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HomeMy WebLinkAbout95-00790 NlVHOOfl+ 179.1 '" o 1= ;! ii! :II o '" ~ 'OA OATIS 0' DIATH Ani A 121~ 1/91 CHICK HIAI INHERITANCE TAX RETURN ~o~::f.,ugtDIT ISCLAIMID rl RESIDENT DECEDENT 'liINUMIIIi------------ COMMO"W""" O"I"""'v'''1A (TO BE FILED IN DUPLICATE ., , n 5 7 qo ,,:I:.~:fj(mJnl;::~t WITH REGISTER OF WILLS) _.. (O_U;COOE_Y~'R NUM.BE_~ c I~ '. N"MIII" ,I ," "'10m INI '''II Il (IlHt~ '(0101'11 I _DDUU It:GUlRE, ELI7J11lE'Il1 II. 100 Mt. Allen Drive .oclA~~~u~~'8~;~~7 -----T'~~~~~.~H--13~~~~~;--. C"~~~~~~' (Upper Allen 'IWp.) t" ......"" "",,~. "'MI. ..., "... i,ilo..,-;;;;,;;;;',;;,;;;,,-- lOCi.. "(iiiii:-"UM..i~=~ri..-OVii"lCm;D-,..iii;;;"U("O".1 ~ 15 lil bl .. I!! ..5::1 blll: "'9 51_ Pn 1. Original R,lur" o 4. llmlt,d Ellal' (] 2. Supplementol Aelu," R,maind., R'lurn ('or dol.. of d.alh prior to 12.13.82) hd.,ol E'lal' Tax R.lurn R.quir.d !!'/ - 4:.)-1 D r - 03. OS. rJ Ao. fulu,e Inter..l Camp ramI,. .- (for dol.. of d.ath oll.r 12.12.82) 06. DIC.d.nl Ol.d T.'lol. fJ 7. PIC.d.nt Maintained 0 living Trull (Attach copy 0' Will) (Alloch c:opy of Trult) AL1.CORR"PONDINCI AND CONPlDINTlAL TAX INPORMATION SHOULD BI DIRECTED TOI OM'l MAIUNG 10 RU _ 8. Total Numb., of Safe C.pallt BOk" -" .t , I. R.ol Eltol. (Sch.dul. A) 2. Slockl and Bondi (Sch.dul. B) 3. Clollly H,ld 510ck/Porln"thlp Inl"..1 (Sch.dul. q .c. MortgoO" and NOI.I RIC.lvabl. (5c:h.dul. 0) 5. COlh, 80nk O,poIIII & Mhc.llan.auI P.nonol Prop.rly ISchedule E) 6, Joll'llly Own.d Proplrty (Sch.dul. fl 7. T,o"'mISch,dule GllSchedule II 8. Tolol Grall AU'II (Iolollln.. 1.11 9. funltol bp.n"I, Admlnhlratlv. COlli, Mhullon,ouI (9 J $ 7,150.50 Exp.n"I ISch.dul. H) 10. O.bll, MOtlgag. lIabllitl.., lI.nl (Sch.dul. I) 11. Tolal D.duclionl (Ialallln.. 9 & 10) 12. N,t Volu. 0' ellol. 11In. 8 mlnuI line 111 13. Charilobl. and Gov.rnm.nlol R.qu'III (Sch.dule J) 1.4. N.I Volu. Sub 'cllo Tak 11In. 12 mlnUIUne 13) 15. Spoulol Tranl'.'I (for dol.. of d.alh ah., 6.30.9.41 5.. Inllrucllon, 'or Ar,pllcobl. Perc:.nloge 01'1 R.ven. SId.. (Includ. volulI rom Sch.dul. K or Sch.dul. M.I 16. Amount of lIn. 14 lakabl. 01 6% rol. Ilnclud. volu.. from Sc:h.dul. K or Sch.dul. M.J 17. Amount ollln. 1.4 takabl. at 15% '01. (Includ. volu.. from Sch.dul. K or Sch.dul. M.J 18. PrlnclpaltaJl. due (Add taJl. ham Un.. IS, 16 and 17.) 19. C,.dill Spoulal Poverly Credit Prior Poym.nll Di,count Inl.rlll o + $16,244.67+ $854.9R 0 20. If L1n. 1911 oreal., Ihon lIn. 18, .nllt lh. dlffer.nce on lIn. 20. Thll II th. OVERPAYMENT. II O...rm.'I,.I'''._''''I....,...LI,I'll.'.,III.'."'lmm~_''''I'I_'..I'''''WI.''''''LI'' :il15 "0 ..", B~ Charles E. Shields, III UU'HON( NUMIU 2 W. Main Street Mechanicsburg, PA 17055 III 0 o (2) -_ (3) 0 o 141 __ 151 $ 31,975.56 $260, R62. 34 o (6) 171 (8) $292,837.90 '" ~ ~ ~ bl .. (10) $ 693.21 1111 (121 (131 141 $ 7,843.71 $2R4,994.91 o $284,994.91 o o . 1151_____.___________.....__ 116) _$_2R<i.1.9~_4~_~J__ o .____.M .06. _LEJl99.65 o 1171 .M ,IS. 1181 $ 17,099.65 (191 $17,099.65 (20) 0 1211 0 121A) 0 1218) 0 21. If lIn. 18 II gttol.r lhon lIn. 19. .nler the differenc. on Un. 21. Thilll 'h. TAX DUE. A. Enl" th.ln'.,.., on Ih. balance due on line 21A. B. Enl., Ih.IOlol of line 21 and 21A on lin. 21B, Thl,lIlh. BALANCE DUE. Malee Check Pavabl. '01 R.gllt.t af Will., Ag.nt !, BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH Undtt p,nalll.. of p.rlury. I d.dotllhall han 'xamln.d lhh r"urn. Indudlng accompanying Ich.dul.. and IIal.menh, and 10 th. b.II of my knowl,dg. and beli.,. II I. fru.. correct and compl.I.. I d.clar. Ihat all ,.01..101. hOI been reporl.a 01 true market valu.. D.clarallon 0' p"par., other than Ih. p.nonol "pr...nlatlve II paled on alllnformolian of \It p,. arer hal any knowl.dg.. ~ION U 0' 'USON Iura lE R filiNG Il(tURN _OORUS OAf( . ~.?/.~/A" &" - 35 Fox Croft Dr., Canp Hill, PA 17011-1530 '~E OJ "'('AU 01 R AOOlUS DAlE .I. , (' 2 W. Main St., Mechanicsnurg, PA 17055 10 ';J ;I.>'.)~ IIY-l,"" ,.. II'TJ ESTATE OF ~'Ja",()~ W SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY COMMONWfAUH 0' PfNNSYlVANIA INH.IITANC. TAX InUIN IUIDIHT DICIDINT Please Print or T e FilE NUMBER Elizabeth H. McGuire (All pr.perly 1.lnlly.own.d with .h. Righi .f Syrvlvonhlp my.1 b. dllCl...d on Schedule '1 ITEM NUMBER 1. 2. DESCRIPTION Refund fran Capital Blue Cross, Security 65 Policy Reinbursements for prescriptions ($225.30) 3. united Services Life Annuity Principal amJunt at d.o.d. (see letter attached I 4. Queen Anne chair in Sc:rre.oIhat dilapidated condition and in need of re-upholstering 5. One 6lTI3ll oval wall mirror 6. Old floor laI1ll in need of laI1ll shade 7. Assorted custane jewelJ:Y of min.i.rnal value 8. (CARlone-half (1/21 interest as tenant in camcn in 1985 Ou:ysler LeBaron. (cash value $1,900 t retail value $2,900 = $4,800 divided ~ 2 = $2,4001 (see letter attached) *INFO NOl'E: Decedent ncved into the nursing hare facility approximately 2 1/2 years ago and disposed of her property and jewlery at that tine. At approximately that tirre items on Sched. F were rrade joint as well. VALUE AT DATE OF DEATH $ 114.10 $ 111. 20 $30,520.26 $ 5.00 $ 5.00 $ 5.00 $ 15.00 $ 1,200.00 TOTAL Also enler an line 5, Reca Itulallan $31,975.56 (Attach oddlllonal 8~" )C II" .h.... if more .pac.l. n..d.d.) ",.., . f.'- .... . . . . . . . . . : . . . . United Services Life ... R"....~' (....,.., Annuity Sr,Yh'.. Crnlf'f I~n, 110121017 ' Sr.lllr, \VA URl11';IDH I.RlM....~t1.7t1ntl september 01, 1995 Lawrence fl. HcOuire Jr. 35 Foxcroft Drive Camp Hill, Pennsylvania 17011 ReI Elizabeth fl. McGuire, Deceassd Policy Number. 2A02367740 Claim Number. 5G7l3 Delu' Hth H....OLllctii Thank you for supplying the requirsd documentation. We are pleased to enclose a benefit check in the amount of $ 29,840.48 made payable to Lawrence H. HcGuire Jr., beneficiary of Elizabeth H. HcGuire, decsased. OetaUs of calculations are ae followe. Principal Amount Intereet (08/07/95 to 09/01/95) Lsss Federal Income Tax Withhsld $ 30,520.26 80.27 760.05 Total Proceeds $ 29,840.48 The company is required to report earned interest to the IRS for the current tax year. You will receive a 1099-INT for $ 80.27 and a 1099-R for $ 7,520.26 under your Social Security Number 162-22-5772. The 1099-INT L'eporte interest earned from the date of death to the date the ben..fit waD paid to the beneficiaL'Y. The 1099-R reports the !.ntua:est.: f:lbCne'U while the lJ.,:,ll....y WAlS Act!...." pr';;.d.ou::s to tha dote of death. ~ Should you have any questions, please do not heeitate to contact this office 1-800-726-6221. Sincerely, ~M?~ Michelle Oattilo Senior Claims Examiner Enclosure CCI Pionner Financial Group, 1301171 UVU09II'IJlfll I I eo,",o.w,'''.O' ".."".." SCHEDULE F I.~WI\:.~\'."~:~:~~'. JOINTLY -OWNED PROPERTY ESTATE OF Eli~:-;l. /oL'Gu~=-_H=~~~~_------- .--------'mE- NUMBER Joint l.nonl(.I. NAME A, Iawrence H. McGuire, Jr. ADDRESS 35 Fbx croft Drive Camp Hill, PA 17011-1530 B. c. Jolntly.own.d p,op'''y' ITEM NUMBE LmER FOR JOINT TENANT DATE MADE JOINT (all i re 1M oint i s It year rior .o.d.) DESCRIPTION OF PROPERTY TOTAL VALUE OF ASSET Kerr{:ler H gh Yield-Fund A $56,127.60 1. 2. (all i with Kemper High Yield-Fund B $95,624.84 .) 3. Kemper Municipal Bond-Fund A $95,915.70 Putnam High Yield Advantage $98,152.26 CC-A (as to itans 1-4 see letter of F. Pfister attach 4. 5. $15,000 CUmberland Valley $15,242.00 Pa. Bonds, 5.60%-09-01-1996 at 101.613 680 shs. DaUphin Deposit $18,020.00 COrp. at $26.125 16 sha. Gen. M:ltors elE at $ 738.00 $46.125 6. 7. RELATIONSHIP TO DECEDENT son DECD'S DOLLAR VALUE OF 'HI INT. DECEDENT'S INTEREST 50 $28,063.80 50 $47,812.42 50 $47,457.85 $49,076.13 50 50 $ 7,621.00 50 $ 9,010.00 50 $ 369.00 (continued I TOTAL IAho ""'.r on I1n. 6. R.eopllulollo") S III more 'pace i. ne,d,d insert additional .hee', 0' sam. size) Estate of Elizabeth H. M:Guire Schedule F Jointly-o.med property (c:ontinuedl Item 1/ Description of Property 'Ibta1 Value Deed's Dollar Value Of of }\Sset % Int. Decedent's Interest 8. 2,956 units Lord J\bbett $27,343.00 50 $13,671.50 Bond Fund at $9.25 9. 521 units lord Abbett Bond Fund 1./105 at .009 $ .09 50 $ .05 10. 2,112.21 units Prudential $ 2,112.21 50 $ 1,056.10 ~ney Market }\Ssets at $1. 00 (as to itans 5-10 see , , letter of David Plish attachedl 11. PNC Bank Interest Checking $ 5,703.13 50 $ 2,851.51 Account 1/5070082323 (PrinciPal & accrued into to d.o.d.) (see letter of Edith Tance1 attachedl 12. Delaware Group, De1chester Fund A. 17,157 shares. NEl' ASSET VAWE (fran Wall St. Journa11 = $6.28 per share. = $107,745.96 50 $53,872.98 TOTAL (Also enter on line 6, Recapitulationl $260,862.34 p ~ September 7, 1995 Charles E. Shields 111 Esq. Mellon Bank Bldg. 2 West Main St. Mechanicsburg Pa 17055 Dear Mr. Shields: In reference to your request of the account value on the date of death of Elizabeth McGuire the figures are as follows. 15,000 Cumberland Valley Pa Bonds 101. 613 @ $15,242.00 5.60% 09/01/1996 680 Dauphin Deposit Corp. 26.125 @ $18,020.00 16 General Motors CIE 46.125 @ $738.00 4 General Motors corp CLI! 42.125 @ $169.00 2,956 Lord Abbett Bond Fund 9.25 @ $27,343.00 521 Lord Abbett Bond Fund l/MS .009 @ 0.09 2,112.21 Prudential Money Market Assets 1.00 @ $2,112.21 Total Account Value on 08/07/95 $63,623.30 I hope the information supplied is sufficient, if you require any additional information or clarification , please do not hesitate to contact me. Regards, 2)/$ David Pllsh Assistant to Bruce Mulvey =~1~~~~' 1lYoo ~ llt1vo, Lernoo,ne, PA 17043-P,O, Box 7, Camp HlI, PA 17001 DECEDENT NAME: DATE OF DEATH: SOCIAL SECURITY NO.: Elizabeth H. McGuIre 08/07/95 184-48-2897 TYPE OF ACCOUNT: ACCOUNT NUMBER: NAME(S) ON ACCOUNT: Interest Checking. 5070082323 Elizabeth H, McGuire Lawrence H. McGuire, Jr. DATE OPENED: DATE OF DEATH BALANCE: ACCRUED INTEREST: INTEREST PAID YEAR TO DATE: OTHER INFORMATION: 01/01/79 $5,700.96 $2.07 $33.42 TYPE OF ACCOUNT: ACCOUNT NUMBER: NAME(S) ON ACCOUNT: DATE OPENED: DATE OF DEATH BALANCE: ACCRUED INTEREST: INTEREST PAID YEAR TO DATE: OTHER INFORMATION: TYPE OF ACCOUNT: ACCOUNT NUMBER: NAME(S) ON ACCOUNT: DATE OPENED: DATE OF DEATH BALANCE: ACCRUED INTEREST: INTEREST PAID YEAR TO DATE: OTHER INFORMATION: STOCK INFORMATION CAN BE OBTAINED FROM CHEMICAL BANK AT 1-600-982-7652 .IYUllU. ''''I E F ITEM NUMBER . J PI.a.. Print or Typ. NUMBER SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCEllANEOUS EXPENSES COMMONWEAltH O' P(NN'YlV.A.NI.A. INHUn.A.HC( TAk II(JUIIN 1I(SIDfHT DfCfDlNr Elizabeth H. McGuire DESCRIPTION AMOUNT A. Fun.ral Exp.n.... 1. 2. 3. 4. 5. Myers-Hamer Funeral Hana St. .:tohn's Cemetery - grave opening Oeissler's Flowers - for casket Messiah Village - catering Gingrich Memorials $5,758.00 $ 400.00 $ 45.00 $ 141. 57 $ 72.00 B. Aclmlnl.trallv. Co.lI. 4, C. I. 2, 3, 4, 5. 6. 7, 8, 1. N/A Perlonal Reprelentallve Cammlnlonl Social Security Number of Penonal Reprelentallve: Vear Com minion I paid 2. Allorney Feel Olar1es E. Shields, III (estim.l $ 718.75 3, Family E.empllon Clolmant AcId,... of Claimant at decedonl'. doath st,.ol Acldre.. Relallonlhlp N/A City slale Zip Code Probale Feel Mltc.llan.ou. Exp.n.e.. Filing Inheritance Tax Return $ 15.00 TOTAL IAllo entor on line 9, Recapltulalion) (If more .pac. I. need.d, In.ert additional .heet. of .am. .Iz..l S 7,150.50 11\l1J1J I" 11."1 '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS PI. a.. P,lnt or T . FILE NUMBER (OMMOHWIAUH Of reNNin_NIA INHllltANCI tA. InUIH InlolHt OlelDINt ESTATE OF Elizabeth H. McGuire ITEM NUMBER DESCRIPTION AMOUNT 1, Messiah Village - Final bill $693.21 TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional shee's o( same size.) $ 693.21 Ih Iil)l" IU'I ~ COMMONWIAUH 0' ,INN'flVANIA INHIIIlANCI lAX ."UIH .nIDINI DICIOINI SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Elizabeth H. McGuire ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE 1, A. Taxabl. B.qulltll Lawrence H. McGuire, Jr. 35 Fox Croft Drive Camp Hill, PA 17011-1530 son 100% ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charllabl, and Gav.rnm.nlal BequI.hl l. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AlIa .nl., on lin. 13, R.copll.lollon) S (I' mort .pace I. n..d.d, In..rt addltlonal.h..t. o' .am. .11.) - ~ r; :,( . ',' ~ 1;;1 I?~ , I --...~.,-_..__..~.--- ~ Mr." III t.Jw\JUl...:rI;:;]'l\I1I;;f!'LQL.J;',lMJlIITIUL-1:l~QYJllli 1, I::l~IZ^III:'f1l II. UcGtJIUI.:, of tho Township oC Uppar hllen, County or Ctlrl1barl.1nd, oud ntnto or Ilonnnylvnnln, boll1l1 or Dound ,'ntl diuIlouil1tJ rnirhl, rnoMury .lllt! umJol'ul;lntlJI1lJ, UU m.lko, I'Uhliuh ,. \'; , 'i nut! dC!clnro thIn to ho ny I.not Hill nnd 'I'out.lmonl.:, hOI'ohy ro\'o~:l"(J lllle! Milklnl) void .1) 1 (ormul' ,'" J In by mo 011.: ony timo ~.....i "'1 : ,~~ " heraloeo!"o JlhlUU. 1. 1'1 l: ;~, I I dia'oct tho p,]y~cnt or illl my juut dobtD nml Cunornl O)(POhoca nn noon na convoniontly may bo nCtor my uoconuo. All ootato, inhcl"itllnco, nuccooolon .lod othol' tl1)(CD imponed or 1, pnyable by rOQnon of my denth, with ronpoct to nl1 proporty pnooin<j unl!er thlo 11111, or otherwise, shnll be paid out of the principal of my rosiduary cstate, as if such taxes wore adminis- trdtion expanDoD, without apportionmont or right of roimbursoment. I authorize my Executors to pay nIl such toxos at ouch timo or timos 00 they doom advisable. 2. All tho rOGt, rooiduQ nnd romainder DC my Estato, ranI, perDonn} nnd rnh:cd, whatGoovor nnd whorosoover situate, I givo, clovino nnd boquoath to my Don, [.awronco II. HcCuiro, Jr., currently of Foxcrott DrIvo, Camp lIill, Ponnsylvania. . J. In tho avant, howevor, that my said Don should prodecoQso mo, I givo, dovise and boquoath my said Estnto in equal shares unto my throo (3) grandchildron, Lawrence II. MCGuiro III, Jeffrey S. MCGuIro, and Kathloon E. MCGuire. Shoull! nny of thorn prodocOQOO mo, then uuch procodont'o ohnro shall go to his or her Durvivinq children ~ nttrnon. 4. I nominata, conotitute and appoint my son, Lawrence If. MCGuire, Jr., to be the Executor of thin, my Last Will and Tostament. It ho ohould predeceaso mo, or tor any othor roason bo unablo to act aD Exocutor, I appoint Tho First Dank and Trust Company ot Mechonicoburq to bo tho Exocutor in hiD place and 1 ~.~----_..._..-...__._.,v.....__..., ~""'.. ._.__~~._..___-....-.---:-.,.,.,..,..,......_~~~. .' 15-&J - JD toe J R!V-1547 !X AFP (12-95* Cotl'tONWUL T" OF POltsVlYAHIA DEPUTttEHT Of' REv[HUE IUREAU Of INDIVIDUAL "leU O[PT. ""01 HARRUIl>>G, PA 11UI-UDl ACN 101 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 02-12-96 FIL! NO. OAT! OF DEATH 08-07-95 COUNTY CUMBERLAND NOTE I TO IHSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT TltE UPPER PORTION OF THIS FORN IIITH YOUR TAX PAYMENT TO TNE REGISTER OF WILLS, MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAYMENT TOI CHARLES E SHIELDS III 2 W MAIN ST MECHANICSBURG PA 17055 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 -...t R..lttod CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .. iii';:U4-j-ix-jiFjI--ii2':9sriiiiiici--oF-YNHEiiii'ANci-TAx"A'PpRA'isEiiiiii'-;-jii.L'oiiANci-iili----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCGUIRE ELIZABETH H FILE NO. 21 95-0790 ACN 101 DATE 02-12-96 TAX RETURN WAS I I X I ACCEPTED AS FILED I I CIWIGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. Reel E.t.t. ISchedule AI 2. Stock. ond Bond. ISchedul. BI 5. Clo..ly Held Stock/Partnerahlp Int.r..t (Schedule C) ~. Hortg.ges/Not.. Receivable (Schedul. DJ 5. C.ah/B~ Deposlta/Hlea. Parsonal Pr~rty (Schedule EJ 6. Jointly Owned Prap.rty ISchedul. FI 7. Tran.fara (Schedule OJ I. Tot.l A...t. APPROVED DEDUCTIONS AND EXEHPTIONSI t 7,150.50 9. Funeral Expen.../AdII. Ca. ./Hlao. Expen... (Schedule H) C,J 10. Debto/Mortg_ LhbUiU../U.n. ISchedul. II 1101 693.21 11. Tot.l Ooductian. 1111 12. Nat Value of TaM Return (12) 15. Charltabla/Goyarnaant.l aeque.t. (Schedule J) (15) 14. H.t V.lu. of E.t.t. SubJeat to Tox 1141 NOTE I If an aBBallBment wall iBBued praviouBly, linall 14, 15 and,or 16. 17 and 18 will reflact figuraB that includa tha total of ALL returns allllaBsad to data. ASSESSMENT OF TAXI 15. ~t of Lin. 14 .t Spou..l r.t. 1151 16. ~t of Line 14 t.xable .t Lin..l/Cl... A ~.t. (16) 17. ~ount of Line 14 t.xable at Coll.t.ral/Cl... 8 rat. (17) 11. Prinaipo1 Tox Due TAX CREDITS I PAYMENT DATE 10-23-95 111 121 151 141 151 161 171 .00 .00 .00 .00 31.975.56 260,862.34 .00 III 292,837.90 7,843 71 284,994.91 ,DO 284,994.91 .00 284,994.91 .00 X . DO. X .06. X .1S. UII .00 17,099.65 ,DO 17,099.65 RECEIPT NUltBER AA082247 DISCOUNT 1+1 INTEREST I-I 854.98 AItllUHT PAID 16,244.67 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 17,099.65 .00 .00 .00 . IF PAID AFTER DATE IHOICATED, SEE REVERSE fOR CALCULATION OF ADOITIONAL INTEREST. I If TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDrr" ICRI, YOU MAY BE DUE A REFUND. SEE REVERSE SlOE OF THIS FORN FOR INSTRUCTIONS. I t -- . - \ '. 1 <)( b.! RfIERYAllDNI E,t.t.. of dec~t. dying on D~ be'or. u.c..ber 12, 1'" ~~ If ~ future Int.,...t In ~ ..'at. I, tr~''''red In po.....lon or enJoYMnt to Ct... . (COU.t.AU benltfJol.r... of the deced.nt Ift.r u.. Ikpl,.aUon 0' ..., ..t.t. for 1.1,. or fa,. W""" the C~.lth her., '!cp,.lIh ,.....-v.. the rllht to ...,..... Md ...... tr....'.,. Jm.rUIIMI Tu.. .t the l~'ul el". . (colll'.r..) r.t. on ~ .uch futu,., Int.r..t. PlIlPOU OF NaTlCEr To tvlfUl thrI r~lr.....ta of s.aUon 2.40 of the I""rlt~ end Elht, Tax Act, Act ZZ of 1"1. 72 P.I. IeotlDn 2141. PAYHDfTI , Detecft the top porUon 0' thh NotlCI Md IIUblIlt with vour ...,...t to the A".lt.,. of W11h printed on u. r.v.n. .Ide. ...... check or ~v orct.,. p"MlI, to. REOISTEI OF HILLS, jGEIfT All pIYMnb rKIlvN ....11 'Int tMI ...11_ to WI, Inte,..t .....Ich -V be ... with en, ,._1,..,. .,,11. to the tax. REf1ICD caUl' ,..fund of . tu credit, INhlch .... not r8qUillt... an U. Ta Rltum, ~ bit r..,..t.t by c~l.Ung WI -Application 'or Refund of Pennlylv.nla 1m.,.lt~. ~ E,t.t. Tax- (REV-ISIS). ApplIcation. ar. .v.ll~l. .t the OffIce of the A..I.t.r of Will., ~W of the 2J A.venue DI.trlot Offlc.., or by call1n1 the eplCl.1 14.hour ~.werlng ..rvlc. ~r. for 'or.. ordering I In '-nn1Y1v.n1. 1....-561.1.5., out'lda P~'vlv~l. and within local ",rrlabor. .r.. (7171 7.7...94, TID' (717) 77Z-11S2 (Hlarlng 1.,.lrld Onlwl. OBJECTJONS, Anv p.rh In Int.r..t not ..'hflltd wIth thl! appnl"-\t, aU0W;anC8 or dl..UOMMCtI of deducUon., or .......,t of tn (IncludIng dlltCount or Inhr..U .. IhcMln on thll Notice ....t obJKt ..I thin .hltv (601 dewe of rKIIlpt of thh Notlc. bWI .....rltt.. prot." to the PA Daparbwit of hVMUII, Board of Appeal., Dlpt. 111011, Harrlabur., PA 1711'.1111, OR "".Iectlon to hft. the ..U.r dat.r.lned .t .....It of the Kcount of the panonal r.r...nt.Uv., OR ..-.....1 to thl Orphan.' Court. AIlIIIN IITRATJW CORRfCTJDHlI '_tual .rror. dhcov.red on thh ........"t 1hou1d btI IIddr...ed In writing to. PA o.p.ru..nt of R.VIf1Ul, lura.u 0' IndividUal TIXI" ATTHI Po.t A....seent R.vl... unit, Dlpt. 1'0601, Harrllburl, PA 1711..0601 Phone e7171 7'7.'501. S.. pee' S of the bookl.t wln.tructlon. 'or Inherltanca TaM A.turn for a A..ldant Dacadentw (REV.1.011 for.. .xplanatlon of ad.lnl.tratlv.l~ correctabla .rror.. If ..v taM due I. paid ..Ithln thr.. (51 calandar ....lh. aft.r the Headent.. death, a five perc..t UXl dlltCount of the taM paid hallowed. Inter..t h charled beGlnnlna with flnt day of dlllnrwuancv, or nIne e'l IMlftth. .. ana (1) daw frM the data of death, to the det. of P')"IIlInt. 'aJII' whIch bee... delinquent ba'or. JInUlf"W 1, 19" bear Int.r..t at the r.t. of ,I. e~1 peroent per am..- c.lcul.ted It .. dellv rat. of .DDOlM. All tlX.. whICh bee... dallnqu.,.t on and .ftar .....rv I, 1912 will bear Int.ra.t .t .. rat. Nhldt ..Ul vary f,.,.. calendar YHf" to c.lendar V"r ..Ith that rat. ~... bv the PA Depart.."t of bvll'lUl. The appllcabl. Inter..t rat.. for 1'.1 through 19M .r., alleourU. INTER!ITI ~ Inter..t R.ta Dally Int.r..t 'IICltar ~ Inter..t RIIt. Dallv Int.r..t 'aotar 1911 ZDX .DD'Ma 1917 OX .DOotn I'IS 101 .DD04Ja 1"'-1"1 l1X .DDDSOl 1914 IU .ODDSDI I"Z OX .100147 1911 IS" .IOOSS. InS-19M n .0001" 19.. I'X .IOU74 Ins. 1'" ox .IOU47 ".In"r..t h c..cuhted .. followlI JItTEIIElIT . SAUNCE OF TAlC UNPAID X IlVIlBER OF DAYS DELINQUENT X DULY JIfTERE8T FACTOR ".Anw Hatlc. I..ued .ft.r thl! t.x beeDle. delinquent will r.flact an Int.r..t calcul.tlon to fIfteen (151 daVI blvond thl! d.t. of the .....uent. If paPMt II ... aft.r the Int.r..t COllpUt.tlon at. IhoMn on the Notice, IIddltlonal Int.r..t .,.t ba calculated.