The URL can be used to link to this page

Home My WebLink About02-0350PETITION FOR GRANT OF LETTERS Estate of TERRY B. SHROEDER also known as TERRY B. SHROEDER No 21-02-350 ,Deceased Social Security No.567-42-8326 Petitioner(s), who is/are 18 years of age or older, apply)ies) for (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or named in the Last Will of the Decedent, dated 3/11/02 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: ^ B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente life, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 630 Wilson Street, Carlisle Borough (list street, number and municipality) Decedent, then 66 years of age, died April 3 , 2002 , at Carlisle, Cumberland County, Pennsylvania (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ 460,000.00 (if not domiciled in PA (if not domiciled in PA Personal properly in Pennsylvania .................... $ Personal property in County .............................. $ 240,000.00 Value of real estate in Pennsylvania ........................................................................................ $ Total ..................................................................................................................... S 700,000.00 Real Estate situated as follows: Two Parcels in Carlisle Borough Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence Edward W. Holland, Jr. !~ ~~~ ~- (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Oath of Personal Representative Commonwealth of Pennsylvania COUnty Of CUMBERLAND The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. 5~.~--rte ~ ~ -. Sworn to and affirmed and subscribed before me this 5th d2y of APRIL 2002 7 dam «r~4~~ ~ - DECREE OF REGISTER Estate of TERRY B SHROED R Deceased No. 21-02-350 also known as Social Security No: 587-42-8326 Date of Death:4/3/02 AND NOW, APRIL 8. 2002 ,inconsideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Q Testamentary ^ of Administration ((c.t.a., d.b.n.c.t.; pendente life; durante absentia; durante minoriate) are hereby granted to Edward W. Holland, Jr in the above estate and that the instrument(s), if any, datedMarch 11, 2002 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ 445.00 ~~" i ,~~/ i Register ills Short Certificates(s) Renunciation ......................... Extra Pages ( ) ............... I.T.R........ JCP Fee Inventory ................... Other ......................... $ 72.00 $ 30.00 .. $ $ 5.00 .... $ .... $ Signature Attorney: Paul Bradford Orr, Esquire I.D. No: 71786 Address: 50 East High Street Carlisle PA 17013 TOTAL .............................$ 552.00 Telephone: 717-258-8558 DATE FILED: ns.gn5 hFV 9/gC, This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8169540 No. H,D$. t U Rav. 7/q7 .NT ENT NAME Of DECEDENT p ~ /. AOE IUR B+tMSyl 66 Yn. .~ COUNTY OF DEATH a' :Cumberland a. ~~~ Local Registrar APR 5 2002 Date COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH STATE FqE NUMBER SEX Male SOCUL SECURITY NUMBER DATE OF OEATN.Marn, Dax'nwl UNOER1Dp OA7E O f 8 1RTN BBI'TMPIACE I C ,_ ,. 567 - 42 - 8326 .. April 3, 2002 Iloua I MNyI•a ~ r ~ 'MMM Oty.'Mrl , 1y•ny SMNdFd•pn Carty) PLACE OF DEQH1Cn~w ~~-~~"~'~an al!«uoal December F 1 South Gate MO5°'T"` OTHER: ' I , 1935 CA 7. InpaRw IX ERIDIApalnn ^ M. ow ^ „o„N'"`"°„ ^ RarBFrip• ^ rs~M ^ Cf Y, 8080. TWP OF DEATH Carlisle FACILT' NAME PI na rnnNw., prva w••t •nB nunOwi Carlisle Regional Medical Center VMS DECEDENT OF HISPANIC ORRiINT ~ ~«^B RACE.Amw¢anYN.n,EMek.W ISP.cFr1 ,,. Yaa. NN~cIrCWan. ~ M. . PMnm Rion, «.. White RIND OF gU$INESSANOUSTRY YMS DECEDENT EVER IN DECEDENT' E~ ,B• U.S. ARMED FOHCEST S EDUCATR7N MMRAL STATUS-Maniad Sl1NVIVING SPOUT u~S. Foreign Servic Na ~ "°^ ES'TO^ow1' lo,r CoEaq ,.«4., Oipcad ISOacM IM «la, qr. mitln n.nlal 630 Wilson St. Carlisle, PA 17013 RNER S NAME (Fr},. MiOdN, U!Q ,_ Ben Heilbrun Shroeder dal DECEOENT'q "' "• ,.. Never Married ,,. ~31D NCE ,T•. s«._PA Dla +Ta.^n.,a.c.wnEneil- rwuesaM dFC.a.n ,m. Cumberland _ ~'°"PT na.® .RNn.cw,M R'~..r Cdrlial F• Da,«i•n ^ on~w rSo.uN~~'mn ~ R«no.r.an SI«. ^ iM.nm. wy. wwl ,,.. ^ _ April 5, 2002 wy.MJMrna MaaBM i,am.awim io "'^"' •aam aIIM Imn, M11 ,aa. B.nM 2••2B ml,N a conpl«aa M ~~ n„o Ma+aBlcr daa,n TIME dF OE DATE PRONOUN CEI / !.. O O M / . K. / r. PAIR L• Enw IM dBaaaaa, iy«wa w W111paeaNlna a11iCn pMME IM d ln D Li wrycna uw on N r lit. a . o nq wRw BM npEa .RIM BBIKDIATE CAUBE (F+w OYW b ~GW40f1 IilBbinrMWN w UNDERLYN'q agar w r*wy f aoww Bras) LAST iaanr« Oalnaan I _ - - __.-. "r'"""" w Brr«anddaN nol+MllBMp iltlN OF 0&O'NT OFCAUSE ~ IMann. 0ay.11ar1 - - _... •.• ••••••'•• a,n~eee ~« Hom'tiM ^ AaadaM ^ PanBNp Mnaall,•Ibn ^ N• ^ Na^ w ^ laa~ "" ^ NB ^ Sucia ^ coua l,aae•Nnnmw ^ PLACE aFIN1URY-At lnm•, l.rm. «ra«. laaary, adka M. °e LOCATRXI ISaa C•Wbw na zn. 2f, ~ q, ate. l5pacrvl xRTIr,ER ICnarn arlq. av1 „I. 'CERTRNBN, PNYfIC1ANSP~T•C.an terMyny ewm.tlae•M wnw.•rglly,pryq,wUiy aawrKay b•m ano tanp«aC Eam 3JI SIGNATURE dF TFIER R Br Ea•i W m7 ~^«'lad9a. da•,B a•ewrW duia b,M ruae(al art manna r ala,W ..................................................... ^ 4,0. 'PIIONpiNCgq AND CERTIFYING PHYSN;,AN IPNySCran EOa+.~aw LICENSE R ~, to BN Baa, «my.ne.Na,a, OaaU aemnrd •, Bn Bma, e.,., •ne ncwp orm •M cenFyvq ro car a aeaml O / pra.•naawmn,.cau«R•1•ndm•m,w•u,«ad .......................... ~ S,e. C-- T,a NAME AND ADDRESS OF PERSON wH0 COMPLETED 'MEDICAL EXAMINER/CORONER (Rem 2T1 Typo w Print On INB GaN Of namina,lon and/or lnyu,lgation, in my oPinbn,do,R Oecmnd ., IBe,Ima, d«a, and bcq and dua to,M eauae(al and (sTQF/f/A l0 ~' REGISTRAR'S SIGNATURE AND M R ~ ~ ~ p ~ ~ 42. ~ .~ ' ~ ~~~~~~~~~C ~"'r+~F7C~.+~/ '~~ DATE FILEDIMaMn. Oar. 11 l 1. Yorktowne Cremation ~~~ York, PA 17404 ,,.. NAME ANDADOiIESSaF FApuTr o man-Rot Hera Ome m. 219 N. Hanover St. Carlisle, PA LICENSE NUMBER DATE SgNED b. C_ i yam) toe. // ~ ~J V«9CASE REFERRED 70 MEDIAL TE~%AMINERK:OR GO 'G M ~ W~ Ne~ _ //~/~ LAST WILL AND TESTAMENT OF TERRY B. SHROEDER I, Terry B. Shroeder, of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I am unmarried. I have no children, living or deceased. SECOND: My parents are deceased. I have one sibling, my half-brother Robert Burt Shroeder, of Mt. Vernon, Washington. THIRD: I direct my Executor to pay my just debts, including the expenses of my last illness, and also my funeral expenses in such amount as he may deem proper, without regard to any limitation imposed by law or rule of court which this direction may supercede. (Note: As of December 1, 2000, my primary health insurer has been Medicare. My secondary insurer is Aetna, Group # 361336-16-001, Payor 60054 0058. My tertiary is the Foreign Service Benefit Plan, I.D. Number: 567 42 8326.) FOURTH: BURIAL INSTRUCTIONS: If I die in the United States, I direct that my body be cremated and my ashes put into the Pacific Ocean. (Two old salts, Ted Holland and Alan Weller, who sailed out with my mother's ashes, will surely agree to put to sea with mine! Holland's phone: (650) 326-1431. Weller's phone: (650) 321-0896. 1f I die outside the United Page 1 of 11 States, I request that my ashes be put into some other ocean. (f this makes things too complicated because of logistics or local laws, my next preference would be to have my ashes buried in a United States military cemetery. (The file on military service, in my filing cabinet, will show that I am eligible.) FIFTH: LISTING OF ASSETS A. Apartment house at 630 Wilson Street, Carlisle, Cumberland County, Pennsylvania, managed by Henrietta (Sue) Schlegel, 5209 Terrace Road, Mechanicsburg, Pennsylvania. (Telephone Number: (717) 975-1637). B. Apartment house on South Hanover Street, Carlisle, Cumberland County, Pennsyh~ania, jointly owned with Sue Schlegel of 5209 Terrace Road, Mechanicsburg, Pennsylvania. (Telephone Number: (7l7) 975-1637) C. Mutual funds and stocks with USAA of San Antonio, Texas, member number: 1781578. D. Savings and checking accounts at USAA Bank, San Antonio, Texas, member number: 1781578. E. Bank accounts at iVl&:1' Bark, Carlisle,, Currtberiand Count', Pennsylvania, with account number: of 1500420; 1720122, and two checking accounts managed by Sue Schlegel, Page 2 of 11 one of which is half hers, having to do with the' property located on the corner of South and ~ ~^ ~~ Hanover Streets. F. 500 shares of Old Dominion. Brewery Stock, Phone number: (703) 724-9100. G. Savings account at Allfirst Bank, Carlisle, Pennsylvania. SIXTH: SPECIFIC BEQUESTS: I make the following specific gifts of tangible personal property to the following beneficiaries who survive my death. If any of the named beneficiaries should die before I do, his or her gift shall lapse and become part of the residue of my estate. A. To my friend Jude Smith, of 611 W. North Street, I leave any automobile that I may own at the time of my death (Phone number: 249-5854). B. To my woman friend, IViija Kim, I leave thirty-six thousand ($36,000.00) dollars, in hopes that she will use it for her education. C. I leave Robert and Shell-Be Shroeder my half share of the commercial property on the corner of South and Hanover streets in Carlisle, Cumberland. County, Pennsylvania. D. I leave Robert and Shell-Be Shroeder the sum of $60,000.00. This is over and above the amount they are receiving in paragraph 1 1, the Residuary Clause. Page 3 of 11 E. I leave Robert and Shell-Be the contents of my bank accounts at M8iT Bank in Carlisle, Cumberland County, Pennsylvania. (Sue Schlegel owns one half of one of these accounts. She also uses these accounts to manage the two properties, so please coordinate with her.) I also leave to Robert and Shell-Be Shroeder the contents of my account at Allfirst Bank. If both Robert and Shell-Be should predecease me the gift shall lapse and become part of the residue of my estate. F. I leave to Bob and Shell-Be Shroeder my shares in Old Dominion Brewery. G. To Bob and Shell-Be Shroeder I give all the rest of my remaining tangible personal property (excluding money, negotiable instruments, brokerage accounts, and the like.) I ask that from these things Bob and Shell-Be also make suitable gifts to John and Marge Shroeder and each of John and Marge's children. SEVENTH: LIFE INSURANCE POLICIES: I have two life insurance policies. One is through the Foreign Service (Phone: 1-800-521-2553 or 1-703-875-7110), the other through RFE/RL, Inc. in Washington, D.C. (Phone: 202-457-6928) Their values decrease with each year. As of this writing the amounts are approximately $5,000.00 each. EIGHTH: SPECIFIC MONETARY BEQUESTS: I give the following gifts of money to the following beneficiaries who survive my death. If any of these should predecease me, the gift to that beneficiary shall lapse and become part of the residue of my estate: Page 4 of 11 A. To each of the surviving children of the late Robert Bowler and of his widow, Pat Bowler (now Pat Dumas) of 2882 Old Military Road, Central Point, Oregon 97502 (Telephone Number: 541-664-3775) the sum of five thousand ($5,000.00) dollars. The whereabouts of the beneficiaries may also be found through Larry and Theresa Tasiemski, 4274 Ostom Avenue, Lakewood, California (Telephone Number: 310-429-4286). B. To Patrick Gaude, son of Mike Gaude of Hardwick Street, Lakewood, California, the sum of five thousand ($5,000.00) dollars. (Michael Guade was until recently employed at Boeing Aircraft in Long Island Beach. He may be retired now. Tasiemskis will know the current address.) C. To Mrs. La-ong Srithong of Bangkok, Thailand, the sum of five thousand. ($5,000.00) dollars. La-ong may be found through Mr. Somthavin Ningsananda of 255 Soi Charoenmit, Sukmvit 71, Bangkok 10110. (Telephone: 662-390-1107). D. To Somthavin Ningsananda of 255 Soi Charoenmit, Sukumuit 71, Bangkol 10110 (see above), ten thousand ($10,000.00) dollars plus whatever remains in our joint account in Bangkok. E. To Phanom, daughter of the late Boonmee Osaklang and sister to the late Arunee Osaklang of 51/7 Tambon Kud Khao, Kuchinarai District, Kalasin Province, Thailand the sum of five thousand ($5,000.00) dollars. (Somthavin has the number of the family bank account.) Page 5 of 11 I request that the money be used for the education of Phanom's children. F. To Edward Holland, Jr., 366 California Avenue, Palo Alto, California 94306, the sum of twenty-five thousand ($25,000.00) dollars. G. To Jonathan Weiss, 142 West 87"' Street, New York, New York 10024 (Telephone Number: 212-391-0120) the sum of twenty-five thousand ($25,000.00) dollars. H. To Massimo and Kristel Ali, Franz Wolterstr. 5, 81925 Munich, the sum of five thousand ($5,000.00) dollars. I. To Nelly Boyan Mugnier and her daughter Amalie, of 15 Rue de la Bievre, 92220 Bagneux, France, or the survivor of them, twelve thousand ($ l 2,000.00) dollars to be divided equally between them. J. To Brigitte Kopf, Lindwurmstr 145 Munich (Phone No. 49-89-766127) the sum of five-thousand ($5,000.00) dollars. K. To the trustee(s) of the Stanley Family Trust, which I am establishing to benefit Benedict and Roy Maria Stanley and their twin daughters Jennifer and Josephine, the sum of one-hundred thousand ($100,000.00) dollars. The trust documents and other relevant information may be obtained from Marie-Louise Dixon of the law firm Dixon, MacGregor, Appell, and Burton Page 6 of 11 of Toronto. Phone number: (416) 927-0891. If for any reason this bequest fails, the one-hundred thousand ($100,00.00) dollars shall be retained intrust for the education of Jennifer and Josephine Stanley, up to the age of 25, and administered in accordance with the laws of the Commonwealth of Pennsylvania. On the 25`h birthday of the twins any balance remaining in the trust shall be distributed, in equal shares, to Benedict, Roy Maria, Jennifer, and Josephine Stanley. It is my intent that both the principal and interest shall be made available to support the education of the two girls. NINTH: IN TERROREM PROVISION: If any beneficiary or devisee under this will opposes or challenges the probate of this will or any of its provisions in any manner whatsoever, then in such event the benefit or share of my estate given to such beneficiary or devisee under this will is hereby canceled and forfeited, and in such event, I give such respective benefit or share to the Estate. TENTH: CHARITABLE BEQUESTS A. To the Carlisle Historical Society, any commissions, documents, or photos deemed to merit the society's involvement, as long as Bob and Shell-Be agree. B. To Wat Uppatam Photaram, the Buddhist temple in Tambol Kud Khao, two thousand ($2,000.00) dollars. (Somthavin will know how to do this. See eighth paragraph above for pertinent addresses, etc.) Page 7 of 11 C. One equal share of the residue of my estate to Amaravati Buddhist Monastery of Great Gaddesden, Herts, HPl3BZ, UK (Telephone Number 011-44-1442-843721). If you have trouble with this number you may try their sister monastery in California, named Abhayagiri. The number there is (707) 485-1630. They will tell you how to contact Amaravati. ELEVENTH: RESIDUARY CLAUSE: I direct my Executor, or his successors, to divide the residue of my estate, after payment of taxes, debts and costs of administration, into equal shares and distribute them as follows: A. One share jointly, to Robert and Shell-Be Shroeder, or the survivor of them. This is over and above the $60,000.00 bequeathed to them under Specific Bequests, above. B. One share to be divided equally between the three children of Robert and Shell-Be Shroeder who survive me. (To: Michael, David and Stephanie, 1/3 of a share each) C. One share to Tomoko Shroeder, daughter-in-law of Robert and Shell-Be; should Tomoko predecease me, her single share shall be given to her daughters, Jennifer and Shell- Be, and her son, Robert per stirpes D. One share to be divided equally between the three children (Karen, JoAnn and Mikael) of Mark and Michelle Glago. Mark and Michelle live on Parliament Road in Springfield, Virginia (Phone: 703-978-1069). If any predecease me, their share lapses to the Page 8 of 11 survivors within this clause. TWELFTH: EXECUTOR PROVISIONS A. I nominate and appoint my friend Edward W. Holland, Jr. as Execut or of this Last Will and Testament. If for any reason he fails to qualify or ceases to act as Executor, I nominate my friend Barry Fulton as Alternate Executor. (Address: 2615 Washington Ave., Chevy Chase, MD 20815, Tel: 301-588-4944). B. Except for checking accounts necessary for the operation and settlement of my estate, I direct my Executor to invest and reinvest any surplus monies in interest-bearing accounts, money market funds or short-term bond funds. The Executor shall not invest surplus moneys in any other manner. C. I authorize my Executor to sell at either public or private sale and to lease any property belonging to my Estate, subject to such confirmation of Court as may be required by law. However, I direct that my Executor permit by friend Mija Kim to stay rent-free at my property located at 630 Wilson Street, Carlisle, Pennsylvania for up to four months following my death. D. The house at 630 Wilson Street shall be sold to raise money for the Estate. However, if Bob Shroeder, or Sue Schlegel, in that order of precedence, wants to buy said real property within four months of my death, he or she may purchase it for one-hundred ninety Page 9 of 11 thousand ($190,000.00) dollars, regardless of fair market value. If she does not purchase the property during that time, it shall be sold for fair market value and the proceeds made part of the Estate. E. I authorize my executor to undertake and pay for any travel and lodging expenses plus reasonable per diem for himself or others that may be reasonably necessary at his absolute discretion to carry out the purposes of this my Last Will and Testament, including but not limited to the distribution of bequests in person. E. I direct my Executor to contact the Law Offices of Paul Bradford Orr, Paul Bradford Orr, Esquire, 50 East High Street, Carlisle, Cumberland County, Pennsylvania, to act as Attorney/legal representative for the Estate. THIRTEENTH: I direct that no bond be required on any Executor nominated in this Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of eleven (11) typewritten pages, each identified by my signature, this !'~ day of March, 2002. L~^"'~ ~ ' ~G.,~'°"`-""~ - (SEAL) Terry B. Shroeder Signed, sealed, published and declared by the above-named Testator, Terry B. Shroeder, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. i Gr o .Cutler April L. Deatrick Page 10 of 11 COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND 1 I, Terry B. Shroeder, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by Terry B. Shroeder, the Testator, this ~ ~ ~^' day of March, 2002. D --- ~ ~. ---y.~. ~~,_..,.._.----z ~ 5~ -' (SEAL) iotarial Seal Heather L. Smith, Notary Public erry B. Shroeder, Testator Carlisle Boro, Cumberland Gounty ~`~~~'~~-' ` iv':~; Commission Expires Apr. 7, 2003 iNernb>Ar, Per;nsylvania Association of Ne?cries Notary Public COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF CUMBERLAND We, Gregory L. Cutler and April L. Deatrick, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that Terry B. Shroeder signed willingly and that he executed it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me by Gregory L. Cutler and April L. Deatrick, witnesses, this 1 ~ ih day of March, 2002. (SEAL) Greg~iry/I,. Cutler, Witness Notarial Seal Heather L. Smith, Notary Public Carlrsl2 Boro Cumberland Cor,n,v 1 Pr^y GUrnmiss~~n Exp res Ap, 2 )3 ,,~ ~r , n~ o.ri~ , rer;rs}n ,~~i ~ ociat~>>~ - ~ ~. ~ /zv ~ (SEAL) pril L. Deatrick, Witness ~~ ~~~,~~ Notary Public Page 11 of 11 i i ~,,' r f.. ~ ~ H N M x m~ M ax 9'~ n ~~~ ~' O ~+ u' a o o m ~ ~ O CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Terry B. Shroeder Date of Death: 4/3/02 Estate No. 2002-00350 SSN: 567-42-8326 File No. 21-02-0350 Date Letters Granted: 4/8/02 Will or Administration No. 2002-00350 ;, To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Terry B. Shroeder Name Address Michael Shroeder 1416 Alpine View Place Mt. Vernon WA 98274 Stephanie Shroeder 1416 Alpine View Place Mt. Vernon WA 98274 David Shroeder 1416 Alpine View Place Mt. Vernon WA 98274 The Carlisle Historical Society 21 N. Pitt Street Carlisle PA 17013 The three children of Mark and Michelle Glago 8712 Parliament Drive (Karen, JoAnn and Mikael) Springfield VA 22151 Jude Smith 611 West North Street Carlisle PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Patrick Gaude, no address; La-ong Srithong , no address; Wat Uppatam Photaram, the Buddhist temple in Tambol Kud Khao, no address ; Date: ~ (~ V~ Capacity: Personal Representative ~~ Counsel for Personal Representative 1 Signature PAvc. g. Ong Name (Please type or print) Address ~0 ~,5~, 1 , ~ > ~ c T ~~ ~ ~ISL E ~ ~A ~ X013 Telephone No. ~ ~ ~ _ ZSB-- ~~~a S~ ~} ~ ~ ~ '~ 1'1 S~~ Ter B Shroeder Continuation of Certification of Notice Under Rule 5.6(a) 4!3!02 ry Page, Names and addresses Name Nelly Boyan Mugnier and daughter Amalie Mugnier Brigitte Kopf Amaravati Buddihist Monastery The Stanley Family Trust c/o Dickson MacGregor, Barristers & Solicitors Somthavin Nigsananda Jonathan Weiss Robert Shroeder Shell-Be Shroeder Pat Bowler (Dumas) Mija Kim Edward Holland, Jr. Massimo and Kristel Ali Phanom Osaklang Address 15 Rue de la Bievre 9220 Bagnerux, France Lundwurmstr 145 Munich Great Gaddesen Herts, HP13PBZ 10 Alcorn Avenue, Suite 306 Toronto, Ontario M4V 389 255 Soi Charoenmit Sukumuit 71 Bangkok 142 West 87th Street New York, 1416 Alpine View Place Mt. Vernon 2882 Old Military Road Central Point 630 Wilson Street Carlisle 366 California Avenue Pato Alto Fran Wolterstr. 5, 81925 Munich 51/7 Tambon Kud Khoa UK 10110 NY 10024 WA 98274 OR 97502 PA 17013 CA 94306 r` ti ~ Postage $ IT" ~ Certified Fee r~ Postmark ~ Return Receipt Fee Here ~ (Endorsement Required) O Restricted Delivery Fee O (Endorsement Required) ~ Total Postage & Fees O '~ ient s Nam lease Pri t Clearly) (to be completed by mailer) D p Stree[, Apt. No.; or PO Box No. 0 o ---- ----------------------------------------------------------------------------------------- C~ty, State, ZIP+4 oa- _. UNITED STATES POSTAL SERVICE ppstage & Feels Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • ~i5'1~e_.r'Of ~ i ~~S ~lea'K ~ prPh~.ns ~our'~ Co ~~-~, ~~ s~,~~.. C'.,~rz~'~s1~ ~, ~~0~3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ORR PAUL BRADFORD ESQUIRE 50 E HIGH STREET CARLISLE, PA 17013 REV-1162 EXI11-961 NO. CD 001539 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssrv: ss~-42-8326 FILE NUMBER: 2102-0350 DECEDENT NAME: SHROEDER TERRY B DATE OF PAYMENT: 08/ 1 9/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/03/2002 101 ~ 575,000.00 TOTAL AMOUNT PAID: REMARKS: PAUL B ORR ESQUIRE C/0 PAUL BRADFORD ORR ESQUIRE SEAL CHECK# 1008 INITIALS: SK RECEIVED BY: MARY C. LEWIS 575,000.00 REGISTER OF WILLS REGISTER OF WILLS '1//~ ~~ i~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Terrv B Shroeder Date of Death: April 3, 2002 Wi11No.: 2002-00350 Admin. No.: 2002-00350 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes L] No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: June 1 , 2 0 0 4 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No ~] b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes II No II c. Copies of receipts, releases, joinders and approval of fo or informal accounts maybe filed th th ler of the. 'Court and maybe attached to this repo Date: 4 / 2 / 0 4 ` Signature Paul Bradford Orr, Es quire Name ._~~l~i~j 50 E. High Street, Carlisle, PA - . ~ Address 17 01 3 (7171 258-8558 b h: L d Z- ~JdN b0. Telephone No. Cap~c~ity: ^ Personal Representative -,;~ x~ Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 1)1280601 RECEIVED FROM: ORR PAUL BRADFORD 50 E HIGH STREET CARLISLE, PA 17013 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER -- - -Iola ESTATE INFORMATION: sSN: 5s7-a2-832s FILE NUMBER: 2102-0350 DECEDENT NAME: SHROEDER TERRY B DATE OF PAYMENT: 12/09/2004 POSTMARK DATE: 12/09/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/03/2002 REV-1162 EX111-961 N0. CD 004715 AMOUNT 101 ~ $17,894.12 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK#10738 INITIALS: JA RECEIVED BY: 517,894.12 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS RE~-,~E"`~' COMMONWEALTH OF REV -15 0 0 .~' PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER DEPT. 280601 o2 00350 ~ ~ HARRISBURG, PA 17128-0601 IDENT DECEDENT - - - RES YEAR NUMBER ~ DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Z Shroeder, Terry B. 567-42-8326 W _ _ - _ __ DATE OF DEATH (MM-DD-YEAR) __ DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE V 04/03/2002 12/01/1935 REGISTER OF WILLS __ _ _ - _ - W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER O ~ ~ 1. Original Retum ^ 2. Supplemental Retum ^ 3. Remainder Retum (dare or deacn Pd« ~o iz-ia-ez) w a ~ ^ 4. Limited Estate ^ 4a. Future Interest Compromise (eafe or deem arter 12-12-82) ^ 5. Federal Estate Tax Return Required m ~ ~~ X^ 6. Decedent Died Testate (Attach spy orwdq ^ 7. Decedent Maintained a Living Trust (Attach copy or Trust) _ 8. Total Number of Safe Deposit Boxes o . ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (day of deem between 12-s1-81 and is-ssi ^ 11. Election to tax under Sec. 9113(A) (Attach scn o) ~. THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: w NAME COMPLETE MAILING ADDRESS o Paul Bradford Orr _ _ _ _ Law Offices of Paul Bradford Orr ra FIRM NAME ptApp~icable) 50 East Filgh Street Law Offices of Paul Bradford Orr Carlisle, PA 17013 o TELEPHONE NUMBER ~ (717) 258-8558 1. Real Estate (Schedule A) (1) 288,500.00 2. Stocks and Bonds (Schedule B) (2) 468,767.89 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) -7,088.00 4. Mortgages & Notes Receivable (Schedule D) (4) 0.00 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 120,028.07 Z (Schedule E) ~ 6. Jointly Owned Property (Schedule F) (6) 6,966.26 ^ Separate Billing Requested ~ 7. Inter-Vvos Transfers & Miscellaneous Non-Probate Property (~) 0.00 ,. H (Schedule G or L) ~ - Q 8. Total Gross Assets (total Lines 1-7) (8) ; •'--~877,.174.2~ W 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 87,151.24 ~,M~ ~ • • - t ; ~ 10. Debts of Decedent, Mortgage Liabilities, 8 liens (Schedule I) (10) 10,641.63 CJ"i "%..-'7 Cro - , 11. Total Deductions (total Lines 9 & 10) (11) 97,792.29 12. Net Value of Estate (Line 8 minus Line 11) (12) 779,381.93 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been (13) 134,276.60 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 645,105.33 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z 15. Amount of Line 14 taxable at the spousal tax a rate, or transfers under Sec. 9116 (a)(1.2) -- - - - - x .0 (15) I - 16. Amount of Line 14 taxable at lineal rate x .0 (16) ~ 17. Amount of Line 14 taxable at sibling rate 276,424.79 x .t2 (17) 33,170.97 V 18. Amount of Line 14 taxable at collateral rate 282,529.82 x .15 (18) 42,379.47 19. Tax Due (19) 75,550.44 H > > BE SURE TO ANSWER ALL QUESTIONS ON"REVERSE SIDE kND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 630_Wilson Street - _- - .- - - CITYCarIISle STATEPA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 line 19) (1) 75,550.44 2. CreditslPayments A. Spousal Poverty Credit _-----_-----_-___-._ -------.--__ ._-- B. Prior Payments 92,894.12 C. Discount _.. - -__ __ Total Credits A + B + C 2 () 92,894.12 3. InteresUPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 17,343.6$ 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 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 :.......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ c. retain a reversionary interest; or .......................................................................................................................... ^ ^x d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ ^X Did dent own an Individu it nt Account, annuity, or other non-probate property which contai a beneficiary desig tion . ...................................................................................................................... ^ IF E AN ER TO A E ABOV QU TIO S IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under n 'es of rj I declare t I h e amin this r um, inclu g acc panying schedules and statements, and to the best of my knowledge and belief, it is true, cortect and complete. DeGara ion f prep r Cher than th person presen five i based o I in anon of which preparer has any knowledge. SIGN U PE SON SPON FI NG R R ~.A.P,_ ~ ~\ DATE 02/04/05 LAW OFFICES OF PAUL BRA[~FC~RD l9F~l~ - 50 Eastl-ligh Stet, Carlisle, PA 17013 SIGNATURE OF PREPARER OTHER THAN R PRESENTATIVE DATE _ - - 02/04/05 __ _ _ _ - ADDRESS __ _ _ _ _ _ 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 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% (72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemgt 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 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. his is to certify that the information here given is correctly copied from an original certifcate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: tt is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 `~ ~• ~e.1.!-_~'lw~,rl~.-~ Local Registrar P 8.69543 No. wiT ENT a HT 1~ ~ L1iJQZ Date COMMONNCE/1lN OF PENN'SYLVANIk • DEPARTMENT Of HEALTH • VITALrRECORbS C1rA'~1F1CA~fc Of DEATH NAME Of DECEDENT Ifw: wiaW,Lwq SEX SOGiAl9EDUl11Tr NDMSER DREG OEAHdA•nn,0q,?•rl M l ,. ~ " ,, a e ;~ 567 X42 - 83'26 .. April 3. ,2042 R,YEM LS,DER 10/d ~ b91RTH .. ICM•^a :AOE M1•r"6:f.o.Y1 PLACE Of DEANICMcaaWw-~.. r+vwabonolna flaw 66 M•rWr ; D•n N•Y11 S Mli.llw 1 DIC.MrI. SWaa Fwagncasrh 1 South Gate c r NOSFRAL• HER: ~ l fi , • ; Y~ ,,,~„w„ C~ Ewowwlw. C.~ ou O ~ D R.w.,r. O ~ n ^ • : T. 60lriTY Of DEAR Cf1Y,SORO.)WVOf AN fACLLTry HAA/Epep NM,ai,pw,li•w ana nuiw,rn MM9 CE Of _ X:ORXiIN? RACE •MMAeN MIdSr~'lMek. W11a•: NC Carlisle Carlisle Regional Medical Center ",,~ ~,~••~"~^•^' ~Wiite Cumberland , K " . ;EVERE, ~ ' : OE OENT'SEPVCAlPN"~:. 'STATUS•NLMrr6 BURVNSq EMUBE` -DECEDENT' U UAL OCCUPAIDN : XINO BU ESEA RY VKEDE lird Eyy,.,;„.:*y U.S:M tORCEl7 Nw«~ pvM.OMwwON wrr/ ~ Aa~1 "°O fir Dipl~Oornata~~ ~~ S. Fdreign Servi ~''°s~~ -N M i d , 1 , . „ , ever . arr e u: PEDEDENr•EM~E,NtL upa«tic.yrto.•.sria:zewed ' DE ~TS Ew~ as ,A.O w.a•.swaEwM • 630 Wilson St. • . f nEbiDEN~E a.«+Nr Carlisler PA 17013 .~VCI.w. +«~^•. a.a.«,~dal_ ~ w.a.lwf :land ~ ~ ~s3rli<sle w ,E. {~ ,T•, . E a . -. PATHER'sw~wE /.+~•:I:±ro - - . ~. Hen He~lb~ Shroe3er MOTNER'B w.aE1f'++l M.OW..MMW11.SUnYry) - Grace Laude nsD,vwTrsHAUCnyfw-~w a,fORMANrsMAlt,NDADDREBS cww~nsw.;zoeaa.~: Rok~ert Bert Shroeder . ': .191:6 Al ine:•Vew F1ace.MOUnt Vernon,. WA;_98274 'N•aiaolCwnwwy, CN.nwaY IOCAM]N:CMylW+n, SYw. C•a ~~~ ~ UiVE erO1N'Rlw' GKIM) la s rl ^ c r nl aun ^ w j7C R ~ •.l • .•Mw • wi Yorktowne Cremation ~April 5,;2002 = o4wla,0 anwlsawm O York, PA 1'404 ~ ~~ ~ ~ EANDADOIIESSOf o _ : era Oltle fuNERk. ,w~ ~ TU16ASSUCN ~"1 - L 9- >~. 219 N. Hanover St, Carlisle, . PA .. «a»tlah•aHSngy6tiawr•tl. LICENSE' R' OAE. c••~o~w• «~aE!•eewf.nwlanrylAE al.eawa awn.. ' ~ _ ~dri;D.K'+w °f'www~aawnu anal r as ' G n;~ ~S7 / ~ ~ ~/ r / Sar E+r ••a••~f4!•a u, CJF OAEMIONOVN/.ED PEAR D•1{1•w)MMSC7ISE'REf D'TO ME W f.e••n.wpwlrw¢«aawN: a o M .... ~ ~~ 3 a•~ ~~ ~! ~ .. n. RAIRf. EwwEw awwf..,hMr•w tomoKillwnw•M.9~cw.dtlr aaa Daaa «ww Yw nwei~ .., wcha «.•.gway r~w.uw!•wtwn~l~iFn. MPO++mw.. -MT-E: pnw ~ . 01I . ~ Llw wMy~1. •S••~MMMEI!a. - ~YawV~~•..A wX,wnArp illMrlM 1/bM1~A1g0Y/~f~Y•11 Y11~R p1M1SM aun ~ - , -SSMED/STt CAUSE (F•W . r /. ~saw.Ea aXprol C 0'! ~ f.~ f;,. . ~ „ 'IONR~A,.GDNBEDUENCEOfk _ i . S r.wwW • AS71,i1SALONSEOUENGE" 1 . fw.l.. E•M!.N[IDtRLY,11D ~ :eAa,Epr.ra•r.T ,.. , , .. fY1YYEwfawwilt 01XE lD A$A NCE Ofk... ..~. - .. waMi LAST ~M t 1 6 a • -ElIFORMEA,IID PSY ~MM.ASLE ffY0111,1PSiOS 'MANNER Of DE~VN..,.- 1~~~ : TIME OF StlUI1Y N•S,RY /PKd1KT. DESC IIDLV VtN1RY OCEX,IIRED. ofeAUEE w.ww ~ H~awe. a a o ». "a N, O ' XXp~~,,, M w. O N•,{.1 m ^ N• ^ tl+aela• CJ CouMmC.irl.nn.re O: ryACEDfMUURr.AII„m.;a/.n,w+..,.i.awY,aEU aNpvw.cMw.a~rw" ": E;Mlsowe:a;oaeM •CS/ITIhYWO,fNYfICMMf*WfOM.CMYf/+.gt•inMa awn MNn wq•pf phY•CW.Mf vo~Oadp ane cdngwM11rn 7-0 O 516NAURE: TIFSUi AE4wwa1.Y-nw.l.sp,aMe••wr•a arM M;sww(w NWie Mif NnaN .. ......:... ..... ... .... ..... ........ ~ • •MONDUNpNGAlbCE1RIfYNIDfNY,SIC1A111fM~OM M+1~aMti!q Mw~wN~wIM91 ae~MdO[MI qpI lnerN• A1MMa'a• awl•wvwawS,law. :M,• wMa•wlM inaia•n •nnawwl wAM a ~• LICENSE DRESW.REDAbRD.K NrI / / , G~•^ Sl /Y CS7~ • ry p. ; , , e • ......................:... y] • wNV •YE4ICAL E7GSIINER/CORONER ~ . NAME ANO ADDf1ESSOf RSON Tf/W-COMKETEO OFDEATN 7 ONna Y 1^!yp• a fYMn / ,~ /•7U~~ ! ~ . :." ~On ru NW a.••wMn•INM anNaf ImEatlyAlbn, In my oylnlan GSIA oCeurtW ft IM~1im- aN• aM ylaet +na duf btM e•uw(i) w~a ~ 4 ~/ T4'~C~ /O~D~Jr' IIIM1M, w1a4lM ......... ................... .... ... .....:.... .....:. :.....,. ..... .... .......... ^- Y ~ . 7, ~ Yl., •C ~ ~/ ' RE618TMR'1.S16NRVRE AND R ~• ~ G~ DATE fM.E61Mp~In,Dp• 1 7S. N. LAST WILL AND TESTAMENT OF TERRY B. SHROEDER A TRUE COPY FROM RECORD In Testimony wherof, I hereunto srtmy hand~and the seal adsaid Court at Cart~le.~A of the rt ' " ~tirrtt~rla~d' ur~nY 1, ~~~ '. / I, Terry B. Shroeder, of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, .memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I am unmarried. l have no children, living or deceased. SECOND: My parents are deceased. [have one sibling, my half-brother Robert Burt Shroeder, of Mt. Vernon, Washington. THIRD: I direct my Executor to pay my just debts, including the expenses of my last illness, and also my funeral expenses in such amount as he may deem proper, without regard to any limitation imposed by law or rule of court which this direction may supersede. (Note: As of December 1, 2000, rriy primary health insurer has been Medicare. My secondary insurer is Aetna, Group # 361336-16-001, Payor 60054 0058. My tertiary is the Foreign Service Benefit Plan, I.D. Number: 567 42 8326.) FOURTH: BURIAL INSTRUCTIONS: If I die in the United States, I direct that my body be cremated and my ashes put into the Pacific Ocean. (Two old salts, Ted Holland and Alan Weller, who sailed out with my mother's ashes, will surely agree to put to sea with mine! Holland's phone: (650) 326-1431. Weller's phone: (650) 321-0896. If I die outside the United Page 1 of 11 ~. State's, l retluest that my ashes be put into some other ocean. If this makes things too complicated because of logistics or local laws, my next preference would be to have my ashes buried in a United States military cemetery. (The file on military service, in my filing cabinet, will show that 1 am eligible.) FIFTH: LISTING OF ASSETS A. Apartment house at 630 Wilson Street, Carlisle, Cumberland County, Pennsylvania, managed by Henrietta (Sue) Schlegel, 5209 Terrace Road, Mechanicsburg, Pennsylvania. (Telephone Number: (717) 975-1637). B. Apartment house on South Hanover Street, Carlisle, Cumberland County, Pennsylvania; jointly owned with Sue Schlegel of 5209 Terrace Road, Mechanicsburg, Pennsylvania. (Telephone Number: (717) 975-1637) C. Mutual funds and stocks with USAA of San Antonio, Texas, member number: 1781578: D. Savings and checking accounts at USAA Bank, San Antonio, Texas, member number: 1781578. E. Bank accounts at M&:T Bank, Carlisle, Cumberland County, Pennsylvania, with account number: of l 50042020122, and two checking accounts managed by Sue Schlegel, Page 2 of 11 one df which is half hers, having to do with the' property located on the corner of South and Hanover Streets. F. S00 shares of Old Dominion Brewery Stock, Phone number: (703 j 724-9100. G. Savings account at AI[first Bank, Carlisle, Pennsylvania. SIXTH: SPECIFIC BEQUESTS: I make the following specifc gifts of tangible personal property to the following beneficiaries who survive my death. [f any of the named beneficiaries should die before I do, his or her gift shall [apse and become part of the residue of my estate. To my friend dude Smith, of 611 W. North Street, I leave any automobile that I may own at the time of my death (Phone number: 249-5854). To my woman friend, Mija Kim, I leave thirty-six thousand ($36,000.00) dollars, in hopes that she will use it for her education. /C. I leave Robert and Shell-Be Shroeder my half share of the commercial property on the corner of South and Hanover streets in Carlisle, Cumberland County, Pennsylvania. /D. I leave Robert and Shell-Be Shroeder the sum of $60,000.00. -This is over and above the amount they are receiving in paragraph 1 1, the Residuary Clause. .~ Page 3 of 11 ~,, .~~E~ I leave Robert and Shell-Be the contents of my bank accounts at M& ~ ank in Carlisle, Cumberland County, Pennsylvania. (Sue Schlegel o one half of one of these ~.1 1 accounts. She also uses these accounts to manage the two properties, so please coordinate with l ~QI ?~ i 7 a-y9. , her.) I also leave to Robert and Shell-Be Shroeder the content my account at Allfirst Bank. If r r both Robert and Shell-Be should predecease me the gift shall lapse and become part of the residu~~~ of my estate. F. I leave to Bob and Shell-Be Shroeder my shares in Old Dominion Brewery. /G. To Bob and Shell-Be Shroeder I give all the rest of my remaining tangible personal property (excluding money, negotiable instruments, brokerage accounts,~and the like.) I ask that from these things Bob and Shell-Be also make suitable gifts to John and Marge Shroeder and each of John and Marge's children. SEVENTH: LIFE INSURANCE POLICIES: I have two life insurance policies. One is through the Foreign Service (Phone: 1-800-521-2553 or 1-703-875-7110), the other through 1tFE/RL, Inc. in Washington, D.C. (Phone: 202-457-6928) Their values decrease with each year. As of this writing the amounts are approximately $5,000.00 each. EIGHTH: SPECIFIC MONETARY BEQUESTS: I give the following gifts of money to the following beneficiaries who survive my death. [f any of these should predecease me, the gift to that beneficiary shall lapse and become part of the residue of my estate: Page 4 of 11 . To each of the surviving children of the late Robert Bowler and of his widow, Pat Bowler (now Pat Dumas) of 2882 Old Military Road,,Central Point, Oregon 97502 (Telephone Number: 541-664-3775) the sum of five thousand ($5,000.00) dollars. The whereabouts of the beneficiaries may also be found through Lang and Theresa Tasiemski, 4274 Ostom Avenue, Lakewood, California (Telephone Number: 310-429-4286). B. To Patrick Gaude, son of Mike Gaude of Hardwick Street, Lakewood, California, the sum of five thousand ($5,000.00) dollars. (Michael Guade was until recently employed at Boeing Aircraft in Long Island Beach. He may be retired now. Tasiemskis will know the current address.) C. To Mrs. La-ong Srithong of Bangkok, Thailand, the sum of five thousand t ($5,000.00) dollars. La-ong may be found through Mr. Somthavin Ningsananda of 255 Soi Charoenmit, Sukmvit 71, Bangkok 10110. (Telephone: 662-390-1107). To Somthavin Ningsananda of 255 Soi Charoenmit, $ukumuit 71, Bangkol 10110 (see above), ten thousand ($10,000.00) dollars plus whatever remains in our joint account in Bangkok. To Phanom, daughter of the late Boonmee Osaklang and sister to the late Arunee Osaklang of 51/7 Tambon Kud Khao, Kuchinarai District, Kalasin province, Thailand the sum of flue thousand ($5,000.00) dollars. (Somthavin has the number of the family bank account.) Page 5 of 11 I request that the money be used for the education of Phanom's children. ,~. To Edward Holland, Jr., 366 California Avenue, Palo Alto, California 94306, the sum of twenty-five thousand ($25,000.00) dollars. ~ G. To Jonathan Weiss, 142 West 87th Street, New York, New York 10024 (Telephone Number: 212-391-0120) the sum of twenty-five thousand ($25,000.00) dollars. H. To Massimo and Kristel Ali, Franz Wolterstr. 5, 81925 Munich, the sum of five thousand ($5,000.00) dollars. I. To Nelly Boyan gnier and her daughter Am ' , of 15 Rue de la Bievre, 92220 Bagneux, France, or the survivor of them, twelve thousand/ ($12,000.0~~0)tt dollars to be ~j ~ OUO Q0.W divided equally between them. 1 ~,-J. To Brigitte Kopf, Lindwurmstr 145 Munich (Phone No. 49-89-766127) the sum offive-thousand ($5,000:00) dollars. To the trustee(s) of the Stanley Family Trust, which I am establishing to benefit Benedict and Roy Maria Stanley and their twin daughters Jennifer and Josephine, the sum of one•hundred thousand ($100,000.00) dollars: The trust documents and other relevant information may be obtained from Marie-Louise Dixon of the law firm Dixon, MacGregor,. Appell, and Burton Page 6 of 11 of Toronto. Phone number: (416) 927-0891. If for any reason this bequest fails, the one-hundred thousand ($100,00.00) dollars shall be retained intrust for the education of Jennifer and Josephine Stanley, up to the age of 25, and administered in accordance with the laws of the Commonwealth of Pennsylvania. On the 2'S`h birthday of the twins any balance remaining in the trust shall be distributed, in equal shares, to Benedict, Roy Maria, Jennifer, and Josephine Stanley. It is my intent that both the principal and interest shall be made available to support the education of the two girls. NINTH: IN TERROREM PROVISION: If any beneficiary or devisee under this will opposes or challenges the probate of this will or any of its provisions in any manner whatsoever, then in such event the benefit or share of my estate given to such beneficiary or devisee under this will is hereby canceled and forfeited, and in such event, I give such respective benefit or share to the Estate. TENTH: CHARITABLE BEQUESTS ~lC. To the Carlisle Historical Society, any commissions, documents, or photos deemed to merit the society's involvement, as long as Bob and Shell-Be agree. To Wat Uppatam Photaram, the Buddhist temple in Tambol Kud Khao, two thousand ($2,000.00) dollars. (Somthavin will know how to do this. See eighth paragraph above for pertinent addresses, etc.) Page 7 of 11 ~C. One equal share of the residue of my estate to Amaravati Buddhist Monastery of Great Gaddesden, Herts, HP 13BZ, UK (Telephone Number O l I -44-1442-84372 I ). If you have trouble with this number you may try their sister monastery in California, named Abhayagiri. The number there is (707) 485-1630. They will tell you how to contact Amaravati. ELEVENTH: RESIDUARY CLAUSE: I direct my Executor, or his successors, to divide the residue of my estate, after payment of taxes, debts and costs of administration, into equal shares and distribute them as follows: l~• One share jointly, to Robert and Shell-Be Shroeder, or the survivor of them. This is over and above the $60,000.00 bequeathed to them under Specific Bequests, above. B. One share to be divided eaually between the three chilrirPn of Rnhart Aid Shell-Be Shroeder who survive me. (To: Michael, David and Stephanie, I/3 of a share each) ~/~v/s ~~. y , ~ , t ~.,1 3 ~ '~~ C. One share to Tomoko Shroeder, daughter-in-law of Robert and Shell-Be; should Tomoko predecease me, her single share shall be given to her daughters, Jennifer and Shell- Be, and her son, Robert per stirpes One share to be divided equally between the three children (Karen, JoAnn and Mikael) of Mark and Michelle Glago. Mark and Michelle live on Parliament Road in Springfield, Virginia (Phone: 703-978-1069). If any predecease me, their share lapses to the Page 8 of 11 survivors within this clause. TWELFTH: EXECUTOR PROVISIONS A. I nominate and appoint my friend Edward. W. Holland, Jr. as Execut or of this Last Will and Testament. If for any reason he fails to qualify or ceases to act as Executor, I nominate my friend Barry Fulton as Alternate Executor. (Address: 261 S Washington Ave., Chevy Chase, MD 2081 S, Tel: 301-588-4944). B. Except for checking accounts necessary for the operation and settlement of my estate, l direct my Executor to invest and reinvest any surplus monies in interest-bearing accounts, money market funds ar short-term bond funds. The Executor shall not invest surplus moneys in any other manner. C. I authorize my Executor to sell at either public or private sale and to lease any property belonging to my Estate, subject to such confirmation of Court as may be required by law. However, I direct that my Executor permit by friend Mija Kim to stay rent-free at my property located at 630 Wilson Street, Carlisle, Pennsylvania for up to four months following my death. D. The house at 630 Wilson Street shall be sold to raise money for the Estate. However, if Bob Shroeder, or Sue Schlegel; in that order of precedence, wants to buy said real property within four months of my death, he or she may purchase it for one-hundred ninety Page 9 of 11 thousand ($190,000.00) dollars, regardless of fair market value. If she does not purchase the property during that time, it shall be sold for fair market value and the proceeds made part of the Estate. E. I authorize my executor to undertake and pay for any travel and lodging expenses plus reasonable per diem for himself or others that may be reasonably necessary at his absolute discretion to carry out the purposes of this my Last Will and Testament, including but not limited to the distribution of bequests in person. E. I direct my Executor to contact the Law Offices of Paul Bradford Orr, Paul Bradford Orr, Esquire, 50 East High Street, Carlisle, Cumberland County, Pennsylvania, to act as Attorney/legal representative for the Estate. THIRTEENTH: I direct that no bond be required on any Executor nominated in this Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of eleven (11) typewritten pages, each identified by my signature, this ~ i ~' day of March, 2002. ~~'''~ ~ ~ (SEAL) Terry B. Shroeder Signed, sealed, published and declazed by the above-named Testator, Terry B. Shroeder, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. Gr o .Cutler ~1 ~ ~~ April L. Deatrick Page 10 of 11 COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF CUMBERLAND ) I, Terry B. Shroeder, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the insttutnent as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by Terry B. Shroeder, the Testator, this I I ~`' day of March, 2002. - ~ v (SEAL) Notarial Seai Heather L. Smith, Notary Public erry B. Shroeder, Testator Carlisle Boro, Cumberland Coun~ ~~~~~~ My Commission Expires Apr. 7, 20 3 ' Member, ennsylvania Association of Notar es Notary Public COMMONWEALTH OF PENNSYLVANIA ) . SS. COUNTY OF CUMBERLAND We, Gregory L. Cutler and April L. Deatrick, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Last Will and Testament; that Terry B. Shroeder signed willingly and that he executed it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affumed to and subscribed to before me by Gregory L. Cutler and April L. Deatrick, witnesses, this ~ {~ day of March, 2002. (SEAL) Gre~6ry/L: Cutler, Witness Notarial Seal Heather L. Smith, Notary public Carlisle Boro, Cumberland County ~ . / / NY Commission Expires Apr. 7, 2003 ( J b'emtrer, Pernsylvarna A~sociatiort'ot r~!otaries ,/ (SEAL) pril L, Deatrick, Witness a Notary Public Page I 1 of 11 Register of Wills of CUMBERLAND County, Pennsylvan Certificate of Grant of Letters No. 2002-00350 PA No. 21-02-0350 ESTATE OF SHROEDER TERRY B Late of CARLISLE BOROUGH , Deceased Social Security No. 567-42-8326 WHEREAS, on the 8th day of April 2002 an instrume~ dated March 11th 2002 was admitted to probate as the last will of SHROEDER TERRY B late of CARLISLE BOROUGH CUMBERLAND County, who died on the 3rd day of April 2002 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to HOLLAND JR EDWARD W who has duly qualified as Executor(rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 8th day of April 2002. ~: egi er o i s **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) r '- , ~ ~~~~ ~~.'F~:i~..., '~'~,~,,~-ST W~~, AND TESTAN~,ENT .: ~ ~ ' ~' ~~ ,` OF ~ ` ,.. TERRY B. SHROEDER ~; ~~~ ~airlisle, Gwmherland County, Fe~s~+Iv~ia, being of sound amd r. ~~Staading, do hereby make,: publa~sb: ~~ d~cla~te this to ~be ~y . ~; .~#~' ~Y. revalcing a~~ other wills and ccx,Iicils heretc~fare made by use. r''~.w,~ied, I have no children, IiYin~ pr deceased. ~~,:t ~~ ~ ~ . }~ parents are deceased. I have ome s~b~g, my half brother Rola~rt 4~~~ ~; ~himgton: ft ~J~J .. R:: - - -~ir~t m Fx~c~tar to aY ~ Jas#:~b~ss final . x Y P Y wing the ~xpe~es of ~~~'° r. ral expenses in such amount as:he c ~ prQp~r, ~~a~ regard ,..5 , or rule of spurt which this dire~ticti .may superce~ie. (Nate: ~ oaf yh; 3~ aalth insurer has been Medicare; INy secondary inst~ret~ is ~ct~a, `'. ~~4:005$. My tertiary is the Fcu'~~~ Service ~erteftt Ply, ~.D., . K i Pa~~ 9 of l l } COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0801 RECEIVED FROM: REV-1182 EX111-981 ~~ PENNSYLVANIA ~ I's ~UG 2 ~ ~~ ~~ INHERITANCE AND ESTATLI AX ,i ` i OFFICIAL RECEIPT ,~._,~~...~.:-..-I~:~~~ D 0015 3 9 ,. ORR PAUL BRADFORD ESQUIRE 50 E HIGH STREET CARLISLE, PA 17013 ACN ASSESSMENT CONTROL NUMBER fob ESTATE INFORMATION: SsN: 567-42-8326 FILE NUMBER: 2102-0350 DECEDENT NAME: SHROEDER TERRY B '' DATE OF PAYMENT: 08/ 19/ 2002 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 04/ 03/ 2002 AMOUNT 101 ~ $75,000.00 TOTAL AMOU~JT PAID: 575,000.00 I REMARKS: PAUL B ORR ESQUIRE C/0 PAUL BRADFORD ORR ESQUIRE CHECK#1008 INITIALS: SK sEAL RECEIVED BY: ~ MARY C. LEWIS ', REGISTER OF WILLS TAXPAYER <. REV-1502 EX~ (688) r COMh40NWEAlTH OF PENNSYLVANfA INHERITANCE TAX RETURN RESfDENT DECEDENT SCHEDULE A REAL ESTATE ---- ESTATE OF FILE NUMBER TEf2RY B. SHROEDER 2002-00350 Ail real property owned solely or as a tenant in common must be reported at lair market value. fair marital value is defined as the price at which properly would be exchanged between a wilting buyer and a willing seller, neither being compelled to buy or seU, both having reasonable knowledge of the relevant fads. Ral property which is joiMly~ownsd with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH (If more space is needed, insert addRionai sheets of the same size) 1099 REPORTING FOR SALES OF REAL ESTATE OTHER THAN PRINCIPAL RESIDENCE ~ ~~ j or machine print FILER'S name, street address, city, state, and ZIP Code 1 Date of closing (MMDDYY) OMB No. 1545-0997 PROCEEDS FROM Frey & Tiley Law Office 5 South Hanover St. Carlisle, PA 17013 FILER'S Federal identification No. TRANSFEROR'S identificatior 25-1730538 ~.5 - (o (p y ~{ t Type or machine print TRANSFEROR'S name (first, middle, last) Estate of Terry Shroeder Edward W. Holland. Jr.. Executor Gross proceeds Address or legal description 10 Wilson Street 'Irlisle, PA 17013 -074 12/13/02 202 190,000.00 Street address 50 East Hi h Street City, state, and ZIP code 4 Transferor received or will receive property or services Carlisle, PA 17013 as part of the consideration (if checked) ~~ I I Account number (optional) 5 Buyer's part of real estate tax (See Box 5 on back) REAL ESTATE TRANSACTIONS For Transferor Department of the Treasury -Internal Revenue Service Solicitation of TIN Seller is required by law to provide the Attorney/Company with his/her correct taxpayer identification number. If correct taxpayer identification number is n provided, he/she may be subject to civil or criminal penalties imposed by law. INSTRUCTIONS For sales or exchanges of certain real estate, the person responsible for closing a real estate transaction must report the real estate proceeds to the Internal Revenue Service a furnish this statement to you. To determine if you have to report the sale or exchange of your main home on your tax return, see Form 1040 instructions. If the real estate tr was not your main home, report the transaction in the applicable parts of Form 4797, Sale of Business Property, Form 6252, Installment Sale Income, and/or Schedule D (Form Capital Gains and Losses. Box I.--Shows the date of closing. Box 2.--Shows the gross proceeds from a real estate transaction. Gross proceeds include cash and notes payable to you and notes assumed by the transferee (buyer). This does not include the value of other property or services you received or are to receive. Box 3.•-Shows the address of the property transferred or a legal description of the property. Box 4 --If you received or will receive property (other than cash) or services as part of the consideration for the property transferred, this box should be checked. The value of any property (other than cash) or services is not included in Box 2. Box 5.--Shows any real estate tax on a residence charged to the buyer at settlement. If you have already paid the real estate tax for the period that includes the sale date, subtract this amount from the amount already paid to determine your deductible real estate tax. But if you have already deducted the real estate tax in a prior year, generally ronnrt rhie amn~mr ac inr•.nma nn the line for 'Other Income" on Form 1040. For more information, see Pub. 523. U CORRECTED (if checked) FILER'S name, street address, city, state, ZIP, and telephone no. 1 Date of closing OMB No. 1545-0997 Frey and Tiley 5 South Hanover Street 12/13/2002 ~OO^ Proceeds From Real Carlisle, PA 17013 2 Gross proceeds ` Estate Transactions 717-243-5838 $ 990000A0 Form 1099-5 FILER'S Federal ID number TRANSFEROR'S ID number 3 Address orlegal description Copy B 25-1730538 75-6644048 630 Wilson Street, Carlisle, PA For Transferor TRANSFEROR'S name, address, and ZIP code Est. of Terry Shroeder Edward W. Holland, Jr., Executor 50 East High Street Carlisle, PA 17013 Account number (optional) FOrm 1099-S (Keep for your records.) II This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other 4 Transferor received or will receive property or services sanction maybe imposed as part of the consideration (if checked on you if this item is • - required to be reported and 5 Buyer's part of real estate tax the IRS determines tha $ 955.93 Department of the Treasury -Internal Revenue Service Certification Under penalties of perjury, I certify that 1 have completed either Section I or II above; that all the above information is true and correct as of the end of the day of the sale or exchange; and that I acknowledge receipt of a copy of this statement. Seller Seller DEC-12-02 11:33 AM FREY&TILEY 7172436441 P. 02 1 ) 1. FI1A Settlement 3tatem nl - U, nt of Noualn n0 Urban Develo em Form U9 HUO - 1 Pepe ho. I ) 2. Fln-tA g. File Number 7 loan Number e. MOrt9Ati`t Intur~nce ( 1 3. Conv, Unlna. Csee kumber ( ) a, VA Cam. Ins. C, Tn~61um1 is tarnished 10 plVe you a austemertl of aolual aet6emenl Ceats. Amounts pall 10 one M the settlement ¢8•nt pro BnOWn. ItemB marked •(p.p.c.J' were p.tto outelod 01 No clc sm7, they u• shown hero for inlormllGOn•I u sea end ors na1 Ir~luoed In the lotel6. D Name Rn0 Aeeress of ronower. E, Name one Address pl 8eU•G William R. 8chlppel lrtate of Tsrry Shro4ider Senrittta s. echleQel !award FP. Hollwad, Jr., sxacueor 630 Wilson 9tra.t 50 last High street ct-rxisle, oa 17013 Carlisle, ea 17013 __ _ TIN F Name enp Aeruess 01 Lenuer 7lraerican Home sank, N.71. H. $•nerr: Ssntemenl Apant. rreY 6 Tiiay Lew Ot'f iCe 5 South Hanover 9t. '~N 75-1730578 Cirliele, P7- 17013 ,~,- U`zMMARY OF BORROWER`S TRANSAC~,~ 100 Or1us Amoum Dw From sorrotw•r 101 COnuea gala aria tOZ ~araural property 107 SaMxmenl charQen Irom Arne 1400) tw +95 AdluB6uerlfs rot hems paid DY tags, In advance: tae Cityltewn texr.• 1213/02 l0 12/31/02 107 County rases tae Ae669f mdnls 109 110 Scnatl laxas V?h Y02 to W30/03 n1 112 110 arou Amount Duo From Borrower G Property Location 630 Wilson Btreet Carlirla, Pa 17013 I. Sel6err»nt Dala: Piece of set IertlenC bseember 13, 9007 5 Boutkt Hanover ritrsat: Cwrlisle, F1- 17013 400 Oroaa Amount Due To 51111f 190, 000 . DO 401 COnlract Selee Once 401 Personal property 3, 632.25 403 4ad 406 AtY/uahnalls rot trams paid by Beter rn adverse, 0.00 408 Cnyhown taxer: 1?/13/04 to +2,3+/02 407 County taxes 4ae Assrssments dOB 0 .0 0 410 School taxes 12/10lOR to 8/30/03 111 412 193 , ~ 39 .96 470 Oroee Artwunt Oue to Seller 190,000.00 0,00 Or00 190,000.00 aeaaaaeaaaasas 200 Amounts Pdd 0y Or in Qehslf Of ISerrow~r 101 Deposl~ or eantaet money 207 Pnnclp.tl emounl of new loan(s)" 203 Exr6Uny l0an(8) Idxan eubled to ?~ 105 206 29r Rent proratsoa BYaa I;va~o~rl",1 : t, ;:003 206 :rat,4ier or aevurity eepvatt tv rvrrower 209 Adjusrmenrx /or Verna upold by seller 210 CIIyAOV,n taxes t/U07 10 12110,/02 311 CWllly 14xd6 211 Ataeaenerua 717 2 u Sct rc7vl •exes 7r I rot to 12/13,02 215 218 21~ 218 218 220 Tolel Pllld By/For 6errewer O.OD 1a2,500.00 1,733.87 p.O.C., 113,733.A7 500 Neduetlons In Amount DuR To 6slter 501 Excess dapasit (su Instructions) 607 Settlement atler8•s la collar (Irne 1400) 603 Existin8 loan(s) token subJact to brit Paydl of lirsl mort0apv loan 6116 Payafi al sacone mprtpppe loan 506 5a71tent Oreraesea leoar L'~aemt,.v '..1, zoo! 508 Tzaaezer of 9aeukily DaDeasp CO ioss•r•s 508 Ad/UBrrnenre /or Berns upald 6y flUp 510 Cuynowntexea vtro2 to 17/13/x2 511 County taxes 612 Aecesementa 613 514 Scholl taxes 7/1/02 l0 12/13/02 515 51e 517 51H 51B 120 Total ReduvUvna to Amt Dus 3elisr .f0o can AI BetWmenl FrornrTO eorrOWSr: 301 On1ve 8n0un[ uue Irom bovawar (ono 1701 aUZ LYSS an,oyntt pRW by/for borrower (Item wn• 770) '501 Ca•1` lxl Flom ~ ~ Te serrovr¢r 600 Caen At Settlement raRrom 8•tl•r: 193, L97 . 76 801 (,:raww gmpunt to serN, Irom hens 470) (103 733 . B7 802 Less reductions in amount uue seller (Irom Ilse 520): • 9, 69 Q . 3 B 603 Cuh OFrom (X) To Seller a.oo 1,900.00 1,933.87 A.O.C. 3,133.97 ------.=~=.a•. 190,000.00 _(3, 133.117) 186,866.13 .- -....vWasaa DE•,C-12-02 11:33 AM FREY&TILEY 7172436441 P. 03 L. slTTI,EMENT CFIARGE5 700 TotAl Sala`/Brolurs Comm, based on price: aro, ooo. oo ~•o • 00 OA•lilon O! CAmmliilpn (IMB 7r70) Ai /OAOWB' / 70f (0 NA 702 In 7U] 70a Comniss~ou pad at Battlement 705 1'iD0 Items Peyebts In Connectlan Wlth Loan: (MwlDayv Ai11C 142,509.001 Totfll chirpei, Unva 801 INOUgh B 0.00 901 Lunn Orlya+iuron Fee .000 k t0 907 :ear Dtscourtt .000 k to 801 Apur7lAAIFee to 904 Credl Report t0 905 Cenaens m:FSCtion Fee to 909 Montage insurance Appncel~on Fee to 901 A9eumphun fee 10 909 Tax 90rViCe COAtracE t0 909 Flood Certification lee to 910 7JOCWneAt Fr~>7aration i.e to 91 t to Sao Items Aequlred ey t.ender To tae Pald In Advance: DOt inten~at From 1~-Deo-07 to Q 0.00000 per day . D02 Mor'tyie0e In3umnee premium for monlhc to 903 w5,e~d in6ur•tnce Prernlum for 1 years to Dw years to 905 loco Reserves Deposited With Lander: Toal RaNrvea, urtulool thorupn loos: 1001 Ma:a-d msu.pnro moc~ d Der month ta02 MortEag. insurance mos. a per month 1009 Cily propdrty lazes MOs. OP $0, QQ per month tow r•,oumy praporry rexei mos. ® par mvnih 10D5 Annutleaseisrnents mm. ® per month 1009 m06~ ® paf month 1007 6rnn+l taxes mos. ® $0.00 per month loos 1-ggrapste aettlemeat Adjustment mos. ® per month ,too Title Charged: +101 3dntEmenl or clusiny Iva to 7102 AU81r.7C1 O~ tr;le starch Id +103 Tdld ~rr,ammduon to t 1w Tilts niurence bindar to 1105 L)xwnvnt pnrperaUOn ip 1109 NOlar/ lees 10 1107 AttOri ey'e lens to LsW O!li0e/ Of Paul 8radlosd Orr (m01u Je9 Abuve items numbvro: 1109 T,ua I+suranca to sr.y 4 Tilay, Attornaye at Lew IinmuJes above hems numbare~ 1109 Lender's Coverage 6 147, SOD ICadoseemeate 1 1n0 Owne 6 Cvveraga 9 1901000 tu1CloWinp service LeEter to Conul7onwesltb LAad Title In^uranoe Co. Itt7 1.13 Ov^rtaiyht dslivary te.^ ,zoo Government Recording and Transfer Charge o..e P•0••: ~ Mit) papas,: ,701 Raoord,np leas, Daed 63e . SO MOr19aDv; S Releases +2a7 Crtyrcwnty/stumps: Deep 0111100,00 Mvrtpape: $ +209 3tAle :Art/eterr,ps~ Geed $1, 900.00 Monpepe; ~ r?oo +JoS t3oo Additlonpl Battlement Charges; +307 Survey to +ao7 Poal Inipemrc^ to 7303 Currant Taxva due Irom Borrowvrr&v0er 1301 FStaa1 water bill to Carlisle 8vronph, 1laoount No. 1305 I JO6 1307 1400 Total Settiemsnt Ch~trgee (enter Onltnas 103, Section J end 602, Section K) pA9a No Peitl Frpm Pele From 700 BorrewePa BetNr'a Funee et Punveet lot eetttement Sottbmant 707 70~ 704 705 soc o,oo 0.00 a,00 A.O.C. 1,456.75 35.00 38.50 11900.00 P,O.C,I ao, so7 j 803 9041 eos 606 807 809 909 eto 911 Dos 801 602 D03 901 DOS loco +001 7002 +003 tooa 1005 +por +009 1 t~ 1101 ++07 ++03 1104 1705 11~ +107 1108 1109 ++10 t+t+ 7+t7 1713 lzoo 1701 t70~'. 1,900,00 1203 120s tzos 1100 1801 YP7 3,t3Z.95 1/900.00 101 306 306 307 ~_ J ,. ~E. Ht~lb-1 ~~NIG,... SEPTEMBER 12, 2002 PAUL ORR RE: WILLIAM & SUE SCHLEGEL DEAR PAUL, BASED ON THE CREDIT AND INCOME I HAVE REVIEWED FOR WILLIAM & SUE, THEY ARE APPROVED FOR A CONVENTIONAL PURCHASE IN THE AMOUNT OF $190,000. THIS APPROVAL IS SUBJECT TO A SATISFACTORY APPRAISAL AND AN UNDERWRITERS REVIEW. IF YOU SHOULD HAVE ANY FURTHER QUESTIONS PLEASE FEEL FREE TO GIVE ME A CALL. SINCERELY, ALAN DAVIS, LOAN OFFICER 385-5166 CELL/V.M. 245-0580 HOME s~~ ~~~ oc~C 3(~ z~oz DEG,-A3'02(TUE) 1506 BARRETT REAL ESTATE TEL~717 243 8627 P, 001 SUMMARY APPRAISAL REPORT SMALL RESIDENTIAL INCOME APPRAISAL REPORT ~.. ~e°, Pro Address 630 Wilson eel C Carlisle Stale Pq Z Coda 17013 ~ L al Desal ion Deed Book W- a 804 Count Cumberland Assessor's Parcel Na 04-22-0481-07d Tax Year 02/03 RE, Taxes S2 482 S AmessmeMs 5 NIA Ne' hbtshood a P ed Near 13orou h of Carlisle Ma Reference 22-0d81 Census Trail 0124.00 „ Borrower SCHLEGAL Wm../ enrletta CunentOvmer Shrceder Ter 8. Ocar ant; Owner X Tenant vawnl Pro d his raised X Fee Si a Loasehokl Pro'edT o PUD Condominium HORS NIAIMo. Sales Price 5 N!A Date of Sale NIA d S amatnt of ban eslmnrasagna to be aid selerN/A Lenda/Gient Ameripn Home Bank Addtasa 905 stelle Drive Suite 101 Lancaster PA 17601 A raiser Stan A. S owron k A Loptbn Urban X Suburban Rural 6u1t up Ora 75% X ZS-75% Under 25% Growth tale Rapid X Stable Slow ddnas 128 North rredominant stn9le Family neoupaney ©Owner 95 Hanover Street Carli Stngletamllyhouatng PRIC AG S (~) (Yre~ 120 Law New sle pA 1 013 Predominant 21 Pamlly Occupancy ^ Owner 2~Cjamltyhausing PRl l: AGE i (000) (yrs) 90 Low Mew Property slues Increasing ^ State Declining ^ Tenant 350 Hi h 100 QX 7enaM 95 225 Hi h 100 Derr®nd/wppy Shortoge X Inhalsrroe Orerwppy X Vaoat (0$,6) ~ ` .: '• predominant • • X Vacant (65.6) :: ~ •~ Predommant ..: ~:. Markelin time Unda3 mos. X 5~ rros. Over 6 rtros, vas. taw ~ 180 40 veon rover sx 150 40 Typical 2J family bldg. Type Detached No. aloros TWO No. units 1-4 Age 50 yrs. Typ'rgl rants i 500 to S 800 Inurasng stable Dad'ning Est. neighborhood apt. vacancy 0 S6 Inaeasirp QX Slabls [] Ded'mkrg Rent wnlyds [~ Yes QX No~LTcaty lfyacaNkay,dearnbe Present land use M. One burly 70°!0 2~ famly 2% MuflHamiy 2°~ Land use ehanga ^ Not likely ^ Likely QX In prouss to Residential Comlterciel 15°h Vacant 11% Note: Race and the racial eomposltlon of the neighborhood are not appraisal faMOrs. Neighborhood bcundariesand oharaclerisiid: Sub-ect is bounded on the north b Hl h St and on the east b East St on the south b Walnut Bottom Rd and on the west b Belvedere St. Factors that affect the marketability of the properties in the neighborhood (proxim'dy to employment and ameniliaa, employment sfabrlily, appeal to market, etc.): There are no adverse factors to affect marketabill of sub ect, D'verse stable em !o ment and all su ortin amenities are within eas drivin distance. SMsA 3 40 The fclowig avaiaHefelfngs repreaeni the most current, simia, and proximate mmpetilive properties tv the wbjed properly in Iha subject neighborhood. This analysis is intended to avduala Iha krreMay nareraly on the rtarkel ~rpe{irg with the wbjeed propery In the subject neighborhood and recent pace and marketing rims Vends alFsding the subject properly. tin s aulsida the wb'ed ne' hbarhaed are no con Idered a ble The lislin en grades can be the rental le wm stables if the are eunenll for sale. ITEM SUBJECT COMPARABLE LISTING N0.1 COMPARABLE LISTNG N0, 2 COMPARABLE LISTING N0.3 630 Wilson Street Address Carlisle 117-119 W. Loather Street Carlisle 337 York Road Carlisle 344.346 E. North Street Carlisle ProxknA tosub'act :,:ctX`°.,,°t`'.>•'od'>'.'': = 1.03 MI ENE 1,d0 Mf ENE 1.58 MI ENE Listin 'co 3 N/A X Unf, Fum. S 135 000 X Unf Fum, f 149 900 X Urd. FUrr~ f 159 900 IeGBA 3344 3388 2144 2812 Data souru Ins ion MLS/Courthouse Records MLS/fourth use Records ifuruWlolmsJ8R18A d'12' d' d.00 4' 13' S' 4.00 4' 9' 4' 5.00 4' 18' 8' 6.00 ' to bait 1900 1900 1950 1900 der onmalket N!A 152 00 180 l:ompar"sanoflistmgalo wbjed property. Listin art is inferior as to r~nditio R is su crier as to number of rooms/bedrooms_ Listin *2 is inferior as to GLA condition and number of rooms. It is su erio as to number of baths. Listin *3 is Inferior as to GLA and condition, h is su er r as to number of rooms/badrooms. Market condillons that affect 2-~ family properties in the subject neighborhood (including the above neighborhood indicators of growth rata, properly values, demand/supply, and marketing lime) and the prevalence and Impact In the subJeel market area regarding loan discounts, Interest buydowns and Conceasiens, and idontifiralian of fronds in Ihling prices, average days on market and any change over the past year, alp : Research of recent sales of 2-4 unit ro roes for the first three ca a der uarters of 2002 Indicates an avers a markitin time of 151 der s. Interest rates are retativel low• therefore few loan concessions are offered. Anal Is of the der s on the market and consideration of current economic trends indicates a demand for Investment erties in this rice ran e. l?imensbra See I al descri lion Silearea .50 Acre roll Coma lot No Yes SpoClft2onlflg dessSxaiion and d qn R-1 Low Densi Residential Zoningoorrtpliarke XQugal ~Legatrg4c~oati4g(Grsrrrallraduat) Illegal Nomnkig Highest 6 bast use as lmprwed: QX Pnsen! use ~ Other use (explain) Topography Basicall Level Size T 1Ca1 for area Shape Redan ulcer Drainage A ears Ad uate View Residential Lsrrdscapirg Avers e Utllidea Public Other ~eelridty X Gas OR-91te Improvement Type PVrbOc Pri~raaU Street Macadam ® tx4rblgutta Concrete X Driveway Nona Apparenl.asemenis None A arent Water X Sanitary sewer storm sawar X Sidewalk Concrete X Street lghls Adequate X ALL ens FEMA Special flood Hazard Aroa Yes X No FEMA Zone C Map Dale 02/05/82 FENIA Ma No. 4253a200D4H Comments (apparent adverse easements, enaoachnrnts, epeeist eaaeaamento, aliderareas, ilsgal or legal nonconforming zoning, use, etc.): There are no a accent adverse ease ents encroachments or other adverse condillons. "tsddia Mac Form 72 10-04 Par.F 1 AF 4 amr~r_~ rCtliutN I IAL INCOME APPROISOL REP[71RT Genersldesulptton UnitslWdga 411 Stories 2 Typo (deltaic.) Detached Design(slyle) 2 Sto ErdAigtproposod Existin UndermrMnxlion No YearBuit 1900 Fdedireage(yR.) 10-15 - - - Eraerturdeaaiptlon (MaterialalWndilion) Foundation StonelAv Extarbrwells Brick/AsbestSh I/A Rootsurface AS ha1VAV Clltters8dwnapts Aluminum/Av rYrndrnrtype Double h n /A SlamsaeNSueee Thermal/Av Marwfaduradhousing• - Yes X No '(Corrrplieawih the HUDMawfaduredHouaing - - - - - Foundation Slab None Crawl apace Partial Sump Pump None Dampness None Obs. Settkmanl None Obs. Infarfalion None Obs. BaeemeM SO ~of1stllocrarea Baserantfiah 0°A VLV`JO ~ Insulation (R+~alietlarorm) X Roof ~ Cei'~ng ~ WaUs Floor Kane Adequacy "RFactorUnk EnergyeRicienlien>,: T Ical fora a and Good C onditla n Consfrutli onandSaF al Standar ds. condition Unis Lerel a F r Live Dinin Ktcfien Dan Farm rm ed rooms f Baths Lawn Other S , t1,Arni( Total W 1 1 1 1 1 944 94d 1 1 1 1 1 f 728 728 1 2 ~ 1 1 1 944 944 1 2 1 1 1 1 728 728 I ements con 'n: 12 Rooms; 4 B adroo s ~ 4 B s 3 344 S are feel o{ GROSS BUILDING AREA GROSS BUILDING AREA (GBA) IS DEFINED AS THE TOTAL FINISHED AREA (INCLUDING COMMON AREAS) OF THE .' IMPROVEMENTS BASED UPON EXT RIOR MEASUREMENTS. ' surfaces (Malerials/mndition) Floors HardwdNin I/Gd walla D all/Gd ~ TrirrJfinish Woad/Gd Bathlloor Niv IlGd Flsating Type FHA Fuel Gas Condition Good Wtohenequlp. (flunicond.) Retigeradn 4/Good i4argsWn d/Good Disposal D"aisreatar 4/Good Attie Noes Slain Drop alai Scuttle Car3loraQa No. Cara 0 Garage Carport ^ ARaehed ^ Odached ^ Balhwahsoot DW/CerT/Gd Doors Wood/Gd Good Condition Fire la s Nohe rY Coollnp Central Yes Other None Condtion GOOd Fanfhcad 4/GOOd Campada Wmhaldys• Microwave 4/GOOd Intercom Roor Heated F'Nahed Unfln'rshed Adequate ^ Inadequate o Otistreet ^ Nane ^ Conditon of the irtprovsmanla, repais noeded, qualdy of conslrudion, addtlional Features, modemVation, etc.: Im rovements are in ood eoridition with no h sical ar functional inade uacies a scent. Depredal'an (physieaL fundional, and e~demal inadequacieR eta}There are tto h sical functional or external inade uacies a scent. ~ Adrene environmenlai conditions (such as, but not limited to, hazardous wastes. laxie substances, etc.) present in the improvements, on the site, or in the immediate vicinity of the subject property: No adverse environments eand'Rions area arent/dlsclosed. VALUATION ANALYSIS ESTIMi1TEDSITE VALUE ............................... =S 30 000 ESTIMATED REPRODUCTION COST-NfiW OF IMPROVEMENTS: GBA: 3344 Sq. Ft. Q S 55,00 =S 183,920 @ S 8.00 =S 6.688 Ft Basement 636 s Comments on Cost Approach (such as, source of cost estimate, site value, square toot calculation and. for NUD and VA, the estimated remaining economic life of the property): Cost neW from Marshall Swift Valuation Service Ha dbook and Iocai cost anal is, Land q. . Ft ~ S = 5 Sq value from Market Data Com orison.. De reciatlon based on . . Q S =S Ft S a e life observed condition and Market Data Anal sta. . q. s Ff G S =S Estimated Remainin Economic Life is 4D~5 SEE q, . S ATTACHED SKETCH ADDENDUM. =S =S =S =S Elriaard Rene None ' S er i l E e S gy a n pec stoap ° S 5,000 Porch entrY ate Pales h P . . , os, ore = S 195.608 t N d C t E i aw . . . . . ........................ os ms e Total el 7damal Ph sical Wndional F y L . ess 35 000 ~ bti D 0 0 = 3 35,000 , on eprec rore ted Valus of Im d D menir} ° S 160 608 . . ................... p epre a = s 5 ODO lue of Sae Irr rovemanls ' V 'A I ........ . . ............ s a p s INDICATED VALUE 8Y COST APPROACH ............... ~ S 185 608 . __ _ _. r'eMla Mae roan 1025 70-94 nWWwOUYe 14e,eY GYlal5aleei~..q~r.IrrlN.rRr wroaemYh,eLMa SUMMARY APPRAISAL REPORT SMALL RESIDENTIAL INCOME APPRAISAL REPORT Dz-0981 AI least Ihrae rental comparables should be reported and analyzed in This section. The rental comparables should represent the oast current rental information on properties as simgar and prolrimaia to tho subject property as possible, (This eompar~on is based on currant rental Bats, thonforo, the rental comporeDlas typically are not the same compareblas used in the sales comparison analysis.) Tha appraisal report should assure the reader That the units and properties selected as comparables are comparable to the wbjeG property (both the unite and the were!! propaAy) and accurelely represent the ronlai market for the wbjeel property (unless otherwise staled wdhin the report). ffFJvl SUBJF~T COMPARABLE RENTAL N0.1 COMPARABLE RENTAL W0.2 COMPARABLE RENTAL No. 3 Address 830 Wilson Street Carlisle 13d W. Loather Street Carlisle 132 S. Hanover Street Carlisle 146 W. High Street Carlisle Prolamity to subject _ ~?~.; :~ 0.91 MI NE 0.84 MI ENE 0.82 MI NE Leasedatee avalabia Month to Month Month to Month Month to Month Month to Month Rentsttrve date 11/29/2002 11!29!2002 11/29/2002 11/29/2002 Data source Courthouse Ins ectipn MLS/Courthouse MLS/Courthouse MLS/Courthouse Rent concessions None None None None Wo. Va4 0 hlo. Unts4 Na Vac 0 Yr,li 1900 Nc uNa4 tra. Vac 1 Yr, Bt: 1900 Nc Unh4 No. Vac 0 Yr.Itt: 1900 Description of Yr. Blt-' 1900 property-units, 2 Ste Detached 2 Sto Detached 2 S emjDetached 2 Sto Detached design, appeal, age vacanc~es A t, Bld A t Bid A Bld A t. Bid . , , and conditions Good Condition Avers a condition Avers a condition Avers a condition R m. Count S¢e R m C ourn S'¢o Tasl R m C wrd Sao Tow R m, c ount sae total Tot & Ba 5 . Ft_ Tot & Ba 5 . Ft. fret Tol & 8a , R. Red Ta Br Ba S . Ft. Red Individual 3 1 1 9dd 5 2 1 868 d05 3 1 ! 652 295 3 1 1 1052 500 unit 3 1 1 728 6 2 1 99B 485 d 2 1 888 350 4 2 Z 1404 500 breakdown 3 1 1 944 5 1 1 776 365 3 1 1 652 320 3 1 1 1052 350 3 1 1 728 3 1 1 444 300 4 2 1 652 360 3 1 1 1052 350 Wat er Sewer Water Sewer Heati Wat er Sewer Trash Elect. Water Sewer Trach Elect Utilities Heatin , ftaniture, and amenities inducted ~ rant Partial Basement Partial Basement Partial Basement Full Basement cti l tilit F FHA/CA HWStealllMone EBBMone HWSteam/None ona u un y, basement Poroh Porch Porch Porch , heatinglwoling, On Street Parkin 3 Car Gera a Off Street Parkin Off Street Parkin - project amenities, etc. Analysis of rental data and support for estkmted market rents far the indNidual subject ants (ndud'mg rho adjustments used, the adequacy of comparables, roMal cancessiona, Nc.) .~ Rental fiN is fetter as to GLA ammenities such as central alt eondkionin and condition. B is su riot as to number of rooms/bedroom and era a availabil .Rental *2 is inferior as to GLA and ammenltles such as central air conditionin It is < su crier as to number of rooms/ rooms and arkin .Rental tY3 Inferior as to condition and ammenities such as central air wnditionin . It is su riot as to number of rooms/bedrooms and arkln , SubjeeCs not schedule Tha tool schedule teconcdes ih• applicable indicated monthly market roots to the appropriate aubjed Holt, and proridea the eslimalad roofs for Iho wbjod property. The approisor coral renew the root eharaclerislics of the cotnparehle sales to determine whether estimated Hots should reflect actual or market coals. For example, 'd actual roots ware avagabls on the riles compaables and used to der'ne iho gross rent multiplier (GRM), actual rents For the subject should be used. If market roots wore used to construct the eomparables'ronts and derive the GRid, market rents should bs used. The total gross sslimaled rent must represent rent charadedstiu ooaaislenl wth the setae narQaratrb data used to derive {he GRAA. Tha total Orasa eetknatad rern is not adjusted Pot vapney. LEASES ACTUAL ES71 ATED RENT S ease Dale ns. Pa U t Total Per Unit Total Und in E d v i Un rnished Fu fished is Unbnnieh Furnished Rents 1 Month Month 0 S 550.00 S f 550.00 S 550.00 S S 550.00 1 Month Month 0 525.00 525.00 550.00 550.00 1 Morrttt Month 0 625.00 525.00 550.00 550.00 1 4 Month Month > :..tts~~'.#~~;.~.. y.^ 0 0 525A0 ~~°<.a;<' µ sa, <t~a M^ > .. 525.00 Z 125.00 • 550.00 :.SC~ r:~f%a.;~° -, ~~.i: '~i~tc' .... .R 550,00 S 2 200.D0 S Othrmorshlyireana(lerrce) None Vacancy: Actual last year Unk X Previous year S !6 CJlimaled: 5 :6 S 1 320.00 Mnuahy Tow gross esfirrolod tool S 2 100.00 Ulfdias inducted in nFuroted Hots: Fredric ©Watar XQ Sewer ^ Gss ^ 01 Trash cadeaion ^ Comments on the rent schedule, aclud rants, estimated rents (especially regarding differences betvreen actual and estimated rents), uliilies, etc.: Rent/ex uses a ear Tair far local market conditions. ~eddie Mac Frrm 79 tndld ~"~~ °'"~ ' DEC.-03'02(TUE) 15;08 BARRETT REAL ESTATE TEL:717 243 8627 P. 003 SUMMARY APPRAISAL REPORT SMALL RESIDENTIAL INCOME APPRAISAL. REPORT o2-0sa1 TM undsmiptud Mi roan/ IMie Neea aalu et eraNrllq etMl d1ANV an/ YeaAap le Ne aY1Hat prspsrty and hu duWaad and awryzea tMaa In Ws atrlysle. If tMra b a a1xN11pM rarNWn Mlraah IM suejece end ismpxalla pre(+atlas, tM ms(yab 1seWOtl • e.nar eituasAeM renaeUne Me a+estat nacuss m tMSe Innis a an esplanaaan auppartad °Y tM merbl data. If a d9Nfleanl Ibm In Ae tempaalla property b super(a n, or maN farMHls tha0. tM aullaet MsNrIY, a TInW (-) adlwliteM Ie Aade, toes neucing IM adluita0 situ prln of 1M eamparaele propmty, V^ alpNepH Wm In tai eimprsNa prapany is inrerier te, er lace hverille tM he aul ea fi art tW * 1e YatASw( la ranee. 1Tua Incraaaln Ina ad ustrd rlee of tM ism male r /fl . ~ Sai1a Pflw• 0 fllerl Ran( REM SU9,lECT COMPARABLE N0.1 COMPARABLE N0.2 COt+IPARA9 N0.3 630 Wilson Strcet 148 W. Hlgh Street 132 S. Hanover Street d8~S2 West Pomfret Street Address Carlisle Carlisle Carlisle Carlisle Prozi ' la au 'ed ; . 0.82 MI NE O.B4 MI ENE 0.88 MI ENE Sales S N/A X Unf. Furs S 153 000 X UM. Fum. S 155 000 X Unf. Fum, S 220 000 sales w GBA S 57.42 S 33.55 S 54.89 S b8.54 Grvas trontN reel 2200 1 700 1 325 3 166 C>rods mdl. 1 8.27 80.00 16 98 69,69 Silos w unN S d8 000 S 38 250 S 38 750 S 73 333 Sales m 16000 11 768 S 917 S 2 500 Data andlat Inspection MLS/Courthouse Records MLS/Courthouse Records AppDate/OWner Vdrfiwlion Sources Courthse Rec AQIUSTtdENTS DESCRIPTION DESCRIPTION . _ s DESCRIPTION udmw DESCRIPTION .. x Sales or financing "=<;;,;;; None, Conv None, Conv Non®, Conv concessions DOM 288 DOM 173 DOM Unknown Date of saleAime ;i.'1.' ' : 07120 00 1?l 0/2001 02/17/2000 fi 600 Location Suburban Urban Urban Suburban Le hd a e i I I -m e ~ Sim le SRe .50 AdA .18Ac/Av 2 000 ~.11 AdAv 2 000 .33 Ac/A View Residontial Urban Urban Urban Dosi n and a sal 2 St0 /Av 2 Att/A 10000 SemiDet/A 5 000 2 Sto /Av W ofcorlsWdion Av Brick/Asbsts Av rick Av /StoneBrk i4 18rk/Stn/Fr ' • 100 re 00 rs 100 Yrs 10 Y s Cond'dlon Good Avers a +10°~ 15 300 Avers +10°/a 15 500 Gcod Gross Buddin Mee 3 344 S . ft. 4 560 S .R.' -18 240 2 824 S .ft.' 7 800 4 532 S .R.' -17 820 15 ~ I ha s aua no d Ra mua ~~ ~ ae. mur : W am road rn tr M r°E' a• Tq N Na r"i Tet ar tb w. ~OCi d Ta , & Ns w vac. Un8 1 3 1 1 0 1 3 1 1 0' 1 3 1 1 0• 7 1 0 5 0' breakdown 1 4 Z 2 0 i -2,000 1 3 2 1 0~ 1 4 1 . 1 0 1 3 1 1 0 1 3 1 1 0. 1 3 1 1 0. 7 3 1 1 0: 1 3 1 1 0 1 3 1 1 0' 9 3 2 1 0' 5 000 Basemem des ~ ion Pa rtiallUnf(nished Fu lt BsmUUnfi n ~ Partial/Unfin Pa rtlsl /U ntln Fundlon•I u0' Aver a Avera a Aver a v e e Healin coclin FHA/CA HW/None 5 000 EBBMone 5 000 FH A/None ' S 000 Parkin oNaft Re On street Off Street Off rest i Of f Street ProjedartArt~lesand Porch None 2,500 None 2,500 porch fee da Gcahle i , t t NetAd'. total '' '"0'Y:Z'.]:w.. - 14560 a - X s 7 0 X s 1 220 . •'::: r:~:::x^~ Adj. ribs prim of "° ~ie~~raixta:r $' ~" '"' . > ~ "~"z~~°w• •E "°L "% - ~ - ...t . •< • • a.., 6 580 ~ e 1s Bo .. ~ ::::<::: 216 7fi0 Co»rnenfs on Sales Comparison m uding reconciialion of a0 indicalon orvatue as to ooneislenoy and relative etrcnglh and evaluation of the Iypital inveslar'a/purchaser's motivation ktthat rrarkoig o lue Is 5168 000 to 5219 000. Acre e a 'ust eats a m de 5 000/acre. An ex ended time search was ulred to locate suitable qom arables• however it was within the three ar ti a er(od coeval! acce tad for multi-lam() sales. Time ad'ustment based on data su lied b local multi-list. These aro tho bast sales rim arahles kno to be available. ITEM SUBJECT COMPARABLE N0.1 COMPARABLE N0.2 COMPARABLE N0.3 Dais, Pritt and Data 06/30/78 Sourceforpriaraeks 564,000 None None None arlhin da C u house Courthouse Courthouse Court case Amrys'ts d arty currant agreerneM d sale, option, a tiding dlhs subjad properly and analysis of any pri~atales of subject and oorrpaarrbler wdhh ons year otthd dale M appraaal: No rior sales ithin the ant twelve moMtts. Talal gross monthly estirrrabd tiro( S 2.200 z grog roM tntRipfwr (GRM) 95.00 = S 209.OOp INDICAT®VALl1E BY INCOME APPROACH Comments on income app(oach (including tu~er>ze ratios, f avaiade, and recondidllon of the GRM) The wm arable GRM has a mean of 92 and a standard de iation of 24, sad u n this nil sin retxncil th GRM at a5. INpiCATEp VALUE BY SALES COMPARISON APPROACH , ..................................5 192000 tNDtcATED vALUE 8Y INGOME APPROACH ........................................... S 209000 INDICATED VALUE 8Y COST APPROwcH . .................. 3 195608 .. This appnital ie made ©'as is' ^ tadtjeq lothafe pais• sRar/tion~ FApedions oraonQldrts Glad below ^ subjad to completan per plans and apets'ficalions. CommsMsandCettd3idrAalAppraisat The roe has been a raised in current condition, This a raise! is for mort e u ones enl nontransferable. See atta ed addendum. Foal Remndlelion: trt anal sla Cost and GRM su rt m estlmede of ma et aI The purpose d Ihia appraisal id to ulirrntd the marite! value or tM real property Thal is the subject ar IhB report, bsaed on Iha ebdre t:ondRiona and fha oertifiration, contingent . and limiting conddiorts, and rterkal ralUe dofinRion that aro atated'n the attached keddle Mac Farm 439/Fannie Mae Form 1(1618 (Revised fi/93 )_ 1(WE) ESTIMATE THE MARKET VALUE, AS OFf1Nm, OF THE REAL PROPERTY THAT IS 7 HE SUeJF.G7 OF THS REPORT, AS OF 11!29/2002 (WHICH IS THE DATE OF tNSPECTTON AND THE EFFECTIVE DATE oFTHts REppRT) TO BE S 795 000 . D APPRAISER: SUPEgyfBORYAPPR!(JSEIF(QNLY REpUIRED):I ~- Sgnalun ~ - _ ~ i [fat Sgnalun lhd ^ ®Did Nol dame Stan A. Skowronek Name Steven W. Barrett, SRPA. SRA lnsped Property Data Recut S'tgrwd 12/02/2002 Dab S' nsd 12/0 002 Stale Certification i RL-001572-L Slate PA Slate t:ertifraiion tl GA-000 8-L State PA r SI r M Stab Or State L'axma ~ RB 69 1 A Stale .---- •°--. _....- •- -- cemnea teasiaermat „a.a,d,.,,,,aaa„urs.t;•i...:~:.,7wss,.nr. .wa~a..rr-.ertified General ranma mac ram uuo Haan Appraiser Steven W. BA.ewtt R.F. Ann. c.r., .----~--- ~P-401•AT-11-Warranty Dssd, Short Form. Atl of 1909--Nranysd for Photo-Rscwdlnp Hsnry Hall, Hx., Indiana, PA „_„ <:_~ ~.~ } .. i. . .. I .. .- - . k Lf~ , 1 „ o ~.J~~~ l 1~::1NSFfR ~T~= a l' 1 Cs ~,: t:.. ~~ ~~ iF,X JUH~4'84 .~~,, ? W ~eeb, MADE THE 14th day of June of our Lord one thousand nine hundred eighty-four (1984) in the year BETWEEN MARIO R. BARTOLI, .Single Man, and JAMES C. BARTOLI and JILL E. BARTOLI, his wife, all of the Borough of Carlisle, Cumberland County, Pennsylvania, hereinafter Grantor s , and Thy B, SHROIDER and HENRIETTA F. BEAM, now by reason of her marriage, HENRIETTA F. SCHLE7GEL, all of the Borough of Carlisle, Cumberland County, Pennsyl- vania, hereinafter Grantees WITNESSETH, that in consideration of Eighty-five thousand and ------------------------ ------- ---°00/100 ($85, 000.00) Dollars, . in hand paid, the receipt whereof is hereby acknowledged, the said~ryMf,~.,_._--.~-~^ .-.._1i, nt and convey to the said grantee ~ their heirs and assigns , as equal .tenants in co»mon. ALL that certain tract of land with improvements thereon erected, situate in the Borough of Carlisle, Cumberland County, Pennsylvania, bounded and described as follows: ,, , BOUNDID on the East by South Hanover Street; bounded on the South by West"°~outh Street, bounded on the West by property formerly of Dr. Thomas Stewart., ~`fio~a`oi~`" formerly of the George B. Fagen Estate; bounded on the North by~grgpe~r~ ~ Orly of Dr. Thomas Stewart, now or formerly of the Pearl E. Meily Est~te;~sa .property fronts Tfiirty-one (31) feet, more or less, on South Hanover ~tre~~,..a~,,., Ae~y lYf.:,. .... `~ ,.`~ (90) feet more or less, in depth, BEING improved with a two and one-half story brick apartment house known as and numbered 160 South Hanover Street and a frame garage ~n the rear. BEING the same property which Erma L. Scharer et ux granted and conveyed to the Sellers herein by deed dated March 26, 1973 and recorded in the Office of the Recorder of Deeds for Cumberland County in Deed Book "B", Vol. 25, page 945. (continued on reverse side) ~ ~^ ~n ,s~~t- Q co V a ti H aW H . H LYi r~-7j O ~~ F+ w w ^~ ~ [_+ pp O oZ~ ~ w C1~ ,'Npr4H COMMONWEAL?'H OF PENNSYLVANIA z ~.r County of ~ , ., , i , t ... , , i - .f-,.,.,~. ,,~ i A. D~~i9,~~~;.. . ~`i~ ~t)~e'~~~ex's offcce of the said County, in Deed Book Vol. -:.~.~_,C~`~'i~~~~~-'-E'~~-~`'°,~~-------.. Given `'zi~Cder "jn~.~h~i~l*~an~t.t~e seal of the said of,~ice, he date above written. -__ < ~ -_, Recorder, Tax ID No. THIS INDENTURE MADE THE `~ ~ ,.~~ day of July in the year of our Lord two thousand three (2003), BETWEEN EDWARD W. HOLLAND, JR., Executor of the Estate of TERRY B. SHROEDER, deceased, late of Cazlisle, Cumberland County, Pennsylvania, GRANTOR, and ROBERT B. SHROEDER and SHELL-BE SHROEDER, husband and wife, of Mt. Vernon, County, Washington, GRANTEES, WHEREAS, the said Terry B. Shroeder became in his lifetime seized as of fee of and in a ONE HALF ('/Z) INTEREST in a certain lot or parcel of ground together with the buildings and improvements thereon erected situate in Cazlisle, Cumberland County, Pennsylvania, and being so thereof seized departed this life on April 3, 2002; and WHEREAS, Letters Testamentary in said estate have been duly issued by the Register of Wills in and for Cumberland County wherein Edward W. Holland, Jr. has been appointed Executor; and WHEREAS, said Letters Testamentary remain in full force and effect; and WHEREAS, the within sale is made pursuant to Section 3351 of the Probate, Estate and Fiduciaries Code. NOW THIS INDENTURE WITNESSETH, that the said Edward W. Holland, Jr., Executor of the Estate of Terry B. Shroeder, for and in consideration of the sum of one ($1.00) Dollar in hand paid by the said Robert B. Shroeder and Shell-Be Shroeder, Grantees, have granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto to the said Grantees, their heirs and assigns ONE HALF ('/:) Il~TTEREST ONLY as joint tenants with the right of survivorship: ALL THAT CERTAIN tract of land with improvements thereon erected, situate in the Borough of Carlisle, Cumberland County, Pennsylvania, bounded and described as follows: BOUNDED on the East by South Hanover Street; bounded on the South by West South Street, bounded on the West by property formerly of Dr. Thomas Stewart, now or formerly of the George B. Fagen Estate; bounded on the North by property formerly of Dr. Thomas Stewart, now or formerly of the Pearl E. Meily Estate; said property fronts Thirty-one (31) feet, more or less, on South Hanover Street and is ninety (90) feet more or less, in depth. BEING improved with a two and one-half story brick Apartment house known as and numbered 160 South Hanover Street and a frame garage in the rear. BEING the same premises which Mario R. Bartoli, single man, and James C. Bartoli and Jill E. Bartoli, his wife, by their deed dated June 14,1984, and recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed Book S, Volume 30, Page 859, granted and conveyed unto Terry B. Shroeder died on Apri13, 2002, thus vesting full fee simple title in the Estate of Terry B. Shroeder and Henrietta F. Schlegel as equal tenants in common. BEING the intent of this Deed to convey Grantor's one half ('/Z) interest only to said Grantees, Robert B. Shroeder and Shell-Bee Schroeder, and Henrietta F. Schlegel to have and hold remaining one-half ('/Z) interest as equal tenants in common. TOGETHER with all and singular buildings, improvements, ways, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever thereunto belonging or in anywise appertaining, and the reversions and remainders, rents, issues and profits thereof; and also all the estate, right, title, interest, use, trust, property, possession, claim and demand whatsoever of the sand Terry B. Shroeder. at and immediately before the time of his decease, in law or equity or otherwise howsoever, of, in, to or out of the same: TO HAVE AND TO HOLD ONE-HALF interest only of the said buildings, improvements, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances, unto the said Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, as joint tenants with the right of survivorship, their heirs or assigns, forever. And the said Grantor does covenant, promise, and agree, to and with the said Grantees, their heirs and assigns, by these presents, that the said Grantor has not done, committed, or knowingly or willingly suffered to be done, or committed, any act, matter, or thing whatsoever, whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or incumbered, in title, charge or estate, or otherwise howsoever. WTTNESS the due execution hereby the day, month and year first above written. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF 2'~ _~ ~.~~..__--.~. ~-~ (SEAL) Edward t~V. Holland, Jr., Execut the Estate of Terry B. Shroeder STATE OF CALIFORNIA ) SS. COUNTY OF ~ ~ ~~ C LQ. r~ } On this, the 3 day of July, 2003, before me, the undersigned officer, personally appeared Edward W. Holland, Jr., Executor of the Estate of Terry B. Shroeder, known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledged that he executed the same in the capacity therein stated and for the purposes therein contained. In witness whereof, I hereunto set my hand and ofI•icial seal. . ppryry.,, ~.t.~t.,~±±ry~63~~ .~.~ ~• o' ~y -OV1.71F~ f.. ~3 C f~n~ ~~ii '~7. -~-r-.^___. o, ....... con~r~. ~~av:,~~~ ~ (SEAL} to ~ ~ ~ Plata~y F~4,i~~:Ec-~3C~f~n3~ ~A ~ , S~N3'tt "Lsak~ ~f3UPd~ ~ ~y ~urara. ~~. tae i0, 2007 ~^ CERTIFICATE OF RESIDENCE does hereby certify that the precise residence and complete post office address of the within named Grantees is Date: Attorney for Grantor COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND RECORDED on this day of A.D. , in the Recorder's Office of said County, in Deed Book ,Volume ,Page Given under my hand and the seal of the said office, the date above written. Recorder „ ... ~~ ,~ ~~~~ Diversified Anaraisal Services Real Estate Appraisers and Consultants RESTRICTED U5E APPRAISAL REPORT 160 SOUTH HANOVER STREET CARLISLE, PENNSYLVANIA PREPARED FOR -- TIIE ESTATE OF TERRY B. SHROEDER BY LARRY E. FOOTS DIVERSIFIED APPRAISAL SERVICES 35 EAST HIGH STREET, SUITE 101 CARLISLE, PENNSYLVANIA 17013-3052 (717) 249-2758 TABLE OF CONTENTS PAGE NO. Table of Contents ........................................................................................................ 2 Letter of Transmittal ................................................................................................ ...3 Summary of Important Facts and Conclusions ........................................................ ...4 Appraisal Certificate ................................................................................................ ...5 Purpose of the Appraisal .......................................................................................... ...7 Location Analysis .................................................................................................... ...8 Ownership History ................................................................................................... .10 Estimated Marketing Time ...................................................................................... .10 Economic Trends ................................................................................................. .. .10 Site Description .............................................. ..................................................... .11 Improvements .......................................................................................................... .12 Taxes and Assessment ........................................................... ............................... .14 Highest and Best Use ............................................................................................... .15 Cost Approach ......................................................................................................... .18 Sales Comparison Approach .....................................................................................21 Income Approach ...................................................................................................... 24 Reconciliation and Final Value Estimate ................................................................. 27 Underlying Assumptions and Limiting Conditions .................................................. 28 Certificate of Appraisal ............................................ ................................................. 31 APPENDIX - Qualifications of the Appraiser Photographs of the Subject Property Location Map 2 Diversified Appraisal Services Real Estate Appraisers and Consultants 35 East High reef Carlisle, PA 17013-3052 (717) 249-2758 FAX (717) 258-4701 June 10, 2002 TO: The estate of Terry Schroeder FM: Larry E. Foote RE: Restricted Use Appraisal Report 160 South Hanover Street Carlisle, Pennsylvania - At your request, I have appraised the captioned property: The restricted use ap- praisal report of a limited appraisal, which follows this letter, is submitted in support of my opinion of Market Value of the Fee Simple Interest in the property, as of April 4, 2002. I hereby certify that, to the best of my knowledge and belief, the data, facts, and opinions set forth therein, are accurate, subject to the Statement of Assumptions and Lim- iting.Conditions that is also made a part of the report, and that the indicated Market Value of the subject property, as of April 4, 2002 is: ONE HUNDRED AND NINETY-SEVEN THOUSAND DOLLARS $197,000 This restricted use appraisal has been made using the Departure Provision in ac- cordance with the guidelines set forth by the Appraisal Standards Board and is in con- fortuity with the standards of professional practice of the National Association of Real- tors Appraisal Section. I appreciate your having considered me for this assignment and trust that you .find the report entirely satisfactory. Respectfully submitted, J Larry .Foote Certified General Appraiser GA-000014-L 3 SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS LOCATION: 160 South Hanover Street - Carlisle, Pennsylvania TAX PARCEL NUMBER: 04-21-0320-236 OWNERSHII': Henrietta F. Schlegel and Terry B. Shroeder LAND SIZE: 31' x 90' ZONING: C-1, Central Business District. . FLOOD HAZARD DATA: The subject site is not located in a FEMA identified flood ___ hazard zone, according to map #425382-0004-B. PROPERTY RIGHTS: Leased fee interest. SCOPE OF ASSIGNMENT: The scope of the assignment included an analysis of the subject's area, an inspection of the subject property, an es- _.. timation of the property's highest and best use, considera- tion of all three approaches to value, and the application of those relevant to the valuation of the subject. IMPROVEMENTS: Apartment building and garage. ___ OB3ECTIVE: To estimate the market value of the subject property as un- encumbered. -- USE OF THE APPRAISAL: Estate settlement. EFFECTIVE DATE: Apri14, 2002. HIGHEST AND BEST USE: Continued use as an apartment building and garage. -- COST APPROACH: N.A. SALES APPROACH: N.A. INCOME APPROACH: $197,000 VALUE CONCLUSION: $197,000 4 APPRAISAL CERTIFICATE I hereby certify that upon application for valuation by: T'HE ESTATE OF TERRY B. SHROEDER the undersigned personally inspected the following described property: All that certain tract of land, with the improvements thereon erected, situate in the Borough of Carlisle, Cumberland County, Pennsylvania, more particularly bounded and described as follows: Bounded on the East by South Hanover Street; bounded on the South by West South Street; bounded on the West by property now or formerly of the George B. Fagen Estate; bounded on the North by property now or formerly of the Pearl E. Melly Estate. Said property fronts 31 feet, more or less, on South Hanover Street and is 90 feet, more or less, in depth. Being improved with a two and one-half story brick apartment house known and numbered as 160 South Hanover Street and a frame garage in the rear. _ _ To the best of my knowledge and belief the statements contained in this report are true and correct, and that neither the employment to make this restricted appraisal report nor the compensation is contingent upon the value reported, and that in my opinion the Market Value as of Apri14, 2002 is: ONE HUNDRED AND NINETY-SEVEN THOUSAND DOLLARS $197,000 The property was appraised as a whole, subject to the contingent and limiting 5 conditions outlined herein. { ;~ tj P~ ~~%~ LarrY,E. Fpote raiser Certified General ApP GA-40~a14 6 PURPOSE OF THE APPRAISAL The purpose of this restricted use appraisal of a limited appraisal is to estimate the Market Value of the subject property as of Apri14, 2002. - Market Value is defined as the most probable price which a property should bring in a competitive and open market under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the price is not affected by undue stimulus. Implicit in this definition is the consummation of a sale as of a speci- feed date and the passing of title from seller to buyer under conditions whereby: a. Buyer and seller are typically motivated. b. Both parties are well informed or well advised, and each acting in what he considers his own best interest. c. A reasonable time is allowed for exposure in the open market. d. Payment is made in terms of cash in U.S. dollars or in terms of fi- nancial arrangements comparable thereto. e. The price represents the normal consideration for the property sold unaffected by special or creative financing or sales concessions granted by anyone associated with the sale. 7 LOCATION ANALYSIS The subject property is located in the south central part of Pennsylvania in Cum- Berland County. Cumberland County has pronounced boundaries. The Susquehanna River forms the eastern boundary shared with Dauphin County and the state capitol, Haz- risburg. The Yellow Breeches Creek forms the southeastern boundary with York County. The boundary then extends to the southwest following the Paney and South Mountains. That line also constitutes the southern boundary with Adams County. The southwestern boundary with Franklin County is traced by Laughlin Run, Middle Spring Creek, Gum Run, and Maines Run while the ridge line of Blue Mountain forms the northern boundary with Perry County. Based upon statistics from the Commonwealth of Pennsylvania Department of Labor and Industry Bureau of Research and Statistics, total civilian labor force in the Harrisburg-Carlisle-Lebanon MSA as of March, .2001 was 350,500, up 8,700 from .March, 2000, which was 341,800. The unemployment rate for Cumberland County as of March, 2001 was 3.0 percent, up .7 percent from March, 2000 which was 2.3 percent. These figures of unemployment are lower than 4.5 percent for the commonwealth of Pennsylvania. Over the yeaz service producing industries are up 3,000 jobs and goods producing industries are down 1,200 jobs. Major east-west transportation links serving the general area are U.S. Route 22 and 322, Interstate Route 78, and Interstate Route 76. Major neazby north-south arteries include Interstate Route 81, Interstate Route 83, and U.S. Routes 11 and 15. Rail service is provided by Amtrak on ConRail's line. The rail terminal is located in downtown Haz- 8 risburg. Air transportation includes four airports with Harrisburg International Airport serving the major carriers of U.S. Air, American, and Pennsylvania Commuter Air Lines. General aviation is also served by Capital City Airport and the Carlisle Business Airport. Higher education is offered through the Harrisburg Area Community College, the University Center at Harrisburg, Pennsylvania State University at Harrisburg, Dickinson College -and Dickinson Law School. Millersville State University, Shippensburg State University, Susquehanna University, Franklin and Marshall College, and York College, among others, are all within a one hour drive of the general area. Carlisle is located in the southeast section of central Pennsylvania, approximately twenty miles from Harrisburg, the state capitol. The town itself is presently undergoing a ` considerable degree of renovation and restoration of older properties. The southeast por- tion of Carlisle along Interstate 81 is currently experiencing rapid growth with restau- rants, offices, motels and other businesses. Employment opportunities are good, with Commonwealth of Pennsylvania, Her- shey Foods Corporation, Tyco, Herco, Inc., Bethlehem Steel, Harrisbwg Hospital, Penn- sylvania Blue Shield, Rite Aid Corporation, Hershey Medical Center, Carlisle Barracks, PPG Industries, Carlisle Tire and Whee] and Lear Corp. being the major employers in the area. There are also manufacturers of crystals, paper products, and steel products in Car- lisle. 9 OWNERSHIP HISTORY The subject property is owned by Henrietta F. Schlegel and Terry B. Shroeder. The property was purchased on June 14, 1984 for a reported consideration of $85,000 and ownership transferred on deed reference 30-S-859. ESTIlVIATED MARKETING TIME It is estimated that if the subject property were offered for sale at the indicated Market Value, a reasonable marketing time would be six to twelve months. This estimate is based upon quarterly sales figures published by Central Penn Multi List, Inc. ECONOMIC TRENDS Historically, rental income for similar properties has steadily increased, with va- cancy rates remaining stable. Financing is readily available to qualified purchasers at reasonable rates and terms. 10 SITE DESCRIPTION The subject site is rectangular in shape, consists of a total area of approximately 2,790 square feet, and has approximately 31 linear feet of macadam road frontage along South Hanover Street. There is also approximately 901inear feet of macadam road front- __ age along West South Street. The site is relatively level throughout and there does not appear to be any drain- age problems. According to the Federal Emergency Management Agency map number __ 425382-0004-B, the site is not located in an area which is prone to flooding. In the absence of core boring, it has been assumed that there are no mineral deposits of a commercial nature underlying the subject site. For the same reason, it is assumed that there are no unusual sub-soil conditions that would adversely affect the sub- ject site. Access to the site is via South Hanover Street and West South Street, and visibil- - ity of the site from these roadways is considered to be good. Utilities available at the site include water, sewer, gas, electricity and telephone service. There appears to be sufficient capacity in each of these utilities to permit opti- mum utilization of the site. 11 IMPROVEMENTS The subject property is improved with a two and one-half story apartment build- ing containing a total of approximately 4,491 square feet of gross building area above grade. Constructed upon a 1,645 square foot basement, the building has foundation walls of stone and brick, and exterior walls of brick. Roofing is of the flat type, covered with rubber sheathing and standing seam steel. Cutters and downspouts aze of galvanized steel. Exterior doors are of wood and windows are of the wood-framed double-hung type - with combination storm and screen units. The first floor is divided into two apartments, each consisting of a living room, kitchen, bedroom and bathroom. The second floor is divided into two apartments, one -- having a living room, kitchen, bedroom and bathroom; and the other having a living room, kitchen, two bedrooms and a bathroom. The third floor consists of an apartment with a living room, kitchen, bedroom and bathroom. --- Interior flooring is primarily of hardwood, with some carpet or vinyl in the kitch- ens and bathrooms. Interior walls aze of painted plaster. Interior ceilings aze of plaster and suspended acoustical the blocks. Interior trim and .doors are of painted wood. Kitchen cabinets are a combination of painted metal and painted or stained and varnished wood. Heating is provided by individual gas-fired hot water furnaces. Electricity is dis- ~- tributed by six recently installed 200-ampere circuit breaker electrical services, which aze individually metered. Water is heated by five gas-fired water heaters and plumbing throughout the building is of iron and copper. 12 Attached to the front of the building is a 186 square foot covered porch. Attached to the side of the building is a 120 square foot covered porch, a 136 square foot covered porch, and a 136 square foot covered balcony. Attached to the rear of the building is a 240 square foot brick one-car garage. Along the south side of the building is a steel fire escape that leads to the second and third floors. The site is further improved with approximately 90 linear feet of 8-foot wide con- crete sidewalk with curbing and approximately 41 linear feet of 11-foot wide concrete sidewalk with curbing. All improvements are considered to be in good condition on the interior and on the exterior, with mechanical systems appearing to be adequate and functioning properly. 13 TAXES AND ASSESSMENT The real estate tax assessment, synonymous with assessed value, is the official valuation level of property for advalorem tax purposes. Since the assessment is a dollar amount assigned to taxable property by the assessor for the purposes of taxation, it may not reflect the independent value conclusions found within this report. The following is the assessment and tax liability for the subject property as determined by the County As- sessor's Office: _ Assessment: Land $ 15,320 Improvements 137.810 Total $153,130 Mill Rates: Borough .002660 County .001882 School .010250 Total .014792 Tax Liability: Borough $ 407.33 County 288.19 School 1.569.58 Total $2,265.10 14 ffiGHEST AND BEST USE Highest and Best Use is defined by the Appraisal Terminology and Handbook, published by the Appraisal Institute, as "the most profitable likely use to which a prop- erty can be put". The opinion of such use may be based on the highest and most profit- able continuous use to which the property is adapted and needed, or likely to be in de- mand, in the reasonable neaz future. However, elements affecting value that depend upon events or a combination of occurrences which, while within the realm of possibility, aze not fairly shown to be rea- sonably probable, should be excluded from consideration. Also, if the intended use is dependent on an uncertain act of another person, the intention cannot be considered. The following tests must be passed in determining the highest and best use of the subject property. a. The use must be physically possible. The size, shape, and topography of the site affect possible uses for which it can be developed. b. The use must be legal, i.e., permitted under zoning and other municipal, county, state, or federal regulations. - c. The use must be financially feasible, probable, and not speculative. There must be an economic, social, or mazket demand for the existing or proposed use. All uses that are expected to produce a positive return are regazded as fi- nancially feasible. d. Finally, the highest and best use must be that which produced the highest pos- sible net return for the longest period of time. 15 The highest and best use of the site as vacant may be different from the highest -~ and best use as currently improved. This is most likely to occur with older properties, where physical condition, market changes, and neighborhood changes have been signifi- cant since the period when originally constructed. HIGHEST AND BEST USE AS VACANT: The highest and best use of the property as vacant assumes the site has no existing improvements. This concept is important to the appraisal report as it is carried through to the valuation of the land in the cost approach, if applicable. It assists in the selection of comparable sales of vacant sites to apply to the subject site. Considering the physical characteristics of the site, neighborhood uses, current zoning, location, and financial pa- rameters, it is my opinion that the highest and best use of the subject property, as vacant, would be for construction of an office and apartment building. HIGHEST AND BEST .USE AS IlVIPROVED: The analysis of highest and best use of a property as improved addresses what use _ should be made of the current improvements. Possible choices include renovation, ex- pansion, demolition, or maintaining its current use with no changes. Considering the physical characteristics of the property, neighborhood uses, current zoning, location, and - financial parameters, it is my opinion that the highest and best use of the subject property, as improved, is for continued use as an apartment building. 16 THE APPRAISAL PROCESS Three approaches to value aze generally included in an appraisal report. These techniques include the cost approach, sales comparison approach, and income approach to value. The cost approach to value is based on the assumption that the reproduction cost of a building plus land value, tends to set the upper limit to value. A key assumption is that a newly constructed building would have advantages over the existing building, therefore an evaluation focuses upon disadvantages or deficiencies (depreciation) of the existing building compared to a new facility. The sales comparison approach to value assumes that under normal conditions, a _ given number of parties acting intelligently and voluntarily, tend to set a pattern from which value can be estimated. Application of this approach relies on a comparison of the subject with a sufficient number of recent transactions of comparable properties in the _ mazket, based on a common unit, such as price per square foot of building area. The income approach concerns itself with present worth of the future potential benefits of a property. The initial estimate involves the net income, which a fully in- -- formed person is justified in assuming the property will produce during its remaining use- ful life. This estimated net income is then capitalized into a value estimate, based upon the level of risk as compazed with that of a similar type and class. -- At the request of the client and in accordance with the departure provision of the Uniform Standazds of Professional Appraisal Practice, only the income approach to value has been applied to the subject property and is subsequently presented. 17 THE COST APPROACH The cost approach to value is based on the principle of substitution, which pro- poses that an informed buyer will pay no more than the cost of providing a substitute property with similar utility. In estimating the value of the subject property by the cost approach, the following steps must be completed: a. Estimate the value of the site to its highest and best use as though vacant, which we have done. b. Estimate the reproduction or replacement cost of the improvements on the ef- fective date of the appraisal. This includes direct and indirect costs. c. Estimate other costs incurred after construction to being the new, vacant building up to market conditions and occupancy levels. d. .Estimate entrepreneurial profit, when appropriate, .from an analysis of the market. e. Add estimated replacement or reproduction cost, indirect costs, and entrepre- neurial profit, often expressed as a percentage of total direct and indirect costs to arrive at the total replacement or reproduction cost of the primary structure. f. Estimate the amount of accrued depreciation in the structure, which is divided into three major categories; physical deterioration, functional obsolescence, and external obsolescence. 18 ~~ g. Deduct the estimated depreciation from the total reproduction or replacement cost of the structure to derive an estimate of the structure's depreciated repro- duction or replacement cost. h. Estimate reproduction or replacement costs and depreciation for any acces- sory buildings and site improvements, and then deduct estimated depreciation from the reproduction or replacement costs of these improvements. Site im- provements and minor building improvements are often appraised at their net value, i.e., directly on a depreciated cost basis. i. Add the depreciated reproduction of replacement costs of the structure, the accessory buildings,. and the site improvements to obtain the estimated total depreciated reproduction or replacement cost of all improvements. j. Add the land value to the total depreciated reproduction or replacement cost of all improvements to arrive at the indicated value of the fee simple interest in the property. k. Adjust the indicated fee simple value to reflect the property interest being ap- praised, if necessary, to produce an indicated value for the interest in the sub- ject property. Comparison is the essence of the cost approach to value, similar to the sales com- parison and income approaches. Construction costs, plus land values, are compared to the values of existing improved properties. The four principles used for the sale compari- -- son approach (substitution, supply and demand, balance, and externalities), are also ap- plicable to the cost approach. 19 So the cost approach to value can be derived and equitably compared with the other approaches to value, adjustments for accrued depreciation from all causes are de- ducted from the reproduction cost, including: a. Physical Deterioration: Physical wearing out of property. b. Functional Obsolescence: Lack of desirability in terms of layout, style and design as compared to that of a new property, serving the same func- tion. c. External Obsolescence: Loss of value from causes outside the property it- self. The cost approach to value is most applicable for new properties, where the com- ponents of physical deterioration and functional and external obsolescence are small. The Marshal Valuation Service is used in this approach with actual costs for the subject property. The Marshall Valuation Service is a complete, dependable appraisal guide for de- _ veloping replacement costs, depreciated values, and. inswable values of buildings and other improvements. Modifiers are applied to make the cost applicable to any size build- ing in any locality. Known costs for locally constructed properties are also analyzed and - compared with derived cost estimates. At the request of the client and in accordance with the departure provision of the Uniform Standards of Professional Appraisal Practice, the cost approach to value has not - been included in the development of this restricted use appraisal report. 20 THE SALES COMPARISON APPROACH The sales comparison approach is a process of comparing market data, that is, the prices paid for similar properties, prices asked by owners, offers made by prospective purchasers willing to buy, and rents and leases. In applying the sales comparison approach, various appraisal principles are ap- plied, ensuring that all relevant issues have been included in the analysis. The principles of primary importance are supply and demand, balance, substitution, and externalities. _._ Additionally, a fundamental premise of the sales comparison approach is the concept, that from analysis of sales of reasonably similar properties, an appraiser has a factual basis upon which to estimate the value of the subject. Proper application of the sales compari- son approach requires that: a. Only market transactions be weighed, and the date of each transaction be con- firmed to the greatest extent possible. b. The degree of comparability of each sale to the subject be considered. c. The value conclusion be consistent with the analysis of the sales data. A definition of market value is: "The most probable price which a property should bring in a competitive and open market under all conditions requisite to a fair sale, the buyer and seller, each acting prudently, knowledgeably and assuming the price is not affected by undue stimulus. Implicit in this definition is the consummation of a sale as of a specified date and the passing of title from seller to buyer under conditions whereby: a. Buyer and seller are typically motivated. 21 b. Both parties are well informed or well advised, and each acting in what he considers his own best interest. c. A reasonable time is allowed for exposure in the open market. d. Payment is made in terms of cash in U. S. dollars or in terms of financial az- rangements comparable thereto. e. The price represents the normal consideration for the property sold unaffected by special or creative financing or sales concessions granted by anyone also- ciated with the sale. The degree of comparability that exists between a sale and the subject is often a function of the volume of sales activity in a market. For any class of real estate, if sales are infrequent, the mazket area must be expanded in scope of time and or geography to whatever extent is necessary to accumulate sufficient data on which to base a judgment. To judge the degree of comparability between a sale and the subject, several . guidelines can be applied. a. The sale should be in the same market as the subject. To the extent that a market is a meeting place for buyers and sellers of real estate of a given type, the boundaries of the market are set by the participants in merchandising and absorbing competitive properties. The boundaries of a market area are conse- quently economic in character, and not purely physical or geographic. b. Physical characteristics of the sale and subject should be as similar as possible in terms of size and amenities customarily found within the applicable class of real estate. c. Real estate price trends over time must be taken into consideration. 22 d. The functional adequacy of the sale property and the subject should be com- petitive in terms of the ability of each to support similar functions. At the request of the client and in accordance with the departure provision of the Uniform Standards of Professional Appraisal Practice, the sales comparison approach to value has not been included in the development of this restricted use appraisal report. 23 THE INCOME APPROACH The income approach is a method of converting income streams into present worth. Income and expense data for the subject property has been collected from the property owner and adjusted to include a vacancy factor and a property management fee. Analysis of this data resulted in an annual net operating income of $16,942. Using this approach, the net operating income should be sufficient to cover total mortgage payments and offer a return on equity investment. The net operating income is capitalized to obtain an estimate of value by income approach. Using the band of investment technique to develop a capitalization rate, the ap- praiser contacted lending institutions to determine the availability and terms of invest- ment capital, and the equity return desired by investors in this type investment. It was found that eighty percent of the property value could be borrowed at 7.25 percent interest per annum for a term of twenty years, adjusted at the end of three years. Also, investors desire an equity yield of five percent. The mortgage constant under the above terms would be .094845. Applying the band of investment technique, the overall capitalization rate is developed in the following manner: .80 x .094845 = .075876 .20 x .050000 = .010000 .085876 Based upon the above, capitalizing the net operating income at the overall capi- talization rate of .085876 indicates a value of $16,942 _ .085876 = $197,284.46. There- 24 fore, the Market Value of the subject property by the income approach is best estimated at $197,000. 25 INCOME AND EXPENSE SUMMARY SCHEDULED INCOME: Apartment # 1 @ $450 mo. Apartment #2 @ $450 mo. Apartment #3 @ $450 mo. Apartment #4 @ $450 mo. Apartment #5 @ $400 mo. Garage @ $35 mo. Less vacancy and credit loss Gross Income OPERATING EXPENSES: Utilities Property taxes Property insurance Repairs and maintenance Property management Replacement reserve Total Operating Expenses NET OPERATING INCOME: $5,400 5,400 5,400 5,400 4,800 420 1.341 1,236 2,265 1,462 500 2,548 526 $25,479 8.537 $16,942 26 RECONCILIATION AND FINAL VALUE ESTIMATE Reconciliation is the analysis of alternative conclusions to arrive at a final value estimate. Reconciliation is required because different value indications result from the use of multiple approaches to value and within the application of a single approach. The final value estimate is not derived simply by applying technical and quantita- tive procedwes; rather, it involves the exercise of judgment. The value conclusion reached must be consistent with market thinking. The parts of this appraisal report are the following approaches to value your ap- praiser used: Value Indicated by Cost Approach N.A. Value Indicated by Sales Comparison Approach N.A. Value Indicated by Income Approach $197,000 These approaches aze representative of the market value of the property. I have Y cazefully examined each step in each method, and I believe the conclusions accurately __._ reflect the attitude of typical pwchasers of this type property in this neighborhood. It is my belief that this reexamination has confirmed the original conclusions. As a result of this restricted appraisal and analysis, it is this appraiser's considered - judgment and opinion that the Market Value of the subject property,. as of April 4, 2002 is: ONE HUNDRED AND NINETY-SEVEN THOUSAND DOLLARS -- $197,000 27 UNDERLYIlVG ASSUMPTIONS AND LIMITING CONDITIONS SUBJECT TO THIS APPRALSAL 1. I assume no responsibility for matters legal in nature, nor do I render any opinion as to the title, which is assumed to be marketable. The property is appraised as though under responsible ownership. 2. The legal description used herein is correct. 3. I have made no survey of the subject properly, and the boundaries are taken from records believed to be reliable. 4. I assume that there are no hidden or unapparent conditions of the property, subsoil T or structures which would render it more or less valuable. I assume no responsi- bility for such conditions or for engineering which might be required to discover such factors. S. The information, estimates, and opinions furnished to me and contained in this re- port were obtained from sources considered to be reliable and believed to be true and correct. However, no responsibility for accuracy can be assumed by me. 6. This appraisal report is to be used in its entirety and only for the purpose for which it was rendered. 7. Neither all nor any part of the contents of this appraisal report, (especially any conclusions as to value, the identity of the appraiser or the firm with which he is connected) shall be reproduced, published, or disseminated to the public through advertising media, public relations media, sales media, or any other public means 28 of communication, without the prior written consent and approval of the ap- praiser. 8. Unless otherwise stated in this report, the existence of hazardous material, includ- ing without limitation asbestos, polychlorinated biphenyls, petroleum leakage, or agricultural chemicals, which may or may not be present on the property, was not observed by the appraiser. The appraiser has no knowledge of the existence of such materials on or in the property. The appraiser, however, is not qualified to detect such substances. The presence of substances such as asbestos, wea- formaldehyde foam insulation, or other potentially hazardous materials may affect the value of the property.. The value estimate is predicated on the assumption that there is no such material on or in the property that would cause a loss in value. - No responsibility is assumed for any such conditions, or for any expertise or engi- neering knowledge required to discover them. The client is urged to retain an ex- pert in this field, if desired. - 9. I do not have knowledge or experience required to evaluate whether physical changes have to be made to existing facilities to conform to the Americans With Disabilities Act regulations or whether alterations or new construction meets the - requirements. Therefore, the value reported is based upon the assumption that the subject property conforms to the ADA regulations. The client is urged to retain an expert in this field, if desired. -- 10. Acceptance of and/or use of this appraisal report constitutes acceptance of the foregoing assumptions and limiting conditions. 29 11. Adherence to the confidentiality requirement of the Uniform Standards of Profes- sional Appraisal Practice requires that, prior to making any copies of the appraisal _ report or having discussions related to this appraisal assignment with anyone other than the client, approval from the client be obtained in writing. Upon re- ceipt of said written authorization, copies of the appraisal report shall be produced or discussions with a third party may be held. Fees for these additional services shall be mutually agreed upon. and are payable in advance. 12. This appraisal was prepared for the exclusive us of the client identified in this ap- -- praisal report. The information and opinions contained in this appraisal set forth the appraiser's best judgment in light of the information available at the time of the preparation of this report. Any use of this appraisal by any other person or en- -- tity, or any reliance or decisions based on this appraisal are the sole responsibility and at the sole risk of the third party. The appraiser accepts no responsibility for damages suffered by any third party as a result of reliance on or decisions made or -- actions taken based on this report. 30 CERTIFICATE OF APPRAISAL Your appraiser hereby certifies that: 1. I have no present or contemplated future interest in the subject property. 2. I have no personal interest or bias with respect to the subject matter of this ap- praisal report or the parties involved. My findings are not based on the employ- ment to make the restricted appraisal, a requested minimum valuation, a specific valuation, or the approval of a loan. 3. To the best of my knowledge and belief, the statements of fact contained in this appraisal report, upon which the analyses, opinions, and conclusions expressed herein are based, are true and correct. 4. This restricted appraisal report sets forth all of the limiting conditions (imposed by the terms of my assignment or by the undersigned) affecting the analyses, opinions, and conclusions contained in this report. - S. This restricted appraisal report has been made in conformity with the Uniform Standards of Professional Appraisal Practice adopted by the Appraisal Standards Board of the Appraisal Foundation, and is subject to the requirements of the Code of Professional Ethics and Standards of Professional Conduct of the Appraisal Section of the National Association of Realtors. 6. No one other than the undersigned prepared the analyses, conclusions, and opin- ions concerning real estate that are set forth in this restricted appraisal report. 7. This restricted appraisal repot has been completed in a manner that does not mis- lead or confuse the client or the intended users of the report. 31 8. The appraiser has advised the client that the assignment calls for something less than, or different from the work required by the specific guidelines. 9. The client has agreed that the performance of a restricted appraisal would be ap- propriate. O1Q~fi ~~~~~ Larry E. Foote Certified General Appraiser GA-000014-L 32 _ LARRY E. FOOTE REAL ESTATE APPRAISER EXPERIENCE: 1979-Present: Chief Appraiser, Diversified Appraisal Services, Carlisle, Pa. Principal Broker, LaRue Development Company, Carlisle, Pa. 1976-1979: Associate Broker, Colonial Realty, Carlisle, Pa. 1972-1976: Realtor Associate, Jack Gaughen Realtor, Carlisle, Pa. Appraisal experience included undeveloped land, farms, building lots, single-family dwellings, mobile home parks,. medical centers, nursing homes, motels, apartment buildings and complexes, office buildings, service stations, veterinary clinics, rehabilitation centers, retail buildings, day- care centers, warehouses, and manufacturing facilities. EDUCATION: Bachelor of Business Administration, Pennsylvania State University, 1976. Associate Bachelor of Business Administration, Harrisburg Area Community College, 1974. Diploma, Carlisle Senior High School, 1965. __ Certificate, Pennsylvania Realtors Institute, GRI I, GRI II, GRI III. Certificate, Realtors National Marketing Institute, CI 101, CI 102, CI 103, CI 104, CI 105. Standards of Professional Practice, American Institute of Real Estate Appraisers. Real Estate Appraisal Principles, American Institute of Real Estate Appraisers. Residential Valuation, American Institute of Real Estate Appraisers. Appraisal Procedures, Appraisal Institute. Principles of Income Property Appraising, Appraisal Institute. Case Studies in Real Estate Valuation, Appraisal Institute. Report Writing and Valuation Analysis, Appraisal Institute. PROFESSIONAL LICENSES: General Appraiser #GA-000014-L, Commonwealth of Pennsylvania. Real Estate Broker #RB-029729-A, Commonwealth of Pennsylvania. PROFESSIONAL DESIGNATIONS: __ GRI: Graduate of the Pennsylvania Realtors Institute, awarded by the Pennsyl- vania Association of Realtors. CRS: Certified Residential Specialist, awarded by the Realtors National Market- _ ing Institute of the National Association of Realtors. CCIM: Certified Commercial Investment Member, awarded by the Realtors National Marketing Institute of the National Association of Realtors. PROFESSIONAL ORGANIZATION AFFILIATIONS: National Association of Realtors Appraisal Section. Carlisle Association of Realtors. - Pennsylvania Association of Realtors. National Association of Realtors. Realtors National Marketing Institute. 33 PAST CLIENTS: Borough of Carlisle Keystone Financial Mortgage Cornerstone Federal Credit Union Pennsylvania State Bank -- Commerce Bank Cumberland-Perry Association for Retarded Citizens Carlisle Suburban Authority - Members 1" Federal Credit Union Pennsylvania National Bank Evans Financial Corporation _ Greenawalt & Company, CPA • Smith's Transfer Corporation Carlisle Department of Parks and Recreation _ Executive Relocation Services Carlisle Area School District . Messiah Homes, Incorporated ERA Eastern Regional Services -- Pennsylvania Turnpike Commission Chase Home Mortgage Corporation Defense Activities Federal Credit Union - Pennsylvania State Employees Credit Union PNC Mortgage Corporation F&M Trust Company - National City Mortgage Corporation Washington Mutual Home Loans, Inc. Prudential Relocatiion Services _ Lender's Choice Market Intelligence, Incorporated United Telephone Employees Federal Credit Union __ Cumberland County Commissioners Allstate Enterprises Mortgage Corporation Dickinson College PPG Industries, Incorporated - Gettysburg College Redevelopment Authority of Cumberland County Record Data Appraisal Services, Incorporated -- First United Federal Savings Association Fulton Bank United States Marshall Service - GMAC Mortgage Corporation Orrstown Bank Letterkenny Federal Credit Union BancPlus Mortgage Corporation Coldwell Banker Relocation Services, Incorporated Central Pennsylvania Savings Bank __ Mellon Bank Provident Home Mortgage Corporation Various law firms and individuals 34 - PHOTOGRAPHS OF THE SUBJECT IMPROVEMENTS 35 STREET SCENES AT THE SUBJECT PROPERTY 36 REV-1503 EX+ (8-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER TERRY B. SHRQEDER 2002-00350 All property Jointly-oMm~d with right of survivorship must bs disclosed on 8cMdula F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t ~ 500 membership units of Old Dominion Brewing Co, (value is an est. @ 2$$/unit plus dividend 14,100.00 ': 2. USAA Fund 43 tax exempt long term account #43900503222 - value on 4!30/02 68,886.79 3. USAA Fund 44 tax exempt intermediate atx~unt #44900290143 - value on 4/302 __ 221, 572.54 4. __ _ __ __. USAA tax exempt mutual fund account #46900465429 - value on 4/30/02 17, 770.55 5. USAA Fund 35 income stock account #35900349596 - value on 4/302 103,678.00 " 6.: USAA Fund 45 tax exempt short term account # 45900214829 - value on 4/30/02 28, 954.44 7. USAA Fund 50 preaous metals and minerals aatount # 50901050909 - value on 12/31/01 ____ 12,013.41 8. __ __ USAA &okerage account #64563088 - value on 5/20ro2 __ .......... 1, 792.16 TOTAL (Also enter on line 2, Recapitulation) _` 468,767.89 (If more space is needed, insert additional sheets of the same size) P U R ~ RESHNES ti. 1939 D ~ OMsI~I\TI aOlsT D ~ '~~~I l\TG ~° ....... ..... .... ... . . . . . . .. . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . .. . . .. . . ... ... . . .. . .. ...... .. . 44633 Guilford Drive • Ashburn • Virginia 20147 • Phone: 703-724-9100 • ,Fax: 703-729-6717 September 13, 2002 Mr. Edward W. Holland, Jr. Attorney At Law 366 California Avenue, Suite Three Palo Alto, California 94306 Dear Mr. Holland: Terry Shroeder owned 500 Membership Units of Old Dominion Brewing Company, L.L.C. He purchased the Units on July 10, 2001. I believe he purchased the Units for $28 apiece. Old Dominion Brewing Company is a privately held company so the securities are not publicly traded Establishing a precise value for the Units is not easy. One measure is to use the last security sales. In 2001 the company sold 4,600 Units or Shares (in our case these are, value wise, the same) to 30 investors for $138,000 to raise capital for the expansion of the company's Brewpub, Each investor paid $30 for each Unit or Share. The only other sale of securities in 2001was to Mr. Shrceder._In 2002 there have been two sales of securities (400 Units) at $28 :per Unit. The precise value of the Units is what an individual can get for them At the moment there are several investors who would like to sell their Units or Shares but have not been able to find buyers for the price they are asking, $26-30 per Unit or Share. Old Dominion is a profitable Company. Next week I plan to send out dividend checks for the first half of the year. I will hold the check that corresponds to the Units owned by Mr. Shroeder. Please advise me about what I should do with the dividend check. I would also appreciate hearing about the ownership of the Units. If 1 can be of any other assistance, please call or Y:ritc to ...~. Sincerely, ~""-1 Je Bailey, President PAGE 02 6503210990 HOLLAND OR WELLER 09{25{2002 16:11 44633 Guilford Drive • Ashburn • Virginia 20147 • Phone; 703-724-9100 • Fax: 703-729-6717 Septeixtber 13, 2002 Mr. Edward W. Holland, Jr. Attorney At Lew 366 California Avenue, Suite Three Palo Alto, California 94306 Dear Mr. Holland: Tetry Shroeder owned S00 Membership Units of Old Dominion Brewing Company, L.L.C. He purchased the Units on July 10, 2001. I believe 1u ptu~haeed the Units for S28 apueoe. Old Dominion Brewing Company is a privately held company so the ooc~urities aro not publicly traded. Establishing a pt~eciae value for the Units is not easy. One tneastu~e is to use the last secinity sales, In 2001 the oontpany Bald 4,600 Units or Sham (in our case these atr., value wise, the same) to 30 itrvestora for 5138,000 to raise capital for tltQ eacpansiott of the company's Brewpub. Each investor pmtid S30 for each Unit or Shane. The only other sale of socatrities in 2001was to Ivlr. Shroedtr. In 2042 there have been two sales of securities (400 Units) at S28 per Unit. The precise value of the Units is what an individual ~ get for them. At the tttoment them ane several investors who would like to sell their Units or Shares bnt have not been able to find buyers for the price they are asking, 526-3o per unit or Share. Old Dominion is a proStable Company. Next wee3c I plan to send out dividend che~Glcs for the first half of the year, I will hold the chock that corrosporids to the Units owned by Mr. Sht+oeder. Please advise me about ~vtoat I should do with the dividend check. I would also appreciate hearing about the ownership of the Units. if I can be of airy other assistance, please call or write to me. Sincerely, ""'1 ~ ~ ~ s /`! G uo Je~iy Bailoy, Z ~ /~ a.w ~' SDO Sit o-r J President 7S y~ Gl tJ ~ de~^-e~' /'d w- 0~.2~ ~/"• v~a./e-T ~" /tj d ~~S X1/0 Page 10 of 10 VESTMENT MANAGEMENT COMPANY k,~l.~ xo.a 8.a Antado, Tx 7~ss INVESTMENT ACCOUNT STATEMENT Statement Period: 01/01/2002 -12/31/2002 Customer Service 1-800-531-8448 TouchLine~ 1-800-531,8777 Websi ems' www.usascom Fand Code-Account Number: 4S-45900214829 AVERAGE 30-DAY S.E.C. YIELD AS OF 12/30/02: 2.42% NO FORM 1099-DIV WILL BE SENT. THE INCOME IS NOT SUBJECT TO FEDERAL OR ALTERNATIVE Ivf1IMMUM TAXES. Date Transaction Description ~ ,Share Quantity Share Price Amount Ending Value as of 12/31/2001 811.299 510.69 S8,672.79 01/30 Buy Purchase By Exchange From 44900290143 1,863.933 10.73 520,000.00 01/31 Earnings Reinvested Dividend 2.600 10.73 .527.90 02/28 Earnings Reinvested Dividend 7.947 10.77 585.59 03/28 Earnings Reinvested Dividend 7.908 10.65 584.22 04/30 Reinvested Dividend 7.823 10.73 583.94 OS/31 Earnings Reinvested Dividend 8.517. 10.73 591.39 06/28 Sell Redemption By Check - 2,710.027 10.77 - 529,186.99 06/28 Earnings ~ Dividend BY ~ 577.07 C Ending Value as of 12/31/2002 0.000 S10.85 50.00 Year-to-Date Taz-Etempt Dividends 5450.11 SC I S SET2 YNYY •003763 -30170 - MP.JM4JtFS.PAO&t.N000016 DT OIOt ! 1:3-d! I~I~I~I~~~~~~~~~~~I~N~aq~~dll~~ rage s ot~ l0 ~ A~GEMEIVT ~M~~ INVESTMENT ACCOUNT.. STATEMENT Statement Period: 01/01/2002 -12/31/2002 Customer Service 1-800-531-8448 TouchLine~ 1-800-531-8777 Webai~ www.usaa.com Fund Code-Account Number: 3~339D0349S96 ' Date Transaction .Description Share Quantity .Share Price Amount Ending Value as of 11J3 12001 6,1Z7.S41 S16.83 5103,126.52 03/26 Earnings Reinvested Dividend 31.988 17.24 5551.48 50.09W/sl~ase 06/26 Earnings Reinvested Dividend 26.522 15.56 5412.69 (a~ 50.0670/share . 06/28 Sell Redemption By Check - 6,156.051 15.79 -597,677.75 06/28 Adjustment Reverse Redemption 6,186.05 1 15.79 597,677.75 09/26 Earnings Reinvested Dividend 30.600 13.14 5402.09 (a~ 50.0650/share 10/02 Transfer Transfer To - 6,216.651 12.63 - 578,516.30 Account 35902329964 Ending Value as of 12/31/2002 0.000 512.37 50.00 Year-to-Date Tasable Dividends S1,3b6.26 SC 0 S SEl2 YNYY •003763.30113 • INPJINlSfFS.PAOEi.N000016 07'0101 11:39'.31 I~adi~ggl~~I~~~qlqq~~q~Iq~~qqlqq~~qqqqqM Page 9 of 10 MANAGEMENT COMPANY to.a s,~l Aecaoto, Tx sass INVESTMENT ACCOUNT STATEMENT Statement Period: 01/01/2002 -12/31/2002 Customer Service 1-800-531-8448 ToucbI~inem i-S00-S31-8777 Webs eif- www.usaa.com Fund Code~Account Numbers 46-46900463429 AVERAGE 7-DAY SIMPLE YIELD AS OF 12/31/2002: 1.24% .. NO FORM 1099 DIV W1LL BE SENT. THE INCOME IS NOT SUBJECT TO FEDERAL OR ALTERNATIVE Iv~@TIMUM TAXES. Date Transaction Description Share Q~tih' Share Pike . Amount Ending Value as of 12/31/2001 3307.710 ~ 51:00 533,907.71 01/07 Sell Retie lion By - 5,000.000 .1.00 - 55,000.00 Check 0085 01/18 Sell on By 0 -1,500.000 1.00 - 51,500.00 0086 01/31 Earnings Reinvested Dividend 29.810 1.00 529.81 02/01 Sell lion By ~ - 2,279.000 1.00 - 52,279.00 0087 C 02/06 Sell Redemption By ~, F 5,541.000 1.00 •55,541.00 Check #0088. .. ~ .t ~ .. °: ' 02/19 Buy Purchase By29~0i4ha3nge From 44900 30,000.000 1.00 530,000.00 02/21 Sell ~m 9 y - 30,000.000 1.00 - 530,000.00 ~~8 02128 Earnings Reinvested Dividend, 22.120 ~ 1.00 522.12 03/11 Seli Retiemp~on By ~ -662.210 ~ ~ 1.00 -5662.21 Chxk #0090 03/15 Sell By R t~ -1,200.000 1.00 - 51,200.00 C k 9 03/28 F.atitiags Reinvested Dividend 18.350 1.00 518:35 04/30 Earnings Reinvested Dividend ._ 19.010 ~--- 1.00 ,.x. 19.01 _ OS/31 Earnings Reinvested Dividend 21.510 1.00 521.51 06/28 Sell Redemption By Check -17,836.300 1.00 - 517,836.30 06/28 Earnings mod Dividend By 516.02 C Ending Value as of 12/31/2002 4.000 51.00 50.00 Year-to-Date Tai-Eaempt Dividends Si26.82 SCOS SEIRYNYY•OOb76S•30119•MPJW4>1P8.PA08i.IJ000016 D?0101 11:3~S1 ~~~e®~uee~~~~~e~er~r~~~~~r Page 7 of 10 ~FBrMENT MANAGEMENT OOMPANY ~~t1.e~IPe iza.a s.A Antonio, Tx ~s2as ~ INVESTMENT ACCOUNT STATEMENT Statement Period: 01/01/2002 -12/31/2002 Customer Service i-800-531-8448 ToachLin~ 1-800 531-8777 Websif Mnv.uisaa.com Fund Code-Aawrurt Nxmba-r 44-4d900Z~143 .. ~ . AVERAGE 30.DAY S.E.C. YIELD AS OF 12/30/02: 3.52% NO FORM 1099-DIV WILL BE SENT. THE INCOME IS NOT SUBJECT TO FEDERAL OR ALTERNATIVE bffiJII~tIJM TAXES.. Date Transaction Description Share Quantity Share Prlce Amount Ending Value as of 12/31/2001 20,590.126 513.00 S267,671.64 01/30 Sell Exchange To -1,525.553 13.1.1 - 520,000,00 45900214829 01131 Earnings Rein d Dividend v e s te 82:995 13.11 51,088.07 02/19 Sell h ~ n ~ ~ Exc~~4b To 46 5429 ~ • - 2,283.105 13.14 - 530,000.00 02/28 Earnings Reinvested Dividend 75..232 13.19 5992.31 03/28 Earnings Reinvested Dividend - 70.131 12.93 5906.80 04/30 Earnings Reinvested Dividend t ~' `• ; ~ . +, : ~ :~; ;- ~ .69.803 13.09 5913.72 OS/31 Earnings Reinvested Dividend 75.347 13.10 5987.04 06/28 Sell Redemption By Check -17,154.976 13.15 - 5225,587.93 06/28 Earnings . Dividend BY 5870:59 Cbodc 06/28 Adjustment Reverse Redemption 17,154.976 13.15 5225,587.93 06/28 Adjustment Debit Adjustment - 5870.59 07/31 Earnings Reinvested Dividend , .70.452 13.24 .5932.79 08/30 Earnings Reinvested Dividend 74.171 13.29 5985.73 09/30 Earnings Reinvested Dividend • 65.081 13.46 5875.99 10!02 Transfer Transfer To -17,364.680 13.44 - 5233,381.30 Aooount44901131492 10/02 Earnings Tt ~ Dividend By • 560.33 1~'nding Value as of i?J31/2002 0.000 Si3.33 50,00 Year-to-Date Tax-Etempt Dividends S7,742.78 SCOS SEI2YNYY-003763.30117.1NPJW11iP8.PA08i.1i000016 D?0101 11:3P31 ~~~e~uau~e~~~~~~~~~~~~e~e~~~ Page 8 of 10 ~ ~ ,,`•° INVESTMENT ACCOUNT STATEMENT Statement Period: 01/01/2002 -12/31/2002 Customer Service 1-800-531-8448 TouchLlne~ 1.500-531-8777 Websi e~ w~ww.waa.com Fund Code-Account Nunrba: 43-d3A003032Z2 AVERAGE 30-DAY S.E.C. YIELD AS OF 12/30/02: 4.07% NO FORM 1099-DIV WII.L BE SENT. THE INCOME IS NOT SUBJECT TO FEDERAL OR ALTERNATIVE h~fNIMUM TAXES. Date Transaction Description Sbare Quantity Share Price Amount Ending Value as of 1?J31/2001 5,138.529 513.18 567,725.81 OI/31 Earnings Reinvested Dividend 21.308 13.31 5283.61 02/28 Earnings Reinvested Dividend 21.868 13.43 5293.69 03/28 Earnings Reinvested Dividend 22.141 13.11 5290.27 04/30 Earnings Reinvested Dividend 22.044 13.31 5293.41:. -- 05/31 Earnings Reinvest ividend 23.454 13.34 5312.88 06/28 Sell Redemption By Check - 5,249.344 13.41 - 570,393.70 06/28 Earnings Dividend By C 5275.46 heck 06/28 Adjustment Reverse Redemption 5,249.344 I3.41 570,393.70 06/28 Adjustment Debit Adjustment - 5275.46 07/31 Earnings Reinvested Dividend 21.659 13.53 5293.04 08/30 Earnings Reinvested Dividend 23.054 13.65 S314.69 09/30 Earnings Reinvested Dividend 19.698 13.95 5274.79 10/02 Transfer Transfer To - 5,313.755 13.92 - 573,967.47 Aocount43901192385 10/02 Earnings Dividend By 518.60 Tra Eading Value as of 12/31/2002 0.000 513.76 50.00 Year~to-Date Tai-Ezempt Dividends 52,374,98 SC 0 S SET! YNYY • 003763.30111 - QiP.JINIStPB.PAOB~.N000016 Orf 0101 11:39:SI I~I~I~~~II~~~I~I~M~~N~I Page 1 of 1 t- 1•~ t js~6 1 ~.~:*. 1~1'!'.St':~1E11' YlAtif~GEMI!:NT COMPANY ~++ 9ts(>U F'rrdericltsburg Road San Mtuniu, TX 98288 000113 030113 INVESTMENT ACCOUNT STATEMENT Statement Period: 01/01/2002 - 12/31/2002 Customer Service 1-800-531-8448 TouchLine® 1-800-531-8777 WebsffF~e www.usaa.com USAA NUMBER: 001781578 TERRY 8 SHROEDER 366 S CALIFORNIA AVE STE 3 PALO ALTO CA 94306-1634 TOTAL ACCOUNT VALUE: so.uu It's tus time! The USAA Mutual Fund Tax Guide is now available on usaa.com. It krovides general information about recent tax law Changes, tax rates and descriptions of forms for tax filing. Visit the Tax Center on waa.com today. Also, check with your tax adviser regarding the tax consequences of your retirement plans and imesuuent accounts. Start the neH ycar• off right -begin funding lour IRA for 2003. Open a new account or add to an existing one through usaa.com or by calling T-800-531-8148. Set up an automatic investing plan in which you invest a set amount at regular intervals. Although it down t assure a profit or protect against loss in declining markets, it ensures you invest regardless of market conditions. Pay yourself first and start today! I.~SA.A Income Stock Fund ~'SAA Precious Metals -~nri Mlnclals Fund US.-~-~ lax Exempt i ntcrmediate-Term Fund li~A.=~ Tax Exempt Long-Tenn Fund ~ t;S.AA Tax Exclnpt '~1one~ ~'~farkct Fund USAA Tax Exempt Short=form Fund $O.OOI $67,725.81 $0.001 $33,907.71 $O.UI) ~ $8,672.79 ~;- 1'atai AccountsValug ~ x ~ ': ~ ~., <;-:~ s `: Q ~E '~ ..w f\<. s t, Description Fund Code - Symbol Account Share Share `'Market ' Account Number % Quantity Price ~V>~ue.~. E ~ i,~SAA Income Stock Fund , 3 5-3 5 9003195 96 USISX U.00 0.0001 $12.37 t $0.00 tiAA Precious Metals I _50-50901050900 USAGX ~ 0.00 I 0.000 $10.62 I. ~ ~OAU end titincrals Fund 1 .~ ~ I U`iAA "1•ax Exempt I ` 44-44900200143 ~ USATX 0.00 0.000 $13.33 1 SO.OU Ir,tenuedlate=i'erm Fund ~ i I ~ r" Period Ending !2/31/2002 Period Ending 12/31!2001 Period Ending I Ycar-to-Date 12/31/2002 I $U.00 f $103,126.52 013 41 12 Taxable Tax-Exempt $ l ,3C>6.26 ~, $ l ,366.36 $10,694.69 ~ $ f (f.69.1.6~) $0.00 . . $ 9ta1;~',~z•~tvgs , ~., S12,Ofr0<9,5 ~ 512,060.95 $UAU j $267,671.64 . . ~ i6`I: 1'~'Yl'.003?ti5.30113.4NP.JIN458FS.PAGEB.NOOOOIo I7r0101 11:39:31 ~'I I!N Ill{I{ Ill{ {4{{I itI{I lllh II{N III 11111 IN11 Iilll N!~ llll! fll~ 11111 SIN Niil 1NIi 1011 NIA IIIN ~fN dill III I(II COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ATE OF TE SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP Sd,edule C-1 or C-2 (Including all supporting tnformation) must be attached for each closely-held corporatioNpartnership interest of the decedent, ott,erthan asole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Apartment Rental Parnership where Terry B: Shroeder and Wenrietta Sue F. Schlegel rented Building they_personally woned (Terry B. Shroeder had one hundred (100%) percent interest Street-and each had fifty (50°~6) percent interest in 160 South Hanover Street.: Henrietta Sue F. Managed the daily operations of the partnership. Agreement executed by partners on EIN# 23-21$7639 - 2002 Tax Year {x4,115.00) 2. 2003 Tax Yearper Attached Return -(x2,973.00) TOTAL (Also enter on line 3, Recapitulation) I {x7 more space is needed. insert additional sheets of the same size) RE1hi5o8 EX+ (900) COMMONVIIEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scNSOU~ cs PARTNERSHIP iNFOR~noN R~PO~r li?STATE OF FILE NUMBER TERRY B. SHROEDER 2002-00350 1. Name of PartneneFtip ~@pel and ,~f1f Date Business Commenced 2/18/80 Addross ~~no Tonfl~ Rnad business Reporting Year p2 02 City Mec~Ianit~bum Sfate.~_ Zip Code 17055 2. Federal Employer I.D. Number 23-2187639 3. Type of Business Annrtmsant Rantal/Man~gement Product/Servioe RentARartrrlents 4. Decedent was a ®Genaral D Umited partner. If decedent was a Nmited partner, provide initial investrnerrt $ PERM I'tV~ - BA(~kN:4`~a?F:: 5. PA[~'NI~ t,)>r: t111~Qi~ , t~ lP . C~W~'A#w ACCi~NT q, Terry B. Shroeder 50% 5090 0.00 g, Henrietta Sue F. Schlegel 50°Yo 50% 0.00 C. D. 6. Value of the decedents interest $ 4.115.00 7. Was the Partnenthip Indebted to fhe decedent? ................................. O Yes ®No If yes, provide amount of indebtedness $ 8. Was there Nfa insurance payable to the parbiership upon the death of the decedent? ..... D Yes B No If yes, Caeh Surrender Value $ Net proceeds payable $ Owner of the poticy 9. Did the decedent seA ortransfer an krterest in this partnership within one year prior to death or within two years if the date of death was prior th 12-31-82? D Yes W No If yea, D Transtier ^ Sale Percentage transferred/sold Transferee or Purchaser Consideration $ Date Attach. a sepanete sheet for addrtionai transfers and/or sales. 10. Was there a written partnership agreement in eilrsct at the time of the decedent's death? ...... ®Yes ^ No If yes, provide a copy of the agreement. 1t. Wes the decedents partrten;hip interest sold? ....................................... O Yes ~ No If yes, provide a Dopy of the agreement of sale, etc. 12. V1krs the paMership dissolved or Aquideted after the decedents dealh? ............... ®Yes D No If yes, provide a breakdown of drstr+175uAons received by the estate, atdudurg dates and amounts received. 13. Was the decedent related tp any of the partners? .................................... D Yes ~ No if yes, explain 14. Did the partnership have an interest in other corporations or paMerships? .............. D Yes ®No if yes, report the necessary information on a separate sheet, including a Schedule G1 or C-2 for each interest. •• ~ • ~ A. Detailed calarlafions used in the valuation othe decedents partnership interest. B. Complete copies of tinanciel statements or Federal Parttrerahip Income Tax n#tums (Form 1 t>65) for the year of death and 4 preceding years. C. If the partnership owned meal estate, submit a list showing the complete addresses and estimated iaamarket values. if real estate appraisals have been secured, attach caples. D. Any other information relating to the valuation of the decedents partnership ir>teresL REV-1506 EX+(9-00)) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT ESTATE OF Shroeder, Terry B. FILE NUMBER 1. Name of Partnership Date ~-~ Corrxrierx~ed Address Business Reporting Year City State Zip Code 2. Federal Empby~.+e I.D. Number 3. Type of Business Product/Service 4. Decedent was a General ®larited pargiel: ff deoedentwas a limited partner, provide nitial investment 5 6. Value of the decedent's interest ~~ I 7. Was the Partnership indebted to the decedent? Yes No If ves. orovide the amount of the indebtedness 8. Was there life insurance payable to the artnershi u n the death of the decedent? Yes No If yes, Cash Surnender Value Net roceeds a able Owner of the policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12-31-82? ®Yes ®No If yes, Transfer Sale Percents a trarrsferred/sold Transferee or Purchaser Consideration Date Attach a separate sheet for additional transfers and/or sales 10. Was there a written partnership agreement in effect at the time of the decedent's death? ~ Yes ®No If yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? ®Yes No If yes, provide a copy of the agreement of sale, etc. 12. Was the partnership dissolved or liquidated after the decedent's death? ®Yes No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners? Yes No If yes, explain 14. Did the partnership have an interest in other corporations or partnerships? Yes No If yes, report the necessary information on a separate sheet, incuding a Schedule G1 or G2 for each interest A. Detailed calculations used in the valuations of the decedent's partnership interest. B. Complete copies of finarxtial statemerrts or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 pre~ng years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate AGREEMENT entered into this /S~ day of ~~-~U'cuGV 1980 between TERRY B. SHRC?EDER, single man, with addres~c/o Revere Real Estate, 115 West High Street in the Borough of Carlisle Cumberland County, Pennsylvania, hereinafter called Shroeder, AND HENRIETTA F. BEAM, unmarried, of 123 West High Street in the Borough of Carlisle, Cumberland County, Pennsylvania, hereinafter called Beam, WITNESSETH: in consideration of the terms and conditions herein set forth, the parties hereto agree as follows: 1. Shroeder and Beam are purchasing on an Installment Sales Contract the apartment building aQd land known as 160 South Hanover Street, Carlisle, Pennsylvania from Mario Bartoli et al. , for a purchase price of Eighty-five Thousand ($85, 000. 00)--------------------Dollars of which price $24, 000. 00 is being paid on account of 'the purchase price and the balance of $61, 000. 00 is being financed with the Installment Sellers, Mario Bartoli et al., amortized over atwenty-five (25) year period with interest at eleven (11%) per centum per annum and payable in monthly installments of principal and interest of Five Hundred Ninety- seven an 88 / 100 ($597.88) Dollars each. 2. The down payment referred to in paragraph #1 above of $24, 000. 00 is being paid $8, 000. 00 by Beam and $16, 000. 00 by Shroeder, but Beam and Shroeder shall each have a Fifty (50%) per cent equity in the property as equal tenants in common, and shall be equally responsible for obligations under the Installment Sales Contract and shall be equally entitled to the rents, issues and profits of the operation of the apartment building and the proceeds of its eventual sale. 3. Beam shall be solely responsible for the manasement and PC !~'~-~ CF ATTORNEY '~ENE~~A L KNQ'~J ALL MEN BY THESE PRESENTS, That I, Terry B. Shroeder, ogle man of c o Revere Real Estate, 115 W. High St. , Carlisle, PA have made, constituted and appointed and by these presents do make, constitute and appoint Henrietta F. Beam whose address. is 123 West High St., marl sle. PA 17013 my true and lawful attorney to act in, manage, and conduct all my estate and all my affairs, and for tha# purpose for me and in my name, place and stead, and for my use and benefit, and as my sat and deed, to do and execute, or to concur with persons jointly interested with my- self therein in the doing or executing. of, all or any of the following acts, deeds, and things, that is to say; (1) To buy, receive, lease, accept, or otherwise acquire; to sell, convey, mortgage, hypothecate, pledge, quitclaim, or o#herwise encumber or dispose of or to contract or agree for the acquisition, disposal or encumbrance of; any property whatsoever and wheresoever situated, be it real, personal or mixed, or any custody, possession, interest, or right therein or pertaining thereto, upon such terms as my said attorney shall think proper; (2) To take, hold, possess, invest, lease, or let, or otherwise manage any or all of my real, personal, or mixed property, or any interest therein; to eject, remove, or relieve tenants or other persons from, and' recover possession of, such property by all lawful m<:ans; and to maintain, protect, preserve, insure, remove, store, transport, repair, rebuild,modify or improve the same or any part thereof; (3) ^•.'o make, do, and transact ail and every kind of business of what nature or kind soever, including the receipt, recovery, collection, payment, compromise, settlement, and adjustment of all accounts, legacies, bequests, interest, dividends, annuities, demands, debts, taxes and obligations, which may now or hereafter be due, owing, or payable by me or to me; (4) To make, inda.rs.e, accept, receive, sign, seal, execute, acknowledge, and deliver deeds, assignments, agreements, certificates, hypotheeati.ons, checks, notes, bonds, vouchers, receipts, and such other instruments in , writing of whatever kind and nature as may be necessary, convenient, or proper in the p.remisea; (5) To deposit and withdraw.for the purpos;:s hereof, in wither my said attorney's name or my name or jointly in both our names, in or from any banking institution, any funds, negotiable paper, or moneys which may come into my said attorney's hands as such attorney or which I now or hereafter may have on deposit or be entitled to; (5) To institute, prosecute, defend, compromise, arbitrate, and dispose of legal, equitable or administrative hearings, actions, suits, attachments, arrests, distresses or other proceedings or otherwise engage in litigation in connection with the premises; (7) To act as my attorney or proxy in respect to any stocks, shares, bonds, or other investments, rights or interests, I may now or hereafter hold; (S) To engage- and dismiss agents, counsel, and employees, and to appoint and remove at pleasure any si~hstitute for, or agent of my said attorney, in respect to all or any of the matters or things herein mentioned and upon such terms as my attorney shall think fit; (9) To execute vouchers in my behalf for any and all allowances and re- imbursements properly payable to me by the United States, including but not restricted to allowances and reimbursements for transportation of dependents or for shipment of household effects as authorized by law or Army regulations, and to receive, indorse, and collect the proceeds of checks payable to the order of the undersigned drawn on the Treasurer of the United States: (10) To prepare, execute, and file income and other tax returns, and other government reports, applications, requests and documents; (111 To take possession, and order the removal and shipment, of any of my property from any post, warehouse, depot, dock, or o#her place of storage or safe keeping, governmental or private; and to execute and deliver any release, voucher, receipt, shipping ticket, certificate, or other instrument necessary or convenient for such purpose. This Power of Attorney shall remain in full force and effect even though 1 may subsequently become mentally incompetent. GIVING AND GRANTING unto my said attorney full power and authority to do and perform all and every act, deed, matter and thing whatsoever in and about my estate, property, and affairs as fully and effectually to all intents and purposes as I might or could do in my own proper person if personally present,. the above specially enumerated powers being in aid and exemplification of the full; complete, and general power herein granted and not in. limitation or definition thereof; and hereby ratifying all that my said attorney shall lawfully do or cause to be done by virtue of these presents. ANb I hereby declare that any act or thing lawfully done hereunder by my said attorney shall be binding on myself, and my heirs, legal and personal representatives, and assigns whether the same shall have been done before or after my death, or other revocation of this instrument, unless and until reliable intelligence or notice thereof shall have been received by my said attorney. IN VRT E ~ VI~HEREOF, I have hereunto set my hand and seal the l~''~ day of ~ „y. t.~..-R.~1 nineteen hundred and Ei~.ht~19$0) '~~7 T !~"'"''' ~ ' ^... ~ ..,,.~-~.N ~ ~-~ (SEAL) n1 Terr B. Shroede,r .~ '~ COMMONV~~EALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND SS. On this, the~day of '1 ~ -M--~-~ 19 80 ,before me, the undersigned officer, personally appeared erry B. Shroeder known to me to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes theirein contained. IN WITNESS ~f~fiEREOF, I hereunto set my and o -cial `al. '~ l ~~..--x--~-^-* ~ (SEAL) ~ ~~~~4uouc~wQ ®4 4P~c~ 4m~~~an~y ~ In~t~e~if~nal Revenue Servf+ce 1 i ~ Date of This Notice i' I If you inquire about ~ 28221225 (- 12.1781 j your accouht, pease Employer Identification Number refer to this number or attach a ~ 23-21$7b39 HENRIETTA F BEAM ~, TERRY R SHRQEDE~opy of this notice ~_~ ~ PTR ;; r;; 123 W HIGH ST ' CARLISLE PA 17Q13 ~~:.~ i 575 f3 555555515 55555555 ,..) I ~: ~ NOTICE OF NEW EMPLOYER 1DENTIFICATiON NUMBER /4SSFGNED ~r_~ ( I Thank you for your application for an employer identification number. The number above ~) has been assigned to you. We will use it to identify your business tax returns and any other re- . ; H i la#ed documents, even if you have no employees. ~) ~ Please keep this number in your permanent records. Use the number and your name, ex- '" ~ actly as shown above, on all Federal tax forms that require this information, and refer to the num- ber in all tax payments and in tax-related correspondence or documents. You may wish to make ~) i a record of the number for reference in case this notice is lost or destroyed. ~ Note that the assignment of this number-does not grant tax-exempt status to nonprofit or- ganizations. For details on how to apply for this exemption, see IRS Publication 557, How to Apply '`) i for and Retain Exempt Status for Your Organization, available at any IRS office. i We appreciate your cooperation. • !; I Form 5372 (Rav. 2-8.0) (~~ Q~~~~:~ _. Waggoner, Frutiger & Daub ~j~~ 5006 E Trindle Rd Suite 200 Mechanicsburg, PA 17050 (717) 506-1222 (717)506-1222 April 5, 2003 ~~ Estate of Terry B Shroeder ~~~ Rfeirl Oettingenstrasse 67 W-8000 Munich 22, ~Fr~(Z. ~_._. Re: Henrietta Schlegel & Estate of Terry Shroeder Dear Partner: Attached is your copy of the Partnership Form 1065 Schedule K-1. This schedule summarizes your information from the partnership. This information has been provided to the Internal Revenue Service with the U.S. Partnership Return of Income, Form 1065. The information provided on this schedule should be entered on your tax return, in accordance with the instructions in column C. If your return will be prepared by your accountant or attorney, you should provide a copy of this schedule to the preparer with your other tax information. We thank you for the opportunity to serve you. Very truly yours, Waggoner, Frutiger & Daub 3 SCHEDULE K-1 Partner's Share of Income, Credits, Deductions, etc. OMB No. 1545-0099 (FOrm 1065) For calendar year 2002 or tax year ~ O 0 Do,~ertment of the Trassury Internal Revenue Service be innin and endin Partners Identifvina number - 7 5 -6 6 4 4 0 4 8 Partnership's identifvine number - 2 3 -218 7 6 3 9 Partner's name, address, and ZIP code Partnership's name, address, and ZIP code ENRIETTA SCHLEGEL & ESTATE OF ESTATE OF TERRY B SHROEDER ERRY SHROEDER RFEIRL OETTINGENSTRASSE 67 W-8000 209 TERRACE ROAD MUNICH 22 ECHANICSBURG PA 17055 A This partner is a ©general partner ~ limited partner F Partner's share of liabilities: Q limited liability company member Nonrecourse .................................... $ B What type of entity is this partner? - ESTATE Qualified nonrecourse financing ............ $ C Is this partner a ~ domestic or a ®foreign partner? Other ............................................. $ 15 ,16 6 . D Enter aRner's () Berore change (I~ End of P or tertninatlon yea percentage of: G Tax shelter registration number - Profdsharing ,.,... % 50.0000000% H Check here if this partnershipisapubliclytradedpartnership Loss sharing ....,.... °k 50 . 0000000° as defined in section 469(k)(2) ................................................ Q Ownership of capital % 50.0053831° E IRS cents where artnerahi flied return: CINCINNATI OH I Check a licable boxes: 1 Q Final K-1 2 ~ Amended K-1 .I Anslvcie of n~rtnera rsnif~l ~e~mmt• ' (a) Capital account at beginning of year (b) Capital contributed during year (c) Partner's share of lines 3, 4, and 7, Form 1065, Schedule M-2 (d) Withdrawals and distributions (e) Capital account at end of year (combine columns a throw h d 9 819. 4 115. 13 934. (a) Distributive share item (b) Amount (c)1040 filers enter the amount in column (b)on: 1 Ordinary income (loss) from trade or business activities ....................................... 0 . 2 Net income (loss) from rental real estate activities ................................................ 4 115. See papa 8 of Partners Instructions for Schedule K-1 (Porto 1065) 3 Net income (loss) from other rental activities ...................................................... 4 Portfolio income (loss): a Interest .................................................................. Sch. B, Part I, line 1 ., b Ordinary dividends ....................................................................................... Sch. B, Part II, line 5 N c Royatties ................................................................................................... Sch. E, Part I, line 4 d Net short-term capital gain (loss) ..................................................................... Sch. D, line 5, col. (f) m $ e (1) Net long-term capital gain (loss) .................................................................. Sch. D, line 12, col. (f) c (2) 28% rate gain (loss) ................................................................................. Sch. D, line 12, col. (g) (3) Qualified 5-year gain ................................................................................. Line 5 of worksheet for Sch. D, lino 29 f Other portfolio income (loss) (attach schedule) ................................................ enter on applicable hoes of your return 5 Guaranteed payments to partner ..................................................................... s e s ns W cdons ~ u 8 Net sec.1231 gain (loss) (other than casualty or theft) .......................................... ) ~o ~ 1 ~ } Sch~ eKP 7 Other income loss attach SChedUl@ ............................................................... Enter on a licable Ilne of cur return 8 Charitable contributions (attach schedule) ......................................................... Sch. A, line 15 or 16 ~ c 9 Section 179 expense deduction ..................................................................... C ~ 10 Deductions related to portfolio Income (attach schedule) .................................... See papas 7 and a of Partner's Instructions ror Schedule K-1 11 Other deductions attach schedule .................................................................. (Porto 1065) 13 OthefCredltS ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, (Enter an applicablellneaofyourretum) EW 14 a Interest expense on investment debts ............................................................... Form 4952, linel ~~ b (1)Investment income included on lines 4a, 4b, 4c, and 4f above .............................. See page 9 of Partner's Instructions ~ (2)InVBStment expenses InClUded On Tine 10 above ................................................... ~ ror Schedule K-1 (Form 1065) ~~ 15 a Net earnings (loss) from self-employment ......................................................... Sch. SE, Section A or B ~ b Gross farming or fishing income ..................................................................... sae page 9 cf Partners Inatrucdcna V c Gross nonfarm income ..................... ............................................................ rorsohoriuleK-t (Form toss) ~ 18 a Depreciation adjustment on property placed in service after 1986 ........................... 2 7 . . ~ b Adjusted gain or loss ................................................................................... See Partners Instructons for Schetlule K-1 (Form 1065) and e Other ad'ustments and tax reference items attach schedule ...............:.............. Instructions ror Form 62si 19 Tax-exempt interest Income ........................................................................... Form 1040, line 8b m 20 Other tax-exempt income .............................................................................. 21 Nondeductible expenses .............................................................................. See paQea 9 and 10 of Partners InaWoOcna for scnetlule K-~ 22 Distributions of money (cash and marketable securities) ....................................... ~ORn 10~) 29 Distributions of roe other than moos ......................................................... JWA For Paperwork Reduction Act Notice, see Form 1065 Instructions. No Information Required for Page 2 Schedule K-1 (Form 1065) 2002 211161 ~_,a_«r 3 10290405 706230 56120 2002.05020 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 SCHEDULE K-1 CAPITAL CONTRIBUTED DURING THE YEAR DESCRIPTION AMOUNT TRANSFERRED CAPITAL 9,819. TOTAL TO SCHEDULE K-1, ITEM J, COLUMN B 9,819. SCHEDULE K-1 COLUMN C RECONCILIATION DESCRIPTION AMOUNT RENTAL REAL ESTATE INCOME (LOSS) 4,115.' TOTAL TO SCHEDULE K-1, ITEM J, COLUMN C 4,115. Partner Number 3 10290405 706230 56120 2002.05020 HENRIETTA SCHLEGEL & ESTATE 56120 1 0206516023 PA Schedule RK-1 (09-02) 2002 Resident Schedule of PA S Shareholder/Partner Pass-Through Income, Loss, and Credits ?56644048 C ESTATE OF TERRY B SHROEDER REFIRE OETTINGENSTRASSE 67 W-8000 N Shareholder Y Partner MUNICH 22 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR MECHANICSBURG PA 17055 Part II.Owners Distributive Share of Income and Loss The PA-20 S corporation or partnership enters each owners share of PA taxable Income, allowable loss, and any credits by PA Income class and under PA PtT rules 1 PA Taxable Business Income or Loss from Operations If a loss place an x in the box ^ 2 Interest Income 3 Dividend Income 4 Net Gain or Loss from the Sale, Exchange, or Disposition of Property If a loss place an x in the box ^ • 5 Net Income or Loss from Rents, Royalties, Patents, and Copyrights If a loss place an x in the box ^ 6 Income from Estates or Trusts 7 Gambling and Lottery Winnings Part III.Owners Share of PA Credits 8 PA Resident Credit - PA S Shareholders only 9 PA Employment Incentive Payments Credit 10 PA Jobs Creation Tax Credtt 11 PA Research and Development Tax Credit Part IV. Distributlons from Partnership -see instructions 12 Distributions of Cash, Marketable Securities, and Property 13 Guaranteed Payments for Capttal 14 Guaranteed Payments Part V. Distributions from PA S Corporation -see instructions 15 Distributions from PA AAA 16 Distributions of Cash, Marketable Securities, and Property Part VI. Nontaxable PA S Corporation Income or Loss -see instructlons 17 Nontaxable PA S corporation income or loss If a loss place an x in the box ^ Do not report this income or loss on your PA-40 Tax Retum -see instructlons z~as2~ oz-osoa EC FC 0206516023 m ^ ^ N S Corporation Y Estate/Trust N C Corporation N Partnership N PA S Corporation Y Partnership 232187639 C Owners Share of Income and Loss, whether distributed or not 1 0 2 0 3 0 4 0 5 4115 6 0 7 0 8 9 0 10 0 11 0 12 0 13 0 14 0 15 16 17 0206516023 J J 0206616021 PA Schedule NRK-1 2002 Non-PA ResiderrYS Schedule of PA S Shareholder/Partner (09-02) Pass-Through Income, Loss, and Credits 756644048 C ESTATE OF TERRY B SHROEDER REFIRE OETTINGENSTRASSE 67 W-8000 N shareholder Y Partner MUNICH 22 HENRIETTA SCHLEGEL 8 ESTATE OF TERRY SHR MECHANICSBURG PA 17055 L N S Corporation Y Estate/Trust N C Corporation N Partnership N PA S Corporation Y Partnership 232187639 C Part II.Owners Dlatributive Share of Income and Loss The PA-20 S corporation or partnership enters each owners share of PA taxable Income, allowable loss, and any credits by PA Income class and under PA PR rules 1 PA Taxable Business Income or loss from Operations If a loss place an x in the box Q 2 Net Gain or Loss from the Sale, Exchange, or Disposition of Property If a loss place an x in the box 3 Net Income or Loss from Rents, Royalties, Patents, and Copyrights If a loss place an x in the box Q 4 Income from Estates or Trusts Part III.Owners Share of PA Credits 5 PA Nonresident Tax Withheld 6 PA Employment Incentive Payments Credit 7 PA Jobs Creation Tax Credit 8 PA Research and Development Tax Credit * AMOUNT PAID ON FORM PA-V Part IV. Distributions hom Partnership -see instructions 9 Distributions of Cash, Marketable Securities, and Property 10 Guaranteed Payments for Capftal 11 Guaranteed Payments Part V. Distributions from PA S Corporation -see Inatructlona 12 Distributions of PA AAA 13 Distributions of Cash, Marketable Securities, and Property 115 Part VI. Nontaxable PA S Corporation Income or Loss • see instructions 14 Nontaxable PA S corporation income or loss If a loss place an x in the box Q Do not report this income or loss on your PA-40 Tax Retum -see Instructions 274601 oz-o6-oa Owners Share of Income and Loss, whether distributed or not 1 D 2 0 3 4115 4 0 5 115 6 D 7 0 8 0 9 0 10 0 11 0 12 13 14 EC FC 0206616021 m m 0206616021 J aPR o 2 zoos ;' ' WAGGONER, FRUTIGER & DAUB 5006 E TRINDLE RD SUITE 200 (r`~r+1- ~i MECHANICSBURG, PA 17050 ~~~~rM~....~p~+~~~~•--w~• (717) 506-1222 (717)506-1222 MARCH 13, 2004 TERRY B SHROEDER ESTATE 366 CALIFORNIA AVENUE, SUITE 3 PALO ALTO, CP,, 94306 RE: HENRIETTA SCHLEGEL & ESTATE OF TERRY SHROEDER DEAR PARTNER: ATTACHED IS YOUR COPY OF THE PARTNERSHIP FORM 1065 SCHEDULE K-1. THIS SCHEDULE SUMMARIZES YOUR INFORMATION FROM THE PARTNERSHIP. THI5 INFORMATION HAS BEEN PROVIDED TO THE INTERNAL REVENUE SERVICE WITH THE U.S. PARTNERSHIP RETURN OF INCOME, FORM 1065. THE INFORMATION PROVIDED ON THIS SCHEDULE SHOULD BE ENTERED ON YOUR TAX RETURN, IN ACCORDANCE WITH THE INSTRUCTIONS IN COLUMN C. IF YOUR RETURN WILL BE PREPARED BY YOUR ACCOUNTANT OR ATTORNEY, YOU SHOULD PROVIDE A COPY OF THIS SCHEDULE TO THE PREPARER WITH YOUR OTHER TAX INFORMATION. WE THANK YOU FOR THE OPPORTUNITY TO SERVE YOU. VERY TRULY YOURS, WAGGONER, FRUTIGER & DAUB 3 SCHEDULE K-i i',Farrt, ,~ pepartrnent or fhe Treasury Partner's Share of Income, Credits, Deductions, etc. For calendar year 2003 or tax year 2003 PartnePs idl>;nti in number - 7 5 -6 6 4 4 0 4 i3 Partnershl 's menu In number ~ ~ ~-~ 1 ~ r V J I address, and ZIP code Partner's name Partnership's name, address, and ZIP code , ENRIETTA SCHLEGEL & ESTATE OF TERRY B SHROEDER ESTATE ERRY SHROEDER 366 CALIFORNIA AVENUE, SUITE 3 209 TERRACE ROAD PALO ALTO CA 94306 ECHANICSBURG PA 17055 A This partner is a ©general partner limited partner F Partner's share of liabittties: [~ limited liability company member Nonrecourse .................................... $ B What type of entity is this partner? - ESTATE Qualrfied nonrecourse financing ,.,.,....,,. $ C Is this partner a ®domestic or a [~ foreign partner? Other ............................................. $ 0 W Before d""Q° pq End or D Enter partner's percentage of: ortsrndnatlon rear G Tax shelter registration number - % 5 0.0 0 0 0 0 0 0% H Check here ff this partnership is a publicly traded partnership Profit sharing ,..... % 5 0.0 0 0 0 0 0 0 % O as defined in section 469(k)(2) ................................................ Loss sharing ......... Ownership of capital % 50 .0000000% end d K-1 2 Q A l E IRS centerwn srtnershl .filed rot„m: CINCINNATI OH m e nal K-1 I Check a licable boxes: 1 F J An81 Sli Or ar[neri ca nor (a) Capital account at beginning of year a~~uuur. (b) Capttal contributed during year (c) Partner's share of lines 3, 4, and 7, Form 1065, Schedule M•2 (d) Wtthdrawals and distributions (e) Capital account at end of year (combine columns a throw h d 13 934. 2 973. 25 261. <8 354.> (a) Distributive share item b Amount () (c) 1040 filers enter the amount in column (b)on: ................................ income (loss) from trade or business activities Ordinar 0 ...... y 1 ... .............................. .. 2 Net income (loss) from rental real estate activities 2 9 7 3. ro°~su,Qeedu e K 1 ~a s In065)ctiena ... .......... ................................. Net income (loss) from other rental activities ..................... 3 ...............:................. 4 Portfolio income (loss): a Interest Form 1040, line 8a ................................. ........................... b (1) Qualified dividends form 1040, line 9b ........... ........................................... ..................... dividends 2) Total ordina Form 1040, line 9a a ...................................................... ry ( ...................... .. . tties Ro Sch. E, Part I, line 4 ~ . . ........................................................................ ya c ................ 2003) .... 1) Net short-term capital gatn (loss) (Post-May 5 d Sch. D, line 5, col. (g) . , ............... ( ........................... (2) Net shorMerm capital gain (loss) (entire year) Sch. D, line 5, col. (f) - .................. ................................. e (1) Net long-term capital gain (loss) (post-May 5, 2003) Sch. D, line 12, col. (g) ... ................................. .. . (2) Net long-term capital gain (loss) (entire year) Sch. D, line 12 col. (f) ......... . .. ................................ . t Other portfolio income (loss) (attach schedule) .......... ..... ........................... ..... 5 Guaranteed payments to partner . .................................... ........................... 2003) 8 (a) Net section 1231 gain (loss) (post-May 5 seepapas 6 and ~ of Partners Inatn~ctlona for Schedule K-1 ............... , ....................................... (b) Net section 1231 gain (loss) (enttre year) (Form 106 ............ 7 Other income loss attach schedule ............................................................... ................................... .. 8 Charitable contributions (attach schedule) Sch. A, line 15 or i6 ~ c .................. .. .................... .. . 9 Section 179 expense deduction see page a or Partners o ° ..... .. .............................. .................................... 10 Deductions related to portfolio income (attach schedule) Instruouons ror Sor,sdule K-t (Form 7065) 11 Other deductions attach schedule .................................................................. .................................................................... 13 Other CreditS (Enter on applicable lines oryour rotum) w mN ......................... ............................................. . .... 14 a Interest expense on investment debts Form 4952, line 1 v; ~~ ....... .... .. b (1)Investment income Included on lines 4a, 4b(2), 4c, and 4f above ........................... 1 See pope 9 or Partners Instructlons v ~ ~ (2)Investment expenses included on line 10 above ................................................... 1 for Schedule K-1 (Form 1065) m [ ~ 15 a Net earnings (loss) from self-employment ......................................................... Sch. SE, Section A or f3 ................................................................................. c Gross nonfarm Income Sea 1>~ 9 or Partners Inatructlona ror etl la K-1 orrn 1 1 B a Depreciation adjustment on property placed in servir~ after 1986 ........................... 2 6 • see paps 9 and to or P.rtnere ~ ' ................................................... b Adjusted gain or loss . . .... ~ rnstructlona brscheduls K-1 (Form 108!7 and Inshuetlona ~ Y . . ...................... ... ...................... e Other ad ustments and tax reference Rems attach schedule ........ for Form8z57 ....................................... 19 Tax-exempt interest income Form 1040, tine Sb .................................... .................................................. 20 Othertax-exempt income .... .... ~ ~ ................ .. .. .............................................................................. 21 Nondeductible expenses 9se ppaappss 10 or Partners Inatnwtlon. brScheduls K-1 ~ .............................. ...... 22 Distributions of money (cash and marketable securttles) .. 5 0 0 0. tF°"" i os5) . 23 Distributions of orooerM other than money „ ....................................................... 2 0 2 61 . JWA For Paperwork Reduction Act Notice, sea Form 1065 Instructions. No Iniormatlon Required for Page 2 Schedule K-1 (Form 1065) 2003 371161 02-17-Od 3 11220313 706230 56120 2Q03.05000 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 SCHEDULE K-1 COLUMN C RECONCILIATION DESCRIPTION RENTAL REAL ESTATE INCOME (LOSS) TOTAL TO SCHEDULE K-1, ITEM J, COLUMN C AMOUNT 2,973. 2,973. Partner Number 3 11220313 706230 56120 2003.05000 HENRIETTA SCHLEGEL & ESTATE 56120 1 J 030651.7095 2008 Resident Schedule of PA S Shareholder/Partner PA Schedule RK•1 (09-08) Pass Through Income, Loas, and Credits 756644048 C TERRY B SHROEDER ESTATE 3 6 6 CALIFORNIA AVENUE , SUITE 3 owners 4 (Individual=t, S Corp=2, All Other Corp=3, Estate/Trust=4, Partnership=5) Amended N Partner's % of: Profd sharing PAL 0 ALT 0 C A 9 4 3 0 6 Stock Ownership % 0 Loss sharing HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR MECHANICSBURG PA 17055 232187639 C Part II. Owner's Distributive Share of Income and Loss Shareholders and partners enter the amounts from this schedule on the corresponding Ilnes of the Pennsylvania Income tax or Information returns they must file. Read the instructions for completing the PA-40, PA-41, or PA-20S/PA-85. 1 PA Taxable Business Income (Loss) from Operations If a loss place an x in the box. Q 2 Interest Income 3 Dividend Income 4 Net Galn (Loss) from the Sale, Exchange, or Disposition of Property If a loss place an x In the box. 8 5 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights If a loss place an x in the box. 6 Income from Estates or Trusts 7 Gambling and Lottery Winnings Part III.Owner's Share of PA Credits 8 PA Resident Credit - PA S Shareholders only 9 PA Employment Incentive Payments Credit 10 PA Jobs Creation Tax Credit 11 PA Research and Development Tax Credit Part IV. Distributions from Partnership 12 Distributions of Cash, Marketable Securties, and Property -not including guaranteed payments 13 Guaranteed Payments for Capital 14 Guaranteed Payments Part V. Distributions hom PA S Corporation 15 Distributions from PA AAA 16 Distributions of Cash, Marketable Securities, and Properly Part VI. Nontaxable PA S Corporation Income or Lost 17 Nontaxable PA S corporation income (loss) If a loss place an x in the box. Q Do not report this income or loss on your PA-40 Tax Retum Part VII. Supplemental Information 18 Member's Share of Depreciation Expense 19 Member's Share of Straight-Line Depreciation 37a621 01.07.04 FINAL K-1 EC FC 0306517095 m m Capital Ownership N PA S Corp. 0.5000 0.5000 0.5000 Y Partnership 1 0 2 0 3 0 4 0 5 3107 6 D 7 0 8 0 9 0 10 0 11 0 12 25261 13 0 14 0 15 0 16 0 1? 0 18 0 19 0 0306517095 J 0306617093 2008 Non-PA ResldeM's Schedule of PA S Shareholder/Partner PA Schedule NRK-1 (09-03) Pass-Trirouph Income, Loss, and Credits 756644048 ~ TERRY B SHROEDER ESTATE 366 CALIFORNIA AVENUE, SUITE 3 owners 4 Amended N PALO ALTO CA 94306 Stock Ownership~o HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR MECHANICSBURG PA 17055 232187639 C L (Individual=1, S Corp=2, All Other Corp=3, Estate/Trust=4, Partnership=5) Partner's % of: Profit sharing 0. 5 0 0 0 0 Loss sharing 0.5 0 0 0 Part II.Owner's Distributhre Share of Income and Lost Shareholders and partner: enter the amounts from this schedule on the corresponding lines of the Pann:ytvanla income tax ar information returns they must tile. Read the Instructions for completing the PA-40, PA-41, or PA-20S/PA-88. 1 PA Taxable Business Income (Loss) from Operations If a loss place an x in the box. 2 Net Gain (Loss) from the Sale, Exchange, or Disposltion of Properly ff a loss place an x in the box. 3 Net Income (loss) from Rents, Royalties, Patents, and Copyrights If a loss place an x in the box. 4 Income from Estates or Trusts 5 Gambling and Lottery winnings * AMOUNT PAID ON FORM PA-V 87 Part III. Owner's Share of PA Credits 6 PA Nonresident Tax Withheld 7 PA Employment Incentive Payments Credlt 8 PA Jobs Creation Tax Credit 9 PA Research and Development Tax Credit Part IV. Distributions from Partnership 10 Distributions of Cash, Marketable Securlties, and Property -not Including guaranteed payments 11 Guaranteed Payments for Capital 12 Guaranteed Payments Part V. Distributions from PA S Corporation 13 Distributions of PA AAA t4 Distributions of Cash, Marketable Securlties, and Property Part VI. Nontaxable PA S Corporation Income (Loss) 15 Nontaxable PA S Corporation Income or Loss If a loss place an x in the box. Q Do not report this income (loss) on your PA-40 Tax Retum Part VII. Supplemental Information t6 Member's Share of Depreciation Expense 17 Member's Share of Straight-Line Depreciation of oioa FINAL K-1 Capital 0.5 0 0 0 Ownership N PA S corp. Y Partnership Owner's Share of Income and Loss, whether distributed or not 1 D 2 0 3 3107 4 0 5 6 87 ? 0 8 0 9 0 10 25261 11 0 12 0 13 0 14 0 15 0 16 0 17 0 EC FC 0306617093 Q ~ ~ ~ 0306617093 J Forrn 1065 Department of the Treasury Intemai Revenue 3enlos A Prindpal business adNity REAL ESTATE 13 Prindpsl product or servioa U.S. Return of Partnership income For calendar year 2003, or tax year bsplnninp ,and andinp Name of partnalshlp ENRIETTA SCHLEGEL & ESTATE OF IRS ERRY SHROEDER IabN. Oei~ Number, sheet, antt room a sulfa rb. M a P.O. box, sw papa U of the Instructlons. p,~ 209 TERRACE ROAD OMB No.,~46-0o1a9 2003 D Employer identiflcetlon number 23-2187639 E Dab bualnau started 03/01/1980 RENTALS or Clty or town, ebb, and zlP Dods F Total assets nusinsa+ code number ~~ 531110 ECHANICSBURG PA 17055 0. G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) 0 Amended return H Check accounting method: (1) ® Cash (2) O Accrual (3) ~ Other(specity) ~ I Number of Schedules K-1. Attach one for each person who was a partner at any time during the tax year ~ 2 Caution: Include onty trade or business Income and expenses on Ilnes 1a through 22 below. See the instructions for more information. :..;, f. >.:..: .. 1 a Gross recei is or sales p .................................................................................... 1a :,, : .,<ls. Yr' v, .. b Less returns and allowances ........................................................................... 1b 1c 2 Cost of goods sold (Schedule A, line 8) ............................................................................................................ 2 ~ 3 Gross profit. Subtract line 2 from line 1c ............................................................................................................ 3 ~ 4 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule) ................................................ 4 5 Net farm profid (loss) (attach Schedule F (Form 1040)) ....................................................................................... 5 6 Net gain (loss) from Form 4797, Part II, Ifne 18 ................................................................................................... 8 7 Other income (loss) (attach schedule) ............................................................................................................ 7 8 Total income loss .Combine lines 3 throw h 7 ................................................................................................ 8 9 Salaries and wages (other than to partners) (less employment credits) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, g N ~ 10 Guaranteed payments to partners .................................................................................................................. 10 • ~°- 11 Repairs and maintenance ........................................................... ................................................................... 11 ~ •E 12 Bad debts ................................................................................................................................................... 12 '~ 13 Rent ......................................................................................................................................................... 13 ~° y 14 Taxes and licenses ....................................................................................................................................... 14 ~ o 15 Interest ......................................................................................................... .................................. .......... 15 ~ 10 a De reciation ff re wired attach Form 4562) P Q ................................... 8a •::.::: •:::::. ..,,... '~~~~~• a b Less depredation reported on Schedule A and elsewhere on return ,,,,,,,,,,,,,,,,,,,,,,,,,,, Bb 16c c 17 Depletion (Do not deduct oil and pas depletlon.) 17 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,„...,..,..,,.,.,.,..,.,........,,.,,..... 18 Retirement plans, etc . 18 r.. .................................................................................................................................... ~ 19 Employee benefit programs 0 .............................................................................:............................................. 19 ~ d 20 Other deductions (attach schedule) ,,,,,,,,,,,,,,• .,, ................................................................ Y0 0 21 Total deductions. Add the amounts shown in the far ri ht column for lines 9 throw h 20 .......................................... 21 22 Ordlna Income loss from trade or business activities. Subtract line 21 from line 8 ................................................ 22 0 . Undo penaltles of perjury, I dedaro that I have examlrted this Mum, tndudlnp aaompanylny schedules antl statarnsnb, and to the frost of my knowledys and bNisf It is bus coned, end complete. Dedvafkx, of proparer (other than panaral partner or limited Ilabllity oomperry msmbaQ is trosed on all Information of wh Si n , , ldr pnparar has any knovned9e. g Here M w ' ay the IRS tllsass this Mum ith the preperer snows trolow Slpnatun of yanersl partner or limited Ibblllty company nwnbar p~ (s ea Inatry! Yea NO Paid p~~ys ' uon,a,ro Dab Ct1eCk 1f Prapanls 33N or PT1N a.lt-.mployatl - PO 0 0 8 7 32 5 • "'r'°'°' • '°"r~~tw WLiVbV1vL' X r ttU'11t:7Pitt: dt LHUt3 yours If ael}- Use Onty ampwy.dj, 5 0 0 6 E TRINDLE RD SUITE 2 adtlnss,antl ~p~• MECHANICSBURG, PA 17050 EIN -~l3-1583249 Phon. no. r 71 7 1 5 0 Fi -1 3t~oof JWA For Paperwork Reduttlon Ae! Notice, sea teparata Inatructlona. tz•ta-oa Form 1065 (2003) HENRIETTA SCHLEGEL & ESTATE. OF TERRY SHR Form 1065 1 2 3 4 5 6 7 8 9a 23-2187639 Inventory at beginning of year ........................................................................................................................... Purchases less cost of items withdrawn for personal use ....................................................................................... Cost of labor ................................................................................................................................................ Additional section 263A costs (attach schedule) ................................................................................................ Other costs (attach schedu/e) .................................................................................................................. Total. Add lines 1 through 5 ........................................................................................................................... Inventory at end of year .................................................................................................................................... Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Check all methods used for valuing closing inventory: (I) [] Cost as described in Regulations section 1.471-3 (Ii) [] Lower of cost or market as described in Regulations section 1.471-4 (lli) [] Other jspecity method used and attach explanation) - b Check this box if there was a writedown of'subnomtaM goods as described in Regulations section 1.471-2(c) ................................................... - c Check this box if the LIFO inventory method was adopted this tax year for any goods (If checked, attach Form 970) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, - d Do the rules of section 263A (for property produced or acquired for resale) apply to the partnership? ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 0 Yes Q No e Was there any change in determining quantities, cost, or valuations between opening and closing inventory? ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ~ Yes Q No if'Yes; attach explanation. 1 What type of entity is filing this retum7 Check the applyable box: a ®Domestic general partnership b [~ Domestic limited partnership c Q Domestic limited liability company d 0 Domestic limited liability partnership e ~ Foreign partnership 1 ~ Other- 2 Are any partners in this partnership also partnerships7 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ........................................... 3 During the partnership's tax year, did the partnership own any interest in another partnership or in any foreign entity that was disregarded as an entity separate from its owner under Regulations sections 301.7701-2 and 301.7701-3? If yes, see instructions for required attachment ................................................ .. . ............................................................... 4 Is this partnership subject to the consolidated audit procedures of sections 6221 through 6233? It "Yes ;see Designation of Tax Matters Partner below ....................................................................................................................................... 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than x250,000; b The partnership's total assets at the end of the tax year were less than x600,000; and c Schedules K-1 are filed with the return and fumished to the pafirers on or before the due date (including extensions) for the partnership return. If'Yes; the partnership is not required to complete Schedules L, M•1, and M-2; Item F on page 1 of Form 1065; or Item J on Schedule K-1 ............................................................................................................................................................... 6 Does this partnership have any foreign partners? If'Yes; the partnership may have to file Forms 8804, 8805 and 8813. See page 20 of the instructions .......................................................................................................................................... 7 Is this partnership a publicly traded partnership as defined In section 469(k)(2)? ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, , 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? ,,,,,,,,, ,,,,,,,,, ,,,,,,,,, 9 At any time during calendar year 2003, did the partnership 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 page 20 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If 'Yes,' enter the name of the foreign country. - 10 During the tax year, did the partnership receive a distribution from, or was h the grantor of, or transferor to, a foreign trust? If 'Yes ;the partnership may have to file Form 3520. See page 20 of the instructions ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,, 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If'Yes; you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described under Eleetlons Made By the Partnershin on nacre 9 ettha inctmrtinne Desiflnation of Tax Matters Partner (see page 20 of the Instroctions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: X X X X X .... L_ ~ X Name of Identifying designated TMP - number of TMP - Address of - designated TMP 3Woi~ Form 1065 (2003) ~z•~a-a~ z 2 10150319 706230 56120 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 & E -2187639 tai Dlstrtbuthre:hare Rams I fbl Total amount 1 Ordinary income (loss) from trade or business activities (page 1, line 22) „,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 1 0 . 2 Net income (loss) from rental real estate activities (attach Form 8825) ..,..SEE STATEMENT 1 ,.•., ........................................... 2 5 94 7 . 3 a Gross income from other rental activities 3a ~~~`~~3~v` b Expenses from other rental actNities (attach schedule) .............................. 3b r':: :•~v:: :~<;.:;:~;r . : c Net income (loss) from other rental activfties. Subtract line 3b from line 3a ................................................... 3c -- 4 Portfolio income loss attach Schedule D Form 1065 for lines 4d and 4e : •~~~•~•~^~~ ••• • ~•••~~~•~~•~ ~~•~~~••~~~~~ ~~~~~~~~~•~~~~~~ ~~ •~ •~• o a Interest income ............................................................................................................................. ... 4a m b Dividends: (1) Qualined dividends - (2) Total ordinary dividends - ,,,,,,,,,,,,,,, 4b c c Royalty Income ................................................................................................................................. 4c d Net short-term capital gain (loss): (1) post-May 5, 2003 - (2) Entire year - ,,,,,, 4d 2 e Net long-term capital gain (loss): (1) post-May 5, 2003 - (2) Entire year - ,,,,,. 4a 2 1 Other portfolio income (loss) (attach schedule) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ............................ .......................... 4f 5 Guaranteed payments to partners ......................................................................................................... 5 8 a Net section 1231 gain {loss) (Post-May 5, 2003) {attach Forth 4797) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Ba b Net section 1231 ga(n (loss) (entire year) (attach Form 4797) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Bb 7 Other income loss attach schedule ...................................................................................................... 7 c 8 Charitable contributions (attach schedule) ................................................................................................ 8 9 Section 179 expense deduction (attach Form 4562) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,•• 9 ' ~ 10 Deductions related to portfolio income (itemize) ....................................................................................... 10 0 11 Other deductions attach schedule ......................................................................................................... 11 12 a Low-income Housing credit: (1) From partnersh(ps to which section 42(j)(5) applies ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 12a 1 a (2) Other than on line 12a(1) .................................................................................................................. 12a 2 r b Oualifled rehabilitation expenditures related to rental real estate activities (attach Form 3468) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 12b ~ c Credits (other than credts shown on Imes 12a and 12b) related to rental real estate actvities ,,..,,,•,,,•.,,,,,•,,,,,,,,,,, 12c d Credits related to other rental activities ................................................................................................... 12d 13 Other credits ....................................................................................................................................... 13 14 a Interest expense on Investment debts ...................................................................................................... 14a ~ o « b (1) Investment income included on lines 4a, 4b(2), 4c, and 4f above ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 14b 1 _ ~ ~ ~ 2 Investment a enses included on Ifne 10 above ................................................................................. 14b 2 ~« ~o 15 a Net earnings (loss) from self-employment ................................................................................................ 15a 0 . L ~ E ~ b Gross farming ortishing income ............................................................................................................ 15b W c Gross nonfarm Income ........................................................................................................................ 15c ~ ~ 18 a Depreciation adjustment on property placed in servk;e after 1986 .................................................................. 15a 5 2 . `0 ~ v~ ~ b Adjusted gain or loss ........................................................................................................................... 18b ~ E ~ m c Depletion {other than oil and pas) ......................................................................................................... 15c ya= d (1) Gross income from oil, gas, and geothermal proPerties ............................................••,••,.,,•,.••,•••,.••.,..., 16d 1 ~~ (2) Deductions allocable to oil, gas, and geothermal properties ......................•,.•.,•,,,,••.,,•,•••••••..•...••._,•.,•_••. 15d 2 < e Other ad'ustments and tax reference Rams attach schedule ......... 18e 17 a Name of foreign country or U.S. possession - '~'~~~{~~%~~~~ eft>:~ b Gross income from all sources ............................................................................................................... :> 17b c Gross income sourced at partner level ...................................................................................................... 171 ~ d Foreign gross income sourced at partnership level: '''''`'%~ ~~ t2f Luredn>t>a~cnm-) - ~ oeneralWNt~tlon- 17d 3 o, a Deductions allocated and apportioned at partner level: ,,. w "'<~'. ~• o (1) Interest expense - (2) Other ......................................................... - 17e 2 t Deductions allocated and apportioned at partnership level to foreign source Income: 1 (~) P~he - (~ Ueleanleo~•t~hM~.) - (3- (terbnlgrr~lrion- 17f 8., g Total foreign taxes (check one): - Paid (~ Accrued [~ ............................................................... 17 h Reduction in taxes available for credit attach schedule .............................................................................. 17h 18 Section 59(e)(2) expenditures: a Type - b Amount - 18b 19 Tax-exempt Interest Income 1si .................................................................................................................. 20 Othertax-exempt income .......................................................................................................:............. 20 S 21 Nondeductible expenses 21 ........................................................................................................................ 22 Distributions of money (cash and marketable securities) ,,,,,,,,,,,,,,,,,,,,•,•,.,,,.,••,,,,,,••••„••,,,..,••.,••,,.,,.,,,•..,•.. •• 22 19 702 . 23 Distributions ofproPertyotherthanmoney ,,,,,,,,,,,,,,,,,•,,,,,, ,,,,,,,.• •,__••••, ••..•,_•• ...•.•••• ••..••...••.•.... 28 20 261 . 24 Other items and amounts re wired to be re orted se ante to artners attach schedule ... c~^~'< ~^ "•>'•'%.>i.:::'~~~~<v'."s.:~~:v:<.#s;;,.;:<' JVJA Form 1065 (2003) 311021 12.18-03 3 10150319 706230 56120 2Q03.05010 HENRIETTA SCHLEGEL & ESTATE 56120 Form 1065 (20031 HENRIETTA SCHLEGEL & ESTATE. OF TERRY SHR 23-21$7639 Paae4 anal sis` of Net Income Loss 1 Net Income possl. Combine Schedule K Tines 1 throw h 7 In column .From the rosul subtract the sum of Soh K floss 8 throw h 11 1 17 and 18b ~ 5 9 4 7 . 2 Analysis by partner type: a General partners b Limited artners (i) Corporate (ii) Individual (active) (iii) Individual (passive) (N} Partnership (v) Exempt organization (vi) Nominee/Other 2 974. 2 973. Note: Schedules L, M-1 and M-2 are not reQUired k Question 5 of Schedule B is answered "Yes' Assets 1 Cash ................................................ 2a Trade notes and accounts receivable ,,...,,.. b Less allowance for bad debts .................. 3 Inventories .......................................... 4 U.S. government obligations ,,,,,,,,,,,,,,,,,, 5 Tax-exempt securkies ........................... 6 Other current assets (attach schedule) .,,... 7 Mortgage and real estate loans ............... 8 Other investments (attach schedule) ..,.,.... 9a Buildings and other depreciable assets ,,,... b less accumulated depreciation ,,,,,,,,,,,,,,, 10a Depletable assets ................................. b Less accumulated depletion ,,,,,,,,,,,,,,,,,, 11 Land (net of any amortization) ,,,,,,,,,,,,,,, 12a Intangible assets (amortizable only) ,,,,,,,., b Less accumulated amortization ,,,,,,,,,,,,,,, 13 Other assets (attach schedule) ,,,,,,,,,,,,,,, 14 Total assets ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, Liabilkies and Capkal 15 Accounts payable ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 18 Mortyapee, notes, bonds peyabk In less thsn 1 ysar 17 Other current liabilkfes (attach schedule) ,,, 18 All nonrecourse loans ,,,,,,,,,,,,,,,,,,,,,,,,,,, 1 g Mortpapss, notes, bonds payable In 1 year or moo 20 Other Ifabilkies (attach schedule) ,,,,,,,,,,,, 21 Partners' capital accounts ,,,,,,,,,,,,,,,,,,,,, 1 Net income (loss) per books ,,,,,,,,,,,,,,,,,,,,,,,, 2 Income included on Schedule K, Imes 1 through 4, 6b, and 7, not recorded on books this year (itemize): 3 Guaranteed payments (other than heakh insurance) ................................................ 4 Expenses recorded on books this year not included on Schedule K, lines 1 through i 1, 14a,17g, and 18b (kemize): a Depreciation 3 b Travel and entertainment Z 1 Balance at beginning of year ,,,,,,,,,,,,,,,,, Z Capital contributed; a Cash ,,,,,,,,,,,,,,,,, b Property ..,.,.,,., 3 Net income (loss) per books ................. 4 Other increases (kemize): : • ~. :~ :. u : . ' i '.{'v':{Jfi nir r,: 4; 4•.•;i'y:.:~'SK:. i':•.~~v ,yy{;e , ': '• :y':,.. :v .. Sian"t::' <:: .F: rr::i;5:ti:?::y:::~w:'n~.:;':~::i :r: . wit::; A.,;:+~~,'•'.,ay,;,:t:>::, ; '::..>..t.; .{ ~•~ cy.::':..,:;a..x:•:.{..y::{,•:::.:••. .y :.: ny:y:•y: :::.: }y:: y::•:.:.::.yyy •: y::::.~::::::.::..::::::y:•::::•.y::: , $ 129 6 7 : •,y ..::.: ....:....::..... yyh....; . . .: : F..': .yk..:. Av`: ••,S•. .:...:.....:...::.:.:.. ....:.: :. : : :::. 95 658. 34 029. . . . .. . .. .d$¢/. :{:4\$::ti :i::;:y?rr$::f,•S;Y{{•i:: 'r.:~ ryr:: ....:..::......:+r}::n.n.:::tiLYx.... ..... "•yi'::.i:Yff{;j.+ti:y;Sl:~:::i::?i: ,'rix': : :::y{{iy::: }:w'i t~!'"';• 1 612 "' •<~> '~ ::.::•:;u<<• ~~:.~ ~~><y>.»:<:{:::: 1 400. 212. 58 198. 0 .~ 'v'ii. 8. lv~x$,:h:::vn ~r}.:5~' { . ;~. ~'•~• r F.:ri• '.i~~rf}..'S.v'S:.i'/.ip.:. :;:Y~'.~ is ,4f~:::: is N ntii •:~ ~ii$::y:iti'{?:yin' f {: .:? ................. {~, y 4 201. ~~ 2 200. 23 932. :> . , y ,, f nr. ~ c ~ Loss r Books With income Loss r Return 5 9 4 7. 8 Income recorded on books this year not _ included on Schedule K, lines 1 through 7 (kemize): a Tax-exempt interest S 6 151. ~•~~•~~~~•~ 5 947. 7 Deductions included on Schedule K, lines 1 through 11, 14x,178, and 18b, not charged against book income this year (kemize): a Depreciation S 8 Add Imes 6 and 7 .................................... 9 Income poss) (Analysis of Net Income (Loss) 947. 8 Distributions: a Cash ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, b Property ........................... 7 Other decreases (itemize): ~. ,.,~. 20,261. 8 Add lines 6 and 7,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ~ 39 , 9 6 3. iz=1e-os ,Iwo 4 Form 1065 (2003) 10150319 706230 56120 2Q03.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 ,.. aszs pepartmsnt of the Tienury IntemM Rwenw 9eryke N~HENRIETTA Rental Reai Estate Income and Expenses of a Partnership or an S Corporation - ee Instructions on page 2. - Attach to Form 1065, Form 1085-B, or Form 1120S. & E OMB No. 1546.1186 2003 NOyN gp1UIIGUUn nu~rM+•, TERRY SHROEDEK 23=2187639 t Show the kind and location of each ro . See a e 2 for additlonai ro Ries. q RENTAL REAL ESTATE 160 S HANOVER STREET CARLISLE PA 17013 B C D Rental Real Estate Income 2 Gross rents 2 ~°- 16 , 800 . Rental Real Estate Expenses 3 Advertising 3 .............................. 4 Auto and travel 4 4 3 9. ........................ 5 Cleaning and maintenance 5 ..,......... 8 Commissions 8 ........................... 7 Insurance 7 ................................. 8 legal and other professional fees 8 6 0 0 • .., 9lnterest 9 1 271. .................................... • 10 Repairs 10 1 185 . .................................... 11 Taxes 11 2 5 5 8 . ....................................... 12 Utilities 12 5 7 8 . .................................... 13 Wages and salaries 13 ..................... 14 Depreciation (see Instructions) 14 3 4 9 4 . ...... 5 - STMT li t t Oth 7 2 8 ,., .,..,.,.... er ( ) s 5 ............................................... 15 16 Total expenses for each property. Add lines 3 through 15 ............... 18 10~ 85 3 . 17 Total gross rents. Add gross rents from line 2, columns A through H ........................................................................ 18 Total expenses. Add total expenses from line tti, columns A through H ..................................................................... 19 Net gain (loss) from Form 4797, PaR II, Ifne 18, from the dlsposiGon of propeRy from rental real estate activities ................................................................................................................................................ 20a Net Income (toss) from rental real estate activities from partnerships, estates, and trusts in which this partnership or S corporation is a partner or beneficiary (from Schedule K-1) ......................................................... b Identify below the paRnerships, estates, or trusts from which net Income (loss) fs shown on Ifne 20x. Attach a schedule if more space is needed: (1) Name (2) Employer idenCdication number 16,800. .:, 21 Net income (loss) from rental real estate activfties. Combine lines 17 through 20x. Enter the result ~~<~:~~<: ~; here and on: • Form 1085 or 1120S: Schedule K, line 2, or ................................................................................................... 21 5 9 4 7 . • Form 1005-8• PaR I Ifne 4 ~~~~£~~~~`~•,••~~~ ;~ ~~ ~~~'" ,o•z1-oa JWA For Paperwork Reduction Act Notice, sea papa 2 of form. Form 8828 (2003) 5 10150319 706230 56120 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 i $fiiiw tie kl(1i7 a~ iiiC2C(i5ti u~ aa~ ttT E F G H Rental Real Estate Income 2 Gross rents ................................. Rental Real Estate Expenses 3 Advertising ................................ 4 Auto and travel ........................... 5 Cleaning and maintenance ............... 6 Commissions .............................. 7 Insurance .................................... 8 Legal and other professional fees ,,,,,, 9 Interest ....................................... 10 Repairs ....................................... 11 Taxes .......................................... 12 Utilities ....................................... 13 Wages and salaries ........................ 14 Depreciation (see instructions) ,,,,,,,,, 15 Other (list) - 15 16 Total expenses for each property. Add lines 3 throuflh 15 16 ~yyA Form 8825 (2003) a2oia2 12-ol-oa 6 10150319 706230 56120 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENRIETTA SCHLEGEL & ESTATE OF TERRY~SHR 23-2187639 Fwm 8823 QOfA) Pays Z Fo~ 4562 OM9Nd.i545-U,72 Depreciation and Amortization 2 Q ~ 3 Department of tns Treasury (lncludin~ Information on Listed Property) R- 1 Attachment Internal Revanw Ssrvloe - See separate instructions. - Attach to your tax return. sequalce No. 87 Name(s) afwwn on rotum Busineq or aeWly m whblt thb forth rolatee Idantiyiny number HENRIETTA SCHLEGEL & ESTATE OF TERRY SHROEDER ENTAL REAL ESTATE 3-2187639 ~?E,~ Election To E ense Certain Tan Ible Pro a Under Section 179 Note: If ou have an listed props , corn lets Part V before ou complete Part I. 1 Maximum amount. See instructions for a higher limit for certain businesses ...................................................... 1 100 0 0 0 . 2 Total cost of section 179 property placed in service (see instructions) ............................................................... 2 3 Threshold cost of section 179 property before reduction in limftatlon ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 3 4 0 0 0 0 0 . 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter •0• ......................................................... 4 rj Dollar limitation for tax ysv. Subtnsct line 4 from Ilne 1. If zero or lees, enter-o-. If mvrled filing ssparatNy, sae InsWctlons .............................. 5 (~ Desuipdon of property (ti) Cost (business use only) (c) Fleeted coat .. ............................ B ..... ................ - - - _ 7 Usted property. Enter the amount from line 29 • ........................................................ I 7 I 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 9 Tentative deduction. Enter the smaller of line 5 or Ilne 8 .................................................................................... 10 Carryover of disallowed deduction from Ilne 13 of your 2002 Form 4582 ............................................................ 1 i Business income limtation. Enter the smaller of business Income (not lase than zero) or Tine 5 ,,,,,,,,,,,,,,,,,,,,,,,,,,, 12 Section 179 expense deducton. Add fines 9 and 10, but do not enter more than line 11 .................................... 13 Carryover of disallowed deduction to 2004. Add lines 9 and 10, leas line 12 ,,,,,,,,,,,, - 13 Note: Do not use Part lI or Part 111 below for listed property. instead, use Part 14 Special deprecistion allowance br qualified property (other than listed property) plerxtl In service during the tsx year (see instructions) ....... ........... 14 3 4 5 . 15 Property subject to section 188(f)(1) election (see Instructions) ........................................................................... 15 _ 18 Other depreciation tncludina ACRS) (see instructions) •.........• ••.••.•...•..••.•...•. ......•.. ....•.... ._ ..... ......... 18 2 , 2 2 0 . 17 MACRS deductions for assets placed In service in tax years beginning before 2003 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 17 8 8 0 . 18 If you are electing under section 188(n(4) to group any assets placed in service during the tax `~.:~;.:,;.;<..;•.;:::•.;:.:;.:;::.>..;.:.;.;•::::<,;•:::•>;•>;:.:;.; near Into one or more oeneral asset acc ounts. cnecK Here ............ k;:~;;--.'.....•....'>;..<:.:.:<r:.;:.::_::~:.::».~.~"`.: Section B -Assets Placed in Servic e Durin 2003 Tax Year Usin the Gene ral De recia tion em (a) Classifleatbn of ro ert (b) Month .nd ear laced (d Bnb ror depndatlon slneWinvatmsnt es (~ v~' p p y p y in sarvlee u ony -see Instructions) ~ ~ (s) Ctmvention (t) Method (~ OspreGation deduction 19a 3• ear ro rt •ih p,$Wyrr~,s ' ~~``'~'"''" '~ b 5• ear ro art >°` ~. ~.. ' ~ c 7•year propert ` 3 4 3. 7 YRS . HY O O D 4 9, d 10- ear ro ~ :'~~•.~:~ ''iK~ e 15• ear ro ~::;:r;.::'~$~~ f 20• ear ro rt .:.,•.<:•:; ~ 25• ear ro art `"'"'''``'"` 25 rs. S/L h Re id ti l t l rt / 27.5 rs. MM S/L s en a ren a prope y 1 27.5 rs. MM S/L i Nonresidential real r ert / 39 rs. MM S/L p op y / MM S!L Section C -Assets Placed in Service During 2003 Tax Year Using the Alterna tive Deurec iation Svstem 20a Class Iffe ~'°`~~:{`~~'~,~`'~."Y~ ~ ~ - b 12• ear :•~^~'~3's.:. :,,• . 12 rs. c 40• ear 40 rs. MM S/L ~;:~~ summary (Dare Instructions./ 21 Listed property. Enter amount from line 28 ...................................................................................................... 21 22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 In column (g), and line 21. Enter here and on the appropriate lines of your return. Partnerships and S corporations • see instr ...................... 22 3 4 9 4 . 23 For assets shown above and placed in service during the current year, enter the ~~~~`s'~:YiS A<•'"~,o`:o-,•er'ti_ ....... .... .:. rtion of the basis attributable to section 283A costa ........................................... 23 •..::..::,>~.:.<,::,;~::{;;w:;:~;~: 31a2i ta'i LHA For Pa perwork Reduction Act Notice, see separate instructions. Form 4562 (2003) 7 10150319 706230 56120 2003.05010 HENRIETTA SCHLEGEL & ESTATE 561?0 1 Form 4562 (2003) HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 Page 2 Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and property used for entertainment, recreation, or amusement.) Note: Forany vehicle for which you are using the standard mileage rate or deductlny lease expense, complete only 24a, 24b, columns (a) through fc) of Section A. all of Section B. and Section C H aoalicab/e. Section A -Depreciation and Other Information (Caution: See instructions forhmlts forpassen~erautomobiles.) 24a uo ou nave evfoence to su on the ousfnessnnvestmem use craimear U Tea u rvo zoo rt -T ea - rs the evfaence wmten~r T@S LJ NO (a) (b) (c) (d) (e) (fl (s~ (h) U) Type of property i l f Date n Business/ s s c Cost or i Baeia for depredatlon tment (buelnees n Recovery eriod Method/ ti C Depreciation ded ti Elected section 179 (l st vehic es irst) seN ce e per ent u a 9 other bas s o n~l p onven on on uc cost 25 Special depreciation allowance for qual~ed listed property placed In service during the tax ear and used more than 50% in a ual~ed business use ........................................................................ 25 '~':•`~•':`~':•'""':.'`"":":::': 26 Prooertv used more than 50% in a qualified business use: 27 Prooertv used 50% or less In a 28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 2g ""•'~ ':f<'::t'~> ..:....; 29 Add amounts in column m, line 26. Enter here and on Ilne 7, page 1 ................................................................................. 29 Section 8 -information on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other more than 5% owner,' or related person. If you provided vehicles to your employees, first answer the questions in Sectiolf C to see if you meet an exception to completing this section for those vehicles. 30 Total business~nvestment miles driven during the (a) Vehicle (b) Vehicle (c) Vehicle (~ Vehicle (e) Vehicle (f) Vehicle year (do not include commuting miles) .................. 31 Total commuting miles driven during the year ,,, 32 Total other personal (noncommuting) miles driven ............................................................... 33 Totai miles driven during the year. Add lines 30 through 32,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 34 Was the vehicle available for personal use Yss No Yes No Yes No Yes No Yes No Yes No during off-duty hours? .................................... 35 Was the vehicle used primarily by a more than 5% owner or related person? ,,,,,,,,,,,,,,,,,, 38 Is another vehicle available for personal use? Section C -Questions for Emclovers Who Provide Yah icles for Use 6v Thei. E n.niw...Q Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5% owners or related persons. 37 Do you maintain a wrtten policy statement that prohibits all personal use of vehicles, including commuting, by your Yes No employeesl ................................................................................................................................................................. ................ 38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? See instructions for vehicles used by corporate officers, directors, or 1 °~ or more owners .......................... ............... 39 Do you treat all use of vehicles by employees as personal use? .................................................................................... ............... 40 Do you provide more than five vehicles to your employees, obtain Information from your employees about the use of the vehicles, and retain the information received? ,,,,,,,,,,,,,,,,,,,,,,,,,, ................................................................ ............... 41 Do you meet the requirements concerning qualffied automobile demonstration use? ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, .................... Note: If your answer to 37, 38, 39, 40, or 41 !s "Yes," do not complete Section B for the covered vehicles. ............... k>#:'>F#~r ~~>:~:::: '";'::~ti; Amortization fa) Osaalptbn of poste fbi Mb arnorhri0n OsOkK (~) ArrartlzabN smount (d! Code seetlon fe) Mnortlxztl°n period a pq~„ypp tf) Amortlzetlon for this year 42 Amortization of costs that basins durino vour 2003 tax veer. 43 Amortization of costs that began before your 2003 tax year ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,•,,..,,,,,,,.,,,.,,...,,,.,...,..,._.......,. ~ 43 4q Total. Add amounts in column (f). See instructions for where to report ..........................•,,.,,,,..,....,..................._. A4 3 1 62 52/1 0-2 1.03 Form 4582(20031 8 0150319 706230 56120 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 A Q O a w z O F w ~h Q iW a~ z O f= W 4 ~+ U ~ ~ a Ei W oz f..) W oa 0 N < ; re .~ .~ .4..{. " : c~ ~ f<•;;: c 0 s M .. ,~~,.,~: ~:: - ~~~ C ,~ .- U • ~i::''~i: <~' a~ O n E N < a 0 555:;:«:: .r rn c ~ _ a~ ~ U 61 U N :k~: : • +: f~ :ii:%~::: . l0 `i :~>~~''.~.:: lIl :y;':'?p~: ...r ... ~ w`•t••'t4':;. .4. t ~ :::.,y!,.:: •::.fi.~.,.; t,..::. . ~ • •:: •. :::. '~ ,., O lD 'i~i'•{';.A1 N i+':{i' ~ %:x~..: •1..'•!!~: ,.., ..,,r.; .~,y~;g ,•,:.•.•'~•1.: ~ r'": ~:. •'Y.'][ ~~ :..;!~ ~ ~ `~:::::..::: ~O ~.- r.; ............ ...; . >.. xi .. U E s ' s . a•::• ~ ' f5}i' ~ ~i'2''i' is•%~~: x''25: . ~~ a N •. •• t ::c.. : rl ~~ v v U h : v v ;: ' 0 Q v,{ :'5,5:;:: 4. i `< ~•Sx ~~{ • ,r • ... ;;'`may ; • :{•: ih i .~ ' ' ~~'' • ~~ ~ ' ~ i5ki.:.. • ;,':;?.. O ~: : v, • ~p ti~, :: :• Lfl :• •,: ~p 2 ... • :; :• : .... l! 1 L11 •~r:t ~ :: ~ O p :::;{:~:::3%t:: N :vvi•'i::r:~'• ~ Si ~.<,>.;:N.~:; ~ h}}}>'`w•A!!~:; M y>: S•`.'•~~.••~•.••!:; ~ C:;:`•:•:~;.T,.{5 ~ t?:•:~in .,j ` ~ ::;:{:::{::~'~f ~ ~ V O f N :£ ' S 5• f ~: O .: .. \O f•`:• i ` ` M :`•; ->l~~i ••~:v.`.:.:,:}< d~ ~~: +} ' ~' \C Ei :?:f": N . { : ; iyi .: •C•: ~~ 4< \:i:}2+i ~~S55 o }~ : :: ::: \ y co ` O : +•i. . \. ..\. •.:}: . N 5 M+:?+ ~ ~? O ~ :: ;}?' ... . c N O .- .; ,y. ......... ~5ii~::~ .. ........ '- N i "' A U ~ CD C d o U V7 X W m : fir,:~: . • :% ?::45 :25;x: ....4.~:• :l ..:SS.,.*5 ':e:4: :555!k# ~ :'<;~5:;:555:' 't N ~ O :... % : L"} 1 ::.:i N': %:'~:: •:iiii•:::: v{.. Y / :i•.:^v v4.., •i: } ['~ H S.l. ~ ': ~:+?jT;.:;: 00 '`'' v: ~~~S,~,~~i M «:` y / ; f'5~~,,S~~,~/pp:; ~+ ! }y,'.•'2}:,:!~:Y.: 5!~ ~ ` ~ :v:~i7'i•~i :{4!'S% ~. 10 m v, O , . . > :-i' Nis ':i:5s :~:.. ~ O .•.~,':..:'~t.. :. ~O :z~i4''~i ` f'7 <% i • er i~ : 'W..~t:: 1D ~ '~::;•:•,:•.~%: ;:;5.4,'• :::'4'•: ..4::;:: .:: tv4.::rr ~• >~~~ };;:.•'Sih 3~Y ~{:: :•`5:5::`.,;:2 ~?:;{:;:::}::;: ~: R w+ c , .~ .:}''~•: N•: • :5~ ~' O U f:. ,•: 4..•: :.•> 5 ::,...... ::y:: '+` 5: £ yr t .; •5::. .~ :• b . n +'i: ''S ' ' ;:;} • .i ... {•ti . .:? .. +n~6': #Si •: 5+l:i::>.: :!:'~:`• •} :?i ~::. is+i:' ` :' •,4i i5} v:'~^nv LtS:S r.{i::{}5 : : ~G :no- } • . . lp :::~:., . ~C . %•Y: . +,I~ '^ r-1 s::%:?•.',`.' S ~"1 :>:'Sf:4 r"I •.?x,:. r-I r~l :x:,:\G ~--1 •.,..,• r'1 ;Ye>{..'..:: ~--~ ::::':;~5.:: 5 r-1 O :: j O ti;r,:; 'i O :~~.;~ L•. ,~.~' O .•,.,. ..~ : n .. < O >4i" ` O ,`v:2~i:. O :`';~i~ti{~: O '~•:;5%~. : O O < ,;;Q.; O k :•'.~l . O e~:n.,~1~y O '' }~ O zr , O ::i~?~'}'~ E~{.. ..::; fi ,,•.}.. C t : • y: ? S;~i ~ }:o l F ; (? y -~~~ .~ ~~~~ I'~ v::.:vT^I:v ;,:; .. i P'.~ :: ~ ~?i5:~':::. 1~ ~:y'i'{ v::'S . ~ ~ l ~ %.,5?•'?5:~^.1:: P'I B O .:. ~~r~' ~5~> L w' '~~~~ ~~ w: am. :~::> : w . x .........: o :<> •..: ,,N.. N #E:3:C?rT N ::6:..:?: d~ ::~:::;.M,~!:: 'CM ::::3:i;>YiSE~ Ln ?: ?~ ~~ `: l0 ::::::::Sk•':': ~: ~' 00 : ;s;:~:: ~ ::%<i~ii~: 00 ~::.2~t•.: 00 ',•';:%~%S~S2 CO i:;:55`:~:i: CO :,:%`:;:::: • .: OD ;::::>~. • '•i~ pp z::':~%E~E: CD i ~ - ~'~ O : ~: t~iC'Yi: '' M :`:'•:~E: ~` >' ' 111 .ii~i'•;~~•!ii~i '' ' ~ it?i!:~ •.::'`• ' ~ 5:#:. ' 00 iS:S:~, ' ~-1 ?::~:$:':: :,:+!~!. ~--1 ~~::; : ?Kt! : In p v M : ;~%.:;:,, rl ::;:;;•; .. i; :; •;':: '-•/ <f: 4>•?,•,;• .: • ::" i'i:~ ....: ;: . . O is ::i: {5 ~' sj Zvi: 2•~•\y: ~'•1 : j.; fi:•f .~• ..' C555:2:.:`::;:y: ~'•3 to i:;`;:;.'::?3: •:#:~:: ~ :::~.1.:: ..........r:•r, ........ ~:. ~.. • {:, . . .,... . :::::.::::::. >: `_~` :.:,~:. :....:..::::. o `~<'` a . :5>;,: ....~~ o :::::::::: ~:.,... - A ...., :,... ~ >=:4: ,.. w ~y .~ . o .~`` .,v}v ::. ?.. . .Q ::::::::::::. A ,• ;>.:. .: ffMS ti E'i :;i'i::'::'ti:~: :n~ ;~..}• v.~:. ~•`:: ~ik~{: ..4. •':~% z z . } :... A ~ f . <,.:,..• ~~ z 5: .. {4•• ,. y~ >` FI : :j~~f•: 3 i; yY :: '•.,{. •} W ...$, f rte. , n Kti %.}•,.~;~•C : •:~,'r. L "v'•:'~`! •: O ~%f ~,~''.,: ;~yy'~JJ•~~• ~/~ V' i` ,; `as: v M1: }}~1;rk;~{ •r,.Y~•: r~I'i yi:?.. a H :; x;:+~i ~y.,•Yr,:; U~ .l,?M.i:: }:G4'.i v:}•. :: •+Cv2 { :.:.si'i' [~'J S•f:r:f ti::. ~i? Y ."'~~'. ILI ':f'Y;~~vQ ~'n r,}v'C~'' { ,Si,P,:;K.: ^ < :j A ~ ~'~:~ :: x . ++~i,::: H •;.,y:~ r~ %°+c%'~••~.~ a ai 5...cr, a :;':.w!r{ H .~ ~>,.. ~.~' . >. :,.:r<~>~ ' :.: fit w ..{:.~• w .. w <~ ~> :. .:: it::~!"I;: O :r4;::,;: ', O :,,~.... ; ~ h ; ..} O 2„5~: , H ::~;< A >x..55s H .><.};> . :.:: ,.:. 3 5'.::5 r~ t ..:Ck • H ~: . SsS: •:•:^•.'~.~. :: H ~ ..~ >:: H< H:% .,~•• W ~:#:~'': :{,:.... ~ :::::' ~ W :•s~: ~f..... WW ~: ~: :'': $::' ~. rs~ ~ : ,... . a. r; ?::::• U> .: .;;.:~.::. .::;. 5>; ::•~t..` ~~` :. --~ :.. =i::5:>:>~~ A> ::.~: v::~'c::;:iti.! v:: ±<: :5!.MI. ~:: ;::.::>.. v::: {:.:.??}W. v;::;f:•'.:~iwt v5:;::•:::Air1: ~/::::•:.::?:+?wI. v::.:::<;:'4~i/' vF:Y•...~:.: .. ri :' 2::i'•\7:~ :;:.,,'K.H,,...:: Ill ~ 2%:::' ' O~ :'~~:'. ': ~-i ::5'i:%~Yi M ii:>•>E•. u . ...~. i:w?:i~i .. /:~ NO ;,~5:: {:r `.:; ~:v }.. n. 2 i:i»i +':t::;;'::: . ~s: . .:; :3.. ~<:~.. '"'+ N 0 g ~" N C1 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 SCHEDULE K NET INCOME (LOSS) FROM RENTAL REAL ESTATE STATEMENT 1 DESCRIPTION AMOUNT 5,947. 5,947. RENTAL REAL ESTATE TOTAL TO SCHEDULE K, LINE 2 OTHER CURRENT ASSETS STATEMENT 2 SCHEDULE L DESCRIPTION BEGINNING OF TAX YEAR END OF TAX YEAR 2,521. 2,056. o. O. LOAN RECEIVABLE - SCHLEGEL LOAN RECEIVABLE - SCHROEDER TOTAL TO SCHEDULE L, LINE 6 4,577. o. SCHEDULE L OTHER CURRENT LIABILITIES STATEMENT 3 DESCRIPTION BEGINNING OF TAX YEAR END OF TAX YEAR 2,200. 2,200. O. SECURITY DEPOSITS rOTAL TO SCHEDULE L, LINE 17 o. FORM 1065 PARTNERS' CAPITAL ACCOUNT SUMMARY STATEMENT 4 PARTNER BEGINNING CAPITAL SCHEDULE M-2 WITH- ENDING ~UMBER CAPITAL CONTRIBUTED LNS 3, 4 & 7 DRAWALS CAPITAL 2 13,931. 6,151. 2,974. 14,702. 8,354. 3 13,934. 2,973. 25,261. <8,354.> rOTAL 27,865. 6,151- 5,947. 39,963. O. l0150319 706230 56120 9 . STATEMENT ( S ) 1, 2, 3, 4 2Q03.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 OTHER RENTAL EXPENSES STATEMENT 5 PROPERTY: RENTAL REAL ESTATE 160 S HANOVER STREET, CARLISLE PA 17013 DESCRIPTION AMOUNT SUPPLIES 728. TOTAL TO RENTAL SCHEDULE, LINE 15 728. 10150319 706230 56120 10 STATEMENT(S) 5 2Q03.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 '" Vi ... I-a:l :2:~ ~o t) o U ~~ ~....J '0 1-0 :!:5 ~~ '0 S.~ ...=> 0<:1" ii. c Q) 1-,$ :!:", <C::l :c ~ M o ...-i I- cr 0 0.. W cr Z 0 f= c: <C 0 0 :;:l CI. ~ .C '-' '" D- O> W 0 0 ~ ~ ::J ~ Z ~ w > 1= <C Z cr =0 ~a w ~Z I- ~~ ..J <C c: g I- ... :2:0 ~e 0- ., o c: g~ ~.~ a: 0. ~ ]l ... \-- :!:=> <C~ ~ 1.0 ....:. :..: ...:..... ...w .CU; .~ I ell iil 0>. .5l Partner's Share of Income, Credits, Deductions, etc. For calendar year 2003 .or tax year and endln Parlnershl 'sldentl In number . Partnership's name, address, and ZIP code ENRIETTA SCHLEGEL & ESTATE OF ERRY SHROEDER 209 TERRACE ROAD ECHANICSBURG PA 17055 F Partner's share of liabilities: Nonrecourse .................................... $ Qualified nonrecourse financing ............ $ Other ............................................. $ G Tax shelter registration number . H Check here If this partnership Is a publicly traded partnership as defined In section 469(k)(2) ................................................ 2 SCHEDULE K-1 (F'Orm 1065) Depattment of the Trwsury Internal Revenue Servk:e be Innln Partner's Identl In number . Partner's name, address, and ZIP code 210-30-1706 HENRIETTA F. SCHLEGEL 5209 TERRACE ROAD MECHANICSBURG PA 17055 A This partner Is a 00 general partner D limited liability company member B What type of entity Is this partner? IND IVIDUAL C Is this partner a 00 domestic or a D foreign partner? o Enter partner's percentage of: (\)0== ~Q:;: of Profit sharing ...... % 50.0000000% Loss sharing ......... % 50.0000000% Ownership of capital % 50.0000000% m: CINCINNATI OH limited partner E Check a Ilcable boxes: J Analvsls of oartner's caa Itl I account: (I) Capital account at beginning of year (b) Capital contributed during year (c) Partner's share of lines 3,4, and 7, Form 1065, Schedule M-2 2,974. 13,931. 6,151. iii III o d. I .5 (I) Distributive share Item 1 Ordinary income (loss) from trade or business activltles ....................................... 2 Net income (loss) from rental real estate activities ................................................ 3 Net income (loss) from other rental activities ...................................................... 4 Portfolio Income (loss): a Interest .................................................................. b (1) Qualified dMdends ................................................................................. (2) Total ordinary dividends ........................................................................... c Royalties ......................................................... .......................................... d (1) Net short-term capital gain (Joss) (post-May 5,2003) .................................... (2) Net short-term capital gain (loss) (entire year) ............................................. e (1) Net long-term capital gain (loss) (post-May 5, 2003) .................................... (2) Net long-term capital gain (loss) (entire year) ................................................ f Other portfolio Income (loss) (attach schedule) ................................................ 5 Guaranteed payments to partner ..................................................................... 6 (I) Net section 1231 gain (loss) (post-May 5, 2003) .......................................... (b) Net section 1231 gain (loss) (entire year) ................................................... 7 Other Income Ilossl lattach schedulel ............................................................... 8 Charitable contributions (attach schedule) ......................................................... 9 Section 179 expense deduction ..................................................................... 10 Deductions related to portfOliO Income (attach schedule) .................................... 11 Otherdeductlons lattach schedule) .................................................................. 13 Other credits ............................................................................................. 14 I Interest expense on Investment debts ............................................................... b(1)lnvestment Income Included on lines 41, 4b(2), 4c, and 4f above ........................... (2)lnvestment expenses Included on Une 10 above ................................................... 151 Net eamlngs (loss) from self-employment ......................................................... c Gross nonfarm Income ................................................................................. 168 Depreciation adJustment on property placed in service after 1986 ........................... b Adjusted gain or loss .................................................................................... e Other adiustments and tax Dreference Items {attach schedUle} .............................. 19 Tax-exempt Interest Income ........................................................................... 20 Other tax-exempt Income ............... ....... ....... ........... ............... ......... .............. 21 Nondeductible expenses . ............ ............. ..................... ........... ..... ............... 22 Dlstrlbutlons of money (cash and marketable securities) ....................................... 23 Distributions of oroDertv other than monev ......................................................... I C)'" :Ie: '2.2 0" Iii ... GI ~ o JWA For Paperwork Reduction Act Notice, see Form 1065 Instructions. 311161 02,17-04 OMB No. 1545-0099 2003 23-2187639 o. o Anal K-1 Amended K-1 (d) WIthdrawals and distributions (e) Capital account at end of year (combine columns(ai throuah Id)) 8.354. (C) 1040 filers enter the amount In column (b) on: 14,702. \ (b) Amount o.} 2 , 9 7 4 . See page 6 of Pertn.... In.tructlon. for Seheclule K.' (Form 1065) Form 1040,line 8a Form 1040,IIne 9b Form 1040, line 9a Sch. E, Part 1,IIne 4 Sch. D,lIne 5, cor. (g) Sch. D,line 5, col. (1) Sch. D,lIne 12, col. (g) Sch. D,lIne 12 col. (1) } See psgee e and 7 of Pllltn.... In.wctlon. for Seheclule K-1 (Form 1065) Sch. A,lIne 15 or 16 .., See page 8 of PIrlner'. In.wellon. for Seheclule K.1 (Form 1065) o. (Enter on applicable IIn.. 01 your ",!urn) Form 4952,IIne 1 } See page II of PIrlner'. In.Wellon. lor Seheclule K-1 (Form 1065) 8ch. SE, Section A or B t-~~::r.~~ ~=ellon. } See pao-ll end 10 of Psrtn.... In.tructIons lor ScIIecIule K-1 (Form 1066) end In.ltuctIon. lor Form 82'1 26. 14,702. Form 1040, line 8b } See page 10 of Psrtn.... In.wctIona for ScIIecIule K.' (Form 1065) No Information Required for Pille 2 Schedule K-1 (Form 1065) 2003 2 20.03.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 .0150319 706230 56120 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 SCHEDULE K-1 COLUMN C RECONCILIATION DESCRIPTION AMOUNT RENTAL REAL ESTATE INCOME (LOSS) TOTAL TO SCHEDULE K-1, ITEM J, COLUMN C 2,974. 2,974. 10150319 706230 56120 12 Partner Number 2 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 3 SCHEDULE K-1 (Form 1 Ct65) Department of the T""",ury Intemal RlI\Ienue Service Partner's Share of Income, Credits, Deductions, etc. For calendar year 20.03.or tax year and endln Partnershl 's Identl In number ... Partnership's name, address, and ZIP code ENRIETTA SCHLEGEL & ESTATE OF ERRY SHROEDER 209 TERRACE ROAD ECHANICSBURG PA 17055 F Partner's share of liabilities: Nonrecourse .................................... $ Qualified nonrecourse financing ............ $ Other ............................................. $ G Tax shelter registration number ~ H Check herelf this partnership Is a publicly traded partnership as defined In section 469(k)(2) ................................................ 75-6644048 TERRY B SHROEDER ESTATE 366 CALIFORNIA AVENUE, SUITE 3 PALO ALTO CA 94306 A This partner Is a general partner D limited liability company member B What type of entity Is this partner?'" ESTATE C Is this partner a 00 domestic or a 0 foreign partner? o Enter partner's percentage of: 1Il== 00:= of Profit sharing ...... % 50.0000000% Loss sharing........ % 50.0000000% Ownership of capital % 50 .0000000% E IRS Cente, where artnetShl ftled return: C INC INNATI OH limited partner OMS No. 1545-0099 2003 23-2187639 o. D 1 00 Final K.l Amended K-l J Analvsls of Dartner's caDltal account: Check a Ilcable boxes: ...u! .cU) .~ ~ ell Iii 0> .. cGl -J (a) Capital account at beginning of year (b) Capital contributed during year (c) Partner's share of lines 3,4, and 7, Form 1065, Schedule M-2 2.973. i{ 13,934. "iii ! ~ 8 E (a) Distributive share Item 1 Ordinary Income (loss) from trade or business activities ....................................... 2 Net Income (loss) from rental real estate activities ................................................ 3 Net income (loss) from other rental activities ...................................................... 4 Portfolio Income (loss): I Interest .................................................................. b (1) Qualified dlvldends ................................................................................. (2) Total ordinary dividends ........................................................................... c Royalties ................. .................. ..... ....... ............ ........................ ..... ........... d (1) Net short-term capital gain (loss) (post-May 5, 2003) .................................... (2) Net short-term capital gain (loss) (entire year) ............................................. e (1) Net lono-term capital gain (loss) (post-May 5, 2003) .................................... (2) Netlono.lerm capital gain (loss) (entire year) ................................................ I Other portfolio income (loss) (attach schedule) ................................................ 5 Guaranteed payments to partner ..................................................................... 6 (a) Net section 1231 gain (loss) (post-May 5, 2003) .......................................... (b) Net section 1231 gain (loss) (entire year) ................................................... 7 Other income (Ioss~ lattach schedule~ ............................................................... 8 Charitable contributions (attach schedule) ......................................................... 9 Section 179 expense deduction ..................................................................... 10 Deductions related to portfolio Income (attach schedule) .................................... 11 Other deductions (attach schedule\ .................................................................. '3 Other credits ............................................................................................. 14 a Interest expense on Investment debts ............................................................... b(1)lnvestment Income Included on lines 4a, 4b(2), 4c, and 4f above ........................... (2)lnvestment expenses Included on line 10 above ................................................... 15 a Net earnings (loss) from self-employment ......................................................... c Gross nonfarm Income ................................................................................. 16 a Depreciation adjustment on property placed in service after 1986 ........................... b Adjusted gain or loss .................................................................................... 8 Other adjustments and tax nreference items (attach schedule\ .............................. 19 Tax-exempt Interest Income ........................................................................... 20 Other tax-exempt Income .............................................................................. 21 Nondeductible expenses . ....... ..... ........... ................. ..................................... 22 Distributions of money (cash and marketable securities) ....................................... 23 Distributions of nronertv other than money ......................................................... . UlIl i.~ c'" l/J .jil .. Gl .J:. o (d) Withdrawals and distributions (e) Capital account at end of year (combine columns lal throuoh (dll <8.354.> (I:) 1040 filers enter the amount In column (b) on: 25,261. \ (II) Amount o. } 2 '9 7 3 . See page 8 of P8l1ner's Instructions for SchjlCjule K-1 (Form 1066) Form 1040, line 8a Form 1040, line 9b Form 1040, line 9a Sch. E, Part I, line 4 Sch. D,lIne 5, col. (g) Sch. 0, line 5, col. (f) Sch. D,lIne12, col. (g) Sch. D,lIne 12 col. (f) } See pages 8 and 7 of P8l1ner' a Inatructiona for Scheclule K-1 (Form 1065) Sch. A, line 15 or 16 .. See p.ga 8 of PllIlMr'a > Instructlonator Schedule K-1 (Form 1065) (Enter on epplI'*'le IIn_ of your return) Form 4952, line 1 } See page II of Pwtner's Instructiona torSclleclule K-1 (Form 1065) Sch. SE, Section A or S ~~~:lt~~ ~~ctIona 26. } See pages II and 10 of P.roter'a Inetructiona for Scheclule K.1 (Form 10llll) and Instructione for Form 6251 5,000. 20,261e Form 1040, line Sb } See page 10 of Partn.... a InatNc\lons for Schedule K.1 (Form 1065) JWA For Paperwork Reduction Act Notice, .ee Form 1085 lnatructlona. 311161 02-17-04 No Information Required for Page 2 Schedule K.1 (Form 1065) 2003 3 20p3.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 .0150319 706230 56120 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 SCHEDULE K-1 COLUMN C RECONCILIATION DESCRIPTION AMOUNT RENTAL REAL ESTATE INCOME (LOSS) rOTAL TO SCHEDULE K-1, ITEM J, COLUMN C 2,973. 2,973. .0150319 706230 56120 14. partner Number 3 2Q03.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 .-J 0305911098 PA-20S/PA-&5 (09-03) 2003 Pennsylvania PA S CorporatlonlPartnershlp Infonnatlon Retum ENTER ONE LmER OR NUMBER IN EACH BOX. Do Not Use Your Preprinted Label Filing Status: PA-20S N PA-65 y 232187639 C HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 5209 TERRACE ROAD MECHANICSBURG PA 17055 SUBMIT ALL SUPPORTING SCHEDULES If a loss place an X in the box Part I. Total PA Taxable Buslne$S Income (Loss) from Operations Everywhere 1 a PA Taxable Business Income (Loss) from its Operations Everywhere ~ 1 b Share of Income (Loss) from All Other Entitles 1c Total Income (Loss). Add Une 1a and Une 1b 1d Previously Disallowed CNI Deductions - PA S only 1 e Total Adjusted Business Income (Loss). Subtract Une1d from Une1c 0 Part II. PA Tauble Buslnesllncome (Loss) Allocable to PA 2 Net Operating Income (Loss) from Line 7 PA Schedule H 2 Net Income (LOSS) from other Entities PA Sourcel Outside PA PA Sourcel Outside PA PA Sourcel Outside PA PA Sourcel Outside PA 2 Previously Disallowed PA Source CNI Deductions. PA S corporations only 2 Compute Adjusted/Apportioned Net Operating Income (Loss)- Total each column Part III. Other PA PIT Income (Loss) 3 Interest Income 4 Dividend Income 5 Net Gain (Loss) from the Sale. Exchange. or Disposition of Property 6 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights 7 Income from Estates or Trusts 8 Gambling and Lottery Winnings 9 Total Other PA PIT Income (Loss) - Add Unes 3 through 8 374501 01-07-04 EC Page10t3 FC L 0305917098 [I] o.::IIIIJ IT] L Fiscal Year N Extension Requested N Final Return y Do you want to receive a 2004 Y PA-20S/PA-65? EINlName/Address N Change Amendedlnfonnation N Return ENTER ONE NUMBER IN EACH BOX ~ 1a 0 1b 0 1c 0 1d 0 1e 0 2a 0 2e 0 2b 0 2f 0 2c 0 29 0 2d 0 2h 0 3 0 4 0 5 0 6 6215 7 0 8 0 9 6215 8 8 o 0305917098 ...J ....J 030601.7096 PA-20S/PA-65 . 2003 (09-03) 232187639 C HENRIETTA SCHLEGEL & ESTATE OF T If a loss place an X in the box Part IV. Other PA PIT Income (Loss) Allocable to Pennsylvania 10 Net Gain (Loss) from the Sale, Exchange, or Disposition of Properly B 11 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights 12 Income from Estates or Trusts Part V. Total PA S Corporation or Partnership Income (LOll) 13 Total Income (Loss) per Underlying Pennsylvania Books and Records ~ 14 Total Reportable Income (Loss) (Add Line 1e and Line 9) or (Add Unes 2h, 10, 11, and 12) 15 Total Nontaxable/Nonreportable Income (Loss) - Subtract Line 14 from Line 13 X Part VI. Pass-Through Credits - see Inltructlons for each credit 16a PA Resident Shareholders Tax Credit - PA S corporatlonl only 16b P A Employment Incentive Payments Credit 16c PA Jobs Creation Tax Credit 16d PA Research and Development Tax Credit 17a PA 2003 Tax Withholding Payments from Nonresident Shareholders and Partners 17b Final Payment of Nonresident Withholding Tax 17c Total PA Income Tax Withheld - Add Lines 17a and 17b Part VII. Distributions - see Instructions Partnerships Only 18 Distributions of Cash, Marketable Securities, and Properly 19 Guaranteed Payments for Capital 20 Guaranteed Payments PA S Corporations Only 21 Distributions from PA Accumulated Adjustment Account (MA) 22 Distributions of Cash, Marketable Securities, and Properly L 10 0 11 0 12 0 13 5947 14 6215 15 -268 16a 0 16b 0 16c 0 16d 0 17a 0 17b 87 17c 87 18 19 20 39963 o o 21 22 o o Signature and Verification Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledoe and belief it is true correct and comolete. (FILE ALL 3PAGES\ Preparer Name, based on a/l information on which preparer has any knowledge. Please print: Date Daytime Telephone Number TIMOTHY C WAGGONER, CPA (717)506-1222 For the PA S Corporation or Partnership Name. Please print Date Daytime Telephone Number HENRIETTA SCHLEGEL & ESTATE OF TERR Signature Title Street Add ress City, State, ZIP Code 5006 E TRINJ>LE RJ> SUITE 200 MECHANICSBURG, PA 17050 374502 01-07-04 Page 2 of3 EC FC L 0306017096 CD cr:rr:IIJ CD 0306017096 ...J ..J 0307117093 L PA-20S/PA-65 .2003 (09-03) 232187639 C HENRIETTA SCHLEGEL & ESTATE OF T Part VI/I. Shareholders and Partners Summary Enter the total number of owners of the PA S corporation or partnership, and the number for each type of owner. The entity must provide a PA Schedule RK-1 to each resident Individual owner and a PA Schedule NRK-1 to each non-PA resident individual. The entity must provide each owner that Is not an individual with both a PA Schedule RK-1 and a PA Schedule NRK-1. Read the Instructions. Total shareholders or partners 2 Type of Shareholder or Partner PA Resident Non PA Resident Individuals Pa rtnerships Estates Trusts PA S corporations All other corporations 1 1 Part IX. PA S Corporations Only - Accumulated Adjustment Account 1 Balance at the beginning of the taxable year 2 Total reportable Income from Part V, line 14 3 other addillons - Submit an itemized statement. 4 Loss from Part V, line 14 5 other reductions. Submit an itemized statement. 6 Add Lines 1 through 5 7 Distributions other than dividend distributions 8 Balance at taxable year end - Subtract line 7 from line 6. Place an X In the box 1 2 3 o 4 5 6 7 8 o o o o o o o o Part X. Nonresident Wnhholdlng Payments PA S Corporations and PA Partnerships Use this part to list all the withholding payments that the PA S corporation or partnership made on behalf of shareholders or partners that were not residents of Pennsylvania during the taxable year. A PA Tax Due on PA Taxable Income to Nonresidents. Enter on line 17c 87 NOTE. The amount on Line A must equal the total from all PA Schedules NRK-1 and the Total PA Income Tax Withheld, Une 17c B Nonresident Withholding Payments during the Entity's Taxable Year. Date Amount o o o o o Date Amount 0 0 0 0 0 0 87 Total Nonresident Withholding Payments. Enter In Part VI, on Une 17a C Reconciliation Payment. Subtract B from A. and enter In Part VI, on Une 17b Pay any balance due with: · X The PA-20SIPA-65 Information Retum, or · The PA-40NRC, Nonresident ConSOlidated Tax Retum,lf all the nonresident owners elect to participate In a group return. FILE All3 PAGES Page 3 013 374503 01-07-04 EC FC L 0307117093 CD DIIIIJ CD 0307117093 --.J HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 PA-65 PARTNERS DIRECTORY PARTNERS DIRECTORY (A) (8) (C) (D) (E) OWNERSHIP % CODE NAME AND ADDRESS BOX WMBER/X for PA-40NRC 1. HENRIETTA F. SCHLEGEL 5209 TERRACE ROAD 50.0000000 RI 210-30-1706 MECHANICSBURG, PA 17055 n 2. TERRY B SHROEDER ErTATE 3b6 CALIFORNIA AVENUE, SUITE 3 50.0000000 E 75-6644048 PALO ALTO, CA, 94306 n 3. n 4. n 5. n 6. n 7. n 8. n 9. n 10. n 11. n 12. n Codes: RI- ResIdent Individual: NR - Nonresident Individual: PI . Part-Year Resident Individual: P - Partnership; C - Corporation; E - Estate; T - Trust 374821/06-01-03 ..J PA SCHEDULE E Rents, Royalties, Patents, or Copyrights PA-20S/PA-65 E 2003 Schedule E (09-02) 0207216029 0FFlCIAL S ON Y Kind of ProDertv For oroflt nronertv? Address RENTAL REAL ESTATE YES ( ) 1bO S HANOVER STREET, CARLISLE A NO { I PA 17013 B YES ( ) NO ( ) C YES ( ) NO { I Part B Enter the corresponding Initial of the property from Part A. A I T Income ProBertles 1. Rent received .......................................... 1. 168001 I 2. Rovalties received .................................... 2. I T E~Denses 3. Advertising ............................................. 3. 4. Automobile and travel ................................. 4. 439 5. Cleaning and maintenance ........................... 5. 6. Commissions .......................................... 6. 7. Insurance ................................................ 7. 8. Legal and professional fees ........................ 8. 600 9. Management fees .................................... 9. 10. Mortgage interest .................................... 10. 11. Other interest .......................................... 11. 1271 12, Repairs ................................................... 12. 1185 13. Supplies ................................................... 13. 728 14. Taxes. not taxes based on gross or net Income 14. 2558 15. Utilities ................................................... 15. 578 16. Deoreclatlon ellnense .................................. 16. 3198 Important. PA PIT law does not permit any optional federal depreciation election, other than ACRS, MACRS, and IRC Section 179. You may not deduct the 'bonus depreciation' allowable under Public Law 107-147 of 2003, or any other accelerated depreciation optional method that the Intemal Revenue Code permits 17. Other (Itemize): .......................................... 17. 18. Total e~Denses' Add Lines 3 throuah 17 ...... 18. 10557 Income or Loss: 19. Income - Subtract Line 18 from Line 1 or 2. 19. b 2 4 3 20. Loss- Subtract Line 18 from Line 1 or 2. ...... 20. ( 21. Net Income or Loss Total Line 19 and 20. Fill In the oval If a net loss ................................................................................................ 22. Rent or royalty income (loSs) from other partnership(s), from PA Schedule(l) RK.1 or NRK.1. ................................. 23. Rent or royalty income (loss) from other PA S corporatlon(s), from PA Schedule(s) RK-1 or NRK-1. ........................ Total Income or Loss Irom Rentl, ROYIllIel, Pltenb, Ind Copyrlghb 24. Income or Loss. Add Unes 21, 22, and 23. If submitting more than one schedule, total all amounts, and include on Line 6 ofthe PA 20SIPA-65lnformatlon Return ........................................................................... 37eoo1 02.13-04 :::1: : 6241 24.1 ( 62431 L 0207216029 0207216029 ---I .....J PA SCHEDULE M Reconciling of Federlllncome to PA Income by PA Income CIIII (09-03) PA-20SIPA-65 Schedule M 2003 0301910018 Name as shown on PA-20SIPA-65 Infonnatlon Return HENRIETTA SCHLEGEL & ESTATE OF TERRY SHROEDER PA Schedule M Part A Classifying Federal Income (Losl) for PA Personal Income Tlx Purposel Classify without adjustment for PA PIT rules, the federal/ncome (loss) from the Schedule K of Federal Fonn 11205 or from Federal Fonn 1065, The entity must allocate or apportion the amounts from the federal categorles to the reportable PA PIT classes. The total ofthe PA-class/fled Federal Identification Number. OFFICIAL USE ONL V PA Sales Tax LIcense Number: 23-2187639 ... Federal Form Classified for Pennsvlvanla Personal Income Tax Puroose Form 1120S, Schedule Kline (a) (b) (c) (d) (e) (f) description Federal PA Business Interest Dividend Gain (loss) Rent & royalty Form 1065, Schedule Kline Income Income Income Income from sales Income (Joss) description (loss) (loss) PA Schedule A PA Schedule B PA Schedule D PA Schedule E Ordinary income (loss) from trade or business activities 0 0 0 0 0 0 Net Income (loss) from rental real estate activities S9lf7 0 0 0 0 5947 Net Income (loss) from other rental activities 0 0 0 0 0 0 Portfolio income (loss) 0 0 0 0 0 0 Interest income 0 0 0 0 0 0 Ordinary dividends 0 0 0 0 0 0 Royalty income 0 0 0 0 0 0 Net short-term capital gain (loss) 0 0 0 0 0 0 Net long-term capital gain (loss) 0 0 0 0 0 0 Other portfolio Income (loss) [] 0 0 0 0 0 PA S corporations ONLY Net section 1231 gain (loss) from Form 4797 for Form 1120S 0 0 0 0 0 0 Partnership ONLY Guaranteed payments to oartnel$ from Form 1065 0 0 0 0 0 0 PA S corporations ONLY other income (loss) from Form 11205 0 0 0 0 0 0 Partnership ONLY Net section 1231 gain (loss) from Form 4797 for Form 1065 0 0 0 0 0 0 Partnerlhlps ONLY other Income (loss 1 0 0 0 0 0 0 PA Income (lOSS) by classification. Total amounts In each column. 0 0 0 0 5947 Please enter losses in parentheses ( ). Columns (c) and (d) can never result In a loss. The Federal Schedule K were not released when the Department printed PA Schedule M. After the release of the federal schedules the Department wIU update PA Schedule M. See the PA PIT Guide for the cross-references to the Federal Schedules K. 374881 10-10-03 L 0307910018 0307910018 --I ....I PA SCHEDULE M Reconciling of Federal Income to PA Income by PA Income Clall (09.03) 2003 PA-20SIPA-65 Schedule M []30802D015 Name as shown on PA.20S/PA-65 Infonnatlon Retum HENRIETTA SCHLEGEL & ESTATE OF TERRY SHROEDER PA Schedule M Part 8. Determining PA Reportable Income or LOll by Classification The entity may need to prepare a P A Schedule M, Part B for each PA Income class It it must make adjustments to properly determine Its reportable classified income for its PA-20S/PA.65 Information return. This specltk: list of adjustments prlmarlly applies to ordinary Income from a business or farm. Section 1. Federal Classified Income Loss. Income class from Part A Column: F Enter the Initial of the column. 1. Section 2. itemize Income adjustments that Increase PA reportable Income (reduce the toss) a. Deferred income relating to advance payments for goods and services .............................................................................. b. Difference In gain (loss) for each sale of property where PA basis Is lower than federal basis ................................................ c. Gain from like-kind exchanges. other than transactions qualifying as PA allowable like-kind exchanges - IRC SectIon 1031 .. ....... d. Gain (lOSS) on inVOluntary conversions -'RC Section 1033 ........................................................................................<>... e. Income from cancellation of debt that PA treats differently from federal rules ..................................................................... f. Increases in income in the year of change resulting from spread In the year of change associated with IRC Section 481 (a) adjustment. ........ ............. ........ .... ..... ............................. ..... .................... ....... .... ..... .... .... .................. 1. g. Income from obligations of other states and organizations that Is not exempt for PA purposes ............................................. h. OthertaxablelncomeforPA u osesthattheent doesnotre 0 for federal u oses-submltstatement ........................ h. 2. Total Lines a throu h h 2. Section 3. Itemize Income adjustments that decrease the PA reportable Income (Increase the 10") OFFICIAL USE ONL V Federal Identification Number: 23-2181639 5947 a. 0 b. 0 c. 0 d. 0 e. 0 o o o o a. Decrease In gain for each sale of property where PA basis Is higher than federal basis ......................................................... a. 0 b. Income from obligations ofthe U.S. Government and other organizations thatls not taxable for PA purposes ........................... b. 0 c. Decreases for previously reported Income in prior year resulting from spread associated with IRe Section 481(a) c. 0 d. Other PA nontaxable income that the entity reoorted for federal oumoses - submit statement ......................... ............................................ d. 0 3. Total Lines (althrouoh Idl 3. 0 Section 4. Adlusted PA Reoortablelncome. Total Lines 1 olua2 mlnu.3. 4. 5947 Section 5. itemize those expen.esthat PA la. doel not allow that the entity deducted on Its federal form. These adjustments Increase PA reportable income (reduce the loss) a. Taxes paid on Income from the worksheet In the PA PIT GuidI....................................................................................... b. Differences in accelerated depreciation taken for PA and federal purposes ........................................................................ c. Key man life Insurance premiums (owners as beneficiaries) .......................................................................................... d. Differences in PA treatment of guaranteed payments for capital ....................................................................................... e. Differences in depreciation for bonus depreciation PA law does not allow bonus depreciation ................................................ 1. Expense adjustments to qualify for the PA credits claimed In Part Vi................................................................................. . other e enses that the en took on Its federal retum that PA does not allow - submit a statement ....................................... 5 . T ota I Lines a throu h Section S. itemize those upens81 that PA law allows that thllntlty could not deduct on ItI federal form. These adjustments decrease PA reportable Income (increase the loss) a. 0 b. 0 c. [] d. 0 e. 296 1. 0 [] 5. 29 a. 50 percent of business meals and entertainment that the entity could not deduct and club dues a. 0 ............................................. b. Sales tax on depreciable assets .................................... ............................. ................................................................ b. 0 c. Qualified charitable contributions that the entity made c. 0 ................................................................................................... d. Differences in depreciation taken for federal and PA purposes d. 28 ....................................................................................... e. IRe section 179 expenses - the maximum for PA purposes is $25,000 ........................................................ e. 0 f. Differences in depreciation for bonus depreciation ...................... f. 0 ...................................................................................................... g. Expenses for employees, Including PA S corporatton shareholder-employees ..................................................................... Q. 0 h. Life Insurance premiums (PA S corporation or partnership as benefiCiary) h. 0 ........................................................................ i. Expense adjustments to qualify for federal credits .......................................................................................................... I. 0 l. other exoenses that PA allows that the entitY did not deduct on Its federal return - submit statement ....................................... I. 0 8. Total Un8& fa) throuah III II. 28 SectIon 7..PA Classified Taxable Income floll'. Total Line. 4 Dlua Ii mlnu.'. "a /1011). olace an X In the box. r J 7. 6215 374882 01-28-04 L 0308020015 0308020015 --I HENRIETTA SCHLEGEL & ESTATE OF TERRY SHROEDER .pift'): Election To Ex ense Certain Tan Ible Pro e Under Section 179 Note: If OU have an listed ro e . com lete Part V before 1 Maximum amount. See Instructions for a higher limit for certain businesses ...................................................... 1 2 Total cost of section 179 property placed In service (see Instructions) ............................................................... 2 3 Threshold cost of section 179 property before reduction In limitation .................................................................. 3 200 000. 4 Reduction In limitation. Subtract line 3 from line 2. If zero or Jess, enter -0- ......................................................... 4 5 Dollar limitation for tax y_. Sub~ line 4 fIom 11".1. Ifz_ or.... entw-o-.If"*"-d Illlng MP4lN'-'Y, _Inatrucllona .............................. 5 6 (8) Daac:rtpllon 01 proptllty (bl Coat (bual- u.. only) (e) EIectecI coat 7 Usted 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 01 line 5 or line 8 .................................................................................... 9 10 Carryover of disallowed deduction from line 13 of your 2002 Form 4562 ............................................................ 10 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 ........................... 11 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 .................................... 12 13 Carryover of disallowed deduction to 2004. Add lines 9 and 10. less line 12 ............ ~ 13 JJliii%ttKNNMlW@JJktfm Note: Do not vse Part 1/ or Part III below for fisted property. Instead, use Part V. :::::';';';;::''-;J::: S ecial De reciatlon Allowance and Other De reelation 0 not include listed 14 Special depreclation allowance for quallfted proptllty 101ll...lIIan lIalad proptllty) pl~ III MlVIce during lIIetax y.... (see InalnJellons) .................. 14 15 Property subject to section 168(1)(1) election (see Instructions) ........................................................................... 15 16 Other de reclatlon ncludln ACRS see Instructions ....................................................................................... 18 2 220. ;:..:..;.:.::::;....:;:.. .. .;.... .: '.: MACRS De reelatlon 0 not Include listect . See Instructions. Secrtlon A 17 MACRS deductions for assets placed In service In tax years beginning before 2003 .......................................... 18 If you are electing under section 168(1)(4) to group any assets placed In service during the tax ear Into one or more eneraJ asset accounts check here .................................................................. ~ Section B - Assets Placed In Service Durin 2003 Tax Year Usin the Oeneral De reclatfon S (b) Month 8IId Ic:j BMIa !Dr eIapNclalIon '''' Recov- (8) cl..slncallon of proptllty v- pllicecl (\lUe\neMIlnveatmlnt use 'v, ......... -, lei Convention (1l M-'hod (g) OlpNelallon deductfon In MrVlc:e only - -1natNctIons) ....- Foon 4562 Depreciation and Amortization (Including Infonnatlon on Usted Property) R- . See separate Instructions. . Attach to your tax return. Business or actlvlty to which tIlla form relata Department 01 the TrNSUry Internal Revenue Selvlce Name(s) sllown on retum PA OMB No. 1545-0172 1 2003 All8chment Sequence No. 67 IdenUfylng number 198 b 688. 7 YRS. HY 200D c d e h S/L I MM ~L I MM SIL I MM SIL I MM SIL Section C - Assets Placed In Service During 2003 Tax Year Using the Alternative Depreciation System SIL SIL S/L Residential rental property Nonresidential real property 20a Class life b 12- ear c 40- ear :P.iitf:' Summary (See instructions.) 21 Usted property. Enter amount from line 28 ................................................;..................................................... 22 Total. Add amounts from line 12. lines 14 through 17, lines 19 and 20 In column (g), and line 21. Enter here and on the appropriate lines 01 your return. Partnerships and S corporations - see Instr. ..................... 23 For assets shown above and placed In service during the current year. enter the rtion of the basis attributCible to section 263A costs ................................................ 23 ~::nk LHA For Paperwork Reduction Act Notice, see separate instructions. 12 rs. 40 rs. MM 98. 21 22 Form 4562 (2003) Form 4562(2003) HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 Page 2 Listed Property (Include automobiles. certain other vehicles. cellular telephones, eertaln eomputers, and property used for entertainment, recreation. or amusement.) Note: For any vehicle for which yot) are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (8) throuoh (c) of Section A. sll of Section B. and Section C if SDolicabfe. Section A Depreciation and Other Information (Caution: See InstnJctions for limits for passenger automobiles.) - 248 Do YOU have evidence to suooort the buslness/lnvestment use claimed? r 1 Yes [ ] No 24b If 'Yes 'Is the evidence written? Dyes [ 1 No (a) (b) (c) (eI) (e) (f) (9) (h) Q) Type of prope~ Date Businessl Cost or Baal. lor deprecl.tion Recovery Methodl Depreciation Elected (list vehicles firs } place~ In Investment other basis (buslneaallnveslmei11 period Convention deduction section 179 servlce use percentage usa only) cost 25 ~:c:::~::~: t~~w;~el~o: ~~::: I:~::~~y .~I~.I~.~~~~.~~.~~~.~~~.~~......................... I 25 :1'~I'I:!i!llli!IIIIII::IIIII:r~:::::::i .. p,_ ,sed monl than 50% In a ral1ftad bu....... use: I ' : j :1 I I 27 Prooertv used 50% or less In a Qualified bus ness use: : : % SIL . . : : % S/L . : , % S/L . 28 Add amounts in column (h). lines 25 through 27. Enter here and on line 21 , page 1 .................................... I 28 29 Add amounts in column (I), line 26. Enter here and on line 7. page 1 ................................................................................. I 29 Section B - Information on Use of Vehicles Complete this section for vehicles used by a sole proprietor. partner, or other 'more than 5% owner,' or related person. If you provided vehicles to your employees, first answer the questions In Section C to see If you meet an exception to completing this section for those vehicles. (e) (b) (c) (eI) (e) (f) 30 Total business/lnvestment miles driven during the Vehicle Vehicle Vehicle Vehicle Vehicle Vehicle year (do not Include commuting miles) .................. 31 Total commuting miles driven during the year .., 32 Total other personal (noncommutlng) miles driven.. . ............................................................ 33 Total miles driven during the year. Add lines 30 through 32.................................... 34 Was the vehicle available for personal use Yes No Yes No Yes No Yes No Yes No Yes No during off-duty hours? .................................... 35 Was the vehicle used primarily by a more than 5% owner or related person? .................. 36 Is another vehicle available for personal use? . . . . . . . . . . . . .,...,........................................ Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine If you meet an exception to completing Section B for vehicles used by employees who are not more than 5% owners or related rsons. 37 Do you maintain a written policy statement that prohibits all personal use of vehicles, InclUding commuting, by your employees? ........... .... ..... ........ .......... '" ............. ....... ..................................... ..... ...... ............ .... ............. .... ......... ... ...... .......... ....... 38 Do you maintain a written policy statement that prohibits personal use of vehicles. except commuting, by your employees? See instructions for vehicles used by corporate officers. directors, or 1 % or more owners .......................................... 39 Do you treat all use of vehicles by employees as personal use? ................................................................................................... 40 Do you provide more than five vehicles to your employees. obtain Information from your employees about the use of the vehicles, and retain the Information received? ......,.................................................................................................. 41 Do you meet the requirements concemlng qualified automobile demonstration use? Note: If your answer to 37,38,39,40, or41/s 'Yes,' do not complete Sect/on B for i;;~~~;;j~;;;;i.:~..................................... ],?iif:;. 'li: Amortization la Oaacrlptio 01 coals Yes No ff:{~~~~f~l ~!l~~tw~mm~ 42 (0) ArnortIzsble amount (d) Code sactlon (e) Arnortzdcn perlod<< peaRtIQI (f) Amortlz.tion lor 1111. y_ 43 Amortization of costs that began before your 2003 tax year .............................................................................. 43 44 Total. Add amounts in column (t). See Instructions for where to report ............................................................... 44 316252110-21-00 Form 4582 (2003) 5~ r:: 0 ~1i U .:x; "'u ;:, 0'" ~ ~ EO. <~ r:: 0 i N _a> ~ c,.... l!!.... .1:: > =l!l G) U(/'l a: (ij .~ .-I G) "Cc E S~ E .!!'" E';:; 8 ",l!! g ~g. I <0 0 M ~ a: :I: C oj ~o l6' o~ ~'" ~ ",'u v;~ en "'c- co", oj Cl ,.... ,... r:: 0 .E .~ 5.sa .:e ~ en "'<Xl g "C '" a: . o-eu eIl)( ~w ell ~.~ ell <Xl ::l~ I :co "'- Ceil ::;)0 U .lIl '0 110 J :JZ txJ ~ 8 ~ .:x; 8 ..:; U) (il "C 0 ~ fi '" (il ~ 0:: "C ~ .&.~ ",,,, ocr 8 I..) < "'Z a:(il ~o:: w a: z 0 ;:: is ;:: C a: .~ 0 Q. ~ 'C U < ell Cll 0 0 Z <I: Z 0 ;:: < C3 w a: Q. w 0 Xci M ~z g ('II o.~ r:: ,2 c.~ t) ~ ::>0 ;:, ~ oE ~ Eo.. <'" 0 r:: 0 ~ ~a> (ij c:,.... l!?.... .t: > ~u G) ::>", a: U(/'l (ij 'e .-4 G) 'Cc: E .5.9 "' ... E -co 8 ::>- E~ ::>~ 0 uo. u<lJ O'l I <0 Cl M ~ a: :I: c: oj ~o 16' 0';::; ~'" ~ v>U to -'" eIl~ (/) "'0. co", oj Cl ,.... ,... r:: .E 0 a.~ '~ .:e ~ en "'<Xl c.5 '0 !::: '" a: . '#. c::; eIl)( ::>w <Xl V> '0- ",ell -'" v> <Xl ::>~ I -co "'... ev> :::>0 <..> VI 'i5 ~.g $ ~ txJ I 8 ~ ~ .:x; ::J 8 U) txJ '0 0 ~ 5 ~ txJ 0:: '0 ~ '" Cl) ~ 'CV':; ocr 8 :i "'Z a:txJ ~o:: w a: z 0 ;:: < N ;:: c: ex: .2 0 9- ~ u < V> '" Cl 0 Z <I: Z 0 ;:: < C3 w a: Q. W 0 10 g~ "8 :22 0 ~o ('II Plil ..J 0306511095 2003 Relldent Schedule of PA S Shareholder/Partner PA Schedule RK.1 (09-03) Pall-Through Income, LOll, and Credltl 210301706 HENRIETTA f. SCHLEGEL C 5209 TERRACE ROAD Owners 1 N Amended MECHANICSBURG PA 17055 Stock Ownership % HENRIETTA SCHLEGEL & ESTATE Of TERRY SHR MECHANICSBURG PA 17055 232187639 c Part II, Owner" DI,trlbutlve Share of Income and LOI' Shareholders and partners enter the amounllfrom thlllchedule on the correlpondlng IInel of the Pennsylvania Income tal or Information returns they mult file. Reid thl Inltru~lonl for completing thl PA-40, PA-41, or PA-20S/PA-85. 1 PA Taxable Business Income (Loss) from Operations If a loss place an x in the box. 0 2 Interest Income 3 Dividend Income 4 Net Gain (Loss) from the Sale, Exchange. or Disposition of Property If a loss place an x In the box. B 5 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights If a loss place an x In the box. 6 Income from Estates or Trusts 7 Gambling and Lottery Winnings Part III. Owner'. Share 01 PA Credltl 8 PA Resident Credit - PA S Shareholdlrs only 9 PA Employment Incentive Payments Credit 10 PA Jobs Creation Tax Credit 11 PA Research and Development Tax Credit Part IV. Distributions from Partnership 12 Distributions of Cash, Marketable Securities, and Properly - not Including guaranteed payments 13 Guaranteed Payments for Capital 14 Guaranteed Payments Part V. Distributions from PA S Corporation 15 Distributions from PA AAA 16 Distributions of Cash, Marketable Securities, and Property Part VI. Nontaxable PA S Corporation Income or Loss 17 Nontaxable PA S corporation Income (losS) Do not report this Income or loss on your PA-40 Tax Return Part VII. SupplementallnlormatloR 18 Member's Share of Depreciation Expense 19 Member's Share of Straight-Line Depreciation 374621 01-07-04 if a loss place an x In the box. 0 fINAL K-1 EC FC L 0306517095 CD CIIIIJ:J IT] L (Indlvldual-1, S Corp-2. All Other Corp..3, Estate/Trust-4, Partnershlp-S) Partner's % of: Profit sharing 0 . 5000 o 0.5000 Loss sharing N Capital Ownership PA S Corp. 0.5000 y Partnership 1 0 2 0 3 0 4 0 5 3108 6 0 7 0 8 0 9 0 10 0 11 0 12 14702 13 0 14 0 15 0 16 0 17 0 18 0 19 0 0306517095 ---I ..J 03065.1:;'095 PA Schedule RK.1109-03) 2003 Relldent Schedule of PA S Shareholder/partner Pass-Through Income, Loss, and Credltl L 756644048 C TERRY 8 SHROEDER ESTATE 3bb CALIFORNIA AVENUE, SUITE 3 Owners 4 (Indlvldual-1, S Corp-2, All other Corp-3, Estate/Trust-4, Partnershlp-5) Amended N Partner's % of: Profit sharing 0.5000 PALO ALTO CA 94306 Stock Ownership % 0 Loss sharing 0.5000 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR Capital 0.5000 Ownership MECHANICSBURG PA 17055 232187639 C N PA S Corp. Y Partnership Part II. Owner's Distributive Share of Income and LOll Shareholders and partners enter fhe amounts from lhls schedule on the corresponding lines 01 the Pennsylvania Income tax or Information returns they must file. Read the Instructions for completing the PA-40, PA-41, or PA-20S/PA-&5. 1 PA Taxable Business Income (Loss) from Operations If a loss place an x In the box. 0 2 Interest Income 3 Dividend Income 4 Net Gain (Loss) from the Sale, Exchange, or Disposition of Property 11 a loss place an x In the box. 8 5 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights If a loss place an x in the box. 6 Income from Estates or Trusts 7 Gambling and Lottery Winnings Part III. Owner's Share 01 PA Credltl 8 PA Resident Credit - PA S Shareholders only 9 PA Employment Incentive Payments Credit 10 PA Jobs Creation Tax Credit 11 PA Research and Development Tax Credit Part IV. Distributions from Partnership 12 Distributions of Cash, Marketable Securities, and Property - not Including guaranteed payments 13 Guaranteed Payments for Capital , 4 Guaranteed Payments Part V. Distributions Irom PA S Corporation 15 Distributions from PAAM 16 Distributions of Cash, Marketable Securities, and Property Part VI. Nontallble PA S Corporation Income or LOIS 17 Nontaxable PA S corporation Income (loss) Do not report this Income or loss on your PA-40 Tax Return Part VII. Supplemental Information 18 Member's Share of Depreciation Expense 19 Member's Share of Straight-Line Depreciation 374621 01-07-04 If a loss place an x in the box. 0 FINAL K-1 EC Fe L 0306517095 CD CIIIIIJ [I] 1 0 2 0 3 0 4 0 5 3107 6 0 7 0 8 0 9 0 10 0 11 0 12 25261 13 0 14 0 15 0 16 0 17 0 18 0 19 0 0306517095 --.J --I 030661':1093 PA Schedule NRK-1 (09-03) 2003 Non.PA Resldenfs Schedule of PA S Shareholder/Partner Pass-Through Income, Loss, and Credits 756644048 C TERRY 8 SHROEDER ESTATE L 366 CALIFORNIA AVENUE, SUITE 3 Owners 4 (Indivldual-1, S Corp-2, All other Corp-3, EstatelTrust-4, Partnersh/p-5) Amended N Partner's % of: Prollt sharing 0.5000 PALO ALTO CA 94306 Stock Ownership % 0 Loss sharing 0.5000 HENRIETTA SCHLEGEL & ESTATE Of TERRY SHR Capital 0.5000 Ownership MECHANICSBURG PA 17055 232187639 C N PA S Corp. y Partnership Part II. Owner's Distributive Share 01 Income and Loss Shareholders and partners enter the amounts from this schedule on the corresponding lines 01 the Pennsylvania Income tax or Information returns they must nIe.Read the Instructions for completing the PA-40, PA-41, or PA-20S/PA-65. 1 PA Taxable Business Income (Loss) from Operations 2 Net Gain (Loss) from the Sale, Exchange, or Disposition of Property 3 Nellncome (Loss) from Rents, Royalties, Patents, and Copyrights 4 Income from Estates or Trusts 5 Gambling and Lottery winnings * AMOUNT PAID ON fORM PA-V Part III. Owner's Share 01 PA Credits 6 PA Nonresident Tax Withheld 7 PA Employment Incentive Payments Credit 8 PA Jobs Creation Tax Credit 9 PA Research and Development Tax Credit 11 a loss place an x In the box. ~ If a loss place an x In the box. If a loss place an x In the box. 87 * Part IV. Distributions from Partnership 10 Distributions of Cash, Marketable Securities, and Property. not Including guaranleed payments 11 Guaranteed Paymenls for Capital 12 Guaranteed Paymenls Part V. Distributions from PA S Corporation 13 Distributions of PA AM 14 Distributions of Cash, Marketable Securities, and Property Part VI. Nontaxable PA S Corporation Income (Loss) 15 Nontaxable PA S Corporation Income or Loss Do not report this Income (loss) on your PA-40 Tax Retum Part VII. Supplementallnlormatlon 16 Member's Share of Depreciation Expense 17 Member's Share of Stralght-Une Depreciation 374601 01-07-04 fINAL K-1 EC L If a loss place an x In the box. 0 FC 0306617093 CD CCII:IJ::J CD Owner's Share of Income and LOll, whether distributed or not 1 0 2 0 3 3107 4 0 5 b 7 8 9 87 o o o 10 11 12 25261 o o 13 14 o o 15 o 16 17 o o 0306617093 --.J Fo~ 1065 Department of the Treasury Internal Revenua Selvlce u.s. Return of Partnership Income OMB No. 1545-001I9 FO\' calendar year 2003, 0\' taK year beginning '_ ,and tIlIdlng '-' 2003 C Bualn_ code number 531110 ECHANICSBURG PA 17055 G Check applicable boxes: (1) Initial retum (2) Final return (3) Name change (4) H Check accounting method: (1) [Xl Cash (2) D Accrual (3) D Other (specify) ~ I Number of Schedules K.1. Attach one for each person who was a partner at any time during the tax year ~ Ntmeof~hlp ENRIETTA SCHLEGEL & ESTATE OF ERRY SHROEDER Number, etnIel, and_oraul.no.lla P.O. boll, _ page 14 ofthelnatNctlona. D ~=erldanllftcetlon A Principal bull..- ICtlvlty REAL ESTATE B Principal pIOCIucl or earvlce 23-2187639 E Date bualn_ etwted RENTALS 209 TERRACE ROAD CIty or town, atate. and ZIP code 03/01/1980 F ToQl MMla o. Address change (5) D Amended return 2 Caution: Include only trade or business Income and expenses on lines 1a through 22 below. See the Instructions for more Information. :.:.:.:.:.:.: 1 a Gross receipts or sales .................................................................................... 1a iiiJl!l~l b Less returns and allowances ........................................................................... 1b 1C 2 Cost of goods sold (Schedule A, line 8) ............................................................................................................ 2 41 3 Gross profit. Subtract line 2 from line 1 c 3 E ............................................................................................................ 8 4 Ordinary Income (lOSs) from other partnerships, estates, and trusts (attach schedule) ................................................ 4 oS 5 Net farm profit (loss) (attach Schedule F(Form 1040)) 6 .......................................................................................... 6 Net gain (loss) from Form 4797, Part II, line 18 .................................................................................................... 6 7 Other Income (loss) (attach schedule) ............................................................................................................ 7 8 Total Income IJOlIl. Combine lines 3 throuah 7 ................................................................................................. 8 g Salaries and wages (other than to partners) (less employment credits) .................................................................. 9 1ii' 10 Guaranteed payments to partners 10 c: ..................................................................................................................... 0 11 Repairs and maintenance 11 ~ .............................................................................................................................. III ~ 12 Bad debts 12 ,g ................................................................................................................................................... .. 13 Rent ......................................................................................................................................................... 13 2 14 Taxes and licenses 14 III ....................................................................................................................................... c 15 Interest ........................................................................................................... j.... ~ i........................... -... -.... 15 0 t1 16 a ~f$1t: ::I Depreciation (if required, attach Form 4562) ......................................................... 18a .. b Less depreciation reported on Schedule A and elsewhere on return ........................... 116bl ... 16c III .S: 17 Depletion (Do not deduct 011 and gal depletion.) 17 1 ............................................................................................. 18 Retirement plans, etc. ..................................................................................................................................... 18 III 19 Employee benefit programs 19 c: ..............................................;............................................................................. 0 t1 ::I 20 Other deductions (attach schedule) 20 'i ............................................................................................................... Q 21 Total deductlonl. Add the amounts shown In the far riaht column for lines 9 throuah 20 .......................................... 21 22 Ordlnarv Incomelloll) from trade or busIness activities. Subtract line 21 from line 8 ................................................ 22 O. Under peneltlaa of P8IlUI'/. I dacIws that I '-- eocarnInad thle IIIlUm. InclUcllng ~ng echedulee and etatenwlm and to \he beat of my knowledge and bellet It Ie true, Sign correct, and complete. Dacllnllon of plWp8IW (other than gena pMner or 1Im1t11c1llablllty company membaljle baaed ';n "'Information of Which P"'I*W h_ any k~ ~ I~ May \he IRS dlacu_ thla retum Here will> \he pnIpWW enown belOW Signature of general partner or limited liability company member Data (_Inalr.)? 00 Yel n No Preperer'a ~ I Data I Check If ,I P~aSSNorPTIN Paid signature ",!-empIoyed ~n POO087325 Preparer'$ ~o'::'~a,r=(or~WAGGONER, FRUTIGER & DAUB ElN ~3-1583249 Use Only ~~~d 5006 E TRINDLE RD SUITE 200 Phone no. (717)506-1222 ZIP coda MECHANICSBURG. PA 17050 311001 12-18-03 JWA For Paperwork Reduction Act Notice, leeleplrate Instructions. ~orm 1065 (2003) HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 Pa e 2 Foim 1065 i003 :l$Q6~f:";':';'''::':'::jA:: Cost of Goods Sold see a e18 ofthe Instructions 1 Inventory at beginning of year ................................................................................... ....... ..... ............................ 2 Purchases less cost of ttems wtthdrawn for personal use ........................................................... ............................ 3 Cost of labor .............................................................................................................................. .................. 4 Additional section 263A costs (attach schedule) ................................................................................................ 5 Other costs (attach schedule) ........... ..... ........... ...................................... ..... .................................... ....... ....... 6 Total. Add lines 1 through 5 ........................................................................................................................... 7 Inventory at end of year ............ ........... ................................................... .......................................................... 8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 ......................................................... 9 a Check all methods used for valuing closing Inventory: (i) D Cost as described in Regulations section 1.471-3 (Ii) D lower of cost or market as described in Regulations section 1.471-4 (iii) D other (specify method used and attach explanation) ~ b Check this box if there was a writedown of 'subnormal' goodS as described in Regulations section 1.471-2(c) ................................................... ~ 0 c Check this box if the LIFO inventory method was adopted this tax year for any goods (If checked, attach Form 970) .................................... ~ 0 d Do the rules of section 263A (for property produced or acquired for resale) apply to the partnership? ............................................. 0 Yes 0 No e Was there any change in determining Quantities, cost, or valuations between opening and closing inventory? .................................... 0 Yes 0 No 1 2 3 4 5 8 7 8 If 'Yes' attach exolanation. Ir~jSB6ihii;;r~jj Other Infonnatlon 1 What type of entity is filing this retum? Check the applicable box: a [X] Domestic general partnership b 0 Domestic limited partnership c D Domestic limited liability company d 0 Domestic limited liability partnership e 0 Foreign partnership f D Other ~ 2 Are any partners in this partnership also partnerships? ........................................................................................................................ 3 During the partnership's tax year, did the partnership own any Interest in another partnership or In any foreign entity that was disregarded as an entity separate from Its owner under Regulations sections 301.7701-2 and 301.7701-3? If yes, see Instructions for required attachment ..................... ............................................................................................. 4 Is this partnership SUbject to the consolidated audit procedures of sections 6221 through 6233? If 'Yes: see Designation of Tax Matters Partner below ., ...... ...... ...................................... ........................... .......................... .............................. 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-l are filed with the retum and fumlshed to the partners on or before the due date (Including extensions) for the partnership return. If 'Yes,' the partnership Is not required to complete Schedules L, M-l, and M-2; Item F on page 1 of Form 1065; or Item J on Schedule K-l ................................................................................... .............................. '" .................... ....................... 6 Does this partnership have any foreign partners? If 'Yes: the partnership may have to file Forms 8804, 8805 and 8813. See page 20 of the Instructions .......................................................................................................................................... 7 Is this partnership a publicly traded partnership as defined In section 469(k)(2)? ....................................................................................... 8 Has this partnership filed, or is It required to file, Form 8284. Application for Registration of a Tax Shelter? .. ........................................... ...... 9 At any time during calendar year 2003, did the partnership 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 page 20 of the instructions for exceptions and filing requirements for Form TO F 90-22.1. If 'Yes: enter the name of the foreign country. ~ 10 During the tax year, did the partnership receive a distribution from, or was It the grantor of, or transferor to, a foreign trust? If 'Yes: the partnership may have to file Form 3520. See page 20 ofthelnstrucllons ............................................. ............................... ..... 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership Interest during the tax year? If 'Yes: you may elect to adjust the basis of the partnership's assets under section 754 by attaChing the statement described under Elections Made By the Partnership on page 9 of the Instructions ................................................................................................... 12 Enter the number of Forms 8865 Return of U.S. Persons With ResDect to Certain Foreian Partnershlns attached to this return ~ Designation of Tax Matters Partner (see page 20 ofthe Instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: Name of designated TMP ~ Identifying number of TMP ~ Address of ~ designated TMP JWA 311011 12-18-03 Yes No II x x x II x x x X x X x ijjiiji1i@rr~ftmmtm 0150319 706230 56120 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 Form 1065 (2003) 1 Iii III o d- el E o (,) .= HENRIETTA SCHLEGEL & ESTATE-. OF TERRY SHR Partners' Shares of Income redlta Dedu ons etc, IDIatrI utIY 1 Ordinary Income (loss) from trade or business activities (page 1,IIne 22) ...................................................... 2 Net Income (loss) from rental real estate aclivltles (attach Form 8825) .....s.~~...S.~A~g.MgN~....L........ 31 Gross Income from other rental activities ................................................ 3. b Expenses from other rental activities (attach schedule) .............................. 3b c Net Income (loss) from other rental activities. Subtract line 3b from line 3a ................................................... 4 Portfolio income (loss) (attach Schedule D (Form 1065) for lines 4d and 4e): ................................................... a Interest income .............................................................................................................................. ... b Olvidends: (1) Qualified dividends ~ (2) Total Ordinary dividends ~ ............... c Royaity Income ........ .................. ....................................................................................................... d Net short-term capital gain (loss): (1) post-May 5, 2003 ~ (2) Entire year ~ ...... e Net long-term capital gain (loss): (1) post-May 5, 2003 ~ (2) Entire year ~ ...... f Other portfoliO Income (loss) (attach schedule) ....................................................................................... 5 Guaranteed payments to partners ............................................................................ ........ ..................... 6 a Net section 1231 gain (loss) (post-May 5, 2003) (attach Form 4797) ............................................................ b Net section 1231 gain (loss) (entire year) (attach Form 4797) ........................................................................ 7 Other Income loss attach schedule ...................................................................................................... 8 Charitable contributions (attach schedule) ................................................................................................ 9 Section 179 expense deduction (attach Form 4562) ................................................................................. 10 Deductions related to portfolio Income (itemize) ....................................................................................... 11 Other deductlons attach schedule .. .......... ........ ....................... ................ ...... ................. ........ ....... ........ 12 a Low-Income housing credit: (1) From partnerships to which section 42(1)(5) appUes .......................................... (2) Other than on line 12a(1) ............................................................................................................. ..... b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468) .............................. c Credits (other than credits shown on lines 121 and 12b) related to rental real estate actlvities .............................. d Credits related to other rental activities ................................................................................................... 13 Other credits ........,.......................................................... ............................................................. ....... 14 a Interest expense on Investment debts ...................................................................................................... b (1) Investment income InCluded on lines 4a, 4b(2), 4c, and 4f above ............................................................ 2 Investment e enses Included on line 10 above ................................................................................. 15 a Net earnings (loss) from se"-employment ................................................................................................ b Gross farming or fishing income ............................................................................................................ c Gross nonfarm Income ....................... ...... ........ ................................ ........... .................... .................... 16 a Oepreciatlon adjustment on property placed In service after 1986 .................................................................. b Adjusted gain or loss ........................................................................................................................... c Depletion (other than 011 and gas) ......................................................................................................... d (1) Gross Income from oil, gas, and geothermal properties ........................................................................ (2) Deductlons allocable to oil, gas, and geothermal properties .................................................................. e Other ad ustments and tax reference Items attach schedule ..................................................................... 17 a Name of foreign country or U.S. possession .. b Gross income from all sources ............................................................................................................... c Gross Income sourced at partner level ...................................................................................................... d Foreign gross Income sourced at partnership level: (11 Passl>lI ~ (2) llndcalllgOrlel(a\tIdIld1.) ~ (3) GeneralIImIlI.on" e Deductions allocated and apportioned at partner level: (1) Interest expense ~ (2) Other ......................................................... ~ f Deductions allocated and apportioned at partnership level to foreign source Income: (1) Passl>lI ~ (2) llndc:allgarlll (attach 1d1.) .~ (3) General Hmtdon ~ g Total foreign taxes (check one): ~ Paid 0 Accrued D ............................................................... h Reduction In taxes available for credit attach schedule .....................................:........................................ 18 Section 59(e)(2) expenditures: I Type ~ b Amount ~ 1 9 Tax-exempt Interest income ......... ....... ..... ....................... .............. ...... .......... .............. .......... ........ ........ 20 Other tax-exempt Income ....... .................. ......... .... .............. ..................... ...... .... ....... ............ ............... 21 Nondeductlble expenses .............................................. .............................................................. ............ 22 Distributions of money (cash and marketable securities) .............................................................................. 23 Distributions of property other than money ................................................................................................ 24 Other Items and amounts re ulred to be fe orted se a.rate to artners attach schedule ................................. .. .. ~~e QlCGl >41.. .= E..: III C o :g ~ i c III ~ .. o >. '0" :t:_c Gl Q. Gl (l)EE w ~3 lIIc Ill. C~1Il .11 E E,". "Vi~= .i!.~ ~1- I )( ~ C 01 .! o u. ~ JWA 311021 12-18-03 23-2187639 Pa e3 O. 5 947. O. 52. Form 1065 (2003) .0150319 706230 56120 20p3.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 & ESTATE OF TERRY SHR 23-2187639 Paoe 4 1 Net Income (Iosa). Combine Schedule IIn.. 1 th 2 Analysis by partner type: a General partners b Limited artners Note: Schedules L M.1 and M-2 are not re ulred If Question 5 of Schedule B is answered 'Yes.' ::ts.6.6ii:klti.::tb Balance Sheets r Books mol (Iv) Partnership 1 (v) Exempt organization 5 947. (i) Corporate (II) IndMdual (acttve ) 2 974. (III) Individual (passive) (vi) Nominee/Other 2 973. Assets 1 Cash ................................................ 2a Trade notes and accounts receivable ......... b Less allowance for bad debts .................. 3 Inventories .......................................... 4 U.S. government obligations .................. 5 Tax-exempt securities ........................... 6 Other current assets (attach schedule) ...... 7 Mortgage and real.state loans ............... 8 Other Investments (attach schedule) ......... 9a Buildings and other depreciable assets ...... b Less accumulated depreciation ............... , Oa Oepletable assets ................................. b Less accumulated depletion .................. 11 Land (net of any amortization) ............... 12a Intangible assets (amortizable only) ......... b Less accumulated amortization ............... 13 Other assets (attach schedule) ............... 14 Total assets ....................................... Liabilities and Capital Accounts payable ................................. MortgIIgee, notes, bOnds payeble In Ieaa thM 1 y- Other current liabilities (attach schedule) ... All nonrecourse loans ........................... MortgIIgee. no.... bonds poly..... In 1 y.- or IllON Other liabilities (attach schedule) ............ Partners' capital accounts ..................... f~~~1~~r~~~~1~~t~~~~~~~~Wt#fll~~t~~~~~~~~~I~~1~~~~~ 1~*'J~~fJJ~~jt~t~j~~~1~~~li~i~~11 ~~~~~~lt1~~~m~;~~~~~~*~~;~~~~~~~~~1~;~~~1~rf~f~~l~i~ o. o. o. 3 Guaranteed payments (other than health insurance) ................................................ 4 Expenses recorded on books this year not Included on SChedule K, lines 1 through 11, 14a, 17g, and 18b (itemize): a DepreCiation $ b Travel and entertainment $ 7 Oeductlons Included on Schedule K, lines 1 through 11, 14a, 17g. and 18b, not charged against book Income this year (itemize): a Depreciation $ Add lines 6 and 7 ....................................... Income (loss) (Analysis of Net Income (Loss), line 1 . Subtract line 8 from line 5 .................. 5 947. 19 702. 20 261. 1 2 II Distributions: I Cash ...................;............. b Property ........................... 6 151. 7 Other decreases (itemize): 5 947. 3 4 5 Add lines 1 throu h 4 .................................... n~f:-k JWA .0150319 706230 56120 8 Add lines 6 and 7 ....................................... 39 963. 39 963. 9 BalMculendofy_. Sublnlc:lllneeframllne5 ...... . Form 1065 (2003) 20.03 .05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 Fonn 4562 OMS No. 1545-0172 Oepa~toftheTnMSU~ Intemal Revenue Service Name(s) shown on return Depreciation and Amortization (Including Infonnatlon on Usted Property) R- ~ See separate Instructions. ~ Attach to your tax return. Business or actlvlty to which this fonn relatea 1 2003 AtlIIcIIment Sequence No. 67 Identifying number & ESTATE OF 1 2 3 4 Dollar limitation for tax y_. Sublnlct line 4 fTom line 1. If zero or len, entar -0-. If lI'WI1ed ftllng aapwataIy, _ Instructions .............................. 6 (81 Oeacr1ption of pRlperly (b) Coat (bu.'neu u.. only) (e) Elected ooat 400 000. . . .~llt*~l~:1:1:1:~:~:~~111 8 9 10 11 12 ~;~~;~;~r~I~~;M~t~~~~~~~l~~j~@1~~~lt~~11~~rmf 14 15 18 345. 2 220. 17 18 (81 Cllalftcation of property (g) Depreciation dacluction 19a b c 343. 7 YRS. HY 49. d e h Residential rental property S/L I MM S/L I MM SIL I MM SIl I MM SIL Section C - Assets Placed In Servl~ During 2003 Tax Year Using the Alternative Depreciation System S/L SIL SIL Nonresidential real property 20a Class life b 12. ear 40- ear r:.:'''':::'::'':~r: Summary (See Instructions.) 21 Usted property, Enter amount from line 28 ...................................................................................................... 22 Total. Add amounts from line 12, JInes 14 through 17, lines 19 and 20 In column (g), and line 21. Enter here and on the appropriate lines of your retum. Partnerships and S corporations' see Instr. ..................... 23 For assets shown above and placed In servIce during the current year, enter the ortion of the basis attributable to section 263A costs ................................................ 23 n~2f.k LHA For Paperwork Reduction Act Notice, see separate instructions. 12 rs. 40 rs. MM 21 22 Form 4562 (2003) 0150319 706230 5612~ 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 Form 4562 (2003) HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 Page 2 mrS*fMf Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers. and property used for entertainment, recreation. or amusement.) Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (a) throuoh (c) of Section A. all of Section B. and Section C if BDolicable. Section A _ Depreciation and Other Information (Caution: See Instructions for limits for passenger automobiles.) 24a Do vou have evidence to support the business/investment use claimed? r 1 Yes [ ] No 24b If 'Yes' is the evidence written? DYesDNo la) (b) (c) (d) (e) (f) (9) (h) P) Type of prope~ Date Businessl Cost or Baals for depreciation Recove ry Methodl Depreciation Elected (list vehicles firs ) placed In Investment other basis (bu.ineasllnvestment period Convention deduction section 179 se rvlce use percentage u.. only) cost 25 Special depreciation allowance for qualified listed property placed in service during the tax 125 1~!IIIIIJ;illll~IIIIIIIIIIIII'IIII:I:I.! vear and used more than 50% In a Qualified business use ........................................................................ .. Pmpert)'""'" "",",Ihon 50" '0 '1""- """"... .- I ' : :1 I I 7 Prooertv used 50% or less In a Qualified business use: : : % SIL . . : : % S/L - : : % S/L - 28 Add amounts in column (h). lines 25 through 27. Enter here and on line 21 , page 1 .................................... I 28 29 Add amounts in column (i). line 26. Enter here and on line 7. page 1 ................................................................................. I 29 2 Section B - Information on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other 'more than 5% owner,' or related person. If you provided vehicles to your employees, first answer the questions In Section C to see If you meet an exception to completing this section for those vehicles. (a) (b) (c) (d) (e) (f) 30 Total business/lnvestment miles driven during the Vehicle Vehicle Vehicle Vehicle Vehicle Vehicle year (do not include commuting miles) .................. 31 Total commuting miles driven during the year ... 32 Total other personal (noncommuting) miles driven............................................................... 33 Total miles driven during the year. Add lines 30 through 32.................................... 34 Was the vehicle available for personal use Yea No Yes No Yes No Yes No Yes No Yes No during off-duty hours? .................................... 35 Was the vehicle used primarily by a more than 5% owner or related person? .................. 36 Is another vehicle available for personal use? .."."" ..",.. ............................................. Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section 8 for vehicles used by employees who are not more than 5% owners or related ersons. 37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees? ............................................................................................................................... .................................................. 38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? See instructions for vehicles used by corporate officers, directors, or 1 % or more owners .......................................... 39 Do you treat all use of vehicles by employees as personal use? ................................................................................................... 40 Do you provide more than five vehicles to your employees, obtain information from your employees about the use of the vehicles. and retain the information received? ......................................................................................................... 41 Do you meet the requirements concerning qualified automobile demonstratIon use? Note: If your answer to 37, 38, 39, 40, or 41 Is 'Yes,' do not complete Section B for ih~ ~~~;;; ~~hid;:'''''''''''''''''''''''''''''''''''''' i:p.Ul:.!i Amortization (a) Oescription of costa Yes No ?4~~~t.i~r~t~ ~~~~W:~;tf:~11~ 43 Amortization of costs that began before your 2003 tex year 43 44 Total. Add amounts In column (t). See Instructions for where to report ............................................................... 44 316252110-21.03 Form 4562 (2003} (c) AmorllzabIe amount (d) Code aactlon (f) Amortization ~r ~'s year 42 Amortization of costs that 0150319 706230 56120 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 Fonn 8825 Rental Real Estate Income and Expenses of a Partnership or an S Corporation ~ See Instructions on plue 2. ~ Attach to Form 1085, Form 1065.8, or Form 11208. ESTATE OF OMBNo.1545-1186 Department 01 tile Treasury Internal Revenue Setvlce 2003 Employerldenti1lcation number 231-2187639 c o Properties Rental Real Estate Income 2 Gross rents............................. 2 Rental Real Estate Expenses 3 Advertising .............................. 3 4 Auto and travel........................ 4 5 Cleaning and maintenance ............ 5 6 Commissions ........................... 6 7 Insurance ................................. 7 8 Legal and other professional fees... 8 9 Interest .................................... 9 10 Repairs .................................... 10 11 Taxes ....................................... 11 12 Utilities .................................... 12 13 Wages and salaries ..................... 13 14 Oepreciation (see Instructions) ...... 14 15 Olher(list) ~$.';I;'~.';I;'....~........... A 16 800. B c o 439. 600. 1 271. 1 185. 2 558. 578. 3 494. 728. 15 16 Total expenses for each property. Add lines 3 through 15 ............... 16 10 853. 17 Total gross rents. Add gross rents from line 2, columns A through H ........................................................................ 17 16 800. 18 Total expenses. Add total expenses from line 16, columns A through H ..................................................................... 18 10 1 9 Net gain (loss) from Form 4797, Part II, line 18, from the disposition of property from rental real estate activities ................................................................ ................................................................................ 19 20a Net income (loss) from rental real estate activities from partnerships, estates, and trusts In which this partnership or 5 corporation Is a partner or beneficiary (from Schedule K.1) ......................................................... 201 b Identify below the partnerships, estates, or trusts from which net Income (loss) Is shown on line 20a. Attach a schedule if more space Is needed: (1 ) ,Name (2) Employer Identification number 21 Net income (loss) from rental real estate activities. Combine lines 17 through 20a. Enter the result here and on: · Form 1065 or 11205: Schedule K,lIne 2, or ................................................................................................... · Form 1065-8: Part I line 4 10-21.03 JWA For Paperwork Reduction Act Notice, lee plge 2 ofform. }!~ Form 8825 (2003) 0150319 706230 5612a 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR Form 8825 (2003) 1 Show the kind and location of each property. E 23-2187639 PIQ8 2 F G H ProDertles Rental Real Estate Income E F G H 2 Gross rents ................................. 2 Rental Real Estate Expenses 3 Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Auto and travel ........................... 4 5 Cleaning and maintenance ............... 5 6 Commissions .............................. 8 7 Insurance .................................... 7 8 Legal and other professional fees ...... 8 9 Interest ........................................ 9 10 Repairs ....................................... 10 11 Taxes .......................................... 11 12 Utilities ....................................... 12 13 Wages and salaries ........................ 13 14 Depreciation (see Instructions) ......... 14 15 Other (list) ~ 15 16 Total expenses for each property. Add lines 3 throuah 15 .................. 18 JWA Form 8825 (2003) 320142 12-01-03 0150319 706230 56120 2093.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENR~ETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 -' SCHEDULE K NET INCOME (LOSS) FROM RENTAL REAL ESTATE STATEMENT 1 DESCRIPTION AMOUNT ~ENTAL REAL ESTATE rOTAL TO SCHEDULE K, LINE 2 5,947. 5,947. 3CHEDULE L OTHER CURRENT ASSETS STATEMENT 2 )ESCRIPTION BEGINNING OF TAX YEAR END OF TAX YEAR rOTAL TO SCHEDULE L, LINE 6 2,521. 2,056. 4,577. o. o. ~OAN RECEIVABLE - SCHLEGEL ~OAN RECEIVABLE - SCHROEDER o. 3CHEDULE L OTHER CURRENT LIABILITIES STATEMENT 3 )ESCRIPTION BEGINNING OF TAX YEAR END OF TAX YEAR 3ECURITY DEPOSITS 2,200. 2,200. o. o. rOTAL TO SCHEDULE L, LINE 17 ~ORM 1065 PARTNERS' CAPITAL ACCOUNT SUMMARY STATEMENT 4 >ARTNER BEGINNING CAPITAL SCHEDULE M-2 WITH- ENDING lUMBER CAPITAL CONTRIBUTED LNS 3, 4 & 7 DRAWALS CAPITAL 2 13,931. 6,151. 2,974. 14,702. 8,354. 3 13,934. 2,973. 25,261. <8,354.> ~OT AL 27,865. 6,151. 5,947. 39,963. o. 0150319 706230 56120 STATEMENT(S) 1, 2, 3, 4 2093.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 OTHER RENTAL EXPENSES STATEMENT 5 ?ROPERTY: RENTAL REAL ESTATE 160 S HANOVER STREET, CARLISLE PA 17013 )ESCRIPTION AMOUNT 3UPPLIES 728. rOTAL TO RENTAL SCHEDULE, LINE 15 728. 0150319 706230 56120 STATEMENT(S) 5 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 '. ". . WAGGONER, FRUTIGER & DAUB 5006 E TRINDLE RD SUITE 200 MECHANICSBURG, PA 17050 (717) 506-1222 (717)506-1222 MARCH 19, 2004 HENRIETTA F. SCHLEGEL 5209 TERRACE ROAD MECHANICSBURG, PA 17055 RE: HENRIETTA SCHLEGEL & ESTATE OF TERRY SHROEDER DEAR PARTNER: ATTACHED IS YOUR COpy OF THE PARTNERSHIP FORM 1065 SCHEDULE K-1. THIS SCHEDULE SUMMARIZES YOUR INFORMATION FROM THE PARTNERSHIP. THIS INFORMATION HAS BEEN PROVIDED TO THE INTERNAL REVENUE SERVICE WITH THE U.S. PARTNERSHIP RETURN OF INCOME, FORM 1065. THE INFORMATION PROVIDED ON THIS SCHEDULE SHOULD BE ENTERED ON YOUR TAX RETURN, IN ACCORDANCE WITH THE INSTRUCTIONS IN COLUMN C. IF YOUR RETURN WILL BE PREPARED BY YOUR ACCOUNTANT OR ATTORNEY, YOU SHOULD PROVIDE A COpy OF THIS SCHEDULE TO THE PRE PARER WITH YOUR OTHER TAX INFORMATION. WE THANK YOU FOR THE OPPORTUNITY TO SERVE YOU. VERY TRULY YOURS, WAGGONER, FRUTIGER & DAUB 2 SCHEDULE K-1 (Form tJ65) Department of tha Treasury Intemal Revenue Service 210-30-1706 Partner's Share of Income, Credits, Deductions, etc. For calendar year 2003.or tax year and endin Partnershl 'sldentl In number ~ Partnership's name, address, and ZIP code ENRIETTA SCHLEGEL & ESTATE OF ERRY SHROEDER 209 TERRACE ROAD CHANICSBURG PA 17055 F Partner's share of liabilities: Nonrecourse .................................... $ Qualified nonrecourse financing ............ $ Other ............................................. $ G Tax shelter registration number ~ H Check here If this partnership Is a publicly traded partnership as defined In section 469(k)(2) ................................................ OMB No. 1545-0099 . 2003 23-2187639 HENRIETTA F. SCHLEGEL 5209 TERRACE ROAD MECHANICSBURG PA 17055 A This partner is a general partner D limited liability company member 8 Whatlype Of entity Is this partner? ~ IND IVIDUAL C Is this partner a 00 domestic or a t:i foreign partner? (1) Before ell.,.,,,,, O~End of D Enter partner'S percentage of: or termination y_ Profit sharing ...... % 50.0000000% Loss sharing ......... % 50.0000000% Ownership Gf capital % 50 .0000000% E IASCenterWhare ershl nledretum: CINCINNATI OH limited partner o. o Check a llcable boxes: 1 00 Final K-1 2 D Amended K-1 J Analysis of partner's caDltal account: (a) Capital account at (b) Capital contributed (c) Partner's share of lines (d) Withdrawals and (e) Capital account at end 3,4, and 7, Form 1065, of year (combine beginning of year during year Schedule M-2 distributions columns la) throuah Id)) 13,931. 6,151. 2.974. 14.702.\ 8,354. (a) Distributive share Item (b) Amount (c) 1040 filers enter the amount In column (b) on: 1 Ordinary Income (loss) from trade or business activities ....................................... O. } 2 Net Income (loss) from rental real estate activities 2,974. See page e of Partn.... In.tructlon. ................................................ for Schedule K.1 (Fonn 1065) 3 Net Income (losS) from other rental activities ...................................................... 4 Portfolio Income (loss): a Interest .................................................................. Form 1040, line Sa b (1) Qualified dividends ................................................................................. Form 1040, line 9b "jjj' (2) Total Ordinary dividends ........................................................................... Form 1040, line 9a C/l 0 c Royalties 5ch. E, Part I, line 4 d. ................................................................................................... G d (1 ) Net short-term capital gain (lOSS) (post-May 5. 2003) 5ch. 0, line 5, col. (g) E .................................... 8 (2) Net short-term capital gain (loss) (entire year) ............................................. 5ch. 0, line 5, col. (f) oS e (1) Net long-term capital gain (loss) (post-May 5, 2003) Sch. 0, line 12, col. (g) .................................... (2) Net long-term capital gain (loss) (entire year) ................................................ Sch. D, line 12 col. (f) I Olher portfolio Income (losS) (attach schedule) ................................................ } 5 Guaranteed payments to partner ..................................................................... 6 (-I Net section 1231 gain (loss) (post-May 5, 2003) See trl:: 6 and 7 of Partner'. .......................................... lna . for Schedule K.1 (b) Net section 1231 gain (loss) (entire year) (Form 1065) ................................................... 7 other income Iloss) lattach schedule) ............................................................... I 8 Charitable contributions (attach schedule) ......................................................... Sch. A,line 15 or 16 UC/l 9 Section 179 expense deduction ~ ::Ic Seetrl::"e of Partnar's 'i.S! ..................................................................... 10 Deductions related to portfolio Income (attach schedule) In. . for Schedule K.1 C- .................................... (Form 1065) 11 other deductions lattach schedule\ .................................................................. -~ 13 Other credits ............................................................................................. (Enter on applicable IIn. of your retum) .cu) 148 Interest expense on Investment debts ............................................................... Form 4952, line 1 :lG 'iECIlI b (1 )Investment income Included on lines 4a, 4b(2), 4c, and 4f above ........................... } See page 9 of Partn.... In.tructlona ..il (2)lnvestment expenses Included on line 10 above ................................................... for Schedule K.1 (Form 1065) CJ~! N~t eamlngs (lOSS) from self-employment o. -oS 15a ......................................................... Sch. SE, Section A or 8 c Gross nonfarm Income ................................................................................. ~~:,:k~~=ctIon. iil 16a Depreciation adjustment on property placed In service after 1986 ........................... 26. } See pagaa 9 and 10 of Pwm.... b Adjusted gain or loss In.tructlona lor Schedule K.1 .................................................................................... (Form 1085) and Inetructlon. e Other adlustments and tax preference Items (attach schedulel .............................. lor Form 8251 19 Tax-exempt Interest Income ........................................................................... Form 1040, line Bb .. 20 other tax-exempt Income .............................................................................. QI ~ 21 Nondeductible expenses } ~~O._. 0 .............................................................................. In. lor Schedul. K.1 22 Distributions of money (cash and marketable securities) 14.702. (Fonn 1085) ....................................... 23 Distributions of orooertv other than money ......................................................... JWA For Papefwork Reduction Act Notice, Ise Form 1065 Instructions. 3"'61 02-17-04 No Information Required lor Page 2 Schedule K.1 (Form 1065) 2003 0150319 106230 56120 2 2003.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 3CHEDULE K-1 COLUMN C RECONCILIATION )ESCRIPTION AMOUNT 2,974. 2,974. ~ENTAL REAL ESTATE INCOME (LOSS) rOTAL TO SCHEDULE K-1, ITEM J, COLUMN C .0150319 706230 56120 Partner Number 2 2093.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 ...J 0306517095 2003 Resident Schedule of PA S Shareholder/Partner PA Schedule RK-1 (09-03) Pall-Through Income. LOll. and Credits 210301706 HENRIETTA F. SCHLEGEL C 5209 TERRACE ROAD Owners 1 N Amended MECHANICSBURG PA 17055 Stock Ownership % HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR MECHANICSBURG PA 17055 232187639 c Part II. Owner'1 Dlltrlbutlve Share of Income and LOll Shareholders and partners enter the amounts from thlllchedule on the conelpondlng IInel of the Pennsylvania Income tll or Information returns they mUlt Ole. Read thelnltructlonl for completing the PA-40, PA-41, or PA-20SIPA-85. 1 PA Taxable Business Income (Loss) from Operations If a loss place an x In the box. 0 2 Interest Income 3 Dividend Income 4 Net Gain (Loss) from the Sale, Exchange, or Disposition of Property If a loss place an x in the box. 8 5 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights If a loss place an x In the box. 6 Income from Estates or Trusts 7 Gambling and Lottery Winnings Part III. Owner'1 Share of PA Credits 8 PA Resident Credit. PA S Shareholders only 9 PA Employment Incentive Payments Credit 10 PA Jobs Creation Tax Credit 11 PA Research and Development Tax Credit Part IV. Dlltrlbutlonl from Partnership 12 Distributions of Cash, Marketable Securities, and Property. not Including guaranteed payments 13 Guaranteed Payments for Capital 14 Guaranteed Payments Part V. Distributions from PA S Corporation 15 Distributions from PA AM 16 Distributions of Cash, Marketable Securities, and Property Part VI. Nontaxable PA S Corporation Income or LOSI 17 Nontaxable PA S corporation income (loss) Do not report this income or loss on your PA-40 Tax Retum Part VII. Supplemental Information 18 Member's Share of Depreciation Expense 19 Member's Share of Stralght-Une Depreciation 374621 01-07-()4 If a loss place an x in the box. 0 FINAL K-1 EC FC L 0306517095 CD o:r:o:o CD L (Indlvldual.1, S Corp.2, All Other Corp.3, EstatefTrust.4, Partnership..S) Partner's % of: Profit sharing 0 . 5000 o 0.5000 Loss sharing N Capital Ownership PA SCarp. 0.5000 Y Partnership 1 0 2 0 3 0 4 0 5 3108 6 0 7 0 8 0 9 0 10 0 11 0 12 14702 13 0 14 0 15 0 16 0 17 0 18 0 19 0 0306517095 --I -. WAGGONER, FRUTIGER & DAUB 5006 E TRINDLE RD SUITE 200 MECHANICSBURG, PA 17050 (717) 506-1222 (717)506-1222 MARCH 19, 2004 TERRY B SHROEDER ESTATE 366 CALIFORNIA AVENUE, SUITE 3 PALO ALTO, CA, 94306 RE: HENRIETTA SCHLEGEL & ESTATE OF TERRY SHROEDER DEAR PARTNER: ATTACHED IS YOUR COPY OF THE PARTNERSHIP FORM 1065 SCHEDULE K-l. THIS SCHEDULE SUMMARIZES YOUR INFORMATION FROM THE PARTNERSHIP. THIS INFORMATION HAS BEEN PROVIDED TO THE INTERNAL REVENUE SERVICE WITH THE U.S. PARTNERSHIP RETURN OF INCOME, FORM 1065. THE INFORMATION PROVIDED ON THIS SCHEDULE SHOULD BE ENTERED ON YOUR TAX RETURN, IN ACCORDANCE WITH THE INSTRUCTIONS IN COLUMN C. IF YOUR RETURN WILL BE PREPARED BY YOUR ACCOUNTANT OR ATTORNEY, YOU SHOULD PROVIDE A COPY OF THIS SCHEDULE TO THE PREPARER WITH YOUR OTHER TAX INFORMATION. WE THANK YOU FOR THE OPPORTUNITY TO SERVE YOU. VERY TRULY YOURS, WAGGONER, FRUTIGER & DAUB 3 SCHEDULE K-1 (Form 1\)65) Department of the T~ury Inlemal Revenue Service b Innln Partner's Identl In number ~ Partner's name, address, and ZIP code Partner's Share of Income, Credits, Deductions, etc. For calendar year 2003 9r tax year and endln Plrtneflhl '.Identl In number ~ Partnership's name, address, and ZIP code ENRIETTA SCHLEGEL & ESTATE OF ERRY SHROEDER 209 TERRACE ROAD ECHANICSBURG PA 17055 F Partner's share of liabilities: Nonrecourse .................................... $ Qualified nonrecourse financing ............ $ Other ............................................. $ G Tax shelter registration number ~ H Check here If this partnership Is a publicly traded partnership 8$ defined In section 469(k)(2) ................................................ 75-6644048 TERRY B SHROEDER ESTATE 366 CALIFORNIA AVENUE, SUITE 3 PALO ALTO CA 94306 A This partner is a 00 general partner D limited liability company member B What type ofentity is this partner? ~ ESTATE C Is this partner a 00 domestic or a D foreign partner? (I) Before CIlMge OQ End of D Enter partner's percentage of: or termination YWI Profit sharing ...... % 50.0000000% Loss sharing ......... % 50.0000000% Ownership of capital % 50 . 0000000% E IPSCenterw11er9 hi .\edreblm: CINCINNATI OR limited partner OMB No. 1545-0099 . 2003 23-2187639 o. D 2 0 Amended K-1 J AnalYsl. of Dlrtne", eanltalleeount: Check a l!cable boxes: Final K-1 ...w .cui $I" 'ftEeCl ij"-; ..Ie O~$ -.= (a) Capital account at beginning of year (b) Capital contributed during year (e) Partner's share of lines 3,4, and 7, Form 1065, Schedule M-2 2,973. ( 13,934. Cii ~ tI E 8 .= (a) Distributive share Item 1 Ordinary income (loss) from trade or business activities ....................................... 2 Net income (lOSS) from rental real estate activities ................................................ 3 Net income (loss) from other rental activities ...................................................... 4 Portfolio Income (loss): a Interest .................................................................. b (1) Ouallfied dividends ...............................................................................,. (2) Total ordinary dividends ........................................................................... e Royalties ................................................................................................... d (1) Net short-term capital gain (lOSS) (post-May 5, 2003) .................................... (2) Net short-term capital gain (lOSS) (entire year) ............................................. e (1) NeUong-term capital gain (loss) (post-May 5, 2003) .................................... (2) Net long-term capital gain (loss) (entire year) ................................................ f Other portfolio Income (loss) (attach schedule) ................................................ 5 Guaranteed payments to partner ..................................................................... 6 (I) Net section 1231 gain (lOSS) (post-May 5, 2003) .......................................... (b) Net section 1231 gain (lOSS) (entire year) ................................................... 7 Other Income lIoss\ (attach schedule\ ............................................................... 8 Charitable contributions (attach schedule) ......................................................... 9 Section 179 expense deduction ..................................................................... 10 Deductions related to portfolio Income (attach schedule) .................................... 11 other deductions (attach schedule) .................................................................. 13 other credits ........ ............................ ....... ............................ ........ .............. 14 a Interest expense on Investment debts ............................................................... b(1)lnvestment Income included on lines 4a, 4b(2), 4c, and 4f above ........................... (2)lnvestment expenses Included on line 10 above ................................................... 15 a Net eamlngs (loss) from self-employment ......................................................... e Gross nonfarm Income ................................................................................. 16 . Depreciation adjustment on property placed In service aiter 1986 ........................... b Adjusted gain or loss .................................................................................... e other adlustments and tax oreference Items (attach schedule\ .............................. 19 Tax-exempt Interest Income ........................................................................... 20 Other tax-exempt Income .............................................................................. 21 Nondeductible expenses ............................ .................................................. 22 Distributions of money (cash and marketable securities) ....................................... 23 Distributions of DroDertv other than monev ......................................................... , "Ill ::lc: 'Co CII'- c'" Iii .. " J:. 5 (d) Withdrawals and distributions (e) Capital account at end of year (combine columns la) throuoh Id)) <8.354.> (e) 1040 filers enter the amount In column (b) on: 25,261.' (b) Amount o. } 2 , 9 7 3 . See pege e of P8t\ne(e Instructions for Schedule K-' (Fo",,'066) Form 1040, line 8a Form 1040, line 9b Form 1040, line 9a Sch. E, Part I, line 4 SOO. D, line 5, col. (g) 8ch. D, line 5, col. (1) 8ch. D, line 12, col. (g) Sch. D, line 12 col. (1) } :=.::~~~~~. (Form , 066) 8ch. A, line 15 or 16 ... See pege e of P8t\ne(e Inswellons for Schedule K-' (Form '085) (Enter on IPplIC8ble lines of your ",turn) Form 4952, line 1 } See pege II of P""""slnstructions lor Schedule K-' (Form' 085) SOO. SE, Section A or 8 ~_pIIll8l1 o~~~ ~'::..ntructiona 26. } See P8ll88 II end , 0 of P8t\ne(e Ine\Nc\lone lor Schedul. K.' (Form , 085) end 1...\ruQtIona for Fo"" 8251 5,000. 20,261. Form 1040, line 8b } See pege10 of P8rlner's Instrilcllona lor Schedule K-' (Form 1085) JWA For Paperwork Reduction Act Notice, see Form 1065lnatructlona. 311161 02-17-04 No Informatlnn Required for Palle 2 Schedule K.1 (Form 1085) 2003 3 20p3.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 .0150319 706230 56120 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR 23-2187639 SCHEDULE K-1 COLUMN C RECONCILIATION DESCRIPTION AMOUNT 2,973. 2,973. RENTAL REAL ESTATE INCOME (LOSS) rOTAL TO SCHEDULE K-l, ITEM J, COLUMN C .0150319 706230 56120 Partner Number 3 20~3.05010 HENRIETTA SCHLEGEL & ESTATE 56120 1 ....J 030 b 5 ],.7 0 9 5 L PA Schedule RK.1 (09-03) 2003 Resident Schedule of PA S Shareholder/partner Pass-Through Income, Loss, and Credits 756644048 C 366 CALIFORNIA AVENUE, SUITE 3 TERRY B SHROEDER ESTATE OWners 4 N (Indivldual-1, S Corp.2, All Other Corp-3, Estate/Trust-4, Partnershlp-5) Partner's % of: Profit sharing 0 . 5000 Amended PALO ALTO CA 94306 Stock Ownership % o Loss sharing 0.5000 Capital 0.5000 Ownership PA S Corp. Y Partnership I 0 0 0 0 3107 0 0 0 0 0 0 25261 0 0 0 0 0 0 0 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR MECHANICSBURG PA 17055 232187639 C N Part II. Owner's Distributive Share of Income and LOll Shareholders and partners enter the amounts from this schedule on the corresponding lines 01 the Pennsylvania Income till or Information returns they must file. Read the Instructions for completing the PA-40. PA-41. or PA-20S/PA-85. 1 PA Taxable Business Income (Loss) from Operations If a loss place an x In the box. 0 1 2 Interest Income 2 3 Dividend Income 3 4 Net Gain (Loss) from the Sale, Exchange, or Disposition of Property If a loss place an x In the box. B 4 . 5 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights If a loss place an x In the box. S 6 Income from Estates or Trusts 6 7 Gambling and Lottery Winnings ? Part III. Owner's Share of PA Credits 8 PA Resident Credit. PA S Shareholders only 9 PA Employment Incentive Payments Credit 10 PA Jobs Creation Tax Credit 11 PA Research and Development Tax Credit 8 9 10 11 Part IV. Dlstrlbutlonslrom Partnership 12 Distributions of Cash, Marketable Securities, and Property. not Including guaranteed payments 13 Guaranteed Payments for Capital 14 Guaranteed Payments 12 13 14 Part V. Distributions from PA S Corporation 15 Distributions from PAAAA 16 Distributions of Cash, Marketable Securities. and Property Part VI. Nontaxable PA S Corporation Income or Loss 17 Nontaxable PA S corporation Income (lOSS) Do not report this Income or loss on your PA~O Tax Return Part VII. Supplemental Information 18 Member's Share of Depreciation Expense 19 Member's Share of Straight-Line Depreciation 374621 01-07.04 lS 16 If a loss place an x in the box. 0 17 18 19 FINAL K-]' EC FC L 0306517095 [IJ CIIIIIJ CD 0306517095 ...J .:..J 03066.17093 L PA Schedule NRK-1 (09-03) 2003 Non-PA Resident's Schedule of PA S Shareholder/Partner Pass-Through Income, Loss, and Credits 756644048 C TERRY B SHROEJ)ER ESTATE 366 CALIFORNIA AVENUE, SUITE 3 Owners 4 (Indivldual-1, S Corp.2, All Other Corp..3, Estate/Trust-4, Partnershlp-S) Amended N Partner's % of: Profit sharing 0.5000 PALO ALTO CA 94306 Stock Ownership % 0 Loss sharing 0.5000 HENRIETTA SCHLEGEL & ESTATE OF TERRY SHR Capital 0.5000 Ownership MECHANICSBURG PA 17055 232187639 C N PA S Corp. Y Partnership Part II. Owner's Distributive Share of Income and LOll Shareholders and partners enter the amounts from this schedule on the corresponding lines of the Pennsylvania Income tax or Information returns they must fill. Read thllnstructlons for completing the PA-40, PA-41, or PA-20S/PA-85. 1 PA Taxable Business Income (Loss) from Operations If a loss place an x In the box. ~ 2 Net Gain (Loss) from the Sale, Exchange, or Disposition of Property If a loss place an x In the box. ' 3 Net Income (Loss) from Rents, Royalties, Patents, and Copyrights If a loss place an x In the box. 4 Income from Estates or Trusts 5 Gambling and Lottery winnings * AMOUNT PAID ON FORM PA-V 87 Part III. Owner's Share of PA Credits 6 PA Nonresident Tax Withheld 7 PA Empioyment Incentive Payments Credit 8 PA Jobs Creation Tax Credit 9 PA Research and Development Tax Credit Owner's Share of Income and Loss, whether distributed or not 1 0 2 0 3 3107 4 0 5 * 6 7 8 9 87 o o o Part IV. Distributions from Partnership 10 Distributions of Cash, Marketable Securities, and Property - not Including guaranteed payments 11 Guaranteed Payments for Capital 12 Guaranteed Payments 10 11 12 25261 o o Part V. Distributions from PA S Corporation 13 Distributions of PA AAA 14 Distributions of Cash, Marketable Securities, and Property 13 14 o o Part VI. Nontaxable PA S Corporation Income (Lou) 15 Nontaxable PA S Corporation Income or Loss Do not report this Income (loss) on your PA-40 Tax Retum Part VII. Supplementallnforrnatlon 16 Member's Share of Depreciation Expense 17 Member's Share of Straight-Line Depreciation If a loss place an x In the box. 0 15 o 16 17 o o 374601 01.07.04 FINAL K-1 EC Fe L 0306617093 [IJ ITJ:IIIJ CD 0306617093 ...J REV-1501 EX . (1-17)(1) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF TERRY B. SHROEDER FILE NUMBER 2002-0035 Include !he proceeds c:J IiIigaIion and the dale the proceeds were receNed by !he estaIe. All property joInlIy-owned with the rtght of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. DESCRIPTION USAA Federal Savings Bank Savings Account No. 006 0234 5 - date of value: 413/02 USAA Federal Savings Bank Savings Account No. 010 1959 7 - date of value: 413/02 A11f1rst Bank Money Market Account No. 095101205 8 - date of value: 419/02 Allfirst Bank Golden Age Checking Account No. 095101205 8 - date of value 41'/02 1997 SC400 Lexus Automobile, VlN No. HJT8CD32Z6V1000051- Kelly Blue BOfk Value M&T Bank Account No. 15004201720122 - date of value: 418/02 ! I USAA Annuity Account No. 01781578AA - date of value: 6/30/02 I I USAA Auto Insurance Refund Check ! State Fann Fire & Casualty Refund Check US Treausry Tax Refund for Tax Year 2001 VALUE AT DATE OF DEATH $14,070.94 $5,064.20 $5,749,29 $7,249.32 $22,700.00 $28,859.92 $10,392.93 $562.63 $412.84 $8,966.00 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) $104,028.07 REV-1501 EX. (1-87)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF 2002-0035 TERRY B. SHROEDER FILE NUMBER Inctude!he proceeds c:J IIigalion and !he dale !he proceeds were receNed by !he eslale. All property joInlIy..owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. DESCRIPTION USAA Federal Savings Bank Savil'1gs Account No. 006 0234 5 - date of value: 413/02 USAA Federal Savings Bank Savings Account No. 010 19597 - date of value: 413/02 Allfirst Bank Money Market Account No. 095101205 8 - date of value: 419/02 Allfirst Bank Golden Age Checking Account No. 095101205 8 - date of value 418/02 1997 SC400 Lexus Automobile, VlN No.HJT8CD32ZSV1 000051 - Kelly Blue Book Value M&T Bank Account No. 15004201720122- date of value: 418/02 PERSONAL TV: COl'1tents of decendent's home and storage facility: valued by Executor and Distributed to residual beneficiaries per .their residual shares USAA Annuity Account No. 01781578AA - date of value: 6/30/02 USAA Auto Insurance Refund Check State Farm Fire & Casualty Refund Check US Treausry Tax Refund for Tax Year 2001 VALUE AT DATE OF DEATH $14,070.94 $5,064.20 $5,749,29 $7,249.32 $22,700.00 $28,859.92 $16,000.00 $10,392.93 $562.63 $412.84 $8,966.00 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) $120,028.07 l/ ~ US,AA ~ v ~;l"; USAA FEDERAL SAVINGS BANK June 27, 2002 " Edward W. Holland, Jr. 366 California Avenue, Suite Three Palo Alto, CA 94306 Re: Estate of Terry B. Shroeder I Account #006-0234-5 & #010-1959-7 To Whom It May Concern: this letter is in response to the request for the date of death value of the above mentioned account holder in the request USAA Federal Savings Bank recently received from you. ~ .' i The debit for $3,310.88 was for a reversal of a deposit on April 30, 2002 from the U.S. Treasury for FedAnnuity. There was also a deposit made on April 9, 2002 for $504.00 that was reversed out of the account on June 26, 2002 from Social Security. Should you have any questions, please call our toll free number 1-800-832-3724, or send correspondence to the ~~s 1.isted below, Sincerely, ;,t. ' ~ ;'.... ':,.:' -:. '" . \. . .' Maria 1. He andez'<, '-,':~:"-,!,:; Deposit Sales & Services Specialist, USAA Federal S~vings Bank:,: '.' );,~:, .f ' .' .,... . '. .;. ;'., . ,; ',';.:~;';;~ ::.;.:~.,., , " '. .~ USAA fo:deral Savings Bank 10750 McDermon Freeway San Antonio, TX 78288..0544 (800) 531.2265 (210)456-8000 FDIC INSURED USAA Savinp Bank 3nJ Howard Hupes PkwySle I90N , '~LuYepa,NV89109 (800) 922.9092 FDIC INSURED USM Relocation Services, Inc. 10750 McDermott Freeway SIn Antonio, TX 78288-0553 (800) 531-7741 'tF.RRS -e SHP'QE12~~ -". "'_.?m.~:r;m~n~i~;;i;,;,.;'~:;~-;:';;";;;":'I';~:".:;'.;.., .,-. ~. .'~" ". 15004201720122 PERSONAL STATE"ENT SAVINGS "AR.18-APR.17,2002 1 OF 1 00 o 04319H NH 017 14455 TERRY B SHROEDER 5209 TERRACE RD MECHANICSBURG PA 17055-6813 INTEREST EARNED FOR STATEMENT PERIOD INTEREST PAID YEAR TO DATE 67.76 9.70 H~GH STREET-CARLISLE 30,569.30 ri'r:i:~~tJb\'tt~ NO. AttOUNT NO. o O.OG 4 ::::: :::::::::::::CU ,EN: ,,::::,:::', ::: , :: ,': IBtE~ESt<it'IiL':" ACCOUNT """8E G <aALAHCE) 10.62 0.00 ACCOUNT ',:fI'OS::"HG::: ." :':bATE :::: ,',::',.,:,::',':,,:,':',:,,::::,:,:'.:.::,:."RAHSACUOHtJESCRIP'UOIir::,:::::':.: 03-18- 02 BEGINNING BALANCE 03-18-02 "&T AT" CASH WITHDRAWAL ON 03/16 STONEHEDGE,960 WALNUT BOTTOM RD,CARLISLE,PA 03-20-02 "&T AT" CASH WITHDRAWAL ON 03/20 STONEHEDGE,960 WALNUT BOTTOM RD,CARLISLE,PA 03-25-02 CHECK NUKBER 0101 04-09-02 INTEREST PAYMENT 04-09-02 CLOSEOUT $30,569.30 260.00 30,309.30 260.00 1,200.00 30,049.30 28,849.30 10.62 28,859.92 0.00 ENDING BALANCE $0.00 ANNUAL PERCENTAGE YIELD EARNED = 0.55 % TAKE ADVANTAGE OF "&T WEB BANKING, WHERE YOU CAN CHECK BALANCES, VIEW ACCOUNT HISTORY, TRANSFER FUNDS AND MUCH, HUeH MORE. IN FACT, "&T WEB BANKING GIVES YOU ACCESS TO PRACTICALLY YOUR ENTIRE "&T RELATIONSHIP, 24 HOURS A DAY, SEVEN DAYS A WEEK - AND BEST OF ALL, IT'S FREE! START SAVING TI"E _ ENROLL IN H&T WEB BANKING TODAY! SIHPLY VISIT WWW.HANDTBANK.COM OR STOP BY ANY "&T BANK BRANCH. The Law Offices of Paul Bradford Orr 50 East High Street, Carlisle, P A 17013 Estate of Terry B. Shroeder; Vehicle valuation Kelly Blue Book Value, www.kbb.com 1997 Lexus SC400 VIN HJT8CD32Z6VI 000051 Some scratches and dings AC AT PS PB ALB Sunroof Spoiler CD AM/FM w/12 disk changer Valuated one year after time of death therefore used the 1998 model year valuation. Value - $22,700.00 97Lxs Val Page 1 of 1 717258 8558 7/16/2003 II al fi " TERRY B SHROEDER 366 CAUFORNIA AVE #3 PALO ALTO CA 84308-1834 11.111.1111'111.111111111111111111111111111111.11",1111111.11 " '''' f 01 3 Money Market _.~ ~. IOOZUW ".Y I. 200Z Terry B ShI'oeW Acct No 08510-1205-8 . .... Q~'...ftriI.Oom "0 ....... ., CUlton.- '.-vice 1-1ClO-533-483O Activity Summary Annual percentage yield earned Avg. dally ledger balance Avg. dally collected balance Interest ear~ .~hll ltatel1l8~t'.i Interest paid thll.atement. '.' Interest paid thll year Days covered by thll Itatament 0.00* Balance on 04108 ts~7q9.~' .00 Other activity .., . . ~S,7q9~29 . .00 . Balance on :.01108 :J.,i~;:~;>~';.'::~::"il .;.ii..~'.";",,~OO"', ,';J~ ..: .;.,.,o,C>>q "11" ',' .,.; ..,....,;,:;~~:~.~~~.~~:,~;~t,X~I:i/~?~~~:,.~:~'l~:;,;.(;,:;~~ .:,;' . ..00 . ;' ~: \. .: '.:~; i.i.' ::.', ~,J;':'.';ift~ -10 ~l.t1~'l':~':.i:~!:".r\,.r~' ; .'.. *22.21:-" .;,. 30 Other activity D.t. De,cttpllOlJ ,,' '<..;; ;"t. .,.~ "'." .......: '1.:. ~;'<~I.lf.i.',:~"''';i'..,.; ;..':!., 04109 CLOSING WITHDRAWAL . ,",:' ~~';; ;"-.1: ". '". '. ~ . .' '., t' ":; . '., ,,' .5,7119.29" -5,7119.29 . End of Day Ledger Balance . ". .' "". .-" . '. - ."\..~ ~ ,.." , . Account balancel are updated In the aectlon below on dayl when tranlactlo"'-polted": . " to thll account. :. "', .: :"..,. "', . ,,"! .;.',,, ~ .' ~, 0.1. a.'.ne. 04108 04/09 .S,7q9~29 .00 . $; :_.~ ; -"', . ';'l: ; '. . . .:;,..;...;.... ',,. if" ';... '"0 . ~; ,. r .".'~.;:' . .. .1 l....,;.'.. "" .....i.'.:.:::. " The annual percentage yl~~ eamed reftectl the.n,ount of Interest e.~,~.~ ~~nt..j . during the Itatement period and the average dally balance In the account-~Jh.~... " The Interest rate paid will fluctuate according to money market condltlonl. .... . ,. '. ",' ; , 011241 0004-02024204822 0110 - ....~ ::-r......~~-l18... REV-15Oll EX + (1-87)(1) COMMONWEALTH OF PENNSYlVANIA DDDDDDDDDDDDDDDDDDDDDaDDDDDDDDDDDDqDDDDD RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF TERRY B. SHROEDER FILE NUMBER 2002-0035 If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME A. Henrietta Sue F. Schlegel ADDRESS RELATIONSHIP TO DECEDENT Business Partner 5209 Terrace Road, Mechanicsburg, PA 17055 B. c. JOINTLY -OWNED PROPERTY: \ ITEM LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH NUMBER FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. DATE OF DEATH DECO'S VAlUE OF TENANT JOINT Attach deed for joinUy-held real es1ate, VAlUE OF ASSET INTEREST DECEDENrSINTEREST 1. A. 06/14184 Apartment building and garage located on a roughly 31' by 90' lot in Carlisle, Pennsylvania -160 S, Hanover St. (Also listed on Schedule A w/same $197,000.00 50 $98,500.00 valUe 2. A. 07/01/84 M&T Bank Account $579904 $9,789.05 50 $4,894.53 3. A 07/01/84 M&T Bank Account #550965 $4,143.45 50 $2.071.73 *Back Out as Item #1 on this Schedule Is already listed on Schedule A under Real Estate Asseus of Estate -$98,500.00 TOTAL (Also enter on line 6. Recapitulation) $6,966.26 . . (If more space IS needed, Insert additional sheets of the same sIZe) I. I' ~. I.... '.' [. ,....: . ,.'. f.: I~.: r' I l. ) I' t . .. I:., . I.' \. '. I.... . ~ I;!' t ". ;i I {)iv~rsified Appra;sal ServicfJ,s " ,.. ' '. ,.,. .. ,",. .'" . . RfaI &iait'~aIld CotJsultants . .. . . 35 East High Sfreet : . Carlisle, PA 1701~3052 . (717) 24g;.2758 FAX (717) 258-47Q1 JUIle 10. 2002 . '.ro,: ~estate of TerrY Schr.oC4er FM: Larry ~.Foot~. R.E;: .';Res!ric~ed Us~A~ Report' l@,~ut1J,~ver Street. Carlislc;,PeJwsYlv..ma .,,~. . " . \ '. . . .. . '. AtYQur r~uest,1~v~~~~4th~, c.aptionedproperty;!he r~trieteduse ap.- ~ t~ QfaJ~~M1P~$.a,f; Wltichfollowsthis letter~. tssubmittedin.8upport of 'my.opUUQn o.fMatke.t.V~l1~eofth~ Fee. Simple AitQrestintbe pro~rtY, 'as ofA:prlI'4, . 2002.' . I herd)y certify tlult,to ~e ~est ~fRlYknQwl~e atldl?elief; the. data,facts, and opi$~ set fortbthereiJl~at(:"acc.\ilWe~ s.l.lbj~t 19,t)le .StatementQf Asswnptiqns ~dLim- . it,iDg Conditions tJ.uU is :also rna4ea,part of:~repof:l. and ~t the indjcated. 'Mar~ Value. . Qftbesbbject prop'rty,~ of Aprl14,2QQ2isi" '. . . . . ONE ffUNDRED ANp 'NlNETY-SEVEN TlIOU&ANl? DOLLARS $197000 '. . . -, , .-, This Nstrivle9.ijse appraj~~~~e~i~:41e.;Departure f'rovision in ac- CO~Mnce with the'i8lAdeline.s set fortbby~~ iWP@isal Standards BOard and is in. con,. , f~tywjth tl.1e ~~ds Qtpr~f~si.()Dalp~ceqfthe'Na<<ona1 Associ~ti()nofR~- tOI$ App~ Sr:etjon.. I apprec~yotw havJriS coll$ide.rechne fo~ thi~~sipent and ~ttbat Y4Ufind the reportentirelysatisf~rY, . . . . . Res~tftillysubJl)itted, Lairy '.Foote . Certified. General Appraiser GA~OO14~L. . . 3 I;" .' I',' ...-:. . .'."..'...,';. I',.. ' I" "./;, ," I...,.. .. ~." . ~......:. I: ~~l._....: I'.:' :/... :-~t ..', I. .;':.;'.,' ,.' I", "..; .~-':'.. ' j',",'''- 47 . ," ~ I. i, ~:""'. ' I', . i ;f~:" '. I' , :~~:.r .,'.~ 1 I.,' ."...... 1"'<, , '"r,' ri~~:;.:'. I <t . :.~':. . It, i :~;{..:~. :,' I,:" , SUMMARVQF 'lMP~ltT~ FACTS AND CONCLUSIONS LOCATION: 160 South Hanover Street Carlisle, Pennsylvania TAXP~CEL NUM:ElER: ,04,.21~320-236 , ,O~aIP: LAND'SIZE: "ZONING: . ' Henri~ F,Schlege1 ang. Terry ~:SlJr~der 3P x 90' FLOOD HAZARD DATA: C~ 1, Cen,tra1:Susi1less Di~ttict. ' Th~ ~ubj~ siteisnp(lQcated ina ,FEMAidentified flood ~d ZOne, ~cordiugto map #425382-0004~B: ~ fe,e iriterest. ., PROFEQ.TY IUGHTS:, ii" SCOPE OF ASSIGNMENT: The ~~pe oft4~~signment itlclu,ded 2W., analysisQf the , . '~ject'sarea,.an,il1S~ction 'Qf the subject propeJty,ane~ ,timationQf~e~perty"s highest. and 'best use~conside~.. tion ofall,.tb.r~~app,rOaches to v~ue" a1ld the application of 'thoSe; relevant to the valuartian ofllte sqbj~, A~nt buildin~lan4garage" , , IMPROVEMENTS: · . OBJECTIVE:: TQ .1il4' tlte niar~et.valueofth~ subjectpro~rtyas un.. eJlCwubc;red,' ' ,. USE OF THE APPRAISAL:" Estatesettletnent. ':" '" .', . " '-".". ,. ". :EJ"mCTIVE pATE: , Apri14,2QQ~, , . HlQaES'r ANDl~ESTUS~: C~ntinu.ed \lSC '/ilS.'.8Jl awtnlept building and praSe., CQST APPROACH: ' N,A ',SALESAPP~OAqH:, N.A. INCOME APPROACH: $197,000 ,.VALUE CONCLUSION: $197;000 4 P-20)-AT-l1-Warronty Deed, Short Form. Act of.l909---ArTonged for Photo-Recording Henry Hall, Inc.. Indlono, PA , o.c:r ('C'J.,~if.,~'J~'\~\/1"rlt:..L'; ~.: ()r rE'>.li\!:.:.\"L\/.A.t.,:~:!':, ~':~.: c> f,j:L"'.Pr,II('I.:T 0;: kl.-",;';'..,;: IE " ... ~I:::,!~r'v ::7~~~;::::~ l;'~.;~r::~~; r"--' .'1 :~'~ F' "N"FER (~~.~p,p\ \ 0 r f: ill () I ~'.:.~ Ll") , ,.....) JIJHl4'84 ~'~",h! Il, .~; {t, C . J .._ (1'\1'. .........,... ".~ ~ H 8. t jiG (: t........_....._. ." ,I ~.~~:.~ o ," '.. .". I: .i ... .-. I ;. ;...~ .~',_ S .i ;, I... " "- . , ~ ,". ...........-.....,. . ,. "',' _ ."~ 1 I; , ~;. ~ . ?8'i JUfl 11} 1"\\111 52 ~ ~.\)'~ ~bi~ iBtt)), MADE THE 14th day of June of our Lord one thousand nine hundred eighty-four (1984) in the year BETWEEN MARIO R. BARTDLI, Single Man, and JAMES C. BARTDLI and JILL E. BARTOLI, his wife, all of the Borough of Carlisle, Cumberland County, Pennsylvania, hereinafter Grantor s' and TERRY B. SHROEDER and HENRIE'ITA F. BEAM, now by reason of her marriage, HENRIETTA F. SCliLEl}EL, all of the Borough of Carlisle, Cumberland County, Pennsyl- vania, hereinafter Grantee s : WITNESSETH, that in consideration of Eighty-five thousand and -------------- ------- -----00/100 ($85,000.00) DollALrs, in hand paid, the receipt whereof is hereby acknowledged, the said grantor s do hereby grant and convey to the said grantee ~ their heirs and assigns, as equal tenants in conmon. ALL that certain tract of land with improvements thereon erected, situate in the Borough of Carlisle, Cumberland County, Pennsylvania) bounded and described as follows: -"I :' BOUNDED on the East by South Hanover Street; bounded on the South by West'''''Souto Street, bO\.U1ded on the West by property fonnerly of Dr. Thomas Stewa~t;~'h6w'b't' formerly of the George B. Fagen Estate; bO\.U1ded on the N01;tq. b. y....p.q).,...pe.~... . ~.. ,rly of Dr. ~~s Stewart) now or fonnerly of the Pearl E. Me1.1y Est~te,;.~k . p~operty fronts Thuty-one (31) f~et, more or less, on South Hanq'!(~F ,,$.~r.e~t;., ~:di. ..~y (90) feet more or less, 1n depth.' '''' ..,' ." BEING improved with a two and one-half story brick apartment house known as and numbered 160 South Hanover Street and a frame garage in the rear. BEIN; the same property which Enna L. Scharer et ux granted and conveyed to the Sellers herein by deed dated March 26, 1973 and recorded in the Office of the Recorder of Deeds for Cumberland Co\.U1ty in Deed Book "B", Vol. 25, page 945. (continued on reverse side) Ilnnv C "0 DIN" 0 r:Q ~ ~ , ~ ., E~~ u~ :.I~ I CI)~ ~ ~~tJ) l-- J:j ~ .1 z ~ .,~ <( ::1 ~ c., ~d0 ~ ~~~ 0 C&:: ~ ~~ ~ " % Pd~ ~~~ <( O~ ~;I ~ i ~~:::~G::~:Z::::~~::hmh } 88. . ......~ /" .,.,',. -" .~, / LL 7-7'l ~ -' . , . '......... ". ", ,....~ REC, , 0, RD~, E>-.~n.., ~f{.~8 :<...._"n_n_____________un day of ._ ___ __.n_u________.___..________..____u_. .~, ..~' -1""!"? ...., A. D: ~~,' _ u 'i~'~i'~e; ~e~'8 office of the said County, in Deed BookS ' \.. ....-' ,..A,.,.(;~.~A.. " . _ '," ',\ 0." "{'F", c: "_~' '. .. V oZ. -::..--'Fl,;.-~{~ -~ :F'l1fl~';;,e:z..sy'--n_--. r -: ......._.~... ...:...._.....\ -. ._' .,/ ~~:," / Given .,,'M"'~.'J'y,.;hf~:~Y1i.#e 8eal of the said offi,ce~ oote above written. . --__~__~,~_u~)~__, Recorder. flEV.tl5Ol ex .(t-en C EST ATE OF o eN FILE NUMBER -r:e.. (" r made joint within one year of the decedent's date of death,~"ported on Schedule G. ADDRESS A. 1-ffH\ .,.....-e; ~~.... yo, S",h \4~' 5"'~ocr ..,. -e.-.,-.rTA-c,<:- ~~ ft14!t:h~",.'es bu-r-~- 1=>11- 17b5"'~ 8 c JOINTLY -OWNED LETTER ITEM FOR JOINT NUMBER TENANT 1. A. ROPERTY: DATE DE CRlpnON OF PROPERTY MADE Include name cl flnanctaIlnstltullon ahd bri ac:coont nllTlber or sinllar ldenllfylng number. Attach JOINT deed for jo/nlly-held real eslaIe. ItptH-tw\ e..:t-' bN \&..'(\.~ ~,^J.. ~.,.~ I<HULcl' 0'1'\, c;t.. f'Dv..b~l~ 3}' ~ tjtJl 10 t ,'N (!..c.1" \i"'sl-c::) 1> Itj ~<"~awjIJ t.LS, ;~,N)t) SD......."^-II~ov4r str....e.t' DATE OF DEATH VALUE' OF ASSET } q 7 ) (f)Ij(). TOTAL (Also enter on line 6, Recapitulation) (If more space Is needed, Insert addRlonal sheets of the same size) /' %OF DECO'S INTEREST 5""0% $ RELATIONSHIP TO DECEDEN BtA~"/I"5f P_f", 1IJ'l-"' DATE OF DEATH VALUE OF DECEDENT'S INTEREST 9SJt;~.lJC) 99 ~oa,oe;, ~/ P.201.AT.1l-WCIITOnty Deed, Short Form. "'" of 1909-Arronged for Pho'o-llec:Ord'nll He"", Hall, Inc., Indiana, PA . - . o.c:t ('r-.t.I'.''''''>''\U!7'" '., Ll (.,~; I':'E\.!'\'~'.:'!/.\~' "i.. :.~.: .:.~:' ,I!., .Il'~<..~ k:-:.l,.,.[" ~~~'l" .... -<I' ~...I"(.,.""".''''!'l'''. .....~ <::- fIIY'!;'J:1r.M;l'.; I Or l~f.,\i!:.,~~,dl;: RF " r" ::::::::::::::::::: 0:~.-f'~ .~\ r"- '.'. j .:.I,,\I~ r' ~~J~nl '8 t'~' f\ l~ I t) :'::-: ,h:,'\N~FER JIJIi I 4'84 ~V I , ~~~ 1.J ..! \.J ::= ~l"') (I\X '"_...... I Poa.111 u 2 L.,~~_.. c:::> .~. ,I :~.:.~ (: ~ I; ~'t~: :. :~. ~ , ~::.:' ~. ;,. "~ .~. ~.' S !~;- ~,,!... t", ' ,. "',' .~ 1 . ~' I - i i'", '811 JUH ,t~ 1\111' 5., ~ ~.\)'~ tEbi~ l\ttb, MADE THE 14th day of June af aur Lord ane thousand nine hundred eighty-four (1984) in the year BETWEEN MARIO R. BARTOLI, Bingle Man, and JAMES C. BARTOLI and JILL E. BARTOLI, his wife, all of the Borough of Carlisle, Cumberland County, Pennsylvania, hereinafter Grantor s' and TERRY B. SHROEDER and HENRIE'ITA F. BEAM, now by reason of her marriage, HENRIETTA F. SCHLEGEL, all of the Borough of Carlisle, Cumberland County, Pennsyl- . vania, hereinafter Grantee s : WITNESSETH, that in consideration of Eighty-five thousand and ------------------ -- --00/100 ($85,000.00) Dollars, . in hand paid, the receipt wherea f is hereby acknowledged, the said grantor s do hereby grant and convey to. the said grantee ~ their heirs and assigns, as equal tenants in comnon. AIL that certain tract of land with improvements thereon erected, situate in the Borough of Carlisle, Cumberland County, Pennsylvania, bounded and described as follows: . .T! BOUNDED on the East by South Hanover Street; bounded on the South by WesC'Soutn Street, bounded on the West by property fonnerly of Dr. Thomas Stewa]S:t.~ .'fiow'~or" fonnerly of the George B. Fagen Estate; bounded on the Nortl}by'prBPe~.. - ~rly of Dr. Th<;xnas Stewart, now or fonner1y of the Pearl E. Meily Est~te,;. k property fronts TIhrty-one (31) f~et, more or less, on South Han~Yc~f ..~~r.:~e-~)~i1i., Jt~).wa~y (90) feet more or less. 1.n depth.'> !..,~,.1\ - BErN; improved with' a two and one-half story brick apartment house known as and numbered 160 South Hanover Street and a frame garage in the rear. BEIN:; the same property which Enna L. Scharer et ux granted and conveyed to the Sellers herein by deed dated March 26, 1973 and recorded in the Office of the Recorder of Deeds for Cumberland County in Deed Book liB", Vol. 25, page 945. (continued on reverse side) IlnnvC ~n elN" 01:0 r ~ . ~ ., E ~" ~...' 0::1 ji~ ~ ~~ >'" ~ &:I g~1 a~~ I z ~ < c., g ii~ to ~ ~ Fa ~~., e::: .... J p:J:j ~~~ < ~ o~ ~il ~ i ~::o;~:;~=:~:~~:=__..._. }... . /.,~ /' ,,-,'" ,'" ...;.(, / LL ~ ~ . '. ..~........ ....~...... (~ RECORDffiET.;e.n...t~f8 ..:;..........n.............n day of ..... ............................n.......... .- !@"71"'!"")";1 A. D~ J9.,:'. .. i~,/i'~i~, ,,: :::~ e~'8 office of the said County, in Deed BookS ~ I' .-'t/.y.4"~~. ' . - .' ' V oZ. ..:~.~!t..~.i~.:.l~ 'eliJl~<.~e~SJ.......... .. "..."... ~. '" j" ,".... " /'~ ", . -'..... " y.'~ t' . Given.u'M~:..:m.~:...ha~,:'la~d~~~e seal of the said Qffice, ~e oote a.bove writte.n. . , ,.J ,1'\' ,..r..,.),.' ~ ~ . ". ." \: " .,' ........... t ..... ..!..... .~.., Recorder. '~1 J.VJ.&l DaIlK 'Ar::e~t~;.:. 579904 ....., )~CCQUNftvp.~/.. . -", ,,~;' "~ ,::;!,,::-' ':' \". ',' '7: /~"'1>~i',~:;, ,.;~ .,..... ,) ,..:;':.'..,?,"t, · . .. .....$tAt~~ijitp.~~i()~.. 11 & T FIRST I1AR.22-APR.19J2002 1 OF 1 00 4 0431911 11 021 590 TERRV B SHROEDER HENRIETTA SUE F SCHLEGEL 5209 TERRACE RD HECHANICSBURG PA 17055-6813 HIGH STREET-CARLISLE 9J006.98 ... ........ ..... ." ...... ... .. ..... ..... .. .".. '. .. . . '..:: :TRANS1CT:tOtr.DESCR:tPTION........ ACTIVITY .DEPOSIlS:;1HTERESJ : <CHECKS:: & OTHER . ... & OTHER ADDITIONS ..:sUBTRAtTIONS 5.30 8.63 $9,006.98 9,001.68 8,993.05 llJ228.05 10,506.40 lOJ458.36 9J800.24 9,790.05 9,789.05 03-22-02 BEGINNING BALANCE 03-22-02 CHECK NUI1BER 1638 03-29-02 CHECK NUI1BER 1640 04-04-02 DEPoSIT 04-05-02 CHECK NUtlBER 1642 04-08-02 CHECK NUtlBER 1641 04-09-02 H&T REAL ESTATE I1TG PAYI1HT 04-10-02 PP ELEC BILL 04-19-02 FEE FOR CHECK RETURN OPTION 2,235.00 721.65 48.04 658.12 10.19 1.00 ENDING BALANCE $9,789.05 r: :::..:::....:::..:.:..::.:.,.:.:::. .. ........ ' ..." .. ...... ..... . ....... .......... ~. ......... .. .':.... ... :<;"Ec.K$.:.tWl.Q:$~A~Y . ... -, " . . . . . . . .. ........'............, - . . . . . ,,-' ,......'1 ...... 1638 03-22-02 1642 04- 05- 02 5.30 721.65 1640lf 03-29-02 8.63 1641 04-08-02 48.04 TAKE ADVANTAGE OF I1IT WEB BANKING, WHERE YOU CAN CHECK BALANCES, VIEW ACCOUNT HISTORY, TRANSFER FUNDS AND I1UCHJ I1UCH I1ORE. IN FACT J I1&T WEB BANKING GIVES YOU ACCESS TO PRACTICALLY YOUR ENTIRE I1&T RELATIONSHIP, 24 HOURS A DAYJ SEVEN DAYS A WEEK - AND BEST OF ALL, IT'S FREE! START SAVING TIHE _ ENROLL IN HaT WEB BANKING TODAY! SIHPLY VISIT WWW.I1ANDTBANK.COH OR STOP BY ANY l1aT BANK BRANCH. ~o".."...... ~ Q.R. ~.&.o .J$ 7S~.OS ~ '+-SD~ g-/-t~1 ~/'~l~O ~~)n~ 4,&/0 7-1-(}/ ~~7t ,()S~. 3 ~ 45(Jco 7-/-~1 _______ (''f1 At ~ ~S6 iJO 9- I ~ () I .__------- 5 R<:4 . t/OOt() 6-/~ -# .;)~()() fit) ___ "~,~":Yr-'l:~::,)f$:~'./, ~,~,' '-,~1~;('\;",;1',', f;K LOOBA (12/93) 'Aec~~.tvpf .' ~~ .J;-,'~:~'~:\i~2,\i[~.t:.f,l~!.,~:,,'il;:,"{;~,,~:, "..: '<./, .,,' './i}/, .1 .. ~" _ r--1lYlOU DC:U.1I.\. . . A~CQijH'r~. . ..... '..sfA:tijtt.~t"~~RMI)"..' · ... ..... ........:. 'P.A~~.:'.." '" ......,....... 550965 " I T FIRST I1AR.22-APR.19J2002 1 OF 1 00 4 0431911" 021 538 TERRY B SHROEDER HENRIETTA SUE F SCHLEGEL 5209 TERRACE RD HECHANICSBURG PA 17055-6813 HIGH STREET-CARLISLE ...~it~'.. ....OAIly.." . 8ALAHtE> 03-22-02 BEGINNING BALANCE 03-25-02 UGI UTILITIES UGI BILL 03-25-02 UGI UTILITIES UGI BILL 04-05-02 DEPOSIT 04-05-02 CHECK NUI1BER 1783 04-05-02 CHECK NUI1BER 1782 04-08-02 CHECK NUttBER 1781 04-16-02 PP ELEC BILL 04-19-02 CHECK NUttBER 1784 04-19-02 FEE FOR CHECK RETURN OPTION $4,418.42 95.25 67.92 4J255.25 lJOOO.OO 746.51 58.66 119.61 16.42 169.60 1.00 4,450.08 4,330.47 4J314.05 4J143.45 ENDING BALANCE $4J143.45 I>.' .... .................................. ..........'........"...,'.-,.......... . ,..... ...., .... .....CHECK$ .rkt.o$vAAARY ........ . . . . . , . . . . . . . . . . . . . , . , . . I .." ..' . ...................... ..................... :.~-::.: ;'>: ;.:-:":-;.;.;:;':'; :;.;:;. 1781 04-08-02 1784 04-19-02 119.61 169.60 1782 04-05-02 58.66 1783 04-05-02 746.51 TAKE ADVANTAGE OF "IT WEB BANKINGJ WHERE YOU CAN CHECK BALANCESJ VIEW ACCOUNT HISTORY, TRANSFER FUNDS AND tlUCHJ I1UCH I1ORE. IN FACT J "IT WEB BANKING GIVES YOU ACCESS TO PRACTICALLY YOUR ENTIRE "IT RELATIONSHIP, 24 HOURS A DAYJ SEVEN DAYS A WEEK - AND BEST OF ALLJ IT'S FREE! START SAVING TI"E - ENROL~ .....,.. T_V! SIMPLV VISIT """-;;:';;;:'8:i; OR ST;; t13,jJfT ..... BRANCH. ~ t~'15..t>\. '-' .~ '/3',L/S ~ .!!f!(;;.1:: . } I J 'i ~ "fID 7, .'" '~~':1r'7ir~~t;t~~, LOO6A (12193) II> . !P -~~ . c . }} F) I') \. I I - fIr: ! f,) I I I () I I I ,.. I I I ~, i \i I ~ .~ H I 0) I .. I I ~.. 1 I ~. \. . ~ Of H ..t. ~1P>1l1l'll1lM11ll~ @~ ~Ihle 'irNIl~W1ay Internal Revenue Service fa. ~ Date of This Notice 28221225 L If you inquire about your account, please refer to this number or attaqha . BEAM fI TERRY B SHROEDERoPY of this notice . 12-17..81 Employer Identification Num.ber 23..2187639 HENR IETTAF PTR 123 W HIGH ST CARLISLE PA 17013 575 e 555555515 55555555 NOTICE OF NEW EMPLOYER IDENTIFICATION NUMBER ASSIGNED Thank you for your application for an employer identification number. The number above has been assigned to you. We will use it to identify your business tax returns and any otherre~ lated documents, even if you have nO employees. . Please keep this number in your permanent records. Use the number and your name, ex- actly as shown above, on all Federal tax forms that require this information, and refer to the num- ber in all tax payments and in tax-related- correspondence or documents. You may wish to make a record of the number for reference in case this notice is lost or destroyed. Note that the assignment of this number does notgran:t tax-exempt status to nonprofit or- ganizations. For details on how to apply for.this exemption, see IRS Publication 557, How to Apply for and Retain Exempt Status for Your Organization, available at any IRS office. We appreciate your cooperation. -~ Form 5372 (Rev. 2-flO) REV-1511 EX. (1-111)(1) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF TERRY B. SHROEDER FILE NUMBER 2002-0035 Debts of decedent must be reported on Schedule I. ITEM N R DESCRIPTION AMOUNT A. FUNERAL EXPENSES: .... ...................... ... ...... ...... ....................................................................................... ........... ..................... ~*i-:~~hi~~d~~Sk~h~r~z~~~HPffmciri~gQthf4ti~f~liB~m~: . .", ", ," '. . . ." , ',', -- -'.' ,," . .. , ", . .. "., ....-,.,.,..-'..'...-,..'..,.....:"..-.:....., . " '., .' ,.....,.,... .... -',,-' -.-' .'n _ ,_ . '....'...,.-...'...... . .....'.....:-.........-.. 1. Personal Representative's Commissions Name of Personal Representative (s) iEqw~~vv..B611~h(fi.............. Social Security Number(s) I EIN Number of Personal Representative(s) Street Address :3~9.~ifojjll~.Ay~~f3;:$~llf:l3.i......i................ Cityj:)E11~,ijt9-< ..:........:,. .e..... StateCA> ZiP:$43Qe '. . 2. 3. Year(s) Commission paid::ZQ9~~2()Q$:;i Attorney Fees LAW OFFICES OF PAUL BRADFORD ORR Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent $31.421.59 ,....... .... . . '. ,". 4. Probate Fees 5. Accountant's Fees TOTAL (Also enter on line 9, Recapitulation) $87 151.24 FLOWERS FOR CALIF. MEMORIAL SERVICB- -AVBNUR FLORIST--CHECK # 9904 FOOD/RRFRBSHMENTS FOR CALIFORNIA MEMORIAL SERvrCE--BANGKOK THAI RESTAURANT; CHECK # 9905 FOOD/RBFRBSBMBNTS FOR CALrFORNIA MEMORIAL SERVICE - ~ BERKELEY YACHT cr,UB;CHECK .ft 9906 DONATION FOR BPISCOPAL' SBRVICE AT SEA; CHRIST . CH--#9907 GEORGE'S FLOWERS--FOR P 1001 06/17/02 HOFFMAN ROTH FUNERAL HOME-"-FOR PENN. CREMATION AND MEMORIAL SERVICES 06 j 17 j 02 g . W. HOLLAmil- -UDUaURSilMlirr~.JrQR- f'OBf.i PURCHASE FOR BOAT .TRIPPrtOM.. sAlri'-A 'CRaz' 16. SAN" tRAMel'eo, ANI> RETURN, FOR" $CA'rI'ERING " TllRRY'S ASlUfS' ONDER GOLDEN GA-'1'B (Ptlxehased,'from Berkeley MaTUIe Services- -'5/17/0'2)' t.... .. ~ -. .. . . .... .. .. . ~..... i 02/02 02/02 03/ o 03/02 o 06/02 o 06/02 o 07/02 /09/02 /09/02 /09/02 05/10/02 05/18/02 05/18/02 F~f ~}C;.ra .,,-~ ESTATE OF TERRY SHROEDER EXPENSES -I Meal a.t ChieagE> Airport: Penn Turnpike "t;s1.1(=toC:arlisle) -Dinner .forMi -j.a ,Shel..bee, Joe Sachs ,Smiths, .and .... BrE! --Jude Smith ,Holland U - aaul- - iag mat;.e~ials Brunch- -Joe , Holland dinne'J;'---Mi-ja, and Janelle Saehs1Hol.land photocopies and mailing .POSTAGB - -books, CD I 8 ete., . (Weller, M'. C. Wong-auk Auto rental Brunch--Joe Sa air-fare, price re 45.56" 257.53 16.00 124.49 275 . 60 104.00 1M. 79.58 2108.56 ....-.-.----...- .-_._,_.~------~--- 99.74 .... or ~ Jj a. I q "J I , q~ - "RETURN TO ELEGANCE" 0.2043 347 C1L1fORNIA .1\1€. '. PALO .1UO. 01 94306 WHEN WANTED t.:::; j ~ 1 c t- "'. . .! \~(' \ (, ~''/f , (j TIME OF SERVICE ," (650) 322-5585 DATE <_. /~ ) 0 2- DEUVER TO ADDRESS CITY SPECiAl INSTRUCTIONS STATE ZIP I I ~,I I '1 i CAREr. .:! J ., ! AMOUNT . ~ () / r"> c.., ~... CHARGE TO .............-.--., ~' , " , ,,-.: ',~ DEUVERY CHARGE ,.--' I i I I I i I I i I I ; I I I I ! ,-. ,v,.(.:. <.....1,<,_ / C~~'/ CHARGE C.O.D. ~ PHONE NO<. 7 l .f F.tOC ORDERED ~ J\ -. . ) \,.,.....\ /"...... ~. YOUR FTD flORIST Will SU mUTE IF NECESSARY. NO REFUNDS ON PHONE CHARGES. WIRE CHARGES AND SERVICE CHARGES ON FTD OUT OF TOWN ORDERS. fJhank lfou ALL CLAIMS AND R8URNED GOODS MUST BE ACCOMPANIED BY THIS BILL. I . i ~", ". .~ . : EDwARD W HOLLAND, . '. 366" CALIFORNIA AVE .3 . .. p'A~O ~L T~,' ;"';::. ..i:::'~' ; ,> ':. . ~. " . .:' . .;~;' . . ,.1:. it~>~~~ii].~" 'i.:':7~.~l~ff I, .; . ,', [ i:j:l~{~ffiT~"l$U ~::;"] -, . i.,...;,.i',.~.......1idW A..e Of ~ 1nclIIIII,.(LL!~ :;f~i ~fr.".~#i~:;;/~{ ..,:.';~+;.'-F~i:~~~::,~,,~~~;:':~:~j~':~'~~;f:~'.' .' :'. "i.,D~;;: "'-:;'1 ." P.' O'~: 'BOX -'6406' ..\.'0'" ''-':'-'- .' THE LAKES r NY. n"""<' -,,, i.. . . ",,;:'>l";"'';~1(; .88901.~6406~..: '., ,-""',;',., ,', 1-',.] ,:' - ,II. ~,I. ~,.,.I.I.I~.1.I I ~,';'I..l~.~,U'lI I.,~..',n ',...11...1...1 ,I;~ :~ . :'; r::.1n ':fl-~.,~~:j!'.i.:tr.~:iJ ..:;i .~.",:"':~\"~.;, ~:I~! . H~. "';"'_'~' '.' '...., ,,!~.<h' ,;~,'i,~: ':' Cltl '.~ .,' . Visit www.cltlclrds.com;Li!,"" ::i ':.1': >~. '.':.~~~"~"~"J~. ;/. ~.'!_l: ~.Il ...;,.... "," . . . '. . . 318D41~255b072~4b4aDD52'5DDDbD JUL 04 t002 i2i~6.~8~ . .'. .1946~~N MCOO'UA07Z6BR2011435 11.1. ~.I ~~ i,. .11 ~ II ~ ~ ~.II.:. ~'~ n .11 ~ ~; .11..I..lli ~ ....11.... II I ,; "-..i '.", : )',' " . ',.'" .. .;. :: .~ .l.~. :.; ., '...!- .-,'. ;'.i ~ CA;,~~.QQ6;'J,634 () . . ( ) - .. '~=~';!~:"~"3:~~'~~,~' ,~:.:;;'~~' .....~~_. I;....,'. 'lIy_-,*,,_ _ ......._..... ...._""'1 It 10, . ....... WeIlM\'_It.. MntHt..J: -::, ..MUIl'.....t....., . ifW.~~~~ ~., ~~;IM"~" . PrInI.........., ...~........... ... _II ....... .,,:.-,.,. . . '.. --"~'-"""-'---'-_..""-----' ._.. , . . . ............... ~...~-_. ._...~......._~-- --." ~.."......_...... . "Of CUltoIMf S.rvlc,. coP Of write :, ..1,.~0<>,:~~Q..:~~14"..:,., ,,' ~~ed~ ;~ee "oPfuitF: *--1 maili~ ~ ll' .'. "<: ~~ r::J ~ \iJ_ CARLISLE MPO CARLISLE, Pennsylvania 1"10132935 08/1912002 (800)27~-8777 JQ:5e:45 AM 11'19'1 _ ---:----.-- Sales Receipt --.. --..--- Product Sa 1 e Uni t F; ria 1 Descr'iptiOft Qty Pr'j..p fjr ice 8(h~ S t ~1!!!r.! 6 $O.t.iJ 11 $0.37 1 $0 . 60 $-'1.80 $ll.07 ~;iJ . 60 37; St Ct~ S Tvtai: $9, 47/' $9.47 Paid by: Personai Check Please call 1-800-ASK-USPS (1-800-275-8771) for USPS i nformat i on or visit us on the web at www.usps.com.To order stamps by phone. call 1-800-StsOIp24. Bll1#: 1000400187007 Clerk: 04 Refunds only per DMM P014 - Thank you for your business --- Customer Copy f~ ~1S Cumberland CoIJnty Reco~ier of Deeds Miscelhlleous Irlconie Receipt<< 393883 Instr# 2002-999999 11/22/2002 12:31:13 Rellarks: Copy PAUl BRADFORD ORR Checktt 1060 Total Received....... '$1.50 $1.50 / RETAIN THIS PORTION FOR YOUR RECORDS '^~A~ J? .0. BOX 130 AD NUMBER 222756 AD DESCRIPTION ESTATE NOTICE LETTERS TESTAMENTARY PUBLICATION INSE TlONS RATE 3 THE SENTINEL - LEGAL 3 LGL TOTAL AD CHARGE S L - LEGAL CARLISLE PA ClASS 10 17013 ILL TO PAUL BRADFORD ORR PUBLIC NO'fICES SALESPERSO c31 BILLING .DA TE OS/29/02 S T DATE 05/09/02 NET AMOUNT 84.24 84.24 LINES 26 STOP DATE OS/23/02 GROSS AMOUNT Pf(}~? e.'" y( 3 2002 PROOF OF PUBLICATION 01PRF DAYS RUN PURCHASE ORDER Terry Shroeder PAY THIS AMOUNT 108.71* * AFTER 06/28/02 MESSAGE: Thank you for advertising with The Sentinel. Deadlines for in-column legal advertisements: Monday is Friday at 11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon; Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday is Thursday at 12 Noon. If rou have any questions regarding your Legal bill please call Lor1.Saylor 243-2611 ext. 201 Fax your legals to 243-3754, attention Lori Saylor You can also EMAIL yourlegaltoClassifiedads:ads@cumberlink.com. Plea.se send a cover letter including your name and address as an attachment (l>~O~ e-r0 d ,~'"-t r')-L'.;~. '7 \D Y __' IlJ'k 'IVI>loz", 108. -,) ,)i v Pro boh ~ RECEIPT FOR PAYMENT ------------------- ------------------- Distribution Of Receipt ------------------------ Payment Amount Payee Name 7.50 CUMBERLAND COUNTY GENERAL FUN $7.50 - /' $7.50 V Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 SHROEDER TERRY B File Number 2002-00350 Remarks AC ------------------------ Transaction Description CERT COpy OF WILL Receipt Date 10/25/2002 Receipt Time 11:51:10 Receipt No. 1030903 Check# 1042 Total Received......... ~ RECEIPT FOR PAYMENT fro l:JCk =================== Distribution Of Receipt ---------------_________ Payment Amount Payee Name 445.00 CUMBERLAND COUNTY GENERAL FUN 30.00 CUMBERLAND COUNTY GENERAL FUN 72.00 CUMBERLAND COUNTY GENERAL FUN 5.00 BUREAU OF RECEIPTS & CNTR M.D /' Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 SHROEDER TERRY B File Number 2002-00350 Remarks PAUL B ORR ESQUIRE AC Transaction Description PETITION FOR PROBA EXTRA PAGES SHORT CERTIFICATE JCP FEE Check# 2150 Total Received......... $552.00 $552.00 ~.: gy~ Receipt Date Receipt Time Receipt No. 4/08/2002 13:06:10 1028921 :'I;..~. .. ...~ ~."';;..~&-4-' Us+~ e~cJ,1fv'- "'1 ESTATE OF TERRY SHROEDER EXPENSES 04/02/02 Meal a.t Chieage Airport 04/02/02 Penn Turnpike .taJ.l{ttoOarlisle} 04/03/02.Dinner.forMi-j.a,Shel....bee, JQe Sachs, Smiths, Holland "- 04/03/02 Breakfast--Jude Smith, Holland 04/06/02 U:"Haul---packil'lg mate~ials 04/06/02 Brunch--Joe Sachs, Holland 04/07/02 dinne.~---Mi-j'a, Jude and Janelle Smith, Joe Saehs1.Hol.Iand 04/08/02 photocopies and mailing tubes 04/09/02POST.AGE--books, CD's etc., for distribution . (Weller 1M. C. Wong-auk na Lamphun) 04/09/02 Auto rental 04/09/02 Brunch--Joe Sachs, . Holland 04/09/02 air-fare, round. trip SF/Carlisle, PA '(original price of $295 increased to $380 for change in reservation due to rapidly det~riorating condition of Shroeder 04/09/02 Penn. Turnpike toll (return to Philadelphia) 04/09/02 POSTAGE 04/10/02 Bridge toll- -San .Mat~o8rid9$(R.eturn 'from Pennsylvania '? .11 3.75 66.00 15.00 64.61 14.00 72.00 4.18 45.56' 257.53 16.00 380.00 3.75 51.62 eck # 1003 Internet 004 ~e BANKilfEWEST CUSTOMER NAME ESTATE OF TERRY B SHROEOER ACCOUNT NO 6-076984 a...t....OL\'t'c..~';tu\ '3J:-:s ~'" "',_, eft 411'\'10' n" ,~ ,..,\ ... .r/r fg- '~ ~ ji/'-''~- b-- : n' a' ff.if -.- 6\" .ar ::m-::-'.:I . ... ~'"'~ t:::::._ ~ P X ':UUOO'.,':.401o 00'0,....... ,0aaoen.1o .., CBZCK "04, PAID 5 15 2002, ~ 12..4. - - P'f,o-. -"_ ~ ~ JKIf<<::'~ 6)~, rz..(../y)o' 0/,/..-. _ ~. ~~~~, . D.~rL..!'fJ. l , . ,"(4 .. ::; 0. ~~': .~~ _'_I~ . J . ~ =;..5F';= , IlIl c::::::c::. au ~-' . .:uuoo,.ae:.'IO& 00'0'....... ,~~, "0', PAID a 23 2002, ~ 104.00 - ., 9 I~ "..,.. STATEMENT PERIOD 5/08/02 - 6/07/02 CHECKSCAN" STATEMENT PAGE 2 OF 2 1107, :rll r/lJL- -. - 'f U:"..;!f., ~ -hI!" II!\ For Your Protection: Please examine this statement and report any discrepancy within 30 days. MEMBER FDIC PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929); P. L.1784 STATE OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND : Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, . VIZ: MAY 17,24,31,2002 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. ~ Shroeder, Tony B., dec'd. Late of Carlisle Borough. Executor: Edward Holland, Jr.. 366 California Avenue, Suite Three. Palto Alto. CA 94306. Attorney: Paul Bradford Orr, Es- quire. 50 East High Street. Carlisle. PA 17013. SWORN TO AND SUBSCRIBED before me this 31 day of MAY. 2002 NOll . LOIS E. SNYDER, Nobry PublIc CIrI8Ie Bcro, Cumbertand Colny My CommII8Iori ExpiIw MIrth 5, 2005 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland. Lori Saylor, Classified Advertising Manager of THE SENTINEL, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto Is exactly the same as was printed and published In the regular editions and Issues of THE SENTINEL on the following dates, vlz Copy of Notice of Publication May 9, 16 & 23, 2002 Affiant further deposes that he Is not interested In the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publication are true. ~~:~~. May 29,2002 Sworn to and subscribed before me this d~y of May, 2002. ~~O. 29th ~/U}(..t..~1 Notary Public My commission expires: NOTARIAL SEAL SHIRLEY O. DURNIN, Notary Public Carlisle Boro., Cumberland County Commission Expires Au . 9, 2003 1e/eG/2ee4 17:58 6503210990 HOLLAND OR WELLER PAGE 02 Toronto Trip, with Mija Kim-June, 2003 Plane ticket.- Travelocity $211.50 (receipt Enclosed) Holiday Inn (Hotel) L' Auberge (Hotel) 118.15 (Receipt enclosed 70.17 Canadian (Receipt enclosed) Gasoline 53.20 Canadian (Receipt enclosed) 123.37 Canadian Canadian expenses in US$ $101.18 (Exchange rate-Canada $1.0<FUS $0.82 Per diem- 3 days/2 peoplel$40/day $240. (Per diem-food, gas, and misc.) Toronto Total $670.83 l' Q.~~CU!;;Cl .I.\.CvvlJ.l" ....p.lI...p" < ."'lY ..<V...U)' ....V<...IJVI AU... -...,. ~"".A"..J1~U .J1A~"-~.U"""." y ...p, ~ Trovelocitlf Ho",:,e Flights Hotels Cars/Rail Vacations Cruises Last Minute Deals Guides & Advice t Mv Stuff e ~I~I~I~I~I~I~ 10f2 . Passenger Receipt ________'H.....~...__.HHH.___ Please review your passenger receipt and required notices. A printed ticket receipt may be requested from the airline at check-in. Trip 10 Number: 686673718871 Please refer to this number anytime you contact the Customer Service Center. In the United States call 888-709-5983 (En Espanol 7am-11 pm: 8'66-828-3933, TOO/Hearing Impaired: 800-555-7585). Outside the United States call 210-521-5871. U.S. dollars Price Per Adult: USD 211.50 Price Breakdown Base Price: Taxes & Fees: Service Fee: Total: USD 174.88 USD 31.62 USD 5.00 USD 211.50 Billed to: MasterCard card number xxxxxxxxxxxx5607 Total amount due: $0.00 - PAID IN FULL Ticket Numbers: 0377348002710 Ticket Restrictions. STNDBY FEE/NO RFNDIIPREFL TS CHG . FEEI/AFTR FLTS NO EXCH VALUE Your Passenger Receipt Details Passenger Name(s): HOLLAND/EDWARD Passenger Classification: ADUL T Flight/Class: US Airways flight 740/Class L Depart: San Francisco. CA (SFO) - June 20 at 7:00am Arrive: Pittsburgh, PA (PIT) - June 20 at 2:41pm << connecting to :>> Flight/Class: US Airways flight 73/Class L Depart: Pittsburgh, PA (PIT) - July 05 at 9:30am Arrive: San Francisco, CA (SFO) - July 05 at 11 :43am << connecting to >" .== - === .- === 5/15/03 11:17 AM Guest Name I~IIJA 06 /2f..! /03 Room Number Room Rate Deparlure Date 16 J. .i118.15 Share With Sf.-1cond.:\l-Y H.;:lte ..00 ~" 1,- WELCOME TO / BIENVENUE AU *~~~ NOTICE TO GUEST I AVIS AU CLIENT VALUABLES I OBJECTS DE VALEURS For your convenience and sefety, we suggest that you leave any valuable possessions in the safe deposit facilities provided for guest's use, Please enquire at the front desk for lhis free service, Please do not leave money, travellers' cheques or ;ewellery In your room, Holiday Inn cennot be responsible for any valuables not deposited, Pour plus de commodlte et de sOrete, nous vous conselllons de laisser vas objets de valeur dans un des colfrels de sOrete que nous metlons a la disposition de nos clients, Le pnipose a Ie reception se tera un plaisir de vous donner de plus amples renseignments concernant ce service gralui!. Ne laissez jamals d'argent, de cheques de voyage nl de bljoux dans votre chambre, Holiday Inn n'acceptera aucune responsabllite pour les objets de valeur qui n'auranl pas 91e places dans son coltrs-tort. SECURITY I SECURITE Guests ara raquested to ansure that their room door Is locked when leaving, Whan retiring, the chain should be secured, the night lock engaged and the sliding door secured also, by use of the "charlie" bar, Nous vous demandons de bien lermer Ie porte de volre chembre a de lorsque vous la quiltez, Avant de vous metlre au lit, nous vous conselllons d'eccrocher fa chaine, de bloquer la sarrure de la porte et de verrouiller Ie porle coullssanle au moyen de fa barre, IMPORTANT: Pleasa read fire proceduras posted on the inside of the door to your room, IMPORTANT: Vaulllez lire la marche a suivre en cas d'incendie, qui est alficht\e sur I'interieur de la porte de votre chambre, INDEPENDENTlY OWNED AND OPERATED BY HEART OF NIAGARA HOSPITAUTY \, ;;(" ~ fE.~" .......- ~.:!.';..' rp". 8lU't./Der '. .... . '. ~.~:,; ...,..~I :"'4~ ,'t,. ~,\ TEL.: (41i) 638-2674 ". ~;:j09,rue ell Quai -. lSt-Sim601l, O18rl~oix GOT lXO ~':~aubergesurmer.coin ~~:v 1<" t:.. f' pate' CARTE O'ENREGISTREMENT REGISTRATION CARD ..' - - 14794 ;~ Chambre No.. ROOm No. Nombre de clients No. in 1'ar!:Y' 1llux Rate AVIS . NOTICE 'IlIxe F.P.T. RT.P/ taxe.. 'Thxc T.P.S. O.S.T. taxe 'IlIxe T.:\';Q. . P.S.t. taxe TOTAL :;:- ,. .~~ .~' Nous ne serons pas responsab1es pour Ia perle d'alll:\lll argent, bijoux ou tout autre objet de valeur.... We arc not responsible for any loss of money, jewilby and other va1uables. Licence y .-..... PN RBMBOURSBMBNT :' -_......~ yoQ ~ qo V"o-) J. ~-I ~ ~rc(' --' It.; \.\ .:. \'.,,< . " ;. - . ,."t. '\ . 6. :,. "'lA , '" ,.,.l. .' ~- -' ! . ~ \ ',' <'\' 'l<~' , \ ...'.\.... . . . : ....\. CI) ~ . i ... 1:'< ! t, i ~,~.." \:.~...\. . 1..~<oI'i . "'\' I . .,,' t ,.;.:. i ,. l Pennsylvania Trips April 02-Air fare arranged and funds advanced by Thomas Miles-$375; copy of Miles credit card; attached itemized statement from Holland (To attend Shroeder last moments at Hospital, arrange funeral, initiate estate administration) Please see attached accounting, receipts, etc, totaling ~998.11 (All receipts not available) The individuals mentioned in the accountings are friends, relatives and/or beneficiaries of Terry's who lived in Carlisle or who came to town to be with Terry and to attend his services. They all helped me in one way or another arrange the memorial service and start the administration of the estate April 03 Travelocity ($241.50 air fare) and Enterprise auto rental ($127.67) receipts attached Total: $369.17 Oct. 03----Travelocity ($273.50 air fare) and Enterprise ($86.80) receipts attached Total: $360.30 October 04- Travelocity air fare (Receipt attached $138.90); auto rental estimate $100 T ota!: $238.90 Grand Total: $1.966.48 04;'02/02 04/02/02 04/03/02 04/03/02 04/06/02 04/06/02 04/07/02 04/08/02 04/09/02 04/09/02 04/09/02 04/09/02 04/09/02 04/09/02 04/10/02 Meal at Chicago Airport Penn Turnpike toll (to Carlisle) Dinner for Mi-ja, Shel-bee, Joe Sachs, Smiths, Holland Breakfast--Jude Smith,:Holland U-Haul---packinq materials Brunch--Joe Sachs, Holland dinner---Mi-ja, Jude and Janelle Smith, Joe Sachs, Holland photocopies and mailing tubes POSTAGE--books, CD's etc., for distribution (Weller, M.C. Wongsuk na Lamphun) Auto rental Brunch--Joe Sachs, Holland air-fare, round trip SF/carli~sle PA (original price of $295 increased to $ for change in reservation due to rapidly de eriorating condition of Shroeder Penn. Turnpike toll (return to Philadelphia) POSTAGE (double-check fo what was sent) Bridge toll--San Mateo Bridge (Return from Pennsylvania) 7.11 3.7!5 66.00 15.00 64.61 14.00 72.00 4.18 45.56 257.53 16.00 ';1'1 ~ -- .,...3-&6'.00 3.75 51. 62 2.00 TOTAL COSTS 100) .1J? 'tfg. II ., '1~......___...._._---_.~- .-."".-.....,..... ~6'..~ . , , . ''1',::' ] UIl i ,;..q .t'. - NI,j..,. . I ':\1 "I ~. 10."": , ~r!i :.1.".. ':;"?c , 'C... Z) rt ~' ~ ':> If'. ~rf l\.t~ I .~ , i:>!,~~ :~ i'C<' ,,' n;'HE f'HI:..1. ~. ::::L;,.: lOG ~'1\jF: f}~ r'hV',;O~)';::(::. .. .:"';' -"'"{'~~~ . .;./ l1"/-".;':":::i.'/' Dctt:? ~ O~./~\Jh.)'2 C:ust: CI~) i 'U!;::~;' f(f]. ;;~ ()~::;z ~.. ~ .....---...,.,... .../-" -,~.-- ..~ .---- N' IN f;.; ,; h.=,.. :~"~~.l, "1, I j" Tj~~. :,':it -, I \ i.... .,.r'.;i~~: ~..' f ~~ . ~ ~.". ....::~..~:-~:~.i~; ./ ~f1" .;~. "'/:~2'~'.:,i:-.'":;' ,~~.. :. / J!ile vis it Ndl}' Pier PI dce . ' urdrr ~.(-c: Lj C,Eih l 'L W COFTE; COPIES V,C 71.} E/:: ~~ 7.11 ..... 7, ~'!) lti: ~:~C~:UF' 11.rSCtl ~)UFPL.Y Ii"i:::t"l 1 [Pi <# rIISC';UP t; 'j'UBi::" 14 r.::f-i \~ J". ....' . y' ..~; .' . r.1" '..... "'~" . ,.. .~.: --~~ ~ .... ; ~.;:~ ''-, c. _" '.- ..:.:.....-;,'.. I ..,.~.... ~ " . ,..... ..' ". " L. J ~.. .. . ",' ..'.. . ...-' __" _'. . "_.' L~ ,:_ ;_(o't .~ ~~i!J~~~ia ,.~:~~~;~ Cf ~ l \ ~..~ :.; .yo' }-' ID'~ 2~l .... ~ ~~:=i: " .!,.,: ~~':'..: ;.\; :'~ 'j ':,J ~ ;! !;~: '~:-::' ':' ~ .;. c, 4......' :.j/~~~; .......';: ..,..... .: t.' ~:; :~.il.~~ f~; ~...i r"' :- ':::'; .~ . ~::.E\~'f ~. .~. ~ +8 = :5', ~) ,; :.:::~)l::)::~:. 001 If ::;:: 'l~:. '/,~ ()"' GA.G ~ :'?7(~.;<) .1." .~~'O 4"?7650 1.,; "r?G <;)\\0 'fGt~:I.l T.:\x !"m;-:\ 1 T_\f':[i 0.. ~\6 1. J9 i II ~t'l~ .:;: 94 0,,24 'l.. lr~i {II J.B ~\. {)O U.S. Postal Service SURED MAIL RECEIPT DAN' A1':J9 n. . 9"'~. ". .~. ;, ~ ". ~y ~ r ~.." , }~ ., t;1 $15.13 . ;:) postage $ tJ. .~:~ F:' I'- Insurance F.... :r..D Restricted DelIv/ill'Y F.... (Domestic-only: llI\dofS8m8l\t required) f'- f'- Special Handling Fee 0:0 Return Recelpt Fee m (Exc:epl for Canada: lJ'" endOfMl1'18Ot requlnld) ..D Tot81 Pc>allllle & F_ $ $&.00 to.OO to.OO i' $O.OC'" . $21.13' ,"", ,/ CD Sent to: ::> 'S~i;API:'N(,.;';;"PO'ii;;(N(,:"hh""""""""':::""--'''':::......... ...-................................................................................---...... .ciiy,.Si8ie:.zjji.;4;.CO;'nt;y'..... .. CARLISLE. ennsylvania 17 132935 04/09/2002 <711 2q3-3531 10: 12: 46 AM ------- --- Sal9s Receipt .--.-....... -,.. ----.. Product Sale Unit Final Oeser i pt i on Qty Pr i ee Pt" ce h~l f) ALTLl CA 94106 Medi Cl $15.13 foIai I I, ,,,,,,,,'ed $6.00 Insl.:rallce Amount : $500.00 Label Serial H: V66938t7647US Issue PilI: $21. 1') PALO I CA 94306 Hedi a $lo...jJ Mail Insured $6.00 Insurance JlOlOl:nt ; 'f,~)OO. OU Lar" 1 . Sar I a l Ii: VB6~:ii:, i 1655U5 --....- .._.- Il>sue PVI; $2'1.43 Addl'ess $1. 98 $1.98 Labels - ReadyPost 13< $4,08 34c Stamp 12 ~- - Total; $51. 62 Paid by: $51. 62 Check Usa NetPost Mai ling Onl ine to send full-colot' postcards right from your computer I It's qu i ck, easy and on II ne at WWW.usps.com. 8111#; 1000200715158 C i er'k : 06 Refunds only per OHM POl;; Thank you for your bu",iness Customer Copy ~ .. ... . t;1 ;:) f L. t~ J :::3- Postage $ ".. U') Insurance Fee U') R"'trict~~ $0.00 ..D endonI8<'f1eOt required) $0.00 ~ Special Handllog Fee f'- 0:0 Return Rec:elp! Fee $0.00 ' i. (Except for Canada: I'T1 eniloraement requlrecl) lJ'" Total poatllg. a F_ $ .24.43 ..D , " CD Sent to: ::> - -........p.'... .su;;I;.~i:No::.;,.P6.ii;;(NO:.................................................... .a;y:slati..zjp;4;.C;;U;.rt-,y............................................................ St: C) Hi \/l'rSC for Instructlons PS Form 3813 p. tk'J 2000 c , . . . , RE 77'16 *** EMPLOYEE PURCHASE 07200013217 PHTbPRINTKIT 1<l @ 1(6,99 * EHP DISCOUNT **** TAX 5.28 XXXXXXXXXXXX5607 VISA/Me APPROVAL 159185 *IH 97,86*T 9,80- BAL 93.31 EXP 0<103 VF VISA/He CIiANGE TOTAL NUMBER OF ITEMS = 14 93.3'1 ,00 1111/11 ~11I J~IJ~~JIII~II 'I'~ 1~1111111l11111l1 ~IIII ~111I11111I1111~m'~ 1I1~~ltllll ~96 SSL LJE ~5F NIY P~7 RECEIPT. 07746 040902 030 30110 04/09/02 3:22 PH 7746 30 3011 9056 MerchandJse includ.d in toda~'s transaction Aa~ be returned or exchanged beFore 07/08/02 with this receLPt. 1. The co~plete retu n & exchange polic~ is available at the SeryJce fiesk. **** THANK YOU FOR **** **** SHOPPING OUR kHART **** r llne en. t: Cor To Be Returned To Above Unless Slated Rental EJ.'k'iRD [USnt: !JPDJ7! ::WE i~~ ~9!~4m:t2 Pf:d..O AUG 6~-it~h~ : \ER ~ None ~i:'[S m~ iR. llAStS ,- . HfrH~nH5607136e534/ 'C57. 53/04/0Sic~ i~ Clmd At ~' IlAlJEL.oHIA AIRPOR1~4/i9/2'~ AY2B2243-3 Vehide Information r j 04/0'2/2002 1936 Hr- 1 TOTAl.. r , ConcFeeSl!cov il. 1~ SUB TmtlL State Ti:l~ 7, vehLL:flsFee 2.'- State Tt;" ia 7 Dys@ 2.~ Rental T>:~ 2. ii!'ePaid f\l~l TOTh1. om. lES f*CREDll,/PAV~~fS** NET DUE AAY>lF.NTS SHiH: 0dl01 CW10Z9 FULL FUlL 11050 11049 26512673 301.7B6/025 Weeks TIff. Hl 04/09i20i2 1841 .iH k~ @ 18ol.99 1114.19 184.99 20. ~.s 2~5.54 14. 39 t ~ \ tJ.,i.. 14.00 4..11 15,38 ~.." '" ~'':I.,;,J 257.53 -257.53 ~ ; You ~ and repruen' !hot You ore IeAoIIv oulhorized 10 operate !he Vehicle by valid clriver's license and that You h0V8 read and C1Qree . ions and nolicei boIh printed ,oncj writItn, including'loss Domoge ~ Ihat appear on ihlsl8l1kll slaIImenI ond on !he ~ kI;1II. If . IS by credit;;d, You authorize DoIIor 10 process or sWm!1 ~ charge 10 Your credit card for esllmated chorgea lor !his renlal ~Y~re 0. 00 uent Ia the r_MlIion of credit wi!h !he cord issuer 01 thegreal8r 01 $350 or !he esllmated charges due. If Dollar sulimib 0 charge lor )81, and the charges ore less thon $350, You 01.0 authorize DoIIor 10 reseMl credit wi!h !he cord issuer lOr !he diflerence between $350 and the omounl oIestimoted charges due riven _ peni1lINcI wIIhout DoIar's apprcMII. ' RENTER x .. -~--l--fe' ---- --..-,;-;Ii'at~T~, fl~i :7j r "'-, . ~"I'I~ ....\: J ~ ;. i' . }'l t } ,. f\' ...... ,I~ .~I ; rlllol\... tp 1A- :itjr ,k -~~~ ~:J I -''I;. \: oJ t '\ .. ,. ~''; ~ i; I ,~~, A V> 'I' .~..;,.) 'j . J~"~,~~' " . f A ~ i ,. . ",,-""'- ~ ')d*' :i ,i.:Mr' ;,iii, h'~'~;r ' -:'.;c,~- r" '': ~;;~ft":"';'~i ~ . ..~..t; ,.1' :,:~ Ie ,:'.~\ -7Q ',:! ,'.i.:~, !", ...~ .... :':G:.t.~~ ;."l};oT. Cf' !.,\ i;:'}TEL:;l;. ~ Jf sl ~g' ': ; ; :,;'\ i~~~ :- l'in!' ,". .. ~,,~,,~ ~ .': K;t r:;": 1-::: ... ~ ~, ~ I' " i' l' . . ~ \I. ;::~;'r " '.:H(\Hr~r :: }: "':' .. ! Ii " RENTER/AUTHORIZED DRIVER /.. CUSTOMER COpy . ow., ...._._....w... .___."___ .'_'"__" ";-_ .__._..__..._....._.~......."__.,_.._,,.,...,_... _.__". _.__......_.__. __ .____....~. .'. Tor~cENIER Y[lLOU=CUSTO"l~ ('" , \ .. ., .-Si)K._ E 1: -r ~;'Ii",i 'l'if HV OJ[ It,: ll''' . '_ 1\_ I I ,j 'i I' ../1) Ur::UII"IEIH "jj' '!lII: ~;: I[JlO 2 ::fl 3 ():fj; 6 S:RTUR~HY 04~06-V2 &:43 ~H U-HAUL CENtER OF CARLISLE HIKE TAYLOR - NA~ASER , 1111 HARRISBURG PIKE eARlISlE. ?~ 17013 (71?) 249-&819 -------------.--- I I ~ ;! i! Ii i 81)-06l ~_ 4 __.___~.... /~\ S ~ i. E 1 TEN 5 -.-----..~--.---_M. ---......-.. ... ---.~ "---...- 1.0 40001 1.0 gP1615 3.0 [fl, 25.0 SI'I " :j 11 ., ,. f' ,I :/ , TuTAl. SHLU~ TfIXES: TOHll CHAR9ES: TOTAL C,IjE iOf)p.\, PAID J(rf)AY eRforr CRRO CHf~GtD -, \ , 5lf2~j l'~,,.2~ 4.05 ~4.a:; :;~JO ~15.~'D 1,.43 i35.?~! ---...-..-..---- '~6;~.. /.; $.l.U ~b'l.~,l it,,,.61 H:i.61 ~\~-4..61 ....._...~.~~- _ JC_ ...._- ,_._._~.~-_._-_. .--..-..,... -""..,... --. [--.'.-- "..,......- ""--'''-'--'''.--:--:''-'''''~ ...--,.-..-...._-'-:'-'..__.,._-'--~.' - ".'- -" ._~-~.. :s SUaJECHO fINAL' AblDIT. r nl'ls beIwe!lI).}'llU!.chn", ' C -'DOLl;;RR RENT, ~ CAR ,SYSTEMS, I we. . ii:linseeofDi:llklfRtnlACOr. 'f PHIL IN"" t ~AI RPGRT .~,ricliiid:h ','" " ". '",' .~',.' PHILADE:Lf't':Il~;Pf:l ,!,S',t:i3 .'. ,,:i.SJ~i:N':~-~,;"J:7,f.7)' 3$5cfFf ~,~ A1FAlJE':;' ,.' 'Cli~/Q4/2M2 .DRHf.R: tlone ;lJlTiifi,!S fit" 24HR. BASIS .".,.;.~~!::::}~.;;~>.,}.:::,,~~;.',~.;~:.; . .""., ,:::./:':'r:::,'i;' ..' ::'~::"_ :~' ..~.".-.., ,_ "~"L'_'; . Tift. i~_ !>,~. '..~ ..... :'\,~ -(!il}~i:, WF~. tt, '. ..,....,/ .~~7 .:' ~" - .. ti'it . ;:, i C'U ii'li ;~J II"> .l~ ,.)IiJ~T T~J !l(~iI>ri.A!'I)IJD * _\\ :-l'-P~_[!,~t.1 f IN HrrJbE (FOOD 1.- IN f-inUSE :FG{JO . T I '1:"\I'-'U~lI1r. I~j fl~~~ ~~J p.. Hf1',IS :Fonn ~.' If...h,. - ""10. ~ T. H HOUSE FOOD "t' i H HOUSE fOOD ~ Hl HGUSE FOOD J!.J II1lflC;E Fru1f'! "- t: I.i'..,.. ..Lu".ft.. IH h'1J1JE .rOOD (~ HJ <!!'\llr-r' f' ,OOIf"\ ..,. 11, illJu;Jt. , " " BEER m ~USE .~ IH HOUSE fOOD .' . 1"ll\:lTl '. : J:: .:)\.10, - 1.-.'" .-'. TAX 1;:1', -.... ".\,' T' (l 1.1 ,.",.' J..i: Hi.. .)~ I'~ ~"Tr'll" (,' 'Ii LH I tJ'!U ~" :,' r""'\~r;[;; :i: ..J1na I~. i': , ,p , " : TQP=Cf:tHEll YElLfJW=CUSTOf!fR .'l'.'.,,: '.. :; \ . ,r. f,A~tJC:~.';~HT .;:Q;O :l~34~6' ...- ~ ',' n . '.. . '>-'If .' . . ,~~tJlt~,t}14~06-02:g:'4e ~II' " I1-H~J.JiEfff[R .OF, CARLISLE i', ,lllKE/HV.LDR -HA~AGER " ' ' . I.,. '1~1~ .HA:8RIS;BURG,phE j,..' . e~2LI;~4~~ ,~A 17M3' f", (7ln;2~:~-;aai8 ',' ,f; \" ',.... '. ';~~:'f',:,. 81.t-067 : ~, . . I 2169 2 ~--~~-~-._-~--~--~.- ,_r:~ _:~~_~:'~~~~:_'_'= ~! ~= ~;~ ;-- --- - - - ~.- ~ 1 A . . ----~~-------,-.- " '.).0'40001' . ~.25 t~.2S' ,,' 1.Q BP16t5 4;'O~'i~ i>~ .3~!l:.;Ea~' 5~30 $1590. I .' . 25;~ d<:St:f. :-. '. \oJ' ". 1.;43:.. ~-.'aS.75 I I ! I i ; I i ITEM ~CL 1 ~ l't ...... " ,~. ..' ~ ~...-. 19. ~.~ ~!~fet~ ~ :', . I__~~__-~-~--~--~--.- ---~------------- loa. $'5 Fay'~~untry ~ Ki~en 20m......" ~ Carll8lc. fA Receipt Amount Fay's Country . Ki~~oen 20:5 S, Hanover St Carlisle. rA ReceIpt Amount /3.1l&, Tax Tax Total 13.'lo Total \ \.b Ul I~ ~ S .1 g ~~: J ~,; rIj 12.' ' ~'C ~ ~ 0 E ~ - >( ~ ....., ~ ~ "S Q) CJ ~ ....., o v' / ~",:","'."'" ~':;.,~.; ...: .,.~,?'; L...\ ~';,<~ 'cS't. t':J . (Q....' 4;..) ~;;:~ <'!" ,...,.-"-'7-..,..-_,..,,~_ l' \~ ~_-,_,__::-"""''''''---:-~'''~''''---::-''''-:V-:-~ \i: -~.: ..." . t'-J'~l'~' ....1' .,..~ ~":t" ~ 1~\ ,. . ......" ,,;;'J ~ :::t:Jt. .:.;.:. "- , . ' . I ,.''\li: ' '};'1l ~...' .... I . ,. ~ := c..,;:: ,." i'- , ',;; I:' .( , ~~,'~ 1$1;1 ,&;>. , 'a ~ r::; ;,;: ~-l-' ....Q~... H lk , ," . :'16~'" ~ ,~-..~, .. ::..J ~ .. ~~ .~.I. f~:!,~ ~ >;>". ~'. ..,~.! ,~/t~ .. :J,..I( . -<~ ......j::s ia'f&J.' '1:$.". . ,.g r....'t I'"r.'t~"'t ~ . . ..:' {~. ~-",'-~ ~d\ ,.,.~~~;:J:;>~~ "~..... ,!;;tf:::... ~;.....~- ......;~ (:i<:t r, i' ' ' ,.~ is) -o! ~ ~ .. ~ .......', ::w I '-.::> ......\ ::J;:. \\ . ..~,. I',:~ $A.;:.'" ',,'0.,.: . . ~,~'$lI'~1;}.~ ' "~'~ .' .r~ :::tl'..~ c-~ .-, .' ..r~ '. ';"~k~ . ..,'~..:'.",.... ''''g~ . ~~. '-~&:i~~i . g. ..ti " ~~~:~~c}~~!;:::;:~I:.!~t;;.. ';';....;..,~~,i. .~:.' ~ "~\\ .,~~"~ f3:. ~.~ ' .";~~~:'t\~::-'J:,'tI'J;i(.,, . .~ '. ~; .' .'.".. "". . ',,>' :'.,: . . ,_,_ __'_,sf . . ~,.: .. ", . _...----..=~__...t::":'::__._____ ~ 1 t? rI ~ ~ ')': ~~~-; , ~, Trip Details ~ Traveloclt,. PUPlltl.EO . Page 2 of3 Your Trip Detail. Flight(s): Thu, April 04, 2002 Flight: American Trans Air flight 890 (Non-Stop) Flight Details ~ Depart: San Francisco, CA (SFO) - Terminal Information Unavailable Thu, Apr 04 at 6:30am Arrive: Chicago-Midway (MOW) - Terminal Information Unavailable Thu, Apr 04 at 12:30pm Seat: 5C (Boeing 757 Jet) Meal: No Meal Served Status: Confinnation Code fa BHCXEC << (lon"ectIQg to >> Flight: American Trans Air flight 236 (Non-Stop) Flight Details ...... Depart: Chicago-Midway (MOW) - Terminal Information Unavailable Thu, Apr 04 at 3:20pm Arrive: Philadelphia, PA (PHL) - Terminal Information Unavailable Thu, Apr 04 at 6:20pm Seat: 22C (Boeing 737-800 Jet) Meal: No Meal Served Status: Conflnnatlon Code m BHCXEC Fllght(s): Tue, April 09, 2002 ....... Flight: American Trans Air flight 239 (Non-Stop) Flight Details ........... Depart: Philadelphia, PA (PHL). Terminal Information Unavailable Tue, Apr 09 at 7:66pm Arrive: Chicago-Midway (MOW) - Terminal Information Unavailable Tue, Apr 09 at 8:66pm Seat: 19C (Boeing 737.800 Jet) Meal: No Meal Served Status: Confinnatlon Code D BHCXEC <c: <;onnctCtbig to >> Flight: American Trans Air flight 206 (Non-Stop) Flight Detail~ Depart: Chicago-Midway (MOW) . Terminal Information Unavailable Tue, Apr 09 at 9:36pm Arrive: San Francisco, CA (SFO) - Terminal Information Unavailable Tue, Apr 09 at 11 :69pm Seat: 25C (Boeing 757 Jet) Meal: No Meal Served Status: Confinnatlon Code D BHCXEC ~ Alrfar. Summary . Price. .hown In U.S. dollar. Travelers Price per person Taxes & Fees Total: 295.00 Total Price '\ A I C'~'-,.f' "\ 295.00 J( \...., f....J., ~37~~ I Check out helpful infonnatlon and special deals on Philadelphia, PA. 'L.c:..- ~ Continue belowl 1/ ' ~ G 1 adult 240.00 55.00 https:l/dpsl.travelocity.com/gJblchoice.ctl?SEQ=10 173683 5950080603282002&LANG=EN 3/28/02 09/19/2002 15:10 _51a3513293 TMA AND CEE BEE ~AGE 01 .. I "~ l,.~ ' I" . .... .... ,', ~ ':1 . I' ~.' I ',I . ..'. I . I: ~. I .~ '\' ", J ~...." t' i ~ .,t~" ,c'.'~ II t.~.. \I ,... . . ..: ::': (~r' ::'" .:f"I",T"':V7 ::'~"" C'.~.'~t"'\"".!i'l'" r:~, .~j\lj...: rj"'~ Jl.t...', ....:::~' '~~f,11' '~:'::' : ~:'::l .... :.11 .:~.:..~'" "'~'t" ",'~:t:'j.. ~ I,'.".~ VISA :.' .:' ::-;1",;,:.1 '~::~t!.!~.. . 3428115-60 ..."..;.... .... . ,:',' : ,:\~:;,:. i :'. ~~ ::." i, '0' ".,":.~ . ....f" '0 ..:.~~ B'.OO .00 .00 8~.M :l 1 ....'.....) ......t 'nIOMAS H HI L1i:a p 0 BOJl no~ liAY.WhRD CA 94.S40-620S ',~ '.. . ..... 'i' 426$ . @Ii 05~0!'i-02 '. ",. t , .' ViSA; f.:: ... :;~ " .~,:+"'IoClII:ffM!'.IIIi'~S\;t;' .,."'1!(,oIo'!:!;r, .. ',jM'f." ir;:;r,i;! ,.,j;f,'~...:tr.' 'fold titf.~> .. .... "I ."'''1'... ....:1" '; : '.;:::;:' 'f' . ....:.,.:.: ,"..,.,.. I.' . , . ~. ; ; ~ i f. ,:.1 ; "'. I ! ~_1 . UIIII.. :.l~ , ,,'. ~.: ~ ",,' ~ r: '.., 1..1 " " , '.' . ,:" 'I .. ' , ,'I ',03-16-02 ;04-15-0;2 ,1 ',' " .. ',',;.,.. ]4:i!S"-S-60 USTR:rerF.o '1'ROWJ3 R MItJl:S 30r:O.00 . "rH.;'_ ~6 .CD .OS.:-.q5:,~:l 31.. I. 1 1 Y'OU'VI!l ~Rn approved to 1I~~.p th~1!' mnnth's paym.ntl, Your tle>f.t. p~.ym.n~ iN nDW ~ue on 6105/0~. I~LorQ~~ will cont~nu. t.o ~oeru~ on YOVT. b.lanee. For quo,tinne/ c~ll ,SO 38'-172'. POST PORCH TR~9~IOn ORSCRX~TI0N RBnaENCJr. NTmaJilR AMOUNT IJA.TE tlA.7'E 1)3 -:L8 03-U ~J:RvYNa 00002832 SONOM CA 2416407~O7.27007328312 90.0' O)-lR 03-1.4 CHAMPS t..OFiO t'LBASMTOtII CA 246104J2074004D22~12~B 86.59 O]-AO 03-U I." VI1I1.A MaXXCAN USTAUAATRACY CA 241.5813201890000010.1.41 24.'1 Oh22 03-20 DlS HBRBRANSON AND JAB 5\0-89S-1+7Q CA 244726a208n1601080000~ 75.ClO 0),22 V:l:SA PAYMENT - TH~ YOU -1500.00 SMCtT On 1.1",. 03-::15 02 -22 COPPER CRIMNr! CUIS:tNE FREMONT CA 2~'39~3~0834COOOO7100' ).3 . 23 03-28 03 -~6 "'1'&1' Wor) dNet Sarvi ce 80(1-4001441 M~ A41S2S'208S09053B12J15 ;1.6.'5 04-01 0.) -2.9 CJtOWW SAt..!S J1\MIS'J'O'IfN CA 240927'209000027154602 50.~S 004- 01 03.-28 AM TRANS ~1 3'67267061t'6~AN ANTON1O TX 2471705208858088084066 295.00.J _. 04-02 04-01 AM ~RANS Al 36606l020a2~~INDIANAPONIS IN ~41170S209~580~~OO!10n 80.00 04-02 03-3Q C & 1f SlJP'PL'Y SONO'ItA CA ~43~30)20i~12~~2S01268 54.70 C4-03 04-01 PETSMAR'1'* 00'5 rAN LSANDRO C~ 2445S0220'120'270~42~8 91.96 01-08 Of:~05 DIAHOND JIM'S RB~UR~T MIMUK VJLLAGE=A ~44'21'20'71l&323~"30i 42.19 04-08 0~-Q4 DltS HEURlWSON Alo"D JA.Ja 51(1.. 895-1"0 CA 24H26820957601l900003 980.00 0'-15 l"IN1\NCS CHARC1B 39.58 A.k U8 about our ;uarant~ad low r~te on New'Home Bqui t y 1..i:185 ot Cl"8di t ;ood through ell r; I 02 .' . '''--''':''''':'-::~~;-:-' .:-~.~: .~"".t<<-:lt]....~.~ ~ ,,'IftCo\:J"'O~ n1:'-'.f~&-l:.~9-=VR~c:-",~- _.. ._ __. , _..... ._ ..._. _.. . ,_._ ... , ... . '.... , .' ," " .... :'.'. ,.' ....,. i. -".. . Tir"oo ' ~~..~~ t'e -....... ~':L'i'Oc;:ms" ..~:,.O!'7llr- ....... 'IfD . .. '.'IrA '':.4$',I~~t'';/.\l\'''1::~ VII : ill'} . '~9'~'!:Ij""-- '-i"J~:-tfg--' Ir-'-,-:", -.~;;. :';:. . '7'---:'~""~,,:-' '::,::;"~.'.~ ''i- ;:::. '-~.-:- ... ::-..-::. i.::,"':"",'- .. .._':~~~~.';.;~.:~.,:'.: -'.-~;' ... "'-'.'_'_ '.. ~".':-;-. .. ,,'. . .... t. tt;:-::"""":~;:-: .-'~""':-" '-:;'-::':': .00 13'.9500 3..1625 . .on H04..'~:1' 13.95'00 ):. 16:ZS' 3'9. '!lS '. . "u .~ . ........ '" '.. .... . . B~..:'S2 !U~}I.I/ U}li)! .U4 Vl;;!V~U'y .~Vll!.()VI 4ll...-L.'o! ~()('!4i)~-I-'OU J'el!>.;. / r T rovelocitlf We've made It easy to get around en )'OOr $pring, Rent for only $140 per week m! All ;e, Flights Hotels CarslRail Vacations Cruises Last Minute Deals Guides & Advice 'Mv Stuff & f I D Passenger Receipt' .. ... .__ .___._.__.___.____._ I Please review your passenger receipt and required notices, A printed ticket receipt may be requested from the airline at check-in. of2 Trip 10 Number: 718578677870 Please refer to this number anytime you contact the Customer Service Center. In the United States call 888-109-5983 (En EspanoI7am-11pm: 866-828-3933, TOO/Hearing Impaired: 800-555-7585). Outside the United States call 210-521-5871. U.S. dollars Price Per Adult: USD 241.50 Price Breakdown Base Price: Taxes & Fees: Service Fee: Total: USD 202.78 USD 33.72 USD 5.00 USD 241.50 Billed to: MasterCard card number XXXXXXXXXXXX5607 Total amount due: $0.00 - PAID IN FULL Ticket Numbers: 0377339844710 Ticket Restrictions' STNDBY FEE/NO RFND/lPREFL TS CHG . FEEI/AFTR FL TS NO EXCH VALUE Your Passenger Receipt Details Passenger Name(s): HOLLAND/EDWARD Pusenger Classification: ADULT FllghtlClass: US Airways flight 740/Class Y IIJ Depart: San Francisco. CA (SFO) - April 25 at 7:00am _ Arrive: Pittsburgh, PA (PIT) - April 25 at 2:41 pm << connecting to >> FllghtlClass: US Airways fllQht 741/Class Y ._ Depart: Pittsburgh, PA (PIT) - May 04 at 5:55pm ::::.::: ArrIve: San Francisco, CA (SFO) - May 04 at 8:22pm << connectIng to >> 4/1/03 2:04 PM 4i);>\jUDC;1 !'-~~ Enterprise . 1 800 ren't-a-car ENTEEfRrss: ~~ Ol"F'ANy (F PITTS~ 191):) W LI:EEF'n' {::Mi 41&.-;34.1-4245 40-Pit~ RE ......~. l'..l ~ FH r':~:::J :::J\)(.)!P- ..S ~ ~)(:fl "n...! '"/ ~ ~::~.~'t'~.f"'" i.)~i:(P T!<'.j 7t3f)t;,.. ~~ ~ (i(:f' s.~ 9 ~ C(:'1':"" t i""-' o 1.0.# I: .f,'" ZIP . . STATE In '"."'r.. WEIGHT EYES HOME PHONE ;0 2:}f:.: _... 0" (".,r.::~ i~) /"'11 FT:'fJL F.' /~:I~ OFFICE PHONE OTHER PHONE lCf.7iG MI f::,'EE F"/1",l::E 2(((i t'l I r-Ft:E FiJ"n'. ~(l \! ..~;. c.:' ~~. t '.f::l_t:,~ F"i:1~~:I L ,.IOI)RS .. : ~. ~B5 [U cry I "~l'"' ~t DAYS. .~:) It (x) ,..l~J:.~'}L; :~SJ. \;~:;: ./.I)~::' \. ..:t.... i J ~ ;-:iJ~'" HAIR' l..n-E ,2;:"''';,'. '-:;9 i!;JE~J !"f.:E~ t:~"?=;1 Ii .;;r'~. ./f~lC:t.~~ l ciTY ~ 2 I' I STATE ZIP AITN: PHONE EXT. AEPLACENleNT VE;IiICLJ;\' RENTER ACCEPTS DAMAGE RESPONSIBILITY RENTER DECUNES OPTIONAL PERSONAl. ACCIDENT INSU RENTeR DECUNES SUPP\.EMENTAl UAPlLITY x --... RENTER ~ F OI)T U r IN E till 1!4 3/8 Irl 518 3/4 7/8 F x RENTER I AM REJECTING UNINSURED MOTORIST COVERAGE UNDER THIS RENTAL OR LEASE AGREE- MENT AND ANY POLICY OF INSURANCE OR SELF-INSUR- ANCE ISSUED .UNDER THIS AGREEMENT, FOR MYSELF AND ALL OTHER PASSENGERS OF THIS VEHICLE. UNINSURED cov- ERAGE PROTECTS ME AND OTHER PASSENGERS IN THIS VEHICLE FOR LOSSES AND DAM- I AGES SUFFERED IF INJURY IS CAUSED BY THE NEGLIGENCE OF A PERSON WHO DOES NOT HAVE ANY INSURANCE TO PAY FOR lOSSES AND DAMAGES. 00 AU ~T X R - NONE PERMITTED WITHOUT OWNERS APPROVAL. .., . 1- ..... S1: XP. H'-'f.';J\fSr ;.,;, 2 .<:<1) Df~~:'; ~r{~x .-SI .:,.. ~::~.. flJl:L CHARGE .2. (.<,~ '::&\LLC!!'.I. MILE- AGE TOTAL CHARGES 9 ~la'B~! ~ID I~~ ! ~Bao I DEPOSITS REFUNDS F OUT U r IN e 1/8 1/4 112 !5/8 314 7/8 F E 1/8 "4 318 1/2 518 314 71ll F AOOTL OEP. ADOT'\. OEP. AOOT'L OEP. DATE ~~CEIVEDX AMOUNT _ AOOT'\. OEP. . .. CLAIM lNFOflll4ATIO POL OR CLU INSD. LOSS DATE THI!FT ACCIOE> NAME PHONE REPAIR SHOP Ef':€CI~.~ MII....ES TYPE CAR ...'!.~ CUSTOMER COPY - ADDITIONAL STIP~~~ ON REVERSE SIDE See Terms and Conditions on Reverse al"\d J}ttached Rental Agreement: Ticket Jacket (C) Pntprnr;,"~ DPon't ^ r"'..._ r"......._._ _.~.. ""\("'1.1'\1'''10 J / .. Freel Step One Book any GoodBuy tagged hotel ~GETS20CASH ~K and stay two nights or more. Step Two You will receive a confirmation e.-mall for your booking and a second e-mail 24 to 48 hours later confirming your Qualification for $20 cash back. Your $80 Last Minute Deals coupon will be attached. Tip: Use your Last Minute Deals coupon to purchase a fllght-and-car or flight-and-dlne getaway to complete your current tripl Step Three Travel and have a great tlmel You will get $20 cash back eight to ten weeks after your trip. Booking must be made by October 10, 2003 for travel on or before November 30, 2003. Click here for more information. Cl2003 MasterCard Intematlonal. MasterCard Is a registered trademark of MasterCard Intemational. MasterCard and the Interlocking circles device are registered trademarks of MasterCard Intematlonallncorporated. " II ~t! f" l:"~. t,.: t)1:?ta; ~'5 ....,... Fllght(s): Frl, October 10, 2003 Flight: ATA flight 864 (Non-Stop) Flight Details .... Depart: San Jose, CA (SJC) - Terminal Information Unavailable FrI, Oct 10 at 6:35am Arrive: Chicago-Midway, IL (MOW) - Terminal Information Unavailable FrI, Oct 10 at 12:39pm Seat: 340 (Boeing 757-200 Jet) Meal: No Meal Served Status: Confirmation Code a COTTVO ... << connecting to >> Flight: ATA flight 266 (Non-Stop) EU9JILQet!;!1I~ Depart: Chlcago-Mldway,IL (MOW) - Terminal Information Unavailable Frl, Oct 10 at 3:45pm Arrive: Pittsburgh, PA (PIT) - Terminal Information Unavailable Frl, Oct 10 at 6:06pm Seat: 28A (Boeing 737-800 Jet) Meal: No Meal Served Status: Confirmation Code a COTTVO Fllght(s): Sat, October 18, 2003 ~ Flight: ATA flight 265 (Non-Stop) Flight Details Depart: Pittsburgh, PA (PIT) - Terminallnforrnation Unavailable Sat, Oct 18 at 3:57pm Arrive: Chicago-Midway. IL (MOW) - Terrninallnformatlon Unavailable Sat, Oct 18 at 4:31pm Seat: 280 (Boeing 737-800 Jet) Meal: No Meal Served Status: ConfirmatIon Code D COTTVO << connectIng to >> 20f3 9/29/033:41 PM "'r- .................'.'.. . /f::' , .;"'. j; 'f' ! / ... "",," " """"" Flight: ATA flight 867 (Non-Stop) FHgbl.0.etail.$. Depart: Chlcago-Mldway,IL (MOW) - Terrnlnallnformation Unavailable Sat, Oct 18.at 8:30pm Arrive: San Jose, CA (SJC) - Terminal Information Unavailable Sat, Oct 18 at 11:03pm Seat: 320 (Boeing 757-200 Jet) Meal: No Mea'l Served .stl.t.Y.J..~ Confirmation Code D COllVO Travelers ,:t,:.~J";.'h.::: St..;trsn~~n,.. ." ?reCttS tihov~n ~n U,S, Ci(}!1::;r5 Price per person Taxes & Fees Total Price o 1 adult Service Fee ....""".. "n........ 230.69 42.81 5.00 273.50 5.00 tJ\Jt Ir,jVeli~t...:ltv Click hereto dalm from Reservation Rewards for vour booklna todavl r-,,: Home Flights Hotels CarslRall V.caUons Crolses Last Minute Deals Guides & Advice Customer Care Cl2002 - 2003 TraveJocIty.com LP. All rights reserved. Travelocl~, Traveloclty.COm4!) and the Traveloclty ~':'eattl skyline logo are trademarks and/or service marks of Traveloclty.com LP. Use of this Web sIte constitutes acceptance of the Traveloclty .U.s.erAgr.eemtlnl and Pliya.l;ll..P.oII.cy. : (1.\ .:~ IW 300 -. 9/29/033:41 PI l'~ MILE. _IN AGE OUT DRIVEIII !UlJ to'. .- -~nterprlse 1 800 ren1'-a-car ENTERPRISE RENT-A-C 1900 W LIBERTY Ave 40-Pllts REv. 4Il);J ......... JIIl\ STATE ZIP TV 7:30A- 6:00P TH 7:30A- 6:00P SA 9:00A- l:OOP D 45843a MILES. l ItG. O.;'?~./~(f '( -JUR 1.0./# .* 150. ~"'I FREE P /OAY GOl.OR o.AL i"IOND- MOnEl. 1050 MI FREE P /WEE!< 2000 MI FREE P/MONTH qQ~ AY 24 HOUR.PERIOD HOURS 0 . 1O.OO!HOUP DAYS. (I 38. 9.9/DAY . 209. 99jW~E}:: 769. 99/M(lNTH WKS MOS ~t08 9oB~~' ! cryBB~1 Lot S '. CITY STATE ZlP ATTN: PHoNE. EXT, F OUT U r IN 3/4 718 F RENTER ACCEPTS DAMAGE RESPONSIBILfTY RENTER DEClINES RENTER RENTER REClUESTS OPTIONAL g!';!JONAlllENTL PERSONALINSUD'~E. X PERSONAL ACCIDENT INSURANCE -.." ~- PAl . . EVERSE.. AIiNTER lleCI,JNES . RENTER REQUESTS SUPPLEMEN1l'.L .==~UAaJl'( X LiABILfTY PROTECTION (SLP). X ADDITIONAL !ZED DRIVER. NONE PERMfITED WITHOUT OWNERS APPROVAL, 1_0wn0n.....-, 1Il_ AGE LICENSE NO. RENTE,if """'" IlEQlJESTB ClPT1ClNAI. PARTW. DAMAGE WAIVER. SEE TERMS & COHDI- TICJre ~ NENTAl. N3AEaENT: TlCK- 2. ~' 12.99/DAY. _. .2..00IDA Y ,. . "( X .REPi.:.ACEMEM'~f'llri~lt..'.' : . ".).-, .' :".-"~;;' ''it "~:."", . 1 .:. MOOEL ECAR, TAX IRANSTAX2.,o.o..:'~y.'.: 'I t IC', 9.0 ~ FUEL CHARGE DO AU ~T STATE EXP. COLOR LICENSE NO. ,,' .q,' "2;00 !6Al.:lON MILE. AGE IN OUT Authorized __ 01__ . DRIVEN i CONDITION AGREED TO X I' I tkbBB 0 RENTER ~ f[f~ITB~~ i crya B~ i x !;>E,NJ TOTAL CHARGES ;.Z", Q NO GASOUNE REFUND. 1 DAY MINIMUM. OWNER SUPPUES NO I l'IANCE ACKNOWLEDGMENT OFlliE ENTIRE AGREEMENT INCL"'DING RENTAL ACRIOEMENT:ncKa JACKa I HAVE READ AND AOREE TO THE TERMS AND CONDITIONS ON BOTH SIDES OF THIS PAGE AND THE ATTACHED RENTAL AOREEME/'lT: TICKET JACKET wHIcH INCORPORATED IN AN PART OF THIS AGREEMENT. ALL CHARGES ARE SlJ8JEdT TO FINAL AUDIT. S REVERSE OR R. IONS. DEPOSITS REFUNDS F OUT U [ IN E 1IS 114 318 1/2 518 3/4 7/8 F AUTH . CLOSED BY AMOUNT DUE ) E 118 114 318 1/2 518 3/4 718 F ADDn D~. ADDT'L 0eP. ADDT'L DEP. ADDT'L DEP. AMOUNT I AM REJECTING UNINSURED MOTORIST COVERAGE UNDER THIS RENTAL OR LEASE AGREE- I MENT AND ANY POLICY OF INSURANCE 'OR SELF-INSUR- . ANCE ISSUED UNDER THIS AGREEMENT, FOR MYSELF AND ALL OTHER PASSENGERS OF THIS VEHICLE. UNINSURED cov- ERAGE PROTECTS ME AND OTHER PASSENGERS IN THIS VEHICLE FOR LOSSES AND DAM- . II AGES SUFFERED IF INJURY IS I CAUSED BY THE NEGLIGENCE OF A PERSON WHO DOES NOT HAVE i ANY INSURANCE TO PAY FOR ~OSSES AND DAMAGES. CLAIMJNFQAMATION .. POL. OR .CL # ~.. INSD. . LOSS DATE PHONE THEFT ACCIDENT NlWE REPAIR SHOP SPEC I ~l".: ,,;:,W t ,ry~ES,. J.". ',"0 P~S9> :~...I' :;....~ :'...._. ./.:...,. o~.~'.;~ i:.:.: <.j .~.~.:.:.': 1:~..~ ~'-..',,: .~~.': DAYS 0)'22.99 150 MILES WKSO) M .'" * INVOICE ON FILE RES # ;t76659 See Terms and Conditions on Reverse and Attached Rental Agreement: Ticket Jacket .MIU:s TYPE CAR ." ""'~..r."1_...__...__. ""'(,\f\') l 'C~\"Cl}lC lV1ClU .. lnCi)i)Cl!)C VI".... ULLlJ.11 U\"UlClU.llCLl>\"CllJC.\"UllU U1l)!) V 11'.... .ClUy: lU1UC1-" n .I1UJ~-""U1U Seat: Freq. Meal: Status: United Airlines flight 140 (Non-Stop) San Francisco, CA (sro) - TERMINAL 3 Tue, Oct 12 at 10:00am Chicago-Ohare, IL (ORD) - TERMINAL 1 Tue, Oct 12 at 4:04pm Seat: 21C (Boeing 757 Jet) Freq. Flyer: UA 9V257Y4 Meal: Food For Purchase Status: Confirmation Code LOQ8KE Flight: United Airlines flight 2216 operated by US AIRWAYS (Non-Stop) Depart: Chicago-Ohare, IL (ORD) - TERMINAL 2 .. Tue, Oct 12 at 5: 10pm Arrive: Pittsburgh, PA (PIT) - Terminal Information Unavailable Tue, Oct 12 at 7:39pm REQUESTED (Boeing 131-300 Jet) Flyer: UA 9V257Y4 No Meal Served Confirmation Code LOQ8KE Arrive: Flight: Depart: .. Flight: United Airlines flight 707 (Non-Stop) Depart: Pittsburgh, PA (PIT) - Terminal Information Unavailable .. Tue, Oct 19 at 8: 30am Arrive: ChicagO-Ohare, IL (ORD) - TERMINAL 1 Tue, Oct 19 at 9:16am Seat: 10C (Boeing 737-500 Jet) Freq. Flyer: UA 9V257Y4 Meal: No Meal Served Status: Confirmation Code LOQ8KE Flight: United Airlines flight 857 (Non-Stop) Depart: Chicago-Ohare, IL (ORD) - TERMINAL 1 .. Tue, Oct 19 at 10:00am Arrive: San Francisco, CA (SFO) - TERMINAL 3 Tue, Oct 19 at 12:23pm Seat: 53C (Boeing 747 Jet) Freq. Flyer: UA 9V257Y4 Meal: Food For Purchase Status: Confirmation Code LOQ8KE Airfare Summary-Prices shown in U.S. dollars Travelers Price per person Taxes & Fees 1 adult 88.36 45.54 133.90 Service Fee 5.00 5.00 Total: USD 138.90 Total Price Why choose between airline miles or hotel points programs when the Travelocity MasterCard gives you both! Enjoy a low introductory 0\ APR on balance transfers for 6 months and receive 4,000 points instantly. Earn points anywhere, anytime and receive free and discounted travel with no restrictions or blackout dates. Travelocity gives you options! Visit https://www.citibankusa.com/cards/travelocity/onlineapp.cgi?mktcode=WMASR+3054+TRVL+2213126614&pageID~stnd *********w********** If you need further assistance, please contact our Customer Service Center. Telephone within the United States: TOO/Hearing Impaired telephone service within the United States: Telephone for customers outside the United States: Fax number within the United States: Fax number for customers outside the United States: En Espaftol 7am-11pm: 888-709-5983 800-555-7585 210-521-5871 800-944-0005 210-258-2034 866-828-3933 Email Address:memberservices9travelocity.com For faster service you need to have your Trip 10 ready. Your Trip 10 is: 697274876568 EHJWAD Gm Mall Wrim Mall Address ~ ~ Reply All Forward Keep As ~ (( Previous I ~)) Qelete L~"e~~2~To~:.. Preferences I tieIQ I Sign Out . , ...; , ").: .; ~,f' '; (', '.' t:'(' 20f2 10/4/04 2:22 PM Shroeder Accounting Mail Books to Thailand (Gifts for Prince V ongchak na Lamphun) $160.15-Receipt enclosed Trip to Thailand Air fare to and from Thailand Ted (E. W. Holland) BKK Mija Kim (Pittsburgh/SF & return) BKK TOTAL 768.45 Citicard Bill 236.50 (Receipt encl.) 768.45 Citicard Bill $ 1773 .40 Violin storage at airport (Mija's Violin) $ 112.00 (Rcpt. Enclosed) Per diem in Thailand Ted Mija Somthavil Klaus 13 days @ $40/day 13 days @ $40/day 6 days @ $40/day 8 days @ $40/day TOTAL $520 $520 $240 $320 $ 1600.00 Air fare in Thailand (Chiang Mai to Bangkok) (No receipts for Mija and Klaus's tickets, but same price as Ted and Somthavi}'s) TOTAL 2275B Copy of Ticket enclosed 2275 2275 Receipt enclosed 2275 9,100B = $227.50 Ted Mija Somthavil Klaus Van rental in Thailand (6 days) Van and Driver 9,500B = $237.5o-receipt enclosed Gasoline TOTAL 640B 714 770 703 830 570 4227B 1/15/03 1/16/03 1/16/03 1/18/03 1/18/03 1/19/03 = $105.65 + Thai memorial service Organization Gifts to monks Food Misc. TOTAL GRAND TOTAL 4,000 (Receipt for 3,000 baht enclosed) 2.000 3,000 1,000 10,000B = $250 $4.465.80' NB: Per diem used to cover hotels, food, taxis, and miscellaneous daily expenses. Hotels averaged about $20 per day per person. Copies of several bills enclosed for reference Exchange rate approximately 40 baht per US dollar VI VI... (IV c..J I' Ute'1f (:)r(: 5~ ; i~;,_~: ,:! " , '. ' ,r., ~: r,':t:~~~ ';''''''. ~., , ;- ~ ~.. _j" ',." I I; i. (~ :~ :.1.;"':. . .::'Jl ::',;.; .":;:: ':,.jl!; .: :,'q \ , t '1.; !.:: -~ - ;.,'. ;. ... "n, ,j' .-. :. I i 0'1 ~ / f .< r :"-~'-, ... 'r. ;; f" ~ ,.~ ~ ;JI ! .. ..'(;.i t.~ ',., '~:' ;:',' . j ,'. . '. . :!:1~!, , '..:~- ",i ,._, ,,' : -. ;. _:H'!';l .J:: . '; - ~, ; "i'. r.;:-: ;' ;~i .~~ ~, '::' i ~ . .", ;; ~!'I :;' ."~; ~,t.,':.i ;"\.r;:-: : >;1', ~ ~;:::< ....f. " . t'!-.: ;. I 'i,: .;', -'>' ",.;):;'['1' ;; ;.' : ~~.: / ;. :'JP :~>,:;:l' '~(i~~ d~Nj ~r: jJt.1 .:.)'. ,'.,~:; i '1,'It:: U.S. Postal Service INSURED MAIL RECEIPT "'" :::>> l(Jblfianf I C I A L U S.... E-" i~:;:: -. ,'j ::r ..II m Poetage $ \naUrIInC8F.. Ir~~ rB lIIldor88m8nl required) Specl8l H8nd1lng Fee Retum Recelpl Fee (Except for CIInada: lllIdcnament I8QUIred) ~ Tol8I Poetage .. F_ $ ..II ::r :r 1 Up UCUWl) llU}.Ill.IIU}.IIU .UAYtaU"uy ."U111.-,JllS"'~ 1 U,J7~,J l.J.J-'V 1 U l.J-'l~VV~VV~uc..a..,nl"~-1. --- CIIIt Up to $50 back on. fllghtl Clk* MALARIA is endemic to I" KN=I .. your selected destination. , _... ImeIBell.,.eanr . Ifi Trip Details , Destination Guide , ' Maps Please print this page for your records. A Weather This Itinerary has been e-malledtoyouat:ewhollandjr@netscape.net .J Concierge Your Traveloclty Trip 10 Is: 736686788981 . Services Itinerary for: m Tours & Activities EDWARD HOLLAND .i.. Sports & Leisure Your tlcket(s) will be Issued by the Customer Service Center. Once ticketed, changes m . Restaurant made through the Customer Service Center. Tickets must be purchased online to ensure co Reservations with all fare rules and restrictions. E-mail/Fax t Note: The FAA will require all passengers to show their receipt as well as a photo ID. paper ticket will serve as your receipt. Due to Increased security measures you should plan to arrive at the airport two hours prior t departure. Additionally, you should expect that: -Only ticketed passengers will be allowed past security All carry-on baggage will be subject to search No knives of any kind will be allowed -on airplanes Please reference the Trip 10 736686788981 anytime you contact the Customer Service Cent There may be a penalty andlor an additional charge for changing a reservation, if your ticket eligible for changes. Customer Service Center: In the United States call 888-709-5983 (En Espat'loI7am-11pm: 866-828-3933. TOO/Hearing Impaired: 800-555-7585). Outside the United States call 210-52 ) Add a Hotel In Banakok. Thailand ) Add a Car In Banakok. Tha Your Trip Details , .t (" h ~ ~~',' , ,,- t. ( ". . " '1. , ~'M-~~; ",:> :l:~~~ ttjU~-~~;; ,,;,.;r~t:lj{'~~r;;~~ '" oj ",I.. ... It'''"~Llfi1ttll.'jl$i~~1~~~,.,,~;..,J;;..MJl 10f3 12/6/027:42 PI lU....ll.IIU..lll.UClYl:>lV'-lLJI ."Ul11.~,JllS".,-!-l U,J7~,J l.J.J-.V 1 U lJ-.l ~VV~VV~uc..a..,n1"~-1.:.1" . Flight: Continental Airlines flight 5027 operated by NORTHWEST FIiQht AIRLINES (Non-Stop) .... Depart: San Francisco, CA (SFO) -INTERNATIONAL TERMINAL Sun, Jan 12 at 12:20pm ArrIve: Tokyo, Japan Narita (NRT) - TERMINAL 1 Mon, Jan 13 at 4:45fm Seat: 590 (Boeing 747 Jet Meal: Dinner I Breakfast Status: Confirmation Code D UN88E7 ,I- ; I V ' ,/ H 'I ': .' ~ !.l~.~...i;1J);h1Jl::t1f:'}:T'.:;~.~j:~,il;r:~~G-: ; trej .~~ ,.,_,j '.f ',1,.1 .'. ~ .... I ~111~~-; I ":1 'ttf~' ~\ '~ ~ ~ . '- ':< 1_ ..,.~ '"'.,', ~ ,,' \t.tr-'::A,~;;.; !{;~''l'~' . Flight: Continental Airlines flight 5001 operated by NORTHWEST AIRLINES (Non-Stop) """tIe! Depart: Tokyo. Japan Narita (NRT) - TERMINAL 1 Mon, Jan 13 at 7:00pm Arrive: Bangkok, Thailand (BKK) - TERMINAL 2 Mon, Jan 13 at 11:59pm Seat: 600 (Boeing 747 Jet) Meal: Dinner Status: Confirmation Code D UN88E7 FIiQht 't~l'! M~ ,I "'!;,~ "H' 1- ,I: !: ;:4:'. ,I ~J"':'tl,1"::'~'''tr'7;h!~~~'::-~~:~~~~l--:~''''~' 1 f~, _-_ l ~ _ f '_ _ ' 1-- ;'1,:4:::._,1;-.... , _',,'~'''' - ;n ':,(fj~,:~t;:rSj;!..;;; M, .. _ Flight: Continental Airlines flight 5002 operated by NORTHWEST FIiQht lIB. AIRLINES (Non-Stop) "'III!l! Depart: Bangkok. Thailand (BKK) - TERMINAL 2 Sun, Feb 09 at 6:10am Arrive: Tokyo. Japan Narita (NRT) - TERMINAL 1 Sun, Feb 09 at 1 :45pm Seat: 610 (Boeing 747 Jet) Meal: Breakfast Status: Confirmation Code D UN88E7 << connecting to >> . Flight: Continental Airlines flight 5028 operated by NORTHWEST FIiQht AIRLINES (Non-Stop) "'III!l! Oepart: Tokyo, Japan Narita (NRT) - TERMINA1. 1 Sun, Feb 09 at 3:25pm Arrive: San Francisco. CA (SFO) -INTERNATIONAL TERMINAL Sun, Feb 09 at 7:25am Seat: 620 (Boeing 747 Jet) Meal: Dinner/Breakfast Status: Confirmation Code D UN88E7 Airfare Summary - Prices shown in U.S. dollars Total: <'. ., I, ; l I, I. I , .+~;'1I'it Jf:~~'1~.~ - . . . ' '. ~ . 1 + u '~'I.~J:t~4'rr~~\~~;:u~~~ ~ ' D 1 adult 700.00 Delivery Charge *Total does not Include delivery charge. 48.50 19.95 748.50 19.95 Delivery Information Your tickets will be delivered to: EDWARD HOLLAND 366 CA1.IF AVE 3 PALO ALTO CA 94306 650-326-1430 Check out heJpfullnformation and special deals on Bangkok. Thailand. Continue be 3 12/6/02 7:42 PM 1'C;;V'''VV UI" y.."'''.....U l""Ul"'UVUlO lVl J'UW Ulp '"..-" "Up.11 up" 1 . <tel Y"IU"U.r ."U1U.UVI Up~...1lIUUW1U.p~U"""'C;;."",~.^-~Jc.x."'C;;1""'~.. . MAllrtr""...."" ,................ ......, I~~!~C~~~~~~ , '" t ,,.. bC'-:Jpe tu Mex CO r.m l-rJntler /" 'IHie::; 1.:J)~n:J~' "I: ~ r:/n"1 7';~/i:i,~ ':'. $249" . .'(, ~ I. U ) WhY are~s not Duaran ) Can I cha~e a non-rerun allle ticket? ) Do I have to read the fare rules? ) E;i;nation of taxes & fees ) What are saved itineraries? lof2 . Review the price and restrictions for your trip Trip Summary: Outbound Flight FrI, Jan 10 7:45am Depart - Pittsburgh, PA (PIT) 10:31am ArrIve - Phoenix, AZ (PHX) Flight time: 4 hrs 46 m1n Connection Time: 1 hr 4 mln FrI, Jan 10 11 :35am Depart - Phoenix, AZ (PHX) 12:44pm ArrIve - San Francisco, CA (SFO) Flight time: 2 hrs 9 mln Total Travel Time: 7 hrs 59 min . America West 90 . Nonstop Adult Fare Rules .' America West 805 Adult Fare Rules . Nonstop .___~______.~~_.w.....__...._.____.._._.._....._~........___..--..-............---.-......-.....-......................................... Return Flight Sun, Jan 26 11:45am Depart - San Francisco, CA (SFO) 2:37pm ArrIve - Phoenix, AZ (PHX) . Flight time: 1 hr 52 mIn Connection Time: 1 hr 20 mln Sun, Jan 26 3:57pm Depart - Phoenix, AZ (PHX) 9:50pm Arrive - Pittsburgh, PA (PIT) Right time: 3 hrs 53 m1n Total Travel Time: 7 hrs 5 mln Save this whole itinerary . America West 614 Adult Fare Rules Nonstop . America West 95 . Nonstop Adult Fare Rules Fare Summary - Prices shown in U.S. dollars Total:, .:, :. ~ .:, .. t I ' . ~ " ' . . II I .,l ~. ., I ~I, ,I \ j II r '- v . -\ I i j . - ~ I - . ,$ ~ ~ H" t..-~wt;..,! - : ,.....3_ ~~;.M1:1 D 1 adult 184.19 Please remember that prices are not guaranteed until tickets are purchased. 52.31 236.50 o I understand that this fare is non-refundable and carries restrictions as follows: . Once ticket Is issued, it may not be reassigned to a different passenger or airline. . Ticket Is non-refundable. . Ticket ct:'anges may Incur penalties and/or Increased fares. I agree to the rules and restrictions of this fare_ 12/6/02 8:24 PI ~ up ve;;\<lUl> U~"Pll.I/U}.l1l1.U4VCJV"'U)'."'VUJ."""JI ~...\,{-1 VJ::1~J~"t"tO""V! 0""..1 !'-VV""VV""I.x..Ld"'! 'U-1. ./'''''' .,~ ~ .... KNOW TN. , ..... . o.t up to $50 back on . flight! MALARIA is endemic to your selected destination. -~ TravelDcltq.CO nr . Trip Details , Destination Guide Maps Please print this page for your records. .. Weather This itinerary has been e-malledtoyouat:pluto75@earthllnk.net ~ Concierge Your Traveloclty Trip ID Is: 716680828783 .. Services r."J1 Tours & Activities Itinerary for: ... MI JA KIM " Sports & Leisure Your tlcket(s) will be Issued by the Customer Service Center. Once ticketed, changes m Restaurant made through the Customer Service Center. Tickets must be purchased online to ensure co Reservations with all fare rules and restrictions. E-mail/Fax t Note: The FAA will requIre al/ passengers to show their receipt as well as a photo 10. paper ticket will serve as your receipt. Due to increased security measures you should plan to arrive at the airport two hours prior t departure. Additionally, you should expect that: Only ticketed passengers will be allowed past security All carry-on bagga~e will be subject to search No knives of any kind will be allowed on airplanes Please reference the Trip 10 716680828783 anytime you contact the Customer Service Cent There may be a penalty and/or an additional charge for changing a reservation, if your ticket eligible for changes. Customer Service Center: In the United States call 888-709-5983 (En EspanoI7am-11pm: 866-828-3933, TOO/Hearing Impaired: 800-555-7585). Outside the United States call 210-52 ) Add a Hotel In Banakok, Thailand ) Add a Car in Banakok. Tha Your Trip Details t ~ - ~, . '.", " _ ' ,~ ~",' t~" ~"2#f "1'tt'of- .., ~ ,(~ll\,';" ,"' "I" ,,,I " :J " '-/"''''''f,/:,,~ ", "~' :, , "", '" '. " "tii"';;'~'},\r,!i,j!.m;,. "', . 3 12/6/027:56 PM "...t'...." .........0.1. ......y \,I.l.u"'~~l.""u~u.""""JI !t...'l-'" VJ;7"".,)""........U~V1 OLJ ...~VULVVL"".L."r\..1 'U-.a.:"l "' . Flight: Continental Airlines flight 5027 operated by NORTHWEST AIRLINES (Non-Stop) ... Depart: San Francisco, CA (SFO) - INTERNATIONAL TERMINAL Sun, Jan 12 at 12:20pm ArrIve: Tokyo, Japan Narita (NRT) - TERMINAL 1 Mon, Jan 13 at 4:45rm Seat: 600 (Boeing 747 Jet Meal: Dinner / Breakfast Status: Confirmation Code II UNPNP7 FliQht ... i!;":::~~ - \ 11\1q~~~\ :',r-'.., , . . -1 I ',::~:'~~~::f~rti.t~f.:~: '.l;,:~~:.t~:,\"" , '~:l-~':~~I~l~i~ , . L'...' ~1 ~ {J I {~"'_l ~,~ ,\ '''I T ~'1l ~ ~"J I H l,L.Ji:ot~1.r:f1:f>o~" ~ ~ . '. Flight: Continental Airlines flight 5001 operated by NORTHWEST AIRLINES (Non-Stop) """lIIlI:'! Depart: Tokyo, Japan Narita (NRT) - TERMINAL 1 Mon, Jan 13 at 7:00pm Arrive: Bangkok, Thailand (BKK) - TERMINAL 2 Mon, Jan 13 at 11:59pm Seat: 60A (Boeing 747 Jet) Meal: Dinner Status: Confirmation Code D UNPNP7 Fliqht I.. t! , ~ ~ ~ \:: I ~ ~ " \. ,.' l> . ~ Lie 1 .! ,\ r I. ," ,I, :;' \~..;:;~!t~:~t~ l" : ,~ ~ ,., J I ,I .. .!.I_~ ;~~-;.y.::, .,.?I\,~ ',1). ::, J;:r~" ' . Flight: Continental Airlines flight 5002 operated by NORTHWEST Fliqht AIRLINES (Non-Stop) ~ Depart: Bangkok, Thailand (8KK) - TERMINAL 2 Sun, Jan 26 at 6:10am Arrive: Tokyo, Japan Narita (NRT) - TERMINAL 1 Sun, Jan 26 at 1 :45pm Seat: 52K (Boeing 747 Jet) Meal: Breakfast Status: Confirmation Code II UNPNP7 << connecting to >,. . Flight: Continental Airlines flight 5028 operated by NORTHWEST Fliqht AIRLINES (Non-Stop) ...... Depart: Tokyo, Japan Narita (NRT) - TERMINAL 1 Sun, Jan 26 at 3:25pm Arrive: San Francisco, CA (SFO) -INTERNATIONAL TERMINAL Sun, Jan 26 at 7:25am Seat: 53A (Boeing 747 Jet) Meal: Olnner / Breakfast Status: Confirmation Code D UNPNP7 Airfare Summary. Prices shown in U.S. dollars Total: '.',' J" j' , I <. I "I "" . -. ~r,.r.!~J' ~~l~i'il~t' , ,f i~.,:--'*I \\i...:'~'1lt~T~.. D 1 adult 700.00 Delivery Charge *Total does not Include delivery charge. 48.50 19.95 748.50 19.95 Delivery Information Your tickets will be delivered to: EDWARD HOLLAND 366 CALIF AVE 3 PALO ALTO CA 94306 650-326-1430 Check out helpful Information and special deals on Bangkok, Thailand. Continue be of3 12/6/02 7:56 PM 8750 Tesoro, Suite 100 San Antonio, TX 78217 T rovelocitq. com- A S a.b r e Com pan y IBVNYGl DA fE: 06 DEe ~p ') '" I PAGE: ",! ~LES PEI~SON: ZA JSTOMER NBR: 656000 IT INERAF<Y TO: EDWARD HOLLAND 366 CALIF AVE 3 PALO ALTO CA 94306 65~"M326-1l~30 IBVNYQ FEDEX TRIP ID 736686788981 invoice JR: HOLLAND/EDWARD < ~TP TICKET PRINTER 74453A ON N0V3. ~TTENTION CREDIT CARD HOLDER.************************** ~LEASE REFER TO TRIP ID 736686788981 WHEN CALLING THE CUSTOMER SERVICE CENTER FOR QUICKER ASSISTANCE. TOTAL CHARGE BILLED TO YOUR CREDIT CARD FOR THIS ~ESERVATION IS 768.45 US DOLLARS. TICKET ASSEMBLY INVOICE NUMBER-0067062. rICKET NUMBER PAX 1.1-7319110047 THANK YOU.********************************************* ~TP VERSION 112502. THANK YOU FOR SELECTING TRAVELOCITY FOR YOUR TICK~TING ~ULFILLMENT NEEDS. IF YOU NEED ASSISTANCE CALL 388-709-5983 OR IF OUTSIDE THE US 2 -521-5871 FAX 800-944-0005 OR 210-258-20 WE HOPE YOU HAVE A VERY PLEASANl TRAVELOCITY -----~-------------~------------- - PLEASE CHECK OUR WEBSITE FOR - SCHEDULE CHANGES WITHIN 48 HO - DEPARTURE. TO DO SO BLE AIRLHU:: TO FLIGHT IF YOUR ITINERARY I CLJSTOMS AND IMM TRAVEL TO A FO REGlU IRED DOCUM ON /DESTIN TH N' CLICK I I I I j W08. )..1.1 80'13f'1~~U OIN01N~ N~S ~3H10 A~aNOW 80 1JO La aa9-1~3S a~~Ma3/aN~110H G388Nn :~3~ 1~NIW~31 1~NOI1~N~31NI :3nI~~~ dOiS-NON ijSZl OJSIJN~~~ N~S ~ij NI~0" ~H60 t '~NIW~31 :1~~d3a G~l 8NI30a :dB3 dsa8 ~lI~~N O)"~Ol nl S~NI'l~I~ lS3MH1~ON Aa a31~~3dO 08S18N~~J N~S-~lI~ S'ij3~ Il,nw AWONO~3 S80S:1'd S3NI'~I~ ,~ a19-1~3S a~~Ma: VllOH 1 '~NI 3nI~~~ ~l. >lO.J.. ~N ~~_ :1 :1~~d3a :dB3 >lO>l8N~a nl S3NI,~r~ OA~Ol-~O~8N~a lSV~~~3~a ~I~ lV1N3NI1N08 ~I~ )..vaNns 80 a3J 60 l::lSStm : .~J:::I~j dlJ.1.S'-NON a~I~M<I:::\I aN~.nOH a lVNIW~31 :3nI~~~ d6S1:1: ~O~8N~a ~v 1: 1~NIW~31 :1~~d3a d0~l V1I~VN OA~Ol nl lS~MH1~ON )..a a31V~3dO >l0>l8N~a-V1I~~N 0,1..>10.1. AWONO~3 100S:.1.1J S3NI'~IV '~lN3NI1NO~ ~I~ a6S-1~3S a~VMa3/aNV1'OH 1 'VNIW~31 :3nI~~~ dS~~ V1I~VN OA~O.J.. ~~ Ava NOW 80 Nvr 81 (,.:::188Nn : .~{:H'J dOlS'.-NON N:r~6!; ~H9" 00~ L~' 8NJ30a :d~3 s:::ItU -'~I v ~::1NNI a Nlwsa ~Hll 1~NIW~31 1~NOIlijN~31NI :1~Vd3a G~l 8NI30a :dB3 d0aal OJSI8NV~~ NVS nl S3NI1~IV lS3~HJ~ON Aa a31V~3dO VII~~N OA>lOl-08S18NV~j N~S Sl~3~ I.1.'n~ AWONO~3 Ga0s:i'~ S~NI'~IV lV1N3NI1N08 ~I~ A~aNns 80 N~r a1 a~~Ma3/aNVll0H :~Oj 18688G98998G ar dI~l X3<I3.::1 (:lANnaI 08~t-9a8-0S9 908~6 VJ 011~ Ol~d 8 3f'1~ .::II .W~) 99E: aN~"OH a~~Ma3 :0.1. ~:>IO^UI . . .~" : ::WVd .~,~ ::3'::10 9'~ : ~Hva t:IANMlI A~~~~NI l.I 0009S9 :~aN ~3wOlsn~ ~z : NOS~13d S::3"WS /. J.~8/. XJ. 'OIUOIUV U8S 00 J. 811ns 'OJOS8,1 05/.8 AuedwoO SJqeS V _W03-hI!30laADJl ~ Accouni Number 5424 1804 1825 PJvMcnt Must De ro Stal.m.nl/CloslnQ Oal. 12/10/2002 ror Cuslomer Service, call or writ, 1-800-950-5114 . citr Ca s... Dat. Posl Del. Re'orene. /'lumber , by 1:00 p. loc.l II.. on 12/30/2002 Tolal C$CrO Anilabl. t$~t~~. Amount Over C rldlt Lln. $0.00 + Activity Since LISt Stat.mant T. up.rl Illlll"'l orroro, ",n. I. IhI. IckIr..; col'/"" wll' nol......"". v- r'qIl'-- BOX 6000 THE LAKES6 NV 89163-600 Cash Advance Limit $310 Past Du. $0.00 + Available Cash Limit $310 J\~{~~~~. $62.00 = /'I.w Balance $2756.05 Minimum Amount Ou, $62.00 Amount Paymentst Credits & Adjustments 11/21 01618330 PAYMENT HANK YOU -1,113.47 11/08 11/09 2PHRO'C3 Standard Purch , ~ 17 2 . 00 WEEKLEY VOICE ALMANAC 650-326-8210 .CA 11/09 11/09 CRfJ6YOf PU8LIX 0490 *GROC SAl BRANDON;/'F'L 53.68 11/11 11/11 ZPC9508K AMERICAN00173146652394 SAN ANTON,lO,;':" TX 169.00 11/12 U/l2 OZ04R8P3 OUTBACK "1014 LARGO ," FL 46.41 11/13 11/13 VC9YZC6S CRABBY BILLS CLEARWATE CLEARWATER FL 25.00 11/16 11/16 HOWK51V5 MARINO'S SEAfOOD INC BRIDGETON' , 'NJ 58.00 11/18 11/18 WM9LLGD7 NATIONAL CAR RENTAL WHITE PLAINS NY ~. 153.85 11/19 11/19 HM4GJ6JO GREEN EYESHADE COM INC 408-2521800 CA rI . j 97.00 11121 11/21 'JNPMWD3 AOUA SAfARIS SANT A CRUZ" CA 349.92 11/28 11/28 DMSN4BT6 R&S SERVICE BELVEDERE ' . ~~ ... c;l...f{" 18.75 12/05 12/05 KZVGNSD6 SAfEWAY STORE00007SC9 SANTA CRUZ 75.54 12/06 12/06 W1PG2WZS ~ CONTINEN005731910211J SAN ANTONIO !~.s 748.50 12/06 12/06 DHPG2WZS ......- CONTINENOO57319U0047 SAN ANTONIO 748.50 12/06 12/06 'T8Z266S -.- TRAVELOCITY COM 18002569089 19.95 12/06 12/06 2.C2266S ~ TRAVELOCITY COM 18002569089 19.95 Our records show home phone 650-326-1431 and business phone 650-326-1430. Please update above coupon if incorrect, HAPPY HOLIDAYS FROM ALL Of US AT CITII We'd like to take a moment to thank you for being a Citl cardmember and let you know ' that we apprec1ate your business. Warmest w1shes for the upcoming year. YOUR TOTAL CREDIT LINE HAS CHANGED I Please note your new total credit line. Previous C+) Purchases Co) Payments (-t) FINANCE (=) New Balance & AdvancfS & Credits CHARGE Balanc. $1,113.47 $2,756.05 $1,113.47 fO.oo $2,756.05 $0.00 ~O,OO $0.00 0.00 JO.OO $1,113.47 $2,7 6,05 $1,113.47 0.00 $2,7 6.05 Account Summary PURCHASES ADVANCES TOTAL Rat. Summary PURCHASES Standard Purch ADVANCES St<lndard Adv BaJance Subject to flnanc. Charge $0.00 $0.00 Periodic Rate' Davs ThIs BII/lng PeriOd: 32 N.omln.' ,ANNUAL ' , APR. - . PERCENTAGE RATE :Z4:;740" 24.740% ,~4,.74~" 24.740% 0.06778%(0) 0.06778%(0) /IV 88901- 6406 189056/1 'TO PASsENGER COUPON ", . I lll'rlhl T""" COOE , II'INl'Nl1ll1iN ,NOI'TIlANllfaWllf ilo",i..d..COIWNCOON TICI<ETS 'I: ...... ". __ _".~ ....M_.._................... CNX gKK $1 r ~ 111'. """-N'llATA I. ZH2Z.J1;;: eOl'llltv1T.n ISSUED tN EXCHANGe FDA ...!...............U"flIIUftl LIo"II~NIIU~OfI5&UE ;;;;:::;:io. 1008 ::31 ""AN CHARALBU~:'" '. "" CH I ANU"'f-1A ".X.'./",?!,',~.",'.'~, 1 H,.":.-,, :\ . :.:~~. , , , C!!i'l"nu ..-.....,..-.--.. ...._" .--, ~. uWt~ftII(UfIIU)Pubtk:~llmlled ....,......" ........./HC:Il ':\CELLAtti ~tiJ!WQ/RFNO / ISSUE-DAG,.. ONL 'f ;~_11 _OFP_ HOLLAND EDWARD MR ,""",,\0'" NOT GOOD POfI.......... x.o ._I'W .....0... FIJQlfl'NO. 'Ii' " i. ....DATE 1111 TIME AN, STATIIS ,ii".~fhlRU.ll FARE BASIS 110 FROM H!ANG MAL TO ANGI<OK · 10 VOl DVl 1ft". '" ~~ ., : ,M..l1fMf . nl11\nnQ;lftll'l!1!l1 f~~TlnN . ,. " . THe 2170 eN x :' ,8 tjiKr<.41.:!i:t,,,, Q01H82 1 10 . OOEND I~UnnEQUfVALfNTFME PO. "'MTAI< fNB IIl~iAX TI-lR ,wiOT~ THe 2275 PW 72092561 5:S'(Q 5<H$ -- n11.1n:,hl!'P.11 FORM OF PAYMENT f":AStVAGT35(.) 1 <)QE: , 'I1tI';iJ.. 0RlGINAl1SSUE~. FORtwI NO., SEAIAl.'NO.. Pl..ACE. DAT!. AGEHr8 ""-""ERIC COOE)- o 217 4272092561 DO NOT MARK OR STAMP IN THE WHrTE AREA ABOVE '"-'._~-'-.-.o:...-o.;,.,;_:,;;,;,~,,;;,;~':':';:;-':';;';':;;:;;;;;';"';:::":-:~.:"':';';"::._,~___.: ~Thai ..I L1'l"lJ'Yl CASH RECEIPT NO'HT071482 THAI AIRWAYS INTERNATIONAL PUBLIC COMPANY LIMITED REGISTERED NO. 422 240 PRAPOKKLAO ROAD, AMPHUR MUANG, CHIANGMAI 50200 ~'m1~~'n NINGSANANDA SOMTHAVIL MR (Received from) "Jf'1::fl1 2174271873159 t of) 2170 VAT EXEMPT TAX 105 \lIfu\~~ ii"::lUJll1llUjjllilIl1VLW'2l11~1l,rn~1~'Yfu L~~ n11i11::i7 v L ifl1~111tTfl1\tl1fifl'::LUllJ1nrLjj lltii'lI \~~fl1aJ L ifl1ll111Ufl1Lfl1fi fl \1tJ1I111 tJ LlR7 v ~.. v. This receipt will not be recognised unless properly signed by collector, If settlement made by cheque or credit card the receipt wlll be valid after the above cheque or credit card Is cleared. (LElmn~ElElmtl""-n") , JAN2003 }()f)d,nJ ni/,.ufq')./.( gJr-N60ts fi-J' fVSdKI(), I . )6 J r>J b . fry. )i~J jJ? G. CYo~ l(6)l:> (Y. ~,~~qY1sJ G~.~.+ ~. ~)SOD;t . 11/J __~-=_~~_ ~'_~""''''''.~ oJ___ ~ ~ co '" ~ .~ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ .,\" p ~ \ ~ ~ $ ~ ... 0 ~ s: ....n... ~.n1.O -~... ~,......o .".1.00 S ~.n... ,- ,~~ - G" 1.0 o~ ~~ ~ .~ ':\>oIC .. 101>- ... .....,. ~ ~ '... ~ ... 1) \ll \ ~ ~"t~~ ~ ~ ~~t"-o;) Gl ~c: Co;s ~ g~ .. .~ :S~~$~~ ~ ~ i ~..~ ~~l~ ~-alfll C~.. l '~'!!'=~~~h ~ ~ F~':"", lC"" l.. ~ b~~~ ~ 'GG~'~ ,,~ ... IT IT t"- ... ~ ~~H ~ \01 t"G)lli r f .~~ ~ ~t~ ~:~ (-'\ ~ S c:; r l'P::S~ ~~s "~lGl S~ _5 ''3 ? ~~.. \ \ \ 0;> Gl ~ ;~ t- ~ ~ '" ~ ....___e-- .~. .,~ ;l 'S (; '* ....., \G ::r ~ ->>< I. C1_ _ <l~~ "1$= r ~ ~ ;1~ 4Z \U ?U )1/"" 1M ;).~7 .c(. "1$= ;l .s U1 ~ 1. -..l ~ '" 4 a 16 l~ (/) ~:g ~:r. <3 < ;l en --;;9 ;):J .. G) ,~.... ~ "'~ H 0 ~ c;:; ,t:) ...;:> " ("" ~;: (Q, "f~ ~ \';l c: ("" o(i: :a - '-;1 Iff'? - )~ ~ fP . ".v- 'CI - '';l ~ cr' 0 . 'cO' ' "'iI .. ' ~"t,~ :. (J ~". ~,~ o,~ . ,. ~;.JI"'~ 1iP uS ~~ g ("It ~ .. I"" C>I ~~ r.i,~ ~ -\ ~ ~ ~ . ~ ~,'l~ '~~. . ,- ~ n s:;~. \)100 l ~ S::. tD . aa ri~~' "' s: .,.. a;r;.):f- ~~ t,. '.~ ~ -.,n ~ _.~ ,.. .,. ~ .' ~ ~~~ _, ~ t3l P f/ ("It .... ..., · o.'P':- ~ "S 0 ~.~ r 1l\ .:~<>". ..~ ,~. . ...-.!IiI . . ' .;r.1~ \f) ~. ..t- .tJ:> .~ !i ,(6; lC .("" .ff' ~ -~ ;t ;,~... ).- ~ .~ t- ~ ~ -<<0 .~ ,~ ~ t- ~ "'ld'" {- 'C' .~ cD . Q' " f"' .. 'Cl' . CO. 11.~'" .,t!" e; ,~ c:: ("" .c:: :. ;S of" ~ ,;:a ; "O~ ~ ~ ,~ ~ (# )~ ':;f. 4~ ~ ;::t .- r- ,."', ... - o;l <"" :- ;f. ~. }1 s\ n , '~~"~ .~t;. ' .'If:'" . . If" . (i; '4 (ti ~.\" . rr. 11 V- ~ 0:0 ~''P ~ ~~ ~ ;t (0) C? ~ u:> OJ Ti. .~ ~ .~ OS ~ .~ i; 2. '.- .~ ", r- ..~ If~ g ..~ ~ ~ oG' -0 C'l p;.;f.., ~ .~. ....S 'f; ~.~ .~ ~~w ,c-.... "li: '.(if" ._~ .... ~'-;Jl. oG'.~ '(9 .. ~ .. ~~ .-;:&w"l ~ ~'f:i ~~... ~ fT? ~ .l ~ C'l ~ ... .0 p~ll' "'\S;:. ~ .~ .~ ~\ "'\$; ,,~ .. .('" \' '-;r. ,fI"f ... ,';:1 .,. ~zt. ~ (' ~ -- on .~ .""1~ .? ~. ~ ~. ~.l.~ \ ... 'tiS "... ~\~. .~ ,,_41~ 4l~ '. ~~ ~ ;+ 'l\~ ~ -t;;. ~ -;;i' 1:11 ..... ~ __ 1- .... ~'" p ~~ )~ (;: .(' .... .. \"" ~ .... ,~ ~ i\ t'" ~ f. 1= It"" ;a '(: .~ .;3 ...,:: .. .... .c: ~ -;:&w 'f~ .... ~. i! r <<-;1 r" .~ .... ~ "'. ~ y--' ;s C.,. . .... ;; ~. .... lC'"" ~ (~ (;t 'f" ;s C" ... ,~ ..... ;.=;1 \ .. ..:~ :t ~ ,....... ... ;&.~ ? ....., ... .... ,::0 ,,- ~ ."Cf' ~'3." ~ ~ .". ... ....r .......... ~,,"'.~. ....'!:\.... .~ .'S '. .'" f "....0.'. . . '.IS, ..'.. ..,s;. I~ \r ..-...... ~ F ~ ( l ~ f! i'.. .". " &: "\ c~ @) ~ ;z '$ ~ ';l r--;. 'I~ C'"' .~ ... ~ '" ';I .)~ C'"' c:; U ~ ~ G: (' .. 10 ~ c: i 01 ~ ~ ;:) ~ '" ,,~ ~ Ii C'"' I~ ... ... ~ G:l ~ S ;;s .~ ~s a J: 'E 'C )~ )s )s )s )s )s ..s ..s ..s ..s ..s ..s ~ ~ .~ ~ \....-l \Q Ct') ....-l ~ >D '" ... -,S;: ~ '" ~ ~ ...((; 0 ~ ~:'~ ~ % .....~p..~ ~ ,; : \t) t"""cg'" ~tI)~ '$ 'C ....IS' I r'" ~ --: ~ ,'$ liP >D r'" .. 0 <:; -QD))~ ... ~ ~ '9 ~ '3;. :s ri- $)~ c:: ~ ~-r. ;i og ,-S ! '" ... ;0 r~):5 @ ~ ~ \Q& ~. ,,'" :; __ i.,. 6\ '~4\ \ t~\ <\ 1~ )~ Z: \ 'l- 1 ~ -~ S 1~ w L.") ~ o tn ~ 411_ IS ~ .,., 'c: ~ Gl .~ i "1l) we .,; -; & ~ & '5 .~ ,~~ )~ ; ~ .~ ; ~ ~ .;; ,~ S Ii! .; ~ ~ C" .. = ~ .....,~ ;1 s .. ~ . ~ ,~'i~ ~ ,~i.,. \ ~ o CP & j ~ \ ~~\ ~~ .,F j ;0 .; g ,: ..c j ~ \ ~ \ ,~ ..........\ >> : F \ ;i ''I;> Cl S2. .~ l'- ~' a...... \ ...... ... : ~ .cs: '" 1. ';I '~ 'Q u:; ~ l(' ~ ... n ~ ~ "~~ -eW ~j , . t ~ ,I~ ~ .~ ~ ~ I E:: ~ J \ C"') ~\ c-;.l ". ~ 'Y i {C - ~i )) I~ -$ S ~. \ ,:. Jl Q ~ .i :. ! ~ ., s: ~ '~ .. ....'/. ..". g e tr $ ". ;:l r ,CO' ..... ..r ,~ s ': a ...... .. ~ II t~ )t "';::) ~ -a ,..,. t" )$ .~ )$ ~ ? ;, ~ ." )~ ~ ., ~ .. .. t" t" ~ C ." a lI-" ..~ ..~ ..~ - 1 ~ \ , j j \ \ \ j \ \ \ \ \ \ \ \ .;ir II) .,s:. \ i \ i i l \ \ i 1 \ ....; ';.t. ~ ~ ;;s c~ )~ .~\ of j ~\ 4 ~ ~ <S: r;:t' r- ;:; "~ ~. $ i' G;l i' Q % ,,. ~ F i c~ i? )3) ~~'Y~~ /'f /146' 9 ~ ~CJ..)Vr()~ 9X16o. )J3,e;o~- /1' , ~ X" ~,(,IXCN oR X ,,16, <6"0.. - ~ ~c k~~ ~1(~ of X ~ r. Tot.. .... " - I '/"-?4' tJf) d flt/CJl.&:)fO /' X j5 z /r6 ~ po- ,fo ! 6) Q)/W> 7#" -{. X,j~ e 8(fl. ~ ~o H - /f6(!J1(- ~ + IS{OO.- ?;~st,. 3660 k~ '}VV' ~" . . ~- -. - _.~._.. "-... ...------ ~\ =,&t l&:I ..... %~ s~ ~ ~ 1A ,.a~ ~ t:: ~~ ~:3o ~ ~ - -: ;:J ! ~ 0 .. :;= ! I ~ i \ t:l ~ ...( .): : ~ 6 ; ..( ! ~ ...l 8. ! ~ ~ ,~~ C;... ,SO .~~ ~... ....>< e -< ! c~ t: '^ )~ t: "..""1 ~ yV" ~ 2 $~ r~ ~ j .. ~ lD ~ 1~ t.C> S a ~ '5 00 ~~' :: ,. e: .r ;:s :: 1a ~ .~ ;! g ~ ~<.?,; -" C7) f: \ .~ 1 ~. ~l ( Q! _i '1~ : p ....! . It; 0 \ ~ ~.~: ~\ . i .~! I". ,:': ~\ \\ iC ',: \ ~\'.. l ii..O\ L::.. ~. c.. i ,:;::: \,: ~\ :1.;': ":'" d.\ .i:.:, ::.' 1"" 4\ ; u ~ I .." :it. l~ -a I I I C"l ~i ~- !.n ~ ) V) .~ .,i) ~ c:p \ ~ .,<) - ~ .-.... t<) x CI e ~ <X ... . ..::; 1 '-..J , 1 u ! .5 .. .1 ~ 1 r'&, e '! 1# 1 D4 l- I ~ 0 l~ ~ ~ "7 #- .:i ..G:) ,.. ! r- c: f: 'C~ f! ." ... .~ ,.. F- ;:s ,:: .~ ':!: .. .r ~ ja ~ ~ ... ... . i i~ I:, \1 ... : i ct. 1 l"3\ ~ I : ()! ! \1 . ''1 i .;1 ,.F -< {~ .~ ~ ~~ .~ ~ .~\ 4..~\ ~ : -~ t\ 1J .\ .-.. ~; :) \ o I ;:( \ , J ! !i ~ :;) _ 0 ~ ~ 'r?' '< "'to (/'0 "" ~ r-g....':,6 ~~a. _....Clti~ ~~N ..~ . ~ ~ "~c.='! S"':'<(N ~Cloo'A ,. M ~ ' loG: r ~ 'U ;to F t: l"" (I:S"- ~ ~ i!~:3;:; ...$ - ~-~1 - ~ -~';:) ,: 0 llC ~ E;= Iii )~". cc. r- E' t; r' 01; ~.- ;l '" ;J !}, "C-- ~ t:l .0:: ..tcJ '" ..( > ...F~E ,.,ro ~ ~ ~~;S ~ ~~~~~ ~ ~ c> ~ ~ o { ( ( 1 ;: l~ a 0 ~ .d- ~ ~i 0 ~ X ~ ~~ I-' ~ - -~ 'iii' - - ~ \ ~ I \ \ \ ~ l- 0 "" \ .g ~ \ ~ \ ~ <:::::::l u ~ ~ ... 9 ,:-t e V) : ~ ." .Z) 0 c- ~ ~ ~ '! 0 ra c::e. \ ~ 0 ... \ C" If- \ ~ ~ ~ lC: t/! 1~ ,.. ~ c; ... l"" ;l ~ ~G:) '0 ;l ro ~ "'E .. \ l- ;E ..~ ,.. r- C:!; os: L...-- r ~ ~ F -/I: ... ;l 1;;1 ~ cS t:\ ~l .". ~ ~ ;) 0 ~ , ."" - , b>\ "'::-- ~ "'IS:: -== \ if:> i .r; ~; -" ~\ \ . \ Q\ :: ~\ \ \~' ill \ \ \ ~ \ ~\ v:\ \ _\~~r::L ~\E\ \~ 3\~\ \~ o\:s\ \...D ~:::s;..: :..J...: ~ "l \ ~ Il~': l-"" 0$::,.:;, '(e ~\ \ \~ \' \ \ \ . \ \ \ 1 ~ ~ " ! ~ to> ~ \ '~:g W 7..: i ',1= ..: c::> ,~~ 6;.-l ...';! 0 .<;: ;>- r- .c: z .a~ -< ;It::: fSt )V" """ w~~ !!~ pel. '1~ ~ ;:1 - ~I" C ! or. ... M ~ 1'\ .,.... a ~ (;) ~ .~ c; S 1~ 1o~ ~ll. ... ~.. E .~ ;1 ~. 'B ~ !l ~ ". ~ t- o c::::: '<l$: -~ -" ....-'....-...... -- ,/-/,.,.n,",j ~, ..,.,-_..'.".~.,. o ......% . .::1 !- " ;> ('3. ... 3l~. I \ i (\ \ i \ I The Decedent's Will provides that his executor, the undersigned, has the authority to deliver in person any of the gifts made by Will and to take along with him any individuals that the Executor feels appropriate, at the expense of the estate. The Will also provided that each person . should receive a reasonable per diem for daily expenses. The undersigned chose to deliver in person those gifts made to individuals in Thailand. Decedent and I worked together in Thailand for 5 years, I knew some of the recipients personally (one died a few days before my arrival in Thailand), I speak Thai and am familiar with the Thai culture, I invited to go along Ms. Mija Kim, decedent's companion for several years and his care- giver (she is a nurse) during his last illness. I also invited Dr. Klaus Bergman, Director of Administration of Duetsche Welle (the German equivalent of the BBC). Dr. Bergman had worked with Mr. Shroeder in Germany and fortuitously had been available (while on a visit) to provide care to Mr. Shroeder during one of the more debilitating episodes of his illness, Dr, Bergman had planned on being in Thailand on a personal trip, so the expense to the estate on his behalf consisted only of paying his expenses within Thailand. I also invited to go along, within Thailand, Mr. Somthayin Ningsananda (herein referred to as Khun Somthaviil). Khun Somthavil received a gift of$10,OOO from Mr. Shroeder. More importantly, he was mutual friend of both of us, and was the one individual in Thailand who knew how readily to contact the various heirs and how to organize a Buddhist memorial service for Mr, Shroeder. Our task was complicated by the death of Mrs. La-Ong, shortly before our arrival in Bangkok and the need to locate her 5 children and 2 grandchildren. Also, the memorial service needed to be organized in the village ofKud Khao, in Kalasin Province, about 300 miles from Bangkok. Khun Somthavil' s help was invaluable in carrying out these duties. After the memorial service we then drove to Chiang Mai, in North Thailand, to locate one of the children of Mrs. La-Ong (who succeeded to an interest in her gift, both under Thai and Pennsylvania law) and to complete delivery of a gift (made prior to Mr. Shroeder's death) to Prince Vongchuk na Lamphun, of Mr. Shroeder's library of books on Buddhism. On Tuesday Jan. 21, Khun Somthavil and Dr. Bergman flew from Chiang Mai to Bangkok. Ms. Kim and I flew to Bangkok several days later. She left Thailand on lan, 26. I stayed for an additional two weeks, on a personal visit, at no charge to the estate, As set forth in the accompanying accounting, I hired a van and driver for 6 days to take us to Kalasin Province, at about $75/day plus gas. I allocated $40 per person per diem for food, hotels, and 'miscellaneous (newspapers, Internet cafe charges, phone calls, etc,), Mr, Shroeder had had extensive connections with the village of Kud Khao and his Will made gifts of $5000 to the sister of a deceased friend there, and $2000 to the village temple. The memorial service involved 9 Buddhist monks and many of the villagers and involved gifts to the monks and providing food for all those in attendance. All charges related to the service totalled c. $250 (10,000 baht).. ~ - (l;,- c9s-~'-f /:,;}O WAGGONER,. FRUTIGER & DAUB Certified Public Accountants 5006 E TRINDLE RD SUITE 200 MECHANICSBURG, PA 17050 TEL 717-506-1222 FAX717-506-1223 FED ID 23~1583249 www.wfdcpa.com SCHLEGEL & SHROEDER, LP 5209 TERRACE ROAD MECHAN/CSBURG, PA 17055 Statement Date 6/17/2004 Client No. 5612000.0 Date Description -"----salince"ForWard 5/31/2004 Finance Charge Charge Credit Balance 9.00 600.00 609.00 Current Balance $ 609.00 0-30 0.00 31- 60 9.00 61 - 90 0.00 91 -120 600.00 Over 120 0.00 Balance $ 609.00 Balance Due is payable upon receipt Delinquent accounts over sixty days will be. subject to a finance charge of 1.50% per month. Payments received after the statement date will be reflected next month. Thank you for keeping your account current. HUBER & ASSOCIATES 3601 N. PROGRESS AVE , SUITE 200 HARRISBURG, FA 17110 717-540-1880 TERRY B. SHROEDER 630 WILSON STREET CARLISLE, PA 17013-3641 Account #: 151 December 2, 2002 Statement Beginning Balance $1,218.00 Date Invoice # Amount No Invoices This Period 0.00 No payment or Other Credi.ts This Period service Charge on Unpaid Balance 0.00- 18.00 Balance Due .$.1,,236,..00 . _.._-".._-----..._.._-------._.__.._~._~ ..... ESTATE OF TERRY B. SHROEDEfti511i:8itr;f,,,:,,\>i<<'i:\ E. w~ HOLLAND JR. EX. EC.UTnDP"" ....''''~6;;j{.~~>'' 1 0 11 366 CALIFORNIA AVE NO.3 ,'~.. .;;.!:".,~r ~"'t ...~-. ;',!;.~" PALO ALTO, CA ~" .-.', ~~i.;:" IdJe/ I ",;' 90-7811211 ':~"."\'\""'" ......./ r '. DATE i~t~1~iWN?::,', ~ . '.' ,,,,;," ':'.,.<~ /'2-36 .J.2! ~~. ,)~:;1);?;~ 'I. "",".v,' .., 0., '= .' w =.-.. ~~ l~:=1r.~J~~Ji~L. .. .:. , o - 30 31 - 60 61 - 90 91 - 120 >120 Total REV.1512 EX + (1-87)(1) (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TERRY B. SHROEDER SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER 2002-0030 Include unrelmbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. DESCRIPTION Allfirst .Bank - Signatuire Credit Account No.: 23 0000 0007 3653 Sprint Phone Bill Comc8st Cable Service Earthlink Internet Service Provider, Shroed4r Diversified Appriaeal Services Freeman Real Estate Appraisals OrrLaw Invoice #763: Revisions; Re-Execution of Decendent's Last Will and Testament dated 3/21/02; Owed to Orr Law by Decedent at time of death USAA Federal Savings Bank Visa #5420000396012921717 CITI- Card Acct. PA Department of Revenue 2001 Tax Due HUD~1 Seller's costs to transfer Realty known as "630 Wilson Street"Cariisle, PA" (see line item 1 on Schedule "A" and line 602 on HUD-1 attached thereto) Notary Fee: California Notary by Executor California State Tax Debt from '1997 AMOUNT $25.00 $331.68 $22.75 $43.90 $1,200.00 $500.00 $905.00 $142.47 $1,536.90 $793.06 $3,133.87 $10.00 $1,997.00 11$ ___ _____ ;_ ...__..1_...1 :___.... _,4...:...___. _&....._"- _4......... ____ ....:__\ TOTAL (Also enter on line 10, Recapitulation) $10,641.63 Sprint~ Monthly atatement: June 25, 2002 10f 4 Customer service 1-800-829-8009 Internet address sprlnt.com/local Customer number 717-243-7237.645 Fast Facts Invoice statement for your records' Total Due: . ,,', $.00 Customer summary Previous charges Payment June 24 - Thank youl Balance Current month charges 331.68 -331.68 .00 .00 Current month charges NNNNNNNN 4 ----------------------------------------.------------------------------ * Please recycl~ : Sprint$ Customer service 1-800-829-8009 Internet address sprlnt.com/local Customer number 717.243.7237-645 Do not send payment. No'amount due. We appreciate your business. 1...111...111......11..111..11.111111..11.1.1.11.1.11....1..11 = AUTOCR**C-002 .+ - TERRY B SHROEDER. - PAUL ORR = 50 E HIGH ST - CARLISLE PA 17013-3015 == Sprint PO Box 740463 Cincinnati OH 45274-0463 1.11.1.1.111.1.111111.1..111.1111..1.11.1.." ..11111 12 71724372376454 00000000000000 000000000 0223514 ~omcast. ~ Account Date Number Due Total Amount Due $22.75 0510186757002 On Receipt ~~!fii;~~f~~ . Payments (jDcltiilesp.ytn~b:~ived I?y Sl12lO2l_.. . . ~':u~~~~:'\~;~::;' , " - --. Taxes & Fees :-' !'..-~~\(<" "'.: " Bow to reach u.... ',. 'l!! .Y OQ ~.rcach our <"'uatomer Service DepsrtlOeul at: (717) 243-4918 '24bOura a day, seven days a werk ,,\.0.' . ..........:..'_. ,~:~:\r lei, ;~~~ " omce Locat101l: ~.;;,.:.~;~~!:'G{~'!f?~;Z\it~r~'lflt:..?;.:}"> BWedir6~ 0!I13102tOO6tl1JOZ :""';;':~:f'~""!. .;_.,~.1:... .i':; <.\, ,..<. .,;,..~-!~:::;~\};-:.:"_,."....,. '-','," .. '. ,~, '-,' ,', " ' - ,~ ", 'j,"';," .- ~...' . ' : "'" '. ~.. . ..: .....,'-i.,.-.:'. ;,.,", :.,';.......-. ..-,...... ',':'. I News from Ccmeast ~.H:..:.'.\{?\~?~J;t;t.r:.;~::';i~.r::y::;" .'.. Currently. past due accouDlS are assessed' a$2:00"~~~:rqr..:'.'... . od billed. Pifecdve with our DOXtm~:.~fij.;i,~. ~n 45 da ci the be' r of die dQdbfueiL'Ne)i?,.,,.,,,,r'., da S oftbe:;' . =:'00=. Jilidditi',:CffelCtiviC y JU1D1D& pen .' . ." ..... .. returned paymontl will mC%oaso from $10t(JS.~~'&9; , " . ....... '~_:. ':.;. .;:~,....1.:;s..,..:...~ FINAL BILLING - We ~am.loSinIYc)g'ai;~1~~'~)Pl~~.' .. .... W mcnt to our local .Comcaet . ...... .~. cO.DtCiWitbiO''10~j;j()iaV; eq p ,y. .' "::~'>~"'. ";" ;'>:.'(:\.:.:;>f",;;r"~i:~~f::: ::. . .;..::.\....:!;: ';c/':;' .' .........IMPORTANT CUSTOMER. NonCE... BffeCtivoJuno'l 2<xw:rib '!:'''f" wi11~)eb8rBCd:~;an),~i'. delinquent accounts when payment is collected at the door. ".....,.. :."::;.';.,>>;:;;:;'/,?':,,>'FL.:..c.;:c...,...;!i<:y..,..s.' -----------------.---------~---~----------------------------------------------------------- . II .,. I \.......,. : ': ;';""" :\'f;~;~\'i:~:;~~f~::~,~~;~....\:...t"I:~.,.~;~.:.~~:t'~:~.t?'. .' '. ......- . I - . ,-,.'..: BD~&'Ann'W' :'~'HO~'" r";~' ::' '>1"D;"~:?'" 'Y.~. ,. '''' ;l~" .,':1~~...1\.,.... ". . ',,;. "xnoB1GYKftAw'(",',,\:'"';';':'1r.~ .:. >.. .' 366 CAUPOltNIAAVINUB,St1l'l'B'11IREB . PALO ALTO. CAUFOaNJA H306 . . . ;;f;.,,/.!),..i)(~) ~~:1:~;~:~(;tj:;,'\;!<~.{.::/;/;,...' . .. . 'AXi (6S0)~1~":":'.'1)':-r);J~:;'~;J" ...<'; . . ;.. .' "~~"~':;J' ..t...,..:.... June 17. 2002 ": .: :~~.J"' ~:0~SPi;~~t;:~:. .~;:.'... "';''''';10:''':'-' 'L., ""':'-'. ::," I.... . ~.. ':. :~:~:~:: . :":~fY,1.(;~~Jfi\;,,~',~, ?i~;:~ i~i;~:;'7.:f; ~il..~f~t..~'.'..~i.t.~.~j.~'f,;,:,:",~'..a.:...~_;tii...~~...~~.t.;i:,.~t.;.~'.:.~~.~..~.i~f.';;'.::. ;: :',: 'f,,~t:~~I:~~~l.i{{:.':' ., '. . Dear COMCAST.'; . . '. ... :.,., .".. .:. ,', ,: :..' ..... '~_~~ ;:";.~; ~.-.':. .>- '. .:.:.',:; :. : _ '. '.'. j:. ..;.;:"'.: :"i:;.,:".. :.>;.~. (~I.::;;~ '::',.:',i"~ .> ::~,;:':.;. ,.:.~j.:::A : '...;;,...~:'J1:;~t-i~l.,J. ~fi;;(;~~~i~\:;it,'(;f#ii.;;-f~kt~~#~;.;J.(:[t!A~t:;;... Ire~StQ\~;,,~:P.f{tlO;~~~c)l:Mr:.I.. :, .:' "'~."'o "'-'~', ....t!.. "." I~'. <f#.j~..,.;..".t .'.'~.'..' .~,..,o '.\';"':'!~;..'~~.." Executor of Mr. ~t..~':~}~~l~ '.. ..' ;' Shroeder's bU1:f:or:.tb.ej~i~ ~I.~ J#'(i2.~};.: term;nsate Mr. ~'~;W1!,~Jl:.~,}f:i1""" yoo for~.1J':~.t~tli;!~::~" .' ;.t.tk~$,;:. ...",...--."/-'> . ~, '(J!/'~':" :. . . .... ';":'. >'" """t:'B' ~"";:~'u01JaDd;' ....~'r;'( ':';:".' . .,,;~~':. '; .,"c' .' "\"'~l':t .e'..'{'<~". ~ t.!iP If, ,'....~I .,; ,.l:'..,;...!,..: :'\ r'1.1 ,. . ;':'",,'~,~''!;P:: '{':~':,;1i~;~~. fr~,!f~~~.&~~Jii~!~~:.;'" ,":. :"''i~;~t: .. i";.,,, . :.;~ ...: '::::," .;:, . . ~'::" .\:~ ;.::: :":X;;:~~W:..';:i;j\' '::: ~xr.\~:: .': '.' ::.\~~~!;~}i.{:#i]! ": t'.: ':. COMCAST' . P.O. Box 3007 Southeastern PA 19398-3007 . . .... Rc: Terry B. Shroeder.' Acct.: , ~19.867S7002 . "'~'.~::,:,.~... J: .......\v..-\ ,,'~'':'1:':_'' .' .. " /..;..,;..:..:,!..:....~. ':.,;:~" ~~A;.~:,ih.~;;?' ;-:;!..;;;;. ; . . .:..;./" , \iI'*~t1::; ., \. ,'. "t:;fj,~~~;f;D::~j . Jo~~" '<c~"Ii,.;"'~. '0 '''0;,~~,~~~;!iii+S\:M'~~';;' . ,. EWH:cg Encl. r' . '.. :...., ,:1:~;.lii(.:.,.>:..'..~...:..~.....:...:;~^.:.I.,~l....~..'..;.....:.....~:...':.~..',..:..._'..~..::......'.': . ::. :-...~..':r: ':~;i'~:~:~{~ I\dj.~~fi~~i." ~ . - ."_ '. ,.,).!:~~ow."l-' .'. :,' ' ;.;: ~ ;'.' ""'.~ . ..,. .' .':r ," I""i.o . .'. ~ '. . '0' , . . ';:".."h 'ql. I' t' :. l ~ : . ~ , . ;..... .j/~;I~\:;';.:~:H~'.'> :.:' '~~~~'~i~~~:.! , .~~~(.i~."~~l!'~t~,:~:o 0\ " '..,. ,.,:-........... ....... .,;-.....' '~:" : '.' ~f:~;. " ~--- CCS, Inc, 232M Chagrin Blvd,#4oo Cleveland, OH 44122 " 136175680001111 0003 0000 Terry Shroeder 630 Wilson St Apt I Carlisle, PA 17013-3641 I", III." III,,,,, ,II "II,,, 111111, III" "11"11., ....11..11.1 $43,90 November 1, 2002 Amount: $43.90 Interest: $0.00 Equipment/Service Fees: $0.00 , " TOTAL:M3:9Q Creditor: EARTIU..INKI A TLANT A Account No.: 5002679 Account Balance: $43.90 Dear Sir or Madam: You have not paid this obligation despite several requests by this office, therefore, we are continuing our collection activity, This account has been verified by our cliC;Dt EAR1HLINK/ATLA~A. To stop all collection activity, it is imperative that full payment be made immediately. Send your remittance to' our office today, ~B ~ . C'~ N~ v~~,w l' } ]11D"V Sincerely, Chris Miller 216-766-5315 Account Rtpresentative 1-800-741-9922 This is an attempt to collect a debt. Any infonnation obtained will be used for that purpose, Corporate Collection Services, Inc. is a debt collector. I~'R I 0 .----------------------------;-.-.--------.-.--.-.----------------------------------- .. Detach and return this portion with payment in enclosed envelope.. c accept money orders, checks, VISA, MasterCard or Discover as method of payment. If paying by credit card you may lithe infoimation in or complete and return this bottom portion. llTI [[[J] ITIJJ ITDJ o DISCOVER [fijJ Creditor: EARTHLINKJ A TLANT A Account No.: 5002679 Account Balance: $43.90 JVISA D MASTERCARD TOTAL: $43.90 Jrd Holder: ulhorized gnature: mount Enclosed: $ Corporate Collection Services, Inc. P.O. Box 22630 Cleveland, OH 44122-0630 1.1..1.1" I,,, 11"1.1,, I, III.", "".",.",.,. .11, II.., .1.1, I :rry Shroeder ~, 90 CCSS4 . onlP" fief , 1\ (") 0 ~ " ~~ :XI 0 ~ $""' 0 -n -n - 0 +PI rorn J "ia ~ tg"(I) 0 ~..~o () 0 c~~-n ~004~"'CJ V\ ... ri 0 -~()~ r ~~gc .s \J1 ~~'5.r- "ia -l . OJ ~ + %~O" 0 '!:: - ~~ .:r .. "'0 0 -n rf"\ ~ ~ C- ... \J1 "~ 0 ... 0 0 \J1 0 " ca ~ " 0 tP .... - .. .. ... ... c.D 0 ~ rf"\ tp ~ 0 0 \J1 0 ~ .... 0 rf"\ \J1 .... -.3 0 rf"\ u.. ~ ~<( 0 r .. "ia 0 ':1W ... ~ ~OUl~ -\- cn-: a::~ \:. ..J\i'in-- rf"\ ~::>~<( .:r 4. Oc>l1- 0 c.g~~ .... .i(1-:eJ) 0 u..~~~ .. og ~ 0 ~ (/)O~ \:. IJ+ will 0 - u.. ~ u.. 0 ~~ ~ ; \3) ~~ 0 & 0 ::-- ,\\ \) 01 H "',.fDmm_mIDlfu~m' .' R:'l!~1(etl)f1!J1'!llil.a"~,.r,' .. ,1l,;td;~~e.~p~ets:9'J4'~hSQJ11t~ . '. ".-' "" . '3":~t'Higl'l:Stt~ SUi~ JOI' ......, . ' " ...' . Carlisle,' Pennsylvania 1701~..3'OS~", . Tel: 717.249.2758 Fax: 717.2S8.470} INV()ICll . PAte: October17,2002 1" :. F(,)R:AppraisltliR~~' .. ." ," 160 :S;.Ha.rtOver8tr'~t]t,tm'630'Wi1S0n:Stteet.. C8tHsle;'P~Ylvailui, ' .... .", '. ,~,;: ';' '..' '. ' . " ' , . .~.."...:.-....."." ,.......,...~...."'., . 0", ,. - . '.'" '. '" ,,'.' , . ".' '." .' "',.;> . ' ":" -; -'.' ';' '; ,',' ',:, :" . < - " .'. '.-' - " ". . 1'.-' .<i;.~>'<. -,.q,~rtif1ttl'(f~neratAp~.s~', .<'t~J.t)(10014-L .' '. ....', > , ',' 'F.,ft)'Numbet 206~3-6~67~t : ' ' FROM: Freeman Real Estate Terry Freeman 3920 Market Street Camp Hill, PA 17011 INVOICE TelephoneNumber: 717-763-7712 Fax Number: 717-731-9612 TO: PAUL ORR, ATTORNY AT LAW 50 E HIGH ST CARLISLE PA. 17013 Telephone Number: AJtemate Number: Fax Number: E-Mail: Internal Order #: 0000388 Lender Case #: Client File #: Main Ale # on form: Other Ale # on form: Federal Tax ID: Employer ID: l~'7 c,rJ \0 \fJ-? \~ I >~.,', :. , L_ ~ __.~ ~___ _ _ ~ - - - -- __ _ _ _ ._~ _0_ _ ~...~_______~_ __ _ o Lender: Paul Orr, Atty at law Purchaaer/Borrower: N/A Property Addre..: 630 Wilson St City: Carlisle County: Cumberland Legal Delcrlptlon: See dimensions below Client: Slate: Pa Zip: 17013-3641 I ~ ~~I~'-~ 11'llil,l- ( ~.....' ~ " , ~ - -- - APPRAISAL SERVICES- 500.00 I p r, 'I':j" 1 " I < ' ! I ~ ~ ,,: i l _.. _ - ~ ~ -- - --' SUBTOTAL 500.00 Check 1/: Check #: Check #: Date: Date: Date: Delcrlptlon: Description: Description: SUBTOTAL TOTAL DUE T$ 500.00 frieman Real Estate Form NIV3 - "TOTAL for WIndOWS" appraisal softwanl by a la mode, Inc. -1-800-ALAMODE P AULBRADFORD ORR LAW OFFICES 50 EAST HIGH STREET, CARLISU!, P A 17013 PHONE (717) 258-8558 FAX (717) 258-5289 Invoice submitted to: Terry B. Shroeder 630 Wilson Street Carlisle, PA 17013 File No. 01-258-P March 21, 2002 In Reference To: Last Will and Testament Invoice #763 For Professional Services: HrslRate Amount 3/11/02 psa Draft/revise Last Will and Testament 1.00 $175.00 $175.00/hr. 3/21102 psa Review/analyze Review Last Will & Testament Revisions made and execution March 11, 2002 - includes Travel to and from Carlisle Hospital 3/21/02 HLS Notary Notary stamp on Testator Plus 2 witnesses Total Costs Total Amount of this bill Previous balance BALANCE DUE: 2.20 $385.00 $175.00/hr. Qtt(IPrice 1 10.00 $10.00 ~~ We now accept VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS and other major credit cards. You can also use your MAC or DEBIT/CHECK card for payments!! A late fee of 1 % will be added to all unpaid invoices monthly. $10.00 $570.00 $335.00 $905.00 Any unpaid balancas that are tumed over for collection will be subject to additional collection col;ltS. .5lJ... BANK&WEST CUSTOMER NAME ESTATE OF TERRY B SHROEDER ACCOUNT NO 6-076984 '9;^ ~ ~ UTA11lCW_L_ f;.~.&DIc::UTllll l'.wl ..10. CA _ a 1001 M~J~ - ~Lt:..~ :vI $~~~.. .& nrlI[.: . 11 I," cAlI!4!:'''' ~, ~~ ~ .1"fM3'l'~'J 7n c:::=a 1.,1 '/. ':UUOO7U":' ., oown.u.... ._ 0000 2....... CRKCK' 1007, PAID 12 24 2002, AMOUNT 142.47 DTAftM_.."'" L ..IIllUAIII& IDCUtOI =...~=.u It/Is-In _ -. .~;~rJ:: ~!1~ 1$~~~11L \~~"'O'R>~ ~~ ICII <t...n. S'r1L6t.7~Y'1lJ!!J!J!L 1 . ,.='z uo078 Z.: '00'1 oi:r~n.... ~ ~ CRKCK' 1009, PAID 12 30/2002, AMOUNT 5.00 ISfAlI Of' 1IIIII'f .. IIIIlOIDIII 101'1 =r~..A~ 3Z0 '02' toe, l"f.29 _ ... co ;:;r"'O""'Y.T 1'1. _/"tJI- 11m =~" ~~' -..J $IJ-Y .!:! -r-~ 6:.-Q ~.~Jr:~~-'F,;..... tali\ .&r~' l' . :'Z"OO'fIZI: '0" OOlio.,:'::~i CHKCKf 1011, PAID 12 2t 2002, ANOUHT 1,23t.OO STATEMENT PERIOD 12/07/02 - 1/08/03 CHECKSCAN'" PAGE 8T A TEMENT 2 OF 2 ~~Ai 10 ( :t% ~+~ q ~ " @,~ UfrQA ISfAlI Of' TIIllIY ..1llIICIBP 1010 P:.'!L"~.A~ .~~- . . Itkl- Av puI .......' mOA~. t:=~-"7tJrl" ~O....-'. .~r"'Ii!i '~=MF.:... . ~... ....... f.otl ~^.~ .. .', , .... . .... I!I!..JD.!""~ .~.n:7.n-8l.' c::::;: --- . . '1=""007811: .0.0 00'0"''1.1,;' loooon 00,... CRKCK' 1010, PAID 12/27/2002, AMOUNT $7,931.00 AMOUNT $1,536.90. For Your Protection: Please examine this statement and report any dillcrepancy within 30 days. MEMBER FDIC ~ DOLLARS \ I)~ r G> ~ ~ REV-1513 EX + (9-00)) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF TERRY B. SHROEDER FILE NUMBER 2002-00350 I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1.$eeattached worksheettitledScheduled JBeneficiaries Part liA"Elhdlotaling: RELATIONSHIP TO DECEDENT Do Not List Trustee(s) I'NO..MCRStME OFESTATE NUMBER ENTER OOLLARAMOUNTS FOR DISTRIBUTIONS SHOWN PBOVE ON UNES 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 1. TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets ofthe same size) Schedule J, Beneficiaries "Part A", Taxable Distributions NUMBER NAME AND ADDRESS OF PERSON (S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee (s) OF ESTATE 1 Jude Smith, 611 W. North Street, Carlisle, PA, Friend $22,700.00 17013 2 Mi Ja Kim, 2946 Glenmore A venue, First Friend $36,000.00 Floor, Pittsburgh, PA, 15216-2050 3 Robert and Shell-Be Shroeder, 1416 Alpine Brother and Sister-in- $276,424.79 View Place, Mt. Vernon, WA, 98274 law which includes $32,276.60 as one share of the estate residuary 4 Michael Shroeder, 4-1-8 Ganeko, #202, Nephew, son of Robert $10,758.87 which Ginowan City, Okinawa, Japan and Shell-Be is 1/3 of one share of the estate residuary 5 David Shroeder, 19535 Newberry Terrace, Nephew, son of Robert $10,758.87 which #204, Lansdowne V A 20176 and Shell-Be is 1/3 of one share of the estate residuary 6 Stephanie Caparoni, 2144 Lindengrove Street, Niece, daughter of $10,758.87 which West Lake Village, CA 91361 Robert and Shell-Be is 1/3 of one share of the estate residuary 7 Patrick Gaude Son of a Friend $5,000.00 8 La Ong Srithong, 58/1 Village #9, Rung Arun Friend $5,000.00 Market, Prakanong, Sukhumvit Road, Klontoey, Bangkok 10110, Thailand 9 Somthavin Ningsananda, 255 Soi Charoenmit, Friend $10,000.00 Sukumuit 71, Bangkok, Thailand, 10110 10 Phanom Osaklang, 42 Ban Kud Khao, Friend $5,000.00 Tambon, Kud Khao, Kuchinarai District, Kalasin Province, Thailand 11 Edward W. Holland, Jr., 366 California Friend $25,000.00 A venue, Palo Alto, CA, 94306 12 Jonathan Weiss, 130 W. 42nd Street, New Friend $25,000.00 York, NY, 10024 13 Massimo and Kristel Ali, Franz Wolterstr. 5, Friend $5,000.00 81925, Munich, Germany 14 Nellie Boyan Mugnier, 15 Rue de la Bievre, Friend $6,000.00 92220 Bagneux, France 15 Amelie Mugnier, 15 Rue de la Bievre, 92220 Daughter of a Friend $6,000.00 Bagneux, France #1-15 SUBTOTAL $459,401.40 16 Brigitte Kopf, Lindwurmstr. 145, Munich, Friend $5,000.00 Germany 18 Tomoko Shroeder, 4-1-8 Ganeko, #202, Daughter-in-law of $32,276.60 as Ginowan City, Okinawa, Japan Robert and Shell-Be one share of the estate residuary 19 Karen Glago, 6033 Curtier Drive, Apartment Daughter of a Friend $10,758.87 which E, Alexandria, V A, 22310 is 1/3 of one share of the estate residuary 20 JoAnn Trimmer, 12477 Grace Hill Lane, Glen Daughter of a Friend $10,758.87 which Allen, V A 23059 is 1/3 of one share of the estate residuary 21 Mikael Glago, 8712 Parliament Drive, Son of a Friend $10,758.87 which Springfield, V A, 22151 is 1/3 of one share of the estate residuary 22 Michelle Spatz, 100 Skyline, Chalfort, P A, Daughter of a Friend $5,000.00 18914 23 Kathy Demaray, 12306 N.E. Second Street, Daughter of a Friend $5,000.00 Vancouver, W A, 98684 24 Theresa Tasiemski, 4274 Ostrom Avenue, Daughter of a Friend $5,000.00 Long Beach, CA, 90713 25 Christina Gilman, 635 South Oregon Street, Daughter of a Friend $5,000.00 Jacksonville, OR, 97 26 Robert Bowler, 482 Hullet Street, Long Beach, Son of a Friend $5,000.00 CA, 90805 27 Anthony Bowler, APO 7418 East Son of a Friend $5,000.00 AOHANKNVY #16-27 SUBTOTAL $99,553.21 Estimated share of the estate residuary # 1 - 15 #16 - 27 SUBTOTAL: SUBTOTAL: $459,401.40 $ 99,553.21 TOT AL: $558,954.61 Schedule J, Beneficiaries "Part B", Charitable Bequests NUMBER NAME AND ADDRESS OF PERSON (S) RECEIVING PROPERTY AMOUNT OR SHARE OF EST A TE 1 Carlisle Historical Society, 611 Street, Any commissions, documents, or photos Carlisle, P A, 17013 deemed acceptable by Robert and Shell-Be Shroeder 2 Wat Uppatam Photaram, Buddhist Temple, $2,000 Ban Kud Khao, Tambon, Kud Khao, Kuchinarai District, Kalasin Province, Thailand 3 Amaravati Buddhist Monastery of Great $32,276.60 as one share of the estate Gaddesden, Hemel Hempstead, HPl 3BZ, residuary United Kingdom 4 The Stanley Family Trust $100,000.00 Schedule J, Part "B" Total: $134,276.60 Cumberland County - Register of Wills One Courthouse Square, Room 102 Carlisle, P A 17013 Phone: (717) 240-6345 Date: 3/0312005 Edward W. Holland Jr. 366 California Avenue, Suite 3 Palo Alto, CA 94306 RE: Estate of Shroeder Terry B File Number: 21-02-0350 Dear sirIMadam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel. Within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 04/0312005 Your prompt attention to this matter will be appreciated. Thank you. Sincerely, ~~~ '- cc: File Judge if Cumberland County - Register of Wills One Courthouse Square, Room 102 Carlisle, P A 17013 Phone: (717) 240-6345 Date: 3/03/2005 Paul B. Orr, Esquire 50 East High Street Carlisle, P A 17013 RE: Estate of Shroeder Terry B File Number: 21-02-0350 Dear sirIMadam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel. Within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 04/0312005 Your prompt attention to this matter will be appreciated. Thank you. ~l~~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Judge cI- STATUS REPORT UNDER RULE 6.12 Name of Decedent: Sbroeder, Terry DffieofDeffih: April 3, 2002 Will No.: 2002-00350 Admin. No.: 21-02-0356 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. St~ther administration of the estate is complete: Y~ No 0 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. lfthe answer to No.1 is Yes, state the following: a. Did the person~wsentative file a final account with the Court? Yes _ NO^ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personwsentative state an account informally to the parties in interest? Yes.;7\ No 0 c. Copies of receipts, release , jo nder a d informal accounts may be II wit t e and may be attached to thi ort. Date: JL2<-1 0) c::- ~- Paul Bradford Orr, Esquire Name 50 East High Street, Carlisle,PA 17013 Address (717) 258-8558 Telephone No. ,I. ,--, ;: t..' .~ \.j Capacity: 0 Personal Representative B Counsel for personal representative vJ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 - INHERITANCE TAX RECORD ADJUSTMENT j"". .~, PAUL B ORR 50 E HIGH ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-30-2006 SHROEDER 04-03-2002 21 02-0350 CUMBERLAND 101 REV-1593 EX AFP (03-05) TERRY B Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- --------------------------------------------------------------------------------------------------------------------------------------- REV-1593 EX AFP (03-05) ESTATE OF SHROEDER TERRY .. INHERITANCE TAX RECORD ADJUSTMENT .. B FILE NO. 21 02-0350 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adllinistrative Costs/ Hiscellaneous Expenses (Schedule H) Debts/Hortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax ADJUSTHENT BASED ON: VALUE OF ESTATE: PROTEST BOARD DECISION 10. 11. 12. 13. 14. TAX: 15. Allount of 16. Allount of 17. Allount of 18. Allount of 19. Principal TAX CREDITS: Line 14 at Spousal rate Line 14 taxable at Lineal/Class A rate Line 14 at Sibling rate Line 14 taxable at Collateral/Class B rate Tax Due DATE 08-19-2002 12-09-2004 NUHBER CD001539 CD004715 INTEREST/PEN PAID (-) .00 .00 INTEREST IS CHARGED THROUGH 02-14-2006 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM ACN 101 (1) (2) (3) (4) (5) (6) (7) 288,500.00 468,767.89 .00 .00 120,028.07 6,966.26 .00 DATE 01-30-2006 (8) (9) (10) 82,015.32 10,641.63 884,262.22 92,657.07 791,605.15 29,282.82 762,322.33 .00 .00 29.056.96 78.027.15 107,084.12 92,894.12 14,190.00 3,671.75 17,861.75 · IF PAID AFTER DATE INDICATED, SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. nil FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU HAY BE DUE 1<1' A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) (11) (12) (13) (14) (15) (16) (17) (18) .OOX 00 = .OOX 045= 242.141.35x 12 = 520.180.98X 15 = (19) AHOUNT PAID 75,000.00 17,894.12 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ~OARD OF APPEALS DEPT. 181021 - HARRISBURG, PA 17128-1021 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE PAUL B ORR ESQ 50 E HIGH ST CARLISLE PA 17013 IN RE ESTATE OF: SHROEDER TERRY B. DOCKET NO. : TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: DECISION AND ORDER 0519038 Inheritance Protest 2102-0350 101 8/3/2005 1 0/3/2005 JEFFREY HOLLEN BUSH Direct Dial: (717) 783-7891 Fax: (717) 787-7270 Email:jhollenbus@state.pa.us January 20,2006 On August 3, 2005, the Department issued an appraisement and assessment that disallowed the deductions reported as items B-7.B and B-7.C on Schedule H of the original inheritance tax return. Those claims involved costs incurred by the Executor while personally assisting "in Ceremonial Proceedings in Thailand" and in delivering "Bequests to Toronto, Canada". Petitioner argues the Thailand expenses are reasonable and necessary deductions when instructions are "explicitly put forth in Decedent's Last Will and Testament". Further, Petitioner questions whether a transfer from an irrevocable trust to non-U.S citizens is subject to Pennsylvania tax if the beneficiaries have no control over the trust. Petitioner requested a hearing in this matter which the Board scheduled for November 3, 2005. Petitioner subsequently withdrew the request for the hearing and stated additional documentation would be provided on November 6, 2005 to support the claim. To date, no such documentation has been received. 'SHROEDER TERRY B. BOARD DOCKET NO. 0519038 Page 2 of 3 Section 2127(4) of the Inheritance and Estate Tax Act of 1991, 72 P.S. 99127(4), provides for the deduction of reasonable and customary funeral expenses. Furthermore, Section 2127(1) states "All reasonable expenses of administration of the decedent's estate and of the assets includible in the decedent's taxable estate are deductible." In Peterson Est., 649 A.2d 1007 (Pa.Cmwlth. 1994), the Court stated "It is well settled that expenses necessarily incurred in preserving and distributing the estate may be deducted and that expenditures not essential to the proper settlement of the estate, but incurred for the benefit of the heirs, legatees, or devisees, may not be taken as deductions." In the opinion of this Board, reasonable and customary funeral expenses would not include costs incurred in accompanying the decedent's ashes to Thailand. Furthermore, as those costs were not essential to the proper settlement of the estate, they are not deductible for Pennsylvania inheritance tax purposes. Section 21 07(b) of the 1991 Act states all transfers of property by will or by the intestate laws of the Commonwealth are subject to tax. Section 21 07(c)(7) further provides that a transfer made without valuable and adequate consideration is subject to tax if the transferor had at his death "a power to alter, amend or revoke the interest of the beneficiary". The relinquishment of such a power within one year of the death of the transferor is subject to tax "to the extent that the value at the time of the transfer or transfers in the aggregate to or for the benefit of the transferee exceeds three thousand dollars ($3,000) during any calendar year." The inheritance tax return as filed reported no assets held in an irrevocable trust. Article Eighth of decedent's Will did, however, bequeath $100,000.00 to the Stanley Family Trust. As that transfer occurred under the provisions of the Will, the bequest is SH'ROEDER TERRY B. BOARD DOCKET NO. 0519038 Page 3 of 3 taxable under S 21 07(b) regardless of whether the nonresident beneficiaries had immediate access or control of the funds. Accordingly, it is hereby, ORDERED, that the Petitioner's protest be denied. FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER A STATEMENT OF ACCOUNT WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE ORPHANS' COURT WITHIN SIXTY (60) DAYS OF RECEIPT OF THIS DECISION. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY). 6, .6 Pennsylvania Department of Revenue Bureau of Individual Taxes Inheritance Tax Division Post Assessment Revenue Unit PO Box 280601 Harrisburg, P A 17128-0601 Date: Subject: To: From: August 14, 2007 Lien Entry Register of Wills Laurel Fulmer Supervisor Attached are copies ofliens entered against estates in your county. Please mark the estate records to indicate the entry of the lien and the lien filing cost due to the Department. Estate Name File # Docket # Terry B. Shroeder 21 02-0350 07-4226 LF:sej attachments r0- o ~ =r: c- o <'\J c..~ :::::, ooo:c r-- c::::, = ~ 1--- a:: --'" f- ~f/ g~-~-)'- U :.:L ; 6::[,; 03 U ~~ f ..... BUREAU OF COMPLIANCE PO BOX 280946 HARRISBURG, PA 17128-0946 '* REY-159 CMAFP(6/96) DOCKET #1b7 .4.:z..U,..~..IJ; DATE "'/l,/A "1 FEES COURT OF COMMON PLEAS OF CUMBERLAND 21 02-0350 COUNTY, PENNSYLVANIA NAME AND ADDRESS: ESTATE OF TERRY B SHROEDER DATE, OF DEAm: 04/03/02 PROPERTY LOCATION: SEE ATTACHED TO THE PROTHONOTARY OF SAID COURT: PURSUAI(!' TO nil! LAWS OF nil! COMMONWEALlH OF PBNNSYL VANIA, 1HERE ISHEREWll1i mANSMlTJ'llD A CER'I1FIBD COPY OF LIEN TO BE EN1EIU!D OF RECORD IN YOUR COUNTY CERTIFIED COPY OF LIEN DATE OF CLASS OF TAX PERIOD ASSESSMENT IDENTIFYING TAX TOTAL TAX (OR DUE DATE) DETERMINATION NUMBER OR SETTLEMENT INHlEST 01/03/03 08/01/05 21 02-0350 $14,190.00 $19,280.53 TOTALS $14,190.00 $19,280.53 FILING FEE (S) $19.00 INTEREST COMPUTATION DATE 01/04/03-06/25/07 The undersigned, the SecRtary of revenue (or his authorized delegate) oftbe Commonwealth ADDITIONAL INTEREST of Pennsylvania, certifies this to be lNe and correct copy of a lien against the above named taxpayer for unpaid tax, interest, additions or penalties thereon due from such taxpayer and which, after demand forpayment,thereof; remains unpaid. The amount of such unpaid tax, SETILEMENT TOTAL Interest, additions or penalties is a lien in favor of the commonwealth of Pennsylvania upon $19,299.53 the taxpayer's property, real, persona4 or both, as the case mLY'~, ,.ti<';'~",l ; ~'f.';-~'l ',,.. ~'l ~,,~~;;9;, li:~~ ~eck or Monev Order will result in the delay ofissuinl! your Satisfaction. f./J'.- C.I ~ I "'".....,. ,.v '-(:/ , '= ....;f,~~ SE Y OF REVENUE . (OR AU ORIZED DELEGATE) PART 3 - TAXPAYER NOTICE COPY DATE . ." REV-1502 EX+ (6-9_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF TERRY B. SHROEDER FILE NUMBER 2002-00350 All real property owned IDlaly or as . tenant In cammon must be rtpolted at fair market vallie. Fair mamt value ~ definlld as the price at which property would be exchanged betWeen a y,jHlng buyer and a wiDing seller, neither being compelled to buy or seD, both having reasonable Icno\'lledge of the relevant fact$. Real property which Is jolntly-owned with r1tht of IUrvlvorUllp mult be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Four unit Apt. Bldg located on a roughly 145' by 150'Iot in Carlisle, PA, 630 Wilson Street Tax number 04-22-0481-074 2. A two and on-half story brick 5 unit Apt. House known as 160 South Hanover Street, in the . Borough of Carlisle, Tax Parcel No.: 04-21-0320-236; owned jointly as equal tenants in Common with Ms. Henrietta Sue F. Schlegel. (100% value = $197,000) VALUE AT DATE OF DEnH TOTAL (Also enteron line 1, Recapitulation) $' 288, (If more spaoe is needed, insert additional sheets of the same size) IN RE ESTATE IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA TERRY B. SHROEDER ORPHANS' COURT DIVISION NO. d-I-Ocl.-- 035D TERM DECEASED PETITION FOR CITATION TO THE HONORABLE THE JUDGE OF SAID COURT: . ~ AND NOW, thIS. ~_ _ A..."""\. \\ ~'" day of -'"S ,^('oo..~ ~ , comes the Commonwealth of Pennsylvania, by Robert Freedenberg, Deputy Secretary for Taxation, for Thomas W. Wolf, Secretary of Revenue, who avers: 1. That Terry B. Shroeder, deceased, (hereinafter referred to as "the Decedent") died on April 3, 2002. 2. That a Petition for Probate of the Last Will and Testament and for Grant of Letters Testamentary was made by Edward W. Holland, Executor, (hereinafter referred to as "the Executor"). Letters Testamentary were granted to the Executor on April 8, 2002. Attached hereto and made a part hereof is a copy of a document attesting to said date on which Letters were granted marked Exhibit "A." r0 ::s = <-- -.J .,.". :x .- .... .:;:- ,r"") : l C1 3. That the Pennsylvania Department of Revenue did cause to have entered an appraisement and a "Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions, and Assessment of Tax," was mailed to the Estate's Representative on August 3, 2005. Attached hereto and made a part hereof is a copy of said Notice of Appraisement and Assessment marked Exhibit "B." 4. That on August 19,2002 and December 9,2004, Executor made a payment on account of Inheritance Tax due in the Decedent's estate, in the amount of$75,000.00 and $17,894.12. An official Tax Receipt was issued to the Executor by the Register of Wills. 5. That as of the date of this Petition, the balance of Pennsylvania Inheritance Tax remaining due and unpaid is $16,995.24, plus interest at the applicable statutory rates from December 10. 2004 until the date of payment. 6. That on October 30, 2006, a certified demand letter was mailed to the Executor outlining the nature and amount of tax due and the consequences if not paid. A receipt was signed and returned to the Department of Revenue. Attached hereto and made a part hereof is a copy of said letter and receipt marked Exhibit "C." 7. That under Section 2176 ofthe Act of August 4, 1991, P.L. 97, No. 22, (72 P.S. ~ 9176), the Secretary of Revenue is authorized to request the Court to issue a Citation directed to those subject to any duty imposed by the aforesaid Act, commanding such persons to appear and show cause why the requirements of this Act should not be met. WHEREFORE, your Petitioner prays your Honorable Court to issue a Citation upon the Executor, directing the Executor to appear and show cause why said Inheritance Tax in the estate of the Decedent should not be paid as required by law; and to further direct that the costs of this action shall be borne by the Executor. COMMO Robert Freede berg Deputy Secret for Taxation BY FOR: Thomas W. Wolf Secretary of Revenue COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF DAUPHIN Robert Freedenberg, Deputy Secretary for Taxation, for Thomas W. Wolf, Secretary of Revenue, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Petition are true and correct to the be t Robert Free enberg Deputy Secr ary for Taxation For: Thomas W. Wolf Secretary of Revenue Sworn to and Subscribed before me this 30d day of /~ dJoo;; ?,.L- /~ L:/ /~ eOMMeNW'A~tj;j el' jilINN."~VANIA NOTARIAL SEAL JOAN M. PETERS, NOTARY PUBLIC CITY OF HARRISBURG, DAUPHIN COUNTY MY COMMISSION EXPIRES APRIL 07. 2008 Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administ~~ ~~~COrdi~g to law., ~ (2-0 a Sworn to and affirmed and subscribed J I~ I before me this 5th deyof APRIL 2002 ~7Ly(l7/h~!fk';~ DECREE OF REGISTER Estate of TERRY B. SHROEDER Deceased No. 21-02-350 also known as Social Security No: 567-42-8326 Date of Death: 4/3/02 AND NOW, APRIL 8. 2002 " in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary r:J of Administration ((c.I.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate) are hereby granted to Edward W. Holland, Jr. in the above estate and that the instrument(s), if any, dated March 11, 2002 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... Short Certificates(s) ............... Renunciation .......................... Extra Pages ( ) ............... I.T.R...................................... . JCP Fee ................................. Inventory ................................ Other...... ........... ..................... TOTAL ......... ....................$ $ 445.00 '7y(J ~LLG<V .?/U) /PO ,4'Ud7 Regil>ter e(Wills $ $ $ $ $ $ $ $ 72.00 \?s Yb~?~~ (O~;'{(!" .~J~ 30.00 5.00 Attorn~Y:/paul Bradford Orr, Es uire I.D.,No: 71786 " A~dress: 50 East Hi h Street I darlisle PA 17013 552.00 Telephone: 717-258-8558 , .--_.~.... DATE FILED: '~~ PETITION FOR GRANT OF LETTERS Estate of TERRY B. SHROEDER 21-02-350 No. also known as TERRY B. SHROEDER , Deceased Social Security No. 567 -42-8326 Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) GJ A. Probate and Grant of Letters and aver that Petitioner( s) is/are the execut or Decedent, dated 3/11/02 and codicil(s) dated named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: o B. Grant of Letters of Administration (c.I.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 630 Wilson Street, Carlisle Borough Decedent, then 66 years of age, died April 3 (list street, number and municipali1y) ,2002 . at Carlisle, Cumberland County, Pennsylvania (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property......................................... $ 460,000.00 (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ 240,000.00 Value of real estate in Pennsylvania ........................................................................................ $ Total.......................................,............................. .... ............................................ $ 700,000.00 Real Estate situated as follows: Two Parcels in Carlisle Borough Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence ~6>" . .>,> ..,? Edward W. Holland, Jr. 'A. 17-o~-~ 08-03-2005 SHROEDER TERRY B 04-03-2002 2102-0350 Cumberland 101 Appeal Date: 10-03-2005 (See reverse side under Objections) , ~ BUREAU OF INDIVIDUAL TAXES ~-::.:~RITANCE TAX DIVISION- . ,r PO BOX 280601 HARRISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE pcr'(lJrt[":n [\[eif'\: ry: I !cJJ..)I':.JC_'.J NbtICEI.{)F-1NHERITANCE TAX P::AJ:lR,RAISEMENT,'/ll:.L:QWANCE OR DISALLOWANCE , ''-OFDEDUCTIONS" AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY ACN 2:10;; t li0 _ c:: tnj ~J ,.'; .: ,:; ...; (i ',' ! l' c: ') ;.'i i ~ I 1 . \oJ t.,) PAUL B ORR ESQUIRE 50 EAST HIGH STREET CARLISLE P A 17013 CLE?!<. .. "~.." Amount Remitted REV.1547 EX (06'()5) PC MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ . - FfEV~154Y i:-x -(06-(fSfPC - - - - - -"" - - - - - -Notic-E -eiF rNj:iERii A-Nc'E"tAj( AP-PRAis'EMe"Nt-, "ALLOWANCE- OR- - - - -" - - - - - - - - - -"" - - - - - - - - - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHROEDER TERRY B FILE NO. 2102-0350 ACN 101 DATE 08-03-2005 TAX RETURN WAS: ( D) ACCEPTED AS FILED ([gJ) CHANGED SEE ATTACHED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortqaqes/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/ Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 82,015.34 10. Debts/Mortqaqe Liabilities/Liens (Schedule I) (10) 10.641.63 11. Total Deductions (11) 92,657.07 12. Net Value ofTax Return (12) 791.605.15 13. Charitable/Governmental Beauests; Non-elected 9113 Trusts (Schedule J) (13) 29,282.82 14. Net Value of Estate Subiect to Tax (14) 762.322.33 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. (1 ) (2) (3) (4) (5) (6) (7) 288,500.00 468,767.89 0.00 0.00 120.028.07 6.966.26 0.00 (8) ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 taxable at Siblinq rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18). 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID - 08-19-202 CD001539 0.00 12-09-2004 CD004715 0.00 X.OO X .045 242.141.35 X .12 520.180.98 X .15 (19) AMOUNT PAID 75,000.00 17,894.12 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 884.262.22 29.056.96 78,027.15 107,084.11 . ~'fl BIT t \ TOTAL TAX CREDIT 92,894.12 BALANCE OF TAX DUE 14,189.99 INTEREST 3.294.48 TOTAL DUE 17,484.47 (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. HARRISBURG DISTRICT OFFICE STRAWBERRY SQ 4TH & WALNUT STS HARRISBURG, PA 17128-0101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * REV-87SFO AFP (07-06) EDWARD W HOLLAND STE 3 366 CALIFORNIA AVE PALO ALTO, CA 94306 DATE: Estate of: 10/30/2006 TERRY B SHROEDER Date of Death: 4/3/2002 File Number: 21 02- 0 350 ACN(s): (See Reverse Side) (Certified Mail-Return Receipt Requested) DeM EDWARD W HOLLAND: This is to again advise you that the above estate is in a delinquent status. According to Department records, the estate still is not settled. As of this date, you have failed to respond to prior contacts to resolve this matter. The Inheritance and Estate Tax Act mandates the filing of a tax return and payment of all outstanding liabilities by the personal representative, transferee, or beneficiary of the estate within nine months of the decedent's death. The DepMtment's records show that this estate remains open because: CURRENT TAX LIABILITY OF $ 18632.77 INCLUDING INTEREST CALCULATEDTO 11/24/2006 HAS NOT BEEN PAID. Accordingly, you Me directed to pay all tax due including interest within thirty days from the date of this letter. If you fail to comply with this directive, your case will be referred for local enforcement and may result in the filing of a citation by this Department with the Orphans' Court Division of the Court of Common Pleas, requiring you to appear in court to show cause for your failure to comply with the law. In order to protect the Commonwealth's interest, the Department of Revenue may also file a lien in Cumber land County. Under Act 40 of 2005, additional collection costs including but not limited to fees of up to twenty-nine percent (29%) of the amount due, and attorney fees incurred in securing payment, may be imposed on any liability not paid prior to referral to a collection agency or contract counsel. MAKE CHECKS PAYABLE TO: REGISTER OF WILLS, AGENT Any questions regarding the tax liability of this estate, please CONT ACT: HARRISBURG DISTRICT OFFICE STRAWBERRY SQ 4TH & WALNUT STS HARRISBURG, PA 17128-0101 TDD# 1-800-447-3020 (Services for taxpayers with special hearing and/or speaking needs) Sincerely, JOSEPH ROMANELLI (717)787-9869 cc: r.18~ L. CD .~ -0; Cl '0 CD ~ cj ~~ 00 C'. ~ E ~ CD 0 ""-0; EoO ~ ~ c: "C !~ '0 ~ 2: -0; "C L. i! ~ -8 ~A^C;; !!l~q; Gl tD l!! lil a. ~ B- E -ci ! ::i tUE o!GlO 0"$.'5 ~~ ~"05""'::ui <(I/)I/)"Po= "- I/) al E t'i~!0~16 -g"~'O~1la. l1lGi1il-GlGl C\iO'OE.'5~ ,..: i fij~ .s ~ s I/)OGl -n~ "C E"CEc"'- CD Q)til1l~~c Zl :t::GlCGlI/),g l!! S!:5~:EGl "C ~; g,ai~.'5 ~ EE'E.'5~5 ~ 8~it ~<( 0 ~ . . .-: " ril\D :>0 ":1'1 ., .:(0\ H 1il6 o r-.o :;: HE-< o :;i!:;i! ~r1U .:( 0 3:ril\D..:I OE-<\D.:( rilCllr1P< I~ t,~ ..:I o :x: L. .E a. =-0; III l!l ~OC ~ ~ q l a.~Qi djoco ODD ~ ~ ~ I J 1U - ~"Q1U iE~ ~~l cplil'U1 ooc.5 ODD H ..:I ..:I ril ~ lil o In 1'1 o I N o M N UI '5 a e ~ CD ~ 0 ...n ru M IT" '" ~ '" 9 '" m '" ~ ~ ru ...n IT" CJ CJ CJ Cl .; CJ t:Q ...n ..-=I rn CJ Cl l'- i :9.1 CD l!l oc EI ::> ~ oc o i E o Cl 8 c:::- C\I ~ ~ 2 L. i ~ 111:;: s,gco z...et> ~ 1 ~ ~ c u- N ~ ~ ~ Je ~ C. ~ .! .'ijj oiGl5E O"gj.'5 ~~ i-cc...... . _ O~_I/) <(.!Ill/) 0= t'i~gj ~E 'O~i3Gl1l8. C .- '0 .c l1l1>l1l-GlGl -0 C.c 0 C\I ""'-8- ,..:ifij~.sl/) s I/)OGl "E~ 1 E"cECl1l- G>'lii11l~015 =G>CGllll,j:: Gla:5~:CGl "C Qj~o -.c ~ Q.v>-ai.c- CD EE'E.'5~5 "0 8~it~~o ~ . . . .-: E-i Ul,::t: p:: p., p::::r:: O(!)r:tl HH ~::r::Ul H 5r:tlH ,::t:o~ p.,lilU Ii> '5 c: III 1! ~ CD ~ 0 .E a. 'iij-O; ~~ ~ ~ q l ~~g$: ODD l[ ~ CI> "ij =ij ~ 8.~i~~ ~i~ii 8~~iil1S '~~OC.5i JJODO oc '" ~ M r-I o r-- r-I H H H r:tl ~ o p:: o lil M o I N o r-I N "\br'l' oil il: '" 9 '" li'l '" ~ .:r U1 t:Q ...n IT" ru ...n IT" CJ CJ CJ CJ CJ t:Q ..l1 ..-=I a. -0; l!l oc E ::> ~ oc 1 o Cl rn CJ CJ l'- ~ o C\I I ~ ~ ~ L. III - 111:;: s,gco ~~ ~ ~~ & N ~ - w o u:: II. o t- a: :J [0 o o Z c( J: D. a: o - a: w J: o Z:J 00 i=> c(..J 1::0 Oa: t- Z o o woO =oW t55 (ijt3ffi ' _a:wu \ ~LL.o:::l5 (') ocr: -/- 0 W OZLLW ~~offi oc:tl-::J> ~~~~ >a..a:x ww::J<( a:OCDI- Ii 717-272-5691 BOYER PRINTING & BINDING CO. .....- 0') N ,." ...... I I') () Ul - ,. '6 J: -E '-J ~~ Cf) o C () ,0 o .; w !:::! ~ :2 ~ w t:: o W ...J u: W l- e( o ...-.... " W l- e( o LL o w 0 I- Z e( w ~ ...J W u:: w :2 e( z >- I- Z ::> o () o o Li ~ ~J f ~ ---"-.) ~ <> (!) ~u; -.:::> ~ r";a: w r ~ '< ..J <( I- o I- . 1 ~ I I I I I I I I I I I I I j ~] iLl. ~( ~I 01 ~I ::JI iJ II. ~I O[ a:. ~I ~I ~I a:l I I I -j I . ! I .[ f I I I- W ~ o o o o W II W I- Z W W I- <l: o IN RE: ESTATE OF TERRY B. SHROEDER, DECEASED : IN THE COURT OF COMMON PLEAS : ORPHANS' COURT DIVISION : CUMBERLAND COUNTY, PENNSYLVANIA : 21-02-0350 ORPHANS COURT ORDER OF COURT AND NOW, this 22nd day of January, 2008, upon consideration of the foregoing petition, IT IS HEREBY ORDERED AND DIRECTED that Edward W. Holland, Executor for the Estate of Terry B. Shroeder, deceased, is hereby cited to be and appear in Courtroom NO.5 on Friday, April 25, 2008 at 1 :30 p.m. at the Cumberland County Courthouse, Carlisle, Pennsylvania, and then and there show cause, if there be any, why the Inheritance Tax in the estate should not be paid; and to further direct that the cost of this action be borne by the said Executor. IT IS FURTHER ORDERED AND DIRECTED that Edward W. Holland, Executor or the Estate of Terry B. Shroeder, deceased, file an Answer to the Commonwealth's Petition on or before Friday, April 11 ,2008. By the Court, ,~~ M. L. Ebert, Jr., Thomas Gohsler, Esquire Office of Chief Counsel Paul B. Orr, Esquire 50 East High Street Carlisle, PA 17013 ~:;:J ::.~ .._......) (::..l.-=> r,' ':J w N \D '~) '-11 ~ Edward W. Holland, Executor Suite 3 366 California Avenue Palo Alto, CA 94306 bas In Re: TERRY B SHROEDER, DECEASED ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-02-0350 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 1/22/08 JUDGE'S INITIALS: MLE TIME STAMP DATE: 1/24/08 IN RE: ORDER OF COURT ~ ~ " .. .. .. ... ... .. .. '\ .. .. .. .. ... '\ .. .. .. .. '\ .. '\ '\ .... '\ .. '\ .. '\ .. '\ .. .. .. .. '\ .. .. '\ '\ '\ .. '\ '\ '\ .. '\.. .. .. .. .. .. .. .. '\ .. .. .. .. .. .. '\ .. .. .. .. '\ .. '\ .. '\ '\ '\ ... '\ '\ '\ '\ .. .. .. '\ .. '\ .. .. .. .. '\ ..... .. .. .. .. '\ .. .. .. .. '\ .... .. .. .. '\ .. '\ .. .. .. .. '\ .. .. .. .. .. .. SERVICE TO: THOMAS GOHSLER OFFICE OF CHIEF COUNSEL PAUL B ORR METHOD OF MAILING: ENVELOPES PROVIDED BY: IZI USPS DRRR D HAND DELIVERED D OTHER_ D PETITIONER D JUDGE IZI CLERK OF ORPHANS COURT MAILED: 1/25/08 """""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" SERVICE TO: METHOD OF MAILING: ENVELOPES PROVIDED BY: D USPS DRRR D HAND DELIVERED D OTHER_ D PETITIONER D JUDGE D CLERK OF ORPHANS COURT MAILED: Deputy Clerk of Orphans' Court COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG;, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HOLLAND JR EDWARD W 366 CALIFORNIA AVENUE SIUTE 3 PALO ALTO, CA 94306 _hn_h fold ESTATE INFORMATION: SSN: 567-42-8326 FILE NUMBER: 2102-0350 DECEDENT NAME: SHROEDER TERRY B DATE OF PAYMENT: 03/24/2008 POSTMARK DATE: 03/19/2008 COUNTY: CUMBERLAND DATE OF DEATH: 04/03/2002 NO. CD 009447 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $16,995.34 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTORNEY CHECK#1032 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS $16,995.34 GLENDA FARNER STRASBAUGH REGISTER OF WILLS EDWARD W. HOLLAND, JR. ATTORNEY AT LAW 366 CALIFORNIA AVENUE, SUITE THREE PALO ALTO, CALIFORNIA 94306 (650) 326~1430 FAX: (650) 321-0990 f}J~ \:j'd- \) March 17, 2008 Ms. Glenda Farner Strasbaugh Register of Wills- Agent Cumberland County 1 Courthouse Square Carlisle, P A 17013 Re: Estate of Terry Shroeder De:ar Ms. Strashbaugh .~J Enclosed please find a check for $16,995.24 for payments of Penn. St. inheritance taxes due from Mr. Shroeder's estate. A letter from Ms. Lora Kulick of the Office of the Chief Counsel of the Dept. of Revenue is enclosed for reference. Ms. Kulick agreed that interest would be waived if the principal is paid in full. I understand that the amount enclosed is the correct amount for full payment. Thank you very much for your kind attention to this matter Sincerely, C0 EWH:cg End. Cc: Ms. Kulick OFFICE OF CHIEF COUNSEL P.O. BOX 281061 HARRISBURG, PA 17128-1061 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE January 31, 2008 Lara A. Kulick Direct Dial: (717) 346-4644 Ikulick@state.pa.us Fax: (717) 772-1459 Edward W. Holland Suite 3 366 California Ave Palo Alto, CA 94306 VIA CERTIFIED AND FIRST CLASS MAIL Re: Estate of Terry B. Shroeder, deceased Citation for Failure to Pay Inheritance Tax Court of Common Pleas of Cumberland County Orphans' Court Division No. 21 02-0350 Dear Mr. Holland: By now you have received a citation from the Court of Common Pleas of Cumberland County, which requires you to do one of two things. As Executor of the Estate, you must pp:y th~ inheritance tax due in the Estate of Terry B. Shroeder, deceased, by April 18, 2008, or appear at a hearing to'be held on April 25, 2008 at 1:30 p.m. in Courtroom No.5 of the -- Cumberland County Courthouse in Carlisle, Pennsylvan~a. At. the hearing, the Court will require you to explain why tpe inheritance tax due in the Estate of Terry B. Shroeaer, deceased should not be paid. .-' Please be aware that the law requires that the inheritance tax be paid. If you need assistance you may contact this office or seek advice from a local attorney. The inheritance tax should be paid at the Office of the Register of Wills for Cumberland County. If you do not pay the tax by April 18th, you also will be responsible for the costs of my attendance at the hearing. I look forward to hearing from you regarding this matter. Once you or your attorney pays the tax, I will petition the Court to discontinue the citation issued against you. Lora A. Kulick Senior Counsel cc: Paul Bradford Orr, Esq. ~- . LAK: dmm No. 24487 OFFICE OF CHIEF COUNSEL P.O. BOX 281061 HARRISBURG, PA 17128-1061 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE January 31, 2008 Lora A. Kulick Direct Dial: (717) 346-4644 Ikulick@state.pa.us Fax: (717) 772-1459 Edward W. Holland Suite 3 366 California Ave Palo Alto, CA 94306 VIA CERTIFIED AND FIRST CLASS MAIL Re: Estate of Terry B. Shroeder, deceased Citation for Failure to Pay Inheritance Tax , ) Court of Common Pleas of Cumberland CounfY::;1 Orphans' Court Division No. 21 02-0350 Dear Mr. Holland: . "\ , j By now you have received a citation from the Court of Common Pleas of Cumberland County, which requires you to do one of two things. As Executor of the Estate, you must pay the inheritance tax due in the Estate of Terry B. Shroeder, deceased, by April 18, 2008, or appear at a hearing to be held on April 25, 2008 at 1:30 p.m. in Courtroom No.5 of the Cumberland County Courthouse in Carlisle, Pennsylvania. At the hearing, the Court will require you to explain why the inheritance tax due in the Estate of Terry B. Shroeder, deceased should not be paid. -' Please be aware that the law requires that the inheritance tax be paid. If you need assistance you may contact this office or seek advice from a local attorney. The inheritance tax should be paid at the Office of the Register of Wills for Cumberland County. If you do not pay the tax by April 18th, you also will be responsible for the costs of my attendance at the hearing. I look forward to hearing from you regarding this matter. Once you or your attorney pays the tax, I will petition the Court to discontinue the citation issued against you. ex Lora A. Kulick Senior Counsel cc: Paul Bradford Orr, Esq. "'ft LAK: dmm No. 24487 ) L l> c;:I l' tt~. 4 ~j .... ~. >(;l <;' ~ fk. 'r) W rr, "" 'i=9 , \ '......! ""'" #.0: ~ ff ~ 4. ifJ I'r. ~ .... w. ("'~ IX <. ~ ~ €Ji ~ . e; .. lli o a:<l) S ~i ::;) < ~ U). ~ ~o~~g 111 i. :c i~o .a:$6 ~ S~~ ~ ~~ 00.. 3 ! @ ..:- c> s::: 'W} ~ c:s ..P ~~ t:i <l) <l) V1 on ;r. a ("l <(~~.- 1i:l rh ~ 0'0 ;:::'-'Ocnr-- a :;:: U <l)'- p...~"d'8<( rot;.-< s::: o~ "'Cloro,..., ~ :::;--c~~ ~ ~ ,.g ~ .~ o .~ ~ O-c .onSUro ~~u'-u -::: ~ -::: -::: .-::: === :: ....-;:: .-:: ::::= ~ === ~ - - :~ :=; - - ~ - - - -:::. .' - - -::: - ,',.\ I'n t\1 '" I. .-t. I') .,..1 "', I... I~" .,.01 . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL INHERITANCE i'AX DIVISION PO BOX 28060]. HARRISBURG PA 17128-0601 TAXES ~ _~_ ' ,' , ,~~ INHERITANCE TAX ?0~~ ~' 30 Phi 12~ 54 E.Ef ~ C 1 _., PAUL B ORR ~~ ~R _ r', ~f1 50 E HIGH ST CARLISLE PA 17013 RECORD ADJUSTMENT REV-1593 EX AFP C03-05) DATE 05-20-2008 ESTATE OF SHROEDER TERRY B DATE OF DEATH 04-03-2002 FILE NUMBER 21 02-0350 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE -~ RETAIN LOWER PORTION FOR YOUR RECORDS E'- REV-1593 EX AFP C03-05) ** INHERITANCE TAX RECORD ADJUSTMENT ** ESTATE OF SHROEDER TERRY B FILE N0. 21 02-0350 ACN 101 DATE 05-20-2008 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION VALUE OF ESTATE: 1. Real Estate (Schedule A) (1) 288,500.00 2. Stocks and Bonds (Schedule B) (2) 468,767.89 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 4. liortgages/Notes Receivable (Schedule D) C4) .00 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 120,028.07 6. Jointly Owned Property (Schedule F) C6) 6, 966.26 7. 'Transfers (Schedule G) (7] .00 8. Total assets IB) 884,262.22 DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/administrative Costs/ Miscellaneous Expenses (Schedule H) C9) 82, 015.32 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 10,641.63 11. Total Deductions (11) 92, 657.07 12. Net Value of Tax Return C12) 791,605.15 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (S chedule J) (13) 29,282.82 14. Net Value of Estate Subject to Tax C14) 762,322.33 TAX: 15. Amount of Line 14 at Spousal rate C15) . 00 X 00 = . 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045= . 00 17. Amount of Line 14 at Sibling rate c17) 242, 141 .35 X 12 = 29, 056.96 18. Amount of Line 14 taxable at Collateral/Class B rate C18) 520,180.98X 15 = 78,027.15 19. Principal Tax Due C19) 107, 084.12 TeX CRFTITTSe DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 08-19-2002 CD001539 .00 75,000.00 12-09-2004 CD004715 .00 17,894.12 03-19-2008 CD009447 2,805.34- 16,995.34 03-19-2008 WRITEOFF .00 3,087.76 TOTAL TAX CREDIT 107,084.12 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RE ~-1470 EX (688) ,~ ~~ COMMONWEALTH OF PENNSYLVANIA DEPAf2TMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 DECEDENT'S NAME Terry B. Shroeder INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER 21 02-0350 Steven James ~~ ~v~ ~ 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The remaining interest due on the above-referenced estate has been waived. Row Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COMPLIANCE oEP7.zeoeaa AUTHORITY TO SATISFY HARRISBURG PA 77128-0948 REV-900 CM AFP (S-08) ~` ~ il~, ~'4~' ~I~~i.'~~~~: ,r ' ARP 60565 _..,., I ,~~~- x~~' ,~ ." .. COMMONWEALTH OF PENNSYLVANIA t1 t't DEPARTMENT OF REVENUE ZODS JvL ~ ~ PM Z' OS V ~~ ~ COURT OF COMMON PLEAS OF ESTATE OF TERRY B SHROEDER~~~1J'S iJQ(JRT CUMBERLAND COUNTY, DATE OF DEATH: 04/03/02 ~ CO., PJA PENNSYLVANIA. PROPERTY LOCATION: SEE ATTACHED Docket Number 07-4226 CIVIL Date Filed 7118!2007 Class of Tax INH/EST Account Number 21 02-0350 Assessment Number 21 02-0350 TO THE PROTHONOTARY OF SAID COURT: The Commonwealth of Pennsylvania, Department of Revenue, the Plaintiff in the above action, acknowledges having received of the Defendant above named, full payment and satisfaction of the above captioned Lien/Judgement Note, with the interest and costs thereon due it; and desires that satisfaction be entered upon the records thereof. AND you, the Prothonotary of said Court, upon receipt by you of your costs of satisfaction are hereby authorized and empowered, in the name and stead of the Plantiff, to enter full satisfaction upon the record as fully and effectually, to all intents and purposes, as we could were we present in person to do so; and for so doing, this shall be your sufficient warrant of authority. IN TESTIMONY WHEREOF, there is hereunto affixed the Seal of the Department of Revenue, Commonwealth of Pennsylvania, this 16TH day of JUNE 2008 THOMAS WOLF Secretary of Revenue _~ " H f ~~~ <a MARY HLiBLER Director, Bureau of Compliance ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES ~ "`IIV#1•E:f~ITANCE TAX INHERITANCE TAX DIVISION _. S TAT E M E;N T' O F AC C O U N T PO BOX 280601 __.~: '..~. .. ., HARRISBURG PA 17128-0601 REV-1607 EX AFP C03-05) ~~~~ ~~ _~ p ~~: 2~ATE 05-27-2008 ESTATE OF SHROEDER TERRY B DATE OF DEATH 04-03-2002 CL.En~ fir FILE NUMBER 21 02-0350 ~RF'~-'~''~ i r"~i.JRT CUMBERLAND COUNTY PAUL B ORR C~ It•"~-~ ~~ ~~~ ACN 101 50 E HIGH ST Amount Remitted CARLISLE PA 17013 MAKE CHECK PAYABILE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA, 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS t- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACOOUNT *** ESTATE OF SHROEDER TERRY B FILE N0. 21 02-0350 ACN 101 DATE 05-27-2008 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN 'THE NAMED ESTATE. SHOWN .BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-17-2008 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDITS): 107,084.12 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 08-19-2002 CD001539 .00 75,000.00 12-09-2004 CD004715 / .00 17,894.12 03-19-2008 CD009447 2,805.34- 16,995.34 03-19-2008 WRITEOFF .00 3,087.76 TOTAL TAX [:REDIT BALANCE OF 1-AX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 107,084.12 .00 .00 .00 V~