HomeMy WebLinkAbout97-00191
Estate of Frank L. Wi.1li~~I!"!___,___
also known as
PETITION FOI{ PROBATE and GRANT OF LETTERS
;2 I - :L'l.::J::LL_
No,
To:
_ ._________ Register of Wills for the
Deceased, County of CUl)lber land in the
Social Security No. 429.-l:l2-e~3 __ Commonwealth of Pennsylvanla
The petition of th~ undersigned respectfully represenls that:
Your petltloner(s), who Is/are 18 years of age or older an the executor
In the last wlll of the above decedent, dated December 2L-
and codlcll(s) dated .___
named
, 19.2i-
(Slate relevanl drCllmsuulC:CS, (,I, renunciation, death or executor, etc.)
~ecendenl was domiciled at death In Cumberland
h s last family or principal residence .al
Cumberland Crossings, 1 Langsdorf Way, Carltsle,
(list meel, numb" and munclpalhy)
County, Pennsylvania, with
PA llUU ~MU~ 7Jt/didtlo.>c
Decendent, then 92 yem of age, died februarv 16 , 1997
at Carlisle Hospital .
Except as follows, decedent did not marry, W&.I not divorced and did not have a chUd born or adopted
after execution of the will offertd for probate; was not the victim of a killing and was never adjudicated
Incompetent: __
Decendent at death owned property with estimated values as follows:
(If domiciled In P".) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property In County
Value of real estate In Pennsylvania
situated as follows: owned no real estate in PA
S 800,000.00
S
S
S
WHEREFORE, petltioner(s) respectfully
presented herewith and the grant of letter,!
theron.
r~uest(s) the probate of the last will and codlcll(s)
TestamentarL
(l"tamentary; admlnJmallnn c.t,a.: admlnlstratlon d.b.n.c.l,a.)
~ - . !
I~ WA-V~~/~
il
~~
!-
r
III
1050 Plum Point Road
Huntingtown, MD 20bj9
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } 88
COUNTY OF. CUMBERLAND
The petltioner(s) above. named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitloner(s) and that as personal represen-
lative(s) of the above decedent petitioner(s) will weUand truly ~Vinls,ter~~eesp:e,accOrdlng to law.
sworn.lo or affirmed and subscribed r~ { ( .. /Ie '. . f 1/' (v ~
before me this _.../" ," day of ~
_ (/9Il"'h \'( 19~ ,- a
/lja,u,,( '. i-;tNV-t., 10cQJ mCUTiat'1 a
~iflRY C LEWI S Register' { ( ~
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I~ST WILL AND TESTAMENT OF FRANK L. WILLIAMS
However, my personal representative need not acce~erate and pay
those unmatured obligations which, in his, her or its opinion, it
might be proper and more advantageous to retain or renew and pay
as they become due and payable. I authorize my personal
representati.ve, in his, her or its sole discretion, to utilize my
burial plot and to engrave the marker in place appropriatelY, and
to expend sums from my estate for this purpose.
3
I give, devise and bequeath the rest, residue and
remainder of my estate, together with all insurance proceeds
thereon of whatever nature and wheresoever situate, as follows:
A. One-Half (1/2) of my remaining estate to my son,
WALTER FORD WILLIAMS. Should my son predecease me or die on or.
before the sixtieth (60th) day following my death, then I give,
devise and bequeath his share in my estate together with all
insurance proceeds thereon of whatsoever nature and wheresoever
situate in equal shares to his children who survive me by sixty
(60) days per stirpes.
B. One-Half (1/2) of my remaining estate to my
daughter, LINDA WILLIAMS HERSPERGER. Should my daughter
predecease me or die on or before the sixtieth (60th) day
following my death, then I give, devise and bequeath her share in
2
LAST WILL AND TESTAMENT OF FRANK L. WILLIAMS
(e) ';I'o invest any funds of my estate in any stooks,
bonds, notes or other securities or property; real
or personal, without regard to the principle of
diversification or any other statute or general
rule of law in his, her or its absolute
discretion, it being my intention to give my
personal representative the broadest investment
powers possible, providing such investments do not
unnecessarily prevent the prompt settlement of my
estate.
(f) To sell or otherwise dispose of any property, real
or personal, tangible or intangible, at any time
forming a part of my estate in any manner and on
such terms and conditions as my personal
representative shall see fit in his, her its
absolute discretion.
<'9') To borrow money for the payment of taxes or for
any other proper pu~'poses in the administration
of my estate, and to mortgage or pled~e estate
assets as security.
(h) To compromise claims without court approval
including, but not limited to, any controversies
with the United States of America or the
,Commonwealth of Pennsylvania concerning estate and
4
ClUU10llWI Al lit !II PI NH~VI vAN I A
Ul PARIHnH 01 HfVi NUl
IHlfU.A1l UI IHnlVllJlJAI TA)lU,
III PI. ,,,UI,OI
liAMH I S~UHO I IlA 111 ?f1- OM I
*
II) 111'L/. I \ ({
INFORMATION NOTICE FILE. NO. 21 .(! 1. /11 I
AND
TAXPAYER RESPONSE ACN 9'/112847
DATE 03-20-97
__--1..
UI"'lhl rr." U "1
EST. OF FRANK L WILLIAMS
5.S. NO, 429-82-8243
DATE OF DEATH 02-16-97
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o S~VIHGS
!Xl CHECKIHG
o TRUST
[] CERTIF,
LINDA W HER5PERGER
1012 DRAYER CT
CARLISLE PA 17013
REHIT PAYHEHT ~HD fORHS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
FINANCIAL TRUST CO has pnll.lld.d the DIPlrtll.nt with the InforllltJon llltld b.low which hall b..n una In calcul.tlnl1 the
potenU.1 tlx du.. Their r,ool'd. Indlnat. that at the daath of th. 'JIbOIolI dle.dent, YOU wer" a joint own.r/benllfiolarv of thh Meount.
If you f..1 this Infor..tion 11 Incorrlot, ph".. obtain wrltten correotlon frOIl the flnbnol"l In.tltutlon, IlIttach tI COPlI to thh fpr.
Md rlturn it to the abolol' .ddl'.... lhlt account 11 taxabh In accord,,"cQ with thll Inhu1tnncll Ta)( lnw. of thl COllllllonwulth of Penn....lvanln.
wuuiioflll .It... oe ~n,w"I"u LI) lWolJlinfl ,IiI/ 'ol~Ii.)t:1.
Account a.l.nce
P.rC'lent Taxabl.
AMount Subject to
T.l( R.t.
Potential Ta~ Du.
. . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
D.t. 05-26-92
E.toblhh.d
177,781.56
50,000
88,890,78
,06
5,333.45
TAXPAYER RESPONSE
F"IL~RI. ,.OIlCSPOND WILLRESUL tIN AN OFPICXAL' TAX ASSESSMENT BASED ON THIS NOnCE J
A, 0 Thll llboV8 InforMation and hi)( due 11 torr.ct.
1. You .a... ehoo.. to rlllllt pay.ont to tho R.ghter of hills with two cOllin of this nothlll to obtnin
II dl.count or avoid Inhr.stl or you 1l8Y ehllok hox "An and rflturn thl. notlc" to thll R.;htllr of
Willi and Itn offJcial &suss..nt ...111 be iUlled by the PA Ollpart..nt of Relolenu..
8, .vYh8 abovll t<nat has b.on (lr will bt ruport.d lJno hit paid with the P.nn....l...ardfl Inh.rltnnc8 Ta)( raturn
~ ttl b. fil.d b... the d.e.dllnt', repr...nhtlv..
C. 0 Thll above lnforMlltlon ilL1.neorrect find/or debts and d.duction. w.r. paid by YOU.
'iou "J.t co.plllt. PART ~ and/or PART [i] bellow,
To In.uro proper credit to your account, twu
(2) copies of thl. not Ie. MUlt lIeco~pnn'" ...our
pny",ent to the Royutor of 104111.. Hake ch.ck
pa...able tOI "Roolster of WIll., Agent",
COMPLETE PART 1 BELOW
Account Ho, 1142798
K
NOTE: If tll)( pll...~.nt. erA Made within thr..
(~J Month. of the ellle.dont'. dllte of dellth,
you ~~~ d.duct a 5% dl.count of the t8)( dUe,
A~y inh.ritance tnx due wIll beco.. dallnqu8nt
nln0 (91 lIIonth. IIftor the tlat. Clf duth.
Tox
K
PART
OJI
[CHECK ]
ONE
BLOCK
. ONLY
P~RT
~
Tft,X
lIHE
If you indic.te . differ.nt t.~ rat., pl.... .t.t.. your
ral.tion.hip to decedentl
~!:TLI~l! - C"~PUT.".T!'.)~
1. D.te E$teblhhed
2. Account aelance
3. P.roont r.x.bl.
4, A.aunt Subject to T.x
S. Debt. and Deduction.
6. AMount T8l(ebl.
7. T.x R.t.
8, r.x Du.
OFFICIAL' USE OIILY Cl AAF
. . f'ADEPARTMENT OF REVENUE
TAX ON JO!~'!' /TRUST A!:COWN'!'~
P~RT
[!J
DATE
DEBTS AND DEDUCTIONS
rAD __
1_
. .2
3
'-4"",~
5
6
.rl"
8i\
CLAIMED
-
OF
1
2
3 K
4_
5
6
7...l1-
8
-
-~
-
-
PAID
",
PAYEE
DESCR 1 PTI ON
AMOUNT
~
.
PAID
~l
TOTAL (Enter on Lln. S of T.x Conput.tlon)
~-
Under p.n.Itie. of
~ao PleteCJ1'.to th~ b..'~ ~f
(/ ~~ . </1/
.{ , (;/(~r<<-"'I')."
X R SIGNATURE
perjury, I decl.re th.t the
IlY knowledge .nd baliaf.
.. " -I
<' ~,(" r ,. , '-
facts I haye reported .bolole .~. true, correct and
HOME (~LO) r3..s..--J$.5/~
WORK ( )
TELEPHONE NUMBER ---
GENERAL INFORMATION
1. fAIlURE TO RESfOND WIt.L RESULT IN AN OHICIAI, TAX ASSESSHl:NT with nr'pllr.l!lhlfl 1/1tDt'llwt tlAlud on Jr\fnrlll8tlol1
lubflllU.d hv tllIl flmuw!ltl 1I1Iltltll~lon.
ji, Inhel-I'i:"l'lctl hilt I1~Hl(UIi.1 dellnqullnt ntr\*i !!Iollthl l1'hu- thl/! th,l)flthUlI'. dftt. of donth,
S. A Joint IIOr-ou"t 111 tlll)l,..I1I., /lyen though the (1It111"""\" fllllllll Willi ruhh.d ftl II IIIftt,,,,. uf cOfwenl.nca,
4. Accounh (Inoluding tho.e held t.:.eh..e" hUlhlmd lInel loll'.) which thll dee.tl."t flllt In joint 1U'1II111 within on.. YUftt' prior to
d.ltth ftl" fully huudlle "I tr."I'erl,
S, ACl(lounh ..'''hi I.had jointly h.t",.." hUllhllnd nnd wl'ft mort \1111" one ye"r prior to denUl nre not ,nKftbl..
6. Aoaounh "_ld by II dee.el.nt "In tnull fnr" Motllor or othllrl fIIn. ttuu,hl4l ftllly,
REPORTING INSTRUCTIONS
PART
I
- TAXPAYER RESPONSE
1. BLOCK A . If the IllforlllatJon and cOI'PutaUon In tho Mtlcll are cl'lrrllct snd dtHlulltlonll nre 110t b.II\g clohla(l, piee. en "k"
In block "A" of P~rt 1 Of thll "hx'Pl'ly.r Rtlllponlln" 91ctJon, Sill!" two caple. I'Ind IUbllllt th.", with your ChIck for the allluunt of
tal( to tho R8111.t.r of Willi tlf the cOlJnty Indlclllhd. The PA Oepl!Irhent of RevQf\ue will !tII,JO an I'Iffloll11l a",ulIl.nt
{!'orll REV l!.~8 DO upon recllpt of the r.turn froll the R_ohter of Willi,
Z, aLOCK B - If the uut IpeclfllBd on thl. notice hllll beln or will bt r.pothlld find tlil( f,lIlJd with the Pennlyl1ol6nill Inh.r1hnclJ
TaK R.turn flhd by the d.cedent', roprullnbtlve, place an ")C" In block "Bo, of Plirt 1 of thll "hxpRvor Rupon.." ..otlon. Silln one
COPy and rllturn to the PA OllpllrtM,mt of Rfwenue, Burllau of Indllolldulll 18x88, Dept l80601, Hllrrhburg, PA 17128~0601 In the
.nvllope provldlld.
3, !HOCK C - If thll notloo Inforf'latlon h ir.corrllot and lor docJuctions flrll blllng chlmod, check bloct.: "c" and cOlllplah Partl 1. and!
~'J",:,r..n...~ t... tk" I...,,trl....tl,,,,.. hftl l"W , !lInn hin cnlllel Ilnd flllhllllt Ihfllll with \,I'-'lIr chook far th4 alllClUrlt of lll)/ Pllv"bla to the R:lluhtar
of Willi of- the county Indlceted. The PA [J8part.",nt of Ravlnue wUI luue an offlolal IlUUlllllnt (ForM REV~154& EX) upon rcu::elpt
of thl retllrn froll the R8vht.r of Wills,
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. E"t.r
NOTE:
thl date the account nrllllnlll1Y Willi ..tllblhhod or tlt1ud In the IIIBnn..r Iltlstlng l'lt nf'lle of dllhth,
for II dlltcIJdclIlt d'ilng Ilft9r lUll/A?: Accounts lolhlch tha dliloedent put in joint ne.... ~11thln on. (\I yur of death Ilr.
taMabl. fully u transferll. Howllvllr, there I, an Il/(clusion not to a)(cluld '3,1)00 pllr tranl;(..rll. rugllrrUe.. of the IoIftlul of
the lIocount 01' thll nUlIlblll' of Rccounts hold,
If II double utftr1sk (lut) appllltrs blltfore your first nf'lllle In the f'lddr"lIl [1ortlon I)f this notice, thu 13,000 .Xchllllon
lllready hu be.n deduchd troll thllt aocount balance .u report.d by the flnlln~11l1 institution.
~, Enter the totf:ll balance of the l'lccount IncludlnQ Intorut f'lccrlled to tha date of cleath.
3, Th. percent of the account. thllt 11 hltllbla for .MIl liurvivor h deterMined 8S follow.:
A, TtwI parcent teu(l!lIbla for joint f'lNSllh IIlt&blhhed ."1'. thf'ln ona year prior to the decud.nt'$ dtlathl
DIVII)f.D BV TOTAL NUHBER OF
JOINT OI4NERS
EXIIIl111.: "joint tluet r"gishred
OI\lIOEO BY lOUl NUMBER OF X 100 . PERCENT TAXABLE
SURVIVIHG JOINT OWNERS
In the oe.. ('If thl dQcudllnt rind two other persons.
1 DIVIDEO BV 3 (JOINT OWNERS) DIVIDED BV ? (SURVI'JORS) .. .167 X 100 . 16,,7% (TAXABLE FOR EACH SURVIVOR)
B. Tho percent tQ/(f'lble for assets crGl'lt.d within one ~a8r af tho dacedent.s llellth or QccClunta ownod by the docedent but held
In trust for another l1'divldue1(tll (trust bcmeflc:lar1u):
1 mVIDf.D BV TOTAL NUHBER OF SURVIVING JOINT
OWNERS OR TRUST BENEfICIARIES
X lbO
PERCENT TAXABLE
EM8.phll Joint 81'lcaunt reghtllrell In th" nus of thll decedllnt and two othor pllfsons and utahl hh.d within one :ieer of de"th bY
tho deceden t.
1 DI\lIDf:[J BV 2 (SURVJ.VORS) .. ,50 X 100 50% (TAKABLE FOR EAeft SURVI!JOR)
li. Tho e"ount Subjeot to \!Ill (l1no 4) h deterMined by lIultlplylng thl ftccaur,t balance (1Iml i!) by the percent tllXable (I1n. 3),
S. Enter the tohl of the dehts Rod d.ductluns Ihhld In Pnrt 5,
6. The lIIaount hll<ftbla (!Jne 6) Is datol'lJinld by subtracting the debts rind deduotlons (line S) frOM the IIlIIount subjeot to talC ~un. 'tJ.
7. Enter tha f'lpproprJfth tax rate (lIne 7l au dRterMlnad billow.
A. For dehs of death occurrJng after 6/!O/94, thu he/( rl'ltu for tranllfors to spous.. ar'e as followlIl
1. uate' of danth on or after 7/1/94 aod bRfore 1/1/95 the ratA 11 3%,
2. Datu of dOllth on or .,Her 111/96 tramfR'" to IIlOUUS will be tf'll<ad at 0% hilt ratl.
Notal For Pf'ltu of def,th prior to 7/1/94 transfars to SPOUSeR fire tllltable nt 6%.
e, Transfers to lineal dUCllllndants includIng fether, lIath"r, setn, r:Illugh18r. grnndr,hlldrtn, lion-in-law,
d.ughhr-ln~1aw. .t.pchlld and thllllr luuII are tfl/(Ilbla at 1111( f1lrclnt (6%),
C. Tran.fer. to &11 othllrll InclL1dlng brothar, .ls18r. uoch, Runt, nnphew and nlecu arCl t!l/(Ilbl" at f1fteen percent OS:O.
D. If YOU ch&ngo tha tb/( rate, pie".e spllcify your rulatlonshlp to the dU<"8dent In thft flrfla provldCld.
.
l
8. The alllount of tftX due (Una ftl h dete"III1nod by III\Jltlplylr.g the a"ount toxl!Iblll CI\n.. 6) by thQ till< I'atl (Une 7),
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
AIlowelll. d.bt_ l:lnd d.ductlons ere dAter.lned liS follows:
A. Vou l'li!llllY ert! rOllPomdbl. for pnyunt, or the .lItl1te .ubjact to edninhtretlon h~ II per'~or.al r.prullII1tatlve Is Inlufflclflnt
to plll'i tho d.ductlbll\ lhll..
B. Vou Itctulllly pldd tho dlbtll after death of th. d.c.dant end can furnish pl'oof of pBvunt,
C. Oahh baIng cll!Il..d MU,t b. l18lllo'.d fully In Pftrt 5. :f Ildditlonal Spf'l<lfl I, n.edod, UII'IiI ph In pa~ler (I 112" It 11", Proof of
paYIl.nt .IlY b. raquII.tad by th_ PA Oepart.llnt of Revenu.,
C'"'" " -- -:J
. .. TAXPAYER ASSISTANCE
,. ..IF YOU NEE D FURTHUR INFORMATION OR ASS ISTANC E, CO NTAC T ANY.
. . .. . REGISTER OF WllLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER ~NQUIRY UNIT HI .
HARIUSlIllRG AT (,n7) 787-8327, TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
...............~.- ..,' .. , -- .
,
Ailv- IMlOl'!X" (Hili
.
COMMONWrA\111 m N:NN~YI VANIA
[)fI'AAll,lH41 or !trVIHI.!!
Ot'l'T.llOl"-ll
II"HAlsttIJRQ,I'A. ,"7110t.ul
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
\'11 WI/,I 1;'01 ;lrJ",
](~/
~~-
'~
Or,CHlI:NT'B NAMr: (I A9T, IIIUlT, AND Ml()(ll" INlTlM I Utllll hll!1k hlocl< 10 M'pnlaln wn'rl8
l!.'
"g!2
~co~
~
fil~
~~
!
WIJ.LlAMS, Fronk I..
'SOCIA' 8ECUltrl I( NUMBER
421).82.8243
0.0\11, or Db\Hl
02/1 Cl/I1)1)7
(IF ""PltC-AIII,!') SURVIVINO m'Ol/flr's NAM[ t IMll, "iH91 AND MIOflll-INIIIA!.)
".
11111'11
1lUIql~
[JAf[OIlmHII
08/17/1904
S()ClA' SI:Cllf~t'Y NlJMIII:n
Ihllfllhlmlf1U51h(l!olodltl rlupllculn w,lh II,,,
40 ,"ulvro Inlor6at Compromise ('or dDIII' olchllllh
lIt1cr12,12.82)
7, D(\cedonl MBlnlalnnd fl LIving Trust (AlIllcl\
copy 01 Trull)
10 Spouial Poverty Credit (d/ltll or death llolwo0/1
11'.3\,91 Ind '.1,9~)
-,,-llllllJliWllIlIll_P.!.
NA ' I.r:TE MAIL! A) RESS
Michael J, Hanft, Esquire
IFIRM NAME: (II ",pplicable)
MARTSON, DEARDORFF, WILLIAMS & 01"1'0
1, Heal Estate (Sohedule A)
2, Stocks and Bonds (Schedule B)
3, Closely Held Corporation, Pa~nershlp or Sole.Proprletorshlp
4, Mo~gag.s & Notes Receivable (Schedule 0)
5, Caeh, Bank Deposits & Mlscellanaous Personal Pmperty
(SchAdule E)
6, Jointly Owned Prope~y (Schedule FI
7, Inter.Vlvos Transfers & Miscellaneous Non.Probate Property
(Schedule G or LI
8, Tota' Gross Asaets (total Lines 1.7)
9. Funeral Expenses & Administrative Costs (Schedule HI
10, Oebls of Decedent, Mo~gage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Vetue 01 Eetete (Llna 8 1111nus Line 11)
13. Charllabla and Govemmental Bequesls/Sec 9113 Trusts for which an election to tax has not
been made (Schedule J)
14. Nat Velue Sub)act to Te. (Line 12 minus Line 13)
O/ltl1nlll f~at(lrn
4 Umlted Estate
6 Docodenl Dlod T ostate (AH.ch cnflV
01 Will)
9 UUgllllon Procoods Hocol\'od
,
'TElEPHONE NUMBER
(717) 243.3341
i!i
1=
:5
E
~
w
co
:.1. SllPlllomnnlnl Rolurn
15, Amount of line 14 taxable at the spousal t.x rate
See Instructions on reverse side for percentage
16, Amount of line 14 taxeble at 6% rate
z
~
t;
~
'-'
S
17, Amount of line 14 taxable at15% rale
18, Tax Due
REGISTER OF WILLS
:I Remalndor RelulII ('(If !lain" Df Ofllllll I!fI(lllu l,'.!IIl,'1
5 Podorpl (sloltl Tllx Roturn ~oqlurfld
o 8 Total Number of Safe DOI)(Jllil Bmms
11. Elocholllo Itlx undor Soe 011 3(A) {Anlletl Sell ())
Ten EMt High Streel
Carlisle, PA 170]]
(1)~.. . .. .....d.rJ OIFICIAIl!SEnNlY
(2) r-.;""'rs"i',O~8"'7'i[ '~~ ~ ffi'~
'H~.m.~...,_H',,,,,:~,~," ....."'~"' ~-,;~J. . :Q 0
(3),~ . , . 46,545.5~~ $ in:1
t~J..",.:I!il,._,__"". ._;o_,,i ,.1, L._, ~ ,IJ
(4)1 .:' _ . '1.
L~,;U.---___,~L~:-.J",.~;.--;,,:' IhlWtV: t...J '. J
(5)~ 167,884.8$1 ',,~
, . . i..oIIl -0 :c~: 1/
k-~;;. _ ; ._-:_J.U_- ::- ~ It,._;,4 " __;H_;: , :._:: {ll
(6H 109,319,40 ,~ Vi
(7) i-' 11'9,000 ,(j;J.l ~ ~ a
(8); 1,323,848.48
t-"~-~"-"-';"'~"':'''''''-M''; _,i51".L~1 \ ,;",=-~'",~
(9)( 47,361,28
(10)
270,504,22
~::''''::,:';~::~',:~:''J x [.'00 :\
" I,005,982,98j x .06
i',~c:.~_~,..:--d,:~ .;~;,,::-- .,..';
,
(11 t-"""""31'7':'g'6 5 . 5 0
t'"ICL!.l ..,cL~iI ;UL.,!;!"
(12)" .... 1,005,1)82,1)8
~,tJ.k.~.,,~) .~.__.
(13)!
~, ~ '" . ~ "
(141~ 1,005,982 98
~_":-,,,f; .........----
(15)1(
i~~-"--~""
(16)1 60)58.98
'.f
x
,15
(17)
(18)
60)58,98
.".~.....--~.._..-" "...~.."-
19. 0 Check here If you are requesting a relund of your overpayment.
,,;,-:.!tM;,;,~,r:;'~h~lt~'f,'l~:.:~~Hiij~;~~i~~.;,L:\:.y,..8II.Mlt6l\V4 _, ..___ ".. __' .,_ .",. .___. .'-J!',:]'.-~;~e
Under penllllie.o; or perjury, I declare lhall have examined lhls return, including llccompanylng schedulos and slalements, and 10 lhe besl of my knOWledge and belief, Ills true,
~18ra ()fl prllpaf~~\pers,)nalreproSel'ltal'v~ .~tJa511d OIlslllnfOlmatlon olwhlctl preparef has any knowledge
t.l/ Y1 ~..I"~/-. 1050 Plum Point Road, Huntingtown, MD 20639
SI N TU~RSON RESPON;('{(FOR FILING RElURN ADDRESS
SlONATUJ1or P~RS si'JFo/~RN
SIGN~~m~ OF PREPARF.r{ OTHE~~~ (EP~ESEN"ATlVE
andcomplele
sill /q ~
DATE
ADDRESS
Ten East High Sh'ee!, Carlisle, PA 17013
ADDRESS
DATE
!:J- t/,{ ) <j 8
\
Deeudent'a Complete Addr.,..:
[" ^mmr~
One I nn~sdOl f Wuy
('II Y CUI lisle
Tex Payments and Credlta:
1. Tax Du. (P.g. 1 L1na 18)
2. Cr.dIIoIP.ym.n18
A Spou..1 Poverty Cr.dll
B. Prior raym.nta
C. Discount
STA'II' I'A
53,060,00
1,740,00
Total Cr.dlts (A + B + C)
3, Int.r.sVP.nalty If appllcabl.
D. Intaresl
E, Penalty
247,15
Totallnt.resUrenelly (0 + E)
4. If line 21s gr.eter than line 1 + IIn. 3. .nler the difference, Thlsla Ihe OVERPAVMENT,
Ch.ck box on P.g. 1 Lln. 19 to r.qu..t a r.fund
5. If line 1 + line 31s gr.eter than 11M 2, enter tho dlff.rence, This Is the TAX DUE,
A, Enter the Interest on the tax du.,
B, Enl.r th. lotal of 1.lne 5 + 5A, This Is the BALANCE DUE,
Make C/leck PayalJle to: REGISTER (IF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS
BV PLACING AN "X" IN TIlE APPROPRIATE BLOCKS
1, Old decedent make a transfer and:
a, retaIn the use or Income of the property transferred;....""",."".."". .."..",,,,..,,,,,,,,,,,,,,...,,..
b. relaln Ihe rlghl to deslgnal. who shall us. the property transferred or lis Incol11e,,,,,,,,,,,.,,
c, retain a reversionary Interest; or"""".,,,,.,,,,,.,,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,., ",'.'"""""",
d. r.celve Ihe promise for life oJ ellher pay men Is. b.nonts or r.are?" "."""."""""
2. If death occurred on or bafore December 12. 1982. did decedenl wllhln two yea.. preceding death Irans'.r
property wllhoul receiving adequale consideration? If death occurred after December 12. 1982. did
decodent transfer property within one year of death without receivIng adequate consideration?...."".
3, Did decedent own an 'In trust for' or payable upon deAth bank account or security at his or her death?..
liP
'''''' J
(11
60,J5H.9H
(2)
54,800.00
(3)
(4)
(5)
(5A)
(5B)
247.15
5,806,"
5,806,IJ
Ve.
No
4, Old decedent own an Individual rellrement account, annuity, or other non-probate property?"
IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS VES,
VOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
, - . .' " "\ ,J,'lJi;
72 P,S, ~91 16 (a) (1.1) (I) provided for Ihe reduction of Ihe tax ralelmposed on the net value of lransfers 10 or for the use of the surviving spouse frol11
6% to 3% for dates on or after Jul)' 1, 1994 and before January 1, 1995,
72 P,S. ~9116(a) (1,1) (ill provided for the reduction of the rate Imposed on the net value of transfers to or for the use of the surviving spouse from 30;;)
to 0% for dates on or after January 1, 1995, The statute c1oe..s.,nwMIllill a transfer to a survIving spouse from tax, and the statutory rAqulrbment$ for
disclosure of assets Gnd filing a tax return are stili applicable even If the surviving spouSElls the only beneficiary,
FOR DATES OF DEATH ON OR Af'TER JANUAR'I1 ,1995. Please acswar the following question by placing an "x"ln the appropriate space,
Old the d.cedenl create e trusl or .Imller arrangement which Is aolely 'or the eu....lvlng .pou..'. b.n.,lt lor his or hor entire
IIlellme? Ve. . No
If you answered yes to the above question, the te\( on the trust or similar arrangement Is postponed unUlthe death of the second spouse, at which
lime It will be fully taxable allhe rale(s) applicable to the remalndar beneflclary(le.), Enter the value of the Irust on Schedule j. Pari II. In order to
rofMve It from the cnlculalion of the tax due In thIs estate, You may wish to file Schedule 0 In order to make the eloclton available under soctlon
9113, If the election is made. the trust or sImilar arrangement Is taxed in the estate of tho first decedent spouse, the portion of the trust 01' similar
arrangement which beneflls the surviving spouse Is taxed at the zero tax rote, and the remlllnder Is taxed at the rate(s) applicable to the remainder
beneficlary(les), If you chose to make the elecllon, you must attach schedule 0 to a timely-flied tax return, alcmg with schedule(s) K anel/or M In ardor
to show tho apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneflclary(les),
UVUO'Ut 1)"1
~~
SCHEDULE C.l
CLOSELY HELD CORPORATE STOCK
INFORMATION REPORT
C:OMMONWf"lTH Of 'tNN$VlVAN1"
INt1ERI'ANCf TAil: RUURN
RUmEN' DfCfOfNl
ESTATE OP =--===:;..-.::::=~;:;;.- -------.--,----
WILLIAMS, Frank L.
~1'QlI T yp' or Print
fILE NUMBER
21-97-191
Tt1(' foll()Wln~ IflfOlmotion Illu'r,l be ~ub;llltlcd with' this schodulc' . ,
A. Oetoilctd d..crlplion .howing thl method of computation utilized In the voluation of the dltCeGol'lt'. .tock,
8. Con\pllte copll. of finandal.tot.mont. or complete copie, of th. Fl!d.r<,1 Tall: Returns (Federal Form 11201 for the year of death ond .4
preceding yean,
C. Stat.menl of dl...;d.nd. paid eoch year, U,'tho... dllclarad ond unpaid,
0, list nom.. of oHicln, solari.., bOI'IUUIS and any other henefits rec.e'loIed from Corporation,
e, If thl Compony owned ,.al..tate, submit 0 list showing the complete addreu/e, and estimated Fair Market Value/s, If R.al btote Appraisals
ho.... b..n secured, pleose alla<:h coplcs,
f, list principal slockholders at date of deoth, numb.r of shores h.ld, and relalionshlp to dececlonl.
Q, Any other information r.latl.... to thl ...alualion of Ih. doced.nl's Inl.reu,
I. Nomo of Corpo,ollon __Solomons Veter inaIC.L,_<:;linic---'.;!.nes,olo of In<. _~aryland
Stro.. Add,... l.l!L72
Cily Solomons
Solomorn
SIOIO~
Is 1 aruL Road
Zip Code 206 8 ~,_,
Dot. of Inc,___
Total Number of Sho,.holdoll
5
2. Foderol!. 0, Number .5.2:-18337 9l
(Somo A. Foderol Form 11201
3. Typo of Bu.ino.. Veterinary practice
4,
Buslne.. Reporting Yeor-1Ll_ to
1U.1.L___
Product Animal heal thcare
------
STOCK
TYPE
TOTAL' SHARES
OUTSTANDING
PAR VALUE
. SHAR5S OWNED
BY DECEDENT
20
Common
77
Prtlf.rr.d
Provide all rights and r...rlctlon. pertaining to .och cia.. of .tock.
5. Wo, decodont omployod by Iho Corporation' 0 V.. [3a No
If Y", POlltlon Annual Salary S _________ Time D.voted to businell
6, Wo. tho Corporation Indoblod 10 tho decodon" 0 V.. I[) No
If Y'll proYid. amount of Indebted".." S
7. WOI there 11ft inluran,. payabl. to the corporalion upon death of dlCedentt 0 Ves [X1 No
II y.., Co.h Surronder Voluo: S Not Proceed. Payable: S
Owner of Policy
B, Did tho docodonl..lI or tronller lIock olthl, compony within one year prior to deoth If the dolO 01 death wac on or o"er 12/13/B2 or within
two YOOII il tho dolt of doath woo prior 10 12113/B2' 0 Ve. [i(] No
If yes: 0 Transfer 0501. I of Shore'_._____.. Transfer.. or Purchoser
Consideraflon S ___~_ Oat.
Attach a s.parat. she.t for additional tronders and/or sales,
9, Old the corporation hay. Dn Ifll"est in olher corporations or partnership,' 0 Ves [XI No
If Y"; report Ihe necessary information on a sepnrate she'l, including Schedule "C. J" or IIC.2" for each Inl.res"
10. Was there a wrlllen shareholder', agreement In effect at the lime of the decedenl's deatht [iYel
If Y", provide a copy of tho agreement. attached
11, Woe the d"odont'. IIock .oldl 0 Ve. Lll No
If yes, pra...ldo a copy of the ogreemenl of lole, etc,
12, Was the corporation diuolvfld or liquidal.d after Ihlt decedent's d.ath' rJ Ves fKJ No
If yes, pro...id. a breakdown of liquidation distributions, elc, Allach a separate .heet,
[J No
,~_..
Form 11205
o.P'""ttnl 01 fW' T,..wry
lnt.mtl Rw.,.,.,. StMl:;.
U.S, Income Tax Return for an S Corporation
~ Do not file thl, form unless the corpor.tlon hIS timely filed
Form 255310 .llct to be.n S co",orotlon.
"S"I'plr~I.lnclructlons.
, 1996. en~
OMS No. I~S.(lUO
1996
Far calendar
~OlEladiorl..
anS Cotpotation
oar 1996, or tal( year beQinning .
Nil".
.19
C [mplovtl 14."1111(11" NumM'
U..
IRS
I.bel.
Olher.
S Bw""'Cod.... (... wl.e PO BOX 887
SpecIfic In\VUC~Of") ple"1
",rint or City Of Town Stat. ZIP Cod. E TOll'A"..m ('" Specific IMWeIton")
8980 tYPI. SOLOMONS MO 20688 S lli..J.23.....__,_
F C.eck eppliceble bo~;(;;o Il1IIiel return (2) 0 Final relum (3) 0 Change In eddl..s (4) ,'\mended return
G o..ck tillS bo, d I." S ,orporel""," sU.lecliollle coo,otid.ied IUdII procedure, 01 ,,,,lions 62.1 tilrouQll6Z4\ (,.. Inst,uctions bel"e checklnO Ihll bo,) .
H Enler runber of shsrehalders in the corporation !,!, cnd of the tal( year.
_Clutlon.:. IncAJdc only trade or busIness Income ~nd ex. nses on lines ,~ /h'ih 2'. See fhe ins/rue/ions for more lfl(ormaliOn,
, II Gloss ,,,elpllO,,,l.. .. L 4 I 4 . 424 '. b les"elurnllnd .1I000n", . I 73. C B4'" 1 C
N 2 Cost of goodssold (Schedule A, line B) ..... ......... . . . .... . ,. ,.. .. . 2
C 'Gross. prallt, Subtract line 2 from hne Ic 3
o
M 4 Net galn (loss) Irom Form 4797. Pa,llI, line 20 (ollach Form 4797) . 4
E \ Oll1er InCome (loss) (allacll SChedule) See Othe' Income (loss) 5
G Totlllncome loss, CombIne hnes 3 throu 5, .. 6
; CompensatIon of oNlcers . 7
8 Salaries ar,d wages (less employment credits) , 8
9 Repalffi and maintenance 9
10 Sad debts . . .,. .:.;) . 10
.
11 Rents. ..".,..,. 11
12 Taxes and licenses " "',',', .', 'II"" " 12
a Inlere,l.. . . " . . " . 13
14. Oepre"aUon (irrequlred. .lIsch Form 4562) 14. 9 392.
b DepreciaUon claimed on Schedule A and elsewhere on retv." 14b
c Subtract line 14b from line 1421
15 DepletIOn (Do not deduct 011 .nd 91$ dlpletlon.)
16 AdvertlSln9. . . . . . . . . .
17 Pension, proflt'sharlng, etc, plans
18 Employee benefit programs
19 O1her deductions (allach schedule) . See Other Deductions.
20 TOI.I deductions, Add the amounts shown In lI1e la, right column 101 lines 7 Ihrough 19
21 Ordlnwy Income (loss) from trade or bUSIness BellVllles. Subtracl hne 20 from line 6
T 22 Tax: .uces, nel passwe ,"come IlU (.11 schedule) , .', ,. [2.2;f
~ b Tax Irom Schedule D (Form 112(5) rzi."bT
(: Ad\! linn Z2a and Z2b (let Inslrucllons lor addlllonallll.res) -
~ 23 P.ymenll: .1996"lim.Ie<lI"paymenlsand'lnounl,ppliedlioml995reluln. ....1=30
D b Tax depoSlled With Form 7004 . .. 23b _
P c Credll lor lederall.. pard on luel, (allach Form 4/.36) . . 23c
A d Add lines 23a through 230 . . . .. , . . . . . . . . . . . . . , ,
~ 24 Eslimaled lax pen~lly, ChecK If FOIm 2220 is allached . .. . . . ... . ... .... ,. , . , . , . ., ., . . ~
.. .
E 25 T" due. II tile lolelollines 22c & 24 islllQOf lhan line 2,1<1. enier amounl owed. See ,"SIll lor depolll.., melllod 01 payment, . ,
N
T 26 Ov.",'yment. IIlina 23d IS larger lI1an the /01.1 of lines 22c end 24, enier amount ovarpBld
5 V Enter lI1lOunlol line 26 u wont Credlt.d to 1m 1S11m.t,d I" ." Refunded
06/15/93
~OlOMONS VE.TERINARY CllNIC,.....!.~_
Numbof', SltM".nd Room cw 5\111, No ~I I PO_ 1>>_, ~ ll'lllNctJon.)
S2 -1833797
o O.t.IMotportl~
06/1 5/93
~
.. 5
411 251.
III 654,
302,597.
5 281.
307 878.
62 764.
80~
884.
o
E
o
U
C
T
I
o
N
5
IS. 644.
12 127.
I 473.
14c
15
16
17
1B
19
~ 20
21
9.39L
3,468.
42,574,
229 207.
78.671.
22c
23d
24
.. 25
~ 26
~ V
Pl....
Sign
Here
Unrl~ p'.nll~.. 01 p.~.1 dKI..r. O'l'll havt ....minad fUt, ,.tum, includinQ momplnyo"9 Wltdulu and 'WI.m.nta. line! k>> .... bet.1 "I my kn~d9' .nd
belial, II i\ 1nJt, ton'KI. .nd compt.I" D,d.,.tlon of pr,plltr (olhtt tlan I&~P'Y") 15 bI~ on In intOfmation 01 whICh pf.p.f.r has .ny know~,
PrtPN.'"
SlQnlklr.
~
L__ ~_
O.t. Till,
rot'l
Cht!'CkII ull,
_ .rnploYfld ,
Pttp.,,'" Soc'-l Sl'Cunty N\Jmber
~,
S~n'\Jr. 01 OffICe,
P.ld
Preplrer's
Us. Only
EIN ..
214.58.4280
S2 -1 571 5SL_._____.
,,,,,,Nom' Michael A, Guy, i;..P.A.
~r.::.~rod) ~ 23104 Three Notch Road
.nd~'u Cal i fornia
.BAA For Paperwor1< Reduction Act Notice, see Instruc1lons,
MO
liP Cod. ..
20619
To;;;, 11205 (1996)
sPSA0112 IIf]Of96
/
For", 11205 (1996)
--
~
SOLOMONS VETERINARY CLINIC, INC.
Cost 01 Goods Sold (saa ,nstruchon.)
52-1833797
----E~
1 Irwenlory at baglmlng of ya., . . . . . . . .
2 P..ch....
! Cost ollllbol
4 Additional section 263A costs (a/lach schedul.)
5 Othar co.ts ("tfllCh schedule) .. S.a.Schadula A. 0111.. Co.ls
6 Total. Add IInas 1 ttlrough 5
7 Invenlory at and 01 ye., . . . . ,
8 Coot 01 good. oold. Subtract line 7 tram Ilna 6. Entar h.r. and on pooe I, line 2
90 Ch.CK ell ",ell1OOs usad lor VllIuInQ closing Invantory:
(I) ~ Cost a. dawlbed In Regulalionsl.471.)
(I~ Lower of cost or m"'Kat as d<lscrlbad In R.gul.lions ..elion 1.471.4
(Iii) OIl1.r (sp.Clfy mell100 used and atlech axplanatlon) ..
b ChacK If lI1.ra wa. a wrltadown of '.ubnormal' goods as dascrlb;d ~n-R~QUI;t;;'ri. ~a-;'iioii 1.471.2(c) ~. :: ~ ~ .- ~ - -.~. ~. ~.~. ~. ~ ~. ~ .:0 -
c Cheek If 1110 LIFO Inventory mell10d wa. adopled II1IS tox year lor any \10"'" (If checked. a/lach Form 970) ... . .. .... .. ..... 0{]
d :~:~t~~:;;;:;I:J ~~:;~~F"(;~ ~.d .'or II1IS lax year. enter parcenlage (or .amoun~) O.f~'o"ng .
. 00 lI1a rul.' olsacllon 263A (for proparly produced or acqwed lor re..'e) apply 10 th. corporation?
1
2
!
4
5
6
7
8
24 500.
95,240.
16,595.
136 335.
24681.
111 654.
'.~~'
f ~~~e~~~ett:J; ~~~:~de,t~~~I~,jn~, ~,~~t~t,ie$,CO$~,. o~ ,1.I81_u~t~~~, ~~_~.ee~,~~enln~. ~~, ~~:~~~ .i~~,e.~t,~r~,?_,
. . .!l.:!!!Jl No
f~etliIlQJlt1a. Other Inlormation
:,;.
,
, Oieek melhod ef ICtVllnlmg: (.) 0 Ca.h (1)) [[J Accrual (C)P. OIl1.r (sp.c'ly) .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2 ReIer to the list In the k1structlons and stale the corporahon's principal:
(.)S..".....ct.ily ." YnE_Rl~!AR.~ _c..Ll~IJ_ _ _ __. (b)I\'ed"'I."""., ." YJ;I JiEI!.V}~~S_ __ __ _ _ ___
3 Old 111. corpor.llon at !he end 01 111. la' year own. dlreclly or ind"aclly. SO% or more 01 the voting slack 01 a dome.t,c
corporation? (For rules of attribution, see secllon 267(c),) If 'Yes,' anach a schedule Showing: <a) name, address,
and employer Identification number and (b) percentage owned, ' X
4 W6S the corporation II member of 8 controlled group subject to the prOl.llS10flS of section 1561? , X
5 Al any time c:tKing calendar,year 1996, did the corporation have an Intereslln or e signature or other authority over
a financial accot..rlt In a foreign country (such as a bank account, securltles account, or other financial accoU"'lt)?
(See 111. Instrucllons for e,cepllon. .nd filing reqUirements lor Forrn TO F 90.22.1.) .. X
If .V.... enter the name of lI1e lore'gn country" _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ .. _ _ _ _ _ _ _ _. _ _
6 OIxing the tax rear, did the corporation receive e dIstribution from, or was It the granlor of. or transferor to, a
foreign trust? I 'Yes,' see instructions for other forms the corporaUon mllY have ro file ., , , . , , . , , . , , ' , , , , , , , ,
7 Check lI1is box lithe corpor.llon has filed or i. requlr.d 10 file Fonn 8264, Appl,c.tlon lor ReglStr.lion
of. Tax Shellar.............................. ...................................................
8 cr,ed< \hIS bo, lllhe corpor.llon Issued publicly olfera~ deblln.trumanl. with orlgln.,lssue dlScounl
If '0. \he corporalion may hava to f"e Form 8281. Inlorm.llon Rei\Xn lor Publicly Olfered Orlglnall..ue
Discount Instructions,
9 If the corpOlalion: (.) filed it. el.ctlon to be an S corpor.llon eher 1986. (b) wa. a C corporation belore it alecled to
be an S corporelion or \he corporallon acquired an a..el wllh . baSIS datermined by ..'erenea to Its b.sls (or th.
basi. of any other properly) In the hand. 01 a C corporatlpn...nd (c) has net urv.alizad built.ln gain Cdeflnad ,n
.ection 1374(d)(I)) In exc... olll1a net racognlzed buill.in gain tram pllor yeilr.. enter tha net u'....lIz.d builHn
geln re<luced by net recognized bUIIt.in g.ln 'rom prior years (see instructions) . . . .. ........... .. S _ _ _ _ _ _ _ _ _
10 Check lI1i. 00' If lI1e corporation h.d subchaptar C earnings and prollt!; el,tha clo.e 01111. tax year (.e. Instruction.
Designation ollax Malters Person (se. Instructions)
Entar balow \he sh"eholder deSignated .. lI1a tax matlers person (T~ lor lI1a I.x year of II1ls rei\Xn:
NllIl10 01 Id.ntllying ~
Oe,'gnated TM" ~ Numbar of TM!"
Address 01 ,..
Oeslgn.leOl TMP
SPS.A.0112 11130f96
I
I
J'lT\ 1120$ 1996 50l0MON5 VETERINARY CLINIC, INC. 52. 183.3797 P'Ot J
Shau11hoiCiers' S!!.~rel OiTn"come. Credits, Deductions. ete
(I) Pro rele sher. lI.m. (b) Tolel amM'i----
Incomo 1 Ordinary Income (loss) ~om ~Ide Of busln... aclivllle. (pao. I, Iln. 21) "., " 1 78.l,EL
(L.a..) 2 Nellncom. (lotiS) trom ,.nll' '.11 I.lal. 8cllvill.. (.lIach Form 8IflS) . , ' , , , , , , ' , , , " "., 2
hG,olllncom.I,om 01111' ,.ntalacllviti.. """" """'" "'~ ,-.-- ,-
--
b Exponses trom other rontal activities (ltttlfch schedu(n) " ,..,,' 3b _
c N.llncoml OOtiS) trom olll.r '."111 IcIIViti.., Subtracllino 3l> trom IIn. 3e , , , , , . 3c
-
4 Por"olio Incom. (loss):
. Inlera.tlncom. ' "" ,'" "'" 40
b Dividend income, ' . '" " .",., ," ' , , , , , , ". "'" 4b
. Royatly income, ..",,, "" ....,,, ,," ",' ..",,,,.,, "".. ,."" 4e
-
d N.I shorl.larm '11I>110' O"in (loSS) (.lIach Schedule 0 (Form' /2(5)) .."",..""" " " 4d
.-
. N.llang.tlnn capital oaln 00") (I/lach SChedule 0 (Form //2(5)) ,," , , , , , , , , , , , , . '" ",' 41
I Other portfolio i'\Com. (loss) (.lIach schedule) . , , ' '" " ' , , , . , . , . . , , , , , ' , . ' . , , , , , . ' 41
5 Nel Olin 00$$) unde' s.ction 1231 (oth.r lI1an dUll 10 casu.'1y or 1t1.1I) (a'tach Form 4797) " " 5
6 Olt.er Incom. rlossl (anach sch.dule) . ," , ' , ." , "",'" ' ",,,,,.'..,,,,,,,.,. ,'" 6
Oltduc. 7 Ch...llabl. contributions (allach schBdula)... VARI.OU5.0RGANI ZED. .cHARAIIE 5., 7 1 716.
lions 8 Section 179 .xponsa d.ducllon (allach Form 4562). . 8 17 500~.
""" ,'.' ..,.. .,,,,,,,
9 Deductions ,.lllod 10 por"ollo Incom. (10") (itemiz.) ,.,,, ,,", 9
10 Othar d.ducllons (allacll schedule), ' ",....,'..., , ,,,,,,,,,,. 10
Inv.st- l' I Interest expe~e on Investment df!bls 111
mant b (1) Inv..lmonllnCom. InCluded on llno. 48, 4b, 40, and 41l1bovI 11b (1
Inl'_1
(2) Investment expenses Included on line Ij above , . , , , , , . " 11 b (2)
Credits 12. eredil tor alcOl1ol used a. a ru.1 (a/loch Form 6478) . ..,., .", 121
b lowotncorne housing credIt: '~, 'I},
, "
(I) F,om portner,hlp,lo y,t,,'h ,,,Iwn 42(IX5) appli"tOl prOll'f'1.pl"ed 10 "IV.' belore 1900 ., ,',' ..,., ""', 12b (1\
(2) Other lI1en on line 12b(I) la, property plac.d .i~,servic. belorl 1990 . "'" """ ..,.. '''''' 12b 1211
(3) F,om ""Iner'hlpslo Yottkh ,ecllon 42(IX5) 'Pl>Ii" 101 properly pllCod" serv.""OI 1989 .. "., .' .. " "" 12b 13'
(4) 01l1ar 111,., on lino 12b(3) lor property plac.d In serVlc. a"., 1969. .. ' "." ,,,,,. " ",' 12b 14
c Oualified rehablhtallon eXpel'ldlMeS related to rental I eal estate ac!il.l;ties (attKh Form 3468) ., 12<:
d C10dlls (olhe1 than on 1m.. lib & 12<) rel.led kI ,..101 ,..I ..1.1'1C1~,Ii.. ' ..", .. ... .", 12d
. Credits related to other rental aclll.llhcs ... 12.
-
13 Other Cfodit!i . .. ",' ",. ...".,.. ",. ... 13
Adjust. 141 Depr.clation adJuslmenl on properly plac.d In serVIce a"., 1986 .."" "'"'''' ,," 141 2 561.
m.ents b Adjusted gain or loss 14b
Ind lox .."" ".... " '..".. ..",
Pr.ler- c Depl.tion (other lI1an 011 and g8S) ,....,,,,,,,, 14c
.nc. d (l)Gro$s income Irom Oil, gas, or geothermal properties 14d (1\
"ems "., ."., "
(2)Deductions allocable to oil, gas, or geothermal properties ....., "" ...., 14d 1211
. Othe, adlustmenls ond t.. pI.ler..ee item. (,nlCh sch<<!ul,) . .
". 14.
F (>relgn 15. '''''' 01 iocome . ..
TaxK ------------------------------------
bNamnofIOleiQII'ounloyorll.S. passon'on .. ......... __ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ __
c Total gross income I'om .ourcos oulsld. the Unll.d Slales (allach schedule)., .. ,,', . 15c
d Tole' applic.ble d.ducllons and losses (ellllch SChedule) . . ,,', , , , , ' , , ,,,,,.. .". 15d
. Tota' foraign taxes (check on.): .0 Paid o Accrued ' ,.... ....".... .. 15.
I R.ducllon in taxes Ivallabl. fa, cr.dll (a/tach SCh.dule) . ' , , , , . ..." 151
OCUli' for.i<>1 tax InfOlmallon (attach sched~lel . . ' .. ... ...., 150
Other 16 Section 59(.)(2) .xpendltures: . Type ..' .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
b Amounl .. .", .."."", .....,,,,, .", ..,,,, .. , , , , , , , , .. '''''''' .", 16b
17 Ta..axempt inleresl 'ncome . '" ,,"" "...' ,'.' ... " .."",.., , , , , , , , , ... ",,,. 17
18 Other 11>(..xempl .\Com. . "'"'' ,'., ."" ' . , , , , ." , . , , , . , , , , ' ,."",,, ""'" 18
19 Nondeductible .xpens.. ...."",."'.'",,.. ,.." ,',' .", ..,,,,,,, ,,', 19 lll.
20 T alai prop.rty distribution. (Including cash) oth.r then diVIdendS ,.ported on lina 22 below .. ..' 20 21...2 9 7 .
21 Othe, it.m. and amounts r.qulred 10 be r.ported separll.ly 10 shareholde,s
(1I/t1JC/t Schedule) . ..", ...."" ." ..,,,, ..",..
22 Tolal dividend distrlbullons paid I,om accumulated e.rnings and proms ......,., .. ". 22 O.
23 Incom. (IO~.~)(R.qU"ed only II Sch.dul. M.l musl b. comf'.led) Combine lines 1 through
61n col...no . From the resull, subtrlcl tho sum 01 li".s II1rough lie, 15., end 160 ',. 23 59,455.
BAA
I
SPSAOI34 '1107196
.
Shareholder's Share of Income, Credits, Deductions, ete tOMB"" '''.8')0
. Stt 'Iplrlt' Inltruc:tlo"I.
For clllndlr Yllr 1996 or IIX YOIr 1996
()tpllf'\l'ntntll~l,..".....
~e1 A,\'tnut S.fVk. bl1llnnfno _ 1996. Ind endln, ' 1.
Shlreholder'lldon'" In ~umber. 429 - 8 2.8243 Co 'otlon'oldon!!!W1I number. 52 - 1833797
&M,........ NIIM. ~." _7JII too. Corponllon'. NfIfM. A6ch1'. tl"IllIlJP CoH
chodul. K.'
10"..112115)
FRANK L. WI L LIAMS
1 L ONGSOORF W^ Y
CARLISLE, P^ 17013
SOLOMONS VETERINMY CLINIC, INC.
PO BOX 887
SOLOMONS, MO 20688
A Sharlll1older'. percentage of stock ownership lor \lox year (saa Instructions lor Sohadula K.l) , , ' " " , " , " , .. 26 . 6817 5 "
B In"'nll ROYtn" Sttvl..Clnt""""POIlllon Iliad 11"01',", ' .. .!'b!.Ijll!~\.phia_._ ~~, _ !~.2li~:.o.9n. _ = = = = = = = = ~ _,
C Tax shallorrogl.:ratlon runber (soo instrucllons lor Schotlllla K, 1) , , """", .. _ _ _ _ _ _ _ _ _ _ _ _ _ _
o Chad< applicable boxas: (1) 0 Final K.l (2) n AmendadK.1
(0) Pro rota share 1I0ms
Imonlt
(loss)
Oeduc.
tions
Invest.
ment
Interest
C,edlls
1 Ord""''Y Incomo (10") from trecto or busln... acllVllles ,.
2 Not incomo (loss) frorn ,"ntal reel ..tato achYllles "
3 NoI Incomo Qo...) from other renlol .cllvitle. ,
4 Portfolio Income (loss):
Ilnterast "",
b~videndo "" ""'" , "",.
c Royallles ".
d Not shorl,larm capital ga,n (loss) , '
e Netlong'lerm cap,llIl go,n (lOSS) , ,;;:
I Other por~ollo income Qoss) (DI/och SChedule) ,",.
5 Not \Join Qoss) lXlder sec~on 1231 (oll1er than due III'casually
Of thelt).."""" ".",..., ",,,..,,.,,,,,,,,, "" .'"
6 Other income loss) (attach schedule
7 Charltabla contributions (attach .che~u/<!) '" '" ,Se~, L j ne, ,23
8 Section 179 t'xpt.nse deduction ,.""""
9 Deducllons rel.le~ 10 por~ollo Incomo (loss) (.lIach sche~ule) ,,'.,.
10 Other deduc~ons (etlach schedule), '~'-' """"""
, 1 . Interest expense on investment debts. , , , , , . , ' , , , ,
b (1) Invosment Income included on lines 40, 4b, 40, ond 41 above
(2') Investment expenses Included on hne 9 above. '
12. Credit,Of alcohol used 85 ruel
b lDw.income housing credit;
(1) From seclion 4l(JX5) perlnOlsh,ps for properlr placed" SOIVICO b.lolt 1990
(2) Olher lhen 01111" 1211(1) lor properly pieced" i.IVIC. bel". 1990 "
(3) From 1"lion 4l(iX5) partnerships 'Of proll"lr placed" SOIVICO 01101 I!m '
(4) 01her than 011 line 1211(3) lor properly pieced In servlC' oller 1989 , .
c OJaliflod roh.bllllollon expenditures reloled io ronial reol
eltato octivllles ,.. ...."""..",,,,'....,,,,,,,,,.,,.
d Credits (other than cred"s shown on line. 12b and 12c) rolated
to rentel real estate activities ""..." "":1"':. , , ,,""",
o Credits "Ioted to other renla' ectlvll,es .
13 Other tredll. , '
14a Cepreclallon adjustment on properly placed in service oller 1986 "..
b Adjustod gain or ioss ,
c Deplotion (ather than 011 and gos) " , , ' , , , , , . ,
d (1) Gross Income ~om oil, go., or geothermal properlles , .
(2) Doducllons ollocable to oil, gos, or geothermol proport..s "
a Other ad u.trnonls end tax releronco 110m. otloch schedule ",,'.,
BAA For Paporwork Roduction Act Notlco, soo Inslruc1lon, lor Form 11205.
Adj",l.
monls
andTIl(
Profer-
one.
Itoms
'$PSA04i2 'lr~
(b) Amounl
(c) Form 1040 IiIor. enlor
tho ImOl.I1t in cot (b) on:
Soe Sharehotd.~
instructions lor
Schodulo K.I
(Form 112(5),
1
2
3
20 991.
4.
4b
4.
4d
4.
41
Schodule e, Part I. line I
Schadulo e, Part II, line 5
Schodule E, Part I, line 4
S<hedule 0, line ~ col (1) " (g)
Schedule 0, lint 13, col (I) Of (g)
~nlilf on ap~ In C1l ~U1l.)
5
6
7
8
9
10
110
b 1
b
12.
See SllMd1old,,', .,~"'I"",s
lor Schedule K.I (fOlm 1I1llS),
(Enlef on ~ Ir, 01 rwUrl.)
Schedule A, litoe 15 or 16
See Shweholder's
Instructions 'Of
Schedule K.I
(Form 112(5),
form 4952, Iii" I
'1 See SI1aleholdff',In,lruc.
r toons lor S<hed.lo K.'
(Form 1I1llS). _
Form 6476, tone 10
458.
4 669.
b 1
b
b
b4
Form 8586, line 5
12c
12d
12e
13
14.
14b
14~
d 1
d
14,
Seo Shareholder's
'nstrucUons lor
Schodulo K.l
(Form 112(5),
683.
See Shareholcto,'s
InstrucUons for
Schodule K, I
(Form 11205) end
Instructions lor
form 6251
Schedulo K.1 (Form 11205) 1996
20 Property distrlbu~ons (,ncludltlg cash) ~lhar than divldand
dlstribu60ns reporlod 10 you on form 1099.DIV . ". ... . .. .
21 Amolo1l 0' loon rapaymonls 'or 'Lo"". Irom Sh",.hold.rs'
ZZ R.clpbJr. 0' low,incomo houSing cr.d'l:
· from .ac~on 420)(5) portn.rs,ups . ZZ .
b Other 111M on line 22a . ZZ b
U SuP9lomtnlll inlorlNl"" Itqu.od 10 be 'opoIIod .....'.,.Iy 10 each 'h...",I"'" (&It"h .ddd_ll<hedula " mil" IPK' " _",,::--
Lj'llt L -. Ib.aJ j la.b] LC9Q \./J Q~tJ Q'lS": ~ :<i~_ _ . _ . _. _ _ _ . _ _ _ _ __ _ __ . _ _ _ _ _ _ . . _ _ __ _ _
_y'A_R1QU..s_Q~G~~IJ!Q _C!l~I!..AJg..S_ - - -. -; _ _ __ __ __ _ _ _ _ _ __ _.. _ _. _ _ _ _ _ _ _ _ __ _ _4J!L
Total. ._______4J.L
-------------------------~~------------------------
""duI. K.l (form 11205) 1'996)
,
fRANK l, WIllIAMS
(.) Pro ,ata shor. lI.m.
(b) AmOlKlI
-
Fortlvn
T.x"
150 Type ollnconlt . _... _ _ ,.. _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _
b "-" foreign ..."Iry 01 U.S. "",,"!.ion . _ . _ . .... _ _ _ _ _ _ . _ ._
, l:U::~:Y~ h<>m sO<>'c...~ .OUI.S.'d~. ~. .~I...d .SI~I..~ .
. Tola! oppllcabl. deducllons Md 10.... (artach .<II.eJule). . . . . ,
o Tolallorol"" laxes (ch,ck one):. 0 Paid 0 Accrued....
, Ra~lon In ta... .va"obl. f~ c'.dll (ertach sch.dul.) .
O!!)II( for.lgn lox Inlormoll!1!l..(allllCh schedul.) ., . . . . . . . . . . . . . .
l' Seclion !II(.XZ) f.I'/lOII(Illuru: 0 Typ..
b Amounl . .
17 T ax.axompllnltr.'llnComo
18 Other lax ,..ompl incoma .
l' Nondeducllbla axpon.a.
30.
180
18d
lS.
151
15
Other
16b
,.,
18
l'
20
21
14.301,
429-82-8243 _t~
(0) form 1040 fila,s anlll( !ho
amount In 001\Xl1n (b) on:
form 1116, Chock bc;;;--
forlTl 1116, ParI I
form 1116, Pl/lll
form 1116, PII'1 III
Ste In.lruction. for form 1116
Ste iiharo!loldec',lftll,uchofl'
for Schedule K.I (fOlm 1\205).
form 1040, line 8b
f See Sharoholder's
Instruc~on. loc
SchedUla K.'
(Form 11205),
form 8611, I,n. S
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menta'
Inlor..
m.tlon
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SPSA0412 l1fo.'6196
--------------.------------------------------------- -----------
, ,/;;" . l U,S. Income Tax Retunl for an S Corporation
,......funS ~ Do nollll.lhl.lorm unlou Ih. eorporlllon hll 1I1ft.ly lII.d
~ FOrm.2.553.t:'II~:.h.~ns.~0:PO~'I~~ . ____ {;.
/ ~~=~~~..- ----
II!! tile.... VII' 1195 " , b. I. n and.n In
A 0,," ollltetlon II in N.me
S corpolllloo UsI
IRS
_ 06.1 15 ..L1.J..2_L "bll,..E;OL.()~l:)l'l~_ y~.,!:~~!.N~13~...fI:. !!,1I c... .~~c::___... __5.2 ~!~ ~.~.~~ . ....
S Busln.1S cod. no (... Other. Numbtr, .11,,1, and room or sud. no. (II I P 0 bou, "I plgo 9 01 Ihl In.lluctlon, I 0 Dlt.lncorpoIII.d
SpIC"" In~tluctIOll') :I~:" _!'....9.Y.Q.!L..?..!l1_..--.-.--...... ......___...._......._..___ _....Q..li.L! 5/19 9.~_._._
print City orlown. st"",lnd ZIP cod. E TotlllSsets ,... Sp<<lkln'~I)Uon.)
8980 orlyPI. S 0 2068 110 543.
F-;;;:'~~(I)~"~llItum (2)... Flnlllltum (3). Ch.nOIIn Iddr", (I) Amlnt1tdl11um L_......-._._.~_..._...
. j:M4IlIIltrv<;\Ion. bIIb'Ii ~ r-J
D Chlek t~I' bou "this S corp6l1l1on Is subjoct 10 Ihl con,olldllld .udd procldurn 01 ..cllon. 62411h,ouOh 6245 _"'" "'...~ ... .. L..'
!L!.nlll nufll!!tr olsh...h~rs In thHorporllloD-allnd of th..!!!.WL .-----~ -2.
Clullo~;.lne!Jcte o~tv ~ or b<,sI""..lneome OIld !!I'l!!!'.!!!!.on I!!!!!.~ 1""""'Oh 2' ._$11 /he/nlltyc'lon!!2Lmo,./nformaUoh'---__ -
I I 0,,,,,,,,,,,,,",,,_ ___34 ?~~~_D L_~''''''''''..'_ ____.._.._,... ~ " __...2..4 2..L 69 8,.
2 CO'I of eoodssold (Schldulo A,lIne 81 2
~ Gross prom. Sublllct lit.. 2 !rom 1In. 1e -1
<< Nel o.ln (loss) lrom Form 479'1, Part II,Une 20 (.tt.ch Fonn 4797) . .4
5 OIh"lncomt(lots) (.ttllCl,scnoc;.,la) .... ... ............. 5
& _..1!l!lIncomelloll..CornblJl.1I1)ll.3IhrOUDh5 ........... ... ............ ~ &
., Compen..Uon of olllcI,,~'l'!\'l:E:/:I.EN.'l'.. L .,
8 S.~rtISlnd WIO" (,",,,mploy,",,,1 credit,) 8
e Ropll.. and mllnt,","c, i.
10 81d d,lIts ................. 10
'1 Ronl' ......._.:0.... ........................ 11
12 'm, Ind Ik:.nm .' ....~.'l'!\.'l:.E:/:I.F!N~ Z: 12
"'''''':.''
13 Inl",,1 ............... 13
14. DepfecIIUonPftequlA>d,.N.chFolm4S62). .............. ,\I' 141 8 984.
b Oopllclatlon elllmod on SeIl,dlll. A ,"d Ilsewhere on ,,'um 1.b
, Sublllct line 14b from line 14.
15 Deplellon (Do nol dldu,' 011 and glS deptellon,)
~ 16 Mvertislno
,., Pen,lon, profit..h'rlnO, elc., plIO'
18 f.mploYI' b,no'ft progllm'
19 OIh" d.ductlons (.ttach sCIIOWIa)I).'l.'~'l.'.E.l-IE.l'l'1' .3.
20 'Oli' dlductlons. Add th.,mounl, ,hown In Ih. f.r .10hl column for lin.. ., IhlOUgh 19
21 OrdlnlJY klComo (IO!'llrom !rIde or bU'hle..!ll9.IIvIlI". Subtllc.!.!I.. 20 from line 6
22 , IX: . Exc"",et passive Income I.. (.lIach .ch.dule)
b Tau from Schedul. D (Form 11205)
c Md lin.. 2211rnl 22b
23 Plvment&:. 1n&_llMllt(l Wl. PIWyITlWlU atld .mount .pp1itlCl from 199~ /'filum
b ,,, depo,n.d wah Form 7004
, Credll fo. Flde"llax plld on fuel' ('II.ch Form 4136)
d M111nes 23. throuOh 23e
24 Estlmalld tax penllty. Choc' d Form 2220 I' In.ched
25 Tn dUI. Illhe tolol of Un" 22c IOd 241' ~ro" Ihan line 23d, .nl", amoun' ow.d, S..ln.llUctloOl for
d.po,nary method of plymonl.f . ~ 25
OVerplymlnt, Illlno 23d is ~ro" thin Ih. 10111 of IIn.. 22c .nd 24, enl" amounl u,",plld ~ n
Enlellmoun .f IIn . vou wanl: Credllld 10 1ge5 ..Umlled I" ~ d ~ 27
Un<*' pen'" 01 pertury, 10te1.,. thllll h....e e.llemlnld tnlt ,.tllm,lnGtloldlng ~~I/lg Ich$du'-:t ItId Itlltmtntl, ~ to IhII ~l of ~ IIn~ge.1'Id
bellM, It I. we, 0Cln'tC1. Mdc:ompllll. Dectarltlon 01 prepanw(ottltflhan tax~ I. tlMldon 1l11nklm'lllllonotwhldl pNPMlI'hUlt'lyllf'loll'Wtedgt
~'Slgnalu" ofoff,e,,' -_....__.---~--._-._- ~ Tnl.
PIII,.re,'. .. 0,1. ~'heCk"
~~II~ .
_______.. .mplot.d ...
FI",,'''_1o< ..MULLEN, SONDBERG, WIMB I SH AND STONE PA
=.:" ,..900 BESTGATE ROAD, SUITE 200 UNo ~
........... ANNAPOLIS, MD
';~'.. H761 For Plplrwork Rldu,Uoo Ael NoUea, 18. p'ell of "plllle in'lru,UO;'.1
5460320 756446 050 SOLOMONS VETERINARY CLINIC INC
,
__._ __~! No _~~~~. ~l,~_._.
5
C ~mp'oy" klenUflCltlon number
_I
_ 34..2_L~98,
f
'"
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~
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63 687.
____.e..._ __
1 , 7 ?2.~_
10,800.
13,520,
___3,90~_
.
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14e
15
16
17
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19
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292",618:-
50,080.
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221
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23b
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27
Please
Sign
Here
Peld
Pre parer's
Use Only
Preparer's
social securIty number
21760 9967
ZIP cod.
52
~ 21
1197902
01
FOIm 11208 (1995)
06174563
tl- SOLOMONS VETERINARY CI.,INIC INC
e- CO'I of Good. Sold
~ry., btoln~ng 01 y,,'
hues
slofllbor
I AddHlon.lucllon 26lA co.,. (,H.ch Ichedulel
ot~~1 cOllI (,H.dllcl1edulel
Ie ToIII. Add Nntl 111ll0ugh 5
7 Invenlory .l.nd of y'"
8 Co,' 01 ooods solil, Sublractlln. 'f hom !In. 8, Enl.. h... .nd on psg. 1, Nne 2
Ue Cneck.N mslhods USed for v.lulng clOllng Inlllnlory:
(I) [] Cosl" dSlcrlbed In R,gul.'lon. settlon 1411.3
(III 0 lowarolco.' 0' marl<.ltI os,crilled In Regullllo", ISctlon 1,471-4
(III) 0 OIhsr I'peclty method "lSd .nIl .,bdl,xpll..llon) ~
b Check N Ih.ra w... wrN.doVln 01 "ubnorm.r goool tI dmrlbtd In R.oul.,lons section 1.471.2Ie)
c Check N lflellFO In",,'ory ,""Ihod WIS 'dopted Ih" I.. y'" fo, eny ooods (" cI1.cked, .tbdl Form 970)
. If Ih. L1FOlnvenlorymolhorf.,1S USld lor lhll IIX YIII, enl" p"eanl.g. (or smounlll olclOllng InVlnlury
tompul.d UlldOl LIFO
e Do the rule. of .8<11.n 263A (fo, property produc.d 0' .cqulred lor rellle).pply 10 Ih. corpollll~n?
I Was 'h.re .ny ""eno.1n d,'.rmlnlng QUlnlllle., cosl, or VlIUlllons b.lweon opening .nd closing Invenlory? ,
_...!t:'!!.t:.!Jt5!! eXJlian.'lon,
GIIl!!I!Il1lI Other Infonnallon
>__52-1833797
P.OI 2
--'- -----..-...
L .___.....,........_..,.._....
.
.
7
~D-
~O
LH..L
Dv.sONo
o VIS 0 No
1 Ch.ck ",.'hod 01 'C<'4Untlng: (e) IX] C..h (bl 0 Accru.1 (c) 0 OthOllsp.cilyl ~
2 Rofll lolh. N., on PIQ' 2. o,lh.ln.,rucllon. end .,.,. Iho corpollllon'. p,lnt\iii,:
(s) Bu.lness.c1Mly ~VETERI!'l~Y CARE (b) ProduClor"rvlco ~ SERVICES
3 Old It.o corporallon 111110 .nd of lh.,IX y"r own, oi"ctly or indlroclly, 50% 0' fIlor. of lh. vollno slock 01. dome.tJc corporation? (For
rule. of .Hrlbutlon,'" soctlon 267(c).) "'I'IS: .Hath . .chod"l. Showing: (e) ..mo, .ddre$$, 1M .mployer Idontlllc.lllon number.nd
(h) pereanlag. owned ............"""""""" l(
. Was lh, corporalloOl mombor of acontrollod group su~~ctlo Ih. provl.lonsof $lctlon 1561? . "..", """" X
5 Alony limo durlllg co.r,dar Yllr 1995, did Ih. cOlpolltlon hm'" Inler..' In or. vlg..'u" or olhor aulhority over. fln.nclal,,,,,oulllln.
for"ion country (suctl as a bank Iccounl, secur"les accounl, or other tinanclalaccounl)? (S88 pIge14 tlf ltla Instructions for exceptions and tHIng
"QulromolllslorlormYD F 90'22,1,) ,,,...,,,,,.. X
II 'I'..:.nlllIh..."" nflhoforelgncounlry ~ _, ._____ ..___
6 WI! Ih. corpollllon lflo granlor of, or IronsferOl 10, . lorelgn lru.llh.t ..i. "d during Ih' cu,,,nll" yea"~ wh.'hor or nol Iho corpolltlon h.d
any bonollel.llllt.re,tln II? 1t'l'..:lhlCorp~ratlon may h.vo 10 filo Forms 3520, 3520-A, or 926" . , ",." X
1 Chock lh~ bo, N 1110 cOlporalloll h.s fil.o 01 ~ required 10 file Form 626.. Appllc.llon for R.gl.lrallOn of. TIX Shoner .. . ~
S Ch.ck 'hi. bo," Ih. corporallon ISlUod publicly o"nred d.bllnslrum.nl. wllh orlgln'l ~."' dlscounl ~
It so, Iho corpolltlon m.y h.vo 10 fiI' Form 8281. Inl"mallon R.lurn for Publicly Off.rod Orlglnall!SU. Olsco"nlln,'rumonts,
~ It Ih. corporation, (.) fllod n. .Iocllon 10 b,," S cOlporation .Ner 1986, (bl wa.. C corporallon b.tore n .lecl,d to be en
S corporallnn orlh. corporallon .cqulred on ....t with . b"l. d.l"mln.d by "f,ronc.lo n. b"l. (or Ih. basts of .ny olher
prop.r1ylln Ih. h.nd. 01 a C corporatlon,..d fc) hIS nol un"a'llId buln11l g.ln (d.fin.d In ..cllon 1374(0)(1)) In .xcas. of lh.
n.t recognl!td buln'ln g.ln from prior y"", ..tor the n'l unrlllllld buill-In g.ln redllc.d by net "coonllld buln-In gain
from prio, y.a" "" ~ $
10 Ch.ck lhl. bo< It tll\ c:lli'orallon h.d subch.pler C earnlll.' anO profIt. al the clos. of Ih. tax "" .......... ' ,.. ~
Designation of Tax Matters Person
'.
'nler b.low the sh.reholder doslgn.l.d as tho lax m.n,,, porson (TMP) to, Iho ta, Y'" of Ihl. "Ium
l.mlOf ...
'OIlgn~~lMP_~ ERA J MOORER
Id,nlltying ...
number otTMP ~
220-40-2868
.dd,... of
OIlgn.,.d TMP
...J050 PLUM POINT
~ HUNTINGTOWN, MD
ROAD
20639
"
.,
I
756446
2
050 SOLOMONS VETERINARY CLINIC INC 06174563
,.EK.11 Shareholder's Sharf! of Income, Credits, Deductions, etc. j' ..()~,,"J!~~~_
"oS) ~ See IBPlflllln.lr.eUon. 1995
,... T_Uff For ..IOndlf y..r lUg, or 'I' yeel
~ kv\QI . Inn'", ~_-,,--= _, 1\ fld 1L- --- '
~lrt''''I!Y!!1.~p~.4J~::~1.-.!!L1L f~~!II~~..~'.fll!~.."'!m!l!1 .~- ~1:-~ - :n~_ - ,,-. ..-
'pOI" n.me, .~d'''', .nd ZIP cod. COIpollllon" n.ml, .dd"". .nd liP cod'
\
,;.NK J... WILLIAMS OI.OMONS VETERINARY CLINIC INC
LONGSDORF WAY 0 BOX 86'1
~R~!SLE, PA...l 'I 0 I}__.._._-.-----..-...- _Q!oQ!1Q!:l.~L..~..Q.-.-.?..Q~~~------.~--~.
~ st.."hokler'. ptlctnl.gl 0' .locl own."hip 10,1.' y." (...In.l,ucllon. 10' Schldol. K.l). . . ... ~ 26. 164 B 5 '1%
. Int.m.1 R...nlll S.cvIcf cenl.. whl" cOJpoIIUon 111.d lis "turn ~ ___R!!!:I:AI?ELPl!.!&..!'JI.-._._- -=-
c ra'~h'KlIlOO~I"\iOnnumbl'(n'ln'l,uclion'fo'Sch'dUI.K")" ...... ~--_.-._-
D ChO(i(JII,2!!cabltbO.": 11L..CJ.iin'IK.l .-m.U.Am.nd.dK.'
(.) PIO ..I. .h".II.m.
_._._---~----..,.....-...----_.._-~._---"
(el Form lD40 hit" .nl..
\he amount In col~rnn (~.L~.,
--14 11 5 .
(blAmOunl
d
"'u
c "
~~
!'It\
ii(l..
.., ~
...
1 0rtI1n.!y income (lOSS) 110m Ir.d. OJ bu.in..' .clivili.'
2 Nolin"''''' (loss) "om ,onl.l ".i ..1.1. .cllvlll..
3 Not 10.."" (10") "om olh" "nt.1 octlvllle'
. Port1o,o income (IDS')'
Ilnt.".1
b DIvId.nd.
c Roy.'.'
d Notlhort.t,(fTI Clpltllg.in (lOSS)
I N.llong~.(fTI c.pR,lg,ln (lOSS)
I OIht! port1.Mo Incom' (loss) (.~ach .chedul.)
ti N.t g.ln (lOSS) und" secli,n 123' (olh" Ihln duo to c.,o.1Iy 01
~,
th.ft)
& OIh" \ne.m' (lossl (.~"h sch.dul.)
1 Ch.'~ablo contrlbuti.n, (,~ach seh.dul')
a Suction' 79 8.pense deduction
9 Doducl~n' 1.lal.d In p.rt1ollo income (lOSS) I,~ach settedul.)
10 Dlh 'dedlletlon,.(a~"hsehe.\I~....=-
" . Interest fl-.pense on Investment dabts
b (1 I Invest"",nt Inco,", includ.. on lin.. 4., 4b, 4c, ,nd 4' .b.v.
2 In'tles'ment 8Xllenus lncludlld on lina 9 above
12. Credn tm IIICDhOl uSlId as lUl'l
b L.w'lncome hOusing ...dil
(I) From s,cliun 42(i)(5) p,rtn",hip, t., prop.rty pl..ed In
..rv\cI bOlo" 1990
(21 othOllh.n on III" 12b(1) tor prop.rty pl.cod in SONiC. b.Io,.
1990
(3) Flom ..tilon 42(i)(5) paJln"'hlp,lor PJOp.rty plac.d In
,.evIe. Iner 1989
(~IOIh"th.n on IIn. 12b(31 tor prop.rty pl...d in solVic. .It"
1989
.,
c Qulll1led IIhablm.lion ..p."~lIu,,s ,.I.I.d 10 "nt.1 r..I..tat.
.ctMt~.
d Clld!,' (olher Ih.n CIOdll' .hown on lin.. 12b .nd 12e) ,,1.I.d to
"nlal ".I..ta'. ICllv~~'
I CI.dlh "lalod to olh" ""I.i ICtlvlli" I'" inslructl.n.)
13 OIhll erod~s . .. .
14 I D.praclatlon Idjustm,nl on p,.p"ly pl.c.d ,n solVl.. .n., I~B6
b Mlu.l.d glin OJ ~IS
C D'P~tlon (oth" It1ln oll.nd gOl)
d (1) G,osllncomolJOm oil, gas, or g,olhllm,1 plOP,rtles
(2) Deduclion, Inocabi.lo 011. oas. n, goolo","'1 p,op.rti.'
. 01 "I . miln , .nd lax pr.'''''....!!e'"s [.~ach sch.d!!ltl.___-~
For PIP.rwork RldueUon ~ct NoUt., se. plgl 1 of Inllructl.n. lor Fo,m 1120S.
--'
} 84e paQOI " trld ~ 01 !hlt
SIl~.If't'II\l(;tioo'kIl'
&t;....ChIIl:K,\ IrQfTTI 112(3)
226.
-~---
Sch. R, P.rt I, nn. ,
Sch. 8, P,rt 11.11'" 5
5th, E,Pal1 l,hO!'-
&ch. D, lin. 5. coll'I.' IgI
Set. D, IIn. 13. col (I) 01 (gl
.___ (Ent.. on appliC*h\1 I"" 01 yl)Ur 1'lI11Jl"l)
!
.
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"".,:.,,~'.~ ' ,.., .,.", ."
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s.. sr....noldll"..".tNtllWl'
11>1 Sc.~edut. 1{.1 (form 1 12(0)
----~--
$. E:E:. ..$TI'{fE:t'E:1':lT....
ntltl' on app-lK:.tlel.,.. 01 Y"'-II ~~
211. Sth. A, !Ine 15 0116
---~~~_1..?1?-~.} S-pIt\lfSOI1,ot'S".tdtlold.1'1
1n.INdlonllof SO,~"III K"
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form 4952. line ,
------iIa.
._--_.,._~.._-_.
See Shaf'tlhDlde'" InlWttionl
lor Senedulaj(.' (FO/fT\112OS1
Form 6476.lIn. 10
Form 8566, IIf.. 5
i
o
,..--
12e
,12d
121
13
'~I
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~ ---..-.--..-
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aM plQl 'I 01 tht Sht/1hOlder'1I
InlwctlonlfofSChte'IlItK,'
(fonTl1120S)
._--~'-
603.
S.. p.g. 7 olth'
Sh.'.hOkl....
Inslruclionslo,
ScMdult K.l IForm
1120S).nd
Instructions lor
Fo,m6251
,--
Schedull K.l (Folm mOS) 1995
H161
~lli~ 111941
SOLOMONS_VETERINARY CLINIC INC
52 -1 8 33 797 P.g. Z
I!DIllII1!IrIiI Cost of Goods Sold
-,------
1 lnventorv.1 ~eglnr,lnl 01 V'.
r Pur."'...
I COI! of II."
4 Addltl.n"uetl.n 26JA .."'II"..h ..h.dul.1
60th.. ..'" Iotto<:h ICh,d.I.1
. l'ol.!. Add lin.. I thr.uoh S
7 fnvtlntory ettnd of VIII' .."".
. Co. I 0' g.... ,old. Sub!r..' lin. 7 Irom lin. 6. Entor h.r. ond.n P'O. l,lin. 2
I. Chec", .11 methods us.d for v.lvlng cluing inventory.
(II Dc.st
(Ii) [J l.w.r of ..st.r m..~.t ,. d..crlb.d in R.gul,'ion"..".n 1.47'-4
Oli) D I'Irited.wn.f ".ubn.rm,l" good'" d.,crib.d in R.oullli.n....".. 1,471-2(.1
(i,1 0 Oth.r 11I..lIy m.th.d u,.d ond It1lCh expionttionl ..
b Ch,c~ if !hI LIFO I.".lory n,.,n.d WIS .d.p,.d 'hi..ex y... lor illY O..d,(11 ch..k,d, Ilto<:h Form 9701 .
e If the LIFO Inventorv method WII used for this \IX vear, IIMer percentlge (or .maunu' of closlnalnventorv
cor,\puted under LIFO ,,_,.. ".,..
., 00 thtf rules of section 26JA Hor prC/perty producr.d or .cqulred for reulel applV 10 1he corporation? ,,'
. W,S thete II'lV chlllg. in determining quantities. eelst, or v.lu.tions between opening and closing Invltntory?
If "Yu," .!!!!S~ explan.Uon,
I
Z
I
4
5
.
7
I
...~
w
L:J Ve. ON;
D Yes ON.
iG1I!I!lIIi.I Olhor Information
v..
1 Cno.k mo,n,d.f lC"untino: III [X] C..h Ibl D AccrUlI lorE] Otho,I,pocl'yl ..
, _.~--
2 Refer to the lis1 in lhe Instructions .nd stile Ihe torpor 'Iion'$; princip~:.
1118u';n.....t";ly~yETERINARY__CARE Ibl ':f..duct."m;c." SERVICES
I Did the corporllian It tne end of the lilt yetr own, directlv or indirectly, SO%. or morl! of th" voting stock of, domestic corpor.tlon? (For
rules of .ttribulion, see section 267(c).) If ~Yll!s." 'n,ch, schedulr. showin;: 1.1 name, Iddress,andemployer identltlcatlon number Ind
tbl percentage owned X
. Was the torpor.lion .member of I controlled group tubJectto the provl.~ions 01 section 15611 , X
5 At .nv lime durin~ ulendar velr 1994, did the corporation have.n InlereS1 in or. signiture or olher II.Ilhorily over, finllnci,l,ccounlln I
foreign country (such.s e bank Iccount, securities .ecount, or other finNlci.llCcound1 (See instruclions for excbptlons Ind filing
requiremenU lor form TO F 90~22, 1.) X
If "Yes," enler the nllOe of the foreiQn country.... .
8 w.s the corpor'lion the gr.ntor of. or t,.n:oleror 10,' foreign trust Ihlt existed during the current IIX ye.r, whether or not the corpofltion his
any beneficill interest in It111 "Yes," the corporltion mly hive to file Forms 3520, 352D-A, or 926
7 Check. this bOllf Ihe corporation has filed or Is required to file FClrm 8264, AppHc.tion for Registrltlon of. Tu Shtlller
8 Check this bDllf the corpor.tl6n issued publicly offered de~t inS1fuments with origin.l issue discount , , ..., " ..." '
If sa. the eorpor'llon m.y hive to file Form 8281,lnform'llon Return for Publicly Offered OrigInal Issue Discount Instruments.
9 If the r.orpotllilln: 1.1 filed its election to be Ml S corpofltion Iher 1986. fbl was I C corpor.tion before It elected 10 be In
S corpofltion or tho corporation acquired Ir. uset with. b.sis determined by relerence to its blStslor the blsls of Inv other
prop"rty) In the hinds of . C corpofltion, Illd fel has net unre.Hud built-in g~irddeflned in section lJ741d)(1)) in ucess of the
net reco\Jnhed buill-In gain from prior .,eers, eMer the nel unreallltd buill~ln glin reduced bV net recognired built-in gain
!rompri.ry.", ...... ............... .. S.
10 Check this bo~;( the corporation had subchapter C earnings lAd profits 11 the close of the tl.ll. ell', " ..
Designation of Tax Malters Person
Entftr below the shlreholder design'led IS the tlX maners person ITMPt 10r the tn yoar of this return:
Nom. .f IIr.
do.lgn't.d TMP ., ERA J MOORER
1d,.tllyl.O IItr..
numbor of TMP ~
220-40-2868
Add,..1I.1
.~t.dTMP
IIr. 1050 PLUM POINT
., Hl1NTINGTOWN, MD
ROAD
20639
2
SCHEDUl.E K -l Sh8rllholdar'. ShllrD of Incoma, Cradlts, Deductions, eto. JJtM! .'cJ.1!.!.:!!.!.o..~
(Form fl20S1 II>- S.. IIp.III. in.I"'tI....
o.,Ilf1..'" ,I ".ttu""y For ullnd" Ylllt '114 or t_. v.ar 1994
IJI.~,,..I "..."~ '~,Iu Ingl""h~.I-, ,."4 .nlll"D .
ih.llhoI4I1',ld.ntlfyln, numb.. ~ 429-82 -82 4 3 C.rp.llt1.n'. i4ontlf.;in, nu..b~':.."':52 -11!..l.lJU ~..
st;;;t;lder'. NIn', Jddteu, Ind lIP cod~-.._..-........---.~~~~-.~--~., Corpar.lIon'll ftlmll, .ddr8u. Ifld ZIP code
FRANK I, WILLIAMS OLOMONS VETERINARY CLINIC INC
1 LONGSDORF WAY 0 BOl( 887
~~ARLISLE, PA 17013___.____.._~ 'O!:>OMONS, MD 2068L-__
A SIIw.holde,', p",onllll. of stock .womhlp fo' I.. year 1s..lnSl,u"ion. fo, Sch.dule K.ll ......... ..... 29 . 87 0039%
. Int....1 Amnlle Sorvice CenlOt who,. corpOrltl"" filed ill 'eturn ~ PHIr,ADELPHI~_ FA .
C Tu shelter regllitr.tl&n nl.!mber bee Instrucllons f01 !:chedule K~ 11 ........"....".",,,.. . .......
D t"eckll9PlicoOleb..es: 111 o FinlIK'" _~
tal Pro r.te sharu itfHflS
1ii
11
d
G
E
o
u
.E
1 Ordinerv income lion) 'rom trlde or business Ictivitles
2 Net Incomo (Ioul from rontll real t1state .ctlvitiU . ,.
! Nat income lion) from ather rent.l.c:tivltles
4 POri folio income 1I0ss):
.Inferost
bOi,irl:nds
t Rov.lties ,.
liNet mort-term ctpitd \I.in (loss)
.t~tltl.n,,-termclpltll g.in (loss) ",_,.
f Other portfolio incolT1lC (Iossllattach 3chedulel , ..,,,:,,';j,.'
5 Net g.in Uasd under section \231 (other thin due to clsullt~ o~
thefd
6 !!)her inc.me Uossllall.ch schodule)
7 Chllillble contributions (e"ach schedulel SEE STATEMENT
8 Seelion 179 expense deduction" . . ..."".. . , ......"",,,..,,..,.
9 Oed~'(1Ians rellted to portfolio ;ncomr. lio55) (attach schedule)" .
10 Olher deductions I.Hlch schedulrl_~.......,
" . Interest expense on investmen1 debts
blllln't't1ument income Included on lines: 41. 4b. 4c. and 4f above
121 Investment upenses included on line 9 abolole
12 I Crt!dil for alcohollJsed 15 fuel
b Low~lncome housing credit
111 Fr~m secllon 42(j)(S) partnerships for property placed In
service before 1990
IZI Other thon on line 12bl1l for property pieced in service before
1990 ..........................
131 From ..ction 42lillSI pertno"hip. for property pieced in
service Iftllr 1989
1410lhe, then on line 12b13) for property placed In service .fter
1989
...........>r...
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.
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c Du.lilled rehabilitation ex.penditures related to rent~t rell estate
attlvilies (see Instruc1ions)
d Credit5 (other than credits shown on lines 12b and 12c) rellted tD
rent.1 rell utttfllCtilfities (see Instructions!
. Credits relatl'ld '0 other rentll activities (see instructions)
13 Other credits (see instructions) ,
14 I Depreci.tion adjus1mllnt Dn proper1V placed in serVice after 1986 .
b Adjusled "till or loss
c Oepletion lothor than oil ..d .,,1
d 111 Gross income frOM! all. "IS. or geothermll properties
121 Oftductions Illoclble 10 011, g.s. or geothurm.1 propenics
--!-Oth!!,!!!i'!!tments Ind lex. preference items llttlch schedulel
For Paperwork Rd.ction Act Notice,,,, plge 1 of Inshuctionl tOf f",m 11205,
~161
(bl Amount leI fOHn 1040 filers enter
thllllmoun1In column Ib) on:
1 10,931-
Z } ,....",.,,,,,',...,,,,,,..,
I III $d";ttl. It-I (for. 1120101.
4. 277 . 5ch, &. Pin I. line 1
4b Sch. B, P...t II, IIno S
4. Sch, E. Part I. line 4
-------
4d 5th. 0, line S. col. III 0' 101
4. Sc~. 0, line 13, col. III or 101
41 lhler IIl.p,llt"bl' II.. ,f ~ft\lf 111.",,1
51t 51lIltll,".'" '"sUnlltn..
5 I., hll...lt 1~1 (fI(M 11105),
6 lht.r tll'IIPUablt lin,,' rClur "'"11.)
7 67. Sth. A,line 1S or 16
6 f,979. } s.. so",.,,.,,',...,,,,,,...
9 'O,S{IlIJ'wltl(-llh,M 1120S),
10
1,. Form 4952. line 1
b(11 277. 5..SIl.rtllolder',hulncUOM
blZI l'tStlll'IIII(-1 IFo'", 112051,
1Za Form 6418. line 10
bill
blZI
For.. 8S86, line 5
bl31
b(41
1Ze
] St.,n".klr.,,'.IlIllrWtllolll
III hllt..lt _.'If."" 1120S!,
114
1Z.
13
140
14b
14.
dl11
4121
14.
__.1,066.
See Shareholder's
Instructions for
Schedule K. 1 IForm
1120SIand
Instructions for
Form &2S1
Sch.d.la K.lIF.,.. 11Z051 1994
Thlo I.hodul. mUlt bl compl-'Id ond mId If tbl InOWllr to ony 0' qu..Uon 1 through 4 on Ihl rov.... olde of REY.1500 COYER 8liEET 10 VII,
ITEM DESCRIPTION OF PROPERTY ~DATE OF DEATH I % OF 'I
NUMBtR 'n....''''".."...,.......,...,''''''....IJon.'''''IoW....n'ondlh...'''f'''n.'... ALUE OF ASSET I.. DECO'S EXCLUSION TAXABLE VALLIE
AIttctl. ccpy of the 0Hd for '&11'$18111 i i INTEREST (IF APPlICABltj i
i
~ash gin of S\O,ooO,()iJ 10 Walter 1', Williams, Ion
~:~;~~~.:.~~.OOO,OO to Mrs, Walter F, Williams,
4 ,. foshginof$l~.(jo~'()()~, Linda W, Hersperger~daughter.
. :. ~~:d;~~:I;~~::.::: ;:~~I~s~~~~.son.jn.law
ICash gift of $10.006,00 ioLliida W. Heinrich, .' ,.,
~rallddaUgh~r., .. ,.,_.. . ...., .' ..,. n .1
981cash gift of S\O,OOO,OOtoAnnc\V. Staley,.granddaughter I ,
~r~:d~~~;:t::o,ooo.OOto Rebecc. H, Ferguson, I
io ~a8hgiflOf$\O,OOO.OOiOVirginiaH,BOynton, !
granddaughter I
___ .1..
II ~;~d~~~::t~:o,ooo,~niOk:~errne'~:Henn~ly,-~.~. n~. 1~'OOO'OOI 100%
12' pash gift of 5 10.000.00 to Kathleen E. Heinrich: In' 10.000.0~ 100%
reat.granddaughter
..::. '. J~a~.;~~E;~;:~:~~::~:~~~~~~r;~~~~i:~~~O~'I~-~~~:~;~::~ . .~:~.
IS' pashgift of$ \ 0,000:00 to Jame.W. Ferguson," _H.' '.1' .10"0.00...0.01 tOo%' I
~reat.grandson
16 Ica,1i gift oB10,ooo.00 to JoshuaC. Ferguson;" . ..\ ro;ooo.oq" 100% I" "3,b()O'OOI'
~reat.grandson
::f~~~~:::;~~:~:~::' HI H:::;:::~ ~::::
.
Schedule G
Inter-Vivos Transfers &.
Misc. Non.Probate Property
COMMONlNEAllli or PFNNSVLVilNI^
lNUEAlfANCE TAAR(;TUAN
RI:SlDENl rn;CF.OfNT
ESTATE OF
WILLIAMS, Frank L,
I
2
3
I O,OOO,O~
to,Ooo.OOI
I.O'OOO'.~,..O....
10,000.
to,OOO. .
7
iO.(jOO~
.:~:~::~~
1000/0
100%
I
I
100% n I
100%
100%
100%
100%
100%
. \0,000.001" foo%U
FILE NUMBER
21 .1J7" 001111
3.000.00
3,000,00'
I
3.000,001
3,000:001
3.000.001
. 3,000,00i
. 3.oo0,W
,
3,000.00:
. 3,000,00,
3.000,001
3,000.001
3,000,001
3.000001
. . 3,000,001
_ .. _'__~_u".'_'."__'_'_'_ _.__~_ .,__ ._.._~.__.._______.__. __._.,.__._,~.~_.._'_4___'~_"___'_."_____ ._~. -~_.,~--- .,._-.. ---
Schedule G TOTAl.
7.000,00
7,00(),()O
7.000,00
7.000,00
7.001),00
7.()00,OO
7.()0(),OO
7,000,00
7,()()0,00
7.000,0()
7,000,00
7,000,00
,. 1.000,00
7.000,00
7,000,00
7,000,00
7.000,00
$119,000.00
1
21
22 Add ii,. amOUnts"ln-tho la~;1" ht-;;Oiu~;; ;or-II;;.~ 7" ~ii,Ttiis-i; our toiiiinc;m. ~ - -~.. 22
Z3 IRA deduction (sea InstructiDns) ,. 23
Adju.ted 24 Medical sa"'ngs accDunt deduction, Mach Form 8853 .' 24
Gros. 25 MDvlng expenses. A"ach FOI'm 3903 or 3903.F 25
Income Z6 One,tlall 01 sell.employmont tax, Mach Schedule SE 26
11 line 32 is V Self-employed health insurance deducl10n (see Instructions) Z1
under $29,291 28 KOO9h and lOlI.employed SEP and SIMPLE plans. 28
(under $9,770 If 29 Penalty Dn eerly withdr awal of savings. . 29
a child did 1101
live with you), !IO. Ahmony paid, b R""pient's SSN ." !IO.
see E IC In th. 31 Add lines 23 . 30a . .
InstructiDns, 32 Subtract line 31 ~om line 22, This Is your .d]ustld gro.. lncom.
BAA For Privocy Act and P.plfWori< Roduellon Act Notic., _lnstNellon..
fDlAOl12 12/10/'97
"
rex!!. 1 040
Label
(SMlnltfv(IlCWl')
U"th.
IRS I.bel.
OtherwIse,
plaase pnnt
or typo,
Pr.sld."tl.1
EI.cIlon
C.mp.lyn
(S..inltrucbonl.)
Filing Statu.
Check only
ana box,
Exemptiona
I f mora than
six dependents,
see instructions,
Income
A<<.ch
Copy B of
your f ormt.
W.2. W.2G. &
1099-11 here.
If you did not
get a W.2, .e.
InstructIons.
Enclos(~1 but do
not attach, any
payment, Also,
please use Form
l040.V.
DECEASED Frank L Williams 02/16/97
1997 _~" Ifm".....1
For thU'8iV .Jon 1 . nee .il, 19971 01' other tax yoar b~1I1lng ,1997, endl,1
V'1lU/flf1,tN.1lWI Ml t..INam.
lleplf!ln.nt01 f1. Tr""'lfV
- 11I1.mal RIVtJrl\j' S'rvlU
U.S. Individu~U!1come Tax Return
19
Vllf helM S.uritl No,
429-82-8243
_,.11111'. .,elM IKllrttw No,
Frank L Williams
w;;:;tn;\;n, 5p;',,',rj';;tN;~.-~Mr-i--;~--~-----
HWM Addfl'"(numbl" .nd ,tr.,t). If You Ha....tJ. 1'.0 (hlll,S..lnlltvcbol1'
APlrtrnenlNo-,
For hllp IIndlng II...
lnttructlonl, ..t
In.tNellon.ln tho bookl.t.
DnupnRdqrf Wav
City, Town Ol'flOlI Offici II Vou tilv" I fOfeiljtfl Addru., S..ln,tnItVoo'
51111 liP Cod,
PA
17013
V.. No
...","""'"",,
'Y.I'Mflno'cf1~
'joJlJt 1M or tfldx.
)'OINt.fund
Carlisle _
~ Do you want $3 to go Ie this lundl . " . " . . . . .." ., . . .".
If a 0ln1 return does our S ouso want $3 to 0 J2...!t.!.s flJld? ,
1 Single
Z Marrlad filing JOint return (evan If only one had Income)
3 Married filing sepwate return. Enter spouse's SSN above & full name here ..
4 "ead 01 hDusellDld (with qualifying person), (See instructIDn..) II tile qualifying parson I. a child bul not YDur
dependent, enter this child's name h~r8. ....
Quail in widower with de endent child ear souse died.... 19 ee Instructions,
YourHIf. If your parent (or someone else) can claim you as 8 dependent on hiS or ] No,""lI" r-l
her tax return, do not check box 6a - L~~i." ,. L-_JJ
S OUS.", """'" """",. '" No,04yoltr
(4) No of i:"t.':' III
menthsllY'" . I...'
in)'OlJrhome "Ulro', ,
In 1997 . "10th.
.WO......
_Me' Of "'..-
--1,...1...
III.tn~o".)
5
61
b
c Oopondonl.:
(2) Derendenl's
socia security
number
(3) Dependent's
relationship
10 you
CJ
CJ
CJ
(1) Flr.t name
last nama
..........
olll...fc
lIot....~.
.....
A.........
....rM"
"",..IiIIHINw.. ~
d T atal number of exem lions claimed,
7 Wagas, saiarles, tips. otc. Mach Form(s) W.2.
h TIlCAbI. intarest. Mach Schedule 8 If requir<d
b T....'.mpt interest. Do not include en lI"e 8a
9 Dividends, Mach Schedule 8 If required .,
10 Taxable refunds, credits, or offsots of state CiI1d local income taxes (see Instructions)
11 Alimony recBl'yed ,
12 BlJslness income or (loss), At1ach Schedule Cor C,EZ ,
13 Capital gain Of (loss), A"ach Schedule D ...., .
14 Otllar gains or Oossas). A"ach Ferm 4797 .. ,., ,..
15. TDtallRA dlS~ibutions . . . ... Lli!1 I b Taxabla amount (sea In.trs)
16. Tolal pllImons and annuities ."" [lli] .. b Taxable amoun1 (see instrs)
17 Reotal f..I..I't~ roy,lIles. parlnorshlps, S corparalio"" trusls. etc. Mach S<hadul. E . . . . . .. . ,.
18 Farm Incoma or (loss), Allact. Sclledule F ,.
19 Unemployment compensation, , . , , , , ' , , , , , , . . , , . , ' , , , , , , , , ' , , , , ' , , , , ' , , , ' , , , , , , , , ,
:roo 5oolals"ullly b...I,1s .. .. Lful 1 ,llij b Taxable amount (see Instrs)
21 Other income, List type and amount - sea Illstructions
7
h
3 657.
........U!!]
1.lJOB .
9
10
11
12
." 13
14
15b
16b
17
18
19
:rob
267~
7. 061.
1,551 .
1 156.
289 198..
31
.. 32
289.198.
Form 1040 (1991;
FOIITl1~.ll.!l97)
To
Computation
If you want
tho IRS to
flgur. your
t8)(, see
~tlons,
Credlte
Other
To..
Paymente
Attach Forms
W-2, W-2G,
and 1099-R
to p.ge 1.
Refund
H.ve It direclly
deposited! See
Instructions and
fill In 6.'2b, 620,
and 62d.
Amount
You Owe
Sign
Here
Keep' copy
of this return
for your rocllrds,
Pllid
PrepaNr's
Use Only
60 Add lines 54, 55. 56a, 57, 58, and 59, These are YOllf
totalDlvments",,",..,'" ' ,.", ',.""'1"...
.1 If line 60 IS more Ih..llne 53, subtraclline 53 from 1",60. ThIS is I'" amounl rou 0vtl1>111 ........ . . . .
62. AmoLl1t of line 61 you want R.llIndodto Vou. .........
.. b Routing number , c Type: 0 Checking
.. d Account number. . ____
65 Amounl 01 line 61 u wanl A Ifod 10 Your IIIH,tlmlt.HIl . ... ~ 63
64 If line 53 Is more Itl.n lino 60, subtract line 60 from lin. 53. This Is Itl. Amount'Vou
awe. For details. on haw to pay, see Instructions, . , , ,,',' ,,' , " , " , , , ,,"""', " ., , ",.. 64
65 Estimated I.x enall . Also ,nclude on line 64 . . 65 4 176.
UIldef p.natlln tit pefjury, I dfld.,1 lh.t I hive IKlmiMd flil filum 1M Iccomp.ny!no lCh~t.. .nd It.llenlef\b, Ind 10 Ihl btlt of ,nv knowI.. .nd
belief, !heV .,.lNe, ton.,l, end compl'le DKI.fllbon 01 pr,p;l1Ir (otl.r "an taxpayer) is N11ed on lllllnlofmlUtm DI whlctl prepam has allY 1lnCM'Itdge,
You, Signalurlt Oa. ~'OUI Oc:cupation
Frank l. WilI1ams
S! ~m"l ~om lin. 32 (adJusled g,,;;;I,,como) . . . .
114. Olock II [g]y.. WOI. b5/0Id.., U BI"d, 1.1 s,.... WI,65/0Ider,
Adt1ltlO numhol of bm(es chuckod nbovo nnd flntftr tile loll'll hftre
[~JBhnd .
~ 114.
b If YOllwe l'nNllnd fIling snpar 1tlely and r,our. spouse ltemlles (1educllons ... ....b 0
or you wert ft dUl1I.Glafus $11811, SRB Ins rucllons uad ctutck !lorD .. , , " ' ~
1I5 r~" ~"omlltd dod...lIo"" ~()m Sch.clulo A, line 28, Or }
I..... 510nd0rd deduction shown ~elow lor your filing status. But
of seft the Instructions It you checked any box on line 34a or 34b
your: or someone c"n claIm you as 8 dopundont.
. Slngl. - $4,150 . Merrled filing JOInlly or Quelifylng wldow(er) - $6,000
. Hoad of hous.IlOld .- $6,050 . Married ~llno .eparalely - $3,450
" Subtract line J!:i frorn 11118 33 ,
!7 1111", 3J " ~.iKIO OIt.." multiply $2,650 br I'" 10111 numhor ot_plion, cl.imed on line 6d. If 1m. 33
"over IOO,iKIO, ,.. the workshoot in Ih. ",Irutt,on, 1011'" amount 10 ent.. ..
sa T...bl.ln.om.. Sublract lin. 37 Irom line 36. IIltn. 37 Is more than IIn. 36, enter .0.
!II T... See ",I.. Olock II any Ia>< from . Of01m(l) 8811 b ~ 1972 ..
40 Cred,1 for child and dependenl cllfe OXPlllIOS. Al\ath form 2<<1 40
41 Credil for Itle elderly or the disabled. Att.ch Sch R 41
4Z Adopbon cred,!. AUacll Form 8839 ... 4Z
43 Foreign tax crodil. Attach Form 1116....................... 43
44 Other. Check If ~om. ... B Form 3800. b DForm 8396
. 0 Form Bool d Form (specify) 44
45 Add I,nes 40 ~"ough 44 ............. .. .. . .. . .
46 Subtract line 45 ~om line 39. If Ilno 45 Is more than IIna 39, en.r .0. . ...
47 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . .
48 Altemal,ve minimum ta><. Attach Form 6251
... SS "'" Medicar. tax on lip mcome not reported 10 ...plo",. Att",h Form 1137
50 T"" on qUlllfied rel,,"'''ot plan, (meluding IRAs) and MSAs. Attach form 5329 if required ..
51 Advance eam.d Incom. credit payments 'rom Form(s) W.2
52 Household emplo~ent t..es. Attach Schedul. H .....
53 I\ddlns46.52.Thillllourtotlllll. ............
54 FtJderallncomo tal< withheld from Forms W.2 and 1099 '
55
....... ,.... 45
~46
47
48
...
50
51
52
.. ~ 53
54
1997 astlm.ted Ill)( payments .nd amount applied
from 1996 rotun ... . . . . . . . .. .. .. . . .. . .. .. .. . .. . .. . .
56. Eomelln_ CltItR. Attach Schedul, Ele if '"U have a qualifying
child. b Nontaxable earned income: amount ....
..dill'" .~______.________________
57 Amount paid wlltl Form 4868 (requosllor extanslon) ...... .
58 E.coss social secunty and RRT A tax withheld (see instrs)
59 Otho, payments. Check if from. .... 0 Fo,,,, 2439
b 0 Form 4136 .
55
560
57
58
59
",,,,,,,'"
o Savings
~
5poU..1a Stgtl'\UI,1'1 Joln\ RIlum, BOTH Mual Slon,
~
o.1tI
Retired
SpOOl.'. Oc:c:up.bon
Oala
Prep.,...', ....
51,...lut. ,..
Chtcklf
,llll..m 10
04/13/98
Hartson Deardorff Williams & Otto
~ JO east Hi!\ll2!..reet
Carlisle
E'N
PA lIP Cod.
Flrm'IlNama
(('lryDU~ il
..ir'.mployed)
and Add,."
fDlMI12 12fJOflJ7
429-82-8243 PageZ
3., .289. 198,
!II
5 150.
36
284 048.
!7
sa
~!II
O.
2 4 4.
76 336.
76.336.
1 178.
77,514,
~
61
62.
Pr.p.,..r', SDci,,1 Seeo.ltity No,
23-~.002197
17013
Form 1040 (1997)
~
"
~
ii
I.
II
II
I
II
I
-.J PA 40 -1997 '17001.11017 L
Pennsylvania Income Tax Return
CommOrfNlt~th 0' P,nnlvlvanll P'A D,p.limenl ')1 Rev.nuI
Fiscal YON bB Innln and nndln
~2IHI2'-6243 WI A 0 fV 0
8 0 RS R
WIl.LI i\MS FRANK L AC 0 fS D
ONE LONGDORf WAY PN
CARLISLE PA 170B SC 21&30
],A .00 18 .00 1C .00
2 2343.00 3 5b7b .00 4 2153 .00
5 2b4&70 .00 5A .00 b .00
7 11500 ,00 & .00 'I 2&b542 .00
10 .00 11 2&b5'.2.00 12 6023.00
--------------------------------------------------------------------.
Pleaso lold pago along this llna
Fis.cal year filers, mark thiS spaco,
If this Is 011 ....""dld
return, mark this space.
Option 'or . 1!lO8 Booklet. II you do not want a
1998 tax booklet next year, check hare. II you paid
2l preparer, ask if he or she Is using this option,
Daytime Phone
Number:
429-82-8243 WI
WILLIAMS
FRANK
l
ONE lONGOORF WAY
CARLISLE
PA 17013
l...II.'.....tloo. Enl., whore IOU lived as.f December 31, 1997.
County: Cumber 1 and
Municipality: South Middleton
Type Filer. Check only one box. SchooIDlsU'lcl: South Middleton
S Single F Final
M MallIed Filing J Married Filing Jointly School Dlslrl'" Code: 21830
Separ.tell
o X Deceased Date 0' Death: 02/16/97
Residen'l Stelll..
DIeck .nllone bo.r.
R
""
P
Ir.m:
to:
X
Resident
Narvesldent
Part. year resident
SSN, N.... or Addns. C1MiItI. It ,.., 01 the abow inl.rmll... 100 enlored I. dHfer.nl from your t99Ei PontlSlt<onil
tax return or the lebel, end H IOU did n.1 file . 1996 PennsylvaniA I" relurn, check this bo~
1. Gross Pennsy1varlia taxable compensation ~om W.2 forms and other wage stalements
1 b Umelmbursad employee business expenses from PA Sd1edule UE
1. Net Pennsylvania taxable oompansatlon. Subtract line lb ~om 10 . . . . . . .
2 PerY1sy1vanla taxable interest. Complete arld .lted1 PA Schedule A if over $1,000 ..
3 Perv,sylvanla taxable dividends. Complete and altach PA Schedule B II over $1,000
4 Net income Dr 005S) from operation of business, profession or farm,
5 Net gain or (loss) ~om the sale, exchange or dispOSItion of property .
50 Amount 01 g.ln excluded (110m PA Sch.dule PA.19) .
6 Net Income or (loss) ~orn rents, royalties, patents and copyrights .
7 Estate and trust income,
8 Gambling and loitery winnings. .
1.
1b
1.
2
3
4
5
50
6
7
8
.00
.00
.00
2,343.00
5,676.00
2.153.00
264,870.00
.00
.00
11 , 500 .00
.00
286,542.00
.00
286.542.00
8.023.00
9 T ol., Gross r'tIn.yIVlnl"Ulblt 111<..... Add the 111<...1 ""..nil !rom line. Ie, ~ 3, 4, 5, 6, 7 and 8.
Do NolSubtr.ctAny (los...)Reporlld onLlnas4,50r6................ ....... .. ....... 9
10 Contributions to YDur Modlc.1 S.vlngs Account (sa. InslnlCtlons) . 10
11 Net PeMlylvania TAXlbt.lncom.. Subtract line 10 lrom line 9, . " , " ..", 11
12 Tot.1 rIM.,,,...I.... lI'blllty. Mulllply linen bl 1.1% (O.Oll). Entlf lour I.. duo he" ..~ on..!!'!! 11, ,.,. 1 . 12
L
...J
9700111017
P.6.IA0412 12105/97
'1700111017
-I PA 40 - 1997 '170021],015 L
WILLIAMS fRANK L 42'1-t.2-1l243
13 8023.00 14 .00 15 .00
1b .00 1 '7 .00 18 .00
1'1 .00 20A 20B .00
20C .00 21 bO .00 22 .00
23 .00 24 .00 25 .00
2b bO.OO 27 7%3 .00 28 .00
2'1 .00 30 .00 31 .00
32 .00 33 .00 34 .00
35 .00
13 Tot.. penn.ylv.nl. t..lI.blllly.
Entor your tax due from Ilnt'f f2, paga 1 , .
14 Totnl Pennsylvania tax withheld from W.2 forms, . . , , , " "
15 Credit from YOllr 1996 Pennsylvania Income Tax Return
16 1997 estimated Installment payments.
17 payrnent made with your roquast 'or an extension of time to file your 1997 PA,40.,
Llno 1B I. fornonreoldenl p.mon, .h.raholden and members only
18 Tax willlheld as reported on your PA Schedllle(s) NRK.'
19 ToliII II.. withhold, p.yments and credlls.
Add lines 15 througll 18..,..,......".,
LI".. 20.. b and c era to list Infonn.llon from PA Scheelul. SP
20. Depondents, Pert S, line 2 '
lOb T olal eligibility income. Perl C, line 11
2Gc Till< forgiveness creditfrom Part 0, Une 16 ,
13
14
15
16
11
8,023 .00
.00
.00
.00
.00
lB
.00
...."....,....... 19
.00
20.
20b
20c
.00
.00
21 Total credit for taxes paid to other states or countries,
Mach your PA Schedule(s) G or PA Schedule(s) RI(-1 ,
"J2 PennsYlvania 'llmployment Incentive payment credit.
Mam PA Schedule(s) W or PA Schedule(s) RK-l or NRK.l
21
60.00
22
.00
23 Pennsvlvania lOb Cfe2ltion tal< crl:ldlt. Attach your certificato of credit from the Pennsylvania
Deparfment 0 Community and Economic Development or PA Schedule(s) RK.l or NRK.1 """ 23
24 Pennsylyanla wasto tire recycling investment tal< credit. Attach your certificate of credit from the
Penns,;vanla Deperbnent of Envhonmental Protection or PA Schedule(s) RK.' or NRK.l ,..".. 24
2S Pennsylvania researcl, and development tax credit ' , , , , , , , , , , , , , , , ' ' , , , , , , , ' 25
26 Total payments 1lI1d credits, Add h"es 14, 19 and 20c through 25 26
XI Tax DlII. If line 13 Is more thatlline 26, Entor tile difference here, ' . . , , , , , , 'D
28 Ov.rpaymanl. 1I11"e 26 is more Ihan IIOe 13. En\er the dlllerence here, 28
29 Relund - Amount of line 28 you want as a check mailed back to you , 29
30 Credit .,. Amount of line 28 you want as a credit to your 1998 Estimated Tax Account. , 30
81 Don.tlon - Amounl of line 28 you want to Vlv. 10 Ihe Wild Resoun:. Con..rv,"on Fund. . ' , 31
S2 O...Uon - Amou"lof I", 2i 1<>0 wanllo 91.. to tlm U.S. Olympk Com.."t.., ,,,.'jlY.nl. Dlvlllon , , S2
33 Don.lh.. - Amount of line 28 you want to Vlv, to the Oro.n Don... Awar.n... Trusl Fund. 33
34 Don.tlon.- Amount of line 28 you want 10 Vlv. to the Ker.aNl.tn.m Memori.I, Inc 34
35 Don.tion - Amounl 01 line 28 you want to Vivo to Breast and Corvlc.1 C.nc.r n....rch ' 35
Th. tolal 01 II,," 29 throuoh 35 musl .Qu.lllne 28.
"._.IlI). Under pW\Altln III plrjury, I d<<:larl Illt I hav.. IlClminld th\$ r.tult\, includin\j AN Kcomp.nyl~ schtocM., .nd llal.menb, and to'" bast of my (Wf) M1i.f fl-v .r. ttv.,
coolCl.nH cDmpie~,
"rour::>lgnllLlr. ~ lJa~_.'-- YflllrQC(llpallun
Retired
.00
.00
.00
60.00
7 , 963 .00
.00
.00
.00
.00
.00
.00
.00
.00
'Sj)OIIIe', S.~n.-.n
Da"
"SjlouUlIuccUPlllort
Pi'ipa"'M con\pln~ Mml,OJi',r ~.!!,. t.IlPlyef(l), bOIled on _n ml1.mnallon 01 'o'o'tllth !fie prepari'ilu'I "1V KnoWIedQt
JJreplfltf 01' Comp.")' Namt (pl.." pnnt)
Martson Deardorff Williams & Otto
10 east High Street
Sarlisle
Dale
llflpnonlll Number
''''''~i~'~
17013
04/13/98
(717) 243-3341
L
';700211015
PAlA0412 121051'.)7
'1700211015
.....J
".
LAST WILL AND TESTAMENT Of' FRANK L. WILLIAMS
However, Iny personal representative need not aocelerate and pay
those unmatured obligations which, in his, her or its opinion, it
might be proper and more advantageous to retain or renew and pay
as th~y become due and payable. I authorize my personal
representative, in his, her or its sole discretion, to utilize my
burial plot and to engrave the marker in place appropriately, and
to expend sums from my estate for this purpose.
3
I give, devise and bequeath the rest, residue and
remainder of my estate, together with all insurance proceeds
thereon of whatever natux'e and wheresoever situate, as follows:
A. One-Half (1/2) of my remaining estate to my son,
WALTER rORD WILLIAMS. Should my son predecease me or die on or
before the sixtieth (60th) day following my death, then I give,
devise and bequeath his share in ~y estate together with all
insurance proceeds thereon of whatsoever nature and wheresoever
situate in equal sha4es to his children who survive me by sixty
(60) days per stirpes.
B. One-Half (1/2) of my remaining estate to my
daughter, LINDA WILLIAMS HBRSPERGER. Should my daughter
predeoease me or die on or before the sixtieth (60th) day
following my death, then I give, devise and bequeath her share in
2
'j
LAST WILL AND TESTAMENT OF FRANK L. WILLIAMS
my estate together with all insurance proceeds thereon of
whatsoever nature and wheresoever situate in equal shares to her
children who survive me by sixty (60) days per stirpes.
4
I grant my personal representative the following powers
in addition to and not in limitati,on of such powers as my
personal representative shall hold by law:
(a) To retain all property received inclUding the
stock of any corporate fiduciary acting hereunder,
provided such property remains productive.
(b) To join in any corporation, partnership,
recapitalization, merger, reorganization or voting
trust plan; to delegate authority with respect
thereto; to deposit investments under agreements
and pay assessments; and generally to exercise all
rights of investors, including but no limited. to,
'the voting of shares.
(c) To manage, operate, repair, improve, mortgage or
lease on any terms any real estate held or owned
by my estate,
(d) To operate any business that I may own at my
death.
3
"
LAST WILL AND TESTAMENT OF FRANK L. WILLIAMS
(e) To invest any funds of my estate in any stocks,
bonds, notes or other securi.ties or property, real
or personal, without reqard to the principle of
diversification or any other statute or general
rule of law in his, her or its absolute
discretion, it being my intention to give my
personal representative the broadest investment
powers possible, providing such investments do not
unnecessarily prevent the prompt settlement of my
estate.
(f) To sell or otherwise dispose of any property, real
or personal, tangible or intangible, at any time
forming a part of my estate in any manner and on
such terms and conditions as my personal
representative shall see fit in his, her i.ts
absolute discretion.
(g) To borrow money for the payment of taxes or for
any other proper purposes in the administration
'of my estate, and to mortgage or pledge estate
assets as security.
(h) To compromise claims without court approval
inClUding, but not limited to, any controversies
with the United states of America or the
Commonwealth of Pennsylvania concernJ,ng estate and
4
.'
.
.'
LAST WILL AND TESTAMENT OF FRANR L. WILLIAMS
beneficiary have the power in any manner to charge or encumber
his interest either in income or principal, nor shall the
interest of any beneficiary be liable or subject in any manner
while ,in the possession of my personal representative for the
liability of such beneficiary.
6
I nominate, constitute and appoint my son, WALTER F.
WILLIAMS, as Executor of this my Last Will and Testament. In the
event my son, WALTER F. WILLIAMS is deceased, unable or unwilling
to serve or shall cease to serve for any reason whatsoever, then
I nominate, constitute and appoint my d~ughter, LINDA WILLIAMS
HERSPERGER, as personal representative of this my Last Will
and Testament. I direct that my personal representative shall
not be required to give or post bond for the faithful performance
of his, her or its duties in this or any other jurisdiction.
7
I hereby declare it to be my expressed desire that my
personal representative employ Michael J. Hanft, Esquire of
Cumberland County, Pennsylvania, for legal advice an~ assistance
regarding this my Last Will and Testament, he having considerable
6
. ,~
J
f
j
j
J
j
I
I
i
I,
,.,
"
..
LAST WILL AND TESTAMENT OF FRANK L. WILLIAMS
knowledge or my arrairs, views and wishes respecting any matter.
that may arise at the probate or this instrument, the
administration of my estate, and the exeoution of the powers
herein mentioned.
,
IN WITNESS WHEREOF, I
my Last Will and Testament this
1994.
set my hand to this
day or December,
WITNESS:
~~~
Frank L. Will am.
.
'j',
7
.. - ,.........--..'
'",.""
,~~- ..,---
~.....,~
\
/ c~) / fr; 'i /
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERlTANCE: TAl( DIVISION
DEPT. 260601
HARRISBURG, PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESS"ENT OF TAX
08-31-1998
WILLIAMS
02-16-1997
21 97-0191
CUMBERLAND
101
[- __~-_~M~I.~~Jt~ _.-1
MAKE CHECK PAVABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORT'ION FOR YOUR RECORDS ...
REv:i547' EiCAFii-fii9-': 97"j" iiiii'"icE"-OF"YNHEiiif ANCE- YA"x-iiPPRX iSEMEii'r; -Ai.i.-owANcnili --- - -------- - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESS~ENT OF TAX
FRANK L FILE NO. 21 97-0191 AtN 101
DATE
ESTATE OF
DATE OF DEArH
FILE NUMBER
COUNTY
ACN
MICHAEL J HANFT ESQ
TEN E HIGH 51
CARLISLE
PA 17013
ESTATE OF WILLIAMS
TAK RETURN WAS: I X) ACCEPTED AS FILED
Ri9ERVATION~ERNING FUTURE INTEREST - SEilREVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. H..l Estat. (So~dul. A)
2. Stook. and Bond. ISoh.du1. 0)
5, Closely ",ld Stook/Pert~,..shlp lnt.r.si: (Schedule Cl
4. Horta.ges/Notes Reoalyablo (Sc~dul. nl
6. Cash/Bank Daposlts/"isc. Personal Property (Schedule El
h. Jointly Owned Property (Schedule f)
7. Tr'w".:fers (Schedule G)
8, Total Assets
1 CHANGED
III .00
(2),. 881.098,7L
(3)_46.545.52
141 ,00_
m 167.884.85
(6) Il~19.40
171 119.000,00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Exp.n..s/AdM. Costs/HiRe. Exp.nsa~ (Schedule Hl
10. Dabto/lIol'to.go U.bIlIH../lion. ISch.du1o I)
n. Toto1 D.duoHon.
12, ...t Va lye; of Tax Return
13. CharltebleJQovarnmuntMl Bequests; Hon-elftct.d 9113 Trusts (Sche~Jle J)
14. N.t Va),ua; of Est.t. Subjant to rax
If an asseSSMent was issued previously. lines 14. 15 and/or 16. 17 and 18 will
reflect figures that include the total of AL~ returns assessed to date.
ASSESSMENT OF TAX:
16. A.aunt of L in. 14 at Spousal f,.t.
l~, AMount of L10* 14 taxable at line.l/el.55 A r.t.
17. A~t of line 14 taxable at Col1~t.ral/Cl.$s B r.t.
18. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
05-~4-1997
11-17-1997
05-13-1998
NOTE:
RECEI~T
NUl10ER
-AA211302
AA242468
AA270073
DISCOUNT (. I
INTEREST/PEN PAID (-I
1,740,00
.00
247,15-
(9)
(10)
47.361.28
l~*
UV"1i47 U UP l"",n
FRANK
L
270.50!L.ll.
(11)
(12)
(13)
(14)
1151_ .00 X . DO,
11.61_ 1,005,982.98 X .06=
(H) ,00 X .15=
A"OUNT PAID
33.060,00
20,000.00
5.806.13
DATE 08-31-1998
NOTE: To insure pr~r
oredit to your ~oount,
....Ib.! t that upper portion
of this forM with your
tax Plly...nt.
1,323.848.48
317.865 'in
1,005.982.98
.00
1,005.982.98
(18)
.00
60.358.98
. ,00
60.358,98
,om '" ",." .. . '50... _j
BALANCE OF TAX DUE .00
INTEREST AND PEN. 2 , 19
-~---~--
TOtAL DUE 2.19
----
I IF TOTAL DUE IS LESS THAN fl. NO PAY"~NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR I. YOU HAY IIF. IlUE
A REFUND, SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.)
BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-14-1998
. IF ~AID AFTER DATE INDICATED, SEE REVERSE
FOR CALCUI.ATION OF ADDITIONAL INTEREST.
[11:1'
\'\t.
.1
'98 l"lIb 21'\ f'? :Oll
Clt'lf
OUlnl)
"t!fl
1-(\
RE$ERVATtOH.
[,tat.. of deOedent. dying an or ~for' D~r 12, 1962 -- if 8nY futur' interalt In the ..tate II tran.f.rrld
In PO'Nldon or ..jo>,ltMt to Cl".. I (coUatllrlll ber~flcl.rle.of the cleOftMlnt aft.". the aMPlrlt10n of IOY ..tat. f<lr
11.. or for year., th41 Co~1I1th hll'ebY .xp,.....lv r...p.... tn. rioht to 8Ppr.i.~ Mld' ...... tr.".f.r InherJ.tlMMl'- 'anll
It the lawful ct... 8 (co11~t.r.l) rate on &n~ .uch future lntwrlllt.
P\I!POSE Of
MOnCE I
To fulfill tha rlqu;\r..lnh of SICtiofl 2140 of the Inheritance and f"tate Tax Act, Act 21. of 1996. (72: P,S.
SClction 9Ili(l).
Detach ttw. top portion of thh Hot1OQ and sublllH wUh yoor pnY.llnt to tt~ RIghttr of WIlls printed 0'fI the ...loIlr" 1I1d1.
--H". ohaek or .onllY order payable to: REGISTER Of' MILLS, AGENT
PAYMENT I
OBJECnOWSI Any p$rty in Intar..t Mt uthfled wIth thCll IJPprah8l1ant, IIIl0waneB or dh~l1owllnc" of dlllt\.lotions, or .,.....-nt
of tftx (In<:ludlng dhcount or int.rest) as show" Ml thts Notice .ust objeot within alxhl (60) days of rec:(lipt of
thh Motioe by:
A refund of a tlllX Cflldlt, which was not requaded on th9 T8>\ R~turn, !laY bill f'yqtJllltt.d by OOllPleUng en "APJlJ IC8Uon
f(H' Refund of PfIflf1sylVArda InherltaMIa and f.stete T.x" (REV-1315). Appliollltions ar.- ..Itillabl. .t the Offlc.
of tn. R.gi.ter of WIIID, any of the Z~ ~eYllnu. Distrlot Offioelt, or by oalllng tho wpecltil Z4-hour
lIt'\.wQrihg ..rvloll nuaber. for for.s ordllrlngl In PeMS!I'lVltnio I-aoO-!i62-20S0, outtld. P.nnlly1venlll W\d
within local Hat'rhbUrg tlre8 (7171 7ft1-6094. TDD' (717l 7'7?-l2f,Z (Hoaring IltPfllr.d OnlY).
REFUND (CR) I
--written prot..,t to the .-A DapartllClnt nf RllvenUQ, Board ot APpeals, Dopt.. ?lHOn, Harrhburg, PA 11128~IOZl, OR
--election to heve the lIatter deterMined ut oudlt of the account of the perRonel repr.llent.t1vA, OR
--appaal to the Orphans' Court.
ADt1IN
IS'fAATIUE
CORRECTIONSl
FIlIOtU81 error II dhcov.red on this 8nlUiSIIllnt IIhould be oodr9.luld in writing tOI PA nepartMlloI1t of R.loIenut',
Bur.au of Inulvidufll Tnxu, AnNI Post AIOiseS5I!4mt R'loIiew Unit, nep\. ;':60601, Harrhburg, PA 171'l8--0601
Phone (117l 187-6505, S.. pllllle fl of the bo04dot "Instructions far InherUrlnee lax Rillturn far III Resident
D~ed~t.. (R[V"lSOl) for an Qxplrlnat!on of adldnhtr.Uloleh' am-rentable errorll,
If BlW tax due is pald wUtdn thr'"~ (!i) (',altmdel' Ilonths aftor thll d.tlo)(ient's ~ith, a fi..... paf'c:,e"t (5:0 dhoount of
the talt peld is allowed.
The 1.5.:( ta..: ......,h non-parUeJipllUon penalty ill coapu1:oft on the tabl of the hlx GOd inter..t .....n.d, and not
paJd b.forll JtllnuI'lry 16, 1996, the flrllt deyafter the and of tho tax unesty periOd, Th15 non-participation
penalty Is apf-lll~lllble in thtl fllll.' lI.nner ftfld in the th\l salla time period flit; ynu ",\)Old appeol thla tax aod lnter.st
that has ba.n .",e..ed as indiaatad on this noUc".
IRt.r..t ill ollaroad beginning with fir..t duy Df delinquerY.lY, 01' oln" (9) Itonthll and one (1) dey frOll the dflte of
~athl to the date of pay...nt, Taxu Which bMHIiI dellnql.Hlnt bllfor. January 1, 1982 bear interllst at the rillte of
IIlx (fiX) peroant p.I' llIlm. Clllcuhted at Il dailY rata of ,QQOIM. All tax... whIch ueOMle delinquent on .nd .,ft.r
January 1, 1\l8Z will benr interest at a rate which will vary frOll oal.ndllr yeer to calendar yaar with thrlf;: rat.
ewmouno.d bY the PA Ilapart..ot of Revenue, Tho "Ppll.cahle intorut ratQII for }CJ8Z thf'ouoh 1998 are:
'!!.PI !!It!fut Rete !!!.lll..Interest ractor W.! Int9rrllt Rnt" !!!.!.!y lrlterest fa(1tor
1982 ZOX .000!i4B 1987 9r. ,000247
lfi8S 16X .0OCiltS& 1988-1991 11% ,000301
IIJ8lt Iii( .GOOlDl ''1'1' 9% ,00021\7
19B5 n:t .000356 1993-199lt 1i: .000192
1916 lOX .000174 l'iI)Sp1991 9X .OO02lt7
-~lntere.t 11 Cllllmllllted .. folloWS I
DISCOUKTl
PENAl TV I
INTEREST!
INTEREST. DALANct: OF TAX UNPAID X KUKDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
n~Y jrfQtlCtl hlued lifter the tlllX ~COllttS dfIllnqutmt will reUlfct an int.r..t Cllllculotlon t(l fifteen (15) daY'1I
bayond thtl date of thtl lIIIu",Hnl. If pey.ant ill Rade nftn the inhtrut oDflPuhtlon dllte shown on thtl
MoUo., ItdfHUooal Jnt.rut !lUst be ca1oulflt.d,
__Of
NOTICE 1
PAVtOfT I
RffUHD (CR) I
\'Ic,
\L
"
'91',
1)\ '.'./1
1\\\1.1 'iI',
G\~'I:
GUll'!
lr\
\'1\
To fulfill tht r",lr.-nts af s.otJon ,2:146 (b) qf ttM InfMtrltenoa and ElIte" Tak Aot, Aot 21 of 1995.
(12 P,S, Section 9145),
Datttth tM top porUon of this Notice -.d .ub111t with ~our pa~t to the Regllt.r of Milll prlnt.ct on thrrt
r.vana .Idt.
..~ KIka check or IIOM~ or~r payable tOl REGISTER OF HILLS, AGENT,
A refund of D tax credit HY be r.qu..tMl by cOIIpleUng an "ApplioaUon for A.fund of PennlylYlnla
Inharlt~ .nd Elht. hx" (REY-15UL ApplloaUon. ara alolallabh at the OfficI of th8 Aqhtar of WUls,
In)' of the 25 M.IoI~ Olstriot Offio., or fr~ th8 o.p.rtaent'lI 24-nour anlwer1ng ..rvio. nu.borl for for" ordering I
In P~'YIYanl. 1-800-S62-20S0, outllldl PtnnaYllollnia .,d within 10081 H.rrl.burg at.. (717)787-8094,
TDO' (711) 772-2252 (....rhlO Iapairltd Only).
OBJECTIONS: Any pllIrty in Int.t..t: not ..H.fl.d with the I!lUfi.lfttlt of tax .. shown on this notlCl' eay obJeot within
.lxty (60) day. of receipt of this Notic. bYI
--written prot.llt to th. PA Depart.'nt of R~loIenue, Bo~rd of Appeals, Dept. 2&1021, HarriSbUrg, PA 17128-1021, OR
--.lacUna tQ h111ol. tfM .aUar cs.ter.load I'tt audit of the per.onal r.pr...ntat1lo1a, OR
--appelll to th8 Orphans' Court.
ADHIH-
ISTAATIYE
COImECTIt'lHSI
PENAL TV,
INTEREST:
Faotuftl .rror. di.oolol.red on thiQ ....I...nt ~ld b. ftddr.,'1d In writing tOI PA bepert..nt of Relolenu8,
Bureau of Indllolldual 'axa., ATTNI po.t A....o-.nt R.Y!"" Unit, bept. %80601, Harrilburg, PA 17128~0601,
Phontl (717) 787'6505, ~ PIDI !i of the bookl.t "Instruotiooll for Inheritance Tax R.turn for a Ra.ldent
Decedent" (REV-1501l for an .~p1~tion of aa.lnl.tratllola1y correctable arror..
Th. 15;( tex ..,..ty non-partlolpaUoo ptlna1ty 11 oOllputed 00 the totlll nf the tIlIx and Inb.rallt ......ad, and not
paid bttfore January 18, 1996, th8 fJrfit day aft.r tile end of the tax unelty p.rlod. Thill non~part1olpat1on
penalty 111 app..leble In thG IUNln .lItlner and In the the .... U.. p.r lod .11 YOU would appeal the tax I8nd Int.r..t
that hall be.n .......d 811 indloaled on this notlo..
For d.t.. of ~ath on or after 10~~-91, Pann.yllolanl. Estete 'ax b..ed on the Fader.l Estat. lax
r.turn beCOMII delinquent at the .xplrllUon of nine (09) .onths frOl the d"t. of death.
For datu of dMath prior to 10'-3"91, Pannsy1lo1anl.. EIIt.te TIll< bued on the f.deral ElIItlllt. Tax return
b8ooaa. dalinquent at the explrpt!on of .Ight.an (181 ~th. frOl tho data of death.
Tex., which b.~ delinqu.nt before January I, 198Z bear int.r.st .t the rat. Of ,Ix (6:0 p.roent per .."..
oaleu1ated at a dally rat. of .000164, All tal(e. whloh bee... de1lnqu.nt on or after January 1, 1982 will bear
!nt.r..t at . rate Mhlch wIll V."Y frOll calendar y.ar to cllIIMld.r year with that rat. announced by the PA
o.partaant of R.v.nue. The appllcabl. Interelt rates for 1982 through 1998 are,
Vellr Intere.t Rate Dally Inter..t Factor V.er Inter.,t Rate Dally In~.r.lt flOtor
--
198% ZOY. ,000548 1987 9Y. .000%47
1985 167- .000458 1988-1991 11;: .000501
1984 11" .000301 '99' .> .0002'17
19115 Ill:< .000556 1995-1994 n .000192
1'" 10;: .000274 1995-1998 .> .ooor/f7
--Inter..t I. Cllculat~ ., follC*1f
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINqUENT X PAILY INTEREST FACTOR
--Any NotlOG i..u.d aftor the tal( tMnOlHfIl delinquent will r.f1eot WI lnt.r'lt calcul.tlofl to flft..... (15) diy,
beyond the date of the ........nt. H pa)'MOt II .ada aft.r the int.r..t cotlpUt.Uon date .hOWfI on the
Notlce~ additional Interest aUlt be calculat.d.
PAYMENT I
Det~ the top portJon of thh NoUoe Met 1UblJ1t with )'our peYMnt ... p')flbl. to tM .... Md IIddr...
prl"t.t on tha rawr.. sld1i.
If RESIDENT DECEDENT uke ohIotc. or IIOMY order pay.tJ.. to: REGISTER Of WILLS, AGENT.
If HOH~RESIDf:HT DECEDENT uk. oMok ar IIOMY order pay_I. tOI COHttONWEAL TH OF PEtfrCSVLVANIA.
REFUND (CR) I A r.fl.lKl of a taM oredit, NhI"Qh wel not rttCflJ'ltert on thll Tax Rsturn, uy be reque.teet by oOllP..Ung WI
"Applloation for R.fund of PennSYlvania Inherltanc. ~ E.tata laIC" (REV-ISIS). Applioatlon. ar. ayell~l. at
tM Dffl~ of thai R....t.r of Willi, .,y of the n Revenut DhtriClt Offlo.. or frOll the Depart.."t'l 24~hour
Wlswrlna ..rvlo. nullber. for for., ordering: In PMn,y.v~la lh80D~562~20!i0, outsldti P..,.ylvanl.
IInd within looal ",rr..burll .rM (717) 787~8094, TOOl (717) nZ~2252' (H..rlng IlIPalred 00.1.11).
REPLY TDI
Gue,tJon. rlaPrdlna error. cant.hwd on th.. notJ~ should be eddr....d tOI PA Depert..nt of Revonue, Bureau
of Indlvldu81 TSlC'" ATTNI Po.t A.......r't R.vlew Unit, hpt. 280601, Karrhburll, PA 171ze,~0601, phone
(717) "&7~6S05.
DISCOUNT:
If .,y t.x due I. p.ln within thrM (!) calender ItOnth. .ftsr thll deoe$nt'. deeth, a fly. per~t (!)X) dlaoount
of thl taM paid II allowed.
PENAL TV,
the 15:< t.x .-nesh non~JNlrtlolp.tlon penalty II oaputed on tho tote1 of the bM end inter..t IIH.Md, Md not
paid before Jenuerll 18, 1996, the fir.t day afhr ttt. encI af ttlll t.x MM.ty ptIrl9d.
2NTERF.STI
Int.rast .. chllrged bellinning with Ur.t dlY of dI'unqu'fl(JY, ot nJne ('9lltOnth. end one O) dey frOll the dftt. of
dIIath, to the dlt. 0; P'~l't. 'axe. which beo.. dftUnqulnt bafora JlflUllry 1, 1'8Z be.r Int.r..t at the rata of
.Iw (6X) ~rcent par MlI'tUII calcullted .t II dally r.ta of .000164. AU tIM.. .....Ich beo.. dellnquant on .,., .ftar
Jenuerll 1, 1'82 wJ11 besr Int.re.t at . rata whloh wJ11 very fr~ calendar y..r to oa1enOer year with that rete
ennouno~ by the PA Depart...,t of RevlN'lW. The IIppllcllble Jntera.t rate. far- 1982 through 1998 ar'l
V.lr Intar..t RIta D.Uy Int.r..t Factor
Ve.r
Int.re.t Aab
DIIUy Intera.t hotor
1982 "X .000541 1987 OX .000247
,.., '6X .000~5I )9aa~1991 It:( .000501
'914 llX .00OSOI '99' 9~ .000247
,.., 152 .000556 1993~1994 "- .DOOl'2
'''6 102 . .00274 1995-1". OX .000247
u Interelt J. calou1.ted .1 fc1Jow..
IHTBRE8T . IALA"CE OF TAX UNPAID X "UHlER OF DAYS DRLI"QUENT X DAILY INTEREST FACTOR
~"Any HoUOI hllUMl Iftlr ttM tlM baOOH' cMlinquant w111 raUltClt an intll,..t o'lou1lUon to flft.." (Ui) deyS
beyond the deta of the ........nt. If pI)'tIlnt II ... aft.r thaint.r." C"putlUon dlt. shown an tM
NotlOll, Mdl tlonel Inter.st IN.t be ca1oulat.)d.