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REV-1543 EX AFP (1-911_
COHHOHWEAlTH OF ~PENHSVLVAHIA
DEPARTHEHT Of AfVEHUE
IUREAU Of INDIVIDUAL TAKES
OEPT. 280601
tlARRISSUAO, PA 11U8-0601
Ill. /1f - / ()
INF6RMATioN NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21~91-. tJ~S7
94107561
03-02-94
ESTATE OF WIlITE
5.5, NO. 164-30-3108
DATE OF DEATH 12-20-93
COUNTY CUMBERLAND
TVPE OF ACCOUNT
H ~ SAVINGS
CHECKINO
TRUST
CERTIFICATE
REHIT PAYHENl AND FORHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MABEL
WHITE JR
2141 WAGGONERS
CARLISLE
WILLIAM
GAP RD
PA 17013
DAUPHIN DEPOSIT ilK I T ha. provided the DIPartunt with the Inforutlon lilted balow which h.. b..n u..d In calculating the
patlntlll tnN dUI. Thalr rlcordl Indlcat. that at thl dlath of tho oboye dle.dlnt, "01.1 Wit' " Joint owner/beneficiary of thh account.
If you ,..1 thh In'o,,,,t1,,n II Incorrlct, pi..u obtain wrlttan correction Irol thl flnanolal Inltltutlon, attach II copy to 'till for.
~"tt rllttnrn It tn th. ..hoVI .del'.... Thlt; Becount 11 talCabll In accordancl with thl Inhlrltancl Tel( Law. 01 the Couonw..lth of Plnn.ylvlnla.
QUI.tlon. IIY bl an.wlrld by calling (717) 767-8321.
COMPLEU PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0090150147 Dltl 08-27-81
E.tlbll.hld
Account ~lloncI 11 , 067.77
Plrclnt TI.lblo K 50,000
A.cunt SUbjlct t. r.. 5,533,89
To. Rlt. K ,06
PotlnUl1 TI. DUI 332,03
~T TAXPAYER RESPONSE
COI FAlLUR! TO R!SPOND WILL RESULT IN AN OFFlClAL TAX ASSESSMENT BASED ON THIS NOTlC! I
A. l\i1 Th. .bove Inforutlon end tll( dUI h corrlct.
~ I, Vou .ay choo'l to rlllt paY.lnt to thl Reglttlr of Will.. with two cople. of thl. notice to obtain
a discount or avoid Int.rut, or you ..y chick bOI( "A" and rlturn thh notlcl to thl Rlghtlr of
Will. and an official 11I......nt will bl I..uld by the PA n,partllnt of R.VOMI.
To In.url proper crodlt to your necount. two
(1) eopl.. of thl. flOtltl IUlt aeco.plny your
pay..nt to thl R.ghtlr 0 WI1It. Hakl check
paYlbl1 tOI "Rlgl'tlr of Will', Aglnt",
HOTEl If tlK paY'lnt. arl eadl wJthln thr..
(31 lonthl of the dle.dlnt'. dati of d.ath,
you '.y deduot I 5% dllCount of the talC dUI.
Any Inhlrltanel tal( dUI will batOMI d.llnqulnt
nlnl (91 lonthl aftlr thl dati of d.ath,
r- CHECK ]
ONE
BLOCK
L ON LV
B, 0 Thl abovl eUlt hlu bllln or will b. r.purtld nnd hI( paid with thl P.nntylvanlf1 InharthncI hI( rlturn
to bl fllld by the dlced,nt', r.prl"ntativI,
C, c=J Thl above Infor..tlon I~ncorrlct and lor dlbt, and dlductlonl Wlrl paid by you.
Vou IUlt cOlpll" PART ~ and/or PART [!] bllow.
If you indioata a diU.rent hx rate, pl.... ,ht. yoUr"
rllltlon.hlp tc dlcldlnt,
P^RT
~
'iAX
LINE
RETUilrl - COilPUi';i.Ctl
I. Dltl E.tlbll.hld
2. Account aelano.
5. P.rcent Taxabl.
4. A.ount Subjlct to TI.
5. Dlbtl Ind Dlductlcn.
6. A.ount TI.lbl.
7. TI. Rlt.
8. TI. DUI
0;'
TAri O~: JOINT .'Trn:~r ,'\Cco!..'~~'!'e
OFF1CIAL USE ON LV 0 AAF
PA DEPARTMENT OF REVENUE
~f>> .~-_."~1~{'
PART
~
DATE
DEBTS AND DEDUCTIONS
rAD
1
2
3
4
5
6
7
8
CLAIMED
:"
I
2
3 K
4_
5
6
7-l!
8
PAID
PAYEE
DESCRIPTI ON
AMOUNT PAID
1=
I
TOTAL IEntlr on Llnl 5 cf TI' Co.putltlonl
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Undlr plnlltlll of plrjury, I dlollrl thot thl
co.plltl to thl bllt of .y knowlldgl Ind blllof,
T~Wl~t ~IGN~~~R'EU J \,
hch I
hlY. report.d aboYI Irl tru.,
HOME ('/1/) ~-/I ,.
WORK ('/ U ) / 'I' "I j
TELEPHONE NUMB~R
corrlct Ind
" J
l,' ~
GENERAL INFORMATION
I. FAILURE TO RESPDND WILL RESULT IN AN OFfiCIAL TAN ASSESSHENT .Ith opplle.bl. Intor..' b...d en InferooUon
'ubIIltt,d by thl Hnancl.1 IntHtuUon,
2. Inn,rltlne. tlM b,eCI., d.linqu.nt nl"~ lon,h. .ft.r the d,ctd.nt', dlt. of d..th.
1, " Joint IC:ount it 'Iubl. Iy,n though the dlud,nt', n... WI' addtd It . ..tttr of C'lonvlnltnCI,
4, Acoountl ClnclucU", tho.. tMld b,tweln hY.btnd Ind wUt) which the dlctdtnt put In joint n.... within O~ YI.r prior to
d..th .r. luth hlCabl, II trAn'f.r..
S. Aecount. ..tlbll.hed jolntlv bltw.,n hu.band Ind Iflf. lor. th~ ana v..r prior to d,.th .r. not t'lClblt.
., ^ooount. hild by . decld.nt "In tru.t for" .nothlr or othtr. Ir. tlllabl. fullV,
REPORTING INSTRUCTIONS - PART 1
- TAXPAVER RESPONSE
1. BLOCK" ~ If the Infor..Uon !\nil COMputltlon In the MOtlclI' ar. corl'oct and deduotion. .r. not bdng Olll.'d, pltel In "K"
In block "A" of Part 1 of the "T.MpIYlr R..pon.." Ivctlcn, Sign two copl.. .nd lub_lt th.. wIth your ch.ck for the ..ount of
tlliC to the R.ghter of Wll11 of the county Indlcat.d. Th. I).parta.nt of Rlv.nu. will 11101 an offlcl.l ...."a.nt
(for. REV.15~a EK) upon r.c.lpt of the R.turn frull the R.gl.tlr of Wtll..
2, BLOCK B ~ If the ....t Ip.clfl.d on thl. not Ie. ha. b..n or will b. r.port.d and taM paid with the P.nn.ylvanla Inherlt.nc.
Tile FI.turn fUld bv the dtc.d.nt'. rlpr.t.ntDUVI, pile. In "X" In block "II" of Ptrt 1 of the "TaMplyar Rllponll" ..otlon, Sign on.
COpy and return to the PA D.parte.nt of Rvv.nu., Burlbu of Individual TaM", DIPt 210601, Harrhburg, PA 1712I~0601 In the
InvIlopl provldttl.
), BLOCK C ~ If the notlc. Infol,..Uon h Incorrlct and/or d.dlJctlont art b.ln" chlevd, chick block "C" and rloIPI.t. Part. 2 .nd 5
accordIng to thl In.trucHon. btlow. Sign two aopl.. Imd .ublllt ,<h.. with VOW. chtck for the lIount of tl)( Pfty.bh to tha R.ght,r
of WIlli 0' the county Indlcatld, Th. PA Dtplrt..nt of Rlv.nul will I..u. an offlolal I.......nt (For. REV~IS41 EX) upon r~ctlpt
of the rlturn fro. thl Rtgl.tlr of will..
TAX RETURN - PART 2 - TAX COMPUTATION
L1Hf
I. Enter tht date the account orlglnallV Wd. ..tabll.h.d or tltl.d In th8 .ann.r 8)(I.tlng at date of d.ath.
NOTEI For a dlcld.nt dying aft.r 12/12/121 Account. which the dlcud.nt put In joint n.... within one (I) y.ar of dtath arl
tlM,ble fully II tran.f.r.. How.v.r, th.r. 11 an 'Molu.lon not to IMclld U,ODO par tranDhr.. rtgar:U... of tht vllul of
the account or the nUMb.r of .ocount. h.ld.
If I doubll .ttlrl.k INN) appelr. b.fer. your flr.t n~Il' In the Iddr'I' portion 0' thl. notlc., the tS,OOO 'Mclu.lon
alrlady ha. b.en dedue~,d fro. the account balane, a. r.portld by thl fln.nctal In.tltutlon.
2, Entlr tht total balancl of the .ccount Including Int.r..t accrued to thl date of dlath,
5, Thl perctnt of thl wccount th.t I. talCable for ..ch .urvlvor II dlttrllln.d a. followll
A. Thl ptrClnt tlMlbl. for Jotnt ....t. ,.tabli.h.d .orl thin on. Ylar prior to the dlcldlntl. dlathl
I DIVIDED BY TOTAl NUMBER OF
JOINT OHNERS
EliCaIPIII A joint atilt r.gltt.red
DIVIDED BY TOTAL NUMBER OF X 100 . PERCENT TAXABLE
SURVIVINO JOINT OHNERS
In thl na.. of tnl dlcld_nt and two othlr p.r.on..
I DIVIDED BY 3 (JOINT OHNERS) DIVIDEO BY 2 (SURVIVORS) . ,167 M 100 . 16, n (lAMABLE FOR EACH SURVIVOR)
B. Thl Plrc.nt talClbll for ....t. craltld within one yenr of the dlcldlntl. d..th or account. own.d by the dlc.dlnt but h.ld
In trolt for anothlr Indlvlduat(.1 (trutt b.n.flel,rll')1
I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT M 100 . PERCENT TAMABLE
OWH~RS OR TRUST BENEFICIARIES
EM..pl.1 JoInt leeount rogl.t.r.d In the nal. of the dlcldlnt and two othlr p.r.on. and I.tabll.h.d within one y..r of d.lth by
the dtc.cItnt,
1 DIVIDED BV 2 (SURVIVORS) . .50 X 100 . 50% (TAXABLE FOR E~CH SURVIVOR)
It, The MCUnt 'ubi.ot to tlM (1lnl It) II dlterllnld by lultlp1vlna thl account blllnc. (line Zl by the plrclnt tlMalllt ntnl )).
S, Ento" tt.,; tQt~l of the dob~: ::",d d'd...."Ucll' U.t::: lr, i'ort :,
6, The aMOunt taMablt (lln. 6) I. dlt.ralned by .ubtractlna tht debt. and d.ductlon. (1In. 5) frol the ..eunt .ubj.ct to talC Illn. 4).
7, Entar tht Ipproprlltl teM ,at. (lln. 7) 81 dehreln.d bllow.
A. Tranlf.r. to Iln'll d..c.ndtnt. Including flthtr, loth.r, helband, wlf., .on, daught.r, grandchJldrln, .0n-In~l~w,
dauDhttr~ln~l.w, .t.pchlld Iud th,lr luue Irt tQlCIbl. at .IM perclnt (6;().
.. Trln.fer. to .11 othtr. Including brothlr, .tltlr, uncle, aunt, nip hew and nlec. are talCabll at flft..n parclnt (15%).
C. !f ycu ching, the tlM rah, pi.... .ptoj#y your ralatJon.hlr to thl d.cldlnt In the ar.. prollldad.
a, Tha a.ount uf taM due (lln. II I. dlt~r.lnld by lultlplYlng thl .aount tlMabl. (llna 61 by the taM rat. IIIn6 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTXON~ CLAIMED
Allowobll dabt. anet dlrkJotlun. art d.terllnld II followll
A, You l'OII1v are rupontJbll for pay..nt, or thl utat. .ubJeet to adalnhtratlon by a p.rsonal roprt..ntatlvl It tn.uffIQI.nt
to PIV thl d.duotlbl. It....
e. You actoally plld the dtbtl after duth of the dlc.dant and can furnllh proof uf paYllnt.
C. D.bt. btlng clal..d 'Ult bt lta,lud fUlly In Pltrt 3, If additional tp'OI I. n..dld, 1.1" plain paper 1 112" Ie 11", Proof of
ply.,nt 'IV b~ requ..t.d by thl PA D.p.rt.tnt of RIYlnut.
TAXPAVER ASSISTANCE
IF YOU NEED FURTHER INFORHATION OR ASSISTANCE. CONTACT ANV
REGISTER OF WILLS, PA DEPARTMENT OF REVF.NUr DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327.
I
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Mr. ..., William White
2141 Waggoners Gap Road
. Carllsre, PA 17013
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To fulfill 'ho 'oqul'......'. of 1"lIon 1141 .f 'ho Inho'"..... .... 1.1.,. ,.~ 1.1, 10' 11 of 1"1, (11 P,I,
"'lIon 21m, .
Ilo'och ,ho "P po,lIon of Ihlo Noll.. .... ,1AIt1l Hllh 'I'" p.,oonl 10 'ho 1"1.,,, .f Wlllo p,ln'ed on 'ho
rlv.r.. "de. '
.. HoI<. .ht<k 0' ....y o,elI, ,"ob'O '0' 1I0lml Df "1111, IDlM!.
All PII_" ,,,.I.ed .h.1I II.., bt _lied 10 ",y In'''..' ....I.h HY 110 duo, .Hh ony ,...Indo' ""lied ,. ,ho ,..,
A nfund of . tiN credit, ~IGh .,... NIt requllt" on the hI! r.turn, .IV be "quI,t,d bv OCHtPl.Unt In "Afttallolt1on
for R,''-''CI 0' Penn.vlvIn" Inhlrltlnu end I,t," Till" (_IY''''U, ,,.,lIl1tlonl .r. IVll1l1tl. at thl Offlc. 0'
the R"htlr of WHlI, env of 'hi U fIllvtnijl DI",lot Offl... or bv a.lllna the ,,"1,1 Z_~hour an....rlng lI,vlo"
nu8ber. for forll ordlrlntll In Penn,ylvenl. l',.....u.n.., out,lde Pemulvlnlt Ind within loc,1
Ho..lobu'. ".. (T171 7."1014, 11111. (1111 ""1111 UIo"I.. .....1'0<1 onlyl,
Any p.rb In Int.'II' IWlt ",tI,flM Nlth thl ....r.II...,,', IUOWInG. or dh.lIowltlc. of deduction. or ......lInt
of tlM Clnoludlnt dhoount 0' Int.,..U II .hchfn on thlt Motla. 'IY aJeot Mlthln liMty (60) d.~, of recllpt .If
'hh Noll" bPI
....wrIUen "otll' to thl PA DItIIr''''' If "IYlnut, laird of ."...., 0.,.. 211011, Htrrhburll, PA 1712'''ln21, OR
.....leaUnt to h.y. 'hi ..Uer dlt,rl'nell It (hi Mldlt af thl lOaoun' of 'hi plr.onll rlflr"tnt.Uv., OR
....."..1 to ,htI O'~1f'1I1 C"'Jrt
"o'utl .rrar. dhllvtr'" on 'hit .....1Nn1 .hellall be Mdr..,ed In wriUne tal PA o.plrtHnt of RIVenue,
lur.", .f In.Uvl....1 '''Mill AnNI Put A....'IIn' "I'll... lMlt, DlPT. 180601, H.rrllburg, PA 17121"0601
PhonI UU) ,,,.,,,,. IM......., 1M ""lit "In.trueU,", far Inh1rltlM. TIlC R.turn for. R"ldtnt
Deoedlnt" CMCV-'"'' f..r In tllI..IIIt'.t11K1 .f "lnh'f.Uv.h onrr"tHI. Irro"I.
If ony ,.. cluo I. ,.I~ ""hln 'h,.. III ..I.....' OOIIlh. .11" ,ho doG.don". elI.'h. . fl.. po,c.n' (5XI
dlooounl ., lho I.. ""II 10 .11_,
In'''..' 10 oM'.... 1tot1..,1.. Hllh "rol '" ., 01011_'. 0' nine m "",'h. ond OM (I) dll
fr. thcl dI~t ~, ...Ih, II IhI ...t. If 'Iv,,"Il 'UII whl.h bet... dell~t IMIfor. Jenulr>>> 1, 1912
boor In,,,..I ., lho ",. .1 .1. (tN, ''''1/1' ,,, ..... ,,1,ul.,... ., . d.lI~ ",. of ,000164,
AU '1.11 whllh 11M.. ...Ii,.,.,ll.n Ir Ifter Jenulrv I. 1'" wUl bllr Intlrllt It . r.'. Nhloh .,U1 VI'>>> fro.
..1tnd1r VHr I. IIleMf, "I' ..Uh thlt rl" ~.. bv the PA Dep"'lIf1t of R.vlnUt. Th. eppl1olbl.
Inl"..1 ",.. for I'" 'h'...... It~ .nl
YMr Inl.,..1 1.1. Bath Int.uat ......t., lair lAlI,aat A.t. O.llv Int.'.lt F.ctcr
Itll IU ,1111\1 It.. lOX ,ooom
191. 'Il louua I'" 'X ,ooom
ItI4 III .111111 "H-'"' IIX ,000101
Itll III . III". I"' 'X .0001\7
1"1-19~ 7X .ooom
"Iftl"..' I. "'Iullt.. .. 1.11.."
IlITaUT . IALANGI or TAM UN'AlO M NUN... OF DAY. DBLINQUENT X DAILY INTBRBlT FACTOR
....Anv NtU" InUII' ."., U,. 'IIC ........ dlll".1If11 will r.flu' .., Int.,..t c.lcullUon to fUtHn UI) dlV'
lMVIM thl ..t. af Uw ....".ttnt. If "YNn' II ... I".r thl lnt.rut COIIPutltlon dlt. .hoNn on the
Noll.., 1/1'1111....1 Inl...., "'., lit ooloul.tl/l,