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Home My WebLink About01-1187 PETITION FOR PROBATE and GRANT OF LETTERS -:2 \ - D\ - \ \ g" No. To: Estate of Helen M. Reber also known as Register of Wills for the Deceased. County of Cumberland in the Social Security No. 201 - 0 5 - 9 2 9 7 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executrix in the last will of the above decedent, dated and codicil(s) dated named 19;; 2001 '.- t:.vl( l..... to tn- d r' d- () ~ i-Iln /L .2. ~ ~o, (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Gumberland County, Pennsylvania, with her last family or principal residence at Messiah Village, Upper Allen Township (list street, number and muncipality) years of age, died December 26 ,+9: 2001, Decendent, then 83 at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 100,000.00 $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. C/O ';:J u " <lJ ~3 <lJ .... c.::<lJ " -00 C"O roo;:: ~<lJ ~o... <lJ4-0 ",0 C;l " Of) Vi JI"J-eVl Mt/?"e;e ;f'~6e/E'1i-~ /~ ~~ ~ . 'fO':;~/14-U;;;t/ ~ . !AJ-e-.C; AJ 5 rvz ~ 6 el'5 !;;,-g' OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYL VANIA 1 ss COUNTY OF CUMBERLAND J 1')- 3D- \ \ The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer .the ~~cCOrding to law. Sworn to or affirmed and subscribed /~ ~ 4-~' it I ~ ~ , before me this ? 8TH day of ~. l::l .... ;;:: ~ ~ No. 21 - 01 - 1187 Estate of HELEN M REBER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW DECEMBER 31, 19 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated OCTOBER 10, 2001 described therein be admitted to probate and filed of record as the last will of HELEN M REBER TESTAMENTARY HELEN MARIE TATE and Letters are hereby granted to FEES ~()~~~ MARY CLEWIS \ (' """ \ e.dn Y\-i . \\Us5" $ 200.00 $ 1 5 . 00 $ $ 1 2.00 j.UU TOTAL _ $ ?i? Of) Filed ..... D.E:C~MB.E:R. 3.1... .20.0.1. . . . . . . . . Probate, Letters, Etc. ......... Short Certificatesp ) . . . . . . . . . . Renunciation ................ X-PAGES Jtp ( 1\\~ ADDRESS -1 q 5 - f It.1 D PHONE 0'1 N P, CL 00 N C".) c:::::l .,l:) .n ,,:: j:;: 3)= 00 r""I; ,"", D hj' (DO:: a:: - p MAILED LETTERS TO ATTORNEY ON 12-31-01 "h 21 - 01 - 1187 ~ .) 1.:" ''\.; . , J .,1' '0 Co:: o;CC: cc: cO c"'-' . . rt"\ 0- ~ c..J - o \; ~'~:'~ p ....) ,1;;, .,. ~ CD..,; f50 ) LAST WILL AND TESTAMENT OF HELEN M. REBER KNOW ALL MEN BY THESE PRESENTS, That I, HELEN M. REBER, of the Township of Upper Allen, County of Cumberland, and Commonwealth of Pennsylvania, do make, publish, and declare this instrument to be my Last Will and Testament, hereby revoking and making void any and all former Wills by me at any time heretofore made. FIRST: I direct the Executor hereof to pay all my just debts, funeral expenses and costs of administration as soon as conveniently may be done after my death. I further direct the Executor hereof to pay all inheritance, estate, transfer and succession taxes which may be levied or assessed upon any property which is included as part of my gross estate for the purpose of any such tax. SECOND: I give, devise and bequeath unto my husband, EARL W. REBER, rest, residue and remainder of my estate, realty and personalty, howsoever designated wheresoever situate provided that he is living on the thirtieth (30th) day after the date of my death. THIRD: If my said husband, EARL W. REBER, does not survive me or does not survive by the said period of thirty (30) days, then in that event, I give, devise and bequeath all the rest, residue and remainder of my estate as follows: 1. One-tenth (1/10) share to Bible Baptist Church in Shiremanstown; 2. One-tenth (1/10) share to Child Evangelism Fellowship, Inc. of Cumberland County. 1M> M, f<1 - 1 - .... l' 3. My grandson David W. Tate. 4. My granddaughter Cherie Tate-Sullivan 5. Remainder to my daughter, HELEN MARIE TATE, per stirpes. FOURTH: I appoint my husband, EARL W. REBER, to be Executor of this my Last Will and Testament. I do hereby give to the Executor hereof full power, discretion and authority at any time or times to sell, at private or public sale, mortgage, lease, pledge, exchange or otherwise deal with or dispose of the property comprising my estate as deemed best, to settle and compound any and all claims in favor of or against my estate as deemed best and, for any of the foregoing purposes, to make, execute and deliver any and all deeds, mortgages, contracts, leases, bills of sale or other instruments necessary or desirable therefor. FIFTH: I direct that no fiduciary appointed by this, my Last Will and Testament, shall be required to give bond and that if, notwithstanding this direction, any bond is required by any law, statute or rule of court, no surety shall be required thereon. LASTLY: In the event my husband, EARL W. REBER, fails or refuses for any reason to serve as Executor of this my Last Will and Testament, then in that event I appoint my Daughter, HELEN MARIE TATE, as Executrix of this my Last Will and Testament. IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of three (3) typewritten pages on the margin of which (except this page) I have affixed my initials this it) th day of October, A.D. 2001. ~V~ J~. K;2-X'~r HELEN M. REBER -2- Signed, sealed, published and declared by HELEN M. REBER, the above-named Testatrix, as and for her Last Will and Testament, in the presence of us and each of us, who at her request, and in her presence, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. y;)~ ~ ..f3eth Myers - 3 - " # County of Cumberland ss. Commonwealth of Pennsylvania ACKNOWLEDGMENT AND AFFIDAVIT We, HELEN M. REBER, the testatrix, and the undersigned witnesses to the Will, the attached or foregoing instrument, having been qualified according to law do depose and say: (a)that I, the testatrix, do hereby acknowledge that I signed the instrument as my Will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b)that we, the witnesses, were present and saw the testatrix sign the instrument as her last Will, that she signed it willingly and as her free and voluntary act for purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the Will as a witness and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed before me by HELEN M. REBER, testatrix, and Beth Myers and Amy Knauer, witnesses, this (0 th day of October, 2001. F~v..)l\' P-0~~ HElEN M. REBER &fz;(~ ./Beth Myers ..... ~{J~ By: David W.' Knauer -4- 21 - 01 - 1187 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that present and saw the testat , sign the same and that signed as a witness at the request of testat_ in h presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19_ (Name) (Address) Register (Name) (Address) REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS -Wdl,AfY') V ~ Ja. DAv',J W. t~TE (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that THEY ARE familiar with the signature of HELEN M REBER XO(j()io(b( testatJUL of (~~~Xr,~XflHIeX~Y,~**Xg:XwYt~~~S<Xt~ the will that THEY presented herewith and XC<>XIioU( believes the signature on the will is in the handwriting of HELEN M REBER to the best of THE I R knowledge and belief. Sworn to or affirmed and subscribed before ~/-r'~ me this 28TH day of . 7;;;;me) DE EMB~R g.. _001 ~~. ~t/ t-/f-Iw1. tV +// r/ J,IJ}Tr ou:u '" _ (Address) Register . \ J ~ (Name) {II"">I ,-::-". r tr_ ('{-j Wes+~XSl.S~I::t:L bO ISL./ (Address) "- ~ CERTU'1CATION 01' NOTICE UNDEH RULE 5.6(a) Namc of Decedent: We: lb\. w.., 'iZe1,es- Dale of De.llh: D€-L. U 1.00 l Eslatc No. 2.J-Dl-ilg7 To lhc ({egister: I certify that notice of estate administration required by Rule 5.6(n) of the O.'ph:&lIs' Court I\ules was serveu 011 or mailcu to the followillg bcneficiaries of the :&bove-c:'ptioned est:,te 011 J<l-"'-, IS 2-002- ) Name Atldrcss ---€,ble. "'Ex"p-hsi C-h1A.ch 2..0\ We sf' mc~~~ ~+'J Sh ; l-~ "",,~c:..:;k,U-A'- Ie l 7 D l \ ~\\.d E:-vC\."'f)d.~ ~ltowsh.\? 'bC'v;cI w, -~+e. ISO t:""~\,",e.~ -C>r-. C.:\...t:s.i~ t:>c.,. i '"7 () i"5 I (115t Sdc>'\. C;L I. \ _' , ~o;;,-tciAest'e~- -' IL. ~()(S;y \-lel e..t "",-fe 4040 C.1A-u-S<"-lI\ Ave_ West-e,VI <;. .,. iL 00S$8 Che.-<- "e.- \ A*e lb t::'S+"",fe Dc, ~-,.bo<:>~o'0i". / ME 0"10 '( Ll NOlice has 1I0W beell givcn lo all persolls cntitlcd thcrclo undcr Hull' 5.6(:1) e.\ccp l ~ ,"\ 0\ :':::r ( I:~:.~ :l: ~ f- L-- Signaturc ' !HO)1ff7J J, . Name (Priul) $S Z 1 C)^lteUs'{e Address JIl/C( ?l1lVJc!Jbvxt:,,1 /(rl If ?AJ -S I1Jj fA {;050 Dale: j"""", is. 2-6C.>z.. I Clpacily: I)ersomll Rcprcscn(:ttivc V CoulIscl for l'crsollC11 Rep,'csell t:ltivc r- ,...... Telephonc No. ( 71 -; ) C:;;17 - /80 D Z 0:::::: ..., ~ if .,.0 -.: j:: \J) = . , -' ~..)G' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMAS J AHRENS ESQUIRE 5521 CARLISLE PIKE MECHANICSBURG, PA 17050 n______ told ESTATE INFORMATION: SSN: 201-05-9297 FILE NUMBER: 2101-1187 DECEDENT NAME: REBER HELEN M DATE OF PAYMENT: 03/18/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 12/26/2001 NO. CD 001180 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $11,050.00 I I I I I I I I TOTAL AMOUNT PAID: $11,050.00 REMARKS: HELEN M TATE C/O THOMAS J AHRENS ESQUIRE CHECK# 101 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS /'7-30-/1 BUREAU or IN~~IDUAL TAXES INHERITANCt~ DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH ,FILE NUMBER Ii COUNTY ACN 05-27-2002 REBER 12-26-2001 21 01-1187 CUMBERLAND 101 "'\' u/ r", i, Ll\ THOMAS J AHRENS AHRENS LAW OFFICES 5521 CARLISLE PIKE MECHANICSBURG PA l, t" 17065: '* lEV-1547 EX UP (Dl-DZl HElEN M Allount Rellitted U) (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 47,981. 76 .00 212,485.02 (S) 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 ~ REV=i5'4-j-'Ex7..FP-COY=OZY-NOYic'E--OF-YNHEififANCi-YAX-A-PPRA-isEiiENT~--Ai:.rowAifci-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF REBER HElEN M FILE NO. 21 01-1187 ACN 101 DATE 05-27-2002 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( x) CHANGED SEE ATTACHED NOTICE APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) S. Total Assets (9) nO) 10,312.30 454.44 NOTE: To insure proper credit to your account, submit the upper portion of this forll with your tax paYllent. 260,466.78 (ll) (2) (3) (4) 10.766 74 249,700.04 10,601.18 239,098.89 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: IS. Allount of Line 14 at Spousal rate (IS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) lS. Allount of Line 14 taxable at Collateral/Class B rate (IS) 19. Principal Tax Due TAX CREDITS. .00 X 00 = .00 239,098.89 X 045 = 10,759.45 .00 X 12 = .00 .00 X 15 = .00 (9)= 10,759.45 . n.......... . l+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 09-26-2002*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 10,759.45 INTEREST AND PEN. .00 TOTAL DUE 10,759.45 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) (~ ~ RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoy.ent to Class B (collateral) beneficiaries 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 Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF MILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraise.ent, allowance, or disallowance of deductions, or assessment of tax (inCluding discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-150l) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZO% .000548 1992 9% .000247 1983 16% .000438 1993-1994 n .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 n .00019Z 1986 10% .000274 2000 8% .000Z19 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 200Z 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. "v/?- eo -// BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-I6D7 EX AFP '01-02) THOMAS J AHRENS AHRENS LAW OFFICES 5521 CARLISLE PIKE ~. MECHANICSBURG PA [7055 " 31 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-28-2002 REBER 12-26-2001 21 01-1187 CUMBERLAND 101 HElEN M '0; :C;3 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ 'Rfv =i 6'ifi-EX--AFP-(' oY.-o2Y------...-iNifERiYANC'E-TAX-STAY EME-NT-OF-AC-coUi.ff--...---------------- -- --- ESTATE OF REBER HELEN M FILE NO.21 01-1187 ACN 101 DATE 05-28-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-27-2002 P R I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 10,759.45 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-18-2002 CDOO1180 537.97 11,050.00 TOTAL TAX CREDIT 11.587.97 BALANCE OF TAX DUE 828.52CR INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 828.52CR . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) REV-1470 EX (6-66) .... . '* INHERITANCE TAX EXPLANA TION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER Helen M Reber 2101-1187 REVIEWED BY ACN Sandra J Eslinger 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES E 4-5 The proceeds of life insurance policies on the life of the decedent are not subject to tax in the decedent's estate. ROW Page 1 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT lIake check or money order payable to: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT lIake check or lIoney order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, lIay be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Departllent's 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). REPLY TO: DISCOUNT: PENALTY: INTEREST: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post AssesSllent Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. If any tax due is paid within three (3) calendar lIonths after the decedent's death, a five percent (5%) discount of the tax paid is allowed. The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. Interest is charged beginning with first day of delinquency, or nine (9) lIonths and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January I, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year DailY Interest Factor Interest Rate Daily Interest Factor Interest Rate Year 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 n .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 n .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days beyond the date of the assessment. If payment is made after the interest cOllputation date shown on the Notice, additional interest IIUSt be calculated. ,./ / -?-c:3o - / / BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-1&D7 EX AFP lDl-DZ) u DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-19-2002 REBER 12-26-2001 21 01-1187 CUMBERLAND 101 HELEN M THOMAS J AHRENS AHRENS LAW OFFICES 5521 CARLISLE PIKE MECHANICSBURG PA Allount Rellitted 17055 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =i6'ifj-E3CAFP-foY=ozY------...--iNifERIi'-A'Nc'E-TA3CsTATEME-tiT-oF'-Ac-coUiff--...--------------- - ----- ESTATE OF REBER HELEN M FILE NO.21 01-1187 ACN 101 DATE 08-19-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-20-2002 P R I NC I PAL T AX DUE: ......................................................................................................................................................................................................................... 10,759.45 PAYMENTS (TAX CREDITS): PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-18-2002 CDOO1180 537.97 11,050.00 07-31-2002 REFUND .00 828.52- TOTAL TAX CREDIT 10,759.45 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J PAVMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department.s 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). REPLV TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENAL TV: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (I) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 1982 bear interest at the rate of six (6%) percent per annum calculated at a dailY rate of .000164. All taxes which became delinquent on and after January I, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Vear Interest Rate DailY Interest Factor Vear Interest Rate Daily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 n .000192 1984 11% .000301 1995-1998 9% .000247 1985 13% .000356 1999 n .000192 1986 10% .000274 2000 8% .000219 1987 9% .000247 2001 9% .000247 1988-1991 11% .000301 2002 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. 0t/ REGISTER OF WILLS OF CUMBERLAND COUNTY COMMONWEALTH OF PENNSYLVANIA IN RE: ESTATE OF Helen M. Reber * NO. 2001-01187 C,!J..Vl.M;l Wi!.. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Helen M. Reber Date of Death: December 26,2001 Will No.: 2001-~1 /I <;(7 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, 1 report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to NO.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes X No Date: d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached A _ to this report. It> 2/02- siLt ~ - Thomas J. Ahrens, J.D. Name (Please type or print) 5521 Carlisle Pike Mechanicsburg, PA 17050 Address (717) 697-1800 Telephone No. Capacity: _ Personal Representative ~ Counsel for Personal Representative In Re: Estate of Helen M. Reber In the Court of Common Pleas Cumberland County, Pennsylvania Orphans' Court Division 11870f2001 Praecipe To Withdraw Appearance To the Clerk of the Orphans' Court: Kindly withdraw my appearance as counsel for the Estate of Helen M. Reber. Respectfully submitted, Knauer & Associates LSC 4l1-A E. Main Street Mechanicsburg, P A 17055 (717) 795-7790 .' .I r By <~~~i,f1n~u.!\~ 'I Dated: vi.: 1;l //(/2 ~Iil 2-. v \..../ / ~~ u In Re: Estate of Helen M. Reber In the Court of Common Pleas Cumberland County, Pennsylvania Orphans' Court Division 1187 of 200 1 Praecipe To Enter Appearance To the Clerk of the Orphans' Court: Kindly enter my appearance as counsel for the Estate of Helen M. Reber. My Supreme Court I.D. # is 80143. Respectfully submitted, Ahrens Law Offices, P.C. 5521 Carlisle Pike Mechanicsburg, P A 17050 (717) 697-1800 By i:!! ,( ~ homas J. Ahrens PA. Reg. No. 80143 Dated: 10 - 17- ()1- , .' ). REV.lt~OH';~-mI) . '* REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER 21 01 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 1187 NUMBE:.R o 2. Supplemental Return o 4a. o 7. o 10. Spousal Poverty Credit (date of dealh between _____J~:31-9J and 1-1-95) 'THIS SECTlONr.llJST BE COr.4F'l,ETED, A~L CQIlR5l!P~ND5N<;EAND<;_()NEID~~TI~~TAXINI'Q.I'!r.l~TI()t!~3>IJ.~()];lggIR5<;TEPTj)'-____. NAME ICOMPlETE MAILING ADDRESS , Thomas J. Ahrens I' FIRM NAME (If acplicablfl\ Ahrens Law Offices, P.c. fELEPHC)NE NUMBER - i 717/697-1800 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 ~ z w a w u w a DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) , Reber, Helen M DA TE- OF DEA TH{MM~DD-YEARj DATE OF BIRTH (MM-DD-YEAR) 1 01/17/1918 12/26/2001 :(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) w ~ ~~ u~ w. zO u~ . . < ~ o ~ 6 09. Decedent Died Testate (Attach copy of Will) litigation Proceeds Received FulurelnlerestCcmpromise{dalecfdeathafter 12-12-82) Decedent Maintained a living Trust (Allach copy of Trusl) 8. Total Number of Safe Deposit Boxes 1 Original Return 4. Limited Estate 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3, Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6, Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) /1-.30 ~ 201-05-9297 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3 Remainder Retum (dale of death prior 1012-13-82) o 05 Federal Estale Tax Return Required o 11.Election 10 tax under Sec. 9113(A) (AlIach Soh 0) 5521 Carlisle PIke Mechanicsburg, PA 17055 (1) None ~,...... 1"'" (2) None::-.}\" " (3) None (4) None (5) 53,102,18 (6) None (7) 212,485.02 (8) (9) 10,312.30 (10) 454.44 d 1'--.' C"\ 265,587.20 (11) 10,766,74 (12) 254,820.46 (13) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 10,601.18 (14) 244,219.28 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 244,219.28 .045 (16) a 16.Amount of Line 14 taxable at lineal rate x ~ < ~ ~ . 17.Amount of Line 14 taxable at sibling rate x .12 (17) ~ a u ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) ~ 19. Tax Due (19) 10,989,87 20. ~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 10,989.87 >>BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH << Copyright 2000 form software only The Lackner Group, Inc, Form REV-1500 EX (Rev. 6-00) Ollcedent's Complete Address: STREET ADDRESS 100 Mt. Allen Drive CITY Mechanicsburg STATE PA ZIP 17055-2015 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 10,989.87 11,050.00 549.49 Total Credits (A + 8 + C) (2) 11,599.49 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty (0 + E) (3) 0.00 609.62 4 If Line 2 is greater than Line 1 + Line 3, enter the difference Tr'.is is the OVERPAYMENT. (4) Check box on Page 1 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. (SA) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT 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?. 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;.... B ~ b. retain the right to designate who shall use the property transferred or its income;.. ~ c. retain a reversionary interest; or.. 8 ~ d. receive the promise for rife 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?. ~ o ~ o ~ o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I have examined this relum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of p~eparElr O!h.er th_an thepers.?r1.~I_re2.resenta_li~e is based on all information of which preparer has any knowledge SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS l.JluYL /11 ;/cdx SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE 4040 Clausen Avenue Western Sprinj\s, lL 60558 </- b - () ~ ADDRESS DATE SIGN-:t::~F iEPb~THAN REPRESENTATIVE tf - iD _'07./ ADDRESS DATE 5521 Carlisle Pike Mechanicsburg, PA 17055 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 3% [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% [72 P.S. ~9116 (a) (1.1) (ji)]. The statute does not exemot 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 0% [72 P.S. ~9116 (a) (1.2)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 la) (1)1. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [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. *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCETAARETURN RESIDENT DECEDENT ESTATE OF Reber, Helen M I FILE NUMBER 21 - 01 - 1187 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. ITEM NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 22,225.00 Refund of acquisition fee for the cottage at 974 Walnut Way, Messiah Village, from Messiah Village - Statement ITom Messiah Village attached 2 Death benefit check from Reliastar on life of Ear! Reber 24,949.48 3 Check ITom Prudential Financial 711.00 4 Death benefit ITom Prudential Financial Policy # 088554977 payable to the Estate of Helen M Reber 935.64 5 Death benefit ITom Prudential for Policy # 09 105 049 payable to the Estate of Helen M. Reber 4,184.78 6 Final Uniroyal retirement check 96.28 TOTAL (Also enter on Line 5, Recapitulation) 53,102.18 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Reber, Helen M FILE NUMBER 21 - 01 - 1187 ESTATE OF ITEM NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2.is yes. DESCRIPTION OF PROPERTY DATE OF DEATH % OF Include the name of the transferee, their relalionshipto decedent and the date oflransler VALUE OF ASSET DECO'S EXCLUSION; TAXABLE VALUE Attach a copy of the deed for real estate INTEREST (IF APPLICABLE) Annuity # GA0680508 at Glenbrook Life and Annuity Company. Beneficiary is Helen M. Tate 76,784.58 100% 76,784.58 2 Fellowship Center Loan to Child Evangelism Fellowship Inc.. Beneficiary is Mr. and Mrs. William D. Tate, Jr. 121,716.16 100% 121,716.16 3 PNC Bank checking account # 5080029809, made joint within one year, joint owner is Helen M. Tate, daughter of the decedent 10,917.09 100% i 3,000.00 7,917.09 4 CD # 31100164481 at PNC Bank, made joint within one year. Joint owner is Helen M. Tate, daughter of the decedent ! 3,000.00 100% 3,000.00 5 CD # 3140021 1053 at PNC Bank, made joint within one year. Joint owner is Helen M. Tate, daughter of the decedent 3,067.19 100% 3,067.19 TOTAL (Also enter on line 7, Recapitulation) 212,485.02 '* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Reber, Helen M , FILE NUMBER i 21 - 01 - 1187 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT FUNERAL EXPENSES: Musselman Funeral Home, Inc. 2 Messiah Village [uneralluncheon buffet 3 B. ADMINISTRATIVE COSTS: Personal Representative's Commissions 1. Social Security Number(s) I EIN Number of Personal Representative(s): 2. Street Address City Stale Zip Year(s) Commission paid Attorney's Fees Ahrens Law Offices, P.C. -- Thomas J. Ahrens 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 4. City Relationship of Claimant to Decedent Probate Fees Cumberhmd County Additional Short certificates State Zip 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Long Distance phone charges 2 Registered letter to DPW Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 4,180.25 152.58 5,300.00 232.00 9.00 65.90 3.94 368.63 10,312.30 '.' , , *' Schedule H Funeral Expenses & Administrative Costs continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Reber, Helen M 3 Postage 4 David W. Knauer, P.c. - Attorney fee FILE NUMBER 21-01-1187 18.63 350.00 I Page 2 of Schedule H ',' *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Reber, Helen M Include unreimbursed medical expenses. ITEM NUMBER 1 Final medical bills 2 Messiah Village for ambulance 3 PP & L phone bill 4 David W. Knauer, PC SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS DESCRIPTION FILE NUMBER 21 - 01 - 1187 TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 40.38 126.35 37.71 250.00 454.44 , " . . . . *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Reber, Helen M I FILE NUMBER I 21 - 01 - 1187 I NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I -- --- -1---~;~~-;~~-- DISTRIBUTIONS (include outright SPOUS;I distributions) . 1 I Helen Marie Tate I 4040 Clausen A venue Western Springs, IL 60558 RELATIONSHIP TO DECEDENT 00 N.ot Ust Trustee(s) AMOUNT OR SHARE OF ESTATE Daughter Remainder of estate i i I ! Enter dollar amounts for distributions shown above on lines 15 through 17, as appropriate, on Rev 1500 cover sheet II, NON-TAXABLE DISTRIBUTIONS: ,A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT , BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I Bible Baptist Church in Shiremanstown 201 W. Main Street, Shiremanstown, PA 17011 , Child Evangelism Fellowship, Inc. of Cumberland County 150 Fairview Drive, Carlisle, PA 17013 5,300.59 2 5,300.59 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I 10,601.18