HomeMy WebLinkAbout95-00781
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
IUY.l ~OO U. 17.Q41
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COMMONWfAlTH 0' PfNNSoVlVANIA
OEPARTMENT 0' REVENUE
DfP, 2'0601
HAUISlURO. PA 171"-0601
DECrDINr'. NAME (t...". flUT. AND MICOll: INIIIA'I
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ili
III
III
CO
MI ER KATIIRYN D.
10CIAL neURIll' NUMIU
DAn or DUoTH
207-09-1735
07-20-95
I" "'t\1CA1UI IUI\'I'I'INQ 'POUlt', ,....IIILAII, ,.,.. AND MWOlllNll/Aij
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e9 I. Original ROlurn
rol DAm 0' DIATH Ami 12131191 CHICK I
" A SPOUSAL 0
POVllfT CIIDIT IS CLAIMID
flU HUM."
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COUNlY CODE
o C DEN' C rt ADDUU
J
/qq5
YEAR
lil
NU.'
144 15th Strl!l!t
New Cumbl!r1and, PA 17010
Co Cumberland
AMOUNT UCfIYID (UIINII.UOIONI!
DAfl or Illl"
04,
06,
Umif,d eslal.
o 2, Supplomonlal Rolum
o 3. Romalndor Rolum
lIar dOlo. of doalh prior 10 12.1:
0.5. F.d.ral ESlat. Tax R,'u,n Rlquir
DAD. Futur. In',,.,, Comproml..
(far dOlO' of dealh aho, 12,12.821
Olcld,n, Di,d rl"al' 0 7. O.cld.n' Maintained a Uvlng Tru.t
(Allach copy of WillI (Allach copy 01 Trusll
ALL CORRESPONDENCE AND CONF/DENnAL TAX INFORMAnON.SHOUUJ:BE:DIRECrED TO, ..
NAMe COMI'LUe #MIUNO ADO.US
Stone LaFaver & StOOl!
P.O. Box E
er1and PA 1707
0101-
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BIC
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1. Roal Ellalo (Schodulo AJ
2, Slack. and Band. (Schodulo al
3, Ca.oly Hold StackJPann."hlp Intoroll (Schodulo q
4, Mangago. and NOlo. Rocolvablo (Schodulo OJ
5. Cash. Bank D'polh. & Mile.llan,oul Plnona' Prop.rty
(Schodulo EI
6, Jointly Ownod Praporty (Schodulo F)
7. T,an.lo" (Schodulo GJ (Schodulo II
8. Talal Grall Allol. (10101 Uno. 1.7)
9. Fun.ral Explnl", AdmfnlstrativI Co.t., MhClllan,oul
Expon.o. (Schodulo H)
10, Dobl., Mangago Uabllitlo., Uon. (Schodulo IJ
11. Talal Ooducllan. (talal Uno. 9 & 10)
12. NOI Valuo of EllatolUno 8 mlnu.lIno I1J
13. Charllablo and Gavemmonlal aoquo," (Schodulo JJ
14. Nol Valuo Subfoct 10 Tax (lIno 12 mlnu.lIno 131
15. Spau.al Tran.fo" (far dOlO' of doalh ahor 6030.941
SI' '"Urudlon. lor Appllcabl. P,rc,ntag. on R.nrt.
Sldo. (Indudo valuo. lram Schodulo K or Schodulo M,I
16. Amount of Un. 14 la.abl. 0' 6% rat.
(Indudo ualuo. Iram Schodulo K or Schodulo M,I
17, Amaunl 01 lIno 14 raxablo at 15% raro
Ilncludo valuo. from Schodulo K or Schodulo M,)
18, Prlndpallax duo (Add lax from lIn.. IS, 16 and 17.1
19. Crodlll Spau.al Pavori)' Crodll P,lar Paymonll
_ 8. Tolal Numb., of Safe O.pcnil Be
(11
(2 )
(31
(4 )
(51
(6)
(7)
~ "t~??n ?n
40,616.17
+ +
20. "Uno 191. groolor Ihan Uno 18, onlor Iho dlfforonce an lIno 20. Thl.l.,ho OVERPAYMENT.
&! O."rr::r.I~t"lllolll_''''I'.'I.'''.''''I''<J.'II'h.f.(ilrrr:r:II'':'I.'J:'I''.tl'~"'.UJ..l'~11
21. "Uno 181. groalor than lIno 19, onlor Iho dlfforonco an Uno 21. ThI.I.,ho TAX DUE.
A. En'., the In',re.' on the balanc. due on Un. 21A.
a. Enlor Iho 10101 of lIno 21 and 21A an Uno 218. ThI.I. Iho BALANCE DUE.
Mako Chock Payable 101 Rogloto, of Will., Avont
>- BE SURE TO ANSWER ALL QUESTIONS ON RlVERSE:SIDf(ANIlTD. REOfECK MATH olI(
nd., plneUI.. of p.rjury, I d.dor. that I hay. uomin.d ,hi. re'urn, Including accompanying .chedule. and Itot.men'., and 10 Ih. bll' of my .nowledge and b.li,'
I II 'rue, correct and campl.r.. I d.c1ar. rha' all r.al ."ar. ho. blln r.pan.a at tru. market valu.. O.dararJon of pr'par.r orh.r than ,he p.nanal repr...nfall"'.
alld on all information of which prepar.r hat any lenawl.dg..
laNA' II El' 'USON JlU'ONSI 1 '0. IILIN II IN ADORUS OArf
144 15th St., New Cumbl!rland, PA 17070 /() _( + "),'
e;))l t;. tJe-./("",Q,~~. f'.A, "}~:ro 0"'0' I~,?f
(91
(101
'nJ C;'1 nn
(81
(ll)
(12)
(131
(lAJ
(151
(161
(17)
x.__
~11. 1'1 17
)( .06.
" .15.
(18J
DJacount
$99.97
'n,.,..t
(19)
(20J
(21J
121AI
(2IB)
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....:. .'
$101,R1fi 17
10.~11.00
33,323.37
33.323.37
1 QQQ 1.00
1.999.40
99.97
1,899.43
$1.899.43
Ad #48 of 1994 provide. for the redudlon of the tax rate. Impo.ed on the net value of tronde,. to or for
the u.. of the .pou.e. The rate. a. pre.crlbed by the datut. will bel
e 3% (,OS) will be appllcabl. for edate. of decedent. dying on or after 711/94 and before 111/96
e 2% (.12) will be applicable for e.tate. of decedent. dying on or after 111/96 and before 111/97
e 1% (,01) will be appllcabl. for e.tate. of decedenll dying on or after 111/97 and before 111/98
e 5,.___ tran.f.,. occurring on or after 1/1/98 will be exempt from Inherltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
8Y PLACING A CHECK MARK (,..-) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old decedent make a transfer and:
x
a. retain the use or Income' of the property transferred, .......................................................
b. retain the right to designate who shall use th. property transferred or it. Incom., ...............
x
c. retaIn a revenionary Intere.t; or ...................................................................................
d, receive th. promls. for life of either payments, b.nefits or care9.......................................
2. If c1...h occurred on or before December 12, 1982, did decedent within two y~ars preceding
death transfer property without receiving ad.quate consld.ratlon9 If death occurr.d aft.r
Dec.mber 12, 1982, did decedent transfer property within one y.or of death without receiving
adequate. consIderatIon'..... II... I........... It_..... .,. II.. II... II' ... II .... ..... II.. ....,. II, II ... II ... ..... II.. II .......
x
3. Old dec.dent awn an""ln trust fort bonk account at his or h.r d.ath9.....,..........................,.....
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YESr
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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SCHEDULE E
CASH, BANK, DEPOSITS
AND MISCELLANEOUS
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Kathryn D. Miller
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATII
I.
PNC BlI11k.BurlaJ Reserve Acxounl No. 1143280179508, Prine. $3,211.45. Inl. $8.75
$3.220.20
$3 220,20
SCHEDULE F
JOINTLY-OWNED PROPERTY
I nLENUMB'.
ESTATE OF
KATIIRYN D, MILLER
JoIDl.......I(.)
NAME
ADDREllS
IIEIATIONSIIIPTO DECEDENT
A, Alice M, Kowo(ch
144 ISUI Stn:cl, New Cumberland, PA
17070
doughlcr
B,
C,
JoIDlI1......... proptri7t
LElTER
ITEM fOR DATE DESCRIPTION OF PROPERTY TOfALVALUE DECD'8 DOLLAR VALUE OF
NUMBER JOINT MADE OF ASSET 'MoINT. DECEDENT'8INTEREST
TENANT JOINT
I. A 01-01-78 PNC Bank-Inlezest ChcckJng No,
S140043S74, Prine. $4S7.01, InL $ 4S7,48 SO% $, 228,74
$.47
2, A OS-12-92
PNC Bank-CCn. oCDcposit No.
1143270lS4182, Princ. $7,000.00, $ 7.081.89 SO% $ 3,S40,9S
OS-04-94~ Inlczest $81.89
3. A
PNC Bank-Ccn. oCDcposit No.
1143240179S06, Ptinc, $7,467.32, $ 7,486.62 SO% $ 3,743.31
1nlezest $19.30
4 A 10-18-94 ..
PNC Bank-Cen. oCDcposil No.
1143270182038, Princ, $2,SOO.DO, $ 2.S01.34 SO% $ 1,2S0.67
Jnlczest $1.34
S. A 02-OS~4
All that cel1aln trnct oC land situate
In the Borough oC Ncw Cumberland,
County oC Cumberland, and Stale oC
PcnnsyIvnnJa, being the same * Rollover
pzemlscs whlcb KaUuyn D. Mi11cr, of CD 1143270154182 open
widow, by her deed doted February more tha one y ar prior to death.
S, 1964, and recorded February 7.
1964 in Cumberland County Deed
Book C-21. Poge S24, grunted and
conveyed unto KaUuyn D, Mi11cr
and Alice E. Kowatcb, os Joint
Tcnnnts wI the right oC survivorship
lIDd not us Tenants in Common.
The said Katluyn D. Mlllcr being
the dcccdcnt herein. Assessed valuc
timcs CLR 46S0 :< 13.70 $63 70S.00 SO% $31 8S2.S0
TOTAL (Alto enter on line 6, R<capilulalJon) $40,616,17
-
ed
',;I.,."
I'NC lIank, N,A,
UI:'!C:'ulh.h'11iL.t.
('UIlI' 11iI1.I'A 17011
PNCBANK.
August 8, 1995
To Whom It May Concern:
As per your request for information on accounts the referenced
decedent held with us, the information follows on the attached
sheet(s),
If I can be of any further assistancet please f.eel free to contact
me at (717) 730-2321.
Sincerel~_ . ()
L5tC:tt::. /..(. ,,,,aW-/
Edith Tancil
Miscellaneous Services supervisor
Bank operations
ET/mky
DECEDENT NAME:
DATE OF DEATH:
SOCIAL SECURITY NO.:
Kathryn 0, Miller
07/20/95
207-09 1735
TYPE OF ACCOUNT:
ACCOUNT NUMBER:
NAME(S) ON ACCOUNT:
Certificate of Deposit
1143270154182
Kathryn D. Miller
Alice M, Kowatch
DATE OPENED:
DATE OF DEATH BALANCE:
ACCRUED INTEREST:
INTEREST PAID YEAR TO DATE:
OTHER INFORMATION:
05/12/92
$7,000.00
$81,89
$211.74
TYPE OF ACCOUNT:
ACCOUNT NUMBER:
NAME(S) ON ACCOUNT:
Certificate of Deposit
1143240179506
Alice M. Kowatch
Kathryn D. Miller
05/04/94
$7,467.32
$19,30
$236,34
DATE OPENED:
DATE OF DEATH BALANCE:
ACCRUED INTEREST:
INTEREST PAID YEAR TO DATE:
OTHER INFORMATION:
TYPE OF ACCOJi'JT:
ACCOUNT NUMBER:
NAME(S) ON ACCOUNT:
Certificate of Deposit
1143280179508
Kathryn D. Miller
Burial Reserve Account
DATE OPENED:
DATE OF DEATH BALANCE:
ACCRUED INTEREST:
INTEREST PAID YEAR TO DATE:
OTHER INFORMATION:
05/04/94
$3,211.45
$8,75
$107,03
STOCK INFORMATION CAN BE OBTAINED FORM CHEMICAL BANK
AT 1-800-982-7652
nOOK C. 21 rM;E ~21
.mt!i~
r ",~IHII'II.:rrrc~ or lHi
111 ~ tt\l';';~;: :;"fm
!lubf t~f .5th day 01 February
Lord one thou8and nine Imndred and sixty-four (J.964)
ilftwffn KAnlRYN D. MILLER, Widow, 01' the Borough ot"New"Uuinberland,
County 01' Cumberland and Btate 01' Pennsylvan1.a, ORantor.
CUII~!.1 '..','.\' (I,UlIlr
rEllin\tlw1llear 01 our
A
N
D
KA'lliRYN D. MILLER, Widow, 01' the Borough 01' Nelf Cumborland,
County 01' Cumberl.and and Btate 01' Pennsylvania and ALICE E.
KO'vTATaI 01' .Teet Chostor, Pennsylvania, as Joint Tenants with
the right 01' surrlvorship and rot 8S Tenante in Col11mJn.
.itnfllSft~, that in con8ideration o( One Dollar ________________________
-------------------------------($J..OO)___________________________________JDollars,
in hand paid, the receipt whereo(is hereby acknowledl!ed; the said Gr,!ntor do. es
heraby I!rant and convey to the said Grantee s their Hetrs and ,4s8ttnl,
All that oer~in traot 01' land situate in the BoroUgh 01' Ne~r Cumberland (
1'onnerly Lower Au.en Tounship), County 01' Cumber111lxl, and Btate 01' Pennsylvania,
more partiouJ.arly bounded and desoribed as 1'ollo~ls, to Witl _
BEGINNING at a point on the South s1.de 01' Fifteenth Street, whioh point is six
hundred sixty-six (666) feet from the southeast corner 01' Bridge Street and Fi1'teen_
th Street, at the corner 01' lot owned by Osoar Steger; thence eastwardly along
F:1.fteenth Street, one hundred (J.OO) feet to a point. the property 01' George lofowrey;
thence soutlmardly three hundred seventy (370) feet, more or J.ess, to land rmr
as lots 01' W1llets Estate; thence westwardly aJ.ong said land one hundred (100)
1'eet, more or less, to said lot 01' Oscar Steger; thence nortlmardly along said
lot three hundred sixty (:360) feet, Hlore or less, to Fifteenth Street, the place
01' BEGrmlIlIG. Improved ~r.l.th a -brc story brick house, ch:1.cken house and other
outbuild:1.ngs.
BEING the same l'rem1ses which RusseJ. B. Updegraff, singJ.e man, by Deed dated
February 21, J.9Lf.J.., and recorded in Deed Boole ''HII, Vol. J.2, Page 131, granted and
conveyed unto Jacob A. Brubaker and lUice B. Brubaker, h:1.s mfe. The said Alice
B. Brubaker pro-deceased the sa1d Jacob A. Brubnker, who died April 23, 1948,
having first made a Last Hill and Testament, now recorded in I"'ill Boole 4.5, Page
277, wherein he devised the above reaJ. estate to Kathryn D. Hiller, Grantor herein.
'!HIS IS A TRAlISACTIOII betweon parent alx! ch.1.ld without conaideratton.
"1111 the said Grantor
JVill JVal'l'ant generaUy tlw property horeby conveyed
In BIIII'II11 JlI~rrrnf, .9aid Grantor
the day and year first abo/le written.
has
hereunto sot her hand and seal
A/~: ,..- .Itl~
....~;'thryn n. Hiller
(--j
"..-/
-"'-- --"---
QlllmmlllUU,.l1~ IIr ",nIIJullllllll
G1l1llntUllr ommERLAND
appeared
5th day 01 February .'1, I), Jl) 64 , lwloro 1110
a Notary Publio Iho IIIHlcrsll!lled uRloflr, /ler8ollall"
Kathryn D. H1ller kllOWIl tu me or (8at/slaetorlly
proven) to be the /lerBon whoBe lIame is BullBOrllJccl!o the lI'If,/II/lil/8t rltment, ami
aoklwwledted that Bho oxeouted tho Bamo lor UlCll/lr1JUNC!8 thoroin eOlltallwd.
III .'tnrJlJl.~rrrllr. I hereltltto Bot my llC11lf1 ami Offill al N ,ClI,~
.
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...................,..I(j....'......'............\...''/;'.....'.....'....II"':.~
I. TIlle'of Offlcer' , "", -~[V. ~'~,"'~ ':':'11. ~ '1' ~
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On this, the
I lIrrrbu G1rrUrU, thut the /lr(!oi,~e rflilid;flnc(J of tho G1'IIIltco
. 144 F'l.:rteenth Street, llew Cumberland, Penns:/.I:va a. ,
.... .'. 11 '
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............... .................. .,t...
.... I ~"i'f ."... ", ." t . I'. :
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G1l1llU1U1nm,.lt~ or 'rnMululntl }
G1I1UntB of &.v.~ -."- ~ <- /J~.t JIll.
'1ii -:::L~
Recorded on this '1 day 01 7'~ ,on
.11. D, 19 ''I, in the Reoorder'B OjJ!oe 01 tho Baid COUllty inDeedBook I.;.,
Yolume .'2 I Pal!e 6 ::?~
Given under my hand and tho Beal 01 the Baid Ofl1.oe, the date above written.
800KQ.. 21 rAGE 525 ,..,/i._ P~.~.......Reoorder
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS
AND MISCELLANEOUS
EXPENSES
-
I FILE NUMBER
ESTATE OF
Kallllyn D. Miller
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
Funeral Espenlel:
Stonc &. Murray
Oingrieh Memorials
$4598.00
99.00
I..
2.
Admlnlstrallve Costs:
B,
Penonal Representative Commissions
Social Security Number ofPelSOnaI Representative:
Y car Commission paid
1.
$2,191.00
Auomcy Fees Stone LaFaver &. Slone
2.
Fnmlly Bxcmption
3,
Clalmant Alice M. Kownteh Relationship
dauehter
Address of Clalmanl al decedent's dcntl1
Street Address 144 15lh Street
City New Cumberlnnd Stale PA Zip Code 17070
$3,500.00
4.
Probate Fees filing Inheritance Tax &. Inventory
$ 25,00
C.
Mlscellancous Espenses:
$ 100,00
1. ResoIVC for closing expcnses
2.
3.
4.
5.
6,
7.
8,
9,
TOTAL Also enler on line 9 Rcca ltuJation
$10 513.00
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
O{/- r; 6 - '7.F/
I
J
u:
being duly
All ee N. KOWll teh
sworn
occordlng 10 low, depolel ond IOY' Ihat Mhe 1M till!
of Ihe Ellale of Kllthryn IJ. Niller
lale of __New. Cumbcrl.l!pd._ .. --.- -_.. , Cumberland County, Pa" docealed and that Ihe
wilhin il on Invenlory made by. Alice N. Kowatch ., the lOid
of the onllre ..Iato of laid decedent. conlllllng of oil Ihe pe..onol pro".,Iy and reel ..tate, except reel estote ouhide
the Commonweallh of Pennlylvenio. ond Ihol the figure I oppollle eoch lIem of the InYentory repr..ent 11', foir yoluo
.. of the dote of decedent'l dulh.
19
(~.:m 7z:.U/lhh"
encutor . Aclmlnhtrator
and ,ub,cribed befo,e me,
144 1 ~th Street
New Cumberlllnd, PA 17070
Addr...
Date of Death
?O
DIY
07
Month
95
Yea,
INSTRUCTIONS
I. An inventory must be flied wilhin three monlh, after appolnlment of personal repreuntatlve.
2. A supplement Inventory must be filed within Ihirty daYI of dlscoyery of addillonal a..oh,
3. Additional sheeh may be attached as to personally or rulty
4, See Article IV, Flduciarl.. Act of 1949,
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Inventory of the real and personal estate of
Kathryn n. Mi 11 flY"
deceased
PERSONAL PROPERTY
1. PNC Bank-Burial Reserve Acct. 01143280179508, Principal $3,211.45, Interest
$8.75
3,220 20
REAL PROPERTY
NONE
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RI!V-1547 I!X AFP (12-95*
CO...OHWUL HI Of' POlfSnVAHIA
O[PAATHE"' Of' RfVOIJt:
IURfAU OF INDIVIDUAL TAXU
DEPT. IID'Dl
HARRIIIURO, PI 171"-.'01
ACN 101
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT DF TAX
DATI! OZ-12-96
FILl! NO.
DATE OF DIlATH 07-20-95 COUNTY CUMBERLAND
HOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SU8llIT THE UPPER PORTION OF THIS FORN WITH YOUR TAlC
PAYHENT TO THE REGISTER OF WILLS. KAME CHECX PAYABLE TD "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
DAVID H STONE
414 BRIDGE ST
NEW CUMBERLAND
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17070
-.nt R_lUMI
CUT ALONO TMIS LINI! ... RI!TAIN LOWER PORTION FOR YOUR RECORDS ~
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DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
I!STATI! OF MILLER KATHRVN D FILE NO. ZI 95-0781 ACN 101 DATE OZ-IZ-96
TAlC RETURN WAS' I X I ACCEPTED AS FILED
C I CHANGED
RI!SI!RVATION CONCI!RNINO FUTURE INTI!REST - SEE REVERSE
APPRAISI!D VALUI! OF RETURN BASED ONI ORIGINAL RETURN
1, R..l E.t.t. ISchedul. AI 111
2. steck. end Bond. ISchedul. al C21
5. Clo..ly Hald stock/Partnarahlp Int.r..t (Schedul. C) (5)
4. teartgavel/Kohl Receivable (Schedul_ D) (4)
S. C..hlBank Dapollta/Hllc. Parlonal Property (Schedul. E) (5)
6, Jalntl~ Owned P~oP.~t~ ISchedul. FI C61
7. Tran.fara (Schedule g) (7)
8. Tot.l A...t.
.00
,00
.00
.00
3.ZZ0.20
40.616,17
.00
ISI
43,836.37
APPROVED DEDUCTIONS AND EXEMPTIONS,
10,513,00
9. Funeral ExPln.../Ada. Coat./Hilc. EMP~'" (Schedula Hl (,)
10, Debt.IHortG.O. Llebllltl../Llen. ISchedul. II CI01 .00
11. Tot.l DeductIon. 1111
12. Nat Valu. of TaM Raturn (12)
15, Ch.~lteblo/00ver".."bl aequ..h <<Schedule J) 1151
14, Het V.lue of E.t.t. Subjeot to T.x 1141
NOT I! I If an asaaasmant was isauad praViDua1Y, 1inas 14/ 15 and/or 16, 17 and 18 will
raflact figuras that includa tha total of ALL ra~urns assasaad to data.
ASSESSMENT OF TAXI
1S. Aaount of Line 14 .t $pou..1 rata (5)
16. Aaount of Lln. 14 t.Mab1a at Llnea1/Cl... A rat. (16)
17. Aaount of Line 14 taMab1a at Co1lat.ra1/Cla.. Brat. (17)
11. Principal TaM Due
In,~L'I no
33,3Z3,37
.00
33,3Z3,37
,00 X .00.
33,3Z3.37 X ,06.
.00 x.ls"
Clal
.00
1 ,999,40
.00
1,999,40
TAX CRI!DITSI
PAYHENT
DATE
10-19-95
DISCOUNT I + I
INTEREST C-I
99.97
RECEIPT
NUHBER
AAOBZ242
AIlOUHT PAID
1,899,43
TOTAL TAX CRI!DIT
BALANCI! OF TAX DUE
INTEREST
TOTAL DUI!
1,999.40
,00
,00
,00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
C IF TOTAL DUE IS LESS THAN .1, HO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" <<CRI, YOU HAY aE OUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
i J(
AlSOYATlOMI E.tat.. of decedenh ctvlng on or befora ~r 12, 1HZ ... if MY future lntar..t In the ..tata h tren.,.rred
.n po.....lon or enJo,...,t to Cia.. . (collataralt beneflclarl.. of the decedent aftar ~ a.,lrat.on of en, a.tata for
ll'a or 'or ~a.r., the C~alth ~reb, akPra..I, ra..rv.. the r.ght to ."ral.. end ...... tran,'.r I~rlt~a T....
at ~ IINful C.... . (collat.r,lt rat. on any .uGh 'utura .nt.r.,t_
_Of
NOnCEI To 'ulflll the r..,lrNant, 0' SecUon 2U. 0' ~ lmer.t-ne. .... Elt.t. T.. Act, Act U 0' 1"1. 7Z P.S.
leatlon U40.
PAMHTI DetKh the top portion of thh MoUc. and "'-It ..Ith your pa,...,t to the R....tar 0' "IUa pr.nted on tha r.v.r.. .Ide.
"'"_a check or 110M' ordn p.V..... tOf REGISTER OF MILIJI, AD'EHT
AU ,.panh rec.lvMt "'U f.nt be applied to .." Int.r..t Wh.ch NV he due ..Ith ."w r....ndar ...lIad to tha tlM.
RUUHD CCRh A n'~ of I t.ll erMtIt, Mhlch .... not r....ted on ttMt TaM Raturn, .., be r.....ted b, CCMlPI.Ung .. ....lIcatlon
'or R"~ of PemnIVWI.' Inherltanca end E.tata hllOO CREV-UIJ). Application. .r. .vallabl. .t the Office
of thl R'llItar 0' Wllh, ..,v 0' the IS R.venua DlItr.ct O".c.., or bW c.U.,., thl 'PHI.. 14.hour
M....rlng ..rv.c. nullblin for 'or.. orderl,.,1 In Pann.vlvanla l-100"361-I05D, ouhlet. pann'Wlvan.a and
..lthln local Harrl~rl ara. (117) 111-1094, TDD' Cl11) 111.Z152 CHaarl.,. I.,..rad Onlvt.
OBJECTIONS I AnV Plrt, In Intlra.t not ..th"ad ..lth U,. apprah..-nt, .11OManca or dh,UOManca 0' deduction., or .....nent
of till (Including d..count or .nt.ra.t) a. ahown on th.. Notlea au.t object ..Ith." .llItv C'D) ct.v. of reca.pt 0'
this Notle. bVI
......rltten prota.t to the PA o.parhent 0' R.".,."., Board of ~.h, Dept. 111111, "'rrlaburll, PA 11nl-IIU, OR
--aIHtlon to hlYII the ..ttar detar..nad at IlUdIt 0' the account Df the pIIt10nal rapr..antaUv., OR
....,..1 to the Orphan.' Court.
AOftI"
IITRAnllE
CORRECTIONSI
I HTDtfIT I
,..tuel arrorl dheovlrad on thh .........,t Ihould be 1Idd,...~ In ..r.Una tOI PA Depart...t 0' Rev."",.,
Sur.1Y of Individual rail", ArTHI Po.t A........,t R.vlew un.t, Dept. l1D601, Herrl.burg, PA 17.ZI.060.
Phona (117) 117-6105. 5.. p... S 0' thI bookl.t .In.tructlon. far Inheritanca ra_ R.turn 'or a R..ldent
Oac~t. (REV..511) for an allplanet.on 0' ~.n..tr.tlv.lv corraotlb.a arror.,
If MV t._ due II paid ..Ithln thr" (,) cal",. Mintha aftar tt. dac...,t.. dMth, . flva parcent fiX) d.acou1t of
the tax paid II ,"owed.
Int"..t II dMIrgad bag.mlna ..lth flrlt da, of ct.lIf1qU1f'M:V, ar n.ne C') Hnth. .Mt ana U) dQ froe the Ata 0'
death, ta tM ct.t. 0' pa,...,t. Tu" MII.ch bac_ delinquent bIIfa" J..." I, l'ez bear Inti,." at tha rat. of
.11I (61) ~rcant par WW'IUI calcul.ted .t . daU~ ,.ata of .0101604. AU t.... which ~ delinquent on and .ftar
Januarv 1, .911 ..... bur .ntar..t at . rat. Mhlch ..Ill vary fr. ca...r ,..,. to calandar VMr with that rata
..-need bw thl PA Depart..". 0' R.v...... Tha appllC8bl. .nta,.., rat.. 'or 191Z through 1"' .ral
DISCOUNT I
'!!!! Intlr..t R.ta D..lv Int.ra.t 'actor !.!!!' Int.,..t A.ta DIU, Intltl.t Factor
1911 ZDX .100141 1917 'X _ Glnu
1'15 lOX .0OOoUl 1911-19f1 lIX .101S0l
1t14 IlX .000301 .". 9X .aGUU
.915 UX .000356 l"I-I9M n .aGOl'2
It.. lOX .DDDZ14 ."5.1'" 9X .DlnU
ulntar..t .. c..cu..ted II fallCMilIl
INTEREST . BALA"CE OF TAX UNPAID X HUKBER OF DAYB DELI"QUEnT X DAILY IHTEREST FACTOR
".Anw Hat.ca ...UId .,t.,. the taM baco.a. del.nquent ..III r.f.act In .ntar..t calculat.on to ,I,t.-n (15) day.
beyond the dati of the .......-tt. If p.~t II ..... .ft., tM Intar..' .-puhtlon dlt. Ihowt on the
Hotle., ~.tlonal Int.ra.t au.t be calcu..tad.