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350942S
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COMMONwe.4.LTHOf PENNSYLVANIA' DEPARTMENT OF HeALTH. VitAL fU!COAOS
CERTIFICATE OF DEATH
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COM~10NWEALTI~ OF PENNSYLVANIA
COUNTY OF DAUPHIN
ss:
':Js A/l1
We, RAYMOND
P 7olvA-.eIC(.j
II. BARRF.1H[', ~c.tfA,€.j) lIJ, CA.-I!: a"Ntfl~
, and
.I the Testator and witnesses, respectively,
whose names are signed to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that
the Testator signed and executed the instrument as his Last Will and
Testament and that he had signed willingly, that he executed it as his
free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the Testator,
signed the Will as witness and that to the best of their knowledge,
the Testator was at that time eighteen years of age or older, of
sound mind and under no
constraint or und~e influence.
"~ . fi"" >x
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-RA.M D._Jj.~~~:(?/ .;?
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Subscribed, sworn to
i
l
acknowledged.
before me by RAYMOND
H. BARRETT, the Testator, and subscribed and sworn to hefore me by
':) \0 . c.. Le C '41i~1L ::Jt:'Allf P 7oNA/!/CH
l\ tUiAtfO and
~ of cOr ,-t.-Il.2_
witnesses, this If /7 day , '1982.
CLECKNr.n Ii HAREN
"nOIlHEU '" lAW
"O\RRllhUIlO,PEHllsnVAHIA
/- ;!,' . X' /' ") A '.'
, ""'. ~- 1'- /. / ?
(,,:Ii ,litO') . /:_).t (t (12-
No1'A W PUBT,IC . /
-5";
t.! 1\":)1-1 K. NAHD, NolclIY p",.l,.
It;, r,doijr-l, 1>:Il'I_,hirl (\)'!IlI}', PI'.
M) [('lioll:I'.i J\ bplrUl J"lf ~O, \904
REV. .~OO EX. j7.Q"l
/.',
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYlVANIA (TO BE FII.ED IN DUPLICATE
DEPARTMENT OF REVENUE
HARRlSRJtb. ~~o~~bo..OI WITH REGISTER OF WILLS). COUNTY~OD~.....,
DECEDENT'S NAME (lAS1. fIM!.T, ANO MIDfll[ INITIAll ;..--..;,.:.;..::.:~---.,;_._,-~..,._--_..~-~-~_._.. (JT@Nr5'cOMfiiTiEAFo"ii'~-
BARRE'r'l', RAYMOND H. 414 Be~hany Ddve
SOCIAl SECURITV NuMifr---.--' '---[OATfOf O{A~Ttt ]OAIl Of 811UH Mecha r,11..C sbu rg I PA
172-01-0655 03/30/96 O()!20/03 Coo", cumberland
I;; M~l'CA'l!1 W~"I"'INO VOUH ~ NAMlll:\i1;I~U "wi Mi~~~I-I;H~~ ]SOCIA\ 5[Cu~Tiy NUM8lM - - '11 AMOUNf',"Ciivro IS[mf,i,ucliiiNS)._.-.~--....
____ _Bat:'t:'e~~ot:'e~?_e~.. . .186-2.'1-9B5_Q. .._.?}_~8..8.~..' 63...._.______._..___.
~J 1. Original Rl:lturn [I 2, Supplomontol R(lturn [) 3. Remainder Relurn
jfor doles of dealh prior to 12.13.02)
[1 4, limited Ellote [.I 40. future lnlarell Compromise [15. Federal ESlate To)( Return Required
(lor dolo. 01 d.alh olior 12.12.821
[&J 6. Decedent Died Tellale [J 7. Decedent Maintcllned 0 living TrUll ~ a. Total Number of Sofe Deposit Boxos
(Allech copy 01 Will) IAIIO,h copy 01 TrUll)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
rh)-o. NAME COMPLfTe MAllINO AO(JRE$S
~~ . Ann_~.-:..._Rhoads, Esg~Lre____.__._____._ ~yE~~N~~dA~~. ~E~~Eg. Box 11847
8~ TElEPHONE NU"8E' liat:'t:'tsbut:'g, PA 17108-1847
.____ _ ( 71 7..L2 3 ~.-1 7.3 ~..~_=7~..""~'==.'~:~=.'"7~=_07~~===~=====.~ =
I. R.ol Elle" {Schodul. AI ( 1 I ____....__Q.!..QO..___........
2. Slock. and Bond. (Schodulo BI ( 2 I ....2.LBll.5...._QQ.... ...____
3. Clo.oly Hold SlocklPorlno"hlp Inl.ro,' (Schodulo C) I 3 I ~.___Q..,-Q.Q_.__
4. MOrl8090' ond NOlO' Rocolvoblo 15chodulo 01 ( 4 I _._.,...._..9.-'.Q9___
5. Cosh, Bank Deposits & Miscellaneous Personal ProplJrly {.5 I --,.,,___.._~.__Q.~J?.9..._...__.____,__.
15chodul. EI
6. Jolnlly Ownod Proporly (5chodulo PI (61 .___0..:..00_.__,.._._
7. TroOlI." (5ch.dulo G) (5chodulo l) (71 _._...Q...Q.9_.._.._
8, Tolal Gran Auels (Iotallines 1.7)
9. Funeral Expenses, Administrative COlh, Mlscellanoous
Expon.o. (5chodulo HI
Debls, Mortgage liabililltn, liens (Schedule I)
T 0101 Deducllons (total lines 9 & 10)
Nel Value of Estate IUne 0 minus line 11)
Charitable and Governmental Bequests (Schedule Jl
Nel Value Subjectla To)( (line 12 minus line 131
Spousal Tronsfefl (for doles of death oher 6.30.(4)
See Instruclions for Applicable Percentage on Reverse
Side. (Include values from Schedule K or Schedule M.l
Amounl of Une 14 taxable at 6% rote
(Include value, from Schedule K or Schedule M.l
Amuunt of line 1.4 taxable 01 15% rate
(Include value, from Schedule K or Schedule M.l
PrindpallO)( due jAdd lox from Unes 15, 16 and 17,)
Credits Spousal Poverty Credit Prior Payments
*
fOR DATES Of DEATH AnER 12/31/91 CHECK HERE
If A SPOUSAL-
POVERTY CREDIT IS~ CLAIMED [ I
fill NUMBER
;'1
1996
enol
YEAR
NUMB~R
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(9) ~:?.200Q..__
(81
2,885.00
10.
11.
12.
13.
14.
15.
16.
17
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co
fi: 18.
...
== 19.
..
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(101__.Q.c.QQ.._~___
4,320.00
(11)
(121
(13)
(141
o ,ll..Q.._._.._.
o ..Q!L__..__.__
0.00
(15) .. 2, 88.5 ,-Q.L_~...__x.Q....a _--o"...Q.Q.______..
0.00
(161__..._~._._.____.x .06 =
(171_._.______.______x .15 a .__..Q.,..9JL______.__
(IA)
0.00
.------.-----.--.--..--
Discounl
Inlerest
_'_.__~_"'_______ -f'
+ .--".----.----- -
(191 ___n.~..29_._____
(201 ...__.'O"'O.Q.____._..
~ 20. If Lille 19 h greater than Line 18, enter the differenco on Une 20. This is Ihlli OVERPAYMENT.
... aD
_tL If line 181s greater than line 19, enlur lhe diffflronce on Uno 21. This is the TAX DUE. 121) u____.._..9.,o..QQ__.
A. Enter the i"terest on tho bokl1l((l due on line 21 A. (21 Al Q_-, .QQ._
B. Enl.r Ih.lolnl olllno 21 and 21A on lino 21B. Thi. i.,ho AALANCE DUI. 121BI ..0....99. ___...........
Ma~. Ch.ck Pa';c:!~~~.~~~I.t.~..,~L~!!!~~_~.!!lL___. ........._.__..~_.._._.,_._.....__.,..._ .. .~_.....___.. ~9~.___~.__~_
- - ~.. BE SURETO.ANSWER ALCQUESTlONS ON REVEP:SES.ioEANO"O REi:HECK!>IATH .. <II(
~~der penoltie, l,)f perjury, I declare that I hove examined thil rolurn, including accompany'ing schndules and 'lalements, and to thft besl of my knowledgfl Clnd bllillef,
IllS true, correel and completo. I declare Ihot 011 teal flstaHI has boon reported 01 true marko! I{oluo, Declaration 01 proporer olhor thOl1 the pononol roprtHentolive is
based on all informallon of which prepartH has any knowledgo
StONATUR:~t, PERSON Rn;PONSIDI'CfOR..(ijTNG";(TURN---"AriD,~f~(--F~E""W:'-"Bl,R1<ETT; -"-414-'HeEhil.~y- -. CJA-,-r '''-r'--'--:;' ..-;.::--.. --
SiUN:;unl,p;, {PAR;,,~ OTHE.,'-Q0N ';iR[,;;,'Afi-.V.t--.~;';li'.. .'~~,~c.,v~, ~IT6~""t,j~~Ct~.;6k~E~AXN!; ?~2RI'I~N , o,~ I~O. .~jj;1.;. .2.._,
..':t'..:i:::v: )~..~ ~P::D.(~L. P~? llox 11847, 3] N. 2nd St. ,Qli-o'J 1).
Harrisburg, P^ .17108-W4'/
CllCc~ here if you orc roquosling a ro.fund of your bvcr~ovmcnt.
~fv,nll E'(. 17,80)
,,~(~d~
,...~~;j"",
COMMONWEALTH OF PfNN5YlVANIA
INHERITANCE TAX RETURN
RESlD~.~! D~_S~l'ENT
1 SCHEDULE H
FUNERAL EXPENSES,
_~~_.,u~~~~~~~R~JJ;'JS CE~~TiN~~~n
ESTATE OF
____u__2ARRETT, RAYMON~_.J:l~_
J Please Print ar Type
- FILE NUMBER
21 - 1996 - 0701
AMOUNT
ITEM
NUMBER
A. Funeral Expensesl
B.
4.
C.
1.
2.
3.
4.
S.
6.
7.
e.
DESCRIPTION
1.
1.
Administrative Colts:
Personal Repre.enlollve Commission.
Social Security Numb.r of Personal Representoflve; _
Yeor Commission. paid
2.
I Attorney Fee.
Cleckner and Fearen
Family Exemption
Claimant Florence W. Barretltelation.hlp Wife
Address of Clalmonf of de"edent's death
5freet Address 414 Bethany Drive
City Mechani csburq __State _YA_ Zip Code 1705~
3.
Probale Fee.
Register of Wills - probate
Miscellaneous Expenses:
Register of wills - filin~ fees
TOTAL (Also ent.r on line 9, Recapitulation)
(If mare space Is needed, Insert additlanal sheets al same size.)
750.00
3,500.00
45.00
25.00
54,320.00
C:OMMONWlALTH 0' PlNNSnVANIA
COUNn 0' CUMIIItLAND
.r
'l
J
...
1,'lol'ence W. Jlarrt>tt
-"~-.._-~------_._~_. --.----- .---------...--..------
".1.9 duly __I;llipr~__ _~___ .cco,di.9 10 I...., ,1'1'01'1 .nd "YI Ih.I she i R
_____~_~~~tri~____ 0/ Ih. EsI.t. 0/ Ravmond H. lJan:ett
1.1. 0/ ~Q.;I!i'r__~lJen_'}'9!"l"!s_hi.P___ ---.---___, Cumborl.nd County, P.., d.cuud end Ih.I th.
...ithin i. .n invenlory m.d. by ___!':.Lore~~;_ Barrett _ _ , Ih. uld Executrix ._,
0/ th. .ntir. ..I.t. 01 ..Id d.c.d.nl. conlillin9 01 .11 Ihe p...on.1 prop<rly .nd ,ul ..I.f., ne.pl rul "hte oullld.
tho Common...ulth 01 Pennlylv.ni.. .nd th.f the fi9urll oppolil. uch it.m 0/ th. Inventory ..p.....t It', f.ir v.lu.
.. of th. d.f. of d.eede.t', d..lh.
---- ----.-
Sworn
. Ind subscribed be/o.. m.,
[Iil(eil/ (j
1 .)) 1'1' ./
.-
(I
1 19 97_
,
Ii ,r,. J~
FLORENCE W. lu.uto,.xXlifIl"lilIl<6'l4lt BARRET1'
'""'
I,t.. _-.--"
_~l'!.~~n~r i ve
Mechanicsburg, PA 17055
Add.."
Olt. 0/ D..fh
30th
O'Y
March
Mo.th
1996
v..,
INSTRUCTIONS
I. An inventory mUlt be filed within three months .fler Ippointm.nt 0/ pe"onll repr..enhllve.
2, A lupplemenf Inventory mu~I be filed within thirty days 01 discovery 0/ .ddlllonat .ssets, I
). Addillo';.1 sheels m.y b. a"aehed as fo ptrlon.lty or ..alty
~. S.. Article IV, Fiduciarill Act 01 1949.
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IF FSl'ATE IS NOr <nlI'lJ.dED, FILE A 6.12 FORM YEARLY UNITL cntPlEI'ION.
STATUS REPORT.UNP-ER RULE 6,12
Name of Decedent I RAYMOND H. BARRETT
Date of Deathl 03/30/96
Will No. Admin, No. 1996-00701
Pursuant to Rule 6,12 of the Supreme Court Orphans'
Court Rules, I report the followIng with respect to cOlllpletJ.on of
the administration of the above-captioned estate:
1. State whether administratIon ot the estate is compleu'l
Yes_1L- No__
2, If the answer is No, state when the personal
representative reasonably believes that the admInistratIon will be
complete I
3. If the answer to No.1 is Yes, state the followlngl
a, Old the personal representative fIle a final
account with the Court? Yes NO-1L-_
b, The separate Orphans' C'.>urtNo. (!fany) for
the personal representative's account iSI
c. Did the personal representative state an
account informally to the parties in interest? Yes x No
do Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court ilnd may be attached to this report.
Datel 1/16/97
C'.A-.~ ,_ d)" _
-0'~ y - J:~ "~~~)ojJ~
Signature
Ann E. Rhoads, Esquire
Name (Please type or print~
31 N. 2nd St., P. O. Box 11847
Harrisburg, PA 17108-1847
Address
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In':U.2;2 8 -17 31
Tel. No.
Cc:\(Jacity:
Personal Represental('""
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(~'rml9;AM3lli ~
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_x. ..Counsel for persona 1
representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXE$
!NHUHUHCf. TAX OII/ISION
flErT. 280(,01
HARRISBURG, PA 11l2/1'0601
NOTICE OF INIILRIlANCE TAM
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAM
DATE
ESTATE OF
DATE OF DEAn,
FILE NUMBER
COUNTY
ACN
Amau". t_:~mJj":=~="~-"""'J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..
R Eli: iS4"i" iif. A F 'Fi" ( OJ: 9'7 Y "No i''i c i.. ti ji. -IN Ii iii if A NC E - 'fAx "iip PRA- is i i'lENT"; -A L i.-owA 'fic E - ciA' - - - - -" - - -" -. - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
RAYMOND H FILE NO. 21 9(,-0701 ACN 101
ANN E RHOADS ESQ
CLECKNER & FEAREN
PO BOX 11847
HBG
PA 17108
ESTATE OF
BARRETT
TAM RF.TURN WAS I (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Estate (Schedule A)
2. stock. .nd Bonds (Soheduh 8)
~, Clo.ely Held Stock/Pertnersh1p Interest (Schedule C)
4. Hartg.g../Not.. Receivable IS~h.dul~ OJ
S. Cash/a.nk Deposits/Hisc. Personal Prop.r~y (Schedule E)
6. Jointly Owned Property (Sohedule f)
7. Transfers ISch~dul. G)
8. Tobl Au.ts
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.rel Exp8nsos/Adm. Costs/Miso. Expens80 (Schedule HI
10. nebh/Mods.g. U.bilHhs./Liens (Schedule Il
11. Tobl OeducHons
12. N.t V.lue of T8x Return
15. Ch.rttable/Governmant.l Bequests (Schedule J)
14. Net ValuB of Eshh SUbject to rex
If an assessment was issued previously, lines
reflect figures that include the total of abh
ASSESSMENT OF TAXI
IS. Amount of l in. 14
16. Amount of L ino 14
17. Alllount of Line 1(t
18. Princtpel Tax OUB
NOTEI
at Spousel
tax.blB et
hxebl. at
rat.
Lineel/Clasl A rat.
Collet.rBl/Clall 8 rat.
TAX CREDITS I
-.--.-..---.> ._~_._-------_._- >----------.---
PAYMENT RECEIPT DISCOUNT (.)
DATE NUHBER INTEREST/PEN PAID (-)
I~ -
ll)
(2 )
(3 )
(4 )
(5)_.
(6 )
( 7)
(9 )
1l0)
04-14-97
BARRETT
03-30-96
21 96-0701
CUM!lERLAND
101
) CIIANGED
.00
2,885.00
.00
,00
...J.Q.
.00
.00
(8)
4,320.00
.00
(11)
(12)
(13)
(14)
~*
Ilwlhl(1 AI' lOllll
RAYMOND
H
.OOX,OO.
.00 X .06.
.00M.15.
(18)
AMOUNT PAID
DATE
04-14-97
NOTEI To insure proper
credit to your ecoount}
submit the upper portion
of this form with your
tex ply",ent.
2,885.00
4.32000.
1,435.00-
.00
1,4~-
14, 15 and/or 16, 17 and 18 will
returns assessed to date.
(15)
(16)
117)
.00
.00
,00
.00
-'''''':''''0''''' t-= ~~~:,"-:.j
:tNj~NRCEESTOFAJDAXp-:NU.E - --~~~-~- =----:-~~-~J
TOTAL DUE .00
_ __ _ n___u_ _ ~--
, IF PAID AFTER DATE INDIC^TEO. SEE REVERSE
FOR CALCULATION OF ADDITION^L INTEREST.
If TOal. DUE IS LESS TH^N II, NO P^YMENT IS REQUIRED.
If TOaL DUE IS REFLECTED ^S ^ "CREDIT" (CR), YOU MAY BE DUE
^ REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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RESERVATION I Eshlt.. 01 doolidenh -dying Ofl or, bclfore D90ember 12, 1962 ~- H !Inyfuture Inhreit in the uht, I, transferred
In poslellion or enjoyment to Cl~ss 8 (oollateral) bon9ficlarina of the decedent "ft.r the expiratIon of any eltate for
life or for Ye~rl, the COMIlIOnWQIIlth hereby o)(prouly ruervGS tho right to apprlil"" and a15811& transfer Jnherlt&nco Tal(es
at the lawful Ciai'll 8 (r.ollatorall rlltw on An~/ such future Intorest,
PURPOSE OF
NOTICEl
To fulfUl the requirements; of Section 2140 of tho Inherlt~nc8 IInd Estata Tl;lx Act, Act 21 of I1J95. 02 P,S,
Seotion 91401.
PAYHENT I
Detach the top portion of this Notice ~nd sub~it with YOUr p8y~ent to thu Register af WJll1 printed on the reverse sid.,
--Hake oheck or mono... order p~Ytlb1e to I REGISTER OF' HILLS t AGENT
REfUND eCR)1
~ rafune of 1I ttiX credit, which was not requested on the Tm( Return, mey be req~IClSted by compl.ting an "ApplicBt1on
for Rofund of Pennsyl....anla Inheritance and Cstete Tax" (REV-1313l, APpUcstlons lIrallvellablo at the OHico
of th. Register of Wills, any of the 23 Re....enue D1striot OffJces, or by calling tho Bpecial 24Mhour
nnswerlng ser....ice numbers for form~ ordorlngl In Pennsylvania 1-800-362-2050, outsIde Penn~YlvanJa end
within local HarrhburlJ area (71ll 787-8094, TDOI! (71ll 772-2;':52 (Hearing Impaired Only),
OBJECTIONS I
Any party In Int8rest not satJsfied with the npprnlsamant, allowanoe or disal10wanoa of deductions, or ~ssessmont
of tax (lnoludlng dlscollnt Dr InteraGt) IIfl shown on this NotJce must ob,lflct withIn sIKh (flO> daysnf receipt of
thh Notice bYI
ADHIN
ISTRATIVE
CORRECT IONS I
"writtan protClSt to thlll PA DG~l!Irtmont of Re....enuo, Board of Appesls, Dept, 281021, HllrrisburSI PA 17128~1021, OR
--election to have tho mattar detormlnod at audit of the account of th9 p.rsonal representative, OR
Happeal to the Orphans' Court.
Factu&l errors cjiscovorod on this llSSOSSlIIont should be addressed In writln!tl tOI PA Department of Revenue,
Bureau of IndivIdual TOI(II&, ATTNI Post Assessment Revlbw Unit, nopt. 280601, HarriSburg, PA 17128-0601
Phone (717) 787~6S0S, See pago 5 of the booklElt "Instructions for Inher!ten()e Tal( Return for a Residant
Decadent" (REV-150I> for un e~pill"ation of ad~lnlstratlvely correotnble errors,
DISCOUtHI
If any t8l( due is p"'\d w.lth1l1 three (3) <JslIlndar 1II0"thl after the docedent's da!\th, a f1\1e peroent (5%) discount of
the tax paid Is ollowed,
PENAL TV:
Tho 1;% tal< aflll19l1ty non'p~rtJclpl!ltJon pona1ty I. cOllli311tod on tho total of the tal( and Intflrest aUll8led, l!Ind not
paid before January HI, 1996, the ~Jr&t day after the frtd of tt,o tal( amnesty periOd, This non-participation
penn 1 ty Is appulablo in thQ SlIllIe nl!lnnor rind In the the lIame t IlIIe per lod 81 yOU would appul tho tal< and Jntflr..t
that has been aSI.ssed as IndJcotad on thIs notJce,
INTEREST 1
Interest Is charged beginning with first d"y of dOllnquency, or nine (9) ~onthl Rnd cno (1) day frOM the'date of
dflath, to the dote of paYllflnt. Ta)(u whlch becAllIo delinquent bofortJ January I, 1982bll8r Interest at tho rate of
IlK (6%) percent per annUM caloutoted at e daUlI rat. of ,000IM, All tal<u whJah beoe_. delJnquont 0,1 and ftHer
January I, 1982 will bear Intarelt et 8 rate which will vary frolll oalendar year to calendar voar with that rat.
~nnounceu by tha PA OepArtlllont ot RflV8nue, The ~pplicable Interest rates for 1982 through lq97 are,
Y.2r !!tterelt !!!!! Dally Interest FMtor ~ Interest R8te Dally lntllrut FMtor
1982 20% .000548 1981 9% ,000247
1983 16% .000438 1988-19111 11% .000301
1984 11% ,000301 )992 9% ,000247
alii l!% ,OOO3S6 Iqq3-1994 1'1. ,00019'2
1986 lOX ,000274 1995~1997 9% ,000Z47
."tnter..t 1& calculflhd .. follows 1
INTEREST a BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~-~~y Notioe JSluad after tho tax becolllel delinquent will refloct ftn inter. It o"lculntJon to flfte.n (151 daYl
bl1yond the datlil of the "SOQ5nent, If p8Ylllent II mode nfter the lntorelt coftlllutatlon ditto lhown on ~he
Notice, nddltlon111 Interfllt MUlt bo clllculllt"d.