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COMMONWf...LTH 0' pfNNSYlY...NI...
Of'AI'M(NT O' IUV(NUf
Of". 210601
H.....IS.URO.'... 17121.0601
IN' HAM (lAJ. '11S . AND "'IDOl
I.) -Rc'< - ~>
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
rol OARS 0' OIATH A1TII 12121191 CHICXH.II
I' A SPOUSAL
POV.ITT CliO IT IS CLAIMIO 0
flU HUMal1
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INI.ALI
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COUNTY COOE
OICIOI,..'" CM'U AOOI
18 Rivervi~ Drive
Enola, PA 17025
Cwo Cumberland Count
AMOUNf IICIIVID tSII INSllualONSI
oAn o. OlAfH
May 25,
JI>
ere,
77
NUMIER
171-30-6653
'" UPUCAIlII W'VfYH:) II'OUsn ...-. ,..". ".n &.NO 1IlIOOl, """WI
(Xl I. Originol R.turn
DATI 0' I'''H
o 2. Suppl.m,nrol R,turn
02.
05,
o A. Urnil.d E.,ate 0 Ac. Future In'....st Comproml..
(fo, do'.' of d.o,h ok.. 12.12.821
o 6. O.cedent Di,d r'''OII 0 7. Oaudln' Moin,ointd 0 living Trus,
(Anoch copy of Wall (Anach copy of T ""I
AU\CORRES!ONDENCE AND CONfIDENTlAC,TA)C",IN RMAno SKoULD,BE;,DIREClED"tO
HAM COM'UII MAIlINO ADDlns
Jean D. Seibert Es. WION, 2ULLI & SEIBERT
"""0'<1 HUMlII 109 Locust Street, Harrisburg,
717 236-9301
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1. R.ol E"a'. ISCh.dul. Al (1 J
2. S'.a. and aondl ISch.dul. II 12)
2. aOI.ly H.ld S'odcJPann."hlp Int.r." (Sch.dul. q ( 2 I
~, Mongag.. ond No'.' R.c.i.abl. (Sch.dul. 01 ( ~ I
5. Cosh, Bonlc O.posits & MiKIUoneou. Personal Property ( 5 )
(Sch.dul. E)
6. loinlly Own.d Prop.ny ISch.dul. F) (6 )
7, T,anl'." (Sch.dul. GIISch.dul. II 17)
8. T oral Gra.. A..el. (Iotal Une. 1.7l
9. Funeral Expen.e., Administroti.,e CaUl, Misc.lloneous ( 9 )
Exp.nlt. ISch.dul. HI
10. O.b'., Mangag. Uabilltl." U.n.ISch.dul. II (101
11. Total D.dudlan'ltotol Un.. 9 & 101
12. Ne' Volue of Estore (Une 8 minus Une 11)
13. Charilable ond Go.,ernm.nlol S.qullr. (Sch.dule JI
lA. N.t Value Subj.ct 10 To. (Un. 12 minus Un. 131
15, Spou.al T,anl'." (fa, da'.. of dtoth ak., 6.J0.9~1
S.. Inslrvdtan. for Ar,pllcable P,rc.nlog. on R..,.n. (151
Side. (Indude .,olu.. rom Sch.dul. K or Sch.dule M.)
16. Amount of Un. lA ,a.abl. at 6~ '0'. (161
(Indude .,alu.. from Sch.dul. K or Sch.dul. M.I
17. Amount of lIn. 14 raAobl. 01 15% role (17)
(Includ. '10 lUll from Sch.dul. K or Sch.dul. M.)
18. Principal 'a. duo (Add 'a. f,om lin.. 15, 16 and 17.1
19. Credits Spousal POy.rty Credil Prior Paym.nll
+
YEAR
R.molnder R.turn
(far da'.. of dto,h priar '0 12.12.821
federal E.,ate Tax R.turn R.qui...d
_ 8. TOlol Number of Sa', O'potit So...
22,350.00
325.00
(8 )
- f-lr~~:;:~~:}~-~.~'~'-
PA
17101
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1111
(121
1121
(U)
)C._a
22.025.00
x .06.
22,350.00
325.00
22,025.00
1.321.50
20. If Un. 19 I. g....t., ,han Un. 18, .nt., tho dlll.,.nce on Un. 20. Thl. i. ,h. OVERPAYMENT.
folD
21. If Un. 18" g,.a'., than Un. 19. .n.., ,h. dill.r.nc. on Un. 21. Th" i. ,h. TAX DUE.
A. En'er Ihe Int...." on Ih. balanc. due on Une 21 A.
a. En'.' ,h. 'o'alof Un. 21 and 21A on Un. 218, Thl.I. ,ho BALANCE DUE.
Make Ch.cle Payable tal Regl.t., of Will., Agent
if~.j"":\l.\!l~~"i';',. .1 :""BE SURE.T0'ANSWERfAtI.':QUES110NS,-ON'REVERSIUIDE'ANDlT.0 Il.ECH
Under p.nalll.. of perjury, I d.dar. Ihot I ha'll ..amin.d Ihl. return. Induding accompanying schedul.. and slol.m.nh, ond 10 Ih. bill of my knowledge and b.n.f,
it i. trve, correct and compl.fe. I declare rho' all real 11101. hat be.n tlporttcf ot lrue marktl yolue. Dtdoratlan of pr.potlr orh., Ihan the penonal repre..ntatiYe I.
based on all Informal Ian of which "portr has on., knowl.d .. .
... I' 'llSON IU SII IIUNO II . AOOIUS OAIt
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DA" /Q
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,I( 15 D
(181
Discounl
Inl.rllr
+
(19)
(201
Chl:'cJc I,l:'u.' ., you or(' rl:'quc\,ing 0 ft..fund of your overpayment.
(21)
(21A)
(ml
1.321.50
.(.~~~~'~. . .~. ...~
Street, Harrisburg, PA
17101
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COMMOHwrAL1H O' PlNNSYLVANIA
INHUJlANCr TAX UTURN
..1I01NT DICfDfN'
Vivian R. Sgrignoli
ITEM
NUMBER
A. Fune.al Expon.OI'
1.
B.
1.
Admlnlst.atlve Costs:
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pilose Print a. Typo
E NUMBER
DESCRIPTION
,
P.nanal R.p....nlatiyo Commission.
Sadal Security Number 01 Penonol Repre.enlotiye:
Year Commission. paid
AMOUNT
2. Atto.ney Fee. Wion, Zulli & Seibert 325.00
3, Family exemplion
Claimant Relotion.hlp
Add..ss 01 Claimant ot decedenl'. death
St...1 Add....
City
4, Prabalo Fo..
C. MltCollanoou. Expon.os:
1.
2,
3.
4.
5.
6.
7.
8.
51010 Zip Code
TOTAL (AI.o onle. on line 9, Recopitulallon)
(If mora spac. II needld, Insort additional sh.ell of sam. "%0.1
S
325.00
/
I
/1
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REV-1547 EX AFP (12-95*
COttMOHWEAlIH OF PEMlISnVAHIA
()[PO'MENT Of REVfNUE
IURUU Of INDIVIDUAL TAXES
DEPT. Zl06Dl
HARAISIURG, PA 171Z'-06Dl
NOTICE OF INNERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ACN 101
DATE 05-27-96
F
DATI! OF DEATH 05-25-95
FILE NO.
COUNTY
CUMBERLAND
HOTE. TD INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTIDN OF THIS FORH WITH YOUR TAX
PAYHENT TO THE REGISTER OF WILLS. HUE CHECK PAYABLE TD "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
JEAN D SEIBERT ESQ
WION ETAL
109 LOCUST ST
HBG PA 17101
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount RI.1 t t.d
CUT ALONG THIS LINE .. RETAIN LDWER PORTION FOR YOUR RECORDS ~
iiE'v: i54"i"Ex--Aiij'--n2=9!;"j-iioYicE ""Oi'""itiHEiiifAN-CE-YAiniPPRiiisEif€iii'-,--'\L,LOWANCE-iilimmm__ m___
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SGRIGNDLI VIVIAN R FILE NO. 21 96-0097 ACN 101 DATE 05-27-96
TAX RETURN WAS, (X I ACCEPTED AS FILED
( I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Rool ht.to (Schedulo Al III
2. Stock. end Bond. (Schodulo BI 121
3. Clo..ly Hold Stock/Po.tno,"hlp Into,olt (Schodulo CI (51
4. "artDIDII/Not.. Rlceivabl. (Sch,dull OJ (4)
S. Cash/Bank Dlpolita'Hllc. Parsonal ProPlrty ISchedul1 E) IS)
6, Jointly Owned P.opo.ty (Sch.dul. FI (61
7. Transflra ISch,dull GJ (7)
8. Total A...t.
.00
.00
.00
.00
.00
22.350.00
.00
(DI
22,350.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expans../Ad.. COlt.'"IIC. Expln... ISchedule H) (,.
ID, Dobt./Ho.tgogo Llobllltlo./Llonl ISchodulo II (IDI .00
II. Totol Doductlon. (III
12. N.t Vol... of Tox R.tu.n 1121
13. Charitable/CovlrnMlnt.1 aequa.t. (5ch,dull J) (15)
14. Not Vol... of Eltoto Subjoct to Tox 1141
NOTE: If an a.....m.nt w.. i..u.d pr.viou.1y, 1in.. 14, 15 and/or 16, 17 and 18 will
ref1.ct figur.. that inc1ud. the total of ~ r.turn. a......d to dat..
ASSESSMENT OF TAX:
IS. A.ount of Llno 14 ot Spoulol .oto 1151
16. A~t of Line 14 taxable at Lineal/Cla.. A rata 116)
17. Aaount of Llno 14 toxoblo ot Colloto.ol/Clolo B ..to (171
11. Principal Tax Due
325.00
'1?~ 00
22,025.00
: 00
22,025.00
.00
22,025.00
.00
X'OO.
X,06_
X .15_
nDI
,00
1, 321. 50
.00
1, 321. 50
TAX CREDITS:
PAVHENT
DATE
02-02-96
RECEIPT
NUHBER
AA082582
DISCOUNT l+ I
INTEREST (01
.00
AHDUNT PAID
1,321.50
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1,321.50
.00
,00
.00
. IF PAID AFTER DATE INGICATED, SEE REVERSE
fOR. CALCULATION OF ADDITIONAL INTEREST,
( IF TOTAL DUE IS LESS THAN tl, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, VDU HAV BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
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RESERVATIONr E.t.t., of decedent. dying on or b.for. D.ce.ber 12, .912 -- If eny future Int.r..t In t~ ..t.t. I. tran,fltted
In po.....lon Dr enJo~ent to Cl... a (coll.t.r..) beneflcl.rl.. of the ~edent .ft.r t~ .xpJr.tlon 0' Ifty ..t.t. for
l1f, or for y..t., the Co..onwe.lth herebv .xpr...ly tl..rv.. the right to ~r.I.. ~ ...... tran,'.r Inherlt~. T.x..
.t the l.wful Cl... . (coll.t.r..) r.t. on any .uch future Int.r..t.
P\lRPOS[ Ill'
NOTICE! To fulfill the r.qulr.-.nt. of S.ctlon 2140 of the Jnherlt~. and Elt.t. T.x Act, Act ZZ of 1991. 7Z P.S.
heUan lUG.
'AYltEHTr D.tach the top portion 0' thlt NoUe. IInd .w.tt ..lth your p.pent to the Rqhllr of Willi prlntH on the r...,.rs. .Jde. .
u.... check or .....y order pIYHI. tal REGISTER OF MILLS, AOEHT
All p'YI*\h rK.lnd shell flr.t be appl1ed to .,y lnt.r..t which ..y ~ ckM with MY r..lnct.r appl1~ to the hx.
RUlJHD (CA)e , r.f&n:l of . t.. crNlt, which .... not requ..teel on the blC A.turn, ..., be r.quuteel bv co_I.U", ., -AppUc.Uon
for R,.und of ~enn'vlvanl. Inhsrltsnc. end E.tst. TalC- (REV-ISIS). Application. Ira .vallabl_ at thl O"lca
0' the R.,I.t.r of Willi, any of the 2S R_venue Ol.trlct O'flc.., or by c'lllng thl .pecl.l Z~-hour
an....rlng .arvlc. ~r. 'or for.. ordering 1 In Pennsylvanl. 1-100-162-2050, outslda Penn.ylv.,l. ~
..I thin loc.l Harrlsbur. ara. Cl1l) lI1-I09~, TOO' (711) 11l.Z252 (H..rl", lap. Ired Only).
OBJECTIONS. Any p.rty In Int.r.st not .atl.flad ..Ith the appral.aeent, allowsnca or dl.lllowanc. 0' deduction., or .....telnt
0' talC (Including dl.count or Int.r..tl .. lhown on thl. Notlc. au.t obJ.ct within .IICty (60) d..,. of rac.lpt 0'
thll NoUc. bYI
AlIIIIH
ISTIATlVE
CORRECTIONS I
....rlttan prot..t to thl PA Dep.rt.."t of RaVIl"Nl, 10lrd 0' AppaI1t, O.,t. :-IIOZl, Hlrrlabur" PA 11nl.UZl, OR
....lllCtlon to hlv. tha ..tt.r deleralnad .t audit 0' the IICcount 0' thl per.onal r.,r.."'htlv., OR
....~.l to the Orphan.' Court.
Factual .rror. dl.cov.rad on thl. ......eent should b. addr....d In writing 101 PA D,partaant of R.vanua,
Bur.au of Indlvldu.l 'alC", A'TNI Po.t A......ant R.vl... unit, O.pt. l10601, Hlrrl.bur" PA 111ll*0601
Phone (711) 117-6505. S.. P'" S of the booklet -In.tructlons 'or Inharltanca TalC Raturn for a A..ldent
Decadent- (REV-150U for an ._planatlon 0' adalnittr.tlvah correctebl. .rror.. .
DISCOIMTI
I. any t.. due I. paid ..I thin thr.. CS) caland.r .onth. a't.r the decad",t'. d.ath, . 'Iv. percent (S~) dllcount of
the t.IC p.ld I. allowed.
PEHALTYI
The 15~ talC ..-re.tv non-p.rtlclp.tlon penalty I. COllPUtad on the tot.l 0' tM tl_ Md Intar..t ........, Md not
paid ba'or. Jenuary II, 1"6, the flr.t da., a'tar the and 0' thl tllC tanI.tv p.rlod. Thl. non-p.rtlclp.tlon
paMI tv 11 appealebla In thl ... .annar end In the thl .... U.. par lad .. YOU would .....1 the till and Int.n.t
that hat bean ......N I' Indlc.ted on thit nolle..
IHTERfSTI
Int.r..t I. charged beginning with 'Irlt dl" of d.llnquency, or nine (9) eonth. and one (1) dIll' 'roe the d.ta of
de.th, to thII data of P'YNnt. blC" which bac... delinquent bafora January I, 1911 bear lnt.r..t at the rat. of
.IIC (6~) percant per tnnuI c.lcul.tad .t . d.lly r.t. of .000164. All t.IC" which bec... delinquent on and a't.r
J~ry 1, 1912 ..Ill b..r Int.r,.t at . r.ta which ..Ill vary fro. c.lend.r .,.ar to c.landlr .,.ar ..Ith thtt r.t.
announced by the PA Dsparttent 0' R.vanua. ThI appllCebla Int.r..t r.t.. for 1912 through 1996 .r"
'!!!r Int.ra.t R.t. DIlly Int.r..t F.ctor !!!! Inter..t Rat. DIlly Inter..t FlHltor'
1'12 ..X .000541 nil 9X .000lU
1915 16% .GOUSI 1911-1991 11% .GOnOl
1914 IIX . GOn01 1992 9X .GGDlU
nn UX .00ns. 1991-1994 7X .0GOnl
1'" lOX .OGOl14 1995*1"6 ,X .OODl47
--Inter..t I. calcul.t~ .. follow.1
INTEREST. BALANCE OF TAX UNPAID X NUNBER OF DAYS DBLINQUElIT X DAILY INTEREST FACTOR
--Any Hotlca I.aued a,t.r thl ta. bacote. d.llnquent ..III r.'I.ct an Int.r..t calculltlon to fl't.an (IS) dIll"
bayond tM data 0' the ..........t. If payunt II .act, .ftar the Int.r..t co..,hUon d... Ihown on thl
Hotlc., addltlon.1 Int.r..t au.t be c.lcul.t.d.
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