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No. ?1 - 96 - nr,l1
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BETTY F. McGUIIlB a/k/a
nRTTV ~'OIIT~~ McGUIllB
, Dcccnsed
DECREE OF PRonATE AND GRANT OF LEITERS
AND NOW OCTOBER ?5, 19~, In conslderallon of the petlllon on
the reverse side hereof, sallsfactory proof havlns been presented before me,
IT IS DECREED thallhe Instrument(s) daled MARCH n. 1996
described therein be admllled 10 pro bale and filed of record as the last will o'f
Betty F. McGuire alkla Betty Forte McGuire
and Lellers Testamentary
arc hereby sranted to Lawrence H. McGuire. Jr.
FEES
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R.s!IIC' or Will.
Horace A. ~~.LWJi.(06340 .
Johnson. Duffie. Stewart & Weidner
305.00
9.00
Probale, Lellers, EIC. ......... S
Shorl Certlficales(3 ) ... ..... .. S
R~nunclallon ................ S
x-pages
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TOTAL _ S
Filed ..... ~.C.~q~~~. .~?:. .l.~~~....... II..
^TIORNEY (Sup. Ct. 1.0. NOJ
301 Market St.. P. O. Box 109
LBoovne. PA 17043-0109
ADDRESS
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COMMONWEALTH OF PEHNSYLVANIA . DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
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While this bcqucst is absolutc, it is my wish that any mcmorandum I may Icavc
addrcssed to my personal reprcscntativc indicating my dcsire with rcspectto the disposal
of these items, or any of them, shall be regarded.
ITEM III: MARITAL DEDUCTION TRUST:
If my husband, LA WRENcI<~ II. MCGUIRE, JR., survives me (and I dircct that
for purposes of this Item of my Will he shall be deemed to have survived me unless it
appears unmistakably that he prcdcceased me), and if the federal estate tax due because
of my death will be reduced by making this gift for his bencfit, I give, dcvise and
bequeath to my Trustee hereinaftcr named, IN TRUST, the least amount (based upon
values as finally determined for fcderal eslate tax purposes) as shall be needcd for the
federal eslate lax unlimited marital deduction to reduce the federal estate tax to the lowest
possible figure after full use of all other deductions and credits allowable in calculating
the federal eslate lax. However, the state death lax credit shall only be taken into account
to the extent that it does not increase the amount of tax payable to any state.
Accordingly, I direct that:
1. If the marital deduction, or any other similar benefit, is allowable with
respect to any property, including property held by entireties, which my
husband, LAWRENCE II. MCGUIRE, JR., has received prior to my
death or at my death will receive otherwise than pursuant to this Item III,
the value of such property shall be taken into consideration in calculating
the size of the gift under this ITEM III.
- 2-
099999,OOOO"Mln:h a, 1996/IIAJIPAR/49760.(4)
2. No property ineligiblc for thc marital deduction, or any similar benefits,
shall bc distributcd to this gift for my husband, LAWRENCE II.
MCGUIRE, JR., pursuant to this ITEM III.
3. Either cash or invcstments or bolh may be allocated to any gift undcr this
ITEM III.
4. Any property allocated under this ITEM III in kind shall be valued at the
value which it is finally included in my gross estate for federal estate tax
purposes, provided that the aggregate market value thereof on the date of
allocation (plus the value as finally determined for federal estate tax
purposes of all other property qualifying for the marital deduction) is at
least equal to the dollar value of the marital deduction as finally determined
for federal estate tax purposes.
5. My husband, LAWRENCE H. MCGUIRE, JR., shall be paid the entire
income from the principal in such periodic installments as the Trustec shall
find convenient, but at Icast as often as quarter-annually or else applied
directly for his bcncfit by the Trustee. Income that accrues between the
date of the last distribution to LAWRENCE II. MCGUIRE, JR., and the
date of his death shall be distributed to his estate.
6. My husband, LAWRENCE H. MCGUIRE, JR., is hereby given a power
to appoint by Will to his estate or to others, in such manner and for such
estates as he may appoint, exercisable only by specific reference by him
alone and in all events over the principal of this Trust.
- 3 -
099999.0000"M.~h I, 1996IIlAJ/PAR/49760 (4)
7. As much of the principal of this Trust as the Trustee may from time to time
think advisable for the support of my husband or during illness or
emergcncy shall be cithcr paid to him or else applied directly for his benefit
by the Trustee.
8. In addition to thc above provisions, my husband, LAWRENCE H.
MCGUIRE, JR., shall have the power to withdraw such amounts from
principal as he shall desire from time to time including the entire exhaustion
of principal.
9. If my husband, LAWRENCE H. MCGUIRE, JR., shall fail, either
wholly or in part, to exercise effectively the power of appointment created
in the preceding Paragraph 6 of this ITEM III, the unappointed principal
shall be added to and thereafter treated as part of, the principal of my
residuary estate passing under ITEM IV hereof, provided that the Trustee
shall first deduct and pay to the personal representative of my husband's
estate an amount equal to the increase in federal and state death taxes and
any increased administration expenses which his estate will have to pay
because of the inclusion of the principal of this Trust in his estate for tax
or adminislration purposes.
10. If any provision of my Will shall result in depriving my estate of the
marital deduction for federal estate tax purposes, such provision is hereby
revoked and my Will shall be read as if any portion thereof inconsistent
with allowance of the marital deduction for federal estate tax purposes is
null and void.
- 4 -
099999.0000S/Mln:h 8, 1996/HAJ/PAR/49760(4)
ITEM IV. CREDIT BYPASS TRUST:
I give, devise and bequeath, IN TRUST, all the rest, residue and remainder of my
estate to the Trustee hereinafter named for the following uses and purposes:
1. To pay the net income therefrom at least as often as quarter-annually to my
husband, LAWRENCE H. MCGUIRE, JR., for and during his lifetime.
2. As much of the principal of this Trust as Trustee in its sole discretion may
from time to time think advisable for my husband's health, maintenance,
and support to maintain him in the station of life to which he is accustomed
at my death, or during his illness or emergency shall be either paid to him
or else applied directly for his benefit by my Trustee after taking into
account his other available assets and sources of income. Insofar as
practical no principal of this Trust shall be paid to my husband,
LAWRENCE H. MCGUIRE, JR., or applied for his benefit as long as
any principal remains in the Marital Deduction Trust created in ITEM III.
3. Trustee may apply the net income of this Trust for the support of my
husband, LAWRENCE H. MCGUIRE, JR., should he by reason of age,
illness or any other cause in the opinion of my Trustee be incapable of
dispersing it.
4. Upon the death of my husband, LAWRENCE H. MCGUIRE, JR., the
remaining principal and undistributed income (Trust Assets) shall be
distributed as provided in ITEM V hereof.
- 5 -
09999'),OOOO5lMan:h 8, 1996111AJ/PARl49760 (4)
ITEM V: HUSBAND )'REDECEASES.
Should my husband, LAWRENCE II. MCGUIRE, fail to survive me, I give,
dcvise and bcqucath thc rcst, rcsiduc and remaindcr of my estate of every nature and
whcrever situate as follows:
I. One percent (I %) to each grandchild, provided said grandchild survives me
and the parent of that grandchild who is also my child, survives mc.
2. The balance of the rest, residue and remainder I give to my then living
issue, per stirpes, provided, however, that as regards any shares to which
my son, JEFFREY S. MCGUIRE, is entitled, my personal representative
shall use said sharc to purchase an annuity which will provide periodic
payments, payable at least quarter annually to JEFFREY S. MCGUIRE
for his life.
ITEM VI: PAYMENT OF DEATH TAXES.
I direct that all death taxcs shall be paid from my residuary estate passing under
ITEM IV or V 2 of this Will. In no event shall the payment thereof (i) reduce or
otherwise affect the amount (if any) distributable under ITEM III except to the extent that
property remaining in my gross estate after satisfaction or provision for satisfaction of all
debts and expenses of administration, and all inter vivos and testamentary dispositions
(other than under ITEM IV) of property included in such gross estate which do not
qualify for the federal estate tax marital deduction, shall be insufficient to satisfy all death
- 6 -
099999-OOOO5IMan:h 8, 1996IHAJ/PARl49760(~)
taxes in full and (ii) be made from any property which is not includible in my estate for
the purposes of one or more of such death taxes and which would be so includible if used
for such payment.
ITEM VII: ELECTIONS. OPTIONS.
My Personal Representative shall have full power to exercise, in my Personal
Representative's sole and absolute discretion, any elections provided by the Internal
Revenue Code, other statutes and regulations, state and federal, relating to the
administration of my estate and the Trusts herein created, including but not limited to the
following:
1. To join with my husband or his personal representative in the filing of a
joint income tax rcturn for any period for which such a return may be
permitted, without requiring him or his estate to indemnify my estate
against liability for the tax attributable to his income, and to consent for
federal gift tax purposes to having gifts made by my husband during my
lifetime treated as having been made one-half by my husband and one-half
by me.
2. To make the election described in Section 2056(b)(7) of the code in respect
of all qualified terminable interest property (or any specific portion thereof)
includible in my gross estate to such extent as my Executors shall deem to
be in the best intcrcsts of my estate and beneficiaries thereof, and any
determination madc in good faith by my Executors to make or not 10 make
- 7 -
099999.QOOO5/March 8, t996lHAJ/PARl497(,o (4)
such election shall be binding and conclusive upon each person having any
interest in my estate and shall not be subject to question or exception in any
manner or proceeding whatsoever or by any person whomsoever.
3. To make the allocation of the GST exemption allowed to an individual
pursuant to Section 2631(a) of the Code in such manner as my Executors
shall deem to be in the best interests of my estate and beneficiaries thereof,
any determination made in good faith by my Executors with respect to such
allocation shall be binding and conclusive upon each person having no
interest in my estate and shall not be subject to question or exception in any
manner or proceeding whatsoever or by any person whomsoever.
4. To choose the alternate valuation date for federal estate tax purposes,
without regard to whether the size of any marital deduction share will be
increased or decreased thereby, without requiring reimbursement.
ITEM VllI: SPENDTHlUFf.
The interest of the beneficiaries hereunder or the beneficiaries of any Trust created
herein shall not be subject to anticipation or to voluntary or involuntary alienation.
ITEM IX: POWERS.
My Personal Representative and Trustee shall have the following powers in
addition to those vested in them by law and by other provisions of my Will applicable to
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CERTIFICA1'ION OF NOTICE UNDER IlUI,E 5.6 ( a)
Name of Decedent:
Betty F. McGuire a/k/a Betty Forte McGuire
Date of Death:
September 24, 1996
Will No. r.JW- 0858
Admin. No.
-------... -
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
beneficiaries of the above-captioned estate on
the ),OlloWing
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Name
Address
Lawrence H. McGuire, Jr.
35 Foxcroft Drive, Camp Hill, PA 17011
815 Ridgewood Drive, Mechanicsburg, PA 17055
35 Foxcroft Drive, Camp Hill, PA 17011
Lawrence H. McGuire, III
Jeffrey S. McGuire
Kathleen E. Pingree
2201 S. Bayshore Drive, Milton, DE 19968
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
None
Date:
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e Horace A. Johnson, Esq.
Johnson, Duffie, Stewart & Weidner
Address 301 Market St., P. O. Box 109
Lemoyne, PA 17043-0109
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE ;!I
WITH REGISTER OF WILL~! _._ ~~~~lY C~D[
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'fOR DAIIS 01 DlATII AnlR 12/31/91 CtHCK HlRl
IF A SPOUSAL
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9/24/96
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~'cGulre, Jr., Lawrence II..
I shimel
o 2,
Supplemental Relurn
$447,1112.81
o 3. Remainder R.lurn
(for dote I of d.olh prior to 12.13.821
o 5. Federal E.lol. TaA Relurn Required
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Original Relurn
o Aa. Fulure Inlere.t Compromi.e
(for do.e. of deoth after 12.\2.B21
Decedent Died Tlllale 0 7. Decedenl Moinloined 0 living Trult
(AlIoch copy 01 WillI (Alloch copy 01 T""1
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
HAMl COM'UTf MA'L!NC, ADOIUS$
Horace A. Johnson, Esquire Johnson, Duffie, Stewart & Weidner
"","ON' NUM'" 301 Market St., 4":K1>. Box 109
761-4540 l43ro PA 17
limited Eltole
_ 8. Tolo1 Number of Sof. Depolil Bou.
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1. Real E.tote (Sch.dule A) (I)
2. Stacie and Bond. (Schedule BI ( 21
3, Clo.ely Held StocklPor1nellh;p Inter... (Sch.dule q 13)
4. MOr1goge. and Note. Rece;voble (Sch.dul. DI 14)
5. COlh, Bonk Depo.ill & Mhcellaneous Penanal Property (5)
(Schedule EI
6, Jo;n.ly Owned Property (Schedule FI 1 61
7, Tron.l... (Sch.dule GI(Schedule L) 171
8. Tolol Gran Auell (Iolollin.. 1.7)
9. Funeral EApenses, Administrative COSII. Miscellaneoul ( 9)
hp.n.e. (Schedul. H)
10. Deb II. Morlgoge liabilities, Lienl (Schedule I) (10)
11. Total DeduC1ionl (lolallin.. 9 & 10)
12. Nel Value of Ellole (line 8 minus line 11)
13. Charitable and Governmenlal Beque.ts (Schedule J)
lA. Nel Value Subjed 10 To.. (Line 12 minulline 13)
15. Spousal Tronders (for dales of deolh oher 6.30.9.4)
See In.trudionl for Applicable Percenlog' on Reverse (15)
Sid.. (Include yolulI from Schedule K or Schedule M.)
16. Amounl of line 14 taxable at 6% role (161
(Include values from Schedule K or Schedule M.)
17. Amounl 01 Line 14 taxable at 15% rote (171
(Include va lUll from Schedule K or Schedule M.)
18. Principal lox due (Add tax from lines 15,16 and 17.)
19. Credih Spou.ol Poverty Credit Prior Poymenh
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20. If line 19 is greoler thon line 18, enler the diFferente on line 20. Thi. ilthe OVERPAYMENT.
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21. If line 18 ilgreoler than line 19, enler the difference on line 21. Thil illhe TAX DUE.
A. Enler the inlerelt on the balance due on line 21 A.
B. Enler the 10101 01 l;n. 21 and 21A on L;ne 21B, Thi. ;'Ihe BALANCE DUE.
Mok. Check Pavable to: Reghl.r a. Willi, Ag.nt
Check hero if y.ou arc requesting 0 refund of your overpayment.
(21)
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>- >-' BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH, -0(' -0('0' ~'.. ,"
Under penollies 0' perjury. I declor. thai I hove IAomined thil return, including accompanying Ichedul.. and Ilolemenh, and to the bell of my Il:nowledg, and beliel
it is true. corred and complele. I dare Ihol 011 real ellole hot been reporiea allrue market value. Declaration of prepare' olher ahon the personal represenlotive ;
baled on all informolion of whit R rho. any Il:no.....ledge.
"0 T '''",ON , ':~'C-a'DD'US 35 Poxcroft Drive D'''/~~r-<J7
C'v\... Ca IIi 11 PA 17011
. , us 301 ~'a~ket St.. P. o. Box 109 DAlt!r/f7
I .
Esquire
Act #48 of 1994 provides for the reduction 01 tho tax rato,/mpo.od on tho not valuo oltranslers to or lor
tho u.. of tho .pou.o. Tho rot.. a. pro.crlbed by tho .tatuto will bo:
· 3% (.03) will b. appllcabl. lor ..Iat.. 01 docodonts dylno on or altor 7/1/94 and bolor. 1/1/96
· 2% (.02) will b. appllcablo lor o.lato. 01 docedents dying on or alter 1/1/96 and boloro 1/1/97
· 1% (.01) will be applicable lor e.tato. of decedent. dying on or alter 1/1/97 and belore 1/1/98
· Spou.al translers occurring on or after 1/1/98 will be exempt from Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (v) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transler and:
a. retain the use or income 01 the property Iranslerred, .......................................................
x
b. retain the right to designate who shall use the property Iranslerred or its income, ...............
x
c. relain a reversionary interest; or ...................................................................................
x
d. receive the promise lor liFe of eithor payments, beneFits or care~ .......................................
x
2. If death occurred an or beFore December 12, 1982, did decedent within two years preceding
death transler property withaul receiving adequate consideratian~ If dealh occurred alter
December 12, 1982, did decedenttransler property within one year 01 death without receiving
adequate consideration' "0 ....... "" " ...... ....... ...,. ....... ..... .... '" ...... It 10 '" .... .... ...... ........ ...... .....
x
3. Did decedent own an 'in trust for', bank accounl 01 his or her dealh?.....................................
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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COMlolOHW!A\lH 0' '!NNSYLVAHI4
INHUnANCI 'AI lUUlN
IUIDINt OlcrOINt
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
McGuire, Betty F. n/k/n
McGuire, Betty Forte
DESCRIPTION
Funaral Explnusl
Myers-Harner Funernl l1ome, Inc. - funernl expenses
1.
Ad,nlnlstratlvl Cashl
Personal Represenlalive Commillians
Social Secu,ity Numbe, 01 Personal Rep,esenlol;ve:
Veor Commllllons paid
Allorney Fees - Johnson, Duffie, Stewart & \~eidner
3.
Family Exemplian
Claimant Lawrence 11. McGuire
Relalionship
Husband
Address 01 Claimant 01 decedenl's dealh
SI,ee' Address 35 Foxcroft Drive
City Camp Hill
Slate PA
Zip Code
Probale Fees - Register of wills - Cumberland County
Pilau Print 0' T I
N BER
2l-96-0B58
17011
MIscellanlous Expenses:
Register of wills - file Inventory & Inheritance Tax Return
Reserve for close-out costs
TOTAL (Also enlor on line 9. Recapitulalion)
(II more spacI Is needed, Insert addltlonalsheeh 01 same sill.)
AMOUNT
5,36B.00
1,500.00
3,500.00
352.00
25.00
75.00
5 10,820.00
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
ss:
I.lwrcncc II. ~lcGujrc, .Jr.
b.ing duly
sv.urn
according 10 law, deposes and ..ys that he I" !"Y""''''-nr
0' tho Estate 0' m:I'I'Y "'JI('11': ~lct;llllm
lat. 0' -U~,TQ'dUllhiJ,'l... "---- , Cumberland County, Pa., decu..d and that tho
within Is an Inventory made by I.-Iwrcncc II. ~1cGlI i 1'0. .h'. _ , the said EX('Clltor
of the entire estate of l4id d.cedent, consisting of all the personal prop.rfy and real estate, except rul estate ouhide
the Commonwealth 0; P,nnsylvania, and that the ligures opposite oach item 0' the Inventory repre..nt it's 'air value
~s of the data of deCEdent's dufh.
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",~,,/:7#;1" < C- A'iC'_
Eucutor . A mr"id,afot
l.1wrence 11. McGuire, Jr., Executor
35 Poxcroft Drive
S\o.urn to
and ,ubscribed be'ore me,
DIANNE lEWG, Nolary Publ
lemoyno Borough Cumberl2nd Co,
My Commission Expires Dec. 21. 1997
-;--.
..
Camp lIill, PA l7011
Add,...
Date of Duth
24th
September
Month
1996
Vu,
D.y
INSTRUCTIONS
I. An inventory must be filed within throe months afler appointment of personal representative.
2. A supplement inventory must b. filed within thirty days 0' discovery of additional alSets.
3. Additional shoeh may be altached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
.
'~..../
*'
BUREAU ;'F INDIVIDUAL TAMES
IHttUlfANCE TAlC DIYISION
OCPT. IIUIl
HARRISIURC, PA 11llll-0601
NDTICE DF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR DISALLDWANCE
OF DEDUCTIONS AND ASSESSHENT DF TAM
.".Ihl"'" 111'''1
HORACE A JOHNSON ESQ
301 MARKET ST
PO BOX 109
LEHOYNE PA 17043
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-26-97
MCGUIRE
09-24-96
21 96-0858
CUMBERLAND
101
F
BETTY
I~_ A~unt Ro.ll.!od
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifE-';:is4i" EXu"Fji-ioi-:mniiii'r"icEuOF-i-N"HEiiiTANCE"YAiD -ppRiiisEHEiir-,--"iTowAiicE"oli---m----------"
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
BETTY F FILE NO. 21 96-0858 ACN 101 DATE
TAM RETURN WAS, ( I ACCEPTED AS FILED I Xl CHANGED SEE ATTACHED
ESTATE OF MCGUIRE
05-26-97
NOTICE
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Ro.I E.toto (SchoduI. AI (II
2. Stack. and Band. (Schodulo BI (21
3. Clo..ly Held stDck/P.~tn.r.hJp Int.r..t (Schedule C) (3)
4. "artg.g.l/Not.. Receivable (Schedul. DJ (4)
S. Cash/Bank Deposita/Hi.c. Par.onal Property (Schedul. EJ (51
6. Jointly Dwn.d Praporty (Sch.dulo FI (61
7. Transf.r. (Schedule G) (7)
8. Total A...t.
.00
359.966.93
.00
.00
.00
.00
98.950.88
IBI
NOTE I To In sur. proper
credit to your account,
sub.it the upper portion
of this far. with your
tax Ply..nt.
458.917 .81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral E)(pen.../A~. COlts/Hisc. Expansa. (Schadula H) (9)
10. Dobt./Hartg.g. Llobllltl../Llon. (SchoduI. II (101
11. Total Daduction.
12. Hat Value of Tax Raturn
13. Charltable/Govarneantal aequa.t. (Schedule ~)
14. Hat Value of E.tata Subject to Tax
10,820.00
285.00
1111
1121
1131
1141
11.1n~ nn
447.812.81
.00
447,812.81
If an assessment was issued previoUSly, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAX:
IS. A.ount of Line 14 at Spou.al rat. (IS)
16. Aoaunt af Llno 14 tox.bI. ot Llno.I/Clo.. A roto 1161
17. A.aunt of Line 14 taxabl. at Collataral/Cla.. a rat. (17)
18. Principal rax Du.
NOTE:
.00 M .00=
.00 M .06=
.00 M .15=
I1BI
.00
.00
.00
.00
TAX CREDITS:
PAYHENT
DATE
RECEIPT
NUHDER
DISCOUNT I + I
INTEREST/PEN PAID I-I
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION DF ADDITIONAL INTEREST.
I IF TDTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY DE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIDNS.I