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HomeMy WebLinkAbout04-23-09 (2)1505607120 R~-1500 ~ (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box.2aosoi 21 0 9 0111 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 204 O1 3410 O1 25 2009 08 05 1916 Decedent's Last Name Suffix Decedent's First Name MI BORDNER MATILDA M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL. IN APPROPRIATE OVALS BELOW X^ 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Return Required (date of death after 12-122) x 6 Decedent Died Testate ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes ^ (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death ^ 11. Election to tax under Sec. 9113(A) ^ ^ between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EARL RICHARD ETZWEILER (717) 234 5600 Firm Name (If Applicable) ETZWEILER AND ASSOCIATES First line of address 105 NORTH FRONT STREET Second line of address City or Post Office HARRISBURG State ZIP Code PA 17101 REGISTER OF WILLS USE ONLY r~ s..~ r:.,~ -- ;'~ !~ .r.~ _ _ ~7 'a - l7 t =~? ':7 ~- ~ ; '_~ 1`J ' -, `_. . 7 ~ i ? .... DA'TEFILED ' -~ _-+ -" f- ~ .. -~ ~.. , Correspondent'se-mail address: REtZWeiler@COmcast.net Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration„of preparer other than the personal representative Is based on all information of which preparer has any knowledge. Dennis E. Lebo ADDRESS 57 Tuscany Court, SIGNATURE OF PREPARERJ~Ti 105 North Front Street, 1505607120 PA 17011 ,_?~ Earl Richard Etzweiler 1~_ ~ -~1 ~ C~ b PA 17101 Side 1 1505607120 PA Inheritance Tax Return Signature of Additional Fiduciaries I ESTATE OF ~ FILE NUMBER li Bordner, Matilda M. 21-09-0111 Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature #2 Name Address1 Address2 City, State, Zip Alice Lebo 57 Tuscany Court Camp Hill, PA 17011 Date 1505607220 REV-1500 EX Decedent's Social Security Number DecedenYsName: Matilda M. Bordner 2 0 4 O 1 3 410 RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 2 1 1 , 9 8 4.11 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 8 , 812 9 2 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 2 2 0, 7 9 7 0 3 9. Funeral Expenses & Administrative Costs (Schedule H) ...................... ................... 9. 2 7, 4 7 1 1 1 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ............. ................... 10. 1 6 4 . 3 4 11. Total Deductions (total Lines 9 ~ 10) ................................................... ................... 11. 2 7 , 6 3 5 . 4 5 12. Net Value of Estate (Line 8 minus Line 11) .......................................... ................... 12. 1 9 3 , 1 6 1 . 5 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) .............................. ................... 13, 14. Net Value Subject to Tax (Line 12 minus Line 13) .............................. ................... 14. 1 9 3 , 1 6 1 5 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 0 . 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 0 . 0 0 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 1 9 3, 1 61.5 8 18. 19. Tax Due ..................................................... ............................................................... . 19. Z0. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 0.00 ' 0.00 0.00 28,974.24 28,974.24 Side 2 15056D7220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-09-0111 DECEDENT'S NAME Matilda M. Bordner STREET ADDRESS 4833 East Trindle Road CITY Mechanicsburg STATE PA ZIP 17050 Tax Payments and Credits: 1. Tax Due (Page i Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 27,525.53 1,448.71 (1) 28,974.24 Total Credits (A + B + C) (2) 3. Interest/F'enalty if applicable p, Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 i:> greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) g. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) Make Check Payable to: REGISTER OF WILLS, AGENT 28,974.24 0.00 0.00 ._ ... . . PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.................................................................................. ^ x b. retain the right to designate who shall use the property transferred or its income :.................................... x c. retain a reversionary interest; or .................................................................................................................. 0 d. receive the promise for life of either payments, benefits or care? .............................................................. ~x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ ~x ~4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................................~~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death,on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent p2 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. LAST WILL AND TESTAMENT OF MATILDA M. BORDNER I, MATILDA M. BORDNER, a resident of Elizabethville Borough, Dauphin County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this instrument to be my Last Will and Testament, hereby revoking any and all wills by me at any time heretofore made. ITEM I: I direct my hereinafter named Executrix to pay all my just debts, funeral expenses, administration expenses and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. ITEM II: All the rest, residue and remainder of my estate, be it real, personal or mixed, of whatever nature and wheresoever situate which I may own or have the right to dispose of at the time of my decease, I give, devise and bequeath to be equally divided as follows: A. 1/2 to my sister, Anna R. Lebo, of 4715B Charles Road, Mechanicsburg, PA 17055, per stirpes. B. 1/4 to my niece, Brenda Vovakas, of 617 E. Hill Road, Middlesex, Vermont 05602. C. 1/4 to my nephew, Harry Troxell, of 4606 Abbington Drive, Harrisburg, PA 17109. I ,1Jit? / ~7 ~ ~y~ r t~r~~-rE~a~t~2~• SEAL) Matilda M. Bordner ITEM III: I hereby nominate, constitute and appoint my nephew, Dennis E. Lebo, of 2951 Central Avenue, Camp Hill, PA 17011, and my niece, Alice Lebo, of 2951 Central .Avenue, Camp Hill, PA 17011, CoExecutors of this my Last Will and Testament, with full power in their discretion to do any and all things necessary for the complete administration of my estate, without being required to file bond for the performance of their duties, with full power to sell at public or private sale and without order of court any real or personal property belonging to my estate, and to compound, compromise or otherwise settle or adjust any and all claims, charges, debts and demands whatsoever against or in favor of my estate as fully as I could if living. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last rr//~ Will and Testament this ~~"~`day of December, 2000. `_ ., ~~,rr7~ (r.~ <_ . ~s~i-~~ r~'~G!..r, ~~~t~-~/ (SEAL) Matilda M. Bordner Signed, sealed, published and declared by the above-named Matilda M. Bordner as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and vi the presence of each other, we believing her to be of sound and disposing mind, memory and understanding, have hereunto subscribed our names as witnesses this 7 ~~' day of December, 2000. f ,. 1~ i i~;. Rev1503 EX+ (6.98) SCHEDULE B STOCKS ~ BONDS CONldONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Bordner, Matilda M. 21-09-0111 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 1,000 shares of Eaton Vance LTD Duration stock @ 10,990.00 $10.99 per share 2 1,200 shares of PNC Capital Trust D 6.125% stock @ 22,734.00 $18.95 per share 3 1,290 shares of PIMCO Corporate Income Fund @ 14,686.65 $11.39 per share 4 1,381.92 shares of Evergreen Multi-Sector stock @ 15,228.76 $11.02 per share 5 1,450 shares of Franklin Templeton LTD stock @ $9.07 13,151.50 per share 6 1,473.34 shares of Western Asset Global High fund @ 10,910.08 7.41 per share 7 1,500 shares of Neuberger Berman Income stock @ 5,167.50 $3.45 per share 8 1,500 shares of Nuveen Multi-Strategy Income Fund @ 7,096.50 $4.73 per share 9 1,600 shares of Bank of America Corp 8.2% stock @ 21,912.00 $13.70 per share 10 250 shares of General Motors Corp. stock @ $3.43 per 856.25 share 11 400 shares of Corts II Verizon Global 6.125% stock @ 8,970.00 $22.43 per share Total of Continuation Schedule See attached page TOTAL (Also enter on Line 2, Recapitulation) 211,984.11 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1503 EX+ (6-98) SCHEDULE B STOCKS & BONDS continued COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bordner, Matilda M. 21-09-0111 ITEM NUMBER CUSIP NUMBER DESCRIP710N UNIT VALUE VALUE AT DATE OF DEATH 12 500 shares of Great Atlantic St Pacific Tea stock @ 8,287.50 $16.58 per share 13 500 shares of New York Community Bancorp stock @ 6,255.00 $12.51 per share 14 500 shares of Regions Financing TR 1118.875 stock @ 9,705.00 $19.41 per share 15 600 shares of Axis Capital Holdings @ $18.59 per 11,154.00 share 16 600 shares of Public Storage (MD) 7.125% Preferred 12,063.00 stock @ $20.11 per share 17 600 shares of Regency Centers Corp. 7.25% stock @ 10,350.00 $17.25 per share 18 743.61 shares of Nuveen Equity Prem Income Fund @ 7,908.29 $10.64 per share 19 800 shares of Ford Motor Credit Co LLC stock @ $9.49 7,592.00 per share 20 884.02 shares of LMP Cap Sr Income FD Inc, stock @ 6,966.08 $7.88 per share TOTAL (Also enter on Line 2, Recapitulation) 211,984.11 Copyright (c) 2002 form software only The Lackner Group, Inc. 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PERSONAL PROPERTY COMMONWEALTH OF PENNSYlVAN1A INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bocdner, Matilda M. 21-09-0111 InGude the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivorship must De disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Capital Blue Cross, refund of portion of medical insurance premium 307.58 2 Citi Smith Barney Global Bank Deposit Program 2,897.66 3 Country Meadows, refund of security deposit 339.52 4 Susquehanna Bank -Checking Account #1215017006 5,254.11 5 The Patriot News, refund of portion of subscription 14.05 TOTAL (Also enter on Line 5, Recapitulation) I 8,812.92 (ff more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) 04-21-2009 12:55PFd FROfr1-ACCOUNT SERVICES March 3, 2009 ETZWEILER & ASSOCIATES 105 NORTH FRONT STREET HARRISBURG PA 17101 RE: Matilda M. Bordner SS#: 204-01-3410 DOD: January 25, 2009 Susquehanna Bank 26 North Cedar Street P.O. Box 1000 Liti¢, PA 17543-7000 Toll free 800.311.3182 Corrected Letter To Whom It May Concern: 1n response to your letter of February 3, 2009, here is the above customer account information as of January 25, 2009. Account Title: Account #1 Matilda M. Bordner • Account Type/# Ckg-1215017006 Date Opened /Maturity gate: 7/22/72 • Interest Rate: .00% • Account Balance'": $5,254.11 • Accrued Interest: $0.00 YTD Interest: $0.00 *Account balance does not include accrued interest. There is no safe deposit box in the name of this decedent. If I can be of further assistance, please feel free to call. Sincerely, ti~~~~~~~~~~ Janet M. Peters Support Services Supervisor 1-717-625-6295 JMP/kklo 717-625-4478 T-942 P.002/002 F-289 Susquehanna Received Time Apr.21. 2009 1:52PM No. 4244 REV-1151 E'K+(12.99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Bordner, Matilda M. 21-09-0111 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 8,863.12 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Dennis E. Lebo Alice Lebo Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 57 Tuscany Court City Camp Hill State PA zip 17011 Year(s) Commission paid 9,000.00 2, Attorney's Fees Earl Richard Etzweiler 9,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 352.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 255.99 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 27,471.11 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Bordner, Matilda M. 21-09-0111 ITEM NUMBER DESCRIPTION Funeral Expenses 1 Hoover-Boyer Funeral Home, funeral expense Other Administrative Costs 2 Cumberland County Journal, advertise Letters 3 Register of Wills, take Oath 4 The Sentinel, advertise estate H-A Subtotal H-67 Subtotal AMOUNT 8,863.12 8,863.12 75.00 20.00 160.99 255.99 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-'1512 EX« (6-98) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANW INHERRANCE TAX RETURN RESIDF1fT DECEDENT ESTATE OF f FILE NUMBER Bordner, Matilda M. I 21-09-0111 Include unreimbursed medical expenses. (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) .~"'. 4}HOOVER-BOYER FUNERAL HOMES, [NC. 103 West Main Street Elizabethville, PA 17023 (717) 362-8522 Dennis Lebo February 18, 2009 57 Tuscany Court Camp Hill, PA 17011 For the Funeral Services of: Matilda M. Bordner Professional Services 18 G. Package $ 7,493.25 Casket Meridian 18G casket upgrade $ 50.00 Cash Advances Cutting of the stone, (2009) $ 95.00 Open and Close Grave $ 650.00 Death Certs 8 @ $6.00 ea $ 48.00 Flowers, casket spray $ 150.00 Clergy Honorarium $ 100.00 Obit notices (Patroit News) $ 242.87 Hairstylist $ 25.00 TOTAL CHARGES $ 8,854.12 STATE SALES TAX S 9.00 PAYMENTS & ADJUSTMENTS $ 8,863.12 February 18, 2009 Estate Check #1001, Dennis and Alice $ 8,863.12 Lebo BALANCE DUE: ~~'~y $ o.oo REV-1513 EX+ (9-00) SCHEDULE J ANIA COMM TA BENEFICIARIES NHERI NCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Bordner, Matilda M. 21-09-01 11 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not List Trustees (Words) ($$$) I. TAXABLE DISTRIBUTIONS [include outright spousal distributions and transfers , under Sec. 9116(a)(1.2)] Dennis E Lebo Nephew 1/2 of Residue 96,580.79 57 Tuscany Court of Estate Camp Hill, PA 17011 Harry Troxell Nephew 1/4 of Residue 48,290.40 4606 Abbington Drive of Estate Harrisburg, PA 17109 Brenda Vovakas Niece 1/4 of Residue 48,290.40 617 East Hill Road of Estate Montpelier, VT 05602 Total 193,161.59 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropr iate, on Rev 1500 cove r sheet III NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FO R WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF Ktv-'15U0 C:UVtK Stitt I I V.uV Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) ETZWEILER AND ASSOCIATES ATTORNEYS-AT-LAW 105 NORTH FRONT STREET HARRISBURG, PA 17101-1436 Office hours: Mon.-Fri. 8:00 a.m.-5:00 p.m. (717)234-5600 Earl Richard Etzweiler, Esquire ----- Christian S. Daghir, Esquire HALIFAX LINE (717) 896-3737 225 Market Street Fax Line: (717) 234-5610 2 West Main Street Millersburg, PA 17061 Email Address: retzweiler(a,comcast.net Elizabethville, PA 17023 (717)692-2519 (717)362-8395 Office hours: Tues. and Fri. 4:00 p.m.-8:00 p.m. Office hours: Thurs. 7:00 p.m.-9:00 p.m. Sat. 10:00 a.m.-12:00 noon April 21, 2009 Register of Wills Office Cumberland County Courthouse 1 Courthouse Square ~-a Room 102 . ~ ~. PA 17013 Carlisle '~~'~=? , ~! N - -_ ~ ~.,~ Re: Estate of Matilda M. Bordner 4 _, .,'# ~~ No. 2009-00111 ` ~' =v=; ,- , ---i .. y` N Dear Sir or Madam: ~ Please find enclosed the original and two copies of the Inheritance Tax Return and the original and one copy of the Inventory together with a check in the amount of $30.00 to file the same. Please time stamp the extra copy of the Inheritance Tax Return and Inventory and return them to my office in the enclosed self-addressed postage prepaid envelope. Please contact my office if you need anything more in this matter. Sincerely yours, ~/%~rr ~~ Earl Richard Etzweiler ERE:kIp Enclosures G:\ W P\DOC\ESTATE-DIR\ESTATE\Bordncr-Matilda\leiiers.wpd 3. ~-,, ~. , t; ,~J C `''. ~ } ~. r„ N -"' ~ C ~ ~ ~y. ~ / S- .. ~,,J ~~ ~ ~+' ,~'"1 y: 4+i'. {=: ', - 0 n /~ ~ n ~ ~ ~ QQ n ~. ~ Q ~ ~ ~ fD N ~ ~ ~ C p+ ~ b m 9 ~ ~ ~'' J ~ ~ ~ ~ ~ ~ G7 ~--. rt W ~~ O H 4 N ?~ 1 ii ~ i ~, r ~~ ~~