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1987 IURC ReportGENERAL INFORMATION SUMMARY Hamilton -Western Utilities No. Water Customers No. Sewer Customers 1987 Water Income 1988 Water Income 1987 Sewer Income 1988 Sewer Income 1988 Reported Combined Assets Contributions in Aid of Construction Long Term Debt Taxes other than Income - 1988 Water Rights payment to R. Wilfong No. New Water Connections - 1988 No. New Sewer Connections - 1988 Ralph Wilfong Income 1554 1265 $318,346 $476,516 $412,786 $490,400 $6,293,762 $4,617,110 $1,496,216 $93,309 $50,000 251 165 1987 1988 Salary $68,000 $68,000 Water Rights 50,000 50,000 Dividends 60,000 0 $178,000 $118,000 Ralph II and Paul Wilfong Income $20,400 $72,000 Net Income 1987 ($149,327) Net Income 1988 ($98,439) GENERAL INFORMATION SUMMARY Hamilton -Western Utilities No. Water Customers No. Sewer Customers 1987 Water Income 1988 Water Income 1987 Sewer Income 1988 Sewer Income 1988 Reported Combined Assets Contributions in Aid of Construction Long Term Debt Taxes other than Income - 1988 Water Rights payment to R. Wilfong No. New Water Connections - 1988 No. New Sewer Connections - 1988 Ralph Wilfong Income 1554 1265 $318,346 $476,516 $412,786 $490,400 $6,293,762 $4,617,110 $1,496,216 $93,309 $50,000 251 165 1987 1988 Salary $68,000 $68,000 Water Rights 50,000 50,000 Dividends 60,000 0 $178,000 $118,000 Ralph II and Paul Wilfong Income $20,400 $72,000 Net Income 1987 ($149,327) Net Income 1988 ($98,439) GENERAL INFORMATION SUMMARY Hamilton -Western Utilities No. Water Customers No. Sewer Customers 1987 Water Income 1988 Water Income 1987 Sewer Income 1988 Sewer Income 1988 Reported Combined Assets Contributions in Aid of Construction Long Term Debt Taxes other than Income - 1988 Water Rights payment to R. Wilfong No. New Water Connections - 1988 No. New Sewer Connections - 1988 Ralph Wilfong Income 1554 1265 $318,346 $476,516 $412,786 $490,400 $6,293,762 $4,617,110 $1,496,216 $93,309 $50,000 251 165 1987 1988 Salary $68,000 $68,000 Water Rights 50,000 50,000 Dividends 60,000 0 $178,000 $118,000 Ralph II and Paul Wilfong Income $20,400 $72,000 Net Income 1987 ($149,327) Net Income 1988 ($98,439) GENERAL INFORMATION SUMMARY Hamilton -Western Utilities No. Water Customers No. Sewer Customers 1987 Water Income 1988 Water Income 1987 Sewer Income 1988 Sewer Income 1988 Reported Combined Assets Contributions in Aid of Construction Long Term Debt Taxes other than Income - 1988 Water Rights payment to R. Wilfong No. New Water Connections - 1988 No. New Sewer Connections - 1988 Ralph Wilfong Income 1554 1265 $318,346 $476,516 $412,786 $490,400 $6,293,762 $4,617,110 $1,496,216 $93,309 $50,000 251 165 1987 1988 Salary $68,000 $68,000 Water Rights 50,000 50,000 Dividends 60,000 0 $178,000 $118,000 Ralph II and Paul Wilfong Income $20,400 $72,000 Net Income 1987 Net Income 1988 ($149,327) ($98,439) a. HAMILTON WESTERN UTILITIES, INC. 1350 GREYHOUND COURT CARMEL, INDIANA 46032 Telephone: (317) 846-6561 April 29, 1988 Indiana Utility Regulatory Commission 901 State Office Building Indianapolis, IN 46204 Dear Sirs, Due to personnel changes in our office, we are hereby requesting an extension on the time to file our annual reports for the year 1987, due April 30, 1988. An extension of 30 days will be sufficient in order for us to compile the necessary information and complete the reports. Sincerely, HAMILTON WESTERN UTILITIES, INC. Je f Henson, Treasurer JH/lb RECEIVED xi2135B ACCOUNTING DIVISION MAMA MT/ FINALAIDFCICONIGGION CLASS "C" WATER and/or SEWER. UTILITIES (Cross Revenue of Less Than $150,000 Each) ANNUAL REPORT OF HAMILTON WESTERN UTILITIES, INC. Exact Legal Name of Respondent RECEIVED ar z 1398 ACCOUNTING DIVISION mumounimasomammo FOR THE YEAR ENDED DECEMBER 31, 19 87 General Instructions 1. Prepare this report in conformity with the 1984 National Association of Regulatory Utility Commissioners Uniform System of Accounts for Water and/or Sewer Utilities. 2: Interpret all accounting words and phrases in accordance with the USDA. 3. Complete each question fully and accurately, even if it has been answered in a previous annual report. Enter the word "None" where it truely and completely states the fact. 4. For any question, section, or page which is not applicable to the respondent enter the words "Not Applicable" or "NA". Do not omit any pages. 5. Where dates are called for, the month and day should be stated as well as the year. 6. Complete -this report by means which result in a permanent record, suds as by typewriter. Money items (except averages) throughout the report should be shown in units of dollars adjusted to accord with footings. 7. If there is not Brough roan on any schedule, an additional page or pages may be added provided the format of the added schedule matches the format of the schedule with not enough roan. Such a schedule should reference the appropriate sdsedules, state the name of the utility, and state the year of the report 8. The report should be filled out in and copies returned by of the year following the date of the repcut. The 'reparteieu2 be returned to: E GENERAL RULES FOR REPORTING 1. This form shall be filled out in duplicate, with one copy returned to the Indiana Utility Regulatory Commission, 901 State Office Building, Indianapolis, Indiana 46204, by April 30, following the close of the year for which the report is made. Attention is specifically directed to the following provisions of the Public Service Act, effective May 1, 1913, as amended to and including the Acts of 1933. The extra copy is to be retained by the utility. 2. 8-1-2-15. Records kept within state - Majority of directors to be residents - Each public utility shall have an office in one (1) of the towns or cities in this state in which its property or some part thereof is located, and shall keep in said office all books, accounts, papers, and records as shall be required by the commission to be kept within the state. No books, accounts, papers, or records required by the commission to be kept within the state shall be at any time removed from this state, except upon such conditions as may be prescribed by the/ commission. A majority in number of the board of directors of each and every company or association organized under Indiana statutes and coming under the provisions of this chapter shall be bona fide residents and citizens of the state of Indiana while acting as such directors. 3. 8-1-2-16. Closing accounts -Date - The accounts shall be closed annually on the thirty-first day of December, and a balance sheet of that data promptly taken therefrom. On or before the thirtieth day of April following, such balance sheet, together with such other information as the commission shall prescribe, verified by an officer of the public utility, shall be filed with the commission. 4. 8-1-2-52. Information to be furnished - Every public utility shall furnish to the commission all information required by it to carry into effect the provisions of this chapter and shall make specific answers to all questions submitted by the commission. 5. 8-1-2-108. Penalty for failure to file reports or give information - Annual reports of municipally -owned utilities - Examination by State Board of Accounts - (a) An officer, agent or a public utility, as defined in this chapter who (1) Fails to fill out and return any blanks as required by this chapter; (2) Fails to answer any question therein propounded; (3) Knowingly gives a false answer to any such question or evades the answer to any such question where the fact inquired of is within his knowledge; (4) Fails, upon proper demand, to exhibit to the commission, any commissioner, any administrative law judge or any person authorized to examine the same, any book, paper, account, record or memoranda of the public utility which is in his possession or under his control; (5) Fails to keep his system of accounting,• or any part thereof, which is required by the commission; or (6) Refuses to do any act or thing in connection with the system of accounts when so directed by the commission or its authorized representative; commits a Class B infraction. (b) A municipally -owned and operated utility shall file with the commission an annual _report of the operation of said plant on forms to be furnished by the commission, which forms are to be substantially the same as for reports filed annually with the commission by public utilities. Such annual reports shall remain in the office of said commission as a public record; however, whenever in this chapter public utilities are required to make reports to the Indiana Utility Regulatory Commission or are otherwise subject to the commission, municipally -owned utilities are exempted from making such reports and are not under the jurisdiction of the commission except as otherwise provided. (c) The state board of accounts shall examine all accounts of every municipally -owned and operated utility at least one each year. On every such examination, inquiry shall be made as to the financial condition and resources of such municipal utility, whether the laws of the state have been complied with, and into the methods and accuracy of the accounts and reports of the utilities examined. Such examination shall be without notice, and the cost of such examination shall be paid out of the funds of the utility. 6. 8-1-2-112. Separate violations - Every day during which any public utility or any officer, agent, or employee thereof shall fail to observe and comply with any order or direction of the commission, or to perform any duty enjoined by this chapter, shall constitute a separate and distinct violation of such order or direction of this chapter, as the case may be. 1. Payments to Counsel: Names Legal Matter (s) for Which Paid Kunz & Kunz 2. Payments to Consultants: Names Ralph L. Wilfong Ralph L. Wilfong Raymond J. Panke General Description of Services Water rights and well site lease Development of water and sewer capacity Director's fee -:U Tota Pa'd $13,125 Total 2a'd $50,000 $68,000 $6,000 3. Contributions of Officeseekers and/or Political Committees: Names of Payees With Whom Registered (Fed. or State) Total Paid " Consultant' for the purpose of this form (JAI) means a person in a status < other than that of employee, paid to render service, advice, or information, and/or to lobby or represent the payer before any agency or branch of government.. °Consultant' does not mean, in this context, any person or firm to whom payment has been made and which has been reported under part one of this form, dealing with legal counsel. If a person has received payment both as a "consultant" and as an employee, reporting herein shall include both types of payment, and the totals of each. There is no minimum for °Total Paid" under which reporting need not be made. This information is requested pursuant to I.C. 8-1-2-26. PERSONNEL DATA Please fill in the following information: 1. Number of full-time employees 2. Number of part-time employees 3. Number of union employees 6 7 0 Please complete the following information. Column A is the number of employees in that salary range. Column 8 is the total gross dollar amours paid to those employees in that pay category. Column C is the total dollar cost for fringe benefits for employees in that salary range: Salary Range No. Of Employees Salary Cost Of Benefits Col.._ A Col. 8 Col. C S 200,000 + 190,001 - 200,000 . 180,001 - 190,000 170,001 - 180,000 460,001 - 170,000 150,001 - 60,000 140,001 - 150,000 130,001 - 40,000 120,000 - 134,000 110,001 - 120,000 100,001 - 110,000 90,001 - 100,000 80,001 - 90,000 70,001 - 80,000 60,001 - 70,000 50,001 - 60,000 40,001 - 50,000 30,001 - .40,000 20,001 - 30,000 1 24,107.70 960 10,001 - 20,000 2 31,790.08 1920 10,000 - 0 10 41,488.00 1920 1 This information is requested pursuant to I.C. 8-1-2-48 TABLE OF ccora S Financial Section Page Identification F-2 Irxnne Statement - F-3 Balance Sheet F-4 Net Utility Plant F-5 :,mandated Depreciation and Amortization of Utility Plant F-5 Capital Stock F-6 Retained Earnings F-6 Proprietary Capital F-6 Lang Tenn Debt F-6 Taxes Accrued F-7 Payments For Services Rendered By Other Than Employees F-7 Cantributions In Aid Of Crnstructicn F-8 Water Operating Section Page Water Utility Plant Accounts W-1 Analysis of Accumulated Depreciation By Primary Account - Water W-2 Water Operation and Maintenance Expense W-3 Water Custaaers W-3 Pumping and Purchased Water Statistics W-4 Wells and Well Pumps, Reservoirs, and High Service Pumping W-5 Other Water System Information W-6 Sewer Operating Section Page Sewer Utility PlantAccounts S-1 Analysis of Acaandated Depreciation By Primary Account 1 Sewer S-2 Sewer Operation and Maintenance Expense S-3 Sewer Custem rs - S-3 pumping Equipment, Collecting and Force Mains and Manholes S-4 Other Sewer Systen Informati.onn S-5 Certification Section Page Certification C-1 ois F-1 REPORT OF Hamilton -Western -Utilities, Inc. (Exact name of utility) 1350 Greyhound Court Carmel (Address) IN Hamilton (Canrsty) Far Year Ended 12/31/87 Date Utility First Organized: 8/4/69 Telephone Number (317) 846-6561 Location where books and recoxds,are located: 1350 Greyhound Ct. Carmel, IN 46032 Contacts: Name Persai to send correspondence: Jeffrey C. Henson Person who prepared this -1 reports Jeffrey C. Henson Officers and Managers: &wand rT tatik.. Title Treasurer Principal Business Address 1350 Greyhound Ct Carmel, IN 46032 President _Eau LWilfQ g - Balpb_Li _siilfQog. BL _ _ _I nCls.EMmett • Jeftrey C. Henson Willis Kunz ire=President YiQP:FLPaidegt Treasurer „ 1, Ksst. I*ecretary Salary I Charged I Utility I YOOCCCOCOIX XOCOCOOC a $ 6,000. $ TSTODOT — — $ $ _1_800_ — — S Report ebery corporation or perms owning or holding directly or indirectly 5 percent or more of the voting securities of the rep ting utility: Name I Raft L. Wilfong_ el -1 Percent f Ownership In I Utility r f 1 1 100% Principal Business Address Carmel, IN Salary Charged Utility 5 $ F-2 iJI.L Y NAtE: Hamilton Western Utilities, Inc. INCME STAinEc YAK Or t7F.r� R . 1 DECafBER 31, 19 87 Account Name Ref. Page No. Gross Revenue: Residential Connercial Industrial Multiple Family Guaranteed Revenues _ Other (Specify) f o r f_ e i t_ e1 d and otter' incotieet on "f)ees Total Gross Revenue _ -_ Operation Expense Depreciation Expense Amcrtization Expense - - - Taxes Other Than Inezns In Taxes Total Operating Expense _ Net Operating Inasne (loss) Other Inane: Nonutility Ing , Interest earner _ _ Other Deductions: Miscellaneous Nonutility Expefnses Interest Expense Amortization of W-3 S-3 F-5 deist discount and expende Net Inane (1.098) F-7 F-7 Water $ 293,099. 12,288 $ $ 12,959 318,346 262,458 57,294 3,307 42,348 0 365,407 $ (47,061) $ (42,061) Sewer $ 389264 20,004 2,918 412,786 264.,776 47,301 17,097 27,846 0 $ 357,020 $ 55,766 $ $ $ 55,766 Other 21,889 $ _31732 _ 163,151 13,038 $, ( 158,032) Total Ccri:anY $ _682963_ 32,292 15,877 $ 731,132 $ 527,234 104,595 20,404 70,194 0 $ 727,427 $ 8,705 21,889 3,732 163,151 13,038 $ (149,327)1 1 F-3 Utrr.rry NAME: Hamilton Western Utilities, Inc. COMPARATIVE BALANCE SHEET 1 YEAR OF REPORT 1 DEcSER 31, 1987 1 Reference Aczotmt Name Page Assets: Utility Plant In Service (101-105) Accumulated Depreciation and Amortization (108) Net Utility Plant Cash Custaner Accounts Receivable (141) Les AS$ets (Specify) other accounts rec. Materials and supplies Prepayments Non-utility property Deferred charges Total Assets Liabilities And Capital: Common Stock Issued (201) Preferred Stock Issed (204Y Other Paid In Capital (211) Retained Earnings (215 ) Proprietary capital (Pxu u.setary and partnership only) (218) Total Capital Lang -Term Debt (224) Accounts Payable (231) Notes.Payable (232) Custer Deposits (2157 Accrued Taxes (236) Other Liabilities (SpeCi1y!T Interest Due related party Due developers Advances Far Constructs* Contributions In Aid Of Construction - Net (271-272) Total Liabilities And Capital I P F -5,W -1,S-1 F -5,W-2,5-3 F-6 F-6 7-6 F-6 F-6 F-7 Current Year Previous Year $ 6,248,752 $ 5,757,247 652,841 548,246 $ 5,595,911 $ 5,209,001 175,849 655,108 65,90,1 54,215 141,206 11,649 5,026 1 1,682 2,793 40,030 45,568 271,146 258,576 $ 6,303,374 $ 2,120 $ 585,.194 869,262) $ 1,625,036 --381_887 _ _47,300 67,109 5,364 163,866 25,650 4,617,110 $ 6,303,374 $ 6,230,287 1 $ 2,1201 585,1941 (659,9351 $ -(72,621) $ 1,686,822 26,295 25,600 —-3-17Z-3 2 42,391 1,185 347,575 4,141,608 $ 6 2 3 0, F-4 UTILITY W€:Hamilton Western Utilities, Inc. NET UTILITY PLANT Plant Accounts: (101-107) Inclusive Utility Plant In Service (101) Water $ 3,883,490 Construction Work In Progress (105) -Other (Specify)_ Acquisition adjustment 6,250 Total Utility Plant $ 3,889,740 $ 2,321,486 $ 2,321,486 1 YEAR OF RUCK: 1 DECEFEER 31, 19_1 W&S Other 1 1 Than Reporting 1 Total SyStECS 37,526 $ 37,526 $ 6,204,976 6,250 37,526 $ 6,248,752 AC:U• ATID DEPRECIATION AND AMORTIZATION OF UTILITY PLANT Account 108 Water Balance First Of Years Credits During Year:' — — —1 -Accruals drarged to depreciation account $ Salvage — — — Other credits (specify)__ —1 ,-1 .tea credits 1$ 57,294 229,991 57,294 Debits Acing Year: Book cost of plant retired - $. Coat of removal 1 Other debits (spa?yf . Total dMits -71$ 0 Balance - Fhd .Of -Year 15 287;285 $ 318,255 $ 47,301 $ w & 5 Other Than Reporting Systems 0 $ $ 0 $.. 365,556 Total $ 548,246 $ 104,595 $ 104,595 $ $ 0 $�'652,B41 F-5 UTUZIY NAE: Hamilton Western Utilitieq, Tnc CAPITAL STOCK ( 201 - 204 )- I YEAR OF REPORT I D'EF.d 31, 19 87 I I I Par or stated value'per share Shares authorized Shares issued and outstanding Total par value of stock issue Dividends declared per share for year Ccrnnon Stack _21 lA.L1 Preferred Stock IETAIIII9 EARNINGS ( 215-) Balance first of year - Changes durirxj Nie year Tepecifyj: Net loss for year 7ividen3 distribution Balance end of year Appropriated $ Un - Appropriated $ !659,7351 £ Q•Q491 $ (869,262) nPCIPRIEPntt CAPITAL ( 218 ) Balance first of year Changes during the year-tspecikTs Balance end cf, year Proprietor Or Partner Partner LONG TERM DEBT ( 224 ) Descsipticn of Obligation ( Ntninal Date.of Issue and Date of Maturity ) 10-1-83- Mortgage -Town of Westfield- due 1s -j 8,2 _. 6-23-86- Mortgage -Town of Westfield- due 3-1D-941 3-23-84- City of Carmel- due 4-1-90. 2-8-86- Installment contract- due 2=8-90 Total - Interest Rate I Pymts 1 Q _I_ s n_ 142U_"1D� 7.9% Mo. Principal Per Balance Sheet Date —2.QOr 110_7 _ 1.13 7-51 10 0 - - 43 71s 6', 3 2 1 $ 1,625, 03, F-6 tr:II.STY NAME: Hamilton Western Utilities. Inc. TAXIES =RUED 236 ) 1 YEAR OF REPO1r I 1 DEOZzant 31, Itaz I I (a) Balance first of year Accruals charged: State ad valorem tax — — Luca' party tax — — — Federal income tax State incase tax Regulatory assessment fee Other (Specify) sales tax payroll taxes Total Taxes Accrued Taxes Paid: State ad valorem tax — — Local property tax — — — Federal income tax — — — State income tax — Regulatory assessment fee Other (Specify) Total Taxes Paid Balance end of year Water (b) $ 14,129 $ 52,493 15,193 $ 37,300 Sewer (c) $ 14,271 $ 3:8,133 $ 14,933 - $ $ 23,200 Other (d) 3,032 (3731_ (1,050) $ 1,609 $ $ 1,609 Total (e) $ 31,432 — 61‘.22.6— (373) 1,12.6— (373) (1,050) $ 92,235 30,126 $ 30,126 62,109 PAYME141S FOR waviest RENDERED BY OTHER T dAN EMPLOYEES Report all information concerning rate, management, o nstructial, advertising, labor relations, public relations, or other similar professional services rendered the respondent for which aggregate payments during the year to any corporation, partnership, individual, or organization of any kind whatever, amounting to $580 or more. Name of Recipient Kunz & Kunz 1 Asoma 1 I$ 13,125 Description of Service Legal services 1$ K.B. Parrish & Co. 1$ 12,417 Rtmond J. Panke Financial statements and tax return 1$ 6,000 I$ - Director fee 33srLFii1tplig----1$-118.iLoa _ 1$ I$ I$ I$ ( I sps_1�}„ng and lease of water right F-7 ty y NA'z: Hamilton Western Utilities, Inc. OONTRIBUTICNS III AID OF CONSTRUCTION 271 ) 1 YEAR OF TOORT 1 DFrr•SER 31, 19 87 (a) Balance first of year Add credits during year Total Deduct charges during year Balance end of year Less Accumulated Amortization Net CIAO Water (b) $1,913,588 $ _ 304 .529 2 au J1? $ 2,214,117 Sees (c) $ 2,228,020 Total (d) $ 4,141,608 $ __L7.4.1 $ 1°2 _ 1 X41 9-9 b _ 3.11 1-7.1_10 $ 2,402,993 $ 4,617,1Iq ADDITIONS 4O CONTRIBUTIONS IN AID OF CXNSTRUCTICN DURING YEAR (CREDITS) Report below all developers or contractors agregnarts toon which cash or property was received during the year. Shorewood corp.-Springmill Crossing Indicate "Cash" or "ply • property State of Indiana- flouridation y stem cash Sub -total Report below all capacity Charges, mains extension charges and customer connections Charges recieved during the year. Description of Charge C Connection fees Main extension fees Number of Oon nectians 335 Charge per Connection $ 285 196 285 232 835 142 835 Water 52,682 4,255 $ 56,937 $ 95,475 1484.117- $ - 300',-529 55,860 19j113 $ 174,973 F -B tyrtrY NAVE:Hamilton Western Utilities, Inc. WATER UTILITY PLANT ACCOUNTS 1 YEAR OF REPORT 1 DECIDER 31, 1987 1 Acct. No. (a) 301 302 303 304 305 Account Name (b) Organization Franchises Land and Land Rights • Structures and Improvements Collecting and Lmpounding Reservoirs 306 Lake River and Other Intakes 307 Wells and Springs 308 Infiltration Galleries and Tunnels 309 Supply Mains 310 Power Generation Equtpnent 311 Pumping Equipment • 0 Water Treatment Equipment _30 Distribution Reservoirs and Standpipes 331 Transmission and Distribution Mains _ _ _ 333 lServices 334 Meters and.Meter Installations 335 Hydrants 339 Other Plant ani Miscellaneous Equipment 340 Office Furniture and (Equipment 341 Transportation Equipment _ 342 Stores Equipment 343 Tools, Shop and Garage 344 Laboratory Equipment_ 345 Power Operated Equipment 346 Communication Equipment 347 Miscellaneous Equip nt 348.. Other_Tangible pmt Total. Water Plant Previous Year (c) $ 83,485_ 142,350 ' 2041225_ 990j041 57199 429j l41 _ 398,097 1,137,555 13,667 62,724' 596 1,265 7,004 0 $ 3,527,348 Additions (d) 131703 122454. --1•,49 _-9.,61 139,477 2,618 44,126 1,978 569 5,463 19,687 $ 356,142 Retirements (e) $ Current Year (f) S 1 EL 0_5.1 _ - L 112,J0.0_ -51.119- 4.3.4 51,.119- 4.3.4 .2- 398,097 12771032 161181 106,850 2,574 _11832 -- 121467 19,687 _ I $ 3, 883,490'' 171'IW1Y : Hamilton Western Utiliti=es;--Inc2-: ANALYSIS OF ACJCUhULATU) DEPRDCIATICN EIY PRIMARY AOCOUNP - WATER 1 YEAR C RP 1 1 DE7CI?USER i., 19 R7 1 I 1 rl Acct. No. (a) Account (b) 304 Structures & Inprovenents 305 Collecting b Impounding Reservoirs 306 307 308 309 310 311 320 330 Average Service Life in Years (c) 67 Average Salvage In Percent (d) $ Lake River S Other Intakes Well & Springs 67 Infiltration Galleries & Tunnels $ — 8 Supply Mains _ Power Generating EquTpnent Pumping Equipment C7 Water Treatment Equipment - Distribution Reservoirs & Standpipes 331 Trans. & Diet. Mains _ _ 333 Services 334 Meter & Meter Installations 335 Hydrants 339 Other Plant ara Miscellaneous Equipment _ 340 Office Furniture and Equipment _ _ 341 Trans tion Poeta Equipment _ 342 Stores Equipment 393 Tools, Shop and Garage Equipment - Laboratory .Equipment - - - Power Operated Equipment _ Communication Equipment Miscellaneous - Miscellaneous Equipment Other - Other Tangible Plant _ - - 344 345 346 347 348 • Totals 67 67 '67 _Sz7_ $ ---+8 Depr. Rate Applied (e) 1.5 % 1.5 % r.3 1 . 5 % $ % 1.5 % 10.0% 20_3% -- 8 Accumulated Depreciation Balance Previous Year (f) $ 5433• 24905 --276-2r 7,7 r6 34,282 18,99.7 101,337.. 7,551 4,157 35 476 1,060 0 $ 229,991 Debits. (g) $ 2 Credits { (h) $ 2340 3065 r5-7.1 - frbr 6,474 5,971 18,109 225 1,272 23 1491 1 Accumulated -Depreciation Balance End of Year (i) $ 7773 27,970 -1R-n r — 5,892 4 Qs, 756 24,968 119,446 7,776 5,429 . 58 625 ---2f Th re 148 $ .57,294 148 $ 287,285 :.4 ITYNeer:Hamilton Western lirilirips Tne WATER OPERATION AND MAINTENANCE EXPENSE 1 YEAR OF REPORT 1 DECEMBER 31, 1987 1 Acct. No. 601 603 604 610 615 616 618 620 630 640 650 655 665 670 675 AccountName Salaries and Wages - Employees Salaries and Wages - Officers, Directors, art Majority Stockholders — Employee Pensions and Benefits Purchased Water Purchased Power Fuel for Power Production Chemicals Materials and Supplies 5695, 34257 16851 Contractual Services 13021,2333, 2389, 50000, 37000 Rents Transportation Expense Insurance Expense Regulatory Commission Expenses Bad Debt Expense Miscellaneous Expenses Total Water Operation And Maintenance Expense Anwnt $ 29,933 29,500 _27'710— _51� JQ3-- 104 $ 262,458 WATER CUS'1C14RS Description Metered Customers: 5/8 X 3/4" 1", 1 -c1/2" 2" 2 - 1/2" 3" Other (Specify): 4" Unuttered Costo rs Total Customers Muter First of Year 943 2 2 0 949 Additions 350 4 0 1 0 356 Disconnects 0 4 0 Number End of Year 129 _S 0 1304 w-3 UTII.rIY W :Hamilton Western Utilities. Inc. SYSTEM NAME: PUMP2C AND PURCHASED WATER STATISTICS (a) January February Mardi April May June July WATER PURCHASED FOR RESALE (Quit 000's) (b) 1 WATER PUMPED FROM WELLS (Quit 000's) (c) August September October November Dece ter Total for year YEAR OF REPOR± I DUCEmBER 31, 19 87 I — I 12 015�{{ 28,5.64___ 2L5DL _ 1,140 —1 21,368 15Qfl 1JLFY._ 12.413 =FAL ?ATER PUMPED AND PURCHASED (Quit 000's) [(b)+(c)3 (d) 188,007 WATER SOLD TO CUSTOMERS (Quit 000's) (e) 121015_ 1 - rii27s_ _11.132D_-1 — 18Sfi4_ _uSnl_ I 18.,140_ _ 21 j _ .1 _?5.953_ 12.413' 188,007 1 _ 81576_ _I 7351— _I —I _I 1- 1,98.4_ _. • L4r4u__ _ 141852_ _ _ 151483_ _ _ 16.936— — _ 1%925— - - 1442$— — ' 10 055 135,818 If water is pud:ased for resale• indicate the following: Vendor N/A Point of delivery If water is sold to Other water utilities for redistributiah utilities below: N/A list names of such UTILITY NAME: Hamilton Western Utilities, Inc. Sh AME: WELLS AND WELL PUMPS 1 YEAR OF REPORT 1 DECEM9ER 31, 1931 I (a) Year Constructed 1986 Types of Well Canatruction and Casing Drilled (b) 1986 Drilled Depth of Wells $0'$0 Diameters of Wells 16"-_ —_ - - T6" — — Pup - GPM 1400 1400 Motor - HP 40 40 Yields of Welts in GPD L126,1009_ 1 J.U.SQO Auxiliary Power (c) - 1980 Gravel Wall r3Tr' NJ A 375 _ 31-i,QDQ _ (d) 1978 Gravel Wall 172' 12, 250 — 131>40l _ (e) I(f) 1975 119E Igcck Gravel Tubularthtl 120' 1375 12-_ N/A N/A N/A N/A N/A 10i,QRQ _ _ RESERVOIRS (a) Descripticn(steel,concrete or pneumatic) Steel Capacity of Tank 500,1)00 Ground cc Elevate3Ele_ated. (b) Steel 10_000_ • Ground (c) (d) (e) HIGH SERVICE PUMPIN3 Motors (a) (b) Manufacturer U.S. Electric Type/ _U.S. Horsepower 12r Pumps Manufacturer Layne _ - T',pe - _ Capacity in GPM 1400 _ Average Nurber-OrHours � �Operaatted. Per Dai+ _ Oil . uxiliarYPion U.S. Electric ---"--- _'a`e - - -'Gne_- (c) U.S. Electric _ Layne__ Lie_ _ Turbine (d) U.S. Electric Layne - Turbine_ _ 01- (e)& (f) Westin house -T5-- Layne _Turbine 0-5 W-5 Utility Name Hamilton Western Utilities, Inc. I YEAR OF I DECDSER 31, 19 87 SOURCE OF SUPPLY • IList for each source of supply: II I I IGa1s. per day of source& 365 060 • I I I IType of source I -- welts. . I I I TREATMENT FAEIL 177.ES List for each water treatment•facility: Tape I Pressure Filter )Cire1jusc 7lgcBg10i1 Make I - I: . Gals. per day capacity I 1400 GPM I 300GPM I Method of measurement I _Flow Metered I Flow Meterea ' arm ?ATER sysrni I FORlATION Furnish information below for eat system not physically connected with another facility. A separate page should be supplied where necessary. 1. Present ERC's * now being served T 2UQ 2. Present EEC's * that system can efficiently serve 3. Estimated annual increase in ERC' s * 4. List fire fighting facilities and capacities 1,063 250 N/A 5. List percent of certificated area we service correctionsare installed - 6. that is the current need for system upgrading arid% expansion? Back up Well 7. What are plans far future systemupgrading and/ar expansion? Another well producing1,500 GPM 6. Have questions 6 and 7 Eeen d�sc"ussed with an engin (if so, state.name and address)Yes,. Robert E. Curry & Associates, Inc. _ 1346—A7onZtcr 171511-7ieTa—TN-4bI5Er — — • * _ a (Total Gallons Sold / 365 days) / 350 Gallons Per Day • MILITY NAME: Hamilton Western Utilities, Inc. SEWER FUTILITY PLANT ACCOUNTS I YEAR OFTRE CES' I DEME' ER 31, 1987 Acte . No. (a) 1 Account name (b) 351 Organization 352 Franchises 353 Land and Lary Rights - - - 354 Structures and Improvements 360 Collection Sewers - Force 361 Collection Sewers - Gravity 362 Species Collecting Structures 363 Services to Customers 364_ Flow Measuring Devices - - 365 Flow Measuring Installations 370 Receiving Wells 371 Pumping Equipment 90 Treatment and Disposal-- - Equipnent 381 Plant Sewers 382 Outfall Sewer Lines 389 Other Plant and - - - - Miscellaneous Equipment - 390 Office Furniture'a d Equipment ---te 391 Transportation Equipment_ - 392 Stares Equipment 393 Tools, Shop and Garage Equipment- 394 laboratory Equipment • - - - 395 Power Operated Equipment - 396 Con municaticn Equipment — 397 Miscellaneous Equipment - - 398 Other Tangible Plant - - Total Sewer Plant Previous Year (c) $ 31,096 --17r,W7 ;4icr57 91,032 8,519 129,760 784 1,265 /7003 126 0 273,760 $ 2,192,375 Addition (d) $ -4-248 .5,250 3,325 250 5,463 19,688 ' $ 129,111 Retirements (e) Current Year (f) 311096 178,875 L6 X05 1,547,225 96,282 8,519 129,760 4,109 1,515 12,466 126 19,688 273,760 $ 2,321,485 5-1 UPIW•I' :Hamilton Western Utilities, Inc. ANALYSIS OF ACLUMU ATU) DF.PRECIAT1cN ISY PRIMARY AMAMI' - SEWER 1 YEAR On 1 1 DUMMER 31, 19 87 1 1 1 Acct. No. (a) 354 360 361 362 363 364 365 370 371 380 381 382 Account (b) Structures and Improvements Collection Sewers - Farce Collection Sewers - Gravity Special Collecting Structures Average Service Life in Years, (c) 50 —50 50 - 50 Average Salvage In Percent (d) Services to Customers — — Flow Measuring Devices Flow Measuring - — — iInstallations Receiving Hells Pumping Equiment Treatment and Dispceal Equipnnent Plant Sewers Outfall Sewer Lines 389 Other Plant and Miscellaneous Equipment 390 Office Furniture and — Equipment 391 Transportation EquTpnent 392 Stores Equipment 393 Tools, Stop and Garage Equipment Laboratory EquTpnent — — — Power Operated Equipment Communication Equipment Miscellaneous Equipment — — Other Tangible Plant — — — Totals 394 395 396 397 398 $ a $ Depr. Rate Red (e) 2.01 2.0% 2.0% 2.0% — 2.3a a 2.0 % 10.0% 20_33% 2.0 % 100% 2.0• % $ Accumulated Depreciation Balance Previous Year (f) 33,597 0 215, 175 3,520 9,319 83 476 11 53,736 $ 318,255 Debits (g) $ $ Credits (h) 3,577 181 30; 77-51 1,872 170 r sgs — 41 133 -• 2,881 3 _ Tr?— 'x,497 $ 47,301 Accumulated Depreciation Balance End of Year (i) $ 37,174 181 221.a3/0__ 5,392 1,361 --1T79r5 124 609 4,048 14 59,211 $ 365,556 UTILITY NAME:Hamilton Western Utilities, Inc. POMP= Da IPMLNI 1 YEAR OF REPORT 1 DE SER 31, 19 87 i Lift station number Make or type and nameplate - data of pump Year installed Rated capacity Size Power:. - Mechanical Nameplate data of motor Office 1987 2" 2 HP a PS Habig _ tlank .Barn _2 _ _3 _ Mtyst SID SP a 19sr — 2,r 11 HP F],ygb>` ' 1977 - 41r 31 HP H.C. Adios Pass SMC -_ 5_ _6 _ 1.5 _ SUS _ S115._ 4._ 1983 1987 1986 4.r 4,r ITP 57.4H—P lOHP 4,r SERVICE =SECTIONS Size (inches) Type (PVC,VCP,etc.)_ Average length Surber of active service connections .. . Beginning of year Added during year Retired during year _ _ — End of year Give full particulars oozi— cerning inactive 6"_ PVC PVC_ 3 191 a SP Se a SW PPM a Rai se SIP SO a COLLECT= AND FORE MAINS AND MAKES Size (inches) Collecting Mains 6 ' 8 110+12 15+18 2 Type of main Length of maintneareat foot): Begisuting of year Added during year Retired during,year End of year.. 218.813 218813 63.1682 13_6$2 52557 3,237 121557 .3172 PVC_ 2,298 :391 Force Mains 6" PVc 7Ake l i33 1533 4S82 4,381 1443 6" Ductile 1„575 51.3 Size Type Number: Beginning of year Added during year Retired during year — _ — — trd of year .N(@_ vrLLITY tY, :Hamilton Western Utilities. Inc. SEWER OPERATION AND MAINIMONCE EOFNSE 1 YEAR CT REPORT 1 DEM'LLR 31, 19 87 1 I Acct. No. 701 703 704 710 711 715 716 718 720 730 740 750 755 765 770 775 Account Name Salaries and Wages - Employees Salaries and Wages - Officers, -Directors, and Majority Stockholders _ Employee Pensions and Benefits Purchased Sewage Treatment Sludge Removal Expense Purchased Power Fuel for Pacer OFoluction Chemicals - Materials arta Supplies Contractual Services Rents Transportation Expense Insurance Expense Regulatory Commission Expenses Bad Debt Expense Miscellaneous Expenses Total Sewer Operation And Maintenance Expense Attrxa:t $ 36,693 29,500 2,002 82,030 9,946 13 394_645 63,135 36 n5.2,9 Q9 461 806 $ 264,776 SEWER a &1aiFIts Descriptiat/ Measured Service - - Oustaters By water Meter Size: 5/8 X 3/4"• 1 - 1/2" 2" 2 - 1/2" 3" Other (Specify): Unmetered Custossers Total Custaass Miter First of Year - 8 a_- 7 2 875 887 Additions Disconnects 209 217 0 0 2 L_ 3 Number End of Year 12 4 2 1084 • 1101 S-3 tTTII.ITY NAME: Hamilton Western Utilities, Inc. SYSTEM NAME: TREAT: err PLAtlr 1 YEAR OF REPOFC 1 DEER 31, 19 87 Manufacturer "$eel" oz. "Concrete"_ Total Capacity Average Daily Flow Effluent Disposal Total Gallons of Sewage Treated Fab CQ. _ _Siee.l _120..09.0 R<L - ScoIltiaSLwith 2ity of £ xrueL 251,51.4,DQ0L3tr_ 346,280 12& j7j SQQ Manufacturer Capacity Motor : Mfr. MASTER LIFT STATION PUNS A ABS 280 gpm ABS Horsepower _ _ Power (Electric or . Mechanical) I- is t1•P_ Sir ss CTHER SEYffR SYSTEM 1NFORKATION 1. Present number of FIiC's * being served _ _ _L2.Q1 2. Maximum number of ERC' s ° whi.d: can be _- t929 3. Estimated annual increase in ERC's * - 200 4. State any plans and estimated completion dates for any enlargements of this system 5. If present systems do.not meet present emir: mental requirements, submit submit the following: a. Evaluation of the present plant or plants in regard to meeting the requirements. j, L. flans. for Zzading and cont ntlat of the re -vire t•r';ng. c. When will construction begin?_ - _ I:: what percent of your certificated area have service connections been installed? 75 t • ERC . (total Gallons Treated / 365 days) / 275 Galin Per Day Note: Total Gallon Treated includes both sewage treated and purchased sewage treatment 5-5 CEFCIFiCai iCN State oft: --2)d; lf14 County of n'1` (-4),\ - 3e -(-f ray C. F4-e,nscn (None of affiant) he is , re re t Hakes oath and says that 11 Orkin_ L2, (Official title of affiant) of 411 m rkin_ S 'C.I i1 L'i t I T Ca1:Pr) G, (Exact legal title or name of respondent) that he/she has examined the foregoing report; that to the best of his knowledge, information, and belief, all statements of fact contained in the said report are true and the said report is a correct statement of the business affairs of the Above named res,.x;dent in respect to each and every matter set forth therein during the period from and including January 1, 19f/, to and including Deventer 31, 1997. Subscribed and sworn to before me, a WOT?iN /L/5 in and far the State and County named, this ./ it c , by commission expires 12 2teti C-1 7u Tf .; 19?Z... day of /tic zi (Signa e of th admi.nistax ) Hamilton Western Utility NAME OF UTILI'T'Y 1350 Greyhound Ct. STREET ADDRESS Carmel Indiana 46032 RECEIVED CITY, STATE & ZIP CODE MAY 0 1 1989 ACCOUNTING DIVIS:G;c INDIANA UTILITY REGULATORY COLaSION CLASS C PRIVATE WATER and/or SEWER UTILITY ANNUAL REPORT INDIANA UTILITY REGULATORY COMMISSION FOR THE YEAR ENDED DECEMBER 31, I9 OFFICER TO WHOM CORRESPONDENCE CONCERNING THIS REPORT SHOULD BE ADDRESSED: NAME loffray r Hancnn TITLE Ser/Treas. TELE. NO. 848-6882 ADDRESS 1350 Greyhound Ct. Carmel, IN 46032 GENERAL RULES FOR REPORTING I, This form shall De filled out in duplicate, with One copy returned to the Indiana Utility Regulatory Commission, 901 State Office Building, Indianapolis, Indiana 46204, by April 30, following the close of the year for which the report is made. Attention is specifically directed to the following provisions of the Public Service Act, effective May I, 1913, as amended to and including the Acts of 1933. The extra copy is to be retained by the utility. 2. 8-1-2-15. Records kept within state - Majorlty of directors to be residents - Each public utility shall have an Office in One (1) Of the towns or cities in this state in which its property or some part thereof is located, end shell keep in said office all books, accounts, papers, end records es shall be required by the commission to be kept within the state. No books, accounts, papers, or records required by the commission to be kept within the state shall be et any time removed from this stato, except upon such conditions as may be prescribed by the commission. A majority in number of the board of directors of each and every company or association organized under Indiana statutes end coming under the provisions of this chapter shall be bona fide residents and citizens of the state of Indiana while acting es such directors, 3. 8-1-2-16. Closing accounts -Date - The accounts shell be closed annually on the thirty-first day of December, and a balance sheet Of that data promptly taken therefrom. On or before the thirtieth day of April following, such balance sheet, together with such other information as the commission shall prescribe, verified Dy en officer of the public utility, shall be filed with the Commission. 4. 8-1-2-52. information to be furnished - Every public utility shall furnish to the commission all Information required by It to carry into effect the provisions of this chapter and shall make specific answers to all Questions submitted by the commission, 5. 8-1-2-108. Penalty for failure to file reports or give information - Annual reports of municipallybwned utilities - Examination by State Board of Accounts - (a) An officer, agent or a public utility, es defined in this chanter who (1) Falls to fill out and return any blanks as required by this chapter; (2) Fails to answer any question therein propounded; (3) Knowingly gives a false answer to any such question or evades the answer to any such question where the fact inquired of is within his knowledge; (4) Fails, upon proper demand, to exhibit to the =omission, any commissioner, any administrative law judge or any person authorized to examine the same, any book, paper, account, record or memoranda of the public utility which is in his possession or under his control; (5) Fails to keep his system of accounting, Or any pert thereof, which i5 required by the commission; or (61 Refuses to do any act or thing in connection with the system of accounts when so directed by the commission or its authorized representative; commits a Class 8 infraction. (b) A municipallybwned and operated utility shall file with the commission an annual report of the operation of said plant on forms to be furnished by the commission, which forms are to be substantially the same as for reports filed annually with the commission by Public utilities. Such annual reports shall remain in the office of said commission as a public record; however, whenever in this chapter public utilities are required t0 make reports to the Indiana Utility Regulatory Commission or are otherwise subject to the commission, municipally -owned utilities are exempted from making such reports and are not under the jurisdiction of the commission except es otherwise provided. (c) The state board of accounts shall examine all accounts of every municipally -owned and operated utility at least One each year. On every such examination, inquiry shall be made as to the financial condition and resources of such municipal utility, whether the laws of the state have been complied with, and into the methods and accuracy of the accounts and reports of the utilities examined. Such examination shall be without notice, and the cost of such examination shall be paid out of the funds of the utility. 6. 8-1-2-112. Separate violations - Every day during which any public utility or any officer, agent, or employee thereof shall fall to observe and comply with any order or direction of the commission, or to perform any duty enjoined by this chapter, shall constitute a separate and distinct violation of such order or direction of this chapter, as the case may be. PERSONNEL DATA Please fill in the following information: 1. Number of full-time employees 6 2. Number of part-time employees 3 3. Number of union employees Please complete the following information. Column A employees in that salary range. Column B. is the tota paid to those employees In that pay category. Column cost for fringe benefits for employees in that salary is the number' of 1 gross dollar amount C is the total dollar range: Salary Range No. Of Em lo ees Salary Cost Of Benefits -Col. A Col. B Col. C 200,000 + 190,001 - 200,000 180,001 - 90,000 170,001 - 180,000 160,001 - 170,000 150,001 - 160,000 140,001 -,150,000 130,001 - 140,000 120,000 - 130,000 110,001 - 120,000 100,001 - 110,000 90,001 - 100,000 80,001 - 90,000 70,001 - 80,000 60,001 - 70 000 50,001 - 6000 40,001 - 50,000 30,001 - 40,000 20,001 - 30,000 1 28,185.63 10,001 - 20,M0 5 71,182.18 10,000 - 0 3 6,425.00 This information is requested pursuant to I.C. 8-1-2-48 1. Payments to Counsel: Names Legal Matter (s) for Which Pald Kunz and Kunz FORM JAL Total Pald Various 42,578.11 2. Payments to Consultants: Names Description of Services K.B. Parrish and Co. Robert Curry & Assoc. Total Paid Accounting 17,738.00 Engineering 7,711.50 3. Contributions of Offlceseekers and/or Political Committees: Names of Payees With Whom Registered (Fed. or State] Total Paid " Consultant" for the purpose of this form (JAI) means a person in a status other than that of employee, paid to render service, advice, or information, and/or to. lobby or represent the payer before any agency or branch of government. "Consultant' does not mean, in thls context, any person or firm to whom payment has been made and which has been reported under part one of this form, dealing with legal counsel. If a person has received payment both as a'"consultant" and as an employee, reporting herein shall include both types of payment, and the totals of each. There 1s no minimum for 'Total Paid" under which reporting need not be made. This Information 1s requested pursuant to I.C. 84-2-26. TABLE OF Cr&t 'TS Financial Section Page Identification F-2 Inc ne Statement F-3 Balance Sheet F-4 Net Utility Plant F-5 Accumulated Depreciation and Amortization of Utility Plant F-5 Capital Stock F-6 Retained Earnings F-6 Proprietary Capital F-6 Long Tenn Debt F-6 Taxes Accred F-7 Payments For Services Rendered By Other Than Employees F-7 Contributions In Aid Of Construction F-8 Water Operating Section Page Water Utility Plant Accounts W-1 Analysis of Accumulated Depreciation By Primary Account - Water W-2 Water Operation and Maintenance Expense W-3 Water Customers W-3 Purging and Purchased Water Statistics W-4 Wells and Well Pump, Reservoirs, and High Service Pumping W-5 Other Water System Informatics w-6 Sewer Operating Section Page Sewer Utility Plant Accounts S-1 Analysis of Accumulated Depreciation By Primary Account - Sewer S-2 Sewer Operation and Maintenance Expense S-3 Sewer Costas rs S-3 Pumping Equipment, Collecting and Farce Mains and Manholes S-4 Other Sewer System Infounation S-5 Certification Section Page Certif icaticn C-1 F-1 REPORT OF Hamilton Western Utility, Inc. (Exact name of utility) 1350 Greyhound Ct. Carmel, IN 46032 Hamilton County (Address) For Year Ended IgAR Date Utility First 0rganized:8-4-69 Telephone Number 848-6882 Location where books and records are located: (county) 1350 Greyhound Ct. Carmel, IN 46032 Contacts: Name Person to send correspondence: JeffreLC. Henson Person who prepared this report: Title �e�1Tse3ss--- Principal Business Address ,135.0_GLey)wuwLCL. Carmel., IN 46032 Officers and Managers: Raxmond J. Panke President Ralph L. Wilfonf II Executive V.Pres. Paul L. Wilfong_ -1 VP & Operating Mgi. JeffreLC. Henson Sec./Treasurer Willis K. Kunz Asst. Sec. Salary Charged Utility )OOOQOOQOQ. )OOOOQOCIJOOC $ _36,9.00_ _ _ $ _ _ $ _Z40a___ $--0'--- Report every corporation cc person owning or holding directly or indirectly 5 percent or more of the voting securities of the reporting utility: Ral2h L. Wilfou Percent C‘mership In Utility 100% Principal Business Address Salary Charged Utility F-2 Hamilton Western Utilities, Inc. INCfl STATECT: 1 YE. AR CL 1 DEO 3ER 31, 1988 1 Account Name Ref • Page No. Gross Revenue: Residential Cacmercial industrial Multiple Family Guaranteed Revenues Other (Specify) forfeited i(scoimt� inspection fee Total Gross Revenue - - - Operation Expense Depreciation Expense_ - - - Amortization Expense - - - Taxes Other Than Income - - Inane Taxes Total Operating Expense - 1'Net Operating Inoine (Loss) Other Inane: Na>,utility Inoane Interest Earner Other Deductions: Miscellaneous Ncnutility Expenses Interest Expense Anoint of debt discount dental operations Net Inane (Loma) W-3 S-3 F-5 F-7 F-7 Water $ 432,420 36,678 0 0 0 1,743 5, 675 $ 476,516 321,045 64,230 3,307 56,030 0 $ 444,612 $ 31,904 $ $ $ 31,904 Sewer $ 4641531 231999 0 0 0 1,870 0 $ 490,400 $ 3451998 51a448 17s 143 37,279 0 $ 451,868 $ 38,532 $ $ 38,532 Combined Other $ 4,303 1581505 131038 1,635 $ (168,875) Total C'pany _$.93951- _ _6Q X677_ 0 0 0 3,613 5,675 $ 966,916 $ 667,043 115,678 20,450 93,309 0 $ 896,480 $ 70,436 5 4,303 158,505 13,038 1,635 $ (98 439) F-3 UTILITY NAME: Hamilton Western Utilities Inc. COMPARATIVE BALANCE si r 1 YEAR OF REPORT 1 DECEMBER 31, 19 88 1 1 Account Name Assets: Utility Plant In Service (101-105) Accumulated Depreciation and Amortization (108) Net Utility Plant Cash Custaner Accounts Receivable (141) Other Assets (Specify)_DUier_Accmut.s3eceivalaie_- - - - Ilater-als anthstpplths - - - Prepacents. - - - .NoritilitY prc by - - - .Dgfe[red_cbarges Total Assets Liabilities And Capital: Canrcn Stack Issued (201) Preferred Stock Iased (2041 Other Paid In Capital (211) Retained Earnings (215) Proprietary capital (Proprietary and partnership ally) (218) total capital Lc g -Term Debt (224) Accounts Payable (231) Notes Payable (232) Customer Deposits (2551 Accrued Taxes (236) Other Liabilities (Specify/ Interest — —Enp o eE heue�i.Ls Sa] acx and iLage4 Advances For Construct -ton Cattributions In Aid Of Construction - Net (271-272) Total Liabilities And Capital Reference Page F -5,W -1,S-1 F -5,W -2,S-3 F-6 F-6 F-6 F-6 F-6 F-7 Current Year $ 6,653,017 765.249 $ X2_887.768 —_ 17.040 64 ,84 1 43.574 --_8.598 _2.642 33_2492 235,807 $ 6,293,762 $ __ 22_120 0 5852_194 (9672_702) $ (380,388) $ 1,4962_216 22,516 892_160 79,059 5,218 70,647 371 798 0 4,910,165 $6,293,762 Previous Year $ 6,248,752 652,841 $ 51595,911 __175849 65,901 _ _14 I 206 1649 —__1682 —41,030 271,146 $6,303,374 $ 2,120 0 585,194 (869,262) $ (281,948) $1_625,036_ 38,887 0 47,300 62,109 5,364 163,866 0 0 25,650 4,617,110 $6,303,374 F-4 UTILITY NAME: Hamilton Western Utilities Inc. NET UTILITY PLANT 1 YEAR OF REPORT l DECEMBER 31, 19&8 7 Plant Accounts: (101-107) Inclusive Water Utility Plant In Service (101) Construction Work In Progress (105) $ 4=196,714 Other .(Specify) Acquisition adjustment Total Utility Plant $ 4,196,714 Sewer $ 2 2_4 1 71609 1,.168 $ 2,418,777 W & S Other Than Reporting Systems 372_526 37,526 Total $ 6,6143_23 1168 37526 $ 6 653,017 AOCUMJIATED DEPRDCIATICN AND AMORTIZATION OF UTILITY PLANT Account 108 Water Balance First Of Year $ 287,285 Credits During Year: Accruals charged to depreciation accamt $ - 64_, 230 Salvage - Other credits (specify) Total credits Debits During Year: Bode cost of plant - retired $ 64,230 $ Chet of reanval _ Other debits (speciiyT Total debits A/D 1,635 Balance End Of Year $ 1,635 -I$ 344 Sewer $ 365,556 $ 51,449 51,449 W & S Other Than Reporting Systems 0 1,636 $ 1,636 $ $ 415.369 Total $ 652,841 $ 1151679 $ 115,679 $ 32_271 $ 3,271 765.249 F-5 UTILITY NAME: Hamilton Western Utilities, Inc. CAPITAL STOCK ( 201 — 204 ) 1 1Par or stated value per share !Shares authorized 1Shares issued and outstanding 1Total par value of stock issued 1Dividends declared per share for year 1 YEAR OF REPORT I DECEMBER 31, 198,s Cacti= 1 Preferrec Stock 1 Suck 142_1 142_ .211211 - RETAINED FARNZ*7Gs ( 215 ) Balance first of year - Changes during the year TspecifyT: Balance end of year Appropriated Un - Appropriated $ S$6s 2631 S _98,� 391 $ (967,702) PROPRIETARY CAPITAL ( 218 ) Balance first of year - Changes during the year Tspeci.fyf: Balance end of year Proprietor Or Partner Partner tar TSRM rem ( 224 ) Description of Obligation ( Including Naninal Date of Issue and Date of Maturity ) 10-1-83 Mast Le_T9WJ1-(LIS atfiaLd=_due_10=La- S9-- 6 - 23 - 86 M0-142 & = -TQwst 3+ e ifi el i - 11 ue 3= 3-23-84 fe-isY- Qf_C.a>;meL-0- Total Interest Rate I Pymte 10%I S 5-70-1—c)tly b'9 I Mo Principal Per Balance Sheet Date 2001000 (_27010_00 _ 761 216 $ 1.496.716 F-6 CITY NN €: Hamilton Western Utilities Inc. TAXES ACCRUED ( 236 ) YEAR OF R._FPOPT 1 DEXX.En3ER 31, 19 88 1 (a) 5 Balance first of year — — - Accruals charged: State ad valorem tax_ Fzral property tax_ Federal income tax State imam tax — — — Regulatory assessment fee Other (Specify) Sales Payroll Total Taxes Accrued Taxes Paid: State ad valorem tax — — Frral property tax — — - Federal income tax State iron tax — — — Regulatory assessment fee Other (Specify) Total Taxes Paid Balance end of year — — — — Water (b) $ 37,300 51,797 $ 51,797 41,482 41,482 47,615 Sewer (c) $ 23.200 $ 331040 33,040 253805 Other (d) 1,609 _.-419)— ( 181) $ ( 600) Total (e) $ 62.109 — — 4 1_9)_ ( 181) 67,287 25,805 30,435 1,009 $ 79,059 PAYM NIS FOR SERVICES RENDERED BY OTHER THAN EMPLOYEES Report all information concerning rate, management, construction, advertising, labor relations, public relations, or other similar professional services rendered the respondent for which aggregate payments during the year to any corporation, partnership, individual, on organization of any kind whatever, amounting to $500 or more. Nacre of Recipient Kunz and Kunz 1 Mount Is _ ____ 1$ -t Frarrrsr am ro 1$ 1$ itaymond—I'anre 1$ I$ -1271171-Wil ring 1$ I$ 1$ I$ I$ I$ Description of Service Legal Services Financial statements and tax returns Director Fee Consulting_and water rights lease F-7 UTILITY NWT: Hamilton Western Utilities Tnc. CONTRIBUTIONS IN AID OF CONSTRUCTION ( 271 ) I YEAR OF REPORT I DECEMBER 31, 1988 1 (a) Balance first of year Add credits during year Water (b) $ 2,214,117 $ 285,899 Total Deduct dharges during year ysexal_jncama La 4.118.,90.7) - Balance 18,90.71 - Balance end of year Less Accumulated Amortization Net CIAC $ 2,381,109 Sewer (c) $ 2,402,993 $ 218,661 Total (d) $ 4,617,110 $ 504,560 C211,505) $ 2,529,056 $ 4,910,165 ADDITIONS TO CONTRIBUTIONS IN AID OF CONSTRUCTION DURING YEAR (CREDITS) Report below all developers or contractors agreements fzzm which ash or property was received during the year. Our Lam of Mt Carmel LhIcsja Indicate "Cash" or "Property" Sub -total Report below all capacity charges, main extension charges and customer connections ,charges recieved during the year. Description of O3urge Connection fees tl Main egt—feP_ _ _ _ „ 11 Nimes of Connections ID 2— _ti Charge Per Commotion Total Credits During Year Water 10,263 $ 10,263 Ia4.-8a5_ 210..75 L_ $ 285,899 Sewer _l bbr79.1— $ 218,661 F-8 UTILITY NAME: Hamilton Western Utilities Inc. WATER UTILITY PLANT AC71JNTS 1 YEAR OF REPORT 1 DECEMBER 31, 19 88 1 Acct. No. (a) Account Name (b) 301 Organization 302 Franchises 303 Land and Land Rights__ — — 304 Structures and Iaprovets 305 Collecting and Impourriirg Reservoirs 306 Lake River and Other Intakes 307 Wells and Springs 308 Infiltration Galleries and Tunnels 309 Supply Mains 310 Pacer Generation Equipment 311 Pumping Equipment 10 Water Treatment Equipment - - 40 Distribution Reservoirs and Standpipes 331 Transmission and Distribution Mains — — — 333 Services 334 Meters and Meter Installations 335 Hydrants 339 Other Plant anis Miscellaneous Equipment 340 Office Furniture and 341 Transportation Equipment 342 Stores Equipment' 343 Tools, Shop and Garage 344 345 346 347 348 Previous Year (c) $ -$3,485 - T5S 053 TOC, n5 rir,7o6 — 8717 9- -.434,002- 398,097 1,277,032 16!281 106,850 2,574 1,834 T2,-477 Additions (d) $ 21206 34 759 1011717 36,603 1,295 38,535 78;237 49,455 7,956 4,893 Retirements (e) Lab t� > — power Operated Equipneart - Communication Equipment — - Miscellaneous Equipment — - Other Tangible Plant — — — Total Water Plant $ 3,883,490 $ 3115,6676 L,452 $ 2,452 Current Year (f) —_83485_ _ 15fi,25s _ — 23H,saa _ 1,214,&.12 _ 95.,$02 L31,9102 _ 399,392. — 1,315,561 — __5 156_, 395_ _1(1,131 _ _fiZ2Z_ JQ_QJ4_ _ $ 4,196,714 W-1 UTILITY!w.t: Hamilton Western utilities. Iuc. WATER OPERATION AND MAINTENANCE EXPENSE 1 YEAR OF R«ORT 1 DECEMBER 31, 19_22 1 1 Acct. No. 601 603 604 610 615 616 618 620 630 640 650 655 665 670 675 Account Name Salaries and Wages - Employees Salaries and wages - Officers, Directors, and Majority Stockholders Employee Pensions and Benefits Purchased Water Purchased Power Fuel for Power Production Chemicals Materials and Supplies Contractual Services 272i21.1 6951 2s604; 37,250 Rents Transportation Expense Insurance Expense Regulatory Oomission Expenses Bad Debt Expense Miscellaneous Expenses Total Water Operation And Maintenance Expense - Amount $ 47,135 — _31 .3 4_0_ — - _59 .D4.0_ — _23 ..6116_ _ _1_0 — _5_5 ,_1Z2_ __61,970_ — -_94_08 _ 4687 --SQ1 — _ _3Q 4 3.572 $ 321,045 WATER C USP:MERS Description Metered Customers: 5/8 X 3/4" 1 1 - 1/2" 2w 2 - 1/2" 3" Other (Specify): Urretered Customers Total Customers Number First of Year 1,293 6 1 3 0 1,304 Additions 246 1 1 1 Disconnects 0 1 Number Erxi of Year 1,539 7 2 3 2 1 0 251 1 1,554 W-3 UTILITY NAME: Hamilton Western Utilities, Inc. SYSTEM NAME: PUMPING AND PURCHASED WATER STATISTICS 1 YEAR OF REPORT 1 1 DECEMRFR 31, 19 gg 1 (a) January February March WATER PURCHASED FOR RESALE (Omit 000's) (b) WATER PUllID FROM WEBS (Omit 000's) (c) 14,496 TUTAL WATER PUMPED AND PURCHASED (Omit 000's) [(b)+(c)] (d) 14,496 WATER SOLD TO CUSTOMERS (Quit 000's) (e) 9,607 12,903 12,903 8,592 April May 14,155 15,862 14,155 15,862 10,109 10,468 36,220 36,220 30,659 June July August 50,417 50,417 42,175 42,175 39,46T T6,267 40,397 40,397 33,622 September October 22,316 22,316 331554 18,500 18,500 13,527 November December 14,445 14,445 114973 Total for year 16,411 298.297 16,411 298.297 9,944 227.776 If water is puchased for resale. indicate the following: Vendor N/A Point of delivery , If water is sold to other water utilities for redistribution, list nanes of such utilities below: N/A UTILITY N71E: Hamilton Western Utilities, Inc. SYSTEM NAM! J : WELLS AND WELL PUMPS I YEAR OF REPORT I DDCE248ER 31, 1988 (a) Year Ccnstructed 1987 Types of Well Construction and Casing Drilled Steel (b) 1986 Drilled Steel Depth of Wells 80' 80' Diameters of Wells_ 16" 16" Pimp - GPM 1400 1400 Motor - HP 40 40 Yields of Wells in GPD 1176,0b0 _L2176,000 Auxiliary Power (c) 1986 Drilled Steel 80' 16" 1400 40 (d) 1980 Gravel Wal 131' (e)* __13.73_ Qrelej Wa 123' 12" ___2s_0_ 1.176.000 _115�04Q_ _2.31,449_ RESERVOIRS *continued on additional page (a) I Description(steel,concrete or pneumatic) _ Qty el _ Capacity of Tank 544, Q.oQ I Ground or Elevated E Is y_as e (b) --S-tSel_ 159 ._oQo _ — firstlP d. (c) (d) (e) HIGH SERVICE PUMPUG Motors (a) Manufacturer y �•_Fi,ec(sic Rated . Horsepower Pulps Manufacturer _ _ Layne _ _ Type _ _ Turbine Capacity in GPM 1400 _ Average Number Of' Hours Operated Per Day _ (2,t _ Auxiliary Parer (b) Layne Turbine 700 5 (c) 1_$_ E1&Strio — — Ry 75 Layne Turbine 700 5 (d) 1 (e)&f 11 •�. •_ELe&tri AU 30 _ Layne Turbine 0.1 Wgssi�gbousg AU 15 _ Layne Turbi ne 300 0.5 W-5 UTILITY NAME: SYSTEM NAM!: Hamilton Western Utilities, Inc. WAIS AND WELL PUMPS 1 YEAR OF REPORT I 1 DECE2-TWR 31, 19 8 8 1 I I (A) Year Constructed Types of Well Construction and Casing Depth of Wells Diameters of Wells Pump - GPM Motor - HP Yields of Wells in GPD Auxiliary Power (f) 1975 Gravel Tubular 120' 12" N/A N/A 105,000 ( (9) 1960 Rock Tubular -3,S r N/A N/A N/A 63,000 (d) (e) RESERVOIRS (a) I Descripticn(steel,concrete or pneumatic) _ Capacity of Tank I Ground or Elevated (b) (c) (d) (e) HIGH SERVICE PIMPING Motors (a) Manufacturer Type Rated Horsepower Ptn:pe Manufacturer Type Capacity 1n GPM Average Nurtber OfEiours Operated Per Day — — — — Auxiliary Power (b) (c) (d) (e) i1-5 Utility Name Hamilton Western Utilities, Inc. SOURCE OF SUPPLY List for each source of supply: Gals. per day of source) Type of source 1 1 798,521 1 YEAR OF REPORT ( I DECE1•'SER 31, 19_a81 1 1 1 18,732 1 1 WELLS WELLS WATER TREATMENT FACILITIES List for each water treatment facility: Type 1 Pressure Filter I gruel Ii1tec.L ca kemoyal Make 1 1 Gals. per day capacity 1 1400 GPM I 3Q0 UM I Method of measurement 1 Fiow Metered 1 JEJpc_ Met,Prac!` _ OTHER WATER SYSTEM INFORMATION Furnish information below for each system not physically connected with another facility. A separate page should be supplied Where necessary. 1. Present FTC's * now being served 2,335 2. Present EPC's * that system can efficiently serve 4,200 3. Estimated annual increase in ERC's * 250 4. List fire fighting facilities and capacities N/A 5. List percent of certificated area where service Ccnnectia!s are installed N/A 6. What is the current neer] far system upgrading and7or expansion? 7. What are plans for future system wading and% expansion? 8. Have questions 6 and `l bsen discussed with an engineer • (if so, state name and address) * FRC r (Total Gallons Sold / 365 days) / 350 Gallons Per Day trI'I 1.1'IY 1^nisi i nn Wntirnrn 1!r i1ir1es Inc ANALYSIS OF AOCUMIUITED DEPRECIATIctJ BY PRIMARY AOCUNt - SEWER 1 YE' 2uoRr I 1 DECEP_ . 31, 19 88 I Acct. No. (a) 354 360 361 362 363 364 365 370 371 380 381 382 389 390 391 392 393 394 395 396 397 398 Account (b) Structures and Inmprovanents Collection Sewers - Force Collection Sewers - Gravity Special Collecting Structures Average Average Service Salvage Life in In Years Percent (c) (d) _5_0_ — _0- - 5-0— _5_0_ Services to Custarers _ _ — Flow Measuring Devices_ _ _ Flow Measuring Installations 5_0 — 5_0_ _5_0_ Receiving Wells Pumping Equipment Treatment and Disposal Equipment Plant Sewers ,_0 Outfall Sewer Lines _ _ _ _ Other Plant and Miscellaneous Equipment _ Office Furniture and Equipment Transportation Equipment _ Stores Equipment Tools, Stop and Garage Equipment 50 10 3-5 50 Laboratory Equipment_ — Power Operated Equipment _ Camunicaticn Equipment _ _ Miscellaneous Equipment _ _ Other Tangible Plant Totals 10 - 50 8 8 Depr. Rate Applied (e) _ _2 _ 8 __2_8 _.2_ 8 ___8 _ 2_8 2 % -- 8 2 % 2 % Accumulated Depreciation Balance Previous Year (f) $ _ _37.174 181 245 330 5.392 0 1.361 11.915 124 609 14 --59-2'Tr $ 365,556 1 Debits (9) $ 3,577 361 31,587 1,926 255 170 2,596 Credits (h) $ 99 390 --T,an- 25 $ 51,449 --"T76T6- 1,636 Accumulated Depreciation Balance End of Year (i) $ __40.751 542 _ 276.917 —_ 7.318 255 _W..53 1 14,511 223 999 _--5-43r 39 --64-6 6- $ 415,369 Hamilton Western Utilities Inc. L'flLITY NAME: SEWER UTILITY PLANE ACCOUNTS I YEAR OF REPORT I DECD DER 31, 19 88 1 Acct. No. (a) 351 352 353 354 360 361 362 363 364 365 370 371 180 381 382 389 390 391 392 393 394 395 396 397 398 Account name (b) Organization Franchises Lard and Land Rights - - - Structures and Innpzwements Collection Sewers - Force Collection Sewers - Gravity Special Collecting Structures Services to Customers Flow Measuring Devices_ - - Flow Measuring Installations Receiving Wells Pumping Equipment Treatment and Disposal Equipment Plant Sewers Outfall Sewer Lines Other Plant and - - - - Miscellaneous Equipment - Office Furniture and Equipment _ Transportation Equipment - Stores Equipment Tools, Shap and Garage Equipment Laboratory Equipment - - - Power Operated Equipment - CoMmunication Equipment Miscellaneous Equipment Other Tangible Plant__ Total Sewer Plant Previous Year (c) 1 - - 9- I 2 -9 -J -§ _ 12 -9 -Ji 4- — — _I s5 1 5 -- 12..4.¢6 Additions (d) _ _bS,.206_ Retirements (e) $ -_1�4S.Z Current Year (f) $ _ ll 8,H 75 _ _ 6.,282_ 25,S2D_ 8.,5 L9_ - L23,26.D_ __5_,839_ 191688 273.760 $ 2,321,486 2,2 28 98,575 $ 2,452 __2,352_ _J2,588_ 773 760 $ 2,417,609 S-1 UTILITY tNAMiE: Hamilton Western Utilities, Inc. SEWER OPERATION AND MAINTENANCE EXPENSE 1 YEAR OF REPORT I 1 DECE'3ER 31, 1988 I No. 701 703 704 710 711 715 716 718 720 730 740 750 755 765 770 775 Account Name Salaries and wages - Employees Salaries and Wages - Officers, Directors, and Majority Stockholders _ Employee Pensions and Benefits Purchased Sewage Treatment Sludge Removal Expense Purchased Power Fuel for Power Production Chemicals Materials and Supplies Contractual Services Rents Transportation Expense Insurance Expense Regulatory CI:mission Expenses Bad Debt Expense Miscellaneous Expenses Total Sewer Operation And Maintenance Expense Amount $ 51,395 37,900 3,740 98,918 9.880 328 61,487 77,055 457 456 476 709 3,197 $ 345,998 SS1E2 CJSIOMERS Description Measured Service Customers By water Meter Size: 5/8 X 3/4" 1" 1 - 1/2" 2" 2 - 1/2" 3" Other (Specify): Unmetered Customers Total C ustaners Number First of Year 12 4 0 1 1084 1101 Additions 165 165 Disconnects 1 1 Number End of Year 12 4 0 0 1249 1265 5-3 UTILITY NAME: Hamilton Western Utilities, Inc. PUMPING EQUIPMESTT 1 YEAR OF REPORT 1 DECEMBER 31, 19 88 Lift station number Make or type and nameplate data of pimp Year installed Rated capacity Site Paver: Electric Mechanical Nameplate data of motor — Office 1 Flyght 1987 2" 2 HP Habig 2 Meyers 1982 2" 1' HP Tank Barn 3 Flyght 1977 4" 34 HP H.C. 4 ABS 1983 4" 31 HP Adios Pass' SMC 5 6 ABS 1 ABS 1987 1 1986 —4" 4" 5.4 HP 1 10 HP SERVICE CCNNECTIC S Size (inches) Type (PVC,VCP,etc.)_ Average length — — — _ _ Number of active service connections Beginning of year Added during year Retired during year — — — End of year Give full particulars cons earning - earning inactive OQYfectims 6" —Ince 13' 1265 1101 165 1 164 COLLETING AND FORCE MAINS AND MANHOLES Size (ind:es) Type of rain Length of mainTnearest foot): Beginning of year Added during year Retired during year — End of year Collecting Mains 6 8 110 6 12 15 & LP 2 PVC Force Mains 4 6 PVC PVC 6 ti14 218,813 • 2181813 63,682 63L682 52,557 nn 531_397 3,937 3`937 2,398 2,398 1,533 1,533 8,463 1,575 8,463 57 Manholes Size Type Number: Beginning of year Adder] during year N/A Retired during year — — — — End of year UTILITY NAME: Hamilton Western Utilities, Inc. PUKING EQUIPMENT 1 YEAR OF DEPORT 1 DEER 31, 1988 Lift station nurber _ Make or type and nameplate data of pulp Year installed Rated capacity Size Power: Electric Mechanical Nameplate data of motor C.C.W.S. 7 Flyght 7976- 4" 976 4" 3%HP C.C.E.S. t. Carmel g 9 ABS APS 79E7— — 1'963 4" 5.4 HP 4" 10 HP SERVICE CCNNE TIONS Size (inches) Type (PVC,VCP,etc.)— Average length _ _ _ T _ _ Number of active service ccnnectirna ' Beginning of year Added during year Retired during year _ — _ End of year Give full particulars con- cerning inactive connections C I LILTING AND FORCE MAINS AND MANHOLES Size (inches) Type of main Length of maintnearest foot): Beginning of year Added during year Retired during year End of year Coll Mains Force Mains Manholes ,e 'IYpe Number: Beginning of year Added during year Retired during year — — — — End of year UTILITY NAME: Hamilton Western Utilities, Inc. SYSTE11 NAME: TREATr¶fl T PLAITT 1 YEAR OF REPORT I DECEBER 31, 19 83 Manufacturer Type "Steel" or "Concrete" Total Capacity Average Daily Flow Effluent Disposal Total Gallons of Sewage Treated Fab Co. Contract with City of Carmel Steel 100,000 gid 257,510,000/yr 419,000 152,937,700 MASTER LIFT STATION PUMPS 8 Manufacturer Capacity Motor . Mfr. Horsepower — — Power (Electric or Mechanical) E SSSS mom SEWER SYSTEM INFORMATION 1. Present number of FIiC's * being served 1524 2. Maximum number of ERC's * whidl can be 2929 3. Estimated annual increase in ERC's * 200 4. State any plans arra estimated completion dates for any enlargements of this system 5. If present systems do not meet present enviraw ental requirements, submit submit the following: a. Evaluation of the present plant or plants in regard to meeting the requirements. b. Plans for funding and construction of the required upgrading. C. When will construction begin? — — — 7.' In what percent of your certificd aaterea have service connections been installed? 80 % * ERC • (Total Gallons Treated / 365 days) / 275 Gallons Per Day Note: Total Gallons Treated includes both sewage treated and purdiased sewage treatment S-5 State of _ -both n.. County of 1-1-Qnl`(-ioh r-c.y G • H-t-let-scn (Name of affiant) CER 1YICA ION makes oath and says that he is S'eu'-c,kr, 7r - (Official title of affiant) of ( 4D vi U -(t'(: (Exact legal title or name of respondent) that he/she has examined the foregoing report; that to the best of his knowledge, information, and belief, all statements of fact contained in the said report are true and the said report is a correct statement of the business affairs of the above named rese-ndent in respect to each and every matter set forth therein IP during the period from and including January 1, 19e2"4 to and including December 31, 19. ignature of affiant) Subscribed and sworn to before me, a „ trio ry 1 a b ( c_ in and for the State and County named, this 02$ I- r , 199. 11y omission expires L'Ni:n D NOTARY PuD..UC c 7e.1q AMI T(* :.'.•u_. TTY Fd: rCF. 6.•'"kD2 19, 0-1 day of '(Signature of oath administer)