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COHHOHWfAl TIt or P[~VLVAHIA
[)[PARTHfH' or R[V[HU(
BURUU OF IHDIVIDUAL ,un
Q[PT, lID'D1
ItAARISBURC, PI. I1UI'D'D1
'*
21 -'1~-. fl3/
95154181
11-14-95
TYPE OF ACCOUNT
o SAVINGS
o CNECKING
o TRUST
00 CERTIF,
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.
"'.IUIII '" 11.'41
EST, OF FLORENCE E CLOUGH
S,S. NO, 211-52-8304
DATE OF DEATH 09-06-95
COUNTY CUMBERLAND
H L VARNER
601 BRITTON RD
SHIPPENSBURG
RE"IT PAYNENT AND FOR"S TDI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17257
DAUPHIN DEPOSIT BIC & T hn provided the Dep.rl..nl with Ihe Infor..tlon IIsled b.lo.. which hu be.. u.ed In ulculetl", the
pat."tlal ta. due, Their record. Incllute that It tha dllth of the lbel",a decedent, you ..ara I Joint owner/ben.flcl.ry 0' thl. ecCowtt.
If yOU ,..l this In'or.atlon II Incorrect, pi.... obtain ..dU.., corractlon frol tha flnancl.l In.tltutlon, aUlch a copy ta this far.
,.",. r.,turn tt t~ ,,.. .tw\... IIWtttr... n... __'"'''''It; Ir 'l'"..ble In -:-pnrrt_C'e 1I1'h tho Intll:rltllr.clt '1:1 L_!' of t.., CUJl:lar.tlD=1t~ Lor !':;""'ol~s....l1...
Qua.tlon. .av be en....red by call1no (711) 7'7.'127.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. BI00200017 D.t. 12-16-93
E.tiabl hh.d
Account a.hoc. 15.036.68
P.rcont T..obl. K 50.000
A""""t Subjoct to T.. 7.518,34
T.. R.t. K .06
PotonU.l T.. Duo 451.10
PART TAXPAYER RESPONSE
[!] I.. FAILURl!. .TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED OM THIS NOTlCl!.
A. 0 Tha abova Infor..tlon Bnd t.. due Is corr~t.
I. You ..y choo.a to t..1t p.~t to ttM Rqlstar of Willi with two copl.. of thl. notln to obhln
. dl.count or .vold Int.,..t, or YOU ..y check bel. ~A. end ,aturn thl. notlca to the R.gIst.r of
WUla end an offlcl.l ..........t ..111 be I..,," by the PA a.p.ttunt of R.venue.
To Inlur. prapat credit to your .ccount, two
UJ copl.. of thh notice .....t IccoapllnY your
p.yaent to the R.,l.tar af Willi, "..... check
p.yabl. tal "Regilt.,. of Willi, AllWlt",
HOtEl I' t.. p.reant. a,. .ed. within thr..
(51 ~ths af t~ decadent'. d.t. of d..th,
yau ..y deduct . 5X dllcCMont af thl ta. due,
Any Inher1t.w:1 t.. due ..UI becOH dtIl1nquent
nine (9) IIDnth. aUa,. the data of death,
[CHECK ]
ONE
BLOCK
ONLY
., r:J Tha abova as.at h.. b..n or ..Ill b. reported and t.. plld wlth thl P~.yl"'lInl. tnherltlnC' ra. ratutn
to b. fll.d by thl d.c.dant's ,.pr...nt.tlv.,
C, D Tha abav. Infor..Uon l,.J.ncorr~t and/o~.bh and deductions ..r. p.ld by you,
You .ust coaplata PARr L!J and/or PARr l!J b.low,
If you indicat. a diff.rent ta. rat., pl.... .tat. your
ral.tJonahip to d.cad.nt.
OFFICIAL USE ONLV' 0 AAF
PA DEI'ARTMENT"OF. REVENUE
PART
~
TAX RETURN . COMPUTATION
LINE 1. Data EstablJshad
2. Account Balanca
3. Parcant Taxabla
4. Aaount SubJ.ct to TaM
S. Debt. ~d D.ductSons
6. AIIOW'lt TaMabl.
7. TaM Rat.
8. TaM Dua
OF TAX ON ~OINT/TRUST ACCOUNTS
1
2
3 K
4
5
6
7 K
a
,"'AD,
1
2
3
4
5
6
I ~
CLAIMED
PART
[!]
DATE
DEBTS AND DEDUCTIONS
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Entar on Line S of TaM COMPutation)
I
.
Undar pan.ltJa. of parJury, I d.clar. that the feet a I
co~l.t. to the ba.t of .y knovladg. ~d baliaf.
'1.1. ) , 'l/~~...,
"""'Tfir.AV& SIGNATURE
hava reportad abOYa ar. true, corract
HOME <tl 1 ,~l~l-'-If1t'l
WORK <7/~ l$'] -1/.:1'7
TELEPH N NUMB R
ood
GENERAL INFORMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OfFICIAL TAX ASSESSHEHT with appllcabl. Int.,.., bUN on Infor..non
,utMltted br IN IInancllll InlUlutlon.
I. Intt.rlhnu la. bUD_' d.UnquW\l nln. .antn. efl., thl dlced.",-, data of d..th.
S. A Joint .ccount II '...1, Iyen though the dlcaden", n_1 w.. lKkted '1 . ..It,,. of connnl~..
4. Account. 'InclUding tho,. h'ld between hu.band and wlfal which t~ dleadant put In Joint ".... within on. Y'" prior to
d.,lh ar. fully (a..b" .. ',."fl".
5. Account, ..Iabll,had jointlY batw.." hu.b~ end wi', lor. In." ona ra.r prior to d..th .t. not ".IIbI.,
6. Account. held b)' . dlcadent -In ',Ult fo,.- ~th.r or olna,.. .t. ',.,bl. fully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
t
1. BLOCK A . If the Infor.,tlon and coaput,tlon In Ih, not Ie. .r. cor'~t And deduction, .r. not baing clat"d, pilei ~ ~
In block ..... 0' P.rt I of the "T,llp,yu R..pon.... ..ctlon. Sign two cop I.. And .ub.1t th.. Mllh your check 'or tIM IMOUnt of
till to tIM AI,htlr 0' Wllh 0' the county IncHestad. Th, PA Dep.rt.ent 0' Rlvenue will I..UI.., offlcl.1 .......ent
Ifor. REV'I~' [XI upon rec.lpt 0' th, r.turn 'rOCl the A.,ht,r 0' WII...
2. BlOCIC I . If the ....t .peclflld on th" notln hu be.., or Mill be report.d cand t.. p.ld Mlth the Pam.ylwan" Inherll.nu
h. hturn flln bw the d.c.dent'. r,pr..entatlv.. pl.c, ." "X" In bloctl; ..... of P.rt I of the "j.lr~....r ,ItJ.~Pon.." ..ctlon. Sign on.
copw IIftd r.turn to the PA n.p.rt..nt of P.v......,., Bur.au a' Individual hll", D.pt n060I, H.rrlsburg, PA nua,oul In the
env.lap. provided.
S. BLOCK C . If the notlc. Infor..tlon I. Incorr.ct and/or deduction. .r. b.lng cl.la.d, ch.ck block ..C- and coapl.t. P.rt. 2 end J
h,';"'iJl;,. tG \t... In'tru~t~~"ul bt1;w. tl;."\ t\lll c::plc:: ::.n~ =~!:s1t t~~ ..1th :'~.l" -:"JC" ,.... ,... ___t ,., t.... ".","'1. t.. '... D..let...
of Will. of thl cOU'ttw Indlc.t.d. Th. PA n,p.rt,ent of R.vWIUI Mill I..", '" offlol.1 ........,t (Fora RtV-UU EIll upon rec'lpt
of the return fr!HI tM Ragh"r of "l1h.
TAX RETURN - PART 2 - TAX COMPUTATION
lIlE
I. Ent.r the d.t. It.- account orlaln.lh Mil ..tlbllshld or tlthtd In thl .1IM.r IMhtlng at d.t, of d..th.
NOTE I for. dIC~...t dwlng .ft.r lUll/ill Accounts which the decedent put In Joint n.... Mlthln one ()) w..r 0' de.th .r.
tlllllbl. fulh .. trln."r.. IIOM.v.r, th.,.. h an IMclu.lon not to 'MC.ed n,ooo par tran.f.r.. rlglrdl... a' the vllue a'
tM Kcount or the nuMa.r of HCount. h.ld.
If , daubl. .."rhk (".J ~'r. bafor. your flnt n-. In u,. addr,.. porUon of thl. notlc., the U,0I0 IMclu.IDr'I
Ilr..dy he. MIih dlWctld frOll tM ecc~t bll~. .. report. by the fln..-.cI,1 In.tltutlon.
2. Ent.r the tat.1 blIBnC' of ttMi account Including Int.rut accrued to the datI of de.th.
3. The percent a' the account th.t I. t.M~I. 'or .ach ,urvlvar I. dlt.r'lned I' fallow.1
A. The perClnt taxab" far Joint ....tI ..tllllll.t1.d Mr. thW'lone y'.r prior to the dec:ldlnt". de.th.
I DIVIDED IV TOUL foMlIER OF DIVIDED IV
JOINT OWHf:AS
Ex-.plll A Joint ....t r-uht.r" In tIM na.. of
TOTAL Nl.IIIEJI OF II 100 . PDtCEHT TAKAllE
SURVIVING JOINT OWNERS
tM decedent and tw other par.on,.
I DIVIDED IV S (JOIHT OWNERSJ DIVIDED IV 2 (SURVIVDRS) . .167 K lOa . 16.n CTUAaLE fOR EACH SURVIVD'U
I. ThI p.rc....t t'IlBbII far ...... cr..t.d within ana VI.r of the decedent'. d..th or eccounts awned by thl decedent but hlld
In trult far another Indlv!tSu.U.) (tru.t b.n.flchrl..h
1 DIVIDt:D BY TOTAL HlIf1aER OF SURVIVING JOIHT
OWH[RS DR TRUST BENEfiCIARIES
X laD . PERCENT TAIlAILE
EllIlplll Joint 'CCDW,t r.ghter.d In th. nu. 0' thl decadent and tw other p.r.on. and ..tlbl hh.d Mlthln on. y..r 0' d..th by
the dececMnt.
I DIVIDED IV 2 (SURVIVORS) . .50 )( 100 . 5n (TAXABLE FOR EACH SURVIVOR'
4. The aaount subJact to t.. (lln. ., II d.t.r.lnad by sultlplWlng the account b.lanc. (1In. 2J by the parcent t..abl. Cline J).
5. Ent.r the totll of the debts Ilnd deduction. Ihhd In Part S.
6. ThI a.ount t,Mabl. (Ilne 6J Is d.tlrelned by .ubtrectlng the debt. and deduction. Ulna 51 'rOIl the MCMoWlt .ubJect to t.x UIM 'J.
7. Ent.r theapproprllt. till nt. (l1ne 1J ., d.tar.lnld b.low.
A. For d.t.. a' d..th occurring .ft.r 6/30/94, the till. r.t.. 'or tran.f.r. ta .pau... ar. ,. followlI
I. n.t.. a' d..th on or .ft.r 111194 and bafore 1/1195 the nt. Is 3:(.
2. n.t.. 0' d..th on or aft.r 1/1/95 tren.f.r, to .pou.., will be ta.ld .t 0% tlX r.t..
Not" Far dat.. of de.th prior to 1/1/94 tren.f.r. to .pou... .r. ta.abl. .t 6%.
I. Tran.f.r. to 11ne,1 de.cendant. InclucUn" IIth'r, _ther, .on, daught.r, grandchildren, .on-ln"I...,
deughl.r.ln-Iaw, stepchild and thalr lu.... .re tnabll at .h parcant (6:0.
C. Tran,'.r. to .11 other. Including brother, .I.t.r, unci., aunt, nephew and nlac. .r. tl.lbl. It 'I't-.n percent (IS~J.
D. If you change the t.M r.t., p..... .peclfv vour r.latlonshlp to thl decedent In the ar.. provided.
e. ThI -.owlt of till. due Cline IJ .. dlt.r'IMd by sultlphlng the .-aunt t'.abl. Cline 6) by the till. r.t. Ulna 71.
ClAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. debt. and d.ductlan. ar. dat.r.lned .. fallow..
A. You 1...lh .r. r..pon,lbl. 'or p.r.....t, or the I.t." IUbJ.ct to adalnhtret10n by I per.onel r.ruent.tlv. II In.ufflalent
to p,y the d.ductlbl. It_..
I. You .ctu.lly p.ld the d.bts Ift.r d..th 0' the dk..s.nt Itnd can furnish proo' af p.1ItWlt.
C. Dllllh b.lnD el.I.N IN.t b8 It..lud rulh In Put J. 11 Iddltl0n81 .plte. Is ne8d8d, 'I" pl. In papar I 112- M 11-. Proo' of
p.y.ent "W ba r.qua.tld bW th. PI. n.p.rt...... of RIVIt'IUII.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORHATION 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. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY)
r I )
, I
C~Al'H Of PENNSVlVANIA
Df:PARIHtHI Of A[V[HlK.
BUREAU or INDIVIDUAl fAM[S
DlPI. ZlDn.
HAAAISlUAa, PA I1UI.0601
*'
FILE NO.
ACN
DATE
111.."111'"''.'''
21 . 1J- 93/
95154166
11-14-95
TYPE OF ACCOUNT
o SAVINCS
IXJ CHECKIHC
o TRUST
o CERTIF,
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
EST, OF FLORENCE E CLOUGH
S,S, NO. 211-52-8304
DATE OF DEATH 09-06-95
COUNTY CUMBERLAND
H L VARNER
601 BRITTON RO
SHIPPENSBURG
RENIT PAYNENT AND FDRNS TD'
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PA 17257
DAUPHIN DEPOSIT OK I T hu provided the DepI,t..n, with thl In'or..lIon listed bllo.. Wilch hu b..n u..d In ulcUlltlng the
potent I.. 11M ~. Thllr rlcord. Indlcntu thlt .t the d..th of thl abovI dlcld.nt, you ..It. I Joint DWn.r/b~flcl.ry 0' thl, lecount.
If you f..l thh Infor..tlon h Incornel, pl.... obl.ln ..dtt." corrlctlon frol thl ,In.,,..l.l Inltltutlon, .thch. copy to this 'or.
..... "..1..'"'" It ... tto:,:, ...'!'''. "1r... ,..,,, _rnu"t' I. t....llobl. I" ...rt'r"~' ,.Ith ,.... Inh.,.lt~. "" ,......., ~..... ('~,.lth"f P_,~I..'t.,l.
Qullllonl ..,. bl an,wlred bw cllllng (717) 787-1527.
COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
A..ount No, 0094163472 D.t. 12-21-82
Edablhhad
To Inlura proper cr~lt to your eccount, two
III copl.. a' thh notice .u.t eccaepllny your
pe.,...,t to t~ Aegl.ter 0' Will.. Meke check
p.yable tal "'Aeght.r 0' willi, Agent...
A..ount 0.1....,. 754 , 15
P......tT..abla X 16.667
Aoount Subj..t to T.. 125,69
Tax Rata )( .06
PotonU.l T.x Du. 7,54
PART TAXPAYER RESPONSE
COIFAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX AS8!SSNEHT,BASED ON THIS NOTICE I
A. 0 Th. above Infor..tlon end tex due .. correct.
1. You ..y chooa. to r.elt p..,...,t to the Reghter of wIU. with two copl.. 0' thh notlc. to obt.ln
. dlacount or avoid Intar..t, or you .ay check box "A" end r.t~rn thl. notlc. to the Rlglltar 0'
Willa end en of'lclal aaalaaeent will be lalued by the PA o.parteent of Rlvenue.
HOlE I If tlX paweent. .r. .Ide within thr..
CSI aontha of the decedent.. date 0' death,
YOU .ay deduct a S:C dhcount 0' the till dul.
Anw lmerltenee tex 0.. will becu.e dallnquent
nine C91 eonth. If tar the dete 0' death.
[CHECK ]
ONE
BLOCK
ONLY
B. D The above a.alt ha. been or will be raportad end tax paid with the Penn.ylvanle Inhlrltanc. Tax raturn
to be flIed bw the d.c.dant.a reprl.entatlv..
C. 0 Tha .bov. Infor..tlon I"-"ncorrect end/o~.bh and dlduCtlon. ...re paid by wou.
You .uat cOlIPlate PART ~ ."d/or PART L!J balow.
If ~ou indlcat. . diff.rant t.x rata, pl.a.. .t.t. your
ral.tion.hip to d.c.d.ntt
OFFICIAL USE ONLY 0 AAF'
PA DEPARTMENT OF REVENUE
PART
I!l
TAX RETURN . COMPUTAUON
LINE 1. Oat. E.tabllshad
2. Account B.lanc.
3. Pare.nt Taxabl.
4. A~unt Subjact to Tax
5. Dabt. and Oaductlon.
6. Aaount Taxabla
7. Tax Rat.
a. Tax Dua
TAX ON JOINUTRUST ACCOUNTS
O~
1
2
3
4
5
6
7
8
X
PAD
I
2
3
"
5
6
7
8
CLAIHED
X
PART
[!]
DATE
DEBTS AND DEDUCTIONS
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Entar on Lina 5 of Tax COMPutation I
I
.
Undar p.naltla. of parjur~, I d.clara that tha fact. I
coftPlata to the ba.t of .y knoMladga and bali.f,
'~ f. /'
, ~. / (", ,; ,
T XPAYER SIGNATURE
h.v. ~aport.d abova .r. trua, corr.ct
HOME () I:; ) S- J } - 'I ~ l "
WORK (71) ) i' j t" - J 1;' I')
TELEPHONE NUMBER
and
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT ..lttl .pttllubla Int.,.., ba.ad on Infor..llan
.~Itt.d bw the IIMlnehl In.tltutlon.
I. Inheritance ta. baeD'" delinquent nln. ~th. alt., Ihe duaden\". data of dnth.
S. A Joint account I. ...abla 1"1" though thl dlceda"", nI'" '''II lidded II' . ..It" of convenl'nc..
It. Accounh I Including Itlo.. hlld beh.." hulblNWl -.,d IIIlfa) which 'he duadent put In Joint ".... ..Uhln OMl Y"" prior 10
dnlh .r. fulh ',.lIIbl. a. I,.",hr,.
S. Account. uhblhhad Jointly b.t...." t~,.band and wlf, .or. thllln one YU' prior 10 d..th .r. not ,..lbl,.
.. Account. held by . dleadlant "In trult fo," .noth.r or oth.,. .r. ,e..bl. fuU,.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
I. BlOC. A - If t~ I"'ot..llon And cDIlPUlatlon In the noUn .r. carr~t And d.ductlon. an not baing cl.laH, piKa M "II"
In block "A" of P.tt I of the "".p.y.r A..pon.... ..ctlon. Sign two copl.. Md .ubalt th.. with your ChKk for the MOUnt of
t.. to the A.,lIhr of wlllt of lhe CGU"lty Irldlut.d. 'h. foA n.p.rt.."t of R.venua will InUII an offlcl.1 ......-.nt
(far. AEV-IS'" DC) upon nc.lpt of thl return fro. the Reght., of WlIlt.
2. IlOCK I ~ If the ....t .p.elfl.d on thlt natln h.. b..n or will b. report.d IWld t.. p.ld with the P.nnlYl"enl. InherltllM'
I.. R.turn fU.d by the dludent.. rIPr..ent.tI"., pile. en "II" In block ..... of Pllrt I of the ..,..p.y.r A..pon.... ..ctlon. Sign on.
copy end r.turn to tha PA D.p.rt..nt 01 R.v.nu., 8ur..u 01 Indlvldu.1 fn.... D.p' 180601, ".rrhoorg, PA 111l1~06Dl In thl
,"v.lop' provided.
5. 8LOCK C - If the nolle. lnfor..tlon It Incorrect andlor dMklctlonl .... being clll"d, ch.ck black "c" WMt co.pl.t. p.,,, r end 5
w:ccrdlng tc t~. I~Jtruetl~" b:lcw. tl~, twc ca~I~; and ~~~=It t~~2 ~Ith yewr c~::~ fcr the e=:~.' af t~ PG.~:: .~ t~: ~:=I:t~~
of Wllh of the CCUlty Indicated. The PA o.p...tunt of hvlln'M will hsue M afflclll ........"t lFor. R[V~IMI [)II ~ rec.lpt
of the r.turn frOll tM R'II.t.r of Will..
TAX RETURN - PART
2
- TAX COMPUTATION
LI"
I. Ent.r tM date tht Kcount orlgln,Uy tolU ..tablhh.d or titled In the .IMIt ,.I.tlnt ,t d.t. Df d..th.
NOTE I For. deeed....t dyl,. .fhr 1Z/U'1I2t AccOU"It. which the ~ldent put In Joint n.... within one (U y..r of d..th.,.
t..lbl. full., .. It.....,..... lI....v.r, th.,. h ." ..elu.lon not to .IIUM '5,001 p.r tran.fer.. rev-rdl... of the v.lue of
the ItCcount or the nu-blr of ItCcount. held.
If . double ..hrltk (n) .....,. b.fore your fI,.t n... In the 1MkI..... portion 0' thlt notice, thl n,OOD nclutlon
.lraldy h.. beWl d.o.Hlted froe the account bel..w:. .. reported by the flMnCI.a In.UtutJon.
Z. Enter the tot.l b.lanc. of 1M acCDW'It Including Int.r..t accrued to the d.t. of d..th.
5. The percent of thl ,CCOWlt th.t I. t.ulbl. for .ach survivor It det.relned .. followlI
A. The pere."t t..abl. for Joint 'Ultl 'Itabllshed eor. u.n DnII w..r prior to the d.cedent', de.thl
I DIVIDED IY TOTAL HUMIER OF
JOINT OWHEAS
E"~"l A Joint .nat "lI..terR
DIVIDED BY TOTAL }UttER OF II 100 . PERtENT TAIlAILE
SURVIVING JOINT OWNERS
In the nll&lll of thli decMlent end two othtlr p....on..
I DIVIDED BY S (JOINT DWHERS) DIVIDED IY Z ISURVIVORS) . .161 X 100 . 16.n UnABLE FDA EACH SURVIVOR)
I. ThtI perc.nt t..lbl' far ...... cr..tld within OMI y..r of the dK~."t" d..th or Kc~h aMl'led b., the d.cMllnt but hald
In tru.t far aneth... Indlvldu.U.1 Itru.t b..,.flcl.,I..11
1 DIVIMO IY lOUL HUHIER OF SURVIVING JOIN'
OWNERS OR 'RUST BENEFICIAAIES
II 100 . PERCENT TAIlAILE
E_-.pI'1 Joint .Ct~lt r.gl.t.rld In the n... of the d.e.dent and ttolO oth.r p.r.on. end ..tlbl'sh.d within on. y..r of de.th b.,
thl dlC.dIt'lt.
I DIVIDED BY Z ($tJIYIVORSI . .50 )l 100 . SOX (TAXAILE FOR EACIt SURVlVORI
.... 'h. NOUnt 'ubJect to tu Illn, ,,) I. d.ter.ln.d by ""ltlpl.,lng the .ccount ballnC. III". 1) by th. perc",t taxable Cline 5).
5. [nter II. tot.l of the d.b.. Md deduction. lht.d In P.rt .s.
6. ,he .lKK.W1t t..llbl. 11 In' ftl It d.h,.ln~ b., Subtracting the d.bh end dtductlon. IlIne 5) fro. th. ~t subject to t.. (line "'1.
1. Ent.r the IPproprllt. t.. r.t. Ulna 'I .. d,hr.lnltd b.low.
A. For d,t.. of d..th occurrl", .fllt '/50""', the t.1l r.t.. for tren".,. to .pou... .r. .. follOlllIt
1. D.t.. af d..th on or Ifltr 711194 end b.fo,. 1/1/95 th. r.t. Is !X.
2. D.t.. af d..th on or .fhr 1/1195 tr.".ftrl to ,pou... will b. hnd .t OJ( taw r.t..
Not.. For d.t.. of d.,th prior to 111/'''' tr.nlf.r. to .pou.., .r. t...bla .t 6~.
I. Tr.".f.r. to IIn..1 d..undant. Including father, Hther, .on, deughhr, grltl\dchlldr.", .on~ln-I"',
d.ught'r~ln~I..., .1~lld end thalr 11.U1 ..... t..abl. at 'Ill parc."t ('~).
C. Tran.f,,.1 to.11 othlrl Including brother, Ihtar, ~II, M.nt, n.pn.." end nl.ce It. t..llbl..t flft.." p.rcllnt ClUI.
D. If YOU chent. the I'. r.t., pi.... lpeelfy wour r.latlonlhlp to the dec.dant In lhe .,... provided.
I. The MOUnt of h. ~ lllne .1 .. d.ter.lnttd by .uIUphlng the uount t..abl. I line 6J by lhe t.. r.t. Ulna 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. d.b" and d.ducUon. ar. d.t.r.lnad .. follow"
A. You IIt.lh It. rtlpanllbl. far p.y.."t, or thl ..t.t. .ubJect ta adelnhtraUon by a per.onel r.,,...,,t,U..,t h Inaufflcl",t
to PlY the d.ductlbl. Itu..
.. You .du.11y p.ld tha debit aftlt d.ath of thl d.udent and can fl.lrnlth proof 01 pay.."t.
C. Debh b.lng el.bad .u.t b. It..b.d fully In Pert.5. If addltlon'l .pace It naaded, l.I.a pl.ln peper' IIZ" . ..... Proof of
p.y.."t a.., be ra""nhd by the PA n.pert.."t of R.venua.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WIllS. PA DEPARTMENT DF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TDD' (717) 772-2252 (HEARING IHPAIRED ONLY)
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D ',A' A 0,,82,3,83 . COMMONWEALTH OF PENNSYLVANIA
110,' , ' . DE,ARTMEIIT OF REVEIIUE
, ,OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
1l~1t.,Ut''''1
It:.
~lW~
&
ACN
ASSESSMENl r:t
CONlROL ...
NUMBER
AMOUNl
RECEIVED FROM:
9'5-1-1541B 1
...e8-o-&+
H I.OUISE VARNER
q:llO..lbb
.,.17
Be6 MUD LEVEL ROAD
SHIPPENSBURG, PA 17e~7
'OlD "'11
ESTATE INFORMATION:
~ FILE NUMBER
Y el-19q5-0931
~ NAME OF DECEDENT (LAST'
~ CLOUGH FLORENCE E
... DATE OF PAYMENT
Iii 1 e 107 195
m POSTMARK DAlE '
COUNTY bJ!V:;
SSN ell-52-6304
(FIRST) (Mil
CUMBERI.AND
fa TOTAL AMOUNT PAID
.435.71
CW
DATE OF DEATH
09/00/95
REMARKS H LOU I SE VARNER
--------------------~----~---------------~~~-~-~~
REGISTER OF WILLS
')'
I .r
RECEIVED BY . /" ,! 'i L /, "d ,.1) , ,,1/
j SIO..OTUO' ~ 1/ II/ ,;-,
. \ ,'/'),1)111 'I-'t
MARV C. LE IS . . '
REGISTER O~ WILLS '
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CDHMOHWUlllt Of P[NHSV1VlHIA
OEPAAIH(NI or R[y[HU[
ftURUU or INDIVIDUAl ..xu
DEPT. n0601
IlARRISIlmG, PA 1711a.0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 . 'h~ ')..;//
ACN 95155929
DATE 11-23-95
'''.1141111''11-911
EST, OF FLORENCE E CLOUGH
S.S, NO, 211-52-8304
DATE OF oEATIl 09-06-95
COUNTY CUMBERLAND
TVPE OF ACCOUNT
o SAVINCS
!Xl CHECKIHG
o TRUST
o CERTIf.
EDNA G FENTON
601 BRITTON RD
SHIPPENSBURG
PA 17257
REHIT PAYHENT AND fORKS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
ORRSTOWN BANK hu provldld thl D.p.rt....' with 1M In'or..tlon lhhd belOlll which hu b.." und In ulcullUna IhIt
pat...tll. t.. ~. lhelr rlcorda Indlcat. thl' It thl d..lh of the ~ov. dlc.dent, you ...r. I Joint owner/beneflcl.ry 0' thl. ICCount.
If you 'HI this Infor..Uon II Incorrect, pi.... obt.ln wrltt... cornctlon fro. the flnanclll 1".tHutton, attach I copy to thh for.
:r.d ."l1turn it tc ~~. obova D:hf~ .!".. Thh aecalm' It te..,tllt In UC.,rdlncl ..ith \t., Inhti,.It,.,~. ,"'.. ,.... :f ,"''': ';c_"",':&IU, of P,,,,:",:,rl"'..'''.
ou..tlon. .., bl ....wered by CIlllnt (7171 717-ISl7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account 1<0. 000-620548 D.te 08-23-85
E.toblhh.d
Account a.hnc. 374.95
P.rc...t T..obh X 50.000
Aoount Subj.ct to To. 187,48
To> R.te K .06
P.tontlol T.. Du. 11 ,2S
PART TAXPAYER RESPONSE
[!] I FAILURI! TO RI!SPOND IfI.LL RI!SUL T IN AN OFFICIAL TAX ASSI!SSHI!NT BAUD ON THIS NOTICI I
A, 0 TM Ilbav. Infor..Uon Md tn ""- Is cornet.
1. You .sy choo.. to rlelt psyaent to the Aeals'.r of Will. with two cupl.. af 'hi. notlcl to obt.ln
. dl.count or .vold Int.r..t, or you ..y check ba~ "A" and r.turn 'hi. natlc. to the R.al.t.r af
Will. end en offlehl ........nt will b. I..u.d by thl PA DIlp.rt.."t of RlvWIUII.
To In.ur. prop.r credit to your lecount, 'WO
(21 copll' of thl. notlc. lU.t acca~",y your
p.,..nt to thl Rlal.t.r of Will.. "... check
p.yllbl. tal '"R.ghtlr of Willi, AII"'t",
HOTEl If t.. p.y.-nt. .re ead. within thr..
(JJ santh. of the dteldant'. d.t. of dl.th,
you .,y dlduct e 5:C discount of tM t.x dul,
Any lm.rltllnC. tlX dull will baea.. dellnqutW1t
nine (9) santh. IUlr thl d.te of de,th,
[CHECK ]
ONE
BLOCK
ONLY
I. c:J Thl aboVI ....t h.. bIen ar will be r.part,d and tlX psld with thl Penn.ylvanl. Inherltenc. rlx r.turn
. to be 'lied by th. deced""', r.pn.."t.UVI,
C, 0 rh. .bov. In'ar.etlon I~ncarrlct and/O~.bt. and deduction. were p.ld by YOU,
You lU.t cu.plet. PART L!J and/or PART L!J below,
If you indicat. . diff.rent taM rat., pl.... .t.t. your
r.l.tion.hip to d.c.d.nt.
OFFICIAL USEONLV 0 AAF
PA DEPARTHENT,OFREVENUE
PART
~
TAX RETURN . COMPUTATION
LINE 1. D.t. E.tab1i.hed
2. Account O.lanc.
5, Pereant Taxable
,., AlIOunt Subject to TaJ(
S. Dabt. and Deduction.
6. A.ount Taxab1.
7. Tax Rate
8. Tax Due
TAX ON JOINT/THUSI' Al;&;OUNTlI
OF
1
2
5 K
4
5
6
7 X
a
PART
I!J
DATE
DEBTS AND
flAD
1
2
3
"
5
6,
7
8
DEDUCTIONS CLAIMED
---'
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL CEnter on Line 5 of T.. Co~t.tlon)
I
.
Undar penalt1.. of parjury, I dec1.r. th.t the fact. I
eo~leta to the b..t of .y knowl.dg_ and b_11ef.
c;:.. ~._ /Y (,-;.-r:;..~.-. -'
TAXPAVER SIGNATURE
h.v. r.port.d above .ra tru., corr.ct
HOME ( /,;~) .~-j.;l_ s'lf"i',J
WORK (..,.,;.0).:> 3~', /..',
TELEPHONE NUMBER
ond
GENERAL INFORMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OFfICIAL TAX ASSESSHEHT with applh:ltbla Inl.r..t b...d on Infar..tlan
tubaltlad by tha flnancl,1 In.tltutlon.
Z. Inh.rlt~. '1M blea... delinquent nln. lonthl .It,r 'hI dlc.n.nt" data 0' d..th.
S, A Joint account I. 'aMabl. avan though tha dac.danl', n... wa. addad .1 . ..tt.r Df conv.nl.nel.
_. Account. (Including tho.. ~ld bltw..n husband and "If.l wnlch Iha dlcadent put In Joint n.... within ana yaar prior to
d..th .t. fully I...bla .. Ir.n.,.r..
5. Accoonts I.t,bl hhad jointlY betw.en hulband end wif. aor. th8ft DIM y..r prior to d..th at. not ,...bl.,
6. Account. hald by . d.c.d~t -In trult for" enolh.r or ath.r. at. t...bl. fully,
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
I. alOCk" ~ If the Infor..tlon end co~t.tlon In the not leI It. corr.ct and deductions .t. not b.lng cl.I..d, plec. en "X-
In block "A- of P.rt 1 of the "raMp.y.r A..pon..- .actlon. Sign Iwo copl.a and .ubalt th.a with your ch.ck for the eeount of
t.. to the R.gl.tar of Will. of the county Indlc.t.d. rh. PA D.p.rt.ant of Ra~~' will I..u. an offlcl.l ......eant
(for. REV-IS~' EX) upon rac.lpt of the r.turn fro. the R.gl.t.r of Willa.
I. IILOCX a - 11 the ....t .p.cifi.d on thll notice ha. b.an or will ba npart.d and tllil p.ld with Ih. P....".y1\l...1. Inherltann
r.. R.turn fllad by tha d.c.dant'. rapra.ant.tlv., pl.c. an "XW In block "B" of P.rt I of tha "rl.p.y.r R..pon.." .actlon. Sign one
copy and raturn to the PA O~.rtaent of R.~anua. Bur.au of Individual T...., Oapt 2a0601, Harrl.burg. PA 1111a-0601 In tha
env.lope provided.
5. ILOCK C - If the notlca Infor..tlon I. Incorrect endlor deduction. ar. baing clalaed, check blo~~ "C" and caaplata Part, I and 5
*ccordlng to tna In.tru~Ilon. balow. ilgn lwo copla. and .uoalt tha. wll" your cn.ca for tne aaoun~ 0' t'liI pay.ula to tne "1,I.t.r
of Will. of the c~.,ty Indlcat'd. The PA D.partaent of Ravenua will I..ua an o'flcl.1 ......-.nt CFor. REV-IS41 EXI upon rac.lpt
of the return fr... the R.ght'r of Willi.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Entar the d.t. the account orlgln.lly wu utablhhad or tltlld In the .annar nhUna .t dda of da.th.
NOTE. For. dacadent dying .ftar Il/lZ/az. Account. which the d.c.dant put In Joint n.... vi thin ana Cl) y..r of da,th ,r.
...abl. fulhl .a trM.f.". Howevar, thara II an ..clu.lon not to a.caad IS,OOO p.r trM,'ara. ragardl... of the v.1ua of
the IM:count or thl nuIlIber of accounta h.ld.
If a daubl. ..t.rl.k C..) app..r. bafor. your flr.t n... In the addr... portion 0' thl. notlca, the 15,000 ..olu.lon
already h.. been deducted frOll 1M account b.IWKl. II reported by the flnancl.l In.t1tutlon.
2. Entar the total balWKla of tha account Including Intora.t accrued to the data of daath.
5. Tha percent of the account that la ta.abla for ..en lurvlvor I. detar.lned .. follow..
A. The parc."t tuabla for Joint ....t. .steblhhad _tI than Dn4t va., prior to thl daced..,t., d..th'
1 DIVIDED IY TOTAL HUKlEA OF DIVIDED IY
JOINT OWNERS
E_aapl., A Joint ....t r.gl.tared In the n... of
TOUL HUHIER OF X 100 - PERCENT TAKABLE
SURYIVlHO JOIHT OWNEAS
tha d.cedent and t~ other ptltlon..
1 DIVIDED IY 5 CJOINT OWNERS) DIVIDED BY 2 (SURVIVORS) - .167 X 100 - 16.n ITAXABlE fOR EAtlt SURVIVOR)
II. ~ p.rc~t ta.abla for ....t. cr..t.d within one va.r of the dec.d.nt'. da.th or account. owned by the dlCadant but held
In tru.t for IInGth.r In,UvlduaH.) (tru.t baneflcl.rl..h
1 DIVIDED BY TOTAL ~8ER OF SURVIVING JOINT
OWNERS DR TAUST B[~EFIClAAIES
X 100 - PERCENT TAXABLE
[_.-pI.1 Joint eccount r.gl.tared In the n... of the d.c.d~t and two othar par.an. and ..tabll.h.d within one y..r 0' da.th bv
thl d.e.dant.
1 DIVIDED IIY 2 CSURVIVORS) - .50 X 100 . SO~ CTAXAIILE FOR EACH SURVIVOR)
.. The NOUnt subJ.ct to taM ClIn. 4) It d.taraln.d bV .ultlplvlng the .ccount b.lanc. Clln. l) bv the percent tuabl. Clln. 5),
C, Fnt_r the totel of ttM d.bt. flftd dedUction. IIttad In PIlI,.t \.
6. The.-aunt t..abl. Cline 6) I. d.t.r.lned by .ubtractlng the dabt. end deduction. Clln. S) 'raa the ..aunt subJact to t.. ClIne 4).
1. Enter the approprl.t. t.. rat. Cline 1) .. d.t.r.lned below.
A. For d.ta. of de.th occurring aft.r 6/50/", the taM r.t.. for tran.fara to .pous.. ere .. follow.,
I. O.t.. of d..th on or .ft.r 7/1/94 and bafor. 1'1"S the r.t. I. S~.
2. D.t.a of de.th on or .ftar 1/1"5 tren.f.r. to spousa. will be t...d et a~ t.. r.t..
Not., far dat.. of d..th prior to 1/1/94 tren.f.r. to .pou... .r. t..abl. at 6~.
B_ Tran.f.rs to llne.l da.cendant. Including f.thar. IOth.r. .on, daught.r, grandchildren, .on-In-Iaw.
daught.r~ln-law. .tepchlld and their I..ua .ra t..lbl. .t .1. parcent C6~),
C. Tran.f.r, to .11 oth.r. Including brother, .I.t.,., unci., eunt, neph.w end nlace .ra ta.abl. .t flft.an p.rcent CIS~).
D. If you ch~ the t.. r.ta, pl.... .paolfY your r.l.tlon.hlp to the decadent In the ara. provided.
e. The aaount 0' t.. due (line a) I. d.t.r.lned bv .ultlplylng the ..aunt t..abla Cline 6) b., thl t.. r.t. Cline 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. debts and deductlona .r. d.tar.lned .. follow'l
A_ You l.g.ll., .r. r..pon,lbl. for p.v.ent, 0,. the ..t.t. .ubJect to adalnl.tr.tlon by . ptlr.onal rapr..entatlv, I. In,u'flclent
to pa., the dedUctlbl. It....
I. You actually paid the d.bt. .,t.r de.th of the dac~t and cen furnish proof of p'v.-nt.
C. Debt. baing ol.lead au.t ba It..lled fully In P.rt 5. If additional .pac. I. ~, us. pl.ln papar . 1/2" . II". Proof of
pa.,.."t ..v ba r.qua.ted b., the PA Dep.,.taant of Rav......
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-B327. TDD' (717) 772-2252 (HEARING IMPAIRED ONLY)
CD""DHWUllll or P[NNSVlVAHIA
[l(PAR'HlNI or NrV[hUE
BUR[AU Of INDIVIDUAl uns
lJ[PI. lID601
IIARRISllJAG, PA I7UI-O'"
'*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 - '/...,-. (/.1/
ACN 95155930
DATE 11-23-95
'IHh,...na...,
TVPE OF
ACCOUNT
D SAVINCS
D CNECK INC
D TRIIST
00 CEHTlF.
TO.
EST, OF FLORENCE E CLOUGH
5,5, NO, 211-52-8304
DATE OF DEATH 09-06-95
COUNTY CUMBERLAND
EDNA G FENTDN
601 BRITTON RD
SHIPPENSBURG
HEHIT PAVHENT AND FaRHS
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17257
ORRsrOWN BANK ha, provided ttMt Depart.."t ..lth thl. Infor.atlon I hlld balow which haa ba." Uled In ulculatlng the
pot....thl tall due. 'hair rKardl IrMtluta tMt at the da.th of the abelII' dec~t, .,DY ...r. . Joint OIilIfMIr/b.,..Uel.ry a' thh .ccount.
If yDY f.1l thlt Infor..tlon Is Incorr.el, ph..a Dbtaln ..,.Ittan corractlon fro. tfl, "~I.I Inatltutlon, ,UltCh a CD9Y to thle 'or.
ANt r.tur" It t" tf10 Itbt"". ~r.... ,,,... _,....."'t I. 11II".....,. I,. tff>or(4t"'1'. ..ah tN! 'nhforlhw~. ,... 1_. fOf t..,. (''''~.lt.. cof p........ylv"'''..
OuuUan. ..., tM M.ver.d by uUI"" 11111 7I1"U21.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No, 003-0049177 D.t. 04-04-94
E.toblhh.d
Account Bohoc. 15,004.93
P..c...t T.,....I. X 50,000
AMount Subj.ct to T.M 7.502,47
T.x R.t. X .06
Pot...t1.1 reM Due 450,15
PART TAXPAYER RESPONSE
m IFAXLUAIt TO AISPONIUlUL. RUULT IHANOFPICIAL,TAX ASSISSHItHT. BASID OH THIS NOnCI I
,. ~ fM &boll. Infon.tlon and tu ckHI II correct.
I. VOU a., choG.. to r..n p..,.."t to th. R.olshr 0' Willi ..It''' h.o capl.. of thlt notle. to obtain
. dltcount ar .vold Int.rut, 01" WDU ..., check bo. ..,.. .-1d r.turn thl. noUn ta tha RIGht.r of
Will. and ." offlel.1 ........"t ..Ill b. l..uad by th. P' D....rtaant of R.vtnul.
'0 InlUr. prOf"tr cradlt to rour ItCcount, tlfD
UI cDflI.. of thlt notle. ."t acCHiPan~ .,our
pa)'Mnt to thti RIGht.r of Will.. H..... chKk
pay_h tal "Aagltt.r of WlIh, 'oant...
NOTEI If tall p..,..,t. .r. .~ Iflthln thr..
UJ ""th. of the daced....t', ct.t. af cIa.th,
.,au ..., deduct . SX dhc-.,t of tha tu duti.
An., IMarUanc:. t,lI due ifill bee... cMllnquant
nine (,) .unth. .,t.r tha det. of de.th.
[CHECK ]
ONE
BLOCK
ONLY
I. 0 Tha aball' ....t h.. bt.... or ..UI be r.port.d ..... tall P.ld ..lth lhe P.",u,lv.,l. IrlMrltMC. f.. ,..turn
ta be ,1I.d by tha d.udlnt', npruantatlv..
C. 0 TM ebov. Infar..Uon l,.J.ncornct Md/o~.bh Ilnd d.ductlan. wera p.ld by )'DU.
VOU ...,.1 coapl.t. PART l!J andlor PAR' l!.J b.lolf.
If you 1nd1c.t. . d1ff.r~t tax r.t., pl.... .t.t. your
r.l.tlon.hlp to d.e.d.nt,
OFFICIAL USE ONLY 0 AAF,
PA DEPARTMENT OF REVENUE, '
PART
~
lAX R~rUKN - CU"~U1AII0ri
LINE I. a.t. E.t.bll.hed
2. Account a.lane.
S. P.rcant T.xabl.
4. Aeount Subject to r.x
5, aebt. end a.ductlon.
,. AltOunt Taxabl.
7. T.x R.t.
e. T.x Due
X
PAU,
1
2
3
,4
5
6,
7
8
CLAIMED
TAX OM JUINI'IKU~1 A~~uU"TS
O~
1
2
3
4
5
6
7
a
X
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS
PAVEE
DESCRIPTION
AMOUNT PAID
I
TOTAL IEnt.r on Lin. 5 of T.x Cu.put.tion)
I
I
Under pen.lti.. of parjury, I d.alar. th.t the f.ot. I
cOIIPI.t. to the beat of .Y knotd.dge and beU.f.
~ ~~'
( _:J.rI-.-..- ,_~/ (_ _/'y_,r ..-J
TAXPAYER SIGNATURE
h.v. repo,.ted above ar. tru., correct and
HOME ('l';' I ,$,] ,';, J ,"? ')
WORK (")"11') J-J"".. 11./1
TELEPHONE NUMBER
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TA)( ASSESSHEHT ",Uh -..,lIc_l_ Int.r... bUM on Infar..lIon
lubIIlttad by the 'Inancl.a In.tltutlon.
Z. .,..,.rltllnCt I.. bK.,. delinquent "In. .onlhl .fh," tht dec.d~t'. dill 0' d..th.
5. A Joint ICCount I. ,...bl. .v~ though thl d.c.d~t'. n... w.. Added II . ..1'., of con~~I~..
4. Accounts I Including tho,. held bit"".,.. hulblWMl Md wlhl -.hlth the dlud.n' pUt In Joint n..... IIIIlthln on. yn, prior III
d.,lh It. fullv ,..abl. '1 ".,...,.,.,
S. Account. ..tabIA'hld Jolntlv bttw..n hulbiWMI nod Mlf. .or. 'h~ ~ Y'" prior to de.lh .r. not I...bl.,
6. Account. held by . dee.dent -In trutt fa,. nnother or ath.r. .t. t..~l. fully,
REPORTING INSTRUCTIONS - PART
I
- TAXPAYER RESPONSE
I. BLOCK A ~ If the Inlot..tlon ~ c~t.tlon In the notle. Ir. corrtct nnd dtductlon. .r. not beln, clll.'d, pl~. ~ .X.
In block "." of P.,t I of the .T'.p.~.r R..pon..- .eetlon. Sign two cop I.. And .~It t~ with your check far the.-GUnt of
t.. to t~ R.,I.t.r of Will, of t~ county indlc.t.d. 'h. PA Dep.rt.ent of M."anue wlll I..u. en afflcl.1 ......-.nt
Ifor. RfV-IS41 [XI upon r.c.lpt of lhe r.lurn fro. lhe R.,I.I.r of Will..
2. IlOCK I - If the ....1 .p.clfl" on Ihl. notln h.. be." or will b. r.porl.d and ta. p.ld with Ih. Penn.ylv.,,'a I~rltenc.
T.. R.turn fllad by IhI dee.d."I'. r.pr.,."lall".. pl~. ftn ~- In block .1" of Part I of Ih. "T._p.y.r Ra.pon.." .actlon. Sign one
cop~ and return to IhI PA D....rtNnt of R."enu., Bur.., of Indlvldu.1 hu., Dapt :a0601, lI.rrhbur" PA 17UI'0601 In the
env.lope provided.
5. BLOCK C - If thl notlc. Infor..tlon ,. Incorr.ct andlor deduction. .r. b.lng cl.lead, check block .C. and coapl.t. P.rl. 2 and 5
.ccordlng to the In.truellon. DlION. aign \WO copi.. ana .uc.lt ,he. Wit" your ChiCk tOt tne ..ount at t.. plyaol. to In. N.,..t.r
of wlI" 0' ttM county Inctlc.tld. The PA DIP.rtaant 0' RI,,__ wUI I..ue an alflelll ........"t (for. MEV-un txl upon r'c.lpt
0' thtl return 'r. thtl R'lIhter of Nil".
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
.1. Enter the date thlaccount orl,lnellv WII ..tMlhhed or tlu.d In the .anner ..htln, at dall 0' d..th.
HOTEl For. decadent dylnll .ft.t 12/12/"1 Account. which the dec"ent put In Joint ".... within one (II y..r 0' d..th .r.
t..MI. fully.. tren.f"l. HOMIIy.r, thlre II WI ..elullon not to ..ned u,aaa p.t tr..,.far.. reglrdl... of the v.lue of
thl HCount or the ~r a' accounll h.ld.
Jf . doubl. ..tarlak (....) appa.,. before your flr.t n... In the addr... portion of thll notlc., the U,OOO ..elu.lon
Ilr.1Idy h.. bun deduct" fr.. the HCaunt b.lanc. I' rlPGrtld by the flnancl.1 Inltltutlon.
2. Ent.r thl totll blllne. of thl ICCount InclUding Int.r'lt accrued to the dlt. of dl.th,
5, The percant of thl account thlt I. ta.abl. for .ach lurvlvar I. d.t.r.lnad I' follON'1
A, The percent taxMI. far Joint ....1I ..t.tJllahed 1MIt1 tNn ~ y..r prior to thl dlCed."t'l d..thl
I DIVIDED IV TDTAl NUHIER OF
.:oINT OWNERS
Ex...I.1 A Joint ....t rlllat.rld
DIVIDED IV TOTAL ~I[R OF X lOO . PERCENT TAXAILE
SURVIVING .JOINT OWNERS
In the n... of thl decedent and two otMr patlonl.
I DIVIDED 1'1' 5 (JOINT OWNERS) DIVIDED IY 2 ISLRVIVORS) . .161 )c loa - 16.7% (TAUBLE fDA EACH SURVIVOR)
I. ThI p.rcent t..abla 'or .11.tl ct.at.d within on. y..r of the dacad.ot'l d..th Ot account. own.d b~ the dec.dant but held
In tru.t far II'IDther IndlvlduaiUl1 (tru.t b."aflcl.tl..h
I DIVIDED IY TOTAL HUHIER OF SURVIVING JOINT
OWNERS OR TRUST IEHEFlCIAAIES
E.-.plll Joint account r.al.t.rad In the n... of thl dlcedent and two otMr p.rlonl and .Itabll.had withIn ana y..r of d..th by
the cMcedent I
I DIVIDED BY 2 (SURVIVORS) -.50 X 100 . SOl( (TAUBLE fDA EACt! SlJNlVORI
)c 100 . PERCENT TAXAllE
~. ThI.-aunt lubJact to t.x (line ~) I. det.r.lned by aultlplylna thl account b.lanc. Illne 21 by thl percent t..abl. (llna 5).
IIIi 'nt... t.... t.....t .., ...'" ...,... ..... ......,..tl_. II,.... In p.... ,
6. Th. IHunt t...bl. CUne 61 II d.t.ralnad by Iwtr.cUng thl d.bt. and d.ductlon. Clln. SJ fro. Itll ..aunt lubJ.ct to t.. (lln. "J.
7. tnt.r the approprl.t. t.. r.t. Ctlne 7) .. d.t.r.lnld b.low.
A. Far d.t.. of de.th occurring .,tlr 6/30/9", the ta. r.t.. far tran.f.r. to lpau.., .r. .1 follow'l
I, D.t.. of de.th on or aft.r 7/1/94 and blfar. 1111'S thl r.t. I. 3X.
2. Dat.. of d..th on ar aft.r t/1/9S tran.f.r. to .pou... will ba t...d .t OX t.. r.t.,
Hotal For det.. of de.th prior to 7/1/94 tranl'.r. to lpaul" Ir. taxable It 6X.
I. Tranlf.r. to Ilna.t delcandent. Including f.ther, IOthlr, Ion. daugnt.r. grandchildren, Ion-In-law,
dlUQhtar-ln-I.w, .tapchlld and thalr I'IUI .r. t..abl. .t .IM parcent 16XI.
C. Tran.f". to aU othara Including brothlt, ...tlt, unci., ....,t, n.ph.w and nlac. It. t..abl. It flft.." p.ruflt (lUI.
D, 11 YOU ~ tM tax rate, pl..la .peclh your ralatlOflM1lp to the dlC:~."t In thl ara. provided,
I, The.....,t of t.. due Ulna II II d.t".lnad by aultlplylne the IItOUnt ta.abl. (Una 61 by the 1I. rat. Cllna 71.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. debtl and deduction. .r. d.t.r.lned .1 fallow'l
A. You I...ll~ .t. r.spon.lbl. far p.yaant, ar thl .It.t. .ubJect to ~Inl.tr.tlon by . parlanal rapr..ant.tlv. I. Inlufflclant
to PlY the deductlbl. It....
I. You actually plld thl dabt. .fter death of thl decadent and can furnhh proof of Ply,."t.
C. Debtl b.lng c.alaad ault be It..16ad fully In p.rt 1. Jf additional IPac. I. needed, UI. pl.ln pap.r I 1/2" . II". Proof of
p.y.ent ..y b. requalted by the PA D.p.rtaant of Revenue.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS. PA DEPARTMEHT OF REVEHUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIOUAL TAXES. TAXPAYER INQUIRY UNIT IN
HARRISBURG A'r (717) 787-8327. TDD' (717) 772-2252 (HEARING IMPAIRED ONLY)
COMMONW(ALTH Of PENNSYLVANIA
DEPARTMENT Df REy[NU[
BUREAU Of INDIVIDUAL TAMES
DEPT. llD6DI
HARAISBURG, Pi .'UI-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 . I';' 'PI
95154165
11-14-95
TVPE OF ACCOUNT
o SAVINGS
fX) CHECKING
o TRUST
o CERTlF,
""IU'" I" "."'1
EST. OF FLORENCE E CLOUGH
S,S. NO, 211-52-B304
DATE OF DEATH 09-06-95
COUNTY CUMBERLAND
EDNA G FENTON
601 BRITTON RD
SHIPPENSBURG
PA 17257
REHIT PAVHENT AND FORKS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
DAUPHIN DEPOSIT BK I T ha. provided the nePlrt.ent Mlth lhe Infor..llon lilted b.lo" lIIhlch hn be.., "..d In ulc"l.tlng the
potential I.. due. Th.lr record. Indlcal. th.t al Ih. d.ath of Ih. above d.ced.nt, you M.r. a Joint own.r/beneflcl.ry of thl. .ccount.
If you f.. 1 thll Infor..Uon II Incorr.ct, pl.... obtain written cornctlon fro. the financial In.tltutlon, att.ch . copy to thll for.
~ ~""Jr., it t.. tM :~o\" =:.tMr.... Th1c ~e.,...,t t. h"otb'" J" ~':c.,rdWW'. with ~h. Ir'lh-~Ih"'... 'III" l...c of th. Cc~~!"ell.to ... P~ryl"eo'l.
cu..tlon. ..y ~ en.wer.d by c.lllng (711) 717-1327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAVMENT INSTRUCTIONS
Account No, 0094163472 D.t. 12-21-B2
E.hblhhad
Account S.l.oc.
P.rcent T.xa.bl.
Aaount SUbj.ct to
T.x R.t.
Potentl.l T.x Due
754,15
16,667
125.69
,06
7,54
TAXPAYER RESPONSE
,FAILURITO RISPOND., lULL R!SUL TIN ,AN OFFICIAL TAX ASS!SSN!ltT BAUD ON THIS HOTICI
To In.ure proper credit to your eccount, two
(2' copl.. of Ihls notlc. ...,.t aCCHPeny your
p.y..nt 10 the Ae.l.t.r of Will.. "eke check
p.Yable tal ""Reglstar of WU1., Agent".
x
x
HOTEl If t.M peyeent. .r. .ade Mlthln thr..
f3. eonth. of the decedent'. d.t. of d.ath,
you ..y deduct. 5% dltcount of thll tn due.
Any Inherltanc. t.M due MUl bacHe delinquent
nine C9. eonth. after U. det. of de.th.
T..
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. 0 Tn. above l"for..Uon and tax due I. corr.ct.
I. Vou ..y choo.e to r..lt pav-tt to the Reg""" of With Mlth two copl.. of thh noUce to obt.ln
a dl.count or avoid Int.r..t, or you ..y check bo. ~A" end r.turn thl. notIce to the A.,lst.r of
Will. and an offlcla. ......eent will ~ Is.ued by the PA n.partsent of R.venue.
B. c:J Th. abov. ....t ha. been Dr will b. r.port.d and t.. p.ld with the Penn.ylvanl. Inheritance Ta. r.turn
to b. fU.d by the d.cedlW1t.. repre.enlatlve.
C. 0 Th. above lnfor..tlon 1~nc:arrl8Ct "'d/o~.bt. Md d.ductlons wu. p.ld by you.
You ...,.t cDllphl. PART l!..J and/o,. PART l!.J billow.
If you lndle.t. . diff.rant tax rat., pl.... .t.t. your
ral.tlon.hlp to d.c.d.ntl
OFFICIAL USE ONLY 0 AAF.i
PA DEPARTMENT OF REVENUE__.j
PART
~
TAX RETURN . COMPUTATION OF TAX
LINE 1, D.t. E.tabll.h.d 1
2. Aecount S.lene. 2
3. P.rc.nt Taxabl. 3 x
4. A.ount Subj.ct to Tax 4
5. DMlt. Ilnd Deduction. 5
6. A~t Taxabl. 6
1. T.x Rat. 1 X
B. T.x Due a
ON JOINT/TRUST ACCOUNTS
PART
@]
DATE
DEBTS AND DEDUCTIONS
PAD
1
2
3
4
5
6
7
8
CLAIMED
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
I
TOTAL lEnt.,. on Lin. 5 of Tax COMPut.tion)
I
.
Undar pan.lt!.. of p.rjury, I dacl.r. that the fact. I
cOMpl.t. to the beat of .y kno"ledga and balt.f.
~ ,:"('.',. ....-:~ C:'7";-::--, ;-~
TAXPAVER SIGNATURE
have report ad above ar. t~, earrect
HOME (/' '7 l ~'.;I ,'/. J ',' '1 ?
WORK ("";l'/""') .,:j-]_'_ /;,,..1/
TELEPHONE NUMBER
and
1.14.,1. ).",""-
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHEHT with IIPpllcabl_ Int.,.., b..~ on Infor..llon
lub.duN bV thtl fI"."el_l Inltltutlon.
Z. Inh.rUMe. 'n bleo... delinquent nln. lonlh. afhr the dKedenP, da'a of dulh.
5. A Joint account I, t...bl. .v~ though Ih. d.c.d~t'. "... w., lidded ft. " ..tt.r 0' convenl.nel.
4. Account. (Including tho.. held b.twI." hulb."d and wlfal which the decadant put In Joint ".... within on. y..r prior to
d..th .r. fullv t..~I. .. trans'.r..
5. Accounh ..tRbI hhad Jolnllv bltwa.n hu,brtnd and wit. IIOr. than on. yeu prior to dulh ar. not '..abl.,
.. Account. held by . dlcldant "In trult for" anolh.r or other. .r. t..ahl. fully,
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A . If thl Infor..tlon and co~t.tlon In the notlc. .r. correct and deduction. .r. not b.lng cl.I..d. pl~. an ".~
In block ~A- of P.rt I of the "'.~p.y.r R.spon..- .~tlon. Sign two copl.. and sub.lt th.. with your check far the ~t of
tn to the Rellhter 01 Willi of the county Indicated. The PA D.p.rteent of R.v.nu. will It.utI an afflcl.1 ......HIlt
eror. REV.IS~I EX) upon r.c.lpt 01 th. r.turn Iroe the R.gl.t.r of Wills.
Z. BLOCK I - If the u..t sp.clfl.d an thh natlc. h.. been or will b. report.d and tn paid with the Pannsrlvlll1l. Inherltanc.
T.M A.turn Illed by the d.c.dant". rapr..antatlv.. pl.ca an "X" In block "a" of Part I of the "T.~p'yer A..pon.e" .actlon. Sign on.
copy and return to H" PA D.p.rt..nt 01 Rev.nu., aureau of Individual'..... D.pt 180601, It.rrlsburg, PA 11118-06DI In the
env.lop. provided.
J. aLOCK C . I' the notll' Inlar.atlon Is Incorr.ct andlor d.ductlons .r. b.lng cl.I..d. ch.ck block "C" and ca.,l.t. Plrt. Z and J
eccardlng t:l t:-.c In~t~:.atlcl'l:l t...lc~. tl;n t\O" ::Iplo:l ....,d ~lObe1t thu ..lth 'i:lur ch::k f:r the. .::..c.Gunt ct 'elf ~=.'=Ic te t!'le n'1I1:tar
01 Wllh of the county Indlcat.d. Th. PA Dapart.ent 0' Rlvenu. will ,..uti an official .........,t (for. MV-I"I EX' upon r.calpt
0' the r.turn frDII the A'lIlst... 0' Wllh.
TAX RETURN - PART
Z
- TAX COMPUTATION
LINE
I. Ent...
HOTEl
the dIIt. the acCOU1t a..lolnaUy w.. ..tabllshed or tltI.d In the ...,.r ...lttlnll .t d.t. of d_th.
for. decedent dying .ft.r IZ/IZ/IZI account. which the decedent put In Joint n.... within one (I' y.... of d..th ....
t,Mlabl. fully.. tran.f.r.. IIow.v.r, th.r. h an ...elu.lon not to ..ca.d U,DDD p.r tren".rH r.lI.rdl... of tM v.lutI 0'
the account or the nueb.r 0' .ccount. h.ld.
If . doubl. ..t.rllk cn) .pp..r. b.for. YDUr Itnt n... In the eddr... portion 0' thl. notlca. the U,DOO .1Iclu.lon
.In-'Y h.. bMn deducted Iroe the account balanc. .. rlfHlrtad by the flnenedal In.tltutlon.
Z. Ent... the tot.1 b.lanea 0' the account Including Intar..t accrued to the d.t. 0' dl.th.
J. The percent a' the .CCOU1t th.t I. t..abl. fa.. ..ch .urvlvar I. det.r.ln.d .. lallaw.1
a. The p.rcent t.Mabl. far Joint ....t. ..tabllahed eor. than one y.ar prior to the dacadant'. d..thl
1 DIVIDED IV TOUL fUtlEA OF DIVIDED IV
.IOINT OWNERS
E_.-ple, A Joint ....t r.lllat.r.d In the n... 0'
TOUL NJKIER Of X 100 - PERCENT TAXAllE
SURVIVING .IOINT oWNEAS
the dac:edent and two otho.. p....on..
I DIVIDED.V J (JOINT OWNEAS) DIVIDED BV Z (SURVlVORSI - .161 . 100 . 16.1X (TAXABLE fOR EaCH SURVIVOR)
I. The percent t.lIabl. 'or ....t. cr..t.d within ana y.ar a' the dac:ldent'. d..th or account. own.d by the decedent but held
In tN.t 'or enoth.r Indlvldu.IC.1 (tru.t b.neflcl.rl")1
1 DIVlDED.V TOTAL HUHIEA OF SURVIVING JOINT
OWNERS DR TRUST B[NEFICIARIES
X 100 . PERCENf TAX AilE
E_IIPI., Joint Rccaunt r.ol.t.r.d In the na.. 0' the d.cadant and two ath.r p.r.on. and ..tabllsh.d within on. Y'.~ a' d..th by
the d.c.dent.
1 DIVIDED IV Z (SURVIVORS) ~ .50 K laD - sox ITAXABlE fDA EACft SURVIVOR)
~. The MOUnt .ubJHt to ta. Oln. 41 I. datarelned by aultlphlng the account balence (IIn. 2) by the p...cent t...bl. (lln. JI.
5. Lnt.~ the total 0' the dabts and deduction. I htad In P.rt J.
6. The NDU1t tallllbl. (llna 6) h detaraln.d by lubtnctlnll the dabts and d.duatlon. Ulne 51 'ro. thl a.aunt subJ.ct ta taM (lln. ilIl.
1. Enta~ ttM approp~l.te t.. nt. elln. 1) a. d.t.r.ln.d b.law.
A. For dat.. of d..th occurring afl.r 6/J0/9~, the t.M rat.. for tran,'.r. to spou... ar. .. follow'l
I. Dat.. a' d..th an or aft... 111/9~ and b.fora 1/1/95 the rat. I. J~.
Z. Dat.. of da.th an or aft.~ 111/95 tren.f.... to .pau... will be ta..d at O~ tn nt..
Nat'l Fa~ d.t.. of d.ath prior to 111/9~ tran.f.r. to .pou... .r. t.lIabl. at 6~.
I, Tranlf.r. to llne.1 d..cendant. Includlnll f.th.... eother, .on. daughter. grandchildren. .on-ln.I....
daught.r-In-I.... stepchild ~ thai.. I..ue .re t-.abla .t .111 p.rcent (6:C).
C. TrBn.f.~. to aU' ath.... Inchldlng broth.... .hhr, unci., ItUftt. n.~w and nl.ea .r. tallabl. at ,1ft.." p.rcent (l5~).
D. If yOU chenge the ta. r.t.. pl.... .paclfy you~ r.l.tlon~lp to the decadent in the .raa pravldld.
I. The.-ount of talC due Uln. 81 .. dltar.lnld by aultiplrlng tha aeount t..abl. [Una 6) by the tn rat. 11Ine 11.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND OEDUCTIONS CLAIMED
Allowabl. dabt. and daductlon. ar. d.t.r.lned .. fallaM'1
A. You leg.lly ar. r.spon.lbla lor payaant. 0" the ..t.t. .ubJect to ~Inl.lr.tlon by . par.onal rapr..entatlv. I. Inau"lel,"t
to pay the dedUctlbl. It....
S. You actually paid the dabt. a,t.r da.th of the d.c.dent and can furnl.h proof of pay..nt.
C. Ddh Mlnll clal.ed au.t b. tI..lud fullY h, Part J. If adcUtlon.1 ,plea Is n..d8d. un plain pap.r I IIZ" M 1I". Proa' 0'
p.y.ant ..y ba r.qu..t'd by the PA nap.rt.ant 01 A.venue.
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. TOOl (717) 772-2Z5ZCHEARINO IMPAIRED ONLY)
". ~. ~.. ... ~ ... .. .
,------ -- - -T-/T - -- -- -..... --Jl"'<""'--'-- --'- ,-- ---.- -.- - --- -- - - - - _ _ _ __ _ __
: '1 I,
I I
. .
I '
I 0 AA 08'2422 COMMONWEALTH OF PENNSYLVANIA
I NO. DEPARTMENT OF REVENUE
I ...""..,.,..' OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATETAX
r-
~~~
"'~,
RECEIVED FROM,
I
ACN
ASSESSMENT Ii'
CONTROL ~
NUMBER
AMOUNT
EDNA G FENTON
9:51:5:5929
..1.e:5
601 BRITTON ROAD
SHIPPENSBURG, PA 17e~7
9:51:5:5930
9:n~4,14:5
.4:50.1:5
.7.~4
- '010 HUI
lOtO Mil'
ESTATE INFORMATION,
fJ fiLE NUMBER
e1-199:5-0931
.,. NAME Of DECEDENT (LAST'
~ CLOUGH FLORENCE E
m DATE Of PAYMENT
m POSTMAR E
COUNTY
SSN el1-:5e-B304
(fiRST' (Mil
CUMBERLAND
DATE Of DEATH
REGISTER OF WILLS
m TOTAL AMOUNT PAID .468.94
"-, "CW
( ) 1/" / ./
RECEIVED BY :,L!!.~(, / i", ".1
/ 5IG~~~R~i_/' .'_:'
MARY C. LEWIS ~ ,
REGISTER OF WILLS
REMARKS
EDNA G FENTON
SEAL
CHECK" 79:5
,- - ------- ----,-- --.------ - -- -- ------- ---- -----;-:--;:.--..- \
v.:
""-'",i
.
I
1;, .
P,
1'- ...
"
.
----
__._.,.----'~...__.._. t. ..-r~
<'1..- .
.
,',
.'
,- I
/'
REV-154B EX AFP (12-951*
COtK.MAlTH Of PENNSYlVAHll
flliJAATHENT Of REVENUE
~ Bur.EAU Of INDIVIDUAL taKES
Df.IIT. 18D6Dl -.
liARRlSIURG, PA 17ua-06001 ~
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLDMANCE DR DIBALLDMANCE
OF DEDUCTION. ,. AHD ASSESBHElIT OF TAlC ON
JOINTLY nELD DR TRUBT ABSETS
DATE 01-29-96
ESTATE OF CLOUGH
FLORENCE E DATE OF DEATH 09-06-95
CDUNTY
CUMBERLAND
FILE NO, 21 95-0931
S,S/D,C, NO, 211-52-B304
ACN
95154165
EDNA G FENTON
601 BRITTON RD
SHIPPENSBURG PA 17257
REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount R..ltt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-{y=isiia-iiC-AFji-ri:i=9si------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 01-29-96
ESTATE OF CLOUGH
FLORENCE E DATE OF DEATH 09-06-95
COUNTY
CUMBERLAND
FILE NO, 21 95-0931
TAX RETURN WAS.
S.S/D.C. NO, 211-52-8304
(XI ACCEPTED AS FILED ( I CHANGED
JOINT OR TRUST ASSET INFORHATIoN
ACN
95154165
FINANCIAL INSTITUTION. DAUPHIN DEPOSIT BK & TR CO
ACCOUNT NO,
0094163472
TYPE OF ACCOUNT. (I SAVINGS (10 CHECKING ( I TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 12-21-82
Account Belnnc..
P..rc..nt Tnxnbl.. X
Amount Subj~ct to Tnx
Dnbts nnd D..ductions
Tnxnbl.. Amount
Tnx Rnt.. X
Tnx Du..
754,15
0,166
125.69
,00
125,69
.06
7.54
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. HAKE CHECK
OR MONEY ORDER PAYABLE TO.
"REGISTER OF WILLS. AGENT,"
TAX CRED:tTS:
PAYMENT
DATE
12-15-95
DISCOUNT (+1
INTEREST (-)
,DO
AMOUNT PAID
7,54
RECEIPT
NUMBER
AA082422
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER TNIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
I IF TOTAL DUE IS LESS 'THAN '1, NO PAYHEHT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI. yOU KAY BE DUE A REFUND.
SEE REVERSE SIDE OF TIllS FORK FOR INSTRUCTIONS. I
7,54
,DO
.00
.00
PUIlPOSEOf
NOna: I
To fulfill the nqulr....,h of Section ZUD of tM Inhlr.bnc. IIt1d flt.t. Tn Act, Act ZZ 0' 1"1. (1Z P.I.
Section 21401.
PAY"EHT,
Detach the top portion of thl. Hotle. and ~It with your p.~t to the Ragllta.. of will. prlnt~ on tM
t.va,... side.
n ...... chKk or ~y order paYebla tal AfGISTER OF WILLS, AC[NT.
AU p..,..,," reealvH shall flrd be ..11M to MY Int.r..t which ..y be dlM, with MY ,....lnrHir -..lIed to the '&It.
RU\NJCtRU
" r.'und 0' . ha crHlt, Mhlch ..a. not r~sted on tM t.. nturn, "'I be r~.t... by cHPlaUno In '"AppllcaUDft
for R,fund 0' P~lyl\/anl. Inheritance end Eatat. Ta.- CREV-1SIS). application. at. IVllleble at the Of,lcI of
~ R-al.tar of WillI, MY of the ZJ Revenue DI.trlct offlc.. or by call1no the ,peela. 24'hour an.~rlng ..rvlc.
nu.ber. for for.. orderlnol In Penn"I".,..', l-IOO-)6Z-ZD50, out,lde Pannlvlv.".. ~ within local
Harrisburg .t.. (117) 7U-eOM, TOOl (117) 17t-tU! CH..rlng I.alred Onh).
OBJECTIONS I Anw partw In inl.r..t not ..tl.flad with the BPPr.I...-nt, .Ilowenc. or dl..lIONenca of deduCtion. or .....seent
of I.c (InclUding dl.count or Int.r..tl .. shown on thl. Hotlc...w object within .IMty e,ol d.y. of recllpt of
this NotlCI bYI
--..dUe" prat..t to lhe PA n.p.rla.,t of R."enue, Ba.rd of Appeal., Dept. 28lDZI, "arrllburg, Pi l11za-IUI, OR
--.Iectlno to h.". Ihl ..llar del.ralned at the .udlt of the account of lhe per.anal rapr..anlatl"., OR
.-appe.l to Ih. Orrtu.,.... Cllurt
ADtUH-
ISTRiTlVE
CORRECTIONS I
fectu.l .rrar. dl.co".rad on thl. ...r....-nt ~.d be addr...ed In wrltlno tal PA n.p.rt..nt of Aevenue,
aur.." of Individual 'au., ATTNI Pa.t A......."t A.vl.., Unit, O[pr. Zl0601, tt.rrlaburg, PA .7IU-D601
Phone (717) 7.7-6505. S.. p-v. 5 of the booklet "In.tructlon. far Inherltanc. 'a. R.turn far. A..ldant
Dec~t- lREY-1501) 'or en ..plen.tlon of ~Inl.tr.tlv.lw correctable .rrar..
DISCOlItT.
If anw t.. due I. p.ld within thr.. (SI c.lendar .unth. .ft.r the decadent'. death, a flv. parcent C5~)
dl.count of the t.. p.ld II Illowed.
INTEREST.
Int.r..t I. ch.road b-ulnnlno with flr.t d.y of d.llnquency, or nine C'I aonth. and one CII day
frOll the d.ta of d..th, 10 the data of pa,..,t. '.u. which bee... delinquent before J..-ry I, IMZ
be.r Intar..t at the nta of ... 16;(1 parc'"t par ...",.. calculated at . d.lly ,.t. of .0001'-.
All t.... which bee... delinquent on or .ft.r January I, 1'.2 will baar Intar..t at a r.ta which viii vary 'roe
calandar y.ar to calend.r y..r with that rat. ~ad by the PA Dap.rt..nt of A."enue. The appllcabl.
lnt.r..t r.t.. far 1'.' through 1996 ar.1
UIr Int.r..t Ret. Dal hi Int.r..t FltCtar UIr Int.r..t R8t. 0.11" Inhr..t Factar
19.2 ,U .DaDS'. 1917 'Z .OODZU
I'IS 16;( .000ltS. ""-1991 11;( .DOnOl
I'" 11;( .aaOSal ..., 9Z .Daoz'"
1915 UZ .DOns. 1995-1994 n .aooln
.... IOZ .00017" 1995-1996 9Z .Ooa2'"
.-Int.,..t I. calculated .. foIlDM.'
INTEREST . BALANCE OF TAX UNPAID II NUKBER DF DAYS DELINQUENT II DAILY INTEREST FACTOR
~.Any Notlc. I..ued .fl.r thl t.. becoaa. delinquent Mill r.fiect an Int.r..t c.lcul_tlon 10 fl,teen (15) d.yl
beyond the d.t. of the .......ent. If p.yMftt II Nde .ft.r 1M Int.r..t co.putatlon dIIt. &hawn on lhe
Notice, addltlon.1 Int.r..' ..,., b. calcul.led.
,/.,')
REV-1548 EX AFP 112-95*
CQHHOUWlALTH or P[NNSVlVANIA
DE:PARIHEHT or R[ytHlJ[
. BUREAU Of INDIVIDUAL TAXES
()(PT. 110601
III.RRISBURG, PA 11UI.0601
. l ).. . /
. " I
NOTICE or INHERITAHCE TAX
APPRAIS~ENTL ALLOWANCE OR OISALLOWAHCE
or DEDUCTION., AND ASSEBSnENT or TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 01-29-96
COUNTY
ESTATE OF CLOUGIl
FLORENCE E DATE OF DEATIl 09-06-95
FILE NO. 21 95-0931
S.S/D,C. NO, 211-52-8304
H L VARNER
601 BRITTON RD
SIlIPPENSBURG PA 17257
CUMBERLAND
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-iv=is4-a-ix--AFP--riif:9Sj------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 01-29-96
ACN
95154181
REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT 1l0USE
CARLISLE, PA 17013
AMount Re.Ut.d
l
ESTATE OF CLOUGIl
FLORENCE E DATE OF DEATIl 09-06-95
COUNTY
CUMBERLAND
ACN
95154181
FILE NO, 21 95-0931
TAX RETURN WAS.
S.S/D.C, NO, 211-52-8304
(X) ACCEPTEO AS FILED () CIlANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION. DAUPHIN DEPOSIT BK 8 TR CO
ACCOUNT NO,
8100200017
TYPE OF ACCOUNT, () SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 12-16-93
Account Bahnca
Pa~cent Taxable
Amount Subjact to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
15,036,68
0.500
7,518,34
,00
7,518,34
.06
451.10
x
x
TAX CREDITS:
PAYMENT
DATE
12-06-95
RECEIPT
NUMBER
AA082383
DISCOUNT (+)
INTEREST (-)
22.55
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS, MAKE CHECK
OR MONEY ORDER PAYABLE TO.
"REGISTER OF, WILLS, AGENT."
AMOUNT PAID
428,54
451. 09
,01
,00
,01
PAYMENT MUST BE MADE BY 06-07-96N, TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
<< IF TOTAL DUE IS LESS THAN f1, NO PAynENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" << CRI, YOU HAY DE DUE A REFUND,
SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS. I
PURPOSE Of'
NOTlCE1
To fu1flll tM requlrllHnt. of s.cUon 2140 of tt. lm.rJt~ and ht.t. hlC Act, Act ZZ of 1991. (7% P.S.
SecUon U"OJ.
PA\'HENT 1
O.tach the top portion of thl, Hotlc. and ,ubalt with your Plya.nt to tha A.glst.r of Willi printed on the
nvarl' side,
n "M. chack or JM)f'My order paylabla tOI RfGlSTER Of' WILLS, ACENT.
All p.,...". rlK.lved &hall first be appllad to ."., Int.r..t which ..y be dua, with MY r...lnder IPPllad to the talC.
REF\JHD(CAJI
A rafLnd of . talC crNIt, which w" not nqu..tad on tt. t.. return, ..y be requa,tad by cDIIIPI.Ung WI "Appllc.Uon
for R.fund of Penn.ylv8nla Inherltanc. and E.t.t. tax- eREV.1SI3), applications ar. avalllabla at the Offlc. of
the A.gl.t.r of Wills, any of the 23 A.venue DI,trlct Offlc.. Dr by c.lllna the ~Ial Z"-hour an.varlna .arvlc.
nu-bar. for for.. ord.rlngl In Pann.vlvenla 1-800.362-2050, out.lda Pannlvlvenla and within local
Ha,.rlsburg .,... (711J 781-80"', TODl (111J nZ-U5Z Ol..rina 1~.I"ad OnlyJ.
OIJECTlOHSI AnV p.,.ty In Int.r..t not ..tI.fled wIth the epprals-1t, .11ovance or dls.l1ovanea of ~ctlon. or ..........t
of tax Clncludlng dl.count or Int.,...t) a. ahown on thl. Notice ..y object within .llltv (60) d.y. of rae.lpt of
thh Hotlca bVI
.-Mrltt-. prot.., to the PA D.p.rt.....t of A.vanua, loard of app..h, Dept. ZIlOZI, l18rrhburg, PA I11Z8.1021, OR
--.Iactlng to hlv. the ..thr datar.lned at the IlUdIt of the account of the p.raonal rapr.sent.tlv., OR
..appall to thl orphans- Court
ADHIN-
ISTRATIYE
CORRECTlONSI
factual .rrorl dlscovlr.d on thl. .......ant .hoUld be addr...ed In writing '01 PA D.part.-nt of R.venue,
lur.au of IndIvidual hili', ATTNI po.t A......ant Rnl.w Unit, DEPr. 210601, t1arrlsburll, PA 17U8.06al
Phone C711J 787-6505, 5.. pag. 1 of the bookl.t "In.tructlon. for Im.rltnnca r.. Raturn for. R..ldant
D.cackant" CAEv-ISOll for en .Ilphn.tlon of adldnhtr.tlv.ly corractabl. .rror.,
01 5COUHT 1
If anv talC due II paid within thr.. (5) clllandar .unth, .".r OM decadent" death, II flv. p.rcant es:u
discount of tM tu p.ld h .UDtftd.
INTEREsrl
Int.r..t I. ch.rged beginning with flr.t dav of dellnquencv, or nine e91 .onth. 8nd ~ el) day
froe thl dllta of d.ath, to thl data of p.yaant. r.... whIch ~ d.llnquent bafor. Januarv 1, 1912
baar Int.r..t at the r.t. of .IM (6~) parcent par ~ calculated .t . dally rata of ,000164,
All telC.. which bee... d.llnquent on or .ft.r January I, 198Z wIll b..r Int.,...t at . r.t. which will vlry froe
celand.,. v..r to r.aland.r y..r with that rat. ....-.-.cad by the PA Dap.rt.....t af R.vanua. 1M nppllcabla
Int.r..t r.t.. for 1911 through 1996 .r"
'WI: tnter.st Rllt. DlIllv Int.r..t Fllctor tor Int.r..t Rat. Dallv Intlr..t Fllctor
I9IZ ZO~ ,000541 1917 OX .00020
1915 16X ,OOOltSI I'Y'I,"1 IIX ,000101
1984 IIX ,000301 '99' .. ,0002"7
1915 ... ,000156 1'"5"1994 1l( ,000192
I'" 'D' ,00021" 1"5.1996 .. .00020
--Intlr.st It calcula'act ., faUaw'l
INTEREST . BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUEHT X DAILY INTEREST FACTOR
'-Any Hatlc. Inuad .ltar the tlX bleDM' dallnctUll\t will r.f1ect an lnt.,.ut calculation to flft.... CIS) days
beyond the data of the .....nent. 11 p.yaant II alda aftar thl Int.,.ut clMlIPUtaUon data shown on thl
Hatlca, addltlonal Int.r..t ....t be calculated.
, "
REV-1548 EX AFP (12-95*
CotltO\lWlAl lit Of PENNSYl VlH I A
DEPARTHE:Nl Of AtYOlJE
. IURfAU or INDIVIDUAL lAXES
(J(PI. ZID6Gl
tUIfRISlURO, PA I1UI.0601
ESTATE OF CLOUGH
FILE NO, 21 95-0931
--; / -
NOTICE OF IHHtRlTANCE TAX
APPRAISE"EHT, ALLOMANCE OR OISALLOMANCE
OF DEDUCTION_ \ AND ASSESS"EHT OF TAX ON
JOINTLY ,[LO OR TRUST ASSETS
DATE 01-29-96
COUNTY
CUMBERLAND
FLORENCE E OATE OF DEATH 09-06-95
S,S/D.C, NO, 211-52-8304
EDNA G FENTON
601 BRITTON RD
SHIPPENSBURG PA 17257
ACN
95155929
REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AMount R..itt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-{v:is4-S-EiC-AFji-fiz-:9S;------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 01-29-96
ESTATE OF CLOUGH
FILE NO, 21 95-0931
TAX RETURN WAS.
FLORENCE E DATE OF DEATH 09-06-95
COUNTY CUMBERLAND
ACN
95155929
S,S/D.C, NO. 211-52-8304
(X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION. ORRSTOWN BANK
ACCOUNT NO.
000-620548
TYPE OF ACCOUNT, () SAVINGS (lO CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-23-85
Account Balance
Percent Taxabla X
Amount Subject to Tax
Debts and Daductions
Tsxable Amount
Tax Rate X
Tax Due
TAX CRED:tT9:
PAYMENT
DATE
12-15-95
RECEIPT
NUMBER
AA082422
374&
0.500
187,48
,DO
187,48
.06
11,25
DISCOUNT (+)
INTEREST (-)
,00
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS, MAKE CHECK
OR MONEY ORDER PAYABLE TO,
"REGISTER OF WILLS, AGENT,"
AMOUNT PAID
11,25
11. 25
.00
,DO
,00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER TNIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
I IF TOTAL DUE IS LESS TNAN 'I, NO PAY"EHT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU "AY SE OUE A REFUND,
SEE REVERSE SIDE OF TNIS FOR" FOR INSTRUCTIONS. I
PUIIPOSEllF
NOIlCEI
To fulfill the ,.....I,..-nt. of SKtJon 'H' of the Inhe,.Jt~ .... Eatat. talC Act, Act It of ."1. (71 P.S.
SMUon tl4DJ.
PAV~HTI
D.tach the tap pDrHem af thl, NaUn and Iubtllt with 'lour PlY"'" to thl Rlllhtl,. of WUb prlnhd an the
rlv,,,,' .Ide.
.. M_. chKk Dr IMIna., orde,. pI'IBbla tal REGISTER OF WILLS, ACENT.
AU p,pen" t.calved ..,.11 fI,., tM 1IPP11M1 to ."" Int.,...t ....Ich ..y be due, with any ,....Inder appl1.d to the talil.
RU\.IfD(CAh
A ,..fund of . bJC credit, which .... not r~.ted on the tall nturn, "'1 be r....ted by cMPlaUna .. "appllutlan
far R.fund of P~''Ilv."l. Inheritance end Eltat. rail" (REV~lSlJ). Application. ara avallabla at the OfficI of
thl Regl.ta,. of Will., eny 0' the IS R.y~ DI.trlct Of,lc.. or by cIIllno the .peel.l Z~.hoUr an.werlna ....vlea
~r. for lor.. o,.o.rlntl In penn''11v.nla 1-8DO-S6Z-ZDSD, out.l~ Penn'Ylyenla and within locII
ttlrrhburg ar.. (717) ll1-IOM, TDDt (717) 772-U52 (Heerlng IlIpalred Onlyl.
OaJECflONSI MlI' parh In Intar..t not ..thfled with the appr.I.....,t. allow."ca or dh.llowWIC. of deduction. or .........,t
of tax elncludlng dl.count or Int.r..tl a. ahown on thl. Notlc. ..w obj.ct within sixty e601 d,lI" 0' rae.lpt of
this NoUce bYI
"writtan prot.,t to tN PA Departaant of R.v..,.. ao.rd of Appe.... Dept. nlOU. ".rrlsburg. Pi 1711I-lOZI. OR
-...ectlng to ha". the ..thr dahr.lned at the audlt af the account of the personal rllflr..."t.Uv.. OR
nlaPpea. to the Orph."s' Court
ADttIH-
ISTRAflVE
CDRRfCTIOHSI
factual .rror, dlscov.rad on 'hi. .......-nt ~Io~ba addr...ed In wrltlna tOI Pi Dap.rt..nt 0' RavanuB.
lur.M1 of Indlvhtual Tax... AnNI Pa.t A.....Mnt R.vl... unit. OCPT. ZaDU1, Ilarrhburg, PA 17111l-06Dl
Phone (717) 7117-6505. S.. page S of 'h. bookl.t ~Jn.tructlon. for Inherltanc. Ta. R.turn for a R..loant
Dec.d.,,'" CREY-ISOI) for en a.llpl..,Uon af ....In..tr.Uv.1Y corrKtBbI. .rror..
DISCOUNTI
If any talC due .. p.ld within thr.. eSI uland.r aonth. .,t.r ,he dltC~t'. d.ath. a Ilv. pareant en)
dhcount of the tax paid .. .llowed.
INTEREST I
Int.r..t .. chargad beGlmlnt with first day of d.llnquancy. or nl,... 191 eonth. W1d one 111 d.lI'
Iro. the data of d..th, to the d.t. of p.pent. ralCu ..t1lch bee.. dellnquant befora January I. 1981
ba.r Int.r.st at the r.ta of .b (6l0 perc."t per ___ calculated at . dally rat. of ,0001".
All taxa. which bee... dall~t on or .,tar Janu.rll' I. 198Z will baar Intara.t at a rata which will vary froe
calend.r lI'aar to calendar lI'..r with that rat. announced by the PA Gapart.."t of Rav..,., The appllcabl.
lnt.r..t rat.. for 19112 through 1996 ani
'tur Intar..t R.t. nail." Int.rnt Flletor tw tntar..t Rllt. nally tntarnt Flletor
1981 ZO~ ,DODSlt8 19117 .. .DOO2U
I98S 16le .000"SI 19aa-I,"1 11lC .DOOSDI
..14 l1lC .oonol 1992 'X .DDD2U
1915 ISle ,OOUS. 1991.1~ 1X .DDDI9Z
.... In .DODZ7" 1995.1996 .~ .0002'"
uJnhr.d Ie celculatad .. followal
INTEREST a BALANCE OF TAX UNPAID X KUKBER OF OAYB DELINQUENT X DAILY INTEREST FACTOR
uAnw Notlca luuad aft.r the tex b.co_e d.lInquent "UI r.IIKt ftI'I Int.r.at calcul.tlon to flft.." US) d.lI'e
bewond the d.t. of the .....~t. If pa..-nt Ie .ads .,tar the Intar..t e~tatlon data .hown on the
Notlc.. addltlon.1 Intar..t auet be celeul.tad.
REV-1548 EX AFP (12-95*
CDHtWJ"MllllI Of PfNNSYlVAHIA
D[PA'UHENf Of RlVuu:
DUA[AU Of INDIVIDUAL "X[I
Dt.Pf. llDftOl
tIARRISIURG, Pi 11"1-0.0&
NOTICE OF INNERITANCE TAK
APPRAISEMENT, ALLONANCE OR OISALLONANCE
OF oElluer 10Na It AND ASSESSNEHT or TAK ON
JOINTLY ELD OR TRUBT ABBETS
\/
DATE 01-29-96
COUNTY
CUMBERLAND
ESTATE OF CLOUGIl
FLORENCE E DATE OF DEATlI 09-06-95
ACN
95155930
FILE NO. 21 95-0931
S.S/D,C. NO, 211-52-8304
EDNA G FENTON
601 BRITTON RD
SHIPPENSBURG PA 17257
REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT 1l0USE
CARLISLE. PA 17013
ESTATE OF CLOUGIl
FLORENCE E DATE OF DEATH 09-06-95
AltO\.W\t R..l tteel
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REii:is4-a-Eif-AFii-iiz-:9Sj------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 01-29-96
FILE NO, 21 95-0931
TAX RETURN WAS,
S.S/D,C, NO, 211-52-8304
(X) ACCEPTED AS FILED ( ) CIlANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION, ORRSTOWN BANK
ACCOUNT NO.
COUNTY
CUMBERLAND
ACN
95155930
003-0049177
TYPE OF ACCOUNT, () SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE
DATE ESTABLISHED 04-04-94
Account Balance
Parcant TaxabIa
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rote
Tax Due
15,004.93
0.500
7,502,47
.00
7.502.47
.06
450.15
NOTEI TO INSURE PROPER CREDIT TO
YOUR ACCOUNT. SUBMIT TilE
UPPER PORTION OF TillS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT TilE
ABOVE ADDRESS, MAKE CHECK
OR MONEY ORDER PAYABLE TO,
"REGISTER OF WILLS, AGENT."
)(
)(
TAX CREDITS:
PAYMENT
DATE
12-15-95
RECEIPT
NUMBER
AA082422
DISCOUNT (+)
INTEREST (-)
.00
AMOUNT PAID
450. 15
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER TNIS DATE. SEE REUERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
I IF TOTAL DUE IS LESS THAN tl, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CAI. YOU HAY BE DUE A REFUND.
SEE REUERSE SIDE or THIS FORH FOR INSTRUCTIONS. J
450,15
,00
,00
,00
DJSCCN.*TI
Jf ~v t.. due I. p.ld wIthin thr.. Il) c.lend.r ~th. .ft.r the decedent's de.th, . 'Iv. p.rc."t 15%)
dllcount of the t.. p.ld I. .llowed.
PURPOSE OF
NOnCE I
To fulfill the r~lr...nts of Section Zl'O of thl Jnn.rltanc. ~ E.t.t. r.. Act, Act II of 1"1. 171 P.I.
Section IUOI.
PAV~NT I
D.tech thl top portion of this Notlc. end Iubllt with vour p.v.ent to the R.gllt.r of Wills printed on thl
rlv.r.. IIdl.
-- ..... check or lIOMV order p.yBbl. tOI REGJlfEA Of WILLI, AGENT.
111 p'v.."tI rec.lved shall I1rst be 8iPPllld to MV In"rllt which ..v be due, ..lth ."v r...lncMr app!Ject to the t...
R!f1JND C CR II
A nf\ftd of . ta. credit, which .... not r~ltlld on thl t.. nturn, "V be requestld bV cOllPI.Ung WI "Appllc.tlon
for R.fund of Pennlvlvanll l~rltlnCl and Elt.t. T.... IREV-ISll). Appllcltlons .r. Iv.lllbl. It the Offlc. of
thl R-elst.r of Wills. ...v of thl IS R.venue Dlltrlct O'flc.s or bV cllllng the specl.1 "-hour In....rlng I.rvlc.
~r. for for.. ordlrlngl In Pennlvlvanl. 1-100-161-1050, outsld' Pennlylvanl. and within loc.1
H.rrllburg Ir.. 1717J 117-1090\, TOO' ClUJ 171"Un IHelrlng JlIPllred OnhJ.
OIJECTlONSI Anv pltty In Intlr'lt not ..tllflld with thl appr......,t. .UI*MC. or dllll1ovanc:. of dltduCUon. Dr .........t
of t.. Ilncludlng dl.count or Interl.t) .1 ~ on thl, Notlc. "Y object within ,I_ty (60) dlVI 0' recllpt of
th" Notlc. bVI
--wrltt.... prot..t to thl PA Dep.rt.....t af R.vMUII. la.rd of Appe.... Dept. lIlOll, tt.rrllburg, PI J7UI.1OZI, OR
--.lecUng to hlv. thl ..ttlr detlralned .t thl IUdlt of thl ItCCDU1t 0' thl ptIr.on.1 nprllant.Uve, OR
--appIll to thl Orphan.' Court
AotUN-
JSTRATlVE
ComtECTJOHS!
fectuI. .rror. dl,caVlred on thl, ......eent ~Id b. eddr...1d In writing tal PA Dep.rt.ant af R.v~,
lur..... of Indlvlduttl T...., ATTN! Po.t .......unt Rlvl... Unit, DEPT. Z1D601, IIlrrhburg, PA 17ua-06tl
Phone (711) 117-6505. S.. pegs 1 af the bookllt ''In.tructlon. for Inherllanc. T.. R.turn for I R..ldlnt
OIcldlnt.. IREV-150IJ for an ..planatlon of ea.lnl.trltlvllv correclabll .rror..
INTERUT t
Jnt.r..t II charged HlIMlne with flr.t d.y 0' delinquency, or nine I') ""the and DnII II) deV
froe IhI d.t. 0' d..th, to the d.t. 0' p'Vlenl. ,.... which bee... delinquent ba'or. Janu.rv I, I'.,
b..r Inl.r..t It tM nl. of ... 16ieJ percenl par ~ ulcul.t... It . d.lh nl. 0' .DIIOI64.
All t.... which bee... d.ll~t on or .ftlr January I, 1.ll ..III ~r Inter..t It I r.l. which will vary 'roe
cllandar y..r to c.1MMilr 'Ulr ..lIh th.t r.t. announc:'" bV IhI PA Dep.r'unl 0' Rlvenue. The ~IIC11bl.
Int.r..t r.t.. for 1'" through 1"6 .r'l
'tilt Inter..t R.t. DIIII'" tnt.r..t rector 'tilt Intere.t Rlt. D.II'I Int.r..t FectDr
I'" ..X .000!t41 1917 'X .oon"
I'll 16' .DODItSl 1'11-1"1 Ilie .00OS01
191' 11X .D00501 '99' OX .D002"
1915 UX .00aU. I99S-I"'" nc .000191
"16 lOX .DOn" 1995-1996 'X .DOn"
--Jnt.r..t II calcul.11Id .. 'oIlOWI!
INTEREST . BALANCE OF TAX UKPAID X HUHBER OF DAYS DELINQUENT X DAILY INTEREST FAl:TllIl
--Any Nolin I..uad .lIer Ih. I.. bee..... d.llnquent ..111 r.flect ,." Int.r..t c.lcul.tlon 10 'lft.an liS) d.u
beyond thlt d.t. of the ......eenl. If p'vaant II I8CM .1I.r thl Inter..t CCMPUlltlon d.l. ~ on tN
Notlc., IIddIUon.l Int.r..t ault b. calculltad.