HomeMy WebLinkAbout05-11-11J REV-1500 ~`(°'-'°'
PA Department of Revenue Dennsylvanla
1505610143
OFFICIAL USE ONLY
County Code Vear Filw NumMr
Bureau of Individual Taxes 0eP""Ta~OFP~N1e
Po Box.2sosof INHERITANCE TAX RETURN 21 f ~ Q
Harrisburg, PA 17128-01301 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
187 30 0777 01 27 2011 10 11 1916
Decedent's Last Name Suffix Decedent's First Name M
ROBINSON ALBERT
(lf Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M
ROBINSON MARY
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL INAPPROPRIATE OVALS BELOW
a 1. Original Retum ~ nd2r
2. Supplemental Retum ~ 3. pn
ma
3e82; (date of death
o
1
o
4. Limited Estate ~ 4a. Future Interest compromise ~ 5. Federal Estate Tax Retum Required
(dale of death after 72-12-82)
5 Decadent Died Testate ~
(Attach Copy of Will) ~ Dec~der~t Maintained a Living Trust 8. Total Number Of Safe De Sit BOxeS
(Attach t;opy of Trust) p0
9. Litigation Proceeds Received ~ t D y~°~enP1v-~~~a dat{d~ et~~f death ~ > > _ Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIREC D TO:
Name Daytime Telephone Number
JERRY A WEIGLE ESQUIRE 717 532 7388
REGISTER ILS USE~NLY -t
~7 ~
~ ~
First Ilne of address ~j Z C--~ -
5 ~ ~ ' `_-~
126 EAST KING STREET r
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Second line of address r-i CJ ~ 'rJ ;
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City or Post Office D
E FILED
State ZIP Code
- O
SHIPPENSBURG ~
PA 17257
Correspondent's a-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanyingy schedules and statemenffi, and to the best of my knowledge and
it is true, wrrect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. lief,
SAN E OF PERSON RESP SIBLE FOR FILING RETURN DATE
/ David A. Robinson y 2.O 1D//
DRESS
P. O. Box 265 New Windsor MD 2 713.-
SIGNATURE PREPARER OTHER THAN REPR ETA
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squire
ADDRESS
126 East Kin Street, Shi ensbu A 17257
Side 1
1505610143 1505610143
v
YI
REV-1500 EX
Decedent's Name: RObIflSOllr Aib@rt Ci.
Decedent's Social Security Number
187 30 0777
RECAPITULATION
1. Real Estate (Schedule A) ....................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3.
4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 83 6 . 7
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous -Probate Property
(Schedule G) ~ Separate Billing Requested............ 7,
8. Total Gross Assets (total Lines 1-7) ..................................................................... 8. 836. 7
9. Funeral Expenses & Administrative Costs (Schedule H) ................................ ....... 9. 4 , 512. 7
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ....................... ....... 10. 6 92 . 2
11. Total Deduetlons (total Lines 9 & 10) ............................................................ ....... 11. 5 , 205. 0
12. Net Value of Estate (Line 8 minus Line 11) ................................................... ....... 12. - 4 , 3 68 .2
13. Charitable and Governmental BequestslSec 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. -4 , 3 68 .2
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 0
00 15
(a)(1.2) X .00 . .
16. Amount of Line 14 taxable
0
00
16
at lineal rate X .045 . .
17. Amount of Line 14 taxable
at sibling rate X .12 0.00 17.
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0 18.
19. Tax Due ........................................................... ...................................................... . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243
1505610243
0.
0.
0.
0.
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1505610243
REV-1500 EX Page 3
Decedent's Complete Address:
Fite Number 21
DECEDENT'S NAME
Robinson, Albert C.
STREET ADDRESS
Green Ridge Village
210 Big Spring Road
CITY STATE ZIP
Nevwille PA 17241
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
0.00
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to nsquest a refund
5, If Line 1 + Line 3 is greater than Line 2, enter the difference. This is tha TAX DUE.
Make Check Payable to: REGISTER OF
(1)
Total Credits (A + B) (2)
(3)
(4)
(5)
AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :...............................................................................
b. retain the right to designate who shall use the property transferred or its income :..................................
c. retain a reversionary interest; or ............................................................................................................... ^x
d. receive the promise for life of either payments, benefits or care? ............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ^ ^
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death?....... ^ ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................................. ^ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE
0.00
0.00
For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su iving
spouse is 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 0 pe cent
[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 disclosu 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 21 years of age or younger at death to or for the use of a natural pa ent, an
adoptive parent, or a stepparent of the child is 0 percent [72 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 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 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 blbod or adopti n.
Rsv7tiaB FJ(t 18.991
SCHE®ULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Robinson, Albert C. 21
InGude the proceeds of litigation antl the date Me proceeds were received by the estate.
All property Jointlyowmed with the right of surWvorehip must De disclosed on schedule F.
ITEM VALUE AT TE
NUMBER DESCRIPTION OF DEAT
1 Valley Rural Electric -final proceeds of patronage account 8 6.76
TOTAL (Also enter on Line 5, Recapitulation) 8 6.76
(If more space is needetl, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Re~. 6-98)
ona~~e~cr. unx~ M
SCHEDULE H
~ FUNERAL EXPENSES 8
COMM~RN
FQ P~F ~~YLVANL4
~'~~'~~ ~`~i"`N
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Robinson, Albert C. 21
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached a,o 5.54
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(sl Commission paid
2. Attorney's Fees Weigle ~ Associates, P.C. 4 0.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zio
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 7.20
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 4,5 2.74
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF (FILE NUMBER
Robinson, Albert C. 21
ITEM
NUMBER DESCRIPTION AMOUN
Funeral Expenses
1 Fogelsanger-Bricker Funeral Home
2 Grace United Church of Christ -memorial luncheon
3 Millie Hartz -honorarium
4 Rev. George Heckard -honorarium
H-A
Other Administrative Costs
5 Register of Wills, Cumberland County -filing Insolvent PA Inheritance Tax Retum
6 U. S. Postal Service -money orders to obtain copy of marriage certificate for life insurance
claim
H-B7
1
1
.20
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Re~. 6-98)
Rav-i5L2 EX+(12Ae)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, 8t LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Robinson, Albert C. 21
Report debts incurted by the deceMM prior to dash that ramalned unpaitl et tha date of dsaM, Ineludina unralmburssd mstl{eal axperuas.
ITEM VALUE AT ATE
NUMBER DESCRIPTION OF DEA
1 Carlisle Regional Medical Center 3 3.25
2 Cumberland Goodwill Fire Rsacue EMS 6.94
3 Graham Medical Clinic 6.57
4 Graham Medical Clinic 1 0.60
5 Graham Medical Clinic 3.37
6 Kinetic Imaging g,32
7 Millenium Pharmacy 1 5.51
8 Mobile X-ray Imaging 7,70
TOTAL (Also enter on Line 10, Recapitulation) 6 2.26
(If more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule 1 (Rev. 12-08)
REV-1513 EYa 111.N11
SCHEDULE J ',
coM~~D •e~r~ANV,
€~ BENEFICIARIES
ESTATE OF FILE NUMBER
Robinson, Albert C. 21
NAME AND ADDRESS OF RELATIONSHIP TO
SHARE OF ESTATE
AMOUNT OF EST
TE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
I TAXABLE DISTRIBUTIONS [inGude outright spousal
• distributions, and transfers
under Sec. 9116 a 1.2
Not relevant as estate is insolve t.
Total
Enter dollar amounts for distributions shown above on lines 15 throw h 18 on Rev 150 0 cover sheet, as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART It -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright (e) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
LAST WILL AND TESTAMENT
I, ALBERT C. ROBINSON, of 120 Green Ridge Lane, Newville, Cumberland
County, Pennsylvania, being of sound mind, memory and dispositioq do hereby make, publish
and declaze this my Last Will and Testament, hereby revoking and making void all wills by
me at any time heretofore made.
FIRST. I order and direct the payment of all my legally enforceable debts and
funeral expenses as soon as may be convenient after my decease.
SECOND. I give, devise and bequeath all my estate, real, personal and mixed,
whatsoever and wheresoever situate, to my beloved wife, MARY MARGARET
ROBINSON.
THI In the event my said wife, Mary Margaret Robinsoq should predecease
me or is not living on the sixtieth (60'x) day following my death, I then give, devise and
bequeath my said estate as follows:
A. I give and bequeath those items of tangible personal property described and
itemized on a certain. three-page typed list dated November 11, 1999, entitled "Specific
Bequests of Personal Property for My Last Will and Testament", executed by me,
attached to this my Last Will and Testament and incorporated herein by reference
thereto, to those persons named on said list.
B. I give, devise and bequeath all of the rest, residue and remainder of my estate real,
personal or mixed wheresoever and whatsoever situate to my sons, namely: DAIVD
A. ROBINSON, JOHN J. ROBINSON, ROBERT B. ROBINSON, THOMAS E.
ROBINSON, and DANIEL J. ROBINSON, on a per stirpes distribution basis.
FOURTH. I nominate, constitute and appoint my wife, MARY MARGARET
ROBINSON to be the Executrix of this my Last Will and Testament; if she be unable to fulfill
the duties of Executrix, I then nominate, constitute and appoint DAVID A. ROBINSON and
JERRY A. WEIGLE, Esquire, or the survivor thereof, to be the Co-Executors of this my
Last Will and Testament.
FIFTH. I direct that my personal representatives shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I, ALBERT C. ROBINSON, have hereunto set my hand
and seal to this my Last Will and Testament, written on one page, signed for identification.
only, this t t ~. day of ~.vww^-~u/ , 1999.
G2,, Ci- .SEAL)
MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 1 725 7-1 397
This instrument was by the Testator, on the date hereof, signed, published and declared
by him to be his Last Will and Testament, in our presence, who at his request and in the
presence of each other, we believing him to be of sound and disposing mind and memory,
have hereunto subscribed our names as witnesses.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
I, ALBERT C. ROBINSON, the person whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will; that I signed it willingly; and that I signed it
as my free and voluntary act for the purposes therein expressed.
Sworn or affurned to and acknowledged
before m by ALBERT C. RO~B`INSON, the. Testator
this ~ ~ day of /{~l/Il~p/YYJV~-- ~ ,.1999.
w
NOTARIAL SFJ1L
Jerry A. Weigle, Notary Public
ipensburg, PA Cumberland Co
MARK, WE16LE AND PERKIN3 - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257.1
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF ERLAND
We, and ~~
the witnesses whose names are signed to the foregoing instrument, being d qualified
according to law, do depose and say that we were present and saw ALBERT C. ROBINSON,
the Testator, 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 Testator, signed the will as witnesses; and that to the best of
our knowledge the Testator was at the time eighteexl (18) or more years of age and of sound
mind and under no constraint or undue influence.
Sworn or affix a and b er' > h
before by ,_
and ,
'messes, this f day f , 1999.
NOTARIAL SEAL
Jerry A. Weigle, Notary Pu
iDensbura. PA Cumberlanr
MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1
SPECIFIC BEQUESTS OF PERSONAL PROPERTY FOR
MY LAST WILL AND TESTAMENT DATED NOVEMBER 11, 1999
To David A. Robinson and Sue O. Robinson:
Antique Gone With the Wind Lamp, electrified -Living Room
Round Duncan Phyfe Table -Living Room
45~' Anniversary picture of Albert C. Robinson and Mary M. Robinson -Living Room
Handcrafted Sconces -Living Room '
Counted cross stitch of cabin and deer by Dave -Living Room
Round stand from Sunset Pines -Living Room
Painted portrait of Mary Margaret Robinson by Sue -Living Room
Painting of Tall Oaks by Sue -Study
Drawing of Camp Ground by Sue -Study
Antique dark oak stand -Study
Antique golden oak stand -Study
Painting of Hutchison homestead by Sue -Study
Line drawing of Tall Oaks by Fred Hutchison -Study
Hutchison family picture -Bedroom
To John J. Robinson and Bonnie S. Robinson:
Antique black waffle iron of Grandpa and Grandma McCaslin -Entrance Way Closet
Bone china salt and pepper set -Kitchen
Grandfather's Clock made from a kit by ACR -Living Room
Stand containing safe and safe -Study
RCA TV -Study
Notebooks with memorabilia and photo albums -Study
Picture albums and other memorabilia -Metal file in hot water heater closet -Bathroom
To Robert B. Robinson and Joanna Robinson:
Stool -Entrance Way
Alice Dorman's blue and white salt box -Kitchen
Decorative china plate -Kitchen
Lazy Susan -Kitchen
Antique fruit dish -Kitchen
Imitation oil lamp -Kitchen -Living Room
Antique oak chair with green nylon seat -Living Room
MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - f 26 EAST KING STREET - SMIPPENSBURG, PA 17257-1397 '.
Antique cabinet containing antique vases and china -Living Room
Hitachi TV and VCR -Living Room
Handcrafted pine TV table -Living Room
Lazge brown recliner -Living Room
Davenport hide-a-bed -Living Room
50~' Anniversary vase from the family -Comer cupboard, Living Room
2 white table lamps -1 Living Room -1 Study
Apple 2C computer and stand, extra disk drive, monitor, printer, supplies and instructions
- Study
Art piece from Israel -Study
Green floor lamp -Study
Bell and Howell binoculars -Study closet
White electric sewing machine -Bedroom
Black cherry bedroom suit with double bed, 2 nightstands and 2 dressers -Bedroom
Table lamp -Bedroom
Antique clothes tree -Bedroom
Rocker from Sunset pines -Bedroom
Picture in brass frame - MM's mother and brothers -Bedroom
Carousel slide projector -Storage Room
To Thomas E. and Maz~azet A. Robinson:
Stool -Entrance Way
Card table with postage stamp collection on top -Entrance Way
Every day dishes -Kitchen
Antique slate -Kitchen
Blue plate clock -Kitchen
Antique stand with 2 drawers Grandpa and Grandma R. -Living Room
Antique Tiffany lamp -Living Room
Antique curved armchair -Living Room
Antique oak chair with green nylon seat -Living Room
Corner cupboazd with Catherine Powell's hand painted china (part of set stored in hall
closet) -Living Room
Antique oak table -Living Room
Antique cane bottom chair -Living Room
Seth Thomas wall clock -Hall
Handcrafted Indian wall hanging -Hall
Double gooseneck floor lamp -Storage Room
Antique folding chair -Storage Room
Brown wooden file cabinet -Storage Room
Handcrafted cedar chest with quilts, woolen blankets, etc. -Bedroom
Movies and slides of family events, our trips and activities -Cage
1992 Plymouth Voyager -Parking Lot
MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 128 EAST KING STREET - SHIPPENSBURG, PA 17257.1397
To Daniel J. and Priscilla T. Robinson:
Panasonic stereo power pack with 2 speakers -Living Room
Chair with flowered needlepoint seat -Living Room
Red naugahide chair -Study
Walnut desk and chair, lamp, clock and Grace Church weather station -Study
Health-o meter scales -Bathroom
To Kendra L. McBride:
4 Ceramic tiles of Shippensburg at sink -Kitchen
7 Leaftiles -Kitchen
SOa' Wedding Anniversary plaque embroidered by Jeannie -Living Room
Old calling cazds mounted in frame -Hall
To Laura Belle Prescott:
Grandpa and Grandma Funkhouser framed wedding certificate -Living Room
Antique P.R.R. brass paperweight -Study
To Joan Alice McTaesart:
None -item already received
To Lois Vir¢inia Borland:
Antique Chinese tapestry of owl -Hall
~~ ~
MARK, WEIGLE AND PERKINS - ATTORNEYS AT LAW - 126 EAST KING STREET - SNIPPENSBURG, PA 1 725 7-1 397
FEB 28, 2011 11:26 Va21ey Rural Electric CC-ESTRET PAGE 1
STATE PRERETIREMENT
CUSTOMER NBR = 20040
NAME AND ADDRESS
ALBERT C ROBINSON'
$WEIGLE & ASSOCIATES, P.C.
126 EAST KING ST
SHIPPENSBURG PA 17257
ACCOUNT TYP YEAR UNRETIRED REFUND ~ PAID COOP
02 1980 16.64 100.00 16.64
02 1981 14.77 100.00 14.77
02 1982 14.05 100.00 14.05
02 1983 7.82 100.00 7.82
O1, 1984 22.25 100.00$ 22.25
02 .1984 18.30 100.00 18.30
O1 1985 45.61 94.34 43.03 2.58
02 1985 27.86 94.34 26.28 1.58
O1 .
1986 72.85 89.00'k 64.84 8.01
02 1986 30.2'7 89.00$ 26.94 3.33
O1 1987 63.2 2 83.96 53.08 10.14
02 1987 26.90 83.96 22.59 4.31
O1 1988 58.96 79.21$ 46.70 12.26
02 1988 13.64 79.21 10.80 2.84
O1 1989 39.43 74.73 29.47 9.96
02 1989 15.56 74.73$ 11.63 3.93
O1 1990 53.31 70.50 37.58 15.73
O1 1991 73.77 66.51 49.06 24.71
O1 1992 61.71 62.74$ 38.72 22.99
O1 1993 112.00 59.19 66.29 45.71
O1 1994 98.81 55.84 55.18 43.63
O1 1995 136.52 52.68 71.92 64.60
O1 1996 66.21 49.70 32.91 33.30
O1 1997 77.04 46.88 36.12 40.92
O1 1998 44.74 44.23 19.79 24.95
TOTALS FOR ACCT: 1,212.24 ~ 836.76 375.48
GRAND TOTALS: 1,212.24 836.76 375.48
UNRETIRED: { ,".,, .~. 1, 212.24
DISCOUNT: (-)`f 375.48
PREV RETIRE NO CHECK '0.00
INACTIVE AR: (:- ) 0.00
UNCOLLECTABLE: (-) 0.00
CHECK AMOUNT:. 836.76
Approval Signature: ----------------------------------
Paula Klester
Office Services Representative
Ca ital Credits Clerk
Valley Rural Electric
Cooperative, Inc
Ywr 7aahswm EncyydD ~ ~ .
Photo: 8141843.2850 Ext 137
10700 Fsirgrounda Road 800M34.0880
PO Box 477 Fax: 8141843.1878
Nuntlngdon, PA 16852A477 Email: paulaldasbr~va8ayreo.com