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HomeMy WebLinkAbout06-12-121505610143 REV-1500 Ex(°'-'°' OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTMENT OF REVENUE PO 80X280601 INHERITANCE TAX RETURN r;' ~'n Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 12 GT-~LY "~~ ENTER DECEDENT INFORMATION BELOW U Social Security Number Date of Death Date of Birth 11 05 2011 02 02 1917 Decedent's Last Name Suffix Decedent's First Name MI HUEY LYDA 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 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 Re uired (date of death after 12-12-82) ^ q 8 Decedent Died Testate (Attach Copy of Will) ^ Y Decedent Maintained a Living Trust 0 8. Total Number of Safe De OSit Boxes (Attach Copy of Trust) - p ^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of deatn 11. Election to tax under Sec. 9113 A between 12-31-J1 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 JOHN S DAVIDSON 717 533 5101 REGISTER OF WILLS USE ONLY First line of address 320 WEST CHOCOLATE AVE Second line of address PO BOX 437 City or Post Office HERSHEY State ZIP Code PA 17033 Correspondent's a-mail address: jdavldSOn@yoStdavidSOn.COm n ° ~ O ~ ~ ^' c._ -~ r._ ~= ~; ~ . ~~~ , E ., ~, .--. N GC';;-. DATE~IIIED' ` .~ ~' r•.~ c~~ ~'~ -*~ ~~ ~j ., s;; r.,.~ f...ri ...r- T"' ~ 1 t`rt ~~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ^~` >^ , ~ ;~ y' " ~r~- ~ ~ -{ ~ Mary Ann Carpenter ADDRESS 175 Hollywood Drive, Middletown PA 17057 SIGNATURE OF PREP RER OTHER THAN REPRESENTATIVE DATE ,;~~~;~£~!l~t~>--- John S. Davidson .y~L~,.-4i ~~i 320 West Chocolate Ave., Hershey, PA 17033 Side 1 1505610143 1505610143 J ~~' 1505610243 REV-1500 EX Decedent's Social Security Number °e°ede"es Name Huey, Lyda Mae RE CAPITULATION -_- "- 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 & Notes Receivable (Schedule D) ...................................................... .. 4. 5~ Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............. .. 5. 2 , 166.07 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested........... . 6. 1 , 74 6.80 7. Inter-Vivos Transfers & Miscellaneous ion,-Probate Property (Schedule G) a Separate Billing Requested........... . 7. 8. Total Gross Assets (total Lines 1-7) ................................................................... .. 8. 3 , 912.87 9. Funeral Expenses i~ Administrative Costs (Schedule H) ...................................... . 9. -- ------- - 1 , 401.75 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............................. . 10. 8 6.13 11. Total Deductions (total Lines 9 & 10) .................................................................. . 11. 1 , 4 8 7 . 8 8 12. Net Value of Estate (Line 8 minus Line 11) ......................................................... . 12. 2 , 424.99 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. 2 , 424.99 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 15. 0.00 16. Amount of Line 14 taxable at lineal rate x .045 2 , 424.99 16. 10 9.12 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X 15 0. 0 0 18. 0. 0 0 19. Tax Due ................................................................................................................ . 19. 10 9.12 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address File Number 21-12 DECEDENT'S NAME Huey, Lyda Mae STREET ADDRESS - -------- Church of God Home 801 North Hanover Street CITY Carlisle STATE ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 0.00 3. Interest (1) 109.12 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 request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. Total Credits (A + g) (2) 0.00 (3) (4) (5> 109.12 Make Check Payable to: REGISTER OF WILLS, AGENT. Wit= '*.'r'±_ ~ ~ ~?Sasl, r ~ F.#, ~~ 3~ eki 11 . ~~ _ .. >....~ 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 :............................................................................... j_~ 0 b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................................................................................................. C~ 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 r~ receiving adequate consideration? ....................................................._..........................................................._ ~~ IJ 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? .................................................................................................................. ^ 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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving 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 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 21 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 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 blood or adoption. Rev-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF H da Mae Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. FILE NUMBER 21-12 o~ ~~~~~c space s neeoea, aaD¢lonal pages or the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+ (6-98) SCHEDULE F COMMONWEALTHOF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Huey, Lyda Mae 21-12 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Mary Ann Carpenter B. C. 175 Hollywood Drive Daughter Middletown, PA 17057 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSE % OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1 A 1992 Citizens Bank -checking account 3,488.59 50.000% 1,744.30 2 A 1992 PSECU -credit union account 5.00 50.000% 2.50 TOTAL (Also enter on Line 6, Recapitulation) (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. 1,746.80 Form PA-1500 Schedule F (Rev. 6-98) REV-1151 EX+(10-06) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Huey, Lyda Mae 21-12 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 866.80 Street Address City State Zio Year(sl Commission paid 2. Attorney's Fees Yost 8c Davidson 300.00 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 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 234.95 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 1,401.75 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-Oti) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Huey, Lyda Mae 21 12 ITEM NUMBER DESCRIPTION AMOUNT Funeral ExnenseS 1 Edward Carpenter -reimburse expenses of restoration of grave site after burial 100.00 2 Gingrich Memorials -cemetery marker 135.00 3 Michele Hughes Lutz -flowers for funeral service 31.80 4 Pastor Billy G. Holmes 100.00 5 Pastor Bradley Moore 100.00 6 Pastor Samuel R. M. Cuningham 100.00 7 Patty Keller -funeral luncheon 200.00 8 Ruth Sweigart -organist for memorial service 100.00 H-A 866.80 Other Administrative Costs 9 Edward Carpenter - 2011 income tax preparation fee and electronic filing fee 219.95 10 Register of Wills -filing fee 15.00 H-B7 234.95 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+~72-08) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Hue , L da Mae 21-12 Report debts incurred by the decedent prior to death that remained unpaid at the date of death. inrludinn nn~ein,n~~~~o.~ moa~~~i o.,..e.,~e~ to mole space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+ (11-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Hue , L da Mae NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I~ TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 Mary Ann Carpenter 175 Hollywood Drive Middletown, PA 17057 FILE NUMBER 21-12 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT (Words) ($$$) o N t List Tru tee s Daughter I entire estate I 2,424.99 ~ ~ Total ~ 2,424.99 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08) LOCAL REGISTRAR'S CERTIFICATION OF DEATt~I WARNING: It is illegal to duplicate this copy by photostat or photograph(. Fee for this certificate, w6-l)(i il,'"~~~ OFp~f~ ~ _I hip i; tt, crtn tl al tht Irrfornul[iun huc t,*i~'en is tytdtl. ~A~6~~ ~zl~i ~~ ~ 111f'C'IIV' ~t1{lIL'LI Ilr I11 ;II1 t)I lr~l [l a~ ~~l'l UI1~aIe lll'[~l'~l)~] I~,~~`~~ ~ ~°~~;, ~i 11v File ! ~~ Ilh rite -t~ 1 tx~al Rclalsu~ar. The ori~~itZal ~`~' ~, z~ c ftlt~it.al~ ~~f!I '~c !~,rev.u~cied to :he State Vital 1;~~ v~~i ~a:, Rrccrrd~ t>*'sLS: t ( .,.,):)anent I~illm~. N~V 0 ~, - -- - --- --_, MfNT 9F err _ _._ _- _ - _ - ----- -1--~--- Certifjcution Number ,,,,=,ryt~~ l tfc;tl Rr~tf,tlar I>atc ]sued !3 REV t1f2006 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS I PRIM IN .ACKN NKT CERTIFICATE OF DEATH (See Instructions and excamoles nn raverswl 1. Name of Decedent (First, middle, last, sullix) 2. Sex + 3. Sodel Securtry Number rv i - d. Oats of Death (MOmh, day, year) 6. Age (Last amdey) Untler 1 ar der 1 de fi. Date of BiM Momh, de , r 7. Bi lace C' aM state or lor e' cou Se. place d Deam Check on one k1r•ima Days Houn Minutes Hospital: Omer: Yrs. ~ - a ^ Inpatient ^ ER / Outpatient ^ DOA N ursing Home ^ Resitlence ^ Other ~ Speciry~. r~ - Bb. County of Death f1c. CAy, Boro, 7wp. of Death Fadl' time (II not nstlNtlon, g street number) 9. Was Decedent d Hlspenk Origin? ICIiNO ^ Yes 10. Race American Indian, Black, While, etc. _ (N Yes, sa~Y seen, (sperm ~ ./? Mexican, Puerto Rican, etc.) ti ' 11. Decedent s Usua10 Ibn Kintl of worN done tludn moll d workin INe. De rid state retiretl 12. Was Decedent ever In the 13. Deceeem's Eduatbn (S onry highest grade completed) 14. MarAal Status: Martietl, Never Marred, 75. Survhing Spouse (If wife, give maiden nemel Kind of Work Kind d Business! Industry U.S. Armed Forcas7 Elementary (Secondary (0-12) College (1d or Si) Widowed, DNOrced (SpeciryJ // e V e 'T'% ^Ves ~JO ~ /' 16. Decedents Mailing Address OStreet c Ny /town, state, zip code) Deceden's / ( Did Decedent / g 0 1 N o r7"7i !fa f1 o Ve r $} r2c~ Actual Residence , 7a. State _I_?Q1] L] S U / / I'l ~ T~^s a , 7c. ^ Vea, Decadent Lived in T l i ' wp I _ ~ 17h. Co ~[ / ir1 ~, 2 `!n H O\ p 17d. ~No, Decedent Lived within. Q ~ ' ~ ~ Acluel Limits of t n r i ~ Q City J Boro 16. Father's Name (First, middl ,last, suffix) 19. Mothers Name (Firs(, mkWe, maiden sumeme) / ~ / 20a. Inlortnam's Name (type I Print) 20b. Inlamant's frig Adtlress (Street, ary I town, state, zip coda( • r ~, ~ ~ '7 ' " 21 e. Memotl d D on ~ ^ Cremation ^ Donation 21 b. Date of DreposMan (MOmh, day, year) 21 c. Place d Dlapos' ~ me of certletery, crematory or dhe place) 21d. Loralion (City Irown, stale. zip code) Ip Buda( ^ Removal from State i Wee Cremation a Daxtlon Aumorhed ^ er ~ l by MMlcel EeeminxlCoronerT ^Ves^ Flo ~ ` r µ 1 , ' 1 .Signature of Funeral Samce Licensee (or person acNrg as such) 22b. License Number 22c. ame end Address d Fedliry k. ~ r4 ~ G ,~ f. n p ~~ r ! / /~1 ~ f TO I L. ~ ~ 7 0 Complete Name 23aa onry when cedlrying 23a. To the best of my ledge, death occurted at the tlme, date aM place stated. (SlgnaNre entl NNa) 23b. umber 23c D t Si d M . a e gne ( onth, day, year) phyekian is not aveileda at Nme d deem to P certA ceuaeddeam `J ~~' C , ` ` y . , I 12.ti15532~1 fl~11f,M.~,lt 071 0201( Items 2426 must be can tetl Wtp prppurx:es deem. ~ ~ ~~ 24. Time or Deam ~ykl O~ D O A ( y ) ~'~tre Pronounced d Monm, de , er l 1 A, 1/" • /lrJ1 26. Wes Case Referted to Medical Examirer I Coroner for a Reason Omer Than Cremation or Donation? , r-1 o O~:I 11 ~~ YY W , L ty mv lr ~ ^ v9a ~I No CAUSE OF OEATN (Sea I atructlo n s a nd a z e D lee) l Appmximete interveh Item 27. Pad I: Enter me rdlein of events -diseases, Inrydes, or complications -met tiredly ralxed th deem. W NOT enter romlirel events such es caNiec arrest ~ O t D Ped IC Edar omer Hgni&ant mnditians hiblm.,w• tc death 28. Did 7obacce Use ConMbute to Death? , nse ro eelh res{dratory artest or ventrkular Abdlladon wNhout showing the eNdogy. List onry a cause on etch Ilna. ; L IMMEDIATE CAUSE IFnel dusaase or /Z bd trot tee Wmg In me undedying cause groan in Pen I. ^pya~~t ^ p~yyly LJ^I No ^ Unknown ~ rondition resuPong in deem) ~, s. ( r ~ f 29. If Female. D t ~ ~ N ue o (or as a uence oQ: fialN list conditions, tl arty, b. ~I~~~ ro the cause Asletl on lire a. ot pregnant wNhin past year ^ Pregnant el lime of Beam Emer a UNDERLYSiG CAUBE Due m (or as a ronsequerwe op: ^ Nc1 pregnant but pregnant wimin 42 tlays (disease or injury mat idNatetl me c. events resulting in deem) FAST. e~ deem Due to for as a cortseguerwe o(1. ^ Not ore nant hm g preonant 43 tlays l0 1 year d ~ belare deem ^ Unknovm N pregnant wahm me past year 30e. Was an Autopsy 30b. Ware Autopsy Endings 37 Manrrer d Deem 32e. Date d In)ury (Month, tlay, year) 32b. Desedbe How Injury Occurred Pedom~etl7 Available Prior ro Completion ~~55 32c. Place of Injury: Home, Fann, Street Factory d Cause of Daem7 r~l Natural ^ Homaida . ONice Builtling, etc. (Sperry) ^ Ves ~No ^Ves ^ No ^ Acdtlem ^ Pending Irrvestlgetion 32d. Time of Iryury 32e. In)ury et Wodr? 321 N Trensponetion Iryury (Ste~H1 32g. Location of inluy (Street c Ay ~ tcmm, state) ^ Suklde ^ Could Not he Detemaned ^Ves ^ No ^ Driver/Operator ^ Paseerger ^ Pedestden M ^ Olher~ Spaciy: 33a. Cermar (dreck ody one) • CMUylnq physkhn (Phyeiden certirykg cause d deem when another physlden has pronounced deem and carpeted Item 23 T h b ~ ~~ T Certlfie~ ~,'` o t e ptMmylmowNege, seem acurretl euam me ausa(s)end manner tie etetae_______________ --------'--------~ • P '/ ronouneing entl anllying phyekien (Physldan both pmnoundng deem and cediylrg ro reuse d deem) T h 33c. Ucense NMMer 33d. Date Signetl (Month tlay Year) o t e beat of my larosrktlge, deem oaurted M the [Ime, dale. tine pMce, entl due to the ceuae(e) and msnror tie ahtee_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ ~ (~ ~ r , , ,- I Neelal ExeminerlCOroner • 7 g ~ 01.~- 1 I ~ I I ~ On the laeeb of exeminetbn entl / or InvesllgaUOn, In my oplnbn, tleam oxurred m the Ume, eels, tine plea, tine sue to the gees(e) entl manner es stsMe ^ 34 Na m d Atltl d P _ . e en reas erson WM Completetl Cause of Deam (Item 27) Type I Prirt 35. Registrars SigneNre entl Disbld NuMar Io2 I ~I al ~ I ~ I ~ :. 36. Date Mon day, year) ~~ ` ` 1"h\C.~3e.~~1Y~\C~s iM~ , - // l/ '_ ~D3 ~ . ~Sa1~-cv,.~~ (i~~ M'1 l~l 5 r , l~0 Dispositlon PermN No. ~ ~n .r ~~ ~ ,~ ti` ~-~ , j 4i'' `~ !~!} ''~ C„ ~ ~... ~~ %1 ~~ ~' •. ~- ~ `" ~ '~ ~ ~: s IY1 ' e.w fiN ~~ .~~ ~~ ~ 1 V. I .f .E '4M~ ~. 4J . ~t ~... :X:,• i ~~...yn~ ~~^~a ~~ N "~3i ~~ `_L_ ~ ~' ti' N ~~} 1~+ j c3 ~ ~~ N A: M W C M M o z v ~ W ~ CS` C a px.a A ~~> ~ ~ S ~- ~ ~ & ~3a - .~?~, ~ ~' # "1 ~ S' .,~ I bA C~ Y I vl ~ ~~~ ~ rl (f ~. ~V 1~/ w o o ,a 1=5~ i-~ .+ '~ V] ~ S-i . -n. .r ~ ~U C •-d ~i ~ ~ t.J a~f ~ O z G., F a Z