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HomeMy WebLinkAbout11-14-05 (2) METTE. EVANS & WOODSIDE .A PROFESSIONAL CORPORATION ATTORNEYS AT LAW HOWELL C. METTE 3401 NORTH FRONT STREET P.O. BOX 5950 HARRISBURG. PA 17110-0950 IRS NO. 23-1985005 TELEPHONE (717) 232-5000 FAX (7171 236-18i6 http://www.mette.com November 11, 2005 VIA CERTIFIED MAIL RETURN RECEIPT REQUESTED Glenda Farner Strasbaugh Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 Re: Estate of H. Clarke Staab File No. 21-05-0193 Dear Ms. Strasbaugh: Enclosed are the following documents: 1. Original and one (1) copy of an Inventory. 2. Original and one (1) copy of a Pennsylvania Inheritance Tax Return, plus a copy of the cover page of the tax return; 3. Copy of Form 706, United States Estate Tax Return; \~~ \'\J ;j~ ~'J I~""" '\ ~~..... \ ~,~\) ') 4. An estate check payable to "Register of Wills, Agent" in the amount of $24,493.92 in payment of the Inheritance Tax owed; 5. fees; and A check payable to your office in the amount of $30.00 in payment of your filing 6. A self-addressed, postage prepaid envelope for return mail. Please file the original Inventory and Inheritance Tax Return. Please forward copies of the Inheritance Tax Return and the Form 706 to the Pennsylvania Department of Revenue. November 11,2005 Page 2 Please return a date-stamped copy of the Inventory and the cover page of the tax return, along with your receipt for the Inheritance Tax payment, to my attention in the enclosed envelope. Please do not hesitate to call with any questions. Thank: you for your assistance. Very truly yours, ~~~. \[CV\oc0 Lisa J. Kn de Paralegal to. Swell C. Mette LJK: Enclosures cc: Veronica M. Rumford, Executrix 436967vl Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of H. Clarke Staab No. 2005-00193 also known as Date of Death February 14, 2005 late of Hampden Township, Cumberland County, Pennsylvania , Deceased Social Security No. 195-30-0754 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IMle verify that the statements made in this Inventory are true and correct. IMle understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Howell C. Mette, Esquire I.D. No.: / / 07217 ~/::& 3401 N. Front St., PO Box 5950, Harrisburg, PA 17110 Dated: Address Telephone: (717) 232-5000 DESCRIPTION VALUE SEE ATTACHED t'--1 f-' ~ i ~ -(', , I \ \ TOTAL $2,129,261.18 (,) ) (.,) , I ..r~~ (Attach Additional Sheets If Necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. 436817v1 Form RW-7 (Dauphin County) - Rev. 9/92 Estate ofH. Clarke Staab Estate Inventory Valued as of Date of Death Cash & Cash Equivalents Money Market, Aura Financial Investment Account #77921470 $ 795.50 Federated PA Muni Cash Trust 18,860.29 M&T Bank Checking Account #3440029381 2,062.21 Interest at Date of Death 0.02 PNC Bank Checking Account #5070032123 3,266.82 Interest at Date of Death 0.13 PNC Bank Checking Account #5140237627 125,330.84 Interest at Date of Death 3.42 PNC Bank Savings Account #5000985615 55,373.59 Interest at Date of Death 53.94 S&M Associates, LP - uncashed partnership distribution check, 02/2005 2,350.00 Smith Barney - Uncashed check for IRA distribution 3,700.00 Wachovia Securities Money Market Account #7461-3892 5,459.63 Total Cash & Cash Equivalents $ 217,256.39 No. of Shares Stocks 100 American Heliothermal Corp. common stock $ 0.00 2 Apponline.com, Inc. 0.00 Fidelity Insurance Group 0.00 2 IMN Equities, Inc. 0.00 400 Provident Energy Trust 4,056.00 Page 1 (1) No. of Shares 13.374 Page 2 Estate Inventory Stocks TXU Corp. common stock $ Total Stocks Tangible Personal Property 1991 Mercury station wagon; VIN 2MECM79FOMX625697 - sales price $ 2000 Dodge Durango; VIN 1B4HS28Z0YF239890. Tangible personal property Total Tangible Personal Property Miscellaneous American Express - refund of overpayment $ Individual Retirement Account #530-62130-17 940, Smith Barney Citigroup. Beneficiary is the decedent's estate. See attached valuation. 5.5556% interest as a Limited Partner in S&M Associates, LP Total Miscellaneous Real Property Real estate situate in Hampden Township, Cumberland County, PA, known as 6373 Stephens Crossing; tax parcel number 10-19-1604-214.-U-B1 $ Total Real Property (2) 1,031.00 2,000.00 10,495.00 5,000.00 1,636,299.26 35,560.00 134,640.00 $ 6.66 5,087.00 17,495.00 1,671,865.92 134,640.00 No. of Shares 135.434 106.446 475.699 374.28 201.197 250.003 1,915.449 65.087 29.266 2,246.119 Page 3 Estate Inventory Mutual Funds Boston Co. International Small Cap Fund Harbor International Fund - INST MTB Large Cap Stock Fund - IN MTB Large Cap Value Fund, Class A MTB Midcap Stock Fund, Cl A MTB Small Cap Stock Fund SEI PA Intermediate Term Municipal Fund Thompson Plumb Growth Fund Vanguard Index 500 Fund Vanguard Short Term Tax Exempt Fund Total Mutual Funds Total Inventory (3) $ 2,458.13 4,604.85 4,143.34 4,225.62 3,307.68 2,227.53 20,610.23 3,019.39 3,258.18 35,061.92 $ 82,916.87 $ 2,129,261.18 eEV-1500 EX (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L COUNTY CODE -.J1L 0193___ YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ Staab H. Clarke ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ 2/14/2005 4/30/1934 W (IF APPLICABLE) SURVNlNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) C SOCIAL SECURITY NUMBER 195-30-0754 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [X] 1. Original Return D 4. Limited Estate [X] 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) [X] 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy oITrust) _ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) w .... ll:: :$(fI (J lI::ll:: w II.(J :1;00 (J g:aj II. <C -.... z w c z o II. CI) W 0:: 0:: o U THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Howell C. Mette, Es ire FIRM NAME (If Applicable) METTE, EVANS & WOODSIDE TELEPHONE NUMBER 3401 North Front Street P.O. Box 5950 717-232-5000 Harrisburg, PA 17110-0950 134,640.00 88,003.87 35,560.00 0.00 234,758.05 0.00 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) - 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (4) (5) z o t= :3 -~ ii: <C U W 0::: 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) ,- .1 1,841,831. 97 G') en 8. Total Gross Assets (total Lines 1-7) (8) 124,081.38 47,419.72 2,334,793.89 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) (13) 171,501.10 2,163,292.79 0.00 - 11. Total Deductions (total Lines 9 & 10) (11) 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) (12) - 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 2,163,292.79 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0.00 0.00 0.00 2,163,292.79 x.O L(15) x.O ~(16) 19. Tax Due 20. D (19) 0.00 0.00 0.00 324,493.92 324,493.92 z o i= <C .... :) II. :i _ 8 )( <C .... 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < e3W46451.000 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " [XJ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury. I declare that I have examined this retum. including accompanying chedules and statements. and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of whl h preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN . Decedent's Complete Address: STREET ADDRESS 6373 Ste hens Crossin Cumberland CITY Mechanicsbur STATE PA . Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount 0.00 285.000.00 15,000.00 (1) . Total Credits (A + 8 + C) (2) 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) 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) . 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Pa able to: REGISTER OF WILLS, AGENT (58) PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS . . ZIP 17055- 324,493.92 300.000.00 0.00 0.00 24.493.92 0.00 24,493.92 Yes No D D D D [Jg [Jg [j Cj ~ ~ . 05 . Veronica M. Rumford, Executrix ADDRESS 13 Walnut Street SIGNATURE OF PREPARER 01HER 1HAN REPRESENTATIVE 1 Howell C. Mette, Es ire ADDRESS 3401 N. Front Street, PO Box 5950 Harrisburg, PA 17110-0950 Shiremanstown, ~'f'. In PA 17011 DATE ., ( J tJ~ For dates of death on or after July I, 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.fj 9916 (a) (1.1) (i)J. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~ 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even ~ the surviving spouse is the only beneficiary. . For dates of death on or after July I, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~ 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~ 9116(1.2) [72 P.S. fj9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. ~ 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. . 3W4646 1.000 .REV-1502 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF . H. Clarke Staab FILE NUMBER 21 05 0193 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at v.t1ich property would be exchanged between a willing buyer and a willing seller. neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM _ NUMBER -- 1. DESCRIPTION VALUE AT DATE OF DEATH . Real estate situate in Hampden Township, Cumberland County, PA, known as 6373 Stephens Crossing; tax parcel number 10-19-1604-214.-U-B1 Valuation is based on the assessed value of $134,640 established by the Cumberland County Tax Assessment Office multiplied by the applicable Common Level Ratio factor of 1.0 established by the Pennsylvania Department of Revenue. 134,640.00 . $134,640 x 1.0 134,640 . . . . . .3W46951.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 134,640.00 .REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER . H. Clarke Staab 21 05 0193 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM _NUMBER ~ 1.100 Shares American Heliothermal Corp. common stock Worthless - last traded on NASDAQ on 09/18/1986 DESCRIPllON VALUE AT DATE OF DEATH 0.00 . 2 2 Shares Apponline.com, Inc. Worthless - no longer actively traded 0.00 . 3 135.434 Shares Boston Co. International Small Cap Fund Part of Portfolio Architect Account #191009467, M&T Investments 2,458.13 . 4 Fidelity Insurance Group Future interest in Fidelity Insurance Group common stock proposed under the Plan for Rehabilitation for the Fidelity Mutual Life Insurance Company; number and value of future shares is undetermined. See attached letter. 0.00 . 5 106.446 Shares . Harbor International Fund - INST Part of Portfolio Architect Account #191009467, M&T Investments 6 2 Shares . IMN Equi ties, Inc. Worthless - no longer actively traded 7 475.699 Shares MTB Large Cap Stock Fund - IN . 4,604.85 0.00 4,143.34 Total from continuation schedules 76,797.55 .3W4696 1.000 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 88,003.87 . Estate of: H. Clarke Staab 195-30-0754 Schedule B (Page 2) . Item No. Description Value at Date of Death Part of Portfolio Architect . Account #191009467, M&T Investments 8 374.28 Shares MTB Large Cap Value Fund, Class A Part of Portfolio Architect .. Account #191009467, M&T Investments 4,225.62 9 201.197 Shares MTB Midcap Stock Fund, CI A Part of Portfolio Architect . Account #191009467, M&T Investments 3,307.68 10 250.003 Shares MTB Small Cap Stock Fund Part of Portfolio Architect . Account #191009467, M&T Investments 2,227.53 11 400 Shares Provident Energy Trust CUSIP: PYX . held in Aura Financial Investment Account #77921470 4,056.00 . 12 1,915.449 Shares SEI PA Intermediate Term Municipal Fund Part of Portfolio Architect Account #191009467, M&T Investments 20,610.23 . 13 65.087 Shares Thompson Plumb Growth Fund Part of Portfolio Architect Account #191009467, M&T Investments 3,019.39 . 14 13.374 Shares TXU Corp. common stock Part of Wachovia Securities Account #7461-3892. See attached valuation. 1,031. 00 . Total (Carry forward to main schedule) 38,477.45 . Estate of: H. Clarke Staab 195-30-0754 Schedule B (Page 3) . Item No. Description Value at Date of Death 15 29.266 Shares . Vanguard Index 500 Fund Part of Portfolio Architect Account #191009467, M&T Investments 3,258.18 16 2,246.119 Shares . Vanguard Short Term Tax Exempt Fund Part of Portfolio Architect Account #191009467, M&T Investments 35,061. 92 . . . . . . . Total (Carry forward to main schedule) 38,320.10 tlEV-1504 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF FILE NUMBER . H. Clarke Staab 21050193 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER DESCRIPTION . 1. 5.5556% interest as a Limited Partner in S&M Associates, LP VALUE AT DATE OF DEATH 35,560.00 . . . . . . '. eW4697 1.000 TOTAL (Also enter on line 3, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 35,560.00 .REV.1506 EX+ (9-00) SCHEDULE C-2 COMMONWEALTH OF PENNSYLVANIA PARTNERSHIP INHERITANCE TAX RETURN INFORMATION REPORT RESIDENT DECEDENT ESTATE OF FILE NUMBER . 21 05 0193 H. Clarke Staab 1. Name of Partnership S&M Associates. LP Date Business Commenced 8/11/1974 Address 2467 Bay Court Business Reporting Year Calendar City State FL Zip Code 33327 Weston . 2. Federal Employer I.D. Number 22-6237744 3. Type of Business Investment ProducUService Shopping Strip Plaza 4. Decedent was a o General ~ Limited partner. If decedent was a limited partner, provide initial investment $ 10,000.00 . 5.1 PARTNER NAME PERCENT OF PERCENT OF BALANCE OF I INCOME OWNERSHIP CAPITAL ACCOUNT A. 2 General Partners 44.4445 44.4445 205 094.00 B. 9 Limited Partners (unrelated) 49.9999 49.9999 230 723.00 C. H. Clarke Staab 5.5556 5.5556 25 650.00 . D. 6. Value of the decedent's interest $ 35.560.00 7. Was the Partnership indebted to the decedent? . . . . . . . . . . ..... ......0 Yes [XJ No If yes, provide amount of indebtedness $ 0.00 . 8. Was there life insurance payable to the partnership upon the death of the decedent? . DYes [3D No If yes, Cash Surrender Value $ 0.00 Net proceeds payable $ 0.00 Owner of the policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was . prior to 12-31-82? DYes [Xl No If yes, 0 Transfer o Sale Percentage transferred/sold 0.0000 Transferee or Purchaser Consideration $ 0.00 Date Attach a separate sheet for additional transfers and/or sales. 10. Was there a written partnership agreement in effect at the time of the decedent's death? . . . . . . IXI Yes D No . If yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? DYes ~ No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If yes, provide a copy of the agreement of sale, etc. 12. Was the partnership dissolved or liquidated after the decedent's death? . . . . . . . . . . . . . . . DYes [3D No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. . 13. Was the decedent related to any of the partners? . . . . . . . . . . . . . . . . . . . . . . . . . . . DYes [3D No If yes, explain one limited partner is the divorced spouse of decedent 14. Did the partnership have an interest in other corporations or partnerships? . . . . . . . . . . . . . . 0 Yes ~ No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest THE FOllOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. .4W46991.000 . SCHEDULE C-2 . S & M ASSOCIATES, L.P. Partnership Decedent Partnership . Distributions Distributions Net Income 2000 $ 67,964 $3,776 $62,152 2001 103,040 5,724 84,622 2002 103,040 5,724 79,026 . 2003 103,040 5,724 84,807 2004 103,040 5,724 145,772 $480,124 $26,672 $456,379 . 5 year average total partnership income - $91,276 5 year average partnership distributions to Decedent - $5,334 . Capitalized at 15% return - $35,560 . . . I I. 436256vl . .REV-1508 EX. (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF . H. Clarke Staab FILE NUMBER 21 05 0193 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH . . . . . . . . 1 1991 Mercury station wagon; VIN 2MECM79FOMX625697 - sales price 2,000.00 2 2000 Dodge Durango; VIN 1B4HS28Z0YF239890. See attached valuation. 10,495.00 3 American Express - refund of overpayment 6.66 4 Money Market, Aura Financial Investment Account #77921470 795.50 5 Federated PA Muni Cash Trust Money Market, Portfolio Architect Account #191009467, M&T Investments 18,860.29 6 M&T Bank Checking Account #3440029381 Interest accrued to 2/14/2005 2,062.21 0.02 7 PNC Bank Checking Account #5070032123 Interest accrued to 2/14/2005 3,266.82 0.13 8 PNC Bank Checking Account #5140237627 Interest accrued to 2/14/2005 125,330.84 3.42 9 PNC Bank Savings Account #5000985615 Interest accrued to 2/14/2005 55,373.59 53.94 10 S&M Associates, LP - uncashed partnership distribution check, 02/2005 2,350.00 11 Smith Barney - Uncashed check for IRA distribution 3,700.00 12 Tangible personal property 5,000.00 Total from continuation schedules 5,459.63 .3W46AD 1.000 TOTAL (Also enter on line 5 Recaoitulationl $ (If more space is needed, insert addnional sheets of the same size) 234,758.05 . Estate of: H. Clarke Staab 195-30-0754 Schedule E (Page 2) . Item No. Description Value at Date of Death Household goods and furnishings . and miscellaneous items of personal property 13 Wachovia Securities Money Market Account #7461-3892 5,459.63 . . . . . . . . Total (Carry forward to main schedule) 5,459.63 . REV-1510 EX + (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF .H. Clarke Staab FILE NUMBER 21 05 0193 INCLLOE 11-E f'Wv1E OF 1}E TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT Af'.I) TI-E DATE OF TRANSFER ATTACH A COPY OF THE oeeD FOR REAL ESTATE. 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 TAXABLE VALUE ITEM NUMBEF 1. Individual Retirement Account #530-62130-17 940, Smith Barney Citigroup. Beneficiary is the decedent's estate. See attached valuation. . 2 Transamerica Life and Annuity, . Policy #007407613 Purchased by decedent on 07/03/2002; beneficiary was Veronica M. Rumford. See attached correspondence . . . . . . DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST 1,636,299.26 100.0000 205,532.71 100.0000 (If more space is needed, insert add~ional sheets of the same size) TOTAL (Also enter on line 7, Recapitulation) $ I : .W46AF 1.000 EXCLUSION (IF APPLlCABLEI 0.00 0.00 1,636,299.26 205,532.71 1. 841 831. 97 .REV-1511 EX+(12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF H. Clarke Staab . ITEM NUMBER A. . . B. . . . 4. . Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: 1. Auer Funeral Home 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Veronica M. Rumford Social Security Number(s) I EIN Number of Personal Representative(s) 148-32 -4532 Street Address 13 Walnut Street City Shiremans town Year(s) Commission Paid: 2006 State P A Zip 17011 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees 5. Accountant's Fees 7. 6. Tax Return Preparer's Fees 1 . 2 . .3W46AG 1.000 Aura Financial Services Annual Administrative Fee on investment account Cingular Wireless Total from continuation schedules TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) FILE NUMBER 21 05 0193 $ AMOUNT 4,156.30 54,580.00 57,000.00 595.00 445.00 50.00 199.79 7,055.29 124 081.38 . Estate of: H. Clarke Staab . . . . . . . . . 195-30-0754 Schedule H Part 7 (Page 2) 3 Comcast Cable 88.38 4 Cumberland Law Journal Legal advertisement 75.00 5 Estate Valuation Valuation of securities 114.70 6 Fisher Investments Management fees for investment account, 01/01 - 04/22/05 5,976.27 7 M&T Bank, Portfolio Architect Management fees 317.66 8 M&T Bank, Portfolio Architect Express Mail fee re: liquidation of investment account 12.50 9 M&T Home Equity Loan Additional finance charges on M&T Bank home equity loan 7.37 10 MCI 121. 49 11 PPL Electric 197.63 12 The Sentinel Legal advertisement 144.29 . Total (Carry forward to main schedule) 7,055.29 .REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX REWRN RESIDENT DECEDENT ESTATE OF . H. Clarke Staab SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 05 0193 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH . Associated Cardiologist - medical bill 25.00 2 Bank One - credit card 114.00 3 California Franchise Tax Board Balance owed of 2004 personal income tax 633.00 . 4 California Franchise Tax Board Estimated payment on 2005 personal income taxes 300.00 . 5 Capital One - credit card 5.00 6 Chase - credit card 88.88 7 Cingular Wireless 47.93 . 8 Comcast Cable 6.05 9 Credit Card Services - credit card 23.90 10 Fisher Investments . Management fees on investment account for 4th Qtr. 2004 4,940.75 11 Internal Revenue Service Balance owed of 2004 personal income tax 25,480.00 . 12 Internal Revenue Service Estimated payment on 2005 personal income taxes 4,000.00 13 2,652.55 Par . M&T Bank Home Equity Loan Account #629355 2,652.55 14 MCI 58.05 15 PA American Water 56.20 . Total from continuation schedules 8,988.41 .W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 47 419.72 . Estate of: H. Clarke Staab 195-30-0754 Schedule I (Page 2) . Item No. Description Amount 16 PA Department of Revenue . Balance owed of 2004 personal income tax 3,380.00 17 PA Department of Revenue Estimated payment on 2005 personal income taxes 200.00 . 18 Peoples Bank 4,898.22 19 Per capi ta tax 2005 per capita income tax paid to Hampden Township 9.80 . 20 PPL Electric 188.18 21 Real es ta te taxes 2005 County/Township real estate taxes 312.21 . . . . . . Total (Carry forward to main schedule) 8,988.41 .EV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF "H. Clarke Staab - 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under Sec. 9116 (a) (1.2)] MeLisa Fuller 6373 Stephens Crossing Mechanicsburg, PA 17055 FILE NUMBER 21 05 0193 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER I . General Bequests: 20,000.00 None 20,000.00 2 Anne MacDonald 1201 Prentice Avenue #6 Ashland, WI 54806 . General Bequests: 10,000.00 None 10,000.00 3 Veronica M. Rumford 13 Walnut Street Shiremanstown, PA 17011 . General Bequests: 223,027.71 100% Residue: 1,865,265.08 None 2,088,292.79 . ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE. ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE . . B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS . . .3W46AI1.000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed. insert additional sheets of the same size) $ 0.00 . Estate of: H. Clarke Staab . 195-30-0754 Schedule J Part 1 (Page 2) Item No. Description Amount 4 . 5 . 6 . 7 . . . . . . Relation Thomas R. Staab, II 520 Thaps Drive Raleigh, NC 27614 Nephew 10,000.00 Jennifer Staab 180 BPW Club Road Apt. L9 Carrboro, NC 27510 Niece 10,000.00 Mary Staab 51 York Drive Pittsburgh, PA 15214 General Bequests: 15,000.00 Cousin 15,000.00 Thea Staab 4221 Brown Road Rougemont, NC 27572 Niece 10,000.00 I, METTE, EVANS & WOODSIDE ATTORNEYS AT LAW HARRISBURG. PENNSYLVANIA 17110-0950 . . mast Bill aUll (Utstamtut . OF H. CLARKE STAAB . I, H. CLARKE STAAB, of Mechanicsburg, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me at any time made. . ITEM I: I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of administration of my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. . . ITEM II: I direct the Executor to pay the expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of administration of my estate. . I. ITEM III: I give all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon to VERONICA M. RUMFORD, if she survives me. Page 1 ~ . . . . ITEM IV: I give the sum of FIFTEEN THOUSAND ($15,000.00) DOLLARS to my cousin, MARY STAAB, if she survives me. . ITEM V: I give the sum of TWENTY THOUSAND ($20,000.00) DOLLARS to MELISSA DILLOW, if she survives me. . ITEM VI: I give the sum of TEN THOUSAND ($10,000.00) DOLLARS to my former wife, ANNE MACDONALD, if she survives me. . ITEM VII: I give the sum of TEN THOUSAND ($10,000.00) DOLLARS to each of my nieces and nephews, the children of my brother, Thomas R. Staab, living at the time of my death. . ITEM VIII: I give the residue of my estate, not disposed of in the preceding portions of this Will, to VERONICA M. RUMFORD, if she survives me. If she does not survive me, the bequests in ITEMS IV through VII of this Will shall be double the amounts set forth therein, and I give the residue of my estate as adjusted to MELISSA DILLOW. . . ITEM IX: In addition to powers given by law, the Executor shall have the following discretionary powers: (a) To retain any property received by the Executor; . . (b) To sell real estate, publicly or privately, for prices and on terms as the Executor deems proper, without liability to the purchasers to see to application of the purchase moneys; -H~j Page 2 . l '<, ." ~ ;:J :f.l lJ J . (c) To compromise controversies; . (d) To distribute income or principal in cash or in kind, or partly in each, at fair market value at the time of each distribution; . (e) To hold investments in the name of a nominee; and (f) To undertake all other acts in the Executor's judgment deemed necessary for the administration and settlement of my estate. . ITEM X: Any person who has died at the same time as I . have, or in a common disaster with me, or under such circumstances that the order of our deaths cannot be established by proof, or within thirty (30) days of my death, shall be deemed to have predeceased me. ITEM XI: I appoint VERONICA M. RUMFORD to be the . Executrix, referred to in this Will as "Executor." In the event of her death, inability or refusal to serve as Executor, I appoint MELISSA DILLOW to serve as Executor. The Executor is specifically relieved from the obligation of filing bond or entering security. . . IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding two (2) pages, at the end of each page of which I have also set my initials for greater security and better identification this Z rI- day of ~~ ~ . 1!J'%': ;' &3-" 'U.- ';5 (SEAL) LARKE STAAB . . . . . We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set oUI hands and seals he day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. . . /~Jf~(SEAL) ~~~ (SEAL) . 1 . .P r' ...L. Residing at -z.tJ 6 f-/' 2LP 'cA' &11L~ PA /7tJl/ / J:f} Residing at 0 t) l. /.:U.t Ib-l /j~,1A,~iJLIJ I '7 II c> Residing at () . ~~~(SEAL) . . . . 127478 1 . Page 1 of 1 ~etailed Results for ParcellO-19-1604-214.-U-Bl in the 2004 Tax Assessment Database DistrictN 0 10 Parcel ID 1O-19-1604-214.-U-B 1 _MapSuffix ~- 6373 HouseNo Direction Street STEPHENS CROSSING _Ownerl STAAB, H CLARKE Owner2 PropType R PropDesc .l-iv Area 1584 CurLandVal 0 CurImpVal 134640 CurTotVal 134640 tfurPrefVal Acreage 0 CIGrnStat TaxEx 1 .aleAmt 66000 SaleMo 9 SaleDa 9 SaleCe 19 ealeYr 80 DeedBkPage 0029C-00126 YearBIt 1975 HF _File_Date 10/19/2004 ttIF _Approval_Status A . . . Ltip:/ /taxdb.ccpa.net/details.asp?id=l 0-19-1604-214.-U-B 1 &dbselect=l 4/1/2005 ~evenue: Cumberland County Page 1 of2 Uoi1iI!Ii . -... .. INDIVIDUAL TAXPAYERS fJ . . , ">;';:jU;ri;;';'t;:k::.":,,ii "';\:.i:>::t:: ~t~.\ o Personal Income Tax o Prooerty Tax and Rent Rebate o Realty Transfer Tax o Inheritance Tax o Cioarette Tax ~ Use Tax ~ Motor Fuel Taxes ~ Local Tax Information ~ Unemoloyment Comoensation ~ Commonly Asked Ouestions ~ e-Services ~ Tax Rates ~ Tax Due Dates ~ Forms & Publications ~ Keystone Oooortunitv Zones ~ Voluntary Disclosure Prooram ~ Office of Chief Counsel ~ Taxoavers' Riohts Advocate ~ Contact Us Common Level Ratio (CLR) Real Estate Valuation Factors . Browse Search Revenue Home Back Printable Version Text-Only Full-Screen eMail Previous Next Cumberland County ACCEPTANCE CLR DATE FACTOR FROM TO 7-2-1986 6-30-1987 9.52 7-1-1987 6-30-1988 10.00 7-1-1988 6-30-1989 10.53 7-1-1989 6-30-1990 11.11 7-1-1990 6-30-1991 12.05 7-1-1991 6-30-1992 12.35 7-1-1992 6-30-1993 12.50 7-1-1993 6-30-1994 12.82 7-1-1994 6-30-1995 13.33 7-1-1995 6-30-1996 13.70 7-1-1996 6-30-1997 14.29 7-1-1997 6-30-1998 14.29 7-1-1998 6-30-1999 14.71 7-1-1999 6-30-2000 15.15 7-1-2000 12-31-2000 15.63 *1-1-2001 6-30-2001 1.00 *7-1-2001 6-30-2002 1.00 7-1-2002 6-30-2003 1.01 7-1-2003 6-30-2004 1.05 7-1-2004 12-31-2004 1.11 **1-1-2005 6-30-2005 1.00 . . ~ View as Text-Onlv ~ Site Feedback ~ Site Index ~ Home . I Login, I e-Alerts Receive notification of changes to our site. Subscrib~ Now . fAt IRS * Adjusted by the Department of Revenue to reflect assessment base change effective January 1, 2001. . ** Adjusted by the Department of Revenue to reflect assessment base change effective January 1, 2005. . Content Last Modified on 1/3/20059:02:08 AM . ltip:/ /www.revenue.state.pa.us/revenue/cwp/view.asp? A =3&Q=204123 4/1/2005 :>VX: Historical Prices for PROVIDENT ENERGY TR - Yahoo! Finance Page 1 of2 · Yahoo! My Yahoo! Mail I Donate to Hurricane Relief YJlHOO'~FINANCE ~~~~s~~~uj) Se.arch the Web Searchl Finance Home - l::'-eJp. . Friday, September 16, 2005, 3:01PM ET - U.S. Markets close in 59 minutes. Dow +0.68% Nasdaq +0.45% To track stocks & more, _R~gI$tex Quotes & Info Enter Symbol(s): e.g. YHOO, ^DJ! I GO I Symbol Lookup I Finance Search Provident Energy Trust (PVX) ~ · ,," B WId~"f~_ Free Trades FREE BlackBerry 7100t. Scotlradt1 At 2:41PM ET: 11.814 ..... 0.026 (0.22%) .. "" "-", "i" ti"I.]:~~:i=::I,..'^ln:l:llI.}rl'j:l:=ilII Join Aoex Todav Still Just $7, Trade with Fidelitv Historical Prices Get Historical Prices for: IGOI .ET DATE RANGE ADVERTISEM ENT Start Date: Feb End Date: Feb 14 14 2005 Eg. Jan 1,2003 @Daily o Weekly o Monthly o Dividends Only 2005 . [ Get Prices First I Prev I Next I Last flRICES Date Open High Low Close Volume Adj Close* 14-Feb-05 10.11 10.19 10.09 10.18 1,471,400 9.39 * Close price adjusted for dividends and splits. . First I Prev I Next I Last 1~..kU;>ownload To Spreadsheet . . . W Ac:iQJ9~911folio ~' Se,t A~r:t B EmailJo lLErLeng . lttp://finance.yahoo.com/qlhp?s=PVX&a=O 1 &b= 14&c=2005&d=O 1 &e= 14&f=2005&g=d 9/16/2005 . Estate Valuation Date of Death: 02/14/2005 Valuation Date: 02/14/2005 Processing Date: 04/14/2005 Estate of: Estate of H. Clarke Staab Account: 12870-0001 Report Type: Date of Death Number of Securities: 1 File 10: Staab.Clarke.estate . Shares or Par Security Description High/ASk Low/Bid Mean and/or Div and Int Adjustments Accruals Security Value 1) 100 AMERICAN HELIOTHERMAL CORP (026497107) COM PAR $0.001 NASDAQ - Industrial 09/18/1986 0.06250 0.03125 A/B . Last price available on 09/18/1986 0.046875 N/A Total Value: Total Accrual: Total: $0.00 $0.00 $0.00 . . . . . . . Page 1 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) . . CII :J iij > - e . :J 0 (J (J <C CO"-"-COO'l~COI"-O~1"- It) It) ..-('I')N('I')I"-COCONI"-I.ON CO? ClIO O'lNCO('l')CO..-('I')I.OO'lCO..- CIC! :JO ""':0 LriMr--.:cx:ia>r--.:-<i-<icx:i - -~ CO"-N~OI.O"-NNOI.O ~ . ns~ OCON..-('I')NONNCO~ "': >- Lrici..j..jMMMN'cO..jN' - N ('I')N ..- 0 - It) 00000000000 0 "-COO'l,,-~('I')O'l"-OCOI.O >0 COI"-NI"- ('I')('I')O'lON..- <C~ Lrio""':cx:icci""':ccicx:i""':Mcx:i Z~ ..- ..- ..- ..-..-~ ~..- - ..- N . 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II) ....: Il'i ~(It 8 8 Il'i CD o o '" II) C\/ ..; - a. w W ~ Ul I- in ~ ~ o Wz o ~Q ::::l ZI- ~ ca& o ~ - - o > l- e ff3 I- a: Ul W W I- ~ ~ ill a: ~ ~ ~ !2 o (; CD an Il'i ~ ..: Ii ___ "5 ~ a. w W ~ Ul I- in ~ w ~~ ~& 'ii - -u- e 011- e u: ___ ~- i._ -- ~- 8- m 011== CI)- ii._ ~ ~ J!! s- en en is ... o - e => ~ III ... => i. Cl e 'E III CI l!! CO> e o = CO> CI) => c:r :0. e OIl i III .c ::I i. I- ~ I- Ul W > Z ill a: :t:: ::i i. ~ i s ~ ~ :; o en- CI) = 'C ::I U CI) en OIl "5 o .c u ~ CI e "j o 'ii i/ t t: - ~ o . . Fidelity I nsurance Group, Inc. p.o. Box 3650, Wayne, PA 19087-8650 Shareholder Services Toll Free 1-866-886-0788 Fax 610-964-1852 OS/20/2005 ESTATE OF H CLARKE STAAB . C/O VERONICA M RUMFORD EXECUTRIX 13 WALNUT ST SHlREMANSTOWNPA 17011 . . . . . . . . Re: Shareholder Nwnber: Shareholder Name: 120024 H CLARKE STAAB We are aware of the death of our shareholder and former policyowner, H CLARKE STAAB. The Plan for Rehabilitation for the Fidelity Mutual Life Insurance Company proposes that Mutual Members of Fidelity Mutual on the Record Date of August 31, 2001 will become shareholders in the new holding company, Fidelity Insurance Group. H CLARKE STAAB was a Mutual Member owning an active Fidelity Mutual policy on August 31, 2001 and was, therefore, eligible to receive future shares of stock in the Fidelity Insurance Group. Although we recognize the shares of stock will have to eventually be placed in someone else's name the shareholder name as of the Record Date cannot be changed until the Plan for Rehabilitation is completed and the stock is issued. At that time, which we currently believe will be in 2005 or 2006, there will be a Stock Transfer Agent available who will assist in processing stock ownership changes. Meanwhile, ifthere is an executor or administrator of H CLARKE STAAB's estate, he or she may wish to consider keeping the estate open in order to more easily administer the future receipt and distribution of the shares of stock. In an effort to assure that an interested party continues to receive mailings concerning the stock, our address records for this shareholder have been changed to the address on this letter. If you are not the person who you feel should be receiving our mailings, please call Shareholder Services toll-free at 1-866-886-0788 and we will be glad to make the necessary changes. If you have any further questions, please call us on the above toll-free nwnber or visit our website www.figdirect.com. Sincerely, Shareholder Services . ~==- \..-- . . . . IU{'J' I C l,j";~:i . . . .' . . S & M IJF 1,1";';1'1':';)) UP :1-.'~\}~;_j.;J.1J~: _J':~3 .1.1 J P l\,:C~;~Q~L0~1~~~ S JJ ~\O~ J h~ ~r L~ . \ . .0cr:l~!':!'mHT, made a,s of this 1st d.::-W of Hay, 1974, by and aHlong\~J'.i.'mu.EY .J. ::;',\;,:r(~:;KY, D.D.S., J:esiding at 95 l'l'estminster . 7\-,'''' ' B" - (.' ,c,',~ 1,1 HI ,-nue, J,_l. ~J ..11.1.. L _.. . , 1'7,:;\1 J('r: ,c::.y i~1)d ROBER'f J. HALI..IN rD. D. S . , re-. s j.(1i,ng 3t. 28 Suut.hf 5. ',:1d, I\Oi,d, E,li:3on r lIe\-T ,Je:csey lhc.reii1af ter re- f.(~I:.I:c:l1 t.O as "Cl:nlo:ral I'ii:i:t.llC):S"), ;:"ld ~'::').\:'~i,H,l;;Y S. CONNER, D.H.D., . II'iC;lnD ,J. CCNImH., both :r:esidL1') il.t (i(j'). ~::i:. ,'f"hns Dl::-i\re, Camp Hill, l>.'nll:-:;ylv.,ilii1.; l:;.TUJI,N B. LOSS, D.D.S., PH)J',.'.E S. I"<)~;S, hoth residing ;:d: 8 ShlJ!tc; C1:0p FO.:ld, Hilmin<]t.on, Dela1,';;u:c; JJ. CJ,/\FJ<i'; :;l'AAB, D.D.S., . \'JJrrG')mD n. :;'I.';,;YB, bot.h residing d.t 52-29 Ea.st TJ:j.r,dlc Road, 1'1cch;.1ll;.c:;],<IJ"J, r,'"'II:'y1v".nio.; fl.. ))"':AN ;>.LPTNE, D.N.D., 'KNi'IUNA A. ALPINE, )).jth 1.".s:i(li!lrJ dt 2G ]':;l:51:, ',).'l.lnui: i)l:XI::lo)t, Hochessen, De l,i:t\-Flrei . lHLLJ.lLM lZl\'l'.ES, D.D.S., i::'JI,j'ji)l,;A TJ. ~<;\~j'E:3, ]K,Lh :r:,-,~)iding at 4.003 ValJ.l~y / ,,: I l I C..-c.r.:n Road, GreenviU,(~, ])('.1..1 ;.JJ:"i ;ilf,I'LJC~t<! TJ. i.'JC CT,UR8, bR.,' C.I\HqL "A.. . V I. ' j+:-CLrm,:r.,both'residing at 18 E;,~3i: CllY.;r~, 11,:,())>:~:)tl)\m, 1,18\'1 JCI:~';I~Y; \.. . J,(iU:I: e:r~ t~. :--",~EP,S:KY,. 1: C' s:La ing at 95 \'Je stI\lin~,.;terAvenl.l.e, Bt'l: l,j l,:~'\r" 'j .-' Jet ( I ')'1'" r Jl' J' ,., . 'I ", "(1 (' I ('\11" ','It.] 7\ V I "'11\.' T T 'r' N 1-""" .j ,1 .i 1" T ;1...t 7 8 r...') (_'U .tJ1 J_: l' l~. .1.,.1.1 .~; ( ~.- <(.1 , ,l..:Vv \ '. ,)~.;. . ..!J -,__ j '-'11-""~-1, 't.... .J J.,h ( .,\.. ..."J__ -l...~-.:J'" - _l l:~(~t i ~~ ().n ( ],"J\p~\.z lJ (;~ ."j: ;'~ C:'.Y (11 (-'.L~ ~ i j1 d. f t (~X: ~C C;:C C~)~~ .L~ (.':(] t: () "1 c.... (...:> "'r 1.' Till' t','d T)".-t'1(Y(""") .J_. . __ .Lul...l ___"J . . 1... r.tl\: ":j~ 7\..;:~-11) .:..~.i'):.~~L';\lJ~.::.3S . 'The paTI:i(;~::; (10 hereby fo:crn a Lind. "I.:(:;d PdrtnC'l' ~;hip plu:suant to the provisions of the Uniform Limited Pcu:tne:c3hip Ld.W as ~dopted in the St.ate of New Jersey (R.S. 42: 2-1 et seq.) to hold, ope:ca'te, imp:t'Ove.lnd led ~:3ei:,he ):I:.dl P}:'C)?C'cty in \',ihich t.he P.'lrLner ship will have c.111 in:':t:::.cei3t. in, JUCil,h'.<1 ;..d: H,,"dl.:. )\v(':nll"'~ and cot.tage ~'lay( S.:lCT3,1l)8nto, Cal-L:i~oJ,T\.i..j, i'.nd ~>nc]l oi~hr'.:c 1:.s...1 2I:Ol.)crty as the P,.1x'tner- ship rn;1.yf:':l:cm t~'ne -CL) i'.:i.Joe '-l.(11I]icc.. 'I'h(~ ndm(~ of the Partnership :c~haJ.l be S & 1'1 /\~3~;i)C',L\'I.'ES( iJnd t.h(~ ~/:r:L'c:!.p,l.l oftice of the Pa:ct,m::.r::;hip shall be at 29 !l., in S 'l::t: (;(~t, iL, c1{1':n:3 ,1 ck: ,1';;"1 J ,''.l'~; cy . . . ."'; . e e ; ~ I I . ! i ei I ! , I . I -f I, er I I ! ei e , . "..~ ',;.- ".,," . .." "-r J 2. 'l'J.: [-:[,1 '.1,] Hi '::<::nn of U)l~ PaJ:""l:n<.~):ship shall begin as of the 18 t clay' of Hay, 1974 and sJwll coni::i.nue until tht~ 31st day of l\pril, 2034, .unless t~:CH1.i.n,:tt(::d ,':;:,.:r:l.ic:c a,s hereinafter p:coviJed. 3. C.i\P1'J'}\L CON'.~":~):r:JU'I.'IONS OF GE:NER~.L PARTNERS ___......______....._ -"t..-..-.-..- ~. -. ..---... .......--...---. I S'l'ANLEY ,,1. pn.:,i?,f:{Y :"'3,n11 HOBEH.'!' ,J. l1ALLIN [:ihall be t,he Gf-~nel~aJ, J?().1.":l::nc~rs. 'rho fl:.l.c:lr::i.,..11,.:l1 ;;hil.:,:e of the capi.tal of the Partner:il1ip which the. General I';~l:"I'ncJ:'~3 :,:hdl1 (;(Hlt:d.bute. in cash and in 0.lluiVilll:!lrt value 5.n the '\:otat :,;(:~t c)ppo:~.i.tn i:hc.i.r )1~~m~~., Gcnpr~l P~rtncrs Con t:c ).1':.1'i:, 1. on s . Number of units _0' -_..__..............- ...- .....---.-- -~..__..., ......---.. ...-... stanley J. Swe~sky, n.D.S. $ 15,000 3 Robe.l:t J. H;\J.lin, D.D.S. _~ ]. 5'Lg~_o.. 3 $ 30, G,O 0 6 ! I I I I (' .;, '.J ')' ',"'1\ I 1'(", '1'1".'i']'I \-"1'.-' ( 'f"! S OF 'f 11"1 'I'ED "').i'" 'r"l'j-.1T;'1:lS ....),.. .., ,1J...J ..... J,. ." __ ...... _, .1 ...J. rJ J: l~._"\ _,.L",,'""\, .. . ,'_'" ........ . ,.'_0-'. . ...__.. '.. ..,.... _.,~ . 4__,,_,__,___,,__,,___4."'- i I I 'J.'Ii l'~ f <') .1,1\"'''';1 Jlq j7":'.u,:;; ('':''~; ::, ha 11 be Lilili t~ed P dl: t llt:::C3 and shall contribute t,o' th(~ C;~l{:t 1';1.,1. 0:1; ::.11<:, Pal:tne:rship the IHUiibe:r: 0:1: unit.s set opposite 'l'.heir nalne lS f(,)lJ.\.i\'IS: I0:~2;,:'~':_:.9--~~.)~~~~.~~~~,~ I SE:~l:E?:J,~~,!~-.}.on~.: ! .t 4. J'1nmberof Units ____..___4_..__.--....__ Stanley s. Conn (~r , D.H.D. $ 10,000 2 IngL"id ~J. C" '!1nc:~:r 10,000 2 - Brian n. Loss, D.D.S. 10,000 2 phod)e (' I,I,):3 s 10 (0,00 2 ,::> . H. CL.u:ko Eii:.'l.ab, D.D.S. J. 0 , 0.0 0 ? Hinif::r:l~d n. st..:l<:lb 10,000 2 A. Dean AJ.pine, D.H.D. 10{000 2 Katxini1. ^. 1\J. P i rli~ :1 0 f 00 0 2,' .l\lilli;'un ~(ji.~: us, D.D.S. J.O,OOO 2 Sandra IJ. K;lt:CS 10,000 2 n' ..,._ \ '---' -'-_/ >!l' Jr. 10,000 2 Carol j\. I'1cClure ' 10,000 2 Louise R. Swe~sky 15,000 3 Giovanna V. Mallin ___,__;!- 5 LQ.2.Q. 3 . 'rota 1 $ .1.50,000 30 5. P1J.OFI'l'S l\ND J,()::,.'3ES . . A. The net profits of the Partnership shall divided and any losses shcill b~ borne by each of the partners in propo~t~ons set opposite his nare,(subject, "h?wev~r, insofa~ as the L'uip.-l:ed Piu:i:,ners are concerped, .to 'the l.ura t<:~1:lon of thelr li:1.)). ill." ty to 1:he amount of their individual investment as herein- aft.er prov idcd: ) ! be the stanley J. Swersky, D.D.S. $ 15 , 00 0 , (() I NU1!!.be~:!._ Units jJf (,)l" , () '\1'0. f1I . 3 .\--'7 -: I> 'woo GC'ln-'1:: alP a.l"tll'(~r.s Cr.))) tr jJ)\lt.i on s . Robert J. :Hallin, D.D"S. .__,}~~>_g,9.~ . /J , I. ,... " I,) 3"f" " -/'" ( ;6 f Tota). $ 30,000 Limited p'artn'e'r.s ' Cont:x'ibu-l::i'ons Number of Units . st':lnley S. Conner', D.H,D. Il)crr;d J rC)j-'ll(-'r. .~ ",J" .1. . _" 1 -_" $ 10,000 1 0 , 0.0 0 10,000 10,000 I 10,000 ;- J. 0 , 0.0 0 10,000 10,0.00 10,0,00 10 , aD 0 2 2 Brian B, Loss, ,D. D,S. 2 . :Pht)(:]J'f-~ s. IJo~)s.' 2 II. Clarke Sf:a,ab, D,D.S. 2 .......~ Winifred D" St'aab 2' , .. A.. Dea.n Alpine,- ,D.H'.D'. 2 Ka tr ina. A. Alpine' 2 .. William Kata~,.p.D~S~' 2 . Sandra L. KJ..C:<;s' 2 -3..". . .'.' \ . ,-' <J IP' 1'7 il.bu:c n L. NcClure, Jr. 10,000 2 Ca'(()l A. McClure 101000 2 L01.'lise R. S'versky 15/000 3 Giovanna V. Hallin ____)2~~g.2~ 3 'rotal $ 150,000 30 B. For income tax purposes, all depreciation dcdur;t:i.on shall be allocated among the part: rH:; C'3 1 bot-.h General and Liil1i ted Par tners, in pr'opo.rtijon to their capi t:al contJ:ibutions. i I . i 6. J''IOR'l'GI\GINIG -'-------1 , I In -the eV]'ent the Pa.rtnership bor.t.ows money and giv8s a Illort.gi:lye on the real pr:ope:r.t:y oVlned by the partnex'ship, the net proceeds which are recei~ed by the Partnership as a result of such financing shall be distributable anIDng all the partiesl both General and Limit.ed, in the :same ratios as set forth in Paragraph SA hereof or the' net: proceeds may bCU;3t,d to add additional' im- pro'/crnents and st.ructure on the pJ:opert:y of the Pc:u:tnership as may be detennined by thri General PRrtners in thei~ discretion. . ....,~ SALE OF.4":!"~' s In theeV]erit of any sale of the real prope:cty or portion 'U1Creof held by t:he P('l.rtner.ship ~ th7 net proceeds realized from such nale shall be alloqated and dlstrlbutable aruo~g all the partners, both Genera.l and TJitniLed, in th(~ rat:ios set forth in Paragraph ~)A h8reof. I_ i.. , i I LIABILI'l'Yj OF LIMITE~D PAR'rNERS 7. . 8. .. ,. i Nob..,it:hs~and.ing anything '1:0 the' con.tra.ry ~le'r'e_in C(Hlt:.-tined1 Uw liability of ~ny of -the Limited Pm:tners shall'in no event (.~xceed in 1:he' aggregab:!the amount of h5.[5 contr:ibution' to the' capital of thePart:nership. I ! , -- 4- . .; . .1 I I I \ i ,i; .1 i! i: 'I' d 111 I .! ! . . . ~'~~.llCl,:"y.';.""~~L.:;JR...:'~'~ " , '-' '-J 9. ::'-1.!I.LAR,IES r DHl~YI.LNG.'3 ,\.111) IH'l\!::!~E~'::i'l' ON Cl\Pl'.l'1\L CON'.J:'RIBU'l'ION . _.__._---_._----~_._---- None of the partners (General or Limited) shall receive ilny saJ.(ll~y or dl.',3,ivings f()1~ services rendered on behalf of the Partnership in th~ ~apa~ity as partners, nor.shall any partner receive ~ny intere~t o~ his cont~U)utj.on to the capital of the Partnership. 10. GENERAL PAIZTNERS ._----------....-...-.N" ______ Th~ GenJral Partners jointly shall have the sole right t.O the management of ilhe Partnership business and shall devote such time to the partnerShil' as shall be reasonably recluired for its welf~re and success. The General Partners jointly or either of them are aut,1101.' ized on behalf of t.Ile Pcirt.ne:csl,ip to borl:ow or lend money, to rnakc, delivc):, oX" U,1',;ccP-t I i:~llY COlHTlF.:':l:'cii'l.l paper, t.:o executei:1.ny mCll. t.<j age, bond, note, or J.c'Cdt~,p.,Lo PU:cd1i.'lSe or contract to purchase, or to sell or ccntxact to' S"r:J.J., any rn(lpC~~cty for or of the Piiri:ner- ship. The G(~n{~:ral Pa,l:tner:s, ,:;.:ce he)J~by .:l.l1tho:cized to enter into a ! Managcli1ent Ag:LC'C-';flGllt for thf3 mC1n~:;''-JeH,(''nt ,'ll1d ope:cations of the pro-'~ perty of the Fax tne:r.-:--,h5.p" 11. LUll/I'En, PI\P.'....'NEHS --- ..~ ~_._-.......-..-I---......_. ~._.-_.... - -~--~-- ! A. No ILbnited Partner shall participate j.n the mallagf~~mcnt of the pa.rtnen3ljip busines s. A Lirni ted pari:nel: will have the rigllt to withdraw his qapital contribution upon the termination of .the Partnership as prov~ded herein, provided, however, that no part of the cap:Lt:al contr il.?ut.ion of ony Limi t.ed Partner shall be withdrawn unless all liabilities of the Partnership, e*cept liabilities to pa.1:''l...ncrs on i'.ccollnt of their contr.i.))l.~'l:ions, have been otherwise provided in Piui;'rc=tph 18 b(~~;()f, no IJi:'.li ted Piutner shall have the riCjht to clc:manrl ur .cecc:i ve' pJ:op(~rLy other than (~a.sh in return for his cont:r: ibu tion. No Limited Pa:r.tnf~j~ shall have p.c ior i.ty over any other Limited Partner eith~r as to contributions to capital or as to colTtl?~:nsa. t.~.on ~)y i'lay of p.rJc;ome. No a.L1.dition:-l Limited Pa):tner s ILlay be a~mlttcd ~o tne"Partnersh1p, except as here1nafter set forth. The Limit~ed Pa..ctnf'~:cs heJ:E'?by cop:ient to any :3.:1.1e or other dispos,itiol1," encwnbrance, mortgage or lease by the General Partners on behalf of the Partnership, of any oJ all of the partnership's assets, now or hereafter acqu 1reo, on sncl'h t(~r.T,1S and conditions as may be determined by the General Partners ilQd to the employment when and if required, of :3uch I-'koker-s -~C1PJ,J-S' "'!l--l-n""nf'Y'~ -, '" ""'---e Ce- neral Partners may deter- ~ _ ...~.. r (......J _ .L L.., l.,... _ .. - .:;Ji t~~..oJ. l. L J... - ( . m' J '" 'J' 'h b' ] b 1 ~ . 1ne, no l':'i'lJ.1.~n::.n.lJnc. .1_l1g 'l: d'. ('tny pax.tYl(;):'C y may lave an J_nterest therein. . ; -5- ..~-'SIlUa!L~."":~>"C"\""''''''~~-:'='.'''' ',,---,.' , ~" .J . B. l'Jr)L\vi th:j.r di!di 21<] a.nything to the Con l::r:-ary hc"",h"bove set forth, in the ('V"ll" II,,, t a Um.Hed Partner shall <.1..." ire to sell, transfer Or ~s"i011 his J.nterest in the Partner"hip, he "h" 11 first ofF. er the Silme for sa Ie b1 "ri ting to the Partner shi p, by ",},Cd ling such offer for sal.e .to th" ""ne.cal Partners "ho shall 'wi Ud n fi ve (~) ,lays of receipt of ""eh offer for sale, notify in '/L' 5.10 .i.i1g .,11 U", i3,8d Par tner s of th c ,..., f ":r for sa Ie and in the eVent th it t no p~r tner, "'h~ ther Limit ()d 0': C "', ":a I, "h a II ace ept the offer by mailing such acceptance to the C':. """,,1 Partners.. then in such evenl: the offe"or shall have lJje d'Jht .,or a period of ninety (gO) day. t~ereaftcr to sell, transfer 6r au.ign the said Limited Part- · ile'. s;J.i.p'" in t"ces': prov ioed al~ pa.:ct i,,,s(r;''l1''-cal and T.imi b'd) agree to "';ai t the 'W'w Limi t ed Par tnep, . In I ho ",V, ''I t th d t t]w "aId 6ft eror or .T,imib,d Pa""'.,..r shall fail ti:> sell, .,''',',i~n or b:ansfer saId Limited P adll",,. 's i. n hn'",,; I: ,'Ii i-.llin thes''':d n i11<O ley (9 a) d,IY P".r.i.od , then in such event before ~.id Limited partne~ can sell hi. pa.1:tnership in- tet'ost, he sh"ll !',Lest offer th(;s<une to ~he PaJ:lnership as h"roin- abo;;e ."t furth. 'rhe foregoingl shall not how,over' .I:oolid,c,t the right of a pu.rtner tQ!'.:cansfG:c his :i..nte:r:c:3"l: to a. l1leIllbe:t: of his immediate .' f''''d,ly or a t:cnst j'or th,; bene,frt of a l!Ioo,"ber' of his Immedi"te 'family, C. Non",I,::;s],'JJv3.hi.li i".y, No J,imi ted Part.ner: shall h a...., the right 1.0 :,,, bs til.n :,e 'm k.i s,i Yll'.' e ,'s con ~r ibutor in hi,s pIa ce , No ,. ,"d, '.! nnonn t of 'my Li",i. ;.c.d p ''-',' tH"'" s ):c', ~ h t to prOCEeds dis tribu table , to 'dm .u a Limitod Pdtb",,: h".I:"'UY")<'.1: "haU be vaUd unless consented to by th(~ General Paxtnc-~:r:s. I I i . . . J.2. BANKING . , All funds of'lth~ Partner~hi~ shall be deposited in its ',L'",,, in s" eh c)'''''ki1lg account Ot' "cc CUn ts as shau be c1es:L9na" ed by l:he G"';H'ra~ l"l):i.n',:rs ~,' All. :',i ~h(]r",w,u,s thet'efroll1 are ,to be Jnad~ "!,on cJ,ecks "'Y;",d Ly el.th.er S""'lloy J. Slfersky or l\obert J. Malhn, t' . d' . I or 'ne.u: eS;lgnee. , . 13 . sr GN!\'CU .1.-0<:; .. .... -..-.-..-.--.-.. ...... -.... - , ~.... i_ I . I Any c10f::d, b.D.a. of .sale, ,)!lu.cLg~J.ge( .lea,se, ,COi11:ra,ct of sale,' or othcJ; commitment purpp,.ting to conveyor encumber: tlte . i,nioAl.'est of' the l?artnership in al~ or' any 1'0rHon of an'y' real or' P?r "on a 1 prop ert.y ': t anytime he.ljl in i ,t.s n"une , shall be signed by;, e.l th.:1:" s ta.nlClY .f. ~'\"ersky or l\obeft J ~ l'1a.llln. j - ." 14. JlOO:t{S . -.---.-...- . , 'rhe Pari.:ne:r:sh.~p s11ll11 W.::lj.ntain fuII and dCCl.lrate books in Us principal offi,ce, or !such off ic", ."W "hal~ he de" iynated for such purpose by the Gcner,<l p",~..t.""[s, .'l!1d aU pal: t.ners 0]",1.1. have the r.i.'1ht to inspect and exaln.i.ne SMch bouks at ,'ca"'ODable U...z:es. The bonks ~h;\.l.l be 'do sed and ba Ian cedi il t ., h c ''',d of (,0 eh C,'l 1."1(] ,H: y,' ar . a~""....~.~_.~.:;>It.:S~-'j~'-,:;:';':':";',.., Ill' '- '1.5~ JWI\iJf, Fj';'.!'I.;'~' .';Jl' C'HI.;'::;;",NI'l'Y 01" 'l'lm (;]'.::J';"';"U:' :J:J?':.'; Z '.t:J'.' l~: 'I~,S ........ .......-....--.. -...------.--.--~._.~..._._n__..__ . III i.hn ;,..7',;~\: ,.J: ;.L.c; (1,:-;.1-1.:11, rei.:irC'r:1011i:, OJ;" i21H.;UIit: r) f 1:1 .i. i.: h I~:C C L' ncra.l P;:u:t n: .~J:-, (:1:u ;.~l. Ii.: ".1' ',.' :,.11 ip G ha 11 be <"xpc:cl i ti IYLl s.ly :"1 ,,1i.n.'li.c(l, p:(ov.i.t1(~cl, .IJI.;"'\::'.;c'r,i.h':ll.:,;'Jic:n~ ::;b.dll not be.:l.l1 ilTllnediate ,'15 :.: :.: o.ll.1 t oi. 0.11' of the 1'.:i):'I. j'.,:r':o) 1 :i.i) ).;.u t I:h c.! P ~'l" ::l'J(}J.' :.:;hip s11 all be b:'lnporil.r i. ''''''1} t.i ') ;1('11 by [!)I~ renl,d.rdn'J C;.; ;" ':.11 P.;:!.': ;_.J:'.r.'X' :C'.n: the purpose of winding '.'J,) i'I1,; r,U::.T:':".:-:.1d.p a.ffa:i.c) >ide! J: ,.,,1 i.,",; i'i.,'!'J' :.i\c'! P;n'LnC'):~3hip a.s pJ:O- ...;,1::<:1 ill !?o;l.:''-;~I.JJ:,'!ph 17 h,~::,:r;r):f. . 11). )n~;A'.l'H OF A J,JJ.JJ't'J':D j-'.!';;'e1.'.I"':R ~_...-- -~-. ---__. ___. 0_._. _. .__......._...".. _._. ". .__ . _..__._.. . "'ht~ T\J..I::'flt";-cc.:1:,J.l) j-l(JI... I '.;'li,~ l.le'lai'll of a Lirnite:d P<:.t:c:Lner ::;hall i:.I"": !I.:Ll':.h i.:(~ LJ; (~ P <.1. J. tn (>:c ship bu r;';.n er.; s . I ! i .1 'I. Oi. 'TI;:/l."'.(l.:-N not d1t;sC)lv(~ . 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Ji:! i)i'.'?'.J,i:'i.l~ t11 c C C':j (': :t:' If.1 P ;u.- t: 1J ~..l: 8 '1.'11" r,n::!, '. .';I).;.p .. ,h'lll indem" LEy and "'"ve )""nnles 5 :""'..,n ""1' I""""".'l 10,," o.r d.omay" ,iL"";T~d by . -- 8- .'c_':cc, " tj'Wiel LJY )_'c.~,son of ;,ny aci.: pcrfl/i:1l11_,d by Lhl'rn for cHid on behalf of the r;j:L-i.T::''J.-:~hip and ftl.l.tJ)(')_'(,r~r.c: of it:; c;cllt':"l.::d::. 22. l'::()'l':r:CJ~:S . ...1\11 11()t:il~~(~::3 1.)"::()'l5~(1(:(J ~.:():(' .i~11 f:l1is Agrec~-1!1C11t. sllall };>e c1icl~Gt,;cc1 t.o the pa.rtic~s at: t l)l.;l ':1(1().:.:.'>-;,::::; j:lc::Cld.n Sl::lt forth <.1nd to I:hc~ Partllccship at .U.:s pI'jllcjp;~l l:.ffi(":;f~ by' .r,".;Ij.i.~;f:(~L-(;'d or cert.:ified Illail. . 23. p.:r:;\l))JNG . 'i'Jd.s '-\'JJJ.er",int ;ch;lll be bindi.ng Upl.:>n all uf i...he p;n:ti.r~s ;lnd thei.r 1.::::;tdLcs, hl,jrs:, en: J.(c':Jd~'I;;es. I 24 . .-~},. :!? J,I {.~ 1-\}~ 1:.:}1~ ~IJ/~ ~'v . Lh .:-1: '-,; ,: 11.1t.::1: !; h<l. J 1 t:.l\.,~ ::'L\h:~ of 1,T;;~'.'l '.'-l.t"lis ':'""":(J".t: f:; l_.(~ 5 :'1 t t.:. "Cr;}.'" :'''~ t. IJI..::I.-~" \'~y . .,,-Int ..;nd:'h(~ rirJhts of the paxt.Jes :d l-icll a.e..:.:,_",.,,-l 'J ',1<:/; \'Ji th t.he laws of I I .r . I /. 5 . ~~.S~~~.~.T~l'E~.t~! . ~. .1,(1: (HJ i ~ '.I :',; .k! :'; ". i~.l' S 'I'hi. s Ag r c,,,,,,, l,t may beG xc C u 1e ed in,; cv 8U 1 ,,,.' "" L c r- P;ll:ts .-lnd all ~;o c:.:\:":culed :.;11.::1J.1 r..:,:mstitlJte one a0rf:C(Hif~nt, bL)d:i.nIJ on .::lll the parties hereto, notwith~tanding that all the parties <l.re not s :i."] n;;d:o:ry to the or5.iJ inal or U;(~ :..::ame counterpart. . - , -.. .. . T9- . ---...-' IN h'I'J'NESS IvlIEHEOF, the undersigned haVl-; hereunto 5ei: UHd.r hands and seals the day Llnd year first above written. . Gt:ne):;:1l Partners ----T~- 1;' -~?J ,/ II, II ~-~;:.:::~:~~~:. .~.:.-~__.~\:~_b.-.~::..:.?S<l/ '-- /~J.J. S . Stanley J:, :3~'}el~[;ky 1'7' // ,t.' (/ . I. ' I,Lnibc-d )?a:ctners __u.___._. / ~::/7~- --'- . 1../:/ .'. .,J ", .,/ I ..... ,. ...... ~. l / t . . ",' ).1 t'- I ,. ..... \. " ,. ./ ' .1 .- ," ~ '. ". . ..,~. " _ .~~ ~iTil-;-;'y"- .~:f.-..CODjl(:;.i-...-- ""-.--- "- . L.S. , I . <J ) 1 /"'.,: j 7, I;.,~. ,....)j JJ. $. _ -_.. ..l..... ......"- .......---..-.-.-...--.....-..--.---.....-._.___.___._ I Inlj~c;.c~J~./,~~(:/jY/ ,/( , . ~I /- /Z f~/':7:'----/~ ,-.(- i o' ( ...!) /;,,;<;:/( " -.:~.....--;. ,.~_ .-1" ;7 ,~ ./7_/ j I (' -- .n__'-~_ -~ .~ ."-__,~. ...,.' _l.)+....~:~.:..!~ ~.::1-::.._....: - ...>~:.;.~_.:._ .f.. '1 . II. Cl;:n:ke ~;'i'.i:'.;::;b I <U/~~,:d~d( d~~&:LI.. J, 4"t,.lfrO',i D. ~ta"b '. I / 1/ i . I -V i t ,j J..1\'\. ~ ~; -t.:.- i -:-,---.'; ._-_._.~-;:'__...i~..'_::..:~__ 'm_. __.._________ I, . S . VVlIlJ.;~.m ~'\ab2!s . . I .._-- ;/ >- :.> (l.'~ :.... ~-:I : . .). 'r.' .I..:' ';" ..~ '_ _.._ . ___' .L . S'a"l; f]l:<i _. I , , j( d. t c s .. - ._-- ---.----~-- -.---.-- '. ;' / , ""-~ " --../ 'j '" - ,-- .!~~:-~~-.~.:....:~ ..P_~'....____:LJ.l:...:~_~_!..:J ~-: I Louise R. Swexsky () L. ." '. . -J.o- ,. / ..' ,1,r . /" / '.. / <(,~. /'....... '" L. S. _...-... -._.. .....--.-...-..--......-....- ..~-_....-..-.._.__.__. n(;b,~:ci: J. :'l;l'.l.lin -? " /7 ';j() /<.. f _ 0'_ -.....' .. :.' ?~'-::::::.:~.::::-~_J..~..:_._L.~~~.- _______J... . S . B.l: i,:ln B. Loss . t. , ;..~ . _._.:...b~.~,\~~~_ 'i: J. '.~-J.:.___.._____.._J, . S . rb-,,::hc S. Loss , i- t.;: ;\._ ,.:J..{._:"-< L. S, .. . . ... .....--.. ........ -- .,.._-.._--.;:,~.._--- A. D(;iln 1\J.pine ,t/ I;. ;/ 6 ~ ' '-: !., ..>.- " J " 1(./ ,.<' .,." . ~ _t...: '.> ( <.,.f...-( :<..J. (:,.,. t';' 1 . ...-1.' . ""u":.I.."-'... /.(.O'....L L . S . v"<'II' 7\ ., J . I rl.~j.r1.11a .a. n. .pJ.t.;Y= ~ ). JI \.~t?)L)f:) ..'1.....:: ::: ,.: &~.,;t>/../'l..f/(1,;:(~:~~?.7...c_..._L . S . '..h.l.l:nnl"'n L."-r'jcClure-, Jr(./ . ..j". ". - (.P- cr.., .7d,...~C...?.vJ__"-..._~ L. S . C,; :L l) 1 . X. ";.1(~~: Eii~ eo.. ... ,.~.._--.. -.- . ------ /1 /e . J;. t...~:V7 It. 0 S~.L:J_:-.-l .2.~,...!.~J}",;_ __.. :.__.~' .!..-.f:~~,=:!__ L . S . /G;' ovanna V. l'.1allin ;. . AMENDMENT TO ARTICLES OF LIMITED PARTNERSHP . TIllS AMENDMENT, dated as of the 15th day of May, 2005, is among the General Partners and the Limited Partners identified on the signature pages attached hereto. Preliminary Statement · A. Reference is made to the Articles of Limited Partnership of S&M Associates dated as of May 1, 1974 (the "Original Agreement"), among Stanley J. Swersky, . D.D.S., Robert J. Mallin, D.D.S., Stanley S. Conner, D.M.D., Brian B. Loss, D.D.S., H. Clarke Staab, D.D.S., A. Dean Alpine, D.M.D., William Kates, D.D.S., and Wilburn L. Mc Clure, Jr., pursuant to which the parties intended to form a limited partnership (the "Partnership") pursuant . to New Jersey law. B. The Original Agreement denominates Stanley 1. Swersky and Robert 1. Mallin as the General Partners, and the other parties thereto as the Limited Partners. . C. Since the date of the Original Agreement, certain assignments of general and limited partnership interests in the Partnership have occurred. D. The parties to this Amendment desire to confirm the existing composition of the Partnership and to make certain changes in the Original Agreement, allan the terms and conditions hereinafter expressly provided. . NOW, THEREFORE, for good and valuable consideration (the receipt and sufficiency of which are hereby acknowledged), the parties to this Amendment hereby agree as following: . 1. Current Partners. The parties to this Amendment agree and confirm that the following identifies the names of the current General Partners and Limited Partners of the Partnership and their respective number of Unit interests in the Partnership: . Name General or Limited Units The Swersky Family Partnership, L.P. General 8 The Mallin Family Limited Partnership:" General 8 Stanley 1. Conner Limited 2 Ingrid 1. Conner Limited 2' Brian B. Loss Limited 2 Phoebe S. Loss Limited 2 . . . . . . . . . . . . . . H. Clarke Staab Limited 2 Limited 2 Limited 2 Limited 2 Limited 2 Limited 2 Winifred Staab A. Dean Alpine Katrina Alpine William Kates Sandra Kates 2. Name of Partnership. The name of the Partnership is S&M Associates, A Limited Partnership. 3. Replacement of One General Partner. The 8wersky Family Partnership, L.P. hereby assigns all its Units to Swersky Sacramento LLC and withdraws as General Partner of the Partnership. Swersky Sacramento LLC hereby accepts the assignment of such Units and agrees to serve as General Partner of the Partnership on all the terms and conditions of the Original Agreement as amended hereby. The other General Partner and all the limited partners hereby approve such assignment and the admission of Swersky Sacramento LLC as General Partner of the Partnership in replacement of The Swersky Family Partnership, L.P. 4. Replacement of Other General Partner. The Mallin Family Limited Partnership hereby assigns all its Units to Mallin Sacramento LLC and withdraws as General Partner of the Partnership. Mallin Sacramento LLC hereby accepts the assignment of such Units and agrees to serve as General Partner of the Partnership on all the terms and conditions of the Original Agreement as amended hereby. The other General Partner and all the limited partners hereby approve such assignment and the admission of Mallin Sacramento LLC as General Partner of the Partnership in replacement of The Mallin Family Limited Partnership. 5. No Termination on Death. Section 15 of the Original Agreement (which provides for a termination of the Partnership upon the death, retirement or insanity of Stanley J. Swersky or Robert 1. Mallin) is hereby deleted. Likewise, in Section 17 of the Original Agreement, the phrase "or in the event of the death, retirement or insanity of either General Partner" is hereby deleted. 6. No Dissolution. The Pl!rtnership shall not be dissolved upon the occurrence of an "event of withdrawal of a general partner" (as such quoted term is defined in the New Jersey Limited Partnership Law); but instead the business of the Partnership shall thereafter be carried on by the remaining General Partner. . 7. Powers. For the avoidance of doubt, each replacement General Partner \ shall enjoy all the powers, rights and benefits conferred on an original General Partner pursuant to the terms of the Original Agreement. Furthermore, the references in Section 12 and 13 of the Original Agreement to "Stanley 1. Swersky or Robert 1. Mallin" shall be deemed to mean any General Partner. Furthermore, each of Stanley 1. Swersky, Robert 1. Mallin, The Swersky Family Partnership, L.P. and The Mallin Family Limited Partnership (all of them having ceased 2 . to be General Partners of the Partnership) shall nonetheless continue to enjoy the benefits of the indemnification provision contained in Section 21 of the Original Agreement, with respect to any act performed by such General Partner for and on behalf of the Partnership and in furtherance of the interests of the Partnership while such General Partner was a General Partner. . 8. Expiration. Section 2 of the Original Agreement is hereby amended by extending the stated expiration of the term of the Partnership for 50 years, from April 30, 2034 until April 30, 2084. . 9. Counteq>arts. This Amendment may be executed in two or more counterparts and by different parties on different counterparts, each of which shall be deemed to be an original, but all of which (taken together) shall constitute one and the same agreement. . 10. Continuing Effect. Except as otherwise expressly provided in this Amendment, all the terms and conditions of the Original Agreement shall remain in full force and effect. IN WITNESS WHEREOF, this Amendment has been executed as of the day and year first above written. . General Partner Being Replaced: . THE SWERSKY FAMILY PARTNERSHIP, L.PiiiIJ ~ By: . ...' Stanley 1. rsky, General P er Replacement General Partner: . SWERSKY SACRAMENTO LLC By: The Swersky Family Partnership, L.P., its Sole ember . . . . General Partner Being Replaced: THE MALLIN FAMILY LIMITED PARTNE~ By: L ~ Robert 1. Mallin, General Partner Replacement General Partner: MALLIN SACRAMENTO LLC By: The Mallin Family Limited Partnership, its sole member ;(?1~ r~L- By: j/ttlMN Robel! 1. Mallin, . neral Partner .,.,;I"~ 3 . Limited Partners . STANLEY 1. CONNER INGRID 1. CONNER BRUCE B. LOSS PHOEBE S. LOSS . H. CLARK STAAB WINIFRED STAAB . A DEAN ALPlNE KATRINA ALPlNE WILLIAM KATES SANDRA KATES . . . . . . . C:\Documen1s and Settings\Bob MalIin\My Documenta\S&MSuggestedl:f.ettertoLimitedPartnerslAmendmenttoArticlesotLP.doc Department of lhe TreasJ _ ollernal Revenue Service U.S. Return of Partnership Income ~ See se arate instructions. 'for calendar year 2000, or tax year beginning ,2000, and ending ~lnclPal BUSiness Activity Name of Partnership Use the IRS label. Other- wise, print or type. 2000 \# IIRS use only - Do not write or slap Ie in this space. ,20 OMB No.1545.0099 o Employer Identification Number Leaslng S & M ASSOCIATES Number, Street. and Room or Suite Number. If a P.O. Box, See Instrucllons. 22-6237744 E Dale Business Started B Prrncipal Product or Service Real Pro ert C Business Code Number 2467 Sa Isle Court 08/22/74 City or Town State ZIP Code F Total Assets (see instrs) $ 482,48l. Amended return 531110 Weston FL 33327-1411 G Check applicable boxes: (1) Initial return (2) Final return (3) Change in address (4) 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 yea; ~ ~ ~ ~ ~ ~ ~ ~. -;. - - - - - - -i"2' Caution: Incfude only trade or business income and expenses on lines ]a through 22 below. See the instructions for more information. . . . . S E E I N D s T E R D u U C T C I T 0 I N 0 s N F S 0 R 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. . . . . . . . 13 1b 1c I N C o M E 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 ]040)) . . ., . ., . . . .. . . .. . . . .. . " . . . . . . . . . . . . . . . . " . . . 6 Net gain (loss) from Form 4797, Part II, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 4 5 6 7 Other income (loss) (attach schedule) .................................................................. 7 8 Total income (loss). Combine lines 3 through 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 Bad debts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 12 13 Rent............ .. . . . . . .. . . .. .. . . . . .. . . . .. . .. . . . . . .. . . . . . . . . .. .. . . .. . . .. . . . .. . . . . . . . . . .. .. . . . . .. 13 14 Taxes and licenses ....................................................... . . . . . . . . . . . . . . . . .. 14 15 Interest........................................................................................ 15 16a Depreciation (if required, attach Form 4562) ........................... 16a b Less depreciation reported on Schedule A and elsewhere on return. . .... 16b 16c 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 right column for lines 9 through 20 21 22 Ordinary income (loss) from trade or business activities. 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 knowledge 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. ~ ~ Signature of General Partner or Limited Liability Company Member Date Pre parer's Signature ~ Date Pre parer's SSN or PTI N Firm's Name (or yours if self-employed), ~ Address. and ZIP Code Self Prepared Check if self. ~ employed. . . . EIN ~ Phone No. . BAA For Paperwork Reduction Act Notice, see separate instructions. PTPA0112 11/29/00 Form 1065 (2000) . /' . . . . . . . . . . / \~ lorm 1065 (2000) S & M ASSOcrK, CS / /' ~nl!!aul~:;1~1!;;IllI11 Cost of Goods Sold (see instructions) '.( 22-6237744 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 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 a Check all methods used for valuing closing inventory: (i) ~ Cost as described in Regulations Section 1.471-3 (ii) Lower of cost or market as described in Regulations Section 1.471-4 (iii) Other (specify method used and attach explanation) .............. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Check this box if there was a writedown of 'subnormal' goods as described in Regulations Section 1.471 -2(c) . . . . . . . . . . . . . . . . " ~ H 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? . . . .. . . . . . . . . . . . '" B Yes No e Was there any change in determining quantities, cost, or valuations between opening and closing inventory? ........... Yes No If 'Yes', attach explanation . 11~~b~~f,f,~!lt~ll_ Other Information , What type of entity is filing this return? Check the applicable box: a ~ 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Is this partnership subject to the consolidated audit procedures of Sections 6221 through 6233? If 'Yes,' see Designation of Tax Matters Partner below ........................................................................................... 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If 'Yes,' the partnership is not required to complete Schedules L, M- 1, and M-2; item F on page 1 of Form 1065; or item j on Schedule K- 1 ................................................................................................ X 6 Does this partnership have any foreign partners? ..................................................................... 7 Is this partnership a publicly traded partnership as defined in Section 469(k)(2)? ........................................ 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? ......... . . . . . . 9 At any time during calendar year 2000, 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 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. . . . . . . . . . . . . . . . . . . . . 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 ....................... 12 Enter the number of Forms 8865 attached to this return ~ X 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 Designated TMP ~ Address of Designated TMP ~ Identifying Number of TMP ~ 22 - 32 11 573 Swersky Family Ltd Partnership c/o Stanley Swersky, 2467 Bay Isle Wes ton, FL 33327-1411 Court PTPA0112 11/30/00 Form 1065 (2000) . . Income (Loss) . . Deduc- tions . Credits . Invest- ment Interest Self- Employ- ment . Adjust- ments and Tax Prefer- ence Items . Foreign Taxes . . Other BAA . S & M ASSOCI;, d.'! S Partners' Shares of Income, Credits, Deductions, etc (a) Distributive share items 1 Ordinary income (loss) from trade or business activities (page 1, line 22) 2 Net income (loss) from rental real estate activities (attach Form 8825) 3 a Gross income from other rental activities. . . . . . . . . . . . . . . . . 3a b Expenses from other rental activities (attach schedule) . . . . . . . 3b c Net income (loss) from other rental activities. Subtract line 3b from line 3a . 4 Portfolio income (loss): a Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . b Ordinary dividends ................................................. c Royalty income ................................................... d Net short-term capital gain (loss) (attach Schedule 0 (Form 1065)) . . . . . e Net long-term capital gain (loss) (attach Schedule 0 (Form 1065)): (1) 28% rate gain (loss) .. _ _ _ _ _ _ _ _ _ _ _ (2) Total for year .............. ~ f Other portfolio income (loss) (attach schedule) .............................................. 5 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Net Section 1231 gain (loss) (other than due to casualty or theft) (attach Form 4797) .......... 7 Other income (loss) ....................................................................... 8 Charitable contributions (attach schedule) ................................................... 9 Section 179 expense deduction (attach Form 4562) .......................................... 10 Deductions related to portfolio income (itemize) . .. .. . . .. . .. . .. . . . .. .. . . ... . . . . . . . . . . . . . . . . . . . 11 Other deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a Low-income housing credit: (1) From partnerships to which Section 42(j)(5) applies for property placed in service before 1990 . . . .. ........... (2) Other than on line 12a(1) for property placed in service before 1990 ........... ........... (3) From partnerships to which Section 42(j)(5) applies for property placed in service after 1989 .................. (4) Other than on line 12a(3) for property placed in service after 1989 . . . . . . . . . . . . . . . . . . . . . . . . . b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468) ... c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities ..................... d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Other credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14a Interest expense on investment debts. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b (1) Investment income included on lines 4a, 4b, 4c, and 4f above. . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Investment expenses included on line 10 above.... .. .. . . .... ... .. . ... . .. . .. . . . . . . .. . .. . . 15a Net earnings (loss) from self-employment. . . .. . . ... ... . . '" . ..... . . .. . ... . . .. . . . . . . . . . . .. . . . b Gross farming or fishing income ...................................... . . . . . . . . . . . . . . . . . . . . . . c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 a Depreciation adjustment on property placed in service after 1986 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Adjusted gain or loss ...................................................................... c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (1) Gross income from oil, gas, and geothermal properties ................. . . . . . . . . . . . . (2) Deductions allocable to oil, gas, and geothermal properties ............................... e Other adjmnts & tax pref items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 a Name of foreign country or U.S. possession ..... .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income sourced at partner level ....................................................... c Foreign gross income sourced at partnership level: (1) Passive .. (2) Listed categories (attach sch.) .. d Deductions allocated and apportioned at partner level: (1) Interest expense .. (2)Other ...... e Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive .. (2) Listed categories (attach sch.) .. (3) General limitation .. f Total foreign taxes (check one):" 0 Paid 0 Accrued . . . . . . . . . Reduction in taxes available for credit and gross income from all sources (attach schedule) 18 SectIOn 59(e)(2) expenditures: a Type. . . .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Amount 19 Tax-exempt interest income. . . . . . .. . . . . . .. . . . . . . . . . . . . 20 Other tax-exempt income.. . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 21 Nondeductible expenses ..... . . . . . . . . . . . . . 22 Distributions of money (cash and marketable securities) .. 23 Distributions of property other than money 24 Other items and amounts required to be reported separately to partners (attach schedule) . . . . . . . . . . . . . . . . . . . . , P (3) General limitation .. PTP AO 134 10/1 0/00 22-6237744 Page 3 (b) Total amount 58,832. 3c 4a 4b 4c 4d 4e (2) 4f 5 6 7 8 9 10 11 12a (1) 12a (2) 12a (3) 12a (4) 12b 12c 12d 13 14a 14b (1) 14b (2) 15a 15b 15c 16a 1Gb 16c 16d 1 16d (2) lGe o. 17 e (3) 17f 17 .. 18b 19 20 21 22 23 3,320. 67,964. Form 1065 (2000) . . . . . . . . . . . 22-6237744 '..Ki Page 4 58,832. (vi) Nominee/Other Net income (loss). Combine Schedule K, lines 1 through 7 in column (b). From the result, subtract the sum of Schedule K, lines 8 through 11, 14a, 17f, and 18b . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Analysis by (i) Corporate (ii) Individual (iii) Individual (iv) Partnership partner type: (active) (passive) 1 (v) Exempt organization 26,152. Balance Sheets Assets 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 schedule) . . . . . . . . . . . . . . . 7 Mortgage and real estate loans. . . . . . . . . . . . . . 8 Other investments (attach schedule) ................ 9a Buildings and other depreciable assets. . . . . .. b Less accumulated depreciation . . . . . . . . . . . . . . lOa Depletable assets ... . . . . . . . . . . . . . . . . . . . . . . . b Less accumulated depletion. . . . . . . . . . . . . . . . . 11 Land (net of any amortization) .............. 12a Intangible assets (amortizable only) ......... b Less accumulated amortization . . . . . . . . . . . . . . 13 Other assets (attach schedule) .. . . . . . . . . . . . . 14 Total assets ............................... Liabilities and Capital 15 Accounts payable. . . . . . . . . .. . . . . . . . . .. . . . .. 16 Mortgages, notes, bonds payable in less than 1 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 Total liabilities and capital.................. 497,835. :Scneaul~1;M~'f& ~~f~~~~~;1:~~e~ro~n~~~S~~~d~~s~ Pse:n~~~e~s,~~~~s~~~~s~~C~~~~)s) per Return 86,339. 581. O. 2,500. 479,400. 482,481. 1 Net income (loss) per books. . . . . . . . . . . . . 62, 152. 6 Income recorded on books this year not included 2 Income included on Schedule K, lines 1 through 4, on Schedule K, lines 1 though 7 (itemize): 6, and 7, not recorded on books this year (itemize): a Tax.exempt interest. . . $ _ _ _ _ _ _).!..~2i>-.:. -------------------- -------------------- 3,320. -------------------- 7 Deductions included on Schedule K, lines 1 through 11, 3 Guaranteed payments (other than health insurance) 14a, 17f, and 18b, not charged against book income 4 Expenses recorded on books this year not included this year (itemize): on Schedule K, lines 1 through 11, 14a, 17f, and a Depreciation $ 18b (itemize): .... . ----------- a Depreciation .. . . . $ --------------------- b Travel and ----------- $ -------------------- entertainment .. . 8 Add lines 6 and 7 ....... . .... . ..... . .... . 3,320. ----------- -------------------- 9 Income (loss) (Analysis of net income 5 Add lines 1 through 4 .......... . .... . .. . 62,152. (loss), line 1). Subtract line 8 from line 5 . . . 58,832. l$pli~C1ulgW!VI:;2:,tl Analysis of Partners' Capital Accounts (Not required if question 5 on Schedule B is answered 'Yes.') 1 Balance at beginning of year .. . .. . .. . 485,212. 6 Distributions: a Cash ................ . ... . 67,964. 2 Capital contributed during year ... . ..... . b Property .. . ... . ... . ...... . 3 Net income (loss) per books ... . ... . . . .. . 62, 152. 7 Other decreases (Itemize): ----------- 4 Other increases (itemize): ~~~~~j~~~~----------- ---------_. -------------------- 67,964. 8 Add lines 6 and 7 ........ .. 5 Add lines 1 through 4 ... . ... . ..... . 547,364. 9 Balance at end of year. Subtract line 8 from line 5 . . -. 479,400. PTP AO 134 11130100 Form 1065 (2000) . Jim 8825 R ,}i"(al Real Estate Income and Expe..f1J€s of a Partnership or an S Corporation Depz.iment of the Treasury It lternal Revenue Service ~ See instructions. ~ Attach to Form 1065, Form 1065-B, or Form 11205. ~~~'~'"' Name Employer Identification Number S & M ASSOCIATES 22-6237744 1 Show the kind and location of each property. See page 2 for additional properties. 5b~2l~~~~0~~________________________________________________ A Sacramento California ------ . ------------------------------------------------------------------ B ------------------------------------------------------------------ ------------------------------------------------------------------ . c ------------------------------------------------------------------ ------------------------------------------------------------------ D ------------------------------------------------------------------ ------------------------------------------------------------------ . Properties Rental Real Estate Income A 8 C D 2 Gross rents -.. .................-..... 2 124,042. 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 2,300. 9 Interest ... -.... .... .... -........ -.... 9 10 Repairs ....... .............. -........ 10 11 Taxes. . . ... . . . . .. . . . .. .. . .. . . . . . .. . . . 11 800. 12 Utilities -....... ................. ..... 12 13 Wages and salaries. . . . . . . . . . . . . . . . . . . 13 14 Depreciation (see instructions) . . . . . . . . . 14 20,466. 15 Other (list) ~ l1~~a.,g~'!!.eJ1.! J_e~~_ 41,544. ~~~k_ ~b.aJ~~s_ _ __ 100. ------------- 15 16 Total expenses for each property. Add lines 3 through 15 ......... . . . . . . . 16 65,210. 17 Total gross rents. Add gross rents from line 2, columns A through H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - 17 124,042. 18 Total expenses. Add total expenses from line 16, columns A through H -... ......... -....,.....- ...,...... .- 18 -65,210. 19 Net gain (loss) from Form 4797, Part 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 partnerships, estates, and trusts in which this partnership or S corporation is a partner or beneficiary (from Schedule K- 1) .. . . . ...... - .. . 20a 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 result here and on: . Form 1065 or 1120$: Schedule K, line 2, or . . . -.... -..... . ..... . .. .. ...._~ 21 58,832. . Form 1065-8: Part I, line 4 BAA For Paperwork Reduction Act Notice, see the separate instructions. SPSZ010l 07/11100 Form 8825 (2000) . . . . . . . . "\'~r' 'Form 1 065 2001 Department of the Treasury Internal Revenue Service U.S. Return of Partnership Income ~ See se arate instructions. For calendar year 2001, or tax year beginning ,2001, and ending A Principal Business Activity Name of Partnership Use the IRS label. B Principal Product or Service Other- Number, Street, and Room or Suite Number. If a P.O. Box, See Instructions. E Date Business Started Real Property wise, 2467 Ba Isle Court 08/22/74 - - print C Business Code Number or type. City or Town State ZIP Code F Total Assets (see instrs) 531110 Weston FL 33327-1411 $ 464,063. 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.l. Attach one for each person who was a partner at any time during the tax year. . . . . . . . . . . . . . . ~ 12 Caution: Include only trade or business income and expenses on lines 7a through 22 below. See the instructions for more information. . . . . . . . . . S E E I N D s T E R D u U C T C I T 0 I N 0 s N F S 0 R L I M I T A T I 0 N S Sign Here Paid Preparer's Use Only IRS use only - Do not write or staple in this space. ,20 OMB No.1545.0099 D Employer Identification Number Leasing S & M ASSOCIATES 22-6237744 I N C o M E 1 a Gross receipts or sales ............ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less returns and allowances ............................ 1c 1a 1b 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 7040)). . . . . . . . . . . . . 6 Net gain (loss) from Form 4797, Part II, line 18 ......... . . . . . . . . . . 7 Other income (loss) (attach schedule) . . . . . . . . . . . 2 3 4 5 6 7 8 Total income (loss). Combine lines 3 through 7 . 8 9 Salaries and wages (other than to partners) (less employment credits) . 10 Guaranteed payments to partners . . . . . . . . . . . 11 Repairs and maintenance ..... . . . . . . . . . . . . 12 Bad debts ............... 13 Rent .................. 14 Taxes and licenses. . . . . . . . . . . . 15 Interest............. . . . . . . . . . . . 16a Depreciation (if required, attach Form 4562) .. b Less depreciation reported on Schedule A and elsewhere on return 17 Depletion (Do not deduct oil and gas depletion.) 18 Retirement plans, etc. . . . . . . . . . . . . . . . . . . 19 Employee benefit programs 9 10 11 12 13 .......... 14 15 ..~ . . . .. 16b 16c 17 18 19 20 Other deductions (attach schedule) ...... 20 21 Total deductions. Add the amounts shown in the far right column for lines 9 through 20 . 21 22 Ordinary income (loss) from trade or bUSiness activities. 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 knowledge 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. ~ ~ May the IRS discuss this return with the preparer shown below (see rnstrs)? Yes Preparer's SSN or PTIN P00083044 No Signature of General Partner or Limited Liability Company Member Date P reparer's Signature Date Check If self- . emp loyed ~ Firm's Name (or yours if self-employed), ~ Addressj and ZIP Code EIN ~ . II ??-23701SQ BAA For Papelwork Reduction Act Notice, see separate instructions. Form 1065 (2001) Phone No. PTPA0112 12/03/01 . . . . . . . . . . . ,,1065 (2001) S & M ASSOCIATES [$:th.~a.jlinHAnl Cost of Goods Sold (see instructions) 22-6237744 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 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 wntedown of 'subnormal' goods as descnbed 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? .... . . . . D Yes No e Was there any change In determining quantities, cost, or valuations between opening and closing Inventory? D Yes No If 'Yes', attach explanation. 1~9bij9ijUf]:r:nnn:1 Other Information 1 What type of entity is filing this return? Check the applicable box: a ~ 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Is this partnership subject to the consolidated audit procedures of Sections 6221 through 6233? If 'Yes,' see Designation of Tax Matters Partner below. . . . . . . . . . . . . . . . . . . . . . 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If 'Yes,' the partnership is not required to complete Schedules L, M-l, and M-2; item F on page 1 of Form 1065; or item J on Schedule K.1 ..... . . . . . . . . . X 6 DDes this partnership have any foreign partners? If 'Yes,' the partnership may have to file Forms 8804, 8805 and 8813. See instructions . . . . . . . . . . . 7 Is this partnership a publicly traded partnership as defined in Section 469(k)(2)? . _ . . . . . . . . . . 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? 9 At any time during calendar year 2001, did the partnership have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, 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 name of the foreign country . ~ X 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. .. . . . . . . .' ........ ....................... 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 . . . ............... .... ... 12 Enter the number of Forms 8865 attached to this return ~ X 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 Designated TMP ~ Address of Designated TMP ~ Identifying Number ofTMP ~ 22-3211573 Swersky Family Ltd Partnership c/o Stanley Swersky, 2467 Bay Isle Weston, FL 33327-1411 Court PTPAOl12 12/03/01 Form 1065 (2001) 22-6237744 S & M ASSOCIATES il Partners' Shares of Income, Credits, Deductions, etc (a) Distributive share items 1 Ordinary income (loss) from trade or business activities (page 1, line 22) 2 Net income (loss) from rental real estate activities (attach Form 8825) 3a Gross income from other rental activities . . . . . . .1 3a I b Expenses from other rental activities (attach sch) . . . . . .13b1 c Net Income (loss) from other rental activities. Subtract line 3b from line 3a . . . . . . . . . 4 Portfolio income (loss): a Interest income .,. b Ordinary dividends . . . . . . . . . c Royalty income ...... . . . . . . . . . . d Net short-term capital gain (loss) (attach Schedule 0 (Form 7065)) e (1) Net long-term capital gain (loss) (attach Schedule 0 (Form 7065)) . . . . . . . . . . . . . . . . . . (2) 28% rate gain (loss) . ~ _ _ _ _ _ _ _ _ _ _ _ (3) Qualified 5-year gain ~ _ _ _ _ _ _ _ _ _ _ _ Other portfolio income (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Net Section 1231 gain (loss) (other than due to casualty or theft) (attach Form 4797) . . . . . . . . . . . 7 Other income (loss) ......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ......................... 8 Charitable contributions (attach schedule) ......................... . . . . . . . . . . . . . . . . . . 9 Section 179 expense deduction (attach Form 4562) . . . . . . , . , , . . . , . , . . , . . , . . . . . . , , . , , . . . . , , , . 10 Deductions related to portfolio income (itemize) ""....",.".,..", , , . . . . . . . , 11 Other deductions. , , . . . . . . . . . . , , , . . . , , . , . . , . . . . . , . . , . . , , . , , , . . . . . . . . . . , , . , , . . . . . . 12a Low-income housing credit: (1) From partnerships to which Section 420)(5) applies ..,.".,.,.... (2) Other than on line 12a(1) , . . . . . . . , , . . . . , , . , . . . . . , . . , . . . . . . . , . . . b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468) . . . , . . . . . . . . , . , . , , . . . c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities d Credits related to other rental activities . . . . , . . , , , , . . , , . , , . , . 13 Other credits ....,.,. . . . . . . . . , , , . . . , . , . . . . . . 14a Interest expense on investment debts b (1) Investment income included on lines 4a, 4b, 4c, and 4f above, . . . . . . . . 2 Investment ex enses included on line 10 above ,..... . . . . . . . . . 15a Net earnings (loss) from self-employment. . , , . . . . . , . . . , . . . . . , , , . b Gross farming or fishing Income . , . . . . . . . . , , . . . . , . . . . . c Gross nonfarm income ... , . . . , . . . . , . . . . 16 a Depreciation adjustment on property placed in service after 1986 b Adjusted gain or loss . . . . , . . . , . . . , c Depletion (other than oil and gas) . . . . . . . . . . ., "..,..".. d (1) Gross income from oil, gas, and geothermal properties. . . . (2) Deductions allocable to oil, gas, and geothermal properties e Other adjmnts & tax pref items . , . . , . . . , . . 17 a Name of foreign country or U.S. possession . , . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources c Gross income sourced at partner level .....,....,., d Foreign gross income sourced at partnership level: (1) Passive ~ (2) Listed categories (attach sch) ~ e Deductions allocated and apportioned at partner level: (1) Interest expense ~ (2)Other f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive ~ (2) Listed categories (attach sch) ~ g Total foreign taxes (check one): ~ D Paid D Accrued h Reduction In taxes available for credit attach schedule .........,., 18 Section 59(e)(2) expenditures: a Type ~ 19 Tax-exempt interest Income 20 Other tax.exempt income 21 Nondeductible expenses . 22 Distributions of money (cash and marketable securities) . 23 Distributions of property other than money. 24 Other items and amounts required to be reported separately to partners (attach schedule) Page 3 . . , I065(20~1) ($g1i~(:fijJ~...f<f (b) Total amount . Income (Loss) . . Deduc- tions Credits . Invest- ment Interest . Self- Employ- ment . Adjust- ments and Tax Prefer- ence Items . Foreign Taxes . Other . 1 2 78,942. 3c 4a 4b 4c 12a 12a 12b 12c 12d 13 14a 14b 1 14b 2 15a 15b 15c 16a 16b 16c 16 d (1) 16 d (2) 16e O. b Amount 103,040, (3) General limitation ~ ~ (3) General limitation ~ ~ 4,726, . .... . .. . ................. ....... ::::::::;::::::::::::::::;/::.;-:....... BAA Form 1065 (2001) PTPA0134 01/01/02 . . . . . . . . . . . . .<.165 (2001) S & M ASSOCIATES 22-6237744 Page 4 .nafvsis of Net Income (Loss) I I ...,.. Net income (loss). Combine Schedule K, lines 1 through 7 in column (b). From the result, subtract the 1 sumofScheduleK,lines8throughll,14a,17g,and18b... ........................... .... 1 79,896. 2 Analysis by (i) Corporate (ii) Individual (iii) Individual (iv) Partnership (v) Exempt (vi) Nominee/Other partner type: (active) (passive) organization a General 35,516. partners. . b Limited 44,380. " ...~~~~ers , .. . . ... IS<;h~dtd~U.:d Balance Sheets er Books (Not required If uestlon 5 on Schedule B IS answered 'Yes.') Beginning of tax year End of tax year (a) (b) 13 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 schedule) .............. 7 Mortgage and real estate loans . . . . . . . . . . . . . 8 Other investments (attach schedule) . . . . . . . . . . . . . . 9a Buildings and other depreciable assets . . . . . . b Less accumulated depreciation ............. lOa Depletable assets. . . . . . . . . . . . . . . b Less accumulated depletion .. . . . . . . . . . . . . 11 Land (net of any amortization) . . 12a Intangible assets (amortizable only) .. b Less accumulated amortization 13 Other assets (attach schedule) 14 Total assets ............ 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 98,453. 581. 1 Net income (loss) per books . . .... . .. . 84, 622 . 6 Income recorded on books this year not included 2 Income included on Schedule K, lines 1 through 4, on Schedule K, lines 1 though 7 (itemize): 6, and 7, not recorded on books this year (itemize): a Tax-exempt Interest $ _ _ _ _ _ _ 3 L ~ 23 --'- -------------------- --------------------- 4,726. -------------------- 7 Deductions included on Schedule K, lines 1 through 11, 3 Guaranteed payments (other than health insurance) . 14a, 17g, and 18b, not charged against book income thi 4 Expenses recorded on books this rear not included year (itemize): on Schedule K, lines 1 through 1 , 14a, 17g, and a Depreciation $ 18b (itemize): .... . ----------- a Depreciation .. . ... $ ----------- --------------------- b Travel and $ -------------------- entertainment . 8 Add lines 6 and 7 ..." . 4,726. ----------- -------------------- 9 Income (loss) (Analysis of net income 5 Add lines 1 through 4 ... . . . . . . 84,622 . (loss), line 1). Subtract line 8 from line 5 . 79,896. 1$<::bf&(:!41~MR21 Analysis of Partners' Capital Accounts (Not required if question 5 on Schedule B is answered 'Yes.') 1 Balance at beginning of year . . 479,400. 6 Distributions: a Cash. 103,040. 2 Capital contributed during year . b Property. 3 Net income (loss) per books 84,622. 7 Other decreases (itemize): ----------- 4 Other increases (itemize): See Other decreases ---------- --------------------- -------------------- 103.040. 8 Add lines 6 and 7 . . . . . . . 5 Add lines 1 through 4 .. . 564,022. 9 Balance at end of year. Subtract line 8 from line 5 . 460,982. PTPA0l34 01/01/02 Form 1065 (2001) Department of the Treasury Internal Revenue Service Name of Partnership ~ Attach to Form 1065. I;~~~"" . Jdil/e D ..' arm 1065) Capital Gains and Losses Employer Identific~tion Number S & M ASSOCIATES . IP~ffL:::1 Short-Term Capital Gains and Losses - Assets Held One Year or Less 22-6237744 (a) Description of property (e.g., 100 shares of 'Z: Co) (b) Date acquired (C) Date sold (month, day, year) (month, day, year) (d) Sales price (see instructions) (e) Cost or other basis (see instructions) (f1cd~~~n~rs ~~j)S) ..... .;..,.,.:.'::":'..:::!::i::::::'.;i:'::;.:;';:;::;:;'::;:1 ..... ...............'......,'... . 2 Short.term capital gain from installment sales from Form 6252, line 26 or 37 2 . 3 Short-term capital gain (loss) from like-kind exchanges from Form 8824 3 4 Partnership's share of net short-term capital gain (lass), including specially allocated short-term capital gains (losses), from other partnerships, estates, and trusts 4 ... ...... 5 Net short-term capital gain or (loss). Combine lines 1 through 4 in column (I) Enter here and on Form 1065, Schedule K, line 4d or 7 5 hPijffJFr;:J Long-Term Capital Gains and Losses - Assets Held More Than One Year :::::::;::::::::::::::::::::: . (a) Description of property (e.g., 100 shares of 'Z' Co) (b) Date acquired (C) Date sold (month, day, year) (month, day, year) (d) Sales price (see instructions) (e) Cost or other basis (see instructions) (f) Gain or (loss) ((d) minus (e)) (g) 28% rate gain or (loss) . (see instructions) 6Van uard Intemediate Fund various various 25,100. 24,397. 703. . 7 Long-term capital gain from installment sales from Form 6252, line 26 or 37 7 8 Long-term capital gain (loss) from like-kind exchanges from Form 8824 ... . 9 Partnership's share of net long-term capital gain (loss), including specially allocated long-term capital gains (losses), from other partnerships, estates, and trusts 8 9 . 10 Capital gain distributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 251. 11 Combine lines 6 through lOin column (g). Enter here and on Form 1065, Schedule K, line 4e(2) or 7 . . . . . . . . . . . . . . . . . .. .......... 12 Net long-term capital gain or (loss). Combine lines 6 through 10 in column (I). Enter here and on Form 1065, Schedule K, line 4e(l) or 7 ....................................... . *28% rate gain or (loss) includes all 'collectibles gains and losses' (as defined in the instructions). ................. ...... .......... .. ........................... .:}~:~:~;~;~:}}}~{:}}~:~:~:}~:~ ......, BAA For Paperwork Reduction Act Notice, see instructions for Form 1065. Schedule 0 (Form 1065) 2001 . '. PTPA0201 01/01/02 . . es . . ..qsU! aleJedas a4l aas 'a:>!loN l:>\f UO!l:>npaH )1JoMJaded JO.:l \f\f8 17 8U!! 'I :).Jed : 8-590 l WJo.:l . .10 'e: 8U!1 ')1 81np8LPS :SOZLl JO 590l WJo.:l . : uo pue 8U!qw08 'S8!:).!^!l8e 8:).e:).S8 188.1 le:).U8.1 WO.1J (SSOI) 8W08U! :).8N lZ .-- jW3 (z) 8weN (L) · :p8p88U S! 888ds 8JOW J! 81np8Lps 12 Lp8+lV LP!LjM WOJJ slsnJ+ JO 'S8:).8:).S8 ISd!LjSJ8UlJed 8Lj+ MOl8Q ^J1lU8PI q WO.1J) AJep!J8u8q .10 J8UlJ8d 8 S! UO!l8Jod.108 S .10 d!LjSJ8Ul.Jed ~l.1ed WO.1J S8!l!^!l8e 8lels8 188.1 lelu8.J WOJJ (SSOI) 8W08U! l8N e OZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . s8!+!^!l88 8l8+S8 jS!P 8Ljl WO.1J '8l 8U!! 'll l.Jed I L6L17 WJO ~ WOJJ (SSOI) u!e5 l8N 6 L .V suwnl08 'gl 8U!! WOJJ S8SU8dx8 lelol PPV 'S8SU8dx8 112+01 8 L JLjl V SUWnl08 '"G 8U!1 WOJJ SlU8.J SS0.15 PPV 'SlU8J SSOJ5 lelO 1 Ll . ~E 9l . . . . . . . . . . . . . .. S l Lj5 n OJ Lj+ E S 8U! I P P V '^lJ8do.1d Lj888 JOJ S8SU8dx8 18+01 9l , -------------------- 5l .:)S~W ---Sd~e~)~U~-------- :r - Sdd~-~u~wd~eueW-~ (:~S!I) J8Lno Sl (: vl . . . . . . . . . (sUO!l8n.1lSU! 88S) uO!lep8Jd8O vL ~'- . . . . . . . . . . . . . . . . . . S8 ue es ue s858 . I P M ~l . ~ Form 1065 U.S. Return of Partnership Income OMB No. 1545-0099 Depa7 .mli:-nt of the Treasury For calendar year 2002, or tax year beg. ,2002, & ending ,20_. 2002 Internal Revenue Service ~ See separate Instructions. A Principal busn. activity Use the Name of partnership, no., street, room or suite no., P.O. box, city or town, state, and ZIP code D Employer ID number Leasing IRS ~2-6237744 B Principal product/service label. S & M ASSOCIATES E Date business started Other- Real Property wise, g I '2."l. \.,-\ C Business code number print 2467 Bay Isle Court F Total assets (see instructions) 531110 or type. !weston FL 33327 $ 439,468 . . G Check applicable boxes: (1) 0 Initial return (2) 0 Final return (3) 0 Name change (4) 0 Address change (5) 0 Amended return H Check accounting method: (1m Cash (2) 0 Accrual (3) 0 Other (specify)~ . I Number of Schedules K-1. Attach one for each person who was a partner at any time during tax year ~ 12 Caution: Include only trade or business income and expenses on lines 1 a through 22 below. See the instructions for more information. . . 2 3 Income 4 5 6 7 8 9 10 11 12 Deduc- 13 tlons (see 14 instruc- 15 tions for 16a limita- b tio ns) 17 18 19 . . . 1 a Gross receipts or sales. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1 a b Less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 b Cost of goods sold (Schedule A, line 8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule). . . . . . . . . . . . . 4 Net farm profit (loss) (attach Schedule F (Form 1040)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Net gain (loss) from Form 4797, Part II, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Other income (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Total Income (loss). Combine lines 3 through 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Salaries and wages (other than to partners) (less employment credits). . . . . . . . . . . . . . . . . . . . . . . . Guaranteed payments to partners. , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Repairs and maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rent. . . . '" ... .... . . . . . .. '" ... . " . . .. ... .. '" . .... . ...... . .. . . ... . .. .. .. .. . . .. Taxes and licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Depreciation (if required, attach Form 4562) . . . . . . . . . . . . . . . . . . 16a Less depreciation reported on Schedule A and elsewhere on return 16b Depletion (Do not deduct oil and gas depletion.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Retirement plans, etc. . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Employee benefit programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Other deductions (attach schedule). . . ..............................,................ . 1c o 21 Total deductions. Add the amounts shown in the far right column for lines 9 through 20 . . . . . . . .. 21 22 o 8 o 9 10 11 12 13 14 15 16c 17 18 19 20 o . OrdInary Income (loss) from trade or business activities. Subtract line 21 from line 8 . . . . . . . . . . .. 22 0 Under penalties of perjury, i declare that I have examined this return, including accompanying schedules and statements, and 10 the best of my knowledge and belief, it is true, correct, and complele. Declaration of preparer (other than general artner or limited liabilit company member) is based on all information of which preparer has any knowledge. Sign Here !. Paid Preparer's Use Only ~ Signature of general partner or limited liability company member Date May the IRS discuss this return with the preparer shown below (see inst.)? Preparer's signature Firm's name (or yours ~ Arnold A. Graham if self-employed), ,,25 Sou t h 5 t h Ave address,&ZIPcode Hi hland Park NJ ~ Date Check if self- Preparer's SSN or PTIN employed ~ 0 0 - 0 8 - 3 04 4 EIN ~ 2 2 - 2 3 7 0 15 9 Company, PC No For Paperwork Reduction Act Notice, see separate Instructions. JVA 2 106512 TWF 1037A Copyright Forms (Software Only) _ 2002 TWNL 08904 Phone no. 732-985-0460 Form 1065 (2002) . . Name of ~ designated TMP Address of ~ designated TMP .JVA 2 106512 . . . . . . . . . . Form 1065 (2002) S & M ASSOCIATES 22-6237744 Page 2 ~du(e A J Cost of Goods Sold (see the instructions) 1 Inventory at beginning of year. . . . . 1 2 Purchases less cost of items withdrawn for personal use 2 3 Cost of labor. 3 4 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 9a Check all methods used for valuing closing inventory: (i) ~ Cost as described in Regulations section 1.471-3 ~~~) Lower of cost or market as described in Regulati.ons section 1.471-4 (III) Other (specify method used and attach explanation) ~ b Check this box if there was a write down 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? . . . . . . . . . . . . . . . . . . .. BYes e Was there any change in determining quantities, cost, or valuations between opening and closing inventory? . . . . . . . . . . . . . Yes If "Yes," attach explanation. $pb~q9,&a Other Information 1 What type of entity is filing this return? Check the applicable box: a ~ 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Is this partnership subject to the consolidated audit procedures of sections 6221 through 6233? If "Yes," see Designation of Tax Matters Partner below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and C Schedules K-1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If "Yes," the partnership is not required to complete Schedules L, M-1, and M-2; Item F on page 1 of Form 1065; or Item J on Schedule K-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Does this partnership have any foreign partners? If "Yes," the partnership may have to file Forms 8804,8805 and 8813. See the instructio ns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No No 7 8 9 10 Is this partnership a publicly traded partnership as defined in section 469(k)(2)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? . . . . . . . . . . . . . . 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 TO F 90-22.1. If "Yes," enter the name of the foreign country. ~ 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 the instructions. . . . . . . . . . . . . . . . . . . . . . . Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the lax year? If "Yes," you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described under Elections Made By the Partnership in the instructions. . . . . . . . . . . . . . . . . Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to this return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 12 Designation of Tax Matters Partner (see the instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: ....~ Swersky Famil LTD Partnershi C 0 Stanley Swersky, 2467 Bay Weston FL 33327 Identifying ... number ofTMP r 22 - 3 2115 73 Isle Court TWF 11 23 Copyroght Forms (Software Only) - 2002 TWNL Form 1065 (2002) . . . . . . . Adjust- ments and Tax Prefer- ence Items . For- eign Taxes . . Other . JVA Income (Loss) Deduc- tions Credits Invest- ment Inter- est Self- Em- ploy- ment Form 1065 (2002) ...~Pf1#ciW.~.K.. S & M ASSOCIATES 22-6237744 Partners' Shares of Income, Credits, Deductions, etc. (a) Distributive share Items 1 Ordinary income (loss) from trade or business activities (page 1, line 22) . . . . . . . . . . . . . . . . . . . . . . . 2 Net income (loss) from rental real estate activities (attach Form 8825). . . . . . . . . . . . . . . . . . . . . . . . . . 3a Gross income from other rental activities. . . . . . . . . . . . . . . . . . . . . .. 3a b Expenses from other rental activities (attach schedule) . . . . . . . . . . .. 3b c Net income (loss) from other rental activities. Subtract line 3b from line 3a . . . . . . . . . . . . . . . . . . . . . . 4 Portfolio income (loss): a Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C Royalty income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Net short-term capital gain (loss) (attach Schedule D (Form 1065)) . . . . . . . . . . . . . . . . . . . . . . . . . . . e (1) Net long-term capital gain (loss) (attach Schedule D (Form 1065)) . . . . . . . . . . . . . . . . . . . . . . . . (2) 28% rate gain (loss) ~ (3) Qualified 5-year gain ~ 73 f Other portfolio income (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Net section 1231 gain (loss) (other than due to casualty or theft) (attach Form 4797) . . . . . . . . . . . . . . 7 Other income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Charitable contributions (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Section 179 expense deduction (attach Form 4562) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Deductions related to portfolio income (itemize) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Other deductions (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a Low-income housing credit: (1) From partnerships to which section 420)(5) applies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Other than on line 12a(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468). . . . . . . . C Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. . . . . . . d Credits related to other rental activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Other credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14a Interest expense on investment debts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b (1) Investment income included on lines 4a, 4b, 4c, and 4f above. . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Investment expenses included on line 10 above. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15a Net earnings (loss) from self-employment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Gross farming or fishing income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C Gross nonfarm income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16a Depreciation adjustment on property plaoed in service after 1986. . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (1) Gross income from oil, gas, and geothermal properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Deductions allocable to oil, gas, and geothermal properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e Other adjustments and tax preference items (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17a Name of foreign country or U.S. possession ~ b Gross income from all sources .................................. . . . . . . . . . . . . . . . . . . . . . C Gross income sourced at partner level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Foreign gross income sourced at partnership level: (1 )Passive ~ (2) ~i~t~ec~ c::~~~~~) ~ e Deductions allocated and apportioned at partner level: (1) Interest expense ~ (2) Other.. .... .. . . . . . '" . . . .. . ... ~ Deductions allocated and apportioned at partnership level to foreign source income: (1) (2) Listed categoroes (3) General Passive ~ (attach schedule) ~ limitation.. ~ 9 Total foreign taxes (check one): ~ Paid 0 Accrued 0 ............................... h Reduction in taxes available for credit (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Section 59(e)(2) expenditures: a Type ~ b Amount. . ~ 19 Tax-exempt interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Other tax-exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Distributions of money (cash and marketable securities) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Distributions of properly other than money. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Other items and amounts required to be reporled separately to parlners (attach schedule) . . . . . . . . . 2 106534 TWF , 190 Copyright Forms (Software Only) - 2002 TWNL (3) Gene~1 ~ limitation. . . Page 3 (b) Total amount 73,354 3c 4a 4b 4c 4d 4e(1) 28 1,118 4f 5 6 7 8 9 10 11 2a(1) 2a(2) 12b 12c 12d 13 14a 4b(1) 4b(2) 15a 15b 15c 16a 16b 16c 28 4,526 103,040 Form 1065 (2002) . Form 1065 (2002) S & M ASSOCIATES 22-6237744 Page 4 . Analysis of Net Income (loss) 1 Net income (loss). Combine Schedule K, lines 1 through 7 in column (b). From the result, subtract the sum of I 1 I Schedule K, lines 8 through 11, 14a, 17g, and 18b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74,500 2 Analysis by (II) Individual (III) Individual (v) Exempt partner type: (I) Corporate (active) (passive) (Iv) Partnership organization (vi) Nominee/Other a General partners 33,114 b Limited partners 41,386 Note: Schedules L, M-1 and M-2 are not required if Question 5 of Schedule B is answered "Yes." Beginning of tax year (a) (b) 3,351 $qh~(;IijJ~P{ Balance Sheets per Books Assets Cash.. '" . .. . . .... . ......... . . .. .. . Trade notes and accounts receivable. . . . . . Less allowance for bad debts. . . . . . . . . . . . Inventories. . . . . . . . . . . . . . . . . . . . . . . . . . . U.S. government obligations. . . . . . . . . . . . . Tax-exempt securities. . . . . . . . . . . . . . . . . . Other current assets (attach schedule) . . . . . Mortgage and real estate loans. . . . . . . . . . . Other investments (attach schedule) . . . . . . . Buildings and other depreciable assets. . . . . Less accumulated depreciation. . . . . . . . . . . Depletable assets . . . . . . . . . . . . . . . . . . . . . Less accumulated depletion. . . . . . . . . . . . . Land (net of any amortization). . . . . . . . . . . . Intangible assets (amortizable only). . . . . . . . Less accumulated amortization. . . . . . . . . . . 88,125 . 1 2a b 3 4 5 6 7 8 9a b 10a b 11 12a b 13 14 . . . Other assets (attach schedule) . . . . . . . . . . . Total assets . . . . . . . . . . . . . . . . . . . . . . . . . LIabilities and CapItal 15 Accounts payable. . . . . . . . .. . . . . . . . . . . . 16 Mortgages, notes, bonds payable in less than 1 year 17 Other current liabilities (attach schedule). . . . 18 All no nrecou rse 10 ans . . . . . . . . . . . . . . . . . . 19 Mortgages, notes, bonds payable in 1 year or more. . 20 Other liabilities (attach schedule). . . . . . . , . . 21 Partners' capital accounts. . . . . , . . . . . . , . . 22 Total liabilities and capital. . . . , . . . . . . , . . . $Cfl$qtil~MH1 Reconciliation of Income 1 Net income (loss) per books. . . . . . . . . . . , . 2 Income included on Schedule K, lines 1-4, 6, and 7, not recorded on books this year (itemize): 3 Guaranteed pymts. (other than health ins.) . . . 4 Expenses recorded on books this year not included on Schedule K, lines 1 through 11, 14a, 17g, and 18b (itemize): a Depreciation $ b ~~1~~ia~g~ent $ 2,500 436,968 439,468 . . Income recorded on books this year not included on Sch. K, lines 1-7 (itemize): a Tax-exempt int. $ 4 , 526 7 Deductions included on Sch. K, lines 1 through 11, 14a, 17g, & 18b, not charged against book income this year (itemi2e): a Depr. $ 4,526 . . 5 Add lines 1 through 4 . . . . . . . . . . . . . . . . . . $cM~qltl.e.M22 1 Balance at beginning of year. . . . . . . . . . . . . 2 Capital contributed: a Cash. . . . . . . . . . . . . b Property. . . . . . . . . . . 3 Net income (loss) per books. . . . . . . . . , . . . 4 Other increases (itemize): 8 9 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . Income (loss) (Analysis of Net Income (Loss), line 1). Subtract line 8 from line 5. . . 4,526 79,026 ital Accounts 460,982 6 7 74,500 79,026 Other decreases (itemize): Distributions: a Cash.. . . . . . . . . . . b Property. . . . . . . . . 103,040 5 Add lines 1 through 4 2 106534 TWF 11 24A 540,008 8 9 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . JVA Balance at end of year. Subtract line B from line 5 103,040 436,968 Form 1065 (2002) . Copyright Forms (Software Only) - 2002 TWNL . . . . . . . . . . . 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 1120S. 2002 OMS No. 1545-1186 Department of the Treasury Internal Revenue Service Name S & M ASSOCIATES 1 Show the kind and location of each property. See page 2 for additional properties. Employer Identification no. 2-6237744 A Shopping Center, Sacramento, CA 8 c o Pro erties Rental Real Estate Income 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)~Bank fees A 114,500 B c o 2,325 6,762 20,466 145 MANAGEMENT FEES 15 11,448 16 Total expenses for each property. Add lines 3 throug h 15, . , . . , , . , , . 16 41,146 17 Total gross rents. Add gross rents from line 2, columns A through H, . , . . . . . . . . 17 114,500 18 Total expenses. Add total expenses from line 16, columns A through H. , . . , . . , , . . . , . . , , , , , . , , . , , 18 19 Net gain (loss) from Form 4797, Part II, line 18, from the disposition of property from rental real estate activities. , , . , . , . . , . . . , . . , , . . . . . . , . . , . . . . , . . , . . . . , . , , , . . . . , , . . . , , , , . . . . , , . . , , . , ' , . . 19 20a 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) , . . , , , , . , . , , , , . , , , , , , , , , " 20a 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 41,146 21 Net income (loss) from rental real estate activities. Combine lines 17 through 20a Enter the result here & on · Form 1065 or 11205: Schedule K, line 2, or ,. ,."'.,......,.""'...,.,..."".}: · Form 1065-8: Part I, line 4 For Paperwork Reduction Act Notice, see Instructions. JVA 2 882512 TWF 1145 Copyright Forms (Software Only) - 2002 TWNL Form 8825 (2002) . SCHEDULE D (Form 1065) Capital Gains and Losses OMS No. 1545-0099 Department of the Treasury Internal Revenue Service ~ Attach to Form 1065. 2002 Name of partnership S & M ASSOCIATES Employer Identification number . 122-6237744 IPiji'ffJ Short-Term Capital Gains and Losses -- Assets Held One Year or Less (a) Description of (b) Date acquired (e) Date sold property (e.g., 100 1 shares of "2" Co. (month, day, year) (month, day, year) (d) Sales price (see instructions) (e) Cost or other basis (see instructions) (1) Gain or (loss) ((d) minus (e)) . . 2 Short-term capital gain from installment sales from Form 6252, line 26 or 37 . . . . . . . . . . . . . . . . . . 2 3 Short-term capital gain (loss) from like-kind exchanges from Form 8824 . . . . . . . . . . . . . . . . . . . . . 3 . 4 Partnership's share of net short-term capital gain (loss), including specially allocated short-term capital gains (losses), from other partnerships, estates, and trusts. . . . . . . . . . . . . . . . . . 4 5 Net short-term capital gain or (loss). Combine lines 1 through 4 in column (t). Enter here and on Form 1065, Schedule K, line 4d or 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 1F1~ftJ!j Long-Term Capital Gains and Losses -- Assets Held More Than One Year . (a) Description of (b) Date acquired property (e.g., 100 6 shares of "2" Co. (month, day, year) Vanguard Iter-term ARIOUS (e) Date sold (month, day, year) (d) Sales price (see instructions) (e) Cost or other basis (see instructions) (1) Gain or (loss) ((d) minus (e)) (g) 28% rate gain or (loss) *(see instr. below) 03-05-2002 31,000 30,142 858 . . 7 Long-term capital gain from installment sales from Form 6252, line 26 or 37. . . . . . . . . . . . . . . . . . 7 8 Long-term capital gain (loss) from like-kind exchanges from Form 8824 . . . . . . . . . . . . . . . . . . . . 8 . 9 Partnership's share of net long-term capital gain (loss), including specially allocated long-term capital gains (losses), from other partnerships, estates, and trusts. . . . . . . . . . . . . . . . . 9 10 Capital gain distributions. . . 10 260 11 Combine lines 6 through 10 in column (g). Enter here and on Form 1065. Schedule K, line 4e(2) or 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Net long-term capital gaIn or (loss). Combine lines 6 through 10 in column (t). Enter here and on Form 1065. Schedule K, line 4e(1) or 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *28% rate gain or (loss) includes all "collectibles gains and losses" (as defined in the instructions). . For Paperwork Reduction Act Notice, see the Instructions for Form 1065. JVA 2 1065D1 TWF 1160 Copyright Forms (Software Only) - 2002TWNL Schedule D (Form 1065) 2002 . Form 1065 U.S. Return of Partnership Income OMB No. 1545-0099 Department of the Treasury For calendar year 2003, or tax year beg. ,2003, & ending ,20_. 2003 Internal Revenue Service ~ See separate Instructions. A Principal busn. activity Use the Name of partnership, no., street, room or suite no., P.O. box, city ortown, state, and ZIP code o Employer 10 number Leasinq IRS 22-6237744 B Principal product/service label. S & M ASSOCIATES E Date business started Other- Real Property wise, 08-11-1974 C Business code number print 2467 Bay Isle Court F Total assets (see instructions) 531110 or type. Weston FL 33327 $ 421,235 . . G Check applicable boxes: (1) D_lnitial return (2) D Final return (3) D Name change (4) D Address change (5) D Amended return H Check accounting method: (1)~ Cash (2) D Accrual (3) D Other (specify) ~ I Number of Schedules K-1. Attach one for each person who was a partner at any time during tax year ~ 12 Caution: Include only trade or business income and expenses on lines 1a through 22 below. See the instructions for more information. ~ Signature of general partner or limited liability company member Preparer's Date signature Firm's name (or yours Arnold A. Graham Company if self-employed), ~25 South 5th Ave address,&ZIPcode 'Hi hland Park NJ 08904 For Paperwork Reduction Act Notice, see separate Instructions. JVA 3 106512 TWF 5665 Copyright Forms (Software Only) - 2003 TWNL . . 2 3 Income 4 5 6 7 8 9 10 11 12 Deduc- 13 tlons (see 14 i nstruc- 15 tions for 16a Iimita- b tions) 17 18 19 20 21 . . . Sign Here . Paid Preparer's Use Only . 1 a Gross receipts or sales. . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . .. 1 a b Less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . , .. 1b 1c o Cost of goods sold (Schedule A, line 8). . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . 2 Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule). . . . . . . . . . . . . 4 Net farm profit (loss) (attach Schedule F (Form 1040)) . . . . . . . , , . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Net gain (loss) from Form 4797, Part II, line 18 . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 o Other income (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Total Income (loss). Combine lines 3 through 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 o Salaries and wages (other than to partners) (less employment credits) . . . . . . . . . . . . . . . . . . . . . . . . 9 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . 11 Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Rent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 13 Taxes and licenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 14 Interest ... . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 Depreciation (if required, attach Form 4562) . . . . . . . . . . . . . . . . . .. 16a Less depreciation reported on Schedule A and elsewhere on return 16b 16c Depletion (Do not deduct 011 and gas depletion.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Retirement plans, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 18 Employee benefit programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Other deductions (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20 Total deductions. Add the amounts shown in the far right column for lines 9 through 20 . . . . . . . .. 21 o 22 Ordinary Income (loss) from trade or business activities. Subtract line 21 from line 8 . . . . . . . . . . .. 22 0 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than general artner or limited Iiabili company member) is based on all information of which preparer has any knowledge. May the IRS discuss this return with the preparer shown below (see inst.)? ~ Date Check if self- employed ~ EIN ~22 -2370159 No Preparer's SSN or PTIN Phone no. 732-985-0460 Form 1065 (2003) 1:$ijb~ij(ij::A::l Cost of Goods Sold (see the instructions) 1 Inventory at beginning of year . 1 2 Purchases less cost of items withdrawn for personal use 2 3 Cost of labor . 3 4 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 . S & M ASSOCIATES Form 1065 (2003) 22-6237744 . . 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 writedown 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? . . . . . . . . . . . . . . . . . . .. 8 Yes e Was there any change in determining quantities, cost, or valuations between opening and closing inventory? . . . . . . . . . . . . . Yes If "Yes," attach explanation. $.9.fdli~ij:H~:$?: Other Information 1 What type of entity is filing this return? Check the applicable box: a ~ 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Is this partnership subject to the consolidated audit procedures of sections 6221 through 6233? If "Yes," see Designation of Tax Matters Partner below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and C Schedules K-1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If "Yes," the partnership is not required to complete Schedules L, M-1, and M-2; Item F on page 1 of Form 1065; or Item J on Schedule K-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Does this partnership have any foreign partners? If "Yes," the partnership may have to file Forms 8804, 8805 and 8813. See the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Is this partnership a publicly traded partnership as defined in section 469(k)(2)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? . . . . . . . . . . . . . . . . . . . . . 9 At any time during calendar year 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 TD F 90-22.1. If "Yes," enter the name of the foreign country. ~ 10 During the tax year, did the partnership receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If "Yes," the partnership may have to file Form 3520. See the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If "Yes," you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described under Elections Made By the Partnership in the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to this return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ Designation of Tax Matters Partner (see the instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: Page 2 . . . . . . Name of ~ designated TMP Address of ~ designated TMP JVA 3 106512 TWF 5667 . Identifying ~ number ofTMP , 22 - 32115 73 2467 Bay Isle Court No No Copyright Forms (Software Only)- 2003 TWNL Form 1065 (2003) . Form 1065 (2003) :$~h~Ah~K? . Income (Loss) . . Deduc- tions . Credits Invest- . ment Inter- est Self- Em- ploy- ment AdJust- ments and Tax Prefer- ence Items . For- eign Taxes . . Other JVA . S & M ASSOCIATES 22-6237744 Partners' Shares of Income, Credits, Deductions, etc. (a) Distributive share Items 1 Ordinary income (loss) from trade or business activities (page 1, line 22) . . . . . . . . . . . , . . . . . . . . . , . 2 Net income (loss) from rental real estate activities (attach Form 8825). . . . . . . . . . . . . . . . . . . . . . . . . . 3a Gross income from other rental activities. . . . . , . . . . . , . . . . . . . . . " 3a b Expenses from other rental activities (attach schedule) , . . . . . . . . . .. 3b c Net income (loss) from other rental activities. Subtract line 3b from line 3a , . . . . . , . . . . . . , . . . . . . . . 4 Portfolio income (loss) (attach Schedule D (Form 1065) for lines 4d and 4e): . . . . . . , . . . . . . . . . . . . . a Interest income. . . . . . . . . . . . . . . . , , . . . . . , . , . . . , . . . . . . . . . . . . . . . . . . . . . . . . , . , . . . . . . . . . . b Dividends: (1) Qualified dividends ~ (2) Total ordinary dividends ~ C Royalty income . . , . . . . , . . . . . . . . . . . . . . . . , . . . . . . . , . . . . . . , , . . . . . . . . . . , . . . , . . . . . . . . . . , d Net short-term capital gain (loss): (1) post-May 5, 2003 ~ (2) Entire year ~ e Net long-term capital gain (loss): (1) post-May 5, 2003 ~ (2) Entire year ~ f Other portfolio income (loss) (attach schedule) . , . . . . . . . , . . . . . . , . . . . . . . . . . . . , . . . . . . . . . . . . . 5 Guaranteed payments to partners. . . . . , . . . . . . . , . . , . . . . , . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . 6a Net section 1231 gain (loss) (post May 5, 2003) (attach Form 4797) . . . . . . . . . . . . . . . . . . . . . . . . . . . b Net section 1231 gain (loss) (entire year) (attach Form 4797) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Other income (loss) (attach schedule) . . . , . . . . . . . . . . . . . . , . . . . . . . . . , . . . , . . . . . . . , . . . . . . . . . 8 Charitable contributions (attach schedule). . . . . . . . . . . . , , . . . . . . , . , , . . . . , . . , . . . . . . . . . . . . . . . 9 Section 179 expense deduction (attach Form 4562) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Deductions related to portfolio income (itemize) ......,.........,........................, 11 Other deductions (attach schedule). . . . . . . . . , . . . , . , . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . , 12a Low-income housing credit: (1) From partnerships to which section 420)(5) applies. . . . . . . . . . . . . . (2) Other than on line 12a(1). . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468). . . . . . . . C Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. . . . . , . d Credits related to other rental activities . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Other credits . . . . . . . , . . . . . . . . . . . . . . . . , . . . . . . . . , . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . , . . 14a Interest expense on investment debts. . . . . , . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b (1) Investment income included on lines 4a, 4b(2), 4c, and 4f above. . . . . . . . . , . . . . . . . . . . . . . . . 2 Investment expenses included on line 10 above. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15a Net earnings (loss) from self-employment. . . . . . . . . . . . . . . . . . . . , . , . . . . . . . . . . . . . . . . . . . . , . . . b Gross farming or fishing income . . . . , . . . , . . . . . . . , . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . C Gross nonfarm income , . . . , . . . . . . . . . . . . . . . . . . . . , . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . . 16a Depreciation adjustment on property placed in service after 1986. . . . . . . , . . , . . . . . . . . . , . . . . . . . . b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . C Depletion (other than oil and gas) . . , , . . . . . . . , . . . , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (1) Gross income from oil, gas, and geothermal properties. , . . . . , . . . . . . . . . . . . . . . . . . . . . . . . , . (2) Deductions allocable to oil, gas, and geothermal properties . , . . , . . . . . . . . . . . . . . . . . . . . . . . . e Other adjustments and tax preference items (attach schedule) . . . . . , . , . . . . . . . . . . . . . . . . . . . . . . . 17a Name of foreign country or U.S. possession ~ b Gross income from all sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . C Gross income sourced at partner level . . . . . . . , . . . , . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Foreign gross income sourced at partnership level: (1) (2) Listed categories Passive ~ (attach schedule) ~ e Deductions allocated and apportioned at partner level: (1) Interest expense ~ (2) Other. . . . . . . . , . . . . . . . . . , . . . .. ~ f Deductions allocated and apportioned at partnership level to foreign source income: (l)Passive ~ (2) ~~~ecdh csa.;m~~) ~ (3) ~~~~~f~n ~ 9 Total foreign taxes (check one): ~ Paid 0 Accrued 0 ......,......................,. h Reduction in taxes available for credit (attach schedule) 18 Section 59(e)(2) expenditures: a Type~ b Amount ~ 19 Tax-exempt interest income. . . . . . . . . . . . . . , . . . . . . . . . . , . . . . . . . . . , . . . . . . . . . , . . . . . . . . . . . 20 Other tax-exempt income. , . . . . . . , . . . . . . , . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Nondeductible expenses. . . . . . . . , . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . , , . . . . . . . . . . . . . . 22 Distributions of money (cash and marketable securities) . , , . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . 23 Distributions of property other than money . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . 24 Other items and amounts required to be reported separately to partners (attach schedule) . . . . . . . . . 3 106534 TWF 5669 Copyright Forms (Software Only) - 2003 TWNL (3) General limitation Page 3 (b) Total amount 80,617 4a 4b(2) 4c 4d(2) 4e(2) 330 4f 5 6a 6b 7 8 9 10 11 2a(1) 2a(2) 12b 12c 12d 13 14a 4b(1) 4b(2) 15a 15b 15c 16a 16b 16c 6d(1) 6d(2) 16e .....,. 17b 17c ~ 3,860 103,040 Form 1065 (2003) . Form 1065 (2003) S & M ASSOCIATES 22-6237744 Anal sis of Net Income Loss 1 Net income (loss). Combine Schedule K, lines 1 through 7 in column (b). From the result, subtract the sum of Schedule K, lines 8 through 11, 14a, 17g, and 18b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Analysis by (II) Individual (III) Individual (I) Corporate partner type: (active) (passive) a General partners b Limited partners 44 , 967 Note: Schedules L, M-1 and M-2 are not required if Question 5 of Schedule B is answered "Yes." $9H~c:tijl.:];;::::: Balance Sheets per Books Beginning of tax year Assets (a) (b) 1 Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 , 5 5 0 2a Trade notes and accounts receivable. . . . . . b Less allowance for bad debts . . . . . . . . . . . . 3 Inventories........................... 4 U.S. government obligations. . . . . . . . . . . . . 5 Tax-exempt securities. . . . . . . . . . . . . . . . . . 6 Other current assets (attach schedule) . . . . . 7 Mortgage and real estate loans. . . . . . . . . . . 8 Other investments (attach schedule) . . . . . . . 9a Buildings and other depreciable assets. . . . . b Less accumulated depreciation. . . . . . . . . . . 10a Depletable assets . . . . . . . . . . . . . . . . . . . . . b Less accumulated depletion . . . . . . . . . . . . . 11 Land (net of any amortization). . . . . . . . . . . . 12a Intangible assets (amortizable only). . . . . . . . b Less accumulated amortization. . . . . . . . . . . 13 Other assets (attach schedule) . . . . . . . . . . . 14 Total assets. . . . . . . . . . . . . . . . . . . . . . . . . Liabilities and Capital 15 Accounts payable. . . . . . . . . . . . . . . . . . . . . 16 Mortgages, notes, bonds payable in less than 1 year 17 Other current liabilities (attach schedule). . . . 18 All nonrecourse loans. . . . . . . . . . . . . . . . . . 19 Mortgages, notes, bonds payable in 1 year or more. . 20 Other liabilities (attach schedule). . . . . . . . . . 21 Partners' capital accounts. . . . . . . . . . . . . . . 22 Total liabilities and capital. . . . .. . . . . . . ... $-onidUlijJ'illH1 Reconciliation of Income 1 Net income (loss) per books. . . . . . . . . . . . . 2 Income included on Schedule K, lines 1-4, 6b, and 7, not recorded on books this year (itemize): 3 Guaranteed pymts. (other than health ins.) . . 4 Expenses recorded on books this year not included on Schedule K, lines 1 through 11, 14a, 17g, and 18b (itemize): a Depreciation $ b ~~~~~Ia~~~ent $ . . . . . 5 Add lines 1 through 4 . . . . . . . . . . . . . . . . . . ~m1ijhf]\i1B~ Anal sis of Partners' Ca 1 Balance at beginning of year. . . . . . . . . . . . . 2 Capital contributed: a Cash. . . . . . . . . . . . . b Property. . . . . . . . . . . Net income (loss) per books. . . . . . . . . . . . . Other increases (itemize): 1 (Iv) Partnership (v) Exempt organization 35,980 er Return Income recorded on books this year not included on Sch. K, lines 1-7 (itemize): a Tax-exempt int. $ 3 , 860 Deductions included on Sch. K, lines 1 through 11, 14a, 17g, & 18b, not charged against book income this year (itemize): a Depr. $ 7 8 9 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . Income (loss) (Analysis of Net Income (Loss), line 1). Subtract line 8 from line 5. . . . 84,807 ital Accounts 436,968 6 7 Distributions: a Cash. . . . . . . . . . . . . . . b Property. . . . . . . . . . . . . Other decreases (Itemize): 84,807 Add lines 1 through 4 . . . . . . . . . . . . . . . . . . 521 , 775 3 106534 TWF 5671 Copyright Forms (Software Only) - 2003 TWNL 8 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . 9 Balance at end of year. Subtract line 8 from line 5 Page 4 80,947 (vi) Nominee/Other 80,815 2,500 418,735 421,235 3,860 3,860 80,947 103,040 103,040 418,735 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. 1545-1186 Department of th e Treasury Internal Revenue Service 2003 Name S & M ASSOCIATES . 1 Show the kind and location of each property. See page 2 for additional properties. Employer Identification no. 2-6237744 A Shopping Center, Sacramento, CA B . c o . Pro erties . Rental Real Estate Income 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 JV A12 Utilities....................... 12 Wages and salaries. . . . . . . . . . . . . 13 Depreciation (see instructions) . . . . . 14 :::>ther (list) ~ A 116,891 B c D 845 975 L 20,466 See Attached 15 13,988 16 Total expenses for each property. Add lines 3 through 15. . . . . . . . . . . 16 36,274 17 Total gross rents. Add gross rents from line 2, columns A through H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 116,891 18 Total expenses. Add total expenses from line 16, columns A through H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 18 19 Net gain (loss) from Form 4797, Part II, line 18, from the disposition of property from rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20a 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) . . . . . . . . . . . . . . . . . . . . . . . . .. 20a 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 36,274 21 Net income (loss) from rental real estate activities. Combine lines 17 through 20a. Enter the result here & on: · Form 1065 or 11205: Schedule K, line 2, or . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . } · Form 1065-8: Part I, line 4 For Paperwork Reduction Act Notice, see Instructions. JVA 3 882512 TWF 5048 Copyright Forms (Software Only) - 2003 TWNL . Form 8825 (2003) . . SCHEDULE D (Form 1065) Capital Gains and Losses OMS No. 1545-0099 Department of the Treasury Internal Revenue Service ~ Attach to Form 1065. 2003 Name of partnership S & M ASSOCIATES Employer Identification number 2-6237744 .pijnit:: Short-Term Ca ital Gains and Losses -- Assets Held 1 Year or Less (a) Description of (b) Date acquired (c) Date sold (d) Sales price (e) Cost or other basis (1) Gain or (loss) property (e.g., 100 (month, day, year) (month, day, year) (see instructions) (see instructions) for the entire year 1 shares of "Z" Co. Subtr. e from d . . 2 Short-term capital gain from installment sales from Form 6252, line 26 or 37. . . . . . . . . . . . . . . . 2 3 Short-term capital gain (loss) from like-kind exchanges from Form 8824 . . . . . . . . . . . . . . . . . . 3 . 4 Partnership's share of net short-term capital gain (loss), including specially allocated short-term capital gains (losses), from other partnerships, estates, and trusts. . . . . . . . . . . . . . . . 5a Combine lines 1 through 4 in column (g). Enter here and on Form 1065, Schedule K, line 4d(1) 5b er Tax Ee ARIOUS ARIOUS 11,500 11,170 330 . . 7 Long-term capital gain from installment sales from Form 6252, line 26 or 37. . . . . . . . . . . . . . . . . . 7 8 Long-term capital gain (loss) from like-kind exchanges from Form 8824 . . . . . . . . . . . . . . . . . . . . 8 9 Partnership's share of net long-term capital gain (loss), including specially allocated long-term capital gains (losses), from other partnerships, estates, and trusts. . . . . . . . . . . . . . . . . 9 · 10 Capital gain distributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 11 Combine lines 6 through 10 in column (g). Enter here and on Form 1065, Schedule K, line 4e(1) or 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Net long-term capItal gain or (loss). Combine lines 6 through 10 in column (t). Enter here and on Form 1065 Schedule Kline 4e 2 or 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 330 *Note: Include in column (g) all gains and losses from column (t) from sales, exchanges, or conversions (including installment payments received) after May 5, 2003. However, do not include gain attributable to unrecaptured section 1250 gain, a "collectibles gain or loss" (as defined in the instructions) or the eligible gain on qualified small business stock (see instructions). For Paperwork Reduction Act Notice, see the Instructions for Form 1065. Schedule 0 (Form 1065) 2003 JVA 3 106501 TWF 8017 Copyright Forms (Software Only) - 2003 TWNL . . DETAIL STATEMENTS S & M ASSOCIATES 22-6237744 STATEMENT #1 - Other Expenses (FORM 8825 LINE 15) . Management fee................................. Service fees................................... Acctg. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,448 90 2,450 TOTAL CARRIED TO FORM 8825 LINE 15................ ......... . Page 1 13,988 . . . . . . . . JVA Copyright Forms (Software Only) - 2003 TWNL S0911S LSSTMT . 2003 PARTNERS CAPITAL ACCOUNT SUMMARY S & M ASSOCIATES 22-6237744 . Partner Profit Sharing Capital at Capital Partners' Share Withdrawals & Capital at End Number Percentage Beginning of Year Contributed of Lines ~ 4 & 7, Distribution of Year Sch -2 #1 22.23 97,010 0 18,848 22,901 92,957 #2 22.23 97,016 0 18,848 22,901 92,963 #3 5.56 24,289 0 4,711 5,724 23,276 #4 5.56 24,289 0 4,711 5,724 23,276 #5 5.56 24,299 0 4,711 5,724 23,286 #6 5.56 24,299 0 4,711 5,724 23,286 #7 5.56 24,289 0 4,711 5,724 23,276 #8 5.56 24,289 0 4,711 5,724 23,276 #9 5.56 24,303 0 4,711 5,724 23,290 #10 5.56 24,289 0 4,711 5,724 23,276 #11 5.56 24,299 0 4,711 5,724 23,286 #12 5.56 24,297 0 4,712 5,722 23,287 TOTALS 100.00 436,968 0 84,807 103,040 418,735 JVA Copyright Forms (Software Only) - 2003 Laser Systems. Kaysville,UT 84037 506025 3_PTK1RW . . . . . . . . . . Form 1065 U.S. Return of Partnership Income OMS No. 1545-0099 Department of th e Treasury For calendar year 2004, or tax year beg. ,2004, & ending ,20_. 2004 Internal Revenue Service ~ See separate Instructions. A Principal busn. activity Use the Name of partnership, no., street, room or suite no" P.O. box. city or town, state, and ZIP code o Employer 10 number Leasing IRS 22-6237744 B Principal product/service label. S & M ASSOCIATES E Date business started Other- Real Property wise, 08-11-1974 C Business code number print 2467 Bay Isle Court F Total assets (see instructions) 531110 or type. Weston, FL 33327 $ 463,967 . . G Check applicable boxes: (1) llinitial return (2) D Final return (3) D Name change (4) D Address change (5) D Amended return H Check accounting method: 6>89 Cash (2) D Accrual (3) D Other (specify) ~ I Number of Schedules K-1. Attach one for each person who was a partner at any time during tax year ~ 12 Caution: Include only trade or business income and expenses on lines 1a through 22 below. See the instructions for more information. . . 2 3 Income 4 5 6 7 8 9 10 11 12 Oeduc- 13 tlons (see 14 i nstru c- 15 tions for 16a limita- b tions) 17 18 19 20 21 22 . . . . Sign Here 1a Gross receipts or sales. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a 1b 1c o Cost of goods sold (Schedule A, line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Gross profit. Subtract line 2 from line 1c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule) . . . . . . . . . . . . Net farm profit (loss) (attach Schedule F (Form 1040)). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Net gain (loss) from Form 4797, Part II, line 17. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 4 5 6 o Other income (loss) (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Total Income (loss). Combine lines 3 through 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 o Salaries and wages (other than to partners) (less employment credits). . . . . . . . . . . . . . . . . . . . . . . . 9 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Repairs and maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Sad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Rent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Taxes and licenses. . . . . . . . . . . . . .. . ... . . . . . . . . ... . . . . . . .. . . . .. .. .. . . . . . . . .. .. ... .. 14 Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . . . 15 Depreciation (if required, attach Form 4562). . . . . . . . . . . . . . . . . . . 16a Less depreciation reported on Schedule A and elsewhere on return 16b 16c Depletion (00 not deduct 011 and gas depletion.). . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . 17 Retirement plans, etc. . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Employee benefit programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . 19 Other deductions (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Total deductions. Add the amounts shown in the far right column for lines 9 through 20. . . . . . . . . 21 o Ordinary business Income (loss). Subtract line 21 from line 8. . . . . . . . . . . . , . . . . . . . . . . . . . . . . 22 0 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than general partner or limited Iiabili company member) is based on all information of which preparer has any knowledge. May the IRS discuss this return with the preparer shown below (see inst.)? ~ Signature of general partner or limited liability company member manager Preparer's Date signature Firm's name (or yours Arnold A. Graham Company if self-employed), 25 South 5th Ave address,&ZIPcode Hi hland Park NJ 08904 For Privacy Act and Paperwork Reduction Act Notice, see separate Instructions. JVA 4 106512 TWF 8746A Copyright Forms (Software Only)- 2004 TW . Paid Preparer's Use Only . No Date Check if self- Preparer's SSN or PTIN employed ~ 0 0 0 8 3 044 EIN ~22-2370159 Phone no. 732-985-0460 Form 1065 (2004) F$~tHij:IIJ.i.iA\1 Cost of Goods Sold (see the instructions) 1 Inventory at beginning of year. .. . . . . . . . .... . .. . . . .. . 1 2 Purchases less cost of items withdrawn for personal use . . .. . . . . . 2 3 Cost of labor . . . . . . . . . . . . .. . . . 3 4 Additional section 263A costs (attach statement) .. . . . . . . . . . . . .. . . . . . 4 5 Other costs (attach statement) . . . .. . .. . ... . . . 5 6 Total. Add lines 1 through 5 . . . . . . 6 7 Inventory at end of year. . . .. . . . . . . . . . . . . . . . . . 7 8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 . . . . 8 9a Check all methods used for valuing closing inventory: (I) ~ Cost as described in Regulations section 1.471-3 (II) Lower of cost or market as described in Regulations section 1.471-4 (III) Other (specify method used and attach explanation) ~ b Check this box if there was a writedown of "subnormal" goods as described in Regulations section 1.471-2(c). . . . . . . . . . . . . . . . . .. ~ c Check this box if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970). . . . . . . . . . . . . .. ~ d Do the rules of section 263A (for property produced or acquired for resale) apply to the partnership? . . . . . . . . . . . . . . . . . .. 0 Yes e Was there any change in determining quantities, cost, or valuations between opening and closing inventory? . . . . . . . . . . . .. DYes If "Yes," attach explanation. l$qH~~q:I~J~\1 Other Information 1 What type of entity is filing this return? Check the applicable box: Yes a ~ 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Did the partnership file Form 8893, Election of Partnership Level Tax Treatment, or an election statement under section 6231 (a)(1 )(B)(ii) for partnership-level tax treatment, that is in effect for this tax year? See Form 8893 for more details. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If "Yes," the partnership is not required to complete Schedules L, M-1, and M-2; Item F on page 1 of Form 1065; or Item N on Schedule K-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Does this partnership have any foreign partners? If "Yes," the partnership may have to file Forms 8804, 8805 and 8813. See the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Is this partnership a publicly traded partnership as defined in section 469(k)(2)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? . . . . . . . . . . . . . . . . . . . . 9 At any time during calendar year 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 TO F 90-22.1. If "Yes," enter the name of the foreign country.~ 10 During the tax year, did the partnership receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If "Yes," the partnership may have to file Form 3520. See the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If "Yes," you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described under Elections Made By the Partnership in the instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to this return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ Designation of Tax Matters Partner (see the instructions) Enter oelow the general partner designated as the tax matters partner (TMP) for the tax year of this return: . S & M ASSOCIATES Form 1065 (2004) 22-6237744 . . Page 2 . . . . . . . . Name of designated TMP Address of designated TMP JVA 4 106512 ~ ~ 2467 Bay Identifying .. number ofTMP" 22 - 32115 73 Isle Court TWF 8743A Copyright Forms (Software Only) - 2004 TW No No No Form 1065 (2004) Form 1065 (2004) S & M ASSOCIATES 22 -6237744 :$Q.h""OiiKi: 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 statement). . . . . . . . , . . . . 3b c Other net rental income (loss). Subtract line 3b from line 3a . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . , . Guaranteed payments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dividends: a Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Qualified dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . 6b 7 Royalties......................................................................... 8 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . #.1 12 Section 179 deduction (attach Form 4562) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . 13a Contributions...................................................................... Deduc- b Deductions related to portfolio income (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . tlons 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 . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15a Low-income housing credit (section 420)(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 . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other credits and credit recapture (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16a Name of country or U.S. possession ~ b Gross income from all sources . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross income sourced at partner level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Foreign gross income sourced at partnership level . Listed categories d Passive ~ e (attach statement) ~ Deductions allocated and apportioned at partner level g Interest expense ~ h Other......................... ~ Deductions allocated and apportioned at partnership level to foreign source income . Listed categories General Passive ~ J (attach statement) ~ k Ii mitation ~ Foreign taxes: (1) Paid ~ (2) Accrued . . . . . . . . . . . . . . . . . . . . . . . ~ m Reduction in taxes available for credit (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17a 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 statement) . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . 18a 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . #.3 b Investment expenses. . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . c Other items and amounts (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 106534 TWF 8744A Copyright Forms (Software Only)- 2004 TW . . . . . Self- Em- ploy- ment . Credits & Cre- dit Re- capture . For- eign Trans- actions . . Alter- native Mini- mum Tax (AMT) Items . Other Infor- mation JVA . 4 5 Income (Loss) 6 f ~~~i~f~n Page 3 Total amount 138,186 228 1,753 10 11 12 13a 13b 13c 13d(2) 13e 14a 14b 14c 15a 15b 15c 15d 15e 15f 2,026 ~ 16k 161(2) 16m 17a 17b 17c 17d 17e 17f 18a 18b 18c 19a 19b 20a 20b 3,580 103,040 2,026 Form 1065 (2004) Analysis of Net Income (Loss) 1 Net income (loss). Combine Schedule K, lines 1 through 11. From the result, subtract the sum of Schedule K, I I lines 12 through 13e, 161(1), and 161(2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 142,193 2 Analysis by (I) Corporate (II) Individual (III) Individual (Iv) Partnership (v) Exempt vi) Nominee/Other partner type: (active) (passive) organization a General partners 63,206 b Umited partners 78,987 Note: Schedules L, M-1, and M-2 are not required if Question 5 of Schedule B is answered "Yes." $ijijijdijl~"tfm: Balance Sheets per 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 statement) . . . . 7 Mortgage and real estate loans . . . . . . . . . . 8 Other investments (attach statement). . . . . . 9a Buildings and other depreciable assets. . . . b Less accumulated depreciation. . . . . . . . . . 10a 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 statement) . . . . . . . . . . 14 Total assets ........................ Liabilities and Capital 15 Accounts payable. . . . . . . . . . . . . . . . . . . . . 16 Mortgages, notes, bonds payable in less than 1 year 17 Other current liabilities (attach statement). . . 18 All nonrecourse loans. . . . . . . . . . . . . . . . . . 19 Mortgages, notes, bonds payable in 1 year or more 20 Other liabilities (attach statement) .. . . . . . . 21 Partners' capital accounts. . . . . . . . . . . . . . . 22 Total liabilities and capital. . . . . . . . . . . . . . 'SMjjdUti\M81: 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 pymts. (other than health ins.) 4 Expenses recorded on books this year not included on Schedule K, lines 1 through 13e, 161(1), and 161(2) (itemize): a Depreciation $ b ~~~~~ia~g~ent $ . Form 1065 (2004) S & M ASSOCIATES . . . . . . . . . 1 5 Add lines 1 throu h 4. . . . . . . . . . . . . . . . . . Saimnmr:M#2 Anal sis of Partners' Ca 1 Balance at beginning of year. . . . . . . . . . . . 2 Capital contributed: a Cash ............ b Property . . . . . . . . . . 3 Net income (loss) per books . . . . . . . . . . . . 4 Other increases (itemize): 22-6237744 Page 4 30,376 2,500 461,467 463,967 7 er Return Income recorded on books this year not included on Sch. K, lines 1-11 (itemize): a Tax-exempt int. $ 3,580 Deductions included on Sch. K, lines 1 -13e, 161(1), and 161(2), not charged against book Inc. this year (itemize): a Depr. $ 3,580 1 145,773 ital Accounts 418,735 8 9 3,580 Add lines 6 and 7. . . . . . . . . . . . . . . . . . Income (loss) (Analysis of Net Income (Loss), line 1). Subtract line 8 from line 5. . . 142,193 Distributions: a Cash.............. b Property............ 6 103,040 7 Other decreases (itemize): 145,772 8 Add lines 6 and 7. . . . . . . . . . . . . . . . . . 9 Balance at end of year. Subtract line 8 from line 5 103,040 461,467 Form 1065 (2004) . 5 Add lines 1 throu h 4. . . . . . . . . . . . . . . . . . 564 , 507 JVA 4 106534 TWF 8745A Copyright Forms (Software Only) - 2004 TW Rental Real Estate Income and Expenses of a Partnership or an S Corporation ~ 5ee Instructions. ~ Attach to Form 1065, Form 1065-8, or Form 11205. . Form 8825 Department of the Treasury Internal Revenue Service OMS No. 1545-1186 2004 Employer Identification no. 2-6237744 . Name S & M ASSOCIATES 1 Show the kind and location of each property. See page 2 for additional properties. A Shopping Center, Sacramento, CA 8 . C o . . Rental Real Estate Income 2 Gross rents . . . . . . . . . . . . . . . . . . . Rental Real Estate Expenses 3 Advertising................... 4 Auto and travel . . . . . . . . . . . . . . . . 5 Cleaning and maintenance. . . . . . . 6 Commissions................. 7 Insurance.................... 8 Legal and other professional fees. . 9 Interest...................... 10 Repairs...................... 11 Taxes....................... 12 Utilities...................... 13 Wages and salaries.. . .. . . . . . . . . 14 Depreciation (see instructions). . . . . 15 Other (list) ~ MANAGEMENT See Attached . . 16 Total expenses for each property. Add lines 3 through 15 . . . . . . . . . . . Pro erties 2 A 239,167 D 8 C 3 4 5 6 7 8 9 10 11 12 13 14 8,485 1,350 20,466 15 19,123 51,557 16 100,981 17 Total gross rents. Add gross rents from line 2, columns A through H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 239,167 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 20a 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). . . . . . . . . . . . . . . . . . . . . . . . . . 20a 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 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . For Paperwork Reduction Act Notice, see Instructions. JVA 4 882512 TWF 8826 Copyright Forms (Software Only)- 2004 TW . . . 100,981 Form 8825 (2004) . 2004 DETAIL STATEMENTS S & M ASSOCIATES 22-6237744 Page 1 STATEMENT #1 - Other Income (Loss) (FORM 1065 PG 3 LINE 11) . Code F - Other income Refund of real estate taxes.... ..... 2,026 TOTAL Code F................................... 2,026 TOTAL CARRIED TO FORM 1065 PG 3 LINE 11................... 2,026 . STATEMENT #2 - Other Tax Exempt Income (FORM 1065 PG 3 LINE 18b) . Code B - Other Tax Exempt Income Vanguard Inter.-term Tax Exemp. ..... 3,580 TOTAL Code B. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,580 TOTAL CARRIED TO FORM 1065 PG 3 LINE 18b.................. 3,580 STATEMENT #3 - Investment Income (FORM 1065 PG 3 LINE 20a) . Code A - Investment income Investment income................... 2,026 TOTAL Code A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,026 TOTAL CARRIED TO FORM 1065 PG 3 LINE 20a.......... ........ 2,026 . STATEMENT #4 - Other Expenses (FORM 8825 LINE 15) . Lease negotiation costs........................ Service fees................................... Out of pocket reimbursements................... 50,000 57 1,500 TOTAL CARRIED TO FORM 8825 LINE 15................ ......... 51,557 . . . . JVA Copyright Forms (Software Only) - 2004 TW 508185 LSSTMT . 2004 PARTNERS CAPITAL ACCOUNT SUMMARY S & M ASSOCIATES 22-6237744 . Partner Profit Sharing Capital at Capital Partners' Share Withdrawals & Capital at End Number Percentage Beginning of Year Contributed of Lines ~ 4 & 7, Distribution of Year Sch -2 #1 22.23 92,957 0 32,398 22,901 102,454 #2 22.23 92,963 0 32,398 22,901 102,460 #3 5.56 23,276 0 8,098 5,724 25,650 #4 5.56 23,276 0 8,098 5,724 25,650 #5 5.56 23,286 0 8,098 5,724 25,660 #6 5.56 23,286 0 8,098 5,724 25,660 #7 5.56 23,276 0 8,098 5,724 25,650 #8 5.56 23,276 0 8,098 5,724 25,650 #9 5.56 23,290 0 8,098 5,724 25,664 #10 5.56 23,276 0 8,098 5,724 25,650 #11 5.56 23,286 0 8,098 5,724 25,660 #12 5.56 23,287 0 8,094 5,722 25,659 TOTALS 100.00 418,735 0 145,772 103,040 461,467 JVA Copyright Forms (Software Only) - 2004 TW L0708M 4_PTK1RW . . . . . . . . . . I!M&TBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 April 12, 2005 . Mette, Evans & Woodside Attorneys At Law 3401 North Front Street POBox 5950 Harrisburg, Pennsylvania 17110-0950 . . Re: Estate of: Dr H Clarke Staab Social Securitv: 195-30-0754 Date of Death: Februarv 14, 2005 Dear Sir or Madam: Per your inquiry dated April 01, 2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account . Account Number 3440029381 Ownership (Names oj) Dr H Clarke Staab * Opening Date 09/29/97 Closed 03/07/05 . Balance on Date of Death $2,062.21 Accrued Interest $ 0.02 Total $2,062.23 . 2. Type of Account Home Equity Loan Account Number 629355 Ownership (Names oj) Dr H Clarke Staab * . Opening Date 12/27/00 Balance on Date of Death $2,652.55 Current Balance $ 00.00 . Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the Trindle Road Office # 717-737- 2308. Sincerely, . -~~//~~ Nancy Clagett Records Management . MAY-02-2005 21:58 PNCBANK 412 768 3458 P.01/01 . 0PNCBAN< . May 03, 2005 . Mette, Evans & Woodside Attn: Lisa J Knode 3401 N Front St. POBox 5950 Ramsburg, P A 17110-0950 RE: Estate ofB Clarke Staab (Deceased) SSN: 195-30-0754 DOD: 02-14-2005 Dear Mr. Knode: scp . . In response to your request for Date of Death balances for the customer noted above, OUt records show the following: CheekiDg Ac:eount Account #5070032123 Established 03-01-1979 H CLARKE STAAB DOD balance: $3,266.82 + $0.13 accrued interest .' Account #5140237627 Established 12-01-1977 H CLARKE STAAB DOD balance: $125,330.84 + $3.42 accrued interest Savings Account . Account #5000985615 Established 05-30-1997 H CLARKE STAAB DOD balance: $55,373.59 + $S3.94 accrued interest . Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not proees. aay flnanclal transactions or provide statement.. If you need assistance with any of these items, please call1-888-PNC-BANK. (1-888-762-2265) or stop by your local PNC Bank branch office, . S~ly, ~ -;:(-~ Erica L Schlegel 1-800-762-1775 P7-PFSC-04-F 500 Fir.it Ave. Pittsburgh l>A 15219 Membcir FDIC . TOTAL P.01 . Kelley Blue Book - Private Party Pricing Report - Dodge, Durango . Page 1 of2 Kelley Blue Book THETRUSTED RESOURCE' l:b!tco. ove75 ) . Our employee cliscount, plus up to $4500 cash allO\l.Tance 55l1OT0I\o1.00 O;:ASK"'U~~ DP~I~rnllC(m MOOER ATPARTICIPATIW(l oe~ER$lON ~DD5"'lODE't,$ SEe DEAl.ER F,JRPHAlI,S U SEO CARS Q Search Used Car Listings . . BLUE BOOKst PRIVATE PARTY REPORT Pennsylvania · September 20,2005 2000 Dodge Durango Sport Utility 40 . BLUE BOOK CLASSIFlEDS" Search Used {or Listings Engine: VB 4.7 Liter Trans: Automatic Drive: 4WD Mileage: 40,000 -Equipment SLT Air Conditioning Power Steering Power Windows Power Door Locks S~i;lI~bjJ?tings for This C~[ List Your Car For Sale Online Quick New Car Price Quote free CARFAX Record Check Auto Loans from 4.99% APR Insurance Quote Print "For Sale" ~lgfl Payment Calculator Quickly browse through over 600,000 used vehicle listings to find exactly the car or truck you want. - advertisement _ . Tilt Wheel Cruise Control AM/FM Stereo Single Compact Disc Dual Front Air Bags Third Seat Roof Rack Alloy Wheels Consumer Rated Condition: Good "Good" condition means that the vehicle is free of any major defects. This vehicle has a clean title history, the paint, body and interior have only minor (if any) blemishes, and there are no major mechanical problems. There should be little or no rust on this .vehicle. The tires match and have substantial tread wear left. A "good" vehicle will need some reconditioning to be sold at retail. Most consumer owned vehicles fall into this category. Private Party Value~earch--,=-oq'll Listings I J..ist ThL~Car for Sal~ $10,495 Private Party Value is what a buyer can expect to pay when buying a used car from a · private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. . Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars Ge.tj:j-12J'1jm.tle_ggsPQJlS~_W he n Y_Qq-~RPJY_fQUl Bla.nk Check@__~!JtQ.J&i'ln a Ittp://www.kbb.comlkblki.dlllkw.kc.ur?kbb.P A;443489;P A041 & 17055 ;suv+p&722;Dodge;2000%20Dur... 9/20/2005 . Date of Death: 02/14/2005 Valuation Date: 02/14/2005 Processing Date: 09/27/2005 . . . . . . . . . Shares or Par 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) Security Description 250 HSBC HLDGS PLC (404280406) SPON ADR NEW New York Stock Exchange 02/14/2005 450 GLAXOSMITHKLINE PLC (37733WI05) SPONSORED ADR New York Stock Exchange 02114/2005 225 GOLDMAN SACHS GROUP INC (38141GI04) COM New York Stock Exchange 02/14/2005 Estate Valuation High/Ask 85.64000 47.97000 Low/Bid 85.29000 H/L 47.52000 H/L 113.38000 111.69000 H/L Div: 0.25 Ex: 01/21/2005 Rec: 01/25/2005 Pay: 02/24/2005 900 GAP INC DEL (364760108) COM New York Stock Exchange 02/14/2005 21.67000 21. 37000 H/L Div: 0.0222 Ex: 02/04/2005 Rec: 02/08/2005 Pay: 02/23/2005 375 GENERAL MLS INC (370334104) COM New York Stock Exchange 02/14/2005 400 GENERAL ELEC CO (369604103) COM New York Stock Exchange 02/14/2005 200 GANNETT INC (364730101) COM New York Stock Exchange 02/14/2005 300 FEDEX CORP (31428XI06) COM New York Stock Exchange 02/14/2005 575 FIRST DATA CORP (319963104) COM New York Stock Exchange 02/14/2005 6775 ISHARES INC (464286848) MSCI JAPAN American Stock Exchange 02/14/2005 250 E ON AG (268780103) SPONSORED ADR New York Stock Exchange 02/14/2005 52.68000 36.40000 81. 27000 97.76000 41. 06000 10.74000 92.30000 Page 1 52.44000 H/L 36.20000 H/L 80.01000 H/L 95.89000 H/L 40.59000 H/L 10.65000 H/L 91. 74000 H/L Estate of: Staab.HClarke.IRA Account: 12870-0001 Report Type: Date of Death Number of Securities: 73 File ID: Staab.HClarke.IRA Mean and/or Div and Int Security Adjustments Accruals Value 85.465000 47.745000 112.535000 21. 520000 52.560000 36.300000 80.640000 96.825000 40.825000 10.695000 92.020000 21,366.25 21,485.25 25,320.38 56.25 19,368.00 19.98 19,710.00 14,520.00 16,128.00 29,047.50 23,474.38 72,458.63 23,005.00 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) . . Date of Death: 02/14/2005 Valuation Date: 02/14/2005 Processing Date: 09/27/2005 . Shares or Par Security Description 12) 450 ENEL SOCIETA PER AZIONI (29265W108) ADR New York Stock Exchange 02/14/2005 . 131 1850 E M C CORP MASS (268648102) COM New York Stock Exchange 02/14/2005 14) 625 ELECTRONIC DATA SYS NEW (285661104) COM New York Stock Exchange 02114/2005 . High/Ask 49.95000 13.19000 20.17300 Estate of: Staab.HC1arke.lRA Account: 12870-0001 Report Type: Date of Death Number of Securities: 73 File ID: Staab.HC1arke.lRA Low/Bid Mean and/or Div and Int Security Adjustments Accruals Value 49.55000 H/L 49.750000 12.97000 H/L 13.080000 19.99000 H/L 151 Div: 0.050000 Ex: 02/11/2005 Rec: 02/15/2005 Pay: 03/10/2005 20.081500 + 0.050000 20.131500 500 DUKE ENERGY CORP (264399106) COM New York Stock Exchange 02/14/2005 . 27.60000 27.12000 H/L 27.360000 16) Div: 0.275 Ex: 02/09/2005 Rec: 02/11/2005 Pay: 03/16/2005 525 DISNEY WALT CO (2546871061 COM DISNEY New York Stock Exchange 02/14/2005 17) 600 DANAHER CORP DEL (235851102) COM New York Stock Exchange 02/1412005 . 18) 350 CHEVRON CORP NEW (166764100) COM New York Stock Exchange 02114/2005 . 29.44000 55.61000 58.37000 29.00000 H/L 29.220000 55.03000 H/L 55.320000 57.70000 H/L 19) Div: 0.400000 Ex: 02/14/2005 Rec: 02/16/2005 Pay: 03/10/2005 58.035000 + 0.400000 58.435000 625 CREDIT SUISSE GROUP (225401108) SPONSORED ADR New York Stock Exchange 02/14/2005 . 20) 525 COSTCO WHSL CORP NEW (22160K105) COM NASDAQ - Industrial 02/14/2005 42.66000 46.76000 42.40000 H/L 42.530000 46.15000 H/L 46.455000 21) Div: 0.1 Ex: 02/04/2005 Rec: 02/08/2005 Pay: 02/25/2005 275 CONOCOPHILLIPS (20825C104) COM New York Stock Exchange 02/14/2005 . 101. 61000 99.59000 H/L 22) Div: 0.500000 Ex: 02/11/2005 Rec: 02/15/2005 Pay: 03/01/2005 100.600000 + 0.500000 101.100000 . 175 COMERICA INC (200340107) COM New York Stock Exchange 02/14/2005 58.76000 Page 2 58.06000 H/L 58.410000 22,387.50 24,198.00 12,582.19 13,680.00 137.50 15,340.50 33,192.00 20,452.25 26,581.25 24,388.88 52.50 27,802.50 10,221. 75 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) . . Date of Death: 02/14/2005 Estate of: Staab.AC1arke.IRA Valuation Date: 02/14/2005 Account: 12870-0001 Processing Date: 09/27/2005 Report Type: Date of Death Number of Securities: 73 File ID: Staab.HC1arke.IRA Shares Security Mean and/or Div and Int Security . or Par Description High/Ask Low/Bid Adjustments Accruals Value 23) 350 CATERPILLAR INC DEL (149123101) COM New York Stock Exchange 02/14/2005 93.19000 91.87000 H/L 92.530000 32,385.50 Div: 0.41 Ex: 01/18/2005 Rec: 01/20/2005 Pay: 02/19/2005 143.50 . 24) 525 BT GROUP PLC (05577E101) ADR New York Stock Exchange 02/14/2005 40.60000 40.28000 H/L 40.440000 21,231. 00 251 400 BAS F A G (0552625051 SPONSORED ADR New York Stock Exchange . 02/14/2005 72.70000 72.05000 H/L 72.375000 28,950.00 26) 475 ASTRAZENECA PLC (046353108) SPONSORED ADR New York Stock Exchange 02/14/2005 39.45000 39.00000 H/L 39.225000 18,631.88 Div: 0.645 Ex: 02/09/2005 Rec: 02/11/2005 Pay: 03/21/2005 306.38 . 27) 400 AMERICAN EXPRESS CO (025816109) COM New York Stock Exchange 02/14/2005 55.16000 54.40000 H/L 54.780000 21,912.00 28) 275 ALLTEL CORP (020039103) COM . New York Stock Exchange 02/14/2005 55.75000 55.40000 H/L 55.575000 15,283.13 29) 400 ANADARKO PETE CORP (032511107) COM New York Stock EXChange 02/14/2005 69.51000 67.95000 H/L 68.730000 27,492.00 . 30) 500 ALLSTATE CORP (020002101) COM New York Stock Exchange 02/14/2005 53.42000 52.80000 H/L 53.110000 26,555.00 31) 650 ALBERT SONS INC 10131041041 COM . New York Stock EXChange 02/14/2005 23.51000 22.95000 H/L 23.230000 15,099.50 32) 625 WASHINGTON MUT INC (939322103) COM New York Stock Exchange 02/14/2005 41.14000 40.41000 H/L 40.775000 25,484.38 . Div: 0.46 Ex: 01/27/2005 Rec: 01/31/2005 Pay: 02/15/2005 287.50 33) 250 UNITED TECHNOLOGIES CORP ( 913017109) COM New York Stock Exchange 02/14/2005 101.43000 100.60000 H/L 101.015000 25,253.75 . Page 3 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) . . Date of Death: 02/14/2005 Valuation Date: 02/14/2005 Processing Date: 09/27/2005 . Shares or Par Security Description 34) 725 US BANCORP DEL (902973304) COM NEW New York Stock Exchange 02/14/2005 . 35) 250 UBS AG (H8920M855) NAMEN ART New York Stock Exchange 02/14/2005 36) 175 TOTAL S A (89151E109) SPONSORED ADR New York Stock EXChange 02/14/2005 . 37 ) 200 SUNTRUST BKS INC (867914103) COM New York Stock Exchange 02/14/2005 38 ) High/ASk 30.38000 87.41000 Estate of: Staab.HClarke.IRA Account: 12870-0001 Report Type: Date of Death Number of Securities: 73 File ID: Staab.HClarke.IRA Low/Bid Mean and/or Div and Int Security Adjustments Accruals Value 30.16000 H/L 86.89000 H/L 111.52000 110.80000 H/L 73.00000 . 2400 BANCO SANTANDER CENT HISPANO (05964H105) ADR New York Stock Exchange 02/14/2005 12.71000 39) 638 SANOFI AVENTIS (80105N105) SPONSORED ADR New York Stock Exchange 02/14/2005 . 40) 375 SONY CORP (835699307) ADR NEW New York Stock Exchange 02/14/2005 41) 200 SIEMENS A G (826197501) SPONSORED ADR New York Stock Exchange 02/14/2005 . 42) 575 ROYAL DUTCH PETE CO (780257804) NY REG EUR .56 New York Stock EXChange 02/14/2005 . 37.72000 38.19000 79.58000 59.15000 72.52000 H/L 12.62000 H/L 37.44000 H/L 37.85000 H/L 78.94000 H/L 58.75000 H/L 43) Div: 0.99482 Ex: 02/04/2005 Rec: 02/08/2005 Pay: 03/15/2005 250 PROCTER & GAMBLE CO (742718109) COM New York Stock Exchange 02/14/2005 52.82000 52.33000 H/L . 44) Div: 0.25 Ex: 01/19/2005 Rec: 01/21/2005 Pay: 02/15/2005 1300 NISSAN MOTORS (654744408) SPONSORED ADR NASDAQ - Industrial 02/14/2005 45) 1050 MICRON TECHNOLOGY INC (595112103) COM New York Stock Exchange 02/14/2005 . 21.72000 11. 83000 Page 4 21. 40000 H/L 11.51000 H/L 30.270000 87.150000 111.160000 72.760000 12.665000 37.580000 38.020000 79.260000 58.950000 52.575000 21.560000 11.670000 21,945.75 21,787.50 19,453.00 14,552.00 30,396.00 23,976.04 14,257.50 15,852.00 33,896.25 572.02 13,143.75 62.50 28,028.00 12,253.50 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) . . Date of Death: 02/14/2005 valuation Date: 02/14/2005 Processing Date: 09/27/2005 . 46) . 47) 48) . 49) . 50) 51 ) . 52) . 53) 54) . 55) . 56) . Shares or Par Security Description 600 MICROSOFT CORP (594918104) COM NASDAQ - Industrial 02/14/2005 175 MERCK & CO INC (589331107) COM New York Stock Exchange 02/14/2005 1300 MATSUSHITA ELEC INDL (576879209) ADR New York Stock Exchange 02/14/2005 925 LAFARGE COPPEE S A (505861401) SPON ADR NEW New York Stock Exchange 02/14/2005 400 LOWES COS INC (548661107) COM New York Stock Exchange 02/14/2005 250 LOCKHEED MARTIN CORP (539830109) COM New York Stock Exchange 02/14/2005 375 LEHMAN BROS HLDGS INC (524908100) COM New York Stock Exchange 02/14/2005 High/ASk 26.12000 29.45000 15.17000 26.28000 59.53000 59.99000 94.38000 Low/Bid 25.91000 H/L 29.02000 H/L 15.01000 H/L 26.00000 H/L 58.95000 H/L 59.37000 H/L 93.68000 H/L Div: 0.2 Ex: 02/09/2005 Rec: 02/11/2005 Pay: 02/22/2005 275 KIMBERLY CLARK CORP (494368103) COM New York Stock Exchange 02/14/2005 600 KLA-TENCOR CORP (482480100) COM NASDAQ - Industrial 02/14/2005 300 JOHNSON & JOHNSON (4781601041 COM New York Stock Exchange 02/14/2005 68.29000 50.17000 66.61000 67.54000 H/L 49.26000 H/L Div: 0.285000 Ex: 02/11/2005 Rec: 02/15/2005 Pay: 03/08/2005 65.80000 H/L 500 INTL PAPER CO (460146103) COM New York Stock Exchange 02/14/2005 37.44000 Page 5 37.23000 H/L Estate of: Staab.HClarke.IRA Account: 12870-0001 Report Type: Date of Death Number of Securities: 73 File ID: Staab.HClarke.IRA Mean and/or Div and Int Security Adjustments Accruals Value 26.015000 29.235000 15.090000 26.140000 59.240000 59.680000 94.030000 67.915000 49.715000 66.205000 + 0.285000 66.490000 37.335000 15,609.00 5,116.13 19,617.00 24,179.50 23,696.00 14,920.00 35,261.25 75.00 18,676.63 29,829.00 19,947.00 18,667.50 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (8181 313-6300 or www.evpsys.com. (Revision 7.0.41 . . Date of Death: 02/14/2005 Valuation Date: 02/14/2005 Processing Date: 09/27/2005 . Shares or Par Security Description 57 ) 975 INTEL CORP (458140100) COM NASDAQ - Industrial 02/14/2005 High/ASk 24.39000 Estate of: Staab.HClarke.lRA Account: 12870-0001 Report Type: Date of Death Number of Securities: 73 File ID: Staab.HClarke.lRA Low/Bid Mean and/or Div and Int Security Adjustments Accruals Value 24.00000 H/L . 581 Div: 0.08 Ex: 02/03/2005 Rec: 02/07/2005 Pay: 03/01/2005 641 ING GROEP N V (456837103) SPONSORED ADR New York Stock Exchange 02/14/2005 59) 650 SAN PAOLO-IMI SPA (799175104) SPONSORED ADR New York Stock Exchange 02/14/2005 . 601 375 ISHARES TR (4642875561 NASDQ BIO INDX American Stock Exchange 02/14/2005 . 61) 425 HITACHI LIMITED (433578507) ADR 10 COM New York Stock Exchange 02/14/2005 62) 225 AMERICAN INTL GROUP INC (026874107) COM New York Stock EXChange 02/14/2005 . 63) 825 AXA (054536107) SPONSORED ADR New York Stock EXChange 02/14/2005 . 641 650 BAKER HUGHES INC (057224107) COM New York Stock EXChange 02/14/2005 29.75000 29.15000 71. 40000 63.65000 72.50000 25.13000 46.95000 29.53000 H/L 28.86000 H/L 70.76000 H/L 63.14000 H/L 70.34000 H/L 24.94000 H/L 46.30000 H/L 65) Div: 0.115 Ex: 02/03/2005 Rec: 02/07/2005 Pay: 02/18/2005 525 BARCLAYS PLC (06738E204) ADR New York Stock Exchange 02/14/2005 . 66) 850 BELLSOUTH CORP (079860102) COM New York Stock Exchange 02/14/2005 . 671 675 DELL INC (24702R101) COM NASDAQ - Industrial 02/14/2005 681 46.29000 26.55000 40.05000 . 2400 MITSUBISHI TOKYO FINL GROUP (606816106) SPONSORED ADR New York Stock Exchange 02/14/2005 9.66000 Page 6 45.79000 H/L 26.22000 H/L 39.52000 H/L 9.52000 H/L 24.195000 29.640000 29.005000 71. 080000 63.395000 71. 420000 25.035000 46.625000 46.040000 26.385000 39.785000 9.590000 23,590.13 78.00 18,999.24 18,853.25 26,655.00 26,942.88 16,069.50 20,653.88 30,306.25 74.75 24,171.00 22,427.25 26,854.88 23,016.00 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions. please contact EVP Systems at (8181 313-6300 or www.evpsys.com. (Revision 7.0.4) . . Date of Death: 02/14/2005 Valuation Date: 02/14/2005 Processing Date: 09/27/2005 . Shares or Par Security Description 69) 1100 NOMURA HLDGS INC (65535H208) SPONSORED ADR New York Stock Exchange 02/14/2005 . 70) 325 OCCIDENTAL PETE CORP DEL (674599105) COM New York Stock Exchange 02/14/2005 71) 1850 ORACLE CORP (68389XI05) COM NASDAQ - Industrial 02/14/2005 . 72) 1300 SIEBEL SYS INC {826170102} COM NASDAQ - Industrial 02/14/2005 73) 325 NATIONAL CITY CORP (635405103) COM New York Stock Exchange 02/14/2005 . . Total Value: Total Accrual: Total: $1,614,827.75 Plus Money Market Funds: $21,471.51 TOTAL VALUE OF IRA ACCOUNT: . $1,636,299.26 . . . High/Ask 14.07000 66.23000 13.38000 8.83000 36.28000 Page 7 Low/Bid 13.88000 H/L 64.98000 H/L 13.23000 H/L 8.65000 H/L 35.74200 H/L Estate of: Staab.HClarke.IRA Account: 12870-0001 Report Type: Date of Death Number of Securities: 73 File ID: Staab.HClarke.IRA Mean and/or Div and Int Security Adjustments Accruals Value 13.975000 65.605000 13.305000 8.740000 36.011000 15,372.50 21,321.63 24,614.25 11,362.00 11,703.58 $1,612,961.87 $1,865.88 This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions, please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4) . . 1.T~~~m~^ . Transamerica Life Insurance and Annuity Company Home Office: Charlotte, North Carolina Administrative Office: 4333 Edgewood Road NE PO Box 3183 Cedar Rapids, Iowa 52406-3183 April 28, 2005 . Howell C Mette Attn: Lisa J Knode 8401 North Front Street PO Box 5950 Harrisburg PA 17110-0950 . RE: Annuity Number(s) 007407613 Dear Howell C Mette: . Our office has received your request concerning the above listed non- qualified tax deferred annuity. . A Form 712 is not issued on tax deferred annuities. The taxable portion of this policy will be reported on a Form 1099-R as taxable to the beneficiary upon receipt of the funds. The value as of 02/14/2005, the date of death for H Clarke Staab is $205,532.71. The accrued interest to 02/14/2005 was $25,532.71. This annuity was owned solely by H Clarke Staab. The death claim on this annuity was paid out to the named beneficiary on 03/31/2005. . Our records do not reflect any transactions made in the year prior to H Clarke Staab's death. We have forwarded your request for a duplicate statement to our . Customer Care Center for processing. . . . Member of the _EGON. Group . Any additional questions regarding this annuity can be directed to the Annuity Service Center at 1-800-821-9090. A Transamerica Life Insurance and Annuity Company representative will gladly assist you with any questions you may have regarding this annuity and help you . meet your financial goals. Sincerely, . ~u~n Carrie Allen Claims Transamerica Life Insurance and Annuity Company . . . . . . . . . i.T~~~fr!!~~ Transamerica Occidental Life Insurance Company Home Office: Cedar Rapids, IA 52499 Transamerica Life Insurance and Annuity Company Home Office: Charlotte, NC 28202 . Administrative Office I 100 Walnut St., Ste. 2400 Kansas City, MO 64106-2152 Mailillg Address P.O. Box41952I Kansas City, MO 64] 41-6521 . April 28, 2005 . Howell C Mette Attn: Lisa J Knode 8401 North Front Street PO Box 5950 Harrisburg, PA 17110-0950 . RE: Annuity Number(s) 007407613 Dear Ms. Knode: Thank you for the recent inquiry on the above listed non-qualified annuity for H. Clarke Staab (deceased). . Our records indicate this annuity was established on July 3, 2002 and was paid out in a death claim on March 31, 2005. There were no additions to or distributions form this annuity during that time period. The following is the value information for February 2005: . Value as of 02/01/2005 Value as of 02/28/2005 $205,245.80 $205,842.14 Transamerica Life Insurance and Annuity Company is a member of the Insurance Marketplace Standards Association (IMSA), an organization . committed to high ethical marketplace standards in the sale and service of individual life insurance and annuities. If you have any questions or concerns, you may call our customer service line. Our toll free customer service line, 1-800-821-9090, is available Central Time from 7:00 AM to 6:00 PM Monday-Thursday and Friday 7:00 AM to 4:30 PM. . Sincerely, . '-Il7~~ Customer Care Group/mk Transamerica Life Insurance and Annuity Company .