HomeMy WebLinkAbout96-00020
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f'l1;'~AA',;:082476;: '. COMMONWEALTH 01' PENNSYLVANIA
,~l"~\'~'i> . ,";' , . . DlPAllTMlNTOPllVlNUI
;.,.ti.tJ!''.'\~-',: '. ' . OffiCIAL OCII" . PENNSYLVANIA INHIRITANCI AND IITATI TAX
ACN
et ASSESSMENT r:'I
RECEIVED FROM: II CONTROL ...
NUMBER
oAnl,
~
AMOUNT
GAN R TUBING
'f;) 1 ;)btll1
_t:t:.OIf
6021 ROBERT DRIVE
MECHANICSBURG, PA 170SS
,
lOtOHII'
ESTATE INfORMATION,
!:'I fiLE NUMBER
5i 21-1996-0020
!:'I NAME Of DECEOENT (lAST)
~ TUBING BRENDA L
II DATE Of PAYMENT
m POSTMARK E
COUNTY
CUMBERLAND
DATE Of DEATH
SSN 19S-32-0044
(fIRSTI (MI)
REMARKS
m TOTAL AMOUNT PAID s22. 64
CW
(l J ,'-'
RECEIVED BY 'j /It,).. ' " ((.,,-,/,) ,-.f- ;./
, /51 NAtUU-, ' .
MARY C. LEW'IS /1""'_; j,/ 'l'
REGISTER OF WILLS
GAN R TUBING
SEAL
CHECK" 329
REGISTER OF WILLS
----------------------------------------------
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IID'AlTMMT ar IIlWII&
~ ar IlIIlVlllUAL TAlIII
IID'T, ''''IL
HARlIIIURG. Pi IlL""".
J!l.. '7'7 - I
IlO'IICll or IIIIIIITIJICI TAX
APPUIIEIIIJlT, ILLOIAlICll 01 OIlILLOIAlICll
or O~~y 'a'rJ O':'=."ff.."[.JAX 011
el-
v
DATI 02'19'96
ESTATE OF TUSING
L DATE OF DEATH 06'13-91
CUHBERLAND
COUNTY
BRENDA
FILE NO. 21 96'0020
S,SID,C, NO. 195-32-0044
95156811
ACN
GAN R TUSING
6021 ROBERT DR
HECHANICSBURG PA 17055
REHIT PAYHENT TOI
REGISTER OF WILLS
CUHBERLAND CO CDURT HDUSE
CARLISLE. PA 17013
_t R.Uted
j
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ....
iif1i:i54-i.iif.AFii-riif:951-.-..-.--..--------------.....-----------------------------------...................
NOTICE OF INHERITANCE TAX APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESS"ENT OF TAX ON JOINTLY HELD DR TRUST ASSETS
DATE 02-19-96
ESTATE OF TUSING
BRENDA
L DATE OF DEATH 06-13-91
COUNTY CUHBERLAND
FILE NO, 21 96-0020
TAX RETURN WAS,
S,S/D,C, NO. 195-32-0044
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
95156811
FINANCIAL INSTITUTION, PNC BANK
ACCDUNT ND.
513D166423
TYPE DF ACCDUNT, (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED D7-31-87
Account Bahnca
Parcant Taxab1a X
Amount Subjact to Tax
D.bt. and Daductiona
Taxabla Amount
Tax Rata X
Tax Dua
754.86
0.500
377 . 43
,DO
377.43
.06
22.64
NDTE, TO INSURE PRDPER CREDIT TD
YDUR ACCDUNT. SUBHIT THE
UPPER PDRTIDN DF THIS NDTICE
WITH YDUR TAX PAYHENT TD THE
REGISTER DF WILLS AT THE
ABDVE ADDRESS. HAKE CHECK
DR HDNEY DRDER PAYABLE TD.
"REGISTER DF WILLS. AGENT."
TAX CREDITS:
PAYHENT
DATE
12-29-95
DISCDUNT (+)
INTEREST (-)
6.84-
AHDUNT PAID
22.64
RECEIPT
NUHBER
AAD82476
INTEREST IS CHARGED FRDH 12-30-95 TD 02-27-96
AT THE RATES APPLICABLE AS DUTLINED DN THE
REVERSE SIDE OF THIS FDRH
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER THIS DAT~I.~EE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
I IF TOTAL DUE IS LESS TIWl 11. NO PAYI1ENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I C~,I.l YDU MY IE DUE A REFUND.
SEE REVERSE SIDE OF THIS FO," FOR INSTRUCTION>. )
15.80
6.84
.10
6,94
I If \
..- W'
HDTlal To fulfill tho r...lr....ta of SeoUon 2141 of the I,..,...... ... bblta Ta Aot, Aat II of 1"1. (71 '.1.
SeaUon Z14OJ.
PAYMEX1'1 o.bch thI top portlan of thb NotlCII ... ....It "Ith vour ~t to the ...I.ter of 1111" prlnt1ld an the
rever.. .Ido.
.... _. ctMk or ..,.y DJ"de.. ~I. tol REGISTD CP IIILlS, AGOIT.
All ~tI ....Ived "'11 flr.t be ..,11... to onv lnt.ro.t ..t1lch .-y be ..., "lth MY .._I.... ...u_ to tho ta.
ItEf\ICD (an I A r.f\nd of . tax credit, ....lctl .... not ......tod an the tu r.turn, .., be ,....st.. by ~I.U". on .....UClltlon
for Rof\nt of PwWlsyl.,.,l. lmorlbnce ... E.t.t. Tax"' Ut[v-15lJ). Appllcetlan..,.. .veil_I. at tho a.Uce of
the R....t.r of '1111., If'IY of the D Rovwuo Dbtrl.t afflCII' or by colli". tho .,.al.l 14-hour on....rl". ....,,1_
.....rs for foro. ordl..ll"llll In PwlnsJ'lwnl. 1....-361..2051, DUhlde ......,....1. ... ..IUlln lacel
....rhburg..... (717) 7.7.IIM, TUD' (717) nt.usz (......lno 1..lrod Onl,).
CllJECTIIICII My plrb In lnt.r..t not ..th,l. "Ith the ......I~t, all__ or dl_11DMW1OO of ......Uon. or ........t
of tu Undudl'" dllClOW'lt or lntortl.U .. ...., on tn" Matlce .., abject within .Ixb (60) _. of racel,t of
Ulh Matico bJ'1
-"""Itt... prot.,t to the PA -,rt.nt of A........, IoIIrd a. ......., ..t. illiZI, Hwrhb,,~, Pi 171U.lI11, 01
"-.lecUno to hIw thI .ttor iM.....IMd .t the ....It of the ~t o' U. plr__l ....ro....totlw, 01
--.....1 to U. a,..,.,.,.t Court
AllIIN'
IITllATIYt:
COARECTIONII 'ooMl ."1"0'" dleccrvend an ttd. .....MMt thould be 1ldd....Md In wrlU,. tal Pi Dept..m.,t of AIIYWUe,
....... of IndlvlMl T...., AnNl Pa.t ,......,t Awl.. !)tIt, DEPT. 110601, .....rhbu..., PI 17121.'''1
Phone (717) 717.'505. s..,... J of tho bookl.t -In,tnaatJon. for IMI..lbnCII Ta Aaturn for a A.,ldent
Deoeden'" UtEV"150l) for .. upl_Uan of edlln..troUwlJ corroablll. ..........
DIICOlIfTI
If ." tu ... I. paid within tt'I.... (J) C81__r ..-tho .ft.,. tho dMedontt, "UI, . flM plrcMt (D)
dl.count of the ... plld I. .11.....
INmlUT.
Into....t 1s chweed bellmlr'll "Ith first doJ of del1~, 0.. n1,. (9) ....th. ... OM (1) day
f..- the dIIt. of ..tn, to thrI dot. Df ~t. T.... ..t11ch bee-. .U........t tt.kn1 Jsn..., I, 1HZ
...,. In......t It the ..... of ... (6%) pII',*,t plr ...... calcul.tad .t . dall, ,..le of .100164.
All ta.. ....lch bee.- iMl1,...,t on or .ft.r .-,...,., 1, 1HZ will bew lnt....t .t . rot. ....Ich will vwY f....
C81"'r roar to cal...r ,..r "Ith thet ,..t. ~ bv the Pi o.p.r....t of RI'VIINM. ThI .,Ucebll
Int.r..t ...t.. for 1HZ tt'l1"OUIIh 1'" ....1
1Ur Int.r.d IhIt. OlIn" In.......t FKtDr 1Ur Intl"lIIt btl 0.11" Int.....t FlGtar
191Z ZU ....541 1917 ox ....247
19U 16% ....411 1911'1"1 lIZ ..00511
1914 11Z ...UOl l"Z n .0..247
1915 15Z .000556 1"5-1994 n .0..ltz
1'" 10Z .000%74 1"5-1'" n ."U"7
....Int.....t I. calcul.ted .. follow' I
In.........r _ IALIIlCIl OF TAX VHPAID X IIUlIIIEII OF DAYS DELIIlQVEIl1' X DAILY IIlTEIIElIT F&CTOII
..-An)' Notice llsued .ft_r the tax becOOI' deU,",,*,t "Ill ranect .. Int.....t c:alcul.Uan to flfte.1 US) din
bQond thII dot. of thII .....~t. If,.,..,t II __ aft.r tM Int.,...t COIIPUtatlan dat. ...... on tM
NoUce, Ilddltl_l Int.....t ..,It be colculated.
)
/5 77-1
"
v../'
RIV-1607 IX AFP 112-95*
CClfIOMALTH DP' PO.dYLVANIA
DUAlTP<<NT Of R(Yf]U:
It.IrI:AU Of INDIVIDUAL r&xu
1)(".110611
HARtUIa..-G, PA 17 u.. 0611
ACN 101
INHERITANCE TAX
STATEMENT OF ACCOUNT
OAT! 04-08-96
FULKROAD DEBRA K FILl NO. 21 95-0020
OAT! OF DlATH 02-23-94 COUNTY CUMBERLAND
HOTE. TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUlHIT THE UPPER PORTION Of THIS fOR" WITH YOUR TAX
PAY"E"T TO THE AOORESS SHOWN, "AXE CHECK PAYABLE AHO RE"IT PAY"ENT TO. "
FRANK PISCIDNERI
257 DEERFIELD RD
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AlIOUl'lt R..Utod
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ....
REy:i6'ilTEX-AFP--ci'F9sY------..ii-iiiiiERITANcif-fAx-sTAfEH'EMf-oF-AccoUNf--.-..---------------- -----
ESTATE OF FULKROAD DEBRA K FILE NO.21 95-0020 ACN 101
THIS STATE"ENT IS PROVIDEO TO ADVISE Of THE CURRENT STATUS OF THE STATED ACN IN THE NANED
ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX OUE, APPLICATION OF ALL PAY"ENTS,
THE CURRENT BALANCE, AHO. IF APPLICABLE, A PROJECTEO INTEREST FIGURE.
DATE 04-08-96
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT. 03-04-96
PRINCIPAL TAX DUE. 1.144.04
PAYMENTS (TAX CREDITS),
PAYMENT
DATE
10-25-95
03-16-96
RECEIPT
NUMBER
AA082258
AA112624
DISCOUNT (+)
INTEREST (-)
92.56-
3.27-
1,144.04
95.90
AMOUNT PAID
~
- :<r 5~
~O) 0 0
1.):,.- E: C.- :
(, ....
-' ""'3
,~:~ '?i N
u ~ , , ~
Q ..~~ 0:: .,~J
r:
0 Ul t'ilJ
gm ,.,Q
0::0:: ~ '1::E
~8
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
1,144.11
.07CR
.00
.07CR
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN .1,
NO PAY"ENT IS REQUIRED.
IF TOTAL OUE IS REFLECTED AS A "CREDIT" ICRI,
YOU t\AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOlll1 FOR INSTRUCTIONS. I
.
) 15-77-/
LI' auRrAu OF INDIVIDUAL TAXII
IItOITAIICl ,All DIVI'ION
Dl".,.16..
HARlIIIURO, 'A 1'."."'1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAlC
STATEMENT OF ACCOUNT
,*CL
"'.Ull............
GAN R TUSING
6021 ROBERT DR
MECHANICSBURG PA 17055
OAT!
ESTAT! OF
OAT! OF DEATH
FILE NUMBER
COUNTY
ACN
05-13-96
TUSING
06-13-91
21 96-0020
CUMBERLAND
95156811
AIoount R_lttod
BRENDA
L
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HOTEl To inaur. proper credit to your account, sub.it the upper portion of thl. for. with your t.. p.~t.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV:i6'iij-EX-"i:ji-COJ":96r-----iiil.--iiiHEiiiTANCif"i'AX-STATEHitii'-oTA'ifcouii"f""iiiii-m--m_-----mu-
ESTAT! OF TUSING BRENDA L FILE NO.21 96-0020 ACN 95156811 OAT! 05-13-96
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATEO ACN IN THE MANED ESTATE. SHOWN BELOW
IS A SUHKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PIIOJECTED INTEREST FlCURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 02-12-96
PRINCIPAL TAX DUE,
22.64
.__...._...__.,._~._-_.._--------_._._----~----
PAYMENTS (TAX CREDITS),
PAYMENT
DATE
12-29-95
02-23-96
RECEIPT
NUMBER
AA08247t
AA112558
DISCOUNT (+)
INTEREST (-)
6.84-
.09-
AMOUNT PAID
22.64
6.94
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADOITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN II,
MO PAYIlENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREOIT" ICRI,
VDU HAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRN FOR INSTRUCTIONS. I
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
22.65
.01CR
.00
.01CR
....'.ln~ln ~ II,.. ,u"Dlul .-Hl"" "'''ON
~, YO ~ ... uou"rMlMa ''''''IU. IMtI "'U' ... " IUMAI4 II .,'*'.........., f' .,. ..." ,uoAeq
I.ep nil UN,," ., UOU',"OIU ''''''Iul UlI 11)1".., "I'" lueNMll1l1P .....Hq .., ..." ",IU' penn, .,..... AUf..
IO~YJ 113131NI A1IYO X lN3nDN1130 IAYO JO 131MnN X OIYdNn XYI JO 3~NY1" . 113131NI
lI*1tto, I' ""IM1111 It ,..".,ul..
'''DID' ~, "'t.!i"l ",noo' ~D1 ""
"IODO' II "",-,,,. ~SOOO' XU U"
'UODD' X, ,,,, UroDO' XIT .."
mOOD' Xli .661-"'. IUDOO' Xtl II'.
lUlU' X6 tlU '~DDO' xoz ,,,.
"D,Hl ,""',Ut 'Ula "11f ,,,,,,,ul "... ",.,:MIj "'.I.,Uf AU'O .... '.....'ul .I".
Iln 96'1 ~Jln Z161 .10' ",U ,..".auf .,qe't1dcN '''U '~^'If'O ,....,...chtQ 'd III.A Aq ,.~
"1" ,~, ~11" .1..11. J~'" 0, .1,,11. Japuet'3 10.11 A.lIA lit" ~1~ ."" . ,. ",,,,,ul "Ieq 1.1" 2'61 '1 AJlnuer
.I"" pue uo luenbUltep ...~ ~'I~ "K', IT' '~10ao' '0 "1" 'tllp . ,. ,."tnlltlll ~ .led lU.IIJld (%9) -.'
'0 ..'" ~, ,. "I""Ut "Ieq z.,. 't AJ~r I"O,eq ,uenbutt~ ...~ ~1I1~ ....! .,~.d '0 .,~ ~, ., '~,-.p
,. '.lIP III.A M.lI Alp (tJ euo pue '~UOII (6) IlUIU .10 'A:tUenbUl1ep '0 AItP '....11 ~ltJl eu'WIIeq peIIJII\P It "'''',ut
IlI10LHI
'po,"ld A,.~ .., ~, '0 pue ~, .II'" Alp '1"1' ~1 '9"1 ',. AJ~r IJO,eq Pled
lou pue 'pe...... .UJ..uI pu. n. ~. to I.U. ~. uo ~.ndlIo:t '1 "'U~d uoU.dl:tUJ.d.UOU "'l'~ K.l 81 ltlU
'oU 1YNld
.~'I. '1 PI.d X.l ~ to
lunD:ttlP CU) lU.:tJH .^II . '""up ',l~ap eI.A J.U. '~lUN JlIP'MtU cn MJ"" u'~l1" p,.d ., enp n. "'u. II
I.1JIlO3SJG
"5as'-lIL CLfL)
euD4d '1"O-'ZILI 'd 'l.lnq',JJIH 'IO'OIZ .ldea "Iun ~'^'H lu......., ..Od IH11' '....1 l~tAlPUJ to
""Jnt '..."....UH to .UMI..I.deD 'd 10l ~IUJ~ .q Ptnotp uuou I,~l uo ~Utl.UO:t 1.10.1.1. ButP.I"'" ,uou..na 101 ...1cD1
"C""UO ~"I.~I IulJ.~) Z5ZZ-ZLL CLIL) 1001 '''Ol-LIL (LIt) ...1. l.lnqslJ.I.H '.:tal Ut~I" pu.
.,U.AT"'luued epll.no 'Osoz-Z,r-OOI-1 1,U.A,"'luued uI IIu,J'P.lO 1..101 JOt I.I~ .:tIA.I.I IuI.leftlU.
.I~...Z l.lUMIl.l.deg ~l .cJI .10 1"ttID ",.Illl0 ~^.H rz ~l to ",u. 'I'll" 10 .I..II"H ~ 10 "1110 ~
II 'I~TI"" ..1. lUOIl.:tl'ddt "(rtrt-~) MK.l '.llI] pu. '~ll.l~J 'IU.^t"'luued 10 punj.H .101 uoI..:tltddtM
UII IuU.tdllo:t "'q SMllllnH.I .q "'W' 'u.ln..H .11 ~. uo PWUMblJ loo U" 'PIli" 'UPIi.l' nl . 10 punje.l , ICID) DNI1.nH
.n. IMA Ol PliJl" .I.pu,....1 "'U11 ~U" enp eq "'.. ~'14" lUJI.uI "'U11 0. llJII PliJldcN .q 11.~' peAlea.l I.........d "'
'YINY^'ASNNicf .:10 HJ.1YiMOWWO:) 10. .tqeA.d .II1PJO <<wo. .10 'lt~~:t 11f't. IHlODlCI INlOJS1~H'" n
. J.Ni:JY 'S"I" .:10 lfiJ.Sl:Jilf 10. .,qe<<.d .Iep.lO <<IMMHI .10 'It:Je4' .... IHlOnlO INlOlSllI n
"ep,1 1..IIA..1 ~. uo peluI.ld
.lqlA.d ep.- lueu.ld .IM<< ~H" HMP" pu. UUOM '1"" 10 uonJod do. IMA &ptIlecl
11NlNA'd
CDMMOHW(ALTH or PlNN1YLVANIA
w"""YMlNT 01 I(YU.~
Il.ftAU rI INDIVIDUAL TAnS
III". "16'1
H&IIIIIURO, Pi .,.,.-,..1
*1
Iii 71-/
INFORMATION NOTICE
AND
TAlCPAYER RESPONSE
EST. OF BRENDA L TUSING
5.5. NO. 195-32-004~
DATE OF DEATH 06-13-91
COUNTY CUMBERLAND
(~
FILE NO. 21 - 9~ - ;;/"l)
ACN 95156811
DATE 12-04-95
TYPE OF ACCOUNT
IXJ SAVINGS
o CHECKING
o TIlUST
o CERn, .
"'.114111'" "."1
GAN R TUSING
6021 ROBERT DR
MECHANICS BURG
PA 17055
REHIT PAYMENT AND FORHS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
P'HC BANK he. provided the o.".rtMl'lt "lth the Infor..Uon lilted aMI.,., which h.. bMn uNcI In ulcubUng ttM
palMU.1 tu due. Their rKord' Indle.t. thet .t the d..th of the ~v. cMcecMnt, you wer. . Joint DWMr/benllflol.,., of this KOGUtt.
If you '..1 thl, Infor..tlon I. Incorrect, pl.... obt.ln ",.Itten correction fr~ the ,lnencl.1 In.tltutlon, .ttach . copy to thl. 'ora
.xl return It to tblllbave IMSdr.... This account Is "ubi. In Kcord~. with the lm-rl..Wk... T.. L_' of thl C........lth 0' P....,.,lvMI..
Que.tlon. .., bIi .....,.ed by CII11lng (117) 111..asZ7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5130166423 D.t. 07-31-87
Eotoblhhod
Account Bol-. 754.86
P.rc...t T.xobl. X 50.000
Aoount SUbjoet to TO)( 377 . 43
TO)( ..t. X .15
Pot...U.l TO)( au. 56 . 61
PART TAlC PAYER RESPONSE
[!] I FAILURllO.RISPOND lULLJIESUL'l'IH AN OFFICIAL lAX ASSISSN!H'l' BAS!D OM "OIISHO'l'ICE l
A. 0 The 1Ibov. Infor..tlon WId ta. dull II correct.
1. You..y chao.. to ,...It P'YMf'lt to the R..lst.,. of Wills ..Ith two copl.. 0' thl' notlc. to obt.ln
. dllcount 0" evold Int.r..t, 0" you "Y chKk bo. "A" end ,..turn this noUCII to U. R....t.,. of
Will. and en of,lcl.1 .....~t ..III be I..ued by the PA DepartMl'lt 0' R.venue.
To Insur. proper credit to your lecount, tvo
U) copl.. of this notice .u.t accap.,y you,.
p..,.ent to the R..l.t.r of will.. "-k. check
p.ylbl. tOI -R..I.t.,. of NIII., Agent...
NOTEI If t.. p..,..,t. .,.. .... ..Ithln thr..
(]) .unth. 0' the deCldlnt'. dIIt. of dMth,
you ..y deduct . S:C dlKCM.l1t 0' the t.. due.
Any IMe,.1t~. t.. due ..Ill bIcOM cMllnquent
nine (9) .unth. .ft,,. ttw dIIt. of dMth.
.[
CHECK ]
ONE
BLOCK
ONLY
I. 0 The !abov. ....t h.. bHn or ..111 be repo,.ted Mid t.. p.ld ..Ith thl hnn.ylnnl. IMe,.1t~. Tax ,..turn
to be fllld by the decedent', repr..."t.tlv,.
C. .3 ThII Ibov. Infor..Uon l~nco""lCt MUor cMbt. .xl dMtuctlon. we... p.ld by you.
You lU.t caple" PART l!J encIIor PART [!] below.
If you IncUcata a diffarent tB~~'4.. .tata your
r.l.Uanohlp to docodont,
PART
~
'fA'" ll~lUK~ . C"joiPUTAHON OF
LINE 1. D.t. E.tobllohod 1
2. Account Balanca 2
5. P.re...t T..obl. 5
4. AIoount SUbjoct to TO)( 4
5. Debb _ _tlan. 5
6. Aoaunt T.xobl. 6
7. T.x R.t. 7
B. T.x Due B
TA, OW JOI~i~T~U~T
7- 31-~7
7!>4. BID
X !fO , 0 0 0
· ~l.~
:~OFFICIAt'.USE';OllLY} OAAF1
. .......;, PADEPAR.TMENT1.~f:REVENUEj
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DEBTS AND DEDUCTIONS CLAIMED
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PART
[!]
DATE
PAID
1
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL CEnter on Line 5 of Tax Co.putatlonJ
I
I
Undor penoltl.. of perjury, I docl.r. thot tho foet.
caopl.t. to tho bo.t af .y knawl0dg0 _ boll.f.
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TA ER SIGNAT&rE
I have reported above ere true, correct and
HOME on) '7/010 -/7'18
WORK (717) /~3- 7S.;;l"
TELEPHONE NUMB R
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GENERAL INFORMATION
1. 'AlLUU TO USPOND ifILL USUL T IN AN OffICIAL TAX ASSISSHENT .I\h _11...1. In..r..' ..... ... In'.r..lI...
~ltted bv the 'Inenel,. In,tltullan.
I. .me,I"M' t.. bMOM' dell".,..,. nlN Nftthl ,ft" the ...eden,.. At. ., _.th.
I. A Jllnt ..c~t .. t...I. Iven thoutth the dec:..-".. n-. .... lidded .. . ..U.r 0' connnlenel.
4. At,..,tI Clnoludl,,- tho'. held _tMen huallMd __ .1f.>> which the dec:..,,! put In Joint MM' ..lthl" .... V'" ,'1.' to
delth .r. fullv t..IIliI, II t,en,f.r..
I. ADCIOI.I1t, ..tlblllhecl J.lntlv bet...... hutbend MIl .If, ..r. then DM )'..r prior to elMth .r. not ta..bl.,
,. a...unt. held by . decedent "In 'rult to,. enether or othor. .r. ',.IIliI. fully,
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. 'LOCK A - If the In'or..Uon _ c......,.Uon In the notice .r. correct 1M deduction. .r. not bel", chlMd, ,... II"l ....
In blDdl ..... 0' Part 1 of the "h.p.yer A.~.." ,ectlon. 51--, two capl.. MIl lubltlt thM ..lth your chedc 'or U. ~t of
t.. to the R..I.", of Willi of the count, Indicated. The Pi o.ptrt-.nt 0' Aev~ ..111 I..u. ." o,flcl.l ......-ent
('or. AEV-1S41 EX) upon recll,. of the r.tu,n fro. t~ _....t.r of Will..
I. ILOCK I - If the ....t ,peclfled on thl. notlc. he. ~ or will be reported end t.. p.ld with thl Penn'Ylv~l. Inherltanc.
T.. _.turn filed by t~ dIe...,t., r..r..ent.tlva, PIK' M '"X"" In block ..... a' Pitt I of thl ....xp.y.r Rllpon... .ectlon. Sign ~
copy end rlturn to the PA Dep.rt.-nt of _ev~, Bur.au of Indlvl~1 TIX", Pept Zla,al, H.rrlsburg, PA 17121-a'01 In the
.nwlopt provided.
5. .LOCI C - If the notlc. InforMIt1on .. Incorrect rdlor dIducltlon. ar. being cI.INd, cheek block ..COO Ind coepl.t. perts I end 5
_a;vIJIo; t... ...... l:'l:ltM.::tl=~: ~clo", !l:oo to.:- C''!''pl.. _not ..,.,It t~ ..Ii:h V".I,. ch<<k 'n,. the .....,.",t of tl. olYllbt. to thl R..I.t.,.
of Will. of ~ county Indlcatld. nn. PA o.p.rt.-nt of Rev~ will 1..ue ~ official ......eent (rare A1V-I541 [X) upon racal,t
of the r.tu~ fru. the .ltl,tar of Wllll.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Ent.r thl ct.ta the eccount orlglnalh .... ..tlblhhed or tltl.. In the ....,.r ad,Ung at dIIt. of ....th.
HOTEl For. dIe..-nt dying .ft.r IZlIZlUI ACCOU"ltl whldt the dlCedlnt put In Joint ~I ..lthln OM (1) y..r of death Ira
t..lbl. fully.. tran,'lrl. HowIv.r, thar. I. ~ .xclullon not to .xclld '5,OaO pa,. tr~I'lr.. r..lrdllll of the v.lue of
the KCOU'\t or the nuebar of eccOlonh held.
If . daubla 'It.rllk (..) appear. ba'or' your flrlt n8II In thl addr... portIon of thl, notlc., the 'J,al' .xclullon
alrudy hi. bien daduc:tad 'rOIl the KCount bal.-.ca .1 rllPOrtad by the fJMnCI.I In.tltutlon.
Z. Ent.r the tot.l balanca of the ICCCU\t Including Int.r..t accrued to thl ct." of duth.
5. The parcent of thl account that" t..abl. for .Kh IUrvlvor .. det.,..lned II followll
A. The parcent t..abl. for Joint ....t. ..tablllhad .ura thM ana yeIIr prior to the dec..-nt.. dMthl
I DIVIDED IV TOTAL N.IdEA Of' DIVIDED BY TOTAL tumER OF X 110 . P[RC[NT TAXAIlE
JOINT DWHERS mNIVlNO JOINT OWNERS
Ex....I.1 A Joint ....t r....t.rad In the nMI of the dleedent Md two other parton..
I DIVIDED IV 3 (JOINT OWNERS) DIVIDED IY Z (SURVIVORS) .. .167 X lao . 16.7% (TAXABLE FOR EACH SURVIVOR)
I. The parcant t..abla for ....t. cr.lted within ana y..r of the decadent.. dMth or accomt, ownId by the dacldlnt but hlld
In tru.t for _thar IndlvlduaHI) (tru.t banaflcl.rl..)1
I DIVIDED IY TOTAL NUKIER OF SURVIVING JOINT
0Wt€RS OR TRUST BENEFICIARIES
x 110 .. PERCENT TAXAllE
Ex....llt joint KCount rltlltarad In the nlll of the decadent end two other patlon. end ..tablllhad within one y..r of death by
the dleadent.
I DIVIDED IV r (SURVIVORS) .. .50 X IDa . 50% CT&XAIlE fOR EACH SURVIVOR)
4. The.-u'lt subject to tax (11,. 4) It det.,..lned by ..,Itlplylng the lCCCU\t belMee (11,. 2) by t~ parcant tuttll. Ulna 3).
S. Ent.r the tot.1 of the dabt. end deduction. II.tad In P.rt J.
6. The.-u'lt t..able Ulna 6) It det.relned by tubtracUr'ItI tM dabt. Ind dedUction. Ulna S) froe thll -...t eubject to tu Ulna 'U.
7. Enter tha approprl.ta t.. r.t. (11,. 7J u det.ralned below.
A. For ~t., of de.th occurring .ft.r '/11/94, the tax r.t.. 'or tran.f.r. \0 apou... ar. .. 'allow.,
1. Dat.. of dMth on or .ft.... 7/1194 and befor. 1I119S thl r.t. .. n.
r. Dat.. of de.th on or .ft.r J/I/95 t...an.f.r. to apou", ..III ba t..ad at OX.t.. rat..
Hat" for dat.. of death prior to 7/1/94 tren.'", to spou..I Ir. taxlbl. .t 6X.
I. 1ran.hrs to llM.1 de.cendant. Including f.thar, aothar, .on, deught.r, ,rMddtlldran, 1Gft-ln-I..,
daught.r-In-I.., ,tepchlld end thalr llsus .r. t.xabl. at ,I. parcent (6XJ.
C. Tranlf.r. to .11 other. Including brothe..., II,t.r, unci., aunt, naphaw end nlac. .ra t..abl. .t flftean parcant (15%).
D. If you change thl t.. r.t., pl.... .paclfy your r.l.tlonshlp to the decadent In the ar.. provided.
I. The IeCUIt of t.. due Ulna I) .. detaralned by ..,Itlplylng the ...-,t t.Xllbl. Cllna ,) by thl t.. rat. Ulna 7J.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowable dabt. and deductlonl .r. det.ralned .1 'ollow'l
A. You legalh .r. rupon,lbl. for p.~t, or the ..t'" eubJect to adIIlnlltrstlon bY:.I.f.~1 r~ra....t..tAw..IAJnlUfflclant
to p,y the deductlbl. It.... 1 :GI Ud tl- Nvr :Jb
I. You actually p.ld thl dabt. .ftar ....th 0' the dKadant and CM furnllh proof of p. t.
C. Dabt, baing cl.lead ..,.t be It..l~ad 'ully In r.rt S. If additIonal ~a I. needed, u.. pl. In papar . lit"" . II~. Proof of
papant ..y be raquatted by thl PA o.p.rtHnt 0' R....anua.
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. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)