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Home My WebLink About04-0406PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of A~d/f//J L~ // ,~',4'1~4~0M~: I ~ No. : ~ /'-(J in/-d~tO (t9 also known as ,9~ :5'' To: :: Register of Wills for the Dece~¢d. ~of C~AL~M~ in the Social Security No. /7~ -.~ - ~d/~ -U4 ~ 26 ~o~hwealth of Pennsylvania The petition of the undersigned respectf~.ll~( represents that: Your petitioner(s), who is/are 18 years ol:~;l'c'L~:age or olde,' r applt~ ~:~ for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in C (]~F_-~ (_/~ A/~ County, Pennsylvania, with h t5 lastfamilyorprincipalresidenceat l, a06 ,c~cra~eY ~-? d~-/d/_/Sr_4~ ~0 (g~r-SC[ (list street, number and municipality) Decendent, then ~ df/ years of age, died d/dVZC/lT~(. ~ ,1.O~c2dO~ , Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) All personal property $ ~/] 000 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: Petitioner ~ after a proper search ha the following spouse (if any) and heirs: Name ascertained that decedent left no will and was survived by Relationship Residence THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COVNTY Or The petitioner(s) above-named swear(s) or affirm(s)that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ~ ~ day of, ....... Register' No. c~-~4-/--/th (,=, FEES Letters of Administration ..... $ Short Certificates( ~ .......... $ Renunciation .... L/~. ........ $ TOTAL __ $ Filed .~/-... ~...7 ....... A.D. Register of Wills - ATTORNEY (Sup. Ct. i.D. No.) ADDRESS P.ONE GRANT OF LETTERS OF ADMINISTRATION _ AND NOW (~J.4~ J?Jf-~ ~-.2 '7 '~ l~ga3-~ ''~, in consideration of the petition on the reverse side hereof,//s-atis~a~tor¥ vro. of hovi, n~g been pr~esented before me, IT IS DECREED that __' ~ ;~at, ~o~~-~_ - is/~ entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to ' ~-~ in the estate of RENUNCIATION In Re Estate of AOOA/,~ L/x ~/.J ~ ~ To the Register of Wills of C~//V/8~---4~ ~f/~ · n~ nnn -~ ~ deceased. t~ E,i~ County, Pennsylvania. The undersigned .~OA.J /}~ fiA. Ot~ {-~'~{~_ of the above d~edent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters hand thi~day of ,2O (Signature) (Address) dSig~t~ture) ;-~l ~, ,' t t .e . lOW ti70 ~ %~- '(~ddrests) / (Signature) (Address) his 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 t~ .~ektificate, $2.00 - Local Registrar '04 APR 26 P3:31 NOV 1 2 2003 ~ttl~ ~o, : - Date IN 4ANENT ,CK INK #29-139 Ronald H UNDER 1 YEAR DATE OF SINTH H ". ~ Minutes (Month. Oay. Yea?) 64 Y"- 25, 1938 Cumberland Carlisle COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH (Coroner) STATE FILE NUMBER SEX SOCIAL SECURITY NUMBE Smallwood a. Hale 3. 176-32-§R014 BIRTHPLACE (Cily and J PLACE OF ~AT H (Ch~k Only o~e -- ~e ias,~l.~ ~ mhor ~) Stale M Fm ~C Car~ ~e, Pennoe 18.. Home bo-uwner Comport 1206 Factory Street ,ES,~NC~ ,7,.s .... ,,.Carlisle, Penna. 17013 ...... ~.) Allen S, Smallwood,Sr. K. Smallwood Cmmall~l [] Remov~mm~,te[] Pennsy3 Cumberland Divorce~ 12, 9-L Gardens 4. November 6~ 2003 .-.;=-.- ~ ~ Black Carlisle Robinson Virginia 23666 Twp. ;umberland County,Penna. ~..M~ *re I~'mlm~l ~llh. [DATE PRONOUNCED OEAD (MOnth. Day. Year) ii:12 P~.__~._. Novembe~ 6, 2003 ~ .__ P_~a~le M ocardial Infarction ~~ b.~Severe CoronarZ Atherosclerosis Remote MI Chief Deputy November Todd C. Eckenrode 6375 Basehore Rd. MechanicsburE, Pa. ~7050 CLAIM FORM RONALD SMALLWOOD ESTATE OF Notice of claim by. THE BON TON in the amount of $. 248.87 ORPHANS. COURT DIVISION OF COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO. 21-04-406 filed pursuant to section 3384, Probate, Estates and Fiduciaries Code Laws of 1972, Act No. 104 effective July 1, 1972 as amended. TO TH~ CLERK OF THE ORP3~ANS' COURT DIVISIONz Enter the claim of THE BON TON 248.87 Date ~ L~ FREEWAY Lock Box 30 ,~.~a~as, TX 75248 19 in the amount of $ against the above entitled Estate. The decedent who resided at PO BOX 526, CARLISLE, PA 17013 (Addres--~7--- died on Written notice of said claim was given to EUNICE H. OLIVER (Date) ,(Pers~ at .. ~.REET CARLISLE_~_pA 17013 (Address) on (Dace) - The basis of aforesaid claim is as follows: (Itemize fully to enable personal representative to make proper investigation). Acct. #109-893-891 Claimant,s Counsel (Name) (Address) FREEWAY TX 75243 PROBATE COURT Cumberland County, State of Pennsylvania Ronald Smallwood, Deceased Case #21-04-406 Proof of Mailinq I mailed the creditors claim to the fiduciary (and attorney, if applicable) as follows: I deposited a copy/copies of the claim with the United States Postal Service in a sealed envelope with the postage fully pre-paid. I used first-class mail. am employed in the county where the mailing occurred. The envelope(s) was/were addressed and mailed as follows: Ms. Eunice Oliver 427 N. West Street Carlisle, PA 17013 Date of Mailing: County of Mailing: Dallas, Texas I declare un~r ~alty of perjury that the foregoing is true and correct. Date: ~t for The Bon Ton P.O. Box 741026 Dallas, TX 75374 PACKE ~E: BTS-COZ ~1F-001 62 RUN ON: 5/ 3/2004 23:53:33 NAME + ADDRESS ADDRESS P0 BOX 526 CTTY STATE CARL]'SLE SPOUSE RONALD SMALLNOOD HOME PHONE DATE OPEN OTHER ACCT PA17013 REQ PAYMENT A/R BAL EMPLOYER CURR PAY ADDRESS MEMO PUR CZTY STATE MEMO CR PHONE: EXT: HOL-BON TOTAL COMMENTS: THE ,-TON NRA - LOP ACCT# 109-893-891 F COLLECTOR 717/249-5515 LZMIT 0 NAC 11/01 ADd CODE ADd AMT 00000000 ZN/COLL 05/04 STATUS %DTLCH 253 CYCLE 79 O MP! 1 0 HIMPZTY 1 0 HIMPILY 0 HZMPZMO 4 253 PREV-BAL PURCHASE PAY/RET F[N-CHRG NEN BAL CUR 248.87 .00 .00 ....................... 4.32 253.19 PAST/DUE AMT-DUE .00 .00 Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 08/02/2004 OLIVER EUNICE H 427 N WEST STREET CARLISLE, PA 17013 RE: Estate of SMALLWOOD RONALD H File Number: 2004-00406 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 08/06/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Counsel Judge ~Sincere~~ GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court CERTIEICATION OF NOTICE UNDER RULE 5.6(a1 Name of Decedent: Date o f Death:k~/~)---6- '> Will No. To the Register: 1 certify that notice of (beneficial interest) 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 : Name Address ~ . ~/ f~ ~ . /'z/~ ~.~c~ .~"~- Notice has now been given to all persons entitled thereto under Rule 5.6(a)except Date: Signature Address J~.'/~ ? Capacity: __ Personal Representative Counsel for personal representative STATUS REPORT UNDER RULE 6.12 Name of D ecedent:~~'LtZ~ ~'~~ Date of Death: /'/.//~/tg.~~r Will No.: ~l ~ 0 °'['] v "' '{_~L/0 ¢ Admin. No.: 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 [--] No If the answer is No, state when the personal representative reasonably believes 2. that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: ao 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 ~-~ No [-] Co Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~gnature Name Address Telephone No. Capacity: ~Personal Representative [--] Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVlDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11-96) NO. CD 004809 OLIVER EUNICE H 427 N WEST STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 176-32-8014 FILE NUMBER: 2104-0406 DECEDENT NAME: SMALLWOOD RONALD H DATE OF PAYMENT: 01/07/2005 POSTMARK DATE: 01/07/2005 COUNTY: CUMBERLAND DATE OF DEATH: 1 1/06/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 t~30.53 TOTAL AMOUNT PAID: $30.53 REMARKS: SEAL CHECK//596 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS RT~E×(~I~ COMMONWEALTH OF I REV- 1 500 USEONLY ~ PENNSYLVANIA OFFICIAL ~/~,~. DEPARTUENT OF REVENUE IFILE NUMB~-~-- -- r~,~.t.~,l~'~ DEPT. 280601 INHERITANCE TAX RETURN c~ ~ - O q -~.ARRISBURG, PA17128-0601 RESIDENT DECEDENT oo*~*~* **:; O~.EP %- I-- Z UJ ILl U.I DECEDENTS NAME (LAST, FIRST, AND MIDDLE iNITIAL) DATE OF DEATH (MM-DD-YEAR)'" DATE OF BIRTH (M~I-DD-YEAR) ,//.~/~ ~' (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER RETURN MUST BE FILEI~N DUPLICATE ~ITH THE THIS REGISTER O FaNtL--L-S~ [~1. Odginal Return E~4. Limited Estate C~6. Decedent Died Testate {A.ach copy of Will) E~9. Litigation Proceeds Received [~2, Supplemental Return ~]4a. Future Interest Compromise (date of death a~er 12-124~2) [~7. Decedent Maintained a Living Trust (A~ch copy of Trust) ~]10. Spousal Poverty Credit (da~e of (~eath between 12-3~-91 and 1-1-95) 1~5, Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME , FIRM NAME (if ^pplicable) TELEPHONE NUMBER 7/7 - ;~ '/~- Y/~ 7~ 1. Real Estate (Schedule A) (1) 2, Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (totat Lines 1-7) OFuneratExpenses&AdministrativeCosts(ScheduleH) (9) ~ (~ *~.,~, ~ ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. OFFICIAL USE ONLY (8) (11) (12) (13) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) ¥ (14) ,¢o s"'3. ~? ¢"o?, ¢.'.'.P SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x ~0 __ (15) 16. Amount of Line 14 taxable at lineal rate x 0 L (16) 17. Amount of Line 14 taxable at sibling rate x ,12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) Decedent's Complete Address: STREETADDRESS . '¢~ "'P. / Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Intarest/Penafiy if applicable D. interest E. Penalty Total Credits (A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) 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) 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. (5B) 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; ............................................ [] [] o. retain a reversionary interest; or .......................................................................................................................... [] 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. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined ~his return, including accompanying schedules and statement, and to the best of my knowledge and belief, it is true, correct and complete. DecJaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. ADDRESS SIGNATURE Of PREPARER OTHER THAN REPRESENTATIVE DATE DATE 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 transfem 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 ES. {}9116 (a) (1.1) (ii)]. The statute does not exemet 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 RS. §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 RS. {}9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP Schedule C-1 or C-2 (Including all suppo~ng information) must be attached for each cfosely-helcl coq~ora~on/partnership interest of the decedent, other than a sole-proprietorship. Sea instructions for the supporting informaaon to be submitted for sole-proprietorships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. (If more space is needed, insert additional sheets of the same size) REV-?06 EX+ (9-0~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT ESTATE OF FILE NUMBER 1. Name of Partnemhip .~ J,(:- .~ '~/k,r~ ~ w ,J,~-~,t~,~.-~_ · Date Busine~ Commen~ Address /2~ ~,~' / ~ ~ . ~ ~ , Busings Re~ing Year Ci~ ~ ~ ~ s ta cobe 2, Federal Employer I.D, Number 3, Type of Business ~-~-5'~0~',<~,/, Product/Service 4, Decedent was a ,E~_General [] Limited partner. If decedent was a limited partner, provide initial investment $ I C. D. 6. Value of the decedent's interest $ ~f"7/~I7/. O <O 7. Was the Partnership indebted to the decedent? ................................. [] Yes ~ No If yes, provide amount of indebtedness $ 8. Was there life insurance payable to the partnership upon the death of the decedent? ..... [] Yes 'g3 No If yes, Cash Surrender Value $ /Y//Z~' Net proceeds payable $ 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 12-31-827 [] Yes '~No If yes, [] Transfer [] Sale Percentage transferred/sold Transferee or Pumhaser 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 i~ 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 If yes, explain 14. Did the partnership have an interest in other corporat ons or partnerships? .............. [] Yes ~No If yes, report the necessap/information on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding 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 appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. PARTNERSHIP AGREEMENT This agreement made this the ~ ~ day of~ 2001, by and between GARY L. STACKFIELD of 126 W. North St., Carlisle, Cumberland County, Pennsylvania, and RONALD H. SMALLWOOD of 1206 Factory St., Carlisle, Pennsylvania, WITNESSETH: WHEREAS, the parties referred to throughout this Agreement as Partners desire to form a partnership, and 'WHEREAS, GARY L. STACKFIELD AND RONALD H. SMALLWOOD shall together own one partnership interest and shall hereafter collectively be referred to as a Partner or the survivor, shall together own one partnership interest and shall hereafter collectively be referred to as "a Partner"; and .WHEREAS, all references in this Partnership Agreement to a Partner shall refer collectively to all owners of the partnership interest and not to the individual owners. NOW, THEREFORE, in consideration of the mutual promises herein contained and intending to be legally bound hereby, the parties agree as follows. : Name and Place of Business: %0~ pIo!J~OU~S "l.(reD ~0 :asO&ncI 'saau~aecI oh~ ~q au~. o~ ou~. tuoa~ uodn ,(urn tp.n-I~ e.rueni,(sm/acI ~o t~lea~uounxxoD o~ ~no~!~ ao .u~!~ ;~a~o q-ons flu ptre 'u.mUal.(SU~aci ,XaunoD ptrelaoqumD ,OlS.!i. :~eD '9~' xofl ~f. xo~es-l' 90~;ll ecI llUqa s~am. snq jo oveid i~d!~u~, d oql pu~ 'd.ntsaou:l:xud u S ~ S ~l IIeqs d.n.Isaau~aud oq~ jo aureu The net profits or net losses of the partnership shall be distn'outable .or chargeable to each of the Partners in the percentages as set forth in this agreement. Net profits of the partnership for any period shall be computed by deducting from the gross profits the amount of disbursements made by or on behalf of the partnership for the usual and customary expenses of conducting the business, taxes charged to the partnership, repairs to or maintenance '?~f facilities, management fees, interest on all ' · mterest-bearmg loans partnership, interest on capital contributions, salaries paid to employees and Partners, rents, depreciation, bad debts and any and all other disbursements made by the partnership incidental to the conduct of the business. Management: Voting power in directing the management and conduct of the business of the partnership shall be held by the parties as set forth herein. Unless otl~erwise provided in this Agreement, all decisions shah be ma~e by unanimous vote. Books and Accounts: The partnership books and accounts shall be maintained at the address set forth herein. Each Partner shah have access to the partnership books' and accounts., at all reasonable times. ~ Duties: Each partner shall have such partnership duties as shall be determined from time to time by the Partners. No compensation shall be paid by the partnership to the partners for the performance of such duties. Transfers: A Partner shall not sell or in any other way transfer his partnership interest during his lifetime without first offering such interest for sale to the other Partner by a wril~en notice addressed and delivered to the other Partner. The notice shall set forth the proposed sale price and terms of sale. Thereupon, the other partner shall have a period of thirty (30) days to notify the selling Partner of his intention to purchase the interest offered for sale pursuant to the terms of that offer, or for the purchase price set forth herein according to the payment terms set forth herein, at his option. If the interest is not pttrchased by the other Partner, then the selling Partner may sell his partnership interest to any person, provided that said interest shall not be sold at a lower price or on more favorable terms than the price and terms offered to the other Pgrtner, without first re-offering said interest to the other Partner in accordance with this paragraph. If the selling Partner does not sell his partnership interest within the six (6) month period, he shall thereafter not sell or in any way transfer such interest without first re-offering such interest for sale to the other Partners. Death: a. It is agreed that any controversy arising in connection with this · . Partnership Agreement may be submitted to binding arbitration pursuant to the Uniform Arbitration Act, 42 Pa. Cons. Stat. 7301-7320, a, hereinafter provided. The parties further agree not to commence any suit, action or proceeding at l~v or in equity based upon any claim which is hereby made subject to arbitrati~~, and this agreement may be presented as a complete defense to any su~h litigation. The arbitration provisions contained herein shall survive the termination or expiration of this contract. b. Any partner may demand that a dispute or claim be submitted to arbitration. The demand must include the name of the arbitrator selected by the Partner demanding arbitration, together with a statement of the matter in controversy. c. Within thirty (30) days of such demand, the other Partners shall name their arbitrators. The arbitrators named by the Partners shall then select a third neutral arbitrator. If the other Partners fail to name an arbitrator, the arbitrator shall be appointed by a court of competent jurisdiction upon application d. Each partner shall bear its own arbitration costs and expenses and shall contribute a percentage as set forth herein of the costs and expenses%of the neutral arbitrator. The costs and expenses of the arbitrator shall include, but not be limited to, the time spent preparing, hearing and deciding the dispute, and any additional costs relating to postage, photocopying, express and messenger delivery charges, long distance telephone charges and travel. cr- Upon the death of either Partner, the surviving children of each p~'ty will inherit the partnership as follows: ' ' A. For Gary L. Stackfield to his three children: Aunye Stackfield, Gary A' Stackfield and Kyla Stackfield in equal shares. B. For Ronald H. Smallwood to his two children: Ronald K. Smallwood and Laurie J. Smallwood in equal shares. Dissolution: This partnership may be dissolved at anytime by any of the Partners with a six months notice from any partner. Rights Upon Dissolution: In the event of dissolution, a complete, adequate and proper accountin~ shall be made of the assets, liabilities and income of the partnership. The assets of the partnership shall first be used to pay all the debts of the partnership. After such payment, all remaining assets shall be distributed to the Partners as set forth herein. Bank Accounts: The partnership shall maintain a bank account or bank accounts at such ba~nk or banks as may be agreed upon by the partnership. Checks and drafts shall be drawn on the partnership bank account or bank accounts for partnership purposes only and may be signed by any one of the Partners. The Partners covenant and agree that any partner may execute any further instruments and will perform any actions, which are or may become necessary to effectuate and to carry on the partnership created by this Agreement. The purpose of this paragraph is to alleviate the necessity of every partner signing each and ever3r document. ' ' Restrictions: No Partner may, without the consent of the other partner: a. Borrow money in the partnership name for partnership purposes, or utilize collateral owned by the partnership as security for such loans; b. Assign, transfer, pledge, compromise or release any of the claims of or debts due to the partnership except upon payment in full, or arbitrate or consent to the arbitration of any of the disputes or controversies of the partnership; c. Make, execute or deliver any assignment, for the benefit of creditOrS or any bonO, confession of judgment, chattel mortgage, deed, guarant.~,. indemnity bond, surety bond, or contract to sell or contract of sale of all Or substantially all of the property of the partnership; d. Lease or mortgage any partnership real estate or any interest therein or enter into any contract for any such purpose; e. Pledge or hypothecate or in any manner encumber his interest in the partnership, except to the other parties to this Agreement; f. Become a surety, guarantor or accommodation party to any obligation on behalf of the partnership. Contingencies: This Partnership Agreement is not subject to any contingencies Arbitration. IN' I~rNESS WHEREOF, the parties hereby have hereunto set tl~r hands and seals the day and year first above written..: ~ AL)~a__ry L~. Stac]~eld// ~:E ~o6[tld.~l~..§~ta llwood~ SEAL). ~, 1065 MAINTENANCE SERVICE MAINTENANCE I U.S. Return of Partnership Income I ForCalendaryaar2OOl,ortaxyearbegi.niog .2COl. andendlng , I 2001 & S MAINTENANCE SERVICE FACTORY ST. O BOX 526 ~ 1206 25-1890393 561720 h PA 17013 G - k.P. Jl~G~pJ~ble boxes: (1) __ (2) Final return (3) Name change H (4) __ Check accounting method: (1) ~ Cash (2) E~] Accrual (3) E~ Other (specify) · Number of Schedules K*I. Attach one for each person who was a partner at any time during the tax year · 06/01/2001 357. (5) Amended return Caution: Include only trade or business income and expenses on lines la through 22 below. See the instmctions for mom information. 1 a Gross receipts or sales ................................................................................... la 16r 105~'I~ b Less returns and allowances .......................................................................... lb lc 16t105. 2 Cost of goods sold (Schedule A, line 8) ........................................................................................................... 2 ~ 3 Gross profit. Subtract line 2 from line 1 c ................................................................................................ 3 1 6 ¢ 1 0 5 · u° 4 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule) ............................................. 4 _c 5 Net farm profit (IDES) (attach Schedule F (Form 1040)) 6 Net gain (loss) from Form 4797, Part Il, line 18 ........................................................................................... 7 Otherlncome (loss) (attach schedule) 7 8 Total Income (loss). Combine lines 3 through 7 ............................................................................................. 8 16 f 105 · g Salaries and wages (other than to partners) (less employment credits) ............................................................... ~ 10 Guaranteed paymentstopartners ............................................................................................................. 10 ~ 11 Repalrsand maintenance ........................................................................................................................ 11 ~E 12 Bad debts .................................................................................................................................................. 12 -- 13 Rent 13 _o 14 Taxes and licenses 14 _~ 15 Interest .................................................................................................................................................... 15 15 I Depreciation (if required, attach Form 4562) ~:~::: i 17 Depletion (Do not deduct olland gas depletion.) 17 18 Retirement plans, ets 18 ~ 19 Employee benef'~ programs lg ~ 20 Otherdeductions(attachschedule) ~.~...$.~c~:~(~]~(~'~....~. .............. 20 6r180. 21 Total deductions. Add the amounts shown in the far right column for lines 9 through 20 .................................. 21 6 f ! 80, 22 Ordinary Income (loss) from trade or business activities. Subtract line 21 from line 8 ................................................ 22 9 r 92 5 ~ald .io..tu., '~--'"-~' ~..¢-.c--.'~.. ':' . D 01/28/02 · ,,~-,.,,n~o.,~ ·1~ P00122142 ~reparer's m~', .... ~Daniel J. P~ily CPA "~ e. ~22-2430893 Jse0nly ~.~,.~°~"1'~. R'505 S. Lenola Rd Suite#102 ~..... (856)235-8440 ~P=~o Moorestown NJ 08057-1549 JWA For Paperwork Reduction Act Notice, see separate Instructions. Form 1065 (2001) Fgrmt065[~001) S & S MAINTENANCE SERVICE 25-1890393 Page2 l:::ii~/~/ Cost of Goods Sold (seepape18ofthe nstructions) Inventory at beginning of year ......................................................................................................................... Purchases less cost of items withdrawn for personal use Coat of labor d"iona' 7 iiiiiiiiiiiiiiiiiiiiiiiiiiii ............................................................... Total. Add lines 1 through 5 Invento~ at end of year .............................................................................................................................. Cost gl goo~s sola. Subtra~ line 7 from line 6. Enter here and on page 1, line 2 Check all methods used for valuing closing inventou: (i) ~ Cost as described in Regulations section 1.471-3 (11) ~ Lower of cost or manet as described in Regulations se~ion 1.471-4 (111) ~ ~her(speci~method used anda~chexplenation)~ b Check this box if thers was a writedown of'subnormar goods as described in Regulations section 1.471.2(c) ................................................... ·[~] e CheckthisboxfftheLIFOInventorymethodwasadoptedthistaxyearforanygoods (if checked, attach Form 970) .................................... ·[~] d Do the roles of section 263A (for property prodoced or acquired for resale) apply to the partnership? ............................................. t-'--I YeI [~] No e Was thers any change in determining quantities, cost or valuafions between opening and closing inventory? .................................... i'~1 yes I!~es · attach explanation. I=!~!:~;~,,:~li~!B!il Other Information What type of entity is firing this return? Check the applicable box: a ~ Domesticgeneralpartnership b [~ Domestic limited partnership r-~ Domestic limited liability company d ~ Domestic limited liability partnership e ~ Foreign partnership I ~ Other· Are any partners in this partnersh p also partnerships? 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 [ts owner under Regulations sections 301.7701 -2 and 301.7701-37 If yes, see instructions for required attachment Is this partnership subject to the consolidated audit procedures of sections 6221 th rough 6233? If 'Yes,' see Designation of Tax Matters Partner below Does this partnership meet all three of the following requirements? The Partnership's total receipts for the tax year were less than $250,000; T he partnership s total assets at the end of the tax year were ess than $600,000; and Schedules K'I ars flied with the rstum and furnished to the partners on or before the due date (including extensions) for the partnership return. - f 'Yes, the partnersh p s not required o comp e e Schedules L, M-l, and M-2; Item F on page I of Form 1065; or Item J on Schedule K-1 Ooes this partnership have any foreign partnem? If"Yes,' the partnership may have to file Forms 8804, 8805 aod 8813. See page 20 of the instructions Is this partnership a publicly traded partnership as defined in section 469(1(}(2)? Has this partnership filed, or iS ,required to tile Form 8284, Application/or Regist;;il(~';i';'~'~'i;li;;'~ ..................................................... At any time during calendar year 2001, 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 secu dries accoun, or other financial accouut)'~ See page 20 of the instructions for exceptions and firing requirements for Form TD F 90-22.1. If'Yes,' enter the name of the foreign country. · Buring 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 of the instructions Was there a distribution of property ora transfer (e.g. by sale or death) ora Partnershil~';l~i;;;;i'(i;;if~g'tl~;'i;; ~*;;~ .......................................... If 'Yes,' you may elect to ad'ust the bas~s of the partnersh p's assets under section 754 by attaching the statement described under Elestlons Made By the Partnership on page 8 of the instructions Enter the number of Forms 8865 attached to this return .................. · 7 8 g 10 12 Designation of Tax Matters Partner (see page 20 of the instructions) Enter below the general partner designated as the tax mattem partner (TMP) for the tax year of this return: Name of designated TMP · RO~ALD S_M. ZLLT,~OOD 1206 FACTORY ST. Ident~lng nomberofTMP · 176-32-8014 NO X X X X X X X X X X Address of · desienatedTMP CARLISLE ~ PA. 17013 JWA 111011 Form l06E,(2001) Form !,065 (20~!) S & S MAINTENANCE SERVICE 25-1890393 Parle3 I,~,,.~ ~1 Partners' Shares of Income, Credits, Deductions etD. (e) Distributive share Items (b) Total I Ordinary income (loss) from trade or business activities (page 1, line 22) ................................................ I 9 2 Net Income (loss) from rental real estate activities (attach Form 8825) 2 3 S Gross income from other rental activities 3L~[- b Expenses from other rental activities (attach schedule) ....................... e Net income (loss) from other rental activities. Subtract line 3b from line 3a ................................................... 3e ~. 4 Portfoliolncome {loss): a Interest income 4s ~ b Ordinary dividends 4b · e Royalty income 40 d Net short-term capital gain {loss) (attach Schedule D (Form 1065)) ............................................................. 4d _¢ e (1) Net long-term capital gain (loss) (attach Schedule O (Form 1065)) ............................................................ 4e(1) (2) 28% rate gain (loss) · (3) Qualified 5"year gain · f Other portfolio income (loss) (attach schedule) 4l 5 Guaranteed paymentsto partnem 6 6 Net section 1231 gain (loss) (other than due to casualty or theft) (attach Form 4797) ....................................... 7 Other income (loss) (attach schedule} ...................................................................................................... 7 =~ 8 Charitable contributions (attach schedule) 8 ; g Section 179 expense deduction (attach Form 4562) g I r 7 6 0. ~ 10 Deductions related to portfolio income (itemize) 10 11 Other deductions (attach schedule) 11 (1) From partnerships to which section 42(j)(5) applies 12a(1) ~ (2) Other than on line 12a(1) ..................... 12a(2) ~ b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468) 12b s Cred~ {other than credits shown on lines 12a and 12b) related to rental real estate activities ........................... 12c d Credits re[atad to other rental activities 12d 13 Other credits ........................................................................................................................ 13 i! 14a Interestex~enseoninvestmentdobts b (1) ................................................................................................... 14a Investment income included on lines 4a, 4b, 4c, and 4f above ............................................................... 14b(1 {2) tavestment expenses included on line 10 above ................................................................................ 14b(2) , ~', 1§ a Net earnings (loss) from serf-employment ~ ............................................................................................. 15e 8r165. ~,,E, E b Gross farming or fishing income 15b s Gross nonfarm income 15c ! 6 r 1 0 5 ~ ~ 16 a Depreciation adjustment on property placed in sen/ice after 1986 ......................................................... 1 ij~= b Adjusted gain or ,DSS 16b a Depletion (other than oil and gas) 16e eD.-- d (1) Gross income from oil, gas, and geothermal properties .................................................................... 18d(1) .="< (2) Deductions allocable to oil, gas, and geothermar properties 16d(2 ~ e Other adjustments and tax preference items (attach schedule) .......................................................... 16e 17 e Name of foreign countu or U.S. possession · b Gross Income from all sources 17b e Gross income sourced at partner level e 175 ~e d Foreign gross income Sourced at partnership level: .......... §:~:~!~.~ ...... o (1) Intarastexpense· (2) Other ..................................... · ~' I Deductions allocated and apportioned at partnership level to foreign source income: (1) Pa~e · (2) Listedcaeg~(aeach~eh.) · (2) ee~r~taU~.· 17f(3) g Total foraign taxes (check one): · Paid ~-1 Accrued~-~ ..................................................... 17g h Reductlo~ in taxes available for credit (attach schedule) 17b 18 Section59(e)(2)expenditures:aType· bAmount · 18b ~ : 20 Othertax-exemptincome ~ 21 Nondeductible expenses 22 Distributions of money (cash and marketable securities) 22 6f206 23 Distributions O! property other than money 23 24 Other items and amounts required to be reported separately to partners (attach schedule) .~=~:~::E~:~:':~'": ,~~:~+'~ ' '~' Form 106.5 (2001) F0rm10~ S & S MAINTENANCE SERVICE Anal sis~)f Net Income Loss 25-1890393 I Net income (loss). Combine Schedule K, lines 1 through 7 in column (b). From the resuR, subtract the sum of Schedule K, llnes8through11,14a, 17g and18b .................................. . ..... [ I I 8~165. 2 Ana/ysls by(0 Corporate ndividual r ( ) individua~ ......[ (v) Exempt pa n.r p.: r I (activa i (passive I , , a nersn,p b Less allowance for bad debts . 3Inventors 4U.S. government obligations ............... 6 ~her currant assets (a~ach schedule) 7 Mo~gage and real estate loans ~ r 00 0. 8 ~her investments (aflach schedule) 9a Buildings and ot~er depreciable assets b Less a~umulated depreciation lOa Depletable assets b Less accumulated depletion 11 ~nd (net of any amoAiution) ........ 12a IntangibM assets (amo~izable one) ........ b Less accumulated amo~ization 13 ~her asseb (aEach schedule) .............. 14 Total assets Liabilities and Capital 4 357. 15 Accounts payable ......................... 17 ~hercurrantliabil~ies(a~achschedule) .. 18 Allnonrecou~e loans 20 ~her liabilities (a~ch schedule) ............ 21 PaAnem' ~p~al accounts ~ 0 ~ 357. ~ Reconciliation of Income (Loss) ~r Books ~th Income (Loss) ~r Return (Not required ff Ouestion 5 on Schedule B is answered ~es.") 1 Netincome (loss) per books Income included on Schedule K, tines 1 through 4, 6, and 7. not recorded on books this year (~iemize):. 3 Guaranteed payments (other than health insurance) .................................... 4 E×penses racorded oo books this year not included on Schedule K, lines 1 through 11.14a, 17g, and 18b (~temize): a Depreciation $ b Travel and entertainment $ Anal sis of Partners' Ca ital Accounts Balance at beginning of year ......................... Capital contributed dudng year ................... 2~ 398 Not income (loss) per books .......................... 9~925 Other incraases (itemize): 5 Add lines I throu h 4 ...................... Income recorded on books this year not included on Schedule K, lines 1 through 7 (itemize): Tax-exempt interest $ 7 Deductions included on Schedule K, lines 1 through 1 I, 14a. 17g, and 18b, not charged against book income this year (itemize): a Depreciation $ 1 r 760 Sec, 179 exvense oassed thru to Darcner$ Add lines 6 and 7 .................................. Income (loss) (Analysis of Net Income (Loss), from line 5 .................. stion 5 on Schedule B is answered b Property 7 0therdecreases(itemize): Sec. 17c/') expense passed thru to ~' 8 Add lines 6 and 7 partners.; 1~760. lr760. 'es_a___ 6r206. lr760. 7 966. 4,357. Form 1(~ (2001) 4562 Depreciation and Amortization (Including Information on Listed Property) OTtIER · See separate instructions. · Attach this form to your return. ~INTENANCE AT CARLISLE S~....~.~o~:.:& S MAINTENANCE SERVICE ~RADE SHOWS J~-~5 1890393 Ii~i!]~il E ect On To Expense Certa n Tang hie Propert~ Under Section 179 Note: If, I Maximum dollar limitation. If an anterpdse zone business, sea instructions ......................................................... 2 Tote]cost ofeaction 179 property placed in service (see instructions) ............................................................... 3 Threshold cost of section 179 property before reduction in limitation .................................................................. 4 Reduction In limitation. Subtract line 3 from line 2. If zero or less, enter .0- . ....................................................... 5 Dollar limitation for tex year. Subtract line 4 from line 1. If zero or less, enter -0-. If marded filing separateh/~ see instructions ................................................................................................................ COIN MACHINE 24r000. lr760. $2oo,~0 24,000. 7 Listed property. Enter amount from line 27 .............................................................. 8 Tote] 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 line 8 ........................................................................... 10 Carp/over of disallowed deduction from 2000 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 ........................... 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 ................................. lt760. lt760. 9r925. 760. 13 Cam/over of disallowed deduction to 2002. Add lines 9 and 10, less line 12 ........... · J 13 J Note: Do not use Part II or Part III below for listed property (automobiles, certain other vehicles, cellular telephones, certain computel~, or property used for entertainment, recreation, or amusement). Instead, use Part V for listed property. I!i~i JJiiJ MACES Deprec at on For Assets Placed in Service Only Durin~l Your 2001 Tax Year (Do not include listed property.) Section A - General Asset Account Election 14 If you are making the election under section 168(i)(4) to group any assets placed in service during the tax year into one or more general asset accounts, check this box. Sea instructions Section B - General Depreciation System (GDS) (See instructions.) 15 a 3-year property :...:~.~.:.~.:.:o...~...~.~:~.~:. b 5-year property !i:i:~:~:~:~::: ::~: .~: ::: o 7.year property ...................... ~- d lO-yearproperty ~:~ ~ i e 15-year property ::::::::::::::::::::::::::::::::::::::::::::::::::::::: g 25-year property :::::::::::::::::::::::::::::::::::::::::::::::::::::: 25 yrs. S/L h Residential rental property / 27.5 yrs. MM S/L / 27.5 },rs. MM SA_ / 39 yrs. MM S/L. i Nonresidential real property / MM S/L Section C - Alternative Depreciation System (ADS) (See instructions.) 16ab Class12.yearlife 12 yrs. ,~ c 40-year 40 yrs. MM S/L I ~ii~i~l Other Depreciation (Do not include listed property.) (See instructions.} 17 GDS and ADS deductions for aseats placed in service in tax years beginning before 2001 ............................. 17 18 Property subject to section 168(0(1) election ........................................................................................ 1918 19 ACRS and et her depreciation ~i~ Summary (See instructions.) Z0 Usted property. Enter amount from line 26 ............................................................................................... ~0 21 Total. Add deductions from line 12, lines 15 and 16 in column (g), and lines 17 through 20. Enter here and on the appropriate lines of your return. Partnerships and S corporations - sea instructions .................. 22 For easets shown above and placed in service during the current year, enter the 22 i::!~~i~ ~y.'..~g · portion of the basis attributable to section 263A costs .... ~ ~625~ ....... ~2.29-0~ LHA For Paperwork Reduction Act ivctice, see the separate instructions. Form 4~{12 (2001 Form 4562 ~00f)S & S MAINTENANCE SERVICE 25-1890393 Page; f Pfl~!~:?~ Usted Property (Include automobiles, certain other vehicles cellular telephones, certain computers, and property used for entertAInmant, recreat on, or amusement.) Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 23a, 23b, columns (a) throuqh (c} of Section A, all of Section Br and Section C if applicable. Section A - Depreciation and Other Information (Ca~tion: See instructions for limits for passenger ~tomobiles.) 23a O0y0uhavoevidencet0supp0rtthebusiness/investmentuseclaimed? [-~Yes ['--'~Nor23blf'yse,'istheevldancewritten?C---Iyes[:~N0 (c) (a) (b) Date I (o') Type of property place~l in Business/ I Cost or (list vehicles first) serv ce investment use percentage ether basis 24 Property used more than 50% in a qualified business use: 25 Property used 50% or leas in a qualified business use: I(e) I I Basis for depreciation Recovery uae only) ilo Od Method/ DepreciaUonI Elected Convention deduction section 179 cost S/L. 26 Add amounts in column (h). Enterthetotaihereandonline20 page1 ................................................. I 26 27 Add amounts in co[umn (i). Enter the total here and on line 7 pa~e 1 ................................................. I 27 I 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) ~ ~8 Total business/investment miles driven during the Vehicle Vehicle Vehicle Vehicle Vehicle Vehicle year (do not include commuting miles) 29 Total commuting miles ddven during the year }0 Total other personal (noncommuting) miles ddven }1 Total mites driven during the year. Add lines 28 through 30 ............................... Yes No Yes No Yes No Yes No Yes No Yes No }2 Was the vehicle available for personal use .:. dudng off-duty hours? .............................. }3 Was the vehicle used primarily by a more than 5% owner or related person? ........... ~4 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 ~n exception to completing Section B for vehicles used by employees who ere not more than 5% owners or related persons. 35 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employses? ............. 36 Do you maintain a written policy statement that prohibits personal use of vehiclas, except commuting, by your employees? See instnJctions for vehicles used by corporate officers, directors, or 1% or more owners .......................................... 37 DO you treat all use of vehicles by employees as persona[ use? 38 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? 39 DO you meet the requirements concerning qualified automobile demonstration use? ................................................................... Note: If your answer to 35, 36, 37, 38, or 39 is "Yes," do not complete Section B for the covered vehicles. I::i~i~t.~ Arno. zat on (a) ,(~b),. (c) (d) (e) 40 Amortization of costs that beeins durin9 )'our 2001 tax year: :12 TA~t~i~td~:m°fo~n~t2~h;otluml~n~ i~r~nYs~rlUjrc~0o~ls::oa~iwY~:rre to report :'2 Form 4562 (2001) SCHEDULE K-1 (Form 1065) ~.t~.~, re,ye.u. Sev~a, beginning Partnm's Iden~;¥.g number IP Partner's name, address, and ZIP code RONALD SMALLWOOD 1206 FACTORY ST. CARLISLEr PA. 17013 Partner's Share of Income, Credits, Deductions, etc. For calendar year 2001 or tax year ~ 2001, and ending 176-32-80'14 A This partneris a ~ generalpartner ~ limited partner F--1 limited liability company member B Whattypeofentityisthispartner? I~ Individual C Is this partner a {~] domestic or a E~] foreign partner? percentage of: Profit she ring % 5 0.0 0 0 0 0 0 0 Loss sharing ......... % 50 o0000000~ Ownership of capital % 50.0000000? E IRSCente~whereparbme~hlpflmdmtum: Cincinnatir OH 2001 Padnershlp's Identifying number ~. 25~-1890393 Partnership's name, address, and ZIP code & S MAINTENANCE SERVICE O BOX 526 , 1206 FACTORY ST. ~ARLISLE~ PA 17013 Partner's share of liabiritles: Nonrecoume ................................. Qualified nonrecourse financing ............ Other .......................................... $ OMB No. 1545-0099 G Tax shelter registration number H Check here ff this partnemhlp is a publicly traded partnership as defined in section 469(k)(2) ................................................ I Check applicable boxes: I1) [~ Final K-1 (2) E~ Amended K-I J Analysis of partner's capltalaccount: (c) Partner's share of lines (e) Capital account at end (o) Capital account at (b) Capital contributed 3, 4, and 7, Form 1065, (dj Withdrawals end of year (combine beginning of year du dng year Schedule M-2 distributions columns (a)through lr199. 4,083. 3r103. 2r179. (c) 1040 filers enter the (a) Distributive share item (b) Amount amount in column (b) on: I Ordinary income (loss) from trede or business activities ............................ 4¢963, 3 Net income (loss) from other rental activities .................................................... 4 Portfolio income (loss): a Interest $ch. B, Part I, line 1 b Ordinary dk, idends ................................................................................... ~ Sch. B, Part II, line 5 s Royalties ' Sch. E, Part I, llne 4 d Net short-term capital gain (loss) ................................................................ Sch. D, line 5, COL e 1 Net long-term capital gain loss (2) 28% rate gain (loss) Gch. D, line 12, col. (g) (3) Qualified 5-year gain Line4 of worksheet for ~ch. D, llne2O I Other portfolio inccme (loss) (attach schedule) Ente~ on applicable lirme of yeur tatum fi Guaranteed payments to partner 8 Net sec. 1231 gain (loss) (cther than casualty or theft) .............................. } s~ p.o. e of P~'. In*tree.for s~u~. I(-I (Fo~ 1 7 Other income (loss) (attach schedule) ............................................................ Ente~ on aoDrlCeble line of your tatum 8 Charitable contributions (attach schedule) ............................................... Scb. A, line 15 or 16 g Section 170 expense deduction 8 8 0 10 Deductions related to portfolio income (attach schedule) [, See 7 end 8 of Pari~m~m 11 Other deductions (attach schedule) .........................................................J (Fem~ 13 Other credits 14 o Interest expense on investment debts Form 4952, line1 b (1)investment income included on lines 4a, 4b, 4c, and 4I above ................. ~[ see a of Purina~, Ins~mJcflom (2)Investment expenses included on line 10 above~ Ior Schedule K-1 (Fom~ 1065) 10 a Net earnings (loss) from self-employment 4 r 0 ~ 3 · Sch. SE, Section A or B b Gross farming orfishingincome c Gross nonfarm income 8r053.) forScbeduleK-1¢orm1065) 10 a Depreciation adjustment on property placed in service after 1986 b Adjusted gain or lOSS/ see Parker'. Insta~6on. k~ I g Tax-exempt interest income Form 1040, llne 8b 20 Other tax-exempt income 21 Nondeductible 8es 9 and 10 of In ~l~P~on. for 8¢k~dule K'I 22 Distributions of money (cash and marketable securities) ............................. 3 ¢ 1 0 3. ~=o,m 2Q Distributions of property other than money ........................................................ JWA For Paperwork Reduction Act Notice, see Form 1065 Instructions. No Information Required for Page 2 Schedule K-1 (Form 1065; .%":3 2001 1 SCHEDULE K-1 (Form 1065) Padner's Identifying number · Partner's name, address, and ZiP code 162-48-0353 beginnin~ Partner's Share of Income, Credits, Deductions, etc. For calendar year 2001 or tax year ,2001, and ending , Partnershlp's identifying number · Partnership's name, address, and ZiP code limited partner Individual r-~ foreign partner? GARY L. STACKFIELD 126 W. NORTH ST. CARLISLEr PA. 17013 A This partneris a r~ generalpartner ~ limited liability company member B Whattypeofentityisthispartner? · C Isthiapartnera ~ domesticora D Enter partner's pementage oft Profit shadng 50.0000000% L0SS sharing % 50 · 0000000% Ownership of capital % 50°0000000% E ,P~Ce~terwhemparmemhipflledmtum: Cincinnatir OH OMB NO. 1545-0099 2001 25L1890393 & S MAINTENANCE SERVICE O BOX 526 , 1206 FACTORY ST. .ARLISLEr PA 17013 Partner's share of liabilities: Nonrecourse .................................... $ Qualified nonreccurse financing ............ $ Other ............................................. $ Oe G Taxsheiter registration number · H Check here if this partnership Is a publicly traded partnership as defined in section 469(k)(2) ................................................ r~ I Check applicable boxes: ¢11 r~] Final K-1 [2i E~ Amended K-1 J Analysis of partner's caghalaccount: (c) Partner's share of lines (e) Capital account at end (a) Capital account at (b) Capital contributed 3, 4, and 7, Form 1065, (d) Withdrawals and of year (combine beginning of year during year Schedule M-2 distribuUons columns (a) through 1 r 199. 4 r 082. 3r 103 2 r 178. (c) 1040 filers enter the (a) Distributive share item (b) Amount amount in column (b) on: I Ordinary income (loss) from trade or business activities 4 r 9 6 2 '~ see page u or pm,m~, 2 Net income (toss) fi~om rental real estate activities ..........................................J for 8d~dule K-1 (Fom~ 3 Net income (loss) from other rental activities 4 Pofffolio income (toss): a Interest Sch. 0, Part I, line 1 b Ordinary dividends Sch. B, Part II, line 5 c Royalties Sch. E, Part I, line 4 d Net short-term capital gain (loss) Sch. D, line 5, col. (f).: ~ e (1) Net long-term capita gan(oss) Sch. O, line12, col.(f) _= (2) 28% rate gain (loss) Sch. D, line 12, cot. (g) (3) Qualified 5-yea r gain un. 4 of work~;'~et for ~ch. O, line 2~ f Other portfolio income (loss) (attach schedule) Ear. on appa=abie lithe of your tatum 5 Guaranteed payments to partner ................................................................. See p~ge U o~ Parb~er'l Ir~tmogor 6 Net sec. 1231 gain (loss) (other than casualty or theft) ......................................... } for Schedule K-1 (Fern1 7 Other income (loss) (attach schedule) ............................................................... Unto- on app,~me ,~ of ~ur r~tum 8 Charitable contributions (attach schedule) ..................................................... Sch. A, line 15 or 16 _~ it Section 179 expense deduction 8 8 0 .; ~ c]*' 10 Deductions related to portfolio income (attach schedule) ~n~Pa~ for ~c, hedule K-1 11 Other deductions (attach schedule) (Fo~ ~ca~ U~' 14a Interast expense on iavestment debts Form4952,1inel >e,~ b (1)investment income included on lines 4a, 4b, 4c, and 4t above [ See ~ e o~p~n,~, = ~ (2)Investment expenses included on line 10 above __~...r for ~chedule K-1 (Fom~ {~ 15a Neteamings(Io~s)fromseff~employment 4r082. Scb. SE, SectionAorB ,. b Gross farming or fishing income t See page g of p~'tr,~, Ir~tn~ot;o~ 0 c Gross nonfarm income 8 r 0 5 2.~' forSchedule K*I (Form i~~ 16a Depreciation adjustment on property placed in service after 1986t b Adjusted gain or loss see Pmtne~ ]n~b'.JOflon~ for ........................... Schedule K-T (F~ 1caS) w~ e Other adjustments and tax preference items (attach schedule) Inlt~ceons for Form 62.81 I g Tax'exempt interest income .................................................................... Form 1040, line 8b ~ 2120 Nondeductibleot he r tax.-exempt incOmeexpenses ........................................................................ ] Seep~n,~,9 told 10 of Pmtrm~ 22 Distributions of money (cash and marketable securities) .......................... 3 r 1 0 3. (Fo.~ 23 Distributions of property other than money ........................................................ JWA For Paperworit Reduction Act Notice, see Form 1065 Instructions. No Information Required for Page 2 Schedule K-1 (Form 10§5~ -"::: 2001 2 $ & S WAINTENANCE SERVICE 25-1890393 Form 1065 Other Deductions Statement 1 Description UNIFORMS NIGHT SECURITY EXPENSE MAINTENANCE SUPPLIES & LUMBER GAS & TOLLS OFFICE SUPPLIES & EXPENSE LEGAL & ACCOUNTING INSURANCE EXPENSE MISCELLANEOUS EXPENSE Advertising Amount 728. 3,350 59O 146 156 528 456 60 166 Total to Form 1065, Line 20 6,180. Schedule L Other Current Assets Statement 2 Description LOAN RECEIVABLE - GARY STACKFIELD Total to Schedule L, Line 6 Beginning of Tax Year End of Tax Year 1,000. 1,000. Form 1065 Partners' Capital Account Summary Statement 3 ~artner Beginning Capital Schedule M-2 With- Ending Number Capital Contributed Lns 3, 4 & 7 drawals Capital 1 0. 1,199. 4,083. 3,103. 2,179. 2 0. 1,199. 4,082. 3,103. 2,178. '~.3tal 0. 2,398. 8,165. 6,206. 4,357. Statement(s) 1, 2, 3 065 Principal business activity MAINT. SERV. Principal product or service MAINTENANCE 561720 U.S. Return of Partnership Income OMBNo. 1545-0099 For calendar year 2002, or tax year beginning and ending ............... 2002 · See separate instructions. IRSother.Use the Name of pannership D Employer Identification number label. S & S MAINTENANCE SERVICE 25-1890393 Number, street, and room or suite no If a PO box, see page 14 of the instructions, : E Date business started wiSe)print PO BOX#526 , 1206 FACTORY ST. 6/01/01 or type. ot,31 asses s e page 14 of CARLISLE PA 17013 $ 5~106 Check applicable boxes; (1)BI taitialretum (2) FI Final retum (3)[~ Name change ~]} E~ Address change (5) B Arnended return Check accounting method: (1) ~ Cash (2) E~ Accrual (3)II Other (specify) · Number of Schedules K-1. Attach one for each person who was a partner at any time during the tax year · 2 ( aution: Include only trade or business income and expenses on lines la through 22 below. See the instructions for more information. l)eductlons .ee pg 15 of 2 3 Gross profit. Subtract line 2 from line lc 4 Ordinary inc. (loss) from other partnerships, estates. & trusts (att sch.) 5 Net farm profit (loss) (attach Schedule F (Form 1040)) 6 Net gain (loss) from Form 4797, Part l I. line 18 Gross receipts or sales 3 0 Less returns and allowances Cost of goods sold (Schedule A, line 8) 7 Other income (loss) (attach schedule) 8 Total Income (loss). Combine lines 3 through 7 ..... 9 Salaries and wages (other than to partners) (less employment credits) ........ 10 Guaranteed payments to partners 11 Repairs and maintenance 12 Bad debts '13 Rent 14 Taxes'ar;~ ii~;~ses 15 Interest 16a Depreciation (if required, attach Form 4562) 16a b Less depreciation reported on Schedule A and elsewhere on return 16b 17 Depletion (Do not deduct oil and gas depletion.) 18 Retirement plans, etc. 19 Employee benefit programs 20 Other deductions (attach schedule) See ,$'c~t ~. Total deductions. Add the amounts shown in the far right column for lines 9 through 20 21 30~140 30~140 30~ 140 51868 5,868 Sign ~tere Paid Preparer's Use Only 22 Ordlnar~ income (loss) from trade or business activities. Subtract line 21 from line 8 2 4 t 2 7 2 Under penalties of perjury. I dec,are that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge BOX 423 and belief, it is true, correct, and completa Declaration of preparer tother than general partner or limitad liability company information of which preparer has any knowledge · Date Check if self-employed · address, and ZiP code MOORESTOWN, NJ 08057-0423 ember) is based on all May the IRS discuss this return with the preparer shown below (see instructions)? r~ Yes F'] No BN · 22-2430893 nP~ne 856-296-9473 F or Paperwork Reduction Act Notice, see separate instructions. Fon~ 1065 (2002) ~ SMA0393 02/03/2003 2:5fi PM ~orm1065 (2002) S ~ S MAINTENANCE SERVICE 25-1890393 Page2 SCl'm~i~i~ Cost of Goods Sold (see pare 19 of the instructions) Inventory at beginning of year 1 2 Purchases less cost of items withdrawn for personal use i ~ 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 ....... 9a Check all methods used for valuing closing inventory: (I) L-J Cost as described in Regulations section 1,471-3 (ii) H Lower of cost or market as described in Regulations section 1.471-4 (iii) Other (specify method used and attach explanation)· b Check this box if there wasa writedown of"subnormal" goods as d~;~i[}~d in ~§uiati~'~ti~'1'.47'1'.~'(~i' i i i i i i i i i i i i i i i i i i i i i i i i i iI' '~' El' ..... c Check this box if the LIFO inventory method was adopted this tax year for any goods Jif checked, attach Form 970) · II d D~theru~es~fsecti~n263A~f~rpr~pertypr~duced~racquiredf~rresa~e)app~yt~thepartnership? E~ Yes E] No e Was there any change in determining quantities, cost, or valuations between opening and closing inventory? U Yes L~ No if '*Yes," attach explanation. Other Information 1 ~ What type of entity is filing this return? Check the applicable box: No a ~ Domestic general partnership b LJ Domesticlimited partnership c U Domesticlimited liability company d U Domesticlimited liability partnership e Foreign partnership f 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 301.7701-37 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-1 are filed with the return and furnished 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-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 X 7 Is this partnership a pub c y faded partnership as defined in section 469(k)(2)? X 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 2002, 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 it 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 X 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 8 of the instructions ~ 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to this retum · Designation of Tax Matters Partner (see page 21 of the instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: desi~mated TMP Identifying RONALD SMALLWOOD number of TMP 1206 FACTORY ST. 176-32-8014 Address of CARLISLE desi~natad TMP PA 17013 t,\~ Form 1 065 (2002) ,%' MAn393 0210312003 2:56 PM 1065(2002) S &' S MAINTENANCE SERVICE 25-1890393 Page3 sch~i~i~~: Partners' Shares of Income, Credits, Deductions~ etc. (a) Distributive share items (b) Total amount 1 Ordinary income (loss) from trade or business activities (page 1. line 22) ............... I 2 4 ~, 2'7 2 2 Net income (loss) from rental real estate activities (attach Form 8825) ............. 2 3a Gross income from other rental activities 3a b Expenses from otaer rental activities (attach sch) 3b ~:,:~:~:::::~::~:: c Net income (loss) from other rental activities. Subtract line 3b from line 3a 3c 4 Portfolio income (loss): a Interest income 4a Income b Ordinary dividends 4b (Loss) c Royalty income 4c d Net short-term capital gain (l(~ss)(attach Scl~ed~le D (Form i065)) 4d e (1) Net long-term capital gain (loss) (attach Schedule D (Form 1065)) ~ ~ i~i~i :::::::: ~;~ :~:~:: : ::~ ......... (2) 28% rate gain (loss) · (3) Qualified 5-year gain · f Other portfolio income (loss) (attach schedule) 4f 5 Guaranteed payments to partners 5 6 Net section 1231 gain (loss) (other than due to casualty or theft) (attach Form 4;7g~) ........... 6 7 Other income (loss) (attach schedule) 7 8 Charitable contributions (attach schedule) 8 9 Section 179 expense deduction (attach Form 4562) 9 6 ! 3 6 5 Deductions 10 Deductions related to portfolio income (itemize) 10 11 Other deductions (attach schedule) ., ~ 11 12a Low-income housing credit::.::::.:.: (1) From partnerships to which section 42(j)(5) applies 12a{1; (2) Other than on line 12a(1) 12a(2; Credits b Qualified rehabilitation expenditures related to rental real estate act (att Form 3468) 12b C Credits (ether than cr shown on lines 12a & 12b) rotated to rental real estate activities 12C d Credits related to other rental activities ' 12d 13 Other credits 13 Invest- 14a Interest expense on investment debts 14a ment b (1) Investment income included on lines 4a, 4b, 4c, and 4f above 14b(1 Interest (2) investment expenses included on line 10 above 14b(2 Self- 15a Net earnings (loss) from self-employment 15a '2 4 f 2 7 2 Employ- b Gross farming or fishing income 15b men( c Gross nonfarm income ....... 15c 3 0 f 3.4 C 16a Depreciation adjustment on property p~aced in service after 1986 16a - 44 Adjust b Adjusted gain or loss 16b c Depletion (other than oil and gas) '16c and Tax d (1) Gross income from oil, gas, and geothermal properties 16d(1 Preference (2) Deductions allocable to oil, gas, and geothermal properties 16d(2 Items e Other adjustments and tax preference items (attach schedule) ~., ........... . . 17a Name of foreign country or U .S. possession ·:.~.:~:.:.:~:.::::::¥:::::::~::: b Gross income from all sources 17b c Gross income sourced at partner level 17c d Foreign gross income sourced at partnership level: (attach schedul~S~b' (3) General Foreign (1) Passive· (2) Listed cate9orie limitation · 17d(3 Taxes e Deductions allocated and apportioned at partner level: (1) [nterestexpense· (2) Other · 17e(2 f Deductions allocate~ & apprtn a~ ptnrshp level [o foreign source inc (1) Passive· (2) Listadcategorie (attach schedul~S~ (3) General g Total foreign taxes {check one):· Paid ~-] Accrued ~] limitation · 17f(3 .......... 17~] h Reduction in taxes available for credit (attach schedule) . ~ ..... · ~ · r .............. 17h 18 Section 59(e)(2) expenditures: a Type· b Amount · 18b 19 Tax-exempt interest income 19 20 Other tax-exempt income 20 Other 21 Nondeductible expenses 21 22 Distributions of money (cash and marketable securities) 22 23 Distributions of property other than money 23 24 Other items & amounts required to be reported separately to pariners (att sch.) Form 1065 (2002) :M^O393 O2/O3/20032:5~ PM I ,m1065 (200'2) S & S MAINTENANCE SERVICE 25-1890393 Page4 Analysis of Net Income (Loss) I Net income (loss). Combine Schedule K, lines 1 through 7 in column (b). From the result, subtract the sum of Schedule K, lines 8 through 11, 14a. 17g. and 18b ........................ 2 Analysis by (I) Corporate I ( ) Individual (Iii Individual (iv) Partnership ' ' (v) Exempt partner type: (active) I (passive) J organization a Generalpartners I I 17,90,I I b Limited partnersI I Note: Schedules L, M-1 and M-2 are not required if Question 5 of Schedule B is answered "Yes." S~i::~i:i!ii Balance Sheets per Books Beginning of tax year End of tax year ,,s.ts 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) ...... $ e.e.. S ~-~Ltt~, .3 7 Mortgage and real estate loans 8 Other investments (attach schedule) 9a Buildings and other depreciable assets b Less accumulated depreciation . 0 10a Depletable assets b Less accumulated depletion ~1 Land (net of any amortization) '2a Intangible assets (amortizable only) b Less accumulated amortization ~ 3 Other assets (attach schedule} : ~ Total assets 10 6 Liabilities and Capital ~ 5 Accounts payable ................. 16 Mortgages, notes, bonds payable in less than 1 year 17 Other current liabilities (attach schedule) .... Se.e.. S~m~,, 4 114 18 All nonrecourse loans 19 Mortgages. notes, bonds payable in 1 year or more 20 Other liabilities (attach schedule) 21 Partners' capital accounts ~l' 992 2 2 Total liabilities and capital .... 4 5 ,, 10 6 S~l~i~i ii Reconciliation ol Income ~Loss) 0er I~ooks With Income ~Loss) Der Return 1 Net income (loss) per books 2 ~ r 2'7 2 6 Income recorded on books this year not in- ; Income included on Sch. K, In. 1 through duded on Schedule K, lines 1 through 7 (itemize): 4, 6, and 7, not recorded on books this a Tax-exempt interest $ year (itemize): ~ Guaranteed payments (other than 7 Deductions included on Schedule K, lines 1 health insurance) through 11, 14a, 17g, and 18b, not charged Expenses recorded ~ 60~ks this yea~ not included on Schedule K, lines I through against book income thi; year (itemize): 11, t4a, t7g, and 18b (itemize) a Depreciation $ a Depreciation $ See S b Trv land ern~e~a'nment $ 6 r.3.6.5 6~365 Add lines 6 and 7 6/,365 Income (loss) (Analysis of Net Income (Loss), 5 Add lines 1 throu,qh 4 . 2 4 r 272 line 1 ). Subtract line 8 from line 5 ............... 17 I 9 07 SC:E~Ui!~::~ ......... Analys~s of Partners Capital Accounts 17/,907 (vi) Nora(nee/Other Balance at beginning of year .... 4 t 3 57 6 Distributions: a Cash .............. 17/, 2 72 Capital contributed: a Cash b Property b Property 7 Olher decreases (itemize) S ~e.. Net income (loss) per books 24¢272 6,365 O~her increases (itemize): 6 ~ 3 65 8 Add lines 6 and 7 23/,637 Add ii,e;' i t~-0;Jg~ ~,I ,,, 28,629 9 Balance at end of y~ar Subtraci'l~i 8'ir~'l~i 5' ' 4r 99~, Form 1065 (2002) Partner# 1 I SCHEDULE K-1 (Form 1065) Partner's identifying number, A Partner's Share of Income, Credits, Deductions, etc. ~See se ~arate instructions. For calendar year 2002 or tax year beginni ~ and ending 17 6 - 3 2 - 8 0 1 4 Partnership's identifying number· Partnership's name. address, and ZIP code PA 17013 LJ limited partner RONALD SMALLWOOD 1206 FACTORY ST. CARLISLE This partner is a ~ general partner ~] limited liability company mem bet B What type of entity is this partner? · Individual C Isthispartnera ~ domestic or a [~ f0;~ig~3~r~;'~ ..... (i) Before change (Ii) End of or termination year D Enter partner's percentage of: Profit sharing % ~0 ?.00.09 Q 0o/ Loss sharing ....... % 50.000000"/ Ownership of capital % 50 ? 0,00QQ0o/ E IRS Center where partnership filed return: Cincinnati ~ OH 45999-0011 OMB No. 1545-0099 2002 25-1890393 S & S MAINTENANCE SERVICE PO BOX#526 1206 FACTORY ST. CARLISLE PA 17013 Partner's share of liabilities (see instrucfions): Nonrecourse ........... $ ...................... Qualified nonrecourse financing ......... $ Other .................... $ ..................... 57 G Tax shelter registration number .... · H Check here if this partnership is a publicly traded partnership as defined in section 469(k)(2) ........................ I Check applicable boxes: (1) ~] Final K-1 (2) ['"] Amended K-1 J Analysis of partner's ca =ital account: (a) Capital account at (b) Capital contributed (c) Parlner's share of lines (d) Withdrawals and (e) Capital account st end of beginning of year dudng year 3.4. and 7. Form 1065. distributions year (combine columns (a) Schedule U-2 throu~]h 2,179 8,953 8,636 2,496 (a) Distributive share item (b) Amount (c) 1040 fliers enter the amount In column {b) on: I Ordinary income (loss) from trade or business activities I 12 ! 13 6 - See page 6 of Paflner's 2 Net income (loss) from rental real estate activities 2 binstrucgons for Schedule K-1 3 Net income (loss) from other rental activities 3 (Form 1065). 4 Portfolio income (loss): ......... a Interest 4a Sch. B, Part I,'iine 1 b Ordinary dividends 4b Sch, B, Part II, line 5 ncome c Royalties 4c Sch. E, Part [, line 4 Loss) d Net short-term capital gain (loss 4d Sch, D, line 5, col. (f) e (1) Net long-term capital gain (loss) 4e(1) Sch. D, line 12, col. (f~ (2) 28% rate gain (loss) 4e(2) Sch. D, line 12, col. (g) (3) Qualified 5-year gain 4e(3) Line 5 of wkst. for Sch. D, In. f Other portfolio income (loss) (att. schedule) 4f Enter on applic. In. of your rtn 5 Guaranteed payments to partner 5 "'[See page 6 of Partner's ~lnstructions for Schedule K-1 6 Net section 1231 gain {loss) (other than due to casualty or theft) 6 (Form 1065). 7 Other income {loss) {attach schedule) 7 Enter on appllc. In. of your rtn 3educ- 8 Charitable contributions (see instr.) (att sch) 8 Sch. A, line 15 or 16 9 Section 179 expense deduction 9 3 r 18 3 See pages 7 and 8 of tions 10 Deductions related to portfolio inc (alt ach ) 10 Partner's instruct[one for Schedule K-1 (Form 1065). 11 Otherdeductions(attachschedule) ..~ .~ ....... .r 11 12a Lowqncome housing credit: (1) From section 42(j)(5)partnerships 12a(1] (2) Other than on line 12a(1) .~{~]'-J Form 8586, line 5 b Qualified rehabilitation expenditures related to rental real estate Credits activities 12b c Credits (other than credits shown on lines 12a and 12b) related :: :::: : ::::: ::::: See page 8 of Parlner's to rental real estate activities 12c Instructions for Schedule K-' d Credits related to other rental activities 12d (Form t065). 13 Other credits 13 29 For Paperwork Reduction Act Notice. see Instructions for Form '1065. Schedule K-'I (Form 1065) 2002 ~' A03 302/03/ 03:5~PM ~a~-'~ner~ ~.. RONALD SMALLW00D S,I/eduleK-1(F~rm1065)2002 ~ & S MAINTENANCE SERVICE (a) Distributive share item 14a b merit (1) Investment income included on lines 4a, 4b, 4c, and 4f Self- 15a Net earnings (loss) from self-employment employ- b Gross farming or fishing income ment Adjust- ments Items Foreign Taxes Other Supple- mental Informa- tion c Gross nonfarm income 16a Depreciation adjustment on property placed in service after 1986 b Adjusted gain or loss c Depletion (ether than oil and gas) d (1) Gross income from oil, gas, and geothermal properties (2) Deductions allocable to oil, gas, and geothermal properties e Other adjustments and tax preference items 17a Name of foreign country or US possession · b Gross income from all sources c Gross income sourced at partner level d Foreign gross income sourced at partnership level: (1) Passive (2) Listed categories (attach schedule) (3) General limitation e Deductions allocated and apportioned at partner level: {1) Interest expense {2) Other f Deductions allocated and appodioned at pannership level to foreign source ~ncome: ti) Passive (2) Listed categories (attach schedule) (3) General limitation g Total foreign taxes (ck. One):· [~Paid ~] Accrued h Reduction in taxes available for credit 18 Section 59(e)(2) expenditures: a Type· b Amount 19 20 21 22 23 24 Recapture of iow-income housing credit: a From section 42(j)(5) partnerships b Other than on line 24a Tax-exempt interest income Other tax-exempt income Nondeductible expenses Distributions of money (cash and marketable securities) Distributions of property other than money 25-1890393 (b) Amount 14a ~4b(1 14bt2 18a 12,136 18c 15,07C 16a -22! 16b 16c 16d(1 16d(2 ~6e ~?b ~?c 17d(1 !17d{2 17e(1 17f{1) tTf(21 17f(31 179 17h 18b 19 2O 21 22 8~636 24a 24b Page 2 (c) 1040 fliers enter the amount In column {b} on: Form 4952, line 1 e 9 ot Pa~ner's 3r Schedule K-1 25 Sch. SE, Section A or B See page 9 of Partner's See page 9 of Partner's Instructions for Schedule K-1 Instructions for Form 6251. Part I Form 1116, Part ii Form 1116~ line 12 See page 9 of P~ner's ~r Schedule (Form 1065). Form 1040, line 8b See pages 9 and 10 of Schedule Ko1 (Form 1065). line 8 Supplementa~ information reeulred to be reported separately to each partner (att additional ~ch if more space is needed): Schedule K-I (Form t065) 2002 Partner# 2 I SCHEDULE K-1 (Form 1065) Partner's Share of Income, Credits, Deductions, etc. ~See separate instructions. For calendar },ear 2002 or tax },ear beginnin~ ~ and ending Partner's Identifying number· 1 6 2 - 4 8 - 0 3 5 3 Partner's name, address, and ZIP code OMB NO. 1545-0099 2002 GARY L. STACKFIELD 126 W. NORTH ST. CARLISLE E _ Cincinnati, PA 17103 A This partneris a ~ general partner ~] limited liability company member B What type of entity is this partner? C Is this partner a ~ domestic or a (I) Before change or termination D Enter partner's percentage of: Profit sharing % Loss sharing % Ownership of capital % IRS Center where partnership filed return: OH 45999-0011 LJ limited partner · Individual (ii) End of year 50.000000~ 50.000000~ Partnership's identifying number · 2 5 - 18 9 0 3 9 3 Partnership's name, address, and ZIP code S & S MAINTENANCE SERVICE PO BOX#526 , 1206 FACTORY ST. CARLISLE PA 17013 Partner's share of liabilities (see instructions): Nonrecourse $ ..................... Qualified nonrecourse financing $ ................... Other $ ................ 57 G Tax shelter registration number .... · H Check here if this partnership is a publicly traded partnership as defined in section 469(k)(2) ..................... I Check applicable boxes: (1) [~ Final K-I (2) ['"] Amended K-1 J Analysis of partner's capital account: (a) Capital account at (b) Capital contributed (c) Partner's share of lines (d) Withdrawals and (e) Capital account at end et beginning of year during year 3, 4, and 7, Form 1065. distributions year (comb[ne columns (a) Schedule U-2 through 2,178 8,954 8,636 2r496 (c) 1040 filers enter the (a) Distributive share item (b) Amount amount in column (b) on: I Ordinaryincome([oss)fromtradeorbusinessactivities I 12r136- See page 6 of Partner's 2 Net income (loss) from rental real estate activities 2 ~Jnstructlons for Schedule K-I 3 Net income (lass) from other rental activities 3 (Form 1065). 4 Portfolio incom (I ) ........... a interest ..... 4a Sch. B, Part I, line 1 b Ordinary dividends 4b Sch. B, Part II, line 5 ncome c Royalties 4c Sch. E, Part I, line 4 LOSS) d Net short-term capital gain (loss) 4d Sch. D, fine 5, col. (0 e (1) Net long-term capital gain (loss) 4e(11 Sch. D, line 12, col. (f) (2) 28% rate gain (loss) 4e(21 Sch. D, line 12, col. (g) (3) Qualified 5*year gain 4e(3] Line 5 ct wkst. for Sch. D, In. f Other portfolio income (loss) (att schedule) 4f Enter on applic. In. ct your rtn 5 Guaranteed payments to partner 5 -Lsee page 6 of Padner's _.~lnstructions for Schedule K-1 6 Net section 1231 gain (loss) (other than due to casualty or theft) 6 (Form 1065). 7 Other income (loss) (attach schedule) .................................. 7 Enter on aDDliC. In. of your Deduc- 8 Charitable contributions (see instr.) (att sch ) 8 Sch, A, line 15 or 16 9 Section 179 expense deduction 9 3 r 182 - Seepages7and8ot tigris 10 Deductions related [o portfolio inc. (atl scll) 10 , Partner's Instructions for Schedule K-1 (Form 1065) 11 Other deductions (at[ach schedule} ......... , ~, 11 (1) From section 42(j)(5) partnerships ~2a(1; (2) Other than on line 12a(1) 72.~!~;-I Form 8586, line 5 b Qualified rehabilitation expenditures related to rental real estate ~::::::::: Credits activities c Credits (other than credits shown on lines 12a and 12b) related See page 8 of Partner's to rental real estate activities 12c , Instructions for Schedule K- (Form 1065). d Credits related to other rental activities 12d 13 Other credits ..................................................... 13 For Paperwork Reduction Act Notice, see Instructions for Form 1065. Schedule K-I (Forn~ 1065) 2002 ~ A03 3 02103/ 03:56 PM ~heduleK-1 (Form1065) 2002 S & S MAINTENANCE SERVICE (al Distributive share item employ- Adjust- ments arid Tax Prefer- Items F oreign Other 14a Interest expense on investment debts b (1) investment income inc[uded on lines 4a, 4b. 4c, and 4f (2) Investment exoenses included on line 10 15a Net earnings (loss) from self-employment b Gross farming or fishing income c Gross nonfarm income 16a Depreciation adjustment on property placed in service after 1986 b Adjusted gain or loss c Depletion (other than oil and gas) d (1) Gross income from oil, gas, and geothermal properties (2) Deductions allocable to oil, gas, and geothermal properties e Other adjustments and tax preference items 17a 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: (1) Passive (2) Listed categories (attach schedule) (3) General limitation e Deductions a[located and apportioned at partner level: (1) Interest expense (2) Other f Deductions allocated and apportioned a~ padnership level to foreign source ~ncome (1) Passive (2) Listed categories (attach schedule) (3) General limitation g Total foreign taxes (ck. o~ei:· ~] Paid [~ Accrued h Reduction in taxes available for credit 18 Section 59(e)(2) expenditures: a Type· ............ b Amount 19 20 21 22 23 24 Recapture of Iow-income housing credit: a From section 42(j)(5) partnerships b Other than on line 24a 25-1890393 Page 2 (b) Amount 14a 14bf2 15a 12t136 15c 15,070 1Sa -224 16b 16c 16d(2 16e 17d(t 17d(2 rte(1 17f{3] 179 17h 18b 19 20 21 22 8,636 23 24a 24b amount In column {b) on: 1040 filers enter the Form 4952, line 1 · 9 of Partner's 3r Schedule K-I Sch. SE, Section A or B See page 9 of Partner's ~r Schedule K-1 See page 9 of Partner's Instructions ,for Schedule K-I (Form 1065) and Instructions for Form 6251. Part I Form 1116, Part II Form 1116~ line 12 See page 9 of Partner's 1055). Form 1040, line 8b See pages 9 and 10 of (Form 1065). line 8 Supple- 25 Supplemental information required to be reported separately to each partner (att additional sch if more space is needed): Schedule K-I (Form 1065) 2002 ~MA0393 02/03/2003 2:56 PM 4562 I%,padment of the Treasury Depreciation and Amortization (Including Information on Listed Property) · See separate Instructions. · Attach to your tax return, MAINTENANCE SERVICE Re,q'ul ar Depreciation Election To Expense Carte n Tangible Property Under Section 179 IOMBNo. 1545-0172 2002 Attachment sequ..ce.o, 67 Identifying number 25-1890393 Note: If you have any listed property, complete Part V before you complete Part I. I Maximum amount. See page 2 of the instructions for a higher limit for certain businesses 2 Total cost of section 179 property placed in service (see page 2 of the instructions) 3 Threshold cost of section 179 property before reduction in limitation 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- . 5 Dollar limitation for tax war. Subtract line 4 from line 1 If zero or less, enter -0-. If married illin {a) Description of property 6 See Statement 7 24r000 6~365 200 000 0 000 Listed property. Enter the amount from line 29 R Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 I ~88 Tentative deduction. Enter the smaller of line 5 or line 8 9 1 ,i Carryover of disallowed deduction from line 13 of your 2001 Form 4562 ~10 1 ! Business income limitation, Enter the smaller of business income (not less than zero) or line 5 (see instructions) '11 lz Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 ......... 13 Carryoverofdisalloweddeductionto2003, Add lines 9 and10,1ess line12 · I 13 I Note: Do not use Part II or Part HI below for listed property. Instead, use Part V. Special Depreciation Allowance and Other Depreciation (Do not include listed property.) 14 Special depreciation allowance for quaflfied prop (otherthanlistedprop)placedinserviceduringthetaxyear(seepg. 3ofthelnstr,) I 14 15 Property subject to section 168(f)(1 ) election (see page 4 of the instructions) 15 16 Other deprec at on nc ud n0 ACRS) (see page 4 of the instructions) 16 _ ~,~?l!!i=,ii MACRS Depreciation (Do not include listed property.) (See pa,qe 4 of the instructions.) Section A 6~365 6~365 24,.000 6r365 Section B-Assets Placed In Service During 2002 Tax Year Using the General Depreciation System (b) Month and (c) Basis for depreciation id) Recovery (a) Classification of property year pl~cea in (business/investment use period (e) Convention (f) Method (g) DepreclaUon deduction servme only-see instrucfionsl t9a 3-year property b 5-year property c 7-year property d lO-year property e 15-year property f 20-year proper%, g 25-year property 25 },rs. S/L h Residential rental 27.5 yrs. MM S/L proper~y 27.5 yrs. MM S/L i Nonresidential real 39 yrs. MM S/L propeR MM S/L Section C.Assets Placed in Service During 2002 Tax Year Using the Alternative Depreciation System 204 Class life ~ S/L b 12-year 12 yrs. S/L c 40-year 40 yrs. MM S/L P.~ [~? Summary (see page 6 of the instructions) 21 Listed property. Entar 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. 23 For assets shown above and placed in service during the current year, 23 :::;:;:: i iii ~i ~ i!i:: l[i~::::i~i~[ ::ill!i: enter the portion of the basis attributable to section 263A costs !iiii:.i!iiiiii ~i~l iii ?: ~ii i~ii ~:~: :or Paperwork Reduction Act Notice, see separate Instructions, Form 4562 (2002) ~A There are no amounts for Page 2 SSMA0393 S&S MAINTENANCE SERVICE 25-1890393 Federal Statements FYE: 12/31/2002 2/3/2003 2:56 PM Statement I - Form 1065, Paqe 1, Line Description PRINTING, ADV & UNIFORMS NIGHT SEC.EXP.& XMAS GIFTS MAINTENAlqCE SUPPLIES & EXP. GAS & TOLLS OFFICE EXP. & SUPPLIES LEGAL & ACCOUNTING INSURANCE MISCELLANEOUS Total 20- Other Deductions Amount $ 1,380 1,950 425 414 343 5OO 456 40O $ 5,868 Statement 2 - Form 1065, Sch K, Ln 24 - Oth Items Reported Separately to Partners Description Amount RONALD SMALLWOOD $ 2,179 GARY L. STACKFIELD 2,178 Statement 3 - Form 1065, Schedule L, Line 6 - Other Current Assets Description Beginning End of Year of Year LO~2q RECEIVABLE -G.STACKFIELD $ 1,000 Total $ 1,000 $ 0 Statement 4 - Form 1065, Schedule L, Line 17 - Other Current Liabilities Description Beginning End of Year of Year PA SALES TA~ PAYABLE $ $ 114 Total $ 0 $ 114 Statement 5 - Schedule M-I, Line 7 - Deductions Included in Sch K, Not on Books Description Amount SEC 179 EXP.ELECTION PASSED THRU TO PARTNERS Total $ 6,365 $ 6,365 Statement 6 - Form 1065, Schedule M-2, Line 7 - Other Decreases Description Amount SEC 179 EXP.ELECTION PASSED THRU TO PARTNERS $ 6,365 Total $ 6,365 Regular Depreciation Statement 7 - Form 4562, Line 6 - Cost of Section 179 Property Description of Property TRAILER ELECTRIC CART COIN MACHINE Total Cost 1,600 1,800 2,965 6,365 Expense $ 1,60o 1,8o0 2,965 $ 6,365 :orm 1065 Department o he T easury Internal Revenue Service A Principal business activity MAINT. SERV. Principal product or service MAINTENANCE Business code number 561720 G Check applicable boxes: H U.S. Return of Partnership Income OMB No. 1545-0099 For calendar year 2003, or tax year beginning ............. , and ending · Sac ................ 2003 Name of padnership Isethe D Employerldentification number ~bel. S & S MAINTENANCE SERVICE 25-1890393 Ither- Number, street, and room or suite no. If a P.O. box, see pag~ started ,sa, PO BOX#S26 1206 FACTORY ST, r type. City or town, state, and ZIp code Total assets (see page 40 the instructions) PA 170 3 8,888 (1} [] Initial return (2) [] Final return (3} [] Name change [~ [] Address change ($) [] Amended return Check accounting method: (1) [] Cash (2) [] Accrual (3) Other (specify) · Number of Schedules K-1. At[ach one for each person who was a partner at any time during thetax year · ......................... 2 Caution: Include only trade or business income and expenses on lines la through 22 below. See the instructions for more information. la Gross receipts or sales ............................................ 'la 21,928 b Less returns and allowances lb Income Deductk - (seepage 15 of the instructions for limitations 2 Cost of goods sold (Schedule A, line 8) 3 Gross profit. Subtract line 2 from line 1c 4 Ordinary income (loss} from other partnerships, estates, and trusts (attach sch.) 5 Net farm profit (loss) (attach Schedule F (Form 1040)) ................................................ 6 Net gain (loss) from Form 4797, Part II, line 18 7 Other income {loss) (attach schedule) . 8 Total Income {loss), Combine lines 9 Salaries and wages (other than to partners) (less employmeat Credits) .................................. 16 Guaranteed payments to partners 11 Repairs and maintenance ......................................................................... 12 Bad debts 13 Rent 14 Taxes and licenses 15 Interest 16a DeprecJaii~r~ ili~r~'~l;;~,'~[t~'c'~ 'F~r;~',~i .............................. I'i~'i ..................... b Less depreciation reported on Schedule A and elsewhere on return 116b I 17 Depletion (Do not deduct oll and gas depletion.) .................................................. t8 Retirement plans, etc. 19 Employee benefit programs ....................................................................... 20 Other deductions (attach schedule) ........................................... ~..St~'~t.. ~.. Total deductions. Add the amounts shown in the far ri~]ht column for lines 9 through 20 21,928 21,928 21,92R 4,546 4,546 Sign Here Paid Preparer's Use Only 22 Ordinal7 Income {loss) from trade or business activities. Subtract line 21 from line 8 1'7,3 82 and belief, it is true, correct, and complete. Decl~:~ti .~ ~;~ pr~rer L_~,~er than general partner or Ilmlted lia b[ll~ company member)Is based on all tnformation~f wh,ch preparer has any knowledge. ~ ~ ~.~ ~, , ~ May the IRS dscuss hs eu n / ~ ~ ~ ~ ~ ' / with the preparer shown below (see Preparers~~~~~~.~~ Date Check if P reparer's SSN or PT IN signature ~. 3/~0/0~ self-employed ~ ~ ~00~22[~2 Fl~'sname(oryours ~ DANIEl, PELLY , CPA % ~ EIN b 22-2&30893 address, andZIPcode MOORESTO~, NJ 08057~423 ~ no. 856-296-9&73 For Paperwork Reduction Act Notice, see separate Instructions. Form 1065 (2o03) DAA SSMA'0393 7orm1065 (2003 S & S MAINTENANCE SERVICE 25-1890393 Page2 ;,:.::~i~! Cost of Goods Sold (see page 18 of the instructions) Inventory at beginning of year 2 Purchases less cost of items withdrawn 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 .................................. 9a Check~all methods used for valuing closing inventory: {I) g-~ Costas described in Regulations section 1.471-3 (11) U Lower of cost or market as described in Regulations section 1·471-4 (111) Other (specify method used and attach explanation) · b Check this box if there was a writedown of"subnormar' goods as des~i~(i jr~ ~;~ti~r~'~(~ti~'l'.~,'7'l'.~i;;i ............................. ~ ' '~'--] ..... 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? [] Yes [] No e Was there any change in determining quantities, cost, or valuations between opening and closing Inv~'r~t~)~'~ ..................... LJ Yes LJ No If "Yes," attach explanation. ii:i~t~ii~iii Other Information Ir;~What type of entity is filing this return? Check the applicable~ box: No a ~ Domestic general partnership b ~.~ Domestic limited partnership c ~ Domesticlimitedllability company d ~ Domesticlimited liability partnership e U Foreign partnership f [J Other · ................................................................. 2 Are any partners in this partnership also partnerships? X 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 301,7701-37 If yes, see instructions for required attachment X 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-1 are filed with the return and furnished 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 d 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 X 7 Is this partnership a publicly traded partnership as defined in section 469(k)(2)? ....................................................... X 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? X 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 It 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 X 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 Respect to Certain Foreign Partnerships, attached to this return · Designation of Tax Matters Partner (see page 20 of the instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: Name of desi,qnated TMP Identi~ing ~ ~ARY STACKFIELD numberofTMP 162-48-0353 126 W. NORTH ST. CARLISLE PA 17103 Address of designated TMP DAA Form 1005 (2003) SSM&0393 ,Form1065(2003) S & S MAINTENANCE SERVICE 25-1890393 Page3 Partners' Shares of Income Credits Deductions, etc. ~ ~ Dletrlbutlve el 1 Ordinary income (loss) from trade or business activities (page 1, line 22) ................................ 1 17,382 2 Net income (loss) from rental real estate activities (attach Form 8825) .......... 2 3a Gross income from other rental activities Expenses from other rental actlv~ties (attach schedule) 3b c Net income (loss) from other rental activities. Subtract line 3b from line 3a 3c a Interest income Income b Dividends: (1) ~ualt~ied dividends · 4a .............................. (2) Totalordinarydivldends · (Loss) c Royalty income d Net short-term capital gain (loss): (1) P;st-Ma~,'5. ~3 '~ .......................................... 4c .......................... (2) Entire year · 4d(2) e Net long-term capital gain (loss): ti) post-MayS, 2003 · ........................... (2) Entire year ·4e(2) f Other po~folio income (loss) (attach schedule) 4f 8 Guaranteed payments to partners 5 Sa Net section 1231 gain (loss)(post-May 5, 2003i (atta<~h ~o~m 4~'~) ..... 8a b Net section 1231 gain (loss) (entire year) (attach Form 4797) ........................................ 6b 7 Otherincome (loss) (attach schedule) ..................... 7 8 Charitable contributions (attach schedule) 8 Deductions 9 Section 179 expense deduction (attach Form 4562) .............................. 9 10 Deductions related to portfolio income (itemize) ....................................................... 10 11 Other deductions (attach schedule) 12a Low-income housing credit: (1) From partnerships to which section 42(j)(5) applies ..................... '12a(1 (2) Other than on line 12a(1 ) 12a(2 d Credits related to other rental activities ...................... .............................................................. 12d Investmenl 14a Interestexpenseon investment debts 14a Interest b (1) Investment income included on lines 4a, 4b(2), 4c, and 4f above ................................... ................................. t4b{1 (2) Investment expenses included on line 10 above ..., ...............~,.ir ........... ~ ..... ~rr+,,~. 14b(; Self- 15a Net earnings (loss) from self-employment ............... 15a 17 · 382 Employ. b Gross farming or fishing income ................................................................... 15b merit c Gross nonfarm income , .... 15c 21,928 Adjust- 16a Depreciation adjustment on property placed in service after 1986 ....................................... 16a ments b Adjusted gain or loss 16b and Tax c Depletion (other than ell'and gas) 16c Preference d (1) Gross income from oil, gas, and geothermal properties t6d(1 Items (2) Deductions allocable to oil, gas, and geothermal properties ............. . 16d(2 e Other adiustments and tax preference items (attach schedule) ........ , 16e 17a Name of foreign country or U.S, possession · ..................................................... b Gross income from all sources tTb d Foreign gross income sourced at partnershi~P21e~'lesl~d cate odes Foreign (~) Passive · ........................ ( ) (attach schgedule) · (3) General Taxes e Deductions allocated and apportioned at partner level; (1) Interest expense · (2) Other · 17e(21 . - k (2) Listed categories k 3 General ti) ~aSSlVe ~- (attach schedule ~' ' limitation · 17f(3) g Totalforeigntax;s'(~:il;(~;}: ~." Paid [~ Accrued [] .... ii...ii ..... .................... '" h Reduction in taxes available for credit (attach schedule) 17h f8 Section 59(e)(2) expenditures: aType · b Amount · 18b 19 Tax-exempt interest income 3ther 20 Other tax-exempt income ..................................................................... 2019 21 Nondeductible expenses 21 23 Distributions of property other than money 23 Form 1065 (2003) SSMA0593 ,Form1065(2003) S & S MAINTENANCE SERVICE 25-1890393 .Analysis of Net Income (Loss) Page 4 1 Net income (loss). Combine Schedule K, lines I through 7 in column (b). From the result, subtract the sum of Schedule K, lines 8 through 11 14a 17g and 18b 2 ~:r~lnY:J~;pYe: (I) Corporata (Il} [;~ii~l~al (1111~ ~lvde~al (iv)Partnership ~ ~ aEn~;_a% Pete (vi)Nominee/Other a General partners 1'7 ~ 382 b Limited partners I I I I I I ~o~?! S.c~les L, M-1 and M-2 are not required if Question 5 of Schedu e B is answered "Y.~" ' * ' :i ~t~::~iI Balance Sheets per Books ee~innln~ of tax -ear ~ ....... I ~f ~f )' I End of tax year Assets (a) 'b Cash ()S 3-°61 ............. 2 .................................. ~ 8, 8 8 8 a Trade notas and accounts receivable b Less allowance for bad debts'" I I 3 Inventories 4 U.S. government obligations 5 Tax-exempt securities ................... 6 Other current assets (attach schedule) ...... S.e.e.. ~ ~'~..:~ 7 Mortgage and real estate loans ............ 8 Other investments (attach schedule) 9a Buildings and other depreciable assets b Less accumulated depreciation 0 t0a 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 ............... 5 · 3.06 8, 888 Uabmiias ;nd Capli=;I ...... 15 Accounts payable ........................ 16 Mortgages, notes, bonds payable In less than I year 17 Other current liabilities Se~ ~ ~./~.~ (attach schedule) 18 All nonrecourse loans 19 Mortgages. notes, bonds payable in I year or more 20 Other liabilities (anach schedule) ........................... 21 Partners' capital accounts ................. 8 · 8 8 8 22 Total liabilities and c 8,8 8 8 Reconciliation of Income (Loss) per Books With Income )er Return Net income (loss) per books ........... 17 · 3 8 2 6 Income recorded on books this year not included Income included on Sch. K, In. 1 through on Schedule K, lines 1 through 7 (itemize): 4, 6b, and 7, not recorded on books this a Tax-exempt interest $ year (itemize): Guaranteed payments (other than health 7 Deductions included on Schedule K, lines I insurance) through 11, 14a, 17g, and 18b, not charged Expenses re~i;(J~ ~ '~:~61~s' t}li~ ~,~ included on Schedule K, lines 1 through against book income this year (itemize): 11, 14a, 17g, and 18b (itemize); a Depreciation $ ........................ Depreciation Trv nd ................... · .............. e~e~r[ment $iiii ............................ ................................ 8 ............................ ...................... 9 Income (loss) (Analysis of Net Income (Loss), ~Add lines 1 through' ~ . " ri '"i 17·382 line 1). Subtract line 8 from line 5 .............. 1'7,382 Analysis of Partners' Capital Accounts I Balanceatbeginningofyear ........... 4,992 $ Distributions: a Cash,. 13,60( 2 Capital contributed: a Dash ......... 114 b Property ..................... b Property ...... 7 Other decreases 3 Net Income (loss) per books 1'7,3 8 2 (Itemize): .............................. 4 Other Increases ........... . ........................................... (itemize): 5 Add lines 1 through 4 22,,~$8 9 Balance at end of year, Subtract line 8 from line 5 8,88,q Form 1065 {2003) SSMA0393 · Partner# i I SCHEDULE K-1 (Form 1065) Depadment of the Treasu~/ internal Revenue Service Partner's [d~ht;;~lng number · 1'76 - 32 - 8014 Partner's name, address, and ZIP code Partner's Share of Income, Credits, Deductions, etc. · See separate Instructions. For calendar year 2003 or tax year beginning ~ and endln~ Partnerehlp's Identifying number · Partnership's name, address, and ZiP code RONALD SMALLWOOD (DECEASED) 1206 FACTORY ST. CARLISLE PA 177013 A This partner is a ~.] genera~partner LJ limited partner ] limited liability company member B What type of entity is this partner? · Individual C Isthispartnera [] domestic or a [] fo;&i~r~;'~ ............ (I) Before change (11) End of or termination year D Enter partner's percentage of: Profit sharing % 5 0.0 0 0 0 0 Loss sharing .................. % ..... ~ 0';'0'0'0 ~J ~ Ownership of capital ..... iii:ii:iiii;ii % ..... 5'0' ;i01010 ~ ~ 0~ E IRS Center where partnership filed return: Cincinnati, OH 45999-0011 6511 OMB NO, 1545-0099 2003 25-1890393 S & S MAINTENANCE SERVICE PO BOX#526 , 1206 FACTORY ST. CARLISLE PA 177013 Partner's share of liabilities (see instructions): Nonrecourse $ ..................... Qualified nonrecourse financing $ ...................... Other ............................... $ ....................... G Tax shelter registration number ..... · Check here if this partnership is a publicly traded partnership as defined in section 46g(k)(2) ......................... [] Check applicable boxes: (1) [] Final K-1 (2} , [] Amended K-1 J Analysis of partner's capital account: (a) Capital account at (b) Capital contributed (c) Panner's share of lines (d) Withdrawals and (e) Capital account at end of beginning of year during year 3, 4, and 7, Form t065, distributions year (combine columns (a) Schedule M-2 through 2r496 57 B 691 6~300 4r94~ (a) Distributive share item (b) Amount (c) 1040 filers enter the amount In column {b) on: 1 Ordinaryincome (loss) from trade or business activities ................... I 8,691 - See page 6 of Partner's 2 Net income (loss) from rental real estate activities ..................... 2 . Instructions for Schedule K-' 3 Net income (loss) from other rental activities ............................ 3 (Form 1065), a Interest income ...................................................... 4a Form 1040, line 8a b (1) Qualified dividends ............................................... ~,b{1) Form 1040, line 9b Income {2) Total ordinary dividends .......................................... lb(2) Form 1040, line 9a (Loss) c Royalty income ....................................................... 4c Sch. E, Part I, line 4 d (1) Net short-term capital gain (loss) (post-May 5. 2003) .................. 4d(1) Sch. D. line 5, col. (g) {2) Net short-term capital gain (loss) (entire year) ..................... 4d(2) Sch. D. line 5, col. (f) e (1) Net long-term capital gain (loss) (post-May 5, 2003) .................. 46{1) Sch. D, llne 12, col. (g) {2) Net long-term capital gain (loss) (entire year) ......................... 46(2) Sch, D, line 12, col. (f) f Other portfolio income (loss) (attach schedule) ........................... 4f 5 Guaranteed paymentsto partner ........................................ 5 See pages S and 7 of 6 a Net section 1231 gain (loss) (post-May 5, 2003) .......................... 6a · Partner's Instructions for b Net section 1231 gain (loss) (entire year) ............................... 6b SchedSle K-1 (Form 1065) 7 Other Income (Ioss)(attach schedule) .................................. 7 8 Charitable contributions (see instr.) (att. sch.) ............................ 8 Sch. A. line 15 or 16 Deduc. 9 Section 179 expense deduction 9 See page 8 of Partner's tlons ........................................ 10 Deductions related to portfolio income (att. sch.} ........................... 10 , Instructions for Schedule K-1 11 Other deductions (attach schedule) ........................ , ..... ,, 11 (Form lO65). 12a Low-income housing credit: (1) From section 42(j)(5) partnerships 12a~1, "] (2) Other than on line 12a(1) .............................................. !2~(2]..~ Form 8586, line 5 b Qualified rehabifltatio, expenditures related to rental real estate Credits acfivRles 12b c Credits (other than credits shown on lines 12a and 12b) related iii:~i::iiiiiiii~ to rental real estate activities ........................................... 12c Instructions for Schedule K-1 d Credits related to other rental activities .................................. 12d (Form 1065), 13 Other credits ..................................................... 13 For Paperwork Reduction Act Notice, see Instructions for Form 1068. Schedule K-I (Form 1065) 2003 DAA S~A~ ~ $cheduleK-l(Form106512003 RONALD SMALLWOOD (DECEASED) S & S MAINTENANCE SERVICE (a) Distributive share Item Invest- Bent Interest Self- employ- ment 14a Interest expense on investment debts Adjust. Bents and Tax Prefer. erlca Items Foreign Taxes Other Supple- mental Informa- tion bAA 25-189039 b (1) Investment income Included on lines 4a, 45(2), 4c, and 4f ................ 15a Net earnings (loss) from self-employment .................................. b Gross farming or fishing income c Gross nonfarm income 16a Depreciation adjustment on property placed in service after 1986 b Adjusted gain or loss ............. c Depletion (other than oil and gas) d (1) Gross income from oil, gas, and geothermal properties (2) Deductions allocable to oil, gas, and geothermal properties e Other adjustments and tax preference items 17a Name of foreign country or US. possessior~ b Gross income from all sources c Gross income sourced at partner level d Foreign gross income sourced at partnership level: (1) Passive (2) Listed categories (attach schedule) ................................... (3) General limitation e Deductions allocated and apportioned at partner level: (1) Interest expense (2) Other f Deductions allocated and apportioned at partnership lave/to torelgn source Income: (1) Passive (2) Listed categories (attach schedule) .................. (3) General limitation g Total foreign taxes (check one .' · [] Paid [] Accrued .............. h Reduction in taxes available for credit 18 Section 59(e)(2) expenditures: a Type · b Amount 19 Tax-exempt interest income 20 Other tax-exempt income ................................................ 21 Nondeductible expenses 22 Distributions of money (cash and marketable securities) 23 Distributions of property other than money ................................ 24 Recapture of Iow-income housing credit: 6512 Pa~e 2 (c) 1040 fliers enter the amount In column (b) on: Form 4952, line 1 See page 9 of Partners Instructions for Schedule K-1 (Form 1065) Sch. SE, Section A or B e 9 of Partner's (b) Amount 14a 45(1) 145f2) 1Sa 8,691 15c 10,964 16a lgd(ll 16d{2 16e 17d(1 17d(2: 17d(3 17e 2 17qlI 17f(2) 17g 17h 20 22 6,300 23 24a ! 24bl s for Schedule K-1 See pages 9 and 10 of Partner's Instructions for Schedule K-1 (Form 1065) and Instructions for Form 6251. Form 1116, Pad I Form 1116, Part II Form 1116~ line 12 See page 10 of Partner's Instructions for Schedule K-1 (Forr~ 1065). Form 1040, line 85 See page 10 of Partner's Instructions for Schedule (Form 1065). a From section 42(j)(5) partnerships b Other than on line 24a Form 8611, line 6 25 Supplemental Information required to be reported separately to each partner (attach additional schedule if more space is needed): RONALD SMALLWOOD GAP:~' 'T',':'' ~XC'K'F~;E~r; ................................................................................................... Schedule K.1 (Fon~ 1065) 2003 SSMAO~93 · Partner# SCHEDULE K-1 (Form 1065) Department of the TreasuP/ Internal Revenue Servl[: Partner's Share of Income, Credits, Deductions, etc. · See separate instructions· For calendar }'ear 2003 or tax year beginning r and ending 16511 OMB No. 1545-0099 2003 Partner's Identlf}'lng number · 162-48-0353 Partner's name, address, and ZIP code GARY L. STACKFIELD 126 W. NORTH ST. CARLISLE A This partner is a ~ generalpartner PA 17103 L] limited partner Partnershlp's Identifying number · 25-1890393 Partnership's name, address, and ZIP code S & S MAINTENANCE SERVICE PO BOX#526 , 1206 FACTORY ST. CARLISLE PA 17013 F Partner's share ofliabillties (see instructions): ] limited liability company member B What type of entity is this partner? · Individual C Is this partner a [] domestlcora [] fo;ei~-~r~[~+ (I) Before change (Ii) End of or termination year D Enter partner's percentage of: Profit sharing ............................. % 50,000000~ Loss sharing % 50 . 00000 Ownership of capital % ..... ~ 0. ~.0,0,O 9 ~ E IRS Center where partnership filed return: Cincinnati, OH 45999-0011 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} .................... [] I Check applicable boxes: (1) [] Final K-1 (2) [] Amended K-1 J Anal)'sls of partner's capital account: (a) Capital account at (b) Capital contributed (c) Partner's share of lines (d) Withdrawals and (e) Capita( account at end of beginning of year during year 3, 4, and 7, Form 1065, distributions year combine columns a Schedule U-2 throufih 2,496 57 87691 7r 300 3 r 944 (c) t040 filers enter the (a) Olstrlbutlve share Item (b) Amount amount in column {b) on: I Ordinary income (loss) from trade or business activities .................. I 8, 691 - See page 6 of Partner's 2 Net income (loss) from rental real estate activities ........................ 2 · Instructions for Schedule K- 3 Net income (loss) from other rental activities ............................. 3 (Form 1065} 4 Portfolio income (=oss)= a Interest income ...................................................... 4a Form 1040, line 8a b (1) Qualified dividends ................................................ 4b{1; Form 1040, line 9b Income {2) Total ordinary dividends ............................................ 4b(2; Form 1040, line 9a (Loss) c Royalty income ..................................................... 4c Sch. E, Part I, line 4 d (1) Net short-term capital gain (loss) (post-May 5, 2003) ............... 4d(1; Sch. D, line 5, col (g) {2) Net short-term capital gain (loss) (entire year) ........................ 4d(2; Sch. D, line 5, col. (f) e (1) Net Iong-tarm capital gain (loss) (post-May 5 2003) ................. 4e(1) Sch. D, line 12, col, (g) (2) Net long-term capital gain ross) (entire year) ......................... 4e{2) Sch. D, line 12, col, (f) f Other portfolio income (loss) (attach schedule) ........................... 4f 5 Guaranteed payments to partner ....................................... S See pages 0 and 7 of 6 a Net section 1231 gain (loss) (post-May 5, 2003) ......................... 6a ~' Partner's Instructions for b Net section 1231 gain (loss) (entire year) ................................ 6b Schedule K-t (Form 1065). ? Other income floss) fatt,3ch schedule) ............ 7 8 Charitable contributions (see instr.) (att. ach.) ............................. 8 Sch, A, line 15 or 16 Deduc- 9 Section 179 expense deduction ......................................... 9 See page 8 of Partner's tlons 10 Deductions related to portfolio income (att. sch.) ........................... 10 , Instructions for Schedule K- (Form 1065). 11 Other deductions fattach schedule) ,,,, . .i r .I r T . r l . ........ ., '1 '1 r · . r 11 12a Low-income housing credit: (1) From section 42(j)(5) partnerships 12at1' -] (2) Other lhan on line 12a(1 ) .............................................. 12a 2;_j~ Form 8586, line 5 b Qualified rehabilitation expenditures related to rental real estate Credits activities ............................................................. 12b c Credits (other than credits shown on lines 12a and 12b)related ~i:iiii[?iiii?:i! See page 9 of Panner's to renta~ real estate activities ........................................... d Credits related to other rental activities ................................. 12d (Form 1005). 13 Other credits ........................................................ 13 For Paperwork Reduction Act Notice, see Instructions for Form 1065. Schedule K-1 (Form 1065) 2003 DAA S~CAO~$ · ~arcner# 2 GARY L. STACKFIELD Schedule K-1 (Form1068)2008 S & S MAINTENANCE SERVICE 25-1890393 6512 Pa~e 2 Invest. merit Interest · Self- employ- ment Adjust- ments and Tax Prefer- Items Foreign Taxes Other (a) Distributive share Item 14a Interest expense on investment debts b (1) Investment income included on lines 4a, 4b(2). 4c, and 4f 15a Net earnings (loss) from self-employment ................................. b Gross farming or fishing Income ....................................... c Gross nonfarm income 16a Depreciation adjustment on property placed in service alter 1986 ............. b Adjusted gain or loss .................................................. c Depletion (other than oil and gas) ........................................ d {1) Gross income from o11, gas, and geothermal properties .................. (2) Deductions allocable to oil, gas, and geothermal properties e Other adjustments and tax preference items 17a 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: (1) Passive (2) Listed categories (attach schedule) (3) General limitation e Deductions allocated ai~d';~l~i~)~e~' ;i ~;'r~r;;; i;~;l': ....................... (1) Interest expense .................................................... (2) Other f Deduc6ons allocated and apportioned at partnership level to foreign source Income: (1) Passive (2) Listed categories (attach schedule) .................................... (3) General limitation g Total foreign taxes(ch~l~---' -- -- "--°n'e):'""~]'Paid 'E]'Accru'edliiiiiiiI- "--- '"' h Reduction in taxes available for credit 18 Section 59(e)(2) expenditures: a Type · b .......................................................... 19 Tax-exempt interest income 20 Other tax-exempt income 21 Nondeductible expenses 22 Distributions of money (cash and marketable securities) 23 Distributions of property other than money 24 Recapture of Iow-income housing credit: a From section 420)(5) partnerships b Other than on fine 24a Supple- mental Informa. tlon bAA (b) Amount 14a 14b(t 14b{2' 16a 8,691 15b 18c 10,964 16a 16b t6c 16e l?b 17c 17d(3] 7e(1) t7ql) t7~2) 17g 17h ~g 2O 2~ 22 7,300 23 24~ 24b (c) 1040 fliers enter the amount In column {b) on: Form 4952, line 1 See page 9 of Penner's instructions for Schedule K-1 (Form 1065), Sch. SE, Section A or O See page 9 of Partner's Instructions for Schedule K-I See pages 6 and 10 of Partner's Instructions for Schedule K-1 (Form 1065) and Instructions for Form 6251, Form 1116, Part I Form 1116, Part II Form 1116, line 12 See page 10 of Partner's Instructions for Schedule K-1 (Form 1065), Form 1040, line 8b See page 10 of Partner's Instructions for Schedule K-1 (Form 1065), Form 86II,line 8 26 Supplemental information required to be reported separately to each partner (attach additional schedule if more sp~ce Is needed): RONALD SMALLWOOD .............................................................................. : .............. Schedule K-I (Porto fO66) 2003 SSMA0393 S & S MAINTENANCE SERVICE 25-1890393 Federal Statements FYE: 12/31/2003 Statement 1 - Form 1065, Paqe 1, Line 20. Other Deduction,~ Description UNIFORMS DRINKS,ICE,ETC· SHOWS MAINTENANCE SUPPLIES & EXP. GAS ,TOLLS & REGISTRATION OFFICE EXP. & SUPPLIES LEGAL & ACCOUNTING INSUR3~NCE MISCELLANEOUS Total Amount $ 907 325 1,239 292 86 725 456 516 $ 4,546 Asset Description Prior MACRS: COIN MACHINE 2 TRAILER 3 ELECTRIC CART 4 COIN MACHINE Grand Totals Less: Dispositions Net Grand Totals Date Bus Sec Sec Basis In Service Cost % 179168(k) for Depr 6/01/01 1,760 1,760 4/08/02 1,600 X X 0 4/26/02 1,800 X X 0 5/07/02 2~965 X X 0 8~125 1,760 8,125 1,760 0 0 1,760 PorConv Meth Prior Current 5 HY 200DB 1,760 5 HY 200DB 1,600 5 HY 200DB 1,800 5 HY 200DB 2~965 8,12~5 8,125 0 0 0 8,125 0 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY Include lhe proceeds of I~ation and the date the proceeds were received by the estate. All prope~ jointly.owned with the right of su~ivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, inset1 additional sheets of the same size) Comm r o RONALD H SP/ALLWOOD PO BOX 526 CARLISLE, PA 17013 Commerce Bank/Harrisburg N.A. 180 Senate Avenue Camp Hill, PA 17011 888-937-0004 STATEMENT DATE o6/16/o4 0616238062 ACCOUNT NO: CLOSED *** SAVINGS *** STATEMENT SAVINGS BEGINNING PATE 0.25000 ACCOUNT NUMBER 0616238062 PP~VIOUS STATEHE~ BALANCE AS OF 03/31/04 ........................ 4,081.01 PLUS 3 DEPOSITS AND OTHER CREDITS ................... 2.06 L~SS 1 WITHDRAWALS AND OTHER DEBITS ................ 4,083.07 CUP. RENT STATEMENT BALANCE AS OF 06/16/04 .......................... 00 AUJMBER OF DAYS IN THIS STATEMENT PERIOD 77 *** SAVINGS ACCOD-NT TRANSACTIONS *** DATE DESCRIPTION 04/30 INTEREST PAYMENT 05/31 INTEI~EST PAYMENT 06/15 INTEREST PAYMENT 06/15 CLOSING WITHDPAWAL DEBITS CREDITS .84 .86 .36 4,083.07 *** BALANCE BY DATE *** 03/31 4,081.01 04/30 4,081.85 05/31 4,082.71 06/15 PAYER FEDERAL ID NUMBER 23-2324730 INTEREST PAID YEAR TO DATE 4.59 .00 *** INTEREST EARNED THIS STATEMENT PERIOD *** DAYS IN PERIOD ......................... 75 INTEREST EARNED ........................ 2.06 ANNUAL PERCENTAGE YIELD EARNED (APY) .... 0.25% NOTE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION Member FDIC 7HiS STATEMENT REPRESENTS AN ACCOUNTING BETWEEN THE BANK AND YOU. IF THERE IS AN ERROR IN IT, CALL IT TO THE BANK'S ATTENTION PROMPTLY IN WRITING. FAILURE TO DO SO WITHIN 14 DAYS FROM THE DATE OF THIS STATEMENT MAY BAR YOUR RIGHT TO HAVE THE ERROR CORRECTED, NOTICE MUST BE SENT BY CERTIFIED MAIL TO US AT THE ADDRESS LISTED ON FRONT OF THIS STATEMENT, iN CASE OF ERROR OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS, telephone us at the number listed on the front ol his statement. Oi write us at the address listed on the front of this statement, Yon must notify the bank if you be!ieve your statement or receipt is wrong or if you need more information about a transfer listed on the staten ent or receipl The bank must hear from you no later than 60 days after we sent the first statement on which the problem e' ccror appeared 1. Tell us your name and account number 2 Describe tl~e error or the transfer you are unsure about, explain as clearly as you can why you beleve it is an error or why you need more information 3. lell us the dollar amount of the suspected error !f you ~eli us orally, we may require that you send us your complaint or question in writing within 10 business days. Pending the outcome of our investigalion, we will provisionally credit your account: 1 within 10 business days or 2 within 20 days for new accounts (within 30 days after the first deposit) investigation of your complaint or question will be resolved: 1 within 45 calendar days, or 2. within 90 calendar days for Point of Sale (POS) transactions, foreign transactions and new accounts You will be notified within 3 business days after completing our investigation of all actions taken to resolve your complaint or question If we decide there was no error, your provisional credit will be rescinded and checks will be honored for up to five days. Upon request we will furnish copies of the documents that were used Jn our investigation, · Mark in your checkbook those checks paid by · Lisl in the "Checks Outstandinft" column at the right ~ll issued checks (hat have not been paid by Curnmerce Bank · Add lo your checkb¢ ok bal;lnce any cledits not Checks Outstanding (Written by you but not yet indicated as paid on any statement) No or Date Amount Sum of check charges on above if applicable 3-- Total ............. (1 and 2_a.~_ove~ ............ I ...... _ d(~l i hi column) .... "~ Total PLEASE REPORT ANY ERRORS IMMEDIATELY AND RETURN ANY CHECKS NOT LISTED ON THIS STATEMENT, EV-,1511 EX+ (12-99)~ COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule [. ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) ~ ~ ~ I C.. -~ { /.) Sodal Security Numbe,'(s)/EIN Number of Personal Representative(s) / '~ ~"~' City ~'(¢~ ~ ' State Year(s) Commission Paid: ~ Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State __ Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) Cremation urn ................... $.__ (Description) SUB-TOT~L OF PROI[~IO~ $~RVICE$ ....... AlS ~0~(') S--- a S [ 7~.l)0 3. AUTOMOTIVE EQUIPMENT ,~ ........................... L,x:~ .........................s ~,qg'.vo t,~a~ s l T t) .~O ....... Register book(s) ................. $ ~t~. t)O Mem0w folde~ ................ $ 7~t~O CUMBERLAND VALLEY MEMORIAL 496 22-0-0112 PAID IN FULL * ACCOUNT HISTORY PRINT AS OF 1/06/05 PAGE 1 SMALLWOOD, RONALD H. c/o RONALD K SMALLWOOD 20 TRIPP TERRACE HAMPTON VA 23666 (757) 825-2279 SALESMAN : 016 L GREGG CONTRACT DATE: 3/27/02 CONTRACT AMT.: 6,072.04 AMT. PAID IN : 6,072.04 BALANCE DUE : .00 TERMS : 48 PAYMENT AMT: 120.98 DAY DUE : 5 MODE OF PMT: 1 1ST PMT DUE: 5/05/02 PAID THROUGH: 4/05/06 LAST ACTIVE: 11/03 DELINQ NTCE: ITEM % DESCRIPTION PRICE 1 1 5 200 1 705 1 131 1 800 1 819 22 SPACE 488.75 SPACE P/C 86.25 CONCRETE VAULT BRA 740.00 28X16 GR BASE GRBZ 390.00 18G NEOPOLITAN BV 2630.00 GRAVE OPENING PN 800.00 ADMIN FEES 95.00 INTEREST 842.04 DATE TRANSACTION AMOUNT 4/01/02 DOWN PAYMENT 265.00- 5/03/02 PAYMENT ON ACCOUNT 200.00- 6/05/02 PAYMENT ON ACCOUNT 200.00- 7/03/02 PAYMENT ON ACCOUNT 200.00- 8/05/02 PAYMENT ON ACCOUNT 200.00- 9/05/02 PAYMENT ON ACCOUNT 200.00- 10/04/02 PAYMENT ON ACCOUNT 200.00- 11/01/02 PAYMENT ON ACCOUNT 200.00- 12/02/02 PAYMENT ON ACCOUNT 200.00- 12/30/02 PAYMENT ON ACCOUNT 200.00- 2/03/03 PAYMENT ON ACCOUNT 200.00- 2/27/03 PAYMENT ON ACCOUNT 200.00- 3/31/03 PAYMENT ON ACCOUNT 120.98- 5/01/03 PAYMENT ON ACCOUNT 120.98- 5/23/03 PAYMENT ON ACCOUNT 120.98- 6/23/03 PAYMENT ON ACCOUNT 120.98- 7/28/03 PAYMENT ON ACCOUNT 120.98- 9/02/03 PAYMENT ON ACCOUNT 120.98- 10/13/03 PAYMENT ON ACCOUNT 120.98- 11/11/03 PAYMENT ON ACCOUNT 120.98- 8/05/04 BA/~ANCE WRITE OFF 2,639.20- FOR SPECIAL PROTECTION BENEFIT REV-! 513 EX+ (9-00~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE 0 SCHEDULE J BENEFICIARIES FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List lYuatee(a) OF ESTATE I 1. 11 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ~ot'l ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART Ii - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 Bill To: EUNICE OLIVER 427 N. WEST ST. CARLISLE, PA 17013 INVOICE InvoiccNo: Invoice Date: Estate of.' Estate No: 154 01-10-2005 RON_AT D I-L SMALLWOOD 21-2004-0406 JA Fee Description Fcc Total Additional Probate 15.00 $15.00 $15.00 Total: Checks should be made payable to the Register of W'dls. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: EUNICE OLIVER 427 N WEST ST CARLISLE, PA 17013 154 1/10/2005 RONALD H SMALLWOOD 21-2004-0406 JA Qty 1 Fee Description Additional Probate Fee Total 15.00 $15.00 Total: $15.00 1 r'-~ Co} Second Request *********** Please pay promptly. l'a.\d Lilli Ql-uc,< "* loL.Jol,? ~ Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. v" BUREAU OF INDIVIDUAL TAXES-.. INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX ... ... APPR41SEHENT. ALLOWANCE OR DISALLOWANCE OF-DEDUCTIONS AND ASSESSHENT OF TAX '* REV-1547 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-11-2005 SMALLWOOD 11-06-2003 21 04-0406 CUMBERLAND 101 RONALD H EUNICE OLIVER_ 427 N WEST ST CARLISLE Allount Rellitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ I!V-~~"YI.m.m!'U!1..tm.W.!wtA'n'''M!r.m.lWAlTftNmf~.~r.W4At!'.or.............. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SMALLWOOD RONALD H FILE NO. 21 04-0406 ACN 101 DATE 04-11-2005 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE 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. 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 U) (2) (3) (4) (5) (6) (7) .00 .00 4,444.00 .00 4.082.71 .00 .00 NOTE: To insure proper credit to your account. subllit the upper portion of this forI! with your tax payment. (8) 8.526.71 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/GovernMental 8equestsi Non-elected 9113 Trusts 14. Net Value of Estate Subject to Tax (9) UO) 8.053.84 .00 UlJ (2) (3) (4) 8.053 84 472.87 .00 472.87 (Schedule J) I~ an assessment was issued previously, lines 14, IS and~or 16, 17, 18 and 19 will reflect ~igures that include the total o~ ALL returns-assessed to date. ASSESSMENT OF TAX: 15. AlIOUnt of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: .00 X 472.87 X .00 X .00 X DO = 045 = 12 = 15 = (9)= .00 21. 28 .00 .00 21.28 TAX CRE.DITS: ... (+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 01-07-2005 'CDOO4809 .36- 30.53 TOTAL TAX CREDIT 30.17 BALANCE OF TAX DUE 8.89CR INTEREST AND PEN. .00 TOTAL DUE 8.89CR . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE i A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~ ~ Q... REV-1470 EX (6-88) INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER REVIEWED BY ACN 2104-0406 101 Smallwood, Ronald H. Daniel Heck ITEM SCHEDULE NO. EXPLANATION OF CHANGES The value of the estate has been adjusted as the result of the correction of an error in arithmetic. ROW Page 1 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/11/2005 OLIVER EUNICE H 427 N WEST STREET CARLISLE, PA 17013 RE: Estate of SMALLWOOD RONALD H File Number: 2004-00406 Dear Sir/Madam: 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 AMENDMENTS 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: 11/06/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~~ GLENDA FAm~ER STPASBAUGH REGISTER OF WILLS cc: File Counsel Judge \;-G- Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 NarneofDecedent: ~t,{ .2~~ Date of Death: / / - 6 - eX Ot>.J5 Estate No.: d {ltJ f'- /).0 ~/)t1:> 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. Stat~ether administration of the estate is complete: Yes ~ No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did ~personal representative file a final account with the Court? Yes JXl No 0 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 0 No f8J c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. .-- ~e: 11J~;:2, {) ~ 0 6 "~ . 1, '.. -.~" , , . ~v~~rtb s1~ature I-/. C) II J E~ fd1 N 'uJd ~~ Ad~ess /"1 I ' ' / J /ltiL /7tJ/3 Telephone No. ~ itA) I~E Name Capacity: j]a'Personal Representative D Counsel for personal representative ,ft