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To fulfUl the requir...ntl of SKUon 21"0 0' the Jnh.rttanol end Elt.tl Tlx Aot, Aot 22 of 1991. (72 P,',
loollon2140),
Detach the top porUon of this Hotic. end lub.lt wUh your plY'lnt to the A"lIt" of NUll printld on thl
r'Vlrla Ith.
.... "tic, chick \lr IkJMY crdlr ply,bh tal REOISTER OF WillS, AOENT.
AU PlYHnh rK,lv'd thlll flrlt b, applhd to any Intlrtlt which IIY bl due, IlIlth Iny "..Ind.r .ppHId to the h)C,
A r.fund of I t..Ie crtdlt, which wal not r.qu..tld on the tile r.turn, IIY bt rtqulltld by eOlpl.t1ng an "AppUelUon
fclr R.fund of Plnnlvlvanl. tnh"ltal1c, Ind Eltlt, hx" (REV-IU3J. Applicationl.rt IvaUlbll It the OffiCI of
thl "'lIl1hr of NIUI, any of thl 23 R.v.nut DhtrIot OffiCII or by e.Ulng th. 'Plcl.l 2.-hour anl.,.r~ng ..rvic.
nwG"l for fer.. ordlrlngl In Plnn.vlvlnJ. 1.800-362.2050, outside P.nnIYlva"la and within local
H.rrllburg ern (717) 787-'094, TCD. (717) 171.2152 (H.artng I'Pllrtd Only),
'OIJECTtOHSI Any partv In Int"..t not IItlsfl.d with the apprall"l"t, 111I)WllOOI or dillllowancI 0' dlduotlon, or 1I1I'''"nt
0' t.x (lnoludlng dhcount or Int.r..t) II Itlcwn on thlt HoUc. .ay olJj.et within ,jl(tv (601 dlYI 0' rtOIJpt 0"
thh MoUe. bYI
--"rIU.n protllt to th. PA D.part"nt 0' Rlv.nul, BOlrd of AppIII., D.pt, 281021, H.rrhburg, pA 17128.1021, OR
-.;..llotlng to hay. thl .attlr d.tlr.t"ld at the audit 0' the actount of thl p.rsonal r.pr...nt.UvI, OR
....eppe.l to thl Orphanl' Court
AllItlH.
ISTAATlYl!
COAA!CTlllMi .
DISCOUNT.
IHTEIIUTr
Factual "rcrl dllco\ltrld on thlt ........nt Ihould bt .ddr....d In writing tOI PA O''''lrtltnt of RIV'nu.,
IUrt., 0' Incflvldull Tftx.., ATTNt POlt ""....."t R.vll'" Unit, DEPT. 280601, Hlrrhburll, PA 17128-0601
Phon. (717) 717-6505, S.. plgl 3 of the bookl.t IItn.truetlonl for Inherltancl Tll( A.turn for a R..ldlnt
Dtoedtnt" CREV.ISOll for an uplanaUon of Idtlnhtr,Uvlty cc.rr.otebl. .rrer.,
If any ta~ due II PIld within thr.. U) cahndar lonthl IIft.r th. d.e.dlnt'. dlllth, a fly. perclnt cs:n
dheount of U\I tlX plld II allowed.
tnterut It chargtd b'Bt,.",!n; with flret day of dtUnqultlOY, or nJn. (9) lent hi and one (1) dlY
fro. th. d.tl of d."th, to thl d.t. of PIYllnt. rexu which ble... d.llnqutnt before Jtnuer~ I, 1982
be.r Int.r..t It thl rat. of 11M (6~) Plre.nt plr annUl calculatld It a dIllY rlt. of .OOOI6~.
All tlXU which bee.,. dlllnqu.nt on or after J.nuary I, 19B2 will bur Inter..t .t a rat. which will Ylry frOll
cII.ndar y.ar to eal.nder Yllr with that rat. In"ouneld by th. PA D.pert"nt of R'VI~, Th.lpp1!clblt
Intlr..t rGt.. for 1982 through 1994 IIr.1
l:W tnt.rut Altl Dallll Inter..t Faotor Xur Inter.1t Rlt. Datlll Int.r..t Flater
1982 lOX , Oaos~1 1916 lOX ,000276
1915 III ,000651 1907 9X .000Z~7
1916 III ,000301 1911-1991 IlX ,000301
1915 m ,000356 1992 9X .000Z~7
1993-199~ 7X ,000192
--tnterut b elle1llat.d II fellowll
INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any NoUcl hlu.d after th. tlX bleo... deUnqu.nt will r.fI.ot an Int.r..t caleul.tlon to Hfte.n (1S) d'YI
blvond th. dttl of thl ........nt. If p.y..nt hi IIdl after thl inter..t eOllputatlon dati Ihown on th.
Notlo., .ddJtJonll Int.r..t 'Ult ba ollculltld,
RI'V"1543 EX AFP (1"91>_
... COMHOHWEAL HI OF PEHHS\'l VANIA
DEPART"EHT Qf REVENUe
IURfAU OF IHOIYIDUAl TAX~S
Dt:PT. ZI0601
HARRISBURG, PA 17121-0601
/ if- FlY (/
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FIL! NO. 21"
ACN 94108284
DATE 03-10-94
c
q 1./ - J 70
ESTATE OF SHEELY
S,S. NO, 162-36-8323
DATE OF DEATH 12-06-93
COUNTY CUMBERLAND
TYPE OF ACCOUNT
J~ [ SAVINOS
CHECKINO
TAUST
X CEATlFICATE
REHIT PAVHENT AND FOAHS TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ROY
SHEELY F R
517 E LlSBURN RD
MECHANICSBURG PA 17055
HARRIS SAVINOS BANK hat prClvld.d th. O.partll.nt with th. Inforllltlon lllttd below which hili bun ulld In clIlculatlng th.
potlnttal talC dUI. Th.lr rlcords Indicnh that at ti1l dlath of tht "bov. dlc.d.nt, you w.r. I Joint owntr/b.n,flclarY of thll account.
If you ,..1 thlt Inforllat1on II Incorrlet, pi.... obtain wrltt.n correotion froll the flnllnolel Inltltutlon, attach a OOpy to thlt for.
and return It to th. l,bOVI addr.... Thh account II taxable In accordanc. with th. Inherltanc. Tall low. of the COllllonwulth III PlInnlY1YIlnln,
QuuUonl illY b, an.w.rtd by nlllnll (7111 lal'S3Z/'.
COHPLETE PART 1 BELOW M M M SEE REVERSE SIDE FOR FILINO AND PAYMENT INSTRUCTIONS
Aooount No, 05-66-229932 o.t. 06-18-92
Establish.d
Aooount O.hno. 33.027,80
P.ro.nt ra..bh X 50 , 000
AMount Subj.ot to To' 16.513,90
T.. R.ta X .15
PotanUal To' Du. 2 , 477 , 09
PAAT TAXPAYER RESPONSE
COI FAILURI TO ReSPOND WILL RESULT IN AN OFFICIAL TAX ASSES$HENT BASED ON THIS HOTICE I
A,
To In.ur. prop" credit to ynur account, two
(Zl copl.. of thl. notlCI 'I'IUlt aCClOllpllny your
plly..nt to th. Rlght,r of Wills. Hilke chICk
payable tal "Alight.r of Willi, Aglnt".
NOTEl If tll)( pllyu"h ar, IIIOd, within thr..
131 Mnth. of the dlcld.nt's dati of duth,
you uy deduct a S% dhceunt of the tal< dUI.
Any Inheritance ta~ du. will blea.. delinquent
nlnl (9) 1II0nth. after the dati of cllath.
[CHECK -"
8~~~K J
ONLY
[g;hl llbOlJ1 Inforut1on ftnd t81< dUI I, torrlct.
I. You llay chao.. to rOlllt pllyllent to thl R,gl.ter of Willi, with two coph. of thh notice to obtain
II discount or lll/old Inter.H, or yoU Illy chIck box "A" llnd rohlrn thit notice to th. ReglU,r 0'
Hill. and IIn official Il.......nt will bl I.suld by the PA nepart,.nt 0' Rlvlnu..
B. [] Thl abov. Il...t hal b..n or will b, reporteu nnd ta~ paid with the PennSylvania Inheritance TaK return
to be filed by the d.e.d.nt's repruentatlve.
C. 0 Th. above lnfor.at1on II Incorrect nnd/or debU nnd deducUonl wer. paid by you.
You .u.t co.plet. PART 0 lind/or PART CD below,
If you indlcat. I diffor.nt hx rat., plla.. sbt. your
rohUonship to doo.d.nt I
~fjCIAL USE ON~V 0 AAF
PA UEPARTH~NT OF:R~9ENUE
PART
[3J
Till': RF.TIIRN . r.ll"lPIITATYIlN IlF
LINE 1, D.t. Est.blish.d 1
2, Acoount Oalanc. 2
3. Poro.nt ra..bla 3 X
4, Anount Subj.ot to To. 4
5. Dobts ond D.duotlons 5
6. Anount T...bl. 6
7, Tox A.t. 7 K
8, To. Du. 8
TA V nN ,Inn!''' n'll'~TA,l:'l:'nIINT!l
P.^.D
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--.....-.-----......-
PART
[!]
DATE
DEBTS AND DEDUCTIONS
1
2
3
4
So
6
7
8
CLAIMED
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PAID
PAYEE
DESCR I PTI ON
AMOUNT PAID
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TOTAL I~nt.r on Lino 5 of T.. Conput.tlon)
l
.
Undar p.nd H.. of po.. jury. 1 doolaro th.t tho
COllpltt. to the b.lt of flY ~nQwltdg. and b.llef,
" /?'h< (l:.'tf'di,t'tf~
hots I
hey. reported
( ? /
(
abov. are tru., correct and
~ t ... ~ J I
- Ii J ,',/ J; I J; ?If'
DATE '
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GENERAL INfORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAM ASSESSHENT with .pp1IcaOI. Int"..t O.ud on Inlora.tlon
Iublltt.d by thl flnano"l Inlt1tutton.
2. IrhtrttlncI till bloo... dllln~nt nln. tooth. "tlf th. dlcld,nt', dl'l of dnth.
S, A Joint aeeount It taxlbl. ,ven though thl d.c.dlnt'. na.. wu add,d II a utt.r uf c:enVlnltnl:ll.
4. Account. lInaludlnll ttlOIl hlld b.twlln t'oulband and ..1f.1 which thl dlcld"nt put In Joint n.... within onl Yllr prior to
dta't> IIr. 'ulh tUlblt .. tron",r..
S. Aeceunt. utlblhnld jointly b.tw..n hUlbMd end wlh lor. than on. yur prior to d..th arl not taMabll,
.. Aeeount. held by a d.e.dlnt "'n trult fur" anothlr or ntht,. IIr41 taMable fully,
REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE
1. BLOCk A . tf thl Inforlllltlon aurl COlp'Jtltlon In the notlc. art corrlOt and d.duotlonl Ir. not b.lnD al.lud, pllce In "le"
In block """ of Part 1 of thl "TaMpoygr RIIPon.." ..otlon. t;tgn two ccpl.. Ind ,ubtlt th.. with your chick for th. ..cunt of
tu to thl Rlght.r of Willi 0' thl counh Indlcatld, Th. Olpart-Int 0' A,v.nuI will luu. I'M official ........nt
(For. REV-1541 EX) upon r,cllpt of thl R.turn fro. thl RI"ithr of willi.
Z. BLOCK I - If thl ,,,"t sp.clfl.d on thlt notlc. h81 bun or wll1 b. r,port'd and tal( paid with tht P.nnsylvanla Inhlrltanct
Till Alturn f1l1d by thl dlr;.dtnt'l r.pr.untntlvI. plac. en ")(" In blor;k "a" of Pert I of th. "TlKpay.r A..pon.... notlon. Sign ani
copy IIld r.turn to thl PA Dlpertunt of Alvlnul, Iuruu 0' Individual hlC", U.pt 280601, Uarrhburll, PA 17121-0601 In thl
.nvllop.. provldtd.
!, BlDCK C ~ If th. notlcl Inforltlltlon II Incorrlct and/or d.duotlon. erl bllng chl..d, chick block "e" and r;o.plttt Puts land 1
according to th. In.tructlon. bllow. Sign two caputi and lubMIt thll wHh your cnlck tor th. a.ount of hlC pllyabll to th. Hlgllur
0' Willi of tht county Indlcl'lhd. Thft PA D.parh.nt of R.vlInu. wIll 1"lulIan of,lc1ollllu....nt (""art REV-1548 flU upon rlellpt
of thl rl~urn 'roM the PIIII"hr 0' Illllt.
TAX RETURN - PART 2
TAX COMPUTATION
LINE
1, Entlr th. d.te th. account or]ginallY VII uteblhh.d or tltlld In thl IIlnnlr '1Cllltlnll et dl!lt. 0' duth.
HOTEl for II dlcld.nt dYlnll aft., IUIl/52l Accounts which thQ d.c.dent put In Joint nu.. within one (lJ yur 0' d..th ar.
tnable fully III tranl"rs. Itow'\lIr, th.rl 11 an IIl(eluslon not to I.Cled n.ooo plr tran.hru regardl.1I of thl valul of
thl account or thl nu.ber of tlccount. h.ld.
if I doubl. .."rllk (MM' apptlrt be forI your flrlt na.. In thl IIddrell portion of thlt notJc., thl n,ooo Illcluslon
alrlddy has hlln dldJotlld fro. thl ftccount bahnc. a. rlported by thl financIal In.tltutlon,
Z. Enttr th, total balene. of tha account Inoludlng Int.r..t I'lccru.d to thl dati of dlllth.
:So Thl perclnt of th. account that II 'nabl. for IlIch lurvlvor 11 dltlrelnld III folloWlll
A. Th' ptrclnt taxlblt fer joint aUI" utabli1hld .Orl than ani yur prIor to thl dlcldlnt'. dltrthl
I DIYlDED lY TOTAl HllIIlER OF
JOIHT OWNERS
E)Ca.plll A joJnt ....t rlght.rld
DIYIDED BV TOTAL NUHBER Of
SURYIYINO JOINT OWNERJ
In th. na.. 0' 'h. dlc.dlnt llnd two oth.,
100 . PERCENT TAKA8LE
Plrton..
I OIYlDED IV ] (J01HT OWHEHS) DIVIDED BV 2 <SURVIVORS) . ,167 M 100 . 16. j% (TAKABLE FOR EACH SURVIVOR)
I. Th. Plrclnt ~IIK1Ibll for lI..ltS cruhd within ono ynr of thlll dlc.dlnt'l dlllth cr accounh cwn.d by thl deClldent but htld
In tru.t for .nathlr IndlvlduaUs' Ctrutt blnlflchrlUl1
1 DIVIDED BV TOTAL HUHBfR OF SURVIVIHO .lOIHT
OWN[RS OR TRUST IIENEFICIARIES
)( 100 . PERCENT TAMABLE
EICO.phl Joint account rtgltterld In thl nll'l of tho dec.dllnt and two oth.r plrlonl end ..tllblhhld within ani Yllr 0' dllth by
thl d.ced.nt.
1 DiviDED IIV Z (SURVIVORS) . .50 )( 100 . SOl (TA)(AllE fOR EAClt SURVIVOR}
4, The ..aunt lubJ.et to tu (lIne 4) II dlt.r.lnld by .ultlplylnll thl account balancl Oln. 2) by thl p.rctnt taxable (Un. !).
S. Entlr thl tl)hl /'If thfl r!~t\h ,.nrl ",u1wllnn"l II'Itllrl In Part ~.
6, Th. JlOunt talCabl_ 111n. 6) h d.ter.ln.d by lubtractln" 'hQ dlbt. IInd deductlonl (llnl 5) frol the a.ount lubjeot to talC (Unf 4),
7. Enter the Ippropr laU tu rat. (I1n. 7) 81 deter.lntd bllow.
A. Transfl" to lln..1 duc.ndantl Including 11th." tlothClr, hU:Jband, wlf., Ian, dllullht.r, grandchlld"n, lon-In-Iaw,
daughtlr.ln-law, tt.pchlld end thllr InuI Jrt talCabh at .\)1 p.rc.nt (6%>'
B. Transf.r. to all othlrl Including brothQr, .lIter. uncll, aunt, n.r.t>.w IInd nllcl IIrl t,Ulabh at flftun ptrc.nt C15:0.
C. If YOU chang. th. tel( rnU, phuI IPlclfy your rllatlonlhip '0 thl d.udlnt In 'hi arn provldld.
e. Thl ..aunt of talC dUI (lln. 6) I. dttur.lned by .ultlplYlnll the a.ount talCabll (1lno 61 by th. tll( retl (line 7),
CLAI~tD DEDUCTIONS - PART
3
DEBTS ANO DEOUCTIONS CLAIMED
Alloweblt dlbU and '.Iductlonl art d.ttr.ln.d II followll
A, Iou l.gallY :'.' rupon.lnll for pay..nt, or thl utat. lubJeet to adllnhtr'IIt1on by n plrlonal rIPr..lntltlv. It Int.ufflellnt
to pay thl dlduct!blt It....
I. Vou actually paid th. dlbh aftlr death of thl dle.dlnt and can furnilh proD' of pay..nt.
C. Dlbt. bllng clai'lu iIIUSt bl Itulnd fully In Part 3. If additional spaca I. nndad, Ult plaIn pap.r a Ill" IC 11", Proof 0'
paY.lnt ~ay be rlqu.lted by 'h. PA D.part.lnt of Rlv.nu..
TAXPAVER ASSISTANCE
IF YOU NEED FURTHER INfORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327,
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