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HomeMy WebLinkAbout02-20-08 .....J 15056051058 REV-1500 EX (06-05) PA Department of Revenue . Bureau of Individual Taxes ..:. PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 07 01000 Date of Birth 263-47-3222 08/27/2007 02/25/1969 Decedent's Last Name Suffix Decedent's First Name MI Ball Scott R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Ball Mrs Leslie R Spouse's Social Security Number 197-52-5596 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW .. 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number /",,} (717) 234-0111 f~o ~~3 ~:"jj.. ...... ..... ..... ...--:"] REGISTER ()F ~f~ ~ ONL~'! '(~3 ~ . 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes Gary M. Lightman, Esq. Firm Name (If Applicable) Lightman Welby First line of address 2705 North Front St. -ry Second line of address f0 f"\..) a City or Post Office State ZIP Code DATE FILED Harrisburg PA 17110 Correspondent's e-mail address:glightman111@msn.com Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ~.P~~SIBLE FDRF'LlNG RETURN cJ-Ir;;f 21 Valle~__~_t~~~t~_S;arlisle,_~!-~_1!~3__ _ ____ n~______n____n_~_____ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY L 15056051058 Side 1 15056051058 .....J 6"'" '" ~. ...J 15056052059 REV-1500 EX Decedent's Name: Scott R Ball RECAPITULATION Decedent's Social Security Number 263-47-3222 1. Real estate (Schedule A). ...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D). . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 12599.72 6. Jointly Owned Property (Schedule F) Separate Billing Requested. . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . 8. 12599.72 9. 775.35 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 775.35 11. Total Deductions (total Lines 9 & 10)......... ..... ..................... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE.. .. .. . . . . . . . .. . . . . . . . . . .. . . . . .. . . . . . . . .. . . . . . . . 0 15. 16. 17. 18. . . . . 19. 0 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 15056052059 --.J .. , REV-1500 EX Page 3 Decedent's Complete Address: DECEDENTS NAME Scott R Ball ---~---- --- --_.__.._-_._-------_._._------~----_._-- STREET ADDRESS 21 Valley Street --- _._._------_.._._-.~-------- File Number 07 01000 DECEDENT'S SOCIAL SECURITY NUMBER 263-47-3222 CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) o 3. InteresUPenalty if applicable D. Interest E. Penalty Total Credits ( A + B + C ) (2) - --- ---- - TotallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in avalon Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (58) o A. Enter the interest on the tax due. o Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 00 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 00 c. retain a reversionary interest; or.......................................................................................................................... 0 [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... D 00 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 [lg IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 PS. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 PS. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. 99116(1.2) [72 PS. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. LAST WILL AND TESTAMENT OF SCOTT ROWEN BALL Dated: August 30, 2006 Prepared by: JFHQ Office of the Staff Judge Advocate LTC Robert C. Spinelli, Esq. Building 7-1 Annville, P A 17003-5002 717-861-8635 LAST WILL AND TESTAMENT OF SCOTT ROWEN BALL I, Scott Rowen Ball, a resident of the Commonwealth of Pennsylvania, make, publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any time heretofore made by me. I am in the military service of the United States. FIRST: I direct that the expenses of my last illness and funeral, the expenses of the administration of my estate, and all estate, inheritance and similar taxes payable with respect to property included in my estate, whether or not passing under this will, and any interest or penalties thereon, shall be paid out of my residuary estate, without apportionment and with no right of reimbursement from any recipient of any such property. SECOND: I give all of my right, title and interest in the real property which I occupy as my primary residence, namely the property known as 21 Valley Street, Carlisle, Pennsylvania 17013, or if I sell said property then all of my right, title and interest in the real property which I occupy as my primary residence at the time of my death, and all rights that I have under any related insurance policies, to my wife Leslie R. Ball, if she survives me. THIRD: I give all the rest, residue and remainder of my property and estate, both real and personal, of whatever kind and wherever located, that I own or to which I shall be in any manner entitled at the time of my death (collectively referred to as my "residuary estate"), as follows: (a) If my wife Leslie R. Ball survives me, to my wife outright. (b) If my wife does not survive me, then to those of my children (Tyler R. Ball and Allie R. Ball and any other children which I hereafter may have) who survive me and to the issue who survive me of those of my children who shall not survive me, per stirpes. If, however, any such child then shall be under the age of eighteen (18) years ( each such child being hereinafter referred to as a "Beneficiary"), the share of such Beneficiary shall not be paid or distributed to such Beneficiary but instead shall be given to my Trustee and held by my Trustee, IN TRUST, pursuant to the following provisions: (i) My Trustee shall hold, manage, invest and reinvest each share set aside for each Beneficiary in a separate trust for the benefit of such Beneficiary and may pay all or any part of the net income from each such trust to or for the benefit of the Beneficiary thereof, for the health, education, maintenance and support of the k~~~~ 1#6 Beneficiary, to such extent arid at such time or times and in such manner as may be determined in the absolute discretion of my Trustee. Any net income not so paid shall be accumulated and added to principal at least annually and thereafter shall be held, administered and disposed of as a part thereof. (ii) In addition, my Trustee may pay to or for the benefit of each Beneficiary, for the health, education, maintenance and support of each Beneficiary, from the principal of each Beneficiary's trust, such amounts, including the whole thereof, as determined in the absolute discretion of my Trustee. (iii) When any Beneficiary shall attain the age of eighteen (18) years, the trust for such Beneficiary shall terminate and any re- maining principal and income shall be paid and distributed to such Beneficiary, discharged of trust. If such Beneficiary dies before said age, such principal and income shall be paid and distributed to any then living issue of such Beneficiary, per stirpes, or if such Beneficiary has no issue to my then living issue, per stirpes. If any such issue is a beneficiary of a trust under this will, the same may be held in accordance with such trust. If there are no then living issue, the same shall be paid and distributed to the beneficiaries of my residuary estate then in being as provided in this will, or if there are none, to those who would take from me as if I were then to die without a will, unmarried and the absolute owner of the same, and a resident of the Commonwealth of Pennsylvania. (c) If my wife does not survive me and there shall be no issue of mine then living, I give my residuary estate to those who would ta~e from me as if I were then to die without a will, unmarried and the absolute owner of my residuary estate, and a resident of the Commonwealth of Pennsylvania. FOURTH: If any principal or income of my estate or any trust hereunder vests in absolute ownership (free of trust hereunder) in a minor or incompetent, my Executor or Trustee, at any time and without court authorization, may: distribute the whole or any part of such property to the beneficiary; or use the whole or any part for the health, education, maintenance and support of the beneficiary; or distribute the whole or any part to a guardian, committee or other legal representative of the beneficiary, or to a custodian for the beneficiary (including a custodian appointed by my Executor or Trustee without court order) under any gifts to minors or transfers to minors act, or to the person or persons with whom the beneficiary resides. Evidence of any such distribution or the receipt therefor executed by the person to whom the distribution is made shall be a full discharge of my Executor and Trustee from any liability with respect thereto, even though my Executor or Trustee may be such person. If such beneficiary is a minor, my Executor or Trustee may defer the distribution of the whole or any part of such property until the beneficiary attains the age of eighteen (18) years, and may hold the same as a separate fund for the beneficiary with all of the powers described in Article SIXTH hereof. If the beneficiary dies '} ~/( ~~ 2 before attaInIng said age, any balance shall be paid and distributed to the estate of the beneficiary. . FIFTH: I appoint my wife Leslie R. Ball to be my Executor. If my wife does not survive me, or shall fail to qualify for any reason as my Executor, or having qualified shall die, resign or cease to act for any reason as my Executor, I appoint Pauline McAlister as my Executor. I appoint Pauline McAlister to be my Trustee. If Pauline McAlister shall fail to qualify for any reason as my Trustee, or having qualified shall die, resign or cease to act for any reason as my Trustee, I appoint Lisa McAlister as my Trustee. I direct that no Executor or Trustee shall be required to file or furnish any bond, surety or other security in any jurisdiction. SIXTH: I grant to my Executor and Trustee all powers conferred on executors and trustees under the Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and all powers conferred upon executors and trustees wherever my Executor or Trustee may act. I also grant to my Executor and Trustee power to retain, sell at public or private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit; to borrow money and encumber or pledge any property to secure loans; to hold property in bearer form or in the name of a nominee; to render liquid my estate or any trust in whole or in part, at any time and from time to time, and to hold cash or readily marketable securities of little or no yield for such periods as my Executor or Trustee shall deem advisable; to exercise all powers of an absolute owner of property; to incorporate any business and form limited liability companies and hold any interests in corporations and limited liability companies; to vote stock or securities, in person or by proxy; to exercise subscription and conversion rights, and to participate or refuse to participate in any reorganization, recapitalization, merger, consolidation, liquidation, dissolution or other action with respect to any corporation; to transfer any business or property to a partnership and to be a general or limited partner; to compromise and release claims with or without consideration; to execute and deliver deeds and other instruments, including releases; to change the situs or governing law of any trust hereunder to any state my Executor or Trustee from time to time may deem desirable; and to employ attorneys, accountants and other persons for services or advice. The term "Executor" wherever used herein shall Inean the executors, executor, executrix or administrator in office from time to time. The term "Trustee" wherever used herein shall mean the trustees or trustee in office from time to time. Each Executor and Trustee shall have the same rights, powers, duties, authority and privileges, whether or not discretionary, as if originally appointed hereunder. The determination of my Trustee as to the amount or advisability of any discretionary payment of income or principal from any trust hereunder shall be final and conclusive on all persons, whether or not then in being, having or claiming any interest in such trust. Upon making any -such payment, my Trustee shall be released fully from all further liability therefor. SEVENTH: I direct that for purposes of this will a beneficiary shall be deemed to predecease me (or any other person upon whose death the interest of such beneficiary depends) unless such beneficiary survives me (or such other person) by more than thirty days. ,\ l~pbt.-u-~&tIVv~~ 3 The terms "child," "children" and "issue" as used in this will include children and issue hereafter born. EIGHTH: No disposition, charge or encumbrance on any income or principal of any trust hereunder or my estate by any beneficiary thereof shall be valid or binding upon my Executor or Trustee. No beneficiary shall have the right to assign, transfer, pledge, encumber, anticipate or otherwise dispose of any such income or principal until the same shall be paid to such beneficiary by my Executor or Trustee. No such income or principal shall be subject in any manner to any claim of any voluntary or involuntary creditor of any beneficiary or liable to attachment, execution or other legal or equitable process prior to its actual receipt by the beneficiary. NINTH: If my wife shall not survive me or is adjudged to be incapacitated, I appoint Pauline McAlister to be the Guardian of the person and property of any children of mine who have not attained the age of majority. If Pauline McAlister shall fail or cease to act as Guardian of the person, I appoint Lisa McAlister as Guardian of the person. No Guardian of the person shall be required to file or furnish any bond, surety or other security in any jurisdiction. If my Trustee or any trust hereunder is the beneficiary of any life insurance policy, my Trustee shall be entitled to the insurance proceeds rather than the Guardian of the person. TENTH: I have served in the Armed Forces of the United States. I therefore request that my Executor make appropriate inquiries to ascertain whether there are any benefits to which I, my dependents or my heirs may be entitled by virtue of any military affiliation. I specifically request that my Executor consult with a retired affairs officer at the nearest military installation, the Department of Veterans Affairs, and the Social Security Administration. IN WITNESS WHEREOF, I, S .-ott Rowen Ball, sign my name and publish and declare this instrument as my last will and test .~~t this 30th day of August, 2006. t~;xdL---i~~ 4 The foregoing instrument was signed, published and declared by Scott Rowen Ball, the above-named Testator, to be his last will and testament in our presence, all being present at the same time, and we, at his request and in his presence and in the presence of each other, have subscribed our names as witnesses on the date above written, -I-1tv~ r 7 having an address at M /E-,-,.fI1N'J (:;:,'~'J.z- ~ ? II ) j(a~ having an address at watS6/1~V1 . PA L#p~)L~~- fL4- 5 ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA, COUNTY OF LEBANON, ss. We, the Testator and the witnesses, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator, Scott Rowen Ball, signed and executed said instrument as his last will and testament in the presence and hearing of the witnesses, and that he had signed willingly, and that he executed it as his free and voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the request of the Testator, in the presence and hearing of the Testator and each other, signed the will as witness, and that to the best of his or her knowledge the Testator was at the time at least eighteen years of age or emancipated, of sound mind and under no constraint, duress, fraud or undue inflZ. _ .. _'. _ . .. .... .' c.- ~.V~~E~~~/?~ ... Scott Rowen Ball -.--. Testator p~~ ~. &\t-&t~ Witness Subscribed, sworn to and acknowledged before me by the said Scott Rowen Ball, Testator, and subscribed and sworn to before me by the above-named witnesses, this 30th day of August, 2006. , . / j) /'[14:-& /f, 1..i(j)..&fJ Notary Public My commission expires on COMMONWEALTH OF PENNSYLVANIA Notarial Seal Pamela A. ,amold, Notary Public Union Twp., Lebanon County My Commisskm Expires Aug. 30,2008 Member, Panns\'\vt'fl;:" !\r?~O~i2tio'1 Of Notaries ~. ... REV-l508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Scott R. Ball FILE NUMBER 07-01000 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Permsy1vania State Police Stipend, Annual Leave and Sick Leave Reimbursement 12599.72 TOTAL (Also enter on line 5. Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 12599.72 'w *' COMMONWEALTH OF PENNSYLVANIA OFFICE OF THE BUDGET COMPTROLLER OPERATIONS December 19, 2007 Leslie Ball 21 Valley Street Carlisle, PA 17013 BUREAU OF COMMONWEALTH PAYROLL OPERATIONS P.O. BOX 8006 HARRISBURG, PA 17105-8006 FAX: (717) 772-3104 Dear Ms. Ball : -'. . ---. """ "---' TheencloSeCf cfleCkrepresents payment: 10 YOlJ on' benaJrof -Scalt" R~ SaW as the executrix of his estate. Please note that you as the executrix will receive a -Form 1 099-Misc. n in the amount of $12,599.72 at year's end. The form will be in the name of the ESTATE OF SCOTT R. BALL and the TIN# 35-6779738 and should be kept along with this letter for tax filing purposes. PAYMENTS (PAY DATE AFTER DATE OF DEATH) DEDUCTION PPE DATE PAY DATE TYPE PAY HOURS GROSS AMOUNT* NET Stipend $520.00 Annual 111.24 $3,506.28 12/19/07 Sick 272.00 $8,573.44 $175.16 $12,424.56 . LESS NON-TAXABLE GROSS DEDUCTIONS: AMOUNT EXPLANATION OF NON-TAXABLE DEDUCTION -------- -....r".-_,-- --.-.-.. -.p....._.." , '. r:~~;~~r;~7:;::;r ~ ~:~ ..... . ~ ,.w~lvtUur~ I t:i''\.t"''L''.'\I~,'''\: IU:\J Vi U:::'UU\.." : IUI'\:~ Il'."r\t::~ .- . -- ~- ~..1 /....:0 ,r-~ ..... , . ..... '''wi' ft III'-o"'t""~t"'''''''' .........-...... --- f......lW4.....,....' 'W" I i i ..--.....-..-...-.-.-.---.-, ! Should you have any questions regarding this letter, please contact Mr. l::dmund Hrenner, at telephone number (717) 772-5368. ~inr-orohf '-'II 'VV' ~., , ,.,1.. .",,/ ..../~.. _. _ / if. .1.-__(, _~"r."- ~ ...--- ~__ i,.../ v' \",.,.r-~ t"...r"~ ,-,., " .._'~ sharon Wentling, Chief Special Pay Processing Enclosure REV-'511 EX. 112.99. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Scott R. Ball FILE NUMBER 07-01000 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: 680.35 1. B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City . State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State .Zip Relationship of Claimant to Decedent 4. Probate Fees 95.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 775.35 REV-1513 EX+ (9-00) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Scott R. Ball FILE NUMBER 07-01000 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Leslie R. Ball, 21 Valley Street, Carlisle, PA 17013 wife 100% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) C""'"cOO \~~~ \C:~ t~\N~ ~ ~ \ 00. \ f/l .."} ct ~., .., c- ca ':.lG OlllNnO ~ .- .. tON .. 0- c- 0- 4or"t"- .. c- r- or" c^:- l- c....:. . - ~) 'C?} -. u.d CC C) N N - -;C 0- o N fa \.t- ct:::I .;;;;:,;1 t""':::) c-I ~ ~ ~. ':? C:} u-O{-_: aCe:, ~<f)-:?; ffiz~ ~~~. Oa:h 0:2 0:::> (.) ~ o t-- ~~ ~< ~ 0 ~cJ ~ ~ ~~~~ ~ p.. ~~; ~ ~ r"l' 0 .t;, ~ "J.. 'Co ~ >.rI ~ ~~ ~ ~ ~~ --'0 ~ ~ ~~ d) ~6 ~cO ~u ~~d c:s .. ~ r- ~~~o~~ r:f)(I$~U~ \-ol .s; '.2 0 ~ ~ e~ ~ ~ ~ ~oo~~a> ~I..\o-l\-ol~o..... ('l$ 0 ~ ~ U .~ ~ ~ .~ a ~ ~ $?~200U t:JU~