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LAW OFFICES OF
ZULLINGER -DAVIS
PROFESSIONAL CORPORATION
JOEL R. ZULLINGER
14 North Main Street
Suite 200
Chambersburg, PA 17201
717-264-6029
Fax:717-264-1884
JoelZullin er zullingerlaw.com
Dale F. Shughart, Jr.
of counsel
March 19, 2009
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
Dear Register:
RE: Estate of C. Goodhart
File No. 21-08-0685
Enclosed for the above estate are the following:
HAMILTON C. DAVIS
20 East Burd Street, Suite 6
P.O. Box 40
Shippensburg, PA 17257
717-532-5713
Fax:717-530-5222
hamiltondavislaw~n,comcast.net
1. Original and one copy of a Supplemental PA Inheritance Tax Retum;
2. Check in the amount of $63.74 for inheritance tax due;
3. ~h~:,'.: ;i'2 tl'ie aa"llouiit of $i,~l.vv .tv~ r~Sllni~ .°..
If you have any questions, please contact me. Thank you.
Encls.
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1505607121
REV-1500 EX (06-05)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280801 INHERITANCE TAX RETURN 2 1 0 8 0 6 8 5
Hamsburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2 0 1 1 8 9 2 6 7 0 6 0 4 2 0 0 8 0 7 2 7 1 9 2 4
Decedent's Last Name Suffix Decedent's First Name MI
G O O D H A R T G E O R G E C
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1. Original Return ^X 2. Supplemental Return u 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
J O E L R Z U L L I N G E R 7 1 7 2 6 4 6 0 2 9
h?
Firm Name (If Applicable) ~ ~:=;
REGISTL~@t`)NILLS U9@=ONLY -- ; ~ ~
~
Z U L L I N G E R D A V I S P C ~ ~~' T
" :
'! -'
_
--
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First line of address ,
n r..~ ;, ,
1 4 N O R T H M A I N S T R E E T
--:~
Second line of address _ '' ~ .
:~
City or Post Office State ZIP Code ~ -DATE FILED ~ ,
C H A M B E R S B U R G P A 1 7 2 0 1 -
~,:
Correspondent's a-mail address:
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 prepan;r other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUREiOF,
RN
ADDRESS U 1 / /
7813 MCCLAYS MILL ROAD NEWBURG PA 17240
SIGyAjJ,1RE O~ PR~~R ~yFIER Tj-I/~! REPRESENTATIVE ,DATE
NORTH MAIIN'STREET, SUITE 200 CHAMBERSBURG
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505607121
PA 17201
1505607121
1505607221
REV-1500 EX Decedent's Social Security Number
Decedent's Name: GEORGE C• GOODHART 2 0 1 1 8 9 2 6 7
RECAPITULATION
1. Real estate (Schedule A) ...................................... .. 1
2 1 4 3 1 • 3 7
2. ................................
Stocks and Bonds (Schedule B) ,
..
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. •
4. Mortgages & Notes Receivable (Schedule D) ...................... .. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested .... ... 6• •
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested .... ... 7.
8. Total Gross Assets (total Lines 1-7) ........................ ... 8. 1 4 3 1 . 3 7
9. Funeral Expenses & Administrative Costs (Schedule H) ........... ..... 9• 1 5 • D D
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ....... ..... 10. •
11. Total Deductions (total Lines 9 & 10) ..................... ..... 11. 1 5 • ~ D
12. Net Value of Estate (Line 8 minus Line 11) .................... ..... 12• 1 4 1 6 . 3 7
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ............ ...... 13•
............
14. Net Value Subject to Tax (Line 12 minus Line 13)
......14. 1 4 1 6 . 3 7
TAX COMPUTATION -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 _ D D D 15.
16. Amount of Line 14 taxable
1 4 1 6
3
7
at lineal rate X .045 . 16.
17. Amount of Line 14 taxable
D
D
D
at sibling rate X .12 17.
18. Amount of Line 14 taxable
D
D
D
at collateral rate X .15 18.
19. Tax Due ............... ........................ .. ..... ..19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L 1505607221
Side 2
1505607221
0. D D
6 3. 7 4
0. D 0
O.o 0
6 3. 7 4
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21 08 0685
DECEDENTS NAME
GEORGE C. GOODHART
STREET ADDRESS
401 Walnut Bottom Road
CITY
Shippensburg STATE
PA ZIP
17257
Tax Payments and Credits:
~ • Tax Due (Page 2 Line 19) (1) 63.74
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2)
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total InterestlPenalty (D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fi!! 'sn ova! on Page 2, L !ne 24 !o rrogusst s refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
0.00
(3) 0.00
(4) 0.00
(5) 63.74
(5A)
(5B) 63.74
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make 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 December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................................................................. ...... ^ ^
3. Did decedent own an "intrust for" 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 designation? ............................................................................................ ...... ^ ^
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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot 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 twenty-one 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 zero (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 four and one-half (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 twelve (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-1503' EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
GEORGE C. GOODHART 21 08 0685
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 37.169 shares common stock, Hershey Co. 1,431.37
@38.51
_ TOTAL (Also enter on line 2, Recapitulation) I $ 1 431 37
(If more space is needed, insert additional sheets of the same size)
REV-`1511 EX + (10-06)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GEORGE C. GOODHART 21 08 0685
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B.
2.
3.
4.
5.
6.
7
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Street Address
City State _
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedents address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Zip
Probate Fees filing supplemental return
Accountants Fees
Tax Return Preparer's Fees
Zip
15.00
TOTAL (Also enter on line 9, Recapitulation) 13
(If more space is needed, insert additional sheets of the same size)
REV-1 S13 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GEORGE C. GOODHART 21 08 (]FifiS
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Carla M. Miller Lineal 708.19
7813 McClays Mill Road
Newburg, PA 17240
2, Carol A. Walk Lineal 708.18
298 High Mountain Road
Shippensburg, PA 17257
Collateral
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(lt more space is needed, insert additional sheets of the same size)