HomeMy WebLinkAbout95-00798
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RI!V-IS47 I!X AFP C12-95_
tOil ~~ALTH Dfl' ~VAHlA
1l<P.._ 01' ...-..
IlIIUo Ill' IHDIVI_L rAllrI
DOJ. "'''1
HARRIlIURG, PII 17121-'601
S FILl! NO.
DATI! OF DEATH 10-20-95 COUNTY CUMBERLAND
HOTE I TO INSURE PROPER CREDIT TO \'OUR ACCOUNT, SllBltIT THE UPPER I'DRTIDH 01' THIs FOIlll WITH YOUR TAll
PAYIIEHT TO THE REGISTER OF WILLS. IWeE CHEClC PAYAIILE TO "REGISTER 01' WILLS, AGENT"
REMIT PAYMENT TO:
NOTICE OF INHERITANcE TAll
APPRAISEHEHT, ALLDIIANCE DR DISALLOWANCE
OF DEDUcTIONs AND ASsEsstlEHT 01' TAll
ACN
101
DATI! 02-19-96
RICHARD C SNELBAkER ESQ
44 W MAIN ST
HECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
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SNELBAKER e BRENNEMAN
^ "",,'USIONAL COAPOMTlON
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MECHANICSBURG, PENNSYLVANIA 17055
HBGPA 170
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REGIS'rER OF llILLS
COIlN'l'Y OF ClJIBERLAND
ONE COURTHOUSE SQUARE
CARLISLE PA 17013
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
YEAR
N UM8E1
+ +
20. If Uno 191. groalor Ihan Uno 18. onlor ,ho dlllo,onco an lIno 20. ThllII ,ho OVERPAYMENT.
gO
21. If Une 18 II sreater than line 19, entlr the differeflce on line 21. This Is the TAX DUE.
A. Enter thelnterllt on the balance due on lInl 21A.
8. Enlor Iho 'olala' lIno 21 and 21A on lIno 218. Thl.I. Iho BALANCE DUE.
Mak. Check Pavabl. tal Regl.te, of Will., Aglnt
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDlAND TO RECHECK MATH ~..c:
Under penalliel of perlury. I declar. that I have examined Ihil relurn, including accompanying Ichedulel and Itatemenll, and to the b.1I of my ~nowledge and b.U.f.
it II Irue, corred and complet.. I declar. ,hot all real '1late hal been reportla at Irue market "alu.. Declaration of preparer other than the penonal r.prelentatl". II
bale on allln'ormoll n of which preporer hal any ~nowledge.
51 IUIle: 0' "u~,e: , N511U 'OA filiNG AUU ADDAU5 102 Forge Road (Joint Owner) OAf( /. . /
'"<r .' (.( J'-I 1/ //1"" /OI2~/f(c.,
51 NAJU , , 01 IHAN ar,IlUENIAllvl ADDun 44 West Hain Street DAn ~ I
Mec1l11nicsbur' PA 17055 loh'!lit,
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15
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COMMONWfAlrH 0' 'fNNSYlVANIA
DErAUMfNr 0' .fVENUf
DfPT. 2I06Q I
HAIIISlURO.'A 11 '1.060'
(CfOIN' NAMllLA'. In. AND MIODlllNI IAll
MOYER, SAMUEL L.
o
.01 DATlSO. DU.TH Ami 12131191 CHICK HIli
If A SPOUSAL
POVII" CIIDIT IS CLAIMID 0
flU NUMUI
.;l/
COUNTY CODE
DIN' C ""U II! AD ~ is
102 Forge Road
Boiling Springs, PA 17007
Cumberland
/qq5
7qg
DAn Of II.'"
WC:IA~ lICURny NUMIU
173-01-5606
OAn Of DIAl"
10/20/93
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(II ."UU....II.II.Y1'o'tHG lPOuU'1 .......IIUU. 'Ill' "NO "uoon '/'U1IAII
AMOUNT _(CfIVID (lU IN"RUCTION'I
iii 1. Original Rolum by one of
joint owners
O~. Umllod EllalO
o 3. R.maind.r R.lurn
Ifor dalo. a' doalh prior 10 12.13.82
o 5. f.d.ral Elfat. To.. Return R.qulred
lil15
.....
"'z
B2
o 2. Supplomon'ol ROlu,n
o Aa. Future 'nterllt Campromlle
('or da'o, a' doa,h ako, 12.12.B2)
o 6. Docodonl Dlod To,'a'o 0 7. Docodonl Molntalnod a Uvlng Trull
(""ach copy 0' Will) IA"ach capy 0' Trulll
AlL CORRESPONDENCE AND CONFIDINTlAL TAX INFORMAnON SHQULD:BI!DI
HAM' Richard C. Snelbaker, Esquire OMrlm..A1UHOADD. ,
SNELBAKER & BRENNEMAN P.C. 44 West Main Street
IImHOH.Hu..... Mechanicsburg, PA 17055
717 697-8528
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..Q... 8. Tolol Numbe, of Safe D.potlt BOUI
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1. R.al E,I:'o (schodulo .~) (1)
2. S'och and Band. ISchodulo 81 (21
3. Clo.oly Hold 5lad<lPartno..hlp In'oro.' (schodulo q 13)
.c. MottgaSII and Notel R.c.ivable (Schedull OJ I ~ I
5. COI~ Bank Oepolltl & Mllcelloneoul Penonol Properly (51
(S odul. E)
6. Joln'ly Ownod Proporty (schodulo F) 16) 7 , 34 1. 15
7. Tran.fon (Schodulo G)15chodulo I) (7) 7.341.15
e. Total Grall Alletl (lolaIUn,. 1.7) I B}
9. Fun.ral Ex~enle.. Admlnfllra,lve COlts. Mlscellaneoul 19} 365.00
Expon.o. I chodulo HI
10. Dobl.. Martgago UablllUo., Uon.(schodulo II (101
11. Ta'al Doductlon. I'a'al Uno. 9 & 10) Ill) 365.00
12. Not Valuo a' Ella'olllno 8 mlnu. Uno 111 (121 6,976.15
13. Charltabl. and Governmental aequeltl (Sch.dul. J) (131
1~. No' Valuo Sub oct 'a Ta. (lIno 12 mlnu. Uno 13) (14) 6,976.15
15. 5pau.al Tran,Io.. (Iar da'o. of doa,h ako, 6.:10.941 (IS)
S.. Inllrudlonl for Ar,pllcabl. P.rcentag. an Reverie x._-
Sldo. (Includo valuo. rom 5chodulo K or schodulo M.I
16. Amount of line 14 'alitabr. at 6% rate (161 6,976.15 )( .06. 418.57
Ilnclude "alu'l from Sch.dule K or Schedule M.)
17. Amount of line 104 laxabl. at 15% rat. (17) .)( .15 III
(lndud. vglu.. (rem 5th.:"I. K or Schedul. M.I 418.57
18. Principal 'a. duo (Add la. fram Uno. 15. 16 and 17.) (18)
19. Cr.dill Spoulol Po"eny Credll Prior Poymenll Dhcaunt Inlerllt
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119)
1201
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CIlf'C~ hew If you ore requ~stin9 0 refund of your overpaymcnt.
418.57
(21)
121A)
12181
418.~7
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COMMQHW'ALlH Of PlHHSnVAHIA
IHHllnAHCI 'AI UIUIH
IUlDlHIlllCllllHI
SCHEDULE F
JOINTLY-OWNED PROPERTY
UTA" OF
FILE NUMBER
MOYER, Samuel L.
Joint t.non'(.I.
NAME
A. Georgie A. Mummert
ADDRESS
102 Forge Road
Boiling Springs, PA 17007
RELAnONsHIP TO DECEDENT
Daughter
B. Dorothy C. Moyer
102 Forge Rosd
Boiling Springs, PA 17007
Wife
C.
Jolntl,..wn.d proport,.
ITEM LETTER DATE
FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBiE~ JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
1. 9/20/93 Certificate of Deposit $14,038.03
01773200171271, PNC Bsnk, N.A.
A - u. divided 1/6 interest to dsughter 16.66! $ 2,339.66
B - UI divided 1/6 interest to wife, not tsxal Ie as
survivi g tensnt by the entireties - -
2. 9/15/93 Certificate of Deposit $15,007.39
01773160171269, PNC Bank, N.A.
A - u divided 1/6 interest to daughter 16.666 $ 2,501.22
B - u divided 1/6 interest to wife, not taxal Ie as
survivi' g tensnt by the entireties - -
3. 2/21/93 Certificate of Deposit $15,001.67
01773160171266, PNC Bank, N.A.
A - u divided 1/6 interest to daughter 16.666 $ 2,500.27
B - u divided 1/6 interest to wife, not taxal Ie aa
survivi g tenant by the entireties - -
TOTAL (AI.o onl.r on line 6. Recapitulation) S 7,341.15
(II mar. spac. js n..ded ins,,' addilional.h..'s of some sin)
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~IAlfttOl""HI'LMt.NIA
INNII~ TAX OmlaN
II_NT DlCIOINT
SCHEDULE H
FUNERAL EXPENSES,'
ADMINISTRAnVI COSTS AND
MISCEUANIOUS EXPENSES
Pl_ Print.... l'
MOYER, SAMUEL L.
/TIM
HUM'"
A. Fu_1 ..,...._.
I.
..
4.
C.
l.
2.
3.
4.
5.
6.
7.
8.
DlSCRIPJION
AMOUNT
1.
A.jllllnbl. ...,... COItII
"'lIOlIallWpl'llMnlallw Commlnia",
Socle" Sea.ri1)i Numb... of ......onallWp...enlatlwl
Yeor CommlsJlont paid
2.
Attom-r ""' Snelbaker & Brenneman, P. C.
$ 350.00
3. family Exemption
Clalmalll Relcrttonshlp
Add.... of Claimant at dlClldent'1 dDClth
s.- Add,...
Cty
Stote
ZIp C'''Cf,o
Probate ""'
Mlscella_. II.. '_1
Register of Willa, filing fee thia return
15.00
TOTAL (All" ent.r on II.. 9. R'a1pltulaIJon)
(If more Ipace It n..d.d, In..rt add/llonallh.... of .am. I'.',)
s
365.00
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a_'AI_
--
SCHIDULI J
BINIFlCJARIIS
111'10" 01'
..... HUMIII
MOYER, SAMUEL L.
11IM
HUMUlI
AMOUNT OR
SHARI 0' UTA"
HAMI AND ADDRUS 0' lIIHIPlClARY
RIlAnONIHl'
1.
A. To....... IeqvooIII
Georgie A. MUllllllert
102 Forge Road
Boiling Springa, PA 17007
Daughter
1/6th intereat in
Certificatea of
Depoait
1/6th intereat in
Certificatea of
Depoait
2.
Dorothy c. Moyer
102 Forge Road
Boiling Spr1nga, PA 17007
Wife
ITEM
HUMID
AMOUNT OR
SHAD 0' UTATI
NAM. AND ADDRUS O' BlNIRCIARY
'0 Charitablo and 00..._1 '~I
1.
NONE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aha .nt., on IIn. 13, Rocapltulollon)
(1/ mOrl 'poco I. nood.d, Inn" additional .hoo'. 01 .om. .1.0'
5
NONE
-- -. --....."'.........
,
___'_._.___________ _0.:...-_ ___ _ _'_ __ ____ _ _ __ _ _ __'_~';:"'" ..:...;.-:.:.;:~;:::::,.,.:l-':::::~~
f;~Vff:~i:"r~~l~~:t}:;;;:,:;[;t;.~ ';.' COMMONWEALTH' OF: PENNSYLVANIA" .
DNo;AA',o82254!.' ,,'. . . . . ....
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ri~;i~'.. j;'.;.\ :t;/r::,',',' O.FFICIAL RECEIPT e, I'ENNSYLVANIA INHERITANCE AND ESTATE TAX
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RECEIVED FROM,
i
ACN
ASSESSMENT Il'
CONTROL ~
NUMBER
AMOUNT
SNELBAKER RICHARD C
44 W MAIN STREET
101
S41B.!57
MECHANICSBURG, PA 170!5!5
'OtOHllf
ESTATE INfORMATION,
EJ fiLE NUMBER e 1-199!5-079S
EJ NAME Ofrl~T sMlUEL L
II DATE Of Pt~~4/9!5 ,
I'!I POSTMARK DATE
... 0/00/00
COUNTY CUMBERLAND
SSN 173-01-!5606
(fIRSTI
(Mil
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DATE Of ol~~eOI93
REMARKS GEORG I E A MUMMERT
CIO RICHARD C SNELBAKER ESQ.
CHECK" 9!5264e
m TOTAL AMOUNT PAID
.41B.!57
IJz-
REGISTER OF WILLS
i
. J
RECEIVED BY hi 1'. . U// "";.1
. NA! '
MARY C. LEW S I;" ." "
REGISTER OF WILLS ~ )'./ ,j .
SEAL
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REV-1S47 EX AFP (12-95*
COHHOHWEALTH OF PENNSYLVANIA
DEPARTHf:NJ Of RfYEtAJE
BUREAU Of INDIVIDUAl TAlCES
DEPT. ZIOUl
HARRISBURG, PA 171'1-0601
NOTICE OF INNERITANCE TAX
APPRAISEHENT, ALLOWANCE OR OISALLOWAHCE
OF OEDUCTIONS ANO ASSESSHENT OF TAX
ACN 101
DATE 02-19-96
S 0 FILE NO.
DATE OF DEATH 10-20-93 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUBHIT TNE UPPER PORTION OF TNIS FORH WITN YOUR TAX
PAYHENT TO TNE REOISTER OF WILLS. HAXE CHECX PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
RICHARD C SNELBAKER ESQ
44 W MAIN ST
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A~t R..ltt.d
CUT ALDNG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiifli: iilW-iX"iiFji-nZ-:9Sriiiifici--ciF--iriHEifiTANCi-TAx-APjiiiA'isEifiii'i'-.--,m:ciiiANCi-oR'----------- ___m
DISALLOWANCE OF DEDUCTIDNS AND ASSESSMENT DF TAX
ESTATE OF MOYER SAMUEL L FILE NO. 21 95-0798 ACN 101 DATI! 02-19-96
TAX RETURN WAS. I X I ACCEPTED AS FILEO
I I CHANGED
RESERVATION CDNCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE DF RETURN BASED ONI ORIGINAL RETURN
1. Roal E.t.t. ISchodul. Al III
2. Stock. and Bond. (Schedul. BI 121
5. Clo..ly Held stock/Partnarahlp Int.r.d (Schedul. C) (S)
4. ttort_./ttot.. Roc.lvobl. (Schodul. DI (41
5. Caahl8.nk o.poalta/Hlaa. Par.one! Property (Schedul. E) (5)
6. .JoIntly O_d Proporb ISch.dulo FI 161
7. fran.fa,.a (Schedul. OJ 17)
I. Total A...t.
.00
.00
.00
.00
.00
7.341.15
.00
(al
7,341.15
APPROVED DEDUCTIONS AND EXEMPTIONS I 365.00
9. F~r.l EMpen.../Ao.. Coata/Hiea. EKPan... (Schedule HJ (,)
10. Dobhlltorto."" LiDblUU../LI.n. (Schodul. II (101 .00
11. Tot.l D.duotlon. 1111
12. Net Vatu. of TaM R.turn (12)
15. ~rlt.bl./Oov.rnaant.l a.queat. ISchedule J) 115)
14. Not V.lu. of E.t.t. Subj.ot to Tax 1141
NOTEI If.n ........nt w.. i..u.d pr.viou.1Y, lin.. 14, 15 .nd/or 16, 17 and 18 will
refl.ct figur.. that includ. tho tot.l of ~ ra~urn. a......d to date.
ASSESSMENT OF TAXI
15. Aaount of Line 14 .t Spou..l rat. US)
16. Aaount of Line 14 taMabla .t Lin..l/Cl... A rat. 116)
17. Aaount of Line 14 taMable at Coll.teral/Cla.. Brat. 117)
18. Pr1n01p.l raM Du.
TAX CREDITS I
PAYHENT
DATE
10-24-95
~~~ on
6,976.15
.00
6,976.15
.00 X .00.
6,976.15 X .06.
.00 X .15.
ual
.00
418.57
.00
41B.57
RECEIPT
NUHBER
AA082254
DISCOUNT
INTEREST
l+1
I-I
43.89-
AItOUNT PAlD
41B.57
INTEREST IS CHARGED FROM 10-25-95 TO 02-27-96
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TDTAL TAX CREDIT
BALANCE DF TAX DUE
INTEREST
TOTAL DUE
374.68
43.89
1.37
45.26
\
I IF TOTAL DUE IS LESS THAN fl, NO PAYHENT IS REQUIRED.
IF TOTAL OUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
:". , ..
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
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RE:lERVATlOHI btat.. of elM...... ctvl". on Dr before DecMber 11, 1912 -- Sf MY future Inter..t In the Iltet, I, ',MI'e,.r.
In po.....lon or enjopent to Ct... . (collateral) benIIUaI.rS.. of the dHedent .ft,,. the IJCpJnUon of .", ..t.t. for
11'. or for V"", the r ...-.11th her., upr...b ra..,.v.. the right to ...,...... end ...... ".,I'.r IrlMrlt-.ce T....
It the l.wful Cl... . (coll.t.ral) r.t. on .",. .uch future Int.,...t.
PllIlPClS(Of'
tl)TJCE:1 To fulfill the ,....I,.....tI 0' Section 2140 of ttM Inherlt..- .nd Elt,t, Tu Act, Aclt ZZ of 1"1. 72 P.I.
SeoUon 2140.
PAvtlEHTl ht.ch the top portion of thl, NoUel Met __U with your PIYNnt to the _..ht'r of "IU. print_ on the renr.. ,...
......... cMck Dr ....., .rdei,. plyllb., tot REGISTER OF MILLS, AaEHT
AU p.,...,. nCIIV8d 1hII11 ,.,.Il be ...,.UMI to ..., Int.ralt which MY be .. Idth M' ,....1..,. ...,.l1ed to the tu.
AUtIGI (CA)I A rehond of I tax credit, whIch .... not r~.ted on the Tax Return, MV be ,...,..ted bv cMP1IUng ., "Application
'or Refund of Pennlylv.nll 1~,.ltenc. end E.t,t, T.... (REV-ISIS). Appllc.tlonl ere ev.II~le .t ~ O"lc.
D' the A-aht.r a' WIU., ...y a' tha n Aevanu. Ohtrlct Offlc.., or by CIIlllng tha IPHI.I 14-haur
....warlng ..rvlc. rMMIber. 'or 'Dre. Drdarlng, In Penn.ylv...l. l-100-S6Z-1151, out.lda Penn.ylvanl. and
within lac.1 Harrlabur, .r.. (711) 7.7-1094, TDD' (717) 771-1Z51 I"-.rlnt lap.lred Only).
aUCTIONS, Any perty In Int.r..t not ..thfled with tM IlPPnh.....t, ,UOMMC. or dl"'l~ D' daducUons, Dr ........,t
of tu (lnclucl!". dhcCU1t or Inter..U .. shown on thh HoUce ..,.t abJeat tllthln .laty (60) dan 0' rCle..pt of
thb NoUc. bYI
......rlttwt prohst to ~ PA Depart...,t of AIV......, IDIlrd of Appe..., Dept. lIlIlI, ",rrlabur" PA 17UI-1011, OR
--.lactlon to have ttM ..Uer a'sr.lned .t ...It D' 'M _count of thl parHnllI rllPr..anteUv., OR
--.....1 to the Orphan.' Court.
""N
JlTRATlVE
CORAfCTJDHI, Faatuel .rron dlM:ov.rM on th" ........"t should ~ addre..ed In wrlUne to. PA Dep.rtMnt of Rawnue,
lur.'" Df Individual T'M", ATTHI Po.t A.......,t A.vlew unit, o.pt. ZIO'OI, HlrrlMbur., PA 17111-0'01
~ (717) 717-'505. aw. page S of the bookl.t Rlnltructlonl 'Dr Inherlt~ T.. A.turn 'or. A..ldent
DecedentR IREV-ISDI) 'or ... .xpl....tlon Df IdIlnl.tr.tlv.l~ correctabl. error..
If eny tlx dull 11 p.ld within thr.. (5) c.lendar .wtth. .fter ~ decedent's death, . fl". percent U,v) dhcCMlt Df
the tu P.ld II .UONId.
OIICDlIfT.
JNTEREST.
Jnt.re.t II chIIrged tMtth.dng with first day of dellnquency, Dr nine (t) ....th. ... one (1) day frOll ~ ct.,. of
..th, to ~ ct.t. of p~t, hxu whldl ~ delinquent bI'or. J.....-y 1, 1911 bur Inter..t .t the rat. af
.1. (U) percant par ....... c.louhted et . dIIlb rata Df .OODIM. AU ,_.. Mhlch baMM dlU,..,..t an ... .fter
.Mnuary I, nil ..111 bur Inter..t at a r.ta which ..Ill wry 'rOIl calandw 1rIIr '0 calendar YMr with that r.t.
anncM.I1Ced by the PA Depert.....t Df R.VMUS. The appllcabl. Inter..t rat.. for 1912 through 1'" er..
~ lnt.ra.t A.t. DellW Int.re.t Feator !!!! Intlr..t A.te Dalh Intar..t FlNltor
1912 ..X .000"1 1917 OX ,DODl47
I9IS .61 .000451 ""-'"1 IIX .ODUOl
..14 IIX .DOOSDI '"' OX .GDn47
1915 'SX . ODDS" 1995.1994 7X .0001.2
.'16 lOX . nun 1"5-1", OX .00n47
--Int.,..t Ie cllcul.t~ .. follow'l
INTEREST . 8ALANCE OF TAX UNPAID X HVK8ER OF DAY8 DELINqUENT X DAILY IHTEREBT FACTOR
--Any Hotlce I.~ .ft.r the tex bec~. delinquent ..III ra'leet an Intlr..t calcul.tlon to flftlan (11) day.
beyond the dlte of the ........,t. If paYNnt I. HdII .ftar the Int.,..t -.put.tlon date IhowI on the
Notlc., edel! tlonal Inten.t .....t ~ c.lculetad.
i':' tv.)
~
,"
REV-1607 EX AFP (12-95*
COHHONWEAlTH Of PENNSYLVANIA
DEPlRrPENT Of REVENUE
IUR[AU OF IHDIVIDUAl fAX[S
OE:pr. ra060.
HARRlllURO, Pi 17U'.06U
ACN 101
INHERITANCE TAX
STATEMENT OF ACCOUNT
DATI! 03-18-96
o MOYER SAMUEL L FILE NO. 21 95-o79B
DATE OF DEATH 10-20-93 CDUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBNIT THE UPPER PORTION OF THIS FORN WITH YOUR TAR
PAYNENT TO THE ADDRESS SHOWN. NAXE CHECR PAYABLE AND RENIY PAYNENT TO. 1r
RICHARD C SNELBAKER ESQ
44 W MAIN ST
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AIlount R_lttod
CUT ALONG THIS LINE ~ RETAIN LOWER PDRTIDN FOR YOUR FILES .....
ifEWii.lij-iiC"iiFP--nF9S-,-----n.ilii-fiiifERiYAiici'-i'AX-STAfiiiENi'-OF-Accouiif--...--_....n..---- -- n__
ESTATE OF MOVER SAMUEL L FILE ND.21 95-0798 ACN 101
THIS STATENENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE MANED
ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS,
THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE.
DATE 03-18-96
DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT. 02-12-96
PRINCIPAL TAX DUE, 418.57
PAYMENTS (TAX CREDITS).
PAYMENT
DATE
10-24-95
02-27-96
RECEIPT
NUMBER
AAD82254
AA1l257o
DISCDUNT (+)
INTEREST (-)
43.89-
1.37-
AMOUNT PAID
418.57
45.26
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TDTAL DUE
418.57
.00
.00
.00
. IF PAID AFTER THIS DATE. SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN II,
NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI.
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
I,i_
; ~~
/)f)
PAYlENT I
o.tllCh thIl top portion of this NoUc. lInd ....U with your P.VII..t .~ p.YMl). to tJM' n.. Md Mlck...
print" on the rev.r.. sleM.
11 AESIDENT DECEDENT .... cMok or NNY order p.yllbl. tal REGISTER OF WILLS, AGENT.
11 HON"RElIDENT DECEDEKT ..... check or HM~ ord.r p.YMlI. tal CotltONWEALTH OF PENNSYLVANIA.
AU p.pents r.celv.d IhIIU b. IIPPllect fir.. to MY Intlr..t Nhlch uy tM ctu. with MY r...lnd.r -..lIed to the tI..
REfUGJ (CRII A refWld of a tax cr.dlt, Nhlch wa. not r.....ted on tM Tax Raturn, .ay b. requeltMl by coapl.tlng WI
"Appllc.tlon for Rafund of P~.ylvanl. Inherltancl and r..tatl Tax" (REV")).)). application. ar. avallabll at
the OfficI of thl R.gl.tar of Will., any of the 25 R.v~ Ol.trlct Dfflc.. or froe the O.part...,t.. 24"hour
anlw.rlng ..rvlcl ~r. for for.. ord.rlngl In P.nnlylvanla 1-100-562"2050, out.ld. P~.YlvlOl.
and within loc.1 Harrl.burg ar.a (717) 717"1094, TOO. (717) 77Z"ZZSZ (Ha.rlng lapalrad only).
REPLY TOI DuII.tlon. rq8tdlng .rrors contllf*l on this notlc. .hould tM Bddr..ud tal PA o.p.rt.."t of A.v."...., aure..
of Individual TIX.., ATTNI Po.t a.....-.nt R.vlew Unit, Dlpt. 210601, H.rrl.burg, PA 171ZI"0601, ~
(717) 717-6505.
DISCOUNT. If any tax due I. paid within thr.. ()) c.I~.t eonth. aft.r thl decedent.. d.ath, a flv. p.rCWlt (5%) dl.count
of thl tax p.ld h aU~.d.
INTEREST I Int.r..t I. chlrg.d blalnnlng with flr.t dlY of dlllnquency, or nine (91 eonth. end ana (I) dey froe the data 0'
de.th, to thl d.tl 0' ply..nt. Tax.. which blc". delinquent b.forl January I, 1912 b.ar Intera.t at the rlt. 0'
.Ix (6XJ p.tC~t p.r InnuI cllcul.ted .t . d.lly t.t. of .000164. All t.x.. which b.c... d.llnquent on and .,t.r
Janu.ry 1, 1912 will b.lr Int.r..t It . rat. which .,111 v.rv fros e.l.nd.r y..r to cllend.r y..r .,Ith th.t rat.
announc.d by thl PA D.p.rt..nt a' A.venue. ThI appliCable Int.r..t rlt.. 'or 1911 through 1996 .r.1
V..r Int.rut A.t. D.IlY Int,,"t Factor V..r Int.r..t Aat. D.lb Int.r..t Factor
1911 ZDX .000541 1917 ,X .000247
1915 lOX .ooooa 19""199. IIX .OODSOI
1'14 IlX .GODSOl 1'92 'X .000247
1'15 UX .00OS56 1995"1994 n .00019l
1986 lOX .000274 1995"1996 'X .0ODZ47
ulntln.t I. calculatad a. follaw..
INTEREST a BALANCE OF TAX UIfPAID X NUKBER OF DAYB DELINQUENT X DAILY INTEREST FACTOR
--Any Notle. II.ued aft.r thl t.~ baca... d.llnquant will r.fJact an lnt.r..t calculation to flft-.n (151 de,.
beyond the data af thl ......aent. If payaant I. .-de .ftar thl Intar..t cu.put.tlon data shown on thl
Notice, addltlon.l Intlr..t .u.t tM c.lcul.ted.