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Home My WebLink About01-0880 ;tJ Estate of :TOl1rJ c~ WI(NYo also known as PETITION FOR PROBATE and GRANT OF LETTERS ~J- ~ /., "10 No. To: Register of Wills for the Deceased. County of Co f.l\.tJ.,.~~f) in the Social Security No. I GIS - 2-$ - 2.1 L, I Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executr.< in the last will of the above decedent, dated .oeCJepn t6 e,... and codicil(s) dated named , 19..&- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in CV(k.&Cfl.LA-tJ C> County, Pennsylvania, with h IS last family or principal residence at 3 HOCtt.,J[1l. C,ltc.~ 8P I L-tll'" .!ifI4~~j It( 17Db7 J (list street, number and muncipality) Decen ent, then foz.. years of age, died 'L/2l> , ~ WtSO, at ,c...L.lS~ ~ L Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ /~ ~~() $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters theron. (testamentary; administration c.La.; administration d.b.n.c.La.) --- '" 'tr 1-;;- IYJ a/''I-. j..,. W d n t: (? il ~'fi;:f~~J:;~/'>/I ~2/Jt)? 3~ IU '- 30 Cii s:: tlIl V) ~ae-r /: ~~II- OATH OF- PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA lss COUNTY OF J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well d truly administer th estate according to law. en c)Q. ::s ~ - ;: ~ ~ 1'7 ;1,;J.uJ, p./o/ ~...C;Q I, ~o. 21-01-880 Estate of JOHN C. WANYO , Deceased DECREE OF PROBATE A~D GRANT OF LETTERS AND NOW SEPTEMBER 14, ~ 200! in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated DECEMBER 1976 described therein be admitted to probate and filed of record as the last will of JOHN C. WANYO and Letters TESTAMENTARY are hereby granted to MARY L. WANYO 'ml-o{' t&U)'~ Ylh.(!ft~~ Regist[r of Wills FEES Probate, Letters, Etc. ......... $ 50. 00 Short Certificates(2 ) . . . ". . . . . .. $ 6. 00 Renunciation....... .1....... $~ EXTRA PAGE }Cp $ 5:~~ TOTAL _ $ 69.00 Filed .. ~~~.rr:~~~~ . ~ ! . ~.qq ~ . . . . . . . . . . . . . A TIORNEY (Sup. Ct. 1.D. No.) ADDRESS PHONE MAILED LETTERS AND ORDERS TO EXECUTRIX SEPTEMBER 14, 2001 05.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. 2L~.~~~~ Local Registrar Fee for this certificate, $2.00 p 6960334 DEe 2 0 2000 Date '1105. 143 R8.. 2187 COMMONWEALTH OF PENNSYLVANIA a DEPARTMENT OF HEALTH a VITAL RECORDS CERTIFICATE OF DEATH liNT ~, ..... Cumber land DECEDENT' USUAL OCCUPIlTIOH UNClER 1 YEAR MonIIlI Da~ W AN V 0 UNDER 1 0IIt HourI l MIftuI.. SEX 2. t\"~ L.[J J DO .ENT INK BIRTHPLACE (City and SIa.. Of FOfeogn Counlry) g::tIy)O 17.. Slata PA MAAITAL !TAI'US. Married N_M."iecl, ~. ~lSPecify) 14. Married 17c.13 'IIIa,_lIvwdirl lWI>. 1711. Cou Old -- _In' Cumberland lOWnI/llp7 17..0 ~~.='" MOTHER'S NAME (Fit.. MiddIa. Maiden Sutnama) 11. S hia R. Ball INFORMANT'S MAiliNG AOOAESS 1Slr.... CilyfTown. ~,lip CodII 2Gb. 3 Hoerner Circle, Beilin S rin s, PA 17007 ~ OF OISPOSITlOH. N.me '" C_l.ry. Crematory LOCATION. CilylTown, Slata,lip CoclI orOlner"'- North Middleton Twp. 21~t. Patricks Cemetery 21.. Carlisle, PA 17013 NAME AND ADORESSOF ~ Brothers Funeral Hane, Carlisle, PA LICENSE NUMBER DArE SIGNED (MontIl. Day. _, 23b. 0 ~) - 6 (:71 5 S L 23c. ' 2. I '2.. (..) J (;:, c.: WAS CASE REFERRED TO MED$.~XAMINERICORONER1 ~ NoD H. , Approxim.t. !~~ *' cilylbonl. 17013 .fR ~,,~ PAAT", OIher 19'illcanl_ CDnIrIIuItng 10 cIa.lII. Ilul not _Ing ln ilia IIIlCIarlying __ given in PART 1. DU a." . ( : WERE AUlOPSV FINDINGS -.u.BU: PRIOR 10 COMPlETION OF CAUSE OfF DERH7 DUE 10 (OR AS A CONSEOUENCE 0Fl: OUE 10 (OR AS A CONSEOUENCE 0Fl: MANNER 01' DEArH Nalulal ~ o o DArE 01' INJURY (Monlll. Day. -.r) TIME Of' INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. Homicide o o o PlACE 01' INJURY. At noma. ta""~;'" (a<:Iory, _ M. 1luiIdng. ..c. lSpecotyl 3Oe. Vat 0 No ii1 -... P'nding In.....g.lflon Coul<ll1Clllla daf.....inad Vat 0 NoD Sulc:ida .. 2110. CUl'TIl'IEIIlCtlack only one) 'CERTIFYING I'HYSICIAN (Ph_ Ce<1JIylng cause 01 de8lh "'*' anothlf physoc"", has P<onouncad death ana completed".... 23) To"'_olm,~. ...t11__IO....clIIIM(.'.ndm.n...r...I.tad..................................................... a. 'MEDICAL EXAMINER/CORONER On _ baata 01 ......in.tlon .nclIot In....llg.llon. In my opinion. de.th occurred ., the 11m., d.'e. .nd pl.ce, .nd due '0 'he C.U"(I} .nd man,..,... at.tH.................................................................................................. 3,.. REGISTR.4R'S SIGNArU.RE AND NUM ~. ~eu..&.~'bJ ~\,di,,()1 301. CERTIFIER }6,b. ~ LICE. ..N~,,\BER.-zJ .IE DATE SIGNE~ ,l.,""':""..Qav. ~l o m(J,Yl/ 0 ~J v.:t2. ~ 3111. ( ^ ~ t1D NAME AND AOOAESS OF PERSON WHO COMPlETED CAUSE OF DEArH (ltemlnTypeorPrint M t 0/1-#164: . o ~IA. 8a1~~e 32, DATE FILED (Montl't. Cay. _I ~..X~ 'I'IlONOUNClNG AND CERTIfYING PHYSICIAN \Ph_ bOth coonounclllQ Oeath and ce<1ifyong.o causa 01 death) To'" ..... of my kno...... d.ath occumtcS at the time, etate, .net place. Ind due to the eaus-<a) and man".,.. atated.. . . . . . . . . . . . . . . . . . . . . . . . . 34. ~ ~ ~ , - . J . A II II II LAST WILL AND TEST~ffiNT OF JOHN C. WANYO I, JOHN C. WANYO, of Boiling Springs, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding hereby make, publish and declare this as and for my LAST ~ILL AND TESTM18NT, hereby revoking all other wills and codicils, heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after the date of my death as conveniently may be done. SECOND I give, bequeath and devise my entire estate to my beloved wife Mary L. Wanyo, to have, to hold and to dispose of as she shall determine in her sole discretion, providing she is living on the thirtieth (30th) day after the date of my death. THIRD In the event that my beloved wife does not survive me by said period of thirty (30) days, I then give, bequeath and devise my entire estate unto Rita Wanyo and Mary Wanyo, to share and share alike. FOURTH In the event that my beloved wife, shall predecease me, I appointEdwardJ. Wanyoguardian of any property, including but not limited to all proceeds of insurance on my life, which passes to a minor to which I am authorized to appoint a guardian and have not otherwise specifically done so. I authorize the guardian to use such amounts of both income and principal as he, deems proper for the support, education and welfare of such minor with- out leave of any Court. .. or " J1' - '" , FIFTH I direct that no executor or other fiduciary named, nominated or appointed in this, my LAST WILL AND TESTM~NT, shall be required to post any bond or give any security of any type for any purpose whatsoe ver, any law or rule of court of the Common<- wealth of Pennsylvania or any other jurisdicition to the contrary notwithstanding. SIXTH Finally, I nominate, constitute and appoint my beloved wife Mary L. Wanyo and Edward J. Wanyo, Executors of this, my LAST WILL AND TEST~'~NT, IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my LAST WILL MJD TEST~~NT, consisting of two (2) pages type~ITitten, the first one (1) of which bears my signature in the margin for the purpose of identification, this day of December, 1976. If- c. J{; 1---r-: ( SEAL) Signed, Sealed, Published and declared by the above named Testator, JOHN C. \'JANYO, as and for his LAST WILL AND TESTAMENT, in the sight and presence of us, who at his request, in his sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ~~/ 4#~ ~j~A ~~JA/ 1'" ame iJ.(tf -1/#--'-'~//- ~ J A dre 55 I cf..:/ () I 21-01-880 REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS MARY L. WANYO ~ (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that SHE WAS present and saw JOHN C. WANYO the testat or , sign the same and that SHE signed as a witness at the request of testat~ in h is presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). J Sworn to or affirmed and subScribed before //( ~ ~ Zr/~cJ-- me4 c~ ~I 3 HOERNER CIRCL~,a~~ILING SPRINGS PA '-ffJ~ e. . _ _ . ~. ~," '1J~lZ (Address) Register . ~ (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS RITA M. CAWLEY testat or (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that SHE IS familiar with the signature of JOHN C. WANYO ~ will presented herewith and codicil believes the signature on the will is in the handwriting of of (one of the subscribing witnesses to) the that SHE JOHN C. WANYO to the best of :HER knowledge and belief. t2h.rrt~ (Name) 3 HOERNER CIRCLE, BOILING SPRINGS, PA (Address) Sworn to or affirme2tnd subscribed before AiS / ~ day of d'1-;~ fuJ.J ] )9~J ~1 e.~liXJJ pn.. e. a....f~ D, /"1 Register (Name) (Address) 21-01-880 RENUNCIATION In Re Estate of JOHN C WANYO deceased. To the Register of Wills of CUMBERLAND County, Pennsylvania. The undersigned BROTHER of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters TESTAMENTARY be issued to MARY L WANYO WITNESS , (' ~~J' f~ // hand this /2.- day of ~/L ,~ 2tXJ1. C) (vl~A'+Co ?A 1&23; (Address) (Signature) (Address) (Signature) (Address) Name of Decedent: Date of Death: Will No. lA - 01- eso To the Register: ~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) 3'oHrJ C. WA~YO IL!ZO/U66 Admin. No. z,C>o)-OO~80 I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 5efT~~~fl- ?,(;)~ 'Z-6o, Name ~~flJ1 ~. WflrJYO' ~~ ~. ()IPrrJYO 8.>~vMW 0: WltNYo :fl, /Ill C. W /t,ryo flprTJett' ~ ~ CI? WU, Address 3 jf6ctU./c/t [,,(<.LE. iJ6,L-/fJ Cr ~,.tJN'~~ ~ 17l>t>1 'fU> ~/rWU'll(,v61 tJlL I itfr. 3/)2 J t~l.€ Ibt, tlc~ Z7~()9 It ., 6l>i. fCf J eo tlE~ fltt:hp':''VJ Rt I 92/ ~ J' ~ 'tI ~ BLA 1I.j~ .it: I /If e Ifcle>l1, iJJ 1/2 S 7 8 rJ. fltl.o~ Pj... f B{);Vf;Jt-5f//lJII65, ~ 17f>67 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: (2/'JV-/ 'J,/)O I _. o If) co c::::r i'" ',~~, \.0 N c...J c::I ~.. ."v.... [....J l.,"~ .:) ~J) o (J.) cPa:: a: p 0icuy ./ "tt/~~ Signature ,-.,' ",.""l.... ~4't ..J.. Name MAf-Y L. ~1t"Y f) (:1 ...; Q) '", ..Q -=: s:: .:u= ..... - 00 Address .3 HtJbIlNE/L CIl.C--le 1$011_ ';j~ ~P-1""6~.. fI, I~ J Telephone (1r/) 2~~ - G'f'~Cf Capacity: -X- Personal Representative _Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WANYO MARY L 3 HOERNER CIRCLE BOILING SPRINGS, PA 17007 -------- fold ESTATE INFORMATION: SSN: 195-28-2167 FILE NUMBER: 21-2001- 0880 DECEDENT NAME: WANYO JOHN C DATE OF PAYMENT: 09/20/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/20/2000 NO. CD 000285 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,468.10 I I I I I I I I TOTAL AMOUNT PAID: $1,468.10 REMARKS: MARY L WANYO CHECK# 98 SEAL INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CAWLEY JOSEPH T 8 N PIN OAK DRIVE BOILING SPRINGS, PA 17007 -------- fold ESTATE INFORMATION: SSN: 195-28-2167 FILE NUMBER: 21-2001- 0880 DECEDENT NAME: WANYO JOHN C DA TE OF PAYMENT: 12/04/2001 POSTMARK DATE: 1 2/03/2001 COUNTY: CUMBERLAND DATE OF DEATH: 12/20/2000 NO. CD 000598 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $91.64 I I I I I I I I TOTAL AMOUNT PAID: $ 91 .64 REMARKS: JOSEPH T CAWLEY CHECK# 3105 SEAL INITIALS: PB RECEIVED BY: REGtS~R OF WiLLS MARY C. LEWIS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA /7-7 _ .:t DEPARTMENT OF REVENUE ~ INHERITANCE TAX STATEMENT OF ACCOUNT .7L REV-li01 EX AFP 112-00) RecorCiE~U Rer1;C1'nr 'ij".H'_" (:8 of ;Vilis JOSEPH T CAWLEY 8 N PIN OAK DR BOILING SPRINGS .02 JAN 11 P 3 :21 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-31-2001 WANYO 12-20-2000 21 01-0880 CUMBERLAND 101 JOHN C PAalaot~ C-lImb"'."'" "J' ~, t:lf'1~ l\.i ~~___:- () u r 1 Allount Rellitted PA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE"v=iitoj-ix-AFP--fi'2-:oo1------...--iNiiERITANCE--TAX--si'1ffEMENY-O,:-Aifcouiff--.-..--------------------- ESTATE OF WANYO JOHN C FILE NO.21 01-0880 ACN 101 DATE 12-31-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-03-2001 PR I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 1,557.77 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-20-2001 CDOO0285 .00 1,468.10 12-03-2001 CDOO0598 1.64- 91.64 TOTAL TAX CREDIT 1,558.10 BALANCE OF TAX DUE .33CR INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .33CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l \ /7- "/-\.3 BUREAU OF INDIVIDUAL TAXES INHERITANC. TAX DIVISION DEPT. Z80601 HAr~SBURGI PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, AllOWANCE OR DISAllOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ReconJ(d- (Yf ,U3 of Regi::tc Vv!lls DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN .01 OIG 17 P12 :02 JOSEPH T CAWLEY 8 N PIN OAK DR BOILING SPRINGS 12-03-2001 WANVO 12-20-2000 21 01-0880 CUMBERLAND 101 *' REY-1547 EX AFP n2-Do) JOHN C P AQir,6<o7;.- - ,...; tmbe"l"- ""' ,.J \.1\. .j - c~~ ! L~ AIIount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=is4j-iX--AFP--fi'2=orfi-NO';--ici--OF-'rtiliiiiifAirci-T-Ai-jrppfiAisiMENT~--Ar:rOWANCE-OR----------- -- - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WANVO JOHN C FILE NO. 21 01-0880 ACN 101 DATE 12-03-2001 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts 14. Net Value of Estate Subject to Tax (1) (2) (3) (4) (5) (6) (7) (9) (10) 1381400.00 .00 4.510.00 .00 9,700.00 26.311.00 142.818.00 (8) 9,519.00 42.662.00 (11) (12) (13) (14) (Schedule J) If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. AIIount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: 244,187.00 X 00 = 21,019.00 X 045= 1,363.00 X 12 = 2,989.00 X 15 = (19)= NOTE: To insure proper credit to your account, submit the upper portion of this forll with your tax paYllent. 321,739.00 1;2.181 00 269,558.00 .00 269,558.00 .00 945.86 163.56 448.35 1,557.77 TAX CREDITS: PAYHENT RECEIPT DISCOUNT l + ) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 09-20-2001 CDOO0285 .00 1,468.10 INTEREST IS CHARGED THROUGH 12-18-2001 TOTAL TAX CREDIT 1,468.10 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 89.67 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1.97 TOTAL DUE 91.64 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (6-88) I" COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME '. INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER WANYO, JOHN REVIEWED BY ACN 2101-0880 101 LARRY SZOLLOSY ITEM SCHEDULE NO. F-J EXPLANATION OF CHANGES Taxable at 150t'o. The tax rate change for siblings is effective for dates of death after 07-01- 2000. ROW Page 1 .. G/~ r STATUS REPORT UNDER RULE 6.12 Will No. ~oOI JOffN C~ iJ /HJ YO 17",/ 'L(> / 'UX>O 00980 Admin. No. Name of Decedent: Date of Death: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No . b. The separate Orphans' Court ~o. (if any) the personal representative's account is: tv/~ c. Did the personal representative state an account informally to the parties in interest? Yes No for ri/f} d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. s~'::;Y~ ~~~ /!:e'(Pl~~e *:/tr print) 3 I16€~JJE'/l.. GIILCA.6 /1,/;,) L /N{,.. q;tL1/Vd ~ {14 /?t>O 7 Address ' Date: / ~ /1 t; h..:z , . / ( 717 ) 'Z~6 - ft,~q Tel. No. Capacity: ~personal Representative Counsel for personal representative (MAH:rmf/AM3) ..' December 19, 2002 Ms. Mary C. Lewis Cumberland County - Register of Wills Hanover and High Street Carlisle, PA 17013 RE: Estate of John C. Wanyo File Number: 2001-00880 Dear Ms. Lewis: Mary L. Wanyo, as sole surviving spouse, was the beneficiary .of all of the property owned by the above referenced Estate and all of the property has been transferred to the beneficiary. Sincerely, ~~ cY' V~cr- Mary L. Wanyo Personal Representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 11/05/2002 WANYO MARY L 3 HOERNER CIRCLE BOILING SPRINGS, PA 17007 RE: Estate of WANYO JOHN C File Number: 2001-00880 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 12/20/2002 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~911.fY;tU-,td I}rl MARY C. LEWIS ~~~ REGISTER OF WILLS ~ CC :I/File Counsel Judge " " r f COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~ L - .Q..L Jl.Q..8.. >>- (L COtJlITY COIlE YEAR "-NBER OFFICIAL USE ONLY DECEDENT'S NNJE (lAST, FRST, AND MOOI..E NTW..) SOCw. SECURITY NlJM3ER I- iJA~YO ~ - C. /95"., ZB - :J-/ b 7 z J/)HAJ W DATE OF DEATH (MM-DD- YEAR) DATE OF BRTH (MM-DD- YEAR) THIS RETURN MUST BE FIlED IN DUPUCATE WITH THE C W Il - bD - 'bODO 03-d.-1-/938 REGISTER OF WILLS 0 W (IF APPLICABlE) SURVIVlNG SPOUSE'S NNJE (lAST, FRST, AND MIDDLE INITW.) SOCIAl. SECURITY NUMBER C WAN yo ~ItI<Y !-. lel- 36 -zasq w ~ 1. Original Rehm 0 2. SuppIemenlaI ReUn 0 3. Remainder Rehm (dale of dealh prior to 12-13-82) ..., ~:!!;(I) o 4. I.iniled Estae 0 4a FlUe Weresl Cal1pranise (dale of dlllhallerI2-12-82} 0 5. Federal Estae Tax ReUn Required uO::~ wo.u 181 6. IJec:eckn Died Testae (AtIach copy of Will 0 :x;oo 7. Decedert Manained a L.iving Trust (AItach copy of TlII5t) --1L 8. T~ NlrOOer cl Safe Deposit Boxes uO::-' o.m ~ o 9. l.itigaial Proceeds Received 010. Spoosa PovertyCredn (daleofdlllh""" 12-31-9101-1-95) o 11. EIedioo 10 tax IRIer Sec. 9113(A) (AItach Sell 0) I- THIS SECTION MUST aE COMPI..EI'ED. ALLC()f$ESP()NDENCE 4NI>CONfII)EJiI1'IAL'ta'I\IFORMA'1'Jc:::HtI SHOULD BE DIRECTED TO: z NNJE f(!t(L'f t. COfoRETE MALN3 ADDRESS w lJlTN YO 0 z 3 IhC~jJ-OZ etlte ~ l( FRM NNJE (I AAicabIe) (I) w ~DI t.../1J6 ~/jJ~S R4 /7d() 7 a: a: TB.EPHONE NUMIlER 0 7/7 - ZS8 - 6V~ ~ u 1. Real Estae (Schedule A) (1) 138 \U)D OFFICIAL USE ONLY ~ 2. Stocks lI1d Bonds (SdIedUe B) (2) NC~~ 3. Closely Held Caporaion, Partnership a SoI&-Proprietasp (3) tf.~JO 4. MlItgages & Nctes ReteivabIe (Schedule D) (4) "'0 tJ E 5. Cash, EIcr1k Deposits & MisceIIa1eous Personal Property (5) '1,1 DO z (Schedule E) 0 ~(p 311 6. JoinlJy <Mned Property (Schedule F) (6) L, ~ o Sepalie BiIfD19 Requested ..J 7. '---VIVOS Transfers & MisceIIaneaJs Noo-flrobae Property (7) I~L. B'~ ;:) (Schedule GaL) , l- ii: 8. Total Gross Assets (td.aI Lines 1 - 7) (8) 32,;l, ., 31 c( II s, q 0 9. FmeraI Expenses & AdrrWislraive Costs (Sc:hedule H) (9) W 0:: 10. Debts cl Decedent, ftbtgage Liabilities, & Liens (Schedule Q (10) c.t~ ~U ../ 11. Total Deductions (tdall.iles 9& 10) (11) ~2) 181 12. Net Value of Estate (Line 8 minus Line 11) (12) 2'9 ~~B ~ 13. ChartabIe and GcMmnen1a18equeslsISec 9113 Trusts ftr which an eIeclim 10 tax has nd been (13) NoN.~ made (Schedule J) 14. Net Value Subject to Tax (Line 12 miIIJs Line 13) (14) u,,9.. S-sB SEE INSTRUC110NS FOR APPlICABLE RATES Z 15. Annrt a Line 14 taxable atlhe spoosaI tax 0 rate. a 1r.I1Sfers under See. 9116 (a)(1.2) ;;ltllf, 197 X .oll- (15) NoNb ~ ,../ O,q x.o~ qw;: B' ~ 16. Amolr1I cl Line 14 taxable at lineal rate (16) ::) tf. '3 5' .;2- {J.-'J.,2'f Q. 17. Annrt cl Line 14 taxable at sibling rate X .12 (17) :E 0 18. Amolr1I cl Line 14 taxable at collateral rate NbNE. X .15 (18) Nor.l€ 0 ~ 19. Tax Due (19) ( t.ffr$. 10 20. 0 I CHECK HERE IF YOU ARE'RECllJES1ltlGARE~~9YERPAY~1 __ B~'C!".."'P."''''''.''.~.__ ........_...____...:1-__..__.____ __._ ......_ __-_....__........_.___ I, If ~ , Decedent's Complete Address: STREET ADDRESS 3 ~ K.,.J t"" (l.. CIIl liE CIlY /30,1- IN&- SPIlIN&-5. I STATE /f4 I ZIP /7(X)7 .. Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) I, lfb8. ID Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the di1ference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) I. ~B. /0 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT l Wos ,/0 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No ~ OCJ IX! ~ I&J [Xl contains a beneficicry designation? .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. 1KI D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties cI perjury, I declare that I have examined this rellm, including accompan)'ing schedules and staIements, and to the best cI my knowledge and belief, n is true, carect and complete. Declaration cI prepaer oIher Iha1Ihe personal representative is based on all information cI which preparer has any knowledge. SIGNATURE OF RSON RESPO IBLE fOR FILING R~!URN . . ~ /# I'" ~ eI 1/-1 ADDRESS 3 #o,;f(tJE';t CI4CLc. &,I../;I€,- -!jffU;J6-S, ~ 1?/)tJ7 SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before Janucry 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent ofthe child is 0% [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use ofthe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. STFPA42021F.2 '1, tl l , REV-1502 EX + (1-97) (I) COMMONV't'EAlJH OF PENNSYl.lllNIA INHERITANCE TAX RETURN RESIDEHT DECEDEHT SCHEDULE A REAL ESTATE ESTATE OF __ FILE NUMBER JOIN\} C. tJlt"'yo ~ - 0 I - Ot>8BtJ All real property owned solely or as a tenant in common must be reported at fair marUt value. Far IT1lIket vakJe is defined as 1he price at which pIqlErty wooId be exchanged between a willing buyer and a willing seBer, neither being c:anpel1ed to buy or sell, bdh having reasooabIe Ia10Medge cl1he reIevlr1I fads. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH tt=S Jf)t;/J"""L L6A\, CSf1J'f6 ~ tHO/-I-It:1t.- C/tlCl..$ e'lL-i Ne-- SfA..lrJ6S If" 1'1067 /3~ Ci t>O (~1iIkIdt:() fA1f2- ~r VA'UJe' USING- Cwrff'l kA~St:~ev I t#QfCo :Jilt, I; UO(), SlFPA42021F.3 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 138Y()O , >, ., REV-1504 el + (1-97)(1) , COMIION\"EAl.TH OF PENNSYUMlA INHERITANCE TAX RETURN RESIlENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP or SOLE-PROPRIETORSHIP ESTATE OF .-:- Jb it'1oj C. (;JftrJY 0 FILE NUMBER UJ- 01., 00880 Schedule C-l or C-2 (Including all supporting information) must be attached for each c1ose1y-he1d corporationIpa1nership interest of the decedent, other tha1 a sole-proprietorship. See insbuctions fllr the suppa1i1g iriormaIion to be submitted fllr soIe-prcpI ietOI ships. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. lfo S IhtttKS "f' Cvt\l ,.,., ~ S <17/ck.- :c VJA-t'JYb 8ft,67~ J ,NG. V,q-We-O Irr 1J1..7b p<rt SlffJILE filll'l MAU-g'D tI~ f)efr;UI1IN~g U~, N b- 6-04>):. VA LfX Jf T 2/416 / CO ~rld!crs U2v\r'1 ~ C:..-p ITA\.. jr)<J:- /OD (lp.J() ,.J (flPl1lJ(... 23.. 'Z--~3 fEr~(I'N~!) Gr,tiJ,,)b"S (I; 0(7) f( -z., 1 it> I J~6'lE: OtASr/rNO,rJl,-- ~ I G-O if c;/ 0 ) - it.,.. sW1Ifl.i I/1J wE" ilL, 1 b -- - =.---' STFPA42021F.5 TOTAL (Also enter on line 3, Recapitulalion) $ (If more space is needed, insert addnional sheets of the same size) Lf;/o . " . ., REV-l505 EX + (1-97) (I) ~T1lOFPENNSYIlNM INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-1 CLOSELY -HELD CORPORATE STOCK INFORMATION REPORT ESTATE OF Jb~ C. LNltrJ YO FILE NUMBER Zo - 01- 00880 Product/Service III 6~'" W-19?(P S- Business Reporting Year :?-./ {)8 LVPrl6e/l '1- IhM~ flU>PVC/f5. State of Incorporation Date of Incorporation Total Number of Shareholders 1. Name of Corporation Wttt-JYo i!:>rt.-oTW-tft5. . trier. Address b Dq G\ l>lAIf/ eST. . City fIG trDl>O State fII 2. Federal Employer 1.0. Number t 5 - 'bOOD If '3 3 3. Type of Business (<'Erlll L- SA-LC.s. Zip Code I I'll 7 4. TYPE TOTAl NUMBER OF NUMBER OF SHARES VAlUE OF THE STOCK Voting J Non-\Icmg SHARES OUTSTANDING PAR VAlUE OWNED BY THE DECEDENT DECEDENT'S STOCK Common VO ,H\lC, 100 I '10 $ If. SIb Preferred $ Provide all rights and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? If yes, Position 6. Was the Corporation indebted to the decedent? 0 Yes If yes, provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? 0 Yes 181 No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8. Did the decedent sell or transfer stock ofthis company within one year prior to death or within two years if the date of death was prior to 12-31-82? OYes ~No If yes, OTransfer o Sale Number of Shares OYes ~No Annual Salary $ Time Devoted to Business l&1No Transferee or Purchaser AlIach a sepaaIe sheet fa additiooallr.l1sfers andla sales. Consideration $ Date 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? If yes, provide a copy of the agreement. 10. Was the decedent's stock sold? 0 Yes ~ No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? 0 Yes 5{] No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? 0 Yes 00 No OYes ~No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. " " ' " THE FOLLOWING INFORMATION MUST'BESUBllnTEOWtTH ltJJSSCtIEDUlE A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) br the 'feat of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete addressIes and estimated fair market vaIueIs. If real estate appraisals have been secured, attach copies. D. list of principal stockholders at the date of death, number of shares held and their reJaIionship to the decedent. E. list of 01licers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. list those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. STF PA42021F.6 -, , "! REV-l508 EX + (1-97) (I) COMM<lH'I1EAI.TH OF PENNSYl\I\NIA INHERITANCE TAX RETURN RESIDENT OECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF JbJf~ C. Wr1-rJy() FILE NUMBER 1AJ- 0 1- OOE80 Include the proceeds of litigation and the dale the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VAlUE AT DATE NUMBER DESCRIPTION OF DEATH 1. /99'1 tlrlCAt..w 'TUWN fA,f'(.. VA(.,VC~ A-J t:f7I,ov",r or- fMLa;I){ /1t.6lI- SAtg OF I/v1?J OfJ (/)~(ux>' J, ~tJO J. 1'91 M6L6 7'#U)!J /!.pvl'C 6 s -r , nrfl"ii;..{) fit I/l. tIf ,Q,t.J:..;t:'/I l/A l..V C VS;~6- N/ff)!J Bvtl>cs. .JJ tJO () 3. If'" flofJ1"Pc- MIINP ffz-, J(. If ~~ Sr:p" TV 6>f)r'I""-e;!;> fRill ~~n.Lt?y VAW~ V.5/AJ6- NtrPII (;vi ptJ..s 3 ~tJ() . 'I, fac..s-o'}J/K-; cr~6vrS. (,51i,w4ns-~ fllllL "'1C~J:;.t:T VAV~ PIWV'0611 /J'1 fefl $blJ Jh.. tcf'a~N( Jff)ll~ ;;, bO C> SlF PA42021 F.9 TOTAL (Also enter on line 5, Recapitulation) $ ~ ? /) 0 (If more space is needed, insert additional sheets of the same size) " , ~ Kl::V-1:>091:X + (1-9/) (I) ~THOFPENNSYl\M1A INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF :J6 JHJ C. (.J IttJ Y /) FILE NUMBER h-Ol- DoesO If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVMNG JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. MAtL'( L. W f\"N 'I 0 3. ~(L CiJtcu.: J 1]6)l./Nf?.spt.,f'I6S.B. 17~b7 Sfol)~e- B. MAtt e:. W/l1'Jyi> '1M> '5IiEUY RIV~1l. lht.. A-PT: j,~ #lLe6ll~ tic. 21to9 iHfV6I1r~/L c. /::fJvJIJ-/l..O J: W" "Y i) IlL I 13~ )q I, /.55,f-/1tfL tHelfpf)VtJ~ f!. 13 Z./ ~ I t5M1kf5R. JOINTLY-OWNED PROPERTY: lETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Illlilde name of IinanciaI inslilUion and bar*: accollt IUIiler or sinilar ~ 1UIiler. DATE OF DEATH DECD'S WUE OF NUMBER TENANT JOINT Allach deed for~ real estate. WUE OF ASSET INTEREST IlECEDENT'S INTEREST 1. A. ~ljaL5 /jr r. C. u. if vo 50 ~/() WII'I6S lIuo,)NV '~6[{-oo ).. A. ~~6It.. S /'Sf" r. G. U. J1J 50 13' f,.JvBrltEN? ~"6s /fa,I)uMJ (,f,)U -tX' ~. A. M~6QL$ /':if" f: C. v. 3S- (O /8 f~,.J6- ~ UbB -I) 4- ~.. f 4- "" flU) ST ).4tp SD /'1 ~ C/;/6Ct.!1JG ~.v(( 33-0"70~ ~ A. FtIt '4. T/W~r 1~'? 50 Lf2 <c, INU69/l>Ic... Stlv)"'6~ da,"vrIT 08 -ooo{,$ ~ ~ NeDit ~6E z( 37 } 7 dTlI '--' TOTAL (Also enter on line 6, Recapitulation) $ U~ 3 I I STF PA42021 F.10 (If more space is needed, insert additional sheets of the same size) '. I " , ru:v- '.;;IU::f' I:A .. ,.~, I \., COIIIIOIllNEAll (J' I'EIIISYUNM MtERfINI:E TIll RETURN RESIlBCT OB:EDEIIT SCHEDULE F JOINTLY-OWNEI) PROPERTY ESTATE OF Fl.E NUMBER :J.-o - 01- 008S0 :J6 tttJ C. <.JrttJ Y f) If an asset was made joint within one year of the decedent's date of death. It must be reported on Schedule G. SUR\IMIlG JOIiTTBWIT{S) MIlE ADDRESS REUIJIOIISIIPTO DECEIlENT A.. JO IJ-N G. r,v~ Y I'> fo'/ e. l>l1t,N6' sr; I I/clJ..f)fJO / fir (1'2-.17 rJc-PIti tf"w B. " ~141fa,J.x ~L,~'1 f }J. Ifw f)1fL /Jrt-.. J &'t..-/1JG- Jfjl.llVr;-~ ~ /7 dO 7 GMNP5t>,.I .. c. JOINTLY -OWNED PROPERlY: lf11ER !WE IESCRP1DI (F PROPERlY "Of !WE OfIS1ll ITEIl R1RJOlNT IMDE 1ncUJe.. .,iIIIIII:lIIinlllliaalllll.............ar....~..... om OFIlEAlIl DEWS w.uE OF tUIIIER TBWfT JOIIT AIIIclIdIed~-"" WJIE (J' ASSET IREREST DECEIlBIT'S IIITEREST 1. AI q..""fcf ~Qa8/:ill> I ~ F.~. (). 'f, B Y<' s""o 2.4-21...- t.8L41 ~,Qffli (Jf ~fT 4-Ostlf'- <<k> g, Ar 1/af I f'Ji'I #f1IVJt7t~ /:s r f: (... (). I, I~ 3 SO ~'1 ~""') "'" 50 1J<<..WtW' 'to 36cJ ~ DO q. gf 'tt~,qfq ~~~ ,sr F:c..U. lfZr )0 ifl;)" /i1JvIJl6$ !lUJl> II"; rr li5!81- t>O 10, C (LIt1/~ ~6lh. s IS< (. G. t> . Z,11-C" (D I/~ '3 C~1s- IIa,Ol1IJNf 35''1 gr-II II. g tlz./fI'tg p.dt6t;1ti> ISr {.: c. U, tI/ 6/ 'f 5'6 'U>~ fJ 07 c. . ~V)Vb~ 1IU/()I.JlJ'J" 1'L1ft!-o~ I()/IJL 7!11.s f,,6'C 1-~ 371 TOTAl.. (Also enter on ine 6, RecaIlibpmq) $ 111__ --..-.......-LvI ......... ~ ~ Jfhe.Iif"1I'ftA~\ " 1 11 t<t::V-ll>lU I::A + (HII) (I) COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER JbIJ-rJ c... tJ A1-I Y t> J-e; - (} I - 0098 (J This schedule IllJSl be ampleled a1d filed if the lIlSWe( to My ci queslioos 1 through 4 on the reverse side ci the REV-1500 COVER SHEET is yes. DESCRPTlON OF PROPERTY %OF ITEM IIDIDE TIt: IWIE OF TIt: 1RNISFEREE, 1lI3R RElA110NSHP TO DECEOENI' MIl TIt: DATE DATE OF DEATH DECO'S EXClUSION TAXABlE VALUE NUMBER OF TRANSFER. ATTACH A COPY OF TIt: DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF APPUCAIll.E) 1. 1 J,JOu (p lJ I.J1- /-I:: ~m FAif ll-vuv Nq"" sru,.." /tJvI5Srll1CiJ {5.. I#l~ 011; 100 IYz~ fJ/B ~1'Of ~ W It'rJ VOl 1IuJtJ.l ~EJC..~ SfoQ'S~ 0 r {JtsGC I)&.Jr fAIt- P1A~T tI~ /3A~o ()tJ ~Ic€fl.. S-rAfenENT JtI tl!3J/UJ60. TOTAL (Also enter on line 7, Recapitulation) $ 1~213' 8 J (If more space is needed, insert additional sheets of the same size) SlFPM2021F.ll I, , \ Kr.V-'''" t:JI. + \"'''') \1) ~TH OFPENNSYlWIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER 8-0- 01- 00880 Jb J.JtJ C. (}J It N '1 () Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 6' "^)) tJ t;. 8 tlAJ1'"..,:Jc...> ~v 101 t;:JUI (" Ih'mc ?-+zc' 9. 'ISO , CAtz-L, sU! jf.k:,.,., fl-/,.v S <9tV I (..~ . 11'1(, :;;., () 2$"'" B. ADMINISTRATIVE COSTS: 1. Personal RepresenIaIive's Canrnissions Nane ci Personal Replese llalive(s) Social Secuity Number(s) I EIN Number ci Personal Represenlalive(s) Street Address Cily State Zip Year(s) Canmissia1 Paid: 2. I>Jlaref Fees 3. FaniIy EllernptiM: (If decedent's address is rD the sane as claima1I's, atach expla1aIial) CIlimln Street Address Cily stale Zip ReIaIionship ci CIaima1t to Decedent 4. Probae Fees fll 5. Acau1la1l's Fees 6. Tax ReIIJn Prepa"er's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ q ~Jq I (If more space IS needed, insert additional sheets of the same size) SlFPA42021F.12 . '. Kt:Y"lO'IL I:::A.... ("1'"tlI( J \IJ COMMONWEAlTH OF PENNSYUIOOA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ~ff-N ~ (jJrttJ yo FILE NUMBER J-()- 01-00860 Include unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION M#1 E e'tJPl r1 l--'N6 Or Uu;:'~n"- /'rl~~s' (S.'-- r-G. (). AMOUNT W s33 . 2-. UrJ f-f}f18lJtLJ;co ~tfOIUlL cl(/J~.u5cS. I~~ SlFPA42021F.13 TOTAL (Also enteron ~ne 10, Recapitulation) $ WJ c,t, Z. (If more space is needed, insert additional sheets of the same size) " KI:V-l:>l;;J t:A + (lHlU) COMMONVoQLTH OF PENNSYUMIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF JbJJrJ G, vJlt-rJ V 0 FILE NUMBER w- 01- oofJ86 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. MA(l..!f t-. W~VO $pO,) 5e:- :;"IftI, I FJ 7 3 ~/l.-N6'tL Of'-( U 8~ IL.-.I>> &,- 5p""4~!;',, t:. 1101J 7 2. ~(L'1~. (.J1tN'(O fAttV6I(TE/l... 2J>, 56; ljU> SWE"u..'1I..IVlt~ Dtl. I Ilf''( 302- A.At. E,(;;.~ . NC... 1,1<00'1 3. EOW/llfll) J: (;JltrJYo eJLt)(~({. I 3<'3 I llJl. , I 61>~ I~' ~tL "" €"ltOf>lo}.5 I R, 182-16> 1./;, Jb~N ~ ())A'N'jO Ai EPM.c"'> :I., 9 fP CJ '" t. 1!J..k, /II~ $( /J.;(J AJ()71 , flt (81-3 1 ~ MA.1fH~fN :r~ Ct1-w[,c~ Gt.IH(D SU,J JIJ. 8 tJ, /?, w Ottt {)It.. 6011..,"'(,..- SfiLt ribS J fA 11 Db I 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 1. B. CHARITABLE AND GOVERNMENTAl DISTRIBUTIONS 1. TOTAl OF PART II - ENTER TOTAl NON- TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) STFPA42021F.14 Estate of John C. Wanyo File Number: 20-01 00880 Document List 1. Last Will and Testament of John C. Wanyo 2. Residential Real Estate Assessment 3. Information Requested on Schedule C-l 4. Copy of Federal Corporate Income Tax Returns For the years ending 2/28/1996 to 2/28/2000 5. IRA Investment Report '.j ~ LAST WILL AND TESTAMENT OF JOHN C. WANYO I, JOHN C. ~ANYO, of Boiling Springs, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding hereby make, publish and declare this as and for my LAST WILL AND TESTM~NT, hereby revoking all other wills and codicils, heretofore made by me. FIRST I direct the payment of my debts and expenses of my last illness and funeral from my estate as seon after the date of my death as conveniently may be done. SECOND I give, bequeath and devise my entire estate to my beloved wife Mary L. Wanyo, to have, to hold and to dispose of as she shall determine in her sole discretion, providing she is living on the thirtieth (30th) day after the date of my death. THIRD In the event that my beloved wife does not sur vi ve me by said period of thirty (30) days, I then give, bequeath and devise my entire estate unto Rita \'lanyo and Mary 'Vlanyo, to share and share alike. FOURTH In the event that my beloved wife, shall predecease me, II Ii I appointEdward J. Wanyoguardian of any property, including but l' 1: not limited to all proceeds of insurance on my life, which passes to a minor to which I am authorized to appoint a guardian and have not otherwise specifically done so. I authorize the guardian to use such amounts of both income and principal as he, deems proper for the support, education and welfare of such minor with- out leave of any Court. FIFTH I direct that no executor or other fiduciary named, nominated or appointed in this, my LAST WILL AND TESTAMENT, shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of court of the Common- wealth of Pennsylvania or any other jurisdicition to the contrary notwithstanding. SIXTH I Finally, I nominate, constitute and appoint.my beloved wife Mary L. Wanyo and Edward J. Wanyo, Executors of this, my LAST WILL AND TESTAMENT, IN \'lITNESS \'lHEREOF, I have hereunto set my hand and seal to this, my LAST WILL MiD TEST~mNT, consisting of two (2) pages typewritten, the first one (1) of which bears my signature in the margin for the purpose of identification, this day of December, 1976. fJ--. c. ~.l--y--- !SEAL) Signed, Sealed, Published and declared by the above named Testator, JOHN C. WANYO; as and for his LAST WILL AND TEST~mNT, in the sight and presence of us, who at his request, in his sight and presence and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ~d4Yc/ $/~ ~ Ad , ~J:(A ~~~ ame 7J(tf ~~~~~/// ~J A dress /tf'..)o / MAILING DATE: July 1. 2000 District: 40 - SOUTH MIDDLETON TWP School..: .SOUTH MIDDLETON SD Location: 3 HOERNER CIRCLE SUNNI-GLO GARDENS LOT 68 BLIt B PB 12 PG 1 TAXABLE UNIT/LOT ID..: L-0068 Land Size....: .54 acres Property Type: R Residential With Buildings Control No,: 40004746 _. -~...... ..-........... THIS IS NOT A TAX BILL Parcel Identifier: 40-29-2482-053. 2000 Assessed Value Old As...essed Value Market Value (2000 Market x 100,..) (1974 Market x 25%) land 30,000 30,000 1,460 Buildings 108,480 108,480 8,670 TOTAL 138,480 138,480 10,130 2000 Clean and Green Values Land NOT NOT NOT Buildings APPLICABLE APPLICABLE APPLICABLE TOTAL Clean and Green values apply to some farm and forest land. Such values become effective only upon application and approval. All applications must be received by the Assessment Office by 4:30 p.m. on October 15, 2000. Those previously approved for Clean and Green do not need to re-apply. CUPAESGV L Estate of John C. Wanyo File Number: 20-01 00880 Information Requested on Schedule C-1 A. See Calculations in the Description of Schedule C B. Copies of 5 years of corporate income tax returns attached C. Corporation owns 3 parcels of real estate: 1 parcel consists of a retail building with 2 storage units on the property Approximately 1.25 acres located at 609 E. Blaine St., McAdoo, P A Estimated fair market value is $90,000 2 parcels consist of undeveloped real estate on opposite sides ofthe retail property Approximately .75 acres ofland combined Estimated fair market value is $40,000 D. Principal shareholders: John C. Wanyo Charles Wanyo Edward Wanyo 40 shares 30 shares 10 shares Decedent Brother of Decedent Brother of Decedent E. Officers: Edward J. Wanyo, President Charles Wanyo, Vice President John C. Wanyo, Treasurer Mary L. Wanyo, Secretary $6,000 annual salary not employed by company not employed by company $2,000 annual salary F. No dividends paid by corporation and no dividends declared and unpaid 1120 u.s. Corporation Income Tax Return OMB No. 1545-0123 Form For calendar year 1999 or tax year beginning 3/1 ,1999, ending 2/28 2000 1999 Department of the Treasury , Internal Rewnue SeMce ~ Instructions are separate. See page 1 for Paperwork Redudion Act Notice. A Check if a: Use Name B Employer ldentiflcatlon number 1 Consolidated return 0 IRS WANYO BROTHERS, INC. 23-2000933 (attach Fonn 851) 2 Personal holding co. label. Number, street, and room or suite 110. (If a P.O. box, see page 5 of instructions.) C Dale incorporated (attach Sch. PH) 0 Other- 609 E. BLAINE STREET 5-20-1976 3 Personal 5elVice COfll. wise, (as defined in 1emporary print or City or town, stale, and ZIP code 0 lOlal assets (see page 6 of instructions) Regs. sec. 1.441-4T 0 type. MCADOO PA 18237 - see instructions) E Check applicable bolces: (1) 0 Initial return (2) 0 Final return (3) 0 Change of address $ 368,392 1a Gross teceipIs or sales I 521,437 I b Less relIm; 81d aIbr.n:es I 189IcBal..... ~ 1c 521. 248 2 Cost of goods sold (Schedule A. line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 391.054 3 Gross profit. Subtract line 2 from line 1c ..................................... ...... ...... ..... ................ ......... 3 130.194 4 Dividends (Schedule C, line 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 863 Gl 5 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.959 E 0 6 Gross rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 u .5 7 Gross royalties ..... ................. ............... ..... ........................... ....... .......... ..... ........ ....... 7 8 Capital gain net income (attach Schedule D (Fam 1120)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 9 Net gain or (loss) from Fam 4797, Part 1I,line 18 (attach Fam 4797) ..... ..... ........ .................... ........... ... 9 10 Other income (see page 7 of instructions - attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 11 Total inCOtne. Add lines 3 through 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 11 134,016 12 Canpensation d officers (Schedule e, line 4) .................................................. .......... .... ............ 12 6,000 ..; 13 Salaries and wages (less employment aedits) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 31. 199 c 14 Repairs and mainlenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4.655 0 :::> u 15 Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 3.396 ::s "i 16 Rents 16 ... ..... ......... ................................. ......................... ..... ......................... .... ........ ........ ............ c Taxes and licenses. . . . . . . . . . . . .. . . . . . . . . .. . .. . . . . . .. .... " . . . . . . . . . .S.TATEMENT . ~. . . . . . 7 748 0 17 17 ... c 18 Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 29 876 0 :::> .:! 19 Charitable cootributions (see page 9 of instructions for 10% limitation) . . . . . . . . . . . r . . '"!"' . . . . . . . . . . . . . . . 19 ~ 20 Depreciation (attach Form 4562) ....................................... 20 5, 518 .. .2 21 Less depreciation claimed on Schedule A and elsewhere on return . . . . . . . . . . . . . 218 I 21b 5.518 ... c 0 22 Depletion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 'fi oS 23 Advertising ........................ ........ ... ............ ..................... .... .......... ............. ..... ......... 23 8.480 ... .5 24 Pension, profit-sharing, etc., pJans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 CD e 25 Employee benefit programs ........ ................ ............................................ ....... ....... ........ ...... 25 I 26 Other deductions (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STATEMENT. .1. . . . . 26 ~h 810 ~ 27 Total deductions. Add lines 12 through 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 27 1 ~~ h~? ~ 28 Taxable incane before net operating loss deduction and special deducIions. Subtract line 27 from line 11 . . . . . . . 28 334 ! 29 Less: 8 Net operating loss (NOL) deduction (see page 11 of instructions) .. .. - i 29a I 334 b Special deductions (Schedule C, line 20) . . . . . . . . . . . . . . . . . . . . . . . 29b1 29c 334 30 Taxable inCOtne. Subtract line 29c from line 28 ........................................................ ............... ....... 30 NONE 31 Total tax (Schedule J, line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 NONE 32 Payments: 8 19911lM!1'J1l1Y11ll1 aediled to 1999 . ;1 J';~;i,... s b 1999 estimated tax payments . . . . . . . . . . . ;c c: c Less 1999 refund applied for on Fam 4466 Gl E e Tax deposited with Fam 7004 32e .ccc.c.c....c.c. >- ......................... ....... ............. ........ ......... CII a.. f Credit for tax paid on undistnbuted capital gains (attach Fam 2439) . . . . . . . . . . . . 32f ~ Credit for Federal tax on fuels (attach Fam 4136). See instructions 32a c: g ............ . 32h CII a 33 Estimated tax penalty (see page 12 of instructions). Check if Form 2220 is attached ......... ......... ... ~D 33 34 Tax due. If line 32h is smaller than the lotaI of lines 31 and 33, enter MlOUnt CMIed .... ..... ......... ..... ..o.o 34 NONE 35 Overpayment If line 32h is larger than the total of lines 31 and 33, enter amount 0Yerpaid . . . . . . . . . . . . . . . . . . 35 NONE 36 Enter amount of line 35 )OJ want Credited to 2000 estimated tax ~ Refunded ~ 36 NONE Under penalties of peljury, I declare that I haw examined this re1um, including accompanying schedules and statements, and to the best of myknowtedge and beliet, it is true. correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Sign ~ Signature of officer I ~ Here Date Tide I Date I ,I Preparer's SSN or PTIN Preparer's ~ Check if Paid signature seIf-emp~D POO033498 Preparer's Firm's name (or ~ BROWN SCHULTZ SHERIDAN FRITZ I EIN ~ 25-1644159 Use Only yours if self-employed) I ZIP code 17011 and address 210 GRANDVIEW AVE. . CAMP HILL. PA ~ !SA SlF FED3903F.l Form 1120 (1999) Fonn 1120 (1999) Page 2 I Schedule A I Cost of Goods Sold (See page 12 of instructions.) 1 Inventory at beginning of year ............ ...... .... ........................... .... ....... ........ ... 1 258,785 2 Purchases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 377,237 3 Cost of labor .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ~ .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 4 Addilional section 263A costs (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 Other costs (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Total. Add lines 1lhrough 5 ...... ........ ............... .....-..................... .... ... ........... .... 6 636.022 7 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 244 968 8 Cost of goods sold. Subtract line 7 franline 6. Enter here and on line 2, page 1 ........... ................. 8 391.054 9a Check all methods used for valuing closing inventory: (I) !Xl Cost as described in Regulations section 1.471-3 (iQ 0 Lower of cost or market as described in Regulations section 1.471-4 (m) 0 Other (Specify method used and attach explanation.) ~ b Check if there was a writedONO of subnormal goods as described in Regulations section 1.471-2(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Check if the LIFO inventory method was adopted this tax year for CII:IY goods (if checked, attach Form 970) . . . . . . . . . . . . . . . . . . . . . . . . . d ~~~::? ~~=~~~~~. ~~ ~~.~~~ ~~: ~~.~~~ ~~.~~~).~.~~i~~. ~~~:. W e If property is produced or acquired for resale, do the rules of section 263A apply to the corporation? . . . . . . . . . . . . . . . . . . . . . . . . Dyes f Was there any change in determining quantities, cost. or valuations between opening and closing inventory? If "Yes," attach explanation ............................................................................................. Dyes ~D ~D IX] No !ZlNo I Schedllle C I Dividends and Special Deductions (See page 13 of (a) Dillidends (bl% (c) Special deductions instructions. ) recei10ed (a) x (b) 1 Dividends franless-than-20%-owned domestic corporaIia IS that are subject to the 70% deduction (other than debt-financed stock) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 2 Dividends fran 2O%-or-more-oNned domestic capaations that are subject to the 80% deduction (other than debt-financed stock) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 3 Dividends on debt-financed stock of domestic and foreign carporatiollS (seclioo 246A) ..... see ins\lUCIions 4 Dividends on certain preferred stock t:i 1ess-lhan-2O%-owned public utilities . . . . . . . . . . . . . 42 5 Dividends on certain preferred stock t:i 20%-0r-more-oMled public utilities . . . . . . . . . . . . . . 48 6 Dividends franleSs-than-2O"~ faeign capaations and certain FSCs that are subject to Ihe 70% deduction. ....................................................... 70 7 Dividends from 2O%-or-ll1Ol'&OM\ed faeign caporations and certain FSCs that are subject to the 80% deduction.... .. . . ..... . .......... . ......... .. .. . .. . . .. .. ......... 80 8 Dividends froo1 \W1olIy e>>ned foreign subsidiaies subject to lhe 100% deducIion (secIiaI245(b)) . . . . . . . . . . . 100 ... 9 Total. Add lines 1throogh 8. See page 14 of instructions for limitation .................. 10 Dividends from daneSlic corporatiOIlS received by a small business inwstment company operating under the Small Business Inwstment Act t:i 1958 ......................... 100 11 Dividends fran certain FSCs that are subject to the 100% deduction (section 245(c)(1)) .., 100 12 Dividends fran affiliated group members subject to the 100% deduction (section 243(a)(3)). 100 13 Other dividends fran foreign COIpOIatialS not included on lines 3, 6, 7, 8, or 11 ........... 14 Income from controlled foreign corporations under subpart F (attach Form(s) 5(71) . . . . . . . 15 Faeign dividend gross-up (section 78) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 IC-DISC and former DISC d'Mdends not included on Jines 1, 2, or 3 (section 246(d)) . . . . . . 17 OIherdividends........................................................... . 863 18 Deduction for dividends paid on certain preferred stock d public ulililies . . . . . . . . . . . . . . . . 19 Total dividends. Add lines 1 through 17. Enter here and on rll1e 4, page 1 . . . . . . . . . . . . ~ 863 20 Total special deductions. Add lines 9,10,11,12, and 18. Enter here and on Iine29b, page 1 ....... ....... .......... ~ I ScheduleS I Compensation of Officers (See instructions for line 12, page 1.) (c) Percent of Percent of corporation (a) Name of officer (b) Social security number time dewted to stock owned (I) Amount of compensation business (d) Common (e) Preferred 1 EDWARD J. WANYO 160-42-6583 100 % 30 % % 6.000 JOHN C. WAN YO 195-28-2167 10 % 30 % % NONE % % % % % % % % % 2 Total compensation t:i officers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.000 3 Compensation of officers c\aimed on Schedule A and eIseMlere on return ..... . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Subtract line 3 franline 2. Enter the result here and on line 12, page 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.000 Note: Complete Schedule Eonly if total receipts (Hne 1aplus Ones 4 through 10 on page 1, Form 1120) are $500,000 or more. Fonn 1120 (1999) SIF FED3903F.2 Form 1120 (1999) Schedule J Tax Computation (See page 15 of instructions.) 1 Check if the corporation is a mermer eX a controlled group (see sec:fioos 1561 em 1563) .................. ~ 0 Important: Members eX a controlled group, see instructia1s on page 15. 2a If the box on line 1 is checked, enter the corporation's share eX the $50,000, $25,000, and $9,925,000 taxable income brackets (in that order): (1) 1$ b Enter the corporation's share eX: I (2)1$ I (3) $ (1) Additional 5% tax (not more than $11,750) $ (2) Additional 3% tax (not more than $100,000) $ 3 lname tax. Check if a qualified personal service corporation under section 448(dX2) (see page 15) .......... ~ 0 3 4a Foreign tax aedit (attach Form 1118) . . . . . . . . . . . . . . .. . . . . . . . . .. . .. . . . . . .. . . . . 4a b Possessions tax aedit (attach Form 5735). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b c Check: 0 NonoorNentional SaJrce fuel credit 0 QEV aedit (attach Form 8834) . . . . . 4c d General business credit. Enter here and check which forms are attached: 0 3800 o 3468 0 5884 0 6478 0 6765 0 8586 0 8830 0 8826 o 8835 0 8844 0 8845 0 8846 0 8820 0 8847 0 8861 4d e Creditfa pria year minimum tax (attach Form 8827) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e 5 Total credits. Add lines 4a through 4e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Subtract line 5 from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Personal heAding canpany tax (attach Schedule PH (Form 1120)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Recapture taxes. Check if from: 0 Form 4255 0 Form 8611 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Alternative minimum tax (attach Faro 4626) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Add Ones 6 Uvough 9 ............................................................................ 11 Qualified zone academy bond aedit (attach Faro 8860) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Total tax. Subtract line 11 from line 10. Enter here and on line 31, page 1 ................................... SChedule K Other Information (See page 17 of instructions.) 1 Check method eX accoooling: a 0 Cash Yes No 7 Was the corporation a U.S. sharehader eX any controlled Ivl 0 faeign corporation? (See sections 951 and 957.). . . . . . . . b ~ Accrual c Other (specify) ~ If "Yes; attach Faro 5471 fa each such corporation. Enter 2 See page 19 eX the instructions and enter the: number eX Forms 5471 attached ~ a Business activity code no. ~ 44 4110 8 At any time during the 1999 calendar year, did the b B .nessaclivity~ RETAIL SALES corporation have an interest in a a signature a oIher USI authority Oller a financial account (such as a bank accooot, c Product a service ~ LUMBER / HARDWARE securities accooot, a other financial accooot) in a faeign 3 At the end eX the tax year, did the corporation own, directly a aultry? . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . indireclly, 50% a more eX the \'Oting stock eX a domestic If "Yes,. the corporation may have to file Faro TO F 90-22.1. corporation? (Fa rules eX atbibution, see section 267(c).) .. If "Yes; enter name eX foreign country ~ If "Yes,. attach a schedule sOONing: (a) name and et11pIoyer 9 During the tax )'831", did the corporation receive a disbibution identification number (EIN), (b) percentage owned, em (c) from, a was it the grantor eX, a lransferor to, a faeign trust? taxable income a (loss) befae NOL and special deductions If "Yes,. the corporation may have to file Faro 3520 . . . . . . eX such corporation fa the tax year ending with a within )'CUf 10 At any time during the tax year, did one foreign person own, tax year. directly a indirecUy, at least 25% eX: (a) the total voting power 4 Is the corporation a subsidiary in an affiliated group a a eX all classes eX stock eX the corporation entiUed to '<<lte, a parent-subsidiary controlled group? ................... (b) the total value eX aJ classes eX stock eX the corpaation? If If "Yes; enter name and EIN eX the parent corporation "Yes; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a Enter percentage owned ~ b Enter owner's country ~ c The corporation may have to file Form 5472. Enter number of Forms 5472 attached ~ 11 Check this box if the caporation issued publicly oIfered debt instruments with original issue disault .......... . ~ 0 If checked, the corpaation may have to file Faro 8281. 12 Enter the amount eX tax-exempt interest received a accrued during the tax year ~ $ 13 If there were 75 a fewer sha"eholders at the end of the tax year, enter the number ~ 8 14 If the corporation has an NOL for the tax year em is eIecling to forego the ccnyback period, check here . . . . . . . .. ~ 0 15 Enter the available NOL carryover from prior tax years (Do not reduce it by any deduction on line 29a.) ~ $ 23 , 258 ~ 5 At the end eX the tax year, did any individual, partnership, corporation, estate a trust own, dlrecUy a indlrecUy, 50% a mae eX the corporation's voting stock? (Fa rules eX attribution, see section 267(c).) . . . . . . . . . . . . . . . . . . . . . . . If "Yes; attach a schedule shoNing name and identifying number. (Do not indude any information already entered in 4 abcNe.) Enter percentage owned ~ 6 During this tax year, did the corporation pay dividends (other than stock dividends and disbibutions in exchange for stock) in excess eX the corporation's current and accum.IIaII!d earnings and profits? (See sections 301 and 316.). . . . . . . . If "Yes; file Form 5452. If this is a consolidated return, answer here fa the parent corporation and on Fonn 851, AfliIiations Schedule, fa each subsidiary. SlF FED3903F.3 Page 3 NONE 5 6 7 8 9 10 11 12 NONE NONE NONE Yes No X X X X Form 1120 (1999) Form 1120 (1999) Schedule L Balance Sheets per Books Assets 1 Cash ................................. 2a Trade notes and accounts receivable . . . . . . . . b Less allaNance for bad debts ............. . 3 Inventories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 U.S. g<:JIIeRlI11eflt obligations . . . . . . . . . . . . . . . 5 Tax-exempt securities (see inslruclions) . . . . . . 6 01her current assets (attach schedule) . . . . . . . 7 Loanstoshareholders.................... 8 Mortgage and real estate loans . . . . . . . . . . . . . 9 Other invesbnents (attach schedule). . .q~~~ 10a Buildings and other depreciable assets. . . . . . . b Less accumulated depreciation . . . . . . . . . . . . . 11 a DepIeIabIe assets ...... . . . . . . . . . . . . . . . . . b Less accumulated depletion . . . . . . . . . . . . . . . 12 Land (net of....y amollktlion) . . . . . . . . . . . . . . 13a Intangible assets (amo.li2..1bIe ooIy) ......... b Less accumulated amortization . . . . . . . . . . . . . 14 01her assets (attach schedule) . . . . . . . . . . . . . 15 Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . Uabilities and Shareholders' Equity 16 Accounts payable . . . . . . . . . . . . . . . . . . . . . . . 17 Mortgages, rUes, balds payable in less lIal1 yell' .... 18 Other current liabilities (attach schedule) ?r~T 19 Loans fran shareholders ................. 20 Mortgages, mes, balds payable in 1 year cr more . . . . . 21 Other liabilities (attach schedule) ........... 22 CapilaI stock: a Preferred stock .. .. .. .. .. . b Common stock ......... .. 23 Additional paid-in capital .. .. .. . . . .. .. .. .. . 24 Retailed earniJ;)s -Appropriated (aIIach schedule) . .. . 25 Retained earnings - Unappropriated . . . . . . . . 26 AdjuslmeI1s to sha'ehoIders' equity (aIIach schedule) ... 27 Less cost of treasury stock .. .. .. .. .. .. . .. . ) 28 Total liabilities and shareholders' 3 95 71 0 3 68 3 92 Note: The corporation is not required to complete Schedules M-1 and M-2 if the total assets on One 15, coL (d) of Schedule L are less than $25,000. Sc::hfi!duleM-1 Reconciliation of Income (Loss) per Books With Income per Return (See page 18 of instructions.) 334 9 AddIines7and8.................. 6 Add lines 1 through 5 ..................... 334 10 hxlme(Ii1e28.page1)-1i1e61ess1i1e9...... ScheduleM-2 Analysis of Unappropriated Retained Earnings per Books (Line 25, Schedule L) 1 Balance at beginning of year .. . .. .. .. . . . .. .. 5 Distributions: a Cash............. 2 Net income (loss) per books .. . . .. .. . .. . . .. . b Stock............. 3 Other inaeases (itemize): c Property........... 6 01her decreases ("derrize): 7 Addlines5and6.................. 4 Add lines 1. 2. and 3 . . . .. .. .. . . .. . .. .. . .. . -12 , 057 8 Balance at end of year (line 4 less line 7) 1 Net income (loss) per books . . . . . . . . . . . . . . . . 2 Federal income tax ... . .. . . .. .. . .. . . .. .. .. 3 Excess of capital losses CNer capital gains . . . . . 4 Income subject to tax not recorded on books this year (itemize): 5 Expenses recorded on books this year not deducted on this return (itemize): a Depreciation ............ $ b Conbibutions ~ . . . . $ c Travel and entertainment. . . $ STFFE03903F.4 Page 4 (a) Beginning of tax year (b) (d) 4 712 End of tax year (c) 196 43 30 841 ) 30 841 244 968 43 340 258 785 44 000 44 000 . 39;3"89 ;z3b 807 196 936) 33 871 10 000 368 392 15642 297,142 2 325 8 937 33 070 lob 23 233 100 100 23 233 -12 057 -12 391 7 Income recorded on books this year not induded on this return (itemize): Tax-exempt interest $ 8 Deductions on this return not charged against book incane this year (itemize): a Depreciation ......... $ b Contributions carT)'O'JeI" . $ 334 -12 057 Form 1120 (1999) 30 Taxable income. Subtract line 29c from line 28 31 Total tax (Schedule J, line 12) . . . . . . 32 Payments: 11997 overpayment credited to 1998 ! C b 1998 estimated tax payments .. 32b ~ c Less 1998 refund applied for on Form 4466 32c ( >- :. e Tax deposited with Form 7004 . . . . .. 32e -g f Credit for tax paid on undistributed capital gai1s (attach Form 2439) . 32f : g Credit for Federal tax on fuels (attach Form 4136). See Instructions . 32h ~ 33 Estimated tax penalty (see page 10 of instructions). Check if Form 2220 is attached ~ 0 33 34 Tax due. If line 32h is smaller than the total of lines 31 and 33, enter amount owed 34 35 Overpayment. If line 32h is larger than the total of lines 31 and 33, enter amolXlt overpaid 35 36 Enter amount of line 35 want: Credited to 1999 estimated tax ~ Refunded ~ 36 Under penalties of perjury, I declare that I have examined this rel~, including accompanying schedules and statements, and to the best of my knowledge and belief. it is true. correct, and complete. Declaration of preparer (other than taxpayer) is based on aI informalion of which preparer has any knowledge. u.s. Corporation Income Tax Return For calendar year 1998 or tax year beginning JLL, 1998, ending 212-8. ,199.9 ~ Instructions are separate. See page 1 for PaperwOftt Reduction Act Notice. Name B Employe.- Identification nurnbet' Wanyo B~othe~~ Inc. 23 ~2000933 Form 1120 Department of ,he T rea.UI)' Internal Revenue Service A Check if a: 1 Consolidated return Use {attaCh Form 8511 0 IRS 2 Personal holding co. label. Number, street, and room or suite no. (If a P.O. box, see page 5 of instructions.) (attachSch.PH) 0 Other- 609 [, Blaine St~eet 3 Personal service corp. wise, {as deftned ill Tempol3fy print or City or town, state, and ZlP code =,~~~:.4T-O type. (YfcAdoo, Pa. 18237 E Check applicable boxes: (1) 0 Initial return (2) 0 FlIlaI return (3) 0 Change of address $ 1 a Gross receipts or sales I 5 0 9 , 8 3 4- I 5 9 I b Less returns and allowances I 1 J J I J 11 c Bat ~ 2 Cost of goods sold (Schedule A, line 8) 3 Gross profit. Subtract line 2 from line 1 c 4 Dividends (Schedule C, line 19) 5 Interest. 6 Gross rents. . . 7 Gross royalties . . . 8 Capital gain net income (attach Schedule D (Form 1120)) 9 Net gain or (loss) from Form 4797, Part II. line 18 (attach Form 4797) 10 Other income (see page 6 of Instructions-attach schedule) 11 Total income. Add lines 3 through 10. . . 12 Compensation of offrcers (Schedule E, line 4) . 13 Salaries and wages (less employment credits) . 14 Repairs and maintenance. 15 Bad debts . . . 16 Rents 17 Taxes and licenses 18 Interest. . 19 Charitable contributions (see page 8 of Instructions for 10% limitation) .E 20 Depreciation (attach Form 4562) ~ 21 Less depreciation claimed on Schedule A and elsewhere on return .g 22 Depletion .. . .. .. . u 5 23 Advertising. .~ 24 Pension, profit-sharing, etc., plans :: 25 Employee benefit programs . !!!. 26 . Other deductions (attach schedule) . 27 ~ta' deductions. Add lines 12 through 26 ~ 28 Taxable income before net operating loss deduction and special deductions. Subtraclline 27 from line 11 29 Less: a Net operating loss deduction (see page 9 of instructions) . 29a b Special deductions (Schedule C, line 20) . 29b lD E o u E .; c ~ u ::> "C .. "C c o .. c o +> :l ~ fl) c: o 1,; ::> i o ~ Sign Here Paid Pre parer's Use Only OMS No. t545-0123 ~@98 C Date incorporated 5-20-76 D Total a~ (.ee page 5 of instructions) ~ 1c 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 999 00 167 69, 222 311 951 53 J1 59 20 951 -0- 59 -0- ~e~ Preparer's social security number 1~6-1~-578~ 23: 2117875 18237 rorm 1120 (1998) Page 2 10 of instructions. 1 2 3 4 5 6 7 8 254- 885 75 386 103 69 1 Inventory at beginning of year 2 Purchases. . . . . 3 Cost of labor . 4 Additional section 263A costs (attach schedule) 5 Other costs (attach schedule) 6 Total Add lines 1 through 5 7 Inventory at end of year. . 8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 9a Check all methods used for valuing closing inventory: (i) rn Cost as described in Regulations section 1.471-3 (if) 0 lower of cost or market as descnbed in Regulations section 1.471-4 (iii) 0 Other (Specify method used and attach explanation.) ~ ._m____.__..__.__.._m.m.u..._.__u_.____u__..._.._u__._.__u_._.__._ b Check if there was a writedown of subnormal goods as described in Regulations section 1.471-2(c) . ~ 0 c Check if the LIFO inventory method was adopted this tax year for any goods [If checked, attach Form 970) ~ 0 d If the LIFO inventory method was used for this tax year, enter percentage (or amounts) of closing I I L inventory computed under LIFO . . . . . . . . . . . . . . . . . ~ . e If property is produced or acquired for resale, do the rules of section 263A apply to the corpoI'8tion? .... 0 Yes f Was there any change in determining quantities, cost, or valuations between opening and closing inventory? If .Yes," attach explanation . , . . , . . , . . . . . . . . . ,. ..... 0 Yes DMdends and Special Deductions (See page 11 of (a) Dividends instructions.) received ONo ,- ~o Schedule C (bl% Ie) Special deductions fa) x lb) 1 Dividends from less-than-20%-owned domestic corporations that are subject to the 70% deduction (other than debt-financed stock) . . . . . . . Dividends from 2O%-or-more-owned domestic corporations that are subject to the 80% deduction (other than debHmanced stock) ......... Dividends on debt-financed stock of domestic and foreign corporations (section 246A) Dividends on certain preferred stock of Iess-than-20%-owned public utilities. . . Dividends on certain preferred stock of 20%-or-more-owned public utilities . Dividends from Iess-than-20%-owned foreign corporations and certain FSCs that are subject to the 70% deduction . . . . . . . . . . . Dividends Irom 20%-or-more-owned foreign corporations and certain FSCs that are subject to the 80% deduction. . . . . . . . . Dividends from wholly owned foreign subsidiaries subject to the 100% deduction (section 245(b1) Total. Add lines 1 through 8. See page 12 of instructions for limitation. . . . . Dividends from domestic corporations received by a small business investment company operating under the Small Business Investment Act of 1958 . Dividends from certain FSCs that are subject to the 100% deduction (section 245(c)(1)) Dividends from affiliated group members subject to the 100% deduction (section 243(8)(3)) Other dividends from foreign corporations not included on lines 3, 6, 7, 8, or 11 . Income from controned foreign corporations under subpart F (attach Form(s) 5471) . Foreign dividend gross-up (section 78) . . . . . . , . . . . . . . IC-DISC and former DISC dividends not included on lines 1, 2, or 3 (section 246(d)) , Otherdividends . . . . . . . . . . . , , . , . . Deduction for dividends paid on certain preferred stock of public utilities Total dividends. Add lines 1 through 17. Enter here and on line 4, page 1 ~ Total special deductions. Add lines 9,10.11.12, and 18. Enter here and on line 29b. page 1 Compensation of Officers (See instructions for line 12. page 1.) Complete Schedule E only if total receipts tJine 1 a plus lines 4 through lOon page I, Form 1120) are $500,000 or more. (el Percent of PercenI 01 corporation (I)) Social security number time devoted to slock owned business (d) Common (eI Preferred 40 % % % % % % % % % % % % % % % 70 2 80 3 4 5 6 see instructions 42 48 70 7 8 9 10 80 100 11 12 13 14 15 16 17 18 19 20 Schedule E (8) Name of offICer (f) Amount of compensation 1 4- 4-00.0(J -0- 2 T ota' compensation of officers . . . . . . . . . . . 3 Compensation of officers claimed on Schedule A and elsewhere on return 4 Subtract line 3 from line 2. Enter the result here and on line 12, e 1 4,100.00 4- 400.00 Form 1120 (1998) 1 Page 3 (2)1$ (3) $ (1) Additional 5% tax (not more than $11,750) $ (2) Additional 3% tax (not more than $100,000) $ 3 Income tax. Check if a qualified personal seMce corporation under section 448(d)(2) (see page 13) 4a Foreign tax credit (attach Form 1118). . . . . . . . . . . . . . 4a b Possessions tax credit (attach Form 5735) ........... 4b c Check: 0 Nonconventional source fuel credit 0 QEV credit (attach Form 8834) 4e d Genernl business credit. Enter here and check which forms are attached: 0 3800 o 3468 0 5884 0 6478 0 6765 0 8586 0 8830 0 8826 08835 08844 08845 08846 08820 08847 08861 e Credit for prior year minimum tax (attach Form 8827) Total credits. Add lines 4a through 4e . . . . Subtract line 5 from line 3 . . . . . . . . Personal holding company tax (attach Schedule PH (Form 1120)) Recapture taxes. Check if from: 0 Form 4255 0 Form 8611 Alternative minimum tax (attach Form 4626). . . . Add lines 6 through 9. . . . . . . . . . . . . . Qualified zone academy bond credit (attach Form 8860) . . . Total tax. Subtract line 11 from line 10. Enter here and on line 31, page 1 . Other Information See 15 of instructions. k method of accounting: a 0 Cash Was the corporation a U.S. shareholder of any controlled b Accrual cO Other (specify) ~ ._..__.h.._..__h foreign corporation? (See sections 951 and 957.). . . 2 See page 17 of the instructions and state the: If "Yes: attach Form 5471 for each such corporation. a Business activity code no. (NEW) ~ .. f. f. f.!. t 9. __ h __ Enter number of Forms 5471 attached ~....... __ . . __ no b Business activity ~ -- .!?!? !JL{{ h ~ f!:!: ~!J.. --.. --. no 8 At any lime during the 1998 calendar year, did the corporation c Product or seMce ~ .!-:y!'!.~.f?I!:._:._:.~'!:B.B.!:~!!:.~__ have an interest in or a sigoat~e or other authority over a 3 At the end of the tax year, did the corporation own, financial account (such as a bank account, securities directly or indirectly, 50% or more of the voting stock of account, or other fmanclal account) in a foreign country? a domestic corporation? (For rules of attribution, see If .Yes,. the corporation may have to tHe Form TO F 90'22.1. section 267(c).) . . . . . . . . . . . . If .Yes; enter name of foreign country ~ __ ___. __ __ __... If .Y es,. a"ach a schedule showing: (a) name and identifying number, (b) percentage owned, and (et taxable income or Qoss) before NOl and special deductions of such corporation for the tax year ending with or within your tax year. 4 Is the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? If .Yes," enter employer identification number and name of the parent corporation ~ __ __ __ __ __ __ . ___ _ ___' __ ___ __ Schedule J Tax Computation (See pa e 13 of instructions.) Check if the corporation is a member of a controlled group (see sections 1561 and 1563) Important: Members of a controRed group, see instructions on page 13. 28 If the box on line 1 is checked, enter the corporation's share of the $50,000, $25,000, and $9,925,000 taxable income brackets fm that order): (1) 1$ 1 I b Enter the corporation's share of: Schedule K 5 6 7 8 9 10 11 12 5 -0- -0- During the tax ve-, did the corporation receive a distribution from, or was it the grantor of. or transferor to, a foreign trust? If -Ves," the corporation may have to file Form 3520 . . At any time during the tax year, did one foreign person own, directly or indirectly, at least 25% of: (8) the total voting power of all classes of stock of the corporation entitled to vote, or (bl the total value of all classes of stock of the corporation? If.V es." 8 Enter percentage owned ~..... __ __ __""" __.........__ b Enter owner's country ~'"__'''''__''__h''''''''__''''' c The corporation may have to file Form 5472. Enter m.mber of Forms 5472 attached ~ __._._____.h.._...__......__. Check this box if the corporation issued publicly offered debt instruments with original Issue discount. . ~ 0 If so. the corporation may have to file Form 8281. Enter the amount of tax-exempt interest received or accrued during the tax ve- ~ $ __ __:-:: _c..~ __ .... __. __. If there were 35 or fewer shareholders at the end of the tax year, enter the m.mber ~ ___..8...__.........__..__. If the corporation has an NOL for the tax year and Y electing to forego the carryback period, check here ~ l:1 Enter the available NOL carryover from prior tax years (Do not reduce it by any deduction on line 293.) ~ $ 2 306. ')2 8 At the end of the tax year, did any individual. partnership, corporation, estate or trust own, directly or indirectly, 50% or more of the corporation's voting stock? (For rules of attribution, see section 267(c).) . . . . . . . If .Y es,. attach a schedule showing name and identifying numbllf. (00 not include any information already entered in 4 above.) Entllf percentage owned ~.h....__..__.___ During this tax year, did the corporation pay dividends (other than stock dividends and distributions in exchange for stock) in excess of the corporation's current and accumulated earnings and profits? (See sections 301 and 316.). . . If .Yes." file FOl1ll 5452. If this is a consolidated return. answer here for the parent corporation and on Fonn 851, Affiliations Schedule, for each subsidiary. liabilities and Stockholders' Equity Accounts payable . . . . . . . . Mortgages, notes. bonds payable in less than 1 year Other currentliabililies (attach schedule). . loans from stockholders . . . . . . Mortgages, noles, bonds payable in 1 year or more Other liabilities (attach schedule) . Capital stock: a Preferred stock b Common stock 23 Additional paid-in capital . . . 24 Retained eamIngs-Appropred (attach schedule) 25 Retained eamings-Unappropriated . . . 26 Adjustments to shareholders' equity (attach schedule) 27 less cost of treasury stock. . . . . . 28 Total liabilities and stockholders' e<:JJity. . 4- 61 627. 57 Note: You are not required to complete Schedules M-l and M-2 below if the total assets on fine 15, coIurm (d) of Schedule L are less than $25,000. Reconciliation of Income (Loss) Books With Income per Retlan See 16 of instructions. Net income (loss) per books . . . . 20 9 5 1 . 5 9 ) 7 Income recorded on books this year not Federal income tax . . . . . . . . included on this ret\m [itemize): Excess of capltallosses over capital gains . Tax-exempt interest $ ..m___..___.___ Income subject to tax not recorded on books __ . m . __. .. _ __ _ __ . _ __ . __ _ .. __. __ _. __ _ . .. this year (Itemize): _., ___.__.____.__ .________ _ __ .__________.._______.___.__.._..__._... . r&rm 1120 ('998) Balance Sheets Assets 1 Cash. .... 2a Trade notes and accooots receivable . b less allowance for bad debts . 3 Inventories. . . . . . . . . 4 U.S. government obligations . . . . 5 Tax.exempt securities (see instructions) . 6 Other current assets (attach schedule) 7 loans to stockholders . . . . 8 Mortgage and real estate loans 9 Other investments (attach schedule) . 108 Buildings and other depreciable assets b Less accumulated depreciation 11a Depletable assets . . . . b less accumulated depletion . 12 land (net of any amortization) . 13a Intangible assets (amortizable only) b less accumulated amortization 14 Other assets (attach schedule) . . 15 Total assets . . . . . . . 16 17 18 19 20 21 22 Schedule M.1 1 2 3 4 5 Expenses recorded on books this year not deducted on this return [Itemize): a Depreciation . . . . $ .____.._.....__.. b Contributions carryover $ ... .. m' m m.. C Travel and entertainment $ _...______...__._ 6 Addlinesltt 5....... Ana sis of Unappro 1 Balance at beginning of year . . . . . 2 Net income (toss) per books . . . . . 3 Other increases (itemize): . . . . __' __ . . . _ . _ __ __ Schedule M-2 4 Add lines 1. 2, and 3 .. PaQe 4 3 3, 1 79 .-67 302,626.14 2,065.22 I 4-,337.4-4- , 4-2,560.67 391.28 Deductions on this return not charged against book Iricome this yetiII (itemize): a Depreciation . . . . $.___.___.___ b Contributions carryover $ m _.. __... 1 . 61ess1ine9 (20 {line 4 less h 12 391.28 Form 1120 Department ollhe Treasury Intarnal Revenue SetvIce u.s. Corporation Income Tax Return For calender yeer 1997 or tax year beginning 3fr.... ,1997, ending ~/?:-.?, 191.6' ~ Instructions are separate. See page 1 for Paperwork Reduction Act Notice. Name B Employer Identlflcetlon number ~@97 A Check If a: 1 Consolidated retum 0 Use (attach Form 851) IRS 2 Personal holding 00.0 label. (attach Sch. PH) Other- 3 PIIISOIlII Serv\ca corp. wise, (as defined In Temporary print or City or town, state, and ZIP code ~egs. 88C. 1.441.4T-O type. If) sea InatructlonI E Check appllceble boxe.: (1) 0 Initial return (2 0 Final retum 1. Gross receipts or sales I 5 7 5 . 1 5 61 '1 4-1 bLess retums and allowances I 2 Cost of goods sold (Schedule A, line 8) 3 Gross profit. Subtract line 2 from line 1 c " Dividends (Schedule C, line 19) 5 Interest. 8 Gross rents . 7 Gross royalties . 8 Capital gain net income (attach Schedule D (Form 1120)) 9 Net gain or Ooss) from Form 4797, Part II, line 18 (attach Form 4797) 10 Other Income (see page 6 of Instructions-attach schedule) 11 Total Income. Add lines 3 throu h 10. . . i 12 Compensation of offlcers (Schedule E, line 4) . .g 13 Salaries and wages Oess employment credits). 8 .14 Repairs and maintenance. . . . 1 15 Bad debts . g 18 Rents I 17 Taxes and licenses I 18 'nterest. ~ 19 Charitable contributions (see page 8 of Instructions for 10% limitation) ... 20 Depreciation (attach Form 4562) .e & 21 Less depreciation claimed on Schedule A and elsewhere on retum i 22 Depletion 23 Advertlsll1g. ._ 24 Pension, profit-sharing, etc., plans J 25 E~ployee benefit programs . - 26 Other deductions (attach schedule) . I 27 Total deductions. Add lines 12 through 26 . 1 28 Taxable Income before net operating loss deduction and special deductions. Subtract line 27 from line 11 ~ 29 less: a Net operating loss deduction (see page 9 of Instructions) . 29a 7 0 b Special deductions (Schedule C, line 20) . 29b 30' Tlxable Income. Subtract line 29c from line 28 31 Total tax (Schedultl J, line 10) .. . 32 PI. ym_nls: I 1991l overpayment credited to 1997128 J b 1997 estimated tax payments .. 32b . c less 1997 refund applied for on Form 4466 32c ( . Tax deposited with Form 7004 . .. ..... 32. I f Credit for tax paid on undistributed capital gains (attach Form 2439) . 321 9 Credit for Federal tax on fuels (attach Form 4136). See Instructions . 32g 32h S 33 Estimated tax penalty (see page 10 of Instructions). Check If Form 2220 is attached ... 0 33 34 Tax due. II line 32h Is smaller than the total of lines 31 and 33, enter amount owed 34 35 Overpayment. If line 32h Is larger than the total of lines 31 and 33, enter amount overpaid 35 38 Enter amount of line 35 you want: Credited to 1998 estimated tax .. Refunded ~ 36 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. &an 0 B~othe~~ Inc. Number, street, and room or 8ulte no. (If a P.O. box, see page 5 of Instructions.) 609 E. Bla~ne St~eet OMB No. 1545-0123 23~ 2000933 C Date Incorporated 5-20-76 o T olal assets (see page 5 01 Instructlonsl of eddre.. 4-,832102IcBal~ I " ~~ Sign Here Date Date Signature of officer Pre parer's ~ signature , Firm's name (or yours if self-employed) and address Paid Preparer's Use Only ~ ISA SlF FED3903F.1 ~ 1c 2 3 4 5 8 7 8 9 10 11 12 13 14 15 . 18 17 18 19 6 7 324- 728 596 57 72 58 14- 01) Pre parer's social security number 1 Inventory at beginning of year . 2 Purchases. . . . . . . . . . . . 3 Cost of labor . . . . . . . . . . . 4 AddItIonal sectloti 263A costs (attach Schedule) 5 Other costs (attach schedule) 8 Total. Add Hnes 1 through 5 . . .. . . 7 Inventory at end of year. . . . . . . '. 8 Cost of goods BOld. Subtract Hne 7 from line 6. Enter here and on page 1, Hne 2 .. Check,l. methods used fpr v8IuIng clOsIng Inventory: (i) ur Cost as described In Regulaitons section 1.471-3 (il) 0 lower of Cost or market as described in Regulations section 1.411-4 (ill) 0 Other (Specify method used and attach explanation.)" _ .. __ .... .. . _.. ... _ ... _ .... ... _............ ...._...... . ... __.... _ . . ... _ . ... . . b Check If there was a wrItedown of subnormal goods as descrtbed In Regulations section 1.471-2(c). . . ~ 0 c Check If the UFO Inventory method was adopted this tax year for any goods (If checked, attach Form 970) ~ 0 d "the LIFO Inventory method was used for this tax ye'N, enter perCentage (or amounts) of closing" I 9d I L Inventory computed under UFO . . . . . . . . . .. .. . . . . . . . ~ . . "property Is produced or IicqUfn!d for resale, dO the rules of section 263A apply to the corporation? .. . 0 Yes 0 No f Was there any chang. In determlnillg quantities, cost, or valuet1on$ between opening and closing Inventory? If .Yes,. ......,/ attach ~planatlon . . . ',' . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes I!J No DiVIdends and SpecIal Deductions (See page 11 of (8J DIvIdends (bt " (e) SpecIal deductions Instructions. AlC8Mld - (a) x lbJ i DIvIdends from less-than-2O%-owned domestic corporations that are subject to the 70% deduction (other than debt-financed stock) . . . . . . . . . '.' 2 Dividends from 2O%-or-more-owned domestic corporations that are subiect to the 80% deduction (other than debt-~ stock) . . . . . . . .'. . . 3 0IvIdends on debt-financed stock of domestic and foreign corporations (section 24M) 4 0IvIdend$ on certain pr8femid stock of Jess-than-20%-owned publIC utilities. . . 6 DIvIdends on certain preferred stock of 2O%-or-more-owned pubUc utIIItIe8 . . . 8 DMdends from kiSs-than-20%-ownedforelgn Corporations and certain FSCs that are sub)ectto the 70% deduction . . . . . . . . . . . . . . . . . 7 DIvIdends from 2O%-or-more-owned foreign corporations and certain FSCS that are sub)ect to the 80% deduction . .'; . . . . . . . . ; . . . . . 8 DIvidends from wholly owned foreIgrt subsldl.Ies subject to the 100" deduction (section 245(b)) 9 Total. Add Hnes 1 thiough 8. See page 12 of Instructions for Hmltatlon, , . , , 10 DIvIdends from domestic corporations received by a limaIl business Investment company operating under the Small Business Investment Act of 1958, " . . . DIvIdends from certaln FSCs that are subject to the 100% deducllon (sectIoil245(c)(1)) DlYIdends from affiliated group memberS SUbject to the 100% deduction (section 243(aK3)) Other dlvfdends irom foreign corporations not IncIud8d on Hnes 3, 6, 7, 8, or 11. , Income from controlled foreign corpc:ir8t1ons under ,subpart F (attach Form(s) 5471) , Foreign dividend gross-up (section 78) . . , . . , . , , " , . ,'. Ie-DISC and former DISC dividends not Included On Ones 1, 2, or :3 (sectIoh 246(d)) . Otherdlvidends . . , , . . . . . , , . . , . . , . Deduction for dividends paid on certain preferred stock of pubic uU\ItIes , , , . . Total dividends. Add lines 1 through 17. Enter here and on line 4, page 1 . ," Total epecI8I deductions. Add Hoes 9,10,11,12, and 18. Enter here and on line 29b, page 1 , , , . . Compensation of OftIeers (See instructions for line 12, page 1.) Complete Schedule E only II fotaIl8C8Ipts line I. plus lines 4 through 10 on page 1, t=orm 1120) are $500,000 or more. let Percent of Pen:ent ... CDIJICII1IIIon (bJ SocI8IIIlicI.dy number time devoled to ' """* own.! buIIND (dJ Common (eJ Pr8femId lJ(, % lJ(, " lJ(, " % % % % % " % % % . Porm 1.120 (1997) Schedule A e 10 of Instructions, Schedule C (aJ Neme of ofllcer 1 2 Total compellsatlon of officers. , , . . , . . . . . . . , 3 Compensation of officers ciaImed on Schedule A and elsewhere on return 4 Subtract One 3 from line 2. Enter the result here and on line 12., 1 P8iJe 2 1 2 3 4 6 8 7 8 680 614 33 254 885 75 425 728 58 70 80 - 42 48 70 . (IJ Amount of ciompensation '-0- 5 600 00 Tax Computation See 12 of instructions. 1 cheCk If the corporation is 8 member of a controlled group (see sections 1561 and 15(S3) l~ Members of a controlled. group. see Iri$tructIons on page 12. ",; I iii If the box on ane 1 IS checked. enter the corporatIon's sftare of the $50.000. $25.000. and $9.925.000 taxable Income brackets (In that on:fer): (1) '* , ,. b Enter the CClfpOI'8tIon's shar8 ot (1) AddItional 5" tax (not more than $11.750) ~ $ (2) AddItional 3" tax (not IT'lOre then $100.0Q0t 'S 3 Income tax. Check this box If the cOrporatIon III a quaIiflec:I p8rsonaI S8NIc& Col'poratIon as defined In sectIen 448(d)(2) (See Instructions on page 13). . .'. . . . . . . . . . . . .. 0 ... Foreign tax credit (attach Form 1118). . . . . . . . . . . . ; . ... b PoasesSlons tax credit (rltt8ch Form 5135) . . .'. . . . . . . . . 4b c CheCk: 0 NoncoIw8ntIonal 90Urce fuel credit 0 QEV credit (attach Form 8834) 4c d -~ Genei'8I business credit. t:nter here 8nd check whtdl forms lW8 attached: 0 3800 o 9488 0 5884 0 8478 0 6765 0 8586 0 6630 0 8828 o 8835 0 8844 0 8845 0 8848 0 B820 0 8847 0 8881 . CredIt for prtor year mInImuin tax (attach Form 8827) 5 Total Cf'edItS. Add lines 48 through 4e . . . . . " Subtract line 5 from line 3 . . . . . . . . . 7 Personal holding company tax (attach Schedule PH (Form 1120)) 8 Recapture taxes. Check If from: 0 Form 4255 0 Form 8811 9. AlttHn8t1ve minimum tax (attach Form 4626). . . . . . . . 10 Total tax. Add lines 6 9. Enter here and on One 31. 1 . Other Information ' 14 of InstructionS. 1 cheq( method of aCcounting: . 0 Cash No 7 Was the corporation a U.S. shareholder 01 any controlled b (if Acci1JaI cO Other (specify) . ...............~__ foreign corporation? (See sections 951 and 957.). . . 2 See page 16 of the lnstrUCtIohs and state the prlncIpaI: If "Yes. - attach Form 5471 for e8ch such corporation. . Business activity code no. ......~g.~g......J......... Enter runtJer of Forms 5471 attacIMld .................. b BusIness activity ..... Ii!?!: [/:!: !...1f!..!-..lf.:~........oo At anytfme during the 1997 Calendliryear. did the corporation c Product or service .. ..__..~!U!!~!?IJ.............h__.. have an 1nt8l'8St In or a iIgnalu1l or other 8UIhor\ty over Ii 3 At the end of the tax year. dki the corporation own. finlIncIaI account (such as a bank account. seamtIes directly or indirectly. SO" or more of the voting stock 01 acCount. or oCher financial aCcOunt) In a foreign country? a ~tIc t:orponltIOn? (For rutes of attribution. see If "Yes, Ii the corporatfon may hive to file Form TO F 90-22.1. section 267(c).) . . . . . . . . . . . . If "Yes. - enter ~ of foreign country .. ...............' If "Y." attach 8 scheduI8 ~ ..., name 8nd ................ Ilut'W,g th8 tax year. did the corporation r8CeIve 8 distrIJutlon "'.......'11- '"'" ....."ut,..'" from. or wa!llt the ~ of, or trallsferor to, a foreign trust? number, (hJ pel(;8ldage ~, end (c) taxable Income or If "Y'" - see page 15 of the Instructions for other fonns the (loss) before NOl and SpecIal deductionS bI such c::orporatlon corporatlon may have to ftI8 . '.. . . . . . . . ,for the tax yea- 8ndIng, WIth' or WfthIn yO&.- f8lc yeer. At .., tm8 during !he tax year, did one fOreIgn person own, 4 Is the corporation 8 subsIdIaiy In an affII1ated group or 8 diiectly or 1ndhctIy, at least 25" of: (a) the total voting power parent-~ controDed group? . . . . . . of ill cIesSes of stock of the corporaIIon MtIIed to vote, or tbl If "Yas.. enter employer identification number and name the tOtiI vaIu6 of II classeS of stock of th8 corporation? If''Yes. . of the parent corporatIOri .. ... .. .. . .. . ...... .. .. 0 .. .... ill Enter percentage owned ~.............................. .... __.......... ......... .... ............................. b Enter owner's country "''''00 __ 000.........00 ~. __...:... c Thli corpOrat1on may h8ve to IDe Form 5472. Enter number of FoimS 5472 attached ~ ................... __......... CheCk this box If the corpot'8tIon ISSued publicly offered debt InStruments with orIgIn8Ilasue discount. . Ii>- 0 If so.' the corporation mIiy have to, file Form 8281. =: dlmgame:: ;:~..~..i~..~ :.x ~:V:er~ =. ~~_~.~~~.~ If the corporation has an NOt for the tax year end is erecting to forego the carryback period. check here . 0 15' Enter the available NOt clilTyoYer from prior tax years A (Do not reduce It by a1Y' deduction on line 29&.)... $ Form 1120 (1997) (211 $ Schedule K 5 At the end of the tax year, did any individual. partnership. corpc:il'atlon. estate or tnJst own. directly or indirectly, 50~ or more of the corporatIon's voting Stock? (For rules of littrIbutIon. see section 261(C).) . . . . . . . If "Yes, It attach a Schedule showing name and IdentlfyIng number. (Do not Include any information ahady entered In" above.) Enter percentage owned ................... 0tA1ng this tax year. did the eorpcratIon pay dividends (bIher than s,tock dividends end distributions In exchange for stock) In excess of the corporation's current end ac:currUated earnings end pmftts? (See sees. 301 8nd 318.).. . . If "Yes.- file Form 5452. If this Is 8 Con$oUdated retun. answer here for the parent COf'pOfiltfon and on Form 851, Affiliations Schedule, for each subsidiary. 8 (3J -0- -0- 5 8 7 8 9 10 -0- Page 3 1 Cash........ 28 Trade notes and accounts rec8IvabI8 . b Less allowance for bad debtS. . . 3 Inventories. . . . . . . . . 4 U.S. govemlll8i1t obIIg8tIons . . .' . 5 Tax-exempt sea.rflies (see instructions) . 8 other current assets (attach $Ch8dule). 7 Loans to stockholders . . . . . it Mortgagtt and real estate loans . . 9 Other InvestmentS (attach schedule) . 108 8uiIdlngs and other depnicIabIe assets b Less accumulated deprec:latlon . 118 0ep\etabIe assetS . . . . . b less accumuIi1tetl depIetlon . . 12 Land (net of any amortization). . 138 Intangible assets (amortizable only) b Less llCClJI'nU\at~ 8morttzation . 14 Other assets (attach schedule). . . . ; 15 Total assets . .. . . . . liabilities and $tC)ckholders' EquIty 18 Accounts peyabIe . . . '.' . . 17 Mortgages. notes. bonds payab/e In less than 1 yeiIr 18 Other current lIabIIItIeS (attach schedule) . . 19 Loans from stockholdenl . . . . . . 20 Mortgsges, nohiS, bonds jl8y8bIe In 1 yB or inore 21 other IlablIties (attach schedute) . 22 ~ stock: . Pl4ifemid stock . . . b Cori1mOr1 stock. . . . 23 AdditIoneI p&Id-ln C8pItal . . . .'. ~ 24 RetaIned eeinlllgs-Appropr\ated (Ilttach ech8duIe) 25 RetaIned eamlngs-UnapproprIated . . . 28 Adjustments to shareho\dlIfS' equIIy (atIach schedule) 27 Less cost of treasury stock . . . . . . 28 Total liabilities IWld $klckho\ders' equity. . .7 4- 6 1 627. 5.7 Note: You are not requ/t8d to ~ SchfdJIes Al-l end M-2 bfJIow if the total assets on Ine 15. column (dJ of Schedule 1 are less than $25.000. ReconciUatioiI of Income ~ Books With Income per Retum15 of Instructions. 1 Net InCome (loSs) peW ~ . . . . . 3 7 3 . 0 1 1 Int:Ome recorded on bookS this yea.. hOt 2 J=eder8l1ncoine tax . . . . . . . . lncIucMd on this return (itemize): a Excess of e8pltjlloSsesover eapitaI gains . Tax-exempt Interest S .........~..,.~.. 4 Income sublett to tax not i'ecOrded on books ..........."_.... h............. _... ...... this year (itemize): ........................... . .........__......~...--..c............... !=Onn 1120 t1997) Balance Sheets Assets / Schedule M-1 5 Expehses recorded on books this year not deducted on thls'retum (1I8mIze): 8 Deprecfatlon . . . . S ....:............ b ContrIbutions carryover $ .........._....._ c TraVel 8nd entertalrlfTKri $................. 8 Add.I~l......--.-. .................. ...... Schedule M-2 1 2 3 4 Add lIneS 1, 2. ind 3 ... . . . . . PaQ.4 (d) 1,863.16 ~ 38,627.74- 254-,885.75 ! 8 560.31 8 DeductionS on this r8tum ndt charged against book Income this year (itemize): Iii Oepf8clatkln . . . . $....... __... b Contributions carryover $... ........ ~ 41esUne rnrrn I I LU u.~. \lurporatlon Income Tax Return OMO .!Io. '54~.~~ llt'f''''I''1eI1\ 011'" treasury For clllendar year 1998 or lax yellr begInning :}.:-. r. 1996 ending 2 - 28 199 7 ~1(ij\9 6 ........ "- Selv1c. .. InsbucUons ate sepatate. See page 1 lor Pap",';'ork neducUon ^~i - N~lice. . . . J ~ A Check" 8: Name 1 Consolldaled .e\um Use 8 Employer '''enllllentloo number 1;lI'~hrormIl5f' 0 In9 Mango Bll.oihell.-tJ1 lnc. 2,: 200093, 2 ~~:::t:~ <:0'0 :;.~~~_ Number. slfltP.I. lItod room or sulle no. '" II P.O. boll. SM peglJ 6 01 InSlructlons., C 0a10) h>r.orpornled 3 rl!lsonal SI'Ivlee corp. wIse, 609 t. B l.aine S tll.e e i 5 - 20- 76 t:doolined ~ 1 en1lO'llry P' Inl or Cl1y 01 town. slale. IInd ZIP code see 1441 4J 1 0 lola' asws 1_ fll'lI'! I; ol in~bllr.';"nsl ~ llisbuctioiBi' -0 ype. 1'1 cAd 00, P a . 1 823 7 E O1eck lIppIIcabIe boxes: (I) 0 InIIIaI return (2) 0 FInaI'e'U1n 13) U Change 01 address $ 493, 783 72 'II GlOSS recelpls 01 sales I 7 1 5, 110 Illib less rehans and IIIIowancesI j I I ~ 1 I c Baf" 'C 7 1 5, 07 J 52 2 Cosl of goods sold (SchecUe A. Hne 8) . 2 - I~Q,-5 7 t T-or 3 O,m;s JlfoRI. Sublraclllne 2 frorn line Ic .. . 3 1 9 ~ , ~ 9 5 11.. .. DIvidends (Schedule C. line 19) . . . . . ... .. 4 5 Inlerest . I, " . . .. 5 8 Gross fer,l!! . . '" . 8 7 Gross roynllles . '. 7 8 CAPItAl gAin net hlCome (attach Sdleduk! D (FOIm 1120)) . 8 9 Nel gAIn or (loss) from Form 4797. Pllft n. Ine 20 (attach fOl'm 4797) . . ." _9_. '0 Other htCOrne (!iP.9 pAge 7 of Inslrucllons-allach schedule) . . 10 1 7 . 1 31 02 11 lo'allncome. Add I"es 3lhrough 10 . . .... ... ........ 11 211, 626 37 1 12, Comperls:'ltlon 01 oll1cers (Schedule E, Ime,f). " .. . 12 8, 000 00 ~)3 S:'Il;vles and wages (less emptoymenl credils) .. ... ~_ 3 7 , 320 uff :J' '4 nepalrs And mah,lenance . .. " . ~!_ 5 , 4 V 4 -.~L ! 15 B:'Id debls .. '" . 15 ~ , 7 J 9 j L ~ 18 nenls. .. . . . 18 ___ :! 17 TAxes and Ilcerlses. .i. . . . 17 _ZLlJ..J.. 4 V i t8 hllr.re!\1 . .... 18 3 9 , 28 6 Z1- ~ 19 ctmrllable contributions (see p--.ge 8 of InslriJcllons fOl' 10% RmIlatlon) . 19 ~ 20 Deptecl:'ltlon (attach fOl'm 45~?) . ; '. l-2~'=.Ola.J- 16 1'08 0 'L':-~~ II 2' less dcpteclatlon claimed on Schedule ^ and etsewllete on relum l!!!U ' L 21b 16. 08 O. fJJL g -g 22 Deplellon . . ... . . .. 22 ____ __ ti 23 Adve,llshtg . .. .. 23 __L8...t-.632. 21L .!: 24 Perlslon, pronl-sharlrtg, elc.. plans., . .. 24___. __ J 25 Employee benefit prograrns . .. . 25 _. ___ ; 28 Other dP.ducttons tallach ~e) . '., .' ". 28 5 0 . 6 7 9 7 7 ti 27 To'al deductions. Add tines 12 ttwaugh 26 ., ... 21 187. 921 '88 g. 28 Taxable tncome befOl'e net operal1l'91oss deduction and spectal deducllons. Sublraclline 27 from Rne f I 28 23, 704- 4 9 11 29 . less: It Net operatlr'9 I()!I}$ deduction (see page 10 of klStrucllons) . . I 29a' 23. 7 0 ~ , ~ 9 .~ o b Special deductions (Schedule C,line 20) . '. . . . . . . r29b 29c (23, 70-1 19) 30 Tall"ble Income. SubhACIllne 29c from W 28 . . . . .. '" 30 - 0 - _ 31 ToIRllax(ScheduleJ.11ne1(Jt. . . ... . . . . . . . . . . . .. 31 -0- i 32: :~::~==:~:ai ~. :. . Tax deposlled wfth Form 7004 . . . i. ...". 32e ~ ! f Credit trom regulated Investment compar~ (llttach form 2439) . .. 32' ~ . III g C,p.dil for FederAl tall on fuels (attach Form 4(36). See k,sttUCtlOllS 329 32h ! 33 F.!\IImAled tAX penally (see page 1 t of instructions). ctleCk If Form 2220 Is ,,"ached : .. 0 _~~ 34 T8x due. If 1h'8 3211 Is srna"er than the tolal ot lines 3' and 33. enter amount owed ." 34 35 Overpayment. It nne 32h Is Iargp-r limn Ihp. lolal oJ Ines :1t arm 33. enler amount overpaId . 2~.. 38 Enter amount of line 35 YOU wan': Credit.d to 1991 .stltna'eeI tax .. n.funded .. 36 Under p4lt:11lie5 01 perjury. I dl!cbe Ihal I have eX;"Nned Ihls 'eluln. including acconlp8nyill9 !'Checluln5 IIIId stR\en1l!llls. amd In II", bo!"-I of "'y kIO(lw....lq~ ...Id "" belel. Ills "ue. COfJect. Bnd co"'fllele. Deelar8llon of JlIep:lfer (other than llIll(lllY8flls based on III InlOl'lnatlon of 1lWhIch JlIl!(la1er ,,"S Dny knowll!dqe, <. . E o u ~ -0- Sign Here r:tld Prp.p;Jrer's Use Only ~ Slgnalure 01 offk:er r'f'flmer'S .. sllJn:t".e , n,",'s 'IOfI" (or ~ Y01l15 " se" .1!f1lf)Ioyed) arid address Oale I Dnle ~ l~ ICht'Ck " self.employed 0 I EIN .. I ZIP code .. f'repllfP'S soclnl s!!Cu.lty I""noo t . Cal, No. 114500 '"',,'" ",20 (I996J - Schedule C f Invenlory a 2 Purchases 3 Cost of tabor .. MdlUonal 5 Other cost 8 lotllt Add 7 "Inventory '" 8 Co.t of go ... Chects' IlIt melhods used for valuing closing Inventorr- (iJ QI Cos' ns described 1n negu1a11ons section t."71-3 (ii) 0 lower of CO!\t or market as described In Regulations section 1.471-4 (iiiJ 0 Other (SpeclfV method used and aUach ekplanatlon.) ~ _...__m'_"_"___' ._m_..._.'_'" ._...._..._. _u, ___ __._ ___........ _..._". b Chf'Ck" thme was It wrlledown 0' subnormal goOds as described In negulatlons section t..17t-2(c). . . . . . . . ... U c CI~\(" the UFO Inven'ory method was adopted this tax year for III1'f goods f" checked. aUlIch Fo,", glut . . . " . ~ LJ . d =1:;'~~::;:::1;~:~1F~ ~~ f~"~ ~ax .ye~. ~t~ ~t:.(or.an~tS).OI ~~ ~__, _____L __ e If pr~Ity Is produced or lIC~ed lor r!!Sall!. do the rules of SflCtIon 2631\ apply to the Corporlltlon? .'. . . "U Yr.s lid No Wl1!I the"! MY change In determIning quan'"Ies, cost. or valuations between opening 8nd closing Inverltory? " .Yes.. attach explanation . . . . . . . . . . . . . . . . . .. ..... U Yes W'tto Dividends and Special DeducUons (See page 12 of Ia) (llvk1-.l1ds __ Instructions.) leclllved , . Osykfends from less.lImll-20%-ownfld domestIc Corporatfons 'hat are subfec' to the 70% deduction lother Ihan debt-financed stock) :" . . " . . . .. . . 2 0Ivtdmwt. frnm' 2O%.or-more-owned domfl!ltlc cbrporetlons that are subJect to U1tJ 80" dMfucllon (oUw 'hM debt-flnanced stocle) '. . . , . . . . . . . Dividends on debt-financed stock of domestic Md forelgn corporations (section 24GA) Dividends on certain preferred stock of less-than-20%-owned f1UbIIc utilities. . . DIvIdends on celtaln preferred stock of 2ri"-or-more-owned public utilities . . . OIyldf!fld!l from Iess-than-20%-owned forelgn corporation!l arld certain fSCs that ere M1btectto the 70" deduction. . . . . . . . . . . . . . , . . 7 Dlyldend!' Irom 2O%-or-more-owned foreign corporations and certain fSCs that are ~lrh\~ct to the 80" deduction. . . . . .' . . . . . . . . . . . 0Mdends from wholly 0MW!d belgn 5\Jbsldal1e5 subIecl to" the tOO% deduction (secllon 245(b)) TolBt. Add lines' 1I1tt1Ugh 8. See page 12 of instructions for limitation. . . . . Dlvlrtf!nds from domestic corporations received by B small bushless bwesbnent - ,~ COItlf'RnY nperatlng tnter the Sma. Business Invest.nent Act of 1958.. .. .. .. . Olvldends Iror" r:ertRln FSCs ""8t Me subjec' to ,he 100% deduction lsectlon 245(cKt)l t'Iv\dends from 81I1t1at,,<I group n.er.tbeo s subIecl to t"e tOO% dfIductIon (section l!43(a)(3)) Other clvtdends from foreign corporations hOt InchJded on Ines 3. 6. 7,8, or t 1 . Income "orn controlled foreign corpofatlons under subpart F lanach Form(s) 5471) . rOlelg" dMdend gross-up (section 78) . . . . . . . . . . . . . . IC-DlSC rmd former DISC dividends not Included on lines 1.2. or 3 (section 246(d)). Other dividends . . . . . .". . . . . . . . . . . . . O<!ductktn lor dividends pl'Id on certain prefened stock of pubic uti1IIles . . . . . To'''' dfvtdends. Add lines 1 through 17. Enter here IInd on nn" of. page 1 '. ." 'olal special deducUons. Add lines 9.10. 11. 12. and t8. Enter here and on.18 29b. page 1 Compensation of Officers (See instructions for Kne 12. page 1.) CompIele SclJedule E only" 'olal.recelp's ~ ,. plus lines" flvough .0 on page f. Fonn "20} ate $500.000 or mOle. tel rercent of Peeenl COfpOllllion (bJ Soc:I8I secUlfty runbet lime devoted to stadl business IdI Common " " ~. % % " " " % % e Cost of Goods Sold (See page 11 of instructions.) t beginning of ye. . ; 1 305,610 56 . . . . . . . . . . . . . . . . . . . '.1' . . . . . . . .. . . . . . . 2 491.562 36 . . . . . . ' . . . . . . . . . . . . 3 section 263A costs (attach schedule) . . . . . . . . . . . . 4 s (attach schedule) . . . . . . . . . . . . . . . . . IS Ines , through 5 . . . . . . . . . . . . . . 8 797.172 92 end of yem . . . . . . . . . . . 7 276.59~ li.. ode sold. Subtract line 7 from Ine 6. Enlet here lIfld on page .. line 2 . . . . 8 520.578 17 "ag 2 IbJ" leI Sfl'"<:;'''' "~I..<:lirll1': 1"1 v 'b) 7() 3 .. 5 e __80__ !!m!~ 42 48 "10 StHedule t: 8 9 10 1t 12 13 ,., 15 '8 t7 t8 t9 20 lit' NIImIt 01 olfIcer let Prefelled % % " % '" Amount of compeosallon 1 ,000.00 2,00U.UO % 2 .. T oInt comJ'let1Satlon of ofllcets. . _ . . . . . . . . . . . :1 Cornpt!f1!lallon of offtcers claimed on Sr.hP.dlltf! A And efsp.where on relUm .. Subbact "n. 3 flom '18 2. EIlter Ute result hete .1d en Ine 12. 1 I . 8 000.00 -0- 8 OOU.OO I ' . ....v "~11.1)J ~ Tax Computation (See page 13 of instructions.) 1 Check If the corporation Is II member of 8 conlrolled group (see sectlor1s 156111nd 1563) . . . . ~ 0 tmportll11t: Members of II controlled~. see !T~'1or1s on page 13. :' ; 1 28 If "lfl box on .18 lis checked, enter thj, coi'poriillOn's shan! of lhe $50.000. $25,000. and $9.925,000 taxable hlCome brackets (In that order): (1) 1$ I I b Enter the corporation's share of: Ct, Mditlonal5% 'ax (not more than Sl1.75Ot , $ 121 Addlllonftl 3% tax (no' more than "00,000) 1$ 3 tncOOl/! t:lw. CtM'Ck lhls box " "18 corporallon Is 8 qualified personal service corporation as dellned In section <1<18(d)(2) (see instructions on page 13). . . ~ 0 4" rorelgrl tax credit (attach torm 1118). .'. . . 4. b rrn;!;esslons lax credit Catlach Form 5735) . . . . . . . . . . . . 4b e Check: 0 NonconventlOl'lal source fuel credit d 'QEV credit (atloch Form 8834) 4c d Ornr,"1 bu!;lness credit. Enter here and check which fOlms are aUoohed: 03800 03<168 05884 06478 06765 0 R586 08830 U 8R26 08835 [] 88-14 088<15 08846 088?O 0 88<17 e CIrri" ffir ",lor ~:1f minimum lax (Attach Form 8827) 5 t otnt credfts. Add lines 4a through 4e . . . . 6 SnbtrAclllne 5 from Roe 3 . . . . . . . . 1 Pr.rsonat holding company talt (attach Schedule PH (Form 1120)) 8 .hecaplllre taxes. Check ""om: 0 Form 4255 0 Form 8611 9 . Allr.rn:ttlve mh\hnum tax (attach Form 4626l. . . . . . . to 10tnl tax. Add lines 6 through 9. Enter here and 0I'l Bne 3t. page 1 . Other Information See a 15 of instructions. ------- 1 ct'?tk method of accounting: a 0 Cash I Was 018 COIf'OI..IIon a U.S. sh:veholdcr 01 allY con"nllF!d b fD Accrual e 0 Olher tspeclly) ~ . _ _ _ _ . . _ _ . _ . ; . . _ . . foreign COtporatlon? (See sccllons 95 t and 957.). . . 2 See page t7 of the Instmctlons 8l1d state the prhlClpat: " .Ves; Attach Form 5<171 lor each sIlCh cOlporalion. Jt ellShlC!'lS Acllvlty code no. ~..... _ ~. 9. J. f! . .. . _ . .. ~.. ... Enter number 01 F OIms 5471 attached ~ - . . -.. - . -- . . .. .. b etlslnC!lS actlvlty ~ _ ... .!.?f?..f..ri.:!.i~ f1:t!?A..; ..... At anyllmedurin9ltIP- 1996 calendar year, rid Ih'! <:"",",nlio" e P,odllCt or servk:e ~ ............~'!!..~~.~............ have an Inlereslln or" slgnab.e or olh,,, Aulholily ovrr 1\ 3 Old Ihe corporatton aUhe end olthe tax year own. dfrectly financial account (such as a oonk acCOlHIt. scr.lnilies or Indirectly, 50% or more of the voting stock of a account. or othe, .,,-mcml accounl) In a lorciqn COII,,"y1 domestic corporalfon1 (For rulft of attribution. see . " .Ves; the corpornllon m;ty have '0 flte For", 10 HIO-22.1. secllOl'l 267(c).) . . . . . . .' . . . . . If .Ves; enter name of foreign countty ~ -.............. During the 'ax yP.'8f(. did the corpomtlon r~ l1 ffislllhllllon ; ".Yes; atlach R schedule showing: (a) name and identifying from, or was it the glen'or of. or trlll15lr.rOllo. n Irn~lryl "U!'ln . r1umhcr. tb) pet'centll9'" ownr.d, and (cJ taxable tncome or If .Ves; see page 16 0' lite instructions lor olllP-' lotom the (lo!~' hefore NOt nnd special deductions 01 such corpetatlon corporation may have 10 lite . . . . . . . . . lor the tall year endk'!i with or within ycu tax year. .. I!: 'he COIpornlfon 1!I !;1tbskfi:vy In an &flllaled group or a Im'ent-subsldfary r:OIlfrolled group? " .Yes; ante\ employer kk!nllllcatlon number and name of the perertt corpotatlorl .. __....... --.. .... .. ... ...... (2)1$ Schedule ~ .................. ........... _w..................................................-.. -.... .........-....... 5 DId any individual, parlnershlp, corporRtlon. estate or trust at the end of the tall yem- own, dlreclly or tndirectly. 50% or more of the corrorallon's voting stock? (For rutes ot Al1rlbullon, see section 297(c).) . . . . . . . " .Vf!<;; all='Ch A schedule showing name and IdentRytng number. (Do nOt hlCtude any InformaUorl already entered In 4 'above,) Enter percentege owned ~.........;."..... During this tAli year, did the corPoration pay dvIdends (other II"", stock dIvkimds lInd dsfllbutlons In exchange for stock' In excf!SS or 'he corporation's current And acctmIaIed f':tll1'n9S And prollfs? (See sees. 301 and 316.). . . . If .Vl!!l; me Form 5452. " this Is a consolldated return, :fh>:w"r hPle 'or the pau,"t corporlltlon 8lld on Form 851. Afflllallon! Schedule, fOl each subsidiary. e (3)15 -0- -0- rage 3 -.!- 6 ...1._ 8 -----_.. 9_ ___ .__._. to - U - DId one foreign (lefSflfl lit any lime dlJrhtg IIIf'! Ime YPlIf OWO. dhctly or indirectly, III ""as! 25% 01: tn) 11m tmlll vot;nC1 pOWf'f ot all classes of stock 01 lIlfl corporAl ion l!lIlill.ut to vole. 0< Cb) the tolalva.1e 01 aIIclassesot stock oIlhe cOlporallon1lt .Yes," . Enter percerltage owned ~ ... ...... ...:. ....... ...... .... b Enter owner's country ~... .....__ ........_...... -. -.. ..-, e lhe COtporRUorl ",ny fmve 10 tile Form 5" 72. enlr.r number o' Forms 5<172 attached ~ ._._ ...._..... -.....- -...... -.. Check this box if IIIf'! cOIporllllon Issumt publicly offmed debt Instrumerlts wllh orIgin,'" Is!;ue ooeollnl. .. LJ tf so. the cOfpotAtIon may have 10 fUe r orm 8::>81. Enler the 8mount of Inll.exempt I"tetest rocelved or accrued during It\e tax year ~ $ .. . N a Ill!.. . . .. .. .. . .. - " there were 35 or fewer stlllreholders at Ihe end of the tax year. erlter the number ..... .!L.................._ If Ihe corporAl/on 1",)5 an Not. for It1f! tAX yr.rn- nnd Is electing 10 forego the carryback period, check hCf P. ... 0 Enter the available NOl carryovP.l' from ptlnr Inll yr.ms (Do nol reduce It by Any dedllcllorl Oil lill\'! 29a.)~$ 26 384.02 V~!I No \01 '-l{ ;W ~~- ~:-:~ :}~: ~:~ ~;, '.<i;." ~ ,"c-.'< ~~:~ ~::, ~.~.~ ~~~ ';~i-- ;~ ,~, ,....,,, ':~: ~~ ~~ .- ~':~~ ..~,~- :.~~~ ~~~.~ ,~ ') CA!:h . . . . ; . . . . . ~" Trade notes and accounts recefv8ble . bLess mtowance for bed debts 3 IllvP.l1torles . . . . . . . . . .. U.S. government obligatIOns . . . 5 Tl'lx-exempt securities (5ee instructions) . 8 Other CUfrellt Assels (attach schedule) 7 LOl'lIlS to stockholders . . . . 8 MmtQAge AlId 'eAt estate loans 9 Oll'er Inveslmenls (attach schedule) . 103 Buildings and other deprecIable assets b l..ss AccumulAted depreclallon 1 tit OppletAble Assets . . . . b lpss accumulated depletion . '2 llmd (net of any amOfllzallon) . 13:'1 IntAngIble A!:sets (amorllzAbIe orlly) b Lpss eccumulated amortization ,.. OthP.l RSsr.ts (attach schedute) . . 15 Tolalassets . . . . . . . . ... L1abllllles and stockholders' EquIty 1tt Accounls paYAble . . . . . . . 1 7 MorlgagllS. nol!!s. bonds payable In Iesslhan 1 year t R OlhP.l Cl "'P.Ilt Hahllilles (attach schedule). . 19 IOl'lIl!\ Irom stockholders . . . . . I . 20 MOlIq~. noIes. bonds payable In 1 year Of more 21 OtllP.r IIAhIIllles (allach schedule) . 22 Capital slock: "Prelerred slock b Common slock ----.-.---- 23 PAlrt.klO1cnpllAlsurplus . . . 2J._~1..1.t_OO_ ~~..~~~ .__~},j_~l..P!) .. "",.......*""" -......,..... """'" "'''''''' ...~\:~ 25 n"tnlnP.d earnIngs-UnAppropriated . 1 9. .~~ ~=~ ,-, 8''7 ..:IiI 28 Lp!ls cosl of Irea!ltJly !IIock . . . . . . } ~~ ,~ ( ) ~! Total HabllIlles and stockholders' equity. . LiL .~* _i2..iLl..!LL. 7/ t~ote: rOll :l/C 110' ICquired fo complete Schedules M-' and M-2 below" fI", fotal asse's OIrlille '5. columll (d) 01 SdlCdulc t :Ill! less lImn $25.(}()o. ReconciUaUon of Incom4! (Loss per Books With Income per Return (See page 16 of illslructiolls.,- Nellncome (loss) per books . . ., 23, 704 . 4 9 7 Incorne rocorded on bookslhls yea:;~ __'~'~~t~ redP.lftllncorne tAX . . . . . . . . Included on lids rclurn (llemlzel: . ~.R1"~1 excess of cllpllRllo9ses over cnpftal gains , Tall-exempt Inlerest S .......--........ ~~,~ Income sllblecllo tax not recorded 011 books m" __'" - __ ..... ...... m _... m -...... .~~~~ Ihls yearlllemlze): _ __ ......__....__ ...... ...- ........, -............ -....... -...... --.. Balance Sheets Assets S,:hetlule M.1 t ~ 3 .. ... .... -................................... -................... --..................... 5 Expense!! 'ecorded on books "115 year not deducted on thl!! return (Itemize): " Oef1leclatlon . . . . $:............ m' b Cor,Irlbullohs cmryovet $ .. __ __ .. .. .. . . .. . c Travel Bnd eI1lertalnmel1t $ ....--..----..... .................... --..-................ -...-....................-............ ......... ..... ................ -.................... ................ ....--.............. ---..... 8 Sth~dul~ M.~ t Balance at bf'glrwllng at ytmr . . . 2 Net Income (Io!!sl pet' books . . . 3 Other Incr eases (1len1lzel: __.. _ _ __ . . .. . _ __. . . .......... -..-.... ...--........ ............~. ...... ......._--.. ....... ---......... 4 Add lines t. 2, Bnd 3 Pag~ 4 End 01 tax year (d) 1 706.88) ~~1 , ~, 4 9. 1 0 7 ...Q2 276.594.75 1U,UUU.UU ~,~..~~":~~ ) 8 Oeductlons 'on this ,eturll not chatgctf IIq:'llnsl hrJc>k Ir\COIn" thIs YI!l1f (It';1I\1711): . Of!prl!r:I:'lllOll . . . . $............ b Contributions carryover $ _. __.. . .. . . - 70L 49 It CR!!h, . b Slock t: Propcrty. 8 Olher decreases (IIemlze): __ __ . m _ .. _ . 7, J\ddlfnp.!l5nnd6 , . . . . . 8 Balance al end of ear (Ine 4 less Ible 7) 8 187.3U . . Form 1120 u.s. Corporation Income Tax Return Depaftmenl 01 the TreeSlJry For calendar year 1995 or tax year beginning 3.=-.1..., 1995, ending 2. :-.29.. , 1996 lnIemaI Rev-. SeMce ~ Instructions are separate. See page 1 for Paperwork Reduction Act Notice. ~ ~~~retum Ul ***.***..** 5-DIGIT 18237 B~ldentIfIcatIonnumber (attach Form 851) 0 ::XC 23-2000933 B9b S26 5 30 M I 23: 2000933 2 ~~CO.D OIldANVO BROTHERS INC R CDatelncorporated 3 PersonaIseMcecorp. w1b09 E BLAINE ST 175 S 5-20-76 ~~t4~~~ ~MCA])OO PA 1823,7 DTotaIassets(seepage601inslructions) E Check applicable boxes: (1) 0 initiai return (2) 0 Final return (3) 0 of address $ 507 053 85 1a Gross receipls OJ sales I 696 I 864 12 t Ib Less retools and allowances 1 907 I 43 I C BaI ~ 1c 695, 956 78 , ',. 2 ,Cost of goods sold (Schedule A, line 8) 2 4 9 9 , 5 4 4 8 5 3 Gross profit. Subtract Hne 2 from Hne 1 e 3 1 9 6, 4 1 1 9 3 4 Dividends (Schedule C, line 19) . . '. 4 5 Interest. . . 5 6 Grossrents....... 6 7 Gross royalties. . . . .. 7 8 Capital gain net income (attach Schedule 0 (Form 1120)) 8 9 Net gain or (loss) from Form 4797, Part II, line 20 (attach Form 4797) 9 10 Other Income (see page 7 of instructlons-attach schedule) 10 11 Total Income. Add lines 3 through 10. . . . ~ 11 ,,; 12 Compensation of officers (Schedule E, line 4) . 12 c o 13 Salaries and wages (less employment credits) . 13 g 14 Repairs and maintenance. 14 "i '0 15 Bad debts . . . 15 ~ 16 Rents . . .' . 16 ~ 17 Taxes and licenses 17 o ~ 18 Interest. . . . 18 ~ ~ 19 Charitable contributions (see page 9 of instructions for 10% limitation) 19 .e 20 Depreciation (attach Form 4562) . . . . . . . . . . ~ 21 Less depreciation claimed on Schedule A and elsewhere on return ~22 Depletion ....... S 23 Advertising. . . . . . . .~ 24 Pension, profit-sharing. etc., plans I 25 Employee benefit programs . . 26 Other deductions (attach schedule) . ~ 27 Total deductions. Add lines 12 through 26. . ~ g 28 Taxable Income before net operating loss deduction and special deductions. Subtract line 27 from One 11 'i 29 Less: a Net operating loss deduction (see page 11 of Instructions) 29a o b SpecIal deductions (Schedule C, IIhe 20) . 29b Taxable Income. Subtract line 29c frOm line 28 . Total tax (Schedule J, line 10) . . . . . Payments: 11994 overpayment credited to 1995 ! 1995 estimated tax payments .. 32b. c Less 1995 refood applied for on Form 4466 32c ( e Tax deposited with Form 7004 . . . . . . . . . . . 32e Credit from regulated Investment companies (attach Form 2439) . 32f Credit for Federal tax on fuels (attach Form 4136). See instructions 32h Estimated tax penally (see page 12 of instructions). Check If f=orm 2220 Is attached ~ 0 33 Tax due. If line 32h ls smaller than the total of Hnes 31 and 33, enter amount owed 34 Overpayment If Une 32h Is larger than the total of lilies 31 and 33, enter amount overpaid. 35 Enter amount' of One 35 au want: CredIted to 1996 estimated tax ~ Refunded ~ 36 Under penalties of perjury. I declare that I have eX8I'IIhKI this retum.1ncluding accompanying schedules and statements. and to the best of my knowledge and belief, It Is true. conect. and complete. 0ecI8ndI0n of preparer (other than Ialcpayer) is based on an information Of which preparer has any knowledge. Gl E o u oS :I c . . i. III a. i III ! Sign Here Paid Preparer's Use Only 30 31 32 b I~~ f g 33 34 35 36 ~ Signature of officer OMB ~. 1545-0123 1]@95 , 8 218 42 40 970 74 21,088 00 23 424 57 56 361 91 219 826 20 (3 792 50) -0- -0- -0- Preparer's ~ signature , % c:vv Firm's name (or ~ yours If self-employed) and address Cat. No. 114500 Cost of Goods Sold (See oaae 12 of Instructions.) beginning of ve.. . . . . . . . . . . . . .' . . 1 J07,764 11 " " 2 496.60J 52 . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . 3 section 263A costs (attach schedule) . . . ; . . . . . . 4 (attach schedule) . . . . . . . . . . . . . . . . 5 787 78 lines 1 through 5 . . . . . . . . . . . . . . . . 8 805,155 41 tend of year . . . . . . ' . . . . . . 7 J05,610 56 ~ . . Sold. Subtract line 7 from line 6. Enter here and on page 1~ Ine 2 . . . . 8 499,544 85 1 Inventory at 2 Pun::hases 3 Cost of labor 4 Additlonal 5 Other costs 8 Total Add 7 Inventory II 8 Cost ot goods 9a C~ aft meIhoc:is used for valuing cIoslng Inventory: . . (I) IilI Cost as described In Rl!guIattons sectlon 1.471-3 ( ... (11} G Lower of cost or mart<et as described In Regulations section 1.471~ (Ill) 0 Other (Sp8cIfy method used and attach expI8natIon.) .. ._____._.___._.____.__.....__...._......_._.._._..._____________............... b Check If there was a wrttedown of subnormal goods as desa1bed'1n Regulations section 1.471-2(c). ., .. 0 c Check If the UFO Inventory method was adopted this tax year ftir any goods (If checked, attach Fc:irm 970) .. 0 d If the LIFO Inventory method was used for this tax year, enter percentage (or amounts) of cIoslng 1 .1 ~ Inventory computed under LIFO . . . . . . . . . . . . . . . . . . . . l!!L1 e Do the rules of section 263A (for property produced or acquired for resale) apply to the corporation? .. . 0 Yes NO t ~~~~~~.~~.or~.~~~~~~?I~-V~.~ Dves GiNo ~ DIvIdends and Special Deductions (See page 13 of , (III DIvIdends \bJ " (ct SpecIal deductions ~ instructions. rec:eIwd ta) x (b) 1 DIvIdends from 1ess-than-20%..owned domestic corporations that are subject to the 70% deduction (other tha1 debt-financed stock) . . . . . . . . . . . 2 DIvidends from 2O%..or-rnore-owned domestic corporations that are subject to the 80% deduction (othef than debt-fln8nced stock) . . . . . . . . . . . 3 DIvIdends on debt-financed stock of domestlc and foreign corporations (section 246A) .. Olvtdends on cet1aIn preferred stock of 1ess-than-20"-owned pubI(c utlHtIes. . . 5 DivIdends on certain prefemKs stock of 20"-or-more-owned public utllltles . . . 6 DIvidends from feSs:.tha1-20'Ko-owned foreign corporations and certain FSCs that are subject to the 70% deduction . . . . . . .'. . . . . ..' . . . 7 DIvkIends from 20'Ko-or-moie-owned foreign corporatlons and certain FSCs that are subject to the 8O'Kodeduction . . . . . . . '.' . . : . . . . . 8 DIvIdends from wholly owned fonlIgn subsIdI8ries subject to the 1Wl' deduCtion (section 245(b)) 9 TotaL Add lines 1 through 8. See page 13 of instructions for IlmItatIon . . . '. . 10 Dividends from domestlc corporations received, by a small business Investment company operating U'lder the SmaI BusIness Investment Ad. of 1958 . '. .' . . 11 DIvIdends from certain FSCs that are 8tJbIeci to the 100" decNctIon (section 245(c)(1)) 12 DIvIdends from affiliated group members SUbject to the 100')6 deduction (secUon 243(8)(3)) 13 Other dividends from foreign corporatIon$ not Included on lines 3,6,7,8, or 11 . ' . 14 Income from controlled foreign corporations under subJat F (attach Form(s) 5471) . 15 Foreign dMdend gross-up (section 78) . . . .'. . . . ~ . . . . . 18 IC-DISC and former DISC dMdends not Included on lines 1, 2, or 3 (secUon 246(d)). .. 17 Other dividends . . . . . . . . .. . . . . . . . . . . . . 18 DeductIon for dividends paid on certain preferred stock of public utIItIes . . . . . 19 Total dividends. Add Ilnes 1 ttvough 17. Enter here and on line 4, page 1 . ." 20 Total spedeI deduc:Uons. Add lines 9,10,11,12, and 18. Enter here and on line 29b, Compensatton of OffIcers (See instructions for line 12, page 1.) Complete Schedule E oniy " total I8C81pts (line 1a plus lines 4 through 10 on page '. Form 1120) lJfe $500,000 or mote. , . Ie) Pen:ent of (bJ SocIiII secwtty number time devoted to Fdrm "120 ('l995) Schedule A teJ ...,. of oIlIcer \ 'HI 'Ko 'HI 'Ko 'Ko 2 Total compensation of officers. . . . '. . . . . . .'. . . 3 Compensation of offlcers claimed on Schedute A and elsewhere on return 4 Subtract line 3 from Dne 2. Enter the result here and on line 12, 1 Page 2 70 80 - 42 48 70 Cd) Common 'HI 'HI % " % (t't Amount of compensation (III Pr8femId 'HI l)(. 'Ko % " " Tax Com lion See pa e 14 of instructions.) .' 1 Check If the corporation IS 8 member of 8 controlled group (see sections 1561 and 1563) Importarit: Members of 8 c0ntr0lied group. see:lnStiuctions on page 14. j 2a If the box on line 1 IS checked, enter'the corporation's share of the $50,000,$25,000, and $9,925,000 taxable Income brackets (In that order): . (1) I $ II (2) I $ (3) $ b Enter the coiporatlon's share of: (1) AddItional 5% tax (not more than $11,750) 1$ (2) AddItI0naI 3% tax (not more than $100,000) I $ 3 Income tax. Check this box If the corpocatIon Is a QUalified personal seMce corporation as defined In section 448(d)(2) (see instructions on page 15). .. . . ~ 0 48~ Foreign tax credit (attach Form 1118). .' . . . . . . . . . . . . 4a b Possessions tax credit (attach Form 5735) . . . . . . . . . . . . 4b c Check: 0 NonconventIonaI SOl.II'Ce fuel credit 0 QEV credit (attaCh Form 8834) 4C d General business credit. I:ntei here and check which forms are. attached: o 3800 0 3468 0 5884 0 6478 0 6765 0 8586 0 8830 o 8826 0 8835 0 8844 0 8845 0 8846 0 8847 e Credit for prior ye8t minimum tax (attach Form 8827) 5 Total credits. Add lines 48 through 4e . . . . 8 Subtract line 5 from line 3 . . . . .. . . 7 Personal holding company tax (attach Schedule PH (Form 1120)) 8 Recapture taxes. Check If from: 0 Form 4255 0 Form 8611 9a Alternative rnInImliri1 taX (attach Form 4626). . . . . . . b Environmental tax (attach Form 4626) '. . . . . . .. . 10 Total tax. Add lines 6 9b. Enter here and on line 31, 1 Other Information See 17 of instructions. 1 Check methOd of accounting: 8 0 Cash es No 7. Was the corporation a U.S. shareholder of any controlled b 0 Accrual cO Other (specify) .. n...__~.._n'__... foreign corporation? (See sections 951 and 957.). . . 2 See page 19 of the Irtstructloris ~ B'8 the principal: If "Yes,. attach FOrm 5471 for each such corporation. a BusIness activity code no. ~.......:._.._____......._... Enter FIUITlber of Forms 5471 attached ~ "m'n__n..n b Business activity ~... J!-.i:.!:<J:.~!:..:I ~~!?1. - U m', 8 At any time duing the 1995 calendar year, did the corporation c Product or service ~ .~..u.'!:~_.~~______._....__'.n. have an Intef'est In or a sIgnatur9 or other authority over a 3 DId the corporation at the end of the tax year own: dlrectty fIniIncIaI iIccotrt In a foreign COU1try (such as a bank or indirectly, 50% or fnO!'8 of the voting stock of a account;secuitIes account. or other financial account)? . domestic corporation? (For rukis of BttrIbtJtIon, see If "Yes,. the corporatlon may have to IDe Form TO F 90-22.1. section 267(c).) . . . '.' . . . . ',' . If "Yes: enter name of foreign coootry .. .____n........ If "Yes,'; attach a schedule showing: (a) name and IdentIfylng Was the corporation the grantor of, or transferor to, a foreign trust that existed dt.R1ng the cll11ll1t tax year, whether or not number, (b) percentage owiled, and (c) taxable Incame. or the corporation has any beneflclaIlnterest In It? If .Yes," the (loss) before NOt. and specI8I deductions of SUch corporatlon corporation may have to tHe Forms 926, 3520, or 3520-A for the tax year ending with or within Y!D tax year. '. DId One foreign person at any time <bing the taX year own, . 4' Is the corporation 8 subsIdlery In an afftIIated group or a directly or indirectly, at least 25% of: (a) the total voting power parent-subsldlary controlled group? . . . . . of all classes of stock of the corporation enUtIed to vote, or (b) If "Yes,. enter employer identification number and name htobil value of all classeS of stock of the corporation? If "Yes, . of the parent corporation ~ ._...........................'. . Enter percentage owned ~ ...........'h.'h.___..._..... -............ "" ..... ...... ......_...~................~... b Enter owner's country ~h_" ._. _.... ,__ _ ._. 0'_ _..._.. .,., c The corporation may have to file Fonn 5472. Enter number Of Forms 5472 attached ~ ..o........_....___.m_...__h Check this box If the corporatlori Issued publicly offered debt Instruments with ortgInallssue discount. ~ 0 It so, the corporation may have to file Form 8281. Enter the alliount of tax-e~N Interest received or accrued during the tax year" $ . .. ~_'!:~.. __ __.. ... . __ _ , ~ there were 35 or fewer ~ at the end of the tax year, enter the number ~. ___. ___ . _ .., ___ _ . ___ __ . ___ If the corporation has an NOL for the tax year and Is eIectIhg to forego the carryback period, check here ~ 0 Enter the available NOL carryover from prior tax years (00 not recI.I.K<.e jt by ~ deduction on line, 298.)'" LL1591.52 . . , . I Fonn 1120 (1995) Scf1edule J Schedule K 6 Old any individuai, partrt8rshIp, corporation, est8te or . trust at the end of the taX year own, directly or indirectly, 50% or more of the coi'poration's voting stock? (For roles of attrtbutlon, see section 267(c).) . . ". . . '. . If "Yes,. attach a schedule showing name and identifying number. (00 nbt Include any information already ~ered In 4 above.) Enter peroentage owned ............___.... DurIng this tax year, did the corporation pay dMdends (other than stock dividends and dlstrlbutIons In exchange fot stock) In excess of the corporation's ctm!I1t and acc:uri1uIated earnings and pr'bfits? (See sees. 301 and 316.). . . . If "Yes," file Form 5452. If this Is a consolidated return, answer here for the parent corporation and on Form 851, Affiliations Schedule, for each subsidiary. ,6' ." -0- -0- 5 6 7 8 9a 9b 10 Page 3 1 Cash. ....... 2a Trade notes and accounts receivable." bLess aHowance for bad debts . 3 Inventories. . . . . . . . . 4 U.S. government obligations . . . 5 Tax-exempt securttles (see instructions) . 6 Other current assets (attach schedule) 7 loans to stockholdets . . . . . 8 Mortgage and r9aI estate loans . . ' 19' ~' Othef Investments (attach schedule) . 108 Buildings and other depreciable assets b less accumulated depreciation 11 a Depletable assets . . . . b less accumulated depletion . 12 land (net of any amortization) . 13a Intangible assets (amortizable only) b Less accumulated amortization 14 Other assets (attach schedule). . :15 Total assets . . . . . . '. . . Liabilities and Stockholders' Equity 16 Accooots payable . . . . . . . 17 . Mortgages. notes. bonds payable In less than 1 year 18 Other cooent labilities (attach schedule). . 19 Loans from stockholders . . . . . . 20 Mortgages. notes, bonds payable In 1 year or more 21 OtherllabiHtIes (attach Schedule) . 22 Capital stock: a Preferred stock b Common stock 23 Paid-In or capital surplus . . . 24 Retained eamlngs-Appropred (attach SChedule) 25 Retained eamlngs-Unappropriated . . . ( 1 5 , 5 1 7 . 1 9 ) 26 Less cost of treasury stock . . . . . . ) 27 TotalllabllltleS and stockholders' 522 04- 9 . 26 507 , 05 3 . 85 Note: You are not requked to complete Schedules M-11MJd M-2 below if the total assets online 15, column (d) of Schedule L are less than $25,000. ReconciliatIOn of Income (Loss per Books With Income per Return See e 18 of instructions. 1 Net Income (loss) per bookS . : . . 3 792. 5 0 7 Income recorded on books this year not 2 Federal Income tax . . . '. . . . . Included on this return (itemize): 3 Excess of capital losses over capital gaInS ~ Tax-exempt Interest $ u. u. u' _ _ m. __ 4 Income subject to tax not recorded Of!. books u.. u u' u U _ __ _ _. _ _ m __ u _ __. __. _ _ m. this year (itemize): .___ u... ___ __ _ _., u _ ~ u u. __. _ __ __ _. _. __.. __. _' __ _.._ _'_ __ u __. _ _.. . A , Porr/1 1.20 (1995) Balance Sheets Assets Schedule M.1 , 5 Expenses recorded on books this year not. deducted on this retuI1'l (itemize): a OeprecIation . . . . $ .u_____~_____."__ b ContrIbutIons carryover $ ... __ __ _. _ __ __... c Travel and entertainment $ ____.___.__.....~ .... ~........ ~........ ~.............. ....... .....--...-- .....- ...-- -.. -.... --......-- 5 . . . . . Analysis of Una 1 Balance at beginning of year . '. . 2 Net Iilcome (loss) per books . . . 3 Other Increases (itemize): u m.. u __ _ m' __. , , ........................ ---.. --................................. --.. -- - - - - -..- 4 Add lines 1, 2, and 3 "" I.. I . Page 4 39,657.73 224,000.00 2,672.68 30,262.26 202,645.37 8 Deductions on this return not charged against book Income this year (Itemize): . 0eprecIatI0n . . . . $___.00______ b Contributions canyover $ _. _ __. __ ... ) a Cash. . bStock . . . . c Property. . _ . 6 Other decreases (itemize): _ _ _ _... _ ___ _. 7 Addlines5and6 . . . . . . 8 Balance at end of year (Roe 4 less Une n ( ,517.19) , ,...' # ~ - 002092 FIRSTAR BANK NA CUST JOHN C WANYO IRA 3 HOERNER CIR BOILING SPRINGS, PA 17007-9708 1...111...111...11" .1...11.1..1...111...1'11.11.....11.1..1.1 ~ Strong Funds: IRA - _"""'~"""'n"'_".lm __'1{_1~'III'___ _ " ~ I .. Investment I~eport January 1, 2000 through December 31,2000 Strong Investments, Inc. P.o. Box 2936 Milwaukee. Wisconsin 53201 Phone: 1-800-368-3940 Automated line: 1-800-368-1050 Internet: \Mww.estrong.com Simplify your portfolio. Open a Strong Preferred Brokerage accoUl ,t today. Access a complete array of investment opportunities: stocks, bonds, and over 2, 000 mutual funds, plus our best commission rates. Call us at 1-800-368-3940 to learn more. TOTAL ACCOUNT VAWE As of December 31,2000 $142,817.79 CHANGES IN YOUR ACCOUNT VAWE Beginning Balance (1-1) Deposifs Withdrawals T otallncome Gainsllosses $198.518.15 0.00 0.00 7,230.87 -62,931.23 :.::IIi!:IM:ellll.lll!j.l:l:I:I:l.:::!::.:l..:!:I:.:.:1::::1:1::':::.1:::::::::::::::::,:::.:':::::::1:111111: INCOME SUMMARY This Period Year-to-Date Dividends Taxable Tax-ExemptlDeferred Capital Gains (paid by holdings) Short-Term 4,803.68 Long-Term 2,329.44 $0.00 97.75 $0.00 97.75 4,803.68 2,329.44 $7,230.87 Total Income $7,230.87 ACCOUNT HISTORY ~: ;I. JHnJnMI(I;-~ SO I I. nlnn nn 12-99 3-00 6-00 9-00 12-00 ~ Total investments (deposiU less M1hdrawals plus dhIidwtds 18inves1.ed) . Total aa:ocmt value CURRENT ASSET ALLOCAnON . Domestic Stock 100.0% Intemational Stock 0.0 Taxable Bond 0.0 Tax-freE- Bond 0.0 Cash and Equivalents 0.0 100.0% (cont'd on back) Paae 10f6