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HomeMy WebLinkAbout96-00262 PETITION Hm GnANT 0... u:rnms <)to' AUMINISTI{ATION blal" IIf ...LnDl~~.:._\,~t.\.!:'-J':JU~-- alslI kllllll'll a.' _~_~___u_ --~--~------- ___()'I.:::_.Lqgl.t1~lli_L__- Nu. lu: _____. ___________ /Jt'('('a,\('{/. S'I<' ... ..1-\' 'S- }'" Oflll ,)('('II"'Y ,,,0. ~~__m__..:...2_L~~______ R~~i'l~r uf Will, for Ih~ ('ounty of J_',__~l~..~LI\.'...j.\ ill the ('onullonwcalth of IJcnll\yl\'aniu Th~ p~liliun of Ih~ nn"~r,i~n~u r~'p~clfully r~pr~'~nl' Ihal: Your p~lilioo~r('), "hu i,/ar~ IK y~ars uf a~~ or uldcr. appl~___ for Icll~rs of :Iumini'lnllion Oil I h~ ~'Ialc of (J.h.n.; PCIUJcIlI~'liIC; lhll.1II11' i1h~cl\li.l; dlllillUI' llIil\lllilillcl Ih~ abow u~c~u~nl. Dcccndcnt wu\ domiciled al death in ( '. .,,' 1 \...: ,l..l ...,.. ...\ Count)'. Pcnn"iyh aniu, with It \"" last fumil)' or principal rc~idcl1cc at ~~ It- tV ,+ ('1 l ." ;~,) C,:,... ,,!,,~-~ .1\,.\ . 11 ;'>v.-~4 (Ii..t ..Ueel. lIumlll,'r illUi lIIunidJ'lillil)') l P I ct~ ,- \/ ....: . \ \.. j (l ) Dcccnucl1l, Ihcn (., I at \ I'-h~ LI'- t M,l 0-" ti \' ,\ I"':" L-\ '-'.l l' -",- ,. ~ _. 19-'~. 1 I I ~ years of age, died \.- 1~~t'"~i\ll.\l-- I".ll'\ Dcccnucnt al dCalh owncu propcrlY with c'limal~" valucs as rolllow,; (If uomicilcu in Pa,) All pcrsomllpropcrlY $ (If nol uomicil~u in I'a.) Pcrsonal propcrly in Pcnnsylvania $ (If nOI domicilcu in Pa.) PcrsonalpropcrlY in Counly S Valuc of rcal cslale in Pcnnsylvania S silllalcu as follows: Pclilioncr_ aflcr a propcr scarch ha:2- a"'crlain~u Ihal u~ccucnllcfl no will anu was survivcu by Ihc following spousc (if any) anu hcirs: Namc I\) ("U:..NL.. <",)1 ~1\.Jt:.. I:t.. , ( .\ ,l.t;, ... rr\ '<-'.left. S..,,",AuEL-- '-", t\ :\It.: \"",.I\l~_"'.'~ ".."\..,,,. I \~ \.~ 1\ L. .:...... f\._:~~'~':'~ ! ,..\,...~HI..( )l'\~.,"Jr:r- , Rclalionship DI\\;(' IlTC,'. .o(,U-( i-\r U'- SU.J Of\Uc:.t~ rt"'- O:\(,.~\\Tt.'" S(.;.... 1131. 'I c: 'A.AJd.\...-\., Ft. 11J~'+ '.^, ._.,~,}1, (0,.1'10.10 THEREFORE. pClilioncrh) respcclfully rcqucst(s) thc gram of ICIlCrs or auministralion in Ihc appropriatc form 10 Ih~ unuc"i~ncu. % c " .",.. 'cf "," c .,,0 c.':: n'':: -~ '- ..,.~ ;c ; c ~ Vi Il1!}'> 1\,'HI', "'" lftl fl"'ll 1",<, C(~l!l" All t. \,'/\Ilttlr;i, ii h ilUi,td 1(1 i\tltH 1111~. L{ii'l (oil III PUf'IILi.fl H, l'!iUI(I:..}f>,! 011 PHil}i){.llid H COMMOUWf Al IH 01 1'1 Nttfi'1'tVANtA OI:I'AIITMI ~H or tHAITll VITAl IUC:OIH)~i LOCAL REGISTRAR'S CERTIFICATION OF DEATH CERT. NO. 2689783 . /(~\i"~'otpi~, /..~. "~,, (i." .~.,.\t\ ~fM ., l~t ..\ ,hI \\<'- . .,,;. ,~,,:--,~,-( ~ >'~~I/ '>'4'/.11":'. -+-\.....)9 (NT n,....!, I) [. '.'I i Q t"I~\" . ~_' ,\.l \ , . _ ,~. __.t~. ::._.. ," '." ",., I ,'1' ,~I, ", Name 01 Decedent - - Fred, F. St arner_..._.._ t.,.. Sex __Male_ ...... SOCial Security No ..185-2B-2390 Dato 01 Death..-.l1ar:C!Ll5.. 1996 Date 01 Birth ... ' 6:14-1934 Birthplace Di ck i nson Townshi p" Cumber1 and..Co.untY,.J'.e.n.n.sY-Lv.ani a Place 01 Death___CJlrltsle-.HomitaL.- f. ','", CumberJand CountY..______._~~_U.i!_E!...__ Pen!l~ylvani<!. , ' " t,.,. I"'" ~, .... ", i' Race __W.hite__.. Occupation. Truck Dr iver A,med Forces? (Yes or No) --.tlQ Decedent's Marital Status Widowed.. Mailing Addles" 94 Peach GlenuRoad ,..Gardn_er.s ..~8J7)24 " f"."""""" ';11!" Informant .--J/inUr:.edQuesenber_ry_ Name and Address 01 Funeral Establishment ...__p.!lgan rl!neraL Home, Inc., Bender_sviJ1.e. PA .J]3QL I:uneral Dlrecto'. M._.Lee_.pugan.. ._______ Part I: Immediate Cause Interval Between Onset and Death (a) ____Prob.a~l e.J'\Yocardiallnf arcti_on. _.~,,__._._._._~___ f. (b) __J.jYPJ~rtlln_sJyg..c.ardioy-a~<:ular. Di sease. .___.__._~_______.-4_____'__' (c) ___ ___.___.. u_..___..._________.-___ Part II: (d) __________.__ Other Signifrcant Conditions Remotl!_r11-"-.... , 0"_ ~._____._j. __u_______ Manner 01 Death: DeSCribe how injury occurred. Natural ~ Homicide [) Accident 0 Pending Ilwestigahon 1--' _ J Suicide 0 Could not be Dcterr11lned [) Name and Title 01 Certlllcr_!'lL~hae 1 Norris . Coroner (MtCb~o.. Coroner. M.E.) Address _________ .405 Fairway Drive, Mechanicsburg, PA 17055 --~- --.-.-- -- -----.-_._---- This is to cerhfy lhat tllP II1tOrl11atloo !lele 'lIVen IS correctly copied Irol11 an orrginal certlfrcate 01 death duly filed With me as Local Re'llstr,J1 Tile OflllHlal cl'rtlfil:ate Will be forwalded to the State Vital Records Oll,w for pCll11anl'nttllln'l 11arch 18. 1996 \ l'.:.(~ {-i-~:...-!9-// """_c;co.J;~g1.L 124 Rice Avenue, BjglerviJ leLPA_11307 . I"~ ,"'''''''1 ",',.1...".,,', . _,._" _....... '<00__-.- '- (: - 1I11111a.AS. 1I0\J(:J.AS & 1I0\l(:J.AS 27 W. 11((;11 S.... "Oil 261 CARJ.ISI.E I'A 17013 n:U:I'1I0Nt: 717-24.1-17911 (icnrl!l' F, f)tlll~lil'i. III. E~(ltlirc SUI'ICII\C Cuml II (,I HH(, .......i"f.j..RE:..EsTATe..c)"F..FFl"EO..F:..STARf.j.ER;....... ................"iil..i"iiEi..cou.ij..Or.Commo.ii...pieas..o'............... DECEASED, LATE OF DICKINSON Cumberland County Pennsylvania TOWNSHIP, CUMBERLAND COUNTY, Orphans Court Division PENNSYLVANIA NO. 1996-00262 .............................................................................................................................................................................................................................. Praecipe withdrawing appearance The appearance of George F. Douglas, III, Esquire, on behalf of this estate is hereby withdrawn. l1L ,.... \.\ P ~ ,U\U!1-o/ I /.ftjU.J'il~ U-J I George F. Douglas, III Dated: October 3,1996 'J"l r-, I ~:~ l_ ;:; ou }1-lq'/0> -)li 7_~ RENUNCIATION In Re Estate of \ ,._L ,\ \ ::. \ f ~.r' \'-.,\ \ r~_ deceased. To the Register of Wills of " "- .\. III l 1,1 t- t\ t... .~ COlllllY, Pcnnsylvania. of The undersigned . the above decedenl, hereby renounce(s) Ihe right 10 adminisler the cst ate and respcctfully a5k(s) that Lellcrs (; t- 1\(\r". .,\; ",' 1'1 \ "._' (. ; be issued to \.l. I rv , i ~ l j) (-.....:l'-l.lll\\\ ~~~...:\j \ WITNESS t'\~Ll.r __ hand this day of M ,\", II , 191.L-. 1) / OJ ' .( - ~i ,,<I _J~ ~ t J' _ iJi A 1;~./l k'~-- t.- ~ o. 6.') 7.1 (Signature) tJrrt~~~'y It. 11~<fJ (Addres.) I~ . /& .'" t..dA~'ll.A ~/A?""/' (Slgn.ture) 71 t;n"Jl,.PJ2"c' ;;f~L (Address) (~,.{/.t(A1U 5 ,{ 1'l-3h ~ k"; Lt/,era.j l.Jt1l,j .1" V _.(j (Slgnalure) 1M. n,-r../ui..lil If? R.l'> .c-~," 1'/):.1 n'y:lct.1v (Addre..) pA r1cho .. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Fred F. Starner Date of Death: Narcll 15, 1996 Will No. 2196-0262 I\dmin. No. To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to thEj.la~Ot,lq'fJ~61g beneficiaries 0 f the above-captioned esta te on Name Address SEE ATTACHED NOTICES Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: Nay 2, 1996 tL N\. ~ r: 7;)OV.,o. CJ a- ~ ~atute ~ Name George F. Douglas, Ill, Esquire Aririress 27 \~. lIigh St. <3 .....l .$ ('.' C:';O= W. C, 0 t'. 0 N I "(;, . ~ . -. .- ~ .- 0 - 0 Gl 'r':l WCC ~\ ":: :...r a: au Carlisle, Pa. 17013 Telephone (17 ) 243-1790 Capacity: Personal Representative xxx Counsel for personal n'presentative NOTICE OF BENEFICIAL INTEIH:ST IN ESTATE BEFORE TilE REGISTER OF WII.LS. COUNTY OF CU~lIlEI{LI\ND. PENNSYL V I\NIA IN RE: ESTATE OF: FRED F. STARNER.. DECEASED NO. 21-%-02(,2 TO: Winifred Que~enherry % Peach Glen Rd. Ganlner~. Pa. 17324 Please take nolice ur Ihe death of decedcnl and Ihe grant uf letter~ lulhe per~onal represenlatives named heluw. You may hal'e a henelicial irueresl inlhe eslate as follows: Under Ihe Inlestate Laws of the Conllnon\\'eallh or Pennsylvania Name or decedent: Fred F. Stamer Lasl known address of decedent: 1).1 Peach Cilen Rd.. Box 4hX. (iardncrs.Pa. 1732.1. Date of Death: t-.'larch 15. 11)% Place or Dealh: CoII'lisle. Cumherlaml ('ounty.Pa. County or Grant of Original Letters - Cumherland Decedent died Inlestate. . Name. address ami phune numher of all personal representalil'Cs: Winifred (Jue~enherry. Alhninistratrix IJ6 Peach Cilen Rd. Gardners. Pa. 1732.1 Name. addres~ and phulle I1lllllher or counsel: George r:. Dougla~. III. E~quire 27 W. lIigh SI. Carlisle. Pa. 17013 Phune: 717-2.U-I7<JO Additional inrurmation may he ohtained rromlhe undersigned: Douglas. Duuglas &. Duuglas . J. r Ill' .jJ 1,,)1, f. Hw.:l.\.A I'::) (j~urge F. Dmlglas. III. Esquire :J 27 W. lIigh 51. Carlisle. Pa. 17013 717-2.U-17<JO Daled: May 2. 19% . --.....-.,..< -_. '- . c. ES'l'I\'l'E OF FHED F. S'I'I\HNlm, 11I,:n:I\SI':1l FILE NO. 1996-00262 FAMILY AGREEMENT 'l'he circumstances l(,adinc) op to the execution of this instrument arc as follows: 1. Fred [0. starner died I.larch 15, 1<)1)6, intestate. On March 29, 1996, Letters of I\dministr'illion ~Iere issued to Wi nifred Quesenberry, daughter of tlw decedent. 2. Under the Intestate la~ls of the CommomlCalth of Pennsylvania, the sole heirs of Fred f. starner are his six children, Darlene 1\. starner, Carol 1\. starner, Rebecca S. starner, Timothy starner, Samuel II. starner, and Vlini fn'd Quesenberry. 3. It is the desire of Darlene 1\. starner, Carol 1\. starner, Hebecca S. Starner, 'l'imnthy Stilrne.-, Silmuel II. starner and \'linifred Quesenberry thai: their shiln,,' ,)f t.lw Estate of Fred F. Stnrnet., deceased, be distributed without the formality of a Court accounting, and the sa i d \~i n i f n'd Quesenberry, I\dminlstratrix, is willing to make such distrihnUon upon receipt of this executed I\grcemen t. 4. I\n informal accountinC) of l.Iw i"lministration of the Estate of Fred F. Sta rner, has I"'(,n pn'p" red by \~ i nl f red Quesenberry, I\dministratrlx and Is iltl,;H~h"d herdo as Schedule "1\". 5. In consideration or l.hc' !llIP'l()in'l and intending l.o be legally bound hereby, DaLlene 1\. :;lill"I\C,r, Carol 1\. starner, Hebeccil S. starner, Timothy starner', :,illnupl II. starner, and ~linifred Quesenberry: 1\. Do hereby \'Iilive i.ln iludit o[ an account of the administration of the Estilte o[ ','red F. starner, deceased, by the Orphan's Court Division or the CourL of Common pleas of Cumberland County. I3. Do hereby deel ille tha t they have examined the attached account of the Estate of Fred F. starner, deceased; that they find it to be true and correct in aU par~ticulars; that they accept and approve i t ~Ii th the same force and ef fect as if it had been prepared and duly filed with, audited, adjudicated and confirmed absolutely by the Orphan's Court Division of the Court of Common Pleas of Cumberland County. C. Do hereby acknowledge that Winifred Quesenberry, I\dministratrix, has distributed all assets of the estate of Fred F. starner, deceased. D. Do hereby absolu l.e I y ilnd irrevocably remise, release, qui tclaim and forever d i SCllil I'CJe Wini fred Quesenberry, I\dministratrix, her heirs, execllLors, administrators and assigns, of and from any and all action, reckonings, liabilities, claims and demands relating in any WilY to her administration of the Estate of Fred F. starner, deceased. E. Do hereby decline i L l.u be their intention that this instrument shall be legally billdi:t'l upon them and upon their heirs, executors, administrators ilnd ilssigns. EXIlIUIT"A" ASSETS: I. Real Estate 2, Partnership 3. Farmers Trust checking acct 4. Cash 5. 1984 Yamaha VenlUr motor cycle 6. 1985 Toyota truck TOTAL ASSETS DEBTS AND DEDUCTIONS: I. Deductions: Funeral expenses Death Certificates Personal Representative Commission Attorneys' Fees Probate Advertise Letters Real Estate appraisal Vehicle Appraisal Realty transfer tax Cost to remove debris from real property Real estate scltlement charges Transfer fees-vehicles Postage $20.029.48 $ 4,500.00 $ 539.04 $ 318.65 $ 0 $ 200.00 $25,587.17 TOTAL $ 2,600.00 $ 12,00 $ 1,000.00 $ 1,650.00 $ 108.00 $ 122.08 $ 200.00 $ 35.00 $ 200.00 $ 4,799.28 $ 101.88 $ 67.50 $ 6.40 $ 10,902.14 , -. .- ~. .- 2. DEBTS: 1995 & 1996 rcal estalc and personal taxes-Carolyn McQuillen $ 104.27 1996 rcal estate taxcs-Carolyn MeQuillcn $ 77.18 John Crcighlcon Tax scrviee $ 35.00 Master card $ 365.47 Visa card $ 380.06 Roy Carbaugh.pcrsonalloan $ 1,000,00 RWC cmcrgcncy physicians $ 245.00 Carlislc Hospilal $ 724.00 Ycllow Brccchcs EMS $ 762,00 Farm Plan financial accl $ 241.88 Ford Citibank master eard $ 771.75 Smith Klinc lab $ 156.00 United Telephone $ 47.62 North American Hunting Club $ 37,10 Lilllc's Gas Service $ 39.33 Reliance Consumcr Discount $ 54.99 TOTAL $ 5,041.65 3. PA INHERITANCE TAX $ 707.68 TOTAL DEBTS AND DEDUCTIONS $ 16,651.47 BALANCE FOR DISTRIBUTION S 8,935.70 DISTRIBUTION: DARLENE A. STARNER $ 1,489.28 CAROL A. STARNER $ 1,489.28 REBECCA S. STARNER $ 1,489.28 TIMOTHY STARNER $ 1,489,28 SAMUEL STARNER $ 1,489,29 WINIFRED QUESENBERRY $ 1,489.29 COMMONWEAI.TII OF I'ENNSYI.V ANIA : ss COUNTY OF CUMBERLAND On (.c "l' <; 'i . before me. (\ )10 \ ('\ t, -I ol.tll ~. . personally appeared Rebecca A. Stamer, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same for the purposes therein contained. WITNESS my hand and official seal. ,.--.- l .~~). (" l\tA r\ NOTARY PUBLIC , .fl \ ~-v-." \ ,\,',-Cy- \ I My Commisssion expires: NOTARIAL SEAL DENISE PINAMONTI. Norary Public Carlislo Bornuijh, Cumberland County M Com~I~~lo'l Ellplres Nov. 20. 2000 O('j :0 S ~ ~ ::l :0", IT ~'1 " ,', L ~ I '0 2 :JJ." (ii. S. y;::o. Ui 0 I, REv ',r~(,. I'QJ} ... .... :.::!UJ U",,, .....u :1:09 ufm .. c< ,.... "'z ...... "'co "'z 8~ fOR OAtiS Of DIATH AnlR 1~'31191 CHICK HIRE INHERITANCE TAX RETURN ~ty::~l~:~DIT ISCLAIMID I RESIDENT DECEDENT Ifill NUMBER 1~~T~E :J~~~T~ ~~p~~~J~ ICOU"~~OOE (JI(I 01 HT'~ lUMPlllt Allti~l ~~ 911 I each Glen Hoa,i Gardnern. j'a. 1'132/1 CO"", Cumberland ~ f '"OU"~I(~Z^i\j~",\"UC1'O>'~---- ---~- \-J 3. Remainder Return liar date' of deolh prior to 12.13.82) [J 5. federal E,tote Tax Return Required J2. 8. Total Number of Safe Depo,il Boxel /:5~ 15 "/ ~~ (OMMm~WE"lttt Of PENtl!lH'y'AUIA OEPAA.IM(HT Of R(V(tW( O(PI 180601 'i"flRI~IlURG. ~A "_'_~~.0601 DIC(O(Nl'!! NAM( IIA!!I, 'IR~I. AltO Io'IODll It;lIIAI) ~itarnpr. Fred F'. 'Q(;'R5~U~~':~~;;~~~~-~ _~_-_ XJ/I'5/~;; . j"~~/(;'~;3'11 ,,' ..",,,,,,, ,,,,,,,"G "Oo;;/'~.'~'::""~." "..'." toc"":';~i'~' "UM'" - ~ 1. Original Relurn \ _] 2 Supplemental Relurn o A. limited E,lote [-_.1 40 Fulure Intere~t Comp,omi,e (for date~ 01 deolh alter 12.12.82) o 6. Decedent Died Te'tole [] 7. Decedent Moinlained 0 liying Tru~1 (Anath copy of Will) (Anach copy of Tru'l) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: .... z ... co ... u ... co NAMf Jacqueline !~. Verney. "sq. HUPHONE NUMUR 1717 ) 211)-9190 __ z co 3 '" .... 0: c< u ... '" 1. Real e,late (Sthedvle A) 2. Sloch and Bond, (Schedule 8) 3. Clolely Held Stock/Partnership Inlerel' 15thedule C) 4. Mortgages and Note, Receiyoble (Sthedule D) S. Ca,h. Bonk Depo,ih & Miscellaneoul Penonal Properly (Schedule E) 6. Joinlly Owned Property (Sthedule f) 7. Tro..fe" (Schedule G) (Schedule LI 8. Talol Gran Ane" (tolalline, 1.7) 9, Funeral Expen,e" Admini"ratiye Co,". Miscellaneou, Expen,e, (Sthedule HI 10. Debu, Mortgage liabilities, lien, (Sthedule I) '1. Tolal Deduction, (total line, Q & 10) Nel Value of ellole (line 8 minus line 11) Charitable and Governmental 8eque," (Schedule J) Net Value Subjecllo Tax (line 12 minUl line 13) Spou,al Tran,fers (for dote, of death after 6.30.94) See In,truction, for Applicable Percentage on Reverse Side. (Include value, horn Schedule K or Sthedule M.l Amount of line 14 taxable 01 6% role (Include values from Schedule K or Schedule M.l Amounl of line 14 tcltable at 15% role (Include value' from Schedule K or Schodule M.) Principal tax due (Add lox from line, 15. 16 and 17.) Credih Spou,ol Poyerty Credit Prior Paymonh --"-~~-'----'- + COMPllTE MAlllNQ-.AOOII(~!! ~iodUfi " verney 7 Irvine How Carlin 1", r a 1701) ( I )20 .OO~. 00 I ~: -~ J;0~o::90---- 14) -~-~()_.- --~-- --- (5) _~I_,II)J!_1\.9_____ ____ 16) ______0 ___n_______._ 17 ) ~._ __ n_()____ -- --- C'--- 'It. YEAR o)(,;{ "UMBER IB) 24,457.69 111) 12,663.02 (12) 11.'194.67 (13) _____0_ (14) 11.794.67 o 707.6fl 121) 121A) (2IB) = o (171 o ._' .15 = (1B)707.6B________ o ~9 If line 19 i, 9reoler thon line 18, enter the difference on line 20. Thi, i, lhe OVERPAYMENT. Ii! 0 .":TT.I"il,II,.taTI.11..11...'I.II'.ltlII1:... (.I rTr.r.1r.1.Tl.}lI..l'l.U!l!.1.~..fll' IF line 18 i, greater Ihan line 19, enter the difference on line 21 Tn;, i\ Ihe TAX DUE. A. Enter Ihe inlere" on the balance due on line 21A. 8. Enler Ihe total of line 21 and 21A on lino 218. Th;, i, tho BALANCE DUE. Make Check Poyab.'. to: Reg;l',!' ~f W!l1s, _~_g.~I_ ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~ ~~der penaltie, of perjury. I declare that I haye uamined ,hi, ,,,Iu,n, including ~~omponying "hedule, and ,Ialemen". and 10 the be,' 01 my ~nowlodge and beliel, It" true, correct and complf'te. I declare that 011 real 0,1010 ha' be"n ft!porfed ollfve mor~"1 yolu.. O"da,a1ion of p'f'pare, other Ihan the penonal repre,enlotiye i, bo,ed on 011 information of which preparer ha' any Lnowledge ~~'5~~E~~:tzZFi.:2 L. ~~~:,:~'l ~~c<i.'! ::Ej~}:C 12. 13. 14. 15. 16. 17. z co ;: lB. c< .... 19. '" .. :E '" u )( 20, '" .... 21. (9) __7-<7J3fl,.o'I-. II,fl7/f.9fl 110) _~___~___' (15) o . ~..~._-------~---- .--- 11.79'1.67 (16) .. ,06 = Diuounl Int(lre,' + (191 1201 707.6R o 707.68 Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: . 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 . 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 . 1% (.01) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98 . Spousal transfers occurring on or after 1/1/98 will be exempt from Inhoritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (.....) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: 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, ............... x c, retain a reversionary interest; or ................................................................................... x d, receive the promise for life of either payments, benefits or care? ....................................... 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequote consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ,. ................"............................................,............................,..... 3, Did decedent own an 'in trust for' bank account at his or her death?..................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. x x x x ~.i.. .'IUt.l - Ull.u'- l.u1lol lu hllJ 1<1 LIll~ I AU.STAn tEeM SUPPlY CORP, 1316 Arth SI., Philadelphia, Po, 19107 f.\IL!iV:' I ( (~I \~ .mfv.hii )U1t~ JL~ndMlltJL~9 ..\fad., Ihe , ill I h., Yf'ar dC/y"f i' November ,.\'illf'l"1'1I 1lIllId,,'d fllld ..,iCjhty-olle 3Hch\ICCn (l9UI) KNOUS!:: FOODS COOP!::HI\1'IV!::, INC., n Pennsylvanin corporation, hnvinCj its principal place of business at Peach Glen, Pennsylvania (/wrdllaft.er called the Omlllor ), vf the vne Jlllrt, Illld FRED F. S1'I\HNER I\ND ALICE J. STARNER, husband and wife (IwI'eillllfta cal/ed the Grantee s ), of the other part: ~nihtC;Si'5cJh? 'I'ha( (/w ,wid Grantol' fvr and in consideration uf the ~IWl. uf \ , SEVEN TiiOUSAND EIGHTY DOLLI\RS ($7, OBO. 00) --------------------- lawful mOlley of Ihe Ullited Stales ,,/ ..Imeri('a, 11111" it It'dlalld tl'lIly paidllY thl' said Orantees at alld be/ore the .~ealillg alld ddil'f'I'Y oj' these I)}'e~ellt~, the rl'l'eipt whereof is hereby Ilckllvwledged, has gl'allled, IWI'gailll'd, sold, alielled, ellfeo/red, released alld cOllfirmcd, cllrcl by these 1}I'es.'nt.~ does Ill'ant, bargain, sell, aliclI, ell/ev/)', I'clease and eVII/inlllllllo the said GI'all.tees, their Heirs and ..Issil!ns, ALL THAT CERTAIN tract or parcel of land located in Dickinson Town- ship, Cumberland County, Pennsylvania, bounded and described in accordance with a Final Subdivision Plan for Knouse Foods Cooperative, Inc., recorded in Cumberland County Plan Book Page , as follows, to wit: BEGINNING at a point marked by a concrete monument at the corner of lands now or formerly of Dale C. and Helen M. Newman and lands now or formerly of Knouse Fruitlands, Inc., thence along lands now or formerly of said Dale C. and Helen M. Newman South 40 degrees 33 minutes 40 seconds West a distance of 125.20 feet to an iron pin; thence along lands of Grantor North 49 degrees B minutes West a distance of 900.93 feet to a beech tree; thence continuing along land~ of Cranto~ N0rth 3e de~~ees S9 minutes 30 seco~dE Eact a distunce of 257.4B feet to an iron pin; thence along lands now or formerly of William Quesenberry South 40 degrees 12 minutes 20 seconds East a distance of 3l0.73 feet to an axle (fnd.); thence along lands now or formerly of Knouse Fruitlands, Inc. South 41 degrees II minutes 40 seconds East a distance of 607.54 feet to a concrete monument, being the place of BEGINNING. BEING Lot No. 2 on the above-referenced Subdivision Plan. BEING PART OF THE SAME PREMISES which S. Leon Weidner and Mildred I. Weidner, husband and wife, by their deed dated December 29, 1975, and recorded in Cumberland County Deed Book 26, Volume J, Page B50, granted and conveyed unto Grantor herein. \ GRAN'rOR HEREBY QUITCLIII/olS, to be used in conunon with Grantor and Grantor's Successors and Assigns, any and all right, title and cJir,p :2U '" b'iJ interest which Grantol- lIIay have In and to a certain 1.1 loot Wlue rl<Jht- of-way shown on Sheet 2 of the above-referenced subdivision Plan. . TillS CONVEYI\NCE i'l turther executed, delivered and uccepted upon the following condi ti,on:J subsc<Jucn t, which shall be bind ing upon und enforceable a'Jain:Jt the Grantce:J, their lIeir:J and I\ssigns, und each of them, and these conditions shall, in addition, constitute under- takinCju, bindinCj upon the Grantees, and their lIeirs and I\snignn, which nhall be independcnt of and survive the execution and delivery of this deed. The Granteen do hereby covenant, (or themnelves and each of thcm, and their lIeirn and I\nsi'1nn, as follows: \ I \ I I I 1. Forever hereafter the prcmines hcrein conveyed shall not be used or permitted to be uscd in wholc or part as: (a) a Junk yard; (b) any other use involving waste disposal or storage of any kind; or I I I I , ! I I I I i I I I I , , I , I i \ I , \ I \ , \ I I I : (c) for any use which, in the sole opinion of Grantor, and the Successors and I\ssigns of Grantor, inter- feres or impairs or threatens to interfere with or impair the water quality in the area of the above- described premises. 2. In the event of a breach of any of the conditions set forth in paragraph 1 above, as a result of whatsoever cause, whether or not foreseeable, whether ordinary or extraordinary, all right, title and interest in and to the above-described property shall, at Grantor's option, revert to and become the property of Grantor, which shall have an immediate right of entry thereon, and Grantees, their Heirs and Assigns, shall forfeit all right, title and interest in and to the above-described premises and in any and all of the tenements, heredi taments and appurtenances thereunto belonging; PROVIDED HO\~EVER, that the failure of the Grantor, or its Successors or Assigns, to insist in anyone or more instances upon complete performance of any of the said conditions shall not be construed as a waiver or a relin- quishment of Grantor's right to exercise its powers and remedies for such nonperformance at a subsequent time, or as a waiver or a relin- quishment of the future performance of any such conditions, but the obligations of the Grantees, their Heirs and ASsigns, with respect to such future performance shall continue in full force and effect. 3. In the event title to the above-described premises is reverted to the Grantor, or its suceessors and Assigns, for noncompliance or is voluntarily rcconveyed in lieu of reverter, the Grantees, their Heirs and Assigns, at the option of Grantor, or its Successors and Assigns, shall be responsible and shall be required to reimburse the Grantor for the decreased value of the above-described property resulting directly or indirectly from such noncompliance, and in addition thereto Grantor shall be reimbursed for such damages, including such costs (including attorneys' fe~s) as may be incurred in recovering title to or possession of the above-described property as it may sustain as a result o~.the noncompliance. 4. The unenforceability of any term, provision or condition in this deed shall not limit or impair the operation or validity of any other term, provision or condition. 5. The obligations, covenants, conditions and agreements herein set forth shall run with the premises and be binding upon the Grantees and all persons and entities who shall hereafter have any interest in all or any part of the premises, and shall inure to the benefit of Grantor, its Successors and I\ssigns. See attached Addendum. ~lH\dht'r //IilIr 1I1/II11d Sill.ll1ll1r /1/" . ,.. \ 'l'" illl/,ru('t'IIWIIIS, lI'IIYS, slr,','ls, II II "ys , /HlsslI!,iI'S, lL'III,'/'.~, /l'lIla,"III1/,S"S, /'ighls, liverlies. pl'il'i1t'gt's, h"/'l',lilll- JIIel/ls IIl1d lI1'/mrle/WI/('es Idlllls,!!'I'"," tll"rellllto v,'longillg, ,1/' il/. III1Y wise I IIppertaining, (/lid tlw ret'crsions 111/(1 remaillders, rents, issues ulIIl I'/'Oflts thercof, alld IIll the estute, I'i:!hl, litle, illle/'l!sl" properly, clllim (//lei dCllwlld wlwlsocl'er of Ihe slliel r;r(//ltor ,in lUlU, l"/lIity, or otherwise lIOWSOCt'e/', of, ill, III/(/ to tllc SllIIIII and every purt th(l/'t:of, , "./7".-. ,>.;4 ~d\l~ r/-.."J ',,, ~ u jL;" hlWt &H,ll la' 11,,111 1111' "/licl . . improvementH, II I'/'I!di I /I 111 CIII.~ /llId /1/'CIIli.~,'S IIa,'111I :JI'IIII I ,'cI , II/' 1lIl'lIlilllll'cI /1//11 illlencll'd SCI ICI lic, roitll 11/,', UJllIII/'I"I/UII(,C,~, 111110 Ihc ,wid (11'1I1111'1'5, their Jleir5 ,/lid ,'I,~"i:!I/", 10 UI/d (a/' I h C ul/ly pl'llpc/' II "e /111I1 liel/llCll o( I he suid Uml/I.ecs, their lIeirs Ulld .'lssi:!II,~ lo/'el.'l!I', "-nil IIIe said (;rc/llto/', (o/' itsdl /llId its SIICc,'s,wr,' docs IIU tllese prcscnts eOl'Clralll, gl'lllll a/HI og/'ce, I() /llId witll Ih,' "uid (lrolll.,w s, their Heirs UIIII ..Issili"s, Ihut it the suid Granto/', and its Slle('e,~so/'s, ull and sillgula/' the. IIc/'cditOIllCl/ls /llId p/'elllises hCI'cill dl's('rilied e/lld grollled, o/' mcntioncd alld ii/.icndcd so to lie, lVitll Ihe IIppll/'tcllollees, rCl/t() tll" ,wid U/'uIIII!(' s, their Heirs l/IId ./""iglls, Iq!OiIlSI it till' suid Urelllto/' ami its Succcsso/'s, and u:)oillsl elil ul/d every othel'I'awl/ ellld PC/'SOI/.~ IVhoIllS()CI'C/', 10w(lIlly clai/lliul! u/' to cloilll the SUllie, ClI' Ul/Y pil/'I thercC/(, by, under and through the said Grantor, its Successors and Assigns, Shall and will W.tJlW.1.n' ellld (u/'cl'el' DA'FE.\'D. ~nb tI/1' ,wid KNOUSE FOODS COOPERATIVE, INC. III'/'I'liy ('ClI/" Ii I III,' s IIlId 1I1'IWil/l s " \ \ .. ., \ . I, III III' it., ,III 1/1'/1 c!I,lCl/' il III/d ill it" 1/111111', 1111I1 (/s (/lId lo/' it s (,o/'IIO/'ut (' ud e/lld dCI'd ICI IIckIlClII'II'd:JI' lI,i" 'lIdl'Clt'II'I' IlIiCl/'{' (/II!lI"'I'S/lII I/(/";II:J UIIII/II/'ily 1111 I hc 101/'" CI( tI/I' CUlIIlIIIIIIIl'e'lIlIh ol"('IIII"yll'olliu 10 toke su('h oelmuldee/glllcn!. tll thc il/t,cl/I thai I hI' SUI/II' IIIUY iiI' dilly /'('e:unl('rI. ~1.tl '3:Hfth\lt:;5~i ,?-lHlil-"xtl1f) . ~ - , KNOUSE FOODS COOPERATIVE, INC., tlw sllie/ Urul/lur. lras 1.'O/'SI'd Ihi" IlIdl!IIII//,{' ICI III' e.\'('I'lIlcd IIY its ~'};';csid;~'ii~ ;,ltl!"led liU il" 1-: -,,"""\ SI"'I'('/'/I'!}, 111/(1 its ('(Jr"oml~ sceli 10 l,c o/J;,.\'ccl I.hc day l/IId !lelll' /i/'sl IIlw/'l' "'I'it/I'II. ~i~ntb. ~tllltb 1mb ;.1tli'lItrtb ~n tilt llU!it'''t &JE KNOUSE FOODS\COOPERATIVE, INC.: , '-.. \ B " ~~ (" ' ,,::\ \ . y: ,,' \.,. ..... ~;;~. " '. ... ' " '~ ".Jf~11 "ct'" ~,:\~,',":,.. ..'" ~ f," .... . '''''') ,..',.. ...' -" ;1' ". " I co. a" ('.1(( : ': ... '.~ '\" ~\.>r.. .." ~, . \0'" ~1' ._/~.....f.:... t/,.!"(J'''''''(~ ~/.,.1 kritif(f.''1.') , . '- ..; .~.~ . ~_~'i.tWlar!fj' I d.,.. _ .'" '(j . "" "" .~: -' . .,t.. I ,~ .. . .. ~. ..,P41 u c: j~ ~.~ 9 cvi~ ';UJ;P ~s , .....~ b'/G , . ;\ttCti\lt~t 011 tI,I' c/1I.'1 "I till' l/uf.' III till' ,IIml'I' IlId.'IItllf,', o( tI". "IWI"t.II"""'" ~111mlllln'\\lt,'\IH~ 11f ~JtmHillh~llUi" ~ ~!1lmtl! !1f, ..._- //I~::/!I_~ .. ~ I herehi/ cerlifi/. thul. UII this !Hi. /:/1',,; I _ . //(' i'/'II/ L'/' ~..- ill tile duy 11/ yeur ul"llr Lurdolle tlwllsalld lIille 1'lIlId,,'d ulld eighty-one. hefure lIIe, Ihe sll!lscrill"', II .\'otary PI/hUt:, residillfi ill the (.,...~/-( .,( /,'.../0""" ;:;I,,";;~/./, ';eN IIt!r."iO/Hllly apPf.!llrcd ..../:;,{,v I/. I... ('"1:":' 11/1' o/lol'lI"I/"'/II/('d ill tile for,'!!uill!! 1",lelllllr,', IIlIdlJi/l'irlll" 11",1 ill 1"II'SIlIlIl"" "llhe '1/It1/f)/'itl/th",l'i1l I'lIlIl",,,'dlllltlll hilll, u('kl/()II'I,~dgrd the ,wid IlIdelltll/,(~ tu he the a('/ ul/(I d<'l'd oJ' tile said KNOUSE FOODS COOPERATIVE, INC. .\\~l"t;;'.", . . \~ ......~ L, "~ .. ".o',liA";'.'t.' ". ,f'\, :r)' . .....- ~, I . 0 '" ;ntitnt911 lilY hall<! ul/(!.\'ularia! seal the rluy alld yC(~' a/i./eslli1.:.~~","'.\ /'(./ ' ). :_ .".:10 ':: .l!i/eollllllission e,rpires 6-& ~;;:;' '/:- <~~: .L, ,/:,: i 1,,.~fi'2 "',1 _". ~...~ ~~-. ,.,' r.. : ,/ - , " ' . ., . .,.:.\.0 P ii' .' . '."'./...... (ku{"f/' It 1 te, .....~I.f or s' ,.-" ~ ,#~cr..hl! ~c:dif~ that the precise addr"ss oj' tlw gral;t'e'ii"""'i~erein is . ,_'.d? iI.;< 1.3 (l,x' ~ C. 5'- A ~- Co(.\-,l,,~_v-... 6l. /7:;.::l<! , I . u Z . H IJ - ~QJ /,":i\\ g; u.... H'.j ~ H ~p ~ 'Cl ~ .%~ Cl I:: ~ Z III "" 0 ..: 0 ~'g 0 ~~ u [=l ~ III ~ ''', 00 ~.g Cl ":::1 ~ 0 e-<,C , . 0 00 '~',~ r.. - -Ill l-l .~ QJ ~o r..~1lJ I 00'" 12'" ::>1:: Cl I:: o III ~.o:1ll Zl-l e-< l-l :<:c.:J r..ooc.:J !:J .. .J;., ~/..;:: A7h;~N/ .-t <Xl O"l ~ @ , , ~ ~tJnml!11t1\,c,\lHt l,f ~JcUn!il!h.ll'Ulht iQ}l'n'tnt~ of e ~/fXjJ/,d0/t.d l 5'5. ~ ~tt'~in th{%{:';~ f,o~ Recording of Deeds in and for (dylx V',uz Cf2r in Deed Book P NOc::? 9 page pJ/3 Etc. ;tllihlt!Hli my hand and seal of Office this/9 tlllY of1J11/u:.~t'i'-{ .'/1/110 ~lIIini 19f1 , 'J -. \\~-" I I..,. b i ( """{ .-1,_, - "', \ t~.........-J \....~_... .. . >P"':J" l..,J'J". ,..:, NOW, 'l'IIEIlliFOIlli, for good and valuable consideration, receipt of which is hereby acknowledged, and in consideration of the mutual promises herein contained and contained in the aforementioned Agreement of Sale, the parties hereto agree as follows: l. RIGHT OF FIRS'r IlliFUSAL IN EVENT OF PROPOSED VOLUNTARY SALE. If at any time Fred F. Starner or Alice J. Starner, his wife, or both, receive a bona fide offer from a third person for the purchase of the Premises (or any part thereof), which offer Starner shall desire to accept, Starner promptly shall deliver to Knouse Foods a copy of such offer, and Knouse Foods may, within sixty (60) days of the receipt of the copy of such offer, elect to purchase the Premises on the same terms as those set forth in such offer, excepting that Knouse Foods shall be credited, against the purchase price to be paid by it, with a sum equal to the amount of any brokerage commission, if any, which Starner shall save by a sale to Knouse Foods. If Starner receives an offer for the purchase of the Premises, which is not consumated by delivering a deed to the offeror, this right of first refusal of Knouse Foods shall remain applicable to subsequent offers. Further, if Starner receives an offer for the purchase of a part of the Premises and such part is transferred to a purchaser, this right of first refusal of Knouse Foous shall remain applicable to the remainder of the Premises which is not transferred. - 2 - '. 2. OPTION '1'0 PURCUASE PREMISES IN THE EVENT OF PROPOSED INVOLUNTARY TRANSFER OR GIFT OR DEVISE. Starner hereby gran:~ '. to Knouse Foods the option to purchase the Premises (or any part .., j) thereof) at any time (a) prior to any proposed involuntary 10:. transfer by Starner (including, but not limited to, a transfer J;esulting from the failure to pay real estate taxes or resulting -f'>;. from Starner's bankruptcy or insolvency) or (b) prior to any# ...~ proposed voluntary transfer by way of gift or devise (including, 1t but not limited to, transfer pursuant to the intestate laws of :~ the Commonwealth of Pennsylvania). In the event of any suc~~ ~ proposed transfer, Starner, or his heirs, administrators, executors, ~ or assigns shall give written notice to Knouse Foods and there- ,~, :outt after Knouse Foods shall have sixty (60) days to exercise its 'lit", option granted herein. The purchase price of the Premises shall ",~ be its current fair market value as determined by a qualified I'~' independent appraiser who shall be selected and paid by Knouse :P! Foods and whose judgment shall be final. The purchase price:~ ,;,;. shall be payable in cash or certified check at the time of settle- '., ,",' of the option. Real estate taxes and other days after exercise .~. lienable items :" ~tJ~ ...., ment which shall be held within ninety (90) shall be prorated to closing. All realty transfer taxes shall ..;" be divided equally between Starner and Knouse Foods. Title,~p ~I the premises shall be conveyed by Starner to Knouse Foods by.a ,":" - 3 - general warranty deed free and clear of all liens and encumbrances, .:\ except for those mattcrs which encumber title to the Premises , .11' on the date hereof and matters which a physical inspection or " :,.: survey of the Premises would disclose. '~~. 3. BENEFITS. This Agreement shall be binding upon and inure to the benefit of the parties hereto, their heirs, :~,I '.~~l 'l! ''':~' 4. NOTICES. All notices and other communications hereunder .'If shall be in writing and shall be deemed to have been duly given if delivered in person or mailed by certified mail, postag:f' ~: prepaid to the following addresses, until changed by general, , .. , executors, administrators, successors and assigns. notice: If to Starner: Fred F. Starner R.D. 2 Gardners, PA 17324 ,~: 'fl. f If to Knouse Foods: Dr. James R. Oyler Knouse Foods Cooperative, Inc. Peach Glen, PA 17306 \\\ .~~~ ~-~\ '\~' ,':::~.' :;1(. ~..u.:. ;,:~:; .'1- 'If,' . :\ '. . ~'''', 111 th a copy to: NcNEES, WALLACE & NURICK 100 Pine Street P. O. Box 1166 Harrisburg, PA 17108-1166 ATTN: John S. Oyler 5. PI\MGMPII HEI\DINGS. The paragraph headings contained \'J in this I\grcement are for reference purposes only and shall not ')11 affect in any way the meaning or interpretation of this Agreement. ." - 4 - EXHIBIT "A" Ii ':.. ALL THIIT CEH'rIlIN tract or parcel of land located in Dickinson Township, Cumberland County, Pennsylvania, bounded and described in accordance with a Final Subdivision Plan for Knouse Foods cooperative, Inc., recorded in Cumberland County Plan Book~ , Page , as follows, to wit: It BEGINNING at a point marked by a concrete monument at the corner of lands now or formerly of Dale C. and Helen M. Newman and lands now or fonnerly of Knouse Fruitlands, Inc., thence along lands now or formerly of said Dale C. and lIe1en M. Newman South 40 degrees 33 minutes 40 seconds West a distance of 125.20 feet to an iron pin; thence along lands of Grantor North 49 degrees 8 minutes West a distance of 900.93 feet to a beech tree; thence continuing along lands of Grantor North 38 degrees 59 minutes 30 second East a distance of 257.48 feet to an iron pin; thence along lands now or formerly of William Quesenberry South 40 degrees l2 minutes 20 seconds East a distance of 310.73 feet to an axle (fnd.); thence along lands now or formerly of Knouse Fruitlands, Inc. South 41 degrees 11 minutes 40 second East a distance of 607.54 feet to a concrete monument, being the place of BEGINNING. ~, BEING Lot No. 2 on the above-referenced subdivision Plan. ," ':.t" , I, n " i; BEING PIIRT OF 'I'HE SN.lE PREMISES which S. Leon Weidner and l1ildred I. I. Weidner, husband and wife, by their deed dated December 29, 1975, and recorded in Cumberland County Deed Book 26, Vol~e J, Page 850, granted and conveyed unto Grantor herein. J '. " '~ I " ; ,I i , ! " ,. " TillS I: 1\ SU~lf,lI\IlY HEl'OIl'l' OF ^ LIMI'l'ED I\PPIU[\,ISI\L. . STAR~ER LAND APPRAISAL REPORT P'operty A.dd!m_ JQ_L!L~ Jl.OBTILOI'_~E:ACH__GLEN_ROAD _~_C:O~,"'1,,~!..9J_219B___ C;ity_DI~K!,;[S9Ji TO\'!'Jt~UI 1".C;ounly.C_UIolBERLAND___ __. 5Ialo.~I\--1lpj:9de legaIJJ.sc~pll~E:L(i')'1'IIC!IED__E~HIBnJI. 1.. . ___________._____ OWoer/OccupaoII'REDI'..SrARNER A ALICEJ. STARNER. ____"'a lI.r...o" 0816021200 .. S.LeE""_LNI\__________[}.le_oLSal. NII______._____ Propertyl1lghl.Appralsad ; loa_~chalqe_'/cotce~~lo~~lo_bepaldby_'el!Nt __.0.00" . _. __._ _._~_____ 00 Fee Simple IIE.h'o'$.o.OO __....___ .._Ia~Yw _._ _ 1I0A$/Mo 0,_09____ 0 le"ehold lOOd.'LCI,,~LJ<N_O.\lSEJOODS_CQOI"ERAnYE___. ~'_'__.._' Coodomlnlum (HUDIVA) 800 PEACH GLEN-IDAVILLE RD PEACH GLEN PUD Sourc. lOCATION U'ban Suburban lIural !lEIGlmOR/IOCD ANALYSIS OUllT UP [] O...r 75X lX]25'75X ] Under 25X EmploymenlSlabill1y GIIOWlIl1lA TE lj Ilapld [X] SI,bl. Slow Convenl.ncelo Employm.nl pIIOl'mlY VALUES [J Incro"lng [Xl SI,bl. Doclfnlng Convenience 10 Shopping OEMANO/5UPPL y 0 Sholl.-IlJu rX]ln Balance Ovec Supply Convenience to Schools MAIIKEII/In TIM, Und.. 3 M.. 3,6 M.. Ov., 6 M.. Adequacy 01 Public Tran.po~.lIon . PIlESUH lMID USE X lAND USE CHANGE PIlEOOMIIIAUT SirlGtE ,AMllY HOUSING f1ecrealfon ,ecllllfco : 510gl0 "clIly .-39 Nolllkely [Xl OCCUPANCY PIlICE AGE Adequacy 01 Utilltico .- 2-4 F'lllily lI,ely a OWnor [Xl $(000) (yrs) Property Compallblllly ~ Mulll-',lfnily ____ Inproccu Tenanl ~ ~. low --1Q..... PtotecUonftomOelrlmentalCond. ~ Corn",or",1 To ._..,___ Vie.nl (0-5X) . ...J5Q IlIgh --1Q.9_ Police &FIfO Prolection Induslflal Volcani (owr 5X) Predominant General Appearance 01 Properties Vacllnl 0 - 0 A eal to Martlel Nole Race or Ihe roci.1 composll"n ollhe neighborhood ere nol con.ldered "li.bleappral"lIaclou, COMMENTS: The sub lect ne I Rhborhood ~-YMraJ~~ld~~1-alon~ boundrv between Dickenson Township. Cumberland Countv PA and :ry.r.one~:r9.!m:).h.lp'._I)~I1\LCQ\1.[Lty-, PA. Basic services & shopplnR are aveileble approximately f?.J!!.il.f,!lL ~.o~th_l~eJglervjJle wlth__more exten~lve amenities and emp-loyment ap~roxlmetelv IS miles North In Carlisle. Surroundln vacant land use Is rlmarll a rlcultural Dimon"on.125_L2~_L900..93~257 .48 X--31Q., 73' X 607,54' Topography SLOPING. WOODED SrleA,o' 3..919 ACRE:S Cornerlol No Size GENEROUS ZoningClass"'calfon CONSERVATION Zo~ngComphance Shape NEARLY RECTANGULAR IlIGIlEST&B,STUSE.Pro.onIU.. OlherU..RESIDENTIAt BUlL SI Drainage APPEARS ADE~UATE UTILITIES Public Olher SITE IMPROVEMEllTS Type Public PMvale View GOOD EleclllClly 00 SI"el GRAVEL ROW landscaping None Gas CurblGuller D~veway Gravel Waler "I.~!-_L N;EDED Sidewaik Appa"nt Emmenl. None Apparent Sanllary Sewer SEPTIC NEEDE Slreel Llghl. FEMA Flood Hazald Yesa No X Slorm Sewer Allo FEMAa M. one 421 8000 SIX COMMENTS (ApPllOnl adverso easemenl.. encroachmenl., spocial assessmonl.. slid. are". ole,): SEE ATTACHED ADDENDUM File No. STARNER lENDER DISCRETIONARY USE Sal.p"" S Dale Mortgage Amounl S Mo~gage Type Dlacounl Pol nil and Other Concession. Paid by Seller S 'tI. IIl1dtlllgll.d IIU "tlltd 111111 ""III u'tI 01 proptllltl mall Ilmlll.r .lId prown.1t to IlIbjttl ,"d h.. tonsldtlld then III ItI. lIlil..1 III.lrlll. Th. dUClipllolllncllldu I dolll! .dlllllm,lIl. ,,1I.tlllll1 m,,~.II..chll11 to Ihou .I.ml 01 .ignlllClllt flll.IIOII b.t.....1I Ih. IlIbJ.tI ,"d umplI.bl. PIOpIIUII. If. lilllllhunl 11111I III lh Ulllpil.bll prop.rlr II IIIPlIlol 10. or molt IHoubl1 th.n. lhl IlIbJ,,1 propttlr. I millll' (-) .dlllllmllll il m.dl. Ihlll r,dllcllIlI 1111 Indlcthd ""111 01 IlIbJ"I, II . IlllllillulIlllllll III lilt complllbl1 II Inlulol 10. or 1111 lawollbl. th.n. Ih. 'lObJ"1 Plopttl,. I pllll (.) .dlllllm.ntll mtd..lhllllllcUlIllllllh Indiulld "'Ill 01 Ih, 'lIbj"t ITEM SUBJECT OT II 2 NORT ICKENSON TO COMPARABLE NO 1 HIPPENSBURG ROAD ~ COMPARABLE NO.2 SHIPPENSBURG ROAD B- - B COMPARABLE NO, 3 WooDVIEW ROAD C-6- 2 Address Proximity 10 Sublect ~ale' Puce prlcel Dala Source . VALUE ADJUSTMENTS . Sales or Financing : !=:oncesstons : Dale 01 SlIJ!Ll!~_ location SileNiew SIZE WATl;ll SEWER SNA 14 00 S I I .000 $ 25.000 $ ~ i-1 i-1 S i-1 DESCRlpTlOII DESCRIPTlOII l+lSAd/lll,,,,,.nl DESCRIPTION Ad 111'1I1111 DESCRIPTION A -T-95 +931 8-28- +641 4-25-96 ural! AVR. OMPARABLE COMPARABLE COMPARABLE OODED OODED WOODED WOODED . tl.C .5 ACRE :~100 2. ACRE + 2003.06 ACRE EtL NEEDED ELL NEDED WELL NEEDED WELL NEEDED N SITE NEED N SITE NEED ON SITE NEED ON SITE NEED NeIA~U~__ Indicilel1Vilu~ olSub'eel 18 841 Commenl,,1 Salo. Comporlson slil,f;S SHOWN ARI; THE MOST RECENT AND SIMILAR SALES LOCATED IN A SEARCH 01' ALL ~IIND SALES 2.5 TO 5.5 ACRES IN SURROUNDING TOWNSHIPS 01' CUMBERLAND AND ADAMS COUNTIES FROM 1-1- 95 TO THE PRESENT. 01 & 2 ARE THE MOST SIMItAR AS TO ACCESS & NEIGHBORHOOD. CommenlsandCondilion.oIAppralsal: ~STIMATE 01' VALUE IS CONTINGENT UPON REMOVAL Of' JUNK CARS AND SCRAP H~T~~._WIITER A[D O[...S)TE SEPTIC AVAItA~ILITY AS DESCRIBED IN ADDENDUM. FlnalReconClII,"on THE SALES APPROACH TO VALUE IS VIEWED AS THE ONLY RELEVANT INDICATOR 01' VALUE. . S~A~C~TY O~SAL~S Of' LARGER LOTS IN THIS RURAL AREA NECESSITATED EXTENDING THE SEARCH CRITERIA :r0 1-1-92.JIlTfI ~. MODEST 57. ANNUAL APPRECIATION NOTED. a I (WE) ESTIMATE TIlE MAfU(E! VALUE. AS DEFIHEO, OF THE SUBJ(CT PROPERTY AS OF OCTOBER 24 199.2... loboS 20.000 . I (Wo) co'lily: Ihallo I . wledgo nd boliol, Ihe facl. and dal. used herein are IIuo an",correc!: Ihall (wa) pm nah,y n.peeled Ihe subjeel proPOlIy :- and Inspected all COI In lhl . all we) have no undIsclosed inlerest. pr'T,i~\.or pro!pect tin. Apprai"'(.) SiGNATU lIevlew Appraiser SIGrIAiu~~ M;!:'f~ Did 0 Old Nol NAME R. S N (II applicable) tWoE . .. 'I In.pecl Property Plopllelary land Form 04188 I'. '.............N.. I", ....._ll~.ul_I.......'..klWIl).I.uWl Wm. A. Bigham. Inc. '''"''''''''IJM~ COMMONWfAUH Of PENNSYlVANIA INHIRnANCI TAX .nUIN RESIDENT DECEDENT ESTATE OF l SCHEDULE C CLOSELY HELD STOCK, ~. PARTNERSHIP AN~ P~~OPRIE~~~S~H~P Pleaso Prinl or Typo FilE NUMBER Fren F'. Stnrner Schedule C-1 or C-2 must bo attached for each business interost of tho decodon'., other than 0 proprietorship. ITEM NUMBER VALUE AT DATE OF DEATH DESCRIPTION 1. C & S Ground Construction The only assots of the partnership are 3 veh1cles appraised by R " W l~qu1pment as follows I 1. backhoe t7,500.00 2. 1970 Porn dump truck t,2.500.00 3. tra1ler t1,AOO.00 t11,AOO.00 t3 ,000. 00 The estate has contacted the survivinr, partner, Roy Carbaugh, who offered to purchase decedent's share of the partnership for tt,500.00. He claims decedent damaged the above vehicles. Mr. Carbaugh claims he has incurred costs to repair them. We estimate a negotiated settlement of t3,OOO.00 TOTAL (Also onlor an line 3, Recapitulation) S S3, 000.00 (II more space is needed, imerl add,tional sheets of some size.' Ih t~.lIll\. :\ ','l ~ :! ,~ "",~.~.t\ ...:t,J. ~ COMMONWlALlli 01 Ptl.N~)I\Atjl'" lNIHMIT"N[( 1"_ Il(Tmt,l N(SFOltH OlC(OtlH SCHEDULE C-2 PARTNERSHIP INTEREST REPORT 1 Plum" Typo or P'lflt "]fiLE NUMBER I -_.-----_.._~-_... - -_.-.- --+--------_.._-- ESTATE OF A. Delailed doscription ~howing Iho melhod of (omputalion utilizod in tho valuation of the decedcnl'~ interest. B. Completo copio. offinonciol.lotemen" or completn copies oflhe Federal Tax Relurn. (Form 1065) for Ihe year 01 death and A preceding yean. including a balance shcet for Ihe yoar of deoth. C, If the Company owned Real blote, [urni.h a li.1 .howing Ihe complelo addrusslo. and e'limated Fair Markel Volue/.. If Real Estate Appraisal~ have beon secured, pleme oltoch copies. D. Any other information relative to the valuaTion of the dcccdent'!I inlerp!.t. 1. Nome of Porlnership C !l :-; Ground Construct ion federull. D. Number 2)-27)-61'.9 - - (A. per Form 10651 Dote Bu.iness Commenced 5/21/91____.._ Address 94 reach [aen Road Gardners. ra 17321. Bu~incss Activity 2. Decedent was 0 !~;Gonorol [.jLimitcd porlner. If decedent wa~ 0 limited parlner, provide initial investmont S_ 3, _~i~~~~-~-J CA~&~~~Ecgt~_ . _.. pIA ______!50;(.oLJ;().2L--- , I \___~b __ i50,' of._t.9!3L___ - 'j- " .. ---- ------ I i ------'--- PARTNER'S NAMES ~o Of INCOME 1 ~D OF OWNERSHIP r .____~ _._ -1_~_ A, Ro CExJ;>.u:e;h._________. 8, !"red F'. Starner ~ _ _. _+5q~'s__ 5.01.__ 50,~ C, I 1 , I 50.; 0, i __~L.-. 4. E.timoted Value of decedenl'. intere'l: S 3,000.00 1 :Vos :~\No 5, Wa. the partnership indebted to Ihe decedenl? If ye., provide omounl of indebtedness S 6, Woo there life in.uronce payable 10 .he porlnership upon Ihe deo.h 01 the decedenl? ! :Ye, l< .No If ye.. Co.h Surrender Value: S Owner of Policy: Ne. proceed. payable: S 7. Was thero a written partnership agreement in effect 01 the time of the dccedcnt'~ death? jCYcs .No If ye., olloch copy of ogreemont. 8. Did the partnership hove on interest in any other partnerships or corporations? [;Ycs fx No If yes, report the necessary information on a ~cporatc ~heet, including Schedule "e. 1 " or "(.2" for each inlere~t. 9. Did the decedent'. inlere.! in the partnership change in the year bolo,e deolh if the dote of death wo, on or ofrer 12/13/82 or if death occurred prior to 12/1 3/82 in the la.! Iwo )'e",,2 Ye. Y. No II ye., explain: 10. Was tho decodent rclolt'd to any of rhe olhnr portner!.? :Vc!. xNo If ye.. explain: 11. Was tho partnership dis~olved or liquidatr>d after decedent's dcolh2 Yf''> X No If yos. roport 011 tho related information, including corics of the Sale\ A~reemcnl andlor Sctl!('mcnl Sheel 12. Was the decedent's partnership interest ,>old?' Yes XNo If yos, provide 0 copy of tho ogrcemnt of ~alc. ote. \\11 =' FINANCIAL 1 TRUSTCORP December 13, 1996 Re: Fred F. Starner J\Ccounts To Whcxn it May COncern: J\s of March 15, 1996, the personal checking account #1162802 had a balance of $539.04. J\s of March 15, 1996, the rosiness account under C & S Ground construction #185515 had a balance of $.27. .-dy MaC ,ky cJYd~ custorrer Service Rep. . Noble Blvd. Office 310 Allen Road. P.O. Box 220. Carlisle, PA 17013 · (717) 243-3212 or (717) 263.9201 Banking Suhiidiaries: Fanners Trust OJ" Chambcrsblll1: Trust OJ" FlISt National Bank and Trust OJ" Waynesboro ~~ ~HOLLAN> LAWN-BOY 717/243.2686 R & W EQUIPMENT CO. FARM. LAWN AND GARDEN EQUIPMENT OF ALL TYPES INDUSTRIAL I< CONSTRUCTION EQUIPMENT 35 E. Willow Slreet Carlisle. I' A 17013 Eli Ingersoll I Dixon I December 12, 1996 EQUIPMENT APPRAISAL FOR These are the appraised prices for the following items as of December 12, 1996: 1. John Deere 1979 410 TLB sin 331110 $7 , 500.00 2. Tonco Tag-A_Long Trailer sin 9470233 $1,800.00 3. Ford 800 Dump Truck sin dna $2,500.00 JcriIJ M, J t-~d} Thomas M. Wivell President I\liHE I': m: WI' between I\GIUm~lImT HI\\JI'; this ~_~:day of '~:t---' r, Roy Cat'baugh, hereafter n,fert-ed to as oy, I\ND IOred F'. 1993, Starner, hereafter referred to a,; Fred. The parties hereto enter into a pal:tnership agreement for the purpose of conr1ucting an excavaU,on and relatecJ services in the I\dams County, Pelllwylv;lIliil, area. The parties hereby agree as follows: 1. trhe initial asset of tlH~ business is a 1110 ,John Deere backhoe \dth scoop, \oJhich the pill-tner,; have purchasecl for Nine Thousalld Dollars ($9,000.00). Hoy paid Five Thousand Dollars ($5,000.00) of the purchase price and Fred paid Four Thousand Dollars ($4,000.00). 2. The partnct"ship shall be a fifty/fifty partnership Each partner shall rc!ceive an equal share of partnership income, shall bear equally any partnership expellse, and shall have an equal say in lIIanagement of the business. Neither partner shall have the authority to enter into any obligation or contract unde which the other pal:tner may be J iahle in an alllount in excess of One Thousancl Dollars ($1,000.00). 3. Partnership record" may be maintained by either partner or a third party as the detennine. In any case, the records shall be open to .Inspection by either party or hi,; reprcsentat.lve at the request of the partnel". 4. Before any work is commenced, commercial liability insurance sllall be obtAined in any amount sntisfactory to the partners. Roy agrees to advance the sums necessary to pay the initial premium for the insurance. Roy shall be reimbursed for the cost of such insurance and his excess contribution for the purchase of the backhoe and the cost of insurance as soon as financially possible from gross earnings of the partnership. 5. The partners recognize tha t ["red wi 11 be doing the bulk of the backhoe and t-elated labor of the business while Roy will provide primarily advice and management direction as well a, making equal contributions to the business. The parties hereto agree to this arrangement. 6. In case of \~ithc1rawal or death of a partner, the other partner shall have the right to purchase partnership asset. at their fair market value. Valuntlon shall be based on a value established based on a willing seller, willillg buyer basis. If no such purchase is consumated within 90 days of notice of withdrawal or death of a pnrtner, the \~ithdral~ing partner or his estnte may purchnse the pal:tneL'ship assets on the same basis. 7. I::xcept ns provJ.ded herein the Pa. Uniform Partnership I\ct shall apply to all J.ssues relating to the creatioll, management, operation and dissolution of the business. rum 1 065 U.S. Partnership Return of Income ~@94 OMD Uu. 1!l4~.lJO~'J 1~..tI...".u.., ...........__ $.-..1 rUI tulotltJ.u rop, 10U4. Uf t.. yeaf b.glllfllng ........ .1W4, .nd e"ding ........ ,1D .... ... SOD 10 )arnlo Instructions. ~!'t''C1IWI taAlneu ICln', !~:r\bc:..,..w_ u rm(..~ pn:dlCl (It Iotr"t<<. Jl:\:l\'JA:r''',J C Uuslnll\' l:l,/tlo I1UI1ll1t!, 089S U&O Iho illS I.~ol. 0lhe,. .....1... ,.e.oJ" ,"Inl or IYll.. ,~':~Ullt'.~"" c;'~\JNO ~S"l\Lll-t.l'U,V Il\1I110'H, "111I01, and 100/11 0' IUllo 110. till P.O. bul, I" pig. 9 01 thtlllSltutliOflS) __3jp,__YEM~ C;UW (Z\), t:11r (,. lu...n, !l.IJlu, UII(j lIP tWO G-. 2.. ,) ,", \In, Olm,lo,trldlntlllullonnllmb B : l.13<o \ '-11 E 0,1, bUline" atJllod FlotllnUlt!IIII,UIl111Illh.IIJI, G Check .ppllc.~lo ~u'05: II) 0 11II11.I,OlulII (21 0 FiIl.I,ulurn (3) 0 Ch.ngo In add,o" (4) 0 Amondod lolurll II Chuck accuull,"y lIIulhuJ (I) ~ Cash 12J 0 Accru.1 (J) 0 Olhor I'pocily) ~ '........'..'...........t;;',.....'........'...... I Ilumber 01 Schl!(Jllles 1<.1. ^'I.u.:h 0110 fur oach pcr~on Voila w..~ a p;,utner nt any limo during tho lax year ... .......T~.~......~;)..................... Caution: III cIullo only "auo 01 tJU:iIlIOSS IIICOIIIO Dlld fJ).pOtlSOS onli/l0S la Oflough 22 bafow. Soo '110 instluctiolls for mora Information. 1n Gros~ ll!cl'jpl~; 01 !;H!l!~ I.J less IClurns amJ alluwallcc5. 10 lb 5"1'\'1 . Ie 5'1 "1/ .. E o u .= 2 Cu~1 01 uood~ ~uld (ScllUdulu 1\, lino 0) 3 Gro~s proltl. Subllacl lino 2 Irom Iino 1c, 4 Ordinary Incol1lo (Io~s) 1t011l oll1or parlnOf~hips. oslalo~, and Irusls (allacll sc/ledulo). 5 Nol tann prolil (Io~~) (aunell Selloclulo F (Form 1040)) o Nul uain (los~llroll1 form ,1797, Pari II, Ii no 20. 2 3 4 5 o :nn 7 Oll1el incomu (Ius~) (~oe in~lruclion~) (a/tach schodulo) . o Tolallnool1lo (Iu~~I. Comuina Ii nos 3 Ihrouuh 7 7 o 5197 " c !l 9 Salmic~ and Y1.uo~ (olhor Ih.n 10 parlno,") (Ia~s omploymont crodits) , 110 Guaranteed paymonts 10 partners. ... 11 nClJaifs nnd maintcnance. 2 12 Dml dobl~ , " g 13 Ronl, U 14 Taxes antllicon~o~ . f, .~ 15 Intoresl. . i" " 100 Dop,ociation (soa inslruclions) . . . . . . . . . . . . 100 I .; b lass dopraciation roporlod on Schadula A and alsowhere on return 116b I ~ 17 Depletion (Do nol daducl oil and gas doploUon.) . .~ 10 Roliromonl plans, ole. . g 19 Employeo bonelil pro9ralll~ . 'tJ ' .. C 9 10 11 12 13 14 ~ ~1 16c 17 10 19 19'1.4- 10 'i'5~'I": I "2..50 21 Tolal deductions, Add Iho emounls shown In Iho far richl column for lines 9 Ihrounh 20 21 7 8't \ '-t?r..5 - 20 20 Oll1er doductions (allach schedulo) ......:..\ ...j, .1'(" 22 Ordinary Incomo (1055) Irom Irado or businoss activities. Sublracl line 21 lrom lino 0 22 q ~ '2- -- Undor J,lGnallloS 01 pOllury.1 doclarelhalI have lxamlned IN' flturn, V\eludlna .ccompanv\na IChtdvlll.nd ,tatemlnls, and tothe b.,t 01 my knowledfJr and holiftl. Ills lIUD. cOlloel, and complel', Oocli1laUon 01 preparei' (oUlM man gen._ral" partner) Is bi.sed on aU InlounaUon 01 which pr.parer has In~ kno....lodou. . . . '~.'..V. :...'..........~..... ..I. .1. .1........1: . .;t) Please Sign Hero ,', . .... Ifj'(,!f5 rOal. rvrJ'Pt'Pi'911I..r," loclal, locurlly ~ Check II O""~'f/ HlI.omployod ~ IT ;JY-; r'} " .. I UNo. ~ I -jP~ I ZIP cod. ~ I?J 2.(.. ~ Slljl\3luro 01 gonoral par1nor 01 hlnllod liability comparl)' mom~.r Prop",,".... y:7 L,/ , - A 10.11 " Paid ,lg"oIUI. "t/'f. UfA/l4.e.!.//% c.-::tp-' 1'.'.'1/'(,'t9J" Proparor's . U 01 Flrm'snill1lo(or ~/.crJW-4.(UJ wnVI~,-JI:"I" ..., I so n y ~~:;':~'d::~;oroPloy.d) Y/1/ fl-. fOe"" 1_ J,.,...t:-.J!A. ('-;, F",m 1065 (19D" For Paperwork noducllon ^cl Uotlco, SOD pogo 1 of loparalo InllrucUonl. Cot. No, 11 JDOZ 4:' 'fM",IOMfl{l'JIJ ~ Cool 01 Goolla Solll , . Invelllory nllwUilluill1l 01 yom. . . . . . . . . . 2 Pure hilS OS rOS!; cost 01 items wilhlJtOwnlor nerson.,r uso. 3 Cosl of labor. , , , , . . . . . . , . . , . " Adelillona! Geetlon 2UJA r.O!iI~ (!iCO Inslruclious) (""11e/, scllodu/o) . 5 Olhor cosls (nl/oc/. scl/odulo) o Tolal. ^dlllinos 1 ""ough 5 . . . . . . . . . . . . . 7 Invonlory 01 ond 01 YOM. , , . . . . , . , . . . . . n Co. I 01 good. sold. Sublracl lillo 7 Irom lino O. ~nlor horo and on pogo 1, Iino 2 Do Chock all O1olholls u.r,d for Valuing closing Invenlory: (I) IJ Cosl (Ill 0 Lowor of cosl or markol as doscribod In Aogulallon. socllon 1.471.4 (III) 0 W,ilodown 01 "subnormal" goods as doscribod In Aogulallons socllon 1.471-2(c) (Iv) 0 Olhor (,poclfy 1II01hl,,1 u.od and allach oxplanallon) ~ ............................,....,..,....., ......,............,........ b Chock Ihis box 1/ lha LIFO Inv"lIlory mclhod was adoplod Ihi" lax year lor any good. (if cheched, ,11'och rorm 910). . ~ 0 c Do Iho rulos of seclion 263^ i','r proporty prp'" . or acquired lor r~sale) apply 10 Iho partnorshlp? , DYes ONo d Was Iholo any challgo In dOICllllining quanlllios, cosl, or voluallons bcl-.veon opening ,,,,,J closing invontory? DYos DNo 1/ "Yes," alloch oxplanalloll. 1 2 3 4 5 o 7 o ":'r.f!'r.T!mh:"l ~ Olhor Inlorrnollon 1 Whallypo of onllly Is filing lllis rolum? Chock Iho appllcablo box ~ 0lJ Genoral partnelshlp 0 Umiled parlnorship 0 Limiled Iiabillly company 2 ^.o any partners In Ihls parlnol5hlp also pnrtnorships? . . . . . . . , , , . . . . . . . . . 3 Is this partnorship 0 pallnor In onolhor partnorshlp? . , , . . . . , . . , . . . . , . . . , 4 Is Ihls partnorshlp subjocl to Iho consolldalod audil procoduros of socllons 6221 Ihrough 6233? 1/ "Yes," seo ooslgnallon 01 Tax Mallors Partnor below . . . . . . . . . . . . . . . . . , . , . . , 5 0005 Ihis partnership meol ALL THREE of tho lollowlng requlromonls? o Tho partnorshlp's tolal rocolpls ror lho lax yoar wero less Ihan $250,000; b Tho parlnershlp's lolal assols allho end or Iho lax year woro loss Ihan $600,000; AND c Schedulos K-l aro filod wilh Iho relum and lurnlshod 10 Iho partnors on or bofole Iho duo dolo [including exlonslons) lor Iho partnorshlp rolurn. II "Yos,"Iho partnorshlp Is nol roqulrod 10 cOlllplalo Schedulos L, M.l, and M-2; 110m F on pago 1 of Form 1065: or lIem J on Schodule K-l . . . . . . . . . . . . , . . . . . 6 ooos Ihls partnorshlp havo any forolgn partners? . . . . . . .'. . . . . . . , . . . . . 7 Is lflls partnorship a publicly lradod partnership as donned In socllon 469(1<)(2)? . . . , . . . . . o Has Ihls partnorshlp filed, or Is /I required to filo, Form 8264, Appllcalfon lor Aeglslrallon of a Tax Shollor? . 9 AI any lime during calorydar yoar 1994, did Iho partnorshlp have on Inloroslln or a slgnaluro or olhor authorllv ovor a nnanclal nccounl In a rorolgn counlry (such as 0 bank accounl, socurillos accounl. ' . olher nnanclal accOunl)? (Sae tho Inslrucllons for cxcopllons and filing roqulromenls lor Form TO F 90,22,1.) If 'Yes," enler tho namo of Iho rorolgn counlry, ~ ............................................................................................ 10 Was Iho partnorshlp lho grnnlor 01. or lransloror la, a lorolgn truslthal exlslod during the cunonl tax year, whothor or nol Ihe partnorshlp or any partnor has any benenclal Inlorostln /I? If 'Yos," you may havo 10 filo Forms 3520, 3520-A, or 926 , . . . . . . . . . . . . . . . . . . , " ..... 11 Was Ihore 0 dislribullon of proporty or a Iransler (e.g., by sa10 or doath) of 0 partnorshlp Inlero,.1 during 1110 lax year? If "Ves," you may olect to adjusllhe basis of tho partnership's assols under seclion 754 by allachlng tho slalement doscribod undor Eloctlons Modo B tho Partnorshl ' ; .':., '.' .:'.;' '. . , . . . . . . . . Deslgnallon 01 Tax Mallors Partner (See Instructions.) Enler bolow tho genoral partnor daslgnalod as Iho lax mallors partnor (TMP) lor Iho lax yaar of Ihls rolum: Vo. No 1m ~ x ~ x J( K Namo of Ito.. deslgnalod TMP r Addross of Ito.. doslgnaled TMP r =: S714IZNr.:tt..' C;; lK,.,) f2.", 1'.4- 17H.L/ Idonllfylng Ito.. numborofTMP r Id'S-U -Z390 44 - , on 1;;_ QJ Q)c~ >l1J~ .5 E.5 ... " .-- _ a.c 'iUSIU ""wE 'grf "c .!2~Ul ~~ E et::!! 100..- "H .-.. ~I- III Q) )( {!. C Ol 'Qj .. & .. .'Ow,......, ~lHlnorG' ShmeG 01 Income, Credits, Doductlons, olc, Ui' III o ::!. Gl E o u .5 tn) Ol.trlbullv. shnr. IInrns 1 OuJinnry Incomo (Iu!;!i) flom tmdo or lmslno5s aclivitlcs (p:190 1, lino 2]) 1 2 Ilet incomo (loss) front H!t1lnl roal o!'.lalo nctivitles (,lU.1C/, Form (J(J25). . . . . . . . " 2 30 Gross Incomo frorn olhor rOlllnl nclivllicSi L~_~L.._.__ I ': :::':~~'., U r::"'POIlSCS from olher renlnl nclivillcs (llt1l1C~1 $~tl~du;o): : : : w=-.---- = ,~~~~ c Ncllncolllo (loss) from olhor renlill nclivlllos. SutJlrncllino 3b from line 311 3c 4 Portfolio Incomo (loss) (sca InstlUcliom;): n Inlorosl incomo 4n b Dividend Incoll1e , 4b c nOl'ally Incoll1o ~- d Nel .hOll-lerl1l cnpilnl goin (10") (.,"ael. Selledulo D (Fom. lOGS)) _:'d , o Nclluflg.lcrm cnpHnl unin (10551 (.1ft.,eI, Scllodu/o 0 (Fofl" IOG~)) 4c , OIher pOlllulio Incol1lo (loss) (all.1cll sc/,edulo) 4f 5 GUl1rnlltcctl pi1vmCnl9 10 pmtnors . . . . . . . . . . 5 o Nol go In (loss) undor .ocllon 1231 (olhor Ihon duo 10 ca.uolly or Ihell) (all,'ell Form 4191) 0 7 Olhor Incol1le (Ios.) (all"cl. scllodule) 7 o Charllablo conhlbullons (soo Insllucllons) (allocll schedule) 0 o Secllon 179 e'penso deducllon (allach FornI 45G2). 9 10 Deducllons relole~ 10 pOlllolio IncOlno (seo Inslrucllons) (ilemile) 10 11 Oll,"r deductions mlloch scl,edule). . , , . , , . , . 11 123 Inlercsl CXllclISO on Inveslmenl debls . 123 b (1) lnvosllllonllncomo Includod on lines 40, 4b, 4c, and 41 abovo ~1 (2) Invesllllenl expon.e. included on lino 10 obove. 12bl2 130 C.edit for Incol1lo lax wilhheld 130 ....~'\..." b Low.lncorno housing crodit (soo Inshuctions): ~~ (1) From parlnelshlps 10 which scclion 42(j)(5) applies fer preperty placed In seNice belore 1990 IJbll (2) Olhor 11m" on Ilno 13b(1) for property placed In sONlco boforo 1990 IJbl2 (3) From partnomhlps 10 which socllon 4201(5) opplios for property placed In seNlco aller 1909 lJblJ (4) Olher lhan onlino 13b(3) for property placed In sONlco ofler 1989. Jbl4 c Oualilied rehabilitallon oxpondituros rolalod 10 renlol real eslalo activillos ("IIoc/. Form 3.IG8) 13c d Credils (olher Ihan credils shown on lines lJb and lJc) relaled 10 renlal real eslale aclivilles (see Inslluclions) 13d e CrodilS relaled 10 olher renlol ocllvlllos (seo Inslrucllons) 130 14 Olhor credlls (seo In.lrucllons) 14 15n Nol oarnlngs (1050) frorn .oll-omployrnenl . 150 b GlOSS forrning or lishlng Incorno . ~!> c Gross nonfmm Incomo . 15c , U :>11I 'tic GlO C~ .l!l 'ii Gl .. o (h) Tolal omounl '13Z-- - '132.. - lGa 1Gb 10c 16dl1 16dl2 IOe ~~ 17c 17d 17e 17f 17g 103 ~~ .:~~~~ 19 20 21 ,,~.~~~~ ~:s.~ ~~~ ~~... .. Gl ;; o lOa Dopleclallon odjuslmenl on property placed In seNlco ollor 198B b Mjusled gain or loss . c Oeplollon (01 her Ihon oil and gas) ... d (1) Gross Incorno from oil, gas, ond goolhermal proportlos (2) Deducllons allocablo 10 011, gas, ond geolhormal propertlos , e Olher ndjuslrnenls nnd lax preferenco lIems (o/Iach schedule) 17n Typo of Incorno ~ ................. b Foreign counlry or U.S, possosslon ~ ................ c Tolal gross Incomo frorn soureos oulslde tho United Slolos (ottoch schedule). d Tolol oppllcable doductions ond losses (attach sel,odule) , e Tolal forolgn laxos (chock ono): ~ 0 Paid 0 Accrued , noducllon In la'es ovallablo for crodit (ollach sc/.odule) g Olhor foreign lox Informollon (allach schedulo) IOn Tolal e'penditures 10 which a socllon 59(0) olocllon rnay opply . b Typo of oxpenditure. ~........................................_......._........................... 19 Tox-oxolllpllnleresllncomo 20 Olher lax.exernpllncomo , 21 Nondeducliblo e'penso. . . . , . . , . . . . , . . . . , . . , . . 22 Olher Ilems ond amounls .eouired 10 be reported seooralelv 10 oarlnelS Isee Inslruelion;\ (all.,eh sched"Ie) 23n lncorno (loss). Cornblno linos 1 Ihrough 7 In colurnn (b). Frorn Iho rosull, sublracllho Sllll1 of lines B lhrough 12n, 170, ond 180 b Analysis by Iypo (0) Corporalo of partner: (I) Gene.ol partners m lImiled porlnClS 233 III ',; :0. iij ~ (b) Individual l. Acllvo II. Passlvo 'fJL - (e) Partnerohlp (dl E'empl org:mlzillion (0) Nominee/Other 45 other Deductiuns FORM 1065, Line 20 Advertising 65. ~'uel 871. Insurance 1,845. Labor 80. I,cgal Fees 20. TOTAL 2,881. SCHEllUtE K.I Parlnur's Share of Income, Credits, Deductions, etc. (Form 10G5) .. Soo 501l0lUlo In.llucllon.. 11"1',~I,'<t'..1 "III.. 11"""') ~I~'~~'" IUll.IIl'lld.1I )1',., IlJ'JluI 1,II.,t..ulll!llllllllllll .1U!J4, Dn,j GlUJlnu . HJ 1'1~1~,,!..._I~!~.!!!!.'.Y.l'.'U_'_'llllll,"r ~ \ ~cL:'?_'\ -'2.l.'I~ Portnershlp's Idonlllylng numbor ~ Z3: ZI')("I '11 Piull1C":j llillllU. nl.hJIC5!i, alld liP Llldu Partnorship's name, ndd,oss, amJ ZIP couo file: \) ~C' , ~'1/-\ \~'v~"- e.. ~ ~ bl'U,l>-lJrl Co-l'jT(1..U.::no\,) (H V<=""-I-'. G\UV R". q--\ 'ilEAC-I.\. 6L.~ ~\). _~)A\~O'-.I.:'\.~, __I?I\_~J.E:-I__.. GA....ONe'..c;. ?A \'1;/..+ ^ I hi:; palllll~' i~; II ~ !1L'1I!!/al parlllur IJ lllnilou pOlrlllar F Partner's sharo of lialJlIitios (suo instructions): (] IlIllllcd IlalJllily t:UIIlPillIY IlIUlllber Nonrocourso. . . . . .. $ ...~.?'!........... II 1'I1I"llypo III onllly i,; II"" parlne,'! I> ,IN:?.~'!.\.'?,':'.<?:!-:':... Qualifiod nonrocoUl~e linllncing $ ....~~~.~..,.,...., C Is 1111:1 pillll\l!f a r~\JuIIICtiliG ur a [I fOlciUn parlnc,'/ Other . . . . . . . .. $ ....~9.'~..'..... U r . I II) 1i1~'UIU t.:halllJ" Iii) [/ltI 01 Illt'1 p:uhll" S pl'rCl'I1I<1~jl! u: Uf ">111110<111011 ~ea' G lox sholler registration number. ... .......................... I',ulll "IHllil1U . .. ::;9... % ...;::iP.. % H Chock hllre If this pOltner~hlp i" II pulJlicly hllded . """"-0 L,,"" "IHIIII'lJ ' .., "C;>.. % .. ..~,... % partnership 0" defined In ~ocllon 4G9(k)(2). . . . Owncrsllip 01 capItal .. ...::!9.. % ....$.c.:J. % E.-!!!S Cynl"r wholll P",-,-",,'"I"'L~od rolurn: QhJ.-uk!, . J Anillysi9 of partner's capital account: OMU Hu. '!,45.00lJ'J "u@94 o Clleck Dppllcoblo 1J0xDS: (1) OFin1l1 K.l (2) o Alllended K.l - te) PwtnOl" lho110 ul hnos Ie) Capital DeCOU'l1 ot end 01 1.1) Cilpil.ll.1CtlllJlll ill Ihl CUI"I,11 cOlllfll1ulct.l (dl Wllhdulwnls and IlP\l,rul:IlU 01 )l',lI lJUtlll!J )I!,1t 3,4, cud 7. Form 10G5, lhslllbullons ye..' (comblno colulII"S litl -- 5chedulo M.2 through (dll ( ) 101) Ui:ihihulivo 5haro item (b) Amounl (c) 1040 lilers ontDr llie Dmount In column (b) on: ,_. --------~._. 1 OrlJumry inC01l11.' (Io~.~) frUlll lralJo or l1Usinoss activilies 1 Ll-lnl. - 2 t4ct InCOlIll..' (Iu!,;!>) frulII wIIlal ,uOII eslato oclivilios 2 } So. Portn,,'. """uc';on, 10' Schodulu K.1 (Form 10(5). 3 Nut im;olll(! (Io!>s) hOIl1 uther lelllal uClivilics , 3 'iii' .\ Purlluhu inCUllll! (lu~~): ~ III 0 IlItelest 40 3th. D, PDrt I, hno 1 0 d- IJ UivllJem.l:; . 4b Seh. D. Part II, lino 5 OJ c noynlliv5 . 4c 5ch. E, port I, line 4 E d Net !.ihorHelll1 capjl~1 !Jail! (Ic!:>s) 4d 0 Seh, D. I;no 5, col. (~ 0< (y) u Nct long.lelfT1 capital Cjain (lu~s). 40 .5 e Seh. 0, Iino 13. col. tQ or (0) f OIlier portfolio im:ul11o (10:;:';) (aUach scllCdulc) 41 (nluon.pploCltlltlin,ol)"oulltll,llR 5 Guaranleed payrTlfmts to partncr 5 } SOO Porln,,'. 'n,ttoctlon, 10< G I/el y'ill (loss) ullder seclioll 1231 (olher 111," do. 10 ,"sually or lh.III 6 Schodule K.1 (Form 10G5). 7 Othcr incollle (1055) (.:JltaclI scllcaufe) . 7 [nluonID~litlbl'III\'Olyoullu~n , 0 Cl1..uilaLJlu cOlllliLJulior,:.; (~eo hl~lructlon~) (attacl, schedule) . 0 5ch. A. lino 15 or 10 U III :> " 9 Section 179 o)(pel1~o deduction. 9 '00 } s,. Portn,,', In"toctlon' 10' OJ'- 10 Doduclion. ruloled 10 purllolio Incollle (allacl, schedule) . 10 Schedule K.1 IFolm 1 Olj~). C~ 11 Olher deductioll:' (;,ltncl, sClwuufe;. . . . . . , . 11 c_ "'u> E'" 12a lllIC(l:~1 e}(penso on Invusllllcnl debts. 120 FOlm 4952, Iino 1 - ~ , . u>'" bl1 ",- b (1) Investmcnl IIICOI1lQ included on lines 4n, .lb. 4e. nnd 4' nbovo } Soe Partnot'! InsltuCIiOl" lor >c .=- (2) Inveslmcnl c)(pcn~cs included on lino 10 nbovo bi2i Schedule K.I IForm 10(5). 13a Credll for inCOll1lJ tax withheld 133 Soe partner's lnstluclions 101 IJ ! Schedulo K.t(Fofm IOu51. Low.ir\COITle tlOu~illU credit: (1) FIOIll seclion '12ljll~) pnrtl1cr5hlp~ lor properly ploced In !.icrvice ueloro 19UO .' .' (2) UIII" III,n olllllle IJ~llllor IIlollclly IIlaced ill service be lorD 1990 b(2) III P) From !.it:!cl1ul1 o12lj)l5) pnr1ncr5hips for propcrty placod in . ! form 85llG, 1'1Il! 5 ~ :a !.if!lvicc aller 1 !J09 OJ ",.", ""'" "" "" "'''' 'm 'OO"" ,,,," '" "'~ 'W ,.,. I: ~ u c 0",,11110\1 rei",b,I.laIiLln "'pend,luro" rulaled 10 lonlol leal eslolo ~ acllVllie5 (~ec in~tructiofl:';) . , . . . . , , , . ... 13c d CIl!lM5 (utllcr Ih,lI\ &;fClJlt::; shown on hnes 13b nnd 13c) rulnled ~ ) ~ ~."".,"'~.. 10 runlnl lUal e:.;tillo actlvities (~co instructions). . , . , '0 13d Schedule K.11Form 10G~1 e CrmJils rclalvd to other u:!IlllJl activities (seD instructions) . 130 10\ Olllcr credlls (~ee instruclions) 14 for Paperwurk neductiun Act Uutico. see Instructions for Form 1005, Cat No. 11J9.R Schedule K-llForm 1005)1994 7J ( ;;; & !j ~ ); ~ & ~ 11 ~ " " :: ~ a ; III c: 0 '"' U ::l 'C Gl C <!: ",,; 1065 U.S. Partnership Return of Income ~@95 UM{I rju 1~.&!, n()'I~ , '0 ;"'1.'0""""""",-"""" lor c.lll'ml.1I ",,',11 t'JlJ~. 01 1.11 yl'.1f bCYllll1l11g . ''i1I~. l"lI 11:111.1111\1 II-- S~e se ilrillo instruction!. I '.,roll'U! Il.Irltll>.:.lql U~C thl' /? IRS.C_~_,s._G.J'(~O fI_^,_P_'-_O_NJ or. J(.Y. tlJ-P1!- label. fj,,'"l"" ..11....1 .I'''! 'll"''' O' 'oll,l,. Ill) tll.1 P 0 h'-II~"" p:;;,,, 10 011t1(' ",..lIve\'Ofl\ I Other' '/.) /" R W",., 9'1 I 'Ell 07 t:r t. . A/ () A t> .. plc,ISC Col. I" Lo,," ',~.l!" ,I' d /'1' cU<ll' print , or type. $ ,,,,,,,...1'.,.........,,.'... o [mplo,tI1denhIIUhDn "IImOrr A l'o"1(_IJ.l' Ill...,.'....'.. ,11:l,.'I~ ~,t.ill_ [D,ll.! llu',,""V. ',I.t""d c p~" ',T.1~'1 ,,., 0"'/, U lJ. "~ p.IIIJ'\\d,,,1 IJI '.\ "'<.1" ,Sc;'lVAT ,tI(.,. F T{jldl .J~",,'I'. \\"l! P.1lf' !S (.1 ".. "\!'J,:t,t'''~ C tl".."w'.'., 'I'd"~ 'l,,'l'l"" __ f)~88.S:__~~_ e~5 21{ G Checl\ ,lPpllcab1t' tJOII:~, H I t11 Ll In,II;,1 reI urn 111 XC",," (2) 0 Final rclurn 12) 0 Awual PIO (3) 0 (4) 0 Amended retum Change In address 01her (speclly) .. CtlC'cl\ accollnllfl\l IIW111011 .2. Numlwl 0' ~)Clll'(l.lh".~, 1 f.lI.Il.1l ()!\I~ 101 each pl!r~;0I1 \',110 W;l5.1 partner allln( tlllle durIng lhe lill year ... Caution: fflCludl! only If.:JUL' lJf bU:iml'!>S mCortlfJ and e.lpl!tlsfJS on fines 'a ,IIfOugh 22 below. See tho instructIons (or morc ,nfonnat,ofl 10 Gross rccclpts or sales bLess relurns and allowances. 1a 1b c,1 1c Gl E o u .5 2 Cosl 01 goods sold ISchedule A, hne 8) 3 Gross prof,!. Sublraclllne 2 from line 1C, 4 QrdHlilry Income (loss) from other partnerships. estates. and trusts (attach sctledufe) . 5 Nellarm ",ohl (10551 (.111.1CIl ScllOdule ,- IFo,m 1040)) 6 Nel gain 1I0ss1 from Fo,m .1797. Part 11, hne 20, 2 3 4 5 6 ~ 7 Oilier ,ncome (10551 (a/tacl. sclledu/e) , 7 ~ O_,Total income (1055), Comblnc.l~ne_s3 Ih'ough~~ -' __'...~'-'-' 8 ~J.$' (') ~ 9 Salanes and wages (otller Ulan to partners) (less employmenl credits) . 10 Guaranteed pllyrncnls 10 partners 11 Repairs and malnlenancc . 12 Bnd debls , 13 Renl. 14 Taxes and licenses 15 Interest. l6a DepreCiation (II rCQuucd. attach Form 4562) bLess dep,ec,alion reported on Schedule A and elsewhere on relurn 17 Deplelion (Do not deduct oil and 9ns depletion.) 18 Relirement plans, elc. . 19 Employee benehl programs . 9 10 11 --'/.-9-'1- _~ 12 13 14 3.1-_ 15 CP. 20 Olller deduclions Int/acll sclledule) 20 21 Totnl deductions. Add Ihe amounts shown 111 the for" hi column lor lines 9 Ihrou h 20 21 22 Ordinary income (Ioss)lrom lrnde or bus,ness nclivlt'es. Sublract line 21 from line 8 22 5"(')5 6''1 Please Sign Here U'ldl'f IlI'n.l,I,,'~' uf P'.'IU"( I (ll'LI.I'e Hi;ill h.h'C elammt'd thiS relurn, IncludIng accompanYing schedules and statements, and to In best at my kr-ow1edg .llld h..I...1 .1 ,'. I',," LO!Il~t.1. ,Iml c;urnpll!le Oecl':IrJltOn 01 prepare. lother than general pJr1nal Of hmllCtl I'ilb,hl)l company lT1Crtlbl'l) .s b,Ul'<J Oil .111 ."lOIll'.lt,on ul ..../.,01 pll.'!).'!!'1 ""... .lll.,. kflOv.Il'dQC ~ S,w,.lIU'(' 0' Ql'r1l'1.llll.lr1nl'! or I,!II.IN ',.lb,l,t.,. company lrIt!mbor ~ Dale Paid Prepaler's Use Only en'"""", ....?:) /oj ~. /J ... /1 'j,'gn.II\jF(! r / (.,~ ~~ (::;k':.*-,~r;oooJ r ,1Jl1!. n.lml' ~;;,--- - ~ 72!J ^". "1:-'" ( '\.:' E , ~ J..I ~OUl'!o.1 ....'I.'CPf1'll...tll _l_. ~ . ;1111) .!lJ<l'p.... I '?' 1l.. Dale JJ,(J~at(J"s soe...,J1 securll.,. no 9 :"'0 G'I3 0 ~/J'% C~oc'" ., sell.omplo~ocJ .. ~ EIN ~ , ZIP codn ~ Cal No 11390Z fo,m 1065 (19951 ,"."'\ ... For POlperwork Reduction Acl Notice. see page 1 of septlrate instructions. mmIIJ Cost of Goods Sold I""" "ag" 1301 tile H"lructlons) I 0"" 10ti~ n'N')1 PdoJ~ 2 Purctla5l!S less Coost ul 11'_'111'; \\'Itlld'awn for persollal use I 2 3 4 5 6 7 8 1 Inventory at tJegl/lIll11(1 of ,..Cilf 2 3 Cost 01 labor 4 AdditIOnal sectlon ?6:JA co'.,ls (.1tt.1c/1 ~r:;llt'(ftJ/f~) . 5 Other costs (lJtt.1cn Selll.'llu/t') 6 Total. Add lines 1 111Iough 5 7 Inventory al1?nd 0: 'I1!ar 8 Cost of, goods sold. SutllrJClllne 7 horn line 6, Enter tlCre and on page 1, line 2 93 Check all Intl"OdS u:.;ecJ lor valUing closing Invenlory: (i) 0 Cost as descIlbed In Regulations sectIOn 1.471.3 (ii) 0 Lower 01 co:;1 or market as descrIbed In Regulations section 1.471~4 (iii) 0 Other (specify melhod used and allach explanation) ~. .......,.. b Check thiS box II there was a ",Iltedol'ln 01 "subnormai" goods as descllbed Ir1 Regulalions secllon 1.471.2(c). . . ,~ c Check thiS box Illhe LIFO Inventory method was adopted thiS lax year for any goods (If checked, attach Form 970), ,~ d Do the rules of ~iCctlon :'fi3A (lor property produced or acqUired for resale) apply to the partnership? . 0 Yes e Was there any change tn delermlnlng Quanlltles. cost. or valuations between opening and clOSIng lnlJentory? 0 Yes If "Yes," attach explanation. l--r.l~l'Il]I!J Other Information What type 01 enllty 15 filing Ihls return? Check the appllcabl~ box ~ ~ General partnership 0 Llmlled partnership 0 Limited liability company 2 Are any partners In thiS partnership also partnerships?, , , ' , :I is thiS partnership a partner In anolher partnership? ,....,..."..."... 4 Is thiS partnership subJecl to the consolidated audit procedures 01 secllons 622 I Ihrough 6233? If "Ves," see Designation of Tax Matters Partner below . . . . . . 5 Does thiS partnership meet ALL THREE 01 the lollowlng reqUirements? a The partnership's tolal recelp!~ for the tax year '.'Iere 'c:;;~ tiKI" $250,000; b The partnership's tolal "5',ots at the end ollho lax year were less than $600,000: AND c Schedules K-' are filed With the return and furnished to the partners on or belore tho due date (including extensions) for the partnership return, If "Ves," the partnership IS not required to complete Schedules L, M. 1, and M-2: Item F on page 1 01 Form 1065: or Item J on Schedule K- I . , , . . . . . . . , . . . . , . . 6 Does this partnership have any foreign partners? . . , . . . . . . . . . , . . , , . . . 7 15 thiS partnership a pubilCly traded partnership as defined In secllon 469Ik)(2)? . . . . , , . , , 8 Has Ihls partnership Illed, or 15 II reQuHed to liIe. Form 8264, Appflcalion lor Registrallon of a Tax Shelter? . 9 At any lime dUllng calendar year 1995, did the partnership have an interest in or a signature or other authonly over a I",ancial accounl '" a lorelgn country (such as a bank account, secunlles accounl, or other linanclal account)? (See page 14 ollhe ",structions lor excepllons and Iliing requirements for Form TO F 90.22.1.) If "Ves," enler the name of the foreign country. ~ ....................................,...,.........,..,....,..,.........' 10 Was the partnership tt,e granlor 01. or transferor to. a lorelgn trust that eXisted during Ihe current tax year, whether or not the partnership or any partner has nny benefiCial Interest In it? If "Ves," you may have to file Forms 3520, 3520.A, or 926 . . . . . , . . , , . . . . . , , . . , , . . , . . . . I I Was Ihere a dlslnbutlon 01 property or a transler (e.g.. by sale or deal h) 01 a partnership interest dunng Ihe lax year? If "Ves: you may eleCI to adjust Ihe baSIS 01 the partnership's assets under section 754 by attaching Ihe statemenl descrihed under Elections Made By the Partnership on pa e 5 01 the instructions , Designation of Tax Mailers Partner (see page 14 of the inslruclions) Enler below the general partner doslgnated as the lax mailers partner (TMPI for the tax year 01 thiS return: r!('(':r;? ~'1",'I!~r:;~ - f)r,r:-r:;A;:r;/)- ')-15''1<- Name 01 .... per<. f/rsP'f/.,Sg","1o'1'TlvfT- r.>,4,ur.HTt;(J. idenllfy"'g .... dos'ynatodTMP,. wI"'IFf'I"D cj.t/':;.'"",fJ"f'./"r numbor01 TMP ,. 11l5.~S-.?3?D Address 01 .... _?_~W.EH_..cJ.o.A/ p",oj 1> designaled TMP ,. G ,.1 ~ /l IV F.i ,. ., . p .~ 1"1 :I 2.. ~ o o DNo ONe .x K x ',\tll' 'Oh~ Il'j'l'" ".m" 3 1.1) Ol!.trlbutlv~ !.h,lJl' llcrns - -- - -. _.-- ---. -- _._-----_. - .-.- _u_ -T---".---------.- - ~ --.... --. --,. . - .----.----- I_lbl Tola~~~u~l_____ ! 1 Ofdlll,II\ JllllUl1t' lh",',' Ilt,rn lI,llh' 0' Ill)';Ull.",', ,lLII\'IIIl'<-,lll.lqC ,. II' 1I~ ;>;'1 ....L __(5.~_~_ -'-'" I I 2 Nl'l II1Cl'I1'" (Io'.'d h011l 'i'fll,11 Fl',lll':,I;ll" ;ILl'\,'llll", (.trr,KIr form 882!l} ....... ,..~_. 3a G'U'.iS 1"[UIl1t' litH" ulll,., '1'111,11 ,I( 11"1111". u~-t-::--=:~-=--=l=: ~", I , b l_Pl'fI~;l'~' !fOtll ()lhl'1 ,,'nl,ll ,1(.ll\,llll.!~; 1,lIt,II:" :;r;lU.'dlill" I "' I e rkt II1Ct'"H' Ihl'.'., "11111 nUll" 't'lll;11 .Ifll'.llll~~; SutJlr;ICI 1.l\t~ 3u hom llnc 3d .1!C. -- III ~ 4 Porlloliu tll(OllW lit).;.,) .1 III It 'I l'~. t Iflr oj 111 I.' 4a -- b OI\o"Idelld UKO'lll.' 4b II> ,- --, E e flo'l"i1lty IflCOII'" 4e ,- 0 d Hel !",tIOfl.!+'1111,.,IIII!,11 q,l;n Ilv~,'.1 I.II/,Il" :";(:'11.'(/1/1,-' (J rrorm 106511 ~L u - .5 0 Netlonq.tf'IIIl CilPllill tJJlllllo:;'j) l.lft.Jell Sc/lec.JlJ/c D/Form lOGS}) 40 t Otllt!! porllolto II1CO,tlC t1o~"';II,Jtt.Jcl1 :;Cttt!Jult.., 41 - 5 Guafanteed Pi1~'r1ll'flls 10 pi.lItllers 5 -' 6 Net giNl (lOSS 1 under seelton 1231 (olhm ttlilrl due to casually Of theft) (,lHach Form 4797) 6 7 Ottler IflCO'll!! Ilossl (.~!tc1ch schedule} 7 , a Chafltable eontrabuhons (attac" sC'ledulcJ . 6 U ::llll 9 Section 179 expense deduction (aU,]c'1 Forni 4562) . 9 'Oc 11>0 10 Deductlons related to portfoho mcorne (Itemize) 10 C',::; 11 Other deductIons (attach SCfICduIC) . 11 ~ . III 12. Interest cxpense on IIweslment debts 12. ~...4) II>C:~ b (11 Investmenl Income Included on hnes ~a. ~b. ~c. and 4f above 2b(1 >C1I.!! .!:E.!: (21 Ir~:.~~~:-~!~~pl'n~es Included on ':':'P.. 10 above. 2b12 13a low.meome "OUSIng cledlt. ~ (1) From pJrt"f!r:;hlp5 10 which section 42tJ){51 applies lor property placed In service belore 1990 . 3al (2) Other than 011 hne 13at 1) lor property placed in service before 1990 ial2 III 3a(3 ~ (31 From p:'H1ner~;lIlpS 10 which 5ccllon 4t1lllt51 applies for property placed In service alter 1989 :0 II> (4) Olher than 011 line 13J(311ur property placed In seNlce after 19B9 . 3a(4 ~ U b Qualified rehabllltJtlon l'xpl!nd.luIeS rt!l~lted to renlalrcal estate actIVities (attach Form 3468) 13b e Credits (olher lhan creclll!', sl1m\n QullnU5 1:1" iHltJ 1:\b) relal~d to fenlal real estale aCllvltles 13e d Credits related to other fCIlta! aCII\ntlcS . l3d 14 Other credllS 14 aPJJl~ --_.,----~--_.- ... 15. Nel earnIng!; 110$5) Iroln sell.emplovmenl 15. 0 .:.'a'E b Gross larmlng or IIst1lng tIlcome . 15b '- I 'CUe'" "'''' e e Gross nonlarm HlCOIIIC . 15e -.-- '0.. 16. DepreciatIon adjustment on proper1y placed In service alter 1986 16. "u .." b Adlusted gaIn or lOSS 16b .... --.. 5~ E e DepIction (oilier Ulan all and gas) 16c e.... 6dl1 t;D:= d III Gross U1CUIIIl,! from 011. gilS, and gC!olhcrmal properties " M 121 Deductloll!', allocable 10 011. gas. and geothermal properties 6dl2 '-.. ~>- 0 ql.h_~r.adJust.menIS. ~n.u.~~l( _ p~~ler~_,:ce_ Items fartaC/) schedule) 160 ---.--- .. III 17. Type of Income II- b ForClgn country or U.S. possession II- ~ II> ................. ................ )( c Total gross Iflcorne from sources outSide the UnIted Slates (attach schedule) 17e ~ c d Tol.1 appl,c.ble cJeduclion5 and 105505 (allaell scllodule) 17d '" 0 r otal foreign la"cs (check one): .. o Pa,d o Accrued 170 'OJ ~ 1 Reduclton "1 laxes aV:lllat)!l' tor crettl! (.utacll 5C/llJdulu) 171 ~ 9 Olht~f lor~I<]!~l~~~..!_~~'..'.."!!.~o~~ ~l.t!~c:/~ S.Cl1l'dl!/e). 179 .- .--- 16 Section 59(eH21 C"pl'lllJt!ures: 0 Type . b Amount . lab 19 T:I"IIl..excmpt Inleres1 incomc 19 ~ 20 Other tax. exempt I!lcome 20 II> 21 Nondeducltble expenses 21 ~ - 22 0 22 Distributions 01 money (cash antlm;:Jrketable securities) 23 Dlslrlbutlons of propf~rty other than money . , . . , . . . , . 23 24 Olher ltcrns Jnd amounts reqUired to be repOr1cd !>cpafalelv to partners (allach schedule' ~ l\.~~ 25a Income (loss). COlllbllle flOes 1 through 7 In column (bl. From the result. subtract the sum 01 III hnes 8 lhrough 12;]. 17e. ond 18b 'in (b) IndiVidual '" b AnalySIS by type (a) COlpo'ale (e) Partnership (d) E,ompl .... of partner: I. Active ii. Passive organization (0) Nomtncc/Olhl!I C ct (1) Gene,.,l pat1nelS (5'-P_$~U) --'-'- (2) limited partners Partner!i' Shares at Incomu, Credits, Deductions, etc. ~ i1 Partner's Share of Income, Credits, Deductions, etc. . Sel! separate In,trucllons. f~I''''l''..''ltll''.. !'''''''''I lI..,."JIII....."u.. '......~.. rm r01II'IllJ.H yl'M '9'lS or I.u reil' bl'()lIlnlng . tl)9!1, .nd I!ndlng . PJ Partn~~_s_identl!yingnUlnber ~ n;:;- :.tS...._~.:._,..,_?O___ __I'.~ne~~~i!':s-,-den!~Iy~ng,n-um.t'e!",,?oJ, :z. 7:' f..~'-'1:J_ Partner's name. adult~!j!j. arlU lIP cadl! partnmthlP's narno, mSdrcss, and ZIP couu C '6 S Gp()VNV CO/llSTf:VCT'/ON 7'1 ?l~ACH t.:l!:AI /?t:lAP G' ~ 1< P N j;,~ S, 'PILLV..!:Y.____ F Partner's shafe of hablllltcS (see Inslructlons)" Nonrecourse $ Ou"hfled nonrecourse tln:mclng $ O~m $ G Tal( shelter registration number. .. H Check he,e ,I this partnership IS a publ,cly I,aded partnership as de lined in section 469(k1l21 . H lei I'.lrtnel!. \Pl,,11' 01 Ione\ lei CJIl".,1 .1Ccuunl J' rlltJ u' (I) ColP,l;]t ,1CCOUn' .,1 lb) C.1P I." con!l,tJult'd J 4. and 1. Fo'''' 'O6!1 ldl Wttld',l....ll" and ~".l' 4CI)'''b.n" colu...."'!. 1.11 bf'Q."nlnQ 01 YI'.V lJuf.nq yr." Sttlf'du'P '-4.1 d,'!.\f.bvIIOn\ IhfUUQ" rlJU ( ) till Distributive shore lIem lbl Amount (c11040 filers Itnt!'t the amount In column (b) on: 1 Ordinary Income lIosslllom trade or bUSiness acllYllles 1 -/'l~", Q2) } 5.. pJQ" ~ J"O 6 0' 2 tJel Income II0SS) ham renlal real eslale acllVIII("s 2 , , 1).1"1""" \ I,.,r'ue,.tln'!. tOf 3 SCtlt'du1f 1<,,' IJO,m 'O6!l1 3 Net income (lOSS) from other rental achvIlIes . 'iii 4 Por1loho Income (10551 ~~' VI 0 Inlerest 40 5Ch D. Part I. l.ne 1 0 4b ::!. b OlYldonds . 5ch D. Par'll!, line !l 4l C Royallies . 4c 5ch E. PM I. Iln!! 4 E d Net shorHerm COlpltal ga,n (loss) 4d 5th 0 ..ne !l. co' II') ot 191 0 u Net long.le,m capllal ga,n (loSS), 4e 5th O. line \3. Col 10 0' 191 oS e 1 Olher portfoliO Income (tosSI (attach schedule) ~ I fl'.' lJI' .ro.....tI.. ~... tit .'J'l' ..,..'" 5 Guaranteed plJymenls 10 partner 5 I Se~ D3QP 6 01 P.1""f' " j"'\"uCloo'l\ lor SChedule K. t 6 N.I 9"n Ilossl under "'''on lZ31 {olher Ih,n due 10 CJ\u,lly or Ih.1I1 6 1'0"" lOG:" 7 Olher Income 1I0ss1 (a/lach schedule) 7 ,..,.. 0" l~c"'HI" t.... 01 .'l'J' ,.t~.~ , 8 Chanlable contrlbullonS (see Instructlons) (;!1t.1ch schedule) 8 ~r.h ^ I,,,,, 1!J O' IG u III 9 :J C 9 Section 179 c)(pense deduction, } s.. P'Q' , 01 PJ"'" , 'Co 10 Deductions ,elaled 10 po"loho ,ncome (aflDCh schedule) 10 1"\l'utl.o'l'l,. 10' S'''t'aJle K.I Ol'- c~ 11 Other deducllons (.1ttach schedule). 11 4JO''''' I ('(i!ll ~ c_ .... 12a e.. 120 Inlerest expense on investment debts. Form 49~2. lIne I -~ .... b (1) Investmenl Income Included on lInes 4a. .1b, .Sc. and oSl abovc b{l) 1St"" o.'Ql" 1 01 P"""f" ~ ..- ,.c I"'!o""~! 'J'''. ")' 5(I"'llu'" 1(.1 S- (2) InvC5lmCl1l c~penscs lflcludcd on lIne 10 abovc i21 tfo'~ tC(l~l 13a Low-income hou~lng credIt: . (1) From sectlon .1201(5) partnershtps lor property placed in service belOfe 1990 0(11 121 Olher Ih,,, 0" I,,,. 13'(11 10' property plmd \rl service b.lor. 1990 . 131 From secllon .S2(J1l5) parlnershlps for p,operlY placed in ", f",m A'lnn I,,,,,!.o VI service afler 1989 0(3) ~ 0(41 :a (4) Olher lhJn on Ime 13;1131101 property plJced 10 service OIlier 1989 ..-- . . - .. ~,..~ I ~ b Quallllcd rehabIlItation cxpendllures relaled to rental real eslate :-;:~,;~ U actiVitIes 13b ---- c Credits (01lu', lh,l" credIts shown on lines 1 301 and , 3b) related '*~ ) -- ".,- "" ",-" 10 rental ,,~al estate OlchvltlCS. 13c 1......".1.""..1,,, ...f'''.''..I,.... , 1---- ----_. -. .1.."..'1','" d Credits relatetJ 10 all1ur rental acllvllles 13d 14 Other credll!; . 14 SCHEDULE K.l (Form 10G5) Fr<&p F. Sr,-IK. f.lt.= I~ '1'-1 ?~ACH l:~i Fill r:'ot"/D . '"' (~- rl R P "~ (:. ~. I. J~___LUJ,.!I_ ^ ThiS partner IS 01 {Xl gl~nl'rJ' pilftner 0 hmlled partner o limited liability COmpany "1f~mbcr B Whttl iyoe 01 entity 15 thl>; {l,lf1ner? .. :r^,1UVll>V~L C Is thiS partner a ~ dUlflt'5tlC or a 0 lorelgn par1ner1 . 1.1 Ot.,o." (h.\"II" Inl [''I(I of o Enter partner s pcrccnlayl' 01, 0' lelm,n.1I'On ~t'.lf Profit sh;mng .5() . % .~.o % Loss sharing ."S'()" % "$:0,, % Ownersh,p 01 cap'lal ".f'. 0" % ,,[;,0.. % E IRS Cenler whe~-E"C!~".'_s!,-'.p Iole~elurn: J Analysis 01 partner's capital account: For Pnporwork "eduction Act Notice. see Instructions for Form '065, Ol~(l 110 I".,"'" oo','} ~@95 5fl "'h, So 0;. ../i.{)..-(!'. o Check appl,cable bo,es'll) OFlnal K.l (21 o Amended K,' C.,I Nn 1139m Schl'dull' K.' (Form '0(5) 1995 t.ll Ol",.buli"" ,hilre Item (bl Amounl lei 1040 lIIe.. enler Ihe ---'--- amount In column (b) on: E ;; 15a Net earnln~ls t1ossllrol11 sell.employmen1 . 15a (.AS':/. q2 \ Seh SE. SecMn A Of D .. '!' E b Gl055 fll'fIllllU 0' 11~.IHIl\J .Ilcunle. t5b } 51'" (1"0" R nll1.,rtn,.,'., ~t" In,lnjl.I,It"" I", !Jlh'..h.l"..... I "';;. e Gross non'arm Income 15c I'o,m 10b~1 . IOn Depreclallon OIlJlu~lllll'1l1 un 11IOI..lCr'y pl<1ccd In servIce altcr 1900 t63 ~ . -- a . b Adlusted 1).110 Of lo!;", J_Ob S""I""I"" A .1twl q "I . ;! .' 1---- " . 16c r.,""!!' '11"""UIIIOll" " . c Depletion (ollll!r th;111 011 OIl1d ~J;1~.) 1m Sf.hl'ljulr K " -..----- I . . . . d (1) Gross InCOfll!! from OIl. gas. and geothermal proper11cs dIll IJ 0'"' 1 O(.~,I .,nd E ~ ~"ii (2) Oeducllons alloc.ltJlc to Oil. gas. and geothermal proper1les dl21 1"'.\I,,rl.II"" tn' rrllMl r.;H,1 , - v" Olher adlustmenls and ta.. preference Ilems (iJttach schedule' 16_ ... - ~~ --------- 17a Type 0' Income ... ".... ... ........................,..,.......... Form 1116. check bOles In b Name ollorelgn counlry or U,S, possesSion .. ] .. .... .."........ ~ >C Total gross Income trom sources oulside Ihe Uniled Slales (a/lach ~ e Form 1116, Part I schedule) 17e c Cl d Tolal applicable deduc\lons and losses (a/lach schedule), 17d .~ - Tolallorelgn taxes Icheck one): .. o Paid o Accrued . 17_ Form 1116, Part II 0 U. I Reduc\lon In la'es available lor credll (a/lach schedule) 171 Form' 116. Part 111 9 Olher loreion lax Inlormation (altach schedule) 179 Ser !nslrutIOO"' 10' Fo'''' 1 116 18 Section 59{e1l21 e,pendltures: a Type .. .,..........,..........,. ~ } Se-e D3Qt 9 01 p"r1n."'S In,!futllon'S '0' Schedule K.' b Amounl 18b IFo,m '06~1 19 Tax.exempl interest income 19 Form 1040. hne Bb 20 Other tnx-exempt Income. 20 I .. .. 21 Nondoductlble cxpr.nses 21 SH paQ! 9 01 Partne'" .c InS1luc\lo"' 10f Sctledu1e K. t - 22 0 22 Olstflbulions 01 money lcash and markelable secUrllles) IFo.m tOGSI 23 Dlstllbutions of property olher than money 23 24 Rp.coplure allow'lncome housing credit: ~ a From section 420115) partnerShips 24a I Fo"n 86", lIne 8 b Other lh.1n on line 243. 24b 25 Supplemental Inlor,"al10n reqUIred to be fcpor1cd separalely 10 each pllr1ner (iJUlJCh tJdd,r,onal schedules ., more space 1$ noed_d): ................... .... ..,............................................................................................................... ......................................................................................................................................... ......................................................................................................................................... ..................,.,.................................................................................................................... C 0 ~ ......................................................................................................................................... " ~ ......................................................................................................................................... .2 .5 iO ................... ....................................,...........................................,...............,.......... ...... - C .. E ..............,...... .................................................................................................................... .. a. c. ..........,....,.......,...................................................................................................,......,...... " en ......................................................................................................................................... .............................,..................................................................................................,........ ................. .,...................................................................................................................... ..................,...................................................................................................................... ......................................................................................................................................... PaQe 2 S(h~Ul.. 10;.' Ira.", 1O(,~1 I'I'I~I @ ,...."~CII'If'lqCMd,,.pet ,,~:j~:?1\ ....M",.. COMMONWEALTH m P(NNSYlVANIA INHIRnANCE TAX UTUIN IUIDINT DICEDINT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploaso Print or Ty 0 FilE NUMBER _(",we (It 12111 ESTATE OF Fred F. Starner (All property loln'ly-owned with the Right of Survlvonhlp mUlt b. dllclo.ed on Sch.dul. F) N~T~~ER DESCRIPTION VALUE AT DATE OF DEATH 1. Farmers Trust checking acct. # 001162802 2. Cash 3. 1984 Yamaha Ventur motor cycle 4. 1985 Toyota truck (potential buyer has offered ~200.00) 5. 1975 Ford Bronco $539.04 ~318.65 $400.00 $200.00 ~ 0.00 TOTAL (Also ontor on lino 5. Rocapitulation) St. 457.6 (Attach additional BY," lC 11" shee" if more .pace il ne.d.d.) II . \ ~" II' i'.. I~~ ! (I il,l....lHwl AHu 01 '1"lj\Uo'AIIIA I Ilflll.IIMltl ,.. tllUIOj I _ ~!,.~I~.~I.~:_'~~~~I~I!-.._.___.._l_.. UlAIlOr SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES . . Pleal" Prlnl or Type r NUMBER . -- --. .--.------ ---.- ITEM NUMBER A, Funeral Expenl'" I 2. !,'rUlI ~'. :ilnrrwr DESCRIPTION AMOUNT llU/~nn Funern 1 lIome llenth corti ncnten S2, 300. 00 S 12.00 I B, Admlnll'ratlve Cal'" .~ 500.00 2, 3. 4. C. I 2, 3. 4. 5. b. 7, 8. Ponanol Ropro'onlalivo Commiuian, Social Socurily Numbor of Ponanal Ropro'onlalivo: _.ZQ.L_ -62 __=-_9..99.2- Yoar Commission, paid _ uJ.~9? Allornoy Foo, Georp:e F. Doup,lan, III, Vsq Jacqueline M. Verney, 'sq 7 Family e.omplion Cloimanl _ _. .. . 27 ~. High st Carlisle Irvine Row Carlisle, Ta ~ 150.00 S1,OOO.00 Rololian,hip __ Addross of Claimant 01 docodonl" doath Strool Addross Cily _.....______5101. ___ Zip Co do Prabolo Foo, S 120.00 Mllcellaneaul Expenle.. Advertise Letters of Administration-Cumb. Law Journal S 60.00 , 71. 04 ~ S 200.00 t 35.00 ~ 2<:'0.00 nOOO.OO ~ 50.00 S90.00 Aclvertise Letters of Administration-Sentinel Relll !'state apprainal :Jtevn !Jarrett Vehicle appraisal R " ~ "qui pmcnt Realty tranllfer tax COllt to remove vehicles and debris from real estate Irorllted taxes for sale of real estate Tmnsfer feell, renn !Jot ...-..--------- .__.__._...._-_._._~ TOTAL (AI,o onlor on lino 9, Rocopilulatian) 57,788.04 (II mare Ipace II needed, lnlerl addltlanallheell 01 lame Ibe.) / STEVEN W. BARRETT REAL ESTATE 124 N. Honovor Stroot Corllslo, PA 17013 (717) 243.6646 ToxlO: INVOICE 09/25/96 96'0762 DAlE NUMBER cnent: Douglas. Douglas and Douglas Attorney At Law 27 W. lIigh Street Carlisle. PA 17013 110m Tolol APPRAISAL FEE FOR SERVICES RENDERED $ 200.00 Borrower: Fred F. Starner Estate Peach Glen Road Gardners. PA 17324 Deed Book P29. Page 873. Dickinson Township WJ/A ~ \Q) Tolll $ 200.00 Thank you. ....----------- I 1 I j 1\ 'r: (p 6986 _ { ,L[', , -., , 1:1 ....- f ..I, f /("'- i:l) ".. , ( ill'/" " (./ '.' t, I,' "-- CU~IOMUC~ UMLJlM NU. UU'I. UATE I NAMl / I ,1 " . , 0'"'1..... t .. ,,' I ., ,(/ t.,:1 , I .''- '- AUDWlS5 \,I.w.. - . I <7' I"'" I ,,~.~ I ~.~" I~...... I'~~' -- l L). '. . i -' {, L QUAN. DISCRIP110N PRlCI AMOUNT I '. ll/. "'j' (1'-' I /,(j I,! j O/J . . _...., .j. 2 I I 3 4 5 /l] / (1 .. .), !ll 1'(,.1 1/1 \\ .~ 6 7 , 8 9 10 11 12 13 14 15 16 17 , 18 l(leu bY ~~. 51350 l) KEEP THIS SLIP FOR REFERENCE o ---- .0 0 0- 0- 00 0 , l'l 00 0 .0 N . . . .... <Xl IllN N , N l'l.o .0 r-. III l'lr-. r-. 0 <Xl .... w 'Ii it III I- e: ~~ <t 0 0 ~ 0.0. ~ . . a: a: . . U1 z WW :a 0 JJ ~ <t<t U1 a: 1-1- ~ 0 HH III 0.0. Iillil ~ C 00 :x::X: WW JJ tJllil HH JJ a: a: 00 U ~ w Ill.o Z .c 0<: 0-0- -, u. <tN ~ " ... e OM C ....Ill - a:a:r-. N.... 1Il oS .... W .... " ,it. c:: ZZ 0 a:W<t w ....0 lJ.l ~? <tJo. C 1Il ... . I-l!l 0 ZZ ~ <;>' tJl 0 HH In ~ :x:tJl ~p. .0 a: U " -r u.<tW lJ.l "'9 WZ *' .....0 ~ -(. 00.0 0. NN lJ.l p., e '" W a: a: ....l'l ::> ~ ..00 a:<t<t ... ....0 oJ'jO "4 !,tl t'3 roO ~ 00"'''' u.o-l!l 00 0 c::~C' .0 .0 'Ctl')ff"l ~ ~ srI;) ~ 0-0- <t ffi... 0.... ft)" *' )( >.J, '" ::1~:g?fc:i '1. :lOw w ,:I:r:;-' a: :lOCI 0< lJ.l 0 ' ~ >< 00. ..::.... H .... p., ?- !.; I- -. ~. ( .1/11 '\11 11".\1'11.11 )If, 1',IU1.."U S/lil.I.r LIIlIISI t, ",1 /i,IJ.I tll/J....~" _=~._.~~!Ilm ,~;.i~ t1~ AccerT VI~A / "^~IEflrARU & Dl~.CO\'En C^ll 7J 7-;:/lq.bb;(J -~.ltil;i""i7:\itii'i. \~"\iJ: _'j 1:~I;-;rN,j'l~j-_. __ -j7,\.i:~~~:!.-,.-~ '._.~_-J~~x~_~.\I~-- ,\( e'l.,".! '.1 \11.1 n f't1^';[ 1'10, IIW. o'IP.ltlllrll 1_0 rnED r 5fAllll[ft --.~n,;^TtfilllllJl,1I!11I I'1Z875(' -.------(~'i~ilfl;' 11M ^!I' I 72(I.nu A.i.i1i i~;.ir ". ':i.\l'lItli ,OU .---- '-UISCll^"uf'i5ITiViCf.UA1E U3I15/96 ---OWIO n^,E MI2Z196 ---rAYiMTii" nllF UAtE 05/13/96 72(I,lIO ,iii,..- AI.lOII!jI ~ l'AllIlunr ---.-'r"rrii ii;iT,r.r~ \(, ;'J'i-FitE"..-.---- -------.----.--- 1",11I."1,,11,,,1,1,1,,11.1,,11,"1.1",1..11.1".1,,11..1,1 1~20754 3 60 1 0 5 21 CK CARLI5lE HOSPITAL Z~6 p^nr.Ep. SlREET CARLI~LE. PA 170130310 FRED r 51 ARIIl:n 9'; I'F.ACII GLEIl nu GARUIIER~ rA 17324-9094-94 o I't~^q r;1l[CI( ll[flr. Mill f>1I0I',' tl~'.'! .^I,f)nr~'l(nllnrr:ll(lI' (Jtlll! 'inl!;1 S'Il'- OETf,CIIIIEnE IOASSlUll.l'll(ll I fllllll'lT I'I! ,,~,t ,',llIrt 10\111/'''11[1'' 'W'.llll II tlll,CIIIlI.lll (r "'/11 III IUIllHlPrrl1 ronllOIIW1TIl n[IJITTAtlCE __._._. , ._u_ -----.-. .__u__ _._~._._~__u . ------~ .-.._--.- DAlE UESCl1ll'lI01~ I)UANTIlY AMOUNT C--_. - ---_..- .-.-- ----.. --.--- -- 03/15/96 LA5S IV V1~H EllrRGEIICY OErT, 1 371. DO 03/15/96 PADS rR IlL HUrlC rAC/OEFIB IIPT 220 1 105.00 03/15/96 EO EKG 1I00IIlOR 1 52.00 03/15/9(, OUCII lELEIlEIRV 1 B.OO 03/15/96 OVER TABLe 1 B.OO 03/15/Q& STA T CII^"~E 1 16.00 ~ 03/15/96 "LOUD LACTATE 1 53.00 . 03/15/96 AR1ERIAL BLUUU GAS AUAL YSIS 1 9B.00 0 03/15/96 ~RlERlAL SAllI'L1I1G 1 8.00 '" y 03/15/96 OLOOO GAS KIT 1 5.00 ~ w . . 0 ~ < 0 ~ ~ Ij ~ w . > . , ~ ~ ~ IMPORTANT MESSAGE PAlllIU flAME; REO F STARllER PAIIElH "W.lBEn 1IIA1o/. YOU rOR U~IIIG IIII' ~ERVICE~ OF lllE 1428754 CARLI~LE 1I0:jI11Tt.l.. ll1J~ 1~ II !;iHF PAV "CCO~lln , A110 1I1E D,~LAlI::E J5 COllnOF.nt:r) ACCOUNT SUMMARY YOUR RI7~POll:;lnlt.JI v. II' '10\1 IIA'ie IrfjlJII^llCE COVER^"E rlEA~E I Ill. III llle IIIromlAIlUrI Orl rnnlOus .00 RAINleE lll~ nEVEIl~E UF llll~ Dill, II' YOU IIAVe AlIV aUE~1l0IlS CALL ,'.0-667(, DUlleEl/ 9AII AlID tlEW 724.00 CIMnof.S 4PII. I!All.lE.IlISJ OUlEn .00 AUJUSIM[WS cunRltl1 -----------.- - .-- ~CCOU'II 724.00 1l1!:.(ll^"IOf io:..'''."-T H/15/% nlllA1lCE I'A" PAH.tPlT IlEEn IIrLr IlII11 OIliER 11I:lllCH BIlL~ 17 ----.- --_.....- CUE t''''E 05/13/96 CARLI~LE 1I0SPl1AL ClAm CAlle 7l7-2/15~515f3 Mi"lrr.lflll .00 A\IIW"I PAY r;::,"i, nl'; ltIUI\IU M" II ";1 I If"" 11"'[ \\'11 ^I'II "II .ltj /jf" <,'^l[l.ll'lf 724.00 1lf.'I\ltlllll',I'('llIllllj TIiIS AMOUNT POOO 1006000 I 02404 l..lB' W,"I/I/"'''',I/'''' 14 2 8 7 5.1 8 860 01 02 RWC EMERGENCY PHYSICIANS BILLING OFFICE 13 BROOKWOOD AVE SUITE 3 CARLISLE, PA 17013 1 AUt OIMlljPi on PAvMWIS m:CEIV[O ArtEn IIll u^,r lIHOW WIU APP[AR 0)' "gun NEItT SI""EMI "^,, "<ellU 04/20/9b TOTAL BALANCE DUE 245.00 AMOUNT Au.mUD (717) 249-9432 FRED F. STARNEIl 94 PEACH GLEN nu GARUNERS, PA 11324 RWC EMERGENCY PHYSICIANS BILLING OFFICE 13 BROOKWOOD AVENUE SUITE 3 CARLISLE, PA 17013 TAX lOt 23-2259396 ANY CtlANOE OF ADDRESS SHOULD DE REPORlED IrJ OlJR orneE. DEIACtt AND RETURN Wlnl youn nEMmANCE 10 IHI$ ADDRESS STATEMENT OILL ED rnOM RWC EMERGENCY PHYSICIANS DATE DILLED 04/20/96 DIllED to ACCOUNT HUMDER FRED F. STARNER 1428754 DATE IPROCEDURE DESCRIPTION OF SERVICE leD 9 DR NtOUNT FRED F. STARNER 3/15/96 99284 EMERGENCY DEPT VISIT 4275 COYLE 180.00 3/15/96 93042 ~HYTHH ECG, REPORT 4275 COYLE 35.00 3/15/96 36415 DRAWING BLOOD 4275 COYLE 30.00 ~NY QUESTIONS PLEASE CALL THE BUSINESS OFFICE BETWEEN ~:00AH-4:00PH HONDAY THROUGH FRIDAY AT (717) 249-9432. - CURRE,..T MO al/LR Jf) Oft _' S OI,'~rJ fo DAYS O'lER 'tI Ol"5 rY.Tn 12~ ('Ift,;~ OVER t50 OAYS F'IN. CHUS. OAlA,.,CE ..- 245.00 245.00 . .... ..\........ ..'.~ ... _.-:- S3 Farm Plan. III' P.g. 101 A S"V,ct 01 (PC rrnanClal Account Numb., A....II.bl. C,.dil 59103-16198 REGULAR $761 FOf Cu,tome, hlqU'O". Call 1-800-356-9033 0.1001 0.1. InvolC' III YronUClion Polled Rof.renc. Dosel ipllon Amounl PREVIOUS BALANCE 261. 24 PAYMENTS ANO OTHER ADJUSTMENTS 02/23 02/23 200000C PAYMEtH-THANK YOU 26.12CR .. FINANCE CHARGE .. 3.35 LOST OR MISSING INVOICE COPIES CAN BE I OBTAINE THROUGH YOUR MERCHANT. I I I ArrnllNT BA' ANrF "MMARV ! REGULAR I 23B.47 I Pw'~~un. 1l"w'~1 .~" Pi,....." "".I. 'wl! "".. I. I~. "'''''''~I 01.11 ""I' ",1 ."... ..101 ..., .....tll I 'u,,"',., i SlIl,mont Oalo I Previous Dalance Pa.,.m.nt,/Cr.dlt. PUlchu,,'O.biU FIHAllCE CHAIIGC New B.I.nco I 3/06/96 20 1.2-1 - 26.12 . .00 . 3.35 . . 23B,47 [ No. Av.,.g. O"ly Pu'iolllc A.lo N1WIJG 7:M! To ....oid additlon.l .........-Mlnlmum 01 c',ly PE'";,EN E lin.ne. Ch,1I9U, Requited Payment Oay, 8alanco ArC P" 29 243.65 REGULAR .047541 17 .40r. 3.35 238.47 bb~~'D~~:~~:nl ------------- 3/29/96 25.00 S.. A,..." S"I. h. ''''''''IM 1."''''11.'. PltI.. RII'" 1I1111'" P"",II ..,,'" "'f' P,,""~I . " A...." O.II~I 6B Farm ~Ian. " Srrvirt vI rpc fi",mrla' 59103-1619B ..rolrlllWlLDJ,lIL041 3/29/96 JlolJn<Ll>. rllnu>unUn<'O'l:ll-! REGULAR Mi"imum Account Numbel 23B,47 25.00 FRED STARNER 94 PEACH GLEN RO BOX 46B A5 GARONERS PA 17324 TOT A l 238.47 25.00 PltllI ""~' Cht~1 ,.~.bl. " 999-999-9999 FARM PLAN DEPARTMENT 77175 PO 80X 77000 DETROIT MI 48277-0115 1,1"11,.1."1,11,"11",111"",,111,,,1,1,1,11,"11,,.1,1.,1 PIUII l~d.u" A""'.n/Ph.~. CII,~," ':'b.... 600000 5910316198 000002500 000023847 4 tlY.UIJU. !llfl ESTATE OF ITEM NUMBER ITEM NUMBER *' eO...."'ONw!AI'HQf "NN\nYANIA IHHUlfAHCI 'AX II'U'N 'UIDIH' DleIDIN' SCHEDULE J BENEFICIARIES Fred F. :ltarner NAME AND ADDRESS OF BENEFICIARY 1. A. T aaable Beque,": Darlene A. ~tarner P.O. Box 73, Orrtanna, Pa 17353 Carol A. Starner F.O. Box 73, Orrtanna, Fa 17353 Rebecca S. Starner 104 Mountain Road, Shermansdale, Pa 17090 Timothy Starner 8 Park St. Mt Holly Spri~fl, Fa 17065 Samuel H. Starner 94 Peach Glen Road, Gardners, Pa 17321~ Winifred Quesenberry 96 Peach Glen Rd., Gardners, Pa 17324 2. 3. 4. 5. 6. NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental BequetoU: 1. FILE NUMBER RELATIONSHIP AMOUNT OR SHARE OF ESTATE Dauc;hter 1/6 Daughter 1/6 Daup;hter 1/6 Son 1/6 Son 1/6 Daughter 1/6 AMOUNT OR SHARE OF ESTATE TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aba enter on line 13. Recapitulation) S (If more .pac. I. n..d.d, In..rt addltlonol.h.... of lam. .In) / /5-<73 .-7 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES IHIl[RI1AN([ fAll DIVISION DEPI. ~aObOl UARRISBURG, PA 111~ft'ObDI NDIICL Of IN!lLRllANCI lAM ArPRAIsrHENT, ALLOWANCe ON DI5AllOWANC[ OF DEDUCIIDNS AND ASSLSSHLNl O' lAM JACQUELINE M VERNEY ESQ SODUS & VERtlEY 7 IRVINE ROW CARLISLE PA 17013 DATE ESTATE OF DATE OF OEATM FILE NUMBER COUNTY ACN 0'" 1', - 97 STARNER 03-15-96 21 96-0262 CUMBERLAtlD 101 ,-.-- AI'lount R.",! t ted ,-=- -"-'-.=-=,-,... ,-:c '-0._"-'.=";;:- -, __=..7- .,.-c.- ~~~' ~;r:a.p~ - ~~ "')it.'. "''''0 .t.:. IF. ;\0/11." 111-"1 FRED -~~o-~j F MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... iifli: is Ci'-Eif- AFP' - i 0:3:97 Y -NoT Icr -oF --iNHEiII;: AN-cE- TAX - A'ppiiA'I 5 EM ENT -;- A n-owANc E - iili - - - -. - ----- - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STARNER FRED F FILE NO. 21 96-0262 ACN 101 DATE 04-14-97 TAX RETURN WAS: I X I ACCEPTED AS FILED C!lANCED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Red Est.t. (Schedule A) (I) 2. Stocks and Bonds (Schedule 8) 121 3. Closely Held stock/Padnership Interest (Schedule C) t3J 4. Hortgages/Notes Receivable {Schedule 01 (4) 5. CashlBank Deposits/Hisc. Personal Property ISchedule EI ISI b. Jointly Owned Property CSchedule FJ CbJ 7. Transfers (Schedule C) (7) 8. Tot.l Assets 20.000.00 .00 3.000.00 .00 1.457.69 .00 ,00 181 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adn. Costs/Misc. E)lpenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens CSchedule I) elO) 11. Total Oeductions 12. Net Value of T.x Return 13. Charitable/Governnental Bequests CSchedule JJ 14. Net Value of Est.te Subject to Ta)l 7,788.04 4.874,98 IIII 112) 113) 1141 If an assessment was issued previOUSly. lines 14. 15 and/or 1&. 17 reflect figures that include the total of ALL returns assessed to ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal 16. Anount of Line 14 ta)labl. at 17. Anount of line 14 ta)lable at 18. Principal Tax Due NOTE: rate Lineal/Class A rat. Collateral/Class 8 rate 115) IIbl 1171 .00 11.794.67 .00 X .00= X .06= X .15= 118) TAX CREDITS: PAYHENT DATE 12-13-96 DISCOUNT It) INTEREST/PEN PAID I,) ,00 RECEIPT NUHBER AA184957 AHDUNT PAID 707.68 TOTAL TAX CREDIT ,BALANCE OF TAX DUEl I INTEREST AND PEN. TOTAL DUE NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. 24.457.69 1?663 02 11,794.67 .00 11.794.67 and IB will date. .00 707.68 .00 707.68 707.68 .00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR). YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS.) DQ :n c , ", -, =1,) ~ " .J :-J , UI RESERVATION I E.t.t.. af d.cad.nt. dying on or b.for. Dlc..b.r IZ, 198Z .- If any future Intar..t In the ..tat. I. tran.f.rrad In Po.....lon or .nJoy..nt to Cia.. . (collataral) b.n.flclarl.. of the d.c.d.nt aft.r the .xplratlon of any ..tat. for II'. or for y.ar., the Co..onw.alth h.reby .xpr...ly r...rv.. the right to appral.. and a..a.. tran,'ar Inharltanca Tax.. at the lawful Cia.. B (collat.ral) rat. on any .uch future Intar..t. PURPOSE OF NOTICE I To fulfill the requlre..nt. of Sactlon ZI~O of tha Inh.rltanc. and E.tat. T.x Act, Act ZI of 1995. 17Z P.S. Sactlon 9140), PAVMENT I D.t.ch the top portion of thl. Notlc. and .ubelt with your pay..nt to the Ragl.tar of Willa prlntad on the r.v.r.. .Id.. --"aka chack or aon.y ordu p.yabl. tal REGISTER OF MILLS, AGENT REFUND ICR)I A rafund af a tax credit, which w.. not raqu..tad on tha T.x R.turn, ..y b. requ..ted by co.pl.tlng an "Appllc.tlon for Rafund of p.nn.ylv.nla Inh.rlt.nca and E.tate T.x" IREY.I]I]). Application. ara avall.bl. at the Offlc.. of the R.gI.t.r of Will" .ny of the Z] Revanue Ol.trlct Office.. or by c.lllng the .p.elal 24-hour an.w.rlng ..rvlc. ~ber. for for.. ordering I In penn.ylv.nla 1-800-]6Z-Z050, out. Ide Penn.ylvanla and within loc.l H.rrl.burg ar.. (111) 187-8094, TOOt (111) llZ-ZZ5Z (Ha.rlng lapalrad Only). OBJECTIONS: Any p.rty In Intar..t not .atl.flad with the .ppr.I....nt, .llowanca or dl.allow.nca of d.ductlon., or ...a...ant of t.x (Including dl.count or Int.ra.t) a. .hown on this Hotlca .u.t Object within sixty (60) day. of recalpt of thh Notice by: -.wrltten prote.t to tha PA D.p.rt.ant of Ravanua, Bo.rd of Appa.l., D.pt. Z810Z1, Harrl.burg, PA ..alectlon to h.va tha .att.r dat.r.lnad .t audit of tha account of tha per.onal rapre.antatlva, --appeal to tha Orphan.' Court. 11121-IOZI, OR OR ADMIN ISTRATIVE CORRECTIONS: F.ctual .rrors dl.coverad on thl. ........nt .hould ba addre..ad In writing to: PA Dep.rt.ant of R.vanua, Buraau of Individual T.xa., ATTN: Po.t A.sa...ant Ravlew UnIt, Dapt. Z80601, H.rrlsburg, PA l11Z8-0601 Phone (111) 181-6505. Saa paga 5 of tha booklet "In.tructlon. for Inh.rlt.nc. T.x R.turn for a Ra.ld.nt Dac.dant" (REY-1501) for .n explan.tlon of adalnl.tr.tlv.ly corr.ct.bl. error.. DISCOUNTs If any tax due 1. p.ld wIthin thra. I]) cal.ndar aonth. .fter the dacad.nt'. d..th, . flv. p.rc.nt 15%) discount of the t.x p.ld I. .llow.d. PENAL TV: Th. 15X t.x .ane.ty non-partlclp.tlon p.n.lty I. co.put.d on the tot.l of the ta. and Inter..t .......d, and not paid b.for. Janu.ry 11, 1996, the flr.t d.y .ftar the .nd of the t.x a.na.ty p.rlod. Thl. non-participation p~.lty I. app..labl. In the .... .ann.r and In the tha .... tl.. p.rlod a. you would app.al the ta. and Int.r..t that ha. ba.n .......d a. Indlcat.d on thl. not Ie.. INTEREST: Intar..t I. charg.d b.glnnlng with flr.t day of d.llnqu.ncy, or nln. (9) aonthl and on. (1) day fro. the data of d.ath, to the data of p.y.ant. Taxa. which b.ea.. dellnquant b.for. Janu.ry 1, 1981 bear Int.r..t at tha rat. of .1. (6%) p.rcent p.r ennu. c.lculated .t a dally rata of .000164. All tax.. whIch bece.e d.llnqu.nt on and aftar January I, 1981 will b.ar Intar..t at a rata which will vary fro. cal.ndar y..r to c.l.ndar yaar with that rata announc.d by the PA D.part.ant of R.v.nu.. Th. appllcabl. Int.r..t ret.. for 1982 through 1991 .r.: '!.!!! Inter..t A.t. Dally Int.r..t Fector !!!! Int.rnt Rat. Dally Inbrnt Factor 1982 zO% .000548 1987 .~ .000Z41 191] l'~ .000~]8 1988-1991 11;( .000301 1984 11;( .000n) 199Z .~ .000141 1915 13:t: .000]S6 1993-199~ 1~ .00019l 1916 l.~ .000274 1995-1991 .~ .00QZ41 ulntarut Is calculatad .. follows: INTEREST = BALANCE OF TAX UNPAIO X NUNBER OF OAYS OELINQUENT X OAILY INTEREST FACTOR --Any Hotlca I.su.d .ft.r the ta. baco.e. d.llnqu.nt will rafl.ct an Int.r..t calculation to flft..n (15) daYI bayond the data 0' the .s......nt. If pay.ant I. .ad. aftar the Int.r..t co.put.tlon data .hown on the Notice, additional Int.r..t ault ba calculatad. , j ....- ~ ( u~ q 3 - 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DUREAU'OF INDIVIDUAL TAXES .iNII[AIU.HC[ TAll DiViSION DlPT. :Ubol IlAAAlnullc. PI 111:a-QftOI NOTICE or INIlERlTANCE TAX APPRAISE~ENT. ALLOWANCE OR DISALLOWANCE OF OEDUCTIDNS AND ASSESS~ENT DF lAX WINIFRED 96 PEACH GARDNERS L QUESENBERRY GLEN RD DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-02-98 STARNER 03-15-96 21 96-0262 CUMBERLAND 101 Anount Ranitted PA 17324 ,__ ~~(~~~ '"tf}~ F MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ifiv: iS4T EiCAj:-p-(ijij':ij7Y-NoYicE--oF-YNHEiiiT;.ifcE-YAX-A'PP RA'isEifENT";-ALi."owiiifcE-oR'mm----m---- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STARNER FRED F FILE NO. 21 96-0262 ACN 101 DATE 06-02-98 i ! I I . ! fl' ,hI"'.. 01' ", FRED TAX RETURN WAS: ( ) ACCEPTED AS FILED I X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL 1. Reel Est.t. (Schedule A) 2. stocks end Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule CJ 4. Hortgages/Notes Receivable (Schedule OJ 5. Cash/Bank Deposits/Hisc. Personal Property CSchedule E) &. Jointly OMned Property (Schedule F) 7. Transfers CSchedule G) 8. Total Assets NO. 01 RETURN 111 121 131 141 151 1&1 171 ,00 ,00 .00 .00 4.729,48 .00 .00 IDI Iq) 1101 4,483.28 166,67 11\1 1121 1131 1141 APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funerel Expenses/Adn. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens CSchedule XJ 11. Total Deductions 12. Het Value of Tax Return 13. Charitable/Governnental aequests; Non-elected qll3 trusts (Schedule J) 14. Het Value of Estat. Subject to Tax NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax paynent. 4,729.28 4.649 9~ 79.53 .00 11,874.20 14, IS and/or 1&, 17 and 18 will returns assessed to date. NOTE: If an assessment was issued previously, lines reflect figures that include the total of ~ ASSESSMENT OF TAX: 15. Anount of Line 14 at Spousal rate CISJ 1&. Anount of Line 14 taxable at Lin.al/Class A rat. Cl&) 17. Anount of Lin. 14 taxabl. at Collateral/Class Brat. Cl1) 18. Principal tax ou. TAX CREDITS: PAY~ENT DATE 12-13-96 ,00 X .00= 11,874.20 x.06= .00X.15= 1181 RECEIPT NU~DER AAI84957 DISCDUNT (.) INTEREST/PEN PAID 1-) A~DUNT PAID 707.68 .00 INTEREST IS CHARGED THROUGH 06-17-98 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ,00 712.45 .00 712.45 707.68 4,71 .65 5.42 . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST, I IF TOTAL DUE IS LESS TNAN .1, NO PAY~ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREOn" (CR I, YDU ~AY DE DUE A REFUND. SEE REVERSE SIDE OF TNIS FOR~ FOR INSTRUCTIONS.) RESERVAIION: tstat.s of d.c.dents dying on or b.for. D.c..b.r 12, l,a2 .- If Any future Int.r.st In tho .stat. Is transl.rr.d In poss.sslon or .nJoy.ent to Cless B (collet.ral) beneficlerl.s of tho d.c.d.nt after the e.plratlon 01 any estate for 11ft or for years, the Co..on~eelth hereby e.prlssly re..rve. the right to appral.. and a..... transf.r Inheritance la.ls at thl la~ful Cla.s 8 (coll.tlral) rat. on any luch future Intlre.t. PURPOSE Of HOTlCEI To fulfill thl requlre.ents of S.ctlon 21~O of the Inheritance and [.tate la. Act, Act 21 of I"~' (72 P.S. Slctlon 'I~OJ. PAYM[NT: Detach the top portion of this Notice and sub.it ~Ith your pay.ent to thl Reglst.r of will. prlnt.d on thl r.v.rse sldl, "Makl check or .0nlY order payabl. to: REGISTER OF MILLS, AGENT AEfUND (CA)I A r.fund of a ta_ cr.dlt, ~hlch ~as not r.qu.sted on thl la. Aeturn. .ay b. requ.stld by co.plltlng an -Application for Rlfund of Plnnsylvanla Inhlritanc. and [state Ta.M (REV'lll1J, Applications are avallabll at thl OffiCI of the A.glst.r of wills. any of thl 21 Rlvlnu. Diltrlct Offlc.s. or by calling thl sp.clal 24'hour an.w.rlng s.rwlc. nu.b.rs for for.. ord.rlng: In P.nn.ylvanla 1.800.162-:0S0. outsldl P.nnsylvanla and ~lthln local tlarrlsburg area (11) 781.an4, TOOl (111) 112'ZZSZ (Hillring I.palred Only). OBJECTIONS: Any party In int.r.st not satlsfl.d with thl Appral....nt. alloMenc' or dl.allowanc. of d.ductlon., or al......nt of ta. I Including dl.count or Int.r..t) al shawn on this Notic. .u.t object within si.ty (60) day. of receipt of this Hotln by: --~rltt.n prote.t to the PA Depart.ent of A.v.nue. aoard of App.al., D.pt. 2810l1, Harrllburg. PI 1112a-IolI. OR .'.Iection to have the .atter d.tlr.ln.d at audit of the account of the p.rlonal r.pr...ntatlv., OR .-app.al to the Orphans' Court. ADHIN ISTAAllVE CORRECTIONS: Factual Irrors dllcovlr.d on this al.l.s..nt .hould b. addre.l.d In writing to: PA Dlpart..nt of A.venu.. Bur.au of Indlwldual Ta..s, ATTN: Po.t Asl.....nt R.vlew Unit. Olpt, la0601, Harrl.burg, PA 1712a.0601 Phon. (717) 7.'.6S0S. 511 pagl S of the bookl.t -Instructions for Inhlrltanc' la. Return for a R.sldlnt Olc.d.nt- tAEV.IS01J for an I.planatlon of ad.lnistratlw.ly corr.ctabl. Irrors. DISCOUHh If any ta_ dul Is paid within thr.1 (3) cal.ndar .onths aft.r the dlcld.nt's dlath, a flv' plrclnt ISZ) discount of the ta_ paid Is allo~ld. PENAlTY: Thl ISZ ta_ aanlsty non.partlclpatlon plnalty Is co.putld on thl total of the ta_ and Int.r.st aSllsl.d, and not paid blforl January la. 19'6, the first day alt.r thl .nd of the ta_ .'"Isty plrlod, Ihls non.partlclpatlon penalty Is app.alabl. In thl sa'l .ann.r a"d In thl the sa.e tl.1 plrlod as you ~ould app.al thl ta. And Int.rlst that has bl.n asslslld as Indicated on this notlc.. IN1UESTl Int.rlst Is chargld blglnnlng with first day of d.llnqu.ncy, or nln. (,) .0nthS and ani (1) day fro. thl date of death, to thl dati of pay..nt. 1a.ls ~hlch blca'l dlllnqulnt blforl January I. l,a2 bear Int.rlst at thl rat. of sl_ e6Z) p.rClnt plr annul calculat.d at a dally rat. of .0001&4. All la.ls ~hlch blca.1 dlllnqulnt on and aftlr January I, l,a2 ~III blar int.rlsl at a ratl Mhlch will vary fro. callndar Ylar 10 calondar Ylar wllh that rat. announCld by Ihe PA D.parl'lnt 01 R.v.nul. thl appllcabll Inter 1St rat.. for 1982 through .'9& arl: '!!!! lntlr.,t P""I Dally Inlorll' rAclor ~ 1"'I,.,t Pale Dlllly lnlernt rltctor 198Z 20;( .ooos"a 1981 '9Z .000l~1 1'9&3 IU .000~38 )I.aa.I''1 llZ .DOUOI l'9a~ 11;( .000301 1'9'2 .% ,DOOl'" l,aS U;( .0003\6 )lJ9)-1'1J4 1'1. .0001'92 l,a, 10;( .000Z1~ 191J'J-IIJ'a .% .000:'" ulnterllt Is calculatld .. fol1olllls: INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..A"y Hotlcl Is.ued altlr 'hi ta. bleo'll dlllnqulnt Mill rlfllct an Inl.rlst calculation to flft.ln (IS) days blYond thl dale of thl as'I"'lnt. If pay.lnt Is .ad. aft.r thl Int.r..t eOIPulatlon dati shown on the Holln. additional inlorllt lUll be ulcuhted. "'Y.U'OUt'''1 . . INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEAlTH OF PENNSYLVANIA DEPARIMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 UARRISOURG PA 17128.0601 DECEDENrS NAME FILE NUMBER Fred F. Starner 2196-0262 101 REVIEWED BY ACN Arcessla Byrd SCHEDULE ITEM NO, EXPLANATION OF CHANGES E Accepted additional assets. H,I Accepted additional debts. ROW Page 1 tr\ ~.::( 0 If) ,0:. <fl N ) >~;~-: E , 0 - " ~ .. ~ '-' ;.' ,,' d Q' oJ U CO ,- I'" Q)a: P' ~5 a: UC COMMONWEAL HI or PUmSYlVAUI^ orPMUMtNT or flEV[tWE ounEAU OF INDIVIDUAL TAXES otPI260G01 IlAflnISnUI1G, PA 11128.0G01 W~. ~ -. ' NO. [.lJ\ 296 440 IlLV"" 'x '''961 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RECEIVED FROM: r- ACN ASSESSMENT CONTROL NUM[lER AMOUNT WINIFRED QUESENBERRY 101 .5.'12 96 PEACH GLEN RD GARDNERS. PA 17324 fOlDtl[lll FOlDtIER[ . ESTATE INFORMATION: FilE NUMnE R a-l~ISlSib..oU2--bSN--l-a~~O NAME OF DECEDENT lLASTI (FIRST) ----SlAANER-F--RE:D F' DATE OF PAYMENT (Mil .' " " " " ,\ " .' --.:J-HlO /1 99El POSTMARK OAiE .,' ::' ~ " ~ .......... . . . SO.42 7.t+:7 /1 Q98 COUNTy . TOTAL AMOUNT PAID _CUMBERLA/lln DATE OF DEATH . ~ ,,: ~ E DO " -p .. -,-_.' , . 'i' - .. RECEIVED BY I.,'/.? /, ) /: '\ I" , ,; j) .;;''',( I r/J ..' . " ~IARYC. LE 15 . ...../ . /;-; REGISTtR,.,d~,,~!,SLS..''--I1Jh '/'11'/' REMARKSW. QUESEN8ERRY SEAL ;~>,~ '~;'t':-. ;-' , 'II !l_ ,., '--- '- ........-4.'"""\iI. .'-1 "T "~. . .---- . '"' -. ... ..,. 4" '... ,~ . --.. q(p. Ibach 6/en {U GaYclrl.!!-rS t?t{ 1732Lf I / , \ -, ) /l'?::-q /:51-0" {)f /1./'/1/.5 {;U-111h. ('0. C(:;ur'f l-,/oiA5e_ c.' Cev/I sLe. I pet 170/3 ~. :;")(j G~ '" (T.> :0 :"Jro '; Q c"- r N Cl ~ :;Sm ine. \,'(",J\.~;~~~" 1,,,111..,111,..,,,'1..11,,,11,,,11,\,1,,..\,1,,.111 __ .' :""'" ~. c...... " , . f', ., "'J " t , ~'" ,: ".# t, ;. . ~ . 'I "t, :; >'. . , " .,;t~ .~ " . v ~ ,! . ---..,..,...-. 7~.--:---"'~. t.. -- 1':"" , " ~ ~ . J . /'J _ :j')' .,1) BUREAU OF INDIVIDUAL TAXES INtIlRl1ANC[ tAlC DIVISION IXPl. 1110&01 tlARRISBURG, PA 11118.0&01 COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT L . WINIFRED L QUESENBERRV 96 PEACH GLEN RD GARDNERS PA 17324 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN II'-hlt...." III.'" OB-31-1998 STARNER 03-15-1996 21 96-0262 CUMBERLAND 101 FRED F AIIQunt Re.itted MAKE CHECK PAVABLE AND REMIT PAVMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paY.Bnt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ifiy:i6iWEX-AFiQO:f:m-------.iiii-iNHERiTAiicE-;:Aif-STA'iEtiEN'r-'iiF'-Accoiitii--ii..--------------------- ESTATE OF STARNER FRED F FILE NO.21 96-0262 ACN 101 DATE 08-31-1998 THIS STATENEHT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-26-1998 PRINCIPAL TAX DUE: .-----------.--------.--------------.----------- PAVMENTS (TAX CREDITS): PAVMENT DATE 12-1:;-1996 07-17-1998 RECEIPT NUMBER AA184957 AA296440 DISCOUNT (+) INTEREST/PEN PAID (-) .00 .65- 712.45 AMOUNT PAID 707.68 5.42 _: ..J , ..". -.- TOTAL TAX CREDIT 712.45 INTEREST AND PEN. TOTAL DUE ,00 .03 .03 BALANCE OF TAX DUE . IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHEHT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I PAVftENT: Oetach the top portion of this Notice and sub.it with your pay.ent .ade payable to the n~e and Bddress printed on the re~erse side. If RESIDENT DECEDENT .ake check or .onoy order payable to: REGISTER OF WILLS, AGENT. If NON-RESIDENT OECEDENT aake check or .oney orde" payable to: COHttONWEAL TH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requestod on the laK Return. .ay be requested by co.pleting an ~Appllcatlon for Refund of Pennsylvania Inheritance and Estate Tax~ (REY-IlI3J. Applications are available at the Office of the Reglstor of Wills. any of tho 23 Re~enue District Offices or fro. tho Departaent's 2~-hour answerIng servlco nuabers for for.s ordering: In Pennsylvania 1.800.362-2050, outside Pennsylvania and within local Harrisburg .rea (717) 787-809~, TOOl (7171 712.2252 (Ifoarlng I.palred onlY). Rt:PL V TO: aueltlons rogardlng errors contained on this notice should bo addressed to: PA Oepart.ent of Revenue. Bureau of Individual laKes, ATIN: Post ASless.ent Review unit, Dept. 280601, HarriSburg, PA 17128.0601, phone (717) 787.6505. DISCOUNT: If any tax due II paid within three 13J calenrlar .onths aftnr the decedent', death, 0 five percent (5%) discount of the tax paid Is allowed. PENAL TV: The 15% tax ..nosty non-particIpation penalty Is coeputod on the total of the tBX and Interest as.essed, and not paid before January 18, 1996, the first day aftor the end of the tax ..nesty period. INTEREST: Intore,t Is charged beginning with flr,t day of delinquency, or nine (9) .onths and one IIJ day fro. tho date of death, to the date of pay.ent. TaKes which beca.e delinquent before January 1, 1982 bear Intorost at tho rate of six (6%) percent per annu. calculatod at a dally rate of .OOOI6~. All tBxes which beca.e delinquent on and aft.r January I, 1982 will bear Interest at B rate which will vary fro. calendar year to calendar year with that rate announced by the PA Oepart.ent of Rovenue. Ihe applicable Interest rates for 1982 through 1998 are: Vear Interest Rate Dally Interost Factor Vear Interost Rate DailY Inter.st Factor 1982 ZOX .0005~8 1987 'X .0002~7 1983 16;( .OOO~38 19&&.1991 IlX .000301 19M 11% .000301 199;! 'X .000247 1985 In .000356 1991-199~ n .000192 1986 lOX .00027~ 1995-1998 .X .0002~1 ulnterest I, calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..Any Notice issued aft.r the tax bacoees delinquent will reflect an Interest calculation to fifteen (151 days beyond the date of the aSlesseent. Jf pay.ent Is eade aftor the Interest co.putntlon date shown on the Hotlce, additional Interost aust be calculated. C/ ?'I'I\.'rlJ.~LHI~I'{}H'I' .U11I11':H HIII.I-: I,. I:' Name of Decedellt: r~CD r. ~T:ll"-Nf.,'l.. ----... ---- -..----". ._- . Date of Death:,--1!' s- /!i!t-,--.-- Will No, I\d.1I ill. II... -~i-;ci 9f,. -0;;'(" :;... Pursuant to HIIII~ 6.1? llf till' ~;lII'II'lnn "I1I1I\. nq.h.1I15' Court Rules, I report the follllwi'IlJ with "'''I'''';\. 1.11 <':llllll'l"'l.llIl1 lJl the aumillistrijtloll of tl1I! i11".Ivu-':"1'1 illlll,,1 "'itil\.U: 1. Stale whethlJl" adlOiniul I dt illll oj thu UHt.dtt! iti cOlllptet...:; Yes_~_ 110 .' 2. If the ilnsw~n is !III, representative reasonably '1,1)1 il!VeS complete: __.._. __.._ :it dt I! \d\l!1l till! pprBfJl\., I 1 hill I hI! (llhnillil.ltrill illll \Ii II I,,,, " 3. 11 the anSWI)1 I" Nil. is Y"'i, tildtl! thl! IIIIIIIIIIII<J: a. Diu t.he pe,'s(mal l'o,'I',o.l.l';III<l\.ivl! lile il lill,,1 ilccount with the Court.? YO"; 11,. )( h. 'l'hn ~1~l'i'I.I'II.! ()qdl,lll:i' j""111 fll). (i I tllIY) IIII the personal n~prespnlativt":i IH'I~llllllt i~;: c. Did the lH!l'Hc1n,,1 11'1111~~jl'ltt.lt.ivu tildln dll account informillly to t.ho POllli",; ill 1111."",;1'1 Yl!ti.}<. !III d. Copies of 1"f:lceipIH, J._~It.~i1tieH, )oindlH'H and approvals of f()J:ma 1 or inlonnill ilr:r:lIlIlll ,; llIay I'l! f i Iuu wi I h t.hu Cerk of the Orphans' Court ilnd llIoIY I,,; <ll t.dr:hl!d to LId 5 . ul'or' SiZ:( i..!;TPi~ (-,L<<. Date: frlq/'}.f' /1 ,-1; If ~.e"""""111' ~ ~~ ;'ii ~I' lIn:" ---.--,. '-'- .-. u____ c; ''1 0\ :'-t !4au\'{II"... ;Lt, VtIC.N\.'J ~.!.q rl,,'nll! (1'\",.,;" - i:yp;~'-,;.: 'p::ri,l') .- ,.t ":.jo.. E: 0\ I .f'/ .::, I-IAII1La..:..,:};- _ eAI~{.d\, p.... ""':3 A' II t I't!~i~) '~ ::s ..., 1'/17) :/<(3 - 7/';6 ,\,.,1. II", , ij ~.'. wa: a: co P' ...J :.. <= ..- -::> 'JU Cd 1'.1<' II i' : ,)'I.H'tiOl"-} 1 H~I'I etit~"l ~Il i vu ;(, 1:01ln5U I lot (1unllln" 1 I pl'nHiUUl.dl i vn ( MAli: I'm f I I\M 3 )