HomeMy WebLinkAbout08-31-10I 1505610140
REV-1500 EX (01-10)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of individual Taxes County Code Year File Number
PO Box 2sosol INHERITANCE TAX RETURN 2 1 0 9 0 1 1 4 1
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY
5 4 1 3 0 3 0 6 1 1 2 0 3 2 0 0 9 0 5 1 1 1 9 1 9
Decedent's Last Name Suffix Decedent's First Name MI
STROUP BARBARA K
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
MI
1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-$2)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required
death after 12-12-82)
0 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Wiil) (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 GOMPLt I tU. ALL GuKhctSrunutnut Anu wnrwtn i iH~ i r~ mrvrcmh ~ ~~n ~nvuw o~ -,~n~.. ~ ~~ ~.,.
Name Daytime Telephone Number
MARK A MAT E Y A ESQ 7 1 7 2 4 1 ~5 0 0
First line of address
5 5 W CHURCH AV E N U E
Second line of address
City or Post Office
CARL I S L E
State
PA
ZIP Code ~
1 7 0 1 3
REGISTER' ~ ILLS US"E,~~NLY : ; ~
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DATE FILED L+
Correspondent's a-mail address: MAM MATEYALAW.COM
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 all information of which preparer has any k jnowledge.
SIGNAjrU~E OF PERSON RESPONSIBR FILING RETUR Du~Z7/ f ~~
ADDRESS
6601 ARIOCK CV AUSTIN TX 78739
SIGNATU E OF P EPA ER THER THAN REPRESENTATIVE D TE
z_ '~ l r~
ADDRESS
55 W CHURCH AVE CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
1505610140
Side 1
1505610140 J ,~~~
r
J
1505610240
REV-1500 EX Decedent's Social Security Number
Decedents Name: BARBARA K. STROUP 5 4 1 3 0 3 0 6 1
RECAPITULATION
1.
.........................................
Real Estate (Schedule A) 1
..
2.
....................................
Stocks and Bonds (Schedule B)
..
2~
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. •
4. Mortgages and Notes Receivable (Schedule D) ........................ .. 4. •
4 2 4 9 ' 3 2
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. 1 3 5 3 0 1 2 6
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
uested
arate Billin
Re
^ Se
l
G
7 4 0 1 4 5. 0 0
....
g
q
p
)
(Schedu
e ...
.
1 7 9 6 9 5 5 8
8. Total Gross Assets (total Lines 1 through 7) ........................ .. . g. .
9 1 3 6 8 7 , 5 7
9. Funeral Expenses and Administrative Costs (Schedule H) ..... ....... ..... .
.
9 6 7 1 6
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... ..... . 10. .
11. Total Deductions (total Lines 9 and 10) ................. ........ .... .. 11. 1 4 6 5 4. 7 3
12. Net Value of Estate (Line 8 minus Line 11) .............. ........ .... .. 12. 1 6 5 0 4 0. 8 5
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
5
0
0
0
0
0
an election to tax has not been made (Schedule J) ........ ....... ..... .. 13. •
14. Net Value Subject to Tax (Line 12 minus Line 13) ........ ....... ..... .. 14. 1 6 0 0 4 0 • 8 5
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
0
0
0
15
0.
0
0
(a)(1.2) x .0 . .
16. Amount of Line 14 taxable
1 5 9 0 4
8
0
5
7
1
5
6.
8
4
at lineal rate X .045 . 16.
17. Amount of Line 14 taxable
0 0
0
17
0.
0
0
at sibling rate X .12 .
18. Amount of Line 14 taxable
1 0 0
0 0
0
1 g 1 5 0 0 0
at collateral rate X .15 .
19 7 3 0 6. 8 4
19. ........................................
TAX DUE ....... ..... .
..
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
1505610240 1505610240 J
REV-1500 EX Page 3
Ila~arlant'c [:mm~lPtP Address'
File Number
21 09 01141
DECEDENT'S NAME
BARBARA K. STROUP __--
STREET ADDRESS
1 LONGSDORF WAY _---
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
~. Tax Due (Page 2, Line 19}
2. Credits/Payments
A. Prior Payments 6, 300.00
B. Discount 331.57
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) 7, 306.84
Total Credits (A + B) (2) 6,631.57
(3)
(4)
(5)
0.00
675.27
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? .................................................................................
h?
ty
" ......
^
...
orpayable-upon-death bank account or security at his or her deat
in trust for
3. Did decedent own an ......
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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse i;
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
j72 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.
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LAST WILL AND TESTAMENT
OF
BARBARA K. STROUP
I, BARBARA K. STROUP, now of Carlisle, Cumberland County, Pennsylvania, being of
sound and disposing mind, do hereby make, publish, and declare this to be my Last Will and
Testament, hereby revoking and making null and void all prior Wills and Codicils made by me at any
time heretofore.
ITEM I. I direct that all my legally valid debts, funeral and administrative expenses, and
debts incurred or payable because of my death, shall be paid by my Executor, hereinafter named,
from my residuary estate as soon after my death as practicable. All death taxes, including federal,
state, and other death taxes, with respect to the property forming my gross estate for tax purposes,
whether or not passing under this Will, including any interest or penalty imposed thereon, shall be
considered an expense of administration. of my estate, without apportionment or right of
reimbursement. Taxes on future interests may be prepaid.
ITEM II. I give and bequeath certain items of tangible personal property that are solely
owned by me at the time of my death and that are identified i.n any separate writing directing
distribution thereof after my death which is dated and is signed by me at the end thereof, to those
persons designated in such separate writing who survive me. Ifany item oftangible personal property
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is identified in more than one separate writing, I direct that, unless stated to the contrary, the separate
writing bearing the last date shall govern the disposition of such item.
ITEM III. I make the following bequests to the following individuals and organizations;
Provided however, if such named individuals do not survive me by thirty (30) days, then that share
shall lapse:
A. The sum of Two Thousand Dollars ($2,000.00) to Gettysburg College or the
successor thereof, to be shared equally by Professors Carol Small and James Ramos
for the purchase of materials, books, slides, or related items for use in their art history
courses.
B. The sum of Two Thousand Dollars ($2,000.00) to Dickinson College or the successor
thereof, as an unrestricted gift.
C. The sum of One Thousand Dollars ($1,000.00) to the Adams County Public Library
in Gettysburg, Pennsylvania or the successor thereof, for the purchase of children's
books.
D. The sum of One Thousand Dollars ($1,000.00) to Florence McGlaughlin now of
Biglerville, Pennsylvania.
E. The sum of Three Thousand Dollars ($3,000.00) to my son, Kirk Michael Stroup.
It is my intention to limit the total amount of my estate going to my son to this sum.
2
~;~ S
ITEM IV. I bequeath the household and personal effects, jewelry, automobiles, and other
tangible personalty of like nature that are solely owned by me at the time of my death, not otherwise
disposed of above, to my daughter, KATHARINE STROUP BROOKS, if she should survive me
by thirty (30} days. Provided, however, if my daughter should not so survive me then this share shall
be distributed as follows:
A. One-half ('/2) to GUY H. BROOKS, now of Carlisle, Pennsylvania, if he should
survive me by thirty (30) days. If he should not so survive me then this share shall
pass under Item IV.B. below.
B. One-half ('/z) is to be used to establish a scholarship fund at Gettysburg College or the
successor thereof. The fund shall be used to assist promising students in the pre-
medical field of study that are in their junior or senior years at the College. The fund
may be used for the payment of tuition and miscellaneous expenses related to their
education. The scholarships shall be known as the Herbert W. Stroup, Jr. Scholarship
Award.
ITEM V. I give, devise and bequeath all of the residue of my estate, whether real,
personal, or mixed, and wherever situate, including any property subject to any power ofappointment
which I may now have or hereafter acquire, to my daughter, KATHARINE STROUP BROOKS
if she should survive me by thirty (30) days. Provided, however, if my daughter should not so survive
me then this share shall be distributed as follows:
3
. X11
A. One-half ('/2) to GUY H. BROOKS, now of Carlisle, Pennsylvania, if he should
survive me by thirty (30) days. If he should not so survive me then this share shall
pass under Item V.B. below.
B. One-half ('/2) is to be used to establish a scholarship fund at Gettysburg College or the
successor thereof. The fund shall be used to assist promising students in the pre-
medical field of study that are in their junior or senior years at the College. The fund
may be used for the payment of tuition and miscellaneous expenses related to their
education. The scholarships shall be known as the Herbert W. Stroup, Jr. Scholarship
Award.
ITEM VI. The interest of beneficiaries hereunder shall not be subject to anticipation or
to voluntary or involuntary alienation.
ITEM VII. I hereby appoint my daughter, KATHARINE STROUP BROOKS, now of
Carlisle, Cumberland County, Pennsylvania, to serve as Executor. In the event of the refusal or
inability of such named person to so serve, I appoint GUY H. BROOKS, to serve as Executor. In
the event of the refusal or inability of such named persons to so serve, I then grant to the person last
so nominated and capable of serving the right and power, exercisable in his or her exclusive
discretion, to nominate and appoint, whether in advance while competent, or at the time of a
renunciation or resignation, a person or persons to serve as such Executor, which nomination shall
be honored as if I had made such an appointment in this Will.
4
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ITEM VIII. I direct that my Executor shall not be required to give bond or post any other
security for the faithful performance of duties in any jurisdiction.
ITEM IX. My Executor shall have the following powers in addition to those invested in
an executor by law and by other provisions of my Will applicable to all property, whether principal
of income, exercisable without Court approval, and effective until distribution of all property:
A. To retain any investments I may have at my death so long as
my Executor may deem it advisable to my Estate so to do.
B. To vary investments, when deemed desirable by my Executor
and to invest in such bonds, common trust funds controlled by my Executor, stocks,
notes, real estate mortgages, or other securities or in such other property, real or
personal, as my Executor deems wise, without being restricted to so-called legal
investments.
C. In order to effect a division of the principal of my Estate or for
any other purpose, including any final distribution, my Executor is authorized to make
said divisions or distributions of the personalty and realty partly or wholly in kind. If
such division or distribution is made in kind, said assets are required to be divided or
5
~' ,'i S
distributed at their respective values on the date or dates of their division or
distribution.
D. To sell either at public or private sale and upon such terms and
conditions as my Executor may deem advantageous to my Estate, any or all real or
personal estate or interests therein owned by my Estate severally or in conjunction
with other persons or acquired after my death by my Executor, and to consummate
said sale or sales by sufficient deeds or other instruments to the purchaser or
purchasers, conveying a fee simple title, free and clear of all trust and without
obligation or liability of the purchaser or purchasers to see to the application of the
purchase money or to make inquiry into the validity of said sale or sales; also, to
make, execute, acknowledge, and deliver any and all deeds, assignments, options, or
other writings which may be necessary or desirable, in carrying out any of the powers
conferred upon my Executor in this paragraph or elsewhere in my Will.
E. To mortgage real estate, and to make leases of real estate for
any period of time as is deemed reasonable by my Executor.
F. To borrow money from any party to pay indebtedness of mine,
or of my Estate, expenses of administration, or inheritance, legacy, estate or other
taxes.
6 ~ ~ ~~-
G. To pay all costs, taxes, expenses, and charges in connection
with the administration of my Estate. My Executor shall pay expenses of my last
illness and funeral expenses.
H. To vote any shares of stock which form a part of my Estate,
and to otherwise exercise all the powers incident to the ownership of such stock.
I. In the discretion of my Executor, to unite with other owners
of similar property in carrying out any plans for the reorganization of any corporation
or company whose securities form a part of my Estate.
ITEM X. Any person who shall have died at the same time as me, or in a common
disaster with me, or under such circumstances that it is difficult or impossible to determine who died
first, shall be deemed to have predeceased me.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament, consisting of seven (7) typewritten pages, this ~' t~~ day of -~ ~ ~ ~ r^ ~-' ~~ , 2000.
. - ~-~
~,
BARBARA K. STR4~JP
7
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
SS.:
We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published
and declared by the above-named Testatrix, BARBARA K. STROUP, as and for her Last Will and
Testament, in the presence of us, who at her request and in her presence and in the presence of each
other, have hereunto set our hands and seals the day and year above written, and we certify that at
the time of the execution thereof, the said Testatrix was of sound and disposing mind and memory.
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residing at
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residing at
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAUPHIN
SS.
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We, the Testatrix, and ~; ~ ~~-~ ~ and
-. ~ ~~i'l11 ' ~~. ~~ ~„...~r -7 - Z~ ,the witnesses, respectively, whose names are
signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned
authority that the Testatrix signed and executed th.e instrument as her Last Will and that she had
signed willingly, and that she executed it as her free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the
Will as witness and that to the best of his/her knowledge the Testatrix was at that time eighteen
years of age or older, of sound mind and under no constraint or undue influence.
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BARBARA K. STROUP
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Witness
Subscribed, sworn to and acknowledged before me by the Testatrix, BARBARA K. STROUP, and
ubscribe and sworn to before me by ~y:~u ~ , ~ - and
-" "~ '~ , wirnesses, this ~~~~ ay of ~~~, h , 2000.
30188.2
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Not Public
(SEAL) NOTARIAL SEAL
CHERYL t. BAKER, NOTARY PUgtIC
HARRISBURG, QAUPHIN COUNTY
MYCOMMISSION EXPIRES JAN. 13 2003
9
REV:1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
BARBARA K. STROUP 21 09 01141
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CUMBERLAND CROSING 107.71
REFUND FROM NURSING HOME
CHECK NO. 001493
2. US TREASURY 2,658.00
REFUND ON 2009 PERSONAL INCOME TAX
3. LUTHERAN MINISTRY PENSION 1,483.61
PAYMENT GROUP X;XXX61 E01
TOTAL (Also enter on line 5, Recapitulation) I $ 4 249 32
(If more space is needed, insert additional sheets of the same size)
REV.1509 EX+ (01-10)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF: FILE NUMBER:
BARBARA K. STROUP 21 09 01141
If an asset was made jointly owned within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A. KATHARINE S. BROOKS
e
c
JOINTLY-OWNED PROPERTY:
6601 ARIOCK CV
AUSTIN TX 78739
DAUGHTER
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECEDENT'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTERESI
1, A. GUNNALLEN FINANCIAL VALET ACCOUNT 248,743.18 50. 124,371.59
ACCOUNT NO. X;XX-XX)CXX-19 RR E25
JTWROS
2. A. PNC BANK 20,337.98 50. 10,168.99
INTEREST CHECKING ACCOUNT
ACCOUNT NO. X;XXXX2622
3. A. PNC BANK 1,521.35 50. 760.68
PERFORMANCE MONEY MARKET ACCOUNT
ACCOUNT NO. X;XXXXX7285
TOTAL (Also enter on Line 6, Recapitulation) I $ 135,301 26
If more space is needed, use additional sheets of paper of the same size.
REV-1510 EX+ (08-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS AND
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
BARBARA K. STROUP 21 09 01141
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY of THE DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
EXCLUSION
(IF APPLICABLE)
TAXABLE
VALUE
1. GUNNALLEN FINANCIAL INC 40,145.00 100.00 40,145.00
ROLLOVER IRA
ACCOUNT NO. XXX-XXXJCX-11-RR E25
_ TOTAL (Also enter on Line 7, Recapitulation) I $ 40,145.00
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+ (10-09)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
BARBARA K. STROUP 21 09 01141
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. HOFFMAN ROTH FUNERAL HOME & CREAMATORY INC 2,408.17
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City State ZIP
Year(s) Commission Paid:
2, AttomeyFees: MATEYA LAW FIRM, P.C. 10,000.00
3. Family Exemption: (If decedent's address is not the same as claimants, attach explanation.)
Claimant
Street Address
4
5,
6.
7.
8
9
City State ZIP
Relationship of Claimant to Decedent
Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS
Accountant Fees: JAMES P O'MARA, P.C.
PREPARATION OF 2009 TAX RETURNS
Tax Retum Preparer Fees:
CUMBERLAND LAW JOURNAL -LEGAL ADVERTISEMENT
THE SENTINEL -LEGAL ADVERTISEMENT
CUMBERLAND COUNTY REGISTER -FILING FEE FOR REV-1500 & INVENTORY
327.50
327.50
75.00
219.40
30.00
TOTAL (Also enter on Line 9, Recapitulation) I $ 13,687.57
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-08)
pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
BARBARA K. STROUP 21 09 01141
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1, YELLOW BREECHES FAMILY HEALTH
MEDICAL SERVICES
ACCOUNT STROBA-01
2. PINKER & ASSOCIATES - PODIATRIC MEDICINE & FOOT SURGERY
MEDICAL SERVICES
ACCOUNT NO. 300030.0(1)
3. CUMBERLAND CROSSING - DAIKON LUTHERAN SOCIAL MINISTRIES
ASSISTED LIVING EXPENSE
ACCOUNT 000055
4. CONTINUING CARE RX
PRESCRIPTION MEDICATION
ACCOUNT NO. 100022827
5. DARRYL K. GUISTWITE, D.O., INC
MEDICAL SERVICES
ACCOUNT 260.0(1)
TOTAL (Also enter on Line 10, Recapitulation) I $
If more space is needed, insert additional sheets of the same size.
1.56
3.14
904.54
37.46
20.46
967.16
REV-1513 EX+(01-10)
pennsylvania ~ SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
RARRARA K STRnl1P 21 09 01141
----------- ---- -------
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. KIRK MICHAEL STROUP Lineal 3,000.00
C/O DONNA RAPP @812 SALEM AVE
HAGERSTOWN, MD 21740
2. FLORENCE MCGLAUGHLIN Collateral 1,000.00
980 BOYER NURSERY ROAD
BIGLERVILLE PA 17307
3. KATHARINE S. BROOKS Lineal 156,040.85
6601ARIOCK CV
AUSTIN, TX 78739
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1. GETTYSBURG COLLEGE C/O PROF CAROL SMALL & PROF JAMES RAMOS 2,000.00
300 N WASHINGTON STREET, BOX 423
GETTYSBURG, PA 17325
2. DICKINSON COLLEGE C/O CAROLYN G YEAGER, ASSOC. VP FOR DEVELOPMENT 2,000.00
PO BOX 1773
CARLISLE PA 17013
3. ADAMS COUNTY PUBLIC LIBRARY 1,000.00
140 BALTIMORE STREET
GETTYSBURG, PA 17325
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 5 000.00
If more space is needed, use additional sheets of paper of the same size.