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Home My WebLink About95-00604 ^,\' .,.",' REV-1543 EX AFP (7-951_ CaHHaNW[AlTH Of PENNSYLVANIA DEPARTHtNT Of REVENUE BUREAU Of INDIVIDUAL TAXES DEPT. ZID6Dl IIARRISlURC, PA 11Iu.a601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 q S -<Doy 95136812 08-08-95 \., DONALD EWERT 75 'MARSH DR CARLISLE TYPE OF ACCOUNT ~ SAVINGS CHECKIHG TRUST CERTIFICATE RENIT PAYNENT AND FDRNS TO. REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 ESTATE OF JAC08 M WERT 5.5. NO. 185-03-1224 DATE OF DEATH 05-31-94 COUNTY CUMBERLAND PA 17013 a.;;:.; - ,,, .' PNC DANK ,', h.. provldad tha Dap.rt..nt with tha Infonatlon I htad balow which ha. b..n uud In nlculaUnll the pot.ntlal tax,du.. Th'lrjr.cordp-~p~C.t. that .t tha a.ath of the abov. d.c.d.nt, you w.r. a Joint own.r/b.n.flcl.ry of thl. account. If YOU f"\l~hli Infor..tlon It .t#.aahact, pl.... obtain wrltt.n corr.ctlon fro. the flnenclal In.t1tutlon, attach a copy to thlt fan end r.turn It to tha .bov. .ddr.... Thl. account I, ta..bla In accord.nca with the Inh.rltanc. TaM law. of the C~onwaalth of Pann.ylvanla. Oo...tI""" ..,.. ha ""....r.d by c.lllnll (111) 111.8321. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1760014239 D.to 05-29-84 Eat.bUsh.d Account Dalanca 10, 000 . 00 p.,.cent Taxabla )( 50.000 Aaount Subjact to T.. 5,000.00 T.. R.to X ~O" Pohnt1al T.x Due JtJJD,lJ01-5u. uu PART TAXPAYER RESPONSE CDI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE A. ~ Th. .bova Infor..tlon and ta. due I. corract. 1. You .ay choo.. to raalt pay.ant to the R.gl,t.r 0' Will. with two cop I.. of thl. not Ie. to obtlln . dl.count or .vold Int.r..t, or you a.y chack ba. ~A" and r.turn thi. not lea to the R'lIllt.r 0' Will. and In offici_I ........nt wIll b. I..u.d by the PA n.part..nt of Ravanu.. To In.ur. prop.r cr.dlt to your account, two (2) copl.. of thl. not Ie. au.t accoap.ny your pa~aant to th. R.gl.t.r of Will.. "aka chack p.y.bl. tal "R.gl.t.r of Will., Agant". NOTE I If t.. paY'ant. er. .ad. within thr.. (]) aonth. of the d.c.d.nt'. dlt. of d'ath, you ..y d.duct . 5% dl.count of tha t.x du.. Any Inh.rltanc. tax due NIIl baco.. d.llnqu.nt nlna (9) .onth. .ftar the data of d'ath. [CHECK ] ONE BLOCK ONLY B. c:J Th. abava ....t ha. ba.n or will b. reported and t.. paid with the P.nn.ylvanl. Inh.rltanc. TI. r.turn to b. fll.d by the d.cad.nt', rapruanhtl'II. C. ~ Th. above Infar..tlon I~ncorrect and/o~ebt. .nd deduction. Wlrl plld by you. Y'l You au.t caaplat. PART L!J and/or PART ~ balow. If you indiceta a d1ffer.n~~ ,.ata, pl.... .teta you,. ,..1.t1onlhip to dec.dentl PART [3J TAX RETURN - COMPUTATION OF Lltll! 1. 0.\. Elbblhh.d 1 2. Account Ba1anca 2 3. p.,.c.nt T.xebla 3 4. A.aunt Subj.ct to Tax 4 5. Debt. and D.ductJons 5 6. AMount Taxebl. 6 7. Tax R.t. 7 X a. Tax Dua a OFFICIAL USE ONLY 0 AAF PA DEPARTHENT OF REVENUE PART ~ DATE .:1 ~ TAX ON JoINT~TRUST ACCOUNTS 5"-2..q~B4 10,000.00 5'0.000 5 ,000,00 ~3H.Ii'O ""..:JO . Dc., :'10. tJ q DEBTS AND DEDUCTIONS M PAD 1 2 3 4 5 6 7 8 CLAIMED -"'-"-- PAID PAVEE DESCRIPTION AMOUNT PAID J. .I ~ " - D - TOTAL CEnta,. an L1na S of T x C .Put.tJon) . fact. I have raport.d HOME (il7) WORK ( 1 . GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with appllcabl. Intar..' b...d on Inforaatlon .~Ittad bv the flnancl.1 In.tltutlon. I. Inherltanc. ta. baca.e. d.llnqu.nt nine .onth. .ft.r the dec.d.nt'. data of d.,th. J. A Joint .ccount It t..abl. ev.n thwth the dlcadent'. n..e WI' added .t a ..Uer of convanIMC'. ,. Account. (Including tho.. h.ld b.tw.en hu.band and wl't) which the d.c.d.nt put In Joint n.... within on. v..r prior to de.th .r. full, ta.abl' .. tran.f.r.. 5. Account. ..tabllthad Jointly betwlen hU.band and wlf. ao,. than on. y..r prior to d..th .r. not tIMabl.. ,. Account, held by . decadent "In tru.t for" anoth.r or oth.r. ar. t..~I. fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. ILOCX A . I' the Infar..tlon ~ coaputltlon I" the notlca .r. corract and dlductlon. are not belnll cl.l..d, pl.ca an "X~ In block "A" Q' Part 1 of the ~"lCp'rar RatPon.." .ectlon. Sign two coplu and lutMllt thM with your chick for the MOUnt of tax to the Rlllht.,. of "lilt of thl county IncHutad. Th. Pi Dlpartsant of Rn.nua will luua an offlcl.l .......ent (Far. REV.1541 EX' UPOI'I raealPt of the return froa the R.ght.r of will.. 2. BLOCK.. If the ....t .pacll.ad on thl. notlc. h., b.en or will be raper lad and tlM p.ld with the pann.ylvanl. Inharlt.ncl TI. R.turn fll.d by the dlCld.nt', r.pre..nt.tlv" pilei an ~x~ in block ~.. 0' P.rt 1 of thll -'..pay.r R"pon..~ .actlon. lion ana copy and return to th. PA Olpartlent of R.vanlJll, lur.", of IncUvlctu'l ....., Depl zaaut, tlarrl&burll, PA 17UI-D6Dl In the anv.lope pravldad. ). BLOCK C . If the notlc' Infor..tlon I, Incorr.ct andlar daductlon. ara b.ln, cl.lead, chack block ~C. and cu.pl.t. P.rt. Z and J according to the In.tructlon. below. Slon two capl.. and .ub,lt th.. with your check far the ..uunt 0' ta. p.yabl. to the R.gl.t.r at win. of the ccunt. Indicated. Th. p-, D4ipart-.nt of Aevanua will I..", "" offlchl .........Wlt (fora IfE~-1f,... [XJ upon rec.lpt of tha r.turn froa the Relll.ter of Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Ent.r the date the account orlllln'llY wa. ..tabllah.d or tltl.d In the aanner ..I.tln. .t d.t. of daath. HOTEl for. dac.dant dwlng .ft.r 12/12/aZ, Accounta whIch the d.cedent put In Joint n.... within one (I) y..r of d..th ar. t.ubl. fully.. trlll"e,... tlaw.vu, thare II III allelu.lon not to ..c..d U,ODD par trlll".,.a. ,..gardle.. of the v.lue of the account or the nuaber of .ccount. h.ld. If a doubl. IItarhk (n) app..rs b.fore your first n... In the .dd,.... portion of thh notice, the n,DGD ,Ilclu.lon elr.ady ha. bean dedUctad froa the .ccount b.lanc. e. raport.d bW 'hi flnancl.1 In.tltutlon. 2. Enter the tat.l b.lanc. of the .ccount Including Int.re.t accrued to the det. of da.th. S. The p.rcent of thl account th.t I. t...bl. for ..ch aurvlvor I. det.rslnad .a follawa, A. The percent ta.abl. for Joint ....t. a.tahll.hId .ure then on. y..r prior to the d.cedent'. d..thl I DIVIDED IV TOTAL HUHtER Of JOINT OWNERS E..-pl.' A Joint ....t r.gl.t.rad DIlJlDED IY TOTAL NUttaER OF' X laD . Pf:RCtNT TAXABLE SURVIVING JOINT OWNERS In the n... of the dec.dent .wt two ather parton.. 1 DIVIDED IV J (JOINT DWNERI) DIVIDEn IY 2 (SURVIVORS) . .167 X laD . 16.1X CTAXAllE FOR EACH SURVIVOR) I. The p.rcent t..abl. for ....t. cr..t.d Mlthln on. y..r of the d.c.dan". da.th or .ccount. owned by tha dec.d.nt but h.ld In tru.t fcr another IncUvhtuaU.) (tru.t banaflclarle.), X 100 . PERCENT TAXAllE I DIVIDED IV TOTAL NUNIER OF SURVIVING JOINT OWNERS DR TRUST IENEFlCIARIES EIl.-pl., Joint .ccount r.gl.t.r.d In the n..a of the dac.dant .nd two ath.r p.r.on. and ..t.bll.h.d Mlthln one y..r of de.th by thl dac.dant. 1 DIVIDED BY Z (SURVIVORS) . .50 X 100 . sax (TAXAILE FOR EACH SURVIVOR) 4. The HDUnt .ubJect to t.. (line 4) II d.tarslned by .ultlplYlng the account b.lance Uln. 2) by the percant h.abl. Uln. S). 5. Ent.r the tot.l of the dabt. and d.ductlon. II.ted in P.rt S. 6. Th. uaunt h.abl. Uln. 6) It detaraln.d bw .ubtr.ctlng th. dabt. and dadUctlon. Clln. 5) fro. tha .eaunt ,ubJact to tile Clln. 4). 7. Ent.r the approprl.t. t.. rat. (1In. 7) .. dater.lned b.lav. A. For dat.. of da.th occurrlnll .ft.r 6/S0/9", the tax rat.. for tran.far. to .paul.. .r. .. follow.' I. D.t.. of da.th on or .ftar 7/1/94 and befora 1/1/95 the r.t. I. sx. 2. D.t.. of d..th on or .ft.r 1/1/95 trlll.f.r. to .pou.a. MIll be ta.ad .t ax t.. ret.. Hotel for dat.. 0' d.ath prior to 1/1/9" trill' fer. to .pou... .ra t..lble at 6X. I. Trlll.f.r. to Ilne.l d..cendant. lncludlna f.ther, .other, .on, daught.r, grandchildren, .an.ln-Iaw, d....hr.ln.I..., .t.pchlld and theIr luu' are t...ble .t .iIl percent (6X). C. Tran.far. to ,U othert Including brottMir, .lIt.,., uncle, aunt, nephew IINI nl.ce arB t...bla at fllt.an percent UU). D. If YOU change the ta. rat., pl.... .paclfY your reletlonshlp to ttMi d.c.dent In the .r.. provIded. a. The uount of ta. due Ulna a) It d.tenlnad by aultlpJylng lhe .sount t..able Ulna 6) by tha t81l rata Uln. 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. debt. and deduction. .r. det.rslnad a. follow.' A. You lag.l1v are rllpontlbl. for p.)'aent, or the ..tat. lubJ.ct to adalnlttratlon bW a personal rapr..."t.tI.,e It In.ufflcl."t to P.V the dedUctlbl. It.... I. You .ctuallw p.ld the d.bt. .fter d..th 0' the d.cadent and can furnl.h proof of payaent. C. Debt. being clal..d au.t b. It.,I,ad fully In Part S. If addItional .p.c. I. n.ed.d, u.. plaIn papar I 1/2" . 11-. Proof of paY88nt .ay b. r.qu..ted b)' the PA D.p.rt8ant of Revenue. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASS1STANCE. CONTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TOO' (717) 772-2252 (HEARING IMPAIRED ONLY) (l REV-1543 EX AFP 17-951_ Ca""ONWfAlTH Of PEHHSYlVAHIA DEPAATHENT Of' REVENUE BUREAU OF INDIVIDUAL TAXES OEPT. 280601 HARRISBURG, PA 111Z8.D6al INFORM4TION NOTICE AND TAXPAYER RESPONSE FILE NO. 21" qS "';'04 ACN 95136815 DATE 08-08-95 ESTATE OF JACOB M WERT 5.5. NO. 185-03-1224 DATE OF DEATH 05-31-94 COUNTY CUMBERLAND TYPE OF ACCOUNT ~ SAVINGS CHECKING TRUST CERTIFICATE RE"IT PAY"ENT AND FDR"S TOo REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 DONALD EWERT 75 MARSH DR'- CARL~~LE ' PA 17013 --, .- ,., PHC DANK I h.. prolllded the D.partaant with tha Infar..tlon lltt.d b.lolll which hat bean uud In calcul.tlng the pat.ntl.. tax due. Thalr r.cord. Indlc.ta that .t the d..th of the obav. d.c.dent, you w.r. . Joint awn.r/ban.flcl.ry of thl. account. If you f.. I thl. Infor..tlon I. Incorrect, pl.... obtain wrltt.n carr.ctlon fro. the flnancl.1 In.tltutlon, .ttach . COpy to thl. for. and raturn It .tq.,\!,' abav',.ddra..... !!lis .ccount It t.xabl. In accordenu with the Inharltanc. Tax law. of the Co_onw..1th 0' PlMnlvanl.. g,...tlo"_ ~""'-Q. _._raft'hy r.~1tI1t"1017l 187-"'27. COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1760014240 D.t. Ed.bUahed 05-29-84 To Insur. prop.r cr.dlt to your .ccaunt, two (21 copl.. of thh notln ltU.t .cco..-..,y your pay.ant to the R.gl.t.r of Will.. H.k. check payabl. tal ~A.gl.t.r of WIll., Agent~. Account D.bnc. 10,000.00 Percant Taxabla )( 50.000 Aaount Subjoct to T.. 5,000 . 00 Ta. Rata X .~ .CXO Potantlal Ta. Dua 11>0.0<> 7SB . Q&- PART TAXPAYER RESPONSE CDI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL lAX ASSESSHENT BASED ON THIS NOTICE A. 0 Th. above Infar..tlon and taM due It correct. 1. You ..y choo.. to r..lt pay.ant to the R.gI,t.r of WIll. with two cop I.. of thl. notlc. to obtain . dhcount or Ivold Inter..t, or you .ay check box ~A~ and r.turn thh notlc. to thtl Rqht.r of will, and an offIcial a.......nt wIll b. I..uad b~ tha PA D.p.rt..nt of R.venu.. HOTEl I' t.x p.y..nt. .r. .ad. within thr.. I!>> .onthl of the d.c.dent'. date of d.ath, you ..y dedUct . 5X dl.count of the tax due. Any Inh.rltance t.x due will b.co.. d'llnqu.nt nln. 19J .anth. .ft.r the data of d..th. [CHECK ] ONE BLOCK ONLY I. c:J Th. above ....t hat b..n or wIll b. report.d and t.x paid with the p.nn.wlvanl. Inh.rltanc. '.x return to b. fll.d by the dec.d.nt'. r.pr...nt.tlv.. C. ~. abo". Infar..tlon I~ncorr.ct and/o~abt. and d.ductlan. w.ra paid by you. ~ V;u BU.t coapl.t. PART l!J and/or PART L!J b.low. If you Indic.ta . dlffar.nt~~r.ta, pl.... atat. your rel.tionship to d.cedantl OFFICIAL USE ONLY 0 AAF PA DEPARTMENT OF'REVENUE PART I!I TAX RETURN - COMPUTATION LINE 1. O.t. Eatabltahad 2. Account Dalanc. 5. Percent T.xabl. 4. AMount Subj.ct to T.x S. Debt. .nd Deduction. 6. A~ount Taxabla 7. Ta. Rate 8. TalC Due OF 1 2 3 K 4 5 6 7 X a TAX ON JOINT'TRU~T ~CCOUNTS r . ., ~ ,,~ CJ -5.L.!:.S..l!t..- . 10.000. on ., 5"0 5,000.00 <>- 5"Oco.oo . C\l" " ?OO.oO PART @] DATE DEBTS AND DEDUCTIONS PAD 1 2 3 4 5 6 7 8 CLAIHED PAID PAYEE DESCRIPTION AMOUNT PAID I TOTAL IEnt.r on Line 5 of T.x COMPutatton) parjury, I decl.r. that tha fact. I MY kn wladge .nd beli.f, I . hay. reported .boye .ra tru., corract and 17/7 1 21r1"~j:zS" ~ ,~ I 1 fj"1</-5I5 '!!ATE HOME WORK GENERAL INFORMATION I. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHEHT with appllcabl. Intar..t b...d on Infor..tlon .ubelltt~ b thli fInancial In.titutlon. r, Inherltanc. t.x bacoaa. d.llnquent nine aonth. aft.r the d.c.dent', d.t. of d..th. S. A Joint IcOOunt 1. taMabl. .van though the d.c.dent'. n... w.. added .. . ..ttar 0' cony,"l~a. 4. Account. (Including tho.. held betw.en hu.band and wife) which the dle.dant put In Joint ".... within on. v..r prior to ~.th Ir. fullV taxable .. tren,f.rl. S. Account. ..tlbll~ Jointly batw.an hu.band end wlf. .ur. th.n on. ya.r prior to d..th art not t.xable. 6, Account. held by . decadent Rln tru.t for" anoth.r or other. .r. t..abl. fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE I. BlOCl A . If the Infor..tlon and coaputatlon In the notlc. .r. carr.ct and d.ductlon. .r. not baing 0111..0, plac. an "X. In block ~A~ of P.rt 1 0' the ~'..p.)'ar R..pon.." ..ctlon. Ilgn two cOP." and tubalt thM wIth vour chKk for the MOUnt of t.. to the Rlgl.tar 0' WillI of the county Indlc.tad. The PA Dapart.ant of Rlvenue will I..u. an officIal ......aant (for. REV-I'" [X) upon r.cllpt of the return fru. tha RIII.t.r of Willi. Z. BLOCK. - .f the ....t ,pacified on thlt notlc. h.. b.an Dr will b. r.port.d and tlM p.ld with the P~.ylvenl. Inherltanc. ,.. R.turn '11ad bv the dacadent'. r.pr..antatlv., pl'c, an ~X~ In block ".~ of P.rt 1 of tha "l..p.y.r R.tpon.a- .aotlon. Ilan one copy end r.turn to the PA a'P.rtaant 0' Revenue, lur.au of Indlvldu.1 ,...., D.pt 'la6Dl, Harrl.bur., PA 171Z8-a'Dl In the env.lope provIded. ., JI , I It 5. .LOCI C - I' the notlc. In'or..tlon I. Incorrect and/ar d~ctlon. .r. b.lng cl.l.ed, check block ~C" ~ coapl.t. p.rt, Z ~ J acClordlng to thll In.tructlon. below. SIgn two coplat ~ .ubIIlt th.. .,lth your ch.ck for thtl MOUnt of talt payabb to thll Rqllht of tUU. (01 the cCKont. 1....c!1nt.d. Tht>;:1o DoIp.r'.. It of """anua wilt. h.", ." affla...l ,u~"'ent '''or. R!Y"U'" UU upotl rea\lpt of the raturn fr~ the Ralll.t.r of Will.. TAX RETURN - PART 2 - TAX COMPUTATION UN! I. Ent.r the data the account arlglnallv w.. ..t.bll.hed or tltl.d In the .anner .xl.tlng .t d.t. 0' d.ath, HOTEl for a decadent dying .ft.r 12/12/121 Account. which the d.cad."t put In joint n.... within Dna (1) v..r 0' de.th ara t.xabl. fullv a. tran,'.r., Howev.r, thera I. an .xclu.lon not to .xclad 'S,aDD par tr~.f.ra. r...rdl'" 0' the value 0' the account or the ~r of account. held. If a doubla a.t.rl.k (MM) appe.r. b,'ora your 'Ir.t na.. In thtl addr... portion 0' thl. notlca, the tS,aaD aMclu.lon alraady he. be.., daductMl frOll the IICCCM\t balanc. at reported by the flnancl.1 In.tltutlon. Z. Ent.r thtl tot. I balanc. 0' the account Including Int.r..t .ccrued to the d.t. 0' d..th. S. The parc..,t a' the acCCM\t that I. t.xabl. for lach .urvlvor I. datar.lnad .. follow'l A. The percent taxabl. for Joint ....t. attablhMd IIOra than one valr prior to the decactant". dtlathl ( 1 DIVIDED IY TOTAL NUftIER Of' JOINT DVHERS Ex.-pl.. A JoInt ....t r'lIl.t.r.d DIVIDED BY TOTAL HlJltIEA (W X lOa - POeEHT TAXAllE SURVIVING JOINT OWNERS In the n... of tha decadent ~ two other parton.. 1 DIVIDlO IV 5 (JOINT OWNERS) DIVIDED IY 2 (SURVIVORS) . .167 X laD - 16.7X (TlXAILE fOR EACH SURVIVOR) I. The percent t.x.bla for ....t. cr.atad wIthIn ona y..r of the d.c.dent". d..th or lecount. owned bV the d.c.dent but hald In tru.t for ~thar IndlvlduaU.) (tru.t baMflolarlat)' 1 DII/IMD BV TOTAL NUttIER Of SURVIVING JOINT OWNERS OR TRUST BENEfiCIARIES Ex...I.. Joint IIOCOU\t raghterad In the n... of the dec.dent Met two other parton. and attablhhad within one yur of death by the d.cad....t. 1 DIVIDED BV Z (SURVIVORS) . ,sa K 100 . sax (TAXAIlE fOR EACH SURVIVDR) X 100 . PERCENT TAXABLE 4. The aaount .ubJ.ct to t.x (line 4) I. d.t.ralned bV .ultlplYlng the account balanc. Cline 2) by the p.rcant taxabl. ClIne S)" 5. Ent.r the tot.l 0' the debt. and deductIon. II.ted In Part S. 6. The.-aunt t.Mabla Cline 6' I. det.r.lnad by .ubtr.ctlng the d.bt. .nd d.ductlon. (1lna 51 'roa the .-aunt .ubJaat to taM (line 4). 7. Ent.r the APproprl.t. t.x r,ta Clln. 7) .. d.t.r.ln.d b.lo~. A. ror d.ta. of d..th occurring .,t.r 6/SD/94, the t.M rat.. for tran.f.r. to .pou... .r. .. follow.. 1. a.t.. of d..th on or .ft.r 7/1/94 and b.fora 1/1/95 the r.t. I. S%. Z. Dat.. of d..th on or .ft.r 1/1/95 tran.f.r. to .pou... will b. t...d at OX t.x r.t.. Not.. for dat.. of death prIor to 7/1/94 tran,f.r. to .pou... ar. t.xabla at 6%. I. 'ran. f.,.. to l1".al de.cand8nta InclUding fathar, IIOther, .on, daughter, IIrandchl1d,an, ton-In-I..., d.uQht.r-ln"I..., .t~lld and ~lr I..ua ar. t.xabl. .t alx percent (6X). C. Tran.f.r. to all other. Including brother, .I.t.r, uncIa, .unt, n.phew and nl.c. .r. t.xabl. .t flft.-n parcent (15%), D, If you chenga the tex r.t., pl.... .p.clf1 your r.l.tlonshlp to tha d.c.dent In the .r.. provldad. I. The.-aunt of t.M due (line I) I. dat.r.lMad by aultlplylng the .-aunt t..abl. (line .) by the t.M r.t. (lIne 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabla d.bt. and deductIon. .ra d.t.r.lnad .. follow.' A. You 1...lly ara rltpan.lbl. for payaant, or the ..t.ta .ubJect to 8dalnl.tretlon by . per.anal r.pr..ant.tlv. I. Intufflclent to pay the deductlbla It.... I. Vou actuallv p.ld the dabtt aftar death of the dac.dant and can furnish proof 0' p.,..nt. C. Debtt baIng cl.IMd .u.t be It..lud fully In Part S. If addltlon.l .p.u h n.aded, u.. plain paper I IIZ" M U... Proof of p.yaant ..y be r....tad by the PA Dap.rt...,t of Ravanua. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORHATIONOR ASSISTANCE; CONTACT ANY REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE " :'> OR CALL THE BUREAU OF INDIVIDUAl. TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IHPAIRED ONLY) ""', - .- -- .~ .~, .- . , - , ~------'---"- -,.--- -.------ ----------- ---- -- - ----'--- -'-~--'- _-_>.J'J_~.'\:'-:~,:_<,~" __ _ "__, -.: '.'--. , .,.,'~,~:.,.., '.' ;..' " -. 0"".1. :,}:A": '-'A'-',,",..'O' '4..'8' 1'0.' S'.').COM.". M.o." N,' WE. ALTtf,OF,PENNS, "ya;,,~, ','A, NIA ., ,~~ ..,', ,;i '),!,' ,DI'AIyro\INTO.RIVINUI:',' " ,..;;.'w "I'~~ ,,' ' OPfICIAL RECEIPT epENNSYLVANIA INHERITANCE AND ESTATITAX '.'.'" ," .' --':,;'~' :. , . . - , ' , , ..."..' ~ RECEIVED FROM. & ACN ASSESSMENT Ii' CONTROL ~ NUMBER AMOUNT DONALD E. WERT 715 MARSH DR. 9:1 HlbEUe .'+1. -/~ 9:513681:5 .311.30 ..fotOtlll' ,otO""' CARLISLE, PA 17013 ESTATE INfORMATION, I!:'I ILE NUMBER ~ 21-199:5-0&04 SBN IS3-03-1224 EJ NAME Of DECEDENT (LAST) (fiRST) (Mil II DATE Of PAYMENT B POSTMAR COUNTY DATE Of 0 ATH m TOTAL AMOUNT PAID REMARKS .3153.03 PB RECEIVED BY)',. .. < . ../' .1..<" .- " J. ../ .' / \10NATUJE,"'; ( . ~ ~:. . / ..,(";' ,-:;/i'd'"", r MARV C. L.EWIS REGISTER OF WILL.S DONAL.D EWERT SEAL CHECK. 3444 REGISTER OF WILLS ~..~._' ___ _ ___.-.-'- _ _ __ __~_ ~ _ ___ ~ ~_~ _ _.--..- --. - -,- ..-o:.-,~-_- -:---r ------.,.....-- ! I t. ., o.. ~ ~ .' . n__' II"~ .. . .... ."_m -- '" 4':.., . I < --'.... r-- .-~..jJl DEPARTftENT OF REVf.J<<.IE BUREAU OF INDIVIDUAL TAXES DEPT. n0601 HARRISBURG, PA 17U8-D6Dl Dr DEDUCTIDN4, AND ASSESSKENT Dr TAX OH JOINTLY HELD DR TRUST ASSETS DATE 10-02-95 COUNTY CUMBERLAND ESTATE OF WERT JACOB M DATE OF DEATH 05-31-94 FILE NO. 21 95-0604 S.S/D.C. NO. 185-03-1224 DONALD EWERT 75 HARSH DR CARLISLE PA 17013 ACN 95136815 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ...... Rifv:islri-Ejf-AFii-riif:94")------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-02-95 REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 A.ount R..ltt.d ESTATE OF WERT JACOB M DATE OF DEATH 05-31-94 COUNTY CUMBERLAND ACN 95136815 FILE NO. 21 95-0604 TAX RETURN WAS. S.S/D.C. NO. 185-03-1224 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION. PNC BANK ACCOUNT NO. 1760014240 TYPE OF ACCOUNT. () SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE DATE ESTABLISHED 05-29-84 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . IF TOTAL DUE IS LESS TH4N II, NO PAY"ENT IS REQUIRED. IF TGTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I Account Bahnce Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rote X Tax Due 10,000.00 0.500 5.000.00 .00 5,000.00 .06 300.00 TAX CREDITS: PAYMENT DATE 08-14-95 RECEIPT NUMBER AA048105 DISCOUNT (+) INTEREST (-) 12.37- INTEREST IS CHARGED FROM 08-15-95 TO 10-10-95 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM . NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE U~PER PORTION OF THIS NOT~CE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYAOLE TO. "REGISTER OF WILLS, AGENT." AMOUNT PAID 311. 30 298.93 1.07 .02 1. 09 I.Oq C~AlTH OF PENNSYLVANIA DtPAATHEHT OF REvtHUE IUREAU OF INDIVIDUal TAXES DEPT. ua6G1 ttARRISIURO, PA 17U8-UGl - nUIj,\.Co ur j,l1nLft.Lln"i,i,;,&;'--inft APPRAISEKENT. ALLDXANCE DR DISALLDMA"CE Dr DEDUCTIDN.t. AND ASSESS"ENT OF TAX 0" JOINTLY KELD DR TRUST ASSETS DATE 10-02-95 ESTATE OF WERT JACOB M DATE OF DEATH 05-31-94 COUNTY CUMBERLAND FILE NO. 21 95-0604 S.S/D.C. NO. 185-03-1224 ACN 95136812 DONALD EWERT 75 MARSH DR CARLISLE PA 17013 REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 A.aunt R..tttMl CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rifv=isiii-iiC-AFP--ri1i:94i--..---------------.------------.-------------------------------------------.------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONs, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-02-95 ESTATE OF WERT JACOB M DATE OF DEATH 05-31-94 COUNTY CUHBERLAND ACN 95136812 FILE NO. 21 95-0604 TAX RETURN WAS. S.S/D.C. NO. 185-03-1224 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION. PNC BANK ACCOUNT NO. 1760014239 TVPE OF ACCOUNT. () SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE DATE ESTABLISHED 05-29-84 Account Balance Percent Taxable X Amount Subject to Tax Debt. and Deduction. Taxabl. Amount Tax Rat. X Tax Due 10,000.00 0.500 5,000.00 4,331.80 668.20 .06 40.09 TAX CREDITS: PAYMENT DATE 08-14-95 RECEIPT NUMBER AA048105 DISCOUNT (+) INTEREST (-) 1.65- NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE U~~~R ~ORTloN OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAVABLE TO. "REGISTER OF WILLS, AGENT." AMOUNT PAID 41. 73 40.08 .01 .00 .01 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL IHTEREST. . I IF TOTAL DUE IS LESS THAN '1, NO PAY"EHT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A '.CREDIT" ( CRJ, YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I INTEREST IS CHARGED FROM 08-15-95 TO 10-10-95 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM /5_'/9-10 " '../ v \ DATE NOTICE OF INHERITANCE TAX APPRAISE"ENT, ALLDMANCE DR DISALLDXA"CE OF DEDUCTION5, AND ASSESSME"T OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (12-94)*1 CQHHOHWEALTH OF PENNSYLVANIA OEPAATHEHT Of REVEHUE BUREAU OF INDIVIDUAL TAXES DEPT. Z8D6Dl HARRISBURG, PA l11Z8-D6Dl 10-02-95 M DATE OF DEATH 05-31-94 COUNTY CUMBERLAND ESTATE OF WERT JACOB FILE NO. 21 95-0604 S.S/D.C. NO. 185-03-1224 ACN 95136812 REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CD COURT HOU5E CARLISLE, PA 17013 DONALD EWERT 75 MARSH DR CARLISLE PA 17013 A..ount R..ltt.d CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ R-EV:iSiri-Eif-AFii-ri1f:94i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLV HELD OR TRUST ASSETS DATE 10-02-95 ESTATE OF WERT JACOB M DATE OF DEATH 05-31-94 COUNTY CUMBERLAND FILE NO. 21 95-0604 TAX RETURN WAS. S.S/D.C. NO. 185-03-1224 IX) ACCEPTED AS F1LED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION ACN 95136812 FINANCIAL INSTITUTION. PNC BANK ACCOUNT NO. 1760014239 TVPE OF ACCOUNT. () SAVINGS ( ) CHECKING ( ) TRUST I lO TIME CERTIFICATE DATE ESTABLISHED 05-29-84 Account Balanca Parcant Taxable ~ Amount Subjact to Tax Debts and Deductions Taxable Amount Tax Rate ~ Tax Due 10.000.00 0.500 5,000.00 4,331.80 668.20 .06 40.09 NOTE. TO INSURE PROPER CREDIT TO VDUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK DR MONEY ORDER PAYABLE TO. "REGISTER OF WILLS, AGENT." TAX CREDITS: DISCOUNT (+) lNTEREST (-) 1.65- AMOUNT PAID 41. 73 PAYMENT DATE 08-14-95 RECEIPT NUMBER AA048105 . TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · IF TOTAL DUE IS LESS THAN '1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU "AV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I 40.08 .01 .00 .01 INTEREST IS CHARGED FROM 08-15-95 TO 10-10-95 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM on ,,.; .u:U c: in =i UI .. Cil ~, , F~J -, I .". -0 ..1 '1J '" r~ :t.. '"~ 1-_1 -.J IUl'OSl!: at' HQnCEI Ta fulfill the requlr..-ntl of section 2140 of the rnherlt~. and E.t.t, T.x aot, Act 22 of .".. (72 P.'. SMtlon 214D). "WENT I DetKh th4I top portion of thh Notle. -.d .....It with your p.,..,..t to the A..iltar of WUh printed on the rrnr.. sieta. __ HIlk. dMck or aonoy order payable tOI REOISTER OF WILLI, ACEHT. All P'YMI'It, racllvlld shIlll flr.t 1M .,1111d to MY Inter..' Which "V' be due, ..Un ....., r...lnclar IlPPIII1d to ttMI hie. REF\.fID (CA', A rafloond 0' . t.M credit, which w.. not reque.tlld on the tll( return, ..v b. ,."".atad by cDl!PllUnt .... "AppllceUon for R,fund of Pann.ylvenl. Inharlt~e and [,tit. T... (REV-ISIS). Appllc.tlon. .r. .v.II~I. .t the Of'lce of the A-e.lt.r of Willi, any of the 2S R.v~ DI.trlct 0"101' or by CIlllng the ,paclll 24-hoUr an.w.rlnt ..rvlcl nuabar. for 'or.. orderlngl In Pann'Ylvanll 1-110-562-2050, out.lda pann..,lvanl. .nd within local Harrlabur. .r.. (717) 7'7-ID94, TOO' (717) 772-2252 CHa.rlna lap. Ired Only'. OBJECTIONS I Any p.rty In Int.r..t not ..tlsfled Nlth the appr.I...-nt, ,11ow8nCI or dl..llowanc. of dedUCtion. or ......eant of tax (IncludIng dIscount or Int.re." I' thown on thl. Hotlc. ..., object withIn ,Ixty (60) day. of "cllpt of this Matlca bVI .~wrltt'" prote.t to the PA Dap.rt.-nt of R.v~, lo.rd 0' Appa.l., Dept. 211011, H.rrl.bura, Pi 11111-10rl, DR u.I~t1ng to h.ve the Nth,. eMter.lned .t the audit a' the KCCMlt of the perton.1 r...ruent.tlve, OR --~.1 to the Orphan.' Court ADMIN- ISTRATIVE CORRECTlONSI Factu.l error. dllcov.r.d an thl. .......-nt .hould be addra..ed In writing tal P' D....rt.ant 0' R.VInUl, Bur.su of Indlvldu.l T...., 'TTNI Pa.t ......eant Rlvlew unit, DEPT. ZIO'OI, H.rrlsbura, P' 17111-0'01 Phone (7.7) 7'7-'SaS, S.. Pili' 5 a' the bookl.t "In.tructlan. for InherItance 'ax R.turn for a R..ldant Dacadant~ (REV-1S01' 'or en ..planetlon of adalnl.tr.tlv.lv correctabl. .rror., DISCOUNT I If enV t.M duI I. p.ld within thr.e (5) c.landar aonth. .ft,r tha decedent', d..th, a flv. parc,"t (IX' dl~ount of the ta. paid I. .llowed. INTEREST I Inter..t II ch.raad beginning wIth 'Ir.t d.y 0' dellnquencv, or nIne (9) sonth. ~ ana (I) dlV 'rH the d.t. of de.th, to the d.t. of pe)"Mnt. TaMil whlth bee... eMillnquMt bafon JMUarv 1, I"Z bear Int.r..t at the r.te 0' ,1M (6~) p.rcent par annua c.lculated .t a dallv r.te of .0001". All t.... whIch bac... d.llnquent on or ,'t.r January., .'11 will bier Intar..t at . r.ta which will vary 'rH c.landlr y..,. to calWMIar va.,. with thait rat. WIl'MU\CK bV the PA Oapart-.nt a' A.yanua. The appllcllbl. Int.r..t r.te. for I,az through 1"5 .r" .911 .'13 "14 1915 ".. utnt.rut 20X .6X llX UX lOX I. c.lcul.ted ., .ODO"'I .DanS8 , DOOSDl .DODS" .000174 foll.'1 Iur Int.r..t R.te D.llv Inter.t:t Fletor 1917 OX ,000147 I'll-Uti llX .oanol .... .. . oaOl47 l"S"l994 'X ,ODOltZ I"S OX .000147 'till: lnt.,.e.t Rate DlIIllv Int"red FlHltnr INTEREST . BALANCE OF TAX UNPAID X HUKBER OF DAYS DELIHQUENT X DAILY INTEREST FACTOR -"Anv NotIce ItlUld .,t.r the taM bacoaa. delinquent wIll r,'lact an Inter..t calcul.tlon to fll',," (II) eMi,. bayonet the data of tho .....Plnt. 11 pev-nt Is Nda 1ft.,. Uti Intarut coaput.tlan data .hown on the NotlC', eddl t10nal Int.rllt au.t be calculated. ,/ /5-'19-10 ('..- REV-1548 EX AFP 112-94)* (OHHQNW(ALTH OF PENNSYLVANIA DlPAATHENT OF REVENUE lUAfAU or INDIVIDUAL TAXES DlPT. 111601 twlRI'IURO, PA 171UaD6Dl NOTICE OF INHERITANCE TAX APPRAISE"ENT, ALLDXANCE DR DISALLDMAHCE OF DEDUCTION... AND ASSESS"ENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-02-95 ESTATE OF WERT JACOB M DATE OF DEATH 05-31-94 COUNTY CUMBERLAND FILE NO. 21 95-0604 S.S/D.C. NO. 185-03-1224 ACN 95136815 DONALD EWERT 75 MARSH DR CARLISLE PA 17013 REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Allount ReMitted CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rirv:isiri-iif-AFii-ri1f:94i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-02-95 ESTATE OF WERT JACOB M DATE OF DEATH 05-31-94 COUNTY CUMBERLAND FILE NO. 21 95-0604 TAX RETURN WAS. S.S/D.C. NO. 185-03-1224 (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION ACN 95136815 FINANCIAL INSTITUTION. PNC BANK ACCOUNT NO. 1760014240 TYPE OF ACCOUNT. () SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 05-29-84 Account Bahnca Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 10,000.00 0.500 5,000.00 .00 5,000.00 .06 300.00 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 1 PAYMENT DATE 08-14-95 RECEIPT NUMBER AA048105 DISCOUNT (+) INTEREST 1-) 12. 37- AMOUNT PAID 311 .30 . TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · I IF TOTAL DUE IS LESS THAN t1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREOn" I CRI, yOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) 298.93 1. 07 .02 1. 09 INTEREST IS CHARGED FROM 08-15-95 TO 10-10-95 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM (")(') ~ fl; -0 Ul r:~1 l..-; ..... I b. I, " loJ :r ~ P-.;, -J P\.lIIPII1E OF NOTlCEI To fulfill the raqulreaent. of Sactlon 2140 01 the Inheritance ~ Estat. T.. Act, Act 22 of .991. (72 P.I. 'action ZI40). PAYHENTI :n :tJ (1) , {.) VI C!, Detach the top portion of this NoUce end .ubIlH with your plpant to t.. Aeghhr of Wills prInted on the r.y.r.. .Ida. -- KIka cMck or MMY order pay_I. tal REOISTER OF WILLS, ACENT. All p.penta rae.lved ahllll flrat tt. applied to ..,y Inter..t which .ay be due, with MY ,....lnder .,.l1ad to the t... REFUND (CA), A r.fund of . tax credit, which .... not raqu..tad on the talf return, ..y ba raquattad by coapl.Uno en "AppUc.Uon for Rafund of Ptnn.ylvlII1l. Inharlt~a end E.tate T.x" (REV-ISIS). application. ar. .v.l1~1. .t the a,f1cI of ttM Register of WUls, any of the 23 Rlv,"", Dlttrlct OffICII 01" by cIUlna thai .peclal 24"hour Mt'lHIrlna IIrvlca nuabar. for for.. ordarlng. In Penn'vlvlII1.' l-aaO-S6Z-ZD5D, out. Ide PannlylvlII11. end wIthIn local H.rrltburg .ra. (117) 717-1094, TDD. (717) 172-225Z (He.,.lng Jllpllrad Onh). OBJECTIONS I Any party In Inter..t not .atlsfled with the apprah"ant, .1Iowanc. or dbaUowanc:1 of deduCUonl or ........"t of ta. Uncludlng discount or Interest) .. shown on this Notice ..y object within .b:ty (60) d.n of rec.lpt 0' thl. NoUc. bYI ......ritten prot..t ta tha PA Depart...,t of R.venue, loard a' App..h, Dept. 281021, Harrhburg, PA 17128-1021, OR ...lacUna ta have the aattar datar.ln.d at the IMJdIt of the account of tM parsanal reprllantatlva, OR ....epp..l ta the Drphan.' Court ADHIN... IITRATlVE CORRECTIONS I Factu.l .rror. dl.cav.red on thl. .........,t .hould b. addr...ad in wrIting tal PA o.p.rtlant of R.venua, lur.eu af Individual TIM", ATTNI Po.t A.....-.nt R.vl... Unit, DEPT. 210601, Harrl.burg, PA 171za.06al Phone (717) 787.6505. I.. peve J 0' tha bookl.t ''In.truatJDfl. for Inherltenc. Ta. Raturn fo,. . Rat'dent Dac.ant.. (REV-15aU fo,. an ,kpllN"l'Uon 0' ect.lnhtreUvah' correotabla error., DISCDUNTt If MY tax due It paid ..lthln three U) cahndar .onthl aftar the d.c.dent', d'ath, a five parcant U:CJ dltcount of the t.. paid It .Uowed. INTEREST I Int.re.t I. charllftl bqlnnll'lll ..Ith first dey of d.Unquency, or nine (9) aanth. and an. 0) d.y frOll the d.t. of d..th. to ttw d.ta of pev-ant. T.... which bac... delinquent b.fare January 1, I'" bear Int.r..t .t the r.t. of .Ix (6:C) p.rcent p.,. annua calcul.ted .t . d.lly r.t. 0' .DODI6~. All t.... which bee... dtIl1nquW'lt on or .ftar January 1, 1'8Z wIll bear Inter..t at . r.t. which will vary fr. calend.r y..r to c.lend.,. y..,. ..I th th.t rat. l!n1OUnCed by the PA Dap."t...,t af R.venua. The eppllcabl. Intar..t rat.. for 1912 throug, 1995 "" tur Inter..t Rate D.I1." Inter..t Facto" tur Int.r..t Rat. D.llv Int.r..t Factor 1'82 'OX . Da 0 548 1987 'X ,000247 1'81 16% .Daoue 1'&1"'1991 IIX .000101 I... IU .000501 I'" 'X .000247 1'85 UX .GDOSS6 1995"'1"" 7X .0001tt I'" lOX .000274 I'" 'X .DaU47 ulnt."..t h calculated .. folio.,.. llITEIlEIIT .. BALANCE OF TAX UNPAID X HUnBER OF DAYS DELInqUENT X DAILY INTEREST FACTOR uAny HoUc. I..u.d .ft.,. the tax bleD... d.llnquent .,111 ".flect ., Intere.t c.lculatlon to flfta.., CUJ dan beyond the data of the ..........t. If papant h .... .fhr the Inter..t coaputaUan det. thawl an the Notlc., addItional Int.r..t lU.t be c.lcul.ted. 15~L/q-/O o J REV-1607 EX AFP (12-94* CDtttOHWEALTH Of' PENNSYLVANIA DEPAAntEHT OF REVEJrIJE IUREALI CF INDIVIDUAL TAXES DEPT. Z8D6D1 HARRISBURG, PI 17121-0601 ACN 95136815 XNHERXTANCE TAX STATEMENT OF ACCOUNT DATE 10-30-95 WERT JACOB M FILE NO. 21 95-0604 05-31-94 COUNTY CUMBERLAND HOTE. TO INSURE PROPER CREDIT TO YOUR ACCDUlfT, SUMIT THE UPPER PORTIlIH OF THIS FDRH WITH YOUR TAX PAYHENT TO THE ADDRESS SHOlIIl. HAKE CHECK PAYAIILE AND REHIT PAYHENT TO. , DONALD EWERT 75 MARSH DR CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AlIOUI'lt RM1Uod CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ ifili:ii.li'f-ijf-"pji-liZ'=94i------..ii-iiiifiiiiTANci'"i'Aif"si'A"iiiiENi'-oF-Alfciiuiii--iii.--------------------- ESTATE OF WERT JACOB M FILE NO. 21 95-0604 ACN 95136815 DATE 10-30-95 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOlIIl BELDlI IS A SUHIlARY OF THE PRINCIPAL TAlC DUE, APPLICATIlIH OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT. 09-25-95 PRINCIPAL TAX DUE.. 300.00 PAYMENTS CTAX CREDITS). PAYMENT DATE 08-14-95 10-11-95 RECEIPT NUMBER AA048105 AA082216 DISCOUNT C+) INTEREST C-) 12.37- .02- AMOUNT PAID 311.30 1.09 a IF PAID AFTER TNIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL OUE IS LESS THAN 'I, HO PAYHENT IS REquIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FDRH FOR INSTRUCTIONS. I TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 300.00 .00 .00 .00 '. \':"" I LJ.; ,~ I ;) , " :J du PA'nEHT1 Debch the t.... porUOI"I .f thh NoUce MIl ......U .lth WOU,. p~t .... ,..1. to the ~ ... Mldr... print. 01"1 the rev.,... '.eN. If RESIDENT tl:CCIEHT ... chack or .....~ order pa_.. to. REGISTER Of WILLS, AGENT. If HON-AUIDDfT DEClDENT ... check or ....v orde,. P8pbl. tal CotltOHWEALTH OF PEtlGYLVAHIA. All ~h racalvad thal1 be ..-1led lint to .". Int.nlt ""left -v be due wIth MY r_lnder ..II" to the ta. RUlICD (CAh . rofund of . tu credit, which .... not r.qu..t-.t on the Tu: .atum, ..v be ,.....t.. by c....I.Ung an "appUceUon for R.f\nI of Pann,ylvanl. Jnne,.ltMC. ... Elt.t. T..~ (fI[Y-IJlU. AppllCIIUono .r. ."..bbl. at the O,fll* of thIi R......,. of Wllh, wrr of the ZJ R...,.,.. Dhtrlct Office. or 'rCMI the o..rt..t'. Z4-haur .......rlng NrvlcD nuaDart ,or fo.... ardtlrb,.. In ...-.,nlnnl. 1.111-561-2151, out"" PWW'lIY1VW11. ..J ..Ithl" local Harrhburl ar_ (717J 7.7"IOM, TUDI (717) nz-zzsz <<......1... 1_I"ad onhrJ. RQlL't Tal o...t1on. ,..prdlng .rror. contaIned on \hie notle. ahoUld bo IIddrauad tal PA DapartMnt of R.v....., Bur.... of JncUvldual T...., ATTlU Pad ,......." Ani.. ...,It, Dept. zaa6D1, HarrIsburg, P' 17121.1601, phone (717) 717-'505, alsccunl If ..,y tax due .. paid within thr_ U) e.l..",..,. aonthl oftar ttM dec.s.nt'. death, . flv. percent CDJ dlacount af the tu paid Is aUDtiMd. 1HTEAf:ITI Inter..t Sa charged belIMI", with flr.t day 0' ddlnquenav, or nine C91 IIDnth. 8nd OM U) dav fr08 the Mt. a' duth, to the dtit. 0' paYMf'lt. T.... which bee.. del1nquent before JllnUllrv 1, 1912 bear lnter..t at the r.te 0' .Ix CU) percent par .... calcul.ted at . ally rat. of .DGGI64. All tu.. which b~ dtlllnqu<<lt on and after ""'rv 1, 1912 ..Ul bear Int.r.d at a nt. which ..Ul vary frM c.lander YNr to calendar y..r with that rat. announced by the PA Dapart.nt af A.v...... TtM appl1U1bI. lnter..t rat.. far 1912 through 1"5 .,.al .... Inter..t R.t. Dally Int.,..at Faotor .... Int.,...t Rata Dalh' Inter..t FlICltor 1912 ZDX .ODOSU 1'81 OX .Oun1 1'" lOX .000,.51 1961-1"1 llX .DUnl .... 1IX .aoasal I"" OX . unit? 1915 1>% .000S56 1"'-1"'- n .000192 .... lOX .000Z1" 1"' 'X .ODDU1 -"Inter..t .. calculatld II fallows. IICTEllEllT . BALAlfCE OF TAX UNPAID X HVKBEI OF DAYS DELINQUENT X DAILY IICTEllEllT FACTOR --Any HoUea ...ued afhr ttMI t.. bacOllaa dallnquMt .,111 r.flect an Int.r.1t calculation to flft.." US) davs beyond the data of the ......~t. If p...-nt .. ... .ft.r the Intar.at c~tatlon data .now. on U. Notice, addltl....l Inter..t ..at bII C8lculatlMt.