HomeMy WebLinkAbout98-03217
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OFFICE OF OIVORCE MASTER
CUMBERLAND COUNTY
COURT OF COMMON Pl.EAS
9 North Hanover Streot
Carlisle, PA t7013
(717) 240.6535
E. Robert Elicker, "
Divoroe Master
Tr.cl .10 Colver
Olllce Manager/Reporter
,West Shore
697-0371 Ext. 6535
May 8, 2000
Theresa Barrett Male
Attorney at Law
115 Pine Street
Harrisburg, PA 1710 1
Sandra L. Meilton
Attorney at Law
TUCKER,ARENSBERG
& SWARTZ
111 North Front Street
P,Q, Box 889
Harrisburg, PA 17108-0889
RE: Sabiha Ahmed vs, AIi Ahmed
No, 98 - 3217 Civil
In Divorce
Dear Ms. Male and Ms, Meilton:
I Attorney Meilton has returned the certification document to my
office dated March 10, 2000, indicating that discovery is complete, Ms.
Male has not returned the certification document so I assume that there
are no outstanding discovelY issues and that the matter is ready to
proceed,
The complaint in divorce was filed on June 9, 1998, raising
grounds for divorce of irretrievable breakdown of the marriage and the
economic claims of equitable distribution, alimony, alimony pendente
lite, and counsel fees and expenses.
I am directing each counsel in accordance with P,R.C,P, 1920,33(b)
to file a pretrial statement on or before Friday, ,June 2,2000, Upon
receipt of the pretrial statements, I will immediately schedule a pre-
hearing conference with counsel to discuss the issues and, if necessary,
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8. Plaintiff has been advised that counseling is available and that Plaintiff may have
the right to request that the court require the parties to participate in counseling.
WHEREFORE, Plaintiff requests the Court to enter a Decree In Divorce.
Count II - Equitable Distribution
9. Plaintiff Incorporates by reference paragraphs I through 8 above,
10. During the marriage, Plaintiff and Defendant acquired real and personal property.
WHEREFORE, Plaintiff requests the Court to enter an Order equitably dividing all the
mari tal property.
COUnt 1I/ - Alimony
II. Paragraphs I through 8 are incorporated by reference.
12, Plaintiff lacks sufficient assets to provide for her reasonable needs and is unable to
support herself fully through appropriate employment.
13. Defendant has sufficient assets to provide continuing support for Plaintiff.
WHEREFORE, Plaintiff requests the Court to enter an order granting her alimony,
Count IV - Alimony Pendellte Lite, Coun:.-el Fees and Expenses
14. Paragraphs I through 8 are incorporated by reference,
15, Plaintiff lacks sufficient assets to provide for her reasonable needs and is unable to
support herself fully through appropllate employment.
16, Defendant has sufficient assets to provide continuing support for Plaintiff.
17. Plaintiff enjoys medical benefits under Defendant's employment benefi,ts.
2
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THIS FORM MUST BE FILLED au'!'
(If you are self-employed or if you are salaried by a
business of which you are owner in whol", or in part, you must
also fill out the Supplemental Income Statement which appears on
pages 8 and 9 of this Income and Expense Statement.)
INCOME AND EXPENSE STATEMENT OF
ALL AHMED
INCOME;
Il:mployer:
Address:
Ali Ahmed. M,D. / Deot. of Veterans Affairs
South Front Stre~~Barrisburg, PA / 1615Wood~
Street, Austin. TX 78772
Type of Work:
PhvsjJ;if;ln / physician
Payroll Number:
Pay Period (weekly, biweekly, etc,):
Department of Veter~s Affairs!
biweekly
Gross Pay per Pay Period:
Itemized Payroll Deductions:
$ 2217
Retirement
$ 291.70
137 .47
22.17
62.08
17,74
Federal Withholding
Social Security
L,ocal Wage Tax
State Income Tax
Savings Bonds
Credit union
Life Insurance
Health Insurnnce
. Other (specify)
Medicare
32,15
2
Net Pay per Pay Period:
Net Pay per Month:
(See attached pay stub)
Ali Ahmed. M.D. - Private Praotioel
$ 165.1
$ 3584
Gross Annual Income:
$62.566
Net Annual Income _
Less 25% deduction taken for taxes;
$46.925
$ 1805
$ 11l..Q
Net Pay per Pay Period:
Net Pay per Month:
Other Income:
Week Month Year
(Fill in Appropriate Column)
Interest
$
$
$--
Dividends
---
Pension
Annuity
Social Security
Rents
Royaltiies
i
I
Expense! Account
Gifts
Unemployment Comp.
Workmen's Comp,
Total
$-
$
$-
TOTAL INCOME
$ 7.49~,OO
3
ill.l!'~M.EN1'l\.I, INCOME STA'l'EMENT
(a) This form is to be filled out by a person (check one) :
(1) who operates a business or practices a profession, or
(2) who is a member of a partnership or joint venture, or
(3) who is a shareholder in and is salaried by a closed
corporation or similar entity,
(b) Attach to this statement a copy of the following documents
relating to the partnership, joint venture, business,
profession, corporation or similar entity:
(1) the most recent Federal Income Tax Return, and
(2) the most recent Profit and Loss Statement.
(c) Name of business:
AU Ahmed, M, D,
Address and Telephone Number: S, Front Street. Harrisbu..rsL..-
PAl (717) 234';4121
(d) Nature of business (check one) :
-1L
(1 ) partnership
(2) joint venture
(3) pz'ofession
(4 ) closed corporation
(5) other
(e) Name of accountant, controller or other person in charge of
financial records:
..J;:gvanauqh Michaels. Ltd.
9
.
Ta~ Ind
, Crtdlw
IWlMtd
OedllGllon
104'11"1
1'"",1.
I,"t'.:
",110
H..d 0'
hou.t"OI,,!
",110
M.nl,,, filIng
IfJlnllw Of
OI.l.lIfytnt
wldow(If):
11,100
M."i.d ,IU",
..p".lIly:
13.1'.
Other
TlXee
Plymente
Allach
Forml W.2,
W.2G on
p.g.1,
AJIOIllach
Form 1~R
I' IU WIll
withheld,
No
I
34 Amount kom Iln. 33 (Idlullld grOlllncom.) , ' , , , , , , , , , , " ""
~.. Chld"f: IXIYou werl 68 01 older, 0 Blind;' 0 'pOUI' WI' 08 01 older, 0 Blind,
Add tho number 0' bo... ohlok.d .bo," Ind onter Ihl total h... , , , , , ~ 351
b " YllU Ir. ml,,11d nllng Ilplrallly and your IpoUI. IIlmlzlI dlducUonl or
you wer' I dUII.ltatUI III.n, II' InltrucUonl and chock herl , , , , , , , .. ~5b 0
35 Entlr thl IlrUI' 0' your IIlmllld dlduollonl kom Schldull A, IInl 28, OR IllIncll,d
doduollon _hown on Ih,l.n, 1Iu1 III Ihllnl~uollonl to nnd your ltandord d.ducUon "
you ohlckld Iny boN on IIn. 381 or 38b or If IOm'onl OlIn alllm ycu I_ I dlp.ndlnt, ,
Sublrtctlln.36 from IIn.34 ' , , , , , , , . , , " ,"',",",',',",
If 11M 34 II IU3,400 or Iell, mulUply 12,100 by Ih. lotal numblr 0' I..mpllonl alllmld on
IIn. Od, "line 34 II o~er SU3,400, s., the workshlllln thl Inltrucllon. for the Imollnt Iv onter ,
To.blllnoom.. Sublrlcllln. 38 from IInl 37, "lin. 3811 morllhln IInl 37, Inler ,0. , ,
To, SH InltrucUonl, ChIck If .ny taM kom 10 FCIlll(I) 8814 b FCIlll4U72" ~
Crldll fOl child .nd dlplndonlOllre .'plnsol, Attach FOlm 2441
Crldll for tho Ilderly 01 Iho dlolblod, Attach Schedule R '
Child ta. Clldll (lei InllluoUons), , . .
EduOlllion oredlla, Attach Fcrm 8863. , , , . ,
AdopUon credit. Attach Form 8839 ,
Fonlilln ta. crldlt. Attach Form 1116 If requilld , ,
Othlr, ChIck" from I 0 Form 3800 b 0 Form 6396
o 0 FCIlll 8801 dO Form (IPlalfy)
41 Add IInl' 41 through 47, Thlsearl youreolal orldl\., , , , ,
Sublra9t IIn8 48 'rom line 40. If line 4818 more than IlaI. 40. enter .o~
So"..mploymlnllex, AMch Schldull se, , ,. ."",
AJtomlU~1 minimum la., Allach Form 6251 . , , , , , , , , , ,
Soclllslcurlly and Mldlca,ol.. on Up Income not rlponed 10 emplaYlr, Attlch Form 4137 ,
T.. on IRAs, olher reUrament plans, and MSAI, Attach Form 5329 If requlled,
Ad~lnce earned Incomo credll payment. from FOlm(.) W.2
Household employm."t ta.e., Allaeh Schedule H ""
sa Add IInlls 49 throuah 55 This 19 vour tot.1 tax. . . . . '....a....t.-Io
57 Federal Income tax wllhheld from Form. W.2 and 1099. , , , , ,
91 1998 I.Umaled tax payments and amounl appll.d from 1997 relurn
',!'-.,'I!:
581 .Irn.d Incom. c,edll, Attach Schedul. EIC If you ha~e a qUallfylJO 11. ..
child b Nontaxable e.,ned Incom.: ami ~I _ ~,~ ,r
and IYP. ~
Addlllonal ohlld taM credll, Attach Form 8612.
Amount paid wllh Form 48681,equ.'1 for e.len,lon),
Exce.. aoclalS6curtty Ind RRTA lex wllhheld (a.lln.truotlona) , ,
Other paym.nt., Check If "0m 10 FCIlll2439 b 0 FCIlll4136
Add Unl. 57 ~8 59a and 60 Ihrouuh 63. These are your totlll Davm.nt.
If line 64 Is more Ihan IIn. 53, aubtract IIn. 56 'rom IIn. 64, Thl. la Ihe amounl you OVERPAID, ,
Amounlofllne65youwanlREFUNDEDTOYOU, ",.", , ",", ~
Roullng numbOT ~o Typo: 0 Checking 0 S.~lnoa
Accounl numb.r
81 Amounl of In 8S vou want APPLIED TO YOUR 1iB' ESTIMATED ~
81 If IIn. 561a more than IIn. 64, sublract IIn. 64 from IIn. 56, Thilla Ih. AMOUNT YOU OWE,
For delllla on how 10 pay, s.e In.lluellon. , , , , , , , , ' , , , , , " """", ~
~d" p~:~~.~I~ ~ru~~?'~I~' ~1~~II?~I~~ turnl"t I II return.n .r.CQm.,lnylng Ie tou It Ind II. .m.nll. .~~o . ." ' my n I
~II'" tht.,. Ire t(\lI, cor"ct In 7i 'I 08ell,.uon 01 prep.'.' loll'ltr th,n 'f.JlIYlrlll ba..d on.U Informtllon 01 which pflp.r., n.. ,ft" IInQW$HOf.
Your Ilg"llut' 0.11 Your Dccup.thon DIYII"" t,I.,no".
PIf( ICIAN ..-rc.."...II'
5"0""'" slgnlluI, If I JOint rtlu,", O.t. Spou.... occupallon
ONS t 17 7 7.
Pttp,,,,',
'llIn,tur.
~7
~.
~U
40
41
42
43
44
45
41
47
49
1IO
51
82
53
64
55
'.Jo.o.l... ..
24:078
2 957
.,. .
80
81
52
83
1I4
Refund 15
HIVI II 81 I
dlr.o:t; ~ b
~n~.:rJI~~ ~ d
681>. 1l8c, Ind 6Od,
Amount
You OWe
SIgn
HIre
Joint retum?
S..lrlltructlona,
Kllp I copy
Paid
preplrer'.
U.e Only
F 11/021i.
0.11
ICH.DULIIl Ala
(!lonn 1040)
O","fMl'l1 0' Ih. Tr"IU,.,
"
MMl.I....... ... 'Of.. 1040
Mldle.1
.nd 1
DIIII.I 2
I!xp.n... 3
.
T'll" You 5
P.ld .
(SH 7
In.lrlJotion.,) 5
I
Int.r..t 10
You P.ld 11
(SH
In.lIIAotiunf,)
NOli:
P.raon.1 12
In......II.
not 13
d.duotible,
U
Gift. to 15
Charily
If you m.d. . 1.
plft .nd got .
ben.fttforll, 17
1M In.lIIAetion., 11
C"u'lly .nd
Job &xp.n... ao
.nd Mo.t
Oth.r
MI.e.n.n.ou.
Deduction.
21
22
(SH
In.lIIAOllon. for
..pen... to 23
deduOI hera,) 2.
ZI
21
Oth.r 27
MI.e.n.n.ou.
Totti 21
It.mlz.d
D.duetlon.
Schedule A . Itemized Oeductlono
(SChlldul. B I. on ..p.rlt. p.".)
.
1998
AllllJtlm,nl
Caullon: Do nollnolude ..penlu relmburo$d 01 p.ld by Olh,,",
Medlcelmnd denl.le.p.nl.. (1..lnllruOllon.), I' ~'f ' See, S}~t ,1 ,
Snlel.mounl from Form 1lJ.40, IIn. 3. , , " ~4 4
MUltiply line ~ above by 7,5% (,075), " .""""
Sublrlct IIn" 3 from IIn. 1. It IInA J II mor. lhan lin.
Sial. Ind locallncom. Ia... .
Rell..1l1lo la,," (1..ln.~uollonl) . . , ,
Parton.1 property la~.., ,
Othar I.~.., L1.ltyp. and amounll> _
. See. Stili 2: :
""'" ,
See Stmt 4
Add IInsl ft Ihrouah 8
~
9,785
,.,. ,
Hom. mortg.g. Intar..1 .nd polnll rop\1rted to you on Form 1098 .
Home mor1g.g.lnlar..1 nol r"port.d 10 you on Form 1098, " paid
10 Ih. parlon from whom you boughl thft home, ..e In.lruellon.
and Ihow Ihal p""on'" n.me, Identifying no., and addrell I>
Polnll nol reported 10 you on Form 1098. Seeln.lrucllon.
for Ip.clalrulee , , , , , , , . , , , , , , , ,
Invlllnllnllnl"..1. AIIach Form 4952, If required, (See
Inllruellon.), , , , , , , , , , , , , , , , , , , , , , , . ,
Add IIn8a 10 throuah 13 , . . . , , . . .
Gifts by e..h or Check, " you made any gift of $250 or
mor',I..I""lNctlonl, , , , , " ,.""" ., See, Stmt 5, ,
Other than by ca.h or check, It any gm ot $250 or more, lee In9lruellonl,
You MUST allach Fonn 828311 ovor $500 , ,
Carryover 'rom prtor year ,
Add IInel 15 Ihrouoh 17
'~
.J. ,
Unrelmburoed employee e~ipenl" . lob Iraval, union duos, job
I
education, elc, You MUST 'illach Fom12108 or 2108.eZ II required,
(SHlnalrucllonl,) I>~,
T.. preparallon te.. , " .""", , , , See, Stmt 6,
Olhe, .~penlea . Invaatmenl, ..te depollt bo~, alc, LIII
type and amount .
Add IIn.. 20 Ihrou9h 22, , . , . , , , , , . , , , , , , , , .
Enler amounl from Form 1040, IIn. 34 , , , , ~
Mulllply line 24 above by 2% (,02) . , , , , , , , , , ,
Subl'80t Un. 2~ from line 23 If line 25 19 mora
Other. f,om 1111 In InAltucllonl, List typ. and amount I>
II Fonn 1040, line 34, ovar $124,500 (ove, $82,250 If mamed nllng IIpar.laly)?
NO. Your d.ducllon II not IImlt.d. Add tho amounll In Ihe tar rlghl column }
tor linea 4 Ihrough 27, AlIO, enter on Fomi 1040, line 38, Ihe I.rg"
of Ihla amount ur your ltandard deducllon,
,., P.ptIWOIjc Reduction AC1 Notlco, a.. Form IlJ.4O Inltruollona, Sohedu" A ("ann 1040) 1M'
J"
F IHOatH
,
I HIfMI' '''0.1\ un Pot", 1040, ~ nOl tnl" ",me ..,d 'QCMlI HCU'IIV numb" ,"own CH' it I.
. ,
II Add the amounts on line 5 Enter the JOl81 here and on Faun 1040
You musl com~lele thl. part II you (I) had over 5400 of Inlerell or ordinary dividends; (b) had I foreign lecount; or
(0) recllved a dlstrlbullon from, or were a granlor aI, or a transferor to, a foreign lru.1.
11 Al any time during 1998, did you heve an Intereslln or a slgnalure or olher lulhorily over I nnlnclal
lceount In I foreign counby, .uch as a blnk accounl.5Icuritles accounl, or olher nnanclal
lceounl? S.. In.lrucllons for excapllon. and filing raqulrements for Form TO F 90.22,1. , , ,
b II .V.... entar the name of the furelgn country ..
8 During 1998, did you recalv. a dlsllibullon from, or were you Ih. grenlor of, or traneferor to, I
t"Y II
For PlpetWOIIc Reduction Acl Notice, IH Falin 1040 Inllructlonl,
JXI
, tIIOlltl
Part I
Intarllt 1
(flee
Inltruolllll1l, )
Noll: ~ou
reeelv e Form
1 Ogo.lNT, Fo,m
10go.DID, or
IUbltltUIe
I18","ent from
I blokereol lI,m,
lilt the nnn'l
nemt II the
Plyer and enllr
the Iollllnlerell
Ihown on thlt
form,
2
3
Part II
Ordinary
Dlvldand
(SH
InelNcllonl,)
Noll: If you
received I Form
10gg.DIV or
lubslltule
elallment from
a brokerage
"rm, 1111 the
"rm's name 18
the payer end
enter the ordinary
dlvldende
Ihown on thlt
form,
Part III
For"gn
Account.
and
Tru.ta
(SH
Inltructlonl, )
Schedule B . Interelt and Ordlnlry Dividends
All.c:ftmlnl
loqUln" No, 08
llll nlme 01 payer, If Iny Inllrest II from I ..lIlr.nnlneed mortglge and the
buYlr u..d the property 18 I ""..onll rllldenee, ..e Inllrucllons and 1111 thll
Inll".1 ""I. AlIa, Ihow thlt buyer'l loolal IIcurlly numb.r Ind Iddreu ..
See $\mt 7
1
Add tho amounts on line 1, , , , , , , , , , , , , . . , , , , , , , , , , ,
Excludable Inllr." on series Ee U,$, savings bonds Iseued after 1989 from FOlm
8815, line 14, You MUST al1ach Form 8818 to Form 1040, ,""'"
.. Subtract line 3 from IIno 2. Enlor the re5ult here and on Form 1Q4U Une 89.
Not.: If yOU had over 5400 In ordinarY dividends. vou must also comolele Part III.
S list nlm. of payer. Includ. only ordinary dlvldands, Report any capital gain
dlslributlons on Schedule D,lIne 13 ..
15 707
..
15 707
_ ~V~R~~l~N TAX F~E FUND
V R R N TAX FREE FUND
75
1
s
DIVIDEND SUBTOTAL
TAX.EXFMPT DIVI]END
Schodule I (Form 1040) 1...
IMftfI "'DIm 'HI
line 0 pel'lOO I' ..mploym.n',lncom. (I' thown on Porm 10llJT
Section e-Long Schedule SE
_ Self.Employment Tax
~90.,14-9~~ '
Noll: II your ooly !noome aubltelto IIIt-employmlnltax Is churoh amploy.. Incoml, aklp IIn.a 1 Ihrough 4b, Enler .0. on IIna 4c and go 10
IInl 810, Income from ~Irvlcea you PlrfOrmed II I mlnlllor or a mamber 0' . rallgloul Orllar II not church Imployo.'ncomo, S,,'nalrucUona,
A II you are . mlnlaler, mamber 01 a rollgloul order,or ChrlaUan Sclonce pr.cUllaner Ind you mod Farm 4381, but you had $400 or
more of oth... nat ollnlnga from IIIt.omploymanl, chacl< herl and conUnuI wllh Pert I, , , , , . , , , , , , , , ,
1 Nat farm pronl or (lOll) from Schedull F, IInl 38, and farm plrlnerlhlps, SchoUula K.l (Form 1085),
IIna 151, Nota: Skip Ihllllnllf you uallh. farm opllonal mathod, Slelns~ucllonl, , , , , , , , , , , , , , , , ,
2 Not pront or (lOll) from Schadulo C,lIne 31: Schedull C.EZ,lInl 3: and Schodula K.l (Form 1085),lIna 15a (olher
Ihln IlImlng): Ind Schodula K.l (ParOl 1085-[1), box 9, Mlnlalera Ind membaro 01 rallgloua ordere, IlIlnalrucllona
for lmounta 10 raport on Ihla line, Sealnatrucllona 'or olher Incomo to report, Nota: Skip Ihla IIna II you ule Ih.
nonfarm opUooal mllhod, Saelnatrucllonl , , , , , , , , , , , " """""""
I Comblnallna. 1 and 2 , , , , , , , , , , , , , , , , , , , , , , . , , , , , , , , , , . , , : , ,
4. If Ilna 311 mora than zero, multiply IIna 3 by 92,35% (,9235). Olharwl.e, enler amounl from IIna 3 ,
b II you alocted ona Of bolh 0' the opllonal rnalhods, anler Iha tolal 01 IInaa 15 and 17 hera, , , , ,
o Camblnalln.. 4a and 4b, It 1001Ihan $400, do nolllle Ihlllchedula: you do not owa aall.amploymant
tall, heaptlon,lt I.aa than $400 and you had chnrch Imployaa Incomo, ent.r .0. and conllnua,
51 Enter your churoh employ" Incoma from Form W.2, Clullon: See Inatrucllons
lor dannlllon 01 church amploYII Incoma , , , , , , , , , , , , , , , , , , , , , , ,
b Mulllply IIna 51 by 92,35% (,9235), It lelllhan $100, anler .0., , , , , , , , , , , , , , , , , , , ,
8 Nat olmlngl fronl aalf-employmont, Add IIn.a 4c and 5b , , , , , , , , , , " ""."
7 Mlxlmum amount 01 comblnod wag.. and lelf...mploymenl earnlngllubJecl10 loclallecurlly lax
or the 8,2% Portion 0' Ihe 7,85% railroad rellremenl (lIer 1) lax 'or 1998 , , , , , , , , , , ,
81 Total lIOcIal aecurlly wagea and IIpa (Iolal of boxea 3 and 7 on Form(a)
W.2) and railroad rellrem.nt (lI.r 1) com""naallon , , , , , , , , , , , , , , , , , ,
b Unreported Upllubjeot to loclalaeeurlly lax (from Form 4137, IIna 9) , , , , , , ,
c Add IInel Sa and 81>, , . , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
t Sublrlclline Be 'rom line 7, It zero or 1881, enler .0. here and on line 10 and go 10 line 11
10 Multiply Ihe amlller 01 line 6 or line 9 by 12,4% (,124) ,
11 MulUply line 6 by 2,9% (,029) , , , , , , , , " ",",",' """,.
.Cl..
~
88.400.00
56 869
~
56 869
1
14
1 2
""""', ,
12 SIII..mploymont tax, Add I1I1ell0 and 11, Enl.r hare and on Form 1040, IIno 50 , ,
13 Ooduollon for ono-l1all of IIlf..mploymanl tax, Mulllply line 12 by
50% un. En.r the result he,e and on Form 10"0. 11"1 27 .
t.. Optional Methods To Figure Net earnings (SlIJlnllrucllonl,)
Porm Opllonll Molhod, You may ule Ihll malhod only If:
I
I Your grou 'Irm Income waa nol mora than $2,400,or
I ,
I Your grosa 'arm Income wla more Ihan $2,400 and your net farm pronta were Ie.. Ihan $1,733,
14 Mlxlmumlncome'oropllonalmalhods"""""" ""',","',
I
15 Enler Ihe omlner 0': \wo.thlrda (213) of gro.. farm Income (noli... Ihan zero) or $1,600,
I~
1 419
"""'" ,
-J.IIO IncludA 'hi!! amount on IIn8 4b above
Nonfarm Optlonl' Mothod, You may u.e Ihla method only II:
I Your nel noofarm pronta '\vere Ie.. Ihan $ 1,733 and allo Ie.. Ihan 72,169% of your gro.. non'arm Income~ Ind
I You hid ne' ..mlnga '''01 aeU.employment of at least $400 In 2 of th. prior 3 years,
Clullon: You OIlY uae this method no mora Iha" flve IImas.
11 Sublrllclllna 15 'rom IIna 14 , , , , , " ""',.,"""""""""""
17 Enter Ihl Imlller of: \wo.lt,lrda (213) 0' groll nonfarm Incom. '(not le"lhan zero)er Ihe amounl on line 18.
Alao, Include Ihlaamounton line 4babove . . , " """""""""""."",."
I From SCh.dUI. F, Un. 11, and Sell.dult K.l (Form IOU). line 151). J From Seh, C, line 31; Sen. c.az. lin. 3: Sen. 1(.1 (Form 1085), line 15. Incl Seh. Kol {'(lIm 1011..), ltoJl'.
2" F Ii 3 I .\ r I fn 5. .., m ,lln l' h.. Iln l' ",m I !in I n h. ~ r 1
F 10/21'"
'0'"
6251
Alternative Minimum Tax-Individuals
. s.. ..p.(.t.ln.t,uctlon.,
.
O'Pltimtn" 0' Ih, Tr..."ry
1n1""11 "I'I'"U' .If.....,. II
HIIN(IiI).ttown on 'otm t040
~m.nt. .nd Pr.f.r.nc..
1 If you It.mlzld deduction. on Sch.dule A (Form 1040), go 10 line 2, OlhelWill, enler yourollnd.rd d.duo1lon
Irom F0IIl11040, Iln. 38, h"..nd go 10 IIn. 8 ' " ",,"" """""""'"
Modlcalond d.nlll, Enl" Ihum.lI" 0' Schedul. A (Form 1040), IIn. 4 or 2111% 0' Form 1040, line 34
TIX... Enter the .mountlrom Sch.dul. A (Form 1040), IIn. 9 , . , , , , . , , , , , ,
Certeln Int"..1 on a h<:im. mung.go nol ulld 10 buy, build, or Improve your home, , , , , ,
MI.cell.neou.ltemlzed deduction., Enler Ihe .mountlrom Schedul. A (Form 1040), IIn. 26
Refund 0' II..., Enler any tax refund Irom Fo,m 1040,IIne 10 or IIn. 21 "
Inv..lm.nllnl"..1. Enl.r dlffer.nce b.tw..n regul.r I.. Bnd AMT d.duction ,
POII.lase d.preclation, Enler dlfferonce betw..n regular tax .nd AMT d.pr.cI.llon
Adjueted gain or lou, Enl.r difference b.tw.en AMT .nd r.gul.r "X g.ln or Iou ,
Incentiv. .Iad< option., Enler ..ce.s of AMT Incom. over IIgul.r la. Incom.. , , ,
Poulv. .cUvlties, Enllr dlffer.nce b.tw..n AMT ."d ,.gul.r lax Inr.ome or 10.., . ,
Beneftcl.n.. of ..III.. .nd lrulls, Enler Ihs .mounlfrom Schedule K.1 (Form 1041), line 9
T......mpllnl.r..t Irom pnv.leacllvlly bondslSlued .ft.r 617/66 , . , " ,,",'
Other, Enler th. .mounl, If .ny, for each Item b.low and .nl.r Ih. lolal on IIn. 14,
· Clrcul.llon expendltur.. h Loss IImllallons, , ,
b Depl.Uon.......... I Mining costs .. . ..
o Depr.cl.llo~ (pre.1967) , , j Patro,,'. .djuslm.nl ,
d I"stallmenl..'..""" k PolluUon conlrol faeJIUle. , ,
· Intangible drilling costs , , , I Research and ..perlmenlal
I Large p.rtne"hlps , , 01 S.cUon 1202 ..clu.lon, , ,
g Long.lerm contraclI , , , , n Ta. sh.lI.r farm acUvlll.s, ,
o R.lal.d adjuslm.nls
iIiI' A~~::~:~::d;t~:;:";'~~:::::.,;:~~:rouoh~ ' ,
1.
17
18
. Attach 10 Form 1040 or Form 104ONR,
2
3
4
8
8
7
8
1
10
11
12
13
14
11
20
21
Enler Ih. amounl from Form 1040. IIn. ;17, If I.sathan z.ro, .nl.r as a (10") , ,
Nit operallng loss d.duction, If any, Irom Form 1040, IIn. 21, Ent.r as a po.lllve amounl, , ,
If Foon 1040, IIn. 34,1. ov.r $124,500 (ov.r 582,250 If marrl.d II/Ing s.paral.ly), and you itemized d.ducllon.,
.nllr th. .mounl, If any, Irom IIn. 9 ofthe work.h..lfor Schedule A (Form 1040), IIn. 26, , , , , , , , , , , ,
Combln.lln.s 151hrough 16, , , , " """."", , , , , , . , , , , , , , " .
AJllm.tiV.II. n.t oper.llng loss duducllon, Se.lnstructlons, , , , , , , , , , , , , ,
Alt.mlllY. MInimum Tax.bl.lncom.. Subtr.ct IIn. 20 from IIno 19, (If marrlod nllng
22 Exllllpllon Amount. (If this form Is for a child und.r age 14, seu Instruction.,)
IF your flllng 'I.tu. I., , , , AND IIn. 211. not over ,. THEN .nter on IIn. 22,
31nglo or h.ad 01 hou..hold, " ",'., 5112,500, , , , , , ,533,750 }
Marrl.d nllngJolnlly or qu.llfylng wldow(or) " 150,000.""""", 45,000 "
M.rr1ednllng.op.r.loly" ",',",' 75,000",.""",,22,500
IIl1nl 211. over Ih. amounl.hown above for your nllng .talus, se. In.'ructlon.,
Sublr.ct IIn. 221rom IIn. 21, If zoro or loss, .nt.r .0. hor. .nd on lines 26and 28 , , , , , , , , , , , , , .
If you compl.,.d Sch.dul. D (Form 1040), .nd h.v. .n amOunl on IIn. 25 or IIn. 27 (or would h.vo had an
amounl on .Ith.r IIn.1f you had complotod P.rt IV) (.. r.ngured for Ih. AMT, If nocoas.ry), go 10 Pan IV of
F0IIl1625110 ngur.lln. 24, All oth".: If IIn. 231s 5175,000 or lose (587,500 or I.se II married nllng separot.ly),
multiply Iln. 23 by 28% (,28), Olh.rwlso, mulllply Iln. 23 by 26% (,26) .nd sublracl 53,500 (51,750 If marrl.d
ftllngsap.r.I.IY)'romther..ull" , , , , , , , , " "",'."" .
AJlem.Uvl minimum II. forolgn t.. cr.dlt, Se.lnstructlons, , , , , , , , , , , , , , , , , , , , , , , , , , , ,
T.nletlv. minimum ta., Sublracllln. 25 from line 24, , , , , , , , , , , , , , , , " ."""", .
Enler your tax from Form 1040, IIn. 40 (minus any t.. from Form 4972 .nd any forolgn tax credit 'rom Form
1040, IIn. 48), , , , , , , , , , . , , , , , . , , , , , . , , , , , , , , , , , , , , , , , , , ,
28 AltomaUvl Minimum T... Sublr.ct IIn. 27 from IIno 28, If zoro or IISS, ent.r .0.,
Enter herll Bnd on Form 1040 line 51 .
For Po,:WWor1c Reduction Act Notlcl, ... ..par.t. In.truotlon.,
Jxa
p: It/o"n
23
24
28
2.
27
OMI No. 1141.02a7
1998
, ,
AlllGhm.nt
Va"' IOCII' ItcUtllv ""'mitt
4jQ.:1.H60~
.
.
45,000 .
Po.m 8281 ""'1
Vehicle Expen... .
. ... .
OtlllltplJori 01 property, ,
Al88IID, ,
AcivltylD, , , , , , , , , , , , , , , , , , , ,
, ,
_~D1U'to
'F.
1-1.1
,\ .
490.74.9503
~Ck box III..paver did nolown vahlcla "Actual.expense method requl red"
o ChecI< box If IIxpav" uaed '"all thin on. v.hlct. II",ulllnlO<lIlv In aCtlvltv
o Chtd< box It IIxpavor did nol uao mllolgo tho Oral VOir vohlcl. WII pllcod In I.rvlce
..." Ihthoct.
IXI Ac1ual..penl. method. calcullted bV the aVlt.m
o Whlch.v.r method r.aulllln I Ilrg., d.duotlon, caloulalad bV tho Iv.t.m
o Choct< box it torctng !h. allndlrd mll.ao. rll., 32,5 ""nls
OHarallnforma.'on
1. I..noth.r v.hlcluvllllbl. tor p.r.onal uaa?, .
2, Waa v.hlcl. Ivallabl. ror ua. during o"-duty hours?, ,
3. Evld.nce 10 IUpport your deduction? ,
4, If 'Y.a', la th..vldance wrltt.n? ,
8, Oa" v.hlcl. w.a placed In a.rvlce , , , , , , , ,
8, Total mll.a v.hlcla WII drtvon during Ih. v.ar , , , , , , , , , , , , ,
7, eusln... mll.alnclud.d on IIna 8, , , , , , , , , , , , , , , , , , , , ,
I, ~"C41nl 01 bualnall UII, Dlvld.llna 7 bV IInl 8, , , , , , , ,
I. Avarog. dallv ro\lnd trip commuting dl.tance, , , , , . , " , , , , , ,
10, Commuting mll.alncluded on IIn. 8 "",' , , , , , , , , , , , ,
11, Oth.r p.llanll mil.., Add IInl 7 and IIn. 10 and '\Ibllacllhllolal from IIn. 8 , , , , ,
Standard Mil... Rat.
12, SUlI"... mllta mulUplV bV 32,5 cenll (,325) , , ,
!G1uILI!KDAn...
.,',.."",..".., ,
13, PlrI<lng and tolla plld ,
14, Selledul. C and Selledull ~ onlv: Inllroat paid , , "'" ,
18. Pa"onal property tax paid, , , , , , , , """ ,
18, Gaaolln.. 041, "palm, v.hlcll, In.urance, .Ic, " , "'" , "". .
17. a, V.hlcl. "nlll., , , '" , ...., , .'", , "'" ,
b, Inelu.lon amount " , ., , "'" , """" . "'" ,
e. Subtract IIn. 17b from IIn. 17a , , ."" , """" , "'" .
18, Valu. ol.mplov.r.provld.d v.hlcll ."., ,
11, Add IIn. la, IIn. 17e, and IInl18 " , .,." ,
20, MultlplV IIn. 19 bV thl percentage of bu.ln... uso ,,", ,
21, Depreciatlnn from IIn. 31 .""", , ",.,. ,
22. Add IIn. 20 .nd IIn. 21 """",.., , "". , "'" .
Qucaclatlon of ~hlal.
23, COltorothtrbasl1 , , , , , , , , , , ,
24, Amount oll.otlon 179 deduellon , . , , , , , , ,
28. MulllplV IIn. 23 bV th. r.rcentag. or bualn..a u..
ZtI, D.pr.ellllon m.lhod Ind p.re.lIllg. , , , , , , ,
27, MulUplV IIIIft 25 bV th. p.rc.ntag. on IIn. 2e ,
ZtI, Addlln. 24 Ind IIn. 27 , . , , , , , , , , , ,
zt, LlmlllUonlmounl, , " """""".
30, MultlplV IImllltlon Imount by tho p..""nl at bUllnel' u.., ,
31, 7hllmaller or IIn. 28 or IIn. 30 .
"", ,
..... ,
"'" ,
32. TOlll vehicle el(OAnle 8110wed
F 1212/11
:' ,
1 .
,;.., .
cu= 5,08L
Supplementary Statements
For Year Ended 12/31/1998
, .
, All & SAsIHA Nt.EU
, ,
Statement 1
Schedule A Medical and Denial Expenses
Expense Descr Ipt Ion Amount
................................... ...............
Heal th Insurance Deduct Ion 6,766
.............".......
Total
6,766
Statement 2
Schedule A Rsal Estate Taxes
Real Estate Tax Description Amount
.................~........_........_._. ................
Real Estate Taxes 3,663
Total
3,653
Statement 3
State and Local Tax Deduct Ion SUlMllry
StlLocal Tax Jan Paym~n t ES Payments Extension Pm!
51 WI thheld Prior Year Cur ren\ Year Pr ior Year
.................... ................... ........................ .....................
PA 1,592 770 1,796
LCL 569
Total
, , ' ,
490.74.9503
Tax Paid lor Total
Pr ior Year Taxa.
.................. .................
4, t58
625 1,194
5,352
, . ...,
Supplementery Statements
For Yelr.E~ed t2/31/1998
ALl' WIHA AlM!D
Stlt_nl 1
Schedule 8 Intlrllt Income
Oross Fed Exempt Fed Exempt Pvt
NI/III of PlYlr Interelt Munl Bonds Aotlvlty Bondi
.........~.............................. ................. .................... ....................
FIRST HATlONAl BANK OF MARYLAHD 2,801
FIRST HAilONAt. BANK OF AMYLAHD 3,414
FIRST NATlONAt. BANK OF MARY1.AAD 99
MELLON BANK 1,831
PA STATE BAlIK 8,019
PNC8ANK, N,A. 1,811
SECURITY BENEFIT LIFE 81
STATE FAAN 1,261
.................... ..................... ......."........"...."'..
Totel 18,701
, . . t
49O.14-V503
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, 'Y~,U.'fO-DATE $TATEMENT
II' II
II t.~ 'OJ lilt, ,",.. /II,. D1III6 -lilt
I, 1 .00-343-2898
I'
"
:1 Ir,'AfJ&Yr oJ
iiA6IHA"'AHM!D JT TEN
!: W~81~~L~T8H3k811 R6E 309
CAMP HILL, PA'17011.2250
I'
"
I'
,
"
,
'I
1;
i,
"
Jlouary I,
STATEMENT DATB
I
1997 \0 December 31, 1997
I,,. 1 0/ 1
1~:O(fMm'lf~
r.... /IM..1oJ "",IH, b: LAUYBR .. CO INC, PH: (717) m-1191 OR l-Ill-W.I'9I, 1040 E MARKET ST, YORK,
PA 1740NWl
r.., "'ptl..IlItl/i'tI II: 001 LAUVBR
I,
MARKET V AI,UE NIff b IA. "''''''' ,1IilI. ,/,- ."..", ... ./IM 'M .1 1M ,.,W'
Pllee
Mllkel Value on I2/lI/97
$11,011.82
I:
,:
,
, Dalo
I,
:i
1
r
:1
I;
1/1/97
I/Jl/n
1/21/97
3/)1/'7
4/30/97
S/30/'7
6/30/97
;: 7/31/97
"l9/'7
mO/97
10/31/97
:: 11/31191
I 11/21/97
': 12.31-97
!' 12/lI/n
'I
I'
i
II
I
TII Pree P1llld
31.UUl41006
Pund - Accouol Number
I'
I'
~,
SharN
1.408,928
Tn Pree Fund
31-'8328142006
S7,82
I: ,SUMMARY OF TRANSACfIONS H,/1 b a ,..,.,..dOl. ..1MUf1 ./1144.10.. ,. or d,du<llo.. ~.m _ .."*"':
I!
r Pund. Accounl Numbllr Invellmonu RedemptloDJ DlvIdcodl C.pllal OalDJ
,
,
,
TII p"", PIIIId
31-Ul1l4:lOO6
r,.,.t'.. Dar. too, T".. Ca,'1lI Oal""
. 1lJ.90
'1l3.to
S541'0
,
,I
I: TRANSACfION ACfIVITV 1/""." 1M d".a., .1 ",h Ir,iWdlo. fof ,.., .,...", ,All ".,:
I
j:
'I
'I ACCOUNT FEATURES
"
"
"
I
,
~ I
d
Pund . Accounl Number
DNlcrlptlun
BoJlulu. IlaIaMO
DlvlrIoDd RolAVOIlmeol
Dlvlrlftld RolllYCf1mu1
Dlvld..d Relll...1olOI1
Dlvldood R.lavoo'....1
Dlvld.od RolavCllmenl
Dlvldoad Rolovollmelll
DlvldOhd RoIlIvollmoul
D,vldoad RolA\vlmool
Dividend ROlaVRIme..
Dlvldond ReiDvRIm...
Cap 0alD RolllvCllmol1
Dlyld..d RolAv..Im...
Dlvld,"d Rollvoolm..1
Ilodlq BoIur:c
Ral.
Amounl Price Sharel Share Bllaoce
1,l21.402
544.70 S7.68 ',no 1,327.lU
44.1l 7.72 '.716 l.lJ19J8
41.50 7.S8 5.47' 1,338.41l
44.95 7.60 '.914 1.344.l17
4...20 7.66 6.:192 1.350,619
45.18 7.70 3.161 1,356.417
46.71 '1.90 UI4 1,361401
49.03 7,7' 6.326 1,)61.727
4160 7.10 5.462 1.374.189
41.30 1,11 6,184 1,380.373
1l3.90 7.72 17.34' 1,397.118
40.66 7.73 '.210 1.40197'
46,$3 7,82 '.950 /,401.911
7.82 1.401.92'
S,097
1/", "" IAi ,,,,,11I opllo.. ,.. Ai,. ".<ltd.'
Dlvidondl
R.lA...t
Capital
Oalol
Syslematic
Inv'llmenl
Plao
NOH
NOH
SYlteIMtlC
Wlthdra",al
Piau
Bloctronle
PundJ
Treder
No,",
RolA...1
II
:1
,
I,
II
/
~ ,
\:VEAR-ro-DATIl STATEMENT
'I'
.1
;'1',0. ,., lilt. I.It~. II,. DlIOd -1m
(P .tOO-343-2.1I8
STATEMENT DATE Iii'I
Jlnuary J, 1997 10 Docember 3 J, '"i9'97 HlI
"" I .11
~1~"l/J8fm'ifl
r.., /lMlICloJ .d'lrr, b.' LAl/VER &: CO INc. Pili (717) 7"-2891 OR 1-111'7.1.1.2191,2040 Il MARKBT ST, YORK.
PA 17.02-2140
r.., ",ff"_1>I b, 001 LAUVBR
':
;1
Pund .. Accounl Nwnber
SIiaIo.1C Orowlh JlUld (K'2)
....31.141006
'I
'I
\,
I:
DIVIdendi
llobov..l
I,
'I
II
"
'I
I,
"
;1
'I
I
II
,
I
d
::
'or IAo ""~ .J
~r~m.tD JT TEN
IIEgICAL AATS BLDCI OTf 309
89 POPLAR CHURCH RD
CAMP HILL, PA 17011.2250
'1
'I
'I
I'uod .. AccollDl Number
MARKET VALUE II." II 1M "'''11/ ,1IilI. 01,.., "'OIl'" III .llh. 'M '/11" ,,'/Dd.'
.
"
:,
:1
"
'I
'I
i~
SharCl
PrIce
Mlrkel Value On 12/31/97
$61.574,72
,
"
,
',I
SUMMARY OF TRANSACI'IONS H.ff II. YfOl'-I<>-d4I, "''''11II/I' .1 ""dl"" I. IN thdvu"'.. Io". ,.., ,,:e_.
"
Iii, SllIlc,lc Orowth Plllld (K-2)
....328142006
--
.'
II Puad - Accounl Nwnber
I,
Stralo.lc a,OWIIl Pund Ot.2)
."132'I.lOO6
r_ro-DII. S""" T"", C"IIII 0.1Jv..
'-r..o., I"", J."", C.'IIII Ot"'"
,
"
"
'I
h
il
!! TRANSACI'ION ACTIVITY
I' Dale De'crlption
,.
'Im/97
17117/97
II
:'JJi~l/P7
,
--
6,620.938 59.30
Investmenl' RodelllpUonl DIVIdend.
C.plbol Oal""
17.614.00
12,72.1.07
14.'".93
--
Sl6.79
Rale
II." "'" Ih. d.../b ./ ,..h "",,,t"'. p ,.., "'0lI", IltIJ Yfv,
-
AmoUllI Price Share. Share 1IAlaacc
-
.I,72J.J22
UJ.l,U 110.11 62.390 '.71.1,712
7.61..00
1.72.1.07 9.22 29','61 6.0'1.273
4,1'1.93 9.22 .lJO,l.l2 Ull.m
'6.79 9,22 9,413 6.620.9.1'
9.30 6.620.9.1'
i,
,11121/97
'il/31IP7
"
l'
d
ACCOUNT FEATURES H'ff "" 1M ......, .,'.... )101I .-w.. ..r.u.d.'
"
Bo&lnula. BalI.D(O
Red P, MId Cp O,olf\la @ .923.112
Prom .10..32'1.1006
Copllal OIlD $1.316
SborI Tonu c.p OaJu loloWll .471
Loa, Tonu Cop OaJu llolovOII ..."
DIYldOlld RelaVUlaloQI .01.1
BQ,"". BaIaacc
Caplbol
Oalnr
SY'lemaUc
I ave.sllaeal
Plan
H_
Ho..
SyakmaUc
Withdrawal
Plan
l!Jeclroulc
PIIDd.
l'rallSler
Houa
RelaYClII
.
1',0. BOM 11ll, Bolton. M" 01106.1121
1-800-343-2898
A
Evergreen (l\Ul<l~ ~
Sl'ATt:MENT DATE
April I, 1998 10 June 30, 1998
1'0,. I .13
.
QUAR1'ERLV STATEMENT
All AHMED &
SA81HA AIlMED JT TEN
MEDICAL ARTS 8LOO SlE 309
890 POPLAR (JliURCH RD
CAMP lULL, PA 17011.2250
You, /IIIoncloJ "",II., b: LAUVER &. CO INC, 1040 E MARKET Sf, YORK. PA 17401.2840
rou, ",prolll/U."" I.: 001 LAUVER
SUMMARV OF FUND V ALVES 1/.,. 0" you, /JI...rm.nlllllt.d by o..oUIll:
Fund - Account Number
Beginning Value
au 4/1/98
Shares 011
6/30/98
Price alA
6/30/98
Market Value Asset
on 6/30/98 Allocaliou
AU AHMBD &:
SABIHA AHMED JT TEN
Tu Free Fund - A
631-8328141006
-------...
$11,104.50 1,441,645 $7,77 $11,201.58 13.7'll>
10.61 70,248.15 86.3
",',:7,77 0,00 0,0
t,,!',"
0.00 0.0
Stratea1c Growth Fund - A
648-8328142006
Tu Free Fuud - B
31-8328142006
I SltalealJ; Growth Fuud - B
48-8328142006
Total Portfolio Value
Fund - Account Number
AU AHMED &:
SABIHA AHMED 11' TEN
Tu Free Fuud - A
631-8328142006
Slralcdc Orowth Fund - A
648-8128142006
Tu Free I'UDd - B
31-8328142006
Slralellc Growth Fund - B
48-83"28142006
Tranaactlon Totals
TRANSAtTlON AtTlVITY
Dale Doacriplion
AU AHMED &:
SABIHA AHMJID 11' TBN
'n'~
o 1
NW/\
QlJARTERLV SfATEMENT
P.O. Bo. 2121, BOMon. MA 01106-1111
1-800-343-2898
All AHMED &
SABIHA AHMED JT TEN
MEDICAL ARTS BLOG STE 309
890 POPLAR CHURCH RD
CAMP fULL, PA 17011.2250
TRANSACfION ACTIVITY, conl/J1u,d
Date
Description
BcglllllIDg BaWlce
Dividend ReIDvlllmenl
Dividend ReIDYCllmenl
Dividend ReIDvellmenl
nndlug Balauce
4/1/98
4/30/98
$/29/98
6/30/98
6/30/98
AU AHMED &
SABIHA AHMED JT TBN
No Account AcltVlly Por Thll Period
6/30/98 Budlug Balauce
AU AHMED &
SABIRA AHMED JT TBN
No Acco\IJI1 Acltvlly I'or Thll Period
6/30/98 I!ndlug Ikllauce
AU AHMED &
SABIRA AHMED JT TBN
61.10/98
ACCOUNT FEA 11JRES IIITu" 11tr!.\
Fund - Account Number
TII Prcc PWld - A
631-8328142006
Stzale&lc Orowlh Pwd . A
648.8328142006
Tu PnlC Pwd - B
31-8328142006
Stzaleglc Orowth PWd - B
48-8328142006
.1:.
~TATEMENT DATE
April I, 1998 to June' 30, 1998
-
=
~
......'
Evergreen Jllmd~'.
Po" 1 01 .f
Rate
"
Amount Price Shares Share Balance
1,42$.482
$41.98 $7.69 '.459 1,430.941
41.30 7.78 '.308 1,436.249
41.93 7.77 '.396 1,441.64'
7,77 1,<<1.64'
Sll'.\e~c Growth ('und . A
64f83~8142(106
,;'t,:-:l';"
to.6l
6,620,938
'-1:.'
"\',,'
.t)\i:
.000
None
".'
,';!N~
" ':;~.~,~i};~";"':
~ono
"~i!~~~,,'::,"~ ~ ~. ~'.
',I,.
'I '1!oj,'~::;' \',".,'
'nl~
o ,
IilWc
D.c-14-gg 04:14,. FrOl-E V C INSTITUTIONAL SERVICES
o KEYSTONE
INIIIITMINTI
'.0. ...~ 1m, "'fIII. itA OJ/IIII -Jlll
1-100-341-4075
B1T2I01114
T-I48 por/lu Hll
JlIlUary I,
YEAR-TO-DATE STATEMEN1' I
1996 to December' 31, 1996
""" 1.11
1~~olfj~
'or ," IIC...", Q/I
STATE STREET BK AND TR CO CUlT
IRA FBO
ALl AHMED
MEDICAL ARTS SLOG eTE 309
880 POPL^A CHURCH AD
OAMP HILL, PA 17011.2250
r.., /lMNUII M>>lw II: LAUV1!.R ... CO INC, 3040 B MAIlkBT IT, VORIt. FA 17403
r_ ,.,,.._11. ".. 001 LAUV'JlR
MARKlT V ALVB H", b rill ...",'" ~ .1)101I1 _Ill .. 1/''''' .114I ./ rill ,.rlIId:
PIIIld - Accounl Number Share. Price Market Value on 12/31/96
Balanced JlUIld (lC:-1) 933,183 $1\,83 $11,039.55
47-83266D4608
SUMMAltY OF 'l'RANSAcrJONS H,.. II . _r...... 1IUrI""",./tM"m I. or ~r4",,"'~' /rv/ll"'" ,.._.
Fund - AccoUllt Number IllvcahllDIIla ll.edcmpUon. Pivlcl(lncU Capllal Oalb.
IIalue..s 1'11II4 (It-ll
4HJld604608
r ..,.,.- hi. ill", /,"" ",,01 ..Ii.....
1265.31
'4010.
$40104
TRANSACTION ACTIVITY H...... ,''' 11.11/11 .I...it rr'lII6../Il~ for _ ..._ Ihll ~,:
-
Data D..erlplloll Rale AlUC\lnl Price !lb.r", Share Balancc
1/1/" IIotIllalq IIa1aullC 175.U.
1/25/" DivIdend RelIIvealmcnl '.07' ,65.65 'IO.U '.OJ! 181,379
4/25/96 Dlvl'.d '",Ia_lInnl .on 66.10 11,11 5.950 887.329
7/25/96 DlYldcn" Rclllvutmnl .075 66.S5 10.9. 6.0U .93.412
IOInI" DlvldllIl' .0laVOllmenl .075 6",01 11.31 5.9ZJ .",331
10/2&1" Cap Galli IleInvellmlllll .., 40104 !l.ll 35.547 934....
III 1'/96 Redcalpllon Por - 20.00 11.76 . 1,701 933.113
AUlIal TMtoo Pee
12/31/96 Endlll, IlalaDce 11.13 933.183
ACCOUNT FEATVJJ!S He,. .,. .,.. ......'" .,110", )"U "".. .."..ell:
SystclllaUc Sy..lelllaUc BlcclroAic
C3;'tal Inveltment Wllhcll'lw.1 fundi
PUllc! - "CClJUGt Nuraber Dividend. alAI Piau Plan TnDlter
.....oed P1u14 lit-I) RolD...1 Rclavett NODO K_ KOlle
.7-83:1l1604I501
12/14/99 TIIIl 15:10 (TX/RX NO 5634) ~007
Olc-I.-DI 0.11.01
o
FrOl-E V C INSTITUTIONAL SERVices
SITZI01TI.
T-S.! P,OI/IO F-UIJ
KEYSTONE
INVI.rMINTI
',0. bit 1111, ...... MA OIID' -1111
1-100-:147-4075
YIAR-TO-DATJi: STATiMP.NT
Jauuary I, 19116 to DDCeIQber' 31, Iii" B
,.,. hfJ
1i~om/lfN.
,,, I- '8@Mf!I
STATE irfll!l!T Bt< AND TR 00 OU9T
IRA FB
All AlfMeD
MEDIOAL ARTS BLOO llTF. 309
8'0 POPLAR OHURCH RD
CAMP HrL~, PA 17011-2250
r..". IN.dll till,.., 11.' LAUVER <It co IHe, 1040 II MAaXJlT ST. YOllk, '1\ 17402
roo, ,.,,.,,ltJfIIlH I" 001 LAt1VIIa
MA.RKIT VALVE H,,. b ,.. "mlll .... '1}ItJIU ..,_ " .1 1M 'M '/1" ,.,114:
l'lInd - Accourrt Number
51ralo.le Orowth Fund (K.2)
41.132660<4601
Share.
1,329.021
Price
~rk.t ValllCl Oil 12/31/96
$10,731.411
$8.08
Pund - AeCOUllt Number
SUMMARY OP TRANSA(''TIONS HI" ,. , )/0".,.."",. ...._, qf othIlIJ.III', " ".,10", /1'0.. )/0" .._It/..
"lrr
SlrlIloIlc OraWlh JIuad (1t-2)
4'.U211eu.t*,.
r",..,...,. '''''If ,_ .."", "'N'
r._r.."",. I.., ,"'" .."", ,.,.,:
lnVD~llllDnll RedemplloDS Dividendi Capital Oaln.
$1.11S.42
$1I7.U
51,107.5'
TRANSACTION ACTIVI'IY H.""",. "".111 "'"A r_loo /Or 1U/Ir 114..,,0' 'Air 10/11:
Dalo Deaerlplloll RIta Amounl Prica
III/'ll Bcaluln& BaIwc
lIIl'/'lI C.,11aI o.u, $1.04 $1.225.42
SIlwl TlQID Cap O'ln ItcJuYClI .10 117.83 $1.13
Lon, Tam Cap Olin IlolnYDII .'4 1.107," 1.13
12/31/" 111l411l1 lala.nco '.0'
-
Sher.. Sl&ata Ballbet
1.178.1'3
I....'J
nUl'
1.192.716
U2'.021
1,32',011
ACCOUNT FEATVRBS H.", _ 1M ..~...'" aptlo..)Iofi.... ""'.'N,'
1'1I/Id - Accoullt Number
Dlvt~Dda
Capita.
aalns
SYlttJmaUc
IIIVCllIllanl
Plln
Sy.l_tic
Wlthdra....l
1'111I
""-
BloclrDJUC
JIwId.
TUlIJfor
H...
SIr1lleJic (fl....u. fI...cl (X-2)
41-112'104'0'
ROlli_I
aolnVWI
Haaa
12/14199 TIIIl 15:10 [TX/RX NO 88341 !jDOOI
Dac-la-II Dill'"
O.
FrGl-& V C IHSTITUTIOHAL SERVICES
81r2lDI114
r-r4D PWo4 F-m
KEYSTONE
, "." . . T M I II T'
',0, 1..1111, ....M, IIA 11I11>> -1/1/
1-100-347-"071
YIAR-TO-DATE STATEMENT !ffi
luUlry I, 1'116 10 December 3S~ 1"6' Iii!
""/~I
1&':.Wj~8fR'
,., r40 _ oJ
STATE STREET PK AND TA CO CUST
IRA rao
All AH~ED
MEDICA ARTS SLOG aTE 308
890 PO LAA CHURCH RD
C~P HILL, PA 17011-2250
1'11II' /1M".'" rill,,,., /&. LAUvaR .. CO INC, 10040 It MAlIC!!T ST. YOlK, 'A /7401
r_ ,.,_IIIMtH "" 001 l,AUVJlR
M4RXBT VALVa H"", II rM "',.,11I .. 0/ _ 0_11I .. 0/ 1M .~ ./,40 ,.1104:
PWIlI . AccoUlIt Numbot Shu.. Price Markel Value aD
,Mld-C.p Orowth Puod (5-3)
SO-. U660460.
166.441
$8.~9
12/31/96
Sl,otAUI
---
SVMMA1tY OF TRANSAC1'IONS N.,. II . _roo", -JI 0/ rIII~'101/l ,. IK ",."",... ~ _ _011//1:
Pund - AecoUIII Number Invallments Redemptions D.lvldelllU Capilli OalllJ
Mld~wtIa had (1-3)
SO-131 a
'1'_,.... ,,,.,, "'/II MI''''''~
'1'_,..... 10", ,."" ..",'" .......
$147.17
$70.20
$7U7
'I1lANSAC1'ION ACTIVITY H...... 140 ~."'" ~... IrIllU''''''~ for _ _OI""lhll /IW':
-
Oate O"ollpllon Rate AmDUIIl Price Sbaz.. Share Balance
1/1116 leJiualaa 1IaIaa.. 149.367
II/26tH C.pllal OIJll S.1I9 S147.17
n.., rorm Cap CJalp lDiIlvoA .47 70.10 ".66 8.106 157.47J
Lalla 'hr. Cap Galli RolaYWI .S2 77.61 8.66 ..,69 1"-<<2
121311" Budlal lIAla/rc.e ..69 1"-441
ACCOUNT FEATURES N", .... 'M "~OII" ",rlo/ll )!OIl .... ""''''.,
Syatemallc S~IlIlJll'lIc BleclroDlc
Capllal Investmcat W thdrawal PuodJ
' PUDeI - Account Number Dlvldellds Oaillll PlaD Plan Trllllfcr
NId~oWlll P.ad (5--3) lleIu_t lDlllvort N""" N_ If...
~J 608
12/20/99 MON 13:20 ITX/IU NO 56991 1Q004
Daa-14-11 04.14P1 Fr..-E Y C IHITITUTIONAL SERYICES
U KEYSTONE
'N,V II TMI III T I
#'.0, ... 1111, ....... itA 1Il10f -IJl1
1-100-347-4015
81TZ IDZTl4
T-UI P 01/10 F-iII
YEAR-TO-DATI STATEMENT ii,
J.nIWY 1, 1996 to Docember 31. 1 he ll!l
"''' I ./1
1ir:.m6~B.'
fTA~ 'Re'! 81< AND TR co OUST
lRA'~80
ALl AHMED
MEDICAL ARTS BLlX'l STE 309
B90 POPLAR OHURCH RD
CAMP HILL, PA 17011-2250
rw j/Itw/ll ... ",. LAtlVD II. co I"C, JOo4O Jl MIlUBT st, YOltlC. PA 17402
y.., ,."....,,1>1 ",. 001 LAUVllR
MARKET V ALUI H." b ,.. ........ ..... .1 _ ......., .. '/'" .101 ./... "",..
1'llIId - Accollllt Number Sbares I'rlo=
Small Call1p&llY Orowth PlIIld (5-,4)
51-832660461:01
618.840
$8.42
~rk.l VIlu. 011 12/H/96
$5,210.63
SUMMARY OF' TRANSACTIONS II.", II . ,._,,..,,.,. ..."""',,, _laU.loIII I. Of ~""Ioo' }t.", _ .......:
PlIIld - ACCOUllt Number
InvestmOllt. Redemplloll' Divldll1d1 Capital Oahu
IIaall eo....y Ormlt. Fuld (1-4)
51-IU6604flOl
y__...d... 100' to.... ..",oJ ,,1M:
,56l.23
"63.23
TRANSACTION ACTIVITY H... Off ," tI.,oI/I .,...h ,.._<I.. /0> _ ..,,11/III r/tb _:
Dal. D,'trlptioD Rato ADIollll1 PrIce Sbat... !lbare Salallo,
111/96 1o&iMIDI llllanllCl U2.1I6
6/1li/9li Clip Ualll Rellly..IIn....1 S1.Dl $563.13 'U5 66,6'4 liJl.I40
l2/31/'li IIIIdlll. Balan... '.42 611.840
i
ACCOUNT FEATUlUIS H,,,, .,. 1M ........ ..,11... ,.. M'" ../11..-..
Sy.teJ1lallr. 5rutolllallC Blcclrolllc
Capital Inve.tme..t W thclrawal Pundl
I'UIld - A~coUllt Number Dlvldenda a.tlli Plan Plan TraDlfer
Stuall COlIl"'r Growth JIIIad (5-4) Rein"" RelnVOf! 1'1011. NOIII "-
JI.8U660460
12/14/09 TUIl 18:10 /TX/RX NO 68341 laiooo
QUARTERLY STATEMENT
P:O. ... 1111, ''''on, M A 01/06-1 W
1 ~800-241-401S
STATE STREET BK AND TR CO CUST
IRA FBO
AU AHMED
MEDICAL ARTS BLDG STE 309
890 POPLAR CHURCH RD
CAMP HILL, PA 17011.2250
A
SfATEMEN1' DATE
April I. 1998 tll June' 30. 1998
Po,. , .14
.11 Ii
I :
Evergreen Punds'"
rOIl' jlMncllll oJ,"" b: LAUVllR &. CO IHe, 2040 B MARKET ST. YORK. PA 17402.2840
rOIl' "1"'''IlI/llI'. It 001 LAUVIlR
SUMMARY OF FUND VALUE.'; II... 0" your In..n'''''III' 1I,I,d b, OCCOUIII:
Fund - Account Number
STATBSTRBBT RK AND TR COCUST
IRA FBO
ALl A.HMllD
lIa....cccI Pwld - A
64 7-832U04608
Stralcalc OroJo'lh Fund - A
648-8326604608
Small ColDpauy Growth - A
651-832U04608
InlcrnallODlI Orowth I'und - A
652-832U04608
BalaDcccI Pwld - B
47-832U04608
Stralcalc Orowtil Fuud - B
48-83~U04608
Small Cclm~y Growlh - B
51-8326G04608
In\Clllllloua1 Otowu. I'und - B
52-832U04608
Total PortfoUo Value
STATBSTRBBT UK AND TR CO CUST
IRAFBO
ALl AlIMllD
lIa....cccI Pwld - A
647-13166046C'8
y"".. To- D<I/. SlIM T."" CIlP'oJ OolM:
Y""..To-DoI. Lolli T."" Cop.1Il Oollu:
Slralcllc OrowUr I'und - A
648-8126604608
Small Cc!Dlpauy Orowlh - A
651-8326604608
Beginning Value
on 4/1/98
Share. on rrlc~ on
6/30/98 6/30/98
$14,084.66
1.104.537
$12.90
17,916.39
1,701.462
, 10.61
6.45U7
.- "'.,;',-,
'736.720 8.09
, "\
3,9JP."5
ci,i;t\.-
481.608
;
8.56
"" "- i ',_'
,'.,:',.Ci
",;--','.!:\-',' ')".;
:0;00 ',"'( < '0.000
d.!' !f,"'"
, '. L '"-: '-' ,,~ .,' ' . -- ' , ,,',-,'
:'lllw '!',,:;O,~ ''',,, , ,i0;58
,l~~':';':\;"'::~:(~\~' \~:~
:\~~~t~"'\"'i('t'~~;~~~!:~ \~;s, '
12.92
.- "
,
..19,78 " . , ''.';''
,l4',A)J,:;:,H' "i ',':\'~I/, '
,::"~:":""~;,{t,:;i::,r~,<',, ,,' "
, "'lI'" 'l"I,~",f(;..}"" 'l\~'''''\ "'" ~/"'l' ,,'
, ., ':\'lMr~':~:1f~?~?~;~~:'~l:~:~,'~)~~ i.'" ,":':;,!~!{~,~,:(;': ,;.J .'(,f' 1~
,;, ,rJ!"~':r~?f.:":',v.i\'~r\t"'f.i'<~i~i\J";W
Market Value Allet
on 6/30/98 Alloclltlon
__0_0-
$14,248.53 33.6J>
18.052,51 42.7
5,960.06 14.0
4,122.56 9.7
0.00 0.0
'0.00 0.0
0,00 0.0
!",'
0,00 0.0
, - .'[
~~ ioo.o 'Y.
$161.65
$173.79
2395
04
9571
Dlc-14-18 D4111P1
o
FrOl"E V C INITITUTIDNAL SERVICES
8112101114
Noll P,o!/IO HI!
KEYSTONE
INVlaTMINTa
r.o. .... 1111. ..".., M A 01111lS - JIll
1.'OO-241-~015
YlAa-TO-DATE Sl'ATBMBNT
)'Olllry I, 111116 to December st. 1996 i
"'..1'11
~~~m6~B.
for ,.. .cen. lit
STAT~ STREET ilK AND TR CO CUST
IRA 110
BAB I fA AHMED
MEDICAL ARTB BLDO STE 909
leD POPLAR CHUROH RD
CAMP HILL. PA 17011-2250
r_ /IM"../Avlw /r: LAWBll A CO IMC, Z040 11 MAJtUT /IT, yoU, PA 17402
y_ ,."....,..IN /&. 001 LAUVBll
MAIUCIT V ALVI H,,,, /I'" """'., ,1Iw " 1W' ..COII,,' " .f'M ,u .f," ,.,/Id.'
PUIIlI - Accoullt N\IIIIber Shares Price Market ValUe 011 12/31/96
--
Balaoced I'IlIId (K-J) 352.102 $11.83 $4.165.37
47-8326604001
SUMM.AJlY 0' TIl4NSACl'IONS H.,. b . _'0-11... "'"".." '181111''''' /. ,., "...,,.,., }I'o", II<<" "c.."':
Puod - AccolI!Il N\IIIIber
10velllDoDt. R.cdnmptlolls DIVlclcllds Capital 0.111'
$100.41 'U2.U
$152,15
Jalallcod PlIIld (K-Il
47-13Z66\141J01
r..,..r..Ul, /mI, rmll "'U/ ",/Ju'
TIlANSACTlON ACTIVITY H,,..,.,/II 111,,11, .j' ,.d ,,,."'",,. ,., )/01/' ....,111/ lAb lfIIM
Date Descrlpllan Rate Amoullt Price Share. Sharo BalaDce
I/I/te Ica:\nlllu. BalaDce 331..164
1/25/96 DM_II Il.olb'lDl1lu8ll1 $.075 524.14 110." :U89 333.553
4/25/'6 1IlYl4olnd lo",.oatmal .075 25.02 !l.1l 2.252 335.'05
7/2J/,6 J:llYl4end lI,iIlY.."""", .07J 21.1' 10.'4 2.303 331.10'
/0/21/'6 J:llYldlll/d Il.olnYllllmlDll .075 ZU6 11.31 :!..24Z 340.UO
10/21/96 Cap Oalla Il.olb'lDl1luOllI .45 152.15 1l.J1 IM53 353.803
11/15/16 IledDlllpUeu Por - 20.00 11.76 - 1.701 352.102
Allllllll Trullole F.
12/31196 BIldllll Ba\aItQI 11,83 352.102
ACCOUNT FEATURES H.,. .,. ,M ...e.,.", '1"/0//1 _ h.., ,./rClod.'
S)'Jtemalic S~lemallC Electronic
CCl:I,al I nv"tm.DI W Ihdrawal Pl/l1da
PuJld . AccOUbl Numh<:r Dividends Mill PIIlD Plao Truder
BalaDcc4 P\rud (11:-1) ll.oill'..1 lI.iIlYelI NOlle NollOl Nona
47-1326llO4OOl
12/14/"" TI1Il 15:10 [TX/RX NO 56341 filI003
D.o-14-88 04.liOl FrOl.E Y C INSTITUTIONAL SE~YICES
o KEYSTONE
1IIIIIITMeNY.
;,0. .., 1111, ..../1, iliA OliN -1111
1-.00-24''''~075
8171101114
T-U8 PU/IO Hll
Yl411-TO-DATE STADMlNT il!
JanUAry I. 11196 IQ Docembor' 31. 111'6 jjJj
"..1011
'1i~on~dBfillrf
", 'lIIlIf'~ II
STATE sTREET BK AND TR CO CUST
IRA FIIO
SABlHA AHMf:O
,Mf:DICAL ARTS SLOG SrE 309
"0 POPLAR CHUROH RD
CAMP HILL, PA 17011.2250
r_ ~",,,'Illolro' llILiWVSa . co lice. ~ ! MAIUCIlT 'T, YORK. PIt. 174O~
r_ ",,,.,,IIUl/wl /iI,' 001 LA\1V!lR
MAItUT V..\LUi N.,. " 111I _'" otrlw 01,.", .,.,_ .. 0/ rAo ,~ '1'11I ",1otI:
P\IIuI - Account NUlllber
Slrale,lc Growlh Fund (K-2)
48-8326604001
SbarM
4.47.87'
Price
Marbt Vallie un 12/31/'6
53,611.13
$8.08
SUMMARY OF TRANSACI'XONS H,,,, b . 1111I"1"""'" "''''''''''')1 .I/IM,,,/U ,. ., "ohcllo/U /r>J/fI 1fIII' '''""III'
Fund - AeeollAt Numlm
Inve.IDlCDII Redempllonl Dividendi Capital OtinJ
1412.9'
U'.71
SJ7U5
Slrate.1c 0IaWtlI Pulld (X-2)
41-U2'f04001
r..,..,.."." ./wI! ,.",. ..,.111 .."".
r_,..", 1<1., ,.,... ,.,.111I ,.iII>:
TRA.NSACl'lON ACI'XVITY H,,,,,,,. 1M d.,,1lt .1 ",h ''''IUtIcIIo. '" ,.", _""III ,All }IIIII.'
Sbarer Sbare SallDco
3J7.010
4.884 401.'64
45.911 447.875
447.175
Dalo Description Rale Amounl Price
1/1/" Bo.llllllJl, IIlIn..
11/26/96 O'Plltl Oalo $1.04 $4U.96
'11011 Torm Cap ow. Ilelllveal .10 ]9.71 SI.U
Lcll, TCI1II Cap Oalu RolAVed .94 373,2' 1.13
12111/" 1111,"", Jalali.. 1.01
ACCOUNT FEA11JRllS H,,,,,","" "'...., ."".. ,.., M" .lrcI,d:
PUIld - Account Number
SIlalelill Orowlll F....d Ue-2)
41-'3211604001
Dividend.
1leluVW'
Capllal
Gains
Rclaveil
S)IIltcmatic
Il\vOIlmont
1'111I
Sy.IOlllatlc
Withdrawal
PIIII
"'-
BloclrOlllc
Pvl\ch
Trllllfor
"'IDle
N_
12/14/99 TlIE 15:10 [TI/Hl NO 58341 ~OO.
Die-ZO-gg 021ZIPI
o
Frat-E V C INSTITUTIONAL SERVICES
II1ZI01714
T-740 P,Ol/04 F-ZBI
KEYSTONE
IIIVIIT.IIITI
",i. ...lW, ..II.... "" OlIDl -1m
1-100-247-4075
n.u-TO-DATE STATEMENT
Juuary I, 1996 10 DoCOlllbor ) I, 19\16 iJ!j
,." I .n
1&r;,o~1
,,, IAII'!_ .J
STAlE sTREET B~ AND TR CO CUST
IRA FBO
SHIHA AHMED
ME IOAL ARTS SLOG STE 309
88 POPtAR CHURCH RD
CAMP HI l, PA 17011-2250
hIP' """..WIlIIY., II: LAUVBI .. co INC, 2040 II M& D'CIIT ST. YORlt. 'A 17402
r_ ,."...",.1H /&' 001 LAUvaJl
MARKJ!T VALUE H.", II ,''' _III ..... 0/ ,..., ......'" Of .f ,110 1M ./,.. JIUW'
PII1I4 - AoooIIIII NWII'" Sbue. Price Markel V.lllO 011
12/31/96
$1,3111.03
Mid-Cap Growth FUM (5.3)
'0-U26604001
151.787
$8.69
SUMMARY OF TRANSAl.TIONS s- " " _I~*" __.I' ./IIIId...., I. ., ......... -"'III __ """"""':
P\lll4 - ACCClUl11 Number IDveslmenla RedemptioDl DIYlcIond. Capita! 0.1/11
-----.
$1)4.85
Mld-Cap Orowtl> P1wd (5-1)
>>-1326404001
r__'.... '1loII'.,,,, ..,.11.......
r_...i.. 10".,.,,,, "",W 1/1111I:
564.02
S70.13
'lUN'SAtTJON AC1'IVITY H... "'" ," ~0I.111 ./NCA ''''_OI''ft /tw )OlU ru:...... 'All )IHr.
SbarCl Sbuo Balance
116.215
7.393 ,\43060.
'.179 UI.7&7
UI.7'7
Oalo Ooaerlpllon Rale AmoUIII Price
1/1/96 8o&iDalIIIIla1auoe
11/26/96 Capital OIID $.99 $134.15
Sh/llt Term o.p Oalll Jlo1I_t .47 64.02 SU6
Loal Twm Cap 0abI Relaveol .52 70,13 8.66
12/31/96 1!Il.u", BalaIlcc 1.69
ACCOUNT FEATURES 8m." rM _III .".... J/f1M .,. ""011/1.'
Fund - Account Number
~:
Systemalic
IDvcslmODI
Plait
BloclTonlc
Pundl
Tranater
S)IIltePleUe
Wlthdr.we!
Plan
Hoae
Dividendi
aoJuVClt
N1d~O:IIIIII PulId (5-1)
5Q.t) I
RoluVNt
N_
H_
12120/90 MON 13'20 [TX/RX NO 5800) ~OOJ
D,c-14-gg D4:13"
o
FrOl-E V C INSTITUTIONAL SERVICES
81TZIOZTI4
T-848 P,0611D F-g13
KEYSTONE
I N V . * T M . NT'
r.o. '" 1111, ~.", IIA fllll11l -1111
1-100-247-4015
YEAR-TO-DATB STATEMENT
January I, 1996 10 Dccombci 31, 1~1I6 i
Ill" I 1/1
~i~oi~L''rf
For 1/11 _III.. .t
STATE gTREET Sf( AND TA co CUST
l~I~ AHMED
MEDICAL ARTS BLOQ STE 30&
8ao POPLAR CHURCH RD
CAMP HILL. PA 17011-2250
r_ ...".iIII/IIh"", IJ: LAUVEJ. .... co 1"0. 2040 B MAJUCBT ST, YOlK, PA 11401
r..,II"".roIMIH I,: UOI l-AUV1lR
MARKET VALUE H.", 111M CIIIN/II VI_ ./ )IW ."._ " '/1/141 ,," ./ r40 period:
-
Fund - ACCOUDt NU1l1bet SbarCJ Price Market VIlUe on 12/31/96
Small CoPlPQY Ol'owth Fund (S.4)
'1-13~6604001
363.611
$8.42
13.061.60
SUMMARY OF TRANSAcrIONS H.", Ir . IIflr-I...Mt. 11I_')/ ./ IIM*... ,. .. d....leru """ j!IlII' _'
FUDd . Accounl Number
I nVestmenll Rodcmplloni Dlvldcudl C,pllal aallll
$Jlo.94
UIM4
SIIIalI Campa)' orawlh 'lI1'\t (5-41
'1-1126604001
r_r.... "'" '''''' ""tel ,.iIu:
TRANSACfION ACI'IVITY H.,. "'" Ilw r/IJt,1lt I/'''''~ ''''~ll'':lloll JO, )101II 1"_ '~Ir )IIIUo'
Dale DelcrlpllllD Rata AmOUDt Price Sharel Share Balance
111190 S.1lUUli lIaJIIIco 334.447
6/a6l96 c.p <>am .lblY.~1 '1.01 $ 330,94 $1.45 3t.l64 363.611
12/31196 IlMbl. lIa3aIlce U1 363.611
ACCOUNT FlAnJRBS H.", .re rlw IICC""" 0,,1tHv JIll' lw.. ,,"~d.'
Systematic S~lt_atlc 81aclromc
C~ilal Investment W theIr,,..al PundI
Pund '. Account NUIlIber DIVIdends DID' Plan Plan Traufcr
Small Com,.y Orowlll I'uIId (9...1 aeiD_l RelllY..l Moue M_ N_
'I-U366040ll1
12/14/99 TIII,15:10 ITX/RX NO 56341 liIIoos
QUARTERLY STATEMENT
A
.
STATEMENT DAT\t
April I, 1998 to June 30, 1998
h,. 4 0/4
-
'.0. B.. 2111. BOIIOft. MA 021~2m
t -800-147 -4015
Evergreen Jlund~'.
STATE STREET BK AND TR .00 CUST
IRA FBO
SABIHA AHMED
MEDICAL ARTS BLDG STE 309
890 POPLAR CtJURCH RD
CAMP HILL, PA 17011.2250
ACCOUNT FEA TlJRES . CDlllbwfd
Electronic
Funds
Tr.Dlfer
Pund . Account Number
Dividends
Capital
Oalns
Systematic
Investment
Plan
Systematic
Wl\hdrawal
Plan
smaU Company Orowth - B
, 1-8326/lO.4OO I
ReIDvClI
RelDveal
None
None
None
In\cmlUoaal Orowlh Pnod - B
,2-83261i04OO1
ReIDvesl
RelDveal
None
None
None
;:::!:.i\;,,::;::J.':; "
,'~,.', (""}',i\e ,,.e,
"(' ,:t:'i)'/ :"'~;':"';'\I~'li';:'.lil\'l,
,'\,;;:41,,:,' ';hi 1.'l,jjr.'f~~(
~~'~C~."Li. '~;,~.~,]..ij,\;):IJ"'--j
";~;~:;!b~J},(':iti ;~:,', :,i~;,!';,
~\Ii1I~,"('-,i!~,j .;, -' ,.I'~r.
<..."\~t',."->'\I' I;"[j
,fj"\i;V)'I,~". l.u:I;!, )",L ~"
~\; ", .,' , ,"
i;,',' 'r'
','
:'
FISCHER FINA'NCIAL SERVICES, INC,
200 Norlh Third Street
Suite 1400
Harrisburg, PA 17101.2055
Portfolio Hololngs
As of 12/02/98
12/01/96 Prices
All AHMED, MD M,P, PENSION ACCT#: 179-109800
ALl AHMED, M,D.
838 KIEHL DRIVE
LEMOYNE, PA 17043
Description
Equities
AMERICAN EXPRESS COMPANY
AT&T CORP
AUTOLlV
BANKAMERICA
CAMPBELL SOUP
CITIGROUP, INC.
COCA COLA
CORNING INC,
GENERAL ELECTRIC
GillETTE
HOME DEPOT
INTEL
lUCENT TECHNOLOGIES
MBNA CORP
MERCK&CO
MICROSOFT CORP
PARKER HANNIFIN CORP
PFIZER
RITE AID
SUN MICROSYSTEMS
TEXACO INC.
UNITED TECHNOLOGY
WAl-MART
December 2,1998
Mutual Funds
FIDELITY GOVT. SECURITIES
FIDELITY INTER TERM BOND
VANGUARD SHORT TERM BOND
Cash, Money Funds and Margin
CASH
FCASH
~uantlty
Qurrent Valut
100,000
175.000
275,000
169.000
150,000
187.000
150.000
225.000
100,000
200.000
300,000
100.000
150,000
450.000
100,000
125.000
175.000
100.000
250.000
100,000
150.000
125,000
175.000
9,937.50
10,871.88
9,762.50
10,995.56
8,58750
9,350.00
10,481.25
9,112,50
9,112.50
8,800,00
15,243.75
11,500.00
13,275.00
10,321.88
15,700.00
16,187.50
5,982.81
11,100.00
111,625,00
17,993.75
I
/3,521,88
13,304.69
13,103.13
250,870.58
56,722.11
54,662,60
53,970.33
165,355.04
22,282.61
43,544.56
65,827,17
482,052.79
5544.683
5307.049
4965.072
WHILE FISCHER FINANCIAL SERVICES, INC. , MAKES EVERY EFFORT TO
ENSURE THE VERACITY OF THIS REPORT, WE MAKE NO GUARANTEE OF ITS
ACCURACY.
December 2, 1998
All AHMED, MD M,P, PENSION AceTN, 179.109800
All AHMED, M,D,
838 KIEHL DRIVE
LEMOYNE, PA 17043
, ,
FISCHER FINANCIAL SERVICES, INC,
200 North Third St_,
sun. 1400
Harrl.bu/l1, PA 17101.2055
C.pll.1 Flowl Ind VIlu.tlona
From 1./311961012/31198
Q2mmtIll
I!III MIIYJlx Quantity I.v.m!l2l l2!D.2l!l WlthdrllW!! OllcrlDlll:ln
02/O8lll7 Depoell 30,000,00 CASH
04/28/97 Depoelt 329,71 CASH
05n8/97 D.poell 329,70 CASH
06118/97 Depoell 329,70 CASH
01100I96 Depoelt 754,41 CASH
01108198 Depoelt 30,000,00 CASH
02/02198 Depoelt 243.37 CASH
03117198 Depoelt 435,88 CASH
03117198 Depoell 435,86 CASH
05101198 Depoelt 438,39 CASH
06I11l198 [lepoelt 715,29 CASH
06I3OI9ll Wllt1drowal (36,000,00) CASH
64,012,33 (36,000,00)
CONTRIBUTION
WCNF ASSOCIATES
WCNF ASSOCIATES
WCNF ASSOCIATES
WCNF ASSOCIATES
1997 CONTRIBUTION
WONF ASSOCIATES
WCNF ASSOCIATES
WCN~ ASSOCIATES
WCNF ASSOCIATES
WCNF ASSOCIATES
OVERFUNDING WITHDRAW
WHILE FISCHER FINANCIAL SERVICES, INO, . MAKES EVERY EFFORT TO ENSURE THE VERACI7Y OF THIS REPORT. WI! MAKE NO GIJARANT!E OF
ACCURACY,
DAUPHIN DEPOSIT BANK AND TRUST COMPANY
~l,",I~r I'Dle
, ,
NUMBER: __ 814082~,391.,_____
TVPE:
822
CERTIFICATE OF DEPOSIT ACCOUNT INFORMATION
OS/28/97
DATE:
AMOUNT $ ____~~OOO,20 ____._
OWNIRIII i II,KI AMr'N,Clly, 11d., r. 1,,.,.,.,IDIfilrlIIMt;-- 6IIr ,...... ......,.
..- 038 KIEHL DR 490.74.9603 7/10/34 71'/.701.4188
ALl AHMED MD 717.737.7383
,_. 8E~P'IMI'I.OVED LEMOYNE PA 1'/043
'-
1,-
I-
I_
I.....,
DTHIR IIONIRS
.....
1_.
.....
,-
.....
,_.
.....
,-,
TfRM
22
MONTHS
EMPlOYEE N
CODl
OTHER ACCOUNt
MA~UR~Y
DAn
03/28/99
CLASS 01
COOl
INIYIAL
!NltREST RAlI
6.840
FREOUENCY . ~
OF PAYMENT /1;111
INTEREST OISTRIBUTION
IIETHOO
CAPITALIZED
C
RENEWABLE
STATUS
A
AUTOMA TICALL V RENEWABLE
PUBLIC FUND N
CODE
NOT A PUBLIC FUNDS ACCOUNT
'fRUST OEPOS~
COOE
NO
CORRESPOHOENT N
BANK COOE
NOT A CORRESPONDENT BANK ACCOUNT
Per.on.t
IV .lQnk\Q n~1t Account In'ormltlon form. INlI hive opined thl tvp' of Iccount dlllgnl1ed .bov, and '8'" 10 be bt.tund bv the .t,"" Ind conditkm. of thl O.pp,t1
AceG",n. Agr..ment Ind thl link'. .plcl.1 lulll Ind 'lgull,Iunl govltning thl tYJ)1 of IlJeount I/wI hlv, OPIned. IfW, .nknowl.dg. "Cllpt of thl O.pa.lt AceGu"1
AlIil.mont, luet! 'ul., .nd "gul.tlaRI Ind 1h. link" Funds AVIlllblllW PoliCy, Truth In $ilvlngs Act Dllclolur. Stlllmlnt Ind dl.~lo"uf" "Iitlno to ,I.ctfonle fund'
"Inlflfl, If mor. th.n on. plrlon hll Ilgnld 'hi, ~ccount Info'm.tlon 'arm, .tch .OkRawl.dOIl r..dlng Ind .g'..lng to thl terml "lltlng '0 toln. Icoountl In th.
OIP". J,..unt Ag,.ln",nt, l. /1
H '~
SP~OfA~~UiiE""7 ---. --'- SIGNATURE
, ,
\I
Cem!l HIli 011101 014 eOl014 ~~
-'"""""iiWiC'H NAME .NUMIEA -- OFPICER CODE ~
RCIF Tax Certification Code = "Y" ,
Joannl M Ulrloh
PREPARED IV IFIAST & ~AST NAME I
-
~.
g :;;
t, -
,..
I
. .'
~
.~' ....
w
.",...."..' ..~".,..~ .,_....._.... ..... t"...~....'"
ne:./"A/q'1
D Dauphin Deposit Bqn~
DATE
PAGE
10-211-98
1
2603
5U62872
--
All AHHED .t1D
1I58 KIEHL DR
LEHOYNE PA 17043
1 B
CV 16
14
YOU CAN HAKE DEPOSITS AT ANY OF OUR
'ANKS' ATMS. AS OF 11/91, DISCONTINUE
MAKING DEPOSITS AT HAC ATH LOCATIONS.
.
SUMMARY FOR ACCOUNT
61.36287.2
ALl ANHED, HD
UI KIEHL DR
PREVIOUS 'ALANeE 09-23.91
I DEPOSITS AHD CREDITS
I CHECKS AND DE'ITS
CURRENT IALANCE
STA TEHENT END DA TE
VALUE CHECK ING
1,214.'7
7.73
ISI.40
1,091.20
10-23-11'
SOC SEC NUHIER
INTEREST RATE AS OF 10-2~.91
1991 INTEl/EST PAID YTD
ANNUAL PERCeNTAGE YIELD EARNED
490-74-9!l0~
1.15U
11.59
1.1561r
CHECKS P osrED
CNECK . DA TE AHOUNT CH~'CK . DATE AHOUNT CHECK . DA TE AHOUNT
109 10-15 HI. 40
. DEHOTES GAP IN CHECK SEQUENCE NUH'ERS
TOTAL NUH'ER OF CHECK S I TOTAL CHECKS PAID HI. 40
HISCE L L A N E o U S DE. ITS AND CREDITS
DATE AHOUNT DESCRIPTION
20-23 7. 7~ + INTEREST PAVHENT
o A I L V . A L A N C f S U H H A R V
DATE IAL ANCE DATE 'ALANCE DATE 'ALANCE
10-15 1,013.47 10-23 1,091.20
, In ....'" tIIOfI or que.lJon. lXlflOllmlng EieOtronlc Tran.'." or your "TM ..Id, plea.. ..1I1-80IMNYTIME (1.800.2flIl-Io483I,
, For "".lIng Impelred ..",ICe ..111.8000621.2088.
,
..
I 5 ~,
I I li:l",~
I . 'I"'!
N Ii f :I...
.....
11 j ~Ir;
III .....
J ; ;;:
,;
..
I ..
..
..
!\
j
... j~
..
!
II
~ I
I I
s
~
J
~!lf
~~ 1>11
;~
,
~
:::
~
~
...
N ~
~~ ~~
.. d
~l E!
....
"~'....'
w,mVif"';'"
';~:,',.':':e ~,~ ;,/"f~~!~~4.i> \- '.'
~ '. '
.. .,~' '
J/l{' II. '
._\,i_ '.t,' '
ii('~';' '
,'I~~f'
, ,Il~"
, ,.!t,t,,-
11."
\A 'I"
:/(,
',{
,8
,
S
1lI1\1
i .~". ~~!! '
: ~ ~JCi,t I f
,I; ': "'l'~'i H IIi
;1", f, !.' EI ' ii ;
R N I:': IS ~ ~
~ ....~, ..!: I - i! i
!i::'~' : ii ii il
I!l~ I Ii -1"1
r" ~ -' rd.
I:':li~ .! fi ,II;!
i ,_ r ~ ,! -.w e'
iisi " I" '. ~i ,i~ ... ~I~;;
I'ii .. i' i I!! il
.lj' ... . ,'! ~I ,Ill ,!
II!i f II ~ bf ~ . f ~~~ ~g
: ~ ,ii i~ II 1I ..
r !' ,I: flll,i.
.)11 5 Ii J "', Ill'"
i!i\": w,; ,.,,/'
.l~:i' I ',i .,' :'il
,1;::.1 ."..~i::!'!d.i:j..'~"II!I:'
{I : it/Ii','!,,:::. f ~";"
I' 1',' ".,,'1-"" ,'. II '
I;' : :,,!.' " , ' i ~
,I' Ii : lil'~; .
:' ' :,,"
,:!, "f",
Ii
P~e~Wt) Plan AccoWlt Statement
rNC lIank, Cenlnll P,\
P,lmalY .e"'>unt numb.r: 50,0074.a 165
Page I of 1
.
v
..r.... ,.,1." Of/.II'".. t. lO'.aI'...
Number of enclosure.: 3
ALl AHMED M 0
SUSQUEHANNA HILLS
858 KIEHL DR
LEHOVNE PA 17043-1205
tI' For 24.hotlf ollllom.r 181vice or
ou"."t ,at.s: Call 1.800.762.3581
ll!!:I Writ. 10' Customo, S.,vlce
pO Dox 609
Plttsbu'gh PA 15230,9738
S Watoh la, au' n.w E,Mall .dd,e..
VI.lt u. .t www,pncb.nk,oom
Ii] TOOto"nlnal: 1.800.531.1648
.'01 ht'uillg lmp:lul."d dll."ntt onJr
-
Premium Plan
Inter..t Cheoklng Aooo..nt Summary
'-unt numbor: 60.0074,3165
....no. Iqmmary
alglnnlng
balancl
3,513,00
rran..otto" Iqmmary
Chick. paid!
wllhdr,wlll
T.ota' ATM
tr.nSlcllonl
In..r... Iqmmary
AnnUli Perclnt.g,
YI,ld Homed IAPYEI
1.26%
All Ahm.d M 0
3
Pl.... ... the Activity Oot.1I .ectlon la,
O'POllts and Chick. and other Ending .ddltlon.llnlo,matlon,
other addition. dlduellonl balance
3,57 7n.71 3,;1115,92
Averag. monthly Charges
balancl andtfHu
3.,172.29 ,00
Sank card/PaS ACCollnt Inform.lIon TIll.,
trlnsacllnns Isslslancl c.lls IranueUons
0 0 n
PNC Bank MAC Olhtr AAAC A TM O1htr ATM
ATM IranSbOtlons Irlnsacllons trlnnctlons
0 0 0
A. .1 10/28. . total 01 ":I". In Int.,..;
Numbilr of days Avtrnge coll.ct.d Inl.rest E.rn.d ..,n.d thl. Y..",
In Interut period balal1<l1 for APYE lhls plrlnd
30 3,'172.29 3,!\7
o
""vlty D_tall
Dop..... anti Oth.r Atldili.n.
o.w Amount OtlcrlpUon
iO/28 ~.~7 'nte..e.t Payment
Amount
19,50
21.95
I) GIP In check lequence
D.ly ....no. Daten
OIt. B.I.nce
09/29 ~,5t3,OO
10/01 3,0193.56
Th.,. wa, 1 Oopo.lt 0' Oth... AddRlon-
tot,lIng .:1,17.
O..te
paid
10/01
10102
Rlferenc.
number
02954109fJ
02it\8157i
Chick
numb..r
213
Oat,
,..Id
10/26
Rtf.renc.
numb.,
021)5,1900{l
Amount
29,26
Th.r. We,e 3 ch.eks lI,ted totaling .70.71.
Oat.
10/02
10/26
B~lanctl
3,>l71.0t
3.H2,3~
0.11
10/28
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Premium Plan Account Statement
'Ne BalIk, Ceniral PA
'Of tho porlolll O"I"t... to tOII"t...
ALl AHMED M D
SUSQUEHANNA HILLS
858 KIEHL DR
LEMOVNE PA 17045-1205
Itremlum Plan
Woney Mark.t AooolJnt Summary
lOOOunt number: 50.0074.3309
a.glnnlng
bllanct
~7,7117,8~
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0,832,22 1,102.6f1 03,237,38
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trannellon. uslstanclt call. "anuellons
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o
Annuli P,rclnhIO'
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2.67x
Numb.r of days
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Average icolltcltd
balance for APVE
Interut Earn.d
thl.. plrlad
132,38
30
61,077.%
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laCe Amount Description
19/29 498,75 Oopo.lt Rolo..onco No, 027030239
10/05 1,858,87 001'0.11 Rolerenc. No, 027031144
10/13 2.920,11 Depo.1I Rof,'..oncr No, 029088130
10/19 t.422,1I Oeposll Ref....,"'. No, o2724n71f>
10/28 132,38 Int.....t Paym.nt
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858,09
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paid
10/21
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number
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number
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Prlon.,y .ecounl number: 50,0074.3309
Plge 1 of I
Number of enclolur.I: 2
'It For 24.hour cu,I01118' ..,vlce or
cur,onl ,.1.1: C.II'.800.762.3581
, 121:1 Wrllolo: CUllomer Selvlc.
PO Bo. 609
PIII.bu,gh PA 15230,9738
.6i W.'ch 10' our new E.M.II.dd'.11
Villi UI el www.pncb.nk.com
iii TOOlelmln.l: 1.800.531.1648
.'or hurln!!: lml'itlud client. onl)"
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w.. e.rned 1111. y.ar.
There were 5 Oepolltl and Olher Addlllon.
101.lIng ....31,...
Amount
-IH,OO
Oat.
paid
JOlts
R.f.r.ncI
number
0278111112
There were I checko lilted tOlallng
...302....
SABIHA AHMED,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
VR.
NO. 98 - 3217 CIVIL
AL! AHMED,
Defendant
IN DIVORCE
.QlmER OF COURT
AND NOW, this -L2{~ day
of ~A/V11/
off ce by
2002, counsel having advised the Master's
correspondence on August 31, 2000. that the above captioned
case settled, and no agreement having been provided the
Master's office, the appointment of the Master is vacated,
BY THE COUR'I',
CCI
Theresa Barrett Male
Atto~ney for Plaintiff
I
i
I
Sandria L, Me i It on
Attorney for Defendant
P. . ~.~ ~.JI-02
<--<'t''-<> ,'n
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AS 0 F J 0 - (/ - ~ 0 0 '"
CASE# I q ql( - 3 ~ , I
HAS BEEN SCANNED.
ALL EARLIER
FILINGS TO THIS
CASE HAVE BEEN
MICROFILMED.
o
Theresa Barrett Male
Supreme Court # 46439
513 North Second Street
Harrisburg, PA 17101
(717) 233-3220
tbm@tbmesquire.com
Counsel for Plaintiff
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
SABIHA AHMED
Plaintiff
v.
NO. 98-3217
All AHMED
Defendant
CIVIL ACTION - DIVORCE
PLAINTIFF'S MOTION TO WITHDRAW CLAIIM FOR ALIMONY PENDENTE LITE AND
TERMINATE APL ORDER
1. On June 9, 1998, Plaintiff filed a Complaint in Divorce raising economic claims,
including a claim for alimony pendente lite {"a pi").
2. On May 13, 1999, an order was entered directing Defendant to pay Plaintiff apl.
3. Because of changed circumstances since entry of the apl order, Plaintiff wishes
to withdraw her apl claim effective September 30, 2006. A copy of the September 29, 2006
letter to the assigned DRS Hearing Officer requesting this termination is attached as Exhibit 1.
4. Plaintiff also desires to remit the arrearages, if any.
Wherefore, Plaintiff requests the Court to enter an order granting this motion.
L~~
Theresa Barrett Male, Esquire
Supreme Court # 46439
513 North Second Street
Harrisburg, Pennsylvania 17101
(717) 233-3220
Counsel for Plaintiff
Date: October 2,2006
2
Exhibit 1
.
THERESA BARRETT MALE
COUNSELOR AT LAW ANDREA HUDAK DUFFY, ESQUIRE
SUSAN C. ApPLEBY, PARALEGAL
sco@tbmesquire.com
JONATHAN J. MALE, LEGAL ASSISTANT
September 29, 2006
Rickie J. Shadday, Conference Officer
Cumberland County Domestic Relations Office
13 North Hanover Street
Carlisle, PA 17013
Re: Ahmed v. Ahmed (# 3217-98 Civil Term; PACSES # 486100195)
Dear Ms. Shadday:
I represent Sabiha Ahmed, the plaintiff in the above-referenced matter. Effective September
30, 2006, my client is withdrawing her claim for alimony pendente lite and therefore requests
that the order be terminated effective that date. It is my understanding that there are no
a rrea rages.
Please contact me if you have any questions or need any additional information.
Sincerely,
Theresa Barrett Male
TBM/
Cc:
Sandra L. Meilton, Esquire
Sabiha Ahmed
VIA FACSIMILE -No Hard Copy to Follow
513 NORTH SECOND STREET. HARRISBURG. PENNSYLVANIA 17101-1058
TEL: 717-233-3220. FAX: 717-233-6862. WWW.TBMESQUIRE.COM
PROOF OF SERVICE
I hereby certify that I am this day serving a copy of the foregoing document upon the
persons and in the manner indicated below which service satisfies the requirements of Pa.
R.C.P. 440:
Service by first-class mail addressed as follows:
Sandra L. Meilton, Esquire
Tucker Arensberg
111 North Front Street
P. O. Box 889
Harrisburg, PA 17108-0889
Attorneys for Defendant
Rickie J. Shadday, Conference Officer
Cumberland County Domestic Relations Office
13 North Hanover Street
Carlisle, PA 17013
Date: October 2,2006
~bwdLJJu-
Theresa Barrett Male, Esquire
Supreme Court # 46439
513 North Second Street
Harrisburg, Pennsylvania 17101
(717) 233-3220
Counsel for Plaintiff
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In the Court of Common Pleas of CUMBERLAND County, Pennsylvania
DOMESTIC RELATIONS SECTION
SABlHA AHMED ) Docket Number 98-3217 CV
Plaintiff )
vs. ) PACSES Case Number 486100195
ALl AHMED )
Defendant ) Other State ID Number
CONSENT ORDER
AND NOW, to wit, on this
5TH DAY OF OCTOBER, 2006
IT IS HEREBY
ORDERED that the APL order in this case be 0 Vacated or OSuspended or
<i) Terminated without prejudice or 0 Terminated and Vacated,
effective SEPTEMBER 30, 2006 , due to:
THE WRITTEN REQUEST OF THE PETITIONER. THIS CASE IS CLOSED WITH NO BALANCE
DUE TO THE PETITIONER.
XC: PETITIONER AND RESPONDENT
SANDRA L. MEILTON, ESQ
THERESA BARRETT MALE, ESQ.
Consented:
Plaintiff
Attorney /Witness
Defendant
Attorney/Witness
JUDGE
g-, 26D~
Date
Service Type M
Form OE-503
Worker 10 21205
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