HomeMy WebLinkAbout95-00421
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D AA047824 COMMONWEALTH OF PENNSYLVANIA
NO. DEPARTMENT OP REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.. \\t!np'
~
-1IV.1I62 111...41
RECEIVED FROM:
&
ACN
ASSESSMENT I'!'
CONTROL ...
NUMBER
AMOUNT
J ROBERT STAU~FER ESQUIRE
101
*10.03
MARKET SQUARE BLOG
MECHANICBBURG PA 17053
ESTATE INfORMATION,
1:11 fiLE NUMBER
511 21-1990-0421
EJ NAME Of DECEDENT (LAST)
II DATE Of PAYMENI
EJ POSTMAR E
COUNIY
BSN 201-18-79:17
(fiRST) (MI)
DATE Of DEAIH
REMARKS
m TOTAL AMOUNT PAID
st!'l.O::l
EVELYN K DLESSLEY
CW
SEAL
\
,
"
CHECK" 429
RECEIVED BY
, "
~GNAlURf
_E . /
i .
I '
REGISTER OF WillS
MARY C. LEWIS
REGISTER OF WILLS
__ - ___ ____ ___ __ __ - - ___ __..._'_ - - - - 0.- __ - - - __ - __ - ____.- -.- __._ - _,. __. ___
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
,"JMMONW[Al1l1 or ",,,,mVAI"A (TO BE FILED IN DUPLICATE
U[J>ARIM(fH 01 R[VflW[
1I1.",~Jl'U~ot'!:"0601 WITH REGISTER OF WILLS) COUNIvr.ODE.)./
-1~t~IUI;;i'5 N.MI-jIA51~fIUI:';i~UMllltli l;lII;AI-I~ - .u____.__. __.n d_ - . .- -fi[CIUI,;I-HOMrIlU ,t.IJOIt5\
I: IJLESS~EY! ooorG~Rr'_-"-'-'-"---"-I'''''- ,-,., -----'" r7rlOI'ala, millabtuon AvepA' 170....
m !I0ClA\ SICURIIY UUMIlIR , "A" Of utAl" ,.." uf '''','', . eo 1 1 0 rg, ;;J;;J
~ 201-10-7957 ~/3/'J5 <;/(,/26 co,,, Cumberland
~, _ ~~~~;~;;o:'~~;'~~~"~~'::M~~':~~~:~r:f:'~:,i'~'~~':il~-=~~~tou":J5~~:'~'~'fC"O"'1
btI I. Orlglnnl Rolurn [J 2. Supplllmnnlol Relurn [J 3. Remainder Relurn
- (fot dOl" of dl'olh Plior.o 12.13.821
o .t. limited eslole ["J .4u. Future Inleresl Compromise 0 5. Fedlfol Eslale Tax Return R.qulred
(for dales of d.oth nlt.r 12.12.02)
06. Doc.d.nt Di.d Teslale [J 7. O.uldenl MUlnlainod 0 living Trult .Q.8. Total Numb.r Df Safe Oepasi' Bo..e,
(Altoch copy of Will) (Allach CDPy of trUll)
ALL\CORRESPONDENCI-AND CONFIDENTIAL TAX INFORMATION SHOULDBI DIRECTED TOI ',:::,"-:!!i~'~'~'~-;' \,'1'" CO"~ '.' :
NAME lOMf'IfH MAIUUO ADOUS!
J. 1l0bOl't StUUf'f'Ol', Atty. Hlll'lcot Square Bldg.
jji,,,,o"'NUMiii .------.,,---------------- Hechanioaburg, PA 17.o~5
l 717 L-766-9~7~
I. Real Eltole (Schedule AI
2. Slacks and Bondi (Schedule 6J
3. Clasel)' Held Sloc~JPorln.nhlp Inleunl (Schedule C)
.t. Mortgages and Nole. Recelyobl. (Schedule 0)
5. Cosh, Bank Oepalit, & MllColluneous Penonal Propelly
(Sch.dul. E)
6, Jololly Own.d P,op.,ly (~ch.dul. F)
7. Trond.n (Sch.dul. G) (Schedul. l)
B. Total Gron Aneh (Iolallln.. 1.7)
9. Funeral E.pens... Admlnl,trallve COlh, Miuollaneous
hp.n"u (Schedul. H)
10. Debh, Morlgage lIabllltl.., lIonl tSthedule I)
11. Tolal D.duelions (Iolallln.. 9 & 10)
12. Ne' Value 0' Ellale (line 8 minus line 111
13. Charill1bl. and Governmental Bequelll (Schedul. J)
14. Nol Value Subl.c1lo Tnx (line 12 minus lino 13)
1 S. Spousal Tronsfen Ifor dallu of death oftor 6.30.94)
5.0 In'lruellons for Ar,pllcahl. Percentago on Rever..
Side. (Indud. values rom Schedule K or Sch.dule M.I
16. Amount of line 14 loxable at 6% rolo
(Includ. valu" from Schedule K or Schedulo M.)
17. Amoun' ollln. 14 loxoble 01 15% role
(Include valu"s from Schedule K or Schedule M.I
lB. Printlpollox due (Add tax from lines 15. 16 and 17.)
19. Crodih Spoulol POVt)I)' 6~dil Prior Po)'menh Oiscaunl Inl.r.sl
. + 0.00 + 0.00 0.00
20. If line 1911 Oreoler Ihan line 18, enlet Ihe difference on line 20. This Is Ihe OVERPAYMENT.
ao
21. If lIno 10 II O,.olot than line 19. enler the diUerencI on line 21. This Is lhe TAX DUE.
A. Entor Ih. intere" on Ihe bolonce duo on Line 21A.
O. Enlor Ihelolal of line 21 and 21A online 218. This 1.lh. BALANCE DUE.
Moke Ch.cle Payable 'or Reglllet of Willi, Ag.nt
1;:-- Ie ~ ~ BISURETO ANSWER ALL QUESTIONS ON REVERSE.SIDE AND TO RECHECK MATH" ...c:' ,
Undor ponohiel of pcorjllry. I dedore Ihnll have un mined Ihis rolurn. inclurJing accompanying "hodul"s and slolemenh. and 10 Ih. h..1 of my ~"awledge and b.lief
Ills lrue, carrocl and complntft. I d.dare It.nl nil rllol O"Ulft 11m boen reporlfld ollrun ll10rktit value. D.darotion of preporer olher Ihon Ihe p.nanal representDtive I;
based Dn alllnfoffl1aliClfl of which preparer heu any ~nowlodoo.
SIONAl,?'~' flR5~~[W6u!lIIL( 'UR ,lllflOJlEIUIlU -AuWiiss--710 Hamil ton A va. DAlE
c;e<'i:' _a._ h.2_({. ___ _,__-11~n.iluJlL~~'L05~ :;-- 3o-'1'~-
'~R f AlllR' tANH I UtllAlIllt AOOIlUS rIo.rkat Squal'6 Dldg. OAT(_
"'I<!:: - /_m__ HAClhaninnbll'rg, PA 1+.0$5 j,/.Jo.,/"~
REV.UOO rx + (1941
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fOA DATES 0' DIATIt A"ER 12/31/91 CItICK ItIAI
If ^ SPOUSAL -
paVIATT CRlDn IS CLAIMID LJ
;iii'NUMBIR ,----,---
vr M ..2s-
y:;.(
NUMBER
----~-- -.
-.------..--
0.00
Q..illl-
0",.00-
o 00
--!};9!)O~dO-
(1)
(2)---
(3)
(4) ,
(5 I _
(6)
(71
0.00
0,00
5.91)0.00
(91 ___5JAtt 9.00
1 B)
liD)
0.00
5,W+9.00
501.00
0.00
501.00
(11)
(12)
(13)
1141
I1SI,_,______,.5Q;L,,__OO_K,Q.1.
116) ____________.:!. 00 __K ,06 .
1171,________, 0.00 K ,IS a
15.03
0.00
0.00
118)
15.03
Chock horo If you oro roquolling a refund Df your overpaymont. .
119)
(20)
0.00
0.00
121)
(2IA)
(2IB)
15.03
0.00
~.s:-or
Act #48 of 1994 provldos for tho roductlon of Iho tax rolos Imposod on Iho not valuo of Irons fen to or for
tho use of Iho spou.e. The role. a. pro.crlbod bv tho .Ialule will bOI
o 3% (.03) will bo appllcoblo for oslates of docodonl. dvlng on or aftor 7/1/94 and b.fom 1/1/96
o 2% (.82) will b. appllcablo for 0.1010. 01 docodonts dvlng Dn or of tor 1/1/96 and b.foro 1/1/97
. 10/0 (.01) will b. appllcablo lor ostate. of docodonl. dvlno on or of tor 1/1/97 and b.for. 1/1/98
. SpouGollransfon occurring on or of tor 1/1/98 will bo oxompt from IlIhorllanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (vI IN THE APPROPRIATE BLOCKS.
YES NO
1. Old d'lcedenl mDke a Iran.for and:
a. rolaln the use or in como of the property transferred, ,.................,....,..............,........,.......
b, rolain ,he rig hi 10 designate who shall use Ihe property 'ransferred or Its IncDme, ...,......,....
c. relain 0 revorslonory inlerest; or ..........,....,..,..............,..,........,..,......,..,....,..,................
d. recelvo Ihe promise for lifo of oi,her poymonls, bonoll's or coro' ....'............,....................,
2, II dealh occurred on or boforo Docembor 12, 1982, did decodont within IWD years preceding
deDlh transfor properly wlthou' rocelving odoquato consldorDtiDn' If doath Dccurred altor
Decombor 12, 1982, did docodonl 'ransfor prol'orly Vllthln ono yoar 01 death wlthDut receiving
adequate consideration' ...'.'......"......",...." ,..,."" ,..",.,.."""...,....,."".."",...."...........,..,..,
3, Old decedent awn on 'in trust fDr' bank accounl 01 his or her deDlhL....,....................,..........
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Ilvuorlltl'..1I
~ji!-
COMMONWI!AUH Of prNNSYlVANIA
INHIIITANCE TAX IITUIN
IIIIDI"T DICIDEHT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Ploa.o Prln' ar Typo
FILE NUMBER
ESTATE OF
GEORGE D. BLESSLEY
(All prap.fly lolnllv~w".d with Ih. Right o' SUfwlwonhlp mull b. dlulo..d on Sch.dul. '1
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1. 1990 Ford F150 4x2 vehiole, VIJlII1F'rDF15Y7LJlB081~17. $ 5,9,0.00
$ 5,9,0.00
(Alloth additional aYlH M 11" ,hills If mort 'pace Is ""d.d.)
.....""11+1'.111
*
COMMOHWfAl1H or 'lHHSYlVAHIA
INItUItANCE TAl( IIETUIN
RULDlNT DECEDENT
SCHEDULE H l
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
ESTATE OF
ITEM
NUMBER
A.
1.
B.
1.
2.
3.
4.
C.
1,
2,
3,
4.
5,
6.
7.
8,
AMOUNT
E
Ploaso PrInt or Typo
GEORGE D. DLESSLEY
DESCRIPTION
Funoral Exponso..
1Ie111 Funeral Home, 3401 Harkot St., Comp Hill,
Pennsylvania, funsrnl expenses.
Admlnl.trotlvo Costl!
Pononal Roprosonlatlve Commllllons
Social Soturlty Numbor 01 Personal Roprolonlatlvo:
Yoar Com millions paid
Allorney Fool J. Robert Stau1'1'ar, EDq., a.ttorney's 1'ee.
Family Exompllon
Claimant Eve1:vn K. Bless1eYRolollonlhlp \o111'e
Addro.. 01 Clalmanl at dotedont', doalh
Slroot Addren 718 Hamil ton Ave.
City HeohaniosburR Stolo PA Zip Codo 1705~
Probato Feo,
Mlstollanoous Exponsos.
G1ngrioh MemorialD, oemetery monument.
Register 01' Wills, 1'iling Pennsylvania Inheritanoe
Tax Return.
TOTAL (Allo onler an IIno 9, Retapllulallon)
(II maro span Is noodod, Insort addItIonal .hoo's 01 samo slzo.)
* 2,714.00
35.00
2,000.00
685.00
15.00
s
5,449.00
1,
A. TOll.obl. Baque.hl
Evelyn K. B1oDs1ey
718 Hamilton Ave.
Meohaniooburg. PA 17055
\'lifo
Entiro Estate.
, .
~IV.IlIJ"t II "I
W
COMMONWIAlUl O. "IlI~."yltj'A
IHIUlnA""''''' .nUI"
IIIIOIHI oICIO.H'
L
SCHEDULE J
BENEFICIARIES
FILE NUMBER
'ESTATE OF
GEOROE D. DLESSLEI
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
O. Charitable and Goyornmontal Deques'l:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aho enter on line 13, Re,opllulollon) S
(If mo'. spoce I, n..ded, In.ert additional ,he\)t. of .ame alu)
,>,
I s-, (., -13
REV-1547 EX AFP (12-94*
C~<H OF PENNSYLVANIA
DEPUTHOff Of' REVENUE
IUREAU OF INDIVIDUAL TAXES
DEPT. lII6D I
""'AneURG. PI 17UI-0601
ACN 101
NOTICE DF INHERITANCE TAX
APPRAISEHENT. ALLOWANCE DR OISALLDWANCE
DF OEOUCTIDNS ANO ASSESSHENT OF TAX
DATE 09-04-95
ESTAT OF
DATE DF DEATH 05-03-95
FILE NO.
COUNTY
CUMBERLAND
NOTE, TO INSURE PROPER CREDIT TD VDUR ACCOUNT. SUBHIT THE UPPER PORTIDN Of THIS fORH WITH VDUR TAX
PAVHENT TD THE REGISTER DF WILLS, HAKE CHECK PAVABLE TG "REGISTER OF WILLS. AGENT"
REMIT PAYMENT TO:
J ROBERT STAUFFER
MARKET SQ BLDG
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
Aaount H..Uted
CUT ALONG THIS LINE ... RETAIN LDWER PDRTIDN FDR YDUR RECDRDS ~
iii-Ii: ii;4i-ix-iij:P--iIF94Y-iioYici--liF"YNHiifii'ANci-i:AX-APjiiiiiisiif€ii'i'-.--iii.i."ciiiAifcinrli-----------------
DISALLDWANCE OF DEDUCTIDNS AND ASSESSHENT DF TAX
GEORGE D FILE ND. 21 95-0421 ACN 101
TAX RETURN WAS, I I ACCEPTED AS FILED I Xl CHANCED SEE
ESTATE DF
BLESSLEV
DATE
ATTACHED
09-04-95
NOTICE
RESERVATION CDNCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I E.t.t. (Schedul. A) (1)
2. Stock. ~ Bonda (Schedul. 8) (2)
3. Clo..ly Hald Stock/p.,.tn.rahlp Int.,...t (Schedul. CJ (3)
4. "orla.gea/Not.. Receivabl. (Sch.dul. DJ (4)
5. Caah/Benk Depoaita/Hi.c. Paraonal Property (Schedul. E) (5)
6. Jointly 0-.1 Property eSc_I. F) 161
7. Transfa,.a (Schedula OJ (7)
8. Total A...t.
,00
,00
,00
,00
5.950.00
,00
.00
lal
5.950.00
APPRDVED DEDUCTIDNS AND EXEHPTIDNS:
t 5.449.00
9. Funaral Expen.../Ac.. Co. ./Hl.c. Expen... (Schedul. H) (9)
10. Dabta/Harig.g. Llabiliti../li.nl CSchedul. Il elo) .00
11. Total Daduction. ell)
12, Hat Valu. of Tax R.turn 112)
13. Charitable/Govarn.."t.l Bequa.h (Schedula Jl (3)
14, Net Valu. of EIt.t. SUbject to Tax C 14)
NOTE: I~ an assessment was issued previOUSly, lines 14, 15 and/or 16, 17 and 18
ra~lect ~igures that include the total D~ a!:.!. returns assessed to date.
ASSESSHENT OF TAX:
15. ABunt of Une 14 .t Spou..l rat. (5)
16. Aaount of Lin. 14 taxable .t Linaal/CI... A r.t. (16)
17. Aaount of Lin. 14 taxable at Collat.ral/Cl... 8 rat. 117)
la. Principal Tax Due
TAX CREDITS:
PAVHENT
DATE
05-31-95
08-28-95
1;.44Q nn
50L 00
.00
501,00
will
50LOOX,OD=
,00 X,06=
,00 X.15=
llal
,00
.00
,00
.00
RECEIPT
NUHBER
AA047824
REFUND
DISCOUNT
INTEREST
1+1
1-)
.00
.00
AHDUNT PAID
15.03
15.03-
TDTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TDTAL DUE
.00
.00
,00
,00
. IF PAID AFTER DATE INOICATED, SEE REVERSE
FDR CALCULATIDN GF ADDITIONAL INTEREST,
IF TDTAL DUE IS LESS THAN U. NO PAVMENT IS REQUIRED.
IF TDUL DUE IS REFLECTED AS A "CREDI'T" ICRI. YOU I1AV BE DUE
A REFUND, SEE REVERSE SIDE Gf THIS FDRM FOR INSTRUCTIDNS. I
0-
....
RESERVATlDHI Est.t.. of dec....t. dying on Dr' tM'or. OM"''' 12, 1912 n if MY future Inh,...t In tN ..tat. 11 trMd.rrlld
In po.....lon or enJo~t to Cia.. . (co\l.t.".ll ~flcl.,.l.. of the decedent .,t.,. the .xplr.tlon of eny ..tat. for
11'. or '0,. v..r., the C~.lth ~rebv IMPr..lly ra..rv.. the right to ~r.l.. ~ ...... tren.'," Inhe,.lt~. ,....
at ~ l~ful CI... . (coll.tl,.lll rat. on eny .uch future lnt.,...t.
PIIlPOSE OF
NOTlCEI To ful,111 the ,.~lr..ent. of s~tlon 2140 0' the Inn.rltBnCI end Eltata 'ax Act, Act IZ of 1991. 72 P.S.
Secltlon 2140.
PAY11EN1'1 o.tBCh tM top portion of thl. Notle. end ,ubltlt with your PI,..,t to the R-eht.,. of WillI printed on the reVlrll .sEMi.
...... ehKk or aone., or.-" payable tal REGISTER OF MILLS, AGENT
All p.,..nt. rHllneS ,hall flnt be IIpPlllId to ."y Int.,...t Which ..y be w. wIth MY r_lnder 1IPP11l1d to thre tax.
REfUND tCAll A refund of . tax crlMllt, which .... not r~l..ted on tt. T.. Return, ..y bl ,.....t.. by c~l.t1ng ., "ApplicaUon
far Aahrd of p.....,.ylvanl. l""ritMu ..:I E.tata hlC- CREV.1515). Appllcatlon. ar. avallMlla at the Offlca
of the RaGI.t.r of Will., any of the Z3 Aav.nua Dl.trlct Offlca., o~ by c.lllng the .peclal Z4-hou~
answering .uvlca n\.IIIMn for for.. ordering. In p...,.ylvanl. 1.aOO-36Z.ZD50, outllda P"""Ylv.tla and
within local H.trhbUrg .r.. (117) 18'.8094, TOOl (711) nZ-US2 (tlNrlng I...lr" Ordy).
DIJECTIDHSI Any ~tty In Int.nlt not ..th,l" "11th the eppr.h...-nt, .UOWMCa o~ dl..UOtdftCa 0' dMtuctlon., o~ ........,t
of tu (lnoludlng dhcOl.W1t o~ Int.rut) .. ahcM1 on thl. ttotlca ...It object within .bty (60) dIIy. of racalpt of
thl. Notlc. byl
.-wrltt.., prot..t to the PA o....rtaent of A.v...... loard of Appe.", Dept. 281021, tl.t~hburlih PA 17128-1021, OR
".Iectlon to hava the ..Uar datar.lned at !lUdlt of the IICCOl.W1t of the par.on.l rapr.....t.Uv., OR
--appaal to the Orphan.' Court.
ADHI"
ISTRATIVE
CORRfCTIOHSI
FlMltuel .~rot. dlscov.r" on thh ..........t .hollld be addr..... In writing to. PA o.part.-nt of Aev....,
Bur.... of Individual TalC.., ATTN. Po.t A.......nt Ravl... unit. Dept. Z806Dl, l~rrl.burg, PA 11128-0601
~ (117) 187-6505. 5.. paae 1 of the bookl.t -In.tructlon. far I~rltanc. TalC R.turn .O~ . A..ldant
Decadent- (REV.1501) for en .MPlenatlon of ao.lnl.tratlv.lY correctabla .rror..
DISCOUNT I
If any tlDC due II p.ld within thr.. IS) cal.ndet IIOnth. IIfte~ the dacacMnt". d..th, . flva percent (!aX) dlacount of
the tax paid I. .llowed.
IHTERUTI
Int.I'..t h charged ~IMlnu with flnt dey of dlIlInquancY. or nlM (9) aonth. .nd one (1) day 'rOll the date 0'
dMth, to the data 0' papant. T..ea which ~ dallnquent bIIfor. J....ry 1. 1'82 bMr Intar..t at the nta of
.1. (6X) parc."t per ..... calculated at . dally rat. of .000164. AU t.... which beC_ dallnquant on and aftar
January I, 1982 will be.r Intara.t at a rllte which .,111 varv froe cal~r year to calendar year with that rat.
announc" by the PA Depart.-nt of A.venue. The appllcabla Int.I'..t rata. for 1'82 through 1995 atal
'!!!! Intenat Rata Oallv tntal'..t Factor V..r tntaralt Aata Oalh tntaralt FrtGtor
1'8Z ZOX .00054_ 1'" OX .000241
l'as lOX .000451 1'88-1991 IIX .000501
1'" IIX .GOOSGl "" OX .OOQZ47
1985 lU .000356 199]-1,," 7X .000192
1'" lOX .Doazn 1'" OX .000247
..I"t.ra.t 1. c.lculated a. fallowI'
I!lTEIlElIT . BALANCE OF TAX UllPAID X IMIBER DF DAYB DELIHQUEKT X DAILY I!lTEIlElIT FACTOR
..Any Matlca luued .ft.r thll tu: bee.... delinquent will raflect an Int.r..t c.lculaUon to flft.... CIS) d.ys
beyond the data of the ........"t. If payaant II .... aftar ttM lnt.r..t cOllPU'aUon d.ta ahOWt on the
Notlc., additional Int.r..t aul' be ulculatad.
"Y,1470"~'1J
*'
INHERITANCE TAX
EXPLANATION
OF CHANGES
,-
COMMONWEALTH Of PENNSYlVANIA
DEPARTMENT Of REVENUE
BUREAU 0' INDIVIDUAL TAXIS
DEPT, 2B0601
HARRISBURG. PA 1712B.0601
DECEDENI'S NAME
filE NUMBER
Geor e D. BleBsle
ACN
2195-0421
101
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
uA.<;,L 2LoLt~95. roducedtho tax rate pOll tranafers t,o a survivingapouae
frOD 3 percent to 0 percent for datea of death on or after January I,
.,1995,. _.TlIe,eatate record haa been adjusted in accordance with ,thechangea.,
..0.....". _ ,,,.. _.._... _,_ __-...~...___c_-._.,__,"_.__.._.~~.~.,...., .
_._.~.._'M.._~ ..~ ...........~._..."..~. ~~ ~-... ..'''' "c_.........,."~....-.._...~~_.~ ~-_.__.. ,... ,..-.
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11\ .
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_.._----~g_.
TAX EXAMINER,
DebDrah WaehingtDn
PAGE
,-
) ..\ {.' .'/.:~
ACN 101
REV"16D7 EX AFP (12-95*
C~AlTH OF PENNSVlVANIA
DEPAATtEHT OF REVEHlE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
:INHER:ITANCE TAX
STATEMENT OF ACCOUNT
DATE 03-18-96
ESTATE OF BLESSLEV
DATE DF DEATH 05"03-95
GEORGE
FILE ND. 21 95-0421
CDUNTV CUMBERLAND
o
HOTEl TD INSURE PRDPER CREDIT TD VDUR ACCOUNT. SUBNIT THE UPPER PORTIDN DF THIS FORN WITH VOUR TAX
PAYNENT TO THE ADDRESS SHONN. NAXE CHECK PAYABLE AND RENIT PAVNENT TO, ,
J ROBERT STAUFFER
MARKET SQ BLDG
MECHANICS BURG PA 17055
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
AlIOUnt R..ut.d
CUT ALDNG THIS LINE ~ RETAIN LDWER PORTION FDR YDUR FILES ~
REY=iio'if7"EX-AFP"n2':9Sr-----...-iilH€iiii"A'iic'E-flix-STAfEiiEIiT"oF"liifcciiiiif--..-..---m---------------
ESTATE DF BLESSLEV GEORGE 0 FILE ND.21 95-0421 ACN 101
THIS STATENENT IS PROVIDED TD ADVISE DF THE CURRENT STATUS DF THE STATED ACN IN THE NANED
ESTATE. SHOWN BELDW IS A SUNNARV DF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYNENTS.
THE CURRENT BALANCE. AND. IF APPLICABLE. A PRDJECTEO INTEREST FIGURE,
DATE 03-18-96
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 08-28-95
PRINCIPAL TAX DUEI.___,______ .00
PAYMENTS (TAX CREDITS) I
PAYMENT
DATE
05-31-95
08-28-95
RECEIPT
NUMBER
AA047824
REFUND
DISCOUNT (+)
INTEREST (-)
,00
.00
AMOUNT PAID
15.03
15,03"
TDTAL TAX CREDIT
BALANCE OF TAX DUE
.00
,00
.00
INTEREST
TDTAL DUE
.00
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FDR CALCULATION DF ADDITIONAL INTEREST.
( IF TDTAL DUE IS LESS THAN '1,
ND PAYNENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCRI,
YDU NAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRN FDR INSTRUCTIDNS. I
"
PAntEHTI
aetach ttMI top portion of thh NoUee Md .ubIIlt .,ith your paVMf't ... pa"Male to the "... end Itddnn
prlnt.d an t~ rav.,... lid..
If RESIDENT DECEDEHT aaka cMck or 110M>> order ~1. tOI REGISTER OF WILLS, AGENT.
If NOH-RESIDENT DECEDENT .aka chIck or 1IOn1" ord.r ply_II. tal COI1HOHWEALTH OF PENNSYLVANIA.
AU p.,...," reel Iv" shen be appl1..t flnt to MY Ints,..t which ..., be due .,ith an., ,....lnd." ...UMI to the t...
REFUND (CAli A rafund of . tax cnd!t, which .... not rllqUested on the raK Raturn, ..'1 ba requ..tad by co...h,lng .,
"application far R.fund of Penn.ylv~l. Inn.rltenca 8nd Eltat. T..- (REV-ISIS). Applications .1'. Iv.lllbl. at
the O"lcI of thl Regllt.r of WillI, any of the 2S R..-nue District Offlc.. Dr fro. thl O.,lrt.ent'. 24-hour
erlwerlng ..rvlc. ~.r. for fa,... ordering I In penn.vlvanla 1-800-]62-2050, out. Ida P~.ylv."l.
end within locII Ha,.rlsburg .1'.. (717) 781-80", TOOl (717) 77Z.ZZS2 e~arlna I~alred only).
REPLY TOs au..tlona ragsrdlna .rror. contained on thl. notlc. ~ld ba addra..ed tas PA Dapart.-nt of Aavenus, Buraau
of Indlyldual Tax.., ATTNl po.t A......ant Ravlew unit, Dapt. ZaD601. Harrl.burg, PA 111za-0601, phons
el171 111.6505.
D[S~T1 If IInY ta. due is paid within thna (3) calandar ..,\hl attar the deeedantta d..th, a fiva parcant es:n dhcount
of tha ta. p.ld I. allowad.
INTEREST I Intare.t I. chargad baalnnlna with flr.t day of dallnquency, or nine e') aonth. and one el) day froe t~ data of
daath, to the data of pay.ent. Taxa. which bee... dal1nquant bafora January 1, l,a2 b.ar Int.ra.t at tha rat. of
.1. e,X) p.rcent par ~ calculatad at I dally rata of .000164. All tlxa. which b.c... d.lln~t on and aft.r
January 1, 1'12 will baar Intar..t at a rat. whIch wIll vary fro. cal.ndar yaar to cal.nd.r y.ar with that rat.
announced by the PA Dapartaant of Alv.nu.. Thl appllcabl. Int.r..t rat.. for l'IZ through 1'" ar.l
V.ar Inhr..t Aat. DaUy Int.nlt Factor V..r Intar..t Rata OaUy Intar..t F BO tor
l'IZ ... .00054' 1987 .. .000247
191' 1" ,00001 1'81-1991 11;( .00D!al
1'14 1\' .0OasOl 199' .. ,000247
1915 IS' ,000356 199'-1"" 1X .000192
1986 lOX .000274 1995.1'" .. ,OOOZ47
..Int.r.at I. oalcul.ted .. follOM.1
ItITEIlEST a DALANCE DF TAX IIItPAID lC HUNDER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlo. I.su.d .ft.r thl ta. baeo... d.ll~t will raflect an Int.r.at calculation to flft.an (151 day.
bayond tha data of the ........,t. If payaent 11 IIIlde aftar the Intar..t coaputatlon data tho.n on the
Hotlca, additional Intara.t .u.t ~ c.lculatad.