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. Deceased
BEcnEE OF !>IWIlATE AND GI{ANT ()Io' LETTEI{S
ANII NO\\' __.. MAY 9. 1'/. 9~.. ill ,:<""ideralillllllf Ihe pCliliollllll
lhe fen,'['l' ,ide IH.'reol. \;lli,rilclory )lIllOI' ha\-in~ heen prC\l'lItl'U "dole me,
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dc!'tl.'rihcd thcn'in he admitted 10 prohilll' ami fih.'u '1f Ic('oul ~l'., l11l' 1""1 \,,'ill uf --~--
CARL A DAHLSTROM
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JAI~ES C MOONEY
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MARY C. LEWIS
FEES
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Mailed letters and order to Executor on 5-9-96.
21 - 96 - 378
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L~ST WILL AND TESTAMENT
OF
CARL A. DAHLSTROM
I, CARL A. DAHLSTROM, of 52 Greenmont Drive, Enola, Cumberland
County, PA 17025, declare this to be my Last will and Testament,
hereby revoking all prior Wills and Codicils.
ITEM I. I direct that the expenses of my last illness and
funeral shall be paid from the funds of my estate.
ITEM II. I give, oevise and bequeath all of my property, both
real and personal, cf every nature and wherever situate as follows:
First, I give, devise and bequeath my coin collection equally
to Richard John Mooney, Robert Edward Mooney, James Carl Mooney and
Patricia Carol Dicke, now or formerly of the addresses listed
below. If the parti.es cannot agree on distribution, then I direct
my executor to set value of the collection or parts thereof, or
make distribution in whole or in part, including making
distribution of tho entire collection to one or more of the above
and adjust accordin~ly those persons' shares of the residuary of my
estate.
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Second, I give thE rest, residue, and residuary of my estate
as follows:
A. Nineteen (19%) to my sister, Alice D. Mooney, 756
Arlingtcn Ro;d, Camp Hill, PA
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Ten perce lit (10%) to Richard John Mooney, 2552 Neff Lane,
Salt Lak~ city, utah 84109;
C. Ten percnnt (10%) to Robert Edward Mooney, 12700 Etris,
Roswell. .:;A 30075;
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Ten percfmt (10%) to James Carl Mooney, 1720 Orrs Bridge
Road, Enola, PA 17025;
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E. Ten percent (10%) to Patricia Carol Dicke, 15 Blackberry
Lane, Huntington, New York 11743;
F. Four perc:ent (4%) to Carolyn Gale, 23 Oak Terrace,
Kittery, Maine 03904;
G. Four percent (4%) to Dorothy Jane Wurman, 29 B Eastbrook
Heights, i1ansfield, CT 06250;
H. Four percent (4%) to Sandra Leonard, P. O. Box 357,
Brooklin, ME 04616;
I. Four percent (4%) to Calvin Horsman, 149 Birch Street,
Dover, New Jersey 07801;
J.
Four percent (4%) to Susan Allmendinger, 100 Radcliffe
Drive, Newark, Delaware 19711;
N. One percent (1%) to Mark Dahlstrom, 936 Skyway Boulevard,
Colorado Springs, Colorado 80906;
K.
Seven percent (7%) to Lois Rigoulot, Maple Avenue,
Millbrook, New York 12545;
One percent (1%) to Robert Rigoulot, c/o Lois Rigoulot,
Maple Avenue, Millbrook, New York 12545;
One percent (1%) to Peter Dahlstrom, Little Rock,
Arkansas 72208;
O. One percent (1%) to Beverly Dahlstrom, 936 Skyway
Boulevard, Colorado Springs, Colorado 80906;
P. One percent (1%) to Karen Schmock, 2414 W. Kiawa,
Colorado Springs, Colorado 80904;
L.
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Q. Three percent (3%) to the Baptist Home of Brooklyn in
Rhinebeck, New York;
Three percent (3%) to the West Shore Baptist Church, 2025
Market Street, Camp Hill, Pennsylvania 17011.
ITEM III. No interest of any beneficiary under this Will or
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Three percent (3%) to the First Baptist Church, 260 Mill
Street, PJughkeepsie, New York 12601; and
\~ any COdicil hereto shall be subject to anticipation or voluntary
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alienation.
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ITEM IV. No provision in this Will is intended to exercise
any power of appointment.
ITEM V.
In addition to powers vested in them by law, my
Executor and his successors shall have the following powers,
applicable to all property held by them, including all property
held for minors, effective without the order of any Court and
until actual distribution of all such property:
A. To retain any property received by them including the
stock of any corporate fiduciary acting hereunder.
B. To sell real estate for any purpose, publicly or
privately, for such prices and on such terms as they deem proper,
without liability on the purchasers to see to application of the
purchased monies.
C. To compromise controversies.
D. To distribute in cash or kind or partly in each at
valuations fixed by them.
E. To hold in'/estments in the name of nominee,
ITEM VI. All taxes and interest and any penalties thereon
payable by reason of my death with respect to property comprising
my gross taxable estate, whether or not passing under this Will,
shall be paid from the principal of my residuary estate.
ITEM VII. I hereby nominate, constitute and appoint James C.
Mooney, Executor, of this my Last Wi 11 and Testament.
If my
Executor predeceasGs me or if for any reason does not act or
continue to act i.'S such, I appoint Richard Mooney, Alternate
Executor of 2552 N;>ff Lane, Salt Lake City, Utah 84109, and Robert
Mooney, 12700 Etris, noswell, GA 30075, as the Executors in his
place. No fiduciary ncting hereunder shall be required to post
bond or enter secUl'.ity in any jurisdiction.
CERTIFICATION O!:'..JID:!:!.q:_llNDER RULE 'i.fila)
Date of Death:
C.A\1....L p..
<--\-2-I-Cl0
No. \q q lc - 0 ()~ 71)
\:)A\~'LS. TKOM
Name of Decedent:
Will
M!m in. No. Z. \ q (c - 0'::' 7 6
To the Register:
I certify that notice of benef1cial interest required by
Ru Ie 5.6 (a) of the Orphans' COU1:t Hu les was served on or mailed to
the following beneficiaries uf the above-captioned estate on
5-2-10 -C-jC"
Name
Address
SEE A-rTt\C.r\-e:::-P US!
Notice has now been given to ?\,V^P.ersons entitled thereto under
Rule 5.6(a) except ~/~
Date:
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Arlrlress 172D f){LJ."?..s, ~12.\\JG-t- \('\)
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Telephone(117l7=i7_- '-Is1~
Capacity: ../ Personal Representative
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Counsel for personal
n~presentat. ive
DNO.AA
146523 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
~~
WIl62f114....1
RECEIVED FROM:
ACN
ASSESSMENT Il'
CONTROL iiI
NUMBER
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AMOUNT
JAMES C MOONEY
1720 ORR'S BRIDGE RD
101
$:12,750.00
ENOLA, PA 17025
ESTATE INFORMATION:
~ FilE NUMBER
~ 21-1996-0378
1:'1 NAME OF DECEDENT (lAST)
~ DAHLSTROM CARL A
tI DATE OF PAYMENT
Iii 07/16/96
m POSTMARK DATE
COUNTY
SSN 123-10-0542
(FIRST)
(MI)
CUMBERLAND
DATE OF DEATH
04/21/96
REMARKS JAMES C MOONEY
m TOTAL AMOUNT PAID
$32,750.00
DO
SEAL
CHECK II 118
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RECEIVED BY.' ",', (
REGISTER or WillS
SIGN""UR~
f1A/lV C. LEW I S
/lEGISTER OF WILLS
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faR D,\IE~ OJ DE~lU Ann 12/J 1/91 CHECK lURE
If ~ SPOUS'\L
POVERTY C~ED" IS CLAIMED
fill ~IUMOl~
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2 Supple menIal Return
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INHERITANCE T A;< RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH R~GISiER 0;: WillS)
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Original Relurn
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~ Ja, Future Inler"U Comprom""
(for dOllS of death aher 12.12.821
Decedenl Died Testate [j 7. Decedent Maintained 0 Living Trust
(Altach copy of Willi (Allach copy 01 Trustl
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
~jAMf /' (aMPUl( MAIliNG AOOIIE:':'
r IGi.. J. frll,;);l.,,J 5""U/~i!f\.. S,...,;. -r :';1Ju~".."r..;'j
TU(PIoiONf NUMUII '111 v.Jl,i \,'" 6"u,...A....u.... 121,l,~'J
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I. Real Estate (Schedule A)
2. Slocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Intereu (Schedule C)
J. Mortgage, and Notes Receivable (Schedule D)
5. Cosh, Bonk Cepalih & Miscellaneou, Perianal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
7. Trende" (Schedule GI (Schedule l)
8. Total Gran Anets Itotal Linel 1.71
9. Funeral Expen,es, Adminislrative COSh, Miscellaneous
Expenses (Schedule HI
10. Debts, Mortgage Liabilities, Uens (Schedule I)
11. Tatol Deductions (lata I Unes 9 & 10)
12.
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Remainder Return
(lor doles at death pfior to 12.13.821
Foderal Estole Tax Return Required
T 0101 Number of Safe Depo,it Boxes
11) /33,oocJ.OlJ
( 21 II J7~. 00
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151 / J"-, (,J 3. j f
161 ,Va_c'
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~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~
Under penallin of perjury, I declare thai I hove examined this return, including accompanying schedule 1 and Itatemenh, and to the be" of my I..nowledge and belief,
it iltrue, cartect and complete. I declare thai 011 real eltate has be~n reporled alltue mar~el value. Declaration of preporer other lhon Ihe personal reprelentative i,
based on all information of which preparer ho, any knowledge.
!II ATUIt( or '!ll:.ON IIUPON!lIII( '011 'ILING .ElU.N ADDAU!! OAt(
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$IGN f f Of PIHPAA(It OfH, fHA) IIEP.UfNTATIV( ADDIIl$!!
li.u -' :5..3L~Rd,.._r_~~aQ~3_ .-1~-97_
Ne' Value of Eltale (Line 8 minu, Line 11)
Charitable and Governmental Bequesl1 (Schedule J)
Ne' Value Subject to Tax lLine 12 minul Line 13)
Spou,al Transfers (lor dotes of death alter b.30.941
See In"ructions for Ar,plicoble Percentage an Reverse (15)
Side. Ilnclude values rom Schedule K or Schedule M.)
Amounl of Line 14 taxable at 6% role
Ilnclude yalUel from Schedule K or Schedule M,)
Amount of Line 14 lox able at 15% rote
(Include yalues from Schedule K or Schedule M.I
Principal tax due (Add lax from Linel IS, 16 and 17.)
Credil1 Spousal Poverty Credit Prior Paymenl1
+ Jl. 1$"1). ~2 +
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Interest
If Line 19 is greater than Line 18, enler Ihe difference on line 20. Thil illhe OVERPAYMENT.
aD
(19)
120)
Check her. If you are requesting a refund of your,averpayment.
If Line 18 i, grealer than Line 19, enter the difference on Line 21. This is the TAX DUE..
A. Enter the inlere,t on the balance due on Line 21 A.
B. Enler the 10101 of Line 21 and 21 A on Line 21 B. This is the BALANCE DUE.
Make Check Poyoble tal Register o' Will.. Agent
121}
(21AI
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CAT(
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Act 1143 of 1994 provides for thu roduction of tho tax rato. impo.ud on the not value of :ran.lors to or fer
the usa of the spouso. The rates as prescribod by the stalute will be:
. 3% (,03) will be applicable lor estates 01 decodonts dying on or alter 7/1/94 and bolore 1/1/96
. 2% (.02) will be applicable lor estatos 01 docedonts dying on or altor 1/1/96 and before 1/1/97
. 1% (.01) will be applicable for estates of decedents dying on or alter 1/1/97 and before 1/1/98
. Spousal translers occurring on or after 1/1/98 will be exompt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (..-) IN THE APPROPRIATE BLOCKS.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred, .......................................................
b. retain the right to designate who shall use the property transferred or its income, ...............
c, retain 0 reversionary interest; or ...................................................................................
d. receive the promise for life of either payments, benefits or care~ .......................................
2, If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate consideralion~ If death occurred alter
December 12, 1982, did decedent transfer property within one year of death without receiving
adequate consideralion~ ..........,....... ....... ...........".....,...... ........... ..... ....,....,...., ............., ....
3, Did decedent own on 'in trust for' bonk account at his or her deathL....................................
YES NO
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IF THE--ANSW..,ER TO ANY OF THE ABOVE QUESTIONS IS YESr
YOU MUST CPMPLFl:E SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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COMMONWEALTH OF PENNSVLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF OEATH
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L~ST WILL AND TESTAHENT
OF
CARL ~. DAHLSTROM
I, CARL A. DAHLSTROM, of 52 Greenmont Drive, Enola, Cumberland
county, PA 17025, declare this to be my Last will and Testament,
hereby revoking all prior wills and Codicils.
ITEM I.
I direct that the expenses of my last illness and
funeral shall be paid from the funds of my estate.
ITEM II. I give, aevise and bequeath all of my property, both
real and personal, cf every nature and wherever situate as follows:
First, I give, devise and bequeath my coin collection equally
to Richard John Mooney, Robert Edward Mooney, James Carl Mooney and
patricia Carol Dic\:e, now or formerly of the addresses listed
below. If the parties cannot agree on distribution, then I direct
my executor to set value of the collection or parts thereof, or
make distributior. in whole or in part,
including making
distribution of the entire collection to one or more of the above
and adjust accordin~ly those persons' shares of the residuary of my
estate.
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second, I give th( rest, residue, and residuary of my estate
as follows:
A, Nineteen (19'.) to my sister, ;'.lice D. Mooney, 756
Arling~cn Ro~d, Camp Hill, PA
B, Ten pe::-ce:lt 110',) to P.icha::-d John 110oney, 2552 Neff Lane,
Salt Lak~ city, Utah 84109;
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Te:l pe::"c(:;;~ (lu:-~) toe ?obe:"-: E.::L':c::"d Hooney, 12700 Et.:.--is
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E. Ten percent (10%) to Patricia Carol
Lane, Huntington, New York 11743;
F.
Four percent (4%) to carolyn Gale,
Kittery, Maine 03904;
~""t~:,
2 3 Oak'~;
,4
~~.
G. Four percent (4%) to Dorothy Jane Wurman, 29 B
Heights, Mansfield, CT 06250;
H. Four percent (4%) to Sandra Leonard, P. o.
Brooklin, ME 04616;
I. Four percent (4%) to Calvin Horsman, 149
Dover, New Jersey 07801;
J. Four percent (4%) to Susan Allmendinger, 100
Drive, Newark, Delaware 19711;
K. Seven percent (7%) to Lois Rigoulot, Maple Avenue,
Millbrook, New York 12545;
L. One percent (1%) to Robert Rigoulot, c/o Lois Rigoulot,
Maple Avenue, Millbrook, New York 12545;
M. One percent (1%) to Peter Dahlstrom, Little Rock,
Arkansas 72208;
N. One percent (1%) to Mark Dahlstrom, 936 Skyway Boulevard,
Colorado Springs, Colorado 80906;
O. One percent (1%) to Beverly Dahlstrom, 936 Skyway
Boulevard, Colorado Springs, Colorado 80906;
P. One percent (1%) to Karen Schmock, 2414 W. Kiawa,
Colorado Springs, Colorado 80904;
Q. Three per~ent (3%) to the Baptist Home of Brooklyn in
Rhinebeck, New York;
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Three percent (3%) to the First Baptist Church, 260 Mill
street, PJughkeepsie, New York 12601; and
s. Three percent (3%) to the West Shore Baptist Church, 2025
Market Street, Camp Hill, Pennsylvania 17011.
.
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ITEM III. No interest of any beneficiary under this Will or
any Codicil hereto shall be subject to anticipation or voluntary
,
......,
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alienation.
.
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any power of appointment.
.'11'....
ITEM V.
In addition to powers vested in them by 1 w y
a , m
Executor and his successors shall have the following powers,
applicable to all property held by them, including all property
held for minors, effective without the order of any Court and
until actual distribution of all such property:
A. To retain any property received by them including the
stock of any corporate fiduciary acting hereunder.
B. To sell real estate for any purpose, publicly or
privately, for such prices and on such terms as they deem proper,
without liability on the purchasers to see to application of the
purchased monies.
C. To compromise controversies.
D. To distribute in cash or kind or partly in each at
valuations fixed by them.
E. To hold in'/estments in the name of nominee.
ITEM VI. All taxes and interest and any penalties thereon
payable by reason of my death with respect to property comprising
my gross taxable e~tate, whether or not passing under this will,
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shall be paid from the principal of my residuary estate.
ITEM VII. I hereby nominate, constitute and appoint James C.
Mooney, Executor, of this my Last will and Testament.
If my
Executor predeceasas me or if for any reason does not act or
continue to act as such, I appoint Richard Mooney, Alternate
Executor of 2552 Nsff Lane, Salt Lake city, utah 84109, and Robert
...
~
Mooney, 12700 Etris, noswell, GA 30075, as the Executors in his
.'
......
place. No fiduciary "cting hereunder shall be required to post
\J
bond or enter security in any jurisdiction.
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: 55:
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Testator,
and
the witnesses, respectively, whose names are signed to the attached
or foregoing instrument, being first duly sworn, do hereby declare
to the undersigned authority that the Testator signed and executed
the instrument as his Last will and Testament and that he had
signed willingly, and that he executed it as his free voluntary act
for the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the Testator signed the Last will
and Testament as witness and that to the best of their knowledge
the Testator was at that time eighteen (18) years of age or older,
of sound mind and cnde~ no constraint or undue influence.
,
t (1. J. [l- l; 6.. /,J... 2-ft :'v y-
, residing at 52
Pennsylvania 17025
Testator
Greenmont}Dr~;,e, /EnOla/ ~umberland County,
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witness _/' ./1 / Ii'. {?~ , residing at
Witnenn ([1", .Jl'J;(~/?U:froniding at
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witness
, residing at
subscribed, S'tlorn to and acknowledged before me by Carl A.
Oahlstroml ,~stator, a~d subscribed and sworn to before me by ---
1,,J'v~/l7-f /' /'1../. !I , .-:!::ill; j) {'("{./..t- -y' , 'rd
, the witnesses, this U - day of ... CTV'". I, , 1995.
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IIDI!RrI[l'ir\ rrfil\lTm WTTII.
illOI llluld Imuldrt(l" rronlh!l ~ I per Il'IJflth
iUOI t\Jlt9~gl'-hl\Ur.1!l(e ronthS ~ I per 1!()f11h
iOOJ CHy/tl\ol'lla1es rronths ~ I per IIOflth
100\ Count)' 14-e\ ronthS PI per IOOnth
IOO!j School 1,J_!'s Il'IJflthS ~ , per Il'Qrlth
lOP,. I'IJflths PI per ft;)fllh
iOOl rronlhs ~ I per Il'l)(llh
1003
im-fi II (I\",m
1101 5eUh."If'('nl 01 (lo\lnq ree to
1101 Abstract or TItle Sl'dlCh to
1103 tOe ha!lllnallon to
1I0t 'HIe Insurance Binder 10
1l0~. OoclJTllml rrep.tfatlol1 to WI.. wenqer & Weidner 1':l00
1106 N';lury r{'(ls to (uh ~,OO !J,OO
UOr Attor~1's rus 10
(IncludeS abo...e llt'lll rurt>ers- I
ilO3 HUe Insurance to NnerlCan llerltage Abstract 86~,00
ll"eludes abo...e 11t"lD rurt>en: I
iio') t~lder'!i (o'o'eraqe I
iiio, 1\o11e"s lovE'uge I 13l.000.00
1111 OlSblJrsen't'nl r('C' 10 Merlcan lterltage /Ib!llracl J':l 00
1111
IIIl
\~''''''T .."'0 ;Releues' IZOO
1;01 Rl'fortllft-llee!t [)(IN' 11.00 ;ttlrtgage'
1101 CIty/County 'a"Sta~\: Ileod I 1.330.00 ;ttlrlgage' I.JJOOO
1103 SUtt" ta./'itdr,J\ Offill ;tt>rtgage S 1.330.00 1.33000
II"
110~
1[100= I Irm rTIW!Grl'"
\)~1. Survey 10
DIl? rt>\l IM~l('ClIOn 10 1I1echler & TIller)' Msoclales ?!J 00
130].I~I"sP'?'l'0l1 to 9lechler & TIller)' Msoclales moo
IJN [o.(I(1oi fur hUle la.es to Wh. 'kllQer & 'k1dner. Ment 1 In.~113'J
~%.
t,1~0. TOTAl. SEITUt"(Nt C1\fo.RGES IEnter On LInt'S 103. Secllon J am S02. Section 1:;) /.43100 lJJ.m 39
1\1 sll~iilnq pagl! I Of tiltS slatl:"lrenl. the stgnatorles atlnowledqe receipt of a ttl"(l eted tOpy 0 pJqe ? 0 thiS pclqestat('!l'(>nt
1-'
',IIIiI~hl ',l^lIt'Pil I'N,I ..
liLt1f (j;itltt~!l<--
"/Poo';IP\,IWIPOC';lR\)
(trllflN 10 II(' a tfUfo copy
Who Wenger & Weidner
SeUh:>ment Agent
lIY.ISO] IX. 1'.'61
I SCHEDULE B
.~OCKS AN.D ~O_~_D~
FilE NUMBtli
"
~ ('.>},q
'!:~'1G.:.:!'
COMMCN'NULTH 0' PWU5YlVANlA
INHtAlrAuCI UllllUUlm
AISIDftlt DEC[Owr
ESTATE OF
,I" '/'
'J ''1/~ ~ /1. lj/lr~ L j -:>.. J,fA
IAII proporty lolntly.ownod wllh Right a' Survivorship mu.t bo dlsclo..d on Schodulo F.)
lf~ ~ .,;,1--o!
ITEM
NUMBER
VALUE AT DATE
OF DEATH
k'11"" ()))
, .; j..,.
DESCRIPTION
1.
12, S!iA,td {:;........,J .s1~U' -/:.;'1".< 0(- ;v./L~I.!":'>)"'-
TOTAL (Aha onlor on IIno 2, RlCopitulotion)
(I' mort Ipoce ;1 netd.a, ins.rl odditionol shilts or some sizt.)
S / /, 37~, D.II
')
'1 'II~C' ". '1 '"
ESTATE OF
~,;~ .~
".~;t,.~
....-:..~
COMl.lm,wrAomt Of P[NU5YlVAoNIA
INHIIIJANCI fAX RnURN
RESIDENf DECIDINf
I SCHEDULE E
I CASH, BANK DEPOSITS AND
MISCELLANEOUS
1 PERSONAL PROPERTY
"' _h '_ _~Ieole Prinl or Type
FilE NUMBER
; "
:.: "I", .:.. /1', I~/.I. _ .. -~~:';"A-'
fAll Plop.rty Jolnllv.owntd with 'h. RIght 01 Surv'vonhlp mUll b. dhdol.d on Sr~J
ITEM
NUMBER
2,
t(
,..
~,
("
1
s.
" ,; P t) j .:.' I
DESCRIPTION
VALUE AT
DATE OF DEATH
, ':"0 z., z.i
7' I, 00
/,
tJAul1lJ,,J Ikloj,;,
/I. /'0' ., y' -'cd- {'
- - ,
!J,f,NII. ~ Cc.n u#~(
,
e./rJIf ~,J HA,-Jd
.3,
~ t!,u ",i"
11 , f' r, ,
'J 11Il:A-$, . I,,(} yt'll. 0", c.
II :''''~'''~'''2[c(L-(''J-7
fl.l,-J4 - t3
,4 c.'Ou,.J(
/0, 6.H.. tJ
l'I:',..Ai~ ;-1/6/1 1"I.'{"4 fU,-Ja' /.1
Acc..o""r /I S.{'{'Jf)~"'()31-1
,..
lo, /'10, f~
r'
J A,J,J,: r
Ac..eof.l.,J/
/V/O,.lrt;o",cit<-Y Sco('i
... a....
/I /J,I( / t ' z.~ J J ' 1(. J ~
9,/101,:/K
/,1f1J {..t:' ("t.ltt'lti ,NS to'..) CtJI..t.e ,-no)
/3otJ,oo
;1.." So,A,- lIsc.' /I",r.,u'/J' ,-,,' (so,-" '/).(. /1~ )
tfJoo, 00
IVlls{..c t.t.A,v"'o "S flu...s,; /fo,-.,
........
J- 1l;....S
j 3 {..10, In}
TOTAL Also enler on line 5, ReeD ilulolion) S
J,Jr' 6.J3, 3'
(Attach odditlonol8\o\" )( 11- ,hee'l if mar. Iportll n..d.d.J
D Dauphin Deposit Bcm~
DATE
PAGE
06-13-96
1
1427
10292098
CARt DAHL STROH
52 GREENHONT DR
ENOLA PA 17025
1 B
CY 10
14
NO NEED TO REHENBER YOUR HAG ICARD
NUHBER AT THE GAS PUHP, PRESS VISA
AND LET US DO THE REHEHBERING FOR YOU
.
. -. -
SUMMARY FOR ACCOUNT
10-29209-8
:ARL DAHLSTROH
;2 GREENHONT DR
'REVIOUS BALANCE 05-1~-96
1 DEPOSITS AND CREDITS
1 CHECKS AND DEBITS
:URRENT BALANCE
iTATEHENT END DATE
PRIHE OF LIFE
502,5~
.27
502.81
,00
06-13-96
sac SEC NUHBER
INTEREST RATE AS OF 06-13-96
1996 INTEREST PAID YTD
ANNUAL PERCENTAGE YIELD EARNED
123-10-05~2
1.0007. .
15,~9
0.98~7.
DATE
06-0~
06-0~
HIS C ELL A N E 0 U S 0 E BIT S
AHOUNT DESCRIPTION
,27 t INTEREST PAYHENT
502,81 - CLOSING WITHDRAWAL
o A I L Y B A LAN C E
AND
C RED ITS
DATE
06-0~
BALANCE
.00
DATE
BALANCE
S U H H A R Y
DATE
BALANCE
B28S -
I
II
I
,
ITHDRAWAL ACCOUNT NUMBER
DOA CLOSING W D /
~ n' D tJ'7 s_.:LDd,!L
DATE (0 - ."19YL. ~ ' ?-I
-- ,\ r\. l\ d DOLLARS
^"nll",T 0. ;..Q~}-,,--,~I 't- ~ I.~l
~.e..... -~-. (~'J RECEIVED OF
I,CCOUNT e.<...J D.. aJJ~4t,,~ ~ Nt- 9(, IR. Dauphin Deposit Bank
TITLE <;', P n . \I ~~~~.!.~L- IYI Cnd(~u~c~onv
SIGN!.TURE C6l.-J...J;;..-:-~'-'~ J .-;.., f/ -P: -Z~~,,- ,-I(\.J...-).,- :F-
e'" r-. .. U , - /.,~sc<><. ""'('0 <///.1/'
' \,\ 'l{!. ::,...'.....~ ["< ~~ <
:"","'\...(,;-j.=- - -.......... . .-'. ' '1/.
NON.NEGOTIABLE
,,,
I: SOb 5"'00001:
00 ~O 29 209BI" OOb? ,"00000 so 28 I.,"
. ....... .........C\../~
,-."-'. ...--,,,,".- c.:;tll '.eUO.~~1.?Ol)!'
Account Statement
KEMPEll DIVERSIFlm INCOME FUND.II
~
I( E\ I PE 1\ FU:--i DS
C~)",:rIR.\'t\llO'-i DAfl: II I !i,1 lIP)"
1",111",11I,,,,,1,1,1,1,,,1,1,11,,,1,,1,,11,,1,1,,,1,1,,11,1
CARL DAHLSTROM
52 GREENMONT DR
ENOLA PA 17025-2643
1,INCOI.:'-~ I~N f'IA'-iNI~C INC
Pc) I~O\ JII'I'1
h:1~C~IO:--; ,,<y 1~.;Ol.!Jf) W
"int1Ji ~t'nlfll\' 'Jr
TJX In Number
123-10-0542
flmd'-:o ",eCf1unl So Chk 11;11
I 210 555254263 9
Trad. Description Dollar Amounr Share Shar.. thl. Total
Dat. Of Tranlac.lon Of Transaction Prlc. Transaction Shar.. Owned
BEGINNING BALANCE 3.514,938
2/16 INCOME OIV $ ,0367 CASH $ 129,00 3.514,93B
3/14 INCOME OIV $ ,0371 CASH $ 130.40 3.514,938
4/17 INCOME OIV $ ,037 CASH $ 130.05 3.514,938
4/1B SHARES REOEEMED $ 10.000.00 $ 5.B7 1,703,578 1.811,360
CALL SHAREHOLOER SERVICES TO LEARN HOW KEMPER-DREMAN FUNDS CAN ADD VALUE TO YOUR
PORTFOLIO. WE'LL BE HAPPY TO SEND A PROSPECTUS WITH MORE COMPLETE INFORMATION
INCLUDING MANAGEMENT FEES AND EXPENSES. PLEASE READ IT CAREFULLY BEFORE YOU INVEST.
Vear-Yo-Data Income Tax-hemp' Capital Total
Dividend. + Dividend. . Galnl = DI.trlbutlon.
Summary $3B9,45 $.00 $,00 $3B9,45
Your':l'"en, Opllon R.pr.sentatlve Nam. a.p. Number Certificated Sha....
Dlvld. Cap.Oaln.
rd<U rd<U our Tn," 1<10
,
CARL DAHLSTROM
52 GREENMONT DR
ENOLA PA 17025.2&43
Invest By Mail
~f',lttrl(rg
~, J
:~~ KEMPER FUNDS
Use TIlls Encoded Slub To Make Addilional
Purchases Into 1111s Account Only.
list EDCh Check Below
,
,
. IJIc:::uc make aU checks pa)'3bh: tOI
~
SocialSecont)'D'123 1005"2
Tax ID Number - - It
Fund No.
210 555254263
ChkO
9
KEMPER DIVERSIFIED INCOME FUND.B
. Wrile: your account number on each check.
Return checks witb this stub In the enclosed
envclupe.
Changing Your Address?
Campl..e the revenc side and place an X In the box { .} bdo"'.
Investment Amount
S 100 Minimum
Is
I "
1111111 ~11111111II1 ill II~ \III
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Glohal J:uJUL...
(ill)ll;1lll1l't)lI1l'
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11Ilt'nm'lh,u\' ,\IUlll(IP,lllkllltl
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Complete This Section For Address Corrections
,i '\I d 1111 ; :-:1I1-,ll : I, ~"
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. .
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ill\l"'l h~lIl.lil..IiI', 'hlllll,. UlIIl.k1 ,nur lin,U1dd n'(ln'l.'IU;Uht'llr
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Account Statement
KEMPER WGH YIELD fUND.1I
1,1,:.\ II'F 1\ HJ \i DS
(:{):\.rlf~,"'\Il():\. D..\II" III 1'1 llj'lh
1,"111".111,""1,1,1,1,,,1,1,11,"1,,1,,11,,1,1.,,1,1,.11,1
CARL DAHLSTROM
S2 GREENMONT DR
ENOLA PA 17025-2643
1,Ii'.LOI ~ I~V PIN\;~J1'jC I~C
I'() HO\ \1,;\'1
h.1:'\C~'()~......y l.!.llJl-n'JHI
~J\'IJI St'lUnlYflf
T.IXm~lIrntlt'r
FIlIllI~1I
123-10-0542
.Vrnlllll Nn r:hk n !T
208
555305031
.
.
.
Trade D..(rlp.lo" Dollar Amount Shat. Shar.. This To.ol
Dat. Of Transacllon Of Transaction Prlc. 'ronlac'lon Sha,.. Owned
BEGINNING BALANCE 3.126.972
2/16 INCOME DIV $ .0576 CASH $ 1BD.11 3.126.972
3/14 INCOME DIV $ .D5B5 CASH $ 1B2.93 3.126.972
4/17 INCOME DIV $ .0569 CASH $ 177 . 92 3.126,972
4/18 SHARES REDEEMED $ 5.000,00 $ 8,04 621.891 2,505,081
CALL SHAREHOLDER SERVICES TO LEARN HOW KEMPER-DREMAN FUNOS CAN ADO VALUE TO YOUR
PORTFOL I O. WE'LL BE HAPPY TO SEND A PROSPECTUS WITH MORE COMPLETE INFORMATION
INCLUDING MANAGEMENT FEES AND EXPENSES. PLEASE READ IT CAREFULLY BEFORE YOU INVEST.
Year-Yo-Date Income Tax-I..mpt Capital To'al
Dividend. + Dividend. . Oaln. = Ol,hibutlon.
Summary $540.96 $.00 $,00 $540.96
Your ':Jmenr Op.lon aepre..nlatl.e Nam. a.p. Numb.r Cent'leaf.d Share.
Divide Cap.Oaln,
rA.~ rA<~ DArrln", Ulr~HI "'"
CARL DAHLSTROM
52 GREENMONT DR
ENOLA PA 17025.2643
Invest By Mail
'11"1'
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'" KEMPER FUNDS
Use 11lis Encoded Stub To M.ke Additlon.1
Purchases Into This Account Onl)'.
list Each Che.k Below
.
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. l'lC3M: make all chcc.k.5 pa)'ablc 10:
i
~fDs~~~r 123-10-0542
Fund No.
208 555305031
Chk f) t
KEMPER HIGH YielD FUND.B
Wnte your account number on each check.
RetUrn checks with thb !ttub In the cnclO!lc.'d
cnvclopc.
Changing Your Address?
ComplclC the n:vc:nc sid. and place an X In Ih. box {.} hclaw.
Investment Amount
S 100 Minimum
I s
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{} 0000 48841120 005553050311 0000208
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SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
"J ,",'111' ,'>\'11 ,I ,"'II",'!.Ar.I.\
',1" ~,',.. 1\' f ':.; ., 1'11111
~, " ',I'.f OJ! ': (I 'If
Plua,o Print or Typo
FliTNUiiliIEil---
E5TAiCOF-------------- -
I
_.~_..~~~~--._-...~,-
," ,,'
ITEM
NUMBER I
A, I Funeral E.ponses:
1.
DESCRIPTION
IA(:JA: .. /1'.",(",-,(.
,
/,- ..' .I'~ If 4(.
,,~'.!~~'.:'
B, Administrative Casts:
3. Family Exemption
Claimant
Address of Claimant at decedent', death
Streel Address
City
4.
C.
1.
2.
3.
4.
5.
6,
7,
8.
1.
2.
Personal Representative Commissions 7
00, -dd - ('oj
Social Security Number of Personal Represenlative: I 7 L a
Yeor Commissions paid I ?1'. 'J, 0 U ". 0)/
11 n. 'e,,,".. u.
Allorney Fees
Relotionship
State
Zip Code
Probale Fees
MI.cellaneous Expens..:
t Sf ..t11:' /.{.,,',I.c' 5 (!t:,<flf>cA,I!J
,
j) ..r -'~' S
AHOU"n,l1r llll" rtu:/A,<.,.,J',J Or- J.~tf~.."A,J"- ~'I"""
TOTAL (Also enter on line 9, Recopitulation)
(If more space I. needed, In.ert additional shull of samo .Izo,)
, ~ .
. .
...-'
AMOUNT
"'-'1"1G':!.
fI " -:l"
7, c)Oc), OJ/.
ZScJo,lJf)
,
j /7, 00
t.(~, 10
z.,ot"eJ,Oc)
S /f f7t. ~
,',
ESTATEOf
ITEM
NUMBER
1-
,
, A.
J. ..l':
1.
IV.
II.
,t,
/J.
ITEM
NUMBER
. ..-'
Co r~'}
'::'i:;.:;!
SCHEDULE J
BENEFICIAR I ES
"" ,,"'A, '.. '. ~I."",
,....I.H...llet'....".JI'.
If\llI11ifllHIUllil
-----.----..--------.
FILE.~Iu:..,ilEi----------.-
/ ,
"
.......--..---
'..... .
AMOUNT OR
SHARE Of ESTATE
M~~____'
NAME AND ADDRESS Of BENEFICIARY
RELMIONSHIP
.- .-----------.
--- -.-----------.
T aAcbls BttqU8\t\:
).I,":C.~'
j:,:.;o. J U
i Z"JM.j t.." u,", ~."..
.' 1 .. .. .. /
';' rJ. ptJX J:' I 1_~tl)..J,'~:,.J,
1,1,.,.;,
.:, '1''' ,
CAt." /,J /(",q ",.,+,.J
"(1 /J,,(':'11 Sr,L"o:l
/lk/lle';
/&OU.oo
{)V""", ,.11 07101
~ ~ IIl,J /IlL ",,/!.,dJ (#h,t
IOU IAdCt-lff" fJ)./I/t:'
p'/lie[;'
If-oo.OO
;Vt:'w/f,'''. IkC.A.-JA'<"
(11/1
IJ,JotJ.Dll
L.vl~ ;2(&O"L.D'
/,4 Alt./! A {/,;,..,,, t:'
)./1'" Ct:t
,{....
/,/{(((./J ;<vu,< ,/)'/ ,-z. ~
12M';"'"
jV!AIt-f:'
.,j .-
f;..'YOV/"OI
/1"'-' ""C!
;t/c'I1f'~'"J
,'1 VO. 00
;4/1.C.IJI-OU)! ,/)( ,2."1':
jJe'rdA.
L / irLl;
/JAt-It S; t!~,....
I,u< ,A",tA,JIAS
1 :-:'" J
#t:'//ft;"J
/'100,OD
1<1.
;vT,4'<K. /JAtfl. Ji'J4 0'"
93(. Slcyr";I'! I3Ll/o.
d:lde''''
/900,00
COL./J r..ido S!;t,,J&t,
Cv~o/lA;JO So 90 C
NAME AND ADDRESS OF BENEfiCIARY
AMOUNT OR
SHARE OF ESTATE
8. Charitable and Governmenlal Beque$ls:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS lAt.o onler on line 13, Recopilutolion) S
(If mort span II n..d.d, In,.rt additional sh..t. of sam. slu)
/.J ;, /'
BUREAU OF INDIVIDUAL
I NU[RJ rANt[ fAIl DIVISION
DEP'. laOblll
liARAISlU"G, PA 111:8-0"01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(>
i*
),:
.' c
TAXES
NorlCE OF INHERITANCE TAK
APPRA1SEMINT. ALLOWANCI OR DISALLOWANCE
or DEDUCTIONS AND ASSESSMENT OF TAX
"'-1"'11'" IU,tll
PATRICK J MIDRIN
SMOKER ETAL
339 W GOVERNOR RD
HERSHEY PA 17033
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-12-97
DAHLSTROM
04-21-96
21 96-037B
CUMBERLAND
101
CARL
r
AlI'lount R....lthd
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 .....
ifE"v:i54"i"EiCiiFi.--nii-:9;T"iiii'r"iCE-.OFuiNHEiiii'iiiic,n'-"x-ifPPRA-isEi.fE'iii'-;-iii.LOwiiNCE-OJiuumuumm
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DAHLSTROM CARL A FILE NO. 21 96-037B ACN 101 DATE 05-12-97
TAX RETURN WAS: I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R.al Est.t. {Schedule AI (1)
2. stocks and Bonda (Schedule 8) (2)
3. Closely Hald stock/P.~tn.~ship Intera.t (Schedule CJ (3)
4. Horta.g../Nota. Racalvabl. (Schedule D) (4)
S. Cash/Bank Oeposits/Hi.c. Parsona1 Prop.rt~ (Schedule E) (5)
b. Jointly Owned Property (Schedule f) (6)
7. T..ansfarl ISchedule G) (7)
8. Total Aluh
CHANGED
133,000.00
11.376.00
.00
.00
135.683.39
.00
.00
181
NOTE: To insura prope..
credit to your account,
sub.it the upper portion
of this forn with your
t.)( peynent.
280.059.39
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funerel E)(penses/Adn. Costs/Hisc. E)(penses fSchedule H) (9)
10. Debts/Hortgege liabilities/Liens ISchedule I) (10)
11. Totel Deductions
12. Net Value of Ta)( Return
13. Cheriteble/Governnentel Sequest. (Schedule J)
14. Net Value of Est.t. Subject to Te)(
18.972,80
.00
IllI
1121
1131
1l4J
lR.Qn RD
261.086.59
17,100.00
243.9B6,59
If an assessment was issued previDusly, lines 14, IS and/or 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed tD date.
ASSESSMENT OF TAX:
15. Anount of Line 14 .t Spou..l rete (15)
16. Anount of Line 14 ta)(abl. at Line.l/Class A rate fIb)
17. AMount of Line 14 te)(ebl. .t Coll.terel/Cless 8 rete (17)
18. Principel T8)( Due
NOTE:
.00 X .00,
.00 X .06,
243.986,59 X,15,
.00
.00
36,597.99
36,597.99
1181
TAX CREDITS:
PAYHENT
DATE
07-16-96
01-21-97
RECEIPT
NUMBER
AA146523
AA185092
DISCOUNT It I
INTEREST/PEN PAID I-I
1.723.68
.00
AMOUNT PAID
32,750,00
2,122.99
INTEREST IS CHARGED THROUGH 05-27-97
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
36,596.67
1. 32
.04
1. 36
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN SI. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
A
'.T
('\
I
,--
,',
" ~)
r .;; ,-~
.~V
u.
RESERVATION I Ell.t.. of dacadants dYing on or bafor. Dlc..b.t IZ, 1981 -. If any future Intar..t In the ..tet. I, tran".rrad
In pa.....lon ar enJay..nt to Cl... a (coll_taral) ban.flel.rl.. of the dacadant .ft.r the ..plretlon of any ..tat. for
11'. or for y..r., the Co..anw.llth hareby ..pr...ly r...rv.. the right to appraIse end ...... transf.r Inheritance ra...
at the lawful CI... a (coI1e'arel) rat. on any such future 1"lar.'t.
PURPOSE OF
HOTtCEI
To fulfill the requlr...nts of Sactlon 2140 of the Inherltanca and E'tet. ta. Act, Act 21 of 1995. 171 P.S.
Section 9hD),
PAVHEHh
O.tach the top portion 0' thl, Hotle. and lubalt with your pay..nt to the Ragllt.r of Will, prlntad on the ravar.. .Id..
"Hak. ch.ck Or' .on.y ordar payable tal REGISTER OF HILLS, AGENT
REFUND (CA)I
A rafund of a tax cradlt, which was not raqualt.d an the rax R.turn, .ay b. r.qu..t.d by co~l.tlng an "Application
far R.fund of P.nnlylvanla Inh.rltanca and Eltat. rax" (REV-131)). Applications ar. avallabl. at the Offlc.
of thl Ragllt.r of WIlls, any of the 13 R.v.nu. DI.trlct OffiCI', or by calling thl ,p,clal l~-hour
anlWlrlng I.rvlc. nuab.r. for' fora. ordarlngl In Pannlvlvanla 1-800-362-2050, out.ld. Pann.ylvanla and
within local Harrllburg araa (717) 787'809~, rDDI (117) 772-2252 (H.arlng lapalr.d Only).
OBJECTlDHSI
Anv party In Int.r..t not .atl.fl.d with the ftPpral...ant, allowanc. or dl.allowanc. of daductlon., or ........nt
of t.x (Including dl.count Or' Int.rllt) a. Ihown an thl. Hotle. IUlt obJ.ct within .Ixty (60) davl of r.c.lpt of
thlt Notice by:
AD"IN
ISfRAflVE
CDRRECTIDHSI
--wrltt.n prot..t to the PA D.part..nt of R.vanu., Board of ApP.al., Dapt. 281021, Harrl.burg, Pi 171ll-1021, OR
--llactlon to hava the aatt.r d.taralnad .t 'Udlt of the 'CCount of tha par.on.l r.pr..ant.tlv., OR
--.pp..l to the Orph.n.' Court.
Factu.l ,rror. dllcov,r'd on thl. ....II..nt should b. .ddr,.s.d In writing tal Pi Dlpart.ant of Ravanu.,
Bur.au of Individual raxa., ArTH: Po.t Als.....nt R.vl.w unit, Dapt. 280601, Harrl.burg, Pi 17128-0601
Phona (717) 187-6S0S. S.a p.g. 5 of tha bookl.t "In.tructlon. for Inharltanca rax Raturn for a Ra.ldent
Olcadant" (REV-1501) for an .xpl.natlon of .d.lnl.tr.tlv,ly corractabla .rror..
OISCOUHTr
If any tax dua 1. paid within thr.. (3) calandar aonth. aftar tha dlcadant'. da.th, a flva parcant (5~) dl.count of
the tax paid I. allowad.
PENALlY,
Tha 15~ tax a~a.ty non-partiCipation pan.lty I. co.put.d on the total of the tax and lnt.r..t "....ad, and not
paid b.for. January IS, 1996, the flr.t d.y aftar tha .nd of the tax aana.ty parlod. Thi. non-participation
panalty I. appaalabl. In the .a.. .annar and In tha tha .... tl.. p.rlod a. YOU would app.al tha tax and Int.rast
that h.. baan a..a...d a. Indica lad on thl. nolle..
INTEREST;
Int.ralt I. chargad b.glnnlng with flr.t day of dallnqu.ncy, or nln. (9) 'onth. and on. (I) day fro. the data of
d.ath, to the d.t. of pav..nt. r.xa. which bac... d'llnqulnt b.fora January 1, 1982 baar Intarl.t at the rata of
.Ix (6~) plrcant par annul calculatld at a dally rata of .000164. All taxI' which blca.a dellnqu.nt on and aftlr
Januery 1, 1912 will b.ar lntarl.t at a r.ta which will vary fro. calander v.ar to cal.nd.r y.ar with th.t rata
announcad by thl PA DIPart..nt of R.vanua. Tha apPllcabl, Intar..t rata. for 1982 through 1997 ara:
!!!! Interest R.ta Deily Interest Fl'lctor !!!r Interest R.t. Dally Intare.t Factor
19a1 lO:C .DDOS"8 1987 .~ .000147
1913 16:C .000438 1988-1991 IU: .000301
1944 11~ .000501 1992 .~ .0001'"
1985 13:C .000356 1993-1994 1~ .000192
.91' 1D:c .00017~ 1995-1997 OX .0001"7
--Intlr..t I. calculat.d .. '0110'111
INTEREST = BALANCE OF TAX UNPAID X NUNBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hotlca I..uad .ft.r thl t.x bacoa.. delinquent will raflact an Int.ra.t calcuietlon to flft..n (IS) day.
b.yond the date of the a'la...ant. If payalnt I. .ad. aftar tha Intara.t co,putatlon data shown on tha
Notlca, addltlon.l lnt.r..t ~.t b. calculatad.
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STATUS REPORT UNDER RULE 6.12
Name of Decedent:
CARL A. DAHLSTROM
Date of Death:
APRIL 21, 1996
Estate No.:
21-1996-0378
pursuant to Rule 6.12 of the supreme Court Orphans' Court
Rules, I 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 L No
2. If the answer is No, state when the personal
representative reasonably believes that the
administration will be complete: N/A
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 ___ NoL
b. The separate Orphans' Court No. (if any) for the
personal representative's account is: N/A
c. Did the personal representative state an account
informally to the parties in interest?
Yes L No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and may
be attached to this report.
Respectfully submitted,
WIX, WENGER & WEIDNER
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David R. Getz, ~squfre
Attorney ID No. 34838
508 North Second Street
P.O. Box 845
Harrisburg, PA 17108-0845
(717) 234-4182
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By:
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capacity: Counsel for personal
representative
Dated: May 26, 1998
JRD/June 30, 1992/17858
nEGISTER OF WILLS
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
NOTICE PURSUANT TO RULE 6,12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To:
PccsDnal Representative
Counsel:
JAMES C. MOONEY
RE: Estate or CAHL A. DAHLSTHOM ,Deceased, Late or
EAST PENNSBOHO TWP
Estate No.: 21-1996- 03 78
Date or Decedent's Death: 4 - 2 1- 9 6
PursuanttD Rule 6.12, the above named personal reprcsentallve or the above named allorney. if
applicable, withia two (2) years of the decedent's death, and annually thercafter until administration is
completed, is required to file with the Register of Wills a Status Report as rcquired by Rule 6.12, in
substantially the prescribed form, showing the dale by which the personal representative, or allorney. as
applicable, reasonably believes administration will be completed. The purpose of this Notice is to advise
you that unless the requisite Status Report is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register of Wills
is required to notify the Orphans' Court Division, Court of CDmmon Pleas of such delinquency and to
request that said Court conduct a hearing to determine whether sanctions should be imposed upon the
delinquent personal representative and the delinquent personal representative's counsel, if any.
Accordingly, if the requisite Status Report is not filed by 6 - I- 9 8 , 19_, you are hereby
advised that a request will be submitted tD the Court in accordance with Rule 6.12. 4
Date: 3-12-98 l;t~(l.,~UU..Jfjlrlt;/nIf.u(/(.
De ut Register of Wil
Distribution to Estate File