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REY-1543 EX AFP (S-941*,
COHHOHWEALTH OF PENNSYLVANIA
DEPARTHfNT OF RfVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ZID6Dl
ItARRlSIURQ, PA 11UI.D6Dl
15-1'7 - I
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 -95-~7>7
95126358
06-19-95
CARL M MCWHORTER
20A W SPRINGYILLE RD
80ILING SPRINGS PA 17007
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIfiCATE
REHIT PAYHENT AND fORHS Tal
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ESTATE OF SYMBOLENE MCWHORTER
S.S. NO. 526-34-3071
DATE OF DEATH 02-24-95
COUNTY CUMBERLAND
PHCBANK h.. provld.d the D.p.rt.ent with the Infor..Uon lht.d b.low which hu b..n u.ed In C8lculaUng the
pot.ntlal t.M due. Th.lr racord. Indlcata th.t ot t~ d..th of tha abova dacadant, you wara a Joint own.r/b.n.flclary of this account.
If you '..1 thIs Infor..tlon I. Incorract, pl.... obtain wrltt.n corr.ctlon fro. the financial In.tltutlon, .ttach . copy to thl. fora
end return It to the abova .ddr.... This account I. t.Mable In accordanca with tha Inharltanca T.M llw, of tha Co..onw.alth 0' P.nn.ylvanl..
Qu.,tlon. ..y ba .n....r.d by ~alllnll (111) 111.15Z7.
COMPLETE PART 1 BELOW . . . SEE REYERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Account No. 5140425572 Dat. 1l-01-S2
E.tablhhed
Account aalance
Parcant Taxable
A.ount Subjact to
Tal( Rata
PotentJal Tax Du.
To Inlur. prop.r credIt to your .ccount, two
(Z) copl.. of thl. notlca .u.t Iccoapany your
pay..nt to tha Aagl.t.r of Wills. "aka ch.ck
payabl. tOI "A.gl.tar of WIll., Agent".
PART
[!]
10.078.44
50.000
5.039.22
.066",.J .A-5'
755.88
TAXPAYER RESPONSE
FAILUR!TO R!SPOND ifILL REBULTIN'AN OFFICIAL TAX ASS!SSHENT BASED ON THIS NOnC!:
x
NOTEI If t.M paYlant. ar. ..d. within thr..
()) lonths of the d.cadent's data 0' d..th,
you .ay d.duct . S~ dl.count 0' the taM du..
Any Inherlt.nca taM due will bacoee d.llnquent
nln. (9) .onth. .,t.r the d.ta of d..th.
Tax
x
[CHECK ]
ONE
BLOCK
ONLY
A. E:J Tha above Infor..tlon and taM dua Is corract.
1. You .ay chao.. to ra.lt p.ye.nt to the A.gl.tar of Wills with two copla. 0' this not Ie. to obt.ln
. discount or Ivold Intar..t, or you ..y chack bo. "A" ~ r.turn this notlca to tha Aaglstar 0'
Wills and an official a........t will ba Issuad by the PA Daplr...nt of Ravanull.
B. E:J Th. above .".t ha. b.an or will ba r.portad and taM paid with the Pannlylvanl. Inh.rltanc. ta. return
to b. ,Il.d by the d.cad.nt'. r.pre.ent.tlva.
C. ~h. above In'or~atlon J~ncorract and/o~.bt. and d.ductlon. w.ra paid by you.
You MUlt co.pl.t. PAAT l!J and/or PART L!J balow,
If you indicata a different tax r.te, plee.a .tat. your
ral.tion.hJp to decedent,
OFFICIAL USE ONLY OAAF
PA.DEPARTHENT.OFREYENUE
PART
~
TAX RETURN - COMPUTATION OF TAX
LINE 1. D.ta e.t.blJ.had 1
2. Account aalanca 2
3. Parcent T8x.ble 3 W
4. A.ount Subject to Tex 4
5. Debt. and Deduction. 5
6. A.ount T.xabl. 6
7. Tax Rat. 7 w
a. Tex Due 8
ON JOINT/TRUST ACCOUNTS
\\~~I -8'2.
\0,6"7g.'-1Y
..!iO
5""03". '2.:z.
.s-t. ~ 7,"7 (.
.0 b
Z?f
DE8TS AND DEDUCTIONS
PAD
1
2
3
4'
5
6
7
8
CLAIMED
PART
I!l
DATE PAID
..2-.2-
'-~ ~ "9!1'
- -Ii
PAYEE DESCRIPTION AMOUNT PAID
- 1'0 ,;OJ ~"tt., .c.: /)
.. "c;. .c:;
~C no c,. K bD
TOTAL (Enter on Line 5 of Tax ConputatJonJ . ,L6
Under panaltJ.. of perjury, I declara thet the fact. I
co.pl.t. to tha be.t of .y knowledge end belief.
have reported above era true, correct
HOME (7/7) :15"8 - If" '7V
WORK ( 1 ~~,., '"
TELEPHONE NUMBER
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GENERAL INFORMATION
1. FAILUR! TO RES'DHD WILL RESULT IN AN OFfICIAL TAX ASSESSHENT with appltCebl. inter... ba.-.:t on In'or..uon
.ut.lttlld bJj' tt. financlll In.tltutlon.
Z. ImerltMC' h. ~... dallnque,nt nIne ""tha aft.r the dft'''*'t'l d.t, 0' d..th.
I. A Joint acODWtt h "MIIbla .v.., though the d.CllNMnt'l n... .... IMtded .. . "U.r 0' convanlWlCI.
~. ACCOWlll (lnaJudlng tho.. held b.t...." hulband and wlf.) which the decadent put In Joint n.... ..lthln one we.,. prior to
death ara full>> taxMle .1 tr""'lr..
I. Acoounh ..t_U.n.d Jolnth b.t....... husband IInd wU, .r. thM one nar prIor to cfaath ara not t'.llbla.
,. Aocounh MJd by a dec.dWlt "In trua' for" WtOtMr or other. .r. tlllabl. fully.
REPORTING INSTRUCTIONS - PART 1
- TAXPAYER RESPDNSE
I. _Loa: A .. If ttMI In'or..Uon and COIlpUt.tlon 1n the notice Ir. correct and deductions are not beina cJa.Met, placa ." "X"
In block ..... of Pa,.t 1 of the "TaxpaYlr A..pon.... .aotlon. Sign two cop I.. and .ue-It thu wIth Your check 'or the MOunt of
tax to the Aeglatar 0' NUh 0' the county Indicated. Th. PA D,p.rt..". of Aavenue will luu. M o'f!cl.. ........,.
(For. REV-1MI EX) upon rec'lpt of the return frH thtl R.gllt.r 0' WUh.
I. .LOCk." If ttt. ....t 'PlCHlad on this notlu hII. b.." or .,111 be r.port.d and tax paId with the P""'.>>,I"..," InharltMe'
lax Rltum fUN by ttMl decadent'. nfJr......t.uv.. pl~. an "X" In block ..... of P.rt 1 of the "TIMp.y.r A..pon.... .eotlDr'l. Sian one
cop>>, and r.turn to the PA Dap.rtaent 0' R.v~. lura.u of Jndlvlduel Taxa., Dapt Z10601, H.rrlsburg, PA 171ll-0601 In ~
anwlope provJ...,.
S. Iloa C ... If u,. notle. In'or..Uon h Inc:orr.ct and/or deductions .ra baIng cl.l.ad, check block "e"' and cOSlpl_ta hrh Z and 5
.coordl,. to the Jnstructlon. b.low. SIgn two copl.. and 'w.1t thee ..lth your check for the MOlMlt of taM pay.tJle to tha R.,ht.r
of "UII of tfM county Indlc.tact. Tt. PA D.part.."t of A.venu. wUI Inue WI officIal ........"t (for. RtY-1541 EX) upon receipt
of the raturn froe the Aagllt.r 0' Wllh.
TAX RETURN - PART 2 - TAX COMPUTATION
liNE
1. Enter the det. the accCUlt orlglMlb .... a.t.t)lhhad or titled In the .elVtlr .xllUnll at d.t. of d.ath.
frCITEI for a d.cl8d."t dying .tt.r JUll/ll1 ACCOWlh whIch the d.cadent put In JoInt n.... ..lthln 0fMI (I) yur of death .r.
t.._J. fully e, tr.".fer.. However, there II en eMc1uaJon not to axc'ad 15,000 per tran.far.. r.gardJ... 0' the value of
the account or thP nuaber of HGCMI1ts held.
If a ~Ia ..tarl.k (..) appear. befora your flr.t n... In the addral, portIon of thl. notlca, the 15,000 .xclu'lon
.lr..... has been deductact fr~ the ICCOW'lt b.lanc. a. reported by the flnenel.1 In.tltutlon.
2. Ent.r the total bahnc. 0' the eccount InclUdlna Int.ra.t IItCcruH to the det. of de.th. """,...,
}. The percent of the accOU1t that I. texable for allch aurvlvor II dat.r.lned .. '011011.1 '" ~ ~
A. The percent hMabl. for Joint ...... ..t.tJlhh.d IIOre "*' one Y.lr prIor to the dec.dent", ~t;lh
-~ . j
)( 101 . PERCEHT ;r~J(A'lE
~
:0
::am
ll' 0
... (j
I DJVlDED IV
E....I..
TorAl HUfrtI[R OF
JOJNT DWHEAS
A Joint ....t rlghtarl8d
c
F
.167 X loa . 16.7X (TAXABLE fOR EAat SURY~)
DIVJDED IY
TOTAL NUHIER OF
SURVJVJHQ .JOINT OWNERS
In the n... of the dec.dent end two other parson,.
I DIVJDED IV S (JOJNT OWNERS) DIVIDl:D IY 2 (SURVJVORS) .
I. The percent ta.abla for ..,.t. cr.at.d ..I thin one y.ar of the dec'dent", d..th or account. oNnld by the decadent but held
In tru.t for .-,ott\,r IndlvlduaU.) (tru.t ben.flcl.rl..h -c
N
~n, ~
~;.l
the n... of the dec.dent Md two other parsona IInd establhhed within one y..r of d..th by
1 DJVJDED IV TOTAL I<<JHI[R Of SURVIVJNG JOINT
OWNERS OR TRUST BENEFICJARJES
)( 100 . PERCENT TAXAILE
VI '.)
Exaapl.1
JoInt account r.gl.t.rad In
the decedent.
IV 2 ($URVIVORS) . .50 X
100 . 50;( (TAXABLE FOR EACH SURVJVOR)
1 DJVIDED
4. The a~t subJ.ct to taM (lIne 4) I. dat.r.lnad by aultlplylng the .ccount balanc. (1In. 2) by the p.rcant taxabl. (lJn. 5).
5. Entar the total of the dabts and d.ductlon. 11ltad In Pert 5.
6. The nount taxabJ. (l1ne 6) h d.taralned by 'ubtractlng the d.bh and deduction. Ulna 5) fro. the uount .ObJ.ct to tax Uln. 4).
7. Entar the approprlat. tax rata Ulna 7) .. dat.r_Jn.d balow,
A. For d.t.. of d.ath occurrIng .tt.r 6/50/94, the tax rata. 'or tran.f.r. to 'POU'" ara .. 'ollow.,
1. D.ta. of death on or aft.r 711194 and b.for. 111196 the rata 11 U.
2. D.t.. of d..th on or aft.r 1/1/96 and befar. 1/1/97 the r.t. I. ~.
J. D.t.. of death on or att.r IIJ/97 end befon 111191 the rat. 11 IX.
4. D.t.. of death on or .tt.r 1/119. tran.f.r. to 'pouse. wIll be .M..t frOll tlx.
Hote. for data. of dNth prior to 711/94 tranlf.r, to .POU... ara t."abl. at 6X.
I. Tran,'.r. to Unaal d"cendanta Inczludlna father, aother, .on, daughtlr, grandchildren, .on..Jn"I...,
dauohtar-In-l..., .tapchUd and thalr hsua ara tIM.tJI. .t .he parc."t (6)0.
C. Tran...r. to .U other. IncludIng broth.r, .t-tar, unci., IU'lt, naphew and nl.ca .r. taxable at flft.." percent U5iU.
D. If YOU change the tlM rat., pl.... .paclfy your r.lat1on.hlp to the decadent In the ar.. provided.
.. The MOUnt 0' ... due Ulna I) h d.t.raJned by ..,ltlpJylng the aIIOUIlt tlMabla (Un. 6) by the tax rat. UJna 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allow.tJla dtlbh W1d daduot1on. ar. d.taralned .. follON"
A. You lag.llY ara re.ponllble for pa~t, or tt. .,t.t. 'ubJact to Itdelnlltr.t1on by . perlonal rapr....,..t1v. II In,ufflclent
to PlY tha deductible It....
B. You actually paId the dMlt. _tt.r d.ath 0' tha d.ced..,t and c.., furnIsh proof of p.y.."t.
C. Debt. baing clal-.d lU.t be It..I~.d fUlly In Part}. If addItIonal 'pac. I. naadad, u.a pl.ln paper. Ill- x II". Proof of
P'YMf'It .Iy ba r.qu..tad by the PA Dap.rtunt of A.venue.
.i................... ...... '.' '.....ii... ......i ..i'. ......i<T AXPAYERiASSIST ANCEi "" '.<<i'i> i......... .........ii.i ".
:..: :'O'i ..... ,i ':.' IF'. YOU '.. NEED. FURTHER <INFORMATION '.. OR ' ASSISTANCE, :.' CONTACT. 'ANY 0:, ,,:....,i... .. .
i'ii, .....,>RE9ISTER...OFWILLS i.PA'DEPARTMENTOF'REVENUE DISTRICT. OFFICE: i<i.:i'
,i,'OR> CALL THE BUREAU OF. INDIVIDUAL TAXES .' ... TAXPAVER INQUIRY UNIT IN>
. .... .: OHARRIliBURG . AT:. (717) ':. 787-832VTDD. ....(717)?72~2252: CHEARINBiIHPAIRED." ONL V):
I REY-1548 EX AFP 112-94*
CottltONWfALTH OF' POMSVLVAHIA
tJ(PARntVn or REVENUE
IUR[AU OF INDIYIDUAL TAXEI
DEPT. 110611
HARRISBURC, PA 17UI.UOl
15-J!7-1
~
NOTICE DF INNERITANCE TAX
APPRAISEMENT. ALLOHANCE DR DISALLDHANCE
Of DEDUCTION" to AND ASSESSHEHT OF TAX ON
JOINTLY nELD OR TRUST ASSETS
DAT! 09-25-95
ESTATE OF MCWHORTER
SYMBDLENE
DATE OF DEATH 02-24-95
COUNTY
CUMBERLAND
FILE ND. ;</-t)S-SfD'7
S.S/O.C. NO. 526-34-3071
ACN
95126358
CARL M MCWHORTER JR
20A W SPRINGVILLE RD
BDILING SPRINGS PA 17007
REHIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Aaount R..ltt.d
CUT ALONG THIS LINI! ~ RETAIN LOWI!R PORnON FOR YOUR RECORDS .....
RiE'v=isiia-ix--AFii-iiif=94i----------------------------.-----.-------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISI!MENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 09-25-95
ESTATE OF MCWHORTER
SYMBOLENE
DATE OF DEATH 02-24-95
COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 526-34-3071
TAX RETURN WAS, (XI ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
95126358
FINANCIAL INSTITUTION. PNCBANK
ACCOUNT NO.
5140425572
TYPE OF ACCOUNT. I) SAVINGS 110 CHECKING I ) TRUST ( I TIME CERTIFICATE
DATE ESTABLISHED 11-01-B2
Account Balance
Percent Ta~eb1e X
Amount Subject to Tax
Debts and Deductions
Ta~ab1e Amount
Tax Rat. X
Ta~ DUB
10,07B.44
0.500
5.039.22
5,667.76
.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
DISCOUNT 1+)
INTEREST 1-)
RECEIPT
NUMBER
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. If PAID AfTER THIS OATE, SEE REVERSE fOR CALCULATION Of AODITIONAL INTEREST. .
I IF TOTAL DUE IS LESS THAN .1. NO PAYHENT IS REQUIRED.
If TOTAL DUE IS REfLECTEO AS A "CREOIT" I CRI, YOU HAY SE ~UE A REf UNO.
SEE REVERSE SlOE Of THIS fORH fOR INSTRUCTION.. I
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