HomeMy WebLinkAbout06-28-13 J 150561d1�5
REV-1508 EXi�'-°"'F°t�1
PA Department of Revenue Pe��Ytvarria tlFFIC1AL USE ON1.Y
Bureau ofIndividuatTaxes �� ��NHERITANCE TAX RETURN CountyCode Year Pile Num4er
PO BOX 280601 �y �
tiarrisbum,Pn xn28-osoi RESiDEtJT 6ECEDENT i � I� � FJt�
ENTER DECEDEN7 INF6RMA710N BELOW
Social Secudiy Number Date at Death MMODYYYY Dete af Birth MMDDYYYY
. _ .._ _. . . .. . ... .... .. .. . . ....._ ..
_. _. �___. __.. ..._
�04l2812D93 �061Q1t9998 �
._._.. ._..__._- .—..._'__"__—._-'. L___....._._.'__".__"'� �.—_.�...—_.�_..._:
DecedenYs Last Name Suffix DecedenYS First Name MI
..____ . _ ...._ ___ ___.. .__—..__ .. �___._._. r._._.___..� .—. T.___-__.—..._--_._ __.-
' Diilen � ' Frederick i W �
i
tif AppRcabiej Enter Surviving Spouse's Intormation Below ��. � �
5pouse's Last Name Suffix Spouse's First Name � pAI
_._._ ._____ .- .-.___.__ _..._—._._- _._ __._ ._._— .__..._ ._. ... .._. ... �, .._ ..
I �
_ _ _----- -- ---_ � .....__ 1
Spouse's Social Security,Number__ _ ��
--- THIS RETURN MUST BE FILED tN DUPLICATE WITH TNE
_-___----._.._-------.� REGISTER OF WILLS
Pltt 3N AFPROPRIATE 4VAlS BEt.OW ��
� i.Onginal Return p 2.SupplemenWl Raturn p 3_ Remaintler Retutn{Date of Deakh
Prim to 1z-t3-8Z}
O 4. Limitetl Estate O 4a.Future Interest Comprpmise(date of p 5. Federe!Estate T8x Retum Raquired
tleath afteri2-12-82}
� 8. Decedent Dietl Testate O 7. Deqadent Maintaned a Living Trust 0 8. Totat Num6er of Safe Deposit Boxgs
(attacn copy or wiii} {nttaa,co�y ot Trust)
Cl 9. Litigetion Proceeds Receivad p 10. Sppusal Poverty CredR(Date of Death O 11. Election to Tez umder Sea 91t3(A)
8etwesn 12-37-91 atxt t-t-95} (Aitach Schedui�0}
CORRESPONDENT- THIS SECTION MUST 9E COMPLETBD.ALL CORRESPONDENCE AND CONFlDENTIAL TAX INF�RMATfON SHOUiD 86�IR6CIE0 TQ:
Name Y q . __ . ^ _ ,, Deylime Tai�one Nuilnber�v��
_ . �'�
Richard l. Place , Es-- I (717} 23@�� ' � � �
_ - — _. __ __. _ - ._ __ _ .._ _: __—_. _�__�- --v'
REG � I�F LSi�SF�ONLm
� Z � �1 .`O
First Line of Address � � ,�C O
. ._ ..._.... _...._- ----__ __- -
Piacey&Wright ca o � 3 E
c
SecondLineotAdrkess � � ,� �
. � �
3621 North Front St. y. � �
ts'!
City or Post Di(ice � State ZIP Code oATE FI�E� �
_ _____.__._.._.—.__ _._--___... _._—...—_.�_
_.__ ...___ .___.__.__.__..
Harrisburg � PA i1711Q
CorraspondenYs e-mail addresa:pWl2w{p'�epiX.flet �
Under{renaliias W perjury,i tledare Ihet I have exemined this retum,includin9 accompanying achetlule3 and statemeNS,antl to the 4est of my knawletlge aM belief,
It is true,correct aM complete,�eclaretio�of preparer other Nan tha pereonal repreaentadve i�paxe�on a!t irtwmalion ot w�ich oreperer any k!m�Wetlge.
SIG R OFpER50IJ3�SPON B f{4 GRETURN pq E
a DiYESS t� �'�— �� J � �!�
Ralph . Dillen, Executor, clo Placey &Wright, 3621 North FroM Street, Harrisburg, PA 17114-15 3
SIGNANRE OF P ER p E N REPRE&ENTATIVE q
ADORESS
Richard L. cey, E a `"8 821 North Front Street, Harrisburg, PA 17110-1533'
PLEASE USE 4R14INAL PORM ONLY ��
Side 1
� 1505610105 15D56101�5 ' J
��
� 150561�2�5
fYEV-1500 EX(FI)
DecedenCS Sooial Security Number
.-'_-_.____-_...____.-.
oeceaenrs Name: Frederick W. Dillen
RECAPRULAT1pN
_ . . . _._ _ ._- _ _ _�_. __
t. Reai Estate(Schedute A}. .......................... .................. t. O.dO '
. . . ..,. .._. . . . . . _. .._.. . . ._._,
. 2. Stocks and Bonds(SChedule 8} ................................... .. .. 2. 0.00 i
3. Closely Hgid CorpqraTlon,Partnership or Sole-Pre�prietorship{Schedule C} ..... 3. 4.d4 !
4. Morigages and Notes fteceivaMe(Schedule D)........._........._..... 4. . Q.{70 .�
5. Cash,Bank Deposits aad Misceilansous Personal Property{Schedule E},..,. . . 5. �. 2$6,088.d7 ��,
6. Jointiy Ow�d Properfy(Schedule F} C} Separate Billing Requested ....... 6. 0.00 '�.
7. Inter•Vivos Transfers&Miscell8neous Non•Probate Property � � ���
{Schedu4e G) O Separate Bilkng Requested........ 7, �. 0.04 �
8. 7ota1 Grosa Assots{tbts!Lines T through 7}.................... ......... 8. � . 24$,08$.d7 ,.
8. Funeral Expenses arW AdministraUVe Gasts(Schetluie H}....__....._..... 9, � 19,802,7$ ;
..._. .______._
t0. pebts of Decedent,Mortgage liabflitles and tiens(SCheGu7e i}............... '10. . 4,731.53 �
N. 7ota1 Deductioos itaNal Lines 9 and 7Q).._............................. ti. � 1$,$34.28 �
_....--.._ , __�,.-....� .
72. Net Yalue ut Estate(Line&minus Ltne'11) .............._............ .. 72. � 229,554.19 ,
13. Charitable and Gpvernmsntal Bequesls/Sec 9113 Trusts for which u"""'-"�""'�""-""-"'"' ��
an election to tax has rwt 6een made{Scheduie J) .. ...................... 19. 0.44 �..
14. Net Value SubjecC to Tau{Line 12 minus Line 13} ........................ '14. 229r554.1$ ..��.
TAX CALCULATION•5EE INSTRUCTIONS FOR ApPLICABLE PATES '
15. Amount af I.ine 14 taxabte
at me spousei tax rate,or
transfersunderSea9156 -_-. -_-_____ .. ._..
i __ .. _.__. _... .__... . .__.
(a7(1.2)X.0_ 0.00 � 15. I 0.00 ,
18. Amount o#Line]4 ta7caMe .
at lineal rate X.0 45 229,554.19 i �6. i ' 10,329.9A
t7. Amount af lane 14 tar.able . . .- . . . . . ; , .. . . .. . .. . �,_ ._ - ... . ._
at sibling rets X.12 0.00 � 77, I O.nD �
18. Amount of Line 14 taxa6le �.�_��..-.....--..-...-_. i . ...-�. _.-_._�_.
et collateral rate X.15 ���p � �g_� O.pO�
19. TAX DUE .... ... . . ... . . .. .. . . ... ...... ................. .......... . 19.'I 10�$29.�4 �
20. F7LL IN THE OVAi.IF YdU ARE REQUESTING A REFUND OF AN OVERPAYMENT � p
Slde 2
� 15Q5610205 15056102�5 '': J
REV-1509 EX{ft) Pege 3 Fl�e Number
Qecedent's Gomplete Address:
oECEO�rs rrnafe
Frederick W. DiAen
STREE7ADDRESS � � ��i.T��� —v�--� ,
121 Messiah Cirde
GlTY .—...___—__________—_.—...��__._—_.�_—_�'_.-rSTATE—_--.— I ZIP .�..—
Mechanicsburg j PA � 17055
Tax Payments and Credits:
1. Tax pue(Page 2,Lina 19) (7) � 1 Q329.99
2. CreditslPayments �� _
A.PnorPaymenis �_._ d•�d
B.Diseount 516.50
��� 7otst Credits(A+B} (2} 516.50
3. Interest
(3) 4.Q4
4. !f line 2 is greatar than Line t+Ltne 3,enter the diife�ence. This is the OVERPAYMENT.
Fil!itt oval an Page 2,Line 2Q ta reques2 a relund. {4) 0.00
5, ii Line 1 +Lins 3 is greaier than Line 2,enter the difference.This is the TAX DUE. (5) 9,813.44
Make check payab(e ta: REGISTER OF WILLS,AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIl47E BLOCKS
1. Did decedent make a hensfer and: Yes��� No
a. retain ihe use or inwme of the propedy transferted.......................................................................................... ❑ �
b. retain the righi to desgnate who shatt use the pmpetly iransferred or its income............................................ ❑ �
o, ret�i�e reversronary irnarest.............................................................................................................................. ❑ ■
d. rec�ve the prvmi�ior life af either payrtrents,benefits or care?...................................................................... (� �
.. 2. It rkath acwtted after pec.12,1982,did decedeni transfer propeAy within one year ot death �
without recaiving adequate consideratioa?............................................................._.._...._............_.................,..... ❑ �
3. pid decedent own en"in trust for"or payable-upon•death bank account or security at his or her death?............_ ❑ �
4, Did decedent own an individual retirement actnwt,annuity or other non-probate property,which
coMains a beneficiary designation? ........._......................._.................................................................................... ❑ � �
IF TNE ANSWER 7Q ANY 4f THE ABQYE QUE5TIONS IS YES,Y4U�UST COtAPLETE SGNfQULE G AND FILE IT AS PART OF TNE RfTURN,
For dates of death on nr after July 1,7994,and before Jaa t, t995:the tax rate imposed on the net value o€t^ansfers to or for the use of the surviving spouse
is 3 percent(72 P.S.§9116(a)(1.1)(iJJ.
For dates of death on or afler ,lan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use oi the surviking spouse is 0 percenf
[72 P.S.§911 B(a}(1.7)(ii)].The statute does not exempt a transCer to a surviving spouse from tax,and the statutory requirements fqr disclosure of asseis and
filing a tax retum are still applicable even if the surviving spouse is the oniy beneficiary.
For dates of deaih on ar afler July 1,2000:
. The tax rate imposed on the net value af transfers from a dsceased child 21 years of age ar younger at death to or for the uge af a natural parent,an
adoptive parenY ar a stepparent of ihe chitd Is 0 peroent(72 P.S.§8118(a}(1.2)).
. The tax rate impased on the net value af iransfers to or for the use af ihe decedenYS iineal benefioiaries is 4.5 percent,except as not$d in(72 P.S.§9116(a){1)].
. 7he tax rate imposed on the net value of trensfers ta or for the use of the decedenPs siblings is 12 percent j72 P.S.§9116{aj(�.9)].A sibling is defined,
under SecYion 9142,as an individuai who has ai least ane parent in common with ttre decedent,whether by blaod or adoption. '
REV-y5o8 EX+(o8-r2) !
�pennsylvania SCHEDULE E
bEPAftTMEMOFAEVENUE CA,SH, BANK DEP4SiTS & MI5C.
INHE2RANCE TAX REfURN pERSONAL PR4PERTY
RESIOENT DECEOENT
ESTATE OF: fIL6 NUMBER:
FREDERlCK W. DtL�EN 21-13-0515
Inc7ude the proceeds of iitigation and the date the proceeds were received by the estate.
p{I property joinUy owned witt�right of survivorship m�si be disciosed on Scfiqdule F.
ITEM VA�UE A7 pATE
NUMBER pESCRIPTION OF OEATH
_. _. ...._ .... .. ._...._ �._-...._..__ ._. .__... .. .... ..... ...__. _ . .. ,n.,,�,a.�n.�..n�r�,�..�
1." 'Susquehanna Bank Checking Account 1710U4880 (Principal-$1,895.98;Interest-$,21) � � ��g3g T7 !:
2 Susqushanna Bar�k Cheeking Account 17100i2376 (Princip s �, �� w ��4 � � I ���Y� �� � �
. ���LL aW�ai $39,777.49,Intarest-$6.91) ; ` 39,78360
_ _..,._ _....�..__,. _. . .�.. �>.,m. . ,...,. _.::,.- -
3, Members ist Federal Credit U�ion Savings 161223-00 {Principa!-$2,7224Q;lnterest-$.28} 2,722.68�
.. _ . ... . . , ... .. ._... ..__ ...... .... ,..... ...:. , v�;;� �r � �'..Mw:'�;r,"
4, Members 1st�aderal Gredit Union Savmgs 181223 04 (Pnnapal $4,OOOAO,interest-$41) 4 p00.41 �
.:,. � ...... _. .-,��...� ..,_..,...m k..,.. .._..., _ . . . ,,... _ .... ,.,�..... �._ n°.�iFz ,i a��l�5d ��I���,
5, Mambers tst Federal Credit Union Savings 161223�43 (Prinoipaf-$162,025.22;interest $83.23} 1gZ,�pg,3�k.
, _ < . �...:,... .. �:�.,...u.v .. ... . �. .. . .. .-
,. . .,-... � _. .H..<.,.. ���u._:� . ,k,;:
g,; Members 1st Federal Credit Union Savings 161223-45 (Principal-$35,606.59;Interest-$15,85j 35,622,44�.
. ,.._.._ .. ..._._ ......., , ._....�...... .. .......... . .. ..... _..... .. .:,.._ �C'S,�§�s.�,e�7'��Sa�S
.7 Verizon-retund ,, 14,82�'
, � .. �����.
g, Miscellaneous Personal Effects 6 � � � � � X No Vali�
. .:. �� .. . . . ..... . . ......... ... . .. .. ,.,, . .. . .�. ,�.,. •�,�.�'�`.�.�.,, x±R r;�,.
��i�
s
_,. .,:.. ....:,.: . . . ..::. , .....�., . ..,. .6....,�...... .. ...:.._. . �...,...., ;�'�,'v.��'' �C���.�'-._�`�lt::
_ ._, ..._ .., ..,.�. , . . ._.... . ., . -.. . ....- .,.,��. . . . �,,, � ¢!k=S,iW-�.d ..r _'. '�ava,.d€
i'
i
,. ._.. ...: . .... ..�.� .,.� .,�„. , . . _.,.. __. , . ...�,,. �s �..��r f+Mx��•c�'.
. .... . . . ..... .. . :.:. . ,..,. , ._.. , .. ...,� _;15!0. v�Tx ar",?GGaa:F;a'�.a�"�.
�
-__.,. .:. .<. -,,. . _ ..... _ � ..._ ..-��.,_ .,.. .e,.. ..,,.�....�...., . p�
_ ..�.., .w,rP�a°.P1�i'�'ka`�'�5�'x':.l.
(
, .... ... . . _. :.. :-,: ...... ,.:.: . _. .:,. . ..'i!o.. ,.�u.cu...f5.-' i.
; i
u
... ... ,.,e._ ..� .�„� , a-.� „n. . .�. . ,,.. ._,,.. ..,., �.., � .._.U�. ��,R'rur�.:rc..ncu"��"x.
�
. .. . . .. ... ._ . __ ...... ,.:.._. . _. .: .::
. . . .,... . .. . . .,__, �u<.,.� .rx ar5 ' r��.
,,,_" . .__ .� -�.. .-.._ r, .,__ ,. _ , > .,..�. , ,..� 9fi .'s atr RaT�.�f�.`f
„.. .. . ..._ ..... . _._ . .�.� .. .. .. �s .k�ri..,. . 3`.3.`£-�-:;�h:="
i.
, . . .... ,_... . � .. :
_.. _ _.. .. .. ... _ , . . _. �l�!"!'d k .:� s.x,.,r,�:�;.
. ._ ... ..... , ..,,, ..„,..,,>. .,.. .�,,,,�. . ._.... . . ,_,.._., _. .,,... 1^(��it,'i .�x, .� ,.'�:o. ���
t
..:. ....,. _.. .:.�. . � .:�... � .�. .,.:-.,,, . �,� .. ,�:
. . � �...,.... .,:,.... , .,,..�:...�., ,� s,; w ,t�.�.S.tS�_ _.._x;
. _,.. .. ... . ... ....._, � ,.w_,..,.._ ��. ., _.,�._. ..'_". . . ... _ ._.. _' � y�i
r .-_..._ _ _. _ ffi� u.':.°xLt.u�` ..,'�, vr'_
. _ . . . ._. . .... , . ..... _. . _._...-,.. � ...,. ...,..,_. . ......,. ._ .......,.. � #+,g: �.,:. }��..
TOTAL(Also anter on Line 5, RecapituiaCion) $ 246,088 q7s`
If more spa�e is needed,use additionai sheets of paper of the same size.
REVd911 E%+(10-09)
�:�jpennsylvania ��HEDl1LE H
�� pFPAflTMENT�FREVENUE FUNERAI EXPENSES AND
INHpRITANCETA%REN0.N ADMINISTRATIVE COSTS
IlESIDEM 6ECEDENT
E57ATE OF fILE NUMBER
FREDERICK W. DiLtEN 21-13-0515
Decedenk`s debts must be reported an Schedule I.
� ITEM
NUM9ER DESCRIPTIQN AM6UM
A. FUNERALEXPENSES:
1 Padhemore Funeral Hame _ _ _ _ __ _ `.4M Y�V o-3��� .� N
049m54"
. _ w.:, �.:»�"
2 Olde Town Florist-memorial flowers 201.38=
_ _ . �.w�.: .wW. ..,.� �
_ ,
�,:.v�;.. y,�wM,�w44-a�.,�,.�
3. Msssiah Lffeways-memonai mea! 739 88 ?
��_ �- ��a3 ,�x�r� „�:.
_
a. Pastor Irving-honorarium 400.00
: ��3.:
� 5. Pastor Hostetter-honorarium � � � �� ������ ����
,
95Q.00�
_. .�: a .� m�„�
s. Kristenlrvi . _. ,: � ..,� .
ng-memorial music 150.00"
_. _ ,: __ > . _. _ � ,
_ ��. � ,.,.� ��m
_.,.
7. 'Virgi!Books-memoriai technician 75 Op'
_ . , . _
B. ADMINI5TRATIVE COSTS: �
1, Personai Representative Commissions; � �
Name(s)ot Personal Representakive(sl--- ,�,_.`_,_—...--._.�-----.._— ' � ;;:��. . � � �,�.:� � ,.
S[reet Address
GtY�v.----------------Siate-----ZIF-------
Yeafjs}Commission Paid:�.._..._^._ ..__.—_--.—_—..—...—_ I ' ..,,, y'..F..., ?
! J 3 500 00¢�
2. ACtomey Fees: � .,,�. �
3. Famiiy Exemption:(If decedeot"s address is noC the seme as claimanPs,atrach explanetlan J � ,�... �a , „ .�.,, „�„
Claimant
Street Address
. City_—_.—_-----__...—...—.—..—.�..�.Stdte__ZtP_.—.__—._.
Relatianship of Qaiman#to Decedent,__i__�__,i,___�__�___ ,
4, Pro6ate Fees: �r� .�.:: � � '353.50�:
5. Accountant Fees; ..., r�. .�� . .. �
* . .
� _ � . _
6, Tax Retum Preparer Fees: �
._. . ._... __... ...__. _.. .. .� .,,. :,. .�.��
� Patriot-News Company-estate advertising 1�i 8 45
,.e,. -x,�.��„wx
_ _ . _ _... _ . ,i.a.,, . .,,..�,,
a. Cumberland law Joumal estate advertising 75.Oq'
_ � ., �_.�..,„-
_ _ r - �.�.�� �,,�.,
s. Reserve for future costs,taxes and expenses 3 QOq 4Q'
r„.
»,�. ..
_ _ _ i .�:�: . . �����.�. �:
.F ,,,, .b,.M...�. ,
x,}_... _�,..;:�,.�v.,
: __.. .- r _ -_ . ,.� �: .�� .< �.:
_ _ _ , _ i . ,. ... : .,
TOTAC(Also enter on Line 9, Recapitulation) $ y ���8d���� '
_ ..: .. ......:..
If mara spate is needed,use aBdiNonai sheets of paper of the same size.
REV-1512 Ex+(12d2) �
� pennsylvania SCHEQULE I
n�enarMeNTO�sev�nuE DE87S OF DECfDENT,
INHE(UTANCE TAX 0.bTU0.N MORTGA6E IIABILiTIES & l.IENS
0.E5SDENT DfCEDENT
ESTATE pF FILE NUMBER
FREDERICK W. DIL,LEN 21-13-0515
Report dabts incurred by the decedent prior to death that remained unpaid at the date ot death,intiuding unreimbursgd medical expenses.
7TEFfi VpLUE pT DATE
NUMBER DESCRlPTlON OF DEATH
_.._ ...._._ _... __. _ ... __.__._ ._.._ ..._.. ,�.Y4 .,,.: ..xa,..,...,a,..�«.,-.��.:
1 �,AlertPharmacy-debtofdecedent . 40261 �
_ _ ,� t
,_� �.�a.n,-�w. M����,
2.'. Verizon•deht of decedent 26 22!'
__ . _:_. _. .... _ 1� s�':t�a.�,�.��a�:±:
_.
9. Home Instead-debt of decadent 589.70 �
—- � — — � :,:.:: . . �. _ _ - �. � __ I�. . ,� ne��;��a�F r�.
_ _
w_ _ _. � �,
4. Lifeways{Messiah Vlllage}-debt Qt decedent 3 713.p0�
_ ,. � ,_ � ,. _,,.�.
:
_ � _ �� . _� >., :, , � .� . { ,r�;G� � .r ,�:=� .�'
4
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.."" _ . . . _ .__, _ __ :_.., �_ ._ _ . -. '�avr.rom- ..-,,.4 v�mr..mrmu-
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.
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_ _ ,,. � . __. .. _ �" „F.�,> c*`
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T07AL iblsa enter on Line 10, Recapituietion} $'- � 4,731.53`:�
._.. ,. ..,... ......
If more space is needed,insert additionBi sheets bf the same size.
REV-1513 EX+(O1-i0J
�pennsylvania SCHEDULE 3
DEPAPTMENTOFNEYENUE
mHEaRAN�E nix R��RN BENEFICIARIES
RESIDENT OKEDENT
ESTATE 6F: �FILE NUMBER:
FREDERiCK W. DILLEN 21-13-0515
REIATIONSHIP TO DECEDENT AMOIIM OR SHARE
NUMBER NAME AND ADDRE55 QF FERSQN{5)RECENING PR6PER'fY Do Not lis#Trustee(s} 4F ESTATE
I TAXABLE OISTRIBUTIONS pndude outrigbt spousal distdbuUOns and transfers under
Sec.9116(a)(1.2j,]
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1. Raiph E.Dillen,257 S.Lewisberry Road,Meehanicsburg,PA 17055 ' Son One Half Residue�a
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2 Fredrick L.Dillen,1463 Pineapple Avenue,Meibourne,FL 32935 : `Son , Qne-Half Residue�!
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� ENTER�OIUIR AtA4UNT5 FOk DISTRtBUTI0N5 SHOWN ABOVE ON CINES 15 TNROUGH 18 OF REVd5p0 COVER SHEEf,AS APpROPRIATE.
II NON-TAXA6lE DISTRI8UTi0N5
A. SPqUSAL DISTRI&U7tONS UNpER SECT20N 9113 FOR WHICfl AN ELECfIDN TO TAX IS NOT TANEN:
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T07A1 OF PART II- ENTER TOTAi NON-TAXABLE[3ISTRIBUTIONS 4N LSNE 13 OF REV-ISUO COVER SHEET $ �� ����E�0�00 ii
If more space is needed,�se eddikionai sheets of paper of the same size. � � ��
LAST WILL AND TESTAMENT
I, Frederlcic W. Dillan, an adult individual, re-
siding in the Tovmship of Fairview, County of Yor}c, and
State of Pennsylvania, being of sound and disposing
mind and memory do herehy declare this to be my Last
Will and Testament hereby revoking all wills by me
heretofore made.
7 ,
It is my will that all my �ust debts and funeral
expenses be fully paid,
II .
I give, devise and bequeath all the rest, residue
and remainder of my property to Eva Pauline Dille�n, my
wife, aLsalutely, provided that she survives me for a �
period of three (3) calendar months.
III .
In the event that my said wife shall predecease me
or die within three (3) calendar months after the time
of my death� I then give, devise and bequeath all the
safd rest, residue snd remainder of my property to my
children, share and share a11ke, absoLutely.
1V,
I hereby nominate, constitute and appoint my wife,
Eva Pauline Dillen, as the sole executrix of this my
Last W111 and Testament and I direct that she shall not
be required to enter security in any �ur•isdictlon in which
she may act,
IN WITNESS WHEREOF, I have hereunto affixed my hand
and seal thls day of April, 1957•
�a..�iw1.:J�,�7 W. ��XYi._ �SEAL) �.
�reaePiCx W, lli11eR
Page 2
The foregoln� instrument consisting of one ( 1 ) page
was on this day of Aprll, 1957, svLscribed on Page
1 and at the end thereof by Frederic}c W. Dillen, the above
named testator, and by him signed, sealed, published and
declared to be his Last Will and Testament, in the presence
of us and each of us, who thereuFon at his request, in his
p�esence� and in the presence of each other, have hereunto
subscribed our names as attesting witnesses thereto.
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' T _, ' %� c—�_9-c' niA � %1`/9 /✓ �_ rS�'� / � �
\ame Address
Susqc�eh�at�n�a
May 13, 2013
Susquehanna Bancshares,Inc.
26 North Cetlar Sheet
. P.O. Box 1000
PLACEY & WRIGHT Lititz,PA 17543-7000
3627 N FRONT STREET Tel 1.800.311.3182
HARRISBURG PA ]7]10-1533 Fax 717.625.4478
RE: Frederick W Dillen Estate
DOD: 4/26/13
SS#l: XXX-X7�-8419
Tracking# 323016
To Whom It May Concern:
In response to your letter of May 6,2013, here is the above customer account information '
as of Apri126,2013.
Account#1 Account#2
• Account Title: Frederick Dillen Frederick Dillen
Ralph E Dillen POA Ralph E Dillen POA
• AccountType/# Checking 1710004860 Checking 1710012376
• Date Opened/MaturiTy 6/7/07 12/22/09
• Interest Rate: .OS% Z�o�o
• Account Balance*: $1,835.96 $39,777.49
• Accrued Interest: $0.21
$6.11
• YTD Interest: $2.92 $20.13
*Account balance does not include accrued interest.
� There is no safe deposit box in the name of the decedent.
If I can be of further assistance, please feel free to call.
�', �.,,�4-Y�. �
Dawn M Berrier
Susquehanna Bank
Deposit Reseazch - Reporting Deparhnent Lead
1-717-625-6546
DMB/aed
St
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MEMBERS i'�
F�HRAL CRBDTT UMON
REGULAR SAVINGS ACCOUNT•
Account Number/Suffix 161223-00*
Date Account Established 11/15/1995
Principal Balance at Date of Death $2,722.40
Accrued Interest to Date of Death $0.28
Total Principal and Accrued Interest $Z,722.gg
Name of Joint Owner None
*Rollover from SMITHCO Credit Union Account opened 09/16/1968.
LIFE SAVINGS ACCOUNT•
Account Number/Suffix 161223-04•
Date Account Established 11/15/1995
Principal Balance at Date of Death $4,000.00
Accrued Interest to Date of Death $0.41
Total Principai and Accrued Interest $4,000.41
Name of Joint Owner None
"Rollover from SMITHCO Credit Union Account opened 09/16/1968.
*Rollover from Saving 161223-00 on 02/01/2001.
CERTIFICATE OF DEPOSIT•
Account Number/Suffix 161223-43*
Date Account Established 10/16/2012
Principal Balance at Date of Death $162,025.12
Accrued Interest to Date of Death $83.23
Total Principal and Accrued Interest $162,108.35
Name of Joint Owner None
"Rollover from certificate 161223-44 opened 11/17/2011.
CERTIFICATE OF DEPOSIT•
Account Number/Suffix 161223-45"
Date Account Estabiished 02/26/2013
Principal Balance at Date of Death $35,606.59
Accrued Interest to Date of Death $15.85
Total Principal and Accrued Interest $35,622.44
Name of Joint Owner None
'Rollover from certificate 161223-42 opened 03/29/2012.
MEMBERS 15T FEDERAL CREDIT UNION
V �
Tessa L Klugh
Lending Insurance Support Specialist
May 7, 2013
Estate of: FREDERICK DILLEN
Date of Death: 04/26/2013
Social Security Number: 195-16-8419
5000 Louise Drive • P.O. Box 40 • Mechanicsbutg, Pennsylvania 17055 • (800)283-2328 • wwwmembexslst.org
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