HomeMy WebLinkAbout04-0016 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Frederick W. Hauptle
also known asFrederick W. Hauptle. Jr.
Deceased
SociaISecurttyNo 176-18-015~2
The petmon of the undersigned respectfully represents that
Your petitioner(s), who is/are 18 years of age or older an the execulrix
in the last will of the above decedent, dated July 11.
and codicil(s) dated
To
Register of Wills for the
County of Cumberland___
Commonwealth of Pennsylvania
m the
named
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h xs last family or principal residence at 4 Central Street, West Pennsboro Township
Cumberland County~ PA
(hst street, number and munc~pahly)
Decendent, then - 83 .. years of age, died December 16 )L~9 2003 ,
at 4 Central Streett-Newville, PA West Pennsboro Township. Cumberland County
Except as follows, dec~d~fit did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate, was not the vicUm of a killing and was never adjudicated
mcompetent Decedent Oas married to Joan Bush 9m,,pr]o: ~ho d~o~ ~-- ~ch !5. 1997
Decendent at.deat, h owned-p£operty with estimated values as follows
(If domiciled m-Pa ) '-~ : All personal property $ _115,000 ~00
(If not domiciled m Pti ) Personal property in Pennsylvania $
(If not domiciled m Pa ) Personal property in County $
Value of real estate m Pennsylvania $
situated as follows
WHEREFORE, peUt~oner(s) respectfully request(s) the probate of the last wall and codicil(s)
presented herewith and the grant of letters Testamentary
(testamentary, admlmstratlon c t a, admlmstraeon d b n c t a )
theron
4 Central Street
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY, 0 5C~lV~L~ E- ~R~ ~
The petltl6n,_~r(s)fabove-na~e.d swear(s) or affirm(s) that the statemy~ts l~ t~e forego,ng ~t~s~~
true and correct'to the best of the knowledge and behef of petmonerts) ann tnat as personm rcp ~
tauve(s) of~e above decedent petmoner(s) wdl well ~truly admxmster the~s~te accorda~o law
Sworn to or affl~d and subscribed ~ .~~~
~ore me th~s ~ day of ~ ~ ~
Estate of
No.
Frederick W. Hauptle
aka Frederick W. Hauptle, Jr.
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW~s'w/~-/~-J '~Y ' ~ in conmderat~on of the petition on
the reverse m ereof, satx ctory proof having been presented before me,' , ,
IT IS DECREED that the instrument(s) dated July i1, 2000
described there~n be admitted to probate and filed of record as the last wall of ~tle
aka Frederick W_ ~m,pPle, ,Tr,
and Letters Toeva~ntmry
are hereby granted to Patricia M. Hauptle
FEES
S ~-~/~n' C ~t ~c a t es ( )
Richard L. Webh,_r.' Jr,,
126
Sh~ppensburg, PA 17257 , '.
~DD~SS
(717) 532-7388
PHONE
h~s is to certify that the information here g~ven 15 correctly copied from an original ceruficate of death duly filed w~th me as
Local Registrar The original ceruficate will be forwarded to the State V~tal Records Office for permanent fihng
WARNING: It is Illegal to duplicate this copy by photostat or photograph.
Fee for th,s cemficate, $200P 98988S4 ~ ~3t~l~ ~ o ~l,,~c~~Local {]"~, Reg,strar ]
No Date
COMMONWEALTN OF PENNSYLVANIA · OEPARTMEN? Or: HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Frederick
W. Hauptle ~ale ~,176 --18 ~152 ~December 16, 2003
Cumberland est Pennsboro 4 Central St {~.S.~. {~,
{., Twp. {.Ne~v~lle PA 17241 {~-- {,,~ite
Central St
Newville PA 17241
Frederick W. HauDtle
Patrtc~a M. Hauptle
~*,,~ .... 0,,~2/18z2003~ ' '
I~l~ilneI~s1 Home Inc 15 Big Spring Ave
"~ ,r~FD 13895 L
~ O ~1 ~O ~ O I~ 0 ~ Dl~.....,..~m~
LAST WILL AND TESTAMENT
OF
FREDERICK W. HAUPTLE
I, Frederick W. Hauptle, of 4 Central Street, Newville, West Pennsboro Township,
Cumberland County, Pcnnsylvama, bcmg of sound and disposing mind, memory and
understanding, do make, publish and declare this to be my Last Will and Testament, hereby revokmg
and making void all previous Wills and Co&mis heretofore made by mc
1
I direct that my Exccumx, hereinafter named, pay all my just debts, funeral expenses,
expenses of my last dlncss and thc costs of administering my estate which arc not barred by thc
Statute of Limitations or other affirmative defense, as soon as convemcnt after my death In the
event any of thc foregoing expenses have bccn paid by my Executrix, I direct that she shall be
rem~bursed that amount I hereby confirm that I desire that my body be cremated and my ashes bc
burlcd next to thc ashes of my wife, JOAN B HAUPTLE. m a military cemetery, if possible If not
possible, I request that my ashes be buried m the military section of a private cemetery
My daughter, PATRICIA M HAUPTLE, shall receive my military discharge papers and shall
use thc same for the arrangements of my burial
2
I give, dewsc and bequeath my vehmlcs, household and personal effects and other tangible
personal property of like nature, (including all books) together with any existing insurance thereon
unto my daughter, PATRIC1A M HAUPTLE, if she survives me My Department of Veterans
Affmrs Government Life Insurance in the face amount of Five Thousand ($5,000 00) is payable to
my estate and shall be used by the estate for my funeral expenses
1
LAST WILL AND TESTAMENT OF FREDERICK W HAUPTLE
3
I note that my home at 4 Central Street, Newvflle, Cumberland County, Pennsylvanta, ~s
owned by me and my daughter, PATRICIA M HAUPTLE, as Jmnt Tenants w~th Rtght of
Survtvorshtp, and therefore will pass to PATRICIA M HAUPTLE by operation of law
4
I give, demse and bequeath the rest, residue and remainder of my estate, be the same real,
personal and/or mixed as follows
(A) Two Thirds (2/3) to my daughter, PATRICIA M HAUPTLE, and
(B) One Third (1/3) to my daughter, PAMELA B WATKINSON If the satd
PATRICIA M HAUPTLE predeceases me, her share shall be d~stnbuted to
PAMELA B WATKINSON If PAMELA B WATKINSON predeceases me, her
share shall be dtsmbuted to her tssue
Unless otherwise promded for heroin, any ~ncome or princtpal payable to any beneficiary who
IS under the age of twenty-one (21) years shall be dtstrlbuted to my Trustee, hereinafter named, and
shall be held tn trust by my Trustee until such person reaches the age of twenty-one (21) years
While the child is a mtnor, my Trustee ts authorized to expend from tncome or pnnclpal such sum
or sums as may be necessary for the proper care, mamtenance, support and education of such person
d~rectly wtthout the intervention ora guardian or committee, or nay Trustee may pay the same to any
person havtng care or control of said benefictary or with whom the beneficiary resides, w~thout any
duty on the part of my Trustee to supervise or inquire into the apphcation of the funds by any person
to whom payment ts so made
2
LAST WILL AND TESTAMENT OF FREDERICK W HAUPTLE
Any income and principal not so expended by my Trustee shall be retained by my Trustee
to be used for college tuition, room and board, and related educational expenses The residue shall
be paid to the beneficiary upon said beneficiary reaching the age of twenty-one (21) years, or to the
estate of the beneficiary if he or she dies while under the age of twenty-one (21) years
Should the amount remaining in any trust herein provided for become too small, in Trustees
discretion, so as to make continuance of the trust inadvisable, Trustee may make immediate
distribution of the then remaining pnnclpal and any accumulated or undistributed income outright
to the person or persons who are then entitled to the income Upon such termination, the rights of
all persons who might otherwise have an interest as succeeding income beneficiary or in remainder
shall cease
6
I grant my personal representative the following powers in addition to and not in limitation
of such powers as my personal representative shall hold by law.
(a) To retain all property received including the stock of any corporate fiduciary acting
hereunder, provided such property remains productive
(b) To join in any corporation, partnelshlp, recapitalization, merger, reorganization or
voting trust plan, to delegate authority with respect thereto, to deposit investments
under agreements and pay assessments, and generally to exercise all rights of
investors, including but not limited to. the voting of shares
(c) To manage, operate, repair, improve, mortgage or lease on any terms any real estate
held or owned by my estate
(d)To operate any business that I may own at my death
(e) To invest any funds of my estate in any stocks, bonds, notes or other securities or
property, real or personal, without regard to the principle of diversification or any
other statute or general rule of law in his, her or its absolute discretion, it being my
LAST WILL AND TESTAMENT OF FREDERICK W HAUPTLE
(0
(g)
0)
O)
(k)
~ntentton to give my personal representative the broadest ~nvestment powers possible,
providing such investments do not unnecessarily prevent the prompt settlement of my
estate
To sell or otherwise dispose of any property, real or personal, tangible or intangible,
at any time forming a part of my estate in any manner and on such terms and
conditions as my personal representative shall see fit m h~s, her, or its absolute
dtscreUon
To borrow money for the payment of taxes or for any other proper purposes in the
administration of my estate, and to mortgage or pledge estate assets as security
To compromise claims w~thout court approval including, but not hm~ted to, any
controversies with the Umted States of America or the Commonwealth of
Pennsylvama concerning estate and inheritance taxes on any ~nterests that may pass
under this my Last Will and Testament
To distribute in cash or ~n kind upon any d~vlslon or distribution of my estate
To undertake any and all acts deemed necessary and proper by my personal
representative for the proper, advantageous and prompt management of the
settlement of my estate
In general, to exercise all powers ~n the management of my estate which any
tnd~vidual could exercise ~n the management of s~mfiar property owned ~n h~s own
right, upon such terms and conditions as to h~m, her or ~t may seem best and to
execute and dehver all instruments and to do all acts which he, she or ~t deems
necessary or proper to carry out the purposes of this, my Last Will and Testament
No interest of any beneficiary of my estate, either in income or ~n principal, shall be subject
to anticipation or pledge, assignment, sale or transfer ~n any manner, nor shall any beneficiary have
LAST WILL AND TESTAMENT OF FREDERICK W HAUPTLE
the power in any manner to charge or encumber his interest either in income or principal, nor shall
the interest of any beneficiary be liable or subject m any manner while m the possession of my
personal representative for the liability of such beneficiary
8
I nominate, constitute and appmm my daughter, PATRICIA M HAUPTLE, as Executrix of
this my Last Will and Testament If for any reason the said PATRICIA M HAUPTLE is unable or
unwllhng to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and
appoint PAMELA B WATKINSON as personal representative of this my Last Will and Testament
I direct that my Executrix shall be paid the sum of Ten Thousand ($10,000 00) Dollars as an
Executrix Commission I direct that my personal representative shall not be required to give or post
bond for the faithful performance of his, her or its duties in this or any other jurisdiction
9
I nominate, constitute and designate my daughter's husband, ROBERT W WATKINSON,
as and for the Trustee ofany trusts created in this my Last Will and Testament If for any reason the
said ROBERT W WATKINSON is unable or unwilling to so act, then and in that event, I nominate,
constitute and designate my daughter, PATRICIA M HAUPTLE, as and for the substituted Trustee
of any trusts created in this my Last Will and Testament
10
Unless otherwise directed by my Executrix, all Federal, State and other death taxes payable
by reason of my death, with respect to property comprising my gross taxable estate, whether or not
passing under this Will, shall be paid from the principal of nay residuary estate
5
LAST WILL AND TESTAMENT OF FREDERICK W HAUPTLE
IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament
this t~0q day of ~ ,2000
WITNESS
Frederick W. Hauptlc ' ~
/~ (~ ~ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
I, Frederick W. Hauptle, the testator whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament, that I signed it wllhngly, and that I signed
~t as my free and voluntary act for the purposes therein expressed
Frederick W. Haupt e ~ ~
,this .
Swom or affirmed and acknowledged before me by Frederick W. Hauptle, the testator
day of ~ ,2000
Notarial Seal
Teny E W~lker, Notary Public
S~uth UUd~etonl~, Curr~rVu~ County
My Commission ~:xpims Mar 31, 2003
Me.r, Pennsy~ni8 A~OC~t~O~ o~ NO~
6
LAST WILL AND TESTAMENT OF FREDERICK W HAUPTLE
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
WE, /]-; ~,.d/ L- I..,.,~-6~-- 3Jr-. and
l::cn se
witnesses whose names are attached to the foregoing document, being duly qualified according to
law, do depose and say that we were present and saw testator sign and execute the instrument as his
Last Will and Testament, that he signed willingly and that he executed it as his free and voluntary
act for the purposes thereto expressed, that each subscribing w~tness in the hearing and s~ght of the
testator signed the Last Will and Testament as w~tnesses and that to the best of our knowledge the
testator was at the time 18 or more years of age, of sound mind and under no constraint or undue
influence
Sworn or affirmed and subscribed before me by
I"x~l~ L.~C~ this /Iv~'~dayof (~
,2000
Notarial Seal
Te~y E Walker, Notary Public
S~ut~ Mk~leto~Tl~ .Cumt~l~ln~ County
Ivly ~n Ex,ms Ma~ 31, 2003
7
~2
FREDERICK W HAUPTLE, LATE
OF TOWNSHIP OF WEST PENNSBORO,
CUMBERLAND COUNTY, PENNSYLVANIA,
DECEASED
1N THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE NUMBER 21-04-0016
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent Frederick W Hauptle
Date of Death December 16, 2003
Will No 21-04-0016
To the Register
I certify that notice of beneficial interest required by Rule 5 6(a) of theiOrphans
Court Rules was served on or mailed to the following beneficiaries of the above-captioned
estate on January 21, 2004:
Pamela B Watklnson Patncla M Hauptle
1541 Little Conestoga Road 4 Central Street
Glenmore, PA 19343 Newvflle, PA 17241
Notice has now been given to all persons entitled thereto under Rule 5 6(a)
Date. [ ~')'ltl07-~ _~,,/,~
Signature -'--'--~.._~
Name Richard L Webber, Jr, Esquire
Address Welgle & Associates, P C
126 East King Street
Shippensburg, PA 17257
Telephone (717) 532-7388
Capacity Personal Representative
X Counsel for Personal
Representative
JERRY A WEIGLE
Associates
JOSEPH P RUANE
RICHARD L WEBBER~ JR
Of Counsel
THOMAS L BRIGHT
WEIGLE & ASSOCIATES, P.C.
Attorneys-at-Law
126 EAST KING STREET
SH1PPENSBURG, PENNSYLVANIA 17257-1397
TELEPHONE (717) 532-7388 or (717) 776-4295
FAX (717) 532-5289
weiRleassoc~ates~earthhnk net
March 12, 2004
VIA CERTIFIED MAIL 7000 1530 0003 5401 2850
Cumberland County
Register of Wills Office
One Courthouse Square
Carhsle, PA 17013
Dear Ladies and Gentlemen
RE Frederick W Hauptle Estate
No 04-0016
I have enclosed a check in the amount of $7,500 00 for payment of Inheritance Tax at
discount relating to the matter referenced above
Please note the postmark date of March 12, 2004
Please forward a receipt to me at your earliest convenience
Thank you for your attention to this matter
Very truly yo
WEIGLE & ASSOCIATES, P C
Richard L Webber, Jr, Esquire
RLW/paf
Enclosure
cc Patncla M Hauptle, Executrix
WEIGLE & ASSOCIATES, P.C.
Attorneys At Law
126 East Kang Street
Shippensburg, PA 17257-1397
7000 1530 0003 5401 2850
CUMBERLAND COUNTY REGISTER OF WILLS OFFICE
ONE COURTHOUSE SQUARE
CARLISLE, PA 17013
~ COMM(3 EALTH OF PENNSYLVANIA
~D~ARTMENT OF REVENUE
~? BUREAU OF INDIVIDUAL TAXES
NARRISBURG, PA 17 ~ 2B~O601
RECEIVED FROM
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX{1196)
NO. CD 003672
WEBBER RICHARD L JR
126 EAST KING STREET
SHIPPENSBURG, PA 17257
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $7,500 00
E.STATE INFORMATION SSN 176-18-0152
FiLE NUMBER 2104-0016
DECEDENT NAME HAUPTLE FREDERICK W
DATE OF PAYMENT 03/15/2004
POSTMARK DATE 03/12/2004
~(~OUNTY CUMBERLAND
"DATE OF DEATH
IREMARKS
CHECK# 12
12/16/2003
TOTAL AMOUNT PAID'
INITIALS JA
RECEIVED BY'
REGISTER OF WILLS
$7,500 OO
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
JERRY A. WEIGLE
Associates
JOSEPH P. RUANE
RICHARD L. WEBBER, JR.
Of Counsel
THOMAS L. BRIGHT
WEIGLE & ASSOCIATES, P.C.
Attorneys-at-Law
126 EAST KING STREET
SItIPPENSBURG, PENNSYLVANIA 17257-1397
TELEPHONE (717) 532-7388 or (717) 776-4295
FAX (717) 532-5289
weigleassociates~earthlink, net
March 12, 2004
VIA CERTIFIED MAIL 7000 1530 0003 5401 2850
Cumberland County
Register of Wills Office
One Courthouse Square
Carlisle, PA 17013
Dear Ladies and Gentlemen:
discount relating to the matter referenced above.
Please note the postmark date of March 12, 2004.
Please forward a receipt to me at your earliest convenience.
Thank you for your attention to this matter.
Very truly youl:s,
I have enclosed a check in the amount of $7,500.00 for payment of Inheritance Tax at
& ASSOCIATES, EC.
~,ttorneys At Law
East King Street
I lsburg, PA 17257-1397
-h aqtt. h'~.,
C! I ~q ~70,
7000 1530 0003 5401 2850
CUMBERLAND COUNTY REGISTER OF WILLS OFFICE
ONE COURTHOUSE SQUARE
CARLISLE, PA 17013
z
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128~601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Hauptle, Frederick W
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
FILE NUMBER
21
COUNTY CODE
OFFICIAL USE ONLY
04 0016
YEAR NUMBER
SOCIAL SECURITY NUMBER
176-18-0152
THIS RETURN MUST BE FILED IN DUPLICATE INITH THE
12/16/2003 09/22/1920 REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death pdor to 12-13~2)
[]
[]
[]
~ ~ 12-31-91 and 1-1-95}
4AME
Richard L. Webber, .ir. Esquire
4. Limited Estate [] 4a. Future Interest Compromise (date of death after
12-12-82) [] 5. Federal Estate Tax Return Required
6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 0 8. Total Number of Safe Deposit Boxes
of Will) copy of Trust) --
9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11. Election to tax under Sec. 9113(A) (Attach Scfl O)
COMPLETE MAILING ADDRESS
FIRM NAME (If applicable)
Weigle & Associates, P.C.
TELEPHONE NUMBER
717/532~7388
126 East King Street
Shippensburg, PA 17257
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
No ~n~ ~
No~ '
Node
None
77,251.24
None
99,228.77
11,603.65
1,294.88
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
OFFICIAL USE ONLY
(8)
176,480.01
12,898.53
163,581.48
163,581.48
(11)
(12)
(13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2)
x .00 (15)
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
163,581.48
x .045 (15) 7,361.17
x .12 (17)
x .15 (~8)
(19) 7,3 61.17
20. []
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
IScTREET ADDRESS 4 Central Street
ITY Newville
STATE PA z~P 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
7,500.00
368.06
(1)
Total Credits (A + B + C) (2)
7,361.17
7,868.06
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) 0.0 0
4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. (4) 5 0 6.8 9
Check box on Page 1 Line 20 to request a refund
5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
i' i~
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; ..................................................................................
b. retain the right to designate who shall use the property transferred or its income; ....................................
c. retain a reversionary interest; or ........................................................................................
d. receive the promise for fe of either payments, benefits or care? ........................................... ' .....
2.Ifdeath occurred after December 12, 1982, did decedent transfer property within one year of dealh without
receiving adequate cons derat on?
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .......................................... . ....................... [] []
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 perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of
preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT~f{E OF PERSON RESPONS BLE FOR FILING RETURN ADDRESS
Z~]/~/~~~.~Patr' "a . Hau4~tle _
~PONSIBLE FOFYFILING RETURN ADDRESS
SIGNATURE OF PREPARER OTHEI~ THAN REPRESI~NTATIVE ADDRESS
Richard L. Webber, Jr. Esquire
4 Central Street
Newville, PA 17241
DATE
126 East King Street
Shippensburg, PA 17257
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
sun/lying spouse is 3% [72 P.S. §9116 (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. {}9116 (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 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 natural
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 decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116
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 decedent's siblings is 12% [72 P.S. {}9116 (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.
COMMON~_ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT ·
ESTATE OF
Hauptle, Frederick W
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 -04- 0016
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivomhlp must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
Janney Momgomery Scott, LLC Account # 4097-8236
F&M Trust Checking Account #33-27779
Franklin Templeton - 2187.794 units ~ $6.75/unit
1988 Plymouth Sedan Motor Vehicle VIN #1P3BJ36K4JC186836
Miscellaneous Personal Property
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
60,378.86
1,604.77
14,767.61
400.00
100.00
77,251.24
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Hauptle, Frederick W
FILE NUMBER
21 - 04 - 0016
This schedule must be completed and filed if the answer to an, of uestions I thro~
DESCRIPTION OF PROPERTY --
ITEM Include the name of the transferee, their relationship to decedent and the date of transfer. DATE OF DEATH % OF
NUMBER Attach a copy of the deed for real estate. VALUE OF ASSET DECD'S EXCLUSION TAXABLE VALUE
INTEREST 0F APPLICABLE
1 Janney Montgomery Scott, LLC 32,291.27 100% 32,291.27
IRA Account #4097-8337
Transferees:
Pamela B. Watkinson - Daughter
1541 Little Conestoga Road
Glenmore, PA 19343
Date of Transfer - 12/16/03 (DOD)
Patricia M. Hauptle - Daughter
4 Central Street
Newville, PA 17241
Date of Transfer - 12/16/03 (DOD)
2 Real Estate, together with improvements thereon, situate in 133,875.00 50% 66,937.50
West Pennsboro Township, Cumberland County,
Pennsylvania, known as 4 Central Street, Newville, PA
17241, containing 0.42 acres.
Transferee:
Patricia M. Hauptle - Daughter
4 Central Street
! Newville, PA 17241
Date of Transfer - 12/16/03 (DOD)
TOTAL (Also enter on line 7, Recapitulation) 99,228.77
ESTATE OF
COMMONWEAL~-I OF PENNSYLVANIA
INHERiTANCE TAX RETURN
RESIDENT DECEDENT
Hauptle, Frederick W
FILE NUMBER
21 -04-0016
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
FUNERAL EXPENSES:
Egger Funeral Home, Inc.
ADMINISTRATIVE COSTS:
Personal'Representative's Commissions
Patricia M. Hauptle
· of Personal Representative(s):
Street Address 4 Central Street
City Ncwville State PA Zip 17241
Year(s) Commission paid 2004
Attorney's Fees Weigle & Associates, P.C.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Patricia M. Hauptle
Street Address 4 Central Street
City Newville State PA
Relationship of Claimant to Decedent Daughter
Probate Fees Cumberland County Register of Wills
Z~p 17241
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland Law Journal-legal advertisement
The Valley Times-Star - legal advertisement
AMOUNT
955.00
4,000.00
2,500.00
3,500.00
278.00
75.00
83.00
Total of Continuation Schedule(s) 212.65
TOTAL (Also enter on line 9, Recapitulation) 11,603.65
$chadub H
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Hauptle, Frederick W FILE NUMBER
21 04- 0016
3 Cumberland County Register of Wills - Short Certificate 3.00
Cumberland County Register of Wills - filing fee for inheritance tax return
F&M Trust Co. - fee for information
Cohick & Associates - income tax preparation
United States Postal Service
15.00
5.00
176.00
13.65
Page 2 of Schedule H
CObltdONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hauptle, Frederick W
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
FILE NUMBER
21 - 04- 0016
Include unreimbursed medical expenses.
ITEM
NUMBER
1
2
3
4
5
6
7
8
9
10
DESCRIPTION
Hoovers Plumbing & Heating
PP&L - Electric Bill
Sprint - Telephone Bill
Family Home Health Care
Comcast Cablevision
Sprint - Telephone Bill
Newville Water & Sewer Authority
Sprint
Waster Management
Lakeview Home Health Services, Inc.
TOTAL (Also enter on Line 10, Recapitulation)
AMOUNT
362.00
145.76
158.68
39.90
39.80
110.92
155.00
102.91
67.91
112.00
1,294.88
REV.1513 EX+ (g-o0) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hauptle, Frederick W
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 -04- 0016
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Pamela B. Watkinson
1541 Little Conestoga Road
Glenmore, PA 19343
Patricia M. Hauptle
4 Central Street
Newville PA 1741
RELATIONSHIP TO
DECEDENT
~ Do N~tLlsLTrustee(~)
Daughter
Daughter
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
AMOUNTORSHARE
OF ESTATE
$ 41,562.72
$134,917.29
LAST WILL AND TESTAME
OF
FREDERICK W. HAUPTLE
I, Frederick W. Hauptle, of 4 Central Street, Newville, West Pennsboro Township,
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking
and making void all previous Wills and Codicils heretofore made by me.
1
I direct that my Executrix, hereinafter named, pay all my just debts, funeral expenses,
expenses of my last illness and the costs of administering my estate which are not barred by the
Statute of Limitations or other affirmative defense, as soon as convenient after my death. In the
event any of the foregoing expenses have been paid by my Executrix, I direct that she shall be
reimbursed that amount. I hereby confirm that I desire that my body be cremated and my ashes be
buried next to the ashes of my wife, JOAN B. HAUPTLE, in a military cemetery, if possible. If not
possible, I request that my ashes be buried in the military section of a private cemetery.
My daughter, PATRICIA M. HAUPTLE, shall receive my military discharge papers and shall
use the same for the arrangements of my burial.
I give, devise and bequeath my vehicles, household and personal effects and other tangible
personal property of like nature, (including all books) together with any existing insurance thereon
unto my daughter, PATRICIA M HAUPTLE, if she survives me. My Department of Veterans
Affairs Government Life Insurance in the face amount of Five Thousand ($5,000.00) is payable to
nay estate and shall be used by the estate for my funeral expenses.
LAST WILL AND TESTAMENT OF FREDERICK W. HAUPTLE
3
I note that my home at 4 Central Street, Newville, Cumberland County, Pennsylvania, is
owned by me and my daughter, PATRICIA M. HAUPTLE, as Joint Tenants with Right of
Survivorship, and therefore will pass to PATRICIA M. HAUPTLE by operation of law.
4
I give, devise and bequeath the rest, residue and remainder of my estate, be the same real,
personal and/or mixed as follows:
(A) Two Thirds (2/3) to my daughter, PATRICIA M. HAUPTLE; and
(B) One Third (1/3) to my daughter, PAMELA B. WATKINSON. If the said
PATRICIA M. HAUPTLE predeceases me, her share shall be distributed to
PAMELA B. WATKINSON. If PAMELA B. WATKINSON predeceases me, her
share shall be distributed to her issue.
5
Unless otherwise provided for herein, any income or principal payable to any beneficiary who
is under the age of twenty-one (21) years shall be distributed to my Trustee, hereinafter named, and
shall be held in trust by my Trustee until such person reaches the age of twenty-one (21) years.
While the child is a minor, my Trustee is authorized to expend from income or principal such sum
or sums as may be necessary for the proper care, maintenance, support and education of such person
directly without the intervention ora guardian or committee, or my Trustee may pay the same to any
person having care or control of said beneficiary or with whom the beneficiary resides, without any
duty on the part of my Trustee to supervise or inquire into the application of the funds by any person
to whom payment is so made.
LAST WILL AND TESTAMENT OF FREDERICK W. HAUPTLE
Any income and principal not so expended by my Trustee shall be retained by my Trustee
to be used for college tuition, room and board, and related educational expenses. The residue shall
be paid to the beneficiary upon said beneficiary reaching the age of twenty-one (21) years, or to the
estate of the beneficiary if he or she dies while under the age of twenty-one (21) years.
Should the amount remaining in any trust herein provided for become too small, in Trustees
discretion, so as to make continuance of the trust inadvisable, Trustee may make immediate
distribution of the then remaining principal and any accumulated or undistributed income outright
to the person or persons who are then entitled to the income. Upon such termination, the rights of
all persons who might otherwise have an interest as succeeding income beneficiary or in remainder
shall cease.
6
I grant my personal representative the following powers in addition to and not in limitation
of such powers as my personal representative shall hold by law:
(a) To retain all property received including the stock of any corporate fiduciary acting
hereunder, provided such property remains productive.
(b) To join in any corporation, partnership, recapitalization, merger, reorganization or
voting trust plan; to delegate authority with respect thereto; to deposit investments
under agreements and pay assessments; and generally to exercise all rights of
investors, including but not limited to, the voting of shares.
(c) To manage, operate, repair, improve, mortgage or lease on any terms any real estate
held or owned by my estate.
(d)To operate any business that I may own at my death.
(e) To invest any funds of my estate in any stocks, bonds, notes or other securities or
property, real or personal, without regard to the principle of diversification or any
other statute or general rule of law in his, her or its absolute discretion, it being my
LAST WILL AND TESTAMENT OF FREDERICK W. HAUPTLE
(g)
(h)
(i)
(k)
'To undertake any and
representative for the
settlement of my estate.
In general, to exercise
intention to give my personal representative the broadest investment powers possible,
providing such investments do not unnecessarily prevent the prompt settlement of my
estate.
To sell or otherwise dispose of any property, real or personal, tangible or intangible,
at any time forming a part of my estate in any manner and on such terms and
conditions as my personal representative shall see fit in his, her, or its absolute
discretion.
To borrow money for the payment of taxes or for any other proper purposes in the
administration of my estate, and to mortgage or pledge estate assets as security.
To compromise claims without court approval including, but not limited to, any
controversies with the United States of America or the Commonwealth of
Pennsylvania concerning estate and inheritance taxes on any interests that may pass
under this my Last Will and Testament.
To distribute in cash or in kind upon any division or distribution of my estate.
all acts deemed necessary and proper by my personal
proper, advantageous and prompt management of the
all powers in the management of my estate which any
individual could exercise in the management of similar property owned in his own
right, upon such terms and conditions as to him, her or it may seem best and to
execute and deliver all instruments and to do all acts which he, she or it deems
necessary or proper to carry out the purposes of this, my Last Will and Testament.
7
No interest of any beneficiary of my estate, either in income or in principal, shall be subject
to anticipation or pledge, assignment, sale or transfer in any manner, nor shall any beneficiary have
LAST WILL AND TESTAMENT OF FREDERICK W. HAUPTLE
the power in any manner to charge or encumber his interest either in income or principal, nor shall
the interest of any beneficiary be liable or subject in any manner while in the possession of my
personal representative for the liability of such beneficiary.
8
I nominate, constitute and appoint my daughter, PATRICIA M. HAUPTLE, as Executrix of
this my Last Will and Testament. If for any reason the said PATRICIA M. HAUPTLE is unable or
unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and
appoint PAMELA B. WATKINSON as personal representative of this my Last Will and Testament.
I direct that my Executrix shall be paid the sum of Ten Thousand ($10,000.00) Dollars as an
Executrix Commission. I direct that my personal representative shall not be required to give or post
bond for the faithful performance of his, her or its duties in this or any other jurisdiction.
9
I nominate, constitute and designate my daughter's husband, ROBERT W. WATKINSON,
as and for the Trustee of any trusts created in this my Last Will and Testament. If for any reason the
said ROBERT W. WATKINSON is unable or unwilling to so act, then and in that event, I nominate,
constitute and designate my daughter, PATRICIA M. HAUPTLE, as and for the substituted Trustee
of any trusts created in this my Last Will and Testament.
10
Unless otherwise directed by my Executrix, all Federal, State and other death taxes payable
by reason of my death, with respect to property comprising my gross taxable estate, whether or not
passing under this Will, shall be paid from the principal of my residuary estate.
LAST WILL AND TESTAMENT OF FREDERICK W. HAUPTLE
this
IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament
day of ~X,~ , 2000.
WITNESS:
Frederick W. Hauptle" ~
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY OF CUMBERLAND ·
SS.
I, Frederick W. Hauptle, the testator whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly, and that I signed
it as my free and voluntary act for the purposes therein expressed.
Frl~derick W. HaU~tle '
,this
Sworn or affirmed and aclmowledged before me by Frederick W. Hauptle, the testator
]/?'~ day of (~)t~. , 2000.
N~afl~ Seal
Te~ E. Wal~r, No~ Public
~ ~e~n ~xpir~ Mar. 31, 2~3
~r, Pennia ~ti~ ~ N~a~s
6
LAST WILL AND TESTAMENT OF FREDERICK W. HAUPTLE
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY OF CUMBERLAND ·
SS.
witnesses whose names are attached to the foregoing document, being duly qualified according to
law, do depose and say that we were present and saw testator sign and execute the instrument as his
Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary
act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the
testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the
testator was at the time 18 or more years of age, of sound mind and under no constraint or undue
influence.
Sworn or affirmed and subscribed before me by ~l~rl0.1r0~_ L.. [0~3~F:qnd.
,~-4~_
this I'~'day of (.~.~c.~-~-~ ,2000.
F:\User Folder\Firm Docs\Wills\1703fivh will.wpd
Notarial Seal
Meml~er. Pennsylvania Association ot Notaries
Tern/E. Walker, Notary Public
South MkldletOfl T~q3., Cumberland County
My Commission Expires Mar. 31, 2003
Janney Montgomery Scott
Member New York Stock Exchange, Inc. and other principal exchanges
Member Securities Investor Protection Co~poratioll
STATEMENT OF ACCOUNT
MASTER ACCOUNT NUMBER WH17 4097-8236
FOR THE PERIOD ENDING NOVEMBER 30, 2003
MICHAEL LARSEN
TEL 610-701-6067
ONE NORTH CHURCH STREET
WEST CHESTER, PA 19380-9977
I i~i~ ~a N~:.U ~ Ei~ii~! Ni!~/.~.~.. U~:~i}i~i~ ~M ~i~:~ :::::::::::::::::::::::::::: ,::: :':,:::,: :::::::::::::::::::::: ,:~:~'~:~ :~:: ~:::::~:: ~:.:.~: ~:::i :ii: '?~ :':i~ :':'~ :'~ +:':'! :' '~": :'~' ~r'~ ~":': ×~:i~':'W~' ?""!i ~" ''~ ~':' '~ ~ ......... ? 'i'~ ~ ~ ~t~!!~tI~i~ ~ ~!i~ ~ i~' '"' ~'[~ ~ ~i~ 5~ }''''~:
ACCOUNT ACCOUNT NAME ACCOUNT
N UMBER DESCRIPTION
4097-8236 FREDERICK WHAUPTLE INDIVIDUAL
4097-8337 FREDERICK W HAUPTLE (IRA-ROLL)ROLLOVER IRA
FREDERICK W HAUPTLE
4 CENTRAL STREET
NEWVILLE PA 17241
OOMBINED ALLOCATION OF FUNDS
FIXED INC_
19,741.39
FDS/UIT.__
9,180.00
ACIMNY MKT
7,744.91
EQTY/OPTN
57,960.00
ACCOUNT
NUMBER
ACCOUNT MONEY MARKET EQUITIES AND MUTUAL FUNDS & FIXED INCOME OTHER
BALANCES BALANCES OPTIONS UNIT TRUSTS SECURITIES INVESTMENTS
TOTAL CURRENT YEAR-TO-DATE
PORTFOLIO PERIOD
4097-8236 0.00 2,095.03 51,060.00 9,180.00 0.00 0.00
4097-8337 0.00 5~649.88 6~900.00 0.00 19~741.39 0.00
TOTALS 0.00 7,744.91 57,960.00 9,180.00 19,741.39 0.00
8.2% 61.3% 9.7% 20.9%
* NO STATEMENT WAS PRODUCED FOR THIS ACCOUNT IN THE CURRENT PERIOD
62~335.03 0.35 2,028.90
32~291.27 90.24 1 ~263.01
94,626.30 90.59 3,291.91
100%
,..; .... 40~7,.82~9~
i ~:) ;~5;.~~ · '..~ i~ :q~P~t f':~/~:.q~,{~F iP. ~;! L~Pi Ff,/,F~TF,r} R¥' AD~ITIONAJ PROTECTION OF ~49.500.000 BY A MAJOR INSURANCE COMPANY. FOR IUPORTANT INFORUATION PLEASE SEE REVERSE
Jjanney Montgomery Scott LLC
Member New York Stock Exchange, Inc. and other principal exchanges
STATEMENT OF ACCOUNT
FREDERICK W HAUPTLE
FUND
I
,MMKT
EQTY
MICHAEL LARSEN
610-701-6067
ONE NORTH CHURCH STREET
WEST CHESTER, PA 19380-9977
ACCOUNT BALANCES **
MONEY MARKET BALANCE
EQUITIES AND OPTIONS
MUTUAL FUNDS & UNIT TRUSTS
FIXED INCOME SECURITIES
OTHER INVESTMENTS
ACCOUNT NUMBER WH17 4097-8236 CENTRAL ASSET ACCOUNT
STATEMENT PERIOD t 1/01/03 - t 1/30/0:} Paqe 1 of 3
AT 11/30103 AT 11101103
0.00 0.00
2,095.03 3.4% 2,911.41
51,060.00 81.9% 50,591.00
9,180.00 14.7% 9,160.00
0.00 0.00
'0.00 0.00
TOTAL PORTFOI~t0 I 62,335.03 100.0% 62,662.41
PORTFOLIO HELD AT JMS ! 53~155.03 53~502.41
I:~!!!ii~i~i~ii~i~i~}~i~!i~i!i ii!!ii~;il i!i i?~ ili ill 9,180.00 9,1 e0.00
~. AcCoUnt d~bit ba ~nces are aecluctea trom't~e tOtal val'Uati0h ~ncl account credit ba ances are added to the total valuation.
CURRENT PEI~OI~ YEAR TO DATE
TAXABLE DIVIDENDS 0.35 1,21 5.12
TA~ABLI= INTERI~T 0.00 813.7R
TOTAL INCOME [ 0.35 2,028.90
11/01/03 BALANCE FORWARD 0.00
INCOME AND EXPENSE ACTIVITY 0.35
OTHER ACTIVITY 89.58
MONEY MARKET CHECKING AND BILL PAYING ACTIVITY 906.31
MONEY MARKET PURCHASE & SALE ACTIVITY 816.38
J11/30/03 ENDING BALANCE
2,911.41
816.38-
[ 0.00 2,095.03
A FEW YEAR8 OF MARKET FLUC, TUA TION8 AS WELL 18 ANYLIFE~TYLE
C, HANGE$ OAN AFFEOT YOUR PORTFOLIO. THEREFORE, IT'S IMPORTANT
TO REVIEW YOUR INVE,~TMENT PLAN REGiULARL Y TO MAKE SURE THAT
IT'8 UP TO DA TE AND APPROPRIATE FOR YOUR OURRENT SITUATION.
CALL YOUR JANNEY FINANOIAL OONSULTANT TO ARRANGE A REVIEW.
......... :,-{. ~o\, _~aG= .~ SUPPLEMENTED BY ADDITIONAL PROTECTION OF $49.500.000 BY A MAJOR INSURANCE COMPANY. FOR iMPORTANT iNFORMATION PLEASE SEE REVERSE SIDE.~
JJanney Montgomery Scott
Member New York Stock F. xchange, Inc. and other principal exchanges
Member Securities Investor Protection Corporation
STATEMENT OF ACCOUNT
FREDERICK W HAUPTLE ACCOUNT NUMBER WH17 4097-8236
STATEMENT PERIOD 11/01/03 - 11/30/03 Paqe 2 of 3
i
~tlow P~ Value 8nnual Income Cu~nt ~bld T~ue
ALLIANOEBERNSTEIN 2,095.03 2.93 0.140% CASH
Lonq Shgrt Deso~ptien {~ymbol price
300 ALLETE INO ALE 29.7700
200 DUKE ENERGY CAP TR II DUK'V 25.4600
PFD 7.2%
200 ENTERPRISE CAP TR III PEG'R 25.2500
TOPRS SERO 7.25%
DUE 6/30/47
200 MORGAN STANLEY MWN 25.6800
QUIBS 7.25%
6-17-29
400 MIDDLESEX WATER CO MSEX 19.6400
300 PENN REAL EST INV TR PEI 34.5000
SBI
200 ROYAL BANK OF SCOTLAND RBS'Y 24.4000
GROUP PLO EXOHANGEABLE
PERPETUAL PFD OUML 5.75%
500 USEO INO USU 7.5300
[ TOTAL EQUITIES AND OPTIONS ]
:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ~,:.:~ :.:.: ,~:.~:.~ ................. ~.'~.:.~:~i~:::.:.:~.:?:~.~:~::,,:~.'~ ~gi ~ ............ :~'~' 1~':'*~::~'~:':'~ ~'~"~' ~ 'ie': ~.'
Estimated Estimated Acct
Value Annual Income Current Yield Tvoe
8,931.00 339.00 3.7% CASH
5,092.00 360.00 7.0% CASH
5,050.00 362.50 7.1% CASH
5,136.00 362.50 7.0% CASH
7,856.00 264.00 3.3% CASH
10,350.00 · 648.00 6.2% CASH
4,880.00 287.50 5.8% CASH
3~765.00 275.00 7.3% CASH
51,060.00 2,898.50 5.6%
Estimated Estimated Acct
Annual Income Current Yield Type
288.60 3.1% CASH
Lonq Short I;)es~rlptlon Synlbgl price Value
:.. :: ii i?:~ii~0~ *** EATON VANCE PRIME RATE EVPRX 9.1800 9,180.00
RESVS SH BEN INT OL B
I TOTAL MUTUAL FUNDS & UNIT TRUSTS I 9~180.00 288.60 3.1% '
L TOTAL PORTFOLIO J 62,335.03 3,190.03 5.1%
Transaction Acct
Date Type Ouar~tity De~r~pqon Price I~l~b~s q~dlts Type
11/14 DIVIDEND ALLIANOEBERNSTEIN 0.35 CASH
CAP RESERVES
111403 2,833
TOTAL 0.35
FREDERICK W HAUPTLE
ACCOUNT NUMBER WH17 4097-8236
{~TATEME~IT PERIOD 11/0t/0:~- 11/30/03
Transaction
Date Type qq;~nt~ty Descripti9n
11/04 JOURNAL TRFFROMAC~40978337-1
11/17 STOCK DIV 100 MIDDLESEX WATER OD
Transaction
Date Type I~escriptlon
11/05 CHECK MGM
11/10 CHECK MGM
11/13 CHECK PPL ELECTRIC UTILITIES O
11/18 CHECK MGM
11/18 CHECK MGM
11/20 CHECK MGM
11/21 CHECK NWSA
11/24 CHECK VFW
11/26 CHECK LARRYGODSHALL
pr~e
TOTAL
Debits
Credits
89.58
89.58
Check# / Cede
00312 M
00313 M
00314 P
00316 M
00317 M
00319 M
00318
00315 V
00320 H
Debits
36.34
46.48
85.07
68.09
24.98
78.58
162.95
15.00
388.82
Credlt~
TOTAL
906.31
Transaction
Date Type
11/05 PURCHASE
11/05 SALE
11/10 SALE
11/13 SALE
11/14 REINVEST DIV
11/18 SALE
11/20 SALE
11/21 SALE
11/24 SALE
11/26 SALE
~,~rlp1ioll
ALLIANOEBERNSTEIN
ALLIANOEBERNSTEIN
ALLIANCEBERNSTEIN
ALMANOEBERNSTEIN
ALLIANCEBERNSTEIN
ALLIANOEBERNSTEIN
ALLIANOEBERNSTEIN
ALLIANOEBERNSTEIN
ALLIANCEBERNSTEIN
ALLIANOEBERNSTEIN
price
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
Debi~
89.58
0.35
Credits
36.34
46.48
85.07
93.07
78.58
162.95
15.00
388.82
TOTAL
816.38
Acct
Type
CASH
CASH
Acot
Type
CASH
CASH
CASH
OASH
OASH
OASH
OASH
OASH
OASH
CASH
CASH
CASH
OASH
CASH
OASH
OASH
OASH
OASH
OASH
Paqe 3 cf3
GENERAL INFORMATION
iF THIS IS NOT A CASH ACCOUNT, IT MAY BE A COMBINED STATEMENT OF YOUR GENERAL ACCOUNT AND OF A SPECIAL MISCELLANEOUS ACCOUNT MAINTAINED FOR YOU UNDER SECTION 4 (F) (6) OF REGULATION
T ISSUED BY THE BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM. THE PERMANENT RECORD OF THE SEPARATE ACCOUNTS AS REQUIRED BY REGULATION T IS AVAILABLE FOR YOUR INSPECTION UPON
REQUEST.
PLEASE RETAIN THIS AND SUBSEQUENT STATEMENTS FOR INCOME TAX PURPOSES AND TO PROVIDE INFORMATION TO ENABLE YOU TO VERIFY ANY INTEREST CHARGES APPEARING THEREON.
A FINANCIAL STATEMENT OF THIS FIRM IS AVAILABLE FOR YOUR PERSONAL INSPECTION AT ITS OFFICES, OR A COPY WILL BE MAILED UPON YOUR WRITTEN REQUEST.
ANY FREE CREDIT BALANCE REPRESENTS FUNDS PAYABLE UPON DEMAND WHICH ARE PROPERLY ACCOUNTED FOR ON OUR BOOKS OF RECORD.
ERRORS AND OMISSIONS EXCEPTED. IF THIS STATEMENT IS FOUND INCORRECT, PLEASE NOTIFY US IMMEDIATELY.
CERTAIN MUNICIPAL AND CORPORATE BONDS FOR CUSTOMERS OF JANNEY MONTGOMERY SCOTT LLC MAY BE HELD AT THE DEPOSITORY TRUST COMPANY, IN WHICH CASE A RANDOM METHOD OF ALLOCATION IS
USED BY JANNEY MONTGOMERY SCOTT LLC FOR SELECTION OF CALLED BONDS. THIS METHOD RANDOMLY SELECTS FROM AMONG OUR CUSTOMERS WHOSE BONDS ARE HELD AT THE DEPOSITORY. A DETAILED
DESCRIPTION OF OUR ALLOCATION PROCEDURE IS AVAILABLE UPON REQUEST,
OPTIONS CUSTOMERS
INFORMATION WITH RESPECT TO COMMISSIONS AND OTHER CHARGES INCURRED IN CONNECTION WITH THE EXECUTION OF OPTION TRANSACTIONS HAS BEEN INCL~IDED IN CONFIRMATIONS PREVIOUSLY FURNISHED.
FURTHER INFORMATION WILL BE AVAILABLE ON REQUEST,
PLEASE ADVISE JANNEY MONTGOMERY SCO'I-r LLC PROMPTLY OF ANY MATERIAL CHANGE IN YOUR FINANCIAL SITUATION OR INVESTMENT OBJECTIVES.
WE WOULD LIKE TO REMIND YOU THAT JANNEY MONTGOMERY SCO'I-r LLC USES A RANDOM METHOD OF ALLOCATING OPTION EXERCISE NOTICES AMONG CUSTOMERS SHORT OPTION POSITIONS, THIS METHOD
RANDOMLY SELECTS FROM AMONG ALL OUR CUSTOMERS' SHORT OPTION POSITIONS INCLUDING POSITIONS ESTABLISHED ON THE DAY OF ASSIGNMENTS, CONTRACTS WHICH ARE SUBJECT TO EXERCISE, ALL
SHORT OPTION POSITIONS ARE LIABLE FOR ASSIGNMENT AT ANY TIME, A MORE DETAILED DESCRIPTION OF OUR RANDOM ALLOCATION PROCEDURE IS AVAILABLE UPON REQUEST.
PORTFOLIO PRICING.
BOND PRICES ARE APPROXIMATE AND ARE PROVIDED BY AN INDEPENDENT QUOTATION SERVICE, FOR A CURRENT MARKET QUOTE, PLEASE CONTACT YOUR INVESTMENT CONSULTANT
GENERAL ACCOUNT INTEREST CHARGES
AN ANNUAL RATE OF INTEREST IS CHARGED ON THE DAILY ADJUSTED DEBIT BALANCE IN ALL OF YOUR ACCOUNTS CARRIED BY OUR FIRM. IT IS COMPUTED AT A SELECTED RATE BASED ON THE PRIME RATE
AS PUBLISHED IN THE EASTERN EDITION OF THE WALL STREET JOURNAL. THE CHARGES ARE:
If the Debit Balance is: Percentage of Interest Charged If the Debit Balance Is; Percentage of Interest Charged
Less than $10,000 The Prime Rate plus 1.50% Between $50,000 and $99,999 The Prime Rate plus 0.50%
Between $10,000 and $24,999 The Prime Rate plus 1.25% Between $100,000 and $249,999 The Prime Rate
Between $25,000 and $49,999 The Prime Rate plus 1.00% $250,000 and up The Prime Rate minus 0.25%
FROM TIME TO TIME THE PRIME RATE WILL FLUCTUATE WHICH WILL RE3ULT IN AN AUTOMATIC CHANGE IN YOUR INTERE3T RATE ~THOUT PRIOR NOTICE TO YOU. IF THERE I$ A CHANGE IN THE INTERE$T
RATE DUE TO A CHANGE iN THE PRIME RATE DURING ANY INTEREST PERIOD, SEPARATE CHARGES WILL BE SHOWN FOR EACH PERIOD UNDER EACH DIFFERENT RATE. WHEN YOU MAINTAIN A CASH ACCOUNT,
INTEREST MAY BE CHARGED (1) ON PURCHASES FOR WHICH PAYMENT IS NOT RECEIVED UNTIL AFTER SETTLEMENT DATE OF THE TRANSACTION AND (2) ON MONIES PAID OUT BY US, REPRESENTING THE
PROCEEDS OF SALES, PRIOR TO THE SETTLEMENT DATE.
INTER EST IS CALCULATED MONTHLY ON THE DAILY ADJUSTED DEBIT BALANCE IN YOUR/~CCOUNT, EACH MONTH YOU WILL RECEIVE WITH YOUR REGULAR MONTHLY STATEMENT A STATEMENT OF INTEREST CHARGED.
THIS STATEMENT WILL SHOW THE INTEREST PERIOD. YOUR MONTHLY STATEMENT WiLL SHOW EACH TRANSACTION ON THE DATE OF TRADE; HOWEVER, INTEREST AS SHOWN ON THE STATEMENT OF INTEREST
CHARGED IS CALCULATED ON A SETTLEMENT DATE BASIS. IN ORDER TO CHECK THE CALCULATION OF INTEREST CHARGED TO YOUR ACCOUNT, IT MAY BE NECESSARY TO REFER TO BOTH YOUR PRIOR AND CUR-
RENT MONTHS' STATEMENTS. THE MONTHLY STATEMENT OF INTEREST CHARGED WILL SHOW:
1. THE CURRENT RATE CHARGED TO YOU AND ANY CHANGES IN THE INTEREST RATE DURING THE INTEREST PERIOD.
2, THE DAILY NET OF ALL TRANSACTIONS. THIS FIGURE IS OBTAINED BY ADDING THE DAILY CLOSING SETTLEMENT BALANCES IN ALL GENERAL ACCOUNTS. THE NET BALANCE IN ANY GIVEN ACCOUNT WILL BE
DETERMINED BY ADDING THE OPENING BALANCE, IF ANY, TO ANY DEBITS CREATED BY PURCHASES BY YOU OR PAYMENTS TO YOU AND SUBTRACTING ANY CREDITS CREATED BY SALES OR PAYMENTS BY YOU,
3, ANY FREE CREDiT BALANCE IN YOUR CASH ACCOUNT (WHICH REDUCES THE DALLY NET DEBT BALANCE),
4, ANY MARK-TC~THE-MARKET AS A RESULT OF A SHORT PosrrlON, I,E. ANY CREDIT THAT APPEARS IN YOUR STATEMENT DUE TO SHORT SALES (INCLUDING SHORT SALES AGAINST THE BOX) WILL BE USED TO
REDUCE ANY DEBT BALANCE. SINCE JANNEY MONTGOMERY SCOTT LLC MUST BORROW THE SAME SECURITY IN ORDER TO DELIVER IT TO THE BUYING BROKER, THIS CREDIT IS NOT AVAILABLE TO YOU. THERE-
FORE, ON A DAILY BASIS, THE MARKET VALUE OF A SHORT SALE IS DEBITED AGAINST YOUR MARGIN BALANCE IN ORDER TO ARRIVE AT ANY ADJUSTED DEBIT BALANCE FOR INTEREST PURPOSES, THE DAILY
CLOSING PRICE ROUNDED TO THE NEAREST PENNY IS USED TO DETERMINE ANY APPRECIATION OR DEPRECIATION OF A SECURITY SOLD SHORT WHICH WILL, IN TURN, ADJUST YOUR DAILY NET BALANCE.
THIS PRACTICE IS KNOWN AS "MARKING-T(~THE-MARKET'.
5. THE NUMBER OF DAYS YOUR ACCOUNT HAD A DEBIT BALANCE.
6, THE ADJUSTED DAILY DEBIT BALANCE ON WHICH INTEREST IS CHARGED,
7. THE AMOUNT OF INTEREST, BASED UPON THE FOLLOWING FORMULA: ADJUSTED DEBT BALANCE/1 X RATE/100 X NUMBER OF DAYS/360
8. TOTAL INTEREST CHARGED FOR THE PERIOD.
SOME PERTINENT FACTS ABOUT INTEREST CHARGES
DEBIT BALANCES IN YOUR ACCOUNT REPRESENT MONEY LOANED TO YOU BY JANNEY MONTGOMERY SCOTT LLC WHEN YOU PURCHASE SECURITIES ON CREDIT. YOU MUST PROVIDE A SPECIFIED MINIMUM AMOUNT
AS REQUIRED BY REGULATION T OF THE FEDERAL RESERVE BOARD, AND THE BALANCE OF THE PURCHASE PRICE IS LOANED TO YOU. INTEREST CHARGES ARE BASED UPON THE DEBIT BALANCE CREATED BY THIS
LOAN. EACH ADDITIONAL LOAN ADDS TO YOUR DEBIT BALANCE, AS DOES ANY INTEREST CHARGE OR ANY MISCELLANEOUS CHARGE WHICH MAY BE ASSESSED TO YOUR ACCOUNT, UNLESS SUCH CHARGES ARE
PROMPTLY PAID BYYOU,
Janney Montgomery Scott LLC
Member Securities Investor Pro~¢ction Corporation
STATEMENT OF ACCOUNT
FREDERICK W HAUPTLE (IRA-ROLL)
JMS LLO OUST F80
MMK-r
~ EQTY
o- FIXE
MICHAEL LARSEN
610-701-6067
ONE NORTH CHURCH STREET
WEST CHESTER, PA 1g380-9g77
ACCOUNT NUMBER WH17 4097-8337 JM$ RETIREMENT PLAN ACCOUNT
STATEMENT PERIOD 11/01/03 - 11/30/03 P~.qe 1 of 3
ACCOUNT BALANCES **
MONEY MARKET BALANCE
EQUITIES AND OPTIONS
MUTUAL FUNDS & UNIT TRUSTS
FIXED INCOME SECURITIES
OTHER INVESTMENTS
AT 11/30/~{I AT 11101103
0.00 0.00
5,649.88 17.5% §,649.22
6~900.00 21.4% 6,680.00
0.00 0.00
19~741.39 61.1% 19~834.69
0.00 0.00
! TOTAL PORTFOLIO ] 32~291.27 100.0% 32~163.91
Account debit balances are deducted from the total valuation and account credit balances are added to the total valuation,
CURRENT PERI0p YEAR TO DATF
DIVIDENDS 0.66 430.28
INTI~RI='~T 8g. sP,
[ TOTALINOOME [ 90.24 1,263.01
RELATED INFORMATION
RETURN OF PRINCIPAL PAYMENTS 0.00 15,000.00
11/01/03 BALANCE FORWARD
INCOME AND EXPENSE ACTIVITY
OTHER ACTIVITY
MONEY MARKET PURCHASE & SALE ACTIVITY
~11/30/03 ENDING BALANCE
0.00 5,649.22
90.24
89.58
0.66 0.66
[ 0.00 5,649.88
FOR THE TAX YEAR 2003 YOU CAN OONTRIBUTE MORE TO YOUR IRA OR
ROTH IRA THAN EVER BEFORE . $3000.00 OR $3500.00 IF YOUR'RE
OVER AGE 50. TAKE ADVANTAGE OF THE OPPORTUNITY TO CA TOH-UP
CNA ~A VlNG8 AND INVESTMENT PROGRAM FOR THE FUTURE. BUILD
YOUR RETIREMENT BEOURITY ONE CONTRIBUTION A T A TIME.
.....
; "~'::?'"~" ¥'C, UR S;PC COVERAGE iS SUPPLEMENTED BY ADDITIONAL PROTECTION OF $49.500.000 BY A MAJOR INSURANCE COMPANY. FOR IMPORTANT INFORMATION PLEASE SEE REVERSE
JJanney Montgomery Scott
Member New York Stock F-xch~nge, Inc. and other principal ~ch~nges
Member SecurttJe.~ Investor Protection Corporation
STATEMENT OF ACCOUNT
FREDERICK W HAUPTLE (IRA-ROLL) AQQOVNT NUMBER WH17 4097-8337
JMS LLO OUST ~=BO STaTeMENT pERIOD 11/01/03 - 11~{)/0~' Paqe ~ 9f 3
~}9~ Pdce Value Annual Income Cu~ent Y~Id
ALLIANOEBERNSTEIN 5,649.88 7.90 0.140% ~ASH
Loqq ~;hort D~grlPtlpl~ ~yl~ibol P¢ce Va~lue
E00 PENN REAL EST INV Tfi PEI 34.5000 6~900.00
8BI
[ TOTAL EQUITIESAND OPTION8 J 6,900.00
Listed in due date seque~e
Lonq Sho~ ~sc~pt~gp Due Da~ PHce Value
15,000 FEDL HOME LOAN MTG OORP 04/15~3 100.3361 15,050.41
MUL~OL REMIO 2598 eL MM
MONTHLY 14 DAY DE~Y
OPN 5.500% DUE 04~ 5~3
DTD 04/01/03
FAGTOR: 1,00000000
OURRENT BAL: 15,000
5,000 FEDL HOME LOAN MTG OORP .07/15~3 93.8197 4,690.98
MULTIOL REMiO 2650 eL BB
MONTHLY 14 DAY DE~Y
OPN 5.000% DUE 07/1
DTD 07/01/03
FAOTOR: 1.00000000
OURRENT BAL: 5,000
Estimated Estimated Acct
Annual Incom9 Curr~nt Yield Type
432.00 6.2% OASH
432.00 6.2%
Estimated Estimated Acct
Annual Income (~tl~rpllt Yield Type
825.00 5.4% CASH
250.00 5.3% CASH
[ TOTAL FIXED INCOME SECURITIES [ 19,741.39 1,075.00 5.4%
[ TOTAL PORTFOLIO [ 32,291.27 1,514.90 4.6%
I
Tmn~ctlon Acct
Date Ty~ QuantiW ~eW~ptl~n PHce Debits Credits Type
1/14 DIVIDEND ALLIANOEBERNSTEIN 0.66 CASH
CAP RESERVES
111403 5,559
11/17 INTEREST FEDL HOME LOAN MTG OORP 68.75 CASH
MULTIOL REMIC 2598 CL MM
MONTHLY 14 DAY DELAY
OPN 5.500% DUE 04/15/33
DTD 04/01/03
111503 15,000
, ~:,' --~. ,"Qi JR AiP.~. t':F¥,/~-iRA~.-~ iR ,gl JP,oi FM,~NTED BY ADDITIONAL PROTECTION OF $49,500.000 BY A MAJOR INSURANCE COMPANY. FOR IMPORTANT INFORMATION PLEASE SEE REVERSE SIDE.
FREDERICK W HAUPTLE (IRA-ROLL)
JMS LLC CUST FBO
Transaction
Date Tree Quanti~' DescriDtlon
11/17 INTEREST FEDL HOME LOAN MTG CORP
MULTIOL REMIC 2660 CL BB
MONTHLY 14 DAY DELAY
OPN 5.000% DUE 07/15/33
DTD 07/01/03
111503 5,000
ACCOUNT NUMBER WH17 40E)7-{337
,STATEMENT PERIOD 11/01/03 - 11/30/03
Acct
Price ~eblts C~its Type
20.83 GASH
TOTAL 90.24
~8 .~...It. ~:~ ,~[ .,~:, ~ .~.~..** ~ ~' ,,
on Acct
Date Type qpalflti~f Oe~,~r~pt~ price ~b~ Cmd~s Ty~
11/04 WITHDRAWAL RETIREMENT DISTRIBUTION 89.58 OA~H
TRF TO AO~409782361
~'aqe .3 or ,~
TOTAL 89.58
Transaction Acct
Date Type Description price ' pebi~s Credits Type
11/04 SALE ALLIANCEBERNSTEIN 1.0000 89.58 CASH
11/14 REINVEST DIV ALLIAN(.3EBERNSTEIN 1.0000 0.66 GASH
11/18 PURCHASE ALLIANCEBERNSTEIN 1.0000 89.58 GASH
TOTAL 0.66
Tran~a¢~on Umlt Current Acct
Dpte ' Type Quantity Pg~rlP~IgP Pr~9 lWr~91~ Type
10/28/03 SALE 200 PENN REAL ESTINV TR * 32.0000 34.5000 CASH
Deductible Non Deductible
Tax Year Contributions Contributions R~llpvers ' ~lstrlbutlons Wlth~toldlnq~
2003 FOR 2003 0.00 0.00 0.00 1,442.65 0.00
GENERAL INFORMATION
IF THIS IS NOT A CASH ACCOUNT, IT MAY BE A COMBINED STATEMENT OF YOUR GENERAL ACCOUNT AND OF A SPECIAL MISCELLANEOUS ACCOUNT MAINTAINED FOR YOU UNDER SECTION 4 (F) (6) OF REGULATION
T ISSUED BY THE BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM. THE PERMANENT RECORD OF THE SEPARATE ACCOUNTS AS REQUIRED BY REGULATION T IS AVAILABLE FOR YOUR INSPECTION UPON
REQUEST.
PLEASE RETAIN THIS AND SUBSEQUENT STATEMENTS FOR INCOME TAX PURPOSES AND TO PROVIDE INFORMATION TO ENABLE YOU TO VERIFY ANY INTEREST CHARG ES APPEARING THEREON.
A FINANCIAL STATEMENT OF THIS FIRM IS AVAILABLE FOR YOUR PERSONAL INSPECTION AT ITS OFFICES, OR A COPY WILL BE MAILED UPON YOUR WRITi'EN REQUEST.
ANY FREE CREDIT BALANCE REPRESENTS FUNDS PAYABLE UPON DEMAND WHICH ARE PROPERLY ACCOUNTED FOR ON OUR BOOKS OF RECORD.
ERRORS AND OMISSIONS EXCEPTED. IF THIS STATEMENT IS FOUND INCORRECT, PLEASE NOTIFY US IMMEDIATELY.
CERTAIN MUNICIPAL AND CORPORATE BONDS FOR CUSTOMERS OF JANNEY MONTGOMERY SCOTT LLC MAY BE HELD AT THE DEPOSITORY TRUST COMPANY, IN WHICH CASE A RANDOM METHOD OF ALLOCATION IS
USED BY JANNEY MONTGOMERY SCOTI' LLC FOR SELECTION OF CALLED BONDS. THIS METHOD RANDOMLY SELECTS FROM AMONG OUR CUSTOMERS WHOSE BONDS ARE HELD AT THE DEPOSITORY. A DETAILED
DESCRIPTION OF OUR ALLOCATION PROCEDURE IS AVAILABLE UPON REQUEST.
OPTIONS CUSTOMERS
INFORMATION WITH RESPECT TO COMMISSIONS AND OTHER CHARGES INCURRED IN CONNECTION WITH THE EXECUTION OF OPTION TRANSACTIONS HAS BEEN INCLUDED IN CONFIRMATIONS PREVIOUSLY FURNISHED.
FURTHER INFORMATION WILL BE AVAILABLE ON REQUEST.
PLEASE ADVISE JANNEY MONTGOMERY SCOWl' LLC PROMPTLY OF ANY MATERIAL CHANGE IN YOUR FINANCIAL SITUATION OR INVESTMENT OBJECTIVES.
WE WOULD LIKE TO REMIND YOU THAT JANNEY MONTGOMERY SCO~-I' LLC USES A RANDOM METHOD OF ALLOCATING OPTION EXERCISE NOTICES AMONG CUSTOMERS SHORT OPTION POSITIONS. THIS METHOD
RANDOMLY SELECTS FROM AMONG ALL OUR CUSTOMERS' SHORT OPTION POSITIONS INCLUDING POSITIONS ESTABLISHED ON THE DAY OF ASSIGNMENTS, CONTRACTS WHICH ARE SUBJECT TO EXERCISE. ALL
SHORT OPTION POSITIONS ARE LIABLE FOR ASSIGNMENT ATANY TIME. A MORE DETAILED DESCRIPTION OF OUR RANDOM ALLOCATION PROCEDURE IS AVAILABLE UPON REQUEST.
PORTFOLIO PRICING
BOND PRICES AR E APPROXIMATE AND ARE PROVIDED BY AN INDEPENDENT QUOTATION SERVICE. FOR A CURRENT MARKET QUOTE, PLEASE CONTACT YOUR INVESTMENT CONSULTANT
GENERAL ACCOUNT INTEREST CHARGES
AN ANNUAL RATE OF INTEREST IS CHARGED ON THE DAILY ADJUSTED DEBIT BALANCE IN ALL OF YOUR ACCOUNTS CARRIED BY OUR FIRM. IT IS COMPUTED AT A SELECTED RATE BASED ON THE PRIME RATE
AS PUBLISHED IN THE EASTERN EDITION OF THE WALL STREET JOURNAL. THE CHARGES ARE:
If the Debl~ Balance is: Percentage of Interest Charged If the Debit Balance Is: Percentage of Interest Charged
Less than $10,000 The Prime Rate plus 1.50% Between $50,000 and $99,999 The Prime Rate plus 0.50%
Between $10,000 and $24,999 The Prime Rate plus 1.25% Between $100,000 and $249,999 The Prime Rate
Between $25,000 and $49,999 The Prime Rate plus 1.00% $250,000 and up The Prime Rate minus 0.25%
FROM TIME TO TIME THE PRIME RATE WILL FLUCTUATE WHICH WILL RESULT IN AN AUTOMATIC CHANGE IN YOUR INTEREST RATE WITHOUT PRIOR NOTICE TO YOU. IF THERE IS A CHANGE IN THE INTEREST
RATE DUE TO A CHANGE IN THE PRIME RATE DURING ANY INTEREST PERIOD, SEPARATE CHARGES WILL BE SHOWN FOR EACH PERIOD UNDER EACH DIFFERENT RATE. WHEN YOU MAINTAIN A CASH ACCOUNT,
INTEREST MAY BE CHARGED (1) ON PURCHASES FOR WHICH PAYMENT IS NOT RECEIVED UNTIL AFTER SETTLEMENT DATE OF THE TRANSACTION AND (2) ON MONIES PAID OUT BY US, REPRESENTING THE
PROCEEDS OF SALES, PRIOR TO THE SETTLEMENT DATE.
INTEREST IS CALCULATED MONTHLY ON THE DALLY ADJUSTED DEBIT BALANCE IN YOUR ACCOUNT. EACH MONTH YOU WILL RECEIVE WITH YOUR REGULAR MONTHLY STATEMENT A STATEMENT OF INTEREST CHARGED.
THIS STATEMENT WILL SHOW THE INTEREST PERIOD. YOUR MONTHLY STATEMENT WILL SHOW EACH TRANSACTION ON THE DATE OF TRADE; HOWEVER, INTEREST AS SHOWN ON THE STATEMENT OF INTEREST
CHARGED IS CALCULATED ON A SETI'LEMENT DATE BASIS. IN ORDER TO CHECK THE CALCULATION OF INTEREST CHARGED TO YOUR ACCOUNT, IT MAY BE NECESSARY TO REFER TO BOTH YOUR PRIOR AND CUR.
RENT MONTHS' STATEMENTS. THE MONTHLY STATEMENT OF INTEREST CHARGED WiLL SHOW:
1. THE CURRENT RATE CHARGED TO YOU AND ANY CHANGES IN THE INTEREST RATE DURING THE INTEREST PERIOD.
2. THE DAILY NET OF ALL TRANSACTIONS. THIS FIGURE IS OBTAINED BY ADDING THE DAILY CLOSING SETTLEMENT BALANCES IN ALL GENERAL ACCOUNTS. THE NET BALANCE IN ANY GIVEN ACCOUNT WILL BE
DETERMINED BY ADDING THE OPENING BALANCE, IF ANY, TO ANY DEBITS CREATED BY PURCHASES BY YOU OR PAYMENTS TO YOU AND SUBTRACTING ANY CREDITS CREATED BY SALES OR PAYMENTS BY YOU.
3. ANY FREE CREDiT BALANCE IN YOUR CASH ACCOUNT (WHICH REDUCES THE DAILY NET DEBT BALANCE),
4. ANY MARK-TO-THE.MARKET'AS A RESULT OF A SHORT POSITION, I.E. ANY CREDIT THAT APPEARS IN YOUR STATEMENT DUE TO SHORT SALES (INCLUDING SHORT SALES AGAINST THE BOX) WILL BE USED TO
REDUCE ANY DEBIT BALANCE. SINCE JANNEY MONTGOMERY SCOTT LLC MUST BORROW THE SAME SECURITY IN ORDER TO DEUVER IT TO THE BUYING BROKER, THIS CREDiT IS NOT AVAILABLE TO YOU, THERE-
FORE, ON A DALLY BASIS, THE MARKET VALUE OF A SHORT SALE IS DEBITED AGAINST YOUR MARGIN BALANCE IN ORDER TO ARRIVE AT ANY ADJUSTED DEBIT BALANCE FOR INTEREST PURPOSES. THE DAILY
CLOSING PRICE ROUNDED TO THE NEAREST PENNY IS USED TO DETERMINE ANY APPRECIATION OR DEPRECIATION OF A SECURITY SOLD SHORT WHICH WILL, IN TURN, ADJUST YOUR DAILY NET BALANCE.
THIS PRACTICE IS KNOWN AS "MARKING.TO-THE-MARKET".
5. THE NUMBER OF DAYS YOUR ACCOUNT HAD A DEBIT BALANCE.
6. THE ADJUSTED DAILY DEBIT BALANCE ON WHICH INTEREST IS CHARGED.
7. THE AMOUNT OF INTEREST, BASED UPONTHE FOLLOWING FORMULA: ADJUSTED DEBIT BALANCEJl X RATE/100 X NUMBER OF DAYS/360
8. TOTAL INTEREST CHARGED FOR THE PERIOD.
SOME PERTINENT FACTS ABOUT INTEREST CHARGES
DEBIT BALANCES IN YOUR ACCOUNT REPRESENT MONEY LOANED TO YOU BY JANNEY MONTGOMERY SCO'Iq' LLC WHEN YOU PURCHASE SECURITIES ON CREDIT. YOU MUST PROVIDE A SPECIFIED MINIMUM AMOUNT
AS REQUIRED BY REGULATION T OF THE FEDERAL RESERVE BOARD, AND THE BALANCE OF THE PURCHASE PRICE IS LOANED TO YOU. INTEREST CHARGES ARE BASED UPON THE DEBIT BALANCE CREATED BY THIS
LOAN. EACH ADDITIONAL LOAN ADDS TO YOUR DEBIT BALANCE, AS DOES ANY INTEREST CHARGE OR ANY MISCELLANEOUS CHARGE WHICH MAY BE ASSESSED TO YOUR ACCOUNT, UNLESS SUCH CHARGES ARE
PROMPTLY PAID BY YOU.
ESTATE OF FREDERICK W. HAUPTLE JR.
DOD VALUES 12/16103
Shares Symbol Security High Low Close
~_ 200 ALE Ail'ere Inc.- .... 29.98 29.79 2'9.85
· ' ' ~00 DUK.V-- Duke Energy Cap II PRFD 7.2 26.30 26.15 26.30
'.' 200 -- PEGR Enterprise Cap III 7~25-"~/o 0 0 :)~>'~7,6r59
200 iMWN Morgan Stanley 7.25% 25.83i 25.73 25.80
""300 :PEI Penn Real Es-rate Invi"Tr SBI 35.11 34.35 35.05
200 RBS.Y Royal'Bk Scotland 5.75% 27.00 26.86 26.8'-~
500 USU Usec Inc. 8.56 8.20 8.50
_ ~1000 _ EVPRX _ Eaton Vance Pr Rt Rsvs B 6 01 9.2'~
$.9,587.86 Money Market Alliance Bernstein Cap Reserves----
JAN 2 2 200
January 20, 2004
of a Lasting Kind
Weigle & Associates P.C.
Attorney at Law
126 East King Street
Shippensburg, PA 17257
¸.%
RE:
Frederick W. Hauptle
Gentlemen:
In reference to the above customer, our records show the
enclosed information to be accurate. Our researching fee for the
information we have provided is $ 5.00 Please send your
remittance to the following address:
Farmers and Merchants Trust Company
ATTN Stacey Stenger
20 South Main Street
Chambersburg, PA 17201-0819
If I may be of any further assistance, please contact me.
Sincerely,
Stacey ~Stenger ~
Data Operations Supervisor
TRUST
PO. Box "T~,
RE: FREDERICK W. HAUPTLE
ACCOUNT INFORMATION
DATE OF DEATH 12-16-2003
X
CHECKING
SAFE DEPOSIT
__SAVINGS __CERTIFICATE OF DEPOSIT
SHARES OF STOCK
DATE OPENED 6-29-1998
ACCOUNT NUMBER 33-27779
ACCOUNT BALANCE AT DATE OF DEATH
ACCRUED INTEREST $.20
TOTAL ACCOUNT BALANCE
NAME(S) ON ACCOUNT
REGISTRATION OF ACCOUNT
DATE CLOSED 1-15-2004
$1,604.77
$1,604.57
FREDERICK W. HAUPTLE
INDIVIDUAL ACCOUNT
ACCOUNT INFORMATION
CHECKING
SAFE DEPOSIT
SAVINGS CERTIFICATE OF DEPOSIT
SHARES OF STOCK
DATE OPENED DATE CLOSED
ACCOUNT NUMBER
ACCOUNT BALANCE AT DATE OF DEATH
ACCRUED INTEREST
TOTAL ACCOUNT BALANCE
NAME(S) ON ACCOUNT
REGISTRATION OP ACCOUNT
MAILING DATE= July 1, 2000
School..= BIG SPRING SD
Locat£on:
4 CENTRAL
BiG SP~ZNG HEIGHTS
LOTS 103 & 104 PE 4 FG 16
TAXABLE
UNIT/LOT ID..= L-0103 +
hand Size .... = .42 acres
Control No: 46002013
THiS IS NOT A TAX BILL
Parcel Identifier
46-20-1758-040D
2000 I Assessed Value I Old Assessed Value
Market Value I (2000 Market x !0'0%}I (t974 Market x 25%) ,
Land 18,300 18,300 660
Bulidln~s 109,200 109,200 9,830
TOTAL 127,500 I 127,500 10~490
..~~~00 Clean and Green Values
Land NOT NOT ~ NOT
Buildings APPLICABLE APPLICABLEI APPLICABL~
TOTAL
Clean and Green values apply to some farm and forest land. Such values
become effective only upon application and approval. All applications must be
received by the Assessment Office by 4:30 p.m. on October 15, 2000. Those
previously approved for Clean and Green do not need to re.apply,
CUTUWCQG
l=enns~.tvanis law requires that ail real estate be valued as of the most recent county-wide massessment. The last
reassessment, or tax base year, was 1974. Since the last reassessment in 1974, properties have been assessed at 25% of the
1974 value (the 'Pm-Determined Ratio"). The new tax base year will be the Year2000, with the new assessed values
becoming effective for the 2001 tax year. The Pre-Determined Ratio has been changed to 100% Your new assessed w~l~e
equals your Year 2000 market value.
It Is very Important for you to know that when: Ihs new 2000 tax base is determined after this reasseesment, all taxing
districts are required by law to lower the millage rite by'the same proportfon that the tax base went up. The law
provides that in the first year after reassessment (20Of), the count7 and all townships and boroughs may not increase o~erali
revenue by more than five pement (5%) and school districts may not increase overall revenue by more than ten percent (10%).
The county and the other taxing bodies will make these decisions next year. and may choose not to increase overall revenue.
Of course, some Individual's faxes will go up or down by more than those percentages. The essential point Is that an
Increase In market value~ doe~ not negee~Srll¥ mean e corresponding IncreaSe in taxes. IndiVidual changes In taxes
will depend upon a specific property'aChange a~ compared to the overall change for 'the taxing district.
The ESTIMATED impact statement pdnted below Is our best estimate of change, based on 2000
COUNTY tax figures. This estimate does not'ii~clude any borough, toWnship, or school district impact.
ESTIMATED COUNTY TAX IMPACT, Current 2000 CoUnty m/lls · 27.500
Adjusted 2000 County m~lls · 1.858
288 . 2000 County Tax BEFORE Re&esessment. :
23? = 2000 County Tax AFTER Reassesement.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
RICHARD L WEBBER JR ESQ
WEIGLE & ASSOCS
126 E KING ST
SHIPPENSBURG PA 17257
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE 06-28-2004
ESTATE OF HAUPTLE
DATE OF DEATH 12-16-2003
FILE NUNBER 21 04-0016
COUNTY CUMBERLAND
ACN 101
Amount Remitted
REV-15&7 EX AFP (01-05)
FREDERICK W
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HAUPTLE FREDERICK N FILE NO. 21 04-0016 ACN 101 DATE 06-28-2004
TAX RETURN WAS: (X} ACCEPTED AS FILED C } CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERS~
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSchedule A] Cl) .0
2. Stocks and Bonds CSchedule B)
$. Closely Held Stock/Partnership Interest CSchedule
~. Mortgages/Notes Receivable CSchedule D) C~) .0
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 77t251.2
6. Jointly Owned Property CSchedule F)
7. Transfers (Schedule G) C7) 99~228.77
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H)
lO. Debts/Mortgage Liabilities/Liens CSchedule I) CIO) 1,294.8
11. Total Deductions Cll)
12. Net Value of Tax Return
11,603.&5
15.
14. Net Value of Estate Sub3ect to Tax
NOTE: If an assessment was issued previously,
reflect figures that include the total
ASSESSMENT OF TAX:
15. Amount of Line 1~ at Spousal rate
16. Amount of L/ne 14 taxable at Lineal/Class A rate
17. Amount of L/ne 14 at Sibling rate
18. Amount of L/ne 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID
03-12-2004 CD003672 368.06
Charitable/Governmental Bequests; Non-elected 9115 Trusts CSchedule J)
NOTE: To insure proper
credit to your account,
submit the upper portion
of thls form with Your
tax payment.
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
176,480.01
12.898.~
163,581.48
elS) .00
¢~4) 163,581.48
lines 14, 15 and/or 16, 17, 18 and 19 will
of ALL returns assessed to date.
C15)
C16)
C17)
· O0 x O0 = . O0
163,581 ,~8,*x 045= 7,361.17
· :O0 x 1~= .00
~Oo x 15 oo
¢~)= 7,361.17
AMOUNT PAID
7,500.00
E 506.89CR
.00
506.89CR
( IF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CA), YOU MAY BE DUF~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enSoyment to Class B Ccollateral) benef/ciaries of the decedent after the expirat/on of any estate for
life or for years, the Commonwealth hereby expressly reserves the r/ght to appra/se and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE=
PAYMENT:
REFUND CCR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 22 of 2000. C72 P.S.
Section 9140).
Detach the top port/on of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to:
A refund of a tax credit, wh/ch was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iSIS). Applicat/ons are available at the Office
of the Reg/ster of Hills, any of the 23 Revenue D/s/r/ct Offices, or by calling the special 24-hour
answering service for forms ordering= 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs= 1-800-447-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax C/ncluding discount or interest) as sho~n on this Notice must obSect with/n sixty (&O) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone C717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" CREV-15011 for an explanation of administratively correctable errors.
If any tax due is paid within three CS) calendar months after the decedent's death, a five percent CSX) discount of
the tax paid is allowed.
The 15X tax amnestY non-participation penalty is computed on the total of the tax and /nterest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and /n the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquencY, or nine (9) months and one C1} day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six C6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20X .000548 ~'~'~'8-1991 IIX .O00SOI ~ 9~ .000247
1982 16X .000438 1992 9X .000247 2002 &X .000164
1984 IIX .000301 199S-1994 7X .000192 2003 5~ .000137
1985 ISX .00035& 1995-1998 9X .000247 2004 4X .000110
1986 10~ .000274 1999 7X .000192
1987 10X .000274 2000 7X .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAXD
X NUI{BER OF DAYS DELXNQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF 'rNDZVZDUAL TAXES
TNHERZTANCE TAX DTVISION
DEPT. 280601
HARRISBURG, PA 171Z8-0601
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
RE¥-I~0? EX AFP (01-03)
RICHARD L WEBBER JR ESQ
WEIGLE & ASSOCS
126 E KING ST
SHIPPENSBURG PA 17257
DATE 08-09-200~
ESTATE OF HAUPTLE FREDERICK W
DATE OF DEATH 12-16-2005
FILE NUHBER Z1 ,,~ .~: 0016
COUNTY CUI~ERLAN~
ACN 10
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF N~LLs ~'~
CUHBERLAND
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wi*h your *ax payeen~.
CUT ALONG THIS LINE ~* RETAIN LOWER PORTION FOR YOUR RECORDS -~
ESTATE OF HAUPTLE FREDERICK W FILE NO. 21 0~-0016 ACN 101 DATE 08-09-200~
THTS STATEHENT 'rs PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHONN BELO#
TS A SUHHARY OF THE PR.rNC.rPAL TAX DUE., APPL.rCATTON OF ALL PAYHENTS, THE CURRENT BALANCE., AND, TF APpLTCABLE.,
A PROJECTED TNTEREST FTOURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 06-ZI-Z00~
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYHENTS (TAX CREDITS):
7,361.17
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAZD (-)
$68.06
05-12-Z00~
07-19-200~
CD005672
REFUND
.00
7,500.00
506.89-
'rF PAID AFTER THIS DATE, SEE REVERSE
S/DE FOR CALCULAT'rON OF ADDZT'rONAL INTEREST.
IF TOTAL DUE 'rS LESS THAN
NO PAYHENT IS REQU/RED.
ZF TOTAL DUE 'rS REFLECTED AS A 'CREDIT' (CR),
TOTAL TAX CREDIT
7,561.17
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORN FOR 'rNSTRUCT'rONS. )
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Frederick W. Hauptle
Date of Death:
12/16/03
Will No.
2004-00016
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: N/A .
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:
4'18/05
Signature
\.f")
. ~
Richard L. Webber, Jr., Esq ire
Name (Please type,or print)
126 East King Street
Address
Shippensburg, PA 17257
(717) 532-7388
Tel. No.
Capacity:
Personal Representative
X
Counsel for personal
representative
ui
(MAH:rmf/AM3)