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HomeMy WebLinkAbout95-00815 CO""ONW[Allll or Pt:HHSYl YAHIA OEPAA'~H' or REyrHU( BUREAU Of INDIYIDUAl 'AM(S orp,. l8D6DI tlARAISBUAC, PA l1ua.06DI '* ND.Z1-q5-~/5 95149788 10-IZ-95 TYPE OF ACCOUNT o SAVINGS IX] caEcKING o TRUST o CERTlf. INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE ""I"I...n 11."1 EST. OF CLARENCE B ESTEP 5.5. NO. 169-05-3Z34 DATE OF DEATH 07-16-95 COUNTY CUMBERLAND WARREN B ESTEP 36 WESTWOOD CT ENOLA REHIT PAYHENT AND fDRHS TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PA 170Z5 DAUPHIN DEPOSIT OK I T hn provld.d the C.p.rt..nt with the Infor..Uon Ibt.d b.low which hn b..n uud In calculating the potential t.. due. 1h.lr r.cord. Indlc.te th.t .t the de.th of the above d.c.dant, you war. . Joint ONn.r/b.n.flclary of thl. account. If you f..l thl_ Infor..tlon Is Incorract. pl.... obtain wrlttan corr.ctlon fro. the flnancl.1 In.tltutlon, att.ch a copy to this for. and r.turn It to the above .ddr.... 1hl'. .ccount Is t..abl. In .ccordanc. with the Inh.rltanc. ,.. L.w. 01 the Co..onwulth of PeM.ylvanh. Cu..t1Wlt .COY bol ~..=w.r.d bV ce;lIl!'!: {n.') "'87-"''17 COMPLETE PART 1 BELDW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0031Z468Z6 D.h 03-09-77 esbb1hhad Account Bahne. P.rcant Taxabl. A~ount Subjact to Ta. Rat. Pot.nti.l T.. Dua To In.ur. prap.r cr.dlt to your .ccount, two 12J capl.. of thl, notlca au.t .cca~any your pay..nt to the A.gl,t.r of Will,. "aka ch.ck payabl. tal ~A.gl.t.r of will., AgantM. PART [!] 69,495.44 50.000 34.747.7Z .06 Z.084.86 TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE x NOIEI If ta. pay.ent. ara ..d. within thr.a CS) .onth. of the dac.dant', data of death, you ..y daduct a 5X dl.count of the ta. dua. Any Inheritance ta. due will b.co.. delinquent nine (9) aonth. aftar tha data of d.ath. T.. x [CHECK ] ONE BLOCK ONLY .. 0 Th. above Infora.tlon and ta. dua I. corr.ct. 1. You ..y chaO'. to r..lt p.y..nt to the Ragl.t.r 01 Will. with two copla. 0' thl. not Ie. to obt.ln . dl.count or .vold Int.r..t, or you ..y ch.ck box "A" and r.turn thl. notlc. to the A.gl.t.r of will. .nd an offlcl.l ........nt will b. I.suad by the PA D.p.rt..nt of A.vanu.. B. c:J )h. above ....t ha. b..n or will b. r.port.d and t.. p.ld with the p.nnsvlvanla Inh.rltanc. Ta. r.turn to b. fll.d by the d.c.d.nt'. r.pr.s.nt.tlv.. C. c=l Th. .bav. Inlora.tlan I~ncorr.ct and/or d.bt. end d.ductlon. w.r. paid by you. You .Ult co.pl.t. PAAT L!J and/or PAAT ~ b.low. If you indicat. . diff.r.nt t.K r.t., pl.... .tat. your r.l.tion.hip to dec.dent, OFFICIAL USE ONLY 0 AAF PA DEPARTMENT OF REVENUE PART ~ TAX RETURN . CDHPUTATIDN OF LINE 1. D.t. E.tablhh.d 1 2. Account aalanc. 2_ 3. r.rc.nt T...bl. 3 x 4. A~ount Subj.ct to raK 4 S. Debt. and Deductions 5 &. A~ount Ta.abl. & 7. TaK R.t. 7 x 8. TaK Du. 8 TAX ON JDINT,TRUST ACCOUNTS PAD I 2 3 4 5 6 7 8 DEDUCTIONS CLAIMED PART ~ DATE DEBTS AND DESCRIPTION AMOUNT PAID PAYEE PAID ! . \ TOTAL CEnt.r on Lin. 5 of Ta. CoftPut.tion) Under panalti.. of perjury, I daclar. that the facts I u;t;?!.:'" 10 Ih. bUOO',.~ ~,.r;0);-~. .nd b.II.,. -;::~P:~~~URE Ii ,-1 F~' have r.port.d .bova .r. tru., cGr~,ct '!OME (7;1; ,~,;,,-f'C:>(>'j- WORK ( a ) ~ TELEPlt N flU BE DATE ond GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAK ASSESSHENT with Ilppllcabh Int.rnt ba..d on Infor..tlon .ubaUhd by th. Unanclal In.tltutlon. 2. Inh.rltanca ,.. baea... delinquent nine aonth. .,t.r the dacadan", data of d..th. 5. A Joint account I. ta..bl. avan though the dacadant'. nft.. wa. added a. . .att.r of conv.nl.nc.. ~. Account. I Including tho'. hald betwa.n hu.band and wll.. which the dacadent put In Joint n.... within ana y..r prior to d..th at. fully t...bla a. tran,f.r.. S. Account. a.'abll,had JointlY batw..n husband and wlf. aor. than Dna y..r prior to d..th at. not t...bl., 6. Account. hald by . dacad.nt -In tru.t for" anothar or oth.r. at. ta..ble fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE 1. alOCK A _ If the Inlor..tlon and co.putatlon In the not Ie. .r. corr.ct and daductlon. ar. not being cl.l.ad, pl.c. .n .X. In block .A" of Part I of tha "Ta.pay.r R..pon.." ..ctlon. Sign two copl.. .nd .ub.lt th.. with your check for the a.ount of ta. to the R.gl.t.r of will. of the county Indlcat.d. Th. PA D.part..nt of R.v.nu. will I.'u. en offlcl.1 ........nt Ifor. REV.ls~a EX) upon r.c.lpt of tha r.turn fro. the R.gl.t.r of Will.. 2. BLOCK B _ If the ....t .p.clfl.d on thl, not Ie. h.. b..n or will b. r.ported .nd ta. p.ld with th. p.nn'Ylv.nla Inh.rltanca T.. Return fll.d by the d.c.d.nt'. rapr..antatlv., pl.ca an .X" In block "B. of P.rt I of th. "T..p.y.r R..pon.." ..ctlon. Sign on. copy and raturn to tha PA Dap.rt..nt of R.vanu., Bur.au of Individual hu., D.pt 280601, Ilarrhburg, PA 17128.0601 In tha .nv.lop. provld.d. 3. BLOCK C _ If the not Ie. Infor..tlon I. Incorr.ct .nd/or daductlon. ar. b.lng cl.I..d, ch.ck block .C" and co.pl.t. P.rt. 2 and 3 according to the In.tructlon. b.low. Sian two cop I.. and .ub.lt tha. with your ch.ck for the a.aunt of ta. p.yabl. to tha R.gl.t.r of ltHIS of the county ~nolc'c.o. ih. pa a.p.,'."''' 0' ff.v,nu. wl.l ,..U. an oulcl., ........11' '''or. kr:.,..S... t:.) upon r.calpt of tha r.turn fro. the R.al.t.r of Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. Ent.r the d.t. the account originallY w.. ..tabll,had or tltl.d In the ..nnar ..I.tlng .t d.t. of d.ath. NOTEI for a dacad.nt dying ..t.r 12/12/121 Account. wlllch tha d.c.d.nt put In Joint n.... within on. el) ya.r of d..th .r. t.xabl. 'ully a. tran,'.r.. How.v.r, th.r. I. an a.clu.lon not to ..c.ad 13,000 per tran,'.r.. rag.rdls.. of tha v.lu. of the account or tha nu.b.r of account. hald. If . doUble astarlsk elflt) appaar. b.for. your flr.t na.. In the .ddr... portion of thl. notlc., the 13,000 ..clu.lon alr.adY ha. b..n d.ductad fro. the .ccount balanc. a. r.portad by the flnancl.l In.tltutlon. 2. Ent.r the total balanc. 0' the account Including Int.r..t .ccru.d to the d.t. of d..th. 3. Th. p.rc.nt of tha account th.t I. t..abl. for a.ch .urvlvor I. d.t.r.ln.d .. follow.' A. Th. p.rc.nt t...bl. for Joint a...t. ..tabll.h.d 'Ora th.n on. y..r prior to the d.c.d.nt'. d..thl I DIVIDED BY TOTAL NUHBER Of JOINT OWNERS E.a.pl., A Joint a...t r.gl.t.r.d DIVIDED BY TOTAL NUMBER OF X 100 - PERCENT TAXABLE SURVIVING JOINT OWNERS In the na.. 0' the d.c.d.nt and two oth.r p.r.on.. I DIVIDED BY 3 CJOINT OWNERS) DIVIDED BY Z eSURVIVORS) . .167 X 100 . 16.7~ eTAXABlE fOR EACH SURVIVOR) I. Th. p.rc.nt ta.abl~ 'for ....t. cr.atad within on. y.ar of the d.c.d.nt'. d..th or account. oNn.d by the d.cada"t but h.ld In trult for anoth.r IndlvlduaIC.) etru.t b.n.flclarla.), 1 DIVIDED IY TOTAL NUHBER or SURVIVING JOINT X 100 . PERCENT TAXABLE OWNERS OR TRUST BENEflCIAqlES " E.a.pl., Joint .ccount r.gl.tar.d I" tha na.. of the d.c.d.nt and tNO oth.r p.r.on. .nd ..tabll.h.d within on. y..r of d..th by the d.c.d.,t. I DIVIDED BY 2 (SURVIVORS) . .50 X 100 . 5U eTAxABLE rOR EACIl SURVIVOR) 4. Th. a.aunt .ubJ.ct to t.. (lln. 4) I. d.t.r.ln.d by .ultlplylng th. account bal.nc. (lln. 2) by the p.rcant ta.abl. elln. 3). 5. [nt.r th. total of the d.bt. and d.auctlon. ll,t.d In Part 3. 6. Th. ..ountt...bl. Clln. 6) Is d.tir.ln.d by subtracting the d.bts and daductlon. Clln. 5) fro. the a.ount subJ.ct to ta. (Jln. ~). 7. Ent.r the .pproprl.t. ta. rat. (Jln. 7) a. d.t.r.ln.d b.low. A. for dat.. of d.ath occurring aft.r 6/30/94, the taM r.t.. for tran.far. to .pou... are a. followl' I. Oat.. of d..th on or aft.r 7/1/94 and b.for. 1/1/95 the r.t. I. 3~. 2. Oat.. of d..th on or .ftar 1/1/95 tran.f.r. to 'POU..I will b. t...d at O~ t.. rat.. Notal for d.ta. of d..th prior to 7/1194 tran.f.r. to .pou... .r. ta~abl. .t 6~. B. Tran."" to IIn..l d..cendants Including lathu, .other, .on, daught.r, grandchlldr.n, .on.ln.l.w, daught.r.ln.l.lt, .t.pchlld and thalr I..u. are t,Mabl. .t .IM p.rc.nt C6~). C. Tr.n.far. to all oth.r. Including broth.r, .I.t.r, unci., .unt, n.phaw and nl.c. .r. ta..bl. .t flft..n p.rc.nt eI5~). D. If you chang. the t.. rat., pl.... .p.clfy your r.l.tlon.hlp to the d.c.d.nt In the .r.a provld.d. 8. Th. aaount of tall dua Ulna I) Is d.t.r.lned bY' aultlptylng the a.aunt t..abla Clln. 6J by the tall r.t. Uln. 71. CLAIMED DEDUCTIONS - PART 3 DEBTS ANO DEDUCTIONS CLAIMED Allowabla d.bt. and d.ductlon. are d.t.r.lned a. 'ollow'l A. You l.g.lh .r. r..ponslbl. for v.v.en', or the ..t.t. .ubJect to &Dalnlstr.tlon by . plttonal r.pr.,ent.tlv. Is In'ufflclent to p.y the deductlbl. It.... I. You .ctu.lh p.ld the d.bt. aU.r duth of the decadent Ilnd un furnish proof of pay...,t. C. D.bt. b.lna cl.I..d au.t b. It..I,.d fully In P.rt J. If addltlon.l .p.c. I. n..dad, u.. pl.ln pap.r . Ill" . II". Proof of pay..nt ..v b. r.qu..t.d by the PA Oap.rt.ant of R.venue. TAXPAVER ASSISTANCE IF YOU NEED FURTHER INFORHATION OR ASSISTANCE, CONTACT ANV REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIOUAL TAXES, TAXPAVER INQUIRV UNIT IN HARRISBURO AT (717) 787-8327. TOOl (717) 772-2252 IHEARINO IHPAIRED ONLY) ,.. -, ...---.... -. .... ...... _ ___ _~.... _.______ r___......____.__.._~_._._ -- -- - .-- -- ----- - -..----- -- .-. -- --.-- " ; ,. . i.. ... D'AA ,082271 COMMONweALTH OF PENNSYLVANIA NO~ '. , DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX I.. ._ *.~ ;.,; .... . -11y-unlll.,'.1 I l RECEIVED FROM: 6 ACN ASSESSMENT Pl'I CONTROL i:tI NUMBER AMOUNT WARREN B ESTEP 9314"?78B .e,oe4r,-S6 ESTATE INfORMATION: r:I fiLE NUMBER Y P.1-199~-08H5 r:I NAME Of DECEDENT (LAST) ~ ESTEP CLARENCE B I] DATE Of PAYMENT 1 m POSTMARK DATt COUNTY CUMBERLAND DATE Of DEATH ". 07/16/9~ REMARKS WARREN B ESTEP SSN 169-0~-3e34 I I I I I I 'OtOHI" , I I I i ! 36 WESTWOOD COURT ENOLA, PA 170e~ _'OtOH(II (fiRST) IMI) m TOTAL AMOUNT PAID .e,084.86 VZ .I' _~ECEIVED BY f //(1' j (. 7 (j ji 1./ l/I(. _.;trONA1URf I A J" MARV C. LEWIS /)1'11/1'. REGISTER OF WILLS I,', /,// . I ;7" -------- ----------.---:' -.~.--.-.--. - - - -'""7' - --- - -----."... - --_...... -.-:'- SEAL CHECKtI ~e7 REGISTER OF WILLS I . . " ....... ....................... " _~.~.__...__.__ ..~-.--...-4.~.,.... r~...~'. , . , I.' 'I I., I:) REY-1548 EX AFP 112.94* CDKHONW[AlTH OF PENNSYLVANIA OEPARlHEHT Of REVENUE BUREAU OF INDIVIDUAL TAkES DEPT. Z80601 IlARRlSIUAG, PA l1Ua.D6Dl _/ NOTICE or INHERITANCE TAX APPRAISE"EHT. ALLONANCE OR OISALLONA"CE or DEDUCTION... AND ASSESS"EHT or TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-04-95 COUNTY ESTATE OF ESTEP CLARENCE B DATE OF DEATH 07-16-95 FILE NO. 21 95-0815 S.S/D.C. NO. 169-05-3234 WARREN B ESTEP 36 WESTWOOD CT ENoLA PA 17025 CUMBERLAND ACN 95149788 REHIT PAYMENT Tol REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 Aaount R..Ut.d CUT ALONG THIS LINE .. RETAIN LOWER PDRTlDN FOR YDUR RECDRDS ~ R-{y:isiii-EX..AFp..iiif:94i.....------.....----..........-..................-.......................-........-- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-04-95 ESTATE OF ESTEP CLARENCE B DATE OF DEATH 07-16'95 COUNTY CUMBERLAND FILE NO. 21 95-0815 TAX RETURN WAS. S.S/D.C. NO. 169-05-3234 (X) ACCEPTED AS FILED ( ) CHANGED JDINT OR TRUST ASSET INFDRHATION FINANCIAL INSTITUTION. DAUPHIN DEPOSIT BK B TR CD ACN 95149788 ACCOUNT NO. 0031246826 TYPE DF ACCOUNT 1 () SAYINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 03-09-77 Account Bolonco Porcent Toxob1e Amount Subject to Tox Debts ond Deductions Toxoble Amount Tox Rate Tax Due 69.495.44 0.500 34,747.72 .00 34,747.72 .06 2.084.86 x x TAX CREDITS: PAYMENT DATE 10-31-95 RECEIPT NUMBER AA082271 DISCOUNT (+) INTEREST I.) .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 DR HDNEY ORDER PAYABLE TO. "REGISTER OF WILLS, AGENT." AMOUNT PAID 2,084.86 TDTAL TAX CREDIT BALANCE DF TAX DUE INTEREST TDTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS TH.N .1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI. YOU HAY BE DUE A REfUHD. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I . 2,084.86 .00 .00 .00 J() PUAPllS[ OF NOTla:1 To 'ul'lll the r~lr...nt. of S.ctlon 2140 of tn. Inherltenca end E.t.t. T.. Act, Act 21 of 1991. 171 P.I. Section 2140). PAYttEKTI Detach tha top portion of thl. Hotlca and .ubelt with rour payaant to the R.gI.t.r 0' Will. prlnt~ on the r.v.r.a .Id.. .... Heka d1ack or llCIMy order p.y.tJla tal REGISTER Of WILLS, AG[HT. All P'YMf'It. racalvael shall IIr.t be appllM to Mr Int.....t .....1d1 ..y be due, wlth any re..lnd.r BPPl1ad to the .... REf\ND ICAII A rafund of . t.. credit, .....Ich wa. not reque.tlld on the tax raturn, .ay ba r~.ted br coapl.tlng M "Application for Rafund 0' Penn.rlvanla Inherltanca end bt.ta T.... (REY"UUI. Appllc.Uon. ar. avaU.tJI. .t thai Offlc. of the Ragl.t.r of Will., any of thai IS Ravenue DI.trlct Dfflc.. or by c.lllng the .pacl.l Z4-hour an.~tlng ..rvlca ~r. for far.. ordarlngl In Pann.ylvanl. l..aOO"S6I-ZaSO, out.ld. Pann.rlvanl. end within loc.1 H.rrhburg at.a 17171 717-a094, TOO' (7ln 77Z-USt ("'.rlng I~alrael Dnhl. O.JECTIONSI Anr p.rty In Int.r..t not ..tl.fled with the eppr.l.aaant, allowanc. or dl..llowanc. of deduction. or ......eant of t.. (InclUding dl.count or Int.r..tl a. ~ on thl. Hatlc. ..r object within .I.tr C6DI d.r. of rac.lpt of thlt Notlea byl --written prot..t to tha PA Dapartaant of R.venue, laard of Appa.l., Dapt. lllD21, Harrl.burg, PA 17128-1021, OR ...lactlng to h.v. the ..ttar dat.raln.d at the ItUclIt of tha .ccount of tha parsonal rapr...nt.Uva, OR '-app..1 to tha Orphan.' Court ADHIN" IITRATlIIt CORRECTIONS. f.ctual arrat. dl.cov.rad on thl. .......tnt ~Id b. .ddr....d In writing tOI PA D.p.rt.tnt of R.venue, ....r.eu of Indlvldu.1 TellU, AnHI Po.t A......ant R.vlew Unit, DEPT. 2a0601, lIatrhbUrg, PI l7UI-D6DI ~ (717) 717-6505. S.. pega S of the booklat "In.tructlon. for Inh.rltlnC. Tall R.turn for. Ra.ldant Declldant" CREY-lSDlI far an uplM.Uon of .lnlttr.t1v.iv catr.ettlbl. .rrOrl, DISCOUHTI If anr t.. due I. p.ld within thr.. (SI calandar aonth. .ft.r the dlc.dent'. da.th, a flv. parcent CS~I dlscOWIt of the tu p.ld Is allowed. IHTERESTI Intar..t I. ch.rged b.glnnlng with 'Ir.t d.y of d.llnquency, or nine (" .unth. end ~ (11 d.r froe the d.t. of de.th, to the data of p.y.."t. T.... which tK~... d.l1nquMt b.for. Januarr 1, 1912 ba.r Int.ra.t at thl rat. of .1. (6XI parcent par annua calculat.d at . d.llr r.ta of .000164. All t.... which bee... delInquent on or .ft.r Janu.,y 1, l,a2 will b..r Int.ra.t .t . r.t. which will v.ry fru. calendar y..r to c.lend.r y..r with th.t r.t. announced br the PA D.p.rt.ant of R.venue. The appllCabl. Int.r..t r.t.. for 1982 through 1995 .ral tw: Int.r..t Rlllt. U.II." Inht..t Flllctor tw: Inhr.st Rlllh Dill II." Int.r..t Factor 1911 ..X .0005041 1917 'X .000247 1985 lOX .D004H 1911-1"1 !IX .OODSOI 1984 IU .DDUOI 1992 'X ,000247 198' l3X .OOOSH 1995-1'94 IX .OOOI9Z 198' lOX .00027' 199' 'X .000247 --Int.,..t I. c.lc...lat.d .. follOM.1 INTEREST' BALANCE OF TAX UNPAID X NunBER OF DAYS DELINQUENT X DAJL~ INTEREST FACTDR "'Any HaUc. Is.uact .ltar the talil bacQlla. delinquent will nflact an Int.,.st calculation to ,lfl.an tis. dart berond tha d.t. 0' the ......aant. If pay,,"t a. -.de aft.r the Inl.r..t coaputa'lon d.t. shown on the HaUca, addltlon.l Intar..t au.t be c.lcul.t_. COMMONWEAL tit OF PENNSVl VANIA DEPARTMENt Of pEvrHUE IUREAU Of INDIVIDUAL tAIIES D[Pt. 1I0601 tIARRISlUAC, PA 11121-0601 - IHFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 95-0815 ACN 96000151 DATE 03-02-96 11I.lhl ft,,, II.'" EST. OF CLARENC~ B ESTEP 5.5. NO. 169-05-3234 DATE OF DEATH 07-16-95 COUNTY CUMBERLAND TYPE DF ACCOUNT IX] SAVIHGS D CHECKIHG D TRUST D CERTIF. BARBARA A NEVARA C/O WARREN B ESTEP 36 WESTWOOD CT ENOLA PA 17025 REHIT PAYHEHT AHD FDRHS TOo REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HOME SAVINGS OF AMERIC he. provld.d the D.p.rt..nt with the Infor..tlon llst.d below which h.. be.n u..d In calcul.tlng the potentl.l t.. du.. Their r.cord. Indlc.t. thet .t the de.th of the above decedent. you were a Joint own.r/ben.flcl.ry of thl. .ccount. If yoU f..l thl. Infar..tlon I. Incarr.ct, pl.... obt.ln wrltt.n correction fro. the financial In.tltutlon, .ttach e copy to thl. far. and r.turn It to the above .ddr.... Thl, account I. te.abl. In .ccordanc. with the Inherlt.nc. T.. l.... of the Co..on....lth of P.nn.ylv.nl.. au..tlon. e.y be an.wer.d by ul1lng cun 7'7-11527. CDHFLl!TE PART 1 I!CLO\1 r. I': 11 sn: RFVF.I'SE 51!)!! Fl'R FIL!NG AND PI'.VHEHT !N!!TRIJr.T!I)NS ---.-. Account Ho. 734-000150-7 D.h 01-01-85 Est.blished Account Bdenc. 31 ,896,61 P.rc.nt T.K.bl. X 50 , 000 A.ount SubJ.ct to T.. 15,948.31 T.k Rat. X .06 Polontld T.. Du. 956.90 PART TAXPAYER RESPONSE CDI FAILUR! TO R!SPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BAS!D ON THIS NOTIC! I A. ts] The .bov. Infor..tlon and t.. due I' correct. l. Vou ..y chao.. to ".It pay..nt to the Aaglster of willa with two copl.. of this notlc. to obleln . dl.count or .vold Int.r..t. or you .ey check bo. ~A~ and r.turn thl. not Ie. to the A'III.t.r of Will. and an offlcl.l ........nt will ba I..uad by the PA D.pert..nt of Aavanue. To In.ure prop.r cr.dlt to your eccoUl1t, t..o C2) cop I.. of thl. not Ie. .u.t .cco.pany your pay..nt to the A'gl.t.r of will., Heka ch.ck p.y.bl. tal ~R'lIhter of willa, AII.nt". NOTE I If h. pay..nt. ara .ade within thr.a (SI .onth. of the d.cadant.. data of d..th, YOU .ey d.duct a SiC discount of the ta. due. Any Inh.rlt.nc. ta. due will b.co.e d.llnquant nln. C9J .onth. .ftar the date of d.ath. [CHECK ] ONE BLOCK ONLY I. 0 Th. above ....t ha. b.an or will b, raport.d end taM paid ..Ith the p.nnlYlvanla Inheritance ... r.turn to b. fll.d by the d.cad.nt'. rapr..antatlva. C. c=l Th. aboy. Infar.atlon I~ncorr.ct .nd/o~abt. end daductlons w.ra paid by you. You .u.t coeplete PART l!..J and/or PAAT L!J balow, If you indic.t. . diff.r.nt tax rat., ple.,. ,tat. your rel.tion,hip to d.cld.ntl OFFICIAL USE ONLY 0 AAF PA DEPARTMENT OF REVENUE PART ~ TAX RETURN - CDHPUTATION LINE 1. Dat. Eetab1ilh.d 2. Account B.lanc. 3. P.rc.nt Takabl. 4. AMount Subj.ct to Tax S. Dlbt. and D.duction. 6. A.ount TaMlbl. 7. TaK R.t. a. Tak Du. TAX ON JDINT'TRUST ACCOUNTS OF 1 2 3 4 5 6 7 8 PART l!l DATE DEBTS AND DEDUCTIONS PAD 1 2 3 4 5 6 7 8 CLAIMED x x PAID PAYEE DESCRIPTION AMOUNT PAID i TOTAL IEntlr on Line 5 of T.x Co_put.tion) I . Under penalti.. of perjury, I dlcl.r. th.t the f.at. I ~o l.t. to thl b..t of .y knowl.dg. Ind b.li.f. .,) IJ C'.~ t. .NlAZ It :/7 10 p TAXPAYER SIGNATURE ' hlv. report.d above .ra tru., correct .nd t.!~!1E, ('71'7) 73:1. - 766 If WORK ( ) TELEPHONE NUMBER GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAlC ASSESSHENT ..lth appl h:abl. Int.t..t b",..d on Inlor..Uon .ubalthd by the financial Institution. 2. Inherltanca t.. baea... delinquent nln. aonthl a,t.r the dacadantO, data of d..th, S. A joint account I. taMabla avan though the dacadant'. n... .... added a. . .,ttar of convenl.nc.. 4. Account. (Including tho.. hald bal....n husband and wif.1 which Ih. dacad.nt put In Joint n.... within on. y.ar prior to d..lh at. fully t...bla a. tranl,.r.. 5. Account. ..tobll.had Jolntlv balw..n husband and wlf. aor. than ana y..r prior 10 d..th at. not t..abl.. 6. Account. hald by . dacadant "In tru.t for" anoth.r or oth.r. at. t..abl. fullv. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCk A _ If the Infor..llon and coeput.tlon In the not Ie. are corr.ct .nd d.ductlon. .r. not b.lng cl.l.ad, pl.c. an "X" In block "A" of P.rt I of the "Ta~p.y.r A..pon.a" ..ctlon. Sign two cop I.. and .ub.lt th.. with your chack for the ..ount of t.x to the A.gl.t.r of Will. of th. county Indlc.t.d. Th. PA n.p.rt..nt of R.v.nu. will I..u. .n offlcl.1 ........nt (For. AEY.15~8 EX) upon r.c.lpt of the r.turn fro. tha A.gl.t.r of Will.. 2. BLOCK B . If th. ....t .p.clflad on thl. not lea h" b..n or will b. r.port.d and ta~ paid with the Pann.ylvanl. Inh.rltanc. T.. A.turn fllad by th. d.cadant'. r.pr.,ant.tlva, pl.c. an "X" In block "8" of Part I of th. "T.xpayar R..pon.a" ..ctlon. Sign on. COpy and r.turn to tha PA D.part.ant of Aavanu., Bur..u of Indlvldu.1 T...., D.pt 280601, lIarrl.burg, PA 17128-0601 In the .nv.lop. provld.d. 3. BLOCK C . I' the not Ie. In'or..tlon I. Incorr.ct .nd/or d.ductlons ar. b.lng clal.ad, ch.ck block "C" and co.plat. Parts 2 and ] according to the Instruction. balow. Sign two capias and .ub.lt th.. with your chack for th. a.ount of ta. payable to the R.gl.tar of Will. of the county Indica tad. Th. PA n.part.ant of R.v.nu. will I..u. an offlcl.l ........nt CFor. REY-15~a EX) upon r.c.lpt cf tr.e return trcg t~. ;;..l.t.~ ~r ~ll1~. lAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Entar tha d.t. the account originallY w.. ..tabll,had or tltl.d In the ..nnar ..I.tlng .t data of d.ath. HOTEl Far. d.c.dant dying aftar 12/12/821 Account. which tha d.cad.nt put In Joint n.... within ~ CI) y.ar of d..tt ar' t...bl. fully.. tran.far.. How.var, th.r. I. an ..clu.lon not to ..ca.d 1),000 p.r tran.fer.a rag.rdla.. of th.' valu. of the .ccount or the nuabar of account. hald. If a doubl. a.t.rl.k C~~) .ppaar. b.for. your flr.t n... In the addra.. portion of thl. notlca, th. 1],000 ..clu.lon .lraady h.. b..n deduct.d fro. the account b.lance a. raported by tha financial In.tltutlon. 2. Ent.r the tot.l balanc. of the .ccount Including Int.re.t accru.d to the data of d.ath. 5. Th. p.rc.nt of the account that I. ta..ble for e.ch .urvlvor I, dataralned .. follow'~ A. Th. p.rcent t...bl. for joint ....t. a.tabll.h.d .or. than on. y.ar prior to the dacadant'. da.tht I DIVIDED IY TOTAL HOHBER OF JOINT OWNERS Exaaplat A joint ....t ragl.tarad DIVIOE:D BY TOTAL HUHIER OF X 100 . PERCENT TAXAlLE SURVIVIHG JOINT OWNERS In tha n..a of the dac.d.nt and two oth.r par.on.. I DIYIDED IY ] (JOIHT OWNERS) DIVIDED IY 2 (SURVIVORS) . .167 X 100 . 16.7ie ITAXAlLE FDA EACIt SURVIVOR) B. Th. parcant t...bla for a..at. cr.atad within on. y..r of tha dec.dant'. d..th or .ccount. own.d by tha d.cadant but h.1d In tru.t for anothar Individual e.) (tru.t b.naflclarla.)t 1 DIVIDED BY TOTAL HUHIER OF SURVIVING JOIHT OWNERS DR TRUST BENEFICIARIES X 100 . PERCENT TAXABLE E...plal Joint account r.gl.t.rad In the na.a of tha dacadant and two othar par.on. and ..tab11,had within on. y..r of da.th by the dacadant. 1 DIVIDED BY 2 CSURVIYORS) . .50 X 100 . 50iC nAMABLE fOR EACt! SURVIVOR) ~. Tha ..aunt ,ubJ.ct to taM Cllna 4) I. d.taralnad by aultlplylng tha .ccount balanca 111na 2) by the parc.nt ta.abla Clln. )). 5. Entar tha tot.1 of the dabt. and daductlon. 11.tad In P.rt 1. 6. Tha .aount t..abl. (1In. 6) I. dater.lnad by .ubtractlng the d.bt. and daductlon. 111na 5) frOB the a.ount .ubjact to taM Clln. 4). 7. Entar tha approprlat. ta. rat. 111n. 7) a. d.t.r.lnad balow. A. for d.ta. of daath occurring aftar 6/10/94, the tax rat.. for tran.fer. to .pous.. ar. a. follow'l 1. O.ta. of d.ath on or .ft.r 7/1/94 and b.for. 1/1/9S th. r.t. I. ]ie. 2. Oata. of d.ath on or .ftar 1/1/95 tr.n.far. to .pou.a. will ba t...d at Oie taM r.t.. Hot.t For data' of d..th prior to 7/l/9~ tran.far' to .pou... are ta.abla at 'ie. B. Tran.far. to Iln..1 da.candant. Including f.thar, .othar, .on, daught.r, grandchlldr.n, .onaln.law, daught.r~ln.l.w, ,tapchlld and th.lr I..ua are ta.able at .IM p.rcant (6~). ~. Tran.far' to all othars Including brothar, .I.t.r, unci., .unt, naphaw .nd nlac. .r. t..able .t flftaan percant eIS~). D. If you changa the t.. rat., pl.... .pa~lfy your r.latlon.hlp to th. dacad.nt In tha .r.a provldad. 8. Th. ..aunt of t.. due Clln. II I. d.t.r.ln.d by .ultlplylng the a.ount ta.abla (llna 6) by tha tax rat. (lln. 7). CLAIMED DEOUCTIONS - PART 3 DEBTS ANO DEOUCTIONS CLAIMED Allowabla dabt. and d.ductlon. ara datar.ln.d a. follow.. A. You 1.gally ara r..pon.lbla for p.y.ant, or the ..t.t. ,ubJ.ct to ad_lnl.tratlon by a par.on.1 r.pra..ntatlv. I. In.ufflcl.nt to p.y tha daductlbla It.... I. You .ctu.lly paid the d.bt. aftar daath of the dac.dant and c.n furnl.h proof of pay..nt. C. Dabt. baing d.l.ad au.t b. It..lnd fully In Part 1. If addUlon.1 .pac. II n..d.d, usa plain pap.r I 1/2" . 11". Proof of pay..nt ..y ba r.qu..t.d by tha PA Dep.rt..nt of R.~anu.. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR 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. 'TDD' (7171 772-2252 WEARING IMPAIRED ONLY) _01 NOTICE. PAVtEHT. REFlIm (CAJI .(; ,) r- ~. N I U) '''' ;;; "'1 .- ,. r:;a; a: p: ". ~ .::!:> UU To fulfill the requlra..nt. of Sactlon 11~O of the Inheritance ~ [.t.t. ,.. Act, Act Zt of I".. (71 P,S. Section Z.40), DetKh tM top portion of thll Notln Met ,__it with your p..,."" to the Reahtar of NUll prlnt~ on the tava.... "de. .~ KMa check ar .ona" Drd,.. p,.,abla tOI REGISTER OF WILLS, AGtNT. All p.~.nt. ,.calved ,hall first b, .ppllad to any Int.r..t which ..., ba due. with any .....Inda.. 8Ppl1ad to the t... " refund a. . ta. credit, which ..a. not raqua.tad on thl ta. ..alurn, ..y ba rsque.tad by coapl.tlng an *Appllcatlon for R.fund 0' Penn"lvanla Inh.rlt~. ~ E,tat, T.." CREY.1515J. Applications at. avallabl. at ~ Df,lcI of the Regl.ta.. of Willi, any of the IS A.v~. DI.trlct Qfflc.. or by calling the .paclal Z4~hour an...rlng ..rvle. nu-bet. far for.. orderlnol In P~.ylv~l. l-aDD-S6Z-2DSe, out.ld. P.nn,ylvanl. ~ within local H.rrl.burg .r.. (717) 787-8094, TOO' (717) 772-225Z (H.arlng l.palr.d Only). OBJECTIONS I Any p.rty In Int.r..t not .atl.fl.d with the .PPr.I....nt, .llow.nc. or dl..llawanc. of d.duCtlon. or .......ent of taM (Includlna dl.count or Intar..t) .. .hown on thl. Notlc. ..v obJ.ct within .Ixty C6D. dav. of rec.lpt of th" Notlu bVI --wrItten prota.t to tha PA D.part.ant of Ravanu., Bo.rd 0' App..l., O.pt. 2al021, H.rrl.burg, PA 17128-1021, OR "alectlng to hfta the ..thr det.r.lned .t the eudlt of the ItCC~t of the ptlrlONll r8flru...tatlva, OR --appeal to the Orphan.' Court . I.DHIN- ISfRATlYE CORRf:CTlDMS, DISCOl.tCTI PENAL TV I INTEREST I rectu.l arror. dl.cov.r.d on thl. ........nt .hoUld ba .ddr....d In writing tal PA Dep.rt.ant of R.v.nua, Bur.au 0' IndlvldU.1 ,...., AT'HI Po.t A......ent R.vl.w unit, DEPT. 2aD6DI, Harrl.burg, PA 1712a.0601' Phone (717) 187-6505. 5.. p.g. S of th. bookl.t "In.tructlon. for Inh.rltanc. t.M R.turn for. R..ld.nt Dac.dant" (REV-lSDl) for an 'MPlanatlon of .a.lnl.tr.tlv.ly corr.ct_bl. .rror.. If any t.M due Is p.ld within thra' 13) CIllendar aonth. .fhr th. decadent'. d..th, _ fin parcsnt (5:0 dhcO\l"lt of the tu paid Is allowed. The 15~ tax .-na.tv non-p.rtlclp.tlon penalty I. coeputad on the tot.1 of the t,M and lnt.r..t ......ad, ~ not paId b.'or. Januarv 18, 1996, Uha 'Ir.t day .ft.r the ~ of the t.M ~.ty period. thl. non-participation pen.lty I. appealabla In the .... .annar and In tha the .... tl.. p.rlod a. vou Mould app..1 the tax and Intar..t that h.. bean ......ad .. Indlc.t.d on thl. notlc.. Int.r..t I. chargad bealnnlna with 'Ir.t day of delInquency, or nlna 19. eonth. ~ one (I) day 'roe the data of d..th, to the data of p.y.ant. T.Ma. Nhleh bee... d.llnquent bafora Janu.rv 1, 1982 baar Int.r..t at the rat. of .Ix (6~) percent par ~ c.lcul.tad at a dally rat. of .000164. All t.... which bee... delinquent on or ,'t.r January 1, 1"2 will b.ar Intara.t at a rata which will v.rv fru. call1ndar v.ar to c.lendar yaar with that rata ~ad by tha PA Depart.ant of Ra"lnUe. The appllcabla Int.r..t rat.. for 19.2 through 1996 aral V.ar Intara.t Rata Oallv Int.ra.t Factor Vaar Inhr..t R.t. D.lIy Inhra.t Factor lta2 ,.. .00054. 1987 ,. .0Du" 1981 lU .0DOUa 198a-I991 U:C .OGDSOI I'" \1. .OGOJDI 1992 ,. .OOU" 1985 13:< .OGDSS6 1995-1994 ,. .000192 I'" I.. .00Dl14 1995.1996 ,. .DDD2"7 --Intarnt I. calcul.tad a. follCMfIl INTEREST . BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR uAnv NoUce ..... aft.r the tlUl bIleoea. delinquent will rallMlt an Intara.t ctIleul.tlon to fifteen US) de,. beyond the data 0' the .......-nt. If paweant .. .... aft.r the Int.r..t c..,ut.tlon data IhoWl on the Notlca, additional Intar..t .u.t 1M c.leulat... ~ --:J ('-_.1 f'-~j r_ "-' I..J ,.:;~ if- '.""; :.\ . .,:,,_J :, UU PAvttENTI Detech the top portion 0' thl. Hotlce ~ .ub.lt with your p.y..nt ..d. peyebl. to the n... ~ addrl" printed on the rev.r'l .Idl, 1 f RESIDtNT DECEDENT .eke chick Dr .onlY ord'r peylbl. tal RECISTER OF WILLS, AGENT. 11 NOH.RUIDENr DECEDENT ...... chick or .onlY ordlr p.yable tOI COHHONWEALTH OF PENNSYLVANIA. All p'y"nt. r.celved sh'll be .ppllld 'Ir.t to any Int.t..t which .ey b. due with .ny r"llndlr applied to thl t,.. REfUND ICR)I A r.fund 0' I tl. crldlt, which w.. not rlqu..tld on the rl. Rlturn, .ey bl r.que.tld by cOIPI.tlng en "Appllcltlon for RI'und 0' Plnn.ylvenl, InhlrUene. and [.tet. Tell" (REv.nU). Appllcltlon. .r. IVl1lab11 et the Df,lcI 0' the Rlgl.tl,. of Will., any 0' thl Zl Rlvlnue Ol.trlct O,flc.. or fro. the Dlpert'lnt'. l4.hour en.w.rlnt .etvlce nu-b.r. for far.. orderlngl In P'M.ylvanle 1.loa"16l.Z0iO, aut. Ide Plnn.ylven" IWld within locel Herrhburg .r.. (717) 781.1094, TOO' (717. 712.ZZ5Z UI.erlng 1....lnd onhl. REPLY Tal Du..tlan. rlgerdlng errot. cont.ln.d on thl. notice .hould b. .ddr....d tal PA D.p.rt..nt of R.v.nu., Bur.eu of Indlvldu.l T...., ATTHI Po.t A.......nt Rlvl.w unit, O.pt. 210601, H.rrl.burg, PA 17IZ..0601, phone (717) 717.6505. DISCOUNT I If any t.. due II p.ld within thr'l ()) c.llndlr .onth. aftlr the d'cldlnt'. d..th, e five plrc.nt (iX) dl.count of the te. p.ld I. allow.d. PEHAL TV, Thl 15~ tl. I.n..ty non.p.rtlclpltlon plnllty I. coeput.d an the totll of the tl. Ind Int.r..t .......d, and not plld b.for. Januery 11, I"', the flr.t dey aft.r the .nd a' the ta. lene.ty period, INTEREST I tnt.r..t J. charged b.glnnlng with ,I,.t day 0' dellnqu,ncy, or nln, C9. lonthl end an. (II day 'ro. the dlt. of de.th, to the data of p.~.,"t. T.lll. which ble... d.llnqulnt before Janu,ry I, I,ez b.a, Int.r..t at the rate of Ilx C6~) plreent p.r annul cllcul.tld .t a delly ret. of .000164, All tlllel which beCI.' delinquent on IWld .ftlr Janulry I, I'IZ will be.r Intere.t It . rat. which will vlry frol cellndar Ylar to caland.r y..r with thet rete announcld by the PA Olp.rteent of Rlv.nue. Thl appllcabl' Int.r..t t.t.. for I.IZ through 1996 ar" Veer Int.r..t R.t. O.lh Inhrut Factor VI.r Int.,...t R.t. Dally Int.,.lt F.ctar 19BZ ... .OOOS"I 191' .. .000l41 1915 162 .000u. 1981.1991 Il2 .000501 1914 Ui( .000501 I99Z .. .000l,,7 1915 13~ .000556 1991.199" 72 .00019Z 1916 lOX .0001'0\ 1995-1996 .. .000l.' ulnt.,...t h c.lcul.ted .. '0110"" INTEREST . BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..Any Notlc. I..u.d aft.r the till b~o..' dallnquent ..Ill tlflect an Inter..t c.lcul.tl~ to flftlan 1151 dlY. b.yond the d.t. of the .......ant. If p.y_ent I. lada .ft.r thl Intara.t coapul.tlon dlt. ahown on the Notice. addltlon.1 Int.,...t au.t b. calcuhlad.