HomeMy WebLinkAbout97-00214
PETITION FOR PROUA TE and GRANT OF LETIERS
Eslate of SZW+' \~,D 1,1'\ /~~. No. __.dl.:::it]~l.'::l_
also known us _,_ _-tj-_ To:
__ Register of Wills for the
. Deceased. County of ~..iu. /" " '" In lhe
Social Security No. /,f' :1 . (, '1 rJ? .P / Commonwealth of Pennsylvania
The petition of the undersigned respeclfully represents thltt:
Your petltloner(s), who Is/are 18 years of ag~ or older an the execulLL 1
In the last wlll of the above decedent, dated a" 1 ,. ,j' / /, J'J ,1' 'J
,an~!.~~I~I,I(S)Aa~~;d\~~,.> (c.,~"o,.rN' d"-;~,,,..,-:r;::,p ./~ "y:!)
_____ named
, 19J:..,L
(stale relevant clrcumstances, C.B. renunciation, death of executor I etc.)
Oecendent was domiciled at death In ('" ~ I,.. T /4 n d
IL.L-S.-... last family or r1nclpal residence at_ .', f'
,
(list !ltreCl, number and munclpllllty)
Oecendent, then !( .~ years of aie, died ~ ' ,.{ f_-' __, 19 f 7
at l.L1rIJ'lJe. ;-/H/!,lIL/, L:l1.r/,o;/c, /'Jd. C'lr/I~)t!.. t3..rtf .
Excepl as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was nOlthe victim of a killing and was never adjudicated
Incompetent: _
Oecendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property In Pennsylvania
(If not domiciled In Pa.) Personal property In County
Value of real estate in Pennsylvania
situated as follow,: " I t1
Vi
$ -'/,"'-(10. 0('>
$
$
$
WHEREFORE. petitioner(s) respectfully request(s) the probate of the last wlll and codici1(s)
pr~'ented herewith and the grant of letters " ,...; rrt m "'1 1< r L/
(testamentarYi admlnlslt3110n c.l.a,j administration d.b.n.c.l.a.)
theron.
i
]?
"'~
19
~~
ll'~
~ 0
~
~
~~i~
~:.;J~~''''"
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSnV ANIA } I:lS
COUNTY OF. CUMBERLAND '
The petltioner(s) above-named swear(,) or affirm(s) that the statements in the foregoing petlllon are
true and correct to the best of the knowledge and belief of petltloner(s) and that as personal represen.
larive(s) of the above decedent petltioner(s) will weiland truly aC\~lIlnlster the estate aceordlng to law.
) ';\\
Sworn to or affirmed and subscribed ~ /: .,,/ ,{L";""~' \II
before me this 3RD d~ -, 00'
'- ~ 19 E - ~
,r Uf..,o[) f..t.-<.-. 1)r ~ ~r , _~ ~
([- MARY CLEWIS Regisler _ ~
\D
No, 21-97-?14
Estate of
STERLING S DISSINGER
, Deceased
DECREE m' PROBATE AND GRANT OF LETTERS
AND NOW MARCH 5. 19~7__, in consideration of the pelltlon on
the reverse side hereof. satisfactory proof having been presented before me,
IT IS DECREED that the Instrument(s) dated AUGUST 17. 1989
described therein be admitted 10 probate and flied of record as the last will of
STERLING S DISSINGER
TESTAMENTARY
PEARL DISS INGER
and Letters
are hereby granted to
. '~O Mw~fW/. /In&4c~
(0 Roglstor of Wills U
MARY CLEWIS
PEES
Probate, Letters, Etc. ... . . . . " $ 25.00
Short Certificates( 2) .......... $ 6.00
Renunciation ....,.,...,."., $
X-Pages $ 9,00
JCP TOTAL = $ 4~:gg
Flied .... .~~R.~~ . ii... ,1 ~9? . . . . . . . . . . . . . .
, ATTORNEY (Sup, Cr. 1.0. No,)
ADDRESS
PHONE
~~ ~ ;:o:1J
l't\~
'I:)" ! ~. ' c.
..,
,',1' '-1.: n \
;t ,
f. ; ,
~L ."
c ;~h
;:~~l , 1 ::S-"
'" 11, ()
;'.'0 (;. (~ -
)>~. 00
Mailed letters and order to Executrix on 3-6-97.
),)',"
Tltl\ is HI ll'Jlih' lhill tll!' illfOl'1I1:1l1illl hl'l'l' ~\i"CII j., cOllc,-d)' t(lpll'tllll111l ,1\\ (lll!"lll,d u'11111l,llr or dCillh dul\' fill'll widl Ill('.IS
I t1(:d Hq~lStll\l" Thl' ori!~lll:d l:cl1inultl' will bt' j{l1'\V;lIdl'ti {II lhl' \tij((' ViLlI 1(1'(111.1' ("lHkt' ror Pl'1ll1;llll'111 Ii II II!'"
WARNING: Ills Illegal to duplicate this copy by photostat or photograph.
No,
",;/1"""""-_
,..,.(lliiii~~\W Of it{.-~~,.
;.... !ii..~.. ../ . <4'J'/o....~\
f,,_/ !!f<' ..'t~
~i " .-.
L.-,), 'Il ,:b.
II.. '(..'..' '. ".'\ ".1
~ "" " ",",'
~ "~-,-.. - '. . . -$>~'~"
", ~r.!lEN1 ~\ 't;~C"~t
~!&!J!f1Jfj.IJl-- y~
Zz 0~
a .Wt-J, (~(0A1~~~'~
L(ll\tl l{<'giMrar (/
hT Itll' (hb u'1'I1Ocat{', :C,OIl
4139239
_.__k..~~._______...,~~__._~.~.~~.,_~~_
fES 2 7 1997
"-~<-~<---.......-.~_.,-_.--.--.--------..~,,.~.~~-
\)(\\T
COMMONWIALTNOP PENNSVLVANIA . DEPAATMENT OP HEALTH' UITAL AECOADS
CERTIFICATE OF DEATH
trWM Of tIIIct:CIIIHT '1Itl WddIt. L_
'WI,...I~
SOCIAL 81CU,IJf\' NUMHA
t,
at rlin
s
Oissin r
I
- -
., 163
-. 07
-
....
lMonltl,DI1._1
-""...
5'-.01 fOl"Y"Cwr<<Yl
...
82 Via
1-09-15
Annville, Pa. IW(M(lIl......O ~(] =*rl[]
NAMl{ll'd~.~.'t1fndr...-..r) EDlf.H1O#HISPI'NlCOAlQiN? ."--InditrI.IiIIdI,WhIIt..
, \ l .... l fI 'MO~""''PK'''C\ol)M, (~1
\l~\R nblo()\lv-V' ....-,--,.. White
orClIOlNlf.Vf.AlN OICl:DtNl"'(ll.IC.IIflOHkt"'~.. I, t. .--..
U',IJU,I(O'~U' '$ ~t.Wlltd.~ (."~'I\IlIlllIIl\~
o tU "'~ llMItofd~1
'1M No r~1 (1401 +1 Oivorced Deceased
, ---
1'9,0 VM...............i\--________~____...
'" ""
'land
Carlisle
.. ~U::::;2::r
II&. I:U8 Driver ~B Transit
DIClIOIHf"lMlUHl)AOON,,__c.,.'IIoWI,ra-,~CmM' AC~~~"f'l
D.Irb. eroosing Ret. Center ~~
t 1 Langsdorf way carlisle, Pll.M"'~-
MrHfIf'f4AMI"'-''-~,lM*\
~J.!,8"Jngp.r
17......._.~---_. :.....
....
l".~. Q.rmerlaoo ~7 I~ ::=':::ot
WOlHlEfIl" t4AWIIlh.. N.... ~ SouII\IIMI
Helen Rnsminaer,
1NI'000000"lWLIHQAOOIlll~~-."'COOtl
27 Marqate Dr. llumneletown P/:!. 17036
1"\ ,~oH"~C..-ori l IOff.Clty ~--
.-....
united Zion Cemetery N. Aruwille Twp. Pa. 17003
~~"CifMCa.1lY
54:L 1..,.Mvers-Hamer fll Inc. 1 ')03 Market st. can Hill
;~ ,::>p.t\l '~'""--:c.:,'15 8-7 ~"&':'~'d -~~~!"r,
..... .......IM~a., "~DAIEP AD(~.~V"_I M CAII~t(ncPfO"OlCA1..IlA~M. ~-A-
_-_- \435 Q -~4. .en. ...0 """,
1f'1iln11 .,.."".......,............~wNicII~....d>tIlI'l~NrnodoIIoI#jiniiM.eI'lMW~IffMP"IlOf'Y.,j.,~OIM....IP.ot. ~- ",,"It OUW......~OOi'\ftMlllQ"....,..w
l.~__on"""'liI" :=:'o'IIl.::::' Nll,..........""*""t..._IP\'MIIrlp.tJ{?1
=~~~::...... .. D(\'l?<MY\tlw1k. ~!ll!h _e(;l..,..l.,It\~O,1\ h,l\@',,~<:,
---dlo~out:I1CEOf) -- i .
, .
~-
I
,
--J.-.--
i
Carlisle
~..........rJ
o
""'''','''''''' ".."''''''''' - """",n"""'" \"'sc__.""''''''''''"'''.
(lolot..,o.v"'l
go ""-. .IL___._,.." '::'-11 ...0 ___
!'l.AC'OP~VAltlolNt"'rm..!6tII1CO/'f..oIlll:. tOCAf~l$lI",C4yI\r#\$III'1
buikIr4-.:t$J4'-'Y1
He, .... It. lOt ...
CiMl.""'!~-;;;;;"f [' "."'.~IH'OI'~" -~ l-t. \. .. -
.r.tfIllPYJMQ""IiClAMlrt'l""*""ltJflQ,_lII""'~"""""UI"V"''''l","pt~tIU/I(If.q~lJIn~~Iltm~JI' ,., r:::a
..1flt......IItV~,......_w......"'..........I~--'N'W...,,""'.".."".,..".""'., ...""."",.. . ,
':::",.:::;::=::,.,:::,..u'.t;::-..:',':.~;:;:;"~ :::';.:::::'.~:;'~i'':'"':'~ H..... """"""'" """.." [] ~;;'!iZi~~~it.~c"''''4~;'l.'r;,-.~1i~''t~~~~+._--~
(ll,"'lllh~OlPtlnt ~"-v/t.( t, -,' fl'"
....OlClAL UAMINI",COfU)t>lI" 'i: ~ ~
'I'~~ ~:::.:,~,~,~~ ~~,l~.~: ~~,Y, ~~~: ~~~~ ~~~~.'.~ ~~ ~I~ ~~':,~',I~: ~,~'~~: ~,~~ ~~ ~~ ~~~~',l,'.~ [J II at t1.. U;~it1 c! f,'fiil "';;'l~ s~ ,
-"QIIf"""'iiiO'W1liNI~ .---.-- O"TI'UEOIIA>l/41,o..'IWI! I
an/!2.. %~u~:". ~1~_{.d .. .._od. 7/ 1"97
E
OOlfOlOl'la~CItJlNCi:til':""'
Ol1IlOlOR....,(i~oiilHr.i(1'1
'\WlWMI1OlI"I'f~
IMt.ll.AM.Il"\'IlOIIllO
COWI'\tITlOHO#ON.IIlI
OPOlRH'
WAHHll"OI'OU1H
.....
8"'"
o
[]
,-
...0
-
..if-
P_ldwIII.....~
ClMlIMl"~~
'li:I!1
'II'
I' ,',' I ill,
I 'i ," "''''.'..'.11'11
.:JI!il!:I'
;:::!! 1::111 j::
i:I:1 1'11111::
I'll "
11,,1, I
il,j.II'1 ': I)'
: I '! 'II' v
111.11' I", 'I':'
"II ' '
,.1, I' '"
: ' i ' I ~ I i r l ' '.
11,,'1' I:
1111:11[1 11 ,::
:' :'11' "I','
"" I'::,' '1::1
Ii :'!.I.<I II::!!III" li.;1
," ],;11 : III II I 1_1
I I 'II ' "
l ::1 1:,,:'11. I': I :,,1
: '\' '('II ',j l'
" I in] J;' III ';:; I
;' i I III, I"
',; I ' , ~:! I "" "
I i',1 " ",
,I ,'r n
I Ii:! jl, ;:
"1" " 1.1
i i ];',1 I? i:
:1 i'll ('1 ,j
'i !II 'illl ,\
, I! ;) 111:,1, Ii
,," ",11.11"11"
Iii' , "
I' "I "
!' I j:il i ,,:I N
III i :; I' "I '~
'I I 1,,1 I "I "
",II ,II I, ,
:1: ;'!I'II:'I (!
: ~ , ,,!':, I ,1-.1 II' "
"llf""',,,1 I )
,lil:;i'::'I:!II',1 il 0
'" > I'.",' i' "." I '
I , ;! ~ 1- '-: : ! I !' \ II I' ';';'
: ~ i ' -_ -' : i": i J (.;
I ,:": i! I ili 1..'1.1 :; I'
" I::i '" "I
,i'il' 'II tI
"
,
'ii I I:
I :~ i I JI
", :1',' I "III :
I, Ii! I !
! I':'! III ;, I' 1"1:'
, ,!; Ii' i !; , 'I 'I V
~ ~ i i: i : I ! :: 1 1 I ;: , _ ~ ' I I :; I'!: II
1 : I ! i I:; illl': Ii!.;') I.. I '1:1 I Iii ;.:1 II [I II'III.:!' ! 11::1 III i,~ i :: 'I
,I I i I j> I I'i ., I I "I' I '.' I I'll 'I'
I 1"1' I! I, " I I' - I ,II
: " : :- ': ' ," i,I!,;
,'" ,I ,'",'- I 1,1 . ,'! ,I
,I' I" :11 il! I'll,' - II
I ! I '~ I I ! I,' '" " I I! 1 : , i
I" ! I'
, "i
I" ,
,
, I !.: 'II I'::
'II," '.,'" '.'" 'I'"
I, I J I 11,1' : 'I;
! I : I " ; I : ~ i i" I;, i _: ' ",' I
'I II i i ; ',:': _ : :1 ' 1. , !, i ; ~ I '
"1- \:' I I, _ ',. I. II
,.' Illi .:'.'.' 1.,'1,1'.,1: 11,...i...,I..,I'I'.I'j~ 1:1..,...,.. I i I '.t....: I'
:,1 I I ',"i"II' ,111,,1' 'I'i'
:.1,11 '~. :1:1:/1 II: I:'.:I,'! I.::' 'I) I il!I.::.,.IIII.I.1 :.:.'.'11.
.[..;:J ~:!..III.III ::I.l1] f.: i Ii \
~II ' I' II :, I ' :1,'
;,1'111 ~II' I,I!,I ,I:; (I li:II'
~i' rJ, I \ III Ii: II~ lit,
I:.'!III I 'illl \ 'I; "I
:J 'I~II I": I': :; ';.
~_ I :'ll! :! I ; :~
t~ - I I i -I'; I
!: III ::: 1;:
II If "
~j ;1 ,-
II 'I
" "
I ,j
J ;,
i :I
H tI
, ,
Ii V
i ,
, I
f, {,
V II
I
"
V
II,
f,
,
n
,
c
;\
"
III! (III
II!:!':I !i
I I I i"I'"
: I; I ; ! ! I ~: ! '
,:il; i:: j:,,' Ii: ,"
,
..
"
,llf) I
111:1,
111'i
Iili
[ "
,['II!!"
" ,"I!"
" ",
I
V
]
ii II
[:11
!II!W
I.
I ~ I
"
,I,
,1; i, II 1:'lilltl,: I,il! i I:!
I I I' 'I 'I I i I ~ ! I: ~ 'j j i I I r ! i
,I" "111"1 II,: :"'1 , "
1111..;11 1::1111111. i'llll"1 <:'I'II'II!'il '
II' '1 ill' III I" " ,
111.II'~..'.::llli 1,\11111 It III' :!I!llillll';'i1ill!! ,iiill'
;1'1 i'l "I, illll !'iI'l ' """
il:.... '," II I' I ,illlll'.;,,:"II'.I.l....' I'll!
1(1 !, 1'1 : I Iii III "Iii :,' "
1'''11 II' ': I; "'"I 'I,i I,:'
,I!/ :: I: ii:i!1 Wi;:!I,I!
11::1 :,; ,III" :,;illll ill':illlJl!.'
:..:...,111 I:i 1II1 ,! :.:1!111..1:.:.1.1.1...1.1.11 (1.1.
' ",0'1'1 '11"1111 ,"
.'.'.:..1 ", :.....~..,I.I 'I '......:..:.. i. L 11,."i..'
:: " "III :..'!II :'1
, ';:ill 111:1::jj!II! I!::
I . 1"11'1
, 11i!.II'I"
~l I i I I : I I,'
!" 1':iI'lll I"~
L !I ,,:11111 1,1
It, i II ~I i I1III ,I
11.:."1.11. 'I 1.:.,H...1Irl :.....1
'JII, '1 "1'1 I
:.',:111111:1..11.1 I.;,,'.
~I' I !I~! I i 111;.1
"".'1 111'..'.'..1.1. 1111..
:.:.:111,1.:.1.1'1 1'1:,1
,- 11-" '.'
t I'!!! '1'1
il':lil II.:!iillll!::i
liWIIII'Hli'IIII,!1::! .'Oi
II:..!II;.:.II., il!.
1',1 ''''.'.111' I,j
'il 11,:!III; 1"1 '
') 11..l!11 11"i:i1j'I:; Iii I':
,', 1'1 i'll ,,~i! IIIIJI';': 'i I'
,::11', li.:.:.W.:I.II:1 ;111
I I ! ~_ ! II I I Ii; "
I'.'" '1""11" '
d, I" I 1.1"1.li:IIII',: '\
'i II> Ii..'.'
I'll
: ,I
:1
,
, " I
'I,,; Ii
, 'I,
, ii!
,
V
t.
"
,
"
,
"
,
,
o
,
r;
"
{j j
,
',!
',I
n
"
,'J
,
.-,
,
"1'
::1'
:: I
I :'Ii.
.. r
'I iii,
,11"1,,
I!, -:!iH
,
"
, !
i.
,
'i
"
"
,
"
'Iii
'il
"
,-I"
i "
l!;'!i'
i'.I' ;1, I,
i ~ l P
'I.
ii, ii ",
Ii t,
!, ";;
,,'1"\
tl'i
, I'
1.1'
(i,:
"'II
lilt i
,I,
,"
, .
"
"
III G . L6 - l2
0\. ~rt
0 'n
.J3 C'I l''j. ,
t'l}Iti: <dt 'f 1 " .
0'-,. 'd
Ij_'_:--" .,:-r.)
f~ .' ,1"'\
I '.l
-~; "10 "
j';~' --"
in -:\ a:J-
0: P\ aa
~ II: I')
\l1 III
12: LII C
H 1!I or-
tIl Z ~ ~ ..
tIl - ~ 0 ~ l-
I-
H Ulj~z "
Q Ul. w ~ ...
~ cq~ III
tIl ..
rlI~U1Z ~
l? t z 0
II: Z .. w
12: LII ~ ~ ~ .
H l-
ta t!l~U1 W .
Z~O "' l'l
"' .
f:l - lJ ~ I-
Ul . III
tIl Ul ~ ..
i5 ~
I
. ,
I!,. / I,,:, Iii
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH 01 PENN"'''NI. (TO BE FILED IN DUPLICATE
DEPARtMENT Of Rf_V[NU( ') I 91
"H.RRlSm~U~o\'!b"06~I___ . WITH REGISTER OF WILLS) COUN!VWDE YEAR
DECf EN1' NAME IlA . fIIlST, AND MIDDlE INITIAll.' -jlfc[OrNf r. COMPUTE ADORUS ~
DISSIN(:I\!< STEHLING S . Clul'b('rl.lIHI Cms;:ing !<c'L,Cl'IlI('r .
_I. ... I;~~~~~:,:..",., J:~~E~~;; [,"J:::;~~i;~;:,; . '~i.~~::~:~.F::i:~i.~;:,:~; ,'" I'^ 110J'
K:"J 1, Origini'll Relul'n I] 2, Supplemflnlol Return r-j ~, Rttmalnder Return
lfor dolen of dtlolh prior 10 12.13.82)
[] 4. lImiled eUcle rJ .40. Future Inler.,' Compromise [.I 5. Fed..,,1 Ellale Tax Return Requited
liar dolOl 01 d.olh all.r 12-12.821
[] 6. Decedent Died Teuale 1--1 7, Decedent Maintained a living Trult
IAllach copy 01 Willi I"'"och copy of TrUll)
---.,.......-..... AL~ COR...PO~DINC' AND CONFIDENTIAL TAX INPORMATION SHOULD IE DIReCTED TO.
NAME "=COMPLETE M..ILI;TGA'DDRE5-r---.----------~----
. Pf\,'Jrl f)hrs..illgUr.- __~. - ___ - - - ___ 21 Mllr~t[lt(' Dr.
1ElEPIION' NUM II 1 > I'A 11036
717 566-0315 Lll1l1K' H town,
.-....-..--- -L-oJ-+- --~~,-~=~_=~~~.'=~=7=~'.~=~=~.. ~=.=,~,=,. "==......,
~ REV.l~OO fJ(~ (18AI
~
w
....
..c"'
hlfll
",os
u~..
C
'*'
lilffi
..",
..",
flf
z
o
;::
:5
::>
....
ii;
hl
"'
I R.al E.lot. 15ch.dul. "'1
2, Slack. ond Bond. 15ch.dul. BI
3, Clo..ly H.ld S'ocklPartnmhlp Int.rOl' ISch.dul. CJ
4. Mortgagel and Noles Receivable ISchedule D)
5, Cosh, Bank Deposits & Mlsr.elloneous Personal Properly
{Schedule EI
6, Jointly Ownfld Properly (Schedule Fj
7, Troni/", ISch.dule G)15ch.dulo L)
8, Total Gran Assell (tolol Lines 1.7)
9. Funeral Expenses, Administrative Costs, Mltcellaneous
Expenses ISchedule HI
10. Dobll, Mortgage Liabilities, liens (Schedule I)
II. Totol D.duCllonlllotal Un.. 9 & 10)
12. Net Value of Euate lllne 8 minus LIne 11)
13, Charitable and Governmental Bequ8111 {Schedule JI
1.4, Nel Value. Subject t~ Toll. (Line 12 minus Line 13)
15. Spousal Transfers (for dotes of dealh after 6.30.9.4)
See Instrucllons for Applicable Percenloge on Reverse
Sid.. (Include values froOl Schedule K or Schedule M.)
16. Amount of line 1.4 taxable 01 6% rrJle
llndudfl valuel from Sc.hedulu K or Schedule M,I
17, Amounl of line 14 1t!l<obl. at 15% rafe
(Include values from Schedule K or Schedule M.)
18. Principal tal< due IAdd loll. from Uno I 15, 16 and 17,1
19, Crodi" Spousal Poverty Credit Prior Paym6n11
+
1:-
--..--
'OR OATIS 0' DIATH "'"IA 12/31/91 CHICK HIRa
If ... SPOUS"'L '
POVIATT C_R.I.DITIS. C.L....C_MID LJ
flU HUMI"
O~&~m
_ 8. Tolal Number of Safe Depolll Box.,
{II
{21-
131...----
14 I -... --- ---------.-
151 _..$__fl,9lQ69_.__.___..__
161 -___,____,...__.__.____________
171 ___________
1,777.27
191__~___._.____
1101 _._.l.858.82______
I B I $ 4, 920..-69-.--. ---.
1111 ___2t~.~.?~Q~____
(121 ___L~Q.2rlQL._._
1131 ___.
(141 ___-:=_I'lOl"!.p -----===.=c.
z
o
;::
..
....
::>
...
"'
o
...
~
....
(IS) __._____._________.x,_=
(16) __
(171_
....________.x ,06 =
._. . .._.K ,15 II
IIBI
DilCount
Inforelt
+-----
1191
12DI
20. If Line 19 il grealer thon line 18, enler the difference 011 Line 20. Thh il lhe OVERPAYMENT,
m[]
,
Check here If vou arc requesting' (I relund Qf OUI ov~rpovmt'nl
21. If line lB il groaler thorl Uno 19, enler Ihe differenc" on Linfl 21. This is Ihe TAX DUE.
A. Enter !he Inloresl on Ihe bolCII1CO duo on line 21 A,
8, Enter Ihe 10101 of lint'! 21 Clnd 21 A on Lino 21 B. Thi\ it the BALANCE DUE,
~.ak. ~~~c.~__~Qy_~~I_...t_~I__R!~J_~!_.r o!.~_~ll._, 1\~41~_! ______ ___
------ --- ~ ~ BF. SUR~ TO AN.~Wl~:~~__C!li~:Sii~NS ON AE~ERS[ SIDfAND T~ REC.HICK MATH ;c:;c __
Under peflCllllel of perjury, I dedaro thot I hoye O)(t1mlnfld thil return, induding accompanying ~chodulo, and Italemenh, and 10 Ihe hell of my knowledge and bolief,
il il true, (orr~cl and (omplete, I dedme Ihol 011 reol ostate h(ll been reporled 01 trUG mClrkol v"lutI. Dodarolion of preparer other Iholl Ihe petsonal represflntoliv~ Ii
Dosed on 011 informal ion of which preporer hOI any knowledge,
:1~~.:'~'7.A;ElPON~lil"~R~~;N,G"lU~~~, II,^"OO'I; ..';l . jj"".. ".1-; .. /.",--i /- .,_,n__.__ DAff.,~:,/?,,>,-;,/ .....
tG'~lIl Of PRfPARWoTtitti';A~l~ESEN.iAfl~~i.L~-"-~''':''1fDig;;----:' . ~.1_ ,~'..__..,,_:::':::.1~L-_ OAT'C---'--'-7--~' ~..-
II
1211
(21AI
(218)
mATE-OF
STERLING S,
InM
NUMBER
A.
III V 1\11 01 ('88)
~
'UJD
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES Ploa.. Print ar Typ.
e -~----"'-------l'rtfRUM8IR ., --. --. --
_ L_ _ I~~_ Nq.,--~ ~L:_Q'?'!~_ __ ___
DESCRIPTION AMOUNT
(UMMONWEALTH at PENN!)nV.A.NIA
INHERI'ANCf TAl( Rl'lLlRN
R~:~.~~.~N' OEC~O~~I
DlSSIN(:E1~
---- .. ".-- . ------~_...--, ._-_..---.__.-._.._.~_._~----.............- ._-._-~~,---,.~
Fun.ral bp.n....
1. Pre-paid
lIorHt Mt'1llOrialB - Inscripti.on
Palmyra, PA
65.00
B. Admlnl.tratlvo Ca.t..
4.
C.
1.
2.
3.
4.
5,
6.
7.
8.
1.
P.rsanal Ropro.ontallvo Camml"lan. _
Social Socurily Number of P.rsanal R.p,...nlallvOl __.2iliL 10
Voa, Comml..lan. paid .~__129L-__..__
250,00
...9907
2,
Alla,n.y Fo.. Gerald J. Brinser, Esq,
Palmyra, PA 17078
Family Exomplion
Claimanl ._____._____..__'" Rolallan.hip
Addr... of Claimant 01 d.codont's doalh
St,ool Add,... .__....__.. .___. ___._____..
City ___.____.___ .____" ..,____,_._Slal.
Zip Cad.
150,00
3.
P,abalo F.e,
45.00
MI...llan.ou. Exp.n....
Cumberland Crossings Retirement Center, Carlisle, PA
Carlisle Caununity Ambulance
Symphony Mobile (X-Ray) West~ood, MA
Belevedere Medical Center, Carlisle, PA
CarliBle Imaging ASBOC,
Postage, Telephone, Pl1otocopieH
Regi.Bter of Wills - Fili.ng Fee
1045,62
13.45
113.00
56.3U
8.15
20,75
10,00
TOTAL IAI.o enle, on line 9, Rocapitulatlon)
(II mo,. .pan I. n..d.d, In..,t additional .h.... af .am. .1...)
1,777.27
s
uv 1~\J [Xt pKll
ii'iAiIo,
.
COMt.lOhW!AlTtlor ,fNtHnvAHIA
INH""""CI 'All InUaN
'''IHfol'flICIOtNl
j SCHEDULE J
BENEFICIARIES
_._..--,.__._.~;:,;__ w'''H_..u.__.__",
_....~~rERI~I~2!..gl~~!NG~IL~... .....
ITIM
NUMIER
NAME AND ADDRESS OP IIINIFICIARY
.._._.___~_ _.__.___.__~.u.___.~_<_.___._____.._._._..._._...___u.____.....;.....,__....~__"__________
,iLl NljM"i'~
.....J'A..NQ, 2197-
RllATIONSHIP
.~
,.
r <~
AMOUNT OR
SHARE OF ISTATE
A, Taxable B.quOIII:
1.
Kt'11l1C th L, Dissinger Son OrlC- fourth
. Mervin L, Dissinger Son 0110- fourth
Jay II. Dissinger Son 0110- fourth
Robert S, Dissinger Son One- fourth
!TIM
NUMIER
1.
NAMI AND ADDRlSS 0' BENEFICIARY
B. Charitable and Gavornmenlal BoquOIlll
AMOUNT OR
SHARI 0' esTATE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAllo onlor on lino 13, Ro<apilulallon) $
-~-_._--_._-_._-_._..~.._--
I" mare 'pace I. n..d.d, Inllrl addlllanal .h..t, of ,am. ,I..)