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HgRR FRONT ST R ESQ P~ DATE OF F KI 18-2013 ~
ISB~RG FIDE NU DEATH 05 NTZER
Fq 17101 -1 A OUNT Y MBER 21 12, 2012 NATgL IE
203 CN ~ 0710 M
AppEq 1 IMBERLgND
gmou ~See~.ev ~s~ ~E' 04.
~~ T gLONG TH MgKE CH Rejpltted eunder pb~ cho013
V-154j'EX_ IS' LINE REGIST pgYAB
ESTgTE AFp C12: i i, - _~ _ - RET 1 cOUR ER OF WILgND REMI
OF ~ KI NT2ER DI Sq~ ~ E _OFAIN - ~ OwER, p0 CARS I S~ E OUP E SQUgRE T PAYMENT TO
AppRq IS Nq TgANCE pF ~E~ NCE R q ~N_ FOR_ YOO A 17013
1 • Re ~ V q~ V E OF T qX RETURN LIE MFI L E N T IONS A/yD RAI SEMEjy Ec~RDS- ~,~
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2• stOCks anate CSchRa leRN BASED W qs• Cx) gCCEP O• • 21 12'071 SESSMENTAOFOWgNCE _
3. ClOSely d Bonds CSche A) ON: pRIGINq~ED As FLED 0 ACN. 1'qX OR -'' _
4 M°h Held stOCkip dole B) RETURN ~ ) CHgN 101 DAT
5• Cashes ages,Notes artnehsh QED E. 0
Ba Rec lp 2 18.
6, ~° , nk Depc elvable Interest ~1 j 2013
T • Than tlY Dwned Ph is/Mlsc• Per Schedule D) [schedule C) C2) 44, 725• 0
sfeh opeh s°na 7 0
~pR~N Total Assets chedule ~~ [schedule F~ hopehtY Csche C 3) 6, 254.23 ~ De E- TO ens
ED Nule 4) ~I t vre
9 Fun DaDUCTIONS q E) C5) ••~~ c ub~ i t he up r a ~oUht
10, De l Expens ND EXEMP C6) • 00 tax pas form wi h portion
11 • T bts~MOhtga9e L /Adm' Costs, TIONS: C7) 26' 89 j • 1 0 .vment. th YOUr
°tal iabil , Mlsc 130805• 8
13 • Net Va ~ e uctjons ltles~~iens C expenses Csche 9
•4• Net ~ tablei~o ear Return hedule I) dole H) C9 C8)
)
nt Clo) 6 7 7 • 3
If aloe ° f Est to sal Be9Uests • 0
refl Ct ssess~en~ub~ect to Tax Non-elected 9113 64
AmoT OF TAX leures tha s issued Trusts Csched C11) -
AmOU t f dine 14 at s ~ lncl~de the io~sly, Ll ule J) 0112) 261 X653. 76
a °°4nt of dine 14 to ble sal gat ~~tal p f is lye C 3) 122.55
xa e a l 15, 16 14)
unt °f Cy 14 at sib at lineal returns ' 17, 261,0
hlnci ne 14 ling h hate ass 18 a 22 ••55
ITS• pal Tax Due taxable at ate C15j essed t0 ~d~or
T collateral C16) • 0 date • l y will
rate C1 ~) 0 X 00
12 NUMgIpT C18j X 045
•00
CD016g84 INT DISCpUNT X 12 11, 746. O1
EREST,p C+) • 00 X 15
EN PAID C_) C19); • 00
•00
• 00 gMOUNT pglD 11 ~ 746. 01
11,746.01
DqT TOTAL TA)( p
'N OF gINDI T AT ED' SEE IALANCE OF AYMENT
O-yq~ INTERES~RSE NTEREST AND X DOE 11 ~ 746.01
P
A REF TAL DUE TOTgL DBE EN• • 00
E
UND • SEE REVEL L ECTED A c • 0 0