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Home My WebLink About08-29-06 . . ..J 15056051058 REY-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year ~I c7:b5 File Number l1D<b Date of Birth 192-34-5943 11/28/2005 06/11/1943 Decedent's Last Name Suffix Decedent's First Name MI Marshall Ms Dixie L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Not applicable Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW C8J 1. Original Return <=) 2. Supplemental Return c::::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Numb~r 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes William A O'Donnell,CPA Firm Name (If Applicable) (717) 737-0974 REGISTER OF WILLS USE ONLY First line of address 500 Kevin Court I"'.' ;-j Second line of address o ~'.- ... City or Post Office State ZIP Code DATE FILED Camp Hill PA 17011-1262 Correspondent's e-mail address:bill9813@yahoo.com Under penalties of pe~ury, I declare that I have examined this return, includin9 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. BLE FOR FILING RETURN .----- AD ESS 446 Herman Avenue, Lemoyne, PA 17043 SIGN"f.!~E OF PREPARER TH THAN REPRESENTATIVE ~ )\J~ G., ~ (f? . ADDRESS 500 Kevin Court,' Camp Hill, PA 17011 PLEASE USE ORIGINAL FORM ONLY ,fATE ,(;{OfD Side 1 L 15056051058 15056051058 --.J ~1J --.J 15056052059 REV-1500 EX Decedent's Name: Dixie L Marshall RECAPITULATION 1. Real estate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 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)................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Govemmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ... . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O 45 64,530.00 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 Decedent's Social Security Number 192-34-5943 18,365.00 48,630.00 66,995.00 2,465.00 2,465.00 64,530.00 64,530.00 2,904.00 2,904.00 15056052059 --.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Dixie L Marshall STREET ADDRESS 603 Thrush Court FII!I.N.UIll~l!J. ~ DECEDENT'S SOCIAL SECURITY NUMBER 192-34-5943 CITY Mechanicsburg (Hampden Township) STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,904.00 Total Credits (A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, 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. 2,904.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (5B) A. Enter the interest on the tax due. 2,904.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... ~ D b. retain the right to designate who shall use the property transferred or its income; ............................................ ~ D c. retain a reversionary interest; or.......................................................................................................................... [iJ D d. receive the promise for life of either payments, benefits or care? ...................................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ~ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [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 zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot 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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent [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. REV-1508 EX+ (6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Dixie L Marshall FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Mobile Home -1977 Zimmer; Sold 3/11/2006 for $11 ,000 less selling expense of $500 VALUE AT DATE OF DEATH 10,500.00 refer to Exhibit A 2 Checking account - Wachovia Bank 4,000.00 3 Automobile - 1998 Oldsmobile Achieva 2,500.00 4 Federal Income Tax Refund 1,065.00 5 Fumiture and Fumishings 300.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 18,365.00 REV-1510 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Dixie L Marshall FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUOE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO OECEOENT ANO DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE OATE OF TRANSFER. ATTACH A COPY OF THE OEEO FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Annuity - AIG Insurance Company PO Box 570 Rockland MA 02370-0570. Refer to Exhibit B 24,892.00 100 24,892.00 2 Highmark,lnc - Plan # 1457 Refer to Exhibit C 19,420.00 100 19,420.00 3 Individual Retirement Account - Wachovia Securities Refer to Exhibit D 4,318.00 100 4,318.00 TOTAL (Also enter on line 7 Recapitulation) $ 48,630.00 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Dixie L Marshall FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Cremation expense Wake and other miscellaneous expenses 1,440.00 293.00 2 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) David A Marshall, Execu 0.00 City Lemoyne . State PA Zip 17043 Year(s) Commission Paid: 2. Attorney Fees 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 82.00 5. Accountant's Fees 150.00 6. Tax Return Preparer's Fees 500.00 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,465.00 REV-1513 EX+ (9-00) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Dixie L Marshall FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS ~nclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] David A Marshall Son 32,265 446 Herman Avenue Lemoyne, PA 17043 2 Lisa K Carns Daughter 32,265 200 Verbeke Street Marysville, PA 17053 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 Not applicable B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ None (If more space is needed, insert additional sheets of the same size) No. 2690,484 LAST NAME OR FULL BUSINESS NAME) C-)h (\,\.\ i 1==- eel a: CO-PORCHASER. "., ~ Sj- (j1f~r:J(C; R ~;:E () ~. STREETC'(?l'/l-! hi 'L++ CT Ir:t K:}-l.~",! i (C1Rls~7<~ . pC! r7(~L--x', .... z W ::;; Z " in Ul < .... ~ A. c WW -,Ul u< -J: J:u Wa: >::J .. B. c. , . . PA TITLE NUMBER (AS SHOWN ON ATTACHED TITLE) .~CI4'l XC-1-11 L-f',:; VEHICLE r~Fr1Z~MBER LAST NAME't{l}h;.,,,: ~::.~_S:I..N1ES7\NAMEI Iv Mk,~H Hi l MAKE OF VEHICLE 7.llvl H (.~ CONDITION DrOOOD .j) N ilRSLAME IMODEL YEAR Ii cr71 o FAIR o POOR MIDDLE INITIAL CO-SELLER (1 ~_ FIRST NAME !1 (\i<Or,', I'll CO .J MIDDLE INITIAL I DATE ACQUIRED/ PUROHA~EjD /"J .-J -I I -Uc L COUNTY CODE .11 ;Zl i REFER TO COUNTY CODES USTING ON REVERSE SIDE OF PINK copy D. LAST NAME (OR FULL BUSINESS NAME) .... z W ::;; ill z " Ul < in J: Ul U < a: C ::J iiS .. c iiS E. W -' u :;: W > F. a: ~ z o i1 u :l .. .. < Fee Exempt Number as assigned by the Bureau l COUNTY CODE 5. Duplicate Reg. 11 I N:~~ Cards _ REFER TO COUNTY CODES LISTING ON REVERSE SIDE OF PINK COPY FIRST NAME MIDDLE INITIAL I DATE ACQUIRED/ I PURCHASED PURCHASE PRICE (See note on reverse) i/(((\.- . CO-PURCHASER STREET CITY STATE ZIP CODE LESS TRADE-IN . MAKE OF VEHICLE I VEHICLE IDENTIFICATION NUMBER I BODY TYPE (CP. TK. ETC.) I CONDITION I D GOOD D POOR TAXABLE AMOUNT ! . I I I MODEL YEAR [J FAIR ORIGINAL PLATE ..; Check One o PLATE TO BE ISSUED BY BUREAU (PROOF OF IN- SURANCE MUST BE AT. TACHED.) EXCHANGE PLATE TO BE ISSUED BY BUREAU TEMPORARY PLATE ISSUED BY FULL AGENT D TRANSFER OF PREVIOUSLY ISSUED PLATE D TRANSFER & RENEWAL OF PLATE D TRANSFER & REPLACEMENT OF PLATE D TRANSFER OF PLATE & REPLACEMENT OF STICKE? o o .n "(tip ()f\lll TEMP. PLATE NO. (\ VEHICLE PURCHASED ~GVWal WEIGHT INFO. IIF APPLICABLE) INSURANCE COMPANY NAME 1. Sales Tax Due x 6% l.06) or x 7% .07} See note on reverse) ~:a~~~"'&~~ (must be a number from 1 to 23 or 0) 1 B First AsSIgnment . f#:o I 1 B Second Assignment ,~~.5\ 2. Title Fee 3. Lien Fee . 4. Registration or Processing Fee . 6. Transfer Fee . 7. Increase Fee . 8. Replacemenr Fee I 19 ;J'1 _:'n I dY2<. ~.I . TOTAL PAID (Add 1 thru 8\ 11.GRAND TOTAL (Add 9 & 10) I Send One I ChecK In This Amount ! /'l~ r- .. i ,..-,i.-7\. 1"1..; PLATE NO. EXPIRES I Month Year 'TRANSFERRED FROM TITLE NO. I REASON FOR REPLACEMENT o LOS7 0 DEFACED 0 STOLEN o NEVER ::;:EC~IVED (I_''JST IN MAIL"1 NOTE: If . NEVEr: RECEIVED" block is checkec. aoollcanl must com lete Form MV-44 I VIN i ISSUING AGENT INFOR- MATION SIGNATURE OF PERSON FROM: ~'SIGN HERE WHOM PLATE IS BEING TRANS- FERRED IIF OTHER THAN APPlICANT\ I UNLADEN WEIGHT IREO. REG. GROSS WT. ! INCLUDING LOAD. I POLICY NO. (OR ATTACH BINDER' I CERTIFY THAT ON MONTH DAY _ YEAR _ ISSUING AGENT (PRINT NAME) I HAVE CHECKED TO DETERMINE THAT THE VEHICLE IS INSURED AND ~g~~EI;~~t0~{~~~E:~~~~6';~~~ ~~6t:~I~~~V6l+~~le~~~~~ CODE ISSUING AGENT SIGNATURE AND DEPARTMENT REGULATIONS. I RELATIONSHIP TO APPLICANT I ~EQ REG. GReSS COMB I WT. (IF APPLICABLE I I POLICY EFFECTIVE DATE I FOLlCY EXPIRATION I DATE AGENT NO. TELEPHONE NO. ( ) I/WE CERTIFY THAT I/WE HAVE EXAMINED AND SIGNED THIS FORM AFTER ITS COMPLETION AND THAT THE INFORMATION GIVEN IS TRUE AND CORRECT. IF AN EXEMPTION IS CLAIMED, THE PURCHASER FURTHER CERTIFIES THAT HE/SHE IS AUTHORIZED TO CLAIM THIS EXEMPTION.I/WE ACKNOWLEDGE THAT IIWE MAY LOSE MY/OUR OPERATING PRIVILEGE(S) OR VEHICLE REGISTRATION(S) FOR FAILURE TO MAINTAIN FINANCIAL RESPONSIBILITY ON THE CURRENTLY REGISTERED VEHICLE FOR THE PERIOD OF REGISTRATION. I/WE ACKNOWLEDGE THAT I/WE MAY BE SUBJECT TO A FINE NOT EXCEEDING $5,000 AND IMPRISONMENT OF NOT MORE THAN TWO YEARS FOR ANY FALSE STATEMENT THAT I/WE MAKE ON THtS FORM. ..., ?,gn~~~ First Purch~r or Autho~d Signer TELEPHONE NUMBER ~nature ~r /A' 1ST '~\~'ff..~_- 'VLl/ ~:--_ ( )~\./ ,A",. -/~. ~~~- ) ~naY of eo-Purcha'sl!'r/Titlelpf ~""'rized Signer -- ~ature of};6-Set1!i __ , / AA._ V(~ ~, l Al-::u. Al Pl-t, G. z o i1 u u: ;:: a: W u H. 2ND ASSIGN- MENT Ignature of Second Purchas~orized Signer TELEPHONE NUMBER I ) Signature of Co-Purchaser /TiUe of Authorized Signer Signatur#of Selier Signature of Co-Selier z o ~~ ~~ '" ;; NOTE: If a co-purchaser other than your spouse is listed and you want the title to be listed as "Joint Tenants With Right of Survivorship" (On death of one owner, title goes to surviving owner.) CHECK HERE C. Otherwise, the title will be issued as "Tenants in Common" (On death of one owner, interest of deceased owner goes to his/her heirs or estate). NOTE: IF THE VEHICLE IS TO BE USED AS A DAILY RENTAL OR LEASED VEHICLE. CHECK THIS BLOCK 0 . IF BLOCK IS CHECKED. COMPLE1E AND ATTACH FORM MV-IL. C; JEt. t.. ( N u.. -: Ptf, c€- ~ Il- rs 0 " FZ--: S ( (, tfY"! MESSENGER NUMBER: ..' . . . ~~UREL\U -~= rVl.JTQE \!=:-UC:..::S F 1< [-f (is {I A- 13609 AIGANNUITY INSURANCE COMPANY Insurance Services - #811 P.O. Box 570 Rockland, MA 02370-0570 AIG Annuity Insurance Company A Member of American International Group, Inc. 1...111...111....1.. I.. II... .111. 1...1..1,. I. I. I. .1.11..1,1.,1 110718955 PRIMARY ACCOUNT Nt.'MBER \ 2/26/2006 \ STA tios DAVID A MARSHALL 446 HERMAN AVENUE LEMOYNE PA 17043-1942 TAX ID NO: AIG ANNUITY BRIDGE ACCOUNT NO. 110718955 BALANCE THIS STATEMENT 0.00 BALANCE LAST STAT""..-MENT 12,443.59 NO. I 1 I CREDITS TOTAL AMOUNT 2.75 CHECKS AND DEBITS NO. 1...~T-Jlr..L 2 If' 12,446.34 ,,-- r ACCOUNT TRANSACTIONS DATE........... AMOUNT.. .......... .BALANCE... DESCRIPTION 01/30 12,429.28- 14.31 CK# 501 02/25 2.75 17.06 CREDIT-INTEREST EFF DATE 02-26-06 DEBIT-MIN BAL CLOSE EFF DATE 02-26-06 02/25 17.06- 0.00 RATE HISTORY DATE.... .... .... RATE 01/26 2.000% DATE............ RATE DATE............ RATE ****** CURRENT INTEREST RATE ****** INTEREST CREDITED YEAR-TO-DATE 2.000% ****** 17.06 ****** ********** END OF STATEMENT ********** 7) f)-/t f> ~ L l > I't- (r; S I~fi.. ft-rvNV I M V trl- \) Ii:. :5 fl-tj- n.t:: 1> fA U--(<- , ,).. L/-I..).L. , $. ~ tf 8 l!J "J.- I A-s It- 13 . VI(... ~ r;: fi.. tJ I f'ZJ I r B NOTICE: See reverse side for reconciliation of this statement and important information. 811-11 LUMP SUM DISTRIBUTION CHECK HIGHMARK INVESTMENT PLAN PLAN I 1457 DAVID A MARSHAll 446 HERMAN AVE LEMOYNE PA 17043 **TAX INFORMATION************* CAPITAL GAINS $ ORDINARY INCOME $ UNREALIZED APPRECIATION $ EMPLOYEE AFTER TAX CONTR. $ NET TAXABLE AMOUNT $ 0.00 9> 710.24 0.00 0.00 9,710.24 **FORFEITURES/FEES TAKEN PRIOR TO THIS DISTRIBUTION************* FORFEITURES $ 0.00 CHECK FEE $ 20.00 CHECK 1:00003479812 **DISTRIBUTION INFORMATION**** GROSS AMOUNT **DEDUCTIONS****************** FEDERAL WITHHOLDING $ STATE WITHHOLDING $ OUTSTANDING LOAN $ ROLLOVER AMOUNT $ IN-KIND DISTRIBUTION $ NET CHECK AMOUNT THE ATTACHED CHECK IS YOUR DISTRIBUTION FROM THE HIGHMARK INVESTMENT PLAN THE APPROPRIATE TAX FORM WILL BE SENT TO YOU EARLY NEXT YEAR. r~N ( 01/04/06 \\ "'" .~----~ .~'.... .,.,.~..........-J-J<...ti .~ '--~ " 1,942.05 0.00 0.00 0.00 0.00 -------------- -------------- $ 7,768.19 5 H tr<'2..fU 5 f1Ifrrl {:..- $,. a iLt. v.L~o(1i. --I, /' () rJ-' f'J'''' q l/U -!l'i 0 c.; d- 0 7) ~/ I~) l~ ~_ (~ A- 's --,-&r Ih-- vJ,-~ lJ~- I L/ ':. - 7 (? /---flrJ r-;.."f. If In I -,- <: TRANSACTION NOTIFICATION II WACHOVIA. SECURITIES Contact Information: Wachovia Securities Client Services Department P.O. Box 6600 Glen Allen, VA 23058 000271 40lb 0010200741. DIXIE L MARSHALL 603 THRUSH CT MECHANICSBURG P A 17055 (866) 785-6746 (704) 383-4063 Account Number: 57632134 January 3,2006 Dear Valued Client: We want to thank you for your recent transaction(s) with Wachovia Securities. Industry regulations require brokerage firms to issue notifications when certain transactions result in securities or funds being transferred out of a client's account. These transactions include movement of assets to third parties or to outside entities bearing the same account holder name. This notification is not a replacement of your regular account statement. If you have questions regarding the transaction(s) listed below. please contact our Client Services Department at the phone number or mailing address shown above. Should you have any other questions regarding your account, please contact your Financial Advisor. Thank you 12/29/05 12/29/05 Transter Out to Beneticiary Transfer Out to Beneticiary $2,159.47 $2,159.48 ..$ fi. of l'?~' u~ ( )S --r or kL- V 1}vU .l- - - - - r;-^ J..j I ~ I r D Wachovia Securities LLC, member NYSE SIPe. Accounts carried by First Clearing LLC, member NYSE SIPC. Page I of I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MARSHALL DAVID A 446 HERMAN AVENUE LEMOYNE, PA 17043 U__n__ fold ESTATE INFORMATION: SSN: 192-34-5943 FILE NUMBER: 2105-1108 DECEDENT NAME: MARSHALL DIXIE L DA TE OF PAYMENT: 08/29/2006 POSTMARK DATE: 08/28/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/28/2005 NO. CD 007157 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,904.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: DAVID MARSHALL CHECK# 1015 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS $2,904.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS r -=-- uJ C) N cr: cr: (00 l- a.. 01 (fl .' N OC1C)C(1 .00 Cl-_a:C,CO<r("l a::::l-,NN- .00.COr- _0 (fl (fl_,C)0r-- . t-t :::J.o- :::l a: cr:o a: cr: :I: ~'A :::l o :I: cr: - - - - - - - - 0- 0- Cl o == - --' -E:Ft ""~ ~t ~~. 0'"';\ ,00:\ (fl' Q) Ul ::l o ..c: t:: ::l r-- o 00 U rrl >,Q)t'( .....Hrrl Ul ~ ~..... _ ::l c::r'O :;:::OVlr-- ~UQ)- 4-;"OUl....... O~::l"'" H_Oo.. Q) H..c: ~ ..... Q) t:: Q) .~..g ::l Cil 01)\=<0;':::: Q) ::l U H "" r) - r~ Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 1033 8/29/2006 MARSHALL DIXIE L 2005-1108 MARSHALL DAVID A 446 HERMAN AVENUE wz LEMOYNE, P A 17043 Qty 1 Fee Description Additional Probate Fee Total 40.00 $40.00 Total: $40.00 Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you.