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;
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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)
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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)
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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
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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
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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
.
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..
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
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Ouestions
~ e-Services
~ Tax Rates
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Zones
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Prooram
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Advocate
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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
.
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* 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
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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)
.
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TXU Corp. (TXU)
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'''' '~lb' ,.1J,j" or.:[
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Historical Prices
I GO I Symbol Lookup I Finance Search
At 4:01PM ET: 106.40 "1.40 (1.33%)
SciJttiade-
11'{[']:~:I:1:iI:I'''.'fjnJ:. ::I':II'tjrj"J =::1
Still Just $7.
IGOI
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ADVERTISEMENT
'ET DATE RANGE
Start Date: Feb
Eg. Jan 1,
2003
@Daily
o Weekly
o Monthly
o Dividends Only
14
14
2005
2005
End Date: Feb
.
Get Prices
First I Prey I Next I Last
flRICES
Date
Volume
Adj
Close*
Open
High
Low
Close
14-Feb-05
75.79
78.40
75.78
77.94 2,320,000
76.38
* Close price adjusted for dividends and splits.
.
First I Prey I Next I Last
A Download To Spreadsheet
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@ Add tQ2ortfoliQ '41' Set Alert B Email to a Fr:i~nd
.
lttp://finance.yahoo.com/q/hp?s=TXU&a=Ol&b= 14&c=2005&d=0 1 &e= 14&f=2005&g=d
9/16/2005
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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
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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
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.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
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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..
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j+:-CLrm,:r.,both'residing at 18 E;,~3i: CllY.;r~, 11,:,())>:~:)tl)\m, 1,18\'1 JCI:~';I~Y;
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,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
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'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 .
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'.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
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(' .;, '.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",,'""\,
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'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~.:
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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' ..,._
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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
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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
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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.
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6. J''IOR'l'GI\GINIG
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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_
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LIABILI'l'Yj OF LIMITE~D PAR'rNERS
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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
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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. . ;
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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
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J.2. BANKING
.
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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. ,
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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.
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14. JlOO:t{S
.
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'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~'-,:;:';':':";',..,
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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-
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11). )n~;A'.l'H OF A J,JJ.JJ't'J':D j-'.!';;'e1.'.I"':R
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"'ht~ T\J..I::'flt";-cc.:1:,J.l) j-l(JI...
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'.;'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 .
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'.i'hn F'l:r:j.ll'.'....~;Jjip l,I;'Y b~= .i:I?~nninated by U).e GI.:J)f':cal
:,','(,i"jf'l:~;, or lhe ::.>1.11.":;../'):1.. ,:):i3 -:h''j;),j)):'.'i.cu.- tl) U)I~ cmd of it~; tC!J.-m,
1...... ',' 'j'I' 1 ..,..,.t. 1-111.....J.Y i'.")) 11".,.. .. "'.)" .. .)...J......1 l' -J.; ..,.., l..,y J.1,,, (./..1.1....11
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. :,':, "1"):~;3, OJ:" ":'-H= sU:CVJ.vGr Tt "",(,]'1, i.'0 I';C 1 ('J!: ;'~)C ..,:11/'I:1.":t.:( Par".))I''!J:S.
i"ll :;L!f"11 1.',""11'., C)): .i.n 'l:he c:~,c::rd: I:'f ; )!(! (~ ,,:'1'1, ).'.~i'-i.J:t ;'t..lli:, 'l1."i.11:3i1nit.y
," . t 1 .., ] "'1 !, I l] (' 1"'\' I 1 . ,
(l( "i.''-';(:'.l.'' "";!''':-,'(l. J..-I'Ci.:ner, 'l:'1e J:'.i,"'r;l. .; ;U.l:.....:.~3 tl:c '~J1::; t-i"":l.1n:l.llg
('1:, 1'-'~;l.1, l~."oJ:I.'.., J~ :.h,'.1l 'iV:i.j')r1lup c~nd J 'i~l'lj.d.,:.(~ .; hf'.! Pol:r:lj;(.'.1:~3hi1? l)y eil.ll".t-
. - . -' 11 1': I' .-] l' :) .. 1
ell. J.11.J, 1".1. ".le 1:0. .1)W.ln9 m'-ri"1!.('I,-_S:
() i'J]' '1 I I' d '1' J "I
\;1 [jq...'I.llIJ L,l.e P;i.[ :.neJ:'S:L1P a.ij:.::(~t.S lill.' (1:,,:.(.1..'1.1'-'
t..i 1l(1 th e ~1,~ i: 1'.' ',-. -I::' ''''11,.- t. h C",' I') r.., .('....1 :,'0.;.. f:' r t I1P ");1"1':' ':.1')'.... 0 f p..., '," t r ('r" 11 "Ll)
;;J .... '.".:> ..... _.. .,-'.... ...._.I. ." _. . __ 1-.. .1.1,. 1... ....... ,. .... ,:> .
l.i..abi.liLio~"3 to ,'.'<')1.:11 ).-'a.l:tj)I.~).i in :,'aL.i uLlct.i.on uf his illb:>re:;t in tho
P ;!. ... ~:lle.t. ::;hip.
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1);) !.' i:, ;;::.1: S in ]<-j.jJ(l, I~a.ch pLil' I".~<~('r ;, '.:C :.'ld..j ))'.1 '.'.il 1) ""LLvo.i (.1 r: cl .i n i.(~:,.- (,:5 -l: in
:'l!l~ ;.),jX'i'.IH'J:~J.}lip's <l~;;;cts, s:I.'!JJ:i(~c;t :.() :i.t:; l;;'b:i.J.:LLi.,:.s, .i.n :.>dt.i.sfilCt.lf)l1
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Upon cot.IPleu. all 0 l' the lei. '1ui,]o ti. on, t: h~ ,1' artn "" "h 5. P
~:h.IJ 1 }:'.: d(!c.I).-..d C()'~PJ.l.:::C!J.y f].i,:.,:solvc:d a.nd tr.:.c,i! i.na'i':ed.
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:;.'hr.~ lY"-':";',.:;,;:1~; ut J; 'i,jl.d;; l.j 1))1 :;h:l.1.l bn I1L..;t:.l.-.i.hll'h~r1
;is r:t...1J.i.;~,-~'d in P:<:.l:""",:'nl: l)f 'Ille li..';1,:'.i'l.i.::i,.:;; ("of f:1J(~ FaJ:i:n(~r:;;;lip 5n the
:(L)110'.-ling nJ.-dej:: (1) h) c.rddi::UJ:':3 (:or ;;H~ P....l:i:rw:....~:;Jti.p, ,"Jj!d (:2) to
al.l of t!w 1?d.1."i.nl~l.-S (C.':;)i..'1.';:1.1, ;1,J!1 J,;'.)i.tc.:.d) in J't::,pc;ct of l-J)(..i.:c c;'pital
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'1.h" G."".,.,'l P"d: t"..,,,,; "}-,,'.l1 ".',t bo ,>c., ,J"n,oUy 'li.a.ble [:0 Ule I<i'".i,I."d
1"nt "ors for ""Y 'J ":'.lei t jn <he .L':.."j, h,d P,.IHner s' capi t:al aCCc'lllt
rYe :for t.h e. J: t~ t .11J: n ()f t.:lH~ 5.1:: (: (Jll;:.l: 5.1:., l t.i.lJn.,
.
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.Tn tUG l~V(~ilt o:r .1 ,.J.'11.l10,:l:'l.ng Cl.::;I'.J:J.J)U :l.on (j:
:. he Pil..'l:r,c.>,3hIp'" f":'''l'cU,y in )':"'.d, .lJlC ." ;d, lnai'ket ',Talue of "ueh
p 1: c>perty ;:)", U be d d'..,''''''' 5. n"<1 Ly 'n1 ." lOpr ',i 'J ers e 1 ected by U1e G ('n, 'J: a 1
P" ,,:. ['0 r s ''''".1 '?i'ch nCl ,c 1.",;,,. ,., ),'1.'-1 .<: ':c" i" on" "md i v idod in bo"..." t ill
"'.":h i,,:olO,r ty equal to th.e 1'.0,,,, .J" il ,jf lho l'.'.""",ed5 to "hI eh h" \/')!lld
bo "n ::,i, 1",d ''''''0,. Pa1:"Si',-,ph 'I h""""'f if """h F>.'Opcrty were "Qld.
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]?OT'iER 01" l\'i. 'J.'r)i'i.!;~y
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1';'."'h qf the Um.i, hod 1'..1"1:;,c..:,, h"",,,to >::on"t.i. tut,,"
;. r If.'l .-.];.'{.t.j i 1: i.s tJ 10 l~'":.)h!.1';'11 B1a.r t.'1())." s, i.:h 0 L:nlo ,.end la Wfll1 a 'l: f;O:l:!ley :1:01..'
U, ,. @':"''':;:i"" >':'>1 , to "",)0", ex ceu"", , si. ~ n , 0 ': k ';c"., 1. ">:1,, '" , "nd '''i.l e a
(' '. LU.k 0.1 '" ".f',J,,;. hid>:: iv:lt ," n,' ..;1, i p Or "'"'.."'L";,,.,f'." U" ;),' C' 1;0 , ''''01 upon
I.'."i..,i"" 1:5"n ,,j' 1.1", r"r:"".,:r:r;)1.Lp, '.1 C".HiLie"t.8 of Dic'''>J.(lU.on, "s
"",,, j,., .,] "."," .C" h" .1. ""; of i :.h c ,; .:. ,., t" of 1;,,'1,' J e", C ey, ""'.] 1.0 j" '" }ud ~
'.1. ,.(.j)l .'~l !._"-.. ... .'-i.'ll -:,'1."......1 J.y ."11" 1"1' ..J:: '.'11'.'11 "".,J,o 't).),~ "1"'0
· "'. 'L'''':J..., . ;". ",,,' ., " c ',,, ,..... ,,' . , """ ..,.., "L 0 _~ .n,...,. " ., ,,-,
h) ,,," I,,,, ";""lJ'", ,; iU u, "." n'n1., J~c, "lJ<1 .f.i .1." Such oth er ins ""'u'l>ents
,,. "'.'y ')" ". lJi... 1 --."'.'J..' .l.l!,.... 1 '". (l.f "'1" "'.'11, r:i~ J.1'.'\1 J>r"'.."y '1'110
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Cr "."-;j'/ 11... '1',., -.' ;,. ., .;.,'I".....f; .',".'1 .1., i ~., '.j..,] , i.. ./.., " _., ] _ 'n ):) -l.'
. L. . "'.' '-"0 .L', ",.L..'",.,.(, "....'- '" .'. ,0 ,nL na, l'J. .f-'-r ,y
11,..,.,., j '1 "" ".. ',', "'.] to '",',] "0,',,, '"',, '''''y '. J" ., 1 1 "n,..,,'.., "'1 '." "p 1 ," r.d
"1 ,;,. , ." ,.; '.,~'.." ~,\' ,;- "': i'~ ; :,'. ;, :', 'n _'.; ", ':,:i '<.. .. ,
'.1 ,>. d) . '.1 -,.J ,. Ii 0" U'L J '-1-' .. ,,,,,, L1., .", ",,'.'J. "l .U', a C,., ( I... J J. _." cc
'J f Li,;, i. h, d P.,,, l:n "r ;;hI P h a" """ 'm i'.i 1." d 1'.>.::. '.r (>.) ;,]", ,J., l" of "u >:h
"ce"l' l: "'!" ,,' "f U. 'cJ e Or eXe cb ti" n of ,,,' eh ., 'x" "I",,, t .'3, ;; ud ., U >.) f th e
".or U e s h".1:" to h 01: ',by to", 1:.i lEy and c <) 1.1 n.n,' "" y "u ('h "'c 1:.i 'm by (h"
C; ''''''.'''' 1 P,,;: 1,,,,,,, 5. 'J'; '" ~ f 01' b,"'n; 5,on ed G ..n",c' '" i l' '.1d:n," ,:" ,.,ha U '.'Cl!'.,,:y
1: h" 1',,,, 1 1."" '1":1' ty, 1,(';, e!.n),e l' 0':" rc:f 'O:c t' cd ':0, to tho P ,,,:,'", (':r: ..c), 5. p
1.1,""n th" J'ili.llV of a c.'.:r':H.i.c:"tc oof r.i:nit "d Pi<rl:llershIp "nd the
(~'I.):!lpl,~t:i.().i1 of tho :;:'Y,;n.-i.::d. Lc~! i"lt1"J(,J, i~L;j.j)f:r.
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llC t ))y ''',y C'''''"ral Poll'!: ner, 11"" >.'He" I. of '.,hIGh """Y C'''""C or .res\lIt
In 10"s ,,),' "'''''''9'' ;;0 ',he l'arj:n',"';hIp, if PU':"""nt .10 "pinIon .of
1. c~" 1 e,,,,,,::,, 1 "'np loY"'.1 by th" I), '.'l<' r" J. p ,0]: ':.' '>' i::; ,," bd'iJ If of th e
T'l:i"'- j"nf""''':J1.j if) '":h'''11 J""'l()i- '''1.11-)J'(-::.(.1,1. .....: -I h(:....l' ".1.1_" ",1--:,\ r-:".'":.... ::'.t'''1 I)-:)l'.tn(',).'c J..o
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IN h'I'J'NESS IvlIEHEOF, the undersigned haVl-; hereunto
5ei: UHd.r hands and seals the day Llnd year first above written.
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Gt:ne):;:1l Partners
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AMENDMENT TO
ARTICLES OF LIMITED PARTNERSHP
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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.
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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.
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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:
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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:
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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
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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.
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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
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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.
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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.
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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.
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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.
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General Partner Being Replaced:
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THE SWERSKY FAMILY PARTNERSHIP,
L.PiiiIJ ~
By: .
...' Stanley 1. rsky, General P er
Replacement General Partner:
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SWERSKY SACRAMENTO LLC
By: The Swersky Family Partnership, L.P.,
its Sole ember
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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
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Limited Partners
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STANLEY 1. CONNER
INGRID 1. CONNER
BRUCE B. LOSS
PHOEBE S. LOSS
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H. CLARK STAAB
WINIFRED STAAB
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A DEAN ALPlNE
KATRINA ALPlNE
WILLIAM KATES
SANDRA KATES
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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.
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D s
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E R
D u
U C
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C I
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I N
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N F
S 0
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L
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T
A
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0
N
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Sign
Here
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Paid
Preparer's
Use Only
1 a Gross receipts or sales. . . . . . . . . . . . . . . .
b Less returns and allowances. . . . . . . .
13
1b
1c
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N
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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.
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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.
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BAA For Paperwork Reduction Act Notice, see separate instructions.
PTPA0112 11/29/00
Form 1065 (2000)
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lorm 1065 (2000) S & M ASSOcrK, CS
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/' ~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)
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Income
(Loss)
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Deduc-
tions
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Credits
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Invest-
ment
Interest
Self-
Employ-
ment
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Adjust-
ments
and Tax
Prefer-
ence
Items
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Foreign
Taxes
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Other
BAA
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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)
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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)
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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 ------
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------------------------------------------------------------------
B
------------------------------------------------------------------
------------------------------------------------------------------
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c
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------------------------------------------------------------------
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)
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"\'~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.
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S
E
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D s
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E R
D u
U C
T
C I
T 0
I N
0 s
N F
S 0
R
L
I
M
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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 ~
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II ??-23701SQ
BAA For Papelwork Reduction Act Notice, see separate instructions.
Form 1065 (2001)
Phone No.
PTPA0112 12/03/01
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,,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
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.<.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
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PTPA0201 01/01/02
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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
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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)
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.
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
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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
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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.
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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
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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
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Page 2
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Name of
designated TMP
Address of
designated TMP
JVA 4 106512
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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
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.
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.
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
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Kelley Blue Book
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Q Search Used Car Listings
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BLUE BOOKst PRIVATE PARTY REPORT
Pennsylvania · September 20,2005
2000 Dodge Durango Sport Utility 40
.
BLUE BOOK CLASSIFlEDS"
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Engine: VB 4.7 Liter
Trans: Automatic
Drive: 4WD
Mileage: 40,000
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"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
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need some reconditioning to be sold at retail. Most consumer owned vehicles fall into
this category.
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.
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
.