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...
COtIWHWULIIlor PfkHSVlVAHIA
D[P1ATHlNT Of RlIJIHUE.
IURr'~ Of INDIVIDUAL IAMrS
o(PI. ~lDiOl
t1l1fRISIURG, Pi unl-D.O'
-
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
ND.
21-Q5113'-/.
95157355
12-04-95
TYPE OF ACCOUNT
o SAVINGS
IX] CIIECKING
o TRUST
o CERTlF.
In'lhtU,.. ",M.
EST. OF HELEN E STOUDT
5.5. ND. 197-01-4973
DATE DF DEATH 09-14-95
CDUNTY CUMBERLAND
GLADVS L LAUBENSTINE
8 KAREN CT
CAMP HILL PA 17011
REHIT PAYHENT AND FORHS TO,
REGISTER DF WILLS
CUMBERLAND CO CDURT HOUSE
CARLISLE, PA 17013
PHC BANK hu provided the Oapa,t..-nt with the I"hu..tlon Illtad baloM Mhtch h.. bl.n u..d In calculatln, thll
potentlat ta. du.. Tha.' r.cordl Indlnt. that .t the d.ath of tha Abov. dec~Mt, YOU ..ar. a Joint ownar/beneflclary or thl. account.
If you f... tnh Infor..tlon Is Incorr.ct, pi.... obtain ..rIU.,. c:urracthm fro. the financial In.tltutlon, .ttach . copy 10 thh fllra
~ r.turn It to the abo~. .~dr.... lhl. .c~~,t I, t...~I. In accordance with 'he Inharltanc. ra. la... or the Co~.lth of P""I.,lvenl..
~..tlon. ..., be .."....'.d b,. Ulllng UI1J 117-8"'.
CDMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5140162004 D.t. 08-01-79
E.tablhhed
Account a_lance 1,429.19
Per-c.nt T.)C.bl. X 16 . 667
A.ount SubJ.ct to Tox 238.20
T.. R.t. K.f)fl/'r,'Ii1- .15
Pot.nti.l TaM: Due 35.73
PART TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
.. 0 1h1i aboVI Infor..Uon and t.. ckM II correct.
1. You ..y choas. to r..lt plya."t to the RagSa'.r of Will. with two copl.. of 'his notlc. to obtain
. dl.count or avoid Int.r..t, or you ..y chick bo. "A" and r.turn thl, nolle. to the Rlalat.t of
Willi and IIn offlc:l.a ........", will ba luued by thl PA Dlp.r'..nt of Rn."..,.,
fa In.ut. proper credit to your account, two
III copl.. 0' thlt notlc. .....t ICCO"''''Y your
p.y..nt to thl R.al.t.t of Will,. HI.' chick
plyabla tal "Rlall'.r of Willi, Aoent-,
HOlE I I' 'e. PIY'on.. at. .~. within thr..
IS) lonthl 0' thl dlcedent', date of duth,
you ..y deduct . S~ d'.count of the ,.. due.
Any Inherltenca t.. due will beeo.. dallnquent
nln. 1'1 .onths .ft.r th. d.t. of d..th.
[CHECK ]
ONE
BLOCK
ONLY
II. D The .bov. ....t hu bun Dr ..UI b. r.parted llInd tu P.ld with the P.,.,s.,.".,I. Inherlhnu Tn return
tD b. fll.d b., Ih. d.e.d.nt.s r.pr.s~t.tl"..
C. ~h' Abav. I"for..tlon I~ncorr.ct ftnd/o~.bt. and d.ductlon. ...r. plld by you.
You .us' co.pl.t. PART l!J and/Ot PART L!J b.low.
If you Indlcat. . dlffer.nt t.K r.t., pl.... st.t. your
r.l.tlonship to dec.dent,
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TAX RETURI; . CCiliPUTAiIOll
LINE 1. D.t. Established
2. Account B.lanc.
5. P.rc.nt TaMabl.
4. AMount SubJ.ct to T.M
5. Debts and Deductions
6. AMount T.M.bl.
7. T.x Rat.
8. Tax Du.
OF
I
2
3
4
5
6
7
e
TAX Oil JDIIlUTIlU3T I.:CC:mT:l
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f'C
I'AD
1
2
3
4
5
6
1
8
CLAIMED
.
PART
~
DATE
('0
DEBTS AND DEDUCTIDNS
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
!
fOTAL IEntar on Lin. 5 of Tax COMPutation'
I
I
I
I
.
Under pan.lti.s of perjury, I declar. that the fact. I
cOMPI.t. to the be.t of MY knoMI.dge and b.ll.f.
",/) , ../
>>r.~-1'IJkI A . ."( au /, ". ' 1,-;",
TAXPAYER SIGNATURE
hey. report.d above .re tru., corr.ct
HOME (/17 I 7.::.:J .~-,\- (/..<
WORK ( I L
TELEPHONE NUMBER
ond
,
,
...
GENERAL INFORMATION
1. fAllURE TO RESPOND WILL AESUL T IN AN OFFICIAL TAX ASSESSMENT with "ppllubla Int.r..t b...d on ."'or..Uon
lubel\ted by thl flnanels' lnllltullon.
Z. InhtlrltM\u lu bICH.. delinquent nln. .onlhl .'hr thl dluden", d.,. of d.,th.
S. A Joint Lecount I, ,...bl. .ven though thl dlc.dent', n.-. WI' added .. " ..t,.t of conv.nl.ne..
~. Account. I Including thO" hlld bllwlen hu.b~ and wl,., which the dlcldent put In Jalnt n.... within one "..t prior to
d..th .t. fully t."'ltbl. .1 Ir.".,.r.,
S. Account. .,tRblt,hld Jointly batwe'" hulbend end wlf. ~r. th~ ~ y..t prior to d..th .t. not ',.abl.,
6. Account. tMlld by . decedent "In 'ruI' rOt" IanOt~r or alMr. .t. tlllabl. fullv.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPDNSE
1. aLOCK A . U thl Infur..tlon WId COlput.Uon In thl notlc. .r. corr.et and deductions .r. not baing clllNd, placl M "X"
In block "A" of Part I or tha "TaMpawar Aa.pon.." ..ctlon. 518" two cop I.. and .ubalt th.. with vour check ror the ~t of
ta. to the A.gl.ter 0' Will. of tha countw Indlcat.d. Th. PA Oaplrt-.nt of A.venu. will I..u. an orflcl.i ......aent
eror. REV-IS,. [X) upon r.c.lpt of the r.turn fro. Ih. A.gl.tar of will..
2. ILOCK I a If the ....t .paclfl.d on thh notice h.. been or will b. r.port.d and talC plllld with the Penn.wlvlllnl. Inherltanc.
T.. R.turn fll.d bW the i.cedent'. r.pr..entatlv., pl.c. an "X" In bloc~ "B" of P.rt I of the "Ta.p'war Ae.pon.." ..ctlon. 518" on.
copw and r.turn to the Pi Dep.rt..nt of Revenue, Bureau of Indlvldu.1 T...., D.pt l10601, Harrl.burg, PA 1'111-0601 In the
envelop. provided.
S. IlOCK C a If the not lea Inror.atlon II Incorr.ct Indlor d.ductlon. ar. being clal..d, ch.ck block "C. and coapl.t. P.rtl randS
.ccordlng to the In.trucuonl DalOw. l:olgl1 two copl.. .no .UUIIH 'h.. ....1. ""... ..._ir. i.., ~:,. ........." wi t..,; "I.~:" t:. tr,& r.c;l:~,:~
of Wills of tM counh Indlcatad. Tha PA Deput.."t of A.venu. will I..ua an offll:hl .......ent (fon AtV.15"'1 EX) upon rac.lpt
of the r.turn rro. the A.gI.t.r of Will..
TAX RETURN - PART 2
- TAX CDMPUTATION
LINE
I. Entar
HOlEt
the d.t. the account orlgln.llv w.. ..tabll.had or tltl.d In the sannar ..I.tlng at d.t. of d..th,
For. d.c.d.nt dwlng aft.r IlllZllZ, Account. which the dec.d."t put In Joint n.... within one ell y..r 0' d.eth .r.
t..abl. fullw .. tran,f.r.. Howav.r, th.r. I. an ..clu.lon not to a.c..d .S,ODO p.r tran.f.r.. r.gardl.., of the v.lue of
the account or the nuab.r of account. h.ld.
If . doubl. a.t.rl.k I..) .ppe.r. b.for. your flr.t n... In the addr... portion a' this not Ie., the 'S,OOD '.clu.lon
.Ir.adw ha. be.n d.duct.d 'roe the .ccount b.lanc. a. report.d bW the 'Inancl.1 In.tltutlon.
Z. Ent.r the tot.l balanc. Dr the 8Ccount Including Int.r..t accrued to the d.t. of de.th.
S. The p.rcent Dr the .ccount that I. ta.abl. 'or a.ch .urvlvor I. d.t.r.lned .. 'ollow'l
A. The parc.nt t..abl. 'or Joint ....t. ..tabllshed eor. than one y..r prior to the d.cedent'. d.atht
DIVIDED IY TOTal NUMBER OF
JO I N T OWNERS
E..-pla' A Joint ....t r.gl.tar.d
DIVIDED BY TOTAL NUMBER Of X 100 . PEACENT TAXABlE
SURVIVING JOINT OWHERS
In the n... 0' the dK.dant and t_ oth.r p.rton..
I DIVIDED BY S (JOINT OWNERS) DIVIDED IY 2 CSURVIVORS) . .161 X loa . 16.n nAUILE fOR EACIt SURVIVOR)
I. Th. percent ta.abl. for ....t. craat.d within ona v..r 0' the dacadent'. d..th or .ccount. owned by the dec.dant but h.ld
In tru.t for anoth.r Indlvldual(.) (tru.t ban.,lcl.rl..)1
I DIVIDED ay TOTAL NUHBER OF SURVIVING JOINT
OWNERS OR tAUST BENEFICIARIES
X 100 . PERCENT TAXABLE
..
[Maapl'l Joint account raal.t.r.d In the n.aa 0' the d.ctdant and two othar p.r.on. and ..t.bll.had within on. yaar of da.th by
the d.Cld~ t.
I DIVIDED IV 2 (sURVIVORS) ..SO X 100 . 50:< nAMABLE fOR nat SURVIVOR)
Tha nount .ubJ.at to t'M Oln. It. It d.hraln.d bw aultJptylf1il the account b.lanc. Cllna 2) bv the parcent ta.abla Ulne )J.
tr,tar tha tet::' c' tto.: If:!:t~ .,"!~ :!':~J~Ho;:o~t' 1It'~.~ I" PIIl,.t ..
Th. Mount h._I. Cline 6) It dahr.lned by 'Ubtractlng the dabh and deduction. Uln. 5) fro. the ellOUnt .ubJKt to tu Ulna "..
Ent.r t~ approprlat. t.. r.ta ellna 7) .. d.t.r.ln.d balow.
A. far dat.. a' de.th occurring .ft.r 6/30/94, the ta. r.t.. for tren,'.r. to .pou.a. ara a. follow'l
1. oat.. 0' d..th on or a,tar 7/1/~ and b.fora 1/1/95 the r.l. I. lX.
2. Oat.. 0' d.ath on or a't.r 1/1/95 tren.f.r. to IpOUI.. will be ta.ed at OX ta. r.ta.
Notal for dat.. 0' daath prior to "1/94 tran.f.r. to .pou... a,. t..abl. at 6X.
I. Tran.far. to Ilne.1 d..c.ndanh Including ,.thar, aother, .on, d....ghter, grandchildren, .on-In-l.w,
d....Dhtar.ln...w, .t.pchlld end th.lr I..u. are t..abla at .ill parc."t (6le).
C. Tren.llra to all olher. InclUding brother, .lIhr, unci., ItUt'It, n.ph_ ond nlec. a,. t..abl. at flfhen p.rc."t UU).
O. If you change lhe t.. rat., pl.... .p.clfy your r.latlonshlp to the d.cadent In Iha ara. provided.
I. The aHUnt 0' ta. due Cllna II II dat.raln.d bv .ultlptylng the aaount ta..bl. (line 6) bv th. ta. rat. 11Inll 71.
..
7.
CLAIMED DEDUCTIDNS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. dabt. end d.ductlon. ar. d.t.r.lnad a. fallow.1
A. You lag.lly era r.IPonslbla for p.y.ent, or the ..tat. .ubJect to iMWlnhtr.tlon bw . pertonal rapr.....t.Uv. Is In.ufflclent
to pay the deductlbla It....
a. You actu.lly paid the dabt. a'l.r d.ath of the decadent and can furnl&h proof a' pav.ent.
C. Oabt. b.lng clal..d .u.t b. Ita.tzed fully In p.rt S. I' addltl~l .pece I. n.adad, u.a plain papar I 1/2. . ll~. Proor of
pay..nt .ay ba raqu..t.d by the PA nap.rt'ent 0' R.venue.
TAXPAYER ASSISTANCE
If YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WIllS. PA DEPARTMENT OF REVENUE OISTRICT OFFICE
OR CAll THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY)
..
('
RONALD K. LAUBENSTINE
GLADYS L. LAUBENSTINE
8 KAREN COURT PH. 7170132.5092
CAMP HILL,PA. 17011.'102 " ".. ...._.A.,,It~. ,2 '1 IY 9~-
"\ .- ,
'W " .
PAnll nil. I.. - .J . ..L. ',1. J. - //. Q..I $ .,.'S"
l'IlI'"I'/-U~"""'_ ''''~1!dj~::r{U1..l:HL. ,"~J~ .:;~ 7:5. -
~~"'7'-a.-w~~ ~ C.~. ~c> 1J{1Ll.ARS
~N..J~\~N~a1t:!~4W6f' 30Cl 19 U93 1204
Snulhcrntral rA 0..0 ..,flll,,/II '!ff'"
. 'Il"" LId!- JIr.J1r,., Lc.:1J-J.. b'~" L ~1.~7::.
1:0:1 ~:I ~ 27:181: ":I:lCJ ~II' 5 ~100c:i':lb8b811' "'DODO 2 27:1 75."
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REV-lS48 EX AFP (12-9S)*,
COMOHWUlllt Of rntHSYLYAHIA
D[PAA1HtNl Of REVENUE
BUREAU Of IHDIVIDlIAL tun .
QEPf. 1'80611
IlARRlsaURC, PA 17111.0601
(:
NOTICE Dr INHERITAHCE TAM
APPRAISE"ENT, ALLDMAHCE DR DISALLOMAHCE
Dr DEDUCTIDN,\ AND ASSESS"EHT Dr TAM ON
JOINTLY .ELD DR TRUST ASSETS
DATE 05-20-96
ESTATE OF STOUT
HELEN
E DATE OF DEATll 09-)4-95
CDUNTY
CUMBERLAND
FILE ND. 21 95-0934
S.S/D.C. ND. 197-01-4973
ACN
95157355
GLADYS L LAUBENST1NE
B KAREN CT
CAMP HILL PA 17011
REHIT PAYMENT TOl
REGISTER DF WILLS
CUMBERLAND CO CDURT HOUSE
CARLISLE, PA 17013
AMount R..itt.d
CUT ALDNG THIS LINE ~ RETAIN LOWER PORTIDN FDR YDUR RECORDS ....
h-EV:isirB-Eif-Af'p-ri-i:9Si--------------------------------------------------------------------------------.---
NOTICE DF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALl,OWANCE OF
DEDUCTIDNS. AND ASSESSMENT OF TAX ON JDINTLY HELD DR TRUST ASSETS
DATE 05-20-96
ESTATE OF STOUT
HELEN
E DATE OF DEATH 09-14-95
COUNTY
CUMBERLAND.
FILE NO. 21 95-0934
TAX RETURtl WAS I
S.S/O.C. NO. 197-01-4973
(X) ACCEPTED AS FILED ( ) CHANGED
JDINT OR TRUST ASSET INFDRMATION
ACN
95157355
FINANCIAL INSTITUTION. PNC BANK
ACCOUNT NO.
5140162004
TVPE OF ACCOUNT I () SAVINGS (lO CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED OB-01-79
Accaunt Balance
Percent Taxable X
Amount Subjact ta Tax
Debts and Deductians
Taxable Amount
Tax Rate X
T ax Due
1,429.19
0.500
714.59
2,273.75
.00
.06
.00
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TD THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REGISTER DF WILLS, AGENT."
TAX CREDITS:
PAVMENT
DATE
DISCDUNT (+)
INTEREST (-)
AMOUNT PAID
RECEIPT
NUMBER
TDTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TDTAL nUl::
. If PAID AfTER THIS DATE, SEE REUERSE fOR CALCULATION Of ADDITIONAL INTEREST. .
I If TOTAL DUE IS LESS THAN fl, NO PAY"ENT IS REQUIRED.
If TOTAL DUE IS REfLECTED AS A "CREon" I CRI. yOU "AY BE DUE A REfUND.
SEE REVERSE SIDE Of THIS fOR" fOR INSTRUCTIONS. I
.00
.00
.00
.00
PURPOSE: Of
NDTlttl
PAYH(N',
REfUND CCA)I
P-Q
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To fulfill the r.qulr..Mt. of S.ctlon 2140 of the Inh'rlt~. Md E.t.t. T.. Act, Act 22 or 1991. III P.S,
S.ctlon 21"0).
D.t.eh the top portion of thl. Hotlc. and .Ubalt with your p.y..nt to Ih. R.gI.I.r of Will. prlnl.d on t~
r.v.r.. .Id..
-- "... ch.ek or .une~ ord.r p.~abl. tal RECISTER OF WillS, AC[NT.
All p.y..,.I. r.ulv.d .h.1l first be IltPplled 10 MY Inllr..1 which ..y b. due, w1lh any r.e.lnder applied to the tIll,
A r.fund 0' I tl. cradlt, which w.. not r.~.t.d on the tall r.lurn, ..~ b. r.qu..t.d by co.pl.tlng an ~Applle.tlon
for R.fund of P~.~lvanl. Inh.rltancl and E.t.t. Tell~ (REV-ISIS). Application. ar. av.llabl. at Ihe of,lcI of
the Ragl.t.r 0' Willi, any of thl 2S R.venu. DI.trlct Of'lc.. or by calling Ih. .p.cl.. 2~-hour an.w.rlng ..rvlca
nu-bar. for for.. orderlngl In p~.ylvanll l-aOO-S62-20sa, out.lda Penn.ylvanla and within local
H.rrl.burg .r.a (117) 111-1094, TOOl (717) 712-22S2 (H.arlng I.palr.d Only).
OBJECTIDHSI Any p.rty In Int.r..t not .,tl.fl.d with thl .ppr.I....nt, ,llowance or dl..llow~. 0' d.ductlon. or ........nt
of tIll ClncSudlng dl.count or Int.r..i} " .hown on Ihl. Hotlc. ..y Object within .I.ty 160J d.y. of rlellpt 0'
this Notlc. bYI
"-wrIU." prot..t 10 the PA D~p.rt.."t 0' R.v.nu., lIo.rd of App...., D.pt, 211021, tt.rrhburll, PA 17121-1021, OR
--,lactlnD to have tha ..tt.r d.t.r.ln.d .t the audit 0' the aceaunl 0' Ih. p.r.an.1 r.pr.,ant.tlv., OR
.-.pp..1 to thl Orphln.' Court
AD"IN-
ISTAATlVE
CORRECTIONS I
DISCOUNfI
PENALTYI
INTEREST.
Flctull .rror. dl.cavI,.d on thl. ........nt .hould b. .ddr....d In writing to' PA D.p.rt.ant a' R,vlnul,
aur..u of Indlvhtu.1 Talll', ATTNI po.t A.......nl Rlvl.w Unit, DCPT. 210601, ltarrhburD, PA 17121-0601
Phonl (717) 7'7-6S0S, S.. P'1I1 S of the bookl.t ~In.tructlon. for Inh.rltanc. r.. R.turn 'or, R..ld.nt
D'c.dant~ CREV-IS011 for an ..plan.tlon of .allnl.trallv'IY corr.ctabl. .rror..
I' any ta. au. I. paid within thr'l IS) cal.nd.r .anth. ,ft.r the d.c.d.nt'. d..th, a flv. p.rc.nt IS~I
dl.count 0' the t'll p.ld I. al1ow.d.
Th. IS~ tall lan..ty non"p.rtlelp.tlon p.nalty I. cOlPUt.d on the total of the taw tnd Int.r..t a......d, and not
p.td b.for. Janu.ry II, 1996, the 'Ir.t day aft.r Ih. .nd or thl taw aana.ty p.rJod, Thl. non-p.rtlclpatlon
pen.lty I. appI.labl. tn the .... .ann.r and In the the .a.a tl.. p.rlDd a. you would app.al the taw and Int.r..t
th.t ha. b.en .......d .. Indlc.t.d on thl. notlc.,
Int.r..t I. ch.rg.d b.glnnlng with 'Ir.t d.y 0' d.llnqu.ncy, or nine 1" .onth. and on. el) day
'roe thl d.t. of d..th, 10 t~ d.t. of p.v..nt, T.... which b.e... d.llnqu.nt b.fDr. January I, 19.2
b..r Int.r..t at thl r.t. 0' .1. C6~1 p.rcent p.r ~ calculatld at . d.lly r.t. 0' .000164.
All ta... which b,cI'. d.llnquent on or a,t.r Janu.ry I, 1912 will b..r Int.r..t at . r.t. which will v.ry 'roe
e.I~.r y.ar to cal.nd.r y..r with that rat. announc.d bv the PA D.p.rt_ant 0' Rav.nu., The .pplICabl'
Int.r..t r.t., far 1'12 through 1'96 .r.,
V..r Int.r..t Rat. D.llv Int.r..t Factor
V..r Inter..t R.t. Oallv Inter..t Factor
1987 .~ .000241
1981-1991 Il~ .DDDSDI
199Z .~ ,aDOZU
1991"199" 7> ,OaOl9Z
1995-1996 .~ ,aOOZ41
1912
I9IS
191,.
I9IS
1916
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INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
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b.yond the data 0' the .......ent. If pay..nt I. .ad. a't.r the Int.r..t co.putatlon d.t. .hown on Ih.
Notlc., addltlonai Int.r..t au.t b. c.lcul.l.d,
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