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Home My WebLink About09-19-05 REV. t500 EX (6-JOl W I- :.:~(J) UO:::': Wl1.U :I:OO UO::..J l1.lIl l1. <( COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2 1 - 0 5 o 0 4 0 COUNTY CODE YEAR NUMBER I- Z W o W U W o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) CLECKNER, RIC~qn W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 12/24/2004 09/21/1926 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) CLECKNER, MARGARET 0 [Xl 1. Original Return D 4. Limited Estate [5S 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received I- Z W C Z o l1. (J) W 0:: 0:: o U Ann E. Rhoads FIRM NAMI;, (If ApRjicable) CleCKner and TELEPHONE NUMBER 717-238-1731 Fearen 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) SOCIAL SECURITY NUMBER 726 05 4641 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER 0 WILLS SOCIAL SECURITY NUMBER 174 20 3091 D 2. Supplemental Return D 4a. Future Interest Compromise (dale of death after 12-12-ll2) [R] 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (dale of death between 12.31.91 and 1-1.95) 4. Mortgages & Notes Receivable (Schedule D) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) z o ~ ..J ::J t:: c.. <( U w e::: 14. Net Value Subject to Tax (Line 12 minus Line 13) (1) (2) (3) (4) (5) (6) (7) (9) (10) D 3. Remainder Return (datelofdeath poor 10 12.13-ll2) [R] 5. Federal Estate Tax Ret~rn Required I ~ 8. Total Number of Safe ~eposit Boxes I D 11. Election to tax under 1ec. 9113(A) (Attach Sth 0) .,'_ '.e.X}: 119 Locust Street P. O. Box 11847 Harrisburg, PA 17108-1847 0.00 693,4~7.50 750.00 648,035.32 602,076.74 OFFICI t..PSE ONLY ')) II,~ ..::.:1 .' ,'1 ....J ,"") ,1 );~~ I 1- .:;;~ j'.) :::J :=-~ ."'... r~ il j'l ,;' ') . '" '-:) " 1 162,056.20 q) cj) \ 886,800.28 (8) 2,993,146.94 44,814.60 0.00 (11) (12) (13) 44,814.~0 2,948,331.~ I 0.90 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) I I 2, 948 , 331. 4i4 0.00 I I 59,89.2.1li~ I I 0.00 , o.ob I I 59,892.!L~ ....- :tb . ~~~#;:J~~~t~-'1~~:j Z 15. Amount of Line 14 taxable at the spousal tax 0 1,617,394.~6 x.o~ ~ rate, or transfers under Sec. 9116 (a)(1.2) (15) l,33Cl,936.98 x .0 45 ~ 16. Amount of Line 14 taxable at lineal rate (16) ::J c.. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17) ~ 0 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18) U X 19. Tax Due (19) ~ 20. Decedent's Complete Address: STREET ADDRESS 1119 Country Club Road CITY I STATE PA Camp Hill Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) I ZIP 17011 ! i 1 591892.16 0.00 58,000.00 ~.nn? 1:)4 Total Credits (A + B + C ) (2) 61,002.54 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 0.00 1~110.38 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 0.00 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 0.00 ~~~~~Hm'JB~~~~--::i~WIll!__~~"2.~~~~~'Z] PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did :Jecedent make a transfer and: Yes a. retain the use or income of the property transferred:.......................................................................................... IX] b. retain the right to designate who shall use the property transferred or its income; ............................................ IRJ c. retain a reversionary interest; or.......................................................................................................................... IX.] d. receive the promise for life of either payments. benefits or care? ...................................................................... 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .....................................................................................................,.................. [X] No n o o ~ o ~ o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perJury, I declare that I have examined thiS return, including accompanying schedules and statements, and to the best of my knowledge and belief, il is true. correct and complete. Declaration of preparer other than the personal representative is based on all infonmation of which preparer has any knowledge, SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~ c:6t.. a.r~J'4./ 'largaret D. Cleckner ADD S 1 19 Country Club Road, Camp H111, PA 17011 ~ctJATURE OF PR~AR~HER THAN REPRESENTATIVE ~ ~.\~ AnnE. Rhoads ADDRESS P. O. Box 11847, Harrisburq, PA 17108-1847 D~E 9 //.:z.~ ~ l DAT~ '1 }~ D~ :~~~:~~:~~.~.:_:~ -;.-:~r~232~~~'1Z&~~~:1~:t:~~'5'":'~:~~~~s}":!1-t~r~~~~~~~~$~~~~~~2:J For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after J; b \. (-=- The statute does r,ot exemot a I the surviving spouse is the only t k: \ For dates of death on or after Jui ('\ P 0 The tax rate imposed on the ne rl or a stepparent of the child is O"lr ~. ~ The tax rate imposed on the net -J ~~ dent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S..~9116(a)(1)]. The tax rate imposed on the nl decedent's siblings is 12% [72 P.S. 99116(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. \ I I \.r:C q \(-. '...,r '15(:-' ..... (_.J'-J . ('~, net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. he statutory requirements for disclosure of assets and filing a tax return are still applicable even if (~G mty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent. REV.I503 EX. (1-97) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 2. 3. 4. ESTATE OF CLECKNER, RICHA..1:ID H. FILE NUMBER 21-05-0040 '1 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Morgan Stanley Account #410-02227-103: A) 175 she Sanpuaolo 1m: Spa Ads @ 28.40 B) 285 she Vodafone GP PLC ADS @ 26.99 C) 55 she Total Fina E/F S/A @ 109.09 D) 135 She Glazo Smith Kline PLC ADS @ 46.83 E) 270 She Tesco PLC Sponsored ADR @ 18.00 F) 90 She Royal Dutch Pete NY 12560 @ 56.95 G) 80 She Enel Societa Per Azioni @ 49.01 H) 35 She Roche Holdings ADR @ 113.25 I) 100 She HSBC Holdings PLC Spon ADR New @ 85.00 J) 40 She Swiss Reinsurance Co. Spon ADR @ 72.35 K) 135 She Unilever PLC (New) ADS @ 39.30 L) 55 She ENI Spa AIDer Dept Rcpt @ 125.50 M) 100 She BP PLC ADS @ 58.88 N) 19 She KAO Corp. Spons ADR @ 245.50 0) 325 She Societe Generale SP ADR @ 20.15 p) 180 She AXA ADS @ 24.58 Q) 110 She Novartis AG ADR @ 49.62 R) 140 She Credit Suisse Group @ 42.05 s) 100 She Diageo PLC Spons ADR New @ 56.90 T) 55 She Siemens AKTIENGESELLSCHAFT @ 83.71 U) 185 She Compagnie Fin Richemont ADR @ 33.00 V) 110 She UBS AG New @ 83.95 t\l) 145 Sh. Danske BK A/S Spon ADR @ 30.00 X) 55 She Scherling AG @ 74.14 Y) 295 She Nomura Hldgs Inc. @ 13.75 Z) 116 She Sanofi Aventis ADS @ 39.74 AA) 205 She Barclays PLC &~~ @ 44.95 BB) 240 She Cadbury Schw PIc ADR 10 Ord NV~ @ 37.60 CC) 115 She Canon Inc. ADR New @ 52.67 DD) 175 She Heineken NV ADR @ 33.60 EE) 75 She Nestle Spon ADR Rep. Reg. Shr. @ 65.10 FF) 315 She Nokia CP ADR GG) Tax Free Daily Income Trust 148 She MetLife Common @ 40.59/sh. 14614.07 MTB Group Funds Pa. Tax Free ~1I1 @ $1.00/sh. 6411.937 She MTB Group Funds Pa. Mun. Bd II. @ 10.36/sh. CONTINUED ON ATTACHED SHEET VALUE AT DATE OF DEATH I ',4,970.00 :7,692.15 :5,999.95 16, 322 .05 !4,860 .00 ':5,125.50 :3,920.80 ',3,963.75 1,8,500.00 [2,894.00 i5 , 305 . 50 !6 , 902 .50 !5, 888 .00 ::4,664.50 , \6,548.75 ~,424.40 i5 ,458 . 20 !5,887.00 5,690.00 i ~,604.05 0,105.00 9,234.50 ~,350.00 't!,077.70 '(!,056.25 ~,609.84 ~,214.75 9,024.00 ~,057.05 p,880.00 .f.l,882.50 4,989.60 6,633.93 I , ~,007.32 , 141,614.07 , 6Et;,427.67 , TOTAL (Also enter on line 2, Recapitulation) $ 693,427. 50 (If more space IS needed, Insert additional sheets of the same size) ESTATE OF RICHARD W. CLECKNER FILE NO. 21-05-0040 CONTINUATION SCHEDULE B. (Stocks & Bonds) ITEM NUMBER DESCRIPTION I I i VALUE AJ DATE OF D+-TB i i I I 5. Morgan Stanley Account #410-022228-103: A) Northhamption SD Bond B) Highland SD-REF Bond C) Governor Mifflin Bond D) Big Spring S.D. Bond E) Franklin County Bond F) Moshanno Valley S.D. Bond G) W. Allegheny S.D. Ref. C. Bond H) Downingtown S.D. Bond I) Chambersburg S.D. Bond J) Harrisburg Water-Ref. Bond K) Tax-Free Daily Income Trust i I i 41,483.6b 35,087.1b 40,236.ob 34,859.6i 35,907.9 34,212.5 40,389.6 40,572.4p 39,584.8~ 37,677.5~ 3,563.1* 6. Three (3) $10,000 Series EE Savings Bonds, issued 01/2002 7. $5,000 Series I Savings Bond, issued 06/2001 16,344.0~ i i 5,908.0~ I 8. $10,000 Series I Savings Bond, issued 06/2001 I ll,816.0~ REV.150A c. + 1..891 ~ ,~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLECKNER, RICHARD H. SCHEDULE C CLOSELY HELD STOCK, PARTNERSHIP AND PROPRIETORSHIP II Please Print or Type FILE NUMBER 21-05-0040 (Schedule C.1 or C-2 must be attached for each bUline.. interest of the decedent. other than a proprietorship.) ITEM NUMBER DESCRIPTION 1. Partnership with son, Richard W. Cleckner, Jr., t/d/b/a Cleckner Properties under partnership agreement dated October 4, 1995 See Schedule C-2 and attachment thereto VALllJE AT DATE OF DEATH , 750.00 TOTAL (Also enter on line 3, Recapitulation) Is 750.00 (If more space is needed, insert additional sheets of same size.) REV-1506 EX + 15-921 . SCHEDULE C-2 PARTNERSHIP INTEREST REPORT COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Please Type or Print FILE NUMBER 21-05-0040 ESTATE OF CLECKNER, RICHARD W The following information must be submitted with this schedule: . A. Detailed description showing the method of computation utilized in the valuation of the decedent's interest. B. Complete copies of financial statements or complete copies of the Federal Tax Returns (Form 1065) for the year lof death and 4 preceding years, including a balance sheet for the year of death. ! I I C. If the Company owned Real Estate, furnish a list showing the complete address/es and estimated Fair Market Vqlue/s. If Real Estate Appraisals have been secured, please attach copies. D. Any other information relative to the valuation of the decedent's interest. 1. Name of Partnership Cleckner Properties Federal I. D. Number 23-2822q95 (As per Form 1065) : Address 1119 Country Club Road Date Business Commenced ~ I I Camp Hill, PA 17011 Business Activity ownership qf rental real estata 2. Decedent was a [iJGeneral D limited partner. If decedent was a limited partner, provide initial investment S I 3. PARTNER'S NAMES % OF INCOME 1 % OF OWNERSHIP SALARY BAL NCE OF CAPITA ACCOUNT A. Richard vi. Cleckner B. Richard W. Cleckner, Jr. 50% 50% 50% 50% none none c. D. 4. Estimated Value of decedent's interest: S 750.00 5. Was the partnership indebted to the decedent? If yes, provide amount of indebtedness S 6. Was there life insurance payable to the partnership upon the death of the decedent? DYes IXl No DYes IKJ No If yes, Cash Surrender Value: S Owner of Policy: 7. Was there a written partnership agreement in effect at the time of the decedent's death? ~Yes D No If yes, attach copy of agreement. Net proceeds payable: S 8. Did the partnership have an interest in any other partnerships or corporations? DYes [X] No If yes, report the necessary information on a separate sheet, including Schedule "C-l" or "C-2" for each i~terest. 9. Did the decedent's interest in the partnership change in the year before death if the date of death was on or ~fter 12/13/82 or if death occurred prior to 12/13/82 in the last two years? D Yes 0 No If yes, explain: 10. Was the decedent related to any of the other partners? IXJYes DNo If yes, explain: Decedent is the father of the other partner 11. Was the partnership dissolved or liquidated after decedent's death? IXlYes D No If yes, report all the related information, including copies of the Sales Agreement and/or Settlement Sheet. Please SEE attached explanation. 12. Was the decedent's partnership interest sold? DYes [XJ No If yes, provide a copy of the agreemnt of sale, etc. IPlease note that although partnership agreement indicates that decedent had 25% interest, the partnership tax returns for 2002-2004 indicate that his interest was 50%, ESTATE OF RICHARD W. CLECKNER FILE NO. 21-05-0040 SCHEDULE C-2 Partnership Interest Report EXPLANATION OF VALUE OF DECEDENT'S INTEREST IN PARTNERSHIP KNOWN AS CLECKNER PROPERTIES This partnership was in the process of winding up its affa~irs and dissolving in 2004, prior to the Decedent's death. At the beginning of 2004, the value of the Decedent's capital account was $19,317.00; the value of the other partner's account was $56,759.00. See K-1s, Form 1065, 2004. At that time, the assets of the partnership consisted of a piece of real estate locatedl at 1015 Sherman Street, Linglestown, Dauphin County, Pennsylvania and a mutual funds account at American Express Financial Advisbrs (#01137282005-7-002) . . In September, 2004, the partners distributed the real est~te to the partners as individuals, each with a one-half (1/2) interest. Subsequent to the distribution, the Decedent gifted his one-half (1/2) interest in the real estate to his son and daught~r- in-law. See Deed dated September 10, 2004. A gift tax return ~as filed for the Decedent which valued this gift at $20,000.00. ~ee letter from Robert J. Murphy, CPA, dated June 20, 2005. The gift is shown on Schedule G (#s 6&7) of this return. As a result of the distribution of the real estate as described above, the Decedent's capital account was reduced to $750.00, which was its value at the time of his death. See Capital Account reconciliation enclosed in letter from Robert ~ Murp~y, CPA, dated June 20, 2005. Thus, the estate values the Decedent's remaining interest in the partnership at $750.00 as of his datel of death. REV-1507 EX + (7-88) w..... ~ ~~ SCHEDULE D MORTGAGES AND NOTES RECEIVABLE Please Print or Type FILE NUMBER 21-05-0040 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLECKNER, RICHARD W. (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION NUMBER 1. U.S. Treasury Notes Treasury Direct Account #1300-084-2118 A) 1 5/8 Note J 05 CUSIP 912828AWO Maturity date 3/31/05 Par $25,000.00 B) 1 1/4 Note L 05 CUSIP 912828BB5 Maturity date 5/31/05 Par $25,000.00 C) 1 5/8 Note Q 05 CUSIP 912828BL3 Maturity date 9/30/05 Par $30,000.00 D) 1 5/8 Note R 05 CUSIP 912828BN9 Maturity date 10/31/05 Par $25,000.00 E) 1 7/8 Note S 05 CUSIP 912828BS8 Maturity date 11/30/05 Par $25,000.00 F) 1 7/8 Note T 05 CUSIP 912828BU3 Maturity date 12/31/05 Par $25,000.00 G) 1 7/8 Note K 06 CUSIP 912828BX7 Maturity date 1/31/06 Par $25,000.00 H) 1 1/2 Note M 06 CUSIP 912828CDO Maturity date 3/31/06 Par $50,000.00 I,); 2 1/4 Note N 06 CUSIP 912828CF5 Maturity date 4/30/06 Par $25,000.00 J) 4 5/8 Note E 06 CUSIP 912827GX5 Maturity date 5/15/06 Par $25,000.00 VA~UE AT DATE qF DEATH 24,967.25 24,973.00 , 29,$58.90 24,945.25 24,968.75 24,~63.50 24,$73.25 , 49,980.50 24,990.25 24, $61. 25 CONTINUED ON ATTACHED SHEET TOTAL (Also enter on line 4, Recapitulation) S 648,03$ .32 I (If more space is needed, insert additional sheets of same size.) ESTATE OF RICHARD W. CLECKNER FILE NO. 21-05-0040 CONTINUATION SCHEDULE D. (Mortgages and Notes Receivable) ITEM NUMBER DESCRIPTION VALUE A'l1 DATE OF DEATH 1. K) 2~ Note P 06 CUSIP 912828CK4 Maturity date 5/31/06; Par $25,000.00 24,981.50 L) 2 3/4 Note Q 06 CUSIP 912828CMO Maturity date 6/30/06; Par $25,000.00 24,983.00 M) 2 3/8 Note S 06 CUSIP 912828CU2 Maturity date 8/31/06; Par $25,000.00 24,942.25 N) 2~ Note T 06 CUSIP 912828CW8 Maturity date 9/30/06; Par $30,000.00 29,930.30 0) 3~ Note F 06 CUSIP 9128277F3 Maturity date 11/15/06; Par $25,000.00 24,195.00 P) 2 7/8 Note V 06 CUSIP 912828DD9 Maturity date 11/30/06; Par $50,000.00 49,932.50 Q) 3 Note W 06 CUSIP 912828DF4 Maturity date 12/31/06; Par $20,000.00 19,953.82 R) 2 1/4 Note H 07 CUSIP 912828BY5 Maturity date 2/15/07; Par $25,000.00 24,942.50 S) 4 3/8 Note E 07 CUSIP 912828AC4 Maturity date 5/15/07; Par $25,000.00 24,889.00 T) 3 1/4 Note F 07 CUSIP 912828AH3 Maturity date 8/15/07; Par $50,000.00 49,776.00 U) 3 Note G 07 CUSIP 912828ANO Maturity date 11/15/07; Par $20,000.00 19,948.80 V) 3 3/8 Note K 08 CUSIP 912828BQ2 Maturity date 11/15/08; Par $25,000.00 24,937.25 W) 3 7/8 Note H 09 CUSIP 912828CH1 Maturity date 5/15/09; Par $25,000.00 24,941. 50 ".,~".,," . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY CLECKN&q, RICHARD W FILE NUMBER 21 - 05 - 0040 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM fJALUE AT DATE NUMBER DESCRIPTION I OF DEATH 1. Fulton Bank C/D #022-0164865 581,233.76 I 2. Fulton Bank C/D #022-0186599 371,515.28 3. Fulton Bank C/D #032-0171489 171,364.30 4. PNC Bank C/D #31000214361 591,614.84 5. PNC Bank C/D #31300243597 251,413.18 6. Ci tizens Bank C/D #6140772753 611,386.54 7. Citizens Bank C/D #6140792789 391,981.13 I 8 . Citizens Bank C/D #6140814634 22!, 670.15 1 9. Citizens Bank Checking Account #610060-505-1 1.00 10. II. 12. 13. 14. 15. 16. M&T Bank C/D #031003910719607 M&T Bank C/D #031003910983450 Payment under oral agreement with remaining partners in law firm of Cleckner and Fearen. SEE attached explanation MBNA C/D #402079150 Wachovia C/D #247412071503636 Sovereign Bank C/D #0575404272 Sovereign Bank C/D #2335253551 301,100.43 761,903.93 , 0.00 I 261,260.70 ! 64!, 353.96 , 271, 969.15 I 541,308.39 TOTAL (Also enter on line 5, Recapitulation) $ 602,076. 74 (If more space is needed, insert additional sheets of the same size) ESTATE OF RICHARD W. CLECKNER FILE NO. 21-05-0040 CONTINUATION SCHEDULE E. Decedent retired from his law firm, Cleckner and Fearen effective December 31, 1997. The law firm is a gen~ral partnership, the two remaining partners are Dennis J. Shatto and Ann E. Rhoads. These were also the only remaining partners at the time the Decedent retired from the practice of law. The partnership had no agreement regarding payment t<t> a retiring partner as there was in place a retirement plan under Section 401K of the Internal Revenue Code. At the time of the Decedent's retirement, however, the partners orally agreed that he would be paid one-third (1/3) of any receipts on acco~nts receivable prior to January 1, 1998 and 14% of any contingency!fee for cases which were begun prior to January 1, 1998. The partnership had no obligation to actually collect any account. The partnership made periodic reports and payments to .the Decedent following his retirement. The last payment, in the amqunt of $1,965.45 was made on June 16, 2004. That payment incl~ded receipt from the last contingency fee case from prior to January 1, 1998. No obligation for any payment under the oral agreement has accrued since June, 2004. The total remaining accounts receivable from prior to Jan~ary 1, 1998 from which the Decedent could have theoretically rece~ved payment as of his date of death is $5,025.00, involving two ! (2) clients. If these were paid, the Decedent's share would. be $1,675.00. A copy of the partnership accounts receivable repor~ up to 12/31/97 is attached. It is extremely unlikely that any pa~ent will be received on these accounts. No payment has been recei~ed on Matter No. 4931-01 since September, 1997. The last payn1ent received on Matter No. 1201 was in February, 2003. The last payment received on Matter No. 1201-05 was received in Septembier, 2001. The estate, therefore, submits that this potential asset !has no real value as of the date of death. ~'ai"i D-3 ~~'OO~, MATTER Cl ~ LWYR Harbold. Dale E. Home. Buo. 493.,01 1239 OJS Custody/Divorce r~r\TTER. iOiAL: Lane. John HD:fie: Bus: 1.201 14:~ DJ:; General !4ATfER TOTAL: 1201.05 142 OJ: Back Analvsis Corp, MATTER 'OTAL: CLIEin TOTAl.' FIFM TOTAt.: *** REPORT SfLEC'rIONS *** REPORT' Receivables bv Client DATE: Man Jar! G3 09.58:3Q 2005 NAWF CLIENT. lAWVER: all lawvers ENDING DATE: 19971231 SEARCH KEY: OE1AIL~D REPORT: No SUMMARY REPORT. No I I I I I l CLECKNER AND FEAREN, ATTORNEYS AT ~AW Receivables bv ClIent UP TO Dee 31 1997 CU;iRENT .31 '~60 tax: Fa\. 0,00 0.00 61-90 1 St,(l;)ij .' 7082.50 3464.50 0.00 5025.00 91+ TOTAl Pf::GE T R,US T C GO ).00 0.00 -.--------------------------------------------------------+---------- - - ._____~___rl______.__._._________..__._______ _ _________.~_M__________ 1560.5~ :00 1382 . O~ 2082.5~ 3464. 5~) 'S025.0dl ) REV.1509 EX. (1.97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CLECKNER, RICHARD W FILE NUMBER 21 - 05 - 0040 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS REL!\ TIONSHIP TO DECEDENT A. . R~chard W. Cleckner, Jr. 7706 Hanoverda1e Drive Harrisburg, PA 17112 Sbn B. c. JOINTLY.OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial Institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 7/1986 Forty-two (42) Series EE savings bonds 303,106.40 50% 151,553.20 1/2005 of varying denominations and issuance dates. SEE attached list 2 A 1/1999 Three (3) $5,000.00 Series I Savings 21, 006 . 00 50% 10,503.00 Bonds issued 1/1999 SEE attached List TOTAL (Also enter on line 6, Recapitulation) $ 162,056.20 (If more space is needed, insert additional sheets of the same size) GavingG Bond Calculator Page 1 of2 Value Atf;. Of Savin l~~/~~?~.....: 1~rm:I.[~1 m:[:~[rHlli:[nII C.ALcv:u Bond hllo> Series I.~.~.~.?~?~..........I~: Denomination $I.~.?,g?g...~ Serial Number' Issue Date I....................................; t....................! m Ii . . .. .. . .... ... Result1i> # Bonds Total Price Total Interest Total Value YTD 42 $179,500.00 $123,606.40 $303,106.40 $10, Serial Issue Issue Interest Nextl Fin Number Date Series Denom Price Interest Value Rate Accrujtl Matu 07/1986 EE $10,000 $5,000.00 $9,340.00 $14,340.00 4.00% o 1/20~5 07/20 I 07/1986 EE 5,000 2,500.00 4,670.00 7,170.00 4.00% o 1/20~5 07/20 1 01/2003 EE 10,000 5,000.00 240.00 5,240.00 2.84% 01/20~5 01/20 , 1 01/2003 EE 10,000 5,000.00 240.00 5,240.00 2.84% 01/20~5 01/20 01/2003 EE 10,000 5,000.00 240.00 5,240,00 2.84% 01/20~5 01/20 01/2001 EE 10,000 5,000.00 732.00 5,732.00 2.84% 01/20~5 01/20 01/2001 EE 10,000 5,000.00 732.00 5,732.00 2.84% o 1/20l!>5 01/20 01/2001 EE 10,000 5,000.00 732.00 5,732.00 2.84% o 1/20~5 01/20 01/2000 EE 10,000 5,000.00 1,044.00 6,044.00 2.84% 01/20~5 01/20 , 01/2000 EE 10,000 5,000.00 1,044.00 6,044.00 2.84% 01/20~5 01/20 01/2000 EE 10,000 5,000.00 1,044.00 6,044,00 2.84% 01/20~5 01/20 03/1998 EE 10,000 5,000.00 1,676.00 6,676.00 2.84% o 1/20~5 03/20 , 03/1998 EE 10,000 5,000.00 1,676.00 6,676.00 2.84% 01/20(j)5 03/20 03/1998 EE 10,000 5,000.00 1,676.00 6,676.00 2.84% o 1/20~5 03/20 05/1997 EE 10,000 5,000.00 1,940.00 6,940.00 3.25% o 1/20I5 OS/20 05/1997 EE 10,000 5,000.00 1,940.00 6,940,00 3.25% 01/20 5 OS/20 I 05/1997 EE 10,000 5,000.00 1,940.00 6,940,00 3.25% 01/20~5 OS/20 04/1996 EE 10,000 5,000.00 2,068.00 7,068.00 2.68% 04/20$5 04/20 04/1996 EE 10,000 5,000.00 2,068.00 7,068.00 2.68% 04/20~5 04/20 01/1995 EE 10,000 5,000.00 2,688.00 7,688.00 2.79% 01/20~5 01/20 I 01/1994 EE 10,000 5,000.00 3,036,00 8,036.00 2.60% o 1/20~5 01/20 I 01/1994 BE 10,000 5,000.00 3,036.00 8,036.00 2.60% Ol/20@5 01/20 1 01/1994 EE 10,000 5,000.00 3,036,00 8,036.00 2.60% 01/20~5 01/20 , 01/1993 EE 10,000 5,000.00 4,868.00 9,868.00 6.00% 01/2005 01/20 , 01/1993 BE 10,000 5,000.00 4,868.00 9,868.00 6.00% 01/20G5 01/20 01/1993 EE 5,000 2,500,00 2,434.00 4,934.00 6.00% 01/20()5 01/20 , 01/1993 EE 5,POO 2,500.00 2,434.00 4,934.00 6.00% 01/2005 01/20 , 01/1992 EE 10,1000 5,000.00 5,368.00 10,368.00 4,00% o 1/20Q5 01/20 http://wwws. publicdebt. treas.gov/B C/SB CPrice 1/27/05 ::lavingJ Bond Calculator Page 2 of2 01/1992 EE 10,000 5,000.00 5,368.00 10,368.00 4.00% 01/2005 01/20 01/1992 EE 10,000 5,000.00 5,368.00 10,368.00 4.00% 01/2005 01/20 01/1991 EE 10,000 5,000.00 5,788.00 10,788.00 4.00% 01/2005 01/20 01/1991 EE 10,000 5,000.00 5,788.00 10,788.00 4.00% 01/2005 01/20 01/1991 EE 10,000 5,000.00 5,788.00 10,788.00 4.00% 01/20~5 01/20 I 02/1990 EE 5,000 2,500.00 3,112.00 5,612.00 4.00% 02/20~5 02/20 02/1990 EE 10,000 5,000.00 6,224.00 11,224.00 4.00% 02/20~5 02120 03/1989 EE 5,000 2,500.00 3,338.00 5,838.00 4.00% 03/20~5 03/20 03/1989 EE 10,000 5,000.00 6,676.00 11,676.00 4.00% 03/20$5 03/20 I 03/1989 EE 10,000 5,000.00 6,676.00 11,676.00 4.00% 03120~5 03/20 01/1989 EE 1,000 500.00 667.60 1,167.60 4.00% 01/20 5 01/20 I 01/1989 EE 1,000 500.00 667.60 1,167.60 4.00% 01/20~5 01/20 01/1989 EE 1,000 500.00 667.60 1,167.60 4.00% 01/20@5 01/20 01/1989 EE 1,000 500.00 667.60 1,167.60 4.00% 01/20~5 01/20 Fii\i~@i:ij I Viewing Bonds 1-42 I I . let euti . . . Note Description Nl Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty MA Matured and Not Earning Interest Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator r r r r !!::l*i:_ji~.i]::!!~l~ !!III::II http://wwws. publicdebt. treas. govlB C/SBCPrice 1/27/05 11 Savings Bond Calculator ~wc {) r \::Lv..) C- ~ ( Page 1 of 1 Value tis Of 1.1.~/~??~....': [ililllim [iHilMil,tml Savin ~.... . Bond Info ::~:l: ~: Denomination $1.~~g9.9 ..Jff~:1! Serial Number Issue Date Series I !..~?Il?~.. I.....................................: I.......................! r ~ . ... .. Results # Bonds 3 Total Price $15,000.00 Total Interest $6,006.00 Total Value $21,006.00 YTD $1,3 Ne~ Fina ACCrual Matur 0112005 01120 01/2005 01/20 01/20~5 01/20 Issue Interest Serial Number Issue Date Series Denom Price Interest Value Rate 01/1999 I $5,000 $5,000.00 $2,002.00 $7,002.00 5.72% 01/1999 I 5,000 5,000.00 2,002.00 7,002.00 5.72% 01/1999 I 5,000 5,000.00 2,002.00 7,002.00 5.72% .... . b,~" etld Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty MA Matured and Not Earning Interest Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator (' (' r (' !:!!::j~:~;[!III~~~.ii!i!;!!;!:;1 ;;~~!i!!!1 http://wwws. publicdebt. treas.gov/BC/SBCPrice 1/27/05 REV.1510EX.(1.971 ~ - COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY ESTATE OF CLECKNER, RICHARD W. FILE NUMBER 21-05-0040 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME Of THE TRANSfEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE Of TRANSfER DATE OF DEATH DE CD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST flf APPlICABUE) 1, M&T Trust Account #4100927004 Assets shown on Schedule B (Items 3 & 4) Payable to estate at death. 2. Morgan Stanley IRA Acct. #410-022231-103 Beneficiary: Margaret D. Cleckner (spouse) 10,292.04 100% 0 10,292.04 3. Morgan Stanley IRA Acct. #410-022232-103 Beneficiary: Margaret D. 'Cleckner (spouse) 129,693.62 100% 0 129,693.62 4. Jefferson pilot Choice Flex Index Annuity Policy #EQ5069797 (Qualified) Beneficiary: Margaret D. Cleckner (spouse) 302,079.07 100% 0 302,079.07 5. Jefferson Pilot Fixed Annuity Policy #QP5008l73 (Qualified) Beneficiary: Margaret D. Cleckner (spouse) 430,735.55 100% 0 430,735.55 6. Gift of 1/4 interest in real property at 1015 Sherman St I' Linglestown, PA to Richard w. Cleckner, Jr. (Son) on 9/10/04 10,000.00 N/A 3,000.00 7,000.0 7. Gift of 1/4 interest in real property at 1015 Sherman St., Linglestown, PA to Mary K. Cleckner (daughter-in-law) on 9/l0/0~ 10,000.00 N/A 3,000.00 7,000.00 TOTAL (Also enter on line 7, Recapitulation) $ 886,800.28 o (If more space IS needed, insert additional sheets of the same size) 11 REV-1511 EX+ (12-99) . ~~:,~/rl' ...::~-i:?~~ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-05-0040 ESTATE OF CLECKNER, RIC~qn w. ITEM NUMBER A. 2. 3. Debts of decedent must be reported on Schedule J. DESCRIPTION IAMOUNT FUNERAL EXPENSES: Auer Memorial Home & Cremation Services, Inc. 1,474.84 Country Club of Harrisburg - funeral luncheon 5:,968.35 Internment 200.00 1. B. ADMINISTRATIVE COSTS: Personal Representative's Commissions None 2. Name 01 Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: Attorney Fees Cleckner and Fearen 32~924.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 4. 3 A 500.00 Claimant r,IJargaret f>- ('1 p("kn~r Street Address 1119 Cnllntry r1nh ROnd City Camp Hill State ~ Zip 17011 Relationship of Claimant to Decedent Probate Fees 1/14/2005 - Register of Wills 460.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 8. 9. 10. 11. Cumberland Law Journal - legal advertising The Patriot-News - legal advertising Register of wills - short certificates Register of wills - filing fee - disclaimer Federal Express 75.00 138.93 , 54.00 5.00 14.48 TOTAL (Also enter on line g, Recapitulation) $ 44,814.60 (/f more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) t; '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF CLECKNER, RICH&~ W FILE NUMBER 21-05-0040 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not ListTrustee(s) OF ESTATE NUMBER I 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Margaret D. Cleckner 1119 Country Club Road Camp Hill, PA 17011 Wife Item,;No~. 1-5 on Schedul~ G & .392 of the residue 2. Richard W. Cleckner, Jr. 7706 Hanoverdale Drive Harrisburg, PA 17112 Son .608 of the residue *Margaret D. Cleckner has disclaimed her interEst in the Trust provided for in ITEM IV of the ~ ill. This gift, therefore, goes toth'&, Decedent's Ion. 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 $ 0.00, (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF RICHARD W. CLECKNER I, RICHARD W. CLECKNER, of East Pennsboro Township, Cumbe~land County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. ITEM I: I hereby direct that all my funeral expenses and estate and inheritance taxes be paid by my Executrix or Executor as soon after my death as may be found convenient. ITEM II: I give and bequeath all my tangible persdnal property, together with all policies of insurance ther~on, including but not limited to, any and all automobiles, furnitu~e, furnishings, china, silverware, jewelry, ornaments, works of a~t, books, pictures and wearing apparel, but excluding cash on hand ~nd tangible evidences of intangible personal property, to my wife, MARGARET D. CLECKNER, if she survives me. ITEM III: I give, devise and bequeath unto my wi~e, MARGARET D. CLECKNER, if she survives me, the smallest fractional share of my estate required to reduce to a minimum or to zero the Federal Estate Tax liability of my estate after taking into account all other items includable in my gross estate for Federal Esta~e Tax purposes whether or not such items pass under this Will. In computing the share of my estate to which my wife shall be entitled II under this Item of my Will, the final determination in the Federal Estate Tax proceedings of my estate shall control, and only such assets as qualify for the marital deduction shall be allocated to the fractional share of my estate passing to my wife under 1this Item. It is hereby declared to be a primary objective of this Will to reduce to a minimum or to zero the Federal Estate Tax liability of my estate, and my personal representative is accordingly hereby granted full power to take whatever measures and to make what$ver appropriate adjustments may at any time be required by the Internal Revenue Code, the Federal Estate Tax regulations or decisional law to clearly qualify the assets passing under this Item of my Will for the marital deduction. ITEM IV: If I am survived by my wife, MARGARET D. CLEC~IER, I give, devise and bequeath all the rest, residue and remainder: of my estate unto MARGARET D. CLECKNER and RICHARD W. CLECKNER, JR., in trust, for the benefit of my wife, MARGARET D. CLECKNER, and said Trustees shall hold, invest, manage and otherwise administer said property for the following uses and purposes: A. To pay the net income therefrom to my wife, MARGARET D. CLECKNER, during her lifetime, said payments to be made at least annually and more frequently if my wife shall iat any time request the Trustees in writing for more frequent payments of income. B. In addition to her right to the income from th~s residuary trust, my wife shall also have the power to invade the principal of this residuary trust in her sole and absolute - 2 - discretion, provided that such invasions of the principal of this residuary trust shall not exceed Five Thousand Dollars ($5,000.00) annually or five percent (5%-) of the princ\ipal annually, on a non-cumulative basis, whichever of the two 'sums just mentioned is the greater. C. During the lifetime of my wife, the other Trustee, in his sole discretion (without the participation of my Wife as a Trustee), may invade the principal of this resid$.ary trust whenever in his judgment such invasions are reasonably necessary for the support, maintenance, and medical care of my wife. D. Upon the death of my wife, the trust shall terminate and the remaining Trustee shall distribute the principal and all accumulated income to my son, RICHARD W. CLECKNER, JR., free of trust. If my said son is not living at the time for distribution to him under this ITEM IV, the Trustee sh~ll distribute the principal and all accumulated income to the following beneficiaries, free of trust, in the percenta~es stated; (1 ) To MARY K. CLECKNER - Forty-five percent (45%-; (2 ) To WENDY HEINZ - Twenty percent (20%-) (3 ) To SANDRA SPIEWAK - Twenty percent (20%-) (4) To WILLIAM BARNES - Five percent (5%-) (5 ) To DAVID S. DEIBLER - Five percent (5%-) (6 ) To JEFFREY K. DEIBLER - Five percent (5% ) - 3 - If any of these beneficiaries is not living at the time for distribution hereunder, his or her share shall be distributed pro rata among my surviving beneficiaries. E. In the event there is a vacancy in the offic~ of Trustee of the Trust created hereunder, I appoint Ann E. Rhoads to act as successor Trustee. ITEM V: If my wife, MARGARET D. CLECKNER, does not survive me, I give, devise and bequeath my entire estate to my $on, RICHARD W. CLECKNER, JR. If both my wife and my son do not survive me, I give, devise and bequeath my entire estate in equal share$ to the following beneficiaries, free of trust, in the percenta,ges stated: (1) To MARY K. CLECKNER - Forty-five percent (45*) (2 ) To WENDY HEINZ - Twenty percent (20% ) (3 ) To SANDRA SPIEWAK - Twenty percent (20%) (4 ) To WILLIAM BARNES - Five percent (5%) (5 ) To DAVID S. DEIBLER - Five percent (5%) (6 ) To JEFFREY K. DEIBLER - Five percent (5%) If any of these beneficiaries is not living at the time for distribution hereunder, his or her share shall be distributed pro rata among my surviving beneficiaries. ITEM VI: I hereby expressly authorize and empower my personal representatives and also Trustees of the trust herein created, ~n their sole and absolute discretion: A. To retain as part of my estate, or of the trust estate hereinbefore established, any property or investments - 4 - which I may have at the time of my death, whether authorized by law as proper investments for fiduciaries or not, it being my desire that the same may be held unless, in the judgme~t of my personal representative or Trustees, such property or investments are clearly not suitable investments. B. To invest, reinvest, alter, vary and change investments and reinvestments, and in so doing, my personal representatives and trustees may act without restriction to so-called legal investments and without responsibility for diversification. C. To sell, lease, pledge, mortgage, trans~er, exchange, convert or otherwise dispose of, or grant opti:ons with respect to, any and all property at any time forming a part of my estate or of the trust estate, for such prices ~nd upon such terms, credits and conditions as may be deetned advisable. Any lease made by my personal representative or by my Trustees may extend beyond the period fixed by statute for leases made by fiduciaries. D. To borrow money for any purpose connected with the protection, preservation or improvement of my general estate or of the trust estate whenever deemed advisable, and, as security, to mortgage or pledge any real estate or personal property of which I may die seized or possessed or forming: a part of the trust estate, upon such terms and conditions ~s may be deemed advisable. E. To v6te in person or by general or limited proxy with respect to any shares of stock or other securities held - 5 - I' by them; to consent, directly or through a committee or other agent, to the reorganization, consolidation, merger, dissolution or liquidation of any corporation in whicn my estate or the trust estate may have any interest, or to the sale, lease, pledge or mortgage of any property by or to any \ such corporation; and to make any paYments and to take any steps which may be deemed necessary or proper to enable it to obtain the benefit of any such transaction. F. To hold investments in the name of a nominee. G. To complete, extend, modify or renew any loans, notes, bonds, mortgages, contracts or any other obligat~ons which I may own or which I may be a party or which may be liens or charges against any of my property or against my estate, although I may not be liable thereon, in such manner as may be deemed advisable; to pay, compromise, compoUJhd, adjust, submit to arbitration, sell or release any claims or demands of my estate or the trust estates against others, or of others against my estate or the trust estate as may be deemed advisable, including the acceptance of deeds of real property in satisfaction of bonds and mortgages, and to make any payments in connection therewith which may be deemed advisable. H. To make distribution of my estate or of the principal of the trust estate in their discretion, in kind or in cash, and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share. - 6 - I' I. To execute and deliver any and all instruments in writing which may be deemed advisable to carry out any of the foregoing powers. No party to any such instrument in writing signed by my personal representative or by my Trustees shall be obliged to inquire into its validity, or be bound to see to the application by my personal representative or by my Trustees of any money or other property paid or delivere~ to them pursuant to the terms of any such instrument. ITEM VII: All estate, inheritance, legacy, successio~ or transfer taxes (including any interest and penalties ther~on) imposed by any domestic or foreign laws now or hereafter in f~rce with respect to all property taxable under such laws by reason of my death, whether or not such property passes under this, my Will, and whether such taxes be payable by my estate or by any recipi~nt of any such property, shall be paid by my personal representat~ve or my Trustees, at such time or times as may be deemed advisable, out of my general estate as part of the expenses of the administra- tion thereof with no right of reimbursement from any recipient of any such property. ITEM VIII: No interest of any beneficiary under this Will br any Codicil hereto or any beneficiary under any trust created und~r this Will shall be subject to assignment, anticipation, attachment I or other voluntary or involuntary alienation, nor shall suth interest of any beneficiary be subject in any way to the claims of creditors of the beneficiary. - 7 - I r ITEM IX: I nominate, constitute and appoint my wife, MARGARET D. CLECKNER, to be the Executrix of my estate, and if she is deceased or unable to serve, I appoint my son, RICHARID W. CLECKNER, JR., as Executor, and if my said son is decease& or unable to serve, I appoint Ann E. Rhoads as Executrix. No fiduciary named herein shall be required to post bond or other security in any jurisdiction. ITEM X: In the event that my wife and I die in a common accident or under conditions making it impossible to tell which of us survived the other, my wife shall be deemed to have survived me if such presumption shall be advantageous in determining the tax liability of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this l~day of ~ 2002. ,.......,-.,.--;:7 ;/ ~~ '{~~~t?;:~./ CLECKNri'~ ( S E~L ) Signed, sealed, published and declared by RICHARD W. CLECKNER, the Testator, as and for his Last Will and Testament, in our presence, who, at his request, in his presence, and in the presence of each other, we believing him to be of sound, disposing mind ailid subscribed our names as witnesses. PU l1'~ jLj. A/~ ~,IA I?D1D ~ / OF L/ " 0/ ,....---:=)// ,rJ /--??C.7:' "/;!!7?t~e (.-~. . ' OF J r:::::re;"?? C::/:1W'. { - 8 - COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN We, RICHARD W. CLECKNER, Lt'r7da /n~/O/? <:.._ OCI"7r7 /S ^ c/ t5hailo and the Testator and witnesses, respectively, whose names are signed to the attached or foregoing instrument. being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he had signed willingly, and that he executed it as his free and voluntary \act I for the purposes therein expressed, and that each of the witnes~es, in the presence and hearing of the Testator, signed the will as witnesses and that to the best of their knowledge, the Testator ~as I at that time eighteen (18) years of age or older, of sound mind ~nd under no constraint or undue influence. -7 , / r;/ "-"",,,= ~ ~. ,/7 ~_~~);'>~/J(;~ //;Pk/4 Subscribed, sworn to and acknowledged before me by RICHARD W. I the Testator, and subscribed and sworn to before me ~y cl SJUA; 6't!-u and LI h ?1'4'- /?1a/O/7<- witnesses, this /'f/X day of chae. ,2002. CLECKNER, f}t!:'/lr7IJ ~r7~ d ~ Notary blic / Notarial Seal Jenny A. Toblae. Notary Publty\c Hari'lacul'Q. Oauphln coon MV Ol'}mml~s\(In expires Feb.15. 2005 _.._ 1.O:\1~1".:,;,:;..~....~.GlUloll~II~"" I' PARCEL NO. 35-018-089 ADDRESS: 1015 Sherman Street (Lower Paxton Twp.) Linglestown, tp A THIS DEED Made the 10 l...I':::- day of 3Qp~~'Y::J.y.J, in the year of our Lord two thousanp and four (2004), BETWEEN RICHARD W. CLECKNER, by Margaret D. Cleclmer, his agent, speCially constituted by Power of Attorney dated the Septembe." 14, 1999, and recorded June 18, 2004, in Dauphin County, Pennsylvania, in Record Book 5552, !Page 516, and RICHARD W. CLECKNER, JR., tldlbla CLECKNER PROfER- TIES, and MARGARET D. CLECKNER, parties of the fi.'st part, the Grantors; AND RICHARD W. CLECKNER, JR., and MARY K. CLECKNER, his wife, parties of the second part, the Grantees. 'WITNESSETH, That the said parties of the first part, for and in consideration of the ~um of ONE DOLLAR ($1.00), lawful money of the United States of America, unto them weiland truly paid by the said parties of the second part at and before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, have granted, bargained, sold, aliened, enfeoffcd, released, conveyed and confirmed, and by these presents does grant, bargain, sell, aJ ien, enfeoff, release, convey and confirm unto the said parties of the second part, their heirs ~nd assigns, ALL THAT CERTAIN tract or parcel of land situate in Lower Paxton Township, Dauphin County, Pennsylvania, more particularly bounded and described as follows, to wit: I' BEGINNING at a point on the easterly line of Sherman Street which point is 361 feet North of the Northeasterly corner of Catherine Street and Sherman Street and at dividing line between Lots Nos. 288 and289 on the hereinafter mentioned,plan of lots; thence along the easterly lineofSherI11(ltl. Street North 1 degree East40 feet to a point at dividing line between LptsNos.290 and 291 on said phm; thence along said dividing line South 89 degrees EastlOO feet to a point on the westerly line of Smith Avenue; thence along the westerly line of Smith Avenue South 1 degree West 40 feet to a point at dividing line between Lots Nos. 288 and 289 on said plan aforesaid; thence along said dividing line North 89 degrees West 100 feet to a point, the place of BEGINNING. BEING Lots Nos. 289 and 290 on Plan of Lots recorded in the Office of the Recorder of Deeds in and for Dauphin County, Pennsylvania, in Plan Book G, Page 53. BEING known as 1015 Sherman Street, Linglestown, PA 17112. TAX PARCEL NO. 35-018-089. The improvements consist of a single family dwelling. BEING THE SAME PREMISES which l.R. Lotwick, High Sheriff of the County of Dauphin, in the State of Pennsylvani(i, by deed dated March 3, 1998, and recorded April 21, 1998, in the Office\of the:~ecorder of Deeds in and for Dauphin County, Pennsylvania, in Record Bt)ok 3085, Page 476, granted and conveyed unto Richard W. Cleckner and Richard.W.. Cleckner, < Jr:,t/dlb/a Cleckner Properties. Margaret D. Cleckner joins in this deed to relinquish any right, title and interest she may have by virtue of her marriage to Richard W. Cleckner. TIDS IS A TRANSFER FROM FATHER, MOTHER AND THEIR SON TO THE SON AND IDS WIFE, AND IS THEREFORE EXEMPT FROM REALTY TRANSFER TA~S. TOGETHER with all and singular the buildings, improvements, woods, ways, rights, liberties, privileges, hereditaments and appurtenances, to the same belonging, or in anywise appertaining, and the reversion and reversions, remainder and remainders, rents, issues and prqfits thereof, and of every part and parcel thereof; AND ALSO all the estate, right, title, interiiest, property, possession, claim and demand whatsoever, both in law and in equity, of the said p~ties of the first part, of, in, and to the said premises, with the appurtenances; , TO HAVE AND TO HOLD the said premises, with all and singular the appurtenan~es, unto the said parties of the second part, their heirs and assigns, to the only proper use, benefit ~nd behoof of the said parties of the second part, their heirs and assigns forever., AND THE SAID parties of the first part, for themselves and their heirs, executors, and administrators, do by these presents, covenant, grant and agree, to and with the said parties ofthe second part, their heirs and assigns forever,.that, they, the said parties of the first part, their heirs, I' all and singular the hereditaments and premises hereinabove described and granted, or mentioned and intended so to be, with the appurtenances, unto the said parties of the second part, their heirs and assigns, against the said parties ofthe first part and their heirs, and against all and every other person or persons, whomsoever, lawfully claiming or to claim the same or any part thereQf, by, from, or under him, her, them, or any of them, shall and will, warrant and forever defend. IN WITNESS WHEREOF, the said parties of the first part have hereunto set their hands and seals the day and year first above written. WITNESS: ,}\ ' \'~ )-:. r .~ ) \. Q\ )l::P') ~/). a~, -,oo./!- ,(seal) MA ARET D. CLECKNER, Agent for RICHARD W. CLECKNER, (Record Book 5552, Page 516) (seal) t/d/b/a CLECKNER PROPERTIES ( )\""--- /"- - ) r.=.: , " ':~y?~- ~ D~~ciJfi~~ii L~-2 J ($cal) Commonwealth of Pennsylvania, County of Dauphin SS On this, the 10M day of September, 2004, before me, a Notary Public for the Common- wealth of Pennsylvania, the undersigned Officer, personally appeared MARGARET D. CLECKNER, known to me (satisfactorily proven) to be the person whose name is subscribed to the within instrument as agent for Richard W. Cleckner, and acknowledged that she executed the same as the act of her principal for the purposes therein contained. IN WITNESS WHEREOF, 1 hereunto set my hand and official seal. /5/ J~..,y' L~~(;~ +-- ( Notary Public , I Commonwealth of Pennsylvania, County of Dauphin SS On this, the loth day of September, 2004, bef()re me, a Notary Public fo~, the Com~on- wealth of Pennsylvania, the undersigned Officer, personally appeared MARGARET D, CLECKNER, known to me (satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. / :10~7 /l /J6rcs I Notary Public Commonwealth of Pennsylvania, County of Dauphin SS On this, the /tlh.. day of September, 2004, before me, a Notary Public for the Com~on- wealth of Pennsylvania, the undersigned Officer, personally appeared RICHARDW. CLECK]lffiR, JR., known to me (satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. /5/ ~ />-/ ~ 7Jj; /"i's ! / Notary Public CERTIFICATE OF RESIDENCE I, hereby certify that the precise residence of the grantee(s) herein is: 77{)fa Ik-v70lreJ da/e P/: / /J.w-//J~/{ /!4 /7//..<. ./ /:/ ~O( / Attorney or Agent \ I 21 1 House Avenue, Camp Hill, PA 1701 1 P. O. BOx 8300, camp Hill, PA 17001-8300 TEL (717) 761-7210 - FAX (717) 761-7134 1-800-843-1 120 Web Site: www.cpabr.com (BR.) BOYER & RITTER CERTIFIED PuBLIC ACCOUNTANTS AND CONSULTANTS June 20, 2005 Ann E. Rhoads Attorney at Law Cleckner and Fearen P. O. Box 11847 Harrisburg, PA 17108-1847 Dear Ann: Per your request, I have enclosed three years of partnership tax returns for Cleckner Prop~rties (2004, 2003 and 2002). The Sherman Street property was distributed by the partnership t<l> the partners, as individuals, with 50/50 ownership. Subsequent to the distribution, the Yz int~rest owned by Dick was gifted to Rick and Mary. A gift tax return was filed for Dick, indicatint the gift on September 10, 2004 had a value of $20,000. At the time of Dick's death, the only asset remaining in the partnership was an American Express cash management account. His calpital account was $725, which was tran~ed to the Estate. Rick's capital account was $38,167':(see attached Capital Account ReconciliatiOn)~ If you have any further questions, please do not hesitate to call. Very truly yours, RJMlpam enclosures copy w/o enclosures: Margaret D. Cleckner CAMP HILL CARLISLE CHAMBERSBURG LEWISTOWN STATE COLLEGE An Independently Owned Member of the RSM MCGladrey Network 1 r 2004 CAPITAL ACCOUNT RECONCILIATION PAGE 1 CLIENT CLECKPRO CLECKNER PROPERTIES 23-2822095 6/20/05 1 0:28AM FEDERAL ANALYSIS OF PARTNERS' CAPITAL ACCOUNTS Partner Beginning Capital Partner's share of Withdrawals Ending Number Partner Name Capital Contributed lines 3, 4, and 7 and Capital Account during the year Fm 1065,Sch. M-2 Distributions Account 1 RICHARD CLECKNER, JR 56,759. 951. 19,543. 38,167. 2 RICHARD W CLECKNER 19,317. 226. 19,543. 3 ESTATE OF RICHARD W CL 725. 725. TOTALS 76,076. 1,902. 39,086. 38,892. PTPL0501 L 11/09/04 3/17/2005 3:51 PM FROM: Fax TO: 23B-84B1 PhGE: 002 OF OOB PARTNERSHIP AGREEMENT THIS AGREEMENT, made t.his 4f{ day of October r 1995! by and between RICHARD W. CLECKNER and RICKARD W. CLECKNER, JR., (herein- after referred to as the "Partners"), who, with the intent to be legally bound! agree as follows: 1. QrganizatiolJ of Partnership. The Partners hereby declare tlWH\selves to be associated as a ~Jeneral partllership under the name CLECKNER PROPERTIES (hereinafter referred to as "the Partnership") under the terms, conditions and agreements contained herein. 2 . Term of Partnership, The Partnership commenced on September I, 1995 and shall continue until dissolved by mut.ual aqreement of the pox'ties or terminated as pr0vided for in t.his Agreement, 3. Place of ~!J~jnq2..Ei. The principal place of business of the Parl:nel:'sbip shi'dl be c/o Richard W. Cleckner I lIr., 125 Ridge Road, Etters, York County, Pennsylvania, 17319, a,nd any other place or places t.hat lllay be mutually agreed to by the parties to this Agreement. 4. Purpose of the PartIle:r:~l~ol,P. The partner::l associate them, selvef3 together as general Partners for the purpose of enga~fing in l~uch business as t.he parties may fr:om time to time agree. Th(~ initial activity of the Partnership will be to engage in the business of purchal'>ing, developing, imp)~ovin.g, owning, leasing, managing and selling real estate. The Pa:ctnership may enga.ge in such other.' business as the Partrlel's may from t. tme to tirtle agree. \ I -- 3/17/2005 3:51 PM FROM: FaR TO: 238-8481 PAGE: 003 OF 008 t: -' . ,Z!,ccountJncr MetllQ.9. and Fisc<.~l Year. The PartnerShip shall keep its accounting x'ecords and shall r:eport its income dnd losses fo)~ income tax purposes on the cash method of accounting (unless it is required by applicable law OJ::' regulations to use the accrual melhod of accounting), and its fiscal year G11a11 end December 31. 6. CCl.pi tal Con t.l-::i,1:)llt;j,.Qnfi . Each Partner shall initially conL.cibute Forty Pi ve ThOilE,and Dollars ($45 1000.00) . The Partners shall make sucll otlK'L' capital contI'ibutions a.L such times and in such amount.s as they agree i provided, t.hat such additional cont.rib1.lt ions shall. be made pT:oportionally tlY each Partne.r unless thc~ PClJ:.'tn~rH i19n~p. otherwi.se; 11 wri t.in~:r. 7. Ci:I,J):!,.tp,.1 ACCO..lli.'1.U:I, An indivldLLal capital account shall be. illaintained for each Parl~.nc;J:.'. The capital intp.rest of each PaL'Lner shall consi st of his ol'iginal cont.ribution, irlc:ceaseci by his additional contr'ibutions to capital and his share of Partnership profits, and decreased by distI'iJ:mtions to him in L'l;ductioIl of his Partl1er"slli:p capit_al arl,O "his slla:r:e of Partl1.ersl1ip looses. Capital account balancRs shall not. bear interest. unless other'wise a~:rreed to i.n w:citing by t.he Partners. 8. Fron to aIld },jp.'i:;;'c;..(;!. REtch it.etn of irlCOn18-{ ~rail1.i loss, deduct.:Lon and credit shall be allocated to and sho.red by caeb ParLner as follows; J:l~:rt}lill;: PerC('?!l tAS.~ Richard W. Cleckno.r' 2!j% Richard W. Clec:kner: r Jr. 7 S~o - 2 - l' 3/17/2005 3:51 PM FROM: Fax TO: 238-8481 PAGE: 004 OF 008 9 . M.~m9gJ;:lflr:;nt;. The overall management and cont.rol of the business of the Partnership shall be vested in the Partners collectively. Each Partne:r shall have an equal votce in the management of the Pal:-tnership, No I'ar1:ner may, without consent of the other Partner: A. Borrow money in the name of t.he Partnership for Part.nership PllI-pr:)1:3eS, or: utilize collater.'t;'tl owned by the Part.ner' ship as security for such loan; B. Assign, transfer r pledge, comp:comise, 01' release any of the claims or debts due the Partnership, except upon payment in full; or arbitrate or consent to the ilI"bitI'ation of any of the disputes or contr.'ovel-sJes of the partne:rsllip; C. Bind the Par.'tnerstdp i.n makii1g contracCt-3 or incu:cring obli~Jations in the name and OIl th>.'=' Credit ot tht0 Partnership; D, Make any assignment fcll." the benefit of creditors or.' any bond, conf2s~:;ion of judgment:, deed, chattel mortgage, quar2..nt.ee, indemnificat.ion bond, surety bond or contxacL LO sell all or any subst.antial part of t.he property of the partner'ship, E, PlCClgC or hypot.heca,te or in any manner transfer his interest in tbe P,3rtnership, except to other part.ies t.o this Agr:colUcmt; F, Make r;he Partnership a. surety, :Ju,u'antOI: or accomrnoda- t.ion party to any obligation; or: G. Do or willingly permit t.obe done aIlythin~j wheroby t.he capit.al 01: propert.y of the Partnership or his iIlten~Ht ther:ein may - 3 - \ I 3/17/2005 3:51 PM fROM: fax TO: 238-8481 PAGE: 005 Of 008 be attached, encumbered, or. otherwise injuriously affected. In the event a Partner violates any of the above prov:l sions he shall be liable to, and indemnify and save l1annless, the remaininq Partner~, as well as the Partnership, fI'OI\l a.ny and all liabilit.y and loss arising therefrom, induding the payment of reasonable attorney's fees and expem,ea. 10. Partnership Books. The books and rf:cordR of the Partner- ship shall be open t.o examination by any pa:ctner at. any cime. n. VotinG. In the course of the business of the Partne:c- '-illip, at a fonnal meeting or ot11.eI'wise, each Partner shall have one vote. 12. partne:rsilir;!.. to COIl tillue. Undel' no circumstances shall the l:r'cHlsfer by il Partner of his Pa:ctncI'ship intercst or tho admission of a successor ~Jeneral Partner operate as or cause the tenninat.iol1 of [,be Part,nership for federal income Lax PlU"POSCS i and if necessary, a withdrawing Pi.'iI'tneJ.:" s right to withdraw, transfe:r.-, or otherwise dispose ot or altbr his interest shall be restricted to t.hat. portion of the interest, if any, which will prevent the PartnGL'ship fr.'om te:tmiIliltiIl~j under Sect.ion 708 (1.;) (10 (B) f. o the Internal Revenue Cod of 1986. 13 . DissoIution. On dissolution of the Partn.er.'shipJ Uw affairs of the Partnership shall be wound uPJ the assets of the Partnership liquidated, the debts paid, and t.hesurplus divided pro rata between the Partners. 4 - I' 3(17(2005 3:51 PM fROM: fax TO: 238-8481 PAGE: 006 Of OOB 14. AccQ\Jntjna. As soon as practicable after December 31 of eacll year, theParLllership shall complet.e an operat.i ng E',tat.c,ment prep,;u:ed by an independent. public aCCowltant which shall show all usual ope:cating data, for the Partnership [or the pn~ceding year in accordance Wi.tl1 g-ood accounting pI'actice. Such operating statement: need not be audited or certified except at tho request and the expense of any Partner:, Each Pal'tIler' shall :t:'ecei ve a copy of sucll operating stat.ement as soon as it shall be available. 15, Indemnification. Eadl Pal.tIler ohall iIldenmify and defend. the otheL' PartIH~I' and hold him harmless against and from all claims, demands, actions and rigllts which sllall OJ:' lllay an.i:,e by virtue of anything clonE'! by t.he Partner: O'\Jtside the 5C;OPC ot, or in l:n:e,3ch ot f tile teIms of this A<;rreement j provid'"d, that the Partner a~}3i.n8L which indemnity is Gought shall bE'! promptly notified and shall be giver) reasomlble opportun:!. ty to pa:rticipate in defense thereof f and fl.lt't.l1eI' provided that fa i 1m.: c.' to give snch not.ice shall not. affect such Part.ner's obligations hereunder, except to the extent of any dctuill pl.-ejudice to him r'esulting thet-efroltl. 16, Noti~,:;;. All noti.ces between the parties p1.:ovided for, Or' permitted under tJns Agn::ement f or by law shaJ..L be in writing a,nd shall be deemed duly served whp-n personally served On a Part.ner OX. f instea,d of p'2J:'sonal sE!l:vice, when deposited in the United Stat.es mail, certified, post.age prepaid, and addressed to the Partner at tllf;? address of the princi.pal place of business of the Partnership or Lo another place t.hat. may from time to time be - 5 - I' 3/17/2005 3:51 PM FROM: Fax TO: 238-8481 PAGE: 007 OF 008 spec.ified in a notice :-;iven pursuant to this para9raph as the address for the service of notice on the Partner. 17. Rn tj. re A,q{,S;'emen t . This Agreement contains the enti.re underst"mdin~J amml~:r the Pin.ties. ThcI:C are no rcs'prcsentations I ag1'eements, arrangement.s, or 1.mderstandings, oral or written, between Clnd i.lltlong the parties lv:::reto relating t.o the subj eet matter ot this Agreement \vhich axe not. fully expressed hen:dn. 18. MCJditdr;':.it::1,QXJ. Modification of t.he terms of this Agreement. shall be effect:ive only if in wri.ting and signr2d by aJl the par:l~ics hC:L'r::to. IN WITNSSS NHEREOF I t.he partie~:; have hereunto set their hands and sE:als the day and yr2!ar fi:rst above vlrit.ten. WITNESS: //.....-J~;7 / /~:J-, /" #J~~;Y;/ #:/~! 1/ /" ;~ ,r7 ~~)YI~~Ictif~~ (6. .~ ry{. MAOJ\ RICHARD W. CLECKNER, JR. . (SEAL) iSEAL ) - 6 - \ I 3/17/2005 3:51 PM FROM: Fax TO: 238-8481 PAGE: 008 OF 008 COMMONWEALTH OF PBNNSYLVik~IA ss: COUNTY OF DAUPHIN /Iy..f} On this, the 7 day of October, 1995, before me, a Notary Public, the unden;igned officer, personally appeared RICHARD W. CLECKNER, knO';<ll1 Lo me (or satisfactorily pr:o"~eIl) to be the person whoSE: name is subscribed to the fOI:egoin~j PartnershIp Agreement and acknowledged that he executed the same for the pu:rposr;?s thex'ein contained. IN WITNEDS WHEREOF, I hereunto set my hand and official seal. ~.~ ~ (/,':'., i, d ~U:X.(.g,:_,/{1-l.l-lljtA---,'" ,~PUbl~c' ' My Commission ExpIres: ~ :'i:t3r:;;>lSeal J ' sr;;;1rc,n" K S:1rJ'",r, Noiary F'I.,\)lil) f"i.1.~':1:'kurl1. o.SUphll1 Ccunr. lA"C^n"'n"":":, ''''J'''"''Aun 1" .""'" I\'"'I A~ " ',."W>._". ,..Ai ilQ... t::" 1!+r.:i'U Mt~mGE;;',f'l~1hiYK.:w;r~OC1iUicinoTNOtirles ***-I.'*k COMIVIOllwEALTH OF PENNSYLVANIA ss= COUNTY OF DAUPIIIN On this] the "I.jJA day of October, 1995, befox'e me, a Notary Publj,c, the undersigned offi.cer, pex'sona,J} y appeared RICHARD W_ CLECKNER, J'R. I known to me (or satisfact.odJ,y p:r:oven) t.o be Ule person whose name is subscribed to the fore<)oing Partne.t'shiIJ A~Jreemenc Clnd t.1.ckno\vledge(J that he executed the same for the pUJ~pose;s t.hcI'ein contained. IN WITNES~~ WHEREOF, I horeunto set. my hand and ofticial seal. ?itLa?f.1c:',I/ V1'~/tfJ!,h-" otary PllbllC . My Commission Expires; - 7 - Q f1-',,'-ISiY<,d 1 Sharon K 5;i~i;~;,'r. N6t:iJY F'lJt~ic ' H(~r'r;~:tt!l'fJ.. QI~,~'PI)jn C?IJ.:l;!I, ~ 11'1)' Com;n'$",~n t''<Pil"t';; A(IQ ", 1900 j Me-mOOr, p,;nil.y.vi,\;;;a;;;;:.;;..~.;n~iri~l> II Form 1 065 U.S. Return of Partnership Income For calendar year 2004, or tax year beginning ,2004, and ending , 20 ~ See se arate instructions. Department of the Treasury I nternaJ Revenue Ser\lice A Principal business activity YL 23-2822095 DEC2004 17 531390 LP CLECKNER PROPERTIES CLECKNER RICHARD W JR GEN PTR 7706 HANOVEROALE OR HARRISBURG PA 17112-9769 r R S REAL ESTATE B Principal product or service RESIDENTIAL R/E C Business code number \ I OMB No.1545.0099 2004 o Employer identification number 23-2822095 E Date buSIness started 6/30/ 995 F Total as~ets (see instrs) 531390 $ 38 892. G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) Atnended return H Check accounting method: (1) Cash (2) Accrual (3) Other (specify). . . . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I Number of Schedules K.1. Attach one for each person who was a partner at any time during the tax year. . . . . . . . . . . . .. ~ 3 Caution: Include only trade or business income and expenses on lines la through 22 below. See the instructions for more inforiYlation. S E E I N S T R 0 U c E T 0 I U 0 N C s T I F 0 0 R N S L I M I T A T I 0 N S Sign Here Paid Preparer's Use Only 1 a Gross receipts or sales. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a 1b I N C o M E 2 3 4 5 6 7 8 9 Salaries and wages (other than to p (I employment credits). . . . . . . . . . . . . . . . . . . . . . . 10 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Repairs and maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Bad debts. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . 13 Rent........................................................................................... 14 Taxes and licenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Interest......................................................................................... 16a Depreciation (if required, attach Form 4562) . . . . . . . . . . . . . . . . . . . . . . . . . . 16a b Less depreciation reported on Schedule A and elsewhere on return. . . . 16b 17 Depletion (Do not deduct oil and gas depletion.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 18 Retirement plans, etc. . . . . . . . . . . . . .. . .. " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 19 Employee benefit programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. ., . . . . . . . . . . . . . . . . . 20 Other deductions (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c 2 3 4 5 6 7 8 21 Total deductions. Add the amounts shown in the far ri ht column for lines 9 throu h 20. . . . . . . . . . . .. 21 20 22 Ordina business income loss. Subtract line 21 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " . . . .,. 22 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knQwledge and belief, it is true, correct, and complete. Declaration of preparer (other than general partner or limited liability company member) is based on all information of which preparer has any knowledge. ~ ~ Date Pre parer's signature Check if self. ~ employed. . . . Firm's name I (or yours if self.employed), E address. and ZIP code HILL, BAA for Privacy Act and Paperwork Reduction Act Notice, see separate instructions. EIN ~ 23-13110 5 Phone no. (71 7 ) 7 61- 721 0 PTPA0105L 01106/05 Form 1065 (2004) May the IRS discuss this return with the pre parer smown below (see instrs) 1 Yes No Preparer's SSN or PTI P00077358 Form 1065 (2004) CLECKNER PROPERTIES 23-2822095 I Schedule A I Cost of Goods Sold (see instructions) 1 Inventory at beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Purchases less cost of items withdrawn for personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Cost of labor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 1 2 3 Additional section 263A costs (attach statement). . . . . . . . . . . . . . . . . 4 Page 2 5 Other costs (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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) ~ Cost as described in Regulations section 1.471-3 (ii) Lower of cost or market as described in Regulations section 1.471-4 (iii) Other (specify method used and attach explanation) . . . . . . . . . . . .. .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ _ _ _ _ _ b Check thiS box If there was a wrltedown of 'subnormal' goods as described In Regulations section 1.471-2(c). . . . .. . ..... .. ~ ~ c Check thiS box If the LIFO Inventory method was adopted thiS tax year for any goods (If checked, attach Form 970) .. .... ~ d Do the rules of section 263A (for property produced or acquired for resale) apply to the partnership? .. .. . . . . . . . . . .. 0 Yes No e Was there any change In determining quantities, cost, or valuations between opening and clOSing inventory? .. .. 0 Yes No If 'Yes', attach explanation. 1 What type of entity is filing this return? Check the applicable box: a B Domestic general partnership b ~ Domestic limited partnership c Domestic limited liability company d Domestic limited liability partnership e Foreign partnership f Other. . . . . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 2 Are any partners in this partnership also partnerships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 3 During the partnership's tax year, did the partnership own any interest in another partnership or in any foreign entity that was disregarded as an entity separate from its owner under Regulations sections 301.7701-2 and 301.7701-3? If yes, see instructions for required attachment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 4 Did the partnership file Form 8893, Election of Partnership Level Tax Treatment, or an election statement under section 6231 (a)(l)(B)(ii) for partnership-level tax treatment, that is in effect for this tax year? See Form 8893 for more details. . . . . . X 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If 'Yes,' the partnership is not required to complete Schedules L, Mol, and M-2; Item F on page 1 of Form 1065; or Item N on Schedule K-1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 6 Does this partnership have any foreign partners? If 'Yes,' the partnership may have to file Forms 8804, 8805 and 8813. See instructions. . . . . . . . . . . . . . . . . . . . X 7 Is this partnership a publicly traded partnership as defined in section 469(k) (2)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? . . . . . . . . . . . . . . . . . . X 9 At any time during calendar year 2004, did the partnership have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? See the instructions for exceptions and filing requirements for Form TD F 90-22.1. If 'Yes,' enter the name of the foreign country.. .. X 5 6 7 8 ISchedllleBt I Other Information ------------------------------------------------ 10 During the tax year, did the partnership receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If 'Yes,' the partnership may have to file Form 3520. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If 'Yes,' you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described in the instructions under Elections Made By the Partnership. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. X 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to this return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. 0 Designation of Tax Matters Partner (see instructions) Enter below the general partner designated as the tax mallers partner (TMP) for the tax year of this return: Name of designated TMP ~ RICHARD CLECKNER, JR Address of 7706 HANOVERDALE DRIVE designated TMP ~ HARRISBURG, FA 17112 Identifying number of TMP ~ 199-50-4886 PTPA0112L 01105/05 Form 1065 (2004) CLECKNER PROPERTIES 23-2822095 Schedule K Partners' Distributive Share Items 1 Ordinary business income (loss) (page 1, line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Net rental real estate income (loss) (attach Form 8825). . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . 3a Other gross rental income (loss). . , . . . . . . . . . . . . . . , . . . . . . . .. . . . . . . 3a b Expenses from other rental activities (attach stmt). . . . . . . . . . . . . . . . . . 3b c Other net rental income (loss). Subtract line 3b from line 3a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Guaranteed payments. . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . 5 Interest income. . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . 6 Dividends: a Ordinary dividends. . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Qualified dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . '" 6b 7 Royalties...,....................................,......................................... S Net short-term capital gain (loss) (attach Schedule D (Form 1065)). . . . . . . . . . . . . . . .. . . . . . . , . . . 9a Net long-term capital gain (loss) (attach Schedule D (Form 1065)).. . . . . .. . . . . . . b Collectibles (28%) gain (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9b c Unrecaptured section 1250 gain (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . 9c 10 Net section 1231 gain (loss) (attach Form 4797). . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Other income (loss) (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . 12 Section 179 deduction (attach Form 4562) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 a Contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Deductions related to portfolio income (attach statement). . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . c Investment interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Section 59(e)(2) expenditures: (1) Type .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (2) Amount. ~ e Other deductions attach statement . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14a Net earnings (loss) from self-employment. . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . , . . . . , . . . . . c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . 1Sa Low-income housing credit (section 42(j)(5))....,.................. .....,................,.. b Low-income housing credit (other). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . , . . . . . . . . . . c Qualified rehabilitation expenditures (rental real estate) (attach Form 3468). . . . . . . . . . . . d Other rental real estate credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , . . . . . . . . . . . . . . . . . . . . , . . . . . e Other rental credits, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . f Other credits and credit reca ture (attach statement). . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . 16 a Name of country or U.S. possession. ., ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources. . . . . . , . . . . . . , . . . . . . . . . . .. . . . .. . . . . . . . . . . . . . ., . . , . . . . . . , . . . .. 16b c Gross income sourced at partner level. . . . . . , . . .. .. , . . . . . . , . . . . . . , . . . . . . . . . . . , . , . . . . . . , . . . .. 16c Foreign gross income sourced at partnership level d Passive .. _ _ _ _ _ _ _ _ _ e Listed categories (attach statement).. _ _ _ _ _ _ _ -' General limitation. ~ 16f Deductions allocated and apportioned at partner level g Interest expense" _ _ _ _ _ _ _ _ _ _ _ h Other......,......,.............,...,..,... ~ Deductions allocated and apportioned at partnership level to foreign source income i Passive .. _ _ _ _ _ _ _ j Listed categories (attach statement).. _ _ _ _ _ _ _ _ k General limitation .. ~ I Foreign taxes: (1) Paid" _ _ _ _ _ _ _ _ _ _ _ (2) Accrued............................... m Reduction in taxes available for credit (attach statement ..,......,.......................... 17 a Post- 1986 depreciation adJustment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . d Oil, gas, and geothermal properties - gross income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e Oil, gas, and geothermal properties - deductions. . . . . . . . . , . . . . . . . . . . . . . . . . . . . . .. .......... f Other AMT items (attach stmt) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Sa Tax-exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . , . .. . . . . , . .. . . . . . . . . . . . . . .. . . b Other tax-exempt income. . . . . . . . . . . . . . . . . . . . .. ........................................... C Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . .. ............,.............................. 19a Distributions of cash and marketable securities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Distributions of other property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20a Investment income. . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . .. . . . . . . ., . . . . . . . . . . .. . . . . . . . . . . b Investment expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Other items and amounts attach stmt .......................... . . . . . . . . . . . . . . . . . . . . . . . . . . . Income (Loss) Deduc- tions Self- Employ- ment Credits & Credit Recap- ture Foreign Trans- actions Alternative Minimum Tax (AMT) Items Other Infor- mation BAA PTPA0134L 01105/05 3c 4 S 6a 10 " 12 13a 13b 13c 13d 2 13e 14a 14b 14c 1Sa 1Sb 1Sc 1Sd 1Se 1St 16k 161 2 16m 17a 17b 17e 17d 17e 17f 1Sa 1Sb 1Sc 19a 19b 20a 20b \ I Pa e 3 Total amount 1,668. 234. 53. 10 000. 29,086. 234. Forl(T1 1065 (2004) 1 Net income (loss). Combine Schedule K, lines 1 through 11. From the result, subtract the sum of Schedule K, lines 12 throu h 13e, 161(1), and 161(2)........... ............... 2 Analysis by (i) Corporate (ii) Individual (iii) Individual (iv) Partnership partner type: (active) (passive) a General partners. . . . b limited artners . . . Note: Schedules L, M- 1 and M-2 are not re Sc:heduIEfL"' Balance Sheets er Books Assets 1 Cash.. .........,..............,...... 2a Trade notes and accounts receivable. . . . . . . . b Less allowance for bad debts, . . . . . . . . . . . . . . . 3 Inventories.............................,... 4 U.S. government obligations. . . . . . . . . . . . . . . . 5 Tax-exempt securities. . . . . . . . . . . . . . , . . . . . . . 6 Other current assets (attach stmt). . . . SEE. ST. .1. . 7 Mortgage and real estate loans. . . . . . . . . . . . . . ' 8 Other investments (attach stmt). . . . . , . . . . . . . . . . . . . . 9a Buildings and other depreciable assets. . . . . . . b Less accumulated depreciation. . . . . . . . . . . . . . 10 a Depletable assets, . . . . . . . . . . . . . . . . . . . . . . . . . b Less accumulated depletion,................ 11 Land (net of any amortization). . . . . . . . . 12a Intangible assets (amortizable only). . . . . . . . . . b Less accumulated amortization.............. 13 Other assets (attach stmt). . . . . . . . . . . . . . . . . . . 14 Total assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Liabilities and Capital 15 Accounts payable. . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Mortgages, notes, bonds payable in less than 1 year. . . . . 17 Other current liabilities (attach stmt). . . . . . . . . . . . . . . . 18 All nonrecourse loans. . . . . . . . . . . . . . . . . . . . . . . 19 Mortgages, notes, bonds payable in 1 year or more. . . . . . 20 Other liabilities (attachstmt)...................... 21 Partners' capital accounts. . . . . . . . . . . . . . . . . . . 22 Total liabilities and ca ita!................... !'Schedute<M.q. Reconciliation of Income 1 Net income (loss) per books. . . . . . . . . . . . 2 Income included on Schedule K, lines 1, 2, 3c, 5, 6a, 7, 8, 9a, 10, and 11, not recorded on books this year (itemize): -------------------- -------------------- 3 Guaranteed pmts (other than health insurance). . . . . 4 Expenses recorded on books this year not included on Schedule K\ lines 1 through He, 16/(1), and 161(2) (itemize): a Depreciation. . . . .. $_ _ _ _ _ _ _ _ _ _ _ b Travel and entertainment. . . .. $_ _ _ _ _ _ _ _ _ _ _ -------------------- 1 Balance at beginning of year. . . . . . . . . . . . 2 Capital contributed: a Cash. . . . . , . . . . . . b Property. . . . . . . . . 3 Net income (loss) per books. . . . . . . . . . . . 4 Other increases (itemize): _ _ _ _ _ _ _ _ _ _ ~J~~EM~~~~__________ 5 Add lines 1 throu h 4. . . , . . . . . . . . . . . . . . . 1 (v) Exempt organization 1,884. uired if Question 5 of Schedule B is answered 'Yes.' Beginning of tax year End of tax year (a) (b) (c) 6 Income recorded on books this year not included on Schedule K, lines 1 through 11 (itemize): a Tax-exempt interest.. $_ _ _ _ _ _ _ _ _ _ _ -------------------- 7 Deductions included on Schedule K, lines 1 through 13e, 161(1), and 161(2), not charged against book income this year (itemize): a Depreciation. . . .. $ -------------------- -------------------- 1 902. ital Accounts 76,076. 8 Add lines 6 and 7. . . . . . .. . . . . . . . . .. . . . . . . 9 Income (loss) (Analysis of Net Income (Loss), line 1). Subtract line 8 from line 5 . . . . . . . . . . . . . . . . . . . . . 1,902. 6 Distributions: a Cash. . . . . . . . . . . . . . . . . . . . b Property. . . . . . . . . . . . . . . . . 7 Other decreases (Itemize): _ _ _ _ _ _ _ _ _ _ _ 707. 78,685. -------------------- STATEMENT 3 -------------------- 8 Add lines 6 and 7. . . . . . . . . . . . . . . . . . . . . . . . 9 Balance at end of year. Subtract line 8 from line 5. . . . PTPA0134L 01/05/05 Page 4 1,902. (vi) Nominee/Other 18. (d) 38,892. 38 892. 38,892. 38,892. 1 902. 10 000. 29,086. 707. 39 793. 38,892 . Form 1065 (2004) I' Department of the Treasury Interna\ Re\lenue Service Rental Real Estate Income and Expenses of a Partnership or an S Corporation .. See instructions. .. Attach to Form 1065, Form 1065-B, or Form 11205. OMS No. 1545.1186 Form 8825 2004 Name Employer identification number CLECKNER PROPERTIES 23-2822095 1 Show the kind and location of each property. See page 2 for additional properties. A RESIDENTIAL REAL ESTATE 1015SHE~ANST:HARRISBURGPA-Ulli------------------------------------- B ---------------------------------------------------------~------- c ______________________________________________________----------- o ----------------------------------------------------------------- Pro erties Rental Real Estate Income A B c o 2 Gross rents. . . . . . . . . . . . . . . . . . . . . . . . . . 2 Rental Real Estate Expenses 3 Advertising........................... 3 4 Auto and travel. . . . . . . . . . . . . . . . . . . . . . . 4 5 Cleaning and maintenance. . . . . . . . . . . . 5 6 Commissions......................... 6 7 Insurance............................ 7 8 Legal and other professional fees. . 8 9 Interest.............................. 9 10 Repairs.............................. 10 11 Taxes................................ 11 12 Utilities........................... 12 13 Wages and salaries. . . . . . . . . . . . . . . . . . . 13 14 Depreciation (see instructions). . . . . . 14 15 Other (list) .. ____________ POSTAGE 4,625. 446. 275. 468. 798. 933. 37. 15 16 Total expenses for each property. Add lines 3 through 15. . . . . . . . . . . . . . 16 2, 957 . 17 Total gross rents. Add gross rents from line 2, columns A through H....................................... 17 18 Total expenses. Add total expenses from line 16, columns A through H.................................... 18 19 Net gain (loss) from Form 4797, Part II, line 17, from the disposition of property from rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . . " . . . . . . . . . . . . . . . . . . . . . . .. 19 20 a Net income (loss) from rental real estate activities from partnerships, estates, and trusts in which this partnership or S corporation is a partner or beneficiary (from Schedule K.1). . . . . . . . . . . . . . . . . . . . . . . . b Identify below the partnerships, estates, or trusts from which net income (loss) is shown on line 20a. Attach a schedule if more space is needed: (1) Name (2) Employer identification number 4,625. -2,957. 21 Net rental real estate income (loss). Combine lines 17 through 20a. Enter the result here and on: . Form 1065 or 11205: Schedule K, line 2, or . Form 1065.8: Part I, line 4 BAA For Paperwork Reduction Act Notice, see the separate instructions. ]- 1 668. ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- Form 8825 (2004) SPSZ0101L 10/22/04 \ I n Final K-' n Amended K-1 OMS No, 1545-0099 Schedule K-' 2004 IPartlll,! Partner's Share of Current Year Income, (Form 1065) Deductions. Credits. and Other Items Department of the Treasury Tax year beginning ,2004 1 Ordinary business income (loss) 15 Credits & credit recapture Internal Revenue Service and ending ,20 - - -------------- Partner's Share of Income, Deductions, 2 Net rental real estate income (loss) * 834. Credits, etc. .. See separate instructions. 3 Other net rental income (loss) 16 Foreign transactions I Part I I Information About the Partnership - -------------- 4 Guaranteed payments A Partnership's employer identification number 23-2822095 - -------------- 5 Interest income B Partnership's name, address, city, state, and ZIP code - -------------- 6a Ordinary dividends CLECKNER PROPERTIES 117. - -------------- 7706 HANOVERDALE DRIVE 6b Qualified dividends HARRISBURG PA 17112 - --------------- C IRS Center where partnership filed return 7 Royalties CINCINNATI, OH - -------------- 0 "- Check if this is a publicly traded partnership (PTP) 8 Net short-term capital gain (loss) E Tax shelter registration number, if any - F _ Check if Form 8271 is attached 9a Net long-term capital gain (loss) 17 Alternative minimum tax (AMT) items A 26. -------------- 1"P,al1l1ftdl Information About the Partner 9b Collectibles (28%) gain (loss) - ------......------- G Partner's identifying number 9c Unrecaptured section 1250 gain 199-50-4886 H Partner's name, address, city, state, and ZIP code 10 Net section 1231 gain (loss) 18 Tax-exempt inCome and nondeductible expenses RICHARD CLECKNER, JR 11 Other income (loss) 1-- - - - -- - -'-- - ---- 7706 HANOVERDALE DRIVE 1-- --------------- HARRISBURG, PA 17112 1-- ~ General partner or LLC - - - - - - _.,- - - - - - - I U ~imited partner or other 1-- member-manager LLC member --------------- J [RJ Domestic partner OF oreign partner 19 Distributions 12 Section 179 deduction I-~ _________~L~O.Q.:... K What type of entity is this partner? INDIVIDUAL 13 Other deductions B 14,543. L Partner's share of profit, loss, and capital: - 20 Other information Beginning Ending --------------- Profit 50 s. 50 % I-A_ ___________lJl.:... 0 - --------------- Loss 50 ~ 50 % 0 CaDital % 98.135863 % - -------------- 14 Self-employment earnings (loss) M Partner's share of liabilities at year end: - --------------- - -------------- Nonrecourse. . , , , , , . , , . , , . . , , . . . , . . . , $ Qualified nonrecourse financing, , . . , , , $ Recourse, , . . . , , . , , , . , , . . . , , . , . , , , . . . $ *See attached schedule for additional informati~n. N Partner's capital account analysis: F 0 Beginning capital account. , . . , , . . . , , , $ 56 759. R Capital contributed during the year, , . . $ I R Current year increase (decrease). , . . . , $ 951. 5 Withdrawals and distributions, . . . . , , . . $ ( 19 543. ) u 5 Ending capital account, , . . . . , , . . . , , , . $ 38,167. E 0 o GAAP o Section 704(b) book N ~ Tax basis L y Other (exDlain) BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. PTP A0312L 01/05/05 Schedule K-1 (Form 1065) 2004 CLECKNER PROPERTIES 23-2822095 SUPPLEMENTAL INFORMATION SCHEDULE K.' FORM 1065 2004 BOX2 RENTAL REAL ESTATE ACTIVITIES PROPERTY DESCRIPTION RESIDENTIAL REAL ESTATE GROSS INCOME 2,313 . NET EXPENSES 1,479. $ TOTAL $ NET INCOME 834. 834. PASSIVE NONPASS PASSIVE SEC. 1231 TOTAL \ I PAGE 2 RICHARD CLECKNER, JR 199-50-4886 SPSL1201L 07/31/03 [Xl Final K-1 n Amended K-1 OMS No. 1545 -0099 Schedule K-' 2004 leaif,IlI'.1 Partner's Share of Current Year Income, (Form 1065) Deductions, Credits and Other Items Department of the Treasury Tax year beginning ,2004 1 Ordinary business income (loss) 15 Credits & credit recapture Internal Revenue Service and ending ,20 - -------------- Partner's Share of Income, Deductions, 2 Net rental real estate Income (loss) * 818. Credits, etc. ~ See separate instructions. 3 Other net rental income (loss) 16 Foreign transactions 1":Pait"I.', Information About the Partnership - --- -- - -:-- - ---- 4 Guaranteed payments A Partnership's employer identification number - -------,------- 23-2822095 5 Interest income B Partnership's name, address, city, state, and ZIP code - -------.------- 6a Ordinary dividends CLECKNER PROPERTIES 115. - -------------- 7706 HANOVERDALE DRIVE 6b Qualified dividends HARRISBURG PA 17112 - -------------- C IRS Center where partnership filed return 7 Royalties CINCINNATI, OR -------......------ D Check if this is a publicly traded partnership (PTP) 8 Net short-term capital gain (loss) f0- E Tax shelter registration number, if any , fo- F '- Check if Form 8271 is attached 9a Net long-term capital gain (loss) 17 Alternative minimum tax (AMT) items A ____________22.:.. I. Part'll { Information About the Partner 9b Collectibles (28%) gain (loss) -------------- G Partner's identifying number 9c Unrecaptured section 1250 gain 726-05-4641 H Partner's name, address, city, state, and ZIP code 10 Net section 1231 gain (loss) 18 Tax-exempt income and nondeductible expenses RICHARD W CLECKNER 11 Other income (loss) - -------0+------- 1119 COUNTRY CLUB ROAD 1-- --------------- CAMP HILL, PA 17011 ~ General partner or LLC U Limited partner or other - -------------- I 1-- member -manager LLC member --------------- J ~ Domestic partner D Foreign partner 19 Distributions 12 Section 179 deduction A _ __ _ _ _ __ _ ~ LQ..O.Q.:.. 1-- K What type of entity is this partner? INDIVIDUAL 13 Other deductions B 14,543. L Partner's share of profit, loss, and capital: 20 Other information Beginning Ending - --------------- Profit 50 % % A ___________U~.:.. --------------- - Loss 50 % % Caoital % % - -------------- 14 Self-employment earnings (loss) M Partner's share of liabilities at year end: f-- --------------- - -------...------ Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . $ Qualified nonrecourse financing. . . . . . . $ Recourse. . . . . . . . . . . . . . . . . . . . . . . . . . . . $ *See attached schedule for additional information. N Partner's capital account analysis: F 0 Beginning capital account. . . . . . . . . . . . $ 19,317. R Capital contributed during the year. . . . $ I R Current year increase (decrease). . . . . . $ 226. 5 Withdrawals and distributions. . . . . . . . . $ ( 19,543.) u 5 Ending capital account. . . . . . . . . . . . . . . $ O. E 0 D GAAP D Section 704(b) book N ~~ax basis L Other (exolain) y BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. PTP A0312L 01/05/05 Schedule K-l (Forrin 1065) 2004 CLECKNER PROPERTIES 23-2822095 SUPPLEMENTAL INFORMATION I' BOX2 RENTAL REAL ESTATE ACTIVITIES PAGE 2 PROPERTY DESCRIPTION RESIDENTIAL REAL ESTATE GROSS INCOME 2,268. NET EXPENSES 1,450. $ TOTAL $ NET INCOME 818. 818. PASSIVE NONPASS PASSIVE SEC. 1231 TOTAL RICHARD W CLECKNER 726-05-4641 SPSL 1201 L 07/31/03 II n Final K-1 n Amended K. 1 OMS No. 1545-0099 Schedule K- 1 2004 IPartIIF! Partner's Share of Current Year Income, (Form 1065) Deductions. Credits, and Other Items Department of the Treasury Tax year beginning .2004 1 Ordinary business income (loss) 15 Credits & credit recapture Internal Revenue Service and ending ,20 - -------------- Partner's Share of Income, Deductions, 2 Net rental real estate IIlcome (loss) * 16. Credits, etc. ~ See separate instructions. 3 Other net rental income (loss) 16 Foreign transactions I Part I "[ Information About the Partnership -------------- ~- ;' 4 Guaranteed payments A Partnership's employer identification number ------.......------- 23-2822095 5 Interest income B Partnership's name, address, city, state, and ZIP code -------------- 6a Ordinary dividends CLECKNER PROPERTIES 2. -------+------- 7706 HANOVERDALE DRIVE 6b Qualified dividends HARRISBURG. PA 17112 -------------- c IRS Center where partnership tiled return 7 Royalties CINCINNATI, OH - --------!------- 0 Check if this is a publicly traded partnership (PTP) 8 Net short.term capital gain (loss) l- E I- Tax shelter registration number, if any F Check if Form 8271 is attached 9a Net long-term capital gain (loss) 17 Alternative minimum tax (AMT) items '-- A l. - -------,------- 1;9811<11'''1 Information About the Partner 9b Collectibles (28%) gain (loss) - - - - - - - -: - - - - - - - G Partner's identifying number 9c Unrecaptured section 1250 gain 41-6539981 H Partner's name, address, city, state, and ZIP code 10 Net section 1231 gain (loss) 18 Tax-exempt inGome and nondeductible $xpenses ESTATE OF RICHARD W CLECKNER 11 Other income (loss) - -- - - ---,-- - ---- 1119 COUNTRY CLUB ROAD - --------------- CAMP HILL, PA 17011 ~ General partner or LLC o ~imited partner or other - ------_._------ I - --------------- member .manager LLC member J ~ Domestic partner o Foreign partner 19 Distributions 12 Section 179 deduction - -------------- K What type of entity is this partner? FIDUCIARY 13 Other deductions L Partner's share of profit, loss, and capital: 20 Other information Beginning Ending - --------------- Profit % 50 % f-A_ 2. - --------------- -------------- Loss % 50 % Capital % 1.864137 % -------....------ 14 Self-employment earnings (loss) M Partner's share of liabilities at year end: - --------------- i-- -------------- Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . $ Qualified nonrecourse financing. . . . . . . $ Recourse. . . . . . . . . . . . . . . . . . . . . . . . . . . . $ *See attached schedule for additional informatiQn. N Partner's capital account analysis: F 0 Beginning capital account. . . . . . . . . . . . $ o. R Capital contributed during the year. . . . $ I R Current year increase (decrease). . . . . . $ 725. 5 Withdrawals and distributions. . . . . . . . . $ u 5 Ending capital account. . . . . . . . . . . ... . $ 725. E 0 o GAAP o Section 704(b) book N ~ Tax basis L y Other (explain) BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. PTPA0312L 01105/05 Schedule K- 1 (F orin 1065) 2004 CLECKNER PROPERTIES 23-2822095 SUPPLEMENTAL INFORMATION Jl BOX2 RENT AL REAL ESTATE ACTIVITIES PAGE 2 PROPERTY DESCRIPTION RESIDENTIAL REAL ESTATE GROSS INCOME 44. NET EXPENSES 28. $ TOTAL $ NET INCOME 16. 16. PASSIVE NONPASS PASSIVE SEC. 1231 TOTAL ESTATE OF RICHARD W CLECKNER 41-6539981 SPSL120lL 07131/03 2004 FEDERAL STATEMENTS CLECKNER PROPERTIES STATEMENT 1 FORM 1065, SCHEDULE L, LINE 6 OTHER CURRENT ASSETS AXP CASH MANAGEMENT FUND... BEGINNING ...............$ 46,057. $ TOTAL $ 46,057. $ STATEMENT 2 FORM 1065, SCHEDULE M-2, LINE 4 OTHER INCREASES I' PAGEl 23-2822095 tNDING 38,892. 38,892. TRANSFER TO ESTATE.. .......................................................................... $ 707. TOTAL $ 707. STATEMENT 3 FORM 1065, SCHEDULE M-2, LINE 7 OTHER DECREASES TRANSFER TO ESTATE.......... ......... $ TOTAL $ 707. 707. \ I U.S. Return of Partnership Income For calendar year 2003, or tax year beginning , 2003, and ending , 20 ~ See se arate instructions. Form 1 065 OMS No.1545-0099 2003 Department of lhe Trauury Internal Revenue Service A Principal business activity Na lle of partnership o Employer Iden1lllcallo" "umber Use the IRS label. Other- wise, print or type. REAL ESTATE CLECKNER PROPERTIES Number, street, and room or suite number. If a P.O. box, see instructions. 23-2822095 E Date business started HOUSES B Principal product or urvice 7706 HANOVERDALE DRIVE City or town C Business code number State ZIP code 06/30/95 F Total assisls (see instrs) 531390 HARRISBURG PA 17112 $ 76.076. G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) Amended return H Check accounting method: (1) X Cash (2) Accrual (3) Other (specify) . . . . . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _' I Number of Schedules K- 1. Attach one for each person who was a partner at any time during the tax year. . . , . . . . . . . . . . . ~ 2 Caution: Include only trade or business income and expenses on lines 1a through 22 below. See the Instructions for more informaltion. S E E I N S T R o u E ~ o I U 0 C ~ T I F o ~ N S ~ M I T A T I o N S Sign Here Paid Preparer's Use Only BAA I N C o M E 1a Gross receipts or sales . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . , . . . . . 1a b Less returns and allowances ......,.,.................,............. 1 b Illl~~:!:I~~I: 1c 2 Cost of goods sold (Schedule A, line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Gross profit. Subtract line 2 from line 1 c ........................................................ 4 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule) . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Net farm profit (loss) (attach Schedule F (Form 1040)) . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . , . 6 Net gain (loss) from Form 4797, Part II, line 18 , . . . . . . . . . . . . . . . . . . . . . . . . , , . . . . . . . . . . . . 7 2 3 4 5 6 Other income (loss) (attach schedule) . . . . . . . . . ' . . . , . , . . . . , . . . 7 8 Total income loss. Combira lines 3 throu h 7 8 9 Salaries and wages (other than to partners) (less employment credits) . . . . . . . . . . . . . . . . . . . . . . 9 10 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . .. . . . . . . ' . . . , . . . . . . . . . . . . . . . . . 10 11 Repairs and maintenance .,.'...................................... 11 12 Sad debts ............... . . . . . . . . . . , . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . , . . . . . . . . . ., 12 13 Rent.................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . , . . . . . . . . ' . . , . . ., 13 14 Taxes and licenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . , . . . . . , . . . . . . . . . . . . . . . . . . . . .. 14 15 Interest......... .............,............ . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 16: ~::;edc~:~:~i;~;;~~~~:~~::~c~:hO;::12~n~' ~;~~~~~~'~~'r~'~~~'::::: H*1 :ili~::~~i 17 Depletion (Do not deduct oil and gas depletion.) . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . .. . . . . . . . . .. 17 18 Retirement plans, etc .............................. . . . . . . . . . . . . . . . . . . . . . . . . 18 19 Employee benefit programs ........................ . . . . . . . . . . . . . . . . , . . . . . . . . . . . . 19 20 Other deductions (attach schedule) . . . . . . . .. ......'............................................................ 20 21 Total deductions. Add the amounts shown in the far ri ht column for lines 9 throu h 20 , . . . . . . . . . . . ., 21 22 Ordina income (loss) from trade or business activities. Subtract line 21 from line 8 ...........,.... 22 Under pen allies of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowl~dge and behef, it is true, corr co o.ec~, .'\ .,ot-41r,ep"a1" .~ (other than general partner or limited liability company member) is based on all information of which preparer has" ~~ ~.l' ~ " ,;.' f ~ May lI1e IRS discus~ lI1is return . with the prefar.r shown below Date (see instrs). Ye. Preparer's SSN or PTIN No Preparer's !'t, signature ~ ~. Firm'. name Carolyn S. Wallace Tax (or yours if self.employed), ~ 4314 C res t view Road address. and ~Pcode Harrisburg For Paperwork Reduction Act Notice, see separate instructions. Date Check jf .elf. ~ X e",ployed ,.. 03/23/04 Service 202-20-6104 PA 17112 EIN ~ 23-2203678 Phone no. (717) 540-5700 Form 1065 (2003) PTPA0112 08125103 \ I Form 1065 (2003) CLECKNER PROPERTIES ([Schijijhh';Witl Cost of Goods Sold (see instructions) 23-2822095 Page 2 1 Inventory at beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Purchases less cost of items withdrawn for personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Cost of labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 1 2 3 Additional section 263A costs (attach schedule) . . . . 4 5 Other costs (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . , . . . . , . . . . . . . . . . . . , . . . . . . . . , . . . , . 5 6 Total. Add lines 1 through 5 ......................,.....".,...".........",..",...,................ 6 7 Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . , . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . , . . 7 8 Cost of goods sold. Subtract line 7 from line 6, Enter here and on page 1, line 2 . . . . . . , . . . . . . . . . . . . . . . . . . . . 8 9. Check all methods used for valuing closing inventory: (i) ~ Cost as described in Regulations section 1.471.3 (ii) Lower of cost or market as described in Regulations section 1.471.4 (Iii) Other (specify method used and attach explanation) . . . . , . . . . . . . ., ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . b Check thiS box If there was a wntedown of 'subnormal' goods as descnbed In Regulations section 1.47l.2(c) ......', .,...., ~ ~ c Check thiS box If the LIFO inventory method was adopted thiS tax year for any goods (If cheeked, attach Form 970) ...., .. ,. ~ d Do ttle rules of section 263A (for property produced or acqUIred for resale) apply to the partnership? " ...." ,...",. 8 Yes No e Was there any change in determining quantities, cost, or valuations between opening and clOSing Inventory? . , . . . . . . Yes No If 'Yes', attach explanation 1::r;;o.:I;i,",*"I'.'!"::.:::~:'$::$$l Other Informat'lon _~~~~~....:::M:::;:::::::::;:) 1 What type of entity is filing this return? Check the applicable box: a ~ Domestic general partnership b ~ Domestic limited partnership : D ~:~~~i~~i~~:::~:~bility comp3ny ~ tj ~~h:;st:~ ~i:i~e~ I~~I~ ::::S~i: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ '::" 2 Are any partners in this partnership also partnerships? ..' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . X 3 During the partnership's tax year, did the partnership own any interest in another partnership or in any foreign entity that' was disregarded as an entity separate from its owner under Regulations sections 301.7701.2 and 301.7701.3? If yes, see instructions for required attachment .., . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 4 Is this partnership subject to the consolidated audit procedures of sections 6221 through 6233? If 'Yes,' see Designation of Tax Matters Partner below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . X 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K.l are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If 'Yes,' the partnership is not required to complete Schedules L, M.l, and M.2; Item F on page 1 of Form 1065; or Item J on Schedule K.l ....................................,.......,..,........................................ X 6 Does thiS partnership have any foreign partners? If 'Yes,' the partnership may have to file Forms 8804, 8805 and 8813. See instructions. . . . . . . . . . . . . , . . . . . . X 7 Is this partnership a publicly traded partnership as defined in section 469(k)(2)? .......,...... . . . . . . , . . . . . . . . . . . . . . . X 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? ...............,. X 9 At arlY time during calendar year 2003, did the partnership have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? See the instructions for exceptions and filing requirements for Form TO F 90.22.1. If 'Yes,' enter the na:l1e of the foreign country . ~ X ------------------------------------------------ 10 During the tax year, did the partnersolip receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If 'Yes,' the partnership may have to file Form 3520. See instructions. . . . . . . . . . , . . . . . . . . . . , , . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . X 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If 'Yes,' you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement descnbed in the instructions under Elections Made By the Partnership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached :.:.~.;.:::.;:;.:::.i:.:.i::.:...;.:...;.!.:.::1:!...f::.::[:!.:.::~:.:.::::.:.[::.[:~..[::.\:.:.:.:.:.\..:,\,:., to thiS return ... . . . . . . . . .. ...............,.......,........... . . . . . . . . . . . . ~ Designation of Tax Matters Partner (see instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: Name of designatea TMP .. Address ot designated TMP .. RICHARD CLECKNER, JR 7706 HANOVERDALE DRIVE HARRISBURG, PA 17112 Identifying number ofTMP .. 199-50-4886 PTP AO 112 08!25/03 Form 1065 (?003) II Form 1055 (2003) CLECKNER PROPERTIES 23-2822095 Page 3 1~S.""bijijl"""K""""""m P rt ' Shares of Income, Credits, Deductions, etc ': :Q. .:. ... ...t:.:~t~::::f; a ners (_) Distributive share items (b) Total amount 1 Ordinary income (loss) from trade or business activities (page 1, line 22) . . . . . . . . . . 1 2 Net income (loss) from rental real estate activities (attach Form 8825) '3~i . . . . . . . . . 2 2,850. 3a Gross income from other rental activities . . . . . . . . . . . . . . . . . . . . . . . ~ I ilj~II~II:llll!!!)I:!!:. b Expenses from other rental activities (attach 5ch) . . . . . . . . . . .1 3b] c Net income (loss) from other rental activities. Subtract line 3b from line 3a . . . . . . . . .. . . . 3c 4 Portfolio income (loss) (attach Schedule 0 (Form 1065) for lines 4d and 4e: .. . . . . . . . . . . . r:jm!;~i~~~lm~~~mi~;~~ ~j11~~~j~l~&~j~ilii~~l~1~f:j~t1I~1i~~~%1~~~~~@~~jj!j a Interest income . . . . . . . . ., . . . . . .. . . . ..... . . . .. . . . . . . . . ,. . . 4a ! Income b Dividends: (1) Qualified dividends ~ O. (2) Total ordinary dividends ~ 4 b (2) 201 -- - -- ------ (Loss) c Royalty income . . . . . . . . . . . . ... . . . . . . . . . .. . . . 4c d Net short-term capital gain (loss): (1) post-May 5, 2003 ~ ___________(2) Entire year ~ 4d (2) e Net long. term capital gain (loss): (1) post. May 5, 2003 . . ~ ___________(2) Entire year ~ 4e (2) . . f Other portfolio income (loss) (attach schedule) . . . . . . . . .. . . .. .... . .. . . .. .. . . . 4f 5 Guaranteed payments to partners. . . .. . . . . ., . . . . .... . . . . . .... . . . '" . . . 5 6a Net section 1231 gain (loss) (post. May 5, 2003) (attach Form 4797) . . . . . . . . . . . ... . " . . . 6a b Net section 1231 gain (loss) (entire year) (attach Form 4797) . . .. . . . .. . . . . . . . 6b 7 Other income (loss) . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Charitable contributions (attach schedule) ., . . . .. . . . . .. . . . . . 8 , Deduc- 9 Section 179 expense dedL..ction (attach Form 4562) . . . . . . . . . . . . . . . . . . . . ... , . . 9 tions 10 Deductions related to portfolio income (itemize) 10 . . . . ... . . . . . .. .. . ... . ., . .. . ..... . , . 11 Other deductions . . . . . . . . . . . . . . . . . . . . . . . . 11 12. Low-income housing credit: (1) From partnerships to which section 420)(5) applies .. . .. . 12a-(n Credits (2) Ottler than on line 12a(1) . . . . . . .. . .... . ... . . . .. . . . . . ... . . . .. . 12a (2)- b Qualitied rehabilitation expenditures related to rental real estate activities (attach Form 3468) . . . . . . . . . . .. . 12b c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities . . .. .. -.. . .. . . . . 12c d Credits related to other rental activities . . . . .. . . . .... . . . . . . . . . . . . . 12d 13 Ottler credits . . . . . . .. . . . . . ., . ..... . . . .. . .. . . . 13 Invest- 14_ Interest expense on investment debts . . . . .. . . . . . . . " . .. . . . . . 14a ment b (1) Investment income included on lines 4a, 4b(2) , 4c, and 4f above .,. . . . . . . . . . . . . . 14b (1) 201 Interest (2) Investment expenses included on line 10 above 14b (2) . . . . . . .. . . . .. . '" . . . . . Self- 15a Net earnings (loss) from self.employment. .. . . . .. . . . . .. ....... . ... . . . . . . . . . 1S. Employ- b Gross farming or fishing income . . . . .. . . . . . . . . . ... . . . .. . 15b ment c Gross nonfarm 15c income . . . . . . . . " . . . . . . . . . .. . .. . . . Adjust- 16a Depreciation adjustment on property placed in service after 1986. . . . . . . .. . . , .. . 16a 437 ments b Adjusted gain or loss . . . . . . " . ... . ., . . . . . . . . . . . . . 16b and Tax c Depletion (other than oil and gas) . . . . . ... . . . . . . .. . . . . . . . . . . . 16c Prefer- . . ence d (1) Gross income from oil, gas, and geothermal properties . . .. . ., . . . ... . . . 16d(1) Item s (2) Deductions allocable to oil, gas, and geothermal properties . . . . . . ... . .. . . . 16 d (2) e Other adjmnts & tax pref items . . . . . . . . .. . . . ..... . . . . . .. . . . .. . 16. 17. Name of foreIgn country or U.S. possession . ~t~~t~lr:tmm~~ ---------- - - ---------- - - - b Gross income from all sources . . . . . . .. . ., . . . . . . . . . . . . . . . .. . .. . .. . . . 17b c Gross income sourced at I"artner level . . . .. . . .. .. . .. . .... . .. . . . . . 17c d Foreign gross income SOUl ced at partnership level: ~~~~~~~~I~~~I@~~~t (1) Passive . (2) Listed categories (attach 5ch) . (3)General limitation ~ 17d (3) Foreign e Deductions allocated and apportioned at partner level: mlmmi~1!~i111~i~~~llj Taxes (1) Interest expense · (2)Other ~ 17. (2) . . . . . . . . ., .. . f Deductions allocated and apportioned at partnership level to foreign source income: i;i1iti1~;~jj~jt~il~tjj (1) Passive . (2) Listed categories (attach 5ch) . (3)Generallimltation ~ 17f (3) g Total foreign taxes (check one): . Dpaid 0 Accrued .. . .... , .... . . ,.... ... . . . 17Q h Reduction in taxes available for credit (attach schedule) . . . .. . . .. . . . .. . ,.., . . . . . . . 17h 18 Section 59(e)(2) expenditures: a Type . b Amount ... 18b ----- --- ---- --------- . . 19 Tax.exempt interest income . . . . .. . ... . .. . " . . . . . . . 19 20 Other tax-exempt income . . . . . . . . . . . . . . . . .., . . . .. . . . ..' , . . . . 20 Other 21 Nondeductible expenses . . . . . . . . .... ,. . . .. . . . . . .. . .. . .. . 21 22 Distributions of money (cash and marketable securities) . . . . . . .. . .. . . . . . . . ., . ... . 22 23 Distributions of property other than money .. . . . . . . . . . .. . .. . . . . . . . . . 23 24 Other items and amounts required to be reported separately to partners [)il:l::1il::i;.:ii[!ili:ii;.liiil!l11i:l:liiillllliiiil1IIIlilll~!~ilij:ii;.jil\i[~:ii\1:illl\il~ji.i; (attach schedule) ,.",., .',.......... ..,......................... .. . . . . . . . . . BAA Form 1065 (2003) PTPA0134 12126103 - l' Form 1065 (2003) ( L E ( K N E R PRO PER TI E S ?3-2822095 Page 4 - Analvsis of Net Income (Loss) 1 Net Income (loss). Combine Schedule K, lines 1 throu~h 7 in column (b). From the result, subtract the .1 1 sum of Schedule K, lines 8 throuQh 1" 14a, 17q, and 8b............................................ 1 3,051. 2 Analysis by (i) Corporate (ii) Individual (iii) Individual (iv) Partnership ~v) Exempt (vi) Nominee/Other partner type; (active) (passive) organization I General 3.051. partners . ., . b ~~~~:'rs .. .. Note: Schedules L, M.l and M.2 are no' re U1red If Question 5 of Schedule B is answered 'Yes,' e.h"lm~t :\:%%{i,: Balance Sheets er Books Beginning of tax year Assets (I) (b) 1 Cash..................................... mr\:lN:i;i:t:\:\i%ttml:\:t:fttt 21 Trade notes and accounts receivable. . b Less allowance for bad debts. . . . . . . . . 3 Inventories............................... !!!!i!!!!!if 4 U.S. government obligations. . . . . . . . . . . tlm 5 Tax.~xempt securities ..................... 6 Other current assets (attach schedule) .L n. 41 260. :. ~~i::~::~: ~::;:~:~:;:~:: ;~,~ . . . . . . "'--34:33'_ b Less accumulated depreciation ............. 6 919. 27 , 417 . 10. Depletable assets. . . . . . . . . . . . . . . . . . . . . . . . . 1j~ijjji~j!!i~t1ti1~!ij~;~i!~~~j~ji~~!1I1~I1mj~1jj~~11~~~jj~~1ti!i~! b Less accumulated depletion ... . . . . . . . . . . . . . 11 Land (net of any amortization) .. . . . . . . . . . . . . :!t:::t:tit~;!!::;tt:t\!!j\t(MtwWr: 121 Intangible assets (amortizable only) ...... . . . b Less accumulated amortization 13 Other assets (attach schedule) ............. i!\ii\!i}il!i!iiiii!};;r':':':':':':':::::':':':':':':.:.::.:...:.:.:. 14 Totl' assets .. ..................... .... Lilbilities Ind Clpitll 15 Accounts payable ..................... , 6 Mortgages, notes, bonds payable in less than '. year. 17 Other current liabilities (attach sch) . . . . . . . . . . . . . . . . 18 All nonrecourse loans. . . . . . . . . . . . . . . . . . . . . . 19 Mortgages, notes, bonds payable in 1 year or more 20 Other liabilities (attach schedule) . . . . . . . . . . . . 21 Partners' capital accounts. . . . . . . . . . . . . . . . . . :;:;::: 22 Totllliabilities and ca ita I . . . . . . . . . . . . tt .e.fti.' .....Iii: . k j( Reconciliation of Income 1 Net income (loss) per books ............ 2 Income included on Schedule K, lines 1 through 4, Gb, and 7, not recorded on books this year (itemize): End of tax year; (c) 348 . ji:\;\t:mmttmj~l~ji@{mjIf!@l ~~~~1~~~;\~~~~~~~~~~~~i~1~~~~~t~~~\t~~i;~~m~~~j~jij~~~\\~~~*t\~ (d) .!j;~m~~\~t.tJW.JtU1 ~jl~W~*~jji;1t~~~;~mt1i;~;~;i;1;~~ 46 057. 26,019. f:ili~1~1~t~t1j~~~ :~I~li~tr*llli~~1~t~~1I~j~m~111i 4 000. @1;tt1lFnit!l;l~lill~!t:J 4 000. ~~~1~~~~~tj\~~m~~\t~~1\~j\~\j~~~~j~tm~~j~~~jjj1~j~mmtIjij ;m~1~!~~~~ili~t ;~ t~~~~~li!ltl~~l1~1~~11 76,076. 76,076. 76,076. 3 Guara~teed pmts (other than health insurance) . . . . . 4 Expenses recorded on books this year not included on Schedule K, lines 1 through IT, 14a. 17g, and 18b (itemize); I Depreciation . . . . . . $_ _ _ _ _ _ _ _ _ _ _ b Travel and entertainment . . . ., $ 7 Deductions included on Schedule K, lines I through 11, 14a, 17g, and 18b, not charged against book income this year (itemize); I Depreciation ..... $_ _ _ _ _ _ _ _ _ _ _ 3,051. ital Accounts 73,025. 8 Add lines 6 and 7 ....................... 9 Income (loss) (Analysis of Net Income (Loss), line I). Subtract line 8 from line 5 3,051. 6 Distnbutions: I Cash .. . . . ., ........... b Property 7 Other decreases (itemize); _ _ _ _ _. _ _ _ _ _ _ 3 4 3,051. 5 Add lines 1 through 4 8 Add lines 6 and 7 ........... . . . . . . . . . 76 , 076 . 9 Balance at end of year. Subtract line 8 from line 5 . . 76,076. PTP AO 134 12126103 Form 1065 (2003) Form 8825 Rental Real Estate Income and Expenses of a Partnership or an S Corporation .. See instructions. .. Attach to Form 1065, Form 1065-8, or Form 11205. OMS No.1 545.1186 Department of the Treasury Intemal Revenue Service Name 2003 Employer Idenllllc.llon .umber CLECKNER PROPERTIES 23-2822095 1 Show the kind and location of each property. See page 2 for additional properties. A JQ!.5_ ~I:iE_R.t1~N_ ~I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ HARRISBURG, PA 17112 8 ------------______________________________________________________ c __________________________________________________________________ D -------------_____________________________________________________ ProDerties Rental Real Estate Income A 8 C D 2 Gross rents .. . .. . . , , , , , 2 5, 700. Rental Real Estate Expenses 3 Advf!rtising . , . , 3 4 Auto and travel . , . , .' , 4 5 Cleaning and maintenance , , . . 5 6 Commissions , , , , . . 6 7 Insurance , , , . . , , . 7 379 8 Legal and other professional fees , . 8 275 9 Interest 9 \ , . . . , . . , 10 Repairs . . . . , . . . 10 65 -- 11 Taxes. . , . . . . 11 733 12 Utilities, . . . , , , 12 13 Wages and salaries .. , , , . . , , 13 14 Depreciation (see instructions) . . . , 14 1 398 15 Other (list) .. - --- --- -- - - -- - -- - --- ------------- 15 - ------------ ------- 16 Total expenses for each property. Add lines 3 through 15 . , , . . . 16 2, 850. 17 Total gross rents. Add gross rents from line 2, columns A through H ., . . .. , . . . . 17 5, 700. 18 Total expenses, Add total expenses from line 16, columns A through H.. , , ... . , , . , . . . . , , 18 -2 , 850 19 Net gain (loss) from Form 4797, Pan II, line 18, from the disposition of property from rental real estate activities, . . " . . , , , . ' ., ... . . , ,. , ... . , , . , , . , . , ' .. . 19 20 a Net income (loss) from rental real estate activities from ~artnershiPs, estates, and trusts in which this 20a partnership or S corporation IS a partner or benefiCiary from Schedule K-l) .".,...,.",."..",'.... , , . . b Identify below the partnerships, estates, or trusts from which net income (loss) is shown on line 20a. Attach a schedule if more space is needed: (1) Name (2) Employer identification number -- ------ ------- ---------- ------------------ ------- -- -. --------- ------------- ---------------------- - - - - - _. - - ---- - -- ------------- ------ ---------------- -. -- 21 Net income (loss) from rental real estate activities. Combine lines 17 through 20a. Enter the result here and on: ,'l- . Furm 1065 or 11205: Schedule K, line 2, or , . . , . , , .. , . . , , . ,. . 21 2, 850. . Form 1065-8: Part I, line 4 ttl1tJ 111f1@@1ft1fWi1tlHiiHtti11'11tt BAA For Paperwork Reduction Act Notice, see the separate instructions. Form 8825 (2003) SPSZ010l 10/21103 I' Schedule K-l (F onn 1065) Partner's Share of Income, Credits, Deductions, etc OMS No. 1545.0099 Partner's identi in number ~ Partner's name, address, and ZIP code For calendar year 2003 or tax year be innin , 2003, and endin , 20 726-05-4641 Partnershi 'sidenti in number ~ Partnership's name, address. and ZIP code 2003 Department 01 the Treasury Internal Revenue S.Nice 23-2822095 RICHARD CLECKNER, SR 1119 COUNTRY CLUB ROAD CAMP HILL, PA 17011 CLECKNER PROPERTIES 7706 HANOVERDALE DRIVE HARRISBURG. PA 17112 A This partner is a X general partner limited partner o limited liability company member B What type of entity is this partner? .,. ~ IN D I V I D U A L C Is this partner a [R] domestic or a 0 t;~ig;p~rtn;r? - - - - - D Enter partner's % of: (i) B.'r~;mf~:Q~~ or (ii) Ey~arOl Profit sharing "" _ _ _ _ _ _ _ _ _ _ % _ _ _ _ ~..o_' QQO_OQ % Loss sharing. . . . . _ _ _ _ _ _ _ _ _ _ % _ _ _ _ ~ 0_. QQO_OQ % Ownership of capital.. _ _ _ _ _ _ _ _ _ _ % _ _ _ _~O_.QQO_OQ % E IRS Center where partnership filed return: CINCINNATI , OH J A I . f . I F Partner's share of liabilities (see instructions): Nonrecourse .......................... $_ _ _ _ _ _ _ _ _ _ _ Qualified nonrecourse financin;) . . . . . . . . . $_ _ _ _ _ _ _ _ _ _ _ Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_ _ _ _ _ _ _ _ _ _ _ G Tax shelter registration number ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ H Check here if this partnership IS a publicly traded partnership as defined in section 469(k)(2) ............................. 0 Check applicable boxes: (1) [lFinal K.l (2) n Amended K-l nalysls 0 . partner s cal:llta account: (a) Capital account at (b) Capital contributed (c) Partner's share of (d) Withdrawals and (e) Capital account at end of beginning of year during year lines 3, 4, and 7, distributions year (combine columns (a) Form 1065, Schedule M-2 through (d)) 17 792 1 'i2'i 19 317 (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: 1 Ordinary income (loss) from trade or business activities ..... ..,., 1 1 2 Net income (loss) from rental real estate activities . . . . . . . . . . . 2 1 425. See Partner's Instructions for ..'.,........ . Schedule K.l(Form 1(65). 3 Net income (loss) from other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Portfolio income (loss): :j~~liW~1mitjjIi~: Income . Interest income. . . . . . . . . . ,'.,........ . ........,..... . ...... , 4a Form 1040, line Sa (Loss) 4bl1 '- b (1) Qualified dividends. . .... . ........,. , .,....... . . . . . . . . . . . O. Form 1040, line 9b (2) Total ordinary dividenljs ....., . ,.,........ . ,.., , .,....... . 4b(2' lOO. Form 1040, line 9a c Royalty income . . . . . . . . . ................................,... . 4c Schedule E, Part I, line 4 d (1) Net short-term capital gain (loss) (post.May 5, 2003) . . . . . . . . . . 4dl1 Schedule D, line 5, column (g) (2) Net short. term capital gain (loss) (entire year) ......,....... . 4d(2 Schedule D, line 5, column f) e (1) Net long. term capital gain (loss) (post-May 5, 2003) ......... . 4.m Schedule D, line 12, column g) (2) Net long-term capital gain (loss) (entire year) ....,......... . 4e(2) Schedule D, line 12, column (I) f Other portfolio income (loss) (attach schedule) 4. -, .............. . ........... . 5 Guaranteed payments to partner ....,..........,....,........' . 5 ~ S.. p,rt"., 0.""",;,,, to< 6a Net section 1231 gain (loss) (post-May 5, 2003) . . . . . . . . . . . . . . . . . . 6a Schedule K.l (Form 1(65). b Net section 1231 gain (loss) (entire year) . . . . . . . . . . . . . . . . . . . . . . . . 6b 7 Other income (toss) (attach schedule) 7 ~, .,..................... . . . 8 Charitable contributions (see instructions) (attach schedule) . . . . . . . . . . . . . . . . . . 8 Schedule A, line 15 or 16 Oeduc- 9 Section 179 expense deduction 9 ~, tions .............,................. . ~ See Partner's Instructions for 10 Deductions related to portlolio income (aNach schedule) . . . . . . . . . . . . . . .....' , 10 Schedule K-l (Form 1 (65), 11 Other deductions (attach schedule) . . . . . . . . . " 1--' ,.... . '....,....' , , . . . . . . 12. Low.income housing credit: ~~j\~~~j~mm~f\~t~~ (1) From section 420)(5) partnerships ,................,.."..' . 12am l- Form 8586, line 5 (2) Other than on line 12a(l) ..'.................."..."..... . 1 2a(2) b Qualified rehabilitation expenditures related to rental real 1] !~~)!i!~! i~ ~~!!i~t !ii j~: 1 '" p,rt",', ,"'''''',;""' to< Credits estate activities. . . . . . . . . . . . . . . . . . . , . . . . . . . . .................. . 12b c Credits (ottler than credits shown on lines 12a and 12b) :1i~if1m~t~i!tW related to rental real estate activities. , . . . . . . . . . 12c Schedule K-l (Form 1(65) . . . . . . . . . . . . . . . . . d Credits related to other rental activities .............. . ......... . 1Zd 13 Other credits . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . 13 BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. PTPA0312 10/21/03 Schedule K-1 (Form 1065) 2003 11 Schedule K-' (Form 1065) 2003 RICHARD (LECKNER. SR 726-05-4641 Page 2 (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: Invest. 14a Interest expense on investment debts, , , , , . , , , , , , . , ........ . ... . 14a Form 4952, line 1 ment b (1) Investment income included on lines 4a, 4b(2), 4c, and 4f , . . " , 14b(l) 100. ~ See Partner's Instructions lor Interest (2) Investment expenses included on line 10,., ,..""""", ... . 14b(2) - Schedule K.l (Form 1065), Self- 15a Net earnings (loss) from self-employment ...................... . 15a Schedule SE, Section A or B employ- b Gross farming or fishing income. ' , . . . . . , . , . . . . . . . , . . . . . , , ..... . 15b -~ See Partner's Instructions for ment c Gross nonfarm income 15c Schedule K-l (Form 1065). ...........,.........,..........,.,.... . Adjust- 16a Depreciation adjustment on property placed in service after 1986 . . . . ' , . . , . . . . . . 161 218. 1 ments b Adjusted gain or loss. . , , . . . , ' . . , , . . , . . . . . . . . . , , . . . . . , . . . , . . . . . 16b See Partner's and c Depletion (other than oil and gas) ...................... . , , . . . . . 16c Instructions for Tax 16d(1) Schedule K-1 (F orm Prel- d (1) Gross income from oil, gas, and geothermal properties . . . . . . . . 1065) and,lnstructions erence (2) Deductions allocable to oil, gas, and geothermal properties ... . 16d(2) for Form a251. "ems e Other adjustments and tax prelerrnce items (attach sch) , . . ' 16e f-' ..........,..... . 17 a Name olloreign country or U.S. possession. . ~ .l!1~m;~mi]i{ -------------- - b Gross income from all sources ..........................,..... . 17b c Gross income sourced at partner level ......................... . 17c d Foreign gross income sourced at partnership level: m~~lj1*r~lf (1) Passive, . , . . . . . . . ' , . . . . . . . . . . . . . . . . . . . . , . . . . . . . . , . . . , . ' . ' . 17d(1 ) (2) Listed categories (attach schedule) ...............,...,..... . 17d(2) (3) General limitation. , , , . , , . . , , . , . . . . . . . . , . . , . , . ' . . . , . . . , . . . . . 17d(3) r- Farm 1116; Part I Foreign e Deductions allocated and apportioned at partner level: :~ilmmfmmt) Taxes (1) Interest expense, . . . . . , ....,.....,....,...".... . , . . , . . . , . . 17e(1) (2) Other, . . , . . , . . , . , . . . . . . ' , . , . . . . . . . . . . . , . , . . , , . . . . , . . . . . . . ' 17e(2) I Deductions allocated and apportioned at partnership level to loreign source income: .m;~~;~t~~~~~j~t. (1) Passive, . . . . , . , ' . . . , , , , . , , . . , . , . . . . . . , . . . . , . . . . . . . . . . , . . . , 17f(1) (2) Listed categories (attach schedule) .'....................... . 171(2) -- ~ (3) General limitation . . , , . . . , . , . . . . . , , . . . . . , . , . , . . , . . , . . . . . . . . ' 171(3) g Total foreign taxes (check one): ~ o Paid o Accrued , . 170 Form 1116, ParUI --- h Reduction in taxes available for credit (attach schedule) .......'..,......... . 17h Form 1116, line 12. 18a Section 59(e)(2) expenditures: a Type ~ 'i1jf~~1~fj*ir~ } See Partner's Ihstructions lor ---------------- b Amount, ...,.......................,...... , ......,.... . , . , , . . 18b Schedule K.l (Form 1065). 19 Tax-exempt interest income ..........'.,......,..,...,....... . 19 Form 1040, line 8b Other 20 Other tax.exempt income, . . , , , . . . . . . . . . . . . , . . . , . , . . . . , , . . . . . . . 20 r-- 21 Nondeductible expenses. , . . ' . , . . , . ' . , . . . , . , , . . . . . . . . . . . . . . . . . . 21 See Partner's IllStructions lor 22 Distributions of money (ca;h and marketable securities) """'" . 22 Schedule K-l (Form 1065). 23 Distributions of property other than money .......,..,....,...., , 23 f- 24 Recapture of low. income housing credit: lm~~~~;j~j~~~jf G Form 8611,line 8 a From section 42(j)(5) partr,erships . . . . . . . . , . , . . . . . . . . , , . . . . . . . . . 24, -- b Other than on line 24a . . . . ..,......,..., . ..".."......,.. . 24b 25 Supplemental inlormation requid to be reported separately to each partner (attach additional schedules if more space is needed): , Supple- mental Infor- mation PTPA0312 10/21/03 Schedule K-l (Form 1065) 2003 Schedule K- 1 (Form 1065) , I I! I OMS No. 1545-009<J Partner's Share of Income, Credits, Deductions, etc 2003 Department of the Treasury lntemal Revenue Service beginnin 199-50-4886 ,20 Partner's identi in number. Partner's name, address, and ZIP code RICHARD CLECKNER, JR 7706 HANOVERDALE DRIVE HARRISBURG, PA 17112 A This partner is a X general partner limited partner o limited liability company member B What type of entity is this partner? ... .. INDIVIDUAL C Is this partner a IRJ domestic or a [Jfo~ign-p-;;rtn;r? - - - -- D Enter partner's % of: (i) Berf~~mf~:P,rn Cl (il) E~~arof Profitsharing ""__________ % ____~O_..QQO_O.Q% Loss sharing.". _ _ _ _ _ _ _ _ _ _ % _ _ _ _~O_..QQ.Q..o.Q % Ownership of capital. . _ _ _ _ _ _ _ _ _ _ % _ _ _ _ ~O_, .QQ.O_O.Q % E IRS Center where partnership filed return: ( 1 N ( IN NA T I, 0 H J A I . f rt 't I t 23-2822095 CLECKNER PROPERTIES 7706 HANOVERDALE DRIVE HARRISBURG, PA 17112 F Partner's share of liabilities (see instructions): Nonrecourse ..... . . . . . . . . . . . . . . . . . . . . . $_ _ _ _ _ _ _ _ _ _ _ Qualified nonrecourse financing . . . . . . . . . $ Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ G Tax shelter registration number .. H Check here if this partnershiQ is a publicly traded partnership as defined in section 469(k)(2) ............................. 0 Check applicable boxes: (It.DFinal K-1 (2) 0 Amended ~ nalYSIS 0 . pa ner s cap I a accoun : (a) Capital account at (b) Capital contributed (e) Partner's share of (d) Withdrawal~ and (e) Capital account at end of beginning of year during year lines 3,4, and 7, distributions year (combine columns (a) form 1065, Schedule M-2 through (d)) 55 233 1 526 56 759 (a) Distributive share item (b) Amount (e) 1040 filef"$ enter the amount in collilmn (b) on: 1 Ordinary income (loss) from trade or business activities 1 - ......... . 2 Net income (loss) from rental real estate activities. . . . . . . . . . . . . . . . . . . . . 2 1,4~ See Partner's Instruction~ for .,. . I- Schedule K-1 (Form lOGS). 3 Net income (loss) from other rental activities ......'.,.,.....,,'...., , ... . 3 )m1t1)lfmJj; - 4 Portfolio income (loss): Income a Interest income. . . . . . . . . . . . . . . . . . . , , . . , . . , . . . . , . . . . . , . . . . , . . . . 4a Form 1040, line 8a (Loss) b (1) Qualified dividends. . . . . . 4b(1 O. Form 1040, line 9b .. . , . . . . , . . . . . . . . . . . . . . ... . ...... . (2) Total ordinary dividen~s .............,.,......,.....'..... . 4b(2 ~Q.L. Form 1040, line 9a e Royalty income. . . . . . . . . . . . . . . . . . ...................,..,..... . 4e Schedule E, Part I, line 4 d (1) Net short-term capital ,]ain (loss) (post-May 5, 2003) . . . . . . '" . 4d(1 Schedule D, line 5, column (g) (2) Net short-term capital gain (loss) (entire year) .............. . 4d(2 Schedule D, line 5, column f) e (1) Net long-term capital ~ain (loss) (post-May 5, 2003) ........, . 4e(1) Schedule D, line 12, column g) (2) Net long-term capital gain (loss) (entire year) ",.......... . . . 4<(2) -- Schedule D, line 12, column (f) f Other portfolio income (loss) (attach schedule) 4f - .............'.,......,.,. . 5 Guaranteed payments to partner ....,........,................ . 5 f- See Partner's Instructions for 6a Net section 1231 gain (Iosr) (post-May 5, 2003) , . . . . . . . . . . . , . . . , . 6a Schedule K-\ (Form 1(65). -- b Net section 1231 gain (loss) (entire year) . . . . . . . . . . . . . , , . . . . . . . . . 6b --- 7 Other income (loss) (attach schedule) .......................... 7 - - -- 8 Charitable contributions (see instructions) (attach schedule) . . . . . . . . . . . . . . . . . . 8 Schedule A, line 15 or 16 Deduc- 9 Section 179 expense deduction ...........,.....,........., . .. . 9 -~ See Partner's Instructions f~r tions --- 10 Deductions related to portfolio income (attach schedule) . . . . . . . . . . . . . . . . . . . . . 10 Schedule K-I (Porm lOGS). 11 Other deductions (attach schedule) . . . . . . . . . . . . . . . . ....... . ..... . ..... . 11 -' 12a Low-income housing credit: j~!i~ji1~1~[j~@~1Wi -~ (1) From section 420)(5) partnerships ....,.,..,............',. . 12a(1) Form 8586, line 5 (2) Other than on line 12a(1) 12a(2) '.,....,...............,...,..... , -' b Qualified rehabilitation expenditures related to rental real ~mii~1~~~1~~i))1~ji1~iii 1 s~ ",,,., ,.,"'.,.., ,,, Credits estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . ... . 12b e Credits (other than credits shown on lines 12a and 12b) :~m~~;~~~~mml~~~~: Schedule K-l (Form lOGS). related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . ...... . 12c d Credits related to other rental activities ,.....,.".... . . . , . . . . . . . 12d 13 Other credits . . . . . . . .........,. . .,......... , . . . . . . . . . . . . . . '" . 13 BAA For Paperwork Reduction Act Noticl!l, see Instructions for Form 1065. PTPA0312 10121103 Schedule K-l (Form 1065) 2003 \ I Schedule K-1 (Form 1065) 2003 RICHARD lLECKNER, JR 199-50-4886 Page 2 (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: Invest- 14a Interest expense on investment debts. . . . . . . . . . ......,.......,. . 14a ~rm 4952, line 1 ment b (1) Investment income included on lines 4a, 4b(2), 4c, and 41 . . . . . . 1 4b(1 ) 10l. ~ See Partner's Instructions for Interest (2) Investment expenses included on line 10......... . ........ . 14b(2) _, Schedule K-l (Form 1065). Self- 15a Net earnings (loss) from s~lf-employment ...................... . 15a Schedule SE, Section A or B employ- b Gross farming or fishing irlcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15b -~ See Partner's Instructions for ment c Gross nonfarm income 15c Schedule K-l (Form 1065). ............,.. . ....................... . Adjust. 16a Depreciation adjustment on property placed in service after 1986 . . . . . . . . . , . . . . . 16a 219. } ments b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . 16b See Partner's and c Depletion (other than oil and gas) 16c Instructions for Tax . ,-.......,................,.. Schedule K-l (F orm Pref- d (1) Gross income from oil, gas, and geothermal properties ....... . 16d(1) 1065) and Instructions Irenee (2) Deductions allocable to oil, gas, and geothermal properties 16d(2) for Form 6251. Items ." . e Other adjustments and tax preference items (attach sch) , . . . . . . . . . . . . . . . . . . . . 16e 17a Name of foreign country or U.S. possession. . .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ :~t\t~l~j~~~~1~j. - b Gross income from all sources .."............................ . 17b c Gross income sourced at partner level .....,................... . 17c d Foreign gross income sourced at partnership level: .~[t[Ij~~@[~~1~\ir (1) Passive. . . . . . . . . . . . . . . . . ................................. . 17d(1) (2) Listed categories (attach schedule) ......................... . 17d(2) (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17d(3) Form 1116, Part I Foreign e Deductions allocated and apportioned at partner level: :~~mjj~1jim~1mt!j Taxes (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178(1) (2) Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17e(2) f Deductions allocated and apporticned at partnership level 10 foreign source income: l~~~~~~~~mm1~~~I~' (1) Passive. . . . . . . . . . . . . .......,......................,..... . 17f(1) -- (2) Listed categories (attaery schedule) . . . . . . , . . . . . . . . . . . . . . . . . . . 17f(2) - (3) General limitation . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . , . ......... . 17f(3) -- , g Total foreign taxes (check )ne): . o Paid o Accrued . . 17g Form 1ll6,Partll h Reduction in taxes available for credit (attach schedule) . . . . . . . . . , . . . . . . . . . . . 17h Form 1116, line 12. 18a Section 59(e)(2) expenditures: a Type · :jj~~~mf:~~~~~~~~m~~m. -~ See Partner's Instructions for ---------------- b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18b Schedule K. t (Form 1065). - 19 Tax-exempt interest income .,......,.,.....,.........,....... . 19 Form 1040, line Sb Other 20 Other tax-exempt income. . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . 20 1 21 Nondeductible expenses. . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 See Partner's Ilnstructions for 22 Distributions of money (cash and marketable securities) . . . . . , . . . . 22 Schedule K-l (Form 1065). 23 Distributions of property other than money . . . . . . . . . . . . . . . , . . . . . . 23 --- -' 24 Recapture of low-income housing credit: ;~\~ ~i\ ~jl~\~~~~~i\~~~~: [} a From section 420)(5) partnerships ............................. . 24a Form 8611, line 8 b Other than on line 24a ..,..................,................. . 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if more space is needed): Supple- mental Infor- mation PTPA0312 10121103 Schedule K-1 (Form 1065) 2003 \ I CLECKNER PROPERTIES 23. 2095 Form 1065, Schedule L, Line 6 Other Current Assets Other Current Assets (itemize): Beginning of tax year End of tax year AXP CASH MANAGEMENT FUND 41,260. 46,057. Total 41,260. 46,057. \ I 2003 Taxes Cleckner Properties Tax 10# 23-2822095 Richard W. Cleckner Jr. and Richard W. Cleckner Sr. Expenses Repairs and maintenance $ 65.14 Total Repairs and maintenance $ 65.14 Misc.- $ Total Misc. $ Real Estate Taxes 1015 Sherman St $ 733.46 Total Real Estate Taxes $ 733.46 Insurance Coverage $ 379.00 Total Insurance Expense $ 379.00 Total Expenses $ 2,355.20 2 \ I 2003 Taxes Cleckner Properties Tax 10# 23-2822095 Richard W. Cleckner Jr. and Richard W. Cleckner Sr. One (1) property continues to be rented during calendar year 2003. No distributions into or out of the Partnership for the calendar year were taken by myself or Richard W. Cleckner Sr. ProDerties (1) Onaoina. 1015 Sherman St - Rental Linglestown, PA 17112 Current Status: 1015 Sherman St continues to be a rental property. Income 1099-Dlv IDS Cash Management Fund $ 200.66 Interest Income $ Rent Income 1015 Sherman St $ 5,700.00 Real Estate Income $ Total Income $ 5,900.66 .1 \l Uio.,..1,;lnr-, ERIF INSURANCE EXCHANGE ULTRA SURE . i..ICY FOR LAHDLORDS 'IERIE ~ ,INSURANCE GROUP 100 Erie In~ PI EIUE Erie. PA 166JO . RENEWAL CERTIFICATE ;?'!:.:..:':'.':;T.:;::&::::~;FtW@9I.?Rtr::::;r:i.:ASFN;r@!@p:::!.:0;;mm?:;f:rtX{!;::]H:~;m;{::tm;H;;@lJIJ;M:~::;eQJJQ~'aemOQ::::M;;:i~n'F;@:t{:~I\JM.ea:'Uf:.'::~ AA7373 J P WOLFE INSUR IHe 07/22/03 TO 07/22/04 Q43 2280115 H '?::;:.'.:'.',..':'::::..''irrlM'1~ttM~:1N$fJ.tUll:M::a~e.tyt;:W:tt::=:%ttfj:;f{:::W!?ft:m:?t%:REM:i'{:~fJJE8~:.~it.Ji..:q::::,:,@::;::.:,..".,.":"...,...:..,....,.,,.,.,:, I, "II J III III" I'" 11,1,111"1111",, ,1,1.. 11111111'11",1 ..II CLECKNER PROPERTIES " BNDT II 1119 COUNTRY CLUB RD CAMP BILL PA 17011-1023 Rid '1-fS'(j3 (ff IZfq AGENT - J P WOLFE INSUR tNC 'It**** AGENT PHONE - (717) 737-f981 23B WEST MAIN STREET SHIREMAKSTOWN PA 17011 POLICY PERIOD BEGINS AND ENDS AT 12.01 AM STANDARD TIME AT THE LOCATION OF THE INSURED PROPERTY. THE INSURANCE APPLIES TO THOSE PREMISES DESCRIBED BELOW. THIS IS SUBJECt TO ALL APPLICABLE TERMS OF THB POLICY AND ATTACHED FORMS AND ENDORSEMENTS. INTEREST OF NAMED INSURED IN SUCH PREMISES - OWNER COMPREHENSIVE PERILS COVERAGE DEDUCTIBLE $ 200 (SECTION I ONLY) OCCUPANCY LOC 1 - 1 -VAM1LY, FRAME TIRR YC 03 -- "1"973 PROT CLASS 09 LOCATION OF PRBMISES LOC 1 - 1015 SHERMAN ST, HARRISBURG, LOWER PAXTON TWP, DAUPHIN CO, PA 17112. SECTION I PROPERTY PROTECTION COVERAGES LOC UNIT AMOUHT OF INSURANCE PREMIUMS A. DWELLING 1 B. BUSINESS PERS PROP C. RENTAL INCOME PROTECTION 1 $ 75,500 $ 369.00 ACTUAL LOSS SUSTAINED NOT TO INCLUDED EXCEED 12 CONSECUTIVE MONTHS AUTOMATIC ADJUSTMENT OF COVERAGE WAS APPLIED. YEARLY INCREASE ON DWELLING IS 3\. FULL TERM PREMIUM FOR THIS LOCATION - - - - -. - - - - - - $ ~ FULL TERM PREMIUM FOR THIS POLICY - - - - - - - - - - - - $ ~ FORMS AND ENDORSEMEHTS- UL-MAl 03/03*, UL-NI 05/92, ULL-R 05/88, GU-15 12/85, GU-18 01/96, GU-ff 03/93, GU-5f 01/96, GU-32 03/95, GU-56 05/96, UF-8705 06/96*, GU-59 09/97, GU-70 10/98, UL-MQ 04/99, GU-86 12/00, UF2106 05/01, UL-MU 03/03*, UF4050 03/03*, UFt070 02/03*, IL0952 11/02*, CG2170 11/02*, UFfl10 02/03*, UPfIll 02/03*, ENDT II. \ I TAX INFOR' ~ION 2003 Form 1 099-DIV ~ Copy B Far Recipient Dividends and Distributions KEEP FOR YOUR RECORDS. o ,z:.. >0 (H N (H Recipient: RICHARD W CLECKNER JR AND RICHARD W CLECKNER 7706 HANOVER DALE DR HARRISBURG PA 17112-9769 Payer: AXP CASH MANAGEMENT FUND 10 AXP FINANCIAL CENTER MINNEAPOLIS MN 55474-9900 A PARTNERSHIP FOR CLECKNER PROPERTIES Taxpayer ID: 23-2822095 Class A OMB No. 1545-0110 Federal ID Number: 41-1254759 ACCOUNT NUMBER: 0113-7282005-7 002 1a. Total ordinary dividends lb. Qualified dividends 2a. Total capital gain distributions 2b. Post-May 5 capital gain distributions 2c. Qualified 5-year gain 2d. Unrecaptured Section 1250 gain 2e. Section 1202 gain 2f. Collectibles (287.) gain 3. Nontaxable distributions 4. Federal income tax withheld $200.66 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 The above information is being reported to the IRS. Value of account on December 31, 2003 Shares owned on December 31, 2003 $46,168.49 46,168.490 0.687. of the ordinary income on line la was derived from federal obligations. Please read the instructions on the back of this form and consult your personal tax advisor to properly report this information on your tax return. If you have questions concerning the amounts listed, please write to the above address or call 1-800-862-7919. rOFF. F <40,"1 n - OCI .'''AFB R (07l?OOOI 1""" "'" "'" "'" ""' ""11111'11" 1111'""'"111111111'111 ill'"~ """ "' "" SIIOFl 1049323 MRDFI ST45J TAX INFORMATION ?Jl03 VF or", 1099-DIV .. Copy . Dividends end For Recipient Distributions KEEP FOR YOUR RECORDS. o II- 00 CH N CH Recipient: RICHARD W CLECKNER JR AND RICHARD W CLECKNER 7706 HANOVER DALE DR HARRISIURG PA 17112-9769 Payer: AXP CASH MANAGEMENT FUND 10 AXP FINANCIAL CENTER MINNEAPOLIS MN 55474-9900 A PARTNERSHIP FOR ClEat_. ''''1::*110 Taxpeyer IB': 23-2822095 Cless A OMI No. 1545-0110 Federal ID Number: 41-1254759 ACCOUNT NUMIER: 0113-7282005-7 002 Ie. lb. 2a. 2b. '--2c. 2d. 2e. 2f. 3. 4. Total ordinary dividends Qualifi.d dividends Totel capital gain distributions Post-May 5 capital gain distributions .~lified 5-y..r aain _._ "'._ __ Unr.captur.d Section 1250 gain Section 1202 gein Col1ectib1.. (28X) g.in Nont.xabl. di.tributions Federal 1noo.. tax withheld $200.66 t.OO t.OO $.00 t.OO t.OO t.OO $.00 t.OO ..00 The .bove information i. being r.ported to the IRS. Valu. of account on Dac.",ber 31. 2003 Share. own.d on Dece.ber 31. 2003 .46,168.49 46,168.490 O.'IX of the ordinary income on line 1a was d.rived fro", federal obligations. Pl.... r.ed the in.tructions on the back of this for", .nd consult your personal tax advisor to prop.r1y r.port this infor",ation on your tax return. If you have questions conc.rning the .",ounts listed, pla.s. write to the above address or call 1-800-862-7919. i Dr'."""1 D. oal .'4AE..'.7/ZGeOJ IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII~IIIIII - 2Lllt~1 ~~f.N~ rA1E Ic,_~I-O~ -\ERMS "0 1:>\ r, ..'_~ ' ~ A >_n<"~'~C ~\ O~ .OPRESS __ . S '\).,1 ,~ <.:.. ,,- i." ~~:-J -- ;"\', l\lV ... L,-V_' ,~.~. ,,'. -':{:>'" \ -, - 1..1-1..- IN ,.ccOUN'!r -"\} U::\\' ;or. , ~ 0>6 ,~C.L'~ "-' \b<.t" c:..".. - An Pr-- i\'\ r;. r \..\ . - '"D~. , .'}(",S '\ -O.n. ^' __n - .......0."" ~,:,<-~ -cDrI ~'L I I _,tX ::. \l\. r , <: ...... 7Y\f\~ e:, A( )1-/ II iJ -. \:.J D LIJI(. J./J - , ""'1"'tiiA ~S IJ./_ - \ . f'~ OC58'\2 - \ I MAKE CHECKS PAYABLE TO: _2~O.3~~~~F;~T~"I':~N _,~~OR LOWER PAXTON TWP. & DAUPHIN CO. !DATE.. .. -- . --u----:Bi:LNUMB-ER-.-----.-.-.-~ IF~br~ary 1, 2003 _ \__~~~~~_~ I' PROPERTY lOCATION: I . 1015 SHERMAN ST I l-PROPERTYmE~~IFICA;ION NO.: 35 018 08 9 ASS E SSM E N T.1.~8-.----...,..-0.-0--.0~ Noon - 6PM December 31, 2003 Holidays Closed November 28 LAND: $ ~::~~E~E~_T:_ H ~___ _ ~_~~ ~ ~~ Paid l.fnftJ3 c.~.. I ut, The countywide reassessment has been completed. The annual assessment appeal filing deadline with the Board of Assessment Appeals for tax year 2004 is August 1, 2003. Patsy R. Donmoyer, Tax Collector 4919-C (Rear) Jonestown Road Harrisburg, PA 17109-1705 (717) 652-5555 Monday - Friday Noon-~PM Closed ******************AUTOCR**C004 CLECKNER RICHARD W CLECKNER RICHARD W JR 1119 COUNTRY CLUB RD CAMP HILL PA, 17011-1023 11111111111111111111111111111111111111111111111111111111111111 IF YOUR TAXES ARE IN ESCROW FORWARD THIS BILL TO YOUR MORTGAGE COMPANY. 0009176 r .------ --"-'--T-- ----------- ---1'----- -----..--. - .-..-- -----.---.--.--... -- -------..- _________u_______... .-----.--------- ~-----.IAXE~-----------J~IL~~~~AX ~~!E _ _____!~~~MOUN_~_ __.. 0 U R I N G T HIS P E. RIO 0 PAY T HIS AM 0 U N T I :ounty Real Estate I' 4.83500 ML $ 208.39 FEBRUARY - MARCH I County Library 0.23300 ML $ 10.042% Dlscoun.t Payment Period $ 251.02 I Municipal Real Estate 'I' o. 59800 ML $ 25 . 77 APRIL - MAY Municipal Library 0.04100 ML $ 1. 77 Tax Amount $ 256.14 Fire Protection I. 0.23600 ML $ 10.17 JUNE - JULY 5% Penalty Payment Period $ 268.95 i AUGUST THRU DECEMBER T . \1 Q% Penalty Payment Period 1 $ 281 . 75 I ------------.---- ---.---------. I UNPAID TAXES RETURNED TO TAX CLAIM AFTER ~r.jitvR~&~EB~~ii~~~b~~i~O~Ro~~i~~~:.~g~T.OISCO~NT ~.o-l D":EMBER~,~3WIL:SULTINADrnTrONAL~~R~ES. ! IF YOU DESIRE A RECEIPT, ENCLOSE A SELF-ADDRESSED, STAMPED ENVELOPE WITH YOUR REMITTANCE. 111111111111111111111111111111111111111111111111111111111111111111111111111 .. Keep lhls portion for you, records .. \ I MAKE CHECKS PAYABLE TO: 003 REAL ESTATE TAX NOTICE FOR L_.HRAL DAUPHIN SCHOOL DISTRICT Patsy R. Donmoyer Tax Collector IDATE ------------TSILLN"UMBER----l ~;;~i;~~~~~)p~O~~~5~wn Read F~O~;~L~~~ST _~=~.-___.__~3~ J~~~~y 6:2F~I~iy 12 Noon _ 6PM IPROPERTYIDENTIFICATION NO.: 35 018 089 , December 31, 2003 Noon-4PM I --j Closed Holidays Closed November 28 ------ I=-=_____~~SESSMENT I ******************AUTOCR**C004 CLECKNER RICHARD W CLECKNER RICHARD W JR 1119 COUNTRY CLUB RD CAMP HILL PA 17011-1023 1111111111111111111111111111111111111111111111111111.111.11111 * rA iet ~-JS-63 Jtt IZ.ln ORIGINAL ASSESSMENT $ HOMESTEAD EXCLUSION $ I FARMSTEAD EXCLUSION $ NET ASSESSMENT $ 43,100 o ~ Lower Paxton Twp The annual assessment appeal filing deadline with the Board of Assessment Appeals for tax year 2004 is August 1, 2003. IF YOUR TAXES ARE iN ESCROW PLEASE FORWARD THIS BILL TO YOUR MORTGAGE COMPANY. TAXES SCHOOL DISTRICT MillAGE/TAX RATE 11.4220 ML TAX AMOUNT $492.29 DURING THIS PERIOD PAY THIS AMOUNT TAXES ARE DUE AND PAYABLE. DO NOT Al fER TAX AMOUNT. DISCOUNT AND PENALTY HAVE BEEN COMPUTED FOR YOUR CONVENIENCE. JULY.AUGUST __ -_- -2% _Discount Payment Period -- IF YOU DESIRE A RECEIPT, ENCLOSE A SELF-ADDRESSED, STAMPED ENVELOPE WITH YOUR REMITTANCE. _SEPTEMBER -OCTOBER -Gross Payment Period Applications for Homestead I Farmstead exclusion are available annually on December 15th from the Dauphin Co. Tax Assessment Office, the local school district business office, and other selected locations throughout the County. An original must be filed with the Dauphin County Tax Assessment Office on or before March 1 st of the following year. NOVEMBER -DECEMBER _ < 5% penattyPayment Period -- - AFTER DECEMBER 31, 2003 ... - 10% Penalty P~yment Period Unpaid Taxes Will Be Turned over For Collection After DECEMBER 31. 2003. Delinquent Tax To Be Paid To Dauphin County Tax Claim Bureau with additional charges. ~ Keep this portion for your records ~ II Department of the T rea!a.ury Internal Revenue Service U.S. Return of Partnership Income ~ See separate instructions. r or calendar year 2002, or tax ear be innin A PrinCipal busIness activity Name of partner.t1lp Form 1065 2002 Use the IRS label. Other- Number, slreet. and room or sUIte number, If a PO, box, see InstructIons, E Dal.. business started wise, 7706 HANOVERDALE DRIVER 06/30/95 print C BusIness code number or type. CIty or town Slllt. ZIP code r T ollll assel$ (se. ,nslrs) 531390 HARRISBURG PA 17112 $ 73.025. G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) Amended return H Check accounttng method: (1) X Cash (2) Accrual (3) Other (specify) , , , , , ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , I Number ot Schedules K-'. Attach one tor each person who was a partner at any time during the tax year. . . ~ 2 Caution: Include only trade or bUSiness Income and expenses on lines la through 22 below. See the instructIOns for more informatIon, IRS us. only - Do not write or s!llpl. in th,S space, . 20 I OMS Nol?45.0099 o Employ., Id.ntlllclllon numb., , 2002, and endin REAL ESTATE CLECKNER PROPERTIES 23-2822095 HOUSES B PrinCipal product or servICe 5 E E I N 0 5 T E R 0 U U C T C I T 0 I N 0 5 N F S 0 R l I M I T A T I 0 N 5 Sign Here Paid Preparer's Use Only BAA 1 a Gross receipts or sales b Less returns and allowances 1a 1b '::II!::I::1j'l 1c I N C o M E 2 3 2 Cost of goods sold (Schedule A, line 8) 3 Gross profit. Subtract line 2 trom line lc 4 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule) , . . . . , . . . , . 5 Net tarm pro tit (loss) (attach Schedule F (Form 1040)), , . 6 Net gam (loss) from Form 4797, Part II, line 18 4 5 6 7 Other income (loss) (attach schedule) . ' 7 8 Total income loss. Combine lines 3 throu h 7 8 9 SalaTles and wages (other than to partners) (less employment credits) ... . ' . . . . . , ' 10 Guaranteed payments to partners, ' 11 Repairs and maintenance 12 Bad debts .... 13 Rent 14 Taxes and licenses. 15 Interest", ' , . . . . . . , ' , , . . . , . . . 161 Depreciation (It reqUlled, attach Form 4562) 161 b Less depreciation reported on Schedule A and elsewhere on return "'" 16b 17 Deplellon (Do not deduct oil and gas depletion.) . . , ' , . . ' . . . . . . . ' . , , . . . ' . . . . . . , . , ' , . . . . , . . . ' , . . . 18 Retirement plans, etc ....' ' , . . . , . . . ' . . . . . . . . . . . , , ' . , . . . , . , . . . . , . . , . . . . 19 Employee benefit programs ' . , . ' . . . . . . , . . 9 10 n 12 13 14 15 ~~~~f~lt~ 16c 17 18 19 20 Other deductions (attach schedule) , ."""""" 20 21 Total deductions. Add the amounts shown in the far ri ht column for lines 9 throu h 20 ' ' . . . . . . . . " 21 22 Ordina income (loss from trade or business activities. Subtract line 21 trom line 8 ,.,...'."...... 22 und, er penalties of perjury, I declare that 1 have examined th~S r n, inclU,ding accompanying SChedU,leS and statements, and to the best of my knowledge and belief, It is true, correct. and complete. Declaration ot prep (0 th~:~eral partner or limited liability company member) is based on all intormation of which preparer has any knowledge. ;.., .(., 1;. 1:...1...'....; " .. .,.~ ..; Iii'.' or May the IRS discuss this ,elum '~""..,.., f!. " With the pre,farer shown below Dale (see Instrs). Ve. Preparer's SSN or PTIN No Preparer's sIgnature Check if self. employed ... X 202-20-6104 Form's name (a ro 1 yn S. Wa 11 ace Tax (or yours It - sei/employed), .. 4314 (r est view Road address, and ZlPcode Harrisburg For Paperwork Reduction Act Notice, see separate instructions. ~ 23-2203678 (717) 540-5700 Form 1065 (2002) EIN 17112-2005 PA Phone no, PTPAOl12 12/27/02 11 Form 1065 (2002) C L ECKNE R PROP E RTI E S !SdhiduliiA:::1 Cost of Goods Sold (see Instruclions) 23-2822095 Page 2 1 Inventory at beginning of year, , . ., . ., , ...... . .... ..> ....., . 1 2 Purchases less cost of items withdrawn for personal use, , , . ... . . . . . . .., . " , , . , . 2 3 Cost of labor . . . . ., . , . .... . . , . , . , ... . .' . .. . . , . . . -.' . . 3 4 Addllional section 263A costs (attach schedule) ... . . . ... , ,. . , . . . . , .. . ".. , ... . ,.. . ... . ... . ,. . 4 5 Other costs (attach schedule) , . . . , . .. . .. . , , . . ,. , ,. , ..... . , , , . , . ..... . ... . , . '" . .". . 5 6 Total. Add lines 1 through 5 . . . , ., . . . . . .. , . . ..' . ..... . ....... . .,. . , . , , ,. . 6 7 Inventory at end of year . , " , .. . ... . . . . . , , ..... . ., , ...., . . , . . .. , ... . 7 S Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 ,. . ....... . , . . , ., , , 8 9a Check all methods used for valuing closing inventory: (i) 8 Cost as deScribed In Regulations section 1,471-3 (ii) Lower of cost or market as described In Regulations section 1.471-4 (iii) Other (specify method used and attach explanation) . . , . , . . . , . . . ,. · _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - b Check this box If there was a wntedown of 'subnormal' goods as described In Regulations section 1.471-2(c) " .' . " , · ~ c Check this box If the LIFO Inventory method was adopted this tax year for any goods (If checked, attach Form 970) . ., .,. ... d Do the rules of section 263A (for property produced or acqulfed for resale) apply to the partnership? , ,.' , . 8 Yes No e Was there any change In determining quantities, cost, or valuations between opening and closing Inventory? ,Yes No If 'Yes', attach explanation 1:~:'::I;j;:;j;j;:oIi;j.' ":',-::':t}} Other Information .~'~~~~.I,~.......",.~ 1 What type of entity is filing this return? Check the applicable box: a ~ Domestic general partnership b 8 Domestic limited partnership c Domestic limited liability company d Domestic limited liability partnership e Foreign partnership f Other . . , , · _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - 2 Are any partners in this partnership also partnerships? ."........ . , , . . . . . , . , . . . . . , . . . . . . , . . , , . . ,. '" .,.'" ." 3 DUring tt1e partnership's tax year, did the partnership own any interest In another partnership or in an}' foreign entity that was disregarded as an entity separate from ItS owner under Regulations seclions 301.7701-2 and 301.7701-3? If yes, see. Instructions for reqUired attachment , . , . . . , . . . .' ....... .,..,...........,.,....."".......,."",...".,.,.."... 4 Is this partnership subject to the consolidated audit procedures of sections 6221 through 6233? If 'Yes: see Designation of Tax Matters Partner below. . . . ..' , , , . . . ,. .", . . . , , , , . . . . . , . , . . . . , . , , , . . .' ,.. ." , . . . . . . , . . , . . . . . . . . . . 5 Does this partnership meet all three of the following reqUIrements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-l are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If 'Yes,' the partnership IS not reqUired to complete Schedules L, M.l, and M-2; Item F on page 1 of Form 1065; or Item J on Schedule K.l " , . . . , , , , , , , . . . . , . , . . . . . . , , , , , . . , . . . , . . , . . . , , , . , , , , .. ,...,.....,."....., .. ,.., 6 Does this partnership have any foreign partners? If 'Yes,' the partnership may have to hie Forms 8804, 8805 and 88\3. See instructions . , , , . . . . . . , ,. ." 7 Is thiS partnership a publicly traded partnership as defined in section 469(k)(2)? ."". ...,." ...".,' .,...".".",.".. 8 Has thiS partnership flied, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? .",.. . . , , , . , . . . 9 At any time during calendar year 2002, did the partnership have an Interest In or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? See the Instructions for exceptions and filing reqUirements for Form TD F 90-22.1. If 'Yes,' enter the name of the foreign country .. ------------------------------------------------ Yes No Ii x x x II x x X X X 10 DUring the tax year, did the partnership receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If 'Yes,' the partnership may have to file Form 3520, See instructions. . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . , , , . . . , . , . , . , . , " X 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership Interest during the tax year? If 'Yes,' you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described In the instructions under Elections Made By the Partnership . , , . . . . . . . , . . . , . , . . . . . . , . , . , . . . . . . . . . . . . , . . . . . , , . . . . X 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached ~.::,::,:.::.;:,:~,::.:,.::,:.::.:,i,~,.,:~,..;,'~,:::,)..:,:,..:.:..:.:,:,.:,';.::,':.:::;.::,~,...:.:.;::.::,::,::.f::.:.:.' to thiS return .. .. . . . . , ,. """'" <. .... .... . , . , . . . . . . . . .. .........,.. .. Designation of Tax Matters Partner (see instructions) Enter below the general partner deSignated as the tax matters partner (TMP) for the tax year of this return: Name of deslgnatedTMP .. RICHARD W CLECKNER, JR Address of 1 25 RID G E R 0 , ETTE R S. PAl 7319 deSignated TMP ~ Identifying number ofTMP .. 199-50-4886 PTPA0112 12/27/02 Form 1065 (2002) II 23-2822095 Page 3 Forrn 1065 (2002) CLECKNER PROPERTIES IS~b..4ijJjK\Wt::U Partners' Shares of Income, Credits, Deductions, etc (a) Distributive shire items 1 Ordinary income (loss) from trade or business acllvlties (page 1, line 22) .. .. 2 Net Income (loss) trom rental real estate activities (attach Form 8825) 31 Gross Income from other rental activities .. .. . . ... .1 31J b Expenses from other rental achvihes (attach sch) .. . . . . . .., . r--3bl c Net Income (loss) from other rental activIties. Subtract line 3b from line 3a . . . . . . . 3c 4 Portfolio Income (Joss): I Interest Income .. .. ....... ..' . . . . . . . . . . . . . 41 b Ordinary dividends .. .. . . . . . . . . . . . . . . . . .. .' 4b c Royalty Income . . . . . ..' . . . . . . . . . . 4c d Net short-term capital gain (loss) (attach Schedule 0 (Form 1065)) . . .. .. 4d e (1) Net long-term capital gain (1055) (attach Schedule 0 (Form 1065)) '" . . . . . _ . 4e (1) (2) 28% rate gain (loss) ~ _ _ _ _ _ _ _ _ _ _ _ (3) Qualified 5.year gain ~ _ _ _ _ _ _ _ _ _ _ _ }%JJ'nWJ?i .jWrmi:tmi@:Jm:t}}:}f\'@}/?} 1 Other portfolio Income (loss) (attach schedule) . . . . . . _ . . . . . . . . . . . . 41 5 Guaranteed payments to partners .. .. ., _ . . _ . . . . . . ... . . . . . . 5 6 Net seclion 1231 gain (loss) (other than due to casualty or theft) (attach Form 4797) .. 6 7 Other Income (loss) .INCOME .FROM DISCHARGE. _OF. .INDEBTEDNESS 7 8 Charitable contributions (attach schedule) .. . . .. .. . _ . . . . . . 8 9 Section 179 expense deduction (attach Form 4562) . . . . . . . . . . . . .. ... . 9 10 Deductions related to portfolio income (Itemize) .. . . . . . . . . . . .. .' . . - . 10 11 Other deductions . . . - . . . . 11 12. Low-income hOUSing credit: mrm::tt}fWr: (1) From partnerships to which section 420)(5) applies .. .. . . ... . 12a (l) (2) Other than on line 12a(1) . . ... . .. _... .. . . - . . . ... . . . 12. (2) b Qualified rehabilitation expenditures related to rental real estate activities (,tt,chForm 3468) .. .. ., .. .. 12b c Credits (other than credits shown on lines 12a and 12b) related to rental real estate acllvities .. . . _ . . . . .... 12c d Credits related to other rental actiVities . . . . . . .. .. .. .. ... . . . . . . . . . . - .. 12d 13 Other credits .. . _ .. . . . . . . .. .. . . .. .. 13 14a Interest expense on investment debts.. .. ... . . . . . . _ .. . . . . . .. .. . . . . . . 14a b (1) Investment Income Included on lines 4a. 4b, 4<:, and 4f above .,. . . ... . . . . . 14b (1) (2) Investment expenses included on line 10 above .. . . .... _. ... . . . - . . 14b (2) 15. Net earnings (loss) from self-employment. . . . . . . . . . . . ... . - .. . - 15. b Gross farming or fishing income .. .. .. .. .... .... ..... .. ...... 15 b c Gross nonfarm income . . . . . . . . .. .' -' 15c 16a DepreCiation adjustment on property placed In service after 1986. .., .......... ..... ., 16. b Adjusted gain or loss . _ . . . . . . . . . . . . . . . 16 b c Depletion (other than oil and gas) .... .... ........ .. .. ..... 16c d (1) Gross Income from oil, gas, and geothermal properties. . . . . ., .... ... . . . . . ..' . 16d (1) (2) Deductions allocable to 011, gas, and geothermal properties .... .. ... .. . . . .. - . 16d (2) e Other adimnls & tax pref Items . . . . . _ . . . . . .. .... .. . . . . . . .. .... 16 e 17. Name of foreign country or U.S. possession . . · _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ::::iti:rlNlir b Gross Income from all sources .. .... ....... .... ..... .... 17b c Gross income sourced at partner level.. .. ........ ... .. ..... .... 17 c d Foreign gross income sourced at partnership level: mliiH,:",::mn" (1) Passive . (2) Listed categories (att,ch 5ch) · (3)Generallimltation ~ ,:,:,;,.;,;";;,, e Deductions allocated and apportioned at partner level: ::nmiitittt (1) Interest expense. (2)Other .... . . . . .. .. . . . . . . . . . . . .. ~ H 17 e (2)' t Deductions allocated and apportioned at partnership level 10 foreign source income: i~::]ilWim: (1) Passive . (2) Listed categories (attach 5ch) · (3)Generallimitatlon ~ 171 (3'\ 9 Total foreign taxes (check one):. 0 Paid 0 Accrued .. .... ...... - . .. . - . . . . . 170 h Reduction in taxes available for credit (attach schedule). .. _ .. _ " ... . . . . . 17h 18 Section 59(e)(2) expenditures: a Type . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Amount ~ 18b 19 Tax-exempt interest income . . . . . . .. .... . . .. . . . - . . . 19 20 Other tax-exempt Income . . . . . . .. .,. _ . .. .. . . . . . . 20 21 Nondeductible expenses . . ." . . . ..' . . . . . . . . . . . . . . - . 21 22 DistributIOns of money (cash and marketable seCUrities) .... .... .. ..' . . . . . . . . . 22 ~: ;~:~~~~~:s:i:i;~~~~t~~:~u:~:2 ~:e~eported separatelytop~rtn:e.rs..: :..... .. .... ;i.;!iil:il!i!illi:iiUli:ii_ Income (loss) Deduc- tions Credits Invest- ment Interest Self- Employ- ment Adjust- ments and Tax Prefer- ence Items Foreign Tlxes Other BAA (b) Totlllmount 1 2 2,394. 1.::i::i~i:l.li~:::~':~'I,!'I:: 360. 499. 115 859. 438. Form 1065 (2002) PTPA0134 08/13102 II Form 1065 (2002) CLECKNER PROPERTIES 23-2822095 Page 4 Analvsis of Net Income (loss) 1 Net Income (loss). Combine Schedule K, lines 1 throu~h 7 in column (b). From the result, subtract the .\ I sum of Schedule K, lines 8 throu h 11. 14a, 170, and 8b,.. '."" .....,......,.......,.."..,. 1 3.368. 2 AnalysIs by (i) Corporate (ii) Individual (iii) Individual (iv) Partnership (v) Exempt (vi) NOminee/Other partner type: (active) (passive) organl~ation a General 3.368. partners b Limited partners. Note: schedules L, M.l and M.2 are not re Ulred if Question 5 of Schedule B IS answered 'Yes.' .ihjdijl'];:?'U:\~'U Balance Sheets er Books Beginning of tax year Assets (a) (b) 1 Cash 21 Trade notes and accounts receivable. . b Less allowance for bad debts. ' 3 InventOries 4 U.S. government obligations. 5 Tax-exempt seCUrities 6 Other current assets (attach schedule) L n 7 Mortgage and real estate loans 8 Other Investments (attach schedule) . 9. BUildings and other depreciable assets b Less accumulated depreciation 101 Depletable assets b Less accumulated depletion 11 Land (net of any amortization) '" ' . 12a Intangible assets (amortizable only) b Less accumulated amortization ..... 13 Other assets (attach schedule) l n.13. 14 Total assets Liabilities and Capital Accounts payable ." Mortgages, notes, bonds payable In less than 1 year. . Other current liabilities (attach sch) , All nonrecourse loans Mortgages, notes, bonds payable In 1 year or more Other liabIlities (attach schedule) . . . Partners' capital accounts Total liabilities and capital ........ Ii . ';:' I+ Reconciliation of Income Net income (loss) per books ..'.... Income included on Schedule K, lines 1 through 4, 6, and 7, not recorded on books this year (itemize): (d) 297. 348. ':::!J::J:f::::n::::::m:m:m:m:J::!j~tlfJm:m::::: ~rm1rfrlI;{{ii~Jtj~~j~I~Ji~~~;!jjIrtmf~i~~i 65tmt I!! 36 544. II! 41,260. 34.336.0iiffit%@(lj@tBtM 5 520. 28.816. 34.336. 6 919. ~;r{mt j}I\tf~!tf{t;)1)jm~ti)~~m)i)ri)l! 27.417. :\t~~~~~\~\iti~\~~\\~~iI~\~~i~t~it~l~l~ml~~@~~;~j~}~~j[ ~~1rI~~mt ~~~j~~mm~~mt~l~~:j~?\m~~ffjttm~~~ ~~1!j~ij!~1imIfj~~ii;~I![{ii~1jlt!i}fj1jj!f~;~1jjtfjj 4 . 0 0 o. ~;:tj::::}@}[:[j:~~N~f:~;:;[t:\J::{J{i.{~:{j 4 000. J~)jit~~1i1!iitfjttii!iit!{ifiI)1ii1Im~~tm~f~~W 'l~tim~lm i~;r[j@iIfj~Wf;[j~trtr;i~~m~~~~f}li 73.025. er Books With Income Loss r Return 3 368. 6 Income recorded on books this year not included on Schedule K, lines 1 though 7 (Itemize): a Tax-exempt interest.. $_ _ _ _ _ _ _ _ _ __ 73 025. 73.025. 3 Guaranteed pmts (other than health insurance) . . . . ' 4 Expenses recorded on books thiS year not included on Schedule K, lines I through 1 T, 14a, 17g, and lSb (Itemize): a Depreciation. ,.. $_ _ _ _ _ _ _ _ _ _ _ b Travel and entertainment . $ 7 Deductions included on Schedule K, lines 1 through 11, 14a, 17g, and 18b, not charged against book income thi year (itemize): a Depreciation ..... $_ _ _ _ _ _ _ _ _ _ _ 3.368. "tal Accounts 69 657. 8 Add lines 6 and 7 ' . . , . . . . . 9 Income (loss) (Analysis of Net Income (Loss), line 1). Subtract Ime 8 from line 5 3.368. 6 Distributions: a Cash .., b Property 7 Other decreases (itemize): _ _ _ _ _ _ _ _ _ _ _ 3 4 3.368. 5 Add lines 1 through 4 8 Add lines 6 and 7 .. .....,....' 73 , 025 . 9 Balance at end of year. Subtract line 8 from line 5 . . 73,025. PTP A0134 08113/02 Form 1065 (2002) Form 8825 Rental Real Estate Income and Expenses of a Partnership or an S Corporation ~ See instructions. ~ Attach to Form 1065, Form 1065-B, or Form 11205. OMS No. 1545.1186 Department of the Treasury Internal Revenue Service 2002 Name EmplDyer IdenliftcoliDn number CLECKNER PROPERTIES 23-2822095 1 Show the kind and location of each property. See page 2 for additional properlles. A Jgt~~~~~~~~I________________~_____________________________________ HARRISBURG, PA 17112 8 --------------____________________________________________________ c __________________________________________________________________ o ------------------________________________________________________ ProDerties Rental Real Estate Income A 8 C D 2 Gross rents ... . . . . . . . . . . . . . ... . 2 5 , 100. Rental Rea' Estate Expenses 3 Advertising .. . . . .. . . . . . . . 3 4 Auto and travel . . . . .. . .. . 4 5 Cleanrng and maintenance . . . . .. . 5 6 Commissions . . 6 7 Insurance .... . . . . . . . . . ... . 7 292 8 Legal and other professional fees 8 275. 9 Interest . . . . . . .. . .. . . . . . .. . ... . 9 10 Repairs . . . . . . . . .. . . . . . 10 11 Taxes. . . . . . . .. . .. . . . . . 11 703. 12 Utilities. .. . ... . ... . 12 13 Wages and salaries . . . . 13 14 Depreciallon (see Instructions) . . 14 1 , 399. 15 Other (list) ~ POSTAGE 37. ------------- - -- ----- ------------ 15 -- - ----------------- 16 Total expenses for each property. Add lines 3 through 15 ..... . . .. . . . . . 16 2, 706. 17 Total gross rents. Add gross rents from line 2, columns A through H .. . . . .. . . . . . . . . . . ................... . 17 5, 100. 18 Total expenses. Add total expenses from line 16, columns A through H . .. . ..'.... . .. .. ..... . .... . . . ...... . 18 -2 706. 19 Net ~ain (loss) from Form 4797, Part II, line 18, from the dlsposillon of property from rental real esta e activities. . ... . . . .. . . . . , . . .. , . . .. . . . .... . ,..,.... . .. . ......,..., . ,...... . . . ,. . ... . ..., , 19 20. Net Income (loss) from rental real estate activities from partnerships, estates, and trusts in which this 20. partnership or S corporatIOn IS a partner or beneficiary (from Schedule K-1) .............................. b Identify below the partnerships, estates, or trusts from which net income (loss) is shown on line 20a. 1j~l1\~m~~ Attach a schedule If more space is needed: (1) Name (2) Employer identification number ----------- - ----- -------- ------------------------- m~1ilj~1~~j; - - - -- -------------------- ------------------------- - - --- -- ------- --- -------- ----------- -------------- 21 Net Income (I ass) from rental real estate activities. Combine lines 17 through 2Oa. Enter result here :i!:~lil:i:!!::1 and on: -~ . Form 1065 or 11205: Schedule K, line 2, or ...... . .. . .. , .....,.. . . . . . . . . . . . . . . .... , ..,. . 21 2, 394. . Form 1065-8: Part I, line 4 i~!ttff; }:!i::::t::~{HMfFtWt:rtftfW{~~: 8AA For Paperwork Reduction Act Notice, see the sep.rate instructions. Form 8825 (2002) SPSZ0101 08/19/02 \ I Form 6252 Installment Sale Income OMS No. 1545.0228 Department of the T rusury Internal Revenue Service Name(s) shown on return · Attach to your tax return. . Use a separate form for each sale or other disposition of property on the installment method. 2002 79 hl.ntitylng numb., CLECKNER PROPERTIES 23-2822095 1 Descnptlon of property · J~4.. _N_ ~EJQ~D_ .?IR_E!I ,_ .?I~f!-IQ.~ _~A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 2a Date acquired (month, day, year). Va r i au 5 bDate sold (month, day, year) · 02/29/00 3 Was the property sold to a related party (see Instructions) after May 14, 1980? If 'No,' skip line 4. . 0 Yes IRJ No 4 Was the propertr you sold to a related party a marketable secunty? If 'Yes,' complete Part III. If 'No,' complete Part" for the ear of sale and the 2 ears after the ear of sale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . No .It: Gross Profit and Contract Price. Com lete this art for the ear of sale ani . 5 Selling pnce including mortgages and other debts. Do not Include interest whether stated or unstated. . . . . . 5 6 Mortgages, debts, and other liabilities the buyer assumed or took the property subject to (see Instructions) 6 7 Subtract line 6 from line 5 . 7 8 Cost or other basIs of property sold 8 9 Depreciation allowed or allowable . . . . . . . . . 9 10 Adjusted basis. Subtract line 9 from line 8 . . . . . . . . . . . . 10 11 Commissions and other expenses of sale 11 12 Income recapture from Form 4797, Part III (see Instructions) . . . . 12 13 Add lines 10, 11, and 12 ... . . .. .. .. . . .. .. .. . 13 14 Subtract line 13 from line 5. If zero or less, do not complete the rest of thiS form (see instructions) . . . . . . . 14 15 If the property described on line 1 above was your main home, enter the amount of your excluded gain (see Instructions). Otherwise, enter .0. . 15 16 Gross profit. Subtract line 15 from line 14 . . . . . . . . . 16 17 Subtract line 13 from line 6. If zero or less, enter .0. 17 18 Contract rice. Add line 7 and line 17 . 18 Jirt':If/:'{ Installment Sale Income. Complete thiS part for the year of sale and any year you receive a payment or have certain debts you must treat as a payment on Installment obligations. 19 Gross profit percentage. D,vide line 16 by line 18. For years after the year of sale, see Instructions. . 19 20 If thiS is the year of sale, enter the amount from line 17. OtherWise, enter .0. 20 21 Payments received dUring year (see Instructions). Do not Include interest, whether stated or unstated 21 22 Add lines 20 and 21 . . . . . . . . . , . . . . . , . . . . . . . . 22 23 ~~~~~~t~t~i;~i~;~~~t~~~o~ years (see Instructions). Do not include interest, W 37 , 671 . :ll:lilll!!~!i::ll 24 Installment sale income. Multiply line 22 by line 19 ..................,. . . . . . . . . . . 24 25 Enter the part of line 24 that is ordinary income under recapture rules (see instructions) ..' . . . . . . . . ., 25 Z6 Subtract line 25 from line 24. Enter here and on Schedule D or Form 4797 (see instructions) . .' 26 :.:ifti~ Related Pa Installment Sale Income. Do not com lete if OU received the final a ment this tax ear. 27 Name, address, and taxpayer identifying number of related party _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 21.0862 O. o. o. o. 28 Did th; ;;;I;t;d -p;r~ ;:-e~eil ~r dl~P~S~ ~f lh~ pr;p;r~ (';~O;ddispo~t~~) d~ri-;:;g-this-t;x y;a;:? ~ ~ ~ ~ ~. ~. ~ ~. ~ ~ cr y~~ - TI N; - - 29 If the answer to question 28 is 'Ves,' complete lines 30 through "Sl below unless one of the following conditions is met. Check the box that applies. a 0 The second dispOSition was more than 2 years after the first disposition (other than dispositions of marketable secunties). If thiS box IS checked, enter the date of disposition (month, day, year) ....... . . . . . . . . · b ~ The first disposition was a sale or exchange of stock to the iSSUing corporation. c The second diSP, oSition was an ,in, VOIU, ntary conve.rsion and the threat.of convers.ion occu,rred aft,er the first d. isposition. d The second disposition occurred after the death of the anginal seller or buyer. e It can be established to the satisfaction of the Internal Revenue Service that tax avoidance was not a prinCipal purpose for either of the diSpOSitions. If thiS box IS checked, attach an explanation (see Instructions). 30 Selling pnce ot property sold by related party. . . . . . . . . . . . , . . . . . . . . . 30 31 Enter contract pnce from line 18 for year of first sale 31 32 Enter the smaller of line 30 or line 31 . . . . . . . . . . . . . . . , . . . 32 33 Total payments received by the end of your 2002 tax year (see Instructions) .... 33 34 Subtract line 33 tram line 32. If zero or less, enter .0. ..... . . . . . . . . . . . 34 35 Multiply line 34 by the gross profit percentage on line 19 for year of first sale. . . . 35 36 Enter the part of line 35 that IS ordinary Income under recapture rules (see instructions) 36 ~ Subtract line 36 from line 35. Enter here and on Schedule D or Form 4797 (see instructions) "Sl BAA For Paperwork Reduction Act Notice, see separate instructions. Form 6252 (2002) FOIZ1501 07/24102 \ I Schedule K- 1 (F orm 1065) Partner's Share of Income, Credits, Deductions, etc OMS No. 1545-0099 Oepa rtment of the T rusury Internal Revenue Service be inning 199-50-4886 2002 Partner's identi in number. Partner's name. address. and ZIP code , 20 in number. Partnership's name. address. and ZIP code 23-2822095 RICHARD CLECKNER, JR 7706 HANOVERDALE DRIVE HARRISBURG, PA 17112 CLECKNER PROPERTIES 7706 HANOVERDALE DRIVER HARRISBURG, PA 17112 A This partner IS a X general partner limited partner o limited liability company member B What type of entity IS this partner? .... INDIVIDUAL Cis this partner a [K] domestic or a 0 for~ig; p~rtn;r? - - - - - o Enter partner's % of: (i) Befr~~mf~:C~~ or (ii) E~~arOI Profit sharing _ _ _ _ _ _ _ _ _ _ % _ _ _ _~0_.QQ.o_09 % Loss sharing .' __________ % ____~O_.QQ'O_OQ% Ownership of capital. . _ _ _ _ _ _ _ _ _ _ % _ _ _ _ ~O_, QQO_O.Q % E IRS Cen ler where partnership filed return: C I N C INN AT I, 0 H F Partner's share of liabilities (see Instruclions): NonrecDurse . . . . . . . . . . $ Qualified nonrecourse financing . . . . . . $ _ _ _ _ _ _ _ _ _ _ _ o~~.......... ......$ G Tax shelter registration number · _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ H Check here if this partnership is a publicly traded partnership 0 as defined In sectIOn 469(k)(2) .... ................. .... Check applicable bDxes: (1) fJFinal K-1 (2) n Amended K.l J Analvsis of partner's callital account: (I) Capital account at (b) Capital cDntrlbuted (c) Partner's share of (d) Withdrawals and (e) Capital account at end of beginning of year during year lines 3,4, and 7, distributions year (combine columns (a) FDrm 1065, Schedule M.2 through (d)) 53,549. 1 684. S5 233, (I) Distributive shire item (b) Amount (c) '040 filers enter the amount in column (b) on: 1 Ordinary Income (loss) frDm trade or business activities . . . . ..... . 1 ~ 2 Net income (loss) from rental real estate aclivilles 2 1. 197. See Partner's Instructions for ......,.. . .., . .. . . . .. . .' . Schedule K.l (Form 1065). 3 Net Income (loss) 1rom other renlal activities .. . .. . ..... . . . '.' . ...,., . ., . 3 4 Portfolio income (loss): :~tj~~~m~~ft~~r Income I Interest. .... , .. . . . . . . . .. . . . ..... . ,..' . . . 4a 180. Schedule 8, Part I, line 1 (Loss) b Ordinary dividends. . . . . ... . ..,... . .,. . .... . 4b 250. Schedule 8, Part II, line 5 c RDyalties ...... . .. . .... . '.... . .... . . . 4c Schedule E, Part I, line 4 d Net short. term capital gain (IDSS) ... . .... . . . .. . .... . 4d Schedule D, line 5, column (f) . (1) Net long.term capital gain (loss) . . . . . . . . . . . ...... . 4eC1 ) Schedule D, line 12, column (f) (2) 28% rate gain (loss) .,......, . .. . ........ . .... . ...... . .,., . 4e(2) Schedule D, line 12, column (g) (3) Qualified 5.year gain ... . .... . ..., . .., . ..,........ . ...... . 4e(3) line 5 of worksheet for Sch D, line 29 f Other portfoliO Income (loss) (attach schedule) .. . ... . .. . .".. . ...,..' . 4f Enter on applicable In of your return 5 Guaranteed payments tD partner .....,... . .........., . ...... . . . 5 ~ 1231 1fiWt1~~ji!f!t. See Partner's Instructions for 6 Net section gain (loss) (Dther than due to casualty Schedule K.l (Form 1(65). Dr theft) ....... . ...... . ... . . . . . . . . . , . . . , . . . . . . . . . . . . . . . ..... . 6 7 Other Income (IDSS) (attach schedule) . ....... .SEE. .LINE. 2.5 7 58. Enter on applicable In of your return 8 Charitable contributions (see instructions) (attach schedule) . . . . . . . . . . . . . . ... . 8 Schedule A, line 15 Dr 16 Oeduc- 9 SectlDn 179 expense deduction ....... . . . . . . . . . . . . . . . ... . 9 J tions 10 Deductions related to portfolio income (attach schedule) . . 10 See Partner's Instructions for .... . ..... , '...... . Schedule K.l (Form 1(65). " Other deduchons (attach schedule) ... . ..' . ..... . .. . .............. " 121 Low.incDme hDusing credit: !@~~~M~IM~ ~ (1) From sectlDn 420)(5) partnerships .. . . . . . . ,....... . .. . , . . . . 1 2aC1 ) Form 8586, line 5 (2) Other than on line 12a(1) .. . ...... . ..,.., . . . .. . . . . . . . . . . .' . 121(2) b Qualified rehabilitatiDn expenditures related to rental real :i~~i]~~~f1\~~\jMj~~~' 1 Credits estate activities. . .. . ... . ... . . , . . . . . . . . . . " .. 12b c Credits (Dther than credits shown Dn lines 12a and 12b) '1~!fIM!@!i1j@j!: See Partner's Instructions for Schedule 1i-1 (Form 1065). related tD rental real estate aclivltles . . . . ....... . ...... . ..." . 12c d Credits related to other rental actiVities .... . . . ..,.. . ..... . .... . 12d 13 Other credits .., . ... . . . ,......... . .. . .. . 13 BAA For Paperwork Reduction Act Notice, see Instructions lor Form 1065. Schedule K-1 (FDrm 1065) 2002 PTPA0312 12/27/02 \ I Schedule K-1 (Form 1065) 2002 RICHARD CLECKNER. JR 199-50-4886 Page 2 (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: Invest- 14a Interest expense on Investment debts. .. . ....., . ... , 14a Form 4952, line 1 ment b (1) Investment Income Included on lines 4a, 4b, 4c, and 4f 14b(1 ) 430. ~~ See Partner's Instructions for Interest .. . . . (2) Investment expenses Included on line 10. ... . . . . . , ..... . '4bCZ) Schedule K-l (Form 1065). Self- 15. Net earnings (loss) from self-employment ", . ... . ..... , . . . . ... . 15. Schedule Sf, Section A or E employ- b Gross farming or fishing Income. . ....,..... . .. . . . . . . 15b ~~ See Partner's Instructions for ment c Gross nonfarm Income 15c Schedu.te K-l (Form 1065). . . ....... . ... . . . ... . . . .... , Adjust- 16a Depreciation adjustment on property placed in service after 1986 . . . . ...., . 161 219. } ments b Adjusted gain or loss. . ... . ... . . . . . . ... . ... . ... . 16b See Partner's and c Depletion (other than 011 and gas) ... . ... . ., . .. . ... , 16c Instructions for Tax ... . Schedule K-l (Form Pref- d (1) Gross income from oil, gas, and geothermal properties ... . . . 16d(1) 1065) and Instruclions erence (2) Deductions allocable to oil, gas, and geothermal properties 16d(Z) for Form 6251. Items . . e Other adlustments & tax preference items (attach sch) .. . ... . . . . . 168 17. Name of foreign country or U.S. possession. . ~ ::::::;:::::::::':'~::::::" -------------- .::::::~::::?:*:::::;::~:: I- b Gross Income from all sources . . , . . . . . ... . .. . ....... . 17b c Gross Income sourced at partner level . . ... , '" .. .. . .. . , . . . . 17c d Foreign gross income sourced at partnership level: .i~jmtf!1ii!~fr (1) Passive. ... . ..... . '" . ...... . . . . . . ... . ,.. . 17d(l) (2) Listed categones (attach schedule) .. . ..... . . . . . ... . .. . 17d(2) (3) General limitation. . . . . . ,.. . ..... . . . ..... , .. . 17d(3) - Form 1116, Part I Foreign e Deductions allocated and apportioned at partner level: .~~jj~~t][~it~~~~ Taxes <1> Interest expense ..... . '" . .... , ".., . . . . . . . . .. . 178(1) (2) Other. . . . . . . ',..' , .... . . . . . . . . , , , . . .,.... . 17&(2) I Deductions allocated and apportioned at partnership level to foreign source income: {ti~~jmtjf;:t (1) Passive. ...... . ... . .. . ...... . .,....... , .." . ... . ....." . 171(1) (2) listed categories (attach schedule) ,..".......... "' ....... . 17t(2) - (3) General limitation . . . . . . . . ....,..... . . . . . . . . ... , . . , . . . . . . . . 171(3) 9 Total torelgn taxes (check one): ~ o Paid o Accrued . . 17a Form 1116, Part II h ReductIOn In taxes available for credit (attach schedule) ,... . .' . .' . .,.." . .. . 17h Form 1116. line 12. 18a Section 59(e)(2) expenditures: I Type ~ .1ll[imj~t1i~~j\~. ~ See Partller's Instructions for ---------------- b Amount. . . . . . . . ,.. . ... . '. . .,. . .. . ..,.... . 18b Schedule K.I (Form 1065). 19 Tax-exempt interest Income .... . .., , .... . ..,..,.." " .... . .. . 19 Form 1040, line 8b Other 20 Other tax.exempt income. . . . . 20 } .. . .. . , . . . . . . . . . , . . . , . . . 21 NondeductIble expenses. . . .. . ... , .. . . . . . . .... . . . , . . . ... ' .., . 21 See Partner's Instructions tor 22 Distributions ot money (cash and marketable securities) .. ... . ... . 22 Schedule K.l (Form 1065). 23 Distributions of property other than money ......" , ....... . .., . 23 24 Recapture of low-income hOUSing credit: 1~jijiii!t[jftj. :~ I From section 42U)(5) partnerships. . .... , .. . ., . ........., . ... , 24a Farm 8611, line 8 b Other than on line 24a ..., ' .. . " . . . .., . ......... . ..... . . . . . 24b 25 Supplemental informalion required to be reported separately to each partner (attach additional schedules if more space IS needed): LINE 7 - OTHER INCOME (LOSS) INCOME FROM DISCHARGE OF INDEBTEDNESS 58. TOTAL 58. Supple- mental Inlor- mltion PTPA0312 12127/02 Schedule K-l (Form 1065) 2002 Schedule K-l (F orm 1065) OMS No. 1545.0099 Partner's Share of Income, Credits, Deductions, etc 2002 Department of the Trea.ury Internal Revenue Sef'\llce be inning 726-05-4641 , 20 in number ~ Partne..hIP" name, .ddru., and ZIP code 23-2822095 Partner's identif in number ~ Partner'. name, addru., and ZIP code RICHARD CLECKNER, SR 1119 COUNTRY CLUB ROAD CAMP HILL, PA 17011 A ThiS partner IS a X general partner limited partner o limited liability company member B What type of entity is thiS partner? ... INDIVIDUAL C Is thiS partner a [R] domestic or a 0 fO~lgn- p~rtn~r? - - - - - D Enter partner's % of: (i) Self~~mf~:n8~ or (ii) E~~aror Profit sharing _ _ _ _ _ _ _ _ _ _ % _ _ _ _~O_..9QO_O.9 % Loss sharing _ _ _ _ _ _ _ _ _ _ % _ _ _ _ ~ 0_. .9 QO_O.Q % Ownership of capital. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ ~ 0_. .QQO_O.Q % E IRS Center where partnership filed return: C I NC I NNA TI, OH CLECKNER PROPERTIES 7706 HANOVERDALE DRIVER HARRISBURG, PA 17112 F Partner's share of liabilities (see instructions): Nonrecourse . . . . $ Qualified nonrecourse financing . .. ..... $ Other. . . . . . . . . . . . . . . . . $ G Tax shelter registratIOn number . H Check here if thiS partnership IS a publicly traded partnership 0 as defined In sectIOn 469(k)(2) ......... ....... ......... Check applicable boxes: (1) OFinal K-1 (2)0 Amended K.1 J Analysis of partner's capita' account: (a) CapItal account at (b) Capital contributed (c) Partner's share of (d) Withdrawals and (e) Capital account at end of beginning of year dUring year lines 3, 4, and 7, distributions year (combine columns (a) Form 1065, Schedule M-2 through (d)) 16. 108. 1 684. 17.792. (a) Distributive share item (b) Amount (c) 1040 'filers enter the amount in column (b) on: 1 Ordinary Income (loss) from trade or bUSiness activities . . . . . . . . . , 1 2 Net Income (loss) from rental real estate activities. . . . . . . . , , . . . . . . . . . . . . . . . 2 1 197. ~ See Partner's Instructions for Schedule K-I (Form 1(65) 3 Net Income (loss) from other rental activities. ..... . .,...... . . . . . . . . . . . .. . 3 4 Portfolio Income (loss): ;fjfiiil;11!1!t~~j!: Income a Interest . . . . . . .. . .. . ." . ,.,. . ." . '.... , .. . ,....... , 4a 180. Schedule B, Part I, line 1 (Loss) b Ordinary diVidends . .. . ,'. , ,.". . . . . . . ' , . . , . . ...,... . 4b 249. Schedule B, Part II, line 5 ,., . c Royalties . . .. . , . . . . . . . , . ' . . . 4c Schedule E, Part I, line 4 d Net short-term capital gain (loss) . , .",... . ". . ... . . . . . . . . , . . " , 4d Schedule D, Ime 5, column (f) e (1) Net long-term capital gain (loss) .. . , . . . . '.. . .. . ,.. . 4.m Schedule D, line 12, column (f) (2) 28% rate gain (loss) .. . .. . ,.. , .. . ..'.. . "....... . 4el2\ Schedule D, line 12, column (g) (3) Qualified 5-year gain ....., . ..,. , . . ...,.. . ,...... . ... , 4e('3) Line 5 of worksheet for Sch D, line 29 f Other portfolio mcome (loss) (Ittlch schedule) .. . .. . .,...... . . , . . . 4f Enter on applicable In of your return 5 Guaranteed payments to partner ."..,.,....... . ... . . .. ,'. . ,.. . 5 ~ 6 Net sectIOn 1231 gain (loss) (other than due to casualty :i~j)jj~~~~1~mt!rj: See Partner's Instructions for Schedule K-l (Form 1(65). or theft) ,'... . . . . . . . . . ' . , . . . ,...........,..,........ . ... . ... . 6 7 Other income (loss) (attach schedule) .., . "." .SEE .LINE 25 7 57. Enter on applicable In of vour return 8 .Chantable contribulions (see instructions) (attach schedule) . . . . . . . . . . . . . . . . . . 8 Schedule A,lIne 15 or 16 Deduc- 9 S eclron 179 expense deduction ........... . .....,..... . ...'.. , 9 J tions 10 Deductions related to portfolio mcome (Ittach schedule) . . . . . 10 See Partner's Instructions for . . ...., . .. . .,. . ScheduleK.f (Form 1065). 11 Other deductions (Ittlch schedule) . ........ . . . . . . . . , ..... . 11 12a Low-income hOUSing credit: f:~~~t~~~jm~;1jj~j~: (1) From section 420)(5) partnerships . . ....... . ..,.. . , . . . . '... . 1211(1) -~ Farm 8586, line 5 (2) Other than on line 12a(l) .. . .. . .. . ........ . .............. . 12a(2) b Qualified rehabilitation expenditures related to rental real ~[fi~jjj~1jmtjjj~' 1 Credits estate activities. . , . . . . . .. . . , , . . . ,.... . . . . . . . . . . . . . , . . . .... . .. . 12b c Credits (other than credits shown on lines 12a and 12b) tm~1jt~j~~1~ii~t1j See Partner's Instructions for related to rental real estate aclrvlties . 12c ScheduleK.l (Form 1(65), . . .. . "...,. . ... . ..,'..... . d Credits related to other rental actiVities . . ......., . .. . ,..,.. . 12d 13 Other credits ,.. . ..,.,...,.. . ..... . . . .. . ,...., . 13 BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. Schedule K-1 (Form 1065) 2002 PTPA0312 12/27102 S h.. d I K 1 (F 1065) 2002 RICHARD CLECKNER SR 726 05 4641 c e ue - arm . - - Paqe 2 (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: Invest- 14. Interest exoense on Investment debts . . .....,. . . . . . . . . . .. . 14a Form 4952, line 1 ment b (1) Investment Income Included on lines 4a, 4b, 4c, and 41 14b(1) 429. ~ See Partner's Instructions for Interest (2) Investment eXDenses Included on line 14b(2) Schedule K-) (Form 1(65). 10. . - Self- 1S. Net earnings (loss) from self.employment .. . ... . .. . 1Sa Schedule SE, Section A or B employ- b Gross farming or fishing Income. . "" . . . .. . . . .. . . . . . . . . ... . 1Sb -~ See Partner's InstructIOns for ment e Gross nonfarm Income 1Se Schedule K.l (Form 1(65). . . ..... . . . , . . .. . Adjust. 16a Depreciation adlustment on property placed in service after 1986 . . . . .. . ..... . 16a 219. 1 ments b Adjusted gain or loss .. . ........ . .. . ..... . 16b See Partner's and e Depletion (other than oil and gas) .. . .,... , .,..... . 16e Instructions for Tax .... . Schedule K.1 (F orm Pref. d (1) Gross Income from oil, gas, and geothermal properties .. . . . .. . 16dCl) 1065) and InstructIOns erenee (2) Deductions allocable to oil, gas, and geothermal properties 16d(2) for Form 6251. Items ... . e Other adlustments & tax oreference Items (attach sch) . 16e ~' ...,. . .. . 17 a Name of foreign country or U.S. possession. ~ ::::::::::::::::::;::::::::' -------------- :~:i:!:~~:!:~:i:~:i:i:!:~: - b Gross Income from all sources .. . ...... . .. . . . . . . .. . 17b c Gross income sourced at partner level ........,.. . . . .. . . . . . . . . 17c d Foreign gross Income sourced at partnership level: '~~ij~1!i~~~tt!~li: (1) Passive. . . . . . .. . ..... . .. . ,....... . .. . ....... . .. . ..... . .. . 17d(1) (2) Listed categories (attach schedule) .. . . . .... . ......... . .... . 17d(2) (3) General limitation. . . ..... . .. . ..... . ............ . ..... . .. . 17d(31 Form 1116, Part I Foreign e Deductions allocated and apportioned at partner level: 1~~1j1~mj~j~1i!1~j!iti Taxes (1) Interest expense. .. . .... . ........ .. .. . ......... . 17e(1) (2) Other. . . .. . .. . ........ . . . .......... . .... . . . '" . 17e(2) f Deductions allocated and apportIOned at partnership level to foreign source Income: :.:.:.:.;.:.:.:.:.:.:.:.:.:. ~i~ 11 11~1~! ~ tit j~! ~~ ~ (1) Passive . . ...... . . . . . . . . . . . . . . . . . .......... .' . , . . . . . , . . . . . 171(1) (2) Listed categories (attach schedule) ......... . .. . . . .......... . 17f(2\ - (3) General limitation. . ... . ..,. . ...... . . . . . . . .. . . . ... . ...... . 17f(3) g Total foreign taxes (check one): . o Paid o Accrued . . 17a Form 1116, Part" h Reduction In taxes available for credit (attach schedule) . . ... . .. . .... . ... , .. . 17h Form 1116, line 12. 1Sa Section 59(e)(2) expenditures: a Type · :~~1m~~~~1~jf~~ir1~. -~ See Partner's Instructions for --------------- b Amount. .. . . . . . . ..... . .. . ............ . . . . . . .. . ...... . lSb Schedule K.1 (Form 1065). 19 Tax.exempt interest income .. . ... . ..... . ........ . '., . .. . 19 Form 1040, line 8b Other 20 Other tax. exempt income. 20 1 ... . ..... . ... . '" . 21 Nondeductible expenses. ... . ... . . . . . . . . ."... . . . ,... . ..., . .. . 21 See Partner's Instructions for 22 Distributions ot money (cash and marketable securities) .. ...... . 22 Schedule K-l (Form 1(65). 23 Distributions of property other than money .,.. . .,...... . . . .,.. . 23 ~' 24 Recapture of low. income hOUSing credit: ~i!1~1~~~jt~1!mf~~~: ~~ . From section 42(j)(5) partnerships ... . .. . ,..... . ........... . 24a Form 8611, line B b Other than on line 24a . . ... . ..... . . . .. . ,... . ... . ........ . ... . 24b -' 25 Supplemental intormation reqUired to be reported separately to each partner (attach additional schedules if more spdce is needed): LINE 7 - OTHER INCOME (LOSS) INCOME FROM DISCHARGE OF INDEBTEDNESS 57. TOTAL 57. Supple. ment.1 Infor- mation PTPA0312 12/27102 Schedule K-l (Form 1065) 2002 """ II CLECKNER PROPERTIES 2822095 Form 1065, Schedule L, Line 6 Other Current Assets Other Current Assets (itemize): Beginning of tax year End of tax year AXP (ASH MANAGEMENT FUND 36,544. 41,260. Total 36,544. 41,260. Form 1065, Schedule L, Line 13 Other Assets Other Assets (itemize): Beginning of tax year End of tax year SECOND MTG 554 N SECOND ST, STEELTON O. Total o. II CLECKNER PROI ,,'IES 23-2822095 2 Supporting Statement of: Form 1065 p3-4/Sch K. Line 4a (Regular) Description Amount INTEREST ON SALES AGREEMENT Total 360. 360. \ I i 2002 Taxes Cleckner Properties Tax 10# 23-2822095 Richard W. Cleckner Jr. and Richard W. Cleckner Sr. One (1) property continues to be rented during calendar year 2002. No distributions into or out of the Partnership for the calendar year were taken by myself or Richard W. Cleckner Sr. Properties (2) Onaoina. 554 N 2nd St - now in default again Steelton, PA 17113 1015 Sherman St - Rental Linglestown, PA 17112 Current Status: 554 N 2nd St property was sold on a Sales Agreement for 65,000. Cleckner Properties as Seller agreed to assume 19,500 Second Mortgage. Buyer defaulted on 1 st and 2nd Mortgage (our loss written off in 2001). Buyer however. came out of default and did make 2 payments to Cleckner Properties in 2002 which we are now reporting. Property is again under an actionable process by the 1 st mortgage holder and subject to County Sheriff Sale 1015 Sherman St continues to be a rental property. 1 2002 Taxes Cleckner Properties Tax 10# 23-2822095 Richard W. Cleckner Jr. and Richard W. Cleckner Sr. Income 1099-Div IDS Cash Management Fund $ 498.61 Interest Income 554 N 2nd St Sales Agreement $ 359.80 Rent Income 1015 Sherman St $ 5,100.00 Real Estate Income Second Mortaaae Princioallncome $ 115.00 Total Income $ 6,073.41 2 -11 2002 Taxes Cleckner Properties Tax 10# 23-2822095 Richard W. Cleckner Jr. and Richard W. Cleckner Sr. Exoenses t!:itkttJ Second Mortgage at 554 N 2nd St $ -;> 18,606.56 . . tOO' Total Mortgage $ 18,606.56 ,,.1 Repairs and maintenance $ Total Repairs and maintenance $ Misc. $ 37.00 Total Misc. $ 37.00 Real Estate Taxes 1015 Sherman St $ 702.75 Total Real Estate Taxes $ 702.75 Insurance Coverage $ 292.00 Total Insurance Expense $ 292.00 Total Expenses $ 39,276.62 3 II Date 4- / -(V '.I Carolyn S. Wallace Tax Services Phone 540-5700 4314 Crestview Road Harrisburg, PA 17112 C~~) Tax P,ep.,atlon - - - \ '0/ - - _ld .;2 ~ 00 ~ _5 LJ~ . I29HO I ERIEt> ERIE :;.JSURA.NCE GROUP 100 Em~ ;r;~ Pi, . Er;~. PA lEE.j'f; AA7373 717-737-4981 J P WOLFE INSUR INC ULTRASURE LANDLOnn POLICY NUMBE~ Q43 2280115 NAMED INSURED IfIIIn...1It 111II.11...ItI" HU.... .1.11111'111111. i 11111. U CLECKNER PROPERTIES fr EJ1DT 'I 1119 COUNTRY CLUB RD CAMP BILL PA 17011-1023 OTHER INTERESTS g-EE INVOICE BELaW- SEE REVERSE SIDE FOR CLAIMS DIRECTORY INFORMATION ~~-IJ 'l-l~-o~ L(~ 'l(~ D 05/11/' RETURNEO CHECK FEES WILL BE AOOFlj" TO YOUR. ACCOUNT . HAMED INSURED - PLEASE REFER TO P,4VMENT PLAN INFORMATION ON REVERSE SIDE. t UT.Il.CH INV. OJCE. . P!.1:ASE MAKE CHEQ: PJa.VAeLE TO ~FlIEINSUR""NCE CROUP. SHOW YOUl'l POliCY NUM8ER ON THE CHECK AND RETURN THIS STUB WITH v OUR PAYMENT IN THE ENCLORD 'EMVElOPE. AGENT POLICY NUMBER OAT~ DU~ PAYMENT DUe AA7373 J P WOLFE INSUR INC Q4.3 2-230115. H 07-22-02 292..00 OET ACH CLECKNER PROPERTIES . KNDT t1 1119 COUNTRY CLUB RD CAMP HILL ~ 17Q~1-102.3 I L PAYMENT PLAN I A IIF yOU OESlRE TO CHAt PAYMENT PLAN. WRITE. YOUR CHOICE HERE. .t$EE F.\EVEP-SE SIDEll !I PLEA~E 1).0 HOT .......liE BELOW T'il!> 11N€ '" r- I ERiE INSURANCE GROUP P.o. BOX 1699 ERIE, FA. 15530" TI MAKE CHECKS PAYABLE TO: Patsy R. Donmoyer Tax Collector 4919-C(Rear) Jone.town RD Harrisburq, PA 17109-1705 2' REAL ESTATE TAX NOTICE FOR CE' ~L DAUPHIN SCHOOL DISTRICT ~------..--.-------___._., __._____m____n._._____________ O,"TE : IllLL NUMBER ~ July 1, 2002 I 01748 --.--------______.____...1._______________. .______.__ PROPERTY LOCATION: 1015 sHERMAN ST !PROPERTY IDENTlFICATION'N-;~-35--018 0;;------ (717) 652-5555 or private (717)652-8301 Monday thru Friday 12 Noon - 6PM Closed November 22 CLOSED HOLIDAYS r ******************AUTOCR**C004 CLECmER. RICHARD W CLECDD:R RICHARD W JR 1119 COUNTl\!' CLUB RD CAMP HILL PA 17011-1023 I... III... 111,1111111.. .11. 11111111...1.11111111 .111.1...1. .11 Ltt I'L\~ /) Lower Paxton Twp p. ::L~ (j (./ ll. - f B The annual a..esament appeal filing deadline with the " \d,.. Board of A8..8ment Appeals for tax year 2003 Is August 1, 2002. IF YOUR TAXES ARE IN ESCROW ~lEASE FORWARD THIS BILL TO YOUR MORTGAGE COMPANY. ASSESSMENT II ORIGINAL ASSESSMENT $ I HOMESTEAD EXCLUSION $ I FARMSTEAD EXCLUSION $ NET ASSESSMENT $ 43,100 I o I 43, 10~ I TAXES SCHOOL DIS'l'RICT I MILlAGElTAX RATE r ! 10.6948 ML I TAX AMOUNT $"60.95 DURING THIS PERIOD PAY THIS AMOUNT ......,.."... .' $." "H.:::'~:(..IS;,~ $.' ..,......':.<~~9~~~j )plications for Homestead I Farmstead exclusion are available annually I December 15th from the Dauphin Co. Tax Assessment Office, the local hool district business office. and other selected locations throughout the Junty. An original must be filed with the Dauphin County Tax Assessment " 'fice on or before March 1st ofthe following year. ...:il~~~~\':.".." . .. ..... -..." '. . .. .. . . ....... .~.".... -.. .. .... ... "0" ..." ".". _ '. .."... .... .......>..i:.~=:!.;...:..;:;-;........... . - .' ..- ., '. ..' ,-...,.. . .'. . ..-. :~-: :::-". :::: .".: --::::. :". . :';':...:/:.~;. ..', ;:.':::..;-;.-:-:.-.;.:;: .::: .':.:-"' ;::. . . ....~;IJEd..BItR\. .... .......J~~.~;'~:i... '$..P'.' "83~99 UES ARE DUE AND PAYABLE.. DO NOT ALTER TAX AMOUNT. DISCOUNT AND !HAL TV HAVE BEEN COMPUTED FOR YOUR CONVEMENCE. YOU DESIRE A RECEIPT, ENCLOSE A SELF-ADDRESSED, STAMPED ~VELOPE WITH YOUR REMrTTANCE. ... ... ......."...'.-.,.-,.. .. . . .--- -.. -" "".--. '. . {.'B~.:W~p':: $.....,...... :....:5oi~oi... Unpilld T.- Will" Tum.d _ For eon.ctton Aftw DIlCEM8IIlI1, ~ 2002. Delinquent Tu To Be Paid To Dauphin CountyTu Claim Buruu wtth 8ddlllonal c:harveL ..... ... .. --... .-. .... .. .. ..... ... '...... 111~~~IM~I~mllllllll~1111111 .A Keep IhllS portion tor your ~ .A \ I MAKE CHECKS PAYABLE TO: ~ February 1, 2uv2 . ,.-. ~~ -'1;:' - -~.'=." ~ -~""---i. - -;'_ _ ,....~.... 'i , :',""" - . 1_..... '::;-,_.1 ... I. . ; II..l. NIIMIIER I 1,729 .... ________L_______.________ Patsy R. Donmoyer, Tax Collector 4919-C (Rear) Jonestown Road Harrisburg, PA 17109-1705 PAOPEIm LOCAT1OII: 1015 SHERMAN ST PROPalTY IlfPlTFlCAT10H NO.: 35 018 0 8 9 (717) 652-5555 Monday - Friday Noon - 6PM December 31, 2002 Noon-~~ Closed Holidays Closed November 22 I ASSESSMENT r------.------ , LAND: $ IIMPROVEMEHT: $ I TOTAL: $ 18,000 25,100 43,100 ************** AUTOCR ** C-004 CLECKNER RICHARD W CLECKNER RICHARD W JR 1119 COUNTRY CLUB F.D CAMP HILL PA, 17011-1023 ,," ttI...IH","," III H.uHtlllllll.I..II. III WI""'''" ..-~ ..... .... - t "-i-'""T~';J l : . I , .. . - IF YOUR TAXES ARE IN ESCROW FORWARD THIS BILL TO YOUR MORTGAGE COMPANY. _ ._._ -A.O.U17. ! MILLAGElTAx RATE li---YAiAMQUNT 14.83500 ML $ 208.39 0.23300 ML is 10.04 0.59800 ML !$ 25.77 0.04100 ML i$ 1.77 0.23600 ML 1$ 10.17 I I 1 i I i I , TAXES :ounty Real Eatate :Ounty Lihrary MuxU.cipal Real. Estate 14uni.ci..pa.l Library rire Protection ! UNPAID TAXES RETURNED TO TAX CLAIM AFTER I DECEMBER 31, 2002 WILL RESULT IN ADDITIONAL. CHARGES. f-- I I ! : YOU DESIRE It RECBPT, ENCLOSE A Sfl.F-ADORE.SSE.Q. STAMPED NVElOPE WITH YOUR REMmANCE. 111I1111111111111 .. ICMp tHa porlIon Ill, yau, .-do .. 1212 0113 7282 005 7 RICHARD W CLECKNER JR RiCHMU) W C\.ECKNER 75-<1&'9111 'AY D ~~~OF. TAtsi R.l':&tl1foy~"" J T IIuO - J.vAld ~J Fi f~l\.re AXP CASH MANAGEMENT , "INC. DRAFT ""YABLE THROUGH: WELLS FAAGO BANK RED WING. N.A. lAx Clletfof- ANd ifIA,d., 2.7 I 7J)()l $ DATE ~ ~rn Z.S/.02 DOLLARS f3 lIl"-or...., F..lu'" D_l... .1\ ..,. MlNtMUM AMOUNT $100;00 :is" - 0/8 - 089 -:0 q I. qDO'" b 5': __~ tJ3~J/I r1 Q080 5 1... 2Q..... I. 21. ~ 0 I. I IW' '00 JtJl~ S~If\A^, \ I TAX INFOR' ION 2002 Form 1099-DIV <!> Copy B For Recipient Dividends and Distributions KEEP FOR YOUR RECORDS. Recipient: RICHARD W CLECKNER JR AND RICHARD W CLECKNER 1106 HANOVER DALE DR HARRISBURG PA 17112-9769 ...... ,.... 1"1 N III o Payer: AXP CASH MANAGEMENT FUND 10 AXP FINANCIAL CENTER MINNEAPOLIS MN 55474-9900 A PARTNERSHIP FOR CLECKNER PROPERTIES Taxpayer ID: 23-2822095 Class A OH8 No. 1545-0110 Federal ID Number: 41-1254159 ACCOUNT NUMBER: 0113-7282005-7 002 1. Ordinary dividends 2a. Total capital gain distributions 2b. 28Y. rate gain 2c. Qualified 5-year gain 2d. U~recaptured Section 1250 gain 3. Nontaxable distributions 4. Federal income tax withheld $498.61 $.00 $.00 $.00 $.00 $.00 $.00 The above information is being furnished to the IRS. Value of account on December 31, 2002 Shares owned on December 31, 2002 $41,260.29 41, 260.290 O.OOY. of the ordinary income on line 1 was derived from federal obligations. Please read the instructions on the back of this form and consult your personal tax advisor to properly report this information on your tax return. If you have questions concerning the amounts listed, please write to the above address or call 1-800-862-7919. fOfr.r40710' OCI. r"AfB8 (07/2'000) I "I~I 11111 11111111 11111 11111 111111111 1111 '/1111111111111 " 1111111111 "' 1111 coa, n~' ."r-__,"" . \ ~ o /--- lP1rfiw!1{t~ lB3!1l1DlkfilJll~ Dispositive Provisions - During my Life Dispositive Provisions After My Death Right to Revoke and Amend ~ SELECT PORTFOLIO ACCOUNT AGREEMENT I, (ltC{(IIAO CtLCl(iVt,e { (Settlor) of tJMJll4ta./ CZ>C)/v'Ty hereby transfer to Dauphin Deposit Bank and Trust Company (hereinafter called the Trustee), a Pennsylvania bank and trust company, such property as may be delivered contemporaneously herewith, or at such time or times hereafter, to be held in Trust as follows: 1. During my lifetime: A. All of the net income shall be paid to me at least quarterly or shall be paid or accumulated and added to principal, as I may direct in writing; B. As much of the pri~s I may from time to time request in writing shall be paid to~e, of as I may otherwise direct; C. If, in the Trustee's opinion, I am at any time unable to act or to apply the payments to my own best interest and advantage, the Trustee may apply directly for my benefit as much of the incom.e and! or I?rincipal as the Trustee may, from time to time, deem approprIate for my welfare, comfort, support or emergency needs, dIrectly and without the intervention of a guardian, and may add to principal as much of the income as the Trustee deems advisable. D. Trustee shall keep true and correct books of account, which books of account shall at all reasonable times be open to the inspection of Settlor or his duly appointed representative. Trustee shall also quarterly render Settlor a detailed statement showinK all receipts and disbursements on account of the trust estate and the manner and form in which the trust estate is invested at the time of the rendition of such statement. 2. Upon my death while the trust continues, the Trustee shall pay the then-remaining principal and income to my Executor or Admimstrator for disposition as part of my Estate. 3. I reserve the right to revoke or amend this trust, in whole or in part, at any time and from time to time by an instrument in writing, delivered to the Trustee and intended to take effect during my lifetime; except that the duties, powers and liabilities of the Trustee shall not be changed withou t its written consent. The Trustee reserves the right, at any time upon thirty (30) days advance written notice to me, to resign the trust and deliver the trust estate to me, after deducting therefrom its fees and any expenses then due and payable. o Dauphin Deposit Bank and Trust Company ~~~ " Wll'fiwmit<!l IffiIDlIllIkfilJ!l@ ~ ~ /'- /' - Additions to Trust 4. Subject to the approval of the Trustee, either I or any other entity may add property, real and personal, to the principal of this trust. 5. In addition to the powers granted by law, my Trustee shall have the following discretionary powers, applicable to principal and income, which shall be exercisable without leave of court and shall continue until distribution is actually made: A. To accept and retain any or all property at any time hereafter delivered or in any other manner hereafter acquired, including stock or other securities of the Trustee, or of a holding company controlling the Trustee; Trustee's Powers B. To invest in all forms of proferty (including, but not by way of limitation, real estate, all types 0 stocks, bonds, options, and participations in common trust funds and money market funds); without being confined to investments prescribed by statute and without being required to diversify; C. To buy investments at a premium or discount; D. To hold property unregistered or in the name of a nominee; E. To give proxies, both ministorial and discretionary; F. To compromise claims; G. To join in any merger, consolidation, reorganization, voting trust plan, or other concerted action of security holders, and to delegate discretionary duties with respect thereto; H. To borrow from Dauphin Deposit Bank and Trust Company or from others, and to pledge real or personal property as securi~ therefor; to loan cash or securities upon SUCh terms and conditIons as trustees deem appropriate. I. To sell at public or private sale for cash or credit or partly for each to exchange, to improve or to lease for any period of time, any real or personal property; and to give options for sales, exchanges, or leases. J. To allocate any property received or char~e incurred to principal or income or partly to each, without being obhged to apply the usual rules of trust accounting; K. To distribute in cash or in kind or partly in each; D Dauphin Deposit Bank and Trust Comparry L. To retain any part or all of my business interests held in this Tnlst as long as the Trustee considers it advisable to do so; and to conduct, alone or with others, any such business in which I am engaged, with all the powers of an owner or with respect thereto, ~BANKOF ~~~~~ ~ ~- ,/ rPrrftWIKl1t<E ~fi!l!l!ID Compensation Non-Assign- ment Guardianship Law Governing Trost including the power to delegate discretionary duties to others and to pay adequate compensation to any such person; to invest other property in such business, and to incorporate it or change its form. 6. The trustee shall be compensated in accordance with its standard schedule of charges in effect Irom time to time during the period of its services, and this compensation shall be paid from principal or income or partly from each in the sole discretion of the Trustee. Settlor hereby acknowledges receipt of Trustee's current fee schedule, which is subject to revision from time to time. 7. No part of the income or principal of the property held under this Trust shall be subject to attachment, levy or seizure by any creditor, spouse, assignee or trustee or receiver in bankruptcy prior to actual receipt thereof. The Trustee shall pay over the net income and the principal to the persons herein designated, as their interests may appear, without regard to any attempted anticipation (except as specifically provided in this agreement), pledging or assignment under the Trust, and without regard to any claim thereto or attempted levy, attachment, seizure or other process against me. 8. If at any time hereafter, a proceeding is initiated in any jurisdiction to have a Guardian appointed for my estate, it is my express intention that the Court making such a determination, appoint Dauphin Deposit Bank and Trust Company, or its successor, as the Guardian of my estate. 9. This trust is created and accepted in the Commonwealth of Pennsylvania and shall in all respects be governed by its laws and shall have its situs at Cumberland County, Pennsylvania. Executed on 7JJ1ftAAv-R- Witness: '. _ t!!/~ ~r. c.r(ll. 720- 05- Lj~/r/ Social Security Number 712//2b Date of Birth LjgS9 Hue-v-ihcif,/\ rp';l fhw, s.b(jT>j /7/11 Address: . 19~2... Dauphin Deposit Bank and Trust Company By ~ COffl If (Title) ~ /7 zit{ 2- Agreement Date: Executed on o Dauphin Deposit Bank and Trust Corl'lpCn{ ~~~~ IN RE: RICHARD W. CLECKNER ESTATE IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. ..2..\ - CD - 00110 DISCLAIMER OF INTEREST IN TRUST ONDER WILL OF RICHARD W. CLECKNER, DECEASED C"~ -"I I, MARGARET D. CLECKNER, of 1119 Country Club Road[ Camp fl111, Pennsylvania 17011[ wife and inter alia[ testamentary life-time beneficiary of a certain Trust created under ITEM IV of the Last will and Testament of Richard W. Cleckner[ dated June 19, 2002 (hereinafter "Trustll) [ do hereby[ with the intention to be legally bound, disclaim[ waive and give up any and all interest and benefits to which I may be entitled under the provisions of the Trust under my husband's Will and in connection therewith do aver and acknowledge the following: 1. I have been fully informed and understand that under the terms of the Trust[ I am the Co-Trustee[ am entitled to all the net income from the Trust during my lifetime[ have the power to take $5,000.00 or 5% of the principal of the Trust, whichever is greater, annually on a non-cumulative basis[ and that during my lifetime the Co-Trustee may use principal for my support [ maintenance and medical care. 2. I am Executrix of the Estate of Richard W. Cleckner and am fully aware of the assets in the estate. 3. I understand that the Trust is provided for as a Unified Credi t Trust for federal estate tax purposes and that after consideration of certain lifetime gifting and~int accounts which my husband held with our son[ the Trust -will be funded with approximately One Million, Two Hundred Thousand Dollars ($1[200,000.00) in assets from my husband's probate estate if I do not disclaim my interest in the Trust. 4. I have either consulted with an attorney prior to executing this Disclaimer or do hereby waive my right to do so. 5. I understand that this Disclaimer is a complete and total renunciation of my right to any distribution and any interest which I may have in the Trust provided for under ITEM IV of my husband's Will. 6. This Disclaimer does not apply to and shall not affect any other provision for me under my husband's Last Will and Testament or otherwise and is limited solely to my interest in the Trust under ITEM IV of his Will. 7. I understand that as a result of this Disclaimer and in accordance with ITEM IV of my husband's Will, the amount which I have disclaimed will be distributed to Richard W. Cleckner, Jr. (my son), free of trust. 8. As of this date, the Trust has not been funded, nor have I accepted any benefit from the Trust. IN WITNESS WHEREOF, I have signed this DISCLAIMER, this day of Ifpr,'/ , 2005. VIA ~~.~ MARG ET D. CLECKNER 1119 Country Club Road Camp Hill, PA 17011 II"'" II COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF DAUPHIN On this, the '-!f7r day of A-/o .; , 2005, before me, a Notary Public, the undersigned officer, personally appeared MARGARET D. CLECKNER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and notarial seal. J-;/1~ d~ftL~ Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL JENNY A. TOBIAS, Notary Public City of Harnsburg, Dauphin County M Commission Expires February 15,2009