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HomeMy WebLinkAbout07-27-07_, 15056051058 REV-1500 EX (os-05) OFflC1ALt,3E ONLY PA Department of Revenue CouFtiy Code Year File Number Bureau of individual Taxes INHERITANCE TAX RETURN ' PO BOX 280601 21 06 '00240 Hartislwrg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sodal Security Number Date of Death Date of Birth 188-64-9320 03/05/2006 09/06/1970 Decedent's Last Name Suffix Decedent's First Name MI _ _ _ DERR _ CHAD M, (H Applicable) Enter Surviving Spouse's tnformation Below Spouse's Last Name 5uttix Spouse's First Name MI _ _ _ __ _ Spouse's Social Security Number FILL INAPPROPRIATE OVALS BELOW t'/7 1. Original Retum THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER 4F WIL,LS t~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) C~ 4. Limited Estate C~ 4a. Future Interest Compromise (date of C'? 5. Federal Estate Tax Retum Required death after 12-12-82) 6. Decedent Died Testate G? 7. Decedent Maintained a Living Trust __0__ 8. Total Number of Safe Deposft Boxes (Attach Cqpy of III) (Attach Copy of Trust) +~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death G'~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SNOtICD BE DIRECTED T0: Name _ _ _ Daytime Telephone Number VICTOR A. NEUBAUM {717) 843-8001 ..Firm Name (If ApplipWe) _ _ 1~lLi.B USE ONf~ - ~ REt31$TER OF MALONE &NEUBAUM ~ 4:' '. -p ~-~ ~ _ _ .~ ~ ~ First line of address _ ~~ ~ `--- ~_ C7 f-_ ~ 42 SOUTH DUKE STREET , ~ ~'--r'-~, Iv 1 :.~ ~ i - -- Second line of address _ .; _, -T _ ~ -rt ` i _ DATE FIND --- ~ City or Post tDffice State ZIP Code _ _.._._ _.. _~ ...~ - -- _ ___......._ 1 1 , YORK ! PA 17401 eb Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, inducting accomperrying sdredules and atatemerds, and to the best of my Imowiedge end belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU~ ~f~RSt ~ESP~IBLE F(~1R FIL,G RETURN „n~ ~ ,~~~n~ ~ S ~I ~~ /~ ADDRESS • ~ - '- - 2252 PINETOWN ROAD, ~.EWISBERRY, PA 17339 Side 1 15056051058 15056051058 ~m ADDRESS 42 SOUTH DUKE STREET, YORK, PA 17401 PLEASE USE ORIGINAL IeORM ONLY J 15056052059 REV-1500 EX De+~dent's Social Security Number _.._ _ DBCed~,rSNeme: CHAD M. DERR ' 188-64-9320 RECAPITULATION 1. Real estate {Schedule A) ............................................. 1. ' I 2. Stocks and Bonds (Schedule B) ....................................... 2., 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ' 7,232.35 4. Mortgages & Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank De sits & Miscellaneous Personal Pr Schedule E po ~rtY ( ) ....... . 5. 280.57 ', 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 7. Inter-Vrvos Transfers & Miscellaneous Non-Probate Property (Schedule G} ~7 Separate Biling Requested........ 7. 8. Total Gross Assets (total Lines 1-7) .................................... 8. 7,512.82 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. ' 15,114.02 10. Debts of Decedent, Mortgage Liabilitles, & Liens (Schedule I) ................ 10. 144,774.64 '. 11. Total Deductbna {total Lines 9 8 10) ................................... 11. 159,868.66 12. Net Value ot` Estate (Line 8 minus Line 11) .............................. 12. , -152,345.74 , 13. Charitable and Governmental Bequests/Sec 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. ' 0.00 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLIGABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or _ transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate X .0 45 0.00 16. , 0.00 17. __ Amount of Line 14 taxable .. __._ at sibNng rate X .12 17• 18. Amount of Line 14 taxable at collateral rate X .15 18. , 0.00 19. ...................................... TAX DUE ................... is.; 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C~ 15056052059 Side 2 15056052059 REV-1500 EX Page 3 Decedent's Complete Address: ~_~..21 -)f__~ ~ 0240mber.. __ a 4i --- - __. _ DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER CHAD M. DERR 188-64-9320 STREET ADDRESS 10 EAST GREEN STREET CITY SHIRESMANTOWN STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 0.00 2. CreditsJPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D + E) (3) 4. ff line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Pa®e 2, Line 20 to ragas:t a refund. (4) 5. ff Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. {5) A. Enter the in~rast on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0•~ Make Check Payable to: REGISTER OF W1LLS, 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 shah use the property transferred or its income : ............................................ ^ c. retain a reversionary inthrest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. ff death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adec~ate consideration? .............................................................................................................. ^ 3. Did decedent own an intrust for" or payable upon death bank account or security at hls or her death? .............. ^ 4. Did decedent own an Individual Retirement Aoceunt, annuity, or other non-probate property whid- contains a benefiaary 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent (72 P.S. §9116 (a) (1.1) (i)]. For dates of death an or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0} percent [72 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 stiN applicable Sven if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefiaaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent (72 p.S. §9116(a)(1.3)]. Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1504 EX+ fg•~) GOMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDfNT s~NEOU~E c CLOSELY HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER CHAD M. DERR 21-06-0240 Schedule C-1 or C•2 (indudirg atl supporting information) must be attadied for each cbsely-held coiporatbnlpartnership interest of the decedent, other than a sole-proprietorship. See bstrudbns for the supporting information to be submitted forsole-proprietorships. ITEM NUMBER VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ ~ CASH ON HAND (WACHOVIA BANK 6202) CHAD M. DERR D/B/A/ DERR'S LANDSCAf'iNG SERVICE 22,516.19 2 PRIVATE SALE OF EQUIPMENT TO SCOTT EBERLY (SEE ATTACHMENT) 4,802.00 3. PRIVATE SALE OF EQUIPMENT TO ANTHONY HECKMAN (SEE ATTACHMENT) 2,912.00 4. PUBLIC AUCTION OF EQUIPMENT, JULY 29, 2006, ZIEGLER AUCTION CO., HUMMELSTOWN, PA (SEE ATTACHMENT) 64,461.19 5. PUBLIC AUCTION OF EQUIPMENT, JANAURY 31, 2007, ZIEGLER AUCTION CO., HUMMELSTOWN, PA (SEE ATTACHMENT) 11,151,00 NOTE: AUCTION SALES OF EQUIPMENT WITH SECURED DEBT AS SHOWN ON LIST OF ELIMINATED THE SECURED DEBT, SUCH THAT NET PROCEEDS TO ESTATE WERIE FURTHER REDUCED BY PAYMENT OF SECURED DEBT. TOTAL (Also enter on line 3, Recapitulation) I $ 105,842.38 (If more space is needed, insert additbnal sheets of the same size) ATTACHMENT TO SCHEDULE C: BUSINESS DEBT D BUSINESS DEBT 1. Davis Landscape ,Ltd., Harrisburg, PA $ 6,930.00 2. Natresco Lansdcape Servides, Ltd. $ 2,355.00 3. Greenlawn $ 750.00 4. Verizon $ 70.01 5. Cingular $ '186.00 6. Weavers Lawn & Garden $ '186.00 7. Lesco Credit Services (8005) $ 4,960.00 Total Unsecured Business Debt. $ 15,437.01 SECURED BUSINESS DEBT 8. PNC Bank (F350 Pickup) $ 20,940.64 9. Ford Credit (F350 Crew cab) $ 10,?75.00 10. Chase Auto Financing (F350 Crew cab) $ 21,486.34 1 1. Town & Country Leasing (Ford Chasis) $ 4,000.00 12. Ingersoll Rand (Bobcat) $ 2,147.00 13. Harleysville Bank (Blower) $ 24,324.04 Total Secured Business Debt. $ 83,173.02 TOTAL BUSINESS DEBT $ 98.610.03 RE1~15U8 EX+ (6.98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scNeou~E ~ CASH, BANK D~POSRS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER CHAD M. DERR 21-06-0240 Indude the proceeds of litlgadon and the date the proceeds were received by the estate. All property jointlyawned with right of survivorship must be disclosed on Schsdule F. (tf more space is needed, insect additional sheets of the same size) REV-1512 IX+ (12•D3) CAMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT scNiou« i DEBTS OF DECEDENT, MORTGAGE l1ABILITIES, & LIENS ESTATE OF rat: nuMr~ttt CHAD M. DERR 21-06-0240 Report detds incurred by the decedaM prior to death vrh~h remahrod unpaid as of the date of death, >ncludin~ unreimlwreed media{ expenses, ITEM 4ALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ CHASE MANHATTAN BANK, N.A. (6636} (CLAIM FILED} 3,930.63 2. CAPITOL ONE (8166) (CLAIM FILED} 3,571.10 3. MBNA AMERICA (3518) (CLAIM FILED} 18,1$6.87 4. CITICORP CREDIT SERVICES (9548) (CLAIM FILED) 16,784.00 5. AMERICAN EXPRESS (51002) (CLAIM FILED) 7,939.00 6. AMERICAN EXPRESS (31002) 11,303.00 7. HERITAGE DIAGNOSTIC 126.00 8. HAMPTON TOWNSHIP AMBULANCE 395.00 9. HOLY SPIRIT HOSPITAL (PAID BY PA MEDICAL ASSISTANCE) 44,824.90 10. QUANTUM DIAGNOSTIC (PAID BY MEDICARE) 36.00 11. ASSOCIATED CARDIOLOGISTS (WRITTEN OFF) 25.00 12. 2005 FEDERAL INCOME TAX LIABILITY 25,037.00 13. 2006 FEDERAL INCOME TAX LIABILITY 6,019.00 14. 2004 PENNSYLVANIA STATE INCOME TAX LIABILITY 376.34 15. NTEREST ON 2004 PENNSYLVANIA STATE INCOME TAX LIABILITY 34.00 16. 2005 PENNSYLVANIA STATE INCOME TAX LIABILITY 2,582.00 17. 2006 PENNSYLVANIA STATE INCOME TAX LIABILITY 656.00 18. 2005 WEST SHORE E.I.T. LIABILITY 1,381.00 19. 2006 WEST SHORE E.I.T. LIABILITY 348.00 20. PA DEPT OF REVENUE ASSESSMENT 33.59 21. NIEMAN MARCUS DEPT. STORE 885.22 22. J.C. PENNY DEPT. S70RE. 301.00 TOTAL (Also enter on line 10, Recapitulation) S I 144,774.65 (If more space Is needed, insert additional sheets of the same size) REV•1513 EX+ (fl-00) scx~ou~ ~ COMINON4VEALT-I of PENNSrLVANtA BENEFICIARIES INHERRANCE TAX RETURN RESIDENT DECEDENT ---- _ ___ ESTATE OF FILE NUMBER CHAD M. DERR 21-06-0240 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECENING PROPERTY Do Not Ust Trustee(s) OF ESTATE T `~ t TAXABLE DISTRIBUTIONS (include outright spousal distdbutiorrs, and Uanafers under Sec. 9116 (a) (1.2)j 1 ~ SYLVIA B .DERR, 69 CARAVAN COURT, MIDDLETOWN, PA 17057 MOTHER 50% 2. JAMES D. DERR, 2039 ESHELMAN ST., MIDDLETOWN, PA 17057 FATHER 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE ANO GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S (If more space is needed, Insert additional streets of the same size) .,+ 4~ SALES a+--G1~El~N~ ~etwelea E$tat~ a~ _C,h~d 1~ pert And Anthony ~ectc~nan December 28, 2006 Terms of the agreement: - Equipment is sold as is and where is (building used by Derr Landscaping operations). -Equipment will be removed from the building not later than 1~/~ 1/06 by the buyer. - Sellers will provide a notarized copy of trailer title to the, buyer within 10 days of the sale date. Consideration: Amount of the sale is $2912 to be paid by the buyer to the seller.* *Paid without PA sales tax as an isolated sale for estate liquidation. ~~ Philip C. chards Airthony #~ieclcman Administrator for the Estate of ,(buyer) Chad 1VI. Derr (seller) Equipment: Carmate enclosed trailer )~-Z dump frailer ~/0 // ~o~d( l~i~G -' ,. v ~ ~ ~ . '~ SALES AG1t1EEMENT Between Lst~te of Chad 1~ berr And Scott Et~erly December 28, 2006 Terms of the a~teethent: - Lqui~meht is sold ~ i$ ~~ ~vhete itl (building used li'y Derr 1/ands~apin~ operations). - Equipment Will be rethn~@d ~rbtti the buildih5 tint later than 1~%3 ~/06 6~- the buyer. f ,. ~ d tt~ - Sellers ~v111 ~ro~ide a tt~te bops nt~t~ ' ~~ title to the buyer withltt 1b days of the sale date. Consideration: AtFltiiftit o~the alb t§ ~~ to b~ ~~ld ~~+ the bugtt tri the ~eller.~ ~l'ai~ without ~A salh~ faX do isolated sale for estate l~gt~idat~ot~. Philip C. 'chards Scott $berly Administrator for the Estate o~ (buffer) Chad lbt. Derr (seller) Equipment as listed on attachment ~,~g4v berr Estate Items sold to Scott Eberly appraisers NAanufacturer bescription Model, Condition Fr Mkt Vai X Mark Laser 5' aioWer Muicliing good 2,800 X Mark Laser 5' mower blowing good 2,800 X-Mark Laser 5` mower blowing good 2,800 i Dayton Twin tank air compressor good 450 Lii Wonder bed edger i=H381 f3 good 7,800 Lil Wander commerdal blower Shp good 650 Stihi back pack blower good 150 Stihi weed whacker SOR 'good 1 ~5 i Stihi hedge trimmer ; good 125 Husky tool chest = top/bottoM Lair $5 unknown utility troller 72' 'good 1,800 Taal 14,035 AUditi~i 1`edor 38'iG applied 5,335 ~ommissitlit dvoid~nt~ 1096 ~d,~d2 fit~al dU5 `~: ~ ~ s ~~~~ ;; z ,, ,,;: 1550 SAND HILL RD. HUMMELSTOWN, PA 17036 VOICE: 717.533.4267 FAX: 717.533.2114 www. zieglerauction. c om E-:MAIL::tnfo®zieglerauction. com Req.l Estate, Commercial ia.nd Personal Property Auctions AUCT~~.1~ S~T'~'I~~ME~T ~~L~,ER; ~?~ LA~SC~~~~G ~U!C~'~QN ~~'~'~, ~Iuly ?9, 2pob ~UC~'~ON LOC~A.'~~ON; ~yt~1' ~?~.~ #~~r~-~sburg ~~ ~.UC'~'~C1N ~~AC~~DS~ ~ 7~,735,QQ SELLERS EXPENSE: A~~TCT~pN COIV~PAN~ C~111~1V~ISS~Q~11; $ 5,021,47 ~pY~~TISIN~; Guide $434.00 Lancaster Farmer $424,6 Lebanon D~~y News $ 389,55 Post Card 1'Via~le~r~ ~r~d Postage $727,75 $ 1,975,92 Other Exspenset Battery $148.38 Toilet $ 89,04 3 over night for pay Lean Pay Qf~ .$36,40 $ 273,42 Auction`` Net'rotal $ 64,464,19 155p SAND HILL RD. HUIV~MELSTOWN, PA 17p36 VOICE: 717.533.4267 FAX: 717.533.21 ~ 4 www. zieglerauction. com E-MArII•; Info®zieglerauction.com ~~0!! (~+F~~~ ~'0~'~~tlts3 Real ,Estate, CorrUnercial anal ~ersottal Property Auctions 2Q,229,5$ ~~rleY ~c~u~~~l~nt C~ #~4Q~? ~ B~t'~ ~~ower~ $ 7,~A~~35 Find ~Cr+~dit ~ ~ ~5Q ~u~~ ~' ~K# 4860 $ 2,x'73,44 C~TI ~CAF~QI. fob ~~t ~1~ # 4859 $ 4,013.45 down and Country Leasing 1995 Ford CF8000 Ck# 4858 '~ ~'otal paid $ 33,517.82 to pad off le~~ ox ~e~ses. Net Amount $ 30,946.37 Thank you fob using Ziegler Auction Company, Ltd. •T ., ~~~ r . ZIEGL_ER AUCTION COMPANY LTD. 1550 SAND.` HILL RD r 1 HUMMEI..STOWN, PA . :.17036 ~ WWW. Z I E[3L_ER~tUCT I ON. COM 717. 53 3. 4267 : @8111/06 - - C~ISI6NOR STRTEMENT - - ~ PAGE 1 CONSIGNOR NUMBER : 1322 AUCTION NUMBER :06@729 NAME s D/B/p DERR LANDSCAPING ~ ESTATE OF CHAD DERR , • LYTEA RD HRRRISBUR6, PA 17111 808 088 0800 ~ PROD ITM INV UNIT TOTAL COMMISSION SELLER'S CODE __ ~ N0. _____ ----- ITEM DESCRIPTIQN ------- NO. ___r___.-----------_~ ~~. QTY .._____ PRICE ~.~r.------- PRICE ----- ----- AMOUNT ._. --- - - NET AMOUNT , - - -- - ___ _ Fll 2888 15 FOOT CHAIN _ 1 6.88 6.00 7% -- .__- -- .42 -_------ - - - - - 5.58 FU 2801 CHOICE OF MEASURING WHEELS 1 8.00 8.00 7% .56 7.44 FU 2802 2 MEASURING 11HEELS 1 16.00 1fi.08 7% 1.12 14.88 FU 2883 COMPUTER DESK, SHEI.VIN6 1 5.88 5.00 7% .35. 4.65 FU 2884 SLRTE T~ POOL TABLE 1 18.08 18.08 7% .70 9.30 ' fU 2@85 OFFICE CHAIR i .15.88 15.80 7% 1.85 13.95 _~ ~ FU 2886 ALUMINUM CART 1 55.@0 55.00 7% 3.85 51.15 FU 2887 CRAFTSMAN THRTCHER 1 2.08 2.80 7% .14 1.8fi FU 2888 AIR COMPRESSOR 1 75.08 75.88 7% 5.25 69.75 FU 2889 RUNNING BOARDS 1 38. N 38.@8 7% 2.18 27.98 ;~ FU 2818 LESCO BACK SRAAYERS, CHOICE 2 52.50 185.88 7% 7.35 97.65 FU 2@11 2 TOOL BOXES, CHRINS, DRILL! 1 22.58 22.58 7% 1.58 20,92 ANGLE GRINDER, 1&EELS FU 2@12 CHOICE DF PAIR OF CI~IRS 0 .88 .~ 0% .00 .@@ ' FU 2813 GYM SET 1 6. M 6.88 7% . 42 5.58 FU 2814 SLEIGH BED KITH MRTRESS 1 75.88 75.08 7% 5.25 '~ 69.75 FU 2@15 AC UNIT 8 - .80 .80 0% .88 ~, .08 FU 2816 FUTON 1 x1.88 < 1.08 7% .87 .93 Fll 2817 DROP LEAF TABLE 1 8.88 a.88 7% .56 7.44 FU 2818 CARD TABLE 1 2.08 2.08 7% .14 1.86 ~ FU 2@19 TRAILER JACK 1 '10.8@ 18.88 1% .78 9.~ FU 2828 PLASTIC TABLE AND 2 CHAIRS, 1 2.88 2.80 7% .14 1.86 LAWN CHAIRS, 5TOOL FU 2@21 MIGROWRVE @ .80 .88 8% .08 .~ `°'FU 2822 DESK AND CHAIR 8 .~ .88 @% .08 .08 FU 2823 BAR AND WEIGHTS 1 3.88 3.88 7% .21 2.79 FU 2824 VACCUUM 1 < 58.88 58. ~ 7% 3.58 46.58 FU 2825 580@ WATT GENERATOR 18 HP 1 5.80 S. @8 7% .35 4.65 FU 2826 TRASH CAN OF SALT 1 2.88 2.88 7% .14 1.86 t FU 2027 CHOICE ~ SPfB:ADEAS 1 2,888.80 2,888.88 7% 1148.08 I, 860.80 FU 2828 DIAMOND SPREADER 1 11388.08' 1,388.08 7% 91.08 1,289.80 ~ FU 2829 CHOICE OF SKID OF SALT 3 58.08 158.E 7% 18.58 139.58 • FU 2030 FERTILIZER, SEED COVER 1 '1.88 1.08 7% .87 .93 L5 2031 SPRAYER CHOICE 1 035.80` 235.88 7% 16.45 218.55 L5 2832 SPREADER 1 238.88. 238.E 7% 16.18 213.98 = L5 2033 DRAIN PIPE 1 '. I.N 1.~ 7% .87 .93 LS 2@34 MOWER OOLLEY i 5.88 5.88 7% .35 4.65 BIDDER 8 590 491 490 496 573 378 s9s 496 579 382 584 567 NOBID 498 571 NOBID 571 571 565 56S 396 NOBID NOBID 498 SB4 567 490 498 488 597 593 498 498 498 sea ~~, ,, , , ZIEGL_ER AUCTION COMPANY LTD. 1550 SAND HILL RD HUMMEI..STOWN PA 17036 WWW. Z IEGL_ERAUCTION. COM 717. 533. 4257 8B/ l1 /06 - -:CONSIGNOR 6TA'tDENT - - PAGE E . CONSIGNOR NUMBER : 1322 'AUCTION NUMBER t 060729 NAME : D/B/A DERR LANDSCAPING ESTATE OF CHAD DERR LYTER RD HARRISBURG, PA 17111 ~ 800 8008 PROD ITM 1NV UNIT TOTAL CQMMISSION SELLER'5 CODE N0. ITEM DESCRIPTION '------- N0. OTY PRICE PRICE AMOUNT NET F8101~VT DDER 8 T4 ~ . ;; ~,. LS 2035 SCRAP METAL 1 37.50 37.58 7% 2.63 34.87 393 LS 2036 TIIB:S AND N1~EL5 1 12.88 12.88 7% .64 11.16 490 L5 2837 PAIR OF ~IEEI. BARROWS 1 35.08 35.00 7% 2.45 32.55 490 L5 2838 GARDEN CART 1 .22.08 22.E 7% 1.54 20.46 490 l5 2839 2 WHEEL BARROWS 1 ..14.80 14.80 lx .98 13.02 393 L5 2840 GAS BRILL 8 .88 .00 8% .~ .00 NDBID LS 2841 METAL SHELF UNIT 8 .80 .88 8x .00 ,08 N08ID L5 2842 BUGGY 1 28.80 28.80 7X 1.40 18.60 560 LS 2843 CRAFTSMAN 5 SPEED LAM TR~TOR 1 .5.00 5.00 7% ,35 4.65 393 LS 2844 2 TRAILER J~KS 1 5.00 5.00 7% .35 4.65 56S LS 2845 M5C Nl~1.S i i. 00 1. ~ 7% . 07 .93 490 LS 2046 LAWPI ROLLER 1 .1.00 i, 00 7% . 87 .93 496 L5 2847 CANVA5, TARPS, NETTING, SHELF 1 35.80 35.00 7X 2,45 32.55 490 LS 2046 BUCKET OF CHAIN 1 22.50 22.50 7% 1.58 20.92 469 lS 2849 WHEEL @ARROW WITH WHEQS 1 42.58 42.50 7fc 2, 98 ~ 39.52 480 LS 2858 NHEEL BARROW WITH WHEEL 1 28.88 20.80 7X 1.48 ti 16.60 380 LS 2851 SPILL RE5PON5E KIT 1 1.~ 1.88 7% ,07 .93 400 LS 2052 GAS CANS AND FUNI~LS i 2.00 2.88 7X .14 1.86 599 L5 2853 PAIR OF BATTERIE5 i 4.~ 4.08 7% .26 3.72 396 LS 2854 ORANGE CONES AND REFLECTORS 1 16.88 16.80 7z 1.12 14.68 ~ 5~7 lS 2855 PLANTERS AND BRACKET5 1. 1.88 1.80 7% .07 .93 490 L5 2856 RAIN PANT5, SHIELD, CUTTERS 1 :-9.88. 9.08 7% .63 6.37 564 LS 2857 PAIR OF RAMPS 1 '.1.88 1.88 7% .87 .93 599 LS 2858 RAKES AND WINOON CLEANER 1 3.00 3.08 7% .21 2.79 599 L5 2859 CRAFTSMAN SHOP VAC ! 1.88 1.08 7% .07 .93 490 LS 2060 2 FENCE POSTS, BUCKET, FOOT 1 2.88 2,00 7% .14 1.86 599 @ALL, STRING LS 2061 FINS, BINDER5 1 6.80 6.00 7% .42 5.58 565 L5 2062 CHOICE OF TORO SNOW BLOWERS 2 238.80 468.80 7% x2.28 427.88 4~ LS 2863 PULL BEHIND SPREADER 1 2.80 2.80 7X .14 1.66 584 LS 2864 LINE PAINTER 1 22.88: 22.80 7X 1.54 20.46 579 L5 2865 ED6'ER l 95.00 95.00 7X 6.65 88.35 597 LS 2066 AARONS ELECTRIC 5TART SNDW 1 475.80 475.08 7X 33.25 441.75 498 BLOWER ~ LS 2067 CHOICE OF MDT SNOW THtRS 1 168. M 188.00 77c 12.68 167.40 379 LS 2866 CHOICE OF MDT SNODI THROWERS 2 168.88 328.00 7% 22.48 297.60 579 LS 2069 STEEL RTTACHMENT 1 ; 48. ~ 40.80 7% 2.98 37.20 498 y:~ f; . -,.; CONTINUED. ~ ~~ E~ ~ - ~i, ZIEGLER AUCTION COMRANY LTD. 1550 SAND'HILL RD HUMMELS TOWN FyA 1.7036 WWW. Z I EGLERAUCT I ON. GOM 717. 533. 4267 08/1 11@6 - - CONSIGNOR STATEMENT - - pA6E 3 CONSIGNOR NUMBER ; 1322 AUCTION Nl#IBER c 060729 NAME : D/B/A DERR L.ANDSCAPIN6 ESTATT: OF CHAD DERR LYTER RD HARRISBURG, PA 17111 `~~= 080 000 0~ ~ ~~; PROD I1M INV ' UNIT TOTAL COMMI SSION SELLER'S ~ ~ : CODE ~NO. -----_ ITEM DESCRIPTION N0. QTY ,PRICE PRICE AMQ I»IT NET AMIxN+IT BI DOER # , r . ~~ LS 2070 - CHOI(I: OF WALK BEHIND MOWERS i 545.ee 548.00 7x 37.ee 502.20 496 °'` LS 2071 WALK BEHIND MOWER 1 425.00 425.00 7X 29.75 395.25 306 L5 2072 MODEL 88 AERATOR 1 130.00 130.00 7X 9,10 12@.90 578 ~,~ LS 2873 BED EDGER I 400.00 400.08 7X 28.00 372.08 577 LS 2074 TROY BUILT ROTA-TILL 1 180.00 1A0.50 7% 12.Ei0 167.40 490 L3 2075 TAN BARK MULCH 1 60.00... 60. N 7x 4.20 55.80 S97 LS 2076 RAMP PLAN( - 1 ;:1.00 1.05 7% .07 .93 599 L5 2077 BOBCAT SKID STEER 1 11,000.80 i1,A00.80 7% ~f70.0@ 10,238.E 378 LS 2078 FORKS 1 .400.00 4.410 7X 28.00 372.00 581 LS 2079 AUGER gTTAq~1T 1 1,850.00 1,830.00 7% ;129.50 1,720.50 308 LS 2080 2002 FORD F350 SUPER DUi'Y 0 .~ ,00 0X .00 .ILNDA NIBID PICK-UP LS 2081 MYER PLfnlER KITH CONTROLS 1 1,500.00 1,5410.00 7% 1105.00 1,395.4 565 L5 2082 F350 FORD DUMP TRUCK 1 13, 4~. ~ 13, 400. ~ 7% `138.00 12, 4E~2.80 388 lS 2083 PLOW AND BRACKET 1 1,800.00 1,800.00 7X 126. N 1,674.08 308 LS 2084 PLOW WITH BRACKET 1 .1,600.@0 1,600.E 7% 112.E 1,488.00 308 LS 2085 1977 FORD DUMP TRUCK 1 1,108.00 1,1~. ~ 7% 77.00 1,023, @1@ Sfi6 L5 2886 1997 16 FOOT TRAILER 1 1,0.00 1,000.00 7% 70.E 930.08 400 L5 2087 FORD TRUCK WITH BARK BLOWER t 8 ,00 .418 0% ,410 ,00 NDBID L5 2088 GREEN CHAIRS i 1.00 1.00 71c .@7 .93 ~ S69 FU 2889 1995 1 6,580.00 6,50@.0@ 7X ~~55.0@ 6,®45.@0 382 FORD CF84100 TRUCK FU 2098 FINI MULCH BLOWER 1 23,500.E 23,5410,E 7% 1,645.08 21,855.@0 382 TOTAL 68085 GALE AMOUNT 71,735.00 ACTUAL. SALE5 TOTAL 71,735.4 LESS CIIMMISSION 5, 021.47 COMPLETED : YES NO TOTAL NET PROCEEDS 66,713.53 TOTAL'ITEMS: 41 TOTAL DLlE TO SELLER 66,713.53 KITE : THANt Y4U FOR YIkJR BUSINESS ' +~ =BIDDER OF THIS ITEM HAS NDT CHECKED OUT.- .. AUCTION ID: 068729 ZIESLER AUCTION COMPANY 88!11/@6 - - pIX±TION NET INCOME 5UMMRRY REPORT - - Total Price of goods SOW 71,735.00 Total Expenses .~ Total Caeeission 5,0"21.47 Total Seller Proceeds : 66,713.53 Total 0/A A~ount a 2,883.50 Total Buyer's Pre~iu~ .80 Total Additional Cfs : .00 Total Prad ~ .`_ .@0 ' Total5ales ,00 ' ` Total Taxable ~~ ~.~; M .00 Total Non-Tax ': r. ~ i e°S~ 71,680.801 ,, ~+~#.PLE(1SSE NOTE fee TAXABLE SALES + IAN-TAXABLE SALES =TOTAL PRICE OF'Glk~'SOLD + BUYER'S PREMIUM + ADDITIONAL CHARSES CREDIT CARD/CI~CK Rb'E AMOUNT tREFER TU BALANCE~SHEETI eee NOTE: SOME BIDDERS STILL NAVE NOT CIIECNED OUT ~ Break Down of Miscellaneous Deductions .,~ ,;~; ~' ~z ~ r ~~ ?yi ~~N; , d'Ji ZIERLER /ACTION CO. LTD. 1550 SAND HILL RD. HUMMELSTOWN, PA 17036 . -, ,,. Consignor hl~amher : 13E~: Se 11 er^s N~-~me Auctian Numher 070131 D/P/A DERR LANDSCAPING ESTATE OF CHAD DERR LYTER RD HARRISBURG PA 17111 GROSS Proceeds fr^om Auction 12,740.00 Auction Commission & Expettise(s): 1,589,,,00 NET Seller^ Pr^aceeds : 11, 151.00 Please see enclosed shpetis ,1*detailed list ;~ "~'~~ No. 55 5553 ~ I EGLER AUCTION COMPARIY LIED. 1550..SAND HILL RD HUMMELSTOWN PA 1?036 WWW. ~ I EGLERAUCT I ON. COM 717. S~i3. 4267 02/08/07 - - C()hlSIGNOR STATEMENT - - PAGE 1 C~IGNOR NUMBER : 1322 AUCTiOPJ 1+L#iBER :070131 ' `NAIL a D/B/A DERR LANDSCI~ING ESTATE OF CHAD DERR LYTER RD HARRISBURG, PA 11111. 000 008 080e PROD CODE ITM NO. INU -- ITEM RIPTION ---- p~1. RTY UNIT PRICE TOTAL PRICE COMMISSIINJ SELLER'S - - -- -r -- -` -- ----,- -_......._.._ _~ AF~UNT IVET AM11AdT BIDQ~R # 8X 99 SPRAYER, 2 5 GALLON.CANS, 0 ~V._~_____~ .08 ..____..__._.__ .00 0% ~.~_--- 00 ~ ' SAFETY CAN . . t~BID FU FU 133 CHOICE OF LITTLE WONDERS 1 130.00. 130.00 10% 13.08 117.00 4A2 FU 134 135 LITTLE WONDER HURRAY LAWN MOWER 1 80.08 80.00 10% 8.00 72.00 402 .~ FU 136 BLACK SPREADER 1 1 22.50 2.88 22.50 18% 2 00 10% 12. c5 20 20.25 4~- ; ; FU FU 137 18 SHOVELS 1 12.50 . 12.50 10% . 1.25 1.80 11.25 419 389 ,~ 13A CHOICE OF STIHL FIEDGE TRII00rR5 i 115.00 115.00 10fc 11.50 103 S8 365 ,: FU F 139 CHOICE OF STIHL HEDGE TRIMMERS 1 90.00 90.08 18x ~ . 81 08 ~_ 316 ~? y4• ; ~ U FU 140 141 STiHL HEDGE TRIMI~R PAIR OF STIHL BLOWERS i ,50.08 ` 58.00 10% ~ 5 . 45.88 ` 434 ~ 4 FU 142 361 STINL CHRIN SAW 1 1 28.08 300 80 20.80 18% c^:00 18.00 ~ ~~~ h FU 143 CHOICE ~ NEED WALKERS . . : nay mo ~ 380.00 18% ~• ~ ~ 10>< '30.00 8 08 270.00 2 ~ 415. i ~~'. t ''`t`' -, ~; FU 144 CHOICE OF ~lEEII INFERS _ ~ ~ ~ ~~' ~' i ~~~'~` ~ ~a5.88 " ` `` :o 45.00 10x . . ~;~: s 4 58 7 . 4 5 ~ f + .. ~.~ FU 145 CHOICE DF WEED HACKERS 2 ~ 35,08.' .~, 70.00 102 . . 7 00 . 0. 0 63 00 " w,~ FU FU 146 147 CHOICE OF SRREADERS " ' CHOICE OF WEED HACY ERS 1 "~,20, ~ ~rA k ' . 20. 0010% . 2.08 . 18.00. ~`, , . ~ ~ "X FU 148 , CHOICE OF IJE~D 1~1(ERS ~ 1 s 1 ,. , ' 40.80,' 3 , .,, - ~ 40.00,' ~~ 48.08 l8~c ~~ 48. A8 `10~ 4.88 `~ 4 00 36.00 36 00 ~ .: ~~ . °:. , ' FU 149 WEED WALKER ~~1=',` ~ ;22.50 q~ a , 22~~'18% ~ . 2 25 . .. 20 25 ~ ~ '~ ` ~ ~ ~~ ,~ FU FU 150 LA4p+l SPREADER ~ f 500 " ~ 4 5.80 18x . . 58 . . 4.58. ~ ~ 4B2 ` . , i91 BOX OF MOWER BLADES 1; ~. '= 508.,` ~x ~~;~~ 5.00 18% .50 4.50 ~~~: 43}~r. FU 192 PAIR OF STIHL BACK PACK BLOWER 1; 88.00 ~ 80.08 18% 8.00 72 08 ~ ` 34~ .~ FU FU 193 5T1NL BACK PACK BLOWER 1 '. 35.80 35.08 10~c 3.50 . . 31.50 , ,351 FU 194 195 ROLL OF THINE GAS CAN FOR BOAT 1 5.00 , S. 00.10% ` . 50 4.50 , 346 , ; ,. J FU 196 2 BOXES OF HARDWARE 8 t .08 20.00 . 80 0% 20 ~ 10% . ~ 2.00 , ~ 18 08 NO$ID 348 ,~ FU FU 197 2 HITCHES WITH BALLS 1' 18.08 10.814 18% l.~ . 9,00 351 ' FU 198 199 SET OF 4 WEI6HT5 CLEVIS JUMPER CABLES IMPACT 1. 1 15.00 15.00.10% 1.50 13.58 32(,' ~ , , WRENCH, JACK, MOWER BLADES ;: 5.00 5.00 10% .$8 4.50 389 f ' Fu Zee c-arc~ of sr~aW aLOw I.ISHTS 2 i0. se 20.00 10% z. 00 ~ le 43a C t ~ ~U rte 201 ? '~ ' COfl1.LEA, JUMhER CABLE .. , ~ ~ • i ?, AP 5. PO 1L?X .5A , h 50 3a7 ; ~ : nr~~~~ :;n r.~ .ir( ~~ri~ct' -r: , .. ~ ,~ . . ~ ~: l41'f .. ' l lll.~ l~ UI :.I 1..11{1 vl'~(1$1 $ L.. 1', l 4,. l~YI l.. 'l'~(I ,4 K':• • 4V A • UW J•It! FU 20S CHOICE OF PILES OF'~TOOLS 2 5.00 10.00 10% 1.80 • 9.00. ~ 351 >' . ~. . ~ ,F. CQNTINUED Air. '• ~ . ~ Z IEGL_ER ALIC TLON CQMPANY L.TD. 1550' SAND:=HILL RD HUMMEL_S TQWN' PA 1'T036 WWW. Z I EGLERAUCT 1 C7N.' COM 717. 533. 4~Ey7 02/88/07 - -CONSIGNOR STATEMENT - - PAGE 2 CONSIGNOR NUMBER : 1322 AUCTION NUMDER :070131 NAME D/B/A DERR LANDSCAAING ESTATE OF CIiAD DERR LYTER RD NARRIS8i1RG, PA 17111 000 000 0000 PROD ITM INV UNIT TOTAL COMMISSION SELLER'S CODE. NO. ------ iTEM DESCRIPTION -----~ NO. ' ; QTY `PRICE PR[CE AMOUNT NET RPRN.N~1T ~ BIDDER !k FU 206 Tom. BOX WITH TI]OL5 1 25.00 25.E 10X 2.50 2c, 50 330 FU 207 BROTHER FNX MACHINE 1 15.00 15.E 10% 1.50 1'x.50 351 FU 289 MILK CRATE FULL QF CORDS AND 1 3.00 3.80 10% ,30 2.70 365 KARTS FU 210 BATTERY CHARGER 1 15.00 15.80 10% 1.50 13.50 365 FU 211 2 MILK CRATE5 MSC HAR(~RE ;, 0 .00 .00 0% .80 .00 kOBID FU 212 BA6 CART i 2.00 2.00 10% .28 1.80 339 FU 213 5PfZEADER AND 6A5 CANS 0 ,00 .00 0x .00 .~ NDBID FU 214 VELKY ANA THATCHER i 5,00 5.88 18% .50 4.50 351 FU 215 CHOICE DF LITTLE WONDER5 1 ~ 37.50. 37.50 10% 3.75 33.75 351 FU 21b LITTLE WO~JDER 1 10.88 10.00 10% 1.00 9.00 389 FU 217 CHOICE DF WHEEL BARROWS 1 20.88 20.00 10% 2,~ 18.08 326 FU 218 SMALL WHEEL BARROW '., , . =1 5.80 S. 00 10% . S0 4.58 340 , ; FU 219 GRASS CATCHER 1 12.50 12.50 10% 1.25 .11.25 434 FU 220 CATCHER5 AND BRACKETS 0 .80 .00 0% ,80 .00 NDBID '. FU .221 SPREADER 1 5.00 5,08 10x .50 4.50 436 ~'' FU 222 TRUCK 1 2.00 x,00 18% .28 1.88 414 x.r.~': FU 223 STARTER FERT I1.I ZER ` i 5.00 5. ~1 18% . S0 4.58 351 '" ' FU cc4 LE5C4 FERTILIZER 1937 ,i 37.50 ." 37,58 10% 3.75 33.75 351 FU 225 2 BOXES ~ MOWER BLADES 8 .08 .00 0x .~ .00 NDBID , FU 226 GRINDER ~ STAND i ~ 5.00 5. ~ 10% ,50 4. S0 359 ~` '` FU 227 8A6 ~ PEAT MOSS 1 2.00 2.00 10% .20 1.80 , 34B ~:~ FU 228 STACK QF SHOVELS AND PRUNER 1` 20.08 20.88 18% 2.80 18.08 351 `' FU 229 X MARK MOWER 1 600.00 500.00 10% 60.08 540.E ' ; 415 ;.: ' ~ ,; FU 2s'0 LASCO UNIT 1 ~ 50.00. 50.8@ 10% 5.88 45.00 . . 389: ';r~ ;`~ FU 231 MSC DELTS AND WHEELS 1 2.00 2.80 10x . 28 1.80 327 ; Ri 2302 DIAMOND SNOW PLOW 1 500.00 508.08 10% 50.E 458.08 , , r~, .. 42b .." R1 2303 2000 FORD DIESEL 4 DOOR TRUCK 1 18800.00 10,000.00,10% 1,00.00 9, 800.Ae 321 `;' y A '~" ~ f ~, ~, . CONTINU ED "`; ' r -: ~ ~• !f1~ { ~ ~9'~ r 02/08!07 -• - CONSIGNOR STATEMENT ~ - PAGE. s CONSIGNOR NUNBER : 1322 ..-;,t ~, . ~ ~ _ : ~ ~ ~ ~ AUCTION NUMBER: 070!31 ;,,. . , NAME : D/B/A DEAR lAND5CAPIN6 i~ ; " >,. ~ ESTATE OF CHAD ; ,DERR ~ • ~ . ; f .; ~ , LYTFR RD , , _ , , A ~, HARRISBURG, PA 11111 , ;„, Q 000 000 00~ PROD ITM INV 'UNIT TOTAL COMMISSION SELLER'S CODE N0. ------- ITEM DESCRIPTION ----- NO. -------------- _..__.~_~.,~_._~.__Y..-.,____ QTY PRICE PRICE - ----------__.----- -_ E~l1NT NET AMOUNT BiD~R ~ TOTAL GROSS SALE AMOUNT - _ -__-----_.__----- 12,740.6'0 ------------------------ -------- ACTURt. SALES TOTAL 12, 740. ~ LESS COMMISSIQN 1,274.00 ADVERTISING FEES 300.60 DIESEL FUEL.. FOR TRUCK 15.00 COMPLETED : YES NO TOTAL. NET PROCEEDS 11,151.60 TOTAL.ITF.pIS: fil TOTt~. DUE TO 5ELLER 11,151.60 NOTE :, 71•IAhBE YOU FqR YOUR BUSINESS ;~~~ ,r,. ~~ ~_ __.)~: t" .Y .b. ~; yK.: ,~:i. ,' ; ~, { ;~ y -. ,. 5 ~~+ ., J / ~~ '::. .. ' DECEASED ~ 0 0 ~ 10 4 0 U.S. Individual Income Tax Retum IRS U::e Onry - Do not write or staple In Utis space. € ~l ~ For the year Jan. 1-Dec. 31, 21x16, or other tax year beginning , 2006, ending 2p o. - .a Your first name and initial Last name (DEC . 0 3 / 0 5 / 0 6) Your social security number (See instructions A CHAD M. ERR 188 64 ~ 9320 on page 16.) E If a joint return, spouse's first name and initial Last name Spouse's social security number Use the IRS ~ label. H Home address (number and street). If you have a P.O. box, see page 16. Apt. no. You must enter Otherwise, E 10 EAST GREEN STREET • your SSN(s) above.• please print R or type. E City, town or post office, state, and ZIP code. If you have a foreign address, see page 76. Checking a box below will not Presidential SHIREMANSTOWN PA 17011 change your tax or refund. Election Campaign - Check here if you, or your spouse ff filing joint) ,want $3 to go to this fund see page 16j - ~ You 0 Spouse 1 X Single 4 Head of household (with qualifying person). If the qualifying Filing Status 2 ~ Married filing jointly (evenrf only one had income) person is a child but not your dependent, enter this child's Check only 3 0 Married Kling separately. Enter spouse's SSN above name here. - one box. and full name here. - 5 0 Qual' in willow er with de endent child see a e 17 Boxes checked 6a X Yourself. If someone can claim you as a dependent, do not check box 6a ................................................ on sa and sb Exemptions b f-1 spouse ..........................................................................................................................-...... No. of children If more than four dependents, see page 19. Dependents: (1) First name Last name (2) Dependents soda) security number (3) Dependent's relationship to you (4n)q childfa Childrixcredit (yroeD~9e tg) on 6c who: ~ lived with you • ditl not live with you due to divorce or separation (see page 20) Dependents on 6c not entered above _ Add numbers r on lines- I 1 above 7 Wages, salaries, tips, etc. Attach form(s) W-2 ...................... .......... I 7 I1COme ~ Taxable interest. Attach Schedule B ff required .............................................................................. 8a Attach Form(s) W-2 here. Also b Tax-exempt interest. Do not include on line 8a ... ..... ........... ~ 8b attach forms 9a Ordinary dividends. Attach Schedule B if required ........................................................................... 9a W-2G and 1099-R if tax b Qualified dividends (see page 23) .............. ................................. 9b 10 Taxable refunds, credits, or offsets of state and local income taxes .......................................... ............ was withheld 10 . 11 Alimony received ................................................................................. ............. ....................... 11 12 Business income or (loss). Attach Schedule C or C-EZ ..................................................................... 12 2 6 4 32 . If you did not 13 Capftal gain or (loss). Attach Schedule D if required. If not required, check here .................. - ~ et a W-2 13 , g see page 23. 14 Other gains or (losses). Attach Form 4797 .................................................................................... 14 15a IRA distributions ..................... 15a b Taxable amount .................. 15b Enclose, but do 16a Pensions and annuities .........._. 16a b Taxable amount .................. 18b not attach, any 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E ........................ payment Also 17 . , please use 18 Farm income or (loss). Attach Schedule F .................................................................................... 18 Form 1040-V. 19 Unemployment compensation ......,.... ......... ......... ........ ......... ........ ......... ......... 19 20a Social security benefits ............ ~ 20a ~ ~ b Taxable amount (see page 27) 20b 21 Other income. List type and amount (see page 29) ... 21 22 Add the amounts in the far right column for lines 7 through 21. This is your total income _ - 22 2 6 , 4 3 2 . 23 Archer MSA deduction. Attach Form 8853 .................... ................... 23 >::>::>::;::: Certain business expenses of reservists, performing artists, and fee-balls government djlusted 24 offidals. Attach Form 2106 or 2106-EZ ........................... 24 :::. """"'' GrOSS 25 Health savings account deduction. Attach form 8889 .. ........ .............. 25 >>; Income 26 Movin ex enses. Attach Form 3903 27 One-half of self-employment tax. Attach Schedule SE ...................... 27 1 8 6 8 . 28 Self-employed SEP, SIMPLE, and qualified plans . ..... ....... ........ 28 ' 29 Self-employed health insurance deduction (see page 29) ..................... 29 30 Penalty on early wfthdrawal of savings ......................__. __ .............. 30 :>::::::>::>::::: ""° 31a Alimony paid b Recipient's SSN - 31a 32 IRA deduction (see page 31) ................................. . ..................... 32 33 Student loan interest deduction {see page 33) ................................. 33 ><>s> 34 Jury duty pay you gave to youremployer...._.._„ ................................ 34 35 Domestic production activities deduction. Attach Form 8903 ............... 35 >::::::>::::>::: ' 36 Add lines 23 through 31a and 32 through 35 ................................................ ................................. 36 1 86 8 . stooo7 o3-7g-o~ 37 Subtract line 36 from line 22. This is your adiusted Gross Income .. ......... ......... .............. - 37 2 4 5 6 4 . LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 80. Form 1040 (2oosy r=~,.,, ~ nen nrvu~ C' H A Tl M_ 1nF. R R ~~~• . t 4- 9 3~ ~ Pace 2 Tax and 38 Amount from line 37 (adjusted gross income) ....................................................................................... 38 2 4 , 5 6 4 . Credits 39a Check ~ You were bom before January 2,1942, 0 Blind. Total boxes standam ff: ~ 0 Spouse was bom before January 2,1942, Q Blind. checked ... - 39a Deduction for- • People who b If your spouse itemizes on a separate Tatum or you were adual-status alien, see page 34 and check here ,,,,,, - 39b ~ ~k~' a"y 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) ................................. ::. o- 'n:: 40 15 0 . box on line 39a or39b Or who 41 Subtract line 40 from line 38 ............. ............................................................................................... 41 can rk dalmed as a dependent 42 If line 38 is over $112,875, or you provided housing to a person displaced by Hurricane Katrina, see page 36.Otherwise, muttipry $3,300 by the total number of exemptions claimed on line 6d ................ ....... . 42 3 3 0 0 . 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- ................................. 43 16 114 . • All others: 44 Tax. Check'rf any tax is from: a ~ Form(s) 8814 b 0 form 4972 ..... ................................................. 44 2 0 41 . Single or d fili M i 45 Alternative minimum tax. Attach Form 6251 ....................................................................................... 45 arr e ng separatey, .................................................................................................. - 48 Add lines 44 and 45 .............. 46 2 04 ss,lso 47 Foreign tax credit. Attach Form 1116rf required .................... ............... 47 Married filing joinny or 48 Credit for child and dependent care expenses. Attach Form 2441 .................. 48 ~~ Dualifying widow(er1, 49 Credtt for the elderly or the disabled. Attach Schedule R .............................. 49 '.`~ s1o,3o0 50 Education credtts. Attach Form 8863 50 Head of 51 Retirement savings contributions credit. Attach Form 8880 ........................ 51 household, s7,sso 52 Residential energy credits. Attach Form 5695 ......................................... 52 53 Child tax credit (see page 42). Attach form 8901 if required ........................ 53 54 Credits from: a ~ Form 8396 b 0 Form 8839 c ~ Form 8859 54 55 Other credits:a 0 Form 3800 b ~ Form 8801 c ~ Form 55 56 Add lines 47 through 55. These are your total credits .................................... ......... ................................. 56 57 Subtract line 56 from line 46. If line 56 is more than line 46 enter -0- ................................................... - 57 2 , 0 4 1 . .......................................................................................... 58 Self-employment tax. Attach Schedule SE .. 58 3 735. . Other 59 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 ........................... 59 Taxes other qualified retirement plans, etc. Attach Form 5329 if required .............................. 60 Addttional tax on IRAs 60 , 61 Advance earned income credit payments from Form(s) W-2, box 9 ............................................................ 61 52 Household employment taxes. Attach Schedule H ........................ ............... ........................................ . 62 63 Add lines 57 through 62. This is your total tax ................................................................................. - 63 5 7 7 6 . Payments 64 Federal income tax withheld from Forms W-2 and 1099 .............................. 64 """"' 65 2006 estimated tax payments and amount applied from 2005 return ............ 85 .;;:.;;:.;:.;: ::«:>:>::s:: If you have 66a Earned Income credit (EIC) ...... ............................................................ 86a ::::;:;;;;;;;:: a qualifying child, attach Schedule EIC. b Nontaxable combat pay election ,........ - 86b 57 Excess social security and tier 1 RRTA tax wtthheld (see page 60) ...........:.. S;::r:~:;t:r ~ .:::. 67 '`''`"``"'`' ~~~~~~~~`~~'~~~ 68 Additional child tax credit. Attach Form 8812 ........................................... 68 89 Amount paid with request for extension to file (see page 60) ........................ 59 70 Payments from: a ~ Form 2439 b 0 Form 4136 c ~ Form 8885 70 71 Credtt forfederal telephone excise tax paid. Attach Form 8913 if required .._... 71 30 . .......... 72 Add lines 64, 65 66a, and 67 through 71. These are your total payments ........ .. ....... ............................ - 72 3 0 . Refund 73 If line 72 is more than line 63, subtract line 63 from line 72. This is the amount you overpaid ...:....................... 73 o;rect deposlCl 74 a Amount of line 73 ou want refunded to you. If Form 8888 is attached, check here ........................ ~' 0 See page 61 and fill in 74b, - b nurr~r - C Type: 0 gxclarg ~ Sadrgs - d number 74c, and 74d, or Form ease. 75 Amount of line 73 you want applied to your 2007 estimated tax ......... - ~ 75 ~ 74a ~~~~~''~'~~~~~~~ :::.:::>;::»: Amount 76 Amount you owe. Subtract line 72 from line 63. For details on how to pay, see page 62 ... ........................ - 76 6 019 . You OWe 77 Estimated tax penalty (see page 62) ......................................................... 1 77 ~ : .::::::::::::::.::::.:..::.,::..:.:.:..... Third Party Do you want to allow another person to discuss this return with the IRS (see page 63)? U Yes. Complete the following. U Na Designee° ~"°e~s- PREPARER o°ne- numbea(P'N'tification- St n Under penalties of perjury, I declare that 1 have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, 9 and complete. Oeclaretion of preparer (other riran taxpayer) !s based on all infomwtion of which preparer has any knowledge. Here Your signature Date Your occupation Daytime phone number Joint retum7 ANDSCAP ING see page , 7. - S use's occu anon K a copy S use's si nature. If a'oint return both must si n. Date po p eeP Po 9 1 ~ 9 for our Y records. .................................................... Paid Preparers , Date Check if self- Preparer's SSN or PTIN Preparer'ssignature ~rPl°Yed Use Only Firtn'sname(or SELIGMAN, FRIEDMAN AND COMPANY, P.C. EIN 23:2708607 yours if self-ern- ' 1 0 2 7 MUMMA ROAD Phone no.7 17 -'~ 61- 0 2 1 1 s~ ~ ployed), address' WORMLEYSBURG , PA 17 0 4 3 and ZIP code Fay 221 o underpayment of Estimated Tax by Individuals, Estates, and Trusts Department of the Tn~sury - See separate instructions. Internal Revenue Service - Attach to Form 1040,1040A,1040NR,1040NR-EZ, or 1041. Name(s) shown on tax return CHAD M. DERR OMB No.1545-0140 Zoos Attachment sequence No. 06 Identlfying number 188-64-9320 Do You Have To File Form 2210? Complete lines 1 through 7 below. Is line 7 less than $1,000? Yes Do not file Form 2210,. You do not owe a penalty. No Complete lines 8 and 9 below. Is line 6 equal to or more than line 9? No ~ You may owe a penalty. Does any box in Part II below apply? ~ No Do not file Form 2210. You are not required to figure your penahy because the IRS will figure it and send you a bill for any unpaid amount. If you want to figure it, you may use Part III or Part IV as a worksheet and enter your penalty amount on your tax return, but do not file Form 2210. You must file Form 2210. Does box B, C, or D apply? No Yes -- You must figure your penalty. You are not required to figure your penalty because the IRS will figure it and send you a~ bill for any unpaid amount. If you want to figure lt, you may use Part I11 or Part IV as a worksheet and enter your penahy amount on your tax return, but file only page 1 of Form 2210. 2 of the 1 Enter your 2006 tax after credits from Form 1040,1ine57(orcomparablelineofyourretum) .......................................... 1 2 041. 2 Other taxes, including self-employment tax (see page 3 of the instructions) .................................................................. 2 3 7 3 5 . 3 Refundable credits. Enter the total of your earned income credit, additional child tax credit, credit for federal tax paid) on fuels, and health coverage taxcredit ............................................... ........................... 3 ..................................... 4 Current year tax. Combine tines 1, 2, and 3. If less #han $1,000, see page 3 of the instructions .......................................... 4 5 , 7 7 6 . 5 Multiply line 4 by 90% (.90) ........................................................................... ~ 5 ~ _`i 19 8 .;<`< 6 Withholding taxes. Do not include estimated tax payments. See page 3 of the instructions ............................................. 6 7 Subtract line 6 from line 4. If less than $1,000, you do not owe a penalty; do not file form 2210 ....................................... 7 5 7 76 . 8 Maximum required annual payment based on prioryear's tax (see page 3 of the instructions) .......................................... 8 2 4 951 . 9 Required annual payment. Enter the smaller of line 5 or line 8 ............................. .................................................... 9 5 19 8 . Next: Is line 9 more than line 6? No. You do not owe a penalty. Do not file Form 2210 unless box E below applies. Yes. You may owe a penalty, but do not file Form 2210 unless one or more boxes in Part II below applies. • If box 6, C, or D applies, you must figure your penalty and file Form 2210. • If onry box A or E (or both) applies, file only page 1 of Form 2210. You are not required to figure your penalty; the 1RS will figure lt and send you a bill for any unpaid amount. If you want to figure your penalty, you may use Part III or Part IV as a worksheet and enter your penalty on your tax return, but file only page 1 of Form 2210. j~~at'E€~j Reasons TOr tlling. Check applicable boxes. If none apply, do not file Form 2210. A U You request a waiver (see page 2 of the instructions) of your entire penalty. You must check this box and file page 1 of Form 2210, but you are not required to figure your penalty. 0 You request a waiver (see page 2 of the instructions) of part of your penalty. You must figure your penalty and waiver amount and file Form 2210. C 0 Your income varied during the year and your penalty is reduced or eliminated when figured using the annualized Income installment method. You must figure the penalty using Schedule Al and file Form 2210. 0 ~ Your penalty is lower when figured by treating the federal income tax wthheld from your wages as paid on the dates it was actually withheld, instead of in equal amounts on the payment due dates. You must figure your penalty and file Form 22'10. E 0 You filed or are filing a joint return for either 2005 or 2006, but not for both years, and line 8 above is smaller than line 5 above. You must file page 1 of Form 2210, but you are not required to figure your penalty (unless box 8, C, or D applies). LHA For Paperwork Reduction Act Notice, see page 7 of separate instructions. Form 2210 t7oosl s125ot o1-so-o~ Yes ~ You do not owe a penalty. Do not file Form 2210 (but if box E below applies, you must file page 1 of Form 2210). 2.1 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 Forth 2210(2006) ~ ~ Page 2 Short Method You may use the short method ff: • You made no estimated tax payments (or your only payments were withheld federal income tax), or • You paid estimated tax in equal amounts on your due dates. You do not need to You must use the regular method (Part IV) instead of the short method if: .r~P file Fom- 2210 unless • You made any estimated tax payments late, you checked a box in • You checked box C or D in Part II, or Part I! on page 1. • You are filing Form 1040NR or 1040NR•EZ and you did not receive wages as an employee subject to U.S. income tax withholding. Note: If any payment was made earlier than the due date, you may use the short method, but using it may cause you to pay a larger penalty than the regular method. !f the payment was onty a few days early, the difference is likely to be small. i 0 Enter the amount from Form 2210, line 9 ..................................................................................................................... 10 5 , 19 8 . 11 Enterthe amount, if any, from Form 2210, line 6 ..................................................... 12 Enter the total amount,'rf any, of estimated tax payments you made .................................... 13 Add lines 11 and 12 ................................................................................... ...................................... ...................... 13 14 Total underpayment for year. Subtract line 13 from line 10. If zero or less, stop here; you do not owe the penalty. Do not file Form 2210 unless you checked box E on page 1 ..................................... ..................................................... 14 5 , 19 8 . 15 Multiply line 14 by .05258 {use the factor shown in the instructionsrf you are eligible for Hurricane Katrina relief) ..................... 15 2 7 3 . 16 ~ I# the amount on line 14 was paid on or after 4/15/07, enter -0-. ~ If the amount on line 14 was paid before 4/15/07, make the following computation to find the amount to enter on line 16. Amount on Number of days paid line 14 x before 4/15/07 x .00022 ............................................................... 16 0 . 17 Penalty. Subtract line 16 from line 15. Enter the result here and on Form 1040, line 77; Form 1040A, tine 48; Form 1040NR, line 75; Form 1040NR-EZ, line 27; or form 1041, line 26 ..................................................................... - 17 2 7 3 . Fonn 221 ~ (2006) 612502 01-30-07 2.2 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 SCHEDULE C i~rofit or Loss From Business OMB No. 1545-0074 (Form 1040) (Sole Proprietorship) ~ O O Department of the Treasury - Partnerships, joint ventures, etc., must file form 1065 or 1085-B. attachment (ntemal aevenue Service (99) - Attach to Form 1040,1040NR, or 1041. -See Instructions for Schedule C (form 1040). sequence No.09 Name of proprietor Social security number (SSN) CHAD M. DERR (DEC. 03/05/06) 188-64-9320 A Principal business or profession, including product or service (see page C-2) 8 Encercode from pages ae, s, 8 to LANDSCAPING - 561730 C Business name. If no separate business name, leave blank. D Empioverio number(EiN>, it any DERR'S LAWNCARE & LANDSCAPING 25-1839200 E Business address {including suite or roomno.)- 10 EAST GREEN ST ._____________________________ City, town or post office, state, and zIP code SH IREMANSTOWN, PA 17 011 F Accounting method: (1)OX Cash (2)0 Accrual (3-~ Other(specity) - -------------------------- G Did you "materially participate' in the operation of this business during 2006? If "No; see page C-3 for limit on losses .............................. OX Yes ~ No H if you started or acquired this business during 2006, check here ............................................................................................................ - .#':~> Income 1 Gross receipts or sales. Caution. If this income was reported to you on Form W-2 and the "Statutory employee" box on that form was checked, see page C-3 and check here ....................................................................................... - 2 Returns and allowances 3 Subtract line 2 from line 1 ....................................................................................................................................... 4 Cost of goods sold (from line 42 on page 2) ........................................................................................... .................... 5 Gross profit. Subtract line 4 from line 3 ............................................................... ...................................................... 6 Other income, including federal and state gasoline or fuel tax credit or refund (see page C-3) ..,..._._._ ..................................... 54,720. 3 54,720. 4 5,482. 49,238. 7 Gross income. Add lines 5 and 6 - 17 I 49,238. (#>ii#( Expenses. Enter exr~enses for business use of vour home only on line 30. 8 Advertising .................................... 8 18 Office expense.......................................... 18 342. 9 Car and truck expenses 19 Pension and profit-sharing plan:> ........... ....... 19 (see page C-4) .............................. 9 1 , 210. 20 Rent or lease (see page C-5): 10 Commissions and fees .................. 10 a Vehicles, machinery, and equiprnent ..._........ 20a 7 0 7 . 11 Contract labor b Other business property ........................... 20b (see page C-4) .............................. 11 21 Repairs and maintenance ........................... 21 2 461. 12 Depletion ..._ ............................... 12 22 Supplies (not included in Part Ilil) ....,__......., 22 13 Depreciation and section 179 23 Taxes and licenses .................................... 23 expense deduction (not included in Part III) (see page C-4) ..................... 13 13 0 4 6 . 24 Travel, meals, and entertainment: a Travel ................................................... >:<::<.:>::: 24a 14 Employee benefit programs (other than on line 19) .............................. 14 h Deductible meals and entertainment (see page C-6) ...............,.,... 24b 15 Insurance {otherthan health) ........,_. 15 3 , 7 31 . 25 Utilities ........................ ...... ........ 25 18 Interest: :::::.:::: [ 28 Wages (less employment credit:>) ............... 26 a Mortgage (paid to banks, etc.) ......... 18a 27 Other expenses (from line 48 on b Other .......................................... 18b Page 2) ................................................... 27 759 . 17 L al n rf i n l e a d o ess o a g P services ....................................... 7 50. ::::>:::<: :»:::>::::>::>s:::>::::»::>:>:>:::<:».::: «:>: 28 Total expenses before expenses for business use of home. Add lines 8 through 27 in columns ....................................... - 28 2 2 806 . 29 Tentative profd (loss). Subtract line 28 from line 7 ....................................„.....,._...,.,.,.........,........_._..._,..,,.,._..............._. 29 2 6 4 32 . 30 Expenses for business use of your home. Attach Form 8829 .......................................................................................... 30 31 Net profit or (loss). Subtract line 30 from line 29. • If a profd, enter on both Form 1040, line 12, and Schedule SE, line 2 or on Form 1040NR, line 13 (statutory employees, see page C-6). Estates and trusts, enter on Form 1041, line 3. 31 2 6 4 32 . • If a loss, you must go to line 32. 32 If you have a loss, check the box that describes your investment in this activity (see page C-6). • If you checked 32a, enter the loss on both Form 1040, line 12, and Schedule SE, line 2 or on Form 1040NR, line 13 (statutory employees, see page C-6). Estates and trusts, enter on Form 1041, line 3. • If you checked 32b, you must attach Form 8198. Your loss may be limited. 32a Q Ail investment Is at risk. 32b Q Some investment is not at risk. LHA For Paperwork Reduction Act Notice, see page C-8 of the instructions. s2ooot tt-os-os Schedule C (Form 1040) 2006 3 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 ScheduleC(Form1040)2006 CHAD M. a„~RR DEC. `03/05/06 188-64-9320 Paget << Cost of Goods Sold (see page C•7) 33 Method(s) used to value closing inventory: a ^ Cost d ^ Lower of cost or market c ^ Other (attach explanation) 34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory? If "Yes; attach explanation ................................................................................................................................................ ^Yes ^ No 35 Inventory at beginning of year. If different from last year's closing inventory, attach explanation .................................... 35 36 Purchases less cost of items withdrawn for personal use ....................................................................................... 36 37 Cost of labor. Do not include any amounts paid to yourself .................................................................................... 37 38 Materials and supplies ............................................................................................. ...... 38 2 , 9 3 2 . ............................... 39 Othercosts ..................................................................................................SEE...STATEMENT....1.... 39 2 550. 40 Add lines 35 through 39 ....................................................................................:............................................ 40 5 4 82 . 41 Inventory at end of year ................................................................................................................................. 41 42 Cost of oods sold. Subtract line 41 from line 40. Enter the result here and on pa a 1, line 4 ....................................... 42 5 4 82 . Information on Your Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 on page C-4 to find out if you must file Form 4562. 43 When did you place your vehicle in service for business purposes? (month, day, year) - / / 44 Of the total number of miles you drove your vehicle during 2006, enter the number of miles you used your vehicle for: a Business b Commuting c Other 45 Doyou(oryourspouse)haveanothervehicleavailableforpersonaluse? ....................................................................... .......^Yes ^ No 46 Was your vehicle available for personal use during off-duty hours? ............................................................................. ....... ^Yes ^ No 47a Do you have evidence to support your deduction? ..................................................................................................... .......^Yes ^ No b If'Yes ; is the evidence written? ................................. ............................................................................................ ....... n Yes n No >?1~t< Other Expenses. List below business expenses not included on lines 8.26 or line 30. TELEPHONE 376. OTHER EXPENSES AMORTIZATION 383. 48 Total other expenses. Enter here and on page 1, line 27 ....................................................................................... 48 7 5 9 . s2ooo2ii~-oa-os Schedule C (Form 1040)2006 4 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 N U W a A W x U i L i c i i c L a V z G ~ a )~ C V A S~ iW i~ U i~ -~ ~a ;~ ~~ a ~ R'+ W iq • :i i ;;Si:;Y~i ::::~: - • G:' :::';::~f • :y}i Yvi:::+ • : } i::::ii:S~:~ • :i:2: i~:~ ~i ~i:~:ri • {:iiiii :: ii • :i:: :::i _i ~:~ :<S: O .: :: ;: ";: '; O :'::: ::;'; .:'; ~ .::.; ::<.... O ':::5 ::>...:. O ':;: ~::: Y;:...:' ::::, O 'ii:Lii.~ {i v::::::. O <i:Y:i::....i w:::::....~ O '' • '::: '::. .~: t0 c d O `;:> :~5: ~i:>: ..+ U C D ~ N ~:3i P" :S:;:;:;:;: O U ...~ rn c r ~~ ~- U 7 N U N :.:: :::... ..: ~, :: `:: 4::~:i.r ::..: :.~.: : :. ~~ •- .. . ::....... E a~ ~~ a U ~ ,, ~... . :::. U o N 1!!~:. • >, r> *: O ECi 4"t. CX> `` ::;:..C'~;. O C? O ,' C? O Q: O O : C.T. 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M N ~ ~ ~ Ql N a 0 o~ NON NO SCHEDULE SE (Form 1040) Department of the Treasury Internal Revenue Service OMB No. 1545-0074 Self-Employment Tax - Attach to Form 1040. - See Instructions for Schedule SE (Form 10401. 2006 Attachment Sequence No. t 7 Name of person with self-employment income (as shown on Form 1040) Social security number of person with self••employment CHAD M. DERR (DEC. 03/05/06) income ........................... - 188:64:9320 Who Must File Schedule SE You must file Schedule SE ff: • You had net earnings from self-employment from other than church employee income (line 4 of Short Schedule SE or line 4c of Long Schedule SE) of $400 or more, or • You had church employee income of $108.28 or more. Income from services you performed as a minister or a member of a religious order is not church employee income {see page SE-1). Note. Even If you had a loss or a small amount of income from self-employment, lt may be to your benefit to file Schedule SE and use either 'optional method" in Part II of Long Schedule SE (see page SE•3). Exception. If your only seff•empioyment income was from eamings as a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361 and received IRS approval not to be taxed on those earnings, do not file Schedule SE. 'Instead, write 'Exempt•Form 4361 " on Form 1040, line 58. May I Use Short Schedule SE or Must I Use Long Schedule SE? Note. Use this flowchart only if you must file Schedule SE, if unsure, see Who Must file Schedule SE, above. No ~ Did you receive wages or tips in 2006? I Are you a minister, member of a religious order, or Christian Science practitioner who received IRS approval not to be taxed on eamings from these sources, but you owe self-employment tax on other eamings? No Are you using one of the optional methods to figure your net eamings (see page SE-3)? No Did you receive church employee income reported on f=orm W-2 Yes of $108.28 or more? No I You may use Short Schedule SE Below 1 Yes Was the total of your wages and tips subject to social security Yes or railroad retirement tax plus your net earnings from seif- employment more than $94,200? No Did you receive tips subject to social security or Medicare Yes tax that you did not report to your employer? ~ You must use Long Schedule SE on page 2 J Section A-Short Schedule SE. Caution. Read above to see'rfyou can use Short Schedule SE. 1 Net farm proftt or poss) from Schedule F, Gne 36, and farm partnerships, Schedule K•1 (Form 1065), box 14, code A ................................................. ............................................................................. 2 Net proftt or (loss) from Schedule C, line 31; Schedule C-EZ, line 3; Schedule K•1 (Form 1065), box 14, code A (other than farming); and Schedule K•1 (Form 1065.8), box 9, code J7. Ministers and members of religious orders, see page SE•1 for amounts to report on this line. See page SE•3 for other income to report STMT .. 2.... 3 Combine lines 1 and 2 .......................................................................................... 4 Net eamings from self-employment. Multipty line 3 by 92.35% (.9235). If less than $400, do not file this schedule; You do not owe self-employment tax ................................................................„_.-............ - 5 Self-employment tax. If the amount on line 4 is: • $94,200 or less, multiply line 4 by 15.3°r6 (.153). Enter the result here and on Forth 1040, line 58. • More than $94,200, multiply line 4 by 2.9% (.029). Then, add $11,680.80 to the result. Enter the total here and on Form 1040, line 58. 6 Deduction for one-half of self-employment tax. Multiply line 5 by 50% (.5). Enter the result here and on Fomm 1040, line 27 ................................................ ~ g ~ 1 , 8 6 8 . LHA For Paperwork Reduction Act Notice, see Form 1040 instructions. 624501 10-24-06 09450412 759605 53250 5 2006.05050 DERR, CHAD M. 2 26 432. a 26,432. 24.410. 3,735. Schedule SE (Form 1040) 2006 53250_1 ~ ~ OMB No. 154&0074 Form 6 2 51 Departrnent of the Treasury Internal Revenue service (99) Alternative Minimum Tax -Individuals - Attach to Form 1040 or Form 1040NR. 206 Attachm~t sequence No.32 Name(s) shown on Form 1040 or Form 1040NR CHAD M. DERR Your social security number 188;64:9320 #?~; Alternative Minimum Taxable Income 1 If filing Schedule A (Form 1040), enter the amount from Form 1040, line 41 (minus any amount on Form 8914, line 6), and go to line 2.OthenNlse, enter the amount from Form 1040, line 38 (minus any amount on Form 8914, line 6), and go to Ilne 7. (If less than zero, enter as a negative amount.) ......... 1 2 4 , 5 6 4 . 2 Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4, or 2 1 /2°rb of Form 1040, line 38............ 2 3 Taxes from Schedule A (Form 1040), line 9 ......................................................................................................... 3 4 Enter the home mortgage interest adjustment, If any, from line 6 of the worksheet on page 2 of the instnlctions ... 4 5 Miscellaneous deductions from Schedule A (Form 1040), line 26 ........................................................................ 5 8 If Form 1040, line 38, is over $150,500 (over $75,250 if married filing separately), enter the amount from line 11 of the Itemized Deductions Worksheet on page A•7 of the instructions for Schedule A (Form 1040) .................. 8 7 Tax refund from Form 1040, line 10 or line 21 .................................................................................................. 7 8 Investment interest expense (difference between regular tax and AMT) ............................................................ 8 9 Depletion (difference between regular tax and AMT) ......................................................................................... 9 10 Net operating loss deduction from Form 1040, line 21. Enter as a positive amount ................................ ............. 10 11 Interest from specified private activity bonds exempt from the regular tax ......................................................... 11 12 Qualified small business stock (7% of gain excluded under section 1202) ........................................................... 12 13 Exercise of incentive stock options (excess of AMT income over regular tax income) ......................................... 13 14 Estates and trusts (amount from Schedule K•1 (Form 1041), box 12, code A) ..................................................... 14 15 Electing large partnerships (amount from Schedule K•1 (Form 1065•B), box 6) .................................................. 15 18 Disposition of property (difference between AMT and regular tax gain or loss) .................................................. 18 17 Depreciation on assets placed in service after 1986 (difference between regular tax and AMT) ..... STMT....3.... 17 -4 0 3 8 . 18 Passive activities (difference between AMT and regular tax income or loss) ..................................................... 18 19 Loss limitations (difference between AMT and regular tax income or loss) ........................................................ 19 20 Circulation costs (difference between regular tax and AMT) .............................................................................. 20 21 Long-term contracts (difference between AMT and regular tax income) ........................................................... 21 22 Mining costs (difference between regular tax and AMT) .................................................................................... 22 23 Research and experimental costs (difference between regular tax and AMT) ..................................................... 23 24 Income from certain installment sales before January 1, 1987 .......................................................................... 24 25 Intangible drilling costs preference ................................ ........... 25 28 Other adjustments, including income-based related adjustments ....................................................................... 28 27 Altemative tax net operating loss deduction ..................................................................................................... 27 28 Alternative minimum taxable income. Combine lines 1 through 27. (If married filing separately and line 28 is more than $200,100, see instructions) ..................................................................................................... 28 2 0 5 2 6 . i' Altemative Minimum Tax 29 Exemption. (If this form is for a child under age 18, see instructions.) IF your filing status is... AND line 28 is not over... THEN enter on line 29... Single or head of household .............................. $112,500 ........................ $42,500 Married filing jointly or qualifying widow{er)......... 150,000 ........................ 62,550 Married filing separately ..................... . . 000 ........................ 31 275 ............................ 75 .......... :;>::»>:::>:: ::::::::::: ' ' '> " ' 29 5 ~ 0 . . . ........... . , If line 28 is over the amount shown above for your filing status, see instructions. 30 Subtract line 29 from line 28. If more than zero or you are filing Form 2555 or 2555•EZ, go to line 31. lt zerro or less and you are not filing Form 2555 or 2555•EZ, enter -0• on lines 33 and 35 and skip the rest of Part II .. _,,. _..._. 30 ~ . 31 • If you are filing Form 2555 or 2555•EZ, see page 8 of the instructions for the amount to enter. ~ If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends on Form 1040, line 9b; or you had a gain on both lines 15 and 16 of Schedule D {Form 1040) (as refigured 31 0 • for the AMT, if necessary), complete Part III on page 2 and enter the amount from line 55 here. • All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately), multiply line 30 by 26°.U (.26). Otherwise, multiply line 30 by 28% (.28) and subtract $3,500 ($1,750 ff married filing separately) from the result. 32 Altemative minimum tax foreign tax credit (see instructions) ........................................... ... ..... .. .., 32 ...................... . . . 33 Tentative minimum tax. Subtract line 32 from Gne 31 33 ~ 34 Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040, line 47). If you used Sch J to figure your tax, the amount for line 44 of Form 1040 must be refigured without usincl Sch J 34 2 0 4 1 . 35 Alternative minimum tax. Subtract line 34 from line 33. If zero or less, enter -0•. Enter here and on Form 1040, line 45 .......................................................................................................................................... 35 0 . 6z 22 O6 LHA For Paperwork Reduction Act Notice, see instructions. Form 8251 (2006) 5.1 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 Fom, 6251 (2006) CHAD M . ,)ERR ' 188-64-9320 Page 2 38 Enter the amount from Form 6251, line 30 .......................................................... ............................................... 37 Enter the amount from line 6 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 13 of the Schedule D Tax Worksheet on page D•10 of the instructions for Schedule D (Form 1040), whichever applies (as refigured for the AMT, ff necessary) (see the instructions) ..................................................................... 37 38 Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT,rf necessary) (see instructions) ................... -.-----,---, ................................... 38 39 If you did not complete a Schedule D Tax Worksheet for the regular tax or the AMT, enter the amount from line 37.Otherwise, add lines 37 and 38, and enter the smaller of that result or the amount from line 10 of the Schedule D Tax Worksheet (as refigured for the AMT, if necessary) .......................................... 39 40 Enter the smaller of line 36 or line 39 ................................................................ ............................................... 41 Subtract line 40 from line 36 ............................................................................... ............................................... 42 If line 41 is $175,000 or less ($87,500 or less if married filing separately), multiply l ine 41 by 26 % (.26). Otherwise, multiply line 41 by 28% (.28) and subtract $3,500 ($1,750 ff married filing separately) from the result ...................................... ................................................................. ......................................... - 43 Enter. • $61,300 if married filing jointly or qualifying widow(er), • $30,650 ff single or married filing separately, or ............................. 43 • $41,050 'rf head of household. 44 Enter the amount from line 7 of the Qualified D'Nldends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 14 of the Schedule D Tax Worksheet on page D-10 of the instructions for Schedule D (Form 1040), whichever applies (as figured for the regular tax). If you did not complete either worksheet for the regular tax, enter -0• ..................... 44 45 Subtract line 44 from line 43. If zero or less, enter -0• .....:................................. 45 48 Enter the smaller of line 36 or line 37 ............................................................... 47 Enter the smaller of line 45 or line 46 ............................................................... 48 Multiply line 47 by 5% (.05) ............................................................................... 49 Subtract line 47 from line 46 ........................................................................... 50 Multiply line 49 by 15% (.15) .............................................................................................. If line 38 is zero or blank, skip lines 51 and 52 and go to line 53.Otherwise, go to line 51. 51 Subtract line 46 from line 40 ........................................................................... ~ 51 52 Multiply line 51 by 25% (.25) ..................................................................................................................... - 53 Add lines 42, 48, 50, and 52 ....................................................................................... .................................... 54 If line 36 is $175,000 or less ($87,500 or less if married filing separately), multiply line 36 by 26°rb (.26). Otherwise, multiply line 36 by 28% (.28) and subtract $3,500 ($1,750 ff married filing separately) from the result ~ ........................................................................................................................................................ 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Y lp 1;p;. t,p :ice . t~ . ;:::: yZ Q O~ ~y~ O NO to Form 4562 SCHEDULE C- 2 Depreciation and Amortization Department of the Treasury (Including Information on Usted Property) Internal Revenue service ~ See separate instructions. ~ Attach to your tax return. Name(s) shown on return Business or actlvity to which this form relates ERR'S LAWNCARE & CHAD M. DERR ANDSCAPING I,t':~~ Election To Expense Certain Property Under Section 179 Note: If you have any listed property, complete Part V before 1 Maximum amount. See the instructions for a higher limit for certain businesses .......................................... ..... . 1 2 Total cost of section 179 property placed in service (see instructions) ............................................................. 2 3 Threshold cost of section 179 property before reduction in limitation .................................................................. 3 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0• .................... 4 5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, solar -0-. If married filing separatety, see instructions .. 5 6 (a) Descrlptlon of property (b) Cost (business use only) (c) Elected cost 7 Listed property. Enter the amount from line 29 ......................................................... ~ 7 ~ 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 ............. ....................... 9 Tentative deduction. Enter the smaller of line 5 or line 8 .................................................................................... 10 Carryover of disallowed deduction from line 13 of your 2005 Form 4562 ............................................................ 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 .............. ............ 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 .................................... 13 Carryover of disallowed deduction to 2007. Add lines 9 and 10, less line 12 ............ - 13 Note: Do not use Part ll or Part 111 below for listed property. Instead, use Part V. Special Depreciation Allowance and Other Depreciation (Do not include listed property.} 14 Special allowance for qualified New York Liberty or Gulf Opportunity Zone property (other than listed property) placed in service during the tax year . ........................ 15 Property subject to section 1680(1) election ................................................................................................... 16 Other de reciation includin A RS ............................................................................................................... _ '_ ': MACRS Depreciation IIDo not include listed property.) (See instructions.) Section A 17 MACRS deductions for assets placed in service in tax years beginning before 2006 ................ ........................ 18 If you are electing to group any assets placed in service during the tax year into one or rtare general asset accounts, check here _........ OMB No. 1545-0172 2006 Atradtment Sequence No. 67 Identifying number 88-64-9320 nplete Part !. 108,000. 430,000. 52. Section 6 -Assets Placed in Service During 2006 Tax Year Using the General Depreciation System (b) Month and (c) f3asls for depreclatlon (~ Classification of property year placed (buslnesslnvestmentuss Id) ~~ery (e) Convention (f) Method in service only -see instructions) Lril Depreciation deduction 19a 3•vear proDertv i 1 h Residential rental property I / I 3 , 18 0.17 YRS . ~ HY ~ 0 0 DB~ 114 . 27.5 rs. MM S/L 27.5 yrs. MM S/L i Nonresidential real property ~ MM S/L Section C -Assets Placed in Service During 2006 Tax Year Using the Alternative De~rer_iatinn svstam 20a Class life - _ g~ b 12- ear ~ 12 rs. S/L c 40• ear / 40 yrs. MM S/L 21 Listed property. Enter amount from line 28 ................................................................................ 22 Total. Add amounts from line 12,1ines 14 through 17, lines 19 and 20 in column (g), and line 21. Enter here and on the appropriate lines of your return. Partnerships and S corporations • see instr. 23 For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs .................. 23 61x17 ~ LHA For Pa perwork Reduction Act Notice, see separate instructions. 6 09450412 759605 53250 2006.05050 DERR, CHAD M. ................ I 21 I 1, 7 8 0. 13,046. 10 12 Form 4562 (2006) 53250_1 Form 4562 (2006) CHAD M . DERR ~ 18 8 -6 4 -9 3 2 0 Page 2 ;~ ~ Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and property used for entertainment, recreation, or amusement.) Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (41 through (c) of Section A, all of Section B, and Section C if applicable. Section A -Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.) r~ n r n i n c4a vu vu uavc cv~ucucc w au vn uw uuanwaannvoau no~~~ uae aauuvu .• Lu t; es lJ rvo LVD IT T e5 I:i me evide nce WfRien ! L~ J Tes u rvo (b) (c) d (e) (fl l9) (h) (l (a) ( ) Type of property Date Business/ Cost or Basis fordepredation pecovery Method/ Depreciation Elected {list vehicles first) placed in investment other basis (businesslnvestment Period Convention deduction section 179 service use percentage use oniy- cost 25 Special allowance for qualified New York Liberty or Cwlf Opportunity Zone p roperty placed in service during the tax year and used more than 50% in a Uualfied business use .............................. ................................. ................... ........ 25 €€ €>`<:€z;r>>>; 26 Property used more than 50% in a qualified business use: STATEMENT 4 % 1,780. 27 Property used 50°r6 or less in a qualified business use: 2t3 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ... . .. . . . . .. ... . . 28 1 7 8 0 . 29 Add amounts in column (), line 26. Enter here and on line 7, page 1 ................... ........ ..........,......, ..._.. , ... 29 Section B -Information on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner,' or rel~ded person. If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles. 30 Total business(nvestment miles driven during the (a) Vehicle (b) Vehicle (c) Vehicle (d) 'Vehicle (e) Vehicle (f) Vehicle year (do not include commuting miles) .................. 31 Total commuting miles driven during the year ... 32 Total other personal (noncommuting) miles driven ............................................................... 33 Total miles driven during the year. Add tines 30 through 32 .................................... 34 Was the vehicle available for personal use Yes No Yes No Yes No Yes No Yes No Yes No during off-duty hours? ........................... 35 Was the vehicle used primarily by a more than 5% owner or related person? .................. 36 Is another vehicle available for personal use? Section C -Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5% 37 Do you maintain a wrftten policy statement that prohibits all personal use of vehicles, including commuting, by your Yes No employees? ........... 38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, t>y your employees? See the instructions for vehicles used by corporate officers, directors, or 1 % or more owners ............................... ..... 39 Do you treat all use of vehicles by employees as personal use? ................................................................................................... 40 Do you provide more than five vehicles to your employees, obtain information from your employees about the use of the vehicles, and retain the information received? ......................................................................... ....... .. 41 Do you meet the requirements concerning qualified automobile demonstration use? .,_._.._ .............................. ...................... Note: If your answer to 37, 38, 39, 40, or 41 is "Yes, " do not complete Section B for the covered vehicles. ~,~[ Amortization (a) Description of costs (b) I (c) I (dI I (e) Dateamatlzation Amortizable Code AmoNZa6on heyir~s amount section paiodorpercan. Amortization forthls year 383. 383. Amortization of costs that begins during vour 2006 tax 43 Amortization of costs that began before your 2006 tax year ............. ................................................................. 44 Total. Add amounts in column (f). See the instructions for where to report ......................................................... q4 sis2sznan-os 09450412 759605 53250 7 2006.05050 DERR, CHAD M. Form 4562 (2006) 53250_1 __ CHAD M. DERR ~ i88-64-9320 SCHEDULE C OTHER COSTS OF GOODS SOLD STATEMENT 1 DESCRIPTION ~OST OF CONTRACTED SERVICES ~OST OF EQUIPMENT RENTALS SMALL TOOLS DOTAL TO SCHEDULE C, LINE 39 AMOUNT 2,550. 2,550. 8 STATEMENT(S) 1 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 CHAD M. DERR ~ 188-64-9320 SCHEDULE SE NON-FARM INCOME STATEMENT 2 DESCRIPTION LANDSCAPING DOTAL TO SCHEDULE SE, LINE 2 AMOUNT 26,432. 26,432. 9 STATEMENT(S) 2 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 CHAD M. DERR i88-64-9320 ?ORM 6251 DEPRECIATION ON ASSETS PLACED IN SERVICE AFR'ER 1986 STATEMENT 3 DESCRIPTION 1988 JEEP WAGONEER EXMARK LASER MOWER EASY LOAD SALT AND CINDER SPREADER COMMERCIAL TRUCK MOUNTED LEAF COLLECTOR 1991 CHEVY TRUCK rINN BARK MULCH BLOWER 1997 FORD TRUCK ~OMPUTER EDGER TOTAL TO FORM 6251, LINE 17 AMOUNT 1,031. -155. -41. -83. -354. -3,369. -711. -129. -227. -4,038. 10 STATEMENT(S) 3 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 _ _ CHAD M. DERR ~ 188-64-9320 FORM 4562 PART V - LISTED PROPERTY INFORMATION, MORE THAN 50$ STATEMENT 4 (A) (B) (C) (D) (E) (F) (G) (H) (I) 179 DESCRIPTION DATE BUS $ COST BASIS LIFE MTH/'CV DEDUCTION ELECTED (J) (K) (L) (M) (N) (O) (P) (Q) ?AUTO TOTAL BUSINESS COMMUTING PERSONAL WAS VEH. > 5~ ANOTHER NO. MILES MILES MILES MILES AVAIL.? OWNER? VEH. AVAIL.? Y N Y N Y N 1995 FORD 04/01/96 PICK-UP 100.00 16,500. 16,500. 5.00 200I>B-HY 1 X X 1988 JEEP i~TAGONEER 100.00 8,900. 8,900. 5.00 200I)B-HY 1,780. 2 X X TOTAL TO FORM 4562, PART V, LINE 26 1,780. 11 STATEMENT(S) 4 09450412 759605 53250 2006.05050 DERR, CHAD M. 53250 1 €10 4 0 0 0 ~ U.S. Individual Income Tax Return L IRS Use Onty - Do not write or staple In this space. Label For the year Jan. 1-Dec. 31,2005, or other tax year beginning , 2005, ending , 20 OMB No. 1545-0074 (See A Your first name and initial Last name Your social security numb instructions CHAD M. ERR 188 ': 64 ~ 9320 on page 16J E If a joint return, spouse's first name and initial Last name Spouse's social security number Use the IRS label. Otherwise, l i ~ H E Home address (number and street). If you have a P.O. box, see page 16. Apt. no. 10 EAST GREEN STREET You must enter • your SSN(s) above.• p ease pr nt R or type. E City, town or post office, state, and ZJP code. If you have a tbralgn address, see page 16. Checking a box below will not Presidential SHIREMANSTOWN PA 17011 change your tax or refund. Election Campai gn - Check here ff you, or your spouse ff filing jointly, want $3 to go to this fund (see age 16) ... - 0 You ~ S use Filing Status 1 X Single 4 Head of household (with qualifying person). If the qualifying 2 Q Married filing jointly (even if onry one had income) person is a child but not your dependent, enter this child's Check only 3 ~ Married filing separately. Enter spouse's SSN above name here. - one box. _ and full name here. - 5 0 Qualiivina widowfer) with dependent child lsee Dane 171 Exemptions 6' t If more than four dependents, see page 19. t XJ Yourself. If someone can claim you as a dependent, do not check box 6a ................................ ................ Spouse .................................................. .................................................................................... Dependents: (1) Flrst name Last name R-Dependent'ssodal security number (3-~ep~nden~s relationshi to P y°U (~ I~lity- Inng9 chi d for childtaxcretfit (see D~ 1~ on 6a and 6b No. of children on 6c who: ~ lived with you • did not live with you due to divorce or sepa2tion (see page 20) Dependents on 6c not entered above Add numbers d Total number of exemptions claimed ................................................... ................. -................... ......... .... on lines- above 1 Income 7 Wages, salaries, tips, etc. Attach form(s) W-2 .................................... ....................... . ........... ... 7 Attach Form(s) ~ Taxable interest. Attach Schedule B 'd required ................„ .................. .......................................... 8a W-2 here. Also attach Forms b 9a Tax-exempt interest. Do not include on line Sa ................................. Ordinary dividends. Attach Schedule 8 'rf required ................ . . ............... 8b .......................................... 9a W-2G and 1099-R if tax was withheld. b 10 Qualified dividends see a e 23 ( P 9 ) ................................................... Taxable refunds, credits, or offsets of state and local income taxes ............ 96 ......... ................................. 0 11 Alimony received ........................................................................... .......................................... 11 If you did not 12 Business income or (loss). Attach Schedule C or C-EZ --------------------------- ----------------- ------- 12 91, 15 3 . get a W-2, 13 Capital gain or (loss). Attach Schedule D if required. If not required, check here --------- --------- - 0 13 see page 22. 14 Other gains or (losses). Attach Form 4797 .......................................... .............................. .......... 14 15a IRA distributions ..................... 15a b Taxable amount (see page 25) 15b Enclose, but do not attach any 16a Pensions and annuities ...--.-..... 18a ~ b Taxable amount (see page 25) 16b , payment. Also, 17 Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E ........................ 17 please use 18 Farm income or (loss). Attach Schedule F ------------------------------------- ... . .......................................... 18 Form 1040-V. 19 Unemployment compensation ......................................................... ........ 19 20a Social security benefits _..._....-.- ~ 20a ~ ~ b Taxable amount (see page 27) 20b 21 Other income. List type and amount {see page 29) NOL CARRYOVER TO 2005 -14 912. 21 -14 912. 22 Add the amounts in the far ri ht column for lines 7 throw h 21. This is our total i ncome .................. - 22 7 6 2 41 . 23 Educator expenses (see page 29) ...............................„-,,.-_-.--.,.....- 23 Adjusted 24 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Fortn 2106 or2los-EZ ................................................... 24 GfOSS 25 Health savings account deduction. Attach Form 8889 ........................ 25 Income 26 Moving expenses. Attach form 3903 ......................„-„--,,,---...._.-... 26 27 One-half of self-employment tax. Attach Schedule SE ........................ 27 6 4 4 0 . 28 Self-employed SEP, SIMPLE, and qualified plans ------------------------------ 28 29 Self-employed health insurance deduction (see page 30) ..................... 29 30 Penalty on eady wfthdrawal of savings .................. ........................... 30 31 a Alimony paid b Recipient's SSN - 31 a 32 IRA deduction (see page 31) ......................................................... 32 33 Student loan interest deduction (see page 33) ................................. 33 34 Tuition and fees deduction (see page 34) ................. ..................... 34 35 Domestic production activities deduction. Attach Form 8903 ............... 35 510001 36 Add lines 23 through 31a and 32 through 35 .................................... ... -..._,-_- ................................. 36 6 4 4 0 . 11-os-os 37 Subtract line 36 from line 22. This is vour adjusted cross Income ... ............ - 37 6 9 8 01. LHA For Discbsure, Privacy Act, and Paperwork Reduction Act Notice, see page 78. Form 1040 (zoos) Formtoao(zooej CHAD M. DERR 18., =64-9320 Paget Tax and 38 Amount from line 37 (adjusted gross income) ....................................................................................... 38 6 9 8 O 1. Credits 39a Check ~ ~ You were bom before January 2,1941, ~ Blind. 1 Total bo:es o~au~ "~r_ if: ~ Spouse was bom before January 2,1941, Q Blind. JI' checked ... - 39a ~ People who b If your spouse itemizes on a separate return or you were adual-status alien, see page 35 and check here -. ,-., - 39b a checked any 40 ttemized deductions (from Schedule A) or your standard deduction (see left margin) ................. box on line 39a ................ 40 5 O 0 0 . or39b Or who q1 Subtract line 40 from line 38 ..................... can be daimad ....................................................................................... 41 4 8 0 1 . as a dependen 42 If line 38 is over $109,475, or you provided housing to a person displaced by Hurricane Katrina, see page 37.Otherwise, muftipry $3,200 by the total number of exemptions claimed on line 6d ........................ 42 3 2 0 0 . 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter-0- ................................. 43 61 601 . • all others: 44 Tax. Check If an tax is from: a y 0 Form(s) 8814 b ~ Form 4972 ..................................................... 44 12 0 71 . single or q5 Alternative minimum tax. Attach Form 6251 ........................... Monied filing ........................................................... a5 separately, 48 Add lines 44 and 45 .................................................................................. ...................... - 46 12 0 71 . ss,ooo .......... Married filing 47 Foreign tax credit. Attach form 11.16 ff requirrd ....................................... 47 jointly or 48 Credit for child and dependent care expenses. Attach Form 2441 .................. 48 Qualifying widow(er1, 49 Credit for the elderly or the disabled. Attach Schedule R .............................. 49 $10'00° 50 Education credts. Attach Form 8863 .............. ........................................ 50 household, 51 Retirement savings contributions credft. Attach Form 8880 ........................ 51 s7,3oo 52 Child tax credit (see page 41). Attach Form 8901rf required ........................ 52 53 Adoption credit. Attach Form 8839 .................................... ...... ............. 53 54 Credits from: a ~ Form 8396 b ~ Form 8859 ............... 54 55 Other credits. Check applicable box(es): a ~ Form 3800 b 0 Form 8801 c Q Form ...... 55 56 Add lines 47 through 55. These are yourtotal credits ................................. ., .,,...__....__... 58 ................ . 57 Subtract line 56 from line 46. If line 56 is more than line 46 enter -0- ..... ............. ............ - 57 12 0 71 . Other 58 Self-employment tax. Attach Schedule SE .......................................................................... . ............. 58 12 880. Taxes 59 Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 ........................... 59 60 Additional tax on IRAs, other qualrfied retirement plans, etc. Attach Form 5329 if required .............................. 80 81 Advance earned income credit payments from Form(s) W-2 ....................................... ............................ 61 62 Household employment taxes. AttachScht:duleH .......................... ....................................................... 62 83 Add lines 57 through 62. This is yourtotal tax .......................... ......... - 83 2 4 951 . .............................................. Payments 64 Federal income tax withheld from Forms W-2 and 1099 .............................. 64 65 2005 estimated tax payments and amount applied from 2004 return ,...._.,_-.. 65 If you have 66a Earned income credit (EIC) ............. ..................................................... 66a a qualifying child, attach b Nontaxable combat pay election ...-...., - 58b Schedule EIC. 57 Excess social security and tier 1 RRTA tax withheld (see page 59) .._,.,., 68 Additional child taxcredft. Attach Form 8812 ............................................. 68 69 Amount paid with request forextension to file (see page 59) ........................ 89 70 Payments from: a 0 form 2439 b ~ Form 4136 c Q Form 8885 70 71 Add lines 64, 65, 66a and 67 through 70. These are Your total payments .......-..., - 71 Refund 72 If line 71 is more than line 63, subtract line 63 from line 7f .This is the amount you overpaid.~ .................. 72 Direct 73a Amount of line 72 ou want refunded to you ..................... . daposiYl ...........Account ........................................... - 73a See page 59 NouUng ys,e: 0 Cheddn0 Q SaNrgs - d number and fill in 73b, - b number - C 7 73c, and lad. 74 Amount of line 72 you want applied to your 2008 estimated tax - ~ 74 Amount 75 Amount you owe. Subtract line 71 from line 63. For details on how to pay, see page 60 .................. ......... - 75 2 5 0 3 7 . You Owe 76 Estimated tax penalty (see page 60) ............ 175 I 8 6 . Third Party Do you want to allow another person to discuss this return with the IRS {see page 61)? ~X Yes. Complete the following. 0 No Designee•S- PREPARER ~~- Personalidendfication numberlPlM - Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, cortect, and complete. Declaration of preparerjother than taxpayer- is based on all infomlatbn of which preparer has any knowledge. Here Your signature Date Your occupation Daytime phone number Joint retum7 See page t7. , ANDSCAPING Keep a copy Spouse's signature. If a joint return, both must sign. Date Spouse's occupation for your records. Paid Preparers ' Date Check if self- Preparers SSN or PTIN Preparef'Ssignature employed Use Only Firm's name (or SELIGMAN, FRIEDMAN AND COMPANY , P . C . EiN 2 3 : 2 7 0 8 6 0 7 yours if self-ern- ' 10 2 7 MUMMA ROAD Phone no7 17 - 7 61- 0 211 stooo2 ployed), address, WORMLEYSBURG, PA 17 0 4 3 t t-~-~ and Z1P code Fo~n 2210 ~ ' Underpayment of Estimated Tax by Individuals, Estates, and Trusts - See separate lnstructiona. Department of the Tr~sury ~ntemal rievenue Senr~ce - Attach to Form 1040,1040A,1040NR,1040NR-EZ, or 1041. OMB No.1545-0140 2005 Attachment sequence No. 06 Name(s) shown on tax return I Identifying number CHAD M. DERR _1.188-64-9320 Do You Have To File Form 2210? Complete lines 1 through 7 below. Is line 7 less than $1,000? Yes Do not file Form 2210. You do not owe a penalty. No Complete lines 8 and 9 below. Is line 6 equal to or more than line 9? 1 No ~ You may owe a penalty. Does any box in Part II below apply? ~ No Do not file Form 2210. You are not required to figure your penalty because the IRS will figure it and send you a bill for any unpaid amount. if you want to ftgure it, you may use Part III or Part IV as a worksheet and enter your penalty amount on your tax return, but do not file Form 2210. No ~, --- You must figure your penalty. You are not required to figure your penalty because the IRS will figure it and send you a bill for any unpaid amount. If you want to figure ft, you may use Part III or Part IV as a worksheet and enter your penalty amount on your tax return, but file only page 1 of Form 2210. 2 of the instructions) 1 Enter your 2005 tax after credtts from form 1040, line 57 (or comparable line of your return) .......................................... 1 12 , 0 71 ;t 2 Othertaxes,includingself-employmenttax(seepage2oftheinstructions) .................................................................. 2 12 880. 3 Refundable credits. Enter the total of your earned income credit, additional child tax credit, credit for federal tax paid on fuels, and health coverage taxcredtt foreligible individuals .......................................................... ...................... 3 4 Current year tax. Combine lines 1, 2, and 3. If less than $1,000, see page 3 of the instructions .......................................... 4 2 4 , 9 51. 5 Muttipry line 4 by 90% (.90) ........................................................................... ~ 5 ~ 2 2 4 5 6- <>>> 8 Wtthhokling taxes. Do not include estimated tax payments. See page 3 ofthe instructions ............................................. 6 7 Subtract line 6 from line 4. If less than $1,000, you do not owe a penalty; do not file Form 2210 ..................................... .. 7 2 4 9 51 . 8 Maximum required annual payment based on prior year's tax (see page 3 of the instructions) .......................................... 8 1 92 0 . 9 Required annual payment. Enter the smaller of line 5 or line 8 ..................... ............................................................ 9 1 920 . Neil: Is line 9 more than line 6? No. You do not owe a penalty. Do not file Form 2210 unless box E below applies. Yes. You may owe a penalty, but do not file Form 2210 unless one or more boxes in Part II below applies. • If box B, C, or D applies, you must figure your penalty and file Form 2210. • If only box A or E {or both) applies, file onry page 1 of Form 2210. You are not required to figure your penalty; the IRS will figure tt and send you a bill for any unpaid amount. If you want to figure your penalty, you may use Part 111 or Part IV as a worksheet and enter your penalty on your tax return, but file only page 1 of Form 2210. '~[;_' Reasons for Filing. Check applicable boxes. ff none apply, do not file Form 2210. A ~ You request a waiver {see page 2 of the instructions) of your entire penalty. You must check this box and file page 1 of form 2210, but you are not required to figure your penalty. B Q You request a waiver {see page 2 of the instructions) of part of your penalty. You must figure your penalty an~i waiver amount and file Form 2210. -- - C ~ Your income varied during the year and your penalty is reduced or eliminated when figured using the annualized Income installment method. You must figure the penalty using Schedule AI and file Form 2210. 0 Q Your penalty is lower when figured by treating the federal income tax withheld from your wages as paid on the dates tt was actually withheld, instead of in equal amounts on the payment due dates. You must figure your penalty and file Form 2210. E ~ You filed or are filing a joint return for either 2004 or 2005, but not for both years, and line 8 above is smaller than line 5 above You . must file page 1 of Form 2210, but you are not required 1o figure your penalty (unless box B, C, or D applies). LHA For Paperwork Reduction Act Notice, see page 6 of separate instructions. Form 2210 12005) 512501 01-18-06 Yes You do not owe a penalty. Do not fife Form 2210 (but if box E below applies, you must file page 1 of Form 2210 below). Yes ~ You must file Form 2210. Does box B, C, or D apply? 5.1 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1 Forth 2210(2005) ~ p Q Short Method You may use the short method if: • You made no estimated tax payments (or your only payments were withheld federal income tax), or • You paid estimated tax in equal amounts on your due dates. You do not need to You must use the regular method (Part IV) instead of the short method ff: j.~P file Form 2210 unless • You made any estimated tax payments late, you checked a box in • You checked box C or D in Part II, or Part 11 on page 1. • You are filing Form 1040NR or 1040NR-EZ and you did not receive wages as an employee subject to U.S. income tax withholding. Note: If any payment was made earlier than the due date, you may use the short method, but using it may cause you to pay a larger penalty than the regular method. If the payment was only a few days early, the difference is likely to be small. 10 Enter the amount from Form 2210, line 9 ..................................................................................................................... 10 _ls 9 2 0 . 11 Entertheamount,'rfany,fromForm2210,1ine6 ............................................................ 11 ;; ::::::<:>::::»:: 12 Enter the total amount, if any, of estimated tax payments you made .................................... 12 ;;' ,::::: ..................................................................... 13 Add lines 11 and 12 ...................... ................-------.............................. 13 14 Total underpayment for year. Subtract line 13 from line 10. If zero or less, stop here; you do not owe the penalty. Do not file Form 2210 unless you checked box E on page 1 ................................................................. ... . ... ......... ... 14 1 , 9 2 0 . 15 Multiply line 14 by .04457 (use the factor shown in the instructions 'rf you are eligible for hurricane relief) ................................. 15 86 . 16 • If the amount on line 14 was paid on or after 4/15/06, enter -0-. • If the amount on line 14 was paid before 4/15106, make the following computation to find the amount to enter oin line 16. Amount on Number of days paid ,. .;:::::::.;; line 14 x before 4/15/06 x .00019 ............................................................... 16 0 . 17 Penalty. Subtract line 16 from line 15. Enter the result here and on Form 1040, line 76; Form 1040A, line 48; Form 1040NR, line 74; Form 1040NR-EZ, line 26; or Form 1041, line 26 ..................................................................... - 17 8 6 . Forth u' 1 ~ {2005) 512502 01-18-06 5.2 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1°_ scHE~u~E c P fit L F B i °"Ae "°~'~°~°°'° (Form 1040) Department of the Treasury Intamal Revenue Service (~ ro or oss rom us ness (Sole PropHetarahlp) - Partnerships, joint ventures, etc., must file Form 1065 or 1065-B. - Attach to Form 1040 or 1041. -See Instructions for Schedule C ( Form 1040). ~ 0 0 Attachment sequence N°.09 Name of proprietor CHAD M. DERR Social security number (SSN) 188-64-9320 A Principal business or profession, including product or service (see page C-2) LANDSCAPING g Enter ooae from pages c-a, s, 310 - 561730 C Business name. tf no.separate business name, IeaVe blank. DERR'S LAWNCARE & LANDSCAPING D Employer ID number (EIN), if any 25-1839200 E Business address (including sutte or room no.) - 10 EAST GREEN ST . C' , town or post office, state, and zIP code SH IREMANSTOWN PA 17 011 F Accounting method: (1) ~ Cash (2)Q Accrual (3)0 Other(specity) - ---------- G Did you 'materially participate' in the operation of this business during 2005? If "No'see page C-3 for limit on losses .. H If you started or acquired this business during 2005, check here ................................................... ................... ----------------- ............................ OX Yes ~ No ........ - .......................... `?~:„ Income 1 Gross receipts or sales. Caution. If this income was reported to you on Form W-2 and the "Statutory employee" bo:t on that form was checked, see page C-3 and check here .............................................:........................................ . - Q 1 30 6 7 3 4 . 2 Returns and allowances ........................................ ..................................................................................... ............. 2 3 Subtractline2fromlinel ..--,_ ........................ ........................................................................................... .... ...... 3 306,734. 4 Cost of goods sold (from line 42 on page 2) .................................................. .............................................. ............. a 5 5 4 . 5 Gross profit. Subtract line 4 from line 3 ............................... ......................................................................... ............. 5 211 5 8 0 . 6 Other income, including Federal and state gasoline or fuel tax credft or refund (see page C-3) .............. ..................... ............. 6 7 Gross income. Add lines 5 and 6 ................................................................................................................. ....... - 7 211 5 8 0 <i>i Exaenses. Enter expenses for business use of your home only on line 30. 8 Advertising .................................... 8 32 6 . 18 Office expense ....................................... . 18 1 181 . 9 Car and truck expenses . . 19 Pension and profit-sharing plans .................. 19 (see page C-3) .............................. 9 20 Rent or lease (see page C-5): 10 Commissions and fees .................. 10 a Vehicles, machinery, and equipment ............ 20a 9 , 7 75 . 11 Contract labor b Other business property ................. .......... 20b (see page C-4) .............................. 11 21 Repairs and maintenance .......:..._...... .... 21 16 2 32 . 12 Depletion .................................... 12 . .... 22 Supplies (not included in Part lll) ........, 22 13 Depreciation and section 179 .,,... 23 Taxes and licenses .................................... 23 expense deduction (not included in Part III) (see page C-4),,,,,,,,,,,,,,,,,,,,, 13 22 , 750. 24 Travel, meals, and entertainment: a Travel ................................................. . >:«>z>: 24a 14 Employee benefit programs (other than on line 19) .............................. 14 . b Deductible meals and entertainment (see page C-5) ._._...-....._......_ 24b 15 Insurance (other than health) _ ......... 15 17 , 42 5 . 25 Util'dies ...................... ......... ........... 25 4 102 . 16 Interest: ..... 26 Wages (less employment crediks) ............... 26 a Mortgage (paid to banks, etc.) ......... 16a 27 Other expenses (from line 48 o~n b Other .......................................... 16b 10 , 5 0 0 . page 2) ................................................... 27 31 9 9 0 . 17 Le al and rofessional 9 P services ....................................... 7 6 14 6 . 28 Total expenses before expenses for business use of home. Add lines 8 through 27 in columns ....................................... - 28 12 0 4 2 7 . 29 Tentative profd (loss). Subtract line 28 from line 7 ................................................................ ....._.. 29 91 15 3 . 30 Expenses for business use of your home. Attach form 8829 ...................................................... .................................... 30 31 Net profit or (loss). Subtract line 30 from line 29. • If a profd, enter on Form 1040, line 12, and also on Schedule SE, line 2 (statutory employees, see page C-6). 1 Estates and trusts, enter on Form 1041, line 3. ? 31 91 15 3 . • If a loss, you must go to line 32. J 32 If you have a loss, check the box that describes your investment in this activity (see page C-6). • If you checked 32a, enter the loss on Form 1040, line 12, and also on Schedule SE, line 2 (statutory employees, see page C-6). Estates and trusts, enter on Form 1041, line 3. 32a Q alai „ektment • If au checked 32b, ou must attach Form 6198. Your loss ma be limtted. soma Investment Y Y Y 32b ~ is not at risk. LHA For Paperwork Reduction Act Notice, see page C-7 of the instructions. Schedule C (Form 1040) 2005 520001 01-11-06 6 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1 ScheduleC(Form1040)2005 CHAD M. ERR 188-64-9320 2 (] Cost of Goods Sold (see page c-6) 33 Methods} used to value closing inventory: a ^ Cost b ^ Lower of cost or market c ^ Other (attach explanation) 34 Was there any change in determining quantities, costs, or valuations between opening and closing inventory? 11` 'Yes; attach explanation ........................................:.... ..................................................................................... ........ 35 Inventory at beginning of year. If differentfrom last year's closing inventory, attach explanation .................................... 35 36 Purchases Tess cost of items withdrawn for personal use .._.._.._„ ................... ......................................................... 36 37 Cost of labor. Do not include any amounts paid to yourself ............................................................. 37 38 Materials and supplies ..:......................... .......................................................... 38 39 ahercosts ...................... ..... SEE... STATEMENT...1..._ ..................................................................... 3g 40 Add lines 35 through 39 ................................. ................................................................................................ ao 41 Inventory at end of year ..._. 41 ^ Yes ^ No 59,126. 31, 372 . 4,656. 95,154. 42 Cost of oods sold. Subtract line 41 from line 40. Enterthe result here and on a e 1, line 4 ....................................... P 42 95 1'5 4 . Information on Yiour Vehicle. Complete this part only if you are claiming car or truck expenses on line 9 and are not required to file Form 4562 for this business. See the instructions for line 13 on page C•4 to find out ff you must file Form 4562. 43 When did you place your vehicle in service for business purposes? (month, day, year) - / / _ 44 Of the total number of miles you drove your vehicle during 2005, enter the number of miles you used your vehicle for: a Business b Commuting c Other 45 Do you (or your spouse) have another vehicle available for personal use? ................................ ..,,.. ^ Yes ^ No ........................................ 46 Was your vehicle available for personal use during off-duty hours? ,...,.,_.... ...,..... ^ Yes ^ No ............................................................... 47a Do you have evidence to support your deduction? ............. .......... ^ Yes ^ No b If "Yes; is the evidence written? ........................................... ......................................................................................... n Yes n No ;:x::11;;::; Other Expenses. last below business expenses not included on lines 8-26 or line 30 TELEPHONE 4 126 OTHER EXPENSES . 26 642 AMORTIZATION . 1 222 . 48 Total other expenses. 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' ?? ~. .: ~ :: ;::. ~:: ::::;?;i. ~:?ii >z~'? :;. =< .:..::::::: ;~'?« .-~ > <>' t` '::> ..... :: :•:: ...... A .......... . .. H >:<:>:>:::: >`!>> :::::>::>:::<::: <::> ~ .::.;:.:;.;:.>;:.> rn :»: . :<: ':: .... o, <::::::<: :< < :: :~: ::::<:><:> > . H ~--I i2Yli ii L'i ~:~:::~;:~:~i:: i:. ~:::::::::::: : ~ M >::>: >:>:" :: :i:i:i: ~::::: ~:::.:: f::i>:i:i:i:.::;: i: :i ~> ...... .... ttL>i>:::~::5 Y>:it~> NO ~. .iG. t~ :::£:»: : i: qZ i SCHEDULE SE Form 1040) Department of the Treasury internal Revenue Service Self-Employment Tax - Attach to Form 1040. - See Instructions for Schedule SE (Form 1040). Name of person wkh self-employment income (as shown on Form 1040) Social securky number of OMB No. 1545-0074 2005 Attachment Sequence No. ~ 7 person wkh seH-employment CHAD M. DERR income ........................... - 188:64:9320 Who Must File Schedule SE You must file Schedule SE ff: • You had net earnings from sek-employment from other than church employee income (line 4 of Short Schedule SE or line 4c of Long Schedule SE) of $400 or more, or • You had church employee income of $108.28 or more. Income from services you performed as a minister or a member of a religious order is not church employee income (see page SE-1 ). Note. Even ff you had a loss or a small amount of income from sell-employment, k may be to your benefit fo file Schedule SE and use ekher "optional method' in Part II of Long Schedule SE (see page SE-3). Exception. If your only seff•employment income was from eamings as a minister, member of a religious order, or Christian Science practitioner and you filed Form 4361 and received IRS approval not to be taxed on those earnings, do not file Schedule SE. Instead, wrke 'Exempt•Form 4361 " on Form 1040, line 58. May I Use Short Schedule SE or Must 1 Use Long Schedule SE? Did You Receive Wages or Tips in 20054 No ~ Yes Are you a minister, member of a religious order, or Christian Science practdioner who received 1RS approval not to be taxed on eamings from these sources, aut you owe self-employment tax on other earnings? No Are you using one of the optional methods to figure your net eamings (see page SE-3)? Na Did you receive church employee income reported on Form W-2 Yes of $108.28 or more? Na I You May Use Short Schedule SE Below I Was the total of your wages and tips subject to social security Yea or railroad retirement tax plus your net eamings from seff- employment more than $90,000? No Did you receive tips subject to social security or Medicare Yes tax that you did not report to your employer? I You Must Use Long Schedule SE on oaee 2 1 Section A-Short Schedule SE. Caution. Read above to see if you can use Short Schedule SE. 1 Net farm profit or (loss) from Schedule F, line 36, and farm partnerships, Schedule K•1 (Form 1065), box 14, codeA .............. 2 Net profk or (loss) from Schedule C, line 31; Schedule C•EZ, line 3; Schedule K-1 (Form 1065), box 14, code A (other than farming); and Schedule IC-1 (Form 1065•B), box 9. Ministers and members of religious orders, see page SE-1 for amounts to report on this line. See page SE•2 for other income to report ...,......-STMT--. 2..-. 3 Combine lines 1 and 2 ............................................................................................................... 4 Net eamings from self-employment. Mukipty line 3 by 92.35°.6 (.9235). If less than $400, do not file this schedule; You do not owe sell-employment tax .............................................................................. . - 5 Self-employment tax. If the amount on line 4 is: • $90,000 or less, mukipiy line 4 by 15.3% (.153). Enter the resuk here and on Form 1040, line 58. .............................. • More than $90,000, mukiply line 4 by 2.9% (.029). Then, add $11,160.00 to the resuk. Enter the total here and on Form 1040, line 58. 6 Deduction for one-half of self-employment tax. Mukiply line 5 by 50% (.5). Enter the resuk here and on Fohn 1040, line 27 ............................................... ~ 6 ~ 6 , 4 4 0 LHA For Paperwork Reduction Act Notice, see Form 1040 instructions. 524501 ii-io-o5 08070412 759605 53250 8 2005.09001 DERR, CHAD M. ~~91,153. a 91.153. 84,180. 12.880. Schedule SE (Form 1040) 2005 53250_1 Fertn 6 2 51 • ` ~ ~ OM9 No. 1545-0074 (Rev. January2oos- Alternative Minimum Tax -Individuals 205 Department of the Treasury ~ Attach to Form 1040 or Form T040NR. Attachment Internal Revenue service (99) sequence No.32 Name{s) shown on Form 1040 CHAD M. DERR Your social security number 188 :649320 Altemative Minimum Taxable Income 1 If flling Schedule A (Form 1040), enter the amount from Fonn 1040, line 41 (minus any artrount on Forth 8914, Ilne 2), and go to line 2.Othenvisa, enter the amount horn Forth 1040, line 38 (minus any amount on Forth 8914, Tine 2), and go ro line 7. (If less than zero, meter as a negative amount) ......... __ 1 6 9 ~ 8 01. 2 Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4, or 2 1 /2% of Form 1040, line 38....... _.... 2 3 Taxes from Schedule A (Form 1.040), line 9 ......................................................................................................... 3 4 Enter the home mortgage interest adjustment, 'if any, from line 6 of the worksheet on page 2 of the instructions ... 4 5 Miscellaneous deductions from Schedule A (Form 1040), line 26 ..........................„..-„...,...-_.---.--.----.,.......----..... 5 6 If Form 1040, line 38, is over $1A5,950 (over $72,975 ff married filing separately), enter the amount from line 9 of the Itemized Deductions Worksheet on page A-9 of the instructions for Schedules A & B (Form 104.0) . _...... 6 7 Tax refund from Form 1040, line 10 or line 21 ................................................................................................... 7 8 Investment interest expense (difference between regular tax and AMT) ............................................................ 8 9 Depletion (difference between regular tax and AMT) ........... ............................................................................... 9 10 Net operating loss deduction from Form 1040, line 21. Enter as a posftive amount ............................................. 10 14 912 . 11 Interest from specked private activity bonds exempt from the regular tax ......................................................... 11 12 Qual~ed small business stock (7°r6 of gain excluded under section 1202) ............................................................ 12 13 Exercise of incentive stock options (excess of AMT income over regular tax income) ........ .................................. 13 14 Estates and trusts (amount from Schedule K-1 (Form 1041), box 12, code A) ...................................................... 14 15 Electing large partnerships (amount from Schedule K-1 (Form 1065-B), box 6) ..................... - ............................ 15 16 Disposition of property (difference between AMT and regular tax gain or loss) ................................................... 16 17 Depreciation on assets placed in service after 1986 (difference between regular tax and AMT) ..... STMT --.3.... 17 5 3 0 . 18 Passive activities (difference between AMT and regular tax income or loss) ...................................................... 18 19 Loss limitations (difference between AMT and regular tax income or loss) ......................................................... 19 20 Circulation costs {difference between regular tax and AMT) .............................................................................. 20 21 Long-term contracts (difference between AMT and regular tax income) ............................................................ 21 22 Mining costs (difference between regular tax and AMT) ................... ................................................................. 22 23 Research and experimental costs (difference between regular tax and AMT) ...................................................... 23 24 Income from certain installment sales before January 1, 1987 ........................................................................... 24 25 Intangible drilling costs preference .................................................................................................................. 25 28 Other adjustments, including income-based related adjustments ........................................................................ 26 27 Altemative tax net operating loss deduction ...................................................................................................... 27 28 Alternative minimum taxable income. Combine lines 1 through 27. (If married filing separately and lima 28 is more than 191 000 see nstructions ...................................................................................................... 28 8 5 2 4 3 . Altemative Minirrium Tax 29 Exemption. (If this form is for a child under age 14, see instructions.) IF your filing status is.-- AND line 28 is not over... THEN enter on line 29... Single or head of household .............................. $112,500 ..-....-.-...........-.. $40,250 Married filing jointly or qualifying widow(er).....,... 150,000 ........................ 58,000 .-....-.....--....,,,,,,,.,.. .......... ;'' -~29 0 250. Married filing separately ......................:............. 75,000 ......---............... 29,000 If line 28 is over the amount shown above for your filing status, see instructions. 30 Subtract line 29 from line 28. If zzero or less, enter -0-here and on lines 33 and 35 and stop here ........................ .......... 30 4 9 9 3 . 31 • If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends on Form 1040,Jine 9b; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040) (as refigured for the AMT, if necessary), complete Part III on page 2 and enter the amount from line 55 here. • All others: If line 30 is $175 000 or less ($87 500 or less ff married fili se t lti l li 30 b ~ ..31 11 6 9 8 . , , ng para ety), mu p y ne y 26% (.26). Otherwise, mutiply line 30 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result. 32 Altemative minimum tax foreign tax credit (see instructions) .............................................................................. ;:.::;.; 32 33 Tentative minimum tax. Subtract line 32 from line 31 ....................................... ...,...._-----. 33 11 698 . 34 Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040„ line 47). If you used Schedule J to figure your tax, the amount for line 44 of Form 1040 must be refigured without using Schedule J {see instructions) .................... .................................................................................. 4 2 0 71. 35 ARemative minimum tax. Subtract line 34 from line 33. If zero or less, enter -0-. Enter here and on Form 1040. line 45 ................................................................................................~--....................................... 35 0 . oi9 s os LHA For Paperwork Reduction Act Notice, see instructions. Form 6251 (2005) (Rev. 1.2006) 8.1 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1, Form 6251 (2005) {Rev. 1-2006) C HAD M . 'DE}tR ' 18 8 -6 4 -9 3 2 0 Page 2 ..... Tax Computation Usina Maximum Capital Gains Rates 36 Enter the amount from Form 6251, line 30 ............................... 37 Enter the amount from line 6 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 13 of the Schedule 0 Tax Worksheet on page D•9 of the instructions for Schedule D (Form 1040), whichever applies (as refigured for the AMT, tt necessary) (see the instructions) ..................................................................... 37 38 Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT. if necessary) (see instructions) .................................................................. 38 39 If you did not complete a Schedule D Tax Worksheet for the regular tax or the AMT, enter the amount from line 37.Otherwise, add lines 37 and 38, and enter the smatter of that result or the amount from line 10 of the Schedule D Tax Worksheet (as refigured for the AMT, ff necessary) .......................................... 39 40 Enter the smaller of line 36 or line 39 41 Subtract line 40 from line 36 .............................................................................................................................. 42 If tine 41 is $175,000 or less ($187,500 or less if married filing separately), multiply line 41 by 26% (.26). Otherwise, multiply line 41 by 28% {.28) and subtract $3,500 ($1,750 if married filing separately) from the result ........................ .............. - ......................................................................................................... 43 Enter: • $59,400 if married filing jointly or qualifying widow(er), • $29,700 if single or married filing separately, or .............................. 43 • $39,800 tt head of household. 44 Enter the amount from line 7 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 14 of the Schedule D Tax Worksheet on page D•9 of the instructions for Schedule D (Form 1040), whichever applies (as figured for the regular tax). If you did not complete either worksheet for the regular tax, enter -0• ..................... 44 45 Subtract line 44 from line 43. If zero or less, enter •0- ....................................... 45 46 Enter the smaller of line 36 or line 37 ..........................:........................ 46 47 Enter the smaller of line 45 or line 46 ........................................... ...... . 47 48 Muttipty line 47 by 5°r6 (.05) .. .................................................... 49 Subtract line 47 from line 46 50 Multiply line 49 by 15% (.15) ..................................................................................................................... - If line 38 is zero or blank, skip lines 51 and 52 and go to line 53.Otherwise, go to line 51. 51 Subtract line 46 from line 40 ........................................................................... ~ 51 52 Multiply line 51 by 25°r6 (.25) ................................................... .......... - 53 Add lines 42, 48, 50, and 52 .............„--_-_................................ . ................................................................ 54 If line 36 is $175,000 or less ($87,500 or less if married filing separately), multiply line 36 by 26% (.26). 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A ::. :: ~ ~. :;:.: :;...;. ~ .::.:.; »::: ; : >w :: ;:. a a <: ~ o ~€ ~ o :s ~ H :` :.: : . ~. ::~ :..::: : ~: a < .: ::<::.: >: >::::>: :»:<: :: : < :: . ~ ::>::>::>: : : a> ~ ~ :::: :: a ~: ~; w ... :< w ::.::. ... w : : fit. a ~ : :: H ::<:: w <: :::>:> .:<.;: <;:.;:. rn :: '.:: ~ ~ ~ to ~ ~ ~ z ~ .: .. .: .:::::. w: cam. . . : . .: ; .: ;..: ; w ;cs~:: ::~:: ~ <:::>:::> :>~:<:: >::>: :~ ::ri: :Ti:'. ;:.;:.:.; ::: ::>~r> :: tl3. ; ::C:~~: ..; try. ~ ~ »:<:> o ;;;::.: M - .: n qZ ~' ~-o N h~ Forth 4562 ~ SCHEDULE C- 2 Depreclatlon and Amortization (Rey. January 2oosl (Including Information on Listed Property) Department of the Treasury Intamal Revenue service - See separate instructions. - Attach to your tax return. Name(s) shown on return Business or activity to which this torte relates ERR'S LAWNCARE & CHAD M. DERR _ ANDSCAPING .;::. __ ':~ Election To Expense Certain Property Under Section 179 Note: if you have any listed property complete Part V before 1 Maximum amount. See the instructions for a higher limit for certain businesses ............................ 1 .................... 2 Total cost of section 179 property placed in service (see instructions) ...................................................... ........ 2 3 Threshold cost of section 179 property before reduction in limitation ... ......... ......... 3 ................................. 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter-0• ........................................................ 4 rj Dollar limitation for tax year. Subtract Ilea 4 horn Tine 1. If zero or less, enter -0-. If martied filing separately, sae instructions ., 5 6 (a) Description of property _ _ (bj Cost (business use only] (c) Elected cost 7 Listed property. Enter the amount from line 29 .................................................. ~ 7 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 .................. ............ .......... 9 Tentative deduction. Enter the smaller of line 5 or line 8 ..................................................... ........................ 10 Carryover of disallowed deduction from line 13 of your 2004 Form 4562 ..................... ....................................... 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 ........................... 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 .................................... 13 Carryover of disallowed deduction to 2006. Add lines 9 and 10 less line 12 - 13 Note: Do not use Part II or Part Ill below for listed property. Instead, use Part V. Special DepreciationN Allowance and Other Depreciation (Do not include listed property ) 14 Special allowance for certain aircraft, certain property with a long production period, and qualified NYL or GO Zone property (other than listed property} placed in service during the tax year 15 Property subject to section 166(f)(1}election ........................ ......... ......... ......... ......... ........ ......... 16 Other depreciation (including aCRS) ................... .................. 21 l 1, 7 8 0 . OMB No. 154&0172 2005 Attachment Sequence No, 67 Identifying number 188-64-9320 complete Part 1. 105,000. 420,000. i~~j MACRS Depreciation (Do not include listed orocertv.l (See instn:cfinna 1 Section A 17 MACRS deductions for assets,placed in service in tax years beginning before 2005 ......................................... 17 2 0 9 7 0 . 18 If you are electing to group any assets pl$ced in service Burin the tax ear Into one o 9 Y r more general asset axounts check here ......... - a :::::::.:::..... . Section B ;Assets Placed in Service During 2005 Tax Year Using the taeneral Depreciation_System (a] Classifiption of ro (b) Month and (c) Basis for depredation P Pertl/ year placed (businesslnvestment use (~ ~OV~' (e) Convention (1) Method D reciation deduction in service eery -sea Instructions) period (91 ep 1 1 ~~~-~~~ 1221 22,750. h Residential rental property / 27.5 rs. MM S/L / 27.5 rs. MM S/L i Nonresidential real property / 39 rs. IMM S/L / IMM S/L Section C -Assets Placed in Service During 2005 Tax Year llsirus rMe eee~..~*c.,e ne...e,,:,a:,... ~....._- 20a Class lrfe S/L - - - _ b 12- ear 12 rs. S/L c 40-year ;~~::ri:r.:: / 40 rs. MM S/L ts:•swr.~sss<::t vvnnnary tseC 11151r ulillVrlS) 21 Listed property. Enter amount from sine 28 .._.,, 22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21. Enter here and on the appropriate lines of your return. Partnerships and S corporations • see instr... 23 For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs ~ of ~~ LHA For Paperwork Reduction Act Notrice see se paste instructions. 9 08070412 759605 53250 2005.09001 DERR, CHAD M. 9 11 S/L Form 4562 (2005) (Rev. 1.2006) 53250_1 Form 4562(2005)(Rev.1-2006) CHAD Ai. DERR__ 188-64-9320Page2 ~i~ Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and property used for entertainment, recreation, or amusement.) Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable. Section A -Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.) ,~ zaa uo ou nave evwence w suppon the ousmessnnvesunemuw ciauneu r i n ~ Tes u no zao n -Y es - is me eviae nce wrnten r u res u no (b1 la) leI (fl (9) (h) G) (a) Type of property Date Business/ (~ Cost or Basis for depredation Recovery Method/ Depreciation Elected (list vehicles first) placed in investment t other basis (business/investment uae °n~ l period Convention deduction section 179 servrce use percen age v cost 25 S ecial allowance for certain aircraft certain roe with a Ion roduction eriod, and ual~ed NYL or GO Zone P P PAY 9P P q property placed in service during flee tax year and used more than 50~° in a qualified business use .............................. 25 >::>::>::>::>:::<:>::»:z;<>:::>::::: 26 PrnnPrrV ucxi mnrP than 5094 in a nual~ad husin~s use' % STATEMENT 4 % 1 780. 27 28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 .................................... 28 1 7 80 .<:'. 29 Add amounts in column (), line 26. Enter here and on line 7, page 1 .................. ........ ........ ............................... 29 Section B -Information on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner,' or related person. If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an e>';ception to completing this section for those vehicles. 30 Total business(nvestment miles driven during the (a) Vehicle (b) Vehicle Icl Vehicle (d) Vehicle (ei Vehicle lfl Vehicle year (do not include commuting miles) .................. 31 Total commuting miles driven during the year ... 32 Total other personal (noncommuting) miles driven ............................................................... 33 Total miles driven during the year. Add lines 30 through 32 ..:................................. 34 Was the vehicle available for personal use Yes No Yes No Yes No Yes No Yes No Yes No during off-duty hours? .......... .......................... 35 Was the vehicle used primarily by a more than 5°~6 owner or related person? .................. 36 Is another vehicle available for personal use? Section C -Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5°r6 owners or related persons. 37 Do you maintain a written policy statement that prohibits alt personal use of vehicles, including commuting, by your Yes No employees? ............................. 38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? See the instructions for vehicles used by corporate officers, directors, or 1 % or more owners .................................... 39 Do you treat all use of vehicles by employees as personal use? ......................:. 40 Do you provide more than five vehicles to your employees, obtain information from your employees ab~wt the use of the vehicles, and retain the inforrnation received? ....................................................................................... .................. 41 Do you meet the requirements concerning qual~ed automobile demonstration use? ...................................................... Note: !f your answer to 37, 38, 39, 40, or 41 is "Yes, " do not complete Section B for the covered vehicles. :~!~ Amortization (a) Description of costs (b) Dab anaNzatlon 6epiia (c) Amortizable amount (~ Code I section T (e) AmOrtiza6on cerioda°acentaoa (fl Amortization for this year 42 Amortization of costs that begins during your 2005 tax Year: 43 Amortization of costs that began before your 2005 tax year ...................... 44 Total. Add amounts in column (t). See the instructions for where to report .................................................. 516252/01-05-06 10 08070412 759605 53250 2005.09001 DERR, CHAD M. 1.222. form 4562 (2005) (Rev.1-2006) 53250_1 CHAD M. DERR ' 188-64-9320 SCHEDULE C OTHER COSTS OF GOODS SOLD STATEMENT 1 DESCRIPTION COST OF CONTRACTED SERVICES COST OF EQUIPMENT RENTALS SMALL TOOLS AMOUNT 4,019. 637. TOTAL TO SCHEDULE C, LINE 39 4,656. 11 STATEMENT(S) 1 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1 CHAD YI. D'~RR ' 188-64-9320 SCHEDULE SE NON-FARM INCOME STATEMENT 2 DESCRIPTION LANDSCAPING TOTAL TO SCHEDULE SE, LINE 2 AMOUNT 91,153. 91,153. 12 STATEMENT{S) 2 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1 CHAD M. DERR ~ 188-64-9320. FORM 6251 DEPRECIATION ON ASSETS PLACED IN SERVICE AFTER 1986 STATEMENT 3 DESCRIPTION 1988 JEEP WAGONEER 1999 FORD HEAVY DUTY.TRUCK SNOW PLOW LANDSCAPE TRAILER EXMARK LASER MOWER EASY LOAD SALT AND CINDER SPREADER COMMERCIAL TRUCK MOUNTED LEAF COLLECTOR 1991 CHEVY TRUCK FINN BARK MULCH BLOWER 1997 FORD TRUCK COMPUTER TOTAL TO FORM 6251, LINE 17 AMOUNT 899. -869. -94. -44. -311. -82. -168. 93. 885. 187. 34. 530. 13 STATEMENT{S) 3 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1 CHAD ~i. DERR ~, ~ 188-64-9320 FORM 4562 PART V - LISTED PROPERTY INFORMATION, MORE THAN 50~ STATEMENT 4 (A) (B) (C) (D) (E) (F) (G) (H) (I) 179 DESCRIPTION DATE BUS ~ COST BASIS LIFE MTH/CV DEDUCTION ELECTED (J) (K) (L) (M) (N) (O) (P) (Q) AUTO TOTAL BUSINESS COMMUT ING P ERSONAL WAS VEH. > 5~ ANOTHER NO. MILES MILES MILES M ILES AVAIL.? OWNER? VEH. AVAIL.? Y N Y N Y N 1995 FORD 04/01/96 PICK-UP 100.00 16,500. 16,500. 5.00 200DB-HY 1 X X 1988 JEEP WAGONEER 100.00 8,900. 4,450. 5.00 200DB-HY 1,780. 2 X X TOTAL TO FORM 4562, PART V, LIN E 26 1,780. 14 STATEMENT(S) 4 08070412 759605 53250 2005.09001 DERR, CHAD M. 53250 1