HomeMy WebLinkAbout96-00364
COMMONwEALTH or P[HHS~LVANIA
OEPARIHEHT OF REVEHU(
BUREAU Of INDIVIDUAL IAXES
DEPT. :aO&OI
HARR1SBUQC, PA 11lla-obOI
~
/j-'Ii.Y) -1
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
FILE NO. 21
ACN 96108270
DATE 03-14-96
(( (,. ~ (p "
TVPE OF ACCOUNT
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00 CHECKING
o tRUST
o CERlIf .
ES't. ~~ :HCMA~ H lAt!~
5.5, NO. 203-10-6554
DATE OF DEATH 11-04-95
CDUNTY CUMBERLAND
HELEN H MACKENZIE
17 KINGS ARMS
MECHANICSBURG PA 17055
RENIT PAYHENT AND fORNS Tal
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
NELLDN PSFS h" p,.vld.d 'h. D.p",..n' .lth 'h. Inf.'.."on 1I...d b.l.. vhl,h h" b..n .,.d In c.lc.IO,I... 'M
p.,.n'I.1 ,.. dU.. lh.l, ,.,.,d' Indl'.'. 'h.' ., 'h. d...h .. 'h. .bOv. d.c.d.n', ,.. ..,. . j.ln' ..n.,'b.n.fl,I." .f 'hi. .".un',
If ,.. ...1 'hi. Inf.,..'I.n I. In'.".'" pl.... .b,.ln .,I".n ,.".c.l.n f,.. 'h. flnoncl.1 In.'I,.,I.n. .".ch . c.P' '0 'hi. f.'o
~ "..~ ,. .. .., ~~ ~"'" .... ~~. ,. ....... " ~~,~ ..,. ,~ .~,..... .~ ,~. ., ~ ~.,~ .. ~.~,..
'_' ..I.l:.~: ~:.~...: -:......,...... k!' -:.I1I"1J 1117\ 7A7"'11.
COMPLETE PART 1 BELOW · ·
Account No, 252-112-5258
. SEE REVERSE SIDE FOR FILINl.i AND PAYMENT INSIRUCHONS
Doh 10-28-88
EshbU,hod
To Insurl prOPlr crldlt to ~our account, two
(2) copils of this notlc' aust accoapan~ ~our
pBy.ent to the Rlglster of Wills. Mak' check
paYBble to: '"Register of willi, Avent".
PART
m
1.679.56
50,000
839,78
,15
125,97
:
TAXPAVER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED OH THIS HOTICE
Account Balance
Percent Taxable
A.ount subject to
Ta)( Rate
potential Ta)( Due
HOlE: If tB_ pa~.ents are 'Bdl within three
e,) 10nthS of the decedent" dBte of death,
~ou .ay deduct a 5% dIscount of the ta_ dUe.
Any InherltBncl tB_ doe will becO.e delinquent
nln. (9) .onthS after the date of dlath.
x
To'
x
.. r:J lh. .b.vO Infa,..'lan .nd ,.. duo I' c.".c,.
I. v.. .., ch.... '0 ,..1' p.,..n' .. 'h. ...1"" .' will. wl'h ,.. capl.' .f 'hi. no,lco 'a ob'oln
. dl.caun' ., .v.ld In""'" ., Y.. ..y ch.ck b.' ... .nd ,...,n 'hi' na.lc. .. 'h. ...1".' .f
will. .nd .n .f.lcl.1 ........., .111 b. I..... bY 'ho P' D.P."'on' .f ..v.n."
[CHECK l
ONE
BLOCK I
ONL V -'
!. ~ 'h~ ,"~". ",,' ,,' b"n .' will b" ,""",'.d """ t., ..Id .I'h 'h. p.nn.,lvenl. Inh.,I,.nc. I.. ,o,.,n
,. b. fII,d b' 'h' d..,den'" ,..,...nte"v,. 00
C _ ' :0
c. r:J lh. ob.v, In.o......n 1. Inca"'" .nd/o' d,b" end d.duCU.n, .". p,Id:1>PyOU. ~ ?J '"
Va. ..., ,..plo" p..l 0 """,., p..l IT] b.I.... c' ' ,.: ~~
OFfICIAL E ONLY? 0 AAF
PA DEPARTME"' OF REVENUE
.', ._t :.. l.)
~ ..',
,
PART
~
TAX RETURN _ COMPUTATION OF TAX ON JOINT/TRUST
LINE 1. 0.\. Es ~.bl uh.d :.
2. Account aelanea 2
3. Percent Taxable 3 X
4. A~ount Subject to Tax 4___
5. Debts and Deductions 5
b. A.aunt Taxable b
7, ta. Rato 7 X
8. lax Due 8
ACCOUNTS
PAD
<ri
;:''''
... ~
1.&
...,
2
~~
5
6
7
8
CLAIMED
vI..
:-- -.
~
~
DEBTS AND DEDUCTIONS
AMOUNT
PART
~
DATE PAID
DESCRIPTION
PAVEE
:..-
I
t
TOTAL (Enter on Line 5 of tax toaputation)
Under panalti.. of perjury, I declare
. , c.".lot, to ~hO ~..t of. "y )<n~dg.
I.h- U.L~ f.J-. )1",,- t:'LL'- '- ,(..... ~\..
I have reported above ara true, correct and
(1/'-1) /t.l.;.. 3c{.D
(# )
--
DATE
=
-
PAID
-
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with IIPpllcabl. Int.rut bltud on Infar..tlon
subalttad by the financial 1n.titutlon.
Z. Inheritance taM baea... delinquent nln. lIonths afl., the decadentOs dllt. of allath.
1. A Joint account I_ t..abl. lI",an though thll dacadent's nil.. Will added .1 II alltter of convenlenclI.
4. Account. {Including thO'. hald batw..n husband nnd wlf.1 which Ihe decadant put In Joint nall.' within on. YlIar prior to
d..th .,. 'U!JY \a_dul.. dtl u ... ,,,f lOll SO
S. Account. ..tabllshlld Jolntlv b.twII.n husband Bnd wlf. liar. than ana Yllar prior to dll.th ar. not t.Mable,
6. Account. held by . dlleedent "In trust for" another or olh.r. "r. taxable fully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAVER RESPONSE
1. BLOCK A . If the lnfor..tlon and co.putatlon In the notice are correct and deductions are not being clal.ed, pl.ce an ~X~
In block ~A~ of P.rt 1 of the ~f.~payer Ralponse~ section. Sign two copIes ftnd su~lt the. with your check for tha aaount of
tax to tha Raglstar of Wills of tha county Indicated. The PA Depart.ent of Revenu. will lssu. an official .ss.....nt
(For. REV-1548 EX) upon receipt of the return fro. the Roglster of Wlil..
Z. BLOCK a _ If the aSlet sp.cifled on this notice has bo.n or will be reported and tax paid with tho Pennsylvania Inherltanca
Tax Return filed by the decedent's repres.ntatlv., place an ~X~ In block "a" of Part I of the "Taxpayer Relponse" section. Sign one
copy and return to tha PA Depart.ent of Revenue, Bureau of Individual Taxes, Dept Z8060l, HarriSburg, PA I11Z8-0601 in tha
anvelope provld.d.
3. BLOCK C _ If the notice Infor.atlon Is Jncorrect andlor deductions are being claJ.ed, check block "C~ and co.plete Partl 2 and 3
according to tha Jnltructlonl below. Sign two caples and sub.lt the. with your check for tha a.ount of tax payable to the Regllter
of Will,:, .o:f t!'le ~ou..t.. I..to'..et,... Tt... at I!l:.."..~~.....t :If ~:::....~.." orll_!. t~~.l1Z .~f :'If,!..!~t ~:..':..!'........t H'~,.., ru:u_!~<:." C:~, ';-:0:" !":,:.!:,~
of the r.turn fro. the Regllter of Will..
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Entar
NOfE:
the date the account originallY wa. established or titled in the .annor existing at date of death.
For a decedent dying after IZ/1218Z: Accounts which the d.cedent put in joint na.as wJthln one (I) year of death are
taxable fully a. tran.fer.. How.ver, thore I. an e~clu.io" not to e.ceed 13,000 per tranlferee regardle.s of the value of
the account or the nu.ber of accounts held.
If a double ast.risk (..1 appe.r. bafore your first na.e In the .ddre.. portion of thJs notJce, the 13,000 e~clulion
.lteady has been deducted froe the account b.lance .. reported by the flnanclal In.tltutJon.
2. Entar the total balance of the account Including Int.re.t accrued to the date of de.th.
3. Tha parcant of tha .ccount that I. t..able for each lurvlvor is datar.lnad as follow.:
A. the parcant ta.abl. for joint allets eltablished .or. than on. ve.r prior to the decedent's death:
DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
Ex..ple: A joint alset regl.tered
DIVIDED BY TOTAL NutlBER OF X 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the na.e of the decedent and two other per.on..
1 DIVIDED BY 3 (JOINf OWNERS) DIVIDED BY Z (SURVIVORS) . .167 X 100 . 16.7~ (TAXABLE FOR EACH SURVIVOR)
B. The percent ta.able for .s.ets creat.d within one ve.r of the decedent's death or accounts owned by the dac.dent but held
In trust for anothar Indlvldual(s) (trult b.naflcl.riesl:
I DIVIDED BY TOTAL NUHBER OF SURVIVINC JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
Ex..ple: Joint .ccount raglatared
the decedant.
I DIVIDED BY 2 (SURVIVORS) . .sa
In the na.a of tha decadent and two other parsons and astabllshed within one y..r of daath by
X lOa
50% (TAXABLE FDA Uti; :OURVIVOh)
4. The a.aunt subjact to tax (1lna 4) ls dater.inad by .ultlplvlng tha account b~lance (1In. 2) by the parcent t.~able Cline 3).
S. Entar tha totel of tha debts and deductions llstad in Part 3.
6, Tha alKl...,t t.lIIabla Uln. 6) Is dataralned bV subtractinG tha dabtl end d.ductlonl (lIn. 5) fro. the a.OW1t lubject to tu (IIn. 41.
7 r:..t.,. tt>. "oornert"t_ t".. ,."tn (line 71 liS det.rainad ~.low.
A. For d.tes of d.ath occurring aft.r 6/30/94, the tax ratas for tr.nsfers to .pou.a. are al follows:
1. Oatas of daath on or aftar 7/1/94 and b.fora 1/1/95 tha rat. Is 3%.
2. Dates of da.th on or .ftar 1/1/95 tranlfers to spousas will ba taxad at 0% tax rata.
Nota: For data. of d.ath prior to 7/1/94 transfars to spouses are ta.able at 6~.
a. Transfarl to lineal d.scendants Including father, .othar, Ion, daughter, grandchildren, son-in-I.w,
daughtar.ln-I.w, It.pchlld and thalr ISlua ara ta~abla at lix percant 16%).
C. Tr.nsfers to .11 othars Including brothar, slstar, uncia, .unt, nephew and nlace ar. taxable at fift.en parcent (15%).
D. If you change the tax rate, plaa.a spaclfv your ral.tlonshlp to the dacadant in tha ara. provided.
a. Tha a.ount of t.x due (1lna 81 is det.r.lnad by .ultlplving tha alKlunt taxable (Ilna 61 by tha tax r.ta (1lno 71.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabla debta and deductions ar. detar.lned as follows:
A. You lagallv ara ra.ponsible for pay..nt, or the e.tate subject to adelnlstratlon by " p.rlon.1 raptesant.tlve II Insufflclant
to pay tha daductible Ita.s.
B. You actually paid the debts aftar d.ath of the d.ced.nt and can furnilh proof of pay..nt.
C. nebts baing clal.ed .ust be ite.ll.d fully in Part 3. If addltion.l spac. is n.edad, u.a plain papar 8 I/ZR x II". Proof of
pay..nt .ay b. requ.stad by tha PA oepart..nt of Rav.nu..
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. TAXPAVER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY)
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D NO, AA
146594 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
dlk
RECEIVED FROM,
ACN
ASSESSMENT l'l'
CONTROL ~
NUMBER
AMOUNT
INllUlxt....'
D
101
~J~;J.'f7
MICHAEL W GANG ESQUIRE
417 WALNUT STREET
ONE COMMERCE SQUARE
HARRISBURG, PA 17101-1904
ESTATE INfORMATION,
~ filE NUMBER
~ 21-1996-0364
!II NAME Of DECEDENT (LAST)
~ LANE THOMAS H
II DATE Of PAYMENT
EI POSTMARK DATE
COUNTY
SSN 203-10-65511
(fiRST) (MI)
CUMBERLAND
DATE Of DEAlH
')125.97
Vz
fa TOTAL AMOUNT PAID
REMARKS
NVMA PLANE
CIO MICHAEL W GANG F.SQ
CHECK" 219
, '
(/ / ('_../
, ' ,
RECEIVED BY . /,{, l' I { -../ d<'.">/ /: v'
, / SIGNATURE . . t
- / / .' ..G,.. t
MARY C. LEWIS '.. ,"'~ "
REGISTER OF WILLS . .
1
SEAL
REGISTER OF WILLS
'1....
t"
.'
.__1
-~
-.- : _.__m .-----""ll.~.j.
10. -; '"1:,:.
I
,
1"1)09 I:'. (IIUI
'*'
CQMMONWUUH 0' 'ENNSYlVANIA
INNUIIANCI v.x lIlUIN
IUIDINT DICIDINT
SCHEDULE F
JOINTLY.OWNED PROPERTY
I FILE NUMBER
ESTATE OF
'lhanas H. tane
Jolntt,nont(.).
NAME
A. Helen H. MacKenzie
ADDRESS
Church of QXi Hare, Inc.
801 North Hanover Street
Carlisle, PA 17013
RELATIONSHIP TO DECEDENT
Cousin
B,
C,
Jolntly.own,d property.
ITEM LmER DATE DOLLAR VALUE OF
FOR TOTAL VALUE DECD'S
NUMBEI JOINT MADE DESCRIPTION OF PROPERTY OF ASSn %INT, DECEDENT'S INTEREST
TENANT 10lNT
1. A 10/88 ~llon Bank Cliecking Account 1,679.56 50% 839.78
11252-112-5258
TOTAL (Aha enter on line 6. Recapitulation) S
(II mort spaCt is ""d.d insert addj,jonal sheets of som. size'
. lI'llUIIII. 1"11
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
(OMMONWIAltH or "NNsnVANIA
INHI.nAhCf TAX .nUIN
.UIDIN' DICfDfN'
Ploa.o Print or Typo
FilE NUMBER
E F
'1hcmas H. Lane
ITEM
NUMBER
A. Funoral Expon.os:
1.
2.
3.
B.
1.
DESCRIPTION
Myers -Hamer FUneral Hare, Inc., Canp Hill PA (burial)
Ccmnissioned Officer's ness, Naval Inventory Control Point,
l>Echanicsburg, PA (focxi and refreshnents)
lbthernel's Florist, l>Echanicsburg, PA (flOlo.t!r5)
Admlnistratlvo Co.ls:
Personal Representative Commissions
Social Security Number of Personal Represenlotive:
Year Commissions paid
2. Anorney Fees
3, Family Exemption
Claimant Relationship
Address of Claimant 01 decedent's death
Slreet Address
4.
C.
1.
2,
3.
4.
5.
6.
7.
8.
City
Slate
Zip Code
Probate Fees
Mlscellaneou. Expen.es:
TOTAL (Also enter on line 9, Recapitulalian)
(II more spaco I. needed, In.e,t additional .heels 01 .ame .i.o.)
AMOUNT
6,29B.00
1,205.94
6B.90
$7,572.B4
retain or sell articles of tangible personalty or distribute them
to a minor or any person to hold for the minor or to the minor's
estate.
o . 1IQllil.
shall be required to
jurisdiction.
No Executor or Guardian acting hereunder
post bond or enter security in any
IN
my Last will
WITNESS WHEREOF, I have~et my hand and seal to this
and Testament this / fl"day of f;v ,,,~ r ' 1991.
~Jt~Ll
signed, sealed, published and declared by Thomas H.
Lane, the above-named testator, as and for his Last Will and
Testament, in the presence of us, who, at his request, in his
presence, and in the presence of each other, all being present at
the same time, have hereunto subscribed our names as witnesses.
k. rk#(v.
~() 3 WlVt(Ir,/CWh Rd. ~~
Address
iJ f'. Mo.,'" St. Mowd-~ fltJ1S'S)..
Address
!.Jw9 ~/
JJ5" Cn;. eJ {h~JI.J/~ ./')011
Address ----0-
2
ACKNOWLEDGMENT OF TESTATOR
COMMONWEALTH OF PENNSYLVANIA
.
COUNTY OF Dallpk\J\
.
.
ss.
I, Thomas H. Lane, the testator whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my last will; and that I signed it
willingly and as my free and voluntary act for the purposes
therein expressed.
Sworn to or affirmed and acknowledged before me by
Thomas H. Lane, the testator, this /1.,,!. day of A~&.<~r
1991.
~NJ~-
Thomas H. Une, Testator
WwJ
At~rney
,
s~~on
of Attorney
C'Jft'CIMAL," 01 JlI(MNln YANIA
DlJIAlnmn 01 Rl\'DI.R
...... or INDIVlllUOL lUll
OOT. 11"11
KAIIII"",'A 1111'."'1
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONse
I'ILI NO. 21
AC" 96108270
DATI 03-14-96
TYPE OF ACCOUNT
!::ST. OF THOMAS H LANE 0 SWIIlllS
S.S, ND. 203-10-6554 !Xl CHlCKINII
DATE DF DEATIl 11-04-95 0 TItUST
COUNTY CUMBERLAND 0 cunr,
REHIT PAYHENT AND ro~ TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
en.lN. a tIf .,...,
HELEN H MACKENZIE
17 KINGS ARMS
MECHANICSBURG PA 17055
MELLott ftSFS h.. provided the o..r.....t 1lI1Ut the Infor.tlon thted billow w,1d'l hII. bMn uMd In nlcullU"l the
,ot.,U.l t.. dUe. TMlr rHord. Indlc.tl tNt It the dNtn of tN .oov. decedent, you wer. I Joint OIlMr~f1cl.,.y of th" KCGUnt.
11 you '..I thlt In'aratlon I. Incar,,"t, '1.... Dbtaln witt., correction frOll the financial InlUtuUon, Itbctt I ~>> t. thh '0,..
and nturn It to the IbcrvII Iddra... ThI. KC~t 11 tulbll in IOCGrdlnce 1lI1ttl thII lm.rltWtCI fax L.... of the eo.on....Uh 0' P"'Qlv."la.
~S.tJ~"\2 =r ':2 '''9W1''~ !)l' ClIIlIl"tI (717) lA7"'''7.
COMPLETE PART 1 BELOW. . . SEE REVERSE SIDE FDR FILINU AND PAYMENT INSfRUCTIONS
Account Ho, 252-112-5258 D.t. 10-28-88
EatabUahed
Account 181...... 1.679.56
P.~cont Taxable X 50.000
A--.t SUbject to Tax 839,78
Tax R.te X .15
PotonUel Till< Due 125 ,97
PART TAXPAYER RESPONSE
1Il1. 'AllURE TO RUPGMD WILL RlSUl.TIII\<~)OI!Jlt~IAL:.TAX A8$!SSII!HT;IASIUtOli,,1H%S NOTICE l
.. 0 The 1Ibov. In'or.tlon ... ta dUrI It correct.
1. You All' choo.. to r..U ~t to the R...."r 0' "1111 with two copl.. of Utll notice to otJt1Iln
, dhcomt or lYOid Int....t, or you .-y chedt box .... ... return this notice to u. R..I.hr of
will. and ., offlelll .....__t Mill be Is...... by the PA Dep.r~t of A..........
To InlUt'. praper credit to )'OUr ~t, two
(Z) cop I.. of thh notle. .....t K~""".,y your
pa~t to the A....t.,. of "IUI. .... check
p'.-ble tal ~..I.t.r .f "Jl1., &oint..
HOTEl If tu pa~tI .... ... ..Ithln thr..
(S) ItOl"Ith, of the doc.Ident.. dlte of dMUt,
you IIY deduct . SX dlscou,t of tne tu: 0..
Any IMer!t~ tu 0. will beooeI dell~t
n1M (t) Itonth. after the dlt, of death.
[CHECK ]
ONE
BLOCK
ONLY
I. 'iJ Th. above ....t hu been or Mill bII r....ted .-,d tu Hid with the Pwrlnlvenla r""'r!tWICI Tu return
to " 'Illld by tN decedent'. r......Mr'lt.U",..
c. 0 TM abov. In'or.tlon 1J...-1.ncorrect ..sIo~t. and doductlon. war. plld by YOU.
You ...It c.,.l,t, PAaT l!.J flflJOf' PUT l!J bel....
If you 1ndle.t. . diff.rent tax rat., pI.... .t.t. your
roleUonlhlp to dee_II
PART
[!J
DATE
DEBTS AND DEDUCTIONS
.';'OFFICIAlt USEONt YI? EJ AAF
",c"..'",, PA" DEP.A!U~Jn::' O""'RE\lENUE~l", .'
"PAm-~Y;: :~.. :.:;~- Y;!'<:~'ll;.J~~~J::>:~:: ~~~~j....:,~-:,.,::--.:".-: :'.,:
~ ~~':::~:i~~~~.";" '" .:.:~';~;~J~ .~'t;~;;'~,~",:,,;:::-: :.;.....;,~:.. ~,:., :.,'v :....:
,.. :- -,:;:i~;;:::::':";:'; ;:.!-'-;.:.;.':::..:.....'.:;.)~~;,~: '::~.,-, ','.... '.'.' .'
: ~~F; ", .'.;,n.... .::T.:!;!-:::':":~ti~~t'~.....;..-:',:
~:_. :,<4('...: ,:', ~;:,:;.-i>;<:~;; ~.:~'<~~:>:.iiLt;,;~.i.!.".,..
.. :5.'" .. ..
. ,:~' ~':;d".... .: .:':';';.:,:,:~:~7. ;~~~_~i . .,'..:.!..
7
8
CLAIHED
':~..'...':' ."
"
PART
~
TAX RETURN - COMPUTATION OF TAX ON JDINT/TRUST ACCOUNTS
LINE 1. D.t. EoiabU.hod 1
2, Account 101...... 2
s. P.rcent To..l. 5 x
4. AIIa..,t SUbject to Tax 'I
5. Dabh and Deduction. 5-
" AllOUnt Tuablo 6
7. Tlx Rat. 7 X
I, Tax Ilua II
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
I.. I
TDUL IEnte~ on }.lna 5 of Tax c_t.tlonJ .
Under penaltt.. of perjury, I declare that the facti I have reported ~V. Ire true, correct ~
. c.....Jft", to t~ ~..t of .Y /''''i''ladoa and bel HOME (1"7) 7(.,{;- 39~
'lL G..,-,- 1+. /JW( tU \.. ' -k ,'-1. l.'\.W- WORK (6- )
GENERAL INFORHATION
1, FAILURE TO RESI'OlCII WILL RESULT IN AN D,nCIAL TAlC ASSESSIlENT -I'" _11...1. Int.,ut.._ ... Inf.,.II...
......lttM by the ,Inencl.l lnlUtutlon.
I. Im.rltenol tax beCOeel dlil1~t nlM' '1tOn"" eft,,. the dectdent', del, of dlMtn.
S. A Jain' ec~t II '....bl. ~ though tM decedent', ...- wa. lidded .. . ..U.r 0' COf'lV'MI~.
.. AcI~tI Uncludln1 tho.. Mid ben..n hulbend MIll ,,11,) which the dec:.o.nt put In Joint MM' IIillthln one YMr ,rlo,. t.
dMth .r. tuliy t....al. .1 ~I-"'er'.
S. AcCCU\tI ..t..UNMd Jolnth betw.1 hullMnd end "If, .ra tNn OM YM,. prior to delth In not ,...bll.
.. Acc~t. held by . dececMnt "In tru.t for. .-.other or othen Ira taxable "'th.
REPORTING INSTRUCTIONS - PART 1
- TAXPAVER RESPONSE
1. 'LOCK'" If the tnlor..Uon Met cc*put.Uon In the notice .t. correct rid ~tlon. Ir. not being ell."', pl~ WI .....
In block "',. ., Plrt 1 0' the "'h.,.yl,. A..po"..- nctlon. Sign u.o cop In ... .....U u.. with your check for the ~t of
t.. to the I..llt',. of N11l1 of the cOW\ty Indl~ted. The PI o.,artMnt 0' RIY.".,. ..lit luu. WI offlcl,l ..........t
(For. R[V"U41 EX) UPOn recl.pt 0' the return 'rOIl tN .....t.,. of 111111.
Z. BLOCI." If thl ....t specified on thll notlc. hili bMn or ..Ill be report*, ... t... p.ld ..Ith the P""'Y1VWlI. IrlMrItMC.
Ta. R.turn fll.d b~ the dec~t" r~r..ant.tlv.. plec. an -X- In block ~.- 0' P.rt 1 of the -T'.Ply.r R.~..- .ectlon. Sign one
copy'" r.turn to the PA De9art..nt of RaY~. lurl8U 0' Individual T....s. Dept l106ol, Harrl.burg, PA 171ZI.0611 In the
wwalope provided.
1. 8LOCX C . I' the notlca Infor..tlon I. Incorr~t ~or deductions ara baing claleed, cheek block ~C- ... coeplat. Part. Z ... 1
lM:COrdlno to the Instructions b.lo... Sign two copl.. ... auMlt u.. ..lth your chedl. for the ~t of tu pe_l. to the Reglltar
of wills ~f ~c O:O\l"t\. 1"'(II,.str.l1 T~. 0& fl.:,"~~...,t 0' ~:'.'."''' wJU I':ua ,., aff!:Ie1 a::-:!:::t'tnt (~OPW REV.!!'1 ~, \.Tl:r. ~t':alr~
of tfMI nturn frOll thll Regllt,r of Willi.
TAX RETURN - PART 2 - TAX COHPUTATION
LINE
1. Ent... the date the lM:ClM1t o..I.lnally ".. ..tllblllhed or titled In thII IWlMr ..hUng at dIIt, of death.
HOTEl Fo... decadent dying .ft... IUlz/Us AcclM1t. which the ~t put In Joint n... within one (1) y..r of death are
t..~l. fully., t..an.'..... Howey,r. there I. en ..elutlon not to ..ceed ",DDo par trant'.r.. regardl.,. 0' the v.lue 0'
the ecCOU'lt or tM ~r 0' ac:COU'ItI ....ld.
If . doubl. .,ttrltk (..) appe.r. bafor. your flr.t ~ In the eddr... portion of thl. notlcl. the ",000 ..elu.lon
alnedy h.. been deducted frOll the ~COW'lt belMCe .. reported by the flna"lClal In.Ututlon.
Z. Ent... t.... total bllMCI of the KCOW'lt InclucU", Int.reat eccrued to the dIIt. 0' cII.th.
1. TM parcent 0' the ecCOU'It that II taxllbla for aach suMllvor I. dlt....lnad .. 'Ol1Oli1SI
A. Thti parcent taxabl. 'or Joint ....tI ..ttlblllhed .r. then OM YHr prior to the cMcedant'l deathl
1 DIVIDED IV TOTAL tufJEA fIF
JOINT OWNERS
Ex..11I A Joint ....t r~lIt...~
DIVIDED IY TOTAL N.ICIOt f11 X 101 . PERCOfT TAXAILE
SUNIVIIC JOINT CMOS
In ttMi hIM of the dacedant and two other "rton..
1 DIVIDED IV 1 (JOIHT OWNERS) DIIJIDE:D IY Z (Sl.RYIVORS) . .167 JC laD . 1'.7% CTIXAILE FDA Oat SUNIYOA)
I. The p.rcent ta..bla for ....tt crutad within ana ~..r of the decedent', de.th or ac:COU'ltt oWled by the ac.dant but Mid
In trust for another Indlvldulilt.) (tru.t bantflc1...I..h
I DIYIOEO IV TOTAL NUHIER OF SURYIVINC JOINT
OWNERS OR TRUST IENEFICIARIES
JC 101 . PERCDfT TAXAIlE
E....I.l Joint .cc~t ....ltt.r~ In the hIM of the ~t and two othar per"". and ..t~llthecl ..Ithln OM YNr of cII.th b~
the d~adant.
1 DIVIDED IV Z (SURVIYORS) . .50 X 100 . 501 lTAXAILE F~ EACH ~IYOA)
". Tha ~t SUbject to tu Cllna .) It dlt....lned by ...ltlphl", the ICCOW'It btilanea Cline Z) b~ tha parcent tax~l. Cline 1).
5. Entar thtl tot'l of the dabt. Met deduction. lI.ted In Part S.
6. Th. ~t taxllbl. Cline 6) II det....lnad by aatracU", the dab" end daductlon, (11",. 5) fro. the -.a"lt subject to tu Cllna 4).
J, -='nhr tN ImOr"Orlat. tit." ,.at. (11M 71 .. dlt....lnad bel....
A. For dat.. 0' death occur~l", .'t.r '/10/94. the tu ret.. 'or tren.f.r. to spou... ara ., follow"
I. Data. of death on or .ft.r 7/1/94 end ~for. 1/1/9S the r.t. I. J%.
Z. O.t.. of death on or aft.~ 1111'S tran.f.r. to apou... ..Ill ba taxed .t. OX tax rata.
Nota' Fo~ d.t.. of d..th ,rlor to 7/1/94 tren,f.r. to apou... ar. taxabl. .t 6X.
I. T..en.f.... to lIne.1 dlJC....s.nt. Including f.ther. .other. son. daught..., arenddllldren. ton-In. I...,
daught...-ln.I..., .t.,chlld and their I..ue .r. taxabl. .t .Ix percent ('X).
C. Tranlf.r. to .11 other. Including brothtlr. .1.t.r, uncI.. .unt, nephew ... nl~. ara t..abl. .t 'If teen parcent (1St).
O. II you change ttMi tax rat., pI.... apeclfy your rel.Uon."I, to the dK~t In the ..... provided.
I. The.-aunt of t... due (line I) It det....lnad by ...ltlphlng the MCU'tt taxllbl. (11.... ,) by the tlJC rat. (line 7).
CLAIHED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. debt. and d.ouctlon. ar. dlt.r.lned a. follow'l
A. You l'a.ll~ .r. r.,ponllbl. 'or p..,..nt. or the ..t.t. subject to ~1"I.tr.tlon by a parlonal rapr.lant.tlva I. lnsuf'lclant
to P.Y thl dlductlbl. It....
I. You lM:tual1~ paid thl dabt. aftar d..th of the dKadMt ... cen furnllh proof of p.~t.
C. Oabt. baing el.l-.d .u.t b. Ita.lzed 'ull~ In P.rt S. I' additional Ipac. ls naedad. u.. pl. In p~r . I/Z- . 11-. Proo' of
pa~t aay be raqua.tad by the PA DlPart.ant of R~.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORHATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS, PA DEPARTHENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327, TDD' (717) 772-2252 (HEARING IHPAIRED ONLY)
1.'1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'I
BUREAU Df IHDIVIDUAL TAXES
IHIILAI UHcr TAil DIVISION
IlLPI. ;,1I0ttal
IlAIIAI saullc, PA I/I:8-0bOI
NOTICE Of INIlERITANCE TAX
APPRAISEHENI, ALLOWANCE DR DISAllOWANCE
Dr DEDUCTIONS AND ASSESSHEHT Dr TAX
MICHAEL W GANG
MORGAN ETAL
417 WALNUT ST
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17101
11-19-96
LANE
11-04-95
21 96-0364
CUMBERLAND
101
AIlouot Re"Hted
/
, .~
rtr.
'"-1''' 111"111....
THOMAS
H
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE"v:iSlij-EX-iiFj>uioY:9&Y"NOricE--oi'--fNHEififANCn'-li-x-iippiiiiiSEtf€Ni'-;-iiLi.-OWAtfCE-oli-nm-m-------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LANE THOMAS H FILE NO. 21 96-0364 ACN 101 DATE 11-19-96
TAX RETURN WAS: (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule AJ (1)
2. Stacks and Bonds (Schedule 8) e21
3. Clol.1~ Hald Stock/P.~tn.rshlp Int.r..t (Schedule C) (3)
4. Hartg.gas/Not.. Rac.ivabl. (Schedule DJ (4)
5. Cash/aank Deposits/HI.c. Parsonal Property (Schedule EI IS)
6. Jointly Owned Property (Schedule FJ (6)
7. Transfers (Schedule GI (71
8. Total Assat.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funa,.al Expanse./Adm. Costs/Hisc. Expanse. (Schedule H) (9)
10. Dobts/Hoctgogo Llobllltlos/Llons lSchodulo II (101
11. Total Deductions
12. Net Va1u. of Tax Retu~n
13. Cha~itable/GoYa~n.ant.l Bequa.t. ISchadule J)
14. Net Value of est.t. Subject to Tax
CHANGED
.00
.00
.00
,00
.00
839.78
.00
(8)
7,572,84
.00
Ull
U21
U31
U41
NOTE: To insu~. p~opar
c~.dit to you~ account,
sub.it the uppar po~tJon
of this for. with you~
tax paYllant.
839,78
7.~n R4
6.733,06-
,00
6.733.06-
I~ an assessment was issued previOUSly, lines 14, 15 and/or 16, 17 and 18 will
re~lect figures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal ~at. liS)
16. AIIQunt of Line 14 taxable at Line.I/Class A ~.ta (16)
17. AIIQunt of Lina 14 taxable .t Coll.t.~.I/CI.ss B ~.t. (17)
18. P~incip.l Tax Du.
NDTE:
TAX CREDITS:
PAYHENT
DATE
08-05-96
RECEIPT
NUH8ER
AA146594
DISCOUNT ('1
INTEREST (-I
.00
.00 X .00=
,00 X ,06=
,00 X .15=
UBI
AHDUNT PAID
125,97
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
,00
.00
.00
.00
125.97
125,97CR
.00
125,97CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FDR CALCULATIDN DF ADDITIONAL INTEREST.
IF TDTAL DUE IS LESS THAN '1. NO PAYHENT IS REQUIRED,
IF TDUL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAY 8E DUE
A REFUND. SEE REVERSE SIDE DF TNIS FDRH FDR INSTRUCTIONS,I
RESEAVATION: Eltatel of decedent. dying on or before Dece.bar IZ, 198Z .. If any future Interelt In lh. eltat. II tran.f.rr.d
In pOls.sslon or enjoy..nt to Cia.. B Ccolleteral) benefici.rle. of the d.ced.nt aft.r the eMPlratlan of .ny ..t.t. for
Ilf. or for 'leer., the Co..anw..lth h.r.by e.pr.ssly r.s.rve. the right to apprai.. .nd ...... transf.r Inh.ritanc. fa...
at the lawful CI... B Ccall.taral) rate an .ny such future Int.rest.
PURPOSE OF
NOTICE:
To fulfill the r.qulre..nt. of Section ZI~O of the Inheritance and E.tate Ta. Act, Act ZZ of 1991. 7Z P.S.
Section ZI~O.
PAVHENT I
Det.ch the top portion of thil Hotlce and subelt with your pay.ent to the RIghter of Wlll1 printed an the rIver Ie IIde.
--Hake check or .aney order payable tOI REGISTER OF' HILLS, AGENT
All pay.ent. received shall fIrst be .pplled to any Intere.t which .ay b. due wIth any re..lnder applied to the ta..
AEFUND CCA)I A refund of . tax cr.dlt, ..hlch .... not requuted on the Ta. Aeturn, .ay be requuted by coepletlng an "Application
for Refund of P.nnlylvanla Inherltanc. and E.tat. 'ax" CREV-151]). Appllc.tlon. ar. av.ll.ble .t the Offlc.
of the A.glst.r of Wills, any of the 23 Aev.nue District Office., or by calling the sp.ci.1 Z~-hour
an.w.rlno .ervlc. ftU8ber. for fore. orderIng I In P.nn.ylv.nla 1-800-36Z-Z0S0, out.ld. P.nnsylvanl. and
withIn local H.rrlsburg ar.. (717) 787-8094, TOOl (717) 77Z-Z252 (Hearing I~alr.d Only).
OBJECTIONS: Any plrty In Intere.t not ..tlsfl.d with the appr.I....nt, .llow.nca or dl.allowanc. of deductIon., or a.......nt
of ta. Clncludlng dl.count or Int.r..t) I' shown on thl. NotIce ault obj.ct within .I.ty (601 day. of ree.lpt of
this Notice by:
--wrltt.n prat..t to the PA O.parta.nt of Revenue, Board of App.al., Dept. Z810ZI, HarriSburg, PA
"alection to have the .atter d.teraln.d .t audit of the .ccaunt of the parlan.1 reprnent.tlva,
--.ppe.l to the Orphan.' Court.
17128-IOZI,
OR
DR
ADHIN
ISTAATlVE
CORRECTIONS:
Factual error. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writIng tal PA D.pert.ent of Aevenue,
Bur.au of Individual T...., ATTN: Pa.t A....I..nt Aevlew Unit, aept. Z80601, Harrl.burg, PA 171Z8-0601
Phone (717) 187-6505. 5.. p.ge 5 of the booklet "Inltructions for Inh.rltanc. Tax Return for. R..ld.nt
a.c.dent" (AEV.15011 for an ..plan.tlon of adalnl.tratlv.ly cor~.ctable error..
DISCOUNT I
If any t.x due h paid within thr.. U) c.l.nd.r eanth. after the d.c.d.nt'. d.ath, . flv. percent (5X) discount of
the t.x p.ld I. .llow.d.
PENALTY,
Th. 15:C tax .an.sty non-Plrtlelp.tlon p.nalty I. caaputed on the tot.1 of the t.. and Int.r..t .......d, and not
paid b.for. January 18, 1996, the flr.t day after the end of the tlX aen..ty period. Thl. non-partIcipation
p.n.lty I. app.alabl. In the .... .ann.r and In the the .... tl.. p.rlod .. YOU would .pp..1 the ta. .nd Int.r..t
th.t has b.en .......d a. Indlc.t.d on this notlc..
INTEREST:
Int.r..t I. charg.d b.glnnlng with flr.t day of d.llnquency, or nine (9) .onth. and an. Cl) day fro. the d.te of
d..th, to the d.t. of pay..nt. ,.... which b.c... d.llnquent b.fare Janu.ry 1, 198Z b.ar Intere.t .t the r.te of
.Ix (6X) p.rcent p.~ annu. calcul.ted .t a dally rat. of .0001&4. All ta..s which bec..e dellnqu.nt on and aft.r
January 1, 1982 will be.r Int.r..t at . r.te which wlil vary fro. calendar y.ar to cal.ndar year with that rat.
announc.d by the PA Depart.ent of Revenue. rhe appllcabl. intere.t rates for 198Z through 1996 are:
~ Internt Rllt. D.llY Int.rnt Fllctar ~ Interest Rat. DIIlly Interest factor
1982 ZOiC .0005~8 1987 9Z .DODZU
198] 16:< .00D~18 1988.1991 U:C .000lDI
1984 1l:C .000301 199Z 9Z .000Z47
1985 13:< .000356 199]-199~ 7Z .00019Z
1986 lOX .000Z74 1995-1996 9Z .OOOZU
--Interut I. c.lcul.t.d .. follow'l
INTEREST = BALANCE Dr TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY INTEREST rACTOR
.-Any Hotlee I..u.d .fter the tn. beco.e. delinquent will refl.ct an Interelt c.lcul.tion to flft.en (151 day.
b.yand tho date of the ....sl..nt. If payeent I. .ad. lifter the lnter..t ca.putatlon date shown on the
Notlc., .ddltlonal Int.r..t au.t b. calculated.
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