HomeMy WebLinkAbout96-00165
C~AlTH OF PENNSVlVANIA
D[PARTP'LHT DF REvtNJE
IURUU OF INDIYIDUAL TAXn
DEPT. 210601
HARAISIURG, Pi 171ZI-0601
*'
I~-
<' I-,
;'j -
,
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
e
FILE NO. 21 9~ -I ~.s-
ACN 96103503
DATI! 02-13-96
TYP~ OF ACCOUNT
EST. OF CHARLES N EVANS !Xl SAVINGS
S,S. NO, 171- 28- 3526 0 CHECKING
DATE OF DEATH 11-26-95 0 TRUST
COUNTY CUMBERLAND 0 CERTU,
REHIT PAYHENT AND FORMS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
'n-IUIIt II' ".",
CHARLES N EVANS
376 MODREDALE RD
CARLISLE PA 17013
HARRIS SAVINGS BANK h.. provided tM Dep.rtMnt with tM Infor..Uon lilted belOM which h.. bMn u.ed In ulcuhUna the
pat~tl.l t.. due. Th.lr record. Indlc.t. th.t It the de.th 0' the IbaVI decedent, yau w.r. . Joint owner/bene'lcl.ry 0' thl. account.
If you fHI thl. Infor..Uon 11 Incornct, pl.... obt.ln "rltt., correction frOll the flnancl.1 In.tltutlon, attach. capr to thh 'or.
~ r.turn It to tM Ibavl addr.... Thl_ account I, t..lbl. In accordanc. with the Inherltanc. T.. l..,. of tM C~.lth of P~'rlv~I..
0UI.Uon1 .., WI .,uwtlrod by \olllUlnlf '717} III-C3:/.
COHPLETE PART I BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIDNS
Account No, 17-50-003704 Data 05-10-90
Eatablhlted
Account Balanca 572.80
Parcent Taxabla X 16,667
_t Subject to Tax 95 ,47
Tax Rata X ,06
Potential Tax Qua 5.73
PART TAXPAYER RESPONSE
[!] I FAILURa. TO RaSPOHD ifILL.. RUUL T. IN AN OFFICIAL.. TAX ASSUSH!ICT BASlD ON THIS. NOTICa I
A. 0 Th. aboVI Infor..Uon and t.ll ~ 11 cornet.
1. You..y choa.. to r..lt p.,..nt to tM Regl,t.r of Will. with two capl.. of thl, notle. to obt.ln
. dl.count or .vold Int.r..t, or you 'IY chick bo. -i- and raturn thl. notlc. to tM Regl.t.r of
Willi and an offlcl.1 .....UWIt will be luUld br tM PA DapartMnt of RIVW'IUI.
To Insur. proper credit to your account, two
(l) cop I.. of thh notlca .,.t ICcoapany your
pa~t to the R..I,t.r of Will,. ~. ehlck
p'YIbI. tOI '"R..llt.r of "1111, Agent".
HOTEt If tl. p.yaentl Irl ~ within thr..
15) aonth, of the dIcldlnt", d.t. of death,
YOU IQ' dlduct I 5% discount of thl tl. due.
Anr Inhe,.!tMea till duI will bKu. delinquent
nine (,) .onth. I,tlr thl dltl of death.
[CHECK ]
ONE
BLOCK
ONLY
I. 0 TM lbav. ....t h.. bHn or wUI be r.parhd and t.. p.ld with the Pann'rlvenll IrlMl"1tMCI Tn return
to b. fll~ b~ thl decadent., rapr..entatlva.
C. 0 TM abova Infor..Uon l~ncorrlCt and/or dRt_ and deduction. wara plld b~ you.
You .,.t coapl.t. PART l!J and/or PART [!J below.
If you indicat. . diff.rent t.x r.t., pl.... .t.t. your
..latlonahlp to decadent.
>OFFICIAl ~USE ONl'fl':O AAF
PADEPARTHENtOFREVENUE
PART
~
TAX RETURN - COHPUTATION OF TAX ON JOINT/TRUST
lINE 1, Data Eatabllahed 1
2. Account S.lanc. 2
3. P.rcent Taxabl. 3 x
4, Aaount Subject to T.x 4
5. Debt. and Daductlon. 5
6, Aeount Taxabla 6
7. T.x R.t. 7 X
e. T.x Due e
PART
[!]
DATE PAID
ACCOUNT! PAD
. 1
2
3
II
5
6
7
.8
DEBTS AND DEDUCTIONS CLAIHED
,..
,:.d
t-.."l
~.;:. -"
',,'
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Ent.r on Line 5 of Tax Co.putatlon)
I
.
Under penaltla. of perjury, I declare that the fect. I haye raported ebova are t~, correct and
cDllPlat. to the beat of .. kltCltlladga end beUaf,
TAXPAYER SIGNATURE
, .
HOME (
WORK (
TELEPI:lONE
DATE
GENERAL INFORMATION
1. fAILURE TO RES~OND WILL RESULT IN AN OfFICIAL TAX ASSESSHENT .lth ...11...,. Int....t ..... ... Inf....tI...
lubIIltted bv the flnMCla. Institution.
Z. lnherlt8nC1 tlK ~o.e' delinquent nine ~th. .ft.r the decedent", data of death,
1. A Joint .cC<<M1t II tlxabl_ IVM though the MeMen", n.-. .... wtded .. . ..ttar of convenl....ce.
4. Accounh Clncludlng tho.1 held bat..... hulbMd Met wlftl which thl dlcedent put In Joint n.... within OM ntt prior to
death .r. full, tlll'-.' '1 .r.n.,.r..
I. Account. ..tabll,hed Jolntl, betMeen hu~ ~ .,1'. .or. t~ ~ ,..r ~rlot to d..th .r. not tlxabla.
,. Acoount. held by . decedent .ln 'rut' 'or. ~ther or other. .t. tallabl_ full"
REPORTING INSTRUCTIONS - PART 1
- TAXPAYER RESPONSE
1. ILOCI A . If the In'oruUon IInd cnputatlon In the noUn .r. correct Met deduction. .r. not belne c.aIAd, plKI Wi "X"
In block ..,o. 0' Patt 1 0' the "TI.p.,.r R.~.... section. Sian two cop I.. ~ .~It the. with your check for the .-ount of
till to ttMI R....t.,. of Willi of the CDU'lh 1r~luted. fhe PA o.putunt of R.v~ will I..\M en official .........t
CFort REY-15U EX) upon rec.lpt of the r.turn fro. the Reght.r of Wl1h.
z. IlOCK I - I' the ....t .pacl'l.d on thl. notlc. he. been or will be rl9Grted end t.x paid with the Penn.ylvanl. Inherltanca
T.. A.turn 'lied by the decadent'. reprt.ent.tlv., pleee en -X- In black -." of Part I 0' the -T'Mp.yar R..pon.,- .actlon. Sian ana
copy end r.turn to the PI DIPartnnt a' Aevenut, luratu 0' Indlvldu.l T,M", Dlpt Zla6.1. Harrisburg, PA 171ZI-a6al In the
env'lope provided.
3. .lOCl C - If the notlca Infor..tlon I. Incorrect and/or deduction. art baing cl.I-.d, chtck block -C- ~ cu.pltta Part. Z and 3
acctordlnt tc tha l:o..tr\,;:tlon. btla't. st~ ~..~ e<:,:I., ",.,d <rubalt thee ...It~ you" C""t,:!t '"r tht MnlI"t nf t.. p.yel. tn the Pa,ht.,.
of Will. of the county Indicated. ThI PA Dapartunt of R.vtnUI will Is.ut an o,'lcl.1 ......-.nt CFor. REY-IS" [X) upon r.c.lpt
of the r.turn fro. thl A.,I.ttr of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
liNt:
I. [nt.r the data the ICCount orl,ln.lly wa. e.tabll.had or titled In thl tenner 'MI.tlng .t data of de.th.
NOT[I For a dtctdtnt dying .ft.r IZ/1Z/121 Account. which thl decedent put In Joint n.... within one (I) year of death ara
t.xlbl. fully.. tran.ftrs. Howevar, thlra I. an a.clu.lon not to eMceld IS,aaa par tran.ftre. re,ardle.. a' the value 0'
the ItCcaunt or thl ~r of KCount. held.
If a double ,.terlsk (xx) appear. bafore your flr.t ~ In thl addr... portion of thl. notlca, the 13,aaa ..clu.lon
alrHC:lw ha. bean dtducttd fro. thl eecaunt balenc:e .. rl9Grtltd by the flnancl.1 In.tltutlon.
Z. Ent.r tht tot'l balanc. of thl account InclucUng Intlr..t ItCcrutd to tht date of de.th.
S. ThI percent of thl ICCount that I. ta.lbl. far .ech .urvlvar I. deter.lned .. follow.:
A. The parcent t..eble for Joint ...." e.tlblhhed lOr. thin ana yur p,.lo,. to thl decadent.. d.ath:
1 DIVIDED I' TOTAL It.IfI[A Of'
JOINT OWNERS
[x-.plel I Joint ....t r.,I.t.red
DIVIDED I' TOTAL fUtl[R Of' lC In . P[RCEHT TAXABLE
SURYIVINC JOINT OWNERS
In the n... 0' the decadent and two other p.rton'.
1 DIVIDED I' S CJOINT OWNERS) DIYIDED BY Z CSURVlVORS1 . .167 X lOa . 1'.7% (fAXAllE FDA Uot SURVIVOR)
I. The percant hnble for ....t. cr..tltd within ana yur of the decadent.. d..th or account. owned by thl dactdent but held
In tru.t for anathtlr IncUvlctuaU.) Uru.t btntf!cl.,.I..)1
1 DIVIDED IY TOTAL NUMIER OF SURVIVIHC JOINT
OVN[RS DR TRUST IENEFICIARIES
X lao . PERCENT TAXAILE
b..,I.1 Joint account real.ttred In thl "... of the dlcldtnt end two othlr p.r.on. Ilnd ..t~lhhld within ana y..r a' de.th by
thl dtcteMnt.
I DIVIDED IY Z CSURVIVORS) . .sa X loa . sax CTAlCAILE FOR EACH SURVIVOR1
4. ThI -.aunt tubjtct to taM (lint 4) I. d.ter.lned by .ultlplYlng the account b.l~t (lint Z) by the percent tax.ttl. Clint 51.
S. Enhr the total of thl dabts ~ deduction. lI.ted In P.rt 5.
... n.. _.:. \__:.. U:._ ,: h ':.~.;..::.._;:: L. ...::t:'s:t!~; thl :Pst:':: ::.:u! ~:::I:.1~.,.,n: ~11r.; !!:) ''''''!II thlt 'll:!Itltr.'\t :\.."b~let tr. hx CUr.. 41.
7. Ent.r the ~roprlat. taM r.ta Clint 7) .. dat.r.lned below.
A. Far dat.. 0' dt.th occur,.lng a't.r 6/sa/94, the ts. rat.. 'or tren.f.r. to ,poule. are a. 'allow.:
I. D.t.. of de.th on a,. .,t.r 7/1/94 ~ b,'ore 1111'S thl r.te I. SX.
2. D.t.. of de.th on or e'ter 1/1/95 tren,'.r. to 'POU'" will b. t..ed .t ax t.. rate.
Nat.1 For dlt.. 0' d.ath prior to 7/1/94 tren.f.rs to IPOU'" sre tax.ttle .t 6X.
I. Tren.f.r. to Iln..1 de.cendant. Including f.ther, .other, .on, d~t.r, grandchildren, .on-In-Ilw.
dlUQlht,,,"ln-ltw, .ttpehlld and their I..", .n t'.lbl. .t .Ix p.rcent ('X).
C. Tren.fer. to .11 other. Including brother, .I.ter, uncle, aunt, nephew end niece .re t'.lbl. .t fl,taen percent 115X1.
D. If you change the tax rat.. pl.... .paclfy your rel.tlonlhlp to thl decedent In thl .r.e provided.
I. The.-aunt 0' tax due Clint I) I. deter.lned by IUltlplylng thl aeount ta.able Clint '1 by thl ta. rata (lint 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Al1owebl, debh and deduction. sre deter.lnteI a. fallow.:
A. You 1...lly .,.e re.pan.lble far p.~t, or thl a.t.te .ubjact to ~Inl.tr.tlon by . per.onal repre.entatlve I. Insufficient
to P'Y thl deductlbl. It....
I. You actu.lh paid the 1Mb" .fter deeth 0' the decedent end un furnlth proa' 0' P'YMnt.
C. Dabt. balna cl.11ed lU.t ba It..12td fully In P.rt S. I' addltlon.l .peca I. ntIdId, u.. pl.ln p.,.,. . I/Z. . II". Proaf of
payaant e.y b. requa.tltd by the PA Depert.."t 0' R.venue.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
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)
-,-......
\
COtI'OIW(ALTH l:W Pr.HNSVlVAHtA
DlPARTHEHT Of REv[HU[
ItItfAU 01 INDIVIDUAL TAXES
DUT. ZlUDl
HARRIIIURC, PA 171ZI-D,al
*
1~--:S"7-1
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
('
FILE
ACN
DATI!
NO. 21"'- 9(,,-1(,6-
96103504
02-13-96
TYPE OF ACCOUNT
o SAVINGS
IXl CHECKING
o TINST
o CERTIF.
....IUI ""' 1'-"1
EST. OF CHARLES N EVANS
S,S. NO. 171-28-3526
DATE OF DEATH 11-26-95
COUNTY CUMBERLAND
CHARLES N EVANS
376 MOOREDALE RD
CARLISLE PA 17013
REHIT PAYHENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
HARRIS SAVINGS BANK h.. provided the o.,.rtunt with the Infar.atlon lht~ below ~I~ h.. bHn u.~ In ulculatlng the
potenUIl t.. due. Their ncard. Indlc.t. thllt at the d..th of the abov. decedent, YOU ~r. . Joint OWter/beMflcl.ry of thlt .cCCM.W1t.
If yau f..l this Infor..Uon II Incorrect, pl.... obt.ln wrltt." correction frOll the flnenchl In.tltutlon, attKh . copy to this far.
end nturn 1t to the ~v. Mktr.... Thlt ecCClU"lt I. t.ubl. In accard.-.c. with the rnh.rltWM:1 T.. L.... of the C~1th of P.,..,.ylv.,I..
CUeatlon. ..y D. ""~r~ by c.lllng (717) "7-All7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIDNS
Aoo.......t No, 17-00010961 o.te 03-02-90
Elteb1hlttld
Aoo.......t a.bn.. 3.823.23
P....._t T""Ml1. K 16,667
~t Subj..,t to T.x 637.22
T.x R.t. X ,06
Pot_th1 T"" ou. 38,23
PART TAXPAYER RESPONSE
I!ll FAZLURI TO RISPOND llZLL. RUUL T IN AN OFFICIAL TAX ASSI!lISIl!K1'.IASlD ON THIS NOTICI I
A. 0 The IIbov. Infar..Uon end tu due Is carreot.
1. You ..y choo.. to realt para."t to the R.al.t.r of Will. with two copla. of thl. notlc. to obtain
a dl,cClU"lt or avoid Intar..t, or yau ..y check be. "A" and r.turn thl_ notlc. to the RIII.tar of
Will. end In official ......-.nt will be I..ued by thl PA o.p.rt.ent of R.v~.
To Inaura proper crlMllt to your ecCOlllt, two
III copl.. of thlt notice ....t acc~.,y your
P')'8Int to thl RIII.t.r of Will.. ~a chick
paYabla tal "RIII.t.r of Will., Agent-.
NOTE I If tax pav-nt. In -.eM within thr..
(5) aonth. of thl decedent" date of death,
you ..y Mduct a 5% dltcOlllt of the tax dIM.
Any IrlMrltWIC. ta. due will becCIM delinquent
nine (lU tlClnth. Iftar the date of delth.
[CHECK ]
ONE
BLOCK
ONLY
I. r:J Th. abov. ....t hi. bien or will b. report.d Bnd ta. paid with thl Penn.ylvanl. Inherltanc. T.. r..urn
to be fll~ by thl dec~t'. rlpr..entatlva.
C. 0 The IIbov. Infor..Uon 1,.,~.JltCarrect and/or dabt, end dlductlon. wer. p.ld by you.
You ....t coaplat. PART l!J and/or PART [!] b.low.
If you JndJcete e dJff.r.nt tex rete, pl.... .t.te your
..1.tlonlhlp to doc.dlnt.
o~flICIAL,U~E ONLr:O 0 AAF.
PA.DEPARTHENl' OF. REVENUE
PART
[!J
TAX RETURN - CDMPUTATION OF TAX ON JOINT/TRUST ACCDUNTS
LINE 1. Olt. Elt...1llhed 1
2. Account a.lance 2
S, P.rcent Texable S X
4, ~t Subj..,t to r-x 4
5. OMIt. _d OIlduOtlonl 5-
6, ~t T.x...1. 6
7. T.x R.t. 7 K
a, T.x ou. a
PAD
.
..
... ..~ ".' "-.'
,
p."
":""" ....
PART
~
DATE PAID
2
3
"
5
,.,
7
8
DEBTS AND DEDUCTIONS CLAIHED
. .
".../
: '1:~. .. < .;
....
PAYEE
DESCRIPTION
AHOUNT PAID
I I
TOTAL (Enter on LJne 5 of rex c~t.tlonJ I
Under peneltle. of p.rjury, I decl.r. that the fect.
o.-p1.t. to t~ b.lt of .Y know1~ -..d ...ll.f,
I h.ve r.ported ~ve er. true, correct and
HOME (
WORK (
TELEPHONE
GENERAL INFORMATION
1. FAILURE TO RESI'OIlIlIIILL RESULT IN AN OFFICIAL TAX ASSESSIlENT with ...11'''1. Inhn.' ........ 'nfo,..II...
lubIIltted by the flnenclal In,tltutlon.
I. J""rltenc. 'IX bee... dellnquent nine .,,'hl .fh,. the elK""", data of d..th.
J. . Join' KCount II ,...bl, IV'" though tM deed..t', n-. .... added ft. 1lI ..Ua,. of cDnv."lancl.
It. Iccvunt, Uncludlng tho.. held bIIt""" hultMtnd Met "lfa>> -hh:h tN ,I.,'''''' put In Joint ~. within one .".,. pdor to
~~ .r. fully t.x~l. II trlnlf.r..
I. Acoount, ..hblllhed Jointly bIIt....... huab-.f Ilftd , I" Mr. thM one 'W..r pr l Jr to d..lh .r. not 'Iubl..
i. Account. held by . decedent "In trutt 'or. ~ther or a~r. ara t..tbla fully.
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. .LOCl'. 11 the I"'orutlon Md cOIlPUtaUon In thll noUn ar. corr.ct Met deduction. .,.. not b11lnt ellIMd, plac, WI "X"
In 111_ .... of P.rt 1 0' the -r,.pIYI,. ..spon.... ..ctlon. Sign two cop... Md ,ubIIlt thell ",lth your check fa" the ......t 0'
,._ to the ...I"ar 0' Will, of the county Indicated. The PA o.part-.nt of R.v~. will I..~ en o"lcl.1 ........nt
('01"" REV-IS4' [X) upon r~.lpt of the r.turn fr~ the Regl.t.~ 0' Will..
Z. IlOCl I - If the ....t .peclfled on thl' tic. hili bMn nr ..111 b. reported and tu p.ld ..lth the P.......yl".,I. InherltMC'
TI. R.turn filed b~ the decedent'. rap .1 ~t.tl"l, ~I.c. ' -X- 1n blo,k "I" 0' P.rt 1 0' the "fl.p.y.r AI,pon.l" .~tlon. Sign one
copy end nturn to the PA o.p.rt~t 01 lIev......., a...r.., 0 lrl\HvldU81 le..., D.p," ZII6DI, Hlrrhburg, PA 17111~G6DI In the
envllope provided.
S. IlOCl C .. If the notlCI In'or"UGn It Incorrect endJ'or deduction. ,r. n.lng clal..d, ehtck block "C" end coepl.tl P.,.t. z McI S
HCordlng to the In.tructlon. belIN. Sign two copllll end .~It ttl~r1 with your Check Inr the .-aunt 0' ht. o,v.'. tn thot Ae:I...,.
of Will' of th. county lnolc.ted. The VA Dap.rteent 0' A.v~ ..Ill I.,u. In of'lclll .......-nt (ror. R[V~IS41 EX) UPOn rec.lpt
0' the nturn 'r~ the Regilt.,. 0' "IU..
TAX RETURN - PART 2 - TAX COMPUTATION
LlltE
I. [nter the dlit. the acCOl.A'1t arlglMllh .... utltblilhed 01'" titled In the .anner .d,tI,.. .t d.t. 0' d.ath.
MOTEl For. decedent dying .ft.r U/ll/lZl Account. which the d~ed....t put In Joint MIM. ..lthln one U) y..r 0' de.th '1""
t...bl. fully.. tr.....f.r.. Howev.r, therl I. ., .xclu.lon not to ..ceed 'S,DDD p.r tr.....'.r.. r.g.rdl... of the value 0'
the account or thl nuabtr of account. hlld.
t, . double I.t.rlsk (..) ~Ir. blfor. your flr.t neae In the addr... portion of thl. notlc., the 'S,DDD ..clu.lon
Ilrndy hII. bten deducted fl"'. the account b.IMCI .. reportld b~ the flnWlCl.1 In.tltutlon.
Z. Enter the totll b.lenel 0' thl acClM\t InclueUng Int.,...t accl"'ued to thl dlt. 0' dllth.
S. The parc.,t 0' the account that I. taxlbla for .ach survivor I. dlter.lnad .. follOM'1
A. ThI parc....t taxabl' 'or Joint ...." ..tlbllshed IOn tNn OM y.,r prior to the decedent" deathl
1 DIVIDED IV TOTAL NUMlER OF
JOINT llWHEIl$
Ex..,111 A Joint ....t regl.t.rld
DIVIDED IV TOTAL NUMBER OF X lO' . Pt:RCEHT nUIL[
WR\'IVIHG JOINT OWNERS
In the "... of the dlcedent and two othlir perton..
1 DlvlDDlIV ,(JOINT OWNERS) DivIDED IY 1 (SURVIVORS) . .161 X 100 . 16.n ITAXAllE rOR EACH SURVIVOR)
.. ThI parc.,t t...bl. for ...." crHted ..Ithln or'II Yllr If 'hIi d.cedent', de.th or ICCountt 0MMd by tN dacedent but hlld
In tru.t 'or MOther IndlvIduaU,) (tru.t beMflclarl..J:
1 DiviDED IV TDUl ....IER OF SURYI\ ,jt; JOINT
OWNERS OR TAUST &EHEFltl~IES
X 100 . PERCENT TAXAllE
EJI..,III Joint account nglttartd In the n.. of the decadent and two other perlCl'''' end IIItabllshld within one y..r 0' de.th by
the decedent.
1 DIVIDED IY Z (SURVIVORS) - .50 X IDD - 50% ITAXAILE FDA EACH SURVIVORI
.. Tht -..,t subject to tax UI". .) I. dIIt.r.lned bl Mlltlplylng thli account b.lMe' UI". 2J by the percent t.x.bl. Ul". SJ.
S. Ent.r the tot.1 of the debt. end dedUctions listed In P.rt S.
.. The 8IOUf'It t.xlbl. UI". 6) It det.,..l".d by 'ubtractlntl t.... d_ts and deductlo". II"'''' 1i1 frf'_ ,tot ~. .._~t.-et tf' te"! (II... 4).
1. Ent.r the approprlat. l.1C retl lilt:. 1) U d.,.r.!nt:l bllow.
A. For dat.. 0' death occurring .,t.r "SOl"', the t.x rat.. 'or tran.,.r. to .poust' '1"" a. foll~'1
1. D.t.. of delth on or .f!.r 1/1/... and bafor. 1111'S thli r.t. I. 3~.
Z. D.t.. of de.th on or .ft.r 1/1/95 tran.f.r. to ~... ..III be t.xad at OX tax r.t..
Not., For dlt.. 0' d..th prior to 7/1/... tran.f.rs to ~.., .1"" t..abI. .t 6X.
.. Tr....'.,.. to 11"..1 delCend.,tt Including fathlir, IOthlir, Ion, d.ught.r, grandchildren, 'on.ln~I.."
dtught.r"ln~I"', stepchild and their I.~ .r. t.xlbl. at .Ix p.rcant (6XI.
C. Tr....f.t. to .11 other. Including brothlir, 'I.t.r, unci., -...nt, ntPhtM and nlee. 11"" t..lbl. .t fl't..n percant (15XJ.
D. If"", chengt the t.x nt., pl.... .peclfy your r.l.tlonshlp to the dec.dlnt In the ar.. provided.
I. The.-aunt of t.x due (lint .) I. det.r.lned by .ultlplYlng the .-aunt t..abl. (lint 6J by thli t.x rat. (line 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. dtlbtt McI deduction. .r. det.r.lned .t fOUOMIl
A. You I"'ll~ ar. r.span.lbl. for p.yeent, or the ..t.t. .ubJact to edalnl.tr.tlon by . ptraonal rlPr.ttntatIv. I. InfUf'Iclant
to p,y the deductlbl. It....
I. You actU8lh p.ld thl debt. .ft.1'" dttth 0' thl decadent tnd can furnish proof of p'YIIent.
C. Debt. bel", cl.Ieed .u.t be It..lztd 'ull~ In P.rt S. I' addltlon.l .pee. I. ntIdtd, u.. plain PlPlr I Ill" M II". Proof 0'
p.yaent ..y be requa.ted by thl PA Depart....t of A............
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
-_._-~......._.,",
-- --- - - - - -.. - - - -_.. ---.- ---.- --.- ~-_.
-.--------------'...,
,
RECEIVED FROM:
&
ACN
ASSESSMENT '='
CONTROL I;i
NUMBER
AMOUNT
CHARLES N EVANS
9blC;3~03
.~.7;3
376 HOOREDALE ROAD
CARLISLE, PA 17013
IOtDHII,_
(lASl)
SSN 171-28-3:526
(fIRSl) (Mil
II POSTMARK
COUNTY
DATE Of DEATH
REMARKS
CHARLES N EVANS
m TOTAL AMOUNT PAID
.:5.7:3
CW,
RECEIVED BY:'--!"%'-fI.Ii,' (, -,~7', u,-,' .....,,''-' i!
" N ' ,.
//.,;;..J/!J.'1,If :
MARY C. LEWIS _ ) c. i
REGISTER OF WILLS !
SEAL
CHECK" 0343
REGISTER OF WILLS
-,-.---. ~,- -:-- - - - -_ - ---0 _ __ _ __ ,_ _._ _ _ ~_ _ _ _ _ _ _ ~ --..~__.....-'
~. ~
.
, 1
"
p.'
I' I, ~
,
':
"
,-
,
r:;-
-"".,..,..- -',
~--....J.Jl ~ - .~ f":""
.-
\.
vi. Rr.V.1541 EX AFP (12.95*
. CCIIICIIWUL TH OIF POIrfSYLVANtA
IVAIlTMDfT 01' II[1IDOJ[
ILItOU OIF INDIVIDUAL TAXEI
DOT. ZI"U
KARlIIIURO, PA 171ll-0'll
/5i7- I
,
"
NOTICE OF IIIIIEllITAllCE TAlI
APPRAISEftENT. ALLOMANCE OR OISALLOMAllCE
OF DEDUCTIONs LAND ABSESSMENT OF TAlI ON
JOINTLY nELa OR TRUST ABSETR
/
I
DATE 04-01-96
..
ESTATE OF EVANS
CHARLES N DATE OF DEATH 11-26-95
COUNTY
CUHBERLAND
FILE NO. 21 96-0165
S.S/D,C, NO. 171-28-3526
ACN
96103503
CHARLES N EVANS
376 HOOREDALE RD
CARLISLE PA 17013
REHIT PAYHENT TOI
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AIoaunt R_t tteel
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REii:i5iri-i)f-AFii-(i2~95i-------------------------------------.----------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLDWANCE OR DISALLDWANCE DF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-01-96
ESTATE OF EVANS
CHARLES N DATE OF DEATH 11-26-95
COUNTY CUHBERLAND
FILE NO. 21 96-0165
TAX RETURN WAS.
S.S/D,C. NO. 171-28-3526
(X) ACCEPTED AS FILED () CHANGED
JDINT OR TRUST ASSET INFORMATION
96103503
ACN
FINANCIAL INSTITUTION. HARRIS SAVINGS BANK
ACCOUNT NO,
17-50-003704
TYPE OF ACCOUNT. (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 05-10-90
Account hlanca
Parcant Taxab1a X
Amount Subjact to Tax
Dabta and Daductiona
Taxabla Amount
Tax Rata X
Tax Dua
572.80
0.166
95.47
,00
95,47
.06
5,73
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO.
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYHENT
DATE
02-21-96
RECEIPT
NUHBER
AA11254D
DISCOUNT (+)
INTEREST (-)
.29
AHDUNT PAID
5.73
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER THIS OAT~I SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, .
I IF TOTAL DUE IS LESS THAN '1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU NAY BE DUE A REFUND,
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS, I
\
6,02
.29CR
,00
.29CR
.-,.
t-- "'I
vi REV~i54a EX AFP (12-95*
COtICJHWIEALllt 01 POftSYlVAHIA
DOAATttEHT 01 REVEJrIJE
IURUU OF INDIVIDUAL TAXES
QEPT. zeD'Dl
HARAISIURQ, Pi 17121.0'01
IS -27- /
L/
NOTICE OF INHERITAKCE TAX
APPRAISEIlENT. ALLOMANCE OR DISALLOMANCE
DF DEDUCTIONBt_AND ASSESSMENT OF TAX ON
JOINTLY "~LD OR TRUST ASSETS
DATE 04-01-96
ESTATE OF EVANS
CHARLES N DATE OF DEATH 11-26-95
COUNTY
CUMBERLAND
FILE NO, 21 96-0165
S,S/D,C, NO. 171-28-3526
ACN
96103504
CHARLES N EVANS
376 MOOREDALE RD
CARLISLE PA 17013
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AllOUI'It R_1U.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
Rifv:i54-i-Ei[-AFji-iiif:is)------------------------------------------------------------------------------------
NDTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-01-96
ESTATE OF EVANS
CHARLES N DATE OF DEATH 11-26-95
COUNTY CUMBERLAND
FILE NO, 21 96-0165
TAX RETURN WAS.
S,S/D.C. NO. 171-28-3526
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
96103504
ACN
FINANCIAL INSTITUTION. HARRIS SAVINGS BANK
ACCOUNT NO.
17-00010961
TYPE OF ACCOUNT. () SAVINGS (lO CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 03-02-90
Account Be18nce
Percent Texeble X
Amount Subject to Tex
Debte end Deductions
Taxeble Amount
Tex Reta X
Tex Due
3,823,23
0.166
637.22
,00
637.22
,06
38.23
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,"
TAX CREDITS:
PAYMENT
DATE
02-21-96
DISCOUNT (+)
INTEREST (-)
1.91
RECEIPT
NUMBER
AA112541
AMOUNT PAID
38,23
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION DF ADDITIDNAl INTEREST, .
I IF TOTAL DUE IS lESS THAN fl, NO PAVHENT IS REQUIRED.
IF TOTAL DUE IS RE'lECTED AS A "CREDIT" ( CRI, VOU HAV SE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS. I
40,14
1. 91CR
.00
1. 91CR
'-
COMMONWEAL TH Of PE*SYLVAHIA
D(PARTtlEHT Of REVOU:
IURUU Of INDIVIDUAL TU[S
DEPr. Z"'OI
KURISIUtQ, PA 17UI.O'Dl
'*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FIL! NO. 21 -'I''' - J("J.-
ACN 98113855
DAT! 04-14-98
TYPE OF ACCOUNT
EST, OF CHARLES N EVANS 0 SAVINGS
S,S. NO, 174-05-0622 IXlCHEClCINIl
DATE OF DEATIl 01-07-98 0 TRUST
COUNTY CUMBERLAND 0 CERTIf,
RE"IT PAYKEHT AND fORKS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
"'.lIdll,nu...,
ReGole, .
Rl;~
, of
, ,',;ts
'98 APR 29 1\11 :37
LOIS J EVANS
376 MOOREDALE RD
CARLISLE
PA 1~~i1',
.url
" PA
HARRIS SAVIHOS IAN( he. provided ttM ......t.."t ..Ith ttM I"'or.tlon lI.tM bel~ Mhlch ... bMn uMd In
c.lcubtlng thl potentlll tu ctu.. Thel.. ncord. IncHatl tNt It the de.th o' tM .aov. declldent, you Iller. . Joint DWIe..IbenI,lcil..Y 0'
thllllC~t. If you ...1 thi. I"'o...tlon .. Incorrect, P..... obt.l" ..rltt., cornetlon fro. the f1~I.1 I"ltltutlon, .ttach . copy
to thll fo... end rdurn It to tN ~Y8 Idd...... Thll lICCCM.ftt II bnbl. In IICcor~ ..Ith tM 1m...ItMC. Tu L.... 0' thI c.o.on...lth
o' PeM....I"...I.. Quutlon..., tMI ......red bY al1lfM1 (717) 717~a.sl7.
COMPL!T! PART 1 B!LOW . . . S!E R!V!RSE SIDE FOR FILING AND PAYM!NT INSTRUCTIONS
Aeo~t No, 17-00010961 o.to 03-02-90
htob1hltod
Aee~t a.1one. 888,36
p..e...t Toxob1. X 50.000
~t Subject to T.x 444,18
Tox R.to X ,15
Pot...U.1 Tox Duo 66,63
PART TAXPAYER RESPONSE
ITlIFAXLUU TO RUIlCItIDlf%U RUULT;III;AH'~CIAL TAX A8SlSSHIHI' IAIID C1t111fIS NOTJcal
i. 0 The MloY' In'or.tlon end tax due II correct.
1. You AY c:hoo.. to ....It ,.~t to the b,ht... of N1111 ..Ith ho copl.. 0' thh notlc. to abt.l"
. dllcOl.I'\t or .void Int.....t, 0.. you _y dMdc bolc -,- -.I r.tum thll notice to tM Allht... of
Will. end In offlclll ......-ent ..III be I..ued by tN Pi Depe..~t of R.venue.
To I"sur. proper credit to your ICCOU"lt, two
eZI copl.. of thll notice .u.t ICCoep.,y you..
p.~t to ttM AIII.t... of Will.. "-k. dMdc
p.yetll. tOI ....I.t... of Will., Agent-.
NOTE I If tu p~t. ara ... ..Ithi" thr..
UJ -.nth. of tM deClldent'. ct.t. of dMth,
you .-y deciJct . U dllCOl.l'\t of tM tax ctu..
Arty IrhIi..ItMCe tu .... Iillll bee-. .11,..,t
"Ine e'l .w'lth. aft... tM dIIt. of dMlth.
[CHECK ]
ONE
BLOCK
ONLY
I. 0 The eboVII "Nt ".. Men or ..Ill be reportM end tu ,.Id ..Ith thl p.,.".ylv.-,I. liVM..ltance TIllC return
to be filM by tM dacltdent". r......an..tlv..
c.'Y n- IIbovI I"fo.....tlon I~ncor..act endIo.. debtl end deciJctlon. Iller. paid by YOU.
~ You ...t cOllPI.t. PART l!.J lndIo.. PART [!] below.
PART If you indie.t. . d1ff..~ox ..t.. pI..... .~.t_ ypu~
~ ..hUonlhip to doo_t1-=f;U_I'7M"~-.;:E,!, &~U
TAX R!TURN - COMPUTATIDN OF T ON JDINT,TRUST ACCOUNTS
LiHE 1. Dot. EltobU_ 1 a hn ()
2. Account 801_
3, P.l"COI'lt Toxob1.
4. ~t Subject to Tox
5, Debt. _ Deduction.
6, ~t Toxobl.
7, Tox R.t.
a. Tax DuIi
3 X
4
5
6
7 X
a
J,}}\OFllICIAa; .. US!. aNL Y; OAAfjl
'iF:" PA". DEPARTMENT,. .Ol!' IlEVENUE}:.:!
';~~~i.,.;,....'.,...:;,:, ;;':.,':"':":,,,,;:;~~::~:;:~:';,-;:'~ ..~.",~\
"""":"'.Z~ .,.,.,.,..,.".... ,~", " ,'" ,^"''''''';': 'w'," , ""'," ~
k~' ~"L ~~;~i~~~;~~~
0: g ~'}';tf" ..,; "'.~' ':':';;:;.;..;,J
to . 00"".,8 .. ..... '.. '....' . ,. >., '.'\~. i'~
DEBTS AND DEDUCTIONS CLAIMED
PART
[!]
DATE PAID
~-/
<
r.Witf
,
,
,..J
me.
~
e.....
AMOUNT PAID
7.zz-
PAYEE
DESCRIPTION
TOTAL (Entar on Line 5 of Tax C~t.tlonJ
.
.~
Under ~ltl.. of perjury, I declara that the
eoop1.t. to the be.t of .y knotl1.dgo _ bell.f,
~. K' ~;'-<t-IL-L/
V~ IG URE
facta I have reported above er. true, correct .,-,d
HOME ('7/7 )2-4.3,3<.'2y,
WORK (if?) 2Jt3 I~-/.:>
TELEPH NUMBER
GENERAL INFORMATION
1. FAILURE TO RESPOND NILL RESULT IN AN OFFICIAL TAX ASSESSltENT .Ilh _11"'\0 Into'... ..... .. In'.rooU..
aue.lthd by the f!rwteSal In.tltutlon.
2. Jnherltlnc. tlX McOHI cMllnquent "I.,. Nnth. .fhr tt. dec~t'. at, 0' death,
S. , Joint ecCOlM'It .. h..le IVM though the dKedent" n-. "'.. adcMld .. . ..tt.r of convMIW'CI.
4. Account. Clncludtng tho.. held between huabMd Md .,lfe) which the decedent put In Joint MM. within one .,ur prior to
de.th '1"" fully t..~l. II '1"'''''''1''''.
S. Account. ..hblhhed Jolnth' between hulblnd Md ..If, .1"" th... ..... y.... prior to death '1"" not 'anbll.
.. Account. held by . decedent -In trutt 'orR ~ther or other. '1"" t..ebl, fully.
REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE
1. .lOCl" - If the lnfor..tlon ~ CMPUtatlon In the notlc. '1"" correct Md deO.Ictlon. '1"" not being clal., plea. In "'r
In block -,,- of Part 1 of the '"T"'YII'" R..pon.... .ectlDf'l. Sign two copl.. .... sut.lt t~ ..Uh your check far the -..t of
tax to the Altl..,1'" of Will. 0' the county Indlc.t~. The Pi Depart.-nt 0' R.v~ ..Ill I"ue In o"lclal .......-nt
(forti REV-IS4I EX) upon receipt 0' the nturn 'ro. the ..,hhr 0' Willi.
Z. ILOCI I . If the ....t specl'led on thl. notlc. has been or wIll be r~rted end tax paid with the Pann.vlvanl. I~rltanc.
Tax ..t\lrn 'l1ed by the dec~t'. repr..ent.tlv., PIK' an ..... In block ...- a' P.rt I 0' the -Yallp.y.r Rllpon..- section. Sign one
copy and r.t\lrn to the PA o.p.rt-.nt of Revanua, &ur.au 0' Individual '.x.., Pept 2.0601, Harrllbura, PA 17121-0601 In the
anvalopa provldad.
S. .lOO( C . If the notlc. In'ar.tlon h IncorrKt .-.dIar daductlon. ar. baing c1.IMd, chec:k block -c-' and COIIPI.t. Part. Z and S
ItOCOrdlng to the In.tructlon. below. Sign two cop I.. and __It thee ..lth your chec:k 'or the .-ou'It a' t.. penlll. to the Raghtar
at "1111 of the county InclSc.tact. 1he"A bapartMnt 0' hlYWlUll wlU ....... en alUcl.1 ..........t Ifor. RiV-1S4a D) upon rlallpt
0' the r.turn 'r~ the Ragl.tar 0' WIll..
TAX RETURN - PART 2 - TAX COMPUTATION
lIlE
1. Enter thl date thl KCount originallY .... ..tablllhed or titled In the ....,.r ..htlng .t d.t. 0' dei.th.
NOTE, Far. decadent dylna .fter lU1UaZ, Accountlllhlch the decedent P\lt In Joint MM. ..Ithln one (1) Yllr 0' death ar.
tallabl. '\Illy.. tran.,.r.. Howev.r, thara I. an .xcl\l.lon not to a.c-.d Is,aao p.r tran.'.r.. r-.ardl... 0' thl v.lue of
the KCCU1t Dr the nullbar 0' KCOU'\t. held.
I' . doubl. ..tarllk tM.) appe.r. before your 'Ir.t ~ In thl Iddra.. portion of thl. not Ie., thl IS, ODD ..clullon
alrudv has been daductad 'ro. the KCount balance .. rlPDrt..t br the flrwncl.1 In.Ut\ltlon.
Z. Ent.r the tot.. balanc. of the KCount Including Int.r..t IKCruad to the dIIt. 0' death.
S. The parcent of the eccount that II t...bl. for uch I\l,.."lvor h dlit.ralnad .. '01l0lll1l
A. Tha parcent tbabl. fo,. joint ....tI IItablla.d IIOr. than ana rur prior to the decedent'. death,
. DIVIDED 1'1 TOTal NLICIER CIF
JOINT owt€RS
Ex..,I., A Joint ....t ,.agl.t.rad
DIVIDED 1'1 TOTAL NLICIER CIF X loa . PERCOfT TAXABLE
SlINIVIND JOINT OWNERS
In thl na.a of the dllcedant and two other ~,..on..
1 DIVIDED.Y 3 (JOINT CMERS) DIVIDED 1'1 2 (SlINIVDRS) . .167 X 100 . 16.7% CTAXABLE FDA EAot Sl.INIVOIU
I. Tha ~rCWIt tbabl. fo,. ....tI cr..tld ..Ithln ana v..r 0' the decadent'. death 0,. KCountl C*Md by U. dacedant b\lt held
In tru.t 'or another Indlvldual(.) (tru.t bana'lel.rl..),
1 DIVIDED 1'1 TOTal tIJKIER CIF Sl.lNIVlfC .JOINT
owt€RS DA TRUST IEHEfICIAIUES
X loa . PERaHT TAX.UIlE
Ex..,I.1 Joint Kcount ragllt.rld In the na.a of the dctc:edant and two other paraun. ... ..tablhhld ..Ithln OM ,..,. 0' death by
the decldlin t.
I DIVIDED 1'1 Z (SURVIYORSI . .50 X 100 - SOX (TAXAIlE FDA EACH SURVIYDA)
4. The -...t .....j~t to ta. Cllna U II detanllnad br aultlpblng tha KC~t balanc. Cllna Z) bv tha parcent tbllbl. Cllna SI.
5. Enter the tohl of the debta ... dacbltlon. lilted In Part S.
6. The -...t t..llbl. Ulna 6J .. det.r.lned by MJbtr~U,. the debts and cMcb:tlon. Ulna 5) 'ro. the .-ou'It "j~t to tax (11,. 4).
7. Ent'r~: ."rcprl~t. t~~ r.te (11M2 7) a. datcr.I~~d b:low.
A. Far dat.. of "th occu,.l"'I,.. .ft.,. USII"', the tb r.t.. fa,. tran.,.ra to .,.au... .nI .. 'allow..
I. OIt.. of ....th on 0,. .ft.,. 7/1/M and before 111195 the nt. II n.
Z. OIt.. 0' ....th on or .ft.,. 1/1191 t......,.,.. to apou... IIdll t. t....t .t ax tb rat..
Motar For dat.. of ....ttII pl"'lo,. to 7/1/M tran"a,.. to apou... .ra tax.bl. .t 6%.
I, Tr..,.,.r. to 11,..1 deaoendanh lnoludlng fathe,., _the,., .un, dalght.,., grandchlldr...., 1Oft-ln-I..,
....,t.r-ln-l.., .tapctlllld and thalr h~ ar. t..llbl. at she parcent (6%).
C. Tran.'.,.. to .11 other. Including brother, ...tar, lrICI', ..,t, nIiPf'*' and "lac. .r. tbllbl. .t ,1ft.., parCWIt US):).
D, If you ~ the tax nta, pi.... spaelly YOU" r'latlon"'lp to the ~t In the .r.. provided.
I. TN IIlM'lt of tax due Ulna I) II det....lnad by ..,Itlphlng the -..,t t...abl. (11,. 6) br the tax r.t. Ulna 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
All...l. dabt. and dad.lctlons are det.ralned .. foll.,...1
A. You 1...lly .r. r.~.lbl. fa,. payaant, or the ..t.ta .ubJact to adalnl.tr.tlon br . ~raonal rapr'lInt.tlva I. Inauf'lelent
to par thti daductlbla It....
I. You ~tualh p.ld the dabta "tar death of the dec...,t and ean furnish proof of p.yaant.
C. o.bh baing el.l.... ..,.t be It..bad 'ullr In Part S. If "'Itlonal spac. h naeded, usa pl.ln p.,.r a 1IZ"" . 11-. Proof 0'
Plyaant ..v t. raque.tlld br the PA aap.rt.."t 0' R.v.....
. .. TAXPAVERASSISTANCE. .::".,." . ....'.:':., .,.".'.f>fff.;;:"
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY,/",':W'iM~~W%:
..' REGISTER OF WIlLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE:,,:_:.:.:t,:,,""t~;;,:..,
OR CALL THE BUREAU OF INDIVIDUAL TAXES,TAXPAVER. INQUIRV. UNITIN):"'}:"W;'{'
HARR~SBURGAT (717) 787-8327. .,.,.,:TDDI,;S,Z;V . 772-2252 ..CHEARINGIMPAIRED,ONL V,%X\;.
.-
.-
,
CCMQMAL1H Of PO.dYlVAHIA
OE:PAAlttEHT Of R(VOU:
IURtAU Of INIlIVIDUAL tAXES
IJ(PT. 111601
HARAISIURG, PI 17UI-1601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
RCCOh_.
RLI," ;,
of
.,:tl:s
E5T. OF CHARLES N EVANS
5,5, NO. 174-05-0622
DATE OF DEATH 01-07-98
COUNTY CUHBERLAND
FILE NO. 21 -<JG. . ) l:J.
ACN 98113856
DATI! 04-14-98
TYPE OF ACCOUNT
iii SAVINClS
o tHEClCINCl
DTII\IST
o tERTIF,
""114'11"''''"'
'98 APR 29 1\11 :37
LOIS J EVANS
376 MOOREDALE RD
CARLISLE
ell-I,
PA 17QUnb,,: I
..urt
,,., PA
REHIT PAYMENT AND fORHS TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS BAHK hili provided the o.p.rt~t with the Infor..Uon I litH tM1Dl' vhl~ hili bMn uHd In
calculating the potential tu du8. Tt.lr rKord. Indlut. tfMIt at U. duth of the 8bov. dltc:ecMnt, >>ou wer. . Joint CNMrlbwMiflcl.ry of
thlt KCOW\t. If you '..1 thlt Infor.tlon Is IncorrKt, pl.... obtain lIIrltten corrHtlon fr. the flMnClal In.tltutlon, .tt8Ch . copy
to tnll for. end raturn It to u. 1IIboY. Mktn... This HCount II t..llbl. In MlcordMc. 1II1th the InherltWICa Tall L... of tM eo-w.wulth
o' PMnaylVWIla. o..,tlan_..-I eM .,....red bY c.UI"'!! (711) 717-aU7.
COMPLETE PART I BELDN . . . SEE REVERSE SIDE FOR FILING ANU PAYMENT INSTRUCTIDNS
Account No. 17-50-003704 o.te 05-10-90
Eatablhhed
Acoount a.lane. 2,037,95
Parcant Taxabl. X 50,000
-..t _jaot to Tax 1,018.98
Tax R.te X ,15
Potential Tax Dua 152.85
PART TAXPAYER RESPONSE
[!] l'AILlIUTO RUPOHII ifILL. RUUL TIN AM OIIJI%CJAL.TAX A8SU$IIKT.1A11D CIII THIS: lIOTICl.i, I
I. 0 The IIboYe lnfo,..tlon end tu du8 Is corrMt.
1. You.-y c:hoo.. to r.1t p.~t to u. R..lst.r of WUh 1II1th tva copllll of this notlu to obtain
. dllCOU"lt Dr avoid Int.r..t, or you .y cn.ck boll .1. .... r.turn this notlctl to u. R..lst.r of
Will. .... en offlcl.l ......-.nt viii be I..ued bv the PI DIp.rtlent of R.venue.
To Inaur. proper credit to your account, tva
(l) copl.. of thl. notlc. .u.t accoapeny )'OUr
pav-ent to the ..,lIt.r of WUIs. ..... chKk
payabl. tal ....I.t.r of Will., Agent".
HOTEl If tn: pav-1t1 .ra IIadI Mlthln thr..
en .unthl of thl dIcldlnt.. at. of _th,
)'ou ..v dlduct . SX dbCOU1t of tM tu du8.
Anv InherltWIC. hll du8 Mill becfMa delinquent
nine (9) .unth. aftar tt. date of _tho
[CHECK ]
ONE
BLOCK
ONLY
I. 0 ThlIbov. ....t hII. been or vlll be raportld and tu paid vlth u. Penn'Vlvanl. rmarltWlCa Ta: ratum
to be '1I1d bV U. dIcldlnt'. rapr..."tatlv..
C. V The 1IIboY. Infor.Uon I~~ncorrect and/O~tl and dlckJctlon. wera "Id by )"DU.
rvou ...t COIIPleh PART l!J and/or PART l!.J belov.
PART ~l:~~::::.:: ~:~~~t7't tax r.t., pl.... .tat. YotIr:.>.o,,~ICIAL,USE,ONl,Y OA~
T~X RETURN -, COMPUTATION OF TAX DN ,Jjl,XNT '!TRUST ACCOUNTS~~.;~r~~,~~~I~~~!~;e~;.~~~~,~~~~::ie:1
L1"t 1. D.t. tu.allan.d 1 L't.!l t n:;.!'::Hi ..: .;:",~~~:,,::';:;,;,:';'~:i-,~;.;':" -"";.~';-':",,~':i:::i,:,;,(;;,,;~:",;->'''.l':~i;::'';':i::'t
2. ACCOW\t Bal~ 2"':}/') ..3 7 ~ q ...s- , "..." .." ,. ". ,.:';~~::;:;::::::;!~~';~~'.;;;{:'~r..' .. ,*!~~),:if,~::;..:
:: =\::~.to Tax : X /0 -:ll: ~:!'.H.i:..,.j.:5....~.':;';':~;~~.:;:;.','<';r;'.~'~;:@:;:;;:;:<~~';'~;:
I. o.bt. Ilnd DeduaUon. S /D~~-~ .3 2-- " , ;'; .:'::{;.:~::~;,~W.:;:' .:.:-~:..:'.~::::::::::;::;:<~:~:::':::::;:'~
6. -..t Taxabl. 6 O. OQ .,. ....".,.".,.,.,.......::,.:::..",...
7. Tax R.t. 7 M ~ ~" :; ::: 7 ~-:: :::,:..;:;,;
a. Tax Dua a 0, CJ CJ .....'.. . ..'.'. ... ...0'. ...."."':,:.-,,,
DEBTS AND DEDUCTIONS CLAIMED
PART
~
DATE PAID
/- Z. z -
/-
..
i'm
e-
111
..
'5''<-
e
,n
Il,{"~
{!~ftC
AMOUNT PAID
~. z.-
PAYEE
C'rNuJ <t
r(,C
DESCRIPTION
TOTAL CEnt.r on Line S of r_x Co.pu .tton)
. o~:> ~ : .t--
Und.r p.n.ltt.. of ~rJury, I decl.r. th.t the feet.
ooapl.t. to tha be.t of .Y k....ladga and bell.f,
cr;/;ff ~' f;1ft~~/
T ER GNATU
I h.v. reported abov. .~. t~, correct and
HOHE (117 l 24-~-?'oz.,.<,
WORK (117 l 2 '/3 - 15:'1-> t.j--Z,7-yB
TELEPHONE NUMBER DATE
GENERAL INFORMATION
1, fAILURE TO RESI'DND WILL RESULT IN AN OFFICIAL TAX ASSESSltEHT with _11'''1. In'.'." b._ on Info...llon
~Itted br the fln.naJal Inltttutlon.
Z. InherJtMCe tax -OM. deltnquent n1,... IIOr'lthl aU,,. the dec.....t.. dUe of death.
J. , Joint ~t h taubb IVWI though the _"",', "... .... addtld '1 . ..tta,. 0' convWlIW'ICI.
4. ACCOW1h Unalucllng tho,. held bet....,. hu,bMd end ..1f,1 which the ~edent pUt In Joint ".... .,lthln one Y"" prior to
~th ara full, lax.ol, '1 Ir....'.,...
S. &cCOWlh ..hIbU.... Jolntb betwMn huabMd end .11, IIOr. tNn OM Y"" prior to ....tlt .r. not t....a.
,. Account, held by I decedent "In truI' fo,.- ~ther or other. 'r, taxeble fUll,.
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. ILoa: A .. If the Infor..Uon end CMputatlon 1n the notice ar. cornet.., .s.ductlon. Ira not being clal-.d, pleea ... .....
In bl.... -." .f Po,. I .f 'ho "1_..., R........- '..lIon, SI....... ...1.. _ ....It u- .Ith ...., _ f., tho -.... .f
t.. to t,. _"lit',. of NU" of the county Indlcetlld. The PA o.p.rt-.,t of .avenue "UI h..... WI official............
(Fot'1l R[V-1541 EX) ~ ,....pt 0' the nturn f,.~ the -....t,,. of NUh.
Z, ILIlCIC I - If 'ho ..... ....111.. on 'hlo noli.. h.. ..... ., will" ,_,... _ .., '.'d with 'ho P......lv..'. 1....,It....
T.. R."'rn '11.. b. .ho "'-". ,..,......lIv.. .10.. .. ..... In bl.... ..- .f ..,. I .f 'ho -T......, R........- ...lIon. SI......
cop, ~ r.turn to the PA Deptrt-.nt 0' RIVenu., Burleu of fndJvJ~l rIX.., D.pt Z80601, "-rrlaburg, PA 17Il'-0601 In the
~lape provided.
3. ILIlCIC C ' If .... noli.. Inf.'''lIon 10 Inc."... -,., -.eUon. .,. "I.. ".1_. __ bl.... "... _ '_1... Po,.. Z _ 3
....'dl.. .. .... In..rucuon. ..I... SI....... ...1.. _ ....It U- wi th ...., _ fo, tho .....,. .f .., p.,"I. .. tho RooI...,
.f "III: .f the ....,.., I,..:",.... Th:,. C"':,'-, ., n."...,.... wlll ...... .... ."1.1:1 :,........ 'r.,. lI[\O,mc CO ""on ,ocolp!
0' t.... nturn ft. the R....tll' 0' NUb.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the dIIt, the KCCQtt or'1111nelh .,.. IltllblJlhed or tlU.- In the IIW1Nr uhUng It dl', of de,th.
NOTE, r.,. ...-. "I.. .ft., IUIUIl. ......... "",.. .ho ..._. pUt In J.ln. .... within... (II 'H' .f _Ill .,.
'Ixllbl, fulb '1 'rllnl'.r,. Ho..ev.,., thlr. II In Ixelu.lon not to 'lCeNd 13,000 ~,. t..llnt',,,,, reprdl... 0' the velUII of
the KCCU1t or tM nu-ber 0' KCOWlh held.
tf . doubl. ..t.rllk (..) ~r. before rour ,.,.,t ~ In the ~r... portion of thl, notle., the '],000 exclu.lon
11rlUlCtr hi, bMn deductld 'rCNI the KCOWlt t.l~. II rlipOrtecl by the fllW1CJ.l In.t1 tuUon.
Z. Ent.r the tot.1 MlMeI of the ec:COU'lt lnclucUng Int.r.1t eccrued to the dill. of death.
3. The "tcent 0' the KCOU'lt thllt h taxllbh for MCh IUrvlvo,. II dIIt.,..lned ., 'ol1ow.r
A. The .-reMt taxllbl. 'or joint ....h ..tllbllstMd .or. thwI one YMr prior to the dllcadllnt". dMthr
1 DIVIDED IV TOTAL fI.IG[R OF DIVIDED IY TOTAL tuIIER CF X lID . PERCENT TAXABLE
....INT DIlNERS SUlVIVINIl ....INT DIlNERS
Ex....l.1 A Joint ....t r-.Ist.r. In the n-. of the decedent .. tt.o other person..
I DIVIDED IY 3 (JOIHT CM€RS) DIVIDED IY Z (SlRYI\ImIS) . .167 X laO . .'.7% nAXAIlE FDA EAat SlINIVORJ
I. Tho "'con, .....1. fo, ...... "H'" within... 'H' .f tho _". _'h ., ......... _ b. tho _. .... hold
In tru.t for InOther IncUvlckleU,J (trult e..flel.rl..Jr
1 DIVIDED IY TOTAL tumER OF SURVIVING JOINT
0Wt€RS OR TRUST IEHEFICIARJES
Ex_h. Join' ........ '..h'.,,, In tho ... .f tho ...-. _ .... .tho, ..,..... _ .""110.... withIn... _, .f _Ill by
the decedent.
1 DIVIDED IV Z (SURYI\ImIS) . .50 X loa . 50% (TAXAIlE FDA EACH SURVIVOR)
X 101 . PERCOfT TAXAILE
o. Tho -.... -J... .. ... (II.. 01 10 ....'.1.... b. ...IUplyl.. tho _. ..I.... 'II.. Zl by .... ..,.... .....1. UJ.. 31.
S. Ent.r the tot.l of the debt. end deduction. ll.ted In P.rt 5.
6, Tho -.... .....1. UJ.. 61 10 ....'.1.... b. -.,..U.. tho ..... _ -.ellon. UJ.. 51 ".. .... -... -J... .. ... Ill.. 01.
7. Ent.r the ~rODrl.t. t.. r.t. (lIne 7) .. dIIt.r'lned below.
A. For dlt.. of "th occurring .ft.r 6130/94, the tax r.t.. for tren.,.,.. to IPOU... .r. .. followlI
1. Det.. of dMth on or .ft.r 7/1194 end before 1/1"5 the r.t. I. 3%.
Z. Oat.. 0' dMth on or .ft.r 111"5 tren.,.,.. to 'POU... wlU be tax. .t OX tax r.t..
Hot.1 For dat.. of death prIor to 7/1/94 tnn".r. to IPOU... Ir. tax_II .t 6%.
I. Tnn,'.r. to lInreel deKendlnh InclucUng '.ther, .other, son, ~t.r, IIInndehl1drM, Ion-In'"l...
deught.r'"ln~I.., .t~1Id end their 1.tue .r. takabll .t .Ix pereMt (~).
C. T.......,..o.1l .....,. IncIUdI.. b'.tho,. .10'.,. ....10. ...... _ _ nl_ .,. .....10 .. flft_ "'con' (15%1.
D. If you chwlgIe the tax ret., pl.... IpIcJfy your r'latlonShlp to the dlICldent In the .r.. prOVided.
I. The ~t 0' tax ckIe (Une I) II det.ra1,. by ..,Itlplvlng the ~t tIXIlbI. (11.. " by the tax rlt. (J1". 71.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Al101MbI" debts ... deduotlon. Irl det.,..I,. I' fOllow'l
.. You 1...11. .,. '......Ibl. f., P......, ., tho ...... -J... '0 Idolnl"'.'lon b, . ..'....1 '..'.......Iv. I. InlUffl.I...
to P.y the decb:tlbll H...
I. You ectwlb ,..Id the debts Ift.r death of the dlICedent If'Id e," furniSh proof of p.~t.
C. Deb.. "I.. .101_ ..... .. 1t..1... MI. In P.,. 3. If _IU...I _ 10 _. WN phln p_, . 11.. w II". P,oof.f
,.,.."t "I' be requa.tld by the PA DIp.rt..,t of Rev....
.'--'.......,.-,'......-.
.. . ..,,',,':'y',',,~':,}:,':,... . .TAXPAVERASSISTANCE. . . . .. .... 'w"":,~".,,,
....':..IFYOUNEEDFURTHER INFORMATION .OR ASSISTANCE; CONTACT ANY..",,"'..'
.,."",',. REGISTER. OF WILLS, PA DEPARTMENT. OF REVENUE DISTRICT OFFICE . . . .
..\"..)..~.:OR CALL THEIUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRV UNIT IN ......(
.>HARRISIURGAT (7)787-8327,. TDD'A~HU772-2252 (HEARINO IMPAIREDOHlv~Mtwr
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PIIAPOSE 01'
MDTlCEI To fulfill the r...I,...-... of Section 2141 of the InherUMCe end E.bt. Ta Act, Act 21 of 1995. C72 P.I.
SOCU... '14'1.
PA'nENTa Det80h the top portion of thl. NoU~ end .....U with YOUr ~t to the R....t.r of WUII printed on the
rwer.. .lde.
... ...... cheok or IiIllnQ order ,..h tol REGISTER Of WILLI, AGOfT.
I!F1IID CCllII A r-f\nI of . tax credit, which .... not .......ted on the ta r.turn, .., tMI r.....ted by COIIPl.tI,.. en -AppUcetlon
for hh.nd of ""'syIYWII. Int.rlbnce end E.bt. TIIX"' CREY.UU). Appllcetlon..,.. IW8lhbl. .t the Offlae of
the Reghter of WUh, wry of the Z3 R..,..,.. Dhtrlot Office. or by celli,.. the specl.1 2".hour .........1.. ..rvloe
~. for fOMe. o~rlnol In Penn.ylYWII. 1.1.1.362.21'0, out.lde Pennsylvenl. end wIthIn local
.......Isburl..... C7l7) 717.1"", TDa. (717) 772.2252 C......I,.. I.-Ired Only).
~lONSI My party In Int.r..t not ..t"fled wIth the eppr.l--.nt, .U~ or dlsaUowence of deduction. or .....~t
of tax Clndudlng dleocM'lt or Int.re.t) .. shlM\ on thl. Notlee .., object within sixty C6I) _. of receipt of
this Motl~ bra
.-wrltt... prot..t to the PA Deper~t of R..,..,.., ao.rd of ....., Dept. 281121, tlerrllburl, PA 1712..1121, OR
...lecU.. to heft U. .U.r dIItl,..lned .t the IlUdlt of the IKc:ount of the perlOnlll r.r'MI'lt.tlYtI, OR
.......1 to the Orphen.' Court
AII..M-
IIlllATlYE
CCJRII[CTIOMII '.tual error. dllOOYered on "'Ie ........t should tMI eddt..MliI In writing tOI Pi Dep...~t of R~,
Iureeu of Indlvlduel Tal', ATTNI Po.t A.......t Revl... unit, DEPT, 21"11, Harrlsburl, PA 17121."'1
Phone (717) 7'7-ut5. See,.... 5 of the bookl.t -In.tructlon. for Int.rlbnoI llX R.tum for . ...Idlnt
DIoIdenr CREY.15llJ for ... apl_tlon of "lnlltretlYtltr correct.h errorl.
DISCOUNT a
PEMAL7Y.
1IflD[Sf,
If InJ' ta: ... .. peld within thr.. cn cel...r IIOnth. .ft.r the decedent'. dMth, . flYtl percent CU)
dleoount of the ta: paId.. .Uowd.
The 15% ta: _.ty non..,.,.UolPltlon penalty 11 OGIIpUtecl on the total of the tu end Intere.t .....Md, end not
peld tMltorl ~ry 1', 1"', the first _ after the end of the tax ....ty period. Thll non..,...UolpaUon
.......1 ty 11 .....llbl. In the ... ....r end In the the ... t 1_ per loci .. you would .....1 the tax Md Int.,..t
thet I'll, been .....IICI .. Indlutld on thh notic..
Int.r..t 11 ohIrgId ..IMI,... wlth first., 0' dellftClUlnGV, or nl,... c.) IIOnth, and one (1) dey
fro. the deta of dMth, to the dlt. 0' P.~t. l.... tfhlch bee-. dellnquMt tMlfore .IMuIry 1, IH2
bear Int.....t .t the rata of .s. CU) PlrOlnt per ...... C81cul.ted .t . dllb ret. 0' ."UM.
All ta.. ....Ich bIoIM dell"..,t on or .ft.,. ~ 1, 1911 will beltr Int.n.t .t . rat. ....Ich wIll VII,.. fr~
eel"'r rear to calender YMI' with thet rete .......-.ced by the PA Drlper.....t of RIYWUII. The ~llcabl.
Int.,..t r.t.. for 1"2 through 1998 .,.1
v_ Int.....t Rat. DillY Intere.t ,..tor v_ Int.....t "te Dilly Int.,...t FlOtor
1HZ UX ,...54. 1.17 'X ....247
1m 161 ....41. 1'00-1"1 IU ."UOI
1904 IIX ,"U'. I"Z 'X ...."7
IHS 151 . "ISM 1""1994 n ...n92
1916 lOX ....27" 1"5-1"' 9Z ....247
..Int.,..t I, calcullted .. follow. I
IIITEIEIIT . IALAllCE OF TAX UlCPAID X IlUlIIER OF DAYS DELIHQ\IEItT X DAILY IH.......I FACTOII
..Aft1 Not I.. 1.1UId .,ter the tax beooIe. dlllnquMt will r,'I..t an Int.r..t caloulltlon to fIfteen (11) ~.
beyond the dlt. of the .....l8Mt. If ~t II -.de .fter the Int.r..t OOIlpUtlUon dIIt. '*"-' on the
Noti.., addUI_l Int.....t ...t tMI caloullted.
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