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GENERAL INFORMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OFfICIAL TAX ASSESSHENT with 1lPP1Icllbll Inter..' bUM on Infan.tlon
.....1"" bV the flMnCllal In,titutlon.
I, InNrlt~ t.. bK..... eMu"..,.,t "1M .with, ,ftl" the IMcMen'" dlt. of de.th.
J. . Joint HCount I. 'o.lIbl. IV.n though the dleHen", "... w.. edded .. . ..Un of COftVllnlllncl.
4. Accounh (Including tho.. hlld b.t..-en hu.band and ..UI) which thl dleHen' put In Join' ..... within ona w.... prior to
de.th Ir. fut h hIlMI. .1 tren,'o..l.
I. Account. .ltabthhed Jolnth Ht....... hulblMd Me! ..UI Mr. thwt on. V"" prior to d..th ara not hMIlbI..
.. Accounh htld b,. . decedent "In trult fa,," MOther or otl'Mn It. telllblo fullv.
REPORTING INSTRUCTIONS - PART 1
- TAXPAVER RESPONSE
1. aLOCK'" If thl In'orntlon and co.putatlon In the notlc. Ir. corrHt Md deduction. .t. not Hint chi...., plac. M wr
In block "A" of Part 1 of t~ "'I_PI,.I,. A..pon.... Itctlon. Ilgn two copl.. and .~lt t~ with your check 'or the ..aunt of
'IX to thl A..l,t.r of Will. of t~ county Indlc.tld. The PA D.,.rt-.nt of A.v~ will I..u. ~ offlol.1 ......-.nt
C'or. RfV.I541 EX) upon rlC.lpt of t~ r.turn froe thl ...I,t.r of Will..
I. ILOCI.. If thl ....t 'PMIfIId on th" notlc. hot been Dr .,111 be nportM and tex p.ld ..lth thl P""'l)'lv",l. IntMdtencl
T'M R.turn fllld by thl dlCed",t.. r.,r..."t.tlv., plac. ~ "r In block ..... of P.rt 1 of thl "T.llp.v.r A.span..- 'Htlon. Ilgn one
copy end r.turn to thl PA a.,.rt-.nt of A.venu., Bur.au of Individual T,II", Dlpt IID'Il, Harrisburg, PA 1711'.0'11 In tl_
env.l~ provldld.
s. ILOCI C - If the notlc. Infor..tlon II Incorrect and/or deduotlon. .re being ol.I-.d, chick block "C"" and cDllPI.t. perte I end S
Iftoordl"o to tto, In.truotlona wID... Sign tlfO copl.. .td ~1l tr.- wUII you,. chIdl. tor thl ...unt of taJC p.ylbl. to the RIII.t.r
of Will. of thl countv Indlc.ted. The PA o.p.rt-.nt of Aev~ .,111 I..ue ~ offlcl.1 ......eent CForl REV.l"a [X) upon rac.lpt
of the return frOl the Reghbr of "11&..
TAX RETURN - PART Z - TAX COMPUTATION
LIN!
I. lnt.r thI d... the IICcount orlllMllv .... ..tliblhhed or titled In thl .annar ....U". .t dat. of death.
HOTE. 'or I dec..,.t dvl". .ft.r IIIIZlal, ACCOW'lt. which the decedent put In joint ,..... within one ClJ )'Iar of dNth ....
taxlbl. fullv ., tren.f.r.. ~.r, thlr. I. en 'lIclu.lon not to IIIC.-d 'S,IDD per tr",.f.r.. rlOlrdl... of the value of
the IIOCount or the nullMr of IClCOIo.nt. held.
If . doubl. ..t.rllk C--) ."..r. blfor. your flr.t ,.... In the -'dr... portion of thl. notlc.. the tS,IaD ..clu.lon
.lreedy hu been deducted froe the IICCount b8111f'1Ce .. r..-artM bv the flnancl.l In.tI tutlon.
Z. Ent.r the tot.l b.lenc. of the ICCount Including Intlnlt MCIrued to thl dat. of de.th.
J. ThI plrcant of thI ICCOW'lt tMt II t.IIM11. for .ach survivor II INtlr.lned II faUCMfIl
A. The parc",t tlxlibl. for joint ...... ....bllshed .on thin one v.ar prior to thl dIe..,.,.t'. dtlath'
1 DIVIDED 1'1 TOTAL tufI[R Dr'
JOINT DWHDtS
EJc....I.. A joint ....t r....tll.ad
DIVIDCI .V TDTAL MM&DI OF' X lGI . PERCENT TAXAILE
-..vIVINO JOINT I:NNDtS
In thl RIM of the dIe...."t end twa other Plrton..
1 DIVIDED IY S (JOINT DWtERI) DIVIDCI IV Z CSURVIVCItI) . .167 X 110 . I,.n (TAXABLE FDA UCH SURVIVOR)
I. The peroMt tulibl. for ....b cr_tad .,lthln one I'Mr of thl dIlcedtnt.. dNth or acCCKA'tt. 0NnId bV the ~t but hlld
In tru.' fcr ana~r Indlvldual(.) Ctru.t bInIflcl.rla.JI
1 DIVIDED IV TOTAL IfJt(lEA OF SURVIVING JOINT
OWNERS DA TRUST IEHEfICI'ARIU
X liD . POtCEHT TAXAILE
b....lll Jalnt account ,.gl.t.r~ In thl n.. of thl dec..-,t WId two ather pe,.on. end .....11... within one yN' of death bV
the decedent.
1 DIVIHD IV 2. (SURVIVORS) . .50 )( liD . SOX (TAXABLE FDA EACH SURVIVOR)
4. ThI.-unt IlUbj"t to tllC (line 'I 1. detar.IMd bv ....ltlplvlng thl account b.llnC. nlna 2) b)' the percent t..MI. (11M S).
5. (nt.r thl to hi of thl cMbt. and deduatlon. 11.tld In P...t J.
6. 1h1.-ouRt t.II*,I. 11Ine.) t. dlt.r.tned bv .UII'rllCtI", tM Db" end ckHNotlon. utna 51 frOl tM IICK.nt IWjlCt to ta. CllM 4).
7. (ntar tM IIppropdat. ta. rat. nlna 7) .. d.t....I'*' below.
A. For o.t.. of da.th occurring .ft.r 6/SD/", tha t.. r.ta. for tran.f.r. to .pou... .r. .. follow..
1. Dat.. of d..lh on or .ft.r 7/1/94 and befor. 1/1/" thl r.t. I. J~.
Z. D.t.. of death on or aftar 1/1/96 end befcra 111'" the rat. .. IX.
3. Dat.. of ....th on or aftar 1/1"7 end blfcr. 1/1"1 the rat. II IlC.
4. Dat.. of death on or .ftar 111191 tr"'''.... to spou", ..UI be .M..... frOl tax.
Nota, for dIItu of ....th prior to 711/94 tr.,.f.,. to spou", .... tlllabt. .t O.
I. Tran.f.... to l1naal ducandent. tncludlng father, ..thlr. .on, daught.r. grandchlldr"" .on.ln-....,
....t.r-In-l..., .tepchlld end thllr luua .... taxabl. .t .Ill Plrcent ClUJ.
C. TrM.f.... to .11 othl... tncludlna brother, .htar, WMll.. ....,t, nIIIhIN and nlac. .... tlllabl. .t flft,," perc",t nU).
D. If you c~ thl ... rat., pl.... .paclfy youI' r.latlonshlp to thl dleMel'lt In the ..._ prcrlldlct.
I. TIMI.-unt of t.. _ ClIM I) .. dIIt....lned bv "'ltlplVlng tM ~t t..abl. nlna ,) bv tlMl t.. rat. Cllna 71.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AllDNIibI. debt. WId dIduCltlon. .... det....lned .. foil....'
A. You legallv .,.. r..pon.lbl. for p.yaent, or the ..t.t. subj"t to ldalnl.tr.tlon bv . personal rlPr..~t.tlva 1. Insufficient
to p.v the deductlbl. It...
I. You 8Cltullh p.ld the dMJta .ftar death of the dleldant end C~ furnl'" proof of pa~t.
C. Debt. being ol.l-.d ",.t be It.lz~ fully In P.rt S. If additional .pac. I. needed, u.. ~1.ln paper I 1/~ . I1R. Proof of
p.v.ant NY " r....ted bv thl PA Dep...tHnt of A......,..
:<"TAXPAVER,:ASSISTAHCE' . ' ... ,'''' ", ~::"""';-: "
IF. VOU, NEED: FURTHER '.INFORMATlON OR ':' ASSISTANCE~' CONTACT ANV('~'
,<.:j:>>RE9ISTER: OFWlLLS; PA DEPARTMENT< OF, REVENUE DISTRICT OFFICE'"
::: 'OR. CALL THE JlUREAU OF. INDIVIDUAL. TAXES, TAXPAVER' INQUIRVUNITIN
HARRISBUROAT(7171787-8::lZ7. TDD' (717) 77Z-ZZ5Z (HEARING IMPAIREDONLV)
:.::,::.:.:...,
REV-1543 EX AFP IB-94) '*
CnKHOHWfA1.11l OF PEHHSYlVANIA
D[I'Ul'-:Ht OF REY[HU[
"'.I!i:AU Of INDIVIDUAL 'Uti
DEPT. llD'DI
UAAR1IIURO, PA I7UI'0601
I S- '1:3 - II
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.Z1- qS:SI'1
951Z2633
05-25-95
GERALDINE I WARD
C/O KELtY
BZO LISBURN RD B04
CAMP HILL PA 17011
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIfiCATE
RENIT PAYNENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ESTATE OF GERALDINE SKELLY
S.S. NO. Z03-10-0591
DATE OF DEATH OZ-ZO-95
COUNTY CUMBERLAND
FARHERS TRUST COHPANY h.. provided the Dllfllttaent with the lnfor..Uon IlItad below .....Ich NIl been used In ulcuhtlnt the
potlntll. '1M due. Their r.cord. Indle." thlt .t thl d..th of thl eboYI decedent, yOU ~r' I joint owner/~.flcl.r~ of thl. ~count.
If VDU ,..1 thh Infonatlon is Incornct. pl.... obtain wrlttM corr.ctlon 'roe thl flnenclal Institution, ,ttach . COPy to \hh for.
~ r,\Ulll 11. 'u U.. ~.;,; ~...... 11,:,1, ;,;;:::~t .1 tll"=:'h In =,:~-rc!..,e. otP" t:~. !ntwarlt-''\ h. I,...... of the r~..'th of penn,ylnnl..
au..tlon. .,y be ~...red by call1no (711) 711.1521.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 11-63345 Ooto OZ-lB-93
Eltoblhhod
Account Balance
Percent TaMable
A.ount Subjact to TaM
TaM Rata
potantial TaM Due
To In.ura pr~r cr~lt to vour account, two
(2J copla. 0' this notlca -...t accDIIp"'Y your
paya~t to t~ Ragl.tar 0' will.. "~a chack
pnabla tOI "R"lItar 0' wUII. Ag..,t".
PART
[I]
55Z . 94
50,000
Z76.47
.06
16.59
TAXPAYER RESPONSE
',FAJLURlt'fO '. RI!SPOHD,WJLL RI!SUL T,'IH,' AN ,OFFICIAL TAX ASSI!SSHEtI'I'. BASED OHTtllS NOTtCI! "
x
HOTEl l' ta. pavaent. ara ..de within thr..
(s) aontha of the decadant'. data 0' de.th,
vou .ay deduct a 5% dl.count 0' the ta. dU..
Any InMir ltanca ta. dua ..Ul bacoaa delinquent
nine (9) ~th. a'tar the data 0' d.ath.
x
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The abova Infonatlon and talC due Is corract.
1. You aav choa.a to ra.lt p.vaent to the Ragl.tar 0' Will. with two copl.. 0' thl. notlc. to obtain
. dl.count or avoid lnt.r..t, Dr you ..y check bolC "A" and raturn thl. notlc. to the Reol.tar 0'
Will. and an offlcl.l .......ant will be 1..UId by the PA Dapart.-nt 0' RevlnUe.
B. [:] Th. abova a..at h.. bean or will b. r.portad and talC paid with the Penn.Ylvanla Inherltanca T.. raturn
to be ,Had by tha d.udent'. repruantatlv..
c. M Th. abova InfClr..tlon I~ncorr.ct and/o~.bt. and daductlon. war. paid by you.
You au.t co.plata PART ~ and/or PARY ~ b.low.
, '
If you Indlc.t. a diffarant taM rata, pl.... atat. your ,,' ' .
rel.tlon.hlp to decad.nt,
PART
~
1AX R~TU~N - ~OMPUTATION
LINE 1, Ooto E.toblllhod
2. Account Balanca
5. Parcant T.Mabla
~. A.aunt Subjact to TaM
S. 0_" and Daduct!on.
6. AMOUnt TaMabla
7. TaM Rata
8. TaM Dua
PART
[!]
DATE PAID
DEBTS AND
f-Aif' ','.~
1
2
3
4 '
,",''' 5' -:'
"",,
"6
7:
8
DEDUCTIONS CLAIMED
,Ai( (ii. .lOlli, "RUST ';CCCUI1,S
"F
1
2
3 X
4
5
6
7 X
a
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DESCRIPTION
AMOUNT PAID
PAYEE
IV
,
{t..<H\..-h\..c''"r rl.e...-'\'-f'L..-'
t':'- I
-
~ - .. ( -:--,
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TOTAL (Enter on Lina S of Ta. Computation)
Undar pen.ltla. of perjury, I decl.ra that the faot. I
cor.-loto to th. bOlt of .. kno.lodgo ond bollof.
.iJL.\(teA-,.\. ,-() , c,} '-"'/ - . ,/u'."'Y;/I,
.
heva report ad abova .ra trua, correct
( Ii 7 ) ~ J\~ :'l.l( 71
( )
and
HOME
WORK
J REV-1548 EX AFP 112-94_
COMONW(AlIH or PENNSYlYANIA
D[PAAI~Hf or REVENUE
aUR[AU or INDIVIDUAL fAMrS
PEP'. llO601
tlARAlsaURO, Pi 17UI-0601
/5.' '/3- II
c..,.
NOTICE or INNERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR OISALLOWANCE
or OEDUCTIONs,. AND ASSESS"ENT or TAX ON
JOINTLY HELO OR TRUST ASSETS
DATI! 08-28-95
ESTATE OF KELLY
GERALDINE S DATE OF DEATH 02-20-95
COUNTY
CUMBERLAND
FILE ND.dl-'i5-.:f'I'1
S.S/D,C, NO. 203-10-0591
ACN
95122633
GERALDINE I WARD
C/D KELLY
820 LISBURN RD 8D4
CAMP HILL PA 17011
REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
A.aunt R.nltt.d
CUT ALOND THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
Rifv:is4-a-iif-AFP--ri1i:94j------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF KELLY
GERALDINE S DATE DF DEATH 02-20-95
CDUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 203-10-0591
TAX RETURN WAS, (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
95122633
FINANCIAL INSTITUTION, FARMERS TRUST COMPANY
ACCOUNT NO,
11-63345
TYPE OF ACCOUNT, () SAVINGS 1 Xl CHECKING 1 ) TRUST 1 ) TIME CERTIFICATE
DATE ESTABLISHED 02-18-93
Account Balance
Percent Taxable ~
Amount Subject to Tax
Debts and Deductions
Taxabla Amount
Tax Rate X
Tax Due
176.00
0.500
88.00
231. 22
.00
,06
.00
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT. SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO.
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT 1 +)
INTEREST (-)
AMOUNT PAID
.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REUERSE FOR CALCULATION OF ADDITIONAL INTEREST, .
IF TOTAL DUE IS LESS TH.N fl. NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI. YOU KAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS, I
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