HomeMy WebLinkAbout12-19-05
Petition and Decree
In the Court of Common Pleas of Cumberland County
Orphans' Court Division
No. 21-2005-0777
John R. Druschel, Deceased
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Petition for Distribution Under Section 3102 of the Probate, Estates and Fiduciaries Code (and
Claim for Family Exemption). :~,
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To the Honorable, the Judges of the said court:
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The petition of Janice Jean Druschel respectfully represents:
(1) John R. Druschel, died on August 19,2005, resided at 3901 Chestnut Street, Camp Hill,
Pennsylvania;
(2) Janice Jean Druschel, wife ofthe decedent, was part of decedent's household at the date of his
death;
(3) Petitioner is the surviving spouse, the date and place of the ceremonial marriage, and the
name and official capacity of the person who performed the ceremony are as follows:
Date of Marriage: DECEMBER 13, 1974
Place of Marriage: FIRST LUTHERAN CHURCH OF GREENSBURG, PA
Name and Official Capacity of person who performed the ceremony: PASTOR WILLIAM
PFEIFFER, FIRST LUTHERAN CHURCH OF GREENSBURG, P A
(4) The decedent died testate, and letters have been granted to Janice Jean Druschel, and no bond
was required pursuant to the terms of the decedent's Last Will;
(5) The Petitioner is the only person entitled to share in the decedent's estate under the terms of
the decedent's will, a copy of which is attached hereto;
(6) The Petitioner is entitled to the family exemption;
(7) The property ofthe decedent's estate consists of only one item, as follows:
One Thousand (1,000) Membership Interests in John R. Druschel & Associates, LLC, a
Pennsylvania limited liability company. Such Membership Interests are fully paid for with no
liens against them, and are evidenced by a Certificate of Membership.
(8) No disbursements have been made prior to the filing of the petition from decedent's estate;
(9) There are no unpaid claimants whatsoever upon decedent's estate;
(10) There is no inheritance tax due whatsoever;
(11) Petitioner's prayer is for a distribution ofthe property (i.e., the Membership Interests) to
petitioner.
Respectfully submitted,
THE LAW FIRM OF MAY & MAY, P.C.
Dated: December Ig , 2005
By: . ~ C r&rf.
ROBERT C. MAY, ESQUIRE
Attorney J.D. # 65602
4330 Carlisle Pike
Camp Hill, P A 17011
(717) 612-0102
Attorneys for the Petitioner
The following exhibits are attached to this petition:
(1) A copy of the decedent's probated will;
(2) Copy of the Certificate of Membership Interest in the LLC.
(3) Copy of the Inheritance Tax Return of the decedent.
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No. 2005-00777 PA No. 21-05-0777
Esta te Of: JOHN R DRUSCHEL
(First. Middle, Last)
Late Of:
HAMPDEN TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Securi ty No: 177-46-2001
WHEREAS, on the 31st day of August 2005 an instrument dated
June 7th 1985 was admitted to probate as the last will of
JOHN R DRUSCHEL
(First, Middle, Last)
la te of HAMPDEN TOWNSHIP, CUMBERLAND County,
who died on the 19th day of August 2005 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH Register of wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
JANICE JEAN DRUSCHEL
who has duly qualified as EXECUTOR(RIX)
and has agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 31st day of August 2005,
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* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
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OF
JOHN R.-nRUSCHEL
, JOHN R. DRUSCHEL, of the City of Greensburg, County of
~eland, Commonwealth of Pennsylvania, being of sound and
~ng mind, memory and understanding do hereby make, publish and
~ this as and for my Last Will and Testament, hereby revoking
ler wills and codicils heretofore made by me.
FIRST
direct the payment of my expenses of my last illness and
1 from my estate as soon after my death as conveniently may be
If there be no cemetery lot available for my interment owned
at the time of my death, I authorize my personal representativ
chase such cemetery lot with a contract for perpetual care,
therefore funds from my estate, in such amount as she shall
er necessary and desirable, and I authorize my personal
entative to cause title to or ownership of such lot so
,sed to be vested in such person as my personal representative
designate.
'urther, in this connection, I authorize my personal
:entative to expend funds from my estate, in such amount as my
lal representative shall consider necessary and desirable, for
lrchase, erection and inscription of a suitable marker for my
Page One of Nine Pages
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SECOND
I give, devise and bequeath all the rest, residue and remainder
of my property, whether real, personal or mixed, and wheresoever
situate, together with all insurance policies thereon, unto my wife,
JANICE JEAN DRUSCHEL, if she survives me by sixty (60) days.
THIRD
In the event that my wife fails to survive me by said period of
sixty (60) days, I then give, devise and bequeath all the rest,
residue and remainder of my property to my father, ALBERT EUGENE
DRUSCHEL, in trust, however, to act as trustee upon the terms and
conditions as set forth below, said trustee is to serve without bond.
The trust hereby created shall be held, administered, and distributed
in the following manner:
A. I direct trustee to payor apply so much of the
net income and principal of this trust to the support,
maintenance, and education of any of my children who have
not reach twenty-three (23) years of age as in the
discretion of trustee seem necessary for the proper
support, maintenance, and education of such children.
In making any payment or application, I direct that
trustee take into consideration other resources and income
of my children. I direct trustee to accumulate all
Page Two of Nine Pages
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undistributed net income of the trust property and add
it to the principal.
In exercising its discretion in making such
payments of net income or principal, trustee is not
limited to making equal distribution to all the
beneficiaries, but may make such distributions, con-
sidering the balance remaining in the trust and the
estimated future requirements of the beneficiaries, as
appear necessary under the circumstances.
Trustee shall charge support payments made under
this provision against the trust estate, rather than
against the ultimate distributive share of the
beneficiary for whose benefit the support payments are
made.
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B. When my youngest surviving child has attained
the age of twenty-three (23) years of age, I direct the
trustee to divide the trust estate into a number of
shares equal to the number of my living children and
deceased children having surviving issue. I direct
trustee to divide the shares, giving one share to each
living child, and one share to the surviving issue of
each deceased child, per stirpes.
Page Three of Nine Pages
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c. The term "education" as used in the trust
provision of this will includes both college and
postgraduate study. by the beneficiary concerned at
an accredited institution of his choice. Distribution
by trustee from the trust of amounts for "education"
shall include reasonable living and travel expenses of
the beneficiary concerned.
FOURTH
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I direct that no trustee, executor, guardian, or other
fiduciary, named, nominated or appointed in this, my Last Will and
Testament, shall be required to post any bond or give any security 0
any type for any purpose whatsoever, any law or rule of court of the
Commonwealth of Pennsylvania or any other jurisdiction to the
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contrary notwithstanding.
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FIFTH
My executors and trustee shall have the following powers in
addition to those vested in them by law and by other provisions of
this will, applicable to all property real, personal, and mixed and
wheresoever situated, including property held for minors, whether
principal or income, exercisable without court approval, and
effective, with respect to each item of said property, until actual
distribution thereof:
Page Four of Nine Pages
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A. To retain, as investments of my estate or
trust, any or all assets of my estate, real, personal,
or mixed, without regard to any principle of diver-
sification, and to purchase and acquire real or personal
property retained or acquired without making the same
productive of income.
B. To permit the children, or any of them, to
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occupy any real estate retained or acquired upon such
terms and conditions as my trustee shall deem proper.
C. To pay all taxes, charges, and expenses of
maintenance, upkeep, improvement, development. protection,
preservation, and investment of any retained or acquired
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real or personal property, such payments to be made from
either principal or income as my said trustee shall
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determine.
D. To retain or invest any and all funds, whether
principal or income, in any real or personal property
without restriction to legal investments; to purchase
investments at premiums; to exercise all rights of a
security holder or shareholder in any corporation; and
Page Five of Nine Pages
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to lease, mortgage, pledge, give options upon or sell at
public or private sale and without approval of any court
and without any responsibility to the buyer or buyers to
see to the application of the purchase price, any real or
personal property, or, portion or portions thereof,
irrespective of the manner or means by which the same was
acquired by my said trustee.
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E. To make any payment or distribution herein
provided for in cash, kind, or partly in cash and partly
in kind, at valuations fixed by my trustee at the time
of distribution.
SIXTH
Any and all payment or payments of any sum or sums, whether in
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cash or in kind and whether for principal or income, payable to the
said children, or any of them, shall be made upon the sole receipt
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of the respective individual to whom the payment is made, and free
from anticipation, alienation, assignment, attachment, pledge, and
free from control by the creditors of any such beneficiary. All
shares of principal and income herein given shall be free from
anticipation, alienation, assignment, attachment, and pledge and
free from control by the creditors of any such beneficiary. All
shares of principal and income herein given shall be free from
Page Six of Nine Pages
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anticipation, assignment, pledge, or obligation of any beneficiary,
and shall not be subject to any execution or attachment.
SEVENTH
In the event my wife and I should die in a common disaster or
under such circumstances which do not afford sufficient evidence as
to who is the survivor, it is my intent that I predeceased my wife.
EIGHTH
In the event my wife predeceases me, I appoint my brother,
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WILLIAM ALAN DRUSCHEL, of Rockingham, North Carolina, as Guardian of
my minor children, JOHN PAUL DRUSCHEL and JASON ALAN DRUSCHEL. In
~ the event said WILLIAM ALAN DRUSCHEL fails to qualify as such
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~ Guardian, I appoint my sister-in-law, CAROLYN K. HOFFMAN, of
~ Alexandria, Virginia, as Guardian. In the event said CAROLYN K.
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HOFFMAN fails to qualify, I appoint my brother, RODNEY EUGENE
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DRUSCHEL of Lancaster, South Carolina, as Guardian of my minor
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children, JOHN PAUL DRUSCHEL and JASON ALAN DRUSCHEL.
NINTH
I nominate, constitute and appoint my wife) JANICE JEAN
DRUSCHEL, Executrix, of this, my Last Will and Testament, but should
my said wife fail to qualify as such Executrix, I appoint my father,
ALBERT EUGENE DRUSCHEL, as Executor. In the event said ALBERT EUGEN
DRUSCHEL fails to qualify as such Executor, I appoint my mother,
Page Seven of Nine Pages
ALBERTA MARIE DRUSCHEL, as Executrix. In the event ALBERTA MARIE
DRUSCHEL fails to qualify, I appoint my brother, RODNEY EUGENE
DRUSCHEL, as Executor.
TENTH
In the event my father, ALBERT EUGENE DRUSCHEL, fails to qualify
as Trustee, I hereby appoint my mother, ALBERTA MARIE DRUSCHEL, as
Trustee. In the event my mother fails to qualify as Trustee, I
appoint my brother, RODNEY EUGENE DRUSCHEL, as Trustee.
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ELEVENTH
I have intentionally omitted to provide for all my heirs at law
or other relatives who are not specifically mentioned herein. I
hereby specifically disinherit any person claiming to be my heir at
law except as otherwise specified in this will.
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IN WITNESS WHEREOF, I have hereunto set my signature to this, my
Last Will and Testament, consisting of nine (9) typewritten pages, thE
first eight (8) of which bear my signature in the margin for the
purpose of identification, this l day of r' ,1985.
(:;::- ,:--:L /f. .J /Vvt~cL/(' [ SEAL]
JOHN R. DRUSCHEL
SIGNED, SEALED, PUBLISHED and DELCARED by the above named
Testatrix, JOHN R. DRUSCHEL, as and for his Last Will and Testament,
in the sight and presence of us, who, at his request, in his sight
and presence and in the sight and presence of each other, have
hereunto subscribed our names as witnesses.
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A F F I D A V I T
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF WESTMORELAND
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WE, DENNIS J. GOUNLEY and KRISTEN L. SCP~LLER, the witnesses
whose names are signed to the attached or foregoing instrument, being
duly sworn according to law, do depose and say that we were present
and saw Testator sign and execute the instrument as his Last Will;
that JOHN R. DRUSCHEL executed it as his free and voluntary act for
the purposes therein expressed; that each of us in the hearing and
sight of the Testator signed the will as witnesses; and that to the
best of our knowledge, the Testator was at that time 18 or more years
of age, of sound mind and under no constraint or undue influence.
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SWORN to and subscribed
before m, this ~2td~y
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qcf..-/!.lA' ,,/ , 1985.
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DENISE L. KNOX, Notary Public
Greensburg, Westmoreland County
My (>r'~ i;"j n f;<piro., "korch 5.1988
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ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF WESTMORELAND
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ss:
I, JOHN R. DRUSCHEL, Testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified accord-
ing to law, do hereby acknowledge that I signed and executed the
instrument as my Last Will; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein
expressed.
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S~DRN to and subscribed
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J-- day
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DENISE l. Kr-.10X, i.;o.ary Public
Greensburg. 'vVestmoreland County
My Commission Expires March 5,1988
REV., 500 EX (6-00)
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FILE NUMBER
21 05
0777
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COUNTY CODE
YEAR
NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
JOHN R. DRUSCHEL
SOCIAL SECURITY NUMBER
177-46-2001
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
195-42-0725
o 3. Remainder Return (date of death phor to 12.13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Altach Sch 0)
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DATE OF DEATH (MM.DD.YEAR)
08/19/2005
DATE OF BIRTH (MM-DD-YEAR)
03/09/1954
COMPLETE MAILING ADDRESS
4330 CARLISLE PIKE, CAMP HILL PA 17011
0.00
0.00
0.00
0.00
0.00
0.00 x.O~ (15) 0.00
0.00 x.O~ (16) 0.00
0.00 x .12 (17) 0.00
0.00 x .15 (18) 0.00
(19) - 0.00-
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DRUSCHEL, JANICE J.
[!] 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of death after 12.12-82)
o 7. Decedent Maintained a Living Trust (Atlach copy ofTrust)
o 10. Spousal Poverty Credit (dale of death belween 12.31.91 and 1.1.95)
0.00
0.00
(8)
10,077.76
0.00
0.00
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NAME
ROBERT C. MAY
FIRM NAME (If Applicable)
THE LAW FIRM OF MAY & MAY, P.C.
TELEPHONE NUMBER
(717) 612-0102
(11)
(12)
(13)
10,077.76
-10,077.76
0.00
(1)
(2)
(3)
(4)
(5)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter. Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(14)
0.00
(6)
(7)
(9)
(10)
14: Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
3901 Chestnut Street
CITY Camp Hill I STATEpA I ZIP 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
0.00
0.00
0.00
Total Credits ( A + B + C ) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
0.00
0.00
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)
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... 0 [K]
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [K]
c. retain a reversionary interest; or.......................................................................................................................... 0 [K]
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [K]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 [K]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0 [K]
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 pe~ury, 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 the personal representative is based on all information of which preparer has any knowledge.
2c~; S
ADDRESS
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EPRESENTATIVE /
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1'2; II
DATE
12
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after 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. 99116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 99116(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. 99116(1.2) [72 P.S. 99116(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. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1504 EX+ (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSelY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF
John R. Druschel
FILE NUMBER
21-05-0777
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
NUMBER DESCRIPTION
1. John R. Druschel & Associates, LLC, a Pennsylvania limited Liability Company
VALUE AT DATE
OF DEATH
0.00
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
0.00
REV-1505 EX+ (6-9*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-'
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
ESTATE OF
John R. Druschel
FILE NUMBER
21-05-0777
1. Name of Corporation John R. Druschel & Associates. LLC
Address 3901 Chestnut Street
City Camp Hill
2. Federal Employer 1.0. Number 02-0698686
3. Type of Business IV administration to nursing home patients
State~Zip Code 17011
State of Incorporation Pennsylvania
Date of Incorporation OS/21/03
Total Number of Shareholders One (1)
Business Reporting Year Cal.
Product/Service administration of IV's to nursing home patients
4.
. TYPE
Voting/Non-Voting'
TOTAL NUMBER OF
SHARES OUTSTANDING
. PAR VALUE
NUMBER OF SHARES
OWNED BY THE DECEDENT
. VALUE OF THE .
DECEDENT'S STOCK
Common Votin
1000
none
1000 $
$
0.00
Preferred
Provide all rights and restrictions pretaining to each class of stock.
5. Was the decedent employed by the Corporation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. III Yes 0 No
If yes, Position President & CEO Annual Salary $ 16,00000 lime Devoted to Business
100%
6. Was the Corporation indebted to the decedent? ................................. 0 Yes f!] No
If yes, provide amount of indebtedness $
7. Was there life insurance payable to the corporation upon the death of the decedent? . . . .. 0 Yes KI No
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
8. Did the decedent sell or transfer stock in this company within one year prior to death or within two years
if the date of death was prior to 12-31-82?
DYes r::J No If yes, 0 Transfer 0 Sale Number of Shares
Transferee or Purchaser Consideration $ Date
Attach a separate sheet for additional transfers and/or sales.
9. Was there a written shareholder's agreement in effect at the time of the decedent's death? ....D Yes IBl No
If yes, provide a copy of the agreement.
1 O. Was the decedent's stock sold? .................................................. 0 Yes IKJ No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedent's death? ................... 0 Yes Ii(J No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships? . . . . . . . . . . . .. 0 Yes IKJ 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 stock.
B. Complete copies of financial statements or Federal Corporate Income Tax retums (Form 1120) for the year of death and 4 preceding years.
C. If the corporation 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. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
(If more space is needed, insert additional sheets of the same size)
Schedule C-1 Attachment to Inheritance Tax Return of John R. Druschel, 21-05-0777
A. The value of decedent's stock is calculated with reference to the income statement for the
period ending November 30,2005, and the balance sheet as of November 30,2005, copies of
which are attached hereto, as follows:
1. Operating Loss of $21 ,203 YTD showing no value based on a multiple of earnings.
2. Negative Book Value of$90,255 as of 11/30/05, showing no value based on a
multiple of book value.
3. The Company has no revenues, no operations, no assets, no employees, no
independent contractors and no activity of any sort aside from ongoing litigation. See G below
for a discussion of the ongoing litigation.
B. All Federal Corporate Income Tax Returns are attached for this company from its inception in
2003 as a corporation.
C. No real estate was owned by the company.
D. Decedent was the only stockholder in the company.
E. Decedent was the only officer in the company. For 2005, he received a salary at the annual
rate of $16,000 without any benefits or bonuses, except for the reimbursement of business
expenses shown on the income statement. As of his death on August 19,2005, he had collected
$11,900 in salary.
F. No dividends were declared or paid for 2005. For 2004, a dividend of$109,962 was declared
and paid. For 2003 no dividends were declared or paid.
G. The Company filed a claim against the independent contractor to whom an $84,850 account
payable is owed on the basis that the independent contractor tortiously interfered with and took
business from the Company while the decedent was living. This was the Company's largest
customer. Upon the transfer of the Company's Membership Interests to the sole heir to the
Estate, the decedents wife, the costs of this lawsuit, will also fall upon the decedent's wife. The
potential value of this litigation is the only asset of the Company. The Pleadings in this litigation
are attached hereto.
John R. Druschel & Associates, LLC
Financial Statements
For the Period Ended November 30, 2005
(Unaudited/Interim)
Financial Statement-Druschel
11/30/05
Carey Associates, Inc.
Accounting & Tax Services
November 30, 2005
Estate of John R. Druschel
3901 Chestnut Street
Camp Hill, P A 17001
To whomever it may concern:
Attached is the Balance Sheet as of November 30,2005 for John R. Druschel &
Associates, LLC and the related Statement of Income and Retained Earnings for the year
then ended. These statements were prepared based upon information submitted by you to
our office.
If you have any questions regarding these statements, please contact our office. Thank
you very much for your business.
Sincerely,
CAREY ASSOCIATES, INC.
/i/J.A#
Skyler Daugherty, Accounting & Tax Manager
Carey Associates, Inc.
542 Bridge Street New Cumberland, PA 17070
Phone (717) 774-4382 Fax (717) 774-4928
John R. Druschel & Associates, LLC
Statement of Income and Retained Earnings
For the Period Ended November 30, 2005
Revenue:
Gross Sales less Discounts & Allowances
$341,082
Total Revenue
$341,082
Direct Job Costs:
Contracted Services
Job Materials
$234,581
$3,250
Total Direct Job Costs
$237,831
Gross Profit
Total Operating Expenses, See Schedule
Net Income (Loss) From Operations
Other (Income) & Expenses:
Interest Income
Interest Expense
$0
$0
Total Other (Income) & Expenses
Net Income (Loss)
Beginning Retained Earnings
Distributions to Shareholders
Ending Retained Earnings
Financial Statement-Druschel
$103,252
$124,455
($21,203 )
$0
($21,203 )
$15,798
$0
($5,405)
11/30/05
John R. Druschel & Associates, LLC
Schedule of Operating Expenses
For the Period Ended November 30, 2005
Compensation of Officer's
Salaries-Operations
Payroll Taxes-G&A
Administrative Services
Professional Development
Advertising
Vehicle Expense
Dues & Subscriptions
Licence
Insurance
Office Supplies & Expense
Equipment
Postage & Delivery
Legal & Professional Fees
Payroll Service Fees
Telephone
Meals & Entertainment
Depreciation (Estimated)
Amortization (Estimated)
Total Operating Expenses
Financial Statement-Druschel
$11,900
$56,982
$5,269
$1,320
$1,277
$1,675
$22,902
$275
$75
$2,696
$83
$1,080
$30
$5,933
$773
$4,211
$7,973
$0
$0
$124,455
11/30/05
John R. Druschel & Associates, LLC
Balance Sheet
As of November 30, 2005
Assets
Current Assets:
Cash in Bank and On Hand
Accouts Receivable
($5,405)
$0
Total Current Assets
($5,405)
Fixed Assets:
Depreciable Assets
Accumulated Depreciation
$11,064
($11,064)
Total Fixed Assets
$0
Other Assets:
Software
Accumulated Amortization
$0
$0
Total Other Assets
$0
Total Assets
($5,405)
Financial Statement-Druschel
11 /30/05
John R. Druschel & Associates, LLC
Balance Sheet
As of November 30, 2005
Liabilities & Stockholders' Equity
Current Liabilities:
Accounts Payable
$84,850
Total Current Liabilities
Long-Term Liabilities:
Loans Payable
$0
Total Long-Term Liabilities
Total Liabilities
Stockholders' Equity:
Paid-in Capital
Retained Earnings
$0
($90,255)
Total Stockholders' Equity
Total Liabilities & Stockholders' Equity
Financial Statement-Druschel
$84,850
$0
$84,850
($90,255)
($5,405)
11/30/05
For calendar ear 2004, or tax
A Eff.c11v<> dill<! 01
S olooUon
u.s; Income Tax Return for an S Corporation
... Po not file this lonn unless the cOl'J>oration h~5 timely filed
Form 2553 to Illectto be:! an S corporation.
... 51!(} separate instructions.
2004, and endin
OM!;! No.1 5450.0130
Form 11205
2004
Ol!""rtrrJonl Qt Iha T",nsury
lntclm-,I R~~nua Sc:",I~
C Empl..,.r k1.rdifio.lion """"'or
Use the
IRS
label.
Other-
. B elr.lln^~CQdonumMt wise, 3901 Chestnut Street
(~o lnr.lrlJOlIons) print Or City or town. st.la, and ZIP cooo E Tot3l asS8ts (saa instructions)
541990 type. PA 17011 $ 100 798.
F Check t1pplieablc boxes; (1) Initial return (2) Final return (3) Name change (4) Address Change (5) 0 Amended return
G Enter number of shareholders in the corporation at end of the lax year, . . , . . . . . . . . , . . . . , , . . . . , . . . . . . . . . , . . . ., . ' . . . . . , . , . . . . . . . . . . ...... 1
Caution: Incl/,J(1e on trade or business income tilnd ex nses on Jines 1a throu h 2T. See ffle instructions for more information.
1 a Gro~ll1l~ipls or sales .. 438 , 721. b Less returns and allowince~ , . Co 8al.... 1 e
2 COl;t of goods sold (Schedule A, line 8) .""..,........,.........,...............,.,..,......,...,... 2
3 QroS$ profit. Subtract line 2 from line 1 c , . . . . . , . . . . . . . . . . . . .. . , . . . . . . . , . . , . . . . , . , . . , , . . . . . . . . , , . . . . , . . 3
4 Net goin (los~) from Form 4797, Part n. line 17 (attach FDrm 4797)....,..........,.........,.,......... 4
5 Olher income (loss) (attach schedule) . . . . . , , . . . . . . _ . . . . . . . . . . . , . . . . . . , . . , , . . , . . . . . . . . . . . , . . , . . . . . . . . . 5
G Totlll income OSS. Add lines 3 throu h 5 .........,.,............,......,...."..............', '. .. II- 6
o 7 Compensation of officers. . . . . . . , . . . . . . . . , . . , . . . . . . . : . . . . . . . . . . . , . . . . . . . . . . . . . . . , . . ~ . _ . . . . . . . . . . . . . . . 7
E 8 Salari"s and wages (less employment credits) ,.,................,......,....... . . . .. . .. .. . , , , . . , . .. . . 8
o 9 Repairs and maintenance ................' . . , . , . . . . . . . , . , . . . ' . . . . . . . . . . . . . . . . . ' , . . . , . . , ' . . . . , , . . , . . ' 9
U
C 10 Bad debts ..,.',..."......,........,....,.,.........,.......,.................,.,.......,......... 10
T 11 Rents.. , . , . , .. . . . ' , ' . , , . . ... . . . . , . . . . . . . . . . . , . . , . . . . . . , . . . , . . . . . , . . . . . . , . . , . . . . , . . . . . . . . . . . . , , . . .. 11
6 12: Taxes and licenses......,......,. ., .,. '... ..."....... ....... ,...... .., ' .. ..... .. .. ........... ..... 12
/II HI Interest." ' , . .. .. . .. . , . . .. . . . . . , . .. .. . . . . . . , . , , . . , , , , . . . , .. , . . . . . . . . . . . . . . . , . . . . , . . . . . . . . . . ' . . . . . .. 13
S 14a Depreciation (attach FoM4s1i2; .............,........................... 14;11
b Dopreciation claimed.on Schedule A and elsewhere on return.....,.,......, 14b
c Subtract line 14b from line 14& ..............,.,..,.. , , .. . . . , . . . , . . . . . . . . . , . . . . , . . , . . . . . . , , , , ' 14c
~ ~: ~:~~~::~~~o~. ~~~ .d,~~~~ ,~i~ ~.~~ .~~~ .~~~I.~t~~~:), : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : :: ~:
T
. ~ ~~ ~~~~;~::~;~~;:~~:a~~ ~~~~~ , : : : : : :: :: : : : : : : : : : : :: : : : : : :: : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : ::: ~~
6 19 Other deductions (attach schedule) ...,.. ..... S1MT, . .. .. .. . .. .. . .. .. .. .. .. . .. .. .. .. .. .. .. .. .. . .. .... 19
N 20 Tobll deductions. Add the amounts shown in the far right column for lines 7 through 19 . , .. , .' .. .,. .' ..... 20
s 21 Ordlna business income loss. Subtract line 20 from line 6 .......,.....,.......,......,....,.....,.. 21
T 22 Tl,I~ a tJcCQSS net passive income llIx (attach schedule).. .. . . . .. .. . . , . ' . , .. .. . . . , . . .. 22__
A
X b Tax from Sch<edwle D (Form 11205) .. .. .. .. . , .. .. , .. . .. .. .. . .. ' .. . .. .. , ... 22 b
c Add lines 22~ and 22b (see i~structians far additional taxes) .,..',..,..........."....,......,..,...,..,.,...,....
~ 23 Payments: a 2004 estimated !llX payments and amaunt applied from 2003 return ....."..,. .23 a
o b Talt deposited with Form 7004 . . , . . . . . . . . . , . . '. . . . . . . . . . . . , . . , . . . . . . . . , . . '. .23b
P c Credit for Federal tax paid on fuels (att8(;h Farm 4136) . . . . . . . . . , . . . .. , , . . .. Z3c
A d Add lines 23a through 23e .. . .. .. .. .. .. .. . .. .. . . .. . . . . .. .. .. .. .. . .. .. . .. .. .. . .. .. .. .. .. . .. .. .. . , .. ... 23 d
~ 24 Esth1'\2tcd tax penalty (see instrl.JCtions), Check if Form 2220 is attached, , . . . ' , . . . . . . . . . . , . . , . .. ... 0 24
e: 25 TlIX due. If line 23d i$ smaller than the total of lines 22c and 24, enter amount owed . , . , ' , . , . . , , . . . , . , . .. 25
~ 26 Overpayment. If line 23d is larger than the total Of lines 22c and 24, ente( amount overpaid. , . . . . . . , . , , ,. 26
S 2.7 Enter amount of line 26 ou want: Credited to 2005 estimated tax '. ~ Rdunded ... 27
0:1. 01/04
John R. Dru$chel & Associates, LLC,
N\JJT1bcr. .lraal, and room or .utIe 110. (~" 1".0, bole, """ in91ruaions.)
02-0698686
o l:>a18 ;n.""'llCl,8lE!d
OS/21/03
I
N
C
o
M
E
438721.
172,862.
265 859.
7 365.
S
I!
/;
77 164-
155 897.
109 962.
Sign
Here
hn.., ,C:dminad Ulls reI urn, inclo,lc;ling "IXOI11panying schcdul.~ and ~1"!em~nl5. and to lhe: WI or my knowloclg<: ~nd
~r.j,on of prep"'e, (Olller lhan W"l>i1l"'r) is based on all intorm.'~on ot whic:h pre parer hn ~ny knOwledge.
~~" ~ ~::;~~~ ~:~~
(.ee tnslruaion:;)?
Yes
Propara,'s 83N or PTlN
No
Dale
.... Presid.ent
T'~l.
Prcpl'lrr,:r":;.
.l~n"luro
....
189-46-7069
EIN 25-1819849
Fm1'S name
~n=::yecJ), ....
ndd,..~. "nd
ZIPcod<o New Cumberland PA. 17070
BAA For Privacy Act lIndPa:perworkRl!duction Act Notice. see1he separate Instructions.
Paid
Pf'I!J)3rer's
Use Only
PhQnono. (7 17
SPSAU112 " '08JQ4I04
774~4362
Form 1120S (2004):
l( - ~,.r
~(:.....v\..
Sc ,~.~-v~/
John R. Drusche1 & Associates, LLC
Cost of Goods Sold (see instructions
1 Inventory at beginning of year. . . . . . . , . . , . . , . . . . , . . - . . . . . . . . . . . . . . . . , . . . . . . . - . . . . . . . . . . . . . . , , . . . . . . . . . . . .
2 Purchases... . . . . . . . , . . , , . . . . . . . . . , . . . . . . . . , . . . . . , . . . , . . , , . . . . . . . . . , . . , . . . . . . . . . . . . . . . . , . . . . . . ' . . , . , . . .
3 Cost of labor ,.......,..............,...'.......... - -.. ,....., '... , , , .', - -.. , . '... . . . .... ....... .. -. ....
4 Add Itional section 263A costs (attacl1 schedule) ,.",.',..,.......,...."......... - . . .. .. . . .. . ' . . .. .." .. ..
S other costs (attach schedule) .....~.. S:tMr. - .. . .. , .. . . .. . , . . , , . .. . . , . . ' . .. . . . , .. . .. . .. , . . . . . - . . . .... . .. ..
6 To~l. Add lines 1 through 5 . . . . . . . . . . . . . . . . . . . . , , . . - . , . . . , . . . , . . . . , . . . - . , , . , , , . ' . . . . . . . , , . , . . . . . - . , , ' . , .
7 Inventory at end of year .,'........,..,... - - - . . . , . . . . , . . . . . . . ' . . . . , . , . . . . . . . . , . - . - . . . , . . . . . , . , . . . . , , . . . .
8 CO$t of goods sold. Subtract line 7 from line 6. EJ'lter here and 011 page 1, line 2 . . . . , ' . . , . . . . . . , , . . . . . . , . . . .
9a Ch~ck 1111 methods used for valuing closing inventory;
(I) ~ Cost as described in Regulations section 1.471-3 '
{II] Lower of eos\ or market as described in Regulations section 1.471.4
(ill) other (sl'ecify method used and attach explanation) .. - .. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - B-
b Check if there was a writedown of subnormal goods as described in ~egulations section 1.471 -2(c) ..,.............'.. - . - . . . . . . . . . . ....
e Check If the LIFO inventory method Was. adopted this tax year for any goodS (if cheeked, attach Form 970) ..........' - . . . . - . . . . . . .. ....
d :~~~;t~~~~~;~~~6u~j~~~Fvg~ ~,s~.~ :~~ ~~~~ ~.~~a~,. ~~.t~r.~~~~~~~~~~ .(~.r,~~~~~~~), ~~.C.I~~~~~..... _.,.... ,[ 9dl
e If property Is produced or acquired for resale, do the rules of Section 263A apply 10 the corporation? - . . . . , . , , . . . . . -.. DYes ~. No
f Was them any change in determining quantities, cost. or valuations between opening
end clo~ln invento ? If 'Yes: attach ex lanation .....,.. - . , . .. , . .. ... .. . . .. . ' . .. . . . - . . .. . , .. ' . . . .. .. .. . , ..
, 'du elai Other Information (see instructions)
1 Chcc~ methQd of accounting: (a) Cash (b) X Accrual (c) 0 Other (Specify) .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2 S~C the instructions and enter the:
(a) Bu~lness 8et1Vi1y"11~ct.i_c~h ..P~f.'..)!i~f!.. _ _ _ _ _ _. (b) Product or service . ... J:1~qi_c2J:.. .1>.!2f.'Li.9~~ _ _ _ _ __
3 At the end of the lax year, did the corporation OWT', directly or indirectly, 50% or mOre of the voting steck of a domestic
corporation? (For rules of attribution, see section 267(c).) If 'Ves,' attach a schedule showing; (a) name, address,
and employer identification )ll1Imber and (b) percentage owJ'\ed . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . - . . . . . . . , . . . . . . . . . . . . . , . .
4 Was the corporation a member of a controlled group subject to the provisions of section 1561? . , . . . . . . . , . , . , . . . . . . . . . _ _ _ . .
S Check this box if the corporation has filed or is required to file Form 8264. Application for Registration
of l! Tax Shelter. . . . . . . . . . . . . . . . , . . . . . . , . . . . . . . . , . . . . . . . . . , . . . . . . . . . . , . . . , . . . , . . . . . . . . _ . . . . , . . . . . _ . . . . , . , . . . . .. ...
G Check this. box if the corporation issued publicly offered debt instrvments with original issue discount .....,. _ . .
It checked. the corporation may have to file Form 8281. Information Retvrn for Publicly Offered Original Issue
Dil>count If'\Struments.
7 If the corporation: (a) was a C corporation before it elected to be an S corporation or the corpQration acquired
an a::set with a basis. determined by reference to its basis (or the basis of any other property) in the hands of a
C corporation and (b) has net unrealized built-in gain (defined in section 1374(d)(1)) in excess of the net
recopnizcd built. in gain from prior years, enter lhe net unrealized built-in gain reduce<.i by net recognized
built. In pain from prior years. ' . _ . . . . , . . . . . . . . . . . . . . . . . . .. . . . , . , . . . . . , . . , . . . . . . . . . . . . . . . . . ., ,.. $
8 Check~~is box if the corporation had accumulated earnings and profits at the close of the tax y~ar .. -:-:~.~,~. -:-. -:-: -:-. ~;. TI
9 Arc the corpor~tio~'S lo.tal receipts (see instructionl;i) for the tat year and its total assets at the end of the tax year less
than $250,000. If Yes, the corporatIOn IS not reqUired to complete Schedules Land M.l ...,..,.......... _.. . ,. .. ., '. , .. ..
Notl!: If the corpor;Jtion had assets or operated a businesS in a foreign c;auntl)' or U.S. possession, it may be required to attach
5~u't1 N 'Form 1120. Forei n 0 rations of U.S. Cor orations, to this return. See Schedule N for details_
e 'jj ",. Shareholders' Shares of Income Deductions Credits etc
Shareholders' Pro Rata Sh.are Items
Ordinc,,)' business income (loss) (page 1. line 21) .. ' . . . . .. . . . . . . , . . ' . . . . . , . . . . . . . , , . , . . ' . . . , . _ . . , . , . . ,
2 Net reJ'ltal real estate income (loss) (attach Perm 8825). . . . . . , , . . . , . . , . . . , . . . . . . , , . . . ' . . . . , . . _ . . . . , . ' . .
3 n Other gross rental income (loss) . , . . . . , , , . , . , , . . . . . . . . . . , . ".. . . . . . _ . , . . 3 ill
b Expenses from other ~nlJI Jctivities (alt3~h schedule) . . . . . . , . . , , . . . , . . , . . . . . , . . . . , 3 b
c Other net rental income (loss). Subtract line 3b from line 3a "........,....,..,.......",...,.......,..
4 Interest irlcorne ..,..............,........"....",.......,...,.,.,...".,....,.....................
5 Dividends: a Ordinary dividends. . . . . . , . . . . , . . , . . , . . . . . . . , . . . , , ' . . . . . . . . , . . . . , . . ' , . . . . . . . . . . . . , . . . .
b Qualified dividends ... , .. .. .. . .. .. . .. , .. . .. , , , . .. .. . .. . .. .1 5 bl
Ii Royl'lllics. . . . . , . . . , . , . . . ' . . _ . . . . . . . , , . . . . . , . . . . , . . . , . . . . , . . . _ , . , . _ . . . . . . . . . . . , . , . . . . . . . , . ' . . , . , . _ . .
7 Nel short-term capital gain (loss) ,.,'..............,....".,......,....,.,.....,......,.. _ . , . . , . , . . . .
Sa Net long-term capital gain (loss) .... .. ..... .. , .. .... ...... , .. , ...... ... .... ..... . .. .. .. , .. . . . , . .. ....
b Collectibles (28%) gain (loss) ......,.......................,..... , ... .. .. 8b
c U"rec2plurcd section 1250 Ijlin (attach Sl;heduleJ, . . . . . . . . . . . . . . . . . , . . . . . . _ . . . . . . . . , , 8 c;
9 Net section 1231 gain (loss) (attach Form 4797) .... _... ,.. ' ...... ... ,., ., , ., ..... .,. , .. , .... ., . , .. ,..
, 0 Othef income loss attach schedule .,.",...... _ _ . . . . , . . , ' . , , , , . . , . . , . , , . . . , . _ , . , , , . . . . , . . . . , , . . , . .
02-0698686
I
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C
o
M
e:
~
S
S)
$P$AD 112 08104/04
Pa e2
1
2
3
4
5
G
7
8
169,431.
3 431.
172 862.
172,862.
Total amount
109 962.
Form 11205 (2004)
ForM'l ~120S .004 John R. Dru5chel & Associates, LLC
Shareholders' Pro Rata Share Items (continued)
Deduc:. 11 Section 179 dedl.l~tion (attach Form 4562) . ... -. . . _.. . .. , . .. . .. . . . .. .. . , .. .... . . , .. .. . , . . . . . .
Uon51 1,za Contributions. .. . .. . . , . . .. . . _.. . . . _.. , .. . . . .., . " .. . . . , ... . . . . . . , .. . . . . . . . . . . . , . . . . . . . . . . . .
b Deductions related to portfolio income (attach schedule) , .. .. . .. . .. , .. . .. . .. .. . . .. . . , .. . . . . . . .
c Investment interest expense. . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d Section 59(e)(2) expenditures (1) Type ... _ _ _ _ _ _ _ _ ~ _ _ _ _ _ _ _ _ _ . (2) Amount ....
e Other deductions attiilch $ch~lJle ......,............... _ . . . . . . . . . . . . . . . . . . . . . . . . . . _ . _ . _ . . .
13a Low-income hOusing credit (section 420)(5)).... _.. ...................'. .... ........ ..'......
b Low.incOme housing credit (other) ... _... ... .. . . .. ...... .. . . , .. . _... . ... .. .. .. .. .. .. ... ... .. .
c Qualified rehabilitation expendi1ure$ (renbl real estate) (sttach Form 3468)., . . , . . . . . . . _ . . . . , . . . . . . . . . . . . .. . . _ . .
d Other rental real estate credits ............,.......,..............".....,. _ . . . . . . . . . , . . . . . .
c Other ren\~1 credits ... , . . . . . - . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . , . . . : . . . . . . , . . . . . . . _
f Credit for ~Icohol used as fuel (attach Form 0478) .....,.,.... _ _ . _ . . . . , . . . . . . . .. . . . . . , . , . . . . .
Other crl!dil$ and credit ~8 ture(.ttschedule ................"......................... _....,.....
14a Name of country or U.S. possession _ . .. . .. ~ _ _ _ ~ _ _ _ _ _ _ _ _ _ _
b Gross income from all sources .....,........................................ _. . . . . . . . . . . . _ .
c Gross income sourced at shareholder level ....................,.............,...............
FOf'flign gross incomti! sourced at corporQte level:
d Passive ....................................... _ . . . . . . , . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . ,
e Listed categories (attach schedl,Jle) ...................................................... _ ..
f General limitation ............................:................,............. _ _ . . . . . . . . . . . .
Oecil.JCtions allocated artd apportioned at shareholder level:
g Interest expense ..............,..., _ . . . _ . . . _ . . , . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . , . , . , . . . .
h Other.. . .. .. .. . .. . . . .. . .. .. . .. .. . .. . . . .. . .. .. . .. .. . .. .. .. .. . . . . .. .. . .. . . . .. .. . .. . .. . .. . . . .
OeOlJctJons allocated and apportioned at corporate level to foreign SOllrce income:
j Passive ........... _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . _ . . . . . _ . . . _ . . .
J Listed categories ~ch schedule) ...,..............................................,......
k General limitation ................ _ . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . _ . _ . _ . , , , . . . .
Other Information:
I Foreign taxes paid. . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . , . . . _ . _ . . . . . _ . . . . . . . . . . . . . . . . . . . ... 141
mForeign taxes accrued ............. - .. .. .. .. .. .. . . .. .. .. .. .. .. , .. . . .. .... . . .... . .. , . . . . .... 14m
n Reduction in taxes available for credit
attach schedule ................................... - . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . , . . . . " 14 n
1511 Post-I 986 depreciation adjust~nt ......................................,...... _........... 15a
b Adjusted gain or los$ ........ - .. . . .. .. .. .. .. .. .. . .. .. .. . . . , , .. . .. . . .. . .. . . . . .. . . . , , .. . .. . " 15 b
c Depletion (other than oil and gas) ... . . .. ..... .. . .. . ... .. .. .. . .. _ .. .. .. . .. . . .. .. .. .. . .. . . . . " '5c
..~ Oil. gas. and geothetmal properties - gross income ............ - .. . . .. .. .. . . . .. . .. . , . . . . . . .. 15 d
e Oil, g3S. and geotherrTJil,1 properties - deductions..., ,-.... _.. _...... ... ... .. .......... . ... ,. 150
f Other AMT items (attach schedule ..........................................,.. _..... . _.... 15f
16 a Tex-cxemptinterest income. .. . .. .. .. .. . . . .. .. . .. - . .. .. .. . .. .. . , . . .. . .. . . .. .. .. . .. . . , . . . . .. 1 G a
b Olnoar t~)(-...)(p.mpt inr.nmp. ......... - . . .. . . . . . . . , . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . , . .. '6 b
c Nondeductible eXlXlnses ..................................,..................."........... 16c
d Properly distributions...... .................,..., . ..... _. _.. '........ ................. ..... lad
e Re a ment of loans from shareholders . .. .. .. .. .. . . , . . . .. . .. . .. . .. . . .. .. . .. , . .. .. .. .. . _ . . ... 16 e
17a Investment income..... -.................,.............,................. .......,......... 17a
b Investment expenses....,................. -....................,.....,.................... 17b
e Dividend distributions paid from accumulated earnings and profits.. . .. .. _.... ....... . , .. . ..... 17c
d Other items and llmounts
(attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . , , . . , . . . . . . . .
o (ncomenoss recQnc:illatlon. (Required only jf Schedule M-l must be completed.)
Combine the amounts on lines 1 through 10 in the far right column. From the result. subtra<:t
the sum of the amounts on lines 11 through 12e and titles 141 or 14m. whichever a Iies"....._
Credits
and
Credit
ReC::ilp-
tul'C:
FOI'l!/gn
Tran!!:-
actlollS
Alterna-
tive
MinI-
mum
TAX:
(AMT)
Items
Items
Affec.
tlng
S~"te.
h()ld~r
B.as/s
Other
Inform-
ation
BAA
0.2-0698686
Total stT\Qunt
7 549.
11
12a
12b
12c
12d
12e
138
13b
13<:
13d
13e
lSf
13
5PSAOI34 Q!I{lSIDS
Pa e3
o.
o.
1,615.
85 000.
o.
102 413.
Form 1120S (2004)
tt r Balance Sheets er Books
Assots
1 Ca:;h"" .........'." ,., '...., ,.' ...' ',' ,..
~a Tr~de notes and accounts receivable ...,.,.,
b Les~ allowance for bad debts ",.",.."....
3 Inventories,...".,., . . . . , . , . , . , , . . , . . , . . . ,
4 U.S. ~avernment obligations ...,.,..,...,...
5 T<lX'Gxcmpt ,s,Qcurities ., ' . . . , . . . , . . , . ' . , , . . ,
6 O1:I1er current asscls (attach scherisJ/e). , . 0 , , , , . . . , . , .
7 Loans 10 stulreholders . ' . , . . . . . . . , , . ' , , , , . . ,
8 MOrtgo1lge and real estate loans. 0 . , , , ' , 0 , , , . ,
9 Other Invcstmems (attach schedule) .....,..........
10 a eulldln~s clOd other depreciable assets, . 0 0 . . .
bLess sccumulated depreciation , . . , . , . . . . . ' . .
11 a Deplelllble 85sets ,.,."".,. 0 , , . , 0 0 . . , , . . , .
b Le:::: llccumulated depletion, . . . 0 . . . . , . . . , . , .
12 Land (net of any amortization) "."".',..,.
13:1 Intangible :.isseIS (amortizable only) ..'... o. .
b Less accumulated amortization . . . , . . . . . . . . . .
14 Other assets (attach schedul~) . ....... ... ., ,
, S TotClllJS5CtS..."......,....... . . . . . . . . . . . .
Ullbilities and Shareholders' Equity
16 Accounts payable.................... 0.....
17 Mo~\lCs. notes, bonds payable in less than 1 year .. o.
, B Other CUrrent liabilities (attac,~ sch) ......,..,......
19 Loen:.from Shareholders ...r................
20 Mcrtg4gc, notes, bonds payable. in 1 year or more .....
Z1 Otllp.r Jlabllltlas (.I1ff<1ch scbedule) ...,..... 0 . . . . . , . .
22 C:lpit::ll stock ,.......,...,..,..............
Z3 Additional paid.in capital ....,..............
24 Rete l!'led earnings , , .. .. .. .. . .. .. .. .. . .. . . ..
25 Adjustment: 1XI sh:Jroholders' equity (aft s'Cb). . . . . . . . . .
26 L~ss cost of treasury stock. .. . . . . .. . , . . . . .. .
27 Total liabilities and shareholders' e ui . , . ., ,
, . 'reow~. Reconciliation of Income (Loss)
1 Net inoome (loss) per books ...............,
2 IneclTl~ in~t1ed On Schedule K. lines 1, 2. 3c, 4, Sa, S, 7,
88,9, snd 10. not recorded on books this year (itemize):
Pa~e 4
'}, ~
15,798.
15 798.
15 798.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6. Deductions inelwed on Sthedule K, lines 1 througn
3 Expen,cs r'lleordcd on books this year not included on 12, and 141 or (14m). not charged against book
Schedule K, IIne~ 1lhrough 12, & 141 or (14m) (itemil:e): income this Ye:lr (itemize):
:I Oepreciatlon .....,. $_ _ _ _ _ _ _ _ _ _ _ a Depreciation. , , . $_ _ _ _ _ _ _ _ _ ~ _~
b Travel und entertainment. $_ _ _ _ _ _ J L ~ 1) -=.
_ _ _ _ __ _ _____ _ _ _ ______ _ 1 615. 7 Addlj;es5and6 ~~:-: :-:~.:-::-::-::-::-::-:
4 Add lines I thra h 3 .. .. .. .. .. .. " . .. .. . .. . 102 413. 8 l1lC!lme (loss)(Schedule In 17e). In 4 less In 7 .. 102 J 413 .
Analysis of Accumulated Adjustments Account, Other Acfjustments Account. and
Shareholders' Undistributed Taxable Income Previously Taxed (see instructions)
(:I) Accumulated ,(b) ather ~b~~~~~~T~;n~~~'
adjustments ao;;oul"lt ad)l,lstments account prQviousl taxed
, B..lsncc ~t beginning of tax year ",..,..,...,......,.....,.,...,..
2 OrdiMl)! Income from page 1. line 21 ..'...,...,....,. 0 . . . . . . . .. . .
3 Other add ilions .."..............................................
4 Lo:;s from page 1, line 21 . . . . , . . . , ' , . , . . . ' . . . . . . , . . . . . . . , , , . , , . , . .
S Other reductions. . . . . . . . . . . . .". . S1MT. . . , , , ' . , , . . . . . . . . . . . . . , . . . . .
6 Combine lines 1 thrOi,lgll 5 . . . . . . . . ' . . . . . .. . . . . , . . . . . . . ' . , ., , , . . . ..
7- DistributIons other-thandividenddiWibc/tions ~-.;-..-.,; . c.;, ",-,;; ;;
9 BalMce at end of tax ear. Subtract line 7 from line 6 ....."....."
109, 962. ~'.
ii! ;,' '0-
9 164.
100,798.
85 e DO;
1 S 798.
o.
O.
---0.
O.
Form 1'205 (2004)
SPSA0134 01105105
eM
u.s. Corporation Income Tax Return
For calendar year 2003 or We year beginning M a y 2 1 .2003, C!ndil'lg 0 e c 3 1 ,2 Q 0 3.
~ Instl11ctions anr se arale. Se~ instroetions for Pa erwork Reduction Act NoticlJ.
C\4;Ime B 1IZmp/0)/ft" idenlffi~8IJon nurnltet
Use IRS J 0 tn R . D nro-e 1 & A Sg) cia t.e s LlC 0 2 -0 6 9 8 6 8 6
Ofilbeh I.. Numlle,. ~tt.:et, and ta"", 0< suite Ilumber (If a ".0. bo.. see Inllrul;tions.) COatI! lncorp<lrl)led
t erwlsc,
print or 3 9 Ole r-e stnJI: S tre e t
type. Cily or \own Sl~'" ZIP coal!
F:orm 11 20
Oo-PArtmenl of Ihe T",l'S1ITY
Iftl~'"l.1l ROYI>ll~ s"",iCle
A Clleelc rh:
, Oo<1:/Olldaled ...,turn 0
(Df\llch FOr'" 851) ...
2 F'~rr.o..,r ~~~1~
mu']r,~Ii):'.... ,0
3 p.rl'OnJ:'1 'eNICI! ""'p
(~ ""r,roco III Rl!ps
~ctlon 1.....1.31~) -
'O(t Jnr.tr"UctJon:; ....
E Check a Iicable boxes: Final return (3) $
1 a GroS3 receipts or sales 2 n,lO 2 _ b Less returns & allowances . c Balance. . to 1 c
2 Cost of goods sold (Schedule A, line 8) . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . , . , . . . . . . . ' . . . , . . . . . . . 2
3 Gross profit. Subtracl Ii ne 2 from line I c . . .. .. .. . , . .. . . , . .. .. . , .. . . .. . .. . .. .. . . .. . . , , . .. . . .. ' . . . . . .. 3
4 Dividends (Schedule C. line 19) . .., .. .. . ... .. , . .. ... .. ... . .... . .. . . .. . , __ . . . .. .. . .. .. . . . .. , . . . . , . . . 4
5 Interest..., . ' . . . . , , . . . . . , . , . , . . . . . . . . . . , , . . , . . . ' , . . . . , , . . . . . . . . . . . . . . . . . . . , . . . . , . . . . . . . . . . . , . . . . . 5
6 Gross rents ...,..................................,...............,'....... _ , . . . . . . . . . . . . . . . . . . . . . 6
7 Gross royalties ........... - . . , . . . . , , . . . . . . . . . , . . . . . . . . . . . . . . . , . ' . . . . . . . . . . . . . _ . . . . . . . . . . . . , . . . . . . . 7
a Capital gain net income (attach Schedule D (Form 1120)) . , . . . . . . . . . . . . . . . , . . . . . . . . , . . . . . . . . . . . . , . . . . 8
9 Net gain or (loss) from Form 4797, Part II, line 18 (attach Form 4797) .....'...... _................... 9
10 other Income (see instructions - attach schedule) ....... ....,....., ..............,.. ... ,..,.., .... ......... .. 10
11 Total income. Add tines 3 throu h 10 ...........,....,............,....................",....... II- 11
12 Compensation of officers (Schedule E. Iin~ 4) . . . . . . . , . . . . . . . . . . . . . . . . . . , . . , , . . . . , . . . . . . , ' . , , ' . . . ' . .. 12
D" 13 Salaries and wages (less employment credits) ..........,.....',..............,........., _ , . . . . . . . ,. 13
5 ~ ~~ ~~~~~~~n~. ~~~t~.~~~~~. : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : :: ~:
g ~ 16 Rents...,..,..................................,........,...,....................,................ 16
T ~ 17 Taxes and licenses ...............................................,......,.........,.............. 17
b I 18 Interest.........,..................,.. -..... ..........,. .......,.. ..............., .,......... .... 18
NT'9 Charitable contributions (see Instructions for 10% limitation) ."........................,............. 19
S 0 20 Depreciation (~ttach Form 4562) .... .. ... .. .... .. ... ... .. . .. . .. .... .. .. .1 20 I 3 .5 15 .
s ~ 21 Less depreciation claimed on Schedule A and elsewhere on return ........ f2i"al
~ 0 2Z Depletion '...'..'....................'....-......................'...'............................
, N 23 Advertising...,.. . . . . . ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . '.
~ ~ 24 Pension. profit-sharing. etc, plans. . . . . . . . . ' , . . . . . . . . . . . , . . . . . . . . . . , . . . . . . . . . . .. . , , . . , . . . . . . . . . . . , . .
R ~ 25 Employee benefit programs ,..................,...........,...........,..............".,.........
~ T ~~ ~::~Id~~~~:~~~:~~~~~~:~ '1;~~~~~~ 2~e.~~t::~~:~:~~.~t::..::::::::::..:........:..:,,:::::::::::: ,'::'~
6 ~ Z8 Ta~Qble income before net operating loss deduction and spe,ial deductions. Subtract line 27 from line 11 ......,.............
~ :; ~9 Less: ill Net operating loss (NOL) deduction (see instructions). . . .. . , . . . . . . , . , . " ,. _ 29a
b S ecial deductions Schedule C. line 20) ., .. . .. .. . . . .. . . ' .. . '" 29 b
30 Taxable income. Subtractline 29c from line 28 .....................................................
31 Total lax (Schedule .I, line 11) ." .. . .. . . . . .. . . . . .. .. . .. .. . . . .. .. .. .. . .. " .. . .. .. . .. . , .. . . .. .. _ .. , ..
.3Z Payments: 01 ~~~~ . ., . . .. 32 a
b 2003 estimated tax payments... . " 32b
c L~s 2003 refund applied lor on Form 44G6 .. 32 c d 8al"
c TlllC deposited with Form 7004' . . . . . , , . . . . . . . . . . . . . , . , . . . . , . . , . . . . . . . . . . .
f Credit for tax paid on undistributed capital gains (attach Form 2439) . . . . . . .
g Credit for federal tOll<. on fuels (attOlch Form 4136). See instructions ......,. 32!:! 32: l'I
33 ~$ttmated tax penalty (see Instructions). Check if Form 2220 is attached. . . . . . . . . . . , , . . . . . . .. ~ 33
34 Tax due. If line 32h is smaller than the total of lines 31 and 33, enter amount owed ................,... 34
35 Overpayment. If line 3 is larger than the total of lines 31 and 33. enter emount overpaid ............, as
36 Enter ~mount of line 35 wa Credited to 2004 esti mated tax . . . . . , . . " ~ Refunded" 36
una", nftItleS 01 ~'jury. I <l I"'I! U II nlitled Illi. ,olurn, including Aa:omp"ny;"!l $Chodulr:$ And J~l,,",ent:;. ~nd to the br,;\ of mv knowledge
Sign nod; rt " ~'Llt. <"'teel. ~l ,Ie 'Ia. t;o,l or Pi'tP~'I!' (l>lhe, than . x","yo,) II I>i>:-.ed on oU i"","""l1on of whi<;h P'lIP""" h,,. ;>ny kflOWledge.
Here .. Pre sid e nt
TiU;
OMS No. 154!;.{Jltl3
2003
OS/21/03
o Tot.>l assets (set in;truclk>n.~)
I
N
C
o
M
E
T
A
X
A
Ii
D
P
A
Y
M
E
N
T
S
Paid
Pre parer's
Use Only
~~~~'s ...
Pirm's Namt
(or )'OUfSil
.a".amploytdl.
sdd,ess. and
Z1PCOOt
Pn:~r~r'$ SSN or P11N
18 9 -4 6 -7 06 9
57 -117 6 0 0 3
tf!S
542 Brid e Street
New (un b e rla rd
AA
17070
""Ol'I1! NQ.
CPC1oo0212 011I29103
.~sh'
1.987.
211.102 .
211.102.
211102.
8,075.
1500.
964.
3.515 .
197 048.
211102.
O.
0_
""'Y Ine IRs oi5cl"", /his
re\Um with UI9 sm:parer
shown beloW? {se~ inol)
X Ye$ No
Form 1120 (2003)
Ftlrm "20 (2003 J 0 tn R . 0 ~ 1& A sso cia t:l! s., LLC 02 -0698686 Pa e 2
CI Cost of Goods Sold see instructions
. 1 Inventory at beginning of year.. .. . . . . . . . . . . . . . . . . . . . . _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . 1
2 Purchases,.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . , . _ . . . _ . . , . . . . . . . , . , . . . . . . . . . . . , . . . . . . . . . , 2
3 Cost of labor. . . . . . . . . , . . . . . -. . , , . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . , . . . _ . . . . . , . . . . . _ . . . . . . . . . . . . . . . . . , . . . . . . 3
4 Additional Section 263A COsts (attach schedule) . . . - . . . . . . . . . . . , , . . . . . . . . . . . , . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . 4
S Other costs (attach schedule) ..,........................................,.....,.......,.........,.,..... 5
6 Totlll. Add lines 1 through 5 . . . . . . . . . . . . . - . . . . . . ... . . . . . . .. . .. . . . . . . .. . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . 6
7 Inventory al end of year ......,............,..............................,......................,...... 7
a Cost of goods sold. Subtraclline 7 from line 6. Enter here and on line 2, page 1 ...............,.........,... 8
911 Ch<!ck. all methods used tor valuinQ closing inventory: .
(l) ~ Cost as described in Regulations section 1,471.3
(il) Lower of cosl or market as described in ~egulaliol'l$ section 1.471-4
(Iii) Other (specify method used alld altach explanation.) ....... ...
b Check If lhete was a wriledoW1'l of subnormal goods as deserib~d~n- ~;l.Ilat-;;'~ ~;ctio~ ~.~;.2(;' ~.~.~.~.~.~.~.~.~,~ .~.-.~.~;: -8- --.
e Check if the LIFO inventory method was adopted lhis tall: year for any goods (if checked. attach Form 970) .........,.......... ,..
d ~~~~~:~ u::~~7o ~e~~~~ .~~~. ~~.d. :~~ ~~i.~ ~~ .~~~~'. ~~~:~ :.~r~.~~::'.e ~~~ .~~.~~~~?, ~~ .c~~~~~~ .i~~~~.t~:. . . . t 9d I
e If property is produced or acq~ired for resale, do the rules of section 263A apply to the corporation? ................... 0 Yes ~
f ~~~~h~~~:~rc Ch?~~~~~.~~W~~n~~gl~~~~~~~'. ~~~~'. ~~ .~~I~t~~~. ~~~~. ~~~.~i~~. ~~.~ . . . . . . . . . . . . . . . . . . , . . . . . . . . . . Yes No
Dividends and Special Deductions (a) Dividends (b) F'ercentlilge (c) Special dedvclions
(see Instrvc\!ons) received . (a) x (b)
1 Dividends from less.than.20%-0Wl1ed domestic corporations that are
SUbject to the 70% deduction (other than debt.finarn;ed stock) .......
2 Dividends from 20%.or.more.owned domestic corporation$lhat are
li\ubJccl to lhe 80% deduction (other than debt.financed slock) .......
3 Dividends on debt. financed stock of dome$~c and foreign corporations (sedion 24611.) .
4 Oividend~ on certain preferred stock of fess.lf1an.20%.awnBd public utilities. . . . . . . .
5 OIvldcnds on eertlin preferred stock of 2O%-or.rnore-owned public utilifies .... . . . . .
70
80
42
48
6 Dividends from less-than-20%-owned foreign corporations
and certain FSCs that are subject to the 70% deduction. . . . . . . . . . . . . 7 0
7 Dividends from 20%.or.more.owned foreign corporations
and certain FSCs that are subject to the 80% deduction. . . . . . . . . . . . . 8 0
8 Dividends from wholly owned foreign subsidiaries subject to the
100% deduction (section 245(b)) ......,.. . . . . . . . . . . . . . . . . . . . , , . . . . 10 0
9 Total. A~d lines 1 through B. See instructions for limitation .......... .
i 0 Dividend; from domestic ct)rporations received by a small business investment
compuny operating under the Small Business IMSlment AI;t of 1958 . . . . . . . . . . . . . . 10 0
11 Dividends from certain FSCs th~t are s~biect to tile 100% deduction (see 245(c)(1)) . . . 10 0
12 Dlvlocnds. from affiliated group members subject to thll 100%
deduction (section 243(a)(3)) ................,....................
other dividends from foreign corporatlons pot Included on lines 3, 6, 7, 8, or 11 ......
1l\col'l1Q from controlled foreign corporations under sullpart F (attach Form(s) 5471) .. .
Forelpn dividend gross.up (section 78) ............................
le.DISC and former DISC dividends not i~cluded on line$ 1, 2, or 3 (section 246{d)) . . .
Other dividends. . . . . . . . . , , . . . . . . . . . . . . . . _ . . . . . . . . . , . . . . . . . . . . . . . .
OedllCtion for dividends paid on cenain preferred stock of publiC u~hl.ilU . . . , . . . . , . . '-. '"
Total dividends. Add lines 1 through 17. Enter I1ere end on line 4, page 1 . , . . . , . . .-
Totill s eci2l1 deductlons. Add lines 9,10.11,12, and 18. Enter here and on line.2gb a e 1 ................... ...
If dl'~e Compensation of Officers (see instructions for line 12)
Note: CDmplete Schedule E only iftolal receipts (line la plus lines 4 through 10 on page 1) are $500,000 or more.
1 (8) (b) \C:) Percent of Percent of corporation smck owned (f) Amount of
Name of officer Social security numb9r ime devoted Cd) Common (e) Preferred compensation
to bvsiriess
% % %
% % %
% % %
% % %
% % %
2 Tolal compensation of officers. . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Compensation of officers claimed on Schedule A and elsewhere on return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . , . . .
4 Svbtrect li!'le 3 from line ?. Enter the result here ;;Inti on line 12, pace 1 ..'....'......._........'..................
Cl>CAll212 08129103
F' orm "20 (2003)
7 At lilny time during the tax year, did on~ foreign person
own, directly or indirectly, at least 25% of (;l) the total
voting pOwer of all classes of slock of the corporation
entitled to vOle or (b) the total value of all classes of
stock of the corporation? ..........,.............."".....
If 'Yes: enter: (a) Percentage awned ..,..,.. ~
and (b) Owner's country" _ _ _ _ _ _ _ _ _ ~ ~ ~ : : :
c: The corporation may have to fife Form 5472,
Information Return of a 25% Foreign.Owned U,S,
Corporation or a Foreign Corporation Engaged in
a U.S. Trade or Business. Enter number of
Forms 5472 attached . . . .. .. . .. . . .. .. , , , .. ~
8 Check this box if the corporation issue<1 publicly offered ~ - -
debt instruments with original issue discount ,. , , . , ." 0
If checked, the corporation may have to file Form 8281,
Information Return for Publicly Offere<1 Original Issue
Discount Instruments,
9. Enter the amount of tax-exempt interest receive<1 or
accrued during \he tax year .... 10- $ _ _ _ _ _ _ _ _ _ _ _
10 Enter the number of shareholders at the end of the lax year
(if 75 or fewl;!r) . . , , , , . , , . . . . . . . . . . . . . . . . . . . . . . . ., ~ _ _ _
11 If the corporation has an NOL for the tax 'year and is elec~
to forego the carryba<::k period, <::heck here , , , . . . , .... U
If the corporation is filing a consolidated return, the statement raquired by
Temporary Regulations section 1.15()2.21(b)(3)(i) or Oi) must be attached or
the election will not be valid.
12 Enter the available NOl carryover Irom prior tax years
(Do not reduce it by any deduction on line 29a.)
6 Durln~ this tax year. did the corporaliOn pay dividends . $
(other than stock dividends and distributions in
exchange for stOCk) in excess of the corporation's Are Ine torpO'ration'i.Totalreceipts (line 1.. plus lines 4
eurrl!nt CU'ld accumulated earnings C1nd profits? (See through 10 on page 1) for the tax year and its total assets
sedlons 301 and 316.) .......................,'..... at the end of the tax year less than $250,0001 .. .. . . .. . , , . , ..
If 'Yes: file Form 5452, Corporate Report of If 'Yes: Ihe corporalion is not required to complete
NondJvldend Oistributions. Schedules l, M-l, and M-2 On page 4. Instead, enter the
If lhis is a consolidated retvrn, answer here for the total amount of cash distributions al'ld the book value of
parent corporation and on FQnn 1151. Affiliations property distributions (other than cash) made during the
Schedule, for each subsldary. tax year.. S _ _ _ _ _ _ _ _ _ .9~ _ _ _ _ _ _ _ _ __
Note: If the corpor8tion. at any ti1Tl8 during the t8x year, had assets or operated /1 business in a foreign country or U.S. p()5Session, it may be
required to nfttJch St;hedule N (Form 7 720), Foreign Operations of U.S. Ccrpor"tions, to this return. SH S(;heav/e N for cietaiJs.
BAA CPCAlI234I:!-'08IOJFormn1 120 (2003)-
J 0 m R . 0 n.&t-e 1 & A sse da te s ll.C
Tax Com utation (see instructions
ChecS< .f the corporation is a member of a controlled group (see sections 1561 and 1563). . . .. . , . . . . . . ~
Important: Members of a controlled group. see instructions.
2 a If lhe box on line 1 is chec.ked, enter !he corporation's share of the $50,000, $25.000, & $9,925,000 taxable income brackets (in l11at order):
(1) $ (2) $ (3) $
b Enter the <::orporation's share of; (1) Additional 5% tai(11Ot more than $11,750) .,....... $
(2) Ad~ilionel 3% l.a~ (not mora than $100,(0)) ........ $
3 IJ'lCome t<lX. Che<::k if a qualified p€rSOnal service corporation under section 448(d)(2)
(3ee instruclions) . . . , , . . . . . . . . , . , . . . . . . . . . , , . . . . . . . , . , . . . . . . . . , , . . . . . . . . , . . . . . . . . , , , . . . . . . . , , , , . 10- 0
4 Alternative miniml.lm tax (attach Form 4626) . , . . . . . . . , , . . . . . . . . . . , . . . . . . . . , . . . . . . . . . , . . . . . . . . , . , , . . . . . . . . .
5 Add lines 3 and 4 ........."............................",........."......",.....................",
6 a Foreign lax credit (attach Form 1118) , , . . . . .. . .. , .. .. .. . .. , . . .. .. . , . , , . . .. . . . , 6 a
b Possessions lax credit (altach Form 5735) ...,.........,.........., , , . . . . . . . , . 6 b
c Check: 0 Nonconv~ntional source fuel credit 0 OEV credit (attach Form 8834) .......,,'. 6 c
d General business <::redit. Check box(es) and indicate which forms are attached.
o Form 3800 o Form(s) (specify). ~ 6d
~ Credit for prior )'Q:;lr minimum talC (attachF~r;;; 8827) ~.~.~.~.~.~,~.~.~.~.~,~..,. 6e
f Qu&lified zona Olcademy bond credit (attach Form 8860) ..... ."..... ...... , ,... 6f
7 Tolld credIt$. Add lines 601 through 6f . .. . .. .. .. .. . .. .. . .. , , .. . . . . . . .. . .. . . .. . . . . .. . , , .. . .. .. .. , . , , , .. .. . .
S Subtract line 7 from line 5 ',............,',..........".........."...........",.........."".........
9 Personal holding company tax (attach Schedule PH (Form 1120)) , .. . . .. ... .. , . .. .. .. . .. . . .. .. .. . . .. .. .. .. ,
10 Other taxcs, Check if from: B Form 4255 B Form 8611 0 Form 8697
Form 8866 Other (attach schedule) . . . . . , , , . . . . . . . . . . . , . , . . . . . . . . . .
'1 Total tax. Add lines B Ihrou h 10, Enter here and on line 31, a e 1 ............,............,.."........
al'etful ", . r. '. Other Infonnation (see instructions)
, Checl( method of accounting;
:8~:r~specdy~ ~~::~__ __ _ _ _ ___ ___
2 See the instrl.lCtions and enter the:
a Business a<::tivity cooe no," 5 4 19 9 0
b Bu:;ln~s activlly ... M 8) IC A-CS1R'V In:s - - - -
c Product or service · - 'MErfftA'[ 5 EifV-IC 5- - -
3 Al the end of the lax year;-dTdthe corporationown, --
directly or indirectly, 50% or more of the voting slack
of a domestic corporation? (For rules of attribution,
see scctlon 267(c).) ......................... .. .. .. . .
If 'Yes,' attach a schedule showing: (3) name
end employer identification I'\umber (ErN), (b)
~rcentage owned, and (c) taxable in<::ome or
(loSS) before NOL and special deduchons of such
corporAtion for the tax year ending with or within
your tax year.
4 Is the corporation a subsidiary in an affiliated group
or a parent-subsidiary controlled group? ,.............
If 'Yes,' cnter name and EIN of Ihe parent corporation
.
02-0698686
Pa e3
5 Altli'e end oftlie lax year:- did-any lndividuaCparj: - - -
nc~hip. corporation, estate or trust Own, directly or
indirectly. 50'10 or more of the corporation's voting
:;tock? (t'or rules of attribu1ion, see section 267(c),) , . . .
II 'Yes: attach a schedule showing name and
identifying number, (Do not include any information
&lreeoy entered in 4 above,)
EnjClr % oWMd" _ _ _1.Q.Q _:.0_0. See Ques 5 Stmt
Form 1120 (2003) J 0 tn R . D I\5C:l"e 1 & A $SO cia te s, LLC 0 2 -06 986 86 .
ration Is nol required to complete St::.hedules /... M.T and M.2 If Questicn 13 on Scnedule K is answerad 'Yes. '
Balance Sheets er Books Beginning of tax year End of tax year
Assets (a) (b) (c)
1 Cu:oh ... ........, ,., .., ....................
2.1 Tr1ilde notes and acoounts receivable....... ,
b Less allowance for bad debts .......,..,....
3 Inventories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 u.s. 90vcrnment obligations ................
5 Tax.exempt seeunties (see instructions) .....
6 Olher currant assets (aUacn Sd1l!dule) . . . . . . . . . . . . . . . .
7 LOlms to shareholders .........' . . . . . . . . . . . .
8 Mortqaflc and real estate IOiill'l$ . . . . . . . . . . . , . .
9 Other investments (attach schedule) ................
lOa Buildings and other depreciable assets.. ..,. .
b L.e:;s accumulated depreciation. . . , ... .. .....
" 3 Depletable assets. . . . . . . . . . . . . . . . . . . . . . . . . .
bLess l'ICc:umul3ted depletion , . . . . . . . . . . . . . . . .
12 Land (net of any amortization) .............. .'
13 a Intangible assets (amortizable only) .........
b less accumulated .amorti-:ation . . . . . . . . . . . . . .
14 Ol'np.r assets (attach schedule) ...'..........,.....
15 TotDI assets ...............................
Uabllltics and Shareholders' Equity
16 Accounts payable ................. ........
17 Mortgages, notes, bonds payable in less than 1 Yllar ....
1 B OthIlr current liabilities (attach seh) ....,'..........
19 loans from s.hareholders .....,............,
20 Mortqa!lO~. nct~. bond$ payable in 1 year or more .....
21 Oth~r lIeblllbes (attach schedule) ..................
~ Capital stock: a Preferred stock .. . . . . . . . . . .
b Common stock ............
Additional paid.in COlPi!al ...........,.......
P.~I~I~~(f ";\"U1\~ - Apprap (:lll~) . . . . . . . . . . . . . . . .
Retained earnings ~ Unappropriated .....,..
F\djmnt l~ ~h",..halQ<,r:;' !;Quily (:>11 sdI) .. . . . . . . . . . . . . .
Los:; cost of treasury slack. . . . . . . . . . . . . . . , . .
Page 4
(d)
1987.
1.987.
1,987.
o.
-----------------------
5 Expenses recorded on books this year not
deducted on this return (itemize):
a Depreciation ....... $ _ _ _ _ _ _ _ _ _ _ _
b CMarltabla contributions . $ _ _ _ _ _ _ _ _ _ _ _
c Tr IIvel & entertainment. . $
----------------~~------
o.
--------------------
-~---------------------
CFCAOZ34 121Q8rOl
O.
Form 1120 (2003)
4 Add lines 1. 2, and 3
John R. Druschel and Associates, LLC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
vs
: DOCKET NO. 05-3496
Deana Davis, David Furline, and
The IV League, LLC,
Defendant
: JURY TRIAL REQUESTED
: CIVIL ACTION AT LA W
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the
following pages, you must take action within twenty (20) days after this Complaint and Notice
are served, by entering a written appearance personally or by attorney and filing in writing with
the Court your defenses or objections to the claims set forth against you. You are warned that if
you fail to do so the case may proceed without you and a judgment may be entered against you by
the Court without further notice for any money claimed in the Complaint or for any other claim
or relief requested by the Plaintiff. You may lose money or property or other rights important to
you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT
HA VE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW.
THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A
LA WYER.
IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAYBE ABLE TO
PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER
LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
32 SOUTH BEDFORD STREET
CARLISLE, P A 17013-330S
(717) 249-3166
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Jo1m R. Druschel and Associates, LLC,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
vs
: DOCKET NO. 05-3496
Deana Davis, David Furline, and
The IV League, LLC,
Defendant
: JURY TRIAL REQUESTED
: CIVIL ACTION AT LAW
AMENDED COMPLAINT
AND NOW, comes the Plaintiff, Jo1m R. Druschel and Associates, LLC, by and through
their attorney, Mark K. Emery, Esquire, and files this Amended Complaint as follows:
1. John R. Druschel and Associates, LLC, ("Plaintiffs") is Pennsylvania Limited Liability
Company with an address for transacting business at 3901 Chestnut Street, Camp Hill,
Pennsylvania 17011.
2. Defendant Deana Davis ("Davis") is an adult individual with a current residence of 524
Chaparral Drive, Cranberry Township, Pa. 16066..
3. David FurIine ("Furline") is and adult individual with a current address of2607 Wyncote
Road, Bethel Park, Pa. 15102.
4. Upon information and belief, The IV League, LLC, is a Pennsylvania Limited Liability
Company with a current address for conducting business of 524 Chaparral Drive,
Cranberry Township, Pa. 16066.
5. Plaintiff is in the business of providing pharmacy supply companies with nurse staffing
and nurse availability for intravenous medical services.
6. As part of Plaintiff s business, it subcontracted with Defendants Davis and Furline to
provide services to Plaintiffs clientele.
7. Plaintiff and Defendants Davis and Furline entered into a related business relationship
where as Davis and Furline would act as independent contractors to provide nursing
services to Plaintiffs' clientele.
8. No written contract was entered into between the parties, nor were there any specific
terms as to when payment would be made for services provided by Davis and Furline.
9. It was the agreement of the parties that Davis and Furline would receive payment for their
services subsequent to when Plaintiff received payment from the pharmacy supply
servIce.
10. Upon information and belief, Davis and Furline created The IV League, LLC in or about
August, 2004, and since such time the have operated under such entity.
11. Based partially upon late payments from the various general pharmacy supply companies,
payments from Plaintiff to Defendants became in arrears.
12. In or about June 2005, Plaintiff and Defendants entered into an agreement where Plaintiff
would make payment to Defendants of all outstanding balances due on or before June 30,
2005.
13. Unbeknownst to Plaintiff, on June 16, 2005 Defendants contacted at least one of the
Plaintiff s clients, OmniCare Pharmacy Services of Pennsylvania, stating to OmniCare
that Plaintiff was not making payments to them, and that if payment was not made by
June 30th Defendants would cease all further services.
14. The intent of such contact was not to advise Omni Care of the potential loss of services,
2
but rather to attempt to usurp the contractual relationship between Plaintiff and Omni
Care.
15. Defendants did usurp the existing contract between Plaintiff and OmniCare, and have
now commenced providing services directly to OmniCare and direct interference with the
contractual relationship between Plaintiff and OmniCare.
16. . Defendants action was calculated to create a distrust and concern on the part of Omni
Care in order to induce Omni Care to terminate its' contract with Plaintiff and reestablish
such contract with Defendants.
17. In or about June 2005, Defendant Furline, while providing services as a subcontractor of
Plaintiff, advised a nursing home that the general pharmaceutical supplier, Millennium
Pharmacy Services, was not making payment when due.
18. Furline's comments were meant to induce the nursing home to contract directly with the
IV League, rather than using Millennium Pharmacy Services.
19. Millennium Pharmacy Services utilizes Plaintiff to provided such services.
20. Furline's comments were made in his individual capacity, as well as in his capacity as a
representative and member of The IV League.
21. Defendant's conduct was meant to induce Millennium Pharmacy Services and or the
nursing home to contract directly with Defendants rather than through Plaintiff.
22. Due to Defendant's actions, Millennium Pharmacy Services has canceled its contract with
Plaintiff and now contracts directly with Defendants.
3
COUNT I
TORTIOUS INTERFERENCE WITH BUSINESS RELATIONSHIP
23. Paragraphs 1 through 22 are incorporated fully herein by reference.
24. Plaintiff possessed a current contractual relationship with both OmniCare and
Millennium.
25. Defendant's actions were neither privileged nor justified, and were done with specific
purpose or intent to harm Plaintiff by usurping the contract Plaintiff held with such
entities in order to obtain the contract directly.
26. Plaintiff has suffered actual damages through the loss of the contracts with OmniCare and
Millennium and the profits that are generated through such contracts.
WHEREFORE, Plaintiff respectfully requests this Honorable Court enter judgement for it
and against Defendants jointly and severally and award all further relief allowed by law.
Respectfully submitted,
LA W OFFICES OF MARK K. EMERY
By:
:-9~~~~..
~"'- ./(~J........~~
Mark K. Emery, Esquir~
Supreme Court J.D. No. 72787
410 North Second Street
Harrisburg, P A 17101
(717) 238-9883
Attorney for Plaintiff
DATE: July 26, 2005
4
VERJFICATiON
I. John R. Druschel, on behalf of John R. Druschel & Associates, LLC,
hereby verify that i have read tM foregoing Complaint and that t"e Information
contained therein IS true and correct to the be~1 of my knowledge. informa.tion
and belief. I understand that false statements herein are subject to the penalties
of 18 Pa.C.S. 94904 relating to unsworn falsiflcation to authoritie8.
~A~~
bh R. Druschel, Manager
I
\j
DATE:
7~'/-ur
JOHN R. DRUSCHEL AND
ASSOCIATES, LLC,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiff
DOCKET NO: 05-3496
vs.
JURY TRIAL REQUESTED
DEANA DAVIS, DAVID FURLINE,
AND THE IV LEAGUE, LLC,
CIVIL ACTION AT LAW
Defendants
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TO:
John R. Druschel and Associates, LLC
and
Mark K. Emery, Esquire (Attorney for Plaintiff and Counterclaim Defendant)
You are hereby notified to file a written response to the enclosed Defendants' New
Matter and Counterclaim Plaintiff s Counterclaim within twenty (20) days from service hereof or
I a judgment may be entered against you.
SNELBAKER & BRENNEMAN, P.c.
1 'c COpy FROM REcd\!lO ~ Esquire
: ~\ T rr . . ony WMr~of, I hare unto rd IlY hInO 44 West Main Street
r e s~1 Of S(1ld Coo. ~ Car1tsIe. ~:( P.O. Box 318
,dSv ~. Mechanicsburg, P A 17055-0318
~r (717) 697-8528
Attorneys for Defendants and Counterclaim Plaintiff
JOHN R. DRUSCHEL AND
ASSOCIATES, LLC,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiff
DOCKET NO: 05-3496
vs.
JURY TRIAL REQUESTED
DEANA DAVIS, DAVID FURLINE,
AND THE IV LEAGUE LLC
CIVIL ACTION AT LAW
Defendants
DEFENDANTS' ANSWER TO AMENDED
COMPLAINT WITH NEW MATTER AND COUNTERCLAIM
ANSWER
AND NOW, come the Defendants by their attorneys, Snelbaker & Brenneman, P.c., and
respond to the Plaintiff's Amended Complaint as follows:
1. Admitted.
2. All averments in paragraph 2 are admitted except the status of Deana Davis as a
defendant. For the reasons hereinafter set forth, it is denied that Deana Davis has been properly
named as a defendant, said averment being scandalous and impertinent and should be stricken.
3. The averments in paragraph 3 are admitted as stated. If Plaintiff intends by such
identification to characterize David Furline as a defendant, it is denied for all the reasons set
forth hereinbelow, that he has been properly named as a defendant, said averment being
scandalous and impertinent and should be stricken.
4. Admitted.
5. Admitted.
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.c.
6. Admitted except to the characterization of Davis and Furline being defendants.
For all the reasons set forth hereinbelow, it is denied that Davis and Furline have been properly
named as defendants, said avennent being scandalous and impertinent and should be stricken.
7. Admitted except to the characterizatio.n of Davis and Furline being defendants.
For all the reasons set forth hereinbelow, it is denied that Davis and Furline have been properly
named as defendants, said averment being scandalous and impertinent and should be stricken.
8. It is admitted that no written contract was made by the parties. It is denied that
there were no specific terms as to when payments would be made to Davis and Furline. On the
contrary, on Plaintiffs proposal, the parties agreed that Plaintiff would pay for the services two
(2) times per month in full.
9. It is admitted that only for payment timing and cash flow purposes, it was agreed
that Plaintiff would pay Davis and Furline for their services after Plaintiff received payment from
the pharmacy supply service, but it is denied that Plaintiffs liability to Davis and Furline was
conditioned on Plaintiffs receipt of payment from such pharmacy supply service. On the
contrary, Plaintiff was obligated to pay Davis and Furline for their services regardless of
Plaintiffs recovery of monies from the pharmacy service. By way of further response, it is
averred that on Plaintiffs proposal, the parties agreed that such payments would be made two (2)
times per month in full.
10. Admitted. By way of further response, it is averred that contemporaneously with
the formation of The IV League LLC the parties mutually cancelled Davis' and Furline's
relationship as individuals and substituted said new limited liability company for said
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
individuals, all other tenns of their contract remaining the same.
2
1 I. It is admitted that payments from Plaintiff to The IV League LLC became in
arrears. After reasonable investigation, Defendants are without knowledge or information
sufficient to form a belief as to the truth of the avemlent that said arrearage situation was based
partially upon late payments from various general pharmacy supply companies and, therefore, it
is deemed to be denied pursuant to Pa. R. C.P. I 029 (c), proof of which is demanded at the trial of
the case, if relevant. By way of further response, it is averred that Plaintiff breached the parties'
contract by failing to pay for the Defendant's services in full.
12. It is denied that the parties entered into the agreement as alleged in paragraph 12.
On the contrary, it is averred that Plaintiff unilaterally promised payment of all outstanding
balances by June 30, 2005, which promise Plaintiff failed to keep.
13. It is denied that Defendants made the contact as alleged. On the contrary, it is
averred that The IV League LLC made such contact, the substantive content of the contact being
as contained in paragraph 13. It is denied that said contact was made "unbeknownst to Plaintiff'.
On the contrary, it is averred that after numerous unsuccessful attempts to obtain payment fro111
Plaintiff, Defendant The IV League LLC contemporaneously with its contact with OmniCare
Pharmacy of Pennsylvania ("OmniCare"), gave notice to Plaintiff containing the same content.
14. It is denied that the intent of the contact with OmniCare was an attempt to usurp
the contractual relationship between Plaintiff and OmniCare. On the contrary, the sole purpose
and intent of such contact was to advise OmniCare of The IV League LLC's intent to discontinue
its services in a good faith effort to discharge its ethical responsibility to OmniCare and Plaintiff
in order that other services could be arranged for OmniCare's clients in a timely manner.
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
15.
It is denied that the Defendants usurped any contract between OmniCare and
Plaintiff or interfered with any such contractual relationship. On the contrary, for reasons
3
beyond Defendants' actual knowledge, OmniCare and Plaintiff terminated their business
relationship whereupon OmniCare agreed to have The IV League LLC perform the required
services. It is denied that Davis and FurIine individually have a contractual relationship with
OmniCare. On the contrary, only The IV League LLC has provided services for/to OmniCare.
16. It is denied that Defendants' action was calculated to create a distrust and concern
in order to induce OmniCare to terminate its contract with Plaintiff and reestablish such contract
with Defendants. On the contrary, it was The IV League LLC's action to advise OmniCare of its
intention to discontinue its services in a good faith effort to discharge its ethical responsibility to
OmniCare and Plaintiff in order that other services could be arranged for OmniCare's clients 111 a
timely manner.
17. It is denied that Furline was a subcontractor of Plaintiff in June 2005. On the
contrary, as averred in paragraph 10 above, The IV League LLC became the subcontractor of
Plaintiff in August 2004. It is further denied that Furline made the alleged statements for any
improper purpose. On the contrary, and again as averred hereinabove, The IV League LLC via
Furline gave good faith notice to one of its service recipients that it would be terminating its
services because The IV League LLC was not being paid by Plaintiff who blamed the non-
payment on Millenniums' failure to pay Plaintiff.
18. It is denied that FurIine's comments were made to induce the nursing home to
deal directly with The IV League LLC rather than Millennium. On the contrary, The IV League
LLC's comments via Furline were made to give timely notice to the nursing home to obtain
substitute services upon The IV League LLC's discontinuance of service through Plaintiff.
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
19.
After reasonable investigation, Defendants are without knowledge or information
sufficient to form a belief that "Millennium Pharmacy Services utilizes Plaintiff to provided [sic]
4
LAW OFFICES
SNELBAKER &
BRENNEMAN, P.C.
such services" and, therefore, the same is deemed to be denied pursuant to Pa. R.c.P. 1029 (c),
proof of which is demanded at the trial of the case, if relevant.
20. It is denied that Furline's comments were made in his individual capacity. On the
contrary, such comments were made solely as a member or representative of The IV League
LLC.
21. It is denied that Defendants' conduct was meant to induce Millennium Phannacy
Services and/or the nursing home to contract directly with Defendants rather than through
Plaintiff. On the contrary, as averred above, it was The IV League LLC's good faith purpose to
infol111 the nursing home of The IV League LLC's impending tennination of services in order for
the home to arrange for substitute services.
22. After reasonable investigation, Defendants are without knowledge or information
sufficient to form a belief as to the truth of the averments that Millennium Pharmacy Services
cancelled its contract with Plaintiff, and, if true, that such cancellation was "due to defendants'
actions" and, therefore, the same are deemed to be denied pursuant to Pa. R.C.P. 1029 (c), proof
of which is demanded at the trial of the case, if relevant. It is denied that Millennium Phannacy
Services now contracts directly with Defendants. On the contrary, none of the persons/entities
identified as a Defendant herein has any contractual relationship with Millennium Phannacy
Services.
5
COUNTl
23. The responses contained in paragraphs 1 through 22 hereinabove are incorporated
herein by reference thereto as though fully set forth herein.
24. The content of paragraph 24 is a series of conclusions of law to which no
response is required and, therefore, are deemed to be denied. To the extent that said content is
determined to be factual, Defendants, after reasonable investigation, are without knowledge or
information sufficient to form a belief as to the truth of the statements and, therefore, are deemed
to be denied pursuant to Pa. RC.P. 1029 (c), proof of which is demanded at the trial of the case.
if relevant.
25. The content of paragraph 25 is a series of conclusions oflaw to which no
response is required and, therefore, are deemed to be denied. It is specifically denied that
Defendants' alleged actions were not performed to harm Plaintiff nor to usurp contracts in order
to obtain the contracts for the account of The IV League LLC or anyone else. On the contrary, it
was Defendants' purpose to alert interested persons/entities of the discontinuance of The IV
League LLC's services because of Plaintiffs defalcation in properly paying The IV League LLC
in order that such persons/entities could make arrangements for substitute services in a timely
maimer.
26. After reasonable investigation, Defendants are without knowledge or information
sufficient to form a belief as to the truth of the averments that Plaintiff has suffered actual
damages and/or profits generated through the alleged loss of contracts with OmniCare and
Millennium and, therefore, said averments are deemed to be denied pursuant to Pa. R.C.P. 1029
LAW OFFICES
SNELBAKER 8:
BRENNEMAN. P.C.
(c), proof of which is demanded at the trial of the case, if relevant.
6
WHEREFORE, Defendants request the Court to dismiss Plaintiffs Complaint and enter
judgment in favor of Defendants and against Plaintiff.
NEW MATTER
By way of further response and defense, Defendants aver the following New Matter:
27. No contract exists whereby any Defendant is restricted or prevented from
competing with Plaintiff.
28. Under the original contractual terms, Davis and Furline, as individuals, were
separate subcontractors of and with Plaintiff.
29. Upon the formation of The IV League LLC on or about August 20, 2004, and by
agreement of all parties, Davis and Furline as individuals ceased being subcontractors of and
with Plaintiff, and The IV League LLC became the sole subcontractor in substitution for said
individuals.
30. Plaintiff as improperly joined David and Furline as defendants.
31. Plaintiff and Defendant The IV League LLC agreed (as did the previous
individual subcontractors) that Plaintiff would pay The IV League LLC for its services in full
two (2) times per month pursuant to billings from The IV League LLC.
32. Attached hereto marked "Exhibit A" and incorporated herein by reference thereto
is a tabulation of amounts billed by The IV League LLC for services rendered to OmniCare and
Plaintiff's payments on account thereof.
LAW OFFICES
SNELBAKER &
BRENNEMAN, P,C.
33. Beginning in September of2004, Plaintiff began to fail to pay two (2) times per
month as agreed and failed to remit payment in full at any time thereafter.
34. Plaintiff's last payment to The IV League LLC was on May 25, 2005.
7
35. The unpaid balance owing by Plaintiff to The IV League LLC on the OmniCare
account is $74,045.00.
36. Attached hereto marked "Exhibit B" and incorporated herein by reference thereto
is a tabulation of amounts billed by The IV League LLC to Plaintiff for services rendered to
Millelmium and Plaintiffs payments on account thereof.
37. Beginning in February 2005, Plaintiff began to fail to pay two (2) times per month
as agreed and failed to remit payment in full at any time thereafter.
38. Plaintiffs last payment to The IV League LLC was on June 30,2005.
39. The unpaid balance owing by Plaintiff to The IV League LLC on the Millennium
account is $10,805.00.
40. Upon information and belief, it is averred that OmniCare and Millennium paid
Plaintiff for all amounts billed to Plaintiff as shown on Exhibits A and B.
4 I. Before making the contacts averred in paragraphs 42 and 43 hereinbelow, The IV
League LLC made repeated efforts to discuss with Plaintiff the Plaintiffs defaults, leaving
numerous telephone messages, to which Plaintiff made no responses thereby indicating its
intention to not pay The IV League LLC in breach of the parties' agreement.
42. The IV League LLC's contact with OmniCare in June 2005 was for the sole
urpose of informing OmniCare that The IV League LLC was intending to terminate its services
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
o OmniCare clients in order that OmniCare could make timely arrangements for substitute
43. The IV League LLC's contacts with a nursing home client of Millennium in July
005 was for the sole purpose of informing the nursing home that The IV League LLC was
8
LAW OFFICES
SNELBAKER &
BRENNEMAN, P.c.
intending to terminate its services in order that said nursing home could make timely
arrangements for substitute services.
44. In making the contacts averred in paragraphs 42 and 43 above, The IV League
LLC was motivated solely by moral and/or ethical concern for the medical welfare of the
patients otherwise anticipated to be served.
45. Upon information and belief, it is averred that Plaintiff voluntarily cancelled its
contract with OmniCare for those customers served by The IV League LLC.
46. All of Defendants' conduct was privileged and justified.
47. Plaintiffs Amended Complaint fails to set forth any claim or cause of action upon
which relief may be granted.
48. Plaintiffs Amended Complaint should be stricken for failure to comply with Pa.
R.C.P. 1021 (c).
WHEREFORE, Defendants request the Court to dismiss Plaintiffs Complaint and
enter judgment in favor of Defendants and against Plaintiff.
COUNTERCLAIM
THE IV LEAGUE LLC V. JOHN R. DRUSCHEL AND ASSOCIATES. L.L.C.
COUNT I-CONTRACT
49. The Counterclaim Plaintiff herein is IV League LLC, a Pennsylvania limited
liability company, having its principal office and place of business at 524 Chaparral Drive,
Cranberry Township, Pennsylvania 16066.
9
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.c.
II
,
50. The Counterclaim Defendant herein is John R. Druschel and Associates, L.L.C., a
Pennsylvania limited liability company having its principal place of business at 3901 Chestnut
Street, Camp Hill (Hampden Township), Cumberland County, Pennsylvania 17011.
51. Counterclaim Plaintiff is in the business of inserting intravenous catheters in
patients in nursing homes.
52. Counterclaim Defendant is also in the business of inserting intravenous catheters
in patients in nursing homes.
53. On or about August 20, 2004, the parties hereto entered into an oral contract
whereby Counterclaim Plaintiff agreed to perform intravenous catheterization services to various
nursing homes or other similar facilities in western Pennsylvania on behalf of Counterclaim
Defendant the relevant terms of which were/are as follows:
A. Counterclaim Plaintiff would provide its services as a subcontractor
(independent contractor) to Counterclaim Defendant.
B. Counterclaim Defendant promised to pay to Counterclaim Plaintiff for
said services on a unit basis fee per procedure as follows:
Procedure/Service
Midline Catheter
Midline Catheter
Basic IV
PICC Line
Advance Visit
Fee per Procedure
$120.00 for first 100 per calendar month
$115.00 for next 100 (101-200) per calendar month
$75.00
$285.00
$150.00
The amount due to be determined from Counterclaim Plaintiff s submission of itemized
billings therefor to Counterclaim Defendant two (2) times per month. Payment in full
was to be made by Counterclaim Defendant for each such billing two (2) times per
month.
10
54. Counterclaim Plaintiffs first services were for patients of Omnicare Pharmacy
Services of Pemlsylvania ("Omnicare") (a client of Counterclaim Defendant).
55. In keeping with the parties' contract aforesaid, Counterclaim Plaintiff submitted
its periodic billings to Counterclaim Defendant for services to OmniCare patients as set forth in
detail under the headings of "Billing Date" and Billing Amount" on the attached statement of
account marked "Exhibit A" and incorporated herein by reference thereto. Counterclaim
Defendant paid the amounts shown on Exhibit A under the headings of "Payment Date" and
"Payment Amount".
56. As charted on Exhibit A, Counterclaim Defendant neglected and failed to pay
Counterclaim Plaintiff in accordance with the parties' contract as aforesaid, leaving an unpaid
balance of $74,045.00 due Counterclaim Plaintiff.
57. Commencing on or about February 1, 2005, at Counterclaim Defendant's request,
the parties agreed to expand the services of Counterclaim Plaintiff to include facilities served by
Millennium Pharmacy Services ("Millennium") (another client of Counterclaim Defendant) on
the same general terms as the parties' original contract aforesaid, but using the following fee
rates per procedure:
Procedure/Service
Midline Catheter
Basic IV
PICC Line
Advance Visit
Fee per Procedure
$150.00
$100.00
$285.00
$150.00
58. In keeping with the parties' contract aforesaid, Counterclaim Plaintiff submitted
LAW OFFICES
SNELBAKER &
BRENNEMAN, P.C.
its periodic billings to Counterclaim Defendant for services to Millelmium patients as set forth in
detail under the headings of "Billing Date" and "Billing Amount" on the attached statement of
account marked "Exhibit B" and incorporated herein by reference thereto. Counterclaim
11
Defendant paid the amounts shown on Exhibit B under the headings of "Payment Date" and
"Payment Amount".
59. As charted on Exhibit B, Counterclaim Defendant neglected and failed to pay
Counterclaim Plaintiff in accordance with the parties' contract as aforesaid, leaving an unpaid
balance of $1 0,805.00 due Counterclaim Plaintiff.
60. Counterclaim Plaintiff has demanded payment from Counterclaim Defendant,
which Counterclaim Defendant has failed and refused to pay.
61. The amount due Counterclaim Plaintiff is the sum of the "Unpaid Balances" from
Exhibit A and Exhibit B, in the total amount of $84,850.00.
WHEREFORE, Counterclaim Plaintiff demands judgment against Counterclaim
Defendant in the amount of $84,850.00 plus interest and the costs of this action. The damages
claimed by Counterclaim Plaintiff exceed the amount established by this Court for compulsury
arbitration.
ALTERNATIVE: COUNT II - QUANTUM MERUIT
In the event it is determined that no express contractual basis existed in fact or law as
alleged in Count I above, Counterclaim Plaintiff avers in the alternative as follows:
62. The averments contained in paragraphs 49 through 61 hereinabove are
incorporated herein as though set forth at length hereinbelow.
63. Counterclaim Defendant accepted Counterclaim Plaintiffs services and work.
64. Counterclaim Plaintiffs services and work fulfilled Counterclaim Defendant's
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
obligations to OmniCare and Millennium.
12
65. The fair market value of Counterclaim Plaintiff s services and work performed at
Counterclaim Defendant's request are the values set fOlih in paragraphs 53 and 57 hereinabove
and as totaled on Exhibit A and Exhibit B attached hereto, all of which are incorporated herein
by reference thereto.
66. Counterclaim Defendant has failed and refused to pay the fair market value of
said services and work performed by Counterclaim Plaintiff as aforesaid.
67. It is unjust and unfair for Counterclaim Defendant to receive, use and consume
the values of Counterclaim Plaintiffs services and work without full payment therefor.
WHEREFORE, Counterclaim Plaintiff demands judgment against Counterclaim
Defendant in the amount of$84,850.00 plus interest and the costs of this action. The damages
claimed by Counterclaim Plaintiff exceed the amount established by this Court for compulsory
arbitration.
SNELBAKER & BRENNEMAN, P.C.
By
~
ic ard C. Snelbaker, Esquire
Pa. Supreme Ct. J.D. #: 06355
44 West Main Street
P.O. Box 318
Mechanicsburg, P A 17055-0318
(717) 697-8528
Attorneys for Defendants and Counterclaim Plaintiff
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
13
BILLING BILLING PAYMENT PAYMENT UNPAID
DATE AMOUNT DATE AMOUNT BALANCE
9/1/04 - 9/15/04 9,965.00 9,965.00
9/16/04 - 9/30/04 8,020.00 17,985.00
10/1/04 - 10/15/04 11,910.00 29,895.00
10/15/04 8,000.00 21,895.00
10/16/04 - 10/31/04 12,000.00 33,895.00
10/26/04 1,965.00 31,930.00
10/30/04 8,020.00 23,910.00
11/1/04 - 11/15/04 9,070.00 32,980.00
11/15/04 12,000.00 20,980.00
11/16/04 -11/30/04 12,695.00 33,675.00
12/1/04 - 12/15/04 12,290.00 45,965.00
12/1 7/04 11,910.00 34,055.00
12/16/04- 12/31/04 16,695.00 50,750.00
1/1/05 - 1/15/05 13,805.00 64,555.00
1/8/05 9,070.00 55,485.00
1/16/05 - 1/31/05 13,925.00 69,410.00
1/25/05 12,695.00 56,715.00
2/1/05 - 2/15/05 15,980.00 72,695.00
2/16/05 - 2/28/05 13,670.00 86,365.00
2/16/05 12,290.00 74,075.00
3/1/05 - 3/15/05 11,715.00 85,790.00
3/16/05 - 3/31/05 11,405.00 97,195.00
3/17/05 18,000.00 79,195.00
4/1/05 - 4/15/05 13,315.00 92,510.00
4/11/05 27,000.00 65,510.00
4/14/05 10,760.00 54,750.00
4/16/05 - 4/30/05 12,175.00 66,925.00
5/1/05 - 5/10/05 6,445.00 73,370.00
5/11/05 - 5/20/05 6,655.00 80,025.00
5/12/05 13,315.00 66,710.00
5/21/05 - 5/31/05 7,310.00 74,020.00
5/25/05 13,670.00 60,350.00
6/1/05 - 6/10/05 6,735.00 67,085.00
6/11/05 - 6/20/05 6,960.00 74,045.00
TOTALS 232,740.00 158,695.00 74,045.00
EXHIBIT A
BILLING BILLING PAYMENT PAYMENT UNPAID
DATE AMOUNT DATE AMOUNT BALANCE
2/1/05 - 2/15/05 1,600.00 1,600.00
2/16/05 - 2/28/05 1,100.00 2,700.00
3/1/05 - 3/15/05 1,800.00 4,500.00
3/16/05 - 3/31/05 3,250.00 7,750.00
4/1/05 - 4/15/05 1,950.00 9,700.00
4/5/05 1,525.00 8,175.00
4/14/05 1,800.00 6,375.00
4/16/05 - 4/30/05 3,075.00 9,450.00
4/28/05 1,175.00 8,275.00
5/1/05 - 5/15/05 1,950.00 10,225.00
5/10/05 3,880.00 6,345.00
5/16/05 - 5/31/05 2,300.00 8,645.00
5/22/05 640.00 8,005.00
6/1/05 - 6/15/05 3,250.00 11,255.00
6/13/05 3,000.00 8,255.00
6/16/05 - 6/30/05 2,750.00 11,005.00
6/30/05 2,500.00 8,505.00
7/1/05 - 7/11/05 2,300.00 10,805.00
TOTALS 25,325.00 14,520.00 10,805.00
EXHIBIT B
LAW OFFICES
SNELBAKER &
BRENNEMAN, P.C.
VERIFICATION
I, Deana Davis, do hereby verify as follows: that I am a named Defendant in the
foregoing Answer with New Matter and Counterclaim; that the facts contained in said document
within my personal knowledge are true and correct; that the facts contained in said document not
within my personal knowledge, I believe them to be true and correct based upon the information
of others; and that I understand that any false statements made herein are subject to the penalties
of 18 PAC .s, 94904 relating to unsworn falsification to authorities.
~fl>
Deana Davis
Dated: August 15 , 2005
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
VERIFICATION
I, David Furline, do hereby verify as follows: that I am a named Defendant in the
foregoing Answer with New Matter and Counterclaim; that the facts contained in said document
within my personal knowledge are true and correct; that the facts contained in said document not
within my personal knowledge, I believe them to be true and correct based upon the information
of others; and that I understand that any false statements made herein are subject to the penalties
of 18 P A c.s. ~4904 relating to unsworn falsification to authorities.
CiJ~~
David Furline
Dated: August /5' ' 2005
LAV\' OFFICES
SNELBAKER &
BRENNEMAN. P.C.
VERIFICATION
I, Deana Davis, do hereby verify as follows: that I am a member of The IV League, LLC,
a limited liability company, which company is a Defendant and the Counterclaim Plaintiff in the
foregoing Answer with New Matter and Counterclaim; that I am authorized to make this
verification on behalf of said Defendant and Counterclaim Plaintiff; that the facts contained in
said document within my personal knowledge are true and correct; that the facts contained in
said document not within my personal knowledge, I believe them to be true and correct based
upon the information of others; and that I understand that any false statements made herein are
subject to the penalties of 18 P A c.s. 94904 relating to unsworn hlsificat10fl to authorities.
~~ {)~)
Deana Davis
Dated: August /5' , 2005
CERTIFICATE OF SERVICE
I hereby certify that I am this date serving a true and correct copy of the within
Defendants' Answer to Amended Complaint with New Matter and Counterclaim by sending the
same by first-class mail, postage paid, to the attorney for Plaintiff addressed as follows:
Mark K. Emery, Esquire
Law Offices of Mark K. Emery
410 North Second Street
Harrisburg, P A 171 01
K ard C. Snelbaker, Esquire
Snelbaker & Brenneman, P.C.
44 West Main Street
P.O. Box 318
Mechanicsburg, P A 17055-0318
Attorneys for Defendants
Dated: August 15, 2005
LAW OFFICES
SNELBAKER &
BRENNEMAN. P.C.
.<
John R. Druschel and Associates, LLC,
Plaintiff
: IN THE COlJRT OF COMNION PLEA$
: OF CUMBERLAND COUNTY .
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Deana Davis, David Furline, and
The IV League, LLC,
Defendants
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: JURY TRlAL REQUESTED
: CIVIL ACTION AT LAW
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PLAINTIFF'S ANSWER TO NEW MATTER AND COUNTERCLAIMS
AND NOW, comes the Plaintiff, by and through its attorney, mark K. Emery, Esquire, and
files this Answer to New Matter and Counterclaims, as follows:
27. Admitted. It is admitted that no written contract exists which includes a restricted
covenant. Lack of a written contract including such a restricted covenant does not vitiate
Plaintiff's rights at common law to protect the contractual relationship between it and its
clientele.
28. Admitted.
29. Admitted.
30. Denied as a legal conclusion.
31. Denied. It is specifically denied that Plaintiff agreed to pay any Defendant hI/a times per
month pursuant to billings from Defendants.
32. Denied. Paragraph 32 refers to a writing which speaks for itself and is therefore denied.
33. Denied. It is denied that the parties agreed that payments would be made two times per
month. Therefore, Plaintiff was not required to make payments on such terms.
34. Admitted. It is admitted that the last payment on the Omni Care account was made on
May 25,2005. By way offurther response Plaintiff and the Defendants had an agreement
in which Defendants agreed and acknowledged that they would be paid in full by June 30,
2005. Prior to the date such payment was going to made Defendants tortuously interfered
with Plaintiff's contractual relationships and therefore forfeited their right to such
payment.
35. Denied as a conclusion oflaw.
36. Denied. Paragraph 36 refers to a writing which speaks for itself and is therefore denied.
37. Denied. It is denied that the parties agreed that Defendant would be paid two times per
month.
38. Admitted.
39. Denied as a conclusion oflaw.
40. Admitted. It is admitted that Omni Care and Millennium eventually made payments to
Plaintiff for all amounts that Defendants invoiced. The full payments were made after
June 30, 2005.
41. Denied. It is specifically denied that Defendants made attempts to discuss the payments
due them. It is further specifically denied that Plaintiff provided no response. On the
contrary, Plaintiff and Defendants had reached an agreement where Defendants would be
paid in full by June 30, 2005, and Defendants accepted such terms.
42. Denied. Upon information and belief Defendants' contact with Omni Care in June 2005
was for the sole purpose of attempting to usurp Plaintiff's contract with Omni Care. By
way of further response, Defendants had no contractual relationship with Omni Care or
the treatment facilities. There is no reason to make any such contacts or for Defendants to
believe that either Plaintiff or Omni Care, had not, and/or would not, have in place
substitute services. Further, Plaintiff was the actual provider of the services to the
treatment facilities, not Defendants, and therefore Defendants' refusal to provide services
after June 2005 would have had no impact on the treatment services as Plaintiff would
have none the less provided such services had Defendants refused to do so.
43. Denied. Upon information and belief Defendants' contact with Millennium in June 2005
was for the sole purpose of attempting to usurp Plaintiff's contract with Millennium. By
way of further response, Defendants had no contractual relationship with Millennium or
the treatment facilities. There is no reason to make any such contacts or for Defendants to
believe that either Plaintiff or Millennium had not, and/or would not, have in place
substitute services. Further, Plaintiffwas the actual provider of the services to the
treatment facilities, not Defendants, and therefore Defendants' refusal to provide services
after June 2005 would have had no impact on the treatment services as Plaintiff would
have none the less provided such services had Defendants refused to do so.
44. Denied. It is specifically denied that Defendants motivation was for moral and/or ethical
concerns. Such self-serving statements attempt to obscure the fact that there'would have
been no break in treatment or services had Defendants refused to provide services after
June 2005 as either Plaintiff and/or Millennium and/or Omni Care would have been able to
provide such services on their own.
45. Denied.
46. Denied as a conclusion oflaw.
47. Denied as a conclusion oflaw.t
48. Denied as a conclusion oflaw. By way of further response, such argument may be raised
solely by preliminary objections, which Defendants have not done, and therefore such
claim is waived.
COUNTERCLAIM
THE IV LEAGUE LLC v. JOHN R. DRUSCHEL AND ASSOCIATES, LLC
COUNT I
CASH CONTRACTS
49. Admitted upon information and belief.
50. Admitted.
51. Admitted.
52. Admitted.
53. Admitted.
a. Admitted
b. Admitted in part, denied in part. It is admitted that the fee per procedure is correct.
It is specifically denied that Counterclaim Plaintiffs were going to be paid two times per
month.
54. Admitted.
55. Admitted. It is admitted that Counterclaim Plaintiffs submitted periodic billings for ..
services to Omni Care and Counterclaim Defendant made payments when Omni Care paid
for the invoices submitted by Counterclaim Plaintiff.
56. Denied. Paragraph 56 is denied to the extent that it refers an Exhibit "A" as such exhibit
is a writing which speaks for itself and it is therefore denied.
57. Denied. Paragraph 57 refers to a writing which speaks for itself and is therefore denied.
Byway of further response, it is specifically denied that the parties agreed that
Counterclaim Plaintiff would be paid two times per month.
58. Admitted. It is admitted that Counterclaim Plaintiffs submitted periodic billings for
sef\:ices to Millennium and Counterclaim Defendant made payments when Omni Care paid
for the invoices submitted by Counterclaim Plaintiff
59. Denied as a conclusion oflaw.
60. Denied. It is specifically denied that Counterclaim Defendant refused to pay. On the
contrary, the parties entered an agreement where Counterclaim Plaintiffs agreed to accept
payment in full by June 30, 2005. Prior to such date Counterclaim Plaintiffs tortuously
interfered with Counterclaim Defendant's contractual rights with Omni Care and
Millennium and therefore forfeited right to payment.
61. Denied as a conclusion oflaw.
WHEREFORE, Counterclaim Defendant respectfully requests this Honorable Court enter
judgement for it and against Counterclaim Plaintiffs.
COUNT IT
QUANTUM MERIDT
62. Paragraphs 27 through 61 are incorporated fully herein by reference.
63. Admitted.
64. Admitted.
65. Admitted.
66. Denied as conclusion oflaw. By way of further response, it is specifically denied that
Counterclaim Defendants failure to pay is unjust and unfair, as the amount aIJegedly due is
far less than the damages sustained by Counterclaim Defendant for counterclaim Plaintiff s
tortious acts.
WHEREFORE, Counter Claim Defendant respectfully requests this Honorable Court
enter judgement for, in and against Counter Claim Plaintiffs.
Respectfully submitted,
LAW OFFICES OF MARK K. ENlliRY
DATE: 10-7-0 ')
By: ;:?~PC:~~
Mark K. Emery, Esqmre .
Supreme Court J.D. No. 72787
410 North Second Street
Harrisburg, PAl 71 0 1
(717) 238-9883
Attorney for Plaintiff
VERIFICATION
I, Janice Druschel, as the personal representative of the Estate of John R.
Drushel, hereby verify that I have read the foregoing Answer to New Matter and
Counterclaims and that the information contained therein is true and correct to
the best of my knowledge, information and belief. I understand that false
statements herein are subject to the penalties of 18 Pa. C. S. ~ 4904 relating to
unsworn falsification to authorities.
s;?i4U../JJ jJ- U/AJJ..-L/.
janice Druschel
DATE: /0- 7 <:i~
CERTIFICA TE OF SERVICE
AND NOW, T, Mark K. Emery, Esquire do hereby certify that Plaintiff's Answer
-
to New Matter and Counterclaims was served upon Defendants on October 7,2005 by
mailing a true and correct copy via United States fIrst class mail, addressed as follows:
Richard C. Snelbaker, Esquire
Snelbaker & Brenneman, P.c.
44 West Main Street
P.O. Box 318
Mechanicsburg, P A 17055-0318
Respectfully submitted,
LAW OFFICES OF MARK K. EMERY
By:
~~
Mark K. Emery, Esquire
Supreme Court 1.0. No. 72787
41 0 North Second Street
Harrisburg, P A 17101
(717) 238-9883
Attorney for Plaintiff
REV-1511 EX+ (12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
JOHN R. DRUSCHEL
FILE NUMBER
21-05-0777
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
BARNHART FUNERAL HOME, GREENSBURG, PA
6,234.82
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
0.00
Name of Personal Representative{s)
Social Security Number{s)/EIN Number of Personal Representative{s)
Street Address
City
. State
Zip
Year(s) Commission Paid:
2.
Attorney Fees
0.00
3.
Family Exemption: (If decedent's address is not the same as claimant's. attach explanation)
Claimant Janice Jean Druschel
Street Address 3901 Chestnut Street
3,500.00
City Camp Hill
Relationship of Claimant to Decedent SPOUSE
State PA .Zip 17011
4.
Probate Fees
128.00
5.
Accountant's Fees
0.00
6.
Tax Return Preparer's Fees
0.00
7.
Newspaper Notices
214.94
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
10,077.76