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Home My WebLink About01-2913 FX T....mm"'..'-'" .." 'w James W. Abraham, Esq, Abraham Law Offices 2157 Market St. CampHill,PA 17011 (717) 763-1700 E-mail: abelaw@comcast.net Atty. for Plaintifli'Respondent, Rosana Davis : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 01 - 2913 CIVIL TERM ROSANA DAVIS P1ainti:ffi'Respondent v. TWITTY G. DAVIS, JR. DefendantlPetitioner PLAlNTIFF/RESPONDENT'S ANSWER WITH NEW MATTER TO DEFENDANTIPETITIONER'S PETITION TO MODIFY OR TERMINAlE ALIMONY ...., AND NOW, comes P1aintiff/Respondent, Rosana Davis, by and througlr<'j..er ~ < ;;~ \~q ~ attorney, Abraham Law Offices, James W. Abraham, Esquire, Camp Hill, Pennsy1vaii>i;\j:and::;!': ~~',:::: U; ,_ 57 files the following: 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted, ..:.,:.. F" ~ -..; -< 5. Admitted. By way of further answer, DefendantlPetitioner, Twitty G. Davis, Jr. (hereinafter "Husband") is currently fifty-eight (58) years of age and the Agreement provides that when Husband is sixty-two (62), approximately three (3) years and four (4) months from now, on October 3, 2008, the monthly payment shall be $750, a reduction of$1,750.00 per month. '''1'J!'' 'I~ , '-'~I , , - ,- , ',r -n =.1':: o ...,., ....... ...,.- fil~ L-. ~'c.J -'--' j ~~.\~~ ~-~~ ~~ c);-ll -",1 2-~ ._L.I ..< r,) (,) "',.. ~ 4 " ~ - ^ ~='I~""A"'" ' 6. Admitted and Denied. It is admitted that the amount of alimony is modifiable if there is a "change of circumstances of a substantial and continuing nature." It is denied that the term and/or period of payment of alimony is modifiable, as said term and period of payment of alimony is permanent as stated therein. 7. Admitted. 8. Admitted and Denied. It is admitted that Husband's job with Bechtel required him to work outside the United States. It is denied that Husband only worked overseas with Bechtel as throughout Husband's career with Bechtel, which fust began in the late 1970's/early 1980' s, Husband worked primarily within the United States, including but not limited to, Washington state, Califomia, Georgia, Florida, Connecticut, Texas, New Jersey, Maryland and Louisiana. 9. Admitted and Denied. PlaintifflRespondent, Rosana Davis (hereinafter "Wife") admits that Husband worked in Iraq for some period oftline. Wife lacks sufficient knowledge or information as to the truth of the remaining averments in this paragraph and strict proof thereof is demanded at trial. 10. Admitted. I I. Denied. Wife lacks sufficient knowledge or information as to the truth of the averments in this paragraph and strict proof thereof is demanded at trial. 12. Denied. Wife lacks sufficient knowledge or information as to the truth of the averments in this paragraph and strict proof thereof is demanded a time of trial. "'~"'f"',,;, F"""'r""''''' ~ '! " ' 1 r ~ " - -" =, '"~""'" r - - -- -. .-----.-.. 13. Denied. Wife lacks sufficient knowledge or information as to the truth of the averments in this paragraph and strict proof thereof is demanded at time of trial. 14. Denied. Wife lacks sufficient knowledge or information as to the truth of the averments in this paragraph and strict proof thereof is demanded at time of trial. 15. Denied. Wife lacks sufficient knowledge or information as to the truth of the averments in this paragraph and strict proof thereof is demanded at time of trial. 16. Denied. It is denied that Husband can no longer afford to pay alimony at the ordered rate and strict proof thereof is demanded at time of trial. 17. Admitted. By way of further answer, the parties were married thirty-four (34) years, from November 16, 1966 through their date of separation, on or about December, 2000 when the parties were in Malaysia where Husband was working for Bechtel and they separated when Husband had an affair with a Malaysian woman, now Husband's current wife, and Wife never worked a full-time job or even part-time job during the marriage. 18. Denied. It is denied that Wife, age fifty-eight (58), is gainfully employed as Wife works part-time, approximately 26 hours per week at a hourly rate of $8.65 at a retirement home, Country Meadows of Hershey and in consideration of her age and lack of work experience after thirty-four (34) years of marriage during which she did not work, Wife cannot make a greater contribution to her own support as compared to the time of divorce, especially compared to her standard of living at the time of divorce. ""'-'''''''''~:<'''1'-~<<-''~-- , - ~ I "'1""--" ~. " - I' l' . , '1"l ." . ""Tmmilll~11Tr IIlIH"".""~~"~ """' WHEREFORE, Wife respectfully requests Your Honorable Court to dismiss Husband's Petition. NEW MATTER 19. Wife incorporates by reference her answers to paragraphs 1 through 18 herein. 20. There has not been a substantial change in circumstances of a continuing nature which would entitle Husband to any decrease of the $2,500 per month in alimony as Husband's Petition: A. merely speculates as to Husband's future employment and therefore Husband's claim that there has been a change of circumstances of a substantial and continuing nature is not credible and is purely speculative. B. Husband continues to work for Bechtel which has provided Husband with consistent employment, not necessarily constant employment, i.e., down time while waiting for another assignment, which has always been the nature of Husband's employment with Bechtel, and which employment has always involved work within the United States and outside the United States throughout Husband's ten (10) to fifteen (15) year career with Bechtel. C. Husband's alleged pursuit of other employment earning $60,000 per year and acceptance of such a position would constitute a voluntary reduction of his income and voluntary change of circumstances without a substantial change in his earning capacity. --~- l' -"' -", ''''1~- ~, ^ '-_0, ~ ,~"~- ~ ~~." '~"llll"fff"'f~~r ,,~ ' . 21. Wife believes and therefore avers that Husband simply does not want to travel any more in his employment with Bechtel and/or temporarily relocate during various assignments with Bechtel and wants to work locally in Florida where he resides, at a lower paying job with no travel; and therefore wants to reduce his $2,500 per month obligation approximately three (3) years prior to its automatic reduction to $750 per month when Husband reaches age sixty-two (62) pursuant to the Agreement. 22. Wife believes and therefore avers that Husband's Petition is not meritorious and is simply an attempt to accommodate Husband's current desired lifestyle and his desire to no longer travel and/or temporarily relocate by continuing to work for Bechtel. 23. Wife resides in a half a house in New Cumberland, Pennsylvania worth approximately $85,000 with a $63,000 mortgage, which she purchased with the $13,000 she received in the divorce from the sale of the marital residence (Husband received $60,000); she has a car worth $2,500 and has $47,000 from receiving one-half of Husband's IRA and Wife submits that Husband is not entitled to a decrease in alimony any more than Wife would be entitled to an increase in alimony. 24. The Agreement provides that Husband receives the full tax deduction of all alimony paid and Wife must claim said payments as income which is a fInancial benefIt to Husband and detriment to Wife as to taxes and overall. "'~I~" _f' ,--',,- ,,' r. " . ~~ .- . '" 25. Wife believes and therefore avers that the intention of the alimony provision in the Agreement and the amount and term of alimony stated therein was predicated upon the significant income, salary and earning capacity of Husband and the lack of accumulation of significant assets over thirty (34) years of marriage despite said income and therefore it is inequitable to reduce the amount of alimony for the reasons stated in the Petition. WHEREFORE, Wife respectfully requests Your Honorable Court to dismiss Husband's Petition and award Wife any other relief the court may deem proper, including but not limited to, attorney fees. Respectfully submitted: ~ ::.... James W. Abraham, Esq. Abraham Law Offices 2157 Market St. Camp Hill, PA 17011 (717)763-1700 Attorney for Plaintiffi'Respondent, Rosana Davis DATE: 6/15/05 '-:!'T '"'''~I'''~' c '1-"; ,~, , , 1 . ~._~ , . VERIFICATION I, (ZOS 74t.u4- ));4-1/1 r , the undersigned, hereby verify and confirm that I have reviewed the foregoing document and the statements made therein are true and correct to the best of my knowledge, information and belief. I further understand that any false statements made herein are subject to the penalties ofl8 Pa.C.S.A. Section 4904 relating to unsworn falsification to authorities. DATE: / G - { 3 -u '7 Ci< 0--4AAA\~ C/ cW;;-' ~'~"'''!'~. '0"",," ~1 ~ 'f ~~ f~ - "~ '-0 "' o~ . - ROSANA DAVIS, PLAINTIFF/RESPONDENT : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA V. TWITTY G. DAVIS, JR., DEFENDANT/PETITIONER : 01-2913 CIVIL TERM ORDER OF COURT AND NOW, this ~ day of May, 2005, a hearing on the within petition to modify or terminateli\llimony shall be conducted in Courtroom Number 2, Cumberland County Courthouse, Carlisle, Pennsylvania at 1 :30 p.m., Wednesday, June 15,2005. /~~ ' BY,!pe Court, / C f Nichole M. Staley O'Gorman, Esquire For Petitioner Rosana Davis 409 4th Street New Cumberland, PA 17070 ~ .~ 5-~-~ 9-. :sal '-'~"-' - ::]"--".", ~<^"---,,9 f"_ "" .""""--',,,7'_",~,__,,,,,,~,,,,,,,~~~,_.~o_,.,,,,,,,_ _,_~~_~.~~, ~iq ~ \- 1..D~ ,'),,"':: ~C} tt?~ ~::J () 'so: \1.\0- \:.J w:~ 1==: U'~ o N o .- ~...) :c 0... ?: t!,:;~ N '- ~~ ::c.C \!6 = c.... ~"~ .0'_ ,"0,. __, ._~"" ,,~, _.~~","',~,,''',;.''" "";-""""~_ - . " ~'T'i1~_IIllJ~Tll'lii ~ ,_~~~~~l!\j:;'}'I~~W~III'i,1.<;O'fii",!-~f;~iIcl{"l~~~~I!\!lUJ~~!1\!!i Nichole M. Staley Q'Gorman, Esquire ID #79866 PURCELL. KRUG & HALLER 1719 North Front Street Harrisburg, PA 17102 717234-4178 nstalev@pkh.com ROSANA DAVIS, Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA v. : No. 01-2913 Civil Term TWITTY G. DAVIS, JR. Defendant : IN DIVORCE : CIVIL ACTION - LAW PETITION TO MODIFY OR TERMINATE ALIMONY AND NOW, comes Petitioner, Twitty G. Davis. Jr., by and through his attorneys, Purcell, Krug and Haller, and files the following Petition to Modify or Terminate Alimony: 1. Petitioner is Twitty G. Davis. Jr., Defendant in the above captioned divorce action. 2. Respondent is Rosana Davis. Plaintiff in the above captioned divorce action. 3. The parties were divorced from the bonds of matrimony by Decree of Court dated December 27, 2001. 4. On the same date, the parties entered into a Matrimonial Settlement Agreement (hereinafter "Agreement") which was incorporated in the final Decree. 5. Paragraph 16 of the Agreement provides for a present alimony payment of $2.500 per month to Wife. The pertinent portions of the Agreement are attached hereto '''''-~''''''"=''~I- ,. ~ " 1 1''''''' l'.< ' ~.',_. _,""W&_~_,~ and made part hereof as Exhibit "A". 6. The Agreement provides that alimony is modifiable upon a showing of a change in circumstances of a substantial and continuing nature. 7. At the time of divorce, Husband was a contract manager for Bechtel earning in excess of $134,000 annually. 8. Bechtel is an engineering, construction, and project management company which provides its services around the globe. Mr. Davis' position required him to live and work outside the United States. g. Most recently, Mr. Davis was assigned to a project in Iraq where he was earning $176,800 annually. 10. Given the ongoing war in that country and the known danger to contractors working there, Mr. Davis requested completion of this assignment in June, 2004. 11. From June, 2004 until December 22, 2004, Bechtel offered only business trip assignments. The business trip assignments will not pay the same premium rates paid for overseas work. He will now earn a salary of $101,076 annually, when he works. However, business trip assignments do not have any guaranteed duration. 12. Mr. Davis did not work from December 23, 2004 until April, 2005. Bechtel offered a business trip assignment in April, 2005 to extend until May, 2005. A one month extension might be granted, but there are no guarantees. 13. If Mr. Davis was able to work the balance of the year, the most he would earn in 2005 is $75,807. However, it is more likely that he will not have full time employment with Bechtel for the balance of the year. 14. Based on the uncertainty of employment with Bechtel, Mr. Davis is looking "'''''''''IlIl:W-lif~ " ,- ," .- ~ ~ ,,~ - - for employment elsewhere. Since January, 2005 he has not been able to locate a position paying more than $60,000 annually. 15. The decrease earnings described herein are anticipated for the foreseeable future. 16. In view of the above, Mr. Davis can no longer afford to pay alimony at the ordered rate. 17. At the time of divorce, Wife was unemployed. 18. It is believed and averred that she is now gainfully employed and capable of greater contribution to her own support than at the time of divorce. WHEREFORE, Petitioner respectfully requests this Honorable Court to reduce or terminate his alimony obligation to Rosana Davis. PURCELL, KRUG AND HALLER By Ni hole M. St I #79866 19 North Front Street Harrisburg, PA 17102 717234-4178 Attorney for Petitioner, Twitty G. Davis, Jr. Date: May 9, 2005 ~, , - , ~. ~"~ '""~,~~, =<-~ - ~ VERIFICATION I, TWITTY G. DAVIS, JR., hereby verify that the facts contained in the foregoing Petition to Modify or Terminate Alimony are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. , - J.. Date:J\'\~ '3, deo6 ?""_"","V~~I"""'~, -I"! - , '. ~ " - ~ ,~ MATRIMONIAL SE'flrLEMENT AGREEMENT THIS AGREEMENT, made this{l1A~y of J}CUY1{Jer , 200 J, between ROSANA DAVIS, hereinafter called "Wife" and TWil'TY G. DAVIS, .ffi.., hereinafter called o C' c: ~ -c6; 92,9, ~~ &)~~",: "- ....::.:.::.. The parties hereto, being Husband and Wife were lawfully married on Novetalft 12~ >0 ""'0 W Jo' c: .. 1966 in Denver, Colorado; ~ ~ There were two children born of the parties; namely: Twitty G. Davis, III, born "Husband". CJ ;"l CJ rv WITNESSETH: September 9,1967 and Mary Kim Davis, born February I, 197\. Diverse and unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of HUSBAND and WIFE to live separate and apart for the rest of their natural lives, and the parties hereto are desirous of settling fully and finally their respective fmancial and property rights and obligations as between each other including, without limitation by specification: the settling of all matters between them relating to the ownership and equitable distribution of real and personal property; the settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of each other; and in general, the settling of any and all claims and possible claims by one against the other or against their respective estate. NOW THEREFORE, in consideration of the premises and mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby, covenant and agree as follows: Page -1- --",,,",,,,, - ,)~ ,,-- .. 1 I~ r:l -","I ....\ '1--:: -" _.'~"'.t --".C? '.-,,~,c; ::,:,,,-;-\ ,"-,~ ~~:~)M :::; ..",. ::0 '< ,~_V~,',". ~_ -,"~ - -'.'". From and after the date of the signing of this Agreement, both parties shall have the complete freedom of disposition as to their separate property and any property which is in their possession or control, pursuant to this Agreement, and may mortgage, sell, grant, convey. or otherwise encumber or dispose of such property, whether real or personal, whether such property was acquired before, during or after marriage, and neither Husband nor Wife need join in, consent to, or acknowledge any deed, mortgage, or other instrument of the other pertaining to such disposition of property. 16. ALIMONY/SPOUSAL SUPPORT From the date of execution of this Agreement until the entry of a decree in divorce, Husband shall pay Wife spousal support in the amount of $2,250 per month. From and after the date of the decree in divorce, Husband shall pay Wife alimony in the amount of $2,500 per month. All alimony payments shall be made directly to Wife and not through the Domestic Relations Office. Upon Husband reaching age 62, the amount of alimony shall be reduced to $750 per month. This amount shall be further reduced to $500 per month when Wife reaches age 65. It is the intent of the parties that all payments which are designated as alimony under this Agreement shall be includable as income by Wife under Section 71 of the Internal Revenue Code and deductible by Husband under Section 2105 of the Internal Revenue Code. Wife's Social Security Number is 522-58-3537. Husband's Social Security Number is 503-50-7] 78. The parties agree to treat the payments set forth above consistently on their federal tax returns. Page -11- "OF:"_""~~-"~ . -, . As security for the Alimony payment, Husband agrees that he will assist Wife in obtaining a term life insurance policy with a benefit of $1 00.000.00 payable to Wife on Husband's death. Wife shall pay all premiums due on the policy. If it is necessary for Husband to be the owner of this policy, he shall designate Wife as irrevocable beneficiary. Husband's obligation to pay alimony hereunder shall terminate upon Husband's death, the death or remarriage of Wife, or upon her cohabitation with a male not her spouse for a continuous period of seven days or longer. The period of payment of alimony hereunder shall not be extended. The amount of alimony shall not be changed or modified in any way by either of the parties hereto, absent a change in circumstances of a substantial and continuing nature. 17. ALIMONY PENDENTE LITE. COUNSEL FEES AND EXPENSES Husband and Wife acknowledge and agree that the provisions of this Agreement providing for the equitable distribution of marital property of the parties is fair, adequate and satisfactory to them. Both parties shall accept the provisions set forth in this Agreement in lieu of and in full and final settlement and satisfaction of all claims and demands that either may now or hereafter have against the other for alimony pendente lite, counsel fees or expenses, or any other provision for their support and maintenance, before, during and after the commencement of any proceedings for di vorce between the parties, except as provided herein. Each party shall be responsible for his or her own counsel fees. Each agrees to indemnify, defend and save the other harmless from any action commenced against the other for alimony pendente lite, counsel fees and/or expenses. Page -12- "-~';ii~~__. "'TWp].], ,- ~-- . ~ . 33. HEADINGS NOT PART OF AGREEMENT Any headings preceding the text of the paragraphs and subparagraphs herein, are inserted solely for convenience of reference and shall not constitute a part of this Agreement nor shall they affect its meaning, construction or effect. 34. AGREEMENT BINDING ON HEIRS This Agreement shall be binding and shall inure to the benefit of the parties hereto, and their respective heirs, executors, administrators, successors and assigns. BY SIGNING THIS AGREEMENT, EACH PARTY ACKNOWLEDGES HAVING READ AND UNDERSTOOD THE ENTIRE AGREEMENT, AND EACH PARTY ACKNOWLEDGES THAT THE PROVISIONS OF THIS AGREEMENT SHALL BE AS BINDING UPON THE PARTIES AS IF THEY WERE ORDERED BY THE COURT AFTER A FULL HEARING. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first written above. WITNESS: v;11'/t?z-lj ,Y /6 /J n f ( /--'\ cY"-..J...--C(..1-"v(^--- /Ly;z?!(...-o;1 ROSANA DAVIS xL-- P (l/l( 2- 2- U TWITTY G. DAVIS Page -21- """"",,,.,,.."" IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. Melanie Erb, Esquire ;;;ue j ltfJ-C ')) r . osana Davis j;1 D......." 7'") CERTIFICATE OF SERVICE I, MICHELE PRITCHARD, an employee of the law firm of Purcell, Krug & Haller, counsel for Plaintiff, hereby certify that service of the Petition to Modify or Terminate , Alimony were made upon the following via First-Class Mail, Postage Prepaid on May 10, 2005: Rosana Davis 409 4th Street New Cumberland, PA 17070 ~ Mi he Ie Pritchard -1- 1"--!," ,-., ",j ",- _~ ' ," ,. _, " ""_ n. . ~ , "!' :--~'JI\! ~" .'. ~"- "' .... ." .'" ,=.."~,,",,.. "".'i'N\i'rWiilll .I]D i. L ~ ....r- ~ o C . ~ ~ -.. ~ ',nlit - o '~ -' :.t-n rne. -Cl\O :0 L a.c' ~----,~, :'CjJ r, ~"l ;~'M'\ g = <;~ ::';!; ~.,.-< t' r':-',__. v -:7- C' ,-< r: " ')7 -0 ""It.: -" c..f:l -- c;:> """',._r"'"'_"" ,~,> " :~~"",_,"_"",~;Jl.l~ [~"rl~_~IW~~~~"i!~'f"~""f"1"""~_"'%"'''I!''<![;,''l!W!'"W_oM"",p,'n~''=1'_'~M"'{l1f1j\'il'F,,"jWm~lq;~\wmNllll!'i!l"l'!~"~~f'l' . Form 1 040 Department of the Treasury - Internal Revenue Service 2004 Ilgg\ u.s. Individual Income Tax Return IRS Use Only - Do not write or staple in this space. For the year Jan 1 . Dee 31, 2004, or otherlax vear beninninn , 2004, endino ,20 OMS No. 1545-0074 Label Your first name MI Last name Your social security number (See instructions.) Twittv G Davis 503-50-7178 If a joint return, spouse's first name MI Last name Spouse's social security number Use the IRS label. Frannie S Davis 662-07-3096 Otherwise, Home addtess (number and street).lfyou have a P.O. box, see instructions. Aparlmen1no. ! Importantl ! please print or type. 23316 Kev Larqo Loon You must enter your social City, town or post office. If you have a foreign address, see instructions. Slate ZIP code security number(s) above. Presidential Land 0 Lakes FL 34639 ~ Nob,: Checking 'Yes' will not chan~e your tax or reduce your refund. You Spouse Do au, or our spouse if fllin a 'oint return, want $3 to 0 to this fund? . . . . . . . . ~ Yes No Yes X 1 Singie 4 Head 01 househoid (with qualifying person). (See 2 instructions.) If the qualifying person is a child X Married filingjoindy (even if only one had income) but not your dependent, enter this child's 3 Married filing separately. Enter spouse's SSN above & full name here ~ name here. ~ 5 0 Quarlfvin~ widow(er) with dependent child (see instructions) 6: X ~O~~Ss~f:I~S~~~O~~~~~I~i~~o~~s.a.d~~e~~e~t,.d.o.n~tche.c~~o~~a........: ...:J- :~:a;:~~. (2) Dependent's (3) Oependent's (4). 0" 0, who, social security relationship qualifying. lived number to you child for child with you . . . tax~it . did not (see Instrs) live with you due to divorce or separation (seelnstrs) . . Dependents on 6c not entered above. Election Campaign (See instructions.) Filing Status Check only one box. Exemptions If more than four dependents, see instructions. Income Atlacb Form(s) W.2 bere. Also aUach Forms W.2G and l099-R if tax was withheld. Ii you did not get a W.2, see instructions. Enclose, but do not attach, any payment. Also, please use Form 1041J.V. Adjusted Gross Income 11eti~~tts d Total number of exem tions claimed. . . . . . 7 Wages, salaries, tips, etc. Attach Form(s) W-2 . 8 a Taxable interest. Attach Schedule B if required b Tax-exempt interest. Do not include on line 8a 9 a Ordinary dividends. Attach Schedule B if required b~~~~~~~) . . . . . . . . . . . . . . . . . . . . . 9bl 10 Taxable refunds, credits, or offsets of state and localincome laxes (se einstructions) ............ 11 Alimony received. . . . . . . . . . . . . . . . . . . . 12 Business income or (loss). Attach Schedule C or C-EZ . 13 Capital gain or (loss). Att Sch 0 ~ reqd. If nol reqd, ck here. 14 Other gains or (losses). Attach Form 4797 . . . . . .. .......... 15a IRA distributions. . . . . . .I.~~ I b Taxable amount (see instrs) . . 16a Pensions and annuities . ..[J!!] - b Taxable amount (see instrs) . . 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E. . . . 18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . . . . . . . . 19 Unemployment compensation. . . . . . . . v . . . . . . . . . . . . . . . . . . . . . . . 20aSocialsecuritybenefits. . . . . .120al I b Taxableamount(seeinstrs) .'. 21 Other income 22 Add the amountS-inthe far rl hi ~~~nfo~ I~;s "7 throu- h 21.-ThlslS- our totallncom; .-. ~ ~ 23 Educator expenses (see instructions) . . . . . . . . . . .. 23 24 Certain business expenses of reservists, performing artists, and fee-basis government officials Attach Form 2106 or 2106.EZ . . . . . . . . . 25 IRA deduction (see instructions) v . . . . . . . . 26 Student Joan interest deduction (see instructions) .-. . 27 Tuition and fees deduction (see instructions). . . . . 28 Heaith savings account deduction. Attach Form 8889 29 Moving expenses. Attach Form 3903. . . . . . . . . 30 One-hall 01 sell-employment tax. Attach Schedule SE 31 Self-employed health insurance deduction (see instrs) . 32 Sell-employed SEP, SIMPLE, and qualified plans . . 33 Penalty on early withdrawal of savings. . . . . . . . . a imonypaid b Recipient's SSN. . . ~ 522-58-3537 .lines23through34a. ... . .. . , ... . ... . . 'btract line 35 from line 22. This is our ad usted ross Income. . cy Act, and Paperwork Reduction Act Notice, see Instructions. c bependents: 1 First name Glad s A Davis Ka M Kok Jean M Kok Last name 266-24-8958 662-07-3962 662-07-2523 ,,~,. ,,~ ~"~" " " Parent Dau hter Dau hter 8b ~D 10 11 12 13 14 15b 16b 17 18 19 20b 21 22 24 25 26 27 28 29 30 31 32 33 34a 4,807. 30,000. . . . . . .~ FDIA0112 11f10/04 No 2 2 1 167,833. 34,807. 133,026. Form 1040 (2004) Form 1040 Tax and Credits Standard Deduction for- . People who checked any box on line 38a or 38b or who can be claimed as a dependent, see instructions. . All others: Single or Married filing separately, $4,850 Married filing jointly or Qualifying widow(er), $9,700 Head of household, $7,150 Other Taxes Payments If you have a qualifying child, attach Schedule EIC. Refund Direct deposit? See instructions and fill in 72b, 72c, and 72d. Amount You Owe Third Party Designee Sign Here Joint return? See instructions. Keep a copy for your records. Paid Preparer's Use Only ~';~:~"! \,""u ~. ~ ,~. " 503-50-7178 Pa e2 133,026, Twitt G & Frannie S Davis 37 Amount from line 36 (adjusted gross income) , . . . ., ................ 38a ~heck {D You were born before January 2,1940, 0 Blind. Total boxes If: D Spouse was born before January 2, 1940, 0 Blind. checked'" 38a b If your spouse itemizes on a separate return, or you were a dual-status alien, se~ instructions and check here . . . . . . . . . . . . . . . . . 39 Remized deductions (from Schedule A) or your standard deduction (see leR margin) 40 Subtract line 39 from line 37 . . . . . . . . . . . . , . . . . , . . . . 41 If line 37 is $107,025 or iess, multiply $3,100 by the total ~umb~r of ex~mptions claimed online6d.lfline37isover$107,025,seetheworksheetlnthemstructlons ..........41 42 Taxable income. Subtract line 41 from line 40. UIine41;smorelhanline40.enter.Q- . . . . , . . . . . . , . . . . . . . . . 43 Tax(seeinstrs),Checklianytaxisfrom: a DFonn(s) 8814 b D Fonn 4972 . . . 44 Alternative minimum tax (see instructions). Attach Form 6251 45 Add lineo 43 and 44 . . . . . . . . . . . . . . . . . 46 Foreign tax credit. Attach Form 1116 if required . . . , . 47 Credit for child and dependent care expenses, Attach Fonn 2441 . . 48 Credit for the elderly or the disabled. Attach Schedule R . 49 Education credits. Attach Form 8863. . . . . . . . . . . 50 Retirem~nt savings contributions credit. Attach Form 8880 . 51 Child tax credit (see instructions). . . . . . . . 52 Adoption credit. Attach Form 8839. . . . . . . . . , . . . 53 Credits from: a D Fonn 8396 b D Fonn 8859 . . . . . . . . 54 Other credits. Check applicable box(es): a D Fonn 3800 b D ~b~ c Dspecify 55 Add lines 46 through 54. These are your total credits 56 Subtract line 55 from line 45. If line 55 is more than line 45, enter -0- . 57 Sell.employment tax. Attach Schedule SE. . . . . . . . . . . . . . , . . . 58 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 59 Additional tax on IRAs, other qualified retirement plans. etc. Attach Form 5329 if required 60 Advanc~ earned income credit payments from Form(s) W-2 61 Household employment taxes. Attach Schedule H . . . 62 Add lines 56~61. This is ourlotal tax . . . . . . . . . , . . 63 Federal income tax withheld from Forms W-2 and 1099 64 2004 estimated tax payments and amount applied from 2003 return 65a Earned income credit (EIC). . . . , , . . , . . , . , J b Nontaxable combat pay election, . . ~ 65 b I 66 Excess social security and tier 1 RRTA tax withheld (see instructions) 66 67 Additional child tax credit. Attach Form 8812. . . . . . . 67 68 Amount paid with request for extension to file (see inslructions) . . , . ,. 68 69 Olherpmtsfrom: a DFonn2439 b DFonn4136 c DForm81185 69 70 Add lines 63, 64, 658, and 66 through 69. Theseare urtotalpayments...,."..,.....,.,.,. ,. . , . . . , . . . ,... 71 If line 70 is more than line 62, subtract line 62 from line 70, This is the amount you overpaid ' 72a Amount of line 71 you want refunded to ou . , . , . . . . ~ b Routing number, , . , , 231382241 ~ dAccountnumber. , . , ,2181472818 73 Amount of line 71 au want a lied to our 2005 estimaled tax , . , . ... 73 74 Amounl you owe, Subtract line 70 from line 62. For details on how to pay, see instructions 75 Estimated tax enal see instructions ,..,..,..... 75 Do you want to allow another person to discuss this return with the IRS (see instructions)? . , . . Designee's Phone name ... Preparer no. ... nurnber(PIN) Un?er penalties of pe~ury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowl~dge and belIef, they are tru~, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Date Your occupation ~ 9,700. 123,326. 15,500. 107,826. 20,432. 42 43 44 .~ 45 20,432. 46 47 48 49 50 51 52 53 54 55 .~ 56 57 58 59 60 61 .~ 62 20,432. 20,432. 63 64 65a 22,280, 22,280. 1,848. 1,848. ~ ~ Spouse's signature. If a joint return, both must sign. ~ Date Contracts Administrator Spouse's occupation Procurement Asst. Date Preparer's .... signature r John A. D den, EA, CFP 04/01/2005 Check if self-employed Firm's name Dr den Worldwide Tax Service (or yours if .... self-employed),r 6141 Wolfstar Ct. address,and ZIP code San Die 0 EIN CA 92122-3951 (858) 457-8545 Form 1040 (2004) Phone no. FDlA0112 11/10104 ">- OMS No. 1545-0074 Your social security number Pa e2 Name(s) shown on Form 1040, Twitt G & Frannie S Davis Schedule B - Interest and Ordinary Dividends 503-50 7178 1 List name of payer. If any interest is from a sel.ler.fina~ced mo~gage: a!1d the buyer used Amount Part I the property as a personal residence, see the Instructions and fist UlIS ,nterest first. Also, Interest show that buyer's social security number and address . . . . . . . . . . . . . . . . . . ... ~~~~E~X!~~_~CY____ 208 - -- ----- --- -- --- - --- -- -- -- (See instructions ~~~~E~ X!~sj: -~qr- 55 for Form 1040, - --- - -- ------ -- --- -- - --- ---- - line 8a.) -- - ----- ----- ---- - -- --- -- -- ------- --- -- - --- - -- -- -- - --- ----- --- --- -- --- ----- - -- - -- --- -- - - -- -- - -- - ------ -- -------- -- - -- ------- -- -- - Note. If you -- - - ---- --- ------ --- ----- ---- - ------ --- ---- received a Form 1 1099"INT, Form - --- - - - --- ------ --- --- ----- -- ------ --- --- - - 1099"0ID, or substitutestatemant -- ---- - -- - --- - --- --- - -- --- --- ----- --- -- - -- - from a brokerage firm, list the flrm's - -- -- --- --- ----- - --- -- --- -- - -- --- --- -- - -- -- name as the payer andenterlhelotal - - ---- - --- ---- - - -- - ---------- -------- - -- -- - interest shown on !halform. -- ---- --- --- - - ---- - ---- -- ------ -------- - --- - ---- -- - ---- ---- ---- -- --- -- - -- --- -------- -- ----- - - - -- --------- ----- --- -------- --- -- -- - -- - - -- ------- - ---- - - - ----- --- -- --- --- --- --- - -- -------- - ----- -- - --- -- --- ------ ----- -- -- 2 Add the amounts on line 1 2 263 3 Excludable interest on series EE and I U.S. savings bonds issued after 1989. Attach Form 8815 3 4 Subtract line 3 from line 2. Enter the result here and on Form 1040, line 8a. .. 4 263 Note. If line 4 is over $1,500, vou must comolete Part III. Amount 5 List name of payer ... - ------ ---- - - -- - - -- - --- ----- -- -- Part II - --- -- - ------ - - --- - ---- --- ----- --- ----- - -- - Ordinary - -- -- - -- ---- ----- --- ---- - --- -- --- ---- -- - - -- Dividends -- --- --- - ---- - ----- -- - -- --- --- --- -- - -- -- - -- - - --- --- -- - - ---- --- --- -- --- -- ------ --- -- - -- (See -- ----- --- ------ --- --- -- --- -- --- ------ -- -- - instructions for Form 1040, -- --- -- --- ----- - --- --- ------- --- ------ -- -- - line9a.) - - -- --- -- - --- - - ---- -- -- --- --- -- - -- ------ -- - - --- -- --- ---- - ------- -- --- -- --- --- --- --- --- ~=~:hForm - ------------ - - -- - -- - -- -- -- - --- --- --- - - - - -- 5 1099-DIVor - -- -- ------- - ---- --- ----- --- ------------- -- substitulestatement - -- -- --- --- - ---- - - -- -- - - - --- -- --- --- ----- -- from a brokerage firm, list the firm's - -- -- --- -- - - ---- - --- -- ----- --- ------ -- -- - -- name as the payer and enter the -- - ----- --- -- ----- -- - --- ----- -- --- ordinary dividends - - - -- -- - - shown on that form. --- -- -- --- ------ -- --- -- - -- - -- ----- ------ --- - -- -- --- -- - - ---- - --- -- -- - -- -- - --- --- -- --- - - - -- -- --- --- - ---- - --- ------- -- - --- --- -- --- -- - ---- ------ - -------- ------- --- ------ - ---- -- - - - -- --- ---- -------- -- -- --- -- - --- --- - ---- -- - -- -- --- --- - -------- -- -- --------- --- -- --- -- - -- -- --- -- - - -------- -- -- --- --- --- -- ----- - -- 6 Add the amounts on line 5. Enter the total here and on Form 1040, Iine9a ... 6 08 Part III Foreign Accounts and Trusts Note. If line 6 is over $1 ,500, ou must com lete Part III. You must complete this part If you (a) had over $1 ,500 of taxable interest or ordinary dividends; or (b) had a foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. (See instructions. ) 7 a At any time during 2004, did you have an interest in or a signature or other authority over a financial account in a foreign country, such as a bank account, securities account, or other financial account? See instructions for exceptions and filing requirements for Form TO F 90-22.1. . . . . . . . . . . . . . . . . . . . . . . . . b If 'Yes,' enter the name of the foreign country. . . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 8 During 2004, did you receive a distribution from, or were you the grantor of, or transferor to. a foreign trust? If 'Yes,' ou ma have to file Form 3520. See instructions. . . . . . . . . . . . . . . . . For Paperwork Reduction Act Notice, see Form 1040 instructions. FDIA0401 OS/24/04 Schedule B (Form 1040) 2004 BAA ,~~"" . -I "",,,. _ ~ "'" ~r,. , " Form 3903 Moving Expenses OMS No. 1545-0062 ~ Attach to Fonn 1040. 2004 62 Departmeflt of the Treasury Internal ~venue Service (gg) Name{s) shown on Form 1040 Your social security number Twitt G & Frannie S Davis 503-50-7178 ./ See the Distance Test and Time Test in the instructions to find out if you can deduct your moving expenses. ,/ If au are a member of the Armed Forces, see the instructions to find out how to com lete this form. Before you begin: Enter the amount you paid for transportation and storage of household goods and personal effects (see instructions) . . . . , . . . . . . . . . . . . . . . " . . . . . . . . . . . . . 2 Enter the amount you paid for travel and lodging in moving from your old home to your new home (see instructions). Do not include the cost of meals . . . . . . . . . . . . . 1 1 4,448. 2 359. 3 Add lines 1 and 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4,807. DNo. You cannot deduct your moving expenses. If line 3 is less than line 4, subtract line 3 from line 4 and include the result on Form 1040, line 7. 4,807. Form 3903 (2004) 4 Enter the total amount your employer paid you for the expenses listed on lines 1 and 2 that is not ~~d~~~n ~~h ':9:p b:x. (~o~ ~) .o~ y.o~r .F:~ ~-~. ~h.ls. a~~~n~ s~~U~d .b~ ~h~~. i~ ~o~ :2. o~ ~o~r. 5 Is line 3 more than line 4? [!] Yes. Moving expense deduction. Subtract line 4 from line 3. Enter the result here and on Form 1040, line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . BAA F=or Paperwork Reduction Act Notice, see separate instructions. FD1A3701 10119/04 Jt'J!!fli!I. -1'" c ,~ " ',I'=~f?,""" .. u Part-Year Resident State Allocation Worksheet .. Keep for your records 2004 Name(s} Shown on Retum Social Security Number Twitty G & Frannie S Davis 503-50-7178 INCOME Federal Resident Source Allocated Amount State State Amount 1 T Wages, salaries, tips ...... . 167,570. LA LA 22,074. FC DE O. FL TN O. FC FC 145,496. - S Wages, salaries, tips ...... . - - - - - - Federal Amount Residency Info From To Res mm/dd mm/dd St . Allocated Amount Src St 2 T Taxable interest. . . . . . . . . . 55. 01/01 OS/27 LA OS/28 ~ ~ 23. 32. S Taxable interest . . . . . . . . . . 208. 01/01 J2IIL ~ OS/28 12/31 ~ 87. 121. 3 T Dividends. . . . . . . . . . . . . . S Dividends. . . . . . . . . . . . . . S State/local tax refund . . . . . . . 4 T State/local tax refund . . . . . . . 5 T Alimony received. . . . . . . . . . S Aiimony received. . . . . . . . . . ,~[l!'}~ 'I. -" "1 - Twitty G & Frannie S Davis 503-50-7178 ~ Page 2 Subtotal Residency Info From To Res mm/dd mm/dd St . Allocated Amount INCOME (continued) Federal Amount Total Src St 6 T Business inc or loss . S Business inc or loss . 7 T Farm income or loss. S Farm income or loss. 8 Total Schedule E. T S INCOME Federal Residency Info . Allocated (continued) Amount From To Res Src Amount mmldd mm/dd St St 9 T Capital gain or loss ...... . . - - - S Capital gain or loss - ...... . - - - 10 T Other gains/losses. . . . . . . . - - - S Other gains/losses. . . . . . .. - - - - - - - - <~1 -'1"" ",=,- Twitty G & Frannie S Davis 503-50-7178 Page 3 Federal Residency Info Allocated Amount From To Res Amount mm/dd mm/dd State 11 T Taxable IRA distributions . . . . . . S Taxable IRA distributions . . . . , 12 T Taxable pensions/annuities. . . ' S Taxable pensions/annuities. . . ' 13a T Taxable social security benefits. S Taxable social security benefits. b T Taxable railroad retirements . . S Taxable railroad retirements . . . INCOME (continued) Federal Amount Residency Info From To Res mm/dd mm/dd St . Allocated Amount Src St 14 T Unemployment compensation . S Unemployment compensation . 15 Total other income. . . . . . . T S '-1f~~rll" ~""-I'~,~ " -- Twitty G & Frannie S Davis 503-50-7178 Page 4 ADJUSTMENTS Federal Residency Info Allocated Amount From To Res Amount mm/dd mm/dd St 16 T Educator expenses . . . . . . . . . . . S Educator expenses .......... . 17 Certain business expenses . . . . . T S 18 T IRA deduction ........... . . . S IRA deduction ............. . 19 T Student loan interest deduction. . . . . S Student loan interest deduction. . . . . - 20 T Tuition and fees deduction ...... . - - - - S Tuition and fees deduction ...... . - - 21 T Health savings account deduction .. . - - S Health savings account deduction - .. . - - - 22 T Moving expenses ........... . 4,807. 01/01 OS/27 LA O. OS/28 12/31 FL 4,807. - S Moving expenses ........... . 'i",.,..,-_, . I. r~" ,~ Twitty G & Frannie S Davis 503-50-7178 ~ Page 5 ADJUSTMENTS Federal Residency Info . Allocated (continued) Amount From To Res Src Amount mm/dd mm/dd St St 23 T Self-employment tax. . . . . . . . . . - - - - - - - 5 Self-employment tax . . . . . . . . . - - - - 1,--- - - - - - 24 T Self-employed health insurance . . - - - - 5 Self-employed health insurance . . 25 T SEP, SIMPLE and qualified plans - - - 5 SEP, SIMPLE and qualified plans ADJUSTMENTS Federal Residency Info Allocated (continued) Amount From To Res Amount mm/dd mm/dd St 26 T Penalty on early withdrawal of savings. . 5 Penally on early withdrawal of savings. . 27 T Alimony paid. . . . . . . . . . . . . . . . 30,000. 01/01 OS/27 LA 12,500. OS/28 12/31 FL 17,500. 5 Alimony paid . . . . . . . . . . . . . . . . 28 Other adjustments . . . . . . . . . . . T - 5 "W;~'" "'I '_' ,_~~'7' . 1'~"' I ~ 0 Form 1040 Forms W-2 & W-2G Summary ~ Keep for your records 2004 Name(s) Shown on Return Social Security Number Twitty G & Frannie S Davis 503-50-7178 EmDlover SP Waaes Federal Tax State Waoes State Tax Bechtel Corp 22,074. 3,963. 22,074. 454. Bechtel International 111,377. 14,060, O. Bechtel National 34,119. 4,257. O. Form W-2 Summary Box No. Description Taxpayer Spouse Total 1 Total wages, tips and compensation: Non-statutory & statutory wages not on Sch C . . 167,570. 167,570. Statutory wages reported on Schedule C . . .. . Foreign wages included in total wages. . . . .. . Non-taxable combat pay .......... . .. . 2 Total federal tax withheld ... . .... . .. . 22,280. 22,280. 3 & 7 Total social security wages/tips. . . . . . . . . 87,900. 87,900. 4 Total social security tax withheld . . . . . . . . 5,450. 5,450. 5 Total Medicare wages and tips . . . . .... . 167,570. 167,570. 6 Total Medicare tax withheld. . . . . . . . . . . 2,430. 2,430. 8 Totai allocated tips. . . . . . . . . . . . . . . . 9 Total advance earned income credit. . . . . . 10 Total dependent care benefits ........ . 11 Total distributions from nonqualified plans. . . 12 a Total from Box 12 ......... . . . 25l. 25l. b Elective deferrals to qualified plans. . . . . c Deferrals to government 457 plans. . . . . d Deferrals to non-government 457 plans . . . . e Uncollected Medicare tax . . . . . . . . . . . . f Uncollected social security and RRTA tier 1 . . g Uncollected RRTA tier 2. . . . . . . . . . . . . h Income from nonstatutory stock options . . . . i Total other items from box 12 . . . . . . . . . . 25l. 25l. 14 a Total deductible mandatory state tax. . . . . . b Total RR Tier 1 wages. . . ... . ...... . c Total RR Tier 1 tax. . ... . ... . ..... . d Total RR Tier 2 tax. . . . . . . . . . . . . . . . e Total RRTA tips. . . . . , , , . . . . . . . . . . f Total other items from box 14. . . . . . . . . . 16 Total state wages and tips. . . . . . . . . . . . 22,074. 22,074. 17 Total state tax withheld .. . .. . .. . . . 454. 454. 19 Total local tax withheld. . . . . . . . . . . . . . Form W-2G Summary Box No. Description Taxpayer Spouse Total 1 Total gross winnings. . . . . . . ....... . 2 Total federal tax withheld . . ... . .. . .. . 14 Total state tax withheld .. . .. . . . . . 16 T otallocal tax withheld. . . . '" . .. . .. . "-';'1~j",l"'~ ~ ':""l""'''''''1*''1'l\1j!1' 11r,~ Interest and Dividends Summary ~ Keep for our records 2004 Name(s) Shown on Return Twitt G & Frannie S Davis Social Security Number 503-50-7178 Interest Summary Total Interest Tax-Exempt 1 Seller-financed mortgage. 2 From Schedule B, Part I . 3 From Schedule B, Part II . 4 From K-1 Worksheets . . . 5 Exempt-interest dividends (net of adj.) 6 From Forms 6252 7 From Forms 8814 . 8 Subtotal...... Less Adjustments: 9 *Tax-exempt interest (net of adjustments). 10 U.S. savings bond interest previously reported . 11 Nominee distribution 12 010 adjustment. 13 ABP adjustment . 14 Accrued interest . 15 Other adjustment. 16 Series EE and I bond exclusion. 17 Total Adjustments. . . . . 18 Total to Schedule B, line 2 . . . 19 Total to Form 1040, line 8b. . . . ~ 20 Total U.S. government interest. . ~ 21 TotaltoForm6251,line11... *Does not include K-1 tax-exem t interest Dividends Summary 1 From Schedule B. . . 2 From K-1 Worksheets 3 Subtotal. . . . . . Less Adjustments: 4 Nominee distribution 5 Other adjustment. . 6 Total Adjustments. 7 Total to Schedule Btline 6 .~ 8 Total qualified dividends . . .~ 9 Total capital gains .... . ,~ 10 Total nontaxable dividends . ,~ Ordina Qualified Capital Gains Nontaxable Capital Gains Summary 28% rate 1 From Schedule B. . . . . . . . . . . . . . . . . . Less Adjustments: 2 Nominee distribution 3 Other adjustment. . 4 Total Adjustments. . 5 Total to Schedule D 6 Total to Schedule 0 7 Total to Scheduie 0 .~ Section 1250 Section 1202 .~ .~ FDIY5602 07/30f04 i':\L.". '1-- .," I ,"t., P"~",~. Tax Payments Worksheet ~ Keep for your records 2004 Name(s) Shown on Return Twitty G & Frannie S Davis Social Security Number 503-50-7178 Estimated Tax Payments for 2004 (If more than 4 payments for any state or locality, see Tax Help) Federal State Local Oate Amount Oate Amount 10 Oate Amount 10 1 04/15/04 04/15/04 04/15/04 2 06/15/04 06/15/04 - 06/15/04 3 09/15/04 09/15/04 - 09/15/04 4 01/18/05 01/18/05 01/18/05 - 5 a - b - c d Total Estimated Payments. . . . Tax Payments Other Than Withholding Federal State 10 Local 10 (If multiple states, see Tax Help) 6 Overpayments applied to 2004. . . 7 Credited by ,estates and trusts . . . . 8 Totals Lines 1 through 7 ..... . :~: 9 2004extensions........... . Taxes Withheld From: Federal State Local 10 Forms W-2 . . . . . . . . . . . . . . . . . . . . . . 22,280. 454. 11 Forms W-2G . . . . . . . . . . . . . . . . . . . . . , 12 Forms 1099-R . . . . . . . . . . . . . . . . . . . . 13 Forms 1099-MISC and 1099-G. . . . . . . . . . . :~ 14 Schedules K-1 ................... . 15 Forms 1099-INT, DIV and OlD. . . . . . . . . . . 16 Social Security and Railroad Benefits . . . . . . . 17 Form 1099-B. . . . . . . St Lac 18 a - - Other withholding ... . St Lac - - b Other withholding ... . St Loc - - c Other withholding ... . St Lac 19 Total Withholding Lines 10 through 18c, .-:-:-:- 22,280. 454. 20 Total Tax: Payments for 2004 . . . . . . . . . . . 22,280. 454. Prior Year Taxes Paid In 2004 State 10 Local 10 (If multiple states or localities, see Tax Help) 21 Tax paid with 2003 extensions. . . . . . . . . . . . . . . 22 2003 estimated tax paid after 12/31/03 ......... , 23 Balance due paid with 2003 return. . . . . . . . . . . . , 149. LA 24 Other (amended returns, installment payments, etc) . . '~'" I~! . ,,'" Federal Carryover Worksheet .. Keep for your records 2004 Name(s) Shown on Return Twitty G & Frannie S Davis 2003 State and Local Tax Information (See Tax Help) (a) State or Local 10 LA (b) Paid With Extension (c) Estimates Pd After 12/31 (d) Total With- held/Pmts 4,079. Totals. . 4,079. Other Tax and Income Information 1 2 3 4 5 6 7 8 Filing status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Number of exemptions for blind or over 65 (0-4). . .. ... .. Itemized deductions after limitation. . . . . . . . . . . . . . . . . Check box if required to itemize deductions. . . . . . . . . . . . Adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . Tax liability for Form 2210 or Form 2210-F . . . . . . . . . . . . Alternative minimum tax. . . . . . . . . . . . . . . . . . . . . . . Federal overpayment applied to next year estimated tax. IRA Information 9 a Basis ofTaxpayer's IRA(s) as of 12/31 ............. b Basis of Spouse's IRA(s) as of 12/31 ......... 10 a Taxpayer's excess IRA contributions as of 12/31 . . . . . b Spouse's excess IRA contributions as of 12/31 . . . . . . . . . 11 a Taxpa~er's excess Archer MSA contributions as of 12/31 b Spouse's excess Archer MSA contributions as of 12/31 12 a T axpa~er's excess Roth I RA contributions as of 12/31 . . b Spous~'s excess Roth IRA contributions as of 12/31 . . . 13a, Taxpa~er's excess Coverdell ESA contributions as of 12/31. . b' Spouse's excess Coverdell ESA contributions as of 12/31. . . 14 a T axpa~er's excess HSA contributions as of 12/31 . . . . . . . . b Spouse's excess HSA contributions as of 12/31 .. . . . . . . . Loss and Expense Carryovers 15 a Short-term capital loss . . . . . b AMT Short-term capital loss . 16 a Long-term capital loss . . . . . . . . . b AMT Long-term capital loss . . . . . . . . . . . . . 17 a Net op~rating loss available to carry forward . , . . . . . . . . . b AMT N~t operating ioss available to carry forward . . . . . . . . 18 a Investment interest expense disallowed. . . . . . . . . . . . . . b AMT Investment interest expense disallowed. . . . . . . , . . . 19 Nonrecaptured net Section 1231 losses from: a 2004,.. b 2003... c 2002... d 2001" e 2000.. f 1999.. {\ ,-,," ,0' T' f11i"1'f-7""'" - Social Security Number 503-50-7178 (e) Paid With Return 149. (f) Total Over- a ment (9) Applied Amount 149. 2003 2004 1 2 3 4 5 6 7 8 2 MFJ 2 MFJ ~~ 113,468. 133,026. 13,500. 20,432. 2003 9a b 10 a b 113 b 12a b 13a b 14a b 2003 15a b 16a b 17a b 18a b 19a b c d e f 2004 2004 R-8453 (1/05) LA 8453 Louisiana Individual Income Tax Declaration for Electronic Filing IRS DCN ~ [QQ)-1331108 1-101341 I-EJ Your first name and initial (If joint return, also give spouse's name and initial.) last name 1 Your Social Security Number TWITTY G DAVIS Spouse's first name and ll)itial laslname 503-50-7178 2 Spouse's Social Security No. FRANNIE S DAVIS Present home address (number and street includIng apartment or rural route) 662-07-3096 Daytime Telepl10ne Number 2004 23316 KEY LARGO LOOP City, town, or post office Slate ZIP Code LAND 0 LAKES FL 34639 Part A - Tax Return Information Balance Due Refund due 307. Part B - Direct Deposit of Refund (Optional) ~ or Direct DebitO Routing Number ihe first 2 digits of the routing number must be 01 through 12 or 21 through 32. Direct Debit Payment 231382241 Account Number 2181472818 Withdrawal Date Type of Account: I!] Checking (Check one.) D Savings Full Payment 0 Partial Payment D Part C Declaration of Taxpayer r!] I consent that my refund be directly deposited as designated in Part B, and declare that the information shown in Part B is correct. If I have filed a joint ret\Jrn, this is an irrevocable appointment of the other spouse as an agent to receive the refund. D I do not want direct deposit of my refund or am not receiving a refund. D I authorize the Louisiana Department of Revenue and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicated in Part B for payment of my State taxes owed on this return. I also authorize the financial institutions involved in processing the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I understand that if I have filed a balance due return and if the Department of Revenue does not receive full and timely payment of my tax liability, I will remain liable for the tax Iiabmty and all applicable interest and returns. I declare that I have examined my state income tax return prepared for electronic transmission to the State of Louisiana and, to the best of my knowledge and belief, it is true and complete. Please sign here. Your signature Date Spouse's signature (if joint return) Date Part D - Declaration and Signature of Electronic Return Originator (ERO) and Paid Preparer I declare that 1 have reviewed the above taxpayer's return and that the entries on the return are complete and correctly represented to the best of my knowledge, based on the information submittedlfumished by the taxpayer. I also declare that I have complied with all of the requirements of the Department of Revenue and in the Louisiana Handbook of Electronic Filers. Please sign here. POOl91656 Social Security No. or ID No. 04/01/05 O,te (858) 457-8545 Preparer'ssignature Telephone I!l Mark box if also ERO. Electronic Return Originator's sIgnature Social Security No. or 10 No. Dale Telephone This form is to be maintained by ERO. LAIA0602 12106104 ~'" u. FIling status (Enter ~ Exemptions ~ auproprlate number In the Total ofeA and 68 f1 Ing status box.) 1 Single 6A Yourself X 6C Total dependents 2 Married filing jointly 65 or over 60 Total exemptions 3 Married filing separately Blind Dependent's Name(s): 4 Head of household. 6B Spouse X GLADYS DAVIS 5 Qualifying wldow(er) 65 or over KAY KOK * Dependent Name Blind JEAN KOK IT -5408 2004 LOUISIANA Nonresident Individual Income Tax Retum Mail to: Department of Revenue P.O. Box 3440 Baton Rouge, LA 70821-3440 or Fiscal Year Begun 2004 Ended 2005 1001 Attach W-2 here o If your name has changed, mark here. o If your address has changed, mark here. o If this is an amended return, mark here. o If this is for decedent, mark here. 503507178 662073096 TWITTY G DAVIS FRANNIE S DAVIS 23316 KEY LARGO LOOP LAND 0 LAKES, FL 34639 Calendar year returns due 5/16/2005 Please do not staple, use paperclip instead. Do not submit a photocopy. ~O 00200 000305 5740 9 DAVI2331 0000000000 0 0 00000 1 o Dl TPSSN 0503507178 LN15E 00000000 SCG1D 00000000 SCG23 0000000 SPSSN 0662073096 LN15F 00000000 SCG1E 00000000 SCG24 0000000 DEVID 0000001001 LN15G 00000000 SCG2A 00000000 SCG25 0000000 TAXPD 0012312004 LN15H 00000454 SCG2B 00000000 SCG26 0000000 FORMN 0000006532 LN16 00000307 SCG3A 00000000 SCG27 0000000 PTIN OPOO191656 LN17 00000000 SCG3B 00000000 SCG28 0000000 LINE7 0000133026 LN18 00000000 SCG4 00000000 SCG29 0000000 LINE8 0000009684 LN19 00000307 SCG5 00000000 SCG30 0000000 LINE9 0000000727 LN20 00000000 SCG6 00000000 SCG31 0000000 LN10A 0000020432 LN21 00000000 SCG7 00000000 SCG32 0000000 LN10B 0000001485 LN22 00000000 SCG8 00000000 LNll 0000008199 LN23 00000000 SCG9 00000000 LN12 0000000147 LN24 00000000 SCG10 00000000 LN13 0000000000 LN25 00000000 SCGll 00000000 LN13A 0000000000 LN26 00000000 SCG12 00000000 LN13B 0000000000 SCHD1 00000000 SCG13 00000000 LN13C 0000000000 SCHD2 00000000 SCG14 00000000 LN13D 0000000000 SCHD3 00000000 SCG15 00000000 LN14A 0000000147 SCHD4 00000000 SCG16 00000000 LN14B 0000000000 SCHD5 00000000 SCG17 00000000 LN14C 0000000147 SCHF1 00000000 SCG18 00000000 LN15A 0000000000 SCHF2 00000000 SCG19 00000000 LN15B 0000000000 SCHF3 00000000 SCG20 00000000 LN15C 0000000454 SCHF4 00000000 SCG21 00000000 LN15D 0000000000 SCHF5 00000000 SCG22 00000000 I dedare that I have examined this return and to the best of my knowledge, it is lrtJe and complete. Declaration of paid preparer Is based on all available information. If I made a contribution to the START Savings Program, I consent that my SSN may be given to the Louisiana Office of Student Financial Assistance in order to properly identify the START Savings Program Account Holder. If married filing joint, both SSN's may be submitted. Date Taxpayer Date Spouse Paid preparer JOHN A. DRYDEN, EA, CFP LAIA0301 11/11/04 11111 HIIIIIIIIII Date 04/01/2005 4 SSN P00191656 (858)4578545 Telephone I),C"",~,. -'"~I--"- ,~~, . 1- -1~-' ". . ~ - ~ 653~ Nonresident Worksheet ~ Attach to Form 540B 2004 Name TWITTY G AND FRANNIE S DAVIS Your Social Security Number 503-50-7178 Form 5408 Worksheet, Line 8: Adjustments to Louisiana Taxable Income Enter the adjustments to the Louisiana taxable income Adjustment Description Amount Part-Year Resident/Nonresident Allocation Worksheet, line 35 -12,500. Totai Adjustment to Louisiana Taxable Income. -12,500. Summary Total Louisiana Taxable Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total Adjustmentto Louisiana Taxable Income. . . . . . . . . . . . . . . . . . . . . . . . Net Louisiana Taxable Income to Form 540B Worksheet, Line 8. . . . . . . . . . . . . . 22,184. -12,500. 9,684. Nonrefundable Tax Credits Worksheet, Schedule G-NR 1 Schedule G-NR, Nonresident Nonrefundable Tax Credits, line 1e 1 O. 2 Credit for contributions to educational institutions a Value of computer equipment donated. 2a O. b Multiply 2a by 40%(. 40). b O. 3 Credit for certain federal credits a See instructions 3a O. b Lesser of 10 % of line 3a or $ 25 b O. 4 Other credits . 4 O. 5 Total credits against Louisiana tax Add lines 1 e, 2b, 3b, and 4 . 5 O. Refundable Tax Credits Worksheet, Schedule F-NR 1 I nventory tax credit 2 Ad valorem tax credit for offshore vessels 3 Credit for property taxes paid by telephone companies 4 Prison industry enhancement program credit . . . . . . 5 Total-Add lines 1,2.3,and4 .......... 1 2 3 4 5 o. o. o. o. o. NRTEMp.SCR 12/11/04 . I ,.,.~ ,~ ". Nonresident Tax Computation Worksheet ~ Keep for your records 2004 Name as Shown on Return Your Social Security Number TWITTY G AND FRANNIE S DAVIS 503-50-7178 A Nonresident taxable income: Enter amountfrom line 11, Form IT-540B ,. . . . . , A 8,199. B First bracket: Enter first $12,500 ( $25,000 for filing status 2 or 5). If line A is less than $12,500 ( $25,000 for filing status 2 or 5), enter amount from lineA. . . . . . . . . . , , . . . . . . . . . , , . . , . . . . . . . . , . . ... . B 8,199, C1 Combined personal exemptions. If filing status 2, 4, or 5, enter $9,000 ; or, if filing status 1 or 3 enter $4,500 .......................... . C1 9,000. 2 Creditfor dependents . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3,000. 3 Total: Add lines C1 and C2 and print the result. . . . . . . . . . . . . . . . . . . . . 3 12,000. 0 Enter ratio from IT-540B, line 9. . . . . . . . . . ............ . . . .... . 0 0.0727 E Allowable deductions: line C3 times line D ............... . ...... . E 872 . Tax F T bl fi tb k t r B . Tax axa e Irs rac e: Ins minus me mu Iple by 2 %. Enter in the Tax column . . . ... . " . .. . 7,327. 2 % Rate 147. G Second bracket: line A minus iine B; if greater than zero enter balance, or $12,500 ( $25.000 filing status 2 or 5) whichever is less. Reduce amount by the amount line E exceeds line B. Multiply balance by 4 % and enter in Tax column. . . . . . . . . . . . . . . .... . O. 4 % Rate O. H Third bracket: line A minus $25,000 ( $50,000 if filing status is 2 or 5). Enter balance (not iess than zero). Multiply balance by 6 % and enter in Tax column . . . . . . . . . . . . . . . ..... . O. 6 % Rate O. I Total tax: Add F, G and H. Enter here and on line 12, IT-540B ....... . .. .. I I 147. I' E It' r d LAIW1201.8CR 11f20f04 ri,t" '0"'''''1 "'lI'"I' 1 Fonm IT -5408 Worksheet Louisiana Nonresident and Part-Year Resident Tax Return Worksheet Calendar year returns due 05/16/2005 Mail to: Department of Revenue P.O. Box 3440 Baton Rouge, LA 70821-3440 2004 or Fiscal Year Begun ~ Ended ~ If your name has changed, mark here . . . . . . . . . . . . . . . . . . . , . . . . . . If your address has changed, mark here . . . . . . . . . . . . . . . . . . . . . . . . . If this is an amended return, mark here. . . . . . . . . . . . . . . . . . . . . . . . . . If this is for decedent, mark here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :::::::: B ..........::.:B First Name, Initial, and last Name TWITTY G DAVIS Spouse's First Name, Initial, and Last Name FRANNIE S DAVIS In Care of Une Present Home Address (no. and street including apt no. or rural route) 23316 KEY LARGO LOOP City, State, and ZIP Code LAND 0 LAKES, FL 34639 Your Social Security No. 503 -50-7178 Spouse's Social Security No. 662-07-3096 Filing Status Daytime Phone No. Enter the appropriate number in the filing status box. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1 Single 2 Married filing jointly 3 Married filing separately 4 Head of household' 5 Qualifying widow{er) 'Dependent name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Exemptions: You must claim an exemption for yourself on line 6A even if someone else claimed you on their federal tax retum. Yourself..... W 65 or over .,...0 Blind........O Spouse. . . . . W 65 or over. . . . . 0 Blind. . . . . . . . 0 Total of 6A and 6B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total dependents (from line 6c of the federal return) . . . . . . . . . . . . . . . . . . . . . . . . . . Total exemptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dependent's name(s): . . . GLADYS DAVIS KAY KOK JEAN KOK 6A B C D 2 6 C 3 D 5 -',\i"lL"""~r"~ ., 1~:-1~ ,.., , i"i~1 TWITTY G AND FRANNIE S DAVIS 503-50-7178 Page 2 7 Federal adjusted gross income (not less than zero). . . . . . . . . , . . . . . . . 7 133,026. 8 Louisiana income (Attach Nonresident Worksheet). , , . . . . . . . . , . .. . 8 9,684. 9 Ratio Louisiana income to federal adjusted gross income (line 8 'line 7) . ... . 9 0727 lOA Less federal tax: Fonm 1040, line 56 (or Form 1040A, line 36, or Form 1040EZ, line 10) . ..10 al 20,432. Less Form 4972, line 30 ...... .'......... .. a2 0, Plus Form 1040, line 46 (see instructions). ... . . . .. a3 O. A 20,432. B Allowable federal deductions . . . . . . . . . . . . . . . . ., . .... . . . . . B 1,485. 11 Louisiana net income (line 8 minus line lOB; but not less than zero) ...... . 11 8,199. 12 Your Louisiana income tax(see Nonresident Tax Computation) . 12 147. 13 Federal child care credit. . . . . . . . . . . . . . . , . . . . . . . . . ...... . O. A Nonrefundable Louisiana child care credit carried forward from prior year . . . . A B Nonrefundable Louisiana child care credit. . . . . . . . . . .... . . . .. . B . o. C Other nonrefundable credits - From Schedule G-NR. . . . ... . . . ... . C O. D Total nonrefundable credits -Add lines 13A, 13B and 13C .... . . . ... . D O. 14A Adjusted Louisiana tax (line 12 minus line 13D; notless than zero). . . . . . . . 14A 147. B Consumer use tax (mark one box) . W none D amount B O. C Total Louisiana income tax and consumer use tax (line 14A plus line 14B). . . . C . 147. 15A Allowable refundable Louisiana child care credit ................. . 15A O. B Other refundable credits - From Schedule F-NR . . . . . . . . . . . . . . . . . . B C Total Louisiana income tax withheld in the current tax year (Attach W-2's). . . . C 454. D Credits carried forward from the prior tax year. . . . . . . . . . . . . . . . . . . . D O. E Paid by composite partnership filing . . . . . . . . ................ . E F Estimated payments made in the current tax year ................ . F O. G Payments with extensions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G H Total refundable credits and payments (Add lines 15A through 15G) . , . . , . . H 454. 16 Overpayment - Jfline 15H is less than or equal to 14C, enter zero, "0," and skip lines 17 through 20. If line 15H is greater than Line 14C, the subtract Line 14C from Line 15H and enter the result here. . . . . . . . . . . " . . . 16 307. 17 Amount of overpayment you want to be donated . . . . . . . . . . . . " , 17 O. 18 Amount of overpayment you want to contribute to START . . . . . . .. . . . 18 O. 19 AmOlmt of overpayment you want to be refunded to you . . . . . . .. . . . 19 307. 20 Amount of overpayment you want to be credited to next year's tax ... . , . 20 O. 21 AmOunt you owe -If Line 14C is equal to Line 15H, enter zero, "0." If Line 14C is greater than Line 15H then subtract Line 15H from Line 14C and enter the result here. ......................... . . . .. . 21 O. Penalty and interest: 22 Interest. . . . . . . . . . ............. . ................ . 22 O. 23 Deliquent filing penalty. . . . . . . . . . . . . . . . ............... . 23 O. 24 Delinquent payment penalty. . . . . . . . . . . . . ................ . 24 O. 25 Underpayment penalty. . . . . . . . . . , . . , . . . . . . . . . . . . . . , . . . . 25 O. Total interest and penalty. . . , . . , . . . . . . . . . . . . . . . . . . . . . . . . O. 26 Balance due. Make check payable to Louisiana Department of Revenue , , 26 O. LA1W0103.SCR 1~/14/04 "", ,. ~, -~ ~ Tax Payments Worksheet ~ Keep for your records 2004 Name Social Security Number TWITTY G AND FRANNIE S DAVIS 503-50-7178 Tax Payments for the Current Year State Date Payment 1 First Payment 2 Second Payment. 3 Third Payment 4 Fourth Payment Additional Payments 5a Payment b Payment c Payment d Payment e Payment 6 Overpayment from previous year applied to current year 6 O. 7 Amount paid with current year extension 7 8 Total tax payments. 8 O. Income Taxes Withheld for the Current Year 9 State withholding on Forms W-2 9 454. 10 State withholding on Forms W-2G 10 11 State withholding on Forms 1099-R 11 12 a State withholding on Forms 1099-MISC . 12 a b State withholding on Forms 1099-G b 13 Other state tax withholding , 13 14 Total income tax withheld. 14 454. 15 Date return will be filed and balance paid 15 OTHVQ301.SCR 12106104 -J:'"~"""--""'T~ ~~ to ~-1 Part-Year Resident/Nonresident Allocation Worksheet 2004 Name(s) as Shown on Return Your Social Security No. TWITTY G AND FRANNIE S DAVIS 503-50-7178 Federal Resident Nonresident Period Amount Period (nonresidents and (part-year part-year residents) residents only) Column C Column 0 Column A Column B Income from Income from Income from Income from column A for column C from federal return column A for this period LA this period sources 7 Wages, salaries, tips, etc.. . . . . T 167,570. 22,074. 145,496. O. 5 8 Federaliy taxable interest inc. . . T 55. 23. 32. O. 5 208. 87, 12l. O. 9 Dividends. . . . . . . . . . . . . . T 5 10 State/local tax refunds. . . .. . T 5 11 Alimony received. . . . . . .. . T 5 12 Business income or loss .... . T 5 13 Capital gain or loss . . . . T 5 14 Other gains and losses . . T 5 15 Taxable IRA distribution. . . . . . T 5 16 Taxable pension and annuities. T 5 17 Rentals, royalties, p'ship, etc.. . T 5 18 Farm income or loss. . . . . . . . T 5 19 Unemployn'lent compensation . . T 5 20 a Taxable social security benefits T 5 b Taxable railroad retirements . . T 5 21 Other income. . . . . . . . . . . T 5 22 Total income. Add lines 7 - 21 . T 167,625. 22,097. 145,528. O. 5 208. 87. 12l. O. -"f""""~'~ -;1 - ~ ,'~-" -"~ ,- , ~ , TWITTY G AND FRANNIE S DAVIS 503-50-7178 Page 2 Federal Resident Nonresident Amount Period Period Column A Column B Column C Column 0 Amount Amount from Amount from Amount from from column A for column A for column C from federal return this period this period LA sources 23 Educator expenses . . . . . . . . T 5 24 Certain business expenses. . . . T 5 25 IRA deduction . . . . . . . . . . . T 5 26 Student loan interest deduction. . T 5 27 Tuition and fees deduction .. . T 5 28 Health savings account . . . . T 5 29 Moving expenses . . . . . . . . . T 4,807. O. 4,807. O. 5 30 Self-employment tax deduction. . T 5 31 Self-employed health insurance T 5 32 Self-employed SEP, SIMPLE. . . T 5 33 Early withdrawal penalty .... . T 5 34 Alimony paid . . . . . . . . . . . T 30,000. 12,500. 17,500. O. 5 Total other adjustments. . . . . T 5 35 Total adjustments .. . . . T 34,807. 12,500. 22,307. O. 5 36 Adjusted gross income .. . T 132,818. 9,597. . 123,22l. O. 5 208. 87. 12l. O. OTHV4012.SCR 1.'2120/04 ;~~I ~ "-'~f""""'r"'- ,.,. . . ~F"Ul1bef ....,.. ~ to( 1Wt1(r1tstps_~kir\ l21.al 111576.97 """"-,.. S.911 ..... ~, 11.l-3.U.~.9:'9 94~2Ul915 . .. 'ECNTEl /#IIWP, l'le, ~~, ~~~ t~~~~~~O"~~ ~~ST~~S. 5'51 Wi.ST rALAlIl UYD . ;LEHDA~;,~ 4S~D'~7700 '-.' ".,'";, " . ..... . "-.'.',' L78A .ilJ~i:7--1irii;:' .', ,.... Twrny _~ l1AVn::.-..1 :" 2SSU, K:!;(" LAAi:Cf "tJifJ.F"'" LAND QWt..dt's: no' ~..&~9 '''~'''ZfPCJ::4e f!l~ ~'5..1O~ .llli.. =4UllU.:.QJU. fonn W-2 wage and Tax staWrt\lW: 2004 " . <<;.~ <';::;;:,/~iF- ~,..l:leiItIr""",""",,,,,,... ..;..,..-...,..1OI__. , 1aSt8W~!lp$..eIe ~(I/..,.Tr"$l.lI').,WlIr!1lllRe~Stlr>Mo OfABttl~S-OOOe Co~8Ti) S. FllodWlih EmpfQ)'M" FEDtRAt.T.u R"""ll ;z(Il~_ b ::..ltionr'Ul'i.>!:( -to s_..a,jre$~...a Peoo. 94~2681915 . BECHTEL ~ROUP. tNe. FOR BECHTEL IHTERNATIONAL SY$TEHS$ 5"51 :wnl' :tALAVr 'It Vb GLEHDA:LE" AZ 85'~6,-770~; . , ~~'.e1. u021221., -.,,: 1.784 a,zn:t7 RS' TWITTY t: "JiAVI"S" . ~:~~' o~~~~~~: ,j~f~~:: f ':"~ew.iIii1dm>~ 'tSluoE~stWltIONnloer JlL :_~;l'_{lJ_tl~_~99.L____.. F(Jm1 W.2' wast_ '8nd Tax Stateml7lOt 2004 1~5_llps_(llherC~_"" ULlH 111376.99 ~""'..... ..5S25~ 98 ...,.. ttl,37".U . "" ,. , . ;, :;.<< .."~ ,.. '~;.eac~ UHonquUfle<l"pIll1i lIlSUlli'.......gu,tp$,~ ~<<lIDfbTrNwry-.~'1Wh'llolR........-......5Q!\II<:fI We,,1545-OOOl1 2F.owarlt'lCOrNltll.\Ol1fToilkl 140S~.70 WGSi 1lI......-Y..-ld 4.0.81.21 1414.91 .... ~. . 2ffodeflll<noorNilWWllthold 1'-059.70 ~ $oglilMCl.l'lt1\alfwrtl\llllll 4081.21 e<)=~lal("'.1hekl 1614.91 . ,(l~ciKe~-!ll5 " ""41>'Oll' .... - .~ Copy 2To'" FlIadWill1 Ernflll>)'''''. STATE, crr'l'0I LOCALln<.omu TlU( R"tu'h ,,""""'- b-. k/oorI~fic.~Qr1fU'f'~ C~"_,ll flU,end :;Q;k; '4-2'-81915- IECHTEl GRQUP. INC. FOR BECHTEL INTERHAYtOHAL SYSTEKS, 5-.5" WEST. TALAVI ll"VD. CiOLENDXU AI, 85,$(1"';;77'0'0 , .:. :'~ ~~. ~,::J:. ~:;,';, '" . .... L7IA '8~~~d;~:"'" "'..:~v" TWITTY h,"';-P-~-VT.~_-.!::.-'-' . 2531' ~~ 'LOOr LAHD o.l.AlE1.n. ~1iA:O--" .., ,'~.'L ' (.... I tSSli!IIe JlL t:'4r;We"andZlP~ ~$-"'IItIDlV'oor ;:_'t~:f_HL'U?- 001 _w.. and r.1I $tatCtr,1ln! 2004 '''' '" 1W4l/'1S,\Ip5,othllrCOlflJl<ll'lloiIlfln 111374.99 li4C\lflly~n ~$.8.2.$...JtB . ...,.. 111376." 1SOC:lll1~tps;._ . 121.81 " 1927.83 .M4ft(;eE.lC~ 11~pIAns ....1.011* HISl4l1<two",',II;r.i.<:k. 2~~\IOWIltt.eld 1<i059.10 1ol'IClI11"t-~~ <4C)81.jl1 e&...~l.ll. 1614.'7 " c_bffii;i~~ " ~{>flt",Trf:l4!o~llIlrR_~ 0f.l8,,'$lI~ COJlY2'ToB<iF11edWlJhEmpl~...'.STATE,.ClTYlKLOCAl.k1,.,.,..T..R.w'f1 ~L~_ . ""~ c: Ili~,.dctess,&nd lPc~ 94~26B191!i IECHTE~ GRGUP, INC. FOR BECHTEL INTERNATIQNAL SYSTEMS, 5~51 ~T.X^L^V~ BLVD &LENDAl~:~'f ,.~~~~t~7'1;OO ,~~:~:;t;'~:,?f:;~l~:} :~~,.:,/ Lfl1~A 8i1J.j~1';'tis::~.~'ji~~~::"':~~':' Tl'lITTY'P" 1:lA:m~ ,~:;~~:^'~:.'~ 2Ul' "kEV' lARGt:I 1.;00;>'".__, LAND Q:".t.AkEs'.. H, _~4.6:U:' .. > ..," .'" .,;.~?::~': . . . ." r~1i~~iw~' USlfil~,l>Iftlt!ro1lllrl"b<< D~ l~9'2'aI91s-00 fomlW-"l.Wl!g.arKITu$tl\tl:ml>nt::tQ0.4 ~IorOCaIZ lw..pIlp5~I;~ 121.81 lLISt'.'J9 ,-- _~a;!:s.~.U Ctlto.....~ 1 'i'lr. u " .' lJ.)'~~'-4'2-~._ __' al-=trl\'f_ ~~.-- 1<l0lllef "1.IxaI~~ ~of~T~I~Rever...eSe<\.lcfl 81f'~s.l5iXl3 2$d1erIll~llo.l1l'l~1d 140S9.1ll "5<1o*~1uWlItt1eld 4081..21 . Ul~.9'1 'AIOl::e\ed~ ,. .~. ~ Co~ C'Of ~'"t:lIlC:Ol.:aiS-l<kotj"Olt<l Employ... 111'1 b<>d, I 2O~ly"'-ne i)-L eXHIBIT; ~\(J 1 nCYlcr<; J t.\ ~ I,. \L, .fr..., 10 lcIWCf~rutlbt!l ~ ..-. . )ECHT~L ;ROUP. INC. ~CR .~~~EL CG~~trRA~~OH 5'51 WEfT:TALAVI BLVD GLENDALE AZ $5~b'~170U ',:' . '.'_ ~"'\"-""'l 1S01, .i"87 'R~ti:>'...: ,. TWnry',s'Ul/U' < ",'- . 25516 '~',"t.AFGtf.tO'l;fP" LA1iD O",l-A':E:S, Ft. ')l.t'nt-6.74f .' '~;~:, ; .. , , ....ltd<t~!ttldZlf'codfo 11~~'~1fl101"i.fI'tI;,r .J.L. .I..U!t.:ii:lll_ Form W~ ~ t.I\d Tax Statement 2004 94~Z68U15 :c 'Ib I '" 19.06 h. . ~r-<--:--f'-'F>"'::""--=,I$~"'''' ttN~pl&t-. d__....'.,_,.. nS\l!teO/lll~,\lpftrl:: ~"074 0' ~OfhiTr~r~.:.n'IlIl ~ ~ 1> ~,~""~ "'~!'llIIflll.~.IiINIZtP~ t4-2'8~915 JECHTEL GROUP, IRC. FOR )ECIfl'EL ,C-DRPOfl:MtON 5'51 ~t lALAVl Ilvn ;lENDALE.~Z $~3~'~lr~D . ""'" leusib 11:501 ~~lv:t('R:Ei:<~:' TWITTY ~:','i'l'AVI:$__' c_ 2nu. Uv' LAlrso-i..p'ttP - LAND a'?'1.-At:~S,',F.:l:$~09-~.741 , ,,- _~A. _ ./':, ~-~andZ1f'code ~"Ia\eIDIU11tJw !j),.?lllPJ!! ____~__ ____~~ FQ'lll w-.: wape- and talC $latA!ment 2CI<>t . . 1'9.06 '" " 3489 .12 " ~-. . v. ~ :- '.,.'~ ':y..../}.~~; '.' ~ '.-,.;",,' 1W1tll", ~t6i!IiOro 22014.02 ...... 7 .. " ir>c00'lG1lbc....'lh&ld 3963.(j6 M<;ur!fyllilli~ Un_59 .-,.. . ~__Z-.2JU".4_...o2. "'''' 1~lIP'l.'*""'~_ 22074.02 - H_.D.2... ...... - 2-Z-O-14.D2 lI~ElC~ ttNooqualthlldpla'1S 1'~Qt;IlI"'lellm.:1I~ . ~~ ..!21LO] ,~ " 1'0 ltled)o "*I'J'MI " ~.. rtPElfAt. U Itlrllllt'l ~ f(lOOraliJ\C(ltf'o(> llrI)w!ll"lNlld 3<)43.46 .. ~lIij(...1tt'leIl:l . 13u... $9_ $20_(11 1a~ell,.,beneli" 1~~ =_ ~~ ...",.,~==,~ Ol:ldll' '4-2641'115 ~oflt'tli!trllMl'""""f--ln'<<fIlI'R:~~ OOa/ll'5-4~ooOe: Cu~-:lTQB.';ir...Wti.h~;;~'.STA'rt.citvurtOCAl.lncomel.~'R;'IU'" :tl;JUx:Illily~ .ECH1El SRQUP. rNC, FOR.!~~El CORPORATION 5'51 ~T TALAV~_BlVO GLEHl'!~,~A' a~3~~.~11?O, ,.-:,.:',.-'> .e ., ~~, )SOl CMhl~Ei/::: _ " TWtl'ti' t; 'IlAV:tS ~,_ _' . ,- .~ , , 21-11' nt'1__ LARGO' (OO-P' ": . LAHD Q_~~(AKE.!? .I:~, ~.~.~~~~~_i:!41 , ....... -~ "~Ss";;'llPCO'>> ~'6~1ilkllO~ 6194$2001 ,~ " and: .~$tatf-l'l!eM b- ldiInlI1lcdon~ c. ~,~..Ilt'd )ECHTEL ~ROUP. INC. FOR B~~~~L CORPORATIOH 5'51 ~ST TALAVt )L~D GLEHDAt~ ~'~?~O~71tOO .,. "<;;',,"'~ ~,. . <:~l':"., ~. . .... mtrf~t~~W:~~o~:'.;::', LAND Oj~E~_':l~:~.~~~~;~_4{:. I:. f~.~w.o:Z1P-~ t5SlMr1~'.$!alelOllllll'tll\/' _'-:..-!_ }6194~:?.!'-O 1 _ Form W-:J, W3Qc-,llnd r.x stMel'l!ent 2QO.C . 1').06 54;89 ~ ~2 ,,;, ~ ,~ ;:~,lpf.~,," 22014.02 )Soeiet~f""lJM " 2'Ztl74.J>" e"""gM bps ,2-2'01'4.dQ2 --'Iv'" .~f'IC~ l1N""""II\tIIe<lplBt"$ 14~llII_ 2F~Ill~IQJ<Ill~ 3963.4& "~lttl4)(W1 13U.59 ..-tIllXMIhhloId 320.07 ,. 1:V1!~b " ..... ~ntllwTf,"$;.I)'-1"1\ernlll~9IltvIe~ OMBtti~~ eoPr2T<\..rnocfWhi1tmproy...'~ A . 94-2,U1915 ii-06 34119.-12 ,,,'" ,;.. :;1.:, ~.. .-'.'''-. "".' - <'I~}> ,.. L _~ , ,~ ,.,,' '(-., ,. ',--'. aep.rtM-r1lf:'''Tr~~-InI6maI-R~~ ..... 22074.02 -"'...... " _2$.:9,!~_, 02 earew~9U ';Z:,~01~ _ O? .-.~~ ~-- '~ElC~ 14~ .. ,;.,... ,~ .. 1 0(;4t 1I'l<;9fne ~ ~efOl'- od.OCAt, 1",-(>"". Till' lI':V'lufll ~. J9'~L 46 ~ HCI.flIYIlu:WlTo! 1368.59 ~. , 3'20.07 .-... elIflr~,I$ " ;':;-'.. WW. \lWc:c...r. (tH'ftoll~.I.. E'mf'I"'Y'I'. O'~ biot;L) ~lll;illfU'l'blll' &TlIlTlt "_lII1d GO<Se 94-248191S l;~(..~'-'E.).. 9-l'lOUr- I IN.e. 'l'-a.'l\. ''C.'C~'L ~J.:tl.n'ol~ lW~. 5~SL ~tt TAlAVr BLVD. GLENDALE AZ 853~6-1~ao lvw.~1lpliClNre~ ~4118. 70 , IIHw"~ . L 9.57 12l> U_, '" ~.. .. . ~ , <>.:\ , J.~1l8..1-9 . ... L" '''' ~ "',",. - 1,,_ '. om .21i~'~l'R~'" '.... , TWITTY' /:-'_l1lvn'" ,~: -. " 2n1' -m'f,."lt~tr t..'Oop " lAND a~_lJ(lt'E'S'_'f;~ ~~9:;._"4t . , ,.. :_"l-'~~~~. ~'l~":'::.-"'''' 11~ - "." 1401l>ef , ,,- ~"- .&.t$1IfIdzrp-e~ ~'.5lll:teIO~ 1&S1llte\\litgu\ljSt,ck .W' 1llo.::l!Iill'1tO'nfliu': -~.'fo~ rll'\(ll~...mtftMl.~IiI.l'-"" - FQm'I W-2: ViltgIt: and Tax statement 2004 ~pf"1herrepMty:ltMl'nel ~ . 'donl"lJiTbe( 5lll)1TJ4l,1I~Rt;,arw:lZW<:<ldt 'tj-2681915 ;ECHT~L GROUP, tNC. FOR B~RtEL NAtIoNAL tHe 5'51'-wE'$T'tAtAVI BLVD GLENDA~ AZ't~~06.t100' lw.9t~ tp;:-Olhet-<:~_ 10'.57 34118.10 )- i1M'W-IIy~ 'c "" ,.. ....ey,-~ ~ua,70 . U.OIC3lij--';:-: ~'~':;:':-: .701 i!i..h'tltE); TWITTY -<t' nA.Y'I~'- 2$1$16 xrr:, t.AAr~tr LAHD Q~J,''^tES: f~l.;: 11 Nur.quelf1edplilm ;.'.: ~J'" 1.w..~OCpll)'l!>elll _"_00)...,' ,~< "-", '" n,".;"'" . ~:- .".' ~1 .'~, .~..., ,. .:1_1- ., L.UOE',. ~4'6'39.~7ta., f ~"$tJn\J"lJI'>ccdc nSWble ~ul<lll,lDI'LItlb<<' J:J:t_ _~~__~__~_~..______~__w~........ a:inOQ<nl:la~ 425'.U .cc~NCIXItfllo.WlH1d;l ~ 494.n <:lMt'>6I 2F~lineorMlll~~ 4256,6$ "~WCUll'/ta):~ .tA ,br-tt\e\.... 494.72 .. 100f<!~e.r(l~'1:j, FIln'!\W.2W..-rtdTtlXStatil1m.r\t~ Oc.~ or1heTfeull:'t,~'R&V~$ttr>ilC'l Ot.fflfff~ C..py2To "-~iI.dWllh-EmPIn,,*'" riA'i"E;-etft,,-rt&;JU.lrl~')"'(1 Tn R.tUIIl 2lj!l~l~ti;rtM b Ml'Me~'W>~ 94-2"81915 .. rollllfl\ll.OOO'll'l$,.1'td eoOe BECHTEL GROUP. IHC. FOR BE~L NATIONAL IHe 5~Sl W~r,TAl~Yl lLVD GLENDAt~.~~ .!~~O~~~7~O 1'W.~1;pG.,(lh!(~Wi1 3-4118.70 ] ~~- s 109.57 lojI. ~.~ ewe_lI6'" 34118,7.0 r~.~.". "', -.' ,:~ '.;JL. t -'~ .. S - ,-,-: ~c ."<Mn:>oe;/C:PlI~ . .. "'~'.'-'-;'- .7., ~"'~'~~tf?"." TWITTl:,.fi DAVU' ,,".'-- -':' 2>3" kEY uRtd. tDn~<: ' LAND C!"..I..AKES.. rl"'T4::o;l1:':'1074'1 . .>, \ ., ,"'" ~ -...r, " '~ . ".,-,,:,\-' . ~t 11N~lfKlpI&M "',,' rx: 1'IOOmeu.. wtifi~oyM'" ,. ..cttyor'tOCAl1n~om.'r..RflWm 2OL~:Y'lilrT!(! " .." ,,,,,.. , USiBW J.!! '-~...Jirr~ ~"S~MI\O~ lSL1iil~.lii~oo:: Form.W. '" Oep6~gfhTr~R~lter'ke OMBit15-t~oooe C"'P't fD-s.- eand alt idePCll~alfonl'U11:lel" ..,.. iECHTEL GROUP, tnc, FO~ .~El NATt~HAL INC S,,!U ~ST TA.L.l\VI IIL.VD GLE:NDAt.~ AZ..8~:SO'6..;710:0 . ~~ &lI'l" -~sa 34118,70 Ili~f~l,- 94-2681915 109.57 I }~ ..cWll{ll'$ ~ 3"4~ Ul., 1.Q -... ':'-~k:.',"" . "~:'i,~,<",04"~''-:',,;,,~'- ',~ ~~~jTY~MJit,~;,,:-::.~:. "-~ '''~' 25$16 _XEV l.A>>:t'Q -tOtlP, ,,~~:.., ~ "- LARD U_"1"A'Kts' ',N.: ~4U)'~614r ,-..... . .~; ':~,<: :~; S~: '.', ~;: :,:~ "-' ~ '::~~ ~_i :;;~ ~:: ", e,~ " :"'L-<.:i'~:--': _iO:: -.-.,."'- 1J~'f~- 1.~Nor~f"-<1$ ,1',1 (~'~u"r4zW~ 1~~ ~'..t.Itt""ln~ TI! . USWlc~Jft$ loeolll nt<.ome \ll;~ a-p;.l:fDi 1I\p~...~.Jl'*<"-lmf.fs..,; of "fo If>!'''I''''' "f\boo-<,"_l ""'. F_ W{l Wtlg411 and TiI)( $W:ert'llnt 2lJG4 OIpllrtmenlo'tt'leTm"wy+intcinstn:~~ -ClfJti:'1!:1(S!:lOO8 %r~lIllr'lC_lln....lftlt;kJ 4254.68 .& ~ta~ c_f3'~ 4'J4,72 " a..-.t~lS " or.rc:trl(' .-WI 4254.68 .oII~~w.l\'fT1'll;1G me 1I~ 494.72 *Al9t:atoMIlIpl 16 c"'6_M~ .,'--. .. ..-:~' .- '\ , Form 1040 Department of me Treasury - Internal Revenue Service 2001 1(99\ U.S. Individual Income Tax Return IRS use only - Do not write or staple in this space. FOrlhe year Jan 1 - Dee 31. 2001. or olherlax year beginnino .2001, endino ,20 OMB No. 1545-0074 Your First Name MI Last Name Your Social Security Number Label (See Instructions.) Twittv G Davis 503-50-7178 If a Joint Return, Spouse's Firsl Name MI Last Name Spouse's Social Security Number Use the IRS label. .. Otherwise. Home Address (nUnlber and street). If You Have a P.O. Box, See Instructions. Apartment No. .. Importantl please print Roval Oak Circle You must enter your social or type. 13 City, Town or Post Office. l1You Have a Foreign Address, See Instructions. Slate ZIP Code security number(s) above. Presidential Caron Hill PA 17011 Election Campaign (Seeinslructions.) Filing Status SEE STMT Check only one box. Exemptions If more than six dependents, see instructions. Income Attach Forms W-2 and W-2G here. Also attach Form(s) 1099-R if tax was withheld, If you did not get a W-2, see instructions. Enclose, but do notattach,any payment. Also, please use Form 1040-V. Adjusted Gross Income Jt1i~vP~ ! !> I,,~ " " ~"'_~" ~'"I..^ I;':t"'~'l """II~llnr~ lII.. Note: Checking 'Yes' will not chanl}e your tax or reduce your refund. ". Do oU,or ours ouseiffilin a'olntreturn,want$3to otothisfund? , . , .. , .... 1 Single 2 Married filing joint return (even if only one had income) 3 Married filing separate return. Enter spouse's SSN above & full name here. . , . .... 4 Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child's name here . .... Quali in widower with de endent child ear souse died'" . See instructions. Yourself. If your parent (or someone else) can claim you as a dependent on his or her tax return, do not check box 6a , No 5 6a l- No. of boxes checked on . . . 6a and 6b. . _ No. of your . . . children on (4) , 6cwho, qualify!n!! . lived chlldforchdd taxcr6dit withyou.. (see instrs) . did not live with you due to divorce or separation (seelnstrs) . . 1 b s~use . c Dependents: (2) Dependent's social security number 1 (3) Dependent's relationship to you 1) First name Ma K Davis Glad s A Davis Last name 533-88-8194 Dau hter 266-24-8958 Parent Dependents on 6c not entered above . 1 d Total number of exemptions claimed. , . . , . 7 Wages, salaries, tips, etc. Attach Form(s) W-2 . 8 a Taxable interest. Attach Schedule B if required b Tax-exempt interest. Do not include on line 8a 8 b 9 Ordinary dividends. Attach Schedule B if required , . . , . . , 10 Taxable refunds, credits, or offsets of state and local income taxes (see instructions). 11 Alimony received, , . . , . . . . . . . . . . . . . . . . . . . . . . 12 Busine6S income or (loss). Attach Schedule C or C-EZ. . . . . . 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here. . . ~ 0 14 Othergainsor(losses).AttachForm4797........................... 15a Total IRA distributions. . . . ~ I b Taxable amount (see instrs) . . 16a Total pensions & annuities. .f168l b Taxable amount (see instrs) . , 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E. . . . 18 Farm income or (loss). Attach Schedule F . . . , . . . . . . . . . . . . . . 19 Unemployment compensation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 a Social security benefits. . .. ~ I b Taxable amount (see instrs) . . 21 Otherineome FORM 2555 -96718. 22 Add the am~~ts-i;the far ri- hi ~~';nfor ii~;s "7 th~u- h 21.Thlsls- ;;ur t~~1 in~o;'e .-. ~ .... 23 IRA deduction (see instructions) . . . . . . . . . 23 24 Student loan interest deduction (see instructions) 24 25 Archer MSA deduction. Attach Form 8853 . . . . 25 26 Moving expenses. Attach Form 3903. . . . . . . 26 27 One-half of seif-empioyment tax. Attach Schedule SE 27 28 Self-employed health insurance deduction (see instructions) . 28 29 Seif-employed SEP, SIMPLE, and qualified plans 29 30 Penalty on early withdrawal of savings. 30 31 a Alimony paid b Recipient's SSN. . . ~ 31 a dd lines 23lhroug~ 31a. . . . . . . . . . . . . . . . . . . . . btract line 32 from line 22. This is our ad.usted ross Income. . cy Act, and Paperwork Reduction Act Notice, see Instructions. FD1A0112 12f10/01 9 10 11 12 13 14 15b 16b 17 18 19 20b 21 22 24. -2,391. -96,718. 81,256. . .~ 81,256. Form 1040 (2001) "1",,,,",,, ._."",_. ~ ~ ., Form 1040 Tax and Credits Standard Deduction for- . People who checked any box on line 35a or 35b or who can be claimed as a dependent, see instructions. . All others: Single: $4,550 Head of household, $6,650 Married filing jointly or Qualifying widow(er). $7,600 Married filing separately. 3800 Other Taxes Payments If you have a qualifying child. attach Schedule EeIC. FDIA0112 12/10/01 Refund Direct deposit? See instructions and fill in 68b, 68c, and 68d. Amount You OWE! Third Party Designee Sign Here Joint return? See instructions. Keep a copy for your records. Paid Pre parer's Use Only :~~ ~ Pa e2 81,256. Twitt G Davis 34 Amount from line 33 (adjusted gross income) . ..................... 35a Check if: 0 You were 6S/older, 0 Blind; 0 Spouse was 6S/older, Add the number of boxes checked above and enter the total here . . . . b If you are married filing separately and your spouse itemizes deductions, or you were a dual-status alien, see instructions and check here . . . . 36 Remized deductions (from Schedule A) or your standard deduction (see left margin) . 37 Subtractline 36 from line 34 . . . . . . . . . . , . . . . . . . . . . . . 38 If line 34 is $99,725 or less, multiply $2,900 by the total number of exemptions claimed on line 6d. If line 34 is over $99.725, see the worksheet In the Instructions . . . . . . . 39 Taxable income. Subtraclline 38 from line 37. If Rne 38 is more than line 37, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 40 Tax (see instrs). Check if any tax is irom a 0 Form(s) 8814 b 0 Form 4971. . . . 40 41 Alternative minimum tax (see instructions). Attach Form 6251 . . . . . . 41 42 Add lines 40 and 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 42 43 Foreign tax credit. Attach Form 1116 if required . . . . . 43 44 Credit for child and dependent care expenses. Attach Form 2441 . . 44 45 Credit for the elderly or the disabled. Attach Schedule R . 45 46 Education credits. Attach Form 8863. . . 46 47 Rate reduction credit. See the worksheet. 47 48 Child tax credit (see instructions). . . . . 48 49 Adoption credit. Attach Form 8839. . . . . . . . 49 50 Other credits from a 0 Form 3800 b 0 Form 8396 c 0 Form 8801 d 0 FOI1ll (specify) 50 51 Add lines 43 through 50. These are your lotal credils . . . . . . . . . . 51 52 Subtract line 51 from line 42. If line 51 is more than line 42, enter -0- . ,... 52 53 Seli.employment tax. Attach Schedule SE. . . . . . . . , . . . . . . . . . 53 54 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 54 55 Tax on qualified plans, including IRAs, and other tax-favored accounts. Attach Form 5329 if required. . . . . . . 55 56 Advance earned income credit payments from Form(s) W-2 56 57 Househoid employment taxes. Attach Schedule H . . . 57 58 Add lines 52.57. This is ourlolaltax . . . . . . . . . . . . . . . ~ 58 59 Federal income tax withheld from Forms W-2 and 1099 60 2oD1 estimated tax payments and amount applied from 2000 return 61 a Earned Income credit (EIC). . . . . . . . . . . . . . I b Nontaxable earned income. . . . . 61 b 62 Excess social security and RRTA tax withheld (see instrs) . 63 Additional child tax credit. Attach Form 8812. . . . . . . 64 Amount paid with request for extension to file (see insb'Uctions) . . . 65 Other payments. Check if from. . . . a 0 Form 2439 b 0 Form 4136. . . . . . . . . . . . . . . . . . . . . 66 Add lines 59, 60, 61a. and 62 through 65. These are your totalpa ments . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . 67 If line 66 is more lhan line 58, subtract line 58 from line 66. This;s the amount you overpaid . 68aAmountofline 67 you want refunded to you . . . , . . . . ~ b Routing number . . . . ~ c Type: D Checking ~ d Account number. . . . . 69 Amount of line 67 au want a lied to our 2002 estimated tax . . . . .... 69 70 Amount you owe. Subtract line 66 from line 58. For details on how to pay, see instructions 71 Estimated tax ena . Also include on line 70 . . . . . . . .. 71 Do you want to allow another person to discuss lhis return with the IRS (see instructions)? . . . . Designee's Phone Name ... Preparer No. ... Number (PIN) Un~er penalties of pe~ul)', I declare that I have exal!lined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information ofwhich preparer has any knowledge. Your Signature Date Your Occupation o Blind. ... 35a 4,550. 76,706. 38 8,700. 68,006. 15,400. O. 15,400. 9,322. 9,322. 6,078. 6,078, 59 60 61a 3,463. 62 63 64 65 .. .... 66 67 68a 3,463. .. ..... D Savings ~ ~ Spouse's Signafure. If a JoW Return, Both Must Sign. ~ Date Contracts Administrator Spouse's Occupation Date Preparer's lIrrr. Signature r Firm's Name Thomsen-Dr den Tax Services (or yours if .. self-employed),'" 6141 Wolfstar Court Address. and ZIP Code San Die 0 Check if self-employed EIN CA 92122-3951 Pho"eNo. Interest 33. Total 2,736. (858) 457-8545 Form 1040 (2001) Name(s) Shown on Return Twitt G Davis Income or Loss from Rental Real Estate and Royalties Note: If you are in the business of renting personal property, use Schedule C or C~EZ. Report farm rental income or loss from Form 4835 on page 2, line 39. . . tal 1 tat. 2 For each rental real estate 1 Show the kind and location of each ren rea es e pro e . property listed an line 1, did you A R~~i.9.~Iltj.e~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. or your family use it during the 982 Carter Cove, Hummelstown, PA 17036 tax year for personal purposes for more lhan the greater of: .14 days, or .10% oflhe tolal days rented at fair Tentar value? (See instructions.) . Schedule E (Form 1040) Supplemental Income and Loss (From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, ete) ~ Attach to Form 1040 or Form 1041. ~ See Instructions for Schedule E (Form 1040). Department of the Tr~sury Internal Revenue Service (99) B c Income: Pro erties B 3 4 A 11,044. 3 Rents received . 4 Ro alties received Expenses: 5 Advertising............ 5 6 Auto and travel (see instructions) . 6 7 Cleaning and maintenance . 7 8 Commissions........... 8 9 Insurance ............ 9 10 Legal and other professional fees. 10 11 Managementfees . . . . . . . . 11 12 Mortgage interest paid to banks, etc (see instructions). . . . . . . . . . 12 13 Other interest. 13 14 Repairs. 14 15 Suppiies 15 16 Taxes . 16 17 Utilities. 17 18 Other (list) ~ ___ _ _ _ _ __ __ __ 1,450. 827. 4,457. 2,248. 2,180. 18 19 Add lines 5 through 18 . . . . . . 20 Depreciation expense or depletion (see instructions). . . . . . . . . 21 Total expenses. Add lines 19 and 20 . 22 Income or (loss) from rental real estate or royalty properties. Subtract line 21 from line 3 (rents) or line 4 (royalties). If the result Is a (loss), see inslructions to find out if you must fiieFonn6198 . . . . . . . . . . . .. . 22 23 Deductible rental real estate loss. Caution: Your rental real estate loss on line 22 may be limited. See instructions to find out if you must file Form 8582. Real estate professionals must complete line 42 on page 2 . .. . .. . . 23 -2 391. 24 Income. Add positive amounts shown on line 22. Do not include any losses . . . . . . . . . . . . . . . 25 losses. Add royalty losses from line 22 and rental real estate losses from line 23. Enter total losses here 26 Total rental real estate and royalty income or 0055). Combine lines 24 and 25. Enter the result here. If Parts II, III, IV, and line 39 on page 2 do not apply to you, also enter this amount on Form 1040,line 17. Otherwise, include lhis amount in lhe totaJon line 40 on a e2.... ... .. .. .. . . . . . .. .. BAA For Paperwork Reduction Act Notice, see Form 1040 instructions. FDIZ2301 11f15/01 19 11,162. 20 21 2,273 . 13,435. -2,391. 't", -"'r'~~ ." '.~r. " OMS No. 1545-0074 2001 13 Your Social Security Number 503-50-7178 Yes No A x B c C Totals Add columns A, B, and C. 3 11,044. 4 4,457. 11,162. 2,273. 24 25 -2,391. . 26 -2,391. Schedule E (Form 1040) 2001 . Form1116 OMS No. 1545..0121 Foreign Tax Credit (Individual, Estate, Trust, or Nonresident Allen Individual) ~ Attach to Form 1040,1040NR, 1041, or 990-T. ~ See separate instructions. COPY 1 Department of the Treasury Internal Revenue Service (99) Name 2001 19 Identifying Number Twitt G Davis 503-50-7178 Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. Check only one box on each Form 1116. Report all amounts in U.S. dollars except where specified in Part II below. a ~ Passive income d ~ Shipping income . 9 ~ Lump~sum distributions b High withholding tax interest e Dividends from a DISC or fanner DISC h Section 9010) income c Financial services income f Certain ~istributions from a foreign sales i Certain income re-sourced by treaty corporation (FSC) or former FSC j X General limitation income k Resident of (name of country) ~ China Note: ff you paid taxes to only one foreign country or lj. S. possession, use column A in Part I and line A in Part II. If you paid taxes to more than one foreign country or U.S. possession, use a separate column and Une for each country or possession. a Home mortgage interest (use worksheet in the instructions) . . . . . . . . . . . . . . b Other interest expense. . . . 5 Losses from foreign sources. . . . . . . . 6 Addlines2,3g,4a,4b,and5 .. . .. . . 4,202, 7 ~ub~~ct line 6 from line 1. Enter the result here and on line 14, a e 2 .. . . . . . . . . . . . . Fdrei n Taxes Paid or Accrued see instructions CreOd: is claimed Foreign taxes paid or accrued for laxes lYo~ must checlt one) (m) Paid Accrued (0) Date paid or accrued I Enter the name of the foreign country or U.S. possession . . . . . . . . " . . . . 1 Gross income from sources within country shown above and of the type checked above. See instructions: From Form 2555 Deductions and losses (Caution: See instructions): 2 Expenses definitely related to the income on line 1 (attach statement). . . . . . . . . . . . . . . . . . 3 Pro rata share of other deductions not definitely related: a Certain itemized deductions or standard deduction. See instructions b Other deductions (attach statement) . . . . . . . . . cAdd lines 3a and 3b . . . . . . . . . . . . . . . d Gross foreign source income. See instructions. . e Gross income from all sources. See instructions. f Divide line 3d by line 3e. See instructions . . . . gMultiplyline3cbyline3f. . . . . . . . . . . . . 4 Pro rata share of interest expense. See instructions: In foreign currency Taxes withheld at source on: (p) Dividends (q) Rents & Royalties A 12/31/2001 B C Checked Above Total (Add cois A, B, and C.) 80,057. 4,550. 176,775. 191,409, 0.9235 4,202. 4,202. 75,855. In U.S. dollars (r) Interest (s)Other foreign taxes paid or accrued (v) Interest (w)Other foreign taxes paid or accrued (x) Total foreign taxes paid or accrued (add columns (t) through (w)) Taxes withheld at source on: (t) Dividends (u) Rents & Royalties 19,347. 19,347. 8 Add lines A throu h C, column x. Enter the total here and on line 9, a e 2. . BAA For Paperwork Reduction Act Notice, see separate instructions. FDIZ2612 12/10/01 '.'W!'f""I'~f'~ ,.. ~ " -"I" ........".........~ 8 19,347. Form 1116 (2001) . 503-50-7178 Page 2 Form 1116 (2001) Twitty G Davis _ Figuring the Credit 9 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I. . . . . . . . . 9 19,347. 10 Carryback or carryover (attach detailed computation) . SEE STMT . 10 560. 11 Add lines 9 and 10. . . . . . . . . . . . , . . . . . . . . . . . , . . . . . . . . .. 11 19,907. 12 Reduction in foreign taxes. See instructions. . . . . . . . . . . . . . . . . . . . . . 12 10,585. 13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit. 14 Enter amount from line 7. This is your taxable income or (loss) from sources outside the United States (before adjustments) for the category of income checked above Part I. See instructions. . 15 Adjustments to line 14. See instructions. . . . . . . . . . . . . . . . . . 14 15 75,855. 16 Combine the amounts on lines 14 and 15. This is your net foreign source taxable income. (If the result is zero or less, you have no foreign tax credit for the categoiy of income you checked above Part I. Skip lines 17lhrough 21. However, If you are filing more than one Form 1116, you must complete line 19.) . . 16 17 Individuals: Enter the amount from Form 1040, line 37. If you are a nonresident alien, enter the amount from Form 1040NR, line 36. Estates and trusts: Enter your taxable income without the deduction for your exemption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 Caution: If you figured your tax using the special rates on capital gains, see instructions. 18 Divide line 16 by line 17. If line 16 is more than line 17, enter '1' . . . . . . . . . . . . . . . 75,855. 76,706. 19 Individuals: Enter the amount from Form 1040, line 40. If you are a nonresident alien, enter the amount from Form 1040NR. line 39. Estates and trusts: Enter the total of Form 1041, Schedule G, lines 1a and 1b, or the total of Form 990-T, lines 36 and 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Multiply line 19 by line 18 (maximumamountofcredit). .......................... 19 20 21 Enter the smaller of line 13 or line 20. If this is the only Form 1116 you are filing, skip lines 22 through 30 and enter this amount on line 31. Otherwise, complete the appropriate line in Part IV. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~: 21 _ Summary of Credits from Separate Parts III (see instructions) 22 Credit for taxes on passive income. . . . . . . . . . . . . . . . . . . . . . . . . . . 22 23 Credit for taxes on high withholding tax interest . . . . . . . . . . . . . . . . . . . . 23 24 Credit for taxes on financial services income. . . . . . . . . . . . . . . . . . . . . . 24 25 Credit for taxes on shipping income . . . . . 25 26 Credit for taxes on dividends from a DISC or former DISC and certain distributions from a FSC or former FSC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 27 Credit for taxes on lump-sum distributions. ................ 27 28 Credit for taxes on certain income re-sourced by treaty. . . . . . . . . . , . . . . . . 28 29 Credit for taxes on general limitation income. . . . . . . . . . . . . . . . . . . . . . 29 30 Add lines 22 through 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Enter the smaller of line 19 or line 30 . . . . . . . . . . . . . . . . . . . . . . . . 32 Reduction of credit for international boycott operations. See instructions for line 12. . . . . . , 33 Subtract line 32 from line 31. This is your foreign tax credit. Enter here and on Form 1040 line 43' Form 1040NR,line42; Form 1041,Schedule G,line2a; or Form 990-T,line4 Oa..... ,'... .', FDIZ2612 12110/01 30 31 32 ~ 33 ( , ~~ ~.'. -. -~ 9,322, 0.9889 15,400. 15,229. 9,322. 9,322. 9,322. Form 1116 (2001) . Form 6251 Alternative Minimum Tax - Individuals ... See separate Instructions. ~ Attach to Form 1040 or Form 1040NR. Department of the Treasury Internal Revenue Service (99) Name(s) Shown on Form1tl4o G Davis Alternative Minimum Taxable Income 1 If you itemized deductions on Schedule A (Form 1040), go to line 2. Otherwise, enter your standard deduction from Form 1040, line 36, here and go to line 6 . . . . . . . . . . . . . . . . . . . . . . 2 Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4 or 2-1/2% of Form 1040, line 34 3 Taxes. Enter the amount from Schedule A (Form 1040), line 9 . . . . . . . . . . . . . . . . . 4 Certain interest on a home mortgage not used to buy, build, or improve your home. . . . . 5 Miscellaneous itemized deductions. Enter the amount from Schedule A (Form 1040), line 26 . . 6 Refund of taxes. Enter any tax refund from Form 1040, line 10 or line 21. Enter amount as negative. . . . . . . . . . . . . . . . . . . . . . . . . 7 Investment interest. Enter difference between regular tax and AMT deduction. . . . 8 Post-1986 depreciation. Enter difference between regular tax and AMT depreciation 9 Adjusted gain or loss. Enter difference between AMT and regular tax gain or loss. 10 Incentive stock options. Enter excess of AMT income over regular tax income . . . 11 Passive activities. Enter difference between AMT and regular tax income or loss . . 12 Beneficiaries cf estates and trusts. Enter the amount from Schedule K-1 (Form 1041), line 9 13 Tax-exempt interest income from private activity bonds issued after August 7,1986. 14 Other. Enter the amount, if any, for each item below and enter the total on line 14. a Circulation expenditures i Mining costs . . . . . . b Depletion. . . . . . . . j Patron's adjustment . . c Depreciation (pre-198?) k Pollution control facilities. d Installment sales . . . . I Research & 'experimental. e Intangible drilling costs. m Section 1202 exclusion. . f Large partnerships. n Tax shelter farm activities 9 Long-term col1tracts . . 0 Related adjustments . h Loss limitations. . . . . 15 Total adjustments and preferences. Combine lines 1 through 14 . . . . . . . 16 Enter the amount from Form 1040,line 3? If less than zero, enter as a (loss). 17 Enter as a positive amount any net operating loss deduction from Form 1040, line21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 If Form 1040, line 34. is over $132.950 (over $66.475 ff married filing separately), and you itemized deductions, enter the amount, if any, from line 9 of the worksheet for Schedule A (Form 1040), line 28. Enter amoutlt as negative. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Combine line$ 15 through 18 . . . . . . . . . . . . . . . , . 20 Alternative tax net operating loss deduction (see instructions). 21 Alternative Minimum Taxable Income. Subtract line 20 from line 19. (If married filing sea.,atel and line 21 is more than $173,000, see instructions. ...,... Alternative Minimum Tax 22 Exemption amount. (If this form is for a child under age 14, see instructions.) And line 21 is If your filing status is... not over... Single or head of household . . . . . . . , $112,500 Married filing jointly or qualifying widow(er) . 150,000 . Married filing separately . . . . . . . . . , 75,000 . If line 21 is O'l'er the amount shown above for your filing status, see instructions. 23 Subtract line 22 from Hne 21. If zero or less, enter -0- here and on lines 26 and 28 and stop here. . . . . . . . . . 15 16 17 18 Then enter on line 22 ... $35'7501 49,000 24,500 OMS No. 1545-0227 2001 32 503-50-7178 Your Social Security Number 6 7 8 9 10 11 12 13 4,550. 76,706. 19 20 21 .. .. 23 24 Go to Part 11/ of Form 6251 to figure line 24 if you reported capital gain distributions directly on Form 1040, line 13, oryo~ had a gain on both lines 16 and 17 of Schedule D (Form 1040)(as refigured for the AMT, if necessary). All others: If line 23 is $175,000 or less ($87,500 or less if married filing separately), multiply line 23 by 26% (.26). Otherwise, mUltiply line 23 by 28% (.28) and subtract $3,500 ($1,750 If married filing separately)fromtheresult . .... . .. . . ... . .. . 24 25 Alternative minimum tax foreign tax credit (see instructions). 25 26 Tentative minimum tax. Subtract line 25 from line 24 . . . . 26 27 Enter your tax from Form 1040, line 40 (minus any tax from Form 4972 and any foreign tax credIT from Form 1040, line 43) . . . . . . . . 27 28 Alternative Illlnlmum tax. Subtract line 27 from line 26. If zero or less, enter ~o~. Enter here and on Form 1040, Iihe 41 , . . . . . . . . . . . . . . , . , , . . . . . . . . . . . . . . . , . . . . . . . . . . . . .. 28 BAA For Paperwork Reduction Act Notice, see separate instructions. FOlA5312 11/06101 ','<<= - '1'1 ~, -~ '.." r'~ " , 1 2 3 4 5 4,550. o. 81,256. 81,256. 35,750. 45,506. 11,832. 10,649. 1,183. 6,078. O. Form 6251 (2001) -: Maximum Ca ital Gains Rates 503-50-7178 Caution: If you did not complete Part IV of Schedule D (Form 1040), see the instructions before you complete this part. 29 Enter the amount from Form 6251, line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Enter the amount from Schedule -D (Form 1040), line 23, or line 9 of the Schedule D tax worksheet in the instructions for Schedule D (Form 1040), whichever applies (as refigured for the AMT, if necessary) (see instructions) 31 Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT, if necessary) (see instructions) . . . . . . . . . . . . . . . . . . . . . 32 Add lines 30 and 31 .... . . . . . . . . . . . . . . . . . . . . . . . 33 Enter the amount from Schedule D (Form 1040), line 23, or line 4 of the Schedule D tax worksheet in the instructions for Schedule D (Form 1040), whichever applies (as refigured for the AMT, if necessary) (see instructions) 30 31 32 33 34 Enter the smaller of line 32 or line 33. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 34 35 Subtract line 34 from line 29. If zero or less, enter -0- . ......35 36 If line 35 is $175,000 or less ($87,500 or iess if married filing separately), multiply line 35 by 26% (.26). Otherwise, multiply line 35 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 36 37 Enter the amount from Schedule D (Form 1040), line 28, or line 16 of the Schedule D tax worksheet in the instructions for Schedule D (Form 1040), whichever applies (as figured for the regular tax) (see instructions) . . 38 Enter the smallest of line 29,I!ne 30, or line 37. If zero, go to line 44 . 39 Enter your qualified 5-year gain, if any, from Schedule D (Form 1040), line 29 (as refigured for the AMT, if necessary) (see instructions) 40 Enter the smaller of line 38 or line 39. 39 41 Multiply line 40 by 8% (.08) . 42 Subtract line 40 from line 38 43 Muitlply line 42 by 10% (.10) 44 Enter the smaller of line 29 or line 30. 45 Enter the amount from line 38 46 Subtract line 45 from line 44 47 Multiply line 46 by 20% (.20) 42 44 45 46 If line 31 Is zero or blank, skip lines 48 through 51 and go to line 52. Otherwise, 0 to line 48. 48 Enter the amount from line 29 49 Add iines 35, 38, and 46 . . 50 Subtract line 49 from line 48 51 Multiply line 50 by 25% (.25) 48 49 50 ..........................................51 52 Add lines 36, 41,43, 47, and 51 .. . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . .. 52 53 if line 29 is $175,000 or less ($87,500 or less if married filing separately), multiply line 29 by 26% (.26). Otherwise, muitlply line 29 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from theresult. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 53 54 Enter the smaller of line 52 or line 53 here and on line 24 . . . . . . . . . . . . . . . . . . . . '. . . . . . . . . 54 FDtA5312 11/06101 :r1,,,,,, """'~r""'" I' I ~ ~, ".. Pa e 2 Form 6251 (2001) Alt Min Tax Foreign Tax Credit (Individual, Estate, Trust, or Nonresident Alien Individual) ~ Attach to Form 1040, 1040NR, 1041, or 990-T. ~ See separate Instructions. COpy 1 . Form1116 Department of the Treasury Internal Revenue Service (99) Name OMB No. 1545-0121 2001 19 Identifying Number Twitt G Davis 503-50-7178 Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. Check only one box on each Form 1116. Report all amounts in U.S. dollars except where specified in Part II below. a ~ Passive income d ~ Shipping income 9 ~ Lump-sum distributions b High withholding tax interest e Dividends from a DISC or former DISC h Section 9010) income c Financial services income f Certain ~i5tributions from a foreign sales i Certain income re-sourced by treaty corporation (FSC) or former FSC j X General limitation income k Resident of (name of country) ~ China Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Pari J/. If you paid taxes to more than one foreign country or U.S. possession, use a separate column and line for each country or possession. I Enter the name of the foreign country or U.S. possession. . . . . . . . . . . . . 1 Gross income from sources within country shown above and of the type checked above. See instructions: From Form 2555 Deductions and losses (Caution: See instructions): 2 Expenses definitely related to the income on line 1 (attach statement). . . . . . . . . . . . . . . . . . 3 Pro rata share of other deductions not definitely related: a Certain itemized deductions or standard deduction. See instructions b Other deductions (attach stalement) . . . . . . . . . cAddlines3aand3b.............. . d Gross foreign source income. See instructions. . e Gross income from all sources. See instructions . f Divide line 3d by line 3e. See instructions . . . . gMultiplyline3cbyline3f. .. . . . .. . . . . . 4 Pro rata share of interest expense. See instructions: In foreign currency Taxes withheld at source on: (0) Date paid or accrued (p) (q) Rents & Dividends Royalties A 12/31/2001 B C Checked Above Total (Add cols A, 8, and C.) 80,057. O. 176,775. 191,409. 0.9235 O. o. O. 80,057. In U.S. dollars (r) Interest (s)Other foreign taxes paid or accrued (v) Interest (w)Other foreign taxes paid or accrued (x) Tolal foreign laxes paid or accrued (add columns (I) lhrough(w)) Taxes withheld at source on: (t) (u) Rents & Dividends Royalties 19,347. 19,347. 8 Add lines A throu h C, column x . Enter the total here and on line 9, a e 2. . BAA For Paperwork Reduction Act Notice, see separate Instructions. FDIZ2612 12/10/01 -<"~-il. ., c, " . . . . . . . . . . . . . . . . . . ~ 8 19,347. Form 1116 (2001) , Al t Min Tax Form 1116 (2001) Twitty G Davis _ Figuring the Credit 9 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I. . . . . . . . . . . . . . . . . 9 10 Carryback or carryover (attach detailed computation) . . . . . . . . . . . . . . . . . 10 11 Add lines 9 and 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11 12 Reduction in foreign taxes. See instructions. . . . . . . . . . . . . . . . . . . . . . 12 13 Subtract line 12 from line 11. This is the total amount of foreign taxes available for credit. 14 Enter amount from line 7. This is your taxable income or (loss) from sources outside the United States (before adjustments) for the category of income checked above Part I. See instructions. . 15 Adjustments to line 14. See instructions. . . . . . . . . . . . . . . . . . 14 15 16 Combine the amounlS on lines 14 and 15. This is your net foreign source taxable income. (If the result is zero or less. you have no foreign tax credit for the category of income you checked above Part I. Skip lines 11 through 21. However, If you are filing more 'than one Form 1116, you must complete line 19.) . . 16 17 Individuals: Enter the amount from Form 1040, line 37. If you are a nonresident alien, enter the amount from Form 1040NR, line 36. Estates and trusts: Enter your taxable income without the deduction for your exemption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 Caution: If you figured your tax using the special rates on capital gains, see instructions. 18 Divide line 16 byline 17. If line 16 is more than line 17,enter'1' . . . . . . . . . . .. . . . 19 Individuals: Enter the amount from Form 1040, line 40. If you are a nonresident alien, enter the amount from Form 1040NR, line 39. Estates and trusts: Enter the total of Form 1041, Schedule G, lines 1a and 1b, or the total of Form 990-T, lines 36 and 37 . . . . . . . . . . . . . . . . . . . . . . 20 Multipiy line 19 by line 18 (maximum amount of credit). . . . . . . . . . . . . . . . . . . . . . . . . . . 503-50-7178 Page 2 19,347. 2,042, 21,389. 10,585. 80,057. 80,057, 81,256. 19 20 21 Enter the smaller of Une 13 or line 20. If this is the only Form 1116 you are filing, skip lines 22 through 30 and enter this amount on line 31. Otherwise, complete the appropriate line in Part IV. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 21 _ Summary of Credits from Separate Parts III (see instructions) 22 Creditfortaxes on passive income. . . . . . . . . . . . . . . . . . . . . . . . . . . 22 23 Credit for taxes on high withholding tax interest . . . . . . . . . . . . . . . . . . . . 23 24 Credit for taxes on financial services income. . . . . . . . . . . . . . . . . . . . . . 24 25 Credit for taxes on shipping income . . . . . 25 26 Credit for taxes on dividends from a DISC or former DISC and certain distributions from a FSC orformerFSC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 27 Credit for taxes on lump-sum distributions . ................ 27 28 Credit for taxes on certain income re-sourced by treaty. . . . . . . . . . . . . . . . . 28 29 Credit for taxes on general limitation income. . . . . . . . . . . . . . . . . . . . . . 29 30 Add lines 22 through 29 . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . , 31 Enter the smaller of line 19 or line 30 .. . . ... . . . .. . .. . . . . .. . . . 32 Reduction of credit for international boycott operations. See instructions for line 12. . . 33 Subtiact line 32 from line 31. This is your foreign tax credit. Enter here and on Form 1040 line 43' Form 1040NR, line 42; Form 1041, Schedule G, line 2a; or Form 990-T, line 40a. . . . . .' . . . .' . FDlZ2612 12110101 ;i~~,"~,,",.,11r'r- 30 31 32 . .. 33 10,804. 0.9852 11,832. 11,657. 10,804. 10,804. 10,804. Form 1116 (2001) , Form 2555 Foreign Earned Income OMS No. 1545..0067 Department of the Treasury ,,__ internal Revenue Service t 991 ~ See separate instructions. ~ Attach to Form 1040. 2001 34 For Use by U.S. Citizens and Resident Aliens Only Name Shown on Form 1040 I Your Social Security Number 1503-50-7178 Twittv G Davis _ General Information 1 Your foreign address (including country) I 2 Your occupation Lido Place, Apt 6014, Jichang Road, Jiang Tai Road Beiiinq, China 100004 38 Contracts Administrator 3 Employer's name ~ .!l!:,,",h.!:!:,~ .!l:!:!!.a_ J.lia]~y'sj.~L E~ !lg~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - - - -- 4a Employer's U.S. address ... 5Q Beale S~..r~~'I:./_ .e~n_ E:tz..aE~~s.9~I_.f~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. b Employer's foreign address -;. l~tj; .:JJs_ J,!e:,'~~ J'1!:,~d-,-.J~ .,;rala!?o .B-<0~_CE",l~'!J_ ~O~OO _~~li' _ L-'.'1llp-'.'!:'._ fial~ELa_ 5 Employer is (check a 0 A foreign entity b liCJ A U.S. company c 0 Self any that apply): ~ d I!l A foreign affiliate of a U.S. company e 0 Other (specify) ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6 a If, after 1981, you filed Form 2555 to claim either of the exclusions or Form 2555-EZ to claim the foreign earned income exclusion, enter the last year you filed the form ~ ]QQ.O__ --- -- -- - -- -- --- ------ ----- -0- - - --- -- -- -- - ---. b If you did not file Form 2555 or 2555-EZ after 1981 to claim either of the exclusions, check here'" and go to line 7 now. c Have you ever revoked either of the exclusions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Ves ~ No d If you answered 'Yes,' enter the type of exclusion and lhe tax year for which lhe revocation was effective'" _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . 7 Of what country are you a citizen/national?'" JI.@12._______________________________________. 8 a Did you maintain a separate foreign residence for your family because of adverse living conditions at your tax home? 0 See Second foreign household in the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Ves I!l No b If 'Yes,' enter city and country of the separate foreign residence. Also, enter the number of days during your tax year that you maintained a second household at that address ... _ __ _ _ _ __ __ _ __ __ _ ______ __ ___ __ __ __ ___ __ __ _ __ ___ 9 List your tax home(s) during your tax year and date(s) estabiished ~ ..l\'I~~a'y~~a_ _ 71]1.02 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ China 04/14/2001 Next, complete either Part II or Part ,III. 'f an Item does not apply, enter 'NA.' If you do not give the information asked for, any exclusion or deduction you claim may be disallowed. _ Taxpayers Qualifying Under Bona Fide Residence Test (See instructions.) 10 Date bona fide residence began ... 07/31/1999 ' ,andended ... continue 11 Kind of living quarters in foreign countrY - -;- - a-B-p~~h;S;d-h;;-u;e- - - b TRl Rented house 0; ap;~~t- - - ~ D R~t;d-;'~~ - -- d Quarters furnished by employer 12aDidanyofyourfamilylivewithyouabroadduringanypart'ofthetax year? . . .. . .. . . . .. . .. . . .. .. .. . . . DYes [I No blf'Yes:who&-... forwhatperloor"'- __ _ __ _ ______ ___ __ _____ __ __ _ ___ ___ __ ___ __ __ __ ___ __ __ _ __ __ _ _. 13 a Have you submitted a statement to the ,authorities of the foreign country where you claim bona fide residence that you are nota residentofthatcountry? (See instructions.} . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dves b Are you required to pay income tax to the country where you c'aim bona fide residence? (See instructions.). . . . . . . . . . ~ Yes If you answered 'Ves' to 13a and 'No' to 13b, you do not qualify as a bona fide resident. Do not complete the rest of this part. 14 If you were present i~ ~e United states or its possessions during the tax year, complete columns (a) - (d) below. Do not include the income from column Id, in P;;Irt IV, but report it on Form 1040. (a) I?ate (b) Date left (c) N~mberof (d) Incomee~med in ~a) I?ate (b) Date left (c) Numberof (d) Income eamedin arrived In U.S. U.S. days 'n, U.S. U.S. on buslneS!s amved In U.S. U.S. days in U.S. U.S. on business on bUSiness (attach computation) on business (attach computation) I!l No DNa 07/21/2001 07/28/2001 5 3,466. 15aUstanycontractualtermsorotherconditionsrelatingtothelenglh ofyouremploymenl abroad . " . . . . .. . . .... _C~l!!P].~~i..9~_oJ_I2..r.9i~c.!___ ----------------------------------- ------------------------------ bEnlertypeofvisaunderwhichyouenteredtheforeigncountly. . .. . . . .. ..... J'l~:;:.k______________________ c Did your visa limit the length of your stay or employment in a foreign c ountry?lf'Yes,'attachexplanation . . . . . . . . . . . . . . . . . IRlxx Yyee-sS---8-NN~0- d Did you maintain a home in the United States while living abroad? . . . . . . . . . . . . . . . . . . . . . . . . . . . /ill e If 'Yes,' enter address of your home, whether it was rented, the names of the occupants, and their relationship to you ... ~~~S~~~ES..9~~_g~m~~~.!Q~~_~~__________ Not rented. -- - - -- --- -- -- - - - --- ----- --- BAA. For Paperwork Reduction Act Notice, see separate instructions. FDIA3312 12/10101 Form 2555 (2001) -fj~~0'f--~I"lj!"'I~f.".- ~~ ,. ~ Form 2555 (2001) Twitty G Davis _ Taxpayers Qualifying Under Physical Presence Test (See instructions.) 16 The physical presence test is based on the 12pmonth period from. . ~ 17 Enter your principal country of employment during your tax year . . ~ 503-50-7178 Page 2 through ~ ________________ 18 If you traveled abroad during the 12-month period entered on line 16, complete columns (a) - (f) below. Exclude travel between foreign countries that did not involve travel on or over international waters, or in or over the UnIted States, for 24 hours or more. If you have no travel to report during the period, enter 'Physically present in a foreign country or countries for the entire 12-month period: Do not include the income from column (f) below in Part IV, but report it on Form 1040. (a) Name of country (including U.S.) (b) Date arrived (0) 0,101'" (d) Full days (e) Numberof (f) Income earned in U.S. present in days in U.S. on business (attach country on business computation) _ All Taxpayers Note: Enter on Jines 19 through 23 a/J income, including noncash income, you earned and actually or constructively received during your 2001 tax year for services you performed in a foreign country. If any of the foreign earned income received this tax year was earned in a prior tax year, or will be earned in a later tax year (such as a bonus), see the instructions. Do not include income from line 14, column (d)~ or line 18, column (t). Report amounts in U. S. dollars, using the exchange rates in effect when you actually or construc- tively received the income. If you are a ca.sh basis taxpayer, report on Form 1040 all income you received in 2001, no matter when you performed the service. 2001 Foreign Earned Income Amount (in U.S. dollars) 19 Total wages, salaries, bonuses, commissions, etc 19 176,775. 20 Allowable share of income for personal services performed (see instructions): a In a business (inclUding farming) or profession . . . . . . . . . . . . . . . . 20a b In a partnership. List partnership's name and address and type of income. .. --------------- ---------------------------------------------------. 20b 21 Noncash income (market value of property or facilities fumished by employer - attach statement showing how it was determined): . a Home (lodging). .. 21a b Meals 21b cCar. 21c d Other propeny or 1ac.\lities. List type and amount. .. ------------------------------ --------------------------------------- ------------ 21d 22 Allowances, reimbursements, or expenses paid on your behalf for services you performed: a Cost of living and overseas differential 22a b Family 22b c Education 220 d Home leave 22d e Quarters 22e f For any other purpose. List type and amount .. ------------------- --------------------------- ---------- 22f g Add lines 22a through 22f 22g 23 Other foreign earned income. List type and amount. ... --------------- ----------. ------------------------------ ---------------------. 23 24 Add lines 19 through 21d, line 22g, and line 23. 24 176,775. 25 Total amount of meals and lodging included on line 24 that is excludable (see instructions) 25 26 Subtract line 25 from line 24. Enter the result here and on line 27 on page 3. This is your 2001 foreign earned Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 26 176,775. FDIA3312 12/10/01 Form 2555 (2001) ~ '~~r .., , Form 2555(2001) Twitty G Davis _ All Taxpayers 503-50-7178 Page 3 27 Entertheamountfromline26. . . . . . . . . . . . . . . . . Are you claiming the housing exclusion or housing deduction? jjf] Yes. Complete Part VI. ~ No. Go to Part VII. _ Taxpayers Claiming the Housing Exclusion and/or Deduction ...........................GJ 176,775. 28 Qualified housing expenses for the tax year (see instructions) . . . . . . . 29 Number of days in your qualifying period that fall within your 2001 tax year (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 30 Multiply $28.92 by the number of days on line 29. If 365 entered on line 29, enter $10,557.00 here. ....... 30 31 Subtract line 30 from line 28. If the result is zero or less, do not complete the rest of this part or any of -~.......................................................~ 32 Enter employer-provided amounts (see instructions) ................ 32 176/775. 33 Divide line 32 by line 27. Enter the result as a decimal (rounded to at least three places), but do not enter more than '1.000'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Housing exclusion. Multiply line 31 by line 33. Enter the result but do not enter more than the amount on line 32. Also, compiete Part VIII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Note: The housing deduction is figured in ParllX. If you choose to claim the foreign earned income exclusion, complete Parts VII and VIII before Part IX. .......28 29,275. 365 da s 10,557. 18,718. 33 x 1. 000 ... 34 18,718. __ Taxpayers Claiming the Foreign Earned Income Exclusion 35 Maximum foreign earned Income exclusion. . . . . . . . . . . . . . . . . . . . .. " .. I' . . . . 36 . If you completed Part VI, enter the number from line 29. 1 ... 36 . All others, enter the number of days in your qualifying period that fall within your 2001 tax year (see the instructions for line 29). _ 37 . If line 36 and the number of days in your 2001 tax year (usually 365) are the same, enter '1.000.' . Otherwise, divide line 36 by the number of days in your 2001 tax year and enter the result as a decimal (rounded to at least three places). 38 Multiply line 35 by line 37 . . . .. . .. . . . . . . ... . . . . .. . . . . . .. .. .. . . . . 39 Subtract line 34 from line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 ,Foreian earned income exclusion. Enter the smaller of line 38 or line 39. Also, complete Part VIII _Taxpayers Claiming the Housing Exclusion, Foreign Earned Income Exclusion, or Both 35 365 days 1. 37 x 38 39 ," 40 $78,000. 1.000 78,000. 158,057. 78,000. 41 Add lines 34 and 40 41 96,718. 42 Deductions allowed in figuring your adjusted gross income (Fonn 1040, line 33) that are allocable to the excluded income. See instructions and attach computation. . . . . . . 42 43 Subtract line 42 from line 41. Enter the result here and in parentheses on Form 1040, line 21. Next to the amount enter 'Form 2555.' On Form 1040, subtract this amount from your income to arrive at total income all Form, 1040, line 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 43 96,718. _.. Taxpayers Claiming the Housing Deduction - Complete this part only if (al line 31 is more than line 34 and (b) fine 27 is more than line 41. ' 44 Subtract line 34 from line 31 . . . . . . . . . . .. . . . 44 45 Subtract line 41 from line 27 45 46 Enter the smaller of line 44 or line 45. 46 Note: If line 4S is more than line 46 and you could not deduct all of your 2000 housing deduction because of the 2000 limit, use the worksheet in the instructions to figure the amount to enter on line 47. Otherwise, go to line 48. 47 Housing deduction carryover from 2000 (from worksheet in the instructions) ............... . . . 47 4B Housing deduction. Add lines 46 and 47. Enter the total here and on Form 1040 to the left of line 32. Next to the amount on Form 1040, enter 'Form 2555.' Add it to the total adjustments reported on that line , . , . ," 48 / BAA Form 2555 (2001) FDJA3303 11/0BJ01 ~~",. Form 4562 (Rev March 2002) Departmen\ of the Treasury Internal Revenue SeNiee Name(s) Shown on Return Twittv G Davis Business or Activity to Which This Form Relates Sch E Residential _ Election to Expense Certain Tangible Property Under Section 179 Note: If you have any listed property, compTete Part V before you complete Part I. 1 Maximum amount. See instructions for a higher limit for certain businesses. 2 Total cost of Section 179 property placed in service (see instructions). . . 3 Threshold cost of Section 179 property before reduction in limitation . . . . 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- . 5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing se aratel t see instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depreciation and Amortization (Including Information on Listed Property) ~ See separate Instructions. ~ Attach to your tax return~ OMS No. 1545-0172 2001 67 Identifying Number 503-50-7178 1 2 3 4 $24,000. $200,000. 5 6 a DesCl'iptionofproperty b Cos! (business use only) C 8ected cost 7 Listed property. Enter the amount from line 29 . . . . . . . . . . . . . . . . . . . . 7 8 Total elected cost of Section 179 property. Add amounts in column (c), lines 6 and 7 . 8 9 Tentative deduction. Enter the smaller of line 5 or line 8. . . . . . . . . . . . . . . . 9 10 Carryover of disallowed deduction from line 13 of your 2000 Fortn 4562 . . . . . . . 10 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instrs) 11 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 . 12 13 Ca over of disallowed deduction to 2002. Add ,lines 9 and 10, less line 12. . . . . . . ... 13 Note: Do not use Part /I or Partlfl below for listed properly. Instead, use Part V. S ecial De reciation Allowance and Other De reciation Do not include listed pro e 14 Special depreciation allowance for certain property (other than listed property) acquired after September 10, 2001 (see Instructions) . . . . . . . . . . . . . . . . . . . . " .. . . . . 14 Property subject to Section 168(1)(1) eieclion (see instructions). .. .......... 15 Other.de rec1ation includin ACRS see instructions . . . . . .. .......... 16 MACRS De reciation (Do not include listed pro e . See Instructions Section A 17 MACRS deductions for assets placed in service, in tax years beginning before 2001. . . . 18 If you are electing under Section 168{i)(4) to group any assets placed in service during the tax year intooneormore eneralassetaccounts,checkhere........................ ~ Section B - Assets Placed in Service Durin 2001 Tax Year Usin the General De reclation S stem (a) (b) Month and (c) Basis for depreciation (d) (e) (1) Classification of property year placed {business/investrnent use Recovery period Convention Method in service only - see instructions} (g) Depreciation deduction 20 a Class life . b 12- ear. . c 40- ear. . Summa See instructions 21 Listed property. Enter amount from line 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 21 22 Total. Add amounts fro~ line 12. lines 14 t~rough 17, li.nes 19 .and 20 in column (9), and line 21. Enter here and on the appropriate Hnes of your return. Partnerships and S corporations - see Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 22 23 For ass~ts shown abt;>ve a~d placed in service during the current year, enter the rtlon of the baSIS attnbutable to Section 263A costs. . . . . . . . . . BAA For Paperwork Reduction Act Notice, see instructions. 12 40 rs S/L S/L S/L S L S/L reclatlon S S/L S L S/L 2,273. 05/01 25 rs 100,000. 27.5 rs MM 27.5 rs MM 39 rs MM MM Nonresidential real . property . 2001 Tax Year Usin the Alternative De stem rs MM 23 FDIZ0812 03l20f02 Form 4562 (2001) (Rev 3-2002) ,;~'1II'lf"'l' '''''"'''"q . 0 Form 4868 Application for Automatic Extension of Time to File U.S. Individual Income Tax Return 2001 Your spouse's giftlGST taxpa ent......... Total 9 TotaIliabilily. Add lines 6.7, and 8. . $ 10 Amount ouarepain.... ..... Confirmation Number If you file electronically, you will receive a confirmation number telling you that your Form 4868 has been accepted. Enter the confirmation number here Check lhis box ... ifyourspouse is requesting a Gift orGST tax retum eKtension. andkee itfor our records . . . .~ BAA For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Department of the Treasury Internal Revenue Service (99) For Calendar year 2001, or other tax year beginning Identification 1 Your Name(s) (see instructions) Twitt G & Rosana J Davis Address (see instructions) 13 Ro al Oak Circle City, Town or PostOflice state ZIP Code Cam Hill 2 Your Social Security Number I?A 17011 3 spouse's Social Security Number Caution' Only for gifflGST tax axtension' Checking box(es) may result in . correspondence if Form 709 or 709-A is not filed. This form also extends the time for filing a gift or generation-skipping transfer (GST) tax return if you file a calendar (not fiscal) year income tax return. Enter your gift or GST tax payment(s) In Part IV and: Check this box .. if you are requesting a Gift or GST tax return extension. OMB No. 1545-0188 .2001. ending , 20 Individual Income Tax 4 Esijmate of total tax liability for 2001 . . . . . . , . . . .. . $ 5 T otai 2001 payments. . . . . . 6 Balance due. Subtract 5 from 4 O. 3,463. O. GiftlGST Tax - If you are not filing a gift or GST tax return, go to Part V now. See the instructions. Your gift or GST tax payment. . . . $ o. ------------------------------!D~~h~rn~----------------------------- Form 4868 (2001) Where To File Your Extension Mail Form 4868 (with payment, if applicable) to the address listed below. Internal Revenue Service Center Philadelphia, PA 19255 FD1A4601 11/07/01 ':~_"",,-, -"r Form 1040 Forms W-2 & W.2G Summary ~ Keep for your records 2001 Name(s) Shown on Return Twitty G Davis Social Security Number 503-50-7178 Form W-2 Summary W-2 Description Taxpayer Spouse Total Box No. 1 Total wages, tips and compensation: Non-statutory & statutory wages not on Sch C . . 180,24l. 180,24l. Statutory wages reported on Schedule C .. . . . Foreign wages included in total wages. . . . . . . 180,241. 180,24l. 2 Total federel tax withheld ........... . 3,463. 3,463. 3 & 7 Total social security wages/tips . . . . . . . . . 80,400. 80,400. 4 Total sociai security tax withheld ....... . 4,984. 4,984. 5 Total Medicare wages and tips ........ . 180,24l. 180,24l. 6 Total Medicare tax withheld . . . . . . . . . . . 2,613. 2,613 . 8 Total allocated tips. . . . . . . . . . . . . . . . 9 Total advance earned income credit . . . . . . 10 Total dependent care benefits ........ . 11 Total distributions from nonqualified plans. . . 12 Total from Box 12 ............... . 16l. 16l. Elective deferrals to qualified plans. . . . . . . Deferrals to 457 plans . . . . . . . . . . . . . . Uncollected Medicare tax . . . . . . . . . . . . Uncollected social security and RRT A tier 1 . . Uncollected RRTA tier 2. . . . . . , . . . . . . Total other items from box 12 . . . . . . . . . . 16l. 16l. 14 Total deductible mandatory state tax. . . . . . 355. 355. Total RR Tier 1 wages. . . . . . . . . . . . . . Total RR Tier 1 tax. .. . . . . . ... . Total RR Tier 2 tax. . . . . . . . . . . . . . . . Total RRTA tips. . . . . . . . . . . . . . . . . . Total other items from box 14 . . . . . .. . 16 Totai state wages and tips. .. . .. . .. . 17 Total state tax withheld .. . . . .. . 19 Total local tax withheld. . . .. . .. . .. . Form W-2G Summary W-2G Description Taxpayer Spouse Total Box No. 1 Total gross winnings. . . ........... . 2 Total federal tax withheld ........... . 14 Total state tax withheld ... . . . .. . 16 T otallocal tax withheld. . ........... . - Form 1040 Form W-2 Worksheet ~ Keep for your records 2001 Name as shown on return Twitty G Davis Social Security Number 503-50-7178 Employer Name. . . . . . . . . . . . . . . , . .. Bechtel Malaysia Employer Name (Continued) . . . . . . . . . . . . EmployerfederaIIDnumber(SeeHelp)......................... 94-2681915 Check this box to automatically calculate lines 3 through 6 below. . . . . . . . . . . . . . . . . . . . ~ D Check this box if this is Spouse's W-2 . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . ~ D 1 Wages, tips, other compensation. 1 37,549. 2 Federal income tax withheld 2 3 Social security wages . 3 37,549. 4 Social security tax withheld . 4 2,328. 5 Medicare wages and tips 5 37,549. 6 Medicare tax withheld . 6 544. 11 Important. For tiC, Form 2441, Form 8812, and IRAs, box 11 is important. See Help. Disfributions from Section 457 and other nonqualified plans. , Code ~ 11 13 b Check box if retirement plan participant . .. .. ~tE Check if foreign source income eligible for exclusion on Form 2555 ... ,.... X Box 15 Box 16 Box 17 State Employer's state LD. no. State wages, tips, etc. State income lax DE 1-942681915-001 Box 20 Box 18 Box 19 Associated Locality name Local wages, tips, etc. Local income tax State - - - 7 8 9 10 Social security tips. ................ ................. . 7 Allocated tips. . . . . . . . . . . . . . . . . . . . ................. . 8 Advanced EIC payment. . . . . . . , . , . . . . . . . . . . . . . . . . . . . . . . 9 Dependent care benefits (Check if employer furnished care at work). . . ,~D 10 Dependent care benefits - Amount forfeited from flexible spending account. . . Box 12 Box 12 If Box 12 code is: Code Amount A: Enter amount attributable to RRTA Tier 2 tax M: Enter amount attributable to RRTA Tier 2 tax P: Double click to link to Form 3903, line 4 . . . . . R: Enter MSA contribution for Taxpayer ... . Spouse .... . Box 14 Descrtption Amount Type ProSeries description of Type - - - NOTE: The box 14 "TyPe" is specific to ProSeries and may not be the same as one letter descriptions on some W-2 forms. "'''''~''IlTj~- ""~I~' f"~, Form 1040 Form W-2 Worksheet Additional Information ~ Keep for your records 2001 Twitty G Davis 503-50-7178 Page 2 Employer Name. . . . . Bechtel Malaysia Statutory employees Box 13a. Check box if a statutory employee. .., . . . .. . . ., . . . . .~D Check box if deducting expenses in connection with this income. . . . . ,~D If deducfing expenses, double click to link to Schedule C . . . . . . . . . . . .. C A B C Clergy, church employees, members of recognized religious sects Clergy only: o Housing or parsonage allowance. . . . . . . . . . . . . . . . . . . . . . . . . .. 0 E Unused (taxable) portion of housing or parsonage allowance. , . . . . . . . .. E F If no FICA was withheld, check the applicabie box below 1 Pay seif-employment tax on housing or parsonage allowance only. . . . '~~ 2 Pay self-empioyment tax on W-2 income only. . . . . . . . . . . . . . . . . ~ 3 Pay self-employment tax on W-2 income and housing allowance. . . . . ,~ 4 Exempt from self-employment tax and has approved Form 4361 . . . . . . ~ Non-Clergy only: G If no FICA was withheld, check the applicable box below 1 Pay self-employment tax on this W-2 income. . . . . . . . . . . . . . . . . ~n 2 Exempt from self-employment tax and has approved Form 4029 . . . . . ,~D Substitute Form W-2 H If substitute Form W-2 needed, double-click to link to Form 4852 . H Additional Information for Electronic Filing and Certain States (See Help) 13 c Third-party sick pay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~B Non-standard W-2 (handwritten, typewritten, or altered in any way). . . . ~ Control number. . . . . . . . . . . . . . . . . . . .............. . .. . Employer information: Employee information: Employer's ID number . . . . . 94-2681915 Employee's social security no. . . 503-50-7178 QuickZoom to Employer Worksheet .~ First name M.I. Name Twitty G Bechtel Last name Davis Address Address 50 Beale Street 13 Royal Oak Circle City St ZIP code City St ZiP code San Francisco CA 94105 Camp Hill PA 17011 Employer has a foreign address (see Help). . ~D Employee has a foreign address (see Help). . ~ D ,"t.___ Form 1040 Form W-2 Worksheet ~ Keep for yourrecords 2001 Name as shown on return Twitty G Davis Social Security Number 503-50-7178 Employer Name. . . . . . . . . . . . . . . . . .. Bechtel Corp Employer Name (Continued) . . . . . . . . . . . . Employer federallD number (See Help). . , . .. ....... . . . . . . Check this box to automatically calculate lines 3 through 6 below. . . . . . . . . . . Check this box if this is Spouse's W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . 9~~~6.8.1~~5~8 ........ ... 1 Wages, tips, other compensation. . .. . . . . . '" . . . . , 1 42,63l. 2 Federal Income tax withheld .,. . .. . . . . . '" . . . . . 2 3,463. 3 Social security wages . . . . . . . . .. . . . . . '" . . . . . 3 40,200. 4 Social security tax withheld . ... . .. . .... . . . . . .. . '" . .... . 4 2,492. 5 Medicare wages and tips . . . . . . . . . . . . . . . , . . . . . ... . . . 5 42,63l. 6 Medicare tax withheld . . . . . . . . . . . . . . . . . . . . . .. . '" . .... . 6 618. 11 Important. For EIC, Form 2441, Form 8812, and IRAs, box 11 is important. See Help. Distributions from Section 457 and other nonqualified plans. . . . ' Code ~ 11 13 b Check box if retirement plan participant. . . . . . . . . . . . . . . . . . . . ~~ Check if foreign source income eligible for exclusion on Form 2555 . . . ,~ X Box 15 Box 16 Box 17 State Employer's state I.D. no. State wages, tips, etc. State income tax CA 286-7104-8 Box 20 Box 18 Box 19 Associated Locality name Local wages, tips, etc. Local income tax State - - - . 7 8 9 10 Social security tips. . . . ...... . ......................" . 7 Allocated tips. . . . . . . ...... . ....................... . 8 Advanced EIC payment. ...... . ....................... . 9 Dependent care benefits (Check if employer furnished care at work). , . ,~D 10 Dependent care benefits - Amount forfeited from fiexible spending account . . . Box 12 Box 12 If Box 12 code is: Code Amount A: Enter amount attributable to RRTA Tier 2 tax C 16l. M: Enter amount attributable to RRTA Tier 2 tax P: Double click to link to Form 3903, line 4 . . R: Enter MSA contribution for Taxpayer . . . . Spouse . . . . Box 14 Description Amount Type ProSeries description of Type CASDr 355. A California SDr - - - NOTE: The box 14 "Type" is specific to ProSelies and may not be the same as one letter descriptions on some W-2 forms. ""'=~~~-- ,,~.,.. "~~" - ~ Form 1040 Form W-2 Worksheet Additional Information .. Keep for your records 2001 Twitty G Davis 503-50-7178 Page 2 Employer Name. . . . . Bechtel Corp Statutory employees Box 13a. Check box if a statutory employee. . . . . . . . . . . . . . . . . ,..D Check box if deducting expenses in connection with this income. . . . . ...D If deducfing expenses, double click to link to Schedule C . . . . . . . . . . . .. C A B C Clergy, church employees, members of recognized religious sects Clergy only: o Housing or parsonage allowance. . . . . . . . . . . . . . . . . . . . . . . . . .. 0 E Unused (taxable) portion of housing or parsonage allowance . . . . . . . . . .. E F If no FICA was withheld, check the applicable box below 1 Pay self-employment tax on housing or parsonage allowance only. . . . ...~ 2 Pay self-employment lax on W-2 income only. . . . . . . . . . . . . . . . ." 3 Pay self-employment tax on W-2 income and housing allowance. . . . . ." 4 Exempt from self-employment tax and has approved Form 4361 . ." Non-Clergy only: G If no FICA was withheld, check the applicable box below 1 Pay self-employment tax on this W-2 income. . . . . . . . . . . . . . . . ...D 2 Exempt from self-employment tax and has approved Form 4029 . . . . . ...D Substitute Form W-2 H If substlfute Form W-2 needed, double-click to link fo Form 4852 . H Additional Information for Electronic Filing and Certain States (See Help) 13 c Third-party sick pay ............................. . :8 Non-standard W-2 (handwritten, typewritten, or altered in any way). . . . Control number. . ................ . .............. . .. . Employer information: Employee information: Employer's ID number . . . . . 94-2681915 Employee's social security no. . . 503-50-7178 QuickZoom to Employer Worksheet ." First name M.1. Name Twitty G - Bechtel Last name Davis Address Address 50 Beale Street 13 Royal Oak Circle City St ZIP code City St ZIP code San Francisco CA 94105 Camp Hill PA 17011 Employer has a foreign address (see Help). . ..D Employee has a foreign address (see Help). . ..0 }~~k ~1~ , ~><1"_r-' Form 1040 Form W-2 Worksheet ~ Keep for your records 2001 Name as shown on return Twitty G Davis Social Security Number 503-50-7178 Employer Name. . . . . . . . . . . . . . . . . ,. Bechtel China Employer Name (Continued) . . . . . . . , . . . . EmployerfederaIIDnumber(SeeHelp)...... ....... ...... 94 2681915 Check this box to automatically calculate lines 3 through 6 below. . . . . . . . . .. " ~ . . . . . ..D Check this box if this is Spouse's W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..D 1 Wages, tips, other compensation. . . , . . . . . . . . . . . ........... . 1 100,061. 2 Federal income tax withheld . . . . . . . . . " . . . . . . . . . . . . . . . . . . . 2 3 Sociai security wages . . . . . . . . . . . . . . . . . . . . . ........... . 3 2,65l. 4 Social security tax withheld . . . . . . . . . . . . . . ... . ....... . .. , 4 164. 5 Medicare wages and tips. . . . . . . . . . . . . . . . . . . . . . . . . . . 5 100,06l. 6 Medicare tax withheld. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1,45l. 11 Important. For EIC, Form 2441, Form 8812, and 'RAs, box 11 is important. See Help. Disfributlons from Section 457 and other nonqualified plans. . . . , Code .. 11 13 b Check box if retirement plan participant . . . . . . . . . . . . . . . . . . . ," tfj Check if foreign source income eligible for exclusion on Form 2555 . . . ,.. X Box 15 Box 16 Box 17 State Employer's state J.D. no. State wages, tips, etc. State income tax NV Box 20 Box 18 Box 19 Associated Locality name Local wages, tips, etc. Local income tax State - - - 7 8 9 10 Social security tips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Allocated tips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Advanced EIC payment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Dependent care benefits (Check if employer furnished care at work), . . ,..D 10 Dependent care benefits - Amount forfeited from flexible spending account . . . Box 12 Box 12 If Box 12 code is: Code Amount A: Enter amount attributable to RRT A Tier 2 tax M: Enter amount attributable to RRTA Tier 2 tax P: Double click to link to Form 3903, line 4 ... . R: Enter MSA contribution for Taxpayer .... . Spouse .... . Box 14 Description Amount Type ProSeries description of Type - - - NOTE: The box 14 "Type" ;s specific to ProSeries and may not be the same as one letter descriptions on some W-2 forms. .'""",~,-~ ,"I ~ "-"-,..,,, ~l""""'r~ ," Form 1040 Form W-2 Worksheet Additional Information .. Keep for your records 2001 Twitty G Davis 503-50-7178 Page 2 Employer Name. . . . ,Bechtel China Statutory employees Box 13a. Check box if a statutory employee. ................ ,..0 Check box if deducting expenses in connection with this income. . . . . ,..0 If deducting expenses, double click fo link fo Schedule C . . . . . . . . . . . " C A B C Clergy, church employees, members of recognized religious sects Clergy only: D Housing or parsonage allowance. . . . . . . . . . . . . . . . . . . . . . . . . .. D E Unused (taxable) portion of housing or parsonage allowance. . . . . E F If no FICA was withheld, check the applicable box below 1 Pay self-employment tax on housing or parsonage allowance only. . ,..~ 2 Pay self-empioyment tax on W-2 income only. . . . . . . . . . . . . . . , ." 3 Pay self-employment tax on W-2 income and housing allowance. . ' .. 4 Exempt from self-employment tax and has approved Form 4361 . . .. Non-Clergy only: G If no FICA was withheld, check the applicable box below 1 Pay self-employment tax on this W-2 income. . . . . . . . . . . . . . . . ...n 2 Exempt from self-employment tax and has approved Form 4029 . . . . . ." 0 Substitute Form W-2 H If substifute Form W-2 needed, double-click to link fo Form 4852 . H Additional Information for Electronic Filing and Certain States (See Help) 13 c Third-party sick pay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..a Non-standard W-2 (handwritten, typewritten, or altered in any way). . . . .. Control number. . . ............... . .............. . .. . Employer information: Employee information: Employer's ID number . . . . . 94-2681915 Employee's social security no. . . 503-50-7178 QuickZoom to Employer Worksheet ." First name M.1. Name Twitty G - Bechtel last name Davis Address Address 50 Beale Street 13 Royal Oak Circle City St ZIP code City St ZIP code San Francisco CA 94105 Camp Hill PA 17011 Employer has a foreign address (see Help). . ..0 Employee has a foreign address (;;;, Help). . ..0 ,a:,., ~r " I ~_w,~ Name{s) Shown on Return Twitt G Davis 1 Seller-financed mortgage. 2 From Schedule 8, Part I . 3 From Schedule 8, Part II . 4 From K-1 Worksheets . . 5 Exempt-interest dividends 6 From Forms 6252 7 From Forms 8814 8 Sublotal..... Less Adjustments: 9 *Tax...exempt interest (net of adjustments). 10 U.S. savings bond interest previously reported. . . . 11 Nominee distribution 12 010 adjustment. 13 A8P adjustment . 14 Accrued interest . 15 Other adjustment. 16 Series EE and I bond exclusion. 17 Total AdJustmenls. . . . . 18 Total to Schedule 8, line 2 . . . 19 Total to Form 1040, line 8b. . . 20 Total U.S. govemment interest. 21 Total to Form 6251, line 13. . . *Doesn't include K-1 tax-exempt interest 1 From Schedule B. . . 2 From K-1 Worksheets 3 Subtotal...... Less AdjLlstments: 4 Nominee distribution 5 Other adjustment. . 6 Total Adjustments. 7 Total to Schedule 8, line 6 8 Total capital gains . . . . 9 Total nontaxable dividends. 1 Frorn Schedule B. . . . . . . . . . . . . . . . Less Adjl.Jstments: 2 Nominee distribution 3 Other adjustment. . . 4 Totel Adjustmenls. . 5 Total to Schedule D, line 13f . 6 Total to Schedule D, line 13g . 7 T otai to Schedule D 8 Total to Schedule D . . . . . :!';,<"w"",^ ','~ _'/""'''''0/1' '-<J' Interest and Dividends Summary ... Keep for our records 2001 Social Security Number 503-50-7178 Interest Summary Total Interest .~ .~ .~ .~ Dividends Summary .~ .~ Ordinary Capital Gains Nontaxable 24. 24. .~ Capital Gains Summary 28% rate Qualified 5-year Section 1250 Section 1202 .~ .~ .~ .~ FDJY5602 09{16/01 ~~ Form 1040 Line 47 Rate Reduction Credit Worksheet ~ Keep for your records 2001 Name(s) Shown on Return Twitty G Davis Social Security Number 503-50-7178 Before you begin: .r If you received (before offset) an advance payment of your 2001 taxes equal to the amount shown below for your 2001 filing status, stop. You cannot take the credit because you have received the maximum amount of the credit. . Single or married filing separately - $300 . Head of household - $500 . Married filing jointly or qualifying widow( er) - $600 .r If you, or your spouse if filing a joint return, can be claimed as a dependent on another person's return, stop. You cannot take the credit. .r If you received (before offset) an advance payment and you filed a joint return for 2000, you and your spouse are each considered to have received one-half of the payment. TIP: If you received Notice 1275, 1277, or 1278 have it available. The notice shows the amount of your advance payment (before offset). 1 Enter the amount from Form 1040, line 39. If line 39 is zero or blank, stop; you cannot take the credit. . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . 1 68,006. 2 Enter the amount shown below for your filing status. · Single or married filing separately - $6,000 } . Head of household - $10,000 .. . 2 6,000. . Married filing jointly or qualifying widow(erl - $12,000 3 is the amount on line 1 less than the amount on line 2? No. Enter: $300 if single or married filing separately; J- $500 if head of household; $600 if married filing jointly or qualifying widow(er). .. . 3 300. Yes. Multiply the amount on line 1 by 5% (.05). Enter the result. 4 Enter the amount from Form 1040, line 42 . . . . . . . 4 15,400. 5 Add the amounts from Form 1040, lines 43 through 46. Enter the total . . . . . . . . . . . . . . . . . . . . . 5 9,322. 6 Subtract line 5 from line 4. If the result is zero or less, stop; you cannot take the credit ................................ . ..... . 6 6,078. 7 Enter the smaller of line 3 or line 6 ..................... . .... . 7 300. QuickZoom to the information Worksheet to enter tax rebate amount ... . 8 Enter the amount, if any, of your advance payment (before offset). If filing a joint return, include your spouse's advance payment with yours .... . . . .. . 8 300. 9 Rate reduction credit. Subtract line 8 from line 7. Enter the result here and, if more than zero, on Form 1040, line 47. If line 8 is more than line 7, you do not have to pay back the difference. . . . . . . . . . . . . . . . . . . . . . . . . . 9 O. >~T;, ., - Tax Payments Worksheet ... Keep for your records 2001 Name(s) Shown on Return Twitty G Davis Social Security Number 503-50-7178 Estimated Tax Payments for 2001 (If more than 4 payments for any state or locality, see Tax Help) Federal State Local Oate Amount Oate Amount 10 Oate Amount 10 1 04/16/01 04/16/01 04/16/01 2 06/15/01 06/15/01 06/15/01 3 09/24/01 09/17/01 09/17/01 4 01/15/02 01/15/02 01/15/02 5 a - b - c - d - Total Estimated Payments. . . . Tax Payments Other Than Withholding Federal State 10 Local 10 (If muitiple states, see Tax Help) 6 Overpayments applied to 2001. . . . 7 Credited by estates and trusts . . . . - 8 Totals Lines 1 through 7 ..... . :~ :e 9 2001 extensions. . . . . . . . . . . . Taxes Withheld From: Federal State Local 10 Fonms W-2 . . . . . . . . . . . . . . . . . . . . . . 3,463. 11 Fonms W-2G . . . . . . . . . . . . . . . . . . . . . 12 Fonms 1099-R . . . . . . . . . . . . . . . . . . . . 13 Forms 1099-MISC and 1099-G. . . . . . . . . . . .~ 14 Schedules K-l . . . . . . . . . . . . . . . . . . . . 15 Forms 1099-INT, DIV and OlD. . . . . . . . . . . 16 Social Security and Railroad Benefits . . . . . . . 17 Fonm 1099-B. . . . . . . St Loc 18 a - - Other withhoiding ... . St Loc b - - Other wnhholding . . . . St Loc - - c Other withholding ... . St Lac 19 - - Total Withholding Lines 10 through 18c. . . . . 3,463. 20 Total Tax Payments for 2001 . . . . . . . . . . . 3,463. Prior Year Taxes Paid In 2001 State 10 Local 10 (If muitiple states or localities, see Tax Help) 21 Tax paid with 2000 extensions . . . . . . . . . . . ... , 22 2000 estimated tax paid after 12/31/00 . . . . . . . . . . 23 Balance due paid with 2000 return. . . . . . . . . . . . . 24 Other (amended returns, installment payments, etc) . . ~:.~"~- .' i t ,-- ", "'i"'~~! ~~ ~ ~ , , ,.." Schedule E Schedule E Worksheet ... Keep for your records. 2001 Name(s) as shown on return Twitty G Davis This copy of the worksheet will be on . . . . . . . . . . . . . . . . . . . . . ... Schedule E, Paqe I, COpy 1, 1 Property location. 982 Carter Cove, Hurrnnelstown, PA 17036 Property kind. Residential Check all that apply A Owned by spouse ~ B Owned jointly . . . . . . C Rental property. . D Royalty property , , . . . E Commercial property. F Other passive exceptions. G Active participation . . X H Material participation. I Not at risk . . . . . . J Complete disposition. K Treat all MACRS assets for this activity as qualified Indian reselVation property? . Ownership Percentage L Check to allocate income and expenses using ownership percentage. M Enter ownership percentage . " . . . . . Combined personal residence and rental use N Check to allocate personal use items. o Percentage of rental use . . . . . . . . . Vacation home P Check if this is a vacation home property. . . Q Check to allocate interest and taxes using Tax Court Method. R Number of days rented . . . . . . . . . . . . . S Number of days personal use. . . . . . . . . . T Number of da s ro e owned if less than 365 Income Enter rental income (not reported on 1099). Rents from 1099 - MISC Worksheets . . . 3 Totalrentsreceived .. .. . . .. . . . . Enter royalties received (not reported on 1099). Royalties 1099 - MISC and K-1 Worksheets. . 4 Roaltiesreceived............ Expenses Social security Number 503-50-7178 Property A Yes 0 No X o % 66.670000 rKl % B % if Different Total 11,044. 11,044. 100.000000 11,044. (a) Total (b) Enter% if not 66.67 (c) Reported on Schedule E (d) Vacation Home Loss Limitation (e) Allocated to Personal Use 5 Advertising. 6aAuto.... b Travel . . . 7 Cleaning and maintenance . 8 Commissions........ 9 Insurance ......... 10 legal and other professional fees. 11 Management fees . . . . . 12a Mortgage interest qualified b Mortgage interest other. 13 Other interest. 14 Repairs. . . . . . 15 Supplies..... 16 a Real estate taxes. b Other taxes. . . 17 Utilities..... 18 Other expenses a b c d e Indirect operating expense f Operating expense carryover. 9 Vehicle rental. . . . . . h Amortization . . . . . . 19 Add lines 5 through 18 . 20 a Depreciation . . . . . . bDepletion. . . . . . . . c Depreciation carryover . 21 Total expenses. Add 19 and 20 . 22 Income or (loss) . . . . . . . . 23 Deductible rental real estate loss. 1,450. 100.00 1,450. 827. 100.00 827. 6,685. 4,457. 2,248. 100.00 2,248. O. 3,270. 2,180. 1,090. 14,480. 2,273. 11,162. 2,273. 13,435. -2,391. -2,391. FDJX1701 09/05101 ~~j!"""~""" ,-~~ ,,,=~~ . . ~.., ~......"""""""'" , Foreign Tax Credit Computation Worksheet 2001 COpy 1 Name(s} Shown on Return Twitty G Davis Social Security Number 503-50-7178 :8 i~ k Resident of (country). . . . . . . . . . . . . , . . . . . . , . . . . China Passive income High withholding tax interest Financial services income d B Shipping income e DISC dividends f FSC distribution Lump-sum distribution Section 901 m income Inc re-sourced by treaty General limitation Part I - Taxable Income (Loss) . Total A B C I Name of country or U.S. possession. .... . .. China/Malaysia 1 Gross income: a b c Interest and dividends from Schedule B . . . . d From Schedules K-1. . . . . . . . . . . . . . . e From Form 2555 foreign earned income. . . 80,057. 80,057. T olal gross income this category. . . . . . . .. 80,057. 80,057. 2 Expense definitely related to gross income: . a (1) Deduction from K-1 worksheets. .. . . . (2) Deduction from GI related to FEI (3) Allowable itemized deductions related to foreign eamed income . . . . (4) Foreign source state income tax ... . (5) U.S. source sfate income tax . . .... . Codes for line 2b. . .... ..... I/J ABCUO b Other - - c - - d - - e - - Totai expenses definitely related to gross income. . . . . . . . . . . . . . .. . .. 3 Deductions not definitely related: a Standard/certain itemized deductions: (1) Standard deduction. . . . . . . . . ... . 41550. 4,550. or (2) Real estate taxes on personal residence . .... . . . . . (3) Medical expenses . . . . . . . . . . (4) Gifts to charity. . . . . . . . . . . . . (5) Other a Remaining itemized dedns. . b c Total itemized deductions not definitely related . . . . . . . . . . .... . .. 4,550. 4,550. 3b Deductions from gross income not on line 2 (not definitely related to gross Income): (1) Remaining dedns from gross income. . . (2) (3) Total other deductions not definitely related ................. . .. , .. -_""'l''''i' ,,~.~ 'r ~I_ . , Twitty G Davis 503-50-7178 Page 2 COpy 1 Part I - Taxable Income (Loss) (Continued) Total A B C 4 Interest expense: a Home mortgage interest: (1) Deductible home mortgage interest. . (2) Total foreign source income of type indicated above. . . . . . . . . . . . . (3) Gross income from all sources ..... . (4) Allocation ratio .............. . Pro rata share of home mortgage interest. .~ b Deductible other interest: (1) a Investment int exp. . . b Adjusted basis of investment assets generating foreign income ...... . c Adjusted basis of total investment assets. . . . . . . .. . d Allocation ratio. . . . . . . . . .. . Investment interest allocable to foreign income ........... . . . ~ (2) a Trade/business interest expense . . b Adjusted basis for business assets generating foreign income ...... . c Ad'usted basis for total J business assets . . . . . . . . d Allocation ratio. . . . . . . . . Business interest allocable to foreign income . . . . . . . . . . . . . . .... (3) a Passive activities interest expense b Adjusted basis for passive activity assets generating foreign source income. . . . . . . . . . . . c Adjusted basis for total passive activity assets . . . . . . . . . . . . d Allocation ratio. ........... Passive activities interest allocable to foreign source. . . . . . . . .... Total allocable share of other interest expense . . . . . . . . . .... 5 a Foreign losses for this category b Foreign losses from K-1 Worksheets. . . . Part II - Foreign Taxes Paid/Accrued, Line 8 m Paid 290 Date t u v w (1) w (2) n Accrued (mm/dd/yy) Dividend RenURoyalties Interest Other K-1's Country A 12/31/2001 19,347. Country B Country C 503-50-7178 COPY 1 Page 3 Twitty G Davis Part III - Foreign Tax Credit Computation 10 Carryback or carryover relating to this category. . . . . . . . . . . . . . . . . . . . . 10 560. 12 Reduction in foreign taxes: a (1) Current year foreign earned income excluded less related deductions . . . . 12a 1 96,718. (2) Total foreign earned income (FEI) less related deductions. . , . . . . . . 2 176,775. (3) Allocation ratio: (line 1231 divided by line 12a2). . . . . . . . . . . , .. . 3 0.5471 (4) Total foreign taxes on Form 1116,line8minusline 12a6. ...... . . . . . 4 19,347. (5) Total reduction for current year taxes (line 12a4 times 12a3). . . . . .... . 5 10,585. (6) Foreign tax paid in 2001 for this category related to prior year FEI. . ... . 6 (7) a Net FEI exclusion that previous year . . b Total net FEI that previous year. . . . . . . .. . 7 (8) Total reduction for prior year FEI (line 12a6 times line 12a7). .. . .. . 8 (9) Adjustment (explain) . Taxes allocable to excluded income (line 12a5 plus line 12a8) . . ... . .. . 12a 10,585. b From K-1s Desc " . 12b c Reduction due to participation in intemational boycott operations. .... . .. . . . 12 c Totai reduction in foreign taxes (line 12a plus line 12b plus line 12c) . .. . . . . . ~ 12 10,585. 15 Adjustments to line 14 a (1) Losses from other categories ........................... . 15a 1 (2) Foreign income this category/total foreign income. . . . . . . , . . . . . . . . . 2 Pro rata share of losses from other categories (limited to income this category). . . 15a b Recapture prior year overall foreign loss (1) Overall foreign loss, this category, not recaptured from previous year. . . . . . 15b 1 (2) 50% of tax income foreign sources, all categories. . . . . . . . . . . . . . . . . 2 (3) Amount from Form 1116, line 14, less any amount on line 15a above. . . . . . 3 Smallestof15b1,2,3-recapturerequired...................... . 15b c Recharacterization of income (1) Pro rata share, this category, of loss from other categories, from prior year. . . 15c 1 (2) T otalloss from other categories, from prior year. . . . . . . . . . . . . 2 (3) Current year income in prior year loss category . . . . 3 (4) Allocation ratio: (line 15c1 divided by line 15c2) . . . . . . . . . . . . . . 4 Recharacterization adjustment, this category. . .. . . . .... . . . .. . . . 15c d Allocation of current year U.S. source losses (1) Net loss from U.S. sources ........ . ,. , . . . . .... . .. . .. . . . 15d 1 (2) Allocation ratio ................................... . 2 U.S. losses allocable to this category (line 15d1 multiplied by line 15d2). . . . . . . 15d Total adjustment to Form 1116, line 14 (minus line 15a minus line 15b plus line 15c minus line 15d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 -4~'I'lt-_,,_,__,.... -l.'nc 503-50-7178 COPY 1 Page 4 Twitty G Davis Foreign Tax Credit Carryovers Foreign Tax Credit Carryovers from 2000 Regular Tax Foreign Taxes Disallowed Utilized Carryover 1996 . . . . . . . . . . . 1997 .......... . 1998 .......... . 1999 .......... . 3,347. 3,156. 92. 99. 2000 .......... . 17,149. 12,347. 4,34l. 46l. Carryover to 2001. . . , . . . . . . . . . . . . . . . . . . 560. Alternative Minimum Tax Foreign Taxes Disallowed Utilized Carryover 1996 .......... . 1997 .......... . 1998 .......... . 1999 .......... . 3,347. 3,156. 75. 116. 2000 .......... . 17,149. 12,347. 2,876. 1,926. AMT Carryover to 2001. . . . . .............. . 2,042. Foreign Tax Credit Carryovers to 2002 Regular Tax Foreign Taxes Disallowed Utilized Carryover 1996 . . ........ . Expired 1997 . . . . ...... . 1998 .......... . 1999 . . ........ . 3,347. 3,156. 19l. O. 2000 . . . . . . . . . . . 17,149. 12,347. 4,802. O. 2001 . . . . . . . . . . . 19,347. 10,585. 8,762. O. Carryover to 2002. . . . . . . . . . . . . . . . . . . . . . . O. Alternative Minimum Tax Foreign Taxes Disallowed Utilized Carryover 1996 .......... . Expired 1997 .......... . 1998 .......... . 1999 .......... . 3,347. 3,156. 19l. O. 2000 .... . . . ... . 17,149. 12,347. 4,802. O. 2001 .... . .... . 19,347. 10,585. 8,762. O. AMT Carryover to 2002. . . . . . . . . . . . . . . . . . . . o. _X,~ -,--~. ~ " Foreign Tax Credit Supplementary Statement 2001 Name(s) Shown on Return Twitty G Davis Social Security Number 503-50-7178 Source of Income (a) (b) (c) Description Total U.S. Source Foreign Source 1 Wages 180,241- 3,466. 176,775. 2 Interest. 100, 100. 3 Dividends. 24. 24. 4 State/locai tax refunds. 5 Alimony (1040)/Scholarship (1040NR). 6 Schedule C income . . . . . . . . 7 Capital gains . 8 Other gains. 9 Pension, IRA . 10 Schedule E income 11,044. 11,044. 11 Farm income. 12 Unemployment compensation 13 Social security benefits 14 Other income. 15 Gross income for allocation. 191,409. 14,634. 176,775. 16 Section 911 exclusion. 96,718. 96,718. 17 Exempt and nontaxable income 18 Gross income less exclusion & exempt income. 94,691- 14,634. 80,057. 19 Sch C, E, F, 4835, REMIC, K-1 expenses. 13,435. 13,435. 20 Losses 21 Other. 22 Other. 23 Adjustments to gross income. 24 Adjusted gross income 81,256. 1,199. 80,057. 25 Sfandard deduction 4,550. 348. 4,202. 26 Definitely reiated itemized. 27 Ratably allocated itemized 28 Ratable itemized interest 29 Tax income before personal exemptions 76,706. 851- 75,855. '-)~ (~I . Foreign Tax Credit Carryover Statement 2001 COpy 1 Name(s) Shown on Return Twitt G Davis Social Security No 503-50-7178 Foreign Tax Credit Carryovers from 2000 ~B d B Shipping income e DISC dividends f FSC distribution i~ Lump-sum distribution Section 901 (j) income inc re-sourced by treaty General limitation Passive income High withholding tax interest Financial services income Regular Tax Forei9n Taxes Disallowed Utilized Carryover 1996 1997 1998 1999 3,347. 3,156. 92. 99. 2000 17,149. 12,347. 4,341. 46l. Carryover to 2001 . 560. Alternative Minimum Tax Foreign Taxes I Disallowed Utilized Carryover 1996 1997 1998 1999 3,347. 3,156. 75. 116. 2000 17,149. 12,347. 2,876. 1,926. Carryover to 2001 . 2,042. -, .=- .., -'~ ~ ., - ~~n" ,"_, .~ . Late Penalties and Interest Worksheet .. Keep for your records 2001 Name(s) Shown on Return Twitty G Davis Social Security Number 503-50-7178 _ Late Payment and Filing Penalties Check to Not calculate (See Tax Help). . . . . . . Late Payment W Late Filing W Interest D 1 2 3a b 4a b 5 6 7 8 9a b 10 Date retum will be received by IRS (mmldd/yyyy) . . . . . . . . . . . . . . . . . . . . . ., 06/30/2002 Date balance due will be paid, if later than date above (mml~). . . . , . . . . . . . . Check if valid extension(s) . . . .W Fonm 4868 LJ Form 2688 W Out of country Or,Checktheboxandenterduedateincludingextensions(mm/dd/yyyy}.......D 08/15/2002 Balance due on original due date. . . . . , . . . . . . . . . , . . . . . . . . . . . . . . . . . 2,615. Balance due is not more than 10% of total tax and will be paid by time to file on Form 4868 ~ Number of months, or fraction thereof, that payment was late. . . . . . . . . . . . . . . . . Late payment penalty percentage, line 5 multiplied by .005 (max of .25) . . . , . . . . . . . Total Late Payment Penalty. Line 4a times line 6 . . . , . , . . . . . . . . . . . . . . . . Number of months, or fraction thereof, that return was filed late. . . . . . . . . . . . . . . . Late filing penalty percentage, line 8 multiplied by .05 (max of .25) . . . . . . . . . . . . . . Late payment penalty offset(max 01.025). . . . . . . . . . . . . . . . . . . . . . . . . . . . Total Late Filing Penalty. Line 4a multiplied by line 9a less 9b (or $100 min) . . . . . . . _ Interest on Balance Due and Late Filing Penalty "Interest rates can be entered once for all clients. Press F1 for Help. (a) (b) (c) (d) (e) (f) 11 Balance Due Interest Interest Days Compounded Interest ------------ Late Filing Penalty Rate Periods Rates" Late Interest Rate Amount a _______2-'~~5...:_ 04/15/02 - 06/30/02 6 % 76 0.01257024 33. --------- --------- b 07/01/02 - 09/30/02 % ------------ - ---- --------- --------- c 10/01/02 - 12/31/02 % ------------ - ---- --------- --------- d 01/01/03 - 03/31/03 % ------------ - ---- --------- --------- e 04/01/03 - 06/30/03 % ------------ - ---- --------- --------- f 07/01/03 - 09/30/03 % ------------ - ---- --------- --------- g 10/01/03 - 12/31/03 % ------------ - ---- --------- --------- h 01/01/04 - 03/31/04 % ------------ - ---- --------- --------- i 04/01/04 - 06/30/04 % ------------ - ---- --------- --------- j 07/01/04 - 09/30/04 % ------------ - ---- --------- --------- k 10/01/04 - 12/31/04 % ------------ - ---- --------- --------- I 01/01/05 - 03/31/05 % -----------. - ---- --------- --------- m 04/01/05 - 06/30/05 % ------------ - ---- --------- --------- 12 Total interest. Sum of lines 11 a through 11 m, column f 33. ':r'~I'''''''' -~ '. . . Federal Carryover Worksheet ~ Keep for your records 2001 Name(s) Shown on Return Twitty G Davis Social Security Number 503-50-7178 """ '~I~"""'" ~_ ..~,._. 2000 State and Local Tax Information (See Tax Help) (a) Slate or LocallD (b) Paid With Extension (c) Estimates Paid After 12/31/00 (d) Paid With Return Totals. . Other Tax and Income Information 1 2 3 4 5 6 7 8 9 10 Filing status . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1 Number of exemptions for blind or over 65 (0 - 4). . . . . 2 Itemized deductions after limitation. . . . . . . . . . . . . . . .. 3 Check box if required to itemize deductions. . . . . . . . . . .. 4 Adjusted gross income . . . . . . . . . . . . . . . . . . . . . .. 5 Tax liability for Form 2210 or Form 2210-F . . . . . . . . . . .. 6 Alternative minimum tax. . . . . . . . . . . . . . . , . . . . . .. 7 Federai overpayment applied to next year estimated tax, . . .. 8 Reserved for future use . 9 Reserved for future use. . . . . . . . . . . . . . . . . . . . . .. 10 IRA Information 12 a Basis of Taxpayer's IRA(s) as of 12/31 .............. b Basis of Spouse's IRA(s) as of 12/31 ............... 13 a Taxpayer's excess IRA contributions as of 12/31 . . . b Spouse's excess IRA contributions as of 12/31 . . . 14 a Taxpayer's excess MSA contributions as of 12/31 . . b Spouse's excess MSA contributions as of 12/31 . . . 15a Taxpayer's excess Roth IRA contributions as of 12/31. . b Spouse's excess Roth IRA contributions as of 12/31 . . . . . 16 a Excess contributions to taxpayer's Coverdell ESA (Ed IRA) . . b Excess contributions to spouse's Coverdell ESA (Ed IRA). Loss and Expense Carryovers 17 Short-term capital loss. . . . . . . . . . . . . . . . . . . . . . . 18 Long-term capital loss . . . . . . . . . . . . . . . . . . . . . . . 19 a Net operating loss available to carry forward . . . . . . . . . . . b AMT Net operating loss available to carry forward . . . . . . . . 20 a Investment interest expense disallowed. . . . . . . . . . . . . . b AMT Investment interest expense disallowed. . . . . . . . . . . 21 Nonrecaptured net Section 1231 losses from: a 2001... b 2000. c 1999. d 1998. e 1997. f 1996.. (e) Total Over a ment (f) Applied Amount 2000 2001 2 MFJ 1 Single ~~ 77,267. 81,256. 8,730. 6,078. O. O. 2000 12 a b 13 a b 14a b 15a b 16a b 2000 17 18 19a b 20a b 21 a b c d e f 2001 2001 # Twitty G Davis 503-50-7178 1 Explanation Statement Fonm/Line: Explanation of: Form 1040;1040A;1040EZ Overseas Extension On April 15, 2002, the taxpayer(s), u.s. citizen(s) or u.s. resident{s) were residing outside the U.S. or Puerto Rico and had a tax home outside of the U.S. and Puerto Rico. Accordinqly, the taxpayer(s) are qranted an automatic extension of time to June 17, 2002, in which to file the 2001 income tax return, pursuant to Requlation 1-6081-2. Form 4562 Regular Tax Depreciation Report Activity: Sch E Residential - 2001 In Service Cost Land Bus% Type Class ConY Imp Disposed Basis 179 Listed Meth Life Yr ~ 05/01/01 123,000. 23,000. 100.00 MACRS R MM 100,000. -0- SL 27.5 1 Depr Prior 2,273.1 Total 123,000. 23,000. 100,000. 2,273. Fonm 4562 Alternative Minimum Tax Depreciation Report Activity: Sch E Residential - 2001 Description Real Leased AMT Cost AMT Life AMT Depr AMT Adj AMT Basis AMT Meth AMT Prior AMT Pref IHouse DD 123,000. 27.5 100,000. SL 2,273. 0.1 Total 123,000. 100,000. 2,273. o. OS!,_'!""'!:" -" , ,- ~ .~, .. a I year/Form: corrected 20P,. . . I W-2 b Employee's name, address, and ZIP code TWITTY G DAVIS JICllANG RD. JIANG TAl LIDO PLACE,APT 5014 BEIJING, For Official Use Only j OMS No-. l54s.oooa: r....-] Corrected name 1......" (i!~h$Ck:9(l,al$Q complete twx hI c Employer'S name, add"""" and ZIP code BECHTEL GROUP, INC. 50 BEALE STREET SAN FRANCISCO CA 94105-1895 d Employeifs correct SSN -7 g Employee's Incorrect SSN 100004 CH Complete boxes 9 and/or h (below) e Employer's Federal EIN only lflncorrect on last form filed. h Employee's name (as incorrectly shown on prevlOO<l form) f Employer's _10 ,,"mbar Previous! re orted ages, fips, er compensallon 172594.39 lal secu wages Correct lnfonnati.on ages! tips, other compeosat 180241.43 a security wag.s PrevlollS[ orted Feder ncorne tax w Note: 0!iIy compIeIemoney f1eIlli\ thatara being corrected. Correct Infonnation raI income tax loara wages and 172594.39 SOcial secunty tips re- wages and tips 180241.43 oc securityftps Me e d 2613.50 security tax withhe secunty ooat tips 13 ~A"PT:',\""Thl~ -I 13 ~ Rmi:m ,~ , x Copy C For Employee'. _ Depastmoot<ll1MT~1Y In\emljJ RQVW'Ws &;Mtie Form W-2c (Rev 12.2001) Corrected Wage and Tax Statement \1.tiEXHIBIT. brt.- nOrt'r<; :Jl I _ j VI In.I'S.Ot; ;",~""",-"i'f"""!""'!' 1'~~_' " I>>de '940-2&81915 ~L GROUP, DC. STATE=BECHTEl MALAVASIA S<I eE~Lt STllEtT '$AM nU.Nc.-x:sco. CI. ~l.-OS-'l8"S 1$ $ l:lI!I!'!l't;~.;W _<<de Cltl~09015 iR . , C1'09 IIH8A 820987 IlI'G nmTY G 'DAVIS JICltANG RD, JI,ltI; TAt RD LIDO PLACE.APT 6014 IlEIJDI:> 100004 CHINA 'C!ljiy21orSfate,CitYOr 1 I.n<>ll Tax Departments d '5-6Oe.,ttlCf\O L 1oyeI'5-M$l/tI.O, NQ l.::.'9llZ68~QO.1_ ' 11 L.oealW&Cift.l!p$. etc. 1fiSUl\ll:l.....iIIQ!lll.tipos.~. ~1SUl*JnOOn'Wi1al< ~:lJl'lI.Qt01_00~M<l1lm 37548.$2 -- 315'\8.52 .~~..,..q. 31S48.52 "" t YIIlnqlEICparmenl. -- 19L.oxal.if1C(llllI!l:<U ~f'1COlTlf:I1BI("", <G ..t.~tQ:w]lhlalld 23U,Dl (lM<<iir;4Ill,,"-~ 544.45 I Al\ot.a\W * 1DDepe'1Wlnt~~ 2OLVClIII!ynftflUt III prEl(J1(1:1 OMB/l.1545-0008 CDfI)'2TohFlledWlthEmplQ~"'STATE.Cm'orl..OCALT""~ ra lnGQme. ... Form W.2 wag.. and Tu Statement 200' ~f,1(ltlf!cil'usl.ll)'~lnlamtlfRewJ!!'Ol.IeStw,~ \---.---------------- r;dlnmJl!lber-_ 1'I$lle",,, ~. l'J4.-2681915 IJ.ECHTEL GROUP. INc. STA.TE=e.ECHTEl HAUV,ASIA SO' BEALE STREET !WI FRANCISCO e4 94105-1895 , IS . . Y\4tITIe.~~~fII'I(lllP~_ . ~- . 8UM 820987 REG TKnTV G DAVIS JICfiANi RD,. .JIAf'G TAI RD LIDO PLACE.APT 6014 8FIJING 100004 ellXN4 CoPY2foTSlille: CitY or ~ ;ra:<Bepartn1~ms ~1IOe.1lO -50- n78 '8Looalwllgea_1l~.etc. 15St#tlt En'!~'tl".flt/jLD,N;i IL k_6lllilS;;O.ll.l_ "5latU~~~.Iip~ele.. l1StMe~(ak FI)I'I'ft W.2 Wage and 1',u St,.tement 2001 ~r'lmimtdthe irulUlY-lnl~ Revt!rn:& SeNj(.<) OM8111~.s.oooa ~2Toel:FtlIdWlCtlEtnplCly.."aTATE.ctTYI>>tLOCAL T-..:De!M'l1l'Mf1b; llKlllf~l<!)(W' - ~ ~ aQlt~. ,0 ,(,'O)lllplln$ll :en .~~~ 37543.52 S~~lmdijpe- _'PO ~ElC ~Ymenl p"" 140ltlar 1iLofall1'\OO!'Tlll.IlI..'( -"""""",....-...;.....,.''"''''......- I.tSodal"t:aJrt'~J~wjltIhvld 2323.01 '~OO!'tu:wrtMoIC '~l$dl\p& 1lJDilI)<I>nr.:l..l'>tCAte~rllS ~13 i --~ ifl..Ol:aiiiY';arn;;-- -_.'. -~- m ...- ----------------------------------------------------------------~-----.--~ .~In:'4Zl.P,CP5!e ~-t68191S BECHTEL GROUP, n<<:. ST"TE==BEClfTEl KA.I..AYASIA 50 BEALE STREET SAN FRAl'CISCO CA 94105-1895 , ~.~.'arlItZlP<<>dc 8H8A. 820987 AEG TIlITTV G DAVIS ...lICHANG ROJ- JIANG TAX RD lIDO PlACE,APl' 6014 BELIn<<; 100004 CIIlN4 9lfiy C for Employee's ~~~ t~noliQlonback.} -d mpIoyee'a'QC.lIae,1'IO 15 f4' E... r5slatel.o.Nc. l.d'<oz68J.!l]li"Dlll_ 1'Stale~"tip&.DtG.. 1(Stl;l\ll~Ia;l;, 1IlLoealw~Iipe...m.. "'oon W.2 WlIlge Ilnd Tu St#lemont 2001 Oepl!ltt~nt Q! Itle TrtlUury-!nlfJl'lllll R_nuc S!!Mee Ot4B;, '54S-COO8 {Ige;,'~ (lQITJpII"~ 3 SodlIIsacurltyw.e\l8s 'Med~~roMGtipS. Adv~ ElC PIlyment l1Nooq~lEIdpllt'l$ .."""" 'fLrxallPf;:ut'tleW '.5oclaI~lalt\\lltl't'J&ld 6 M~icalD tb withlleKl IAl\ooa\8IS1i!m 10 Dependent ~ bonef.1$ ---. 20LDpahll'IIliIIJItI Copy C fw EmplOJ"efl" RIoeor<b .J 94-26081915 ZI ~_de SiCHTEL GilOUP, IN:. STATE:z:8ECtfTEl CRnu nc !:d boEl.lE ST'Ri::ET SAN FRANCt.SCO CA 'J4~OS-18'i'S ~,-~.- OG!11l74 FA: T O",D'II 1<.530 aZ09a7 REG TMI:TTV G DA\lIS JICHANG RD, JIANG T AI RO UOO PLACE,APr 6014 BEIJXNG 100004 CRnlA el'SmtitI. Q, U.Stl1le",~l!p$.,.(lh;, tale IT\ftW FOllTI W.2 Wagl!l and Tu statemen.t 2001 ~~ 01 !tie T~(IU/)'~I!'l\.maIR4""Ill,lll Stlr.-k:e 1I}4-2:681915 BECHTEL CIDJP, me. STATE.sECHTEl CHINA !NC SO BEALE STREET !1m FlWlCISCD CA '14105-1895 . ~.Pd~J:md_eiXk: KS30 82:0987 REG naTTY G DAVIS .JIC~ RD, .JIANG rAt RD UOO- PUCE ,APT 6014 B.EJ:JING: 100004 ClIINA 1. Stelle wage!!, (iJ1a. ~ 17 Ultem"Q;Tlt!la!. Ol'lpi'lt1rr-.efll 0-1 \he 7re,u....-y..lmemallWver'lue S.rw.;~ co~~:::!_6!!.!.~___->-._. BECflTEl GR(UI, It<<:. STATE=8ECKrEL CHINA INC 53 8EALE STREET SNf FRANC:IS'CO CA 94-105-1895 . , .ad.d'(~ .- K530 820987 TKIITY G DA\lIS JXCIW<G RIl. JI.oNG TAl . RD LIOO PLACE.APT 6014 &EIJING 100004- CRnlA REG . HL r's sla1e 1.0. 'No tI\-Wa~.llP'-<*1c. Still", nctlffi(lta~ " form W~2 Wag. and Tal( Statement 20M tlep..-t.~io'fhe'rre&WlY-lni'fl'llU~crl\JtSef'\oice Illgld, pol, M__ . '~14.3' '" . ..... YWag<!I$ 1 IS Z65l.l\ll I . ......-.... " '2414.3-9 I . f.~~~ps . . V ----11...... _,__._~ 9 AlWallOit EIC p..yme"" Copy 2 for state, Cily or LocalTax Iflyartmenls ., '$;oe.$GC;,flO 503-50-7178 111 WG\)M. tlM.1tlC ,..." t.""" a L<Xa1 iocl.lmll tn ~ 4 ai~ty-\olK~ 16<\.59 GMe9ll;-ll!"'!!ia);wi!IloIl<I>/d l~O.Ol '~\ipt; 'a~nllef11Cdlf!'tI-UI " M~ is OMS It 1545-0001I ~2Toe.FU6d_Employ"'roSTAfE,cm'orl.OCAL luo.partlMnll ~ . . 1~ Copy 2 for Slate, City or Local Tax Departments .~lI'OC.no 503-50-n7& !.oca. wagel>, 1lp~. ~k ~. ',Ol:fCl:l!'llj)M1:>IIIQI1 924-14.3' .s. ~.;~i. 2:651 .48 ~ .~-fWldt 92414.3' . adIl~llP'f tMvllflteElCpa)'fMll1 11 IlQI.I"l pllml> """", . -,~ "Sod*~h.l...wiVIhell1 164.39 ~rew:.~ 1340.01 . '''' 1GO~er.t<:arebMWfrts (lqillt)'fIlllrlll: OMeIl 154s.0008 Copy2rolle:FStdWi1l',Em~'$ STATt, ctTY(JflOCAl. r*lto.fUIrttnol\t$ . . . . I $ n.~sblil\lbritool!ll~ ___~.\'W"~k>.'" :'~~~~~wtl!'ld~ "'t)l"'_' cilpycfciiEinployee's Records {See ~ 011 b3tk l ~$QC,.Mt~ ~+"'fllc.. OM-B It 1~S.0006 "" .~o,or~1\<lfl)" 3Soda1~WlIgl)$ 5Modk';arawavMantlt1l$ . -"". MvilllOl! 'ElC--p;lYl'Mnt .t1Norlqusnfledplam. ''''''' "t.ocaJ !aj( 1l..r.(,>tl17llt "~wln 4SOC:131Sl:!lWf1tytalcv.otl1tleld 6l\o1€t::lltare-\aI(wil!1toe(O , '.. '0 O1:pcooenl.carewllll1\ls "anlyflil"l~ Copy C!'of E."ployH'. Recoaft .J ntl~.. r-...nlffir 94-2&81'915 ~ arod,.oxh> BEHTEl GROUP) IN:. STATE=8ECHTEL CORP. ill BEALE STREET ~ f'RM'4CI.SCO ell. '"t41.D!.-'lac)S .. ~'''~,l'lllrl2'1Peodll OOS0-868 FR 0'119 T 8530 82:0987 REG no:rrv G DA.VIS J:rCHANG RD) JI,AlIC TAl RD uno Pl..ACE 1.lPT 6014 BEIJING lOOOQ4- ClIZNA .. ~. ~r"l':...tel.D,NQ. til/.::nl!4::1l_ _ j1'SI<Mtt"""llQ%,tip~,eic, \l1S!~il\.;>>IYW.!tou -!--------- ---- Form W-2 W~ and Tall; Sta~mt:nt 7001 Departfl1ftrl III Ihe lr81lIury~lr.temal R$w".'Ut!l ~"-e 009G,\-..~:~~~n915 I'JECHTEL GROUP, :tNC. STATE=8ECHTi:L com>>. 5(1 BEALE STREET SAN FRANCISCO CA 94105-1895 .~'...",,"ltI,1I&IIl:l>5andZIPl.<.l(iv 9.530 82:0987 REG TKlTTY G DAVIS JICttAJ<<; RD1 JIAtG TAl RD LIDO PLACE1APT 6014 B-EIJDC 1ODD04 ClIZNA 16S14ko.....,g.....IIv",..h 11Sl:.Jtelrn;cmetll" ~om'l W.2 Wag_ and Tax Statem&nt 2001 Dep.ftl't!rier't<:.rUleTrMll-Uly-lnl"nllllRfr..'t''1t)''~ '. . ~kl(>l'\:m .1iO<l"ul)'.bllr ~.~1l,l'il'ld .wd~ 94-2681915 BECHTEL GROUP, DE. STATE=8ECHTEL CORP. JiG BEALE STREn- SAN FIlAl'I::= CA 94105-1895 . ''It<.am<!,aJ:!dreu,,endZIP<'t;'4t> 8$30 8t0961 REG Tl'!rTn' G OAV:IS J1OfANG; RD) JIAtG TA! RD LIDO PLACE)IJ'T 6014 lIEl.n:OO 100004 ClIZNA rSstatDf,tl,NQ. In ta!ll.......g<;tS,~\lh.; ?J!6::.n:....04.:Jl_ - - f- - - - - - - l' tllleincomeilD: FomI W-2 Wage and Tn Statement ZOr;l1 Dapllrttr-.!ll'lntllifll'nt,jllllJT'y_In.ternll1RevelllJeStltvlul 'C 160.68 . -,-~----- ,.. ; V 0.00 -tOpy_2JorSl3!e, --crt; Or Loca1.T~~artmeols .-- 503-.50-711& 1ILoe&lwllQM.~~.lC 1198". ,dlWrC""l)er"l5atrDl"t 42.631.48 ..... 'lCmll.OO -j""~WB;Mllndtlpol U631. 48 !kJIZIWMl:il:Ifftytlpl . ~EIC~nt '-- . l'l.oc.11J,"\t()mtrliU n!llrlCOlrlllbAA I!I..JjJ 3462.70 .SQdal tal<c~Ht,r.ekl 24'~ ...0 S Medicalv boor -.neid '18.1& 8 AllIldl1$d1lp$ 10cmpa",;lE'l1lQ;lnotH!oofot'l- CA-SDI 355.42 2GLocl\~'lame 'e , ii '$ iF--' 16Q.68 OMB 1f-15<1~,0008 CQpy ZTlIBto Flk4\11/th EmpIoyoe'.S1'A.TE, CITY lll' LOCAL. To o.pl!1mflntJ . l!V i$ i cGjiyiroisblle. elf yo, ~lJ?~~Pilrtm~ts _ 6-*X:.WC.0Cl .503-50-n78 1'l(ll(;8J Wageti, tlp~. t!~c. --1------- ages, ps,o~ r~oo 42631..48 ....,. ...... 40200.00 -Mfdic:I,r.WlIlQ'M--l!lI'Id1ip1 4Un.48 ~..' tl f1I1,PCormlla;o.W 3462..70 -4SoQ;a1~ta~wl!:tltIeId 2:49%.40 '~llI>cW)ltJbokt 6-18.16 Iedllpl 11~r~p1$fl$ 9AdYa~E1Cp2)Tllfll'lt 'O~taffttx,r6fil~ 1" 1I)6f 11 Loc.aliooo.rflIllib CA-SOI 3.55.42 2OLocellIV{~ _..J________ , OMBit 1545..0008 ee,y 2T~Bto flI8dWlllt EIllPlQ)'"'S,$TA1'E, CITY Otl..OCAl T.u.OlipJlrtlMnh. $ $ $ $ $ -niI....iI~~to..!IIlnt.t ~~.pl...~~illo,"" ",'~~l!"\IIiIt'~Nr 1~~.r1!l"fiII~'wueliI_j"JIi gopy.C for Empioyee's Re:to.td~ ~ ~iro ~ ba~ I "':,111). , 11 local wages. tlpz, ele OMBf#154S.0008 Ol(,lIII",~,m,'lllrcOmpllf>a!lpn .. SUllirIflleelJriCy~< 6~-oM__" 42631.48 , """""'''' . Advaoce EIC p;1l'fl'I....d 11~lInf.edpll/'lS 1.~lir>cometllX CA.-SOI 355.42 %(lL(!(.;lIlilvnamfl Copy C tOl' !mploy~e'" Roc.ortlll ~'",. / EXPENSE STATEMENT OF TWITTY G. DAVIS Monthlv Yearly Home: Rent $ 1,295.00 $ 15,540.00 Maintenance $ 100.00 $ 1,200.00 Utilities: Electric $ 130.00 $ 1,560.00 Gas Oil Telephone $ 190.00 $ 2,280.00 Water $ 95.00 $ 1,140.00 Sewer Garbage $ 11.22 $ 134.64 Coal Emp1ovrnent: Public Lunch $ 40.00 $ 480.00 Taxes: Real Estate Personal Property Income $ 19,760.00 Prep $ 29.16 $ 350.00 Insurance: Renters $ 93.42 $ 1,121.00 Automobile $ 291.66 $ 3,500.00 Life $ 350.00 $ 4,200.00 Mothers $ 54.70 $ 656.40 Health $ 303.33 $ 3,640.00 Other $ 105.88 $ 1,270.62 Automobile: Payments $ 299.04 $ 3,588.48 Fuel $ 150.00 $ 1,800.00 Repairs $ 60.00 $ 720.00 ~ ?e~~~rs jl s " ~-,., 'I '"'~ - ., '~1<r 1 ?,' Medical: Doctor $ 250.00 $ 3,000.00 Dentist $ 666.66 $ 8,000.00 Orthodontist Hospital Medicine $ 133.33 $ 1,600.00 Glasses $ 166.66 $ 2,000.00 Personal: Clothing $ 266.67 $ 3,200.00 Food $ 1,000.00 $ 12,000.00 Barber/Hairdresser $ 60.00 $ 720.00 Credit Payments $ 1,748.42 $ 20,981.04 Credit Card Charge Account Memberships Loans: Unsecured $ 101.28 $ 1,215.36 PSL $ 225.00 $ 2,700.00 Miscellaneous: Household Help Child Care Papers/Books/Magazines $ 10.00 $ 120.00 Entertainment $ 75.00 $ 900.00 Cable TV $ 112.00 $ 1,344.00 Vacation $ 250.00 $ 3,000.00 Gifts $ 83.33 $ 1,000.00 Legal Fees $ 125.00 $ 1,500.00 Charitable Gymnastics $ 300.00 $ 3,600.00 Alimony Payments $ 2,500.00 $ 30,000.00 Pet Needs Vet Mother $ 100.00 $ 1,200.00 Total EXDenses: $ 11,771. 76 $ 141,261.12 , I__~l'r" --", Il'....,~.~'" - ROSANA DAVIS PlaintiftlRespondent : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYL VANIA v. : NO. 01 - 2913 CIVIL TERM TWITTY G. DAVIS, JR. Defendant/Petitioner PLAINTIFF/RESPONDENT'S INCOME & EXPENSE STATEMENT PlaintiftlRespondent, Rosana Davis, files the following Income & Expense Statement in the above-captioned action in divorce in accordance with Pa.R.C,P. 1920.31 as verified by PlaintiftlRespondent pursuant to the Verification attached hereto and made part hereof. ABRAHAM LAW OFFICES James W. Abraham, Esq. 2157 Market Street Camp Hill, P A 17011 (717) 763-1700 Attorney for PlaintiftlRespondent Rosana Davis DATE: 6/15/05 rz-~2 ,'e~"~~~,~"",!,,,,,,,, - " ~. ,.. I,' "V~_.,., . -"~ INCOME Employer: Country Meadows of Hershey Gross pay per period: $8.84 per hour - 26 hours per week/52 hours bi-weekly $455.26 bi-weekly or $995,97 gross per month Deductions (See attached pay stubs): Federal Withholding: Social Security: Medicare: Local Wage Tax: State Income Tax: Unemployment: Retirement: Savings Bonds: Credit Union: Health Insurance: Life Insurance: Union Dues: Other (Specify): Net Monthly Income: ($455.26 - $165.46 = $289.80 x 26 = $7,534,80 div. by 12 = $627.90) $ 628 Other Income (Net Amounts): Interest: Dividends: Annuity: Social Security: Rents: Royalties: Expense Account: Gifts: Unemployment compensation: Worker's compensation: Other: Spousal Support: Month 2.500 3.128 $ TOTAL NET INCOME: $ 2 '.Jl~llmr'-'," J r -~I -',-, , Year 30.000 37.536 - ~,~~-, ~ .~.~,~~~~" t""' . .~ -'1"~\r-<YO--: I" '1.". , Miscellaneous: Household help: Child care: Cable/Computer Legal Fees: Charitable contributions Vacation Entertainment Gifts - HolidayslBirthdays Other: Life Insurance Taxes from Alimony Income Support! Alimony TOTAL EXPENSES: : A"lfi.')~_"""__ \_)1_ _\'", - f \" _\ ~ ~ - ,~" - - r r ' 4 ,. 110.00 80,00 20.00 50,00 40.00 80.00 40.00 91.00 $ 3.151.00 1.320 960 240 600 480 960 480 1.092 $ 37.812 E"'p1oY"'" no.... Dovls z !-(j/~~k-L7 CoIlntty M..dow. of --,-~ DESCRIPTION HOURS RATE DOLlARS DESC, HOURS RATE DOLLARS REMAINING - REG 5150 1') 'aj'400 45526 PBRS , 10.59 ) . . VAC 2~64 / ol55.26 I , 165.46 . DtlJu..II""'" I f-....._. CUIIlU!NT Y[ARTO DATE CU_ YeMTO D"T! ; ! ; EARNS' 45526 3312'9 FED 6S'44 494PS FICA 31!32 228a4 STATE 1257 9Ul3 LOCAL 6a3 49170 SUlliH :41 2!99 OPT 00 10!lO PPSl1 3S!J.2 26654 UCS31 3~2 2T VITl1 4i45 3lf5 , , , ' . , , , , , , . . , ~ ,1- "021-;Fo.2~A35371-'-'--~a-3537 I~n 04/03/20050...26259'-' -289.80 l.... .. Emplov<>e: no.... Davis DESCRIPTION REG 51$0 RATE ap400 DOLLARS 45526 --_.. T DESC. ' HOURS RATE PERS VAC DOLlARS c...ntty Meed_. of REMAINING 1059 21\64 455.26 !.Q!~~lOft5 165.46 D """RENT YEAA TO DATE CUIIAl'NT YEAR TO OATE EARNS 45526 3312179 FED 6ail4 494:08 FICA 31~2 228114 STATE 1257 91113 LOCAL 683 49170 SUIWII 41 299 OPT Do 1000 PPSII 38).2 266!a4 UCS31 3r2 23~4 VITI1 445 3115 2- -3537 289:-80 '~"'I"~""~.~ '1"'''''q "". I , ._ ., ,........._,,~, - DESCRIPTION !lEG Country Meadow. of -.........------, DOLLARS DESC. HOURS RATE DOLLARS REMAINING 39180 PERS 12:89 --TOTAL GROSS VAC 3Q62 397.80 TOTAL DEDUCTIONS 152.63 C...-. ~ TO DATe CUARalT 'fEAR to DATE EARNS 39780 4199DO FED 62:<;9 .628;52 FICA 26il2 289~2 STATE 1080 116:22 LOCAL 597 63DO SUIWH 36 3.79 OPT 00 1000 PPSll 38.12 343(18 UCS31 3?2 2988 VITl1 4'45 4005 Employee: R~.na Davis ~.... .- ,~~ .c CbII~ OS 01 58 3537. 245.17 ; ...1. I , ._~~ J" Employee: Rotan. OMit Country MelldowI of T . - ...... ---~ HOURSI DESCRIPTION HOURS RATE DOLLARS DESC. RATE DOLlARS REMAINING RSG 4sioo 88400 I -.- , I 39780 PERS 12.89 TOTAL GROSS VAC 3a62 397,80 I , TQTN....omuctIOH$ I I 152.63 ! . -tiEDUC.'...;.... , , ~R~ .~TO~TE CUIlllENf VEARTO DATE ! , , ! , , EARNS 39780 41911DO FED 62:<;9 62852 I i FICA 26il2 289~2 STATS 1080 116:22 LOCAL 597 63DO SUINIl 36 3.711 I OPT DO 1000 WSll 3812 34308 UCS31 3~2 29il8 VITll 445 4005 , I I """-"2 .. 3~37'P 522-<'-:"i37 I -... , , ,'F.. 057017200sr~2~54s 1- 245.17.- ___1 ! ._-~. , ...- ...,. .. ....',_..". ..~ --I". .,..,,~ ,.~. r. ., -" "." -~ ...,.-, " DATE: i,"~ _T, f"""""l VERIFICATION K..oSMA lM-lIiJ, /; (5-0;; , "., Q~~0rA'(/A' -~ ~ -, . ~ T - US-FL-West PalIn Beach-CUNTRACT ADMINiSTRATUR Page 1 of 1 search Jabs MV Monster Career Center For Emplnve..s ~ lTIOrlster Back to Job Search Results ()uaB~esource( CONTRACT ADMINISTRATOR Company: Quantum Resources Corporation Full Time, Temporary/Contract/Project US-FL-West Palm Location: Beach Supply Job Category: Chain/Logistics status: ~. APPLY NOW Monster recommends using Apply Now. Learn morEh Job Description Our client in Port SI. Lucie, FL is currently looking for a Contract Administrator for a one-year contract position. Position may extend to up to 18 months. Local candidates will be considered first as there is no relocation. Top level experienced professional contract adminlstratorlfield buyer with a background in technical procurement, preferrably in the nuclear power generation industry. The position requires a proficiency in major contract negotiations, risk management, contract law, financial analysis and adminstration of contracts and claims. The individual will be responsible to support major project/construction teams through the day-to-day management of contract commercial issues as well as sourcing and procuring project related materials and services. - This position requires clearance by a Nuclear Sne Safety. Background will be conducted back to age 18 and a drug lest is required. Some local travel required. Contact Information Company: Quantum Resources Corporation Contact: A1lyson Berger EmaU: ~b~r.m~L@QI=l..~Dtwrnte~9~r:G~_S,o_et Reference Code: PSL-Contract Admin ~. APPLY NOW Send this Job to a Friend Qick here to see ~ntum Resources CQ[QQ.ratjon':",QQQQrtuol~_~ Learn more about Quantum Resources Corporation ~-) http://jobsearch.monster.com/getjob.asp?JobID=29823241&A VSDM=2005%2D05%2D05... 6/13/2005 i"'iIf"",...,.,~, _ """" ';;;1 . ....... T -~ , - ~-~ Hudson - US-NC-Charlotte-Contract Adnrinistrator - F ARs & DEARs Page 1 of 1 - Job Searcb Career Support Career home I for employers I about Hudson I find local office I contact Job Description llS- [-.--- ~.~!!!!~~!..~AJ.!l_i.!listI.:.~!.~.!_:..~M!.~.~_.P.J:'Al!.~.........__._._.._..................__............._......._...I.~:~_i Our client, a Fortune 500 company traded on the NYSE, Is a multinational energy company with an integrated networ assets and expertise. They manage a dynamic portfolio of natural gas and electric supply, delivery and trading busine meeting the energy needs of customers throughout North America and in key markets around the world. They are seeking a Contract Administrator with federal government contract experience for a contract to permaner position at their headquarters in Charlotte, NC. This is a contract to hire opportunity. Permanent salary on conversion $80,000, contract rate $40-48/hr for a 3-4 month duration. Should the candidate selected not be local, per diem and be provided. QU,aUfied candidates will have 4~6 years current experience managing federal government contracts in accordance wi. (Federal Acquisition Rules) and DEARs (DOE supplement to the FARs). Candidates MUST have experience wit Requirements also include a Bachelor's Degree in Business or Accounting, government engineering and construction I background, working knowledge of cost and price analysis, experience in lease vs. buy decisions, as well as strong M~ Excel skills. Job responsibilities include complex contract administration, cost/price analysis, coordinating and administering mem agre~ments and subcontracts, assisting in the development of proposals, evaluating offers and draft mods, evaluatin! risks, and other responsibilities as assigned. Interested and qualified candidates should forward a Word version of their resume to kri?te:n,jqhn,sto'O@l1l.)_d~.on.com f consideration. Please do not apply if you have FARs but not DEARs. About Hudson Hudson delivers specialized professional staffing, outsourcing, and human capital solutions worldwide. From single pIc total solutions, the firm helps clients achieve greater performance by attracting, selecting, engaging and developing t brightest people for their businesses - people like you. We offer contract, consulting and direct hire positions for talented individuals across a complete range of disciplines a We are committed to the principles of diversity and equal opportunity. For more information, please visit www.hudsOf Additional Information Salary/Wage: USD 40.00 to USD 48.00 per hour Position Type: Full Time, Temporary/Contract/Project Relevant Work Experience: 5+ to 7 Years Career Level: Experienced (Non-Manager) Education Level: Bachelor's Degree Contctct Information Company: Hudson Energy ,. View all_"l-judson Energy" opportunities ,. Learn more about "Hudson Energy" r EmaJ help I privacy ~ http://jobsearch.monster.comlgeljob.asp?JobID=29743583&A VSDM=2005%2D05%2D 18", 6/13/2005 r"',~~_,:ulb~' "~~"l~ -, =1"""'1'- ,0 "-- 'I' US- V A-Reston-Contract Administrator 1 When you turn on the lights, answer your phone, drive your car or when your flight lands safely, Siemens is there. You may not always see the things we do, but our technology is virtually everywhere. From medical scanners and power plants to lightbulbs and high speed data networks, our electronic and electrical engineering products, systems and services improve the way we live, travel, make things, communicate and care for each other. Siemens offers YOU the power to spin the globe. Making the most of your career - and your world. Position: Contract Administrator 1 Company: Siemens Government Services Field of business: Executive Management Location: US-VA-Reston Mode of employment: Job number:PCK22l-79132 Company: Siemens Government Services Division: SGS - Siemens Government Services ReqID: 24125 Siemens Government Services Inc is currently looking for Contract Administrator. Candidates must have 2-4 years experience as a Contract Administrator. Also be familiar with government contracting to include: GSA schedules, GW AC contracts, Blanket Purchase Agreements (BP As), GSA schedules. They should be versed in the F ARS, DF ARS, FIRMRs, etc. They should also be able to negotiate and manage large contracts with the government agency or with a major prime contractor. They should also be familiar with subcontracting regulations with small businesses, and disadvantaged businesses, Candidates must be able to obtain a Page 1 of2 -Gloi>oll AJD,OC . sterner I" the I '. Fo.r 1S1 fOcogI\ 'o<!1nol . In .roru opprw. In...... mo"'. Um" ;l( Lean IlSielnel S usa,S http://jobsearch.monster.com/getjob.asp?JobID=30892492&A VSDM=2005%2D06%2D08,.. 6/13/2005 ,.~"-, r~- ~l'--~ ,~ -!.- us- V A-Keston-Contract Adnnmstrator 1 Page 2012 clearance. --~---,~--" --- ~' ""APP_Y ~"ONt..INE Now Company: Siemens Govermnent Services Job Reference Code: PCK221-79132 Siemens is an Equal Opportunity Employer encouraging diversity in the workplace http://jobsearch.monster.com/getjob.asp?JobID=30892492&A VSDM=2005%2D06%2D08... 6/13/2005 ~ '1"'!l<.-.. "-"'r <- ~ < I -<1 " , t"'!~< . I ~- u ~-UK-portlan(H;r. Contract Admmlstrator Page I on ~ Imagine a company committed to its employees, the environment and the community. PacifiCorp is one of the West's leading investor- owned utilities, serving about 1.6 million residential, commercial and industrial customers in six western states. Headquartered in Portland, Oregon, PacifiCorp is committed to providing safe, reliable and affordable power and exceptional customer service as Pacific Power andlor Utah Power in California, Oregon, Washington, Idaho, Wyoming and Utah. PacifiCorp is part of the ScottishPower Group, a leading international multi- utility group based in the U,K., which provides utility services to 5.5 million customers throughout the United Kingdom. The Compensation Package One very important component in joining the ranks of a strong, stable organization is the ability of the company to provide a comprehensive compensation package. PacifiCorp takes pride in offering employees a scope of benefits that have both present and future value: Competitive salaries Bonus plans for non union positions Sr. Contract Administrator Company: Pacificorp Location: US-OR-Portland Status: Full Time, Employee Job Category: OiVGas/Utilities Career Level: Experienced (Non-Manager) Job Ref Code: 050606 This position participates as a member of a team or under individual assign men in the management, administration and documentation of transactions related t, wholesale purchase and sale of bulk power among utilities, marketers and power producers. Ensures that transactions are,conducted and reported in accordance with the fequirements of federal and state regulatory agencies and company policies. The qualified candidate will require interaction with all functions of the company including, Mid-Office, Back-Office accounting, Origination, market traders, preschedulers, legal counsel, credit management, risk management, and Company officers. The position requires: . Development of relationships with counterparts at other utilities and utililj organizations to effectively administer the company's obligations under mulit-party contracts. . Participation in processes that review and document contracts and/or requests fOf service to ensure that applicable standards and guidelines are met. . Analyze, assess and investigate the requirements of contracts andlor proposals; the ability to develop alternatives and to provide recommendations. This position may require moderate travel. This position available to be hired at the Career level (3+ years exper.). Requirements for the position include: · Bachelor's degree in engineering, finance, economics or equivalent education and experience contributing to the development of proven skills and knowledge of power trading. · 5+ years of energy experience including responsibility for large contracts in excess of $25 milliion. · Demonstrated progression in career with increasing responsibility. . Be able to work independently and with teams. · Ability to present and defend alternatives and recommendations to uppel http://jobsearch.monster.comlgetjob.asp?JobID=30997460&A VSDM=2005%2D06%2DI I... 61l3/2005 "'~f'''T'''' '-'~-~-IJ'V-l I-"'~ = . ~." r ~~ '" ~~ . ~- . . US-OR-Portland-Sr. Contract Administrator Page 2 of2 Group medical/dental/vision Gen~ustimeoffb~efus 40lK with matching fund component Employee stock ownership Retirement plans Life insurance Education assistance reimbursement for work- related courses For more information about PacifiCorp, please visit our web site at www.PacifiCoro.com. PacifiCorp is an equal opportunity employer that values diversity in the workplace. management. . Consult and resolve inter-departmental and inter-company issues which may be sensitive in nature. Work with all levels of the company including those with different styles and backgrounds. Preference may be given to candidates with the following: . Knowledge of the terms and conditions of the Western Systems Power Pool Agreement and the Federal Regulatory Commission pro forma transmission tariff. . Experience as a Contract Administrator All offers of employment are contingent upon the successful completion of a background check and drug screening. Apply Online hltp://jobsearch.monster.comlgetjob,asp?JobID=30997460&A VSDM=2005%2D06%2Dll... 6/13/2005 """''"'~'~-I''''''''''''\''-~'''''~I'''''' 1 - .. j CONFJDENTIAL 27-May-2005 Twitty Davis Oakridge, TN Dear Twitty: This will continn our conversation on May 31, 2005 regarding the forthcoming completion of your current assignment and the efforts heing made to identify a new position for you. We also talked about the possibility of putting you on holding status if a new assignment had not developed by your release date. To date, we have been unsuccessful in loeating a new assignment for you and your release date from your current assignment is June 30, 2005, In order to offer you the opportunity to retain your continuous service while awaiting possible reassignment, we are placing you on a throe-month holding status, heginning July I, 2005 and ending on Septemher 30, 2005. Holding status is a non-paid employment status wherein Bechtel continuous service and eligibility for certain insurance coverages remain in place. Attachments I and II eontain important infonnation eoncerning holding status. After you read and complete Attachment 1, return it within one week to your immediate supervisor and forward a copy to Sherry Ferguson (location BP3 IA3) 5275 Westview Drive Fredcrick, MD 21703. I encourage you to check BecWeb for job openings on the Bechtel Opportunities Program website - http://I47.1.23.197/BecOpps!andBechtel'sexternal website -www.bechteLcom. Bechtel employees placed on holding status will have limited access to the Bechtel network in accordance with our information security policies. This limited aCCeSS goes into effect on the date your status changes to holding. Additionaily, direct acceSS to the Bechtel network through dial-up services will not be available for personnel on holding status. Network access is limited to e-mail.myINFO. Bechtel Opportunities, and Bechtel University, '" For access to e-mail.myINFO. and Bechtel Opportunities from your home computer, use the following link: https://citrix.bsiLbechtel.com. To download the eitl'ix plug in to your home computer, use the foilowing link: httpt;;//citrix.bsiLbechtel.com/CitrixlMetaFrame/defaultldefault,aspx '" Bechie] University provides access to online and classroom training and courses. To access Bechtel University go to https://elearning,bechtel.com. BECHTEL NATIONAL, INC. 5275 W~!>"tvJew Drive Filid(lrl<k, MD 11703-83% usA l\.."J:;XHIBIT , ~ J-C'H nDYt"rS i 2. I )f~"" I t r.., "' ~. Before your last day of work, please ensure that we have your current address and tclephone number so that we may contact you in the event that a suitable assignment opportunity comes to the Company's attention. Please understand, however, that it is your responsibility, not the Company's, to learn about and seek placement to vacancies elsewhere within the Company. Si cerely, J(j . Newman. Principle Vlce President Manager of Government Procurement and Subcontracts cc: Employee Reiations (w/o all.) Payroll Deparbnent (Glendale) (wiatt) Master Personnel File (Glendale) (w/o art.) :~'I~~' , ~ . Statement of Earnings - Non-NegQtiab1e ~ Bechtel Nationa1k Inc pay per,od, 06(05(200S Regular payroll 00 20~:? ~~Spu~T.y G. JRSick Leave Savings 192.42. PTO 38.80 NET PAYMENT 2,501.46 Remittanc~ Number 00820987002300 1iti~:iij:~:~~~:~::-------------~~-----~8------------------;~~~i-Ij~~: ~!ed1.l:s llR S6.10._ 7 1.S1 ~O PayOff S 2.9' G1"L FICA Wages *Imputed Income* 10.32 123.8' ~-~~~::_~:~~:_------------------------~~~~~::~------------------~~~:~~::~- PRE-TAX DEDUCTIONS ctJRR.."NT Y'XD Hea1thCare ~pendin9 EE 16.:1g~6-: 157.72- Aetna Oental EE 11 197.93- Vol. perso~a1 Accident EE 101.26- ~~~~1l?~81~1!;ggglement 9 .87- 1,2'~:85- ~~fc~~1HO!at~~~i~ient 5~:8i TOTAL PRE-TAX DEDUCTIONS 139.96- 1,634.82- .~------------------------------------------------------------------------------- Is Mar Nbr Add ctJR-TAXABLE ctJR-TAX Y'XD-TAXABLl! Y'l.'D-TAX ~ ORITY Sts A1w Amt D ~~t~~g+J:gtn M 05 ~;~~t:~i ~~~:3~: ~l;,~~*:.~6~ ~'i~~:~~: EE Med car j,814.4~ s5~11- fi: 696 0 '459.60- :::<.:::~_~~____________________________________~~~::~:__________________z.:.~~~:~~: ~Jj:R TAX DEDUCTIONS CURRENT ill ~yg~Qff!ga~~i~i~ft-tax 1~~:3~: 1, 14 :~~: 'tru$t7ThJ:"1.t"t Loan Deduct 2~~~g7- 1117 .7H- TOTAL AFTER TAX DEDUCTIONS 542.54- ~,693.6.- -~-----~------~---~---------------~------~------~-------------------------------- ~~~~~!~~~~:____:~~~::~~__~.:~::_!~~~~~~~_____________~~~~~S~:__ T If'h r m~~PJI B I l,,/It.jll)h- ) . . ,.;;~ ,'10/. ~ r ,~~~'- <,",'''.~' , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,., "':Ii if. :f;;ti;f. "':ti ffi;t; ;r. . . . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNA. No. 01-2913 CIVIL TERM DECREE IN DIVORCE AND NOW, Q~," , ~ ( IT IS ORDERED AND DECREED THAT Rosana Davis , PLAINTIFF, AND Twitty G. Davis, Jr. , DEFENDANT, ARE DIVORCED FROM THE BONDS OF MATRiMONY. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT YET BEEN ENTERED; tv~ . . . . . The attached Separation and Property Settlement Agreement dated ~ . December 27, 2001, shall be incorporated into, but shall not ~ merge in this final Decree rsuant to Paragraphs ~ 4 and 5 of said Agreement. ~ . . . . . . . . . . . . . . At::~ . . . . . "'''' ",,,,,,,,,,'Ii .. . . 'Ii 'Ii:+: "''''''':Ii''':+: :+: :+::+::+::+: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J. 2".ij.i.~-'~""'~-li""""'"~"""""\8~iI~~~lM~~,"~I~I~~~~~""'" ~-. /OJ-;J7f,N /:J-;;fit:Jt' R.I!,,~_ ~,~I)..1(t~. ~..LUUJU_,('J!_!~MJI!.RUJl,l! .1. . ",_ """1.,_..,,. ._'..' ___ . - .........~-......~~ ~. -W'd , cY;A S3 M.t'~~~4~~ /1~~~4U' '" ROSANA DAVIS, IN THE COURT OF COMMON PLEAS Plaintiff/Respondent: CUMBERLAND COUNTY, PENNSYLVANIA vs. NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., IN DIVORCE Defendant/Petitioner: CIVIL ACTION - LAW ORDER AND NOW, this day of , 2001, upon consideration of Defendant's Petition for Special Relief, the requested relief is GRANTED. Respondent is directed to turn over to Petitioner, within two (2) days of the date of this order, the 1997 Volvo 850R and the 1994 Ford Ranger for sale and satisfaction of the loans, with the proceeds of sale exceeding the loans and cost of sale to be held in escrow until a final resolution of this case. BY THE COURT: J. Distribution: Nichole M. Staley O'Gorman, Esquire Attorney for Petitioner Melanie Erb, Esquire Attorney for Respondent --~~'I7''''M>'\'''rfi''< "': "1 , ~ ' Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. C I - .:2 91.3 Go ~ l <.: L'2n..YJ ROSANA DAVIS, vs. TWITTY G. DAVIS, JR., Defendant CIVIL ACTION - LAW IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the court. A judgment may also be entered against you for any other claim or relief requested in these papers by the plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary at CUMBERLAND COUNTY COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PENNSYLVANIA 17013. IF YOU DO NOT WISH TO FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOUR SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. COURT ADMINISTRATOR, 4TH FLOOR CUMBERLAND COUNTY COURTHOUSE 1 COURTHOUSE SQUARE CARLISLE, PENNSYLVANIA 17013 TELEPHONE: 240-6200 .' """l:'!f-''''f~"''"'f '1~~1 ~ "'" . . ., "~ - ,-~~ . '" -- ~ V. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA ~NO. 0/- :2 '11.3 Cwd 1.t.U>'- Rosana Davis, Plaintiff Twitty Q, Davis, Jr., Defendant : CIVIL ACTION - LAW : IN DIVORCE COMPLAINT IN DIVORCE UNDER SECTION 3301(c) AND 3301(d) OF THE DIVORCE CODE AND NOW COMES the above-named Plaintiffby Melanie 1. Erb, Esquire, and the law firm of SERRATELLI, SCHIFFMAN, BROWN & CALHOON, P.C., and seeks to obtain a Decree in Divorce from the above named Defendant, upon the grounds hereinafter more fully set forth: COUNT I 1. Plaintiff is Rosana Davis, who currently resides at 1025 Yverdon Drive, Camp Hill, Cumberland County, Pennsylvania since April 27 , 2001. Plaintiff s Social Security Number is 522- 58-3537. 2. Defendant is Twitty Q, Davis, Jr., who currently resides in Beijing, China since April 2001. Defendant's Social Security Number is 503-50-7178. Defendant's current business address is BSF China Company, Ltd., 101F Hyundai Millenium Tower, No. 38 Xiaoyun Lu, Chaoyang District, Beijing, China 100027. 3. Plaintiff has been a bona fide resident in the Commonwealth for at least six months immediately previous to the filing of this Complaint. :":\'C~"""~I' ."""~r~' . I-PI :~ 4. The Plaintiff and Defendant were married on November 12, 1966 in Denver, Colorado. 5. The Plaintiff has been advised of the availability of counseling and that she may have the right to request that the Court require the parties to participate in counseling. 6. There have been no prior actions of divorce or for annulment between the parties. 7. The marriage is irretrievably broken. 8. The Defendant is not a member of the Armed Services of the United States or any of its allies. 9. The Plaintiff and Defendant are both citizens of the United States. 10. Plaintiff avers that there are no children of the parties under the age of 18. WHEREFORE, the Plaintiff prays your Honorable Court to enter a Decree in Divorce from the bonds of matrimony. COUNT II 11. Paragraphs one through ten are incorporated by reference herein. 12. By reason of the institution of the action to the above term and number, Plaintiff will be and has been put to considerable expense in the preparation of her case, in the employment of counsel and the payments of costs. 13. The Plaintiffs income is disproportionately lower than Defendant's income and Plaintiff is without adequate funds to pay the costs and expenses of this litigation, and is, likewise, without adequate funds to maintain herself and the parties' children during the pendency of the litigation. !"~"""""''''''r -~-. ""'!' ~'~l'~ I -. " , ,- " ' r 14. The Plaintiff is currently unemployed. 15. The Defendant is currently employed by Bechtel Corporation as an engineer earning a gross income of approximately $100,000.00 per year, WHEREFORE, Plaintiff prays that your Honorable Court grant an Order upon Defendantto pay your Plaintiff, alimony pendente lite, counsel fees and costs of the litigation. COUNT III 16. Paragraphs one though ten are incorporated by reference herein. 17. Plaintiff is unable to adequately support herself through appropriate employment. 18. Plaintiff lacks sufficient property, including but not limited to, any property distributed pursuant to the Divorce Code of 1980, as amended, to provide for her reasonable needs. WHEREFORE, Plaintiff requests that the Court grant and award alimony. COUNT IV 19. Paragraphs one through ten are incorporated by reference herein. 20. Plaintiff states that the Plaintiff and Defendant possess various items of both real and personal marital property which is subject to equitable distribution by the Court. WHEREFORE, Plaintiff requests that this Court: (a) Equitably distribute all property, personal and real owned by the parties; 'ii'-Jl!!';l;_r ~,_ (b) For such further relief as the Court may deem equitable and just. Respectfully submitted, /fS Melanie . Erb,Esquire Attorney ID No. 84445 SERRA TELL!, SCHIFFMAN, BROWN & CALHOON, P.C. 2080 Linglestown Road Suite 20 I Harrisburg, PA 17110-9483 (717) 540-9170 Attorney for Plaintiff !,~~-'- ."1-1 ,"< ,,_ -,1" "",. , '" ~ . VERIFICATION I verify that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa, C.S. Section 4904, relating to unswom falsification to authorities. Date: s/Iolo I y~ Ua-v~~ Rosana Davis ''':''i~-~- ? FA'I -----~ , .. . .., ROSANA DAVIS, Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, : PENNSYL VANIA v. : NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., Defendant : CIVIL ACTION - LAW : IN DIVORCE AFFIDAVIT OF CONSENT AND WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(C) OF THE DIVORCE CODE (1) A Complaint in Divorce under 3301(c) of the Divorce Code was filed on May 14, 2001. (2) The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. (3) I consent to the entry of a final decree of divorce, without formal notice of the intention to request entry of divorce decree. (4) I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses, if I do not claim them before a divorce is granted. (5) I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Sec. 4904 relating to unsworn falsification to authorities, (2 -d, '7~,;2D 0 DATED a~Q/W~ Rosana Davis 'W"~'1'~~""'~~~_. 1~ .-. ~ , ,.,-." . ,,-~- -~;~ ,- , ~ . '-,' "-" . ,-, 'no -~ , '-.; ~ - ~- M ~ - '-""."". -C~, o";rur-~ -"-Jt';'"-"-i'-r-li~J"lft~lr "';'''_'''('; -ir-l~t\~fw;-t"-tl:Tr(~J~':~ "' " ,'~" -'~ ~ '. (') 0 ~ - CI -o~ 0 -'i EP ff;' ,,, -:::t, '" <-, z~ 1\.) ;::....-;! ~=~~' ::J1il -.I ";r _-Ci ~..: " ~!(..J 2C: ~ S?,E~ --0 Pc:: ~ Z (Siq :< N );! -..J :u -<: ~~__.~~__JIl;;1Mf'f~'W>Wl''''l~W_'''I'!'ili"''''''-.'l1""~'''!'F''!'$i}'''r;r",',""c-,#",,,,;~~~~'._~!!lIllliIlII~"~~ .~"~ .~" . " n._ , ~=- ~ J ... Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ROSANA DAVIS, vs. NO. 01-2913 Civil Term TWITTY G, DAVIS, JR., Defendant IN DIVORCE CIVIL ACTION - LAW AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on May 14, 2001. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. ~4904 relating to unsworn falsification to authorities. Date: t;)JJ.7/0) / I l,.",,,,"~ -I"... -_-"_"""''""~'_~~'''~ .=... - ..~. ~ ~- .... , .. . .~ . '" . , , I;, > ~~. ",. ... . .' .... - ,- ..., ij' -~'~Jt1r~rf c' f-<:n .-c~s""li~r"fn;;'fil<'j~;t'-F ."1- ""'~'':'ti';'",i~}!.~ffffi'Ji!'t''~rlijfti\ltiJ-'H>\;~r~r'''''ttn6;ij ,. 0 C1 C) C "r, ;;;: 0 -oP" 1"'1 mrT r" ;:0= Z~.c- Zr;;. ;"\.) ofT, ....., ";-: '. ~i ~~" C>(~ r:::\'::T- -, ~ v ..~1; :H :i>O 3 LO 'ON '~~~;:~ :J>C ,~> ~ :-{ 1'0 .J;o'- ;:n -< CO -< ,llj,~~f'jJ1'-'!_li'r~t;r.<'j',",HC'-#i'-f>W"'M"'W%',ij~~~~W"lmflJMJU~~~I~l! '': v.~_~ _ ~_ __ , ... ,.. , Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ROSANA DAVIS, vs. NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., Defendant IN DIVORCE CIVIL ACTION - LAW WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER S3301(c) OF THE DIVORCE CODE 1. I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subj ect to the penal ties of 18 Pa. C. S. ~4904 relating to unsworn falsification to authorities. Date: 1;;'/.;.") /01 I / ndant i',~",-! ,",. _.1- -',~"~"~.,,,, __;" ,."~'"_''' 'P ",. __P~ ."__ ___~ _,_c_--, _, . I" .... , , "~,,~~~ ","'-~--^----"' - -;'-,w___ ,.,,-"- ',~,_~~'~ _ 0,,< tn ~1l1 " ... 'r"lIIrr 1f jj "'n!'IWi"'rJ ITJijl' "[' "'[ n T1WJtl""]Ji]l'iliij,t1' !ti1'Jj)j!tl'1i .. , (") C> C) c:: ~''''l ~: C) -ace rn '1'1'1 rnF' C') , ~ Z::CI N . ;"!,::!:l ~S;.: "";,-_1 -J ',-,j,-\ ::..("L S:~ r:::C) -0 - ~ ~--:;~Q ~o ~O ~ f-"";\" ;J;>c ~ ~ '1:~ 5:> 0:> .< ',__""'"" ,__~"P~^,",""""",,_ ft",_,_","f",,,,,_,~,~~~~t-<I;'5~~'Il'~~~~!!'~~\!l8~~! .'k-" r-.r" ~.'~'M Iilf .' ..... w ROSANA DAVIS Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA v. :NO. 01-2913 Civil Term TWITTY G. DA VIS,JR., Defendant : CNIL ACTION - LAW : IN DNORCE ACCEPTANCE OF SERVICE I, Twitty Davis, Defendant in the above-captioned matter, hereby certify that I accept service of the Complaint jn Divorce filed in the above-captioned matter on May 14,2001. witty Da . BSF China mpany, Ltd. 10/F Hyundai Millennium Tower No. 38 Xiaoyun Lu, Chaoyang District Beijin, China 100027 Witness by: J~~c-7~ f-( .6,"S 3,., J:~ ( Date: I Daniel F Fraser Attorney At Law California License No. 189427 - - J ,"!ill ' "~'''1i~tln11t!*".5Zt'"n1'~~' J'Tl!1i 'h'iIlIIIli'"""'fj'~'1i~.'" ... .. .. 8 0 0 -n ~ <- ,-< -U ('.~ c:: ?~lfg C!1 ri', z 4--_'-.1 I ",-,l-n Zr;: ~3~~; en,"; -' -< "'- CG -0 3> :),: ?~:D zQ .... C) ....7.. -( , r:-: 0,11 )>-C ~ Z r::- :<! 0"> I , I " I I " " , " , , , , " I " :1 I , , 'i " :1 i I I " ,! ~' f; ~~rmlllW~'~~~;p.l!''''''),''''''i'~F.t~l~,~"mf.'jla,"%.Ji'lW\'",,",'lN,,%.Wl\&liIlM>liM~_o:,_\[jf,I_Jil!e:_iII~_""""'_;i! ROSANA DAVIS, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs, NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., Defendant CIVIL ACTION - IN DIVORCE PRAECIPE TO STATE SOCIAL SECURITY NUMBERS PLAINTIFF'S Social Security number is 522-58-3537. DEFENDANT'S Social Security number is 503-50-7170. PURCELL, KRUG & HALLER N'cllole M. . D. NO. 7 866 719 North Front Street Harrisburg, PA 17102 (717) 234-4178 Date: December 27, 2001 -1['0"_" ,"-." " <,' ,~ _,. N' ... . .... ROSANA DAVIS, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 01-2913 CIVIL TERM TWITTY G. DAVIS, JR., Defendant CIVIL ACTION - LAW IN DIVORCE PRAECIPE TO THE PROTHONOTARY: Please enter the appearance of Nichole M. Staley O'Gorman, Esquire on behalf of Twitty G. Davis, Jr., Defendant in the above-captioned case. PURCELl" KRUG & HALLER Esq. Date: July 30, 2001 i: '"~_~ I ., ., _~. , ~, ~ ROSANA DAVIS, IN THE COURT OF COMMON PLEAS Plaintiff/Respondent: CUMBERLAND COUNTY, PENNSYLVANIA vs. NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., IN DIVORCE Defendant/Petitioner: CIVIL ACTION - LAW RULE TO SHOW CAUSE AND NOW, this 'Z-'>'" day of ()cr~ , 2001, upon consideration of the foregoing Petition for Special Relief, Respondent is directed to show cause, if any, why the requested relief should not be granted. Rule returnable 2.0 days from the date of service. BY THE COURT: Distribution: Nichole M. Staley O'Gorman, Esquire Attorney for Petitioner 4~ Melanie Erb, Esquire Attorney for Respondent .~ ~\ '-~!J!", "''''''"j '-'='1 '- . , ",j '.- ,~l? ('>. c., c:'; 1..- ,n , '_~__ '~,!'; c::; .'>.. l......~ ,:;:... :~"5 .:~,? Jl.7 .::;( --", ,....,.f ~~:)' ~;d~(~fl ....~~~ ..J... -.5 () ~ ---- ,-. ~.~ <~. ~~ ''''',_~' ",,';;:,') "_0",,'_ -'<> '",,";. ''''''2''f f""'k'y-~t":,,, ;.- 'if"'tt"ti'jr,.;,,)~~.t"" ',':rr""tnritr'A ~~!I!,;1o~'m!t~~~(~'~~;'Ii'-'iI'>';,fl'!f"~'W"~'~-'~""~''''{';'''~- "'';'-,'''''''''-',; ill~ .If>'J,';-;mF;;t'.;;;;rfj;!ll1'!j'\''''''M;''lfm':1'f~~mp'i[~I~WIlIT~f[;;;' ROSANA DAVIS, IN THE COURT OF COMMON PLEAS Plaintiff/Respondent: CUMBERLAND COUNTY, PENNSYLVANIA vs. NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., IN DIVORCE Defendant/Petitioner: CIVIL ACTION - LAW PETITION FOR SPECIAL RELIEF AND NOW, comes Petitioner, Twitty G. Davis, Jr., by and through his attorneys, Purcell, Krug and Haller, and files the following Petition for Special Relief: 1. Petitioner is Twitty G. Davis, Jr., Defendant in the above captioned divorce action (hereinafter "Husband"). Husband currently resides in Beijing, China. 2. Respondent is Rosana Davis, Plaintiff in the above captioned divorce action (hereinafter "Wife"). Wife resides in Cumberland County, Pennsylvania. 3. In or about February, 2001, the parties, then residing in Malaysia, separated and Wife moved back to the United States. 4. Upon her return to the United States, Wife took over possession of the marital vehicles, a 1997 Volvo 850R sedan and a 1994 Ford Ranger, and has had exclusive use and possession of the vehicles since that time. 5. Husband has continued to make the monthly payments on these vehicles, totaling about $879 per month, since the parties' separation and through September, 2001. "\"''''''F'''''''''''''''''!""","", l' I"" " ..,.. '" .. " . 6. Following the entry of a support order in favor of wife on September 12, 2001, Husband requested Wife to either turn over the vehicles for sale and satisfaction of the loans or take over payments on the vehicles, as he does not have the financial wherewithal to pay the support obligation and the vehicle loans. 7. Wife has failed and refused to do either, responding in a September 21, 2001 letter from her counsel that she wanted to keep the vehicles, have Husband continue to pay for them, and have Husband pay a qreater amount of alimony than the support he is now paying. 8. It is believed and therefore averred that Wife does not have the financial ability to pay the loans and does not intend to pay the loans despite her continued exclusive use of the vehicles. 9. As the vehicles and their loans are jointly titled in the names of both Husband and Wife, Husband's credit rating will be affected detrimentally if the loans are not paid in a timely manner. 10. Furthermore, the parties stand to lose the equity value of the vehicles if they are repossessed. 11. As Wife has refused to consent to a divorce, this action cannot be scheduled for a hearing in its entirety by a divorce master until approximately February, 2003. Husband will suffer irreparable harm if this issue is not resolved well in advance of that time. WHEREFORE, Petitioner respectfully requests this Honorable ";~;~;;;'l~_r"'7 r" ~,~ ~~""- !rf~~' ,,,'" '-,' - ,- ~ Court to direct wife to turn over the marital vehicles to Husband within two (2) days for sale and satisfaction of the loans, with the proceeds of sale exceeding the loans and cost of sale to be held in escrow until a final resolution of this case. PURCELL, KRUG AND HALLER lC ole M Esquire ID #79866 i 1719 Nor Front Street Harrisburg, PA 17102 717 234-4178 Attorney for Petitioner/Defendant Dated: September 26, 2001 3 "<&lRffl ,,"t .1 . VERIFICATION I, Twitty G. Davis, Jr., hereby verify that the facts contained in the foregoing PETITION FOR SPECIAL RELIEF are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. Date: q/)~/Ol I I :(~ --f" I., ","~,'-'.. '<"''''~I~=' '_=,,_, H _~^__, - .~ ~"." "'< - " '1-- -- .,''', ">'~'I . CERTIFICATE OF SERVICE I, ANGELA S. EATON, an employee of the law firm of Purcell, Krug & Haller, counsel for Plaintiff, hereby certify that service of the PETITION FOR SPECIAL RELIEF was served on the following by Regular Mail, on September 26, 2001: Melanie Erb, Esquire SERRATELLI, SHIFFMAN, BROWN & CALHOON, P.C. 2080 Ling1estown Road Suite 201 Harrisburg, PA 17110-9483 (Attorney for Respondent/Plaintiff) OM~4Jafuon ::;-"-'''''''''''=-"'4~!'<>"''''"''''''''~'1 ~ ~ ~ ~ t;o ",;w,.~ !_- "n!IIIII !" "....",""'"=~ " ,- " "~",. "-,,~ - , "~'" "~.<" '-"'y:ni' r '~'~.r:"""-i"'"'[''f'.;f't''''";.-'-,!''W .'j:, ',;, ~.~,':'" f~~ rf-}'':!bl~f'l'<~ff(!l'i!~'"nfuiriQ~fbT'ft~'f~''i~{'jf'"o' . q5t .'.":, cr; ~: > ,;p. ':"_J () c :~- '",,,' () -;'-j :....') ,hr1 -~lJ :" ,) 0) ,) 4-:-' 31'1"""'~i!iM~"""""""",,"lmllm:,\J!i$l!'J'F'ffi!!llW"Y.:1IW-!H,H1;::n<1YT~,"""" -', ". ""1P"P"~"'il~~-!V4l'~!i!l;'\i!i~Hll~~~~I~~~!!li' '''_~" _ ~c~ , ROSANA DAVIS, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., Defendant IN DIVORCE CIVIL ACTION - LAW QUALIFIED DOMESTIC RELATIONS ORDER WHEREAS, ROSANA DAVIS ("Alternate Payee") is the former spouse of TWITTY G. DAVIS, JR. ("Participant"); and WHEREAS, Participant has an Account in the Bechtel Trust & Thrift Plan ("Plan"); and WHEREAS, pursuant to the domestic relations laws of this State, this Court has jurisdiction to create or to recognize certain marital property interests ("Interests") of Alternate Payee in the Participant's Plan Account, and WHEREAS, pursuant to the Employee Retirement Income Security Act of 1974, as amended ("ERISA"), Interests of Alternate Payee in the Participant's Plan Account can be honored by the Plan only if this Order is a Qualified Domestic Relations Order; and WHEREAS, pursuant to ERISA, the Trust & Thrift Plan Committee or its designee (hereafter "Plan Administrator") has the authority to determine whether a domestic relations order received by the Plan is a Qualified Domestic Relations Order; and to'~~r~"""'" ~ ~"~ ~~~,~.. . - , WHEREAS, this Order is intended to be a Qualified Domestic Relations Order ("QDRO") as defined in Section 414(p) of the Internal Revenue Code of 1986 as amended and Section 206(d) of ERISA; and NOW, THEREFORE, IT IS HEREBY ORDERED BY THE COURT AS FOLLOWS: 1. Subject to the terms and conditions of this Order, the Alternate Payee has the right to receive fifty (50) percent of the balance of participant's Plan Account existing on the date of implementation of this order ("current balance"). The current balance should be calculated by deducting $20,000 for the outstanding loan and adding back $5,760.03 for the October, 2001 withdrawal. In addition, Participant's and Participant's EmplQyer's contributions made in March, 2001 and thereafter shall be deducted prior to calculating the current balance. 2. The Plan shall treat this QDRO in accordance with Internal Revenue Code ~414(p) (7). While the Plan is determining whether this order is a qualified domestic relations order, the Plan Administrator shall separately account for the amounts which would have been payable to the Alternate Payee while the Plan is determining the qualified status of this QDRO. 3. The Plan Administrator promptly shall notify the Participant and the Alternate Payee of the receipt of this QDRO and shall notify the Participant and the Alternate Payee of the 2 '~1'~ "en ~~-p ~'I"'" ~ .~ " . , Plan's procedures for determining the qualified status of this QDRO. The Plan Administrator shall determine the qualified status of the QDRO and shall notify the Participant and the Alternate Payee of the determination within a reasonable period of time after receipt of this QDRO. 4. As soon as administratively practical after the Plan Administrator receives a certified copy of this Order and the Plan Administrator determines that this Order is a QDRO, the Plan will establish a separate Account in the name of the Alternate Payee and will transfer to that Account ("the Transfer") the Alternate Payee's share (as defined in the preceding paragraph) of the Participant's Account. a. The Transfer will be made to the Alternate Payee's Account on a pro rata basis from each subaccount under the Participant's Plan Account as of the date of the Transfer; and b. After the Transfer, the Alternate Payee's Plan Account will continue to be adjusted for actual Plan gains and losses through the last valuation date before distribution. 5. After payment of the amount required by the QDRO, the Alternate Payee shall have no further claim against the Participant's interest in the Plan. 6. The Alternate Payee assumes sole responsibility for the tax consequences of the distribution under this QDRO. 7. If the Alternate Payee dies before distribution of any benefits to which he or she is entitled under this Order, those 3 ~"Y,"f-'~"",I ". _, , , . benefits will be paid, in a single sum payment, to the Alternate Payee's estate. 8. After the Transfer, the Alternate Payee or the Alternate Payee's estate, as the case may be, will be considered a beneficiary under the Plan. 9. After the Transfer, the Alternate Payee or the Alternate Payee's estate, as the case may be, may elect to receive from the Plan the Alternate Payee's QDRO Benefits in a single sum payment as soon as administratively practical. 10. The name, last known mailing address, e-mail address, social security number and date of birth of the Participant is: Name: Twitty G. Davis, Jr. Address: c/o BSF China Company, Limited NO 38 Xiqouyn Lu, Chaoyang District Beijing, 100027, China E-mail: davis.twitty@cspc.net.cn Social Security Number: 503-50-7178 Date of Birth: October 3, 1946 11. The name, last known mailing address, social security number and date of birth of the Alternate Payee is: Name: Rosana Davis Address: 1025 Yverdon Drive Camp Hill, Pennsylvania 17011 Social Security Number: 522-58-3537 Date of Birth: July 26, 1946 4 <!~~'''i*'!'t,- ,. ,l, '1'"'1 ~ ~r 12. The Alternate Payee shall keep the plan Administrator informed of the Alternate Payee's address as long as the Alternate Payee has any interest in the Plan. 13. Nothing contained in this Order shall be construed to require the Plan: a. to provide to the Alternate Payee or to the Alternate Payee's estate any type or form of benefit or any option not otherwise available to the Participant 'under the Plan; b. to provide to the Alternate Payee or to the Alternate Payee's estate increased benefits (determined on the basis of actuarial value) not available to the Participant; or c. to pay any benefits to the Alternate Payee or to the Alternate Payee's estate which are required to be paid under another order of any court. 14. Any benefits under the Plan that are not expressly awarded to Alternate Payee under this QDRO are hereby confirmed to belong to Participant. J. Dated: ~ 1'1 l 2{.OL- ~ O' So r,.., OJ! _ tDpie.s fl\Cl,\ed ./ Erb 0 ,,: }q-OA.- 'RJ<S 5 / ':~~,".,.,..,... "'. ;,~ "~, - , -'Wt~~,___._ -""'<-' ",~~, ~',~ ..-- -'," ,'-' ~'nH," "c. '-n~'<-("c~~t"'--'JC"'~5ftI:Il"" lfL~>;ifi51';;':jl'lfrr"~'m~l"J"~;" "'f'~',; \/,,1\\/,/\ } I ~I"r(" ," u,,1.,~,,' '') (" l..., :0 l"",!'," 1\t1',-", 11';-: 0, c,_' ,.J , ) -~~~~jffif'~''''~Jl;O<,W\''l''1m'~'"!'J'''F<j",,';,f,'1'-" """""j'j:';11';'i".qii"'j'>'ti"WIlb'f1lt;ilfM!!~~~"J!IlIR" ~~~If;~ plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ROSANA DAVIS, vs. NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., Defendant CIVIL ACTION IN LAW - DIVORCE PETITION FOR ENTRY OF A QUALIFIED DOMESTIC RELATIONS ORDER AND NOW, comes Petitioner, Twitty Davis, Defendant in the above captioned action, by and through his attorneys, Purcell, Krug and Haller, and files the following petition: 1. petitioner is Twitty G. Davis, Jr., Defendant in the above captioned action. 2. Respondent is Rosana Davis, Plaintiff in the above captioned action. 3. On December 27, 2001, the parties entered into a property settlement agreement which assigned to the former Mrs. Davis a portion of the Bechtel Trust and Thrift Plan owned by Mr. Davis. A true and correct copy of the pertinent portion of the parties' settlement agreement is attached hereto and made part hereof as Exhibit "AU. 4. The proposed Qualified Domestic Relations Order has been approved by counsel for the respective parties and the Plan Administrator for the purpose of implementing the parties' Agreement. WHEREFORE, Petitioner, Twitty G. Davis, Jr., respectfully ;']'l-'!!IJ~"-"--"""l"""r ., .,".~ , I - requests this Honorable Court to enter as an order of court the Qualified Domestic Relations Order attached hereto. PURCELL, KRUG AND HALLER1 ~ ' ~; '{ f (! [; By i 1/ /.' I .. Np-chole M. Btaley/O' Orman, Esquire nD #79866 , \ 1719 North!Front Street Harrisburg, PA 17102 717 234-4178 Attorney for Petitioner/Defendant ,11.111 .7 " Wi l/ 1/ Dated: February 11, 2002 '}fI'~ '-1- '" 1."1 , . ^ .. - MA TRIMONIAlL SE1'1'lLEMENT AGREEMENT THIS AGREEMENT, made thisX1!j~y of lfCUY1.ber ,2001, between ROSANA DAVIS, hereinafter called "Wife" and 1rWHTY G. DAVIS, JR., hereinafter called "Husband", WITNESSETH: The parties hereto, being Husband and Wife were lawfully married on November 12, 1966 in Denver, Colorado; There were two children born of the parties; namely: Twitty G. Davis, III, born September 9,1967 and Mary Kim Davis, born February I, 1971. Diverse and unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of HUSBAND and WIFE to live separate and apart for the rest of their natural lives, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other including, without limitation by specification: the settling of all matters between them relating to the ownership and equitable distribution of real and personal property; the settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of each other; and in general, the settling of any and all claims and possible claims by one against the other or against their respective estate. NOW THEREFORE, in consideration of the premises and mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby, covenant and agree as follows: Page -1- "~=W~~f' ~~ '''-'""j''''~'T r I - . ~" ~, , "~ ^ .~~ Husband agrees to assume full liability for the Member's I sI Federal Credit Union Visa and Personal Signature loan debts and shall indemnifY and hold Wife harmless for any future liability with regard to the debts referred to herein. In the event that either party contracted or incurred any debts other than those specifically set forth above, either before or after the date of separation, the party who incurred said debt shall be responsible for the payment thereof, regardless of the name in which the account may have been charged, and such party shall indemnifY, defend and hold the other party harmless from any claim or demand made against that party by reason of such debt. 14. EMPLOYEE BENEFIT PLANS Except as may otherwise be provided herein, each of the parties does specifically waive, release, renounce and forever abandon all of his or her right, title, interest or claim, whatever it may be in any Pension Plan, Retirement Plan, Profit Sharing Plan, 40 I K Plan, Keogh Plan, Stock Plan, Tax Deferred Savings Plan and/or any employee benefit plan of the other party and any such employee benefit plan shall become the sole and separate property in whose name or through whose employment said plan is carried. Wife shaH be entitled to receive through a Qualified Domestic Relations Order fifty (50) percent of the balance of Husband's Bechtel Trust and Thrift Plan existing on the date of implementation of the Qualified Domestic Relations Order. The current balance should be calculated by deducting $20,000 for the outstanding marital loan and adding back $5,760.03 for Husband's October, 2001 withdrawal. In addition, Husband's and Husband's Employer's Page -9- "'~"""[m'l!!"''''''''''''-r= 1"-' ~" ',- . //C . ,/'i'~ /" contributions made in March, 2001 and thereafter shall be deducted prior to calculating the current balance. 15. DIVISION OF BANK ACCOUNTS The parties acknowledge and agree that they have previously divided to their mutual satisfaction all of their bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value and hereafter WIFE agrees that all said bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value in the possession of HUSBAND shall become the sole and separate property of HUSBAND; and HUSBAND agrees that all said bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value in the possession of WIFE shall become the sole and separate property of WIFE. Each of the parties does specifically waive, release, renounce and forever abandon whatever right, title, interest or claim, he or she may have in any bank account, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value that is to become the sole and separate property of the other pursuant to the terms hereof. Should it become necessary, the parties each agree to sign, upon request, any titles or docwnents necessary to give effect to this paragraph. Property shall be deemed to be in the possession or under the control of either party if, in the case of intangible personal property, any physical or written evidence of ownership, such as a passbook, checkbook, policy or certificate of insurance or other similar writing is in the possession or control of the party. Page -10- -~)),.""",', \'-' 33. HEADINGS NOT PART OF AGREEMENT Any headings preceding the text of the paragraphs and subparagraphs herein, are inserted solely for convenience of reference and shall not constitute a part of this Agreement nor shall they affect its meaning, construction or effect. 34, AGREEMENT BINDING ON HEIRS This Agreement shall be binding and shall inure to the benefit of the parties hereto, and their respective heirs, executors, administrators, successors and assigns. BY SIGNING THIS AGREEMENT, EACH PARTY ACKNOWLEDGES HAVING READ AND UNDERSTOOD THE ENTIRE AGREEMENT, AND EACH PARTY ACKNOWLEDGES THAT THE PROVISIONS OF THIS AGREEMENT SHALL BE AS BINDING UPON THE PARTIES AS IF THEY WERE ORDERED BY THE COURT AFTER A FULL HEARING. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first written above. WITNESS: ~;}$LU,Yh ~ n t ( /"""'\ tY"--.!A:G ').1--(,,-- ..fLz:t-t!0 '- ROSANA DAVIS >CL--- ptlt1C Z 2- iJ TWITTY G, DAVIS Page -21- ,~-I'~ ~'P""""1"""~1 , ,~ . < ,. -'-' , IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. Melanie Erb, Esquire "-;j,'~=-1< T"'~'1~1 'r' ,,~~ ~"~' ,^ /~ C;rx j I'SJC J I , r ,osana Davls Page -22- ,. . CERTIFICATE OF SERVICE I, DONNA E. SWEENEY, an employee of the law firm of Purcell, Krug & Haller, counsel for Plaintiff, hereby certify that service of the Defendant's Petition for Entry of a Qualified Domestic Relations Order, was made upon the following by placing a copy of same in the United States Mail, postage prepaid, Dauphin County, Pennsylvania, on February 11, 2002: Melanie Erb, Esquire SERRATELLI, SHIFFMAN, BROWN & CALHOON, P.C. 2080 Linglestown Road Suite 201 Harrisburg, PA 17110-9483 D~f\~\kWrWo -""""""""'''''''r ,~, '~!- 'f T' ""' " :'l!, ... , ~ ~ ~~Ii'!i'f,'ii!0.1fUW , ' .'C" .~ "'" ..- , """-" ~'. ",,'~ ""'''''''~l N.W'",= ",.,,, () ."-=,,1 r-:J ,,-. en ," '"I1I"iillr'i'dli I" t " t':.:: ~.' ~' {. (: ~,) -,. ,- i~~;:' :.~ -< '.J ':~." :::~ fiJ~tw:~~"W~'lg:W;:!!i""""'.FI1,"";'f"\'~""" """,'Y--":'"'~''''j'ilf'i;'!\'J~,\\'<'R~;';'')''')1<,'r,l'1J0!'''1Ji''''',.oo;iJ~~~iF"; - ~< Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ROSANA DAVIS, vs. NO. 01-2913 Civil Term TWITTY G. DAVIS, JR., Defendant CIVIL ACTION IN LAW - DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a Divorce Decree: 1. Ground for divorce: Irretrievable breakdown under ~3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Complaint was served on Defendant bv personal service on Mav 30. 2001 (see Acceptance of Service filed June 7. 2001.) 3. (Complete either paragraphs (a) or (b). (a) Date of execution of the Affidavit of Consent required by ~3301(c) of the Divorce Code: By Plaintiff: 12/27/01 and By Defendant: 12/27/01. (b) (1) Date of execution of the Affidavit required by ~3301(d) of the Divorce Code: N/A; (2) Date of filing and service of the Plaintiff's Affidavit upon the Respondent: N/A. 4. oarties' shall be Decree. Related claims pending: Pursuant to Paraqraphs 4 and 5 of the Separation and Property Settlement Aqreement. the Aqreement incorporated. but shall not merqe in the final Divorce 5. (Complete either (a)_or (b).) (a) Date and manner of service of the notice of intention to file a Praecipe to Transmit Record, a copy of which is attached:_N/A (b) Date Plaintiff's Waiver of Notice in ~3301(c) Divorce was filed with the Prothonotary: 12/27/2001. Date Defendant's Waiver of Notice in ~3301(c) Divorce was filed with the Prothonotary: 12/27/2001. Date: December 27, 2001 By: Nich Ie 171 N. Front S Har iSburg, PA (717) 234-4178 ID No. 79866 ~~~''''''~'''1'''~1 "0" 1 - . " b ""e"'_' ", ... ~ k',o ^~ M~~"~_m'<~_ ~ "'~ e. "_~~ -- "... ". '.'.,,,, > ,.ii,;"hc" 'S,,' 1\\\"";;;'<"; fti1W"'~"jB!.l"m~' R' ''''''''''"''''''''''.nr ~r1tr:r. f" "17"j ~- () C ;;::: -01"T' f11rT' -:;::.;>- ",~.,~ &3S -<:/ r--:r' ....__ _J -;0- =70 "'=0 >c: -7 ~ o o fY1 n N () -'n ~ --1'1 r= ",::r0J "',',,'; <~t) ;~:j~ CSiTi .~~~ -~;... ~O ~< r.:: '-,) (::> _!nTa!nl!fi1Jll1f'ijl'K'~"'__~~I#~'\.'f',-:'~&'l-''''''''''"'i"i'''',"",''''G';F'''' " . "'~'" "!"",,"'J';;~1Ii"'W"l,1;<I;f"1/j:r",1f,"H'kiJl'I!Ol1,01l1fi!UWlji'j!~:i!It1~~f;r MATRIMONIAL SETTLEMENT AGREEMENT THIS AGREEMENT, made this~by of ~...w ,2001, between ROSANA DAVIS, hereinafter called "Wife" and TWITTY G. DAVIS, JR., hereinafter called "Husband" . WITNESSETH: The parties hereto, being Husband and Wife were lawfully married on November 12, 1966 in Denver, Colorado; There were two children born of the parties; namely: Twitty G. Davis, III, born September 9, 1967 and Mary Kim Davis, born February I, 1971. Diverse and unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of HUSBAND and WIFE to live separate and apart for the rest of their natural lives, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other including, without limitation by specification: the settling of all matters between them relating to the ownership and equitable distribution of real and personal property; the settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of each other; and in general, the settling of any and all claims and possible claims by one against the other or against their respective estate. NOW THEREFORE, in consideration of the premises and mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby, covenant and agree as follows: Page -1- -,. , 1. INCORPORATION OF PREAMBLE The recitals set forth in the Preamble of this Agreement are incorporated herein and made a part hereof as if fully set forth in the 'body of the Agreement. 2. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS This Agreement shall not be considered to affect or bar the right of HUSBAND and WIFE to an absolute divorce on lawful grounds if such grounds now exist or shall hereafter exist or to such defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be condemnation on the part of either party hereto of any act or acts on the part ofthe other party which have occasioned the disputes or unhappy differences which have occurred or may occur subsequent to the date hereof. The parties acknowledge that their marriage is irretrievably broken and that they shall secure a mutual consent no-fault divorce pursuant to the terms of Section 3301(c) of the Divorce Code. As soon as possible under the terms of said Divorce Code, the parties shall execute and file all documents and papers, including affidavits of consent, necessary to fmalize said divorce. In the event, for whatever reason, either party fails or refuses to execute such affidavit upon the other party's timely request, that party shall indemnify, defend and hold the other harmless from any and all additional expenses, including actual counsel fees, resulting from any action brought to compel the refusing party to consent. Each party hereby agrees that a legal or equitable action may be brought to compel him or her to execute a consent form and that, absent some breach of this Agreement by the proceeding party, there shall be no defense to such action asserted. Page -2- "'~, "1 ,,, , -~,' '-" . .~""',',"._~ , 3. EFFECT OF DIVORCE DECREE The parties agree that unless otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 4. AGREEMENT TO BE INCORPORATED IN DIVORCE DECREE The parties agree that the terms of this Agreement shall be incorporated into any Divorce Decree which may be entered with respect to them. 5. NON-MERGER It is the parties' intent that this Agreement does not merge with the Divorce Decree, but rather shall continue to have independent contractual significance. Each party maintains his or her contractual remedies as well as court ordered remedies as the result of the aforesaid incorporation or as otherwise provided by law or statute. Those remedies shall include, but not be limited to, damages, resulting from breach of this Agreement, specific enforcement of this Agreement and remedies pertaining to failure to comply with an order of court or agreement pertaining to equitable distribution, alimony, alimony pendente lite, counsel fees and costs as set fOlih in the Pennsylvania Divorce Code or other similar statutes now in effect and as amended or hereafter enacted. 6. DATE OF EXECUTION The "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. Page -3- -;~''''''~'~~~I - - ,. - I. 7. DISTRIBUTION DATE The transfer of property, funds and/or documents provided herein shall only take place on the "distribution date" which shall be defined as the date of execution of this Agreement unless otherwise specified herein. All spousal support, alimony pendente lite and other such obligations, excluding alimony, shall immediately terminate. 8. FINANCIAL DISCLOSURE The parties confirm that each has relied on the substantial accuracy of the financial disclosure of the other, as an inducement to the execution of this Agreement. 9. SEPARATION Husband and Wife shall at all times hereafter have the right to live separate and apart from each other and to reside from time to time at such place or places as they shall respectively deem fit, free from any control, restraint, or interferences whatsoever by the other. Neither party shall molest the other or endeavor to compel the other to cohabit or dwell with him or her by any legal or other proceedings. The foregoing provision shall not be taken to be an admission on the part of either Husband or Wife of the lawfulness or unlawfulness of the causes leading to their living apart. Neither party shall do or say anything to the child of the parties which might in any way influence the child adversely toward the other party, it being the intention of both parties to minimize the effect of any such separation upon the child. Page -4- ;~".",. . \~ " ""1",','1 ~', , , .",',--t,. 10. PERSONAL PROPERTY The parties hereto mutually agree that they have divided all furniture, household furnishings, appliances and other household personal property between them, and they mutually agree that each party shall from and after the date of execution be the sole and separate owner of all tangible personal property present in his or her possession, except as follows: a. Wife shall have thirty (30) days from the date of the execution of this agreement to select the marital prints she desires. Husband shall be entitled to all remaining prints, and Wife agrees to place Husband's prints in his storage unit; b. If after execution of this Agreement Wife decides she does not want any of the marital prints she has selected, Wife agrees not to sell them. Wife shall deliver these items to Husband by placing them in his storage unit; c. If after execution of this Agreement Wife decides she does not want any of the marital personalty she has retained, Wife agrees not to sell such items. Wife shall deliver all such items to Husband by placing them in his storage unit; d. Husband shall have the option to receive the king bed and the night stands that match the bed. If he exercises this option, he shall purchase comparable night stands for Wife; and e. The parties' daughter shall be entitled to retain the marital sixty-two inch television and Husband will pay the outstanding PSL loan used to purchase same. Page -5- ';"1,.", ' - ~'I ,- ~, ~>'_'f,"~ , W^~, ~ II. REAL PROPERTY The parties acknowledge that they are joint owners of real estate known as 982 Carter Cove, Hummelstown, Dauphin County, Pennsylvania 17036, with an approximate current value of$182,000. Husband and Wife acknowledge that there is currently a mortgage against the marital home with an approximate principal balance of$112,000.00 and a second mortgage (Key Loan) held by Members First Credit Union with an approximate principal balance of$8,000.00. The parties shall cooperate to sign all documents necessary to list and sell the home. The parties' son has authority to act as Husband's attorney-in-fact for the purpose of signing such documents. The marital residence shall be listed for sale as soon as permitted under the current lease agreement, continuously until sold. Husband shall be responsible for making the monthly payments on the mortgages and for paying any taxes and/or homeowner's insurance that becomes due prior to the sale of the home. Upon the sale of the marital residence, the parties shall share equally the net proceeds of sale. "Net proceeds" shall be defined as the gross purchase price less the following: (I) the balances of the two mortgages, (2) real estate brokers' commissions, (3) transfer taxes, (4) prorated real estate taxes and (5) incidental costs of sale. From Wife's one-half share, she shall pay Husband the following: (I) one-half of all out -of-pocket expense incurred by Husband for mortgage, tax, insurance or maintenance expense for the marital home (i.e. after all rental proceeds have been applied), (2) $1,889.50 for 2000 income taxes and tax preparation fees; (3) $1,813.71 for Volvo payments from April through September, 2001, (4) $823.77 for truck payments from April through September, 2001, (5) $2,730 for the marital Visa balance, and (6) Page -6- I'," ~,,,,,, $137.50 for the home appraisal expense. These sums shall be payable to Husband at the time of settlement on the sale of the home. 12. AUTOMOBILES With respect to the motor vehicles owned by one or both ofthe parties, they agree as follows: a. The 1997 Volvo 850R Sedan shall immediately be listed for sale continuously until sold and Wife shall retain the proceeds of said sale after payment of the lien held by GESA; b. The 1994 Ford Ranger Truck shall immediately be listed for sale continuously until sold and the proceeds of said sale after payment of the lien held by GESA shall be used to pay the lien on 1997 Volvo 850R Sedan. Any remaining proceeds shall be retained by Wife. c. If the proceeds of the sale of the vehicles are insufficient to pay the vehicle loans, the parties shall share equally the remaining balance due and the respective share of each party shall be paid within thirty (30) days of the sale of the vehicle. d. Husband shall continue to pay the monthly automobile loan payments and the automobile insurance premiums until the vehicles are sold. e. Within five (5) days of sale, Wife will advise Husband of the sale and payoff the loan balance on the vehicle sold. Page -7- t-T~r-" "7'1" , - ,.~'" ~," ,~, "",,' ~ , ~ f. Wife agrees to advertise the vehicles for sale and field all inquiries regarding the vehicles. Husband agrees to pay the costs of advertising. g. The parties' son has authority to act as Husband's attorney-in-fact for the purpose of transferring title to the martial vehicles. 13. DEBTS Wife's Debts. Wife represents and warrants to Husband that since the separation she has not and in the future she will not contract or incur any debt or liability for which Husband or his estate might be responsible and shall indemnifY and save Husband harmless from any and all claims or demands made against him by reason of debts or obligations incurred by her. Husband's Debts. Husband represents and warrants to Wife that since the separation he has not and in the future he will not contract or incur any debt or liability for which Wife or her estate might be responsible and shall indemnifY and save Wife harmless from any and all claims or demands made against her by reason of debts or obligations incurred by him. Outstanding Joint Debts. The parties acknowledge and agree that they have no outstanding debts and obligations incurred prior to the signing of this Agreement except the mortgages referred to in Paragraph II, the auto loans referred to in Paragraph 12 above and the following additional debts: a. Members 1 st Federal Credit Union VISA, Account #4287590002472815. b. Members 1 st Federal Credit Union Personal Signature Loan. Page -8- f~"'""",~< '1" '1- f" .,-", .. I" ,-- "I ~ , '- Husband agrees to assume full liability for the Member's 15t Federal Credit Union Visa and Personal Signature loan debts and shall indemnifY and hold Wife harmless for any future liability with regard to the debts referred to herein. In the event that either party contracted or incurred any debts other than those specifically set forth above, either before or after the date of separation, the party who incurred said debt shall be responsible for the payment thereof, regardless of the name in which the account may have been charged, and such party shall indemnifY, defend and hold the other party harmless from any claim or demand made against that party by reason of such debt. 14. EMPLOYEE BENEFIT PLANS Except as may otherwise be provided herein, each of the parties does specifically waive, release, renounce and forever abandon all of his or her right, title, interest or claim, whatever it may be in any Pension Plan, Retirement Plan, Profit Sharing Plan, 401K Plan, Keogh Plan, Stock Plan, Tax Deferred Savings Plan and/or any employee benefit plan ofthe other party and any such employee benefit plan shall become the sole and separate property in whose name or through whose employment said plan is carried. Wife shall be entitled to receive through a Qualified Domestic Relations Order fifty (50) percent of the balance of Husband's Bechtel Trust and Thrift Plan existing on the date of implementation of the Qualified Domestic Relations Order. The current balance should be calculated by deducting $20,000 for the outstanding marital loan and adding back $5,760.03 for Husband's October, 2001 withdrawal. In addition, Husband's and Husband's Employer's Page -9- .. "1 q,'~ -- .'" ~, ", " ~,. , , " contributions made in March, 200 I and thereafter shall be deducted prior to calculating the current balance. 15. DIVISION OF BANK ACCOUNTS The parties acknowledge and agree that they have previously divided to their mutual satisfaction all of their bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value and hereafter WIFE agrees that all said bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value in the possession of HUSBAND shall become the sole and separate property of HUSBAND; and HUSBAND agrees that all said bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value in the possession of WIFE shall become the sole and separate property of WIFE. Each of the parties does specifically waive, release, renounce and forever abandon whatever right, title, interest or claim, he or she may have in any bank account, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value that is to become the sole and separate property of the other pursuant to the terms hereof. Should it become necessary, the parties each agree to sign, upon request, any titles or documents necessary to give effect to this paragraph. Property shall be deemed to be in the possession or under the control of either party if, in the case of intangible personal property, any physical or written evidence of ownership, such as a passbook, checkbook, policy or certificate of insurance or other similar writing is in the possession or control of the party. Page -10- <,~~~ I;' .j' I," ,- "0" o . , From and after the date of the signing of this Agreement, both parties shall have the complete freedom of disposition as to their separate property and any property which is in their possession or control, pursuant to this Agreement, and may mortgage, sell, grant, convey, or otherwise encumber or dispose of such property, whether real or personal, whether such property was acquired before, during or after marriage, and neither Husband nor Wife need join in, consent to, or acknowledge any deed, mortgage, or other instrument of the other pertaining to such disposition of property. 16. ALIMONY/SPOUSAL SUPPORT From the date of execution of this Agreement until the entry of a decree in divorce, Husband shall pay Wife spousal support in the amount of $2,250 per month. From and after the date of the decree in divorce, Husband shall pay Wife alimony in the amount of $2,500 per month. All alimony payments shall be made directly to Wife and not through the Domestic Relations Office. Upon Husband reaching age 62, the amount of alimony shall be reduced to $750 per month. This amount shall be further reduced to $500 per month when Wife reaches age 65. It is the intent ofthe parties that all payments which are designated as alimony under this Agreement shall be includable as income by Wife under Section 71 of the Internal Revenue Code and deductible by Husband under Section 2105 ofthe Internal Revenue Code. Wife's Social Security Number is 522-58-3537. Husband's Social Security Number is 503-50-7178. The parties agree to treat the payments set forth above consistently on their federal tax returns. Page -11- 't>~~ "I ,-- ,""'",~ ,1'- !"'," ."" "~1 ,~, ,," ,'-' , -~- .. . , !, I As security for the Alimony payment, Husband agrees that he will assist Wife in obtaining a term life insurance policy with a benefit of$IOO.OOO.OO payable to Wife on Husband's death. Wife shall pay all premiums due on the policy. Ifit is necessary for Husband to be the owner of this policy, he shall designate Wife as irrevocable beneficiary. Husband's obligation to pay alimony hereunder shall terminate upon Husband's death, the death or remarriage of Wife, or upon her cohabitation with a male not her spouse for a continuous period of seven days or longer. The period of payment of alimony hereunder shall not be extended. The amount of alimony shall not be changed or modified in any way by either of the parties hereto, absent a change in circumstances of a substantial and continuing nature. 17. ALIMONY PENDENTE LITE. COUNSEL FEES AND EXPENSES Husband and Wife acknowledge and agree that the provisions of this Agreement providing for the equitable distribution of marital property of the parties is fair, adequate and satisfactory to them. Both parties shall accept the provisions set forth in this Agreement in lieu of and in full and final settlement and satisfaction of all claims and demands that either may now or hereafter have against the other for alimony pendente lite, counsel fees or expenses, or any other provision for their support and maintenance, before, during and after the commencement of any proceedings for divorce between the parties, except as provided herein. Each party shall be responsible for his or her own counsel fees. Each agrees to indemnifY, defend and save the other harmless from any action commenced against the other for alimony pendente lite, counsel fees and/or expenses. Page -12- ~,~:""...,-, " I" 'v I ~'-"""'~'Y'" ~<"~",,,_.,_ ,,'d,,~""" ,< , ,,0 , 18. MEDICAL INSURANCE COVERAGE Each party shall be responsible for maintaining his or her own health insurance. Each shall also be responsible for the payment of his or her own uninsured medical expenses. 19. FEDERAL INCOME TAX RETURNS If the parties are divorced by December 31, 2001, they agree that they shall file separate income tax returns for the tax year 2001 and all years thereafter. Husband shall claim the rental income on the marital home and any miscellaneous interest earned on marital accounts. Husband shall be entitled to claim the dependency exemption for Mary Kim Davis and Gladys Davis for federal tax purposes for 2001 and all subsequent years. Husband shall also be entitled to claim all mortgage interest paid on the joint mortgages. Wife shall execute the necessary IRS forms to effectuate the terms of this paragraph. If the parties are not divorced by December 31, 2001, they shall file jointly for the year 2001, at Husband's option, and Husband shall pay all tax due on the joint returns. Husband shall execute an indemnification agreement at Wife's request. The parties acknowledge that they have filed various joint income tax returns during the course of their marriage. In the event that any additional taxes, penalties or interest are assessed as a result of any such joint return, the party responsible for under-reporting income or claiming any improper deduction by virtue of fraud or intentional misrepresentation shall indemnifY and save the other party harmless from such tax liability, penalties, interest, counsel fees, Page -13- ~u . , , accountant's fees, costs and expenses. Absent fraud or intentional misrepresentation, the parties shall be equally responsible for and shall pay all such taxes, penalties, interest and expenses. 20. OTHER WRITINGS Each of the parties hereto agree to execute any and all documents, deeds, bills of sale or other writings necessary to carry out the intent of this Agreement. 21. DISCLOSURE AND W AlVER OF PROCEDURAL RIGHTS Each party understands that he or she has the right to obtain from the other party a complete inventory or list of all of the property that either or both parties own at this time or owned as of the date of separation, and that each party had the right to have all such property valued by means of appraisals or otherwise. Both parties understand that they have the right to have a court hold hearings and make decisions on the matters covered by this Agreement. Both parties understand that a court decision concerning the parties' respective rights and obligations might be different from the provisions of this Agreement. Each party hereby acknowledges that this Agreement is fair and equitable, that it adequately provides for his or her needs and is in his or her best interests, and that the Agreement is not the result of any fraud, duress, or undue influence exercised by either party upon the other or by any other person or persons upon either party. Both parties hereby waive the following procedural rights: Page -14- - -,~ , , . a. The right to obtain an inventory and appraisement of all marital and non-marital property as defined by the Pennsylvania Divorce Code. b. The right to obtain an income and expense statement of the other party as provided by the Pennsylvania Divorce Code. c. The right to have property identified and appraised. d. The right to discovery as provided by the Pennsylvania Rules of Civil Procedure. e. The right to have the court determine which property is marital and which is non-marital, and equitably distribute between the parties that property which the court determines to be marital, and to set aside to a party that property which the court determines to be that parties' non-marital property. f. The right to have the court decide any other rights, remedies, privileges, or obligations covered by this Agreement and/or arising out of the marital relationship, including but not limited to possible claims for divorce, child or spousal support, alimony, alimony pendente lite (temporary alimony), equitable distribution, custody, visitation, and counsel fees, costs and expenses. 22. MUTUAL RELEASE Subject to the provisions of this Agreement, each party has released and discharged, and by this Agreement does for himself or herself, and his or her heirs, legal representatives, executors, administrators and assigns, release, indemnifY (including actual legal fees) and discharge the other of and from all causes of action, claims, rights, or demands, whatsoever in Page -15- '" , law or equity, including equitable distribution, spousal support, alimony, counsel fees, alimony pendente lite, and expenses which either of the parties against the other ever had, now has, or may have in the future under the Pennsylvania Divorce Code, as amended, or under any other statutory or common law, except any and all causes of action for divorce and all causes of action for breach of any provisions of this Agreement. 23. FINAL EOUITABLE DISTRIBUTION OF PROPERTY The parties agree that the division of all property set forth in this Agreement is equitable and both parties relinquish the right to divide said property in any manner not consistent with the terms set forth herein. It is further the intent, understanding and agreement of the parties that this Agreement is a full, final, complete and equitable property division. 24. INTENT It is the intent of the parties by this Agreement to fully and finally foreclose any resort to the courts for relief on the basis of any statute or case law presently existing or which may exist at some time in the future within the Commonwealth of Pennsylvania, including but not limited to equitable distribution, alimony and other relief under the Pennsylvania Divorce Code, as amended. This Agreement has been drafted and accepted on the basis that such resort would constitute a breach under this Agreement, entitling the nonbreaching party to reimbursement for actual counsel fees. Other than as provided by the terms ofthis instrument, it is intended that the court shall treat the parties as if they had never entered into a marital relationship. This Agreement shall be construed in accordance with the Laws of the Commonwealth of Page -16- :"';,.., - h,"'" ,"~_ . ~,- ,. '"" , Pennsylvania which are in effect as of the date of the execution of this Agreement and, where such law is inconsistent, the terms of this instrument shall govern. 25. ENTIRE AGREEMENT This Agreement constitutes the entire understanding between the parties, and there are no covenants, conditions, representations or agreements, oral or written, of any nature whatsoever, other than those herein contained. 26. LEGALLY BINDING It is the intent ofthe parties hereto to be legally bound hereby and this Agreement shall bind the parties hereto and their respective heirs, executors, administrators and assigns. 27. WANER OF CLAIMS AGAINST ESTATES Except as herein otherwise provided, each party may dispose of his or her property in any way, and each party hereby waives and relinquishes any and all rights he or she may now have or hereafter acquire under the present or future laws of any jurisdiction, to share in the property or the estate of the other as a result of the marital relationship, including without limitation, dower, curtesy, statutory allowance, widow's allowance, right to take in intestacy, right to take against the Will of the other, and right to act as administrator or executor of the other's estate, and any right existing now or in the future under the Pennsylvania Divorce Code, as amended from time to time, and each will, at the request of the other, execute, acknowledge and deliver any and all instruments which may be necessary or advisable to carry into effect this mutual waiver and Page-17- I".," ~ 1 ,..,. ','..l, '.'.' ~ ~~ ",-- , '\. . , \ , relinquishment of all such interests, rights and claims. Each further waives any right to inherit or receive property or act as the personal representative of the estate of the other by Will, Codicil, intestacy, or insurance policy. 28. WANER OF BENEFICIARY DESIGNATION. Unless otherwise specifically set forth in this Agreement, each party hereto specifically waives any and all beneficiary rights and any and all rights as surviving spouse in and to any asset, benefit or like program carrying a beneficiary designation which belongs to the other party under the terms of this Agreement, including but not limited to, pensions and retirement plans of any sort or nature, deferred compensation plans, life insurance policies, annuities, stock accounts, bank accounts, final pay checks or any other post-death distribution scheme, and each party expressly states that it is his and her intention to revoke by the terms of this Agreement any beneficiary designations naming the other which are in effect as of the date of execution of this Agreement. If and in the event the other party continues to be named as beneficiary and no alternate beneficiary is otherwise designated, except as otherwise provided herein, the beneficiary shall be deemed to be the estate of the deceased party, and any benefits paid to the former spouse shall be paid immediately to the estate of the deceased spouse. 29. FULL DISCLOSURE Each party asserts that she or he has made a full and complete disclosure of all the real and personal property of whatsoever nature and wheresoever located belonging in any way to each of them, of all debts and encumbrances incurred in any manner whatsoever by each of Page -18- , '10 . , , ,~, , them, of all sources and amounts of income received or receivable by each party, and of every other fact relating in any way to the subject matter of this Agreement. These disclosures are part of the consideration made by each party for entering into this Agreement. 30. COSTS TO ENFORCE In the event that either party defaults in the performance of any duties or obligations required by the terms of this Agreement and both extra-judicial and judicial proceedings are commenced to enforce such duty or obligations, the party found to be in default shall be liable for all expenses, including reasonable attorneys fees, incurred as a result of such proceedings. 29. AGREEMENT VOLUNTARILY AND CLEARLY UNDERSTOOD Each party to this Agreement acknowledges and declares that he or she respectively: (1) Is fully and completely informed as to the facts relating to the subject matter and their Agreement as the rights and liabilities of both parties; (2) Enters into this Agreement voluntarily after receiving the advice of independent counsel; (3) Has given careful and mature thought to the making of this Agreement; (4) Has carefully read each provision ofthis Agreement; (5) Fully and completely understands each provision of this Agreement, both as to the subject matter and legal effect. Page -19- , " . , . ~ -' 30. AMENDMENT OR MODIFICATION This Agreement may be amended or modified only by a written instrument signed by both parties and executed with the same formality as this Agreement. The failure of either party to insist on strict performance of the provisions of this Agreement shall not be construed as a waiver of any subsequent default of the same or similar nature. 31. RECONCILIATION Notwithstanding a reconciliation between the parties, this Agreement shall continue to remain in full force and effect absent a writing signed by the parties stating that this Agreement is null and void. 32. SEPARABILITY If any term, condition, clause or provision of this Agreement shall be determined or declared to be void or invalid in law or otherwise, then only that term, condition, clause or provision shall be stricken from this Agreement and in all other respects this Agreement shall be valid and continue in full force, effect and operation. Likewise, the failure of any party to meet his or her obligations under anyone or more of the paragraphs herein, with the exception of the satisfaction of the conditions precedent, shall in no way void or alter the remaining obligations of the parties. 32. LAW APPLICABLE This Agreement shall be governed, construed and enforced under the statute and case law of the Commonwealth of Pennsylvania. Page -20- '^,"~"'.. ~ -<"I " -" ,. "" " ~- , "" . " , I/: " 33. HEADINGS NOT PART OF AGREEMENT Any headings preceding the text of the paragraphs and subparagraphs herein, are inserted solely for convenience of reference and shall not constitute a part of this Agreement nor shall they affect its meaning, construction or effect. 34. AGREEMENT BINDING ON HEIRS This Agreement shall be binding and shall inure to the benefit of the parties hereto, and their respective heirs, executors, administrators, successors and assigns. BY SIGNING THIS AGREEMENT, EACH PARTY ACKNOWLEDGES HAVING READ AND UNDERSTOOD THE ENTIRE AGREEMENT, AND EACH PARTY ACKNOWLEDGES THAT THE PROVISIONS OF THIS AGREEMENT SHALL BE AS BINDING UPON THE PARTIES AS IF THEY WERE ORDERED BY THE COURT AFTER A FULL HEARING. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first written above. WITNESS: vr?J --/tk-U oY J76 >eL-- G< ~^--0tW~ ROSANA DAVIS pMr/ 2-- 2- 0- TWITTY G. DAVIS Page -21- '~I"~' "',~ t, ,_, ~ 0 _, , , ,~ , ~ . .... IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. Melanie Erb, Esquire >~--~""",",. ~,,~ ~~""T" 1 ".,.~~ ~.,"~."~.""",, -.. Esquire i ~~ f~sa! LViS Page -22- ;;", % ... J I '" _~ ~ -~', . ,~o-,"'- "" .='" ~ ~ c'""',,,,.. ',..,........" ..".."",'..,.... '.., ....,....'....'......n'lu 'Tllin .. (') c.::> (~ c: " ,',"- ':J -0 ;,i..o: ''1 ifd r,j L,_; C) ;::: '"7 f~~: N ,.' 9 ~ ~1: (,'') .-.l C) -< C' GO '-1 -0 T "Ti ~ :x (;\~ d::.{-:J .L:.h w 0"1 :PC z; N ~ =< -.J ;Q ,~,~ftOY~~~~~ iJ~~;w~w'''-'''''''''''",.c,~'-''~"'~"J','i''''';-''iI0\'F"f,''-'K~/,P'')'IW~''1l'1l,<lI8.;l;'l\'ltlt~'OOIi'l~j'il~~~{l~m' ROSANA DAVIS, PLAINTIFF/RESPONDENT IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. TWITTY G. DAVIS, JR., DEFENDANT/PETITIONER 01-2913 CIVIL TERM ORDER OF COURT AND NOW, this l~ day of June, 2005, the petition of Twitty G. Davis, Jr., to modify or terminate alimony, IS DENIED.1 8yt.'J.e-Court, / / Edgar B, Bayley, . James W. Abraham, Esquire For Rosana Davis Nichole M. Staley O'Gorman, Esquire For Twitty G. Davis, Jr. '~ ~ {, _ /t,,05 ~i :sal 1 Based on petitioner's earnings from the time the order of alimony became effective on December 27, 2001, petitioner has not as yet had a change in circumstances of a substantial and continuing nature so as to warrant a modification or termination of alimony. I.,,,;, '" <~I~-, ""''''',,",>, _'~~"'=""'V"_ ". . ,,~,'"',~ .c, ~, " ,. ~, , '~; ~-". ;; ~ Ji-?, A, ~~ ,Jt -- ~ ' .. '>' ",'. '--~. ,- - """'- < , ,'" < - ^-, ,'~, --r~,'~ ,,' ".__;;'~i'_" ,"',,.:,, 'w:.' ",,, "~,-, ("-ri'illii"""'-"" Fb--' "~"~"="~', -""-",,,,,,,,,,,., - 'J1;jlCtj \iif\; ~1'f\lAS~i\! r.Bd i 1"1..--......,...1 r"'" ,'" '-"'~"'lnr\ ...Ut"iiU,,,. ",:",-, Jr:'d:'\J J ~ S:8 Hd 91 rmnooz Ab'\flONOHWUd 3Hl :10 301:1:10-0311:1 . ll!I "~TtJ":~I~JIte.\~'"-'f.~~~~~~ ~~lWIJjlIJlj[~,~~,~".~,....~,~~~m; James W, Abraham, Esq. Abraham Law Offices 2157 Market St. CaII1P Hill, P A 17011 (717)763-1700 E-mail: abelaw@comcast.net Ally, for PlaintiIDRespondent, Rosana Davis ROSANA DAVIS PlaintiIDRespondent : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA v. : NO. 01 - 2913 CIVIL TERM TWITTY G. DAVIS, JR. Defendant/Petitioner PLAlNTIFFIRESPONDENT'S ANSWER WITH NEW MATTER TO DEFENDANTIPETITIONER'S PETITION TO MODIFY OR TERMINATE ALIMONY AND NOW, comes Plaintiff/Respondent, Rosana Davis, by and through her attorney, Abraham Law Offices, James W. Abraham, Esquire, Camp Hill, Pennsylvania, and files the following: 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. By way offurther answer, Defendant/Petitioner, Twitty G. Davis, Jr. (hereinafter "Husband") is currently fifty-eight (58) years of age and the Agreement provides that when Husband is sixty-two (62), approximately three (3) years and four (4) months from now, on October 3, 2008, the monthly payment shall be $750, a reduction of$I,750.00 per month. 'O''''~_fjJ 6. Admitted and Denied. It is admitted that the amount of alimony is modifiable if there is a "change of circumstances of a substantial and continuing nature." It is denied that the tenn and/or period of payment of alimony is modifiable, as said tenn and period of payment of alimony is pennanent as stated therein, 7. Admitted. 8. Admitted and Denied. It is admitted that Husband's job with Bechtel required him to work outside the United States. It is denied that Husband only worked overseas with Bechtel as throughout Husband's career with Bechtel, which first began in the late 1970's/early 1980's, Husband worked primarily within the United States, including but not limited to, Washington state, California, Georgia, Florida, Connecticut, Texas, New Jersey, Maryland and Louisiana, 9. Admitted and Denied. Plaintiffi'Respondent, Rosana Davis (hereinafter "Wife") admits that Husband worked in Iraq for some period of time. Wife lacks sufficient knowledge or infonnation as to the truth of the remaining avennents in this paragraph and strict proofthereof is demanded at trial. 10. Admitted. 11. Denied. Wife lacks sufficient knowledge or infonnation as to the truth of the avennents in this paragraph and strict proofthereofis demanded at trial. 12. Denied. Wife lacks sufficient knowledge or infonnation as to the truth of the avennents in this paragraph and strict proof thereof is demanded a time of trial. ;-)~r~r,'~,--> _~., ".' 13. Denied. Wife lacks sufficient knowledge or information as to the truth ofthe averments in this paragraph and strict proof thereof is demanded at time of trial. 14. Denied. Wife lacks sufficient knowledge or information as to the truth of the averments in this paragraph and strict proof thereof is demanded at time of trial. 15. Denied. Wife lacks sufficient knowledge or information as to the truth of the averments in this paragraph and strict proof thereof is demanded at time of trial. 16. Denied. It is denied that Husband can no longer afford to pay alimony at the ordered rate and strict proof thereof is demanded at time of trial. 17. Admitted. By way of further answer, the parties were married thirty-four (34) years, from November 16, 1966 through their date of separation, on or about December, 2000 when the parties were in Malaysia where Husband was working for Bechtel and they separated when Husband had an affair with a Malaysian woman, now Husband's current wife, and Wife never worked a full-time job or even part-time job during the marriage. 18. Denied. It is denied that Wife, age fifty-eight (58), is gainfully employed as Wife works part-time, approximately 26 hours per week at a hourly rate of $8.65 at a retirement home, Country Meadows of Hershey and in consideration of her age and lack of work experience after thirty-four (34) years of marriage during which she did not work, Wife cannot make a greater contribution to her own support as compared to the time of divorce, especially compared to her standard of living at the time of divorce. "'"~"""'=C""'F."'1!_'~ "I ," , WHEREFORE, Wife respectfully requests Your Honorable Court to dismiss Husband's Petition, NEW MATTER 19. Wife incorporates by reference her answers to paragraphs I through 18 herein. 20. There has not been a substantial change in circumstances of a continuing nature which would entitle Husband to any decrease of the $2,500 per month in alimony as Husband's Petition: A. merely speculates as to Husband's future employment and therefore Husband's claim that there has'been a change of circumstances of a substantial and continuing nature is not credible and is purely speculative. B. Husband continues to work for Bechtel which has provided Husband with consistent employment, not necessarily constant employment, i.e., down time while waiting for another assignment, which has always been the nature of Husband's employment with Bechtel, and which employment has always involved work within the United States and outside the United States throughout Husband's ten (10) to fifteen (15) year career with Bechtel. C. Husband's alleged pursuit of other employment earning $60,000 per year and acceptance of such a position would constitute a voluntary reduction of his income and voluntary change of circumstances without a substantial change in his earning capacity. -~'" Il,,~ \L~" ~_ ~~, " ",- 21. Wife believes and therefore avers that Husband simply does not want to travel any more in his employment with Bechtel and/or temporarily relocate during various assignments with Bechtel and wants to work locally in Florida where he resides, at a lower paying job with no travel; and therefore wants to reduce his $2,500 per month obligation approximately three (3) years prior to its automatic reduction to $750 per month when Husband reaches age sixty-two (62) pursuant to the Agreement. 22. Wife believes and therefore avers that Husband's Petition is not meritorious and is simply an attempt to accommodate Husband's current desired lifestyle and his desire to no longer travel and/or temporarily relocate by continuing to work for Bechtel. 23. Wife resides in a half a house in New Cumberland, Pennsylvania worth approximately $85,000 with a $63,000 mortgage, which she purchased with the $13,000 she received in the divorce from the sale of the marital residence (Husband received $60,000); she has a car worth $2,500 and has $47,000 from receiving one-half of Husband' s IRA and Wife submits that Husband is not entitled to a decrease in alimony any more than Wife would be entitled to an increase in alimony. 24. The Agreement provides that Husband receives the full tax deduction of all alimony paid and Wife must claim said payments as income which is a fInancial benefIt to Husband and detriment to Wife as to taxes and overall. 'f""""'~'"'' I , I'"~ '1"'1 '" y '~~ Ii 25. Wife believes and therefore avers that the intention of the alimony provision in the Agreement and the amount and term of alimony stated therein was predicated upon the significant income, salary and earning capacity of Husband and the lack of accumulation of significant assets over thirty (34) years of marriage despite said income and therefore it is inequitable to reduce the amount of alimony for the reasons stated in the Petition. WHEREFORE, Wife respectfully requests Your Honorable Court to dismiss Husband's Petition and award Wife any other relief the court may deem proper, including but not limited to, attorney fees. Respectfully submitted: ~ James W. Abraham, Esq. Abraham Law Offices 2157 Market 8t. Camp Hill, PA 17011 (717) 763-1700 Attorney for Plaintiffi'Respondent, Rosana Davis DATE: 6/15/05 ., - VERIFICATION I, (ZOSIt/A 14- 1M /.r , the undersigned, hereby verifY and confirm that I have reviewed the foregoing document and the statements made therein are true and correct to the best of my knowledge, information and belief. I further understand that any false statements made herein are subject to the penalties ofl8 Pa.C.S.A. Section 4904 relating to unsworn falsification to authorities, DATE: ~ o - {3 -() 7 CF ~Ck (;)cvJ;/J '-' '" CERTIFICATE OF SERVICE I, James W. Abraham, Esquire, the undersigned, hereby certify that I have served a true and correct copy of the foregoing document by "fax" to the following person(s) at the following address( es) on the date stated below: Nichole M. Staley O'Gorman, Esq. Purcell Krug Haller 1719 North Front St. Harrisburg, P A 17109 DATE: 6/14/05 ~ James W. 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