HomeMy WebLinkAbout12-21-11
REV- ~ ~70o EX (oz-u) (rl) j it OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes ~`F ~~ ~~' ~ County Code Year File Number
PO BOX z806ot INHERITANCE TAX RETURN
Harrisburg, PA i'7128-o6ot RESIDENT DECEDENT _ ~', ''' O ~,
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth NIMDDYYYY
180-3(i-6959 Ofi/25/2011 01/17/1914
Decedent's Last Name Suffix Decedent's First Name MI
MARTIN MARY D
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
15U561U105
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3 Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5 Federal Estate Tax Return Required
death after 12-12-82)
~ ti. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Liiigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
JOHN D. MARTIN (85Ei) 858-Ei92(i
First Line of Address
404 EVERGREEN AVE.
Second Line of Address
City or Post Office
WESTMONT
Correspondent's a-mail address: johnandaudrey@gmail.com
State ZIP Code
NJ 08108
REGISTER ~0fj WILLS USE OIJLY
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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and comple .Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSO S NSIBL~.~4,R~FILING ETURN DATE
..L 1 ~ YI'1Q ~L 11 ~ I rR !/
ADDRESS
404 EVERGREE AVFy~WESTMONT, NJ 08108-3513
SIGNATURE OF P ER THAN R P ESENTATIVE DATE
E K K ~ A !Lc'~~ !~ TjE' - 12/15/2011
ADDRESS
12 SUMMIT DR., LSBURG, PA 17019
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610155 1505610105 J
;"'n"i
i.
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+/~
1505610205
REV-1500 EX (FI)
Decedent's Name: MARY D. MARTIN
Decedent's Social Security Number
1 l30-36-6959
RECAPITULATION
1. Real Estate (Schedule A) ........................................... .. L
2.
.....................................
Stocks and Bonds (Schedule B) 2.
.. 331,499.95
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 31,022.00
4. Mortgages and Notes Receivable (Schedule D) ......................... .. 4.
5. Cash, Bank Deposits and Miscellaneous Personal Property (schedule E)..... .. 5. 43,269.03
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
7 376.76
415
(Schedule G) O Separate Billing Requested...... .
.. ,
8.
( 9 ) ...........................
Total Gross Assets total Lines 1 throw h 7 8.
.. 821,167.74
9. Funeral Expenses and Administrative Costs (Schedule H) ............. ...... 9. 17,689.37
10. Debts of Decedent, Mortgage Liabilities and Liens (Schedule I) ......... ...... 10.
11. Total Deductions (total Lines 9 and 10) ........................... ...... 11. 17,689.37
12. Net Value of Estate (Line 8 minus Line 11) ........................ ...... 12. 803,478.37
13. Charitable and Governmental BequestslSec 9113 Trusts for which
an election to tax has not been made (Schedule J) .................. ...... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) .................. ...... 14. 803,478.37
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 803
37
478
.
,
(a)(1.2) X .0 45 15.
16. Amount of Line 14 taxable
at lineal rate X .0 _ 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.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
15D56102D5 ]~50561D205
36,156.53
36,156.53
REV-1500 EX (FI) Page 3 File Number
r1PrPrlent's Complete Address:
MARY D. MARTIN _
STREET ADDRESS
100 MT. ALLEN DRIVE
CITY _ _ _. STATE
MECHANICSBURG PA
ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 36,156.53
2. Credits/Payments
A. Prior Payments 34,800.00
e. Discount 1_,807.8. 3
Total Credits (A + g) (2) 36,607.83
3. Interest
(3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, line 20 to request a refund. (4) 451.30
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred .......................................................................................... ^
b. retain the right to designate who shall use the property transferred or its income ............................................ ^
c. retain a reversionary interest .............................................................................................................................. ^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^
3. Did decedent own an "in crust for" orpayable-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.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent (72 P.S. §9116 (a) (1.1) (i}].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a} (1.1) (ii)]. The statute does not exempt 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 21 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 percent [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 percent, except as noted in [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 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503 EX+ (6-98)
_,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF ~_~ FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
(It more space is needed. insert additional sheets of the same size)
REV-1504 EX+ (1-97) ~
.. }
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
__
SCHEDULE C I
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
FILE NUMBER
YV _ ,~
ESTATE OF ,^
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporationlpartnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sale-proprietorships. _
VALUE AT DATE
ITEM NUMBER DESCRIPTION OF DEATH
NUMBER
,~°'
.~ ~~~ ~~
y,.. _
~.
-~~.-. ~ ~.. ~ ~ r ~, .- I „~ ~ ~ ~ . ~
3 ( ~ - a-- .
sL ~'
TOTAL (Also enter on line 3, Recapitulation) $ ~ ~,
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX . (7-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTIOPJ OF DEATH
1. Lb I rr' ~ °~, G ,- ` :~ y ~t U fi ~ f^'w~, E b+,.~"' ~ ~; r< </(C 6 .~ ~~ "~ ~ ~ ~ '~~
~.
~,~ ~~~ ,al7a
4,(~ °~,
TOTAL (Also enter on line 5, Recapitulation) I $ ~-t ~ ~ ~ ~ • `-~ ~
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX ~ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS ~
MISC. NON-PROBATE PROPERTY
ESTATE OF ~, FILE NUMBER
M ~ 1~-`~ ~, ~ `~ /~ ~ -4c ;~--~ --- I i - ~ ~7 ~~
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIRRELATIONSHIPTODECEDENTANOTHEDATEOFTRANSFER
ATTACH A COW OF THE DEED FOR REAL ESTATE .
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST
EXCLUSION
IF APPLICABLE
TAXABLE VALUE
«p^`
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f, ~' C tis r^~ ~,.
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3~ ~~~ ~ ~ ~~~c~<<IP~-acs ~,~, ~~e.~~ r~~
TOTAL (Also enter on line 7, Recapitulation) I a ~ ~ ~, 3 ~ ~ ~ ~ ~'
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (10-06) ~,
• ~ SCHEDI~LE H
' FUNERAL EXPENSES 8~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
Debts of decedent must be reported on Schedule I.
NUM ER DESCRIPTION AMOUNT -
A. FUNERAL EXPENSES:
t . ~ --- - - y ~ -~ ~!... .
~.~ E rte- ,S~ ~ k ~ . , 2-- ..~, +- ~. ~.~ ; .- t~.;d t ~. - ~
w~t~ ~.
g. ADMINISTRATIVE COSTS:
~. Personal Representative's Commissions
Name of Personal Representative(s) _ ----- ---- ----------
Street Address - - ------ --- - -- -
City State Zip _.__ _ - _. - __---
Year(s) Commission Paid: _ - --- - --- -----
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant - - ----- ------
Street Address - -- - - -- - -
City State Zip ----- __-_ ___--
Relationship of Claimant to Decedent ____.___ _ __ _ ___ -__ -_ _. _-_ _.--_ --- - -. -- I ~ , o 0
~""~3, <,C
4. Probate Fees ~ C.. ~ ~ SCR ~ A.~~ L ~~~ ~~a ~~(
5. Accountant's Fees
~~~~.~a
6. Tax Return Preparer's Fees
~IS.o~
R 12~ ~~
~o, ~E~~,,,~_P~ ~'~~~5
TOTAL (Also enter on line 9, Recapitulation) I $ ~~~ ~ g ~~ ~~ `~
(If more space is needed, insert additional sheets of the same size)
REV-1`513 EXt (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCNEDIJLE J
BENEFICIARIES
- __
ESTATE OF FILE NUMBER
RELATIONSHIP TO DECEDENT
--_
AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListT'rustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
"f ~ 1"f G V G (^= cr I::~ y;; iL. ~a I `~ U f F~ ,~„ E ~ C~''r h!1'y 1~''"
o~~~~
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r7 0 ",~..e.-.
- Q
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l P~~~ -G-~~<~vE ~~~-~sQ~r~4~>~-~ ~I~TOR~a
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rye \ ~ ~.F' ,s :~ rd
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ENTER DOLLAR AMOUNTS FORIDISTRIBUTIONS SHOWN ABOVE ON LINES 15 TH ROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
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)
REV•1505 EX,~ (6-98) ~
SCHEDULE C-1
4~. CLOSELY-HELD CORPORATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN STOCK INFORMATION REPORT
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
s
1. Name of Corporation ~ ~` ~= `-~i' ~ +~& ~~ !'~~'"" ~~1= Pr~E, ~'"' "!~ t C State on Incorporation ~•~i
~'
Address ~ ~`f ~'J~l'~ G r C-rccc ~V'L Date of Incorporation ~ -~?- ~ Q ~~
City ,~ _ State.~_ Zip Code Total Number of Shareholders '
2. Federal Employer LD. Number ~3 ' ~ ~ ~ 7~`~ 4 Business I~eporting Year 1~ y'"
~.~.
3. Type of Business -=-- l.; `./r-5:'. "{ ` `"" "' ~ C ~' `~''~rt ProducUService '~ ~ ~~ ~.r~.
4.
TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF tHE
STOCK
Voting/Non-Voting
SHARES OUTSTANDING PAR VALUE
OWNED BY THE DECEDENT
DECEDENT'S STOCK
Common
__ a .. ~~
r 4 `~-~C~ ~ r' .., ,
~
Preferred ).
~`~ ` ~
$
Provide all rights and restrictions pretaining to each class of'stack.
5. Was the decedent employed by the Corporation? ................................. ^ Yes `~,,No
If yes, Position Annual Salary $ Time Devoted to Business
6. Was the Corporation indebted to the decedent? ................................... ^ Yes ,~,jVo
If yes, provide amount of indebtedness $
7. Was there life insurance payable to the corporation upon the death of the decedent? ..... ^ Yes ~o
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
8. Did the decedent sell or transfer an stock in this company within one year prior to death or within two years
if the date of death was prior to 12-31-82?
^ Yes ~).No If yes, ^ Transfer ^ Sale Number of Shares
Transferee or Purchaser __ Consideration $ Date
Attach a separate sheet for additional transfers and/or sales.
9. Was there a written shareholder's agreement in effect at the time of the decedent's death? ....^ Yes `~ No
If yes, provide a copy of the agreement.
10. Was the decedent's stock sold? ..................................................... ^ Yes "~ No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation 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.
12. Did the corporation have an interest in other corporations or partnerships? ............. ^ Yes ~ No
If yes, report the necessary 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 stock. ~ ~l w-s < 5;,~~ sn--" ~' ~"! ~,'r- t~ `' "~$ -~- `~ 3~~ Q ~ ~ , ~'°
B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years;
C. If the corporation 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. N ,i' ~-
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. ` ~ C ~- ~=' `~°' ~ }°`~' -' ~"" -" ~ ,,1
E. List of officers, their salaries, bonuses and any other benefits received from the corporation. ~~r~E
F. Statement of dividends paid each year. List those declared and unpaid. ~( ., ~.~ G
G. Any other information relating to the valuation of the decedent's stock. t--f , ~.°
(If more space is needed, insert additional sheets of the same size)
H105.112 REV,. 1/05
(FLEE FOR THIS
CEAT4FICATE $6.00).
CERT. N4.
WARNING: IT IS ILLEGAL TO ALTER THIS COPY IJR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
GOMMONWEAL'rH OF PENNSYLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
L~CAI_ REGISTRAR'S CERTIFICATION OF I~EA~TH
T63680~7
7'-01-2011,
Date of Issue of This CeRiticetion
Name of Decedent M~R~' D • MARTIN
Flist Middle Last
Sex FEMALE Social Security No. 1$0-36-6959 Date of Death 6-25-2011
pate of Birth ~ 1-17-1914 "Birthplace PENNSYLVANIA
Place of Death MESSIAH VILLAGE CUMBERLAND; UPPER ALLEN TWP . Pennsylvania
Facility (Jame County City, Borough or Township
:Race WHITE Gccupation TEACHER Armed Forces? {Yes or No) NO
Decedent's
Marital Status WIDOWED Mailing Address _100 MT. ALLEN DRIVE MECHANICSBURG PA
Numher `Slreef Cit} ~ r Tdwri Slate
Informant DR. JOHN D. MARTIN Funeral :Director DAVID' T. 5EKELY
'Name and Address of
Funeral Establishment 13 0 N . MARKET STREET ELIZABETHTOWN, PA.
Interval Between
Part 1:' Immetliate Cause ; Onset and Death
ACUTE RESPIRATORY FAILURE '
(a)-
(b) PROBABLE ASPIRATION '
Vic) DEMENTIA WITH UYSPHAGIA '
(d)_
Part II: Other Signi€icant Conditions
.CONGESTIVE HE.~F~t.T FAILURE, HYPERTENSION, ALZHEIMERS TAPE DEMENTIA
Manner of Death `Describe how injury occurred:'
Natural ' C~ Homicide ^
:Accident ^ Pending Investigation U
Suicide ^ Coutd snot be Determined ^
Name and Title of Certifier. SARAH NOORBAKSH, M.D.
(M.D., D.O., Coroner, M:E.)
:Address 100 MT. ALLEN DR. MECHANICSBURG
This is to cer#ify that the information here given is correctly copied from ah original certificate
of death duly filed!. with me as Local Registrar. The original certificate will be forwarded to the
State Vital Recors~s Office.for permanent filing. ;
,:. 36-338
Local Istia AVital-Retnrds Gistric! No
6=29-2011 25 IRTS'CIRCLE ELIZABETHTOWN
Da`e Received by Local Registrar Street Adtlress - - City, Borough, Townsrup
COMMONWEALTH OF PENNSYLVA"' "
COUNTY OF CUMBERLAND
estate of MARY D MARTIN
SHORT CERTIFICATE
I, GLENDA EARNER STRASBAUGH
Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 14th day of July, Two ~['housand and Eleven,
Letters TESTAMENTARY
in common form were granted by the Register of
said County, on the
late of UPPER,4LLEN TOWNSH/P
(First, Middle, Last)
in said county, deceased, to JOHN DMART/N
(First Middle, Lastl
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 14th day of July
Two Thousand and Eleven.
File No. 2011-00785
PA File No. 21- 11- 0785
Date of Death 6/25/2011
S . S . # 180-36-6959
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
WILL n = -~,
F ~'" o c~ ~' ~ s
O _~'~;r- - _ _
MARY D. MARTIN ~ ~ ~ _
~ ~~
-~ .. f
I, MARY D. MARTIN, curr~;ntly of the Borough of Elizabethtown, Lancaster
County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any
and all prior Wills and Codicils made by me.
I. I direct that all my just debts and funeral expenses be paid from the assets of my
estate as soon as practicable after my demise.
II. I direct that all estate and inheritance taxes that may be assessed in consequence of
my death, shall be paid out of the principal of my general estate to the same effect as if said
taxes were expenses of administration and all property includable in my taxable estate
whether or not passing under this Will shall be free and clear thereof.
III. I intend to keep with this my Will a separate memorandum concerning disposition
of certain items of tangible personal property. I bequeath the items on said list to the persons
designated.
IV. All the rest, residue and remainder of my estate, of whatever nature and wherever
situate, including property over which I hold a power of appointment, I devise and bequeath
equally unto my four (4) children, namely, Barbara, John, JoAnne and M. Suzanne, or their
issue pec~ stiipes.
V. I appoint my son, John D. Martin, Executor of this my ~~~ill. In the evert that he fails
to qualify or ceases to act as Executor, I appoint my daughter, Barbara M. Ulery, Executrix
of this my will.
VI. I direct that no bond be required of my fiduciaries for the faithful performance of
their duties in-any jurisdiction.
IN WITNESS WHEREOF, I, MARY D. MARTIN, herewith set my hand to this my
Last Will, typewritten on two (2) sheets of paper including the attestation clause and
signatures of witnesses, this 22nd day of December, 1997.
r f
-1- MARY D. ,•p ARTLN
Signed b}~ ~t~RY D. Ivt.ARTIN, by her declared to be her «'ill in our presence, who
ha~~e hereunto subscribed our names as ~ti~itnesses in her presence anal at her request, this
2~:.~ day of December, 1997.
residing at ~
~~ 'ice./1 ~~-~V~.~'<','~..k~ residing at ~~~-E'~y~-t=1'1 c~ .
-2-
CONiti-iON~~'E.~LTN OF PEtiTSYLVA\1.~
COUNTY OF LEBANON
WE, MARY D. MARTIN, GERALD J. BRINSER and JOLEIN L. SHENK, the
testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing
instrument, being first duly affumed, do hereby declare to the undersigned authority that the
testatrix signed and executed the instrument as her Last Will and that she signed willingly
(or willingly directed another to sign for her), and that she executed it as her free and
voluntary act for the purposes therein expressed, and that each of the witnesses, in the
presence and hearing of the testatrix, signed the Will as witnesses and that to the best of our
knowledge the testatrix was at that time eighteen years of age or older, of sound mind and
under no constraint or undue influence.
MARY D. M RTIN
c
ITNESS
Wx' ESS
Subscribed, sworn or affumed and acknowledged before me by MARY D. MARTIN, the
testatrix, GERALD J. BRINSER and JOLEIN L. SHENK, wifiesses, this 22nd day of
December, 1997.
1, , .
(SEAL) gtary Public
Notarial Seal
Wondy L. Hunking, Notary Public
Paimyra Boro, Lebanon County
My Commission Expires Sept. 10, 2001
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~ P~ BOX 7000 ~ Please call us anytime For answers to your
- ROP-450 que sticns, account info rrna[ion, current rates
Providence RI 02940 cr to update your address & phone number.
~~
AT 01 000273 31578 B 1 E " 3DGT
Illl+llllr+Illlrll~lllll~lr+l~llll~ll+ll+nl ll+1111+11111+ll 11'11
MARY D MARTIN
MARTIN
Circle Gold
Account Statement
Of 4
Beginning May 26, ZO11
through June 24, 2011
Contents
Summary Paye 1
C/0 JOHN Checking Page 2
404 EVERGREEN AVE J
HADDON TOWNSHIP NJ 08108-3513 ~ r
~.
,~ __ t . ~~ .. _
~i" , -. ~'r ._
U5002
Circle Gold Summary
Account Account Number
DEPOSIT BALANCE
Checking _______.-_ -
Circle Gold Checking w/Interest XXXXXXX722-1 `\
Circle Gold Money Market XXXXXXX137-7
Monthly combined balance to waive monthly tee is
Your monthly combined balance this statement period is
Balance
Last Statement
16,258.84
17,622.01
Balance MARY D MARTIN
ihis Statement JOHN D MARTIN
Circle Gold Checking w/Interest
XXXXXXX722-1
19,039.37
20,397.78
Total Deposit Balance
~_ .,,1
39,437.15
~.~.,._
20 000. ~~ /1 Total Relationship Balance
44,830.94 !-•\ 39,437.15
r.,r~rroer r-Urf: ~ Erµur Nuus~np LnrWer
47'tS-IDy- 11 lU~ . ~u rnvtf
~~
Ins;'-on.e And Tn)'z~[nents
'.7P!~f~iu.;~7irn~
~'1~~~~~~ ~ ~'~~~~~~~~~~~~~~
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f .e~L~~~I: ~~/'1 ~1r~^ l:nc~~dlne
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~. ~ TR.ANSA~MERIC~1
~ L1FE 1NSUttANC:~ COMP.aNY
September 06, 2011
AeLrrinisn•uri~•e U~ee:
.4.135 Edgewucxl RuaJ NE
Cedar Rapids, lA 52499
w~~~w.transameri~aannuitie,.rum
~~,
~a1.~ ~~i c~l'~~ ~ ~
JOHNEMAR~REEN AVE ~ c,,~"""" ` f' ~~ ~~~'"~j ' ~~ .~l~A~~y~~+ `f'~
4 0 4 ~ ~`~- ~;~ , ~
WESTMONT NJ 08108 ~ ~2r ~1 ~,~GG'-~d-K- ~c7
X75 ++ ~
..1~..~-~ /Lc? ~-u~~ 3 ~~ ,sue'.
gE ; Annuity Number (s ) 7 S 6 6 9 41 ~ /lam- ~~~~~~~ ~ j~~j ~~~y~ .~~LL. ,
Dear JOHN MARTIN:
A check for $37,500.00, representing the full and final death benefit
payment for the above listed Non-4ivelalForma1099-R reportingtthiss been
sent. Next January, you will rece
distribution as follows: ~
~ 2 Q C ~ ~~~~~ ~,e,.Es ~ ~S ~oJ,'a.7
$37,500.00
Gross Distribution: $0.00
Taxable Portion: $0.00
Federal Withholding: $0.00
State Withholding:
Transamerica Life Insurance Company does not give legal, tax, or
accounting advice. You may wish t:o consult your own attorney,
accountant, or tax advisor with questions or spE~cific points of interest
to you.
Any additional questions regarding5t6205annuAiT~~~nsameriaarLifedlnsurance
Annuity Service Center at 1 800 5 assist you with any questions you may
Company representative will gladly
have regarding this annuity and help you meet your financial goals.
Sincerely,
Claims
Transamerica Life Insurance Company
an AEGON company
nk S. MILLER/David T. SEKELY
---" Funeral Services, Inc.
David T. Sekel}'. President'Supervisor
130 North tilarket Street
Elizabethto~~~n. PA 170??-?040 ~~-
~,.
Statement
DATE
~ `~~~._~ 7;''~~'2011
Phone: 717-367- 1543 ~) ~~ ~~~~~, f~- )
~il"~v~ / 'Y ~/ AMOUNT DUE
Dr. John D. Martin
-30-t Evergreen Avenue
~4'estmont. NJ 08108
1NV01CE NUMBER AMOUNT ENCLOSED
..............................................
.....
Pl~~use,uurn rup purnrua tirrr!1 ruur pcn•nre~~r. r!iari ~•ou.
TRANSACTION AMOUNT BALRNCE
DATE
07~07~'201 I Balance forward 7,748.60 7.748•bl1
; n I I 1NV #3463. OY9~
07; 08, _0 -7,748.60
07%?~!301 1 PMT #099?.
J~~"'- -
V
31-60 DAYS 61-90 DAYS OVER 90 DAYS AMOUNT DUE
CURRENT 1-30 DAYS PAST DUE PAST DUE PAST DUE
0.00 U.00 50.00
0.00 0.00 0.l)0
~1'Gli 51 fF
www.millerfunera-home.com
Form ~ ~ 2~ S
Department of the Treasury
Internal Revenue Service
f: i t, ~"
U.S. Income Tax Return for an S Corporation
Do not file this form unless the corporation has filed or is
attaching Form 2553 to elect to be an S corporation.
See separate instructions.
2010
For calendar ear 2010 or tax ear be inning , 2010, endin
Q Selection effective date Name
D Employer identification number
01/01/87 CARDINAL POINT CORPORATION 23-1727859
B Business activity code 'T'YPE Number, street, and room or suite no. If a P.O. box, see instructions. E Date incorporated
number (see instrs)
999999 PRINT 404 EVERGREEN AVE. 06/17/70
C Check if Sch M-3 City or town, state, and ZIP code F Total assets (see instructions)
^
attached WESTMONT NJ 08].08 $ 100.
G Is the corporation electing to be an S corporation beginning with this tax year? Yes X No If 'Yes,' attach Form 2553 if not previously filed
H Check if: (1) Final return (2) ~ Name change (3) Address change
(4) Amended return (5) ~ S election termination or revocation
Enter the number of shareholders who were shareholders during any part of the tax y ear ........................................ ~ 7.
Ca ution. Include only trade or business income and expenses on lines 1 a through 21. See the instructions for more information.
1 a Gross receipts or sales .. ~ ~ b Less returns and allowances .. c Bal ~ 1 c
I
N 2 Cost of goods sold (Schedule A, line 8) .............................................................. 2
C 3 Gross profit. Subtract line 2 from line lc .............................................................. 3
0 4 Net gain (loss) from Form 4797, Part II, line 17 (attach Form 4797) ..................................... 4
M
E 5 Other income (loss) (see instrs - att statement) . .
.............................................................
5
6 Total income loss). Add lines 3 throu h 5 ......................................................... ~ 6
7 Compensation of officers ............................................................................ 7
D 8 Salaries and wages (less employment credits) ........................................................ 8
E 9 Repairs and maintenance ........................................................................... 9
D 10 Bad debts 10
C 11 Rents ............................................................................................. 11
T
I 12 Taxes and licenses ................................................................................. 12
0 13 Interest ............................................................................................ 13
N
S 14 De reciation not claimed on Schedule A or elsewhere on return attach Form 4562
p ( ) ......................
14
15 Depletion (Do not deduct oil and gas depletion.) ...................................................... 15
E 16 Advertising
...................................................................................
16
E 17 Pension, profit-sharing, etc, plans
...................................................................
17
N 18 Employee benefit programs ..................... ....................
............................... 18
T 19 Other deductions (attach statement) ...... *.. STMT .................................................. 19 3 0 0 .
s 20 Total deductions. Add lines 7 through 19 ........................................................... ~ 20 300 .
21 Ordinary business income (loss). Subtract line 20 from line 6 ........................................ . 21 -300 .
T 22a Excess net passive income or LIFO recapture
q tax (see instructions) .................................................... 22a
X b Taxfrom Schedule D (Form 1120S) ....................................... 22 b
A c Add lines 22a and 22b (see instructions for additional taxes) ............................ ........................... 22e
N 23a 2010 estimated tax payments and 2009 overpayment credited to 2010....... 23a
D
b Tax deposited with Form 7004 ............................................ 23 b 0 .
P c Credit for federal tax paid on fuels (attach Form 4136) ..................... 23c
A
y d Add lines 23a through 23c ........................................................................... 23d 0 .
E 24 Estimated tax penalty (see instructions). Check if Form 2220 is attached ........................ ~ ~ 24
N 25 Amount owed. If line 23d is smaller than the total of lines 22c and 24, enter amount owed ................................ 25 0 .
T
S 26 Overpayment. If line 23d is larger than the total of lines 22c and 24, enter amount overpai<i .............. 26
27 Enter amount from line 26 Credited to 2011 estimated tax ~ I Refunded ~ 27
Under penalties of perjury, I declare That I have examined this rettun, including accompanying schedules and statements, and to the best of my knowledge and
Sign belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all intormation of which preparer has any knowledge.
Here ..~- May the IRS discuss this return
with the preparer shown below
(see instructions ?
Si
t
f
ffi
'
gna
ure o
o
cer Date
Tiile
X Yes No
Printrrype preparer's name Preparer's signalur
ej'', Dafe Check X if PTIN
//
~
P
id Vernon M. Martin, Jr., CPA `'~1,-'' 04/28/11 self-employed P00236811
a
Preparer Firm's name ~ Vernon M. Martin Jr. CPA Firm's EIN ~ 04-3698679
Use Only
Firm's address ~ 12 Sllmmlt Dr _
_
Dillsburg PA 17019
Phone no. (717) 766-8156
OMB No. 1545-0130
BAA For Paperwork Reduction Act Notice, see separate instructions. sl=sAOt t2 otrtf3n t Form 11205 (2010)
Form 11205 (2010) CARDINAL POINT CORPORATION 23-1727859 Page 2
Schedu a>A < Cost of Goods Sold (see instructions)
1 Inventory at beginning of year ....................................................................... .... 1
2 Purchases ......................................................................................... .... 2
3 Cost of labor ...................................................................................... .... 3
4 Additional section 263A costs (attach statement) ..................................................... .... 4
5 Other costs (attach statement) ...................................................................... .... 5
6 Total. Add lines 1 through 5 ......................................................................... .... 6
7 Inventory at end of year ............. .... 7
8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 ........................ .... 8
9 a Check all methods used for valuing closing inventory:
(i) Cost as described in Regulations section 1.471-3
(ii) Lower of cost or market as described in Regulations section 1.471-4
(iii) Other (Specify method used and attach explanation.) ~ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _
b Check if there was a writedown of subnormal goods as described in Regulations section 1.471-2(c) _ _ _ ~
c Clieck if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970)
.................... 8
..... -
d If the LIFO inventory method was used for this tax year, enter percentage (or amounts) of closincl
I
l
inventory computed under LIFO ..................................................................... ....
9d
e If property is produced or acquired for resale, do the rules of section 263A apply to the corporation? ...... ........... Yes No
f Was there any change in determining quantities, cost, or valuations between opening
,nri rlnsino inventnrv? If 'Yes.' attach explanation .......................................... ...
n Yes
n Nn
Schedlale B 'Other Information see instructions Yes No
1 Check accounting method: a Cash b X Accrual c Other (specify) ~
2 See the instructions and enter the:
a Business activity - RENTAL b Product or service ... - REAL ESTATE
3 At the end of the tax year, did the corporation own, directly or indirectly, 50% or more of the voting stock of a domestic
corporation? (For rules of attribution, see section 267(c).) If 'Yes,' attach a statement showing: (a) name and employer
identification number (EIN), (b) percentage owned, and (c) if 100% owned, was a qualified subchapter 5 subsidiary
election made? ................................................................................................ ..... X
4 Has this corporation filed, or is it required to file, Form 8918, Material Advisor Disclosure Statement, to provide
information on any reportable transaction? ....................................................................... ..... X
5 Check this box if the corporation issued publicly offered debt instruments with original issue discount ................ ~
If checked, the corporation may have to file Form 8281, Information Return for Publicly Offered Original Issue
Discount Instruments.
6 If the corporation: (a) was a C corporation before it elected to be an S corporation or the corporation acquired
an asset with a basis determined by reference to the basis of the asset (or the basis of any other property) in
the hands of a C corporation and (b) has net unrealized built-in gain in excess of the net recognized built-in gain
from prior years, enter the net unrealized built-in gain reduced by net recognized
built-in gain from prior years (see instructions) .....................................- $
7 Enter the accumulated earnings and profits of the corporation at the end of the tax year ......... $
8 Are the corporation's total receipts (see instructions) for the tax year and its total assets at the end of the tax year less
than $250,000? If 'Yes,' the corporation is not required to complete Schedules L and M-1 ............................ ..... X
9 Durin the tax ear, was a qualified subchapter S subsidiar election terminated or revoked? It 'Y'es', see instructions .. .....
Schedlale K Shareholders' Pro Rata Share Items _
Totat amount
1 Ordinary business income (loss) (page 1, line 21) ..................................................... 1 -300 .
2 Net rental real estate income (loss) (attach Form 8825) ................................................ 2
1 3 a Other gross rental income (loss) ......................................... 3 a
b Expenses from other rental activities (attach statement) ............................... 3 b
I
N c Other net rental income (loss). Subtract line 3b from line 3a ........... .
...............................
3 c
C 4 Interest income ............................................. . ...................................... 4 18 .
M 5 Dividends: a Ordinary dividends ................................................................... 5 a 1 2 0 2.
I
E b Qualified dividends .......................................I 5bl 259.
~ 6 Royalties .......................................................................................... 6
(
O 7 Net short-term capital gain (loss) (attach Schedule D (Form l 120S)) .................................... 7 1, 619 .
5
S) 8a Net long-term capital gain (loss) (attach Schedule D (Form 11205)) .................................... 8a 5, 110 .
b Collectibles (28%) gain (loss) ............................................ 8b
c Unrecaptured section 1250 gain (att<~ch statement) ................................... 8 e
9 Net section 1231 gain (loss) (attach Form 4797) ........................................ ............. 9
10 Other income (loss) (see instructions) .................. Type ~ 10
Form 11205 (ZU I U)
SPSA0112 01/18/11
Form 1120S (2010) CARDINAL POINT CORPORATION
23-1727859 Pana 3
Shareholders' Pro Rata Share Items (continued) Total amount
Deduc- 11 Section 179 deduction (attach Form 4562) ................................................... 11
tions 12a Contributions .............................................................................. 12a
b Investment interest expense ................................................................ 12b
c Section 59(e)(2) expenditures (1) Type ~- - - - - - - - - - - - - - - - - - (2) Amount ~ 12c (2)
d Other deductions (see instructions ... T pe ~ 12d
Credits 13a Low-income housing credit (section 42Q)(5)) ................................................. 13a
bLow-income housing credit (other) .......................................................... 13b
e Qualified rehabilitation expenditures (rental real estate) (attach Form 3468) ................................... 13c
d Other rental real estate credits (see instrs) Type ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 13d
e Other rental credits (see instrs) Type ~
---------------------------- 13e
f Alcohol and cellulosic biofuel fuels credit (attach Forrn 6478) .................................. 13f
Other credits (see instructions) .. T pe ~ 13g
Foreign
Trans-
actions 14a Name of country or U.S. possession ....... ~
------------------------
bGross income from all sources ................. ' ...........................................
4b
c Gross income sourced at shareholder level ............... ........................ ......... 14c
Foreign gross income sourced at corporate level
d Passive category ................................................................ .........
14d
e Generalcategory ....................................... ........................
.....
14e
f Other (attach statement) ......................................................... ......... 14f
Deductions allocated and apportioned at shareholder level
g Interest expense ..........................................................................
14
h Other ..................................................................................... 14h
Deductions allocated and apportioned at corporate level fo foreign source income
i Passive category ..........................................................................
14i
j General category .......................................................................... 14j
k Other (attach statement) ......................................................... ......... 14k
Other information
Total foreign taxes (check one): - ~ Paid ~ Accrued ......................... ...
141
m Reduction in taxes available for credit
(attach statement) ............................................................... .........
14m
n Other foreign tax information (attach statement)
Alterna- 15a Post-1986 depreciation adjustment ............................................... ......... 15a
tive
Mini- b Adjusted gain or loss .............. .........
.............................................. 15b
mum c Depletion (other than oil and gas) ................................................. ......... 15c
Tax
(AMA d Oil, gas, and geothermal properties -gross income .............................. .
.......
15d
Items a Oil, gas, and geothermal properties -deductions .................................. ... . ..... 15e
f Other AMT items (attach statement) .............................................. ......... 15 f
Items 16a Tax-exempt interest income ...................................................... ......... 16a
Affec-
ting b Other tax-exempt income
........................................................ .........
16b
Share- c Nondeductible expenses ................................................................... 16c
holder
Basis d Distributions (attach stmt if required) (see instrs) .................................. .
....
16d
7, 649.
e Repayment of loans from shareholders ............................................ ......... 16e
Other 17 a Investment income .............................................................. ......... 17 a 1, 2 2 0 .
Inform-
ation b Investment expenses
.......................................................... .........
17b
c Dividend distributions paid from accumulated earnings and profits ................... ......... 17c 0 .
d Other items and amounts
(attach statement)
Recon-
ciliation 18 Incometloss reconciliation. Combine the amounts on lines 1 through 10 in the far right col-
urnn. From the result, subtract the sum of the amounts on lines 11 through 12d and lines 141 ..
18
7, 649.
BAA
Form 11205 (2010)
SPSA0134 07/22/10
nnc inn,m r~TnnTTQTT. D(1TT1T r`r1RPC1RATTr1N
23-1727859 Paae 4
Schedule L Balance Sheets er BOOkS Beginning of tax year End of tax year
Assets (0) (b) (c) (d)
......................
.
1 Cash
..
.............
2a Trade notes and accounts receivable ....... .
b Less allowance for bad debts .............. .
...............................
3 Inventories
.
government obligations ............... .
4 U
S
.
.
5 Tax-exempt securities (see instructions) ... .
6 Other current assets (attach stmt) ................. .
7 Loans to shareholders ......................
8 Mortgage and real estate loans ............. .
9 Other investments (attach statement) .. Ln.. 9.. S.t:... 10 0 . 10 0 .
10 a Buildings and other depreciable assets ...... .
b Less accumulated depreciation ............. .
11a Depletable assets .. ........................
b Less accumulated depletion ................ .
12 Land (net of any amortization) ............. .
13a Intangible assets (amortizable only) .........
b Less accumulated amortization ............. .
14 Other assets (attach stmt) ................. .
15 Total assets ............................... 100. 100 .
Liabilities and Shareholders' Equity
....................
16 Accounts payable
......
bonds payable in less titan 1 year .. .
notes
17 Mortgages
,
,
18 Other current liabilities (attach stmt) ............... .
19 Loans from shareholders ...................
bonds payable in 1 year or more ... .
notes
20 Mortgages
,
,
21 Other liabilities (attach statement) ................. .
..................
ital stock
22 Ca
............
p
23 Additional paid-in capital .................. .
...................
24 Retained earnings 100. 100 .
.......
25 Adjustments to shareholders' equity (atfstmt) ........ .
26 Less cost of treasury stock ................. .
27 Total liabilities and shareholders' equity ...... 100. 100 .
Schedule M-1 ~ Reconciliation of Income (t.oss~ per tsooKS wil<n income v,u_oss~ per rceturn
Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or more -see instructions
1 Net income (loss) per books ................ 7 , 69 9 . 5 Income recorded on books this year not included
2 Income included on Schedule K, lines 1, 2, 3c, 4, 5a, 6, 7,
8a, 9, and 10, not recorded on books this year (itemize): on Schedule K, lines 1 through 10 (itemize):
aTax-exempt interest . $
----------------------
3 Expenses recorded on books this year not
included on Schedule K, lines 1 through 12,
and 141 (itemize):
a Depreciation ....... $_ _ _ _ _ _ _ _ _ _ _
$
bTravel and entertainment ---------------------
6 Deductions included on Schedule K, lines 1 through
12, and 141, not charged against book income this
year (itemize):
a Depreciation .... $
------------
.
----------- ---------------------
7 Add lines 5 and 6 ..................... .
----------------------
4 Add lines 1 throw h 3 ....................... -
7 64 9 .
8 Income (loss) (Schedule K, In 18). Ln 4 less In 7 ...
7 , 64 9 .
Schedule M=2 Analysis of Accumulated Adjustments Account, Other Adjustments Account, and
Shareholders' Undistributed Taxable Income Previously Taxed (see instructions)
(a) Accumulated
adjustments account (b) Other
zidjustments account (c) Shareholders' undis-
tnbuted taxable income
previously taxed
1 Balance at beginning of tax year .................................. 100. 0 . 0 .
2 Ordinary income from page 1, line 21 ............................ .
3 Other additions ............. *.. STMT ............................ 7 , 94 9 .
4 Loss from page 1, line 21 ......................................... 300 .
5 Other reductions .................................................
6 Combine lines 1 through 5 ........................................ 7, 7 4 9. 0. 0.
7 Distributions other than dividend distributions ...................... 7 , 64 9 . 0 . 0 .
8 Balance at end of tax year. Subtract line 7 from line 6 .............. 100. __ 0 . 0
sPSAOtsa o~iz2no Form 1120S (2010)
20S U.S. Income Tax Return for an S Corporation
Form - Do not file this form unless the corporation has filed or is
Department of the Treasury attaching Form 2553 to elect to be an S corporation.
Internal Revenue Service - See separate instructions.
OMB No. 1545-0134
2009
For calendar ear 2009 or tax ear be innin , 2009, ending
A Selection effective dale U5e Name D Employer Identiflcatfon number
01/01/87 IRS CARDINAL POINT CORPORATION 23-1727859
B Business activity code
b
t label.
Othe
-
Number, street, and room or suite no. If a P.O. box, see instructions.
E Dale incorporated
num
er (see ms
rs)
999999 r
wise, 404 EVERGREEN AVE. 06/17/70
C Check ii Sch M-3
attached ~ print or
t
e City or town, state, and ZIP code F Total assets (see rnsfmctiais)
yp
.
WESTMONT
NJ 08108
$ 100.
'
'
G Is the corporation ele
H Check if: (1) ctin g to be an S corporation beginning with this tax year?
Final return (2) ~ Name change (3) Yes X No
Address chang If
Yes,
attach Form 2553 if not previously filed
e
(4) Amended return (5) ~ S election termination or revocation
Enter the number of shareholders who were shareholders during any part of the tax y ear ........................................ - ].
Caution. Include only trade or business income and expenses on lutes Ja throuoh 21. See the instructions fnr more rnfnrmatinn
1 a Gross receipts or sales .. ~ ~ b Less returns and allowances .. ~ e Bal ~ 1 c
I
N 2 Cost of goods sold (Schedule A, line 8) ... , ...... ,
................................................... 2
C 3 Gross profit. Subtract line 2 from line lc .............................................................. 3
O
M 4 Net gain (loss) from Form 4797, Part II, line 17 (attach Form 4797) ..................................... 4
E 5 Other income loss attach statement
( ) ( ) ...............................................................
5
6 Total income (loss). Add lines 3 throu h 5 ........................................... ............. ~ 6
7 Compensation of officers ............................................................................ 7
D 8 Salaries and wages (less employment credits) ........................................................ 8
E 9 Repairs and maintenance ........................................................................... 9
D
U
.......................................
10 Bad debts .......... ................................... 10
C 11 Rents ............................................................................................. 11
T
I 12 Taxes and licenses ................................................................................. 12
0 13 Interest ............................................................................................ 13
N
S 14 De reciation not claimed on Schedule A or elsewhere on return attach Form 4562
p ( ) ......................
14
15 Depletion (Do not deduct oil and gas depletion.) ...................................................... 15
16 Advertising ........................................................................................ 16
E
17 Pension, profit-sharing, etc, plans ...................................................................
17
N 1S Employee benefit programs ......................................................................... 18
T 19 Other deductions (attach statement) ...... *..STMT ................................................... 19 320 .
s 20 Total deductions. Add lines 7 through 19 ........................................................... - 20 320 .
21 Ordina business income (loss). Subtract line 20 from line 6 ......................................... 21 -320 .
T 22a Excess net passive income or LIFO recapture
q tax (see instructions) .................................................... 22a
X b Tax from Schedule D (Form 1120S) 22b
A c Add lines 22a and 22b (see instructions for additional taxes) ............................ ........................... 22 c
N 23a 2009 estimated tax payments and 2008 overpayment credited to 2009....... 23a
D
b Tax deposited with Form 7004 ............................................ 23b 0 .
P c Credit for federal tax paid on fuels (attach Form 4136) ..................... 23c
A
Y d Add lines 23a through 23c ........................................................................... 23d 0 .
M
E 24 Estimated tax penalty (see instructions). Check if Form 2220 is attached ........................ ~ ~ 24
N 25 Amount owed. If line 23d is smaller than the total of lines 22c and 24, enter amount owed ................ ............... 25 0 .
T
S 26 Overpayment. If line 23d is larger than the total of lines 22c and 24, enter amount overpaid .............. 26
27 Enter amount from line 26 Credited to 2010 estimated tax - I Refunded ~ 27
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and io the best of my knowledge and
belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge
Sign .
Here May the IRS discuss this return
^~ _.,G__ _~,.. with the preparer shown below
(see instructions ?
,
Signature of officer Dates' -,
Title
X Yes No
,: ~
Preparer's
I
~
~
Date
Preparer's SSN or PTIN
signature ~
~ - "_~
`~_~`---- ~~ ~
-
P a i ri .~ ~~ 0 3 / 2 3 / 10 employ' ~ elf-... X P 0 0 2 3 6 811
Preparer's Firm's name
Use Only (or yours if
self-employed),
address, and
ZIP code
Vernon M. Martin ~., CPA
__ --
12 SummiY_ Dr
EIN 04-3698679
Dillsbur
PA 1701
BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Phone no. (717) 7 6 6 - 815 6
SPSA0112 t2rtero9 Form 1120S (2009)
rm 11205 (2009) CARDINAL POINT CORPORATION 23-1727859 Page 2
~ched`ule-A Cost of Goods Sold (see instructions) _
1 Inventory at beginning of year ........................................................... ........... .... 1
2 Purchases ......................................................................................... .... 2
3 Cost of labor .......................................................................... ........... .... 3
4 Additional section 263A costs (attach statement) ..................................................... .... 4
5 Other costs (attach statement) ...................................................................... .... 5
6 Total. Add lines 1 through 5 ......................................................................... .... 6
7 Inventory at end of year ............................................................................ .... 7
8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 ....................... .... 8
9a Check all methods used for valuing closing inventory:
(i) Cost as described in Regulations section 1.471-3
(ii) Lower of cost or market as described in Regulations section 1.471-4
(iii) Other (Specify method used and attach explanation.) ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_
_ _ _ _
b Check if there was a writedown of subnormal goods as described in Regulations section 1 .471 2(c) _ _ _
_ _ _ _ _ _ _ _ _
" ^
c Check if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Farm 970) ......................... '' I]
d If the LIFO inventory method was used for this tax year, enter percentage (or amounts) of closing
I 9dl
inventory computed under LIFO ..................................................................... ....
e If property is produced or acquired for resale, do the rules of section 263A apply to the corporation? ...... ........... Yes No
f Was there any change in determining quantities, cost, or valuations between opening
...+ .-L,~inn ..,.,or,+nrv7 If 'Vac ' of+arh aYnlanatinn r-~
~ Yes I I No
Schedule"B Other Information see instructions Yes No
1 Check accounting method: a Cash b X Accrual c Other (specify) ~
2 See the instructions and enter the:
a Business activiiy - RENTAL_ _ _ _ _ _ _ _ _ _ _ _ _ _ - b Product or service ... ~ REAL ESTATE
3 At the end of the tax year, did the corporation own, directly or indirectly, 50% or more of the voting stock of a
domestic corporation? (For rules of attribution, see section 267(c).) If 'Yes,' attach a statement showing:
(a) name and employer identification number (EIN), (b) percentage owned, and (c) if 100% owned,
was a OSub election made? ............................................................................. ............ X
4 Has this corporation filed, or is it required to file, a return under section 6111 to provide information on any
reportable transaction? .................................................................................. ............ X
5 Check this box if the corporation issued publicly offered debt instruments with original issue discount .......... ...... ~
If checked, the corporation may have to file Form 8281, Information Return for Publicly Offered Original Issue
Discount Instruments.
6 If the corporation: (a) was a C corporation before it elected to be an S corporation or the corporation acquired
an asset with a basis determined by reference to its basis (or the basis of any other property) in the hands of a
C corporation and (b) has net unrealized built-in gain (defined in section 1374(d)(1)) in excess of the net
recogrnzed built-in gain from prior years, enter the net unrealized built-in gain reduced by net recognized
built-in gain from prior years ..................................................... ~ $
---------
------
7 Enter the accumulated earnings and profits of the corporation at the end of the tax year ......... $
8 Are the corporation's total receipts (see instructions) for the tax year and its total assets at the end of the tax year less
than $250,000? If 'Yes,' the corporation is not required to com lete Schedules L and M-1 ..................... ............ X
Sc hedule K Shareholders' Pro Rata Share Items Total amount
1 Ordinary business income (loss) (page 1, line 21) ..................................................... 1 -320 .
2 Net rental real estate income (loss) (attach Form 8825) ................................................ 2
3a Other gross rental income (loss) .......................................... 3 a
b Expenses from other rental activities (attach statement) ............................... 3 b
I
................
c Other net rental income (loss). Subtract line 3b from line 3a ......................... .
3 c
N
C 4 Interest income .................................................................................... 4 4 .
M
~
...............................................
5 Dividends: a Ordinary dividends ....................
5a
1, 686.
E b Qualified dividends .......................................I 5bl 410. '`'
6 Royalties .......................................................................................... 6
(L
Q 7 Net short-term capital gain (loss) (attach Schedule D (Form 1 120S)) ................... ................ 7
S
.... ................
8a Net long-term capital gain (loss) (attach Schedule D (Form 117.05)) .............. .
8a
5, 719.
S)
b Collectibles (28%) gain (loss) ............................................ 8b
c Unrecaptured section 1250 gain (attach statement) ................................... 8 e
9 Net section 1231 gain (loss) (attach Form 4797) ...................................................... 9
10 Other income (loss) (see instructions) .................. Type ~ 10
Forrn 11205 (?_009)
SPSA0112 12!16/09
•orm 1120S (2009) CARDINAL POINT CORPORATION
2~-1727R5Q Pana ~
Shareholders' Pro Rata Share Items (continued) Total amount
Deduc- 11 Section 179 deduction (attach Form 4562) ................................................... 11
tions 12a Contributions .............................................................................. 12a
b Investment interest expense ................................................................ 12b
c Section 59(e)(2) expenditures (1) Type ~'- - - - - - - - - - - - - - - - - - (2) Amount ~ 12c (2)
d Other deductions see instructions) ... T pe ~ 12d
Credits 13a Low-income housing credit (section 42(j)(5)) ................................................. 13a
b Low-income housing credit (other) .......................................................... 13b
c Qualified rehabilitation expenditures (rental real estate) (attach Form 3468) ................................... 13c
d Other rental real estate credits (see instrs) Type ~
---------------------- 13d
eOther rental credits (see instrs) Type ~
--------------------------- 13e
f Alcohol and cellulosic biofuel fuels credit (attach Form 6478) .................................. 13f
Other credits (see instructions) .. T e ~ 13g
Foreign
Trans-
actions 14a Name of country or U.S. possession ....... ~
-------------------------
b Gross income from all sources ................'............................................
14b
c Gross income sourced at shareholder level .................................................. 14c
Foreign gross income sourced of corporate level
d Passive category ..........................................................................
14d
e General category .......................................................................... 14e
f Other (attach statement) ................................................................... 14f
Deductions allocated and apportioned at shareholder !eve!
g Interest expense ..........................................................................
14g
h Other ..................................................................................... 14h
Deductions allocated and apportioned at corporate level to foreign source income
i Passive category ..........................................................................
14i
j General category .......................................................................... 14j
k Other (attach statement) ................................................................... 14k
Other information
Total foreign taxes (check one): - ~ Paid ~ Accrued .............................
141
m Reduction in taxes available for credit
(attach statement) .........................................................................
14m
n Other forei n tax information (attach statement)
Alterna- 15a Post-1986 depreciation adjustment ......................................................... 15a
tive
Mini-
...................................................
b Adjusted gain or loss .................. 15b
mum c Depletion other than oil and as .............
g ............................................. 15c
Tax
(AMT) d Oil, gas, and geothermal properties -gross income ....... .
.................................
15 d
Items a Oil, gas, and geothermal properties -deductions ............................................ 15e
f Other AMT items (attach statement) ........................................................ 15f
Items 16a Tax-exempt interest income ................................................................ 16a
Affec-
ting b Other tax-exempt income
..................................................................
16b
Share- c Nondeductible expenses ................................................................... 16c
holder
Basis d Property distributions ...................................................................... 16d 7, 089.
e Repa ment of loans from shareholders ...................................................... 16e
Other 17a Investment income ........................................................................ 17a 1, 690 .
Inform-
ation b Investment expenses
......................................................................
17b
c Dividend distributions paid from accumulated earnings and profits ............................. 17c 0 .
d Other items and amounts
(attach statement)
Recon-
ciliation 18 Income/loss reconciliation. Combine the amounts on lines 1 through 10 in the far right col-
umn. From the result, subtract the sum of the amounts on lines 1 1 through 12d and lines 141 ..
18
7 , 08 9 -
BAA
Form 11205 (2009)
SPSA0134 12!16!09
• T
„~nc i~nno~ rrnnTtln7. A(1TUT ('C1RPnRATTnN
23-1727859 Paoe 4
- •----
Schedule 1. Balance Sheets er Books
Beginning of tax year
End of t
ax year
Assets (a) (b) (c) (d)
....................
1 Cash
..................
2a Trade notes and accounts receivable ........
b Less allowance for bad debts .............. .
............................
3 Inventories
....
government obligations ............... .
4 U
S
.
.
5 Tax-exempt securities (see instructions) ... .
6 Other current assets (attach stmt) ................. .
...................
7 Loans to shareholders ..
.
8 Mortgage and real estate loans ............. .
9 Other investments (attach statement) .. Ln..9.. S.t ... 10 0 . 10 0 .
10 a Buildings and other depreciable assets ...... .
b Less accumulated depreciation ............. .
11a Depletable assets ..........................
b Less accumulated depletion ................ .
12 Land (net of any amortization) ............. .
13a Intangible assets (amortizable only) .........
b Less accumulated amortization ............. .
14 Other assets (attach stmt) ................. .
15 Total assets ............................... 100. 100.
Liabilities and Shareholders' Equity
....................
16 Accounts payable
......
bonds payable in less than 1 year ... .
notes
17 Mortgages
,
,
18 Other current liabilities (attach stmt) ............... .
19 'Loans from shareholders ...................
bonds payable in 1 year or more ... .
notes
20 Mortgages
,
,
21 Other liabilities (attach statement) ................. .
........................
22 Capital stock
......
23 Additional paid-in capital ...................
24 Retained earnings .......................... 100. 100 .
25 Adjustments to shareholders' equity (attstmt) ........ .
26 Less cost of treasury stock ................. .
27 Total liabilities and shareholders' equity ...... 100. 100 .
Schedule M-1' Reconciliation of Income (Loss) per Books With Income (Loss) per Return
Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or more -see instructions
1 Net income (loss) per books ................ 7 , 0 8 9 . 5 Income recorded on books this year not included
2 Income included on Schedule K, lines 1, Z, 3c, 4, 5a, 6, 7,
8a, 9, and 10, not recorded on books this year (itemize): on Schedule K, lines 1 through 10 (itemize):
aTax-exempt interest . $
----------------------
3 Expenses recorded on books this year not
included on Schedule K, lines 1 through 12,
and 141 (itemize):
a Depreciation ....... $_ _ _ _ _ _ _ _ _ _ _
bTravel and entertainment . $ ---------------------
6 Deductions included on Schedule K, lines 1 through
12, and 141, not charged against book income this
year (itemize):
a Depreciation .... $
------------
----------- ---------------------
7 Add lines 5 and 6 ..................... .
----------------------
4 Add lines 1 through 3 .......................
7 , 0 8 9 .
8 Income (loss) (Schedule K, In 18). Ln 4 less In 7 ...
7 , 0 8 9 .
Schedule M-2 Analysis of Accumulated Adjustments Account, Other Adjustments Account, and
Shareholders' Undistributed Taxable Income Previously Taxed (see instructions)
(a) Accumulated
adjustments account (b) Other
adjustments account (c) Shareholders' undis~
tribupted oaxs bl{a ecdome
1 Balance at beginning of tax year .................................. 100. 0 . 0 .
2 Ordinary income from page 1, line 21 .............................
3 Other additions ............. *.. STM.T............................. 7 , 4 0 9 .
4 Loss from page 1, line 21 .........................................
5 Other reductions ................................................. 320.
6 Combine lines 1 through 5 ........................................ 7 , 18 9 . 0 . 0 .
7 Distributions other than dividend distributions ...................... 7 , 0 8 9 . 0 . 0 .
8 Balance at end of tax year. Subtract line 7 from line 6 .............. 100. 0 . 0 .
sPSAOtaa t2neroe Form 11205 (2009)
,.
~ ~ 20S U.S. Income Tax Return for an S Corporation
Form - Do not file this form unless the corporation has filed or is
Department of the Treasury attaching Form 2553 to elect to be an S corporation.
Internal Revenue Service - See separate instructions.
2008
For calendar ear 2008 or tax ear be innin , 2008, endin ___
Q 5 election effective date Name
Use the D Employer identification number
01/01/87 IRS CARDINAL POINT CORPORATION 23-1727859 _
Business activit code Idbel. Number, street, and room or suite no. If a P.O. box, see instructions.
B number (see instrs) Other- E Date incorporated
999999 wise, 404 EVERGREEN AVE. 06/17/70
C Check it Sch M-3 print or City or town, state, and ZIP code
attached ~ type. F Total assets (see instructions)
WESTMONT NJ 08108 $ 100._
G Is the corporation electing to be an S corporation beginning with this tax year? Yes X No If 'Yes,' attach Form 2553 if not previously filed
H Clieck if: (1) 8 Final return (2) ~ Name change (3) Address change
(4) Amended return (5) ~ S election termination or revocation
Enter the number of shareholders who were shareholders during any part of the tax year ........................................ ~ 1
Caution. Include on/V trade or business income and expenses on sines 1 a through 21. See Use instructions for mare information.
1 a Gross receipts or sales ..~ ~ b Less returns and allowances .. c Bal ~ 1 c
I
N 2 Cost of goods sold (Schedule A, line 8) ........
......................................... . ........ 2
C 3 Gross profit. Subtract line 2 from line lc ................................................. ............. 3
0 4 Net ain loss from Form 4797, Part II, line 17 atfacll Forrn 4797
9 ( ) (~ ) ................... .... 4
M
E 5 Other income loss attach statement
( ) ( ) ................................................. .
............
5
6 Total income (loss). Add lines 3 through 5 ............................................... .......... ~ 6
7 Compensation of officers ................................................................ ............ 7
D 8 Salaries and wa es less em to ment credits ......
9 ( P y ) ................................... ............. 8
E 9 Repairs and maintenance ..................................................
.............
....... . 9
D
U ................................................
10 Bad debts ....................... ............. 10
C
11 Rents .................................................................................
............
11 _
T
I
12 Taxes and licenses ....................................................................
.............
12
0 13 Interest ............................................................................... ............. 13
N
S 14 De reciation not claimed on Schedule A or elsewhere on return attach Form 4562
P ( ) ......... ............. 14
15 Depletion (Do not deduct oil and gas depletion.) .........................................
.............
15 _
16 Advertising ........................................................................... ............. 16
17 Pension, profit-sharing, etc, plans ...................................................... ............. 17
N 18 Employee benefit programs ............................................................ ............. 18
r 19 Other deductions (attach statement) ......"..STMT ..................................... ............. 19 390 .
20 Total deductions. Add lines 7 through 19 . . .......... ~ 20 390 .
21 Ordinary business income (loss). Subtract line 20 from line 6 ............................ ............. 21 -390 .
T 22a Excess net passive income or LIFO recapture
A tax (see instructions) .................................................... 22a
X b Tax from Schedule D Form 1120S
( ) .......................................
22 b
A c Add lines 22a and 22b (see instructions for additional taxes) ............................ ............... ............ 22 c
N 23a 2008 estimated tax payments and 2007 overpayment credited to 2008....... 23a
D
b Tax deposited with Form 7004 ............................................ 23 b
P c Credit for federal tax paid on fuels (attach Form 4136) ..................... 23c
A
Y d Add lines 23a through 23c ............................................................... ............ 23 d
E 24 Estimated tax penalty (see instructions). Check if Form 2220 is attached ................... ..... ~ ~ 24
N 25 Amount owed. If line 23d is smaller than the total of lines 22c and 24, enter amount owed .................... ............ 25
T 26 Overpayment. If line 23d is larger than the total of lines 22c and 24, enter amount overpaid . ............. 26
S
27 Enter amount from line 26 Credited to 2009 estimated tax - I
Refunded -
27
Under penapies of perjury, I declare that I have examined this return. including accompanying schedules and statements, and to the Uest of my knowledge and
Sign Ueliel, it is True, correct, and complete. Declaration of preparer (other than taxpayer) is Uased on all inforrnation of which preparer has any knowledge.
H@Ye
~ May the IR.g discuss this return
`_„_ p
t.. ,,,,,,_„
Si
t
f
ffi
D
l with the preparer shown Uelow
(see instructions ?
ure o
gna
o
cer
ate Tit
e
-.-. X Yes No
Preparer's /
~ Dale f'reparer's SSN or PTIN
Pohl signature ~-
,, _ ~,..=
03/11/09 Check if sol
employed F-
.. n
P00236811
Preparer's Firm's name
Use Only (or yours if
self-erployed)
nddress,and
ZIP code
Vernon M. Ma
12 Summit Dr
Jr., CPA
CIN 04-3698679
Dillsbur
PA 17019
BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
~ Phone no. (717) 7 6 6- 815 6
sPSaollz 12r3oros Form 11205 (2003)
OMB No. 1545-0130
-orrn 1120S (2008) CARDINAL POINT CORPORATION 23-1727859 Paye 2
`
Schedule A
Cost of Goods Sold (see instructions)
1 Inventory at beginning of year ........................................................................... 1
2 Purchases ............................................................................................. 2
3 Cost of labor .......................................................................................... 3
4 Additional section 263A costs (attach statement) ......................................................... 4
5 Other costs (attach statement) .......................................................................... 5
6 Total. Add lines 1 through 5 ............................................................................. 6
7 Inventory at end of year ................................................................................ 7
S Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 ............................ 8
9a Check all methods used for valuing closing inventory:
(i) Cost as described in Regulations section 1.471-3
(ii) Lower of cost or market as described in Regulations section 1.471.4
(iii) Other (Specify method used and attach explanation.) ~
b Clieck if there was a writedown of subnormal goods as described in Regulations section 1.471-2(c:) ...... .... ............. ~
........
c Check if the LIFO inventory method was adopted this tax yeat for any goods (if checked, attach Form 970) .... ..................... ~
d If the LIFO inventor method was used for this tax year, enter percentage (or amounts) of closing
dy
inventory compute
under LIFO ......................................................................... ~ 9 d~
e If property is produced or acquired for resale, do the rules of section 2G3A apply to the corporation? .......... ....... Yes No
f Was there any change in determining quantities, cost, or valuations between opening
and closin inventor ? If'Yes,'attach ex lanation ........................................................ ....... n Yes No
ichedule.B : Other Information see instructions Yes No
1 Check accounting method: a Cash b X Accrual c Other (specify) ~
2 See the instructions and enter the:
a Business activiiy ~ RENTAL_ _ _ _ _ _ _ _ _ _ _ _ _ _ b Product or service ... ~ REAL ESTATE
3 At the end of the tax year, did the corporation own, directly or indirectly 50% or more of the voting stock of a
domestic corporation? (For rules of attribution, see section 267(c).) If Yes,' attach a statement showing:
(a) name and employer identification number (EIN), (b) percentage owned, and (c) if 100% owned,
was a OSub election made? ............................................................................. ............ X
4 Has this corporation filed, or is it required to file, a return under section 6111 to provide information on any
reportable transaction? .............................. ................
................................... ............. X
5 Clieck this box if the corporation issued publicly offered debt instruments with original issue discount ......... ....... ~
If checked, the corporation may have to file Form 8281, Information Return for Publicly Offered Original Issue
Discount Instruments.
6 If the corporation: (a) was a C corporation before it elected to be an S corporation or the corporation acquired
an asset with a basis determined by reference to its basis (or the basis of any other property) in the hands of a
C corporation and (b) has net unrealized built-in gain (defined in section 1374(d)(1)) in excess of the net
recognized built-in gain from prior years, enter the net unrealized built-in gain reduced by net recognized
built-in gain from prior years ..................................................... - $
7 Enter the accumulated earnings and profits of the corporation at the end of the tax year ......... $
8 Are the corporation's total receipts (see instructions) for the tax year and its total assets at the end
f th
t
l
o
e
ax ye
than $250,000? If 'Yes,' the cor oration is not required to complete Schedules L and M-1 ..................... ar
ess
............
X
Schedale K Shareholders' Pro Rata Share Items Total amount
1 Ordinary business income (loss) (page 1, line 21) ..................................................... . 1 -390 .
2 Net rental real estate income (loss) (attach Form 8825)
................................................
2
3 a Other gross rental income (loss) .......................................... 3 a
b Expenses from other rental activities (attach statement) ............................... 3 b
1V c Other net rental income (loss). Subtract line 3b from line 3a ........................................... 3 c
C 4 Interest income ................................................... 4
.................................
M 5 Dividends: a Ordinary dividends ................................................................... 5 a 1, 1 4 1.
E b Qualified dividends .......................................I 5bl 397. .,...
(L 6 Royalties .......................................
...................................................
6
~ 7 Net short-term capital gain (loss) (attach Schedule D (Form 1 120S)) 7
S ....................................
g) 8 a Netlon term ca ital ain loss attach Schedule D Form 1120S .................
9- p 9 ( ) ( ( )) ..................
8a
8, 839 .
b Collectibles (28%) gain (loss) ............................................ Sb 0.
c Unrecaptured section 1250 gain (attach statement) ................................... 8 c
9 Net section 1231 gain (lass) (attach Form 4797) ...................................................... 9
10 Other income (loss) (see instructions) ................ .............................................. 10
Form 11205 (2008)
SPSA0117_ 12/30/OS
r.rwrTr nnT~,m r'nDDr1DDTTr1N
23-1727859 Page 3
!-(?I~fll I ILU J ~LVVV) ~.r-li~L..-..•...., ~~--.- --____ ______.
Shareholders' Pro Rata Share Items (continued)
Total amount
................................................
tion (attach Form 4562)
179 d
d 11
Deduc- ...
uc
e
11 Section
tions ...................................................
ti
ib 12a
ons ...........................
u
12a Contr
...........................................
ense
t ex
t i
t 12b
....................
p
eres
n
b Investmen
(2) Amount ~
enditures (1) Type ~
x
2
59 12c (2)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ .
p
) e
(e)(
c Section
d Other deductions (see instructions) ... T pe ~ 12d
credit (section 42(j)(5)) .................................. ..............
in
h
i 13a
Credits g
ous
ncome
13a Low-
.................................................
credit (other)
in
h
i 13b
.........
g
ous
ncome
b Low•
enditures (rental real estate) (attach Form 3468) ........................ ..........
ex
ti
h
bilit
d
f 13 c
p
a
on
a
re
e Quali
ie
l estate credits (see instrs) Type ~
l
t
h 13d
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _
rea
a
er ren
d Ot
dits (see instrs) Type ~
l
t 13e
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
cre
a
e Other ren
sic biofuel fuels credit (attach Form 6478) ..................................
ll
l
l
d 13f
u
o
ce
an
f Alcoho
Other credits (see instructions) ...... T pe ~ 13
Foreign 14a Name of country or U.S. possession ....... ~_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ._ _ _ _ _
Trans- .. •.
ll sources
f
m 14b
actions ..............
ro
a
b Gross income
................................... ......
ed at shareholder level
r
i
14c
........
c
ncome sou
c Gross
Foreign gross income sourced at corporate level
.................................
...........
t 14d
9 Y .............................
e or
d Passive co
...............................................
t
l 14e
egory ...........................
ca
e Genera
....
nt)
t
h
t 14f
.......................
eme
s
a
f Other (attac
Deductions allocated and apportioned at shareholder level
................. 14g
..........................
g Interest expense
............................................... 14 h
h Other ......................................
Deductions allocated and apportioned at corporate level to foreign source income
................................................
t
i 14i
egory ..........................
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.............................................
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t 14j
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.
......................
em
a
s
k Other (attac
Other information
heck one): ~ ~ Paid ~ Accrued .............................
(
i
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l 141
axes
c
gn
fore
Tota
m Reduction in taxes available for credit
............................................
t
t 14m
) .............................
emen
(attach sta
n Other foreign tax information attach statement)
................................. ...........
n adjustment
ti
i
6 d 15a
Alterna- ............
a
o
eprec
15a Post-198
tive ......................................... ....
l
i 15
.........
...............
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b Adjusted ga
Mini-
.......................................... .
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h 15c
mum ...............
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c Depletion (ot
Tax erties -gross income .........................................
ro
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th
d 15d
p
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(AMT)
...........................................
erties -deductions
al
ro
th
d
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Items .
p
p
erm
geo
a Oil, gas, an
f Other AMT items (attach statement ........................................................ 15f
Items 16a Tax-exempt interest income ................................................................ 16a
..........................................................
Affec- b Other tax-exempt income 16b
ting
16c
Share- c Nondeductible expenses ..................................................................
holder .......... 16d 9, 585.
d Property distributions ...........................................................
Basis
e Repa ment of loans from shareholders ...................................................... 16e
.... 17a 1, 141 .
Other 17a Investment income ....................................................................
........................
Inform- b Investment expenses ......... • • .. • ......... • • • ~ 17b
ation
c Dividend distributions paid from accumulated earnings and profits ............................. 17c ()
d Other items and amounts
(attach statement)
Recon- 18 Incomelloss reconciliation. Combine the amounts on lines 1 through 10 in the far right col-
585
9
ciliation ,~.,,., F..,.,, rt,P IPClllt cllhtract the sum of the amounts on lines 11 through 12d and lines 141 18 .
,
BAA
Form 11205 (20081
SPSA013M1 06/25/08
Form 1120S (2008) CARDINAL POINT CORPORATION
SChedule°L Balance Sheets er Books
Beginning of tax year ~,y,,
End of tax year
Assets (a) (b) (c) (d)
1 Cash ...................................... -
2a Trade notes and accounts receivable ........
b Less allowance for bad debts .............. .
3 Inventories ................................
4 U.S. government obligations ............... .
5 Tax-exempt securities (see instructions) ....
6 Other current assets (attach stmt) ................. .
7 Loans to shareholders ......................
8 Mortgage and real estate loans ............. .
9 Other investments (attach statement) .. Ln.. 9.. S t ... 10 0 . 10 0 .
10 a Buildings and other depreciable assets .......
b Less accumulated depreciation ............. . _
11a Depletable assets .......................... '
b Less accumulated depletion ................ .
12 Land (net of any amortization) ............. .
1 a Intangible assets (amortizable only) ........ .
---
b Less accumulated amortization ............. .
14 Other assets (attach stmt) ................. .
15 Total assets ............................... 1 0 0. 1 0 0.
Liabilities and Shareholders' Equity
16 Accounts payable ..........................
17 Mortgages, notes, bonds payable in less than 1 year .. .
18 Other current liabilities (attach stnrt) ............... .
19 Loans from shareholders ...................
20 Mortgages, notes, bonds payable in 1 year or more ... .
21 Other liabilities (attach statement) ................. .
22 Capital stock ..............................
23 Additional paid-in capital .................. .
24 Retained earnings .......................... 100. 100 .
25 Adjustments to shareholders' equity (attstrnt) ........ .
26 Less cost of treasury stock ................. .
27 Total liabilities and shareholders' e uit ...... 100. 100 .
Schedule M=1 Reconciliation of Income (Loss) per Books With Income (Lnscl npr Rptr~rn
Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or more -see instructions
1 Net income (loss) per books ................ 9, 585. 5 Income recorded on hooks this year not included
2 Income included on Schedule K, lines 1, 2, 3c, 4, 5a, 6, 7,
8a, 9, and 10, not recorded on hooks this year (itemize):
---------------------- on Schedule K, lines 1 through 10 (itemize):
a Taz-exempt interest . $
--------
3
Expenses recorded on books this year not
included on Schedule K, lines 1 through 12,
and 141 (itemize):
a Depreciation ....... $_ _ _ _ _ _ _ _ _ _ _
bTravel and entertainment . $
----------- ------------
6 Deductions included on Schedule K, lines 1 through
12, and 141, not charged against book income this
year (itemize):
a Depreciation .... $
-----------
--------------------
----------------------
7 Add lines 5 and 6 ..................... .
4 .odd lines 1 through 3 ....................... 9, 585. 8 Income (loss) (Schedule K, In 18). Ln 4 less In 7 ... 9, 585 ,
Schedule M-2' Analysis of Accumulated Adjustments Account, Other Adjustments Account, and
Shareholders' Undistributed Taxable Income Previously Taxed (see instructions)
(a) Accumulated
adjustments account (b) Other
adjustments account (c) Shareholders' undis-
tnbuted taxable income
previously taxed
1 Balance at beginning of tax year ...................... ............ 100. 0 . 0 .
2 Ordinary income from page 1, line 21 ................. .. .
3 Other additions ............. ".. STM.T................ ............ 9, 975
4 Loss from page 1,Iine 21 ............................. ............ 3 9 0 .
5 Other reductions ..................................... ............
6 Combine lines 1 througl, 5 ............................ ............ 9, 685. 0. 0 .
7 Distributions other than dividend distributions .......... ............ 9, 585. 0 . 0.
8 Balance at end of tax year. Subtract line 7 from line 6 .. ............ 100. 0 . 0 .
sPSAOt3a oerzsroa Form 11205 (2003)
~ •
2~S U.S. Income Tax Return for an S Corporation
Form - Do not file this form unless the corporation has filed or is
Department of the Treasury attaching Form 2553 to elect to be an S corporation.
Internal Revenue Service 'See separate instructions.
OMB No. 1,545-0130
2007
For calendar ear 2007 or tax ear beginning , 2007, ending
A Selection effective date (J5C the Name D Employer identification number
01/01/87 IRS CARDINAL POINT CORPORAT7:ON 23-1727859
Business aciivit code label. Number, street, and room or suite no. If a P.0. box, sce instructions.
B number (see instrs) Other- E Date incorporated
999999 wise, 404 EVERGREEN AVE. 06/17/70
C Check if Sch M-3 print or City or town, state, and ZIP code F Total assets (see instructions)
auacned ~ type. WESTMONT NJ 08108 $ 100.
G Is the corporation electing to be an S corporation beginning with this tax year? '>'es X No If 'Yes,' attach Form 2553 if not previously filed
H Check if: (1) ~ Final return (2) ~ Name change (3) Address change
(4) Amended return (5) ~ S election termination or revocation
Enter the number of shareholders in the corporation at the end of the tax year ........... ...................................... ~ 1
Caution. Include on/v trade or business income and expenses on lines la through ?1. See the in.atrurtinns fnr more infnrmatinn
1 a Gross receipts or sales ..~ ~ b Less returns and allowances .. c Bal ~ 1 c
I
N 2 Cost of goods sold (Schedule A, line 8)
.............. .............
2
C 3 Gross profit. Subtract line 2 from line l c ................................................ ............. 3
O 4 Net gain (loss) from Form 4797, Part II, line 17 (attach Form 4797) ....................... ............. 4
M
E 5 Other income loss
( ) (attach statement) ................................................. .............
5
6 Total income (loss). Add lines 3 throu h 5 ......................................................... ~ 6
7 Compensation of officers ............................................................................ 7
D 8 Salaries and wages (less employment credits) ........................................................ g
E 9 Repairs and maintenance ........................................................................... 9
D
U 10 Bad debts
.................................................................................. 10
C 11 Rents ............................................................................................. 11
T
I 12 Taxes and licenses
.................................................................. 12
O 13 Interest ............................................................................................ 13
N
S 14 De reciation not claimed on Schedule A or elsewhere on return attach Form 4562
P ( ) ................
14
15 Depletion (Do not deduct oil and gas depletion.) ...................................................... 15
E 16 Advertising
........................................................................................ 16
t
17 Pension, profit-sharing, etc, plans ............................................................... ...
17
N 18 Employee benefit programs ......................................................................... 18
T 19 Other deductions (attach statement) ...... *..STMT ................................................... 19 450 .
s 20 Total deductions. Add lines 7 through 19 ............................................:.............. ~ 20 450 .
21 Ordinary business income (loss). Subtract line 20 from line 6 ......................................... 21 -450 .
T 22a Excess net passive income or LIFO recapture
A tax (see instructions) .................................................... 22a
X b Tax from Schedule D Form 1120S
( ) .......................................
22b
A c Add lines 22a and 22b (see instructions for additional taxes) ............................ ........................... 22e
N 23a 2007 estimated tax payments and 2006 overpayment credited to 2007....... 23a
D
b Tax deposited with Form 7004 ............................................ 23b 0.
P c Credit for federal tax paid on fuels (attach Forrn 4]36) ..................... 23c
A
Y d Add lines 23a through 23c ........................................................................... 23d 0 .
M
E 24 Estimated tax penalty (see instructions). Check if Form 2220 is attached .................. ..... ~ ~ 24
N 25 Amount owed. If line 23d is smaller than the total of lines 22c and 74, enter amount owed ................................ 25 0 ,
T
S 26 Overpayment. If line 23d is larger than the total of lines 22c and 24, enter amount overpaid .............. 26
27 Enter amount from line 26 Credited to 2008 estimated tax ~ I Refunded ~ 27
Under penalties of perjury, l declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and
Sign belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here May the IRS discuss this return
with the preparer shown below
(see instructions ?
'
,
Signature of officer Date
Title
X Yes No
Preparer's Date Preparer's SSN or PTIN
signature ,
Pairl
12 / 13 / 11 ~
ernpioyed e lr I~ I
P O O 2 3 6 811
Preparer's Firm's name Vernon M. Martin Jr
Use Only (nr yours it
sett-employed), I 12 Summit Dr
address. and Dillsburg PA 17019
ZIP code
BAA For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
PA
ElN 04-369867
~ Phone no. (717) 7 6 6- 815 6
SPSA0112 12126/m Form 1120S (2007)
~ - s
Form 11205 (2007) CARDINAL POINT CORPORATION 23-1727859 Page 2
Schetlule-A Cost of Goods Sold (see instructions)
1 Inventory at beginning of year ....................................................................... .... 1
2 Purchases ............................................................................... ......... .... 2
3 Cost of labor ...................................................................................... .... 3
4 Additional section 263A costs (attach statement) ........................... ......................... .... 4
5 Other costs (attach statement) .................................................................. . .... 5
6 Total. Add lines 1 through 5 ......................................................................... .... 6
7 Inventory at end of year ............................................................................ .... 7
8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 ...................... . .... 8
9a Check all methods used for valuing closing inventory:
(i) Cost as described in Regulations section 1.471-3
(ii) Lower of cost or market as described in Regulations section 1.471-4
(iii) Otlier (Specify method used and attach explanation.) ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _
_ _
b Check if there was a writedown of subnormal goods as described in Regulations section 1.471-2(c) _ _ _ _ _ _ _ _ _ _ _ _ _ _
~
c Clieck if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970) .................... ... ~
d If the LIFO inventory method was used for this tax year, enter percentage (or amounts) of closing
I
l
inventory computed under LIFO ..................................................................... ....
9d
e If property is produced or acquired for resale, do the rules of section 263A apply to the corporation? ...... ........... ~ Yes ~ No
f Was there any change in determining quantities, cost, or valuations t~etween opening
and closing inventory? If 'Yes,' attach explanation .......................................... .........
........... n Yes
n No
Schedtale B Other Information see instructions Yes No
1 Check accounting method: a ~ Cash b X^ Accrual c Other (specify) ~
2 See the instructions and enter the:
a Business activity ~ RENTAL b Product or service ... ~ REAL ES'.PATE
-------------------- -------------
------
3 At the end of the tax year, did the corporation own, directly or indirectly, 50% or more of the voting stock of a
domestic corporation? (For rules of attribution, see section 267(c).) li' 'Yes,' attach a statement showing:
(a) name and employer identification number (EIN), (b) percentage owned, and (c) if 100% owned,
was a QSub election made? ...................................................................... ... ............ X
4 Has this corporation filed, or is it required to file, a return under section 6111 to provide information on any
reportable iransaction? .................................................................................. . .......... X
5 Checl< this box if the corporation issued publicly offered debt instruments with original issue discount ......... ....... ~
If checked, the corporation may have to file Form 8281, Information Return for Publicly Offered Original Issue
Discount Instruments.
6 If the corporation: (a) was a C corporation before it elected to be an S corporation or the corporation acquired
an asset with a basis determined by reference to its basis (or the basis of any other property) in 'the hands of a
C corporation and (b) has net unrealrzed built-in gain (defined in section 1374(d)(1)) in excess of the net
recognized built-in gain from prior years, enter the net unrealized built-in gain reduced by net recognized
built-in gain from prior years .............................. ..... ................ ~ $
7 Enter the accumulated earnings and profits of the corporation at the end of the tax year ......... $
8 Are the corporation's total receipts (see instructions) for the tax year and its total assets at the end of the tax year less
than $250,000? If 'Yes,' the corporation is not required to complete Schedules L and M-1 ..................... ............ X
Schedule K Shareholders' Pro Rata Share Items Total amount
1 Ordinary business income (loss) (page 1, line 21) ............. ....................................... 1 -450.
2 Net rental real estate income (loss) (attach Form 8825) ........ ....................................... 2
3a Other gross rental income (loss) .......................................... 3a
b Expenses from other rental activities (attach statement) ............................... 3 b
I
N c Other net rental income (loss). Subtract line 3b from line 3a ... ................... .
..........
3 c
C
............................................
4 Interest income ................... ............. 4 1, 491 .
O
M
5 Dividends: a Ordinary dividends ........................... ......................... .............
5 a
3, 5 9 9.
E b Qualified dividends .......................................I 5bl 592.
_
(L 6 Royalties .................................................. ......................... ............. 6
~ 7 Net short-term capital gain (loss) (attach Schedule D (Form 1 ]20S)) ...................... ............. 7
S
S) 8a Net Ion term ca ital ain loss
g- p g ( ) (attach Schedule D (Form 1 120S)) ...................... .............
8 a
4 , 9 9 7 .
b Collectibles (28%) gain (loss) ........................................... 8b
c Unrecaptured section 1250 gain (attach statement) ................................... 8 c
9 Net section 1231 gain (loss) (attach Form 4797) ........................................ ............. 9
10 Other income (loss) (see instructions) .................. ............................... ............. 10
Form 1120S (2007)
SPSA01 12 12/26!07
Form 1120S (2007) CARDINAL POINT CORPORATION
23-1727859 Pane 3
Shareholders' Pro Rata Share Items (continued) Total amount
Deduc- 11 Section 179 deduction (attach Form 4562) ........... .......... ............................ 11
tions 12a Contributions .............................................................................. 12a
b Investment interest expense ............ ............... ................................ .. 12b
c Section 59(e)(2) expenditures (1) Type ~- - - - - - - - - - - - - - - - - (2) Amount ~ 12c (2)
d Other deductions (see instructions) ... Type ~ 12d
Credits 13a Low-income housing credit (section 42(j)(5)) ................................................. 13a
b Low-incorrle housing credit (other) .......................................................... 13b
c Qualified rehabilitation expenditures (rental real estate) (attach Fon1134G8) ................................... 13e
d Other rental real estate credits (see instrs) Type ~ 13d
e Otlier rental credits (see instrs) Type ~
---------------------------- 13e
f Creditfor alcohol used as fuel (attach Form 6478) ........................................... 13f
g Other credits (see instructions) Type ~ 13g
Foreign
Trans-
actions 14a Name of country or U.S. possession ....... ~
------------ --------
bGross income from all sources ......................... ...................................
4b
c Gross income sourced at shareholder level .............. ................................... 14c
Foreign _gross income sourced at corporate level
d Passive category .................................................................. .......
14d
e General category .......................................................................... 14e
f Other (attach statement) ............... ............... ................................... 14f
Deductions allocated and apportioned at shareholder level
g Interest expense .............:............................................................
14g
h Other ................................................. ................................... 14h
Deductions allocated and apportioned at corporate level to foreign source income
i Passive category ......................... ............ ...................................
14i
j General category .......................................................................... 14j
k Other (attach statement) ............................... ................................... 14k
Other information
Total foreign taxes (check one): - ~ Paid ~ Accrued ............................
141
m Reduction in taxes available for credit
(attach statement) ..................................... ...................................
14m
n Other foreign tax information (attach statement)
Alterna- 15a Post-1986 depreciation adjustment ..................... ................................... 15a
tive
Mini- b Adjusted gain or loss
.......... 15b
mum c De letion other than oil and as .................
P ( 9 ) ....................... 15c
Tax
(AMn d Oil, gas, and geothermal properties -gross income .... .
.........
15d
Items a Oil, gas, and geothermal properties -deductions ........ ....................... ........... 15e
f Other AMT items (attach statement) .................... ................................... 15f
Items 16a Tax-exempt interest income ............................ ................................... 16a
Affec-
ting b Other tax-exempt income .............. ............... ................................... 16b
Share- c Nondeductible expenses ............................... ......................... ....... 16c
holder
Basis d Property distributions .............
................................................. 16d
,
9 587 .
e Repayment of loans from shareholders .................. ................................... 16e
Other 17a Investment income ........................................................................ 17a 5, 090.
Inform-
ation binvestmentexpenses
..................................
.....................
17
c Dividend distributions paid from accumulated earnings and profits ............................. 17c 0.
d Other items and amounts
(attach statement)
Recon-
ciliation 18 Income/loss reconciliation. Combine the amounts on lines 1 through 10 in the far right col-
umn. From the result, subtract the sum of the amounts on lines 11 through 12d and lines 141 ..
18
9, 587 .
BAA
Form 1120S (2007)
SPSA0134 09/28/07
• • '' ~
Form1120S(20071 CARDINAL POINT CORPORATION ~~-i~~~RSa o~„on
Schedule L Balance Sheets per Books Beginning of tax year End of tax year
Assets (a) (b) (c) (d)
1 Cash ......................................
2a Trade notes and accounts receivable ........
b Less allowance for bad debts .............. . _
3 Inventories ................................
4 U.S. government obligations ............... i
5 Tax-exempt securities (see instructions) ... .
6 Other current assets (attach stmt) ................. .
7 Loans to shareholders ..................... .
8 Mortgage and real estate loans ............. .
9 Other investments (attach statement) .. Ln.. 9.. S.t ... 10 0 . 10 0 .
10a Buildings and other depreciable assets .......
b Less accumulated depreciation ............. . _
11a Depletable assets ..........................
b Less accumulated depletion ................ . _
12 Land (net of any amortization) ............. .
13a Intangible assets (amortizable only) .........
b Less accumulated amortization ............. . _
14 Other assets (attach stmt) ................. .
15 Total assets ............................... 100 - 100 .
Liabilities and Shareholders' Equity
16 Accounts payable ..........................
17 Mortgages, notes, bonds payable in less than 1 year .. .
18 Other current liabilities (attach stmt) ............... .
19 Loans from shareholders .................. .
20 Mortgages, notes, bonds payable in 1 year or more ... .
21 Other liabilities (attach statement) ................. .
22 Capital stock ..............................
23 Additional paid-in capital .................. .
24 Retained earnings .......................... 100. 100 .
25 AdjusUnents to shareholders' egwty (attstrnt) ........ .
26 Less cost of treasury stock ................. .
27 Total liabilities and shareholders' equity ......
- - - 100. 100.
I ~cneauie rvr i I rceconcniauvn or income ~~oss1 per tsooKS vvlin income (Loss) per Keturn
Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or more -see instructions
1 Net income (loss) per books ................ 9, 587 ._ 5 Income recorded on books this year not included
2 Income included on Schedule K, lines 1, 2, 3c, 4, 5a, 6, 7, on Schedule K, lines 1 through 10 (itemize):
8a, 9, and 10, not recorded on books this year (itemize): aTax-exempt interest . $
---------------------- --------------------
3 Expenses recorded on books this year not 6 Deductions included on Schedule K, lines 1 through
included on Schedule K, lines 1 through 12, 12, and 141, not charged against book income this
and 141 (itemize): year (itemize):
a Depreciation ....... $ a Depreciation .... $
----------- ------
bTravel and entertainment . $
--------------------
7 Add lines 5 and 6 ......................
----------------------
4 Add lines 1 through 3 .. .................... 9, 587. 8 Income (loss) (Schedule K, hl 18). Ln 4 less In 7 ... 9, 587 .
Schedule M-2 Analysis of Accumulated Adjustments Account, Other Adjustments Account, and
Shareholders' Undistributed Taxable Income Previously Taxed (:see instructions)
(a) Accumulated (b) Other (c) Shareholders' undis-
adjustments account adjustments account tributed taxable income
previously taxed
1 Balance at beginning of tax year .................................. 100 .
2 Ordinary income from page 1 , line 21 ............................ .
3 Other additions ............. "-..STMT ........................... .
4 Loss from page 1 , line 21 ........................................ .
5 Other reductions .................................................
6 Combine lines 1 through 5 ................................. ..... .
7 Distributions other than dividend distributions ............... ..... .
8 Balance at end of tax year. Subtract line 7 from line 6 ............. .
SPSA0134 09/2S/07
10,037.
450.
9, 687 .
9, 587 .
100.
0. 0.
0. 0.
Form 11205 (2007)
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