HomeMy WebLinkAbout12-08-78
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RCC-33 (4-73)
- COMMONWEAL TH OF P
DEPARTMENT OF
BUREAU OF COUNTY
RESIDENT DECEDENT
IMPORTANT, This return must be completed in detail and filed in d
County where decedent resided; Return is due within
by the Secretary of Re'\tenue. (Section 703 of the lohe
- IN THE MATTER OF THE ESTATE OF J:
HARRY B. HIPPENSTEEL
(STArE FULL NAME OF DECEDENT)
Late of -- Cumberland County
State of Pennsvlvania } ..,
County of Cumberland
NANCY KAUTZ
~ of the estate of the above-named decedent being duly
Decedent died April 10, 19~ 'a
(MONTH) (DAYI (YEAR)
Nama and add,... of ollo..,y a. } John E. S like
other authorized repres-entotive to whom
011 correspondence should be moiled. ::>lOq M~rkpt': S
That as such executor deponent is familiar
(EXECU TO R~-ADMINI ST RA TO R)
the assets thereof and their fair market value.
That at the time of death there was no safe deposit box r
as agent or deputy of another, or in decedent's individual name,
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A S.~FE DEPOSIT BOX
None
.
, .
That the contents of said safe deposit box or boxes
with the exception' of the following, for the reasons hereinaf
That Schedule A attached hereto and made part here
in the Commonwealth of Pennsylvania of which decedent di
mortga.ge encumbrances upon each parcel of real property
death, name of mortgagee, date, rate of interest, and book
columns provided therefore the assessed valuation of each
as of date of death of decedent.
That Schedule B attached hereto and made part here
wheresover situated owned by the decedent at the time of
death. whether in decedent's immediate possession, standi
banks, trust companies, or other institutions, whether indi
giving also separately the accrued interest thereon, if an
death in the case of savings banks, and to the date of d
savings, treasury certificates or notes and other evidenc
cedent; all obligations, wh~ther by statute or agreement th
or any state, or political subdivision thereof, or of any fo
all wearing apparel, jewelry, silverware. pictures I books,
automobiles, boats, and any and all other personal chatt
together with the fairly"estimated market value thereof; a
claims due and owing decedent at the time or death, and
for the payment of money of which decedent died posses
any, giving the face value and estimated fair market value
less than the face value, it sets forlh briefly the reason
payable to the estate from life insurance policies carried
the proceeds of which were payable upon the death of the
dne thereon and unpaid as of the date of death, bonds an
death and other investment securities OWried by the decede
of at such time.
ENNSYL VANIA
REVENUE
COLLECTIONS
DEe 08 1918
COUNTY OF
CUMBERLAND
uplicate, with all attached, with the Register of Wills of the
nine months after date of death, unless an extension is granted
ritance and Estate Tax Act of 1961,)
FFlDA VIT OF
XECUTOR
~i\!R'x~x
"
Executor
sworn, depose S
(lnd S(lY S
J testote leaving (I lost will, copy of ~hich is hereto attached.:}
lJmX'l'itK .
Esq., Arnold, Slike & Bayley
rrf'f't .- Camp Hill. Pa_
with the affairs of said estate and the property constituting
egistered in decedent's individual name, or jointly_ with, or
with right of access by another as agent or deputy, with the
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
are itemized under Schedules
ter set forth:
of this return,
of sets forth fully and in detail all the real property
ed having an interest therein. It also' sets forth the
at the date of death, giving the amount still due at
and page of record thereof. It also sets forth in the
of said parcels, the estimated market value thereof
of sets forth fully and in detail all personal property
death; all moneys left by the decedent at the time of
ng to decedent's credit in banks of deposit, savings
vidually, or in trust for any other person or persons
y, down to the last interest day prirrrr..to.decede_nt's
ecedent's death in all other cases;..~'il.6bnds','1)Q~'ial
. ~ < . - ......
e of indebtedness of the United' State.s to--the "'d.e-\
. ~ - . -...
ey are designated as tax free, .:bf.:.:the~tiI'1ited Sf'te;~; ....
reign country, which are owned~ ~''i-i}i~ timtYof de'arh;... .
~ \......-.- ;' --
works of art, household furnitu-i.e, -horses, carriages,-
els of whatsoever, kind or natu1~'Pj;~t~f?Y. dec~)j~~t.:',
II bonds and mortgages held by'dec..ed-enl--:aild'of all .
all promissory notes or other-instfu;i6t~1J wrl'ting
sed, of whatsoever nature. With inte;~~t'the-.re~n, if
thereof, and if such' estimated fair,market value be-
s for such depreciation as to each item; all moneys
by decedent; all annuity and endowment contracts
decedent; all and the corporate stocks and- dividends
d accrued interest thereon to the date of decedent's
nt at the time of death, with the.market value there~
. . ~ ....
.
In the case of sec:urities of close or family corporations, the values reported are as far as
possible substantiated by financial statements of the corporations, showing the assets and liabilities
tht>reof 11.5 of the date of death. The schedule also sets forth the interest of ctecedent at the time of
dPRth in tlny co-partnership or business, and in support of the value of such interest there is annexed to
said schf'rt1l1e, finflTIcial statements showing the assets and liabilities of said co-partnership or !'I.us-iness.
.\ copy q:' thp co-partnership agreement, (if oral, a statement setting forth the nature of the ti,greement)
t oge tlw r ...i th a s ta tement set ting forth the charac ter of the business, its loca tion, and such other facts
j'prLd'l.ITlJ!: to the business as may be pertinent to a fair nnd just appraisal of the decedent's interest
tllf'relll IllllSt he submitted. It should also set forth in itemized form, together with the fair market value
ther('nf'. :1l1Y other property owned or bequeathed by the decedent at the time of death.
Thp SC/1@du/@ C attached hereto and made part hereof sets forth a true answer to each inquiry
containf'd tlinrpin ami in the case of transfers of property, real or personal, within two years of decedent's
death, in con1.l?mplation of decedent's death, or intended to tlJ.ke effect in possession or en,joyment at or
af'ter death, said schedule sets forth the nature and value of such property, to whom transf'erred, the
relationship of the transferees to the tiecedent, the proport1onate share received by each transferee and
all other facts of a pertinent nature regarding sairl transfers. In the case of transf'ers intender! to
take effect in possession or enjoyment at or after death, there is also attacheri to the schedule a copy
of the rteed, trust agreement or other instrument creating the trust. Ther~ is also set forth in said
schedulp it list of all property, real and personal, with its value, which pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly w1 th another, or any power of appoint-
ment vestf"d in decedent, either individually or jointly, by the will, deed, or other instrument of another,
wi th a {'opy of the instrument creating such power attached to the schedule.
That Sc~edu/e 0 attached hereto and made part hereof sets forth the names and addresses of all
persons benef'lcially interested in this estate at the time of decedent's neath, the nature of their res-
pectiv,~ interests, their relationship, if any, to the rlecedent, top;ether with the ages at the time of
rll?cedent' s death of' all minors, annuitants anrl beneficiaries for lit'e Hnrter oecedent's Will. It also
contains a statement showing which of the beneficiaries nameo in the oeceoent's will, if any, died prior
to decedent, the dates of their death, their issue, and the relationship of such issue to the beneficiary.
That S~/1edu/e E attached hereto and made a part hereof s~ts forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intanp;ible, standing in the name
of the dl?cedent and others, plus the date and place of record of instrtments effecting the ~estiture of
real estate anrl the date of acquisition of personalty, plus the name, address and relationShip, if noy,
of co-owners to the decedent.
That Sc~edule F attached hereto and made a part hereof sets forth fully and in detail all liebts
and deductions claimed for and on behal f of this decedent's estate, including fUnerfll expenses paid;
family exemption, where applicable; costs of arlministration of this estate: counsel fees anrt f'ucHcio.ry's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decerlent; debts and claims owing and nnpairl at time of
death: taxes accrued chargeable for periorl prior to decerlent's rleath (except those allowed under Section
65101' the Inheritance and Estate Tax Act); tORether with fi statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof' of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or rlebt is less than the
estimatpd amount claiming and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassessed in accorrl.ance therewi tho
That the totals of the appropriate columns in Schedules "A", "Bff, "C", "E", anrt "F" as directed therein,
have been carried forward and properly registered in the Summary.
Subseri;? and sworn to before me this ...............................
c;16 d! o~e.c;~er
........ I If'
lhelma s. .j,Ca..sfin, Notary ~ubIi'
Mv (oMniiniOl't-bpires- July I. t 80
~ Hill, PA... ...._~... (umboNnd (Ollnty
NOTE: Bef'ol~_signing: affidavit make sure all blank spaces in the aff'idavit and scherlllles annexed are
filled in with details or the word "None", ami in case the assets inclwte rare awl unlisted securities,
secur j ties 0 f close or famil y corpora t1 ons or an in teres tin an~' co-pnrtnersh ip or business, tha t the
data Finn stEltements requirer! under the JHlraRraph above relating to Scherlule "B" are flttacherl. Also make
certr1in that column #1 in the "Summarytl has neen properly completer! as Ilhove-'Jirecterl.
.... 19..??
...:;a(~&;*j
.. .....!lJ::3...J?E!.IlIl$t:r~E!j;..........
(Street Number)
S t:E!el,t:OllL .1"A
(City or Town and State)
',.#Co:
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RCC_34 (4-73.1
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
. TRANSFER INHERITANCE TAX
. RESIDENT DECEDEN'1'
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Property held by the decedent as tenant in cammon with another or ather, should be identified
as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held as joint tenants with right of surviorship or tenoncy by entireties should be reported on Schedule "E. "J
The real property loeated In the Commonwea\th of Pennsylvania should be
described by lot and block number, street and street number, together with
a general description of the property, with a reference to the record of the
conveyance by which the decedent took tUle; If a form state number of a~
eru; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, accrued Interest on mortgages, etc., are
to bB listed on Schedule flFu and must not he d.educ:ted from this schedule.
(1)
(2)
131
DEPARTMENT
VALUA TION
CAUTION
(Do not write
In thl. .pace)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEA TH
ESTIMATED
MARKET VALUE
Property situated at 621 Park Avenue,
New Cumberland, Pa., conveyed to deceden
by deed dated October 7, 1977, recorded
in Deed Book "L", Vol. 27, Page 583,
from Betty J. Nogle, Widow;
actual proceeds from sale as per
attached settlement sheet
42,931. 26
1.\.1 '\3LclIP
I
I
Insert this total apposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
4.2qal.al..
t
" ,
Rec -35
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
a+.1\'
'~
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time of his death. P~operty owned by the decedent jointly with another or others
must be listed under Schedule nEn. "Intangible personal property, titled in the name of the decedent, but
payable at death to another or others, including but not limited to P.D.D. U. S. Savings Bonds and tenta-
tive trust accOlUlts, must be listed, despite the fact that they are not o:f the administered estate.
Tangible personal property should be listed :first (e.g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings., automobiles, boats, etc..)
Intangible personal property, such as bonds, treasury certif'icates, cash on hand and in bank,
stockS, mortgages, notes, together with accrued interest or nividends, salaries or wages, insurance pay-
able to the estate or fiduciary in sRid capacity, partnership interests, interest in any undistributed
estate of or income from any property held in trust under the will or agreement of another, even though
located outside of the State, at the time of death, should be listed in this schedule.
Item
No.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKET V AWE
DEPARTMENT VALUATION
(Do not write in
this space)
1. Commonwealth National Bank:
(al
(bl
checking acct.
savings acct.
281-106947-1
28-0010580-7
00.00
2,078.20
O. DO
'~01~.:lO
I
2.
National Central Bank savings account
NO. 6464611526
258.95
~S~. qS'
Insert this total opposite npersonal Property", SchechIle "B" In
the nAs Reported" colunm on the last page of this return.
x X 12,337.15
'~, o~l.l:i
"," ...
RCC-3b
COMMO:i\\'EALTH OF PENNSYLVANIA
TRANSFER 1NI1I':]1.[1'A:iCE TAX.
SCHEDULE lIelt
THANSPIUtS
r\ESIlJENT DECEDENT
(1) Dirt decedent, wj thin two years of death, make any transfer of any material part ,Qr his estate, without
receiving 1l valuable ar.d adequa.te consirieration therefor? (Answer ~:es 01" no) NO
(2) Did decedent, wi thin two years of death, transfer property from himself to himself and another or
others (includ.ing a spouse) in joint ownership? (Answer yes or no) NO
(3) If' the answer to (1) or (2) above is in the af'firmative state:
(a) Age of decedent at time of transfer
(b) State of decedent's heal th at time of making the transfer. (Note 1).
(c) Cause of' decedent's death. (Note 1).
(4) Did decedent, in his lif'etime, make any transfer of property without recei,ving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no) No
(a) Was there any possibility that the property transferred might return t.o transferer or his
estate or be subject to his power of disposition? (Answer yes or no)
(b) What was the transferee's age at time of' decedent's death?
(5) Did decedent in his lifetime make any transf'er without receiving a valuable arid adequate consideration
theref'or nnder which transferor expressly or impliedly reserves for his life or any period whlch does
not in fact end before his death:
(a) The possessi.on or enjoyment of or the right to income from the property transf'erred?
(Answer yes or no) Nn
(b) The right to designate the persons who shall possess cr enjoy the property transferred or
income therefrom? (Answer yes or no) No
(5) If the answer to (5) (b) above is in the aff'irmative, state whether the right was reserved in decedent
alone fJr others
(7) Did decedent in his lif'etime make a transf'er, the constderation f'or which was transferee's promise to
pay income to or for the benefit of care of' transferor? (Answer yes or no)
(8) Did decedent, at any time, transf'er property, the benef'icial enjoyment of which was subject to change,
because of a reserveri power to alter, amend, or revoke, or which cOHld revert t.o decedent under terms
of' transfer or by operation of law? (Answer yes or no) No
(9) If the answer to (8) above is in the af'firmative, was the power to alter, amend, or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)
NOTE 1: The anSwers to these questions should be supported by affidavit by the attendi.ng physician as
well as a copy of the death certificate.
NOTE 2: If anSwer to any of the above questions is yes, set forth below a description of the property
transferred, it's fair market value at date of death, dates of transf'ers and to '."hom tr::msf'erred, with
relationship of transferees to decedent, if' an~'. Submit copy of any trust deed or instrument, if trans-
f'ers are claimed to be non-taxable, also submit detailed statement of' facts on wh.ich said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, ll, or E.
ITEM
DESCRIPTION
MARKET V AJ.IUE
(Es tima ted)
DEPT. VALUAT.10N
(Dept. Only)
t....\ cnQ...
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" colunm on the last page of this return.
t\1 1) f"\Q.
l_
RCC-37 : (12-63)
COMMO:>l\\"EALTII OF rn,XSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
'.
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED
(If step-children or DATE INTEREST OF
State full names and addresses of all who illegitimate chIch"en DECEDENT OF BENEFICIARY
ave an interest, vested, contingent or other are involved, set STATE YES IN ESTATE
wise, in estate) forth this fact) OR NO BIRTH
S. Daniel Cavallaro NO 100%
621 Park Avenue
New Cumberland, Pa..
,
~
\
h
Deponent further says that all the above-named benef'iciaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
-
S. Daniel Cavallaro 4/12/78
. o.
...
o ~
E<ll:
V): ~
.c ~ E
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8--0
'C Co u
<: 8.
~5=c
o u
"St::t:
u 0 0
~ E go
f':! 0::
SUMMARY
o (Sch. "A")
(Sch. "B")
(Sch. "C"')
Real Property
Personal Property
T ransiers
Gross Taxable Estate
(1 )
(As Reporl<'tl)
$
$
$
$
$
$
(2)
(As Dl''''rmiJu.l)
$
$
$
$
$
$
t-o 'C
Z
... W ~
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'" "" u
>< w i: 0(
Q ell
(J) -
- 0(
00( " =c:
c:: ~ .2
~ llo
0 " llo
~ ~
'" ..-: '" 0(
:: :: w ;..
.. W .. I- ~ Q
~ - .. ..-: S ;Z
c != 0 I- "
;,..: (J) ~ ~
~ W ~ I-
~ 0
0 =c:
" c:: - 0
0 llo
., W '" .
" !: ~ ~ =c:
.c 0 "
'2 00( ~ ~. 0
0 E
;:::] ~. ~ :: ~
0
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RCC.3B
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
INSTRUCTIONS: This schenule must disclose all property, real and personal, owned by the decedent jointly
wit.h another or others, including intangibles, standing 1n the name of" the decedent and others. List
real estate first, as entireties, or joint tenan-ts, giving brief' description, as indicated under Schedule
"A", plus the date and place of record of instrument effecting vesti ture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", 1) Ius date of acquisition, and the name, address and relationship (if' any) of co-owners to
I
the rlecedent.
(')S( <X 0< XX
'>6<:)6 <<
~~~<<~~~~
DEPARTMENT VALUATION
CAUTION-Do not Write
. In This Space.
Value of Value of
Entire Decedent' 5
Property Interest
Description of Property, Date of Acquisl-tiQn, Name
Address and Relationship of Co-Owners, And Place
of" Reco~rl of Instrument, where Real Estate.
!Y', <X 0( X >0< ~ ~2X 6& X
!Y', <X<X%;::x;~>(x)<<
c>< (9: >0 ~~
Unit percentage Estate
Value Share Valuation
Series "E" Bonds as per attached
list in joint names of decedent
and S. Daniel Cavallaro
50%
'i?3 ~.L\3
(867 qR" l.l~ 1 (". ~G,
'l3 <l. '1.3
Proceeds of public sale of househol~
goods owned jointly with S. Daniel
Cavallaro
50%
L,352.83
\ 3.5~. \,.3
)
..---_.-....
L ,220.l~]) .
...
Insert this total opposite "Jointly Ownerl Property", Schedule "En
in the" As Reported" column on the lust page of this return.
~. l'il.~lo
~~......
~
~
/"
REV-SIB (B-7B)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O. BOX 2970
HARRISBURG
1711i5
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
NOTICE OF FILING OF APPRAISEMENT
Nancy Kautz
913 Fenn Street
Steel ton. FA 17113
(Executor or Administrator)
In Re: Estate of
Harry B. Hippensteel
Cumberland
County - Fi Ie No.
21-78-0210
Deor Ms. Kautz:
You ore hereby notified thot the original
opproisement in the estote of Harry B. Hippensteel
hos been filed in the office of the Re~ister of Wi lis of Cumberland
County on December 28 , 19~, Said appraisement reflects the following
valuations:
Real Estate
Personal Property
Transfers
Jointly Owned
Total
42,931.26
12,337.15
None
2.191.26
$57.459.67
As to such tax that is paid within three months from date of death, a five (5%)
percent discount is allowable. As to any tax that remains unpaid alter nine (9) months
(filteen months when death occurred from December 22,1965 to June 16, 1971,inclusive;
and twelve months when death occurred prior to December 22, 1965) from date of death,
interest at the rate of six (6%) percent per annum is charged.
.
,
"
,I,
Any party in interest who is aggrieved by this notice may object thereto within
sixty days alter receipt of said notice as provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961, 72 P. S. 2485-1001, P. L. 37~
Date December 28, 1978 Signed ~ a. ~ J{ A.1e~
, ,.
, ,
Title Chief Appraiser
Note: This is nota bi II.
_u -
.
RC C-2 (2-64) . ,'.
. COMMONWEALTH OF PENNSYLVANIA DATE December 28, 1978
DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX COUNTY Cumberland
BUREAU OF COUNTY COLLECTIONS
HARRISBURG. PENNA. 17127 APPRAISEMENT FILE NO. 21-78-0210
Whereas, Harry B. Hippensteel late of Borough of New Cumberland
in the County of Cumberland Commonwealth of Pennsylvania, having died on
the 10th day of April 19~, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Ira K. Gleiljl . an appraiser duly.appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix
the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
In the event that any future Interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
Inheritance taxes at the lawful collateral rate on any such future interest.
J Unit Appraisement
Description of And Made for Inheritance
Values Tax 'Purpoles
Real Property , $ 42,931 26
Personal Property 12,337 15
Joint-Held Property 2,191 26
, ..
Transfers None
I ,
! . , .
,
TOTAL ASSETS 57,459 67
.,. . -
.
,
.
...
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.
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.
.-
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.
.
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Having been duly sworn according to law, I do hereby certify that the above appraisement is made in con.
formity with law on this 28t day of ~ ~eC'lmber 19~.
c::-. d_ K. U!a-..-.~
Appraiser
(lfumbc!r and str~ b
rris urg Penna.
CPoat OftIee) ,
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