HomeMy WebLinkAbout11-22-05 (2)
REV-l500 EX + (6-00)
'* COMMONWEALTH OF
· , PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL)
Goodall Kath n L
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
2/22/2005 10/2/1918
(IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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00 1. Original Return
o 4. Limited Estate
00 6. Decedent Died Testate (AUach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (AUach copy of Trust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
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NAME
David H. Stone Es uire
FIRM NAME (If Applicable)
Stone LaFaver & Shekletski
TELEPHONE NUMBER
717-774-7435
EO. ALL CORRESPONDENCE
New Cumberland
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under See. 9116 (a)(1.2)
0.00
587.852.64
0.00
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
X _(15)
X .045 (16)
X .12 (17)
0.00 X .15 (18)
(19)
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CHECK HERE Ie YOU ;'RE REClUt.STING A REIOUND OF AN OVERPAYr,lENT
20. 0
OFFICIAL USE ONLY
FILE NUMBER
21 -0 5 0262
COONTvCOOE - - - - MMiER--
SOCIAL SECURITY NUMBER
287- 2-5290
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remai~der Return (dale of death prior to 12-13-82)
o 5. Feder~1 Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. ElectiOn to tax under See. 9113(A) (AUach Sell 0)
ULDBEDtR~f)'l'O:
PA 17070
OFF~L USE ONLY
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232,000.00
229.668.7",. ~
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179.383.04:) () Q
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641.051.77
52,470.78
728.35
(11)
(12)
(13)
53,199.13
587.852.64
(14)
587.852.64
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ece en s omple e ress:
STREET ADDRESS
1102 Atland Drive
CITY I STATE I ZIP
Mechanicsburg PA 17055-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
26,453.37
25.000.00
1.315.79
3.
InterestlPenalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C )
(2)
26,315.79
4.
TotallnterestlPenalty (D + 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)
B. Enter the total of Line 5 + SA. 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 alOCKS
1. Did decedent make a transfer and: Y . No
a. retain the use or income of the property transferred; ........................................................................... 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 00
c. retain a reversionary interest; or ...................................................................................................... 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
3. :=~:~~ ~~~:~~~;~:~~~:~;~.~~~~~~~.~~~.~.~~~~~.~;~~~~~.~~~;~.~;~~;~~~~.::::::::::::::::: 8
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which :
contains a beneficiary designation? ......... .......................... ..... ................................................... ............ q
(3)
0.00
0.00
137.58
5.
137.58
00
00
00
ADDRESS
PA 117070
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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 o~ the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (ill.
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 p% [72 P.S. ~9116 (a) (1.1) (ii)).
The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tal< 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 ~atural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. ~9116{a){1.2)]. .;
The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. ti9116(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 decedenfs siblings is 12% [72 P.S. ~9116{a){1.3)). A sibling is defired, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption. I
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REV-1502 EX + (6-98)
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COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Goodall. Kathl)'n. L 21 05 0262
All real property owned solely or IS I tenant In common must be reported at fair mlrket 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 re"vant facts.
Real which Is oInt1 -owned with rI ht of survlvorshl must be disclosed on Schedule F. I
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1
DESCRIPTION
Property located at 1102 Atland Dr. situate in Upper
Allen Twp., Cumberland County, PA sold to Betty R.
Zimmerman on May 20, 2005
VALUE AT DATE
OF DEATH
232,000.00
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TOTAL Also enter on line 1, Recapitulation $
(If more space is needed, insert additional sheets of the same size)
232 000.00
REV-1503 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Goodall. Kathrvn. L
FILE NUMBER
21 05
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
0262
ITEM
NUMBER
1
DESCRIPTION
150 shares AT&T stock @ $19.275 per share
:
VALUE AT DATE
OF DEATH
2,891.25
2
684 shares Bell South Corp. stock @ $25.585 per share
17,500.14
3
1050 shares ICN n/kla Valeant Pharmaceutical Inti stock @ $23.645 per share
24,827.25
4
648 shares Lucent Technology stock @ $3.17 per share
2,054.16
5
3214 shares Northrop Grumman Corp. stock @ $52.495 per share
168,718.93
6
564 shares SBC Communications stock @ $24.25 per share
13,677.00
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TOTAL (Also enter on line 2, Recapitulation) i $
(If more space is needed, insert additional sheets oflhe same size)
229.668.73
REV-l508 EX + (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Goodall. Kathrvn. L
FILE NUMBER
21 05
Include the proceeds of litigation and the date the proceeds were received by the estete.
All property Jolntly-owned with right of survlvol'lhip must be disclosed on Schedule F.
0262
ITEM
NUMBER
1
VALUE AT DATE
OF DEATH
2
3
4
5
6
7
8
9
DESCRIPTION
AT&T-refund
PA Dept of Revenue-decedents final PA40 tax refund
PNC Bank-Checking Acct. #5004338001
The Patriot News-refund
TRW-medical refund
US Treasury-decedents final 1040 tax refund
West Shore ALS-refund on ambulance service
MBNA-refund
Blue Cross/Blue Shield-refund
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TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1.86
268.00
177,031.75
57.60
846.50
1,000.00
80.43
70.63
26.27
179.383.04
REV-1511 EX + (12-99)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Goodall. Kathrvn. L
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21
05
0262
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Parthemore Funeral Home-funeral expenses 8,830.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s) I
Street Address
City Slate Zip
Year(s) Commission Paid:
2. Attorney Fees David H. Stone, Esquire 25,642.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
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City State Zip
Relationship of Claimant to Decedent I
4. Probate Fees Register of Wills 535.00
5. Accountanfs Fees
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6. Tax Return Preparer's Fees
7. Charles M. Moyer-mowing and weeding at property 80.00
2 Marlin A. Yohn, Sr., Treas.-real estate taxes 516.53
3 PPL Electric Utilities-services at property 45.03
4 UGI-gas servo at property 121.49
5 Verizon-telephone servo at property 47.27
6 Com cast Cable-television servo at property 42.66
7 PPL Electric Utilities-serv. at property 28.38
8 Waste Management-trash servo at property 45.70
9 Upper Allen Twp.-sewer servo at property 100.00
10 United Water-servo at property 11.55
11 United Water-water servo at property 6.85
12 UGI-Qas servo at property 26.32
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TOTAL (Also enter on line 9, RecaPitUlationll $ 52,470.78
..
(If more space IS needed, Insert additional sheets of the same sIZe)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
Goodall, Kathryn, L
Decedenfs Name
Page 1
21 05 0262
File Number
Schedule H - Funeral Expenses & Administrative Costs - B7.
ITEM
NUMBER
AMOUNT
13
14
15
16
17
18
19
20
21
22
23
24
DESCRIPTION
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Verizon-serv at property
UGI-gas servo at property
PPL Electric Utilities-serv. at property
United Water-servo at property
Cash-reimb. on misc. items including postage
Register of Wills-filing Disclaimer and 1 short cert
Cumberland Law Journal-advertising grant of letters
The Patriot News-advertising grant of letters
Checks written by decedent but not cleared until after death
Register of Wills-filing Inheritance Tax Return & Inventory
Reserve for closing expenses
Settlement charges on sale of property ($16,429.95) less reimb. on taxes ($694.50)
16.27
15.30
18.22
3.15
137.00
13.00
75.00
113.61
35.00
30.00
200.00
15,735.45
SUBTOTAL SCHEDULE H-B7
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16,392.00
REV-1512 EX + (6-98)
.
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Goodall Kathrvn L
FILE NUMBER
21 05 .
0262
Include unreimbursed medical expenses.
,
ITEM
NUMBER DESCRIPTION
1 Holy Spirit Hospital-debt of decedent
VALUE AT DATE
OF DEATH
60.50
2 Dr. Perna, MD-debt of decedent
26.27
3 Howard Roy Cohen, MD-debt of decedent
120.51
4 Howard Roy Cohen, MD-debt of decedent
17.82
5 MBNA America-credit card balance due
421.07
6 West Shore EMS-ambulance service
82.18
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TOTAL (Also enter on line 10, Recapitulatiorll $
(If more space is needed, insert additional sheets of the same size)
728.35
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
- . .. L 21 Ofi O?R?
RELATIONSHIP TO DECEDENT: AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1 Kathryn C Blackburn Lineal 293,926.32
422 Barker Drive
West Chester PA 19380-
2 Daniel E Goodall Lineal 293,926.32
5202 Fino Drive
San Diego CA 92124-
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ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ~~ REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS: I
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE I
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B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS i
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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)
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my husband, Daniel 3. Goodall, sole executor of my last
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Will and Testament. However, in the event that my husband!i
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should predecease me or that he and I should die in commo~
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di'saster, then in such case I hereby nominate, constitute 1;
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and appoint my daughter, Nancy H. Goodall, executrix of
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this my last Will and Testament.
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I: IN \-lITN"ESS ;IHEREOF. I. KATHRYN L. GOODALL. h,/-ve to Ii
!: this my last 'tlill and Testa.ment, Contained on the. jl
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(1) preceeding sheet set my hand and seul, 11
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to witness, my hand and seal at the bottom. of this! sheet, 11
this .:l ~ day ofm7 . One thousand nine hupdred Ii
and eighty-one (1981) n
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Signed, sealed, published and
declared by the Testatrix above-
named, as and for her last Will
and Testament, in writing, in the
presence of us, 1'fho at her request:
and in her presence and in the :
presence of each other, have
hereunto subscribed our names
as attesting witnesses.
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re\ded\KGOOD~LLzimmerman
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PARCEL '42-30-2106-051
DEED
THIS INDENTURE made the
?(")
day of
(Y)n '(- I
, in the year
2005, between KATHRYN C. BLACKBURN, Administratrix c.. TI. A. of the
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Estate of KATHRYN L. GOODALL, late of Upper Allen Townlship, County of
Cumberland and Commonwealth of Pennsylvania, of the fiirst part,
hereinafter called the Grantor,
- AND -
BETTY R. ZIMMERMAN, of the second part, here~nafter called
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the Grantee; i
WHEREAS, the said KATHRYN L. GOODALL became in her lifetime
seised, as of fee, of and in to a certain tract of lan~, together with
the improvements thereon erected, situate in the Towns~ip of Upper
Allen Township, County of Cumberland, and Commonwealthiof Pennsylva-
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nia, and more particularly described hereinafter; and ~eing so thereof
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seised, died on February 22, 2005, having first made h$r Last Will and
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Testament in writing dated May 2, 1981, duly probated! and registered
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in the Office of the Register of Wills of Cumberland C~unty on March
21, 2005, wherein and whereby said premises hereinafter described were
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not specifically devised. Letters of Administration C T.A. were duly
issued by said Register of Wills on March 21, 2005, to KATHRYN C.
BLACKBURN (Daniel J. Goodall died September 18, 1999, dnd Nancy H.
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Goodall died ~arch 16, 2005), all as in and by said Will" and the
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records of said Register of Wills as more fully appear~;
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NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in
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consideration of the sum of TWO HUNDRED THIRTY-TWO THOPSAND and NO/100
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($232,000.00) Dollars, which has been paid to her by t~e said Grantee
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at or before the sealing and delivery hereof, receipt ~hereof is
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hereby acknowledged, has granted, bargained, sold, ali~ned, released
and confirmed, and by these presents does grant, bargain, sell, alien,
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release and confirm unto the said Grantees,
ALL THAT CERTAIN lot in the property known, named and ~dentified in
the Declaration referenced below, as "Ashcombe Farms P~R.D., a Resi-
dential Planned Community," located in Upper Allen Tow~ship, Cumber-
land County, Pennsylvania, which has heretofore been S4bmitted to the
provision of the Pennsylvania Uniform Planned Community Act, 68
Pa.C.S.A. 5101, et. Seq., as amended by the recording ~n the Office of
the Recorder of Deeds of Cumberland County, Pennsylvan~a, the Declara-
tion for Ashcombe Farms P.R.D., a Flexible Residential IPlanned Commu-
nity ("Declaration"), dated April 6, 1998, and recordeq April 13,
1998, in Miscellaneous Book 573, Page 407, as amended ~y First Amend-
ment to Declaration for Ashcombe Farms P.R.D., a Flexi~le Residential
Planned Community, ("First Amendment"), dated March 13,1 1999, recorded
March 19, 1999, in Miscellaneous Book 607, Page 440, b~ Second Amend-
ment to Declaration for Ashcombe Farms P.R.D., a Flexi~le Residential
Planned Community, dated September 29, 1999, recorded gctober 13,
1999, in Miscellaneous Book 627, Page 652, as by ThirdJAmendment to
Declaration for Ashcombe Farms P.R.D., a Flexible Resiqential Planned
Community ("Third Amendment") dated December 2, 2000, ~ecorded Febru-
ary 26, 2001, in Miscellaneous Book 667, Page 650, and las further
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amended by,Fourth Amendment to Declaration for Ashco~el Farms P.R.D.,
a Flexible Residential Planned Community ("Fourth Amen~ent") dated
July 23, 2001, recorded October 9, 2001, in Miscellaneolus Book 681,
Page 2801, being and designated in such Declaration, aSI amended, as
Lot No. 130 (Identifying Number), described in Paragrap~ 3 of the
First Amendment and shown (and described) in Exhibit B-Il of the First
Amendment.
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LOT NO. 130 contains 7,512.44 square feet, more or less.
BEING LOT NO. 130, Ashcombe Farms P.R.D. Final-Phase 21A Site Plats and
Plans, dated June 11, 1997, recorded in the Office of ithe Recorder of
Deeds of Cumberland County in Plan Book 78, Page 37., i
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BEING THE SAME PREMISES walCH Sewalt, Inc., a Pennsyl~anla corpora-
tion, by its deed dated February 5, 2004, and recorded February 9,
2004, in the Office of the Recorder of Deeds in and folr Cumberland
County, Pennsylvania, in Record Book 261, Page 2957, g~anted and
conveyed unto Kathryn Goodall, deceased.
UNDER AND SUBJECT to restrictions and covenants of recprd, including,
but not limited to, Declaration for Ashcombe Farms, P.R.D., a Flexible
Residential Planned Community, dated April 6, 1998, reborded in the
Office of the Recorder of Deeds of Cumberland County, ~n Miscellaneous
Book 573, Page 407, First Amendment to Declaration of ~shcombe Farms,
P.R.D., a Flexible Residential Planned Community, date~ March 13,
1999, recorded in the Office of the Recorder of Deeds pf Cumberland
County in Miscellaneous Book 607, Page 440, Second Amehdment to
Declaration for Ashcombe Farms, P.R.D., a Flexible Res~dential Commu-
nity, dated September 29, 1999, recorded in the officelOf the Recorder
of Deeds of Cumberland County, Pennsylvania, in Miscel aneous Book
627, Page 652, and Third Amendment to Declaration for ,shcombe Farms,
P.R.D., a Flexible Residential Planned Community, date~ December 2,
2000, recorded in the Office of the Recorder of Deeds ~f Cumberland'
County, Pennsylvania, in Miscellaneous Book 667, Page $50, and under
and subject to easements and rights-of-way of record a*d visible by
inspection. '
TOGETHER with all and singular the buildings, imp~ovements, ways,
streets, alleys, passages, waters, water-courses, rights, liberties,
privileges, hereditaments and appurtenances whatsoever" thereunto
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belonging or in any wise appertaining and the reversio~s and
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remainders, rents, issues and profits thereof, and all the estate,
right, title, interest, property, claim and demand whatsoever of her,
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the said KATHRYN L. GOODALL, at and immediately before the time of her
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decease, in law, equity, or otherwise howsoever, of, in, to or out of
the same.
TO HAVE AND TO HOLD the said lot or piece of grouhd above de-
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!
scribed, with the buildings and improvements thereon e~ected,
,
hereditaments and premises hereby granted or mentioned~ and intended
so to be, with the appurtenances unto the said Granteek to and for the
I
only proper use and behoof of the said Grantee, forevet.
I
I
And the said Grantor, for herself and her respective heirs,
executors and administrators, does covenant, promise atd agree to and
with the said Grantee, her heirs and assigns, that she~ the said
Grantor, has not heretofore done or committed any act, matter or thing
whatsoever whereby the premises hereby granted, or any part thereof,
is, are, shall or may be impeached, charged, or encumb$red in title,
charge, estate or otherwise howsoever.
IN WITNESS WHEREOF, the said Grantor has hereunto set her hand
year first above written.
~~, l ~~1 (SEAL)
KATHR C. BLACKBURN, Administratrix
I
C.T.A., of the Esta1:f.e of KATHRYN L.
GOODALL I
-4-
~
.
COMMONWEALTH OF PENNSYLVANIA:
SS:
COUNTY OF
On this, the d? 0 day of /)/cly- " 2005, before
me a Notary Public, the undersigned officer, personall~ appeared KATHRYN
C. BLACKBURN, Administratrix C.T.A., of the Estate of ~THRYN L.
!
GOODALL, known to me or satisfactorily proven to be th~ person whose
,
name is.subscribed to the within instrument, and ackno~ledged that she
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereto set my hand and notarial seal.
,'7
/
)L '/}L!JLi!
Notary
,
..... "''''''"-'.~''-+-'-''''''''il
. Notarial Saal i .
'I' Anne Carmody, N=ry
rv~achanlcsburg Boro, C County
:. [..;y Commlsslon expires Explree .11,2006
I hereby certify that the precise address of the ran tee
is ItJ..:J
j)" /) Ie i
) II '('ShUll? f;4 I rfPS6
-5-
.
~u~~
April 5, 2005
David H. Stone, Esq
Stone, La Faver & Shekletski
414 Bridge Street
New Cumberland, PA 17070
Re: Estate for Kathryn L. Goodall, Account # FFB-000310
Dear David:
The following is a summary of the certificates deposited into the above referenced account ~nd the date of
death values: I
Number 2/22/05 PrIce Per Share =5
Security Svmbol Shares Hlah Low Averaae V lue
Bell South Corp BLS 684 25.82 25.35 25.585 $17,500.14
Lucent Tech Inc LU 648 3.26 3.09 3.17 $ : 2,054.16
Northrop Grumman NOC 3,214 52.96 52.03 52.495 $1168,718.93
SBC Communications SBC 564 24.50 24.00 24.25 $13,677.00
Valeant Pharmaceuticals VRX 1,050 23.99 23.30 23.645 $ :24,827.25
We are returning the certificate for 2500 shares of Hunterdon Pharmaceuticals, Inc, which ate apparently
worthless.
Please note that Lucent spun off Avaya in September of 2000 and Agere in June of 2002. l1he decedent may
still own shares of the spin ofts which were issued in book registration rather than physical ~rtificates.
Lucent shareholders of record on September 20,2000 received 1 share of Avaya for every 12 shares of Lucent
stock owned. The decedent should have received 54 shares of Avaya which is closed at 11j88/share on April
5,2005 for a total current value of approximately $641.52.
Lucent shareholders of record as of May 3, 2002 received 1 share of Agere Class A for every 97.768991 shares
of Lucent and one share of Agere Class B for every 3.779818 shares of Lucent common st~k. The decedent
should have received 6 shares of Agere Class A and 171 shares of Agere Class B. Agere lass A and Class B
closed at 1.34/share and 1.34/share on April 5, 2005, respectively- for a current value of ap roximately $9.38
and $229.14.
If it is unclear from the decedents records as to the disposition of the spin off chares, we will draft inquires to the
respective transfer agents.
Please contact my office if we can be of any further assistance.
s~///
Edward P. Gormley, CFP, CPA
4999 Louise Drive, Suite 101, Mechanicsburg, PA 17055
Tel: 717-506-2100 / Fax: 717-506-2111 /TolI Free: 800-349-8090
www.sfausa.com / email: info@sfausa.com
Secllritiu Offered Through SecuritiM Servia Network, Inc.
Member NASD/SIPC
..
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5ho',..' ,=hc1F t
ATilT Corp
Date High Low Close Volume
2/28/2005 19.5500 19.3400 19.4300 6,589,300
2/25/2005 19.5100 19.1600 19.4600 4,231,500
2/24/2005 19.4300 19.2200 19.3800 4,215,200
2/23/2005 19.4100 19.0100 19.3200 6,427,100
2/22/2005 ~ ~ J.8JlZQQ 10,921,100 19.{,y
-.I'i.N1
2/18/2005 19.5100 19.3300 19.4100 3,793,200 --
38..5"$ -:-- J- ~
2/17/2005 19.5600 19.3000 19.4200 5,835,100
2/16/2005 19.6500 19.4000 19.4500 4,921,000 {<t. .175 y./~
2/15/2005 19.7100 19.4200 19.5500 6,438,100 ~~.~f. ~S-
~
2/14/2005 19.6000 19.2400 19.4200 11,140,200
2/11/2005 19.5100 19.2100 19.3700 5,606,300
2/10/2005 19.5800 19.3000 19.3800 6,326,100
2/9/2005 19.7600 19.5700 19.6000 5,599,900
2/8/2005 19.8100 19.5900 19.7800 7,430,700
2/7/2005 19.8000 19.5000 19.6500 6,431,100
2/4/2005 19.8300 19.5300 19.8000 11,847,400
2/3/2005 19.7900 19.5000 19.7500 11,395,800
2/2/2005 19.6000 19.1200 19.6000 21,518,200
2/1/2005 19.2600 19.0300 19.1400 19,224,700
I Trade Now
Stock price data provided by Nomura Research Institute, Ltd.
http://moneycentra1.msn.comJinvestor/charts/ chartd1.asp?Symbol=T &DateRangeF ormF 1 &... 9/28/2005
i
- I ___.....1 1111'
I
'+.LO::: (I:lt:l ..:l4:::>l::l
1-'.1::11/'01
..
.
QPNCBAN<
May 4. 2005
David H. Stone
414 BrldF Street
P.O. Box E
New ClDDberIand. PA 17070
RE: Estate of x.tIoyn L. Goodall, deceased
SSN: 287-22-5290
DOD: 2/2212005
Dear Mr. Stone:
In response to your Rlquest for Date of Death balances for the oustDmer noted r' our
records show the following: I
Claeeldag Aceow.t
Account 1#5004338001
Established 1 ~12812003
KATHRYN GOODALL
DOD balance: S 177,031. 7S (non-interest bearing)
,... _ tbat this ~ oaIy""'-s"'" of....... boI.- for ~=:
(IRAs, CDs, Checkina and Savings accounts). We do aot proeeu ....,
tl'aNaedo.s or p...1de *.....11. If you need assistaDce with any oftbcso
please calI1-888-PNC-BANK. (1-888-762-2265) or stop by your local PNC B+k branch
office. i
I
Siacerely,
~UJ-dh-
Rachelle Wells
1-800-762-1775
P7-PFSC-04-F
500 filii Aye.
Pittsburgh PA 15219
I
i
~FDIC
TOTRL P.ell
A. Settlement Statement
U.S. Department of Housing
and Urban Development
.
'. ,
".
B. Type of Loan
1. 0 FHA 2. 0 FmHA 3. 0 Cony. Unlns. 6. File Number
4. 0 VA 5. 0 Cony. Ins.
....-..
,r
OMB Approval No. 2502-0265
! 7. Loan Number
18. Mortgae- lneut~ C... NumtMir
I
C. Note: This form Is furnished' 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 closing; they are shown here for Informational purposes and not
included in the totals.
o. Name and Addr... of Borrower E. Name and Address of SeMet ! F. Name and Add,.... of Lend...
Betty R. Zimmerman
Kathryn C. Blackburn, Admin.
Estate of Kalhryn Goodall
!CASH
105 Cockleys Dr.
Mechanicsburg
PA 17055
G. Property Localion
1102 Atland Dr.
H._Agent
: John O. Grigsby, Esq.
:-"'--
: 101 S. Market SI.
: Mechanicsburg
PA 17055
Mechenicsburg
PA
17055
Lot Btock:
J. Summ.ry of Borrower'. Tr.nsactlon
100. Gro.. Amount DUB From Borrower
101. Contract...... price
102. Person.1 property
103. SllIllarnant chargaa to borrower (ine 1400)
104.
105.
'.
K. Summ.ry of S....... Tr....actlon
400. Gro.a Amount Du. To Saller
232,000.00 401. Contract ..I.. price
. . 402. Peraonel property
. -4,254.25 403.
404.
405.
~ust__1II8 for h."'! pele! by ,,!II~ III !l!IVlIIICe
408. CIty/lOwn ..... to
319.82 407. County Iax88 5!201O5 to 12/31105,
408. Assessments to
297.28 409. School taxes 5120105 to 6130105
~Q to
77.40 411. Assoc.Oues 5/20/05 to 12/31/05
Ad/ustmenll for lIem. paid by aaller In _.nce
106. CIty/lOwn "'e. to
107. County..... 5120105 to 12/31/05
109. Aaaeasmenl. to
109. School taxes 5!201O5 to 6!301O5
1m to
111. Assoc.Oues 5120105 to 12/31105
112.
113.
114.
115.
to
to
to
10
412.
413.
414.
415.
to
to
to
to
120. Gro.. Amount Due From Borrower
236,948.75 420. Gro.. Amount DUB To Seller
500. Reductions In Amount Dua To Seller
3,000.00 501. Exc... d.posIt (888lnatructlon.)
502. S_ant charge. to 8811.r ~Ine 1400)
503. Exiating Ioan(.) l81cen subject to
504. P.yoff of firet mortg!lQ8toen
180,107.80 505. Peyotl of 88Cond "'9'IlI!lQ8toen
50S.
507.
50S.
509.
AdJustmenta for Item. unpaid by ."~r
510. CIty/lOwn tax.. to
51,. County laxe. 10
512. A.........ts to
513. to
54.95 514. Sewer 411105 to 5120/()5
~~ to
516. to
~~ to
516. to
519. to
200. Amounll P..d By Or In Behalf Of Borrowsr
201. DepoaM or eameaI money
202. Principal amount of new Ioan(.)
203. Existing Ioan(.) l81cen subjact to
204. 1 031T ax fee exchange payment 10 Estate of
205. Kathryn Goodell
209.
207.
209.
209.
Adjustment. for lI.m. unpeld by .e11ar
210. City/lOwn taxes to
211. County tax.. to
212. Assesament. to
213. to
214. Sewer 411 IO?, to 5/20/05
215. 10
216. to
217. to
218. to
219. to
220. TOl8I PaId BylFor Borrower
183,162.55 520. ToteI Reduction Amount Due S....r
800. Ca.h At S~llIem~nt TO/From Se!l~r
236,948.75 601. Gr088 amount due to ..Uer(llne 420)
183,162.55) 602. L... reduction. In amI. due .etter (Une 520)
300. Cuh At Settlement FromJTo Borrower
301. Gross Amount due from borrower pine 120)
302. I.ell amount paid by/lor borrower pine 220)
303. ee.h
l&J From
53,786.20 603. Cash
o To Borrower
00 To
o From Seller
216,264.55
II. _ent DR
5/20105
~Oa..
5120105
232,000.00
319.82
297.28
77.40
232,694.50
16,375.00
I
I
I
i
I
I
I
I(
54.95
16,429.95
232,694.50
16,429.95)
SUBSTITUTE FORM 1099 SELLER STATEMENT
The information conI8ined in Block. E, G. H. end I.nd on line 401 (or. line 403 and 404) is important lax Information and is being fumiahed to th.lnlemal Revenue
Service. W you are required to file . ralum, a negligence penalty or other sanction will be imposed on you W this Marn i. required to be reported and tha IRS det.rmine.
that ri hea no! been reported. If thla real ..tate is your principal re.idence, fil. Form 2119. Sale or Exchang. of Princ1p81 Re81dence, for any gain, with your income tax
retum; for - tranaectIons, complete the applicable part. of Form 4797, Form 6232 and/or Schedule D, Form 1040). You "'. required to prOvide the Seldament Agent
(named above) with your correct taxpayer identiflC8lion number. If you do not provide the Settlement Agent with your correcl taxpayer identification number, you may be
subject to civil or criminal penahi.. imposed by law. Under penahi.. of perjury. I certify that the nu shown on this atalemen! I. my correct taxpayer identification number.
ttt6 {l: ;dd~Vv ~.
(ell . Signat'f!IJ ;;
e
L. Senlement Charges
700. TOIII SaleS/Broker's Commission basld on price S
Division of Commission pine 700) as follows:
..Xl1. t 6,985.00
702. S 6,935.00
232,000.00 @ 6.00
,,=
13,920.00
to Exit Realty Capital Area
to Century 21 Walek Associates
Paid From
Borrowe~s
Funds At
Senllment
703. Commission paid at Set1Iement
704.
BOO. Items Plyable In Conneenon With loIn
801. loan Originalion Fee
802. loan Discount
803. Appraisal Fee
804. Credit Report
805. lend~s Inspecllon Fee
806. Mortgagl Insurance Applicalion Feolo
807. Assumption Fee
808.
B09.
810.
811.
812.
813.
900. Itaml Required By lander To Be ....d In Advance
901. Intarest from 10 @S
902. Mortgege Inaurance Premium for
903. Hazard Insurance Premium for
to
10
%
%
Paid From
Selle~s
Funds At
SeWemenl
13,920.00
Exclude last day in calea. line 901
I day
monlhslo
years 10
years to
904.
905.
1000. Reserves Deposited Wllh lender
1001. Hazard insurance
1002. Mortgage insurance
1003. Cily property taxes
1004. County property tax..
1005. Annual_ments
1006.
1007.
1008. _nlin Ad'ustmenl
1100. TItle Charges
1101. Settlement or closing fee
1102. Abstract or title search
1103. TmelXllTlination
1104. Tme insurance binder
1105. 00cu"*'1 preparation
1106. Notary fees
1107. Allorney's fees
(Includes above items numbers:
11 08. TiUe insurance
(Includes above lIems numbers:
11 09. lend~s coverage
111 O. Own~s coverage
1111.
monlhs@$
monlhs@S
monthS@$
monthS@$
months@$
monlhs@S
monthS@S
10
to
10
10
to
to Cash
to John D. Grigsby, Esq.
1101-1104 and 1108
10
232,000.00
1112.
1113.
1200. Governmenl Recording Ind Transfer Charges
1201. Racordingfees: Deed S 40.50 ; Mortgage
1202. Cily/county taxistsmps: Deed S 2,320.00 ; Mortgagl S
1203. Slate tax/stsmps: Deed $ 2,320.00 ; Mortgage S
1204.
per month
per monlh
per month
per month
per monlh
per month
per month
1,568,75
; R....... $
40,50
2,320.00
2,320.00
1205.
1300. AddItIoneI Sentamenl Charges
1301. Survey to
1302. Pest inspection 10
1303. Transaction fee to Walak,wattz
1304. Transaction fee to Extt Reatty Capital Area
1305. Tax Certification fee 10 Cathie Heika
1306. Inillatlon fee to Ashcombe P.R.D.
1307. 2nd qtr. sewer bill to Upper Allen Township (Will be bUled 71112005)
1308.
1400. ToI8l 58_enl Charges (Inler on lines 103, Secllon J and !lO2, Secllon KI
CERTIFICATION
I have carefully reviewed the HUD.l Settlement Statement and to the best of my knowledal Ind bellef,lIls IIrue end Iccurate stalemlnt of III receipts and disbursements
on my~: ~ t.~';i:cr~al ~::: received a copy of ffie HUD.l sewemen~:~~/#~ Borrower
Kath'r)t"6. BIa~,n7 . ~.'~mmerrnan
Seller
125.00
100,00
100.00
4 254.25
125.00
5.00
16 375.00
8orrower
Estate of Kathryn Goodall
To Ihe best of my knowledge the HUD-l Settlement Slatlmenl which I have prepared is a true and accurate account of the funds which were received and hlvl beln or will
be dU by the Und. ersigned as part of the seWemenl of this trsnsaclion.
. /L C"\ . fJT1' ~ - 1.-,... - c.J j'-
,;,srvt-.;--.: ~ . Setllament Agent Data
John1;t. Grigsby, Esq. *
WAFt"'iNG: tt is a crime 10 knowingly make lals statements to the United Statas on lhis or any other similar form. PanalUes upon conviction eln include I fine and
imprisonment. For details see: Tille 18 U.S. C I Section 1001 and Section 1010.
u___,"".........
.
5.00