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", ':/:,,:'.11 ',. 1',1' " ", >,1' l\ ,:1' 'I'" ,,'\: ,0' ,. .,' , " ',: " I.:;. ~ 'I, ' ,~l!\!>,\ ~.t:.. PETITION FOR PROBATE and GRANT OF LETTERS 21-94- ~ 8 &tale of Jamos H. F'lckol, Jr. also known as No. To: -- Register of Wills for ihe d Deceased. County of Cumbo ran In the Sodal Security No. -ill- 2 2 - 6 2 7 7 Commonwealth of Pennsylvania The petlllon of the undersigned respectfully represents that: Your petllloner(s), who Is/are 18 years of age or older an the execut r 1 x _ named In the last will of the above decedent, dated nncnmbor 16 , 19..!!lL- and codlcll(s) dated R"I1-' (IIAle relevanl clrcumuan"" 0.&, renunclallon. dealh ot e,eCUlor, atc,) Decendent was domlclled at death In Cumberland County, Pennsylvania, with " is last famlly or principal residence at 245 Mooroland Avonue. Ca r 1i Ale ((/slmcoI. number and munclpaJily) Decendent,lhen 65 years of age, died Januarv 13 ,19 94 at CarJiAln HOApital . Except as follows, decedent did not marry, was not divorced and did not have a chlld barn or adopted after execution of the will offered for probate: was not the victim of a killing and was never adjudicated Incampetent: . no no Decendent at death owned property wllh estimated values as follows: (If domlclled In Pa.) All personal property (If nat domlclled In Pa.) Personal property In Pennsylvania (If not domiclled In Pa.) Personal property In County Value of real estate In Pennsylvania . situated as follows: $ $ $ ~oq $- 0(':10 WHEREFORE, petltloner(s) respectfully request(s) the probate of the last will and codlcll(s) presented herewith and the grant of letters testamentary (leuamenlary; admlnlslrallon C.I,a,; admlnlmkllon d.b.n,c,l.a,) theron. II l~ ':1.. lI. So J &;.' :Le' /J/I . I !I1/!{)a, .('/ /j v Virginla D. Fickel 245 Mooreland Avenue Carlisle. PA 17013 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF CUMBERLAND The petltloner(s) above.namrd swear(s) or affirm(s) that the statements In the foregoing petition arc true and correct to the best of the knowledge and belief of petitloner(s) and that as personal represen- tatlve(s) l'f the above decedent pc,llioner(s) will well and trttly administer the estate according to law. 1//(1 ,', I ';" .,./; /) Sworn 10 or afflr!Jle~ and subscribed ' '! / t e"/' ("1( ,.( -<".ft",\, ~ beQremClhlst,." d,,{lf, :/ ~ ." ,) , f"'-'!l" tE' ~ ' I (.c,A.),. i '(d,nia D. Fickel ~ LEWIS RCRi.uer .' ~ No. ?l_Q..i_ ~* Estate of JAMES R. I'ICKEL, JR. , Deceased DECREE OF PROBATE AND GRANT OF LETI'ERS AND NOW JANUARY 28. I!L2.L In corulderallon of the petillon on the reverse side hereof, satisfactory proof havlnll been presented before me, IT IS DECREED that the l/lJtrument(s) dated December 16, 1911.8 described therein be admitted to probate and filed of record as the last will of Fickel, Jr. and Letten Testamentary are hereby granted to Virginia D. Fickel a/k/a Virginia rTCKel James R. FEES Probate, Letters, Etc. ......... $ 30~. 00 Shon Cenlflcates( 5) , .. , .. .... $ 1 5 . 00 R.~n\!llclatlon ,..,............ $ . x-pages jO.uu JCP $ 5 88 TOTAL _ $ 361 :00 FUed ..... ~.~~~~~.y. '?~'" .1.~?'. II........ ~A~r(6,Y21 "'~pu ./J~ t'/ii&- :; RealJter 01 WllIJ ";Jl/ MARY C. LEWIS FLOWER MORGENTHAL FLOIIER & LINDSAY James D. nower, Jr. (27742) ATIORNBY (Sup, <:1. 1.0, No.) 11 E. High St., Carlisle, PA 17013 ADDRESS 717-24.3-5513 PHONE ',...... co t;]iC '-. (.".1 ,~ ) ,~ r" " I' " [).. , In N , ~ ,. U ',!: 'j g'I' "r dd ccn:: flI Called attorney on 1-28-94. ., "~I " ~ .+-i ~ ''+41 tl "I ,il ',I' '1'1,' I), I'i " "" " '1 .. 'I.' " , , 1(' I' ,'.' ,,, .. ',i ,'i,' \,,'1 it ~ ~ ,. ,,' iI, HI. " .. " ,. , ii.,', ," (,' '. , , , I'. ,. I.!; ,J' .' \1.4 ~ ,. 'Ii I, ,. ,. "' , 1-., ," ", ',., I' I'," ". (; " ~ . ~, 'u H r.. .' rt: Ul "[;1 ~ " " 'I , , " ,. Ii " (' 'I,' " , '. " ., " .. ,. , "i. ". ,I,' "' " ;. " ". .' I' \' " .. ,. " 'l \. .:1'1; " ,-' " ,. I" ,. , . , . i" , I, ,. " I'. >I," ,. , , , " .' I" ,PO Pr~ lli j\' "" \ . .,1< ~ ' 'aU ):>.:\. "I. 'I~ " " .' " " .\ '.' IJ 'I'" ,. " , , ,', ." il. ,. ,'Ii /, " " 'I, ;"i 'i'., .' " " .' ,. , p ,I I'; J' " ., (, " , L' I, , I,' , " " " i, , "j '\ " '", 'II' .~ ,$; ~ D!' . "\1 ..... ,~ I"" .,. '" ,,' .,. ,. , .' i' "10 ,"j I !:' 'ii " ,," , ::0 :I1eu ' ell n ,In f) ((,',7:; r,~ ni" , ell, .' "",'; :'1-:'", ~,~-;' I ' Iii tl. ~. ~ ~ I~ II .; F.; \. I" " I" "' ji ,'(" . .. " II " 'I' , 'it , .' , , ' '" '\1', ,. ,'I , !I" ',"" '" '1',\ ",' ,. .. . . ", 1. I," " ", " ,,' I) , '," "I' ii', ... .' , " , ,. 'Ii Fickel; 112/5/881 D29 .' " East JlUI aub Westament I. OF I JAMES R. FICKEL, JR. I I I I I I I , I I, JAMES R. FICKEL, JR., of the Borough of Carlisle" Cumberland County, Pennsylvania, being of sound and disposing mind, memory and underst!\nding, do hereby make, pub.Lish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codioils, or writinge in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Ex~cutor, hereinafter named, to pay all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, " I I Transfer and Suocession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I hereby give and beQueath my antique Winchester Rifle, Serial No. 97160, and all other antique guns, to my son, William K. Fickel. THIRD: I hereby give and bequeath my tangible personal property to my wife, Virginia D. Fickel. fr~flUJ - 1 - 12/5/88; D29 , , FOURTH: I hereby give, devia~ and bequeath to the Farmers Trust Company, IN TRUST NEVERTHELESS, an amount equal to the exemp.tion equivalent of the maximum unifed oredi t allowed by Federal Estate Tax law in effeot at the time of my death; provided, however, that suoh flum ehall bo reduoed by an amount, if any, equal to the total of any other amounts reoei ved by .the Trustee as a result of my death whioh qualify for the unified oredit against Federal Estate Tax. The net inoome from the Trust shall be paid in quarterly installments, or more frequently if desired, to and for the use and benefit of my wife, Virginia D. Fickel, for and during the term of her natural life. In addition, after taking into aooount all other finanoial resouroes available to my said wife, as muc.:h of the prinoipaJ as the Trustee from time to time in its eole disoretion may deem desirable for my said wife's health, maintenanoe and support either shall be paid to her or ,shall be applied direotly for her benefit by the Truotee in order to maintain her in aooordanoe with the otandard of living to whioh she has beoome aooustomed at the time of my death. Upon written request of my said wife, up to five (5%) peroent or $5,000.00 of the prinoipal, whiohever is greater, may . ~ ",",,, Il a.JH - 2 - 12/5/88; D29 be withdrawn from the Truet annually and shall be paid to my wife by the Trustee upon suoh request. To the extent that suoh right of withdrawal of prinoipal shall not be exeroised by Deoember 31 of ar.y year, suoh right shall lapse. Upon the death of my said wife, the oorpus of the Trust shall be distributed abssolutely and free of trust to my three ohildren, Linda J. Niesen, William K. Fiokel and David J. Fiokel, in equal shares, share and ahare alike, per stirpes. FH'TH: All the rest, residue und remtnnAr of my estate, be it real, personal or mixed, of whatsoever kind and whereaoevar situate, I hereby give, devise and bequeath to my wife, Virginia D. Fiokel. SIXTH: In the event that my said wife, Virginia D. Fiokel, shall predeoease me, I hereby give, devise and bequeath all the reet, residue and remainder of my estate, be it real, personal or mixed, of whatsoever kind and wheresoever situate, to my ohildren, Linda J. Niesen, William K. Fiokel and David J. Fiokel, in equal shares, per stirpes. SEVENTH: In the event that any of my ohildren shall predeoease me without issue surviving, I hereby give, devise and ~~~V({ ~/ - 3 - 12/5/88; D29 I . ' bequeath his or her share to my surviving ohildren or the issue of deoeased ohildren, per stirpes. EIGHTH: In the event that my aaid wife shall predeoease me, and my said ohild ren shall predeoease me without issue surviving or die without issue surviving before reoeiving final distribution of any interest as the result of this, my Laet Will and Testament or any trust oreated hereunder, I hereby give, deviee and bequeath all the reet, residue and remainder of my estate to the First Evangelioal Lutheran Churoh, of Carlisle, Pennsylvania, to be added to and beoome a part of its permanent endowment fund. The income shall be used annually by the governing body of the church for the purposes and in the best interest thereof. NINTH: In the event that one of my ohildren shall die with issue surviving, aftsr my death but prior to reoeiving his or her final distribution hereunder, and such issue surviving are under the age of 21 years, the share of eaoh euoh ieeue shall be held by the Trustee hereunder until such issue shall reach the age of 21 years. The net inoome shall be paid in quarterly inistallments, or more frequently if desired, to and for the use and benefit of suoh iesue and as muoh of the prinoipal as the -C)"""" d1 !lAtt L - 4 - 12/;/88; D29 Trustee from time to time in hIe eole discretion may deem desirable shall be used for such issue's health, maintenanoe, general welfare and educatIon; provided, however, in the event that there Is more than one suoh issue and the funds are oombined for purposes of administration, no such issue shall reoeive more than his or her pro rata share of the income and prinoipal dus hereunder. TENTH: Each and every beneficiary hereunder or of any trust created hsreby is hereby restrained from and is or shall be without right, power and authority to sell, transfer, pledge, mortga.ge, hypothecate, alienate, anticipate or in any manner effect or impair his, her or their benoficial and legal rights, titles, interests, claims and estates in and to the inoome or prinoipal of the Trust Estate during the term hereof, nor shall the rights, titles, interests, olaime and estates of any benefioiaries hereunder be subject to the rights or claims of oreditors of any suoh beneficiary nor subject or liable to any process of law or court, and all of the income or principal of the Trust Estate shall be transferrable, payable and deliverable only, solely, exclusively and personally to the designated benefioiary hereunder at the time entitled to take the same under -1=~ - ; - 12/5/88; D29 the terms of this Trust and the personal receipt of the designated beneficiary hereunder shall be a oondition preoedent to the payment or delivery of the same by the Trustees to eaoh said beneficiary. ELEVENTH: In the event that my said wife and I should die as a result of B oommon disBster, or under such circumstances as to render lt difficult or impossible to determine who predeceased whom, I hereby deolare it to be my intention and direction that I shall be oonolusively presumed to have predeceased my said wife, statute, law or rule to the contrary notwithstanding, and this, my Last Will and Testament shall be oonstrued on that assumption or basis. TWELFTH: In the event that any beneficiary of the trust hereunder shall be dissatisfied with the management of the Trust by the Trustee, for any reason whatsoever, the beneficiary or his or her legal guarddiun may petition a Court of appropriate jurisdiction to have the Trustee removed, and shall have an absolute right to have an alternative Trustee appointed. Upon receipt of such a Petition, the Court shall remove the Trustee and upon filing of proper Acoo~nts, disoharge the Trustoe of any and all liability. The Court shall then appoint a new Trustee C1~.I"" '12.. ~ J )~ -rUck 'P-:Sit.. - 6 - 12/5/88; D29 subjeot to the same powers and duties set forth in this my Last Will and Tefltament, 8uoh appointment being made after taking into acoount but being bound by the wishes expressed by the beneficiary in qU8fltion. THIRTffiENTH: I hereby give and grant to my Executor and Trustee hereunder, and their 8uccessors, hereinafter sometimes oalled "Fiduciary" or "Fiduciaries", the following powers, duties and discretion in addition to those now or hereafter conferred by law, to be exercised in an;}' capacity to which such powers may be applioable, and in the best interest of my estate and benefioiaries: 1. To purohase or otherwiee acquire or receive and to retain whether originally a part of the Probate or Trust Estate or subsequently acquired, any and all stocks, bonds, notefl or other securities, or any variety of real or personal property, including stocks or interest in investment trusts and common trust funJs as it may deem advisable, inoluding speoifically authorization to rotain, buy or sell any shares of the fltock of any corporate Fiduoiary. 2. To sell, pledge, mortgage, transfer, exchange, oonvert or ~therwi8e dispose of, or grant options with respeot ~(.IOb~ 1l Mil - 7 - .tM-,.,~."I,:,' ...I""t,',, ',','.\C"""I ., ,,,I, .'''~'''I.' 12/5/88; D29 . to, any and all property at any time forming .a part of the Probate or Trust Estate in suoh manner, at suoh time or times, for suoh purposes, for suoh prioes and upon suoh terms, oredits and oonditions as it may deem advisable. 3. To borrow money for any purpose conneoted with the proteotion, preservation or improvement of the Probate or Trust Estate whenever in ita judgment advisable, and as seourity to mortgage or pledge any real or personal property forming a part of the Probate or Truat Estate upon suoh terms and oonditions as it may deem advieab1e. 4. To vote, exchange, and otherwise exeroiee all rights, privileges or options in any way pertaining to the stooks, bonds, eeouritieE: and other assets at anytime belonging , ' to the Probate or Trust Estate; provided, however, that with respeot to any ehares of stook belonging to the Probate or Trust Estats, the beneficiaries hersunder may determine the manner in which said sharee shall be voted and may aotually direot how suoh shares shall be voted. 5. To hold investments in the name of its nominee. +U~ (i i~ - 8 - 12/5/88; D29 6. To make alterations of, repairs upon, additions to and erect improvements upon real estate and to make leases therefor for sach terms as it may deem advisable. 7. To make distribution of the prinoipal and acorued income, if any, of the Trust Estate to and among those entitled thereto at the termination of the Trust in kind or in oaeh, or partly in kind or partly in oaeh, as it deems proper, just and equitable. 8. To determine the manner of asoertainment of inoome and prinoipal in the apportionment of reoeipts and expenses by the tenants and remaindermen of the Probate or Trust Estate. 9. To oompromise olaime, exeoute and deliver any and all instruments in writing whioh it may deem advisable to oarry out any of the foregoing powers. No party to any such agreement in writing signed by the Exeoutor or Trustee shall be obliged to inquire into its validity, or be bound to see to the application by the Exeoutor or Trustee of any money or other property paid or delivered to it by suoh party pursuant to the terms of any su6h agreement. 10. To pay all taxes and governmental oharges, of whatsoever oharaoter, levied or assessed upon or payable by the -4 Ii 1. Iii (lm-lv': ~/ f/ - 9 - I,"" , ,': i, ~ ' 'i> ~ ,';, , ~l \"'" ,-:' ".., ~ ,) , I,' '(,,\ \,1' ~:.. , "') ." , 12/5/88; D29 Trustee, wit, respeot to the Probate or Trust Estate, and all expensee of the administration of the Trust and all interest payable on aocount of any indebtedness or liabilities oontraoted, inourred or assumed by the Trustee, from the inoome of the Probate or Trust Estate, unless the Trustee, in its sole discretion, shall deem advisable under the circumstanoes that all or part thereof should equitably be paid out of the principal of the Probate or Trust Estate. 11. To, in the case of the Trustee, buy assets from and lend money to the personal reprosentative of my estato and to advanoe funds without reimbursement for the payment of the expenses of the administration of my estate includinG all taxes by reason of my death; provided, however, that benefits from 9ualified pension or profit sharing plans received by the Trustee shall not be used for the purpose of paying such expenses or suoh taxes. 12. To distribute the principal of the Probate or Trust Estate to the then inoome benefiCiary if in the Trustee's disoretion the amount of the principal of the Probate or Trust Estate is so small as to be impractical or uneoonomioal to administer properly. % t""y (Z1#-"I/Y - 10 - '_"'''''''~h ,'..,...'~d.,r,'..',,,.,...~.,"'t," ,.,....t,.../'( '._'" ; , " .' "'\."~""jI'" 1.1.''''''' ~ '.- \ --',,' ",',' .' 'I'll'" , ~' " 12/5/881. D29 . , , ' LASTLY: I. hereby nominate, oonsti tute and aJlPoint my wife, Virginia D. Fiokel, to be the Exeoutrix of this, my Lust Will and Testament. In the event thut wife shall be unable to serve as Exeoutrix for any reason, I appoint James D. Flower, Jr., as Exeoutor. No personal representative shall be required to file bond in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this -1 tJ *:h day of Deoember, 1988. ~_R:-1;. tlljr lies R. Fio~,"1;.: , SIGNED, SEALED, PUBLISHED and DECLARED in the presenoe of: (SEAL) I. , " " , 'I, I ,I " I, " " , . , " .' , - 11 , . , , ' t ':~:\: I.>.';" ~!':~~"Il"~':-:-: ~ -,.,,!.,./ ....,..~:-"I..' -"",~",' ..' - :,; ,':~11';'~_I'tI_'1'!,\I.....,,"II'HIII""~l~~;"."'_\~/;- f~l,':"" .,;" ':';., .".,:., r' .. , " , ,,' . .. --., - ',' . " :1: \\ 12/5/88; D29 COMMONWEALTH OF PENNSYLVANIA ) I 8S. COUNTY OF CUMBERLAND ) I, J Elmes H. Fickel, Jr., Testator, whose nume is signed to the ElttElohed or foregoing instrument, having been duly qUEllified Elccording to lElw, do hereby acknowledge that I signed Elnd executed the instrument as my LElst Will; thElt I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and aoknowledged before me, by James R. Fiokel, Jr., Testator, this ~lQth day of December, 1988. ~w4I ~,tt / / l.,Jr)n ~t ~ t)~~ ~J f d!n. _, ~ , NOTARIAL SEAL MERLENE MARtlEVKA. Notary Public Carlllle, Cumberl3n~ County, PB, My COI~mlllion l.pil'll G17190 I' , , , " I , i ! I , , I I . . , , , .. 12 - 1 ~/5/BBi D29 . . , . , OOMMONWEALTH OF PENNSYLVANIA ) 1 ss. OOUNTY OF CUMBERLAND ) We, ..Qp~(CJ (J !.J-P~<"L.U' '\ . and tJ/lJ1Aa Q. t/.Jv'..J-{J"J!j , th witnesses whose ~s are signed ~the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator, James R. Fickel, Jr., sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the ~estator signed the Will as witnesses; and that to the beat of cur knowledge the Testator was at that time 18 or more years of age, of sound mind and under no oonstraint or undue influenoe. Swcrn or affirmsd to and Bupsoribed to before me by / () , d-€~1I--LO \.(11 ,and IiWjlL1J~~~1e It {/ _\l/lth day~er, 1988. . . l ~1 {.Li.1-JYJ;1~A'I/~ NttifrY I N01ARIAL SEAL MERLENE MAfHlEVKA, Notm Public Carlisle, CUlnberl~n~ Counly. Pa, My COIlIn,;'llon Llpim 617/90 1 ' - 13 r; CERTIEICAI Name of Decedent: James R. Fi~k~l. Jr. Date of Death: January 13. 1994 Estate No.: 21.94. Ii A To the Register: I certify that notice of the beneficial Interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above.captloned estate on ---F~bruary 8, 1994 ~ Address Ylrglnia D. Fickel mlam K. fickel 245 Mooreland Avenue. Carlisle, PA 17013 380 Dorwood Drive. Carli~le. PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except _ none Dale: _;).-r;~1 'f F OWER, MOROENTHAI., FI.OWER LINDSAY ame James 0, Plower, Jr" Esouire Address 11 Easl HI2h Slreel Carlisle. PA 17013 '0.'1 .' , ~ '~: ~. .' 1~~ .ICl..: " Telephone am 243.5513 ,..;. "r o. 'Capacity: _ Personal Represenlallve 0, I ffi .... ....lL. Counsel for Personal Representallvo ;,1 ',', ,. , (111i (j (I) mcc 0: "T P' " I.) .\:: ~a /, ,. ,I .. .! .{ !!V.UOO EX. 1'1.911 1. R.al E.lal. (Sch.dul. A) I 11 2. Slack. and Band. ISchodul. BI ( 2). $1 S 1, 98 'j . 8,) 3, Clb..ly Hold Slack/Partno"hlp Inlorlll (Schodulo c) I 3) $1 e ~ , 4 5 -; . 00 4. Martgagll and Nolo" Ro"lyabl. (Schodul. D) I 41 5. Ca.h, Bank Oopa.lI. & MIIC.llanoau. Po"anal Praporty( 5) ISchodulo E) 6. Jalnlly Ownod Praporty (Sch.dulo f) 7. Tran".o" (Sch.dul. G) (Sch.dulo II 8, T alai Grau Au," (Ialallln.. 1.7) 9. funoral Exp.n'", Admlnl.I,atlyo Ca.II, Milcollanoau, ( 91 Exponll' (Sch.dulo HI 10. Oobl., Martgago llablllllll, Llon'ISchodul. II (10) 11, Talal Ooduellan. Ilalallinll 9 & 101 12. Nol Valuo of Ellal. IlIn. 8 mlnu.llno 11) 13. Charllablo and Gayornm.nlal BoqUIII' (Schodul. J) 14. N.I Valu. SublOella Tax (IIn. 12 mlnu.llno 131 15. Amaunl of IIn. 14 laxablo 01 6% ral. (Indud. YO lUll f,am Schedul. K or Schodulo M.I 16, Amaunl of lino 14 laxablo at 15% ral. (Includo yalulI from Schodul. K or Schodulo M.) 17. P,lncl~alla. duo (Add lax f,am IIno 15 and from lino 16,1 18. Crodll, Spau.al POyorty Crodll Prla, Paymonl' OllCaunl + $2.4.Q1l!LJ) c+ S 1 1 ~ Ii "G- , 19. If lin. 18 I. groolor Ihan IIn. 17, onlor Ih. dlfforonco an IIn. 19, Thl.l. tho OVERPAYMENT, aD 20. If IIno 171. groalor Ihan IIn. 18, onlor tho dlfforonco on lin. 20. Thl'I.lh. TAX DUE. A. Enlor Ih. Inloro., on Ih. balanco duo on IIno 20A. B. Enlor Ih. 10101 of Iln. 20 and 20A an IIno 20B. Thl.l. Iho BALANCE DUE. Mah Chock Payabl. tOI R.gllt" al Willi, Ag.nt ... SUII TO ANSW" ALL QUUTlONSON IIYU.I SIDI AND TO IICHICK MATH.... Und.r pinelli.. of perjury, I dicier, thaI I have l)I;omin.d thlt r.lurn, Including accompanyIng .ch.dul.. and Ilal.mlnh, and 10 ,hi bll' of my know/.dg. and b,iI"1 1llIlru. correct and compl.,.. I d.c1ar.lhat all r.al 11101. hat betn r.ported at fru. markt' valu.. D,claratlon of p"parer olh,r than ,hi plnonal r.p'" ntallv. I, balld un alllnfo,matlon of wh~h prop~aror~ho\~n:~ knOWI'd2~0:' R!SI . 5Al ~.(. , }yl' I!, "4:' :'oore1and ,\venue, CnrE:31e, '.'.\ \\";'.:'7..v: '~':: ANW "' A AEII ~ 11 Eust !!ilih Stroet, Carlisle, "~Po ~ ~ l!! ~~S i5~i I~ ~~ '.' .OIDAYU 0' DIATHAml 12131191 CHICKHru " A lPOUIAL POV"" ClID" II CLAIMID 0 PILI HUM'" INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OP WILLS) '~ ~;i~ COMMONWEAllH m PENNSYlVANIA O"~AIMENI 01 REVINUE om, 210601 HAARIIIURO, PA 17121.0601 fCEDeNTt5 NAME (lAST, fiRST, AND MIDDle IfIlfT1A'Ir' 21 COUNTY CODE ~.) YEAR oace NUM~ER :"ICK!~L, IT}\~~i~S R. IJr:. ~ 4 S !'~OOl:O lnn(1 ~71.J/onllo Cill:lis~,c, !'h 17013 Cumbe r li.ln(~ A A 182-22- 62 7') ~'H itA Ol/13/~4 12/31/3~ <':ounl o 2, Supplom.nlal Rolu,n o 40. Fuluro Inlorlll Campramlll Ifor dalll of doalh ahor 12.12.821 !Xl 6. DlCod.nl Ol.d Tlllal. 0 7. OlCodon' Malnlolnod a lIYlng Trull (Allach co of Willi (Allach copy of Tru,') ALL COllllPONDINCI AND CONPlOINllAL fAX INl'OlMAflON SHOULD H DIItIC'llD TO. NAME M !XI 1. Original ROlu,n o 3. R.malndor R.lurn Ifor dalll of doalh prior 10 12.13.821 o 5, fodora' E,lal. Tax Rllurn R.qulrod ::1l. f. Tolal Numbor of Safo Oopallt BoxlI o 4. llmllod E,lal. ;farles D. Plower, l H NUMBeR 1~ (, L . , ,T~s(~lliro 7171 243- 5 513 ?!.,O~':r.1, ~!(}~('~~1ff1~~11" ~'LO~'?~? 11 East !!ioh f~treot ~urli.slc, !l\ 17~.ll t' << LI ~.~DC^ Y 01~ 4~o "3 ~1..J I I ',J . :J $7,435.00 z o i ( 6) (7) $9,184.f14 (8) $ 3 7 ~ , .~ 4 G . 37 (111 (12) (131 (14) $~,1~4.94 $3-;~, IG1.53 $,~-;(), IG1.:,1 (151-Dl.Q.J.JGl.53 lC ,06. ~"'~."n0.~') ~ i u s (16) ,lC ,15. (17) Inl...., (IHock 111"/1' II you (Ill' lI'qUI'\ltlllj u ,..fund nl yOU! OVt'llHlVlIll'll1 (19) (191 03~rl05.:r, (20) (20AI (20B) o ).') 4 . 4 ~ !IY.llwllX+ 14.161 .~....a..f:' , ~ COMMONWIA~TH O' PINNIYLYANIA INHI!ITANCI TAX R1TUIN !IIIDINT DICIDINT ESTATI Of SCHEDULE B STOCKS AND BONDS fiLl NUMBER FICKEL, JR., JAl4ES R. (All proplrtv lolntlv.ownld with Right of Survlvorthlp mus' b. dlsclolld on Sch.dull f,) ITEM NUMBER DESCRIPTION 21-Q4-0nhR VALUE AT DATE OF DEATH 1. Financial Trust Corp., 3,323.5419 shares at $44.00/sh. $146,235.84 2. Orrstown Dank stock, 250 shares at $23.00/sh. 5,750.00 .' .' " " , . . . TOTAL Allo .nl.r on IIn. 2, R.co Ilolallon (/I mare .pac. I. n..d.d, InlOrl addltlanal,h.." 0' .aml .Iu.) $ 151,985.04 uV,UO'U+(),9Jl , . ~~,~ ...~ SCHEDULE C., CLOSELY HELD CORPORATE STOCK INFORMATION REPORT COMMONWEAllH Of PENNIYlVANIA INHERITANCE TAX RETURN REIIOENT DECEDENT .P,I~.?.. !'yJ'.e or Prlnl PILE NUMBER 21-94-0068 ESTATE OP FICKEL, JR., JAMES R. Till' followin!) inlorlnCltion must bo ,ubmitted with thi, ,c11Odule: . A. Delolled dOlCrlpllon .howlng the melhod of compulallon ulHlnd In Ihe ,aluallon of Ihe decedenl" "ock. B. Complete coplu of f1nonclalltalemenll or complele copl.. 0' the Federal T OK Relurns (Federal Form 1120) for Ihe year 0' death and 4 preceding yea". C. Slotemenl of dl,ldend. paid each year. Lilt tho.. declorad and unpaid. D. LIst nam.. of oHlcers, salarle., bonuses and any othcH benellll received from Corpurallon, E. If the Co"pany owned reale.lale, ,ubmll a "'I.howlng Ihe complete addre,,/.. and e,lImoled Fair Market Value/.. II Real Eltale Appral.al. have bean secured, please auach caples, F. lI.t prlnclpal,'ackhalders 01 date of dealh, number of .har.. held, and relallanshlp 10 decedenl. G. Any other Informallan relotlve to Ihe ,oluallan allhe decedenl" Inler..1. 1. Name of Corparallon _J_L__.RodneY_-Eic:keL_AgBncy_,_.Inc~ Slole a' Inc. p~.n_n_ElY)Y_C!I!.ia_._________ Street Addre.. 1~.!'L~!l~I!g.!L.9j:_r_(!(!t__.._.___ _.__u__,_ _ Date of Inc,__.._._o_..._ _u__________m____ Clly _.Qill:.lisl.e__ 51010..._ 1'1\_________ _0_ Zip Code _.17-0.13 _. T alai Number 01 Sharehalde" ..._,___...___..____,__ 2. Federal I. D. Number _o______m__._____ (Same A. Federal Form 1120) 3. Type of Bu.lne.. Insuran9_Q....!!9~1lQY_____ 4. Bu.lne" Reporllng Veor.__. n _.mo____,___.._n_la,_.__....__._______ Product __,J.nfiUrant:e_o_ STOCK TOTAL' SHARES OUTSTANDING PAR VALUE . SHARES OWNED BY DECEDENT TYPE Common Preferred 5. Provide 011 right. and rOltrlello", pertaining to each clan of .tack, Wa. decedent employed by Ihe Carparollan' 0 V.. 0 No II y.., Pa.lllan RrBf!.,!"g~nt___ Annual Salary $ _______._____ Time Devoled 10 bu.lne.. Wa. the Carparallan In deb led to Ihe decedenl' [] V.. 0 ~Ia II ye., provide amount of Indebtedn... $ _.________m_ 6. 7. Wa. there life Inlurance payable to Ihe corparallon upon deolh 01 decedenl' fiiJ 'I.. rJ No II y.., Ca.h Surrender ValuOt $ _u.___'_'__m'_n Net Proceed. PayoblOt $ .100.,_000,._0.0.__._. Owner of Policy ----"_L_..RoJiney_l:'icke1_Inaurancc....i\gency. ,.mlnc~..--..--_.._.._._ Old the decedenl..1I or trans'er .Iack a' thl. company wllhln one yoor prior 10 doolh IIlhe dale of dealh was on or after 12/13/820; within Iwo yea" lithe dale of death wal prior 10 12/13/821 [I V.. eX No II ye" 0 Transfer []Sale , of Sharo.o..o______._o. Tranl'eroe or PurchalOr 8, 9, Consideration $ _...__ .....__ .._._ .____ Dale. Attach a .eparale .heel for additional Irons'", and/or 101... Old the corporallon hove an Inl"o'lln 01 her corporallons or parlne"hlp.' [J V.. LX No If y", r'port Ihe necenary lnformallol'l on 0 separate sheet, Including Schedule "e.l /I or "C.2" for each Inlerest. 10. Was there a wrlllen ,harehalder'. agreemenlln effecl althe time a' the decedenl'. dealh' DVe. 0 No II y.., provide a copy of the agreemenl. 11, Wa. Ihe decedenl'. .Iock .old' rJ V.. [J No II y.., provide a copy a' tho agreement 01,01., elc. 12. Wa. Ihe corparallon dlllolved or liquidated oller tho decedenl'. dealh' [] V.. 0 No II y.., provide a breakdown of liquidation dl.trlbutlanl, elc. Attach a "parale Iheel. ,... _....,.-'1\ AIV.1I0f E)(. (7011) II I ~, SCHEDULE "0" MORTGAGES AND NOTES RECEIVABLE .' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF J 1l1ES H. FICKEL, JR. FILE NUMBER21_94_006B I '( (All proplny Joln'IVoOwned wl1h AIgh' of Burvlvof1hlp mu., bl dllClloHd on8ahldull "Pll) ITEM NUMBER VALUE AT OATE . OF DEATH DESCRIPTION I. AmGunt due under Stock Purchase Agreement executed January 1, 1990, between James R. Fickel, Jr. and the J. Rodney Ficke.l Insurance Agency $37,479.53 '1',' ,,' .. , ". "1' ,. ,. ,. 'i. ,.. ", " " , i'.' ,'" " H ('1-' "1 " , , ~ . ' ,. , ". ,. . J, I' I " 'I . . , , '., " i! , , , '.' j, I' 1,; ,..., ., ,. . .. ,. '''' " " 1.1 (.I , . . ;1 '" i, " , TOTAL IAllo enter on line 4, Reolpltulltlon) I $37 , 4 7 B . 53 IIf mar, IPUI It ""did In..n .~dltlon.1 thll" 0' 11m. till) , " IIV.ISOI,I,hlun )' .. I' W COMMO~WIA"II 01 P1NNSY\VANIA INIIIIII ANCI TAX anUIN R11IDINT DICIDINT ESTATE OF 1 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploase Print or Type FILE NUMBER 21-94-0068 JAMES R. PICKBL JR. IAII prop.rty 1.lntly..wn.d with th. Right .f "",Ivouhlp mU'1 ~.d on Sch.dul. '1 ITEM NUMBER 1. 2. ,,' l DESCRIPTION VALUE AT DATE Of DEATH 1987 Dodge pickup ~ruck sold outri0ht 04/14/94 to Gereth H. /1ains $7,000.'00 Winchester Target Rifle, ca 1900 $425 .qo ' " " I" 'It ", .. . " !; Ii " ,,' . " ". ,. ,. . , TOTAL lAlla enter on line 5, Recapitulation $ 7, 425 . 00 (AUoch oddltlonol811" . 11" .h..II II more opo..1o ...d.d.1 . Uv..U09tllt 112,11) , '* A' COMMONWIAllH 01 P1NNlnVANIA INHIRIIANCI TAX mURN Rill DINT DICIDINT SCHEDULE F JOINTLY.OWNED PROPERTY JAMES n. FICKEL JR. fiLl NUMBIR 21-94-0068 ISTATE Of Join' '"non'llll ..--------- ADDRISS 245 Mooreland Avenue Car.lisle, !'.'\' 17013 RELATIONSHIP TO DECEDENT NAMI A. Vir~inia D. Fickel spollse I. c. Joln,ly.own.d prop.rty I ITlM LmER DATI POR TOTAL VALUI DICD'S DOLLAR VALUE Of NUMBE' JOINT MADI DESCRIPTION Of PROPERTY OF ASSET % INT. DECIDENT'S INTlRIST TINANT JOINT - 1. A 5/1983 Farmers Trust Company, $34,785.99 50% -0- che~king account #6-275 93, including interest, confirmation attached 2. 'N :1/1984 Farmers Trust Company, $6,993.64 50% -0- checking account #6-722 , 11, including interest, confirmation attached 3. . .A 245 Mooreland Avenue ,225,000.00 50% -0- Carlisle, PA 17013 , , , . . , " .. " ., .. , , ' , - TOTAL (Alia .nlor on IIn. 6. Rlcopllulotlonl S _n_ III molt 'pacI ;, n..dld Inll" addilional,h.." of ,ami size) , IIV,UIlU. (1.111 ESTATE O' ITEM NUMBER A. 1. B. 1. 2. 3, 4, C. 1. 2, 3, 4, .5. 6, 7, 8, ~~' COMMONWIALTH 0' 'INNlVlVANIA INHIRITANCI TAX mUIN RIIIDINIDICIDINT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ~l.7\:n:~; '~L 1;1 ICl~EL :f R, DESCRIPTION Funllal bplnll" hoffman-Hoth l'uneral Eor.\o AdmlnlltratlVl Calli I - Vlnivec1 - Plllonal Rlprllentatlve Commllllonl Social Security Number of Pellonal ReprllentatlVlI Year Commllllonl paid AttornlY Feel-Plo\~er, ;,lorqont.l1nl, FlOl'/Cr " Lindsay Family Exemption CI' Virqinin a mant . D. Fickel h Relatlonl Ip !I!'OUflO Addrell of Claimant al decldenl'l death Street Addrell 2 ~ 5 1100re] nn,:, Carlisle JI.venue PA Stall Zip Codl 17 n 1.:1 City Probate Feel - Cumberland County ~lo(!istm: or \'?.i.lls MllCIlIlInlOUI bplnllll Boyer & Ritter - fee for cnlculnting value of J. Rodney Fickel Inc. RESEnVE for closeout & contin(!encics '~ho Sentinel - estate notice adv. Cunbor1anci Lil\~ Journal - astnte notice adv. Rogister of Wills, filing foe Register of ~ill!l, short certifionte TOTAL IAllo enter on IInl 9, Rlcopltulatlonl (II marl .pacI II nlldld, Inllrt addlllonallhlltl allaml 11.1.) Plio II Print or TVpl ~l..~ll-(;%e AMOUNT $1.,fJ22.00 Oil,OOO.OO $2,000.00 $361.00 $775.00 100.00 GO.'l4 ~().Oo 15.00 J.ao S9,1f)~.n" [ I ,. " . L1'.GG MASON """,.~,_",_._."""_h' ..,..~,_ . . , ' L~gg Mason Wood Walk~r.lncnrporatad . 64 SOUIII Pill Str~9t, Carllsla, PA 11013 . 3220 717 . 258 . 4363 M,mb", N.w York Stod {~ch'ng,.lnc.lMqmo" SIPC .. ,,{, j' , ,I' "'I , ..' I' ,;., , iI' "," " , . " , ,,', , " , ' May 25., 1994 .. ," 'd " James D. Flower Flower, Morgenthal, Flower & I.indsay 11 East High Street Carlisle, PA 17013-3016 REI Estate of James R. Fickel , , HlQtl 44.0000 Wi 44.0000 MWi 44.0000 If you have any questions, give me a call. Sincerely, eLt-V ,. 'I' ;'" Charles J. McKain Vice President. '-'" ," CJM/bjm " . ,. '" " I' " , ,. !' l" O'j'i, , I' '0" 1,'- I" ' " ,. I I" ,,', ,,4,' l' .'.:, .I IORRs~WN FINANCIAL SERVICES INC. ,. 1 ": "f April, 8, .1994 ',' t, Mr. ,'James D. Flower, Jr. Attorney-at-law 11 East High Street Carlisle, PA 17013 ,. Dear Mr. Flowerl This is to verify that the Orrstown Financial Servioes, Inc. common stock was selling at $23.00 a share as of December 31, 1993. '.' If you should have any questions, please feel fres to contact me at (717) 530-2607. " Sincerely, , , Patricia Corwell Vice President " L ,!' 'I, .,' " ,. :.. , ," '" ,,':".1' " , ' ". , I IBBftl ~n;~III~C ~~'!l~~ 141 W.S1I"~h HI"'.1. corllSlo, I'^ 17013 1',0, 110' OOH. cor".I.. I'^ 17013 Till, 17171 340.3414. I'^X 11I71l4lHlll14 September 1, 1994 I', , , ," James D. Flower Flower, Morqenthal, Flower, , Lindsay 11 East High stre.t carlisle, PA 17013 Re: Fickel Estate Dear Jim: Enclosed is a worksheet computing the value of the estate's interest in the agenoy as of date of death. I have also enclosed oopies of the last five years corporate tax returns whioh I believe will have to be made part of the inheritanoe tax return. If you need additional information, please call. \slrJ~IY' )l~j~ B. Devlin, CPA Partner :Enolosures , " Virginia Fiokel oe: " , ~. , .. " ,I '. " , " " " , , '1' '" , , ", 'I!' . ,. " . " II. " , . d ' , , " " ,! '..d.",,,.',, '. \, I ' I . J. ~ODNEY FICKEL INSURANCE AGENCY, INC. 01-13-94 CASII ACCOUNTS RECEIVABLE '" $ , 3,815 . '28,688 11,360 , NOTE RECEIVABLE FINANCIAL TRUST CORP STOCK (2160 SHARES @ 44) INSURANCE PROCEEDS GOODWILL ('93 COMMISSIONS) 95,040 100,000 26!5.940 504,843 LII\BILITIES VALUE OF AGENCY (147 ;085\ $357,758 a..._____ " , , 51% $182,457 ~.._..... ,I' , , ,'f' ,r" " .. " I' , ,. , t.-" I \ , ,,' ~ 1 ' ' ", " " I", ,.r " , ",. , ,I" ,. ". ,:1", 'l, ., 'JI, (I " I, ," "'1, .. ',I ,. , , , , , " ", , ,. " " " ' .. " " ' I ., I,' , III " ''', 1'1' 'I;' " , ' " , , ., 202--15375 ,;,; \ '.120 O'PIIIIII._I Ollht TrUIVlr 1~1""'1 RIl.~~' !lflW!c, Check it .- Atonull'II",.Iu,n E] tlPIIUUI.ol"n9co, J CPllun"U"lct corp, III 4.llnt,IRTfmp. Rtg. uc,I.4'I.411 _____[J D CIIIH IjlDllclbl, bOlli' III II"UIII IIlwf" UI I IInll IIlv," m ! I (hua, In Wit" I 262 821.1, LUllflurn\ l ~. Croll Itctlptl GI 11111 L-_ ,. b ."~ .1I0Wlnt" __ 2 Co. I 01 good. .old .nd/or ope"llon. ISchedul. A. line 71 3 GraS! prohlllln. lc I... hn. 21. ,. ,'..,.,... ~. 4 OIVld.nd. ISch.dule C, 'In. 191 ~ . . 6 Inl.r..t, . . , (O)Q. , 6 Gross rents , '~' , , 7 Gross roy.1l16s , , . , , 8 C'PIt.1 9"n nel Incom. 1.Il.ch Schedul. OIForm 112 . 9 N.I 911n or 110,,1 Ironl Form 4797. Part II. Iin. 18 lallach Form 47971 10 Olher Income (se8 mslrucllons . .tllch schedule) 1 1 TOTAL Incom. . Md lines ~ through 10 j 12 Comp.nullon 01 offlC.rs (Sch.d~e ~ Iin. 41, W 13. "lUlU ,n' wig" L 3 , 18. I b 1.11 lObi CII'1l i t 14 Rep.irs, '5 15 O.d d.bl. . :q 18 R.nlS 2 17 Taxes !!i ~ 18 Inl"..I. 19 Contrlbullon. I..eln.truotlon. for 10% IImltatlonl. . , , SE'E' S:TATEMENr5', 449'8.' ~ 20 Oepreci.llon (IIt.ch Form 4562) . . . , . . , , . . . . ~ ~ 21 less deprecllllon cl.,mod on Schedule A ,nd olsewhore on relurn ~I ~ 22 Oepl.tlon .~ 23 Adv.n"lng t 24 PenSion, prol,I..horlng. elc" pl.n. !!! 25 Emplov.. ben.I,1 program. . g 28 Other d.ductlon. (.II.ch .ch.dul.) " 27 Tllt.I d.ducl,on. . Add Itne, 12 through 26 . ~ 28 T.x.bl~ 'ncome belore nel op.rallng loss d.duct,on .nd .peCIII d.~UCII~I' 1110. ~ 29 L.u,. N'l OP"'llnO loss d.ducllon . , , . . . , . , .. 29a b Sp.clal deductions ISchedul. C, Itn. 201 129b I Tlxlbls income-Line 28 less line 29c, Tot.1 tex (Schedule J. Iin. 101, Plymlntlll IIIB DU'IlI~/IIlnl 32. 1..024. (lHIIII I~ 1989 b 1989 UIIIll.t.,III lllym,nu ~ 776. c till 1919 Itlu~' Upll.. to, 32 d B.,~ 32d 01\ 10./11 U65 ~ . 11. "IlO'lIt' wll~ '0111I1004 328 f (,,'1111G1ll "9~hll'lnfllll,unICO/llpUltlhlllch 10111114391. 321 II CIf,ll lor h'.1II lu on Illth 1.IIUh 'orlll 41361 320 32h Enl.r onv o.n.lly lor lInd.rp,vmenl of .",mal.d t.x - Check I>I..J if Form 2220 II .\t.ched 33 Tex due - If 1111 101.1 01 I,no. 31 .nd 33 i. IJlger Ih.n IIn. 32h. .nlOl .mounl owod , I-~ Ov.rpaym.nt - If hn. 32h ,. IJlg" Ih.n the total 01 Itnes 31 .nd 33. .nl.r amol/nl ov.rplld, 35 En1" .mounl 01 IIn' 3S vou w.nl: Credll.d 10 1880 utlmll.d tu I> 212. R.Iu.d.d" 38 Un'" p,nllllll 01 Pff/WIV, I '.el,,. 1_" I Un ...mln.' l!lll IIl.,n, In(lu'lnQ ucomllUVI"lJ Hh.M" In' IIIllIum, ,n' 10 l~. bill 01 IIIV 'nowl'4,_ u. blll.1. II II IIn, Wit I. ,n' compl.I.. Ottllullu 01 p'.pml 1011\11 1~ln IUP'VIll II OIlt' on .11 In'Ullllllo/\ 01 w"ch prepUt/ '" InV lno...I."" ~ SlgulWIf 01 o1liClf DIU ~~ TUI. ::::,'r'.~',' . VV..) 1. 4 1J (l, I'll A J ~ BOYER & RITTER PLAZA 21 425 N CAMP HILL PA .... InltnJoUon. ,n up.r.ll, 0'1 P'gl 1 'or P,plrwork Rlckletlon Ac.t Notlol. III I! . g u .5 30 31 32 ~ ~ E ~ ... " R ~ 33 34 35 38 Pl.... Sign H.r. P.,d Pre parer'. U.. Only 8255-36 053 02 . U,S_ Corporation Income Tax Return For Cllllndlr vel' 1989 or olher lu vel' bdgtnnlng endlnl nMA Ho. I~U.D12J 1989 Nlme J. RODNEY FICKEL INSURANCE AGENCY --_.__._-~,-------- Number end SUeellOl p, 0, bor nwmlill II pull II nol ',llnlt' 10 Will .Utllll Dlmplo~" 14utlllttllOft numbll 23-2226600 fO'I' IncorpOIII.' P.O. DOX 1 ------ CI1V or town, state, end ZIP code CARLISLE 1/03/83 , ToI.IIII.I,II.. Sptcllic Inll1 PENNSYLVANIA 17013 .,Ie s 163 125. ...k I-___~ 62__,_821 . 2 8" I> SEE' STATEMENt 3 4 5 8 7 _8 9 10 11 12 13e 14 _15 , .J2.. z' 17 18 19 262,821. 8,953. ,.. 271,774. l22,216. 37.918... I 0 e.," 153. 6 ~Qo'; 14,787. 180. 659. SEE' STATEMENt 21b 22 23 24 25 26 27 I 28 5,498. 3.844. 3' ," 11 Ie.. line 27) 16,4-78. 38.585. 246,518. 25,256. . " 290 30 31 25,256. 3,788. , ' 1. 800. 2 , 2 S>~ 4,000. 212. 11/111'I n.m, I~f . YOIfIIl uU.,mplovIU u'IUlu, 011. '/IL /<10 O,t' II PFI,mnlOCillllCwlllvlO, till r-L ,."",,1>, I 164-38-8267 E,I. No." 23-1311005 - ZIP cod, .. 17011 21ST ST J. RODNEY FICKEL INSURANCe AGENCY 23-222b~OO Fo,m 1120119891 ~Od' Sold And/or Ope..tlon. (See In.tructlon. for line 2, Plge 1.) 1 Invenlory II beginning of yelr . 2 Purch..e..'. . . . , . . 3 Cost of Ilbor. . . . . , . 41 Addlllonll IOctlon 263A eo.l. (11I1Ch .chedule). b Olher eo.l. (11I1Ch ,chedule) . 6 Tolll. Add lines 1 Ihrough 4b. . . .. . . 8 Invenlory II end of Yelr. . . . . . . . , 7 COli of goodS sold Indlor op",lIons . lln, 5 Imlln' 6. Enl" here Ind on line 2, peg, 1 8 I Check III ,"elhod. ulOd for~u,"g clo.lng ,"venlorv: iii 8 Cosl liil U lower of co.t or m..ket IS described In Regullllon. ,ecllon 1.471.4 11/01 Wrlteclown of ',ubnormll" good. IS de.crlbed In Regullllon. "Cllon 1.471-2Ic) IIVI Olher (Specify molhod u..d Ind 111Ich oxpllnlllon,1 ~ '" " , , " . "" '" '"'''' , , b Check if the lira invenlory melhod w.. adopled Ihi. IIX Yelr for .ny good. (if checked. IlIlch Form 970). . . . . o If Ihe LIFO invenlory method WIS used for Ihl. lox ye.., enler percenllge (or Imounts) of cloSlno l Invenlory compuled under liFO, . . . , , . . . . , , , . . , . , , , . . . . . _80 d Do Ihe rules of ,"cllon 263A (with respecl 10 property produced or Icqu"ed for re,,'e) Ipply to Ihe corpor Illon 7 II Was there .nv chlnge In deler mining quantltlos, cos~ Of' valuatIons between opening Ind clOSing loventOf' ? If "Yes" .ttllch ex lan.lion , , . . , . , , " "" ~ividend. Ind Spe.111 Oeduetlon. (.1 DI.I/../. Ifc.I,.. 053 8255-36 03 Plge 2 1 2 3 41 4b 6 6 7 :",0 No (bl ~ ~ IO)SPIClII'..wClI.n1: (.1. (bl DivIdends from leu"~h.n"20'1,"owned domestic tOrpor.lions thlllerlJ subjecllo the 70% deducllon 101he, Ih.n debt-lln.nced lloekl ' , . . . . . , , , . 2 Dividends from 20'/o"or-mote-owned domestic corporations thllere subjeCllO lhe 80% deducllon (other th.n d,bt-lin.nced lloekl . , . . , . . . . . , 3 Dividends on debl- fin.ncod lloek of domestic .nd foreign CO,pollllon. Isocllon 246A1 4 Dividends on tert.In preferred Slock of less-1h.n..20'1.-owned public Ulililtes. 6 Dividends on cerllln preferred SlOck of 20'lo-or-n",e-owned public uliI,lles 6 Diyldends from Illls-1hln-20'/.-owned foreign corporations and eerllin FSCs Ihlt Ire sublecllO Ihe 70'10 deduction . . . . . . . , . . . . 7 DIvidends from 20'/,-o,-morll"Dwnlld fOUlign corpor.lions .nd certain FSCs thaI .re subjec110 the 80'/. deducliorl, . . . . , . , . . , . , . , 8 Olfl~fft.1 11111I w.Dlly........,OfIlg~ nbll.'llln ublUllO 1_. IDOll. ..hClloll IIItI:OII ZUlbll. 9 Totol - Add lines 1 Ihrough B. See Inllruclion. for limlt.llon. . . . 10 Dividend; from domestic corpor.lions received bV. smlll business Investment company op",lIng under the Sm.1i 8uslnOlllnve!tmenl Act of 1958. . , , 11 Divldonds from uorllln FSCSlh,' ore subject 10 lh\ 100% doducllOn (seclion 2451clll11 12 Dhld,"., I"", ,rfm.td t10.p 'ftt/llbm IabllCl 10 Ill, 100" ..4UCUIIl tuellO/l 243111(3)1 , 13 Olhor dlvid,nd. from forolgn corporllion. nOl Included on line, 3, 6, 7, 8, or 11 . 14 Income from conlrolled f.relgn corpollllOn. undor SUbplrl F ('"lCh Form. 54711 16 Foreign dividend gross-up lsoction 781 ' . . . , . . '. . , . . . 16 IC-DISC .nd former DISC dividend. nOl Included on lines 1, 2, or 3 (secllon 246(011 17 Olher dlvid,nds. . . . . . . . . . , . , . . , . , . 16 Doducllon for dividend. plld on cort.in proferred stoek of public ulliitles . . 19 lut., dlvidonds . Add lines llhrough 17. Enler he,o .nd on line 4, p.go 1. . . ~ 20 TOIII deduclion. - ~9, 10, 1" 12. .nd '8. Enler here 'nd on line 29b, p.ge 1. . ~pen..t1on of Olll.et. (See ,"s\ruclions for line 12. p.ge 1.) Complele Schedule E onl\ If totll receipls (lino 1., plu. line. 41hrough 10, of plge 1, Form 11201 Ire $500,000 or more. lei PUC'ftl 01 PeteUI ,I COIl' .Un III Alllonl 01 lbl Soclll uurlly 1111mb II 111ft' 'nol" 10 ItvtlWI l4lcufIIOft .IPurtlll' UIlPUlIlloll 100 % % % b7 350. 100% % r. % 806. % % % % % % % % % % % % 70 80 5.. 41.176 47.059 70 80 100 100 100 100 lfI filII'" 01 OUlUI 1 J.R. FICK L J WILLIAM 182-22-0277 198-44-7813 2: Totl' compenuUun of Qfflcers, .. ,..""".", 3 leu: Compenullon of officers clllmed on Schedule A Ind el.ewhere on return 4 Compenulion of officers deducled on line 12, plge 1 . . . . . . . , , 1 2,210. 122 Ched II vou Ire I membor 01 I conlrolled group I.ce .ecllon. 1561 Ind 1563). If Ihe box on line I I. chocked: I Enler vour .hlrc of Iho $50,000 Ind $1.5,000 ilxlble "'come brackel Imounl. 1m thll ",dor}: 1/1 ~ I 1/111$ I b Enler vour .hlre of Iho odd,tlonll sr. IIX Inollo exceed $11.75011$ I Income IIX I.ee In.lrucllons to Ilguro Ihe Ilxl, Check thIS box If Ihe rorporlllon I. I qUill fled personll .ervlcocarpOfl\lon ~ 0, . . , , , ,S~~ ?~A:rE.M~~T. ,5, . , . , . . . . . 3 4 . F",elgn tlX credit 1IIIIch Form IllS} 4. ,... b ~o..esslon. I'x credlllllllch F"'m 57351. 4b . Orphln drug credit 1IIIIch Form 67651. 4. d Credit for fuel produced from I nonccnvenllon.1 source. 4d e an8r.1 bUSIness credIt. Enter here .ndcheck which forms aro 'lIlched, Form 3SOO 0 Form 3468 [.J Form 58B4 Form 6478 0 F"'m 6765 0 F"'m 8586 , 4. f Credll lor prlo.. vear minimum IIx 1IIIIch Form 680 I} , 4' 5 TOI.I . Add line. 4. Ihrough 4f 6 Line 3 I... line 5 7 Pe"onll holding complnv IIX (11I1,'h..(ichedule PH IFjlUD, I 12011. . . B RecIPlure tlxes. Check If from: L.J Form 4255 LJ Form 8611 . 9 . Allernlltve minimum llx (11I.ch Form 46261. b Env;ronmenl., tlX (1lIlch Form 46261 , 10 Tolllllx . Add I,no. 6 Ihrouoh 9b, Enlor horo Ind on line 31, Plgo \, Additional Information IS.. In.lruct,on F,I VOl N. J. RODNEY umti1 FICKEL INSURANCE 23-2226600 Tax CorflpUlatlbn ' AGENCY 1 2 3 H Aeler to the hUm the instructions and Slate tho principal; II) Bu.lness ICIIVIIV cad. no. ~ 6411.. ,.', , .., (2) BusrnesllctlVllv ~ I NSURANCEA.G.~.NCY 131 Product 01 .er"co~INSUg~N~E ....",...,......,......... I II) Old Ih, cOlporolion Illh. ond of Iho tl> VW OVln. directlv 01 indlteclly.50'1. or more althe voting Slock of . domestic corporahonl IFor rules of oltrlbullon, '0' SOCllon 261Ic),). X If "'(es,"lltICh a schaduleshowlng: III)nllme,lIddress.lnd identifVlng number: (bl percenllge owned; and (cl tloble Income or (Ioss)belore NOLlndspecllll deductions of such coroorlllon for the tu year ending With or wl1hln your tu vear. f21 Did ,nv indlYiduII. partn8rshlp, corporation, eIllt'. or tUlSlal th8 end 01 the tax vear own, dlrecllv or indirectly. 50';' or more of th8 corporllion's vOllng Slock? (For rules of Itlrl~ullon, "0 SOCllon 267Icl,) If "YIl," complm 1.llhrough Icl . 1.1 Attlch. schedule showing nlme, address, Ind ldenlifYlng' number. Ib} EnlOl POlconlog, owned ~. ..... ......S E EST M T 1 Ie) Wu Ih, owner of .uch 'otlng stock I person olhOl Ihan I U.S. person? Note: If ""'dS," thtl COfpofltlon fTlrIY Mvt to 1,- 1/1. lorm 5472 . X If "Yos," enter owner's country ... '" ..__,..... " .., ,...." J Wu lho eorporotion I U.S, 'haroholder of enV controllod lor"gn I corpO'llionl 15'0 ..cllOn. 9510nd 957.) X If "Yes:' IlIIch Form 5471 for mh .uch corporation. I 1 I . . . . X 053 0255-36 ~u I I . 6 7 R eJI.!. Igh I,n 04 Page 3 3,788. O. 3.788. 3 788. IIIN. K At any lime dutlng the tax yeM, dId the corporation have an Interest in or a stgnlture or other .ulhorlly over a financtal, ICcountln. forellgn country (such as I blnk Iccount, seCUrities .ccount, or other linanclallccounll? X ISoolnstr"ClIon F and filing roqulfomonlllor form TO F 90-22.1.1 If "Yes," enter name of foreign country .... L Was the corporation the grantor of. or lrlnsferor 10, a foreign trust that eXISled dutlng 1he curronllax year, whether or not lhe corporlllon has Inv beneflcllllnterest In It? If "Yes," the corporallon may hI'll 10 liie Forms 3520, J520-A, or 926. M DUring thiS tl,.( year, did thel corpor.1I0n pay dividends (olhelr thin Slack divldelnds .nd dlSlribulIons In exchlngel lor stock) In eJlcess althel corpor81101l's currenllnd 'ccumuJ8led earnings ond proflll? ISoo seCllOns 3010nd 316,1 If "Ves," fll. Form 5452, If IhiS IS I consolldatod rolurn, answer here for parent corporatIon .nd on Form [IS 1, Attlllllions .ehodulo, lor mh lubsldrarV, N DurIng HilS tax velr, did 11118 corporalton melnllin .ny p.rt of 115 Iccounling/lu records on a compulerired syslem? o Check melhod 01 accounllng: :~: B ~:::'~'I :i~~UI'.,., "'" P Chock lhls box II Iho corporollOn Issuod pUbllclV olfered 0 debllnSlruments with orlglnll issue dllcount . If '0, Iho corpDrillon mov have 10 fllo Form 82B 1. Q Enler lhe Imount 01 tu"eumpt Interelt received or .ccrved during Ih. lax VOir ~ I Q!J A Entor Iho number of shorohold!flll Iho ond 01 Iho tax VW If IlIere wore 35 or lowor shorohold." ~ ......".."."........."...... 1 . . X I I I ,. X ':' .1 I' . . . X ,'. . . I. 1,'. " I. I : I . I H711 J. RODNEY FICKEL INSURANCE AGENCY 053 (3255-36 05 23-2226600 Pig. 4 Blllne. Sheo" BeginnIng 01 tax year End Ollu Ylllr ASSETS I.) Ibl lei Idl 1 CII~ 61610. 91,292. 2 . TIHI Rolli ad ICU~~lI ,mhabl. ' 22,197. 33 099. b llll "I.wue. 101 b.. ~.bll, 22,197. 33,099. 3 1~'UIUlII ' . . . 4 V,S, ,OfflRIII'fttoblrg.lIaftl I ".....IIPI IIWUlO'S t M'r ' 6 8 OI~fI ellllftl IIlttl. . , , 7 10m 10 Ilat'~oll",. , . MOIl"" .~~ 11" ",.t. IoU! ' . Olhu In,"l",ull. . . . , 10 . hIWn9'U'Olhff",ullbl'III'1l . b lilt mUluJ,l., "1I/tel'I1Oft, 11 . O,pl'Ubl. 11I,11, , , b l,lI UC""ulll,d '.pl.llon 12 t.H Ift,l of 1ft.,. ImolllllUo~f 13. Iftl'ft,fbIIUUU"IllGlllllblt'ftlyl b till '(c""uIU.. ',"olll,,'lo~ i , 618-: 21-;-565: 29,866. 24 , 741. 22 014. 2 727. 28415. 19 914. 8 SOh 1 Htt lncom. lilt boo'. :I f"fltllnnmt u. . 3 . hUll 01 UplUI lOll" our CUIIII ,.Iftl. IHOIlU I'bltel I. I.. ft~1 llto/h, Oft tit... "'1","'1111/11'"1' R.oonolllltlon 01 In,omo por Book. With 'noomo p.' Roturn IYou sr, nol ,"ou"ed to complOlO lh'llchedul, Illhe 101.llllOIl on hne 15, column Idl, of Schedul. L sr. less lhsn 525.000,) . . , . , · Z B t 916. 7 Iftcom, IICO,It. on book, I_" yll' 1., IWu4.. -- 4 209. U lftllltlm !Itu,IIt): Ir"""'"PI SrR'f"'...... '~..'.."'...,.."'."....};~.~8,.~.. 415. ,. 48. 367. 115 71 163 25. 5L.555-! 74,174. 1 997. 15,960. 19 838. --534. 534. .. , ~;, " 10,000. 10 000. 10 000. 10 000. 29 663. 58 579. 11 163 125. U OlllllllUll . 11 lol.1 111111 L1.bllltlu Ind Btookhold.n' EqultV 11 ACt.."" p'r.blt, ",. 17 MI,tI" ftal'l,bO"f1P'Y~bV ~lll'hlft 1~ 11 Olh" CWlllftI Iilblllll.t> , I, , , , " 20 21 Z2 IO'~1 'ID"" UO(U"'m, , . . . MI'It.,MltI. bO~'IPlytbl"n I V" 'I mOil Othr 1I.blllllu tUB.1 1I000' . P"I"II'IIGCk b ['1Il1l0n .loel., 221 PIII.'~ .r Clplul mplll 4 A.llj~.' .Uftl~". ,,,,..IIU1', , . , . . IItl"U'IIUIR". UftlPPfOP'llt.~ "11 (Olt "lIum)' Iloc~ , , "I,III.bUIII.. .~, IlOcUol'lII. ull' I 7 598. . !.P'Utl IIu,h'.n booU 11111 VIU III ,.helt' OR Ihll IIlnllit.flIlUI' . D,p'WllI.. S, b (onUlhllolt I (Illy,,,, " OT""I,., Un/111ft""'.' a DUwellDnt an Ihlt 111m 1101 Chuf" '9"1111 boo' 'fCOIII. Ihll V'" IUtIlIIUl; . 0,pIUI'1I'" S b ConlHbulIUI, ct/lyou, ......281. "',.'.'.,""",'.'....""..""."..", 10; Schedule M-2 '" .",.....".....",.., ."",,,'..,,,.,,,....,,,,,,,..,,.. ........".",.....,,'. .." .."..'"....""", 1 O. . ToUI 01 11m 1 ... 8, . , . . · Tot.1 01 IIIIIt I I~'~. ~ , . 10 InCOIII' (lln. 18 .. II ~ line & I... II.. g Z Anlly.l. of Unlpproprllhd Rotllnod EI,nlngo per Book.lllno 25, Soh.dul. LI (You.re not roqulred 10 complm IhlllCh.dul. if the tolll.lIotl on line 15, column Id), of Sch.dul. L .re 101llhsn $25,000.) 1 hlllu II bl,'UM, 01 Y'" Z 9 6. B OhlllhUuI; . 'In. , ' 3 11.1 Ino"'. P,I bOO'. ~8 , 916. b Sloe' I Olh, 1I\C,..tIIIU,,,,'u~. Q PIOPlfly ,....",.....,,,. ..""., .",..,,, 8 OI~1f 'UII,", tll'III,,~. "''''''''''''''' ""'"'''''''''' '" ,...,......,...,..,.,..",..".,,,,..,,,,,...,,,,,,,..... 4 1IuI" Itllt 1, J, ,fl' :I Hln 58 579. 7 10111 0' 11'" ~ .n, 6. . 8 B,lIl1el II u' 01 VIII Uhl 4 Imllu 11 , 58,579. ,,,. 4562 INSURANCE AGENCY Depreciation 8255-36 06 OMO No, 1545-0172 1989 Atttthm'nl 67 SIQU'~(f No, Id.nlllyl"il numb.r 053 and' Amortization DUIIII!lUl or I~f ',umy 1111.111I1 An'"" hIYlul41 Name(s) IS IhCT'Nn on relurn ~ See s.PIr.te In.truotlons. ~ Att.ch thl. torm to yOUl r.lurn, J. RODNEY FICKEL INSURANCE AGENCY BUliness or activity I:> which this form relates 23-2226600 ~n (Uu p,,, III10f 'vtom~i/~J, '~;;;:;;;"~r Vf'hicldJ. campUI"!"m p,op,fly VJ<<J for Mr,rt,inm,nt, 'lCf"tlon, or ,mu"",'nt,J S.ctlon A. - EI.ctlon To e.p.n,. Depr.cl.bl. A...ts IS.cllon 1751 Maximum dollar IImit.tlon. . , . . . . 1 2 Totll cost 0' seCliO'l 179 property placed in serVice during the tlX Velr, , . , , 2 3 Threahold cost 0' lection 179 proporty before reduction in limltallon. , . , , , 3 4 A.ducllOn in Ilmil.llon (Subtract lin. 3 from Iln. 2, bUI do nol .nler Ie.. th.n -0-.) 4 5 Dollar IImllstlon '0< tax year (Sub''Iclllne 4 Irom line I, but do nol enter less th.n'-D:.): , . 5 1.1 Description of property ~PIH'. I" "'11(;1/ 101 Cost eEQUIPMENT L~89_______ 3,67 & 10.000 3,674 &200,000 o 10,000 Idl Elect.d cost 3,674 7 LI.I.d prop.rtv - Ent.r smounllrom lln. 28. . , . , , , 8 T.nt.tlv. d.ductlon (Ent.r the I....r of: (.) IIn. 6 plu. Iln. 7; or (bl line 5), , 9 hXlble Income hrnil.llon IEnter the lesser 01: I.) Tax.ble Income; or (bllme 5,) , 10 C"rvover 01 dlUllovvud deduction from 1988 , , " """" 1 1 Secllon 179 .xp.n," d.ductlon IEnt.r Ih. I....r of; (al 110. 8 plu. line 10: or Ibl line 9) 12 Carrvov.r of dlsallow.d d.ducllon 10 1990 (Add line. 8 and 10. I... line III ~ li2i Section 8, - MACAS D.p,.cletlon - , 7 8 9 10 11 3,674 25,256 3,674 1.1 CllS'illcatlon 01 property IbiD", (I placed In C BIISIS for depreclallon service IBusmess use onlvl Igl D.pr.clltion d.ducllon 1.1 (dl Ruoury Convention pt/lD~ III Methcd 13 Gene,,1 DElprecl.lion SVltem IGDS): fOf 'UfU pfleld In JlfVIC~ ONLY dUf/flg r,)( YUf 06ginnlng In 1989 . 3've., prOjJerty b 5-VOlr prop.rly o 7'vel' property d 10-YOlr prop.rly . 15-v.ar prop.rtv 2(}YOlr prop.rty g Auld.ntlll r.nt.1 prop~rty 27.5 yrs, 27.5 yrs, 31.5 VIS, 31.5 VIS. MM MM MM MM S/L SIL 5/L S/L h Nonresidential re.1 property 14 Altern.tive De reci.tlon S stem (ADS); 'Of 'Jut! pl,c<<lln J~rvlc~ ONLY durin "X y,,, btQmnlng in 1989 . CI... III. I ~ 12-y.ar 12 yrs, c 4Q-YOlr 40 VIS. MM 10 L1l1ed proparly - Enter smount Irom IIn. 27 . . . . 18 ODS .nd ADS d.ductlon, for "so" Isced "n ;er~,c~ b.'~r"'9il9' . . , , , , , S.ctlon C. - ACAS .ndlor Oth.r D.pr.cl.tlon 17 Prop.rlv SUbject 10 18cllon 168(11( 11 election, .....,'... 18 ACAS.nd/o<olh.rd.p,eclation. . '. . " .. """""" S.ctlon D. - Summary 18 Totsl (Add deduction. on line II .nd Iln.s 13 through 18.1 Enter here snd on the .pproprlst. line of your r.turn (Partn.rship, .nd S corpor.llons .. a.e Inll,ucllon..1 . . . '. .,'.., 20 Fo< ..uts shown., '. .nd pl.c.d In urvlc. durlOg Ihe curr.nt y.ar, .nler Ihe tl n f tho bs " 'Il,'bu .ble 10 ..cllon 263A cost. 20 S/L S/L SIL 15 16 1 455. :tili 369. . 19 5,498. Por Plptrwork R,duo1lon AOI NOUCI, U. plgl 1 of ~hl IIpn11 Inl1Ncllonl. IU88 Form 458. (19891 J. RODNEY FICKEL INSURANCE AGENCY 23-2226600 Form 4587119891 .. Amortization Amort'lIllon ler properly pllcud In service before 1989 . . . . . , . . . , . , . 22 T t'l. Enter h re .nd n H th r Deduction' H or "Other Exponses" line of Your return. , , . , , , 23 48. Listed Property,-Automob es, Certain Other Vehicles, Computers, and Property Used for Entertain- ment, Recreation or Amusement /I you 'f' using '^~ "'ndlle mil,.g, "t~ Of dfCiUctmg v,hi~/, 'flU ,x/>Inu, compl", column! (,J through (dJ of SlCtion A, ,11 01 Slf:tlon 8. ,rrJ SlCrlon C If ,ppllc,blf, Slctlon A. - De reel.tlo" (C.utlon:s., inJlructiof'J fOf IImQlllons fOf ilulomobi/ul 241 00 you hlVO evidence 10 ,upport the bUlineu us, clelmedl X V.. No - 24b If "Ves," Is lh, evld.nce wrlllenl Ibl D... .1...,.." Idl COli" I.) (fI ( ) Ihl (I) Typ. 01 'fOjllIly pl,clll III lit 'lk., bUll 8U1t lor ~'prtcIlHoft. II.eow." D.,IICI.llolI 11I11 tthlel.. 111111 11I~lu 'flUIl"~' h.. Illllncllu.I,r bulnn' III' Uly II\, M'III.. ....,11011 llU 1....'111111111'1'1 "'oci 27 Tol,'IEnler here Ind on line 15, p.ge 1.1, . . . . . . . . . . , . . . . , . . . 20 TOllllEnter here Ind on itne 7, p.ge 1.1, , . . . . . . . . . . , . , . Seotlon B. - Information Regarding Uoe 01 Vehlol..- II you d<<luc/ ..".nm lor v.hlel'" · Alw'YJ camplft, this $let/on lor vt1hicl,J Ultd by, 10/, proprinor, Plrtn,r, Of otll,r "mo,' ,hln Ii% rMf/ff," or r",rld "'fJOn. I II you provid<<l v'hlcl,s 10 your ,mpIO;IIJ, flrlt IlnlW,f ,hi qUlltlonl In :i~tion C to II' If you mut In uc,ption to complf1/"g thll Jlction for thou v,hlcl,s. (.) OUUlpllOl\ 01 ,IIPIlIV " '.-"'-".l~.-~' 28 P,o~".,' Ultc! 601 Of IIU ''I , ,r.d, or bUJi/~JJ" BUICK 3/86.48 29 TOIII bu'lne.. miles driven during the Yllr (DO NOT Include commuting miles), , . 30 TOIII commuting miles driven dUring the year 31 Totll Olher person.llnoncommutlng) miles drlv.n, . , . , . . . , , 3? TOIII miles driven during Ihe year IAdd line. 29 through 311. . . . , . . 053 8255-36 07 P.g, 2 (01 COIl 01 OIUr 11..11 (.I.hIOI!lJ.- lIu PIIIU (II PI/UnII' IIIA,"OIIIIIOOll lori_II V", Idl e,., u(!lOft 5 48 No III II.U" uWon 111 CUI ~I- --m J 15 158 7 276 1 455 S/L S/L S/L 27 '~ 1 455 28 1.1 Vehicle 1 6 050 2 700 Ibl Vehlcl. 2 101 Vehicle 3 Idl Vehicle 4 lei Vehiel. 5 III Vehicle 6 3,730 ~ 12 480 Ye, No Ves No Ves No Ves No V.. No Ve. No 33 W.. the vehleie .v.lI.ble for person.' u.e during oH-duty hoursl , . . . . , . 34 W.. the vehicle uoed primarily by . more thin 5% cwner or rel.ted personl. , . 35 ~s:~olher. v~hl~le ..v~iI'.bl~ '~ p~r~on." . X Seotlon C. - au..tlon. for EmploV." Who Provide Vehlol.. lor Ute bV Thel, Emplove.. (Answ,r rh,JI qUlltlonJ to dlt"mll1# 1/ YOU m,,, In ttKelPtlon to comp/,1ting SICrion 8, Note: Stctlon 8 romt .1w.YJ bt cClmpllftd for "'hiel'J uud by JoII prnprllforJ, !'Irt",r!, or tlth,r me" thin S% t1NMrJ or ""1<<1 PfflOm,J x X 38 Do you m.lnt.ln . wrlll.n pelley st.lement th.t prohibits III pe"on.1 use 01 vehlel.., Including commuting, bV ~our employee. I . . , , . . . ' . . . . , . . . , . . , . . . . . . . . . . , . , . . 37 Do you mllnt.ln e wrlllen pellcy sl.lIment thlt prohibit. perlon.i use or vehlel.., excepl cornmutlng, bV your employeesl (Se. In.lructlon. lor vehlel.. used by corporate officers, dlreclon, or 1% or more cwners,). , , 88 Do vou truIl1I Ute 01 vehlel.. by emplcyees .. pe"onel usel , . . . . . . . . . , . , . , . . 39 Do you provide more th.n five vehlel.. 10 your .mplov", .nd ret.ln Ihe information recelvld Irom your employe.. concerning Iho use 01 the vehlel..l. . . . . . . . . , . . . . ., .,,'., .0 Do you meet the requlremenls concerning q""lIfied .ulomoblle demonllrat,on u.el. . , . . , , , . , , , Note: /I your InJW" to 36, 37, 38.39,01 40 IJ "Y'J," you,.,<<I not comp/If' Stction S for tII, "",,<<1 ",hlel'!, IlllI Ves No X . X X X X . , , 23-2226600 J. RODNEY FICKEL INSURANCE AGENCY FEDERAL CORPORATION STATEMENTS- YEAR ENDING 12/31/89 053 8255-36 PAGE 1', STATEMENT 1 - CORPORATION OWNERSH1P INFORMATION CORPORATION IS OWNED BY (A) NAME ADDRESS SOCIAL SECURITY NO. (Bl PERCENTAGE OWNED (C) COUNTRY-IF NOT U.S. J.R. FICKEL JR CARLISLE, PA 17013 182-22-6277 90 PCT -----------------------------------------------------~-------------~-~----- STATEMENT 2 - TAXES PAYROLL PA CNI OTHER I' 11,909 2,603 275 , . '--------------- TOTAL TAXES 14,787 ......11..11..... , . , , -------------------~------------------------------------------------------- STATEMENT 3 - OTHER DEDUCTIONS , AMORTIZATION ALLOWABLE MEALS AND ENTERTAINMENT DUES & SUBSCRIPTIONS , INSURANCE AUTO EXPENSE OFFICE TELEPHONE UTILITIES POSTAGE SUBCONTRACT LEGAL & ACCOUNTING MISCELLANEOUS COMPUTER EXPENSE 48 40 2,347 20,241 1,345 , 2,483 .1,983 1,718 2,708 1,197 2,475 614 1,386 --------------- TOTAL OTHER DEDUCTIONS . . . 38,585 .w...I2......... STATEMENTS 1 - 3 , I 1 i I 'I I I 23-2226600 J.RODNEY FICKEL INSURANCE AGENCY FEDERAL CORPORATION STATEMENTS - YEAR ENDING 12/31/89 053 82!i!i-36 PAGE Z STATEMENT 4 - CONTRIBUTIONS CONTRIBUTIONS SUBJECT TO INCOME LIMITATION MISCELLANEOUS UN ITED WAY YMCA AMELIA GIVEN LIBRARY 178 100 200 100 , I --------------- TOTAL CONTRIBUTIONS 578 CONTRIBUTION CARRYOVER 1986 281 ---~---~------- , I TOTAL CARRYOVER 281 -~------------- TAXABLE INCOME ' SUBJECT TO 10 PeT LIMITATION 10 PCT THEREOF 26,115 2,612 . .....11......... CONTRIBUTION DEDUCTION 859' .....a.IIII...a.. . I" ,,' " I I' ',I' ,., , ,I " .. , '., "', '1' , . l' , "H STATEMENT 4 23-2226600 J. RODNEY FICKEL INSURANCE AGENCY FEDERAL CORPORATION STATEMENTS - YEAR ENDING 12/31/89 053 8255-36 PAGE 3 STATEMENT 5 - FEDERAL TAX CALCULATION REGULAR TAX CALCULATION 1. TAXABLE INCOME 25,256 Z. ENTER THE LESSER OF LINE 1. $50,000, OR ALLOCATED AMOUNT IF MEMBER OF A CONTROLLED GROUP 25.,256 3. SUBTRACT LINE 2 FROM LINE 1 0 4. ENTER THE LESSER OF LINE 3, $25,000, OR ALLOCATED AMOUNT IF MEMBER OF A CONTROLLED GROUP 0 5. SUBTRACT LINE 4 FROM LINE 3 0 6. IF LINE 1 IS OVER $100,000 ENTER THE EXCESS HERE, DO NOT ENTER MORE THAN $235,000, MEMBERS OF CONTROLLED GROUP ENTER ALLOCATED TAX ON LINE 10 0 7. 15 PERCENT OF LINE 2 3,788 8. 25 PERCENT OF LINE 4 0 9. 34 PERCENT OF LINE 5 0 10. LESSER OF 5% OF LINE 6 OR $11,750, MEMBERS OF CONTROLLED GROUP ENTER ALLOCATED SHARE TAX HERE 0 --------------- 11. REGULAR TAX - TOTAL OF LINES 7 THROUGH 10. 3,788 1:I.8.aaa=I:I"...1I1I --------------------------------------------------------------------------- STATEMENT 6 - OTHER CURRENT ASSETS PREPAID EXPENSES PREPAID CORP TAXES . BEGINNING OF END OF TAXABLE YEAR TAXABLE YEAR 404 1,214 o o -------------- -------------- TOTAL OTHER CURRENT ASSETS 1,618 o D=IIIIII....=.=== CDaaaaalla..... , ,. STATEMENTS 5 - 6 U.S. Corporation Income Tax Return OMD Nt.'. 1M~'0123 Form. 1120 Dopll1ment 01 the Tr.a.ury Inl.mal Rav.nu. Sorvlc. Chock n I- A Coll$OlId.'.d ,olu,n B B p.,lonllholdlngco, C Personal Ollrvlce corp. roo denned In Tomp. Aog.. ....1.441.H - _ In.lrucUon.) o Cheek IIcabl. bo...: 1 Inllla',olum 2 Flnul,olurn S IIG'OllS'ee.lpl.o'81I"'........?.7.~.I.~.3.? bL..".lUInlln..II'w..... .................. oBII~ Ie 2 Ca.t ef good. IOld (Sch.dul. A, IIn. 7) """".." , , , , , , , ., , , . , , , ., 2 I 3 Gross profit (IIno 10 ktss IIno 2). , . , , , , , , , . , , . . . " ,.",.,..,., I , . , , " 3 n 4 Dividends (Schedule C, line 19) . , " ..""",.", . , . . . I . , , . , , , , , . , " 4 c & Interest."" , , , . , , , , , , , , . . " ,.,..",.,...".", 5 o . Oross renls. , , . . . , , , . , . . " "."."".", I " , , I . , . . , . , I , . , . " e m . 7 Groh royaltIes, , . . .' ' , , . . , , , , I , , . . . . , , , , , , " . . , . . . , I , . , . , , , , . " 7 . Capllal gain n.llncome (anach Sch.dul. D (Form 1120)) , . . , , , . . . , , , , , , , , . , , , , , . , , .. . · N.I gall1 or (loss) from Form 4797, Par1I1, IIn. 111 (altach Ferm 4797) , , , , . , , , , ., .."", 9 10 Olh., Income (soo Instrucllons - anach schodulo). , . , , . , , , , , . , , . . , , , , , " 10 tl Tellt/neoml- Add line. 3 Ihrou h 10 . . , . . , . . . . , , , . . , , , , , , , . , . , ..~ II D 12 Campan.allon 01 offlco,a (Sch.dul. E. line 4) , , . , . . . . , . . , , . . , . , , , , , , , , , , , " 12 I I3<lSalarlo..ndwago. ..........3.?...~.3J b Loss job. cr.dll .................. eBalancn.",,~ 13e d 14 Ropal,a . , , , , , . . , . , . . , , , . , . , . . . , , , , , , . , , , , , , , , , , , , " 14 u c 15 Bad dobt! , , . , , , . , , , , , . . , , , , , , , , , , , , . . . , , , . , , , , , . , " 15 t 18 Renls , . , , , , . , , , . . , , , , , . . , , , . , , . , , . . , , , . , " 16 I 17 Ta.O$ . , , . , , , . , , , . , . . . , , , , . . , , , , , , , , , , . , , . , , , , . , , . ., 17 o n ,. Inlorest. , , , , , , . , , . . , . . " ..".".,. , , , , , , , , , , . " , , , , " 18 I 1. Cantrlbullon. (I" Inltruollonl for 10% IImllltlon). . . , . . , , . , . . , , , , , . , " 19 · 20 Depreelallon (anach Form 41162) , . , , , , , . . . , . , , , , . , , , . , , ,. 20 3 03 2:li!I!ii;';1 · 21 L.... dop,eelallen claimed en Schodulo A .nd .I.owhor. on relurn. , , , , , '. 211 21b . 22 Depletion. , , , . , , . , , , , . , , ,. """'" , , . , . , , , , , , . . , . . , , " 22 I n 23 Advertl9lng, , , , , . , . . , . . . , ,. """." , . . , , . , , . , , , , . , " 23 . 24 Pentlon, profil".hlrlng, eto" plans. , , , , , , . , . , , , . , , , , , ,. , , , , , " 24 I u 25 Employee bonont programs , , , . , " """'" , , , , , . , , , . , . , . , ., 25 c , 25 Olher deducllon. (anach .chodulo) . , . . , , , , . , , , , , , , . , , , , , , , , , . . , , , , , , . , , " 26 I 27 Totll d.ducUonl .. Add lines 12 through 26, , , , , , , , , , , . , , , , , . , . , , , , " " , , ".. 27 , n 28 Taxable Income bolore net opo,allng lo.s deducllon and speelot doduC1lons (IInol1 loss line 27) , , , . . . " 28 . \ 2t LI": IN., opo,allng loss doducUon (000 In'lrucllon,) , . , , , , . , . , . " 291 rUri:::::; b Social d.ducllon. Schodulo C, line 20 . . . , , , , . , , , , . , " 29b 130 290 T 30 Toabll Ineom. . Une 28 10.. IIno 290 . , , , , , . , . , , , , . , , , , . , , , , , . . , , , . , , . " 30 a . 31 Tell' tu (Schedul. J, line 10). , . , , . , , , , , . , ., 31 32 Plym.nl.:lllllt)y.rp.ym.nl tr.dlt.d 10111I0 32. 11 'I I' 1 illll'l;IIIII', a ~II~ n b 1990 e.Umalod tax paymonl.. . . , " 32b ,111'11' d 0 LllSll 'IIo"run......dlOI on '''m.... , . 32e 800 ill!:,II",:I:: P I Tax d'posll.d wllh Form 7004, . , . . , , , . , . , , . . . . . . . , jllll"111 a f Cr.dlll,em '&gulal.d Inveslmenl co"'"anlos (anach F~rm 2439\ , . '11.I'jll'lil Y "", I.. 11,1, m g C,.dll for F.d~ral lax on luol. (anach Form 4136). 580 InSlrucllon. . . , , , ,. 32 32h I 33 Enler any plnllly lor undorplymenl of .,'Imarod lax . Chock ~ 0 II Form 2220 I. anached, , , , , , " 33 n t 34 To dUI - " tha lola' ollln.. 31 and 33 Is 10' go, Ihon IIno 32h, onlo, amounl owed , , , , , , , , . , , , , " 34 I 35 Ovlrplymlnt . II line 32h I. largor than Iho lOlal 01 lines 31 ond 33, .nl.r amounl ov.rpald, , . , . , , , '. 35 38 Enler amount 01 line 3~ au want: Cradltad to 19.1 ullmlted II. ~ 1 864 Rlfunded ~ 36 Undlf p.n.lll.. 0' Plfjuty, 1 d.cltr, Ihlll hlY' '..mined Ihl. "turn, InCluding Ic:complnylng .0h'dul.. ,nd .tal,m,nlt, ,nd \0 Ih, but 01 Illy knowl.dg. and b,N,I, It I. Hu., tOttlel, and tompl'I" I),cltrallon 01 pllp.r" loth" th.n tupay"jl' bu.d on .lIlntolm,llon ot which PftPlr.r hu any knowl'dg., 1990 J. RODNEY FICKEL INSURANCE AGENCY P.O. BOX 1 ~~ CARLISLE, PA 17013 0 {j2' ~ D Employer IdenUnCllUon no. 23-2226600 E 0.1. Inccrporalod 01 03 83 P Tolal a'sel' (See Spoclllo InslrucUon.) 156 278 296 332 o 278 332 162 9456 288 140 37 o 13 11 1 3 032 4 365 17 010 39 900 275 088 13.L!ll 130 12 907 1,936 3 800 Plea.. Sign Her. 1 864 o ~ ~ nile A-J (1; tL Ch~: ::11- .~9Y.':l!:. !':l)R. ~ .~~~;-.I.. ~J?A ~~........ .... ....... 425 N 21st Street E.I. No, ~ Carn" 'Hlii'" .PA.........o ...... ............ ...... ZIP coda ~ Pr.p"or'a IOclal 80CurtlY no, 164-38-8267 Paid Proplrer'l U.. Only Fllm"nam. (oryoulf,1I ~ nH".mploy.dj r '"dldd".. COPyright form lOll...." Only C,nl" PI.e. Soli"". 23-1311005 17011- '''m 1 120 {IIIOI 175 125 33i 83l 550 000 057 664 348 ~ -. ~.. ..... ..' .. . J. ,RQDN,EY FICKEL INSURANCE AGENCY 23,-2226600 Page 2 I C II I' , Cosl 01 Goods Sold Sou InOlluollon. lor line 2, 0 01. 1 Invenlory II beginning of YOal, . , . , . , , , , . . . t 2 PurChISM.,.."."",..."",."......,.., 2 3 CoS1 olllbor, . . , , . . , , . . , . , , , , , , . , . , , , . , , , . . 3 4e Addl1lonal llOCUon 2631. cosl. (500 Inslrucllon.. s"sch schodule). . . , . 41 bOther cosls (I"leh leheduie) , , , , , , . , , 4b S ToL'.1 . Add llneo llhlough 4b . , . . . . . , . , , , , , . , . , . , , , 5 0 . Invenlory et end 01 year, , , , , , . , , .. , . , , , , , , , , , , , , , S 7 Coil 01 goodl lold . Une 0 loss line 6. Enler here and on line 2, page 1 . . , , . , 7 0 Sa Check all melhod. uaed lor volulng clo.lng Invenlory; (I) ~ Co.1 (II) 0 Lower 01 co'1 or msrkelo' dose,lbod In Rogulltions section 1.471-4 (soo In'ln/cUon.) (III) Wrltodown ol'oubnormor goods.. de.crlbod In Rogulallons eoollon 1.471-2(0) (sooln.ln/ction.) (Iv) Othol (Spoolfy melhod u.ed Ind o"lch o'planallon,) ~........................ - . .. ... - .. . .... .. - . . , . .. '0' _.. b Check" Ihe LIFO Invonlory melhod wes adopled Ihl. 18>1 year lor ony good. (II chooked, a"eoh Form 970) . . . . . . . , , , . . , , , o "Ihe LIFO Inventory melhod was u.ed 101 Ihlo 18>1 yeal, onlol porcnnlago (or amounl.) of lJ clo.lng Invenlory compuled under LIFO, , . , , , . , . . . , . . . . . . . . , . . . , . , , , , , . , . . . . " 60 d Do Ihe ruleo of ,oollon 2e3... (with ro.poello property produced or ocqulred lor re.ale) apply 10 lhe corporation?, , , , . . ~~ . Was lhere any change In delennlnlng quanllllo., co.l, or veluation. botwoon oponlng ond cIo.lng Invonlory? ""Yo.', a"ach e,planallon. . . . . . . . . . . . . . . . . , . . . . . , . . . . . , . . . . , , . . . ISohlldule!e I Dividends and Special Deductions (500 In.lrucllon.) (I)Olvldlnd. "c.lv.d (bl'l\ Dividends 110m le..-lhan-20%-owned dome.tic corporallon. Ihal are aubjec1lo Ihe 70'10 ded'JNlon (olher Ihan debl-nnanced alock). . , . . . . . 2 Dividends from 20'1o-ol-more-owned dome.llc corporallon. Ihal are ,ubjocl 10 Ihe 60"10 deducllon (olher Ihan dabl-financed Slock), , , , , , . . . , , , 3 Dividends on dobl-nnancod Slock 01 domesllc and foreign corporallon. I"""" ""I 4 Dividends on ce~aln plelolled alock 01Ie"-lhen-20%-owned publlo ullllllo. . . . I Dlvldondl on ce~.ln prete lied .Iock of 20%-or-moro-ownod publlo ullllllos. . . . . S Dlvldendslrom '0"-lhan-20'1o-owned lo,elgn corporallon. and ce~aln FSCslhal I/e aubjec1lo lhe 70'10 deduction. . . . , , , , , . , . . . , . . , . . . , , . . , , 7 Dividendi from 201'.-or-more-owned 10lelgn corporallons and co~aln rSCslhal I/e lublocllo Iha 601'. deduction, , , . , . . , , , . . . , , , , . . . . . , . . . . . Dlvld.nd. "om whollrown.d fO"lon ,ub'ld,,,I,, 'UbJ.tl to lh. 100'1. d.dutllon lucllon 2<l5Ibll. . To~1 - Add lines llhrough n. Se. In'lrucllon. lor 1Im1lallon. . . , . . . , . . . 10 Dlvldend.lrom dome.llo corporallon. rooolved by I .01011 bu.lne.. Invoslmonl company operating under Ihe Small Buslne.s Inveslmenl ACI of 19sa , , , , , , 11 Dlvld"nd,lrolft t.rllln F!C'1hltl" .ubl.CllO lh. ,00% d.duellon(.,ellon a_S{CMlll ' . . 12 Dlvld,nd.lrom lllUilltd Group m.mbll. ,ubj.CIIO lh. 100'1, d'ductlon ll.clion 243 (IK)ll . . . , 13 OlhOl dividend. from lorelgn corporal Ion a nollncludod on line. 3, 0, 7, 6 or 11 . . 14 Income ~om ccn~olled lorolgn corporallons under subpert F (l"It' FOIm.WI,. . , 15 Foreign dividend gloss-up (.oollon 76). . . . , . . . . , , . . . , . , , , . , . . 1. IC-DISC and folTl'oOl DISC dividend. not Included on IIne91, 2, or 3 I""'on 21~'1I ' 17 Olher dividend. , , . , , . , . . , , , , , . , . , , , . , , , . . . , , , . . . , 11 D.ductlon for dlvld,ndl plld on elltlt,. ~"fur.d .10tk of public ulllillu'''lln'llutllona). . , . 18 'r.~1 dividendi- Add lines llhrough 17, Enter here and on line 4, pege 1, , , . ~ 70 162 80 III In, ,n. 1. 176 7.059 70 80 100 ';li!iiilll'I'I';:,,Li:'liIIJ:"'h)'I:'I!!" ,",1,',;1""',',1,,1,'.",",,',1".,;'.:1, d"II;"ii: I" lIi''''p,r "",'Id, ,:,,"'I,il . . 100 100 100 i!;i;,j;i"I'::; I :I~::l: 1""1,,'1"""1"'" ,','1'1'1'1"",1 jl,'W",II:11'll:!, IIII'I'li'I':I;,,:,ldll,1 :'1 I !lj!,'jllll:i';1 1;1 ,;II'I'lli'I",':I,!" ",I' 'I "1;'1" "'I'~i:'I('i';I'I'i1II'"IIII;I:IIII'II'li"I' 'f'II,II'lilldlilpi" I ,II, III, i ,11.1111, III Iii '1'1111 :" i I" III !, ; '~ ! [I: 1II1 II ;Ii' I !: i j ! ,': 162 fl:ii:l;ili'I:;;:il;;il, 20 To~1 deductions. Add line. 9,10,11,12 end 1!, Enler hore and on line 29b, a e1. . I Sbl1idUI. E' I Compensation 01 Olllcers (See In.lrucUon. fOI line 12, page 1,) Co lele Schedule E onl 1110101 rooel I. line 10, lu.llno. 4 Iltrou h 10, 01 . . . . , , , , .~ (II Him. 01 OfIlCl' I,) P"""3' WrI,d'vOI'lo bU'ln... IdlCommon 51. 0010 49.0010 1'. % % (.IPrtl.",d 0.00/. 0.00/. % % ,bJ!OCI.I.lcurllynumb" 1 J. R. FICKEL JR. WII,LI1I.M FICKEL 182-22-6277 198-44-7813 100.0010 100.00/. % % % 2 TOllo/ compensallon 01 oll1cel8. , , . , , , . , . . , . . . . . . , . . . . , . . . 3 LIII: CompensaUon 01 oll1cela claimed on Schedulo A and el.owhore on rolurn, L Co enSlllon 01 orncera deducled on line 12, a e 1, , , . . . . , . , . . . . . . . . . . . COPyflght fo,m '011.....". only C.nl., PI,el !loll",", Ic)Sp.tlll d.ductlon.: (II II (b) 130 130 :i:I'I' ,; 1,'i:II::!'i :'I'I;i:il"'i,I:'~i :,:i: I" , ' r1! h ,,; ',:' I '~ I, 11 d ; :""",,, I ' ; I I, I ',' "'ii'I""I'::III'II'I'IIIIII"'''II(IIII'''II'''J' !I,JII,:illl!liiIJ!iill,il,i,i::IIJI,:I;il,I:!iil'I,;I.1 1""",III',I!II'II',II[I:II'III'jll,I"i,I','I,",:'.1',11,11,1111111:1:, I!)I I' II: i: i: I II i i Iii I; I ~': i II!' I I, '1'1 ' !illii!'i""lillllill"Ij;;'i""IIILli 1:,I:ilillilll:liIJI1i 11,I.;,IJI.:,li'i:II::dli',I! , '.j ,"';"',::.!',';";'I.''" I 1:"III'riiii'llill:I!III:U",j,llllilill!iI,li,lll 130 IIJ":nounlof eOlllp'llullon 59 300 81,031 '10 140,331 140 331 Fotm 1120 (1110) J, 'RODlIEY FICKEL INSURANCE AGENCY 23-2226600 1 II I Ii Tax Com ulallon 1 Cheek" you lie a mo",bor 01 0 conlrollod group (see BOOtion. lMl ond 1563) . , , , . , , , , , , , , . . ~ 2 II lho box on Ilno 1 I. checked: a Enler your Bhlle 01 the $50,000 and $25,000 lo:ublo Income brackOI amounl. (In IhBI order): (1)......... .......... (II)............. ...... b Enler your BhNe olthe BddlUonol 5'(, lox (nollo excood $11 ,750) ~ $ ................. . 3 lnooma IIJC (see In.~uctlonB 10 IIgUlo IhOlax.L,Check Ihl. bo, II Iho eorporotion I. B qualllled poraonoJ IHlrVioo corporollon (000 In.l1ucllon.). ~ U . . . , , , , , , , , . . . , , , , . . , , , , , . , , , , , , , . , 4a Foreign IIJC ctod~ (B"Bch Form 1118) . . , . 4a b Po......lon.11JC Clod~ (o"Boh Form 5735), , , . , , , . . . 4b o OrphBn drug crodll (B"och Form 8785) , . , , . , , . . . . 40 d Crod~ lor ru.. produood Irom 0 nonconvonllonal sourco ('00 Ililllllllll In.tructlon.) , , , . , , , , , , . . . . , , . . . , , . . , . 4d I GOnelBl bo.lno.. crodll. Enlor haro ond chock which lor"", "0 B"BChod: '1111111111' OForm 3800 B Form 3~68 B Form 588~ ,1,11",111 OForm 6478 Form 0765 Form 6588, . . , , . , 41 1 Crod~ for pllor YON rrlnlrrorn lox (,",ch Form 8601) , . . . . . , . , 41 J'.!a!1. 1'11'1' "'11'11' '11:1',' 11.,'11 .11 iI" ""I,ll ;lilifrll!I' 11'11'1' 1'1"'1'" ]I:;!!],!I:; ,11",11'1, 3 1';1"1;,11, '1'1""1 ,'111"'1,' ",!,I'I ,'illl'II'I" '1'1' ' :i:!i,;I:: ,;; i',J~ '"I"lil!'i ,illlill','II, 1-:1'.: 1',.,111111,' ''''1'1 '1Iil:I,]1 'II"" l,il'i)li( 1 936 5 Total- Add IIn09 4B Ihrough 41. 5 . Uno 3 1?0o line 8 , . . . . . , . . , . . . . . . . . , , . . 7 Personal holding r.ompBny lox (B"Boh Schodule PH (Form 1120)) . . . RecljlhlrollJCo'. Chock Iffrom: 0 Form 4255 0 Form 881 I II Anorn.Uvo rrlnlmum lox (B"och Form 4020). Soo In.~ucllon9, , , , . b Envlronloonlallax (B"Bch Form 4626). . , , , . , , , . , , . , , , . 8 7 . 9B 9b 1 936 10 Total t... Add IIn.. 61hrou h 9b. Enlor haro Bnd on IIno 31, . a 1 . . , . . . . , 10 AddIU.nBlln'.rmBUon (See GenorBlln,"ucllon F,) VeB No H Ral" 10 lho 1Is1ln Iha In.lTUctlon. Bnd siBle tho principal: '1.1 :1':1 K Al any timo du~ng Iho lox YON, did the corpore lion hBVO on (1) BUBln_ ac1lvl1y code no. ~ .6. ~.~~............ ':11:111:1,': Inlor..lln 01 0 algn.nlla 01 olhor lulhorlly ovar 0 nnBnclal (2) Buolno.uctivlly ~ ;r}~!3.VR~!{<;~. !\C:;~IJ~~ ii'i:I!:', accounlln 0 lorelgn country (Buch au bBnk accounl, (3) Produel or llGl'Ilce ~ l:~!3.V~!{<;~.......... 1:llliU'I: B8C,"lUosoccounl, or othor nnBnclal accounl)? . , , , , , (1) Old lhe corporation at the GrId ollho Ill)( yoar own, 1"",1:1, '11: ::, >:' (911 atntllll'"lruc\ion F ,nd flIingnqulflmlr,U lollorm TO F 'O~U.l.l ,1!'!'llt,' 'Ii, 'I':I'~ d ",,,II' ,. 1"11 ';'1'11'11"1 "1'111.1 lrectty or Indirectly, 50% or more of the votlngl::':!'!I, i:'~'::' II "VU,',nl., nlm. 01 fotllg" eOI/Mlrv .. .................................... t\"i;li,I"il:kt BlOck 01 0 do"",,1Io corporation?"" "'" ,I I: ;'11'1: :",'1':'; L Wurho corporallon Iho granlor 01, or u.n,l8Ior 10, alore'gn ,1;li!i!i!11 ,!i',I:i,::!i 'lIttbutlon"" Ucllon U7IC),I. , , . , , , , , I . . , , X trust thai oIClstod during the cunont tft)( y(tat, whothor or ';;irlli,i:: ;li:!i::!:U If "Ves," B"BCh B schadule .howlng, (a) ~Bmo, ,: I"', nollhe corporaUon has any bcnoncloJ Inloro.lln II? , , . . . X Bddress, "nd Idantlk'lng numbor', (b) porconlBgo i'l II':, I f F 3110 3110" III 'I"'" 'I';' "",,, "I . 'I 1/'; U"'I",'lh""p,,""" m.y ."", II. "m. , ." . :", !"...., , owned; and (c) laxBblo lnoomo or ('099) bolnre NOl ,I"',, M During Ihl. lox YON, did the corporallon PBY dlvldond. (olhor :'i 1;[I:i.. I' i: ",' Bnd Bpeclal deducUon. 01 such corporoilon lor ,':1,:',1' Ihan slock dlvldondB and dl.trlbution. In e,chBngo for alock)i,:,"I:,I:'I:.,I"I'lil,I:!~1 "III 1'1111' "I I dil<l In e'cess ollhe corporation's cUlTenl Blld Bccumulalad '1':1, ,:1111 : ,'i:.1d (2) ~I: ':VY~~I;~:~~ p~~;s~~~I~o~;~:~::,o:;.IO 'i!llli::! oOlnlng. and pront.? (See section. 301 Bnd 318,), , , Y- or trus1 al the end of Iha Ill)( YOBr own, dlroctly or ",. , , If 'Yo,,' file Form ~52, If Ihl. 10 0 consolldslod relum, 1,':,1'111 ::11':;''''1 Indlroctly, 50% or moro of the corporBtlOn's voUng "!I'll,::: answer hero lor pNenl corporBUon end on Form 851, 11'11:!:::I,il']I[II:':1 Block? (For rula. 01 a"rlbIJtlon, ... aocllon 287(c),) Iii:,:;;:: Affillallon. Schedule, for OBch aub.ldIBry, 'i,il;ilii 11;;lliijl:i If "Ves,' oolll'lele (a) Ihrough (c) . . , . , . , . . . X N During Ihl. lox yaOl, did Iho corporation malnlBln any part 01 J.:o::::II,II:i,,:,: ,,' (BI A"ach B ochod"lo Bhowlng nBmo, Bdd, ass, snd i;';:lill.' lis accountlngllax rocord. on I compulerllod syalom?, X Identifying number, "" " 0 Chock 1,lOIhod of ac<:.ounting: fl,'i'III'!II,:,I,iil'~I'11 (b) Enler pOlcanl.ge owned ~ 1,1,11,1",',1,',1,1' ((~)) ~ AC::~'aI 1111,11'1"11,1,::, "I,I,il,I;'I',I,1 (0) W"'hoownOlolsuohvolln'g';I;'~k~'"'''''' .~" , , 'i !.I' 1"'1'" 1111"11 loreign person? (See In.l",ctlon.) ,'" ,I ,"'. (J) Olher (.pecl"') ~ . 1111",i',' '1'1":"'1' 11111111111111111';'1, '1 ............................. ,IIIIII!I :llIlllli Hot.lll.....,.l"'. CO'C'lo,.tlon may hlv. to fII, Fo,,,, 1472. X P Check thIs bo)( H lhe carper.non Issued publicly oH~'ed debt ',i':!i'l F, j:'III:'I: 11"'" "'" OI""j'I'!'I"'I"'" ,811, onlor owner's counlry ,!""I,!,! 1,.'lill" In.trumonl. wllh or1glnall..uo dlSCOUnl. , , , , , , . 1"1' 'I: 'I': I):i ~ 'I., i""', ,'," If eo the corporBlIon may hBvo 10 mo Fo"" 8281. ",I,: ,1,1 1,1,.:,1,1 J W he ....Io~...4U.S.........h.......f............d. 1.li'lj ( 1,::"",,', Q E ' f III I lod r ruod 1!,I:I'I!'li,~"I':I:I'I'! .tl corporal na "sharo oldoro anyconlrollo iiiT/I'ill",1 nlor1holl1TlOunlo la)(-oxorTlp no,o'J fec&V 0 acc 1111";11 t!I;'! lorelgn oorporBlIon? (See section. 951 and 957,). . . . X during Iho lOX yeN ~ . :'::':',,' i' Ii ':"1 II "V03', a"Bch Fo"" ~71 for each such corporBllon. ':" R Enlor Ihe nurnbcr 01 .har~;'~id~;; ~i ih'..;rid ~i ihe YOBr II :i,\:'1 ::'1.::,,: Ihnro waro 35 or lowor aharoholdor. ~ 2 " " " " Copyrlghlfo'm .othrtll. only C,n!" P'IC. Sollw," Form 1120 111101 , -., .-...., ._" Form 1120 (le90) J. RODNEY FICKEL INSURANCE AGENCY 23-2226600 1,11.11 ~cnldll" ~'j,: I Balance Sheels IlO<JlnnlnQ 01 Ill< VOII End 01 Ill< V.II Aaaall I.) Ib) (0) (eI) 1 Cuh, , 1,!II!IIII:II:ilil],I!III:II:llill:I:'I:,I,:'I:II", ' 91. 2 92111111::III:lIiiil'III:I,i!IIIIIIII',li "Ii::: '"I: -,....,..,......78 , 490 24 TI4de nolOl 4nd .ceounl. locolv.bl.., 33 . 099 1',1'1 (li:I,,:I: i::I'rlll]I:II,!;II;:IIII, 52 . 350 ,,,,','': :11:i.!I',liii:,:~:,';,llIllli!:lillll' i i b lllUllow4nce for b.d d.bl.. 33 . 099 52 , 350 3 Inv.nloriol, ','I'II:"IIIIII"III,I'I'I::I'I'IIII!!""loI 111'1"11111'"'1"'1""1'1,,1' 11',':'I"""'llill,',IIII' 4 U S govOlnmenl obllg.Uon. 111111:1,' Ili!'!'II'''I'' 1,1'11'1" II": '111::11 !1,ii!li';:!' l'I:I',lilli:;:I:I"II'~II'I!" , . !I~i'!~ I;: ,:'I:! }:: '::,:,:Ii: ,:":":: ',", 1.:1+11,,:,'1 ,1':lll"I:!, II.','!I;" I TIl<-.X""l'1 seeu,llI.. (... In.lrucllon.)" '111I11:'II,I.llilll'I:I:"I"i' ",: :"1': :',' il'lilll!I'I'I,'il"'/llll,,,,lil:!'IIIIIII,: . Olher CIIn.nl ...el. (.M.ch achedul.) , ',[II:IIIII'I,II":'III"',II!I&!,o' '11::1'li!ll: 'I :1'111,'111 :!IIII'::I"'II,III!:;I,. 11111!111:11:"I:II'I'lj':II", ;IIII'lj'II;':i"IIIII'I,III'III'I:.":IIII"1 7 lo.ns 10 o1ockhol~.,. " 'i.:I'il"i:::i:/~ ::':II'YI:, "I 29 . 866 !I:I,":,III' I'll ,'i 'I'::';:: ",'j':IIII'I. · Mortgage and feal Mille IoI"S '1III"rI. ": 1 '1,,1111"''1'" ""'::'1"1" I'! 11,!,lljlllll' I "1'1'1 IIII' i111111'1 · Olher Invesmlnl. (.Mach 9Cho~UIA) , ,j,II',li:!II!!::i':III;:i:!III!I,:""":I,,li';:!lli:::1 ,111!'I,;!i!II!I:il:I:::1111 i:rili:1ji:il::i!!iiil,i 101 Buildings and Olher deprecl.~le lasels, 28, 415 ";' ':"'1' ,'I ",il;i:ill!:IWij!;i:IiI:::, 2 8 I 415 :iill;,::)III::,'i:;I:;;i,i,:;::j":i<l:il:lill;;;':1 bl..uccurool.l.d d.precl.tlon, 19.914 8.501 22,946 5.469 11.0.pl.lebl. ....1., ," "',: :'Ii"I'I""I'I'II:."::", "'111'1"""'.'1,1'11'1'111 d,"111'1'" bless accurool.l.d d.pl.Uon 12 land (nol alany amortIzation)" 11:::I:I:,j:iJi;;,:,;i::II!li!!::";:I: ,;,i;:'l'j".i: '!li:ililiill:ri:!!lil:;iii:l;iii;I::II!lli:!:i:lliillll:: 131 Inlan;Jblo IsseIs (MlOltJzlble only). 415 ;': <:',,1,1:,: 1':I,i,i,!I:ilil!ilUJlilliili:lli:I:: 415 ;,;:i:~iid:ii:I:':I:II!Ii:::lji::i;:;;,lj]lliii:~;/;,1 bl... .CC\Jrool.led ."",lIullon . 4 8 3 6 7 13 1 284 14 OlhOl ....1. (.lIlch ..h.dulo) 1:1:!I~III:I','iil.I!':1 'i. '. i, ,',~, '1111!illllllll',llill'l'i i'liii'li,i'l:i jl::"!' 11 Tolal....I.. ::1;-','111,111":1',:',;1"; , , I 163.125 lli!I':II'II,I'{!h"I":I,'I:I.,II":,,, 156 296 UabIllU.. and Stockholder.' Equity 'ii !'I t, :'::I"II'I,"',I:':';'I!'I'", I,.,:' '. I 'i <,i'I'j'I:I" ',1'1,,,1'11 'l:i'j\IiI':'I'j~";' 'I i I"'il" ii,11111 I:" Ii II ;"!iT ;,,'I!':' :'1i.l1i;"I'1 I: }!I Illi;I,II,L,~~II'ii'lh;,;,) , ',I!'!I":"" tr,., ';,.I,II,'i~;,-,', 'jr,; \'1' 1':111' : 1:lllli:I','\I,i,:i'II~i',;!:/I';II':;!;,'I':I'I,,:!li il"",I,d,11 i,II'ldlll'd:::,,:,r111 1.1.1,,1,: 11 Accounl. p.y.bl.. 1,1,'1' , 1,1,,1,'" ,.",1.1', ", I" '.11,,". 14 . 174 '1"""1" :11'11'1"'11"":"""':1'1'''1 ,"~ 5 7 I 052 11"1 '11'1"'111'11"1,1.. ".""'1"'1 :1' 1'11'1"1' "I'I'I,'li'lld'l 'IJ",I,I, " 17 MM,.,.., notll, bond. ,.,. bit In I,.. 'hln 1 ,ur, IIII,",I",',I~ 1:I,q':",','1 il'I,I, L", ',',',:' II, " I!I li,",11 ,:",II'!li! :I~,'.!':,II, '. !:",lfq',II,-, '11'111'1'1""1'1"1.111"1" "1'1' '1I1'1'1'1,11"i"""'I';I'I"II;"1 "1.1, 11 I :!'!, i'~'! :"1 :,11 i'I':'I'.',', ~",r1:f II,' 19 838 i'I,'I, '!:I ,I i,II1;III/; "'i<,1 :,,'~!",l Ie OlhOl CIIn.nll1.bllllle. (.n.ch ach.dul.) iil'IIII:I!III'IIII'I.'II',!::i,:III;!'I:I,: :1 ,I,"I"'jl:j' ':..1-- .1'11,I!lilrl'liliiili"lli;'I'llllill:l:i,I!'li'II.I'11:11'I11',i'I:, lo.n. ~om Ilockhold.,. . III' i 'I ,I, "'1'1""1",,, "" ,'" 'I,' , j,'III'j 'I'" '1: II" rill ""'+'1' "'I' 20 MOrtO.gll, nOli', bond. p,y,bl.ln t yu, 01 mIll' 1 ;!j' 11111:': 'IHr'I,I:i:i":I'!. '!',~ 1'1.1' 534 1,II:jl/ II lI;i,I!:I' illll'II::I:':i ;:' ,1,111' I~'III dl 'Ii" 1:1,.' I:;" ,;' ,I ,; " , 1,'li 11:11 'II'II'II,III"IIII!III'I' ,II ill I' 21 Olher Ilabllhlet (anach schedule) , a'ii;,i'():i"<!;i;;:i,:" :", 1'1:,'" :!II"'I',:lj,jll"I'I',!1 1';1,1111:'1',-:;,1'1 ',i'I:1 1".'"1,..,1.1.1,:",.",1;,,1.,,,;, ,,:,;.,,',I(i 1"I,"'I.,I'111Ihl>lI'IIIIII'I',IIoIII,I,',I' 22 CapMaI 'Iock:. P,ef.nod Slock :'I~,,j :' ,','1 :'j'.:"'" :'1'111,,1'11'11] l'i'I'I'II'1 1':I'li::I"I"', ,,:iI"I'II'lrll'!'j',':III, 1110:,:'1 1,1; ,"i ,." ,I,' ,";,,'il,: ," Ii I, ;il' I I., ,II,I,I.I.I'I,IH", .h ,.qlll",',.I"I~r1 b COrrmon .Iock 10 000 10 000 10.000 10,000 23 Paid-In or capital .urplu., '1"1"""';1' :'1 ". It: I,' ''''~ : ,,'I': ' I'," ":"l" Iljllll' "11"1"1 "'i 24 Relalned earning. - Approprlalad t.,llch ICh'dul') ',I :!.illl',iiiilil:,I,:'ji:::,II,,',,' : 'ii' iI ::I,'I:I:iilil:lrll!ii,'"i','illl,II',fll :,11:,11,1,1,1 11','1 I! II Ii ii li:l;:'i'Ii,:i:I!:('li :':lli'<: '!:!j,;II::';li!i;ljil:'!II,!I,:';'ii!tl,iil:li::::,1 25 R~I.lood ..rnlng. - Unapprop~.I.d , '1"1.' ',I,'. ",.' I' " , 58 . 579 ""',!:"" ,',I:' 'i:' :'", I','! , , 6 9 , 6 6 ~ ,i '1,I,/II!il,III'!iihL\i,: 'I "::.. i ':":""),1':. Ii:' 111:!,I,I:hi,r:1i.;il,\II:li: j' <I ili'\;, 0 28 Less cost of trGuury SIOCk:: ,!:II:II'iil!l:i'I"i'I'i!(;'; 1'1'" 'L: \11:,il'II~II!I:I:"'::: iLI,II'II;I,!~I,i:JI':' 166 , 53 27 TOlal lI.blllllos .nd .Iockhold.,e' .QuIN, ,-,11,':1111'11"",,:,"11,1',11 ::1 " ,: ' 163 . 12 51,! ","", ,'1101 'i,I'iil';''''",':II,'!'' ',' 156 . 296 I ,S<:hDduIS'Mio1. I Reccnclllatlon 01 Income per Books With Income per Relurn (Thl. ..h.dul. do.. nol h.v. 10 be complel.d P.g. ! 1 746 3.000 14 ,957 , " , ~ , " :,:,":" I " ; 11, : : ' ': i I:" 'I q' I " I 1,lill.II"'I'llill"oll,IIIII:'" 11,1 1,1 "111'1111 1,1 48,823 137 221:. n Ih. lolal ....1. on IIn.lO, column 1 N.llncome per book. , , . . , . , , . , , .- 2 F.d.,aI Incomo Ill<, . , , . . , . . , , . . , 3 E>cC0S9 01 oapltal 10.... ovo< cepllal g.ln9 , , 4 lnoome .ub}ec1lo IOJ( nOI reco,dsd on book. IhIs y.ar (Iteml.):.... . . . . . ..... _.. . ... _.. d , of Sch.dul. l .,. I." Ih.n 52e.oOO. 11 08 7 Incomo record.d on book. Ihl. y.ar nol 1 95 Includ.d on Ihl. r.lurn (It.mll.): . Tax-ox.mpllnler..1 $.. _ _.... _...... ......................................... ............................................ I Exp.n... rsco,ded on book. Ihl. y.1I nol deducled on Ihl. relu,n (It.mll.): . Osprecl.lIon""" ......_..........._ b Con"lbullonlea"yoVIr.,' o TIIYlI'nd,nl"Ulnlll,nl . .................................................. I O.ductlon. on Ihl. IOJ( ,.lurn nol ch.'g.d .g.ln'I book Income Ihl. y.ar (lI.mll.): . O.p,eel.llon, . . , ,...._......_..... b Con"lbullonlu"yOY" S..... ......... ........ ...................... ........................................ ........................ ......................................... .......................................... ........................................ 9 TOlal ollln.97 .nd 8. . , , , , , , , . . , 0 ............................................... TOlalolU,,"lUwou h~.".,..",. 13 OJ to Incomo 110028, . e1 -lIne8Ie99l1noo 13 037 Ddu li,IM"2: AnalY818 01 Unappropriated Retained Earnings per Bcoks (line 25, Schedule L) (Thl. .ch.dul. do.. nol h.Vll0 be com Iol.d II Ih. 1011'.".19 on line 1~, column d, of Sch.dul. l .,.le99lh.n 525,000.) 1 BaI.nc..1 beginning 01 yu, , 58 57 5 Ol.lrlbullon.:. C.lh , , 2 Nlllncomo pOI book. . , , , , . , , , , , , , , 11 08 b Slack , . . 3 Olher Inc,..,es (M.mll.): _ . .... . . . .... .. .. . 0 Pr~p.rty. . ..... _ ................ _............_. 8 Olhor dee'..... (lI.mll.): ............ ....................................... ...................................... 4 T~i~ ~j ilM; ;:2: i;.ji-:..- :.,.: ~.::.::.... C';PVflOhl tOlm lolt..~" Dnl., C,nllt r.,e, !iollwlI' 7 Tol.1 01111191 8 .nd 8. , . . , , . , , , . 69 66 8 Bftl.nc..1 end of ..r line 4 I... IIn. 7 Alternative Minimum Tax - Corporations Form 4626 (Including envlronmenlellalC) Dtpllltment of lhe Treasury ~ !h. .......1. InltruoUona. Inlllnll Revenue !lervIce ~ AttlIoh to vour tax r.tIlm. NII11G II!n'\'>IoVIIf IdenUlIoallon number J. RODNEY FICKEL INSURANCE AGENCY 23-2226600 t TexlbIG lnoome or (Iou) belore neloperlllng loss dedueUon, I'm'''''n'' ."'nlllI.1I YOU'" "bllelto th. on",om,nlt'ltLjl t 12 , 907 2 Adlultmlnta' I' :1 1 Ilil'l I Deprecllllonolllnglbleproportyplleod In ee:vlce IhOl 19BB, . , , , , , , , , , " 2a 0, tl,I'I: b Amor1lzallon 0' cer1llled pollullon conlrolllclllllet pllced In 8elvlce Ihor 1988, , , " 2b 0 I 1,111,1 o AmoIUzallon of ",ning explorlllon Ind dovelopmenl colli paid or Incurrod Ihor 1980 20 01' I' '1: d Amortl'ltlon of cllc:ultUon up.ndltu,.. paid 0' lncun.d ,lit' 111' (pmonll holding comp./l11I onlYI 2d 0 I' 11III . Bull Idlultmenls In delerrr/nlng gain or loss hom sale or exchsngo of proporty , " 2. 0 ' f Long-lerrncontrlctlonlsrodlnloaherFeb,uary28,1988""., """.,. 2f 0 ["II 9 In81a11menlulos 01 cer1a1n proporty, , , , , , , , , , , , , . , , , . , , , , . , " 2g 0 ii, III h Merchlnl mallne capilli conllNcllnn lunds, , , , , , , , , , , , , , , , , , , , " 2h 0 111'11"1:1'1' I SecUon 833(b) deducUon "Ill' CIOII, Blu. lShl,ld, ,nd .Imlltrl~p. OIOI"J'llIoII, unly), . , " 21 0 ill IJ!lii! J Tex lheIler 111m ICtIvltlea (porlonel sorvlco corporlUonl onlv) , . . , , , , . , , " 21 0111'1'11 k PIsslve acUvl1l01 (clnlMlly held corporlllons end poreonallMll\'lco corporlUons onlV) 2k OJI,III i:I!:i! I Certlln loss 1I""llIon.. , , , . , , , . , , , . . , . . , . . , . , , . , , , . , , ,. 21 0 ,I' r,.li m Olhllf IdJu.tmenl. . , , . , , , , . , , , , , , , , , , . , , , , , , . . . , . , ,,2m 0 ,111111, n Combine "net 2a through 2m , , , , . , , , , . . . , , , , . . . . , , , , . , , , , . . , , , , . , . . . , . .. 2" 3 rex pref.,lno. IIlml: 1III'I!III'li I DoploUon. . , , . , , , . . , , . , , , , , , , , , , . . . , . , , , , . , , , , " 3ll3b Oo:::,::I,:,jli!II!!!I'j! b Tex-Ixempllntoro.t hom p~Vllo aellvlly bonds Issuod all" Augult 7, 1908. . , , , , '"'",11,' o Appreclatod proporty chll1labla doduellon , , , , , , , . . , . , , , , , , , , , " 33dO Oo'[!!II:I,"I'I,I"III'!'!,::I:. d Intlnglbkl drilling costs , , . . , . , , , I , , , , , . , , , . . , I . , . , , , . , . III . R8lefVeI lor 10.... on bad dobls 01 nnanclallnslltuUons . , , , , , , , , , , , , " 31 011'1111 f AOCIlIerltod deprecllllon 01 roal pro pol1\' pllced In servlco beforo 1987, , , . , , " 3f 0 :,'IIHiIlIIl:'li'II'j"j' g AcceIOlllad doprecllllon ollelsod por80nal proporty pl800d In sorvlce beforo 1907 0 I" 111111'11111'1' (plftOnll holding co~lnle. onlV) , , , , , , , , , , , , , , . , , , , . , , , , " 3g h Amortlullon 01 cenllled poUullon conlrolllclllUsl placod In lorvlce beloro 1987, , " 3h 0 d I,! , I Add Rnet 31 through 3h , , . . , , , , . . , . . , . . , , , . , . , . , , , . , . , , . . , . , , , , . , . , . ,. 31 4 PrI-Idlu8lment AMTI. Comblnl IIn8s " 2n. Ind 31 """" , , . , , . , , , . . . , , , , . . , , , . , " 4 . AdJulled currlnt ..mlngl IdJullmlnt: "1'1 '1"11" I Enter your IdJUSlod cunonlearnlngs , , , , , , , , . , . , , , , , . , , , , , , ., 51 12 . 907 'III' Il,ii b Sub~act line 4 Irom line &1 {ovon Ilona or bolh ollheso nguro. II I nogallve number). 'illll'I,[1 Enl. ZOIO W lhe '"Un lozoro or losl (aee In'r'ellons lor eXl/Tlllo.) . , , , , , , " 5b 0 I Ildll a Mutttpfy line 8b by 78%, , , , . , , . , , , , , . , . , . , , . . , . . I , , , . , , , , . I . , , , , , , , , . . I 50 . Combine linea 4 Ind Ilo, "zoro or 10'1, slop he,o (Vou 110 nol subject 10 Ihe IIl00nlllv. ",nlmum tllX), , . , , , " . 7 Altern.1Ive IllX nel Opl/IUng 10.8 doducUon, (Do nol anler more Ihan 90% 01 line 8), . . . , , , , , , , . , . , " 7 . Alternltlve ",nlmJm tlX.blllncome (lublrlclllnl71rom IIno 8), , , . , , , , , , , . , . , , , , . , , , , . , ., . · 1!1lImpUon ph...-cut oompulltlon: (memb.1I of I oon~ollad group, u. InltruoUonl for IInel 91 through 90): 1'II il'lllll I T.ntlllv..x..~lIon lITlOunt, Enlo, $40,000 ",.""",." , , , , , ., 91 40.000:1 i,lli, b Enler$11lO,OOO , , , , . , , , . , . , , , , ' . , , , . , , , , , , . , . . , , , " lib 150. OOOI:I!II'I!IIIII[' o Subtract line 9b hom IInl 8, "zoro or 10", enler zo,o. , , , . , , , , , , , , , . " 90 0 i, 1111,11; d Mul1lply lne 90 bV 25% , . . , , , , , , , , , , . , , , , , , , , . , , , , , , . ,. tel 0,'"", ,III: . Exlmption. SubtrlC1llne Od from line 91. If zero or less. enter ZBro , . . , , , , , , , , . . . , , , , . . . , . ,. .. to SubtrlOt lint 81 from line e. II zero or loss, eoler liMO. , , I , , , . , , . , , , . , , I I . , , , , , . , , . , " 10 tt Muttiply line 10 by 20%, . , . . , , . , , , . , , . , . , . . , , . , . , . . I , , , . . . . . . . . . . , , . , ., 11 t2 AltOln.tIv. ",nlmJm IllX 1010lgn lex crodn (see In.\rucUo", lor 1I""llIon), , , . , , , . , , . , , . . , , , . , , .' 12 t3 Tlnllllve ",nlmJm lex (Iubtraclllne 12 "om line 11), , , , , , , , . , . , , , . , , , , , , , , , , , , , . , . ,. t3 14 Regular IllX .Ibillly belore III credlll excopt Ihe foreign IIX C/odlllnd possesslon.lllX credll. , , . . , . , , . , " I~ 11 AftlmaUv. minImum Ialc - Subtllclllna 14 Irom line 13, II lhe rosulIll rero or lisa, onler Zero, A110 onl., lhe reeull on line 91. Schedule J. Form 1120, or on Iho co~lrlblollno 01 Olher Income lex returnl.. , , , , ''':'':''':' 15 II I!nvlronmlnlll tax . Subtrlct $2,000,000 Irom line 8 (co~ulod wllhoul regild 10 vour onvlronmenlal IllX dlductlon), Ind mJlllply Ih. lesulI, IIlnV, bV 0,12% (,OOt2). Enlor on line Gb, Schedule J, Form 1120, 01 on lhe CO~lIlbIe IIn. 01 olhOllneome lax loturns (mambo" 01 a controllod group, 888 InsINcllo",) , , , , . , " " OMB No, 1!l4&-017& 1990 o o 12,907 o 12,907 o 12.907 40,000 o o o o 1 936 o o '" Paplrwork ...ductlon Atl NOlie., ...Inlllucltonl, Copyught lorm loll..." 0'11., Clnl" PIn, loll",,'" r"m 412. (1810) Depreciation and Amortization (Including Inlormallon on Ulted Property) OMS No, 1!-l5-0172 Form 4562 Departmenl ollhe Tle19ury Inlo1Oll Revonuo Selvlce Neme(.) u .hown on loluln J. RODNEY FICKEL INSURANCE AGENCY Su.lflOSlI or ectlvlty 10 whloh Ihl9 lorm lo/ale9 INSURANCE 11:::partlli:d Elecllon To Expense Certain Tangible Property (Secllon 179) (Nato: II you have any'U9led PlOperty,'~so oorT1>lele Part V.) 1 MllIlrrom dollllllrr/llllon (800 In'!nJcllon9), , . , . . . . . . , . . , , , , . , , , . , . . . , , . , , , 2 Tolal oo.t 01 aecllon 179 propelly placod In IONlce during Ihe lax yeal (909 In9!nJcUon9), . , , , , , , , 3 Thl9!lhold 0011 01 &9C1lon 179 properly bolore leduellon In 11",llllon . . . . . , . . , . , , , , , , . , , 4 Rodllcllon In 1I"'lllIon - Sub~lclllno J from IIn. 2, bUI do nolonlo, 10'" Ihan -0- , . , , . 5 Dollllllrr/llllon for lax yell - Sub~aclllne 41,am IIno 1, bUI do nol onle' 1"".lhln -0-. . , . . . . , . {IIOne,IPIIOIl of PrOPlIly (bleot' 1990 ~ Sao "plrlto In.lruetlon., 67 IdonUfylng numb" 23-2226600 , 2 3 4 5 10 000 o 200 000. o 10 000 II ! I ~ ! I ill:!,: : I:.i I, ~: IT!:' : I: ! III : I: '!: i: 'jII, I '~ j'I!;i'ilj:ij::,'!:h:1Ji:I:lililil!il:lil:iiilll; ;::li'::I/II;;:;;'"I:I.':::'I::::II:'!i:I::I,I:j: o 11111:,i,:d::II;':,'i',:'I!!illllllll!;j:;iil1Ih:'1 o o o o o {elll.cl,deolt . 1 U'led Plopelly - Enler amounllrom IIno 26 . . , . . . , . , . . , . . . . , , , . , , , " 1 . TOlal elecled CO.I olsocllon 179 plapolly - Add lUTlIJunl.ln column (el, IIno. 6 and 7 . . . . Tenlallve doducllon - Enl9llhelo..er ollll1e 5 or line 6. . . . . . . . . . . . . . . . , . . . . , . , . 10 ClUTyovel 01 dloallowod deduellon from 19B9 (000In.I,uellon9). . , . . . , . . , , , " .,., , , 10 11 T..lbIe 1flC(l1llO 1Irr/lIUon - Enlo' Ihe 10.9er 01 lax,blo Income 0' IIno 5 (909 In9Iruellon.), , , . . . , 11 12 Soo1Jon 179 expon.e deduellon - Add IIno. 9 and 10, bul do nol onlor moro Ihan line 11. . . . , . . 12 13 CI/Tyover 01 dloollowod deduellon 10 1991 - Add Ilno. 9 ond 10, 1003l1no 12 , . . . , . ,~ 13 0 "~'I :,!"I ,I, ,:.' '"~I :.' 'i : ',1 Nato: Do nol u.. Part II 01 Part III bolow lor .ulomobllo., eOll.ln olhor vOhlelo., cellullllolophon.., compuler., or plOpOrty u,od lor enlertalnment, recloaUan, or .mu.omonl 11910d 10 or . In.load, u.e Part V lor 119ted fO erly. . Part II,' MACRS Depreelallon For Assets Plsced In ServIce ONLY During Your 1990 Tax Year (Do Nollncluda Ulted Property) {.)Cllulllt&llon01 prOP'fty (cIBuf. lor d'ptlel.llon (BUlin". un only.... , " 11llO,pttellllon d.duoUon (dl A,coVl,.,. pUlod IIIM'lhOd 14 I !1,1!I'iiiil:1I!ii1jP!IP;:I,il: I o o o o o o o o o o 27.5 IS. MM 27,5 IS, MM 31.5 IS. MM 31.5 10. MM L I ,," !! I: ,~i!': ; I!: i! I !; - ~'; !, i:I"I,'11 0 0 0 0 0 0 S/L 0 S/L 0 S/L 0 S/L 0 S/L 0 S/L 0 S/L 0 g RosldenUal fanlal propolly 15 Altem.Uve 0 a CI...lffe ", ;, 0 b 12.. 111 ;Yi;" 0 o 40- Oil 0 1:F!art: III' I Other Depreciation (Do Not Include Usted Property) 12 o. 40 re. MM 11 GDS Ind ADS deducUon! fOl 0".1' plleod In ..rvlce In lax YOOf. beginning bofole 1990 (.... In.lrUcUon.). , . . , , . . . , . . . . , , , , , , . , , , , . . . . . . 11 Property tUb/oc1lo eecllon 11ll1(~(1) elecllon (.ooln'lruellun.) . . 11 "CRS Ind/or Olh.. dop'eclallon (.09 In9llUellon'l . , . . . . . . I Pari 11'0'1/ Summary fS 17 11 o o o II UI1.d property - Enllll lmounll,am llnu 25. . . . . . . . . , . , . . . . . . , . . . , . . . . . , , , 20 Total - Add dodueUon. on IIno12, Ilno.14 and 15, column (g), and IIno. 161h,ough 19. Enlot hele and on Iho apPlopr1llollno. 01 youI lolurn, (Pollnor.hlp. and S colpor.llan. - .ooln.lruellon. . 21 FOI ....,. .hown lbove and pllcod In lorvleo during Iho eurronl yoa" onlOl Ihe portion 01 the bill. Inllbullblo 10 oecllon 26JA CO. I. ... in9lruellon. , . . . . . . . . .. ". 21 II 3 032 20 3 032 Ii ,~ I 'J " ; I 'I "I';:' ,,;, I', ,; "'''111,1''''''1''''': ",. '.'" ' 'or P'P.,,,o,k A.ductlonAcl Nol'ct, 'ltlnll'uel,ont. '0,",4582 111101 ",I 0:;",:,:;1::,': COPyright 101m '011""'", only C,nl., P.,,, SOltWI" J. RODNEY FICKEL INSURANCE AGENCY 23.-2226600 Foml4S82 (IG90l Pogo 2 I:P.I1I~"il Wlted Property. -Automobiles, Certain Other Vehicles, Cellular Telephones, Computers, and Property Used lor Entertainment, Recreallon, or Amusement II you 110 using lhe .Iondlld m/lo.go rlto 01 doducUng vohlclo Iolse o'pon.., col11'loto column. (I) Ihrough (c) of 5ooUon A. all 01 s.ctIon B, Ind SecUon C II appllcoblo. lkcUon A. _ DtprlcllUon CluUon: See In'lrucUon. for 1Im/lollon. for ouloroobll09. 221 00 u hlVI ovldonee to llU art Iho bu.lno." UN claimed? X Ve. No 22b II "'(eo,' 1.lho ovldonee Wlmon? (I) 1'1 Ie) ('\ ,") II) 101 Ihl Typ. of ploperty Oal. pllnd in Ou,;n,.. UI, COIl or Oull fo' d,pncllllon n.,,,VI'.,. M,lhodl a,precWlon _II" vlhlel.. fl'lll urvlc. plrUnltg. olh., bul, (bUlln... u.. only) ptflad ConVln\lon d.ducUon 23 Pro used maio thIn 50% In 0 ~odo or buslno.,,' BUICK 3 15 B6 70 15,15B 1'1 Eltcl.d ncllon 171 co'L- 15 15B L 3 032 No ~~ used 50"10 or I.... In I I,odo or bUSlno.s: S/L '1iIIIIIll~I'h!:I!l!i,!:!~i:,!1 SIL "III'II"I~:'ill!lllllllldoi':, S/L 'i1ilHlilll:i!III!!il!lili11Ii: 25 Add omounl.'n e<>lumn (h). Enler Iho 10101 horo Ind on lino 19, pogo 1 , , . , , , , . , 25 3 032 1:I'IIiI::I'III'lilildll:II,'," 21 Add omounl. In column (ij, Enlerlhe 10101 horo ond on line 7, pogo 1. . . . . . . . . . . .. ...... 26 0 Seellon B, _ Inlormltlon Rlglrdlng U.e of Vehicle. - II you doducl o'rons"" lor vohlcles: e AWia,!" complela thll socllon fOI vahlclo. usad by 0 BOlo proprlolor, partnor, or olhol maralhan 5'10 ownor,' or rolalod porson. , II you provldod vohlcles to your omploy..', first answer lho quosllons In socllon C 10 s.. II you mool on e'copllon to Cllmplol'ng Ihls sooUon for lhoao vohlcles o -- (I) (b) (c) (d) (e) (0 27 TOlalbu.ln,umlludrlv," V,hle!,! V.hle1, 2 V.hlcl.3 V,hlcl,4 V,hlel" V.hlcl,S durin: "" ynr \00 NOT B,427 Inch.! 'tommul no mil"), . '-. 21 Toltlctlmmutlnomlllldllv.n durlnolh'Y"'""" . 1. 000 21 Totll Dill" Ptllonlllnon- commullnolml1n drlv,n. . . 2.653 30 ToLllmllU drl",ndurlng th. yll, ~Add hnu 27 12 OBO thloUOIl '} , , . , , , , , Va. No V.. No V.. No V.. No V.. No V.. No - 3t Wu Ihev,hlcluv,llIbl' for ~"'on'IU" dUflnllOIf-duly X DUllt"".,." , 32 wa.th.v,hlcltUlldPII- ""rUtby.mollth,"AV, X OWUfOf"IlI'dp,uon? , , 33 1.tnoth.tv,hlcl..v.1labl. tOfurlon.luut"." ' X SeeUO" Q, _ OuuUon. lor Employ'.. Who Provide Vlhlcl.. for Ua. by Tha:r Employ"" (Answor these qUe'lIon. 10 dolelmlne II you moat on o'copllon 10 e<>mploUng 5ootio" B. Notll Socllon B must alwaya be comploled for vahlcles u.ed b BOlo ro rlelors, ortnOfB, or olhor moro Ihon W. owner. or relaled orson., Vel No 34 00 you moInlalll I wr111en policy allloment thlt plohlbl1s all pef10nal use 01 vehicles, Including commollng, by your O/l'4lloy...?, , , . , . . , , , , , , , , , , . , , , . , . . , , , , . , , , . . . , , , . , , , , , , , , , , . X 3J Do you malnlaln I wr111en policy alllemenllhet prohlbllS perBOnal uS<! 01 vohlcles, e'copl e<>nvnuUng, by your O/l'4lloy....? (See Instructions lor vehlclos ullOd by e<>lporlle ollleola, dlroclof1l, or 1'1. or moro ownefB.) . . . , X :It 00 you troat all use 01 vehicle. by omployoes IS per.onal uso?, , , , , . . , . . . , , , , , . , . , . , . , , X 37 00 you provide moro than fivo vohlcle. 10 your omployoo. and relaln Iho InlormoUon rocolvod from your dmployoo. concerning the use ofthe vehicle.? , . , , . . , . , . . . . , . , . . , . , . . , , . , , , . . . , . , . . . , X :It 00 you mool the requlroment. concerning qUlllfiod aUlomabllo demanslrollon uao (900 Ins\nJcUons)? . . , , . , X Nolll II our Inswer 10 34, 35, 3&, 37, or 3A Is "Vos,' ou ne 'd nol com 1010 Socllon B for tho covored vohlclos. Ii ,"I:Ii:,i!i:!,;U, I, Pilrtllll<'l Amortization ('IOUcllpllonolplop.rly B3 B3 FOil" :z (lIlIlD) (cIAmOl\lubt. .mounl (dICod. S.ellon IllAlnortluUon tOt thl' yur I : ' :,! :i: I i III1 ! 1 ~ :! ii:!': I!: I 31 Atrortlzollon 01 co.l. Ihol begin. during your 1990 lax 40 Atrortlzotlon 01 CllSla1h11 bogon beloro 1990. . , . , . . , . . . , . . . , . , . , . . . . , . 4t TOlal, Enle< hero and on "Olher Deducllons" or "Olher E'pensos" line 01 your rolurn . . , . , . For P.ptlwor' R,ducllon Acl Nollce, "'Inllluc\,onl, Copyllghlln'm u!lwtr' only Clnl" fll,e. Sollw." , . NAME .j, RorJnt.Jj fi'ch~ .tnJILr{lJ1re.- EMPLOYER LD.NO. .23 . J.~J, &,,,oa ADDRESS P. O. 8tN. I FORM NO. //:1. D fIJ.rl/IIe.. fJA YEAR ENDED 1~'.31'10 STATEMENT UNDER SECTION 461(h)(3) OF THE INTERNAL REVENUE CODE Pursuant to paragraph (b) of Temporary Regulations Sec. 1.461-3T, Q/A-7, the above taxpay has, in the preparation of its Federal Income Tax Return for the year ended , 1 .J,'" il /qqo i used thll recurring item exception with respect to a' app ca e ypes 0 iabilities in each of its trades or businesses. The recurring Item exception of Sec. 461(h)(3) of the Internal Revenue Code Is . hereby adopted with respect to all applicable types of liabilities Incurred In each of the above taxpayer's trades or businesses. ' " , , .' , . " ' , 't, ", t L, I , .' ' '., ' , , ., , ,t I, " ,. "" , , " " , ' .. , ' B&R 394 3.094,. (Rev. 1-91) , , ,,, ., . Form Department of tho rteaaury or ell, nil", v'" tUI or lu 'I'll, blglnnlng , IUt, .ndlng ,18 Inlo!nll Rovonuo Sorvlco ~ In.lnlollon. or. '00"'"11. S...;~~.;.;; 'f;'; PlallWor!l R'''cju.oil;';'.A~i Notlc~... A ChocIc H I - 11lConukdl'ldlllutn 1_ltAc,. Fo,mll1' IJ)Pmonalholdln,qco. ltltleh 8oh,Pt11 13)Pmonll urvlu corp, (udlflnldlnTlmp, A'OI,l'c.1...,-,n n ....rn1truellonll I! Chock .nnlloablo bo,o.: (1) 1 Ilnlllol rolurn 12\ I IFI"al/olurn (JI I [Chonao In odd,o," 11 Oro" rocelptll or salOl 283 I 023 b llll ,.turn'"nd "HOWl,"" 0 Bel.. 10 2 CO'I 01 good. sold (Schodul. A, II no 7) , . . . . . , . . . . . . .. 2 I 3 aro99 prolll. Sublrlclllno 2 from IIno lc . . . . . , .. 3 n 4 Olvldondl (Schodulo C, IIno 19), .... . . , . . . , " 4 o 5 InIOlMI,.." """" .... , . , . , . , . . , . , . . " ~ o lara.. ronll. . . . . . . . , , " .,... ... . . . . , , . , . . , .. ..., 5 m I 7 aro.. royll1lol, . , , . , , , .. ..... .. . . . , . . . . . . , . . . ,. 7 I Copllll glln nollncomo (11I1Ch Schodulo 0 (Form 1120)) . . , , . , , . , , , . .. I I Nol glln or (1011) from Form 4797, Par1Il, IIno 18 (Inlch Form 4797) , . , . , , . . , . " 9 10 Olho, Incomo (eee InllnJcUon. - Inlch .chodulo), . , . , , . . . . , , . , . ., 10 11 TOllllncoml, Add IIno. 3 throuah 10, . , , , , , , . , . . , , . , . ..~ 11 12 Con"llOndIUon of oHlcoll (Schodulll E, IIno.) , . , . . . . . . . . . . . . . , ., 12 : 1:1.1 SallIloaand wlgo. 39 , 123 b Loss jobs crodil 0 Bollnco. , , , . ~ 130 . I 14 Ropalro. . . .. .... .,. . , . . . . . . . . , . , . . .. ,. . . , . . .. 14 i 15 aid dobll . " .". .,. . , . , . . . . , . . . . . . . . . , , , , . . .. 15 0: II Ronll . . , . , . ,. ., , . . . .. . . . , . . , . , . . . . ., 15 ., 17 Taxol , , , " .,.., .. ....,... , . , . . . . . , , . , . . . .. 17 dOli InlOlo.1, . , .. .,.,. ,. ....... . . . .. .., . . . , , . , . . . .. 18 u' o I 11 ConlrlbuU0l11 (... InllnloUon. 10' 10% IlmIIlUon). . . .. ... . . . . " ' " I ' , , , , , .. 19 'I T 20 O&l'roclaUon (Inlch FOlm '~82) . , . . . . . , . . . , , , . , , . , , . , . . ,I 20 512! ;1:,1, ,',: 21 lJm doproollllon ell/mod on Schodulo A Ind olsowhoro on rolurn. , . . . . . ,I 211 I 21b ~ 1 22 O9pIeUon. , . . . . , . , . . . ., """ . . . . " ,. , , ., ",..,. . , ., 22 .: 23 Advor1lslng, . , , , . . . , . . ., .,..".." , , . , . . . , . . , . , .. 23 o 24 Ponslon, profil.ohlIlng, olc., pi Ins , ."... ., . . . . . . . . . . .. 24 n 211 En"llloyoo bGnom programs . , " "",.."... , . . , , . . . , , ,,25 d I 21 Olhor doducUons (Inach schodulo) ........"." ,. . . , . ., .".... , ., 28 ~ 27 Totll deducUonl, Add IInos 12 Uuough 20 , , , , , , , , , '" , , , , " ""'" "".. 27 I 28 Taxlblo Incomo boforo nol oporlUng loss doducllon Ind spoolll doducllons, Subllaclllno 27 110m IIno 11. , ., 26 : 211 1.Iu: I Nol opo'allny loss doducllon (soo Insllucllons). , , . , , , , . , , , , ./ 291 I 0 "II":," · b 5000111 doducllons (Schodulo C, IIno 201 . . . . . . . . . . . , . . . ,I 21lb I 687 290 T 30 TUlblllnoom. - Subllaclllno 29C from IIno 28, . . , . . . . . . . . . . . . . , .. ... . . . . . . .. 30 : 31 Tolll tu (Schodulo J, line 10). . . . . , . . " ,..,.........'.. . . .,','. .", 31 32 Plymlnl,: ~lil10 o"ttplYllllnlClldll,d 10 11111t 321 --L~ ,I ':': :ii:!i;I,"':!llli?-:'!::i~1 !:::;';:'! ~ b 1991 ostlmalod I"" payroonts. . . . . . Jab 72 ' , ,"', ',', d cLoss lUl ,,'und Ippllld lor on Fo,m 4488, , 320 d 801.. 32d 1, 936 ':: "::< P . Tax doposllod with Form 7004, . . , . . . . . . . . , . . . . . . . . '. 32. ";',:,::, I 'Crodll f,om rogulalod InvoSlmonl cOn"lllnlos (1lIIch Form 24J9), . , . .. 3:l1liiil!:I:!. y g Crodil for Fodoral 11M on luolo (olllch Form 4138). Soolnslrucllons . . . . . ,. 3211. 17 32h m I 3:J EIUmllod lax penllly (000 plgo . ollnslruCllons). Chook II For~o ....... c j Jj/ . . ,~ U 3:J ~ 34 Tu due, litho lolal 01 lines 311nd 33 Is largorthln IIno 32h, ~ I"rlllT1 ",nl , . . .. 34 I :l5 Ov"lllym.nt If IIno 32h Is largo, thon Ihololll olllnol 31 an~ 3, lln e~ nvorpald.. ~,' . . , . . , . :l5 38 Enll)( amounl oilInG 3' vou wlnt Credll.d to 1992 ..lImll.d ~ -.;::, 2471 Rltund.d ~ 38 1120 ,l.J, Corporation Income Tax . .Jturn OMB No. 11>4'-0123 1991 T. RODNEY FICKEL INSURANCE AGENCY a Employer ldon, no. 23-2226600 B Un IRS 1b.1, Oth.r- ~::.. p.O, BOX 1 prlnl ~ARLISLE, PA 0' typo, 17013 C DOlo Incorporllod 01/03/83 o TalaJ 8ss81s (5.. SPIC, IIUI,,) 138.110 283.023 283.023 981 8.559 768 293.331 159,770 39 123 "6--:006 10 164 10 362 259 512 4.914 19,951 39.941 290.996 2.m 687 1. 648 247 1. 936 1. 689 1.442 Plesee Sign Here Und" p,nllll.. 01 plfjury, I dlc~" thlll hlvl..lmlnld 11111 "Iurn, IncludlngucompanYlng .cll,dulu and Itll'mlnll, Ind 10 Ih. bu' 01 myknowl'dg, .na blk",HIIIUII, co HIe I, Ind campl'l', Olclaratlon 01 pllP"" lolllar Vlln la.pIY"'" buad on 111 tnlOll'lU,on 01 which pr.p.r,r hUlnyknowlldlll, ~ Slanlh"o 01 olllcor Prepl1er'l Iloolluro ~ I OalO ~ nllo I ^' I 0.10 Chock II oell- ,...." Propl/or's soelllloourf1y no. V ""I . h Ie., V omalo od I II 164-38-8267 P.9Y.~!:. AI)~ .~Tt:~~~.,.. ~~A ~ ~................... 425 N 21st Street E,I, No. . Camp. .i1"iiY ...i>ii.................................. ZIP codo ~ 23-1311005 17011- Plld P'opar"" Un Only Fllm"nam. ~ (llrYOlln,I' IIU-amploy'd) Indaddr... DIU Fot Paparwolk naducUOn AeINo!tcl, '"lntH, COPY111Ihtlcl Uillalm Jollwa'llInly e,nl., "ltCI511l!wa", Inc. Form 1120 lIilll J. RODNEY ~KEL INSURANCE AGENCY 10# 1-2226600 Page 2 Fonn 1120 1m c IJ .:'A:: Co.t 01 Goods Sold Seolnstr~cllon" I Invenlory II beginning 01 yell. 1 2 f'Ilrch_.....,..........."........ 2 3 COllolllbor."".""...,....,.",." 3 41 Addition" socllan 2ll3A co.ta (.eo InstrucUon. - IlIlch schodule). 4.l b Olher CO'II (1lIach sohodule) , 4b 5 ToW, Add IIn.. 1 through ~b . . . . . . . . , . , . , , , . . . . & . Invlntory II end 01 yell. . . . . . . . . , , . . . , . . . . , , . , 7 CoI' 01 gooda ao'd. Subulo! IIno 6 ~om IIno 6. ~nlor horo Ind on IIno 2, plgo 1. 7 .. ChoCl< III melhods ~aed lor vllulng closing Invonlory: (I) ~ Coil (II) 0 Lower 01 CDS' or ITWkol Ie doacrlbtd In RegullUOns socUon 1.~71-~ (aeelnstruction.) (III) W,lIeaown ol'subno,mat' goods ee dosCllbtd In RegulsUonssocllon M71-2(c) (...In.u~ctlons) (Iv) Olhor (Specify melhod uaed Ind IlIoch o'plsnIUon.) ~ b Chock fflho UFO Invonlory melhod wee Idoplod Ihlslox yoar lor any g~~d; i~~h~0'd'''a"~~hi:~~'9io)'::': :.:::.:: .::.::.;....0.... o Illho UFO Invenlory melhod wee u.od lor Ihl. lox yoor, onlor porconllgo (or amounl') 01 clo.lng Invontory ool1"4'ulod undor LIFO. , . . , . . . , , . . . , . . , . . . , . . . . . . , . . . , . . . , . ,. .. d Do tho rule8 olllOCtion 263A (for propotty producod or acqulrod lor ,..110) apply 10 lho carporlllon7 . . . , . . . . . . . . I Wee thoro Iny chlngllln dolonrlnlng q~lnUII... caSI, or vllusUon, bttweon oponlng and clo,lng Invonlnry7 II 'Yo,', IlIlch 0' lanlllon. . . . . . , . . . . . . . . . . . . . , , . . , . . , . . . . . , . . , . , . , , . . . . , , , . 20,00" 51. 00'10 100, DOl. 49,00'10 % 'I. 'I. -A '" jl!Soheduf"C:1 Dividend. lInd Speclel Deductions (SIlO In,trucllon,.) 1 Dlvldendslrom le..-lhsn'20%-owne~ dome.llc corporlllon,lhlt 110 IIlbjoollo Iho 70% deducUon (olhor than dobl.financod Slock). . , , . . . . . . 2 Dividends \rom 20%-or-moro.ownod dome.llc corporsllon,lhol oro .ublecl 10 tho 80'" deducUon (olhor Ihsn dobt-financed otock). . . , , , . . . , . . . . 3 Dlvldond. on dobt-finonC<ld .Iock 01 dorno.llc ond forolgn corporollon.,,,,u,, "!A\ 4 Dlvldond. on cOIlAln pro'orrod Slock 0110ss.lhsn-20%.ownod public ullllllos 5 Dlvldond. on conAln prolorrod .Iock 0120%-n,'moro.ownod public ullllllos. . . . . , Dividend. \rom 10..-lhsn'20~.-ownod forolgn corporellon. and conslll FSCs Ihal lIosubJoctto Iho 70'" doducllon. . , . , . . . , . . . . . . . , . . . . , . , . . 7 Dividend. Irom 2CW.-or-moro-ownod forolgn co!porallon. snd conaln FSCs Ihsl IIl1ubJoctto the 60'" doducUon. , , . , . . . , , , . . . . . . , . , . . . . . . . Olvld.nd,ham wholly awn.d lotlllll\ .ub.ldl.,lu.ubjlc, 10 lh. 1001/, d.ducltlll\(ucI1on 2.S(b)). . ToW, Add IIn.. 1 Ihrough O. See Inetrucllons lor 1Im1lsUon. . . . . . . . , . . . . 10 Dlvldende \rom dome.Uc corporaUons recolved by a emall bu.lnoss Invo.tmonl cofl"lllny operaUng undor Iho Small BuslnuSlllnvo.lmenl Acl 011956 . . . . . 11 Dlvidlnd.trom cu'aln FSC.lh.la" ,ubj.ct to thl 100"/, d.duC!lon(uChon J4!(cXlll ' . , 12 Olvld.nd. fromaUlIlal,d ;roup m.mbm .ubjlCllO thl 100"1t dtducllonll1C110n 2U('X311. , 13 Olher dlvldonds from forolgn corporaUons not Includod on IInas 3, 6, 7, 0 or 11 14 Income \rom canuolled lorolgn corporaUon. undor ,ubp.n F lalllOh F..m. ""\. , . 15 Foreign dMdond gross.up (sooUon 78). . . , . , . , . . . . . . . . . . . . . . . 18 IC-DISC Ind lormer OISC dlvldonds nollncludo<l on II no. 1, 2, or 31"""" '''I'll . 17 Olhor dividends . , , . . , . . , . . . . . . . . . . . . , . . . . . . . . . . . , 11 O.ducllon lot dlvld.nd. paId on utl.1n p"ftr"d 110ck 01 publlcuhllllll 1111 Ina\lucIIOnl) . , . , 11 Tol&I dividendi. Add IInos llh,ough 17. Enlor horo ond on IIno ~, pogo 1 . . . ,~ (I) Nam.ofolllc" (b) Sotlatllculllynumbl' J, R, FICKEL JR, WILLIAM FICKEL 182-22-6277 198-44-'1813 2 TollI cofl"llonsation 01 officors, . . . . . , . . . . , . . . , . . . . . . , , , . , 3 Lou: COfl"llonsaUon 01 o"lcora clslmed on Schodulo A snd olsowhoro on roturn. 4 Co onssllon 01 officors doduclod on line 12, s e 1. ",.,.""... '0' Papllwlllk Rlductlon Acl NOUCI, IlIlnl1', (I) Olvldlndl (b) " "t'(vld 981 70 80 ... '" , '" 1.176 7,059 70 80 100 ;,:1 1':1 (0) SPlcl,ldlduOUOnl: . , 687 687 100 100 100 111:!!!':I!!!I!!III,i!'II!I'I!II'!i!II:I!I,i:llj:I' Ij]!illllll 'jlll"I""'I",,'I'!" '111111"j.'1111111 11111' 'l'I'llljl' j II,I,II,!II,IIIII,'I,I',I, I! III !.I:,I!:j,II, I"" II 1'1 ',!III liiillll,. 'liljl'IIII'II': 'l'I'ill,I'II''''I'I'I,III'JIII'I'I'ljll 'i,l,11 ,1,iI111IW, 1111'111,1'1"(:1'1 "II!':II"llilll'I"IIII'I'ljl'll,i ,,,.,1,'1 :,H):,':', ,; ili,. ""i!:,I,I.II,' 1111111 111,:1,1.;1:1; .;'ld,lli:I::i:i';:,::: ,~i:llrli!11:li:,:(:! j' j',; 981 :1)11'1"':' I' '!"'"''''II'''''''''I''I''''''I''' ,0111,11.1"""", ;;j:;'! ;1o"l.li!li'!id1111Iill';il;III:::j'II!: . . , . . . . . . . . . . .~ 687 (f) AllIounlof c;omplnll'lol'I 0.00' O. OO~ 6 800 152 970 159 770 159 770 CapYIIQhttc) tiit lo,m lollwa,. only Clnll, PI,c;l Sollw"l, Int. Form 1120"",) J. RODNEY :KEL INSURANCE AGENCY IDI )-2226600 Formll20 leOl BilU ." ,I Tax Com utatlon 1 Check ~ you are. member 01. controlled group (soo ll8CUons 1561 and 1563) . . , . . . . . . . , . , . .. 2 If the box on line 1 II checked: . Enter your ,hare 01 the $50,000 and $25,000 tlllablo Incomo bracket amount, (In Ih,t order): (I) 0 (II) 0 b Enter your share 01 the additional 5~. IIlI (not to excood $11 ,750) ~ 3 Incomo tax (100 In,trucUonlto IIgure the till). Check this box Illhe corporaUon I.. qualllled peroonal lMlIVlce C;Orporatlon (H<llnstrucUon, on pag,13), . 0,.""........"...,., 41 Foreign till credll (auach Fonn 1116) , . , . . , , 41 b Po_ionl tll( credll (IUach r'.1ll15735). . . . . 4b o Orphan drug credll (aUlch Fonn 6765) , , . , , . 4c d Credll lor luel produced from a nonconventlonal lource (see I""tructlons) , , , . . , , , . . . . , , , , , . . . . . . . , 4d . GanGlal business credll, Enter here and check which lorms are aUached: ,::,..1/ OFonn 3600 8 Fonn 3466 0 Fonn 5684 8 Form 6478 I::!',I,I,II OFonn 6765 Form B588 0 Fonn 8630 Form B628, . 41 1 Credlllor prior yaa. n.nlmum tax (aU,ch Form 6a27) . . . . . . . . . . . 41 Pa 03 'I""; 1"ii'I' ""!,,,I, il!IIII!!!!!! IIIPI1jl'I I:!I'W,'II li"i,d!l. 3 o ";:,t:i:l; O WI"I'II'I li!II,11 '1'1"" 0,1111,'1'1':11 1'1" '.,, '01,,.,,.', O ,iii:,;':, 'IIII!'II:'I '!!dl'l'''' 'II!!I'!'; lilll,l !III!,!I,II' '"II'" o [,;'/i.'i "ltil,.I,1 "'.',.,.1, :::iitdl:' 247 5 Tolll. Add IInos ~a through ~I. . , . . 5 o . Subtract line BIram line 3, . . . . " ...... 7 P9f60nal holding company IIlI (aUsch Schsdulo PH (Fonn 1120)) . . , . . Recapture tIllOS. Check ~ Irom: 0 Fonn 4255 0 Fonn 6611 . . Ila AlternaUvo minimum tax (aUach Fonn ~828), See InstrucUon,. b Envlronmonlal tll( (aUach Fonn ~826). , . , . . . . , . . . . . 7 . e. Ilb 247 o o 10 Tolll"', Add IIn.. 81hrou hOb, Enter here and on line 31, a 01. e edulrtlKil' Other Information See. 015 oltholnslrucllons, 1 Check mothod 01 accounting: V.. No 8 Was tho corporallon a U.S. sharoholdor olsny conuollod . ~ Cash lorelgn corporation? (500 sections 051 and 057.) b X Accrual If "Vos", aUach Form 5471 lor each .uch corporallon. o Other ('peclly) . ........................ Entor numbor 01 Forms 5471 aUachod ........~....... 2 RelGllo the lI't In the InstrucUons and state Iho principal: . 6u,11\OO8 activity code no. ~ 6411 b 6ualneooactivlty .INSUR'riNCE..AGENCY.... o Product or sorvlce .:.INStiRANCE............. ........................... 3 Old tho corporation althe end ot tho tOJ( yoar own, direcUy or Indlroctly, 5O~. or more 01 the voUng alock of a domestk, corporation? (For rulos 01 attribution, soo aecUon 287(c),) . . . . . . . . . If "'ffl,. altaoh I loh.dur. .1l0wlng: II) nlm., addr,.., Ind Idlnlllylnllnumb"ilb)pmlnllll.own.d,.nd{cjlu.lbll.neoml or{lou)blloll NOL .ndlplclll dlducllonl 01 lucllcorpolllion lor 'hi llll 'I"" 'ndlng willi or wllll!n you, l.ll( 'I tar, 4 Old any Individual, partnGlshlp, corporation, ostato, 0. trust at the end of Iho tOJ( yoar own, dlrecUy or IndllecUy, 50'10 or more 01 tho corporation', voUng Slack? (For rules 01 attribution, see soctlon 267(0).) II "Yes," completo aand b. , , . . . , , . . , , . Atlach a echodule .howlng nll/1lll, address, and IdenUlylng number, b EntGl porcenlage ownod ~....~ ~.'. 9.~.... .. .. ... 5 Old ono lorelgn person (see Instructions for doflnltlon) .t any tlmo during tho IOJ( year own alloast 25'10 01: . The total voUng POWGI 01 all classes 01 ,tack 0, Iho corporation enUtied to vote, or b The lotal value of all cla"",s 01 slack of Iho corporation? 'II "Ye,," tho corporation may h.vo 10 010 Fonn 5472. II "Yes," entGl owno(s coun\Jy(les) . Ente. number 01 Forms 5472 aURched.~."... 6...... For PIPlrwork Rlductlon Act Nolle" '''Inll', COPY'lgllllCll~illorm IOftwI,. only Clnll' PIICI SOl\wI,., Inc. 10 247 12 If Ihoro woro 35 or fewer shareholdors .t tho onj ollhe till year, onlortho numbor ~ ........ ~. . .. .. .... .. . Via No X Ilili'i'!111 li,III:'I,I! I'!'I:I:I :i,I:,:I,I',li!,,:j !L,' )1, 7 At ,ny tlmo during tho IOJ( yoar, did tho corporaUon have an ,1!,~ii!II,I, Interest In or a slgnaturo or other authority ovor a nnanclaJ lii!!::11 ,], account In a foreign country (ruch as a bank account, ,ii:iii,~:ii: securltlos Rccount, or olhor IIna/lcl.1 account)? . . . . . . X (s.. palll lS ollh'lnltruclionl for mort Inlnrm.ltlon, V!illlli!lliilliil!t 'r",'oo, '''00' "'"".lnll''' r... TO F iO-ll.l.1 :111!,ill!j:i1,r"I'lli,,',,!!il;i,'1 If "V",. ,nl., nam, ollo"llIn counlry.... ...oo... ............ili:!i!::I!; , !!il::!il o Was tho corporallon tho grantor 01, or transleror to, a foreign 1IIIi"I:I,11 1,1!:,IIII,I'II,"1 trustlhal o)(lstad durIng the cunent tax yoar, whelher or Ihiii1i!!iii -ii~!I!::i'!: not tho corporation h9S any bonollclaJ Interest In II? , . . . , X II ....U,.th. corporallon may hlYllo 1111 Form. 3S20, 3!20.A, or i211, II,I,::;!::',', ,!,','II,:!I,',;I 1111,111, illllll e Ourlng Ihis till year, did tho corporation pay dividends (othoriill",i"i'! 1:11[1':"11 Ihan stock dividends and dlstrlbuUona In oxchange lor stock) 'I:,:",'IIII,I!III,I',II[)I!: In oxcoss 01 lhe corpuraUon's current and accuroolaied '::':I:il :I[ :IH!i:Jill oarnlngs and protlts? (Soo .ecUons 301 and 316.). . . , . . X \I "Yes," 1,Ie Form 5452. If this Is a consolidated relurn, l'il'il:11 1'!I"li,jl an!lWer hare for parenl corporaUon and on Form 851, l:jI "i':illlllil:~!'II' AHlllatlon9 Schodulo, for oach aubsldlary. Illl,!:I:I;11 ' I,:III!!I: to Check this be, II the corporotlon Issuod publicly ollered dobt ""11'11'111'11'" Instruments with original Issue discount, . . . , , .. 0 I"i: I!I,III'II.II:I 1.11'1111'1111"1' II so, 1110 corporation may havo 10 lilo FOlm ~261. iii, 'i! II ,1'!illll'l t 1 Entor Ihe amounl 01 IIlI-oxomplInlorost received or accruod ,I,~ i' 1,.11'1, during the IOJ( yoar . ',I'ljll'Ji,1 ,I'I'II!II 1'1 ::'. ~ ,tll ': 1"'''I'li.I'II',11 ""1",,11',' . " ' ' i ~ I' , I 1111'111111,,;11111 Form 1120 (lU11 J. RODNEY :KEL INSURANCE AGENCY IDI \-22261i(JO Poll" 4. Innln 011.. eor 1:luJ 1111." n., 1 Cuh, .. ., . . 2A Trode notes ond oceount. receivable b Looa ellowonce lor bad debt. 3 Inventories,....."...... 4 U,S. govarnment obllgaUon., . . , . 5 T..-eKempt .ocurIUe. ('00 In.trucUons) . I Other cunent ....18 (ohoch achedule). . 7 Loon. to atockholdera . , . . . . . . I Mortgage ond reel estote Ioan~ . . , . I Other Inveslmenta (ahoch schadule). . 101 Building. and other deprecloble usele b Less occuroolaled depreclotlon , 110 Depleteble lISSet. . . . . . , . . b Le98 accuroollted dapleUon , . . 12 Land (net 01 Iny 8I11Ortlzatlon) . , 131 Intangible 898et. (8I11Ortlzlble only) b Le.. eccurooloted amortization. 14 Other ll9.eta (ahoch achedule). , , 15 Totol o.,eta . . . . . . . . . . . . UlblllUu and Stockholdera' Equity 11 Accounts poyoble . , . . . . . . . . . , . 17 11 11 20 "-o,lg.gn,nol."bond.pIYlbl.ln 1 yurormore, 21 22 _ ___l~L____,._,___.._.tl!L_. 78 49() , "I "','''' , ' 35 119 :,,',1,:1,,",':1,1: ,"i I I' " , , ",;,-1',.,-11,1,; "o.,li";" ~fi (ICJ9 , ','! "'!',I",I;li'''I' 1.:",)il,jl:I'I,,1 ~ Ii 1',.01'1-" ._._I_~_,_ .,. " ".,101_11. I ,.11, 52 350 26 699 ._ __ _..,____~_4 !:,!I,!:i!ll!iilllil:I'lillllljlllli;i!:!!li'llllij!!11III',!II;:II] ;:;'I;I!i:i,:;:'I!!'IIII,!IIII;!'I:ii'!:I":":' 1'1 "";'11"11"'111'11','11,:,1111111,,','1111.1,' -- ',: ,,',I ""1',1'1"1',0'",' , , ------ ';;':::"i:'::ll;llIl:I'j,ili!I,I,II:"':II'111 I 1,1.11 I I' I"":"I'(II"I'I'I'I::'II"IIII,,!II'III'''I 1,111111 It'l'lllilll, I'l', I ------- 'il.l""I"" il: 'II ',;, ,1,1.1111:1':';'1" 1 746 "11"'1 I I I" 4 968 '1',1''','1'''1''''''''''1'''11'''','1',''' "","1'1"'1",'" ~ 1 '.",',"","",,','Ij 1'1 '!I"I",' ,,' ,I, 'I!,' ",' "I" - .. "'I ',I, 1"'1' 'I"" -----. .- 1':I'''li!,;1 'I:' 1:'lIil,lll',' 'h! 1'1"; 3 000' I III II II 'I 'I' I I 9 591 l,ii,I,I':;';,II"II!','j'I'I,.:I:I"li'I"I',I,",",!illl 1",,o,'I'I!'I"'!""'I'I"I'I"'ill':'" --.--=--- 1!"j;IIII'IIII"I.'ii,,I,IIII'IIIJI,1111 I 11"11'1"1111,11'11 ",,11 11;'i'i';:I,I:1 I 1'1::11 "I';:'II'"i !:'ill'il" . I'll' ,'II' 1111,111,1 'II -----~- J:'[i:,::hili,llli j!::i,!::!I!I:llIiii:llli:IIII,11 14 957, II : I,ll II!' 111I 1'111, i I I 4 1 57 6 28 415 '''i'i,, 'I "'i' 1'1""'1' ,"'''' 3 3 7 2 5 " """, '"'7'""l1 ,1:111,111"1 I:I!' ,hili Ii. I;IIII~III !,I,!il,II', l~. ", 1,'1, ,.,1. 1,,:,';1'1' 'I" I, I 22 946 5 469 13 769 19,956 , ;, ,':, i ',:' 1 : " I : I ' , ' Ii 'Ii : II , ~' 1," "L I , ' ~ a !:I::I:l1 :,1(1:111'1' '1Ii'IIII,I~I-'IW '1'1';111' ';ll-,llllil:I'I,IIIIII,111 llli 11"i1jL,'I',"II:1 52 350 11,- Ii "1'1 ,II' 'ldl'l -m 201 Mortg.gll,nolu, bond.payablltn I... than 1 y..' . Other current lIablllUe. (aUach schedule), . Lalna Irom etockholdore, , . , . . . . . . 48 D8,110 , ,',I; : Ii.l: ! I ~ I' , , I!!!! 'i'!! 'I ' I 60,904 -.._.._~ 616 ,----~-- 156 ,):!",:i,;' i ",: ~~':--10{,:-760 Other lIabllltle. (ohach achedule), , , ,1,- CapllaJ slock: I Preforred slock . I ,;1:'::;' i,I,,::I: ill:, ';I~i;i:,i' i'il'l b Common.t,'ck. 10,OOO.---"To-ooo __..!..Q..".,QOO 23 Paid-In or copllal .urplu. . , . . , I,', I", ' 2' Rotalf1lld olllnlng. - Appropriated (1I11Ch IOhld"I' ' , 25 Retainod elllnlng. - Unepproprlaled. . . . . . . -=:=-~:~L~!'-c1 ' 1 69 , 360 20 LOS$costoltrell9ury.tock.... . . . . . . , . "llili !iJO, "" ,,' , 166 530 , I! ',I"" - 27 Total lIablllUosend stockholdors' e ul ...', ' 1 !i 6 2 ~l (, " ," "",' 138 110 I edu eIM..,l',' Reconciliation 01 Income per Books With Inco"iii"e'Por hotum (fltl. ":h,"lulo dllo. IIl1t h.vo to be completed ~ tho 10lal ..sol' on IIno 15, column d, 01 Scllndulol. fin 11I~ '7~,IKKI) ..__ 1 Netlncome per booka, . . . . . . . . . . - 3 0_ 1 In""ll" '''':llIlllId IIlIK,"k. Ihl. V.or nlll 2 Federal Income tllX, . , , , , . . . . . . . . 2 J In,,'udtlll 11111111. 'O'IIII1I'lfollj/ll): 3 Excess 01 cepltelloese. over capllal gllln.. . I r.K-II""1~'llntl1f0.1 .. .. ........... 4 Income subject to t.. not recorded on book. tills yelll (itemize),..... . ... .. . .. . .. _. .. . . 137 .................................. 5 Expon.es recorded on booka thl. YOIII not deducted on thl. return (ltomlze), I DopreclaUon , . , .. .................. b Conlllbutlon, catryovI' o Tr..v.I."d.~I.rltlnm.nt . Omll/ollnll. flllthl, ,nlllll' OUII:h.,uud allaln.t IKlllk IlI(;lIllKl Ihl. vo.r ('!lIl1jlOI: I llnJl",,'olllln, . , ., . .. .. .. ... .. .. . . b Cnll!ft!ill\!lIn, rA","",,, ~................ ........... ....... iij,:i( ^'jljl\A(5i(I.:I'J"licil~;I'JUi:E' 2 ~~~:At~~~~};p::$~~};W~};::::: _~, I A;I;I.,in;'~.i;;lIi...:...:'.:...:..::...:...: 2 Add IInesllhlou h 5 . , . . . . . . . . . . 2 3:r to Inlillll.. fllnUn, I'.~ 1 .. II'.. n lellllne 9 2 , 335 edule'IM.,.2il Analysis 01 Unappropriated Rotllned Esrn ng. p.r Book. (Un. 25, ohlldull L) (Thl. IIChedule doe. not have to be co IDled II the lolala,"ol. on linn In, 1:I,luIIIIII"), III "lilloduln l. 0'0 ~1II.lhon 120,000, 1 Balance at be{llnnlng 01 yelll. l!2.,.i!_~.., I llllllllloullllll" 0 c..lt 2 Net Income per books. . . . . . . . _..:]_~. b "'tIlik . 3 Other Inerell9O. (Itemize):...... . .. ... . .. . _ . 0 ",""ony . I Olhlll dl"'II'lOa (lIon"DI' ............ ............-..................................... ................................................ 7 AlId IInoo n ond to. , . . , . . . . , . . Ii 9-:i-(~( . nolonlin al 011I1 III o.r linn 4 Ins. linn 1 69 360 Fo,m "'j1ii'i') .............................................................. 4 Add lines " 2, ond 3. , , . . . . . For Paperwork R.due1!on Acl Nolle., ..,In II'. COPyll~"IIGll'U IICltm Inllwlll IInl., C..nl., 1',lt' n.,llwall, Int. J. RODNEY ICKEL INSURANCE AGENCY 10, 13-2226600 U. S. corporation 1120 paqe 1, supportinq Sohedules Year End Date: 12/31/91 ____~__~________________________~___________________u__________________________ OTHER INCOME MISCELLANEOUS 768 ---_..~-~--_..._-- 768 ............... " TAXES PAYROLL CAPITAL.STOCK TAX state Inoome Tax 9,577 300 287 ----,----------- " 10,164 '!II............... .. , CURRENT YEAR GROSS CONTRIBUTIONS Contributions KEYSTONE COUNCIL BSA CARLISLE YMCA CARLISLE YWCA MULTIPLE SCLEROSIS AMELIA GIVEN LIBRARY CARLISLE RUNNING CLUB JUVENILE DIABETES PlAA SOCCER OFFICIALS UNITED WAY S~ITAN FELLOWSHIP MUSCULAR DYSTROPHY " -1,866 , 150 500 1,000 15 125 100 50 25 125 25 10 , , ;I'r " " ,. " " " ,. , '. , ':. , --------------- 259 ................ 1,1; '. 01, .. ,'. I,' " , . , ., ,. " , , ,. " \ '.,. " " 'I;' J. RODNEY ICl(EL INSURANCE AGENOY Il)j l:lw2228600 U. S. corporation . 1120 paqe 1, supportinq Sohldul.. Year End Datil 12/:11/91 ' .,'___.....'.........'.._..._.......... ............""""....___...._ "".... N""..., "".... ""......"".. IN..... "",........._...._ ......~"".... .........."... _/ ' OTHER DEDUCTIONS " SUBCONTRACT O"FICE POSTAGE , TELEPHONE DUES , SUBSCRIPTIONS INSURANCE AtlTOEXPENSE tlTILITIES . MISCELLANEOUS LEGAL & ACCOUNTING COMPUTER EXPENSE AIIlortlzation " ,. 1,:1011 2,848 2,731 2,198 2,766 17, 077 2,646 2,748 1,825 2,260 1;454 8:1 " , "I,' .. .. , ',' " , ..----'....------. ,I, " :19,941 ................ I ,. ,., ,. ,. ," ,I ,. I , , " " " " """ 'I" I: "I' " ., '" " 1',1,'1" " ..' " " , ,i'"", j, .. ., " " ,. ," " "'I '" ,. .' ,'.," '. " , I' " , ,. , '" ", .. <," " ". .. " '.. " ,I .. " ..' , " " . , ,. ,I' , d. '. ,. .. ,. .. ." .,. '\" "i " ,,' ,,( ,. , .. !; ',. f;, " i' . , ,. ., " ',I, ,. " ,II /1" <'II ,I, ,I " '; ," " 1,',1 ;'1.' ,. " ,. ,. ,.' ,. ,I '., ," ,. ,. , " 01 ,. '",' ,. '" ., , , , ,. 'II I" ,j:' , - ~ ..' ." I' ." " " /.", , , , " , ,," " ", ",I ,,' 'I; , d'" ,. , I' '!" '" ,.. , , I;, J. RODNEY ICKEL INSURANCE AGENCY ID, 13-2226600 U. S. corporation 1120 Sch K, Supporting Schedules Year End Date: 12/31/91 ________~_N_____.~N__________________W"_______________-________________________ Form 1120, Schedule K, Question 4 Individual(s), partnership(s) or ccrporation(s) owning sot.or more of this corporation,s voting stock: ' 182-22-6277 I J. R. FICKEL, JR CARLISLE, PA 17013 Direct ownership: I~direct ownership: 51.00t O.oot ,.' , ," , ,1' " ., " , , ' 'I, ., ',. , , 'I, .,' ,. ',. .' " ,. , ',' " ,'" ,; : I. J, " ,,' " I' " ';'1, ,. Ii" I, :/' ,I 'J' " " .. " , ,if; I, ;,1 I' ,.1, " I, :,1" I, '., , , ," I. , " ,. , " j,l, " I" lI" " , ' .' " .. , " " " .. .. " I, ,. " , I" ,I ." " \, , ," ". , , "" ,. I, ,.1' 'I', .. ., ' I .' . " t. , , " ,. J. RODNEY .ICI<EL INSURANCE AGENCY IDI .13-2226600 U. S. corporation 1120 Soh L, supportinq Schedules Year End Datel 12/31/91 _N____________N________________~______________________--------~----~--------~-- OTHER CURRENT ASSETS PREPAID CORPORATE TAXES OTHER CURRENT LIA&ILITIES "I, PAYROLL WITHHOLDINGS ACCRUED PAYROLL TAXES ACCRUED SEP PAYMENT .,. d !; ~, . , , ~ . i' II I' II: .,' ., ,. , ,. H, i' .. , .. " '.; oI. 1<, ,. ",I, If' ,. i i ,i , i , ,1< i, , "j , H" , , , , " , ,. , " . " " " ,. " I' I,' ,. " I' ,,1 ", Depreciation and Amortization (Including Inlormallon on w.ted Property) OMB No. 15<15-0172 Form 4562 Oopll1ment of too Trellury Inle,"8I Rovenue Selvlce NlIll8(e) ehown on relUrn J. RODNEY FICKEL INSURANCE AGENCY Bu8l~ or ac:tivlly 10 which Ihle form rolal08 INSURANCE II!iffiII EllCllon To Expenll Certain Tangible Property (Section 179) (Not.: II you havo any "Wsled Properly,' cofl1llole Pe~ V.) 1 MllClmum dollll IIm1taUon (888 InSIruCUona), , . , . . . . , , , , , , . , . . , , , . , , . . . , . . . , , . , . " 1 2 Tol81 coet of secUon 179 propeny placod In eorvlco dUring Iho IIlC yell (1108 InstrucUons), . . . , , , . . . , , , " 2 3 Thleehold coet of secUon 179 proplll1y befor8leduotion In 1Im1laUon , , . . , , . , , . , . . , , , . . . , , , , " 3 4 Reduction In 1Im1laUon - Subtrac:t line 3 Irom line 2, "ul do nol onlO( I... than -0- , , . , , , . , , . . , , , , , " 4 5 001111 limitation lor IIlI rll' Sublreclllne 4 from IIno 1, bul do nolonlOlI08s Ihan -0-. . .. ........... S 1991 ~ S... .rata Inewo1Ione, ~~I.~:~~n~o. 67 IclanUlylng number 23-2226600 200 000 jl)OuetlpllonolproPlflv lalEI,elldea'l IIII : I 'i Ii i Ii! i I ! I : II !: I1II : I : !III : 1Il.11111 i II : : : ~ :: L ! ; '11.11111,'liIlllillll!ilII!lIIIIIlIl,I'IIIIiIIIIIII'il '11111'111111111I1111I11111111I,ldlll','111 111111I:1I111111'111,llIllllIIlllii'I.'II';IIIII: (bleaa' I 7 Wated property - Enler lIl1Ountlrom line 28 , . , , , , . . , , , . , , , , . . , , , , . .. 7 I Tolal elected cosl oleecUon 179 proporly - Add emounls In column (e), IInoo 8 .nd 7 , . , . , . . . " I I TonlallYe deducUon - Enlar lhe Iossar 01 II no 5 or IIno 8. . , , , . . . , . . , , . . . , . . . . . , , " I 10 Carryover 01 dls8llowed doducUon ~om 1000 (soolnslructlon.), , . . . . . . . . . . . . ,. .,..",.." 10 11 T..ablelncol118llm1laUon - Enler lhe I...or ollBJ(eble Incoroo or IIno 5 (soo Inslrucllons). . , 11 12 SecUon 179 expense doducUon . Add IInoa 0 end 10, bUI do nOI orllor moro Ihen IIno 11. ,. ..,...,.... 12 13 Carryover of disallowed doductlon 10 1992 . Add IIn09 9 and 10, IMS IIno 12 . . , . , . ,~ 13 Not.: 00 not use Part II or Part III below for aUloroobllos, eoUaln olhor vOhlclos, collular lolophonos, cOfl1lulors, or propony usod lor onto~slnroonl, recro.'lon, or .musomonl (lIslod proporty), Inslo.d. usa P.~ V lor lI,tnd proporty, if!a~"U.lli/MACRS Depreclallon For Alllt. Placed In Service ONLY During Your 1991 Tax Year (Do Not Include Wated Pro e o 14 (tl Bul,for d.prIC1.lIon IOu.inu.llnv"lm.nl u.. (dlll.cavlty plllod (1IM.thod 101 O.pFlCIIUon dlduclion o o o o o o o 27.~ o 27.5 o 31.5 o 31.5 SIL SIL S/L SIL o o o o o o (J o o o MM MM MM MM 9 RealdonUal renlal propor1y h Nonr881denUaI roal propony o o o lliR!!!ill!!fl Other Depreciation (Do Not Include Wated Property) !IlL S/L SIL o o o 12 r.. 40 r., MM II aDs and ADS deducUon.lor ....1. pl.ced In s.Nlco In I"" yoars beginning before 1991 (.00 Inslructions), , , , , , , , , , . . . , , , , , . . . . . . . , , , . . , . , . . . . . . . , . , . . . , , . . . . " 18 17 Property IUbjectlo secUon 188(~(1) oIooUon (.oolnstrucUon.) . . . , . . . , , . , , . . , , , , , . . . , . , , ,. 17 11 ACRS and othor do rocl.llon ooe Inslructlons . . . . . . . . , , , . . . , . , . . . . . , . . . . . . . . . . . ., 18 ~ Summary o o o 11 Llslod property - Enlor lIl1Ounllrom line 25, , , , , , , . . . . . . , , , , . . . . , , . , , . . , , , . . . 20 Tolal - Add deducUon. on IIno 12, 1lne1l14 and 151n column (g), .nd line. 161hrough 19, Enlor horo and on the appropnale linea 01 your roturn, (partnorlhlp. and S corpor.Uon.. soelnslrucUon, . . . . . . . 21 For....18 ehown .bovo and placod In .eMce during tho Cllrlonl yoar, onler Iho porrlon ollhe ba.la atITlbul.blo 10 .ecllon 263A COIl> {soolnslrucllon,) . , , . . . . . . . . . . , . 21 11 512 20 512 "I'II!II,IIIIIIII"IIIIIIIIIIII'IIII'IIIIIIif'I'1 O~I!!::ii!,;i!li:II!:!!:ii:lii,ill!ii!ll: II! ill,::111 For Plperwofll R,duC:llon Act Nolle" ...IMI" COPYlighl(CllllQllo"n."llw.,. ani.,. C.nt., Pilei SollwIFt, Ine. FOlm 4682 lUll) J. RODNEY FICKEL I JRANCE AGENCY 23-2226600 ~e82 (1001) Plge a ~ Wated Proparty. -Automobile., Certain Other Vehicle., Cellular Telophone., Computers, and Property U.ed lor Entertainment, Recreallon, or Amuaomsnt " you lie ulling the Itlndlld mllelge rile or dedueUng vehk:le le..e o'pon8G, complelo column. (I) th,ough (c) 01 SoclJon A., lit 01 SeclJon e, Ind SeclJon e IIIIlPIk:lblo, SecUon A., . ...lltlon elution: Seo In.truellon. fo, 1Im1lll1on. lor lulomoblle., 221 00 au hlv. ....III.net to ,uppo,' Ih, bUlln..,linY','''''"1 un cl.lm.d' X V.. No 22b If "Ye",~ II the ovldonco wrlllen! (I) (b) (0) (II) (I) (I) (e) (h) BUlIn,..' Oull hu dlpreclatlon In.....I''''nl COlt or lbu..n....lmvnlm.nl UII ullonl.,) PItO.ntllll 0111" bill, uIIIOod bu.lnoss URO ooe In.ll\1ellon. : 70' 15 158 1~ 158 51 ~ 20 468 20 468 Typ.alproptrlv Oal'placldln ,1.1v.hlclutir.l) IIIrv1u 23 Prop ullld moro thin W~ In I BUICK 3 15 86 92 BUICK 12 27 91 0""011110" EI.etlrd IIctlO" '" co.l R.cov".,. Method' p.rlod f,onv.ntlon d.ducllon , o o L L o 512 24 p,o u8Gd WI, or loss In I uollllod bu.lno.. u.o .00 In.l/uello09 : ~ S/L - lll'i,IIIII;Ii!I'II,H+' , S/L - ''1II1I1111I11I Ii 111i'11I11'" , S/L -11,111111"1 11,1,11 Iii" 2ll A.dd lITlOunl.ln column (h). Enter thololal ho,und on IIno 19, plgol , . , . . . . . , . , 25 512 '!I,II,'IIIIII 11,1 lit Add lmount.ln column (I). Enlor the 101.1 hOle Ind on IIno 7, plgo 1. , , . . , . , . , . . , . . . , . . , , 28 0 SectIon a, . InformlUon Rlgorlllng U," of Vlhlolll - " you do duel o'penRn. lor vohleloo, . Nwlya complele Ihl. IlGClJon lor vohlel"" u.nd by a .010 proprlolor, portnor, or olhor "molU Ihan 5'10 own.." or rolalod porson. . If you provided vohk:le. to your omployoe., Or91 Inswor Iho quos lions In Socllon e to soe II you mool an u,eopllon 10 eompleUng Ihls ooclJon 10. Ihoso vehlelo.. 21 Tolll bUI./Invlllm."t mil.. d,lven dUllngthlyt.\OONOT lnckldlcommullngm ,"}. , , 21 TolAl I:QmmuUng mil.. dr'...." durlnllthIY"', , , . . , , 21 Totllotherplt,onll(non- commullngjmllud,iv.n, 30 TQ\almllud,tv.ndu'ln" th. YII'" Add hntl.1' tlUol/gh2ll.."" , (I) (b) (0) (d) (.) (I) V.hicl,l V'hlcl.2 V,hlcl.3 V,hlcl,. V.hlcl. ~ VlhlCI,e 7 978 42 1 000 0 1 870 40 10 848 82 VI. No VI' No V.. No V.I No V.I No VII No 31 Wuth'!f.hlcl'lvllllbl,for UtlonalulldullngoU-duly hou',?"""", , 32 W.. 'h. Ylhlcl. ulld pIt- ml,lIybyamolttll.n&% own.,o,r,lal.dplt.on1. 33 l'lnolhlt",hlcl.,vlllibl, tlH p".on,1 U.." , . , . . X X SectIon C. - QUIIUOnl 10. EmploYII' Who Provldo Vlhlel.. lor U," by Thllr Employ... (A.nowe. th...o qu...Uon. to dolermlne If you moot In o'copllon to eomplollng Soctlon B. Not.: Soctlon B mu.t ntwlYs be completed for vehlel... u.ed by eole proprlelor., pl~nora, or olhor moro thon 5'10 ownOle or relalod po,.ons, x x x x VII No 34 00 you maintain I Wlltlen policy slllomont th.1 plohlbll. III pO/sonsl uso 01 vOhlelos, Including eommullng, by your tlf11lloYIlG8?, , , , , . , , , , , . , , , . , , . . , , . . , , , . , , . . . . . . , . . . , . . . . . . . . , , :Ie 00 you moIntaln I Wlltlen polley .lalorMnllhat prohibits porsonsl uso 01 vohlelos, o'eopt convnullng, by your IIll'loy.....' (Seo In.truelJon. for vehlel... Illlld by corporllo offieor., dlroclnr., or 1% or moro ownor..) . , , , 31 00 you trelt III U8G 01 vohlel... by employee... po,"onal u.e?, . . , . . . . , . . , , , . . . , , , . , . . , 37 00 you provld~ more thin Ove vehicle. to your employeeo Ind 10laln tho Inlormallon rocoivod I,om your omployeo. concerning the u.. 01 the vohlelo.?, . , , . . , . , , . . . , , . , , . . . . . , . , , . . . . . . . . . . . . . 31 Do you moot the roqulromant. concerning quallOed lulomobile domonotraUon uso (lIoe Instruellons)'1 . , . , , , Notl: If our Inower 10 3~, 3S, 36, 37, or 36 I. "Y..... ou noed nol com loin Socllan B for tho coyerod vohlelo.. x x X 1111111111"111111 ~:pll:tliVl'i<l Amortlzallon (O)AmoltIUbl' .m(lunt (eI) Cod, (f) AmortluUon IIcllo/\ 31 Amortlzlllon 01 co.t. thlt I".' , " 40 41 83 83 Form U7ii'i1i !2!!!'rtlzollon nl co.I.lh.1 begin bolo Ie 1991 " ....,.,..,.,. ".",.,.."" 4i Tolal. Enler here Ind nn 'Olher Doducllon," or "OlhOl E'pon.o." IIno 01 you, rolurn "...... Fo, P,ptr\ltOfll A.duellonAcl NoUe., II. In,I', Copyllghl(tllnl fOlln '11 II 'N"" only C.n'" Plec. Sollw"" Int, Altl:lmatlve Minimum Tax - Corpuratlons OMB No. lil40-0170 FORn 4626 (Including environmental tax) Otpll1mtnl 01 the Treuury ~ See Hplrall In.lructlona. 1991 Inlllnll R.....nu. BIlVIc8 ~ AltIch 10 Your to return, NIrTlI I Elr4>loyor Identlflc.tIon number J. RODNEY FICKEL INSURANCE AGENCY 23-2226600 1 TI.MIbft Incomo or (loll) belate nSI operlting loss deduction. (ImpOIt..",: 8.. In,I", If you II.aubj,cl to thl ,"vltom,nul tn.1 1 1. 648 2 AdIuellMnta: Ilill iWII . Deprecl.tion 01 t.nglbl4 propor1y pl.ced In eorvlce Ihor 1006. . , . . . , . . , , . , 21 Ilill,lllil! b Amortization 01 C8!1II\ed pollution con~oll.cJlltIoa pllCed In eervlc8 11101 190a. . . . . 2b '1"'1"1 11,1:: o Amortlzltion 01 rnnlng e.plor.tion Ind developmenl coato pllld or Incuned Iher 1900 20 Illill:m d AmortlaaUon of clrculaUon up'nd1tu,.. paId or Incur"d ,II., 1111I (plrlanal holding camplni.. onlyl 2d :1:lli111Ii,1 I Bull .dJultmenllln dolonr/nlng glin or Iolllrom ,IlIe or e,ch.ngo of propony . 21 1 L.ong-11I1l1 con~lCllentured Inlo .h81 Fobruary 26, 1966. ,. . ., , 21 1'1111':11 9 lnallllment..lee 01 C8I1l1n propony, . . . . , . , , . . . . , , , . , , . . , 20 I,Ijllll;I!1'1 h Murchlnlll\lllne clphll conslruction lunds, . , . . , . . . , , , , . , . . , 2h I, ,II!III I Sectlon 833{b) deducUon (Diu' eto.., BIu, Shl.ld, .nd.lmIIAfIYJI' o,,,."IUllon. only), . . 21 :lil!llilli!: I TIX IhIIl8I flrl11lCllvl1lM (p8llOnli sorvlce corporlllono only). . , . . . , . . " . 21 k Pualvo ICllvlU8I (cloooly held corporltlona Ind pOlllonal oorvlce corporsllono only) 2k Ilill!il!li!1 I Certolln Iou IInltlllona. , , , , . . . . , , . . , . . . . . . . , . . . , . . , , . , 21 "11"1' m Olhet IdJuotmonll ""...".."...,."..,..".,.,. , 2m 'I!i: Iii' n Comblne linea 211hlOugh 2m . , . , . . . , . . . . , . . , . , , , . . . . . . , . . , . . .""..... , 2n 0 3 Tu prll.,ln.. ".m.: i'li!iilil I 08ll1otlon. , , , , . , . , , , , , , . , . . . . . , . , , . . . . . , . . , , ... , ~ ,111:llill b TIX-e'8ll1lt 111181..1 Irom prlvlle .ctivlty bonda I..uod ahor Augusl7, 1066, , ,.. , 3b lIil:I!'! o Apprecllted propony charillblo doduction . . , , , , . .. , ". . '" . 30 '1111111:1 d Intangible drilling coaho , . , , , , . , , , , . , , , . , , . , . , . . . , . .. . 3d !III'lllilil I R.......81 for 10_ on bid debts 01 nnsnclli In.UluUon. . . . . . , , . . . .. . 31 1 AcceIorlted clopreclltlon 01 rOil proporty pllced In service belore 1007. , , .. , 31 ,,11111111: g AcceIorlled deprecl.tIon oll4..ed peroonal Proporll placod In sorvlco bofore 1967 (pooonll holding COlll'lnI.. only) . . , . . . . . . . . . . . . . , . . , , , . , , 30 III II II!I!: h Amortlzltlon 01 certified polluUOn control Ilclllllos pllcod In oervlco beforo 1067. . . 3h IllilllllJiil I Add 11081 31 thlough 3h , , . . . , . , , . , . , . . , . . , , . . . . . . . . . , . . . , , , .. . '., , . , 31 0 4 Pre-IdJuatment l/1emaUve mnlrrum IIlI.blo Income. Combine lineD 1, 2n, alld 31 . , , , , . , " . ,., . . , 4 1. 648 5 ActIUlted current umlnga lcijultm.nL Enl.' th. .moulIl from ~n. 12 01 th, work_h..1 on pg. , of th,lnllr, . .. . , . 0 I Combine linea 4 .nd O. II Z8IO or IOQ, olop h8le (you are nol subJOCllo Ihe elleroallve mnlrrum tlX) ., . . , 1 1. 648 7 AdJuatment blSOd on onergy prelerencos. (00 nol enler moro Ihen 40% olllno 6.), , , , , . . . . . , . . . 7 -- I Moonlllve tlX net Op8llUng 10DS deducUon. (00 nol onler mo,e Ihan Ihe e,cess, II any, 01: (I) 1lO'~ of line 6, OV81 (b) 1100 7.). . . , . . . . . . . . . . . . . . . . . . , . . . , , , . . . , , . , , , , 1 0 0 M8Inlllve rnnlrrum tllllble Income (.ubtrlcllhe oum olllnoo 7 end 0 Irom IIno 6, , . . , , , , , . ,.,. , . 1.648 10 I!lCImpUon phue-oul computaUon: (II line 9 Is $310,000 or moro, oklp IInoo 101 Ind lOb end enlllf 'I"'I':IIII , il"'l-I -0- on llno 100): "I" I !i!II,I:' I Sub~lc1 $1&0,000 from line 0 (II you are I member 01 a conlrollod yroup, see '1IIil,'I" InatlUctlone), II the ,..ulll. zoro or le09, onle, -0-. . . . . . . . . , . . . . . . . . .1101 I 0,1,11'1' f!i.jlil! b Multiply line 101 by 20%, , , . . . , , , , . , , , . , . , , , , . , . . . , , . , . .11Ob o 1lllfll!ill Q Ex8ll1ltion. SubtrlCt line lOb from $40,000 (II you are I member 01 I controlled group, oee ,11,11 Inelructlonl), II the 'Muh Is ZIlfO or le!lll, onl81 -0- . . . . . , . . . . . ". , , . "". , 100 40.000 t1 Sub~lClllno 100 Irom line 9, Illhe resuh la zoro or loss, enler -0- , , , . . ",., , .,." , 11 0 12 Multiply line 11 by 2U'~, , , , , . , . . . . , . , . . . , . . . , . , , , . "," , .", . 12 0 13 Al181nIUve mlnlrrum IIX foreign IIX crodlt (see InoWcUono lor IImleUono,) . .. . "". , , , " , 13 14 Tentlllvo rnnlrrum tlX. Subtrlct IIno 131rom line 12), . . . , , , . . . , , . ,. , ",." . . , , . 14 0 15 RegulorllX IIlbltlly belorelll credlls e'cepllho foreign IIX eredlt and pO!lllesslon. IIlI credit, , , . , , , 15 247 11 Al10rnIUVI minimum to - Sub~lct line lSlrom IIno 14. If Ihe rosulllo zoro or I..s, enlor -0-, Noo enl81 the ,"ull on line 0', Schedule J, Form 1120, or on Ihe comn.rlblo line of olhor Income till relurns.. . . . . . 11 0 17 I!nvlronm.ntal \Ix - Subtrlct $2,000,000 from line 0 (compuled wllhoul reglrd 10 your envlronmonlli IIlI deduction) Ind rrulUply Ihe e,,,,,,s, II Iny, by 0,12% (,0012). EnlDr on line Ob, Schedulo J, FCRn 1120, cr on Ihe cormarablo line 01 olhor Income IIlI rolurno (members LI a controlled nrouo, oe> Inslruellons\ . . . . '" . 17 For PapltWIHIl R.ductlon Act NnlIC., ...lnll" C.opy,lghl(cj1Ilil fo,m loflw," MIV e.M., PIICI Sollwarl, Ine, F... 4121 1""1 , ". " RODNEY FICKEL U. 'S. 23-2226600 SURANCE AGENCY Employe: :0: corporation Income Tax Return Carryover Schedule Year End Date: 12/31/91 J. Amount Current Used Carryover Carried to Year or (back) Amt Current Yr Addition Expired to Next Yr ------------ ------------ ---------...-- ------------ Contributions 2,125 259 1,866 ',' " " ,. ,. " " ". .. " ,. \." , " I I , , \ " I. " 1\ " I. " , " " ,. ,. .. , " "" , , , " " I. ", .. " 1\1' .. " ,. ',. " I , " .. " I',' , " i. I'" 'I '.' " , ,I' ,. " ,!' , , ,. ,'Ii ,I' , .. " ,,'" " ,. , , ,. " . ., 'i I, " lol\ " ,. II" '-j., I" 'I,' , " I, I. , ',.., Iii 'I " " " " " " 'I! , , " , , .." " 1/' " " ". " I, I, " " ,,, I , .. , I, " ,. " , '.. I' . . ' NAME ADDRESS fiC!./GF., (AJs/)/ A-,A/t-f:- "t?o A I'Y I (!.~LISI", /~ J; ,.uc ~ 170 /:3 .,( 3 --1:/:1(, (.0 () 1/,) () /,J . ?JI-(jl EMPLOYER I.O,NO. FORM NO. YEAR ENDED Pursuant to Proposed Regulation Section 1.461-S(d), the taxpayer hereby adopts the recurring item exception method of accounting for the types of liabilities specified below, effective for the tax year beginning in 1990. Pursuant to Temp. Reg. Sec. 1.461-7T, Q&A-7(b), the following information is provided: Each business for which the recurring / i tern except ion is adopted: Q II tJi'S I fl f 50S 1-.5 Types of items with respect to which the recurrillg item exception is adopted: . All items (including liabilities for rebates, awards, insurance, warranty, and servIce contracts and taxes as defined in prol, Reg. Sec. 1.4bl-4(g){3)-(b) (~Section 481(a) adjustment not applicable, as above liability items either , not incurred in prior year or previously reported under accrual method. ( ) Section 481(a) adjustment applicable. Amount to be deducted ratably over three-year adjustment period is $ (one-third amount deducted in this return $ ).. ,,' I ~ ' ., .'. ".'", , , , ;1 , " , ' '..., , B&R 394 3.094 (Rev. 10-91) , ,,' f' "'-1, '.1 Forni 1120 , S. Corporation Incomo Tax .etum OMO No. 1~5'0'23 O.putm,ntntlhlnIUur'f Inllfn.IR.vtnu.8.rvlc. Of uljnd., ~.., "11 Dr tu Y'" beginning . UU, .ndlng , l' ~ InatrueUona Ire aeparll.. S'e~' p;g~ ; ',~; ;'.parwork R~d~~U~~ 'A~i NoUc;: . 1992 A Chick If a: UI. (1)ConlolidIUdlllur" B IRS (.uuh ro"" "II label. IJ) Plllan.1 hOldl"1 co, Other.. (tluch SCh, PH wf... P . IIIPmonl,urvlc.corp, pll..I' 0 I BOX 1 IUd'f1nodl,rom'''''by' print '::ARLISLE, PA 17013 R."., lie. 1.44,.<tT - or typo. ,,,'",ttucHon,' E Chock OllPIIc.bl. 00,,,: (1)1 IlflltlaJ 'alum (2)1 I Final rolurn (3)1 I Chango In addro.. 1. Gross rocclpta or salas 285 I 501 b l,ulIlurnllnd IlIow,nc.. cOol" 10 2 Colt of good. sold (Schodulo A, IIno 8) . . , . . . . . " " ., 2 3 Groa. pront. Subtraelllno 2 from IIno 'c . . . . , . . . . , .. 3 ~ 4 Dividend. (Schodulo C, IIno 19) , , , , , . . , " '" , , " 4 o 5 Inlo,o.I., , ., , . . , , , . . . . , , " .. . " 5 o e Gro.. lanl.. . , . . . ,. ,....,. . . , . . " .. . .. e m . 7 Grcas royaJUas, , . , , , , . . , . , , , , . . . , , , , , , , , , , . . , , I " 7 e Capital gain nollncome (1IIRCh Schoduro 0 (Form" 20)) . . . , , . , . . , . . , . ., 8 9 Not gain or 0093) from Form 4797, Par1I1, IIno 20 (1lIoch Form 4797) . , , , " " . ., 8 10 Other Income (sooln.lI\lcUono - anach schodulo) " . , . . . . . . , ,. " . " 10 11 Tolallncom., Add lines 3 Ihrouoh 10, , , . . , , . . . , . . . . ,. ., . . ~ 11 12 Componoatiol1 of onkers (Schedulo E, line 4) , , , , . . . , , , . ,. 12 = 13l1Sall/lesandwagos 44,231 blo.sJobocrodll o Balance, "~ 130 , I 14 Repal,& ., .,. ,.,. ,."" , , . . , , " ., , " ." 14 i 15 aad debl.. "",.., "..." . . , . , . . , . " ,.,. . .. ". 15 0: 10 Renla , " ",.., , . . . , , . , , , , , , . , , . , , , , , ,. , , , , " 10 . t 17 TlXes , " ". " . . , , , . . , , . . , . , . , , , . . . . . . . . , .. 17 d Q 18 Inlerast, . , , . , , , , . . . , . . , . . .. .,. ..,..., "'""... . , , . .. 18 u r o I 18 Char1leble contrlbutions (see Instn.cUons lor 10% IImllaUon) " . , , , , , . . , , , , , , , . ., 18 II T 20 Dopreclltioll (alllch Form 4502) "". ,., , , , , " ,..".1 20 I 4 094 :i:::::il;l: 21 Less d8p,aclallon claimed on Schodule A and el.owhere on relurn. . . , . , , ,l21aJ 21b o' n I 22 Depletion, , , . , , , , . , , , , , , . , , " , , , , , , , , , , , , , '" , , :a Q . n 23 Advertising, . , , , , . , " ""',' " . , , , , . , , , , , . , , ,., ,. 23 , Q 24 Pension, profit-shl/lng, Olc" plan., . , , , , , , , , . . , , . . . , . . 24 , 25 Emplayoo benefit programs , , . , . , ,. , . , , , . , , , , , , , . . , , 25 d I 28 OlhOf deduction. ("nach schodule) , , , , . . , , . . , . . . . . . , , , , , .. 28 : 27 Tolal dtducU.n.. Add lines 121hrough 28 , . . . . , , . ., "",.".,. . . , . . ~ 27 I 21 TIX.blelncomo before net oporating 1099 doduction and spoclal doductlon., Subo,clline 27 f,om line 11. , . . 28 ~ 28 L.u: . Not opersting loss deduction (soo InSll\lction.). , . . . . . , . . . . . ,I 29. I 0 :'i.::,I,:I: b Sooclal deductions (Schodule C, IIno 20) . . . . , , . . . ' .1 29b 1 . 394 290 30 Tuabl.lncom.. Subtrar.lllno 29c from line 28. . , , .. '...",..,., . , , , , , 30 T . 31 Tolal lax (Schedule J, line 10), . , , , . , . . . . .. .,..,..,.... , . , . . 31 x 32 Paymlnll: .1111 Ovltplymlnt cr,dllad to 1.12 321 24 7 1;\":;,~:Ii'I~il:,'ii!l!iiii:':, -i!::I!::::':~I:H;:;il::~i;!I!i:~!i!ill:illllii!I'!:I::11 'i:11i,i:IJ "i :i;i:r':I:ij"illi"lli;i/i!j'liiij:I:!li(!'I;;il'I'i'II!II!;<j:l:illl,II':I'IIil:II;li: !II'II:II . b 1992 ostimated tax paymonls. . , . " 32b !!:::::'i:IJi!l;ii :"'i i,!II;lII! l'il:II!I:I,',ii!,l'i1:!'illi:l!!illl:llld:;I,llh!II:1r illi~:Vil n a Loss "12 IIhlnd appllld for on Fo,m olUS, , 320 d BaJ'" 32d 247 !!:: i' d . TIX dopo.llod wllh Form 7004, . . , , . . . . . . , . . . . . 32e ':''''i" P I Credit from r&gullled Invo.tmonl complnlo. (Olloch Form 2~39), , . . , . 321 1':::I::!i:1 ; g Credlllor FederaltlX on luelo (1lIsch Fo,m 4138). SOlllnsll\lcUens . . .. 3~ 32h m J3 Estimalod lax penally (008 In'lI\lctiono). Chock it Form 2220 I. IlIachod, . . . . . . . . . . . . . . ~ U 33 ~ 34 Tax du.. If line 32h Is smallor than tho lolalulllno. 31 ond 33, onlor~u ~' . '"' ,7, . . , . , , , 34 t 35 Ov.rplymlnL it line 32h I. larger than thetolal 01 line. 31 snd 3Jj Iiilbf', Iou I . J.L ~ , . , , , . , , ., 35 · 38 Enter amount olllna 3S you wanl: Credited to 1993 ..lImated 1.0\ ~ \ ) J II Refunded . 38 PI Undlrp,n'l1ln or PlrjuIY, I dlC:~" Ihll I hlv.llI.mln.d IhlllllJrn, '''It!u~eo~ Ylng"teh.dulu ,nd .lll,mlnl',and lolh, but 01 my knowl'dlll ,nd ease blllt't Ill. tll"', coulet, and crmpll't. O.clAr.Uon 01 p"p,,,, loth., lhln 'uPlvlIll, b.ud on IlIlnlormtUon 01 which pttp,", hat any ""owl'dlll. Sign Here J. RODNE'i FICKEL INSURANCE AGENC'i B EmploYIf IdlnUIlUlllcIn "UlftbIF 23-2226600 C Otltinco,plHltld 01/03/83 o TOlll....'. {... SPltl'" InlllucUonl' 107 , 972 285.501 285,501 1,992 5,739 42 293 274 147.620 44,231 6.000 10.427 7.700 956 4.02..1 5,211 19.185 39,246 284.670 8.604 1 394 7,210 1 082 247 835 Paid Props,,", Us.OnIV ~ SIQnSlure 01 offlcor Preparor's ... slQnalure r V0 I DalO ~ TIlle I Dale I-J Chock it soil- .1 P,opare,'o ooclal socu,'ty no, I. /1..'1/)'1 omplo ed nl 164-38-8267 ~9Y.':lF:. ~I)R. R~~1:~I7.,.. .c:?A:!':................... PO BOX 8300 E.I. No. ~ camp"ifiTC .P1\........... ........... ............ ZIP codo ~ FI"n'.nlmt ~ (arroulI,l' ulf-,mploytdj and,deft". DIU For Pap.two," AtducUlIn Act Nollce, .nlnltl, COPY'Ighl(cl ,gill 'orm 101"'..." 01'1'( ClflI., Pllr. Sollwarl, Inc. 23-1311005 17001-9300 Form 11:lu(lnll J. RODNE'i 'CKEL INSURANCE AGEllC'i lOt 3-2226600 , Form 1120 1992 Plgo 2 ';8c e IlI.iA' Coal'ol Gobda Sold Sooln.l1IJcllon..) I '"vI"lory II beginning 01 VOII , , , . , , , 1 a Purctt.,el""""".",.,.". 2 3 Collolllbor,.",.,..."""... 3 4 AddlUonol locllo" 263A COlla (1lllch Ichodulo) , 4 a Olher call. (1lllch Ichodulo). ""'" 5 . Tolll. Add IIn.. 11hrough 5, . . , . , , . , , . I 7 l"ve"lory II o"d 01 VOII, , , , . . , , , . , . , 7 . Coil 01 goodo lold. Subulclllne 7 110m linn 5, Enlor hOlo Ind on pugo '1. IIno 2. . I I ChICk 011 molhod. usod for volulng clo.lng Involllo,y: (I) B Coal (II) 0 Lowor 01 coal or malkol as dnscrlbod I" RagullUo"s socUO" 1.471-4 (III) Wrllodow" 01 "sub"orm.r goods a. doscrlbod I" RogulaUo"s aocUo" 1,471-2(c) (Iv) Olhel (Spoclly melttod ull<ld Ind Illlch oxpla"aUo",) ~ b Chock litho LIFO l"vo"lory melhod WIS adoplod Ihl.l.. VOBllor a"v g~~d; (Ii Ch~~k-o-d-:lilach 'F~;';;97-0"'::':: ~ -: ~ -::.:: -:: ~ - - .0.... o If tho LIFO Invonlory ""'Ihod WIS usod lor Ihl, lax voar, onlnr po'conlago (0' amounla) of ~ cloll"g Involllory l.;Ompulud U"dor LIFO. . . . . , , . . , . . , . . . . , . . . . . . , , , , . . . , , . . . , .. 90 d Do Iho 1Il1.. of ,ocUon26JA (1M proporty producod or acqul,od lor ,.,010) apply 10 Iho corporallo"? . , . . . . . , , , , , . Yos ~ . Wu lhoro Inv chango I" dOlomllnlng quanllllo" coal, or voluallon, botwoo" oponlng a"d closing I"vonlory? II "Yo,", Illach ox lanlllon. , . , , , , , . . . . , . . . , . , . . . . . . . . . , , . . . . . . . . , fiSctfedlllaIC11 Dividends and Special Deductions (500 In,uucllon,,) I Dlvldond. from 'OM-lttan-20%-ownad domo,lIc corporallon' Ihalalo lublocllo Iho 70% doducUon (Olho, Ihan dobl-financod alock). . , , . . . . 2 Dlvldond, I,om 20I',-or-molo-ownod domo,Uc corporaUon. Ihol oliO ,ublocl 10 Iho 50% doducUon (otho, Ihan dobl-financed slack), , . . . . , , , . . . 3 Dlvldond. on dobl-fina"cod slack 01 domo,lIc a"d forolgn cOlporallon' 11I,IiOO "'AI 4 Dlvldonds on cortoln prolonod slock 0110,a-lhan-20\.-ow"od public ullllllos , . . 5 Dlvldonds on cortoln prolanod alack 01201'.-or-moro-ow"od public ullllllos. . . . . Dlvldonds from 1...-lha"-20%-ownod lorolgn corporaUons and cortoln FSCs Ihal lie .ubJOCllo tho ?O% doducllon, . , , , , , , , . , . , , . . , , , , . , , . . . 7 DMdond, from 20%-or-moro-ownod fo,olgn corporallons ond cortoln FSCs Ihat 1I00ubJocllo Iho 50% doducUo", . , , , , . , , . . , . . , , . , , , . , . . . , . Olvlcf.ndt hom whollyowntd fotllgn ,ub.fdllfll. lubj.CIIO thl 100'" dlduC:llon(llc:l.on 24$lbll, I To"'l, Add lines I Ihrough 5. 500 InSl1lJcUon, lor IIrrJlaUon. . , . , . , . , , . . 10 Dlvldondl from dome,Uc corporallon' rocolvod bV 0 small buslno", InvoslmOnl co~anv ororoung under Iho Smoll Bu.lnoaslnvoslmOnl Acl 011056 . . . . . 11 Olvld.nd, 110m certain FSC. thai a,. .ubllcllo lh, 100"', d.ducUon(uel,on 24S(cXl)) . , . 12 Olvld,nd, hom .Ill~atld Q10uP fIIlmb". .ubjlc:llo lhl 100'" d'ducUon(lIcllon 24:1 ('Xl)l. . 13 Olhor dlvldo"d. from forolgn co'po,allon. nOII"cludod 0" IIno. 3, 0, 7, 5 0'11 14 Incori1o from conuollod forolg" corporaUons undor subpart F 1II'ICh F..ml" $4111 IS Forolgn dividend Rrc..-uP (Iocllo" 75). , , , , . . , , , . . , , . . . . . . . , Ie IC-DISC .nd former DISC dlvldonds nOllncludod on IInos 1, 2, or 3Im'"n 2<11'11 . 17 Othor dlvldonds , . , , , , , , , , . . , . , , . . . , . , . . . . . . . . . . . 18 O.duellon f<< dl't'ld,nlll Plld onellllln pflhflld I\o:~ (I' publiC: ulllilil' (1IIIntl,ucllonl). . . ~I, i II Tolll dlvld."clo, Add lI"oS llhrough 17, Emor horo o"d on line 4, pogo 1 .. ,~ (a) Oi't'ld'l'ld. (b) '10 flc:II.....d ,. 992 70 80 '" In 'ucllonl 1.176 7.059 70 80 100 ;1;., 1,',.,1,1;1 100 100 100 i""""'" 1 (0) Splejll d.duellont: I . 1 394 1 394 ',",I".,"I'II'I'I"',III'I'I'I"'II,I!I'I"I'I"I'II"Ii,! 11:!:II'lil'I:'I'III"II:'i"li'i'i!II'., '" 1""1' ',,,,,.,,, l'i',lllJ1111i',IIII" ",lilllil,,,li!,I;I'!'I" "i....I;-'1 'I,i!,! Iii 'I' ,_,I 'I I,il:-j,:' 'Ii i(',II: r111!il JlII"\' 11111:III,ifil'll '~il'I'illlll'III!!:I":IIIII'li,'IIIIII"!II!I!:i;ll:!:lllh' "'I",.'.I'II""",','],IIII'I,IIII'i,',II:,III:'; ; ~ II ; . ! i " I' 1 ': :! ii, ,Iii , ':. I: I' q I . I I, ii',,: ,:.d1il:l.lIl.i.. ril'l',.!:!. lil~:lllilll!,JI 1"""1'1"1"1'1'111;1"1"':'1'1111"1'1'" :1,,11-101 III 'i:' 1:II;j!",~I, J,d,:i!i' "" 20 TOllldlducUonl,AddllnesO,10,11,12,ond15. Enlorho'oondonlln020b, 001. ..,',..,"'~ 1 394 08ohedllli)I'E'I'1 Compensation 01 Officers (Son In'l1IJcllon, lor 11"012, pago1.) Co 1010 Schodulo E onl ~ 101.1'0001 I' IIno 1. lu, lino94 Ihrou h 10 on I 0 1. Form 1120 ore $500,000 or moro, (I) Nlm. of ollie., (b) Soclalue'Hllynufllbu I J. R. ~'ICKEL, JR. WILLIAM FICKEL 182-22-6277 198-44-7813 20.0010 100.0010 2 Tolol compo"soUon 01 ol11ce", , , , , , , , , , , . . , . , . . . , . . , 3 Co~OnsoUO" 0' ol11cor. Claimed on Schodulo A and ol,owhoro on ,otu," 4 Subulclllne 3 I,om IIno 2, Enlor tho ro,ull h.lo ""d on line 12, n 01 . . Fot Paplfwork Rtduellon Act Nolie., IIllnll', 51.00';. 49.00';. !l Pllrtt"d O.OO~ 0.00';. '10 '10 'Y, ~ ';' ~ COPy"ghl(t1 liU lorm loll......,. only C,nlll PIIC, 5011""'''1, Ine, (f) Amounlofcoltlp.nllUon 7 440 140 180 ~ 'I. " , 147 620 14" 620 rot", 1120111121 J. RODNEY 'CKEL INSURANCE AGENCY lOt 3-2226600 Form 1120 1992 I:ScheduIB"J Tax Compalallon (So.ln.~ucUon.. 1 Chock n Ih. corpor.Uon I.. mombor of. con~ollod group ('00 .ocUon. 1501 ond 1503) . . . , . . , , . . ~ 2 II tho boK on IIno 1 I. checkod: . Enlor tho corpor.Uon'. .h.,o of Ih. $50,000 .nd $25,000 I"".blo Incomo brockol omounl. (In Ihol ardor): (I) 0 (II) 0 b Entor tho corpor.Uon'. .h.,o of Iho .ddlUonol 5% IIX (no I 10 oxcood $11,750) ~ 3 Incomo tax, Check Ihl. box n Iho corporoUon I. . qu.llnod porsonol .orvlco r.orpor.Uon .. donllod In .ecUon 440(d)(2) ('00 In.trucUon.).. . , . . . . . . . . , . , . . , . . . . , . . , . , ... Forolgn tax crodll (.n.ch Form 1118) . . , . . . , , , . . . . b Po..o..lon. IIX crodlt (.n.ch Form 5735), . , . , , . , . , . . . , , , , o Orph.n drug crodll (.n.ch Form 0705) , , , , . , , , , , . , , , , , , , d Crodll for fuol producod from. nonconvonUona! sourco. . , , , . . . . . I Gonora! buslnoss crodlt. Enler hero Ind chock which forms .,0 anachod: OForm 3000 0 Form 3468 0 Form 5884 0 Form 6478 OForm 6765 0 Form 0586 0 Form UtlJO 0 Ferm 6828. , I Crodlt for prior yoar minimum IIX (an.ch Form 8627) . . . , , , , , , . , 6 TaLa' cradlll, Add IIno. 4. Ihrough 4f . , . , , . . . . , , , . . . . , , . . Sub~act IIn. 5 Irom IIno 3, . , , , , , , , , , . , , . . . . . . . , . . 7 POl8Onsl holding co~lny tax (.n.ch Schadul. PH (Form 1120)) . . , . Rocaptur.lax.., Check If Irom: 0 Form 4255 0 Form 8811 . 9. AlI.rn.Uve minimum lax (.na~h Form 4828), . , . , . . , . . b Envlronmeola! lax (.n.ch Form 4626), , . , , , , , , , , , , 10 To"" lax, Add IInM 81hrou h 9b. Enl~r h.ro and on IIno 31, . a1. IISchodlllol Ki Other Inlormallon Soo In.trucUon.,) 1 Check melhod 01 .ccounUng: Ve. No : B ~~:~ (.:ec~ :cc~.~.................... 2 Reier 10 Ih.lI.t In Ih. In.trucUon. ann .Iale Ih. pnnclpa!: . Bueln... .cUvlly cod. no, ~ 64 11 b Business .cUvlly ~..m~0:WJ~~".~~~fl.s:X"" o Producl orservlco ~ ~lJ~V~!,{S~............ 3 Old the corpor.Uon .llh. ond of Ih. lax yaar own, directly or Indl,oeUy, 50~. or moro ollhe voUng alack 01. dome.Uc corporaUon? (For rula. 01 .ttrlbuUon, .00 .ecUon 2&7(c),) , , , , , , , , , II 'Y....atllc:h. 'Chldula ahowlng: {llnam. and ldlntllying numblt;lb)pI,unugl ownld;"nd {e} Lu..blflln~GI'l' ot (lOll' balor. HOL and .plelal dlductlon. ollueh CDrpOtllion 10' 'hi tllC yUt 'ndlng wllh 0' within your tall yell, 4 Old .ny Indlvldua!, partn.r.hlp, corporaUon, a.lal., or tru.1 .1111. ond 0' 1h. lax yaar own, dl'ocUy or IndlrecUy, 50'10 or mor. ollh. corporaUon'a voUng Ilock? (For rulo. 01 .ttrlbutlon, '00 socUon 287(c).) II "Vo.," co~I.lo ., b, .nd c b.low . . . , , . . . . I. tho corpor.Uon . .ub.ldINY In an aUlllalad group or a peronl-.ub.ldllll'/ con~ollod group? b Enlor the name .nd Identlfylng numb.r of Ihe peront CQrpor.Uon or othor enUIy wI1h 50~. 01 more own.r.hlp ~................. ............... , . .~ 4. 4b 40 4d liI!I[II'II' 'ill;!i:!;i 4. 41 P.go 3 I : i : I ~ I III ~ i : 11111'11'1 ..Iii:r ,i'I,!,!ii!;!1 1111,,+, ;I," '1"1,,1,'10,1 D'II~II'i' '1"'1'" :""1': '1,1,11'11,1, '1'1"'1 111111il'l 1"1: ,:i'II,I'!I' 'lil,IF,:! lil'IIIII,I",,',I, .,11",11, lil;;,i,: !i)i',1 '1IIIi'I' ih;l,i; 5 . 7 8 9. 9b 10 1 082 1 082 1,082 W.. Iho corf*aUon . U.S. .haroholdor 01 .ny con~ollud V.. No forolgn corpo,aUon? (Se. o.cUono 951 and 957.) , . . X If 'Yo,", aUach Form 5471 lor each ouch corporuuon'II'ill'l il'IIIP:HI :~~~yn:::~:~:~:1:::~::::~::~"~I~ 'I~~""" - 1'lli!I,IIIIIII.I'I!;:II:I:!' corporaUon h.v. an Inlaroot In or . algn.luro or olher : 1111il,1 ,I't'I':!:I; aUlhorl1y ov.r a nnanclol aceounlln . foreign country Ii' 'I' ":", 'I.', (sueh as a bank account, secunUos aecounl, or other ,1.111111,11 11;;,11"" nnancla! .ccounl)?, . , . . . . , . . . , , . , , , , . X II 'Yo.", Ih. corporaUon may hava 10 liIa Form TDF 90'22.1 ,1,!II'I:iHlllll!iiil" U.......,..nurnam.of lo"lllncollnt,y .. illl:iiiliili !III'il'III:I:! 8 Wa'lho corpor.Uon Ih. granlor of:;r'tr;;.j;r~; i;, 'a' f~;;lgn '1Ii':llil,II,',I.:lli 11II tru.llhal .,I.I.d during Iha curr.nt IOJ< year, wh.lh.r or Ii 1111111111:1'1:1,11::: no11ho corpor.Uon h.. any bonollclol Inler..lln II? , , , , , X II .....u,.lh. co,po,aUon may lI.v. U hi. Form.U!, 3520, '1Iii::I'I'II'I, 1','I:!il,j:lI",':, ormO-A. 11'li'I:II,il,:II'11 Old on. for.lgn p.roon al any time during Iho lax yoer own, '1'1' Iii'" "1,111::" dlracUy or Indirectly, all...1 25~. 01: (.) Ihololol voUng '1'11'11"'1,1"1'11,1 pow.r 01 .11 cl..... 01 .Iock of Ih. corpol.Uon anUU.d 10 ,ili 11I1 ,',1II11I,i! VOID, OIJb) Ihe lola! v.lue 01 all cl..... of .fock of Ih. ,,' ,'x' corpora on? . , , , . , , . . , . , , , , , , . . . . , , , II "VD'," ,e. In.trucUon. and '1"?llillllllllllll"l IEntor potconlogo ownod ~ ~ ~ ~.. ~.. ~.................. ............ 'Ii:iiljijl!:[ il!!l Iii! bEulor own or'. country ~ ,lll'1'I"IWI"jJ:i: oTho corpo,.Uon may hav~'I~ 'fii; F~i';; '5472: (500......." illl:II:IIIII'I'II" ~~r:~~~~ ':~:C.hnO~u= :~..I.~~~ ~~:~ .~~f:~ :~~~: ~~ . ,!I II iil!' '11111!i,J'I[! 10 Check Ihlo box n tho corpor.tlon I..uod publicly on.r.d dobl 'Ii III ; illllllll'/ Inal/umonl. wllh orlglnol I..uo dl.count , , , , , , . ~ 0 '111:1 ': 111'1 hi If '0, Ih. corpor.Uon m.y h.v. 10 file Form 8281, , I'!'[ 'I II' 11 Enler Ih. omount 01 fax-oxempt Inlor..lrecolv.d or Accrued,i, I : II '!i,III'I:' during Ih.11\)( y.er ~ 0 "1111 i 111'111;1111 12 IIlhoro w.r. 35 or lewar .hlll.hold.r. allhe .nd 0' tho 'lil!I"I::',I'I!,:!,III'li lax yoar, ontor the numbor'" ....................?.................. ;i,:i!i:!!;j;: ;:!!;::!jl 13 IIlho corporallon h...n NOL lor Ihn lax ya.r and I. Illi:II"" 'i':I":', .Ioollng und.r 000, 172(b)(3) 10 for.go 1h. c.rryb.ck,I!II!!I'I:: ii!I"I'iI'I:1 h k h 1"""'1""'1"1' oriod, C OC oro"""""""", ... I '!I.'I. '! Ii 1,1,111, . E~i;r';.,c.;~I~g;"~~;,j'~" .si.:6o.......... ............................... 5 During Ihls fax y.ar, did Iho corpol.Uon p.y dlvld.nds (other Ih.n .Iock dlvld.nds .nd dl.~lbuUon. In .xch.ng. I~r slock) In OXC09O of lh. corpor.tlon'. cunenf .nd accurrMJlalod oarnlngs and pronls? IS.. lIet, 301 and 318.1 II "VOl", nle Form 5452, IIlhl. I. a con.olld.led r.lurn, .nswor horo for Ih. paronl corpJr.llon .nd on Form 851, AIIIII.llon. Sch.dul., lor ..ch ."b.ldl. , FDr Paperwork A,ducUon Act Nolin, ''.In.I,, COprllllhl (cI1112 101lT', ,ollw'/I only C.n'" PI'U SO!IWII., Inc, Form 1120 (\in) Olher liabilities (anach schodule). Capllal slock: a Prelerred slack, b Common slcck , 23 Paid-In or caphal surpluB , , , , 24 Retained .arnlngs - Appropnalod 1"llOh IOh'd"') 25 R.lalnod oarnlngs - Unapproprlalod, . G 9 , 3" GO 75 , 376 26 Leu cost 01 u.ssury slack , .. . , ,. .. . . . 166 530 166 530 27 Tolalllabllltle9lnd Slockhold.rs'. ul 13 8 110 107 972 Noto: Vou are nol ro ulred 10 com lole Schedules M-' ond M-2 below litho 10lalassel' on IIno 15, column (d) of Schedule L are le.olhsn $25.000. 'I,Sctledule~'M"l", Reconciliation 1)1 Income Loss er Books With Income er Return (See In,lrucllon,. 1 Net Income (loss) p.r books, . . . . . . . . . . 6 01 7 Income recorded on book, Ihl, year not 2 Federal Income lax, , , . . , . , . , . , , , . . 1 597 Included on Ihl, relurn (1Iemlze): 3 Excess 01 capllallosses over capllal galn, , . . Tax-.,empllnlere,1 .... _.......... 4 Income sublecllo tax nol locerded on books this year (1Iemlze):... _ _ _.... _.... _..... __ J. ROONE'i . Balance Sheols Alula t Cash....""""".." 2a Trade nolo. Ind accounls rocolvable . b Less allowanco fer bad dobl. , , 3 Invenlone.".,......,.." 4 U,S. govornment obllgallon., , . , . , 5 'fax-o,empl securltie. (see In,l1\Jcllon,) . 6 Olher currant asse" (sttach IlOhedule). 7 Loan. 10 slockholders . , . . , , , , , 6 Mortgage and leal e'lole loan~ , , , , g Olher Investmenls (attach sch.dulo). . 101 Buildings and olhor doproclobl. ,ssal. b L.ss accumulaled daproclation , lla Dapletabl.88.el. . , . , , . . . b L.ss accumulal.d d.plotion, , . 12 Land (nel 01 any amortlzallon) . , 131 Inlanglbl. ....1' (amortizable enly) b L.u accumulal.d amortization. . 14 Olh.r ass.l. (aUlch IlOhodule), , , 15 Total09s.ls.,.." . . , . . . . , UabIllU.. .nd Stockholdar.' Equity 16 Accounl' payable, , . . , . . . . . . . . 17 16 18 20 21 22 Mong&llu,nOIU, bond,plYlbl1 In I... 1hln 1 V'" , Other curronlllobllitie. (attach schedula). . . Loans Irom slockholders, . . . . . , . . . Motllllllll,I'lO'U,bond.paYlobl.lnly",o,moll. . 5 Expanses locordad on books Ihls yaar not deducled on this r.lurn (Item/za): a DopreclaUon.."", .................. b CanltlbuUon.e.auyo...., ......~..........~f.~ o Travel and enl.nalnment 4 Add IInos 1, 2, end 3, . . , , . . . Fo, f1apllwo,k AldueUon Ac1 NoUte, ."Inllr, 'CKEL INSURANCE AGENC'i IDt 3-2226600 Pa 04 , ""'1"""1" ,,,,,'I,i:,II,,II"""',,11 ,,11"'"'' ',I,,',!'I'I',., 26 699 c 1'"",1''' ',' ";;"11" 'I! III 111"11"'" 21 218 :,d'I;,1 I.. , ""I"b,.lIII,1 d"I,I,111 Iii" 2 4 . 2 0 6111"I'I,II'I'!I'IIIII'I,:II"'I"I""I'I,IIIIII:I'1'I'!I,II,' _ ,p',II'I,,"IOI',';,I-I<.,I, " 1'101, 24 206 3..?.L} 2 5 III: I', 13 769 :;'I>!:::I:i::;:i:jl?li:!I:;::~illl:ilijiiii:il'II::!1i;, !;I :'I:l)'jll il:,I';1 ,:11;:':1';1':':\1:: ," A 968 :;lli:I'~'il:<:ti!::~:!!!,!:i:::i11:lil;i!I:I;li;il!!i' ~ t 591 ':i:l!ii!i!ii:::'~:I!li:lil:I::H!i:i!I!!i:li!!iii!lili:: , ~,,:;:- j,' ,J 'I' I:",: i I : ' , Ii : i ,II ,I' III1 i: ~ ,',111"'1, :," ,I "fil;,!,I" ''''11.,(;, ',',1111111 'I';i",!,~,'k' "lil.",I',li' ill,II" 4 1 5 7 6 : "', " "', """',':,",'" "I," ,,' 43 568 ,!'!., ,:ii.' "'11,1,'1"] I 33 '~i '25 '1!I:j,!lijj;i:Uli:i::I:i':i':i:!llij:Ii'I!,rIl::i!II,1 17 863 15,862 ",',1;1:,'1' 'I"" "1.1",,,,1,,,:;,,..;,1,:,,.',,.,,, 3 000 '!,:::-;::i!:!ii:!:!I:i!li;'!i:,p 19 956 , , ' I]!:, I",'""',"",,,,,,, i::, ;,;1 ::11;: :Ji I~ ~li:1 ::1111:: i ::j,:, 415 v' ::111' 'd;II'I'; I'~', I'YI'I!jl"i'~II!":' ,,,1'1';"'1"1"1'1,'1'),',.10,,,,.'111""1<1'1,,,,,,1 297 118 I'i""""" ,'"jj, """"111."1,,,1,, 415 214 :,,1,,:.,;,: 73 567 138 107,972 "III:dli'il':i\'!{:;I"i'i 11,:1':;'1 :,I,I,I!,I,'I,I"".I.II:I,II:!,'I,:II::'!::I...I:,!;111 62 348 57 53,211 106 ! : : : i I: i:: 01 : : i i i : I ,! .:,::: I : ! i, ! ' , : , i i :: Ii. : I ' : : ' ~ : ' ; , i 10 000 ,,',', 6 Deductions on Ihls rolurn nol chargod agalnst book Incomo Ihla yoar (lIe",ze): . Doproclolion, . , .. ............... b Conltib~'liO"'Uflyo....r 8 604 7 Add IInos 5 and 0, . . , . . , , , , , , 8 Balanco al end 01 oar IIno 4 loss IIno 7 75,376 Copyllghllcl un 101m lollwUI only C.nlll 1'1'" SOllw,", Int, Form 112tll1l1l21 J. RODNE' ~ICKEL INSURANCE AGENCY II 23-2226600 U. S. corporation 1120 paqe 1, Supportinq Schedules Year End Date: 12/31/92 _______________________________U___________________N___________________________ OTHER INCOME MISCELLANEOUS' 4~ ....------..----- . 4~ .............c TAXES PAYROLL CAPITAL STOCK TAX PA CNI ,', , I 8,72S, 30C l,39E .. ' ------------... " , " ',., 10,42~ .............c CURRENT YEAR GROSS CONTRIBUTIONS Y.M.C.A. CUHB CO HISTORICAL SOCIETY COMB COUNTY COALITION UNITED WAY OF CARLISLE lolISCELLANEOUS .. 40C 25e 10C 10C 10E --..----...------ 95( ..............,..1: 'HER DEDUCTIONS SUBCONTRACT OFFICE POSTAGE TEI,.EPHONE DUES & SUBSCRIPTIONS . INSURANCE . AUTO EXPENSE, UTILITIES MISCELLANEOUS LEGAL & ACCOUNTING COMPUTER EXPENSE MVR'EXPENSE Amortization " l,40C 5,88e 2,2U 2,282 2,822 16,974 1,078 2,20e 543 2,145 1,578 50 83 ,. ' " I. '-". 't" ..' , " , , -------,-...----- 39,246 .............. " , " "I' I'" , " " "l" ,. ' ,;! " , . ". ...,.:..i..... _;'1',>1.', J. RODNEl' ""ICKEL INSURANCE AGENC'L Ir '23-2226600 U. S. corporation 1120 Sch K, supporting SchedUles 'Lear End Datel 12/31/92 M_____________________________________________________________________________1 Form 1120, Sch~dule K, Question 4 Individual(s), partnership(s) or corporation(s) owninq ,50' or more of this oorporation's votinq stookl 182-22-6277 J. R. FICKEL, JR CARLISLE, PA 11013 Direot ownership: Indireot ownership: 51.00' 0.00%, " , , ,. .; ," "', , . " '. ,. "" ,. ,. '1 .. " I , ... ";". " " ,. 'I , .. " ,.. ., ,. I ...., I;, d.-, ,')1' tl'i' :~,' il':. ~/ I' II', Iii '" (.,' f',' . I;.:;,:. /l', ,\) r:;"II' ,.', ..oj' 'I" " '" ",: d~ ". " " ,. ,. , " (: ~, I I, I ,. 1 , li\:!, " .. .. " " " " , "" ,. , " I ,. .. '-I, " " " , " ,. ,. 'I ,. I. , " I.;., 'i ",..-.>; inl ~'f;;':':; ,! :~4 '~"\I;' " J. RODNE' ?ICKEL INSURANCE AGENClI II 23-2226600 U. S. corporation 1120 Soh M-1, supporting Schedules lIear End Da~al 12/31/92 ~~_N~NN___~____~___N_NN~__~_____________________N___________~_____N__N__N_____. FEDERAL INCOME TAX Federal Income Tax 1,59' , ---'---------_. 1,59' .............. ,I' OTHER EXPENSES ON BOOKS NOT DEDUCTED ON RETURN CORP LOANS TAX I"~ 46! ------..------- 46! I " .............. 'I I " 'L ,-., I', i. " " ',I' I. " 'j, :' '1,' ,. ,. I." I, , ", "', '" I "'1 ,'., .1:, ,~. ',I ," I " " ';" '(' ., j H I, .. ,.' .', ,. '" . <-" "1< " , .. ,. ., " , .. ',', ,. ,. I' ,. i' I" " , j I,' ~ I,',,', I ;'! , ,. t" ,', I" ,. . " i .. I'ii t", 11 " I" \.1' ',. ,. '.', I,".! ,"", . , ,. I' I". ,. ,. .1. I. , , 'i ,. '\ I," , ' " ". " "'" ,; , " " " " 1" " ",' , " , ,. ',", ,I I, .,1, "j, I',' " II' I.' ". ,. ", .' ',',i" \',' " " , ,. Ij,; II,' .,.. ,. , .. " .., II .. " , " 'j,1 ,,' ',:' " q, ' , ,. /. '1 , " ,. "" ". ',' .' " I. 1-' " , .. I' I ";1 i , ". " " ," "" , " " i" .. ,. '1 I ,I' Fit'" 2220 Under, .yment of Estimated Tax by OMS No. 1~S'0142 ,orporatlons O,,,"lm,nlofth,T,...utV Intlfnal RI\~'nuI S,rvlel H."" ~ SOl "plrltl InllNcUonl. ~ Attach to thl co oroUon'. lu r.lurn, 1992 EmploYI' Id.nlillwUon numb., J. RODNEY FICKEL INSURANCE AGENCY 23-2226600 Not.: In mo'I c.... the IRS will n ur. tho snll and tho co otftijon will nol havo 10 co lal8 lhl. form, Sulhlln.\luctlon. to, mOil In'ormlllon. II altl,ill FI urln The Under a menl 1 Tolal tax (.oeln.trucUon.) , , . , , , , , . . , . , , , , . . , , , , , , , . . , , , , a. Portonal holding complny lax Includod on IIn01 (Schodulo PH (Form 1120), IIn. 26). 21 b Inloro.t duo undOf lho Iook.blck method 01 .ocllon 460(b)(2) for complolod long- lonn contraclllncludod on IIno 1 , , , , , . , , , , 2b o Crodlllol Fodaral lax on fuol. ('00 In.\rucllon.), , , , , . . , . . . . . . . , . ., 20 1 Ojl'11Ij!I!I'! 01,111"'11' 01!111!!!1:11 1 082 d Tolll, Add IInos 21 through 20, , , , , , , , , , , . , , , , , , , , , . , , , . . , , , . , , , , , , , , , 3 Subtrlclllno 2d 110m IIn01, litho ro,ulIl.lo"th.n $500, do not complolo or liIo thl. form. Tho corporollon doo. 2d o notowethep8nalty , . . . . . , , , , . , , , , , . . . , , . , , , . , . . , , , , , , , , , . , 3 4. litho corpo/lllon'. tAll YOII bogan boloro July 1, 1092, mulllply IIno Z by ~3%. '11""'1'1 i Ot"...,. III Iy II 3 b 97", 41 1 006 ',, !"'I"!'I"'I' ,,,,,,,..0, mu p ne y """""".""..",.,.,.. 111 I> Enter tho tax ohown on lho corporallon'. 1991 Income Ill( loturn (CAUTION: S.e 'Iil,!ii, tn.lNoUon. beforacompllUng thll IInl,). , , , , , , , , , , , , , . , , , , .. 4b 247 . !il!i!llli c Enler thl .mlller olllng"l or IIn811lb, II lho corporation Is roqulrod 10 ski IIno "b, Inllt lh. .mounltrom lin. "Ion Ilnl "e 40 1,082 247 I (d) o 5 Inlllllmlnl dUI dat... Enlor In ~olumn. (a) Ihrough (d) tho ISth day 01 tho 41h, 6th, 9th, Md 121h monlh. 01 tho corporallon'. lax yall , , , , . . , , . , , . , , . . , ,~ 5 . Rlqulrld Inlllllmlnll, Entor 2S% olllno 4c In column. (aj qi!jil,i; through (d) unlo... or b below appllo.to tho corporaUon: 1I'!1!i'l ': . II thl corporallon UI8I tho onnuallzod Incon... Installment ',liillll !i method Ind/or tho IdJu.tad seasonal 11I.lallment method, Illi:!;' Ii complttltho worlelhoelln tho In.\I', Ind ontor on IIno 6 '!'lll!:1111 tho amounlO trom IInl 4S olth. worle.hoot, AI.o chock thl. II, ..Iill boK ~ 0 Ind Ittach I copy 01 tho worle.hOOI, : "Ilillll blithe coOrltion I. . 111go corpo/tllon,' chock thl. . i:,;,'I',,:~"I" 11'1111' boK ~ Ind lee tho In.\/\Jcllon.lor tho amount ,"11:::11: to enter In 81ch r.olumn ollln. 6 , , , , , , , , , , 6 62 62 62 '_ _-&1 7 Eotimatod tax pald or crodnad for oach porlod (800 Instrucllon.). For column (I) only, ontor tho amountlrom IIno 7 on IInol1 , , ",..".., . 7 0 0 0 Compllllllnll' through 14 0' on. column blfoll goll1ll \0 thl nlxl oolumn, . Entol amount, n any, Irom IIno 14 alth8 procodlng column 8 185 123 61 D Add IInos 7 Ind 6 ., . ..",.."., , " . 9 185 123 61 10 Add amountl on IInos 12 Ind 13 01 tho procodlng column 10 0 0 0 11 Subtrlclllna 10 from IIn. 9, II zoro 01 losa, onlor -0-, For column (I) only, onlor tho amountlrom IIno 7 ". , .. . 11 247 185 12 litho amount on IIn011 I. ZO/O, .ubtractllno 91rom IIno 10, 'l'II"r'I'll"W""I"I'I" 'il'III.I'111'IIIIII'I'1111 Ii! 'i.!i 111,I;li'l,ill,,\'~,::illil, :' 0 Othorwlll, onter -0- , ., , ..". , ".,. , , 12 1"II,i:I'IIII"d"I';I;;I,II.I"'IIIIII,I': 13 UndlrplymlnL IIl1no 111. loss than or oqual to 11110 6, lubtrlctllna 11 trom llna 8. Then go to IIno 8 01 tho noll1 column, Oth8fWl1G, go to IInl 14 (lOG In.\rucllon,), . , ,. 13 0 0 14 OVlrplymlnL IIl1n. 611101S thin IIn011, .ubtrlclllno 6 Iromlln.11, Thon 010 IIno 8 ollho nOKlcolumn , , , ,. 14 185 123 Go to Plrt II on plgl 2 to ngurl thl plnllly. If thlrl orl no onlrto. on IIn. 13, no pln.11y II oWld. o o 61 o For Plperwork R.dwell,n Acl NOlltt, ...In.lf, FOlm 2220 1111'1 Cll"Yllghlfc) 1112 form .ollwI" onlv Clnt" Pilei Sllllw."lln~ FICKEL INSURANCE AGENCY 23-2226600 Page Z - 1.1 Ibl (eI) - (0) I' Enllllthe dale 01 paymont or the 1SIh day ollhe ~rd month ahllllha clo.. 01 thlllAlC year, whichever I. earlier (.... InelnlcUonl), (Form 8DO-PF and Form 880- T nlerl: U.. Slh monlh In'lud ol3rd monlh,), , . . , . , . , , 15 - Ie Numblll 01 d'Yllrom dua d.le ollnllll101onl on IIno S 10 the dlllJ Ihown on line 1&, . , . I . . . . . . , . , , , . 18 17 Numblll 01 daYI on Une16 .her ~/16/12 end before 10/1/02 17 II Numbol 01 daya on line 16 aher 0/30/12 and belore 1/1/13 18 11 Numhor 01 day. on IIno 16 ahor 12/31/12 end boforo 4/1/93 il!- - - 20 Numblll 01 day. on 110016 ahor 3/31/13 and belor. 7/1/93 20 21 Numblll 01 days on Une 16 ahM 6/30/93 and befor.l0/l/93 21 22 Number 01 days on 1100 18 ah.r 9/30/93 .nd bolor. 1/1/94 22 23 Number 01 days on line 16 eher 12131/03 & boforo 2116/04 23 24 Undlfpaym.ntonWnl1311 Numbltof dlY. onlln. 17 )( 80/. 24 !II 2Ii Uni"lpaYIII,n'onllnl1211 Numbltoldly.onlin.1I X 7~. . , 25 >II 2. UndllPlym.nl on Nn. U Ie Numblfol dlYlonlin, tt )( 70/. , 26 311 27 Undltpavm.ntonRnlUJt Numb., ot d.y. on ~". 2\1 )( .~4 . 27 m - 21 Undllplym'ntO"lIn'1~. Numb.rllldl.,.lonlinIZ' )( "I. 28 lIS 21 U"d"ply",.ntonWn'1~. Numb" of dlYI nn Nnl22 X lilY. 21 lIS 30 Und.rpaym."tonlnI13. Numblfot d.y. 011 IIn. U x 11I% 30 III 31 "dd IInee 24 Ihrough 30, , . . . , . , , . , , '., , . . 31 32 PI!NALTV. Add columna (e) through (d), line 31, Enter here end on line 33, Form 1120; line 28, Form 1120-": or como liable line for other Income tAlC relurn. , , , , , , . , . . , , . . , , , , , , . . , . . . . . . , , , . , . . " . 32 0 'I' Uti ourporaUonl. tll )ltat .nd'lft.r DIll.nlbll S1. 1'12,'" th,ln'ttuctlon. fo, Unll 27 Ituough 30. .-. . For "'Pllwor_ R.dutllo" Ao' NOllet,...ln,'" Copy,lghtlcl '..lla,,,, ,ol1wI" onlyC.nl" Ptu. SollwlII, Inc, POfm 2220 1'11I1 1'- ,-,';j-'. 'J. RODNEY FICKEL ISURANCE AGENCY , U., s. corporation Inoome , FORM 2220 - Underpayment of Emplo: . 101 23-2226600 TalC Ret:urn Estimated TalC Year End Datal 12/31/92 ---------------------------------------------------------------------~----~-_. .Under/over Payment Analysis Date of first payment ........... Amount of first payment ......... (a) 04/15/92 247 (b) Date of seoond payment .......... Amount of seoond payment ........ Date of third payment ........... Amount of third payment ......... Date of fourth payment .......... Amount of fourth payment ........ ---------..- ----------- Total amount of payment ......... Add I Prior qtr overpayment .... Less I Cumulative underpayment Amt applied <added> to cur qtr .. Total amount duo on line 6 ?47 185 o ------..---- ----------- 185 ----------- ----------- ..... . 6? ,62 " ----------- ----------- Total amount under or <over> paid -185 -123 .a......... ........... ' . _. ,--.', ' 1-' I"~ l' " , ,.1 , "I ,,'I ., ',\'1 ,-" I " 1\ ,. " ,,' " " " F",m 4562 Depreciation and Amortization (Including Information on Usted Property) OM3 No. 1~~-Ot72 Dlpl"m,n'ollhIT,ulu,y InhrulRIVlnUIIIlr.-ICI 1992 67 IdenUlylng number 23-2226600 .. Soe ee ..!!oato InstnJctlonl. Harnt(lllhownDnlllurn J. RODNEY FICKEL INSURANCE AGENCY Buslneso or activit'( 10 which Ihl. lo,m rolal09 Section 179 - Summar ill Partilll Election To Expensll Certain Tangible Property (Section 179) (Nole: II you havo any "U.lod ProporlY," 001111>1010 Part V boforo you complelo POll I.) 1 Maxlroom dollll 1Im1lallon (800 In.tr\Jcllon.). . . , . , . , , . , , , . . , . . , , . . . . . . . 2 Tolal 00.1 01 aecllon 179 prop9f1y placod In sorvlea during Iho II)( YOII (soo Ins:rucllons) , 3 Throshold oosl 018OOIIon 179 property belo,o roducllon In 1Im1lollon . . . . , . . . . 4 Reduction In 1Im1lation, Subtraclllne 3 from IIno 2, bul do nol onlor 10.. Ihon -0-. . . , , 6 001111 1Im1lallon for II)( YOal. Subtraclllno 4 I,ol11l1no 1, bUI do nol onlor loss Ihan -0- , , . OIlC,lpliM U',JfOPII1V b Coil 10 000 1 2 3 4 6 $200,000 10 000 c) Eleclldcoll "'/11111::"1'1:1';'1:;:1'::":'. 'I' ;'..>'1'.1, 1','1 .",. "101' ''I'';!'iI!'II'IIIdl'I:ld''II;IIII!!'III;i "" l.,1 : ,.,1,'.,;.. 'I . q' 11"""II["lli'III"IIII"IIIIIII,I,':I"1 'I"II':I,! 'I': i'~:'!'( , 'i.lil,I)II!I', 1.1 I' , ' ; III :' 'I " III.'" Ii, _ I ". I,,' I ,II: ~ ," I, 1 : ' , 1 ,!I, 1>!>I'I",II'II'II,:,II:,!!'illll , 8 7 Uslod proporty, "nlor arnounll,om IIno 28. , . , . . . . , , , , , . . , . , , , , . . . " 7 I Tolal eloclod oosl 01 soction 179 proporty. Add amounls in column (c), IInoo 8 and 7 . 8 Teo'ative doduction. "ntar Iho smollor of IIno 5 or IIno 8. , , , . . . . . . . . . . . . . . 10 Carr;ovor cf disallowod doducllon I,om 1991 (000 In'lrucUon.). . , . , . . . . . . , . . 11 Taxablalnoome IIm11aUon. Enllll' lho .mallor olll)(ablo Inoomo ur IIno 5 (soo InouucUons), 12 Section 178 e'pon.. doducllon. Add IInos 9 and 10, bUI do nol onto, ma'o Ihon IIno II . 13 Carr;ovor 01 dlsallowod doducUon 101993. Add IInoo 9 and 10, 1099 IIno 12 . . , . . . . . ~ 13 Not.: Do nol use Part II 0' Part III below lor oUlomablloo, cortaln Olhor vohlclo., cellulal lolophono" computors, or plOpOrty u,ed for enlortalnmant, recroaUon, or amuoomonl (lIslod p/opMy), In,lood. 11'0 Part V lor "'IOd propotly. ,__ !!!IPllrtllllq MACRS Depreciation For Assets Placed In Service ONLY During Your 1992 Tax Year (Do Not Include Usted Prope 8 g 10 11 12 B 604 "I' :1'" (c) 81111'or dlprlCllllon (bUlinlll/iIWI.lmlnlull (g) D.pttC;llion dlduchlln (d) Rfl:oVlrV plrlod (I) ",,'ho< lill!i: IIIIJ:;\ijl!i:I::!'!i,'!iiPii:II" il: ; Ii I i iI i ,I i : 1 i 11I1 : : : ~ II, i!' ,I ~ i I, '!!llliillllii!lil:lil:I:liii:::I,::I: g Rosldonllol lenlal proporlY 27.5 rs, 27,5,!!s. 31.5 's. 31.5 ra. MM MM MM MM S/L S/L SIL S/L h Nonrosldential rool proporty 16 Mornallva Do reclatlon 5 sl.m a Cia.. life b 12- eal o ~O-yolI AOS SGO In.lructlons): !:!li:!I']i:I'l(;':ill'I,I:i!:i,'i: ..1:1:1 'o;,:.::ji MM S/L 51L S/L 12 fa. 40 (9, rfPii'rt'iiiNl Other Depreciation (Do Not Includa Usled Proporty) ..., 18 GDS and ADS doducUons lor a..ol. placod In sorvlco In IllX YOalS beginning bola/e 1002 ('00 Instruction.), . , , , . , . , . , , , , , , , , . , , , , , . . . 17 Proporty aUbJecllo socllon 168(1)(1) oloollon (sGO Inotr\JcUono) , 1. ACRS and olhar da roclallon aoo Inol/uollono . . . . . . . , . 18 17 18 II Rllrt'llVII I Summary 18 U.tod proporty, Enlor amount from line 25. . , , , , , . , , , . . . . , . . . . , , . , , , , . , . , 20 To\.ll, Add doducllon. on line 12, IIno. 14 and 15 In column (g), and IInoo 10 Ihrough 19. ~nlo' horo and on Ihe appropnalo IIn.. 01 YOUI rolurn, (Partnerships and 5 corporoUon. - .00 Ins~ucllons . 21 For a98ale ahown above and placed In aorvlco during the curronl YOal, onlor tho portion 01 tha basi. allribulablo 10 socllon 263A co.lo (000 Inslrucllono) . . . . . . . . . . . , . , , 21 11 20 !'I:!:llllIi!lllilljlll~II'I!:',I:!II"II!I'IIIII,I,!1 '-'I'll"" "".I"!""'1"';'1'111" ,I "I.,!IIII,,,I,i'..,III,q':'I'I'" ,:1'1 ,'.' "" ".,' ,',1'".,1., Fo, Plil>>ltwork Alducllon Act Noliel, I.. 1Mlr. FlI//ll 4562 lunl Copy,lgh1lcl un IOlln lollw." onl)' Clnlll rllel Sollw.". Inc. Farm 4562 Depreciation and Amortization (Including Information on WSlod Proporty) OMO No, 1545-0172 O.partmantollh. nUIUIV Inlllnll Rlvlnll.tl",lct .. S.. Ie ,,"telnatrucUonl, .. Attach \hll form ''!E'~ : .Ium, 1992 67 IdenUfylng numb or 23-2226600 Na"'t{t)thDwnon IIh"'n J. RODNEY FICKEl, INSURANCE AGENCY BUllness or ectlvlty 10 which Ihls lorm lelales INSURANCE fi:; Part' I,' I Election To Expense Certain Tanglblo Proporty (Soctlon 179) (No Ie: 1\ you havo ony .Uslod PIOpOlty," complele PAlt V boloro you complNG ~arll.) 1 M""lmum dolll/llm1tatlon (SIlO Instructions). . . . , . . . . . . . . . . . . . , . . . . , , , . . 2 Total coal ollectlon 170 propOlly pllcod In sONlco during Iho I"" yo", (sooln,~uctlons) . 3 Threshold COil olllOCtlon 170 propOlly 1><110'0 roductlon In limitation . . . , , . . , , . . 4 Reduction In IImlatlon. Subueclllne 3 Irom IIno 2, bul do nol onlor 10,,"lh.n -0-. , , , . 5 DolIlll IlmllollolI for I"" YOlll. Sub~aclllllo 41,om IIno 1, bul do nol onlor '0" Ihon -0- , . (I) OltC'lpllon 01 P'OPIl1V b Coil 1 2 3 4 5 $10 000 200 000 C [Itclld COil "I",' ".1, '" , I . 7 U8Iad proper1y, Enlor M1Ountfrom line 26, . , , , , . , . " ., , . . , . , , , . .. 7 . Tolal eleclod coSI 01 section 179 propor1y. Add ",nounls In column (c), IInas 6 and 7 . I Tonlatlvo deduction, Enlor Ihe smallor olllno 5 or IIno B. , , . . . . , . . . . . . . . . . 10 CarryoVO! 01 dlsallowod doduction from 1991 (soo Ins~uctions). . . . . , . . , . . . . . 11 T",,"blo Income IIm1tetion. Entor Iho smallor oll""lblo Incoroo or IIno 5 ('"0 Instruction,) . 12 Section 179 oxponso doducUon. Add IInos 9 ond 10, but do nol 01110' ""'0 Ihon IIno 11 , ~IT'/over 01 dlsellowod doducllon 10 1993, Add IInos 9 ond 10, 109911110 12 . , . . . . . ,.. 13 Noto: 00 not usa Part 1\ 0' Part III bolow lor aUlomobllos, cOllaln olho, vohlclo" collular 1010pl1onos, compulo,", or proporty usod lor onto~olnroont, rocro.llon, or nmusoroonl 1I'lod ro 0 . In,lood, uso Po~ V lor lislod p,oporty. ",srtU'. MACRS Dopreclatlon For Assots Placod In Sorvlco ONLY During Your 1992 Tax Year (Do Nollncludo- Wsled Pro e '1:,1 1 ,.." --- . I 10 11 12 o 14 (c) eU'llol dtprlmllon (bU.11t.llinvlllmllnlu'l (d) RIGOVft)' plrlod 9 Rosldontial ronlel propor1y 0 0 0 0 0 0 0 27.5 IS. 0 2",5 IS. 0 31,S IS. 0 31,S IS. MM MM MM MM (f)Mtlhod (g) OIPllclllion dldllcl,on 0 0 0 0 0 0 S/L 0 S/L 0 S/l 0 S/L 0 S/L 0 S/L 0 S/L 0 h Nonresidential reel proporty 15 12 (9, 40 19, MM o 1,1.,1 I,' 0 o n'l:!artlllll;1 Othor Depreciation (Do Not Include Wslod Proporty) 1. aDS ond ADS doductlons for e"o,s placod In ,0Nlco In I"" YOlllS boglnnlng boloro 1992 ('"0 Instructiona), , , , , , , , , , , , , . , , , . . . , , , , . . . 17 PfOpOrty sublect to soction 1611(Q(I) olection (seD InstrucUons) , ~RS end olhor de fool.llon .00Inslru,.lIons . . . . . . , . , I,part IVII Summary lS 17 IS o o o 11 Uslod proper1y, Enler M1Ounlfrom line 25. , . , , , , . . , . . . . , , . . . . . . . . . , . . , . . 20 Tolal. Add deduction. on line 12,lIno. H .nd 151n column (g), and IIno, 19 through 19, Enlor hOlD end on Ihe epproprl.lollnoa 01 your rolurn, (PAllnor.hlps and S cOlpo"lIon. . .00 Instrucllons). 21 For ...el. shown ebovo end pl.cod In ,0Nlco du,lng tho cu,ront yoer, onlo, 1110 porllon of Ihe be,IUltrlbuleblolo ,ocllon 263A coni' SOD Inslrucllon,) .",.,...,.." 21 11 4 094 . . . . . . . . 20 4 094 I; II T'II:'I':'ldlll",t,'::I!II'II',!ill:,;;:I'II'! ',,1,1;, ,1.,1.1,11, 1011,'11." ',''''.I'I,!I''II''.:'II'''''''' o 1',I'I',!i,:II'''I''', ~:,Iii:'i' I '1';11 I',', ,.," , For Plpltwork Rtduc\lon Acl NOIICt,," in lit, COP)'11llhl(CI llIlllo,m lollw."only Clnll' PIICI uOIt....ltll, Inc, rOlm 456:1 (111I11 J. RODNE~ FICKEL l Form 4~82 (1992) URANCE AGENCY 23-2226600 67 Pego 2 ~ li1arflViI! I Wated Property - Automobiles, Cortaln Other Vehicles, Collular Tlllophones, Computors, and Property USlld for Entertainment, Rocreatlon, or Amusement For any vohlclo for which you ilia using Iho .Ia"dllld mloego rolo or doducUng 100'0 o'pon,o, complolo only 220, 22b, columnl (I) Ihrough (0) 01 SocUon A, 011 01 SocUon B, end SocUon C II oppllcablo. SllCUon II . Do reclaUon CauUon: 500 In,lrucllon. for 1Im1laUon. lor nulorrobllo.. 22.00 you hlv' ''Ild."" 10 IUPPOtlth, bUIlnul/lnvtllrnlnl UII cl.llm.d? X VelS NCI 22b If "Yos: 191ho ovldonco wrlno"? No a 0)) e) g h) Oa Illot Oal. plloc.d In OUlln'lI/ Coli or d.ptlcllllon R.co....,y M,lhodf a.pllellllon Inv..'m.nt (bullnusl ..,vi" PltcU,'n~.g. olh., bUI, lM'Itllm,.nl pl/lod COnY'nlian deductIon S/L - S/L - ~ ~L- 25 Add MlOunta In column (h). Enl9llho 10101 horo and on IIno 19, pagu 1 , . . , , . , , . . . . . . . ,. 2S 4 094 2B Add MlOunl. In column m. Enlor Iho 10101 hore end on IIno 7, a 0 1. . . . . . ., ......."..., . .. 28 s..cUon B . InformaUon Regarding Use 0' Vehlcl.. - II you do duel "'pon,o. lor vohlclo.: · Nways complelolhll locUon lor vehlclo. usod by 0 solo proprlolor, pan nor, Or Olh81 "moro Iho/l 5'10 ownor," or rolalod porson. · II you provldod vohlclu 10 your employaes, 11"1 answer Ihe quesllons In SocUon C 10 900 II you moolan e,coption 10 comploting Ihl. aocUon lor lho.. vehicles. 00 ~ 00 ~ 00 31 WlIlh.v.hlol"vlllAbl.fo, p".onlluu during oll-dulV hOltl/., . . , , , . . . , , 32 WUlhIVlhli:II","dl"- mllUybyamO,.Ihln Y. ownl,ol'llalldplrlon', , 33 1IIIIothlrv'hlcl'lnllabl. fctpI"anll","1. , , , , X SloUon C . QuuUon. for Employ..o Who Provide Vehicle. 'or Usa by Their Employa.. AnowOllhoso question. 10 dolormlne II you mool en o,copUon to compl.Ung Soction B, Nolo: SocUon B mual A1wayo be complelod for ",ehlelM USE'd by sole propriotors, par1nors, or olhor mota lhan 5'/. ownora or ralaled arsons. L 4 094 o 34 Do you molnloln. wllllon policy .Iolomonllhal prohibits all porsanol uso 01 vohlelos, Including commuUng, by your employeea?, , . , , , , , , . , . , . . , , . , , . . , . . . . . , . . . . . . . , , . . . . . . . , , . , , , as 00 you molnloln e Wlillon policy .Ialemonllhat prohibit. porsonol uso of vohlel", o'copl commuUng, by your employee.? (See InsllucUons for vohlclo. uled by corporelo olOcol9, dlroclors, or 1'10 or mora owners,) . , . , 35 Do you treel 011 Ust of vohlcles by err;>loyoes es porconol uao'(. . . , , , . , , , , . . . , , , , . , , , , . . 37 Do you provldo mora Ihon flvo vehlclos 10 your employons and rolaln Iho InlormoUon roeolved Irom your employeo. concerning Iho use oflho vohlole.?, , , , , , , . , . , , , , , , . . , . , , . . , . . , . , . , . , , , , , . , 31 Do you moellho roqulrOl11Onls concGrnlng quallflod aUlomobllo domansvaUon UBO (soo In9Iructio"')7 , , , , , . Hotll If our InawDf to 34, 3!5, 3e, 37, or 381s "Yos,. au Ml'd nol eom Iota Soctlon B for the covered vehicles. Pillrt:VII Amortlzallon - a 0 24 Propom usod SOl', or 1098 In a 27 Total bUI.flnvlltmanl mil.. dtlV'" dUlllIg Ihl yr, (00 NOT llll:lud. eommulIlIlI mil.." , , 21 Total cO"llmulllI1I mU.. dlltl" durlnG'hl y.., , . , , , , 2" TOl.&lolhllplr'O"II(lIo"" commutlnlll mllll drln" . 30 Tol.&l mil.. d,IVI" durin II Ihl y"'. Add 11""2' 1hrollllhU..,." . OIlCllpUOIIOlcOII. ';' ';' uellOod buslnoss USO ';' .00 In.ltucllon. : '~:.' ';:' I: : I;:' ii i I,: II iii;: i II ill i: i I: I i ~ i Ii: i I: i I ! : ' i iiildilill'I:III:Pllillll:i:I::,:'jli',i "'III;t'II'II'II'lfl'~I"';"" ';1111;:1.1,',1"111>;'1,,:11 :;' o Vlhlcl. t Vahltl.2 8 540 0 3 660 12 200 V.. No V.. No X X (I) Vallltl,3 Vlklel'4 Vlkler,S Vlhlel.5 Ves No Ves No Ves No V.. No I V.. No X " , X X X X IIIiHri:1111j::h I :1 !HHlI:li~i:F! (I) Dat..moIIlUllon blglnl ArnorUullOll Plllodcr P'IUnta a ;'(llnlii !!" I i I i ii !: ill' i:: i: I ~. ': i 11111 :' : I ! 1 i Ii!: ; 1 Amall>ubl, Codl Ur.llon AmolUuUo" 10' Ihl, y.., "mollnl 31 Amortl..llon 01 COSIS Ihal boglna during your 1992 lax oar: , ! i I : 1 : : I "i ~'d: I " , ~ 40 AmortlzoUon 01 coslllh.1 an bolora 1992. , , . . . , , . , . . , , . . . . , , . . . . . . . . . 41 ToIBl. Enl&r hero end on "Olh91 Doducllans' or 'Olhor E, on,o,'li"o 01 our rolllrn . . . . . . . , , Fir P.p"..o,_ R.ducllon AcI Notl'l, .11111"', COPY'llIhlle, Hila 101m 1011'1'1'11' onlyC,nltr Pilei Solh...,., Inc. 40 41 83 83 FGlm 50211"'1 Allt~rnatlve MInimum Tax - Corporations OMB No, 1~e-017e 4626 , Form (Including envlronmontal tax) ~ SOl "plrlto In.!tucUon., 1992 D.plftm.nloflh.T,.UIUY ~ Attach to tho comorallon'l tax ,otu,n, 1"I.,naIA.v,nutS""lu Name I Employor IdonUncaUon numbo, J. RODNEY FICKEL INSURANCE P.GENCY 23-2226600 1 Taxabla Incoroo 0' (Ioas) boloro nol oporaling loas doducUon, (ImporUnt: 500 In,lrucUon, IIlho corporaUon Is aubloct 10 tha onvlronmont lax.). , . . . ,...,....""., , ,.. , "..."" . 1 7,210 2 "dlullmlnll: ':r''l I DopreclaUon 01 tanglblo proporty placod In sorvlco ollor 1980, , . . . . . . , . . . . II!II 2. II, '111: i I ~ b Amor1lzaUon 01 cor1lnod polluUon ClJnUol laclllllo, placod In ,orvlco ohor 1908. , , . 2b 'ill,i'IIPI o AmorllllUon 01 mining oxploraUon and dovolopmonl coals paid or Incurrod alior 1998 20 '11:11'11: d Amor1lzaUon 01 circulaUon oxpondltur.. paid 0' incurr.d allor 1988 (porsonal 1"1,'1, ;,I,lj11i holding oofT4lanies only) .",.",.,.."".".,.,..", . , , 2d '1IIIi!II'111 . Blsla adluslmonllln dol.rmInlng gain or 10.. from slli. or oxchango of proporty . IIllilli_' 20 i1Iiiiiiil!!' f Long-I.rm conUoct. onlor.d Inlo allor Fobruary 28, 1908. . , .. . 21 11"'1' 9 Inatallmenllalo. 01 cMaln proporty, , , , . , , , , , , , , , , , , , , , , , , , 2rI I/',n "1111",,1 h Morchlnl marlno capilli construcUon fund., . , , , . . 2h 11"1'1 ,..",..,... . '!Ih'i::i" I Section 833(b) doductlon lalli' CIon, Sill. Shl.ld,lnd .Imll" tYPI organlUlion' only), . , 21 011.1'1'11 111'11" J Tax shohor larm activities (personalslllVico corporaUons only). . , . , , . , , . . 21 l,ik')II; '1",1, k PassIvo ICUVIUOlI (cloooly h.ld corporsUons and personalsorvlco corporeUon. only) 2k ii,l:ii'I' I C.rtaln loas lIn'/1oUon.. . , . , , , , . . . . . . . . . .,.,.,.,..",. , 21 11"'11'1' II"I'! m Oll1or adju.lmonto 2m !llli'i """""""""""" """," IIIIIH:II: n Comblna IInos 2a through 2m , . , , . , . . . . . . . ......".,...., , ., . ..,'....... . 2n 0 3 Tax p,ala,anco 1I0ma: II " ':LI;',,: 1,"1 Q Depl.Uon , , , , , , , , , , , , , , , , , . , . , .,.' "...... . , 3. Ililll::! b Tax-ex.mpt Interosllrom prlvale acUvlly bonds lo.uod ahor August 7, 1986, . . , 3b 'l'ill!'11 o Appreclal.d prop.rty charllabl. doduction . , , , , , , , , 30 111,11';:ill :'I'!II;III d Intangible drilling coal. , . , , , , , , , , , , , , , . , . , , , . . , , . . 3d 1,11,1,1,11:1 'I ;'1'; o Ros.rv.. lor 10.... on bad debl' of nnanclalln.UtuUons , . . . , . , . .. , 30 IIIIL'II:;: f Aocelelll.d deproclaUon 01 roal property plac.d In .eIVlco boloro 1987, " , 31 Illi:!;:!,li 9 Accolorlled depreclltion cll.ased porsonoJ property placod In seIVlco boforo 1987 '1Ii""I" 11'1,1,'1 (p.rsonal holding comp.nlol only) , , , , , . , , , , . "'..",.",,, . 30 )1:11;11:1' h Amor1lzaUon 01 cor1lnod polluUon conUollaclllUo. placod In sorvlco boloro 1987. . , , 3h !r;i\!::: 1 Add lines 3a Ihrough 3h , , , , , , , , , , , , , , . . , , , , , . , , . , , . . . , , , . "'" . 31 0 4 Pra-adjuslmont alternaUve mlnlroom lilXable Incomo (AMTI). Comblno line. 1, 2n, and 31 . , ."" . 4 7,210 5 Adlultod curr.nt ..,m'ngs (ACE) Idluatmont: III i! II : I: ~ i ,IIJ, I Enler the corporaUon's ACE Irom line 10 ollho work.hOOlln Iho In.trucUon. . 51 7,210 ,I),,!II . . , , "I'lr' b SubUact IIno 4 from line 5a. IIl1n. 4 oxcood. IIn. 5a, onlor Ih. dllloronco as a i'i":II,11 11',"1 nogaUvo number (s.. Instruction, lor examples) """"""" . , , 5b !'I'I'iL' o MulUply IIn. 5b by 75% and onlor Ih. r..u~ .. . po.IUvo numbor. . . , . . , , , , 50 :IIIIIII!I!: dEnier Iho .xccas, ~ any, ollh. corporaUon's lotallncr..ses In AMTllrom prier 11':1"" Ill'd.; 'I ~ i ;: II' I' yell ACE adjuolmonla ovor II. 10lal reducUon. In AMTllrom prior year ACE I'!II'" Idju.lmonll (...In.trucUon.). Noto: You mu.t onlor on amounl on IIno 5d (ovon 11'1",0:' ,rl'li ""il ~ line 5b I. poaIUv.), . , , . , , . , , , . , . . . . . """"""'" . 5d i'I::': I ACE adjuolmonC } 'q':'11. Oil you .nlerod I poalUve numbel or zoro on line 5b, onler Ihe amountlrom IIno 5c on line 50 't:':'II"" :,1",,':1 U I pOlltlVO amounL Sa · ~ you enlered . negaUv. number on IIno 5b, enlor Ihe .mailor olllno 50 or IIn. 5d on IIno 5. liT '''!I' 11'1111 I. a negaUv. amount, li:I:;III:1 1;1;'11 5 Combln.llnoa 4 .nd 50, II zoro or 100', slop h.ro (Iho corporaUon i. nol.ub/oc: 10 Ihe oJlornaUvo :ili'ii:ii;;, minimum tax), , . , . . , , . . , I , , , , . , , . . . , , , , , , , , , , I , , , , , , , , , , , 5 7.210 7 AdJu'lm8nt based on energy prololonco., (Do nol onlor moro Ihan 40% ollino 8,), , , , , , . , 7 . A/1arnaUva lax nal oporaUng 10.. deduction. (Do not onlor mo,. Ihsn Iho oxco.s, If any, 01: (Ij 90% ollln. 8, over (b) IIn. 7.), . . . , , . , , , . . , . . , , . . . , . , . . , , .. , . . .. , a 0 8 ~,lIamlllvl minimum LlIlblelncomo, Sublracllhe sum olllnoo 7 and 8 Irom linn 8 .. . . . .. , g 7,2!Q. For P.p"wotk n.ducUon Alll NoUet, ...lrlll" COPYllghl {clll1l12lo,m .ollw.,. only Cln", Pile. Sollwjrt, Inc. FO/m 4825 1111I1 J. RODNEY CKEL INSURANCE AGENCY IDI 3-2226600 fI"",."'ltlVJ) Enlll thumount fram line 8 (&I1ernaUve minimum laxlblelncome), , , , , , , , , , , , , , , , , , , , , , , , , 10 EJlImpUon phlH-OU1 aompullUan (1llIno 10 II $310,000 ar more, aklp IInOl 111 and 11b and anter -0- 11 on line 11a): I SUb~lCt 'leD,ooo from line 10 (If you .1 cclTflleUng thlallno far I momber 01 I con~olfed group of corporellons, 118 InltrucUonl), IIlhe relullll zero or less, .nter.-o- . I . . . . . . . . . . , , . , . , ,......,.",.."." , 111 b MultlplV"ne 111 by2e% , , , , , , , , , , ...,.... II.,..,..".,. llb o Exlrl'4lllon, Sub~lCt line l1b from folO,ooo (If you .,1 colTflleUng Ihllllno for llnembol of I con~alled group of corparalloM, eeelnltrucUonl), II tho result II zero ar 1081, enler -0- , , , , , , , , la Sub~lCt line 110 from line 10, IIlhe rnuh Is zero or lell, enler -0- """""'" ........,. . "13 Mutupty lne 12 by 20?'. . I . . . . . I . . . I . . . , , , . , , , , . . I . . . . I . I,' I .......... . 14 AllllnaUve I1'Inlmum tax foreign tax credh. (SIlO InltrucUonl for IImIIUonl,) """.,.""",.", 14 1. T.nlaUV8 mnlrn.tm II)(, Subtract 110114 from 11"013 , . . , . , , , , , . . , . . . I , , . . ......,.,. I 1. Ragul., tax "ability btIfore III credlll except the foreign lax credlland pOlle..lonllax crodlt , ......,.,. . 17 AlIemaUve minimum tax. Sublllclllne 18 from linn Ie, IIlhe rosullla zero or lesa, enler -0-, Also enllllhe ruuh an the Hne provided on tho corpareHan'a Income lax reWrn (e,g" II you lie 1111ng Form 1120 lor 1882 enttrlhll amount on line ea, Schodulo J , , , , , , , , , , , , , , , , , , , , , , , , , , , , . , environmental tax. Subuacl $2,000,000 Irom line 8 (ccmpuled wllhoul regild 10 Iho corporaUon'a onvlronmental tax deducUon) and mulUPIV the excell, II any, by 0,12"-' (,0012), Enter Ihe rOluh hore Ind on the line provided on Iho corparaUon'alncome tax relurn (e,g" II you 110 11l1ng Form 1120 for 1882, Intar thlt amount on Hne eb, Schedule J), II you 110 compleung Ihllllne for a memborof ft controlltd toU of co oraUont 'IN InstnlctJona. , , . . I , , , , , . . . , . . . , , . . . . . . . . . , , . , . 1. " II j," ,,' '! reI '.p"wOIk R.~",Uoft A" NOt/IIi ...Int',. Copytl,h1I'I "U fDIMtoIlW"" only Ctnl., Plec. aouw"'.I~o. p, , Z 7 21( 12 40,00C C 13 c 15 c 1. ilir 111!I!il! 17 ill I II ill III II 1. 1 082 o ". ".' ,Porm 41211'11I) f ,,,~,...,,- ;"i.. _~..; I ..' J. RODNEY , 'I FICKEL U., b. ~SURANCE AGENCY Employ 10: corporation Income Tax Reeurn Carryover Schedule Year End Date: 12/31/92 23-2226600 Amount Current Used Curyove -'. Carried to Year or (back) Am Current Yr Addition Expired to Next Y , ------------ ------------ ---""!------_.. -----..-----. Contributions 1,866 1,478 956 2,38 " " ,\ f:. .,. " " ." , , , " , " .. ',' "', I' " " " '. , I; " 1;',,1, , , , , " " , ,. " ,. I' ". " " '. ,''- " " " I' /,' ~. ." .. " ,. ,. " ,. 'I , , I', , " ., , ,. ,,, I: ., " , ,,, " ,. "" ';1'1 , ',j' I' ., 'I:t, , , ,. ", ,1' \j , '" " ji ",j , "1', '.. I. " ,. '" I " ,,' " I' .' ".' '"., I, I' ", 'I' " I:' ,. .1. " '.;~ I':' I" ". ,. ,,\r ,',' ',', "', " , ' 'f , ,I , \, I"~ ,/ OMB No, 1545.0123 Falin 1120 U.S. Corporation Income Tax Return D.pI,tm,nlotlheT"uury 01 c.t1'~d.,.Y"'\UIl3 or ,.. 'I'"' blglnnlng ...--......... ,hlll3,.ndlng .....-......... ,lU .. . 1993 Intlll'lllRlv,nU,aervl,.1 ~ In.tmeUon. ar. ..porol.. s.. pogo 1 for Pap.rwork A.duetlon Ael Notle.. t Checklf.: U.. D Empluyltld.nlltiulltlnnumber Con,oUdlt.dllluln B IAS ~ RODNEY FICKEL INSURANCE AGENCY 23-2226600 1.II.ClhFormUIJ , ~ P."onll hOldlnr co, labol. Olh.r- e Uall1nCOfpO,.l.d (.lllchSch,Pti wlla, p,O. BOX 1 01/03/83 3 P,nonalllrvleIC."p. ploas. I" d,llntd In rllmpollr-, prlnl :::ARLISLE, PA 17013 o To\.ll",ul. R.g....e. 1,<<.\"H" orlvp", (... $p,edlclnllrucllon.) ..iln.l,u~II"n. E Check aDDlle.blD boxo.: (1)1 I Inl1lnl rohnn 1211 I Flnnl rolurn 1311 I Clinn~o 01 ncld,o," 106.100 1. Ol08!l rocolpl. or oalos 265,941 b Lll",.lulnl.ndallow"nc.. e Bol ~ Ie 265.941 2 COat 01 good. sold (Sehodule A, IIno 0) . . , . . . . .. . 2 3 Oro83 prolil. Sublroclllno 2 Iromllno lc . . . .. , . . . . 3 265.941 I 4 Dlvldonda (Schodulo C, IIno 19) , . 4 2.230 n " . , , . , 0 I Inlorosl ,. . ., , .. . . . , . 5 1.636 0 0 Or099 rani. "."".,. , 6 .. . . . , , m 7 Or08!l royalUos, , , , , . , , , , , , . .. . , , , , , . 7 8 Capital gain nollncome (aUach Schodulo 0 (FolmI120)) . , , , , 6 8 Nal gain or (loss) ham Form ~7G 7, PM It, IIno 20 (aUnch Form 4707) ,. , , , , 9 10 Olher Incomo (soo In,UucUorl' - altoch schodulo) . ., , ,. , . . , . . , 10 11 Tollllnco01.. Add IIno, 3 Ihrouqll 10. , . , , . , . , , " . , . . , . , .~ 11 269,807 12 Compansatlon 01 olllcors (Schodulo E, II no 4) . . . . . . . ,. . , . . . . . . . 12 95.717 s 13aSalarlos and wagos 43,682 b La", omploymonl crodlt. c Bolanco ~ 43 ,682 . 13c . I 14 Aopal" and malnlonanco , , . . .. . .. . . . . . 14 n 15 Bad dobl. , , , 15 I .." , . . . . .. . .. . .. . . . 0: 18 Aonls ,.""", , " , . . ,. . .,. , ,," , 16 6.000 f 17 Taxas and tlCOrl.os ." . ,. . , . " . ,. . , , .,., . . . 17 15.099 . 1. Inlarasl 16 4.805 c' ,..",." , .. . , , " . " . ." . ,... . .. . 01 18 Charltabla conlrlbuUons (soa In,Uuctlon, lor 10% Iln>lollon) . .., , ',( , I' ' . .. . 19 3 L2.~! IT 20 DaproclaUon (aUach Form 4562) ...."""", . "",' . .. .. 20 2,550 ,ii:,,', 21 L699 doproclaUon claimed on Schodulo A and ol,owhola on rolum, . . . , , . ,I 218 I 21b 2,550 -I 22 CoplaUon "...".."", . . . ,..'" , '" , "" , , . . . 22 n. 5.77.\ . n 23 Advor1Jslng """...,., , . , .",., , '" . ",. . , , , . 23 . . 24 Ponslon, p,olll-aharlng, ole" plan. . . . . '" , .. , . . 24 13,940 n 2S Employoo benollt proglams , . , , , , 2S , . , , . . ." , ,.. . . . d Olhar daducUons (atlach achodulo) , , 33.609 = 20 . . . . . . ,,' , ." . .. . 26 . 27 Tolll d.duoUon.. Add IIno. 12 Ihlough 20 . .~ 27 225,687 1 . . , , ," , ..", . '. . 28 Tax.bla Incomo beloro nol oporatlng 1099 doducllon and spocinl doductlon., SubllDclllno 27 110m tlna 11 . . 26 44.120 . 28 Lou:. Nol oporaUng lo.s doductlon (soo In,IIuctlon'l . . . . . . . . . , .. I 29. I 0 n ','" . b Soo<:lal daductlon. ISchadulo C. IIno 20) . ,129b 1 1.561 29c 1.561 30 Tax.blo Incom.. SubUocll/no 29c homllno 20 . , . , ,. . , . .. . .,.', , . , ..,. , 30 42.559 T 31 Tolll tax (Schodula J, IIno 10). , , . . . 31 6,384 . ,.. , ." . ..... f'" .. . , . " ":'; :l~ ii,:', 32 " '1:1'1 ):. K Paymlnlllll1ll2 OVllpaymlnl cnul,.d 10 IlI'U 32. " , i .. ,:;1 . b 1993 o.tlmalod lax paymonl. .,.. . 32b 1. 10C; : n o Less In3 nfund .ppb.d 101 on Form ....U8 I . 32c d Bal ~ 32d 1.100 , ;1" d . Tax doposltod with FOlm 7004 320 M r,,::: .",.". . ,.,. . ..,. . " ',;.' ~ P I Cradlt 110m rogulalod Invoslmonl companlos (atlach Form 2439) , . . . .'", it" 11'\' I . '.1 . 9 Crodlt lor Fadoral IIOC on fuols (altach FOlm 4136). Soo Insllucllon, . . ..( ., g J?' 3211 1. 100 V m 33 EstlO1alad tax ponalty (000 Inslructlons). Chock II Form 2220 I. allachod . . 8 . ~ . j, , ,~ .-J 33 . 5.284 n 34 Tu duo. II IIno 32h Is smallor Ihan Iho 10101 01 II no. 31 and 33, onlol amounl owod . . . . . . . , . . ,., , 34 I 35 Ov.rp.V01onL IIlIno 32h 1.lolgor Ihon Iho 10101 oil/no. 31 and 33, onlol anlOunl ovorpald ..", . ,. . 35 . 38 Enlor Amount 01 IIno 3~ vou WAn" C'Adll.d \0 1994 ..thn.lod t.. ~ A.fundod ~ 36 Please Und,r plnalll.. 01 PI/jUlY, 1 d.c"" th.11 h..... ....mlnlld Ihl, ntu'n, including .ccornp.nYI:1g Ich.dur.. and .,.t.m.nU, Ind to th, bestol my knowi.dg. .nd b.b." 1lI'lru"COU'CI, Ind compl"I, O"I.,lllon 01 prlpl"lI (othl/thln ,uplY'flu bind onIUlnlo.mIlIO" 01 which pllp"" h..lny knowl.do" Sign ~ I ~ Here Slgnltun01 olllur 01" TIU' - Propator's ~ y\"", I Dolo I Chock II soli- n I Proparor'a social soclJrlly no. P.ld slanalur. '\/ Ml 11'1 omplo ad 164-38-0267 Pr.p.ror" FI,m'tn.m. ~ BOYER & RITTER CPAS , U.. On IV loryoun,ll P - o' iioie ii:i 00.................................... E.!. No. ~ 23-1311005 uU-,mplov,d) CAMp..H"iiX....... ....... ........ PA" ..,.. ........ 17001-8300 annldllr... 7.IP co do ~ . d DIU FOI PapIIwolk R'dLicllon Aul Nollet, '"Insll, COPY/lghl(el ,gli] lorm tollw.1r, only CI':,y'l.mt, lnt, FOlm 1120 PlIl)]1 Form1120 1993 J. RODNEY FICKEL INSURANCE AGENCY che U &I'~I Cost 01 GClods Sold Sooll1.lrucllon..) 1 Invlntory II beginning 01 YOAl, , . 2 PurchU01l"""""""...,.... 3 COltolllbor""",."..,....., ,,4 AddlllonalaocUon 203A cos's (1lIlch Ichodulo) . . Other co.1.I (Inltch IIChodulo) , , , , , , . , , , , , . ToI.Il. Add IIno. 1 lIuough 5, , , . . . , . , , . , . , , , , , 7 Invonlory .1 ond 01 YOIr. , , , , . , , , , , , . , , , , , , , . , , . . Call 01 goodI.old. Sub~lclllno 7 Irom II no O. Enlor hOlD ond on p.go 1, IIno ~ . I Checl< 1II1T111hodl usod lor valuing closing Invonlory: ~ COsI 0 Lowor 01 cosl or mO/kol.. do,cllbod In Aogulollon, ,ocllon 1.471-4 Wlllodown 01 subnormal goods'l doserlbod In Aogulollon' .ocllon 1.471-2(C) Olher (Spoclly molhod usod ond ,".eh o.plsnollol1,) .. b Checl< Illho LIFO Invonlory molhod WIS .doplod Ihl. lax yoollor 'I~i 'gO'''d''- (il' C'h'';'k~d: ~Ii;;h' F~r;'; 070) : -,- : '. . : ',..- ~ -,- : -,- : ',-~ . - 0"- o Illho UFO Invonlory molhod w.s usod lor Ihlslnx YOM, ol1lor porconlogo (or omounls) 01 clo,lng InvonlDlY compUlod undor LIrO, , , , . , , , , , . , , , , , , , , , . . , , , , , , . , , , . . , , . . , , . . . . . . ., 90 d Do lho rulos olsocllon 263A (lor plOp oily ploducod 01 ocqulrod lor ro'olo) apply 10 Iho coroorollon7 . . . , , . , , . , I Wu IhOle Iny chll1ge In dolOlml1lng quonllllo" cosl, 01 volUOllon. bolWOon oponlng .nd closing Invomory? II 'Yo,,, .nlOhe. Ilnlllon, , , , . . . . , . , . . . ' . . , , . . , , , . . . , . , . , . . . . , . . . ~ISbl1~dllleICII Dlvldonds and Spoclal Ooducllons (500 In,llucllon,.) I Dividends 110m loos-'hln-20%-owllod domoslic corpololloll' Ihol % .ublocllo Iho 70% doducllon (olho' Ihon dobl-llnoncod slack). . , , . . . . . . , . , , . . . . . 2 Dlvldondl from 20"1o-or-molo-ownod domosllc CDlpOIOllol1' Ihol oro '"bloello Iho 60% doducllon (olhor Ihol1 dobl-llnoncod Slock). . , . . , . . . . . , . . . . . . . 3 Dlvldonds on dobHlnancod Slock 01 domestic a.nd lorolgn corporahonsl..,hon l4MI 4 Dlvldonds on cOllaln prolOlroei .Iock 0110ss-lhon-20%-owl1od public ullllllos . , . I Dividends on certain prolorrod ,lock 01 20%-or-moro-owl1nd publio Ullllllo.. . . . . Dlvldondslrom loss-lhon-20%-ownod 1010lgn corpolollon. and corto/n FSCs Ihol wesubjocllO Iho 70% doducllon, , , , , , , . , , . . , . . . . . . , , , , . . . 7 Dividend. 110m 20"1o-or-moro-ownnd lorolgn coroorollol1' ond cOlloln FSCs Ihol WI tubJocllO lho cor, doducllon, , , , , , , . , , . . . , , . . . , . . , . . . . . Dlvld,nd.l,om wholl)'own.d forellln 'Ublldlluu .ubj.'llo lhl tOO'l.dtdu,IIOIl(Uchon H~lbll, . ToI.Il. Add IInos 111uough O. 500 InstlucUons lor IImlollon. . , . . . . . . . , . 10 Olvldondolrom domosllc corporollol1s rocolvod by 0 small buslnoss Invoslmonl complny oporallng undor Iho Small Duslnoss Invoslmonl Acl 01 1050 . . . . 11 Dlvldtnd,IIOme.,llln FaC,lhall" ,ubll~IIO tht 100'/, dtduc.tlOIl IU'Ilon lUlc.Xll) , , , 12 Dlvldendttrom alllhlltd G'OUP mlmbm IUb"CI to thl 100% dlduc.llon (U'IIOII 24] (IX])), , 13 OlhOl dividends ham lorolgn corporoUons nollncludod on Ilno. 3, 6, 7, 0, or 11 , 14 Incomo Irom con~oll.d lorolgn cOlporollons undor subparl FIlii"" '"mlll14"1 . . 15 Forolgn dividend gross-up (socllon 76), , , , , , . . . . . , , . . . . . . . , . . 1. IC-OISC and lorlT1lr DISC dlvldond. nollncludod on IInos 1, 2, or 31"""" '''(dll . 17 Olhot'dlvldendo , , , , . , , , , , , , , . , . . . . . . . . , . . , , . , , 11 " Dtdu~Uon lot dl'ildlndl plld on c.lllIln pre'''''d ,lo~1l 01 publtc ullldlll (UllnllfUC.IIOIlI' ' ToI.I1 d1vldanda. Add IIn~s llhlough \7, Enlol horo ond on lino 4, pogo 1 . 23-2226600 Pogo 2 1 2 3 4 5 e 7 . (I) Olvldlndl ~ (c) Sp.C.llldlducllonl: . . b IIc....oI.d (h)'/, 2 230 1.,561 70 BO In It~'lon' 42 48 70 BO 100 '.j :1 1 561 ... 100 100 100 'il,'II,["I'IIII::I'II'IIII:'lli11111'111'1:,1 ""1"11'1 III 1'1 ,1'1111."1':"'1,11'111 ,1'1,111" ill:!'IIIIII:!!:I;I:III,IIII!lilll 1111111'1,1,111111:-1111'1111'1 ,llldi':1 11::i:1 I 1',1: I1I1 Iii hllll:II'1 """ 11'1:11111'11111:11111 II' 1,,1,,1,11,'1111111'1: lillllll, ',"<"'11'11:111,1111111 ,:1,11,11111 1111,11111' 1 ":'111 II "'I 2 230 1111.111'11"'1111 !i11Ii,I,llllIlidllll,:lllllhlll!'hlllllI1Ihll.l 2\l ToI.Ils oolal dodoollons, Add IInos 0,10,11,12, and 10, Enlor horo ond on IIno 29b, 0 01.. ............ 1 561 I chedu 01 E Compensation 01 Olllcors (500 II1.IIucllol1. 101 IIno 12, pogo 1.) Co 1010 Schodulo E ani 1110101 roeolpls II no 10 lu. Ilnos 41hlou h 10 on 0 01, Form 1120 oro $500,000 or molO, (I) N.meol olllc.., Ie) ""unlol (b) Soc.III..c.u'tIV numbll tlmtdlvnl.d 10 Ullnllll (0 Amount 01 complnullon '10 , O. DO';, O. DO';, ';' ';' ';' 7 6BO BB 037 1 J. R. FICKEL JR. WILLIAM FICKEL 1B2-22-6277 198-44-7613 20.00/, 51.00';, 100.0010 49. DO"/. 2 Tolal coll1'onsollon 01 ollk:Ols, , . . . , , . , , . . . , , . . , . . . . . 3 COmpensoUon 01 olllcols eloHood on Schodulo A and olsowhoro on rolull1 4 Sublloclllno 3 hom IIno 2. Enlor Iho 10s,,1I harD ond on lino 12, pogo 1 % '10 ';' ';' 95,717 95 717 Far P'lpltworll n.duc.Uon Act NOllet, .lIlnlll, COPV"ghlICI HI'i] lorm 101I1It'" onlv CpnVlllml, Inc., Falin 1120(1U3' Form 1120 1993 J. RODNEY FICKEL INSURANCE AGENCY ~SC edu e. J,I TaK Co utallor\ 500 In"ll/clroll' 1 Chock IIlhn corporlUon I. a rnombor ala conlrollod glOl/p (900 socllon91~UI olld lDUJ) , , , , , . ,~ :z. IIlhe box en line 110 chockod, onlor Iho corporollcII" sholO ollho $:;0,000, $2D,OOO olld $9,92D,OOO l/lXoblo Incomo bllckolo (In Ihol ardor): (1) 0 (2) b EnlOl lho CO.porlllon's ollSlo 01 (11 IddlUonsl D% lax (nol mora Ihan $11,7:;0) (2) IddlUonaJ 31'. lax (nol mo.o Ihon $100,000) 3 Incomo IIJ<, Chock Ihlo box II Iho corpOIolloII I. 0 quollllod porsollolSOIVlco corporation 0' dolmod III 'ocllon 448(d)(2) ('OG Ins~Ucllollo), , , . . , . . . . . , . , . , . . . . . . . . . . . . , , . . . . . . , . ~ <II Fo.llIgn tax clodll (olloch Fo.m 1110) , . . 41 b Pouosslons IIJ< Clodll (ollach Fo.m 573D). . . . . . . . , , , , . . . . . , , . , .. 4b o Orphan ~ credll (Sllsch Fo.m 0705) . . . . . . . . . . . . . . . . . . . . . ., 40 d Chock: U NoncollvonUonll1 soweo luol crodil 0 Q[!V crodit (aUath Fo,m 113&1 4d . CleMral business crodll. Enlor horo and chock which lorms 1lI0 ollochod: BFo.m 3000 OForm 3400 BFo.m DaM OForm 8470 OFOIm U70: Form ~O OForm 0030 Form 0020 OFo.m 0035 . 4. , Clodlllor prior YOlll minimum lox (alloch Form 0027) , . . . , . . , . . . . . . . '. 41 5 TolIl orldlll, Add IInoo 4slhrough ~I . , . . . , . , . . . . . . . . Sub~acl IIno 5 Irom Irne 3. . , . , . . , . . . . . , . . . . . . . . . . , . , 7 PorsonaJ holding company lax (ollnch Schodulo PH (Form 1120)) . . . . . . . . Rocapluro laxoo, Chock 1111010: 0 FOlIO ~2DG Form 0011 . . h A1lemaUve minimum IIJ< (allach Fan" 4020). . , . . , . . . . . . . . b Envl.onmonlsllox (allach Fo.m 4020). . . . , , , , . . , , , . . , . 10 Tolllllx. Add IInoo 0 Ihrou h 9b. Enlor hOlo nnd on II no 31. pngo 1. ISchedule I K Olher Informnllon Sooln"lllc,lon,,) 1 Chock molhod 01 accounllllg: I C"h Voo No 7 b []] Acc.ual 0 0 01110. (spocl'v) ~ ............ 2 Reier 10 Ihe Ins~ucUono and slolO Iho principal: I Buolno" IcUvlty codo no. ~ 64 11 b Business scUvlty ~ I NSUMNCif AGENCY" o Producl or servleo ,; J~f;.W{.r:.A9K"""""".'''''''''. 3 Old Ihe corporlUon allhe and ollhe lox voar own, dllocllV or IndlrocUy, 501'. or molO ollhe vollng olock 01 a domosUc co.poratlon? (For ruloo 01 atlrlbullon, soo 'ocllon 207(c).). , , . . . . , , . . , . . , . . . . . , , . . . . II 'Voo," olloch I schodulo showing: (0) nnmo and IdonUfylng numbor, (b) porconlogo ownod, and (c) Inxoblo Incomo or (10 so) boloro NOl snd spocl., doducllon, 01 ouch corpora lion lor Iho Inx yoar ondlng wllh or wllhln your lax YOOl, 4 I. lho corporlUon a oubsldlory In on olllllolod group or 0 pSlonl-suboldlsry conlrollod group? . , . . . . . . . , If "Veo,. onlor omployor Idonllllc.llon numbor and noma 01 Iho parenl corporaUon ~ ....................... o (3) "" 23-2226600 o 5 6 7 6 9. 9b 10 WD'J thu corporation 0 U,S, nharolloldor 01 any controllod 10101gn ":olporallon7 (SOD Gocliang 051 and 057.) . . . II "Yos," attach FOIm 5471 lor oach such corp or allon, EnlornumborolForms5H1 allDchod .................. :i o AI onv IlnlO during Iho 199J colondor VOOI, did Iho corporo- lion havo on Inlo.o,'ln or 0 slgn.'uro or olhor oull;orlly ovor almancial ilccounlln a 1010lgn counlry (ouch as a bank accounl, 5QCUllli03 accoullt, or OlhOllllHUlCli:ll accounl)?, , . II 'Yo,," Iho cOlporollon moV hovo 10 ilia Fan" TO F 90-22.1. x Poqo 3 6 384 6 384 6 384 Vo. No X " 1I"I''',"'nl'' nam. 0' lort,gnc.oul1lly .,. 9 WO'J 1110 corporallan 1110 grantor ol,'d'.I;;n''Ji~,~; id, 'a.I~;~tgn I',' truslIIHlI oXI5lod durIng tho clUlonllax yoa" wholllOr or nol Iho corpor ollon h., .ny bonollclollnlOlo,lln II? II 'Yoo," Iho corporation may hal/o 10 We Forms 020, 3520, or ::J520.A , , 10 Did ona lorolgn pOIson ill any linlO during Iho lax yoar own, diroctly or IndJroctly, ot 10851 25% 01: (a) 1110 lolnl vollng po- wer 01 011 cln:J:Jo:J 01 Glock ollila corporoUoll onlillod 10 volo, or (b) Iho lolnl valuo 01 nil clnstilJs 01 Slock ollha corporal/on II'Yo,," . . " "..,,'.,............. IEIllor porcolllago oWllod ~ ..................... __ bEnler owner's country ... . . . . .. . . . . . . .. . .. . . .. . .. . . . . .. cTllo corporo.lioll mat hava 10 1110 Form 5472, Enlar numbor 01 Forms 5472 allachod ~ .......................... 11 Chock Ihl' bo, IIlho cOlporollon IS'I/od puuliclV ollorod dobl ,.. Inslrurnonl9 wllh orlglniJJ Issuo dJscount , , , , . , .... D I' II so, 1110 corporolion moy hovo 10 1110 Form 0201. , 12 Elllar Iho onlOunl ollnx-oxompllnl"o,' rocolvod or occruod during Iho Inx Va or ~ .................... g. . .. _ . 13 11111010 woro JD or lowor shoroholdolS ollho and ollho IIlX yoor, onlor Iho numbor ~ ...........?.... _... X 14 IIlh. corpolallon 11., an NOl lor 1110 IIlX Va" ond " olocllng 10 lorogo 1110 CorrybRCk ponod, chock /1oro ~ 0 IS Cnlor 1110 aVllllablo NOL cmryovOf 110m prior lax YO:UQ IllunDI ,~rlur.f II 1'1 ~n.,. "l'lll,rl.nr\ on Irnl' 'Q., I ~ 0 CU'lYflliltllltJ llli' 101m lorll'tu. onl'f LI'!j'flll'ml, Inc, FOlm 1120 (lUg,) ................................................... 5 Old Iny Individual, pOllnorshlp, corporallon, oola!e or truSI ollho ond ollho lox YOlll, own, dhocllV or IndhocllV, 50'~ or moro ollho corpora lion's vollng Sloc~? (For ruloo olol1llbuUon, soo oocUon 207(c).) SEE ,A'l'TACUE II 'Veo,' IlIach I ochodul. showing noma olld Idonlifying numbor, (Do nollncludo eny Inlo.mollon olroady onlorod In 4 abovo.) Enlor porcenlogo ownod ~....~ t.. g.~. 6 During Ihlo tax VOOl, did Iho carpal allan pav divldondo (olhor Ihan glOe, dlvldond, and dlSlrlbullon, In oxchongo lor slack) In OXCOSS ollho corporollon'o curronl olld accunlJlalod oarnlngo and prohls7l:ll1 Uti. JO l.nd 310,) II "Vas,' fila Form 5452. IIlhlo " a con,nlldolod .0Iull1, answor horo lor tho paront corporalJan and on Form 8511 AllilllUlan!! Schndlllo, lor oneh nuhroidlnr , For P.pllwDr_ Rlducllon At! NohCl, '" In.". , I .';i x x '1'1 J. RODNEY FICKEL Balonco. Shoots AI..la 23-2226600 End ollnx (0) Pa a 4 3 815 :!:I'I:ij;:<.i::: 28,688 11 360 48 898 ,":1';' ,.', I 13 312 " ,d I 35 ,1,1 82 884 26 722 37 479 Olhor lIablllUos (alloch ochodulo). Capllal alock: a P,OIOIlOd slock , b Common Slack, :13 Paid-In or c.pllal surplua . , , . :,"", 24 Rolalnod oarnlngs - Approprlolod (.11'" IOh""'1 ' " 25 ROlalnad oarnlng. - Unapproprlalod. 75 , 376 115 553 20 Leas COBt oll1oasury slock, , , , , , . , , , , , 166 530 ,II 166 530 27 Tololllablllllos ar,d slockholdars' 0 III 107 972 106 I08 Note: You am not ro II/rod to com 1010 Schodlllo9 M-1 nnd M-2 bolow II Iho lolnl t1!1~nl~ all hnn 15, column (d) 01 Schodulo L aro 109s Ihnn $25,000, ,.Schodula M-1' Reconclllntlon 01 Incomo Loss or Books With Incomo or Rolurn (Sool'ml'"cIIOI'.) 1 Nollncomo (loss) per books, , , , . . . . 40 177 7 IlIcomo locoldod all books Ihls YOOI 1101 2 Fodolal Incomo Inx. , , . . . . . , . , . . . 5 982 IlIcludod olllhls lohlln (,Iermo): 3 Excoss 01 copllallossos ovor copllol gain,. . Tnx..a"mpllnlolo,' ..... _......... 4 Incomo sublocllo IDJ( nol rocordod on books II,s YOIII (lIom1l0):.. ........... .... _ _.... 218, .,.. _"1,,1., ",I,,", ,"1,"1:'.::).:;':1 28,688 Cuh, , , ,. ,.,.,.,.... 1a TrlOO 11>101 arid accounls rocolvsbla b Lou allowanco for bod doblS 3 Invonlorlol"."",....,. 4 U,S. govornmonl obllgollon3. . . , . & TIlC-OMomplsocurlllos (soo Inslrucllon3) . . Olhor cUllonl usols (Olloch ochudulo) . 7 Loons 10 slockholdors . . . . . . . . . Mongogo ond roal oslalo loon. . . . , . Olhor Invoslmonls (allach schodulo). . lOa Buildings Ind olhor doplocloblo assols b Loss accuOlUlalod dOplOClulloll . 11. Doplolablo ussolS . . . . . . , . b Lost accuOlUlllod doplollon . . . 12 Land (no I 01 Iny amonllalloll) . . 131 Inlanglblo assols (arnolUlablo only) b Loss IccuOlUlalod amorllloUon. . 14 Olhor assols (allach schodulo). . . 15 Tolol assols . . . . , . . . . . . . UablllUoo Ind Stockholdors' Eqully 15 AccounlS poyablo , . . . , . . . . , , . . 17 1. 1. 20 21 :l2 ",L,,, 24 206 ,,,,,',,,," '," ',., , " i i : ' ~ I ' : "'; : 24,206 ,I I' 3 000, " , :' , ", ,,:', 'I," 43 568 , ,I,., ;,'11" 33 725 17 863 , 1'1' 15,862 ""1",1,,,', ',',' MOlIglgu,notu, bondlp.y.bl.lnl.nlhln lyUt , Olhor CUrronlllabilillos (allach schodulo). . Loans !rom .lockholdolB. . . . . . , , . . 415 297 118 " 107 972 " 62 348 53 211 73 567 415 380 :,1,;,1, Motlgtgll,notu, bondlPtYlbl.ln I 'I'"' 01 mor.. ," 10 000 10 000 1,': " I"" 10 000 i I : i ::' ;:, i: II 'II : i II i (i: ! I ; 'I : I ',' '111'1 : I ~ !II !, i ~ III i 1 : ~, ': 11'/,1, ;J"I::::,:lilll'llli:'I,:11 1",1 ogolnsl book Incomo Ihls yoar (lIunUlo): .; / , ,j' Ii' "',':.'11 ',' ''':1':1,:':::1;.1 ,: ' ,'" 1:.'1 1',I~1 \ II ':.. I' ,II,,:;; i a Doprocial'on ",. ," :,' , 1'1:1": j' I': I ............... ' 'I ". 'I'l"" b Conlrlbullon. uuyovlt ~....... ~ ~ ?,!~? .8~ ~ ':, 1:i'III'::ill::IIJ;I::;i!llilil'lllli:I;lill:IIII!I:ii 1'1111'11'1' '111'11111,11, .........-....................... " , 'I" ,,:, "1"1 ' " ," ... ~. ~ ~... ~ ~ ~.. ~ ~ ~. ~ ~... ~ ~. ~... ~ ~ ~ I" 1:111 I I,ll'd,' ",:: :11 .'11111 2 388 2 38B 44 120 ..........~.~......~ ~.......~.~.. ....... ~.. ~. 8 Exponsoo rocordod on bookslhls yo" nol doduClod on Ihls rOlurn (lIomllO): a DoproclaUon. , . , , . '.................. b CClOlllbuUonJu"y(I....r o Travol and onlonalnmonl 8 Ooduclions on Ihls lolurn nol cllnrgod ~~~:At~~~@~:::: ::: :::::::: :3:4}l e Add IInos 1 Ih'ou h 5 , . . . . . . . , , 'Schodlllo:M-2" Annl sls 01 Una 1 Balanco 01 boglnnlng 01 yoar, . 2 Nellncorno (loss) par books, , , . . . , 3 Olhor Incroosos (110m/I 0): . .... . . . . .. . .. . .. . ",'",;,,'1 ......... ~... . ..... .. ~.. ..... . ~ . . ~ .. . ..... . " '" ;,.:""" ,,,,,,,,,, 4 Add Ilnos 1, 2, and 3. . . . . . . , 7 Add lines 6 and 6. . . , , . . . , . . . . 115 553 8 Rnlnnco nl and of onr IIno 4 1099 lIOn 7 For Ptplrwotk R,dllt\lon Att NOllt., '''Inllt. COPY/lgM(() Igg] lorm loll......,. Drily erSYll,m" 111(, 115 553 Form 1120 flUll ~/"\.,, \. I) h, ,;y ..~~ ,1- ~ ' I:'{' - ~ .-/1'01 l.",.' ~~;;": . /.. , 1\'; M 1,\, ,t" f H';: t 4:P' ',. f,;',J ~Nt';~ ' a.:;'i\...., {~~':I " t:tl~: 'I.','!' , " J.;ROD~EY FICKEL INSURANCE AGENCY ID# U. S. corporation 1120 Page 3 supporting Schedules Year End Date: 12/31/93 23M2226600 1 'I _,' ._______~__N_______________________________________________________________ '~ .......... Schedule K .......... ,. 5 Fitty percellt or more ot voting stock --------------------------------------- " 182-22-6277 J. R. FICKEL, CARLISLE, PA JR 17013 1(;" ,. \;" Direct ownership: Indirect ownership: 51.00' 0';00' .,' " " " , " ,. .' Iii, Pi, If 'f, " " 11' " " ." d' ,." ,,, ,. ,., " .' , '." ,. ,';' "I' " " , ,. " 'J,. "" ,;' '. .. " " 'I' ," 'j,f " !o'1' , {-,' ,. " " ,.1 . '" ,. ,. ", " ". " , , ", ,. ,. " " " ,. ", ,. " ", ,,' iI' " " "I" , , I,', .. " ,"' ., .., ,.1, ,. " " t" 'l " .. ", " ,.\ I'. I,; ". , " iI' ,,, , " . , ,. I, ,. ,',' '" ,. " ., ':j F.r~ 4562 Depreciation and Amortization (Including Inlormallon on Wslod Property) OMA No. 1545-017~ O.,,,lm,nlolthtT'...llry l"t"naIR.venuIs.rvlce ~ Sell Be .rate Inntructlons. 1993 07 Idonlltylng number 23-2226600 'llll'1til,.hownon"hun J. RODNEY FICKEL INSURANCE AGENCY IUIlnll'" Ill\l't'IlV10 whIch Ihl,lo,,,,,,I.I\.. Trade or business rl~IIPBrtl!i Election To Expense Certain Tangible Proporly (Secllon 179) (Nole: II vou hovo any "U,lod Proporly,' r.omplolo Poll V b1l101O you r.omplolo Po,l!.) Maxlrrom dollll 1I",la1l0n (II an onlolprl'o zona bu,'noss, '00 In,lruclion,.) . . , . . . . Tolal co,t 01 &o<:1Ion 170 ploporly pl.cod In ,orvlco during Iho lOll yoa, (coo In'lrucilo",) . Ttuoshold co,l 01 soc1l0n 170 plOpOlty bololo loducilon In 1I",loilon . . . . . . . , , , . Roduclion In 1I",lallon, Subbaclllno J !rom IIno 2, bul do nol onlol loss Ihon -0- ... . 001111 1I",lalion fOI tax yoor, Sublloclllno ~ !rom II no 1, bul do nol unlo, 1005 II10n -0- (II mo"lod 1,IIng 10 eratol . 900 Instructions, , . . . . , , , , . , , , , . , . , , , ., ,."" 5 (I) Ollcllpllonol prop"l')' b CO'I 1 2 3 4 & 17 500 , 2 J 4 $200 000 17 500 (0) [lllClldcoll 11:.,i:qll.li,;'!I':ii,I'if'll'i'i"'...1 'r"lill!:::li,,',jl!,,'lill!i !'II(lil'i"" I:'_!!:' :),:(;:,;11 'I ::'~"I:::ii -),1'.;:, 1;-/1 "'il'lf'-'I!,IIIII"I;"II!,!,!1,1 1','~;'I!'i'i:I!,i:llilll,i:,lil:I'r!;liil:I:,ii,i>; "I '''''111.1'", 'I ...,11,'1"1111'111'1" ",l'I'il,I'I:,1"'I:,, :1 i,] I I'! I' 1/:,!'i,;';1 ',' 1; .'I:'"I:I~i' i :"';""''''1,11 111"'1",II"IIII'I,,',I','i,'I....;,1 8 . 7 Usled plOpOlty, Enlol lU110unl Irom IIno 20, , , , . , . , , . . . . . . . , . . . . . . ., 7 . TOlaleloclod cosl of socUon 170 p'opOlly. Add omounlsln column Ie), IIno, 0 ond 7 . 8 . Tenllllvo doduc1l0n, Enlo, Iho smsllor olllno 0 01 II no 0 . , . . . . . . . , . . , . . . , 9 10 Carryovol 01 dl,a1lowed doduc1l0n I,om 1002 (soo In'lrucllons) ...... . . , . . . , \0 11 Taxoble IncoIM 1I",loUon, Enlor Iho omollol ollOllOblo Incomo 0' II no 0 ('00 Inslrucllon,) 11 12 Socllon 179 o'ponso doducllon. Add IInos 9 ond 10, bul do nol onlol mora Ihon hno 11 . 12 13 Ca oVal 01 dl,ollowed doducllon 101994. Add IIno, 0 ond 10, los, IIno 12 . . . , . , ,~ IJ ,,":"'1'"/1''' 'oil" Noll: 00 nol use Pat111 01 Part III b1llow 101 IIslod p,oporly (oulomobllo', co~.ln olhor vUl1relo" collulsl lolophonus, corloln compulOls, or plOpOrly used 101 onle~alnmonl, locloallon, or nmusomonl), Ins load, u'u PorI V 10' 1I,Iod proporly, l'IIPartlll,'IIMACRS Depreciation For Assets Placod In Service ONLY During Your 1993 Tax Yoar (Do Not Include Usted Pro ert 17,500 (C)thIllIOf dlp'IC"hon (bulml..!my..\mlnlu.. (g) OIP"CI'llon dlduc:IIOA (d)nICO'ftfy Ptflod mMolh.. 14 . b o d 1!2:lli~~"":lj i" ,~il j:'i<':::'li 'd, ',t,i!:" 1 ! ; : :! ! ":' i ~!;; i " I": I 1::i:11;1I'I,: :1!',I::1.1 27,5 rs, 27.0 rs, MM MM MM MM SIL SIL SIL SIL h 1& . b S/L SIL SIL i,I,,:',d;,I\ i' 12 vrs. 40 rs. MM [:!Ipartllllll! Other Depreciation (00 Not Includo Ustod Property) 1. ODS and ADS deducUons 101 oSSOls placod In SOIVICO In lax yoo" boglnnlng bololo 109J ('00 InsUuclions), , , , , . , . , . , , , , , , , , . . . . . . . . , . 17 PIOpOrty aublocllo socllon 1001n(1) olocllon (soo In,lrucllon,) . 11 ACRS and olhol doploclsllon (soo Inslrucllon,) IH~artllVlil Summary 16 17 16 11 Uslod ploporty, Enlol omounll,om IIno ?O" . . , . . . . . , . . . , . . . . . . , . . , . . . . , . . . . . , , 20 Total, Add doducUons on IInol2, IIno, 14 and 151n column (g), ond IInos 10 through 19, Enlo' hore ond on 1110 'PPlopllato IlIlOS of youl loluln. (Por1no'shlps and S corpol.,lon, - soo Inslrucllon,) , , . .. . . , . , , . 2\ FOI ISSeis ehown abovo and plocod In ,0IVlco dUllng 1110 cUrronl yoar, onlol Iho po'tion ollhe basis n",lbulnblo 10 noellon 2BJA co',' ('00 In,lrucUons , , , . . , , , , , , , .. 21 \9 2,550 20 2 550 ,",'I "'li':"'I"I'll'lil'IIIIIVII'''.'!II';,,!1 :i,",!,I'I:!II'j'I,!"'", '!I,,:,,"":I:,I,'"'' I,,\I!, ,ii, Illjl1 illl,;",!;I'II,I:I: For P.p"wo,k R_duetlon Act Hallet, ...In'lf, Form 4562 PUJI Cl)pyrlghllcllllJ 1"Ilm 'OllWIII only crSYlllm', Inc, form 4eC2 (1903) J. RODNEY FICKEL INSURANCE AGENCY . I 23-2226600 Pogo 2 Grpnrtl,y,'q Uslod Property - Automobiles, Cortoln Other Vehicles, Cellular Telephones, Certain Computers, and Property Used lor Entertainment, Recreallon, or Amusemont For any vohlclo for which you ora using 1110 'londQ/d n.loogo rolo or doducting laasa o'panso, comploto only 220, 22b, columns (0) IIHoup.h (c) 01 Socllon A, 011 01 Socllon e, and Socllon C II opplicobla. SlcUon A - DClPreclatlon and Other Information ICautlon: Soo h19!1Ucllon,;-'or lirl'llnllon~ for nLJlolnobUoIJ.) 221 Clo you hay. ''Ild,ne.lo suppa,llh, bUlln.../lnv,llmenl UII ctltm,rll I X Vos I No :l2h II"Yo!)," 19\110 ovldonco wrlllon7 - rX (I) (b) (c) (d) n,!~),", (~ (g) (h) T,p, 01 PIOP"'V 0.1. pLlc.d In ,UUII"I'"/, COllol d'olt'III,o'l '''covet, M,lflodf O'Pllmllon nvlt m.n (bullnllul lllllv.hlclnfillll ..,vlel UII nlh., !JUI' I"V'llnl''''' fllflOI1 C(in'l,nllon d,duclllln flllur'.aQ' Inl 23 ProDortv usod mora lhnn 50% In 0 aualiliod bUSlntlS9 uno (soo InsHucllolls): 92 BUICK 12/27/91100.00~ 20 468 20,4685 Vas I I No (I) EI.r;lId UCIIOM \18 cOil 2.550 o .^ .^ 24"P;ODOrtv used 50% or loss In a QuaUlIlJd buslnoss tHiD (suo In!llllJcllons): .^ .^ S/L - S/L .. ,'-;;j:I!II;l'I:':":"!" I' : t ,,' , ' , ' i. I. I" III ; I : ., . ~ . , !i:!\'dl':I"I,:id'i{,;!'I" 'I 1,'!;:;::'I"j 'I" " :I'::::";:',".!iL ,:," 'I :. ,', I .'". ," , .;I " ~ M- 25 Add amounts In column (h). Enlor Iha lolal hora ond on 1i110 10, pogo 1 . . . . . . . . . . . , . . . . .125 2.550 26 Add omounlsln column Ill. Enlor Iho 10101 hora ond on IIna 7, 0000 1, . , , , , , , . , . . I 26 Section B .. lnformallon Regarding Usa of Vehlclos .. II you doduCl OXpul1!1o!llor votllC:los: · AMaya completo this socUon lot v(]hiclo9 usod by It solo propriolor, portnor, or olhor "mora lhan 5% ownor.~ or lutalod pOIson, · II you provldod vohlcloo 10 your omployoDS, lilSI (lnswor 11\0 quostionsl" Soehon C 10 tWO I' you moot an OKcopUon \0 complotlng Ihls BocUonlor lhoso vahlclos. (a) (b) (c) (d) (0) (t) 27 Totti bUI,/lnvlltmlnl mil.. drl",n dll,ing (hi yr, (00 NOT Includ. commuting mllllj, , , 21 Toul commullng mllll drivI" du'lnglh.y..r. , , , , , Vehtcre 1 8.995 Vehtcle 2 Vehtcle 3 VehICle" V,hlcl, S Vlhicl,e 2i1 Toulolh"p"lonll(non" commullng) ,.,U.. drivln , )Q Tolllmllll driven during Ii'll y..r, Add IIn.. 2P II'I'oUQI'I21..., "'" , 3.855 12 850 Veo No Ve. No Vo. No Va. No Vo. No Ve. No 31 Wulhlvlhlclllvllllbl,for pI"on.lulI du,lngoll"duly hou"1 , . . . , , . , . . x 32 W.. 'h. v.hlcll uud pll.. mllllybyamor"hen'''' owner or"lItld p.,.on1. X 33 1.lnothlrvlhlclllv&lllbl. lorp"lo",lu..1, , . . , X S.c~on C . OUIIUonl tor Employerl Who Provld. Vohlclos lor U,. by Tholr Employoo. Answer Ihese quosUonslo dOlormlna II you mool an o'copllon 10 complaling Socllon e. Nolo: Socllon B must alwoys Iio complolod lor vahlclos I1sed bv oolll oroorlolo19, oMnals, or olhar rrora Ihon 5% ownors or lolotad porsons. V.. No J4 00 you malnlaln 0 WIllian polley slolomonllhol prolllblls oil pa,sonol usa 01 vallie los, Including commullng, by your employoos?, , , . , , . . . . . . . . , . . . . . . , . . . . . . . . . . . . . . . . . . . . . , . , .. ..,...,... 3S 00 you malnlaln . WIllian polley 'Iolomontlhal prohlbli' porsonol usa 01 vohlclos, o'copl cOl11l11ullng, by your employees? (500 Ins~ucUonslor vahlclos usod by cOlpo,ola olllcOlS, dIIOClo.., or 1% or mala ownors.) . . . . , . . . . 36 Do you ~oal all USO 01 vahlclas by amployoos as parsonol usa?, . . . . . . , . . . . . . . . . . . . . . . . . . . . . . 37 Do you provldo molO Ihan IIvo vohlcles 10 your omployaos ond rololn Iho Inlolmollon rocalvod from your amployaas concerning Ih. us. ollh. vohlclao?, . . . . . . , . . . , . . , . , . . , . , . . . . . . . . . . . . . . . . . . 31 Do you moollh. loqulramonls concornlng quoltllod OUlomoblla demonstrollon u'o (soo Inslrucllons)? . . . . . . Not.: If your answer to 34, 35, 38, 37, {'Ir 'J8 Is "Yos," vou nood nol complolo Socllon B lor 1110 covorod vohlclos. 111:1;':I,lt~:!,!:I:1 HParllVIH Amortization (I) OllellpUonolco.t. (b) Oll,.morlu.llon beg'nl (c) AmOIII,.ble amounl (d) Cod. IItl,on (0) Amo,lltlhon plllodot nllClnltnl m Amolllllllon 10111'111'1'''' 31 Amonlzallan 01 co." Ihal boalns durlno vour 1993 I.. voo" I I 40 Armnlzlllon 01 cosls Ih.ibOllon boloro 1003. , . . . . . . , , , . . . 41 Tolll, Entor hore nnd on "Olhnr Ooducltons" or "OltHlr E)(ponno!l"llno 01 your rnlurn , Fat PIPIIWOlk Aedutllon^tl NOIIC', ..,In,t,, COPY/lllhll" 111113 lorm loll_II, unly tray.t.m" lilt. , 'I," ':, , i ,,' ,'I"~,( ,:i:,;' II"," j',', I~ ~ 83 41 83 Fo,m 4562 (UU) . Alternative Minimum Tax - Corporations OMB No, 1Me-OI7& Form 4626 . (Including onvlronmonlollax) O..,.rtMuHollhaT"a,ury ~ S.. aeplrllalnlltuoUona, 1993 hltlln,' ",v,nuI allvlu ~ Attach to lh. oorpo'llIon'l ta. ralurn, llama I Employor IdonllllcaUon numbor J. RODNEY FICKEL INSURANCE AGENCY 23-2226600 I Tillable Income or (Iou) boloro nol oporaUng 1083 doducllon. (Imporunl: Soo Inslrucllons IIlho oorporlilon r lubloello lhe onvUonmenlla>l.) , , , , , , . , , , , , , , , , , . . , . , , . . . , , , , . . .,. , 1 42.559 a AlIlullmanla: ,lilll!:I!!11 a OepreclalJon of tanglbla propOlly placod In 8Orvlcllallor 1000, , , , , . , . , , . . , 21 .11,1.1'1, ;"111"'" b Amor1Ltailon 01 C8I1Inod pulluUon conUollaclllUol pllcod In aorvlco olio,' 1000, . , , , 2b lil'llllil: Q Amor1Ltailon of rr/nlng o.plorailon and dovolopmenl cOIls plld or Incullod ollor 1000 20 illll!I!II! d Amor1Ltallon 01 clIculaUon oxpondllUloa paid or Incullod ollor 1000 (porlonal holding COfr4)DNe8 onty) , . , , . , . . , , . . , I , , , . , , , , , , . . , , . , , 2d ~ I' i III11 i a Bula adlultmenta In dOlorrr/nlng gain or 1083 Irom 0010 or oxchango 01 proporly . . , 2a IIII!II I Long-Ierm conUacla onlolOd Inlo allor Fobru4tY 20, 1000. . , , , . , , . . ".. . at ':iill!lil::, g InalaJlmanlaaJel 01 cortaln propor1y, , , , , , . , , . . . . , , . . . . , , , . . , , 20 10('1 I,,,,,!,,,, h Merchlnl marino clpllal caosUucUon Iunds, , . , , , . . . , , . , , , . . , . . . , 2h lh!',i:11 'I!"",'. I SecUon 83J(b) deducUon IDIu' Croll, BIu. 8hllld, .nd ,imllallvPI o'V.nl.luolI. onl)') , , , , . 21 1!li'il'llll J Tax 1110IIer larm acUvlUos (por80naJ aorvlco corpolallons only). . . . , , , . . , , . 21 '11'" 111'!:'i,,1 ". , k PasaIvoacUvl1lo8 (c1osoty hold corp%llons ond pOlsonol aorvlco corporallons only) 2k 11'11" ','1','1,11 I r.ellalnlosaUrr/IIUons, , , , , , , , , , . , , , , , , , . , , , , . , , , , , , , . ~I "LI'r' ''''1'1 m Olller 8djultmenl8 ',:,'1 .".....,'..."".",...."...". . 2m ::1,11",,1 n Co~ne line. 211hrough 2m . , . . , , . . , , , . , , , , I , , , , , , . , , , , , , , , , , , , . , ,," , 2n 0 3 Tax prelaranca 118ml: lil!I:11 . Dtpltl'on . . , , . . , , . . , , . , , . . . , , . . . , I , , . . . I , , , 31 """11'11' .". , 1'1,',' b Tax-8xempllnlerosllrom pllvalo acUvlty bonds Issuod IlIor Augusl7, 1900. 3b il,IIIIII:] ",. , i:I!11111111 Q Chllllable conUlbullonl, , , . . , , , , , , , , , . , , , , , , , , , , , . "', , 3c d Intangible drilling COlla, , . . , . , , , , , , , , , . , , ,', , . , , , , 3d ' Ii: I' ill, ~ I ",' , I'III:I:II:! a ROIGIVIIlor Iolloa on bid dobla 01 f1nlnclallnllllutlons . . , . . . , , , , .,.. , 38 ':"llllill .' II , Accelerllod doprocloUon 01 rool propor1y plscod In sorvl~o boloro 10~7, , . .", . 31 lilllllll g AcceIoIalod deproclallon ollolllod porconal proporty pllcod Inlorvlco boloro 10&7 Ili'I'III" 'iiil:llllll: (paroonal holding r.olJllanloa only) . , , , . , , , , , , , , , , , , , , . , , , , , , 30 111.1,11/ h Add loes 311lvough 3g . , , , , , . , , , . . , , , . , , . , , , , , , , , , . , , . . , . I . , , , , . . . . , , 3h 0 4 Prlldlultmenl allornlllvo rrlnl/l"llm la>loblolncome (AMTI). Comblno IInoo 1, 2n, and 3h ..""....,., . 4 42,559 . AdjUlled curr8nt IImlng8 (ACE) IdJullmant: iiilllll]'11 a Enler tho oorporallon'a ACE Irom IIno 10 ollho workahoolln Iholnllrucllons , , , , , 61 42.559 :1)111 Iii Irlb' b SubUacl Uno 4 from IIno ~o. If line 4 oKcoods IIno ~a, onlor Iho dllloronco as I ;,II'iIH!! negaUvo numbor (110O In81luctlona for oxampl08) . . , , , , , , , , . . , , , . . , , ~b Ili(illlllll Q MulUpty Una ~b by 7b% Ind onlor Iho resull as I posHlvo numbor. . . . . , . . . . 60 ,1,1", dEnier lho oxcou, II any, ollho corporatlon'a lolollncloosos In AMTllrom pllol 'itil!II!!I!! yall ACE adJustmenls ovor lis 10lalloducllons In AMTllrom prior yoar ACE iiillllll!ll! adJuatmenll (110O In.lrucUonl), No18: You mual onlO' an ol11ounl on IIno 5d (ovon /l Una bb II posIUvo), , , , , , . . , . . , . . , , , , , , , , , . , , . , . , , , , , Sd "III"'!II a ACE adJuatmenl: lil'illllll: all you enlored a pOIIUvo numbor or zoro on IIno 5b, onlor Iho omounll,om IIno 5r. on IIno 00 11111::111 u a pollUvI amounl, Sa all you Inlered a nogaUvo numbor on IIno &b, onlor Iho amlllor olllnoOo or 11110 5d on IIno eo 11111:lililll u a noglUVO omounl, :111~,illil! . Comblna 111108 4 and eo, /l zoro or 10$8, slop hOlo (Iho corpurallon Is nOllubloollo Iho allOll1allVI rnIn1rrl1mlax). , I , I . , , , , , , . , , , , , . , I , . I I , , , , , , , " I , , , , I , , . , , , , "'" , 8 42.559 7 AIlarnallv. IIX nol oporallng Iou dOducllon, , , , , . , , , , , , , . , , , , , , , , , , , , , , , , , , , , , , , , 7 0 . AUam.llvo mhllmum tnlbla Incoma, Sublraclllno 7 Irom IIno 8. . . . . . . . . . . , . . . . . . . , , , , . , , 8 42.559 '- 'or 'IPlrwol~ Rti..'IJon Ac' NoUn.... In'tr. COPYIIghllc) 111) 10'", follw." onl.,. CPS't.ltm..lnc. '.rm 4828 (Iml 'orM~UI~II") J. RODNE~ FICKEL INSURANCE AGENCY . ---ar . Enler Ihlllmounlllom "'141 0 lallelneUve rr1n1ll'1Jm talClblelncome), , , , , , , , , , , , , , , , , , , , , , , 10 !xampUOII phue'oul oOlOputlUon (II II no 8 It $310,000 or mole, Iklp llnol 10e end lOb end onlor -0- on lne 100): a SUb~acl $100,000 from Une 8 (II you 8/0 co"..,IoUng Ihllllno lor a mombol 01 a con~olled group of corporeUonl, IOlllnl~ucllonl), IIlho 10lullla ZOfO or loll, '"* -0- , , I I , , , , , , I . I , , . . , , . . , , , , . , , , . , , , . . . . ,. 101 b MulUply line loa by 2~'~, , , , , , , , , , , , , , , , , , , , , , , , , . , , , , " lOb o IllcIlllpUon, Sub~1C1 Uno lOb from $40,000 (II you 8/e complollng Ihla Uno lor a momber 01 a conllollod group of co/poreUoIUI, _11UI~ucUoIUI), IIlha rOlulll1 ZIIO or loas, onlll -0- , , , , , , . , , , , , , , , , , 11 SUb~r.c1 Uno lOQ Irom line I, Illhe rosullll ZOIO or lOIS, onler -0- , , , , , , ,...",."...", . '2 MulUpty Uno 11 by 20% ',' . , , , , , , . . , I , , , , . . , , , , . , . . , , . , , I . , . , , . , , , , , , 13 AIlllnlllvo rr1nlll'lJm tax lorolgn IAIl Cledll, (See Inl~ucllonl for 1Irr1lll1onl.) """,'", , , , , , , , , 14 TenlaUve rr1n1mlm IAIl, Sub~lclllne 13 from IIno 12 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 11 Regulat lax "ability belore all credllle"COpllhlloro'gn lax Clodll and pOlmllons IAIl crodll, , , , , , , , , , II AllamaUv. minimum lax. Sub~aclllne 1~ from IIno 14, IIlho rosullll z% or loss, onlor -0-, Also .nllllhe roaull on lhe line provided on Ihe corporlllon's Incomo IAIl rolurn (o,g" II you Ira IiIlng Form 1120 for 1083, enllllhllllllOunl on line II, Schodulo J . , , , . , , . . . . . . . . , . . . . . . , . , . . 17 EnvIronmental lax, Sub~acl $2,000,000 Irom IIno 8lcompulod wllhoullogard 10 Iho corporallon's .nvtronmenlallAll deducUon) and Il'IJlllply Iho O"COSS, II any, by 0, 12% (.OO~2), Enlor Iho rosull horo and on lhe Une plovlded on Iho corporlllon'llncome IAIl lolurn (o.g., II you I/O IIlIng Form 1120 for 1003, .nlOllhll amounl on Une Ob, Schodule J). II you are comploUng Ihls IIno lor a momber 011 conlrolled group 01 cor orallons, loe Insuucllons. . , . . , . . . . . . , . , . , . . . . . , . . . . , . . . (. . .... '" ",.,,,,,11 AlChllllon AOI HOllCl,,"lnllt, Cop~'lgh' 1011.13 'aIm 1011"111I only CPSYII.ml, Ino, 23-2226600 ...2 11 , , 12 13 14 15 '111111il ,,:111'11 :111:1111111 11 ,Iliilllllll 111;111 I! 111111 Iii 17 42 559 40 000 2 559 512 512 6 384 o ',,",4S28111ll1 J; RODNEY FICKEL [NSURANCE . AGENCY Adlulted CUllenlEArnlngl WOlklheel '" Soo ACE Work.hoollnslrucllanl, 23-2226600 P.g, 3 Pre-edluelmonl MlTI (enlor the emounllram line 4 01 Form 4626) . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ACE dGprllClatJon edJullmonl: I DtprllCletJolI expense lecor~ulod lor AMT purpalel . . . . . . . . . . . . . . . . 2 550 b DeprllClatJon expense recompulod 101 ACE pUrpal8l: (I) POll-1883 property . . . . . . . . . .. 2b I 2 (II) Pa11-1868, pre-1894 property. . . . .. 2b II (III) Pre-1880 MACAS properly . . . . . .. 2b III (Iv) Pre-l880 original ACRS properly . . .. 2b Iv (v) Property delCllbod In locUonl I 188(Q(1) through (4) . . . . . . . . . . . I (vi) Other property. . . . . . . . . . . . .. 2b vi I (vII) Total depreclltJon exponse rocompulod for ACE purpaoos (odd I III 111M 2b(l) Ihrough2b(vl)) . . . . . . . , . . . . . . . . . . . . . . . . . . 2b vII 2 550 II, o ACE depreclltJon adJullmonl(lub~lOllIne 2b(vll) Iram line 2a) ....... . . . . . . . . . . . . . . . . . . . . 3 lnolullon In ACE 01 IlelTlll Included In earnlngl and prOnlo (E&P): . Tax"ex&n1)llnlerNllncorno, . . . . , . . . . , , . . , , , , , , , , . . . . . " 3. b Death blll4lllll from IIlelnsurance can~aclo . . . . . . . . . . . . . . . . . . . .. 3b o All olher dla~lbllUons Irom lIIelnsurance can~acls (Including surrondoro) . . . . .. 30 d Inslde buildup 01 undls~lbulod Incomo In 11I0 Insurenco con~aclo . . . . . . . . .. 3d I Other hama (188 Regulallons .ocllons 1.06(g)-1(0)(6)(11I) Ihraugh (Ix) for.partJalUst) , , , . . . , I , , , , , , . , . . , , , . . , . , . . . , , . , " 30 I Tolallncreue to ACE due 10 Inclullon In ACE 01 IIams Includod In E&P (Idd IInel 30 Ihrough 3e) 4 DllaliowlIlC8 01 IIams 1101 doducUbleln compuUng E&P: I Cer1alndMdendsr80elved .. . . . . . . . . . . . . . . . . . . . . . . . . . " 4a b DMdends paid on cenaln preforrod slack 01 pUblla uUIlUo. that aro deduc~bIe under eeoUon 247 , , . . , . , . , , , . . , . , . . , I , . , . , . ., ~b o DlYldendl paid to an ESOP Ihlllllo doducUble undor secllon 404(k) , . . . . . .. 40 d Nonp.~onl\le dividend. Ihat are paid and doducUblo undor socllon 42 559 1382(0) , . I . , . . , I I . . , , . , . . , . , . . . . , , . . , , , . . . . , " 4d e Olher llama (188 RegulaUon. oocllan. 1.66(g)-1(d)(a)(I) and (II) lor a pll1laf Usl) . . . . , . . . . . , . , , , , . , . . , , , . , . , , . . . , , , . . ,. 4e I Tolallncreue 10 ACE due 10 dllollaw.nco 01 IIams not doducUblo In campullng E&P (add IInol 4athrough"') , . . . . . , , , , , , . . , . , . , , , , . . . , . , , , , . . . , , , , , , . . . , , . . . , . " 4f 'I ~:::u~:~~~:a~ ~n.r~lo.' ~a~ ~~~~II~. ~&~:. . . . . . . . . . . . . . .. 51 !III'II b C1rcul.Uonexpendllurea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Sb 'III' ' a Org.nlullonal expendllulel. . . . . . . . . . . . , . . . . . . . . . . . . . . .. 5SdO I II d UFOlnventory.dlu8trn&nts , . , . . , , , . , . . , , . , . , , . , . , , , . . . . I . InatlUrnenl..... . . . . . , , . , , , , , . . . . , . , , , . , , , , , . . , . " s. ! 11 , TollI other E&P adjuslmonl. (comblnellnol oa Ihrough 50) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 51 1 Dlu/low.nee 011011 on exchlngo of dobl pools . . . . . . . . . '. . . . . . . . . . . . . . . . . . . . . . . . .. . 7' AcqullUUon exponle. ~f Ufo Insuronco compsnlos lor quollllod forolgn con~aolo . . . . . . . . . . . . . . . . . .. 7 . Depfetlon ..,...,.""",. I , . . , , , . , , . . . , , . , . , , , . . , , . . . . , , . , . , . " . 1 1l"'8Idjultmen~ In delellrlnlng galn or Iolsllom oale or exchange 01 pre-1U84 proporty. . . . . . . . . . . . .. 8 10 AdlUlled ourrenl IIlnlngl. Combine IInoa 1, 20, 3f, ~I, and ollhrough 9. Enlor Iho rOBull her..nd on line 5. 01 Form ~626 ... . . . . . . . . . , . . . . . . . . . . . , . . . . . . . . . . . . . . . .. 10 42 559 C")'fI,M{'J '"I fo,," eollw.,. only 01'8y'I""I,lno, ',,",4621111111 "..1\.0 'f' .~"""""""""'......-,...,_ .-.... ...... J,'RODNEY FICKEL INSURANCE AGENCY ID# 23-2226600 u, S, corporation carryover summary Schedule Year End Date: 12/3]./93, '''-. _.N._~__N__.________________~__N____________N_______________________________ AIl\o~tnt Carried from Prior Year Current Year Addition Used and Expired carryforward (carryback) Available ---------- ---------- ---------... ---------- Contributions capital Loss Nit operatinq LOSIiI ,alnlral Business Credit Alt Hin 'l'ax NOL 2,388 1,323 3,711 o o o ,Ii, , '" " ,," ", , , I, " , -, ", " ,. \,. , I I- I' " " " , I " " ,,, , , , I"", .' ,- " ,- , i ,. ,: . , " ,. , I " I' " J ~ ' , " " ". " 1\' , " ','I. "" ,- " , , ' " I " , " , " ,- ." "I,'. ., " " , " Ii)' I, " 'I " I. ,- I'" I ,,' " " '-, -.' , " " , , . J,'aODNEY FICKEL INSURANCE AGENCY IDI 23-2226600 . U. S. corporation . contribution Carryover Schedul~ ,"i:,';I": 'I, Year End Date I 12/31/93 ~~~~~~~W~~NN~NNNNN~__________N~M__M_______________________~__________~______.' '- . , ,",' " . , , ',":1','" 'I . '''~' t4tRr '....'""....irt' Amount ..--------- ~911a 1989 , 1990. " 1991 1992 '0 o o 1,866 522 ,I', " I, 'Total o~n~ri~vti9ncarryover,from'prior years "'-------~- " " ,. I'" d' ,. 2,.3U' 'I " , , , " , ;., ,1,':'J23 , 'I 1',~((?,1']j , " ", , ' . <,.\,0 , "~I " , 11',1' ,/ " 1"'11"1 "'!' rill ,/,., ",1, "'i, r', . Contrib"tlar. tlddition for this year Cont::-ibut..L<'Jt\' I\sed for this year ,. I CO~ltribution .oraxpired (Unused from 5th year) I D.(lI.:ellSl'l par :l:RC Sect. 170 (d) (2) (B) and Reg. 1. i:Hlh-ll (c) (2) Cont:ribut:i:n carryfor,,'ard to next year "il II' " 11,1' '" " " 0' ..._...,.__...... 1,1' 0"" , ....!CIa.... " " " " \ " . " " " " '!',,;',- , '1',1 :,!,:' i,' , '.. , ,I' " " " 'I" I, F ~; :',' ,(I', ,,'-,', 1\. ',_,1"',' ." " , \ I. 'I " ,. " , I ,. ,. , " ',. .' , 'I , . "j '. \, " ',I ,. .1 I< j - ~ r ,1' I', I : l' 'I', " ji \' I' (, , " 1', If "-' I" i,1 , '\' dO' .,. ,. I ~ ' " ; II, ,. ", , 1\1, ,. ,. .' " , , " " , ;":- " " " 'il ., ie, .' " i" I'. I I.' ,I 1':', I 'I'"~ " ',i; I' I'. ", " I' ,. ,. ,'I i I ., " " ,. 'i \ 'j. , I' , . i ~ ~ ., ~ !111S' A. . FARMERS . TRUST One ~ High Street Poo. Box 220 Carlisle, Pennsylvania 170U Dalt' Februal1Y 2, 1994 F1Dwer,. Morgenthal, FlOwe) & Lindsay 11 East Hi9h STreet Carlisle, PA 17013 Ra: Emit ot. James R Fickel. Jr SSN 182-22-6277 Dlt. ot Death January 13, 1994 Ow Ja~s 0 Flower. :Jr .. . ' J . In wwtr to YOIII' nquillt oonoernlng loOllounll own.d, ,Ithll' eeparattly CK Jolntl" by the abOY. nt...1lCltcl deo,d,n\ and the balanOI In Noh lCClount ... ot thl clat. ot dNth, w. haY. oheobcl 011I' l'tClordl and an eubmltttnv the tollowing lIlformatlon In dupUoat.. W. IUggtR that you m. onl ot th... l.lten Ittached to th. ,P'nneyIYanII Inv."n.. tcry tClftlll (Ree) to wbelllltlat. the baJangl you rtport. 'Nolt that we hm mown the oomot ngletradon tor each lCClounL Abo, Ill*-! aoorutd to the clatl of dNth, It tII)', It listed U I "P....1t flvun. . 1 I ,I i , , kdz . Karen L. Toma ne Customer Service Checking account #6-27593 was Drigina"y opened 5/25/83. The account was titled joint between James R Fickel Jr or Virginia 0 Fickel. The balance as of 1/13/94 was $34,767.08 plus $18.91 accrued Interest for a. total Df $34.785.99. The account was a NOW Account earning 2.10% interest at the time of his death. Checking account 16-72211 was or'lginally opened 12/20/84. The accDunt was titled joint between James R Fickel Jr or Virginia 0 Fickel. The balance as of 1/13/94 was $6.984.31 plus $9.33 accrued interest fDr a total of $6,993.64. The account was a NOW Account earning 2.10% interest . at the time of his death. ....__..._ .._....~_._. .... ..M...... ,...._. 'H_'" ...,.". ._., 1!;lI""~".-,,, MqH 1 . " " 1'1' '-, II', . TOI "ROM: .. ..15. ...ICI<.... 'IH.URAHC., IHC. .. ",- a LINDEN HALL AHnaUEI 111 OLD ITONI HOUn ROAD WLIILI, 'A tP013 m,m'It71 , , I' , IUnny ricle.l . 245,Ho~relan~ Ave. Carli.l., 'a. 17013. j '.' WllUam Q. Row. APPl:'lli.or Linden Hall Antiq~.. 211 014 Iton. Houa. Rd. Carli.l., 'a. 17013 REI Apprl1,a1 of Kitl. ,. " , \ . ' S.pt.mb~r 30, 1"4 , ' II,,' ' " ,I' " , f: " " , /\,'.!,- .' ('. . ,,-,:0', ,," ',....,1, " I'" ,"!' , "',,'r,', I, ,(-I", :i", ',', II,', , , ',' '" " , " ',' I ,11"",;"""" , { i', "I'Ii- " ,I" ",' J .', :' I;" I , ~. I,. 1. : ',' ~ . I " 'I '{I..I'.'I" ""II' ",\ ',l'r" '.I' '~'..!, \"; :"11 .., u ,:.,,' (I.'. Ii , ,.. '" .': ~ ,1".1' ,: I ,I' .", " " , Wincheattr Targtt Ritl. Ca. 1'00 VALUm .400~OO.4S0.00 " ".' 1:, ',.1' ",I " . , .' ',' , 'I' '" ,,'I ," , '-,. ,e .. , '.' 'I. . .\ " " - 0,. t~-r~ ,Jilliam Q. Rowe .. I' " i I' " , . ,\ , , ., "I." ,I " . i I I I I I I. " I' ',1\ "', .' ,"H_,,_, ,",' ...,',..,-..... ....,...... , '. ~ ,~j- ~-_.---. - - -'- - ..-- - -' .-~. --.. -- .--.. -.......-. ...:----.- -.-. - ~-...- - -- - --- RECEIVED fROM: fJ ACN ASSESSMENT '!' CONTROL ~ NUMBER AMOUNT FLOWER JAMES D JR 11 EAST HIGH STREET 101 .1 ()'I.ll;:! CARL I SL.E F'A 1701S " 'OlCtIfOl ?,1-1994..00bEl LA FICKEL. JAMES R JR NT saN lae-2~-6e7'l T {Mil , ! I I , ". i CUMBERL.AND DEAl'H nt It!:lJQu REMARKS . VIRGINIA D. FICKEL. m TOTAL AMOUNT PAID - SEAL. CHECK II 6sa /:' , , v"" /. RECEIVED BY REGISTER OF WILLS " , \ . ,-"'-0.:-;--0--- __~__,_.,.,_;:--",,_---.____ - _______,~__.__....._.i { . . ! . , . .. - :..............- ," . " .H...,.....__...........~.~...........4J... T~ ......, ....tf'\. I," ' , . , , ....~~.'.. \. ... .... ,~ .....' -.' ". ", -...- -- ,'-- ---. - .-...: _k ._.._. ___.. ___ k_ .___ __ "4__ ..... ~.~ __.. .__.,...:..... 4~ __ __ _ _ __ __ _ _ ._ __ _ _.. RECEIVED fROM, FLOWER JAMES D JR 11 EAST HIGH STREET CARLISLE PA I?OI3 L e l-19<1It-0068 lASTI FICKEL JAMES R JR B ACN ASSESSMENT P:' CONTROL I:iI NUMBER AMOUNT -------tot tel ,000.66 , SBN tBe-ee-6277 IFIRST) . .~ m TOTAL AMOUNT.PAID RECEIVED ~;I;'/ .. 04/0B/94 A CUMBERLAND DATE OF OEATH 01113/94 REMARKS VIRGINIA D. FICKEL SEAL CHECKll 497 , , _._ '--, .__ __. __._ n__. _.._. ____ ..._'_..... __. _._ ..__ /....... ..___ ..__ .__ ___ ___ ._._ ___ __ __ .__ ___ _. _ _ ___.._ _ __ REGISTER OF WILLS . . .._..~--- '..-..,..._---.-.-..,..~ J rvu- 6"T\J"n.~~ I"~ . /1/ . If!) - f R~-1547 EX AFP (08-94) ~~A~'H OF PEHNSV~YANIA o(PAR'~N' OF REYENUE NOTICE OF INHERITANCE TAM IUREAU OF INDIVIOUAL !AXEl APrRAISEHENT, ALLOWANCE OR DISALLOWANCE D€Pl. lISOOl OF DEDUCTIONS AND ASSESSHENT OF TAM DATI 01'30'95 DATI OF DEATH 01-13-94 ~~bftT~D. CUMBERLAND NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTlOH OF THIS FORH WITH VOU~ TAM PAV~EHT TO THE REOISTER OF WILLS. HAKE CHECK PAVABLE TO "REOISTER OF WILLS, AOEHT" REMIT PAVMENT TOI ACN / 1../ 101 JAMES D FLOWER JR ESQ flOWER ETAL 11 E HIGH ST CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HDUSE CARLISLE, PA 17013 ({l :1 c.! ----'ount RI';;Ittld :r.JCJl . 1'.1 t., CUT ALONG THIS LINE ~ RETAIN LDWER PDRTIDN FOR YOUR RECDRDff: .... b- ". REV: i547' E'iC",\FP'f oii:94T"iliii'"icr'oii" INHER'ifANc'E"'fA'x-XP'p iiA-iiiEifiili'-,"ALWiiANC!~-"'-~'-'-'. ...... DISALLOWANCE OF DEDUCTIDNS AND AS9!SSMENT 0' TAX N, JAMES R FILE ND. 21 94-0068 ACN ('.101 0, DATI 01-30-95 ~_J CHANOEII u $~ APPROVED DEDUCTIONS AND EXEMPTIDNSI 9,184.84 9. FUnlrl1 E,pln.II/Ad.. Co,t./Hi.o. E,pln.l. (Schedu11 H) (9) 10. Dlbll/Hortglgl LhbUiUI./L1ln. (Sohldull II 110) .00 11. To tel DlcluoUon. (11) 12. Hot V.1uI of T.. Rlturn 112) 15. Chlritob11/00v.rhOlnt.1 B.qullt. (Soh.du11 J) (15) 1q. Hit Volu. of E.bte Subj.ot to T., I1q I NDTEI If.n ......M.nt w.. i..u.d pr.viouftly, lin.. 14, 15 and/or 16, 17 .nd 18 will r.fl.ct figur.. th.t includ. the tot.l of ~ r.turn. .......d to d.t.. ASSESSMENT OF TAXI 15. Alount of Linl 1q .t Spou..1 rlt. (151 16. A.ount of Linl 1q ,...b11 .t Linla1/C1a.. A rate (16) 17. AlIOUIIt of Line 1q to.ab11 It Collatera1/C1a.. B r.tl 117) lB. Principal TI. Du. ESTATE DF FICKEL TAM RETURN WAS I (X) ACCEPTED AS FILED RESERVATIDN CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED DNI ORIGINAL 1. Raa1 F.ltltl (Soh.du11 A) 2. Stockl ond Bond. (Sch.du11 B) 5. C1cllly Hl1d Stcok/P.rtnlr.hlp Int.....t (Sohldull C) q. Hertg.go./Hotl. RIC.ivab11 (Sohldu1. D) 5. CI.h/Bonk Dlpo.it./HI.c. Plr.ona1 ProPlrty (Sohldu1. El 6. Jointly Ownld Proplrty (Sch.du11 F) 7. Tron.flrl (SOhldu11 Q) B. Tote1 A..all 11) (2) (5) (q) (5) (6) (7l ,00 151.985.84 182.457.0.9.. 37.478.53 7.425.00 .00. .00 II) .00 M .00. 370,161.53 M .06. ..:!Q. M . 15. llU TAX CREDUSI PAVHEHT DATE o -08-94 10'13-94 DISCOUNT (+) INTEREST (-) 1,105.26 .00 AHOUNT PAID 21. 000.00 104.43 TDTAL TAX CREDIT BALANCE OF TAX DUE INTER 1ST TOTAL DUE ~ 'U :-:'\\ (if OJ '.. -." td ~ 379,346.37 9 . I A4 A4 370,161.53 .00 370,161.53 .00 22,209.69 .00 22,209.69 22,209.69 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FCR CALCULAT~ OF AnDITI~AL INTEREST. ..5-3..>-/ ~ IF TOTAL DUE IS LESS THAN 11, NO PAVHEHT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ',. \\ , I, ': I, .' ';, . .' 'Il,' , 1',,' ,I I' I "I " ':'1 " ','" ," ", ,\ I' ,. ,'q I' 'j- I' , ,." '"~I,' . I (, ,: ,C," ",' ,I' I ,J " " " I I- ill ~'~. ,; .t \'-- . " ", ,.,. , ,\ I, I, ,I " . j',' AlIIRYATION. e,I.I.. 01 dooedlnl, d>>lnt on 0' bolo,. OIoaobo, 12. 1"2 ,- II IOV lulu,. Inl.,..1 In Ih. ..1.1. I, l'IO.I."od . In po.....lon or '"JOVlent to Clt.. . (aalltt.rtl) banlflol.rl.. of the.deo.dlnt .ft.t thl Ixplr.tlon ~f InY ..t.te f~r " life or for v"r._ thl C~.lth hlr.bv .wpr...lv r...rv.. the right to tpprel.. and ...... tranlf.r Inherltanoe 'IK..' at thl lIwful CIIl. . (ooUat.r"" rtta on MY .uoh futur. Int.rllt. . _eOI' NOTICE. To fuiflll thl r.qulr.-.nt. of S.atlon 2140 of the lnhtrltenot end E,t,t. llx Aot, Aot 22 of 1991. 72 P.I. SIollon 2140. PAVMEHT. DttlG~ thl tOP portion of thl. Notlol Ind .ubllt with your PIV.ent to thl Rtgl.tl' of Willi printed on thl r.v.rla'lldl. uH"". .hook 0' .....v ardo, p.v.bl. 10' REGIBTER OF MILLS, AOEHT All Plv.tntl rto.lvtd .hall flr.t bI app11td to any Intlr..t whiCh lav b. due with any rt.tlndlr applltd to thl ttM, REF\lHll (CRI. A rlfund of I tlX credit, which WI. not requl'tld on thl Tlx Alturn, .ay b. raque,tld by cOIPlttlng an "Applloatlon for Alfund of Pennlvlvanlt lnhtrltanol end E.tetl Tlx" (AEVM15IS), Appllcltlon. Irt IVl1l1b11 It thl OfficI of thl R..htlr of WUII, "IY of thl ZS Rlv,nu. Dlltrlot Offlall, or by olUlng thl 'Ploltl 24-hour ,".Ntrl"l 'Irvlea nutbtr. for for.. ordtrlntl In Plnn.Ylvanla 1.800.562.2050, out.lda Ptnn.Ylvtnll end wUhln 1...1 H.rrltbu', .... (T17l 111-1094. TOOl 1111l nl-1152 (H..,I.. 1....lrod OnIYI. OIJECTlOHI. Any perty In Intlrl.t not .Itl.fled with thl IPpr.I.I-.nt, ,II0WlnOI or dl.,llowlnOl ofdtduotJon., or .......-nt of tlX Clnoludlnt dl.oount ar Int.r..t) I' shown on thl. Notlcl IUlt objlot within .Ixty (60) dlya af rlallpt of Ihlo Nollo. bVI .....rltttn protllt to the PA Depart_nt of RIVlnut, laird of ApP.IU, DEPT, 211021, Harrisburg, PA 1712a"1021, OR .....Iution to hlv, thl "Ulr dettr.lned It audit of the ICCount of thl Plr.onel rlPrll.ntaUvI, OR "."..1 ta thl Orphtnl' Court. ADHIH IITRITlY! C_CTlOIII. INTrRlIT. FlOtUll .rror. dl.aovared on thl. .....tlant .hould be ~r"'ld In writing tal PA Doplrt-.nt of R'v,nue, Burleu of Individual Tlxa., ATTNI Po.t A.....""t Rlvl... unit, DEPT. 210601, H,rr..bur" PA l712'a060l Phont (717) 7'7-6501. S.. Pili 5 of thl bookllt "In.truetlon. for InherltlnGl ,llX Rlturn for I Rt.ldlnt Dtcldtnt" (REY-II01) for In Ixpl1n1tlon of tdllnl.trltlvaly aorrlOtlbll Irror.. If anv tlx due I. Plld within thr.. ()) a.lendlr MOnth. .ft.r thl dtoldent'l delth, . flvl paroent (IX) dl.count of lho to. p.ld I. .11_. . Inl,"'1 \, ohi'god bltlnnl.. wllh 11,.1 dlv .1 dollnquonov. 0' nino (,) oonlh. ond ... (II d.v 1'01 lho d.t. 01 dleth, to thl dlt. of ply-.nt. TIXI. which btc... dtl1nqutnt bafor. Jenutry 1, 19.2 bllr Intlra.t at thl rlt, of .IM (.x) paraent per ~ Cltculltld at I dillY rlta af .000164, All tlxa. which bee... dtl1nquent on end .ft,r JlnUlrv 1, 1..2 will bllr Int.r..t It I rltl which will varv 'rot al1ender VI.r to al1lndtr Ylar with thlt rat. IMOUnCtd by thl PA o.plrtHf'lt of RlYenue. Thl 1PP1Iotbl. Intltllt rat.. for 1M2 thrOUUh 1"1 arl. ' DIICGWT. VI.r Int.r.. t RI" DillY Intlr..t Factor !!!r Intltllt Alta DillY 1ntlr..t FlOtar - 1912 lOX .100141 1911 'X ;000247 1915 lAX 10004J1 1'11-1"1 IlX .900501 1914 IU .OSOIOI I"Z 9X .900247 1911 m .000516 1"1-1994 1X .900192 1916 lOX .090114 1"5 'X .900241 ..Jnt.rllt 1. alloulatld I' follow.' ~NTllIIT, . BALANCE OF TAX UNPAID H M~SER OF DAYS DELI"QUIHT H DAJLY JNTIIBST FACTOR --anv Nol1o. ...uod .11... lho I.. boo_. doll_t wm rol1..1 on Inl..1I1 0.1..1.11.. 10 1111... 1I11 din bovond lho dol. .1 tho ......"""1. II p._1 11 .Ido .ltor lho lnl""1 o_I.I1.n d.l. .hotIn .. lho Notlal, Iddltlonal Int.r..t au.t bt Ul1oul.ttd. I I I' . . / fA- 311-' I c-j!' 1~_1g'3-r RfY.413 EX AFP (12.94* C_LTH Of' PfHHSVLYAH1A NOTICE OF DETERMINATION AND IlEPoIRT~T Ill' REWIIIE ASSIISME"T OF PENNSVLVANIA IUlO!AU Ill' INOIVIOUAL TAXES ISTATE TAX lAUD ON FEDERAL ~il:~~1 PA 11128-0101 IITATE TAX RETURN ACN 201 C/ DATE 07'10'95 FICKE. JAMES R FILl NO.21 94-0068 DATIl. OF DIATH 01-13'94 CDUNTV CUMBERLAND NOTE I TO INSU~E ~~O~E~ C~EDIT TO VOU~ ACCOUNT. SUIKIT THE U~~I~ ~O~TION OF THIS FORH WITH VOU~ TAX ~AVHENT TO THE ~EGISTE~ Of WILLS. HAKE CHICK ~AVAILI TO "~IOlSTE~ OF WILLS, AGENT". REMIT PAVMENT TOI JAMES b FLOWER JR ESQ FLOWER ETAL 11 E HIGH ST CARLISLE PA 1701S REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA. 17013 A_t ~"Ittod_---i CUT ALONG THIS UNE .. RETAIN LOWER PORTION FOR YOUR FILlS ~ Rifv:4ai(.!x'iiFP"{i2~'94i'-"-.'.~NO.ficif'OF.'DiTi'RMiiiATio.N.AN.D.Aiiiiss.HiHT............................. OF PENNSVLVANIA ESTATI TAX IASID DN FIDERAL ISTATE TAX RETURN __ ISTATII. OF FICKEL JAMES R FILE NO.21 94'0068 ACN 201 DATE 07'10-95 ESTATE TAX DETERMINATION 1. Cr.dit For St.t~ D..th T.x.. .ft V.rifi.d .00 2. P.nn.y1v.ni. Inh.rit.ne. T.x A.....ed (Exeludina Di.eount .nd/or Int.r.st) 21.104.43 3. Inh.rit.no. T.x A......d by Oth.r S~.t.. or T.rritori.. of the United Stet.. (Excluding Di.count .nd/or Inter..t) .00 4. Totll Inh.rit.ne. T.x A......d 21.104.43 5. P.nn.ylv.ni. E.t.t. Tlx Du. .00 TAX CRIDITSI PAVMENT DATE RECEIPT NUMBER 01 SCOUNT (+) INTEREST (-) AMOUNT PAID TOTAL TAX CRIDIT .00 IALANOI DF TAX DUI .00 INTIRIST .00 TOTAL DUI .00 elF PAID AFTER THIS DATE. SEE ~EVE~IE 1101 elf TOTAL DUE IS LESS THAN tl, NO PAVMENT IS ~IQUI~ED FOR CALCULATION Of ADDITIONAL INTI~IST. If TOTAL DUE IS ~EfLICTED AI A "CREDIT" ICRI. YOU HAV II DUI A REfUND. SEI ~EVERSE SIDE OF THIS fORH FD~ INST~UCTIONS.1 , ,,', r r') 1:'!1: ,- r-I " ,~ ::1!l: L) 0 . .. " " tl~ " I 1'1'1 ~ " " /. '5 =, I.;' , 'I ,(i U \../ ~ E &!fC .. ~:;1 uu PlJlll'OIl! lW NOTlCI' To lol!l1l tho "qulr.....to ol'lOlIon 2141 (b) 01 tho Inherit..... ond E.t.t. TOK Aol. Aot lZ 01 1"1, 172 P.I. Iootlon 211SI. PAYlI!N" DotlOh tho top porllon 01 thlo, 110110. ond llAlolt with your p._1 10 tho Rltht" 01 WIUI prlntM on tho rlv.r.. tide. .. 1loIc. chtok or oonoy ordor p.yobl. to, .EOUTER OF MILLI, AIIEHT. AU p.vanh rl(l.lvld ,hall be ...11.- fir.' to 'fW Int.r..t whloh HV btI eM with MY r...lnder IPPUId to thl tlM. R!'lICD (aUI A re,n of . ta.'C areeUt NY be r.qullted by C1011Pl.t!ng en "Appllc.t1Of. for R.f'ht 0' PlMlylv."tl InheritInG' and !It.t. '1M" (REV-1StS) I Appllc.tlon. Ir. .Vllllbl. .t the Offlc. of thl A'lbt.r of MUll, InY of thl 2S R.vonue Dl.tr10t O"lc.. or frOl thl DIp.rt,,"t', 24-hour ,".~rlnt ..rvlol nuIbIr. for far.. ordering 1 In Pennsvlv."l. l-aOO-S6Z-Z0S0, out.lde Pennlvlv,"lt Ind within 100.1 Klrrltbur. .r.. (717) 7.7-1094, TOOl (717) 77z.z2SZ lHo,,11lt II...lrM Only). OIJECTIOH1I Any Plrtv In Int.r..t not Iltt,flld with the ......uent 0' tlM II lhown on thl. not Ie. ..~ object within .he.t~ (60) dI~. of rec.lpt 0' thlt NoUe. b~l --written pretllt to the FtA DeptrtMnt of R.venue, loud 0' ~.1t, Dept. "1021, Htlrrltburl, PA 17ua.IOU, OR .....leatl~ to h.v. the uU.r d.t.relned ., IUdIl 0' the per'OMI r"'r....,htlv., OR ........1 to the Orphln., Court, AlIIIIW' II1AATlYI! C_CTlIlNI, ." FeetUlI .rror. dl.oov.rld on thl. .......-nt .hould be Iddr"'1d In writing tOI PA DIp.rtlent of R,vlnUl, lufllU of Indlvldull T.M.., ATTNI po.t A...I.-.nt Rlvl.w Unit, Dlpt. 2.0601, Hlrrl.bur" PA 1712..0601, Phone (711) 7'7"6505. ... Pili J of the bookl,t "In.tructlon. for l~rltlnO' T.M Alturn 'or. A..ldent Dtotdlnt" (REV"1501) for ~ Ixpllnltlon of adllnl.trttlv.l~ corr.ctabl. 'rror.. IHmlt:ll, For dlt" of dt.th on or .ft,r 10.5"'1, PInn.ylv."l. E.t.t. T.x b..1d on thl Ftdtr.l E,t.t. TaM return *--. dtUnquent It the Ixplr.Uon 0' nine (0') IOnthl 'rOIl thl dlt. 0' dHth. For dat.. of deith prior to 10"5.'1, PlnnlJlvanl1 Elt,tl TaM bt.td on the Ftdtrll E,tltl T'M return beooIIIl dtU".,.,..t It thl axplrlUon 0' .llIht"" nl) IIOMth. frH thl dlt. 0' death. TaMil which beG.. dlllnquant be'or. .IInuIr~ I, I'U belr Intlrllt .t the rltl 0' .he. (6:() ,'rolftt per ~ otloulttld It t dtUv retl of ,000164. All tlXII wt'l1oh bee.. dlllnquent on or .fter Jlnutry 1, 1911 will MIlr ,1nterllt at , rite whloh will vlrv frOll ollend1r Vllr to clllndlr VI., with thet retl tnnOUnCIld bv thl PA DtptrtMnt of RlvtnUl. The IPPUotbll Interllt retlt for 1981 through 1"1 .r'l ~ tnter..t Rlt_ Ollly Int.rl.t FlOtor ~ Interllt A.tl Dtl1~ Int.r.lt FlOtar 1912 m .OOOIlB 1917 9X .1112\7 I9IS 16X . DID ISI 1911-1 "I IIX .IIUDI 1911 IIX . DlDIDI 1"1 9X .1112\7 IN' IIX .OOUH I"S-19" 7X .SOO192 19" lOX ,DlDIII 1"1 9X .1112\7 --lnt.r'lt II o,loul.tld ., 'ollowll INTEIIIT . IALANCE OF TAX UNPAID X HUKIll OF DAV. DELINqUENT X DAILV IHTllElT FACTO. ....Anv MoUOI IlIutd .ftlr thl tlM bIooMI dllInquent wUI reUtet In lnter..t C1lloul.Uon to fifteen (1~) dlv, ' beyond the dlt. of the ......lent. If Plv.nt II IIdt Iftlr the Int.r..t ~tlUon det. Ihown on thl Notlol, tddltlonel Int.r'lt IUlt be oeloulltt4. {..,./ RIV.7.16 IX APP (1,1.9*) CaltKMlWEALTH OF PEHNlVLVANIA DEPAlI. ""NT OF REVEHUE .URflU...., INDIVIDUAL TAXEI '~PT. lISUI HARRIIBUHB, PA 171ZI'0601 lr ,11 \. ,). I '1-1 s., - ,? ACN 202 ~ NDTICE DP DETERMINATION AND ASSESSMENT OP PENNSY~VANIA ISTATI TAX lASED ON FIDEAAL CLOSING LITTER DATI 07'17-95 FICKEL JAMES R FILE NO. 21 94-0068 DATI 0' DIATH 01.13'94 COUNTY CUMBERLAND NOT! I TO IHSUR~ ~"O~ER CREDIT TO YOU" ACCOUNT I 'UIHIT THE U~~ER rO"TlON OF 1111' FO,," WITH YOU" TAX ~AVHENT TO THE REGISTER of WILLS. HAXE CHECK ~AVAlLE Tn ""EGISTER OF WILLS, AGENT". REMIT PAVMEN,. Tal JAMES D FLOWER JR ESQ FLDWER ETAL 11 E HIGH ST CARLISLE PA 17013 REGISTE~ OF WILLS CUMBERLAND CD ~OURT HOUSE CARLISLE, PA 17013 I A.ount "..Ittad CUT ALONG THIS ~INE ... AITAIN LOWER POR':'ION paR YDUA PILlS .... Ri.y:73j;.ix..AFp..iiz:.94j.....M...NO.ficii.OF..uiTi.RHiiiATio.N.AN.U.AS.sisSHiNT............................. OF PENNSYLVANIA ESTATI TAX BASID ON FIDIRAL CLOBING LITTIR .. ISTATI DP FICKEL JAMES R PILI ND.21 94- 0068 ACN 202 DATE 07.17'95 ERTATE TAX DETERMINATION 1. Cr.dit For St.t. D..th T.x.. .. Verifi.d .00 2. P.nn.ylv.ni. Inh.rit.no. T.x A......d (Excluding Di.count .nd/or Int.r..t) 21.104.43 3. Inhlrit.nc. T.x A......d by Oth.r St.t.. or T.rritori.. of the Unit.d St.t.. (Excluding Di.count .nd/or Int.r..t) ,00 4. Tot.l Inhlrit.nc. T.x A......d 21.104.43 5. P.nn.ylv.ni. E.t.t. T.x Du. .00 6. Amount of P.nn.ylv.ni. E't't' T.x Pr.viou.ly A......d S...d on F.d.r.l E.t.t. T.x R.turn .00 7. Additiond P.nn.ylv.ni. E.tete T.x Du. TAX CRIDITSI PAYMENT RECEIPT DISCDUNT (+) DATE NUMBER INTEREST (. ) "", I', ", " I I \.(, N 'OJ '. '.' I'll. Ii, I. ei: .J" ~..I\ '! :':1 00 .00 AMOUNT PAl II · ~&RP~lecO[IT'o~H~~ RftO~TtH~A~EY~~~~E~fDE , IF TOTAL DUE IS LESS THAN n, NO ~AVHENT IS "EQUI"EO. IF TOTAL DUE IS mLECTED AS A "CREDIT" (CR), VDU "AV IE OUE A REFUND. SEE "EVE"'E SIDE OF THIS FO"" FOR INST"UCTIOHS.1 TOTAL TAX CRIDIT BALANCE OP TAX DUI INTlRIST TDTAL DUI "',<" " . , " r',." Ii" . " 'I!, . . " 1\ .., .' . " ,. " ( " , " . . , " ;/' , , I" ,\ ", " 'iI' " " '"('I,j, ,. ;,;,'" " , ~ ,< ,i', ", 'i "" " PIMPOIl! lIP IIOTIet:. ,To fulfill tho roqulr.....t. of',ooUon 2141lb) of tho Inherit.... ond E.t.t. TIN lot, Aot lZ of 1"1. m P,S. StoUon 21IS). Dotoch tho tOP porUon of thh NoU.. ~ ...It with your p......t to tho RlGht.r of Will. printld on tho "IV'"" lidl. .. 1lIk. ._ .r lOIlIy .rdor p.yobl. tOl RBOUTBll OF MULl, AllElIT. All P......t. r...lvld .holl bo oppllld fl"t to ony Int.rut III1loh MY bo duo with lilY r_lndor oppllld t. tho tllC. PAYIIEHT. REP'\HJ CCA) I A refund of . tlX credit MY btl requelted by cOllPlIUftI en "Appl1cIUon for Rlf\rld of PlMlVlvenJI Inherit.... ond E.t.t. TIN" (REY-ISIS), Appll..tlon. .r. ...llobl. .t tho Off I.. of tho RIII.t.r of Will.. eny of thl 25 A,venue DJltrlot 0"101' or frOl thl OIplrt-.ntl, Z4~hour Inlwerl", 'Irv101 nueblr. for fori' orderSngl In Ponn'Ylvonl. 1-110-562-2150, out.ldo Ponn.ylvonl. ond within 1...1 Hlrrllbur. .r.. (111) 111-1194. TIlDI (1111 nZ-ZU2 (Ho.rllll 11p.lrld Only). OIJlCTlDHlI Anw Plrtv In lntlrut not ..U.flld with the .........,t of tlX .1 lhown on thh noUce HY objlOt within .1Mty ('0) dlv. of recllpt of thl, Hotlol bVI ......rUtin protllt to the PA o.plrtltnt of RIVIflUI, aalrd of App..h, Dept. 211021, "'rrl*,rll, f1A 17U'''1021, OR ....ltKItl'" to hlVI the ..Uu det.ralned at IUdlt of the Plrtonel rep'tlentlUvl, OR .........1 to tM Orphen., Court AlIIlIN" IIWTlW ~CTlOHlI "ot\lll1 .rror. dhoover" on thh ...,..~t Ihcluld be Ilddrll... In wriUng tal PA Deptrt..,..t of Revenut. lureeu of Indlvldull Taxa., AT1NI Po.t A','.lIent Revl.w Unit, Dept. 2'0601, ",rrl.burl, PA 17121-0601, Phone (711) 7'7-6501. S.. P'" 3 of the bookllt "In.truotlon. for Jnherltance Tax R.turn for I RI.ldent Dtoldlnt" CREV-1S01) for an .xplan.tlon af IdIlnl.trlt1v.lv oorr.otlbl. .rror.. INTIRl!IT. Add1tlonel Penn.vivantl E.t.t. Tax ....,.ed .. . r.lult of . ohlntt on the Ftdtrli E.tatl T.~ 01011", I.tt.r boo.... dollnquont .t tho .",lr.lIon .f ono III IIOIlth froo tho d.t. tho flnol noli.. of tho IncrHH 1n fldera1 E'tlt. TlX 1. rtol1vld. Tall.. wh1ch .IM deUnquent before -'-nuar>> 1, 1912 bllr intertlt It thl rat. of ,Ix (6X) peroent Plr WlnlM ..Ioul.tld .t . dolly r.t. .f .011164. All t.... which boo... dollnquont on .r .ftor J....r~ I. I'I! will boor Interllt It I rltl whlah '1111 Ylr:t frOll a.l....r vo, to a.llndtr v.er .,1th thlt rat. llMOW1Oed by thl PA o.,lrtllnt of RIYtnuI, The eppllolblD Intlr..t r.t.. far 1982 throuth 1"5 .re. YaIr ,,,t.raat D.ta nallw ,,,tara.t Fafttftr ~ In"ra.t a.t. n.llw '"tara.t ,.~t~~ '. IIIZ ZD~ .IUIII 1911 9~ . U9241 1915 16X .0UI56 1'""1"1 IIX .COUII 19M II~ .uun I"! ,~ .U9241 1911 lJX .SUII6 1"1-19901 1~ .SUI'! 1911 II~ .sum 1"1 ,~ .US!41 -.Inter.,t I. allaullttd II fallow', IHTERElT . .'LAHeB OF TAX UNPAID H MVftIBI OF DAY. DBLINQUENT K DAILY INTERBlT FACTaR ""Anv Noll.. 100* .ft.r tho tllC ....... dollnquont will roflNt on Int"..t ..I.ul.Uon to flft_ (Ill cloy. bevond thl dlte of thl .'H'lHnt. If PIV,,"t II ,Ida Ift.r tM Int"11t OOflpUtltlon dltl lhown on the Hatlal, addltlon.l Int.r..t IUlt be alloullttd. . ' 1 IN RE: ESTATE OF .IAMES It FICKEL, .IR.. : IN THE COURT OF COMMON PLEAS m' : CIIMlmRLAND COUNTY, PENNSYLVANIA : ORI'UAN'S COURT mVISION : NO. 21.94,0068 COURT ORDER AND NOW, this _"-2., \ day of December, 2001, upon consideration of the attached Petition to have Manufacturers & Traders T.'ust Company (M&T) removed as the Trnstee of She Trllst created In the above referenced Estate and to bave the PetitIoner, VIrginia Fickel Ehr, ap(Mllnted as the alternative Trustee, and It appearing that the following facts have been verified b~' the attacbed Petition: A. The Petitioner Is the primary beneficiary of the Trust In question; B. The remainder benel1c1arles of the Trnst have joined In tbls petition; C. The current Trus(ee, M&T, has l1Ied Its consent to be removed as Trustee; Rnd D. Paragraph 12 of the Will l1Ied In the abm'e mil Iter, which created this Trnst, specll1es tbat this court hilS jurisdiction to appoint all alternative Trnstee upon the request of the beneficiaries; based upon the above, It Is hereb~' ordered and directed as follows: 1 M&T Is removed as Trustee of the Tnlst c.'eated In the above referenced Estate. 2 Virginia Fickel Ehr Is appointed as alternative Trustee for the Trust created In the Estate of James R. .'Ickel. Jr, 3 M&T Is hereby directed to deliver all assets of the Trust to Virginia .'Ickel Ehr elTectlve December 31,2001. 4 Upon delivery of the trust property to Virginia Fickel Ehr, M&T, Its employees, successors and assigns, Is released and fore\'er discharged from all actions, suits, payments, accounts, reckonings, claims and demand whatsoever for and by reason of Its administration of the above mentioned Trust or any other act, matter of cause or thing whatsoever, Furthermore, It Is directed that Virginia Fickel Ehr shall Indemnify M&T and hold It harmless, to the extent of any funds or assets received by Virginia Fickel Ehr, hereundel' from and against any and all liabilities, losses, damages. costs, verdicts, judgments, awards and expenses (Including attorney's fees and other costs and expenses of defense), to which M&T may be subjected by reason of Its administration of the Trust, as well as the settlement thereof by means of the Informal distribution accomplished pursuant to this Order. " , . I 1;": . 5 It Is further ordered that VIrginia Fickel Ehr shall refund or return, upon M&T's proper written demand, any funds or assets distributed by M&T to Virginia Fickel Ehr. If the distribution thereof Is detennlned at any time to have been an erroneous or negligent distribution to Virginia Fickel Ehr, whether such error or negligence was claimed to have been premised upon a mistake of law or fact. M&T's right to seek refund of any erroneous or negligent distribution to Virginia Fickel Ehr shall not In any way be limited except to the extent M&T would need to commence IIn action to collect an erroneous or negligent distribution to Virginia Fickel Ehr within two (2) years after such time as M&T shall have obtained actual knowledge of such error or negligence. BY THE CO // ~ 1 ,J. eel Hubert X. Gilroy, Esquire Attorney for Petitioner / David C. Gorlty Trust Department, Manufacturers & Traders Trust Company '. .,1' '. " ''I II, " Reoordud Offlc~; of RGQI!lb\' \11 Will(l . H, ., ", i, ,., 'QI DIG 21. ,p 2':'38 ,: , . " ,I'" " " , 'I" " d\ , . , " ,. 'J, " ,. ,. " , "." Clarl;-(ir, " 'a\lm~'HI';'I(1 .. , , ,. " CCUlt ,.;1), Pt" , ',' " " ,/ I. ',. , " ,I' \' ,l' ',t. ',I', I' , III " , ", ,,' , " , ",' '" " j" " " "~I' .1' Ii .. il' "I' ,l" '. ',. <t._ ,. " , , '" " ',' " "t I. 1\' i," '1'1. \\'1 ,'; " .. I' '" ". ,. " '" ." H .1', ,. ,: " .. " .,"1;: , "j' I' ,. I. _~, ~ ,I , " I." " " " ,"'1 " i. ,i' ". " ' 'j I, " " I,,' ',. " , " I', , " ,. ",1 ,. 'j, " " ..... ',"I ", " " ',j. " '. , ' n'l ,,'I , I ~ '\ ," ,If' , \"1, Ii ,\.. " ,: II,',' t,'I' , " " lit, , ' " ," " '" " .,' " ,. , ,"'\ i" ", 'i" t'. ,. , I" " "i II'," ','j " "1,' ,. .,' ;'j' 1 {i," .,' .' " ;, '" " '. ,. ',\ ,I ,''-, 'ji I,; , J, I, ' I' 1',,1 ,. ,." '-..1' I'" 11" 1'. 1'" ,,," , ", I II. ',I.'f-f,i ,,'1 .. 'I. I' ~'. II,. ". , ,. ,i' 'rl .,' " 'I,' '"',, "," I'r' " " .,' , .. " , " '"I' ;,lI'! : -, II" " '" , ',I' 'p ,. ", ,,' ," ,"1< " ,j",,'.l I t,'" ". " "I I', I'"~ 'i' " . ;.,,1' " ., , " Ii-., ", ',' I,,, I" , ~. i ;" ". .! " ," ""'J '" " ,.r. ',\',-~", .. ,,;/ , '; " " I" " , I'" , " ," i, .' " I. i'j",4' ,', " 'i .,1' " '",' I" , ", I, I I ~ 4. " " " " ,. 'i "I'" " , ',' " . Ii. II' , " ,. " ,. " " ii' "'I , :!' ,. ,'I,' ," )I';':'!' , ,',,! 'I, II: 'I, I" " ,. ," ." \" .,'1 t, d i, ~ )1." "p' 'I' j,,, 'I ,/ i, 1"\' "',, "", /' '1-, 'j., '; " .' " , '" ," ," I;i," ',1 " i,"" , , '11,1.. " '; ,( Ii, ". d' ,,'- " ," ", ',"I " 'It " " q. 'j " " , " " " ,.,' " " " ",. " il' ,. , ,jI ,,' ", " '" '.. " ;1; ,1-, " ", ". " I' I,,' " ", ,'I' I " /," IN RE: ESTATE OF .IAMES R. FICKEL, JR. : IN TilE COURT m' COMMON PLEAS OF : ClJMRERLANI> COUNTY, I'I!:NNSYL VANIA : ORPHAN'S cotJRT mVISION : NO. 21.94,0068 pETITION FOR CllAN(;E OF TRlJSTEE Petitioner, Vir~lnla Fickel I!:hr, hy her llttorne~'s. Rroujos & Gilroy, P.C., sets for the followlnll: 1 Petitioner, Vir~lnla Fickel Ehr, Is an adult Individual resldlnR lit 1..20 (;olfvlew Drive, North Myrtle Heaeh, South Carolina, 29582. 2 .Iames R. Fickel, .Ir. (I>eeedent) died on .Ianuary 13, 1994 and, at the time of the Decedent's death, he was survived by his wife, the Petitioner herein, and three adult children, Linda J. Niesen, William K. Fickel and Da\'ld .1. Fickel (collectively referred to ns the "Surviving Children"). 3 Decedent died testate with II will dated December 16, 1998, whleh will was duly probnted at the above term and number. A copy of I>ecedent's will Is attached hereto nnd marked Exhibit "A". 4 l)ursuant to Decedent's will, Petitioner was appointed Executrix of the I}eeedent's Estate, and Petitioner did act In that eapllelty and property administered the I>ecedcnt's Estate. 5 Pursuant to Paragraph 4 of Decedent's will, a Trust was created with Farmer's Trust Compan~', now Manufacturel's & Traders Trust Compan~' (M&T), named as the Trustee. The Trust provided, In summary, the Petitioner to receive the Income and up to all additional five percent (5%,) from the Trust on an annual basis; upon the death of the Petitioner, the corpus of the Trust was to be distributed equally to the Sun''''lng Children. 6 Pursullnt to Decedent's will, the melltloned Trust was created with Farmer's Trust Company and Its successors (hereinafter referred to as "M&T") properly administering said Trust pursuant to the terms of Decedent's will. 7 Section 12 of I>eeedent's will, with respect to the Trust created pursuant to Decedent's will, pro\'ldes as follows: In the event that any beneficiary of the Trust hereunder shall be dissatisfied with the manallement of the Trust by the Trustee, for any reason whatsoever, the beneficiary or his or her lellat guardian may petition a court of appropriate jurisdiction to have the Trustee rcmoved, and shall have an absolute rlllht to hll\'C an alternative trustee appointed. lJpon receipt of such a petition, the court shall remo\'C the Trustee and upon fillnll of proper accounts, discharge the Trustee of any and allllablllt~,. The court shall then appoint a new trustee subject to the same powers and duties set forth In this my last will and testament, such appointment, being made after taking Into account but belnll bound by the wishes expressed by the beneficiary In question. I I I I i'l 8 . Since the death of the I>eeedent, Petitioner has relocated to South Carolina and,for that reason desires, to r~move M&T as Trustee so that the assets of the Trust may be , I I I.. . I i , , . :,i"'. , <-.--1, manalled and Invested with financial ad\'lsors known to the J'etltloner that are located In South Carolina, 9 Petitioner desires to ha\'c herself appointed as Trustee, with the Intention of the I'etitloner helnll that she would supervise the Trust subject to advice and manallement of financial ad\'lsors of Petltloncr's chooslnlllocatcd III South CarollnR. 10 The Sun'lvinll Chlldrell, Linda ,I. Nlcsen, WIlliam K, IIlckeland \)a\'id ,I. Fickel, who are the remainder benetlelaries under th(' Trust, join In Petitioner's request to have M&T removed as Trustee of the Trust and to have the Petitioner nllmed us the replacement Trustee, The joinder of Linda ,I. Niesen Is """ched hereto and mllrked Exhlhlt "H'" the joinder of Wllllllm K. Fickel is """ched hereto and mllrked Exhibit "C", IInd the joinder of I>a\'id J, Fickel Is ""uched herelollnd mllrked Exhibit "D", 1\ Based upon the Petitioner's stilted desire to ehllnlle trustees because of Petitioner's relocation to South Carolina, M&T Indicates no ohjection to this Court remO\'inll M&T as the Trustee and deslllnatlnllJ'etitloner liS the replaccment Trustee, The consent of M&T Is IIttached hereto and marked .:xhlblt ".:", 12 Section 12 of the \)ecedent's will, as referenced In Para!!rRph 7 abo\'C, would require the Trustee to me a "proper account" prior to he In!! dlseharlled from an~' lIuhlllty Rnd prior to . . , " the appointment of an alternative I'rustee. I'etltloner suggests that the IlIlng of an aeeountlng Is not necessary because Petitioner is satisfied that M&T has pro\'ldcd I'etltloncr over the years with all necessary information in order for the Petitioner to be satisfied that M&T has propcrly admlnlstcred thc Trust. The Surviving Children, as evidenced In thclr joinders set forth In Exhibits "!J", "e" and "D", also suggest that thc filing of an accounting Is not nccessary prior to the al'polntmcnt of an alternative trustee In this matter. Furthermorc, M&T, as cvldcnced In Its consent as set forth on the attached Exhibit "E", is willing to ha\'e the alternative trustee appointed without M&T filing a final accounting, subject 10 M&T being dlscbarged ofallllahlllty. 13 Petitioner's desire to waive the requirement of the IlIlng of a final accounting by M&T is based upon the cost which would be incurl'cd In conncetlon with said aecountlng, Petitioner's desires to avoid those costs along with Petitioner's stated satisfaction with the Information M&T has provided to Pctitloner In conneetlon with the Trust and M&T's hal1dling of the Trust to date. 14 As part of the appointment as an alternatl\'c trustce, the Petltlonel' Is satisfied to have the court ordcr also issue a release and Indemnification to M&T in the terminology as set forth on the attachcd proposcd ordcr. . i, t' " .' , . , 'WHEREFORE, Petitioner requests your Honorable Court to Issue an order removing Manufacturers & Traders Trust Company as Trustee of the Trust created in the above referenced Estate and to appoint the Petitioner AS the Trustee, and to indicate In, the order, a release and IndemnificAtion to M&1'. Respectfully submitted, '/ qlrK ',;, , Hubert X. Gilroy, Esq Attorney for Petitio r Broujos & Gilroy, 4 North HAnover Street Carlisle, PA 17013 (717) 243,4574 Supreme Court ID No. 29943 " \. I" 'i_,.' ." , . . \, ,.' . , , " " . . I, , , , , . ,," " , \, , ' "'I ,r", I" ',I, .' I:: (i i\:, I I;, I 'I l,,; ',,' , " " , ";,1 " ,. ,. " " " /. ..~ "'"1'',''''' 'l' . >, I " ',', , .'j" . , i I I ., ...,' I .', ' I I.' , .JI '. "I', ,- - .: '. D29 , ')5""00 :Z1/~o' - , " :' ,I " " , ' . '1En'st Jllll nub WegtttttUrtl I I, ! ' OF JAMES R. FICKEL, JR. I . "I'" 'I.' I, JAMES R. FIOKEL, JR., of the Borough'of Carlisls, Cumberland County I l'ennoylvania, beinr, of sound and dispoEling > . mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Willa, Codioils, or writinge in the nature thereof, by me at any time heretofore . made. FIRST: I hereby order and direot ~y Exeoutrix or Exeoutor, hereinafter named, to pay all my just debts, funeral . expenses, teetamentary expe~ses and all Inheritanoe, Estate, Tranefer and Suooession Taxes, as soon as may be oonvenisntly done after my death, out of my residuary estats. :i.l/,l.:.:: SECOND: I hereby give and bequeath my antique -& ",",'/ fL4u~l - 1 - '" ' I EXHIBIT /\ , , ......). "'~~n\I." .\11',"\:.,-' ! . ""'I~""11ll..,~H"'r"I~U' ;".~.., "';;\' ',' '''''#''I'''~'''' , r ,i ~." c ", ;",' . ."\' , ... ': ';L\j O?9 " , ' , FOURTH I I hereb~' give t devise nnd bequl')",th .to tho Parmers Trust Company, IN TRUST NEVERTHELESS, an amount equal to the 'exemption equivalent of the maximu1ll unifed credit allowed by Pederal Eetate Tax law in effeot at the time of my death; provid~d, howev$r, that euoh Bum sh~ll be reduoe! by an amount, if any, equal to the total. of 9.ny othel' IllnountEl rl300ived by tho Trustee as a reeult of my death IIhl.oh qualify for the uniriad I ur1dit against Federal Estate T~x, The net inoomo from tho Trust sholl be pnidln {uarterl,. installmentl'l, or mor'Cl :Cr13I1U~ntl:r if den 1.1''1d ,1:0 lllld for the uee and benefit of my wife, Virginia D, F1ck131, for and during the term of her "atur~l lifo. In addition, aftar taking into aooount all other finanoial rosour~ea availllblo to my Bllid \tite, 9.S muoh of the prinoipal au the Truotoe from time to timll in its sole discretion may deem deairable for my eaid wife's , health, maintenanoe Rnd support either shall be paid to her or shall be applied direotly for her benefit by the Tru~teo in order to maintain her in aocordanoe with the standard of livina ho whioh she hae heoome accusiioml.'Jd at the ~imr. of. m~1' llf;'!llth. Upon writton l'eq\\tHlt of. my !laid wife, up +'0 five (5~) . , percent or $5,000.00 of th~ prinoipal, whlchRver is greater, ~ay I , I , l' ..'~., . 11.(1. d2l ---=:to -...- - ~ - .' - 2 - ' - . , . ' . , J81.m: '" ,~ . , be dthdra.wn trom the Trust annua.lly and shall be paid to my wife by the Trustee upon euoh request. To the extent that suoh right .ot vithdrava.l ot prinoipal shall not be sxeroised by Deoember '1 ot ~ny year, euoh right shall la.pse. Upon the dea.th of my o~id wite, the oorpus ot ths Trust shall be distributed absfolutelY and free ot truet to my three ohlldr~n, Linda. J. Nieeen, William K. Fiokel a.nd David J. Fiokel, in equal shares, ohare and share alike, per stirpes. rUTH: All the rest, rellidue and reminder of my estate, be it roal, personal or mixed, of whatsoever kind and wheresoever situate, I hereby give, devise and bequeath to my wito, Virginia D. Piokel. SIXTH: In the event that my said vife, Virginia D. ?iokel, shall predeoeaso me, I hereby give, devise and bequeath a.l1 the rest, residue and remainder of my estate, be it real, \ personal or' mixed, of whatsoever kind a.nd wheresoever !Ii tUl1te, to. my ohi1dren, Linda J. NieBen, William K. Fickel und David J. \ ?iokel, in equal shares, pSI' stirpes. SEVENTH: In ths event that nny of my ohildren shall predeO'!la.se me without i!lBUG surviving, I horeby give, devl.ee and g (/&1 ( - .' - " \ \ , \ \ I \ \ I \ I ....... '.' . ...-..,."......--.--..... , , ' . . . . , " oeq,uel\th his or her ehare to mY' surviving ohildren or the, issue of deoeased ohildren, per stirpes. . EIGH'rH: In the event that my said wife shall 'r", predeoease me, and my said ohildren shall predaoeBse me withgut . issue eurviving or dio without iSDue surviving before reoeiving final distribution of any interest as 'the result of this, my Last Will and Testament or an:,/, trust oreated hereunder I I hereby gtve, devise and bequeath all the rest, residue and remainder of my estate to the First Evange110al Lutheran Churoh, of Oar1is1e, Pennsylvania, to be added to and beoome a part of its permanDnt endowment fund. The lnoome shall be used annually by the governing body of the ohuroh for. the purpoees and in the best interest thereof. NINTH: In the event that one of my ohi1dren shall die with issue surviving, after my death but prior to reoeiving his , ' or her final distribution hereunder, and such issue surviving are under the age of 21 years, the share of eaoh suoh issue shall be held by the 'rrustee hereunder until such issue shall reach the age of 21 years. The net inoome shall be paid in quarterly " inista11ments, or. more frequently if desired, to and for the use and beneti t of suoh issue and as much of the pr incipa1 '19 the - 4 - 1"~-' dz 1:A"tJ.' .' I 'I \ dr:l'f..W'5' I, I '. . Trustee from time to time in his sole discretion may deem desirable shall be used tor Buch issue's health, maintenance, . general welfare and education; provided, however, in the event that there is more than one suoh iasue and the fund's are oombined for purposss ot administration, no suoh issue shall reoeive'more than his or her prorata share of the inoome and prinoipnl due hereunder. TENTH: Eaoh and every beneficiary hereunder or of any trust oreated hereby is hereby restrained trom and is or shall be without right, power and authority to sell, transfer, pledge, mortgage, hypothecate, alienate, antiCipate or in any manner effect or impair his, her or ~heir beneficial and legal rights, titles, intereete, olaims and estate~ in and to the inoome or principal ot the Trust Estate during the term hereot, nor shall the righte, titles, intereste, olaims and eetatee of any benefioiaries hereunder be subject to the rights or olaims of oreditore of any such beneficiary nor subject or liable to any process of law or court, and all of the income or principal of the Trust Estate shall be transferrable, payable and deliverable on11, eOlely, exolueive11 and personally to the deSignated ber.eficiary hereunder at the time entitled to take the same under - ; - if fld;. t. Ii .', .1 .,.,.. tI1IJ',V I.. . . . ~::~'~~~~~~~~~t:~~:'~:'_L...:r~.-.~-..jt.~'':~.:.=:.: --..... -'__.a ...... .--......... .....-- ..-".. .-.......... . ....,. . ~9' .. " . ....."......... the,terma 'ot this:Tru8t 4rtd the personal reoeipt of the et8llisnate~ benefioiary'hereunder shall bs II. oondition preoedent . to the payment or delivery of the same by the Truetees to eaoh s&iet benefioiar1. . ". tLEVENtHI t~'the event that my eaid wi1e and I should d1. as a're3ult of a oo~on disaster, or under suoh oiroumstanoes .',_ I.' . as to render it diffioult or impossible to determine who predeceased whom, I hereby deolare it to be my intention and ".1 ,.... . direotion that I shall be oonclueively' presumed to have predeceased mY' said \tito, statute, law or rule to the oontrary notwithstanding, and this, mY' Last Will and Testament shall be oonetr~ed on that aseumption or basie. TWELFTH: In the event that any benefioiarY' ot the trust hereunder shall be dissatistied with the management of the Trust by the Truetee, for any reason whatsoever, the benetioiary or hill or her legal guar~ian maY' petition a Court or appropriate jurisdiotion to have the Truetee removed, and ehall have an absoluter1'Sht to have an alternative Truetee appointed. Upon receipt of suoh a Petition, the Court shall remove the Truetee and upon filing' of proper Aooounts, diBcharge the Trustee of any and all liability. The Court shall then appoint a new Trustee \ . ?t'.." .~ *''':i}Jv . - Ii - .. , '1 I I , . ,.-.-....,..... , " .' ~B.: D29 '. , I , , .. \, , l!Iubjeot to theeame powers 'and duties set forth in this my Last, Will and Testament, l!IuOh appointment being made after taking into aooouht but being bound'by the ~iBhos expressed by ths benefioiary in question. THIRTEENTH: r hereby give and grant to'my Exuoutor and T~u8tee hereunder, and their euooessors, hereinatter sometimes oalled "Fiduoiary" or "'iducia~ies", the fOllowing powers, duties and discretion in add! tion to those now or hereatter conferred by law, to be exeroised in any o~pacity to whioh suoh powers may be applioable, and in the best'ir1terest of my ostate and benetioiariesl " ,1. To purohase or otherwise aoquire or reoeive and to , , ret~in whether originally a part of the Probate or Trust Estate . , . or'l!Iubeequently acquired, any and all stooks, bonds, notes or other seo~ritiee, or ani "variety of real or personal property, ' , . . inOluding et'ocke or in~erest in investment trusts and oommon truet funde ae it may doem'advieable, 1nolud1ng speoifioally authorization to retain, buy or sell any shares of the etock of 'ny,oorporate Fiduoiary. "'f.. 2. To sell, pledge, mortgage, transfer, eXChange, oonvert or otherwise dispose of, 'Or grant options with respect . {j)-"< 1e -:t/I~{lL - 7 - ...... ..l:....j-'.l~~..:::::.~~_~;.:...:::::~:~...; ; .," 'i~. '.J '~-..._...- -,... _. . +. ........, I .... ....." , - , I to, any and all property at any time forming a part of the Probate or ~rust Estate in euoh manner, at suoh time or times, tor subh purposes, tor suoh prioss and upon such terms, oredits and oonditions as it may deem adv1aable. ..~ . ..,. ,To borrow mone:r for any purpose conneoted with the proteotion, preservation or improvement of the Probate or Trust Estate whenever in its judgment advisable, and ae security to mortBage or pledge any real or personal property forming a part of the Probate or Trust Estate upon ouch torms and conditions as it may deem advisable. 4. To vote, exohange, and otherwise exeroiee all rights, privileges or options ~n any way pertaining to the &tocks, bonds, seourities and other assets ~t ~nytimo belonging to the Probate or Trust Estate; prOVided, however, that with reepect to any shares of stook bolonging to the Probate or Trust Estate, the 'beneficiaries hereunder may determine the mannsr 1n whioh said sharee shall be voted and may actually direct how suoh shares shall be voted. 5. To hold investments 1n the name of its nominee. i1 ,"t/ Ii 1d!:d' I I , I \ I I I I - 8 - . . dB; D29 ,", . . , 6. To make alterations of, repairs upon, additions to and ereot improvements upon real estate and to I!lake leases thereror for suoh'terms as it may dsem advisable. . , 7. To make distribution of the prinoipal and aoorued inoom1~~"ntl of the Truet Estate to and among those entitled thereto at the termination of the Trust in kind or in oaeh, or partly in kind or partly in oaah, as it deeme proper, just and equi table. 8. To determine the manner of asoertainment of inoome and prinCipal in the apportionm~nt of reoeipts and expenses by the tenants and remaindermen of the Probate or Trust Estate. 9. To oompromiee olaims, exeoute and deliver any and all instruments' in writing whioh it may deem advisable to oarry out any of the foregoing powers. No party to any suoh agreement in writing signed by the Exeoutor or Trustee ehall be obliged to , inquire into its validity. or be bound to see to the applioation by the Exeoutor or Trustee of any money or other property paid or deiIvered to It by such party pursuant to the terms of any suoh agreement. 10. To pay all taxes and governmental ohargee, of whatsoever oharacter, lovied or assessed upon or payable by the . 4f''"k fl.1 AI ~ - 9 - "':"~--"'-r- -.- -- . . D29 . I ,/ Trustee, with respeot to ,the Probate or Trust Estate, and all expenses of the administration of the Trust and all interest payable on aooount at any indebtedness or liabilities oontracted, inourred or assumed by ths Truatee, from the inoome of the Proba~~'Trust Estate, unless the Trustee, in its sole disoretion, shall deem advisable under the oircumstanoes that all or part thereof should eqUitably be paid out ot the princival of the Probate or Trust Estate. 11. To, in the oase of the Trustee, buy assets trom and lend money to the personal representative of my estate and to advanoe funds without reimbursement for the payment of the expenses of the administratio~ of my estate inoluding all taxes by reason of my death; provided, however, that benefits trom qualified pension or protit sharing plans recoived by the Trustee ehall not be used for the purpose of paying suoh expenses or such taxes. 12. To distribute the principal of the, Probate or . Trust Estate to the then inoome benefioiary if in the Trustee's disoretion the amount of the prinoipal of the Probate or Trust Estate is so small as to be impraotical or uneoonomical to administer properly. ,.'.-" -1 , t' 1;"&j/Y - 10 - IN RE: ESTATE OF .JAMES R. FICKEL, .JR., : IN THE COURT OF COMMON I'LEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORI'HAN'S COURT I>IVISION : NO. 21,94.0068 .JOINDEI{ OF Rf:MAINUER BENEFICIARY I, Linda J. Niesen, of 454 Allen View Road, Mechanlcsburg, Pennsylvania 17055, hereby acknowledge and agree as follows: 1 I acknowledge that I am aware of my status as a remainder beneficiary In the Trust created by my father, James R. Fickel, Jr., pursuant to his will. 2 I agree with the petition of my mother, Virginia Fickel Ehr, to have M&T Bank removed as the Trustee of said Trust. 3 I agree to have my mother, Virginia Fickel Ehr, appointed as the alternative Trustee of the Trust created within my father's will. 4 I agree with my mother's request to have M&T Bank removed as Trustee and have my mother appointed as alternative Trustee without the requirement that M&T Bank me a formal accounting with the court. Date: 1&-/5-0 I ~ 'jL { A1uU- ).~AUJ Linda . Niesen g EXHIBIT , _ B IN RE: ESTATE OF ,lAMES R. FICKEL, ,IR" : IN THE COURT OF COMMON \'U:AS OF : ClJMIJERLAND COUNTY, \'.:NNSYLV AN\A : ORPHAN'S COURT I>IVISION : NO. 21,94,0068 ,100NI)ER OF R.:MAIND\<:R IIJ<:NE.'ICIARY I, William K. .'Jekel, of 380 Dorwood DrIve, Carlisle, Pennsylvania 17013, hereby acknowledge and agree as follows: I I acknowledge that I am aware of 111~' stilt us liS II remainder beneficiary In the Trust created by my father, JlIlI1eS R. Fickel, Jr., pursuant to his will. 2 I agree with the petition of my mother, Virginia Fickel Ehr, to have M&T Bank removed as the Trustee of sllld Trust. 3 I agree to have m~' mother, Vh'glnla Fickel Ehr, appointed as the alternative Trustee of the TrllSt created within my father's will. 4 I agree with my mother's request to have M&T Bank removed as Trustee and have my mother appointed as alternative Trustee without the requirement that M&T Bank me a formal accounting with the court. Date: \ ~ (~~.~___ {iJiL-lL ,~ William K. Fickel EXHIBIT I c . . . IN REI ESTATE OF JAMES R. FICKEL, JR., IIN THE COURT OF COMMON PLEAS OF I CUMBERLAND COUNTY, PENNSYLVANIA I ORPHAN'S COURT mVISION I NO. 21.94,0068 ~R OF REMAINDEI{ BENEFICIARY I, David J. Fickel, of 5961 County Road, 1-2 Swanton, Ohio, 43558, hereby acknowledge and agree as follows: 1 I acknowledge that I am aware of my status as a remainder beneficiary In the Trust created by my father, James R. Fickel, Jr., pursuant to his will. 2 I agree with the petition of my mother, Virginia Flcllcl Ehr, to have M&T Bank removed as the Trustee of said Trust. 3 I agree to have my mother, Virginia Fickel Ehr, appointed as the alternative Trustee of the trust created within my father's will. 4 I agre,~ with my mother's request to have M&T Bank removed as Trustee and have my , mother appointed as alternative Trustee without the requirement that M&1' Bank flIe a formal accounting with the court. I>ate: I~h e 101 ~-Y\~I ' David J. Fickel EXHIBIT I D . ' . IN RE: ESTATE m' .JAM~:S'R. FICKEL, .JR., IIN TH~: COlIRT OF COMMON I'LEAS OF I CUMIJEI{LANIl COlJNTY. PENNSYLVANIA I ORPHAN'S COURT mVISION I NO. 21.94-0068 ~ONSENT TO cHt\.~m:.OF_.i\PPOINTMENT AS T~!)ST.:E . , Mltnufaeturers & Traders TI'ust ContJlan~' (M&T), successor In Interest to Farmer's Trust Bank, hereby consents to be removed liS Trustee of the Trust crcnted undel' the will of James R. Fickel, Jr., IInd nlso hereby stlltes no opposition to the petition of Virginia Fickel Ehr to be nppolnted liS Alternative Trustee of the Trust under the will of James R. Fickel, Jr. Furthermore, M&T agrees to terminate the Trust and deliver the assets of the Trust to Virginia Fickel Ehr without the need to M&T filing II formal accounting with the court subject, however, to M&T being relieved of all claims and appropriately Indemnified by Virginia Fickel Ehr In accordance with the language of the proposed Order of Court attached to this. Manufacturers & Traders Trust Company Datel 101J;,/fJ! , ~' /l BYI, ~ . . David C. Gor .' Vlc ,President and Trust Officer EXHIBIT j E. . ~.' " " I verify that the statements made In the foregoing document are true and correct. I '" , , understand that false statements herein are made subject to the penalties of 18 P A.e.S. SeCtion ,4904 relating to unsworn fnlslftcatlon to authorities. DATEI~1 {l,i ~1v Fickel Ehr w I. "'1 /. 'I' , , " 'i" ., " /, , " '" " ., '! " , ,. " :1. " I. I." ': , , " " i, ,I " , I " , , ,. I , " " , I, ,I' " 'I, " ,I r" ,. ": , , " I," ,'. . .' ., , ," ,I , 1 ~ , I, Ii' "" I' '"~ ,. I. " ,i'\. "11 ,. ,. 'I, .' II'," , ,. '1," i,I' " ,. ,. " 'i. i. " ','. , I. ,. " " , ;'1 'I' ." ,. i' h I' I,'. ,,' ,,'I " I i. ",' ,. , ' I " I' ,.' , I ~ .,' f ,. :' :1" " " " " " , , " "(, " , l,t I' , ., , " I" I"~. , " . , . I ,. "I I,' 1/ " RElCord<;~: :,ii,,:e of "FlOyiJIJI :)1 Wills " I, 'I 'I '01 01021 P2 :38 I, " ..' I' I, I' ",. ,,'I- , ',~ ""1 '"'f' ,." 'vElI",,,I:...'..'II,.,liCI.lf\ C\llY1bElr\r1n<l lJO., I'A ',I " > ,. ,",I I I' ," . , 'I ,. ,.," " " I " I,.. ., , '.,. '. ., > I" .' '1'" \, /. I " '. , ' " :", 'Ii ,'j, I, ',I' \!; t'; " ~ ,I, i" " ", " t;' " \.' ,. " " I' ; I' \, '" " > .. . ,. " " , . " " ,. t. ,. . , '" ,. " Ii ,I ,I ,~' "',. ,. .l' .. , " " ", II .1 " I.' ", " I', 'I' \,,'1 '; I"~ ',1< ,. I' I' " , " ,. >" 1.( Ii 1 I' ""' I'" " 'i " ',I; I> " , , I' , , I" ,I,;' II', " ,," ,.j. / " I' 'II " , I ," '.' 'I ,;J' ",1,", j; I. " I', ., " "1- " I' " , ,.', .. I, , ,.~ I; , "ilT " ,',,; .,' "." II ..' ,', II i' ~ ' " " , I' I- , I" " I. " I, ./ " I)' d', ,. , ,. ,. .1 '1'.: 'I " '," " ""t' .. j. ',' i,. 'I fll' 1-,J,' I ,14 \., I. " " , ,. " " I/"".f",,',,," " " ',,, " ,,' .' ,. ii' " j" ,," " {,oj ";1 , ' "I " ., 'ii ,_"I ,",;. "~I', Ij "p ,. ,I t. 'I' ,l; " " ,I. I'" " ,II ,,' " ,,' I H' ';'/1,'.1': Ii' 1:'" '" ',', " I> " " II' 'I;, , I;''!'' ,(,', ','j Ii "" II I'" "," '" f'r "i" I' , " ,Iii , ~: " L"i' H' Ii i, '\., "11' .' .. \ i.', " ", " " .II I' II " ," ",I' ',I' ,., '"" '. " " I, I' ,', 4';' (.; II' ,'i_, "I< /", ,. ," ,. '." '" " ;Ii ,: ",. ",' ,I' :1" 'I i, ,-) " ';;i, ",il " Ii , I', " , ,. ,. " "1 I. , , , 'I.i, " I" .. . . .. . STATUS REPORT UNDER RULE 6.12 Name of Decedent I '" fo)).{c s_H, +~~I ci.fl - Dat.e of Deathl 1- 13 -1 /.( Will No. Admin. No. JJ.I '1 i-O~ 6 8' Pursuant to Rule Court Rules, I report the the administration of the 6.12 of the Supreme Court Orphans' following with respect to completion of above-captioned estate I State .whether administration of the estate is complete I Yes_f,- No.___. 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete I 1. 3. If the answer to No. 1 is Yes, state the followingl a. Did the personal representative file a final account with the Court? Yes NO~. b. The separate Orphans' Court No. (if any) for the personal representative's account is I IL (0.... c. Did the personal representative state an account informally to the parties in interest? Yes~ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Datel J~/6 ~ ~'6 0. ~~j {is. (), F {OIA)(.r Jc Name (Please type or print) / I P, l-/if.}- k Sf- (let.. 1/> &.-_~ '-/0 n. Address ~ / ", ill?) d. lJ ],~5 5' /3 Te 1. No. __I, '.)(.) Capacity, Personal Representative Y .Counsel for personal ~ representative (MAH, rmf/ AM3)