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� }�505610140
REV-1500 °`{°Z_„>{�'
PA I?epar6nent of Revenue OFFICIAL USE ONIY
eureau of�ndiWdual 7axes ENMERIT/1NCE TAX RE7UI2N Coumy Cade veer Fi�e Number
Po sax zaaeo� 2 1 1 3 !7 1 5 ?
Hart{ebwn,PA 17128-080f RESlDEM7 DECEDENT
ENTER DHCEDENT INFORMATION BELOW � � ��
Sodal Secufity Number Data of Death MMODYYYY Date of Blrth MMDpYYrr
0 1 2 4 2 � 1 3 d 6 � 1 1 9 6 ?
DecedenPs Last Name Suffix DecedenCs First Name MI
S H 0 P E M A R K A
(If Appllcable)EMSr Survivinq Spouse's Infartnatlon Bslow �
Spouse's last Name Sufflx Spouse's First Name pA�
Spouse's Sodal Security Number .
THIS itETURN MUST BE FII.ED!N DUPLICATE WITH THE
REGISTER OF WI�LS
FILL IN APpROPRIATE OVALS BELOW
� 1.OHginai Retum � 2.Supplernental Retum � 3.Remainder Retum{Date of OeaRh
PrWr�t2-73-82)
Q 4.i.imked Estate � 4a.Fulure iMerest Compromise(date of � 5.Federal Eskate Taz ReNm Requlred
death after 12-12-82)
❑ 6.Decedent Died Tesqtg � 7.Decadant MainWined a livtng Trvst � 8.ToWi Number M Safe Deposit Baxes
(Attach Copy ot WHI} {A�Ctt Copy ot Trust}
Q 9.�idgaNOn Praceeds Received � 1D.Spoueai Poverty Credit(Oate of Death � 1 t.EfecWn M 7ax under Sec.9113(A)
Between 72-31-97 and 1-1-95) (Attach Sdredule O)
� CQRRE3PONDEtlT�TNIS SECTIOM M4IfiT BE COMPLETEt).ALL CORREBPQN�E AtW COt#�ENTIAL TAX kIfORYltTf�i St#EAtk.O 8E QMiECTEO T0:
Name Daydme Teieptwna Numbea'
M U R R E L W A L T E R S I T I E S Q 7 1 7 6 9 7 4 6 5 0
�8srszeR oF w�usc�
c u m �
� ;`_� cx �
Ftrst llne of Address ��
�'.-�, .':_ �.,., __9 US .T.1
� �
5 4 E • M A I N T T R E E T � `"' "'
;u o
Second Llne of Address �� � - � c> o
�. ., ?J °r� -n
"� �City or Ppst Office State ZIP Code �J �AT��� r m
0
M E G H A N Z C S B t1 R G P A 1 7 Q 5 5 �' � � �'
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UnderP�t�es W PaN�Y�F dectve tl'�!Mara azur�tf W thh rahpiG k�ct�tlirp sdbduks�d .a�d�tl�e 6est M�rn/kn�atlps�x!bNI�,
ft is trve,eer�eat mG�.IIeeFantlOn d ptspptbr atlbr Cun tM P��roP���+tive 4f Dased at aii IMarmadon otwMCh ptarwter has wry kiSawAedpe.
RE qF PE r�SPON'�IBLE FOR FN.ING RETURN
i�.r:n. � �n�s..t-- ��,�a3,�o'�IIf 3
� noo�ss
I PATRTGIA A SH4PE 23 PISGAH STATE RD SHERMAN3 DALE PA 1709U
SIGNATURE OFPRE ARER R REPRESENTATNE DATE
�oor�ss
l • 3' -�3
t1URRE AL , , 54 E� MAIN ST MEtHANICSBURG PA 17055
� PLEA9E USE ORI6iNAl FORM ONLY
Sida 1
� 150561Q140 15fl561D14� � �
J Lsa561oz4o
REV-1500 EX(FI) 6ec�denYS SoGal Secutlty Number
t�acedent'ar�ame: 11ARK A. SNOPE
Recu+rruuno►a
1. Real Estata{^ached�e A} ........................................... 1. 8 (a 9 . 0 �
2. SMcks and Bonds(Schedule B) ... ... .. ... .. . ... .. .. . ... ... . .. ... ... . 2. •
3. Ciosely H�CaPoration�Partrrerst�p or SWaProPrie#nrst�p(Sche6�e C} ..... 3. •
4. Mortgages and Notes Receivable(Schedule D) . .. . .. .. . .. .. ..... .. ... .. . 4. •
s. casn,s��oepo�a�ar,a�sc��a�o�a�sa,a�aro�ey iscnea�,ie�}....... s. 3 7 2 ? 9 . 4 4
6. Jolntly Owned Property(5chedule F) ❑ separace enr�rtaa�esied .. ..... s. 1 3 2 5 4 . 5 9
7. IntervVivaS TrenBfers&MiBCSlianeous robete Froperty
{Scheduie G) �S�rarate 6ilHng Requested ....... T. .
8. Tptal Groq Asrsts(tofal Unes 1 throuQh 7) . .. . ..... .. . ....... ........ 8. S 1 4 0 3 . 0 3
9. Funeral Expanses and Administre6ve Costs(Schedule H) ... ....... ........ 9. 1 3 7 3 4 . 5 �
10. Delats W Decedent.Mortgage LiabiliGes,and Liens(Schedule I) ............. 70. 4 1 . 8 6
11. Totai Daduetiorn{totai Lines 9 and 10j .... . ........ .. ..... . . .. . ...... ti. 1 3 7 '7 6 . 3 6
12. Nat Value of Estata(line 8 minus line t t} ............................ 72, 3 7 6 2 6 . 6 7
13. ChariWbie aMl Govsmmenh�I BequaststSec 9113 Ttt�sts fa wtfich
an elec8on ro faz has not been made(Schedule J) ..... .. . ... .... .. .. . . . 13. .
44. !Mt Vatus SubJ�ct fo Taz(Line 12 mf�us Uns 13} ...................... }4. � 7 6 2 6 . 6 ?
TAX CALCUlATiON•SEE IN3TRt1CTiON$POR JtPIn.ICABIE RATES
15. Amount of Line 14 taxable
at tlie spousal t�rate,ar
transf�s und�'S�.8118
(a}(1.2}X.0 _ � . Q � 15. � . 0 (�
78. Amount of Line 14 taxable
at Iineal rete x.oas 3 6 7 9 8 . 9 2 �g, 1 6 5 5 . 9 5
17. Amaant of lrcfe 14 taxa�e
at sibUng rate X.12 8 2 7 . 7 5 �r. 9 9 . 3 3
18. Amount of Line 14 faxable
aecoi�cerairetex.�s 0 . Q 0 �a, p , p Q
19. TAX DUE . .. . . . . .. ... . .. ...... . .. ..... . ... .. .. .... .. . . ... .. .... 19. 1 7 5 5 • 2 8
20. flL#.#N TNE CtVAt IF VdU ARE'REqUESTtN6 A REFUND OF AN OVERPAYMENT �
i
Sldi 2
� 1505610240 15n561C1240 �
.... __-........ I ��
REY-1500 EX(Ft} Page 3 Fila Number
Decedent's Compiete Address: 2� 13 0157
DECEDENT'S NAME
n�ARK a.s�a�E
STREETADDRESS �
208 SENATE AVENUE _ _
CITY - �-- -- — STATE 21P
CAMP NILL PA 17011
Tax Payments and Credits:
�. Ta�c Dua(Page 2,Line 19) (t} 1.T55.2$
�. c`�`�""�"S a.sas.2a
A.Prior Payments
B.Discount 82.48
Tota!Crectits{A�B} {2} 1 731.66
3. intarest
(3)
4. If Une 2 is grealer than Line 1+Line 3,enter the difference.This is the OVERPAYMENT.
FNI M ovaf on P�ye 2,Llns 20 Ea requstt s rctund. (4) 4.4Q
5. If Line 1 +Line 3 is greaier ihan Line 2,enter the di�erence.This is lhe TA7(DUE. (5) 23,g2
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUBSTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
t. Did decedent make a transf�ar�d: Yes No
a. retain fhe use or income of the property trans�ferred ...................................................................... �
h. retain the dght to designffie who shall use the property trar�sferred or its Income ...............................
c. refain a reversio�ary inferest ........................................................................................_........... �
a. re�ve a,e pranise ra�iie�eimer pa�r,ts,t,�r�Gs a e�e2 ....................................................... ❑ �
2. K death occurred aFter pecember 72,1982,did decedent trensfer propeAy within one year of death �7
without recsiving adequate consideration? ....................................................................................... � tdl
3. Did decedant owrr�'�irusf for'w payable�ppn-0eaN b�tk aa:atnt�security af his a h��ath? .........
4. Did dec�dent own an individual retirement account,annuiry or other non-probate property,which
tbntains a beneflaary designation9.................................................................................................. ❑ �
!F THE ANSWER T4 AM!OF THE ABOVE QUES'f'IONS IS YES,YOU MUST COMPI.ETE SCHEDULE G AND FtLE iT AS PAR?'OP THE RETURN.
for�tas of death on or aftar July t,1994,and before Jan.1,1995,the taa�rate imposed o�the net value of transfers to ar for ttre use of tlre surviving spause is
is 3 percent{72 P.S.§9116(a}(i.i}{i}].
For dates of death on or after Jan. 1, 1995,the tax rate imposed ai lhe net value of tranef��s to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116{aj{7.1}(ujJ.The statute dces not e�mpt a tr�afer to a surviving sp�use from t�,a�d�se statutay requiremen�fw disdosure of assets and
� f�ng a t�ratum are sfiN�icabie eren if the surviving spaise is the oNy 6enefiaary.
For dates of death on or after July 1,2000:
• The tax rate imposed on tl�e net value of U�sfers frpm a deceased chik!21 years of age or younger at deatlr to w far ths use of a naturai parent,an
� a�stive p�ent w s stepparatrt af Ure chlid is 4 percent[72 P.S.§9116{a}(1.2}j.
• The tax rate imposed on Me nat value of transfers to or for tt�e use of the decedent's lineal benefioiaries is 4.5 percent,e�ept as noted in p2 Ps.§91�s�a�(1�J.
• Fhe tax rate imposed on the net value af Uansfers to or fa the use of ths decedenYs siWings is 12 percent[72 P.S.§9116{aj{1.3}j.A�Ciing is defm�,
un�'Section 9102,a4 an individuai who has at ieast ane pare�tk in camrrw�with the decedent,wheU�er by btaod or adoption.
�.: —_.
. . .. .... �..�.�n��.�.�.�
f2EV-t5Q3 EX+{&-12}
pennsylvania SCHEDULE B
DEPApTMENfOFRFYENUE
INHEPo'tAtKETAXRETURN STOCKS i� BONDS
RESIDENT DECEDENT
ESTATE OF PILE NUt�R
N1ARK A. SHOPE 21 13 4157
All property jointly awned wkh rlgM oi survivorship must bs dlaclosad on Schsdula F.
lTEM VACUE AT OATE
NUMBER DESCRIPTiQN OF DEATH
i.
I
TOTAL{AlsoenleratU�2,f�CapilWawm) i
'
If more spa�is needed,insert addtlonaf shsets of ihe same size
l: . . .. ._... ..._.. _ ._ ._ . . . �
,
REV-ts�e�*toeaz}
pennsylvania SCHEDU�E E
oeenarr.�riroFaEVer�ue CASH, BAFIK DEP4SITS $� MISC.
�si�Nr���NrT��' PERSONAL PROPERTY
ESTATE UF: P�.E NUA�ER:
MARK A. SHOPE 21 13 0151
Indude tlre proceads of IlUgatipn and the date the proceeds were received by the estate.
All pro�»Ky joinNy ow�stl wlth right oi wrvivonhip must be disclo�sd on ScMduls F.
ITEM VALUE AT DATE
NUMBER OESCRIPTlON OF DEATk
1. BANK OF LANDIBBURG 1,823.21
CHECKING
2. BANK OF LANDI3BURG 34,137.23
SAVINf38
3. CUMBERLAND COUNTY 31.Op
INCOME TAX REFUND
4. PA dEPARTMEPIT OF REVENUE 1,2ea.oa
INCOME 7AX REFUND
� 707At(A+so en�r an Line 5,Recadtvlatbnl i 3T 279.44
� if more space is needed,use additionai aheeis oi paPar M the same aize... . . .
_ ��■
REV-150�3 EX+{4t-t4)
pennsylvania SCHEDULE F
OEPAftTMEMOFREVENUE �ptNTIY-OWNED PROPERTY
INHEPoI'ANCE TAX RE7URN
RESIDENT DECEOENT
ESTATE qF: p�.E NUMgER;
N1ARK A.SHQPE 21 13 0157
H en aaeet waa made Nfintly owned wHhin one year of tlia decedenPi deta of deMh,k mwt be reporbd on Schadule G.
SURVIVING.KNM7 TENANT(S)NAME(S} ADORESS REV+TIONSHIP TO DECEDENI'
n. PATRICIA A. 8HOPE 231 PISGAH STATE ROAD MOTHER
SHERMANS DALE, PA 1 T090
a.GREGORY SHdPE 316 N.4TH STRE£T BROTMER
MEWPORT, PA 17074
G.
JOINTLY-0YYNED pROPERTY:
tETTg2 OATE OFPAOPEftTY � %� D.4TEOFOEATH
ITEM FOR.tOtNT MA6E lNt�.UDENAMEOFFtHANCW.INSTffUtipNAt�BqNKpCCWN7NUMgERQRS�MIUR DATEt7FDEATN �CEDENTS VAlUEOF
NUMBER TENAM JOINT I�NTIFYINGNUM�ER ATTACHOEEDFORJOINRYd1ElDREALE$TATE. VALUEQFASSET INTEREST DECEDENT5INTEREST
t. A. �lzo�o BANK OF IANDiSBURG 11,282.35 50. 5,641.18
Gd
2. A. tzno�o SAVINGS BONDS 13,571.32 S0. 8,785.66
198 80NDS,VARIOUS tiATES,All.PURGHASED
IN EXCES8 OF ONE YEAR pRiOR Tp DEATH
3. A, B ai2oo2 BANK OF U1NDI$6URG 2,508.32 38. 827.75
�Q
JOINT W ITF#
MOTHER-PATRICIA A. SHOPE
BROTHER-GREGORY SHOPE
i TOTAI(Afso enter on Une 6,Recapitulatiai� f �3 254.59 �
�I tt more�Ce b needed.use add46a�ai sAe�af y�erdttre sama a�e.
4... _. . ... .. .. . ... . .
- � I��II
RFU-1.r}�T�+��{a-�}'�
pennsylvania SCHEDULE H
�EPARTA£M OF REVENUE FUMERAL EXPENSfS�MD
'""�TA"c�T^xREr"w�i ADMINISTRAIIVE COSTS
RESIDENT DECEOENi
ESTATE OF F�.E NUI�R
MARK A. SHCiPE 21 13 0157
DeaedanPs dabn ma4t be repoMad on&MduM t.
ITEM
NUMBER DESCRIPTIQN AMOUNT
A. FUNERAL EXPENSES:
t. 80YER8 FUNERA�HOME, NEW Bl.00MFIE�Q 8,448.40
2. RtCE MEMORIAL3 2,868.00
B. ADMINISTRA7IVE COS7S:
1. PersonaiRepresentabveCommisshrns;
1. Name�s�a Pe�sonai RePresenmave�s� PATRICIA A. SHOPE
S�tnam�s 23'F PISt3AH STATE ROAD
Cny SHERMANS DALE su�e PA zia 17090
raade)canm�a,Rarct: fRENOUNCED? ,
2, AtamevFe�+; MURREL R.WALTERS, 111 2,200.b0
3. famiy Ezemption:{If deceder�fs addra93 b notthe sarrw as dffirnaM'9,atlach explanation.)
CleimaM
Streel Addrass
C�y S�@B ZIP
Relatbnship of Qlaimant to Decedent
4. pr�p�s: CUN48ERLAND COUNTY REGISTER 4F WIILS 21$,50
5 AaountentFees:
fi. Tax ReWm Dreperer Fees:
7.
�
TOTAL(Also enter on Une 9,Recapitula�loit) S 13 734.50
Ifmas�ebneeded,�a�tlbnei�Mp�r�g�eaarrie�. .. �
REV-15'72IX+(12-12}
pennsylvania SCHEDULE (
OEPP.RTNENT OF REVENUE p�gTS OP DECEDENT�
ir�+E�ru+c�Taxr�T��r+ MORTGAGE lIA$ILIFIES 8�LtENS
RESIDENT DECEDENT
ESTATE OF P�.E�fR
MARK A.SHOPE 21 13 0157
RspoR dedts Incurrod by the decadar�t prlor to de�lh that remalned unpaid st the date of death,including unreimbuned medkal upensea.
lTEM VAWE RT 6ATE
NUMBER DESCRIPTIpN OF DEATM
t. VISA 37.43
CREDIT CARD
2. VERIZON 4.43
PHONE
I
TOTAL(Also enter on Line 10,RecapitukMbn) i 41.88
If more apace is needed,insert additi�anal sheels of the same sizs.
REV-0513 EX«(Oi-10)
pennsylvania SCHEDULE J
DEPAFtTMENT OF REVENUE BENEFICIARIES
INHERITANCE TN(RETURN
RESIDENT DECEDENT
ESTATE OF: FILE lW�ER:
MARK A. SHOPE 21 13 0157
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not Lk!TrusbNs) OF ESTATE
I TAXABLE DISTRIBUTIONS pndude ouhioM I dishibutbns and transfeB under
Sec.91i6�8 (�.2�,�
1. PATRICIA A. SHOPE Lineal
231 PISGAH STATE ROAD
SHERMANS DALE, PA 17090
2. LARRY N. 3HOPE Lineal
231 PISGAH STATE ROAD
SHERMANS DALE, PA 17090
3. GREGORY SHOPE SlbNng
315 N.4TH STREET
NEWPORT, PA 17074
ENTER DOl1AR AIdOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 CAVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. _
If more space is needed,use additionai sheets of pap�o(the sane size.