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'AIV-1343 IX AFP 0-91) *
. C~ALIH OF PEKH'VIVAHIA
OEPIRTHEHI OF REVEHUE
BUREAU OF IHDIVlDUl1 TAKES
DEPT. 110601
HIRRISSURG, PI 11111-0601
ILl- ')05' /I
INFORMATION NOTICE
AND
TAXPAVER RESPONse
FILl!
ACN
OAT!
NO.21-Cl,,/-L{b~
94113615
04-14-94
RILEV III THOMAS L
1914 CARLISLE RD
CAMP HILL PA 11011
TVPE OF ACCOUNT
L ~ SAVINGS
CHECKING
TRUST
CERTIFICATE
REMIT PAVNENT AND FORMS TOl
REGISTER OF WILLS
CUMBERLAND CO COURT HOUS~
CARLISLE, PA 11013
ESTATE OF RILEV
S.S. NO. 215-05-2139
DATE OF DEATH 01-16-94
COUNTY CUMBERLAND
THOMAS
DAUPHIN DEPOSIT BANK I n.. pr..ld.d Ih. D.perlllnl wllh Ih. Inl.rIlU.n lltl.d b.l.w which h" blln .lId In ..I..I.lln. Ih.
p.I.nll.1 11M dUO. Thllr reo.rd. Indl..I. 'h. I .t 'h. d..'h .1 Ih. .b... d...dlnl, ". w'" . j,ll\l .wner/b.n.f1.I." " Ihl. ...,unl.
If ,.. f..1 Ihl. Inl.r..'I.n I. In..rr.,I, pl.... .bt.ln wrl,l.n ..rr..'I.n Ir" Ih. Iln.n.I.1 Inlll,.'I,n. .II..h . .'P' ,. Ihl. I.r.
.nd r.lurn II I. Ih. .b..1 .ddr.'" Ihl. .....1\1 I. 1.,.b1. In ...,rd.n.' wllh Ih. Inh.rll.n.. I.' l.w, .1 Ih. c,...nw..Llh .1 p.nn.,I..nl..
yu.'\10nl .aY ~. on.wlred bY ~.111ny l/1/J le/-bIZ/.
COHPLITI PART 1 BILOW . . . SII AIVIRSI SIDI FOA FJLING AND PAVHINT INSTRUCTIONS
,-
Acccunt No. 0010i!1b221 D.b 01-21-93
e.tabU.h.d
To 1n.ur. propsr credlt to your IClcount, two
(Zl cop Ie' of thlt notlc, IU.t aocoMpany your
pav..nt to thl RIgltttr of Willi. Hake thiCk
payable tOI "Rlgltt,r o~ WHit, Aglnt".
PART
m
889.02
50.000
444.51
.06
26.61
TAXPAVER RESPONSE
PAILURI TO RIIPOND WILL AISULT IN AN OFFICIAL TAX AISISSHIHTIASID ON THIS NOTICI
Acccunt B.lonc.
P.rc.nt T...ble
AMOunt Subj.ct to
T.. R.b
pot.nti.l Te. Due
HOTEl If taM pav.,ntl are .ad. within thr"
(3) lo~th. of th. d.e.d.nt'. data of d..th,
you lay dlduot a sX dl.count of thl ta~ du',
Any Inh.rltanol ta~ dut will bleo.1 dlllnqu.nt
nln. (9) lonth. after thl data uf d..th.
)(
T..
)(
-
[CHECK J
ONE
BLOCK
ON LV
A. Thl aboll' Infor.aUon and ta~ dUI 11 oar rIot .
1. V,. .., .h.." I. r..I' p.,..nl " Ihl ...I.I.r .1 Hili., wllh Iw. .,pl.. .f Ihl. n.tl.. I' .bl.ln
. dl...unl .r ..,ld Inl.r..I, .r ". .., .h.ck b" "I" .nd rl,.rn 'hi. null.' I. Ih. R..I.I.r .f
Will. and an of"olol a.......nt will b. I..u.~ by thl PA Depart.lnt of ~'II.nuI.
a. c:J lh. .b... ....1 h" b..n or will bl r.p.rl.d .nd t., p.ld wllh Ih. p.nn.,I..nl. Inh.rll.n.. I.' r.,.rn
to bl fJ1ld by thl dlcldont" rlpr...ntatilll.
C. c:J lh. .b'" Inf.r..'I.n l~n.'rr..1 .nd/.r d.b" .nd d.d..tl,n. w.r. ..Id b, ,...
'fOll IUlt cOllpllU PART L!J and/or PART m bllow.
\
II
I
\
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If ycu indic.te . diff.rent t.. rote, pl.... .t.te ycur
r.l.tion.hip tc d.c.dent,
, ~ lAlvVSE O~~"l 0 MF
PA DEPARTHEtlTOF ,~EYENUE ..
_.._...._---.:-"............~~
~~ :~
PART
~
1AX A!TURM . COHPUTATI~N
LINE 1. n.t. E.tobll.h.d
2, Aooount 8.1Ino.
3, P.rc.nt T...ble
~, AMCunt Subject to T..
S, Debt. .nd Deduction.
&. AMount T...ble
7. T.' R.ta
8. To. Duo
Pl.D
1
2
3
4
5
6
1
8
DIBTS AND DIDUCTIONS CLAIHED
OF 1~X IlN ,IOt'lT ITRI1!'IT ACCOUIIT9
1
2
3 X
~
S
&
7 X
8
i',) ,
PART
[!J
DATE PAID
PAVEE
DESCRIPTION
AMOUNT PAID
TOTAL IEnt.r Cn Lln' 5 cf T.. COMPut.ticn) ·
-
Under p.n.ltie. cf perjury, 1 d.cl.re th.t tho
cOMPlete to the be.t of MY knowl.dg. .nd b.ll.f.
TAXPAVER q~birl)l() If) '2 J/>11
f.ct. I h.V' r.ported .bo.. .r. true,
~OHE (7 I)> 7 l.-,'
WORK ( )
TELEPHONE NUHfER
oorrlct and.
0;1- t/ ~/E':J-J-j?~
~
GENERAL INFORMATION
1, FAILURE TO RESPONO WILL RESULT IN AN OFFICIAL TAN ASSESSNENT with ,ppll,lI>l. Intor..t b.ud on Infor..tl,n
,ublltt.ct bV the Hnenol.! lnltltutlon.
2. InhtrltlHlCl' h)( b4teo... d.lInlfUlnt nln. lonth. ,ft.r thl dlc.d.nt', d.tlf of duth,
S. A joint ICCOunt I, taxlbl. IVI" though thl dlcedlnt', n... w_. added al . I.tt.r of convlnl,ncl.
It. AC(l~h (lnoludlno tholo hlld bltw.." hu.band and wlf,) which thl dIC.d,"t put In joint n.... wUhln on. yllr prior to
d~.th Ir. fullV "Nlbl. II tran.f.r..
S. AOCOLrlh utablhhtd Jolntlv b.t~..n hu.blnd and wH. !.lore ~hdn one VII' prior to duth Ir. not tIIClbl..
6. AooOl.l'lt. htld b:l . clleldlnt "JI'I 'rult 'or" anoth.r or oth.r. Ire lIKable fu1!Y,
.
REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE
1. IILOC!l(". If thll Infor..Uon and coitput.Hon In thl notlc. er, corrlo\ and deduotlon, ." not bllng al,hld, pllt1. an "Ie"
In block toA" of Plrt 1 of thl "TupIYlr Ruponu" lIotlon. Sign two copl.. Ind .ub.it th.. with your ch.ck for the a.ount of
talC to the Rlglster of WUh of the county Indlcllted. Th. D,part..nt of R.v.nuI .,111 IlIu. an offlchl .........nt
(Fori REV.1S4t8 EXl upon r.c.lpt of thl Rlturn fro. the Righter of WUh.
z. aLOCK I . If thl ....t IP.clfltd on lhl. notle. hel bIen or will b. reported Ind talC paid with thl Plnnlvlvanla InhlrltlnU
TllC Rtturn fUld bv the dlcldent'l r,prulntaUvl, pllet In "II" In block "a" of Part I of the "Tupayar R..pon.." nctlon. Sign ant
copy and r.turn to thl PA Dlrart..nt 1f RtVlnu., luruu of Individual TaICI', Dlpt Za0601, Harrhburg, PA I11ZI.0601 In the
Inv,lop. provided.
5. aLOCK C . If thl notlc. lnforlatlon ls Incorrlot Ind/or dld\lctlons art bllng olallld, ch.ck block "e" and cOlpllte P.,t, 1 Ind 5
according to thl In.truotlon. b.low. Sign two coplu and ,ubllt tnll with your chiCle for tn" .Iount of talC pllyC\iJh to thl RIght".
of Willi of tha countv' JncJlvlted. Thl PI. D.partllnt of Rlvlnul wUl luuI an offlclll I.......nt (Farl REV.1548 EX) upon rlcelpt
of the r.turn frOll thl Raghter of WUh.
TAX RETURN - PART 2 - TAX COMPUTATION
liNE
1. Ent.r tht date the account orlglnallV 'III uhblhhld or HUld In thl I,nnu IlC1Itlng at dati of duth.
HOTEl For II dlcld.nt dvlng after IUIUaZI Account. which t"l dlcldlnt put In Joint Rltl" w!thln on. (1) Vllr of d..th Ir'
tllClbll fulh .. tr'n.flrs. tlow,vlr, thare 11 an IlCclullon nat ta elCclld U,OOO plr tran.flr.. rlgardle.. of the vlh..e of
the accooot or the nu.blr of accounh hlld.
If II doublt IIItlrhk (lflf) appllr. bafor. your flr.t nUl In the adtlr..s portion of this notlc., thl U,OOO IlColutlon
alreadv hu bQeR dlductld frol the account b"lancl at rlPortld by the financial In.tJtutlon.
Z. Enter the to hI bal.ncl of the C'lCCO\lnt Including lntlrllt accruld to thl dOlt. of duth.
J. The pornnt of the account thlt It taKlIblt for uch .urvlvor In d.t.r.ln.d tit followlI
A, The perclnt t.xlblt for joint a...tt .Iteblhh.d lore than on. Yllr prior to thl dlc.dlnt's deathl
1 DIVIDED IV TOTAL ~8ER OF DI~IDCD BV TOTAL HUH8ER OF X 100 . PERl.ENT TAUILE
JOIRT OWNERS SURYIYIRO JOIRT OWNERS
EKI.,I" A joint a"lt rQgJ.terld In thl n'" of thl dlc.dlnt and two oth.r plrlons.
1 DIVIDED IV J (JOINT OWNERS) DIVID€D av 2 (SURVIVORS) . .)67 )( 100 . 16.1% (TAXABLE FDA EACIl SURVIVOR)
I. Thl plreent tlKuhl1 for "uah oruted within ani yur of tha dlc.dlnt'. death or aocounh ownld bv thl dleedlnt but held
In trust for ,"otht-r Jndl...lduIUs) (trult blnlflehrlull
1 DIVIDED BV TOTAL NUHBEA OF SURVIVING JOINT
OWNERS OR TRUST BENeFICIARIES
K 100 . PERCENT TAXAILE
ElCHPIII Joint Iccount rsghtlrld In the nsa. of the dlcldlnt and two other plr.on. and utabll.h.d within anI yur of dtlth bv
thl dlCldlnt.
1 DIVIDED BV Z (SURVIVORS) . .50 X 100 . SO;{ (T.\XAIILE FOR EACtl SURVIVOR)
4. Thl laount subjaot to talC <1lnl 4) 11 d.taralnad by lultlp1Ylng the aocount balanc. (l1n. Z> bv thl ptrclnt taKabl. (lInl S),
S. l:nh, thl totzll cf tho tJebt:l IInd ds.dt:::tlcna Ustl<1 In Part 3.
6. The Blount taKabl. (!In. 6) Is d.tlrlln.d by subtractlng tha d.bt. and dlductlon. tlln. 5) frol thl saount sUbjlct to tllC (llnl 4),
7. Entar thl approprl.ta taK rata (} In. 1) II dltarllnld bllow.
.. Transflrs to lIn"l duelrld.nt. InchJdlng fathlr, .othlr, hUlband, wlf., .on, daughter, grllndchlhJrln, lon.ln.1Iw,
dauohtlr.ln"law, .tlpchlld and thllr luuI Itl taKabla at Ih: p.relnt C6:(1.
I. Transfars to all oth."s Including brother, littlr, unol', aunt, nlphaw and nllcl arl tlICabla at flftlln parc.nt 05~)'
C. If YOU ctllngl tha tlIC ratl, plulI sP.clh your rtletlonlhlp to the d.cldlnt In thl ar.. provldld.
a. The lNtOunt of tl)( dUI Ulne 8) it dlterlln.d by IUltlplylng thl saount talCabla (llnl 6) by thl talC ratl (I1na 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts IInd dlduotlonl art dst.ralned ft. followl'
A. Vou leg.lly ar. rupon.lbl. lor paYllnt, or ttlll utate lubJ.ot to ad.lnl.tratlon by a plrlonal repru.ntatlvI II In.ufflcl.nt
to pay tha d.duotlbl. It....
I. Vou aatuIlly Plid tho d,bts a't.r dllth of the dlctdlnt and can furnish proof of paY'lnt.
C. Dtbts bllng clallld lust b. U..lnd ful.lY In Part S. If additional sp.c. It n"dld, u.. plain paptr 8 1/l" lC 11". Proof of
Plv.ant lay bt r.qu.sted by the PA D.~.rtlgnt of ~lv.nuI.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WILLS, rA DEPARTMENT OF REVE~UE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN
HARRIS8URG AT (717) 787-8327,
rREV-1543 EX AFP (1-911,*
. C~A(TH OF PEHHSYLYANIA
DEPARTHENT Of RlYENUE
IUREAU Of INDIYIDUAL ,,'ES
DEP!. Zl0601
HARRISBURO, PA l11za~0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 - t') 'I' '/02.,
ACN 94113674
DAT! 04-14-94
TYPE OF ACCOUNT
L ~ SAVINOS
CHECKINO
TRUST
CERTIFICATE
REHIT PAYHENT AND FORNS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT ~OUSE
CARLISLE, PA 17013
THOMAS
ESTATE OF RILEY
5.S. NO. 215-05-2739
DATE OF DEATH 01-16-94
COUNTY CUMBERLAND
RILEY CATHER I NE D
1914 CARLISLE RD
CAMP HILL PA 17011
DAUPHIN DE POUT BANK I hu provldld thl Dlpart.,"t with thl Inforutlon Ihhd below wh\ch hll blln u..d In cIlculatlng thl
pottntl,1 tlK dUI. Thllr r.onrdl Indlcat. thlt at the d..th of thl .bov. dlc.dlnt, you wlr. II joint eMolr/blneflcl.rY of thl. account.
If you fe,1 thh Infor..tlcn 11 Incorrlct, pha.. obtain wrltt.n corr.otlon fr08 thl flnanolal Institution, athch II copy to thlt' for.
Ind r.turn It to thl IIboVI .ddr.... Thl. account I_ taMable In accordancl with thl Inherltanc. TIK Lawl of thl Co..onw..lth of Plnn,Y1vanla.
Cuutlonl .IY b. an,w.rld bY Oll1lna (7171 187.U27.
COMPLETE PART 1 BEL~W . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Acccunt No. 0010216227 D.t. 01-21-93
E.hblhh.d
Account aalanc.
Parclnt Taxabll
bOllnt Subj.ct to
T.. R.t.
Pot.ntl.l T.. Du.
K
889.02
50.000
444,51
.06
26.67
To Insurl proper crldlt to your account, two
(2) cop lis of this notlcl ,u.t .cco'pany your
patnnt to thl R'Ii!hhr of lUll.. Hllkl chick
PllYllbll tal "Rlghtlr of Wl1lt, Aglllt".
x
HOTE: If ta~ pavI.nt. are .adl within thrll
(1) lenth. of the dlcldlnt's dati of dlllth,
you lay dlduct a S% discount of thl tn~ du.,
Any Inhlrltancl ta~ due will blco.1 dlllnqulnt
nln, (9) lonth. .fhr thl dati of duth.
T..
PART
[I]
TAXPAYER RESPONSE
FAILURI TO RISPOMD llILL RESUI.T 1M AN OFFICIAL TAX ASSESSMENT BASED OM THIS NOTICI
[CHECK ]
ONE
BLOCK
ONLY
A. Qr!hlllbOV' InferuUon Ilnd tax dUI I, corr.ct.
1. You "V ~hoo" to r..it pIYllnt to thl Righter of With, with two copl.. of this notlcl to obteln
I dl.count or .vold Int.r..t, or vou Ifty chick bo~ "A" Ind rlturn thlD not lei to thl Rlgl.tlr of
WHit .nd In official 'Ulnunt will b. IlIuld by the PA DI~lrt..nt of H.v.nu..
8. c=J Thl abovl ....t h.. hlln or will bl reportld and tll~ paJd with thl P.nntvlvanl. Inh.rltancl TIl~ rlturn
to bl fllld by thl dlcld.nt', rIPr.s.ntltJvl.
C. 0 Thl IlbOVI ll1forll\lon Ik\ncorrtct IInd/o~lbtl and dlductiont Wtrl paid by YUU.
You IU.t co.plltl PART ~ and/or PART ~ bllow.
PART
[!]
DATE PIIID
PAD
1
2_
3
4
5
6_
1
8
AND DEDUCTIONS CLAIMED
PfF}CIAL USE ON~Y [] AAF
PA IIE'1>ARTMSflT OF~E\lENUE
"i" ." ,
If you Indlo.t. . dlff.r.nt t.. r.te, pl.... .t.t. your
r.l.tlon.hlp to d.o.d.nt,
PART
[!]
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNYS
LINE 1, O.t. E.t.bll.h.d 1
2. Account B.l.no. 2
3, P.rc.nt T...bl. 3 K
4. A.ount Subj.ct to r.. 4
5. D.bt. .nd D.duotlon. 5
6. A.ount T.Nabl. 6
7. To. Rot. 7 K
S, To. Duo S
I""
-
DEBTS
PAYEE
DESCRIPTION
AMOUNT PAID
~
I
TOTAL IEnt.r on Lln. 5 of T., Co.put.tlonl
J
.
--
-
Und.r p.n.ltl.. of
ooopl.t. to tho b..t of
(:{~ 'IJ.,' """4
TAXPAYER S'I tto E
p.rjur~, I d.cl.r. th.t tho
.y knoNl.dge .nd b.ll.f.
^ ,)
if) II .,i~J(i _
hoh I
hlv. rlport.d aboy. ar. truI,
~OMJ (7/ 1) ') t, ,J)
WOR~ ( 1
TELEPHONE NUMBER
corrlct and
(I.~ 1 'I '
t!;E)/i/f
"
GENERAL INFORMATION
1, FAILURE TO RESPONO WILL RESULT IN AN OFFICIAL TAM ASSESSHENT with ..plIo.bl. Inlar..1 booed on Inlor..llon
.alttM bv thl flnanolll InfftJtutJon, '
2. Inhtrltanol tlK btooatt delInquent nine lonthl .ft,r the dleldtnt" d,ty 0' d,.th,
S. A Jol'1' "count II tlMlbl, .,,," though the dletct."t'. nH. WliI Idded .. I ..tt.r of ClORYlnllnel.
4. Aooount. (Including tho,. held betwa.n hu~band and wl'e) which the dleld.nt put In Joint nal" within on. v..r prIor to
death .r. fullv t'lC~l. II tran'f.r..
S. Account. ..tlbl1,hed jolntlv batw..n husband and ~If. lor. thin on. v..r prior to d..th .r. not tIMabl,.
6. Account. held by . dletel,nt "In trutt 'or" anothlr or athll" era t'leabl, fullv.
REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE
1. BLOCK A . If thl I"'or.,tlon Ind co.,ut.tlon In thl notlcl .r. corrlot Ind deduotlon. .r. not baing cl,lltd, pllOI In "M"
In block "A" 0' P,rt 1 0' the "TaMply.r Auponl." lIotton. SIQl'l two copl.1 and loo.lt thlt wltl1 your chick for the nount of
t.M to thl Attllt.r of Willi of th. county lndlc.t.d. Th. c.p.rt..nt of A.v.nu. will IIIU. .n off1ol.l ......Mlnt
(Fort REV-1541 EM) upon r.o.lpt of the Aeturn frol the R.glltlr 01 W1lll,
t, ILOCII. I - If Ut' ....t IPlclfltd on thh notlo. h.. bltn or w111 bt r.portld end taM p.ld with thl PIM,Ylvanl1 InhtrltlnCl.
TIM Rlturn filed by the dee.dent', rtpr..entltlv., pl.ct an "X" In block "I" of Part 1 of thl "T.MpeYlr R..pon.l" ..otlon. Sign ani
cOPy end r.tlJrn to thl PA D.p.rtttnt of R.v.nUl, lureau of Individual TaMil, Dlpt 210601, Hlrrhburg, PA 17121-0601 In thl
tnv.lop. provided.
J. ILOCK t - If thl notlc. Inf~rl'tlon I. Incorr.ct and/or d.ductlon. ar. being Olll..d, chick block "e" end eo.,l.t. P.rt. Z end 3
Iccordlng to the In.truotlonl b.low. Sign two copl.. and lubelt thlt with your Ch'CK for the ..ount of tl)( p,yabl. to thti A.ghttr
of Willi of the county Indlc.tMd. Th. PA D.p!rt..nt of R.vlnu. ulll I'IVI an offlo1.1 a.......nt (rora REV-1541 EM) upon r.c,lpt
of thl r.turn frOll thl RqJtt.r of Nl1l1.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
I. Ent.r tht d.t. the account originallY wal 'Itabll'h.d or titled In the .Inntr 'Mlltlng It date of de.th.
HOTEl For I d.c.dent dvlng aftlr 12/12/0%1 Account. which the dae.d.nt put I~ Joint na"1 within on. (I) Ylar of dl.th .r.
tlMlblt fullv '1 tr.n.f.rl, How.vlr, thlrl II an IMclullon not to IMc..d .3,000 plr tranlf.rll r.g.rdll" of thl vllut of
thl ICCount or thl nu.b.r of account I held,
If . doubll IIt'rhk (11'0 appear I blforl your fll-It nu. In the addre.. portion of thl. notlc., the U,OOO 'M~lutlon
Ilr.ldy h.1 b.en d.ducted fro. th. .cccunt balanc. al r.port,d by the flnlnolal Inltltutlon.
Z. Ent.r thl tot.1 blllnc. of the aocount Inoludlng Int.r..t tecru~d to the date of d.ath,
!. Tht p.rcMlt of the Kcoutlt that II tt)lablt for Itch .urvtvor It dat.r.lnld .. folloWl1
^. The plrclHlt taxahl. for Joint a...tl IItabUlh.d .or. thlln one y.ar prior to the d.c.d.nt'. duthl
I DIVIDED IV TOTAL HUIlIER OF DIVIDED IV
JOINT OWNERS
EM.-pll' A joint all.t r.gllt.r.d in the na.e of
TOTAL HUNIER OF M 100 . PERCENT TAMABlE
SURVIVIHO JOINT OWNERS
the d.c.dlnt end two othlr plrlonl.
1 DIVIDED Ii 5 (JOINT OWNERS) DIVIDED Ii 2 (SURVIVORS) . ,167 M 100 . 16.7M (TAMAILE FOR EACH SURVIVOR)
I. Thl plrcent tlxlbl. for a.lltl cr..t.d within on. y.ar of the dlcld.nt'l dlath or ae~ountl ownld by the d,cld.nt but h.ld
In trutt for InOth4r tndlvldual(l) (tru.t b,n.flellrl")l
1 DIVIDED Ii TOTAL NUHIER OF ~URVIVIHO JOINT
DH*ERS DR TRUST IENEFICIARIES
M 100 . PERCENT TAMAILE
E)(aapl.l Jotnt account r.gt.tlr.d In thl nl.. of th. d.cadlnt and two uth.r p.rlonl end .Itlbltlh.d within ant y.ar of d.ath bv
the dac.d.nt.
I DIYIDED IY Z (SURYIVORS) . .SO K 100 . SOX (TAXAaLE FOR EACH SURVIVOR)
4. Th. .-ount lubject to tlM (1In. 4) II d.tlr.lnld by ,ultlplylng tho account balanc. Cllno 2) by the p.rc.nt t.xabl. (1lna !).
5. Enter thl totlt of the d.btl and d.duction. IlItld In PlIrt !.
6. Tilt! lhu"'lt tlx,l,I. (1111" (.) It J'\.Il,d/lll,J by .Ubtlco..t.I.." tI',,- d.~h o"d J."":ltlClIl' <lln. !D r..... tll. lI'OUi)t )ubJ...t III t.1C (II"" 4).
7. Ent.r thl IPproprllt. tl)( rtt. <1lnt 7) II dlt.r.lrI.d boloN.
A. Tranlflr. to Ilnt.l dalc.ndant. Inoludlng f,thlr, .other, hUlbftnd, wif., Ion, daught.r, grandchlldr.n, Ion-tn-IaN,
dlUQhter-ln-law, Itepehlld and th.lr I..u. art taxebl. at liM p.ro.nt (6X),
I. Trln.flr. to III oth.r. Inoludlng brothlr, Iltt.r, uncll, aunt, n.phl" and nleo. art tlMabla at flft..n p.rot"t USlO.
C. If you ching. the tex rat., pl.... .p.olfy your r.latlonlhlp to thl d.c.d,nt In the erla provld.d.
I, The alount of t.x dut (lln. I) I. d.t.r.ln.d by lultlpl~lng thl alount teMable (line 6) by the tlX rlt. (1In. 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowlbl. d.bt. .nd d.ductlon. .ra d.t.r.ln.d el folloWl1
A. You 11,lily Ira r.lpon.ibl1 for pfty..nt, or the 'Itat. lubJICt to ad.inlltretlon by a p.rlon,1 rlpr'l.ntatlv. I. in,ufflollnt
to PlY the d.duotibl. tt....
.. You lotuallv plid the d.bt. alt.r d.ath of the d.old.nt end cln furnllh proof of paYllnt,
C. Debt. b.h,g oltllld .Ult b. It..lnd full'l In Part 3. If addltiontl 'PIC. .. n.ed.d, Uti pl,ln pe,..r 1 1/2" M 11". Proof of
plytont ..y bt r.que.t.d by the PA D'Plrta.nt of R.v.nu..
. . .. . TAXPAVER ASSISTANCE
IF VOU NEED FURTHER INFORMATION OR ASSISTANCE, CON'fACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAX PAVER INQUIRV UNIT IN
HARRIS8URG.AT (717) 787-8327, ..
.RIV-1843 IX AFP (1-911.
' ,'a_ILTH Of PEHNSYLVINII
Q[PIRTItENI Of REYEHUf
II.IlfIU Of INDIVIDUII UXES
Q[Pl, 110601
tlARRIB1URQ, PA 17120.0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 . 'Ill lit.? oz.,
ACN 94113673
DATI! 04-14-94
ESTATE OF RILEY
S,5, NO. 215-05-2759
DATE OF DEATH 01-16-94
COUNTY CUMBERLAND
TYPE OF ACCOUNT
L ~ SAVINGS
CHECKING
TRUST
CERTIFICATE
REHIT PAYHENT AND FDRHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
THOMAS
RILEY III MMTHOMAS L
1914 CARLISLE Rn
CAMP HILL PA 17011
DAUPHIN DEPOSIT BANK I h.. prolJldld the DIP.thlnt with thl infor"ltlon IlIttd below which h.. bl.n und In cll,ulatlng the
potlnt~.l tlM dut. 'h.lr rlcordl Indlcat. that at the d,.th of thl aboVI d.~.d.nt, VOU Wit. I joint ownlr/blneflclarY of thl, account.
If ,YOU f..l thll Infor..t1on II Incorrlct, pi.... obtain written correction frol the flnanolal Inltltutlon. attach a copy to thit for.
IInd r.turn It to the above .ddr..., 'nil account I, hub!_ In IIccoordancl with thl Inherltancl TIM LlIWI of the Co..on~lIlth of PannIY1Ylnl,.
auuUGn' .Il~ tI, 1\"'Wllr.tt hy nllllllM (17) 781-U27.
COMPLETE PART 1 BELOW. . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Aooount No, 4600057430 D.h 01-21-93
E.hblh~.d
Aooount 8.lono. 85 . 10
P.ro.nt T~.oblo X 50 , 000
Aoount Subjoot to To. 42,55
T.. R.h X ,06
Polontlol To. Duo 2 , 55
~ART TAXPAYER RESPONSe-
COI FAILURI TO RISPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT BASID ON THIS NOTICI I
I.
To Inlur. prop.r cr.dlt to your account, two
(l) cop I., of thl. notJc. .Ult fccotpany your
ply..nt to the Righter of Willi. Hak, ch.c.k
pallable tOI "Righter of Willi, Aglrlt".
HOTEl If tOM pay..nt. arl .~dl within thr'l
(5) lonth, of thl Uleldlntll dati of dlath,
YOU ..y deduot ft S% dllcount of the taM dUI.
Any Inheritance taM dUI will blcae. dlllnqulnt
nine (9) lIonthl aft,r th. dati of death.
[CHECK ]
ONE
BLOCK
ONLY
o The abovl infer.aUon and taM dUI 11 correot.
I. You lilY choell to ,..It pay..nt ~o the Rlol,ter of Will., with two l.opl.1 of thl, notice to obbln
a dl.count or ~vold Inter'lt, or yoU .ay ch.ck box "A" and r.turn thl. not Icy to thl W.gI.t.r of
Will. and an official ........nt ~ll1 be I.,uld by the PA Clpart..nt of RIVlnu..
B. 0 The abolll a...t hu bltn or will b, "ported and taM paid with the Plnn'Ylvanla Inhlrlhnce Tax rtturn
to bl fllld by thl dlc,dlntl. rlpre'lntatlv..
C. 0 The abovI Infer.tltlan I~ncorrtct and/or debt. and dlductlon. were (laid by you.
You IIU.t COllphh PART L!.J and/or PART 0 b.low.
P~2~RT If ~ou Indlo.to . dlff.r.nt t.. r.to, pl.... .t.to ~our
~ r.l.tlon.~lp to doood.nt,
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE I. D.t. E.hblh~.d I
2. Account aalance 2
3. P.ro.nt To..bl. 3 X
4. Anount SUbjoot to To. 4
5. D.bt. ond Doduotlon. 5
6. Anount To..blo 6____
7. T.. R.t. 7 X
8. To. Duo 8
~nCIAL ..USE ONI.'" fJ AAF
PA bEPARTHeNT OF;R~VENUE
PART
~
DATE
PAD
1
2
3
4
5
6
1
8
DEBTS AND DEDUCTIONS CLAIMED
.
".1.
" ,.,
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
~--
r--
TOTAL IEnt.r on Llno 5 01 T.. Cooputotlon)
=i-
.
-
--.
IInd.r p.n.IU.. of p.rjur~, I d.oloro t~.t tho
ooopl.t. to t~. b..t of o~ knowlodg. Ind b.ll.f.
~)&~ ~!1' p, f\Ju'i'1
TAXPAYER I A
facio I
hive rlported above are truI,
HOME ( / / ) ) ) L, I
WORK ( )
TELEPHONE NUMBER
carr.at and
,/}jtd'
DATE
,
GENERAl INFORMATION
1, 'AILURE TO RESPOlID WILL RESULT IN AN OFFICIAL TAM A8SESSH~NT with ...lIoobl. Intor..1 !oo.td on Inlor..lIon
.ubOltttd b. th. 11""",1.1 In.Utullon.
Z. InheritlnGl tlM beeGle' delln~nt nine .onthl .ft,r thl dlc.dent" da'l o. d.,th.
S. A joint IQcount I, 'I.lblt Iven though the dlcldent'. n... WI' add.d m. I ..tt.r of oonvenlenol.
4, Aooount. t1noludl.. tno.. hold b.lw.'" "".bond ond wlf.l whloh th. .......,t pul In Jolnl n.... within onI .m prior to
dllth .r. fullY UMlbl1 II tr..",.r..
5. Acoount. ..ttbll.hed Jolntlv between hu.blnd ~ wlf' lOr. then ani y..r prior to death .r. not 'Iweble,
.. Acoount. held by . declRent "In trult for" another or other' .r. ',ltlbla fully,
REPORTING INSTRUCTIONS - PART 1 . TAXPAVER RESPONSE
I, ILOCK A _ II tho Inlor..tlon end o~l.tlon In tho notlo. .r. corr.ol ..,d do...llon. .r. nol bel.. ol.lood, pi... on "K"
In blook "A" 01 Port I of tho "TlXp...r R..Pon.." 110 lion. Sign Iwo oopl.. ond .ub.1t I... with ..ur chock I.r tno """",t .1
'IX to thl Atllttar of WU11 of thl county Indlcet-d. The OIPArt'tn' of RlvlN'I'.Hl .,Ul 111\11 an offlohl all.IIMn\
e'or. REV-1S41 EX) upbn rectlpt of thl Rltu!'n 'rot thl Rtghter of W111..
2, ILOCK I . If lho ....t ....I/I.d on Ihl. noUo. h.. b..n or will be ,"porlld .nd I.x p.l. with tho p..,n..lyonl. Innorltono.
T.x R.lurn 111.d b. lhO ..o.dont'. r.pr...nl.lly., pl.c, .n "K" In blook "I" of ..rl I of lho "T.xp.,.r R..Pon.." ..0,lon. Sign on.
cop, ond r.lurn 10 lhO PA D.p.r'Wlnl 01 R.y.nUl, lur." 01 Indlyldu.1 T.x.., DIPI 110601, H.rrl.buro, PA 17121-0601 In Ih.
.nv.lope provided.
S. ILOCK C _ If Ih. nollo, Inlor..tlon I. Incorr.ol Ind/or d.duollon. .r. b.lng ol.I..d, chook block "C" .od ooopl.l. P.rt. 2 sod S
.eoordlno I. Ih. In.lructlon. b.low. Sign Iwo cop I.. .nrl .ub.11 I".' wllh ,our ,".ck for lho ...unl of I.x ....b1. 10 Ih. R.ol.t.r
ot Will' o. lho ,,)untV lodlOllld, Th. PA lloP.rl..nl 01 Royonuo will I"u, .n offlol.l ........'1 (Foro REY-IS41 EMl upon roc.lpt
of the r.turn frOl thl R,.lst,r of WII1R.
TAX RETURN - PART 2 - TAX COMPUTATION
LllIE
1. Entlr tM date thl lecOUI'lt orlulnallY "'" ..t..,l1chtd or titled In thl ..nner I_hUng It date of d,.th,
HnT~l for I dlc,dent dying after 12/12/821 Account. which thl UtOldlnt put In joint 1'1.... within nnt (1) YI.r of d..th .r.
t.xobl. lull. .. Ir.n.l.r.. HOWlv.r, lhor. I. .n .xolu.lon nol 10 .xe... tS,OOO p.r Ir.n.l.r.. r.g.rdl... 01 tho y.1vo 01
the ICCount or thl n...lr of ICCOunt. htld.
tf . double .,t.rlsk (MM) .ppI.r. hi for. your flr.t 1'1'" In thl addr..' portion of thl. notlcl, thl 'S,OOO IltCIUllon
.1r,ldv hi. b.en deduoted frol the .aeount bltlnot II reported by thl fln.nol,1 Inltltutlun.
2. Ent,r thl tot.l balancl of thl eccoun~ lnaludlnt tntsr..t loorued to thl date of de,th.
S. TM plrclnt of thl acoount that 11 tlMlble for IIch .urvivor II d.t.r.lned II folloWII
A. The percent tlltlbl. for joint ....t. IItlblhhld lor. than ani V'lr prior to the d.<l.dtnt'. d.lthl
(
I DIYIDED IY TOTAl NUIIIER Of
JOINT OWNERS
f~..,lll A Joint ....t r.al.tlr.d
I DIYIDED IV S (JOINT llllIlERSl DIYlDED IV 2 (SUflYIYDRSl ".167 K 100 . 16. n: (TAKAILE FOR EACfI SUflYIYDR)
D[YlDED IV TOTAL NlIHIf.R Of K 100 . PERCENT TAMAILE
SURYIYING JO[NT OWNERS
In thl n... 0' the d.udtnt end two other ;J.rlonl.
I. Tho p.rc.nt I.x.bl. lor ....1. o,..I.d wllhln ono ,..r of Ih. d...d.nl'. ...Ih or .ooounl' .wnod b, lho d.o.d.nl but hold
In tru.t for lnothlr Ind!vlduIU.l (tru.t blMflollrlU)1
I DIYIDED IV TOTAL NUIIBER OF SURYIYINO JOINT
DWMERS DR TR~ST IENEFICIAR[ES
K 100 " PERCENT TAKAILE
Ex...1., Jolnl .cc.unt r.ol'l.r.d In Ih. ,... 01 Ih. d.e.d.nl ond Iw. oth.r p.r.on. .od .,lobl1.".d within ono ...r of ...Ih b.
thl dlCldlnt.
I DIYlDED IV 2 (SURYIYDRS) . .50 K 100 . SOX (TAKABlE FOR EACH SURYI'OR)
I
4. lno """",t .ubloot to IIX (IIn. 4) I. d.hr.ln.d b. .ultlpl,lno Ih. 1000unl ..1..,01 (lIn. 21 b. lho .."..,1 I...bl. (IIno S).
6. Entlr the tot.l of thl d.bt. and d.ctuotion. lhtad In Put S.
A, Tho _,... ........ Ill.. 61 10 .".."Inod b. .ubtraotlr.g Ih. ..... ,nd J,.uDUen, (II". S; f,u. Ih. "vUfl' ....J.ol 10 lOX (lIno 41.
1. Entlr thl approprlltl t.x rlt. ClIM 1l II d.tlr.ln.d b.low.
A. Tran.fer. to Un'll duclndantl Inolualng tether, IIOthlr, hulband, WUI, Ion, daughtlr, grendchlldr.n, .on~ln~l.w,
dlUlhtlr-ln~I"', .t.pchlld .nd thtlr inut er' hobi. at ,he p.rc..nt (6Xl.
a. Tren.fwr. to ,11 other. Including brothlr, tlltlr, unch, aunt, nlph.W and nl.c, art tlMlbll at fUttln p-trc.nt US:U,
C. If you ohlilOP thl t,l( rlt., pl.... IP'OUV your r.lation,hlp to the dlCldlnt In tht ar.. provldad.
I. The MOUnt of tilt due (11nt Il II d.ttrllned bv IIUltiplvlng thl ataunt 'I)clbll Clint 'l by the '1M ratl (l1n, fl.
ClAIMED DEDUCTIONS - PART 3
DEBTS ANn DEDUCTIONS CLAIMED
Allowabll dlbt. Ind d.duotlonl er. ~ltlr.ln8d II folloW' I
A. You l.g.11. .r. r.,pon.lbl. for p....nl, or Ih. ..1.1. .ubl.ol 10 ,dolnl.tr.llon b. . ..r.on.1 r.pr..ontatIY' I. In.ulllol..,t
to plY thl d.duCtlble U....
I. You ectuIIlv plld thl dlbt. .ftlr d,.th of the dlc.d.nt and c.n furnl6h proof af ply,.nt.
C. Dobl. b.lno ol.I..d .u.t b. It..I,.d full. In P.rl S, II .ddll10n.1 .p.c. I. n.."d, u.a .1.ln pop.r I 1/2" x II". Prool 01
pIV'lnt .tV b, rlqueltld by thl PA Departalnt of Rlvlnut.
TAXPAVER ASSISTANCE
IF yOU NEED FURTHER INFORMATION OR ASSISTANCE, CONT~CT ~NV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFltXCt: ..
ClR CALL THE )UREAUHf:Rl:fJ~JDftL(N7X)ES"'81"AJ<ft7Y,ER INQUIRY UNIT .l~i:w
lREY-l,543 EX AFP 0-911,*
I COI1~H.EAi HI Of IlENHSVlVAHIA
OEPARTHEHT Of REVENUE
BUREAU OF IHDIVIDUAl TAKES
DEPT. 280601
HARRlsaUHQ, PA 111Z8R0601
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
FILE NO. 21 . :> 'I' 'r',' <'-,
ACN 94113672
OAT! 04-14-94
ESTATE OF RILEV
S.S. NO. 215-05-2739
DATE OF DEATH 01-16-94
COUNTY CUMBERLAND
TVPE OF ACCOUNT
L ~ SAVINllS
CHECKING
TRUST
CERTIFICATE
REHIT PAYHEHT AHD FDRHS Ta,
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
THOMAS
RILEV MMCATHERI D
1914 CARLISLE RD
CAMP HILL PA 17011
DAUPHIN DEPOSIT BANK' hll provided the Dlpart.,nt with thl Inforllt1un lilted bulow which hu bltn ulld In calculating the
pot,nUal '11: dUI. Their record I Indloatl that at thl death of tht .be.... dlcld.nt. YOU wlr. II joint own,r/blndichry 0' thll account.
If you '..1 thil Inforntlon It Incorrlot, pllut obtain wrltttn corr.otlon frol tht flnanolal Institution, ftttach I ()OPV to thlt forf'l
and r.turn It to the "boy. Ilddr.... fhll account I. tuabh In accordancl with the Inh.r1tanc, TIlM llwe of thl Co..onwulth of Plnntylvanh,
OUlttlon~ 'IY b, InlW'tAd by cIlllng (717) 'a7~a5l7.
COMPLETE PART 1 BELOW w w w SEE REYERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Aooounl Ho. 4600057430 Doto 01-21-93
Estoblhhod
Aocount 8111no.
P.re.nt Taxabl.
A~ounl Subjoct 10
To. Rllo
Pollnllol To. Duo
85.10
50,000
42,55
,06
2,55
TAXPAVER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT BASID ON THIS HOTICI
)(
To Inlurl prep,r cr.dit to your Iccount, two
III copl.. of thll not Ie. .Ult Icco,plny your
pay.ent to thl R'Qhter of Willi. H.k. r.htck
PIYllbh tOI "R,gllhr of Willi, Ag,nt".
x
HOTEl If tllM pIy..ntl III" ludl within thrl'
(3) Months of the dlc.d.nt'l date of d..th,
you IllY dlduet a S~ dllccunt of the taM dUI.
AllY Inhtrlhncl taM dUI will beeo.. dlllnqulnt
nlnl (9) Month, aftlr thl d.t, of dl,th.
To.
PART
IT]
[CHECK J
ONE
BLOCK
ON LV
A. hi abov, lnforMatlon nnd tax due ie corrlet.
1. Vou laY chao.. to rlllt Ply..nt to the R"ght,r 0' Willi, with two topl.. of thle not leI to obtain
a dllcount or avolu Intlreet, or YOU .ay check box "A" and return thle notlct to the R,gl,tlr of
Wille and an official IIlsl'I~lnt will be Illuld by the PA ~IPlltt'lnt of RlVlnue.
B. [] Thl above ""It hi' bltn or will be roportld IInd tlx paid with the Ponnlylvanlll Inhlrltance Tllx rtturn
to bt fllld by the dlcldent', rlprl'lntatlvo.
C. 0 Tht IIboVI Infor..tlon II Intorrlet flnd/or debt, flnd dlduetlon. Wlrt paid by you.
Vou IUlt r.o.pltto PART [!] flnd/or PART ~ bllow.
If you indic.te I different tax r.t., pl.... .t.te ~our
rolollonshlp 10 docodonl,_
o IALU'SE ONLY, 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE I. Dolo Estobllshod I
2. Aooount a.llnel 2
~. Poroonl To,"blo 3 X
4, A~ounl Subjlol 10 To. 4
5, Dobis ond Dlduollons 5
6. A~ount rlxabl. 6
7. To. Roto 7 X
8, Tlx DUI 8
PAD
1
2
3
4
1'.-
5 ..
-.;,
PART
~
DATE
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
-
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
-1-
TOTAL IEntor on Llno 5 of Ts. Co~pulollonl
I
-j
.
-
Undor ponolll11 of porjury, I doollro Ihol Iho
oo~plllo 10 Iho bill of ~y kno.lodgl snd bollof.
I "I IJ) ')"
lI-J(: f' IUH'.( !t.f.lil'i
TAXPAVER SIGNATURE I
flat. I hive r.port.d Iboy. Are tru., corr.ot Ind
Wo~f-+.lL~ ) l, ;; --L'-.i. f ~~/If"i'
TELEPHONE NUMBER
GENERAL INFORMATION
1, FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAM ASSESSHENT with .ppll"bl. Int"... b.nd on In/or..Uon
.ubIIltttd bv thll '1"lnol,1 In.tltutton.
Z. Inhlrltencl hlC bleol.. dellnqutnt nln. lonth. a'hr thl dle.dlnt', (jlt. /,J' d..'h,
S. A joint Iccount I. 'IKabl, IV'" though thl dle.d.nt', na.. WI' lidded I' . ..tt.r of conv.nllne..
4. Accounh (Including thuII held bit".." hu.btnd and wlft) which thQ dlll,d."t ~ut In Joint n.... within on. vltlr prior to
d.,th Ir. fulh taMabl, II tr.n.llr.,
5. Accountu utlblhhtd Jolntlv b.tw..n hu.band IInd wUt lor. thl" on. yllr prior to dlllh Ir. not tillable.
6. Account. hlld by . dlelMot "In tru.t for" anothtr or oth,r. 1ft \lll,bl, full,;,.
REPORTING INSTRUCTIONS - PART 1
- TAXPAYER RESPONSE
1. BLOCK A . If thl Infor.,tlon Ind c~uh'lon In Ih, notlcll ar. corrlot .nd d.duotlon. ar. not bllng elllud, pl1tC11 ." ")("
In blook "A" of Pert I ot th, "ToMp'YIr R..ponll" uoUon, Sign two copl.. and .ubllt tha_ with your ch.ck for the HOunt of
till to thl Rlghhr of Will. of thl county Jndlnhd. Thl DIPlIrt.,nt of R,vlilnu. wilt IlIu. an offlclll ........nt
(for. REV~IS4. EX) upon r.c.lpt of th. R.turn frol the R.gl.t.r of Will"
I, BLOCK B " If the ....t .p.olfl.d on thJ. not Ie' h., b..n or will b, r.port.d and t"K paid with the JI,nn.ylvanl. Inh.rltlnC'
Tall htur" fll.d bV the d.c.<1.nt'l r.pr.unt,Uv'l plae. an "It" In blcck "a" of Plrt I of the "lIKpaY'i" RIIPcnu" 110 tI on , Sign on.
copy Ifld r.turn to the PA n.parh,.nt of R.v.nu., lurlllu of Indlvldu.l Tallu, OIlPt 2110601, ~h.rrltburq, PA l112a~060l In thl
.nv.loPl provld.d.
S. BLOCK C - If the notle. Infor..tlon It Incorr.ct and/or d.ductlon. are b.lng Clhil..d. ch.ck block "e" .nd oo.pl.t. Parts 2 and S
.ocordl"" to the In.\I'uotloOl b.low, Sign two coplu IInd .ublllt thl' with your chick for the lI.ount of till paY'bl. to the R.ghter
of Willi of the county In:Ue.hd. Th. PA DIPlrtllnt of R.vlrlu, will luu. an offlelll ul.....nt (FOri Rf.V-IS46 EX) upon reefllpt
of thl return frol the R.gllhr of Willi,
TAX RETURN' PART 2 . TAX COMPUTATION
llNlO
1. Enter the detl the Icoount orlglnalh WaI utablhhld or tltl.rt In the unn.r nlttlng at deh 0' death.
NOlEI For a d.c.d.nt dYing afhr IUIZ/aZI Account. which the d,c.d.nt put In joint nu.. within on. (1) Y.lr of dllth 1ft
tu.bll fully at tran.f.rl. How,vlr, thlr' It an 'Molu.lcn not to .MOOld u,aoo per trlln.fer.. r.glrdl... of the valu. of
the loecunt or the nutb.r of account. h.ld.
If a doubl. ..t.rlsk (lull apPurI b.fo" your fl"t nau In the Iddr... portion of thh notle" the 'S,OOO IMolu.lon
,Irudy ha. b.ln d.duet.d fro. the .llccount balance II report.d by the Un.nd.l Inttltutlon.
2, Enter the totll balenc. of the account Inoludlng Intullt accru.d to the da" c' death,
], Th. r"lrclnt of thl acccunt that It taxabl. for lIeh sur...lvtlr 11 d.terllnld II follow'l
A. Thl p.rc.nt taubl. for joint a...tl IIhbll.h.d lore than on. Yllr prior to the dle.dint't duthl
I DIVIDED BV TOTAL NlRIlIER OF
JOINT OWNERS
Ex_pl.l A joint lI"t reghtlred
DIVIDED BY TOTAL NUMBER OF II. 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the n~.. of the d.~.dlnt and two other p.r.on..
I DIVIDED BV ] (JOIHT OWNERS) DIVIDEO BY Z (SURVIVORS) . .161 X 100 . 16.7% (TAXAlllE fOR EACH SUHYIVDR)
I. The p.rc.nt t.x.bll for a...t. cr.atld within on. y,.f of the d.o.d.nt'. d..th or Iccount. own.d by the dlc.dlnt but h.ld
In tru.t for anoth.~ Indlvldual(.) (trult b.n.flolarl..),
1 DIVIDED BV TOTAL NUHBER OF SURVIVINO JOTHT l( 100 . PERCENT TAXAIllE
OWNERS OR TRUST BENEfiCIARIES
EMIIPI.l Joint account r'allt.r.d In the nB" of the d.o.d.nt and two other p.rson. end .,tablllh.d wlthJn on. Y.lr of d.lth bv
tha d.c.dlnt.
1 DIVIDED BY 2 (SURVIVORS) . .50 X IO~ . 50% OAXAIllE fOR EACtt SURYIVOR)
It. The uount lubjtct to till IIln. It} h d.hr.ln.d b~ llIultlphln; thl account balanc. IIln. Z) by the p.rc.nt hubl. (IIn. ]).
5. Entor the totll of the d.bh and dlductlon. lI.hd In Part ].
6, Tho ::alloud toxnbh (11;'\:1 61 1D d::atorrllnou bi ~..I:.trtl:tlr,g th~ dobh :\nd lltd"ctlo,'u lllr.:, !:.l r,'I.!. tlu. d...i\l'I~ ."'L;....t ~... lIu. nl'l. ..l,
7. Enter the .pproprllt. tl)( ret. (11111 1) .. d.hnln.d b.low.
A, Trln.fl" to IInlll duc.ndent. Inoludlng fether, lIother. hu.band, WUI. Ion. dlughttr, grendchlldr,n, 10n"ln-Iaw.
dltUghtlr-ln~1aw. .tlpehl1d and th.lr IIIUI art hublo at .Ile perelnt (6%).
I. Trlnlf"l to al! other. Inoludlng brother, .h"r, uncl., aunt. n.ph.w Ind nhc. are t.lllbl. at flftun perc.nt OS:O.
C, If you ching. the taM rate. plllll IP.cHy your relatlon'hlp to thl d.c.d.nt In thl area pro...lci.d,
a. lhl Haunt of tlM due (lIn. a) h d.terIl1n.d by .ultlplY1ng the lIount taMabl. Oln. 6l by the tll( rat. IlIn. 7),
CLAIMED DEDUCTIONS' PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allo.'lbl. d.bt, Ind d.duotlon. ar. d.t."ln.d II followll
A. You l.gallY are rupon,lbll for pay..nt, or the utah .ubj.et to ad.lnhtratlon by a p.rlonal rtpru.ntetlv. h In.uffJol.nt
to PlY the d.ductlbl. It....
I, You aCltullh plld thl d.bts after duth of the d,c.d.nt and can furnllh proof of pay..nt,
\:, O.bt. b.lng olal.ld .u.t b. 1t'lIlud fully In Part 3. If additIonal Ipac. I, .....d.d, UII plain paper a 112" M 11", Proof of
pay..nt IIY b. r.qu..t.d by the PA D.part.lnt of R.....nu.,
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORHATION OR ASSISTANCE. CONTACT ANY
REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU O~ INDIVIDUAL TAXES, TAXPAVER INQUIRY UNIT IN
HARRISBURG AT (117' 787-8327.
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To fulfill lho ,,,,,,1,_" of IeGUon ZI40 of lho 1"""'"..... oncI EI"I. T.. AoI, AoI ZZ of 1"1. 17Z P,I,
100Uon 214DI,
PAYIEHT,
Dolooh lho I" po,Ilon of thll Noll.. ond loboll with ,ou, p.yoonl I. tho Regl.I., ., Will. p,lnled on tho
ray,r.. tide.
.... MIke ohM'" or 1tOf'MI'I orOlr Plvllbll tal RflnSTEA Of' WILLI, AOEHT.
All PIYltMtI rlGllvld .twlll flr.t be liPPl1ld to 1(1'1 Int.rllt which NY bt eMI, with "'1 r...lnder eppl1td to thl tex,
RfI'I.IIII (CRI'
A nfund of . tllC aredU, which Nil not requested on the tli)( return, "'1 be reqwltld bv capllUng an "AppllolUon
for Refund of PlnnlvlvlWlll Inheritance IWW Est.t. Tile" (REy.nUl, Appl1cIUon. Ir. IVIUlbll It the OffiCI of
ttMI Regilt.r of Ml1h, Inyof the 2S R,vtnUt Oiltrlot OffiCII or by cll11ng the ,peele. 24-huur en,werlne ..rvlel
~r' for fcr'l ardlrlntl In Pennl.,lvlnl, 1"800-562-2050, out.lde Ptnnlvlvlnll ~ within 10011
Herrltbur. .r.. (111) 111-8094, TDDI (717) nt-USZ mllrlng llIpllred Only),
OI~cnDHSI Any Plrh' In Int.r..t not IIthfted with the ..prlh,.."t, .Uowtnel or dlt,UOifInCI of dttduoUonl or .........,t
of tlX (lnol~lnl dhcooot or Int.r..t) It .hown on thlt NoUe. "Y object within .hcty (gO) d'YI of rlCl.lpt of
thl. NoUo. bYl
nHrlUen protut to the P^ OepertHnt of AlYenue, Belrd of Appe.h, Dlpt. 281021, Harrhburg, PA 17121"1021, OR
n.leotlng to hlv. the ..ttlr ct.t.r.Jned It the audit of the lCle~t ef the per.ON! r.pn..ntIUv" OR
""."..1 to the OrpMn" Court
AllIUM-
IITRATlVE
CIlIlRECTlIlKS,
FIClMI .rror. dl'eov.red on thll "....lMnt .hould a addr.uect In writing tOI PA DIp.rt""t of AIVInUI,
BurtlY of Individual rlnl, ATTNl po.t A.......nt A.vl... Unit, DEPT, 1I0601, Hlrrhburll, PA 17121..0601
PhonI (717) 117-6505. SM PIge 5 of the book!.t "In.truotlon' fer Inhtrltenc. TalC Alturn fer I Allldent
OIGldtflt" (REV.IS0l) for an 'Mpl~.tlon of .a.lnl.tr.tlv.lw corrlCltabl. .rror..
IlIlCIlUKT,
If MY taM dull h Plld within thr.. (5) c.lcnd1r IIonthl Ifter thl dtcNent'. d..th, I fly. p.rc."t (SIC)
ditCCKmt of thl tlJe p.ld II IUDWd.
INTEREST.
Inttrllt it chtreed beglnnlne with flr.t dtly of delinquency, or nIne (9) IIOflthl nt one (1) dlY
'rOIl thl dlte of de.th, to the datD of PIYHf1t. T.MII Which bee... cttllnquent befar. JQf'lUllrY 1, 1912
bear Int.r..t .t thl r.t. of II. (6X) p.rcent per tnnUI c.lcullt&d .t I d.lly r.t. of .000164.
All tlX" which .MI dtllnquent on or .ftlr JlnUlry 1, 1912 w111 bI.r Interllt at a r.t. which wll1 Vtry frOll
ultndtr Yllr to a.lend" Yllr with thlt fit. BMOW'lOtd by thl PA DtptrtHnt of A.vfWlUQ. ThllIPPllotbl.
Interllt retll for 1912 through 1994 "'1
'till: Inttr..t A.t. DIllv Int.r..t Fectar ~ Inter..t Attl DIllv Int.rllt Flctar
I9IZ m ,DDD541 1916 ID~ ,DDDZ74
I9IS lU ,DD0451 1917 .~ .DDDZ47
1.14 iii "DDSDI 19"-1991 tl~ ,DDDSD!
1.IS m .00D156 1992 91 ,DDDZ47
1995-1994 7~ ,DDDI.Z
'''Int.r..t 1. cllcul.tld .. followll
IHTERElT . BALANCE OF TAX UNPAID X NU~BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any NoUae lllved .ftlr ~hI tlM becOM' u.lInquent will r.fltot In Inttr..t c.lcuiatlon to flft.." (1S) diY,
beYond th_ d.tl of thl ..........t. If PIy""t it IIde aft" the Int"..t CMlfK.lt.Uon det. .ho"" on thl
Notlc., edclltlon.1 Inttrllt ...t be a.lcul.ttd,
,
_lW
HOTlCE.
Ta fulfill tho r..."lr_to al SMUan mo al tho Ir/ltrlt...o oncl Eoloto l.. Aat, Aat ZZ al 1"1. (71 P.'.
IeGUan 21401.
PAVItIIIT,
DltlCh the top portion of thl. NoUe. Iftd ,utMlit with your P'YMnt to thl Righter of NIlI. printed on the
rlVlr.. ..de.
.. Hek. check or IIOMV or.r p.ylblt tal ItEGIITER OF WILLS, AGENT.
All P'VIl"'" recllved 'hill flr.t bti lIppllld to InY Int.rllt which IIY be due, with eny ,...Inder epp1Jftd to the tp.
RmJNlI (CAli
Ai r.'WId 01 . tax oredlt, which WI' not rtqUl.t~ on ttM t.)C r.turn, HY b. requelted by co~l.t1ng en "AppUoIUon
lor R.fund of Penn,y!v.,I, InherltlnCl. end Ettlt. Tlx" (REy-nUl, AHIUc.t1onl art Iv,thbl. It the Offlc. of
tt. Aeght.r 0' NUll. InV of the 2S Rlvtnul Ohtrlot Offloll or by cIlIlng thl '1*11.1 Z4-hour IIII"I'Nlrl", IIrvle.
nuIbIn for for.. orderlngl In P...,svlvlWll. 1-1000562-2050, out.lde Penntytywtl. end within lOCI.
HlrrltbUr. Ir.. (717) 71'-80", TOO' (717' 712-2252 <HI.rlno IIP.lrld Only).
OIJECTJON$1 Anv p.rtv In Int.r..t not ..U,UId with the appr.h..."t, ,UOWInC. or dl..UOWInCI of deduotlon. or .....Rlnt
of t.)C (Including dheCM1t or Int.r..t) II lhown on ttlll Notlc. AV ClttJlOt .,Uhln .hcty (60) d.y. of rec.lpt of
thll Notlel bVl
".wrltten prot..t to the PA Dlplrtlllf1t of Rlvlnue, Baird of APfHlllI, Dlpt. 281021, Hlrrllbur., PA 171ZI.1021, OR
."Ilectlng to heY. thl "Ulr d.tlr.lned It thl audit of thl IKlcCM1t of the perlOMl r.prlnntlilvl, OR
"-1PPH1 to thl Orphen.' Court
AllIUM-
ISIRATIVE
CllIllll!CTlOHS.
FlCt~l .rror. dllcov'rMt on thll ........"t .hould be eddre..ect In "rltlng tOI PA o.plrtlllf1t of A.venue,
Surwu of JndlvldlIll Tu.., ATTNl POlt A......."t R.vl... lkllt, DEPT. 280601, Hurl.burg, PA 17121"0601
Phone (717) 717.6505. SN PIt4I ] of the boo6<l.t "Jnltructlonl for IMlrU~1 TIM R.turn for I AQlldent
Otctdent" (REV-150l) fnr II'l .)(pllnttlon 0' adIIlnlltr.tlv.tv correetlbt. .rrorl,
DISCOUNT .
If ."t11 tlJiC due !I ptld within thrH (]) cIIII'd.r eonthl aftlr the d'c:edent'. dI.th, I fiv. Plrc.nt u;()
dlloount of thl tlX paid I. II 10N1d ,
I HTtllEIT ,
Int.r..t II chlrgltd betlMlnt with flret dlY of delinquency, or nlf'll (,) ItOnU,. end OMI (1) dly
frOll the ut. of d.lth, to thl cUit. of P'YHnt. Tax.. whloh bee... d4illnquent blforl JInuIrv 1, 1912
bltr Inter..t .t the ret. 0' 11M C6'C) percent per ~ c.lcullttel It . d.lh ratt 0' .000164.
AU tax.. which beG.. delinquent on or ,ft" Jtnuuv 1, 19U .,Ul beer Interut It . ret. whloh wUI VlrV 'rOIl
Clllndllr Vllr to o.I""r vnr with thlt rete tnnOU:'\Ctd bv the PA Ot9lrtnnt 0' Rlvenue. The appllclbl.
Int.r..t r.t'l for 1912 through 1994 Ir.1
~ Int.r'lt Alh D.l1v Intlr..t F~tor :wr Int.r..t hte D.l1v Interut FlKltor
1911 lOX .OaOS4' 1916 m .000174
1915 IU .OOOU' 1987 9X .000147
1916 IIX ,aOOl01 1911.1991 11X .000101
1985 15X , aoOSS6 1991 9X .000147
1995-1994 7X .000191
"'Int.rllt 1. caloulated I' 'OUOtlII
INTEREST . IALANCE OF TAX UNPAIO X NUKIER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
"~Anv NotlCI II"*' Ifttr thl taM becotttl delinquent wUI r.fleet M Int.r..t c.lculltlon to flft"" (Hi) dlYI
bevond tM dltl 0' the .........,t. If PIV.."t III .~ Ifter thtl Inter..t COIlPUtlUon dlt. ,hown on the
Notlol, tddltlontl tntaralt .ust be calculated,
/
REVo1607 EX AFP (1091>.
COHHOHWEALTH OF PENNSYLYANIA
DEPAIlTI1[NT Of REVENUE
IUREAU OF INDIVIDUAL TAXES
DEPT. lIOGOl
HAIlRISIURO. PA 1111S-0601
ACN
94113673
G
INHERITANCE TAX
STATEMENT OF ACCOUNT
DATI
08-22-94
RILEY THOMAS L FILE NO. 21 94-0402
DATI OF DEATH 01-16-94 COUNTY CUM8ERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUB"IT THE UPPER PORTION UF THIS FOR" WITH YOUR TAM
PAY"ENT Tn THE ADDRESS SHOWN, "AME CHECM PAYABLE AND RE"IT PAY"ENT Tal ,
RILEY III THOMAS L
1914 CARLISLE RD
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount R..ltted
l
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR FILES ...
it iV: iiiiWii("Aj: p" iF9iJ" ....... it "iilitE"R'i i' A'Noi"' TAil" 'sT A i'-ii1iiiT 'Oi:"AC'i:OUNT" ili;."'.. au,... ....,."...
UTATI OF RILEV THOMAS L FiLE NO. 21 94-0402 ACN 94113673 DATE OB-22-94
THIS STATE"ENT IS PRaY IDEO TO AOYISE OF THE CURRENT STATUS OF TIlE STATED ACN IN THE NAMED
ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAM DUE, APPLICATION OF ALL PAY"ENTS,
l!ULCURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE,
2 r.]~'
I
I
2.55 I
I
1,
\,
, , f
' ,
I I
r',l I
I
,
,
I
2,55
,00
,00
,00
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 08-01-94
PRINCIPAL TAX DUEl
PAYMENTS (TAX CREDITS)1
PAYMENT
DATE
04-29-94
RECEIPT
NUM8ER
886021
DISCOUNT (+)
INTEREST (-)
.00
AMOUNT PAID
. IF PAID AFTER THIS DATE, SEE REYERSE
SIDE FOR CALCULATION OF ADDlTlONAL INTEREST,
( IF TOTAL DUE IS LESS THAN .1,
NO PAY"ENT IS REQUIRED.
IF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CRI,
YOU "AY BE DUE A REFUND. SEE REYLRSE SIDE OF THIS FOR" FOR 1NSTRUCTIDNS. I
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTlREST
TOTAL DUE
PIYtlENT.
REFl.IID (CA),
REPLY
TO,
DIICDUHT'
INTEREST,
DetlCh thl top portion of thh NoUce and tub.it with your Plv"nt .Ide Plvlbl, h the "HI and adelrt.. prlntad
on the r,v,r.. .Ide.
AU PIVont. r.calv.d ,hill Ur.' bt IPPUtd to InV lntar..t whlClh IIY btI duI with any rll.lnd,r eppl!.d to the till,
A r.fund 01 . till cr.dlt, tfhlch "'" not requa,tld on thl TIX R,turn, .IV b, r.queltld bv co.,l,Ung an
"Application 'llr Refund of Plnnulvanh Inherltancl and Eltate TIM" (RI::V~UU)' ApplicaUon. .r. l"IUabl, .t
thl O"lcI 0' the Rlgl,t,r 0' Willi, any 0' thl 24 Aevlnue Dlltrlot Offlc.., or bv cll11ng thl ,peolll 24.hour
Inl",.rln, ..rvl01 nu.btr. fer for.. orderlngl NEW IN ~ENNSYLVAHIA l-aOO.36Za2010, out.l~ Plnn'Vly,"l.
tnd within thl locII Hetrl.burg .r.. (717) 7.7.1094.
Qulltlonl r.g.rd!", .rror. contained on thl, notlcl thould b. .ddr"'ld tal PA O.pert..nt of Rev.nu., lur..u
of Indlvldull Tlx.., ATTNI Po.t A"'''..nt A...,II" Unit, DEPT. 210601, Hlrrhburg, PA 17UI-0601, phon.
(111) 181.65DS.
If env tax due I. peld within thr.. (5) cal.ndtr .onth. .ft,r th. d.c.d.ntl. d'lth, . flv. Ptrctnt (SX) d!.count
of thl tlX peld I. Illo".d.
Intlr..t II cher"td beginning with Urlt dlv of dellnqutncv, or nlnt (9) lonth. and OM (1) dlv frol thl dlt. of
delth, to tht det, of Plv.tnt. TUII which btc... delinquent boforl J.nulry 1, 191Z bur Interl.t It thl rlt. of
,1M (6Xl Ptrctnt p.r ennUi c,lcullt.d .t . datlv r.te of .000164. All tIXI. which blc", delinquent on and .ftlr
Jenuarv 1, 1912 will b..r Intlr..t .t I r.tl whluh will vlrv 'rol cal.ndlr velr to callnd.r Yllr with thlt rlt.
announctd bV the PA Departaont of R.v.nut. Tht eppllclbl1 Interl.t r.tl. for 1912 thrOUgh 1994 .r'l
U!! Int.r..t RI\! Dilly rntlrl.t~ !!!! Inter..t R.ta Dilly Intlrl.t Flctor
1982 lOX .0005~8 1911 lOX .DDDI1~
1911 16X . OOO~18 1911 ?X .DDOI~1
198~ IU .DDOIDI 1988.1991 m . DOOlOl
1'81 IIX .00DI56 1991 9l .DOC2~1
1991.199~ n .00DI92
..,rnt.r..t Is olloulltld III follow'l
INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--lnv Hotlel l"uld .fttr tht taM bleD'" delinquent will rtfl.ct an Intlrl.t c'lculatlon to flft..n (II) dlv'
blYond the dlt. of the ........nt. If Ply..nt II IIdt .fter the lnt"..t ClMIautlUon dltl .hown on the
Notlol, addltlon.l Int.re.t au.t b. ollculltld.
P~YHl!NT I
D.tleh thl top parUon of thlt Notlcl end tubedt NUh !iour ply"'"t "d, ~.vebll to thl n... .nd addr... printed
on '"ft r.v.r.. tide.
.\11 PIYNn'. recIlvld .hlll flrtt b, IpPUld 10 InY 1ntar..t which ..v b, dUI with .nv renlndtr IPPU'd to the tiM,
REFUND (CR)I A r.fund of . tlK crldlt, which W.I not r.qultted on thl TIM R,turn, "V b, rtouI.ted by coapl,tlng an
"ApplJoltlon for Refund of Plnn'vlv.nl, InherltlnGt Ind Eltftt' TIM" (R~V~i31S). Appllcltlonl er. Iv,llable .t
tilt Offlol 0' thl A.gllbr 0' Willi, Iny 0' the 2. AIVtnu. Dlstriot Offlo.., or by olUlng thl 'PM'II U-hour
an'Nerlng .Irvlel nu.b.r. 'or 'or.. orderlngl HEW IN PENNSYLVANIA 1.100-362-2050, out.lde ~.nn'vlvanl.
Md within thl 10011 Herrhbur, 11'11 (717) 787-'094.
REPLY
TOI
Qulttlont r",rdlng .rror. contllnln on thl. notlcl .hould bl ~ddrl"ld tOI PA DIPlrt'lnt of UIVlnu., Bur.au
of Jndlvldu.l TIK", ATTNI Po.t AI......nt R.vJlw Unit, DEPT. 2'0601, Hlrrl.burg, PA 17121-0601, p~on.
(717) 717-6505.
If any tlK d~ I, paId NlthJ" t~r.. (l) cel,nd.r wonth. .fttr thl dlcld'nt'. da.th, I flvl Plrotnt (iX) dl.oount
of the tlK plld I, ~lloNOd.
OlltOlMT I
INTEREIT.
Intlr..t I. oh.rg.d blglnnlng with 'Ir.t dlY of dellnqulnoy, or nlnl (9) lonth. and ono (11 dty frOl the dati of
dl,th, tu thl det. of p'V'ent. T.xI. which ble... dllJnqulnt before J,nulrv 1, 1912 belr Intlr..t It the r.t. of
IJX (6~) perolnt plr '"nUl oaleullt'd at ft d.llv rete of .OOOI6~. All tIK" whteh bIC"1 d.llnqu,nt on end .ft,r
January I, 1912 wIll b.er Int.r.,t It . r'tl which will y.ry frol ell.ndlr VI.r to oll.ndtr V'lr with thlt rttt
lMOUnold by the PA n.p,rt..nt of Rlvlnul. Thl 'PPltclblt tnt.rut r.tll for 1912 throuth 1994 .r'l
'l!!t Int""t RttJ Dilly Int.rllt Factor ~ tntlrll~ A,t. D.llY tnt.r.,t Fletar
1912 20X .0005\1 1916 lOX ,DOOm
19&! 16l .000131 1917 9X .000241
19I~ IlX .000301 1911-1991 m .000301
1915 UX .000356 1992 9X .000241
199!-199~ 7l .000192
....Jnt.r..t 1. c,lculattd .. falloNII
INTERE8T . BALANCE OF TAX UNPAID X NUNBER OF DAY8 DELINQUENT X DAILY INTEREST FACTOR
-"Any Houel lI,uld Ifter the t.x btcOlte. d.llnquent NUl rlfll\lt In Int.rllt cDleulttlon to f1l1Mn UI) d.y.
btyond thl d,t, of thl .......tnt. If plv..nt '" tide Ift.r tht Intlrllt Clo~utDtton d.tl ,hewn on thl
NotJot, addltlon'l Inter..t ItUlt bt c.leullt,d.
. , RI\'~~!I43 IX AFP (8-94) '*
C_AL1H Of PfHHIVl.YAHIA
DV'A~rItEHl Of REYEIU
BUREAU Of IHDIYIDUAl lAXEI
OEPl, Ila60l
HARRUIlRU, PI 11128.0601
l.
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
FILl NO. 21 94-0402
ACN 94142030
DATI 09-22-94
TVPE OF ACCOUNT
L ~ SAVINGS
CHECKING
TRUST
CERTIFICATE
REHIT PAYliENT AND FORHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
THOMAS
ESTATE OF RILEV
S,S, NO. 215-05-2739
DATE OF DEATH 01-16-94
COUNTY CUMBERLAND
MILV ELAINE M
CIO 101 FOREST DR
CAMP HILL PA 17011
FARMERS TRUST COHPANV hili provided the DIP.rt.,nt with the lnforflltlon I I ,tell below which hill bltn ulld In cIlcuhttng the
potenthl tIle dul. Th'lr rlcordl Indlclh that at th, dllth nf thl IIbov. dlCldlnt, you wert n Joint own,r/bln,flclary of 'hll account.
If you 'nl thit Infor.atlon 11 InCOrrCl<lt, ph... obtaIn wrltU" corr.ctlon fro. the IInancllll InltltutJon, .Hnch II copy to 'hit for.
end r.turn 1t to thl abolll "ddr.... filii aocount I, hlCablr. In occor(lllnCI with thl Inn.rhane. TIll( Law. of thl Co..onw..lth of rtnnlvlvanlll.
QunUonl ..y bl IlnnJetld by call1nQ (111) 1111-3527,
COMPLETE PART 1 BELOW M M M SEE REVERSE SIDE FOR FILING AND PAVMENT INSTRUCTIONS
Account No. 13-301515 nlh 04-22-92 To In,url proper credit to your tlccount, two
Ellhblhhed (2) copl.. of thil notlcl .u,t ncco.pany your
pay..nt to thl Righter of 1011111. Hllkl chick
paynbh tOI "Rlgh'.r ol Willi, Aglnt".
ADDount B.hnD' 1, 855 , 65
P.rD.nt T...bh X 50.000
A.DlInt Subj.Dt to T.. 921.83
Till< R.t. X , 1 5
PDt.nU.I T.. Du. 139.17
PART TAXPAVER RESPONSE
CUI FAILURI TO RISPOHD WILL RISULT IN AN OFFICIAL TAX ASSESSHINT IASID ON THIS NOTICI
A.
NOTEI If taN pay...nt, IIr. udl within thrill
13l Qonth, of thl dlcldlnt', date of dlllth,
YOU lay dlduct a S% dl,count of thl tal( dUI.
Any Inhld tancI tal( dUI wlll blco.. dlllnqulnt
nlnl (9l lonthl tlft.r the nate of duth.
[CHECK ]
ONE
aLOCK
ONLY
c:J Thl abovI Infor..tlon and tlX dUI I. corrlot.
1. Vou .IY l:hoou to r..lt Ply..nt to thl Rlgl.,.r of Will. with twCl coplll of thlt notlot to obtain
a dl,count cr llvoJd Intlrllt, or you .ay ch.r.k bOI( "A" and "turn thlt notlc. to thl Righter of
'wl1lt Ilnd an offiolal 1I.......nt 104111 bl luu.d by thl p~ Olpart..nt of R.v.nuI.
B. 0 Th. abovI a...t hu bun or will b. rlpol.t6d Ilnd talC rtald with thl Plnnlylvanll Inhlrltance hI( roturn
to bl filed by th, dlcldlnt', rlprl'lntatlvl.
C. g Tht IIbov. Inft.lrlltlon iMnoorr.ct Ilnd/or.-..9lbt. and dlductlon. WI" paid by )IOU.
'Iou IU.t cOlpl,ts PART L.:.l andlor PART 0 billow.
If YDU IndID.t. . dlff.r.nt t,~ r~t., pl.... ~t.t. YDur
r.hUDn,hlp tD d'D.dant. ), 11l:.Ji.:L ( k
OFflICIAL USE ON LV 0 AAF
PA DEPARTMENT OF HEVENUE
PART
[3J
TAX ReTURN . CO:l/lUTATION or
LINE 1. D.te E,toblhh.d I
2. Account 81llnee 2
3. P.rD,nt T...bl. 3
4. A.ount Subj.ot to T.. 4
S. D.bt, .nd D.duDtlon. 5
6. AlIOunt T...bl. 6
7. To. R.t. 7
a. T.. Du. a
nx or: JOINTlTIlUOT
II - ). .::\ - ':. .~"
f > 8'.; S. "
X ' ,~ ('!
, (' '{ 'I \"
,. v" . I 1
ACCO!.JNTS
PAil
1 _
2
3
-----,..----,.,.-,..-
/I __
:1
~\ :?") 7:;
, II(
I,' ii', f 'I
DEBTS AND
5
6
1
8
DEDUCTIONS CLAIMED
-
H ,
f.
PART
~l
DATE PAID
PAVEE
DESCRIPTI ON
AMOUNT PAID
~
TOTAL IEnt.r on Lln. 5 of r.. CD"put.tlon)
I
.
-.--
-
Und.r p.n.ltl., Df p.rjury, I d.DI.r. th.t tho
DOllllI.t. to tho but of "y ~no.lIdg. .nd b.ll.f.
'1i'1f (A t ~tll ))/. ))( (('/j
AVER S GNATURE I!
flot. I hive report.d above ere tru., corrlat and
~ll!iL~ I I '/ )-2.(.,/ - ( ,1'1 ,")u
WORK ("It i') J(,i - / ,'0'('(,
TELEPHONE llUMfit:R
, {
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAK ASSESSNENT wllh .ppllellbl. Inl,,"t b,nd on Inforo.IIOft
..lthd by tM 'IMInOI,' Institution.
Z. InhlrltlnCe tile bleol.' d.lInquent nine lonth. aft.r thl dlctcllnt', dati of dnth.
J. , Joint ~ount I. t.~lhl. .~.n though the derlde"t', n... WI' ,ddld .t I ..tt.r of conv.nl.nel.
~. Account. (IncludinG tho.. hlld b.tw"n husb.nd Ind wlf,) which the dice dint put In joint ",... within on' V..r prior to
dI.th .r. fully tlMlblt II trlnsf.r..
5. Acr.ount. ..t~ll.htd j~lntlv b.twlen hUlbtnd and wlf. lor. than on. YI.r prior to doath Ir. not taM.bll.
6. Account. held by . dlced."t "In trult for" anoth.r or othtr. er. taMtbl. fullv.
REPORTING INSTRUCTIONS - PART
1
- TAXPAVER RESPONSE
1. ILOClC A - If the In'orntlon and co~utlt1on In the notlcl ar. correot flnd deductions .,. not being cia Iud, pl.Cle In ")("
In block "A" of Plrt 1 of the "TaIlPIVlr RI.pon.." ,.otlon. Sign two cop II' and lubelt th.. with your chick for the "lOunt of
tnM to the Rlghtlr of wlllt of the county Indlcat.d. Th' PA OIPutllnt of Illv.nUI will IlIu. In offlol.1 ........nt
(FQrw RtV-lS4a E~I upon rlcllpt of the rlturn fro. thl Rlglltlr of willi.
Z. ILOCK I - If thl a,.lt .p.olfl.d on thl. not lei h.1 b..n or will bl rlPort.d and tall paid with thl Plnn,vlvanl. Inhlrltlncl
Tn Rlturn filed bv thl dlcld.ntll rlprulnhtlv., placI an "X" In block """ of Part 1 of the ""IIPIVlr Rupon.." lIotlon. SI;n ani
QOfIY IInd "turn to thl PA Olpart.lnt of Rllllnul, llurllu of Individual Tallu, nlPt 280601, flllrrhburg, PA 171Z1'0601 tn thl
envelope provldld.
J. IILOCK C - If thl noUcl InfornUon It Incorrect and/or dlduotlon, er. bllng clal.ld, chick block "C" and ao.pl.tl Parts 2 Itld 5
't':':Q~ltl~~ to: t"II: 1~t"t~"".I","" ht\~..,. ~I:~ \we C<:"p!H tmJ :lu:Jult H:'.~ w!tr, 'JI,J;J,R .ohc..:;:; r.:;,~ t~: "jll~;...-,t ;;1 ttoll tI~'.~bl. to Uj. R..ahhr
of willi of thl county Indlc_t.d. Thl PA O'Pllrt..nt of R.v.nuI will l"uI IIn official ........nt (For. REY.IS48 E)() uron rllellpt
of thl return fro. thl W.ghter of Willi.
TAX RETURN - PART 2
- TAX COMPUTATION
lINE
1. Ent~ the d.t. thl Iccount originallY Wll, ..tablt.had or titled In thl lannlr Ixl.tlng at date of death.
HOTEr for a dlcld.nt dying aft.r 12/12/B21 Account. which the dlcldlnt put In joint nae., wJthln ene (1) Ylar of dl.th arl
taubh fully lit tran.flr.. Howlver, therl It an IIIclu.lon not to ,xcl,.d H,OOO p.r trllrl.flre' reglrdl.., of thl valul of
thl account or the nueb.r of aecount. hlld.
If . daub 1. .~tlrllk IMN) apPlar. bofor. your flrlt na.1 In the addr"1 portion of thl, notlcl, the '5,000 exelu.lcn
Ilr..dy hll baln deductld froll thl account balancl "' r.ported by thl flnanclel In.tltutlon.
Z. Enter thl totel blhne. of thl account IneludJr,g Interut accrued to thll det. of dllth.
J. ThtI percent of the secount thllt 11 taxabll for IIcll .urylvor It d.terlllnlld a. follew'l
.. Th. percunt tlxabll for joint a,..t. I.tabll.hld lIorl then ani Yler prior to thl docldlnt', dllthl
1 DIVIDED BV TOTAL HlJl<BER OF
JOINT OW~RS
Ex..,lel A Joint a.l.t rlal.t.r.d
DIYIDEO BY TOUl HUMBER OF X 100 . PERCENT fAXABLE
SURVIVINO JOINT OWNERS
In the na.. of thl dlCldlnt and two othlr Plr.on..
1 DIVrDED IV 5 (JOINT OWNERS) OIYIDED BY 2 (SURVIVORS) . .167 X 100 . 16.7% lTAXAIlLF. FOR EACtl SURVIVOR)
B. The parc.nt taxabl. for Ulltl crut.d within OM Yllr of the dlCldlnt'. dllth or accountl own.d by thl dtcldlnt but hlld
In trult for anoth.r Indlvldual(.) (trult bln.flclarl..)1
1 DIVIDED BV TOTAL NUHBER OF SURYIVING JOIHT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
Exa.,I.1 Joint account rlgiltlrtd In thl n,', of thl decldlnt and two other Plr.on. Bnd ..tabllsh.d within on. VIlIr of d..th by
thl d'oldlnt.
I DIVIDED BV 2 (SURYJVORS) . .50 X 100 . SOl: (TAXAIILE FOR EACH SURVIVOR)
... The ..o~t .ubJ.ct to tdX Olnl 4) h d.teralnld by lultlplYlng thl account bllanc. (I1n. 2) by thl perclnt tlllClbll (IIn. 5),
5. Entlr the totll cf the dlbt. and deductlcn. Iht.d In Put 5.
tI. "I-II" aaount tlKlol.lI \11nl OJ It dlurlln.u by 'Ui:)\raotlng the dlbt' lInd deauctlon. llinl 51 ~ro. the allount lIubjlCt to tlllC ClInl 4J.
7. Ent.r thl apprcprlatl tax rat. (lln. 1) II' dltlr.ln.d bllow.
,. Fcr date' of d.ath occurring .ftlr 6/50/94, thl tllX rltl' for tran.f.r, to ,POUII. .rl a. follow'l
1. Olt.. of duth on or aft.r 1/1/94 and blfore 1/1/96 the rat. It 3%.
Z, O.t.. cf d.lth on or Ifter 1/1/96 and boforl 1/1/91 the ratl I, 2%.
J. Oat., of dllth on or aft.r 1/1/97 and b.forl 1/1/98 the ratl I. 1%.
4. ntt.1 uf dl.th on or Iftlr 1/1/98 tranlf.ra to SpCU'I' will b. e~l.pt frce tax.
Motel For datu of duth prlcr to 7/1/94 tranlf,," to .pou.u art taxabll ftt 6%.
II. Tron.fllrt (0 lInnl duelodlnt. Including father, loth.r, .on, daughter, grllndchJldrtn, .on'ln.law,
dauQhtlr.ln-llIw, .tlPchtld and thllr II.ut .r. tlxabl. at ,Ix p.rclnt (6%).
C. Trln.flr. to all othlr. Including broth.r, .I.t.r, unci., aunt, nlphlw and nl,cI aru taxlbll at flftltn Plrc.nt (15%1.
D. Jf you chlngl the tax ratl, pi.... Iplclfy ycur rlllltlon.hlp to thl dlCldent In the ar.. prcvldld.
a. The aeount of tax due (11nl B) I, d.tlr.ln.d bV IUltlplylng thl alount tallabll (11nl 6) by thl t.~ rat. (1In. 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AIlowabl. debt. and dlductJon. ar. dlt.r.lnld al follow. I
A. You leoellY ar. rl.ponllbll for pnY'lnt, or the ..tatl .ubjlct to adllnl.tratJon bv a Plr.onll r.pr"lntatlvl II tnluffloltnt
to p'Y the dlductlbl. It,...
B. Yau aetulll1y paid thl d,bt. aft.r d.lIth of th, dlCldlnt ftnd can furnl.h proof of paY'lnt.
C. Dlbtl bllng ~1.1..d .u.t b. It..lz.d fUlly In Part 3. If additional spacI J. n'ld.d, ule pluln p,plr 8 1/2" ~ II". Proof af
p.y..nt aay b. rlqul.tld bV the PA O.plIrt..nt of Rlvlnul.
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 INQUIRVUNIT IN . ,
HARRISBURG AT (717) 787-8327. TODI (i17) 772-2252 (HEARING IMPAIRED ONLY)
.
\
., ..', \-" ,-..",,~, ...... ...
..
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'.-'" t.
.......,... -----~..,~.~
,,.
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"
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I
PURPOSE OF
NOTICE'
PAVNENT I
REFUND (CRIo
To fulfill thl requlrl.lntl of Slotion 2140 of thl Inhtr!\lncI and E.tat. Ta)( loot,' Act U of 1991. (72 P.S.
Slothm 2140),
O.heh thl top portion of thll Notlcl and tublllt with your pav..nt to thl Rlghtlr of Will, printed on the
rlYlrll ,Ide.
u Hike ohlck or 11I0nl" ol'dtr payable tOI REGISTER OF WILLS, AGENT,
All Ply..nt. rlolJYld thall flrtt he applied to ~ny Inter..t which "IV bt dUll with Iny rlllftlndtr applied to the tiM,
A refund of II tal< credit, which WI' not rlquut.d on the till< r.turr" IIIIlY b, "quilted by oOllplltlnll an "Application
for R,fund of Pennsylvania lnh,rHancl Ind E.tat. TalC" (REY-13131. Application. ere aveHable at the OffiCI of
thl RIglattlt of Willi, lIny of thl Z3 R'YlnUI Dlstriot OffiCII or by calling thl splelel Z4~hour anlwlrlng urvlo.
nUlD.r, for for., ord.rlngl In PennlYlvanla 1'800-362-2050, out,lde P.nnl~lvanla and within local
Harrisburg aru (117) 767'8094, TOO' (7171 772-2252 0111rln; Illpalr.d Only),
OBJECTIONS I ;'n~ party In Int.rut not Illtlsfl.d with the apprllh...nt, allerwanc. or dlllll10wance of deductlonl or a........nt
of hIC <Including lItlcount or Interutl as Ihown on thh Hotlc. llIIa~ object within .JI<t~ (60) day. of recllpt of
this NoUc. b~ I
uwrlthn prot..t to the PA O.partllllnt of R.v.nu., 1I0ard of Appeal., Oept, 281021, t1arrhburg, PA 17128-1021, OR
...I.ctlng to hay. th_ .Ithr det.r.ln.d at the audit at the account of the per.onal repr..entatlve, OR
--appeal to the Orphan.' Court
APNIN-
ISTRATlVE
CORRECT! ONS I
DISCOUNT,
INTEREST,
Factu.l .rror. dl,cov.red on thl, a....~.ent .hould b. .ddr....d In wrJtlng tOI PA Oepartment of R.venu.,
lIuruu of Individual Taxe, , ATTH! Po.t A....U1.nt Revbw Unit, DEPT. 280601, Harrhburg, PA 17128-0601
Phone (717) 787-6505, S.. page 3 of thl booklet "In.tructlonl for InheritancI TalC Return for a RuJdent
O.c.dlnt" (REY-150)) for an uplanatlon of 1Id1lllnlltratlv.tv corrllotablll errors,
If an~ talC due I. paId wIthin thrll ()) calendar ~onth. aftsr the dlcld.nt's death, a live perelnt (S%)
dlteount of the talC raid II allow.d.
Int.r.st I' charged b.glnnlng with flr.t da~ of d.llnqu.nD~, o~ nln. (9) lonth. and one (1) day
frol thl dah of death, to the daU of paY".nt. TalC" which b.euI delinqu.nt befe" January 1, 1982
bur Int"..t at the ratll of ,II< (6%) plresnt pet annul calculated at IS dall~ rall of .000164.
All taICU which b.oa..e dellnqulnt on or !Ifter Januar~ 1, 1982104111 blat InUr.lt at a rlltt whloh IIJ11 v.r~ fro.
cal.nd.r ~lIar to cal.nd.r Ylar with that rat. announc.d b~ thl PA O.p.rt~snt of Rsvsnut. Tht appl1cabl.
lnt.rut ratu for 1982 through 1995 art!
'till: lnttrut Ratl D.llv Int.r'lt Fftctor :tur Interllt Rat. Dally tntuGlt Factor
1982 20% .000548 \987 9% ,000247
1983 16% ,000438 1988-1991 11% .000501
1984 11% .000301 1992 9% ,000247
1985 U% .000356 1993-1994 1% ,000192
198~ 10% .OOOZ14 1995 9% ,000,47
ulnttrut 11 calcuhted .. follow'!
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
uAny Notlcl Inuld after ths hIC bleCIlU dellnqu.nt will refhet 11M lntlrut oaleul.tlon to flftun US) da~1
b.yond the date 0' thG llUI!lIII.nt, If paYJlllnt I. lIIade aftlt thl Interest COllputatlon datA thown on the
Hotloe, nddltlonal In\lrlllt "Ult bs onloulatld.
"
COHHOHWEAlTH OF PENNSYLVANIA
OEPARTNENT OF REVENUE
BUREAU OF INDIVIDUAL TAKES
OEPT. 110601
HARRISIURO. PA 11121-0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILl! NO. 21 94- 0402
ACN 96112426
DATI! 04-15-96
TYPE OF ACCOUNT
EST. OF THOMAS I. R I LEY IXJ SAVINGS
S,S, NO, 215-05-2739 0 CHECKItlV
DATE OF DEATH 01-16-94 0 TRUST
COUNTY CUMBERLAND 0 CERm,
REHn PAytlENT AND FORHS TO I
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
UWoIut II m lI.tll
ELAINE M MILY
101 FOREST DR
CAMP HILL
PA 17011
HARRIS SAVINGS BANK hI' provldld the DIP,rt.,nt with th, Infor.,Uon 1 htld bile.. which hili bun uud 1n ca1cut,Ung the
potlnU,1 talC dUI. Thtlr rlcordl IncUut. th,t It thl doe'" of the aboVI dlced,nt, you wort a joint own,r/b,nffloiary of tMI Iccount.
If you f.,1 'hll Infor..Uon II InGorr.ct, plu.. Obtt!" written corr.ctlon frat the flnanchl In.tttution, attach. copy to thll for.
Ind r.turn It to thl .bov_ .ddr.... fhll Iccount II tIllable In IQcordancl with the Inhlrltanel TalC Law, of the Co..onw..1th of Plnnlyllllnla.
Quntlon, IIIV bl In.wtred by Cllllng (717) 787-4327.
COMPLETn P^RT 1 BI!LOW ~ ~ ~ SEI! REVERSE SIDE FOR FILI~Q ^ND P^YHENT IN~TnUCTIONe
Aooount No, 10-00112834 Data 05-03-88
E.hblhhad
Aooount Balenoa 11 , 491 . 23
Plroant Tlxlble M 16 . 667
A.ount Subjlot to Tox 1,915.24
Tox Rata M , 15
Potantlal Tox Dua 287 . 29
~~ TAXPAYER RESPONSE
[!] r PAILURI TO RISPOND lULL RI!SUL T IN AN OFFICXAL TAX ASSI!SSNINT IASlD ON THXS HOnCI
A.
To In.url proplr crldlt to YQur account, two
(ll cop II' of thl. not lei ~u.t Icca.pany your
PilI/lint ta thl RIghtlr of Willi. Hllkl chick
PIYlbh tOI "Reghtlr of Willi, Aglnt".
NOTEI If tl~ psy..nt. Ira .ade within thrl.
(31 lanth. af th. dlcldlnt', dati of dl.th,
you ,~~ ~,duat a 5% dl.caunt of thl tl~ du..
Any Inhlrltanc. t.~ dUI will bleo.1 dlllnqulnt
nlnl (91 lonths .ftlr thl dati of d'lth.
[CHECK ]
ONE
BLOCK
ONLY
o Thl IboY' Inforlltlon and talC dUI II corrlct.
L You "Y choo.. to r..lt pav.ent to th. Regl.ter of Will. \lIJth two copla. of thh no tie. to obtel"
a dhcollnt or avoid Intlrllt, or YOU IllY chick bo~ "A" and return thh notlce ~o thl Rlllhtlr of
Will. and an offlcl.l a.......nt will bl I..u.d by thl PA O,plrt..nt of R.venu..
I. ~ The aboye ~...t h., blln or will b. reported Ind talC paid with the Plnn,YlVDnla Inhlrltance TI~ return
ta bl filed by thl dlced.nt'. rlpr.e.ntatlv,.
C. ~ Th. ,boy, Inforlatlon I~ncorrlot and/o~~'bt. and d.ductlone wert paid by you.
You luet co_pl,t. PART l.!.J and/or PART ~ bilow,
If you Indloata 0 diUlr.nt hx
ralation.hip to daoadant,
I pl.... .t.t. y~ur
OFFICIAL USE ONLV 0 AAF
PA DEPARTMENT OF REVENUE
PART
[!J
TAX RI!TURN . COMPUTATION OF TAX N JOINT ITRUST ACCOUNTS
LINE 1, Dah Eotlblhhld I.._._____._~ '.' __..,
2, Aooount allenoa 2
5, oar..nt Toxlble 5 M
4, A.ount Subjaot to Tlx 4
S, Dabtl Ind Daduotion. S
6, A.ount Toxlbla 6
7. Tax Rlh 7 M
8. Tax DUI 8
PART
[!]
DATE PAID
/9 ~ '1/
DI!BTS AND
DI!DUCTIONS
PAD
1
2
3
4
5
6
7
8
CLAIHED
-.-...-.
-.
/CI/!i,ar
PAYEE
DESCRIPTION
AMOUN'r PAID
I
TOTAL IEntlr on Lino S of Tax to.putltion)
Undar panaltia. of parjur~, I daolara that tha faot. I
oo..\'~ato to tha but of ., knowl dga Ind ballaf,
t U{.,:U./ / .'),' I,
TAXPAVER SIaN
1-
I
.
-
.nd
GENERAL INFORMATION
I. FAILURE TO RESPONO WILL RESULT IN AN OFFICIAL TAK ASSESSMENT with .pplloobl. Int"..t b.ud on Inlo,oollon
lubllttliJ by the fln'f\cl,llnltltuUon,
t. Inherltancl tile Illco." dlllnquent nlnt Ilonth. _ftlr the dlc.dlntl, dltl of dllth.
3. A Jotnt _oeount It tllllbl. .".n though the dlc.d.nt', nail Wat added III II utt.r of con".nl.ncl.
It, Aocount. [Including tho,. held bit...." hUlblnd Ilnd ..1f,1 which thl dlcedlnt put In Joint nu.. within on. ylI' prior to
d..th Ir. fullY tUlbl, II trln,flr..
S. Account. .,t,bll,hld JointlY blt....n husbllnd and wlf. lor. than on, y..r prior to dQnth ar. not 'IKable.
6. Accountt held by . dlcld.nt "In trUlt for" lInoth,r or othtr. IIr. tillable fulh.
REPORTING INSTRUCTIONS - PART 1
TAXPAVER HE5PONSE
1. BLOCK A . If thl Inforntlon Ilnd cOIPuhtlon In thll notlcl ar. corrlet Ilnd deductlona /lr, not balnll chl..d, plloe an "M"
In block "A" 0' Put 1 of th. "Tawply.r Rllpcnll" IIctlon. Sign two coplll end lub_1t th.. with your chlrk for thl IInunt of
till to the Rlght.r of Will. of the county Indlcatld. Thl PA Dlpart'lnt of RIYlnu. will IlIu. an offlolal ........nt
(fori REV.1548 EMl upon rlollpt of thl rlturn 'rol thl R.gllt.r of willi.
Z. BLOCI( a . If the IU"~ 'PlcHI.d on thlt noUc. hili bun or will bl rlportld nnd ta)l paid with tha Pllm.vlYllnla lnh.rltanc.
Tu Alturn fllld by thl d.c.dlnt'l rlpr...nlaU"'I, PlaCI dn "M" In block "8" of Pllrt I of thll "T8)lPllv.r AIIPonll" Itctlon. Sign ani
COpy and r.turn to the PA Ol~.rt"nt of ~IY.nuII Buruu of Indl...ldual TII)lIl. DIPt Z806OI, Harrllburg, PA 171Z8.0601 In th.
.n"'llopl provld.d.
3. BLOCI( C - If the notlc. Inforutlon It Incorrect IIndlor d.ductlunl II" b.lng elal.ad. ch.ck block "COO IInd cOlrl... PlIrtl Z .nd 3
aocordlng to tht In.truotlonl b.lcw. Sign two copl.o and lubnlt th.. with your ch.ck for thl uount of taw PIlYllble to the R.glttu
of Wllh of the county Indlcatld. Thl PA DIPartllllnt of RIYlnUI will ItlUI IIn oHlclal a....I..nt (For. REV'154! EXI upon reclipt
of thl rlturn frol thl Rlglltlr 0' Will..
TAX RETURN - PART 2
TAX COMPUTATION
LINE
1. Entar
NOTE,
thl dati thl account originally wal I.tablllhld or tltl,d In thl _annllr ')ll.tlng at dlltl of d.ath.
For a d.c.dlnt dying aft.r IZ/12/82, Accountl which thl d.c.dlnt put In Joint na'll within ani (11 Vlar of
tlxllbl. fully 1II tranlfa". HClwlyar. thl" Is IIn uclu.lon not to 'lCcnd 13.000 PI' tral'ilf".. regardl...
thl .'coun\ or thl nueblr of account. h.ld.
duth art
of thl "'Ilu. of
no
If . doubll ..t.rl.k (M.) IIpp..r. blfora your flrlt nal' In thl addrlll portion of thll n&tI41t.
Ilrllldy hili bun dlducted frol thl account balanc. al report'd by th. flnailclal Inltltutlari.' ,
C
I
th. ~~OOO
IlCdlJiRn
en '~l
,-, ,
Z,
5.
Enter the total blhnc. of th. account Including Interut IIctrUld to the dati
Tha plrclnt of thl account that II tll~abll 'ar ,ach ,ur~l",or I. d.ttreln.d ..
A. Tha Plrc.nt t.~abll for Joint all.tl Iltllblllh.d Ilor. than ani y..r prlor
of dllth.
follolfJl
to thll dlcldlnt',
daath'l
~
;U
I.,:
I' :1
EX'Il~I.,
....
TOTAL NUHBER OF K 100 . PERCENT 'TAKABLE \0
SURVIVINO JOINT OWNERS , ,
In thl nut of tht d.ctd.nt IInd two other per.on.. L -r/
. (, ..
1 DIVIDED BY 3 (JOINT OWHERSI DIVIDED B'f Z (SURVIVORS) . .161 X 100 . 16.1% (l,t,)lABlE FO~U~1l SURvf~R)
Tht perc.nt t,ubl. for a..at. crlllted wi thin on. vur of the dectd.nt'. dtlth I'lr IlCCountl 0~iici'1IY tht ~Cld.nt
In trult for anothlr Indl~ldual(,' (trult b.nl'lclarll.l,
""1
.,.
I DIVIOED BY
TOTAL HUMBER OF
JOINT OWNERS
A Joint a"lt r.gilt,rld
DIVIDEO 8'f
"
u, ()
.-,\,
B,
but hlld
1 DIVIDED ftY TOTAL NUHBER OF SURVIVINO JUIHT
OWNERS OR lRUST 8ENEFICIARIES
X 100 . PERCEHT TAXABLE
Exupll1 Joint account reglttlrld In th. na.. of th, d.c.dlnt and two othar p.t'OM and utablhh.d wlthltl ani yur of dllth by
thl d.eldlnt.
I DIVIDEIJ BV 2 (SURVIVORS) . .50 M 100 . 50% (TAU8LE fOR EACIt SURVIVOR)
4. Thl .tount ,ubJlot to talC Clint 41 II d.tar'lIned by 1Il1l1tlplvlng th. account balancI (1lna l) by the p.rclnt taxeb1a (11M 3),
5. Enter the total of the dlbtl and dlnuotlonl llltld In Pllrt 3.
6. Thl alount tlXlblt (11nl 61 h deteralnld bV ,ubtrac\Jng tha dlb" and d.duotlonl Clln. 5) frol the a.ount tubjlct to t.lC (lIne Ie),
1. Enter tha .pproprl~ta tax rllt, (line 1) al d.t.r.ln.d b.low.
A. FOI' tlltll of "uth ucuurrlny u'I.,. 6/j~/'H, \1111 ~o.c ra\\,. fM ttlln"ln to IIIUU'... alto a. '''11u.n.
I. O.t.. of d.ath on or aftyr 7/1/94 and b.forl 1/1/9S th. ratl It 3%.
l. Oat.. of dl.th on or lifter 1/1/95 tran.flrt to IpOUI.. will b, ta~.d at 0% talC ratl.
Hotll for de'e. of d'lth prIor to 111/94 tranlf.rl to IpOUlel art taxable at 6%.
8. Trln.farl to Ilnlll ducendant. InoJludlng father. IlIother. ,on, daughter. gl'llndchlldrtn, ,0n'ln-la",
dlught.r-In.law, ItlPchlld and thltr IIIUI ara talCabl. at .Ix p.rclnt 16%).
C. Tr.n.flr. to III oth.r. Inoludlng brothlr, .I.tlr, un~l., aunt. n.ph.w and nllc' art ta~'btl et flft,ln plroont (ISX).
D. If YOU ohln". the telx ,'ftt., pha.. ',laclfy your relatlon'hlp to the d.c.dlnt In th. aru provJdld.
8. Th. alount of talC dut <lln. 8) I~ detar.ln.d by Iultlp\ylng the alount texebll <lint 61 bV thl t.x rete (11nl 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowtblt dlbt. and deductlonl ftr. d.tlrlln.d lit followl'
A. Vou I'Gally .r. rl.pcnllbll for pay..nt, or th. .ttat. lubJtct to ad.lnl.tratlon b~ a p.r.onal rlpr"lntetiv. I. Insufflalent
to pey tht d.duotlbll 1'....
8. 'fou actualh pnld thl lItbt. after duHI of th. dlc.d.nt and can furnllh proof of pava.nt.
C. Debtl b.lng chlud IUlt bl tt..lud fullv In Part 3. If additional IpaCI h nllded, un plain p"per 8 l/l" x 11". Proof of
ply..nt uy ba requII,.1t by the PA D.p.rt_.nt of RflYlnu..
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 'rAXES, TAXPA'~ER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING I~PAIRED ONLY)
... ..., .... -.,. ~. ,..,.
~
PUllPOSE OF
NOTICE.
VAYHENT,
RmINO (CRI'
....
0'0
...
fll ~',,;:
",
....
'rl
N,
n.
t~ .,(
'In.;
.,
(; t')
,
(0
I) .....
'"
~: \ 'j
15 '; ,I
?J(l)
ccO;:
~
.;\
I
'''I::
88
"
\0
p'
To fu\flll thl requlr..int. of Saatlon 2140 of thl Inh.rlt,no. and eltltl Tax Act, Aot 22 of 1991. (72 P,S,
Stctlon 2140),
Dttloh thl top portlun of thl. Notlol end ,ubllt with your ply..nt to thl Rlgllt.r of Willi prlntld on thl
r,vu" ,Id..
__ Hike chick or lonlY order pavftbll tul REGISTER or WilLS, ACENT.
All Ply.."t. r,cllvld ,hill flr.t b, IPpll,rl to 'n~ Int.r..t whloh fBy b. dUI, with .ny r...lndlr applied to thl tlX.
A r.fund of . 'IX or.dit, which WIU not r.qullted on thl tlX return, 11I)1 bl r.quuted by co,plttlng .., "AppllolUon
for R,fund of Plnn.ylvlnla Inherltlnel and E,t,t. Tlx" (REV-13Il), Appl1cltlonl ar. avallablt at thl Offl~1 of
thl RI.i,tlr of Will" any of thl 23 RI~.nu. DI.triot Off Ie.. or by calling the IPlolal 2~~hour answlrlng Ilr~icI
nuaberl fClr for.. ordlrlngl In PlnnlYl~anh 1~eOO~36Z~ZOSO, outlid. P,nnlylvanll Ind within local
Hlrrllburg Irla (717) 181-^094, TOO' (717) 17Z~ZZS2 (Hlarlng Ilpnlrld Only).
OBJECTIONS' AnY party In Intlrllt not ,atllflld with thl appral'IRlnt, allowancl or dllallowancl of d.duotlonl or al,.,...nt
of tllC (Including d1tcount or Intlrllt> at .hown on th\t HoUcl ..y objlot within IIICh (60) day. of rlollpt of
thlt HaHn bYI
"wrlttln protllt to thl PA Dlp.rt'l"t of RlVlnult, Board of Applah, DIPt. Z810n, Harrhburg, PA 171za~IOZ1, OR
4-lllotlng to hav, th, .att.r dltlrllnld It thl .udlt of thl account of thl p,r.onal rlpr..lntatlvl, OR
-~apPlftl to the Orphan.' Court
AOIU~'
ISTRATlVE
CORRECTIONS'
DISCOUNT.
PENALTY'
INTEREST ,
Factual .rror. dl.cov.r.d on thll a.......nt .hould b, "ddr....d In writing tOI PA Dlpart.,nt of R.v.nu.,
lurllu of IndlvldlJ.l TalC.', ATTNl Po.t A.......nt R,vl,w Unit, OEPT. 280601, Illlrrltburg, PA 17128-0601
Phon. (717) 1a7-6505. S.. page 3 of thl bookl.t "In.truotlon. for Inh.rltln~' TlllC R'turn for a R,.ldlnt
O,cldlnt" (REY-1501) for an IMPllnatlon of adllnl.tratlvlly corrlctabl, .rrorl.
If 'ny tax due I, paid within thr.. (]) col.nd.r .unthl aft.r thl d,c.dlnt', dlath, a flvl p.rc.nt (SX)
dl.count of the t,IC paid I, allow.~.
Th. 15:< t.M lI",th' non"partlclpatlon p.nalty It cOlpiJtld on thl tohl of the taM and 'Interllt .....I.d, .nd not
p.ld be for. Jan~.ry la, 1996, the ftrlt d.y ~ftlr the .nd of thl taM e.nl.ty plrlod, Thl, non-partloipatlon
plnlltv i. .pp.lllblt In the .... .ann.r ftnd In the thl .e.. tl.. plrlod II you would app.al the tlX and Int.r..t
thlt ha. b"n .......d al Indlcatad on thl. notice.
lr.terllt II charg.d b.glnnlng with first day of d,llnqu.ncy, or "In. (9) NQnthl and one (I) dlY
fro. the d.t. of d.eth, to th. dah of pav"nt, taMil which hlea.. d.Unqulnt b.fart JlrluarY I, 1982
b..r Int.r..t at the r.t. of ,Ix (6X) p.rclnt p.r annul calculat.d at a d.llv rat. of ,000164.
All talC" which b.aa.. d.llnqulnt on or ,ft.r January I. 19a2 will b..r Int,r..t at I rntl which will vary fro.
o.l.ndar ~lIr to a.hndar v,ar with that rat. a"nounc.d bV th, PA D.part..nt of R.v.nuI. Th. apPllcabl.
Inhr.~t r.t.. for 19a2 tllrough 1996 .rt!
'!!!! Interllt Rate ~Interfllt Factar V..r Interllt R.t. Dally Intl,.lIt Flotar
1m lOX ,00m8 1987 9X .000147
19U 16X ,000438 198H9'1 llX ,000301
1.84 llX ,000301 1991 .~ ,000147
1986 l3X .000366 1993-1994 71: .00019Z
19S6 lOX ,000174 199!il"1~96 91: ,000147
--lnterllt I. ollculat.d a. followtl
INTEREST. BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
"Any NoUct tlluld aft.r the talC b,C10.11 dlUnqu,nt will refl.ct an Int.rllt oalcuhtlcm to flftlt" US) din
b.vond th. d.t. o' the ........nt, If pay,."t II ..d. after th. Int.r.~t to,putatl~n d"1 .hown on thl
Notice, addltion.l Intll'lIt .u.t bl calculat.d.
...
...."V~._..,.. -.- ...
, ' .,
~".....
, .