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HomeMy WebLinkAbout08-03-121505610101 REV-1500 Ex ~°1.1°' PA Department of Revenue pennsylvania OFFICIAL USE ONLY Bureau of Individual Taxes oEPAR.ME"ToFRE~E""E County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 1128-0601 RESIDENT DECEDENT d2 ~ ~ ~ id ! ~ oZ ~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1~9 ~G 732. /oo~~oi~ coos"i~a3 Decedent's Last Name Suffix Decedent's First Name MI ~ ~ ~,~ s ~~~~ ~/Q ~4 (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI ~ i ~K S ~~~~~4 L Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW O 1. Original Return p 4. Limited Estate ~ 6. Decedent Died Testate (Attach Copy of Will) p 9. Litigation Proceeds Received ~ 2. Supplemental Return O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 3. Remainder Return (date of death prior to 12-13-82) p 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ~ ~~4-~ L ~5 ~ S N ! ~'L ~s / ~ / ?/ 776 ~ :~' Zo ~ ~~~ , ~ _ REGI~R~F WILLS 9E ONI~~, • ~, - ir..~._. - Y r •. ~ ~ • First line of address ~ .. ...~ ~ ~:`-~ ~ - ' ~~, Second line of address ' ~; ;, ~- „D City or Post Office State ZIP Code DATE FILED b+ ~ ~ ~-7 /V / ~ 5 ~ /7 ~ ~ P~ l ! O 7 ~ q / ~ Vr Correspondent's a-mail address: C~ ~% ~/~s 3 ~ Con~cast yet Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on a ll information of which preparer has any knowledge. SIGNATURE~F PERSON F~E~ONS~LE~ OILING RETURN DATE .- - •~ -~ ll ~-- ADDRE ~/ZFQ~ 1.. ,DILKS ~y! I3~Ue ~IDUDiA/n ,~/~S/4, /1~1erh4nic,S~krq~ ,~/1r ~7oS'D SIGNATU F PR ARER ER T PR TATIVE ~ '/ DATE ADDR ~1 h/,~~~ ~. S~/~~~.S ~' (D (.%~DLI SGr ~~~ ,/YI eclr.~n is sb ~c r9~ ~~ ~ 7oSS' i PLEASE USE ORIGINAL FORM ONLY 1505610101 Side 1 1505610101 J i~~~ J 1505610105 REV-1500 EX Decedent's Social Security Number Decedent's Name: ~'dgar /~, ~R /1~-7 , ~ / t ~ ~ ~ ` RECAPITULATION 1. Real Estate (Schedule A) ......................... . ................... 1. • ~ d 2. Stocks and Bonds (Schedule B) ....................................... 2. ~ ~ 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. (] Q 4. Mortgages and Notes Receivable (Schedule D) .......................... . 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)...... . 5. ~ ~ 7 q ~. • 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ...... . 6. U D 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property 7 '" Q ~' (Schedule G) O Separate Billing Requested....... . . 8. Total Gross Assets (total Lines 1 through 7) ............................. $. ~ 7 7 g 2 • ~ 9 9. Funeral Expenses and Administrative Costs (S~hedule H) .................. . 9. ~ 2. ~ q j . Y 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ............. . 10. ~ 3 Q ~ 3 • ~0 7 11. Total Deductions (total Lines 9 and 10) ................................ . 11. a ~ 5 8 S , f 12. Net Value of Estate (Line 8 minus Line 11) ............................. . 12. ~ ~ ~ p '~ . (p 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. . G ~ 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. ;~ ,~, ~ Q -7 . 6 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 ~ -l ~ S s• 7 .3 15. « p 16. Amount of Line 14 taxable at lineal rate X .0 ~ ~ 3 (~ , s / . 9 / 16. s& '~] s 3 17. Amount of Line 14 taxable at sibling rate X .12 ~ ~ 17. • a !~ 18. Amount of Line 14 taxable at collateral rate X .15 • ~ ~ 18. • ~ a 19. TAX DUE ......................................................... 19.;' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 587 •3`f O Side 2 1505610105 1505610105 ~T OF ?~1G KS, ~~i~r2 /~'- F'i c r~ avo. ~Zl-- //- /~z I /. ~. ~. y s //ViS/E,~/TiA/1/G'~' ~ _ L';~C'l~lL~ Tl ~elY ' _ __ __ /Vo~E' -- D.2~~it/fK. .Q~ 7u/~it/ -- -L/~,~ _ _ ~~~o~rir~T ~v~s __ o~ ,~y~~~' _~ _ ~.yE' d,,yE~ .PFC'j,~l~v~s _ •y~~.iY ~~~ ~ZL ~'T ~f,S~ ~r~T~- /,~ ~ ~~/~_C,6 .iJ _ , - __ ~f T /~'/I141~/rT ~'/~/L •~-~t-~` ~~P _~/~i~lB`!T/~1/ ~f~~ /~/~'/11E~Y~ O/c' /¢~D/yI//~~ _ ~r1~1_'-7!'.~~ ~z~3y /~E//yl ~Qlll~S ~'121~-ti ~S ~ ;~,' E~'~ : _' ~'~ .~07, ~ ~l __ __ __ ~~Y-air Ts; __ __ KR ~ST~N ~ _ ,noa~ a, ooo~ o~ s~ - ~~~~~,r~ _, ~° ~ ~ k~-SEy ~; /J1ao,~~ ~,Dov,oo ~~~r~1a~~•/~ ~// ~~ ~cS~ ~ ru~- ~.5~/r-~ ~; Gi%~ ~~~ ~a, dod. vy Sf~. Jrun~'~i.l~ lE~~~ QDD. oo _ __ ~2,ao?, Get 10000.00 l2, ..207. G Y tc, 7S SrY~ T .S~o~tsf- _ -_ 9, 15573 (Q Q ~~ f ~ ~ a~7. ~Y x . 2S ~ ~~~' T i3~ : _ y w~YS, ~ F ~t~lias : _ '~ 05 ~" t 1 t LY~A ~ KuCKEN,8~o0 ~~ 2, 9g __ _ __ SksgAl/ ~-. SE/1>E/YI~C 7(0 2. Q~ ~ ~. J /~' W~~oY ~. /~lao~ ~c 2.9? ~t2FL'R-P jQ~ o©o . oo Sp~4~i~_ ~uests _ ~ 4, ISS. 73 ~ D~v = D ~- ~, o sl. ~ l Y~ ~S~ dui REV-1500 EX Page 3 File Rlumber pZl^~~ "' ~,~~ Decedent's Complete Address: DECEDENT'S NAME .~'d~ar ~. D~/ks STREET ADDRESS /,1~ecla~ ~~sda STATE A~ ~i ZIP / /J a s' o Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments ~' -- -__ --_ B. Discount D 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) ¢5~7.3~ Total Credits (A + B) (2) '~"' (4) ~ 5 ~8• ?8 (5) Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN '"X" IN THE APPROPRIATE BLOCKS 1. Did decedent rnake a transfer and: Yes No 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 a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust far" or payable-upon-death bank account or security at his or her death? .............. ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property; which ~. contains a beneficiary des~atiQn? .................. ,.................. ........................................ ................................. ~I ^ '~ ~ 0%`i~iha/~-~. i~r ~e~tt~~ ~/e~ ~e{~~ ~:s~~~'y ~ a.~a~~~ea•~ tSS~~ -~- ~no,6a?e _ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) (72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent (72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX + (1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHRESIDENTDECEDENTRN PERSONAL PROPERTY ESTATE OF ~~ I K3 , ~.dSQ r ~. FILE NUMBER ~!_ // _ /, Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ . t~'1 em bu^s Jai' ~Calertzl Cr~~ ~ -~ ~ n ~ Qn Vi4 Cus f»d:al i4eCo ~cnfis: ~•) ~e u lar savit fs ,~`c~oknt' ~' 30?!~ 9~6 --oo ~l ~; 3 ~$. /q ~ ~ ~B,~ Chc~~(';n ~~oknf ->~ 326 9~6 --i/ 3~, S~~S.srJ (~se~ f k,~ka ion ~e~/~ ~f~c~e~~ M; SC~~)Q.ncor<S ~oGkL~ ChQ,n ~~. /d ~, ~`' TOTAL (Also enter on line 5, Recapitulation) ($ ~ 7 7 9 ~. ? q (If more space is needed, insert additional sheets of the same size) MEMBERS 1St FEDERAL CREDIT t7NION VA CUSTODIAL ACCOUNT: REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 326986-00 04/03/2008 $15,315.19 $.00 $15,315.19 None 326986-11 04/03/2008 $32,475.50 $.00 $32,475.50 None ~~ ~~~ ~.~ MEMBERS 1sT FEDERAL CREDIT UNION Leigh- ne Stallings Lending Insurance Support Specialist January 24, 2012 Estate of: Edgar A. Dilks Date of Death: 10/01/2011 Social Security Number: 179-16-7382 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org REV-1511 EX+ (10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER 17,115, ~G~ q'R r ,f~ a /- // -- //,2 ~ v Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. ~Ytn,I~~ui ~une>ra~ ~I-rome. of IYteGhanicsbkr~-.ba,la,,nce nol~' p~cpa-d 'x/98'.09 ~. OI ~ /!~' /YIG+~od isf' ~'1Nrtl~ ~e,r ~u.»e~eo11 ~ a~ 37, S~ B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions ~ t, Name of Personal Representative(s) ~ ~ ~~5 ~ _ _ _ ~J 3 ~~ . 7 Q ~tF~reda L . Street Address 'T1_~ ~~U ~ ~~IDU!}.tR ~ /) ~~ 5~4. City ~ p G r7Q,1 I C 3 ~ N ~ State ~~ Zip X70 sp Year(s) Commission Paid: 2. Attorne Fees t~ II a I""~~S ~ • ~h ~ G~d rJ- ~S - ~ ~ /, ~~T ~a ~ f~.sc. t 1'oln~ Fst s~dt~le arot ~;s '~ ~`i;,.~ ~c i n~1Kd-n` on ina.~ rr.~urn 3. Family Exemption: (If decedent's address is not the same as claimant's, attach exp-anation) ~i~l'~ o ~S~y 'h ~Qd • ~~ "~~~ ~ D ~ Claimant ~r'P~Q ~.. 1~~ ~ f5 5 Street Address _y ~_ ~~ ue m D t.t.ilt'L~1 n ~ I S fi4 City ~~an I C5 b~~ State ~R Zip ~~~.5'a Relationship of Claimant to Decedent W i ~ uJ . _ 4. Probate Fees A~IA,d Or'-~ ~ na~ i 55 uC 0T SnDr~ QP,I` 11 fJ~L4.7-G.t f q 3. oS'v 5. Accountant's Fees ~ f; ~(~~45 ChG1QP , Tim /,j~~~r TDB" U/ O$C'""otet la ~a~ P~ ~D, .F,t. ~SDD.OtJ 6. Tax Return Preparer's Fees 7. /~'G~/e/'t~Si~19 ih (..l~(.Ir) ~Gr~a.>rt~ Lp.~.J ~ uril4.t 4 J -7S', d0 `~ . ~ d re rt%.si~q i,n C'~ r/,'s /e cSen f; he/ ~/ 3 6 . ~~ `l. ~ c/d; fio~a/ ,~rQ~~te ~ ,/1e~~StCr o ~ ,6r~•%/s ~ (o . o 0 /D. ~'~"/; h f fee ~ /Qe9; s fey ®~' !/.`//s '`l S, v a ~). ~~; nr.~v~rsF.m~h~ ~o Ch~.rks ~. ~h;~lds t -~.- pn~~, y, e~,r-f-~ied ma~l;n~s ~ Phofb~op~es, ~t~. 1?5, ~a TOTAL (Also enter on line 9, Recapitulation) $ f oZ~ L~ q ~~ y g- (If more space is needed, insert additional sheets of the same size) RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Receipt Date: 1/18/2012 Cumberland County - Register Of Wills Receipt Time: 11:19:52 One Courthouse Square Receipt No.: 1068434 Carlisle, PA 17613 DILKS EDGAR A Estate File No.: 2011-01121 Paid By Remarks: ATTY CHARLES E SHIELDS III WZ ------------------------ Receipt Distribution ----- Fee/Tax_ Descriptior_ Parent Ar;~.ount Payee Name PETITION LTRS TEST 30.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 20.00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23.50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN ---- Check# 2548 ------------ $93.50 Total Received......... $93.50 REV-1512 EX+ (12-03) ~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER 17~~Ks~ .EDGR-2 f~. zl-i/-~~~~ Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. fTEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1' C ~a ~ M O M1 M~ n ~t ~y [~ ~ ~ D IJI~Lt.r1 t G.S D~1 ~~TPiI"Qi~ S ,/~d m R n . ~w» L~./1c~ .~ ,~d ar ~.. ~/ ~ Ik's ~~e r h : s I~e~'ercc» s A-ccv k n7"S ShaUwn ~n Shed. ~ . .~~-tn~ .~ ~i4~ ~n~ 1 ~~ T~ hn,en f/,!y ~lloc~,~tn« abler fv spouse , ~i'eda ~~%f~s, %s ~o~~~'• oo ~ ea~./i Q~ Mort f ti -{ro n~ /xI ~i~c~' ~v4~ ~.sfQd/.s~~d ~r~ / 3, zoos J ~~ .Z~B flno~,~ D~o,6~r e~ o?o/% ~ I T,h;s ~vf~c/s ~~ ~,~f~s ~ .~,xsDO = T~fQ/ off' '~~ fs0• See ~~~r o~ ,~~/~ ~(oSJSi~ sf /~ ~ f~ ns ~/r~%i1 ~~750~ Se~-~ SG"/X/Z,~ .S`lCG ~ .S s~o l~ii1 L~'~L~!~ ~ /SO~',f l1~C/~C~ • . ,~~iize~ aa~al. ho~a/ al/ow~•rces ~ ~.n, ,d ~r s ~m !~~ ~r~occn~• ~~ i fe~r~ize~ sc~,erlt,~ ~Es a f1~ac1>i~ J f3, d `l3. ~7 TOTAL (Also enter on line 10, Recapitulation) $ ( ~~ Ej ~ ~ 67 (If more space is needed, inseri additional sheets of the same size} _ ~ n ~~~ .dam ~~ ` 't' ~ ~¢~gS°t /~'~ ~„d i' ~.. i J' r, ~ ) 4 '~ ~ ~ ~ ~ j .a ~ ~~ s ~~~ ~ ~~' t ~ ~ E f ~ _ _ _ _ ~ f,~_ ~ ~ ~, _._ _. _. E _ .. ~ ~~~ ~ ~ f_ ~:# ! ~~ - .. ~ ~~ C _ ~ ~~>~ _ ~ e ~~ ~ ~ ~ 0 ~ ¢, Iti( Y' "t ~ '', ~ `r~ ~ ~ ~~ E ,~ s r -- ~ ~ ~ ,:, ~~ k~ ~' ~$ t . -- ._ . A ....... !~ ~-~ } `,~ ,. 6 ari ~- ( ~ ~ F~rYw._. _ ._..._ ~~ ~ ' ~ ~~ 4 .~ _ _ _ i ,~. y ~ 1. I ~r ~ I p ~ ""~ ,~+~ ~ ~~ l . ,~' r f t ~° ~.` ' ~ . a ~ ! ... ~ ~ ~ ~ ~ ~ iii` ~!!~ a }fc f i X ~bJ ~` ~l ' i, J! ~ i ~ ., ~~.~= I ~ ~. t :; ~ F ~~l~ ~~ ~. ~ ~ {E 3~Y f , ~ ~ 0 ~~ .. I ~:," ~ ,~ 5.x,. ~ - - ~~ ~~, R,, ,~ ,. ~:~~: ~~x F: ~. ~ 4 21?1i DEPARTMENT OF VETERANS AFFAIRS VAROIC PHILADELPHIA 5000 WISSAHICKON AVE PO BOX 13399/2136 PHILADELPHIA PA 19101 In Reply Refer To: 310/2136/ADME FREDA L DI LKS 44 BLUE MOUNTAIN VISTAS MECHANICSBURG PA 17050 Dear Ms. Dilks: C OS SS2 477 DILKS, Edgar A Recently our field representative visited with Edgar A. Dilks. In the report to our office, it was recommended that a change in authorized recurring expenditures be made. What we have decided We have reviewed the request along with the income and expense information of record and approve the following: Housing $2,858.79 -Medical $ l OS.00 -.Health insurance $178.60 -Incidentals $480.00 - Clothing $100.00 -Personal allowance for Spouse $225.00 -Vehicle maintenance and insurance $112.50 -Credit cards $700.00 No cash/counter/ATM/MAC withdrawals are authorized. No gifts/loans from the Veteran's VA funds are authorized. All one-time expenditures over $1,000.00 not previously approved by the VA must have prior written VA fiduciary unit approval. As a reminder, VA funds are not to be gifted or loaned and purchases of homes or property require prior approval. r'~1~ `~ ~"„ or D~r!as, ~~-,r2 ,~. ~-' SCN,FDUC F o~' /~+~OiTiouA~. 'N~ln13u2S€/j1~"~vTS Ta S~ol~SF _. __ _ ~-ZvPFi2 l y ,/YIA-iV/4~G FiYjE~-!T /N~': o~ _ _ LE/rtvy/iVE~ ~~ ,~,~ _ /l~f,/~/A/TEIY~/Y(~' ~E~.~ ~ 9 f 9~d~ '~~ p ~!~ Do _ ~ _ /-~j~-: 77~cs` ,~p~LSCn1~' ~e ~ -~i° l,~l,.cli .S~oc[Se _ l ___ _. _ __ _ ___ __. ~ ~~ //l9/p g p`~6 y, Do _ ~vvst/A~ ~Jt /pi/X~u,~',tcq! _ ~I iSSin~ /J?l.Yl/hS !,~/C a/~~ /e219 X09 ~a 5!, Od - _ _ ~+uq~ d r rrc-G~f~, _ ~rvm _ !%9~ Q ~aur~t ~~ds~ 3l/o/ie ~2a~fo6 _. ~d~iD ~a0~- ~~ i Lin ~/ •+ ~o~D~.vO {~,ya~D~ e,~~~T~ ~~- ceo~s- ~~ic~ i~su~e~~~- ~~~~ ~ ~ S, an ~~oTE: SEE' wo'TF' it13oliE, ///o` ~~ `3~•~~ _ _ _ _ ____ f ~~iv~~d 3~• 60 _ _ _ _ %v ~ 3 ~ bo ~1~-/~~ ~38,~0 __ _. ~~olO_ ~3~, 6° _ _ _ _ _ _ __ /~io /r~ 3 8'. by ~o/a 33,,8'D __ 7/~%~ ~ 33.0 ~`~a~. ~d __ _ _ _ __ __ _ - __ Noccs~.!{ot.~ /k/~-/A1TEN~iv~- ActocJ~v~S: _ l~'• C„ Il t nvt rr1 E~ ~ F'i4Ti ~liZ Co N,p,, ~1 q 1. ~ d "~ Zt~'atMEl2rit~5 ~-~trrmB~ntG + k~'A-rhlG `fo.~b ,1~-~C. R ~-rlM~ N~'R-T~o~~ ~e .~4iR COND. ~~ ~o• no ~3F 1. no __ _ _ See_ ~ to cca,J~o~ ~sheef Op . 2 SL~Is'~uLF' ~ _,i¢~0(D/TD~~ /QE'!/yfk3t.~,~S~/Y/E~'~s CotiTTw~~ _ __ ~'I~SCECt./ttiFG t~S ' _ _ _ _V~l~ ~h~,~yl/3C-~~S~Y/,+~ D~cES l Soo _ __ _ __ ~l~Z.s~l~' ~9uT ui .k8 7~u~'s(~v,~4.T;~'~3~ :00 /y~Fy~hiT L'LuQ l~?t(E3 ~Lo~ ~/o. oa f.~l~" ~~-',.52!ll~iv cF ~~T~J pia ~_ °O ____ ~R~ fv2NR-@~~ ~~ -py~y~ ..SCE. o0 CL~FJnoNT ~4-ACT. S~ •ov ._ _ __ ~~ r /yl~i~/~E2 -,~~y~vuRsE ~6~ ov ____ /~Ot'~'%~}GF ~~r~r/1/Ty .SYS. '~~yO.oa __ ,. ~/~psyFLf ~¢ltTo Ctt{g .l~t~GE3~L~/o.oo __ ~ G'~ ~rys,~3~rp~ R~Giorti ~ ~u~3 '~ao. OD ~NT~4a~' ~ficTv Cckt3 aF~/~f- ~3S••oU ___ _ _ _ __ _ __ I~G,I~ ~ F t/r~- ~E'i~1~ul?s~1E7v~ s ~ w ~.~ e ~ /~iQQ~E~Ty /yli9/1~/¢GE'.u~YT lit~~.. ~/~ _ ~f.? ~', a6 _ _ __ !'~-~°/iA~ /,~~" h..2o~'S ~ d a76 • SAD floe ~~o~o ~/~4-w~-~~v~F ¢3 ~!. oD _ _ __ ~J/s~,HEvuS / Zo p. z7 __ _ _ _ Try '`.3, G y_3. ~7 __ _ _ _ _ _ -__ _ _ __ __ _ _ __ REV-1513 EX+ (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT --__ ESTATE OF FILE NUMBER ~ ! `// _ //z / ~, lks, ~dyar ~4. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 1 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] ~~ ~3lue ~1'lak~~'a%n ~~s~ ,/Y1¢cli Gn ~ cs 6 u ~, f~~ ,r lose ~~/~1~» ne1~ : ,~es:a~cac~ ,re>F~~rcr,~~' Sri ~~ was h e/q/ ~1. flu t•~f~rrf~es era/ ~s Hof /~Qht o~ ~c /~rvdc~ esfaf ~tor ~e ~x~ 6~e es f Qf~ .?. II l'~risf~n ,~ . ,/~oort, r~rdl~y ~'~a~ry •rs ~Cris~i~ /y!~ C"ards// -S~I~jD/JP-/,tS~kr~,P,/~ /757 ~~ C'6n ~i~c ae ~on S~- cam/ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE SQf3ou5~ ~~~ of ,~GSiC~ke ste(~ -~~tv~ ~ ~i +~c~ ~a, o~, ao ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) ~. z 3 ~I ~. 7, ~- __ _ _ _ __ ~c~~se~ ,~_ /11avr~ _ s~~_- ~ ~ ~ la~_ a~~ 4~ Faun fir'! ~Q! _ /~ _ _ _ _ _ _ _ ,I~I~XKI7u~c°r ~. Lr1`~~kcr ~7W - qr(~~- ~i ~ ~~ __ as ~as~.~~ Dr%~e _ ~, _ _ _ _ _ _ - _ n ~ ~, ooo- o fyl2~l~,~?i~S~~rr~ , .~/~ / 7o ss ,/~ a s ~i~1 C • Lt/a ~/ler 5~'~ - ~ rk~ ~ ~ 1 /hi ~ha~ ~ c . Gt1a~k~r _ _ __ ~~o~,o. _ ~ ~~ a2 /~j ~,~ ~r~ ~r~'ve ~ y ~~~ 2~sv ~~it,Owst~_¢S-_ _4~f~Z c~~~/I/Gr~; .1~r'. ~i a00. ov ~79~Y ~ant~~_ ~f q/. 2oQ w, _ _ Lin dQ f~~ccken b ro d _ _ - of frr `/« Q F Qes ~ c~u~ ~~~,~~y ~~, as ~~~~ ,~r. ~; Mks offal/ /4'uf'uly1,/1 lUD4l~ ~ti I~B __ Nu.nt~~n aoh, PA- i ~~sar _ J __ _ ~~san i4-. ~~_en~ ~K ~4 ~f~r- _~e eF G~~sulue ~7 3 96 ~~~~ k St ~, _ _ _ _ __ ~~a,, m i ~~ a~(o ~5~ Cpn t,n k q,,~' ova gY1ee~' LAST WILL AND TESTAMENT OF EDGAR A. DILKS I, EDGAR A. DILKS, currently of 44 Blue Mountain Vista, Mechanicsburg, Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void an}' and all prior Wills and Codicils by me at any time heretofore made. 1. I direct the payment of all my just debts and fiinera] expenses as soon after my decease as the same can conveniently be done. 2. If for any reason the residential real estate situate at 44 Blue Mountain Vista, Mechanicsburg, Silver Spring Township, Cumberland County, Pennsylvania, has not been sold and is not owned completely as tenancies by the entireties by me and my wife, FREDA L. DILKS, at the time of my death, then I give, devise and bequeath any interest that I own therein to her, absolutely. 3. I give, devise and bequeath to each of the following named grandchildren by blood or by marriage, the sum of Two Thousand and No/100ths ($2,000.00) Dollars: A) KRISTEN McCARDELL B) KASEY MOORE C) ALEXANDER WACKER D) AUSTIN WACKER E) STEVE SEMENICK, JR. i) Iii the event any individual receiving such sum is a minor at the time of my death Then I appoint my wife's son, MICHAEL WACKER, as Guardian of such sum for the benefit of the minor. ii) In the event he is unable or unwilling to serve in such capacity, I appoint my wife's daughter-in-law, WENDY K. WACKER, to serve as guardian in his place and stead. The said sum held for the benefit of any minor shall be held and the income shall be accumulated thereon until the minor shall attain the age of eighteen (18) years. At that time the principal and any interest accumulated thereon shall be paid over directly to said minor. iii) ~~here shall be no right to invade the principal nor any income accumulated thereon except for the payment of income taxes on the income generated. iv) In the event any above-named grandchild predeceases me, his or her gift shall lapse. v) These gifts are to be considered specific bequests and any inheritance or estate taxes due on such sums shall be paid from the residue of my Estate. 4. All the rest, residue and remainder of my estate, real personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to be divided and distributed as follows: A. Three fourths (3/4) thereof to my beloved wife, FREDA L. DILKS absolutely. In the event my said wife predeceases me or dies at about the same time as I die, such as in a common disaster or accident, then my estate shall be divided proportionally and upon the same terms and conditions among those named below. B. One fourth (1 /4) thereof shall be further divided into four (4) parts and distributed as follows: i) One (1) share to my daughter, LINDA H. DILKS, absolutely. ii) One (1) share to my daughter, SUSAN A. SEMENICK, absolutely. iii) One (1) share to my wife's son, MICHAEL WACKER absolutely. iv) One (1) share to my wife's daughter, WENDY A. MOORE, absolutely. In the event any of the above named four (4) individuals has predeceased me and he or she is survived by issue, then his or her share shall go to his or her issue, per stirpes. In the event he or she predeceases me and is not survived by issue, then his or her share shall be proportionally divided amongst the above named individuals who survive me and/or their respective issue in a stirnital manner, as the case may be. 5. I nominate, constitute and appoint my wife, FREDA L. DILKS, to be the Executrix of this my Last Will and Testament. In the event that she is unable or unwilling to act as such Executrix, I appoint my wife's son, MICHAEL WACKER, and his wife, WENDY K. WACKER, to be Co- Executors in her place and stead. In the event that they should both predecease me or for any reason be unwilling or unable to act as such Executors, I nominate, constitute and appoint my wife's brother, JAY S. LIVINGSTON, to be Executor in their place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. 2 IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ ~ day of __ ,y,~~~- , A.D. 2008. x ~ G~ ~~ (sEAL) GAR .DILKS Signed, sealed, published and declared by the above-named, EDGAR A. DILKS as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. W.A2E%4~. 1 ~_