HomeMy WebLinkAbout04-26-13 (2) 1 1505610105
'� REV-1500EX�az_��>�F�,;°.°�,
nn �V0M0 OFFICIAL USE ONLY
PA Department of Revenue Pe p SY County Code Year Pile Number
Bureau of Individual Taxes `+`��`"�` �
Po eox z8o6oi INHERITANCE TAX RETURN
Harrisburg,PA 19128-0601 RESIDENT DECEDENT a� �� �a' —l36C� .
ENTER DECEDENT INFORMATION BELOW .
Sociai Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
3�3 - �U- `tk"(oC� o�izai2ois osiisns2s
DecedenYs Last Name � � Suffix DecedenPs First Name MI
Miller 'Paul p
(If Appiicable)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
FI�L IN APPROPRIATE OVALS BEIOW
� 1. Original Return O 2 Supplemental Return O 3. Remainder Retum(Date of Death
Priort0 12-13-82)
p 4. limited Estate O 4a. Future Inlerest Compromise(date of O 5. Federal Eslate Tax Retum Required
death after 12-12-82)
O 6. Decetlent Died Testale O 7. Decedent Maintained a Living Tmst _ 8. Total Number of Sa(e Deposit Boxes
(Attach Copy of WIII) (Atfach Copy of Trust-)
O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 71. Election to Tax under Sec.9113(A)
Between 1231-91 and 1-7-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPIETED.ALL CORRESPONDENCE AND CONFIDENTIAL TA%INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number .
. . .. .. . .. .. . . ... . . . . .. C� �-�: .
c_,
_.,.
Andrew C Sheely, Esquire , 717-697-7000 �,, � �
� ° � nz �
REGIS7BR O L�.S US NL���
'f�- x" r" -4
2+ .�' rn N r''�
First Line of Address �?' N � � -�'
.�c
127 South Market Street ,� �' � _3 � `
; _ _,
. ... . ... . .. .. .... . .. . .. . .... . ... . .. . .. . .. "..J (. ".. ..
Second Line of Address �. ' �--' �= �� .
P.O. Box 95 j N r
:�' .� y
City or Post Office State ZIP Code OATE PILED� �
Mechanicsburg 17055
CorrespondenYs e-maii address:andrewc.sheely@verizon.net
Untler penalties of perjury,I deGare that I have examined this reNrn,including acwmpanying schedules and statements.and[o the best of my knowledge and belieE.
it is true,correct and complete.Declaration o!preparer other lhan lhe personal representative is based on all information of which preparer has any knowledge.
SIGNAT/UR)E�OF/PER506f��RES�PO�NSIBLE FOR FILING RETURN f'�^,7T�
- f/�/L�_ �✓L.� — , y' Z'�/L4�
pnnacsc f7
Mark Ala Miller,Admini r 72 Home Guard Drive, Buke, VA 22015
SIGpc � OF P EPA� EP RT�TIVE- � �
� �G/Zdl
Andrew C. Sheely, Esquire 127 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
$id@ 1
� 1505610105 1505610105
� 1505610205
REV-1500 EX(FI)
Decedenfs Social Security Number
DecedenfsName: MIII@f, Paul Doyne 3p��.�` c�- y�(pa
RECAPITULA710N
1. Real Estate(SChedule A). . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.
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. �
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 12,464.34
6. Jointly Owned Property(Schedule F) O Separate Billing Requested . . . . . . . 6. 32,70L9��
7. Inter-Vivos Trensiers& Miscellaneous Non-Probate Property ��
(Schedule G) O Separate Billing Requested.. . . . . . . 7. $7$,OB9.4F>
B. Total Gross Assets(total Lines 1 through 7). . . . . .. . . .. . . . . . . . . . . . . . . . . . . 8. $72$,$$5.7��:'
9. Funeral Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . . . . . . . 9. 23,871.31 '
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). . . . . . . . . . . . . . . 70. 2,028.33.
11. Total.Deductions(total Lines 9 and 10). . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 11. $25,899.64���.
12. Net Value of Estate(line 8 minus Line �1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/Sec 9713 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. $97,356.06
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers und=��ec. 9116 � ��
(a1(12)X.0 15.
16. Amount of l.ine 14�=�able � � � �� ��
at lineal rate x.045 $97,356.06 �g $4,381.02
17. Amount of Line'14 taxable �� � � � � � �� ��
at sibling rate X.12 �7,
18. AmountofLinel4taxable � � �"������� �
at collateral rate X .15 �g, �
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
� 1505610205 1505610205 �
REV-1500 E%(FI) Page 3 File Number 130�
DecedenYs Complete Address: �� � �a
DECEDENTSNAME
Paul Doyne Miller
STRPFTAf1�RFSR � �
111 Kerrs Road
rirv . . . .. . ... .. . _... ...... . .__ .._ . . ' STATE..��. . ._ , 21P .__. . . .__
Carlisle I 17015
Tax Payments and Credits:
t Tax Due(Page 2, Line 19) (1) $4,381.02
2 CreditslPayments
A.Prior Payments
B.Discount
Total Credits(A+B) (2)
3. Interest �
(3)
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. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) $4,381.02
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
i. Did decedeni make a transfer and: Yes No
a. retain the use or income of the property transferred................._................................................_..................... ❑ �
b. retain the nght to designate who shall use the property transferred or its income ........................................... ❑ �
c. retain a reversionary interest ....................................................................._....................................................... ❑ �
d. receive the promise for life of either paymenis,benefts or care?...................................................._.....,..::...... ❑ �
2, If death ocarred afler Dec. 12, 1982,did decedent iransfer property within one year of death .
withoutreceivingadequateconsideration?......................................................................................_._.................. ❑ �
3. Did decedent own an"in hust 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 propeRy,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 afler July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use o(the surviving spouse
is 3 percent[7z P.s.§s11s(a)(1.1>(i>].
For dates of death on or after Jan. t, 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 applirable 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 o(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(or the use o(the decedenYs lineal beneficianes is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
. The tax rate imposed on the net value ot trans�ers to or for the use of the decedenYs siblings is 12 percent �72 P.S. §9116(a)(1.3)].A sibling is defned,
under Section 9102, as an individual who has at least one parent in wmmon with the decedent,whether by blood or adoption.
_ _ _ _
REV-i5o8 EX. (ii-io)
;� �''`�� pennsylvania SCNEDULE E
� oeanAr«e�+roFaeveHUe CASH� BANK DEPOSITS & MISC.
mHearrArvice rax aeruaN PERSONAL PROPERTY
NESIDENT DECEDENT
ESTpTE OF: FILE NUMBER:
Paul Doyne Miller 21-12-1306
Indude 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. PenFed regular share acct.#1-01-6 $109.08
2. Decedenfs 2006 Cadillac DTS-fair condition $10,385.00
3. United States Air Force-f nal paycheck due at death $1,970.26
TOTAL(Also enter on Line 5, Recapitulation) $ 12,464.34
If more space is needed, use additional sheets of paper of the same size.
REV�i5o9 EX+(oi-io)
_�: � �' pennsylvania SCNEDIILE F
� DEPAFTMENTOFFEVENUE
mHea�TnNCeTnxnFruarv ]OINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: PILE NUMBER:
Paul Doyne Miller 21-12-1306
If an asset became jointly owned within one year of the decedenYs date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(5) NAME(S) ADDRESS REtATIONSHIP TO DECEDENT
A.Mark Alan Miller 8972 Home Guard Drive, Buke, VA 22015 Son
B�Linda Jean Hopple 111 Kerrs Road, Carlisle, PA 17015 Daughter
C.
JOINTLY OWNED PROPERTY:
IETfER oAiE DESCRIPTION OF PROPERN �m oF onre OF oFATH
ITEM FOR JOINT MADE INCWDE NHME OF FlNANCIPL INSfITUTION AND BANK ACCOUNT NUMBER OR SIMIIAR DATE OF DEATH DECEDEM'S VHWE OF
NUMBER TENANT ]O1M IOENTI%ING NUMBER.ATTACH DEEO F00.]OMTLY HEID REAL ESTATE. VAWE OF ASSB IMEREST �ECEDENT'S IMEREST
1. A. 01111I2012 Wells Fargo Joint Premier CheckingAcct.XX2727 $13,355.44 100% $13,355.44
2. A 12/2006 Wells Fargo Joint Crown Classic checking acct XX9611 $5,458.81 50% $2,729.40
3. A 01/11/2012 Wells Fargo Joint Money Market Savings Acct.XX6450 $7,09126 100% $7,09126
4 A 1212812006 US Savings Bond Series EE $9,308.48 50% $4,65424
5. B 12128/2006 US Savings Bond Series EE $9,743.12 50% $4,871.56
TOTAL (Also enter on Line 6, Recapitulation) ; 32,701.90
[f more space is needed,use additional sheets of paper of the same size.
5?1%��L510 Et:(Q£i-09}
'�� � ��'�pennsy�vania SCHEDULE 6
� oEennro-+enTOFeevENUE INTER-VIV45 TR/�NSFERS AND
,""E"�'^"�ET^xRET�R" MISC. NON—PRQBATE PROPER"i'Y
aes�oeNr oeceaeNT
ESTA7E QF PILE NUMBER
Paul Doyne Miller 21-12-1306
This schedule must be completed and filed if the answer to any of questioos 1 through 4 nn page three of the REV-I500 Is yes,
itEM DESCRIF7ION OP PROPERTY DA7E OF DEATN �to OF DECD`5 EXClU5I0N TAXAB�E
;NRUDI?XE NAME PF Tf�iRANSFEft£E,THESk REtAT['JNSHiP 70 DKEG&.RtiO
NUMBER iNEI�AiEOF`PANSFER. AIIRCHACOPYOFTHEDEE�FOANEPlfSTAiE. VALUEOFASSET INTEREST QiAGVlICABLE) VALUE
i. NC Stale Employees Credit Union IRA acct.#XX8156.Beneficiaries: Mark $78,089.46 100°/4 $78,089.46
Alan Milfer,son,$972 Home Guard Drivg,Burke,VA 22015 and l.inda Jean
Hopple,daughter, 111 Kerrs Road, Carlisle, PA 17015.
70TAL(Also enter on Line 7, Recapitulation) � $�$�p89.46
If m¢re space is naeded,use additiar+a!sheets pf paper aP ehe same size.
REV�1511 EX+ f10-09)
�a �`'�'' pennsylvania SCHEDULE H
oePnHrnervroFaevEr�ue fUNERAL EXPENSES AND
�rvneaiTaNCe rnx aETUan ADMINI5TRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Paul Doyne Miller 21-12-1306
DecedenYs debts must be reported on Schedule i.
ITEM
NUMBER DESCRIPTION AMOUNT
a, FUNERAL EXPENSES:
1' Myers-Buhrig Funeral $11,985.00
z Funeral Luncheon
$805.59
3 Headstone
$4,095.00
e. ADMtNISTRATIVE COSTS:
1. Personal Representative Commissions: $0.00
Name(s)of Personal Representative(s) Mark Alan Miller/Linda Jean Hopple
streec address 8972 Home Guard Drive/ 111 Kerrs Drive
c',�y Burke/Carlisle StateVA/PAZip 22015/1701
Year(s)Commission Paid:
$750.00
Z� Attomey Fees:
$3,500.00
3. Family Exemption: (If tlecedent's address is not[he same as clalman['s, aftach explanation.)
cia�man[ Linda Jean Hopple
Street Address 111 Kerrs Road
City Carlisle State PA Zip 17015
Relationship of Claimant to Decedent .DBUghfBf
4. probate Fees: $96.50
5� Acmuntant Fees:
6� Tax Return Preparer Fees:
� ReimbursementforCo-Administrator'straveling/lodgingexpenses $�,g�g.22
e Register of Wills-additional fees $23.00
9 Miller&Miller Insurance-Bond insurance $100.00
�o Reserves to conclude Estate administration,final accountings $600.00
TOTAL(Also enter on Line 9, Recapitulation) § 23,871.31
If more space Is needed,use additional sheets of paper of the same size.
, 0412612023 1�:13 7I7?957291 MVERS-BUFiRIG FUNERaL. PAGE 03f04
� . . _..�.z_.._�.�'�
�
: ��� l���l'S c.1J��tl`t�'
' �A'a�'�'r.at Hom .� Crerrtatory :.
� � INVQICE
� Mark R. Miiler
$g72 HaneGuard Drive
Btxtce,VA 22Qt5 Invoice Number; 1048$
' i invoice Date: Ju�29, 2012
Page' �
�__._.�. _...�._.__._. _--�---_._ � _.
.�ay;;, �„�yi�, '�S
Paui D.Mitler Juy 28,2012 Net 30�ays Robart l,Buhng Jr. �
--_ __ __ _ _—___.... _ .� .._...- -- �--•- -... �_ _._� _. _�.__. .
r:z�;: � #
-�hur�h Cash Advance-Unian hurch 20D.00
�I CA-Hcmar Gu� � Cssh Advar�ce-Nondr Guard . $ 3p0.1S0 �
? L;A-SOloist C:ash Adv�e-Ba�iper I , $ BOO.W
CA-Gorc�ner F� i At#i'ttl[x�a!Casft AdvaRCe-Coroners'CtemBtion Fee ! $ 30.00 �
i ` ! �
( I : Save$753.04 bY PaY�n9 ihiS invace by We�#nesdaY,Au8u5t . :' . � .
�. � i 29, 2012. Please P�Y$11,985.OQ � .
� I �i i
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I � ��
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, � �
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' �_.___. i!dzank yau_f9r��aws�us ta s�'ve you�.rxl uz a�cril � '
__ I
Subtotal $12,738.DD
_..�.. _ .,�.. _- ..,
We�edN�cePt the foilrnving forms of paymert; 'Shippin9 �_-. -- -� .._ $ 0 00
Cash,Check, Ytsa,Maste�Gard,Distaier,Americ�n Er�ress rSsles7ex � $ .._.p.0_p__j
Ka�diy make your check paYabie fa: ��Totsi irnroice AsrKaurrt � $12 738.4D �
Myers-9uhrig Funeral Nome and Cremffiory 'i(�payme�tlCredd pie�d*- � $12?38 00 �`
Past tlue accounts ars subject to intereat chargss bf i.5%per month. I x' �t ,,�, S3,t' ;i�t*�rr�sae ,�y'
WaRci�rg wiih Thos¢in Griqf
IivbcrY"$Ob°L-Bal$Ytg.Jr.,t�n.5w+�,�+�•r•WiiRam°HitW[,.f�1ri5Mphtr.PD
PRone: n�+17663421 � Fvz� (re*�745.'247 • 3R 6ast Matn 5hcet • Mechxaissburg.PA 17t?i5 • www.Myerg.Buerig.epm � Dirn�EOes(riMyet`�.Buhrig.com
�l4/2F/2013 1�t13 7177957291 MYERS-$UHRZG Ft.WERPL PAGE 02109
.... � ...- . �—.—�`"_""^�-,.
f� i
.�` ����;��'TS clJt��ZI'��'
-�'�.r�1 Ha� �e Cre�r�tary �:
, : �NVO�cE
� Mark A. �Iier ,
� $972 HaneGuard Orive
! Burke,vA 22015 irnoice Number: 10488
f imrace Dste' Jui 29, 2ftt2
� ._ ., _._.'. page: i
,�.`i.,x.,;�:.n:yx.a..
PaU!D.Milier � July 28,2p12 " NCf 39 Day3 Rohert L.Buhrig Jr. �
'
Ai:"�'_..s.:E'.��.
: PS Professional Set+rice3 � „ S 4.252. .
FSE I Faciities, StaN arxi EquipmeM $2,�54.A0 i
�/ VOhidCS � $1.119.fMf
�. M i Merchandise : I. ..�� §-i>�`.� �.
� M '� I Adjustme+�t ta Merchandise-Uro Vsuit , . t�' ��•�? ��
M I Adjustment t0 MercYnndisa-Grematir�Jewelry - {$�_�80.06) I
; M Atljustmentta Merchandise•Gremation Urn!Candles with ', . � $ 90.00 i
� ! Exped$Cd Shipping . . �
I
p� � � Atldt�onai Merc3iantlise-Buna�Fk�9 � �� � $ 80.00 �,
0A
Aq Addi6onal Merd7andise-2 Waoden�ieg C'ases S 130.Dp I
: M � Additlo�ei Video Ir�9es � ' $ 38.U0 �
CA-CemeterY i Cash Advan�s-Cemetery � � $ 300.�D t
' CA-Cem�N � Adlustment t4 Cash AGVanCe,Additi4nai Cemete�Y Cx+�ge� I , $ 't59.Dq ;
� CJ1-Veult Gash AdvanCe-Cem�erY EquipmenY - $ 535-04
CA-Cemetary Cash Advance-Cemetery-Lo4&Deed S "a40.Ot?
i CA-Newspape ; Cesh Advance-Ncwspapers ; � 7���
i CA.New,5pape �i qtljustment to Cash Ativance-NewsQapars I i $ 285•DO '�
I CA-Clergy I Cesh Ativanoe-CIer9Y E $ 30Q.00 I
! CA-l7eath C9r 4,p0 , CBSh Ad�rdnce-Qe2th C2fdfic8t25 $ 6.00 i $ 24.00
CA-Cemehery Cash Advenae-Cemetery-Camer Msrlcers � � $ 15�.00
�, t;a,-Fiowers ; 'I ��n�Qu fStr a1.1_owine us to serve vou and your familvl _ $ 300.00 :
.------- _: ._-- '�'4-1' ._ _ �--•-�--_ ._
�Subta�i Conbnuetl'
We gladly accept the f�llawing fortns ot paymer�!_ ShiPPing ' $ �.00_ �
----- _�----_
Cash,Check, Vsa,MasfierCard,Discover,American Express I Seles 7ax � Con6nuedf
Kindlymake yow check paye6le to: �Total Invdce Amount `, � Gonti�ued I
Myers-Buhrig Funerai Nome and CrematarY ;P8ymdntlC�edk Appied�. . ._�..�-..—. $T2,738.OQ ���
Pest tlue accounts are suhjeci to interest charges ot 1.5°fa per mpnlh. ��. � vxa�`�� z ,• .*�*.,;,�. :i�.. ; .: .
Walkixg with Thnse ix GrteJ'
6obert°HOb�'L.�uANg,Jr.,ri�.c��n;k,�•wiWem•`Bil�"G Cpriceaphp�,ru
P6and: {si�755.3d$1 � Fa-„: cn^J�95.779I ' 3�EeKt Main Suett- MechanfeS6ur�t,PA 17pg5 . www.LiY�s-fluhrl.y.etrm • Uirectors(a�1Ynn-Buhdg.cum
� R�v-'i,rz ex+ r�z-os�
��� ';` pennsylvania SCHEDULE I
� oeanarwEnr oF aeveNUe DEBTS OF DECEDENT�
iNHearrnNCe rax aEruan MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Paul Doyne Miller 21-12-1306
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VAWE AT DATE
NUMBER DESCRIPTION OF DEATH
i. CitiBank Mastercard-final bill $645.83
2. Visa-f nal bill $33923
3. On-Star-f nal bill $75.80
a. Misc. bank charges $24.00
5. Sprint-finalbill $127.64
6. Governmenf Life Insurance Premium $25.75
7. State Farm Auto Insurance-final bill $307.89
8. Pennsylvania Department of Revenue-decedenfs 2012 Pennsylvania income tax $43.00
9. PennDOT car transfer fee $58.50
10. PenFed�sa Platinum-fnal bill $380.69
TOTAL (Also enter on Line 10, Recapitulation) § z,028.33
If more space Is needed, insert additional sheets of the same size.
REV�1513 EX+ (Ot-IG;
�, �`z' pennsylvania SCHEDULE )
OEPARTMENT OFREVENUE
�NHER�TANCE,Ax RET�aN BE N E FICIARI ES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Paul Doyne Miller 21-12-1306
KtLAItUrvSI11YtUUtCtUtrvl HMwrv� uHanHnt
NUMBER NAME AND ADDRESS OF PERSON(S)RECENING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTR[BUTIONS [Indude outright spousal distribu[ions and transfers under
Sec.9116(a)(1.2).]
1, Mark Alan Miller,8972 Home Guard Drive, Buke, VA 22015 Son 50% Rest, residue&
ramainriar nf Fctafe
2. Linda Jean Hopple, 111 Kerrs Road,Carlisle,PA 17015 Daughter 50% Rest, residue &
remainder of Estate
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES IS THROUGH 18 OF REV-I500 COVER SHEET,AS APPROPR[ATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II — ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
[f more space is needed,use additional sheets of paper of the same size.