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Home My WebLink About01-23-06 !/EV.tSOO E:l: '.001 '* COMMONWEALTH OF PENNSYLVANIA . DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 171,...., REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 05 0954 COUNTY CODE YEAR .... z w c w (.) w c DECEDENfS NAME (LAST, FIRST, AND MIDDLE INITIAL) Hutton, Dorothy, M. DATE OF DEATH (MM-DD-YEAR) 09/17/05 NUMBER SOCIAL SE:CURITY NUMBER 177-18-5781 DATE OF BIRTH (MM-DD-YEAR) 01/08/17 I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I REGISTER OF WILLS I SOCIAL SECURITY NUMBER 178-07-7818 (IF APPLICABLE) SURVIVING SPOUSeS NAME (lAST, FIRST, AND MIDDLE INITIAL) Hutton, Robert, D. ~ 1. Original Return D 2. Supplemental Return D 3. Remainder Return (dalo ofdaolll pOOfto 12.13-82) D 4. limited E:slate D 4a. Future Interest Compromise (dalt 01 doalll _ 12.'2-82) D 5. Federal Estate Tax Return Required ~ 6. Decedent DIed Testate (AIIach alp)' of WI) D 7. Decedent Maintained a living Trust (AIIach alp)' o/Trust) 8. Total Number of Safe Deposit Boxes D 9. litigation Proceeds Received D 10. Spousal Poverty Credit (dalto/doalll between 12-31-S1 and '.'.95) ~ 11. Election to tax under Sec. 9113(A) (Allach Sch 01 THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Tricia D. Naylor.._________._______.._______ 104 S. Hanover St. FIRM NAME (~AjlpiaIbIt) . Law Office of John C. Oszustowicz Carlisle, PA 17013 TELEPHONE NUMBER (717) 243-7437 ~ :.::!!!;~ (,)llI:~ wG.::I ~flD G. <( !E w Q Z ~ ffl llI: llI: o (,) z o 5 :) .... e: < (.) W 0:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held COlpOralion, Partnership or Sole-Proprielorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Saparate BiRing 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. Chalitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 743,674.04 (1) (2) (3) (4) (5) 10,356.69 \ .~,~ c. (6) (7) (".c_ ., (~ 754,030.73 (9) (8) 10,083.14 (10) z o ~ ~ :) Q. ::E o (.) ~ 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVlERSE SIDE FOR APPUCABLE RATES (11) (12) (13) 10,083.14 743,947.59 15. Amount of Line 14 taxable at \he spousal tax rate, or transfers under See. 9116 (a)(1.2) _J-4~,?!:}7.2~_ x .0 .<L. (15) !5~'U?!5Q::30 X.o 49. (16) (14) 743,947.59 16. Amount of Line 14 taxable allineal rate 17. Amount of line 14 taxable at sibling rate x .12 (17) 0.00 26,894.26 (19) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due 20.~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUi:$nONS ON REVERSE SIDE ANI) RECHECK MATH < < pt. Decedent's Complete Address: STREET ADDRESS 41 Bullock Circle C1TYC r I I STATEpA I ZIP 17013 arise Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 26,894.26 27,000.00 1,344.71 Total Credits ( A + B + C ) (2) 28,344.71 3. InteresVPenalty if applicable D. Interest E. Penalty Totallnteresl/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 1,450.45 A. Enter the interest on the tax due. (5) (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i] c. retain a reversionary interest; or.......................................................................................................................... 0 [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iJ 2. If death occurred after December 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 d$Signation? ........................................................................................................................ 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. Under penalties of peljury, 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 1he personal representative is based on all infonnatlon of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN """d. ..Lf7~4:.~~_~____.. DATE _.. "/"-"1' /7,. ~~q6 ADDRESS )If~~~: de,;~~~~t~~ENT:Ve ~ ADDR S5 104 . Hanover St., I DATf . .1 i...L. D~ 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) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The lax 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)]. The lax rate imposed 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)]. 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.1503 EX+ 1,6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Dorothy M. Hutton FILE NUMBER 21-05-0954 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH See Attached Schedule 743,674.04 TOTAL (Also enter on line 2, Recapitulation) $ 743,674.04 REV.j50B EX+ (~.9B) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHIDULI I CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Dorothy M. Hutton FILE NUMBER 21-05-0954 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. 7,735.16 sh Legg Mason Cash Reserve Trust - cash @ $1.00 per share 7,735.16 334.24 2. Carlisle Regional Medical Center - refund 3. Tressler Lutheran Services - refund 2,287.29 TOTAL (AlliO enter on line 5, Recapitulation) $ 10,356.69 REV-1511 EX+ (12-99. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT leNIDULI N FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Dorothy M. Flutton FILE NUMBER 21-05-0954 Debts of decedent must be reported onSehedule 1. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Diakon Lutheran Social Ministries - memorial service and catering Robert D. Hutton - beverages Central Pennsylvania Cremation Society, Inc. - cremation service 2,701.50 133.91 1,425.00 2. 3. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name 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 5,040.00 3. Family Exemption: (If decedent"s address is not the same as c1aimant"s, attach explanation) Claimant Street Address City Stale . Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant"s Fees 6. Tax Return Preparer's Fees 7. Legal Advertisement 8. Filing Fee - Disclaimer 602.00 175.73 5.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space Is needed, Insert addRlonal sheets of the same slle) 10,083.14 REV-I513 EX+ (~} '* COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RElURN RESIDENT DECEDENT ESTATE OF Dorothy M. Hutton SCHEDULE J BENEFICIARIES FILE NUMBER 21-05-0954 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 oull1ght spousal distributions, and transfers under Sec. 9116 (al (1.2)] 1. Robert D. Hutton husband 146.297.29 2. Robert D. Hutton, Jr. son 199.216.77 3. William R Hutton son 199.216.77 4. Jane M. Hutton daughter 199,216.76 +:. The Decedent's husband, Robert D. Hutton, disclaimed the righ to any principal distributions allowed under Item Fourth, Paragraph A., Sub-pan graph (Hi) of the Decedent's Will. The Decedent's children, Robert D. Hutton, J , William R. Hutton and Jane M. Hutton disclaimed the right to any principal distributiOl s allowed under Item Fourth, Paragraph A., Sub-paragraph (ii) of the Decedent's Will Said children did not disclaim any rights to distributions that they may have under Ite In Fourth, Paragraph B. These disclaimed amounts fall into the trust provided under !tell Fourth of the Decedent's Will. (See Attached Disclaimer) ..:. The life estate has a value of $ 146,297.29 and the remainder int rest has a value of $597,650.30. Estate has elected to pay the tax on the remainder interest with this return. (See Schedules K and 0) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 16 THROUGH 18. AS APPROPRIATE, ON REV-1600 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART" - ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV.1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) Rt:V-1514 EX.,. (12-0. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on REV-1500 Cover Sheet ESTATE 01: Dorothy M. Hutton ~LE NUMBER 21-05-0954 This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457. Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99, and In Aleph Volume for dates of death from 5-1-99 and thereafter. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. lBI Will 0 Intervivos Deed of Trust 0 Other LIFE ESTATE INTEREST CALCULATION NAME(S) OF LIFE TENANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE Robert D. Hutton 11/28/1916 89 BI life or o Term of Years o Life Or o Term Of Years o life or o Term of Years [J LJfe Qr Q Term Qf Years o life or o Term of Years ,. Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2. Actuarial factor per appropriate table ................................................. Interest table rate = 031/2% 06% 010% it Variable Rate 5.0 % 3. Value of life estate (Line 1 multiplied by LIne 2) ......................................$ 743,947.59 0.19665 ANNUITY INTEREST CALCULATION 146,297.29 NAME(S) OF LIFE ANNUITANT(S) DATE OF BIRTH NEAREST AGE AT DATE OF DEATH TERM OF YEARS ANNUITY IS PAYABLE o life or 0 Term of Years o Life or 0 Term of Years o Ufe or 0 Term of Years Q Life Qr Q Term Qf Ye<1-JS ,. Value of fund from which annuity is. payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2. Check appropriate block below and enter corresponding (number) . . . . . . . . . . . . . . . . . . . . . . . . . . Frequency of payout - 0 Weekly (52) 0 Bi-weekly (26) 0 Monthly (12) o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) 0 Other ( ) 3. Amount of payout per period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 4. Aggregate annual payment, Line 2 multiplied by line 3 ................................... 5. Annuity Factor (see instructions) Interest table rate - 0 31/2% 06% 010% 0 Variable Rate % 6. Adjustment Factor (see Instructions) .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Value of annuity - If using 31/2%, 6%, 10%, or if variable rate and period payout is at end of period, calculation is.: Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . . . .$ If using variable rate and period payout is at beginning of period, calculation is: (Line 4 x Line 5 x Line 8) + Line 3 """"""'""""""""""""",."."". ,$ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on lines 13 and 15 through 18. (If mor6 SpaC6 is n&eded. ins6rt additional Sh66ts of th6 sam6 SiZ6) REV-1649 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 0 ELECTION UNDER SEC.9113(A) (SPOUSAL DISTRIBUTIONS) ESTATE Of' f1LE NUMBER Dorothy M. Hutton 21-05-0954 Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This eleeNcn applies 10 the nnrt'llhy M l-Ittltnn R..~irltt"qt Trtt~t ~llAm Fnttrtn nf n.."ArlAnt'~ Will) Trust (marital, rllsidual A, B, By-pass, Unified Crlldit, ete.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or sim- ilar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. Part A: Enter the description and value of all Interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113(A) trust or similar arrangement. Descriptlon Value See Attached Schedule 743,947.59 Part A Total $ 743,947.59 Part B: Enter the description and value of all interests included in Part A for which the Section 9113(A) election to tax is being made. Description Value See Attached Schedule 743,947.59 Part B Total $ 743,947.59 (If more space is needed, insert additional sheets of the same size) ESTATE OF DOROTHY M. HUTTON File # 21-05-0954 SCHEDULE B Pr per share Value 1 198 sh AT&T Corp 19.775 $ 3,678.15 Common Stock (CUSIP 001957505) 2 6195 sh Allied Irish Banks 42.738 264,758.81 Common Stock (CUSIP 019228402) Accrued interest on 2 3,490.51 3 100 sh American Express 58.785 5,878.50 Common Stock (CUSIP 025816109) 4 42 sh Avaya Inc. 9.89 415.38 Common Stock (CUSIP 053499109) 5 700 sh Bellsouth Corp 26.203 18,341.75 Common Stock (CUSIP 079860102) 6 78 sh CSX Corp 44.568 3,476.27 Common Stock (CUSIP 126408103) 7 301 sh Comcast 29.97 9020.97 Common Stock (CUSIP 20030N101) 8 885.047 sh DOW Chemical 43.713 38,687.62 Common Stock (CUSIP 260543103) 9 125 sh Hanson PLC 54.725 6,840.63 Common Stock (CUSIP 411349103) Accrued interest on 9 65.73 10 4258 sh PPL Corp 32.343 137,714.37 Common Stock (CDSIP 69351 Tl 06) Accrued interest on 10 1,064.50 11 276 sh Qwest Communications 3.81 1,051.56 Common Stock (CDSIP 749121109) 12 1200 sh Rite Aid Corp 3.978 4,773.00 Common Stock (CDSIP 767754104) 13 1306 sh SBC Communications 24.103 31,477.87 Common Stock (CDSIP 78387G103) 14 23246.763 sh Seligman Growth FD 4.02 93,451.99 Mutual Fund - Common Stock (CDSIP 816335103) 15 800 sh 3M Company 73.02 58,416.00 Common Stock (CD SIP 88579YI0l) 16 550 sh Verizon Communications 32.608 17934.13 Common Stock (CDSIP 92343V104) 17 500 sh Viacom 34.328 17,163.75 Class B (CDSIP 925524308) 18 390 sh Vodafone Group 27.64 10,779.60 Common Stock (CDSIP 92857WI00) 19 5000 sh Discover Bank 100.415 5,020.75 CD 7.0% Mat: 11/16/05 2 (CDSIP 25467BE80) Accrued interest on 19 118.90 20 10000 sh Discover Bank 99.744 9,974.40 CD 3% Mat: 12/12/05 (CDSIP 25467BX60) Accrued interest on 20 78.90 Total Stocks & Bonds $ 743,674.04 3 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION INRE: ESTATE OF DOROTHY M. HUTTON, Deceased 60 'C' !! I , . 'J (-,':.~ '1]! C' r r~ :/ .....':.,'\.I ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ORPHANS' COURT DIVISION No. 2005-00954 DISCLAIMER Filed on behalf of Robert D. Hutton Counsel of Record for the Estate: TRICIA D. NAYLOR, ESQ. PA 1.0. No. 83760 104 South Hanover Street Carlisle, P A 17013 (717) 243-7437 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF DOROTHY M. HUlTON NO. 2005~00954 TO THE HONORABLE COURT: DISCLAIMER Dorothy M. Hutton (hereinafter the "Decedent") died testate on September 17,2005. The Decedent's Last Will and Testament dated January 21, 1997 was admitted to probate and Letters Testamentary were issued to Robert D. Hutton on October 28,2005. Item Fourth of the Decedenfs Will provides that after the Decedent's death.. the Decedent's Trustee shall invest and manage all the property not allocated to the Marital Deduction Trust as a separate trust, referred to as the Residuary Trust, and make distributions as follows: A. If the Decedent's husband, ROBERT D. HUTTON, survives the Decedent, during his lifetime: (i) The net income shall be paid to him in monthly or other convenient installments; (ii) as much of the principal as the Decedent's trustee may from time to time think desirable, taking into account funds available from other sources, for the health, support, maintenance or education of the Decedent's husband or any of the Decedent's children either shall be paid to that person or shall be applied directly for those purposes. However, none of the principal of this trust shall be paid or applied for the benefit of the Decedent's husband unless the principal of the marital deduction trust has been exhausted; and (Hi) After the Marital Deduction Trust has been exhausted (or after the Decedent's death if no Marital Deduction Trust will be established), the Decedent's husband shall have the right in each calendar year to withdraw from the principal up to $5,000 at any time and, in addition, if he is living on December 31 of any year, to withdraw up to 5% of the fair market value of the principal determined on December 31 of that year (the amount subject to withdrawal as of December 31 to be reduced by any prior withdrawals during that year, any rights of withdrawals for a particular year to lapse if not exercised during that year). No Marital Deduction Trust has been or will be established by the Decedent's estate. The Residuary Trust under Item Fourth of the Decedent's Will will be established. The Decedent's husband, Robert D. Hutton, reserves his right to receive income and principal distributions under Item Fourth, Paragraph A., Sub-paragraphs (i) and (ii) of the Decedent's Will. The Decedent's husband, Robert D. Hutton, hereby disclaims the right to any principal distributions allowed Under Item Fourth, Paragraph A., Sub-paragraph (iii) of the Decedent's Will. The Decedent's children are JANE M. HUTTON, ROBERT D. HUTTON, JR. and WILLIAM R. HUTTON. The Decedent's children, hereby disclaim the right to any principal distributions allowed under Item Fourth, Paragraph A., Sub-paragraph (ii) of the Decedent's Will. Said children do not disclaim any rights to distributions that they may have under Item Fourth, Paragraph B. Robert D. Hutton, Jane M. Hutton, Robert D. Hutton, Jr. and William R. Hutton reserve the right to make other disclaimers by one or more separate disclaimer instruments. IN WITNESS WHEREOF, and intending to be legally bound hereby, and intending that an original of this Disclaimer shall be filed of record in the Office of the Clerk ofthe Orphan's Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, Robert D. Hutton, Jane M. Hutton, Robert D. Hutton, Jr. and William R. Hutton have l}ereunto set their hands and seals on two originals of this Disclaimer as of the ~day of NDV (2, h) l:u:....r- 2005. -;J?~ f!9: /~ Robert D. Hutton I I , -(' J "':-~'C /-;. -!( . I -' I / ij/_..;;::.:i.-",.,.___.. j \ cct.1 (.." Jane M. Hutton ..RJ~{-}J- ~ ~rt. Robert D. Hutton, Jr. ' '.r/d!u~t_ ~ William R. Hutton " ESTATE OF DOROTHY M. HUTTON File # 21-05-0954 SCHEDULE 0, PART A & B Pr per share Value 198 sh AT&T Corp 19.775 $ 3,678.15 Common Stock (CUSIP 001957505) 2 6195 sh Allied Irish Banks 42.738 264,758.81 Common Stock (CUSIP 019228402) Accrued interest on 2 3,490.51 3 100 sh American Express 58.785 5,878.50 Common Stock (CUSIP 025816109) 4 42 sh Avaya Inc. 9.89 415.38 Common Stock (CUSIP 053499109) 5 700 sh BelIsouth Corp 26.203 18,341.75 Common Stock (CUSIP 079860102) 6 78 sh CSX Corp 44.568 3,476.27 Common Stock (CUSIP 126408103) 7 301 sh Corncast 29.97 9020.97 Common Stock (CD SIP 20030N101) 8 885.047 sh DOW Chemical 43.713 38,687.62 Common Stock (CDSIP 260543103) 9 125 sh Hanson PLC 54.725 6,840.63 Common Stock (CDSIP 411349103) 1 Accrued interest on 9 65.73 10 4258 sh PPL Corp 32.343 137,714.37 Common Stock (CDSIP 69351T106) Accrued interest on 10 1,064.50 11 276 sh Qwest Communications 3.81 1,051.56 Common Stock (CDSIP 749121109) 12 1200 sh Rite Aid Corp 3.978 4,773.00 Common Stock (CUSIP 767754104) 13 1306 sh SBC Communications 24.103 31,477.87 Common Stock (CD SIP 78387G103) 14 23246.763 sh Seligman Growth FD 4.02 93,451.99 Mutual Fund - Common Stock (CDSIP 816335103) 15 800 sh 3M Company 73.02 58,416.00 Common Stock (CDSIP 88579Y101) 16 550 sh Verizon Communications 32.608 17934.13 Common Stock (CDSIP 92343V104) 17 500 sh Viacom 34.328 17,163.75 Class B (CDSIP 925524308) 18 390 sh V odafone Group 27.64 10,779.60 Common Stock (CDSIP 92857W100) 19 5000 sh Discover Bank 100.415 5,020.75 2 CD 7.0% Mat: 11/16/05 (CUSIP 25467BE80) Accrued interest on 19 118.90 20 10000 sh Discover Bank 99.744 9,974.40 CD 3% Mat: 12/12/05 (CUSIP 25467BX60) Accrued interest on 20 78.90 21 7735.16 sh CASH 1 7,735.16 Cash 22 Carlisle Regional Medical Center 334.24 Refund 23 Tressler Lutheran Services 2,287.29 Refund Total Assets 754,030.73 Total Funeral Expenses and Administrative Cost from Sch. H -10,083.14 Part A Total Total Section 9113(A) Trust Assets 743,947.59 Part B Total Value of all interests in Part A for which the Section 9113(A) election to tax is being made. 743,947.59 3