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REV-1543 EX AFP 11-91).
... CO~::'EAL IH or PEHHSVLVAHU
DEPAR1HEHl OF REVEHUf
IUREAU OF IHDIVIDUAl TAXES
DEPI. 110601
twlRISIURll, PA 11111-0601
14
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
(ii/~ (,1"frt
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FILE NO. ;: 1
ACN
DATE
94107188
02-26-94
'1"\ '1'.1: I I
:.1
ESTATE OF PUTT
S,S, NO, 184-12-4384
DATE OF DEATH 07-04-93
COUNTY CUMBERLAND
TYPE OF ACCOUNT
I ~ SAVINGS
CH~CKING
TRUST
CERltFICATE
REHIT PAVHENT AND FDRHS TDI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PAULI NE
CI
CUil
PUTT
'Cto 9 MARSHAll
CAMP HILL
GLENN
DR
PA 17011
FARHERS TRUST CD hOl pro,ldod tho DO"'I..nt wIth tho In'orootlon Ihl.d bolow ,hlch hOl .oon UlOd In "Iculotlns Ih,
polMtlol lox duo, Tholr rocord, Indl..to th.t 'I Iho d..th 0' Iho 'bovo d,oodont, 'ou woro " Joint owner/bonollch" 01 thl. .ccounl,
If ,au 1..1 Ihto Inlor..tl.n I, Inco,,"ol. ph... obloln wrltler, corr"cllon 'ro, lh, 'In.nol,1 In'tllutlon, 'lI,'" cop, to Ihh (oro
1<'" ro.",,, I< I. \f~ 0':" 'oJ,..., Ihl. .,-.,,',1 I, .,','''',1, Ir ,,,',,1.,,",, _I" ,,^ r-,"""ltw" Tov I"" ^. .n.. C,ooenw..lth cl P'""vlvanl.,
Ouutlon. "Y bt arll"'rtd by callIng {fill nt/-lUll.
COMPLETE PART 1 BELON M M M SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Aoeount No, 9-01679 D.to 12-01-70
E.toblhh.d
Aoeount e.lano.
P.relnt To.llbl.
Aoount SubJlot to T..
T.. R.t.
Pot.ntl.1 TI. Du.
712,70
50,000
356,35
,06
21. 38
TAXPAYER RESPONSE
FAILURI TO RISPO"D WILL RESULT IN AN OFFICIAL TAX ASSESSMeNT BASID ON THIS NOTICI
K
To In'lIr. proPIr crldJt to your acco\nt, t!tO
(Zl Cop I.. 01 thh notlcl IU.t "tco'pony your
PltY'.nt to th. R.ght.r of 111111, Hak. ch.ck
payabl. tOI "R.ght.r of 11111., Aglnt",
-
x
NOTE I II tax paYllnt, art udll wUhJn thr..
(3) 'onth. of thl dleldlnt'. dati of duth,
YOU lIlay deduct a 5% dlleount (If thl tll( duel,
Any Inh.r I tanc. talC due .,Ul b.en.. d41Jn~nt
nln. (91 .onth. aftlr thl dat, of d..th,
PART
m
-
[CHECK ]
ONE
BLOCK
ONLY
A. B Thl abev. Jnforlatlon and talC duel 11 corr.et.
1. You ley choo.. to r..1t PRY'lnt to thl RIlI1Itlr of Willi, with tNO copl.. of thh notlcl tc obtain
a dhcotM'lt or avoid lntlr..t, or YOU .ey chick bolC "A" and rUurn thh noUel to th. RIght.r of
"'1111 and an oHlohl aUIU..nt .,Jl1 be h"fld by the PA Otparbont of Rlvlnul.
If YOU Indlo.t. . dlff.r.nt t.. r.t., pl.... ot.t. your
..I.tlon.hlp to d.a.dlntl
I, 0 Tho '''VI ....t h.. boon or will bo "porl'd .nd tow P,ld with tho PO"""lv""l. Inh"1I,n.. To. "turn
to bl fJI.d by thl d.cld.nt'. rlpro.entatlvl,
C, 0 Thl lIbov. Infar.atlan J~ncorrlct l'nd/or dlbh nnd dtduetJon. WIr. paJd by yOU,
You ault COlpJ,t, PART ~ and/or PART 0 blluw.
PART
[!)
TAX ;:CTUrm - c:::rUT!\TICN or
LINE 1. D.to E.tlblhh.d I
2. Account O.l.ne. 2
3, P..e.nt TI..bl. 3 K
4, Anount SubJ.ot to T.. 4
s, D.bl. .nd Dlduotlon. S
6, Anount T...bl. 6
7, ro. R.tl 7 K
e, ro. Du. e
pEBTS AND
PM
1
2
3
Il
5
6
7
8
DEDUCTIONS CLAIMED
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
TM( "" ,1{l!MT ITIIII'IT Anrm"NT~
.....-"---,".-. -
,
PART
[!]
DATE PAID
-
PAYEE
DESCR IPTlON
AMOUNT PAID
I
~
Und.r p.n.ltl.. 01 p~rJury, I d.ol.r. th.t tho
eO.Pll~... to thl b~l,t7'Y/lkn..lldgl ond boll.t,
/ / I.
.. j /{ ,/ ,,~.,'Y'
TAXPAY~R SIGNATUR~
TOTAL (Ent.. on Lln. S of T.. Co.Put.tlon) .
flat. I hev. r.port.d Abov. IIr. true J corrlct .nd
HOME ('/ 1,') ..;) " I '
.--------
WORK ( )
TmJrlmNE NUMBER
GENERAL INFORMATION
I. FAILURE TO RESFOHD WILL RESULT IN AN OFFICIAL TAN ASSESSMENT with _11.obl. Int.rOlI b.nd on Inlor..II..,
....lltod bv lho 11_1.1 InIlIMI.."
Z. Jrr,erHIneI "M btClCNMII dellnquent nine ItOnthl 1ft" the deold<<1t'l dati of dllth.
5, A Joint lGoount II tlMabl. IVIn though the dtGtdlnt', "... WI' added II . ..ttlr of convtnlMl<lt.
~, AcOCKl'\tl CJnoluc:Un" tho.. held between hulblnd and wlf,) which the decldftnt put In Joint n.... within ant Vllr prior to
dllth Ir. futh '1IIMlI, II 'rltll'Ir..
5. AOCOU'1tl IItlblhMd Jolntlv b.t...." hutband and wU, IIOr. then one Vllr prior to death .r.. not 'I.lbll,
6. Aaoount. held bv . dta~t "In trult for" anot~r or other. Ir. 'INIbI, fUlly.
...
REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE
1. ILOCK A . If thl Inforut1on Ind oOllpUt.Uon In thl noUCI I,. carrlot and dtduotJonl Ir. not being ol"Hd, placl WI "X"
tn block "A" 0' Pu. I of thl "rIMPIVlr A..,on.." ltotllH1. Sign two cOPt.. Ind .w.1t the. NUn your c~k 'or the ~t 0'
t.JIC to thl R..ht,r of WUlI of thl oOWltV Indllllt~. ThIi c.p.r'..,,' of AlvlnUI w111 luue ." offJolel ....IIMnt
(Fore MY-15U EX) upon rHllpt of the Rlturn frCHI the Reg"tlr of Willi.
!, ILOCI( I - If the llI..t IpeolfJld on thh notlc. I'll. Hen or .,111 bI reportld Ind tlX Plld with the Pennlvlvlnll InherltlnCll
Tel( Rlturn ,1I1d by the decedent.. rltPrllenhtlvl, plltCl In "X" In block "8" of P.rt I of tht "l'llPIVlr RIIPO".." 'HUon, SIgn on.
copy linG "turn to the PA DIPert""t of R,venue, BUrtey of Incllvldull !IICII. D,pt 280601, Herrllburg, PA 17124-0601 In the
envIlope ~rovlded.
), ILOU( C - If the notlCI Inforlltlon II IncorrltCt andJor ~duotJo"J Plr. bllr\i: ohl..d. r,ht~k blMk "C" r!"ld CClIP14.. rartr 2 and 1
""':'e>..rft~:.: ~" th~ t~~trqottc;u b:1.:..4. CH.:, twu 0:0,:1., etll\l .~H ,iI.oII ,,1\11 )'uur o...uk to/' to. 1..IQUIll ot tllC J!lylb.LI to thl RlSlht.r
of Wl1l1 of thl oOU',ty Indloltld. The PA Dlplrt""t of R,venue will InUl ., offlol,1 ......eent (For. REY-IS4I E~O upon recllpt
of thl rtturn frow the AII"tlr of Willi.
TAX RETURN - PART 2 - TAX COMPUTATION
LUE
1. Entlf thl dlltl thl fCCOW'It orlglMlh WI' IItlblhhld or titled In thl IlMer uhtlng It dlh of d..th.
HOTEl For I d.ctdtnt dying .fhr 12/121821 Aocomtt Ithlch th. d.c.d.nt put In joint n.... within one (I) Vllr of d..th Irl
tulbll fully II tren'f.rl. However, thlrt II an Illolullon not to IMelld U,OOO plr ttanlllr.. rlglrdh.. of the Vllut of
the KOOWlt or the I'lUIItNIr of account. hlld,
If I doubll IItlrllk (n) ~'rI blfOrt your fi"t nIM In the arjdr... portion of thlt n01l0., the IS,OOO .xc1u,lon
.1reedy h.. been cMduottd frOll the ICCOU'\t balancl II rlpOrtltd bv the flnancl.l Inltitutlon.
2. E"tar thl tohl btllWlCI of thl ICCOW'lt lnoludln. Inter..t accrued to tM dlh of "-_th.
5, The percent of the account thlt II tll(abl1 f~r .ach lurvlvor II dtt.r.lnad I' followll
A. ThI perClnt tllClbll for joint ....t. ..tllbll1h1d lOr.. than OM vur prior to the dec.dent'. dllthl
t~
I DIYlDED IY TOTAL NUHIER 01'
JOINT !MEAS
EICllpll1 A joint ....t reghhretd
DIYlDED BY TOUL NUHIER 01' K loa . PERCENT TAXABLE
SURVIYING JOINT OlIIERS
1n thl MM of thl decedent end two othtr Ptlr'onl.
.~.-
.....
I. The peroent hlnlbl. for ...." or..tlld whhJn one yllr of the doelant'l ollth or "count, ollMd bll'
1ft tru,t for another IndlvldullCl) (tru.t blOlflchrlll)1
I DIYIDED IY I (JOINT OlIIERS) DIYIDED IY 2 (SURYIYOflS, . ,W K loa . 16,1X (JAKABLE FOR EACH SURYIYOR)
,
,,)
.1,'''
-,.,
I DIYlDED IY TDTRL _IER OF SlJRIIlYING JOINT
DtIIERS DR TRUST IEIEFICIRRIES
M 100 II I)[RCENl TAMABLE
lho do.odonl but hold
1',)
"
r:;~
EI(IIIPIII Joint Ilocount rallllterld In thl nl" of the d8o'dlnt Itnd two other plrtnn, and ..tabl hh.d within ana Yllr of dllth bv
the dlcedlnt.
1 DIYIDED IY 2 (SIJRYIYOflSI . ,sa X loa . SOK (TRxRILE FOR ERCH SURYIYOR)
4. The MOUnt lubj~t to tax (Unl 4) " dlhra.ln.d bv IUlt1phlng the account balenC:I (1lnl 2J by the plrclnt tlllllbla (l1na 5).
5. Entar thl tot.l of the debt. end dIdl.lCtlon. lltt.d In Put 3.
6. 1M MOWlt tll(lIbll (11M 6) II dlttralned by lubtrltCtlng the debh and dlductlOfl1 (IIi'll 5) frol the uount lubj.ct to t'l( <Ilna 4).
7. Entlr the epproprJltl 111( r1h (lIna 7) .. dlteraAn.d b.1C1w.
A. Trlnlfl,. to lInlll due.ndanh InolOOlnll father, lotMr, hUlband, wifl, lon, daughtlr, arlndchlldren, .0n.ln~J.w,
dMlghtll'-ln~lIw, Itapohlld and thalr ".oa are tallabla at the percent (6:<1.
B. Trenlllrt to III OtMrI 'nolucllng brother, Ilthr, unci., aunt, nlPhlw end nllc, aro taxablt at flftean plrclnt C15~).
C. If YOU c:hlntl thl tll( rltl, pi.... IPlcHv vour "hUonlhlp to thl dlcldlnt In thl arll provided,
I. The MOUnt of till du. Ulna S) II dltlrllned by ltUJtlplyJna thl IlOUOt tllubl. (JIM 6) by thl talC rat. (1lnl 7),
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AlloW1b11 dlbtl 8Rd d.duotlon. 1'1 dlhralnld II folloWll
A. You Ilgllly arl rupon.lbJ. for paV.lnt, or th. utatl lubj.ct to ad.lnlUrltlon bV I plrlonlll rapru.nt'tl~. II In.ufftol.nt
to PlY the dtductlbll I tl'l.
I. You aotulllv Plld thl debh Ifltr dllth of the dludant and 0.., furnlth prOof I)f ply..nt.
C. Debtl bllng cllllld IU.t bl lta.lud fullv In Part 3, If addltlon.1 IplCI II n..dld, u.. pl. In PIIPIr 8 1/2" IC 11". Proof"f
PIYlent I.y b, rl~Jllt8d bv thl PA OIPlrteent of Rlvlnul.
,TAXPAVER ASSISTANCE
IF YOU NEEO FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327, ..
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Zip Codo
PA DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT 280601
HARRISBURG PA 17128-0601
, '
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NOTICE.
To fulfill the requlre..nh of Stotlon Z1~0 0' ,thl InhlrulnOI and Eltlt. TIIC Aot, Aot zz 0' 1~91t (71 PII.
11O\lon mOl,
PAVlEHT I
DltlCh the top portion 0' thh tloUo. and .ub.1t with your ply..nt to the Register uf Willi printed on the
rlv.rl. licit.
".. H.. chick or .onlY ordtr Plytbl. tOI REOISTER Of WILLS, AGEHT,
All PIYMntl rtcllv.d Ihlll firlt be appUed to eny intlrut which .ay bt due, with Iny re..ind.r applied to thfl teM.
Rffl.llD (CA)I A rlfund 0' . tlX orldlt, whloh WII not rtquuttd on thl tu roturn, ..y b. req""t.~ by cOlplttlng In "Applloatlon
for R.fllld of Penn.Ylvanll Inh.ritancI and Eltatl Talt" (REV,,1S13). Appllcatlonl ar. IVllhbl1 .t thl Offlo. 0'
the Rqhtlr of NUll, In)l of the 23 Revlnue DlItrJot OfficII or by caUlng the 'Plclal Z4"hour Inlwlrlng atrvlcl
nUlbtr. for ~or'e ord.rlngl tn Plnnlylvanla l.aOO.362"2050, outtlde Ponn.ylvanla Ind within 10011
Herrhburg ar.. (117) 781"8094, TOOl (711) nZ"ZZ5Z HIllring Ilpalred Onlv).
OIJECTJOHSI Any p,rty In Int.rllt not satllfled with the apprahe..nt, allowanc. or dls.Uowancl of dlduotlon. or ........nt
0' hx (including discount or lnt.rllt) .. Ihown on thlt Motlu lilY obJeot within 11Mb (60) dlyt of receipt of
thi. HoUcl bY1
"'wrIUen protut to the PA Dlpart,ent of Alvlnul, BOlrd of APPIIII, DIPt. Z81~ZI, Harrhburl, PA I71ZI"lOU, OR
""alloUn" to havI thl "Itter deterllMid at the audit of the account of thl pUlonal rtpr..lnt8t1v., OR
"~epptal to 'hi Orphlnl' Court
AIlItlH-
ISTRATlVE
CORRECTlOHSI
FlOtu.l errort dhcovertd on thll ........nt Ihould bl addrfl...d In wrJtlna tOI PI. Depart..nt of R.venu.,
.ur..... of Individual Taitt., ATTNl POlt A.......nt Review Unit, DEPT. 210601, H.rrhburg, PA 1712H~'0601
Phone (117) 111"6505, R" page 3 of thl booklet "Inltruotlonl for Inh.rltancl T.le Return fur I Auld.nt
DttCldtnt" (REY"UOl) "r en lleplflnatlon of alhllnhtr.tlv'IY corr.otabll errorl.
OIICllUHT.
11 My tilt dul 11 pllcl within thrlt (5) calendlr .onthl aftlr thl dlcld.n,lt dnth, a five plrotnt (5~)
dhcount of the talC paid I. Illow.d,
lNTEREt,.
Inter..t It chargtd blglnnlng with fir It day of c1.Unqulncv, or nlnl (9) .onth. and onl (1) dev
fro. thl dlt. of ~..th, to the dlte of pay..nt. Talt" which beea'l dlUnqulnt blforl Janutry 1, 1982
blar Intlnlt It thl rate of tilt (6;0 peroent p.r annul calcullted at . d.lly rat. of ,000164.
All talt.. which b, :a"e dlllnqulnt on or aftl" Jllnuarv I, 198Z will b..r Inter..t at a rate whioh will vary frOll
011.tndar ynr to olllndar y..r with that rltl announcld by thl PA DIPart.ent of Rlvlnue. The IPPllubl1
inter..t r.t.. far 1982 through 1994 arll
'tUr lnt.rut Rah D.llv Int.ralt FBotar 'tUr Intor'lt Rlt. nallv lnt.,ut Flator
1982 20X ,000541 1956 10~ ,000174
1913 16X ,000451 1987 9~ ,000247
1984 IIX ,000301 1980-1991 ll1. ,000501
1915 IlX ,000556 1992 9% ,000147
1993-1994 n ,000l9!
"~Inter..t II ollculetld I!It foUowlI
INTEREST. BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR
nAny Notice IlIuld after tM tOIt beca... delinquent will rlfllot ~n Int.r..t clleulaUon to fifteen (IS) dlY'
beyond the dett of tht ........nt. If pay..nt h Ildl nftlr the Intlr..t co,putatlon dltl Ihown on thl
NOtlC', tddlt10nll Int.r..t lUst be calculated.