFFICES
JON F. LAFAVER
317 THIRD STREET
until actual distribution to the beneficiary, be free and clear
,of the debts, contracts, alienations and anticipations of any
'beneficiary and the same shall not be liable to any levy, attachment,
"execution or sequestration while in the possession of Trustee.
,
VIII.
:1
Ii
"
"
,
TAX CLAUSE: If any estate, inheritance, succession or
I,
!rother death taxes are assessed against or measured by the assets
q
[lof this trust upon the death of myself, this trust shall bear
1;
i~ts proportionate part thereof.
Ii
I:of principal and may pay the same at such time or times as Trustee
'I
I~eems advisable.
I'
!i
Trustee shall pay the same out
IX.
F
I;
"
I hereby nominate, constitute and appoint JOHN H. SHOTT, III,
I
j~s Trustee under this Will. If the said John H. Shott, III, should
I'
ii
ipredecease me, fail to qualify or cease to act as such, then I
Ii
Ii
i;nominate, constitute and appoint my granddaughter, JENNIFER B. GOSS,
Ii
I'
lias Trus tee.
Ii
ii x.
,
ii I hereby nominate, constitute and appoint my daughter,
Ii
I~UDITH L. BUSHONG, as Executrix of this, my Last Will and Testament.
,j
I:If the said Judith L. Bushong should predecease me, fail to qualify,
I;
ipr cease to act as such, then I nominate, constitute and appoint
j:
[my granddaughter, JENNIFER B. GOSS, as Executrix.
(I
XI.
I direct that any fiduciary acting hereunder shall retain
NEW CUMBERLAND. PAthe legal services of my attorney, JON F. LaFAVER, in handling all
Page five of six Pages
jlegal aspects of my estate, if he is then practicing law and
available to undertake these matters.
XII.
!t
No fiduciary acting under this Will shall be required to
'i
:i
ipost bond in this jurisdiction or in any jurisdiction in which he
Ii
:may act.
Ii
11
ii IN WITNESS WHEREOF, I, LOTTA H. BUSHONG, the Testatrix,
If
;have unto this,
i I q. --t-:t:2-
!'this .'\ '3;;;; day
I'
of
my~ast Will a?:d Testament,
fWt )'7?!,t/'l-,l'-t!-~ A D
o ,.' .,
set my hand and seal
1990.
"
"
"
!i
L
n
I'
i:
H
'I
{,'
(SEAL)
Ii
H
".
I ~
I
i:
I
jS
II
,"
if
jr
Ii
n
Ii SIGNED, SEALED, PUBLISHED and DECLARED by LOTTA H. BUSHONG"
"
lithe above-named Testatrix, as and for her Last Will and Testament,
Ii
, ~
iiin the presence of us who have hereunto subscribed our names as
!I
!:witnesses at her request, in the presence of the said Testatrix
i;and in the presence of each other.
,
.,
;)
\i
LAW OFFICES
JON F. L.AFAVER
311 THIRD STREET
NEW CUMBERLAND, PA
Page six of six Pages
Private Client Group
~ Merrill Lynch
214 Senate Avenue
Suite 501
P.O. Box 0810
Camp Hill, Pennsylvania 17001-0810
717 975 4600
800 937 0735
March 17, 2005
Stone LaFaver & Shekletski
Attn: Tina
P.O. Box E
New Cumberland, PA 17070
Re: Estate of Lotta H. Bushong
Account 872-33865
Dear Tina:
Per your request, here are the Date of Death Values for Lotta Bushong's account. The first chart
gives the total portfolio value and the second chart gives the portfolio value on Mrs. Bushong's
portion of the account.
If you need any further information please let me !mow.
Sincerely,
~,
Client Associate for
Sharon J. Steiner, CFM
~ Merrill Lynch
Date:
03/17/2005
TO:
Name:
At:
Phone Number:
Fax Number:
Tina
774-3869
FROM:
Name:
At:
Phone Number:
Fax Number:
Cori Tobias
Merrill Lynch - Harrisburg - 872 Office
717-975-4662
717-975-4663
# of pages to follow:
3 (including cover page)
Message:
linl1 :
aCCD It,r1t was opmed- in
~
~DiY\+ OWnLr ~ in
lttg3
lqcH
NOTE: Tl1E INFORMATION CONTAINED IN THIS FACSIMILE TRANSMISSION IS CONFIDENTIAl. AND INTENDED
ONLY FOR THE USE OF THE ADDRESSEE- I F THE READER OF Tl1IS COMMUNICATION IS NOT THE INTENDED
RECIPIENT, YOU ME HEREBY NOTIFIED THAT ANY RETENTION, DISSEMINATION, DISTRIBUTION COPYING
OR OTHER use OF THE FACSIMILE IS STRICTLY PROHIBITED. IF YOU RECEIVE THIS FACSIMILE IN ERROR.
PLEASE IMMEDIATELY NOTIFY uS BY TELEPHONE AND RETURN THE ORIGINAL TRANSMISSION TO us AT
THE ADDRESS ABOVE VIA THE UNITED STATES POSTAL SERVICE.
D2Vl0 . d
0v:v1 S00C-61-~~W
Total Portfolio Value
Lotta H. Bushong & Judith A. Bushong JTWROS
Account 872-33865
as of 12/24/2004
Security Security Description . Qq~~tity ,. :Yttlue'llso(
.' . ~z:.j~TI~~< nfiZ124!20Q4 .
Svmbol .:,. ,. .... :'.
MO Altria Group Inc. 700 60.7225 42505.75
AID Allied Irish Banks 430 40.4550 17395.65
BLS BellSouth Corp. 1200 28.1500 33780.00
ATF Elf 1st Esch SRAT&T 575 86.4700 49720.25
XOM Exxon Mobil Corp. 800 51.5075 41206.00
GGT Gabelli G. Multimedia Tr. 136 10 .4600 1422.56
G Gillette Co. 950 44.9300 42683.50
GIM Templeton Global Inc. Fund 1000 9.6450 9645.00
HCP Health Car Ppty Invs. 600 27.9875 16792.50
HSY Hershey Foods Corp. 400 54.7675 21907.00
KSE Kevspan Com. 400 39.4825 15793.00
PPL PPL Corp. 200 53.5325 10706.50
PG Proctor Gamble 600 55.7275 33436.50
S1M J M Smucker Co. 8 46.4250 371.40
VZ Verizon Communications Co. 122 40.8000 4977.60
Total 342;343,2J .
Lotta H. Bushong
Account 872-33865
Date of Death Values
12/2412004
Security Security Description QUllll,dty Averllge ....y~JJlei~.()f
Symbol .' 1>Hce' .'lZ!iZ4IZ004
MO Altria Group Inc. 350 60.7225 21,252.88
AID Allied Irish Banks 215 40.4550 8697.83
BLS BellSouth Com. 600 28.1500 16890.00
ATF Elf 1 sl Esch SR AT&T 287.5 86.4700 24816.89
XOM Exxon Mobil Corp. 400 51.5075 20603.00
GGT Gabelli G. Multimedia Tr. 68 10.4600 711.28
G Gillette Co. 475 44.9300 21341.75
GIM Templeton Global Inc. Fund 500 9.6450 4822.50
HCP Health Car Ppty Invs. 300 27.9875 8396.25
HSY Hershey Foods Com. 200 54.7675 10953.50
KSE Keyspan Com. 200 39.4825 7896.50
PPL PPL Com. 100 53.5325 5353.25
PG Proctor Gamble 300 55.7275 16718.25
SJM J M Smucker Co. 4 46.4250 185.70
VZ Verizon Communications Co. 61 40.8000 2488.80
Total .:171,128.38....:<...,.. .
;1.'-1 'd.:...o (~~
If I , Ill, (,1
r!M&fBank
499 Mitchell Street, Millsboro, DE 19966
February 15, 2005
Stone LaFaver & Shekletski
Attorneys At Law
414 Bridge Street
Post Office Box E
New Cumberland, PA 17070
RE: Estate of Lotta H. Bushong
Date of Death: December 24, 2004
Social Security Number: 198-36-4105
Dear Mr. Stone:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account Type........................... Checking
Account Number................. ...... 18845002
Ownership (Names of).............. Lotta H. Bushong
Opening Date...........................08/28/68 (account closed 01/10/05)
Balance on Date of Death..... ... ..$1,901. 45
Accrued Interest
$
0.00
Total................................... ....$1 ,901.45
The above named decedent did not have a safe deposit box with this bank.
For any additional information on this account please contact our West Shore Plaza
branch at 717-255-2271.
Sincerely,
Otaw~JJ ~
Charlene Warrington, Records Management
1-888-502-4349