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COHHOHWEALTH OF PENNSVLVANIA
Ut.PUUtENT Of REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z8a601
HARRISBURC, PI 171Z6.0601
'*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 -qiJ, - /.fqO
96112584
04-17-96
UW-\hlll U. lI.tll
'(~ :
TVPE OF
EST, OF RICHARD H HOLLENBAUGH
S,S. NO, 174-05-2002
DATE OF DEATH 12-24-95
" ._ COUNTY CUMBERLAND
ACCOUNT
o SAVINGS
o CHECKING
o TRUST
!Xl CERTIF.
r!, '
.' I.' Li
ANNA E HOLLENBAUGH
405 W MAIN ST
SHIREMANSTOWN PA
C".
1700U':
.,
REHIT PAYHENT AND FDRHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
DAUPHIN DEPOSIT BANK & has provld.d tha Dapart..nt with tha lnforaatlon Ilstad balow which has been uud In calculating the
pot.ntlal tax du.. Th.lr r.cord. Indlcat. that at the d.ath of the abova d.c.dant, you ..ara a Joint own.r/benaflclary of thl. account.
If you fa. I thl. Infor..tlon I. Incorract, pl.... obt.ln wrlttan corractlon fr08 the financial Institution, .tt.ch a copy to thl. for.
and r.turn It to the above .ddras.. Thl. account I. t.x.bla In .ccordanc. with tha Inharltanca T.x law. of tha Coaaonw.alth 0' Pann.ylvanla.
au..tlon. ..y b. an....r.d by calling (717) 787-63Z7.
COHPLET~ ~ART 1 BELOW . . . SE~
Account No, 8140030678 D.t.
Est.blhhad
REV~HSE SI~E FOR
03-25-93
FILING ANn ~~iH~Nl 'N~'HU~:luHS
Account a.lanc. 5,060,26
Poccont T...blo x 50.000
A.ount Subj.ct to T.. 2.530,13
T.. R.ta x ,06
PotanUal T.. Du. 151. 81
PART TAXPAYER RESPONSE
COIFAILURETO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
A. ~ Th. above Inforaatlon and tu due is correct.
1. You aay chao.. to ra.lt pay.ant to the Ragl.tar a' Will. with two copla. a' thl. notlc. to obtain
. dl.count or avoid Intar.st, or you .ay chack box WAW and raturn thl. notlc. to the R.gl.tar of
Wills and an of'lclal a.s..saant will be Issu.d by tha PI O.part..nt 0' R.venu..
To Insur. propar cr.dlt to your account, two
(Z) copl.. of this notlc. lIU.t accoapany your
payaant to lh. Raolstar 0' will.. "ak. check
paYabla tat ~.glst.r of Wills, Ag~t..
NOTEt I' t.x payaents ar. .ad. within thra.
(3) .onth. of the dec.dent'. data 0' daath,
you .ay dadUct a S~ discount of the tax du..
Any Inh.rltanca tax due will b.coa. d.llnquent
nlna (9) aooth. a,t.r the data of de.th.
[CHECK ]
ONE
BLOCK
ONLY
B. c=J The above a.l.t ha. baen or will b. r.portad and tax paid with the Penn.ylvanla Inh.rltance Tax r.turn
to be ,Il.d by the dacedent.. rapralentatlve.
C. ~ Th. above Inforaatlon I. Incorrect and/or debts and daductlon. w.re paid by you.
You MIlt co~leh PAJaT 0 and/or PART [] below.
If you indlcat. a different tax rate, pl.... st.ta yOUr
relationship to dacadant:
OFFICIAL USE ONLV 0 AAF
PA DEPARTHENT OF REVENUE
PART
~
TAX RETURN - COMPUTATION OF TAX ON
l.t;;e 1. nata r.",lo;blh.h.,...l 1-.
2. Account Balance 2
3. P.rcant Tax.bla 3 ~
4. A.ount Subjact to Tax 4
5. Dabt. and Deduction. 5
6. Anount Taxabla 6
7. T.x R.t. 7 X
8. Tax Dua 8
JOINT/TRUST ACCOUNTS
PAD
1
2
3
4
5
6
7
8
CLAIHED
PART
[!J
DATE PAID
DEBTS AND DEDUCTIONS
PAVEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Llna 5 of Tax COftput.tion)
I
.
Undar panaltia. of perjury, I declare that the
coapl.t. to the b..t of ny knowladga and b.llaf.
'\ I (
I'J1x~A~h(~i'G~AT'U~i ..\.;/ " )[ ( ,'{ L (',: r l
fact. I have reported abova ar. true, correct and
( .., , .~ .. ~
"
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT .It. _lIeoOl. Int"..1 b.... on Inf.r..lIon
.....Itted by the flMnClal In.titutlon.
Z. t~rlt8nc. t.. beC~' delinquent nl~ ~th. .,t.r the deced~t.. data of d..th,
J. .. Joint KCOW'lt II 'subia IV'" though the d.ced....t.. n... .... added .. . ..ttar of convMIWK:I.
4. ACCOU'1t. UnclucUna tho.. hald b,t...." hu,bW'ld and wlfll which thtl dIced"" put In Joint n.... ..!thIn OM y..r prior to
~.th .r. fully taxlbl. II tren.f.r..
S. Accowttl ..tablhMd JointlY belt""" husbMd and wU. IIOf' then DM yur prior to d..th .r. not t..ebla.
6. Account. held by . dec.o.nt -.n tru.t for. enother or other. .r. t..BbI. fully.
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. BLOCK A . If the Infor..tlon end c~t.tlon In the not Ie. .r. corr.et and daductlon. .r. not bllng cl.lled, pleea an ~
In block ..,.. of Part 1 0' the -T..plylr Rupon.." uctlon. Sign two copl.. and ,ub.1t th.. with your check for tha ...ount of
ta. to ~ Regl.t., of Will. of the county Indicated. The PA Oapartaent of R.v~ will I..ue an official ......aent
(For. REV-1548 E.) upon recalpt of the raturn fro' the Reglltar of Will..
Z. BLOCK B _ If the ....t lpeclfled on thl. notlc. ha. been or will be reported and tax paid with the Penn,Ylv~la Innarltance
Tax Raturn filed by the decedent'. rapra.entatlve, pleca an -~ In block ..- of Part 1 of the -Taxpayar R..pon.a- .actlon. Sian one
copy end raturn to the PA Dapartaent of Ravenue, Buraau of Indlvl~1 Taxal, Dept 280601, H.rrllburg, PA 17128-0601 In the
env.lope provided.
3. BLOCK C _ If the not Ie. Infor.atlon I. Incorract and/or deductions .ra baing clal.ad, check block -C- and c~lete Part. Z and 3
according to tha In.tructlonl balow. Sign two caple. and .~lt th.. with your check for thl aeount of tax payabll to the Ragl.tar
of WUl. of the count" Indicated. The PA OaD,,.t,,ant nl R,"M'UII will luu't ItI' nfflcb' ..nu~."t (Fe.... RE"-!~4~ ':)'~ ~". ,..r..!r~
of the ratu,.n Iroe the Ragllter of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Entar the data the aecount originallY w.. ..tablllhad or tltlad In the .anne,. axl.tlng at data of d..th.
NOTE: For a decadent dying aftar lZll2/8Z1 Aceount. which the d.eadant put In Joint n.... within ana (1) yaar of death .r.
taxable fully a. tran.fe,... However, there I. an ..clu.lon not to exeead 13,000 per tran".,.a. ragardle.. of the value of
the account or the ~r of KCountl held.
If a doubla a.terlsk (..) appaar. bafor. your flr.t n... In the addra.' portion of thl. notle., the 13,000 ..clu.lon
alreadY h.s b.an deducted 'rCHI the aceount b.lanea II raported by the financl.l In.tltutlon.
2. Enter the total b.lanc. of the aceount Including Int.ra.t accrued to the d.tl of d.ath.
3. The pareent of the Kcount that Is t..abla '0" aach survivor II det.ral~ a. follow.:
A. The parcant t..ebb for Joint ....t. ..tl!lbllahad IIOre than OM ye.r prior to the dec.dant.. deathl
I DIVIDED BV TOTAL t<<JHBER OF
JOINT OWNERS
Exa.pla: A Joint ....t r-alstared
DIVIDED BV TOTAL NUttBER OF X lOa . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In tha n.. of the decadent end two other pa,..onl.
I. The parcent taxabla for a...t. craatad within ana yaar of the decadent'. daath or accQWltl owned by the decadant but h.ld
In tru.t for another IncUvlctu.HI) (tru.t ban.flelarl..)1
1 DIVIDED av 3 CJOINT OWNERS) DIVIDED av Z CSURVIVORS) . .167 . loa . 16.7X (TAXABLE fDA EACH SURVIVOR)
1 DIVIDED ay TOTAL HUMaER OF SUAVIVIHC JOINT
OWNERS OR TRUST BENEfICIARIES
X 100 . PERCENT TAXABLE
Ex..le: Joint aceount reglst.red In the n... Df the decadent and two oth.r par.on. and ..tablllMd within one y..r of daath by
the decadent.
1 DIVIDED BY 2 CSUlYlVORS) . .50 X 100 . 50% cn.AlLE FOR EACH SlJNIYOR)
~. the..ouRt lubJact to tax (line ~) Is dat.ralnad by sultlplylng the .ccount balance (line 2) by the parcant t..able Cline 3).
5. Ent.r the tot.1 of the dabt. and deduction. Illtad In P.rt 3.
6. The aaount t.xabl. (line 6) II d.taralnad by .ubtr.ctlng the dabts and deductions Cline 5) froe the aaaunt .ubJect to tax (line ~).
7. Entar the aparnarlata tax rata (line 7) al dataralned balow.
A. for d.t.. of death occurring .ftar 6/30/94, thl tax rata. 'or tran.far. to .pou.a. .r. .1 follow'l
1. Data. of de.th on or aft.r 7/1/94 and ba'or. 1/1/95 the rat. I. 3%.
Z. D.t.. of de.th on or a'ter 1/1/95 tran.'arl to SPOU,.I will ba taxed at 0% tax rat..
Nota: for d.t.1 01 death prior to 7/1/94 tranlfar. to .pou... ar. taxabl. at 6%.
I. Tran.'ar. to lineal da.cendant. Including lather, .other, .on, daughter, grandchildren, .on-In-law,
daughter-In-law, .tepchlld and their In"" a,.e taxebb at IIx percent C6:C).
C. Tran.far. to .11 other. Including brothe", II.tar, uncia, aunt, naphew and nl.ea a,.. taxable at ,Ift.an pareant (15%).
D. If you ehang. the taX rat., pl.... .paclfY your ralatlonshlp to the decadant In the ar.. provided.
.. The aaount of tax due (line .J I. dat.,..lned by .ultlplylng the aaount ta.able Clln. 6) by the tax rat. Cline 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowable dabt. and daductlon. are dat.ralned as 'allows I
A. You lagally ar. r..pon.lbl. for payaent, or the altat. .ubject to adalnlltr.tlon by . par.~1 rapraaantatlv, I. InlUfflclant
to p.y the deductlbla It....
a. You KtueUy paid the dabt. aftar d..th of the decadent and can furnish proof of pay.ant.
C. Dabts baing clal.-d aust be Ita.lzad fully In Part 3. If additional Ipee. I. naadad, u.. pl.ln paper 8 1/:- x 11-. Proof of
p..,.ent ..y ba ra~.tad by the PA Departltant of Ravar'IUI.
TAXPAYER ASSISTAHCE'i.........'..........
.IF YOU HEED FURTHER INFDRHATION ORASSISTANCE,CONTACTANV:
.' REGISTER OF WILLS. PA DEPARTMENT OF REVEHUE DISTRICT OFFICE. ...'..
OR CALL THE BUREAU OF INDIVIDUAL TAXES, <.TAXPAVER.INQUIRV UHITINd{
HARRISBURG AT (717) 787-8327. TDDI (71H772-225Z,(HEARIN!)IHPAIREDOHLV)
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COH"ONWUlltl Of III NNSVl VANIA
DIPAAI"' HI Of III. VI NUl
BUR[AU Of INDIVIDUAl lurs
DlP'. :'1I0bOl
IlARR1SIUNC, IIA 1I1:II-DbOI
I 1) - I eil . I ~
W
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.
21 -qto - 4QO
96111343
04-08-96
Ih.lhllll" "."1
r,
, .,\ ~ " i
TVPE
EST. OF RICHARD H HOLLENBAUGH
5.5. NO. 174-05-2002
DATE OF DEATH 12-24-95
COUNTY CUMBERLAND
OF
ACCOUNT
iJ SAVINGS
[J CNECKING
iJ TRUST
[Xl CERTIf ,
TO:
'(
,"
't)
ANNA E HOLLEN8AUGH
405 W MAIN ST
SHIREMANSTOWN PA
C"
,',
11O~1
,t\
REMIT PAYMENT ANO fORMS
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
DAUPHIN DEPOSIT BANK & has provided the Departunt with the Infor..at Ion listed below lolhlch hu been und In c:alculatinlll the
potential tax due. Their records Indicate that at the death of the above decedont, you lolere I!l joint owner/beneficiary of thl. account.
If YOU feel thl. inlor..atlon Is incorrect. please obtain written correction fro.. the financial institution. attach a COpy to this for..
and return It to the above addres.. Thi. account Is taxable In accordance with the Inheritance lax lawl of the Co...onwealth of Pennsylvania.
Que.tlon. .ay be answered by calling 1711) 181'11327.
COMPLETE PARl 1 ~ELOW . . . ~EE P.EV~RSl Slu~ FOR ~IL.NG AN~ PAIH~NI lriaTRuCrlJNS
Account No, 8000162636 O.t.
Established
12-04-89
10 Insure proper credit to your account, two
It) cop Ie. of thl. notico "ult acco.pany your
pay.ent to the Rellll.ter of Willi. Hake check
payable to: "Regl.ter of wills, Agent".
Account Balanc.
Pe..cent Taxable
Anount Subjact to
Tax Rate
Potential Tax Due
K
10.029.04
50.000
5.014.52
.06
300.87
HOlE: If tax pay..ents are ..ade within three
13) ..onthl of the decedent's date of death,
you .ay deduct a 5~ discount of the tax due.
Any Inheritanco tax due 101111 beco... delinquent
nine (91 eonths after the date of d.ath.
T.x
K
PART TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
A. c:J The above Infor..atlon and taM due is correct.
I. You ..ay choos. to reMit pay"~nt to the Register of Wills lollth two caple. of thil notice to obtain
a discount or avoid intore.t. or yOU ..ay check bOM ~A" and return thl. notic. to the Regl.ter of
Wills and an official a.sess..ent will be Issued by the PA Depart..ent of Rovenu..
[CHECK ]
ONE
BLOCK
ONLY
B. c=J The above 8.set has beon or will ba reported and tax paid with the Pennsylvania Inheritance Tftx return
to be flied by tho dacedentOs representative.
C. c:J Ihe above Infor..atlon II Incorrect and/or debts and d.ductlonl were paid by you.
You eust cOMPI.t, PART ~ and/or PART ~ below.
If you indicat. a diff....nt tax ..at., pla.se state your
relationship to decedent:
PART
I3J
TAX RETURN . COMPUTATION
LINE 1. O.t. Est.b1Ish.d
2. Account Balance
3. Pe..c.nt Taxable
4, A~ount Subject to Tax
S. Debt. and Deductions
6, Anount Taxable
7. Tax Rat.
8, Tax Dua
OFFICIAL USE ONLV 0 AAF
PA DEPARTMENT OF REVENUE
OF
1
2
3
4
5
6
7
8
! _0'- _..___._.
TAX ON JOINT/TRUST ACCOUNTS
PAD
K
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIHED
K
PART
~
DATE
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
I
I
TOTAL CEnt... on line 5 of Tax Conput.tion)
I
I
I
$
Unde.. panaltie. of pe..jury, I d.cl.... that the fects I have ...po..ted above .... true, cor..act and
conplete to the bast of ny knowledge 8"4 belIef.
{i" ,\ '1/~K f,/'{{"'il f (I (I L{ l\,
~ SlGNAtURE : I
HOME (
WORK (
TELEPHONE
)
)
NUMBER
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAK ASSESSHEHT wtlh applicable Intarnt hued on In'cr..llon
,ub,ltlad by th. fln.nelal In,tltutlon.
Z. Inheritance t8. baea... delinquent nln. .onlh. .ft,r the dac.dant', data 01 d..lh.
1. A Joint account I. I...bl. .van though Ihe dacad.nt., n... wa. added .. . ..tl,r 01 convenlanc..
_. Account. Ilncludlng tho.. hald batw..n hu.band and wlfal which the dacadant put In Joint n.... within Dna y..r prior to
d..th .r. fully ,...bl. a. tran,'.r..
5. Account, .,'.bll,had JointlY balw..n husband and wlf. aor. than Dna y..r prior to d.ath ar. not t...bl..
6. Account. hald by . dacadant "In truI' lor" anothar or othar. ar. t...bl. lully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK I . If the Infor..llon and coeputatlon In the notlc. ar. correct and deduction. ar. not b.lng clal.ed, place an "X"
In block "A" of Part I of tha "Ia.payar Ra,ponl." ,ectlon. Sign two caple. and lub.it tha. with your chack for tha a.ount of
ta. to the Ragl.ter of Will. of the county Indicated. Iha PA aapart.ant of Ravanue will I..ua an official a"al.aant
(for. REV-Is~a EX) upon racalpt of the raturn fro. tha Ragl.tar of Will..
l. BLOCK' _ If the a.l.t .paclflad on thl. notlc. ha. b.an or will b. r.port.d and ta. paid with the Pannlylvanla Inh.rltanc.
Te. Raturn fllad by tha dac.dant.. rapra.antatlva. placa an "X" in block "S" of Part I of the "Ta.payar Re,pon.a" .actlon. Sign on.
copy and return to tha PA Oapart..nt of Rav'nu., !Iur.au of Individual Ta.... Dapt 280601, Ilarrhburg, PA 11128-0601 In tha
anvalop. provldad.
J. aLOCK C _ If tha notlca Infor.atlon I_ Incorract and/or d.ductlon. ar. being clal.ad, chack block "C" and coapl.ta Part. land J
according to the In.tructlon. balow. Sign two copla. and lub.lt the. with your chack for the a.ount of ta. payable to tha Regl.ter
of Willi of the county Indlcatad. Ih. PA Depart.ant of Ravenu' will 1.lua an official a.la,l.ent (for. REV-IS4a EX) upon r.calpt
of the raturn fro. the Raglstar of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Enter
NDIE:
the date the account originallY wa. ..tabll.hed or titlad In the .ann.r e.i.ting at date of da.th.
for a dacadant dying aftar 12/1Z/aZl Account. which the d.cedant put In Joint n.... within one CI) yaar of d.ath ara
ta.abla fully al tran.f.rs. Howav.r. thar. I. an e.clu.lon not to a.cead $],000 p.r tran.f.rea regardles. of the valua of
the account or tha nu.b.r of account. hald.
If . doubl. a.terllk (..) app.ar. b.fora your flr.t na.. In the addra.. portion of thl. notlc., the $],000 ..clu.lon
alraady ha. ba.n d.ducted fro. the account balance a. reported by the financial In.titutlon.
l. Entar tha total balance of tha account Including Inter..t accruad to the data of daath.
J. Th. p.rc.nt of tha account that I. ta.abl. for aach .urvlvor I. dateralned a. followSI
A. Th. parcent ta.abl. for Joint ....t. a.tablllhed aor. than one ye.r prior to the dacadant'. d.athl
DIVIDED IV TOTAL NUMBER Of
JOINT OWNERS
E.aaplal A Joint a..et ragl.tared
DIVIDED BY TOtal NUHBER OF X 100 . PERCENT TAXAlLE
SURVIVINC JOINT OWNERS
In tha na.. of the decedant and two othar par.on..
a. Tha parcant ta.abla for a...t. craatad within on. yaar of the decadant'. death or account. owned by the dacadant but h.ld
In tru.t for anothar lndlvldual(sJ (tru.t benaflclarla.):
I DIVIDED ay J (JOINT OWNERSJ DIVIDED av 2 (SuRVIVORS) . .167 X 100
16.7~ (TAXABLE fOR EACH SURVIVOR)
I DIVIDED ay TOTAL KUHBER OF SURvIVINC JOINT
OWNERS DR TRUST BENEFICIARIES
X 100 . PERCENT TAkABLE
E.a.pla: Joint ac~ount ragl.t.rad In tha na.a of tha d.ced.nt and two othar parlon. and e.t.bllshad within on. y.ar of d.ath by
the dacedant.
1 DIVIDED av 2 (SURVIVORS) . .So X 100 . SO~ (TAMAalE FOR EACH SURVIVOR I
~. Tha a.ount sUbJact to ta. (1lna 41 I. d.tar.lnad by aultlplylng the account balanca (llna l) by the parcant ta.able (1In. ]).
5, Entar the total of the dabt. and deduction. II.tad In Part ].
6. Th. a.ount ta.able (llna 6) Is datar.ln.d by ,ubtractlng tha debt. end deduction. (Ilna 5J fro. the a.ount .ubJect to taw (llna ~),
7. Ent.r the approprlata tax rat. (1In. 7) a. detar.lned balow.
A. For data. of death occurring aftar 6/]0/94, tha ta. rat.. for tran.far. to ,poula. ar. a. follow.:
I. Oat.. of d.ath on or aftar 7/1/9~ and bafora 1/1/95 the rata I. ]~.
l. Data. of daath on or aftar 1/1/95 transfer. to .pou.a. will b. ta.ad at O~ ta. r.te.
Notal for data. of death prior to 7/1/9~ tran.fers to .pou.e. ara t..abla at 6~.
a. Tran.far. to Ilnaal da.candant. Including fathar. loth.r, .on. daughtar. grandchlldran, son-In-law.
daughter-In-law, stapchlld and th.lr I..ua are la_abla at sl. parcant (6~).
C. Tran.f.r. to all othar. Including brother, .I.tar. uncia. aunt. naphew and nlec. are ta.abla at flfta.n parcant (IS~).
D. If you chang. the ta. rata, pl.a.a .paclfY your ralatlon.hlp to the dacadant In tha ar.a provldad.
a. Tha a.ount of tax due (lln. all. datar.lnld by .ultlplylng the a.ount ta_abla (llna 61 by the tax rat. (1lna 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabla dabts and deduction. ar. datar.lnad a. follow':
A. You legallY ar. r..pon.lbla for pay.ant. or the a.tata ,ubJact to ad.lnl.tratlon by a par.onal raprelantatlv. I. In.ufflclant
to pay the daductlble It....
a. You actually paid tha dabt. aft.r daath of tha dacedant and can furnl.h proof of ply.ant.
C. Dabt. b.lng clal.ad .u.t b. lta.l~ed fully In Part]. If additional space l. naadad. u.a plain papar a 1/2" w 11", Proof of
pay.ent .ay ba raqu..tad by the PA aap.rt.ant of Rav.nue.
TAXPAYER ASSISTANCE
IF VOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327, TDD' (717) 772-2252 (HEARING IMPAIRED ONLY)
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COHMOHwtlollllOl IIIHHSYIVAHIA
DrPIoAIHI HI Of HI VI JoltJI
BUIIUU 01 INDlvlnUAI IAlll"
III Pf. I.DbDI
"AllllueIlIlC.IIA 1/1;'101101
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.
21 -ql;-yqO
96111344
04-08-96
tI, ,hili ,If " HI
Ii
i
TVPE OF
EST. OF RICHARD H HOLLENBAUGH
5.5. NO. 174-05-2002
DATE OF DEATH 12-24-95
COUH1Y CUMBERLAND
ANNA E HOLLENBAUGH
405 W MAIN ST
SHIREMANSTDWN PA 17011
,-,
'"'"
ell
,
REHIT PAYHENT AND FDRHS
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ACCOUNT
n
,-, SAVINGS
iJ CHECKING
o TRUST
:Xl CERTIF .
TO:
,I 1.1
DAUPHIN DEPOSIT BANK & ha. provldad tha Dapnrteant wllh Ihe Inforenllon Iillad balow which hu belln ulIld In calculaUng the
pot.ntla1 la. du.. Thalr r.cord. Indicate Ihnl nt the d.ath of Ihll above declldent. YOU w.r. a joint ownllr/beneflciary of thl. account.
If you '..1 thl. Inforeatlon I. Incorr.ct, pleasll obtain written correction froe the financial In.tltutlon, attach a copy to thl. fora
and r.turn it to the abov. .ddr.... Thi. account I. ta.nble In accordanca with tha Inherltanc. Ta. laws of the Coaaonw.alth 0' Penn.ylvanla.
Qu..tlon. e.y be answ.red by calling (7111 131-3311.
COMPLETE PART 1 b~LUW
Account No. 8000162644
. . . ~t:" Rt.VERSf Slut: 1'0k HLING AHIi F"YHEfiT Ii..iTiluCTIONS
Det.
Established
12-04-89
To I".ure proper credit to your account, two
IZI cop Ie. of thl. nollc. .u.t accoapnny your
payunl to the Reghter of Wills. H.ke check
payable to: "Reglltllr of will., Agent".
Account O.lanc. 10,029,04
Percent T.xeble X 50.000
A.ount SubJ.ct to Tn 5,014,52
Tex Ret. X .06
Pohntlol Tn Du. 300,87
~~ TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
.. 0 The abovll Infor.atlon and ta. due I. correct.
1. You ..y choose to ra.it p.y..nl to the Rllglstllr of wills with two caples of this notic. to obtain
a discount or .vold Interest, or YOU eay check box "10" and r.turn thl. notice to the Register of
Wills and an offlcl.1 asse....nt will be Issued by the Pi aep.rteent of Revenue.
NOTE: 11 ta. payaent. .rll .ad. within three
(3) .onths 01 the dllcedllnt's dale 01 d..th,
YOU "ay deduct a S% di.count of the tax due.
Any inheritance t.. due will beco.. d.llnquent
nino (9) eonths after the date of death.
[CHECK l
ONE
BLOCK ..J
ONLV
B. [J The .bove a.s.t ha. baen or will be raported and I.. paid with the Pennsylvania Inhllrlt.nce ra. return
to be filed by thll dllcedant's representative.
C. [J Thll .bove Inforeatlon Is Incorrecl and/or dabls and deduction, were paid by you.
You IlUst co.plete PART l.EJ and/or PART ~ billow.
If you IndIceta a dIffarent tax rete, pla.se stat. your
relationshIp to decedent:
PART
~
TAX RETURN - COMPUTATION
lIN~ 1. Dota F.=tDbl'~~~~
2. Account Belanca
3. Parcant Taxable
4. A~ount Subjact to Tax
S. Dabts and Deductions
6. A~ount Taxable
7. Tex Rete
8. Tax Due
OFFICIAL USE ONLV 0 AAF
PA DEPARTMENT OF REVENUE
OF TAX ON JOINT/TRUST ACCOUNTS
1_,._,
2
3 X
4
5
&
7 X
o
PART
~
DATE
DEBTS AND DEDUCTIONS
PAD
1
2
3
4
5
6
7
8
CLAIMED
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
I
TOTAL IEnter on lIne 5 of Tex ConputatIonl
Under penaltia. of par jury, I declare thet the
conpl.te to the belt of ny knowledge and belief.
I (' II 1'- (.l... t " . i ;'" 1'1. i.' i, i .;! l .
TAXPAVER SIGNATU~~'
I
I
s
facts I have raported above .r. true, corract and
HOME 1
WORK ( 1
TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAX ASSESSHENT with IIPplICftbl. Int.,..t hlued on Infon..tton
lub.ltted bv Ih. flnancl.1 Institution.
t. Inh.rUance tSII beea... delinquent nln. "onthl "ft.' the d.c8danl', dllt. of d.,.~h.
S. A Join' account II I'ulllbl. ava" though the duada"t', fI".. .,.. added ". ".,,".r of convenlanc..
It. Accounts llncludlnll tho.. held bahu" hUlband and wtfal which the duadent put In Joint nu.. within ana Y..' prior to
d..th .r. fully t.."bl. 8. l,a"I'.r,.
S. Account. ..tabllshed Jolnth bat....." husbAnd anll wlf. aor. Ihlt" ana y.,,' prior to duth are not ,,,..bh.
6. Accounts hald by . dacadant "In trult for" ""othar or olha,. ",. '"."ble fullv,
REPORTING INSTRUCTIONS - PART
1
TAXPAVER RESPONSE
I. BLOCK'. If the InJur..tlon and C08putatlon In the notlc. ar. correct and deductlona are not being clal.ed, piece an "X"
In block "A" of P.rt I of the "T..payer Reaponse" 'ectlon. Sign two copiea and aub.lt the. with your check for the ..ount of
t.. to the Reglater of Willa of the county Indlc.'ed. The PA Dep.rt..nt of Revenue will iaaue an offlciel .aseaa.ent
(For. REy.IS48 EX) upon receipt of the r.turn fro. the Reg later of Willa.
Z. BLOCK B _ If the .,'et apeclfled on thl, notice haa been or will be reported and t.. paid with the Pennsylv.nl. Inheritance
T.. Return filed by the decedent" represent.tlve. place an "X" In block "a" of Part 1 of the "Ta_payer Re,ponse" ,ectlon. Sign one
copy and return to the PA Depart.ent of Revenue. Bureau of Individual la..... Dept 280601. tlarrhburg. PA 11128'0601 In the
envelope provided.
3. BLOCK C . I' the notice Infor.atlon I. Incorrect .nd/or deduction. are being cl.l.ed. check block "C" and co.plete P.rt. Z and 3
.ccordlng to the In.tructlons below. Sign two caple. and sub.lt the. with your check for the a.ount of t.. pay.bl. to the Reglst.r
0' Will. of the county Indicated. The PA nep.rt.ent of R.v.nue will Is.ue an official as..a..ent (for. REY-1S48 EXl uoon r.c.lpt
of the r.turn fro. the Regi.ter of will..
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the date the .ccount orlgln.llY w.s .st.bllshed or tltl.d In the .anner e.i.tlng at d.te of d..th.
For a d.c.dent dying after 12/1Z/8Z1 Account. which the deced.nt put in Joint n.... within on. (1) y..r of de.th are
t..abl. fully .s tr.n.fer.. Howev.r, th.r. I. an e.clu.lon not to e.ceed IS.OOO per tran.feree reg.rdle.a of the v.lu. of
the account or the nu.b.r of account. held.
If a double ..terlak (..) .ppe.r. be for. your first na.. In the addre.. portion of this not Ie., the IS.OOO e.clu.lon
alr.ady hat be.n d.ducted fro. the account balance a. reported by the financial In.tltutlon.
Z. Enter the tot.1 balanc. of the account Including inter..t accrued to the date of death.
3. Th. p.rc.nt of the .ccount that I. t..able for .ach survivor Is deterelned .. follows:
A. The p.rcent t...ble for Joint ....ts e.tabll.hed .ore than on. y..r prior to the d.c.dent.. d..th:
DIVIDED BY TOTAL NUHBER OF
JOINT OWNERS
E...pl.: A Joint ....t regl.ter.d
DIVIDED BY TOTAL HUHBER OF )( IDa . PERCENT TAXABLE
SURVIVINC JOINT OWNERS
In the n... of the decedent and two other per.on..
1 DIYIDED BY S (JOINT OWNERS) DIYIDED BY Z lSURVIVORS) . .167 )( 100 . 16.7~ ITAXABLE FOR EACH SURVIVOR)
B. The percent taxable for ....t. cre.ted within on. ye.r of the docedantt. de.th or .ccounts own.d by the dec.d.nt but held
In tru.t for anothor indlvldu.U.J (tru.t benefici.riu):
I DIVIDED BY TOTAL HUHBER OF SURVIYING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
Ex..pl.: Joint .ccount regl.t.red In the n... of the decedent and two other perlon. and ..t.blished within on. ye.r of de.th by
thl deced.nt.
1 DIVIDED BY 2 (SURVIVORS) . .50 X 100 . sax (TAXABLE FOR EACH SURVIVOR)
~. Th. ..ount .ubJect to tax Clln. 4) I. d.ter.ined bV aultlplying thl account balanc. (lln. 2) by the p.rcent t..abl. Clln. 3).
S. Enter the total of the dabt. and deduction. lilted In P.rt 3.
6. Th. ..ount taxabl. (Jlne 6) il deter.lned by .ubtracting the debt. and deductlonl (line 5) fro. the ..ount sUbJ.ct to tax Illn. 4).
7. Ent.r tha .pproprlate taM r.t. (line 1) a. d.ter.lnod b.low.
A. For dat.. of d..th occurring aft.r 6/30/94, the ta. r.te. for tran.far. to SPOUS.I are 81 follow.:
1. Oat.. of de.th on or aft.r 1/1/94 .nd b.fore 1/1/95 the rate Is 3X.
Z. D.ta. of d..th on or .fter 1/1/95 tran.fer. to .pou... will b. ta..d .t ax t.x rat..
Not.: For d.te. of death prior to 1/1/94 tran.f.r. to .pouse. .re t.xable at bX.
B. Tran.f.r. to Ilne.l de.cendant. Including f.ther, .other. son. daughter, grandchildren. .on'in.law,
daughter-In-law, .tepchlld .nd their ISlue .re ta..ble .t .ix per cant 16X).
C. Tran.f.r. to all other. Including brother, .I.ter. uncle, aunt, nephew and nlace are ta.able at flft.en perc.nt 115~).
D. If yOU change the tax r.t., plea.. .paclfY your rei.tion.hlp to the d.ced.nt In the .re. provided.
a. Th. a.ount of tax dua Illne S) il d.ter.lned by .ultlplylng the ..ount taxable Illn. 6) by th. taM rat. (lin. 71.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allow.bl. debt. and daductlon. .re deter.lned al follow'l
A. You I.g.lly .re re.pon.lbl. for pav..nt, or the e.t.t. ,ubJ.ct to .d.lnl.tr.tlon by . per.on.l repr..ant.tlv. I. In.ufflci.nt
to pay the deductlbl. It..,.
B. You actually p.id the debt. .fter de.th of the decedant and can furnish proof of p.y..nt.
C. Debts being clal..d lU.t be ltealzed fully In P.rt 3. If .ddltlonal space I. need.d, u.. plain p.p.r S 1/2" x II". Proof 0'
pay.ent .ay b. r.quelted by the PA n.p.rt..nt of R.v.nu..
TAXPAYER ASSISTANCE
IF VOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WIllS. PA DEPARTMENT OF REVENUE DISTRICT DFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAVER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327, TDDI (717) 772-225Z (HEARING IMPAIRED ONLY)
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COHHOtMAllll or IIINN~"IVANIA
DlPAIf''''IN' Of 11IVINUI
BUIIUU or INDiviDUAl TAIII5
nlJl'. ;'IIDbOl
IlAIlRISBUPG, flA 111;'.'DbDI
; f'I ./.
.
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.
21 -Cfl.& -Y40
96111325
0',-08-96
II. ,,","IIf"."
[,
TYPE OF
EST, OF RICHARD H HOLLENBAUGH
5.5. NO. 174-05-2002
DATE OF DEATH 12-24-95
II i 1 COUNT\! CUMBERLAND
ACCOUtH
o SAVINGS
o CIIECKING
o TRUST
[Xl CERTlF,
ANNA E HOLLENBAUGH
405 W MAIN ST
SHIREMANSTOWN PA 17011
ell
ell:
"
REMIT PAVHENT AND FORHS TOI
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
DAUPHIN DEPOSIT BANK I has proylded the Departllent with the Inforllat1on listed below which hIlS been uud In calculating the
potential tax due. Their records Indicate that at the death of the aboye decedent. you were II Joint owner/beneflclary of this nccount.
If you flel thh 1nfor.aUon Is incorrect, pleau obtain written correction fro. the financial lnitltutlon, attllch a copy to this for_
and return It to the abova addrass. This Dccount Is ta.llbl. in IIccardanca with the Inheritanca la. LawI of the Co..onwealth of Pannlylyania.
Uue;t1onl ..Y be answered hy call1nq 1711) 787-8321.
O:OMPL!;TE PART 1 B~' nw . . . C:F.F. IlFU~Il"~ STI1F. FOil F'T1 Hill ^N,' IIAYM~NT INSTIlIJCTTONS
Account No.
8000162660
Dat.
Eshblhh.d
12-04-89
To In.ure prop.r credit to your account, two
12) caples of this notice IIUlt aCCOllpany your
paYllent to tha Register of Wills. "aka chack
payable to: "Regllter of willi, Agent".
Account Balanc.
P.rc.nt Taxabl.
Anount Subject to
Tax Rat.
Potential Tax Du.
10.029,04
50,000
5.014.52
,06
300,87
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
x
x
HOlE: If tax paYII.ntl ara ..ade within thraa
13) 1I0nth. of tha dacedant'l data of d.ath.
you lIay daduct a ~Z dllcount of the ta. dua.
Any inh.rltanc. tax dua will baco.a dellnquant
nln. (91 1I0nths aftar the dato of d.oth.
h.
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. c:J lhe aboye Infor.atlon and tax dua il correct.
I. You eay chool. to re.lt paYII.nt to tha R.gIstor of willi with two copial of this notlca to obtain
a dilcount or ayold lntere.t, or you .ay chock box "A" and raturn this notlco to tha Reglst.r of
willi and an official all.s...nt will be Illu.d by the PA Depart..nt of R.vanue.
B. ~ lho abova assat hal bo.n or will be reportod and tax paid with the Ponnlylyanla Inharltanca la- raturn
to b. flied by tha decadent's r.pre..ntatlve.
C. c=J lha above Inforllatlon il Incorrect andlor dobtl and deduction. w.ro paid by you.
You .Ult co.plate PART [!] andlor PARl ~ balow.
If you indicate a different tax rat., pl.... stat. you~
~el.tionship to dec.dent:
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TAX RETURN - COMPUTATION OF TAX
LINE 1, Data Estobllshod 1
2. Account Balance 2
3. Percent Taxabl. 3 X
4. A~ount Subject to Tax 4
S. Debts and Deductions S
6. Anount Taxable 6
7. Tax Rat. 1 X
8. Tax Due 8
ON JOINT/TRUST ACCOUNTS
PAD
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
PART
~
DATE
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
I
TOTAL IEnte~ on Line 5 of Tax Conputatlon)
I
I
I
I
,
Und.~ panaltie. of pe~jury, I d.clar. that the
conpl.t. to tha best of ~y knowladge and belief.
II 'r~' \ '
,'" .".'. I
Ii n:A~fl"(:G ~,II:')1.. L~,LU) n-
T P R sl NA RE ,/
facts I have ~aport.d above a~e t~ue, cor~.ct and
HOME (: J i ) ! 't I
WORK ( )
TELEPHONE NUMBER
,I
GENERAL INFORMATION
1. fAILURE TO RESPOND WIll RESULT IN AN OFFICIAL UX ASSESSMENT wllh "",dlubl_ Int.,.., h"...III" In'or..fttlo'1
lub.Uhd by the Ilnanel.1 In,tltutlon.
t. Inheritance 'n beeo... delinquent nln. ..onthl ..fhr the duell.nt', d..l. 01 .,...Ih,
S. A jalnt account I_ '..abl. .wen thouQh the decedent', "".. Ill'n nelll.1I ,.1 ".,.,tt.r of (onv.nls",..
... Accounts (Including tho.. held b.t...." hushn"d "nil wifel which the decellenl put In Joint n..... within un. 'tur Ilrlot to
d..th .r. fully '.."bl. .1 tranlf.r,.
Ii. Accounh .,tIIblhhed JOintly bet...." husbllnd and wlf. tlor. than on. 'I'''' Inlor to 11...'11 /lr. not '.."bl..
6. Account. held by II decedent "In trull for" IInoth.r or oth.r. ar. t".Able full..,.
REPORTING INSTRUCTIONS - PART
1
TAXPAVER RESPONSE
I. BLOCK A ~ I' Ih. In'or..tlon and co.put_tlon In the notice are corr.ct "nd deduction. ar. not being clal.ad. plac. an "X"
In block "A" of Part 1 of the "Ta.pay.r R..pon.." ..ctlon. Sign two cop Ie. nnd 'ub.lt tha. with your chac~ for the neount of
ta. to the Ragi.t.r of Will. of tha county indicated. Tha PA Depart.ant of Rav.nu. will I..ue an official a....~.ent
CFor. R[V-1S4a EX) upon r.c.lpt of the return froe the Rogi.tar of Will..
z. BLOCK B - If the a..at .peclfl.d on this notlc. has beon or will b. reported and tn. paid wIth the Penn.ylvanla Inherltanc.
Ta. Raturn filed by the decadant'. rapr..antatlve, plac. an "X" In block "B" of Part I of tho "Ia.pay.r R..ponsa" ..ctlon. Sign one
COpy and return to tho PA Dapart..nt of Rllvanu., Bureau of Indhddual la.... D.pt 180601. Ilarrhburg, PA 1111a-Obol in tho
.nv.lop. provld.d.
1. BLOCK C - If the notlca Infor.atlon I. Incorr.ct andlor daductlon. ar. b.lng clal.ad. ch.c~ block "C" and coepl.ta Part. 1 and 1
according to the In.tructlon. b.low. Sign two copla. and .ubeit thA. with your ch.ck for the aeount of ta. payabl. to tha R.yl.tar
of Willi of the county indicated. Tha PA Departe.nt of Ravanu. will hS'J. an nfflclal :n,.uunt U';,'" R['J-IS4!t [XI upon r.celPt
wi ..,., rulu'-" f(Q. .".. ;;."i...., l.r "i....
TAX RETURN - PART
2
- TAX COMPUTATION
lIHE
1. Entar the date tha account originally wa. ..tabll.had or titled In the .ann.r e.l.tlng at data of daath.
NOTE: For a dacadant dying .ftar 11/11/11: Account. which tha dac.dant put In joint n.... within on. III y.ar of d..th ar.
ta.abla fully a. tran.fars. Howavar, th.r. is an a.clu.ion not to ..clI.d .1.000 p.r tran.f.r.. ragardl... of tha value of
the account or the nuab.r of aCfount. hald.
If a doubl. a.tarlsk C..) app.ar. b.for. your flr.t na.a in the addr... portion of thl. notlca, the .1.000 ..clu.lon
alr.ady ha. b..n d.duct.d fro. the .ccount balanc. .. r.ported by the fln.nclal In.tltutlon.
1. Ent.r tha total balanc. of the account Including int.r..t accru.d to the d.t. of d..th.
1. Tha parcant of the account that i. ta.abla for ..ch .urvlvor I. d.t.reJn.d a. follow.:
A. Th. p.rc.nt ta.abl. for joint ....t. .st.bll.had .or. than on. y..r prior to the d.c.d.nt'. d.ath:
I DIVIDED BY TOTAL NUHBER OF
JOiNT OWNERS
E..epla: A joint ass.t ragl.t.rad
OIVIDED BY TOTAL HUHBER OF X 100 . PERCENT "KABLE
SURVIVING JOINT OWNERS
In the na.. of tha d.c.dent and two oth.r p.rson..
1 DIVIDED BY 1 CJOINT OWNERS) DIVIDED BY Z ISURVIVORS) . .167 X 100
16.n lTAXABlE FOR EACtI SURVIVOR)
B. Tha p.rc.nt ta..bl. for as..ts cr.. tad within on. y..r of tho dacadant'. d.ath or .ccount. owned by the dacedent but h.ld
In tru.t for anoth.r IndlvldualCs) Itru.t b.n.flcJ.rl..):
1 DIVIDED BY TOTAL NUHBER OF SURVIVI~G JOINT
OWNERS OR IRUST BENEFICIARIES
K loa . PERCENT TAXABLE
E.a.pl.: Joint account r.gl.t.r.d In tha n.a. of tha d.c.d.nt and two oth.r p.rson. and .stabll.had within on. ya.r of d..th by
the deced.nt.
I DIVIDED BY Z (SURVIVORS) . .SO K loa SO~ (TAKABLE FOR EACH SURVIVOR)
4. Th. a.ount subj.ct to ta. Ilin. 41 I. datar.ln.d by aultlplylng the account b.lanc. (1lna 1) by the p.rc.nt tBlabla Illn. 11.
S. Entar the total of the d.bt. and d.ductlons ll.t.d In Part 1.
6. Th. aaount ta.abl. (lln. 6) I. d.t.raln.d by .ubtractlng the d.bt. and d.ductlon. (Ilna S) froe the a.ount subj.ct to ta. (1In. 4).
7. Ent.r the approprlat. ta. rat. Illn. 7) .. dateralnad b.low.
A. For dat.. of d..th occurring aftar 6/30/94, the ta. rat.. for tran.f.rs to .pou.a. are a. follow.:
1. Oat.. of d.ath on or .ft.r 7/1/94 and b.for. 1/I/9S the rate Is 3l.
1. Datas of d.ath on or .ft.r 1/1/9S tran.far. to spou... will b. ta..d at Ol t.. rat..
NOt.1 For dat.. of d.ath prior to 7/1/94 tran.fars to .pou... ar. ta.abl. at 6~.
B. Tran.f.r. to Ilnaal d..c.ndants Including fath.r, eoth.r. son, daught.r, grandchildren, son-In-law.
d.ught.r.ln-Iaw, .t.pchlld and their I..u. ar. ta.ab). at .i. p.rc.nt 16ll.
C. Transf.r. to all othar. InclUding broth.r. sl.tar. uncle. aunt. n.ph.w and nl.ca are ta..bl. at fifteen p.rcant (ISl).
D. If YOU chang. the taM rat.. pl.... .p.clfY your r.latlonshlp to tha d.c.dent in the area providad.
8. Th. a.ount of taM due CIln. 8) Is dat.r.ln.d by aultlplylng tha a.ount t..abl. (llna 61 by tha ta. rate (lln. 71.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allow.bl. dabt. nnd d.ductlons are d.tarelnad a. follows:
A. You I.g.lly ar. r..pon.Ibla for p.y..nt, or the ..tat. subject to adeinl.tratlon by a p.r.onal r.pr..antatlv. i. In.ufflclant
to p.y the d.ductlbl. It....
B. You actually p.ld the d.bts aftar d.ath of the dac.d.nt and can furnl.h proof of p.y..nt.
C. D.bt. b.lng clel..d .u.t b. Ita.iz.d fully In Part 1. If additional .paca I. n..dad, u.. plain p.p.r Bill" M II". Proof of
p.y..nt ..y b. requ..tad by the PA D.parte.nt of R.v.nu..
TAXPAVER ASSISTANCE
IF VOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAVER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327, TOOl (717) 772-2252 (HEARING IMPAIRED ONLY)
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COMMONWEALTH OF PENNSYLVANIA
DlPARTMENT O' REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
'*'
o NO. AA 112962
RECEIVED FROM:
fJ
ACN
ASSESSMENT r:t
CONTROL ...
NUMBER
AMOUNT
ANNA E HOLLENBAUGH
'Ibll J..j~5
.dVV.t:l1
405 W MAIN STREET
SHIREMANSTOWN, PA 17011
ESTATE INFORMATION:
I:t FilE NUMBER
5i 21-1996-0490 SSN
I:t NAME OF DECEDENT IlAST] (FIRST]
~ HOLLENBAUGH RICHARD H
II DATE OF PAYMEN:
II POSTMARK DATE
COUNTY
17/,-05-2002
(MI)
CUMBERLAND
DATE OF DEATH
m TOTAL AMOUNT PAID
$300.87
Vl
REMARKS
ANNA E HOLLENBAUGH
SEAL
, '
,
RECEIVED BY /., ,,;
, I SIGNA'Uft~'
CHECK11 2120
REGISTER OF WILLS
MAR V C. LEWIS
REGISTER OF WILLS
..--...---
- - __ -..--............Jld'..~.... _- lOt r .-7-:"
, ' ,/
1/
I~
IOV . IS
&1/
REV-1548 EX AFP (12-951*
COHHOHWUl lit OF PENNSYLVANIA
DEPAR'"EHl or REY[HU(
aUAEAU OF INDiviDUAL tAxES .
DEPT. :8GftOI
HARRISBURC, PA l11la-0601
NOTICE OF INHERITAHCE TAX
APPRAISEHENT, ALLOMANCE OR DISALLOMANCE
OF DEDUCTION.. AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 08- 05-96
ESTATE OF HOLLENBAUGH
RICHARD H DATE OF DEATH 12-24-95
COUNTV
CUMBERLAND
FILE NO, 21 96-0490
S,S/O.C. NO. 174-05-2002
ACN
96111325
ANNA E HOLLENBAUGH
405 W MAIN ST
SHIREMANSTOWN PA 17011
REMIT PAVMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
Allount R...1tt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Rifv:isiia-Eif-AFii-ii1f:9Si------------------------------------------------------------------------------..-----
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLV HELD OR TRUST ASSETS
DATE 08-05-96
ESTATE OF HOLLENBAUGH
RICHARD H DATE OF DEATH 12-24-95
COUNTV
CUMBERLAND
S,S/D,C, NO, 174-05-2002
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION, DAUPHIN DEPOSIT BANK & TRST CO ACCOUNT NO.
ACN
96111325
FILE NO, 21 96-0490
TAX RETURN WAS,
8000162660
TVPE OF ACCOUNT.
DATE ESTABLISHED
( ) SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
12-04-89
A"count Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
10.029.04
0,500
5.014.52
,00
5.014,52
,06
300,87
NOTE. TO INSURE PROPER CREDIT TO
VOUR ACCOUNT. SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS, MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REGISTER OF WILLS. AGENT,"
TAX CREDITS:
PAVMENT
DATE
06-20-96
RECEIPT
NUMBER
AA112962
DISCOUNT (+)
INTEREST (-)
.00
AMOUNT PAID
300,87
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
IF TOTAL DUE IS LESS THAN '1. 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
300,87
.00
,00
.00
PURPOSE OF
NOJlCEI
PAvttEHT:
REFlJlO (CR)I
"
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r
lJ.
I
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To fulfill tho r.qulr...nt. of S.ctlon ZI~O of tho Inh.rltanc. and Estat. Ta. Act, Act ZZ 0' 1991. (7Z P.S.
S.ctlon Z140).
Detach the top portion of thl. Hotlc. and .ub.lt with your pay..nt to the Raglst.r of Will. prlnt.d on the
r.v.r.. .Id..
-. "ak. ch.ck or .on.y ordar payabla to: RECISTER OF WILLS, ACENT.
All pay.ent. r.c.lv.d shall flr.t b. appllad to any Intarast which .ay ba dua, with any r..alndar appll.d to tha taw.
A r.fund of . ta. cr.dlt, which was not r.qu.st.d on the ta. return. ..y b. r.qu.st.d by co~l.tlng an "Application
for R.fund of P~.ylvlll'lla Inh.rltance and Est.t. Tax" (REY.UU). Appllcetlons are avallabl. at the Offlc. of
the Raglst.r of Will., any of tha Zl Ravanue District Of ficas or by calling the sp.clal Z4-hour .nsw.rlng s.rvlc.
nueb.r. for fora. ord.rlng: In Pannsylvanla 1-800-36Z-Z0SD. outslda Pannlylvanla and within local
Harrllburg ar.a (717) 787-8094, TOOl (717) llZ-ZZSZ (Ha.rlng lapalr.d Only).
OBJECTIONS I Any party In Intera.t not .atlafl.d with the appral....nt, allowanc. or disallowance of d.ductlon. or a.......nt
0' ta. (Including discount or Int.r.st) a. shown on this Hotlc. .ay obj.ct within al.ty (6DJ daya of r.celpt of
thlt Notice by:
--wrItten prot..t to the PA Depart.ent 0' Revanu.. Bo.rd of Appeala, Dept. Z81DZl, Itarrl.burg, PA 17IZ8-1DZl, OR
.-.I.ctlng to h.v. the aatt.r d.teraln.d at the audit of tha .ccount of the par.on.l rapra..nt.tlva, OR
--appeal to the Orphans' Court
A!>>tIN-
ISTRAlIVE
CORRECTIONS:
OISCOUHh
PEHALTYI
INTEREST I
Factual .rror. dl.cov.r.d on thl. a......ant should b. addras..d In writing tOI PA C.part..nt of Rav.nu.,
Bur.au of Individual T..... ATTNI po.t A..a.s.ant R.vl.w unit, DEPT. Z80601, Harrl.burg, PA l11Z8-0601
Phon. (111) 181.6505. 5.. page 1 of the bookl.t "In.tructlon. for Inh.rltanca Tax Raturn for a R..ld.nt
D.c.dent" (REY-1501) for an axplanatlon of adalnl.tratlv.lY corr.ctable arror..
If any tax dua I. paid within thr.. (l) c.l.ndar aonth. .ft.r the d.c.dant'. d.ath. a flv. p.rc.nt (S~)
dl.count of the t.x paid I. allow.d.
Th. 15~ ta. a~..ty non-partlclp.tlon p.n.lty I_ coaputad on the tot.l of the t.. and Intar..t a......d, and. not
paid bafor. January 18. 1996, the first day .ft.r tha .nd of the ta. aan..ty p.rlod. Thl. non-participation
panalty I. aPP.al.bl. In the .... .ann.r and in the the .... tl.a p.rlOd a. YOU would app.al the tax and Int.r..t
th.t ha. b..n a'..'.ad a. Indlcatad on thl. notlc..
Int.r..t I. charg.d b.glnnlng with flr.t day of d.llnqu.ncy. or nln. (9) .onth. and on. (1) day
fro. tha data of d.ath, to tha date of pay..nt. Ta..s which baca.. d.llnqu.nt b.for. January I, 1981
b..r Int.r..t at tha r.t. of .1. (6~) p.rc.nt par annu. calculat.d .t . dally rat. of .000164.
All ta.a. which b.ca.. dallnqu.nt on or aft.r January I, 198Z will baar Int.r..t at a rat. which will vary 'roe
cal.ndar y.ar to cal.ndar y.ar with that rata announc.d by the PA D.part'ant of R.v.nu.. Th. appllcabl.
Int.re.t rat.s for 198Z through 1996 ar.:
Y.ar Inter..t Rata Dally Intar..t F.ctor V.ar Intar..t Rata Dally Intlr..t Factor
1981 20~ .000548 1981 .. .000241
1983 16~ .OOOH8 1988-1991 11~ .000301
19114 IU .000lDI 1991 .~ .OOOZ41
1985 U~ .000356 1993-199" n .000191
1986 IO~ .00DZ14 1995-1996 .~ .000241
--Int.rnt I. calcul.tld .. follow'l
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hotlc. I..uld aftlr tha ta. bacoaa. dlllnquant will r.fl.ct an Int.r..t c.lculatlon to 'Ift..n (IS) daya
b.yond the data of the a"I...ant. If pay..nt I. ..dl aftar the Int.r..t co.putatlon dat. .hown on the
Notlc., additional Intar..t .u.t b. calculat.d.
P\JIl1'OSE Of
NOTICE!
PA'fflEHTI
REFUND (eA) I
-
::;
(-I
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To fulfill the requlr...nts of Slctlon 2140 of the Inheritance 8nd Estate TIM Act, Act ZZ of 1991. (12 P.S.
SICUon ZlU).
Oltleh thl top portion of thl. Notlel and lub.lt with your Ply.,nt to the Rlgl.t.r of Willi printed on the
r...,lrsl sldl.
e_ Make c~ck or ~V order Plvabl. tOI REGISTER OF WILLS, AGENT.
All ply.entl r,cllvld Ihall flt,t b. applied to any Int.r..t which ..y bl dul, with any "'llnd,r IPpllld to the tlM.
A r.fund of . llK crldlt, wnlch w.. not requl.tld on the 'IX r.turn, ..y bl r.qu..tld by coapllllng an "Appllcltlon
'or R,fund of Pennsylvenla Inherltancl and Elt,t, rlx" CAEV-I1IS). Appl1cltlonl .t. IVIlllbl_ It the O,f1cI 0'
the Rlglltlr of Will.. any of the 23 Revenul District Offlc.1 or bv calling the IP.clal Z4~hour anlw.rlng larvlc.
nueberl for forI I ord.rlng: In Pannlvlvenla 1~800.36Z-2050, outlld. P.nn.vlv.nl. and within local
Harrl.burg .r.. (717) 787-809', TOO' (717) 772-2ZSZ (H..rlng I.p.lr.d Onlv).
oaJECTIONS, AnV party In Int.r..t not ..tl.fl.d with the .ppr.I....nt, .Ilowanc. or dl..llowanc. of d.ductlon. or .......ent
of t.x (Including dl.count or Int.r..t) a. .hown on thl. Notlc. "V objact within .Ixtv (60) day. of rac.lpt of
this MoUc. bV'
--written prot..t to the PA D.part..nt of R.v.nu., loard of Appa.I., D.pt. Z810ZI, Harrl.burg, PA 17IZ8-1021, OR
--.I.ctlng to h.v. the .att.r d.t.r.lned .t the audit of the account of the p.r.onal r.pr...ntatlv., OR
.-app..1 to the Orphan.' Court
AD.ttN-
ISTRATlYE
CORRECTIONS I
DISCOUNT,
PENALTY I
INTEREST I
F.ctu.1 .rror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing tOI PA D.parta.nt of R.v.nu.,
aur.au of Individual Tax.., ATTN: po.t A.......nt R.vl.w Unit, DEPT. 280601, Harrl.burg, PA 17128-0601
Phon. (717) 787-650S. S.. p.g. 3 of the bookl.t "In.tructlon. for Inhlrltanc. T.x R.turn for. Ra.ldant
DlCldant" (REV-ISOI) for an ..planatlon of adalnl.tratlv.ly corr.ct.bla Irror..
If any tax dua I. p.ld within thr.. (3) callndar .onth. aft.r the dlCld.nt'. d..th, a flvl p.rclnt (S~)
dl.count of the t.x paid I. .llowld.
Th. IS~ tax aan..ty non-p.rtlclpatlon p.n.lty I. co.put.d on the total of the t.x and Int.ra.t .......d, and not
p.ld b.for. Janu.rv la, 1996, the flr.t day aft.r tha and of thl tax .an..ty p.rlod. Thl. non-partlclp.tlon
p.n.ltv I. app.al.bl. In the .a.. ..nnar and In the the .... tl.a p.rlod .. you would app.al tha t.. and Int.r..t
that ha. ba.n .......d a. Indlcat.d on thl. notlc..
Int.r..t I. charg.d bag Inning with flr.t day of d.llnqu.ncy, or nln. (9) eonth. and ona (1) d.y
frol the data of d..th, to the d.t. of pay.ant. Ta... which blca.. d.llnqu.nt b.for. J.nuary 1, 1982
b..r Int.r..t .t tha rata of .Ix (6~) parcant par annul calcul.tad .t a dally r.ta of .000164.
All ta... which bac... d.llnquant on or .ftar January 1, 1982 will baar Intara.t .t a rat. which will vary fro.
caland.r yaar to calandar y.ar with th.t rat. announcad bv the PA Depart.lnt of Ravanu.. Th. appllcabl.
Int.r..t rata. for 1982 through 1996 ara:
V..r Intar..t Rat. Dally Int.r..t Factor
Vaar Intarut Rat. Dally Intlrut F.ctor
19117 OX .000247
1988-1991 IU .000301
1992 oX .000247
1993-199" 7X .000192
1995-1996 OX .000Z"7
19112
1983
198ft
19115
1986
ulntlrllt
2U
l'~
1l:C
I3X
10~
I, c.lculat.d a.
.000548
.000438
.000301
.000356
.000274
followtl
INTEREST = BALANCE OF TAX UNPAID X NUn8ER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. II,uld .ft.r the ta. b.co.e. d.llnquant will refl.ct an Intere.t c.lculatlon to flfte.n CIS) d.y.
beyond the d.t. of the .....I.ant. If p.y..nt II .ade after the Intar..t eo.put.tlon data .hown on the
Notlea, additional Interut ""It be calcul.ted.
, ...,
/ 'S ith"/_"'l
GL--'
REY-1548 EX AFP (12-95*
COMMONWEALTH or PENNSYLVANIA
DEPART"EHT OF REVENUE
BUREAU OF INDIVIDUAl TAXES . .
DEPT. 280601
HARRISBURG, PI 11128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOMANCE OR DISALLDMANCE
DF DEDUCTIONs. AND ASSESSMENT OF TAX ON
JDINTLY HELD OR TRUST ASSETS
DATE 08-05-96
ESTATE OF HOLLENBAUGH
RICHARD H DATE OF DEATH 12-24-95
COUNTV
CUMBERLAND
FILE NO. 21 96-0490
S.S/D,C. NO. 174-05-2002
ACN
96111344
ANNA E HOLLENBAUGH
405 W MAIN ST
SHIREMANSTOWN PA 17011
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AJlount R8"itt.d
CUT ALUNG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Fiiv:isi;s-Eif-AFP--ii1i:9Si------------------------------------------------------------------------------------
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 HOLLENBAUGH
RICHARD H DATE OF DEATH 12-24-95
COUNTV
CUMBERLAND
S.S/D,C, NO. 174-05-2002
(Xl ACCEPTED AS FILED (l CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION. DAUPHIN DEPOSIT BANK & TRST CO ACCOUNT NO,
ACN
96111344
FILE NO, 21 96-0490
TAX RETURN WAS.
8000162644
TVPE OF ACCOUNT. (l SAYINGS ( l CHECKING ( l TRUST (lO TIME CERTIFICATE
DATE ESTABLISHED 12-04-89
Account Balance
Per"ent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
10.029,04
0,500
5.014.52
.00
5.014,52
. 06
300,87
NOTE. TO INSURE PROPER CREDIT TO
VOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAVMENT
DATE
06-20-96
RECEIPT
NUMBER
AA112965
DISCOUNT (+l
INTEREST (-l
,00
AMOUNT PAID
300.87
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATIDN OF ADDITIDNAL INTEREST. .
I IF TOTAL DUE IS LESS THAH '1, 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 FDRH FOR INSTRUCTIDNS, I
300.B7
,00
.00
,00
PURPQSE Of
Nl1T1CEI
PAM"T,
REfUND (CA)1
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To fultlll the requlr...nt. of SlctIon Zl~D of thl Inheritance end E.tat. rax Act, 'ct ZZ of 1991. 17l P.S.
Section ZUG).
a.tech the top portlon of thl, Notlc. and lubelt with your ply..nt to the Rlal.ter 0' Will. printed on the
nv.t.. dds.
-- Hakl check or ~y order payabl. tal RECISTER OF WILLS, ACENT.
All ply.ant. r.CllVld ,hall flr.t b. applied to any Intar..t which ..y ba dul, with any r...lndar applied to thl taM.
A r.fund of a tax cradlt, which we. not raqua.tad on the ta. return, ..y ba reque.tad by coapl.llng an "application
far R.fund of Pennsvlvanl. Inheritance and E.t.t. 'ex" tREY-Ill]'. Appllel'lon. ar. IVlllabl. at thl O"lcI of
tha Ragl,t., 0' Wills, any 0' thl Z5 Revlnu. District D'flc.. or by calling thl 'Plcl_l 24.hour an,wlrlng 'Irvlc.
nu.blr. far for.. ord.rlng: In Plnn.ylvanl. 1-800.162.2050, aut.ldl P.nn.ylvanl. and within lac.l
Harrl.burg .rl' (717) 781.8094, TOO. (117) 17Z-2252 (H'arlng I.p.lr.d Only).
OBJECTIONS: Any party In Int.r..t not ..tl.fl.d with the .Ppr.I....nt. .llow.nc. or dl..llowanc. of d.ductlon. or ........nt
of t.x (Including dl.count or Int.r..t) a. .hown an thl. Notlc. '.y abJ.ct within .Ixty (60) d.y. of r.c.lpt of
this Notice by:
--wrlttan prot..t to the PA D.part..nt of R.v.nu., lo.rd of App..I., D.pt. Z81021, H.rrl.burg, PA 17IZ8-IOZI, OR
--.I.ctlng to have t~ ..ttlr d.t.r.ln.d .t the audit of the account of the p.r.onal r.pr...ntatlv., OR
.-appaal to the Orphan.' Court
ADMIN-
ISTRATlYE
CORRECTIONS:
DISCDUHTr
PEHAL TY:
IHTEREST:
Factual .rrar. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing to: PA D.p.rt..nt of R.v.nu.,
Bur.au of Individual Tax.., ATTH: Po.t A.......nt A.vl.w unit, DEPT. l80601, Harrl.burg, PA 111l8-0601
Phon. (1111 181.6505. S.. page 3 of the bookl.t "In.tructlan. 'or Inh.rltanc. T.x R.turn far a A..ld.nt
D.c.d.nt" (REV-1501) for an .xplenatlon 0' .dalnl.tratlv.lY corrlctabl. .rror..
If any tax due I. peld within thr.. (11 cel.nd.r .onth. a,t.r the d.cld.nt'. d..th, . flvl p'rc.~t (5~J
dl.count of the tax p.ld I. .Ilow.d.
Th. 15~ tax a~..ty non.p.rtlclpatlon penalty I. coaput.d an the total of the t.x and Int.r..t .......d, and not
p.ld b.for. January 18, 1996. thl flr.t d.y a,t.r the .nd of the t.x .an..ty p.rlod. Thl. non.p.rtlcJpatlon
penalty I. 'PP'al.bl. In the .... ..nn.r end In the the .... tl.. p.rlOd .. yOU would .pp..l the t.x &nd Int.r..t
th.t h.. b.en .......d e. Indlcat.d on thl. notlc..
tnt.r..t I. ch.rg.d b.glnnlng with 'Ir.t d.y 0' d.llnqu.ncy, or nln. (91 .onth. and an. (I) day
'roe thl data of d.ath, to the d.t. of pay..nt. 'ax.. which blca.. d.llnqu.nt b,'ar. J.nuary 1. 1912
b..r Int.r..t at the rat. of .Ix (6~1 p.rcant p.r annul calculat'd at . d.lly rat. of .000164.
All t.x.. which b.ce.. delinquent on or .,t.r Janu.ry I. 1981 will b..r Int.r..t .t e rat. which will v.ry fro.
cal.nd.r y.ar to cal.ndar YI.r with th.t rat. announc.d by the PA D.p.rt..nt of Ravanu.. Tha .ppllcabla
Int.r..t r.ta. far 1981 through 1996 .r.:
Year Interllt Aat. Oalh Inter..t r.ctor Vaar Inter..t A.ta 0.11'1 Inta,...t ractor
l'll l'~ .000548 1981 .~ .000l41
U83 IU .000lt18 19118-1991 11~ .000lDl
1914 lU .000lDI 1992 'l .000l41
1915 In .000356 1991-1994 II .00019Z
U8' I.l .0001llt 1995-1996 'l .0002lt7
.-Inter..t 1. c.lculatad a. follow.:
INTEREST D BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. I"u.d aftar the tax baco... d.llnqu.nt will rafllct an Int.ra.t calculation to 'I't..n lIS) day.
b.yond tha data of the ........nt. If p..,.ent I. ..d. "t.r the Int.r..t co.put.tlon d.t. .hOwn on tha
Hotlc.. additional Int.,.a.t .u.t b. c.lcul.ted.
PlJRPQSE Of
NOTICEs
PAYl'tEKTI
REfUND (CAl I
OBJECTIONS I
AlIIUM-
ISTRATIVE
CORRECTIONSI
DISCOUNT I
PENAL TV.
INTEREST I
c!
To fulfill the requlr..entl of s~tlon 2140 of the Inheritance and E,tet. 'aM Act, Act ZZ of 1991. (72 P.S.
s.ctlon 2140).
Detech thl top portion of thh Katie. and sub.1t .,lth your PI,""t to tM Rlalste.. of wUlI prlnt" on the
r.v..... .Ide.
__ Make chack or ~y order payable tOI REGISTEA OF WILLS, ACENT.
All PIYHf1tl rec.lved ..,.11 flr.t tM epplllld to 11ft)' lnt.rnt which MY be dUll, with any r...lnd11r epplled to the tax.
A nfLnd of . tax credit, which "I' not requested on the tn raturn, ..y be raquutect by co_iaUog an "'Appl1C8t1on
far Refund of Pennsylvania Inheritance and Elt.t. Tax" (REV-ISI]). AppIJeatJonl ara available at thl OfficI of
the Reglst.r of Willi, any of the ZS Rlv.nue DI.trlct Of 'I c.. Dr by calling the special Z4-hOUr anlwerlng ..rvlce
~r' 'ar 'ar.. ordering: In Penn'Ylvanla 1-8DD-36Z-ZD5D, out,lde Pennlwlvenl, and within l~l
Harrisburg .r.. (717) 787-8094, TOO' (717) 77Z-ZZSZ (Hearing 1~.lred Only).
Any p.rty In Int.r..t not .atl.fl.d with the appral...ant, allowanc. Dr dl.allowance af d.ductlon. Dr a......-nt
af tax (Including dl.count ar Int.r..t) a. shown on thl. Hatlce .ay object within .Ixty (60) day. of rec.lpt of
thb Hotlc. by:
.-wrlUM pratllt to U. PA D.partNnt of RnlnUl, Board of Appeals, o.pt. 281021, Harrisburg, PA 17121-1021, OR
.-.lectlng to have the aattar d.t.ralned at the audit of the account af the p.rsanal rapr..antatlv., OR
.-app.al to the Orphan'. Court
Factual erran dbcav.red an this .......ant .hoUld 1M addre..ed In writing teu PA DaparUll'lt of R.vll'lUtl,
Bur.au of IndividUal 1...., AllN: Pa.t A...s.aant R.vlew Unit. DEP1. 210601, H.rrl.burg, PA 17121-0601
Phone (711) 717-650~. s.. page S of u. baotc.l.t "Instruction. far Inherltanc. lalC R.tum far a R..ldent
Dac~t" (REY-1S01) far an aKplan.tlon of adalnlltratlvalY correctabla .rrorl.
If any tax ~ I. paid within thr.. (3) calend.r aonthl aft.r the dec~t.. death. a flv. percent (5%)
dbcount of the talC paid b aUOdd.
Tha 15% tax .....ty non-partlclp.tlon penalty II cu.puted an U. total of \hi talC and Int.ra.t .....Md, and not
paid befar. Janu.ry II, 1996, the flrst day aftar U. II'ld of U. tax ~.ty period. Thb non-partlclpatlan
penalty b appealabl. In the 18" aannar and In the the .... tiN period a. you would appeal the tax and Int.rut
that hat bHn ......ad as Indlc.ted on thb notice.
Intare.t b charged baalmlng with flrst MY of dlllnqt,lMCy, or nine (9) MX1th. and OM (1) day
froe the d.ta of d.ath, to thI data of pay..nt. Taxa. which bee_ d.lInquent bIIfar. January 1, 1982
bII.r Intara.t .t the rat. of II. (6%) percant par ~ calculated at a dally rate of .000164.
All taxa. which becu. delinquent on or .ftar January 1, 19112 wUl bear Inter..t at a rate which wUl vary fr~
calender ya.r to calendar y..r with that rata lIWV1D'M'Ced by tM PA Dlpart...,t of R.vMUe. The appllcml.
Int.r..t r.ta. far 1912 through 1996 aral
V.ar Intera.t R.t. O.llY Int.r..t Factor V.ar Internt Rat. Dally Int.r..t F.ctar
1912 zax .OOOS41 1987 9X .000247
1981 16X .000411 19&1-1991 11X .000501
19" 11X .000501 199Z 9X .0OOZ47
1915 UX .OOn56 1993-1994 n .00Dltz
1916 lOX .000274 1995-1996 9X .000247
--Int.r..t I. c.lculated .. fallow'l
IKTEREST = BALANCE OF TAX UNPAID X KUKBER OF DAYS DELINQUENT X DAILY IKTEREST FACTOR
..My Notlca bwad aft.r the tax beeMa8 delinquent will reflect., Int.rllt calculaUon to fift.., (IS) dayI
beYond the data of the a......-nt. If p.YMRt b Ada .ft.r the 1ntar..t ~t.t1an data Ihal<<t on the
Notice. eddltlanal 1nt.rllt ...t be calculated.