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03-21-06
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Anna V Carey No.21 05 0605 , Deceased Date of Death 6/21/2005 Social Security No. 204-30-8190 also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: David H. Stone, Esquire '(rsona~resentatiVt).? ~ Gar Care ~ 1.0. No.: 39785 1909 Sheepford Road Mechanicburq 17055- Address: 414 Bridqe Street New Cumberland Dated PA 17070- Telephone: (717) 774-7435 Description Value 1966 Mercedes Benz Title No. 17690925101 CA at blue book value 14,300.00 1969 Rice Trailer Title No. 00788590602CA at blue book value 400.00 1971 Honda Motorcycle Title No. 22506458401 at blue book value 100.00 1985 Mercedes Benz Title No. 37154638201 at blue book value 3,825.00 1987 Honda Sedan Title No. 53547473701CA at blue book value 1,025.00 Carey Rentals Partnership 275,236.73 Total 1,437,022.00 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 ~)j Continuation of Inventory Anna V Carey 21 05 0605 PaQe 1 Description of Inventory Description Citizens Bank-Cert. of Deposit #6140715776, Prine. $74,917.62, Inl. $4.10 Value 74,921.72 M& T Bank-Cert. of Deposit #031003914381452, Prine. $76,648.85, Inl. $67.46 76,716.31 M& T Bank-Checking Aecl. #950631965, Prine. $39,712.53, Int. $.11 39,712.64 PNC Bank-Cert. of Deposit #31600213560, Prine. $62,285.13, Inl. 61.31 62,346.44 PNC Bank-Checking Acel. #5140009472, Prine. $36,215.20, Int. $4.02 36,219.22 PNC Bank-Savings Aeet. #5000938659, Prine. $68.48 68.48 443 shares PNC Financial Services Group stock @ $54.80 each 24,276.40 Property located at 1909 Sheepford Rd. Meeh. PA at assessed value (176,730) times CLR (1.0) 176,730.00 Property located at 568 Nauvoo Rd. York Co. PA at assessed value (132,700) times GLR (1.09) 144,643.00 Riverside National Bank-Gert. of Deposit #20363192 26,693.83 Riverside National Bank-Gert. of Deposit #20370458 83,757.50 Sovereign Bank-Cert. of Deposit #0575275334, Prine. $50,444.52, Inl. $64.76 50,509.28 Sovereign Bank-Cert. of Deposit #2335128266, Prine. $13,503.78, Int. $25.31 13,529.09 Sovereign Bank-Cert. of Deposit #2335128274 Prine. $12,049.90, Int. $12.71 12,062.61 Subtotal $ 822,186.52 Continuation of Inventory Anna V Carey 21 05 0605 Paqe 2 Description of Inventory Description Sovereign Bank-Cert. of Deposit #2335128480, Princ. $68,200.00, Int. $79.33 Value 68,279.33 Sovereign Bank-Cert. of Deposit #2335128498, Princ. $30,000.00, Int. $90.95 30,090.95 Sovereign Bank-Cert. of Deposit #2335128506, Princ. $28,491.41, Int. $30.06 28,521.47 Wachovia-CD #247022046064218 92,813.95 Washington Mutual Bank-Cert. of Dep. #83110224508 100,243.05 Sales Agreement for 41 4 3rd st., New Cumber land and 505 2nd St., New Cumberland, County of Cumberland, State of PA paid in full in 2003 but deeds were never transferred .00 Subtotal $ 319,948.75 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CAREY GARY 1909 SHEEPFORD ROAD MECHANICSBURG, PA 17055 nnnn fold ESTATE INFORMATION: SSN: 204-30-8190 FILE NUMBER: 2105-0605 DECEDENT NAME: CAREY ANNA V DATE OF PAYMENT: 03/21/2006 POSTMARK DATE: 03/21/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/21/2005 NO. CD 006451 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $4,903.88 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: G W CAREY CHECK#1043 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $4,903.88 GLENDA FARNER STRASBAUGH REGISTER OF WILLS REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C w u w c W I- ~ ~cn u a:~ w~u J:a:g u a.. co a.. <( DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Care , Anna, V DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONLY FILE NUMBER 2 -050605 OOUNTY"COOE --vE~ - - NUMBER- SOCIAL SECURITY NUMBER 2 04- 3 0 - 8 1 9 0 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS 6/21/2005 4/14/1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) LOCIALSECURI~ NUMBER I- Z W C Z o a.. en w a: a: o u 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1 ) (2) (3) (4) (5) [Xl 1. Original Return D 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (dale of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) (8) (11 ) (12) (13) (14) D 3. Remainder Return (date of death prior to 12-13-82) [Xl 5. Federal Estate Tax Return Required 1- 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTE!tIO: NAME COMPLETE MAILING ADDRESS David H. Stone, Es uire 414 Bridge Street FIRM NAME (If Applicable) Stone LaFaver & Shekletski TELEPHONE NUMBER 717 774-7435 New Cumberland PA 17070- 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) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (6) (7) z o i= <C ...I :::> t: a.. <C U W 0::: z o i= <C I- :::> a.. ~ o u >< <C I- 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) (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 0.00 X _ (15) 1,629,442.99 X .045 (16) 0.00 X .12 (17) 0.00 X .15 (18) (19) OFFICIAL USE ONLY 309,484.01 l c,~. 1,746,506.C 115,978.12 1,084.90 117,063.( 1 ,629,442.~ 1,629,44f_.E O.C 73,324.~ O.C o.c 73,324.~ >> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 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 S f d R d 1909 heep' or oa CITY Mechanicsburg I STATE PA I ZIP 17055- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 73~24. 65.000.00 3.421.05 Total Credits (A + B + C ) (2) 68,421. 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT o. O. 4,903. 4,903. 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; .......................... ............... ............................. ..... D [X] b. retain the right to designate who shall use the property transferred or its income; ........................................ D [X] c. retain a reversionary interest; or ...................................................................................................... D [X] d. receive the promise for life of either payments, benefits or care? ............................................................. D [X] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................ ................... .......... ............................ ............. D [X] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. lXl D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...... ...... .............................. ... ....... ..... ......................................... ..... lXl D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this 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. SIGNATURE OF PERSON R ONSIBLE FOR FllIN ETURN DATE '3 - L() - Ol... ADDRESS PA 17055 DATE 3-'20-\J~ ADDRESS PA 17070 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even the surviving spouse is the only beneficiary. For dates of death on or after July 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 parer 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. s9116(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-1502 EX + (6-98) '* SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Carey. Anna. V 21 05 0605 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real orooertv which is iointlv-owned with right of survivorshi}! must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION Property located at 1909 Sheepford Rd. Mech. PA at assessed value (176,730) times CLR (1.0) 2 Property located at 568 Nauvoo Rd. York Co. PA at assessed value (132,700) times CLR (1.09) TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 176,730. 144,643. 3~'h373.' REV-1503 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Carey. Anna. V FILE NUMBER 21 05 0605 ------..---- ------- All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION 443 shares PNC Financial Services Group stock @ $54.80 each VALUE AT DATE OF DEATH 24,276/ TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 24,276/1 REV-1504 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP ESTATE OF Carev. Anna. V FILE NUMBER 21 05 0605 Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER DESCRIPTION Carey Rentals Partnership established August 7,1976 Woodrow S. Carey 250/0, Anna V. Carey 250/0, Gary W. Carey 250/0, and Dennis L. Carey 250/0. The said Woodrow S. Carey having died Sept. 4, 1987 giving his share to his wife, Anna V. Carey and there- fore decedent's share would be 500/0 of partnership VALUE AT DATE OF DEATH 275,236. TOTAL (Also enter on line 3, Recapitulation) I $ (If more space is needed, insert additional sheets of the same size) 275,236. REV-1506 EX + (9-00) * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE C-2 PARTNERSHIP INFORMATION REPORT ESTATE OF Carey. Anna. V 1. FILE NUMBER 21 05 0605 2. 3. 4. Name of Partnership Carey Rentals Address Main Street City Lisburn Federal Employer I.D. Number Type of Business Property ManaQement Product/Service Real estate Decedent was a lXl General D Limited partner. If decedent was a limited partner, provide initial investment $ Date Business Commenced 8/7/1976 Business Reporting Year _._ State P A Zip Code 17055 __ 5. .- PERCENT PERCENT BALANCE OF PARTNER NAME OF INCOME OF OWNERSHIP CAPITAL ACCOUNT A. Anna V. Carev 500/0 500/0 32.744.00 B. Garv W. Carev 250/0 250/0 16.372.00 C. Dennis L. Carev 250/0 250/0 16 372.00 - D. 6. Value of the decedent's interest $ 275.236.73 7. Was the Partnership indebted to the decedent? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DYes lXl No If yes, provide amount of indebtedness $ 8. Was there life insurance payable to the partnership upon the death of the decedent? ........ 0 Yes lXl No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12-31-82? o Yes lXl No If yes, 0 Transfer 0 Sale Percentage transferred/sold Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales. 10. Was there a written partnership agreement in effect at the time of the decedent's death? . . . . . . . lXl Yes 0 No If yes, provide a copy of the agreement. 11. Was the decedent's partnership interest sold? .................................. 0 Yes lXl No If yes, provide a copy of the agreement of sale, etc. 12. Was the partnership dissolved or liquidated after the decedent's death? ................. DYes lXl No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 13. Was the decedent related to any of the partners? ................................ lXl Yes 0 No If yes, explain Mother of both remaininQQartners 14. Did the partnership have an interest in other corporations or partnerships? . . . . . . . . . . . . . . . . DYes lXl No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. .: 1::1 :(e] .1I.e1'!'llM.ctIl ~ I ilel:ll'11,:.llieRl1'1LIj.."'1..;l =--~i-~lIjj:"j:U..~"'Itl:.l;td1 J" = A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedent's partnership interest. REV-1507 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF Carey. Anna. V FILE NUMBER 21 05 0605 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Sales Agreement for 414 3rd St., New Cumberland and 505 2nd St., New Cumberland, County of Cumberland, State of PA paid in full in 2003 but deeds were never transferred VALUE AT DATE OF DEATH o. TOTAL (Also enter online 4, RecaPitulati~~$ (If more space is needed, insert additional sheets of the same size) o. REV-15G8 EX + (6-98) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carey. Anna. V FILE NUMBER 21 05 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 DESCRIPTION 1966 Mercedes Benz Title No. 17690925101 CA at blue book value 1969 Rice Trailer Title No. 00788590602CA at blue book value 1971 Honda Motorcycle Title No. 22506458401 at blue book value 1985 Mercedes Benz Title No. 37154638201 at blue book value 1987 Honda Sedan Title No. 53547473701 CA at blue book value Citizens Bank-Cert. of Deposit #6140715776, Princ. $74,917.62, Inl. $4.10 M&T Bank-Cert. of Deposit #031003914381452, Princ $76,648.85, Int. $67.46 M& T Bank-Checking Accl. #950631965, Princ. $39,712.53, Inl. $.11 PNC Bank-Cert. of Deposit #31600213560, Princ. $62,285.13, Inl. $61.31 PNC Bank-Checking Accl. #5140009472, Princ. $36,215.20, Int. $4.02 PNC Bank-Savings Accl. #5000938659, Princ. $68.48 Riverside National Bank-Cert. of Deposit #20363192 Riverside National Bank-Cert. of Deposit #20370458 Sovereign Bank-Cert. of Deposit #0575275334, Princ. $50,444.52, Inl. $64.76 Sovereign Bank-Cert. of Deposit #2335128266, Princ, $13,503.78, Inl. $25.31 Sovereign Bank-Cert. of Deposit #2335128480, Princ. $68,200.00, Inl. $79.33 TOTAL (Also enter on line 5, Recapitulation ;1 $- (If more space is needed, insert additional sheets of the same size) 0605 VALUE AT DATE OF DEATH 14,300.c 400.c 1 00.l 3,825.l 1,025.( 74,921. 76,716.: 39,712.: 62,346.- 36,219.- 68.- 26,693. 83,757. 50,509. 13,529. 68,279. 816,135. Carey, Anna, V Decedent's Name Continuation of REV-1500 Inheritance Tax Return Resident Decedent Page 1 21 05 0605 File Number Schedule E - Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER 17 18 19 20 21 DESCRIPTION Sovereign Bank-Cert. of Deposit #2335128498, Prine. $30,000.00, Int. $90.95 Sovereign Bank-Cert. of Deposit #2335128506, Prine. $28,491.41, Int. $30.06 Sovereign Bank-Cert. of Deposit #233512874, Prine. $12,049.90, Int. $12.71 Waehovia-CD #247022046064218 Washington Mutual Bank-Cert. of Dep. #83110224508 VALUE AT DATE OF DEATH 30,090. 28,521. 12,062. 92,813. 100,243. SUBTOTAL SCHEDULE E I 1--;--- - GRAND TOTAL SCHEDULE E 263,732. 816J~~. REV-1510 EX + (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF Carey. Anna. V FILE NUMBER 21 05 0605 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE (IF APPLICABLE) - --- - 1. Allstate Life Insurance Co.-Annuity i#GA16866428 Gary W. 156,250.23 100. 156,250.- Carey and Dennis L. Carey, beneficiaries 2 Riverside Nat. Bank-IRA Cert. of Dep #2036319245 105,898.55 100. 105,898.- as POD to Gary Carey and Dennis Carey 3 Sovereign Bank-IRA Acet. #0358003168 47,335.23 100. 47,335. Beneficiaries-Gary Carey and Dennis Carey, Prine. $47,126.22, Int. $209.01 --- - - -- -- - - TOTAL (Also enter on line 7 Recapitulation) U___ (If more space is needed, insert additional sheets of the same size) ~Q9,~8~. REV-1511 EX + (12-99) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Carey. Anna. V ITEM NUMBER A. 1 B. 1. 2. 3. 4. 5. 6. 7. 2 3 4 5 6 7 8 9 10 11 12 FilE NUMBER 21 05 0605 Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: Gary Carey-Reimb. for opening grave Malpezzi Funeral Home-funeral expenses 1,045. 9,513. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Gary W. Carey Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 1909 Sheepford Road City Mechanicsburq Year(s) Commission Paid: 2006 Attorney Fees David H. Stone 47,945. 176-34-8350 State P A Zip 17055 47,945. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees 930. Accountant's Fees T ax Return Preparer's Fees United States Treasury-paymt on dec. 2003 taxes PA Dept. of Revenue-3rd quarter est. taxes PA Dept. of Revenue-4th quarter est taxes Javier Exparza-Iawn serv at FL property Erie Insurance-insurance on property Javier Esparza-lawn care at FL property Javier Esparza-lawn care at FL property Javier Esparza-lawn service at FL property Gary Carey-Reimb on AC-FPL Paymt Ctr for FL prop PPL-electric service City of Port St. Lucie-sewer and water (FL) AC-FPL Paymt Center-servo @ FL property 1,874. 210- 210. 50 590 45 45 50 5 98 7 5 TOT Al(Also enter on line 9, RecaPitu,ati;I $ (If more space is needed, insert additional sheets of the same size) 115,978 Carey, Anna, V Decedent's Name --- 1-- Continuation of REV-1500 Inheritance Tax Return Resident Decedent Page 2 21 05 0605 File Number Schedule H - Funeral Expenses & Administrative Costs - 87. ITEM NUMBER DESCRIPTION AMOUNT 13 14 15 16 17 18 19 20 21 22 23 24 25 26 PPL-electric service at Nauvoo Rd property AC-FPL Paymt Ctr-serv. at FL property City of Port 81. Lucie-sewer and water serv AC-FPL Paymt Center-serv (FL) Exemplified copies ($40.00), short cert. ($24.00) Cumberland Law Journal-advertiisng grant of letters The Patriot News Co.-advertising grant of letters Register of Wills-filing Inheritance Tax Return and Inventory Spaker & Prinz-retainer for FL services Savanna Club HOA-c1ub dues (FL) Bonnie A. Miller-taxes on 1909 Sheepford Rd property Patricia Gordon-taxes on property City of Port S1. Lucie-sewer and water Reserve for closing expenses 134. 5. 7. 5. 64. 75. 113. 30. 532. 714. 1,672. 1,547. 7. 500. SUBTOTAL SCHEDULE H-B7 5,409. REV-1512 EX + (6-98) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Carey. Anna. V FILE NUMBER 21 05 0605 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION LVALUEAT DATE OF DEATH -- Gary W. Carey-Reimb. on home care servo 542. 2 Hartman & Assoc.-services rendered 542. TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,084. REV_1513EX+<* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF C A SCHEDULE J BENEFICIARIES arev nna RELA TIONSHIP TO DECEDENT AMOUNT OR S NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTAT 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Dennis Carey Lineal 814, 1957 Sheepford Road Mechanicsburg PA 17055- 2 Gary Carey Lineal 814, 1909 Sheepford Road Mechanicburg PA 17055- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SH II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOT AL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ -- v FILE NUMBER 21 05 0605 HARE E 721. 721. EET (If more space is needed, insert additional sheets of the same size) . l I l I ,~r: ':.. ~:.:J ~ . I ' ~, .11< '. . a ' " - LAST WILL AND TESTAMENT OF ANNA V. CAREY I, ANNA V. CAREY, of the Township of Fairview, York County, and Commonwealth of Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I give, devise and bequeath my 1966 Mercedes automobile, my farm situate on the Sheepford Road in Lower Allen Township, Cumberland County, Pennsylvania (subject to the proviso hereinafter set forth), and all of my farm machinery to my son, GARY CAREY, if he survives my by thirty (30) days, and if GARY CAREY fails to survive me by thirty (30) days, the gift in this Item I shall lapse as to GARY CAREY's issue and shall vest instead in my son, DENNIS CAREY, if he is then living, and if not, in his issue, p~r stirpes. If I have not J (.tJ done so during my lifetime, my gift of ~he farm to GARY CAREY shall be reduced by a strip of land one hundred (100) feet wide around three sides of the lot presently owned by ~y son, DENNIS CAREY and his wife, , CYNTHIA CAREY, (the fourth side bei~g'bounded by the Yellow Breeches Creek), and this strip of land ~s hereby devised to DENNIS CAREY if it has nqt by that time been conveyed to him. ITEM II: I give and devise ~y homestead property situate on Nauvoo Road, Fairview Township, ~ork County, Pennsylvania, and my land ,. and the mobile home t~ereon sitdate at the Savanna Club in Port St. /'" Lucie, in the State of Florida, to my son, DENNIS CAREY, if he sur- vives me by thirty (30) days, and if not, to his issue, per stirpes. Page 1 of 4 ITEM III: I give, devise and bequeath all the rest, residue and remainder of my estate, real and personal, and wherever situate tonny two sons, GARY CAREY and DENNIS CAREY, if they survive me by thirty ( 30) days, If GARY CAREY. fails to survive me by thirty (30) days thi; residuary gift to him shall lapse as to his issue and shall vest instead in DENNIS CAREY, if he is then living, and if not, in his issue, per stirpes. If DENNIS CAREY fails to survive me by thirty (30) days, his share of my residuary estate shall vest in his issue per stirpes. ITEM IV: I name my son, GARY CAREY, exe~utor of this my last will. If he fails to qualify or ceases to act as my executor, I name my son, DENNIS CAREY, executor in his place with the same powers and duties. No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. and seal this cl. day of ANNA v. CAREy, have hereunto set my hand J'~~ ,1994. .. O~A4~ v~ XN WITNESS WHEREOF, I, .....'" Page 2 of 4 ". SIGNED, SEALED, PUBLI~BED and DECLARED by ANNA V. CAREY, the Testatrix above named, as and for her Last Will and Testament, and ia the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. ~~N~. ~ ~ll~! JK. I witness Address ~~-s~' /~ ;~d;::;S~ t. COMMONWEALTH OF PENNSYLVANIA: :SS: COUNTY OF CUMBERLAND . . I, ANNA V. CAREY, the Testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law do hereby acknowledge that I ~igned and executed this instru- ment as my last will; that I signe~"it. willingly and that I signed it as my free and voluntary act for the purposes therein contained. ~4A4/ / ~~ ~- ANNA V. CAR Sworn to or affirmed to and acknowledged before me by ANNA V. ! 0 CAREY, the Testatrix;/this ~ (lid day of .Agf~ , 1994. ~~[(~. Page 3 of 4 , NOTARIAL SEAL CONSTANCE L. KARLI. NOTARY PUBLIC NEW CUMBERLAND, PA CUt!jBERLAND CO. MY COMMISSION EXPIRES APRIL 13. 1995 ....- .-"'~~~'~--~ft'i: COMMONWEALTH OF PENNSYLVANIA : :S5: COUNTY OF CUMBERLAND We, QJl~Q fJ ~ and /{o;r ~. .~ the witnesses whose names are signed to the attach~d or ~regoing . . , instrument, being duly qualified according to law, depose and say that we were' present and saw Testatrix sign and execute the instrument as her last will; that Testatrix signed willingly and' that she executed it as h~r free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix s~gned the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. CfJJ . ( ~_. Qv./V /~ . . ",-'..J.......,-- ,.N~~ ) witness 'f{cup ~. ~ o Wi'tness V Sworn to or affirmed to and day- of acknowledged before me by ,and'-K~ -{(. >f~ , . . , 1994. C!"- , witnesses, ~'>ft~. Notary Publi Page 4 of 4 NOTARIAL SEAL CONSTANCE l. KARL!, NOTARY PUBLIC Na~ cU~mtRLANDJ PA CUi~HE~lANO CO. MY CO:!~~T.SST.ON EXPIP.ES IWRIL 13. 1995 -----_.......-..._.........__....._--~~- .., REV.485 EX + (3.04) '* SAFE DEPOSIT BOX INVENTORY Please Print or Type J DECEDENT'S NAME (LAST, FIRST, MIDDLE) CAREY, ANNA V. . ADDRESS OF DECEDENT (STREET) 1909 SHEEPFORD ROAD DATE OF DEATH 06/21/2005 (CITY) MECHANICSBURG COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS COUNTY CODE FILE NUMBER SOCIAL SECURITY (Reauired) OR DEATH CERTIFICATE NUMBER (only if SSN is unknown) 2005-00605 204-30-8190 NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX (NAME) DAVID H. STONE, ESQUIRE (STREET NAME) 414 BRIDGE STREET (CITY) NEW CUMBERLAND NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) b. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) c. (NAME) (RELATIONSHIP) (STREET NAME) (CITY) · NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (NAME) PNC BANK (STREET NAME) BRIDGE STREET (CITY) NEW CUMBERLAND I NAME OF PERSON MAKING LAST ENTRY ANNA V. CAREY DATE AND TIME OF LAST ENTRY DATE OF CONTRACT TO RENT BOX NUMBER OF BOX J TITLE UNDER WHICH BOX IS REQUESTED ANNA V. CAREY NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX a. (NAME) b. (NAME) (STREET ADDRESS) (STREET ADDRESS) (CITY) (STATE) (ZIP CODE) (CITY) . NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY DAVID H. STONE, ESQUIRE WAS A WILL IN THE BOX? DYES D NO If yes, a. Date of will: b. Name and address of personal representative, if named in the will (NAME) (STREET NAME) (CITY) C. Name and address of attorney, if any (NAME) (STREET NAME) (CITY) (STATE) PA (STATE) PA (STATE) (STATE) (STATE) (STATE) PA (STATE) (STATE) (STATE) (ZIP CODE) 17055 (ZIP CODE) 17070 (ZIP CODE) (ZIP CODE) (ZIP CODE) (ZIP CODE) 17070 (ZIP CODE) (ZIP CODE) (ZIP CODE) INSTRUCTIONS The Department is authorized under federal law ,42 U.S.C. 9 405(c), to use the decedent's Social Security number in administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and ensure proper credit for tax payments. (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, Le., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM ITEM DESCRIPTION NO. 1 WARRANTY DEED DATED 01/15/86 - REC. BOOK 488, PAGE 1961 - LOT#15, BLOCK 9, SAVANNA CLUB - ST. LUCIE, FL 2 DEED DATED 07/24/62 - REC. BOOK 020, PAGE 1112 - TWO TRACTS LAND - LOWER ALLEN TWP., CUMBERLAND COUNTY, PA 3 DEED DATED 05/01/78 - REC. BOOK T27, PAGE 820 - LOWER ALLEN TWP., CUMBERLAND COUNTY, PA (PARTNERSHIP RE.) 4 DEED DATED 05/01/78 - REC. BOOK T27, PAGE 822 - LOWER ALLEN TWP.. CUMBERLAND COUNTY. PA (PARTNERSHIP RE.) 5 DEED DATED 07/19/72 - REC. BOOK U24; PAGE 34 - LOWER ALLEN TWP., CUMBERLAND COUNTY, PA (PARTNERSHIP RE.) 6 DEED DATED 09/09/87 - TRI-COUNTY MEMORIAL GARDENS CEMETARY - SPACE #3 7 PNC STOCK - 443 SHARES - CERTIFICATE #0409-00 1357-0-89000 8 HARRIS SAVINGS ASSOCIATION - CERTIFICATE OF DEPOSIT $28,491.41 - ACCOUNT #04-15-129462 - DATED 10/04/88 9 HARRIS SAVINGS ASSOCIATION - CERTIFICATE OF DEPOSIT $10,000.00 - ACCOUNT #04-:04-108911 - DATED 03/02/87 10 HARRIS SAVINGS ASSOCIATION - CERTIFICATE OF DEPOSIT $10,000.00 - ACCOUNT #04-04-108910 - DATED 10/30/86 11 HARRIS SAVINGS ASSOCIATION - CERTIFICATE OF DEPOSIT $10,000.00 - ACCOUNT #04-04-100154 - DATED 03/02187 12 HARRIS SAVINGS ASSOCIATION - CERTIFICATE OF DEPOSIT $10,000.00 - ACCOUNT #04-15-108998 - DATED 10/15/87 13 HARRIS SAVINGS ASSOCIATION - CERTIFICATE OF DEPOSIT $18,200.00 - ACCOUNT #04-15-108912 - DATED 07/31/87 14 HARRIS SAVINGS ASSOCIATION - CERTIFICATE OF DEPOSIT $13,503.78 - ACCOUNT #04-04-096123 - DATED 10/27/86 15 RIVERSIDE NATION BANK - CERTIFICATE OF DEPOSIT $74,088.90 - ACCOUNT #2037045845 - DATED OS/25/00 16 BARNETT BANK - CERTIFICATE OF DEPOSIT $70,000.00 - ACCOUNT #0022539457 - DATED 01/09/90 17 CCNB BANK - CERTIFICATE OF DEPOSIT $50,000.00 - ACCOUNT #127305 - DATED 09/11/90 18 DAUPHIN DEPOSIT BANK & TRUST CO., - CERTIFICATE OF DEPOSIT $76,648.85 - ACCOUNT #55567 - DATED 04/25/90 19 DAUPHIN DEPOSIT BANK & TRUST CO., - CERTIFICATE OF DEPOSIT $39,378.62 - ACCOUNT#23311- DATED 12/19/88 CONTINUED ON ATTACHED LIST ~IFY ...~ OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF oRBEef AND C~Ta. Tit THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY: V U )JL SIGNATURE PRINT N~ ~ PRINT NAME AND CHECK APPROPRIATE BOX BELOW: DAVID H. STONE PRINT TITLE DATE CHECK APPROPRIATE BOX: ATTORNEY FOR ESTATE 11/29/2005 o Executor(trix) o Administrator(trix) lit Estate Representative o Joint owner of safe deposit box SAFE DEPOSIT BOX INVENTORY Page of 2 NOTE: Attach additional 81//' x 11" sheet(s) if necessary or use duplicates of this page of form. SAFE DEPOSIT BOX INVENTORY Page INSTRUCTIONS 2 of 2 The Department is authorized under federal law , 42 U.S.C. 9 405(c), to use the decedent's Social Security number in administering this state tax law. The Department uses Social Security numbers to establish a decedent's identity and ensure proper credit for tax payments. (1) Cash: Report total only. (2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are to be designated by name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock. (3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership, Le., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM NO. 20 21 22 23 ITEM DESCRIPTION COMMONWEALTH NATIONAL BANK - CERTIFICATE OF DEPOSIT $75,000.00 - ACCOUNT #2600072712 - DATED 05/11/89 AMERICAN PIONEER SAVINGS BANK - SAVINGS CERTIFICATE $10,000.00 - ACCOUNT #0040459941 - DATED 01125/88 GREAT WESTERN BANK - YIELD CERTIFICATE $55,000.00 - ACCOUNT #574-505588-8 - DATED 07/14/91 AAA TRAVEL ACCIDENT INSURANCE POLICY I CERTIFY UNDER P.!..NALTY OF PERJURY THAT THE ABOVE RECORD IS CORRECT ..... THE BEST OF MY KNOWLEDGE AND BELIEF. SIGNAT( [) n )) PRINT~E~~ - DAVI~STONE PERSON RECEIVING COPY OF SAFE DEPOSIT BOX INVENTORY: SIGNATURE PRINT NAME AND CHECK APPROPRIATE BOX BELOW: PRINT TITLE DATE CHECK APPROPRIATE BOX: ATTORNEY FOR ESTATE 11/29/2005 o Executor(trix) 0 Administrator(trix) [iJ Estate Representative 0 Joint owner of safe deposit box NOTE: Attach additional 81/2" x 11" sheet(s) if necessary or use duplicates of this page of form. Page 1 of 1 Detailed Results for Parcel 13-11-0270-004. in the 2004 Tax Assessment Database DistrictN 0 13 Parcel_ID 13-11-0270-004. MapSuffix HouseNo 1909 Direction Street SHEEPFORD ROAD Ownerl CAREY, ANNA V Owner2 PropType A PropDesc Liv Area 1920 CurLandVal 319880 CurImp V al 133000 CurTotVal (~ 176730 =::> CurPrefVal 43730 Acreage 112.85 CIGrnStat Y TaxEx 1 SaleAmt SaleMo SaleDa SaleCe SaleYr DeedBkPage Year Bit 1747 HF _File_Date 10/21/2004 HF _Approval_Status D http://taxdb.ccpa.net/details.asp?id= 13-11-0270-004.&dbselect= 1 9/16/2005 York County Assessment Report Window Page 1 of 1 27000QF0011AOOOOOO CAREY WOODROW S & ANNA V 1781 MAIN ST 568 NAUVOO RD Property location - 568 NAUVOO RD Acreage - 15.550 land Class - 921 Book/Page - 66N-213 Clean/Green Status - Y Assessment Date: land: 1710 Building: 130990 Total: 132700 Close Print Window J [ Print Report http://207 .140.67 .68/york/report.asp?p=27000QFOO 11AOOOOOO 6/28/2005 \~~1 ':is ~S:~ 0 LJ3S, () tJ rl1a. orj '.;r-.~~~~ ~~ 1Irhts 3J:)((d Made the Nineteen hundred and .3 Q\E) dav. oj seventy-three ~1973) , in the year )5ft\\1crn Grantor s, AOO ~ ~ WOODROW S. CAREY and ANNA V. CAREY, his wife, of the Township' of Lower Allen, County of Cumberland and State of Pennsylvania, Grantee s ~itncsscth, that in consideration of TWENTY -THREE THOUSAND FIVE HUNDRED and NO/100- -- --- ----- - - -- --- --------- - -- -- - --- - - -- ($23, 500.00) -- -- Dollars, in hand paid, the receipt whereof is hereby acknowledged, the said Grantor s do hereby grant and convey to the said Grantee s, their heirs and assigns, ALL THAT CERTAIN tract of land, together with the improvements thereon erected, situate in the Township _0(J~~1f.Y1~.~, County of York and Commonwealth of Pennsylvania, bounded and described according to a plan drawn Robert E. Stiffler, Registered Surveyor, dated January 8, 1966, as follows, to wit: BEGINNING at a nail in the centerline of Legislative Route 4/:66103 at land now or formerly of Ralph Ditlow; thence by land now or formerly of Ralph Ditlow 87 degrees 31 minutes East one thousand four hundred seven and fifty-seven hundredths (1,407.57) feet to a post at land now or formerly of George D. Millard; thence by land now or formerly of George D. Millard South 07 degrees 59 minutes East seven hundred and sixty-five hundredths (?Q~,65) feet to a point at land now or formerly of Ivan D. Eichelberger;Q'thence by land now or formerly of Ivan D. Eichelberger South 70 degrees 16 minutes West two hundred sixty-five and seven hundredths (265.07) feet to a pin at land of the former Grantees; thence by land of the former Grantees North 36 degrees 44 minutes West three hundred seventy-five and twenty-one hundredths (375.2l) feet to a pin; thence by same South 77 degrees 46 minutes West one hundred thirty-nine and ninety-two hundredths (139.92) feet a pin at a light pole; thence by same South 80 degrees 46 minutes West three hundred forty-six and one hundredth (346.01) feet to a pin in the centerline of L.R. 66103; thence through the centerline of L.R. 66103 North 39 degrees 08 minutes West five hundred fifty-one and seventy-eight hundredths (551.78) feet to a nail in the centerline of L.R. 66103; thence through the centerline of L.R. 66l03'North 49 degrees 20 minutes West two hundred twelve and no hundredths (212.00) feet to a nail in the centerline of L.R. 66103 at land now or formerly of Ralph Ditlow, the first mentioned point and Place of BEGINNING. CONTAINING 15.55 Acres. BEING the same premises which David C. Shetter, widower, by his Deed dated January 27, 1966 and recorded in York County Deed Book 59-A, Page 12, granted and conveyed unto Ray George and Romayne S. George, his wife, Grantors herein. In the said deed the Grantor, David C. Shetter, reserved unto himself a life estate. The said David c. Shetter, died Febr~~!y 23 1973 whereupon his life estate terminated. BOUK. MSN Money - PNC - Stock chart, Index chart Page 1 of2 MSN Home My MSN Hotmail Shopping Money People & Chat Sign In Web Search: msn~f oe.LL Money Search MSN rvloney: ~I I"~'~I ,~ CNBC Help ~)JnkliK] Investing Planning faxt::'s ~vly rvJoney Portfolio Loan:; Insur-c1f1crc Investing Home Portfolio Markets Stocks Funds ETFs Commentary Brokers CNBC TV Quote, Chart, News Snapshot Company Report Quotes Charts Historical Real-Time Intraday Key Developments Recent News Research SEe Filings Advisor FYI Stock Rating Earnings Estimates Analyst Ratings Financial Results Insider Trading Ownership Community Guided Research Research Wizard Find Stocks Stock Screener Power Searches Top Rated Stocks Related Links E~p-~-':1Elcks E.:-D1j~jL&__81erts IPO Center Me$sqge SQard.s Ca~LGain_s Ana1Y5~ Name or Symbol: PNC I Go I Find Symbol Print Report Download File Show Chart PNC Financial Services Group Date High Low Close Volume 6/30/2005 54.8500 54.3000 54.4600 1,292,700 6/29/2005 55.1000 54.5900 54.8300 601,900 6/28/2005 54.7600 54.4000 54.6500 892,300 6/27/2005 54.5500 54.0700 54.2200 559,000 6/24/2005 54.8300 54.3600 54.3600 886,500 6/23/2005 55.3200 54.4300 54.4600 863,200 6/22/2005 55.4000 55.0400 55.2700 905,800 6/21/2005 55.1200 54.7500 54.8000 705,100 4Y3 ~~ G 5l ~ 6/20/2005 55.1400 54.5800 55.0900 1,091,900 t J ~ :{"n, .4( 6/17/2005 55.0500 54.8000 55.0000 1,689,200 6/16/2005 55.0000 54.5000 54.8800 1,101,000 6/15/2005 55.1400 54.8500 55.1100 773,500 6/14/2005 55.1200 54.8000 54.9400 856,600 6/13/2005 55.0600 54.5000 54.8800 946,700 6/10/2005 54.8100 54.5000 54.7900 728,900 6/9/2005 54.9800 54.5800 54.7700 1,041,400 6/8/2005 54.9400 54.6500 54.7100 1,077,200 6/7/2005 55.1600 54.6400 54.7500 1,210,600 6/6/2005 54.8700 54.5800 54.6400 1,684,100 6/3/2005 54.9700 54.5600 54.8200 991,400 6/2/2005 55.0000 54.5300 55.0000 1,055,700 6/1/2005 55.3100 54.3000 54.9100 1,359,000 I Trade Now I http://moneycentral.msn.comJinvestor/ charts/ chartdl. asp? Symbol= PNC&DateRangeF orm=... 9/16/2005 Carey Rentals Partnership Real Estate Main Street, Lisburn, Lower Allen Township, Cumberland County, PA $ 60,120.00 1777 Main Street, Lisburn, Lower Allen Township, Cumberland County, PA $ 94,600.00 1781 Main Street, Lisburn, Lower Allen Township, Cumberland County, PA $298,740.00 3814 Gettysburg Rd., Lower Allen Township, Cumberland County, PA $ 70,010.00 Cash M&T Bank-Business Checking Acct. #21501548 $ 27,003.47 Total Assets of Carey Rentals Partnership $550,473.47 Anna V. Carey - 50% value of partnership $275,236.73 AGREEMENT I ; ; i I THIS ACREEMENT, made this )\ ~~ day of '\) 0 e~_VV) \; t " , 1983, !iamong WOODROW S. CAREY and ANNA V. CAREY, his wife, as tenants by the entirety, j j DENNIS L. CAREY and GARY W. CAREY, i i II 1 ! I' IIAgreement on August 7, 1976, the purpose of which was to reduce to writing II II their agreement with respect to their ownership as partners of certain tracts , I i i ;: of real estate; and ! I : I , I ! I II , I ilprevlolls agreement should be superseded by a new agreement reduced to writing. II I j II i' II !I agree as follows: 1/ :j 1. The principal place of business of the partnership shall be at IIMechanicsburg, R.D. 3, Pennsylvania. .1 I. ! i Ii i'real property located in Lower Allen Township, Cumberland County, Pennsylvania, !llas well as any other assets of the partnership, and such other business as the I, i ! . l!part~es may from time to time agree upon. f t WHEREAS, the parties have previously entered into a Partnership WHEKEAS, tile circumstances of the parties now indicate that their NOW, THEREFORE, intending to be legally bound, the parties hereby 2. The partnership shall engage in the business of managing the ~ ) 11 3. The capi tal of the partnership consists of four tracts of real j; !/property situate in Lower Allen Township, Cumberland County, Pennsylvania, ., . I!more particularly set forth in the attached Exhibit which is ~de a part hereof. II ! liThe assets and liabilities of the partnership at this date are more fully set ;1 ,!forth in another attached Exhibit prepared by Briner Ashway, C.P.A., which is ,1 ;rONE. SAJER Be STEWART ltorney s at Law 14 Bridge Street lalso made a part hereof. -IV Cumberland, Pa. 17010 , I, i: i The interest of the partners in the capital of the partnership is as follows: Woodrow S. Carey and Anna V. Carey as tenants by the entirety Dennis L. Carey Gary W. Carey 50% 25% 25% 4. Tile net profits of the partnership shall be divided and the net losses of the partnership shall be borne in the following proportions, except 17070 I that all losses resulting from the wrongful act or gross negligence of any ! I! partner shall be charged to him in full: j I Ii i I II " !i \: I' II I; I! II Woodrow S. Carey and Anna V. Carey shall have two votes collectively. Dennis L. II II j; Carey and Gary W. Carey shall have one vote each. ! ' i t I : I Ilat the end of any accounting year. Written notice of intention to retire shall I! Ilbe served upon the other partners at the office of the partnership at least II three months before the end of the accounting year. The retirement of any L II ljpartner shall have no effect upon the continuance of the partnership I: It business. 'I tJ lithe retiring partner's interest in the partnership or to terminate" and liquidate lithe partnership business. If the remaining partners elect to purchase the II II . jlnterest of the retiring partner, they shall serve notice of their election II llupon the retiring partner at the office of the partnership within two months I llafter receipt of his notice of intention to retire. d I' il Ii !i \1 I; II I: ! I 'I Woodrow S. Carey and Anna V. Carey as tenants by the entirety Dennis L. Carey Gary W. Carey 50% 25% 25% 5. All decisions of the partnership shall be by a majority vote. 6. Any partner shall have the right to retire from the partnership The remaining partners shall have the right either to purchase )TONE. SAJER 8< STEWART ttorneysat Law 14 Bridge Street N Cumberland, Pa. Page 2 -;TONE. SAJER 8< STEWART ttorneys.at Law 14 Bridge Street ./II Cumberland, Pa. 17070 II : i (a) If the remaining partners elect to purchase the interest i:of a retiring partner in the partnership, the purchase price shall be based I, !i on tile nct value of the partnership as determined by the most recent statement prepared by the partnership's certified public account, except that in lieu of the book value of the real estate owned by the partnership, it is agreed that the real property shall be valued at Eighty Thousand ($80,000.00) Dollars so that the value of each twenty-five (25%) percent interest shall be Twenty T}\ousand ($20,000.00) Dollars before adjustment for other ,assets and liabilities of L1J(' parln(~r~ddp. The percentage of the retiring partner's interest that (",1<:11 rema i ning partner shall have the right to purchase will be proportionate to the remaining partner's interest in the partnership, excluding the retiring partner's share. Should any remaining partner elect not to purchase the entire interest that he is entitled to purchase, the other remaining partner may purchase such interest on the same terms and conditions set forth herein. (b) If the remaining partners do not elect to purchase the entire interest of a retiring partner in the partnership, the partners shall proceed with reasonable promptness to liquidate the business of the partnership. The net proceeds of the liquidation shall be divided among the partners in proportion to their interest in the partnership. 7. Upon the death of any Qf the partners, the surviving partners shall purchase the interest of the deceased partner. The purchase price shall be as determined in Paragraph 6a of this Agreement. The percentage of the deceased partner's interest that each surviving partner shall purchase shall be proportionare. to the surviving partner's interest in the partnership, excluding the deceased partner's sha~e. Page 3 :;;TONE. SAJER & STE\lVART ,Horney s at Law ,14 Bridge Street IN Cumberland, Pa. 11070 8. Checks shall be drawn on the partnership bank account for , I I partnership purposes only and may be signed by any two partners. 9. No partner may without the consent of the other partners: Ii (a) Borrow money on behalf of the partnership or utilize ! I i (:o11atcral owned hy the partnership as security for such loans; (b) Assign, transfer, pledge, compromise or release any of the claims of or debts due the partnership except upon payment in full, or arbitrate or consent to the arbitrat~on of any of the disputes or controversies of the partnership; (c) Make, execute or deliver any assignment for the benefit of crpoitors or any bond, confession of, judgment, chattel mortgage, ~eed, guarantee, indemnity bond, surety bond, or contract to sell or contract of sale of all or substantially all of the pJ:"operty of the partnership; (d) Leaie or mortgage any partnership real estate or any interest therein or enter into any contract for any such purpose; (e) Pledge or hypothecate or in any manne~ transfer his interest in the partnership, except to the other parties to this agreement; (f) Become a surety, guarantor, or accommodation party to any obligation. 10. That partnership shall maintain a bank account or accounts in such bank or banks as may be agreed upon by the partners. 11. Proper and complete books of account shall be kept at all times and shall be open to inspection by any of the partners or by his accredited representative at any time during reasonable business hours. Page 4 S-rONE, SAJER Be STEW ART \ tlOrneY5 at Law .14 Bridge Street oN Cumberland, Pa. 17070 12. The parties hereto covenant and agree that they will execute :j any further instruments and that they will perform any acts which are or may Ii become necessary to effectuate and to carryon the partnership created by this agreement. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. I I WITNESSES: I i i I -------------- I I I I I I I I a/~ .ct (?a~ WOODROW S. CAREY. &~/~ ANNA V. CAREY ) I ' (SEAL) .,#" (SEAL) J1f /' ( (SEAL) G~~LDr~ (SEAL) "-". ~ P ag e 5 Detailed Results for Parcel 13 - 31- 2134-025. in the 2004 Tax Assessment Database DistrictNo 13 Parcel ID 13-31-2134-025. MapSuffix HouseNo Direction Street MAIN STREET LISBURN Ownerl CAREY, WOODROW S & ANNA V ETAL C/O PropType RO PropDesc Liv Area CurLandVal 54100 CurlmpVal 6020 CurTotVal 60120 CurPrefVal Acreage 5 CIGrnStat TaxEx 1 SaleAmt 6000 SaleMo 5 SaleDa 5 SaleCe 19 Sale Y r 78 DeedBkPage 0027T-00822 YearBIt HF _File_Date 12/23/2005 HF _Approval_Status D Detailed Results for Parcel 13-31-2134-022. in the 2004 Tax Assessment Database DistrictN 0 13 Parcel ID 13-31-2134-022. MapSuffix HouseNo 1777 Direction Street MAIN STREET Ownerl CAREY, WOODROW S & ANA V C/O Prop Type RA PropDesc Liv Area 2132 CurLandVal 20000 CurlmpVal 74600 CurTotVal 94600 CurPretval Acreage 0.09 CIGrnStat TaxEx 1 SaleAmt 10700 SaleMo 5 SaleDa 5 SaleCe 19 SaleYr 78 DeedBkPage 0027T -00820 YearBlt 1900 HF File Date 12/23/2005 HF _Approval_Status D Detailed Results for Parcel 13-31-2134-023. in the 2004 Tax Assessment Database DistrictN 0 13 Parcel_ID 13-31-2134-023. MapSuffix HouseNo 1781 Direction Street MAIN STREET Ownerl CAREY, WOODROW & ANNA V ET AL C/O PropType CC PropDesc Liv Area CurLandVal 54000 CurImpVal 244740 CurTotVal 298740 CurPretVal Acreage 3 CIGrnStat TaxEx 1 SaleAmt SaleMo SaleDa SaleCe Sale Y r . DeedBkPage 0024U-00034 YearBIt HF File Date HF _Approval_Status Page 1 of 1 Detailed Results for Parcel 13-23-0553-030. in the 2004 Tax Assessment Database DistrictN 0 13 Parcel_ID 13-23-0553-030. MapSuffix HouseNo 3814 Direction Street GETTYSBURG ROAD Owner! CAREY, WOODROW S & ANNA V C/O PropType CR PropDesc Liv Area CurLandVal 17850 CurlmpVal 52160 CurTotVal 70010 CurPretval Acreage OA1 CIGrnStat TaxEx 1 SaleAmt SaleMo SaleDa SaleCe Sale Y r DeedBkPage 0024H-00389 YearBlt HF _File_Date HF _Approval_Status http://taxdb.ccpa.net/details.asp?id= 13-23-0553-030.&dbse1ect= 1 3/16/2006 THIS DEED, MADE the ,/.. 3 /l..,{ day of v . '<l,(/2X:::Z;>.vtc<-,c. , in the year of our Lord one thousand nine hundred and seventy-one (1971) BETWEEN DAUPHIN DEPOSIT TRUST COMPANY, Executor of the Estate of Walter K. Brackbill, deceased, late of the Township of Lower Allen, County of Cumberland, State of Pennsy- lvania, Grantor, and WOODROW S. CAREY and ANNA V. CAREY, his wife, and DENNIS L. CAREY and GARY W. CAREY, all of Lower Allen Township, Cumberland County, State of Pennsylvania as tenants in co-partnership for the uses and purposes of the co-partnership. WITNESSETH, that in consideration of Twenty-one Thousand ($21,000.00) Dollars, in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and convey to the said grantees, their heirs and assigns, ALL that certain lot of ground situate in Lower Allen Township, Cumberland County, Pennsylvania, bounded and described as follows: On the North by Harvard Avenue; on the East by Lot No. I on the hereinafter mentioned plan or Lots; on the South by the Harrisburg - Gettysburg Highway and on the west by Lot No. 3 in said Plan, - having a frontage on Harvard Avenue of 74.8 feet; on the Harrisburg-Gettysburg Highway of 75 feet; and a depth of 238 feet, more or less, - and being Lot No.2, in that certain Plan of Lots laid out by William H. Wertz, known as Rana Villa Garden, said Plan being recorded in the office of the Recorder of Deeds in Plan Book 2, Page 47. Having thereon erected a one story dwelling known as 3814 Gettysburg Road. BEING the same premises which James H. Knaish and Cora E. Knaish, his wife, by deed dated March 27, 1929 and recorded in Deed Book "X", Vol. 10, Page 428, Cumberland County Records, granted and conveyed unto Walter Brackbill and Edith C. Brackbill, his wife. The said Edith C. Brackbill having died November 21, 1969 title re- mained vested in Walter Brackbill as surviving tenant by the entireties. The said Walter Brackbill died April 12, 1971 and by his Last Will and Testament duly probated in the Office of the Register of Wills of Cumberland County named Dauphin Deposit Trust Company Executor thereof. This conveyance is made under the authority of Section 541 of the Fiduciaries Act of 1949. It is the intention of this deed that Woodrow s. Carey and Anna V. Carey, his wife, hold their interest as tenants by the entirety as between them and as tenants in co-partnership as between them, as such tenants by entirety, and Dennis L. Carey and Gary w. Carey. . ; trl , ,/J//~ Townn"p of ...;'0.:.. '.:,.,...1.... Cumb, CO'I Pa. /' fl" .. /' (:,- It ,/'. C ' "'-~-~---'------ School Dist. Cumb. Co.; P:, ).% Reel fisrate Transfer Tax :;~~'.- I " ", ".n r L-f L '.Jl:r\ I :3 ti~) AND the said grantor hereby covenants and agrees that it will warrant specially the property hereby conveyed. IN WITNESS WHEREOF, the said DAUPHIN DEPOSIT TRUST COMPANY has caused this Indenture to be signed by its Vice President and attested by its Assistant Secretary and affixed hereunto the common and corporate seal of the said Corporation, that the seal affixed hereto is the seal of said Corporation, that it was so affixed by order of the Board of Directors of said Gbrporation, and they signed their names hereto by like order, the day and year first above written. . ~ 1''' 11 r. ,~(;,;jit~~'~~'\ " " A'" /!/t; / i , ; \f"":;~l~/ :S;:"";;.~~0F PENNSY!.. VANIA DAUPHIN DEPOSIT TRUST COMPANY by \. SS COUNTY OF CUMBERLAND / \ ....."'( JI I . On this the.J3 day of '<:_.;r-:-C", ~1. ~Jl before me the , I /J )-;7 I ~ ' undersigned officer, personally appeared .\;.). <<:. ' .........< L:ty'- who acknow- ledged himself to be the Vice President of Dauph~n Deposit Trust Company, Executor of the Estate of Walter Brackbill, deceased, a corporation, and that he as such Vice President, being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself as Vice President. :!~i~; ).. ..~.. ,', Jl'i,',.',~:~, ;1~l~i ."..~....,'~~ff~'4'r ..~"N '''l)t~~~'~5~~\ ", '. In witness whereof, I hereunto set my hand and official , "\ .n /7 \ \ " / / ) .>rC-V~-L-t !b. J~LP-~A (/ Notary ~b11c Certificate of Residence do hereby certify that the precise residence and complete post office address of the within .na~ed grantee is !9 0 'I .J/I=~"& iM / I') fl. ~ 1W-tiLtv"..(~lt:? Ct 17 0 ~-C c= I (; ~ /J ~~ Attorney for .:r\....3.....~ STA TE OF COUNTY OF .::t>, \ .:1' ~::-- 0J l~i~~1; a:: .,..! rJ SSe RECORDED on this day of , A. D. 1971, in the Recorder's Office of said County in Deed Book Vol. , Page Given under my hand and seal of the said office, the date above written. r--- State of f-'EHln<;\.lv:)ni~ County of Cur:; "00,1,- t. ss ~:<;corded in ,;:'::;.:p':::" If ~+C'I in and 1<)r ',:' ""'" r ~ !(l 'V.... -;-~r ..-L_ 8:,,; {) '- Witnl!"';:; I. Recorder -F!'~'-'r,-t'qg of OeedA, :~'r'./, Pd. ,It _2'_' ..~ if i~'1ge () J''l~ ,'d:/.. <:.Ii oj (.~Hice, at Carlisle, Pd~~;:t) do, Q.~Jc.' ,~~t. jl} :2L r- ,___ ec;or4.er:_ ~OUK 24FiiGE 3~JO a Citizens Bank'" 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 July 22, 2005 GARY W CAREY 1781 MAIN STREET MECHANICSBURG PA 17055 Estate of ANNA V CAREY Date of Death: Jun 21, 2005 SSN: 204-30-8190 Dear Sir/Madam: In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For II.. or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincerely, ~~ ~~bert Roos Operations Services a Citizens Bank'" Account Number 6140715776 Account Title ANNA CAREY Date Opened 6/20/1997 Account Type Time Deposits Principal Balance as of DOD $74917.62 Interest from Last Posting to DOD $4.10 Account Balance as of DOD $74921.72 YTn Interest to DOD $373.56 rI M&rBank 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349 Fax (302) 934-2955 July 15,2005 Stone LaFaver & Shekletski Attorneys At Law 414 Bridge Street - POBox E New Cumberland, PA 17070 Re: Estate of Anna V Carey Social Security: 204-30-8190 Date of Death: June 21. 2005 Dear Sir or Madam: Per your inquiry dated July 08, 2005, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account Checking Account Account Number 21501548 Ownership (Names oj) Carey Rentals * Anna V Carey, Signator * Dennis L Carey. Signator * Garry W Carey, Signa/or * W S Carey, Signator * Opening Date OS/28/79 Balance on Date of Death $27,003.47 Accrued Interest $ 0.00 Total $27,003.47 2. Type of Account Checking Account Account Number 950631965 Ownership (Names oj) Anna V Carey * Opening Date 06/07/01 Closed 07/08/05 Balance on Date of Death $39,712.53 Accrued Interest $ 0.11 Total $39,712.64 3. Type of Account Certificate of Deposit Account Number 031003914381452 Ownership (Names of) Anna V Carey * Opening Date 04/25/90 Closed 0708/05 Balance on Date of Death $76,648.85 $ 67.46 Accrued Interest Total $76,716.31 Please be advised, there was no safe deposit box found for the above decedent. * For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the West Shore Plaza Office # 717-255-2271. Sincerely, 2(:-~/I t2'~ Nancy Clagett Records Management I 1'-'..... ..... ..L. "-.........."'" ..L. '-' . -r ~ I I .,......unl .,r,> '41~ (bl::i ~4::>t:I t-'.~l o PNCBAN< August 2, 2005 Stone LaFaver & Shekletski Attn: David H Stone 414 Bridge St. POBox: E New Cumberland, PA 17070 Iscp RE: Estate of Anna V Carey (Deceased) SSN: 204-30-8190 DOD: 06-21-2005 Dear Mr. Stone: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account #31600213560 Established 07-11-2001 ANNA V CAREY DOD balance: 562,285.13 + $6L~1 accrued interest Che~kiDg Account Account #5140009472 Established 01-01-1978 ANNA V CAREY DOD balance: $36,215.20 + $4.02 accrued interest Savings Account Account #5000938659 Established 08-05-1997 ANNA V CAREY DOD balance: $68.48 + $0.00 accrued interest The decedent maintained INV #19830075. For more info~tion please contact the Brokerage department at 1-800-762-6111. L Ifl Ls-kk .-J ~/ (]J-;tt;i-<~ Page 1 of2 I 1"-'..... '-"... "-'-"'-'..., ... '-" - ~.,r I I 1'"".1....1f 111" '-+J.~ (Oi:j ")'-f.::>l:j t"'.~~ Safe deposit Box The decedent maintained safe deposit box # 174. It was in two names. ANNA V CARBY GARY W CAREY It is located at HAMPDEN 4242 CARLISLE PIKE CAMPHILL PA 17011 717..730-2385 Please note that this office only provides date of death balances for deposit accounts (1RAs, CDs, Checking and Savings accounts). We do not proeess Iny finaneial transactions or provide statements. If you need assistance with any of these items, please call 1...888-PNC..BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, ~~~ Erica L Schlegel 1..800-162-1775 P7...PFSC-04..F 500 First Ave. Pittsburgh P A 15219 Member FDIC Pagr; 2 of 2 TOTAL P.02 ~1l~ November 6, 2005 Stone LaFaver & Shekletski 414 Bridge Street P. O. Box E New Cumberland, Pa. 17070 Attention: David H. Stone Re: Estate of Anna V. Carey Dear Mr. Stone: I am enclosing printouts on the three certificates owned by Anna V. Carey. As regards to balances as of June 21, 2005, these are as follows: Account #2037045845 -- $83,757.50 Account #2037045846 -- $26,693.83 Account #2036319245 -- $105,898.55 As regards to the account with POD to Gary W. Carey and Dennis L. Carey, we will need a notarized letter of their intent to withdraw funds as well as a copy of each of their driver's license. Please note we need letter from each of them as we will be dispersing check to each of them for half of the account. Hope this is satisfactory for you. Sorry for the misunderstanding as regards to the previous letter I sent. Thank you. Very truly yours, ~ Cheryl L. Sereg Customer Service Representative @ Member FDIC EQUAL HOUSING LENDER EEO/AA/M/F/DN T~e Deposit Inquiry Page 1 of 5 10:32:42 CIF number: PA 08526016 C078901 Phone: (H) (717) 697-2478 Birth date: (B) (000) 000-0000 4/14/1925 Tax ID number: 204-30-8190 C/O type: D2 12 MO COMPOUND <100M Account number: 2037045846 ll/U:>/U:> ANNA V CAREY 1781 MAIN ST MECHANICSBURG PA 17055-5946 Current balance: Accrued interest: Penalty amount: Current cash value: Issue date: Original balance: Last payment date: Last renewal date: Last renewal balance: Date redeemed: Interest pmt freq: Interest disposition: F1=Addl functions F6=Messages 26,858.47 54.76 192.17 26,721.06 10/12/01 25,000.00 10/12/05 8/12/05 26,730.46 0/00/00 1 M Add to balance F3=Exit F8=Maintenance Certificate no: Interest rate: APY: C/O term: Maturity date: Hold amount: Y-T-D interest: Per diem: Next payment date: Next pay amount: Value after next pmt: Renewable: Deposit Acct/Type: 2.8620~ 2.90% 12 M 8/12/06 .00 365. 63 2.10599 11/12(05 . 00 . 00 Yes More. . F4=Sweep Inquiry F9=Relationships F5=History F24=More Keys Time Deposit Inquiry Page 1 of 5 CIF number: PA 08526016 Phone: (H) (717) 697-2478 (B) (000) 000-0000 Tax 10 number: C/O type: E2 Account number: ll/U~/U~ ANNA V CAREY 1781 MAIN ST MECHANICSBURG PA 17055-5946 Current balance: Accrued interest: Penalty amount: Current cash value: Issue date: Original balance: Last payment date: Last renewal date: Last renewal balance: Date redeemed: Interest pmt freq: Interest disposition: F1=Addl functions F6=Messages 84,501.42 81.74 1,530.04 83,053.12 5/25/00 74,088.90 10/25/05 1/25/05 82,804.05 0/00/00 1 M Add to balance F3=Exit F8=Maintenance 18 MO Certificate no: Interest rate: APY: C/O term: Maturity date: Hold amount: Y-T-D interest: Per diem: Next payment date: Next pay amount: Value after next pmt: Renewable: Deposit Acct/Type: F4=Sweep Inquiry F9=Relationships 10:32:4:0 C0789D1 Birth date: 4/14/1925 204-30-8190 COMPOUND <10DM 2037045845 2.7160~ 2.75% 1B M 7/25(06 .00 1,791.58 6.28783 11/25(05 . 00 . 00 Yes More. . F5=History F24=More Keys 11/05/05 ANNA V CAREY POD GARY W CAREY & DENNIS L CAREY 1781 MAIN ST MECHANICSBURG PA 17055-5946 Time Deposit Inquiry Page 1 of 5 CIF number: PA 08526016 Phone: (H) (717) 697-2478 (B) (000) 000-0000 Tax 10 number: C/O type: 03 Account number: 10:32:37 C0789D1 Birth date: 4/14/1925 204-30-8190 COMPOUND 100M> 2036319245 Current balance: Accrued interest: Penalty amount: Current cash value: Issue date: Original balance: Last payment date: Last renewal date: Last renewal balance: Date redeemed: Interest pmt freq: Interest disposition: F1=Addl functions F6=Messages 106,741.69 176.94 672.74 106,245.89 2/14/00 90,028.38 10/14/05 2/14/05 104,974.21 0/00/00 1 M Add to balance F3=Exit F8=Maintenance 12 MO Certificate no: Interest rate: APY: C/O term: Maturity date: Hold amount: Y-T-D interest: Per diem: Next payment date: Next pay amount: Value after next pmt: Renewable: Deposit Acct/Type: F4=Sweep Inquiry F9=Relationships 2.5210~ 2.55% 12 M 2/14(06 .00 1,979.72 7.37248 11/14(05 . 00 . 00 Yes More. . F5=History F24=More Keys t MA 1 MB3 02-10 Court Ordered Processing P.O. Box 841005 Boston, MA 02284 July 27, 2005 Stone LaFaver & Shekletski 414 Bridge Street Post Office Box E New Cumberland, P A 17070 RE: Estate of Anna V. Carey Date of Death: 06/21/05 Dear Mr. Stone: Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in the date of death balance. Please feel free to contact me if I can be of any further assistance. Very truly yours, <lJJ1t1v~ Helen Alboth OAG Specialist III (617) 533-1789 Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Anna V. Carey 204-30-8190 June 21, 2005 Account #: 0358003168 Type: IRA Open date: 7/1/83 In the name of: Anna V. Carey Date of Death Balance: $47,126.22 Int.(YTD) from 1/1/05 to 1/31/05 $341.31 Accrued interest to date of death: $209.01 Other Info: Beneficiaries - Gary and Dennis Carey - (sons) - Acet closed 07/19/05 Account #: 0575275334 Type: In the name of: Anna V. Carey Date of Death Balance: Int.(YTD) from 1/1/05 to Accrued interest to date of death: Other Info: Acct closed 07/19/05 CD Open date: 9/6/00 $50,444.52 5/31/05 $64.76 $442.15 Account #: 2335128266 Type: In the name of: Anna V. Carey Date of Death Balance: Int.(YTD) from 1/1/05 to Accrued interest to date of death: Other Info: Acct closed 07/19/05 CD Open date: 10/27/86 $13,503.78 5/31/05 $25.31 $173.74 Account #: 2335128480 Type: In the name of: Anna V. Carey Date of Death Balance: Int.(YTD) from 1/1/05 to Accrued interest to date of death: Other Info: Acct closed 07/19/05 CD Open date: 7/30/87 $68,200.00 5/31/05 $79.33 $544.53 Account #: 2335128498 Type: In the name of: Anna V. Carey Date of Death Balance: Int.(YTD) from 1/1/05 to Accrued interest to date of death: Other Info: Acct closed 07/19/05 CD Open date: 10/15/87 $30,000.00 5/31/05 $ 90.95 $624.26 Page 1 of 2 V~/IU/'UUU lllU la;UO r~A ~ 002/00~ Sovereign Bank ESTATE OF SOCIAL SECURITY #: DATE OF DEATH: Anna V. Carey 204-30-8190 June 21, 2005 Account #: 2335128506 Type: In the name of: Anna V. Carey Date of Death Balance: Int.(YTD) from 1/1/05 to Accrued interest to date of death: Other Info: Account closed 07/19/05 CD OpeD date: 10/4/88 $28,491.41 5/31/05 $30.06 $161.52 Account #: 2335128274 Type: In the name of: Anna V. Carey Date of Death Balance: Int.(YTD) from 1/1/05 to Accrued interest to date of death: Other Info: Account closed 07/19/05 CD Open date: 4/30/87 $12~049.90 5/31/05 $12.71 $69.03 Page 2 of2 TIME DEPOSIT WITHDRAWAL CONFIRMATION Office Name Customer Name(s). Address and Taxpayer 10 Number ANNA V CAREY PA Date 07/18/2005 LlSBURN 1781 MAIN ST MECHANICSBURG PA 17055 5204308190 CURRENT BALANCE: $92,813.95 + ACCRUED INTEREST: $1,026.14 Availlnt WD/PenFree: $1,026.14 - PENAL TV AMOUNT: $0.00 - FEDERAL W/HD DUE: $0.00 - WITHDRAWAL FEE: $0.00 - OUTSTANDING PYMT : $0.00 FULL REDEMPTION CD ACCOUNT NUMBER: 247022046064218 PAID TO CUSTOMER: $93,840.09 566594 WACHOVIA 'VIMEE...... .f0\..~...f:).'0'8rr. . LJ~ru NOT TRANSefE~BbE Opening Date AccountNurnber Taxpayer 10 Number This Receipt Acknowledges That The Depositor Named **"'*:ir***********VOID**'*** / Below Has'Deposited With This Bank The SUm Of Depositor '~-:".'<:',"", ': '-'~.: :,.-..-:-,::., . '...~. . 'e) t t 19:~4, . ::;: ;,,":'i C'~ .. , , ' ,- - , .. ,:, - ": ',' ,', - - --,'- .. ~ .' . '... ." ,- '-. -. '~ ~..' .:'.' q~iltJ~a:oo~f> .'- , . - - . . * N !NE'T'Y"HTi4REE;Tl40t~'-gA'-Ntl}e'I~f.fT;,~i;jr\ff]~e;'ljfO~~rvr.):ULLA~S- '~NtJ':09 "', Q'e:~.r*s / - . ./ $.98,.840_-09 · PayToTi1e 'E!;rtATEOf:;:A~Nfl.{ ."." Order'Of" '. Remitter '. ,'.. ..' . . . .' ..... .. .'. ........ ~e~y~~~~~~~~'='ti~ystems..lnc.,Engle\V~,.COlpr~do Dollars t:l =- W..=Qn IP IIWO q q 5 b 211w 1':.0 2000 q? CH: b800? 28 a. qa. CJO 2011- II Washington Mutual !1cccIl1hcr 15. 2()()5 Stone LaFaver 8: Sheklctski 1\ t torncys at Law 414 Bridge Street PO Box E New Curnberland. P A 17070 R F: Account NlItllhcr Xlll 022450X. Estate of Anna V - Carey Dear 1',,1r. Stone: \Ve recently received your letter and appreciate your con-espondence. We understand that are requesting the date of death balance for the above referenced account. Be low is the in fon11atioll you requested. I L___ L Account Number X3 I -I 022450-X Balance as of 6/21/05 S 100243.05 I r you have any questions about this letter. please contact 111C directly at (X66) 893-0745. Sincerely. q~~ .Jose (10111e7 Accollnt Services \Vashington Mutual Hank R LF-000076343I Pa ge I Build and Price a New Car - NADAguides.com Page 1 of2 , Vehicle Prici n9 & Information nG009U ide, .C()f"'l January 20, 2006 Autos.. Motorcyclos .. BoalS" Classic Cats .. Recreation Vehicles · Mtlnufoctulcd Homos . Collectible Car 1966 Mercedes-Benz 230SL 2 Door Roadster Original MSRP: $6,185 Low Retail Average Retail High Retail $14300 $19,100 TOTAL PRICE E:> $19,100 $28,700 $28,700 Other Vehicle Information Weight: 2855 Low Retail Value This vehicle would be in mechanically functional condition, needing only minor reconditioning. The exterior paint, trim, and interior would show normal wear, needing only minor reconditioning. May also be a deteriorated restoration or a very poor amateur restoration. Most usable "as-is". Some of the vehicles in this publication could be considered "Daily Drivers" and are not valued as a classic vehicle. When determining a value for a daily driver, it is recommended that the subscriber use the low retail value. Note: This value does not represent a "parts car". Average Retail Value This vehicle would be in good condition overall. It could be an older restoration or a well- maintained original vehicle. Completely operable. The exterior paint, trim, and mechanics are presentable and serviceable inside and out. A "20-footer". High Retail Value This vehicle would be in excellent condition overall. It could be a completely restored or an extremely well maintained original vehicle showing very minimal wear. The exterior paint, trim, and mechanics are not in need of reconditioning. The interior would be in excellent condition. Note: This value does not represent a "100 Point" or "# 1" vehicle *. · "100 Point" or "# 1" vehicle is not driven. It would generally be in a museum or transported in an enclosed trailer to concourse judging and car shows. This type of car would be stored in a climate-regulated facility. H [0',.,' Ef;: T IS IN':':; NADAguides. com + YOUR NEW CAR CENTER Pricing Photos Specs Build ConJpare http://www.nadaguides.com/uv/viewresults.aspx?LI=1-12-1-2032-0-0-0&wSec=12&wPr=...1/20/2006 Build and Price a New Car - NADAguides.com Page 1 of2 Vehicle Pricing & Information f10d09!J ;dos com January 20, 2006 Autos" Motorcycles · Boots.. Classic Cars · Recreation VohldC's Ii Manufodured Homes r"~ Luxury Car 1985 Mercedes-Benz 1900 4 Door Sedan (*) EUROPEAN MODEL Original MSRP: $23,510 Low Reta i I Average Retail High Retail Pricl:c: $2,850 $3,825 B $4,925 TOTAL PRICE $2,850 $4,925 Other Vehicle Information Weight: 2700 Low Retail Value This vehicle would be in mechanically functional condition, needing only minor reconditioning. The exterior paint, trim, and interior would show normal wear, needing only minor reconditioning. May also be a deteriorated restoration or a very poor amateur restoration. Most usable "as-is". Some of the vehicles in this publication could be considered "Daily Drivers" and are not valued as a classic vehicle. When determining a value for a daily driver, it is recommended that the subscriber use the low retail value. Note: This value does not represent a "parts car". Average Retail Value This vehicle would be in good condition overall. It could be an older restoration or a well- maintained original vehicle. Completely operable. The exterior paint, trim, and mechanics are presentable and serviceable inside and out. A "20-footer". High Retail Value This vehicle would be in excellent condition overall. It could be a completely restored or an extremely well maintained original vehicle showing very minimal wear. The exterior paint, trim, and mechanics are not in need of reconditioning. The interior would be in excellent condition. Note: This value does not represent a "100 Point" or "# 1" vehicle *. * "100 Point" or "# 1" vehicle is not driven. It would generally be in a museum or transported in an enclosed trailer to concourse judging and car shows. This type of car would be stored in a climate-regulated facility. ft D \.. E~: T I::: I t.~ 0:.; Photos NADAguides.com · YOUR NEW CAR CENTER Pricing Build ConJpare http://www.nadaguides.com/uv/viewresults.aspx?LI=1-12-1-2032-0-0-0&wSec=12&wPr=...1/20/2006 Kelley Blue Book - Private Party Pricing Report - Honda, Accord ~'!',!\ ." . ". Kelley Blue Book . ' ..' ..' THE TRUSTED RESOURCE , . kbb.colll Page 1 of3 a ci ver ti5C f~ie nt Quick Dealer Price Quote ~..'.,. ':~ .... I.~" :"IJc:F"'I(~''';Qc'''le~l:l'~''~_ ._._ J -', -._-' -- L.' --' ,J-,J;,. .. "_, , If -... - . . - - ... Search Used Car Listings t ~ · *' ~-:::; Print This Page Lis Home> Used Cars> 1987 > Honda> Accord> DX Sedan 4D > Equipment 1987 Honda Accord OX Sedan 40 Trade-In Value Private Party Value Suggested Retail Value Photo Gallery Shopping Tools Free CAR FAX Record Check Auto Loan from 6.49% APR Get an Insurance Quote Payment Calculator Extended Warranty Quote Print For Sale Sign BLLE BGe ~:: (LASS: ~:DS Search Used Car Listings Honda Accord 30 Miles or less ZIP Code 17070 To View Ads, Click t:LL t Bee < (LA~\S, ~ ~U~, List Your Car For Sale Reach millions of shoppers on kbb.com, Cars.com, and other popular sites. Find out more, Click BLUE BOOK PRIVATE PARTY VALUE '~~'.~~JJq;.;. Condition Value ~~ <.,-, 1,S80 Excellent 380 More Photos Fair ) $1,025 \ (Sele~ted)_) NEXT STEPS: Search Local Listings List Your Sedan For Sale Vehicle Details Change Equipment Engine: Transmission: Drivetrain: Mileage: 4-Cyl. 2.0 Liter Automatic FWD 60,584 Selected Standard Equipment Air Conditioning Tilt Wheel Power Steering AM/FM Stereo Blue Book Private Party Value Private Party Value is what a buyer can expect to pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings Check Vehicle Title History http://www.kbb.com/kb/ki.dll/kw.kc.ucp?kbb.P A;;P A041;& 17070&;0525 85&;;ucp;&20;... Estim $21 /me Get a Pre from 6.4~ Your Cree Get a Fre a SEt USI LIS. ON r~\a 8) ~1ore tl online Make: Acura Model: Select ZI P Cae 1/20/2006 Kelley Blue Book - Private Party Pricing Report - Honda, Accord Page 2 of3 Under $5,000 :A' ,IF,~ t,E'.V '~UI'CE Compare Used vs. New Both New and Used Sedan Good $1,380 To View List, Click View Another Vehicle Select Year... Fair (Selected) Or Search by Category Or Change ZIP Code $1,025 "Fair" condition means that the vehicle has some mechanical or cosmetic defects and needs servicing but is still in reasonable running condition. This vehicle has a clean title history, the paint, body and/or interior need work performed by a professional. The tires may need to be replaced. There may be some repairable rust damage. Poor N/A * Pennsylvania 01/20/2006 Accurate Condition Appraisal Change Condition Accurately appraising the condition of a vehicle is an important aspect in determining its Blue Book value. Taking our 16 question condition quiz will ensure you know the correct condition rating. NEXT STEPS: Search Local Listings List Your Sedan For Sale http://www.kbb.com/kb/ki.dll/kw.kc.ucp?kbb.PA;;PA041;& 17070&052585&;ucp;&20;H... 1/20/2006 it u.s. Return of Partnership Income For calendar year 2004, or tax year beginning , 2004, and ending , 20 ~ See se arate instructions. OMS No.l545.0099 Fr..rm 1 065 20'04 Department of the Treasury Internal Revenue Service A Principal business activity D Employer identification number Use the Lessors IRS Dennis L, Gary W & Anna V Carey label. B Principal product or service Other- Carey & Sons Buildin s wise, 1181 Main St. print Mechanicsburg, PA 17055-5946 C Business code number or type. 23-1902508 E Date business started 1/01/1972 F Total assets (see instrs) 531110 $ G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) H Check accounting method: (1) X Cash (2) Accrual (3) Other (specify}. ... ~ I Number of Schedules K-l. Attach one for each person who was a partner at any time during the tax y;;; ~ ~ ~ ~ ~ ~ ~ ;. - - - - - - - "3 Caution: Include onlY trade or business income and expenses on lines 1 a through 22 below. See the instructions for more information. S E E I N S T R o u E ~ D I U 0 C ~ T I F o ~ N 5 ~ M I T A T , o N S Sign Here Paid Preparer's Use Only 57 286. Amended return 1 a Gross receipts. or sales. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . la lb lc I N C o M E 2 Cost of goods sold (Schedule A, line 8). .... . . .. . . .. .. . . .. . . . . _. . . . .. .. . . . ... . . . .. . . . . . . . .... . ., . . 2 3 Gross profit. Subtract line 2 from line 1 c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Ordinary income (loss) from other partnerships. estates, and trusts (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 Net farm profit (loss) (attach Schedule F (Form 1040)). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Net gain (loss) from Form 4797. Part II, line 17. .. .. .... .. .. . . . .. . .. ..... ...... . . ... ... .. .. .. ... . .. G 7 Other lncome (loss) (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Total income loss). Combine lines 3 throu h 7. . . . . .. . . . . . . . . .. . . . . .. . . . ... . . . . . . . .. . . . .. . .. . . . . . 8 9 Salaries and wages (other than to partners) (less employment credits) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 10 11 Repairs and maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11 12 Bad debts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 12 13 Rent........................................................................................... 13 14 Taxes and licenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 14 15 Interest...................................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 16a Depreciation (if required, attach Form 4562)..... ..... ... ... . . .. .. . ... 1Ga b Less depreciation reported on Schedule A and elsewhere on return. ... 1Gb lGc 17 Depletion (Do not deduct oil and gas depletion.). . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 18 Retirement plans, ete. . .. . . . .. .. . . . . . . . .. . .., .. . . .. .. .. .. . . . . .. . .. . . . . . . . .. . .. . . . . .. . . . .. . . . ... .. 18 19 Employee benefit programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 20 Other deductions (attach statement). . . . . . . . . . .. .. . . . .. . . . . .... . . . . .. ... . .. . . . . . .. . . .. . . . . . .. . .. . . . . . . .. . . . .. .... .. 20 21 Total deductions. Add the amounts shown in the far ri ht column for lines 9 throu h 20. . . . . . . . . . . .. 21 22 Ordina business income (loss. Subtract line 21 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 22 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than general partner or limited liability company member) is based on all information of which preparer has any know\edge. ~ ~ No Signature of general partner or limited liability company manager Date Date Preparer's signature Check if self- ~ employed . . . 199-05 9138 2/15/05 Firm's name (OT yours if . self-employed). ~ address. and ZIP code EIN ~ 23-1889600 Phone no. (717) 790-0101 PTPA0105L .01/OG/05 Form 1065 (2004) Suite 102 Form 1~ (2004) Dennis L, Gary W & Anna V Carey 23-1902508 Page 2 1"{S~n:eaurEi1At/:r;1 Cost of Goods Sold (see instructions) 1 I nventory at beginning of year. . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . - . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Purchases less cost of items withdrawn for personal use. . . . . . . . . . . . ., ................................... 2 3 Cost of labor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ................................... 3 4 Additional section 263A costs (attach statement). .. . " . . . . . .. . . . ., . .. .. . . . . . . " . . . ... ., .. . . . . . . .., ................................... 4 5 Other costs (attach statement). . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Total. Add lines 1 through 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., ................................... 6 7 Inventory at end of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . 8 9 a Check all methods used for valuing closing inventory: (i) ~ Cost as described in Regulations section 1 .471.3 (ii) Lower of cost or market as described in Regulations section 1 .4714 (iii) Other (specify"method used and attach explanation).. .... . . . .. .. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ b Check this box if there was a writedown of 'subnormal' goods as described in Regulations section 1.471.2(c). . . . . . . . . . . . . . . .. ~ ~ c Check this box "if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970) .... .. .... ~ d Do the rules of section 263A (for property produced or acquired for resale) apply to the partnership? .. . . . .. . . . .. . . . .. 8 Yes No e Was there any change iri determining quantities, cost, or valuations between opening and dosing inventory? . . . . . . . . . YeS No If 'Yes', attach explanation. 1 What type of entity is filing this return? Check the applicable box: a ~ Domestic general partnership b ~ Domestic limited partnership c Domestic limited liability company d Domestic \imited liability partnership e Foreign partnership f Other..... ~ ___ _ ________ ____ _________ ____ 2 Are any partners in this partnership also partnerships? . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 During the partnership's tax year, did the partnership own any interest in another partnership or in any foreign entity that was dIsregarded as an entity separate from its owner under Regulations sections 301.7701.2 and 301.7701.31 If yes, see instructions for required attachment. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Did the partnership file Form 8893, Election of Partnership level Tax Treatment, or an election statement under section 6231 (a)(1)(B)(il) for partnership-level tax treatment, that \s in effect for this tax year? See Form 8893 for more details........ 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K.1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. " If 'Yes,' the partnership is not required to complete Schedules L, M-l, and M.2; Item F on page 1 of Form 1065; or Item N on Schedule K. 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .". . . .. X 6 Does this partnership have any foreign partners? If 'Yes,' the partnership may have to file Forms 8804, 8805 and 8813. See instructions. . . . . . . . . . . . . . . . . . . . 7 Is this partnership a publicly traded partnership as defined in section 469(k)(2)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? .. ., . . . . . . . . . .. .. . 9 At any time during calendar year 2004, did the partnership have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? See the instructions for exceptions and filing requirements for Form TO F 90.22.1. If 'Yes,' enter the name of the foreign country.. ~ x x X x X X x ------------------------------------------------ 10 During the tax year, did the partnership receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If 'Yes,' the partnership may have to file Form 3520. See instructions. . ., .., . . . . . . . '" . . . . . . . . . . . . . . . . . . . . . .. '" .. . . . . . . . . . X 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If 'Yes,' you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described in the instructions under Elections Made By the Partnership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to this return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " ... 0 Designation of Tax Matters Partner (see instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: Name of designated TMP .... Gary W. Carey Address of 1781 Main St. designated TMP ... Lisburn, PA 17055 Identifying number of TMP ..... 176- 34-8350 PTPA0112L 01/05/05 Form 1065 (2004) Form 1065 (2004) Dennis L, Gar W & Anna V Care 23-1902508 ~;s:.G6fi:aQl~jK;~.}n;~ Partners' Distributive Share Items 1 Ordinary business income (loss) (page 1, line 22) . .. . . . . . .. . .. .. . . . . . . . . . . . . . .. " .. .. . .. . . . . 1 2 Net rental real estate income (loss) (attach Form 8825).. .. .. .. ... ..... .. . .. ........ ... ... . . . 2 3 a Other gross rental income (Joss). . . . . . . . . . . . . . . . . . . . . . . . . . . . " . . . 3a b Expenses from other rental activities (attach stint) . . . . . . . . . . . . . . . . . . . . . .. . . . 3b c Other net rental income (loss). Subtract line 3b from line 3a . .. . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . 4 Guaranteed payments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Dividends: a Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Qualified dividends. . . .. . . . . . . . . . .. .. . . .. .. .. . .... 6b 7 Royalties.............. - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Netshort-term capital gain (loss) (attach Schedule 0 (Form 1065)).. . . .. . . . . ... ..... . . . . . . . . . 9a Net long-term capital gain (loss) (attach Schedule 0 (Form 1065)). .. .. . . . . ........ .. .. .. . .. . . b Collectibles (28%) gain (loss) . . . . . . . . . .. .. .. . . . . .. . . . . .. .. . .. . . . 9b c Unrecaptured section 1250 gain (attach sfiltement). . . . . . . . . . . . . . . . . . . . . . . . . . 9c 10 Net section 1231 gain (loss) (attach Form 4797). . .. . . . . .. .. . .. . . . . . .. . .. . .. . .. . .. . . . . .. . . . . . 10 11 Other i nCOrlle Joss) (attach stEtement) . .. .. . .. . . . . . . .. . . .. . . . . . . . . . . . . . . . . . .. .. .. . . . . . . . . . . . . . . . . . . 11 12 Section 179 deduction (attach Form 4562). .... .. ., . . ... .. ., .. .. . . . . .. .. . . . ...... .. ... . " . .. 12 13 a Contributions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 a b Deductions related to portfolio income (attach statement). . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 b c Investment interest expense. . . . . . .. .. ... . . . . . . . . . . . . .. .. . . .. .. . . . . . . . . . .. .. . .. . . . . . .. . . . . . 13c d Section 59(eX2) expenditures: (1) Type · _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (2) Amount ~ 13d 2 e Other deductions attach statement).... . . .. ... . . . . . .. .. .. . . .. . . . . . .. . . . . .. . .. .. . . . ... . . .. . . 13e 14a Net earnings (loss) from self-employment. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 14a b Gross farming or fishing income. . . . . . .. .. .. . . . . . . . ... .. .. . . . ., . . . . . . .. . . .. ... .. . . . .. . . . .. .. 14b c Gross nonfarm income.... .. ..... ........ .. .., . .... ....... . .. ... ... .... ...... .. ... ..... . ... 14c 15a Low-income housing credit (section 42(j)(5}) . .. .. .. . . .. .. . . . .. . .. . .. . . .. . .. .. .. . .. . .. . .. . . .. 15a b Low-income housing credit (other). . .. . . .. . . .. . . . . . . . . . .. .. . . .. . . .. .. . .. . .. . .. .. . . . .. . .. . . . . 15b c Qualified rehabilitation expenditures (rental real estate) (attach Form 3468). . . . . . . . . . . . . . . . . . . 15c d Other rental real estate credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15d e Other rental credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15e f Other credits and credit recapture (attach statement) .... .. ............ . . .. .. .. ...... .......... ......... 15t 16a Name of country or U.S. possession. .. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~I)it*~,t;~t{ b Gross income from all sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16 b c Gross income sourced at partner level.. . . .. . . . . . .. . . . . .. .. . . .. . . . .. . . .. . .. . .. .. . . . . . ... . . . . 16c Foreign gross income sourced at partnership Jevel .~tjJ.~~~Qt- d Passive · _ _ _ _ _ _ _ _ _e Listed categories (attach statement) ~ _ _ _ _ _ _ _.f General limitation. ~ 16f Deductions allocated and apportioned at partner level 9 lnterest expense. _ _ _ _ _ _ _ _ _ _ _ h Other....... _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ 16 h Deductions allocated and apportioned at partnership level to foreign source income i Passive · _ _ _ _ _ _ _ J Listed categories (attach statement). _ _ _ _ _ _ _ _ kGenerallimitation .. ~ I Foreign taxes: (1) Paid · _ _ _ _ _ _ _ _ _ _ _ (2) Accrued............................... m Reduction in taxes available for credit (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17a Post-1986 depreciation adjustment. . . . .. .. . . . . . . . . . . . . . . . . -' . . . . . . . . . . . '" . .. .. ... ... . .... . b Adiusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Depletion (other than oil and gas). . . . . . . . . .. . . . .. . . . . .. . . . .. .. . . . . . . . . . ... . . . . . ... ... . . . .. . d Oil, gas, and geothermal properties - gross income. . . . ... . .. ... . . . . . . . . .... .. . . . . . . .. .. . . .. e Oil, gas, and geothermal properties - deductions. . . . . . . ... .. . . . . . . . .... ... . .. . .. .......... f Other AMT items (attach stmt) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18a Tax-exempt interest income. . .... ........ .... . .. ... . ..... . .. . .. . . .. ........ ....... ......... Other b Other tax -exempt income. . . . . . . . . . . . . . . . . . . . .. ........................................... Infor- c Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . .. ........................................... mation 19a Distributions of cash and marketable securities. . . .... ...... .. .. .. . . .. .. .... . .. ... .. . . . . .... . b Distributions of other property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 a Investment income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Investment expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . - . . . . . . . . . . . . . . . . . . . c Other items and amounts attach stmt) . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income (Loss) Deduc- tions Self- Employ- ment Credits & Credit Recap- ture Foreign Trans- actions Alternative Minimum Tax (AMT) Items BAA PTPAOl34l 01/05/05 16k 161 2 16m 17a 17b 17c 17d 17e 17f 18a l8b lSc 19a 19b 20a 20b Pa e 3 Total amount 15,812. 253. 24,000. Form 1065 (2004) Form 106\l (2004) Dennis L, Gary W & Anna V Carey 23-1902508 Page 4 Analvsis of Net Income (Loss) ", Net income (loss). Combine Schedule K, lines 1 through 11. From the result, subtract the sum of I I Schedule K, lines 12 through 13e, 161(1), and 161(2).. ... .. ..... .... .. .. . .. .. .. .. ....... '" ..... ...... 1 15,812. 2 Analysis by (\) Corporate (ii) Individual (iii) Individual (iv) Partnership (v) Exempt (vi) Nominee/Other partner type: (active) (passive) organization a General 15,812. partners . . . . b limited oartners . . . . Note: Schedules L, M-l and M-2 are not re Balance Sheets er Books Assets 1 Cash . . . . . . . . . . . . . . . . . . . .' . . . . . . . . . . . . . . . . . . 2a Trade notes and accounts receivable... ... .. b Less allowance for bad debts. . . . . . . . . . . . . . . . 3 Inventories................................. 4 U.S. government obligations........ . ..... .. 5 Tax-exempt securities. .. ;.. . ... . . . . . . . . .. .. 6 Other current assets (~ttach stmt). . . . See. St. .1. . 7 Mortgage and real ~state loans. . . . . . . . . . . . . . :i~;. 8 Other investments (attach soot).. . . . . . . . . . . . . . . . . . . 7~{; 9a Buildings and other depreciable assets. . .. .. . b less accumulated depreciation. . . . . . . . . . . . . . 10 a Dep\etab\e assets. . . . . . . . . . . . . . . . . . . . . . . . . . . b Less accumulated depletion....... .. . ....... 11 land (net of any amortization). . . . . . . . . . . . . . . 12a Intangible assets (amortizable only) . . . . . . . . . b Less accumulated amortization. . . . . . . . . . . . . . 13 Other assets (attach stmt) .... .See. .St. 2. 14 Total assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Liabilities an~ Capital 15 Accounts payable. . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Mortgages, notes, bonds payable in less than 1 year. . . . . : 17 Other current liabilities (attach stmt). . . . . . . . . . . . . . . . , 18 All nonrecourse loans. . . . . . '. . . . . . . . . . . . . . . .. : 19 Mortgages, notes, bonds payable in , year or more. . . . . . 20 Other liabilities (attach stmt).. .. .. .. .. .. . .. .. .. . . . t 21 Partners' capital accounts................... :'f~: 65,474. ~!.$ 22 Total liabilities and ca ita'................... ~f~~~.... 65 474. '~~j,:.. S&.Iii~auJe1rft;. Reconciliation of Income Loss er Books With Income Loss er Return 1 Net income (loss) per books.. ... ..... .. . 15,812. 6 Income recorded on books this year not 2 Income included on Schedule K, lines 1, included on Schedule K, lines 1 through 2, 3c. 5, 6a, 7, 8, 9a, 10. and 11. not 11 (itemize): recorded on books this year (itemize): a Tax-exempt interest.. $ _ _ _ _ _ _ _ _ _ _ U1red If Question 5 of Schedule B IS answered 'Ves.' Beginning of tax year End of tax year (a) (b) (c) 18,486. 555. 3, 362 . 57,286. 57 286. 3 Guaranteed pmts (other than health insurance). . . . . 4 Expenses recorded on books this J'ear not included on Schedule K~ lines 1 through 1 Je, 161(1), and 161(2) (itemize): a Depreciation. . . _ .. $ b Travel and - - - --- --- -- entertainment. . . .. $ _ _ _ _ _ _ _ _ _ _ _ 7 Deductions included on Schedule K. lines 1 through 13e, 161(1). and 161(2), not charged against book income this year (itemize): a Depreciation. . . .. $ _ _ _ _ _ _ _ _ _ _ _ 5 Add lines 1 throu h 4. . . . . . . . . . . . . . . . . . . :~S~lfIe:aul~M~2t Anal sis of Partners' Ca 1 Balance at beginning of year. . . . . . . . . . . . 2 Capital contributed: a Cash. . . . .. . . . . . . b Property. . . . . . . . . 3 Net income (loss) per books. . . . . . . . . . . . . 4 Other increases (itemize): __ _ _ _ _ _ _ _ _ _ 15,812. ital Accounts 65,474. -------------------- 8 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . 9 Income (loss) (Analysis of Net Income (loss), line 1). Subtract line 8 from line 5 . . . . . . . . . . . . . . . . . . . . . 15,812. 6 Distributions: a Cash. . . . . . . . . . . " . . . . . . . b Property. . . . . . . . . . . . . . . . . 7 Other decreases (itemize): 24,000. 15 812. S Add Hnes 1 throu h 4. . . . . . . . . . . . . . . . . . . -------------------- 8 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . 81 , 286 . 9 Balance at end of ear. Subtract line 8 from fine 5. . . . PTPAOl341 01/05105 24 000. 57,286. Form 1065 (2004) Form 8825 Rental Real Estate Income and Expenses of a Partnership or an S Corporation ~ See instructions. .. Attach to Form 1065, Form 1065-8, or Fonn 11205. OMS No. 1545-1186 2004 Department of the Treasury Internal Revenue Service Name Employer identification number Dennis L, Ga W & Anna V Care 23-1902508 1 Show the kind and \ocatior\ of each property. See page 2 for additional properties. A ~~U1rr~________________________________________________---------- 3814 Old Gettysburg Rd., Cumberland Co. Office and Warehouse B 1781Main-S~~-Lisburn~PA--------------------------------------------- c ~p~~t~~~tE~~~_~a~~~~__________________________________-------------- 1777-79 main St., Lisburn, PA D ----------------------------------------------------------------- ProlJ ~rties Rental Real Estate 'Income A B C D 2 Gross rents. . . . . . . . . . . . . . . . . . . . . . . . . . 2 5,020. 10,463. 18,432. Rental Real Estate Expenses 3 Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Auto and travel. . . . . . . . . . . . . . . . . . . . . . . 4 5 Cleaning and maintenance. . . . . . . . . . . . 5 405. 360. 6 Commissions. ... .. '" ........ ..... .. . 6 7 Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 200. 1,292. 1,642. 8 Legal and other professional fees. . . . . . 8 9 Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Repairs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 207. 675. 11 Taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 928. 5,022. 1,350. 12 Utilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 96. 96. 1,511. 13 Wages and salaries. . . . . . . . . . . . . . . . . . . 13 14 Depreciation (see instructions). . . . . . . . . 14 257. 774. 2,539. 15 Other (list) ... ------------- J\.E~~u.!!~ .J~Ei,_ !?~nJc_ f.e~.L ~t.c_ 110. 228. 411. -------------------- 15 16 Total expenses for each property. 8,024. Add lines 3 through 15. . . . . . . . . . . . . . . . 16 1,591. 8,488. 17 Total gross rents. Add gross rents from line 2, columns A through H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 33,915. 18 Total expenses. Add total expenses from line 16, columns A through H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 -18,103. 19 Net gain <!o.s~) from Form 4797, Part II, line 17, from the disposition of property from rental real estate act,,,,t\es. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 a Net income (loss) from rental real estate activities from partnerships. estates, and trusts in which this 20a partnership or S corporation is a partner or beneficiary (from Schedule K-l). . . .. . . . . " . .. . .. . . . . . . ... . ... . . b Identify below the partnerships, estates, or trusts from which net income (loss) is shown on line 20a. Attach a schedule if more space is needed: (1) Name (2) Employer identification number ...1' ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- 21 Net rental real estate income (loss). Combine lines 17 through 20a. Enter the result here and on: ~ . Form 1065 or 11205: Schedule K, line 2, or 21 15,812. . Form 1065-8: Part I, line 4 BAA For Paperwork Reduction Act Notice, see the separate instructions. Form 8825 (2004) SPSZ0101L lO/22104 2004 Federal Statements Page 1 Dennis L, Gary W & Anna V Carey 23-19025Q8 Statement 1 Form 1065, Schedule L, Line 6 Other Current Assets Beginning Ending Advances to Partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . $ 3,683. $ o. Total $ 3,683. $ o . Statement 2 Form 1065, Schedule" L, Line 13 Other Assets Beginning Ending Rounding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4. $ o. Total $ 4. $ o. 2004; Partners' Allocation Percentages Page 1 Dennis L, Garv W & Anna V Carev 23-1902508 Partner Partner Partner Partner Partner Percentage Number Partner Name Identification Percentage of Percentage of of Ownership Number Profit Sharing Loss Sharing of Capital 1 Dennis L. Carey 210-40-2212 25.000000 25.000000 25.000000 2 Gary W. Carey 176-34-8350 25.000000 25.000000 25.000000 3 Anna V. Carey 204-30-8190 50.000000 50.000000 50.000000 Totals 100.000000 100.000000 100.000000 PTPL0401L 07117/03 2004 Federal Balance Sheet Summary Page 1 Dennis l, Gary W & Anna V Carey 23-1902508 ENDING ASSETS Cash.......................................................................... Buildings and other as sets. . .. . . .. .. . . . . .. .. . . . . . . .. .. .. . . . . . . .. .. . Less accumulated depreciation..................................... Land.......................................................................... 130,240 (93,871) 17,555 36,369 3, 362 57,286 Total Assets............................................................... ENDING LIABILITIES & CAPITAL Partners ' capital accounts......................................... Total Liabilities and Capital..................................... 57,286 57,286 2004 Federal Income Tax Summary TRADE OR BUSINESS DEDUCTIONS Total deductions.................................... o Page 1 23-1902508 2003 Diff 0 0 0 0 0 0 13,621 2,191 253 0 36,000 -12,000 87,853 -22,379 87,853 -22,379 65,474 -8,188 65,474 -8,188 Dennis L, Gary W & Anna V Carey TRADE OR BUSINESS INCOME Total income (loss)................................ 2004 o SCHEDULE K - INCOME Ordinary business income (loss)............. Net rental real estate income (loss)...... o 15,812 SCHEDULE K - ALTERNATIVE MINIMUM TAX ITEMS Post-1986 depreciation adjustment.......... SCHEDULE K". OTHER Distributions of cash & marketable see.. 253 24,000 SCHEDULE L - BALANCE SHEET Beginning Assets.................................... Beginning Liabilities and Capital.......... Ending Assets........................................ Ending Liabilities and Capital............... 65,474 65,474 57,286 57,286 n Final K-l n Amended K-l OMS No. 1545-0099 Schedule K-' 2004 tlFfa~lIrflll Partner's Share of Current Year Income, (f:orm ., 065) Deductions, Credits, and Other Items Department of the TreasUfY Tax year beginning ,2004 1 Ordinary business income (loss) 15 Credits & credit recapture Internal Revenue Service and ending .20 - -------------- Partner's Share of Income, Deductions, 2 Net rental real estate income (loss) * 3,955. Credits, etc. . See separate instructions. 3 Other net rental income (loss) 16 Foreign transactions tl..li~11 Information About the Partnership -------------- 4 Guaranteed payments A Partnership's employer identification number 23-1902508 -------------- 5 Interest income B Partnership's name, address, city, state, and ZIP code -------------- Dennis L, Gary W & Carey 6a Ordinary dividends Anna V Carey & Sons - -------------- 1781 Main St. 6b Qualified dividends Mechanicsbura. PA 17055-5946 - -------------- C I RS Center where partnership filed return 7 Royalties Cincinnati, OR- - -------------- D Check if this is a publicly traded partnership (pTP) 8 Net short-term capital gain (loss) -- E Tax shelter registration number, if any ~ F Check if Form 8271 is attached 9a Net long-term capital gain (loss) 17 Alternative minimum tax (AMn items '-- A 63. -------------- r~R<<lflirlfJ~r Information About the Partner 9b Collectibles (28%) gain (loss) - -------------- G Partner's identifying number 9c Unrecaptured section 1250 gain 210-40-2212 H Partner's name, address, city, state, and ZIP code 10 Net section 1231 gain (loss) 18 Tax -exempt income and nondeductible expenses Dennis L. Carey 11 other income (loss) -- -------------- 1957 Sheepford Rd. --- --------------- Mechanicsburq, PA 17055 -- ~ General partner or LLC o limited partner or other -------------- I .-- --------------- member -manager LlC member J ~ Domestic partner o Foreign partner 19 Distributions 12 Section 179 deduction _A_ - - - - - - _ _ _.2 !...0.9.9.:.. K What type of entity is this partner? Individual 13 Other deductions L Partner's share of profit, loss, and capital: 20 Other information Beginning Ending -- --------------- Profit 25 ~ 25 % 0 --------------- -- -------------- loss 25 % 25 % Capital 25 % 25 % -------------- 14 Self-employment earnings (loss) M Partner's share of liabilities at year end: -- --------------- -- -------------- Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . $ Qualified nonrecourse financing... . . . . $ Recourse. . . . . . . . . . . . . . . . . . . . . . . . . . . . $ *See attached schedule for additional information. N Partner's capital account analysis: F 0 Beginning capital account. . . . . . . . . . . . $ 16,366. R Capital contributed during the year. . . . $ I R Current year increase (decrease). . . . . . $ 3,955. 5 Withdrawals and distributions. . . . . . . . . $ ( 6, 000 . ) u s Ending capital account. . . . . . . . . . . . . . . $ 14,321. E 0 DGAAP o Section 704(b) book N ~ Tax basis L y Other (explain) BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. Partner 1 PTPA0312L O1/05/OS Schedule K-l (Form 1065) 2004 Schedule.K-' (Form 1065) 2004 Dennis L, Gary W & Anna V Carey This list identifies the codes used on Schedule K-' for all Code partners and ~rovides summarized reporting information for I Undistributed capital gains credit partners who file Fonn 1040. For detailed reporting and filing J Work opportunity credit information, see th~ separate PaJ!ner's Instructions for Schedule K Welfare.to.work credit K-' and the Instructions for your Income tax return. L Disabled access credit 1 Ordinary business income (loss). You must first determine whether the income M EmpowermeJ1t zone and renewal (Joss) is passive or nonpassJVe. then enter on yolK retum as follows: community employment credit Enter on N New York libert;y Zone business employee credit See the Partner's Instructions 0 New markets credit Schedule E. line 28, column (g) P Credit for employer social security Schedule E, line 28. column (h) and Medicare taxes Schedule E, line 28, column 0) Q Backup withholding See the Partner's Instructions R Recapture of low-income housing credit (section 42(j)(5)) S Recapture of low-income housing credit (other) T Recapture of investment credit U Other credits V Recapture of other credits '6 Foreign transactions A Name of country or U.S. possession B Gross income from all sources C Gross income sourced at partner level Form 1116, Part I Foreign gross income sourced at partnership level D Passive Form 1116, Part I E Listed categories Form 1116, Part I F Generallimitation Form 1116. Part I Deductions allocated and apportioned at partnership level G Interest expense Form 1116, Part I H Other Form 1116. Part I Dedvctions a/lo9ated and apportioned at partnership level to foreIgn source Income I Passive Form 1116, Part I J Listed categories Form 1116. Part I K Generallimitation Form 1116. Part I Other information L Total foreign taxes paid M Total foreign taxes accrued N Reduction in taxes available for credit o Foreign trading gross re<;eipts P Extraterritorial income exclusion Q other foreign transactions 17 Alternative minimwn tax (AMT) items A Post-1986 depreciation adjustment } B Adjusted gain or loss C Depletion (other than oil & gas) o Oil, gas, & geo1hermal properties - gross income E Oil, gas, & geothermal properties - deductions F Other AfKr items 18 Tax..xempt Income and nondeductible expenses A Tax-exempt interest income Form 1040, line 8b B Other tax-exempt income See the Partner's Instructions C Nondeductible expenses See the Partner's Instructions 19 Distributions A Cash and marketable securities B Other property 20 Other information A Investment income B Investment expenses C Fuel tax credit information D Look-back interest - completed long-term contracts E Look-back interest- income forecast method F Dispositions of property with section 179 deductions G Recapture of section 179 deductions H Special basis adjustments I Section 453(1)(3) information J Section 453A(c) information K Section 1260(b) information L I nterest allocable to production expenditures M CCF nonqualified withdrawals N Information needed to figure depletion - oil and gas o Amortization of Reforestation costs P Unrelated business taxable income Q Other information 9 C Unrecaptured section 1250 gain 10 N.t section 1231 gain (loss) 11 Other Income (loss) Code A Other portfolio income (loss) B Involuntary conwrsions C Section 1256 contracts and straddles D Mining exploration costs recapture E Cancellation of debt F Other income (loss) 12 Section 179 deduction 13 other deductions A Cash contributions (50%) 8 Cash contributions (30%) C Noncash contributions (50%) o Noncash contributions (30%) E Capital gain property to a 50% orQanization (30%) F Capital gain properiy (20%) G Deductions - portfolio (2% floor) H Deductions - portfolio (other) I Investment interest expense J Deductions - royalty income K Section 59(e)(2) expenditures L Amounts paid for medical insurance M Educational assistance benefits N Dependent care benefits o Pre productive period expenses P Commercial revitalization deduction from rental real estate activities Q Penalty on early withdrawal of savings R Pensions and IRAs S Reforestation expense deduction T Other deduc\lems 14 Self-employment earnings (loss) Note: If lOU have a section 179 deduction or any partner. level deductions. see the Partner s Instructions before compleung Schedule SE- A Net earnings (loss) from self-employment B Gross farming or fishing income C Gross non-farm income , 5 Credits and credit recapture A Low-income housing credit (section 42(j)(5)) B low. income housing credit (other) C Qualified rehabilitation expenditures (rental real estate) o Qualified rehabilitation expenditures (other than rental real estate) E Basis of energy property F Qualified timber property. G Other rental real estate credits H Other rental credits Partner 1: Dennis L. Passive loss Passive income NonpassNe k>ss Nonpassive income 2 Net rental real estate income (loss) 3 Other net rental income (loss) Net income Net loss 4 Guuan~edpaym.ms 5 Interest income 6 a Ofdinary dividends 6 b Qualifaed dividends 7 Royalties 8 Net short-term capital gain (loss) . 9 a Net long-term capital gain (I~$s) 9 b Collectibles (28%) gall; (loss) Schedule E. line 28, column (g) See the Partner's Instructions Schedule E. line 28, column (j) Form 1040, line Sa Form 1040, line 9a Form 1040, line 9b Schedute E, line 4 Schedule 0, line 5, column (t) Schedule 0, line 12, column (f) 28% Rate Gain Worksheet, line 4 (Schedule 0 instructions) See the Partner's Instructions See the Partner's Instructions See the Partner's Instructions See the Partner's Instructions Form 6781, line 1 See Pub 53S Form 1040. line 21 or Form 982 See the Partner's Instructions See the Partner's Instructions Schedule A. line 15 Schedule A. line 15 Schedule A, line 16 Schedule A. line 16 Schedule A. line 16 Schedule A. line 16 Schedule A, line 22 Schedule A. line 27 Form 4952, line 1 Schedule E. line 18 See Partner's Instructions Schedule A, line 1 or Form 1040. line 31 See the Partner's lnstruc\ions Form 2441, line 12 See the Partner's Instructions See Form 8582 Instructions Form 1040, line 33 See the Partner's Instructions See the Partner's Instructions See \he Partner's Instructions Schedule SE, Section A or B See the Partner's Instructions See the Partner's Instructions Form 8586, line 5 Form 8586, line 5 Form 3468. line 1 Form 3468, line 1 Form 3468. line 2 Form 3468, line 3 See the Partner's Instructions See the Partner's Instructions Carey 210-40-2212 23-1902508 Page 2 Enter on Form 1040. line 69, box a Form 5884. line 3 Form 8861, line 3 Form 8826, line 7 Form 8844, line 3 Form 8884, line 3 Form 8874, line 2 Form 8846. line 5 Form 1040, line 63 Form 8611. line 8 Form 8611, line 8 See Form 4255 See the Partner's Instructions See the Partner's Instructions Form 1116, Part I Form 1116, Part I Form 1116. Part /I Form 1116. Part " Form 1116, line 12 Form 8873 Form 8873 See the Partner's Instructions See the Partner's I nstructions and the instructions for Form 6251 See the Partner's Instructions See the Partner's Instructions Form 4952, line 4a Form 4952, line 5 Form 4136 See Form 8697 See Form 8866 See the Partner's Instructions PTPA0312L 01lOS/05 Schedule K~l (Form 1065) 2004 Dennis L, Gary W & Anna V Carey 23-1902508 Su lementallnformation Pe 3 Box 2 Rental Real Estate Activities Property Gross Net Net Passive Sec. 1231 Description Income E~enses Income Nonpass Total Dwelling 1,255. 398. $ 857. NonPass Office and Warehouse 2,616. 2,006. 610. NonPass Apartments and Garage 4,608. 2,122. 2,486. NonPass Rounding or Specially Allocated Net Income (Loss) Adjustment 2. Total $ 3,955. Partner 1: Dennis L. Carey 210-40-2212 SPSL1201L 07/31/03 n Final K-l n Amended K-1 OMS No. 1545.0099 Schedule K-' 2004 ~lIimlt~jl Partner's Share of Current Year Income, (Form 1065) Deductions, Credits. and Other Items Department of the Treasury Tax year beginning ,2004 1 Ordinary business income (loss) 15 Credits & credit recapture Internal Revenue Service and ending ,20 - - -------------- Partner's Share of Income, Deductions, 2 Net rental real estate income (Joss) * 3,952. Credits, etc. ~ See separate instructions. 3 Other net rental income (loss) 16 Foreign transactions Information About the Partnership -------------- 4 Guaranteed payments A Partnership's employer identification number 23-1902508 -------------- 5 Interest income B Partnership's name, address, city, state, and ZIP code - -------------- Dennis L, Gary W & Anna V Carey 6a Ordinary dividends Carey & Sons - -------------- 1781 Main St. 6b Qualified dividends Mechanicsbura, PA 17055-5946 - -------------- C IRS Center where partnership filed return 7 Royalties Cincinnati, OH -- -------------- D Check if this is a publicly traded partnership (PTP) 8 Net short-term capital gain (loss) ...... E Tax shelter registration number, if any I-- F Check if Form 8271 is attached 9a Net long-term capital gain (loss) 17 Alternative minimum tax (AMT) items '-- A 63. - -------------- t&lfar.llV~l Infonnation About the Partner 9b Collectibles (28%) gain (loss) - -------------- G Partner's identifying number 9c Unrecaptured section 1250 gain 176-34-8350 H Partner.s name, address, city, state, and ZIP code 10 Net section 1231 gain (loss) 18 Tax-exempt income and nondeductible expenses Gary W. Carey 11 Other income (loss) -- -------------- 1781 Main St. -- --------------- Lisburn, PA 17055 ~ General partner or LLC o Limited partner or other -- -------------- I --------------- member -manager LLC member -- J lRI Domestic partner o Foreign partner 19 Distributions 12 Section 179 deduction A --___ ____ 2LCLO.Q.:.. --- K What type of entity is this partner? Individual 13 Other deductions L Partner's share of profit, loss, and capital: 20 Other information Beginning Ending -- --------------- Profit 25 % 25 % --------------- -- -------------- Loss 25 ~ 25 % 0 Capital 25 % 25 % -------------- 14 Self-employment earnings Ooss) M Partner's share of liabilities at year end: -- --------------- -- -------------- Nonrecourse.. . .... .. ... ......... .... $ Qualified nonrecourse financing. . . . . . . $ Recourse. . . . . . . . . . . . . . . . . . . . . . . . . . . . $ *See attached schedule for additional information. N Partner's capital account analysis: F 0 Beginning capital account. . . . . . . . . . . . $ 16,369. R Capital contributed during the year. . . . $ I R Current year increase (decrease). . . . . . $ 3,952. s Withdrawals and distributions. . . . . . . . . $ ( 6,000. ) u s Ending capital account. .. ... .. . .. .. . . $ 14,321. E 0 CJ GAAP o Section 704(b) book N j!JTax basis L y Other (explain) BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. Partner 2 PlPA0312L 01/05/05 Schedule K-' (Form 1065) 2004 Schedule K.l (Form 1065) 2004 Dennis L, Gary W & Anna V This list identifies the codes used on Schedule K-l for all Pilrtners and ~rovides summarized reporting information for partners who file Form 1040. For detaaled reporting and filing mfonnation, see the separate Partner's Instrudions for Schedule K-1 and the instructions for your income tax return. 1 Ordinary business income (loss). You must first determine whether the income (loss) is passive or nonpaSSlve. ihen enter on your return as follows: Enter on See the Partner's Instructions Schedule E, line 28, column (g) Schedule E, line 28, column (hl Schedule E. line 28. column (j) See the Partner's Instructions Passive loss Passive income Nonpassive toss Nonpassive income 2 Net rental real estate income (loss) 3 Other net rental income (loss) Net income Net loss 4 Guaranteed payments 5 Interest income 6 a Ordinary diviclends 6 b Qualified dividends 7 Royalties 8 Net short-tenn capital gain (loss) 9 a Net long-term capital gain (I~$S) 9 b Collectibles (28%) gain (loss) Schedule E. line 28. column (g) See the Partner's Instructions Schedule E, line 28, column (j) Form 1040. line 8a Form 1040, line 9a Form 1040, line 9b Schedule E. line 4 Schedule D. line 5, column (f) Schedule 0, line 12, column (1) 28% Rate Gain Worksheet, line 4 (Schedule D instructions) See the Partner's Instructions See the Partner's Instructions 9 C Unrecaptured section 1250 gain , 0 Net section 1231 gain (loss) " Other income (loss) Code A Other portfolio income (loss) B Involuntary conversions C Section 1256 contracts and straddles o Mining exploration costs recapture E Cancellation of debt F Oiher income (loss) '2 Section 179 deduction '3 Other deductions A Cash contributions (50%) B Cash contributions (30%) C Noncash contributions (50%) o Noncash contributions (30%) E Capital gain property to a 50% organization (30%) F Capital gain property (20%) G Deductions - portfolio (2% floor) H Deductions - portfolio (other) I Investment interest expense J Deductions - royalty income K Section 59(e)(2) expenditures l Amounts paid for medical insurance M Educational assistance benefits N Dependent care benefits o Preproductive period expenses P Commercial revitalization deduction from rental real estate activities Q Penalty on early withdrawal of savings R Pensions and IRAs S Reforestation ~xpense deduction T Other deductiOns '4 Self.employment earnings (loss) Note: If you have a section 179 deduction or any partner-level deductions. see the Partner's Instructions before completing Schedule SE. A Net earnings (loss) from self-employment B Gross farming or fishing income C Gross non-farm income 15 Credits and credit recapture A Low-income housing credit (section 42(j)(5)) B Low-income housing credit (other) C Qualified rehabilitation expenditures (rental real estate) D Qualified rehabilitation expenditures (other than rental real estate) E Basis of energy property F Qualified timber prop~ G Other rental real estate credits H Other rental credits Partner 2: Gary W. Carey See the Partner's Instructions See the Partner's Instructions Form 6781. line 1 See Pub 535 Form 1040. line 21 or Form 982 See the Partner's Instructions See the Partner's Instructions Schedule A. line 15 Schedule A, line 15 Schedule A. line 16 Schedule A, line 16 Schedule A, line 16 Schedule A. line 16 Schedule A, line 22 Schedule A, line 27 Form 4952, line 1 Schedule E, line 18 See Partner's Instructions Schedule A, line 1 or Form 1040. line 31 See the Partne(s Instructions Form 2441, line 12 See the Partner's Instructions See Form 8582 Instructions Form 1040, line 33 See the Partner's Instructions See the Partner's Instructions See the Partner's Instructions Schedule SE, Section A or B See the Partner's Instructions See the Partner's Instructions Form 8586. line 5 Form 8586, line 5 Form 3468, line 1 Form 3468, line 1 Form 3468, line 2 Form 3468, line 3 See the Partner's Instructions See the Partner's Instructions 176-34-8350 Carey Code I Undistributed capital gains credit J Work OPportunity credit K Welfare-to-work credit l Disabled access credit M Empowerment zone and renewal community employment credit N New York Uberty Zone business employee credit o New markets credit P Credit for employer social security and Medicare taxes Q Backup withholding R Recapture of low-income housing credit (section 420)(5)) S Recapture of low-income housing credit (oUter) T Recapture of investment credit U Other credits V Recapture of other credits 16 Foreign transactions A Name of country or U.S. possession B Gross income from all sources C Gross income sourced at partner level Form 1116, Part I Foreign gross income sourced at partnership level D Passive Form 1116, Part I E listed categories Form 1116, Part I F General limitation Form 1116, Part I Deductions allocated and apportioned at partnership level G Interest expense Form 1116, Part I H Other Form 1116, Part I Dedl}ctions allo~ated and apportioned at partnership level to foreign source Income I Passive Form 1116, Part I J listed categories Form 1116. Part I K General limitation Form 1116. Part I Other information L Total foreign taxes paid M Total foreign taxes accrued N Reduction in taxes available for credit o Foreign trading gross receipts P Extraterritorial income exclusion Q Other foreign transactions 17 Alternative minimum tax (AMl) items A Post-1986 depreciation adjustment } B Adjusted gain or loss C Depletion (other than oil & gas) D Oil, gas, & geothermal properties - gross income E Oil, gas, & geothermal properties - deductions F Other AMr items 18 Tax-exempt income and nondeductible expenses A Tax-exempt interest income Form 1040, line 8b BOther tax-exemot income See the Partne(s Instructions C Nondeductible expenses See the Partner's Instructions 19 Distributions A Cash and marketable securities B Other property 20 Other infonnation A Investment income B Investment expenses C Fuel tax credit information o Look-back interest - completed long-term contracts E Look.back interest - income forecast method F Dispositions of property with section t 79 deductIons G Recapture of section 179 deductions H Special basis adjustments I Section 453(1)(3) information J Section 453A(c) information K Section 1260(b) information L Interest allocable to production expenditures M CCF nonqualified withdrawals N Information needed to figure depletion - oil and gas o Amortization of Reforestation costs P Unrelated business taxable income Q Other information 23-1902508 Page_~ Enter on Form 1040. Ime 69. box a Form 5884. line 3 Form 8861. line 3 Form 8826, line 7 Form 8844. line 3 Form 8884. line 3 Form 8874, line 2 Form 8846, line 5 Form 1040, line 63 Form 8611. line 8 Form 8611, line 8 See Form 4255 See the Partner's Instructions See the Partner's Instructions Form 1116, Part I Form 1116, Part I Form 1116, Part II Form 1116, Part II Form 1116, line 12 Form 8873 Form 8873 See the Partner's Instructions See the Partner's Instructions and the instructions for Form 6251 See the Partner's Instructions See the Partner's Instructions Form 4952, line 4a Form 4952, line 5 Form 4136 See Form 8697 See Form 8866 See the Partner's Instructions PTPA0312L 01/05/05 Schedule K.l (Form 1065) 2004 Dennis L, Gary W & Anna V Carey 23-1902508 Schedule K- SU lementallnfonnation Box 2 Rental Real Estate Activities Pa e 3 Property Gross Net Net Passive Sec. 1231 Description Income Expenses Income Nonpass Total Dwelling 1,255. 398. $ 857. NonPass Office and Warehouse 2,616. 2,006. 610. NonPass Apartments and Garage 4,608. 2,122. 2,486. NonPass Rounding or Specially Allocated Net Income (Loss) Adjustment -1. Total $ 3,952. Partner 2: Gary W. Carey 176-34-8350 SPSL1201L 07/31/03 n Final K.l n Amended K-l OMS No. 1545'009~ Schedule K-' 2004 IsB~"'niUlf01 Partner's Share of Current Year Income, (Form 1065) /. .,:;-.a ~ :;.. ""-'.;;" Deductions. Credits, and Other Items Department of the Treasury Tax year beginning .2004 1 Ordinary business income (loss) 15 Credits & credit recapture Internal Revenue Service and ending ,20 - -------------- Partner's Share of Income, Deductions, 2 Net rental real estate income (loss) * 7,905. Credits, etc. ~ See separate instructions. 3 Other net rental income (loss) 16 Foreign transactions ~. Information About the Partnership - -------------- ". 4 Guaranteed payments A Partnership's employer identification number - -------------- 23-1902508 5 Interest income B Partnership's name, address, city, state, and ZIP code -------------- Gary W & 6a Ordinary dividends -------------J Dennis L, Anna V Carey Carey & Sons Qualified dividends 1781 Main St. 6b Mechanicsbura. PA 17055-5946 i -------------- C I RS Center where partnership fired return 7 Royalties Cincinnati., OH - -------------- D Check if this is a publicly traded partnership (PTP) 8 Net short-term capital gain (loss) I-- E Tax shelter registration number, if any ..... F Check if Form 8271 is attached 9a Net long-term capital gain (loss) 17 Alternative minimum tax (AMn items L- A ___ ________:L21.:.. - '*Ri~lt~t~1. Information About the Partner 9b Collectibles (28%) gain (loss) - -------------- G Partner's identifying number 9c Unrecaptured section 1250 gain 204-30-8190 H Partner's name, address, city, state, and ZIP code 10 Net section 1231 gain (loss) 18 Tax-exempt income and nondeductible expenses Anna v. Carey 11 Other income (Joss) f-- -------------- 1781 Main St. -- --------------- Lisburn, PA 17055 I-- - [Kl General partner or llC o limited partner or other -------------- I -- --------------- member -manager LlC member J lRl Domestic partner o Foreign partner 19 Distributions 12 Section 179 deduction A ___ _ _ ____11LQ..O.Q.:.. f-- K What type of entity is this partner? Individual 13 Other deductions L Partner's share of profit, loss, and capital: --------------- 20 Other information Beginning Ending 1-- Profit 50 % 50 ~ 0 --------------- -- -------------- Loss 50 % 50 ~ 0 Capital 50 % 50 % -------------- 14 Self-employment earnings (loss) M Partner's share of liabilities at year end: 1-- --------------- -- -------------- Nonrecourse.. .. . .. .. .......... .... . . $ Qualified nonrecourse financing. . . . . . . $ Recourse. . . . . . . . . . . . . . . . . . . . . . . . . . . . $ *See attached schedule for additional information, N Partner's capital account analysis: F 0 Beginning capital account. . . . . . . . . . . . $ 32,739. R Capital contributed during the year . . . . $ I R Current year increase (decrease). . . . . . $ 7,905. s Withdrawals and distributions. . . . . . . . . $ ( 12 I 000 . ) u s Ending capital account. . . . . . . . . . . . . . . $ 28,644. E 0 [J GAAP D Section 704(b) book N \!l Tax basis L y Other (explain) BAA For Paperwork Reduction Act Notice, see Instructions for Fonn 1065. Partner 3 PTPA0312l 01/05/05 Schedule K-' (Form 1065) 2004 Schedule- K-l (Form 1065) 2004 Dennis L, Gary W & Anna V This list Identifies the codes used on Schedule K-1 for all Pflrtners and provides summarized reporting infonnation for partners who file Form 1040. For detailed reporting and filing Information, see the separate Partne"-s Instructions for Schedule K-1 and the instructions for your income tax return. 1 Ordinary business income (Joss). You must first determine whether the income (loss) is passive or nonpassive. the.n enter on yoU' return as follows: Enter on See the Partner's Instructions Schedule E, line 28, column (g) Schedule E, line 28, column (h) Schedule E, line 28, column (j) See the Partne(s Instructions Passive loss Passive income NonpassNe loss Nonpassive income 2 Net rental real estate income (Joss) 3 Other net rental income (loss) Net income Net loss 4 Guaranteed payments 5 Interest income 6 a Ordinary dividends 6 b Qualified dividends 7 Royalties 8 Net short-teon capital gain (Joss) 9 a Net long-term capitaf gain (k.ss) 9 b Collectibles (28%) g.i~ (Joss) Schedule E. line 28, column (g) See the Partner's Instructions Schedule E. line 28, column (j) Form 1040, line 8a Form 1040,Iine 9a Form 1040. line 9b Schedule E, line 4 Schedule D, line 5, column (f) Schedule 0, line 12. column (f) 28% Rate Gain Worksheet, line 4 (Schedule D instructions) See the Partner's Instructions See 1he Partner's Instructions 9c Unrecaptu"';d section 1250 gain 10 Net section 1231 gain (loss) 11 Other income (Joss) Code A Other portfolio income (loss) B Involuntary conversions C Section 1256 contracts and straddles o Mining exploration costs recapture E Cancellation of debt F other income (loss) 12 Section 179 deduction 13 Other deductions A Cash contributions (50%) B Cash contributions (30%) C Noncash contributions (50%) o Noncash contributions (30%) E Capital gain property to a 50% organization (30%) F Capital gain property (20%) G Deductions - portfolio (2% floor) H Deductions - portfolio (other) I Investment interest expense J Deductions - royalty income K Section 59(e)(2) expenditures L Amounts paid for medical insurance M Educational assistance benefits N Dependent care benefits o Preproductive period expenses P Commercial revitalization deduction from rental real estate activities Q Penalty on early withdrawal of savings R Pensions and IRAs 5 Reforestation expense deduction T Other deduct\ons 14 Self-employment eamings (loss) Note: If you have a section 179 deduction or any partner-level deductions. see the Partner's Instructions before completing Schedule SE- A Net eamings (Joss) from self-employment B Gross farming or fishing income C Gross non-farm income 15 Credits and credit recapture A Low-income housing aedit (section 42(j)(5)) B Low.income housing credit (other) C Qualified rehabilitation expenditures (rental real estate) D Qualified rehabilitation expenditures (other than rental real estate) Form 3468, line 1 E Basis of energy property Form 3468. line 2 F Qualified limber property- Form 34G8, line 3 G Other rental real estate credits See the Partner's Instructions H Other rental credits See the Partner's Instructions Partner 3: Anna V. Carey 204-30-8190 See the Paltne(s Instructions See the Partner's Instructions Form 6781. line 1 See Pub 535 Form 1040. line 21 or Form 982 See 1he Partner's Instructions See the Partner's Instructions Schedule A, line 15 Schedule A, line 15 Schedule A, line 16 Schedule A, line 16 Schedule A, line 16 Schedule A, line 16 Schedule A, line 22 Schedule A. line 27 Form 4952, line 1 Schedule E. line 18 See Partne(s Instructions Schedule A, line 1 or Form 1040. line 31 See the Partner's Instructions Form 2441. line 12 See the Partner's Instructions See Form 8582 Instructions Form 1040. line 33 See the Partner's Instructions See the Partner's Instructions See the Partner's Instructions Schedule SE, Section A or B See the Partner's Instructions See the Partner's Instructions Form 8586. line 5 Form 8586. line 5 Form 3468, line 1 Carey 23-1902508 Code I Undistributed capital gains cred j J Work opportunity credit K Welfare-to-work credit L Disabled access credit M Empowerment zone and renewc community employment credit N New York Liberty Zone business employee credit o New markets credit P Credit for employer social secur and Medicare taxes Q Backup withholding R Recapture of /ow-income housir credit (section 42(J)(5)) S Recapture of low-income housir credit (other) T Recapture of investment credit U Other credits V Recapture of other credits 16 Foreign transactions A Name of countty or U,S. posse~ B Gross income from all sources C Gross income sourced at partner level Foreign gross income sou... D Passive E Listed categories F General limitation Deductions allocated and G Interest expense H Other Deductions allocated and foreign source inCOme I Passive J Listed categories K General limitation Other information L Total foreign taxes paid M Total foreign taxes accrued N Reduction in taxes available fe o Foreign trading gross receipts P Extraterritorial income exclusic Q Other foreign transactions 17 Alternative minimum tax (ANT) it. A Post-l9B6 depreciation adjust.. B Adjusted gain or loss C Depletion (other than oil & g~ D Oil, gas. & geothermal properl E Oil, gas. & geothermal proper~ F Other AMT items 18 Tax.exempt income and nondedu A Tax-exempt interest income B Other fax-exempt income C Nondeductible expenses 19 Distributions A Cash and marketable securitie B Other property 20 Other information A Investment income B Investment expenses C Fuel tax credit information D Look-back interest - comple- long-term contracts E Look-back interest - income forecast method F Dispositions of property with section 179 deductions G Recapture of section 179 ded H Special basis adiustments I Section 453(1)(3) information J Section 453A(c) information K Section 1260(b) information l Interest allocable to productic expenditures M CCF nonqualified withdrawal.:: N Information needed to figure depletion - oil and gas o Amortization of Reforestatior P Unrelated business taxable i'l Q Other information ., Dennis L, Gary W & Anna V Carey 23-1902508 Su lementallnformation Pa e 3 Box 2 Rental Real Estate Activities Property Gross Net Net Passive Sec. 1231 Description Income Expenses Income Nonpass Total Dwelling 2,510. 796. $ 1,714. NonPass Office and Warehouse 5,232. 4,012. 1,220. NonPass Apartments and Garage 9,216. 4,244. 4,972. NonPass Rounding or Specially Allocated Net Income (Loss) Adjustment -1. Total $ 7,905. Partner 3: Anna V. Carey 204-30-8190 SPSL1201L 07/31103 Form 1 065 .-rD):~\n?BP]~m?~~ @~JfP\r u.s. Return of Partnership Income For calendar year 2003, or tax year beginning , 2003, and ending , 20 ~ See se arate instructions. OMS No.l545-Q099 .. Department ot the Treasury Internal Revenue Service A Principal business activity Lessors B Principal product or service Buildin s C Business code number D Employer identification nLDftber Use the IRS label. other- wise, print or type. Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, PA 17055-5946 23-1902508 E Date business started 1/01/1972 F Total assets (see instrs) 531110 $ 65,474 G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) Amended return H Check accounting method: (1) X Cash (2) Accrual (3) Other (specify) . . .. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I Number of Schedules K-l. Attach one for each person who was a partner at any time during the tax year. . . . . . . . . . . . . . . ~ Caution: Include only trade or business income and expenses on lines 1 a through 22 below. See the instructions for more information. Preparer's /I ~ Paid signalure .2--: . ,y i [...~tt..L.Jt4,' Preparer's Firm's name Mor an & Ashwa (or yours if Use Only self-employed), ~ 99 November Dr. Suite 302 address. and ZIP code Cam Hill, PA 17011-5064 BAA For Paperwork Reduction Act Notice, see separate instructions. S E E I N S T R D u c E T D I U 0 N C 5 T I F 0 0 R N S L I M , T A T I 0 N 5 Sign Here 1 a Gross receipts or sales. . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . - . . - . . . . - . . . . . . b less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a lb 1c I N C o M E 2 Cost of goods sold (Schedule A, line 8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Gross profit. Subtract line 2 from line lc. . . . .. .. .. . . .. . . .. . . . . . . . . . . . . . . . . -. .. . . . . . . . .. . . .... . . . . . 3 4 Ordinary income <'oss) from other partnerships, estates, and trusts (attach schedule) . . _ . . . . . . . . . . . . . . '.' . . . . . . . . . . . . . . . . . . . . . . . - . . . - . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 Net farm profit (loss) (attach Schedule F (Form 1040)).. .. .. . . .. . . .. . . . . . . ... " . .. ... . ... .... . . . . . . 5 6 Net gain (loss) from Form 4797, Part II, line 18 . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . . . . . .. . . . . . .. .. . 6 7 Other income (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Total income oss. Combine lines 3 throu h 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . 8 9 Salaries and wages (other than to partners) (less employment credits).. .. ... ..... .... ........ . .., . 9 10 Guaranteed payments to partners. . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . .. 10 11 Repairs and maintenance.. . . . . . .. . . . . .. .. . .. . . .. ..... . ... . . . . . . .. .. . . . . ... . . . . . . .. .. . .. " . . . . . " 11 12 Bad debts . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . - - . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 12 13 Rent................................... _ . . . . . . . . . . . . . - . . . . . . . - . . . . . . . . . . . . . - . . . . . . . - . . . . . . . . . " 13 14 Taxes and licenses. .. . ., ... ... . . . . . . ., . . . ... . . ... . .. .. .. . . . . . . . . . . .. . . . ... . . .. . . .. , . . . . " . ... . .. 14 15 Interest....................................................... - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 16a Depreciation (if required, attach Form 4562). . . . . . . . . . . . .. " . . . . . . . .. . 16a b less depreciation reported on Schedule A and elsewhere on return. .. . 16b 17 Depletion (Do not deduct oil and gas depletion.). .. .. . . . . . . . . . .. .. .. . . . . . . . . . . . .. . . .. . .. . . . . . . . . . . 18 Retirement plans, ete. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . - . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Employee benefit programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . 20 Other deductions (attach schedule). .. .. . . . . " . . . . . . . . . . . . .. .... ., .. .. . . . .. . . . . . . . . . . . . . . . '" .. . .. ... .. . .. . . . . .. . .. 20 16c 17 18 -19 21 Total deductions. Add the amounts shown in the far ri ht column for lines 9 throu h 20. . . . . . . . . . . " 21 22 Ordina income OSS from trade or business activities. Subtract line 21 from fine 8. . . . . . . . . . . . . . " 22 Under ~aJties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, It is true, correct, and complete. Declaration of preparer (other than general partner or limited liability company member) is based on all information of which preparer has any knowledge. .. 199-05-9138 .. May the IRS discuss this return with the preparer shown below (see instrs)? X Yes No Preparer's SSN or PTlN Date Check if self- ~ employed . . . PTPA0105L 08/25/03 EIN ~ 23-1889600 Phone no. (71 7) 737 - 8111 Form 1065 (2003) Form 1065 (2003) Dennis L, Gary W & Anna V Carey 23-1902508 Page .' Cost of Goods Sold (see instructions) 1 Inventory at beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Purchases less cost of items withdrawn for personal use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Cost of labor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Additional section 263A costs (attach schedule). . . . . .. . . . .. . . ... . .... . . .. . ... . .. .. .. " . . .. .. . . . . . _ . . . . . . . . . . . . . .. .. . . . " . . . . .. . . . . . .. . 4 5 Other costs (attach schedule). .. . . . . ., . . .. . . .. .... . . . . .. " . . . . .... . . . . . .. . . . .. ..................................... 5 6 Total. Add lines 1 through 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Inventory at end of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Cost of goods sold. Subtract line 7 from tine 6. Enter here and on page 1, line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . 8 9 a Check all methods used for valuing closing inventory: (i) ~ Cost as described in Regulations section 1.471-3 ." (ii) Lower of cost or market as described in Regulations section 1 .471-4 (iii) Other (specify method used and attach explanation) . . . . . . . . . . . .. · _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _- b Check this box if there was a writedown of 'subnormal' goods as described in Regulations section 1.471-2{c). . . . . . . . . . . . . . . .. ~ [ c Check this box if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970) . . . . . . . . .. ~ d Do the rules of section 263A (for property produced or acquired for resale) apply to the partnership?........ .... ..... 8 Yes No e Was there any change in determining quantities, cost, or valuations between opening and closing inventory?. . . . ..... Yes No If 'Yes', attach explanation. Other Infonnation 1 What type of entity is filing this return? Check the applicable box: a ~ Domestic general partnership b ~ Domestic limited partnership c Domestic limited liability company d Domestic limited liability partnership e Foreign partnership f Other..... ~ __ ___________________ ________. 2 Are any partners in this partnership also partnerships? . . . . . . . .. . . . . . .. . . . . . . .. .. .. ..... .. " .. .. .. . . . . . . . . . . .. . .. . .. . . . . . . 3 During the partnership's tax year, did the partnership own any interest in another partnership or in any foreign entity that was disregarded as an entity separate from its owner under Regulations sections 301.nOl-2 and 301.nOl-3? If yes, see instructions for required attachment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Is this partnership subject to the consolidated audit procedures of sections 6221 through 62331 If 'Yes/ see Designation of Tax Matters Partner below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-l are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If 'Yes,' the partnership is not required to complete Schedules L, M-', and M-2; Item F on page 1 of Form 1065; or Item J on Schedule K-l. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 6 Does this partnership have any foreign partners? If 'Yes,' the partnership may have to file Forms 8804, 8805 and 8813. See instructions. . . . . . . .. . . '.' . . . . . . . . 7 Is this partnership a publicly traded partnership as defined in section 469(k)(2)1. ..... .. " .. .... . . .. . . . . . . .. " . . . . . . . . . . . . . . 8 Has this partnership filed, or is it required to file, Form 8264, Application for Registration of a Tax Shelter? .. . .. ~ .. . . . .. .. . . . 9 At any time during calendar year 2003, did the partnership have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? See the instructions for exceptions and filing requirements for Form "TO F 90-22.1. If 'Ves,' enter the name of the foreign country. . . ------------------------------------------------ x x X X X X X 10 During the tax year, did the partnership receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? If 'Yes,' the partnership may have to file Form 3520. See instructions. .. .. ...... .............. . " ..... .. .............. .. .. . X 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If 'Yes,' you may elect to adjust the basis of the (lartnership's assets under section 754 by attaching the statement described in the instructions under Elections Made By the Partnership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 12 Enter the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to this return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ................................................ . 0 Designation of Tax Matters Partner (see instructions) Enter below the general partner designated as the tax matters partner (fMP) for the tax year of this return: Name of designated TMP ~ Gary W. Carey Address of ~ 1781 Main St. designated TMP Lisburn, PA 17055 Identifying number of TMP ~ 176-34-8350 PTPAOll2l 08125/03 Form 1065 (2003) Income (Loss) Deduc- tions Credits Invest- ment Interest Self. Employ- ment Adjust.. ments and Tax Prefer- ence Items Foreign Taxes Other BAA Dennis L Ga W & Anna V Care 23-1902508 Partners' Shares of Income Credits Deductions etc (a) Distributive share items 1 Ordinary income (loss) from trade or business activities (page 1, line 22) . . . . . . . . . . . . . . . . . . . . . 1 2 Net income (loss) from rental real estate activities (attach F ()rm 8825). . . . . . . . . . . . . . . . . . . . . . . . 2 38 Gross income from other rental activities.. " .. . . . ...... .... . .. . . . 3a b Expenses from other rental activities (attach sch). . . . . . . . . . . . . . . . . . . . . . . . . . . 3b c Net income (Joss) from other rental activities. Subtract line 3b from line 3a..... . . . . . . ... . .. . .. 3c 4 Portfolio income (loss) (attach Schedule D (Form 1065) for lines 4d and 46:.... . ... . . .... .. . " a Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a b Dividends: (1) Qualified dividends. .. _ _ _ _ _ _ _ _ _ _ _ (2) Total ordinary dividends · 4b c Royalty income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4c d Net short-term capital gain (loss):. (1) post-May 5, 2003. ., ~ _ _ _ _ _ _ _ _ _ _ _ (2) Entire year. . · 4d e Net long-term capital gain (loss): (1) post-May 5, 2003... _ _ _ _ _ _ _ _ _ _ _ (2) Entire year.. ~ 4e 2 f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 f 5 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6a Net section 1231 gain (loss) (post-May 5,2003) (attach Form 4797) . .. . . '" . . . . .. .. . . ....... . 6a bNet section 1231 gain (loss) (entire year) (attach Form 4797). ................................ 6b 7 Other income (loss ....................................................................... 7 8 Charitable contributions (attach schedule). " .. .. . . . . .. ..... . .. . . .,. .. . . '" . . . . .. .. . . ., . . . . .. 8 9 Section 179 expense deduction (attach Form 4562). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Deductions related to portfolio income (itemize).. .. . .. .. .. . . .. . . . . . .. . . ... .. . . . . . . . . . . . . . . . . 10 11 Other deductions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11 12a Low-income housing credit: (1) From partnerships to which section 42(;)(5) applies. .. . . . . . . .. 12a (2) Other than on line 12a(1) . .. .. .. . . . . .. ... .. . .. . .. .. .. . .. . .. . .. . . . . . . . .. . . . .. . .. . . .. .. .. 12a b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468). . . . . . . . . . . . . . . . . . . . . . 12b c Credits (other than credits stKMn on lines 12a and 12b) related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . 12c d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 12 d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14a Interest expense on investment debts... .. . ... ...... .... .. . ... . . ... .. . .... .. .. .... . .... .,. .. 14a b (1) Investment income included on lines 4a, 4b(2), 4c, and 4f above. . . . . . . . . . . . . . . . . . . . . . . . . . 14b Investment expenses included on line 10 above . . . . .. ., .. .. . . . . . . . . .. . .. . . . .. . . . . . . . .. . . 14 b 15a Net earnings (loss) from self-employment.. . .. .. . . . . . . .. .. . .. . . . . .. .. . .. . . . . . .. .. . . .. .. . . ... 15a b Gross farming or fishing income. . . . . . . . . . . . . . . . . _ . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1Sb c Gross nonfarm income.. .. . .. .. '" .. ......... .. .... .... .. . .. . .. . . . .. .. . .. .. .. .. .. . . .... .. .. 15c 16a Depreciation adjustment on property placed in service after 1986. .. . . . . . .. . .. . . .. .. . . .. .. .. .. 168 b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16 b c Depletion (other than oil and gas) . . . . . . . . . . . . . . . _ . . . . . . . .. .. . . . . . . . . . - . . . . . . . . . . . . . . . . . . . .. 16c d (1) Gross income from oil, gas, and geothermal properties.. .. ... . .. . . .. . " .. ..... . . .. " ., ... 16d (2) Deductions allocable to oil, gas, and geothermal properties. . . . .. .. .. '" .. . . .. .. . . . " .. '" 16d e Other ad"mnts & tax ref items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.6e 17 a Name of foreign country or U.S. possession. . . .. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ :: b Gross income from all sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 b c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 c d Foreign gross income sourced at partnership level: (1) Passive ~ (2) Usted categories (attach sch) ~ e Deductions allocated and apportioned at partner level: (1) Interest expense ~ (2)Other.. .. . . . . . . . . . . .. . . .. . . . . . .. . .. . .. . .. ~ f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive ~ (2) Usted categories (attach sch) .... (3) General limitation ~ g Total foreign taxes (check one): ~ o Paid D Accrued............................... h Reduction ;n taxes avaifable for credit attach schedule .... _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Section 59(e)(2) expenditures: a Type. ., ~ b Amount. . " · 19 Tax-exempt interest income. . . . . . . . ~ :-: :-: :-: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~:-:.~ .-: .-:. . . . . . . . . . . . . . 20 Other tax -exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Distributions of money (cash and marketable securities} . .. . _ . . . . . " .. . . . '" . . ., . . . . . . ... . ., . 23 Distributions of property other than money. . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Other items and amounts required to be reported separately to partners attach schedule). . .. ..... . .. . . .. . .. .. ., . . . . . . . . . . .. .. .. . . _ . . . . . . . . . . . . '" . .. . .. . ., . .. .. .. . (3)GeneraJ limitation. PTPAOl34L 12/26/03 Pa c (b) Total amount 13 621 253. 36 000_ Form 1065 (2003) , ,.. Dennis L, Gary W & Anna V Carey 23-1902508 Page Form 1065 (2003) Analvsis of Net Income CLOSS)H 1 Net income (loss). Combine Schedule K, lines 1 throu~h 7 in column (b). From the result, subtract the 1 I sum of Schedule K, lines 8 throUJh 11, 14a, 170, and 8h............................................ 1 13 621 2 Analysis by (i) Corporate (il) Individual (iii) Individual (iv) Partnership (v) Exempt (vi) Nominee/Other partner type: (active) (passive) organization a General 13,621. partners . . . . b~~~rs.... Note: Schedules L, M-l and M-2 are not re uired if Question 5 of Schedule B is answered 'Yes.' " Balance Sheets er Books Beginning of tax year Assets (a) (b) 1 Cash.......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~~ 40 , 051 . 2 a Trade notes and accounts receivable. . . . . . . . b Less allowance for bad debts. . . . . . . . . . . . . . . . 3 Inventories................. . . . . . . . . . . . . . . . . 4 U.S. government obligations........ ... .. . . . 5 Tax-exempt securities. .. ... .. .. .. .. . .. " . . . 6 Other current assets (attach schedule). See. St. .1. . 7 Mortgage and real estate loans. . . . . . . . . . . . . . 8 Other investments (attach schedule). . . . . . . . . . . . . . . . . ~:':; 9 a Buildings and other depreciable assets. . . . . . . b less accumulated depreciation. . . . . . . . . . . . . . lOa Depletable assets . . .. . . . . .. .. . . . . . . .. . . . . . . b Less accumulated depletion... ..... ........ . 11 land (net of any amortization) .. ... ...... .. . 12 a Intangible assets (amortizable only) . . . . . . . . . b Less accumulated amortization. . . . . . . . . . . . . . 13 Other assets (attach schedule) See. St. .2.. 14 Total assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Liabilities and Capital Accounts payable. . . . . . . . . . . . . . . . . . . . . . . . . . . Mortgages, notes, bonds payable in less than 1 year. . . . . Other current liabilities (attach 5ch). . . . . . . . . . . . . . . . . All nonrecourse loans. . . . . . . . . . . . . . . . . . . . . . . Mortgages, notes, bonds payable in 1 year or more. . . . . . Other liabilities (attach schedule). . . . . . . . . . . . . . . . . . . Partners' capital accounts. . . . . . . . . . . . . . . . . . . Total liabilities and ca ital.................. Reconciliation of Income 1 Net income (loss) per books. . . . . . . . . . . . 2 Income included on Schedule K, lines 1 through 4, 6b, and 7, not recorded on books this year (itemize): ~ '" .,.,;~~iIillt~ 3 Guarantsed pmts (other than health insurance). . . . . 4 Ex~ses recorded on books this year not included on Schedule K, lines 1 through 11, 143, 17g, and 18b (itemize): a Depreciation. . . . .. $ _ _ _ _ _ _ _ _ _ _ _ b Travel and entertainment. . . .. $ _ _ _ _ _ _ _ _ _ _ _ ------------------- Add Sines 1 throu h 4. . . . . . . . . . . . . . . . . . . . ~: Anal sis of Partners' Ca 1 Balance at beginning of year. . . . . . . . . . . . 2 Capital contributed: a Cash....... ..,.. b Property .. . . . .. . . 3 Net income (loss) per books...... .. ..... 4 Other increases (itemize): ------------------- 5 Add lines 1 throu h 4. .. . .......... ..... End of tax year 3 683. 65 474. 654';i4 . 7 Deductions included on Schedule K, lines 1 through 11, 14a, 17g, and 18b, not charged against book income this year (itemize): . a Depreciation.. . .. $ _ _ _ _ _ _ _ _ _ _ 13 621. ital Accounts 87 853. 8 A~~oos6~d~~~~~~~~~~~~. 9 Income (loss) (Analysis of Net Income (Loss), line 1). Subtract line 8 from line 5 .. .. .. .. . .. .. .. . . .. . . 13 621. 36, boo. 13 621. 6 Distributions: a Cash. . . . .. . . . . . . . .. . .. . . b Property.. . . . . ..". .. . .. . .. 7 Other decreases (itemize): _ _ _ _ _ _ _ _ _ _ 101,474. 8 A~~~s6~d~~~~~~~~~~~~. 9 Balance at end of year. Subtract line 8 from line 5. . . . 36 000. 65,474. PTPAOl34L 12/26103 Form 1065 (2003) Form 8825 Rental Real Estate Income and Expenses of a Partnership or an S Corporation .. See instructions. .. Attach to Form 1065, Fonn 1065-B, or Fonn 11205. OMS No. 1545.1186 Department of the Treasury Internal Revenue Service Name 2003 Employer identification n~ Dennis L Ga W & Anna V Care 23-1902508 1 Show the kind and location of each property. See page 2 for additional properties. A _~f}l~f}GettVSbUXqRd~:~rLmdCO~---------------------------------- B ~!f~c~_~~_~E~~O~~~________________________________________________ 1781 Main St., Lisburn, PA c ~p~~~~~~_~n~_~E~~e________________________________________________ 1777-79 main St., Lisburn, PA D -----------------------------------------______________~-------_ Pro rties Rental Real Estate Income A B c D 2 Gross rents. . . . . . . . . . . . . . . . . . . . . . . . . . 2 Rental Real Estate Expenses 3 Advertising........................... 3 4 Auto and travel. . . . . . . . . . . . . . . . . . . . . . . 4 5 Cleaning and maintenance. . . . . . . . . . . . 5 6 Commissions......................... 6 7 Insurance............................ 7 8 Legal and other professional fees. . . . . . 8 9 Interest.............................. 9 10 Repairs.............................. 10 11 Taxes................................ 11 12 Utilities............................... 12 13 Wages and salaries. . . . . . . . . . . . . . . . . . . 13 14 Depreciation (see instructions). ... .. .. . 14 15 Other (list) .. _ _ _ _ _ _ _ _ _ _ _ _ j\..f~~~~ J~~,_ B~I!..k:.. ~Et.e.L !1:...c 5 160.. 9,250. 17,260. 350.. 343. 180. 1,252. 1 622. 350. 877. 96. 257.. 774. 961. 1,276.. 1,270. 2,665. 4 748.. 329. 115. 205. 379. 15 16 Total expenses for each property. Add lines 3 through 15................ 16 1 875. 7,658. 8 516. 17 Total gross rents. Add gross rents from line 2, columns A through H. .. ... . . . .... ... . ... . . . .. .. . .. .. . . .. . .. 17 18 Total expenses. Add total expenses from line 16, columns A through H............ _ . . . . . . . . . . . . . . . . . . . . . .. 18 19 Net gain (loss) from Form 4797, Part II, line 18, from the disposition of property from rental real estate activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 20 a Net income (toss) from rental real estate activities from partnerships, estates, and trusts in which this partnership or S corporation is a partner or beneficiary (from Schedule K -1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20 a b Identify below the partnerships. estates, or trusts from which net income (loss) is shown on line 20a. Attach a schedule if more space is needed: (1) Name (2) Employer identification number 31 670. -18,049. ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- 21 Net income (loss) from rental real estate activities. Combine lines 17 through 20a. Enter the result here and on: · Fonn 1065 or 11205: Schedule K, line 2, or J- · Form 1065-8: Part I, line 4 BAA For Paperwork Reduction Act Notice, see the separate instructions. Form 8825 (2003) SPSZOl 01 L 10/21/03 Schedule K..' (Form 1065) Deparbnent of the Treasury be ..nnin Internal Revenue Service Partner's identi .n number ~ 210-40-2212 Parfne(s name, address, and ZIP code Partner's Share of Income, Credits, Deductions, etc OMS No. 1545-0099 2003 , 20 23-1902508 Dennis L. Carey 1957 Sheep ford Rd. Mechanicsburg, PA 17055 A This partner is a X general partner o limited liability company member B What type of entity is this partner? .. ~ Individual C Is this partner a [RJdomestic or a Dfu;;ign-p~rtrt;r? - - - -- o Enter partner's % of: (i) Bef~~~ or (ii) ~?' Profit sharing.... __________ % ________]~ % Loss sharing..... __________ % ________]~ % Ownership of capital.. __________ % ________~~ % E IRS Center where artnership filed return: Cincinnati OH J Anal sis of artner's ca ital account: (a) Capital account at (b) Capit~1 contributed beginning of year dunng year 1 Ordinary income (loss) from trade or business activities. . .. .. . . . . . 1 2 Net income (loss) from rental real estate activities. . . . . . . . . See. .LLne .25 2 3 Net income (loss) from other rental activities. . . . . . .. . . .. . . . . . . .. _ .. . . . . . . . 3 4 Portfolio income Ooss): ;~~~ a Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b (1) Qualified dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . (2) Total ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . c Royalty income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . d (1) Net short-term capital gain (loss) (post-May 5, 2003).. . ... .. .. (2) Net short-term capital gain (loss) (entire year). . . . . . . . . . .. . . . . e (1) Net long-term capital gain (loss) (post-May 5, 2003) .. . . .. ... . (2) Net long-term capital gain (loss) (entire year). . . . . . . . . . . . . . . . . f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . _ . . . . . 4f 5 Guaranteed payments to partnec . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . 5 6a Net section 1231 gain (loss) (post-May 5, 2003) . . . . . . . . . . . . . . . . . . 6a b Net section 1231 gain (loss) (entire year) . . . . . . . . . . . . . . . . . . . . . . . . 6b 7 Other income oss attach schedule ........................... 7 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . . . . . . . . 8 9 Section 179 expense deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Deductions related to portfoliO income (attach schedule). . . . . . . . . . . . . . . . . . . . .. 10 11 Other deductions (attach schedule) . .. .. . .. .. .. .. .. . . . . . . .. . .. .. . . . .. ... 11 12a Low-income housing credit: (1) From section 42(;)(5) partnerships. ... . . . .. . . . . . . .... . .. .. . .. (2) Other than on line 12a(1) . .. .. .. .. .. .. . . .. .. .. .. . .. .. . .. .. . . b Qualified rehabilitation expenditures related to rental real Credits estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . ., 12c d Credits related to other rental activities. . . . . . . . . . . _ . . . . . . . . . . . . .. 12d '3 Other credits. . . . .. .. . .. .. .. . . .. .. . . .. . .. .. . . . . . .. .. . . .. _ .. . .. .. 13 BAA For Paperwork Reduction Act Notice, see Instructions for Form' 065. PTPA0312l 10/21/03 Income (Loss) Deduc- tions Partner 1 Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburq, PA 17055-5946 limited partner F Partner's share of liabilities (see instructions): Nonrecourse. . . . . . . . . . . . . . . _ . . . . . . . . . .. $ Qualified nonrecourse financing. . . . . . . .. $ - - - - - - - - - - Other.. .. .. .. .. .. . .. . . . .. . . . .. . . . . . . ... $= = = = = = = = = = G Tax shelter registration number ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ H Check here if this partnership is a publicly traded partnership as defined in section 469(k)(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . .. [ I Check a licable boxes: Amended K.1 (e) Partner's share of lines 3, 4, and 7, Form 1065, Schedule M-2 (d) Withdrawals and distributions (e) Capital account at end 0 year (combine columns (a) through (d)) 16366 (e) 1040 filers enter the amount in column (b) on: 21 961. (a) Distributive share item 3 405. 9 000. (b) Amount 3,405. See Partner's Instructions for Schedule K-l (Form 1065). Form 1040, line Sa Form 1040, line 9b Form 1040, line 9a Schedule E, Part If line 4 Schedule D, line 5, column (g) Schedule 0, line 5, column f) Schedule D, line 12, column g) Schedule 0, line 12, column (f) See Partner's Instructions for Schedule K-l (Form 1065). Schedule A, line 15 or 16 See Partner's Instructions for Schedule K-l (Form 1065). Form 8586, line 5 See Partner's Instructions for Schedule K-l (Form 1065). Schedule K-1 (Form 1065) 200= Schedule K-1 (Form 1065 2003 Dennis L, Ga W & Anna V Care (a) Distributive share item Invest- ment Interest Self- employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes other 14a Interest expense on investment debts. . .. .. .. .... . .. ... . . . . . .. . .. 14a b(1) Investment income incfuded on lines 4a, 4b(2), 4c, and 4t.. . .. , Investment ex enses included on line 1 Q . . . . . . . . . . . . . . . . . . . .. , 15a Net earnings (loss) from self-employment.... .. .. " .. . . . . .. ... . .. 15a b Gross farming or fishing income.. .. . . . .. .. . . . . . . .. . . . . . .. . . . . . .. 15b c Gross nonfarm income.... . ... . .. . . . . ... .. .. ... . .. . . . . . . . . .. . . .. 15c 16a Depreciation adjustment on property placed in service after 1986. . . . . . . . . . . . . . .. 16a b Adjusted gain or loss .. . .. .. . .. .. .. . .. .. . . . . .. . .. .. .. . . . . . . . . ... 16b c Depletion (other than oil and gas) .. . .. . . . . .. . .. .. .. . .. . . .. . . . ... 16c d (1) Gross income from oil, gas, and geothermal properties.. .. . . .. 1 (2) Deductions allocable to oil, gas, and geothermal properties. . .. 1 e Other ad'ustments and tax preference items (attach sch) . . . . . . . . . . . . . . . . . . . .. 16e 17 a Narne of foreign counby or U.S. possession . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _.' b Gross income from all sources... .. ... .... ... '" ...... . . . . .. .... 17b c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . .. 17 c d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e Deductions allocated and apportioned at partner level: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule).. . .. . . .. .. .. . . .. . . . . .. . . . . (3) General limitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Total foreign taxes (check one): ~ 0 Paid 0 Accrued. . . h Reduction in taxes available for credit attach schedule .. . . . . . . . . . . . . . . " . . .. 17 h 18a Section 59(eX2) expenditures: a Type ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~t _' .~. b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 18 b 19 Tax-exempt interest income... .. ... .. ... .............. .. .. .. .. .. 19 20 Other tax -exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20 21 Nondeductible expenses.. . .. . .. .. . . .. .. .. .. . . .. . . .. .. .. .. . .. . ., 21 22 Distributions of money (cash and marketable securities) . . . . . . . . .. 22 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 24 Recapture of low-income housing credit: a From section 42(j)(5) partnerships. . .. . . .. .. . . . .. .. .. .. .. .. .. .. .. 24a b Other than on line 24a.. .. . . . .. . .. . .. .. .. .. .. .. . . .. .. .. . .. .. . ... 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if more space is needed): Line 2 Rental Real Estate Activities 23-1902508 (b) Amount Pa ~ (e) 1040 filers enter the amount In column (b) on: Form 4952, line 1 See Partner's Instructions for Schedule K.) (Form 1(65). Schedule SE, Section A or B See Partner's Instructions fOt Schedule K-l (Form 1065). 63. See Partner's Instructions for Schedule K-l (Form 1065) and Instructions for Form 6251. Form 1116, Part I Form 1116, Part II Form 1116 fine 12. See Partner's Instructions for Schedule K-l (Form 1065). Form 1040, line Bb 9,000. See Partner's Instructions for Schedule K-l (Form 1(65). Form 8611, line 8 Supple- Property Gross Net Net Passive Sec. 1231 mental Description Income Ex;penses Income Nonpas's Total rnfor- Dwelling 1,290. 469. $ 821. NonPass mafion Office and Warehouse 2,313. 1,915. 398. NODPass Apartments and Garage 4,315. 2,129. 2,186. NonPass Total $ 3,405. Partner 1: Dennis L. Carey PTPA0312L 10/21/03 210-40-2212 Schedule K-l (Form 1065) 2003 Schedule K-l (Form 1065) Department of the Treasury Internal Revenue Service Partne"-s identi .n number ~ Partner's name. address. and ZIP code Partner's Share of Income, Credits, Deductions, etc OMS No. 1545-0099 2003 be innin 176-34-8350 23-1902508 , 20 Gary W. Carey 1781 Main St. Lisburn, PA 17055 A This partner is a X general partner o limited liability company member B What type of entity ;s this partner? .. ~ _IE-<.!i --".!~U.Jl.! _ _ _ _ _ C Is this partner a OOdomestic or a Dforeign partner? DEnter partner's % of: (i) Bet:::n= or (11) E;:a~ Profit sharing.... __________ % ________1~ % Loss sharing. . . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _1 ~ % Ownership of capital.. _ _________ % ________..?~ % E IRS Center where partnershi filed return: Cincinnati, OH J Anal sis of rtner's ca .taI account: (a) Capital account at (b) Capital contributed beginning of year during year 1 Ordinary income (loss) from trade or business activities. . .. .. . . . . . 2 Net income (Joss) from rental real estate activities. . . . . . . . . See. .Line . 25 3 Net income (loss) from other rental activities. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 4 Portfolio income (loss): a Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . b (1) Qualified dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . (2) Total ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . c Royalty income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . . d (1) Net short-term capital gain (loss) (post-May 5, 2003). .. " . . . . . (2) Net short-term capital gain (loss) (entire year). . . . . . . .. ...... . e (1) Net long-term capital gain (loss) (post-May 5, 20(3) . .. .. . . . . . (2) Net long-term capital gain (loss) (entire year). . . . . . . . .. ....... f other portfolio income (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . ..... . . 5 Guaranteed payments to partner. . . . . . . . . . . . . . . . . . . . . . . . . . .., . . . . 6a Net section 1231 gain (loss) (post-May 5,2003)....... . .. . ... . . .. b Net section 1231 gain (loss) (entire year) . . . . . . . . . . . . . . . . . ... . . . . 7 Other income loss attach schedule .................... ... . . . . 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . ... . . . . 9 Section 179 expense deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Deductions related to portfolio income (attach schedule). . . . . . . . . . . . . . . . . . . . . . 11 Other deductions attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . 12a Low-income housing credit: (1) From section 420)(5) partnerships. . . . . . . . . . . . . . . . . . . . .. . . . . . (2) Other than on line 12a(1) . .. . . . . . . . . . . .. . .. . .. . . . .. . . .. . . . . . b Qualified rehabilitation expenditures related to rental real Credits estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . .. 12c d Credits related to other rental activities . . . . . . . . . . . . . . . . . _ . . . . . . .. 12 d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 13 BAA For Paperwork Reduction Act Notice, see Instructions for Fonn 1065_ PTPA0312L 10/21/03 Income (Loss) Deduc- tions Partner 2 Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, PA 17055-5946 limited partner F Partner's share of liabilities (see instructions): Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . .. $ Qualified nonrecourse financing. . . . . . . .. $ = = = = = = = = == = . Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " $ _ _ _ _ _ _ _ _ _ _ - G Tax shelter registration number ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ H Check here if this partnership is a publicly traded partnership [ as defined in section 469(k)(2). .. .. . . . . . . .. . . . . .. " . . . . . .. . . I Check a Amended K-l Iicable boxes: (c) Partner IS share of lines 3,4, and 7, Form 1065, Schedule M-2 (d) Withdrawals and distributions (e) Capital account at end of year (combine columns (a) through (d)) 16 369. (c) 1040 filers enter the amount in column (b) on: 21 964. (a) Distributive share item 3 405_ 9 000. (b) Amount 3,405. See Partner's Instructions for Schedule K-1 (Form 1(~5). Form 1040, line Sa Form 1040, line 9b Form 1040, line 9a Schedule E, Part I. line 4 Schedule 0, line 5, cofumn (0) Schedule 0, line 5, column f) Schedule D, line 12, column g) Schedule 0, line 12, column (f) 41 5 6a 6b 7 8 9 10 '1 . See Partner's Instructions for Schedule K-l (Form 1(05). Schedule A; line 15 or 16 See Partner's Instructions for Schedule K-l (Form 1065). Form 8586, line 5 See Partner's Instructions for Schedule K-l (Form 1065). Schedule K-' (Form 1065) 2003 Schedule K-l (Form 1065) 2003 Dennis L, Gary W & Anna V Carey (a) Distributive share item 23-1902508 (b) Amount Invest- ment Interest Self- employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes Other 14a Interest expense on investment debts. ..... . . . . .. .. . . .. .. ., . .. . .. 14a b (1) Investment income included on lines 4a, 4b(2), 4c, and 4t . . . .. 1 Investment ex enses included on line 10. . . . . . . . . . . . . . . . . . . .. 1 15a Net earnings Ooss) from self-employment... .. .., .. .. .... ., . . .. .. 15a b Gross farming or fishing income.. ... .. .... . . . . . . . . . . . .. . . . . . . ... 15b c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 c 16a Depreciation adjustment on property placed in service after 1986. . . . . . . . . . . . . . .. 16a b Adjusted gain or loss.. .. . .. .. . .. .. . . . .. . . .. . .. . .. . .. .. .. .. .. ... 16b c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16c d (1) Gross income from oil, gas, and geothermal properties. ., . .. .. 1 (2) Deductions allocable to oil, gas, and geothermal properties.. .. 1 e Other ad'ustments and tax eference items (attach sch). . . . . . . . . . . . . . . .. . . . .. 16e 17 a Name of foreign country or U.S. possession. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ ", b Gross income from all sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 b c Gross income sourced at partner level. .. . . . . . . . . . . . . . . . . . .. . . . -. 17c d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . .. . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation. . . . . . . . . . : . . . . . . . . . . . . . . . - . . . . . . . .. .. . . . . . e Deductions allocated and apportioned at partner level: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. 1~ (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. 1'7i f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . gTotal foreign taxes (check one): · D Paid DAccrued.. h Reduction in taxes available for credit (attach schedule). . . . . . . . . . . . . . - . . . . . . . 18a Section 59(eX2) expenditures: a Type · _ _ _ _ _ _ _ _ _ _ _ _ _ __ b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 18 b 19 Tax-exempt interest income... .. ............ ............ .. .... .. 19 20 Other tax -exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . .. 20 21 Nondeductible expenses. . . . .. . . .. . . .. . .. .. . .. . .. .. . .. . . _ . .. . ... 21 22 Distributions of money (cash and marketable securities).. _. .. .. .. 22 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 24 Recapture of low-income housing credit: a From section 42(j)(5) partnerships... .. .. " . . . .. .. .. . . .. . .. . . . . ., 248 bOther than on fine 24a.................................. ........ 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if more space is needed): . Line 2 Rental Real Estate Activities 9 000. Page (c) 1040 filers enter the amount in column (b) on: Form 4952, line 1 See Partner's Instructions for Schedule K-l (Form 1005). Schedule SE, Section A or B See Partner's Instructions for Schedule K.l (Form 1(65). 63. See Partner's Instructions for Schedule K-1 (Form 1065) and Instructions for Form 6251. Form 1116, Part I Form 1116, Part II Form 1116, line 12. See Partner's Instructions for Schedule K-l (Form 1065). Form 1040, line 8b See Partner's Instructions for Schedule K-l (Form 1065). . Form 8611, line 8 Supple- Property Gross Net Net Passive Sec. 1231 mental Description Income EJWenses Income Nonpass Total Infor- Dwelling 1,290. 469. $ 821. NonPass mation Office and Warehouse 2,313. 1,915. 398. NonPass Apartments and Garage 4,315. 2,129. 2,186. 'NonPass Total $ 3,405. P~rrn~r?' ~~rv w_ ~nrev PTPA0312L 10/21/03 176-34-8350 Schedule K-1 (Form 1 065) 200~ Schedule K-' (Form 1065) ~~~:es~=ry be innin Partner's identi .n number ~ 204-30-8190 Parmer's name, address, and ZIP code Partner's Share of Income, Credits, Deductions, etc OMS No. 1545-0099 2003 , 20 23-1902508 Anna v. Carey 1781 Main St. Lisburn, PA 17055 Dennis L, Gary W & Anna V Carey Carey & Sons 1181 Main St. Mechanicsburg, PA 17055-5946 A This partner is a X general partner D limited liability company member B What type of entity is this partner? .. .. Individual C Is this partner a ~domestic or a Dfu;ign-p~~;r? - - - -- D Enter parmer's % of: (i) ~= or (Ii) E;:a~ Profit sharing.. .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _~.Q % Loss sharing. . . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ ~,Q % Ownership of capital.. _ _ _ _ _ _ _ _ __ % _ _ _ __ __ _...?,Q % E IRS Center where artnershi filed return: Cincinnati, OH J Ana is of rtne"'s ca itaI account: (a) Capital account at (b) Capit~1 contributed beginning of year dunng year 1 Ordinary income (loss) from trade or business activities. . . . . . . . . . . 2 Net income (loss) from rental real estate activities. . . . . . . . . See. .Li.ne .25 3 Net income (loss) from other rental activities. .. .. . .. .. .. .. .. . . .. .. . . . . .. . . 4 Portfolio income (loss): a Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . b (1) Qualified dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . (2) Total ordinary dividends.. .. . . . . .. . . . . . . . . .. . . . . . . . . . . . . . . . .. c Royalty income. . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . d (1) Net short-term capital gain (1oss) (post-May 5, 2003). . . . . . . . . . (2) Net short-term capital gain (loss) (entire year). . . . . . . . . . . . . . . . eO) Net long-term capital gain (loss) (post-May 5,2003). .. . . .. ... (2) Net long-term capital gain (loss) (entire year). . . . . . . . .. . . . . . + . f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Guaranteed payments to partnec . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6a Net section 1231 gain (loss) (post-May 5, 2003) . . . . . . . . . . . . . . . . . . b Net section 1231 gain {loss} (entire year) . . . . . . . . . . . . . . . . . . . . . . . . 7 Other income ass) (attach schedule) ....... ... .. ... . .. .. . . .. . . . 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . . . . . . . . 9 Section 179 expense deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Deductions related to portfolio income (attach schedule). . . . . . . . . . . . . . . . . . . . . . 11 Other deductions attach schedule) .. .. . .. . . .. .. .. .. . . .. .. . . .. . . . . .. . . .. 12a Low-income housing credit: (1) From section 42(j)(5) partnerships.. .. .. . . .. .. .. . .. . . . . . .. . . . (2) Other than on line 12a(1} . .. . . .. .. . . . .. . .. .. .. .. .. . .. . . .. . . . b Qualified rehabilitation expenditures related to rental real Credits estate activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. . _ . . . . . . . . . . . . . . . . . _ . . . . . .. 12c d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . .. 12d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 13 BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. PTPA0312L 10/21/03 Income (Loss) Deduc- tions P:3rt-nQ.r ~ limited partner F Partner's share of liabilities (see instructions): Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . .. $ Qualified nonrecourse financing. . . . . . . .. $ - - - - - - - - - - - Other. . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . .. $ - - - - - - - - - - - G Tax shelter registration number ~ - - - - - - - - - - - ----------------- H Check here if this partnership- is a publicly traded partnership 0 as defined in section 469(k}{2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I Check a licable boxes: Amended K.l (c) Partner's share of lines 3, 4, and 7, Form 1065, Schedule M-2 (d) Withdrawals and distributions (e) Capital account at end of year (combine columns (a) through (d)) 32 739. (c) 1040 filers enter the amount in column (b) on: 43 928. (a) Distributive share item 6 811. 18 000. (b) Amount 1 2 3 6,811. See Partner's Instructions for Schedule K.l (Form 1005). Form 1040, line Sa Form 1040, line 9b Form 1040, line 9a Schedule E, Part I, line 4 Schedule D, line 5, column (g) Schedule 0, line 5, column f) Schedule 0, line 12, column g) Schedule Df line 12, column (f) 41 5 6a 6b 7 8 9 10 11 . See Partner's Instructions for Schedule K.l (Form 1065). Schedule Ai line 15 or 16 See Partner's Instructions for Schedule K.l (Form 1065). Form 8586, line 5 See Partner's Instructions for Schedule K.l (Form 1065). Schedule K.' (Form 1065) 2003 .. Schedule K-' Form 1065 2003 Dennis L Ga W & Anna V Carey (a) Distributive share item Invest- ment Interest Self- employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes Other 23-1902508 Pa~e (b) Amount -.... r (c) 1040 filers enter the .. . _ ___J amount In column (b) on: Form 4952, line 1 See Partner's Instructions for Schedule K-l (Form 1(05). Schedule SE, Section A or B See Partner's Instructions for Schedule K-l (Form t065). 14a Interest expense on investment debts. . . . . .. .. ., . . . . . . " . . . . . . . . . b(1) Investment income included on lines 4a, 4b(2), 4c, and 4f. " . . Investment ex enses included on line 1 Q . . . . . . . . . . . . . . . . . . . . . 15a Net earnings (loss) from self-employment. .. .. .. .... ....... . . . . . . b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Depreciation adjusbnent on property placed in service after 1986 . . . . . . . . . . . . . . . b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (I) Gross income from oil, gas, and geothermal properties. . .. . . . . (2) Deductions allocable to oil, gas, and geothermal properties. .. . e Other adjusbnents and tax reference items (attach sch) .. . . . . .. . .. . .. . .. . .. . 17 a Name of foreign country or U.S. possession . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . . . d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 (2) Listed categories (attach schedule).. .. .. .. . . .. ..... . . . . . .. . .. 17 (3) General limitation . . .. . .. .. .. . .. . . . . .. . . .. . . . .. . . .. .. . . . .. . .. .~., e Deductions allocated and apportioned at partner level: . (1) Interest expense. . . . . . . . . .. . .. . . . .. . . .. .. . . .. .. .. . . . . . . . . . . . (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . .. .. .. .. . . .. . . .. . .. . .. . . (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . g Total foreign taxes (check one): ~ 0 Paid DAccrued .. h Reduction in taxes available for credit attach schedule) . '. . . . . . . . . . . . . . . . . . . .. 17 h 18a Section 59(eX2) expenditures: a Type ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ :" b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . " 18 b 19 Tax -exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. 19 20 Other tax -exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. 20 21 Nondeductible expenses.. . .. . . . . .. .. . .. .. .. .. . .. . .. .. .. . .. . .. " 21 22 Distributions of money (cash and marketable securities). .. '" .... 22 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 24 Recapture of low-income housing credit: a From section 42(j)(5) partnerships.. . .. .. . .. .. .. .. . . . . . .. . .. . . . .. b Other than on line 24a.. .. . . .. .. . .. .. . . . .. .. .. . . .. .. .. .. . . .. . ... 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules jf more space is needed): . Line 2 Rental Real Estate Activities 127. See Partner's Instructions for Schedule K-l (Form 1065) and Instructions for Form 6251. Form 1116, Part I Form 1116, Part If Form 1116, line 1~. See Partner's Instructions for Schedule K-l (Form 1065). Form 1040, line 8b 18,000. See Partner's Instructions for Schedule K. t (Form 1065). Form 86J 1, line 8 Supple- Property Gross Net Net Passive Sec. 1231 mental Description Income E~enses Income Nonpass Total Infor.. Dwelling 2,580. 938. $ 1,642. NonPass mation Office and Warehouse 4,625. 3,829. 796. NonPass Apartments and Garage 8,630. 4,258. 4,372. NonPass Rounding 1. Total $ 6,811. PTPA0312L lOl21J03 204-30-8190 Schedule K..1 (Form 1065) 200: P~rrnAr l' Annn V_ Carev 2003 Federal Statements Page 1 Dennis L, Gary W & Anna V Carey 23-1902508 Statement 1 Form 1065, Schedule L, Line 6 Other Current Assets Beginning Advances to Partners............................................................ $ o. $ Advances to Partners............................................................ 800 . Total $ 800. $ Ending 3, 683 . o. 3,683. Statement 2 Form 1065, Schedule L, Line 13 Other Assets Beginning Endin9 Rounding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ o. $ 4 . Rounding: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . 0 . Total $ 4. $ 4 . . , Form 1 065 u:teR;~;~~f"p~'rte.;e~~~hicp Income 2002 ~ See se arate instructions. For calendar ear 2002, or tax ear be innin ,2002, and endin A Principal business activity iF (F)' rF>>.D Y \ \.,". '\ \ ) J < ". ~, ~ '\'~ /' .. ......., -' ....... " l J IRS use only - Do not write or staple in this space. ,20 OMS No, 1545-0099 D Employer identification number Lessors B Principal product or service Buildin s C Business code number Use the IRS label. Other- wise, print or type. Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, PA 17055-5946 23-1902508 E Date business started 1/01/1972 F Total assets (see instrs) 531110 $ 87,853. G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) Amended return H Check accounting method: (1) X Cash (2) Accrual (3) Other (specify) . . .. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I Number of Schedules K-l. Attach one for each person who was a partner at any time during the tax year. . . . . . . . . . . . . . . ~ 3 Caution: Include only trade or business income and expenses on lines fa through 22 below. See the instructions for more information. , 1 a Gross receipts or sales. . _ . . . . . . . . . . . . ., . . . . . .. . . . , . . . . . . .. " . . . . . . . . 1a b Less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b 1c I N C 2 Cost of goods sold (Schedule A, line 8). . . . . . , . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . 2 0 - M 3 Gross profit. Subtract line 2 from line 1 c. . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . , . . . . . . . . . . . . 3 E 4 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule). . . .. . .. . , . . . . . ., . . . . '" . .. , .. .. . . .. . . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . 4 5 Net farm profit (loss) (attach Schedule F (Form 1040)). . . . . . . . . . . . . . . , . . . . . . , . . . . . . . . . . . . , . . . . _ . . . . 5 6 Net gain (loss) from Form 4797, Part II, line 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . 6 7 Other income (loss) (attach schedule). . . . . . . .. . . . . . . .. . . . . . . . . . .. . . . . . .. . . . . . . . . . , . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . 7 8 Total income Ooss), Combine lines 3 through 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , _ . . . . 8 s E 9 Salaries and wages (other than to partners) (less employment credits) . . . . ,. .. . . . . . . . . . . . . . . . . . . . . . 9 E I 10 Guaranteed payments to partners. . . . . . . . . . . , . , . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . , , . . . . . . . . . . . . . . 10 N 11 Repairs and maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 0 s T E R 12 Bad debts , . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . , . . . . , . , . . . . . . . . 12 D u 13 Rent . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 U c T C I 14 Taxes and licenses.. . . . .. . , . . .. . . . . . . . , . .. . . .. ...., . . . . . . . . .. . . . . . _ .. . . .. , . . . . . . . . . . . . . . . . . . . . . . 14 T 0 15 Interest.........................................................................,............... 15 I N 0 s 16a Depreciation (if required, attach Form 4562) . . . , . , . . . , . . . . . . . . . . . . . . .. 1 16al N F b Less depreciation reported on Schedule A and elsewhere on return . . . . 16b 16c S 0 R 17 Depletion (Do not deduct oil and gas depletion.). . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 L 18 Retirement plans, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 I M 19 Employee benefit programs. .. .. .. .,. . .. ..... .. .. ........ . .. .. . ... . . . . .. .. ... . . . . . . .. . . . . . ..... .. 19 I T A 20 Other deductions T I (attach schedule). _ . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . 20 0 N s 21 Total deductions. Add the amounts shown in the far right column for lines 9 through 20. . . . . . . , . . . . . 21 22 Ordinary income Ooss) from trade or business activities. Subtract line 21 from line 8. . . . . . . . , . . . . , . . 22 Un~er ~e~alties of perjury, I declare that I have .examined this return, including accompanying ~c~edul~s ~~d statements, and to ~e best of my knOWledge and belief, It IS true, correc~ and complete. Declaration of preparer (other than general partner or limited liability company member) IS based on all information of Sign which preparer has any knowledge. Here ~ ~ M~ the IRS discuss this return wi the prefarer shown below Signature of general partner or limited liability company member Date (see instrs). !Xl n Yes No Preparer's C:~A'yI'-J4;A' ) t2du/~th 13ii/ / C3 Check if self- ~ n I P,epa,e,', SSN or PTIN Paid signature employed. . . , Preparer's Firm's name '- Ashway & Haar, cP1i/s (or yours if Use Only self.employed), ~ 99 November Dr. , Suite 302 EIN ~ 23-1889600 address. and ZIP code Camp Hill, PA 17011-5064 Phone no. (717) 737-8111 BAA For Paperwork Reduction Act Notice, see separate instructions. PTPA0105L 12/27/02 Form 1065 (2002) Form 1065 (2002) Dennis L, Gary W & Anna V Carey 23-1902508 I<Schedl.de~'A',l Cost of Goods Sold (see instructions) 1 Inventory at beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Purchases less cost of items withdrawn for personal use, , . , . , . . . . . . , , . , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Cost of labor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Additional section 263A costs (attach schedule).. ..... . . . . . . . . ., . . .. .. .. . .. " . .. . .. .... . .. . ... . ., . . . . .. .. . . . . . . ., ., . ........ . ., . . .. ... 5 Other costs (attach schedule). .... .. . . . . .. . .. . . .. ., ., ....... . . . . " . .. . ., . . . . . . . . . . . . . .. .. . . . . ... .. . . . . . . . . . . . . . . .. . . 6 Total. Add lines 1 through 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . 7 Inventory at end of year. . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . 9 a Check all methods used for valuing closing inventory: (i) ~ Cost as described in Regulations section 1.471-3 . (ii) Lower of cost or market as described in Regulations section 1.471-4 (ni) Other (specify method used and attach explanation) . . . . . . . . . . . ., ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Check this box jf there was a write down of 'subnormal' goods as described in Regulations section 1.471-2(c)... ,. ... .. .. .. . .. ~ ~ c Check this box if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970) . . . . . . . . ., ,.. d Do the rules of section 263A (for property produced or acquired for resale) apply to the partnership? . . . . . . . . . . . . . . ... D Yes No e Was there any change in determining quantities, cost, or valuations between opening and closing inventory?. .., ..... 0 Yes No If 'Yes', attach explanation. b~clj~~~~h.JJ~:f~!k;::.r:4 Other Information 1 What type of entity is filing this return? Check the applicable box: Yes a ~ Domestic general partnership b ~ Domestic limited partnership c Domestic limited liability company d Domestic limited liability partnership e Foreign partnership f Other..... ~ __ _ _ __ _ _ ____ __ ___ __ _ _ __ __ _ ___ 2 Are any partners in this partnership also partnerships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 During the partnership's tax year, did the partnership own any interest in another partnership or in any foreign entity that was disregarded as an entity separate from its owner under Regulations sections 301.7701-2 and 301.7701 ~3? (f yes, see instructions for required attachment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Is this partnerShip subject to the consolidated audit procedures of sections 6221 through 6233? If 'Yes,' see Designation of Tax Matters Partner below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K-l are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. If 'Yes,' the partnership is not required to complete Schedules l, M-l , and M-2; Item F on page 1 of Form 1065; or Item J on Schedule K-l. . ... . . .. . " .. .. '" .. .... . ..... ...... . . . . .. . . . ., . . . .. ........ ... . . . .. . .. . .. . ., . . . .. . . .. .... .., .., . X 6 Does this partnership have any foreign partners? If 'Yes; the partnership may have to file Forms 8804, 8805 and 8813. See instructions. . . . . . . .. . . . . . . . . . . . 7 Is this partnership a publicly traded partnership as defined in section 469(k) (2) ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Has this partnership filed, or ;s it required to file, Form 8264, Application for Registration of a Tax Shelter?. . . .. .., . . .. . . . . . . 9 At any time during calendar year 2002, did the partnership have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)? See the instructions for exceptions and filing requirements for Form m F 90-22.1. If 'Yes,' enter the name of the foreign country. . ~ Page 1 2 3 4 5 6 7 ~- 8 No x x X x X X x 10 D~ring ~he tax year, d.id the partnership receive a distribut.ion frof!1, or was it the grantor of, or transferor to, a foreign trust? If Yes, the partnership may have to file Form 3520. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..; . . . . . . . . . . . . . . . . . . X 11 Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If 'Yes,' you may elect to adjust the basis of the partnership's assets under section 754 by attaching the statement described in the instructions under Elections Made By the Partnership. . . . . . . . . . . . . . . . . . . . . . - . . . . . - . . . . . . . . . . . . . . . . . . . . . . . 12 Ente~ the number of Forms 8865, Return of U.S. Persons With Respect to Certain Foreign Partnerships, attached to thiS return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . .. ~ 0 Designation of Tax Matters Partner (see instructions) Enter below the general partner designated as the tax matters partner (TMP) for the tax year of this return: Identifying number of TMP .. 176-34-8350 Name of designated TMP .. Gary W _ Carey Address of ~ 1781 Main St. designated TMP Lisburn, PA 17055 PTPA0112L 12/27/02 Form 1065 (2002) Form 1065 (2002) ennlS , arv na V arev - 08 Paoe : IS.chedul~"K' I Partners' Shares of Income, Credits, Deductions, etc (a) Distributive share items (b) Total amount 1 Ordinary income (loss) from trade or business activities (page 1, line 22) . . . . . . . . . . . . . . . . . . . . . 1 2 Net income (loss) from rental real estate activities (attach Form 8825). . . . . . . . . . . . . . . . . . . . . . . . 2 16,745. 3a Gross income from other rental activities................... ......1 3al b Expenses from other rental activities (attach sch). . . . . . . . .. . . . . . . . . . . . . . . . . .1 3bl c Net income (loss) from other rental activities. Subtract line 3b from line 3a. . . . . . . .. . . . . . . . . . . . 3c 4 Portfolio income (loss): a Interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a Income b Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b (Loss) c Royalty income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4c d Net short-term capital gain (loss) (attach Schedule D (Form 1065)). . . . . . . . . . . . . . . . . . . . . . . . . . . 4d e (1) Net long4term capital gain (loss) (attach Schedule D (Form 1065))... . . . . . . . . . . . . . . . . . . . . . 4e (1) (2) 28% rate gain (loss). . ~ ___________(3) Qualified 5-year gain . ~ ......j~ ~. .... .... -';-.c'>'; ---------- '/..' f Other portfolio income (loss) (attach schedule). . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 41 5 Guaranteed payments to partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Net section 1231 gain (loss) (other than due to casualty or theft) (attach Form 4797). . . . . . . . . . . 6 7 Other income (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Charitable contributions (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Deduc- 9 Section 179 expense deduction (attach Form 4562). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 tions 10 Deductions related to portfolio income (itemize). . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . 10 11 Other deductions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 12a Low-income housing credit /./V;::.'" (1) From partnerships to which section 42(j)(5) applies. . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 12a (1) Credits (2) Other than on line 12a(1} .. . . . . . . . . . . .. " . . . . . . . . . . .. . . .. . . . . . . . ... . .. . . . . . . . . . . . . . . . .. 12a (2) b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468). . . . . . . . . . . . . . . . . . . . . . 12b c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . 12c d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '2d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Invest- 14a Interest expense on investment debts. . . . . . . . . . . . . . . . . . . . . " . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . 14a ment b (1) Investment income included on lines 4a, 4b, 4c, and 4f above............................ 14b (1) Interest (2) Investment expenses included on line 10 above. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14b (2) Self- 'Sa Net earnings (loss) from self-employment. .. . . . . . " . . . . . . . .. .. . . . . . .. . . . . .. . . . . . . . . . . . . . . . .. 15a Employ- b Gross farming or fishing income. . . . . .. . . . . . . . .. .. . . . . . . . . " .. . . . . . . . . . .. . . . . . . . .. . ..... . . .. 15b ment c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15c Adjust- 16a Depreciation adjustment on property placed in service after 1986. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16a 253. ments b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16b and Tax c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16c Prefer- del) Gross income from oil, gas, and geothermal properties. .. . . . . . . . . . . ... .. . . . . . . . .. . . . . . . " 16d (1) ence Items (2) Deductions allocable to oil, gas, and geothermal properties. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . 16d (2) e Other adjmnts & tax pref items. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16e 17 a Name of foreign country or U.S. possession. . . . . ~ ........:..i<;;.\"';......... ------------------------- b Gross income from aU sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17b c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17c d Foreign gross income sourced at partnership level: .";~;j;~;:jSL (1) Passive ~ (2) Listed categories (attach sch) ~ (3) General limitation ~ 17d (3) Foreign e Deductions allocated and apportioned at partner level: :"'.":'" "'>,',:.,-):';'!:}' Taxes (1) Interest expense ~ (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ 17e (2) f Deductions allocated and apportioned at partnership level to foreign source income: . ..,,,.., (1) Passive ~ (2) Listed categories (attach sch) ~ (3) General limitation ~ 17f (3) g Total foreign taxes (check one): ~ o Paid o Accrued. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17g h Reduction in taxes available for credit (attach schedule) . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 17h 18 Section 59{e)(2) expenditures: a Type. . . ~ b Amount. . . . . 18b --------------------- 19 Tax-exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 Other tax-exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Other 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 22 Distributions of money (cash and marketable securities) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 24 Other items and amounts required to be reported separately to partners ...;-.-:.,',,;,: .-'-": d'.:<'~;> .......Fl: .... (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..:;/:.......::';:.. ',. ......,. . ...'.< .' '. .. D L G W & An c 23 19025 BAA Form 1065 (2002) PTPA0134L 08/13/02 Form 1 065 (2002) Dennis L, Gary W & Anna V Carey 23-1902508 Analysis of Net Income (Loss) 1 Net income (loss). Combine Schedule K. lines 1 through 7 in column (b). From the result, subtract the I I sum of Schedule K, lines 8 through 11, 14a, 17g, and 18b. ... ..... . .. .. ....... . . .. . .... . .. . .. '" . ... . . 1 16,745. 2 Analysis by (i) Corporate (ii) Individual (iii) Individual (iv) Partnership (v) Exempt (vi) Nominee/Other partner type: (active) (passive) organization a General 16,745. partners . . . . b Limited oartners . . . . Note: schedules L, M-l and M.2 are not required jf Question 5 of Schedule B is answered 'Yes.' ISt;;H~(luli?l1/ . > I Balance Sheets per Books Beginning of tax year Assets (a) (b) 1 Cash...................... . . . . . . . . . . . . . . . . I" :;":-<'C~',::'~::\';: ;'. 24, 061 . 2 a Trade notes and accounts receivable . . . . . . . ." "" ;.' b Less allowance for bad debts. . . . . . . . . . . . . . . . 3 Inventories................................. .; :,.: 4 U.S. government obligations.... ., " .... . .. ."~> 5 Tax-exempt securities. .. . . . . . . . . . .. .. . . . . .. .........;.; 6 Other current assets (attach schedule) . See . St. .1... u:,.;. :~ 7 Mortgage and real estate loans. . . . . . . . . . . . . . 8 Other investments (attach schedule). . . . . . . . . . . . . . . . . 9a Buildings and other depreciable assets. .. . . . . b Less accumulated depreciation. . . . . . . . . . . . . . 10 a Depletable assets. . . . . . . . . . . . . . . . . . . . . . . . . . b Less accumulated depletion. .. . . . . . . . . . . . . . . 11 Land (net of any amortization} . . . . . _ . . . . . . . ." . 1 2 a Intangible assets (amortizable only) . . . . . . . . . b Less accumulated amortization. . . . . . . . . . . . . . 13 Other assets (attach schedule) See. St. .2.. ''',,':,;.:>'''} 14 Total assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ..,;~::.'/<::::,:)~"'; Liabilities and Capital . ; '.:;;'~;<:rt.:"." 1 5 Accounts payable.. . .. .. . . . . .. .. .. .. .. .. .. " . ):Y 16 Mortgages, notes, bonds payable in less than 1 year. . . .. '.>;;. 17 Other current liabilities (attach sch). . . . . . . . . . . . . . . . . 18 All nonrecourse loans. . . . . . . . . . . . . . . . . . . . . . . . ,;( 19 Mortgages, notes, bonds payable in 1 year or more. . . . . ";':~ 20 other liabilities (attach schedule). . . . . . . . . . . . . . . . . . '" ';;' 21 Partners' capital accounts................... ,....> 71,105. 22 Total liabilities and capital. . . . . . . . . . . . . . . . . . I';'"'' c,>/ 71, 105. I',,: 1'~S'cff~dJile'fM+l<1 Reconciliation of Income (Loss) per Books With Income (Loss) per Return , Net income (loss) per books. . . . . . . . . . . . . 16, 745. 6 Income recorded on books this year not included 2 Income included on Schedule K, lines 1 through 4, on Schedule K, lines 1 though 7 (itemize): 6, and 7, not recorded on books this year (itemize): a Tax-exempt interest.. $ _ _ _ _ _ _ _ _ _ _ _ End of tax year (c) .'; (d) ;>>,".. ...., 40 051 ~' . I"" "'..:?):;~n;;B(@i':0 .' --:. . . . 43,682. :.,';..;' .";'.,',". ". <\....:.; .;;. :-. . .... ';':'. >:.' ../";::';" /. iX' . > .,;;.>>: '. .>. ;'. ..' ""/.' . ." ':.:y :,,,;,.:0:).::;'.: 130,240.' 86,604. 800. ..',':~(:' '. :' 126,485. 82,803. ....' .,'., ;...;....-i: :::--.:. '.:.,:":'..;;. .... :......:. .r>,..');' 43,636. ':::'. I'::":,' . <, . ",,<.., ;;'; '..,.::;.':" 3, 362 .c, <"e~'" ..,;~:~,:; 3,362. "">,,,", .;;,..':..... :.' :..') '..;: :i'.: 71,105. /',":" .'. <:i(....... ?,</;::/: ,'.,'- 4. 87,853. .;..: '.~. >:, '... . "''';''i , ;...... ...,......... .''- . ::/ ...: .<' .." ;':::.::,c '::.; ':'.' ...h...'.\......::) ';, ,,,;',' .:/ :" ';.::::: >>'.;.: .'::. ;:..: '>. 87,853. 87,853. -------------------- 3 Guaranteed pmts (other than health insurance). . . . . 4 Ex~nses recorded on books this year not included on Schedule K, lines 1 through 11, 14a, 17g, and 18b (itemize): a Depreciation. .. . .. $ _ _ _ _ _ _ _ _ _ _ _ b Travel and entertainment. . . .. $_ _ _ _ _ _ _ _ _ _ _ 7 Deductions included on Schedule K, lines 1 through 11, 143, 17g, and 18b, not charged against book income this year (itemize): a Depreciation. . . .. $ _ _ _ _ _ _ _ _ _ _ _ --------------------- 5 AddlirWslthr;;ugh-4~.~.~.~.~.~.~.~.~.. 16,745. FSC:Ii'edtJte;'M*2;;J Analvsis of Partners' Capital Accounts 1 Balance at beginning of year............ 71,105. 2 Capital contributed: a Cash. . . . . . . . . . . . b Property. . . . . . . . . 3 Net income (loss) per books. . . . . . . . . . . . 4 Other increases (itemize): Statement 3 5 Add ii~~ lthrough4-:-.-:-.-:-.~.-:-.~.-:-.~.~. ~ 8 A~ij~s6~df~~~~~~~~~~~. 9 Income (loss) (Analysis of Net Income (Loss), line 1). Subtract line 8 from line 5 . . . . . . . . . . . . . . . . . . . . . 16,745. 6 Distributions: a Cash. . . . . . . . . . . . . . . . . . . . b Property. . . . . . . . ; . . . . . . . . 7 Other decreases (itemize): 16,745. --------------------- 3. 87,853. 8 A~Ii~s6~df~~~~~~~~~~~. 9 Balance at end of year. Subtract line 8 from line 5. . . . 87,853. PTPA0134l 08/13/02 Form 1065 (2002) Form 8825 Rental Real Estate Income and Expenses of a Partnership or an 5 Corporation ~ 5ee instructions. ~ Attach to Form 1065, Form 1065-8, or Form 11205. OMS No. 1545.1186 Department of the Treasury Internal Revenue Service Name 2002 Employer identification number Dennis L, Gar W & Anna V Care 23-1902508 1 Show the kind and location of each property. See page 2 for additional properties. A _~~~11~~__________________________________________________________ 3814 Old Gettysburg Rd., Cumberland Co. Office and Warehouse B --------------------------------------___________________________ 1781 Main St., Lisburn, PA C ~p~~t~~n~E_~ng_~a~~~~________________________________________________ 1777-79 main St., Lisburn, PA o --------------___________________________________________________ Properties Rental Real Estate Income A B c o 2 Gross rents. . . . . . . . . . . . . . . . . . . . . . . . . . 2 Rental Real Estate Expenses 3 Advertising........................... 3 4 Auto and travel. . . . . . . . . . . . . . . . . . . . . . . 4 5 Cleaning and maintenance. . . . . . . . . . . . 5 6 Commissions......................... 6 7 Insurance............................ 7 8 Legal and other professional fees. . . . . . 8 9 Interest.............................. 9 10 Repairs.............................. 10 11 Taxes................................ l' 12 Utilities............................... 12 13 Wages and salaries. . . . . . . . . . . . . . . . . . . 13 14 Depreciation (see instructions). . . . . . . .. 14 15 Other (list) ~ _____________ ~.f~~uEt _f~~,_ E~n_~ f~e.!. ~t.c_ 5,280. 10,600. 17,610. 148. 754. 146. 915. 1,250. 205. 804. 625. 1,276. 1,176. 2,790. 877. 96. 4,748. 255. 105. 215. 360. 15 16 Total expenses for each property. Add lines 3 through 15.... .... ........ 16 1,429. 7, 085. 8,231. 17 Total gross rents. Add gross rents from line 2, columns A through H. .. .. .. . . . . '" '" . . . ... . . ... . .. .. . . . '" 17' 18 Total expenses. Add total expenses from line 16, columns A through H .. .. . . . . .. . . ... . .. .. " . . . . " .. . . . ... 18 19 Net gain <!o.s~) from Form 4797, Part II, line 18, from the disposition of property from rental real estate activItIes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 19 20 a Net income (loss) from rental real estate activities from partnerships, estates, and trusts in which this partnership or S corporation is a partner or beneficiary (from Schedule K-l). . . . . . . . " . . . . . . . . . . . . . . . . . . . . .. 20a b Identify below the partnerships, estates, or trusts from which net income (loss) is shown on line 20a. Attach a schedule if more space is needed: (1) Name (2) Employer identification number 33,490. -16,745. ------------------------- ------------------------- 21 ~~ ~~~; ~~~ ~~ ~e~t~1 ~e;I~~;e=a~t~i;e;. ~om~i~e=li~e~ ~ 7=t~~~h ~~a~ in~;r;s~l;=h;r; = = = = ~IJW and on: I~;f~ · Form 1065 or 11205: Schedule K, line 2, or J- 1,21. · Form 1065-8: Part I, line 4 ..._" BAA For Paperwork Reduction Act Notice, see the separate instructions. 16,745. 'c.":.>. ,;,....:....'.;-. '........ Form 8825 (2002) SPSZ01 01 L 08/19/02 Schedule K-1 (F orm 1065) Partner's Share of Income, Credits, Deductions, etc OM8 No. 1545-0099 Department of the Treasury Internal Revenue Service Partner's identi in number ~ Partner's name, address, and ZIP code be innin 210-40-2212 For calendar year 2002 or tax year , 2002, and endin , 20 Partnershi 's identi in number ~ Partnership's name, address, and ZIP code 2002 23-1902508 Dennis L. Carey 1957 Sheepford Rd. Mechanicsburg, PA 17055 Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, PA 17055-5946 A This partner is a X general partner limited partner o limited liability company member B What type of entity is this partner? .. ~ Individual C Is this partner a OOdomestic or a Dfi>;ign-p-;;rtrt;r? - - - -- o Enter partner's % of: (i) Bef~e",~{lg~ Of (ii) E~a~f Profit sharing. . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ J ~ % Loss sharing. . . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ J ~ % Ownership of capital.. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _1 ~ % E IRS Center where partnership filed return: Cincinnati, OH J I. f .taI F Partner's share of liabilities (see instructions): Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . " $ _ _ _ _ _ _ _ _ _ _ _ Qualified nonrecourse financing. . . . . . . .. $_ _ _ _ _ _ _ _ _ _ _ Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $_ _ _ _ _ _ _ _ _ _ _ G Tax shelter registration number ~ H Check here if this partnership is a publicly traded partnership D as defined in section 469(k)(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . .. I Check a plicable boxes: Amended K-l AnalYSIS 0 partner seal I account: (a) Capital account at (b) Capital contributed (e) Partner's share of (d) Withdrawals and (e) Capital account at end of beginning of year during year lines 3, 4, and 7, distributions year (combine columns (a) Form 1065, Schedule M-2 through (d)) 17,775. 4,186. 21,961. (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: 1 Ordinary income (loss) from trade or business activities. . . . . . . . . . . 1 - 2 Net income (loss) from rental real estate activities. . . . . . . . . See. Line. 25 2 4,186. _ See Partner's Instructions for Schedule K -1 (Form 1065). 3 Net income (loss) from other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Portfolio income (loss): Income a Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a Schedule B, Part I, line 1 (Loss) b Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b Schedule 8, Part II, line 5 c Royalties. . . . . . . . . . . . . . . . .. . . . .. .. . .. . . . . . . . . . . . . . .. . . .. . . .. . . _ . 4c Schedule E, Part I, line 4 d Net short-term capital gain (loss). . . .. . . .. . . . . . " . . . . . . . . . . . . . . . . 4d Schedule D, line 5, column (f) e (1) Net long-term capital gain (loss). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e(1 ) Schedule 0, line 12, column (f) (2) 28% rate gain (loss}. . ... . . .. .. . . . . . . . . . . . . . . . . . . . . . _. .. . . . . 4e(2) Schedule 0, line 12, column (g) (3) Qualified 5-year gain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e(3) Une 5 of worksheet for Sch O,line 29 f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4f Enter on applicable In of your return 5 Guaranteed payments to partner. . . . . . . . . . . . . . . . . . . . . . . . . . _ . _ . . . . 5 6 Net section 1231 gain (loss) (other than due to casualty ',:, _ See Partner's Instructions for or theft). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Schedule K-l (Form 1065). 7 Other income (loss) (attach schedule) . . . . . . . . . . . . . . . ., . . . . .. .. . . 7 Enter on applicable In of your return 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . . . . . . . . 8 Schedule A, line 15 or 16 Deduc- 9 Section 179 expense deduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 tions 10 Deductions related to portfolio income (attach schedule). . . . . . . . . . . . . . . . . . . . . . 10 r- See Partner's Instructions for Schedule K-' (Form 1(65). 11 other deductions (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 !-- 12a Low-income housing credit: ','. ~'::.: : (1) From section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . 12a(1 } J- Form 8586, line 5 (2) Other than on line 12a(1} . . . . . . . .. .. . . .. . . . . . . . .. . . . . . .. . . . . 12a(2) b Qualified rehabilitation expenditures related to rental real : .'>:>:;::~ ~ Credits estate activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12b c Credits (other than credits shown on lines 12a and 12b) .>'/:...... ~ See Partner's Instructions for related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . 12c Schedule K.1 (Form 1065). d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . 12d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 - BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. Schedule K-1 (Form 1065) 2002 PTPA0312L 12/27/02 Partner 1 Schedule K-1 (Form 1065) 2002 Dennis L, Gary W & Anna V Carey (a) Distributive share item Invest- ment Interest Self- employ- ment Adj ust- ments and Tax Pref- erence Items Foreign Taxes Other 14a Interest expense on investment debts.. . . . . . . . . . . . . . . . . . . . . . . . . . . b (1) Investment income included on lines 4a, 4b, 4c, and 4f.. . ... . . (2) Investment expenses included on line 1Q. . .. " . . .. . . . . . . . . . . . 15a Net earnings (loss) from self-employment... . . . . . . . . . . . . . . . . . . . . . b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16a Depreciation adjustment on property placed in service after 1986. . . . . . . . . . . . . . . . b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (1) Gross income from oil, gas, and geothermal properties.. .. . . . . (2) Deductions allocable to oil, gas, and geothermal properties. . . . e Other adjustments & tax oreference items (attach sch). . . . . . . . . . . . 17a Name of foreign country or U.S. possession. ~ _ _ _ _ _ _ _ _ _ _ _ _ __ b Gross income from all sources. . . . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . . . d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e Deductions allocated and apportioned at partner level: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17e(1) (2) Other. . . . . . . . . .. .. . . .. . . . . . . . . . . .. .. . . . . . . . . . . . . . . . .. . . . . . .. 17e(2) f Deductions allocated and apportioned at partnership level to foreign source income:.:/::,/r~:; (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . .. 17fO) (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . .. 17f(2) (3) General limitation. .. .. .. . . . . . . .. . . . . .. .. .. . . .. . . . . . . . .. . . . .. 17f(3) 9 Total foreign taxes (check one): ... 0 Paid D Accrued. .. 17g h Reduction in taxes available for credit (attach schedule) _ . . . . . . . . . . . . . . . . . . . .. 17h 18a Section 59(e)(2) expenditures: a Type'" _______________ . .... b Amount. . . .. . . . . . . . . ... . . " . . . . . _. . .. .. . . .. .. . . . .. . . . . . . .. .. . .. 18b 19 Tax ,exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 20 Other tax-exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 21 22 Distributions of money (cash and marketable securities} . .. .. . . . . _ 22 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 _ 24 Recapture of low. income housing credit:;:,>:.,~;:,; . } a From section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 24a Form 8611, line 8 b Other than on line 24a... .... . .. ....... ... . . . . . ... . . .. . . . .. '" " 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if more space is needed): Li ne 2 Rental Real Estate Activities 23-1902508 (b) Amount 14a 14b(1) 14b(2) 15a 15b 15c 16a 16b 16c 16d(1) 16d(2) 16e ;,''i,,:.'<,:,,..f. 17b 17c ',':::~i'.'.:.;/': '.""h' 17d(1) 17d(2) 17d(3) .....,.;... Paae 2 (c) 1040 filers enter the ~mount in column (b) on: Form 4952, line 1 L See Partner's Instructions for --l Schedule K-l (Form 1065). Schedule SE, Section A or B U- See Partner's Instructions for Schedule K.' (Form 1(05). 63. I-- See Partner's _ I nstructions for Schedule K.l (Form 1065) and Instructions for Form 6251. - - ~ Forml116,Partl I- Form 1116, Part II Form 1116, line 12. D- See Partner's Instructions for Schedule K-l (Form 1(05). Form 1040, line 8b ~ I- See Partner's Instructions for Schedule K-l (Form 1065). Supple- Property Gross Net Net Passive Sec. 1231 mental Description Income Expenses Income Nonpass Total Infor- Dwelling 1,320. 357. $ 963. NonPass mation Office and Warehouse 2,650. 1,771. 879. NonPass Apartments and Garage 4,403. 2,058. 2,345. NonPass Rounding -1. Total $ 4,186. Partner 1: Dennis L. Carey PTPA0312L 12/27/02 210-40-2212 Schedule K-' (Form 1065) 2002 Schedule K-1 (Form 1065) OM8 No. 1545.0099 Partner's Share of Income, Credits, Deductions, etc 2002 Department of the Treasury Internal Revenue Service Partner's identi in number ~ Partner's name, address, and ZIP code be innin 176-34-8350 For calendar year 2002 or tax year ,2002, and endin , 20 Partnershi "s identif in number ~ Partnership's name, address, and ZIP code Gary W. Carey 1781 Main St. Lisburn, PA 17055 A This partner is a X general partner limited partner o limited liability company member B What type of entity is this partner? " ~ ~EQ.~'!Q.u_a.! _ _ _ _ _ C Is this partner a 00 domestic or a D foreign partner? o Enter partner's % of: (i) 8etcgr~~:~ Of (ii) E~a?t Profit sharing. . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ J ~ % Loss sharing..... __________ % --______J~ % Ownership of capital.. __ _ _______ % _ ______ _1~ % E IRS Center where partnership filed return: Cincinnati, OH I 23-1902508 Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, PA 17055-5946 F Partner's share of liabilities (see instructions): Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . " $ _ _ _ _ _ _ _ _ _ _ _ Qualified nonrecourse financing......... $_ _ _ _ _ _ _ _ _ __ Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ _ _ _ _ _ _ _ _ _ _ _ G Tax shelter registration number ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ H Check here if this partnership is a publicly traded partnership 0 as defined in section 469(k)(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . .. I Check a plicable boxes: Amended K-1 J Analysis of partner"s cal ita account: (a) Capital account at (b) Capital contributed (c) Partner"s share of (d) Withdrawals and (e) Capital account at end of beginning of year duri ng year lines 3,4, and 7, distributions year (combine columns (a) Form 1065, Schedule M-2 through (d)) 17,777. 4,187. 21,964. (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: , Ordinary income (loss) from trade or business activities. . .. .. . . . . . 1 - 2 Net income (loss) from rental real estate activities. . . . . . . . . .See. .Line . 25 2 4,186. See Partner's Instructions for r- Schedule K-l (Form 1065). 3 Net income (loss) from other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Portfolio income (Joss): ....:. Income a Interest. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a Schedule B, Part I, line 1 (Loss) b Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b Schedule 8, Part II, line 5 c Royalties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4c Schedule E, Part I, line 4 d Net short-term capital gain (loss). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4d Schedule D, line 5, column (f) e (1) Net long-term capital gain (loss). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e(1 ) Schedule D, line 12, column (f) (2) 28% rate gain (loss) . . . .. PO . . . . .. . . . . . . . . . . .. .. . . . . . . .. .. . . . 4e(2) Schedule D. line 12, column (g) (3) Qualified 5-year gain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e(3) Line 5 of worksheet for Sch 0, line 29 f Other portfolio income (loss) (attach schedule).. .. .. . .. . . .. .. . . . . . . . .. . . . . . 41 Enter on applicable In of your return 5 Guaranteed payments to partne!: . .. . . . .. . . . . . . .... ., .. .. . .. . . . . . 5 ..,. _ See Partner's Instructions for 6 Net section 1231 gain (loss) (other than due to casualty Schedule K.l (Form 1065). or theft). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 6 7 Other income (loss) (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Enter on applicable In of your return 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . . . . . . . . 8 Schedule A, line 15 or 16 Deduc- 9 Section 179 expense deduction. . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . 9 tions 10 Deductions. related to portfolio income (attach schedule). . . . . . . . . . . . . . . . . . . . . . 10 t- See Partner's Instructions for Schedule K.l (Form 1065). 11 Other deductions (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 - 12a Low-income housing credit: (1) From section 42(j)(5) partnerships. . . . . PO, . . . .. . . .. . . . .. . . . . . 12a(1 ) =:t Form 8586, line 5 (2) Other than on line 12a(1} . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a(2) . n: b Qualified rehabilitation expenditures related to rental real - Credits estate act\vities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12b c Credits (other than credits shown on lines 12a and 12b) .'.>:'''''...':' _ See Partner's Instructions for <>.\. Schedule K-l (Form 1065). related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12c d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . 12d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 - BAA For Paperwork Reduction Act Notice, see Instructions for Fonn 1065. Schedule K-' (Form 1065) 2002 Partner 2 PTPA0312L 12/27/02 Schedule K-' (Form 1065) 2002 Dennis L, Gary W & Anna V Carey (a) Distributive share item Invest- ment Interest Self- employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes Other 23-1902508 Page 2 (c) 1040 filers enter the amount in column (b) on: Form 4952, line 1 . L See Partner's Instructions for -.J Schedule K-1 (Form 1065). Schedule SE, Section A or B J- See Partner's Instructions for Schedule K-l (Form 1065). 63. - (b) Amount 14a Interest expense on investment debts. . . . . . . . . . . . . . . . . . . . . . . . . . .. 14a b (1) Investment income included on lines 4a, 4b, 4c, and 4f. . . . . . .. 14b(1) (2) Investment expenses included on line 10 . . . . . . . . . . . . . . . . . . . .. 14b(2) 15a Net earnings (loss) from self-employment. . . . . .. . . . . .. . . . . . . . . . .. 15a b Gross farming or fishing income........ .. .. . .... . .. ...... .... ... 15b c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 c 16a Depreciation adjustment on property placed in service after 1986. . . . . . . . . . . . . . .. 16a b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. .. . .. 16b c Depletion (other than oil and gas) . . .. . . . . . .. . . . . . . . . . . . . . . . . . . .. 16c d (1) Gross income from oil, gas, and geothermal properties. . . . . . " 16d(1) (2) Deductions allocable to oil, gas, and geothermal properties. . .. 16d(2) e Other adjustments & tax preference items (attach sch). . . . . . . . . . .. 16e 17 a Name of foreign country or U.S. possession. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _1;-:/:;<: b Gross income from all sources. .. ... .... ., .. . . . . . . . . . . . .. .. .. ... 17b c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . .. 17 c d Foreign gross income sourced at partnership level: '::'>~;":;; (1) Passive. . .. . .. . . . . .. .. . . . . . .. . .. .. .. . . .. .. . . . .. .. . . .. .. . .... 17d(1) (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . .. 17d(2) (3) General limitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17d(3) e Deductions allocated and apportioned at partner level:::DhL";.:;: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17eO) (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. 17e(2) f Deductions allocated and apportioned at partnership level to foreign source i ncome::;::{:J/'. (1) Passive. . .. . .. .. . .. .. . .. .. .. .. . .. .. . . . . . .. .. .. .. . . .. . .. .. . .. 17f(1) (2) Listed categories (attach schedule). . . . . . . . . . . .. . . . . . . . .. . .. .. 17f(2) (3) General limitation.. . . .. . .. .. . . . . .. . .. . . .. .. . . . . . . .. . . .. . . ... 17f(3) 9 Total foreign taxes (check one): ~ D Paid DAccrued. .. 170 h Reduction in taxes available for credit (attach schedule). . . . . . . . . . . . . . . . . . . . .. 17h lSa Section 59(e)(2) expenditures: a Type ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ :;.;:..,'..... b Amount.... .... .. ... . .. . . . .. ... ... . . ..... . .. . . . .... . . . .. .. .. . .. lSb 19 Tax -exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " . . . .. 19 20 Other tax-exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. 20 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 21 22 Distributions of money (cash and marketable securities).. . . . . .. .. 22 23 Distributions of property other than money.... . .. .... .. _. . .. .... _ 23 ~ 24 Recapture of low-income housing credit: [., .... } a From section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. 24a Form 8611, line 8 b Other than on line 24a.. . . .. .. .. . .... . .... .. .... " " . .. . . .. . . ... 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if more space is needed): Line 2 Rental Real Estate Activities See Partner's _ Instructions for Schedule K.l (Form 1065) and Instructions for Form 6251. f--- I-- I- Form 1116, Part I - Form 1116, Part II Form 1116, line 12. J- See Partner's Instructions for Schedule K-l (Form 1065). Form 1040, line 8b - r- See Partner's Instructions for Schedule K-l (Form 1065). Supple- Property Gross Net Net Passive Sec. 1231 mental Description Income Expenses Income Nonpass Total Infor- Dwelling 1,320. 357. $ 963. NonPass mation Office and Warehouse 2,650. 1,771. 879. NonPass Apartments and Garage 4,403. 2,058. 2,345. NonPass Rounding -1. Total $ 4,186. PTPA0312L 12/27/02 Schedule K-l (Form 1065) 2002 Partner 2: Gary W. Carey 176-34-8350 Schedule K-l (F orm 1065) Partner's Share of Income, Credits, Deductions, etc OMS No. 1545-0099 Department of the Treasury Internal Revenue Service Partner's identi "n number ~ Partner's name, address. and ZIP code be innin 204-30-8190 For calendar year 2002 or tax year , 2002, and endin , 20 Partnershi .s identi in number ~ Partnership's name, address, and ZIP code 2002 23-1902508 Anna V. Carey 1781 Main St. Lisburn, PA 17055 Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, PA 17055-5946 A This partner is a X general partner limited partner o limited liability company member B What type of entity is this partner? .. ~ _I!!9:~..!Q.l!..al_ _ _ _ _ C Is this partner a rRl domestic or a D foreign partner? D Enter partner's % of: (i) Bef~im~R8~ or (ii) E~a?f Profit sharing. . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ ..? Q % Loss sharing. . . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ ...? Q % Ownership of capital.. _ _________ % __ ___ ~_ _~.Q % E IRS Center where partnership filed return: Cincinnati, OH J I. f "t I t F Partner's share of liabilities (see instructions): Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . .. $ _ _ _ _ _ _ _ _ _ _ _ Qualified nonrecourse financing. . . . . . . .. $ _ _ _ _ _ _ _ _ _ __ Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $_ _ _ _ _ _ _ _ _ _ _ G Tax shelter registration number ~ H Check here if this partnership is a publicly traded partnership 0 as defined in section 469(k) (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I Check a licable boxes: (1 Amended K - 1 AnalYSIS 0 partner S call a accoun : (a) Capital account at (b) Ca~it~l contributed (e) Partner's share of (d) Withdrawa\s and (e) Capital account at end of beginning of year unng year lines 3,4, and 7, distributions year (combine columns (a) Form 1065, Schedule M-2 through (d)) 35,553. 8,375. 43,928" (a) Distributive share item (b) Amount (c) 1040 filers enter the amount in column (b) on: 1 Ordinary income Ooss) from trade or business activities. . .. . . .. . . . 1 ~ 2 Net income (loss) from rental real estate activities. . . . . . . . . .See. Line. 25 2 8,373. See Partner's Instructions for - Schedule K-l (Form 1065). 3 Netincome (loss) from other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Portfolio income (loss): ::':<:. .... Income a Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a Schedule B, Part I, line 1 (Loss) b Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b Schedule B, Part II, line 5 c Royalties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4c Schedule E, Part I, line 4 d Net short-term capital gain (loss). . . . . . . . . .. .. . . " . . . . . . . . . . . . . .. 4d Schedule D, line 5, column (f) e (1) Net long-term capital gain (loss). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e(1 ) Schedule 0, line 12, column (f) (2) 28% rate gain (loss} .. .. . . .. . . .. . . . . . . .. . .. . .. . . .. .. . . . . . .. . 4e(2) Schedule D, line 12, column (g) (3) Qualified 5-year gain.. .. . . . . . . . .. . . . . . .. . . . . . . . . . . . .. . . . . . . . 4e(3) Line 5 of worksheet for Sch D, line 29 f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Enter on applicable In of your return 5 Guaranteed payments to partnet . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . 5 '.:<:: .... '- See Partner's Instructions for 6 Net section 1231 gain (loss) (other than due to casualty Schedule K-l (Form 1065). or theft). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Other income (loss) (attach schedule) . .. . . .. .. . . . .. . . . ... .. .. . . . 7 Enter on applicable In of your return 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . _ . . . . . . 8 Schedule A, line 15 or 16 Deduc- 9 Section 179 expense deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 tions 10 Deductions related to portlolio income (attach schedule). . . . . . . . . . . . . . . . . . . . . . 10 _ See Partner's Instructions for Schedule K-' (Form '065). 11 other deductions (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 - 12a low-income housing credit: . ':.'. ":<:. . <' (1) From section 42(j)(5) partnerships.................... .. ..... 12a(l) =:J- Form 8586, line 5 (2) Other than on line 12a(1} . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a(2) b Qualified rehabilitation expenditures related to rental real :'.,:i~;>:". ", ---. // Credits estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12b c Credits (other than credits shown on lines 12a and 12b) :. :.....;::,",'...,:. I- See Partner's Instructions for !::..:- :...'.:...... Schedule K-l (Form 1065). related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . 12c d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . 12d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 - BAA For Paperwork Reduction Act Notice, see Instructions for Fonn 1065. Schedule K-l (Form 1065) 2002 PTPA0312L 12127/02 Partner 3 W & Anna V Care 23-1902508 Schedule K-1 (Form 1065) 2002 Dennis L, Gar Invest.. ment Interest Self.. employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes Other 14a Interest expense on investment debts. . . . . . . . . . . . . . . . . . . . . . . . . . . . b (1) Investment income included on lines 4a, 4b, 4c, and 4f. . . . . . . . 2 Investment ex enses included on line 1 Q . . . . . . . . . . . . . . . . . . . . . 15a Net earnings (loss) from self-employment... .... ... ....... . . . ... . b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 a Depreciation adjustment on property placed in service after 1986. . . . . . . . . " . . . . . . b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . " . . . . . . . . . . . . . . . . . c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (1) Gross income from oil, gas, and geothermal properties. . .. . . . . (2) Deductions allocable to oil, gas, and geothermal properties. . . . e Other ad" ustments & tax reference items attach sch . . . . . . . . . . . . 17 a Name of foreign country or U.S. possession. ... _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources. . . . . . . . . . . . . . . . . . . . " . . . . . . . . . . . . . c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . . . d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . " " " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . . . . .. . . . . . . . . . . . . . .. . . . . (3) General limitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . e Deductions allocated and apportioned at partner level: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Total foreign taxes (check one): ~ 0 Paid DAccrued... h Reduction in taxes available for credit (attach schedule). . . . . . . . . . . . . . . . . . . . . . 18a Section 59(e)(2) expenditures: a Type ~ _ _ _ _ _ _ _ _ _ _ _ _ _ __ b Amount. . .. . . . . . . . . . .. . . .. .. . . . " . . . . .. . . . . . .. . . . . . . . . . . . .. . . .. 18b 19 Tax-exempt interest income. .. .... . .. . . " . ., .. . .. .. . . .... . . ... ... 19 20 Other tax -exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 21 22 Distributions of money (cash and marketable securities)... . ... . .. 22 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 24 Recapture of low-income housing credit: a From section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 24a b Other than on line 24a. .... ...... .... ... '" ... .. ... .. . . . . . . . . . .. 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if more space is needed): Line 2 Rental Real Estate Activities (a) Distributive share item (b) Amount Pa e 2 (c) 1040 filers enter the amount in column (b) on: Form 4952, line 1 See Partner's Instructions for Schedule K-1 (Form 1(65). Schedule SE, Section A or B See Partner's Instructions for Schedule K-l (Form 1(65). 127. See Partner's Instructions for Schedule K - 1 (Form 1065) and Instructions for Form 6251. Form 1116, Part I Form 1116, Part " Form 1116, line 12. See Partner's Instructions for Schedule K -1 (Form 1005). Form 1040, line 8b See Partner's Instructions for Schedule K-l (Form 1005). Form 8611, line 8 Supple- Property Gross Net Net Passive Sec. 1231 mental Description Income Expenses Income Nonpass Total Intor- Dwelling 2,640. 715. $ 1,925. NonPass mation Office and Warehouse 5,300. 3,543. 1,757. NonPass Apartments and Garage 8,805. 4,116. 4,689. NonPass Rounding 2. Total $ 8,373. Partner 3: Anna V. Carey PTPA0312L 12/27/02 204-30-8190 Schedule K-' (Form 1065) 2002 Form 4562 OMS No. 1545-0172 Department of the Treasury Internal Revenue Service Depreciation and Amortization (Including Information on Listed Property) ... See separate instructions. ... Attach to your tax return. 2002 67 Name(s) shown on return Dennis L, Gary W & Anna V Carey. Business or activity to which this form relates 8825, Rental Real Estate - Dwellin Election To Expense Certain Tangible PropertY Under Section 179 Note: If you have any listed property, complete Part V before you complete Part I. 1 Maximum amount. See instructions for a higher limit for certain businesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Total cost of section 179 property placed in service (see instructions). . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . 2 3 Threshold cost of section 179 property before reduction in limitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0-: . .. . . .. ... .. . . . . . .. . . . . . . . . . . . . . 4 5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing se aratel , see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 b Cost (business use only) C Elected cost Identifying number 23-1902508 $24,000. $200,000. 7 Listed property. Enter the amount from line 29. . . . . . . . ... . . . .. .. . . . . . . . . . . . . . . .. . . . 7 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7.. .. . . ...... ....... -. .., 8 9 Tentative deduction. Enter the smaller of line 5 or line 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Carryover of disallowed deduction from line 13 of your 2001 Form 4562. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. '0 '1 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instrs).. 11 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11..................... 12 13 Car over of disallowed deduction to 2003. Add lines 9 and 10, less line 12. . . .. . . . ~ 13 Note: Do not use Part II or Part 11/ be/ow for listed property. Instead, use Part V. Pan\lt<~;)t~ S ecial De reciation Allowance and Other De reciation Do not include listed ro ert . 14 Special depreciation allowance for qualified property (other than listed property) placed in service during the tax year (see instructions). .. . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . .. . . . . . -. . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . .. 14 15 Property subject to section 168(f)(1) election (see instructions). . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 16 Other depreciation includin ACRS) (see instructions).. . . .. .. .. . . .. - - .. .. .. . . . . .. - . . . . . .. .. . . . . . - .. . .. . .. 16 45 . Partlll'::'/Z MACRS De reciation Do not include listed pro e . (See instructions) Section A 17 MACRS deductions for assets placed in service in tax years beginning before 2002. . . . . . . . . . . . . . . . . . . . . . . .. 17 18 If you are electing under section 168(i)(4) to group any assets placed in service during the tax year into one or more eneral asset accounts, check here. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ Section B - Assets Placed in Service Durin 2002 Tax Year Usin the General De reciation S stem (a) (b) Month and (C) Basis for depreciation (d) (e) (I) (g) Depreciation Classification of property year placed (businesslinvestment use Recovery period Convention Method deduction in service only - see instructions) 19a 3- ear b 5. ear c 7- ear ro ert .......... d 10- ear e 1 5 - ear f 20- ear 25- ear ropert......... h Residential rental. .. . ... . 9/23/02 property. . _ . . . . . . . . . . . . . . Nonresidential real. . . . . . property. . . . . . . . . . . . . . . . . Section C - Assets Placed in Service Durin 2002 Tax Year Usin the Alternative De 20a Class life. . . . . . . . . . . . . . . . b 12. ear................. c 40. ear................. Patt;;I\l':'/'];,,; Summa (see instructions) 21 Listed property. Enter amount from line 28. . . . .. . . . . . . .. ... . . . .. . . . . .. . . . .. .. .. . .. .. .. . . . . . . . . . . . . . .. .. 21 22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21. Enter here and on the appropriate lines of your return. Partnerships and S corporations - see instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 22 23 F or assets shown above and placed in service during the current year, enter the ortion of the basis attributable to section 263A costs. . . . . . . . . . . . . . . . . . . . . .. 23 BAA For Paoerwork Reduction Act Notice. see instructions. FDIZ0812L 12/12/02 3,755. 25 27.5 27.5 39 MM MM MM MM S/L S/L S/L SjL S/L 40. 12 40 rs rs MM Form 4562 (2002) Form 4562 Depreciation and Amortization (Including Information on Listed Property) ~ See separate instructions. ~ Attach to your tax return. OMS No. 1545-0172 Department of the Treasury Internal Revenue Service 2002 67 Name(s) shown on return Dennis L, Gary W & Anna V Carey Business or activity to which this form relates Form 8825, Rental Real Estate - Office and Warehouse IParl.:l:"" .1 Election To Expense Certain Tangible PropertY Under Section 179 Note: If you have any listed property, complete Part V before you complete Part I. Identifying number 23-1902508 1 Maximum amount. See instructions for a higher limit for certain businesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 $24,000. 2 Total cost of section 179 property placed in service (see instructions).. . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Threshold cost of section 179 property before reduction in limitation...... . .. . .... ... .... ... . . .. ... '" .... . 3 $200,000. 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0,,: . _ . . . . . . . . . . . . . . _ _ . . . . . . . . . . . . . . 4 5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or tess, enter .0-. If married filing seoaratelv, see instructions. . . . '" . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . .. .. .. . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . . . 5 6 (al Description of property (bl Cost (business use only) (el Elected cost ~~, :!~~~i;i:~~' '..' t; ,.'<,. Listed property. Enter the amount from line 29. . . . .. . . . . -. . . . . . . . . . . .. . . . . . . . . . . . . .1 :......'. .-; 7 7 -.>:~,' 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7.... . _... .. ...... ....... 8 9 Tentative deduction. Enter the smaller of Hne 5 or line 8.. .. . . . . . . .. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 9 10 Carryover of disallowed deduction from line 13 of your 2001 Form 4562.. . . . . . .. . . . .. . . . . . . . . . . . .. . . . . . . .. . 10 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instrs) . . 11 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11. ..... . ....... _. ... .. 12 13 Carryover of disallowed deduction to 2003. Add lines 9 and 10, less line 12.. .. . " . ~r 13 14 15 16 89. 17 18 (g) Depreciation deduction 25 27.5 27.5 39 MM MM MM MM the Alternative De 2002 Tax Year Usin 12 rs 40 rs MM 21 22 23 23 DA A C'^.. D..u""'u....'^r" Darl",.ti^" 4,.t Nntir,. cpp inc;trlJr.tinn~. FDIZOBl21 12112102 Form 4562 (2002) Form 4562 OMS No. 1545-0172 Depreciation and Amortization (Including Information on Listed Property) ~ See separate instructions. ~ Attach to your tax return. Department of the Treasury Internal Revenue Service '. 2002 67 Identifying number 23-1902508 Name(s) shown on return Dennis L, Gary W & Anna V Carey Business or activity to which this form relates 8825, Rental Real Estate - A artments and Gara e Election To Expense Certain Tangible PropertY Under Section 179 Note: If you have any listed property, complete Part V before you complete Part I. 1 Maximum amount. See instructions for a higher limit for certain businesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Total cost of section 179 property placed in service (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Threshold cost of section 179 property before reduction in limitation. . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . - 3 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -O~. . . .. .. . ... .. . . . .. . . . . . ... . . . .. . 4 5 Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing se aratel , see instructrons. . .. .. .. . . .. . . . .. . . . . . " .... . . . . . . . ., . . .. . . . . .. . . . . . . . . . .. .. .. . . . . . . . . . . . . . . . . . 5 6 a Description of property b Cost (business use only) e Elected cost $24 000. $200,000. 7 Listed property. Enter the amount from line 29. . . . .. . . ... . ..... . . . . .. . . . .. . .. . . . . . . 7 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7. . . . . . . . . . . . . . . . . . . . . . . . 8 9 Tentative deduction. Enter the smaller of line 5 or tine 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . 9 10 Carryover of disallowed deduction from line 13 of your 2001 Form 4562. .... . .. . .... .. . .. .. . . .. ..... .. ... .. 10 11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instrs) .. l' 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11..................... 12 13 Car over of disallowed deduction to 2003. Add lines 9 and 10, less line 12. . . .. .. . ~ 13 Note: Do not use Part /I or Part 11/ below for listed property. Instead, use Part V. :Paffjllr):t:/ S ecial De reciation Allowance and Other De reciation Do not include listed ro ert . 14 Special depreciation allowance for qualified property (other than listed property) placed in service during the tax year (see instructions). . . . .. . . .. . . . . . . . . . . . . .. .. . . ., .. . . ... . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . .. 14 15 Property subject to section 168(f)(1) election (see instructions). . . . . ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 16 Other de reciation (includin ACRS) see instructions.. . .... .. .. .. -. .. .. .. .... .. .. .. . . .. . .. .. . .. . . . ... ... 16 2,681. ~p'aft:Ult\;:- MACRS De reciation 0 not include listed ro e . (See instructions Section A 17 MACRS deductions for assets placed in service in tax years beginning before 2002. . . . . . . . . . . . . . . . . . . . . . . . . 18 If you are electing under section 168(i)(4) to group any assets placed in service during the tax year into one or more eneral asset accounts, check here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ Section B - Assets Placed in Service Durin 2002 Tax Year Usin the General De redation S stem (a) (b) Month and (e) ~is !or depreciation (d) (e) (I) (9) Depreciation Classification of property year placed (buslOessllnvestment use Recovery period Convention Method deduction in service on - see instructions) 25 27.5 27.5 39 2002 Tax Year Usin MM MM MM MM the Alternative De 12 rs 40 rs MM 21 22 2,790. FDIZ0812l12112102 Form 4562 (2002) 2002 Federal Statements Page 1 Dennis L, Gary W & Anna V Carey 23-1902508 Statement 1 Form 1065, Schedule L, Line 6 Other Current Assets Beginning Loan- Partner....................................................................... $ o. $ Total $ O. $ Ending 800. 800. Statement 2 Form 1065, Schedule L, Line 13 Other Assets Beginning Ending Rounding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ o. $ 4 . Total $ O. $ 4. Statement 3 Form 1065, Schedule M-2, Line 4 Other Increases Rounding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " $ Total $ 3. 3. Department of the Treasury Internal Rewnue Service 20'01 Form 1 065 u.s. Return of Partnership Income . .' .' . ~ See se rate instructions. For calendar ear 2001 or tax ar Innin 2001 and endin A Principal Business Activity Lessors B Principal Product ex Service Buildin s C Business Code Number Use the IRS label. Other- wise, print or type. IRS use on - Do not write or staple in Ihis . 20 OMS No.l545-Q099 D =:rr Identiftc.uon Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, PA 17055-5946 902508 Business Started /01 1972 Total Assets (see instrs) 71 105. Amended return 531110 $ G Check applicable boxes: (1) Initial return (2) Final return (3) Name change (4) Address change (5) H Check accounting method: (1) X Cash (2) Accrual (3) Other (specify).... ... I Number of Schedules K-1. Attach one for each person who was a partner at any time during the tax y;a-;' ~ ~ ~ ~ ~ ~ ~ ;. - - - - - - - '3 Caution: Include on/ytrade or business income and expenses on lines 1 a through 22 below. See the instructions for more information. 1 a Gross receipts or sales. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . 1a i~';.. b Less returns and allowances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b lc I N C 2 Cost of goods sold (Schedule A. line 8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0 3 Gross profit. Subtract line 2 from line 1 c. .. .. .. .. .. . . .. .. .. .. . . .. . . .. . .. .. .. . .. . .. .. . . .. . .. .. .. . . . 3 M E 4 Ordinary income (loss) from other partnerships, estates, and trusts (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 Net farm profit (loss) (attach Schedule F (Form 1 (40)). . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Net gain (loss) from Form 4797, Part II, line 18. ............. .. ... .... .... ... ..................... 6 7 Other income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Total income 0055). Combine lines 3 through 7. .. . .. .. . . .. . . .. . . . . .. . . .. .. . .. . .. .. . .. . .. . . .. . .. .. 8 s E 9 Salaries and wages (other than to partners) (less employment credits) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 E I 10 Guaranteed payments to partners. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 N 11 Repairs and maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 D s E T 12 Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 R D u 13 Rent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . '.' . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 U c T C I 14 Taxes and licenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 T 0 15 Interest........ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 I N s 16a Depreciation (if required, attach Form 4562) . . . . . . . . . . . . . . . .. .. . . . . . .. 1 16al .t.....;:::t;~:. 0 .:/:" :.?;"':{~.' N F b Less depreCiation reported on Schedule A and elsewhere on return . . . . 16b 16c s 0 R 17 Depletion (Do not deduct oil and gas depletion.). . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17' L 18 Retirement plans, ete. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '18 I M 19 Employee benefit programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 I T A 20 Other deductions T I (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 0 N s 21 Total deductions. Add the amounts shown in the far right column for lines 9 through 20... .......... 21 22 Ordinary Income 0055) from trade or business activities. Subtract line 21 from line 8. . . . . . . . . . . . . ~ . . 22 Under P.E!nalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of ~ knowledge and belief, It is true. correct. and complete. Declaration of preparer (other than general partner or limited liability company member) is based on all information of Sign which preparer has any kna.vledge. . Here ~ ~ ~ the IRS discuss this return wi the prerrer shown below Signature of General Partner or Limited Liability Company Member Date (see instrs) 1Xl. n X Ves No Preparer's c: tJ~~ \ : /2Jf;h ~ rA ~ ,,/ 13//.1 /&.1- I f'reparer's SSN ... Pl1N Signature Check if self- .. n. 199-05-9138 Paid employed. . . . Preparer's Firm's Name Ashwav & Haar, CPA's V (or ~ if Use Only se -employed), ~ 99 November Dr. , Suite 302 EIN ~ 23-1889600 Address, and ZIP Code Camp Hill, PA 17011-5064 Phone No. (717) 737-8111 BAA For Paperwork Reduction Act Notice, see separate instructions. PTPA0105L 01101102 Form 1065 (2001) Form 1065 (2001) Dennis L, Gary W & Anna V Carey 23-~902508 Page: r.ScliedUI~Jf','.t Cost of Goods Sold (see instructions) , Inventory at beginning of year. . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . 0 0 0 0 . . . . . . . . . . . 0 . . 0 . . . 0 . . . . . . . . . . 0 0 . . . . 0 . . . 0 . 1 2 Purchases less cost of items withdrawn for personal use. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 Cost of labor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Additional Section 263A costs (attach schedule). . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . 0 . 0 . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . 4 5 Other costs (attach schedule). . . 0 . . . . . . . . . . . . . . . . . . 0 . . 0 . . . 0 . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 Total. Add lines 1 through 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . 6 7 Inventory at end of year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . 0 . . . . . . . . . . . . . . . . . . 7 8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2. . .. . . . .. . . .. .. .. .. . . .. .. .. 8 9 a Check all methods used for valuing closing inventory: (i) ~ Cost as described in Regulations Section 1.471-3 01> Lower of cost or market as described in Regulations Section 1.471-4 (iii) Other (specify method used and attach explanation) . . . . . . - . . . 0 .. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Check this box if there was a writedown of 'subnormal' goods as described in Regulations Section 1.471-2(c) . . . . . . . . . . . . . . .. ~ [ c Check this box if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970). . . . 0 . . . . .. ~ d Do the rules of Section 263A (for property produced or acquired for resale) apply to the partnership? . . . . . . . . . 0 . . . . . . 0 0 Yes No e Was there any change in determining quantities, cost, or valuations between opening and Closing inventory? . . . . . . . .. 0 Yes No If 'Ves', attach explanation. l~qff.tllJ\iJ,:~~s};,~a1.w:{ Other Information , What type of entity is filing this return? Check the applicable box: a ~ Domestic general partnership b ~ Domestic limited partnership c Domestic limited liability company d Domestic limited liability partnership e Foreign partnership f Other..... ~ ____________________________ 2 Are any partners in this partnership also partnerships?.. .. .. .. . .. .. .. . . .. . .. . . .. .. ... . .. .. .. . .. .. . .. .. .. . .. .. 0 .. . .. 0 .. . . .. 3 During the partnership's tax year, did the partnership own any interest in another partnership or in any foreign entity that was disregarded as an entity separate from its owner under Regulations Sections 301.nOl-2 and 301.nOl-3? If yes, see instrtJCtions for required attachment . 0 . . . . . . . . . . . . . . . . . . . . . 0 . . 0 . . . . . . 0 0 . . . . 0 . . . . . . . . . . . 0 . . 0 . . 0 . . . . . . . . . 0 . . . . 0 . . . . . . . . . . . . 4 Is this partnership subject to the consolidated audit procedures of Sections 6221 hough 6233? If 'Ves,' see Designation of Tax Matters Partner below . . . 0 . . . . . . 0 0 . 0 . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . 0 . . . 0 . . 0 . . . 0 . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . 5 Does this partnership meet all three of the following requirements? a The partnership's total receipts for the tax year were less than $250,000; b The partnership's total assets at the end of the tax year were less than $600,000; and c Schedules K -1 are filed with the return and furnished to the partners on or before the due date (including extensions) for the partnership return. ~f 'Ves,' the partnership is not required to complete Schedules L, M-1, and M-2; item F on page 1 of Form 1065; or .tem J on Schedule K -1 . . . . 0 0 0 . . 0 . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . 0 . . . . . . . . . . 0 . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . 0 . . . . 6 Does this partnership have any foreign partners? If 'Yes,' the partnership may have to file Forms saM, 81)5 and 8813. See instructions. . . .0 . ; .: . 0 . . . .. . . 0 . 7 Is this partnership a publicly traded partnership as defined in Section 469(1<)(2)? . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . ~ . . . . . . . . . . . . . . 8 Has this partnership filed, or is it required to file, Fonn 8264, Application for Registration of a Tax Shelter? 0 .. . . . . .... ~ . .. . . . 9 At any time during calendar year 2001, did the partnership have an interest in or a signature or other authority over a financi~1 acco~nt in a foreign. country (~~h as a. bank account, securities account, or other financial account)? See the Instructions for exceptaons and fihng requirements for Form TO F 90-22.1. If 'Yes, I enter the name :of the foreign country.. ~ ------------------------------------------------ , 0 During the tax year, did the partnership receive a distribution from, or was it the grantor of, or transferor to, a foreign trust' If 'Ves: the partnerShip may have to file Form 3520. See instructions. . . .. 0 .. . . .. .. ... .. . .. .. . . .. .. . .. .. . .. 0.. .. . . . .. . . :.. . " Was there a distribution of property or a transfer (e.g., by sale or death) of a partnership interest during the tax year? If 'Ves,' you may elect to adjust the basis of the partnership's assets under Section 754 by attaching the statement described in the instructions under Elections Made by the Partnership. . . . . . . . . . . . . . . . . . . . . . 0 . . . . . 0 . . . . . ~ . . . . . . . . . . . . . . . . 0 . 12 Enter the number of Forms 8865 attached to this return ~ 0 Designation of Tax Matters Partner (see instructions) Enter below the general partner designated as the tax matters partner (fMP) for the tax year of this return: Name of Designated TMP ~ Gary W. Carey Address of 1781 Main St. Designated TMP ~ Lisburn, PA 17055 Identifying . NumberofTMP ~ 176-34-8350 No x x x x X X X x x PTPAOl12L 12103/01 Form 1065 (2001) Dennis L Ga, W & Anna V Care 23-1902508 Partners' Shares of Income Credits Deductions, etc (a) Distributive share items . 1 Ordinary income (loss) from trade or business activities (page 1, line 22) . .. . . . . . . . . . . . . . . . . . . 2 Net income (loss) from rental real estate activities (attach Form 8825). . . . . . . . . . . . . . . . . . . . . . . . 3a Gross income from other rental activities. . . . . . . . . . . . . . . . . . .. .. . . . 3a b Expenses from other rental activities (attach sch). . . . . . . . . . . . . . . . . . . . .. .. . . . 3b c Net income (loss) from other rental activities. Subtract line 3b from line 3a . . . . . . . . . . . . . . . . . . . 4 Portfolio income (loss): a Interest income.. . . .. .. . .. .. .. . .. .. .. . . .. . .. .. .. . .. . . .. . . .. . . . .. . b Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Royalty income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . d Net short-term capital gain (loss) (attach Schedule D (Form 1065))... . . . . . . . . . . . . . . . . . . . . . . . . e (1) Net long-term capital gain (loss) (attach Schedule D (Form 1065)).................... .... (2) 280/. rate gain (loss). . · _ _ _ _ _ _ _ _ _ _ _ (3) Qualified 5-year gain.. ~ _ _ _ _ _ _ _ _ __ f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . .. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 5 Guaranteed payments to partners .. . . . .. . .. .. .. . .. . .. .. . ... ... . .. . . .. .. .. . .. .. .. . .. . . .. .. . . 5 6 Net Section 1231 gain (loss) (other than due to casualty or theft) (attach Form 4797).. ........ 6 7 Otl1er income ss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Charitable contributions (attach schedule). . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 9 Section 179 expense deduction (attach Form 4562). . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Deductions related to portfolio income (itemize). .. . . .. . .. .. . .. . . . .. . .. .. .. . .. .. . .. .. .. .. . .. . 10 11 Other deductions. . . . . . . . . . . . . .. .. . . . . .. . . .. . . .. .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. 11 12a Low-income housing credit: (1) From partnerships to which Section 420)(5) applies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a (2) Other than on line 12a(1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a b Qualified rehabilitation expenditures related to rental real estate activities (attach Form 3468). . . . . . . . . . . . . . . . . . . . . . 12b c Ctedi1s (other than credits shown on lines 12a and 12b) related to rental real estate activities. . . . . . . . . . . . . . . . . . . . . 12c d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14a Interest expense on investment debts. . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14a b (I) Investment income included on lines 4a, 4b, 4c. and 4f above. . . . . . . . . . . . . . . . . . . . . . . . . . . . 14b Investment ex nses included on line 10 above. .. .. . .. - . . .. .. .. . .. . .. .. .. .. .. . .. . .. .. .. 14b 15a Net earnings (loss) from self-employment. . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15a b Gross farming or fIShing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15 b c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 c 16a Depreciation adjustment on property placed in service after 1986. . . .. . .. ... . . . . . .. . .. .. . . . . .. 16a b Adjusted gain or loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 b c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16c d (1) Gross income from oil, gas, and geothermal properties. . . . ... . .. . .. . .... . .. .... .. .. .. .... 16d (2) Deductions allocable to oil, gas, and geothermal properties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16d e Other ad'mnts & tax items. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16e 178 Name offorei~ country or U.s. possession..... .. _________ ______ __________ b Gross incolTle from all sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Foreign gross income sourced at partnership level: (1) Passive .. (2) Listed categories (attach sch) .. (3)Generallimitation ~ e Deductions allocated and apportioned at partner level: (1) Interest expense" (2)Other.. .. . . . . .. . .. .. . .. .. . .. .. .. . . .. . .... ~ f DeduCtions allocated and apportioned at partnership level to foreign source income: (1) Passive .. (2) Listed categories (attach sch) .. (3) General limitation ~ , 171 9 Total foreign taxes (check one):" 0 Paid D Accrued. .. .. . . . .. .. . . .. . .. . . .. .. .. .. .. 17 h Reduction in taxes available for credit attach schedule ..................................... ',17h 18 Section 59(eX2) expenditures: a Type... ~ ___ __ _________ _______b Amount.... .,' l8b 19 Tax-exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 Other tax -exempt income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. : 21 22 Distributions of money (cash and marketable securities) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 23 Distributions of property other than money. . . . .. .. . .. .. .. . . .. .. . . . .. .. . .. . .. .. . . .. .. . . .. .. .. . 23 24 Other items and amounts required to be reported separately to partners attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .'. . . . . . . . . . . . . . . . . . Income (loss) Deduc- tions Credits Invest- ment Interest Self. Employ-. ment Adjust- ments and Tax Prefer- ence Items Foreign Taxes Other BAA Pa e= 9 7 98 . 253. Form 1065 (2001) PTPAOl34L 01/01/02 Form 1065 (2001) Dennis L, Gary W , Anna V Carey 23-1902508 Anal sis of Net Income Loss 1 Net income (loss). Combine Schedule K. lines 1 through 7 in column (b). From the result. subtract the sum of Schedule K. lines 8 thro h 11. 14a. 17 , and lab.. .. .. .. .. .. . .. . . .. .. . . .. . . . . .. .. . . . . . . . .. . .. 1 2 Analysis by (i) Corporate (ii) Individual (iii) Indiyidual (Iv) Partnership (v) ~e~pt partner 1ype: (active) (passive) organIZation a ~= .. .. 9 798. b Limited .Sched"tilel..,X::'" Balance Sheets p i3ge 9 798 (vi) Nominee/Other Assets 1 Cash.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 a Trade notes and accounts receivable. . . . . . . . b less allowance for bad debts. . . . . . . . . . . . . . . . 3 Inventories.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 U.S. government obligations........ .. .. .... 5 Tax-exempt securities. . . .. . . .. . . ... .. . . . . . . 6 Other current assets (attach schedule). . . . . . . . . . . . . . . 7 Mortgage and real estate loans. . . . . . . . . . . . . . 8 Other investments (attach schedule). . . . . . . . . . . . . . . . . 9 a Buildings and other depreciable assets. . . . . . . b less accumulated depreciation. . . . . . . . . . . . . . lOa Depletable assets . . . . . . . . . . . . . . . . . . . . . . . . . . b Less accumulated depletion. . . .. .. . . . . . . . . . . 11 land (net of any amortization) . . . . . . . . . . . . . . 12 a Intangible assets (amortizable only) . . . . . . . . . b Less accumulated amortization. . . . . . . . . . . . . . 13 Other assets (attach schedule) . . . . . . . . . . . . . . 14 Total 'assets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ;, Uabilities and Capital 15 Accounts payable. . .. . . .. .. .. .. . . . .. .. .. . . .. 16 Mortgages, notes, bonds payable in less than 1 year. . . . . 17 Other current liabilities (attach sch). . . . . . . . . . . . . . . . . 18 All nonrecourse loans. .. . . . . . . .. . .. . . .. . . ... ' 19 Mortgages, notes, bonds payable in 1 year or more. . . . . . 20 Other liabilities (attach schedule). . . . . . . . . . . . . . . . . . . 21 Partners' capital accounts. . . . . . . . . . . . . . . . . . . 22 Total liabilities and ca ital.................. 61 307. '~'~"iilmi~ ~~~~~1~~~~~~~':;~)~~~~ ~')Income (Loss) per Return 71 105. 71 105. 1 Net income (loss) per books. . . . . . . . . . . . . 9.798. 6 Income recorded on books this year not included, ,- 2 Income included on Schedule K. lines 1 through 4, on Schedule K. lines 1 tf1cxdI7 (itemize): _ 6, and 7, not recorded on books this year (itemize): a Tax-exempt interest. . $------~---- ---------~---------- ------~------------- ------------------- 7 Deductions included on Schedule K. lines 1 through 11, 3 Guaranteed payments (other than health insurance) . 14a, 17g, and l8b, not charged against book income this 4 Ex~es recorded on books this ~r not included year (itemize): on Schedule K, lines 1 thr_l , 14a, 17g, and a Depreciation. . . . . $ , l8b (itemize): ----------- a Depreciation. . . . . . $----------- ----------------~---- b Travel and $----------- ------~------------- entertainment. . . . . 8 Add lines 6 and 7 . . . . . . . . . . . . . . . . . . . . . . . . ------------------- 9 Income (loss) (Analysis of net income 5 Add lines 1 throuah 4. . . . . . . . . . . . . . . . . . . 9 . 798 . (loss). line fi'. Subtract line 8 from line 5 . . 9. 7 98 . hSefildQle~M@2~J Analvsis of Partners' Capital Accounts (I ~ot reQuired if Question 5 on Schedule B is answered 'Yes. ') 1 Balance at beginning of year. . . . . . . . . . . . 61.307. 6 Distributions: a Cash. . . . . . . . . . . . . . . . . . . . . . 2 Capital contributed during year. . . . . . . . . . b Prope~ . .. .. .. .. .'. .. . . . . . 3 Net income (loss) per books. . . . . . . . . . . . . 9.798. 7 Other decreases (itemize): _ _ _ _ _ _ _ _ _ _ _ 4 Other increases (itemize): ---------- ----------------~--- ------------------- 8 Add lines 6 and 7. . . . . . . . . . . . . . . . . . . . . . . . 5 Add lines 1 throuah 4. . .. .. . . . .. . .. . . . . . 71.105. 9 Balance at end of year. Subtract line 8 from line 5. . . . 71.105. PTPAOl34l 01101102 Form 1065 (2001) Form 8825 Rental Real Estate Income and Expenses of a Partnership or an S Corporation .. See insbuctions. .. Attach to Form 1065, Form 1065-8, or Fonn 11205. OMS No. 1545.1186 Department of the Treasury Internal Revenue Service Name 2001 Dennis L W & Anna V Car 1 Show the kind and location of each property. See page 2 for additional properties. A Dwe1lin~ ________________________________________________________ -3814-01d Gettysburg Rd., Cumberland Co. B 2~~~~_~~_~~~2~~~______________________________________---------- 1781 Main St., Lisburn, PA C ~~~~~~t~_~~_~~____________________________~___________________ 1777-79 main St., Lisburn, PA Employer Identification Number 23-1902508 D ----------------------------------------------------------------~ Prop ~rties Rental Real Estate Income A 8 C D 2 Gross rents. . . . . . . . . . . . . . . . . . . . . . . . . . . 2 5,280. 8.200. 15,090. Rental Real Estate Expenses 3 Advertising. . . . . . . . . . . . . . . . . . . . . . . . . . . 3 4 Auto and travel. . . . . . . . . . . . . . . . . . . . . . . 4 5 Cleaning and maintenance. . . . . . . . . . . . 5 909. 6 Commissions. . . . . . . . . . . . . . . . . . . . ~ . . . . 6 7 Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 107. 251. 789. 8 Legal and other professional fees. . . . . . 8 145. 220. 425. 9 Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 10 Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 35. 765. 2.733. 11 Taxes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 842. 4.555. 1.224. ~ - 12 Util ities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 96. 96. 1.873. 13 Wages and salaries. . . . . . . . . . . . . . . . . . . 13 14 Depreciation (see instructions). . . . . . . . . 14 180. 814. 2.713. 15 Other (list) .. ------------- -------------------- ~------------------- 15 16 Total expenses for each property. Add lines 3 through 15.. .. .. .. . .. .. ... 16 1.405. 6.701. 10.666. 17 Total gross rents. Add gross rents from line 2, columns A through H. . . . . .. . . . .. .. .. .. . . .. . . . .. .. .. .. . .. . . . 17 28,570. 18 Total expenses. Add total expenses from line 16, columns A through H. . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . .. -18 -18 772. 19 Net gain (loss) from Form 4797, Part II, line 18, from the disposition of property from rental real estate activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 20 a Net income (loss) from rental real estate activities trom partnerships, estates, and trusts in which this partnership or 5 corporation is a partner or beneficiary (from Schedule K-1). . . . . . . .. . . '. . . . . . .. .. . . . . . . . . . . 20a b Identify below the partnerships, estates, or trusts from which net income Ooss) is shown on line 2Oa. Attach a schedule .f more space is needed: (1) Name (2) Employer identification number ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- ------------------------- 21 Net income Ooss) from rental real estate activities. Combine lines 17 through 2Oa. Enter result here and on: J . Fonn 1065 or 11205: Schedule K. line 2, or 21 9.798. . Form 1065-8: Part I, line 4 BAA For Paperwork Reduction Act Notice, see the separate instructions. Form 8825 (2001) SPSZ0101L 11115/01 Schedule K-' (Form 1065) Department of the Treaswy Internal Revenue Service Partner"s identi .n number ~ Partner's Name. Address. and ZIP Code Dennis L. Carey 1957 Sheepford Rd. Mechanicsburg, PA 17055 A This partner is a X general partner limited partner o limited liability company member B What type of entity is this partner? .. ~ _IE-~ .Yi-~ _ _ _ _ _ Cis this partner a ~ domestic or a D foreign partner? D Enter partner's % of: (i) ~_ or (ii) W Profit sharing.... __________ % ________~~ % Loss sharing..... __________ % ________~~ % Ownership of capital. . __________ % ________~~ % E IRS Center where hi filed return: Cincinnati J Ana is of rtne(s ca tal account: b Qualified rehabilitation expenditures related to rental real Credits estate activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. .. . .. . . . . .. . .. .. .. . . . .. .. .. 12c d Credits related to other rental activities . . .. . . . .. . . . . . . . . .. . . . . ... 12 d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 13 BAA For PapelWork Reduction Act Notice, see instructions for Fonn 1065. Income (Loss) Deduc- tions 'D~ "'~""a..... 1 Partner's Share of Income, Credits, Deductions, Etc OMS No. 1545.0099 2001 23-1902508 ,20 Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Kechanicsburg, PA 17055-5946 F Partner's share of liabilities: Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . .. $ Qualified nonrecourse financing. . . . . . . .. $ - - - - - - - - - - Other. . . . . . . . . . . . .. . . . . . . .. . . . . .. .. . . .. $ = = = = = = = = = == G Tax shelter registration number ~ --------------- H Check here if this partnership is a publicly traded partnership 0 as defined in Section 469(k){2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ I Check a licable boxes: Amended K-l (a) Capital account at beginning of year (b) Capi~1 contributed during year (e) Partner's share of lines 3, 4. and 7, Form 1065, Schedule M-2 2 449. (d) Withdrawals and (e) Capital account at end of distributions year (combine columns (a) through (cI)) 17 775. (e) 1040 filers ente} the amount In column (b) on: 15 326. (a) Distributive share item (b) Amount 1 Ordinary income (loss) from trade. or business activities. . . . . . . . . . . 2 Net income (loss) from rental real estate activities. . .. ... . . See. Line .25 3 Net income (loss) from other rerdaI activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Portfolio income (loss): a Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Royalties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Net short-term capital gain (loss).. . . .. .. .. .. . .. . .. .. .. .. .. . . .. . . e (1) Net long-term capital gain (loss). . . . . . . . . . . . . . . . . . . . . . . _ . . . . . (2) 28% rate. gain (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) Qualified 5-year gain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Guaranteed payments to partnec. . . . . . .. .. . . . . . .. .. . .. .. .. .. . . . . 6 Net Section 1231 gain (loss) (other than due to casualty ;, or theft). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . 6 7 Other income oss attach schedule ........................... 7 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . . . . . . . . 8 9 Section 179 expense deduction .. .. . . .. .. .. .. . .. .. . .. .. .. . .. .. . . 9 10 Deductions related to portfolio income (attach schedule). . . . . . . . . . . . . . . . . . . . .. 10 11 Other deductions attach schedule ..................................... 11 12a Low-income housing credit: (1) From Section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Other than on line 12a(1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 3 2 449. See Partner's Instructions for Schedule K-1 (Form 1(MiS). Schedule 8, Part I, line 1 Schedule 8, Part II, line 5 Schedule E, Part I, line 4 Schedule 0, line 5, column (f) Schedule O,line 12. coIurm (I) Schedule 0, line 12. coIulll1 (g) Une 4 of worksheet for Sch D, line 29 Enter on applicable In of yotI' return See Partner's Instructions for . .ScheduleK-1 (Form 1005). See Parlper's Instructions for Schedule K-1 (Form 1(MiS). Form 8586, line 5 See Partner's Instructions for Schedule K-l (Form 1~5). : Schedule K-1 (Form 1065) 2001 PTPA0312L 01/01102 2001 Dennis L W & Anna V Care Ga Schedule K-1 (Form 1 Invest- ment Interest Self- employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes Other 14a Interest expense on investment debts. . .. .. . . . .. . .. .. . .. . . -. . .. . . b (1) Investment income included on lines 4a, 4b, 4c, and 4f. - . . . . . . Invesbnent ex nses included on line 1 Q . . . . . . . . . . . . . . - . . . . . . 15a Net earnings (loss) from self-employment. . . . . . . . . . . . .. . . . - . . . . . . b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '6 a Depreciation adiustment on property placed in service after 198& . . . . . . . . - . . . . . . b Adjusted gain or loss. . . . .. . .. . . .. . . . . .. .. . . . . . . . . .. . . . . . . . . . . . . c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . d (1) Gross income from oil, gas, and geothermal properties. -. ... . . (2) Deductions allocable to oil, gas, and geothermal properties... . e Other ac:l" ustments &: tax reference items attach sch ........... 17 a Name of foreigl country or U.s. possession . ~ _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources . . . . .. .. . . . . . . . . .. .. . . . . . . .. . .. . . . c Gross income sourced at partner level. . . .. .. . . . . . . . . . . . .. - . .. . . . d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . _ . . . . .. 17 (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . .17 e Deductions allocated and apportioned at partner level: t~i (I) Interest expense. . .. .. . . .. . .. . . . .. . .. .. . . . .. .. . . .. . .. - . .. . .. l' (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . gTotal foreign taxes (check one): ~ 0 Paid DAccrued... h Reduction in taxes available for ~edit attach schedule ... . . . . . . . . . . . . . . . . . . . 18a Section 59(eX2> expenditures: a Type ~ _ _ _ _ _ _ _ _ _ _ _ _ __ b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Tax-exempt interest income. . . . .. . .. .. .. .. .. . . . . .. . . . . . .. . . . .. . . 20 Other tax-exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Distributions of money (cash and marketable securities).... . .... . 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . . . 2A Recapture of low-income housing credit: a From Section 42(j}(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 24a b Other than on line 24a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if more space is needed): Line 2 Rental Real Estate Activities (a) Distributive share item 23-1902508 (b) Amount Pa e (c) 1040 filers enter the amount in column (b) on: Form 4952, line 1 See Partner's Instructions for Schedule K-l (Form lmS). Schedule Sf, Section A or B See Partner's InstnJctions for Schedule K-l (Form 1(65). 63. See Partner's Instructions for Schedule K-l (Form 1065) and instructions for Form 6251. Form 1116, Part , Form 1116, Part II Form 1116, line 12. See Partner"s Instructions for Schedule K-l (Form 1005). Form 1040, line 8b See Partner's Instructions for Schedule K-l (Form 1005). Form 8611, line 8 Supple- Property Gross Net Net Passive Seo. 1231 mental Descr~pt:.i.on Income E~nses Income Nonpass Total Infor- Dwe11.ing 1,320. 351. $ 969. mation NonPass Office and Warehouse 2,050. 1,675. 375. NonPass Apartments and Garage 3,773. 2,667. 1,106. NonPass Rounding -1. Tota1 $ 2,449. Partner 1: Dennis L. Carey PTPA03121 01101102 210-40-2212 Schedule K-' (Form 1065) 2001 Schedule K-l Invest. ment Interest Self. e~a:r. Adj ust- ments and Tax Pref. erence Items Foreign Taxes Other 2001 Dennis L 23-1902508 (b) AmOUI'l W & Anna V Care (a) Distributive share item 14a Interest expense on investment debts. .. .. . . . . . . ... .. . .. . . .. . .. .. 14a b (1) Investment income included on lines 4a, 4b, 4c, and 4f . . . . . . .. 1 Investment ex nses included on line 10 . . . . . .. . . .. .. .. . . . ... 1 15a Net earnings (loss) from self-employment. .. . . . . . . . . . . . . . . . . . . . .. 15a b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15b c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15c 16a Depreciation adiusbnent on property placed in service after 198& . . . . . . . . . . . . . . . 16a b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16b c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16e d (1) Gross income from oil, gas, and geothermal properties. . . . . . .. 1 (2) Deductions allocable to oil, gas, and geothermal properties. . .. 1 e Other a<fusbnents & tax reference items attach sch....... ..... 16e 17 a Name of forei<J1 country or u.s. possession. ~ _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources. .. . .. . . . . .. . .. .. . . . .. .. . .. .. . .. .. 17b c Gross income sourced at partner level. . . . . . . . . . . . . . . . . . . . . . . . . .. 17c d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 (2) Listed categories (attach schedule). . . . . . . . . . .. . . . . .. .. .. . . . .. 17 (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 e Deductions allocated and apportioned at partner level: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 f Deductions allocated and apportioned at partnership level to foreigl source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g Total foreign taxes (check one): ~ D Paid DAccrued... h Reduction in taxes available for credit attach schedule). . . . . . . . . . . . . . . . . . . . . . 18a Section 59(eX2) expenditures: a Type ~ _ _ _ _ _ _ _ _ _ _ _ _ _ __ b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. lab 19 Tax-exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 20 Other tax-exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . ., 21 22 Distributions of money (cash and marketable securities).... _..... 22 23 Distri~ons of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 24 Recapture of low-income housing credit: a From Section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . b Other than on line 24a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 24b 25 Supptemental information required to be reported separately to each partner (attach additional schedules if monJ spa Line 2 Rental Real Estate Activities Supple- Property Gross Net Net mental Description Income Expenses Income Infor- Dwelling 1,320. $ mation 351. 96! Office and Warehouse 2,050. 1,675. 37! Apartments and Garage 3,773. 2,667. 1,10' Total. $ 2,451 Partner 2: Garv W. Carey PTPA03121 01101102 176-34-8350 Schedule K-1 (Form 1065) Department of the Treasury Internal Revenue Service Partner's identi .n number. Partner"s Name. Address. and ZIP Code Partner's Share of Income, Credits, Deductions, Etc OMS No. 1545-0099 2001 be "nnin 176-34-8350 23-1902508 ,20 Dennis L, Gary W & Anna V Carey Carey & Sons 1781 Main St. Mechanicsburg, _PA 17055-5946 F Partner's share of liabilities: Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . .. $ Qualified nonrecourse financing. . . . . . . .. $ - - - - - - - - - - Other. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . ... $= = = = = = = = = = = G Tax shelter registration number ~ --------------- Gary W. Carey 1781 Main St. Lisburn, PA 17055 A This partner is a X general partner limited partner o limited liability company member B What type of entity is this partner? .. .. _IE-~ ..Y';~..!l.!- _ _ _ _ _ C Is this partner a I!]domestic or a Dforeign partner? D Enter partner's % of: (i) Bef:~~ 01 (ii) ~ Profit sharing.... __________ % ________~~!Ii Loss sharing..... __________ % ________~~ % Ownership of capital.. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ ~~ , E IRS Center where rtnershi filed return: Cincinnati J An sis of er's ca. account: b Qualified rehabilitation expenditures related to rental real Credits estate activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. .. .. .. . . .. . .. . .. .. . . .. . . ... 12c d Credits related to other rental activities. . . . . . . . . . . . . . . . . . . . . . . . .. 12d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . .. 13 BAA For Paperwork Reduction Act Notice, see instructions for Fonn 1065. Income (Loss) Deduc- tions Partner 2 H Check here. if this partnership is a publicly traded partnership 0 as defined In Section 469(1<)(2) -. . . . . . . . . . . . . . . . . . . . . . . . . . .. . I Check a licable boxes: Amended K-l (a) Capital account at beginning of year (b) Capi~1 contributed during year (c) Partner's share of lines 3, 4, and 7, Form 1065, ScI1edule M.2 2 450. (d) Withdrawals and (e) Capital account at end of distributions year (combine columns (a) through (d)) 17 777. (c) 1040 filers enter the amount in column (b) on: 15 327. (a) Distributive share Item (b) Amount 1 2 3 1 Ordinary income (loss) from trade or business activities. . . . . . .. . . . 2 Net income (loss) from rental real estate activities. . . . . . . . . See. Line. 25 3 Net income (loss) from other rental activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Portfolio income (loss): a Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . b Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Royalties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d Net short-term capital gain (loss).. .. .. .. . . . .. . . .. . .. . . . .. . . .. .. . e (1) Net long.term capital gain (loss). . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) 28% rate gain (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) Qualified 5-year gain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f Other portfolio income (loss) (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Guaranteed payments to partne[ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Net Section 1231 gain (loss) (other than due to casualty or theft). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Other income oss attach schedule) . .... . .. .. .. .. .. .. .. . . .. .. . 7 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . . . . . . . . 8 9 Section 179 expense deduction . . .. . .. . . . .. .. . . . .. . .. . .. . . . .. . . . 9 10 Deductions related to portfolio income (attach schedule). .............. .. ..... 10 11 Other deductions attach schedule). .. .. . .. . .. . .. .. . . .. . . .. . . . . .. . . . . .. .. 11 12a Low.income housing credit: (1) From Section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Other than on line 12a(1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 450. See Partner's Instructions for Schedule K-1 (Form 1~5). Schedule a, Part I, line 1 Schedule B, Part II. line 5 Schedule E, Part I, line 4 Schedule 0, line 5. column (I) Schedule 0, line 12, column (f) Schedule 0, line 12, coIurm (g) Une 0\ of worksheet for Sch 0, line29 Enter on applicable In of your return See Partner's Instructions for 'Schedule;:K-1 (Form 1(05). See Partner's Instructions for Schedule K-l (Form 1(05). Form 8586, line 5 See Partner's Instructions for Schedule K.1 (Form 1065). -. Schedule K-1 (Form 1065) 2001 PTPA0312L 01101102 Schedule K-1 Invest- ment Interest Self- employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes . Other 2001 Dennis L W & Anna V Care 23-1902508 (b) Amount 14a Interest expense on investment debts. . . .. . . . . .. .. . . . . . . . . - . . . . . . b (1) Investment income included on lines 4a, 4b, 4c, and 4f... ... . . Investment ex nses included on line 10 . . . . . . . . . . . . . . . . . . . . . 1Sa Net earnings (loss) from self-employment. . . . . . . . . . . . . . . . . . . . . . . . b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16a Depreciation adjustment on proper1J placed in service after 1986. . . . . . . . . . . . . . . . b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d (1) Gross income from oil, gas, and geothermal properties. -' ... . . (2) Deductions allocable to oil, gas, and geothermal properties. . . . e Other ad.ustments & tax reference items attach sch ........... 17 a Name of foreign country or U.s. possession. ... _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross income sourced at partner level. . .. . . . . . . . . . . . . . .. . . . . .. . . d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., 1" (2) Listed categories (attach schedule). . . ... .. .. . . . . . . . . . . .. . . . .. 1'J (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17 e Deductions allocated and apportioned at partner level: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f Deductions allocated and apportioned at partnership level to forei~ source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g Total foreign taxes (check one): ~ 0 Paid 0 Accrued. . h Reduction in taxes available for credit attach schedule ............... . . . . . . . 18a Section 59(eX2) expendibJres: a Type ~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 18b 19 Tax.exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 20 Other tax-exempt income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 20 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 21 22 Distributions of money (cash and marketable securities).. . . .. .... 22 23 Distri~utions of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 24 Recapture of low-income housing credit: a From Section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . .. . . .. 24a b OtI1er than on line 24a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if tmre space is needed): Line 2 Rental Real Estate Activities (a) Distributive share item Pa e (c) 1040 filers enter the amount in column (b) on: Form 4952, line 1 See Partner's Instructions for Schedule K-l (Form 1005). Schedule SE. Section A or B See Partner's InstructioRs tor Schedule K-1 (Form 1005). 63. See Partner.s Instructions for Schedule K-l (Form 1065) and instructions for Form 6251. Form 1116, Part I Form 1116, Part II Form 1116 line 12. See Partne(s Instructions for Schedule K-l (Form 1(05). Form 1040. line 8b See Partne(s Instructions for Schedule K-l (Form 1005). Form 8611, line 8 Supple- Property Gross Net Net Passive Sec. 1231 mental Descri~tion Income Exoenses Income NOl'\pas.s Total Infor- mation Dwelling 1,320. 351. $ 969. NonPass Office and Warehouse 2,050. 1,675. 375. NonPass Apartments and Garage 3,773. 2 , 667 . 1,106. NonPass Tota1 $ 2,450. Partner 2: Garv W. Carey PlPA0312L 01101102 176-34-8350 Schedule K..1 (Form 1065) 2001 Schedule K- 1 (Form 1065) De~nt of the Treasury Internal RewnU8 Service Parlne(s identi n number ~ Partner's Name. Address. and ZIP Code Anna v. Carey 1781 Main St. Lisburn, PA 17055 A This partner is a X general partner o limited liability company member B What type of entity is this partner? .. ~ _I.!!~ ..Yi-~ _ _ _ _ _ C Is this partner a ~ domestic or a D foreign partner? DEnter partner's % of: (i) aer::..~ 0( (if) ~ Profit sharing. . .. _ _ _ _ _ _ _ _ _ _ % _ _ _ _ _ _ _ _ -.?.Q % loss sharing..... __________ % ________li.Q % Ownership of capital. . __________ % ________E2 % E IRS Center where rtnersti filed return: Cincinnati J .5 of er's QI .taI account: (a) Capital account at (b) Capital contributed beginning of year during year 1 Ordinary income (loss) from trade or business activities. . . . . .. . . . . 2 Net income (loss) from rental real estate activities. . . . . . . . . See. Line . 25 3 Net income (loss) from other rental activities. . . . . . . . . . . . . . . . . . . . . . .. ..... . 4 Portfolio income (loss): a Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ... . . . b Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . c Royalties. . . . . . . . . . . . . . . . . . . . . '.' . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . d Net short-term capital gain (loss). .. . . . .. .. . .. .. .. . . . . . .. . . .. . .. . e (1) Net long-term capital gain (loss). . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) 28% rate gain (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) Qualified 5-year gain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f Other portfolio income (loss) (atlat:h schedule). . . . . . . . . . . . . . . . . . . . . . . .. . . . . 5 Guaranteed payments to partneL . .. .. .. . .. . . . . . . . . . . .. . . . . . . . . . 6 Net Section 1231 gain (loss) (other than due to casualty or theft). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Other income ass attach schedule ........................... 8 Charitable contributions (see instructions) (attach schedule). . . . . . . . . . . . . .. . . . . 9 Section 179 expense deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Deductions related to portfolio income (attach schedule). . . . . . . . . . . . . . . . . . . . . . 11 Other deductions attach scheduleJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a low.income housing credit: (1) From Section 42(j)(5) partnerships. . . . . . . . .. . . . . . . . . . . . . . . . . . (2) Other than on line 12a(1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Qualified rehabilitation expenditures related to rental real Credits estate activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Credits (other than credits shown on lines 12a and 12b) related to rental real estate activities. . .. . .. .. .. . .. . .. .. . . . . . .. . .. 12 c d Credits related to other rental activities .. . .. . . .. . . . .. .. . .. . .. . . .. 12 d 13 Other credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 13 BAA For Paperwork Reduction Ad Notice, see instructions for Form 1065. Income (Loss) Deduc- tions Partner 3 Partner's Share of Income, Credits, Deductions, Etc OMS No. 1545.0Q99 2001 be innin 204-30-8190 23-1902508 ,20 Dennis L, Gary W & Anna V Carey Carey & Sons 1 781 Main St. Mechanicsburg, PA 17055-5946 limited partner F Partner's share of liabilities: Nonrecourse. . . . . . . . . . . . . . . . . . . . . . . . . .. $ _ _ _ _ _ _ _ _ _ _ ~ Qualified nonrecourse financing. . . . . . . .. $_ _ _ _ _ _ _ _ _ _ ~ Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $_ _ _ _ _ _ _ _ _ _ = G Tax shelter registration number .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ H Check here if this partnership is a publicly traded partnership as defined in Section 469(k)(2). . . . . . . . . . . . . . . . . . . . . . . . . . . ... 0 I Check a licable boxes: Amended K-l (c) Partner's share of lines 3, 4. and 7, Form 1065, Schedule M-2 (d) Withdrawals and (e) Capital account at end of distributions year (combine columns (a) through (d)) 35 553. (c) 1040 filers enter the amount in column (b) on: 30 654. (a) Distributive share Item 4 899. (b) Amount 1 2 3 4 899. See Partner's Instructions for Schedule K-l (Form 1005). Schedule B, Part I, line 1 Schedule B. Part II. line 5 Schedule E, Part I, line 4 Schedule 0, line 5, coIurm (f) Schedule D, line 12, column (I) Schedule 0, line 12, column (0) Une 4 of worksheet for Sch D, line 29 Enter on applicable In of your return see Partner's Instructions for 'Schedule:K.l (Form 1(65). See Partner's Instructions for Schedule K-l (Form 1(65). Form 8586, line 5 See Partner's Instructions for Schedule K.1 (Form 1(05). . Schedule K-l (Form 1065) 2001 PTPA031a 01/0tlO2 Schedule K-1 Invest- ment Interest Self- employ- ment Adjust- ments and Tax Pref- erence Items Foreign Taxes Other 14a Interest expense on investment debts. . . . . . . . . . . . . . . . . . . . . . . . . . .. 14a b (1) Investment incOme included on lines 4a, 4b, 4c, and 4f. . . . . . .. 1 Investment ex enses included on line 10 .. .. . .. . . . . . . .. . . . . .. 1 15a Net earnings (loss) from self-employment. . . . . . . . . . . . . . . . . . . . . . .. 15a b Gross farming or fishing income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15b c Gross nonfarm income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15c 16a Depreciation adjustment on property placed in service after 1986 . . . . . . . . . . . . . .. 16a b Adjusted gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16b c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 16c d (1) Gross income from oil, gas, and geothermal properties. . . . . . .. 1 (2) Deductions allocable to oil, gas, and geothermal properties. . .. 1 e Other ad'ustments & tax reference items attach sch............ 16e 17 a Name Ii foreign country or U.s. possession. · _ _ _ _ _ _ _ _ _ _ _ _ _ b Gross income from all sources . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Gross income sourced at partner level. . . .. . . . . .. .. . . . . . . . .. .. . . . d Foreign gross income sourced at partnership level: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) Listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e Deductions allocated and apportioned at partner level: (1) Interest expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1~ (2) Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1~ f Deductions allocated and apportioned at partnership level to foreign source income: (1) Passive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2) listed categories (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . (3) General limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Total foreign taxes (check one): · 0 Paid D Accrued. . h Reductioo in taxes available for credit atlacb scheduIa . . . . . . . . . . . . . . . . . . . . .. 17 h 18a Section 59(eX2) expenditures: a Type. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ : b Amount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 18b 19 Tax-exempt interest income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 20 Other tax-exempt income.. .. . . . .. .. . .. . . . . . . . .. . .. . . . . .. . . .. . .. 20 21 Nondeductible expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 21 22 Distributions of money (cash and marketable securities) . . . . . . . . . . 22 23 Distributions of property other than money. . . . . . . . . . . . . . . . . . . . . .. 23 24 Recapture of low-income housing credit: a From Section 42(j)(5) partnerships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Other than on line 24a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 24b 25 Supplemental information required to be reported separately to each partner (attach additional schedules if rmre space is needed): Line 2 Rental Real Estate Activities 2001 Dennis L W & Anna V Care (a) Distributive share item 23-1902508 (b) Amount Pa e; (c) 1040 filers enter the amount in column (b) on: Form 4952. line 1 See Partner's Instructions for Schedule K-l (Form 1005). Schedule Sf. Section A or B See Partner's Instructions for Schedule K-l (Form 1065). 127. See Partner's Instructions for Schedule K-1 (form 1 ~ and instructions for Form 6251. Form 1116, Part I Form 1116, Part II Form 1116, line 1~. See Partner"s Instructions for Schedule K-1 (Form 1065). Form 1040, line 8b See Partner's Instructions for Schedule K-1 (Form 1065). Form~11, line 8 Supple- Property Gross Net Net Passive Sec. 1231 mental Description Income E~nses Income ,Nonpass Tota1 tnfor- Dwelling 2,640. 703. $ mation 1,937. NonPass Office and Warehouse 4,100. 3,351. 749. 'NonPass Apartments and Garage 7,545. 5,333. 2,212. NonPass Rounding 1. Total. $ 4,899. "P\__.;L._.....__ -:>>. ~'"......-:. '7 ~=-rAV PTPA0312L 01101102 204-30-8190 Schedule K-l (Form 1065) 200 Life and Annuity Claims P.O. Box 94212 Palatine, IL 60094-4212 ~ Allstate~ You're in good hands. August 4, 2005 Stone LaFaver & Shekletski Attn: David H. Stone, Attorney at Law 414 Bridge St. P.O. Box E New Cumberland, PA 17070 Re: Administrator for: Contract No: Anna V. Carey Allstate Life Insurance Company GA16866428 Dear Mr. Stone: We have been requested to complete Internal Revenue Service (IRS) Form 712 with regard to the referenced contract. The purpose of Form 712 is to provide an estate or donor with the value of a life insurance contract or with its proceeds as of certain date (usually the owner's date of death or date of transfer of the contract). The contract referenced was an annuity contract, which is not reportable on IRS form 712. The following information is provided regarding the value of the annuity and other data as of the date specified: Date of Death: June 21, 2005 Annuity Value* as of Date of Death: $ 156,250.23 Cost Basis: $ 150,000.00 (post-TEFRA) Named Beneficiaries: Dennis L. Carey and Gary W. Carey *The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender Charges. If you have any questions, or need further assistance, please contact the Customer Care Unit at (877) 499- 6418. Sincerely, Shawna Navik Life and Annuity Claims Overnight Address: 544 Lakeview Parkway, Vernon Hills, IL 60061 Toll Free Fax: 1-866-635-4523