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Home My WebLink About08-25-091505607121 REV-1 500 Fx (06-05) OFFICIAL USE ONLY PA DepeNneM d Revenue County Code Yev File Nunlbflr aunty d hldwwa~ Texea INHERITANCE TAX RETURN PoeoxztwsDl 2 1 0 8 0 4 ~. 0 7 HertNburs.PAt7128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Sodal Severity Number Dete of Death Data of Birth 0 1 1 4 2 0 0 8 0 2 0 6 1 9 5 1 Decedent's Last Name SufPoc Decedent's First Name MI ZOOK DORA K (If Applipble) EMSr Surviving Spouae': Irdomladon Below Spouse's Last Neme Su1Poc Spouse's First Name MI Spouse's Soda) Sacur9y Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVAL3 BELOW ® 1.Original Retum ^ 2. Suppbmerual Retum ^ 3. Remainder Relum (date of death ,' prbrto 72-13.82) ^ 4. Limned Estate ^ 4a. Future Irderest Compromhp of ^ 5. Federel Estate Tax Retum Required death after 12-12-82) \ ; t 0 ^ 6. DeoedeM Died Testate ^ 7. Decedent Maintained a Living Trust 8. Total Number d Safe Deposit Boma (Attach Copy of Wilq (Attach Copy d TrusQ ® 9. Lidgatbn Proceeds Received ^ 70. Spousal PoveAy CredR (dam of death ^ 11. EbcUon to tax under Sec. 9113(A) between 12-37-91 and 1-t-95) (Attach Seh. O) CORRESPONDENT - THIS SECTpN MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFlDENTNL TAX NIFOIUf1AT10N SHOUID BE DSIECTED T0: Name Daytime Tebphone Number 7 1 7 5 3 2 3 2 7 0 Finn Name (H Appllabb) H . ANTHONY ADAM S First line of addross 4 9 WEST ORANGE S T R E E T Second line of eddross S U I T E 3 CMy or Post Office S H I P P E N S B U R G 1505607121 State ZIP Code N REGISTER @~ VILI.S U8E v o . ~ ~~% c ~ ~ 7 T ~_)C J7 t0 _i D FILED ~; P A 1 7 2 5 7 Side 1 1505607121 ~'i °~ r~ ~...>> _i7 ^.:'i _. J '~iR Cl ;:, -~ _r~ PLEASE USE ORIGINAL FORM ONLY 1505607221 REV-1500 EX DecedanCs Soaal Securhy Number DacsdanCa Name: DORA K. ZOOK RECAPITULATION 1. Reel estate (Schedub A) ................................. ..... .. 1. 2. Stocks antl Bonds (Schedub B) ........................... ..... .. 2. 3. Closet' Held Coryoration, Partnership or Sob-Proprbtorship (Schedub C) ... .. 3. 4. Mort9apea 8 Notes kecefvabb (Schedub D) ................. ..... .. 4. 5. Ceah, Bank Depostts 8 Mboslbneoua Personal Property (Schedub E) ..... .. 5. 5 O O O O . O O s. Jointly Owned Properly (Sohedub F) ^ Ssparete BlAing Requested ..... .. 6. 7. IMx-VHS Tronaterm 5 Miscellaneous IJ~Probele Property (Schedub G) ~LJJ Separate Billing Requested ..... .. 7. s. Tom Grose Assets (total once 1-7) .................... ..... .. s. 5 0 0 0 0. 0 0 9. Funoral Expenses b AdminbtratM Costs (Sehedub H) ......... ..... .. 9. 3 6 4 7 . O O 10. Debts or Decedent, Mortyepe LiaDiliSes, 8 Lbns (ScMdub I) ..... ..... .. 10. 11. Total DsducBom (total ones 9 810) .................... ..... .. 11. 3 6 4 7 . 0 0 12. Net Valw or Estsb (L'me 8 minus one 11) .................. ..... .. i2. 4 6 3 5 3 • 0 0 13. Cfiarilabb and Governmental BequestsBec 9113 Trusts for which an ebcGon to tax hes not been made (Schedub J) ........... ..... .. 13. 14. Nst Valus Subset to Tax (Line 12 minus Line t3) ........... ..... .. 14. 4 s 3 5 3. 0 0 TAX COMPUTATION • SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount or Line 14 taxabb at the spousal tax rate, w tnnsbra under Sec. 9118 3 8 1 7 6 5 0 1 0 0 0 . (a>(1.z)x.oo 5. . 16. Amourd or Line 14 taxabb 8 1 7 6 5 0 3 6 7 9 4 . ~ u,,,,i raro X .045 1s. . 17. Amount of Line 14 taxabb 0 0 O O O O at sblinp rate X .12 17. • 18. Amount of Line 14 taxabb 0 0 0 0 0 0 . ataheterelrate x.t5 18. . 3 6 7. 9 4 19. Tax Due ......................................... ..... .. 19. 20. FILL IN THE OVAL IF YOU ARE REAUESTING A REFUND OF AN OVERPAYMENT 1505607221 Side 2 1505607221 J REV-1 S00 EX Papa a Decedent's Complete Address: Fite Number z1 oB 02007 DECEDENTS NAME DORA K. ZOOK STREET ADDRESS 80 ZOOK LANE cln NEWBURG srarE PA zlP 17240 Tax Payments and Credits: t. Tax Due (Page 2 Line 19) 2. CredilslPayments A. Spousal PoveAy Credit B. Prig Payments C. Discount 3. InteresllPenafty ff applkade D. Interest E. Penalty (1) 367.94 Total Credits (A +B +C) (2) 0.00 Total InterestlPenaBy (D+E ) 4. g Line 2 ra greats than Line 1 +Line 3, enter the r&fterence. This is the OVERPAYMENT. FTN M oval on Pegs; Una 20 to rsQueat a refund. 5. ft Line 1 +Line 3 is gr~ar than Line 2, enter the difference. This Is the TAX DUE A. Ender the InMrest an the tart due. (3) 0.00 (4) 0.00 (5) 367.94 (~) B. Enter the total of Line 5 +SA, This Is the BALANCE DUE (58) 367.94 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRULTE BLOCKS 1. Did decedent make a transfer and: a. r~I the use a incase d tlra propety transferred : .......................................................... b. retain th right to designate who shall use the property transferred a fts incase : ................... c. main a teversbnary interest; a .................................................................................... d. receive the promise (or Ilte d eldrer payments, beneflfs a care7 ........................................... ff death axxured after December tz,1982, did decedent transfer property wiMln are year of death wiMad receiving adequate axreideralbn7 .......................................................................... Did decedent own an'M bust fa' a payable upon death bank account a severity at his a har death? Did decedent own an IrMividual ReBrement Aaxxud,annuity, a dharnon-probate propedy whkh axrtains a beneficdary ~signatbrr7 ...................................................................................... Yes No ....... ^ ....... ....... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. Fa dates of death on a after July 1,1994 and betas January 1,1995, the tau rate Imposed on th net value of trenstere to a fa the use of the surdvkg spouse Is three (3) peroeM (M P.S. §9115 (a) (1.1) (I)]. Fa dates of death on a atMr Jarapry 1,1995, the laoc rate imposed on Ore net value ai transfers to a for the use of the surviving spouse is zero (O) percent [72 P.S. §9116 (a) (1.1) (iq1. The slabde dose rat exerr~t a transfer to a survhdng spouse tram tax, and the statutaY requirements to disdceure of assets and filing a tax rum are s89 applicable even ff the surviving spouse is the only bendidary. Fa dales of deaM an a after Juty 1,2000: The tart rate Imposed on the net value of transfers trorrr adeceased drlWtwenty-are years of age a younger at death to or to the use of a natural panel, an adopOve parent a a stepparent of the child is zero (0) perarnt p2 P.S. §9116(aK1.2)]. The taz rate imposed on the na value of transfers to a for the use of are decedenPs 9neal benefldades is four and onefiaft (4.5) percent, except as noted in 72 P.S. §911ti(1.2) (72 P.S. §9118(aK1)). The tax rate Imposed on the net value of transfers b a fa the use of the deoadenPs sidk>gs is twelve (12) percent (72 P.S. §911fi(aK1.3)), Asibling is defined, ands Section 9102, as an individual who has at least one parent M common with the decent wheNer by blcod a adoptbn. COMMONWEALTH OF PENNSYLVANIA INHERRANCE TA% RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY AR wph M of ~unNonhip nwrt M dMelowA on SehduM F. ITEM VALUE AT 1MBER DESCRIPTION OF DEA TOTAL taco enteral line 5, Recapilul~al) ~ 2 mmae apace ~ yea. weneaNtlonel amesame ~I REV-1511 EX F (10-08) SCHEDULE H ' coearvwNwEnLn+oFrENNSnvnNw FUNERAL EXPENSES & INMERRANCE TAx RETURN ADMINISTRATNE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER DORA K. ZOOK 21 08 02007 Dsbla of deeadaM muu M reported on Sehaduk I. ITEM NUMBER DESCRIPTION AMOUNT A. I FUNERALEXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Pemonal R9preSelltative'e Comndasfona Nerve o(~emoral Repreaentetlve (a) Street Addreae Criy Smle Zip YeeQa) Cerrnisalon Pafd: 2. Asoniey Feae 9, FemAyFxaagtlon:(ddeoadeMaeddre~isrwitlleaameesd~neMa,etladrexplenatlon) CWmanl JERRY S. ZOOK stremadme,a 80 ZOOK LANE cIy NEWBURG wale PA zip 17240 RetstlorohpdCatrrerdbtkoedent SPOUSE 4. Prooeb Feea 5. AccaaMeMaFeea.. 6. Ten Realm Pmpmals Fees 7. TOTAL (Also enter an line 8, Recapitulatbn) ~ S 3,500.00 147.00 ' REV-1513 EXi(4W) COMMONWEALTH OF PENNSYIVANUI INHERRANCE TA% RETURN SCHEDULE J ESTATE OF FILE NUMBER DORA K. ZOOK 21 08 02007 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llat Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS pntlude auObMapouaal dbMMitena, end trarrefate under . Sea 9116 (a (7.~) t. JEREMIAH ZOOK Spousal 38,176.50 80 ZOOK LANE NEWBURG, PA 17240 2. SYLVIA BEILER Lineal 1,022.08 534 CARMARGO QUARRYVILLE, PA 17566 3. GIDEON ZOOK Lineal 1,022.06 30 ZOOK LANE NEWBURG, PA 17240 4. CHRISTIAN ZOOK Lineal 1,022.06 425 ENOLA ROAD NEWBURG, PA 17240 5. MARY SMOKER Lineal 1,022.06 30 LESHER ROAD NEWBURG, PA 17240 6. ABNER ZOOK Lineal 1,022.06 99 ZOOK LANE NEWBURG, PA 17240 7. RUEBEN ZOOK Lineal 1,022.06 25 ZOOK LANE NEWBURG, PA 17240 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 78, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS i. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE i3 OF REV-1500 COVER SHEET , S (If more apace rs needed, hlaeft addNbnal sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent ' DORA K. ZOOK DecedenYa Name 7 z1 D6 02007 Pile Number Schedule J - BeneBclath-a -1 NUMBER NAME AND ADDRESS OF PE S RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do Not LbtTru a AMOUNT OR SHARE OF ESTATE I TAXABLE DISTRIBUTIONS Qndude autrlght spousal distrllwtbns) 8. IVAN ZOOK Lineal 1,022.06 80ZOOKLANE NEWBURG, PA 17240 9. DAVID ZOOK Lineal 1,022.06 5141 PETERS ROAD KINZERS, PA 17535