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PURPOSE ot'
NOTICE'
To fulfill tht requlr..ent. of Slotlon 2140 of thl Inherltlnol tnrt Elt't' Tlx Aot, Aot 22 of 1?91. (72 PIS.
So.llon Z1401.
PAI'ItENT'
OItlch the top portion of thit Hotlcl .nd ,ub,1t with your ply.ent to th, Rlllhter 0' Willi prlntld on the
r''''lr.. Ilde, '
-- Hike chick or aoney ordlr Plyabl. tOI REGISTER OF WILLS, AGENT.
All ply..nt. r.celvld thlll flr.t bl Dp~lt.d tp any Int.r..t whloh ..y b, dut, with any r...lndtr applied to the tlX.
REFUND (CA)I Ai r.fund of . tile oredit, ~Ich w.. not r.quutld on tM tl)( r.turn, IIY b, requuttd by cOlpllUng In "AppllclUon
for R,fund of Plnn.ylvenl. Inherltanol and f.tat, Tax" (REY-15IS), ApplloltJonl ar. IVll1ftbl. at thl OffiCI of
the AIgI.t,r of Will., Iny of thl 25 R.vlnul Dl.trlot Of,lo,. or by calling thl .plclt. 24-hour .nl".rlng .ervlce
nu.ber. for for.. ord.rlngl In penn.vlvanla l~aOO.3'l-2050, out.lde p.nn.vlvanla and within 10cII
Harrl.burg .r.. (717) 787.8094, TOOl (711) 712-2252 (H..rlng Iapalred Only).
OBJECTIONS I Any party In tnt.r..t not .atl.ft,d with the .Ppr.I....nt, allowane. or dl..llow.nc. of d.duotlon. or ........nt
of taM (Inoludlng dl.oount or Int.r..t) " .hown on thl. Notlc. .av object wlthln .IKty (60) dlY' of r.celpt of
thlt NoUCI bYI
uwritttn protut to the PA a.pert..nt of R.vlnul, Board of ApPtltlt, O.pt. 211021, H.Jrrltburg, PA 11128.1021, OR
..~.llotlng to hlVI thl nttlr d.t.r.lnld at the audit of the account of thl p.r.onal r.prl..ntltlva, OR
"~apPIII to thl Orphan. I Court
AOIUN-
IITRATlVE
CORRECTIONS.
F.otu.1 .rror. dl.oovlrld on thl. n.......nt .hould b. .ddr....d In wrltlnt tOI PA n.p.rt.lnt of Rlv,nu.,
eurllu of Indll;!dull TaICII, ATTNI Po.t A.....lIQnt Rlvllw Unit, DEPT. 280601, Harrisburg, flA 17121-0601
Phone (117) 117.6505, SI' pIg. 3 of the booklet "In.truotlon. for Inhlritancl Tax Rlturn for a R..ldlnt
a.cedent" (REV-1S0l) for In IMpllOatlon of adllnl.trltlvlly corrlot.ble Irror..
DISCOUNT.
If anv t'M dul i. peld within thr.. (3) cal.ndar lonth. aftlr thl dlcldlnt'. dlath, a flv. p.rc.nt (SXJ
dhcount of the tlM paid It ,1I0N,d.
INTEREST.
Int.rl.t I. tharg.d b.glnnlng with flr.t d.y of dellnqulncv, or nln. (9) lonth. and one (1) day
frol thl dete cf dllth, to the date of pay..nt, T.MII which blea.. dellnqulnt b.fore Jlnuarv I, 1982
bltr lnter..t .t the rate of .he (6:0 Pltclnt pit .MUII calcuhted It I dally retl of .ODDI6~,
All t,XII which bee... dellnqulnt on or after January 1, 1912 will bur Intorut at a rate whlth will vary fro.
olhndar y..r to callndar v..r with thlt rat. Innouncld by the PA D.pert..nt of A'Vlnu.. Th. appllcablt
lntlr..t rate. for 1982 through 199~ arll
'Wr Int.rut Rete Dlllv Inter..t Fletar 1W Interut Rat. Dall11 Int.rllt Flletor
19az m ,0005(11 1916 lOX ,000274
19U 16X .00041a 1967 9X ,000247
1964 m ,000501 1966.1991 llX ,000501
1965 m ,00D1S~ 1992 9% ,000247
1995-1994 7X ,000192
. .Interllt II cllculated .. follawll
INTEREST . BALANCE OF TAX UNPAID X NU"BCR DF DAYS DELINqUENT X DAILY IN7EREST FACTDR
~~An't Notlc. IlIued .fter thl tlM bloc..e d.lInquent will refllot an Int.rut ealroul.tlon to flft..n uS) dlY'
b.'taod thl eftt. of tM ........nt. 1f Plv..nt It IIde .fter thl lnterllt OOlputltlon date .hown on the
NoUce, IddltlOMI Intarllt MoI.t bl c.leulltld.
P.:'1I-1.~43 I!X AFP 11-911 '*
CO"1eHWEALTH OF PENNSYLVANIA
OEP..THENT OF REVENUE
IURUU OF IHOIVIOllAL TAXES
DEPI, 210601
tlAARlS8UMU, PA 11111'0601
III - ;;. ().) ".) 'I
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILl! NO. 21 - g 4 --.3/'1
ACN 94108399
DATI! 03-10-94
TVPE OF ACCOUNT
H ~ SAVINGS
CHECKING
TRUST
CERTIFICATE
REHIT PAYHENT AND FDRHS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
(:
ESTATE OF GLASSMVER
5,5, NO. 198-52-6399
DATE OF DEATH 12-23-93
COUNTY CUMBERLAND
EVA
ZIMMERMAN
18 NITTANV DR
MECHANICS BURG
CAROLVN G
PA 17055
DAUPHIN DEPOSIT BK I T hit proyldld thl De"ert".nt with thl Infor.atlon lilted bllQW which h.. bun uud In cfllculatlng thl
potlnthl tall due. Thalr rocorcl. Indlc.'. that at the duth of thl abovI dlc.dlnt, yoU w't' I Joint ownlr/blnlflcllrY of this account.
If you ,..1 this Infor..Uon 11 Incorrlot. ph... obt,ln writhn corrlctlon frol thl financial In.tltutlon, attach h copy to this (or.
flnd r.turn It to thl aboy. .ddr.... Thl. account I, tillable In accordlncl with thl Inhorltnncl 1flll LIWI of the COAlonwl81th of P.nn'Ylvanla.
Quutlon. uy bl an.werld by oal1lng 1111) 731-IU21,
COMPLI!TE PART 1 BELOW. . . SEI! RI!VERSI! SIDE FOR FILING ANU PAVMENT INSTRUCTIONS
Aooount No. 5335611162 Doto 11-14-85
E.hblhhod
Ac~nunt aalanc.
Plrc.nt TI)(abla
A.ount Subjoot to
To. Roto
Potontlol To. Duo
645.46
50.000
322,73
,06
19,36
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNI!NT BASID ON THIS NOTICI
To In,ure proplr crldlt to your nccount, two
(1) topl.. of HII' notltl lu,t aCCOllpany your
pay..nt to thl ~I"htlr 0' Willi, HaitI chick
paYllbl1 tOI "R.gl.t., 01 Willi, Aglnt".
K
HOTEl If tal< PllYllntl arl lIadl within thru
(3) 1I0nth" of thll dlcliIdllnt', dati 01 duth,
you lav deduct a S% dl,count of thl tal< dUI.
Anv Inhlrlttmcl till< dUI will blco.. dl1Jnql:lnt
nlnl 191 lonth' aftlr thl dati 01 dlath.
To.
H
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. ThlllboVI Infortl8t1on and tal< dUI 11 corrlct.
1. You uy chao.. to rlllllt payunt to thl RII"I,tlr of Willi, uUh two copl.. of thlt not ICII to obtain
I dllcount or avoid Int.r.,t, or you lay chllok bOl< "A" and rlturn thl, notlclI to thl R."llter of
WIJII and an offlcJal al,e,,"ent will be 1.lued bV thl flA Dopart.ent of Rlvlnul.
8. c=J Thl above a,wlt ha, blln or will bl rlported dnd tax pdld with thl Plnn,vlvanla Inhllrltancl Tal< return
to b. filld by thl dlcedlnt', rlprlllntltlvliI,
C. c=J Thl IIbov. Infor.atlon I~ncorrect ~nd/or dlut, cnd dlductlont wlr' paid by you.
You lutt co"pl"tl PART ~ andlor PART QJ below,
If you indicata a difflrlnt ta)( rata, pl.... .t.ta your
rolotlonlhlp to dooldlnt,
PART
~
TAli R~TlIlIN - ()O"'lIl,IT~TJO~
LINE 1, Olt. E.toblllhld
2, Aocount aallncl
5, PercRnt T.x~bll
4, A.ount Subjlot to rl'
5, Olbt. ond Ooduotlonl
6. A.ount To,"blo
7, Tox Rlh
8, TI)( DUI
T~\( ON "lnYHT/TD'lllT A~(,O'ltJT!!
OFFICIAL USE ONL V 0 AAF
PA D~~~N~ OF REWUE
l'l:
1
2
3
4
5
6
7
8
r,~,o
H
1
2
3
4
5
6
7
8
DEBTS AND DI!DUCTIONS CLAIMI!D
H
PART
[!J
DATE PAID
PAVEE
OESCR I PTI ON
AMOUNT
~
I
PAID
I
TOTAL IEntor
on Line 5 of TIK co~put.tion)
Undlr plneitil. of plrjury, I dlcllrl th.t thl flet. I hlVI rlPortld abovI Ire true, corrlct and
oo.ploto to thl bOlt of .y knowlodgo .nd bollof, HOME
WORK (
----rrt:EPHOtIE
GENERAL INFORMATION
,
1. FAILURE TO RESPOND WILL RESULT IN AN DFF7CIAL TAM ASSESSHENT with op.llc.hl. Int.mt ....d on In/o,"Uon
tub_1tttd bv thl U"onol,1 Inttltutlon.
Z. Inherlt.ocl blC blec... dellnqulnt I1ln. lIonthl .ftu the dlC,dl"t', dill of duth.
S. A Joint Iceou"t I, "Mabl, IYln though the dlc.dent'. na.. WI' odded II I ..tt.r of cony.nl.nol.
4, Acoounts (including tho.. held b.t",u" hu.blnd and wife' which the dlcldent put In joint "Ia.. within on. Yllr prior to
dllth Ir. fUll'; tl'M_bl, II trlll,'I,..
5. Account. ..tabllshtd Jolntlv bltw.." husblnd end wlf. lor. th.n on. y..r prior to dl.th Ir. not "Mobls.
6. Account. held by . dlCldlnt "In trult for" another or oth.r. ""ll trllllbl, fully,
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A - If the lnfer.,tlon an; co,put,tlon In thl notlcl at. corr.ot and deduction. It. not bllng ol,I.,d, plac. ~ "X"
In black "A" of Put I of thl "TallpaYlr R"Plln.." ..ctlon. Sign two copl.. and .Ub.1t the. with your chlc::k for thl Hount of
tlM to the q,ght.r of WHh of thl county lndlcatld. Thl DIParh,"t of Rlvlnul will IIIUI Iln offlolll 1I......nt
lFor. REV.lS~a tlCl upon rlctlpt of th. R.turn frat tht R'lIhttr of Willi.
2, ILOCK.. If thl ....t IPlclft.d on thl. notlc. hu blln or will bt rlportld aod till Plld with thl PlnnsylvlnJI InhlrltlnC::1
Tu Rlturn fHld by thl dlcldlntll rlprl..ntatlvl, plaCI an "X" In block "B" of Put I of thl "TIIIPIYlr R..ponll'" noUon. Sign OM
cOPV .nd "Iturn to thl PA D'Plrtttnt of Rlvlnul, Bureeu of Individual 1IIMII, DIPt 2110601, tlurllburg, IJA 111U.0601 In thl
Inv,loPt provldtd.
5, BLOCK C . If thl notice Inforl<ltlon II Inoorrlot andlor dtductlon. arl bling chl..d, c::hlck block "C" and cOlpltt, Parh 2 and 5
aocurdlnv to thl Jnltruotlon. b'low. SllIn two cop II' and .ubtlt th.t with your ch.ck for thl Iloun' of tall Plyabla to thl Rlglt,er
of Willi of the county Indlcatld. Thl PA DIPlrttent nf R.v.nu. will I..ua an official a....I..nt (Fort REV.lS~a [X) upon rac::elPt
of the rlturn fro. thl Rlallt.r of Will..
TAX RETURN " PART
2
TAX COMPUTATION
L1HE
1. [ntlr the dltl thl ac::c::ount orlglnllly was e.tablllhtd or tltl,d In thl tannar 'MI.tlng at dati 0' death.
NOTEI for a dlc::.d.nt dying aft.r le/t2/a21 Acc::ountl which the d.c.d.nt put In joint na... wJthln on. (1) Y.lr of d.ath arl
tlllablt fully II tran.f.r.. tlawlVIr, th.r. II In IICclulion not to IMCII.d 13,000 plr tran.f.r.. r.gllrdl... of the vllut of
thl 10COunt or the nUlbu of accollntt hlld.
If a double uterhk (1Ul) appllr. blfarl your flrlt na.. In thl addrtll portion of this notlcl, tM n,ooo uolu.lon
alr,adV hat b..n d.duot.d frol the ac::eount ballnel II rlportld by the flnllnel"1 Inltltutlon.
2. Entlr thl total bal.ncI of thl ac::count In~ludlng Inter..t ae~ruld to 'h. date of d.ath.
5, Thl perclnt of thl .ccount that I. t.Mlbll for .ach 'uryl~ar II d.t.ralned a. followl'
A. The ptreent tUlblt ~o, joint ...." utabllth.d lor. than on. Yllr prior to th. dleld.nt'. dllth,
I DIVIDED IV TOUL ....IER DF DlVlD€D IV
XtIHT OWNERS
EM.-plt' A joint ....t r'lIl.t.rld In thl na.. of
TOTAL NOHBER Of X 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
thl dlc.d.nt and twe athlr parlonl.
1 DIVIDED BY 5 (JOINT OWKERS) DIVIDED!Y 2 (SURVIVORS) . .167 )( 100 . 16.1i! llA)(UlE fOR EACH SURVIVOR)
I. Thl Pllre.nt tllelbll for ...." erntad within on. ynl- of thl d'cldlnt', duth or aeeounh own.d by the d.c::od.nt but hlld
In tru.t for another Indlvldual(.1 {tru.t b.n.flelarll')1
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT U)lULE
EMlepll' JoInt acenunt rlgl.tlrld In the na.. of the d.eed.nt and two othlr p.r.on. Ind ..t.bll.hld within ont V'lr of dllth by
tho d.c.d.nt.
I DIVIDED IY l (SURVIVORS) .. .50 )( 100 . SOl: (TAUBlE FOR EACtl SURVIVOR)
~. ThI alount .ubject to taM (1In. 4) I. d.tlrlln.d by IUltlplylng thl account balanc. Illne 2) by thl p.relnt taMabl1 (1In, 3).
t. ::(l~.. tt... ~:.-::..1 c~ t~,;. ;1:1:':: ~.:-" rt:~J':l~!:~~ Il.-to,l I" o...t \
6, The Haunt ttleable nllll 61 It d.tlrllned by ,ubtraotlng the d.bt. and d.tJvctlon. {1lnt SI froll the alount .ubjlct to t8M (lInl 4),
7. Ent.r thl approprl.t. tall rltl (line 7) a. d.t.ralnld b.low,
A. Tran.f~r. to lInnl dllcendant. Including fathlr, .oth.r, hu.blnd, Wlfl, .on, daughtlr, grandchlldrln, lon-In-Iaw,
dtught.r.ln"law, .tlpohild and their l..u. arl t"ICabll at .IIC p.tc.nt (6%).
B. Tran.f.r. to all atht" IMQludlng brothlr, .l.ter, uncle, aunt, nephew and nl.ee art taMable a' fllt..n p.rc.nt (1SI:).
C. If you change th. tile rftt., plllc, SPlolfy your rllltJon'hlp to (h. d.c::.nlnt In thl ar'l provld.d.
&, Thl atount of tlM dUI (lln. a) I. d.t.rlln.d by ,ultlplylng thl n~ount taMable (1In. 6) by thl taM ratl (llnl 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabll dlbt. and d.ductlon' art dltlrllnld a. follow.,
A. You Ilgally Ire rl.ponelble for pay..n', or thl ..tatl IUbject to .dll~l.tratlon by n Plrsonal rIPrt..nt.tlv. I. Inlufflel.nt
to PlY thl d.duotlble U....
.. You Ictually p.ld thl d.bte aftlr d..th of the dat.den' and can furnl.h proof of pay..nt.
C. Debt. bllng ehllld auet bl It..llId fully In Part 3, If additional .pac. II n.odld, un pinln pap". a 112" M 11", flroof of
plYI.nt Ifty bl r.qu,.tld by th. PA D.pertl.nt of Rlv.nu..
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
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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