HomeMy WebLinkAbout96-00398
C[)""OHWUl1tl Of 1'1 frcHSVl vaNIA
OlP'IIIHlNI or R[Yl HU[
lUIlUU or IHDIYIDUal IAIUS
DlPT. ~1D601
tlARRISlUAC, PA IlIa-OIlOI
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
.11.1"11111'0"11
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FILE NO, 21
ACN 96102175
DATE 02-10-96
EST. OF FRANK A COOK
5.5. NO. 164-30-3946
DATE OF DEATH 05-22-94
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
!Xl CERTlF,
EULAH F GRUGAN
31 FORT ST
LEMOYNE
REHIT PAYHENT AND FORHS TO,
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17043
PNC BANK hu pro\lld.d the C.part..nt wlth the Infor.atJon Iht.d b.l~ which hu b..n uud In calcuhtlng ttM
potential tax due. Th.lr r.cordl Indlcat. that at tha d.ath of the above d.c.dant, you war. a joint ownar/banaflcl.ry of thll account.
If you ta.l thll Infor.atlon II Incorr.ct, pl.al. obtain wrltt.n corr.ctlon fro. the financial Inltltutlon, attach. copy to thll for.
and r.turn It to tha .bov. addrals. Thll .ccount II taxable In .ccordance with the Inharltanca Tax Lawl of tha Co..onw.alth of Pannlylvanla.
Qu..tlon. .ay ba an.warod bll call1nn (717' 787.8l27.
COMPLETE PART 1 BELOW . .
Account No, 21001022275
FLLING AND PAYMENr INSTRUcTIONS
. SEE REVERSE SIDE FOR
Doh 09-24-92
E.hbllshod
To In Iura propar cradlt to your account. two
(2) copl.. of thl. notice .ust accoapany your
pay.ant to tha R.gI.t.r of Will.. "aka chack
payabla to; "R.gIster of WIlIs, AgMt".
10,049.26
8.333
837.40
.15
125.61
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
Account Balanca
Pa,.cant TalCabl.
Amount Subjact to
TalC Rata
Potantial TalC Due
x
x
HaTE: If tax pay.antl ara .ada within thr..
(]) .onth. of the d.cad.nt'l data of d.ath,
you .ay d.duct a S~ dl.count of ttM tax du..
Any Inh.rltanca tax due will beco.. d.llnqu.nt
nln. (9) .onth. aft.r the date of daath.
To'
PART
[!]
A. c=J Tha abOlle Infor.atlon and tlX due I. corr.ct.
1. You .ay chaos. to re.lt pay.ant to the A.glst.r of Willi with two copla. of thll notlc. to obtain
a dl.count or a\lold Int.r..t, or you .ay check box "A" and r.turn thl. not Ie. to the Regl.t.r of
Willi and an official a....s.ant will b. I..ued by the PA n.part..nt of A.vanua.
[CHECK ]
ONE
BLOCK
ONLY
B. c=J Tha abOIl. ....t ha' b..n or will ba r.port.d and taM paid with the P.nnlylvanla Inharltenca Tax r.turn
to ba tiled by the d.c.dent.. r.pr.s.ntatlv..
C. ~ The abova Infor.atlon h Incorrect and/or dabt. and d.ductlonl "ar. paid by you.
/ You .Ult co.pl.t. PAAT 0 and/or PAAT m b.low.
If ~ou indicat. a diff.,.ant talC ,..ta, pia... st.ta ~our
r.lationship to dacadant:
PART
~
TAX RETURN . COMPUTATION
LINE 1. Uat. Established
2. Account Balanc.
3. p.,.cant Taxabla
4. A.ount Subject to Tax
5. Debts .nd Deductions
6. A.ount Taxabl.
7. Tax R.t.
8. TalC Du.
OF TAX ON JOINT/TRUST ACCOUNTS
I '1-1.O-/-q'1-
2 /0 , D</C" .....c"
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8 ~ 7, ;~
PAD
1
2
3
4
5
6
7
8
CLAIMED
PART
~
DATE
DEBTS AND DEDUCTIONS
PAID
PAYEE \ DESCRIPTION
IUi 01, C vt\-, V
'" , ....,\c.. '^" J 1
l~( \CLUeo" I lI\tloJ11 ~S ".,;,,/.1 ::> (
TOTAL IEnlor on Lin. 5 of Tax Co.putetion)
-'1-'1- ,~
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OI(f)~lAL USE ONLY 0 AAF
PA D~~RTHEtm OF R!iV~UE
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AMOUNT PAID
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1.-S,c>
:;. () 0
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co,.,.act and
Under panaltia. of p.,.ju,.y. I dacla,.a that the
c~plata to th.,b..tYJ'O ny knoNladg. and baliaf.
.r-. '(I L'
'Lt;i<..LA-Y) ,'." 'f.. t'e. ','.(. ,--
TAXPAYER SIGNATURE i
f~t. I hava ,..po,.t.d abova a,.. t,.ua,
HOME ('j ) '/) 'h /
WORK ('il'l ) 7,,;
TELEPHONE NUMBER
GENERAL INFURMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAM ASSESSHEHT with applicable Int.r..' buad on I"'or..llon
,ubIIlttad by the flnancl.l Inttltutlon.
I. Inh.rltenc. t.. baco... delinquent nln. aon'hl .ft.r the dae.d.nt', data of d..th.
J. A Joint account I. I...bl. .yan thouQh the dacadent', nea. wa. added ft' . ..tt.r of convenl.nc..
~. Account. (Including tho" hald batw.an hu,b80d end wlf.1 which the dacad.nt put In Joint n.... within on. y..r prl~r to
Hath .r. fully 'aubl. III 'rAn,'.rt.
S. Account. ..tabllshed Jolntlv batw..n hUlband and wlf. aor. thAn on. y..r prior to d.ath are not t....bl..
6. Accounta held by . dacadant -In truI' 'a'. anoth.r or oth.r. .t. t...bl_ fully,
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A . Jf the Infor..tlon and cD.putatlon In tha notlc. .r. corr.ct end d.ductlon. ar. not b.lng clal..d, pl~. en ~X~
In block ~A~ of Pert I of the ~Ta.peyer Re'pon.e~ ..ctlon. Sign two cop I.. and .ubelt th.e with your ch.ck for th. aeount of
t.. to the Regl.ter of Will. of the county Indlcet.d. Th. Pi nepart..nt of R.venu. will I..u. en offlcl.1 a.......nt
(For. REV~IS~e EX) upon r.c.lpt of the r.turn fro. the R.gI.t.r of will..
Z. ILOCK I . If the ....t .p.clfl.d on thl. notlc. has b..n or will b. r.port.d and ta. paid with the P.nn.ylvanla Inh.rltanca
Ta. R.turn fllad by the dac.dant', r.pr'llntatlv., placa an ~X~ In block ~B~ of Part I of the ~Ta.payar RalPonla~ lactlon. Sign on.
copy and return to tha Pi Oapart.ent of Revlnue, Buraau of Indlvldu.1 Tan., O.pt Ze0601, tt.rrhburg, Pi 11128'0601 In thtl
env.lopa provld.d.
S. ILOCK C . If the notlca Infor.atlon I. Incorr.ct and/or d.ductlon. ara baing clal..d, ch.ck block ~C~ and coaplat. Part. Z and S
accordlng to the In.tructlon. balow. Sign two cop I., and lub.lt th.. with your chack for tha aaount of ta. payabl' to the Rlgl.tar
of .1111 o~ th. clNl'lh' Incll........ Tha'::';' ';"tol.rts~,1t wr RoIvoIllu. "Ill luua 6l\ :tflcJal dU.......:-.t ~~::-:. ;;:t"'-I~..a LXI Uf!on r.t:llpt
of the raturn froa the Ragl.tar of will..
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Ent.r the data thl account orlalnally "a. ..tabll.h.d or titled In the .annar a.I'tlng at data of dlath.
NOlE: For a d.cadant dying aftar 12/1lllZt Account. which the dec.dent put In Joint n.... within on. (I) yaar of d.ath ar.
ta.abl. fully.. transl.rs. Ifowever, there It an ..du.lon not to ..c..d 15,000 par transl.r.. regardhn of the valu. of
the account or the nuaber of eccounh held.
If a doubl. a.tarl.k (xxi epp.ar. b.for. your flr.t na.a In the addr... portion of thl. notlc., the SS,OOO ..cluslon
alr.ady ha. b..n daductad fro. tha account balanca a. r.port.d by the financial In.tltutlon.
Z. Ent.r tha total balanc. of the account Including Int.re.t accrued to the data of da.th.
S. Th. parc.nt of tha account that I. ta.lbla for .ach lurvlvor I, datar.lned as follow.:
A. The p.rcent ta.abla for Joint a'lat, a.tablllhed .or. than one yaar prior to tha da~adant'l daath:
I DIVIDED IV TOTAL NUMBER OF
JOINT OWNERS
E.aapla: A Joint allat raglltarad
DIVIDED IV TOTAL NUKIER OF X 100 . PERCENT TAXABLE
SURVIVIHC JOINf OWNERS
In the na.a of the dacedant and two other personl.
1 DIVIDED BY 1 CJOINf OWNERS) DIVIDED BY Z (SURVIVORS) . .167 X 100 . 16.7X CTAXABlE FOR EACH SURVIVOR)
B. The parcant ta.lbla for allats craatad within Dna ya.r of the decadent'. da.th or accounts owned by the d.cadent but h.ld
In tru.t for enethar IndlylduaU.1 (tru,t baMflcl.rtuJ:
I DIVIDED BV fOfAl NUHBER OF SURVIVING JOINf
OWNERS DR TRUST BENEFICIARIES
K 100 . PERCENT TAXABLE
E.ISPlat Joint account raglltarad In tha n... of tha decad.nt and two othlr parlon. and astabll.had within one Ylar of daath by
tha d.cadent.
1 DIVIDED BV l (SURVlVORSI . .50 X 100 . SO~ (TAXABLE FOR EACH SURVIVOR)
,
4. Tha aaOl.W1t lubJ.ct to ta. Ulna 4) Is detaralnad by ItUltlplylno the account balanca Uln. l) by tha pareant ta.abla Ulna S).
S. Enter the total of the dabts end deductlonl Ilstad In Part S.
6. Tha laOl.W1t ta.abla (line 6) I, datar.lnad by lubtractlng tha dabt, and daductlons Clln. SJ fro. tha a.ount lubJact to ta. (llna ~I.
" Entar \na .pproprl.t~ t3A r.\. Clln. 7, .1 d.t.r.ln.~ t.1G..
.
A. For datal of daath occurring aftar 6/10/9~, the taM ratal for tran.f.rl to .pous.' ara II folloMI:
1. Dati' of daath on or aftar 7/1/9~ Ind bafora 1/1/95 tha rata II SX.
Z. Dati' of daath on or aft.r 1111'S tranlfar. to Ipou.a. will ba ta.ad It OX ta. rlta.
Hotal For data. of da.th prior to 7/1/" tranlfarl to IPOU'" ara ta.abla at 'X.
I. Tran.farl to llnaal d..undent. Including fathar, .oth.r, .on, daughtar, grendc:hlldr.n, son.ln.l"w,
daughter.ln-I_w, Itepchlld and thalr 1.lua ar. ta.abla .t .IK parcant (6X).
C. Tranlfar. to III othar. Including brothar, lister, uncia, aunt, n.phaw and nlac. ara ta.abla ftt flft..n p.rcent CISX).
D. If yOU chang. tha ta. rata, plalla IPacify your retatlon.hlp to the d.cadant In the araa provided.
e. Tha a.Ol.W1t of tax due Ulna II It datar.ln.d by .ultlplylng the aaolrIt tlubla Ulna 61 by tha ta. ratl Uin. 7),
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabla dabts and daductlons Ira dahralned .. followlt
A. You lagaUy ara relPOnllbl. for ply""t, or the ..t.ta .ubJact to ItdIIlnhtr.tlon by " parsonal rapruant.tlva It Inlufflcl.nt
to pay tha dlductlbla It....
B. You actually paid the dabt' aftar daath of the decadent and can furnllh proof of pay..nt.
C. Dabt. balno clela.d ault b. Itaalzad fully In Part S. If additional Ipac. I. n.edad, ula plain papar 8 I/Z~ x II~. Proof of
paya.nt .ay ba raqualt.d by tha PA D.part.ant of R.venua.
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)
.j 'II
cOMHONWtAl III Of IIIHHSYLVA"IA
DlPAMIHlNI Of AlVIHUt
IUNlAU or INDIVIDUAL t"klS
DlPI. 1101t01
tIARAISllIMG, PI 111:"OClOI
*'
FILE NO. 21
ACN 96102161
DATE 02-10-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
'''-Ihl III" II.."
EST, OF FRANK A COOK
S,S. NO. 164-30-3946
DATE OF DEATIl 05-22-94
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
[Xl CERTIF.
EULAIl F GRUGAN
31 FORT ST
LEMOYNE
REHIT PAYHEHT AND FDRHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT 1l0USE
CARLISLE. PA 17013
PA 17043
PHC DANK hIlS proylded the Depart..nl with the Inforntlon Iht.d below which h.. b..n u..d In cllculatlnD the
pot.ntla. taM due. thalr rlcords Indicate that at the death of the above dacedant, you ware IS joint owner/ben.flclefY of thl. account.
Jf you f..1 this Infor..tlon II Incorrect. plea.' obtain written corr.ctlon fro. the financial Institution, attBCh I copy to thl. fore
and return It to the above addre.s. thl. account I. taxable In accordance with the Inherltanca Tax Law. of the Co..anw.8Ith of Pennsylvania.
Queltlonl ..y b. anlwar.d by call In; (1111 lal-alZ7.
COHPLETE PART 1 BELOW .
Account No, 210001022336
. . SEE
REVERSE SIDE FOR
03-10-88
FILING A~u ~AYMENT INSTRUCTIONS
Date
Establish.d
To Inlur. prop.r cr.dlt to your account. two
(l) cop I.. of tnll not Ie. .u.t acco.pany your
pay.ant to the R.al.t.r of Wills. Hak. check
payabl. to: "R.aist.r of Wills. Agant~.
PART
IT]
10,056.22
8.333
837.98
,15
125.70
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED OM THIS NOTICE
Account B.lance
Per-cent Ta.able
Amount Subject to
Ta. Rate
Pot.ntl.l Ta. Due
K
HOTE: If tax pay..nt. ar. .ad. within thr..
III .onth. of tn. d.cad.nt.. data of d.ath.
you .ay doduct a SZ dl.count of the tax due.
Any Inh.rltanc. tax due will boco.. d.llnqu.nt
nine (9) .onth. after the date of death.
Ta.
K
[CHECK ]
ONE
BLOCK
ONLY
A. c=J The .bov. Infor..tlon .nd t.x due Is corroct.
I. You ..y choo.. to r..lt pay.ent to the R.gl.ter of Will. with two cop I.. of thl. not Ie. to obtain
. dl.count or avoid Int.r..t. or you .ay ch.ck box "A" and r.turn thl. not Ie. to the R.gl.t.r of
Will. and an official .....Ieant will b. I..u.d by the PA oopart..nt of Revenue.
a. c=l The .bov. a..et h.. b.en or will b. r.portad and tax paid with the PAnnlylvanla Inh.rltanc. Tax r.turn
to b. fll.d by the d.c.dent.s r.pr..entatlve.
C. ~Th' above Infer.atlon I. Incorr.ct and/or d.bt. .nd deduction. war. paid by you.
~ You aUlt coapl.t. PART ~ and/or PART ~ balow.
If you indicate. differ-ent ta. rate, please st.te your-
relationship to d.cedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Data ~stablish.d
2. Account Balance
3. P.r-cent Ta.able
4. Anount Subj.ct to Ta.
5. Debts .nd Deductions
6. Anount T..able
7. Ta. Rate
8. Tax Due
OEfJ1:IAL USE ONL'(,.., 0 AAF
PA D~ARTME~OF ~NUE
? ~.'. . :,',' (.
ON JOINT/TRUST ACCOUNTS
~-/o.B5
/O,O::>(,.,,'Z-'Z--
~'~~~
S '1 '19--
63.1,Qe,
D
OF TAX
I
2
3
4
5
6
7
8
o
PAD
1
2
3
4
5
6
7
8
CLAIMED
..
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PART
[!]
DATE PAID
-l..
DEBTS AND DEDUCTIONS
PAYEE
DESCRIPTION
AMOUNT PAID
9'3 S;,
cJ.evV~:
.~--
('I'(>>N'C<, .
)
TOTAL CEnter on Line 5 of Ta. Conput.tion)
$
Under pen.ltlas of
c,con~l.t~ to (the L..t, ~f
C~(l I jl/1 ( I Vir,! (
TAXPAYER SIGNATURE
perjur-y, I d.clar-e that the fact. I
ny knoMl.dga and bell.f.
(,!
have reported above .r. true, cor-~cf2tn:9
HOME (" I') ) / (, , I ,jj.-- .
WORK t") '} ) 'f '-',;-, ';.1 ,'/
TELEPIlONE NUMBER
a
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GENERAL INFORMATION
1. fAIlURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESS"EHT ill"'" ItPPllcllbla Int.,..t bu.d on Infor..llon
,ubtllUed by thll ,Inenellll In.tltutton.
2. Inheritance t.. baea... delinquent nln. .onthl aft.r the dac.o.ntO, date a. d..lh.
S. A joint necount II t..abl_ .van thoUgh thll dlle.d.nt', ".... w.. added "' . ...,t.r 01 (anvll"I.",..
., Account. (Including tho'. held b.tw..n hu,band and .,Ifa) which thll dacadent put In joint n.... within ona y..r prior to
d..th .t. fully ,...bl_ .. trAnlf.r..
s,. AccD\.W'IlI ."ablhhad Jointly batw..n hUsband nnd wlf. .or. thlln on. y..r prior to d..lh at. not t...bl..
.. Account. hald by . daced.nt -In trult fa'. anoth.r or oth.r. .t. ,....bl. fully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLaCK A . If 'hll Infor..llon and co.puta,lon In thll notlc. .t. corr.ct and dllduetlon. are not b.lng clal..d, pl.ca an -X~
In block _A_ of Part 1 of the ~Ta~payar R..pon.'- ..ctlon. Sign two copl.. and .ub.lt the. with your chack for thl eeount of
taM to the Ragl.ter of will. of tha county Indicated. the PA Cepart.ent of R.v.nu. will I..ua an official a.......nt
(For. REV~lS~a [X) upon r.c.lpt of the r.turn fro' the R.gI.t.r of Wills.
2. BLOCK B ~ If the ....t .p.clfl.d on thl. notlc. has be.n or ~III be r.port.d and taM paid ~Ith the P.nn.ylvanla Inherltanc.
Ta. Return fll.d by tha d.c.d.nt'. r.pr..ant.tlv., plac. an -X- In block "B- of Part 1 of the -Ta~pay.r R..pon..- ..ctlon. Sign on.
copy and r.turn to the PA Depart..nt of R.v,nu.. Buraau of Individual Ta..s, n.pt Z80601, Harrl.burg, PA 171Z8~0601 In the
anv.lop. provld.d.
3. BLOCK C . If the not Ie. Infor.atlon I. Incorr.ct and/or d.ductlon. are b.lng cl.I..d, ch.ck block -C~ and co.pl.t. Parts Z and 3
according to the In.tructlon. b.lo~. Sign two copl.s and .ub.lt th.. with your ch.ck for the a.ount of tax payable to the R.glst.r
oJ' .HU. of thl count', In-Jlcb;,.t.i. ;'1.. t1 :'P3I"'tc~t of kovru' will l..utI an nttlcl..~ ::.~::::.s=.r.t .F:or= nE'.~lS..6 EX) uPOo"l rloulpt
of the r.tUl"'n fro. tha Ragl.t.1'" of Will..
TAX RETURN - PART 2
- TAX COMPUTATION
LINE
1. Entll'"
HOtE:
the dati the account originallY ~a. ..tabll.h.d 01'" tltl.d In the .ann.1'" ..Istlng at data of d.ath.
Fol'" . d.cadent dying aft.r IZ/12/82; Account. ~hlch the dec.d.nt put In joint na... within on. Cl) y.al'" of d.ath are
ta.abl. fully a. tran.f.I"", Howev.r, th.r. I_ an ..cluslon not to ..c.ed 13,000 p.r tran.fare. ragardl." of the v.lue of
the account 01'" the nu.b.r of account. h.ld.
If a double a.t.rl.k C..) app.ar. bafor. your flr.t na.. In the addr..' portion of thl. notlc.. the '3.000 a.clu.lon
alr.ady has bean deductad fl"'o' the account balanc' .. raported by the financial In.tltutlon.
Z. Ent.r the total balance of the account Including lnt.r..t accrued to the data of daath.
3. The p'l"'c.nt of the account that I. ta.abl. for aach .urvlvor I. d.tar.lned a. follow':
A. Tha p'l"'c.nt ta.abl. for joint .s..t. ..tabll.had .or. than one y..r pl"'lor to thl dac.dant's d..tht
1 DIVIDED BV tOTAL HU"BER OF
JOINt OWNERS
E.aapl.; A joint ....t regl.tared
DIVIDED BV TOtAL NU"BER OF X no . PERCENT TAXABLE
SURVIVING JOINT DWNERS
In the na.. of the d.cedant and two oth.1'" p.r.on..
B. The par cant ta.abl. for ....t. cr.at.d within on. yaal'" of the dec.dant'. d..th or account. ownad by the d.c.dant bUt h.ld
In tru.t for another Indlvldualh) C tru.t beneflclarl..);
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 CSURVIVORS) . .167 X 100 . 16.7~ (TAXABLE FOR EACH SURVIVOR)
1 DIVIDED BV tOTAL NUHBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
EMa.plet Joint account reolst.rad
tha decad.nt.
I DIVIDED BV 2 (SURVIVORS) . .SO
In thl na.e of the d.c.dent and two othal'" person. and e.tabll.hed within ana y.el'" of d..th by
.. The lI.ount subj.ct to taM Uln'.) h d.t.r.ln.d by 1lU1tlpJylng the 8CClK.W1t balllflC8 Ulna ZJ by the p'l"'cant taubla Cllna Sl.
s. Ental' the total of the d.bt. end d.dUctlon. Ihtad In Pal"'t S.
6. Th. .eount taMable (1In. 6) I. d.t.r.lned by Subtracting tha d.bts and d.ductlon. (1In. 5) fro. the a.ount .ubj.ct to taM Clln. 4).
,. En~." the ....pro;.d.t. tall: rat. (11n. 7) ..I ::t.'e,..lr..d belOW.
X 100
50% (TAXABLE FOR EACH SURViVOR)
A. For data. of d.ath occul"'l"'lng aftal'" 6/30/94, the tax r.t.. for tran.f.rs ta .pou..s ara a. fcllow':
I, Oat.. of death on 01'" aft.r 7/1/94 and b.for. 1/1/9S the rat. I. 3Z.
Z. Oata. of death on 01'" aft.1'" 1/1/95 tran.f.rs to .pou.e. ~III b. ta.ad at O~ taM rate.
Hot.; Fol'" dat.. of d..th prior ta 1/1/9~ tran.fars to spou... are te~able .t 6~.
I. Tran.far. to lineal d..cendants Including fath.r, .othel"'. son, daughter. gl"'andchlldr.n. .~n-ln-Iaw,
daught.r.ln.la~, stepChild and th.lr I..ue are taMabl. at .IM p.rc.nt (6~).
C. Tl"'anshrt to all others Including broth'l"', .htllr, unci.. aunt. nephew and nl.ea are ta.abl. at flft.an parc...t US~).
n. If you chang. the taM I"'.t.. pl.a.e .peclfy your relatlon.hlp to the d.cad.nt In the area provld.d.
8. The ..ount of t.. due Uln. 8) 11 dater.ln.d by aultlplylng the ..ount taubl. Ulna 6) by the t8M rete Ulna 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
AIlawable debt. and d.ductlon. .r. d.tar.lned a. follow.'
A. You leoally ar. r..pontlbla for pay.ent, or the ..tat. .ubjact to adtIlnhtratlon by a p.non.1 r.pr..antatlv. h In.ufflclant
to pay thl d.ductlbl. It....
B. You .ctually paid the d.bt. aft.r death of the decedant and can furni.h proof of pay.ant.
C. n.bts b.lng ctal..d aust b. Itealud fully In Pal"'t 3. If addltlon.1 .pace h n.ad.d, u.. plain paper a IIZ- M 11-. Proof of
p.y..nt ..y b. requ..t.d by the PA O.pal"'t..nt of Rev~.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
<\^'
'-
^-I
~
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DATE ,j)'Ii-'
COHftOHW(AlHI or PIHHSVlVAH!A
D(PUIHlHf Of PlYfHU[
BUR[AU or INDIVIDUAL ".[S
DtPl. 110601
tllNRISIURC, Pi 111:1-0.01
*
I, ~ '/ I
FILE NO, 21
ACN 96102170
DATE 02-10-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
"'.lhlll an .'.t\1
EST, OF FRANK A COOK
S.S. NO, 164-30-3946
DATE OF DEATH 05-22-94
COUNTY CUMBERLAND
TYPE OF ACCDUNT
o SAVINGS
o CHECKING
o TRUST
IXl CERTlF,
EULAH F GRUGAN
31 FDRT ST
LEMOYNE
REHtT PAVHENT AND FDRHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17043
PNC BANK hu provided the Depart..nt with the Infor..tlon 1 htld below which hu b..n u..d In calculating the
pot~tl.l ta. due. T~lr racord. Indlcat. that at the d.ath of the above dacadant, YOU ..ar. II Joint owner/beneficiary of thl. account.
If you f..l thl. Inlar..tlon I. Incorrect, pl.... obtain wrltt.n corr.ctlon frail the financial Institution, attach. copy to thl. lor.
and r.turn It to the abov. .ddr.... Thl. account I, l...bl. In accordance with the Inn.rltanca Ta. la... of the Co.~..lth of Penn.vlvanla.
Q\...tlunl .3., be o\n'Me..u~ by ,nUlrA (711' l,.'.Il!Zl.
COMPLETE PART 1 BELOW .
Account No, 21001022338
. . SEE
REVERSE SIDE FOR
03-10-88
FILING AND PAYMENT INS1RUCTIONS
o.t.
E.tablhh.d
To In.ure proper credit to your account, tMO
eZl cop Ie. of thl. notice .u.t acco~any your
pay.ent to the R.gl.t.r of Will.. "aka check
payable tOI ~.gl.tar of WillI, Ag.nt~.
Account Balanco 10,056.22
P.rc.nt T.xabl. )( 8.333
A.ount Subjoct to To. 837.98
Tox Roto X .15
Pot-nthl To. Duo 125,70
PART TAXPAYER RESPONSE
COj FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
..
HOTEl If ta. payeent. are .ade Mlthln three
e3l eonth. of the d.c.d.nt'. date of d..th,
YOU .ay d.duct a 5~ dl.count of t~ ta. du..
Any Inh.rltanc. ta. due will beco.e d.llnquent
nine (9J eonth. after the data of death.
[CHECK ]
ONE
BLOCK
ONLY
c=J The above fnfor.atlon and ta. due I. correct.
1. You .ay choo.. to re.lt pay-.nt to the R.gIster of will. with two caples of thl. notice to obtain
a discount or avoid Interest, or you .ay check box ~A~ and return thl. notice to the Aeglster of
Will. and an official .......ant will be Issued by the PA Depart..nt of Aevenue.
a. c=J The above .sset has b..n or will be r.port.d and ta. peld with t~ Pennsylvania Inheritance Ta. r.turn
to be filed by the d.cedent., representative.
C. ~ Th. above Infor.atlon I, Incorrect and/or debt, and deduction, Mere paid by you.
~vou aust coapleta PART [!] and/or PAAT ~ balow.
PARr If you indic.te . diffar.nt t.x rat., pl.... st.t. your
~ ralationship to d.c.d.nt:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
L tNE 1- o.t. Est.blish.d 1 1; -1lJ' 8~ 1
2. Account Bahne. 2 10 (,) S;-'(D . 2- '2- 2
3. P.rc.nt Taxabl. 3 X ~. !."!.~ 3
4. AMount Subject to Tax 4 .P,?>/,,\ 8 4
5, D.bt. and O.duction. 5 f?$7,1~ 5
6, AMount Taxabl. 6 D 6
7, Tax R.t. 7 X U 7
B, To. Duo B 8
PART DEBTS AND DEDUCTIONS CLAIMED
~
DATE PAlO PAYEE DESCRIPTION
~z,.; ~q r ) "
Ir L-I z..... -\ M
OFFICIAL USE ONLY 0 AAF
PA D~~THENt OF RE~UE
~ 0 'f' ~~
,..... l, \
.",
L...
,
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.~., ()
"-.
CXl
AMOUNT PAID
.D
170'>''(0
TOTAL (Ent.r on Lin. 5 of T.x Conput.tionJ
.
~,
Und.r p.n.Ui.. .of
)~~.Plo.to to t{hOt bO'l/~:
L( c. ( { to.. I ,,_ "f i (
parjury, I d.clar. th.t tha f.ct. I
ny knowledga and b.li.f.
HOME
WORK
,
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....
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....
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~
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GENERAL INFORMATION
1. FAilURE TO RESPOND WILL RESULT IN AN OffICIAL TAX ASSE5SHEHT with APPllubla Inl.,..t bU.d on In'or..lIon
,utMltted by the Iln.nc:h' In.Ututlon.
I. Inh.rlt.ncl ,.. blea... delinquent nln. lonlhl nlt,r the d.c.d.nt', d.,. of d.ath.
S. , Jalnt account I. '..,bl. .ven thoueh tha dlc.dant's n... wa. added a. . ..tta, of conv.nl.nc..
_. Account. (Including thO" hald balw.en hosband and wlf,1 which thl dlcad.nt put In Joint n.... within ona y.ar prior to
d..th ar. fully t...bl. II 'r.naf.r..
\. Account. .,tabll'had JointlY batw..n hutband ROd wlf. .or. than ~ Y'.' prior to d..th ar. not ,..abla.
.. Account' held by . dacedlnt "In trult for" another or other. .r. tul'bla fulh'.
REPORTING INSTRUCTIONS - PART 1
- TAXPAYER RESPONSE
1. BLOCK A . 11 the Infcraatlon and coaputatlon In the noUu are corr.ct and daduc.tlon, .r. not b.lng chl..d, placl an "X"
In block "A" of Part I of the ",._p.ylr A..pon.... ..ctlon. Sign two copl.. ftnd .ub.lt th.. with your ch.ck far the .-ount of
ta. to 'h. R.gl.t.r of will. of th. county Indlcat.d. Th. PA a.p.rt.ent of R.venu. will I..ua an offlcl.l .......ent
Ifar. R[V-IS41 EX) upon r.c.lpt of th. r.turn fro. th. R.gl.t.r of Will..
Z. BLOCK I _ If the ....t .p.clfl.d on thl. notice ha. b..n or will b. r.port.d and t._ paid with the p.nn.ylvanla Inh.rltanc.
T.. R.turn fll.d by the d.c.d.nt'. r.pr...ntatlv., pl.c. en "X" In block "I" of Part 1 of the "'a.pay.r R..pon.... ..ctlan. Sign one
cGflY end return to the PA a.part.ent of R.v,nu., lur.au of IndlvldIJel T...., D.pt Z80601. Uarrhburg, PA HUI-OUI In the
env.loPI provided.
). ILOCK C _ If th. notlca Infor.atlon I. Incorr.ct andlor d.ductlon. ar. b.lng clal.,d, ch.ck block "C" and coepl.t. Pert. Z end )
.ccordlng to the In.tructlon. b.low. Sign two copl.. and .Ub.lt th.. with your ch.ck for the ..ount of t._ payabl. to the R.gI.t.r
0' I.IUta of t~. CO\olO';.1/ inJlo..to;d. n...;:.. Depart..nt uf R.venue will Issue .... offldel ........nt \tor. REIf-IS41 EX) upon r.celpt
of the r.turn fro' tha R.gI.t.r of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. [nt.r the d.t. tha account orlaln.llY wa. ..t.bll.had or tltl.d In the .ann.r ._I.tlng .t d.t. of d.ath.
NOTEs For a d.cad.nt dying .ft.r 12/12/12: Account. which the d.c.dent put In joint n.... within on. II) y..r of d.ath ar.
t._abl. fullY" tran.hr.. llow.ver. th.r. h an a.elutlon not to ._c..d .).000 p.r tran.f.,.. regardla.. of the v.lu. of
the account or the no.b.r of .ccount. h.ld.
If a doubl. a.t.rl.k I..) app..r. b.for. your flr.t na.. In the addr... portion of thl. notlc., the .).000 ..clu.lon
alr.ady h.. b.en d.duct.d frae the account balanc. .. r.port.d by the financial In.tltutlon.
Z. Ent.r the tatal balanc. of the account Including Int.ra.t accrued to the data of d.ath.
). Th. p.rcent of the .ccount that It t8lcabl. for 18ch .urvlvar Is d.ter.ln.d a. follow':
A. The p.rc.nt t..abl. for joint ....t. ..t.bll.hed ear. than one y.er prior to the d.c.d.nt'. d..th:
1 DIVIDED IV TOtAL N\JHaER OF
JOINT OWNERS
E_Iaplal A joint ....t r.gl.t.r.d
DIVIDED BY TOtAL NUMIER OF X tOO . PERCENT tAXABLE
SURVIVINC JOINT OWNERS
In the na.. of the dlc.d.nt and two oth.r p.r.on..
1 DIVIDED IV ) (JOINT OWNERS) DIVIDED IV 2 ISURVIVORS) . .167 X 100 . 16.7~ (TAXAILE FOR EACH SURVIVOR)
I. Th. p.rcent ta.abl. for ....t. cr.atld wlthln ana y.ar of the dac~t" d.ath or .ccount. own.d by the decadent bUt held
In tru.t for anoth.r lndlvlduaU') (tru.t beneflclarl..Js
I DIVIDED IV TOTAL NUHIER OF SURVIVINC JOt NT X 100 . PERCEHT TAXABLE
oWNERS OR tRUST !ENEFICIARtES
E.a.pl.1 Joint .ccount ragl.tlr.d In the na.. of the d.c.dant and two oth.r p.r.on. .nd ..tabll.hed within ana y.ar of d.ath by
the deced.nt.
I DIVIDED BV Z ISURVIVORS) . .50 X 100 . SOX (TAXAILE FOR EACH SURVIVOR)
It. Th. l!lllount .ubJ.ct to t._ llln. ft) it d.t.r.lned by sultlplylng the accOW1t b.lence 11In. 2) by the p.runt taubl. llln. )).
S. Ent.r the total of the debt. and d.ductlon. II.t.d In Part 1.
6. Th. a.ount t...bl. (lln. 6) 1. d.tlr.lnad by .ubtractlng the dabtl and d.ductlon. Illn. 5) fro. the aaount subJ.ct to ta_ (lln' ft).
7. Ent.r the apprcprlat. t.~ rata (1In. 1) a. det.r.l~d balow.
A. for dat.. of d.ath occurring aft.r 6/)0/94, the ta_ rat.. for tran,f.r. to .pou... ar. .. follow':
I. Oat.. of d.ath on or aftar 7/1/9~ and b.for. 1/1/95 the rat. I. )~.
2. Oat.. of d.ath on or aft.r 1/1/95 tran.f.r. to .pou... will b. t._.d at ax ta_ rat..
Hotat For dlt.. of d.ath prior to 7/1/94 tran.f.r. to .poula. .r. t..abl. at 6X.
I. Tran.far. to lln.al d..c.ndant. IncludIng f.th.r. .oth.r, .on, daught.r, grandchIldr.n, lon-In-I.w,
daughttr-In-law. .t.pchlld .nd th.lr IlIue ar. taxable at .Ix parcent (6~).
C. Tran.f.r. to all oth.r. Including broth.r, .I.tlr, unci., aunt, "ephew and nl.e. ar. t._abl. at flft..n p.rcent (15~).
D. I' you chang. the ta_ rat., pl.... .p.clfY your r.latlon.hlp to thl decld.nt In the .r.a provided.
8. Th. aaaunt of ta_ due (line I) 1. d.t.raln.d by .uttlplylng the a.aunt ta.abl. (1In. 6) by the ta_ rat. (llna 1).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabla d.bt. and d.ductlon. ara datlr.ln.d a. follow.1
A. You leaally ara r..pon.lbl. for pay.ant, or ttMI ..tat. subject to ~lnl.trat1on by . p.r.onal rapresentatlv. II In.ufflclent
to p.y the deductlbla It....
I. You actually paid the d.bt. aft.r d.ath of the d.c.dent and can furnish proof of pay.ant.
C. Dabt. b.lng elal.ad .u.t b. It..lzed fully In Part). If additional .pac. I. needed, u.. plain pap.r I I/Z" x Ilw. Proof of
paya.nt .ay be r.qua.t.d by the PA D.part..nt of R.v,nu..
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
COMHOHWrAll1t Of l'INNSYlVAN1A
OlPUUINI Of IlIVINUI
IUR1AU Of INDIVIDUAL UIUS
DIP', 110"01
IlARNISIUffC, PA I1lla.a"ol
.
'..
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, '
, '
I
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO, ZI
ACN 9610Z17Z
DATE OZ-10-96
11'-1"1"'" 11."1
EST. OF FRANK A COOK
S,S. NO. 164-30-3946
DATE OF DEATH 05-ZZ-94
COUNTY CUMBERLAND
TVPE OF ACCOUNT
o SAVtNGS
o CHECKING
o TRUST
IX] CERTIf,
EULAH F GRUGAN
31 FORT ST
LEMOVNE
PA 17043
RENIT PAYNENT AND fORKS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PNC BANK hu provld.d the D.pllrt..nt with the Inforutlon Iht.d b.low which has bean u.1Id In calculatlng the
pot.ntlal tllM du.. Th.lr r.cord. Indlcat. that at the d.llth of the above d.c.d.nt, you w.r. a Joint owner/b.n.flclary of thl. IICCount.
If you f.e1 thh Infor.llllon It Incorr.ct, pha.. oblaln wrltt.n corr.ctlon fro. the financial In.tltutlon, attach a copy to thh for.
and r.turn It to the above addr.... Thl. account I. laM.bl. In accordanc. wllh the Inh.rltance TaM law. of the COllllon...alth of P.nn.ylvanla.
Que.tlon. lI~y ~o ~'H.r.~ ~y ,"III"g (7171 787-A\l7.
COMPLETE PART 1 BELOW .
Aecount No, Z10010ZZ337
. . SEE REVERSE SIDE FOR
D.t. 03-10-88
e.bblhhed
FILING AND PAYMEriT inSTRUCTIONS
Account B.1.nc. 10.056. ZZ
Percent Taxable )( 8.333
Amount Subj.ct to h. 837.98
T.. R.t. X ,15
Potont1ol T.. Duo lZ5.70
PART TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
A. [] The above Infor.atlon and taM du. I, correct.
I. You .ay choo.e to r..lt pay..nt to the R'III.t.r of Will, with two copl.. of thl. notlc. to obtain
a dl.count or avoId Inl.re.t, or YOU lIay ch.ck bOM "A" and r.turn thl. notlc. to the R.gl.ter of
Will. and an official a.......nt ..III b. I..u.d by the PA D.part..nt of R.v.nu..
10 Inlur. prop.r cr.dlt to your account, two
(l) cop I., of thl. not Ie. au.t IIcco.pany your
pay..nt to the R.ght.r of Will.. "Ilk. ch.ck
paYabl. to: "RIIghtllr of Wllh, AII."t".
HOTE: If ta. paye.nt. ar. .ad. within thr..
()) .onth. of the d.cadllnt's date of d.ath,
you .ay d.duct a 5;( dltcOU"lt of the lal( du..
Any Inh.rltanc. tax dUll wlll b.co.. d.llnqu.nt
nln. (9) .onths after the datil of daath.
[CHECK ]
ONE
BLOCK
ONLY
B. 0 Th. above nut hu bun or will be r.porhd and taw paid with the pllf'lnsylvanla Inhllrllanc. Tn r.lurn
to b. 'lIed by the dec.d.nt'. r.pr...ntatlv..
C. ~ Thll I!Ibov. Inforutlon It Incornct and/or dllbts and d.ductlon. w.r. paid by YOU.
-' You w,t co.plete PARr 0 and/or PART ~ b.low. () ()
If you indicate a different tax r.t., pl.... .t.te your
r.lationshlp to d.ced.nt:
PART
[!]
TAX RETURN . COMPUTATION
LINE 1. Uat. Ealablhhed
2. Account Balanc.
3. Perc.nt T.xabla
4. Anount Subj.ct to Tax
S. Oebt. and Deductions
6. Anount Taxabl.
7. Tax Rat.
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1 '3-/0.1:: '6
2 I CJ . (> S(p ,2-'-
3 X 3,~~'3
4 ~3.1,9?,
5 '.' 0. 7. 'i ~~
6 C
7 X
B
0., F"ICIAL SE O~Yi 0 AAF
PA DEPARTMENT OF REVENUE
... I >..
z
"
c
PAD
1
2
3
4
5
6
7
8
CLAIMED
"
I
. ,
: ) ..,.
........
')C .. (.'.
:.--..... ; , ,
CO
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
,
'"
....
~\;)
l(
-J....
,
';)
~
~
PART
!!l
DATE
DEBTS AND DEDUCTIONS
IZM
v,
v
~ ,
TOTAL (Ent.r on Lln. 5 of Tax Conputation)
.
"'~ ~
:'1-<\
Q' ,
,,~~ f '\J
" <.:l
I~, '1& .J. ~
~it,/. ~
Under penaltia. of p.rjury, I declare th.t the fact. I
fconPI.t. to th~ b..t~Of n)' knowledge and bal1.f.
'ri~P(A~E~ 1~'I~~tU~:;' " \~ . ~
have r.ported above are true, correc\_
HOME ("//') :1.,/."",-,
WORK ( / I 1 ) (~:.; i' ',J' J 1
TELEPHONE NUM R
1. fAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAX ASSESSHENT with "ppllubl. Inhr..t ba..d on Infor..tlon
.ubIIlttad by tha flnancl.l In.titutlon.
Z. Inherltanca ta. baco.a. dallnquent nln. eonth. .ft.r th. d.cadant'. data 0' d.ath.
1. A Joint account I. ta..bl. .van though thl dlcldant'. n..a wa. eddld .. . ."tt.r of convanl.nca.
4. Account. Clncludlng tho.a h.ld batwa.n hU.band and wlfa) which tha decad.nt put ln Joint n.... within on. y..r prior to
de.th .ra fully ta.abla .. tran.f.r..
S. Account. a.tabllsh.d JointlY batw..n hu.band and wlf. eor. then on. ya"r prior to da.th e'l not t.."bla.
6. Account. hald by . d.cadant "In tru.t for" AnOth.r or othar. .ra t...bl. fully.
GENERAL INFORMATION
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
I. IlOCK A _ If tha Infor.atlon end co.putatlon In tha not Ie. ara corract and daductlon. .ra not baing cl.I..d, pl'C. an "X"
In block "A" of Part 1 of tha "T..p.yar R..pons." ..ctlon. Sign two cop I.. and .ubelt th.. with your chack for tha ..ount of
ta. to the Ragl.t.r of Will. of the county Indlcatad. Tha PA Oapart..nt of Rav.nua will I..u, an offlcl.l ........nt
CFor. REV-I~I EXI upon r.c.lpt of thl r.turn fro' tha R.gI.t.r of Wills.
Z. ILOCK I _ If tha ....t .paclflad on thl. notlcl h.. bl.n or will bl rlPortad and t.. paid with thl Pann.ylvanl' Inharlt.nca
la. Raturn fllad by the dacad.nt'. rapra.lnt.tlvl. pl.cl an "X" In block -B- of Part I of tha "l..paylr Ra.pons'" ..ctlon. Sign onl
copy and raturn to tha PA Oapart.ent of Ravenue, luraau of IndividUal l..... Oapt 210601. Harrisburg, PA 17111-0601 In tha
envllope provldad.
,. IlOCK C . If .h. no.lc. Infar..'lan I. Incarr.c' .nd/ar d.dUc.lon. .r. b.lng cl.I..d, ch.ck black .C. and ca..I.'. P.rt. , end ,
according to tha In.tructlon. bllow. Sign tva capias and sub.lt th.. with your ch.ck for tha ..ount of ta. payable to tha Rlgl.tlr
of wUlI of tn. COU"'." I".,I~.'~=. T..... f'A napartaent of R.....nua .ill IUua an offici..; lI:aU:::<:": (fora ;;r,'J-IS'o1 ElO upon recalpt
of tha r.turn fro' thl R.glat.r of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Ent.r the data the account orlgln.llY wa. ..t.bll.h.d or tltlad In the .ann.r ..I.tlng .t d.t. of daath.
HOTE: For a dlcldant dying .ft.r 11/12/a2: Accounts which the d.cad.nt put In Joint n..es within ana (1) year of daath .ra
t..abla fully.' tr.n.fars. 1I0w.ver. thare h an ..clusIon not to IlIc..d SS,OOO per tr.n.fare. rellardl... of tha v.lul of
thl BCcount or tha nuabar of account. held.
If . doubla .st.rl.k CMM) .pp.ar. before your first naaa In tha .ddress portion of thl. notlca, tha SI,OOO eacluslon
alreadY h.. be.n d.ductad froa the account balance a. raported by tha financial In.tltutlon.
z. Entar tha total balanc' of thl account Including Int.r..t BCcrued to the data of da.th.
3. Thl parc.nt of tha .ccount that I. t..abl. for .ach .urvlvor la datar.lned .s follow':
A. Tha parcant t..abla for Joint ..s.ts a.tabllshed .or. than one yaar prior to tha dacadant.. d.ath:
1 DIVIDED BY TOTAL NUHBER OF
JOINT OWNERS
E..-pl.: A Joint a.s.t reglatered
1 DIVIDED BV 5 CJOINl OWNERS) DIVIOED BV 2 CSURVIVORS) . .167 X 100 . 16.1~ CTAXABlE FOR EACH SURVIVOR)
DIVIDED IV TOTAL NUHBER Of X 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In tha n..a of the d.cedant and two othar p.rson..
I. Thl parcent ta..bla for ass.ts cre.tad within one y.ar of the deC.dent's daath or .ccounts owned by the decadent but hald
In tru.t for anothtlr IndlvlduaU.) (tru.t b.....flchrl..H
1 DIVIDED IV TOTAL HUMBER OF SURVIVING JOINl X 100 . PERCENT TAMABLE
OWNERS OR TRUST BENEFICIARIES
E.aapla, Joint account rotlster.d In the n... of the dacedent and two oth.r p.r.ons and e.t.bll.hed within anI ye.r of de.th by
tha daeadent.
1 DIVIDED IY 2 CSURVIVORS) . .50 X 100 . SOX (TAMABLE FOR EACH SURVIVOR)
4. Thl aaount .ubJ.ct to ta. (1lna 4) Is datar.lnad by aultlplylng tha account balanca Cllna 2) by the p.rc.nt t..able Cllna 3).
5. Entar tha total of thl dabts and daductlon. ll.tad In Part 5.
6. lh. a.ount ta..bla Cllna 6) Is dat.r.lnld by .ubtractlng tha debt. and d.ductlon. Illne 5) fro' the ..ount .ubJ.ct to tax (line ~).
I. EncI,. ~h4J ....pru...rlll~1I l.. (...11 ~~ill. ;} ft. u.~.r.lh4JU ~iUtt.
A. For datas of d.ath occurring aft.r 6/10/9~. the t.. r.t.s for tran.f.r. to spou.a. ar. .s follow':
1. Datas of death on or aft.r 7/1/94 and bafora 1/1/95 tha rat. ls 3X.
2. Datas of de.th on or .ftar 1/1/95 tran.f.r. to ,pou.a' will b. ta..d at ax t.. ratl.
Notll For d.ta. of de.th prior to 1/1/9~ trans far. to .pou... ar. ta.ahll at 6X.
a. Tran.f.r. to lln.al da.candant. Including f.thlr, aothar, son, daughter. grandchlldran, .on.ln-l.w.
daught.r-In-law. st.pchlld and thalr I.su. .ra t...bl. at sl. p.rc.nt C6X).
C. Trensfers to all othars lnclucUng brother. shter, LrlCla, aunt, n.phaw and nl.ea ara ta.ahl. .t flfl.en pereant Cl5Xl.
D. If you changl the ta. rat., pl.asl splclfY your ral.tlonshlp to the decldent In thl araa provld.d.
a. Th. .IOunt of ta. dUI (llna a) I. det.r.ln.d by aultlplylng thl alount ta..ble (llnl 6) by the t.. r.ta Cllna 71.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND OEDUCTIONS CLAIMED
Allo~.bl. debt. and d.ductlons ara datar.lned .. follow.,
A. Vou I.gally are responsible for p.p.nt, or thl ..tat. Subject to .dalnhtratlon by a p.rsonal representatlv. Is In.ufflclant
to pay the deductlbl. It....
I. You actu.lly p.ld tha d.bt. aftar dlath of tha dlcadant and can furnl.h proof of pay.ent.
C. Debt. baing clal.ed au.t ba ltaall.d fully In Part 5. If additional space 's needed, u.. plain peper a 1/2" . 11". Proof of
p.y..nt eay ba raqua.ted by tha PA Dlpartaant of Ravanua.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787.8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
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CD""OMWUl tit or PlHNSVlVANU
DlPAATHlMT of WIVlHU[
!UR[AU or INDIVIDUAL IA_[5
C1'PT. ~ac601
liARIHS!URC, PA 111:8-D6D1
SHIRLEV
31 FORT
LEMOVNE
C COLEMAtl
ST
PA 17043
-
FILE NO. 21' '?,. .:5 rj S-
ACN 96102160
DATE 02-10-96
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
II_.:UI II If' 11.1"
TVPE OF ACcoutn
EST. OF FRANK A COOK 0 SAVINGS
5.5. NO, 164-30-3946 0 CHECKtNG
DATE OF DEATH 05-22-9" 0 TRUST
COUNTY CUMBERLANO [X] CERTlF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PHC BANK hn provldlld thll DlIPartunt with the Inforutlon IIshd bCllow which has bun uSCld In cnlculatlng th.
potontlal taM duCl. Th.lr rClcords Indlcat. that at thCl dClath of tho abov. dClcCldllnt, you WClr. a joint ownClr/bene'lclary of this account.
If you hd this Infor....tlon 1s Incorroct, pluse obtain wrlUGn correction fro. thll flnanclel Institution, at\lch a copy to this for.
and return 1\ to the above addr.u. This nccount Is tn.able In accordnncG ..1\h tho Inhllrltance hi. la..' of the Co..onwu1th of p.Mulvanla.
Cu..tlon~ .,,~ b. ancwernd ~y celll"~ (1171 7a7-!3~7.
10,056.22
8,333
837.98
,15
125,70
TAXPAVER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT BASED ON THIS
COMPLETE PART 1 BELOW M M
Account No. 210001022336
Account aalance
Parcent Taxable
Anount Subjoct to
Tax R.te
Potential Tax Due
Tox
PART
IT]
M SEE REVERSE SIDE FOR
Dote 03-10-88
Established
FILING AND PAYMENT INSTRUCTIONS
To Inlure prG'per crlldlt to your account, hoo
(2) cop Ie. of thll natlce .ust ncco.pany your
pay.ent ta the Register of wills. Make check
payable to: ~Reglst.r of Wills, Agent".
x
HOTE: If taM paYBont' ar. Bad. Mlthln threl
l!) .onths of the declldent's datI of dAath,
you .ay deduct a ~~ dllcount of the ta. du..
Any Inherltanc. taM dUI ..'11 beceee delinquent
nine (9) Bonths after the date of death.
x
NOTICE
A. rxr The :!I~ove lnforutlon Bnd tB. duo Is correct.
~ 1. YoU .ny cheose ta reelt paY.llnt to the RlIgIster of wills Mlth two COpll1 of this notlc8 to obtain
a discount or avoid Interelt. or you .ay chock bo. ~A- and return this notice to the Rogllter of
will. and an offlcl.l als..s.ent will bll ISlued by the PA Cepart.ent of Revenue.
[CHECK ]
ONE
BLOCK
ON LV
B. c=J The above allet has been or Mill be reported and tn. paid with the Ponnsylvanla Inheritance Ta. r.turn
to bo flied by the decodent's r.prolentatlve.
C. c=J Tha above Infor.atlon Is Incorroct and/or debts and doductlons ..er. paid by you.
You .ust coeplete PART ~ andlor PART [!] below.
If you indicate a different tax rata, please state your
relationship to decedent:
OFFICIAL USE ONLY 0 AAF
PA DEPARTHENTOF REVENUE
PART
~
TAX RETURN - COMPUTATION
LINE 1, Date Establish5d
2. Account ealence
3. Percent Taxable
4. A~ount Subjact to Tax
5. Debts and Deductions
6. A~ount Taxable
7. Tex R.te
B. Tex Due
PART
[!]
DATE
PAID
PAVEE
OF
1
2
3
4
5
6
7
8
TAX ON JOINT/TRUST ACCOUNTS
PAD
.1
2
3
4
5
6
7
8
CLAIMED
x
x
DEBTS AND DEDUCTIONS
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Co~putation)
I
I
.
Under penallies of perjury, I declare thet the fects 1 heve reported above are trua, corract and
co~pl.te to the best of ny knowledge and belief.
HOME
WORK (
TELEPHONE
COI1MOHwUoL 111 Of r[HNSVLVANIA
D[PARTM[HT Of R[VLHU[
BUREAU or INDiviDUAL lAll[S
D[PT. llO601
,,"WRISlURCi, PA l1ll6'ObOl
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21, 'i~' ?fl if
ACN 96102169
DATE 02-10-96
1I1.,hl II I" II 'II
SHIRLEY
31 FORT
LEMoYllE
C COLEMAtl
ST
PA 17043
TYPE OF ACCoUtH
EST, OF FRAtlK A COOK 0 SAVINCS
S.S, NO, 164-30-39(,6 OCIIECKIIIC
DATE OF DEATH 05-22-94 rJ TRUST
COUNTY CUMBERLAND !Xl CERTlF,
REMtT PAYMENT AND rORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PHC BANK hili provided the Oepftrhent with t~e Infor.IlUon Ilstod b.low whIch hilS b..n uud In calculating the
pot.ntlal tax due. Th.lr records Indlcat. th't ftt t~e de.th of the "bove decodent, you ~ero a joint own.r/benoflcl.ry of this account.
If you fool thl. Inforoatlon 'S Incorr~ct. pl.ase ohtaln written corroctlon fro. tho flnftnclal In.tltutlon, attllth a copy to thl. for.
nnd return It to the above nddro,.. lhls atcount I. ta_nbl. In actordAnce with tn. Inherlta"c. Tnx laws of tho Coe.onw.alth of P.nnsylvanla.
Qu.stlnns .ay bo answor.d b~ call1nq (117) la7.8~Z7.
COMPLETE PART 1 BELOW M M M SEE REVERSE SIDE FOR FILING ArlO PAYMENT INSTRUCTIONS
Account No, 21001022330 D.te 03-10-08
Established
Account Bd.nca
Percant Taxable
Anount Subject to
Tax Rat.
PotentIal Tax Due
10,056.22
8.333
837.98
.15
125.70
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT BASED ON THIS
To Inlur. pr~.r crodlt to 'lour atcount, two
(2) cop).s of this not Ie. .u.t Icco_pany your
pay..nt to tho R.ght.r of Wllh. t1Ak. ch.tk
PAyable to: "R.ghter of Will', Aoent".
x
x
HOTE: If tax payelnts .r. .ade within thr..
(!) eonths af the d.c.d.nt's date of d..th,
you .ay doduct a S~ discount of the tax du',
Any Inh.ritanc. ta~ duo will b.co.. dlllnqu.nt
nino 19) lonths aft.r thl date of death.
Tox
PART
ill
NOTICE
[CHECK ]
ONE
BLOCK
ONLY
A. ~ Th. obov, Infor'ltlon Ind taK duo Is corr.ct.
~ 1. You _ay chooso to r..it pay.ont to the R.glst.r of wills with two copl.. of thl. notlc. to obtain
a discount or avoid lnt.rest, ar you .ay chIck box "A" And return this not Ie. to the R.gl.t.r of
wllh and an offldal u......nt ifill b' luuod by \h. PA Doparh.nt of R.vlnue.
B. 0 Th. above au.t has baan or will b. r.ported and hx paid with tho Plnnsylvanla Inh.ritance Tax roturn
to b. fllad by tho dlc.d.n\'s r.prosln\atlv..
C. c:J Th. above lnfor.atlon I~ncorrect and/or debts and d'ductlons w.r. paid by you.
You lUst caaplata PlRT ~ and/or PART [!J below.
If you indIcate a dIfferent tax rat., pl...a stata your
relationship to dacadent:
OFFICIAL USE, ONLY 0 AAF
PA DEPARTHENT OF REVENUE
PARr
~
TAX RETURN - COMPUTATION
LINE 1. D.t. E.t.b11,~.d
2. Account Balance
3. Percant Taxable
4. A~ount Subject to Tax
S. Debts end DeductIons
6. Anount Taxable
7. Tax Rat.
8. Tax Ou.
ON JOINT/TRUST ACCOUNTS
OF TAX
1
2
3 X
4
5
6
7 X
8
PART
~
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
\
TOTAL CEnter on LIne 5 of Tax ConputetJonJ
.
Under penaltla. of par jury, I declara th.t tha facts I hav. reportad abov. ara trua, corract and
conplah to tha bast of ny knoMhdga and ballaf. HOME ( .oj
:-.~ ,:"., {, . L-I.l. ,. J WORK (
TAXPAVER SIGtlATURE TELEPHOtlE
'" ,; ",
DATE
CQKHONW(AlTH Of P[NNSYlVANIA
tl[PAJUHl:.NT or R[V[NU(
lURE AU Of INDIVIDUAL TAXES
DEPT. 2110601
IIARAISlURQ, PA I1UI.0601
'*'
FILE NO. 21' 'it" 5'( Ii
ACN 96102171
DATE 02-10-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
In.lhl II lJ' II.'"
TVPE OF ACCOUNT
o SAVIHGS
o CHECKIHG
o TRUST
00 CERTIF,
EST, OF FRANK A COOK
5.5. NO. 164-30-3946
DATE OF DEATH 05-22-94
COUNTY CUMBERLAND
SHIRlEV C COLEMAN
31 FORT ST
lEMOVNE PA 17043
REHIT PAYHEHT AHO FORHS TOI
REGISTER OF WIllS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PNC BANK hn provided the D.pllrt..nt with the Infor.sUon I hted bslow which hn been u..d In eIllculllUna the
po.ontl.. 'n du.. lh.lr r..ord. 1""1.... ,h.. .. ,h. d...h 0' .h. obov. d.codoon', ,ou ".r. . jDln' .....r/b.n.lleI." 0' ,hh .........
l' ,ou ...1 .hl. In'Dr...lon I. In.orr..', pl.... ob..ln .rl...n .orr...lon Ir,' .h. 'Iron.I., In.'I'u'lon, .....h . .0P' '0 ,hl. 'or.
ond r,'urn I' '0 ,h. .bov. .ddr..., lhl. ........ I. ..,.bl. In ...ordon.' .I.h .h. Inherl..ne. t., l... o' .h. to.......l.h 0' p....,lvonl..
Qu..tlon. .IlV be anlw.red b~ cftlllnQ (111) 111'8521.
COMPLETE PART I BELOW . . . SEE REVERSE SIDE FOR FILING AND PAyMENT INSTRUCTIONS
Account Ho, 21001022337 0.1. 03-10-88
Eoloblhh.d
Account Balance
Percent Ta_able
A.ount Subject to Ta_
Ta_ Rate
Potent ial Tax Due
To Inlure proper credit to your IlCCount, two
(2) cop Ie. of thl. notice .ust Ilcco.pany your
p.y.ent to the Realster of Will.. Hake check
pllyable tOI -Realster 0' Wills, Aaent".
PART
ill
10.056,22
8,333
837.98
.15
125,70
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
x
HOTE: If t.x pay.antl are ..de within three
eS) .onthl of the decedent"s dllte of death,
you ..y deduct a S:< discount of the tax due.
Any Inheritance tllX due "Ill beco.e delinquent
nine (9) .onths after the date of death.
x
[CHECK ]
ONE
BLOCK
ONLY
A. The above Infor..tlon and tax due Is corr.ct.
1. You .ay choo.e to reelt pay.ent to the Realster of will. "Ith two copies of thl. notice to obtain
. discount or .vold Inter..t, or yOU .ey ehIlCk box "A" and return this notice to the Reallter of
Wills and en oHlclel .......ent will be I..ued by the PA Dllpert.ent of Revenue.
a. c=J The above es.et he. been or wIll be r.ported end tllX paid with the pennsylven!e Inheritance T.x return
to be filed by the decedent"s reprelent.tlv..
C. c=l The above Infor.lltlon Is Incarr.ct end/or debts and dedUCtions "ere paid by you.
You sust cOllPl.t. PART (!] and/or PART ~ below.
If you indicat. . different tex rate, plee.e state your
relation.hip to decedent:
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TAX RETURN . COHPUTATION OF TAX ON
LINE 1. Date Eltoblllhad 1
2. Account Belance 2
3. perc.nt Taxable 3 K
4. Aaount Subject to Tax 4
5. Debt. and Deduction. 5
6. Anount Taxable 6
7. Tax Rate 7 X
8. Te_ Due 8
JOINT/TRUST ACCOUNTS PAD
1
2
3
4
5
6
1
8
DEBTS AND DEDUCTIONS CLAIMED
-
PART
~
DATE PAID
PAVEE
DESCRIPTION
AHOUNT PAID
TOTAL (Enter on Line 5 of lex Coaputation)
.
Under penaltie. of perjury, I declare th.t t~ fact. I heve reported above .re true, correct and
conplete to the be.t of ay knowledge .nd bellef. HOME (! .1) 1" 1- (' ~ , ",-
~:J..' ~l" , " p. .,,-, ,,' WORK ( ) 'i'
TAXpAVER SIGNATURE TELEPHONE NUMBER
GENERAL INFORMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OFfiCIAL TAX ASSESSHENT with applicable In"r..t b..ed on Infor..tlon
,ubIIlttad bv thl IInanclal In.tltutlon.
Z. Inh.rltance taM baea... delinquent nln. 80nthl .ft,r thl d.c.~ant.. data of d..th.
1. A Joint account I. t..abl. Ivan though the dlcadan", n... ..a. added II . ..tt.t of conv.nlanc..
... ACCO\M'ltl C IncludinG thou held bat".." hu,band end "lfal which thl dlcad.nt put In Joint n.... within on. yur prior to
d.ath .t. fully ,...bl. a. tran,f.r..
~. Accounts ..tabll,had Jointly bat....n hUlbAnd and wlf. aor. than on. y..r prior to d.ath at. not ',.abla,
6. Account. held by . dacadant -In Irult for. anothlr or othar. ar. t..abla fully,
REPORTING INSTRUCTIONS - PART 1
- TAXPAYER RESPONSE
1. BLOCK A ~ If the Inlor..llon end co.pulatlon In thl notlCI at. corract and d.ouctlon. .r. not baing clalaad, placa en -X-
In block -A- of Part I of the -Taxpay.r R..pon..- ..ctlon. Sign two cop I.. and .ubalt thaa with your ch.ck for the a.ount of
t.x to the R.gl.t.r of will. of tha county Indica tad. Th. PA D.part..nt of R.v.nu. will I..u. en official a.......nt
(For. REY~IS~a EX) upon r.c.lpt 0' the raturn fro. the R.gl.t.r of will..
Z. BLOCK I ~ 11 the ....t .p.clfI.d on thlt notice has b..n or will be r.port.d end tax paid with th. P.m.ylvanla Inharltanc.
Ta. Raturn ,11.d by the d.c.dant'. r'Pta..ntatlva, placa an .X- In block -a. of Part I 0' the -Taxpay.r R..pon.a- ..ctlon. Sign one
copy and return to tha PA Daparta."t of R.v.nue, auruu 0' Individual Tau., Dapt 2110601, Itarrlsburg, PA 171211.0601 In the
.nv.lopa provided.
1. BLOCK C ~ If tha not Ie. Infor.atlon I. Incorr.ct andlor d.ductlon. ara b.lng clal..d, ch.ck block .C- and coapt.ta Part. Z and 1
according to thl In.tructlon. balow. Sign two coplol and .ub.lt tha. with your chick for tha a.ount of ta. payabl. to the Rlgl.tar
of Will. of tha county 'ncicatao. ii'I;'.. ;;...., tUtlt of ~"'anue ,11111 In~ an cHlchl c.::~n;;;~t t~:':'D ':~.J.t!l46 EX) ;:pc" racel~t
of tha raturn 'roe the Ragl.tar of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Entar the data the account originallY WI' 'Itablllhad or tltlad In the .ann.r ..I.tlng at data of d.ath.
NOTE I For. dlcld.nt dying aft.r IlllZ/al: Account. which the dlced."t put In joint n.... within on. (I) yaar of d.ath .r.
t..abl. fully II tran.fer.. Howtlver, thar. .. an exclullon not to axce.d U,OOO par tranlf.". "gardl... of the "alu. of
tha IICCount or tha nuabar 0' .ccount. h.ld.
If . doubl. alt.rllk (~.) .ppe.r. bl'or. your flr.t na.. In tha .ddr... portion of thl. notlc., the 13,000 ..clullan
alraady ha. b.an d.dUcted froa the acc~t balanc. a. raportad by the financIal In.tltutlon.
Z. Entar the total balanc. of the account Including Int.r..t accrued to tha data 0' daath.
l. The p.rcent of tha account that I. taxabl. for .ach .urvlvor II dat.r.lned a. folloMl1
A. Tha parc.nt t..abl. for joint ....t. ..tabll.h.d .ur. than one y.ar prior to the dt<.dant'. d..thl
I DIVIDED IV TOTAL HOHlER OF
JOINT OWNERS
EXIIPI.: A joint ....t r.gllt.r.d
DIVIDED av TOTAl HUMBER OF X 100 . PERCENT TAXABLE
SURVIVINC JOINT OWNERS
In tha na.. of tha d.c.d.nt and two other par.on..
1 DIVIDED IV 1 (JOINT OWNERS) DIVIDED av Z (SURVIVORS) . .167 X 100 . 16.7X (TAXAalE FOR EACH SURVIVOR)
I. Th. parcent taxabl. for ....t. cr.at.d within one y.ar of the d.c.dant'. d.ath or .ccount. owned by the d.c.d.nt but h.ld
In tru.t for anoth.r Indlvldu.I(.) (tru.t beneflclarl.I):
1 DIVIDED IV TOTAL HUMIER Of SURVIVINC JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
Exaapl.: Joint eccount ragl.t.r.d In the n~' of tha d.c.d.nt and two oth.r p.r.on. and ..tabllshad within ana y.ar 0' d.ath by
tha d.c.d.nt.
1 DIVIDED BV 2 (SURVIVORS) . .50 X 100 . SOX (TAXAILE FOR EACH SURVIVOR)
~. Th. aaount .ubj.ct to ta. (1In. 4) I. d.t.r.lnld by aultlplylng tha .ccaunt balanc. (1lna 2) by thl parcant t..abl. (11na l).
S. Ent.r the tat.l a' tha d.bt. and deduction. II.t.d In P.rt l.
~ Th. "oaunt tax~~I. (tin. 6) I. dat.r.ln.d by subtracting the d.bt. and d.~tlon' (lln. 5) 'roa tha ..ount .ubj.ct to ta. (llna 4).
, . Ent.r tha ap..,ro;::- lata tu rata (1 !~. 7) u :Sat:rtt!nod ta:.'..
A. For det.. of d.ath occurring aftar 6/10/94, thl tax r.t.. for tran.f.r. to Ipoul.' ar. .. followl:
1. Oat'l 0' d.ath on or .ft.r 7/1/9~ and b.for. 1/1/95 tha rat. I. lX.
Z. D.t.. 0' d..th on or .ft.r 1/1/95 tran.f.r. to .pou... will b. ta..d .t OX ta. rat..
Notal For d.t.1 of d.eth prior to 7/1/9~ tran.f.r. to ,POUI.. ar. taxable .t 6X.
I. Tranl'a" to lIn.el d"Clndanh Including father, .other, son, daughter, grandchildren, lon~ln-I,""
daughtar~ln~law, It.pchlld and thalr I..u. ara taxabl. at .1. p.rc.nt (6X).
C. Tranlfar. to all ath.r. Including broth.r, .I.t.r, unci., aunt, n.ph.w and nl.ca .ra taxabl. et flft..n p.rcant (ISX).
D. I' you chang. the ta. rat., pl.... .paclfy your ralatlon.hlp to tha dec.dent In thl ar.a provld.d.
a. Th. a.ount 0' ta. dua (lln. 8) I. d.t.r.ln.d by aultlplylng the ..ount taxabl. (Iln. 6) by tha ta. rat. Cllna 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. d.bt. and d.ductlon. ara d.t.r.ln.d a. follow.,
A. You legallY a" r..pon.lbl. for pavaant, or the ..tat. .ubj.ct to adalnlstr.Uon by a par.on.l repr..antaUv. II Inlufflcl.nt
to pay tha d.ductlbl. It"I.
I. You actually paid the d.bts aft.t d.ath of the d.c.d.nt and can 'urnlsh proof of pay..nt.
C. D.bts b.lng chl..d IUlt b. 1t..lled fullY In Part 1. If adcUUonal IPac. II nMdad, un plain papar a 1/l. . 11.. Proof of
pay..nt .ay ba r.qualt.d by tha PA nepart..nt of R.v.nue.
TAXPAVER ASSISTANCE
IF YOU NEED FURTHER INFORHATION 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 IHPAIRED ONLY)
COtofOHW{AUH OF P[NNSYlVANIA
()[PARTHENT Of REVENUE
BUREAU Of INDIVIDUal lUES
DEP'. 110601
HARRISBURG, PA 111:I.D6DI
.
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21' '/(.'
96102174
02-10-96
;; 15'
.".1161 (III' 1I.t\t
EST. OF FRANK A COOK
5.5. NO. 164-30-3946
DATE OF DEATH 05-22-94
COUNTY CUMBERLAND
TVPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
[Xl CERTIF,
SHIRLEV C COLEMAN
31 FORT ST ;,: ,
LEMOVNE PA 17043
RENIT PAYNE NT AND FORNS TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PHC BANK ha. prOllld.d the D.p.rt.ent ..lth the Infar..Uon listed below which h.. b..n u..d In calcul.tIng the
potential ta. due. Th.lr r.cord. Indlcat. that at the d..th of the nball. d.c.d.nt, you ...r. . Joint own.r/b.n.flclary of thl. account.
If you f.. I thl. Infar..tlon I. Incorr.ct, pl.... obtain wrltt.n carr.ctlon fro. the flnancl.1 In.tltutlon, att.ch . copy to thl. for.
and r.turn It to the abav. .ddr.... Thl. account I. t...bl. In .ccardanca with the Inh.rltanc. T.. L.... of the Ca..an....lth of Penn.ylll.nl..
Due.tlon. .~y be Dnl..red by c~lllng (?11) 1~1.'5~1.
COMPLETE PART 1 BELOW . .
Account No. 21001022275
. SEE REVERSE SIDE FOR
Doh 09-24-92
EstablJsh.d
FILING AND PAYMENT INSTRUCTIONS
Account 8010nco 10,049,26
P.rc.nt T.xabl. )( 8.333
Amount Subjoct to To. B37 .40
To. Rot. X .15
Pohntlat To. Duo 125.61
~~ TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMEMT BASED OM THIS NOTICE
A. '("71' Th. above Infar.atlan and tax due Is correct.
~ I. You .ay choose to r..lt pay.ant to the Regllt.r of Will. ..Ith two cop Ie. of this notice to obtain
a discount or avoid tnt.r..t, or YOU .ay ch.ck box ~A~ and r.turn thl. notlc. to the R.gl.t.r of
Will. and an official au.u..nt will ~ luu.d by the Pi D.p.rtaent of R.venue.
To Insura prop.r cradlt to your account, two
(l) copl.. of thl. notlc. au.t accoapany your
pay.ant to the Aagl.t.r of will.. Maka ch.ck
payabla tOI MAagl.tar of Will., AgantM.
NOTEI If tax pay..nt, ar. .ad. within thr..
(1) .onth. of the d.c.dant', data of d.ath.
you aay daduct . 5~ dl.count of the t.. due.
Any Inheritance ta. due ..111 beca.a d.llnquent
nine (9) .onth. .ftar the data of d..th.
[CHECK ]
ONE
BLOCK
ONLY
B. c:J Tha aboll. a,sat h.. ba.n or will b. raportad and tax paid ..Ith the Pann.ylvanla Inharlt.nc. 'a. r.turn
to b. fllad bV the dacadent'. rapr..entatllla.
C. c:J tha abolla Infor..tlon I. Incorract and/or dabt. and d.ductlon. wara paid by you.
You au.t coaplata PART ~ and/or PARr [!] balow.
If you indicat. a diffarant tax rat., pl.... at.t. your
r.l.tion.hip to dec.d.nt:
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Dot. Establlsh.d 1
2. Account a.lanc. 2
3. Parc.nt Taxabl. 3 X
4. Anount Subject to Tax 4
5. Debts .nd Deductions 5
6. Anount Taxabl. 6
7. Tax R.t. 7 X
8. Tax Dua 8
PART
[!]
DATE
DEBTS AND
PAD
1
2
3
4
5
6
7
8
DEDUCTIONS CLAIMED
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
i
TOTAL CEnter on Lin. 5 of Tax ConputationJ
Under penalti.. of perjury, I declare that th. fact. I
conpl.t. to th. b..t of ny knoNI.dg. and b.li.f.
I
,
, , "\ .
TAXP;"VE~ \iI~~A'T~~E'
h.y. r.ported .boy. er. true, corr.ct and
HOME (\, i )
WORK ( )
TELEPHONE NUMBER
I' , ":,
1,/1'
o TE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFfiCIAL TAX ASSESStlEHT wUh ftPpllCftbll Int.r..t bend on Intor..tlon
.ub_Uted by thl financial Institution.
Z. Inheritance tax baea..' delinquent nlna .onthl .ft.r the d.cadentO, data of d..th.
S. A Jalnt account 1_ t..able avan though the dacadant., ne.. Mil' Ilddad Il' . alltt.r of convenl.nca.
4. Accounts Ilncludlng tho.. held batw..n husband and wUat which the decadent put In Joint n.... within ona yallt prior to
d.ath .r. fully ta.abl. a. tranlf.r..
S. Account. ..tabllshed JointlY batwa.n husband and wlf. .or. thftn onl y..r prior to d.ath ar. not t.xable.
6. Account. held by Il dlcadln' *In tru.t fa'. anoth.r or other. ar. I..abl. fully.
REPORTING INSTRUCTIONS - PART 1
- TAXPAVER RESPONSE
1. BLOCK A . If thl tnlor..tlon and co.putellon In thl notice ar. correct and deduction. .r. not b.lng clal.ad, placa an "X"
In block "A" of Part 1 of tha "Ta.pay.r RaIPon.a" ..ctlon. Sign two cop I., and .ub.lt th.a with your ch.ck far the aeount of
ta. to tha R.gl,tar of Will. of tha county Indlcat.d. The PA D.part.ant of R.venua will I..u. an olflclal a.lal..ant
(For. REV-lS41 EX) upon r.calpt of tha raturn frol tha Raglstar of wills.
Z. BLOCK B _ If the auat .paclflad on thh notice has baen or will ba reportad and ta. paid with tha Pamnlvanla Inh.ritance
TaM R.turn fll~ by tha d.c.d~t's r.pr...nt.tlva, placa an "X" In block "B" of Part I of tha "TaMp.y.r R.IPon.a" ..ctlon. Sign ~
COpy and r.turn to the PA Dap.rhant of R.v,nu., Burnu of IncHvldual Tan" D.pt zaObOI, H.rrhbUrg, PA 1712a-ObOl In tha
anv.lop. provldad.
3. BLOCK C _ If tha notlc. Infor.atlon I. Incorract andlor d.ductlon. .r. b.lng cl.l.ad, chack block "C" and co.pl.t. Part. 2 and S
according to tha Inltructlon. b.I~. ~ID" two coplal and lubalt t~ with your check far tha ..ount of taM paYabl. to thl Rlgllt.r
of L:ll1. oJ' tha cOWl',~, ~r,,;a.:~~.';;. n..~:' :5..artllnt oi r.C'JUWI will luu. .., olflc..~ .....u.ef.t (Fora PI("-1~4B EX) uPon rllc..lpt
of the return fro' thl R.ghtar of wUlI.
TAX RETURN - PART Z - TAX COMPUTATION
LINE
I. Entar thl data the account originallY wa. ..tablllhad or tltl.d In tha .annar aMIlltlng at data of d.ath.
NOTE: For a d.cadant dying aftar 12/12/82: Account. which tha dlcadant put In Joint na.al within ona (I) yaar of d.ath ara
taMabl. fully a. tranlf.r.. How.var, thara I. an aMclullon not to aMcaad 'S,OOO par tranlf.raa r.gardla.. of tha valua of
tha account or the nu.bar of account. hald.
If a doubl. a.tarllk (..) appe.r. bafor. your flr.t na.a In the addral' portion of thl. not lea, tha 'S,OOO ..clullon
alr.ady ha. baan daduct.d fro' the account balanca a. raportad by tha financial Inltltutlon.
2. Entar the total balanc' of thl .ccount Including Intara.t accrued to the data of d.ath.
S. Tha parcant of tha account that I. ta..bla for aach lurvlvor II datar.lnad a. follo"'1
A. The percent ta.Bbla for joint aua" athblhhed IICIra then ana y.ar prior to the dacadant.. duth:
1 DIVIDED av TOTAL HUMBER OF
JOINT OWNERS
E.'lpla: A joint all.t ragl.t.r.d
DIVIDED BY toTAL HUMBER Of )( 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the naa. of the dec.dant and two othar p.r.on..
1 DIVIDED BV S (JOINT OWNERS) DIVIDED BV Z (SURVIVORS) . .167 X 100 . 16.7Z (TAXABLE fOR EACH SURVIVOR)
B. Th. p.rc.nt t..abl. for ....t. cr..t.d within ana y.ar of the dacad.nt.. death or account. owned by tha dac.d.nt but hald
In trult for .nothar IncHvldu.H.) (tru.t baneflcl.rI..):
1 DIVIDED BV TOTAL HUMBER OF SURVIVING JOINf
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
E.a.pla: Jolnt account r.gl.t.rad In tha na.. of the dlcadant end two othar p.r.on. and ..t.bll.hed ..Ithln ona y..r of d.ath by
tha d.cadant.
I DIVIDED BV Z (SURVIVORS) . .50 X 100 . 50~ (TAXABLE FOR EACH SURVIVOR)
ft. Th. ..ount .ubj.ct to tax Cllna ft) It d.tar.ln.d by aultlplylna the account balanca Ulna 2) by the perc.nt ta.abla Uln. Sl.
5. Ent.r tha total of the debt. and deduction. lllt.d In Part 1.
10. Th. ..cunt ~..clJI. (lIn' 6) h tt'llt.r.lnad by .ubtrltctlna tha d.bt. and daductlon. Clln. ~) fro' the a.aunt .ubJ.ct to tax elln. 41.
7. Ent.r tha 3Pproprl.ta tB. rat. (1lna 11 al d.t.raln.d below.
A. For d.t.. of d..th occurrl~ .fter 6/S0/94, thl lIlX r.t.. for tran.f.rt to spoysat ara .. folio..':
1. D.t.. of d.ath on or aft.r 7/1/94 and b.for. 1/1/95 the rata I. l~.
2. D.t.. of d.ath on or aftar 1/1/.5 tranlf.r. to IPOUI" will b. t...d at o~ t.. r.ta.
Kotal for d.t.. of d..th prior to 7/1/'ft tran.f.r. to ,pou.I' ara taxable at 6~.
B. Tran,fa" to IIn..l datc.ndantl Including father, aother, ,on, d8UQhtar, grandchlldran, ,on-ln-laW,
daught.r-In-Iaw, st.pchlld and th.lr I..u, are ta~abl. .t .IM percant 16~).
C. Tran.f.r. to all oth.r. Including broth.r, II.t.r, uncia, nunt, n.phew and nl.ca ar. t.Mabl. at fllt.an p.rcent eI5~).
D. If you chang. the taM r.ta, pl.... .peclfY your r.latlonshlp to the dec,d.nt In tha ar.. provld.d.
I. Th. a.ount of t.x due Illna 6) I. d.t.r.ln.d by .ultlplylng the ..ount ta.abl. (line 6) by th. ta. rata (llna 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowable d.bt. and daductlon. ara d.ter.lnad .. followl:
A. You leg.lly ara responslbla for p.yant, or tha ..tata subj.ct to Itdalnlttr.Uon by . p.rtona' repru."tallv. It Insufficient
to p.y the dadUCtlbla It....
8. Voy actually paid the debt. .ft.r d..th of the d.cadant and can furnl.h proof of pay.."t.
C. D.bt. b.lng c!al.ad lNlt be It..bad fulh In Part 1. If addltlona' .pac. Is neaded, un pl. In paper 1 Ill" . 11". Proof of
pay.ant .ay ba r.qua.tad by the PA napart..nt of R.venu..
TAXPAVER 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. TAXPAVER INQUIRV UNIT IN
HARRISBURG AT (717) 787-83Z7. TDDt (717) 77Z-2Z5Z (HEARING IMPAIRED ONLY)
"
c-
I
.r
l
~
-t
J
OJ
\J
Q,
P
J
r
COHHOHWEAlTH Of PENNSYLVANIA
OEPARTHEHf Of R[V[NU[
BUREAU Of INDIVIDUAL TAXES
DEPT. :80601
HARRISBURG, Pi 11128-0601
I : i ' \
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
*
SHIRLEY S COOK
31 FORT ST
LEMOVNE
PA 17043
NO. 21 - q~ - 2fH'
96103809
02-14-96
TVPE OF ACCOUNT
EST. OF FRANK A COOK 0 SAVINGS
S,S, NO. 164-30-3946 0 CHECKING
DATE OF DEATH 05-22-94 0 TRUsr
COUNTY CUM8ERLAND IX] CERTIF.
REHIT PAYHENT AND FDRHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FILE
ACN
DATE
In.atl..,,, lI.tll
PHC BANK hat provided the D.pa,.t..", with tha Infor..Uon listed balow which hili b..n uS.d In calculating tha
pot."tl.l ta. due. That,. racord. Indlcat. that at the d.ath of tha above dacad.nt, YOU war. a Joint own.r/ban.flttery of thl. account.
If YOU '..1 thl. Infor.atlon 1. Incorract, pl...1 obtain written corr.ctlon fro. the 'Inancla. InstItution. attach. copy to thl. for.
and r.turn It to tha above addr.... Thl. account 11 t...bl. In accordance with tha Inherltanca Ta. law. of the Co"onw..lth of Penn.Ylvanla.
au..tlon. ..y b. an.v.r.d by c.lllng (717l 787.8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SID~ FOR FILING AND PAYHENT INSTRUCTIONS
Account No, 210001022336 D.to 03-10-88
E.toblhh.d
Acco...,t B.lance
P.rcent T.xabl.
A.ount Subjact to
Tax Rat.
Potential T.x Du.
To In.ur. proper cr.dlt to your account, two
(2) copl.. of thl. notlc. ~.t acco~any your
p.y..nt to the Rlgl.t.r of Will.. Hak. ch.ck
p.y.bl. tOI ~.gl't.r of Will" Agent-.
PART
IT]
10,056.22
8.333
837.98
,15 '- l
125.70 J '
TAXPAYER R SPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
x
T.x
HOTE: If t.x ply.ent, .r. -.d. within thr.e
(]) .unth. of the dec.dent', date 0' d..th,
yOU ..y d.duct a 5Z dhcOWlt of tM tax duI.
Any lnh8rltance t.x due will b.eo.e delinquent
nln. (9) lanth. .ft.r the d.t. 0' d..th.
x
[CHECK ]
ONE
BLOCK
ON LV
A. r=J The .bov. Infor..tlon and t.x due I. corr'ct.
1. Vou ..y chao.. to r..lt p.yaent to the Regl.t.r of Will, with two copll' of thl. notice to abt.ln
. dl.count or avoid Int.r..t, or YOU .ay ehlck box -A- and r.turn thl. notice to tM R.gl,t.r 0'
Will, and an of'lcl.l .....laInt will be I.sued by tha PA Oapart..nt of R.venue.
a. r:J Th. above ....t ha. b.en or will be reported and t.x paid with the P.nn.ylvanl. Inheritance Tax r.turn
to be 'lied by the decldent'. repr".ntatlve.
C. ~Th' .beve Infer..tlon I. Incorrect end/or debt, and deduction, w.r. paid by YOU.
JClVDU au.t (0-..1Ite PART 0 end/or PART [!] belotlt.
If you indic.ta a diffarant tax r.t., pl.... .tat. your
r.l.tionship to dacad.nt:
PARr
[3J
TAX RETURN . COMPUTATION OF TAX ON JOINT/JR~ST ACCOUNTS
LINt: .1, Data t:.stabll::had 1 ~ -,.. 1.1 _
2. Account B.l.nc. 2 10 I D S'to . ~ 7-
3. P.rcant T.x.bl. 3 X ~ . '3. :s. J
4. AMount Subj.ct to T.x 4 F', 7.9
s. Dabt. and Daduction. 5
6. Aftount T.xabl. 6
7. T.x Rata 7 X
8. Tax Du. 8
OFFICIAL USE ON LV 0 AAF
PA DEPARTMENT OF REVENUE
PART
[!]
DATE
PAD
1
2_
3
4
5
82.7,<(8 6
,Db 7
<;"0, )..'f 8
DEBTS AND DEDUCTIONS CLAIMED
-
~ 1 r
-
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL
CEntar on Lina 5 of T.x COMput.tion)
I
.
Undar panalti.. of parjury, I declar. that the facts
complat. to the ba.t of my knowledge and balief.
, -J . , (~: /,
",. c..! (,1 ({~f > ;. ( ,!" 't-
TAXPAVER S GNATUR
I hav. reportad .bove .r. trua, corract and
HOME (7 17 ) '7 ''1'''- I .;
WORK ( )
TELEPHONE NUMBER
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with applicable Int.r..t ba.ad on In'or.atlon
.ubIIltt.d by the financial In.tltutlon.
Z. Inh.rltance I.. baea... dlllnquent nln. eonth. .tt.r the decadant', data of d..th.
3. A Joint account 1. taxable awan though the d.c~l'. ne.. wa. added a. . ..tt.r 01 convenlenc..
4. Account. (Including tho.. hald batw.en husband Bnd wit.) which the decedent put In Joint n.... within ana y..r prior to
d..th .r. fully 'axabl. ft. tran,f.r..
S. Account. a,tabll,had Jolntlv batw..n husband and wlf. aor. than ona y..r prior to da.th ar. not '..abla.
6. Account. hald by . dacadant "In trult for" anath.r or other. .r. '..abla fully.
REPORTING INSTRUCTIONS - PART 1
- TAXPAYER RESPONSE
1. BLOCk A - If the In'or..tlon and (oaput,,'Jon In the notlc. .,. corr.ct and deduction. ar. not baing clat"d, plec. en "X.
In block "A" of Pert I of the "Taxpay.r R..pon.." ..ctlon. Slun two cop I.. and .ub.lt th.. Mlth your ch.ck for the a.ount of
tax to the R.ul.t.r of Will. of the county Indlcat.d. The PA Depart..nt of R.~enue will l..u. an offlcl.1 ........nt
(For. REV-154ft EX) upon r.c.lpt of the r.turn fro. the R-al.t.r of Will..
2. IILOCK II ~ II the au.t sp.clfl.d on this notlc. has b.en or Mill b. r.port.d and tu paid Mlth the P.M.yl~anh Inh.rltanc.
,.. R.turn fll.d by the d.c.d.nt"s rapr...nt.tl~., pl.c. an "X" In block "II" of Part I of the .Taxpay.r Re.pon.." section. Sign one
copy and return to the PA D.p.rt.ant of R.~anue, lIureau of IndI~ldu.l Ta..., D~t 280601, Harrisburg, PA 11128-0601 In the
.n~.lop. provided.
1. IIlOCK C - If the notice Infor..tlon Is Incorr.ct andlor d.ductlon. are being clel.ed, check block "C. and coapl.t. P.rts 2 and ]
according to the Instructions below. Sign two caple. and subeIt tha. wIth your check for the ..ount of t.x p.yabl. to the R_gI.tar
of Will. of the county IndIcated. The P. D~rt.ent of ~.v~ .111 Is~ an ctflcI6l a~.~..~~,t ~tura fn;~-lS~~ EX) u~o" ro~.lpt
of the return fro. the Regl.t.r of Wills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
I. Ent.r the d.t. tM .ccount originallY Mas .stabllshed or titled In the .ann.r ..Istlng at data of d.ath.
HOTE: For a decedent dying .ft.r 12/12/82: Accounts Mhlch the dec.dant put In Joint n.... Mithln on. (1) y.ar of d..th are
t.xabl. fully .s tran.fer.. Itow.var, th.r. Is an eltcluslon not to .ltce.d 13,000 per transferee r.g.rdl... of the v.lu. of
the .ccount or the nuaber of .ccount. held.
If . double .sterlsk (u) appe.r. b.fore your first ,... In the addr... portion of this noUce, the U,OOO ..cluslon
alr.ady has b..n deduct.d fro. the account balanc. as r.ported by the financial InstitutIon.
Z. Ent.r the total b.lance of the account Including Int.r..t &ccruad to the date of death.
5. The p.rcent of the account th.t I. t.lt.bl. for .ach .ur~lvot I. d.t.relned .. follow.:
A. The p.rcent ta.able for Joint ....t. ..tablI.hed ear. than ooe y..r prior to the d.c.dent.s d..th:
1 DIVIDED IIY TOTAL HOHBER OF
JOINT OWNERS
Exeepl.: A Joint a.s.t r.gI.ter.d
DIVIDED IIY TOTAL HUKBER Of X laD . PERCENT TAXAl\LE
SURVIVIHG JOINT OWNERS
In the n..e of the dec.d."t and two oth.r person,.
1 DIVIDED BY 5 (JOINT mINERS) DIVIDED BY 2 (SURVIVORS) . .167 X IDa . 16.7:( (tAXAIILE FOR EACtI SURVIVOR)
II. The p.rc.nt t.x.ble for all.t. cr..ted within on. y.ar of the dec.d.nt", death or account. OMn.d by the d.cedent but held
In trult for anoth.r IncUvldu.U.J (trust b.neflcIarl..)1
1 DIVIDED BY TOTAL NUHBER OF SURVIVINC JOINT
OWNERS OR TRUST BENEFICIARIES
l( 100 . PERCENT TAXAllE
Exa.pl.1 JoInt account reglster.d In the nae. of the dec.d.nt and two other p.rlon. and e.t.bllshed within on. y.ar of death by
the d.udent.
1 DIVIDED BY 2 (SURVIVORS) . .50 l( 100 . sax (TAXABLE FOR EACH SURVIVOR)
4. Th. a.ount lubJect to ta. Uln. 4) Is d.t.r.lnlld by .ulUplylng the .CCDU'1t balanu (l1n. 2J by the perc.nt t.xabl. Ulne ]).
5. Enter the tot.l of the debt. .nd d.ductIonl Ilstad In P.rt 5.
t. t.n,... '''''BPProph.\'''ta,,'~.\. (ltMo"'h.iI."u_t~~I\'l\iUiB811~ti:' .:....1.. _o<i J:.d,'dl...,,~ fll...... 0;\ ,.."_ ..... nsount IUbject tn tall Clln. 4),
A. For d.t.1 of d.ath occurring aft.r 6/50/94, the t.x r.t.1 for tranlf.rl to Ipoul.' .r. .1 followl:
1. Dat.1 of d..th on or aft.r 7/1/94 and before 1/1/9S the r.t. I. 5~.
Z. D.t.1 of d..th on or aft.r 1/1/9S tranlferl to Ipoul.. will be t.x.d at o~ tax rate
Not.1 For dat.. of death prior to 7/1194 transf.rl to IPOU'.1 .r. taxable .t 6iC .
B. Tranlhr, to IIn..1 d.lcendants Including father, .other, Ion daughter gr~dchlldr
deughter.ln-law, stepchIld.nd their ISlu. ar. taxabl. at slx'parcent (6iC) .n,lon-ln.law,
C. Tranlf.rl to .11 oth.rl Including brother, sllt.r, unci., aunt, neph.w .nd'nlec. .r. t x 1 t
D. If YOU chang. the tax rat., pl.... IPecIfy your r.latlon'hlp to the decedent In the ar:a-:r:v~d.:~ftean p.rcent ()5XJ.
ft. Th. uount of t.. due Uln. ft) 11 dehr.Inad by aultJplytna the nount t.xable (11,... 6) by the t.x rat. (11M 71.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
,~
Allowabl. debtl and d.ductlonl .r. d.t.ralned 81 follOWI!
A. You I.gally .r. r.IPonllbl. for p.y.ent, or the .It.t. 'ubJect to adalni.tr.tlon by 1
to pay the d.ductIbl. It''l. a p.rlon. r.pr..."t.Uve I, InsuffIcient
B. You .ctu.IlY paid the d.bt. aft.r d..th of the d.c.dent and can furnish proof of p.y t
C. Debt, b.lng clal..d ault b. It..Iz.d fully In Part 5. If additional Ipece 11 ,...Qdede.". I I .
payaant eay b. requ.lt.d by the PA Departwant of Revenue. ' us. p . n pap.r 1/2")( II". Proof of
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 -J
HARRISBURG AT (717) 787-8327. TOO' (717) 772-2252 (HEARING IMPAIRED ONLY)
-
.,
:{[
Q,
v
A
r
u
1
~
CD~HWEALTH OF PENNSYLVANIA
DEPART"[Hf Of REVENU[
BUREAU OF IHDIVIDUAl tAKES
DEPr. 280601
HARRlSaUAG, PA 11128-0601
*'
\,
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO, 21 - q(p- 3'if'
96103810
02-14-96
TVPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
[Xl CERTIF ,
."."_III..,.,.t\l
EST. OF FRANK A COOK
S.S, NO, 164-30-3946
DATE OF DEATH 05-22-94
COUNTY CUMBERLAND
SHIRLEY S COOK
31 FORT ST
LEMOVNE
REHtT PAYHENT AND FORHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PA 17043
PNC BANK hat provided the DIPart8ent with the Infor.atton lilted balow which has b.." us.d In calcuhtlna the
potential tax due. Th.lr racordl Indlcat. that at the death of the above dlcedent, you ..ar. a Joint owner/banaflclery of thl, account.
If yuu f.. 1 thh Infor..UcR Is Inco:"nct, pl...1 obtllln ~rltt.n corr.:t1on fro. tlte financial In.tlt'Jt!on. attach a r.opw to thh for.
and nturn It to thl abo.... .dd...... ThIS IIccount II taKable In !Jccordonu with th.. Inh.rltance Tax la... of thl Cononv..lth of Plmlylvanle.
Qu..tlon. .ey be an.w.red by calling (11/) 7el.e5Z/.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTION~
Account No, 21001022337 Doto 03-10-88
e.hblhhod
Account Balanc.
Perc.nt Taxabl.
AMount Subjact to T.x
Tax Rat.
Potantial Tax Oua
To In.ure prop.r cr.dit to your account, two
(2) caple. of thl. notice .ust acco~any your
pay.ent to tho Regl.t.r of Will.. "eke ch.ck
payable tot ~R.gl.t.r of Will., Aalnt".
PART
[!J
10,056.22
8.333
837.98
.15' L
125,70 .)L,'"
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
K
HOTE: If tax pay-.nt. are eade within thr.e
(3) IIOnth. of thie dK~ent.. de'- of death,
you .ay d.duct a SX dl.count of the tax due.
Any Inheritance tax due will becoee delinquent
nine (9) .onth. aft.r the date of death.
K
CHECK ]
ONE
BLOCK
ONLY
A. c=l The above Infer.atlon and tax due I. correct.
1. You eay choo.e to reelt payeent to the R.glst.r 0' Wills with two copl.s of thl. not Ie. to obtain
a discount or avoid Int.r.st, or you .ay check box -A" and return this notice to the R.glster of
Will. and an official a.......nt will be l.su.d by the PA D.part_Int of R.venue.
B. c:J The above a.set has been or will be reported and tax paid with the Penn.vlvanla Inheritance Tax r.turn
to b. flied bv the docedent'. repre.entatlve.
C. ~;he above Infor.atlon 1. Incorrect and/or dobt. end d~tlon. were paid bv Vou.
~VOU .u.t co.plet. PART [!] and/or PART ~ below.
VI
'-
If you Indlcata a dlffarant tax rata, pl.... stat. your
r.lationshlp to d.c.d.nt:
OFFICIAL USE ONLY 0 AAF
'PA DEPARTHENTOF REVENUE
PART
~
TAX RETURN . COMPUTATION OF TAX ON JOINT/TRUST ACCOUtlTS
lINE 1. Doh E.hblhhod 1 -:!. -10 -'ii' '("
2. Account Balance 2 / 0 I ortO. t. "l..-
3. Porcont To.oblo 3 K <('. ? :, '3
4. AMount Subjoct to To' 4 ~ ." 1, '1 ~
5. Dabt. and Daductlons 5
6. A.ount Taxabl. 6
7. Tax Rat. 7 X
8. Tax Dua 8
PAD
1
2_
3
4
5
6
7
"",0, l-c.l 8
DEBTS AND DEDUCTIONS CLAIMED
\(':!- 7.'1'6
,DG
PART
[!J
DATE
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I I
TOTAL CEntar on LIna 5 of Tax COMPut.tlon) ·
Undar panalti.s of perjury, I declar. th.t the facts I
co~l~t. to the bait of MY knowl.dga and baliaf.
,'-! 1.,'\ il. / ' /, /~, l./
TAX{AVER S-I6NATURE
hava reported above ara true, corract end
HOME (7/ 7) 7 ." /, \, I ')
WORK ( )
TELEPHONE NUMBER
/)/'/ Ii (
OATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WIll RESULT tN AN OFFICIAL TAX ASSESSHENT .lth ...11,""1. 1nl.,..t b...d on In.....tlon
.ubIIIUad by the flnencla' In.tltotlon.
2. lnherlt.nca ta. beeo..' delinquent nlna .onth. .'t.r the det~t" dRt. of d..th.
S. I Joint account I. '...ble avan though the decaden'" n'" ~. edded .. . ..'t.r of convenl~..
.. Account. Clncludlng tho.. held between husband and wlfa) which the decedent put In Join' n.... within one y..r prior to
d..th .r. fully ,..lbls al tren,f.r"
S. Account. ."abll'had JointlY bat....n hU,bend and wlf. .or. ~ one y..r prior to death .r. not ,..abl..
6. Account. hald by . decadent -In tru.t for. .nather or other' .r. ,...bla fully.
REPORTING INSTRUCTIONS - PART I
_ TAXPAVER RESPONSE
1. 'LOCK & ' I' tho Info,..'lon and ,0opu,.'lon In tho no'I,. or. '0"'" and dodUc'lon. ... no' b.ln. '1.1..., .1... .. ...
In b10,k _&" o' P..' 1 of tho "I.,p.,.' ....on.." ..,'Ion. Sign two ,..I.. and .ub.I' 'ho. .I'h ,ou' ,h.,k fo. tho ooount of
'ax to tM Raglster of will. of the cOU'lh' Indicated. The PI D.,Jllft.ent of R.venue ..Ill Inu. an official........",
(For. REV-IS~a EXI uPon r.c.Ipt of the r.turn fro. th. ReI'st.r of Wills.
Z. BLOCK" If 'ho ...., ....lfl.d on thl. n01l.. h.. b... o. .111 b. ,.po"" ond tn ..Id .lth tho p.....,I...I. 1""".It""",
I.. ..'u.n fll.d b, 'h. d.,.d.n". .......nt.'I.., .1.'. .. OX" In b10<k "." of P..' I of 'h. "Y.,..'.' ...pon.." ..,'lon, Sign on.
'0.' ..d ..tu.n to tho P& D....t...' of R...nu., .u..ou of Indl.ldu.l I.,.., D..' Z....I. H...I.o..., P& 171'.'...1 In 'ho
env.lop. provided.
,. .LOCK C ' If 'h. not I'. Info...tlon 1. Inco"." "./0' d."".,lon. ... b.ln; ,1.1..d, ,n.,k blo,l, "C" .od ,0..1.', ..". , and ,
..,o.dln. '0 It.. 1n."..t1.". b.10". ~1~" t.. ",I:, ..-" ",,:I' ,",.. .lth ,OU' '"0", 'or t'. "'''"' .f t., ,,""'I. 10 'h. ..,ht..
01 will. of tho ,ounL, 1ndl,.'.d, Iho r. D.,o".,n' of ..vonu. .111 1.~"" on off1.1.1 ........., (Fo.. .EY'I". EXl upon ..:.1"
of t~ r.turn fro. the R.gIst.r of Wills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Ent.r t~ det. the account orIginallY was .stabllsh.d or tltl.d In the .ann.r .xlstlng at date of d.ath.
HOtE: for a d.c.d.nt dying aft.r 12/1Z/aZ: Accounts which th. dec.dent put In Joint na..s within on. (1) year of d.ath are
ta~abl. fully as transf.rs. How.v.r, there 11 en e.clullon not to ..ce.d 15,000 p.r tranlf.re. r.gardlell of the value of
the .ccount or the nuab.r of account I ~ld.
If . double alt.rllk (..) app.ars b.for. your first ~ In the addr.sl portion of this not Ie., the 15,000 ..cluslon
.Ir.ady hal b.an d.duct.d fro. the account balanc. as report.d by the financial Institution.
2. Ent.r the tot.l balanc. of t~ account Including Int.r.lt accru.d to the date of d..th.
5. The p.rc.nt of the account that Is ta.abl. for each survivor I. d.t.r.lned .. rollowl:
A. The p.rcent ta.abl. for Joint aSI.t. .Itabllshed .or. than one y.er prior to the decedent.. d.ath:
I DIVIDED BY TOUl HUHBER Of
JOINT OWNERS
Exa~I.1 A Joint .11.t r.glst.r.d
DIVIDED BY TOTAL HUMBER Of X 100 . PERCENT TAXABLE
SURVIVINC JOINT OWNERS
In the na.. of the dec.dent end two other perton..
I DIVIDED BV S (JOINt OWNERS) DIVIDED BV Z (SURVIVORS) - .161 . 100 . 16.7% (TAlABlE fOR EACH SURVIVOR)
a. The p.rcent t.~abl. for a...t. cr.at.d within on. y.ar of the d.c.dent.1 death or account. owned by the d.c.dent but h.ld
In tru.t ror anoth.r Indlvlduall.) (tru.t beneflclarl..)t
I DIVIDED BY TOTAL NUKBER Of SURVIVINC JOINT
OWNERS OR TRUST BENEFICIARIES
X 111 . PERCENT TAXABLE
Ex.apl.: Joint account r.gl.t.r.d In the na.. of t~ deC.dent and two other p.rsons and e.tabllsh.d within on. year of d.ath by
the deudent.
I DIVIDED BY Z (SURVIVORS) . .50 X 100 . 50~ (TAXAILE fOR EACH SURVIVOR)
4. Th. alIQUOt .ubJ.ct to talt Uln. ~) 1. det.r.lned by .ultlptylng ttMi acco..-,t balance Uln. Z) by the p.rcent taxable Uln. 31.
5. Ent.r the totel of the debt. and deduCtion. li.ted In Part 3.
. Tho ....... .....1. 111n. " I. d.t...I... b. .ubt...'ln. tho dobt. and dodu,'lon. Ill.. ., f.o. 'h. .aoun' tUbl." '0 I., 111n. ",
1. Ent.r t~ appropriate tax rat. (lln. 7) a. d.t.r.lned below.
A. For det.. of death occurring bft.r 6/50/94, the tax r.t.. for tran.rers to .pou..1 ar. es folloWI:
I. Oat.. of dlath on or aft.r 1/1/94 and b.ror. 1/1/95 the rat. Is 5~.
Z. Date. of d..th on or .fter 1/1/95 tran.r.r. to spous.. will be tax.d at O~ talt rat..
Note, for dat.1 of d..th prior to 7/1/94 transr.r. to 'POU'" are ta.abl. at 6~.
B. Tran.f.,. to I1neal de.c.ndant. Including father, .other. .on, daught.r, grandchildren, lon-In-la..,
daught.r-In-lllY, stepchild and th.lr IlIu. are taxable at IIx perclmt (6~).
c. Transf.r. to .11 oth.r. including brother, .i.ter, unci., aunt, n.phew and niece are t..abl. at fIfteen percent (15~).
D. If you change the t.. rat., pl.... .peclf~ your r.l.tlon.hlp to the decedent In the .re. provided.
a. The a.ount of tax due Uln. 6) it det.r.lned by .ultlptylng the a.ount taxable Cline 6J by the t.x rate Uln. 11.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
,,.,
','
Allowable dabt. ftnd d.dUCtlon. .r. det.r.lned a. follow.:
&. You 1...11, ... ...pon.lb1. fo. .."'.." o. tho ..,.t. .ubj.., '0 ...lnl....,lon b, . ....on.1 ,"......1011..:10 In.ufll".n'
to pay the d.ductlble It....
B. VOU actually paid the d.bts aft.r death of the decedent and can furnl.h proof of payaent.
C, D.b'. b.ln; ,1.1." ou., b. 1,..I,.d full, In P..' ,. If oddl'lon.l ..oc. I. n.....' u.. .I.ln ..... · I/Z" . .11". p.oof Df
pay.ent .ey b. r.qu..t.d by the PA nepart.ent of R.venue.
TAXPAYER ASSISTANCE -'
IF VOU NEED FURTHER INFORHATION 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. TDDI (717) 772-2252 (HEARING IMPAIRED oNLy)
COHMQHW(At HI or PI HHSn VAHIA
()(PARU.Un or Jl[VfH\Jl
IUREAU or INDIVIDUAl 'ULS
DOL 110601
HAAAISIURC, PA 1111"0601
*'
FILE
ACN
DATE
NO, 21 - qil . 31f
96102173
02-10-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
"'.Ihl'. &I, 11.1'\1
EST. OF FRANK A COOK
5,5. NO, 164-30-3946
DATE OF DEATH 05-22-94
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
00 CERTIF,
SHIRLEY S COOK
31 FORT ST
LEMOYNE
REHIT PAYHENr AND FORHS TOl
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
PA 17043
PHC BANK h.. provld~ the D.p.rt.Mt with the Infor..tlon Ilst.d b.low which hat b..n u..d In calculating the
potMtlal tax du.. Their r.cord. Indlc.t. th.t .t the d..th of the above d.c.dent, YOU w.r. . Joint own.r/b.neflcl.ry of thl, account.
If YOU f.. I thl. Infor..tlon I. Incorr.ct, pl.... obtain written corr.ctlon fro. thl financial In.tltutlon, .ttach . COpy to thl. for.
end r.turn It to the above .ddr.... 'hi, .ccount I. t.~.bl. In 3ccordanc, with the Inherltanc. '.x L.w. of thl CO.lonw..lth of P.nn,ylvanl..
Du.,tl"". ..v b. an.wernd hv call1"o el1l) 131-S31'.
COMPLETE PART 1 BELOW .
Account No. 21001022275
. . SEE
REVERSE SIDE FOR
09-24-92
FILING AND PAYMENT INSTRUCTIONS
D.t.
Eat.bUshed
To Insur. prop.r cr.dlt to your account, two
elJ cop I.. of thl, notlc. IU.t acco'pany your
p.y.ent to thl R.gl.t.r of wills. Hak. ch.ck
p.yable to: -R.gl,t.r of WIll., Agent-.
ACcoWlt B.lance 10,049.26
Percent T.x.bl. X 8.333
Amount Subjact to Ta. 837,40
T.x R.t. X ,15
Pot.ntial T.x Du. /, ., 125.61" . " .
NOTE: If t.. p.y.ant. arl .ade within thr..
Il} lonth. of the d.c.dent., data of d.ath.
YOU .ay d.duct a S~ dl.count of the t.x due.
Any Inh.rltanCI tax due will blcoae d.llnquent
nln. (91 .onth. .ft.r the d.t. of d.ath.
~ PART
~. [!]
~
~
~[
~
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
A. c:J 'h. abov. Infor.atlon and tax due I. corr.ct.
1. You "Y choosl to r.alt ply-.nt to the RIgl.t'r of Will. with two cop I,. of thl. notice to obt,ln
a dl,count or avoid Int.r..t, or you ..y ch.ck box -A- and r.turn thl, notlc. to the R.gl.t.r of
will. and an official ........nt will be I..u.d by the PA D.part..nt of R.v.nue.
CHECK ]
ONE
BLOCK
ONLY
8. c=J Th. above ,...t ha. b..n or will be r~ortld and tax paid with the P.nn,ylvanl. Inherltanc. Ta. r.turn
to b. fll.d by the dlcedent., repr"lntetlv..
C. ~h' above Infor..tlon I' Incorrect andlor d.bt. and d.ductlon, w.r. paid by you.
~~ou .u.t coapl.te PART [!] andlor PART ~ below.
If you indic.t. a differ.nt t.x r.t., pl.... st.t. your
rel.tionship to dec.dent:
PARr
~
~ TAX RETURN - COMPUTATION OF TAX
'-
t- LINE 1. o.to Establhhad 1
2. Account B.lanc. 2
_ 3. Percent T.xable 3 )(
LJ 4. Anount Subjact to Ta. 4
~ 5. Debt. .nd DeductIon. 5
J~ 6. Anount T.x.bl. 6
7. Tax R.te 7
8. Tax Du. 8
OFFICIAL USE ONLY 0 AAF
PA DEPARTNENT OF REVENUE
ON JOINT/TRUST ACCOUNTS
b- z. 'I-e, 7-
J ,~"1'i'.'"
."3~>
~~ (, V J
'C-3. 7. '-( 0
)
PAD
1
2
3
4
5
6
7
8
CLAIMED
PART
[!]
DATE
DEBTS AND DEDUCTIONS
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Lin. 5 of Tax Conput.tlonJ
I
.
Und.r p.n.lti.. of perjury, I declare that the
conpl.te to the be.t of .Y knoNledge end belief.
/ / .' /
'-J"l(:'1/:" \1 :,.,(
TAXPAYER SIGNATURE
fact. I haYe reported aboye are tru.,
HOME (7 / 7) '7?,?,
W~~~EP~~NE N~MB;R
correct and
S, I' j
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHEHT with ItPpllubl. Inh,.., b...d on Infur.atlon
too.lUed b'f' thl 'I"MeI.1 Inltltullon.
Z. Inherlt~. I'. blea... dlllnquent nln. lonth, .ft., the dlc.dant', data of d..th,
!. , Joint account I. t..,bl, Iven though thl dlcld.nt', n... Wt. added .. . ..tt., of convlnlenCI.
~. Account. {Including tho,. held balM.'" husband and wlf.. which tht dlcld.nt put In Joint n.... within on. y..t prior to
d..th Ir. fully ".abl, a. tranl'.r..
S. Account. ..t.bll,had Jointly batw"n hUlband and wlf. lor. than on. y..r prior to d..th ar. not t..~l..
6. Account. held by . dlcadant Rln truI' forR another or oth.,. ar. I..abla lully.
REPORTING INSTRUCTIONS - PART 1
- TAXPAYER RESPONSE
1. BLOCK'. If thl Infor..tlon and coaput,tlon In thl notlCI ar. corr.ct and deduction. ar. not b.lng clal.ed, pl8C. en RXR
In block RAR of Part I of the RTaMPay.r R..pon..R ..ctlon. Sign two copl.. .nd .ub.lt tha. with your check for the ..aunt of
t.. to tha Ragl.t.r of Will. of the county Indlc.tad. Th. PA Dap.rt..nt of R.vanue will I..u. en official .......ant
(For. R[V.IS'I EXI upon rac.lpt of the r.turn froe tha R.gl.t.r of will..
1. BLOCK B . If the ....t .p.clfl.d on thl. not Ie. h.. b.an or will be r.portad and t.. paid with the Pann,ylvnnl. Inh.rltance
Ta. Raturn fll.d by the dac.dant'. r.pr..ant.tlve, pl.ce an RXR In block RBR of Part I of the RTe.pay.r R..pons.R '.ctlon. Sign one
copy and r.turn to the PA Dap.rt_ent of Ravenue, Bureau of Indlvldu.l Tau., D.pt ll06OI, H.rrlsburg, PA 11111-0601 In the
env.lope provided.
1. BLOCK C . If the notlca Infor..tlon I. Incorr.ct end/or d.ductlon. ar. b.lng cl.I-.d, ch.ck block RCR and co.pl.t. P.rt. 1 and 1
according to tha In.tructlon. balow. Sign two caple, and .ub.lt th.. with your ch.ck for the ..ount of t.. p.y.bl. to the Ragl,tar
Ot WlIh of tha county inole.h.G. ;,,";.-A ::c~artaal'it of ~.v.r.u. .111 hI... en =.H,:I.~ .:;..,;;&:...~:-.~ tFe:-a n::V.I!.:'d EX' upcn receipt
0' the r.turn fro. the R.gl.t.r of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
llN[
I. Ent.r the data the account orlgln.lly wa. ..t.bll.h.d or tltlad In the .ann.r ..I.tlng at d.t. of d.eth.
HOTE: For. d.c.d.nt dying .'t.r lZ/ll/ll: Account. which the d.ced.nt put In Joint n.... within on. (1) y..r 0' d.ath ar.
t..abl. fully a. tran.f.r.. How.v.r, th.r. I. an .Mclu.lon not to aMc..d 11,000 p.r tran.f.ra. r.gardl... of the valu. of
the account or the nuab.r 0' .ccount. h.ld.
I' a doubl. ..t.rl.k (..) .pp..r. b.for. your flr.t n... In the .ddr... portion 0' thl. not Ie., the 13,000 ..clu.lon
alr..dY ha. b.an deduct.d fro. the account b.lance .. r.port.d by the financial In.tltutlon.
1. Ent.r the total b.lanc. of the account Including Inter..t accru.d to the data of d.ath.
1. The p.rcant of the account that I. t..abl. for ..ch .urvlvor I. d.t.r.ln.d .. follow.:
A. The p.rcent ta.abl. for Joint ....t. ..tabllshed aor. than ana y..r prior to the dec.d.nt'. d..th:
1 DIVIDED BY TOTAL NUHBER or
JOINT miNUS
Ex.~lel A Joint ....t r.gl.t.r.d
DIVIDED BY TOTAL NUHBER OF X 100 . PERCENT TAXABLE
SURVIVINC JOINT OWNERS
In the n... of tha d8C.d.nt and two oth.r p.r.on..
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 1 (SURVIVORS) . .167 X loa . 16.7X (TAXABLE FOR EACH SURVIVOR)
B. Th. p.rcant tax.bl. for ....t. cra.t.d within ana y..r 0' the dec.dant.. d..th or account. own.d by the d.c.dent but h.ld
In tru.t for anoth.r Indlvldu.I(.) (tru.t ban.flclarl..):
1 DIVIDED BY TOTAL HOHBER OF SURVIVINC JOINT
OWNERS DR TRUST BENEFICIARIES
x 100 . PERCENT TAXABLE
[x.apt.: Joint .ccount regl.t.red In the na.. of the d.c.d.nt and two oth.r p.rson. and ..tabllsh.d within on. y..r 0' d.ath by
the d.c.d.nt.
1 DIVIDED BY 1 (SURVIVORS) . .SO X 100 . SOX (TAXABLE FOR EACH SURVIVOR)
4. The a.ount .ubj.ct to tax (lln. ~) I. det.r.ln.d by aultlplYlng the account balance (lln. 1) by the p.rc.nt taMabl. (1In. 1).
S. Enter the total of the d.bts and d.ductlons ll.t.d In P.rt 3.
6. Th. ..aunt t.Mabl. (lln. 6) I. d.t.r.ln.d by sUbtracting the d.bt. and d.ductlon. (lln. S) froa the aaount .ubject to t.x (1In. ~).
7. Entar th. ~pr~~rla~. t3~ rRt. (lJ~. ~) "S a.t.r.lned b.lo..
A. For d.t.. of d.ath occurring .'t.r 6/30/94, the tax rat.. for tran.f.r. to .pou... .r. a. follow.:
1. D.t.. of d.ath on or aft.r 7/1/94 and b.for. 1/1/95 the rat. I. lX.
Z. D.t.. of d.ath on or .ft.r 1/1/95 tran.f.r. to .pou... will be tax.d .t O~ t.x r.t..
Not.: For dat.. of d.ath prior to 7/1/9~ tren,'.rs to .pous.. .r. t.xabl. at 6X.
B. Tran.'.rs to IIn..1 ducendants Including f.th.r, .other, son, daught.r, grandchlldr.n, .on-in-law,
daught.r-In-I.w, st.pchlld and th.lr I.su. ar. t.xBbI. .t .Ix p.rcent (6X).
C. Tran.f.r. to all oth.r. Including broth.r, sl.t.r, unci., aunt, nephew and nl.c. .r. t..abl. .t flft.en parcent (ISX).
D. If you chang. the t.x r.t., pl.... sp.clfy your ralatlonshlp to the dac.d.nt In the ar.a provld.d.
8. Th. .aount 0' t.x due (lln. I) II d.tareln.d by aultlplylng the MOUnt taxable Ulna 6) by the t.. rat. (line 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. d.bt. and d.ductlons ar. d.t.ralnad .. follow.:
'"
. ,
A. You I.g.lh ar. rupon.lbl. 'or pepent, or the ."at. .ubj8Ct to adIIlnlltr.Uon by It p.rson.1 r.pr..ent.Uv. h.~n.ufflclent
to p.y the d.ductlbl. It....
B. You .ctu.lly p.ld the d.bts a't.r d.ath 0' the d.cad.nt and can furnl.h proof of p.y..nt.
C. D.bt. balnD clal..d au.t b. It..I,.d fully In Part 3. If additional apac. I. naaded, us. plain pep.r 8 I/ZR x 11-. Proo' of
pey.ant ..y be r.qu..t.d by the PA D.p.rt..nt of R.venue.
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 c,
HARRISBURG AT (717) 787-8327. TDD' (717) 772-2252 (HEARING IMPAIRED O~LY)
~
-1
,[
1
"
~
.' . \
CoMOHWUlJlt or PlHHSVlVAHIA
DfPAAI"ENf or REV[NU[
BUREAU Of INDIVIDUAl fAXES
OEPL 11!lU.Dl
ttARMISIUAG. p" 1I1Za-0601
*'
FILE
ACN
DATE
NO,21 - 1~ - 3'18
96102168
02-10-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
1I'.lhlII '" IF....I
EST, OF FRANK A COOK
S.S. NO. 164-30-3946
DATE OF DEATH 05-22-94
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKIHG
o TRUST
[X] CERfIF,
SHIRLEY S COOK
31 FORT ST
LEMOYNE
REHIT PAYHENT AND FDRHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17043
PHC BANK hu provided the Deper'..nt with tM Infor.aUon Ihhd balow which hal be.n u..d In ulcullltlng the
potential tax due. Their r.cordl Indicate that at the d8nth of the above decedent, you ...r. II Joint own.r/ben.flcl.ry of thl. account.
If you f..l this lnfor..tlon I. Incorr.ct. pl01l18 obtain written correction fro. the financial Institution, attach Il copy to thl. for.
and r.turn It to the above addr.... Thl, account I, tllKabl. In accordance with the Inheritance Tax Law, of the Co..onw_llth of Pennsylvania.
Questlcns .a~ he an.N.'ed hy rftlllnq (717) 737-3Jl7.
COMPLETE PART 1 BELOW .
Account No. 21001022338
. . SEE REVERSE SIDE FOR
D.t. 03-10-88
EsbbUshed
FILING AND PAYMENT IIl3TRUCTIONS
To Insure proper credit to your &Ccount, tNO
(2) copl.. of thh noUn .ust acco~any your
pay.ent to the Register of Wills. "ake check
payable to: -Register of Wills, Agent-.
Account a.t.nc. 10,056,22
P.rc.nt T...bl. X 8.333
A.ount Subjoct to T.. 837.98
T.. R.ta X .15
Pot.ntlal Tax Du. 125.70 ,') 'I
~~ TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
NOTE: If taK pay.ents are .ade within three
(3) eonths of the decedent.s date of death,
you .ay deduct a S~ discount of the taK due.
Any Inheritance taK due will becoe. d.linquent
nln. (9) .onths after the date of de.th.
CHECK ]
ONE
BLOCK
ONLY
A. [:] The above Inforeatlon nnd taK due Is correct.
1. You .ay choole to reelt payeent to the Register of wills with two caples of this notice to obtain
a dllcount or avoid Interest, or you eay check bOK -A- and return this notice to the Register of
Wills and an of'lclal alseSI.ent will b. Issued by the PA Depart.ent of Revenue.
B. ~ Th. above asset has been or will be reported and tax paid with the Pennsylvania Inheritance TaK return
to be 'lIed by the decedent., representative.
C. ~The above Infor.atlon Is Incorrect andlor debts and deductions were paid by you.
~You .ust co.plete PART ~ and/or PART [!] below.
If you indicat. a different t.x r.te, pleas. st.t. your
r.lationship to deced.nt:
oJ!
PART
~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. D..t. Established 1 (0 t 0 :;"G. 1.. '1--.
2. Account a.l.nc. 2 10 , OS'~ ' l.. "}.-,
3. P.rcent Tu:abl. 3 )( q-. ~ ~
~, Anount Subj.ct to To. ~ P, ~ -, 'fS
S. Debts .nd Deductions 5
6. Anount Taxabl. 6
7. Tax Rate 7 )(
8. Tax Du. 8
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
[!]
DATE
f3 '!, (, '13
,0(,-
Sf) , l."
DEBTS AND DEDUCTIONS
PAD
1
2
3
4
5
6
7
8
CLAIMED
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
i
TOTAL CEnt.r on Lin. 5 of Tax Co_putation)
I
.
Under p.nalti.. of
conpl.ta to the best of
, .II, I ( . '.
TA~~~EJ S~h~AT6RE
perjury, I declare that the facts I
ny knoNledge and belief.
.1 f' 1-
heve reported above ar. tru., correct and
HOME (7/7> 'j 'I, '/r ";
WORK ( >
TELEPHONE NUMBER
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSttENT with APplicable lnt.,..,. b...d on Inlatutlon
lub.lt'ad by the financial Inllltutlon,
Z. Inn.tltanc. tax baea... delinquent nln. eonth. .ft.r the dacad.nt', data of d..th.
J. , Joint account I, '_Mabla .~.n though the dacad.nt', n... wa. added nl . antt.r of conv.nlanc..
~. Account. (Including tho.. held b.twa.n hulband and wlf.) ~Ich the d.c.d~t put In Joint M...' within ona y.ar prior to
d..th ar. fully 'a.,bl. a. tranl'.r..
S. Account. ..tabll,had JointlY batw..n husband and wlf. aor. than on. year prior to d.ath flit. not t...bla.
6. Accounts held by flI dacadant -In trult for. another or oth.r. ar. t..nbl. fully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A _ If thl Jnlot.atlon and coaput,tlon In thl notlc. ar. corract And d.ductlon. are not b.lng clal..d, plac. an -.-
In block -A- of Part I of the -Ta.pay.r R..pon..- ..ctlon. Sign two cop i.. and .ub.lt th.. with your check for the a.ount of
tax to tha Ragl.tar of will. of the county Indicat.d. th. PA Depart.ent of Revanua will I..u. an official ...a...ent
(for. REV.l~48 EX) upon recaipt of tha raturn fro. tha Regl.tar of will..
2. BLOCK B _ If tha allat IPaclfl.d on thl. not Ie. hat be.n or will b. r.portad and tn. paid with the Pennlylvanla Inh.rltanc.
Ta. R.turn fll.d by tha d.cad.nt's rapr..entatlv., pl.C. an -X- In block -a- of P.rt 1 of the -Ta.pay.r Re.pon..- ..ctlon. Sign on.
copy and r.turn to tha PA Depart..nt of A.vanu., aur.au of Individual t..... Dapt 280601, Harrl.burg, PA 11128-0601 in the
.nv.lop. provided.
1. BLOCK C . If the notice Infor.atlon I. incorr.ct andlor d.ductlon. ar. b.lnQ clal..d, ch.ck block -C- and co.pl.t. Part. Z and 1
accordlnQ to the Inltructlon. b.low. Sign two copl.. and .~It th.. with your chack for the a.aunt of ta. payable to the A.Qi.t.r
vf wills 01 tNi cOUf"~ h..ilo::~t'ltf 1:,.. ~.. nep.rteant n; tf8V1lnUB wl~:' In\HI nn oHha:l ..:'::::'':Ir:t U....oI J:E\/.lSlta EX' upon r.:elpt
of tha r.turn fro. the A.QI.t.r of Will..
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Eht.r
NOTEl
the d.t. the account originallY was .Itabll.h.d or tltl.d In the .ann.r .xlltlng at data of d.ath.
For a d.cad.nt dying aftar 12/12/a2: Account. which tha d.cadant put In joint naea. within on. (1) y..r of d.ath .r.
ta..bl. fully.. tr.nlf.r.. How.var, th.ra i. an a.clu.ion not to a.c..d '3,000 par tr.nsfarea r.g.rdl... of the valua of
tha .ccount or tha nuab.r of account. h.ld.
If . double a.t.rl.k (x.) app.ar. b.for. your flr.t nea. In the .ddr... portion of thl. not Ie., the '3,000 ..cluslon
alr.ady ha. b.en d.duct.d fro. the .ccount balance .. report.d by the financial Institution.
Z. Entar the tot.l balanc. of tha account Including Int.rest accrued to the data of da.th.
3. The p.rcent of the .ccount th.t 1. ta.able for .ach .urvlvor I. det.r.lnad a. follows:
A. The p.rcent ta.abla for joint ....t. ..tabll.had .or. than one y..r prior to the d.cedent'. d..th:
1 DIVIDED av TOTAL HUMBER OF
JOINT OWNERS
E.aapl.: A joint ....t r.gl.tar.d
DIVIDED BY TOTal H\JHBER OF X 100 . PERCENT UUBLE
SURVIVING JOINT OWNERS
In the na.. of the d.c.dent and two othar per.on..
B. The perc.nt ta.able for a...ts craat.d wIthin ana y..r of the decadant.. daath or account. own.d by the dec~t but h.ld
In tru.t for anoth.r Indlvldual(.) (tru.t b.n.flcl.rl.I):
1 DIVIDED BV 1 (JOINT OWNERS) DIVIDED BY Z (SUAVIVORS) . .167 . 100 . 16.1% (TAXABLE FOR EACH SURVIVOR)
1 DiVIDED av TOTAL NUMBER OF SURVIVING JOIHT
OWNERS OR tRUST B[HEfICIARI[S
. 100 . PERC[NT TAXABLE
E..apl.l Joint account r8gl.terad In the naa. of tha d.c.d.nt and two oth.r p.r.on. and astabll.had within on. y..r of d..th by
the d.ced.nt.
1 DIVIDED BV 2 (SURVIYORS) . .50 JC 100 . 50% tfUABlE FOR EACIl SURviVOR)
~. Th. aeaunt .ubj.ct to taM (line ~) 1. d.t.raln.d by aultlpl,lng the account balanc. (1lna 2) by the p.rcant taxabl. (line l).
5. Entar the tot.l of the d.bts and d.ductlons ll.t.d In Part l.
6. Th. a.aunt taxable (1In. 6) I. dater.ln.d by .ubtractlng the dabt. ftnd d.ductlon. (lln. ~) fro. the aaaunt Subject to taw (1In. 4).
1. (nt.r tn. appruprlat. t,,_ rata 'iln_ 1:' a. "'''I.r.in~g I)";'uoo.
A. For data. of daath occurrlnQ .ft.r 6/10/94, tha taw rat.. for tran.f.rs to .pou... era at follow.:
1. Oat.. of d.ath on or aftar 1/1/94 and before 1/1/95 the rat. Is 3%.
2. Det.. of da.th on or aft.r 1/1/95 transf.rs to .pou... will be ta..d .t 0% taw rata.
Hot.l For date. of daath prior to 1/1/94 trans'.rs to .pou... are ta.abl. at 6%.
B. Tran.f.r. to Iln.al d.sc.ndants including fnth.r, .oth.r, son, daughter, grandChlldran, .on-In.law,
deught.r.ln.law, stepChild and th.lr I..u. are ta.ebl. at .1. p.rc.nt (6%).
C. Tran.f.r. to all oth.r. Including brothar, .I.t.r, unci., aunt, n.ph.w and nl.ce "r. ta.able at flft.an p.rc.nt (I~%).
D. If you chang. the taw rat., plea.. sp.clfy your ralatlonshlp to the d.c.d~t In the ar.a provld.d.
,,,
Tha ..aunt of tax dua 11In. a) Is d.taralned by aultlphlng tha aaO\M1t taubla Uln. 6) by the tax rata Cline 1). ( ,
a,
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabla dabt. and deduction. ar. d.t.raln.d a. folio".:
..
You l.galh are ruponslbla for pay..nt, or the .st.te .ubjact to adIIinhtraUon by a panonal rapra.antaUv. h In.ufflclant
to pay tha d.ductlbl. It....
You actually paid tha d.bts aft.r death of tha d.c.dent and can furnl.h proof of pay..nt.
D.bt. baing clal..d aust ba Ita.lz.d fully In Part 3. If additional .paca I. n..dad, u.. plain pap.r a 1/2- x \l~. Proof of
pay.ent a.y b. requa.t.d by the PI Depart..nt of A.v~.
c....
a.
e,
TAXPAVER ASSISTANCE
IF YOU NEED FURTHER INFORHATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
-, ...
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DNO. AA 112847 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT O' REVENUE
....'162 "'IWI OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
I ACN
e'J ASSESSMENT 'l'
RECEIVED FROM: II CONTROL I:.
NUMBER
*'
AMOUNT
SHIRLF.:V 5 COOK QkIO::lRD9 .G',O ~ 2~
QI.. 1 n':lRt 0 -.e:;n PI,
31 FORT ST
96102173 $50,2/'
LEMOYNE. PA 17043
'/6102tb8 "50.24
ESTATE INFORMATION:
B FILE NUMBER 21- t 996-0398
E1 NAME OF 't~~TFR~R A
... DATE OF PAYMENT
iii 05/t5/96
r.I POSTMARK DATE
1:.1 0100100
COUNTY CUMBERLAND
SSN 164- 30.,3946
(FIRST)
(Mil
.200.96
DATE OF DEATH
05/22/94
m TOTAL AMOUNT PAID
lJU
REMARKS
SHIRLEV 5 COOK
('
,I"~
II' , ' '
RECEIVED BY ({j, ,.' I - ' .i '" ,~,'j/ ,-' N./
, " $IGNA1UR( / ./
MARY C, I.EWIS .<..,/,'),,;,/..1
REGISTER OF WILLS" "j ,.Ij
/1,-;' '-.
,-'
SEAL
CHECK" 3355
REGISTER OF WILLS
.'
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...~.-.U'..~ 4>"-,bV .'1:.
r - D - AA 11289 0 COM~ONWEALTH OF PENNSYLVANIA
NO. DlPARTMINT OF RlVlNUI
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
'*
1rv.1161P .....1
RECEIVED FROM:
a
ACN
ASSESSMENT r:t
CONTROL ~
NUMBER
AMOUNT
'/61021'75
$::;7.08
EULAH C GHUGAN
31 FORI 511~EET
LEMOYNE, PA 1701,3
EST,6,TE INfOR/MTIOtt
~ fiLE NUMBER
li 21-\996-0390
I:t N,6,ME Of OECEOENT (lAST)
~ COOK FRANK A
II O,6,TE Of P,6,VMENT
B POST/MRK
COUNTY
SSN 164-30-3946
(fiRST) (Mil
CU~1BERLAND
O,6,TE Of OE,6,TH
r. '"
fa TOTAL AMOUNT PAID
..57.08
SK
REMARKS
EULAH C GRUGAN
REGISTER OF WilLS
.. ,
MARY C. LEWIS ..' I "
REGISTER OF WILLS
,SIQNATUIlfI
/ ".".~,I."'/
SEAL
CHECKlI 31,1,8
RECEIVED BY _' ,
/'
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I
REV-1548 EX AFP (12-951*
CO""OHW[Alltl Dr PENNSYlVANIA
DEPARIMENt OF REVENUE
BUREAU Dr INDIVIDUAl tAXU , . .
O(Pt. lllaftot
HARRISBURC, PA lItu-aUl
/:) k:_'; /
'I
0./1/
NOTtCE OF tNHERtTANCE TAX
APPRAtSEHENT, ALLOHANCE OR OISALLOHANCE
OF OEOUCTtON5, AND ASSESSHENT OF TAX ON
JOtNTLY HELD OR TRUST ASSETS
DATE 08-05-96
ESTATE OF COOK
FRANK
A DATE OF DEATH 05-22-94
COUNTY
CUMBERLAND
FILE NO. 21 96-0398
S.S/O.C, NO, 164-30-3946
ACN
96102168
SHIRLEV S COOK
31 FORT ST
LEMOVNE PA 17043
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD CDURT HOUSE
CARLISLE. PA 17013
A..ount R..,itt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Rifv:isira-Ex--AFii-fi1i:9Sj------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-05-96
ESTATE OF COOK
FRANK
A DATE OF DEATH 05-22-94
COUNTY
CUMBERLAND
FILE NO, 21 96-0398
TAX RETURN WAS:
S.S/D,C. NO, 164-30-3946
(XI ACCEPTED AS FILED (I CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
96102168
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
21001022338
TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 03-10-88
Account Balance
Percent Texab1e X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
10.056.22
0.083
837,98
.00
837.98
,06
50.24
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
DR MONEV ORDER PAVABLE TO:
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAYMENT
DATE
05-15-96
DISCOUNT (+)
INTEREST (-)
5,56-
AMOUNT PAID
50.24
RECEIPT
NUMBER
AA112847
.
TOTAL TAX CREDIT
BALANCE OF TAX DUEl
INTEREST AND PEN, I
TOTAL DUE I
IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
( IF TOTAL DUE IS LESS THAN tt, NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI. YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS, I
44,68
5,56
.12
5.68
INTEREST IS CHARGED FROM 05-16-96 TO 08-13-96
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
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PURPOSE OF
HOTICE:
To fulfIll thl rlquir...nts of S.ctlon 2140 of Ihe IMeritance Ilnd [state TalC Act, Act 22 of 1991. 172 P.S.
S.etlon 2140).
PAVttEHT:
Dltach the top portion of thh Notice and sub.it with your pny..nt to the Reghhr of Wllh printed on the
,.e".r.. tld..
.. "aka check or 80n.y ordl,. payable to: REGISTER OF WIllS, ACENT.
All p.ya.nh racelved .h.1l flr.t b. appll.d to any Int.r..t which ..y be du., with any realllnd.r appll.d to the tllll.
REFUND eCR h
A r.fund of . tax cr'dit, which wa. not r.qu....d on the tax r.turn, .ay b. requ..t.d by co.pleUng an "Application
for Refund of P.M.ylvanla Inheritance and E.tate r.Il" (REV.UIl). Applications are available at the Office of
the Reghtl,. of Wllh, any of the 23 Revenue District Office. or by call1no the Ipeclal 2ft.hour answ.rlno ..rvle.
nueber. far far.. ordering: In P.nnsYlvanla 1.800-362.2050, out.lde Plnn,ylvanla and within 10c.1
Harrl.burg area (717) 787.a09ft, TOOl (117) 172.2252 (H.arJng r.palr.d Only).
OBJECTIONS: Any party In Int.r..t not .atl.fled with the aparals..ent, allowanc. or dhll1lowanc. of d.ductlon. or ........nt
of tax (Including discount or Jntere.t) as shown on this Hotlc. .ay obj.ct within '1llty (60) d.ys of r.c.lpt of
this Notice by:
"wrltt.n prot..t to the PA D.part..nt of R.v.nue. Board of Appeals. D.pt. 21n021. Harrisburg. PA 17128-1021. OR
".llctlng to have the .att.,. deter.lned at the audit of the account of the p.rsonal repr..entatlve. OR
..app.al to the Orph.n.' Court
ADHIN.
ISTAATIVE
CORRECTIOHS:
Factual error. dl.cov.r.d on thl. a,s",..nt should b. addr....d In writing to; PA D.part..nt of Rev.nuI,
Bur..u of Individual Ta..., ATTN: Po.t ,.......nt Revl.'" Unit. DEPT. 280601, Harrl.burg. PA 17128.0601
Phon. (717) 187-6505. S.e pag. 3 of the booklet "Instruction. for Inh.rltanee Tall Return for a R..ldant
D.cld.nt.. (REV.1501) for an explanation of ad.lnl.tratlv.ly correctabl. .rror..
DISCOUNT:
If any talC due Is paid ..lthln thr.. (3) ul.ndar .onth. aft.r thl d.cadent'. d..th. . flv. perunt C!J~J
discount of the tax p.ld Is allow.d.
PENAL TV;
Th. 15% tax aan..ty non.partlclpatlon p.n.lty Is Co.puted on the total of the tax and Int.r..t .n....d. ftfld not
paid be for. Janu.ry 18, 1996, the first day aft.r the .nd of the tax ..n..ty p.rlod. This non-partiCiPAtion
p.nalty Is appealabl. In the se.. .aMer and In the the .... tI.. P.rlod 81 you would app.al the t.. Md Inter..'
th.t has been .......d a. Indlc.ted on this notice.
INTEREST:
Inllr..t Is charg.d b.glnnlng with flr~t day of dellnqu.ncy. or nine (9) .onth. and on. (lJ day
fro. the date of d..th, to the date of pay.ant. Tax.. which bee a.. d.lInquant b.for. J.nuary I, l'''"
b..r Inter..t at the r.t. of .Ix (6%) pereant P'" aMu. calculatld at . dalh r.t. of .0001"".
All taxe. which bece.e d.lInqu.nt on or aft.r January I. 1982 wUI bear Int.,...t .t It rat. which will .".r'll frn.
caland.r yur to calendar year with Ih.t rale announced by the PA Oepart.ent of Iil.v.nue. Th. nflpl h:~III.
Inter..t r.t., for 1982 through 1996 ar.1
V..r Inl.,."t Rat. Dalh Inl.re.t Factor
1982
1983
19114
19115
1986
..Inll,...t
20iC
16:C
U:C
In
10%
I. calculatld
.0005411
.000433
.000301
.000356
.000l74
a. follow.:
Va.r Int.r..t Rill. Oalh Int.r..t 'ltctnr
19117 9% .0001'"
1911a-1991 11% .000.\01
1992 .< .OODi'''7
1993.1994 1< .0001"1
1995.1996 .< .000i''''
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY tNTEREST rACTOR
..Any HotJe. Issu.d aft.r the tax b.eo... dellnquant will refl.ct an Inter..t calculllllon to flrt..1l It\1 dllY'
b.yond the date of the a......ant. If pay..nt I. .ad. aft.r the lntlr..t co.putatlon dllt. IhO,," QIl ",.
Hotle.. additional Inter..t lIU.t be calculated.
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PURPOSE OF
NOTlCEI
To fulfill the requlr..ents of Section 2140 of the Inheritance and Estate 'a. Act, Act 11 of 19'1. fl1 P.S.
Section 2140).
PAY"EHT;
D.tach the top portion 0' thl. Hotlce and sub.lt with your pay..nt to the Regllt.r of Will. printed on the
rov.r.. side.
-- "eke chack or .oney order payable tOI REGISTER OF WILLS, ACENT.
All pay..nt. r.celved shall first be applied to any Int.r..t which .ay be due, with any r...lnder applied to the t...
REFUND (CR) I
A r.fund of . tax credit, which wa. not requl.ted on the ta. r.turn, .ay b. requ..ted by coepl.tlng an "Application
'or R.fund of PennSYlvania Inheritance and Eltate Ta." (REY.llll), Appllcetlons ar. available at the Office of
the RegIlt.r of Willi, any of the Z3 R.v.nu. DI.trlct Offlc.. or by calling the .p.cl.l ~~'hour anlw.rlng ..rvlc.
nu-b.r. for for.s ord.rlng: In P.nn.ylvanla 1~800.36Z.20S0, out.ld. P.nnSYlvanla .nd wllhln local
HarriSburg area (717) 787-8094, TOD' (717) 772-2252 (Hearing I.palrad Only).
OBJECTIONS: Any p.rty In lnt.r..t not .atl.fl.d with the appral....nt, .llowanc. or dl..llowanc. of d.ductlon. or .......ant
of taM (Including dl.count or lnt.r..t) a. .hown on thl. Hotlc. .ay Object within .1.ly (60)> days of rec.lpt of
this Notice by:
"wrltt.n prot..t to the PA O.part..nt of R.vanu., Board of Appnh, D.pt. 281021, Ilarr!sburll. PA 11lla-lo:l, OR
...l.ctlng to h.v. tho .attar d.t.r.ln.d at the audit of the .ccount of the p.r.onal r.pr..onlatlvo, DR
..app.al to the Orph.n.' Court
ADMIN.
ISTRAlIYE
CORRECTIONS:
Factual .rror. dlscov.rld on thl. ........nt .hould be .ddr....d In writing tal PA Dopart.lnt of Pov.nu..
Bur.1IU of Individual T..... ATTNI Po.t A.......nt R.vl.w Unit. DEPT. lll060l, Hl'lrr!sburg, PA 111i't1.0,,01
Phon. (717) 7117~6S05. 5.. p.g. 3 of the bookl.t ~In.tructlon. for lnh.rltanc. I.. R.turn for. W..ld.nt
Dec.dent~ (REY~IS01) for .n ..planatlon of adalnl.tratlv.ly corr.ctable .rror..
DISCOUNT:
If any tax dug I. paid within thr.. (3) cal.ndl'lr eonth. .ft.r the d.c.d.nt.. d.l'lth, . flv. p.rc.nt (\~I
dl.count of the t.. p.ld I. allow.d.
PENAL TV:
Th. IS~ taM a~.sty non'partlclpatlon penalty i. co.put.d on tha total of tho ta. .nd Int.r..t .......d, and not
paid b.fore January Ill, 1996, the flr.t day aft.r the .nd of the ta. ..n..ty p.rlod. (hi. non"partlclpatlon
penalty Is appealabl. In the sa.. .ann.r and In the tho sa.. tI.. par lad", you would ""II.ftl th. tft. MId Intlr..t
that ha. b..n .......d a. Indlcat.d on thl. notlc..
INTEREST I
Int.r..t I. charg.d b.glnnlng with flr.t d.y of d.llnqu.ncy, or nln. (~I .onth. ftnd on. (I) day
fro. the date of d.ath, to the date of pay..nt. Ta... which bee... d.llnquent b.ror. Jftnuftry I, 1'"
b.ar Int.re.t at the rate of Jlx (6%) p.rc.nt p.r annu. calculated al a dally ral. of .00016~.
All t.... which blca.. d.llnquent on or aft.r January I, 1~8Z will b.ar lnt.r..t _I . rnt. which will v.ry Iro.
calandar y.ar to calendar ynr wllh that ral. announced by Ihe PA O.p.,rl..nl of lI.venu.. It,. n'lllllcltlll.
1nlar.st rat.. for 198Z Ihrough 1996 ar.1
V.ar Inl.r..t R.ta O.lly Interut rllet.r V.ar In'.r.,1 "nl. Dftlly Inl.r.,t ',.clllr
198Z 20:< .000S"1I 1981 ., . OOO.~..'
1983 16~ .000438 19811.191J1 II~ .t'00~01
1984 11lC .000301 1~9i' ., .0001..,
19115 13:< .000356 19'~-lfJ"'~ " .0001'1
19116 10lC .000Z14 19'~'lfJ"b ., .000:'"
-.Inhr..t Is calcula'ed as fallowl!
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS OELtNQUENT X DAlLY INTEREST rACTDR
"Any Nollc. Is.u.d afhr tho ta. b.ca... d.llnquent will r.fl.cl "n Int.r.,' [II1c:"lftllt." '0 fllh.n (1\1 d..,.
b.yond the d.t. of the a.u....nt. If Pl'ly..nt Is .ad. afhr the In'.r..t c:oopllhllon dot. .,,,"'" on 'h.
Notlc., addltlon.l Intere.t MU.t b. calculal.d.
-. ......
REV-1548 EX M'p C12.95*'/
<O""OOWC'l'. 0' PC"SVlV"" ,
DEPARr}tE;,r OF REVOtUE
8oo,.U 0' I.D/V/OU'l ,..CS ,
:>lP'. zaO'O' c
HARR1S!UqC. PA J1JZa.060J
FRAN/(
NOTIc:,. OF INHE:RIrANC:E: rAX
APPRAISE:nE:Nr, ALLOHANC:E: OR DISALLOHANC:E:
OF DE:DUc:rION~. AND ASSE:SSnE:Nr OF rAX ON
JOINnv HE:LD OR rRUsr ASSE:rs
L
08-19-96
ESTATE OF COO/(
FILE NO, 21 96-0398
S,S/D,C, NO, 164-30-3946
A DATE OF ,?EATf/ 05-22-94
COUNTY
CUMBERLAND
-
EULAf/ . F GRUGAN
31 FORT ST
LEMOYNE PA 17043
ACN '
.
96102175. (",7,"))
F_~! "ON< TH" "HE .. '''''' "'" ""''' '" "'" "'"'' ....
'. ---------------------------------------------------------------------------------------------------------,,-
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND Co COURT HOUSE
CARLISLE. PA 17013
Allount R811JUed
;;11~ 51
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REV-1548 EX AFP (12-95_
CD""DNWEAlTH OF PENNSYLVANIA
OEPAAT"ENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. :8060l
HARRISIURC, PA 17128'0601' .
NOTICE qF INNERITANCE TAX
APPRAISE"ENT, ALLOHANCE OR DISALLDHANCE
OF DEDUCTION~, AND ASSESS"ENT OF TAX ON
JOINTLV HELD DR TRUST ASSETS
DATE 08-19-96
ESTATE OF COOK
FRANK
A DATE OF DEATH 05-22-94
COUNTY
CUMBERLAND
FILE NO. 21 96-0398
S,S/D.C. NO, 164-30-~946
ACN
. 96103809 .5,1)
PA 17043
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
HOUSE
SHIRLEY
31 FORT
LEMOYNE
S COOK
ST
A.ount R..itt.d
t
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
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REY-1548 EX AFP (12-9S*,
CO""ONWEALTH OF PENNSYLVANIA
DEPARTMEHT OF REVENUE
IUREAU OF INDIVIDUAL TAXES
DEPT. 210601
HARRISBURG, PA 17121.0601
NOTICE OF INHERITANCE TAX
APPRAISEnENr. ALLOHANCE DR DISALLOWANCE
OF DEDUCTION~. AND ASSESsnENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 08-05-96
ESTATE OF COOK
FRANK
A OATE OF DEATH 05-22-94
COUNTY
CUMBERLAND
FILE NO, 21 96-0398
S,S/D,C, NO, 164-30-3946
ACN
96102173 . 5,~}i
PA 17043
REHIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
HOUSE
SHIRLEY
31 FORT
LEMOYNE
S COOK
ST
A-nount R..,itted
CUT ALONG THIS LINE
~
RETAIN LOWER PORTION FOR YOUR RECORDS
~
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0u
PURPOSE OF
NOTJCE:
To fulfill tha roquir...ntl of Sect lor. 1140 of tho Inherltanc. and [stat. Ta~ Act, Act 1Z of 1~91. (lZ P.S.
S.ctlon ZI~O).
PAV"ENT:
D.tach tho top portion of thll Notic. and subalt with your pay..nt to tho Reglst.r of Willi prlnt.d on tho
r.vlr.. .Id..
-- Hak. chock or .onay ord.r payable to: RECISTER OF WILLS, AGENT.
All pay..nt. roc.lvad .hall flr.t b. applied to any int.r..t which .ay be du., with any r..ainder oppli.d to tha tax.
REfUND (CR):
A rafund of e tex credit. which wa. not requested on the tax return, oay be requ.,ted by co.pl.tlng an "Application
for Rafund of Penn.ylvanla Inharltanc. and E.tate TaM" (REV-l111). Application. are available at the Office of
tho Ragl.ter of Will., any of tho Zl Revenu. District Office, or by caillni'the special Z4-hour an.werlng service
nu.bers for for.. ordering: In Pennsylvania I'SOO"16Z"ZOSO. outside Pennsylvania and within local
Harrl.burg ar.a (711) 7a1.80~~, TDDI (117) 17Z"ZZSZ (Hearing I.paired Only).
OIJECTloNS: Any party in Int.re.t not .atl.fied with tho appralse.ent, allowanc. or disallowance of deduction. Dr a'I.,s.ent
of tax (Including discount or int.rest) as shown on this Notlc. .ay objoct within sixty (60) days of r.celpt of
thl. Notica by:
".wrltten proto,t to tho PA Depart.ent of Revenue, loard of Appeals, Dept. 281021. Ilarri'buri, PA 171Z8-10Z1, OR
--alectlni to have the oatter detereinad ot the audit of tho account of tho per,onal repr.,entative, OR
..appeal to tho Orphan.t Court
AD"IN-
ISTRATIV[
CORRECTIONS:
Factual error, dl.covered on this ass".s..nt should bo addr.ssed In writlni to: PA Cepart.ont of Rovenue,
lureau of Individual Ta~a., ATTN: Po.t A...,s.ant Raviaw Unit, DEPT. 180601, IJarrl'burg, PA l11ZI-0601
Phone (117) 781'6S0S. Saa pagl 1 of tho booklat "Instructions for Inheritanca Tax Return for 8 Ro.ldent
Decadant" (REV"IS011 for an eMplonatlon of ad.lnl.tratlvaly corractable arrors.
DISCOUNT:
If any tax due i, paid within thraa (1) calendar .onths aftar tha decadentt, death. a fiva percant (S%)
dl.count of the tax paid I' allowed.
PENALTY:
Tha ISX tax aanesty non-participation penalty Is co.puted on 'the total of the tax and Inter.st ass.ssed. and not
paid bofore January 18, 19~6, tho fir.t day aftor Ih. end of the tax a.no,ty porlod. This non'participatlon
penalty II app.alabl. in Ih. '0.0 .anner and in tho tho sa.. ti..,period a' you would appeal the tDx Dnd intorest
thet has be.n a,slssed as indlcatod on this notice.
~
INTEREST:
Inter.,t 1. charged boglnnlng wlth first day of d.llnqu.ncY, or nine (~) nonths Dnd on. 11) day
fro. tho date of death, to tho d~t. of pay.ent. faMo, which blcD.e delInquent before January I, 1~8Z
boar Int.re.t at the rat. of ,Ix (6%) percent p.r nnnu. calculated at a daily rat. of .000164.
All taM.s which blce.e delinquent on or after January 1. I~BZ will bear Interl.t at a rate whiCh will vary fro.
calendar year to callndar yoar with that rnt. nnnouncod by tho PA Departnont of Revanue. Th. appllcabl.
Interest ratls for 198Z through 19~6 oro:
V.ar Intere.t Rata Dally Intere.t Factor
1912
1~81
1~84
1~8S
1~86
.'lnl.r..t
ZOX
16%
11%
11X
10~
Is calculated
.ODOS48
.000418
.000101
.0003S6
.000Z74
a, follow.:
Vear Interest Rate Dally Intero.t Factor
1~87 ?~ .000147
1~58.1~~1 11% .000101
1~~Z .% .000Z47
1~~1"19~4 7~ .00019Z
1~~S-1~~6 .% .000147
INTEREST = BALANCE: OF TAX UNPAID X NunBER or DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. Issued aft.r tho tax beco.e. dellnqulnt will refloct an intoro.t calculation to fifteen II~J days
beyond tho date of tho al'.ss.ent. If pay.ent I. "ad. aftor tho interost co.putatlon date shown on tho
Notice, nddltlonal Intero,t .ust be calculatod.
,-;,
,'-'
,
} -)
tj0
PURPOSE OF
HOTJCE:
To fulfill the requlre.ents of Section 2140 of the Inheritance Dnd Estate Tax Act, Act Z2 of 1991. (72 P.S.
Section 2140).
PAYKEHT:
Detach the top portion of this Notice and sub.lt with your pay.ent to the Register of Wills printed on the
revun side.
-- "ake check or eoney order payable to: PECISTER OF WillS, AGENT.
All payeents received shall flr.t be applied to any Intere.t which eay be due. with any reeainder DPplled to the tax.
REFUND (CRh
A refund of a tax credit, which wa. not requested on the tax roturn, eay be requested by coeplotlng an ~Appllcatlon
for Refund of PennSYlvania Inheritance and Estate Tax~ (REV-I111). Application. are availabl. at the Office of
the Register 01 Wills. any of the Zl Revenue District Offices or by call1ng'the special 24-hour an.werlng service
nuebers for for.s ordering: In Penn.ylvanla l-eOO'362-20~0, outside Pennsylvania and within local
Harrl.burg area (717) 787-8094, TOOl (117) 77Z-ZZ5Z (Hearing I.palred Only),
OBJECTIONS: Any party In Inter..t not satlsfl.d with tha appralsa.ant, allowance or dlsallowanca of deductions or assess.ent
of tax (Including discount or Jntere.tJ as shown on this Notice .ay object within sixty (60) days of receipt of
this Notice by:
--written prote.t to the PA oepart.ent of Revenua, !oard of Appaals. Dept, Z810Z1, HarriSburg, PA 17IZI-l021. OR
--elactlng to have the aatter deter.lned at the audit of the account of tha personal representative, OR
--appeal to the Orphan.. Court
AD"IN-
ISTRATJVE
.
CORRECTIONS: Factual arror. dlscoverad on thl. assess.ant should be addressed In writing to: PA Dapart.ent of Revanue.
lureau of Individual Taxes. ATTN: Post AI.e.l.ent Review Unit, DEPT. Z80601, HarriSburg, PA 17128"0601
Phone (117) 787'6505. See page 1 of the booklet ~Instructlons for Inheritance Tax Return for a Resident
Decedent~ (REV"1501J for an explanation 01 adelnJstratlvely correctable errors.
DISCOUNT:
.
If any tax due Is paid within three (1) calendar eonths alter the decedent.s death, a flva percent (5~J
discount of the tax paid Is allowed.
PENalTY:
The 15~ tax aane.ty non"partlcJpatlon penalty Is coeputed on 'the total of the tax nnd Interest as.essed, nnd not
paid before January la, 1996. the first day after tho end of tha tax a.nesty period. This non'partlclpatlon
penalty Is appealable In the sa.a nanner and In the the sa.e tl~e,perlod as you ~ould appeal the tax And Interest
that ha. been asses.ed as Indicated on this notice.
INTEREST:
Interest II chargad beginning with first day of delinquency, or nine (9) "onths and one (1) day
Iro. the data of death, to the date of pay.ent. Taxes which beca.e dellnquant before January I, 1982
bear Inter8.t at the rate 01 six (6~) percent per annUl calculated at a dally rate 01 .000164.
All taxe. which beca.. delinquent on or aftar January I, 198Z will bear Interest at a rate whiCh will vary Ira.
calendar year to calendar year with that rate announced by the PA napart.ent of Revenua. 'he applicable
Interest rat.s lor 198Z through 1996 ara:
Yaar Intarut Rate Dally Int.r.st Factor Y.nr IntnrllSt R"te Dally Int.r.st Factor
191Z ZO~ .000!l48 1981 .~ .000:!47
1983 16:( .000418 1988'1991 l1iC .000301
1984 11~ .000301 1992 .~ .000247
1985 13~ .000156 1993"1994 n .000192
1986 10iC .000274 1995"1996 .. ,000247
-~Int.rast is calculat.d .. 101Io~.:
INTERESr = BALANCE: OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice Illued after the tax beco.as delinquent ~III refl.ct an interast calculntlon to fllte.n liS) days
beyond tha date 01 the as...s.ant. If pay.ant Is .ade nfter tho Interest co.putation date sho~n on the
HotIco, additional Int.rut .ust b. cnlculn'ad,
REV-1548 EX AFP (12-951*
CO""OHll[Al m or PENNSYlVANIA
olPAAI,.lHI or REVlNUE ~
aUAUU or INDiViDUAl tAXES , ,.'~"
o[Pt. 180&01
tIARA1SBURG. PA 171Zl!dftOI 'a:
1I0TlCE or INIICRITAIICC TAX
APPRAISEnENT L ALLDHAIICE OR DISALLOHANCE
Dr DEDUCTlOII., AIID ASSEssnWT or TAX 011
JOINTLY IIELD OR TRUST ASSETS
DATE 08-19-96
ESTATE OF COOK
FRANK
A DATE OF DEATH 05-22-94
COUtHY
CUMBERLAND
FILE NO. 21 96-0398
S.S/O.C. NO. 164-30-3946
ACN
96102170
EULAH F GRUGAN
31 FORT ST
LEMOYNE PA 17043
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLANO CO COURT HOUSE
CARLISLE, PA 17013
Anount Renltted
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-iv:i54-s-Eif-AFFi-ii;r:95j------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-19-96
ESTATE OF COOK
FRANK
A OATE OF DEATH 05-22-94
COUNTY
CUMBERLAND
FILE NO, 21 96-0398
TAX RETURN WAS:
S.S/D.C. NO, 164-30-3946
(XI ACCEPTED AS FILED (I CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
96102170
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
21001022338
TYPE OF ACCOUNT: (I SAVINGS ( I CHECKING ( ) TRUST (10 TIME CERTIFICATE
DATE ESTABLISHED 03-10-88
, Account Balance
Percent Taxable X
Amount Subject to Tax
Oebts and Deductions
Taxable Amount
Tax Rate X
Tax Due
10.056,22
0,083
837.98
837,98
.00
,15
.00
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
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST (-)
AMOUNT PAlO
I TOTAL TAX CREDIT- I
iBALANCE OF TAX DUEl
INTEREST AND PEN. !
I TOTAL DUE
. Ir PAID AFTER TillS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, ,
IF TOTAL DUE IS LESS TIIAN 'I. NO PAvnENT IS REQUIRED.
Ir TOTAL DUE IS REflECTED AS A "CREDIT" I CR I, VDU nAV BE DUE A REFUND.
SEE REVERSE SIDE OF TNIS FDRn FOR INSTRUCTIONS. I
.00
.00
.00
.00
PURPOSE OF
HOTICEl
PAV"EHTI
REFUND (CR)1
(;,
. '
~
J8
To fulfill the r.qulr...ntl of S.ctlon ZI40 of the Inherltanc. and Eltat. Tax Act, Act ZZ of 1991. (72 P.S.
S.ctlon ZI40).
D.tach the top portion of this Hotic. and ,ubeit with vour pav.ent to the R.gi,ter of Wills printed on the
r.v.rl. ,Id..
_.. "aka check or Don.y ord.r payable to: RECIStER or WIllS, ACENT.
All pay..ntl r.c.lved ,hall firlt b. appll.d to Dny lnt.re,t which .ay be du., with any r..alnd.r applied to the tax.
A r.fund of a tax cr.dlt, which wal not r.q.elted on the tax return, .ay be requ.sted by co.pletlng an "Application
for Refund of PennlYlvanla In~.rltanc. and Estat. Tax" (REV-ISIS). Application, are available at tha Offic. of
the Ragl,t.r of Willi, any of the Z1 Revenue Di,trlct Offlcel or by calling the ,pecial Z4-hour an,werlng .ervlce
nueber, for fore, orderlngl In PennsYlvania 1-800'362"ZOSO, outsld. Penn,ylvanla and within local
Harrisburg are. (7111 787-8094, TOO' (717) 17Z-ZZS2 (Hearing I.palred Only).
OIJECTI0NS: Any party In Inter.lt not satisfied with the appralse.ent. allowanc. or dlsallowanc. of deductions or als.,s.ent
of tax (Including dllcount or Inter.lt) a' shown on thll Hotice .ay Object within sixty <<601 day. of receipt of
this Hotlca bYI
..wrltten protest to the PA Depart.ent of Revenue, Board of Appeals, Dept. 2810Z1, Ilarrl'burg, PA 171Z8'IOZ1, OR
....I.ctlng to have the .atter dater.ln.d at the audit of the account of tha personal repr.,entatlv., OR
--app.al to the Orphans' Court
AD"IN-
ISTRATIVE
CORRECTIONS:
DISCOUNT I
PENALTY:
INTEREST:
Factual Irrors discovered on this a".".ent should be addr.ssed in writing tal PA Oepart.ent of R.venue,
Bur.au of Individual Taxes, AttH: Post A"e"8.nt Review Unit, DEPT. 280601, HarriSburg, PA 17128'0601
Phone <<717) 717'650S. Se. page 3 of the bookl.t "Instructions for Inheritance Tak Return for a Resld.nt
O.c.dent" CREV"lSOI} for an .kPlanatlon of ad.lnlstratlv.ly correctable errors.
If any tak due Is paid within thr.. (3) calendar 8onth, after the decedent.s death. a five p.rcant (S%)
discount of the tax paid Is allow.d.
The IS~ tak aan.sty non-participation penalty Is co.put.d on the total of the tak and Int.r.st ass.,sed, and not
paid bafore January 11. 1996, the first day aft.r the end of the tak a.ne,tv period. this non-participation
penalty Is appealable In the sa.. .ann.r and In th. the SD.. tl.e periOd as you would appeal the tak and Inter..t
that has bl.n a,s.".d as Indlcat.d on this notlc..
Interest Is charged blglnnlng with flr,t day of delinquency, or nine (9) nonths and on. (1) day
fro. the data of death, to the data of pay.ent. TaKes which beca.. dellnqu.nt b.fore January 1, 198Z
b.ar Intor.,t at the rat. of six (6%) poreent per annu. calculated at a dally ral. of .00016~.
All ta.., which boce.. d.llnquent on or aft.r January I, 191Z will bear Interest at a ral. which will vary fro.
cal.ndar ylar to cal.ndar Ylar with that ral. announc.d by the PA Departnent of R.venUI. Th. applicable
Int.re,t rat.. for 1982 through 1996 Drel
V.ar Intere,t Rate Dally tnt.r.,t ractor Vear Int.rest ~at. Dally Intero.t ractor
1982 'OX .000S48 1987 .X .000Z~7
1981 16% .000~31 1981-1991 11% .000301
198~ 11% .000301 1992 9% .000Z~7
1985 IU .0003S6 1993-1q9~ IX .00019Z
198& 10% .00aZ7~ 1995-199& 'X .000Z41
--Int.r..t Is calculated a. folloWSI
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
'-Any Notice Issuld oflor the tak beco.e. dellnqu.nt will r.fl.ct an Inter.st calculation 10 flfleen (I~) days
b.yond the dat~ of the a,...,..nt. If pay.ent Is nad. after the Int.rest co.pulatlon data shown on thl
Hotlcl, additional Int.rest eust b. calculated.
D NO, AA
146706 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
"k
I,VoIWlll,.lI'1
ACN
ASSESSMENT r:"
CONTROL ...
NUMBER
AMOUNT
RECEIVED FROM:
D
96102168
.5.:56
SHIRLEY 5 COOK
31 FORT ST
LEMOVNE, PA 17043
96102173
9b18:JEl09
$5.72
f>:5.'1e
'16103Ul0
$5.72
fOIDHUf
DO
/ \.../'
( .'
. !r"-_. .,...; ,: If' .....'J..I "1
.. SIGNATURE )/ . ,/ . l,.
" .., ~.I," -; , ,
i .
ESTATE INFORMATION:
~ fiLE NUMBER
g 21-1996-0398
~ NAME Of DECEDENT (LAST)
~ COOK FRANK A
II DATE Of PAYMENT
m POSTMARK DATE
COUNTY
.
5SN 164-30-,3946
(fiRST) (MI)
CUMBERLAND
DATE Of DEATH
fa TOTAL AMOUNT PAID
() ,
, ' ,
RECEIVED BY i /.',
,
$22.72
REMARKS
SHIRLEY S COOK
SEAL
CHECKII CASH
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF W1LL5
-..., --- ..-- . - -- -- - -. -.
.'--....-
-. --
-..~..A...."?l.. _'" Or ,~~'.
REV-1548 EX AFP (12095)*
CD""'OHWrAllll or III Hkin VANIA
D[PA"JH'Nf 01 /ofl\II HUI :'1l..
IIU~UU 01 INDIVIDUAl 1A)lI S /, _ , "",
PlP'. ,.110601 I
tIANRISBUAC. VA III:lI'ObOI ~.
(,I) .,
NOTlCC Dr INllrRITANCC TAX
APPRAlscnCNT, ALLOHANCE OR DISALLOHANCE
or DEDUCTION" AND ASScssnCNT or TAX ON
JOINTLV IICLD OR TRUST ASSCTS
ESTATE OF COOK
FRANK
A DATE OF DEATIi 05-22-9(,
CUMBERlANO
FILE NO. 21 96-0398
DATE 09-)6-96
COUNTY
S.S/D,C. NO. )64-30-3946
96102160
SHIRLEY C COLEMAN
31 FORT ST
LEMOYNE PA 17043
ACN
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLANO CO COURT HOUSE
CARLISLE, PA 17013
I AMount ReMitted
.--
I
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-V:is4-a-EX--AFP--ii2-:9Si----------------------______________________________________________________________
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 09-16-96
ESTATE OF COOK
FRANK
A DATE OF DEATH 05-22-94
CUMBERLAND
S.S/O.C, NO, 164-30-3946
IX) ACCEPTEO AS FILED () CHANGED
JOINT OR TRUST ASSET INFORHATION
FILE NO, 21 96-0398
TAX RETURN WAS:
FINANCIAL INSTITUTION: PNC BANK
COUNTY
ACN
96102160
ACCOUNT NO,
210001022336
TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE
DATE ESTABLISHED 03-10-88
Account Balanca
Percant Taxable X
Amount Subject to Tax
Dabts and Deductions
Taxable Amount
Tax Rata X
Tax Due
10,056.22
0,083
837,98
.00
837.98
.15
125.70
TAX CREDITS:
PAYMENT
DATE
06-29-96
RECEIPT
NUMBER
AA112992
DISCOUNT (+)
INTEREST (-)
15.31-
INTEREST IS CHARGED FROM 06-30-96 TO 09-24-96
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
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 ADORESS, MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT,"
AMOUNT PAlO
125.70
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
t TOTAL DUE
IF PAID AFTER TNIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
I IF TOTAL DUE IS LESS THAN $l, NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS, I
.
11 0.39
15.31
.33
15,64
r;
()u
PURPOSE Of
NOTICE:
To fulfill the requir...nt. of Section ZI40 of the Inrltldl""U and [stilt. 11111 Act, Act Z2 of 1991. ('12 P.S.
Sactlon 2140).
PAV"EHT;
aetach the top portion of thi_ Notlc. and subalt with your pay.e"t to the ReQlstor of Willi printed on th_
rovar.. .Ida.
._ Haka check Dr .onay order payable tOI REGISTER Of WILLS, AGENT.
All pay.."t. received shall fir.t be applied to any lnt.r..t which aay b8 due, with any tea.lnder applied to the tax.
REFUND feR):
A r.fund of a tax credit, which was not raqua.ted on the tax r.turn, oay be requ..ted by co.platlng an "ApplIcation
for R.fund of Pennsylvania Inheritance and Estat. Tax. (REV-131]). Applications at. /lvallable at the Offlc8 of
the Raglster of WIlli, any of the 23 Revenue Dlltrlct OfflCo, or by calling the special Z4"hour answering service
nu.bers for for.s ordering: In Pennsylvania 1-100"362-2050. outside Pennsylvania and within local
Harrisburg area (111) 781-1094, tOOl (711) 772.2252 (Hearing t.palred Only).
OBJECTIONS' Any p.rty In Intor.,t not ..tl.,lod with tho .ppr.I....nt, allowaneo or dl.allow.nc. o. doductlon. or ...o....nt
of tax (Including discount or Int.r.st) .s ,hown on this Hotlc. .ay object within .Ixty (601 day. of receipt of
this Hotln by:
-.wrltten protest to the PA Oepart.ent of Revenue, loard of Appeal.. Oept. 281021, Harrisburg. PA 17121-1021. OR
..electlng to have the .atter deter.lned at the audit of the account of the personal representative. OR
uappeal to the Orphans. Court
AOHtN-
ISTRATlVE
tORRECTlONS:
Factual error. discovered on this assess.ent should bo addressed In writing to: PA Depart.ent of Revenue.
lureau of Individual Taxe', ATTN: Post Assel..ent Review Unit, DEPt. 210601, HarriSburg, PA 1112a-0601
Phone (1111 781-6505. See page S of the booklet "tnstructlonl for Inherltonce Tax Return for a Re.ldant
Decedent" (REV-1501) for an explanation of ad.lnlltratlvalY correctable error..
DISCOUNT:
If any tax due Is paid within three (SI calendar .onth. after the decedent's death. a five percent (52)
dllcount of the tax paid II allowed.
PEHAlTY:
The 152 tax eanesty non-participation penalty II co.puted on tho total of the tax and Interolt allelsed, and not
paid before January la, 1996. the first day after the and of tho tax a.ne.ty period. Thll non-participation
p.nalty I. appealable In the sa.e .anner and In the the sa.. tl.. period ftS you would appeal the tax and Intere.t
that hal bean a.,..,ed a. Indicated on thl. notice.
INTEREST:
tntera.t I. charged beginning with flr.t day of delinquency. or nine (9) .onth' and one (1) day
fro. the date of death, to the date of pay.ent. Taxe. which becaee delinquent before January 1, 1982
b.ar Inter..t at the rate of six (621 percant per annu. calculated at a dally rate of .000164.
All taxa. which beca.e delinquent on or after January 1. 1982 will bear Intere.t at a rate which will vary fro.
calendar ye.r to calendar ye.r with that rate announced by the PA Depart.ent of Revenu.. The applicable
Intere.t rate. for 1982 through 1996 are:
Year Interest A.te Dally Intenlt Factor Yur tntarut Rate DailY Intenlt Factor
lCJ12 20;( .000548 1917 .". .000247
1985 162 .000438 1981-1991 It:( .000501
1984 112 .00n01 1992 0% .000247
1985 In .000356 1993-1994 n .000192
19a6 102 .000274 1995-1996 0% .000247
-"lnUrest Is calculated .. foUow':
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAVS DELINQUENT X DAILV INTEREST FACTOR
"-Any Hotlca Issuad aft.r the tax baco..' dallnquent will rellect an lntara.t calculation to Ilft.an CIS) day'
bayond tha date 01 the al.als.ont, If pay.ent I. ..de aftar the Interest co.putatlon dato shown on the
Hotlca. additional Intora.t au.t ba calculatad.
PURPOSE OF
NOrtCE::
PAY"ENT:
REFUND (CR I :
',,"
,"J
r
'.,1
OJ
JO
To fulf111 the requin.enh of Section ZI40 of the Inheritance and [state fax Act, Act lZ of 1991. 172 P.S.
S.ction 2140).
Detach the top portion of thh Hotln and .ub.lt with your pay..nt to the R.glster of wilh printed on the
rever.e lide.
... Ha~e check or .oney order pavable to: REGIst(R or WillS, ACENT.
All pay.ent. received Ihall flr.t be IIpplled to any inter..t which .av be due. wlth any n..lnder applied to the talC.
A refund of a talC credit. which was not requ..ted on the ta. r.turn. .ay b. reque.ted by co.pl.tlng an "Application
for Refund of Pennlylvanla Inheritance and (Itate Ta." IREV-1313). Appllcatlonl are available at the Offlc. of
the Regl.ter of Will., any of the 25 R.venu. District Offlcel or bv calling the special Z4-hour an.werlng lervlce
nueb.r. for for,s ordering: In P.nnsylvanla 1-800-362-Z050. outllde P.nnlvlvanla and within local
Harrl.burg area (711) 787-8094, TOD' (111) 172-Zl52 (Hearing I_paired Only).
OIJ[CTIOHS: Any partv In Interelt not .atlsfled with the appralse.ent. allowanc8 or dllallowance of deduction. or a'I"I..nt
of talC (Including dl.count or Int.re.tl a. .hown on thl. Hotlc. .ay object within ,llCty (601 day. of r,celpt of
thh Notice by:
"'wrltt,n prote.t to the PA Depart,ent of Rlvenue, Board of Appeal., a.pt. 2810Z1. Ilarrltburg, PA 171Z8-IOZ1, OR
....Iectlng to have the .atter deter.lned at the audit of the account of the perianal repr..entatlv., DR
--appeal to the Orphan,' Court
ADHIN"
ISTUTJVE
CORRECTIONS:
DISCOUNT:
PENal TV:
IHTEREST:
Factual .rror. dl.cov.red on thl. a.......nt .hould bl addr....d In writing to: PA a.part..nt of R.venu..
Bur.au of Individual TalC", ATTN: po.t A...II.ent Revi.w Unit, DEPT. Z80601, Harrl.burg, PA 111:8-0601
Phone (717) 181"6505. See page 5 of thl booklet "In.tructlons for Inh.rltanc. TalC R.turn for a Re.ldent
Oec.dent" (REY.1501J for an e.planation of ad.lnl.tratlvelv correctabl. error..
If any t8IC due h paid within thr.. (J) calendar .onth. aft.r the deced,nt.s death, a five percent (s:()
dl.count of the talC paid h al1ow.d.
The 15~ talC a.ne.ty non-participation penalty i, co,puted on the total of the ta. and Int.re.t a"".ed. and not
paid before Januarv 18, 1996, the flrlt day aft.r the end of the talC aene.ty periOd. Thi. non"partlclpation
p.nalty I. app.alable In the sa.e .anner and In the the s... tl.. period a. YOU would appeel the tax and Inter..t
that has bun all....d as Indical.d on Ihlt notice.
Int.r..t II charged b.glnnlng with fir.t day of delinquencv, or nine 19J .onths and one (1) day
fro. the date of d.ath, to Ihe date of pay.ent. fallel which beca.. delinquent before January I, IlJl2
b.a~ Inte~e.t at Ihe rale of .Ix (6i'.J percent p.r annu~ calculat.d at a dally rat. of .000164.
All tax.. which b.ca.e delinquent on or after January I. IlJ8Z will bear internt at II rate which will vary fro.
cal.nder y.ar to calendar y.ar with that rate announced by th. Pi Oeparl.,nt of Rev.nu.. Th' npplicable
Inl.r..t rat.. for 198Z through 1996 ar.:
Y.ar Intere.t Ral. Dally Int.relt Factor
Y.ar Inter.,t Ral. Dally Inlerut Factor
In1 'X .000Z47
ItJ88-19lJl ItZ .00nOl
1992 'X .000Z41
199]..t9lJ4 IX .0OOllJZ
llJ'ilS-llJt)6 lJi'. .000Z47
1912
1983
1984
1985
19116
ulnt.rut
zu
16i'.
Iti'.
In
10i'.
Is calculat.d a.
.000S48
.000438
.00nOt
.00035&
,000114
foltow.:
INTEREST = BALANCE OF TAX UNPAID X NunBER or DAVS DELINQUENT X DAILV INTERESr rACTOR
....Any Hot Ice Is.ued .ft.r the talC b.cc... d.llnquent will reflect An lnl.rell calculation 10 flft..n (IS1 dart
beyond the dale of Ih. ft.'8....nt. If par..nl 1. .ad. aftlr the Inter..1 co.putatlon dal. Ihown on Ih.
Notice. addlllonal Inl.rut .u.t b. calculaled.
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':c;t: 'Jen:c:;
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REV-15~8 EX AFP (12-951*,
CO""OHWEAlTII OF PENNSYLVANIA .
DEPART"ENT OF REVENUE
IUREAU OF INDIVIDUAL TAXES '
DEPT. ze0601
HARRISIURC, PA 17128-0601
NOTICE or INHERITANCE TAX
APPRAISEnENr, ALLOHANCE DR DISALLDHANCE
or DEDUCTIONs. AND ASSEssnENT or TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 09-16-96
ESTATE OF COOK
FRANK
A DATE OF DEATH 05-22-94
COUNTY
CUMBERLAND
FILE NO, 21 96-0398
S.S/D.C. NO, 164-30-3946
ACN
96102169
SHIRLEY
31 FORT
LEMOYNE
C COLEMAN
ST
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
HOUSE
PA 17043
A.aunt RelliU.d
},;; ~.,
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
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REV-154~ EX ~FP (12-951*,
CD""ONWEALlIt OF PENNSYLVANIA
DEPART"EHT OF REVENUE
IUREAU OF INDIVIDUAL TAXES ., .
DEPI. 280601
HARRISIURC, PA 171Za-0601
NOTICE OF INHERITANCE rAX
APPRAISEnENT, ALLOHANCE OR DISALLOHANCE
or DEOUC1ION_, AND ASSES5nr.~T QF TAY ON
JOINT~V IInu QR TRUST A~NETS
DATE 09-16-96
EST ATE OF COOK
FRANK
A DATE OF DEATH 05-22-94
COUNTY
CUMBERLAND
FILE NO, 21 96-0398
S.S/D.C, NO, 164-30-3946
ACN
96102174
SHIRLEY C COLEMAN
31 FORT ST
LEMOYNE PA 17043
REMIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AMount Re.,itted
.'.id C. 3
.._..__.._~.._---_.._..-_......-.._.._------_..__..__..__.._..----_....---------....--..-..---..-..-..------------
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9 Fori Slreet
Lemoyne,l'A 170,1.'
Seplember 19, 1996
Register of Wills
c:un~berla:ld Counly Courl House
Carlisle. I A 17013
c:
RE: THE ENCLOSED NOTICES OF INHEIUrA~K:E TAXES....
(ACN 96102174, 96102171, 96102169, 961021(0)
Gentlemen:
I previously wrote regarding some other bills Ihal were previously receivcd, I am again writing
this Icllcr on behalf of my mother, who is !Ill years of age, To recap. a few years ago, not
knowing the rnmifications of her actions, my mother placed her Ihree children's names (Frank A.
Cook, Jr" Shirley M. Coleman. and Eulah C, Grugan) on some Cerlilicates of Deposit which she
owned, She did not intend to make us co-owners, bul ralher, beneficiaries, Subsequent to Ihal
action, my brother died unexpecledly,
During lasl winter, inherilance tax bills began 10 arrive, amounting to more Ihan $500.00 for my
mOlher, my siSler, and I. At the lime, my mother was in Califomia, helping my sister care for her
ill husband. We did not know that we were liable for taxes on CD's that my mother kept in her
possession, for her use in case of illness, elc, These cerlificates were kepI in my mother's locked
safely deposil in her name. 'nle money was not available to any of Ihe children.
In speaking to a representative Irom the Department of Revenue, I leamed what steps were
necessary, We then galhered togelher receipts for various expenses for my brother's illness and
funcrn1. About the same lime, I had some health problems which necessilated Iwo surgeries (one
in January and one in Mareh,) Mother relumed home from Califomia in March and in May had
surgery herself,
The aforementioned circumstances contributed to the delay in following Ihrough with Ihe
itemization of expenses and the payment of money due, We have lried 10 gather alllhe needed
materials and money in as expeditious a manner as possible, but il has not been as quick as we had
hoped.
Again, we received more bills--this time for interest on the money that has already been paid,
Since we have had extraordinary circumstances which caused the delays, and since my mother has
had to pay taxes on money that was already hers, I am requesting that she be exonernted from the
addilional expense of interest on the taxes,
In an effort to avoid further interest, enclosed is a check to cover the $62,55 which is shown as
due. Please consider my request for relief of these costs. and refund Ihat amount to her. Any
consideration will be greatly appreciated.
Sincerely,
t;_uz~ (J, 9=Wt(,tXCO-.~
Eulah C. Grugan {,
PAY"EHt:
Dotnth Iha top portion of thl. Notlco And subalt with ~our pAy~ent aAde pAynblo to tho nnae and addros'
prlntad on the roverse side.
If RESIDEHT DECEDEHT llll,"'1I check or oone'l order pnynblll to: REGISTER OF WILLS, AGENT.
If NON-RESIDENt DECEDENT anlta chock or oono'l order pnyable tal COMMONWEALTH OF PENNSYLVANIA.
All payaants rllc.lvod shall bll appllod first to any Intllrast which aa'l bll dUll with ony rllaalndllr applllld to tho tax.
REfUND (CR): A rofund of a tax cradlt, which was not rllqu.stlld on Ihll la. Rllturn, aay bo rllquestod by coapll1tlng nn
"Application for Rofund of Pennsylvania InhllrltanclI and Estatll Ta." (REV"IJI51. Application. ar. avallablo at
tho Offlco of tho Roglstllr of Wills, any of tho 25 RllvllnulI OI.lrlcl Olflco' or froa tho Dopartollnt'. 24"hour
an.worlng ,orvlco nuabllr. for fora. ordllrlng: In Pennsylvania 1"800-5&2-Z050, out.ldo Pllnnsylvanle
and within 10cel tlarrlsburg aron (111) 7U-IC91o. tOOl (711) 77Z-Z252 Itlenrlng lapalrlld onlY).
REPLY TO:
OUIIstlons rllgardlng IIrror. contalnod on thl. notlco should bo addrossed to: PA Ollpnrtallnt of Rovonuo. lurllnu
of IndividUal la.II', ATTH: Post Assossallnt Rovlow Unit, Dept. 280601, Harrisburg, PA 11126.0601, phone
(717) 767-6S0S.
DISCOUNT:
tf any tBx duo 1. paid within throo (3) calondar aonths aft.r thll docodent'. d.ath, a flvo p.rcont (S~) dl.count
of tho tax paid I. allow.d.
PENAl TV I
Iho 15oY. tax aanll.ty non-participation ponalty I. eo.putod on tho total of thll tax and Intorll.t as.....d, and not
paid bllforll January 11, 1996. thll flr.t day aftor thll ond of tho tax oanll.t'l porlod.
INTEREST:
tnt.ro.t I. charglld bog Inning with flr.t day of dollnqullne'l, or nlnll (9) aonth' and ono (1) day froa thll date of
doath, to tho date of pay.ont. Ta..' which boea.. dollnquent b.loro Jnnunry 1. 1982 boar Intor..t at tho rate 01
.1. t6~) pllrcllnt pllr nnnu. ~alculatlld et a dally rato 01 .0001610. All ta... which boc... dllllnqullnt on and nltor
January 1, 1982 will boar Intor~.t at 8 rale which will vary froa calendar yesr to ealondar yoar with that rato
announced by thll PA Dopart.ont of Rovonuo. Tho appllcablo Intorllst rnto. lor 1982 through 1~96 arll:
Yur
Inhro.t Rato Dally tntorll.t Factor
Vonr
Intornt Rato
Dally lntorost Factor
198Z 20~ .000S46 1'J87 91- .000241
1983 16~ .000438 19Ia"1~91 111- .00nOl
1984 1l~ .00OSOI 1992 ,. .000241
1985 UZ .0003S6 1993-1~91o n .0001'J2
1986 10Y. .0002110 1995-199& .~ .0002107
-"Intornt is ealculatod .. followS;
INTEREST = BALAHCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTERESr FACTOR
--Any Notlc. Is.uod aft.r tho tax bOco..' dollnquont will rofloct an lnt.rolt calculation to flftoon (15) day.
b.yond tho dato of the ns.....ont. If payaont I. aado aftor tho lntoro.t co.putatlon dato shown on Ih.
Hotlco. additional Intorolt aust b. calculatod.
~ -. .- ... '.
/) ;(!;: .' I
"I
;~~,
>tJP
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
BUREAU OF INDIVIDUAL TAXES
IHIIERIlANC[ fAX D!VIS!ON
DtP.. 0'80bO!
ttARR!SBURG, PA 1110'11'0&01
.1t-al/lIl" III,t"
SHIRLEY
31 FORT
LEMOYNE
S COOK
ST
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-30-96
COOK
05-22-94
21 96-0398
CUMBERLAND
96102173
FRANK
PA 17043
r-
Anou"t Renltted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To Insure proper credit to your account, subnit the upper portian of this forn with your tax p.ynent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEv:i6'ifi"EX-Aiiji-io3':96y------.ilii-iNHERi"{AiicE'-fiiif-STiiTEHE'rif-oTA'i:ciiu'NT--.-..-nm-m-m-----n
ESTATE OF COOK FRANK A FILE NO. 21 96-0398 ACN 96102173 DATE 09-30-96
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAnED ESTATE. SHOWN BELDH
IS A SUnnARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE. AND, IF APPLICABLE.
A PROJECTED INTEREST FIGURE,
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 07-29-96
PRINCIPAL TAX DUE, 50.24
PAYMENTS (TAX CREDITS):
PAYMENT
DATE
05-15-96
08-28-96
RECEIPT
NUMBER
AA1l2847
AA146706
DISCOUNT (+)
INTEREST (-)
5,56-
.14-
50.24
5,72
AMOUNT PAID
,.)0
TOTAL TAX CREDIT
50,26
.02CR
.00
.02CR
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. If PAID AfTER THIS DATE, SEE REVERSE
SIDE fOR CALCULATION OF ADDITIONAL INTEREST.
( If TOTAL DUE IS LESS THAN $l,
NO PAYnENT IS REQUIRED,
If TOTAL DUE IS REfLECTED AS A "CREDIT" (CRI,
YOU nAY BE DUE A REfUND, SEE REVERSE SIDE Of THIS fDRn fOR INSTRUCTIONS. I
A
PAY"ENI:
Dlltach Ihll lop porUon of Ihil Notice and lubllltl ..tlh yuur pnYlllllnl ...1UII pn'lolJle 10 th. nllll. IInd IIddro..
prlnlod on thll rovllrsll sid..
If RESIDENT DECEDENt 11I11"0 choe" or IIIonoy ord.r Pll'lllble to: REGISTER OF WILLS, AGENT,
If NON-RESIDENT DECEDENT IIl1ke chllck or noney order pllYllblo to: COHHONWEAL TH OF PENNSYLVANIA.
All paylllont. roe.lvlId Ihall bll applied first to ony Int.r..t which lIay b. dUll with any rallBlnder applied to the taM.
REFUND (CR): A r.fund of a taM crlldlt, which WIlS not roquo.tod on the 'a~ R.turn. lIay b. raquII.ted by cOlIplotlng 8n
"Application for R.fund of Pllnn,ylvanla Inhllrlt8ncll ond Estatll 'a~" IREV"1313). Applications ar. Bv.llabl. at
the Offlc. of thll Rllgistor of Will'. any of th. Z3 Rev.nuII District OffiCIIS or fro. the Ollpart..nt', Z4-hour
answ.rlng ,.rvlc. nullber' for for~s ordllrlng: In PlInnsylvanla 1-300-361-1050. outsldll Ponn,ylvanla
and within local HarriSburg area (111) 1A1-50~4. 'DOl (117) 71Z'1Z52 (Ho,.rlng I.palt.d onlyl.
REPLY TO:
Quo.tlon, regarding error' contalnod on tht. notlclI should bll addra.sod tal PA Depart..nt of Revenuo, lur.au
of Individual ra.... AnN: Post "'.'....nt Revlow Unit, Ollpt. Z.!I0601. tlllrrlsburg. PA 17IZ5-0601. phonll
(711) 781-6S0S.
DISCOUNT I
If any taM dUll Is paid within thr.1I (3) cal.ndar IIonth. aft.r tho dllelldant., dealh, a flvo porcent (S~) dl.count
of the taM paid I. allowlld.
PENAL TV I
lhll IS~ ta~ allOo.ty non-participation penalty Is co.putlld on thll total of tho taM and Intere.t as'II,.ed. and not
paid bllfor. January 18, 1996, thll flr.t dlly after tho ond of thll ta~ allnllsty porlod.
INTEREST:
Int.rest I' charged beginning with first day of delinquency, or nlnll (91 .onths and on. 11) day frail thll dato of
dllath. to the date of pay.ant. Ta~e. which bllca.1I dellnqu.nt b.foro January 1. 1982 b.ar Intor..t at thll rate of
SIM (6X) porcent per annu. calculatlld at II dally rat. of .000164. All ta~e. which beea.e dlllinquont on and aftllr
Janunry I, 198Z will bllar Interllst at a rato which will vary frail call1ndar Yllar to calondar yaar with that rat.
announcad by th. PA D.pnrt.ent of RlIv.nua. lha nppllcable Interost rate. for 198Z through 1996 ar.:
Yllar Intata.t Rate Dally Intoro.t Factor
Year
tnternt Rate
Dally Inter..t Factor
1912 ZOiC .000548 1951 .~ .000141
1981 16iC .000438 1~58-1991 11~ .000301
1914 11% .000301 1992 ., .000Z47
1985 In .000356 1991-1994 n _00019Z
1986 10~ .000274 19"S.1996 ., _000247
"Inter..t Is calculated ., folloWIl
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILV INTERESr FACTOR
."Any Hotlc. Issulld aftgr the taM baco.e. dellnqu.nt will tallect an Interest calculation to fifteen (ISI day.
beyond the date of the as,".s..nt. If paY.llnt Is .ade a,ter the Intllro.t eo.putatlon data .hown on the
Not Ie., additional Int.r.,t .ust b. calculated.
.
,.-'...-
,., .
I') -, I<~ L - /l/
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMOIIW[.tlIl ur m''''''VAII'' (TO BE FILED IN DUPLICATE
OEPAAIMHH or RlV(UU(
t1AR"sm:b,~~rJ:" 0601. ____~c._..~ITH!E~IST!.~OF ~I,~LSI_ ... c.oul,~v_cooEjfl LVfA~t~'J'1'lI~uM8ER
DllIUItU!o tl"MIII"'!oT,I.'~I, AIm MlI'lll! 1IlIIIMI IlIUlJltll!o U)Mr!11I ",(lURI..S :3nl'nh ^. 'rodd
FEH'l'Ei/IlAtJOIl, l1u11'h :.;. 1I01II01'1u1 II01HO, 1000 \-1. South st.
:-2~2~'~~~~'~-~~:., _.. \,,;;/-;,~/;(, \",~ID;';/'ll ~o~~lin2~u:lb~~1;~~13
1" "'~""" ";'j/~~'_"'~"~~'u, ,,," '"'' ..,ou."'" ."...." I'U<I., "~""" "u.,,, t",)"i:~i:i"'iii'li ;;;".ucliOii\l
tll1. Original Relurn I I '1 5upplnmMloI Rltlur" I] J. Remainder Return
tlor dale, of death prior 10 12.13.821
I ] o1n. rulu'lt lnlel8SI Compromi,,, {] 5. Fodelal eslal. Tall: Relurn Required
(for dohn of death ollllt 12-12-82)
06. Decedent Died Tlnlal" ,-] 7. Of'(l'ldenl Maintained [] U...ing Tlu\1 ~ B. Tolol Number 01 Safe Deposil Bo..'
IAuach copy of Willi (Alloth copy of Trusl)
ALL CORRESPONDENCE AND CONFIOENTlAL TAX INFORMATION SHOULD BE DIRECTED TOI
HAMf "-------Jo'"'nflf "'''llltIG ADDIl(~S
______,_J_~_J~_~~!'t_ ::;tllllrrel', At';;r' ......1 Illfi1'jketiSqUbnro 1311'Ad~'170~~
IflErttOtUt~UMBfA .oc lo.n en urg, ;;J;;J
_ 17 _ 76()-:-_96.IJ.=_-_,_.~,~~~~~--~~..- =-~, . ,_.._n -- -
III m. _l).OQu
(21 __ __.___m--~ 00_
( 3 1____ _ ___Q.. OQ....
(41--'6 ;'76~~~~m
(5)- m.'U'_. -,.-,------'--
(61-".---- ..__ 0..92-
(7) ".._n__ __9..09_
20. If line 19 il greoler Ihon line 18, enler Ihe difference on line 20. This ilthe OVERPAYMENT.
aD ,,,,:r.n"il,u,.la'I.!...U-.I>I.l11,ulhl:...('-J~~a'I.I'I..l'J'IJ!.Cl..~..I>l'1
21. If line 181s greoler than line 19. enler the difference on line 21. Tf,i, i, Ihe TAX DUE.
A. Enler the inlere,1 on Ihe balonr" duft on line 2'"
B. Enler Ihe 10101 of line 21 and 21A on line 218, Thi' i, thlt BALANCE DUE.
Malee Check Pavable tal ~eghler of Willi, Agent
i. . ." ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<(-<(
Under penohle, 01 pe'i"Y. I declo,e ,hall ho'. ..o;,;n.d ,hi, ,.Iu,n, ;"cI,d;ng accompanying "h-;'dul., and ,'ol.m.n". and 10 Ih. b.,' 01 my knowl.dg. and b.II.1
it is Irue. correct and complele. I declare Ihol all real C,lolft has been rpporlflc! atltue morktl value. Declarution of preparer other Ihan Iho personal repre'entalive i
based On 011 information of which preporer has any knc.wlftdgl!.
"G""U"' or mso".mo",,'" fO."""G',IIU"', ;.vu.,"')OIi'lIoi.i-tztolln-TIond-fJol;--S'--- - 0'"
:.i~,U v;W, 1..L\(. 'V', .:tViU_~___,_J:lyornyo\mL.r~~-lQ.Y-7_------ Lt), z,-.}o'r..
SIGN , · 7'Hl "'" 1S!:::;Zc..~~~'" Ilg~J~~i~~~~~e,~M~-)'7-Q.~~---.----- ;~'\, J ,-- f t.
.
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.
R(Y,IS00 (Jl. t1 9.41
...
ffi
fil
...
w
co
w
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)(:!I.IS
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w"'"
::r;a9
ufm
..
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.....
::lffi
"'co
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8~
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"-.\"" ,'l'
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[J A. limiled e'lale
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1. R.ol E,'o'.ISch.d,l. A)
2, S'ock! and Bond'ISch.d,l. 81
3, Clo,ely Held SlockJPatlnellhip Intetes' tSchedule q
4. Morlgage' and Nolel Receivable (Scl1odule 0)
5. Cash, Bonk Oepo,ih & Milcelloneou, Pellonol rroperly
ISched,l. E)
6. Jointly Owned Properly ISchedule f)
7, T,on,l... (Sch.dul. GI(Sch.dut. l)
8. Tolal Gran Anel' (10101 lines 1.71
9. Funeral Expen,es, Adminiltrativo COSh, Mi\CeUoneou,
Expen,es (Schedule H)
10. Debh, Mottgageliabililie" Uen, ISchodule I)
11. Tolal Deduction, (tolaIUM' Q & 10)
z
co
;::
""
...
~
:E
co
...
12. Ne' Value of e,lote (line 8 minus lillo 11)
13. Cl1arilable and Governmenlal Sequelh (Schedule JI
14. Nel Value Subject 10 Tax (line 12 minus line 13)
15. Spou,al Transfers (for dales of dealh aher 6.30.94)
See lnsltuclion, for Ar,plicable Percenlage on Revelle
Side. (Include values rom Schedule K or Schl'ldule M,)
16. Amounl of line 14 laxable 01 6% fale
(Indude value, from Schedule K Of Scheduln M,I
17. Amount of line 14 laxable 01 15'10 ralo
(Indude value, from Schedule K or Schedule M.)
18, Principal tax due (Add lax from line, IS, 16 and 17,)
19. Credits Spousal Pover'y Credit Prior Poymonh
0.00 __ + __.9....2.Q.-
~
....
lOA DATlS 01 DIATH AnlA 12/31/91 CHICK Hlfr
II A SPOUSAL
POVIRTY CRIDIT IS CLAIMID L I
--- -----.
fill NUMBIR
" ,(
{ ~ '
:,'If ..
191
__ _u_45.6..ltL
____.,..1,J 5_1.~._7 9__
(B I
6,765.41
(101
1,969.57
____4,795.84-
0.00
!~, 795,84
0.00
287.1S.
0,00
287.75
(111
(121
(131
(141
(15)-,----------- O.O~x,__=
,____._4,,7.95..&4-x ,06 =
(161
(l71_____n__-.9_..0JLx ,15 =
(1BI
Discounl
0.00
+ -----. ------
Inlote,1
_.~OQ
(19)
(20)
0.00
0.00
287.75
----------
_ ..J:l...o..o
___--2JJ-7ill
1211
(21AI
(2181
Act #48 of 1994 provldellor the reduction 01 the tax rateslmpolod on tho not value 01 tranllon to or for
the ule of the Ipoule. The rates 01 prelcrlbed by the Itatute will be:
e 3% (.03) will be appllcablo lor oltatOl 01 decedonts dying on or alter 7/1194 and belore 111196
e 2% (.02) will be appllcablo for eltatel 01 decedents dying on or alter 1/1196 and before 1/1197
. 1% (.01) will be applicable for eltatel of decedents dying on or after 111197 and belore 1/1/98
. Spoulal transfen occurring on or alter 1/1/98 will be exempt Irom Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (...-) IN THE APPROPRIATE BLOCKS.
YES NO
1, Old decedent make a transfer and:
a. relaln the use or Income of th. prop.rly transl.rr.d, .......................................................
b, r.laln th. right 10 d.signat. who shall us. Ih. prop.rty transf.rr.d or Its Incom.. ...............
c. r.taln a r.v.rsionary Inl.r.st; or .............................................................,.....................
d. r.c.lv. the promls. lor lif. of .lth.r paym.nls. b.n.flts or car.9 ......................................,
2, II d.ath accurr.d an or b.for. Dec.mb.r 12, 1982, did d.c.d.nt within two y.ars pr.c.dlng
d.ath transf.r prop.rty without rec.ivlng ad.quat. conslderatlon9 If d.ath occurr.d ah.r
D.c.mb.r 12. 1982, did d.c.d.nt transf.r prop.rty within one y.ar of d.ath without r.c.lvlng
adequate consideration',..... .............. to to"" .............,... .....' II..... ..................... ............ ........
3. Old d.c.d.nt own an 'in trust for' bonk occounl at his or h.r d.ath9......................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
11'11511".11111
ESTATE OF
ITEM
NUMBER
l SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
_, ~I~CELLANEOUS EXPENSES Ploa.o Print or Typo
-~mE flllMiiER
HHI'H S. l~EH'rE!JDAIJUII -1 21-96-0397
1l~1~'~l\
.. Siish'
COMMONWIAUH or rlNNIYIVANIA
INtUlllANCI TAX lIInU1N
RUIDINT DICIDINT
DESCRIPTION
AMOUNT
A. Funtral Exponll"
B,
2.
4.
C,
1.
2,
3.
4,
5.
6.
7,
8,
1,
Propaid.
$
1.
Admlnl.tratlvo Co.l..
Personal Represenlative Commissions - II one
Social Securily Number of Personal Reprosenlotive:
Year Commissions paid
Allornoy Fo.s J. Robert Staui'fer, Esq.
3.
Family Exemption
Clalmanl
Retollonshlp
II/A
Address of Claimonl 01 decedenl's dealh
Slreel Address
City
51 ale
Zip Code
Probole Fees negister of' \'1ills of Cumberland County,
Pennsylvania, Letters 'restamentary.
MI..ellanoou. Expense..
Cumborland Lavr Journal, Executl'ix1 s Estate J10tice 0
Regis tel' of \'1ills, throe U) Short Certificates.
The Sentinel, Executrix's Estate Ilotico.
Gingrich Hemorials, Inc., lettering cemetery
monument.
negister of \'/ills, filing POllnsylvallia Inhel.1tnnce
Tax Return.
TOTAL (At so enler on Ii no 9, Recapllulotlon)
5
(II more Ipace II n..ded, Inlort addltlonallh.... ollamo II..,)
175.00
67.50
60.00
9.00
67.37
63.00
15.00
456.87
'""l/''' '"'' ~~ J SCHEDULE I
COM"""."""O'''''''''''''''' DEBTS OF DECEDENT,
'''';:::~~'~\'.:~',:,::::''' _ MOR~GAGE L1ABI~ITIES AND ~,I_~~ _ Plea.e P,I"), 0' Type
nalph S. Fot'tonboul',h _,___ ___ ,______,_____ __ !:LE,:UMB-=- 2l-}6-0397
ESTATE OF
-----~~,-_._---_.------_._..__.._~'--_.. ------.----------
ITEM
NUMBER
AMOUNT
DESCRIPTION
------.----- ------- ------.-----...-....
I. Sot'ah A. 'rodd J.lemorial HOtTIO, Oarlislo, Ponnsylvania,
final bill for April 1996 caro. * 1,506.33
2. Ronald J.I. Sch1ansky, 1-1. D.. balanco duo for modical
servicoD. 6.37
TOTAL (AI.o enler on tine 10, Recopi.utolionl
$ 1,512.70
(I' more space js needed, inse,' oddj'ionol sheell of same size,'
..... ,. .
1-') -If':') ~ /
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
(,*
tn-III1UU' CU-MI
10-15-96
COOK
05-22-94
21 96-0398
CUMBERLAND
96102160
FRANK
A
BUREAU OF INDIVIDUAL TAXES
I..€RITAHCE TAX DIVISION
OCPT. 2811601
HARA1S!URG, PA l1U8-0601
SHIRLEY
31 FORT
LEMOYNE
C COLEHAN
ST
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
Allount Rell1 Ued
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 09-09-96
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, sub_it the upper portion of thi. for. with your tax paYllant.
PAYMENTS (TAX CREDITS),
PAYMENT
DATE
06-29-96
09-23-96
RECEIPT
NUMBER
AA1l2992
AA146710
DISCOUNT (+)
INTEREST (-)
15.31-
.33-
PA 17043
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEv:Hiiii"Ex-"FP-Hi3':9&T"-----.iiii-iiiHERITANCE-TAX-STATEHENT-OF-ACCO(jtiT--iili.---------------------
ESTATE OF COOK FRANK A FILE NO.21 96-0398 ACN 96102160 DATE 10-15-96
THIS STATEnENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAnED ESTATE. SHOWN BELOW
IS A SUnHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS. THE CURRENT BALAHCE, AND. IF APPLICABLE,
A PROJECTED INTEREST FIGURE,
PRINCIPAL TAX DUE. 125,70
AMOUNT PAID
125,70
15.64
TOTAL TAX CREDIT
125.70
.00
BALANCE OF TAX DUE
,00
INTEREST AND PEN.
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL DUE IS LESS THAN fl.
NO PAynENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
TOTAL DUE
,00
"
,
PAMH1'1
O.tKh the top portion of thh NoUe. end .\DiU with your ply...,t aeeM payable to the n.. nnd addn..
printed on ~ ravar.. ,Ida.
If RESIDENT DECEDENT .aka check or ~y order payable tOI REGISTER OF WILLS, AGENT.
If NOH-RESIDENT DECEDENT aeka cMck or .,.,.y order payable tOI COKttONWEALTH OF PENNSVLVANIA.
All ply.."ta raulvld ,hall t.. 1IPP1led fir.t to eny Interut whleh .ay btI due with eny realnds, 8PP1I1d to u. ta)l.
REfUHD (tAh A nftond of . 'II)( credit, which Will not nquutlMl on tM Tu Return, UY ba r~.ted by cOlIPlaUng en
-Application far Refund of Pennsylvania InherltBnCI end Est.t. Tax* (REV-ISIS). Appllcatlonl at. available at
the Office of the Raghtu of ..UII, any of the U R...,enue Dlltrlct Offlc" or 'rOll the Depart..,,'.' 2"-hour
answering .ervlce nuabar. for for.' order IntI In pennsylvania 1..aOO"S6Z-Z0SD, outtlde pennsylvania
end within local Harrisburg at.. (111) 181-1094, TODI (117) nz"'ZZSZ W..ring IlIPatrlMi onlY).
REPLY TOI ou..tlont ragardlnt .ttor. contained on thl. notle. &hQOld b. addra.'~ to: PA DePart..nt of R.venue, lur.au
of IndividUal T...., ATTN: Pa.t A.......nt Revl.w Unit, Dept. Z10601, H.rrlsburg, PA 1112a-0601, phone
(111) 111-6505.
OISCOllfT:
If eny tax ~ I. paid within thr.. (}) calendar .unth. aft.r the dac~t" death, a flva percent (5%) dl.count
of ~ tax paid I_ allowed.
PENAL TV l
Tha 15% tax ...,..ty nan-participation panalty 11 COSlPUt.d an the tat.1 of the tax and Inten.t .......d, end not
paid bafare January la, 1996, the flr.t day .fter the ~ of thl t.x ..na.ty parlod.
ItfT[REST:
Intere.t 1. ch.rg.d beginning with flr.t d.y of delinquency, or nl~ (9) .unth. end ~ (1) day fro. the date of
d..th, to the data of par-ant. T.xa. which beC~ dallnquent bafar. January 1, 198Z b.ar Intara.t at the r.t. of
.Ix (6~) p.rcent per ~ c.lcul.t.d at . dally r.t. of .000164. All t.x.' which ~ delinquent on and aftar
January I, 198Z will baar Int.r..t at a rat. which will vary fro. calendar y.ar to calendar y.ar with that rata
announced by tt~ PA Dep.rt..nt of Revenue. Th. applicable Intera.t rat.. far 198Z through 1996 are:
Year Int.r..t Rate D.lly Intare.t Factor Year Int.rut Rate Dally lntera.t fector
198Z ZO:C .000548 1,a1 .. .000241
1981 161 .ooooa 1988-1991 11~ .000101
I'" \IX .000101 1992 91 .000241
1985 U~ .0001% 1991"'1994 n .000192
1.86 lOX .00027" 1995-1996 .X .0002"1
-.Jnt.rut " c.lculatltCl .. fallow':
INTEREST = BALANCE OF TAX IIHPUD X NUKBER OF DAYS DELINQUENT X DAILY IHTERESr FACTOR
..-Any Notlc. l.sued aftar ~ t.x baC~t delinquent will raflect en Intara.t calculation to flft"" CIS) deyt
beYond tha data of the ......Mnt. If payant " afMla IIftar the Intarut CDIIPUt.tlon chit. shown on the
Katlc., addltlonel Intaratt ....tt be c.lcul.tad.
r"',
V
PA'nEHh
DetKh the top portion 0' this NoUn and .W111t with your pay.."t aade payable to thl! n8M and lMSdr...
printed on ~ raysr.. .Ide.
If RESIDENT DECEDENT ... check or lIOfWV order payable to: REGISTER OF WILLS, AGENT.
If NOH-RESIDENT DECEDEKT aake chedc. ar IIOIMIY order payable to: COKHOHWEALTH OF PENNSYLVANIA.
AU paYMf1t. recalved stulll ba applied flr.t to nny Int.r..t which "y M dull with DlW r...lnder appll.d to the tax.
REFUND (CA): A r.fund of II t.~ credit, which .... not requa.ted on the T.. Return, ..y ba requested by co~l.tlno an
-application for R.fund of PennSYlvania Inheritance end E.t.t. Tax- (R[V"lllSJ. Application. ar. available at
~ Offlc. of the R-al.tar of Wills, any of the 15 A.v~ District offlc.. or fr~ the D~art.."t" 2'-hour
en.w.rlna ..rvlce ~.r. for for.. ordering: In Pannlvlvanla 1-800-36Z"2050, out, Ida Penn,vlvanla
and within local Harrisburg ar.. (711) 711-8094, TOOl (717) n2-ZZS2 Uta.rlng 1~.lnd only).
REPLY TOr QuuUon. raDardlng .rror. contained on this notlu should bII Bddr."~ tal PA O.artaent of R.v"" aur.""
of Individual Ta..., ATTNI Pa.t A.....eant R.vlew Unit, o.pt. Z80601, Harrl.bUrg, PA 17128~0601, ~
(717) 787..6505.
OISCCUfTI
If any tax ...,. is paid ..Ithln thr.. (3) callW1dar M)t'Ith. aft.r the dK~t'. death, a flv. perunt (5%) discot.nt
of U. tax paid is allawd.
PEHAlTV:
1M 15% tax UN.ty non~partlclpatlon p.-.a1h is COllPUtMl on the total of the ta. and Int.rut a..n.ad, and not
paid b.for. January 18, 1996, the flnt day aft.r ttMI tN"ld of the ta. aM.ty p.rlad.
INTEREST I
Int.r..t I. charged beginning ",Ith flr.t day of delinquency, or nine (9) aonth. and ~ (1) day fru. the data of
d.ath, to the data of pay.ent. Tax.. which bac~ d.ll~t befar. January 1, 191Z b.ar Int.r..t at the rat. of
.Ix (6%) ~rc.-.t per 8fV'IU8 calculated at a dally rat. of .000164. All ta... which bee... delinquent on and after
January 1, 191Z ..Ill bear Int.r..t at a rat. which ..Ill vary froe calendar y.ar to caltN"ldar y.ar ",Ith that rat.
announced by the PA D.part.ant of R.venue. The BPPllcabl. Int.r..t rat.. for 1911Z through 1996 ar.:
Y.ar Int.r..t Rat. Dally Int.r..t fector
Y.ar
Int.rut Rat.
DailY Inter..t fectar
19I1Z 20X .000~8 19117 'X .0aOl47
1983 lOX ,OO043a 19aa~I991 llX .000lDl
.... IIX .000!01 ."2 .X .000Z47
1985 UX .000356 1993~1994 7X .000192
.... lOX .000274 1995~1996 OX .000Z47
ulnt.rnt 11 celeulated .. fallow'1
INTEREST : BALANCE OF rAX UllPAID X HUKBER OF DAYS DELINQUENT X DAILY IHTERESr FACTOR
uAny Natlce liNed aft.r the ~.. becoMI dellnquM'lt ",Ill r.flKt fin Int"..t calculation to fifteen (15) day.
beyond the date of the a....~t. If pa~t II aade aft.r the Int.r..t coaput.tlon date ahown on the
Natlu, additional Int.rut au.t bII calculated.
.~:
," i
,
, .
~ ,V
f .
9 Fort Street
Lemoyne,l'A 17043
September 19, 1996
Register of Wills
Cumberland County Court House
Carlisle, PA 17013
, I I' t
,
i '.
}c cr n ': rr;
CI.
RE: THE ENCLOSED NOTICES OF INHERITMl~I\~ TAXES....
(ACN 96102174, 96102171, 96102169, 96(02160)
"
Gentlemen:
I previously wrote regarding some other bills that were previously received, I am again writing
this letter on behalf of my mother, who is 80 years of age, To recap, a few years ago, not
knowing the ramifications of her actions, my mother placed her three children's names (Frank A,
Cook, Jr" Shirley M, Coleman, and Eulah C. Grugan) on some Certificates of Deposit which she
owned, She did not intend to make us co-owners, but rather, beneficiaries. Subsequent to that
action, my brother died unexpectedly,
During last winter, inheritance tax bills began to arrive, amounting to more than $500,00 for my
mother, my sister, and I. At the time, my mother was in California, helping my sister care for her
ill husband, We did not know that we were liable for taxes on CD's that my mother kept in her
possession, for her use in case of illness, etc. These certificates were kept in my mother's locked
safety deposit in her name, The money was not available to any of the children.
In speaking to a representative from the Dcp;utment of Revenue, I learned what steps were
necessary, We then gathered together receipts for various expenses for my brother's illness and
funeral. About the same time, I had some he;lIth problems which necessitated two surgeries (one
in January and one in March,) Mother returned home from California in March and in May had
surgery hersel f,
The aforementioned circumstances contributed to the delay in following through with the
itemization of expenses and the payment of money due, We have tried to gather all the needed
materials and money in as expeditious a manner as possible, but it has not bcen as quick as we had
hoped,
Again, we received more bills--this time for interest on the money that has already been paid,
Since we have had extraordinary circumstances which caused the delays, and since my mother has
had to pay taxes on money that was already hers, I am requesting that she be exonerated from the
additional expense of interest on the taxes.
In an effort to avoid further interest, enclosed is a check to cover the $62.55 which is shown as
due, Please consider my request for relief of these cosLs, and refund that amount to her, Any
consideration will be greatly appreciated,
Sincerely,
/~ (J,A~~
Eulah C, Grogan Zl
.