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RESERVATIONI
'Estat.. of d.c.dents dying on or blfore D.coeb.r 12, 1982 -~ If nny future Int.r.st In the os tate Is transforrod
In possosslon or onjoy..nt to Class a (collat.rall b.n.ficlarl.. of tho docedont aft.r the ._plratlon of any e.tat. for
llf. or for Ylars, the Co..onwoalth h.reby o.pr.ssly reserve. the right to apprals' nnd a..e.. transfer Inheritance Ta...
at the lawful Cla.s B (collat.ral) rat. on any .uch future Int.r.st.
PURPOSE OF
NOTICE:
To fulfill the r.qult...nts of S.ctlon 21~D of the Inh.rltanc. and Estate Ta. Act, Act ZZ of 1991. lZ P.S.
S.ct Ion ZI~a.
PAYKENTI
O.tach the top portion of this Notlc. and subllt with your pay..nt to the Reglst.r of Wills prlnt.d on the r.v.rs. sldo.
"Kak. chIck or laney order payabl. tal REGISTER OF MILLS, AGENT
All p'Y.lnts r.c.lvld ,hall first b. .ppllod to any Int.,.st which lay be due with any r..alnd.r appll.d to the ta..
REFUND (CR I I
A refund of at.. cr.dlt, which was not requut.d on the Ta. R.turn. lay b. tlqlI..ted by co.pl.tlng an "Application'
for R.fund of P.nnsylv.nla Inh.rltance and Est.t, T.... IREV~I!ll). Application. .,. available at thlDfflce
of the R.gI.ter of Wills, any of tho 21 Revenu. District Offices, at by calling the special Z~-hour
answ.rlng service nu.b.rs for for.. ord.rlng: In Pennsylvania 1'80a-36Z-Z0sa, out.ld. Penn.ylvanla and
yH~tr: l,:~.! HI~dr~:Jr; ::.!:31 "':1) 7!'~e:;I(,. Tt!D' tll1! n~-'usz (HuP'!"i1 bpalrad Or"~yl.
OBJECTIONS I Any party In Int.r.st not ..tlsfl.d with the appr.lse..nt. allowanc. or dl.allow.nce of d.ductlons, or as......nt
of tilt llncludlng discount or Intlrnt1 as ,holfM on this Notice .u.t Object within shty (601 d.y. of receipt of
this Notlc. by:
"wrltt.n prot..t to the PA aepartunt of R.vlnUI. Board of Appeals, Dlpt. 281021. tlarrlsburg, PI 1112&-1021. OR
"ellctlon to have the aathr deteraln.d at audit of the account of the plt.onal tlpr..entativl, OR
.~epp.al to the Orphan,' Court.
IDKIN
ISTRATlV[
CORRECTIONS I
Factual .rror. dI.cov.rld on this .,......nt ,hould bl addro,sld In writing tal PA Dopart.ent of Ravonue.
Bureau of Indlvldu.1 Ta.... AnNI Post h.oUllnt Review Unit, Dept. Z80601, Ilnrrisburg, PA 17IZ&-0601
Phon. (711) 187-6S0S. So. pago ! of the booklet "Instruction. for Inherltanc. TaM R.turn for a R.sldent
O.c.d.nt" (REV-IS01) for an e.pl.n.tlon 0' adlini.tratlvaly corroctable errors.
DISCOUNT,
If any te. duo is paid within thr.e (1) calendar oonth. after tho decedent'. death, a five percent (S~) discount of
the taM paid Is allow.d.
. .
Th. lS~ taM alno.ty non~p.rtlclpatlon penalty Is co.putod on tho total of the taM and Intor..t a,.essod. and not
paid bofor. Janu.ry 18, 19'6, tho first day aftor the end of tho ta. alnllly pltlod. This non'partlclpntlon
penalty II appealabl. In the ,ft.. .ann.r and In the tho 'ale tl.e periOd .s you would appeal the ta. and Int.r.st
that has blln .sl.s.ld a. Indlcatad on thi, notice.
PENALTY:
INTEREST:
Int.rost Is charg.d beginning with flr,t day of dollnqulncy, or nln. (9) .onths and ono (I) d.y fro~ the d.te of
death, to the date of pay.ent. Ta.e, ~hlch becao. delinquent bo'ore January I, 1982 bear Interost at tho rat. 0'
.IM (6~) p.rcont per .nnuI calculated .t a daily rnt. of .00016~. All taJI' which beca.e delinquent on nnd aft.r
J.nuary I, 19&2 will b.ar Int.rost at a rnto which will vnry fro. callndnr y.ar to cnlendar year with that rat.
announced by the PA Depart..nt of R.venue. Tho nppllcablo Int.re,t tates for 1982 through 199& are:
'!!!! Interost Rat. Dftlly Inl.rost rllelor ~ Inter..t Ant. Dnll., tnterut rllctor
1982 ZO~ .OOOS"8 19&7 "' .000247
19&3 16~ .DOOU& I1J88-191H lliC .OOUOI
198t, 1IX .000101 19'2 .~ .0002t,7
1985 m .OOOlS6 191J1-J!J'.. I~ .000192
1986 In .OOOU~ \IJIJS.IIJ9& "' .0002t,7
--Intor..t I. c.lculatld .. '0110....:
INTEREST = BALANCE OF TAX UNPAID x NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
"Any Notlc. Iuued aft.r the taM beco... dlllnquent will reflocl nn Inlernt calculation to 'ift"n ClSI days
b..,ond the date of the a".....nt. If paY.lnt Is .nde nfter the inter.,t co.putatlon date shown on the
Notlcl. nddltlonal lnt.rl.t IUsl b. c.lculated.
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REV-ls47 EX AFP 112-9SI*,
COHHONWUltll or fl(NHSVlVAHU
DLPAAUI[,I, or AlVINU[
BUREAU OF INDIVIDUAl fAJt[S i".'
DlPI. "SObOl
t1ARAIS!URG, PA 11118-0601 -=
EsTATE OF DIOIl[t' - -HAZIOC""V
DATE OF DEATH 08-07-95
NOTICE OF INIlERITANCE TAX
APPRAISE HE NT . ALLOWANCE OR DISALLOWANCE.
OF DEDUCTIONS AND ASSESSHENT OF TAX I
ACN 101
-..-
FILE NO.
COUNTY
DATE 07-29-96
21 96:0300
CUMBERLAtlD
NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT TIlE UPPER PORTION OF TillS FDRH WIlli YOUR TAX
PAYHENT TO TNE REGISTER OF WILLS. HAKE CIlECK PAYABLE TO "REGISTER OF WILLS. AGENT"
REMIT PAYMENT TO:
CHARLES E SHIELDS
2 W MAIN ST
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
Al'lount Relllit hd
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
iiEV:i5iii-EX-AFP--ii'2-:9S"i"NOificE--OF-i-NHER-ifAiicE-ifAX-jipPRA"iSEtiENT-,--ALi-oWAiicE-OR------------nm
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DEITLE HAZEL V FILE NO. 21 96-0300 ACN 101 DATE 07-29-96
TAX RETURN WAS: I XI ACCEPTEO AS FILED
CIlANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R.al Est.t. (Schedule A) (1)
2. Stocks and Bonds (Schedule OJ 12J
3. Closely Hald stock/PartnershIp lnterast (Schedule C) (3)
4. Hartg.gas/Not.. Raceivable (Schedula DJ (4)
5. Cash/Bank Deposits/Hisc. Parsonal Property IS~h.dul. E) I~J
&. Jointly Owned Property (Schedule F) (&)
7. Transfers (Schadule G) (7)
8. Total Auets .
.00
.00
.00
.00
b~G.!iO
2,704.88
.00
IBI
3.353.38
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Exp.ns../Ad~. Costs/Hlsc. Expanses (Schedule HI (91
10. Debts/Madgaga LiabiliUes/liens ISchedule U 1101
11. Total Oeductions
12. Hat Value of Tax R.turn
13. Ch.rit.ble/Governnental Bequests CSchedule J)
14. Hat Value of Estate Subject to Tax
7.383.46
241.79
Ill)
(12)
1131
(14)
7.~~~ ~~
4.271.87-
.00
4.271.87-
If an assessment was issued previously, lines 14, 15 and/or 1&, 17 and 18 will
reflect figures that include the total of ahh returns assessed to date.
ASSESSMENT OF TAX:
15. AMount of line 14 at Spousal rat. CIS)
16. AMount of line 14 taxable at line.l/Class A rate 116)
17. AMount of line 14 taxable at Collateral/Class Brat. C17)
18. Principal Tax Due
NOTE:
.00 X .00=
.00 X .06=
.00 X .15=
I1BI
.00
.00
.00
.00
TAX CREDITS:
PAY HE NT
DATE
RECEIPT
NUMBER
DISCOUNT It I
INTEREST 1'1
AHDUNT PAID
TOTAL TAX CREDIT I
IBALANCE OF TAX DUEl
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
. IF PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS TIlAN $1. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" ICRI. YOU HAY BE DUE
A REfUND. SEE REVERSE SIDE OF TillS FORH FOR INSTRUCTIONS. I
11(\' ISOO Il. 1'1,).&1
I 'OR OATIS 0' OIATH AnlR 12/31/91 CHICK HEAl
^~.:~\9l'1 INHERITANCE TAX RETURN '1'~o':,,::f.,ul:~OIlISCLAIMIO r]
...>~..,.. RESIDENT DECEDENT Ifill NUMBER q
COMMON""'''' 0' I'H"'",VA"" (TO BE FILED IN DUPLICATE I 1') I I q I.
(J(PAllfMWT or IIrVWUI I cT\ l.P
"..",fJ:~, ~~o:'):180''''' WITH REGISTER OF WILLS) ;COUt'" COOl Y1AR
OI(;;~~~~~:1 (;;;:?~~~ ~j.(J ~11lI)11 "l 1All 1"'I~I]I)::~ ~ I{~I~;~~ A;:~~:']]-~Hc~nt I faro.
!Ioc'A~isiClillllt' t'UMI{II fOAlt OIIJtAlti j'o'.'.'. '.J.'.'''''' ~ 10 lIouse ^ve. Camp IIi] 1, P^
"~7;~:t;~;2~,~;~",",.~"~" "" ",L~~,:~~.~ _r;;~,,~:~~~}:~'" ~. C"'"I';'~~I~.~",m';FT'~~"~)_u__~_____
~J 1 Original Return ] 2. Supple menIal Return ) 3 Remainder Relurn
(lor doles of dealh prior 1012.13.82)
{J 4. limiled Estate .J 40 Futuro Inleresl Compromiu, ] 5. Fedlnol hlole To... Return Required
(for dales of dealh aher 12.12.821
o 6. Docodent Died Testale ! ; 7. Deco dent Maintained a living Trusl
(Alloch copy of Will) (Alloch copy of Trust)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE OIRECTED TO,
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",00
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Oo'"
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20. If line 19 is greater Ihon line 18, enler the difference on line 20. This is Ihe OVERPAYMENT.
IiJO
Chock horo if you or. requesting a refund of your overpayment.
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'~AM(
Charles E. Shields III
HLIPHON( NUMlIl1I
I S - C/lc . lr
,
.....:J.l7 I
7.66-0 20 ~7.=C'_~=~~c_'c=, ,_"c-~
300
NUMBER
..0..8
T 0101 Numbor of Sale Depo,it Bo""
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:3
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1. Real e,tote (Schedule A)
2. Stach and Bonds (Schedule BI
3. Closely Held Stock/Porlnership Inlerest (Schedule q
4. Mortgages and Notes Receivable (Schedule 01
5. Cosh, Bank Deposils & Miscellaneous Personal Properly
15ch.dule E)
6. Jointly Owned Property (Schedule F)
7. Tran,fers (Schedule GllSchedule l)
8. Total Gran Aue" (Iotallinel 1.7)
9. Funerol e..penscu, Administrolive Cas". Miscellaneous
E.-.penses (Schedule HJ
10. Deb", Mortgage liobililies, liens (Schedule II
11. TOlol Deduction' (Iota I lines 9 & 10)
12. Net Value of estole (line 8 minus line 11)
13. Charitable and Governmental Beque," (Schedule J)
14. Net Value Subject to To... (line 12 minus line 13}
15. Spousal Transfers (for dates of death aher 6.30.94)
See Instructions for Applicable Percentogo on Rovene
Side. (Include volue, from Schedule K or Schedule M )
16. Amounl of line 14 toxable at 6% role
(Include values from Schedule K or Schedule M.)
17. Amount of lino 14 lo...able at 15% role
(Include values from Schedule K or Schedule M.I
18. Principal 10... due (Add 10... from linus 15, 16 and 17.)
19. Credih Spousal Poverty (rrdit Prior Payments
o + 0_____ ~_ ~
(O~Ptt H MAILING AODIlI~!1
2 \'1 ~1ain Street
Mechanicsburg, P^
17055-6231
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-------- ----.- _..--_._-,-~---
------..-------...------.--- . -..--.------ -_..._._~_._---_.
(61
17)
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$648.50
~~ ..$2,704.88
__uOu
111
( 2)
13 )
( 4 I ~
15)
(9)
_$7,}83.46..
$ 241. 79
(81. .$3,353.38.________
(101
(III
(121
(13)
(141
$7 ,62~2.?___
o
__.0
o
(15) 0
(16) 0
(171 0
Discount Inlerosl
+ 0 0
-.-
x.
=
o
x .06 =
0______________
x .15 =
0-
o
(181
(lQI
(20)
o
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21. If lino 18 is grealer Ihan line 19, enler Ihe difference on line 21 Thil is Ihe TAX DUE.
A. Enter Ihe interest on Iho balance due on line 2tA,
B. enter Ihe 10101 of line 21 and 21A on lino 218. This i, the BALANCE DUE.
Make Ch.ck Payabl. to: R.ght., of WiIls,_Ag.nt
>- >- BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~
Under penalties of perjury, I declare Ihot I havo e..omined Ihis r"lurn. including accompanying schedules and Italemenlt. and to the besl 01 my ~nowledge and belief,
it is true, Correel and complete. I declare Ihat 011 real o,tale has beon reported otlruo mar~cl value. Declaralion of preparer olher than Ine personal represenlalive is
based on 011 information 01 which pre parer has any ~nowlodge
!I1(;NAIU '!I RE!lPOt~!Ill1lf '011 '1lING A(IUA~~ AODiiI~-s~2120N~_:Niiie~.Rtl~~--"--.---". _~___~w____.___ ---~ DAlI
/ 9r- ~ , C:u:1is1c,l'A 17013.. _ _ ~!_....!:..~~__
_~I ~I.~' PIl.II:1PA~A(Il(ll_(O'.~IHA'~. 2 \V to-l1in St. D.'.'~'I' P-1t>__
~c::: Mechnnicsburg,- P^ ~ 17055---
1211
(21A)
12161
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(OMMO.... ~ "llH a. "M.HI~""""
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.1\101N1 r,t(lfll'.l
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
_ __ ...._.__JFI_~.~~MB~~_....._uu__~_u_
HAZEL Y. DEITIE
Join' tonont(.I.
NAME ADDRESS
--------- --------- -----.-- --- ------------_.---
A. Jennie E. Gates 540 Mt. Zion Rd.
Di11sburg, PA 17019
RELATIONSHIP TO DECEDENT
...----.------ ---_.----
daughter
B. Ibbert M. Yantz
2120 Newville Rd.
Carlisle, PA 17013
son
C.
I
I
~
Jolntlv.ownod proporly:
ITEM LETTER DATE
FOR TOTAL VALUE DECO'S DOLLAR VALUE
NUMBER JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTE
TENANT JOINT
1. A. /-bre Mellon Bank Checking AcCOLlIlt $2,781.05 50 $1,390.52
than #222-109-7013
one (see letter from Mellon Bank
year attached) . I
before I
d.o.d.
2. B. /-bre PNC Checking AcCOLlIlt $2,628.72 50 $1,314.36
than # 51-4042-7527
one (see latest accoLlIlt statenent
year from PNC attached)
before
d.o.d.
I I
,
I
I
I I
I
.__~____.J__u__ -- --~-
TOTAL IAho cnlcr on line 6. RC,OPilUIOI;ond 52,704.88 -.-..
---.------.-------------. ..------.----..-------.------.
(IF more space is needed insert oddll;onal sheets 0' mme sile)
OF
REST
GENERAL INFORMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAX ASSESSHENT with IIppllcabl. Inter..t bUild on Inforeatlon
lub.Uhd by the flnanellll Institution.
l. Inh.rltance ,.. beea... dellnqullnt nlna aonthl 1I"ar the decadant', dill. of death.
S. , Joint account I, '..lIbl_ aVlln though tha daclldant', n/l.. Will lidded "' II ..tt.r of convenlenc..
4. Account. Clncludlng tho.. held bat",..n husband IInd wlf.1 which the decadent put In Joint na... within on. Yllllt prior to
d.ath .t. fully '...bl. "' Iran,'.r.,
~. Account. a.tabll,had Jolntlv bat",..n husbllnd nnd wlf. aor. than one y.ar prior to death II'. not III_ablll,
6. 'ccountl hald by II dacad.nt "In trult for" a"other or other. IIr. '._abl. fully,
REPORTING INSTRUCTIONS - PART
I
- TAXPAYER RESPONSE
1. BLOCK,. I' th. Infor.atlon and co.putallon In the notlc. Ar. corract And daductlon. ar. not baing clnl..d, plac. 8n "X"
In block ~A" 0' Part I 0' the "Ta.pay.r A..pon'a" .actlon. Sign two copla. and subalt the. with your ChIck 'or the a.ount 0'
t.. to tha Alghtar 0' IIl1h 0' the county Indicated. Tha PA D"part.lnt 0' Ravanua will Issua an official assll..ant
(for. A[V-IS~a [X) upon r.c.lpt 0' the raturn Ira. the Aegl.tlr 0' Will..
Z. BLOCK I . If the a...t ,p.clflld on thl. not Ie. has baan or will b. rlparted and tax paid with the Plnn.ylvanla Inh.rltanca
Ta. A.turn fllad by the dacadent'. raprl..ntatlvl, plac. an ~~" In block "I" of Part I of tha "Ta.payer RI.pon.l" .octlon. Sign on.
COpy and r.turn to tha PA Dapart.ent of RavanuI, Bureau of Individual Ia..., Dlpt laObOl, tlarrhburg, PA I11Za'0601 In the
Invalap. provldad.
5. BLOCK C . " the notlc. Inforaatlon I, Incorrlct andlor deduction, ar. baing clal'ld, chIck black "C" Dnd co.pllt. Parts Z and 5
ltccordlng to the IM,tructlons balaw. Slon twn cODl1I and ~ub.1t the. with ..our ('hack fnr tt'!. It.ount of tAX pnyahle to th_ Raqlstar
0' Will. 0' the county Indlcatld. Tho PA Dopart.lnt of Ravanua will I..ue an official a'.o....nt (ror. REV-15~a EX) upon rocolpt
of the r.turn fro. tha Algl.ter of Will,.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Entar
NOTE:
tha data the account originally wa, ..tabll,hed or tltlad In the .anner e.l.tlng at data of dlath.
For a decadant dying aftar Il/lz/al: Accounts which the dacedant put In joint naal. within onl (II yaar of daath ara
tllxabl. fully a. transfar,. How."'.r, th.r. Is an a.clu.lon not to ..caed 13,000 por trans far.. regardIG.. of the valua 0'
the account or tha nu.b.r 0' accounts hald.
If a doubla ast.rlsk (..) app.ar. b.for. your first naea In the addr... portion af thll notlca, the 15,000 ..cluslon
alr.ady ha, b.an daduct.d froe the account balanc. a. r.port.d by tha financial Institution.
Z. Entar the total balanc. 0' the account Including int.ro.t accruod to the data of daath.
5. Th. parc.nt of tha account that Is ta.able for .ach lurvlvor Is dator.ln.d a. follows:
A. Th. parcant ta.abl. for joint a..at. .stabllshad aor. than on. y.ar prior to tha dec.dant'l daath:
DIVIDED BV TDTAl NUHBER DF
JOINT DWNERS
E.a.pla: A Joint a..at r.glstar.d
DIVIDED BY TOTAL HUHBER OF X 100 . PERCENT TAKABLe
SURVIVING JOINT OWNEAS
In tha na.. of tha d.cadant and two oth.r p.rsons.
1 DIVIDED BV 1 (JOINT OWHrRS) DIVIDED BV l (SURVIVOAS) . .161 X IDa . 16.1~ eTAXABLE rOR EACH SURVIVOR)
B. Th. parcont ta.able for all.t, cr.at.d within one yaar of tha dac.d.nt's d.ath or nccount. own.d by the dac.dant but hald
In tru.t for anoth.r Indlvlduale,) (tru.t b.neflclarlos):
1 DIVIDED IV TOTAL HUHBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARI[S
X 100 . PERCENT TAXABLE
Ewaapl.: Joint account r.glstor.d
the d.cad.nt.
1 DIVIDED IV Z (SURVIVORS) . .~O
In tho na.a of the d.cadant and two oth.r p.rson. and a.tabll.had within ana y.ar of death by
X 100
~O:C (fAXABlE FOA EACH SURVIVOR)
4. Th. a.ount ,ubject to ta. (1In. ~) I. det.relnad by aultlplylng the account balanc. (1In. 21 by the p.rc.nt ta.abl. elln. 1).
S. Entar the total of the d.bts and daductlons II.tad In Part 1.
Ii. TI.. eoo.mt tall.cle (llna 61 I. d.h'lln.,c:: ty subtractl.lq t:,. lI'~~: &~~ ~'~u:tl::::'I' ~llna 5) tres tl'-o a..cu.,t 1\,o~jOCt to t;'l;,c tllns '.).
7. Entar the appropriate ta. rat. Cline 1>> a. det.r.lnad b.low.
.
A. For d.t.s 0' daath occurrlnQ aft.r 6/10/94, the tax rat.s for tran.f.r. to Ipou.as are a. followl:
I. Oat., of d.ath on or aft.r 1/1/94 and b.for. 1/1/9S tha rat. I. 5:C.
Z. Dat.. of d.ath on or a'tor 1/1/95 transf.rs to spou... will b. ta..d at o~ ta. rata.
Not.: For dat., of d.ath prior to 1/1/94 transf.rs to 'POUI.. ar. tn.abl. at 6iC.
B. Tran.far. to Ilnaal d.,c.ndant. Including falhar, aoth.r, son, daught.r, grandchlldr.n, .0n'ln-law,
daught.r-In.law, st.pchlld and th.lr Is.u. are ta.abl. at .1. per cant (6iC).
C. Tran"ar. to all oth.rs Including broth.r, II.t.r, uncle, aunt, n.ph.w and nl.ca are ta.abla ftt flfte.n perclnt (15%).
D. If YOU change tha ta. rat., pl.al. sp.cl,y your r.latlon.hip to tha dlc.d.nt In tha arl. provided.
a. Th. a.ount of tax dua (llna a>> Is d.t.reln.d by aultlplYlng the nlount taxabla (1In. 6) by tha taw rat. (1In. 11.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabll dabt. and daductlon. ar. d.t.r.ln.d al follow.:
A. You logally lira re.pon,lbl. for pay..nt, or th. a.tat. .ubj.ct to adalnlstratlon by a par.onal r.pr.s.ntatl",. Is Insufficient
to pay tha d.ductlbl. It.a..
I. You actually paid tha d.bt, aftar d.ath of the dec.d.nt and can furnl.h proof of pay..nt.
C. Dabt. baing clal.ad au.t b. It..lled fUlly In Part 1. If additional .pac. I, n.ldad, u.. plain papar a 1/2" . 11". Proof of
payl.nt .ay ba r.quastad by tha PA D.part..nt of A.vanu..
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. TDD' (717) 772-2252 (HEARING IMPAIRED ONLY)
11..,.15I1II.,JllI
.t~
CO.......O..WI...i'HOf ,tt~N\'lV"'W'"
INHUllANC. tAX InUIN
IUlOIN' DICIDIN'
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
HAZEL Y. DEITLE
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
1.
A. TOl'l.able Bequesh:
Rebert M. Yantz
2120 Newville Road
Carlisle, PA 17013
Son
1/5
2.
Jennie E. Gates
540 Mt. Zion Road
Dillsburg, PA 17019
3. Bonnita K. Napoli
507 C1estnut Grove Road
Dillsburg, PA 17019
Daughter
1/5
,
,
i
I
!
Daughter
1/5
4. Dorothy L. Cae
3902 W. Northwest Highway - Apt. llOW
Dallas, TX 75220
5. Richard Shirey
Route 4, Box 200
Live Oak, FL 32060
Daughter
1/5
Grandson
1/5
I
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmental Bequesh:
1.
I
, .
,
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o en..r on line 13. Re,opilulo'ion) S
(If ma,e space I. needed, Inse,l additlanal.heets af lame site)
-. -. ~.. ....
,
PURPOSE OF
HOnCEI
To fulfIll the requlre.ent. of Section ZI40 a' the Inherltanc. and E.tate lax Act, Act ZZ of 1991. t7Z P.S.
Section Z140).
PAYHEH1:
Detach the tap portion of this Hotlce and sub.lt with your pay.ent to the Register of Will. printed on the
revers. .Ide.
u Hake check or .oney order payable to: REGISTER Of WILLS, ACENT.
All pay.ent. received shall first be applied to any Interest which .ay be due. with any re.alnder applied to the tax.
REfUND tCR):
A refund of a tax credit, which was not requested on the tax return, .ay be requested by co.pletlng an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-llI3). ApplIcations are available at the Office of
the Register of Wills. any of the Z3 Rovenue District Office. or bv calling the special Z4.hour an.werlng service
nu.ber. for for.s ordarlngl In Pennsylvania l-eOO-36Z-Z0S0, outside Penn.vlvanla and within local
Harrisburg araa (717) 787.e094, 1001 (717) 77Z-ZZSZ (Hearing I.palred Only).
DeJECTIONS: Any partv In Interest not satl.fled with the appralse.ent. allowance or disallowance of deduction. or assess.ent
of tax (Including discount or Interest) as .hown on this Hot Ice .av Object within sixty (60) days of recalpt of
this Notice by:
.-wrltten protest to the PA Depart.ant of Revenua, Board of Appaals, Dept. Z810Z1, HarriSburg. Pi 17Iza-10ZI, DR
ualactlng to have the ..ttar deter.lned at the audit of the account of the personal representative, DR
--appeal to the Orphans' Court
ADHIN-
ISTRATtYE
CDRRECTIONSI
Factual error. dl.covered on thl. assess..nt should b. addre.sed in writing to: PA Departeent of Revenue,
Buraau of Individual Taxes, ATTN: Po.t Ass....ant Ravlew Unit, DEPT. ZB0601, HarriSburg. PA 171za.0601
Phona (711) 787-6505. See page 3 of tha booklet "Instruction. for Inh.rltance Tax Return for a Ra.ldent
O.c.dent" (REY-ISOl) for an e.planatlon of adelnl.tratlvely correctable errors.
DISCOUNT:
If ani tax due Is paid within three (3) calendar aonths after the decedent'. death. a flve pereant CS;()
dl.count of the tax paid Is allowed.
INJEREST:
Intere.t I. charged beginning with first day of delinquencY, or nine (9) aonths and one (I) day
froe the data of death, to the date of pay.ent. Ta.es which beca.e delinquent before January 1. 19aZ
b.ar Inter..t at the rata of .Ix (6;() percent per IIMU. calculated at a dallv rftt. of .000164.
All tax.. which bee... delinquent on or afhr January I. 1911Z will bur Interest at a rate whiCh will varv fro.
calendar year to calendar y.ar with that rat. announced by the PA Depart.ent of Revenue. The appllcabla
Interest rate. for 19&Z through 1996 are:
'Wr Int.rest Rl!Ite Dallv Interest Fftctor !m Inter..t Aftta Dallv Int.r..t Fac:tor
19&Z Zo;c .ODDS4& 19&1 .. .DOOZ47
19&3 16:( .000438 19&8.1991 11% .000301
19&4 11% .000301 1992 9% .OOOZ'"
19&5 In .000356 1993-1994 1% .00019Z
19&6 10% .000Z74 1995.1996 9% .000Z,,7
-- Int.re.t I. calculatad .. follow'l
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
-.Any Notice Issu.d ft,tar tha taM beco.es delinquent will r.flact an Int.re.t calculation to flfte.n (15) days
beyond the data of the a.......nt. 11 pay.ent It aada aft.r the inter.st co.putatlon date shown on the
Hotlce, addItional Int.r..t .u.t b. calculated.