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REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Esther S Hempt
No.21
05
0806
also known as
, Deceased
Date of Death 8/24/2005
Social Security No. 180-26-7087
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the fol/owing inventory include al/ of the
personal assets wherever situate and al/ of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
David H. Stone
Personal Representative:
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Marian H. KinQ, Executrix
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10. No.:
39785
18 Drexel Hills Circle, New Cumberland PA
Address: 414 BridQe Street
New Cumberland
Dated
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PA 17070-
Telephone: (717) 774-7435
Description
Value
PNC Bank-Checking Acct. #5140028112
Princ. $6,187.82, Int. $.66
6,188.48
PNC Bank-Savings Acct. #5003926012
Princ. $11,897.39, Int. $8.65
11,906.04
2,549.23 shares Ryan Beck CO.-Cash balance @ $1.00 each
2,549.23
98.52 shares Ryan Beck CO.-Cash Reserve MM @ $1.00 each
98.52
1,456.523 shares Ryan Beck Co.-Dreyfus Prem St Muni Bd Fd @
$16.27 each
23,697.63
4,373.407 shares Ryan Beck CO.-Eaton Vance Utilities F Fund CI A @
$11.24 each
49,157.09
Total
(Attach Additional Sheets if necessary)
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269,886.87
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may. at the election of thepersop<l' representative,
include the value of each item, but such figures should not be extended into the total of the Invent9ry.:", ._~...):.!'J
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Continuation of Inventory
Esther S Hempt
21
05
0806
Paqe 1
Description of Inventory
Description
2,522.944 shares Ryan Beck CO.-Federated Govt Inc. Sec. Fd. CI F @
$8.94 each
Value
22,555.12
300 shares Ryan Beck CO.-Franklin Universal Trust @ $6.25 each
1,875.00
189 shares Ryan Beck Co.-Gillette Co. @ $52.92 each
10,001.88
555 shares Ryan Beck CO.-Glaxosmithkline PLC @ $47.30 each
26,251.50
3,218.373 shares Ryan Beck CO.-Putnam PA Tax Exempt Fd CI A @
$9.18 each
29,544.66
605 shares Ryan Beck Co.-SBC Communications @ $23.91 each
14,465.55
4,201.83 shares Ryan Beck Co.-Seligman PA Tax Exempt Fd CI A @
$7.99 each
33,572.62
360 shares Ryan Beck Co.-Snap-On Inc. @ $34.86 each
12,549.60
304 shares Ryan Beck CO.-Verizon Communications @ $32.79 each
9,968.16
Social Security check
1,485.00
Uncashed check from Legg Mason
14000.00
Verizon-refund
20.79
Subtotal $
176,289.88
269,886.87
Grand Total $
REV-1!roO EX + (6-00)
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEAL TH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
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Hem t Esther S
DATE OF DEATH (MM-DD.Year)
DATE OF BIRTH (MM-DD-Year)
8/24/2005 5/19/1899
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
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00 1. Original Retum
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
OFFICIAL USE ONLY
FILE NUMBER
21 -0 5 0806
""CoUNTYCOOE --YEA~ - - NuMBER- -
SOCIAL SECURITY NUMBER
1 80- 2 6 - 7 0 8 7
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum Idate of death prior to 12-13-82)
D 5. Federal Estate Tax Retum Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
David H. Stone Es uire 414 Bridge Street
FIRM NAME (If Applicable)
Stone LaFaver & Shekletski
TELEPHONE NUMBER
717 774-7435
New Cumberland
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1 )
(2)
(3)
(4)
(5)
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
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233,638.81
,-PA 1-70il
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36,248.06 .
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(8) 269.886.87
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(9) 21.549.61
(10) 1.769.85
(11 )
(12)
(13)
13. Charitable and Govemmental Bequests/See 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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a}(1.2)
0.00 X _ (15)
246,567.41 X .045 (16)
0.00 X .12 (17)
0.00 X .15 (18)
(19)
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
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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(14)
23.319.46
246.567.41
246,567.41
Decedent's Complete Address:
STREET ADDRESS
. 18 Drexel Hills Circle
CITY
New Cumberland
I STATE
PA
I ZIP
17070-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
11,095.53
Total Credits (A + B + C )
(2)
0.00
3. InterestJPenalty if applicable
D. Interest
E. Penalty
TotallnterestJPenalty ( 0 + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
8. Enter the total of Line S + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, A GENT
0.00
0.00
11,095.53
11,095.53
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ...................................................................................................... 0 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. 0 00
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
PA 17070
DATE
PA 17070
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net val'
[72 P.S. 99116 (a) (1.1) (i)).
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for
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 YOt
or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)].
J; () jJ C{/ ;j - . -..~,i\lil)g spouse is 3%
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The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, exce~\ ai>< ,.___ 1.2) [72 P.S. 99116(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. 99116(a)(1.3)). A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
3.99116 (a) (1.1) (ii)).
e still applicable even if
arent, an adoptive parent,
REV-1503 EX + (6-98)
'*
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 05
All property jointly.owned with right of survivorship must be disclosed on Schedule F.
ESTATE OF
Hemot. Esther. S
0806
ITEM
NUMBER
1
2
3
4
5
6
7
8
9
10
11
I DESCRIPTION
1,456.523 shares Ryan Beck Co.-Dreyfus Prem St Muni Bd Fd @ $16.27 each
VALUE AT DATE
OF DEATH
23,697.63
4,373.407 shares Ryan Beck Co.-Eaton Vance Utilities F Fund CI A @ $11.24 each
49,157.09
2,522.944 shares Ryan Beck CO.-Federated Govt Inc. Sec. Fd. CI F @ $8.94 each
22,555.12
300 shares Ryan Beck CO.-Franklin Universal Trust @ $6.25 each
1,875.00
189 shares Ryan Beck CO.-Gillette Co. @ $52.92 each
10.001.88
555 shares Ryan Beck CO.-Glaxosmithkline PLC @ $47.30 each
26.251.50
3,218.373 shares Ryan Beck Co.-Putnam PA Tax Exempt Fd CI A @ $9.18 each
29.544.66
605 shares Ryan Beck Co.-SBC Communications @ $23.91 each
14,465.55
4,201.83 shares Ryan Beck Co.-Seligman PA Tax Exempt Fd CI A @ $7.99 each
33.572.62
360 shares Ryan Beck Co.-Snap-On Inc. @ $34.86 each
12,549.60
304 shares Ryan Beck CO.-Verizon Communications @ $32.79 each
9,968.16
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
233638.81
REV:1508 EX + (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hemot Esther S
FILE NUMBER
21 05
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0806
ITEM
NUMBER
1.
DESCRIPTION
PNC Bank-Checking Acct. #5140028112, Prine. $6,187.82, Int. $.66
2
PNC Bank-Savings Acct. #5003926012, Prine. $11,897.39, Int. $8.65
3
2,549.23 shares Ryan Beck Co.-Cash balance @ $1.00 each
4
98.52 shares Ryan Beck Co.-Cash Reserve MM @ $1.00 each
5
Social Security check
6
Uncashed check from Legg Mason
7
Verizon-refund
VALUE AT DATE
OF DEATH
6,188.48
11,906.04
2,549.23
98.52
1,485.00
14,000.00
20.79
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
36 248.06
REV.1511 EX +(12-99)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HemDt Esther S
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
21
FILE NUMBER
05
0806
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Musselman Funeral Home-funeral expenses 7,225.00
SI of West Shore-dinner 56.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees David H. Stone, Esquire 13,494.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills, Cumberland County 356.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Cumberland Law Journal-advertising grant of letters 75.00
The Patriot News-advertising grant of letters 113.61
Ryan Beck & CO.-commissions on sale of funds
Register of Wills-filing Inheritance Tax and Inventory 30.00
Reserve for closing expenses 200.00
TOTAL (Also enter on line 9, Recapitulation) $ 21 549.61
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HemDt Esther S
FILE NUMBER
21 05
0806
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Holy Spirit Hospital-debt of last illness
VALUE AT DATE
OF DEATH
912.00
2. Homeland Nursing Home
810.85
3. PA Dept. of Revenue-tax due on decedent's final PA40 return
47.00
TOTAL (Also enter on line 10, Recapitulation) $
1 769.85
(If more space is needed, insert additional sheets of the same size)
REV-1513 ~. '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hp.mnt ... ..u_ S
NUMBER
I.
SCHEDULE J
BENEFICIARIES
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2))
FILE NUMBER
21 05
RELATIONSHIP TO DECEDENT I
Do Not List Trustee(s) I
0806
AMOUNT OR SHARE
OF ESTATE
100,000.00
146,567.41
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
Rex King
4729 Great Oak Lane
Harrisburg, PA 17110
Marian H. King
18 Drexel Hill Circle
New Cumberland, PA 17070
lineal
lineal
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
OF
ESTHER S. HEMPT
I, ESTHER S. HEMPT, of New Cumberland, Cumberland County, Penn-
sylvania, declare this to be my last will and revoke any will previous-
ly made by me.
ITEM I: I give, devise and bequeath all of my estate, real
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personal and mixed, of every nature and wherever situate, to my hus-
band, CLARENCE O. HEMPT.
ITEM II: Should my husband, CLARENCE O. .BEMPT, fail to survive
me, I give, devise and bequeath all of my estate, real personal and
mixed, of every nature and wherever situate, as follows:
A. One Hundred Thousand and No/100 ($100,000.00) Dollars,
shall be paid to my grandson, REX KING. A similar bequest is made in
the will of my husband, CLARENCE O. BEMPT, made this date, and it is
our intention only one such bequest be paid and that this bequest not
be doubled in case of simultaneous death.
B. All the rest, residue and remainder of my estate shall
be paid to my daughter, MARIAN ELIZABETH KING.
ITEM III: At the time of the execution of this will, my husband
CLARENCE O. HEMPT, and I hold a mortgage on property owned by my grand-
son .and his wife, CLIFFORD S. KING and ANGELICA M. KING, at Oxbow
Drive, Hampden Township, Cumberland County, Pennsylvania, and recorded
in Cumberland County Mortgage Book 991, Page 754. We have forgiven the
principal balance of this mortgage except for Twenty Thousand and
-1-
No/lOa ($20,000.00) Dollars. Should this mortgage not have been
forgiven in its entirety or paid in full at the time of the death of
the survivor of my husband and myself, I direct that this mortgage and
the accompanying mortgage note shall be forgiven and that my executor
shall mark the note "Paid in Full" and cause the mortgage to be satis-
fied on the records of Cumberland County.
ITEM IV: I appoint my husband, CLARENCE O. HEMPT, Executor of
..
this my last will. Should my husband, CLARENCE O. HEM1T, fail to
qualify or cease to act as Executor, I appoint my daughter, MARIAN
ELIZABETH KING, Executrix of this my last will.
ITEM V: I direct that my Executor and his successors shall not be
required to give bond for the faithful performance of his duties in any
jurisdiction.
IN WITNESS WHEREOF, I, ESTHER S. HEMPT, have hereunto set my hand
and seal this ~ day of Why! )tJr~ ' 1992.
~utl-f ~
.I ESTHER S. H T..
SIGNED, SEALED, PUBLISHED and DECLARED by ESTHER S. HEMPT, the
Testatrix above named, as and for her Last Will and Testament, and in
the presence of us, who at her request, in her presence and in the
presence of each other, have subscribed our names as witnesses.
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W.l.tness
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Wuness
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Address '
N-ellJ {I~)mlJdf)la;/7.r! ;)4
Address
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COMMONWEALTH OF PENNSYLVANIA:
:SS:
COUNTY OF CUMBERLAND
.
.
I, ESTHER S. HEMPT, the Testatrix 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 this instrument
as my last will; that I signed it willingly and that I signed it as my
free and voluntary act for the purposes therein contained.
cf'~.4I A: ~~
'ESTHER S. HEMPT
Sworn
to or affirmed to and acknowledged before me by ESTHER S.
Testatrix, this I ~ ~~~. ' 1992.
Notary Public
HEMPT, the
NOTARIAL SEAL
CONSTANCE l. KARL!, NOTARY PUBLIC
NEW CUMBERLAND, PA CUMBE:<LAND CO.
MY COMMISSION EXPIRES APRIL 13, 1995
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COMMONWEALTH OF PENNSYLVANIA :
:88:
COUNTY OF CUMBERLAND :
We, ((2 Q {f. 0(") ,
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and
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the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, depose and say that
we were present and saw Testatrix sign and execute the instrument as
her last will; that Testatrix signed willingly and that she executed it
as her free and voluntary act for the purposes therein expressed; that
each of us in the hearing and sight of the Testatrix signed the will as
witnesses; that to the best of our knowledge, the Testatrix was at that
time eighteen or more years of age, of sound mind and under no con-
straint or undue influence.
-~Kt~
witness
0i7-t ~ ill ~. /Jr-yrd; ;)3(j){~
- Witness
to or affirmed to
~~
witnesses, this I g- Yt day of
and acknowledged before me by
aiid(~J ~~
,
, 1992.
r?AU~ ~K~.'
Notary Public
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DEC-20-2005 18:50
PNCBANK
412 768 3458
P.01/01
o PNCBAN<
December 20, 2005
David H. Stone
414 Bridge Street
P.O. Box E
New Cumberland, P A 17070
RE: Estate of Esther S. Hempt, deceased
SSN: 180..26-7087
DOD: 8/24/2005
Dear Mr. Stone:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Cheeking AcCOUllt
Account #S] 40028112
Established 01/01/1978
ESTHER S HBMPT
DOD balance: $6,187.82 + $.66 accrued interest
Savi.gs Account
Account #5003926012
Established 05/14/2002
ESTHER S HEMPT
DOD balance: S11,897.39 + $8.65 accrued interest
Please note that this office only provides date of death balances for deposit accounts
(lRAs, CDs7 Checking and Savings accounts). We do not process aay fiDancial
traDs~tiollS or provide statemeats. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
~Lt1Rltz-
Rachelle We11s
1-800-762-1775
P7-PFSC-04..P
500 first Ave.
PitL'~burgh PA l5219
Member FDIC
TOTAL P.12I1
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. G DavId Bias I Henry J. Potl
Ryan Beck Co.
2/24/2006 10:27 AM
Estate Of Esther Hem1l1
Oat. of Death Values 08124/06
Shs. Ho1dinl1.!i. tI.iJlll Low Close
1.) 300 Sh ares Franklin Universal Trust 6.27 6.25 6.25
2.) 189 Shares Gillette Co. 52.92
3.) 555 Shares Glaxosmlthkllne PLC 47.68 47.21 47.30
4.) 605 Shares sac Communioatlons 24.18 23.88 23.91
5.) 360 Shares Snap-On Inc. 35.4 34.84 Ja.aa
6.) 304 Snares Verizon CommunicatIons 33.39 32.79 32.79
7.) 1456.523 Shares Dreyfus prem St Munl Bd Fd 17.04 16.27 16.27
Pa Series Class A
8.) 4373.407 Shares Eaton Vance Utilities F Fund 11.93 11.24 11.24
Class A
9.) 2522.944 Shares Federated Govt Income Securltie~ 9.03 8.94 9.94
Fund, Class F
10.) 3218.373 Shares Putnam Pa Tax Exempt Income 9,'8 9.18 9.18
Fund, Class B
l' .) 4201.563 Shares Seligman Pa Tax Exempt Fd 8.39 7.99 7.99
Class A
12.) Cash Balance as ot 9/30/05 Legg Mason Statement $ 2,549.23
13.) Legg Mason Cash Reserve Trust Money Market $ 98.52
(as of 9/30105 Legg Mason Statement)
"ThIs performance summary is designed to provide Information to help you evaluate your Investments.
The Information and statistical data contained herein have been obtained from sources we believe to be
reliable, but no independent verification has been made, and Ryan Beck & Co. does not guarantee its
accuracy and completeness. Consequently, you must rely on your monthly Ryan Beck & Co.
statements and trade confirmations as your official record of transactions with us."
1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
R~C~IV~D I=ROM:
PENNSYLVANIA
INI-JI==RIT ANCI:: AND I::ST A TE TAX
OFFICIAL RECEIPT
KING MARIAN ELIZABETH
18 DREXEL HILLS CIRCLE
NEW CUMBERLAND, PA 17070
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ESTATE INFORMATION: SSN: 180-26-7078
FILE NUMBER: 2105-0806
DECEDENT NAME: HEMPT ESTHER S
DA TE OF PAYMENT: OS/23/2006
POSTMARK DATE: OS/23/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 08/24/2005
NO. CD 006728
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $11,095.53
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$11,095.53
REMARKS: KING MARIAN
CHECK# 142
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS