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(:IIHHmIWI.Allll III PI-NNSVIVANIA
III PMHHINI Of IH V~_NUI
l\lJRI AU Of INOIVllllJAt !AxIS
flIPI. ;'801,01
IlAR~[Sl\lJlW, f'A 1/11'8-0hOl
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REVISED NOTICE * * *
FILE
ACN
! DATE
__..L
NO, 21 , '7r.;." 70(.
96126732
Oa..27..96
TYPE OF ACCOUNT
EST, OF HARRY F MATTERN
S,S, NO, 169..10"2491
DATE OF DEATH 03-04-96
COUNTY CUMBERLAND
, I
l j SAVINGS
ii CI1ECKING
[ ] TRUST
IX.! CERTIF,
VIRGINI R COVALESKI
24 NANCY LN
ENOLA PA 17025
REMIT PAVMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS BANK ho. proyidod the OOPllrtmont with tho lnformntlon llstod balow'whloh hnG hCllln lilac! In oalculatlng thCl
llotontlnl till< due, Tholr roollrdli indicate thnt at tho dOlltt\ of tho "bOVl'I dQOlllhu\t, vou wero II joint ownor/bonoficlnry of this llccount,
If you fool this Infarllllltlon ls incorrect, 1110fl59 ohtnln wrlttof1 oorrectlon from tllo flnMelal lnstlt'ltlon, nttllcll 6 COI1V to ttll1l form
and return It to the llboVD nddress, This llccount Is tn.o<ablo In nccllrdnnc(l with the Inherltnnco TIlK lnwl of the Com",unwtllllth of Penn~ylvanlfl.
YUQstlons may Us llnswor80 bV cnlllng lflfl In"d~l',
COMPLETE PART 1 BELOW M M M SEE
Account No, 05-54-279960 Oah
Established
REVERSE SIDE FOR
12'23-93
FILING AND PAYMENT INSTRUCTIONS
Account Balance 10,009.26
Percant Taxable X 16,667
Amount Subjeot '~o Tax 1,668,24
Tax Rah X ,0(, d.~
Pohnllal Tax Duo If 11>.0, ':1..--2-5-0-,";'4
Mn TAXPAYER RESPONSE
rIll FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSES~ENT BASED ON THIS NOTICE I
To Insurll proper crad I t to your "CCQun t, two
(n 1;011105 of this flOtlllO must Ilccnml1mw vour
payment to tho Roglstor of Wills. Mllk8 chock
f1ilYflblo tOI "floglGtor of Wllls, Agont",
NOli:: If tflK flnyments Mil m"dll within throe
(~) nlonths of tho docedent's dllto of dOi1th,
'IOU mav (joclllct 11 1)% discOlmt of the I<lK dllO,
Anv [nIHlrlt/meo ta)( duo 11111 hoeomo dollnq\Hlnl
11[I1U (l)\ months nflor the dato of donth,
[..,..' C~Wl
BLOCK I
ONLY I
A. [J Tho abovo Information l1nd till( duo 15 corroet.
- 1, Vou may chon so to romlt pnY!TI9nt to tho ROlIlstM of WIlls with two cop Ins of this notleo to obtrdtl
a tJlGcolmt Of' IlVolcl Intor9st, or YOU Il1flV chOCk hall. "A" nnd ruturn this notlc;o to tho Rogl5tar of
Wills flnd nn offlc;\i1! ilSSoS5~lont will hl! 15~U(l(1 hv tho II^ lIopartment of RevenllQ.
a,IJ
c, [8
Tho f1hOV9 f'l550 t 11115 haon or will UQ ropor tod and tll)( Pi! hi with tho Pllr1nsy lvnnia Inllor I tnneo r ElK r'n hlrn
to 118 filed I1v tho doeQdont.s roprOsOiltiltlvD,
Tho nbovo Information 15 IncorroC'.t ,IndiaI' (Inht~ ,me! da(luctlons WClro pflld bv 'IOU,
Vou must cO"lpllltn PART U] Mellor PART (iJ 11010'0/,
~C' ".,
,', ~lcIA~"USE ONLVO AAF
PA DEPARTMENT OF REVENUE
PART If you indicat. a different ta~ rate, please $tat. your
i2'1 rolotlonshl~ to docodent: ,.... -:p,{I.-'lc!f-I,.f.f;.:L.,-,..,_...,-,_..
I__J
T^~ n~TURM . CCM~UT^TIO~ OF T^~ ~~! J~INT,'T~UST ^CCOU~TS
LINE I, Doh Establlshed I I), -:v s " 1.3
2. Account Bel line. 2 10 {/-T)t( , ,:J..4
3, Percent hl<abl. 3 )( , '; ~, h c,'I
4. Amount Subject tohx 4 / ~'fJ.;l4-
,
S. Debts and Deduotions S ~
6, Amount Taxoblo 6 / i.{., g, 2'{
7, Tax Rot. 7 X , o~
8, Tax Duo 8 4' IHJ, 0"1
--
PART DEBTS AND DEDUCTIONS
[3J
DATE
P'ID
1,-'
-~fl"r-------
'--,;.:;
1
2
3
4
5
6
1
8
CLAIMEp
I
,1'
-
t.....l
r=
TOTAL (Enter on Line S
of T8x Comput.tion)
AMOUNT
~
$
PAID
PAID
E
PAYEE
DESCRIPTION
Under penalti.ti1 of perjur)l, 1 dechre thet the facts I have r.portad aboy. lire tru., corT8ct and
complete to the best of my knawl.age and belief,
..1/1> C,J/"'Xd-<J(
WORK ( )
TELEPHONE NUMBER
~W.UL
HOME
--JifJ l_ ..;<~ I( ~~v<...c.. k<
ER SIGNATU E
GENERAL INFORMATION
1, FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT wllh llPllllcnhlo Illtorollt bOiled on Informfltlon
!lublllltted by the flnllnclllt Inlltltution,
2. lnhurltllnoo tox b9GOMlIS tJellnquuntnln8 months aftnr tll" tl'H1Qdont'~ datu of dOlllh.
5, II Jnlnt flCl(lcunl \, tllxl'lbla QVfln though ttlfl CIIHHHIQnt', ntl"IO WAil nddod nil n mattor of oonvMlnnc",
4. Aooounts (Irloluding thou h,,\<I tlohw..n huuhnnd and wifo) which tho {loondont put In jolnlIHlmfl5 within ono yellr prior to
death lIr61 fully tn><nbllll IIIi trllflllf'olrfl.
S, Aocounh IUhlbllllhllld jointly betwclIm hllllhrmd tltIrJ w\f" nlOrCl than CJnQ YOM prlor to dGllth llro not tnxlIblo.
6, A,oeauntl held by II dnoQdent "In trust for" "nather or aU,ors lIrfl In)(nble fully,
REPORTING INfTRUCTIONS . PART
1
- TAXPAVER RESPONSE
L RLOCK A " If tho lnfornllltlon and OOIllPutflt!on In tho flOtlOO llro r.orroot find doduotlons <lrO hot bolng olalmod, fJlaco an fI)(II
1n block "A" of PIH't I of the "T8xpn'lor Rosponso" 9ootlon. Sign two r.opla!llltld swtlmlt H1Elm with your c:"lDck for thQ ~llIo(Jnt of
tox to the Registor of Wills of tho county IndloalDd, fllQ flA Oopnrtlllont of RovenuQ will JsSUD on offloial lIU'olumont
(Form REV~I548 EX) \11101\ recelp~ of the return froll\ tho Roglstar of Wills.
2. aLOCK B ~ If tho f1flS8t SP8cIfIQ~ on till!; notica illiG bOlm or will bo roportad and tll>: plIld with tha Ponns'Ilv!lOla Inhoritance
Tox RAturrl filed bv tho d8codont's nmr8sontatlvo, plnco nn "X" In block "a" of 11nrt 1 of the "TaxPlIYor Response" section. Stgn On8
OOPy line! roturn to the PA Depllrtmcmt of RovonuQI Ihlrollu of Indlvldul'll TlIxos, Oopt 7.80601, HlIrrlsburg, PA 17128-0601 In thll
onvelope provided.
3. BLOCK C " If the notice Informntlon Is Incorroct lInd/or deduotlons lIro baing cll'lJmed, chock block "c" lInd complete flort9 2 and 3
1'I()t'nr..1rolJ tn thfl In..trlfotlfHl!1 hlllnlol. ~Ign tloln cnr1fl9 anri !lubllllt thalli with vour chQt'J... for thq ;'l"'nl!rlt (\f tAl< pl'lYl'lh1fl to thfl RCl1lo;tqr
of 100011s of the oounty Jndlollted. Tho PA Deportmont of Rovonue will Issue an offlclnl asse!lSmant (Form REV"IS4& EX) upon reoolpt
of the raturn from the Reglstor of Wills.
TAX RETURN - PART
2
TAX COMPUTATION
LINE
1. Entor
NOTEt
tho date the account orlglnully was ost~bllshnd or titlod in th8 m8nnor Qxlsting at do to of donth.
For 8 decedent d'lln; aftClr lU1U6Z: Aocounts whloh tho deQ{ldont put In joint n8mlaS within 01'0 (1) YOllr of dGllth are
tllxoble fuLly fI9 trlln9fClrs. Howoval', thE!rQ is E1n ol<cluslon f'C1t to oxoflod 53,000 IHlr transforml /'oQQrdIClllll of thCl vl!Ilue of
thea account or thea numb~H of Mcolmts hold.
If 1'1 double nstQrhk (1111) appears beforo your fIrst namE! In tho llddrosll porUon of thts notloQ, tho $3,000 Qxclulilon
nlrCl8dy hos btum deduclod frolll tho nccollnt t'llllanco l'I!l rClportod by thCl financIal Institution.
2. Enter the totlll bahmca of the account IncludIng IntorQ!lt Mcruod to tho data of d'lath,
3. Th8 percClnt of the lICCOllnt th8t Is tn>:Bble for o8ch survivor Is dote,'"linad <Is f\lUoWSI
II. The percent taxable for joint n~~C1ts established more than ono year prior to the denedQnt's denthl
DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
EX8mplal A joint as~et rClulsterud
DIVIDED BV TOTAL NUHHER OF X 100 ~ PERCENT TAXABLE
SURVIVINO JOINT OWNERS
1n the n~m8 of tho deoedont lInd two othDr pDrsons,
1 DI....IDED av '3 (JOINT OWNERS) DIVIOf.D BV ? (SURVIVORS) . .167
100
16.7% (TAXABLE FOR EACH SURVIVOR)
B. The porcClnt taxablo for 8ssets croated within one '1ear of thCl decodont'll doath or ac~ountll o~nod by the deoedent but hfld
1n trult for anothllr Ind1vldual(s) (truft't beneflclllriu)1
1 DIVIDED BY TOTAL HljMBER OF SURVIVING JOINT
OWNERS OR IRUST BENF.FICIARIES
X 100 .. PERCENT TAXABLE
rxa~plel Joint aocount reglsterod
the decltQen t.
1 DIVIDED DY 7. (SURVIVORS) A .SO
1n thn nAmo of thn decenent and two other persons and utllbUshed within one year of death by
)( 100
!i0% (TAXABLE FOR EACll SURVIVOR)
4. The afllount subject tc tax Olno (11 Is dClter~Jned by multiplying the account bslnnco (line 2) by tho percent taxablB (line 3).
5, Enter th~ total of the debts and deductions Il!ltCld in Purt 3.
6. Thll IImount taxsbls nino 61 Is dotormlnod hy SUbtracting tho debts ana deductions i line .'JJ trom the lImount subJect to tttX \11ne tjJ.
7, Entor tho Bpproprlato tOl< r8te (line 7) as determined balow.
A, For datu of dellth Qocur'rlng 8Hor 6/30/94, the tllx nltofl for transfef'S to spauliQs are flS follows:
1. Dates of dll8th on or lIftllr 711/94 nnd bofol'o 1/1/95 the rotD Is 3%.
2, Datos of death on or after 1/1/95 trllnsfers to spousos will bo tllXCld at 0% tax rate.
Nota: For ~at8li of de!lth prior to 711194 trllnsfors to SpOUSOll llrCl tllx8bla lit 6%.
8. Tr!lnsfQrs to Ilnelll ducondllnts Including fllthor, mothor, son, dllughtor, grnndClhlldren, son-In-law,
d!luOhter-ln-hlw, stepChild al1d their Illsua llro tnxllbh at six porcont (6%),
C, Transhrs to niL others inclUding brothor, r;lstor, lInch. lIunt, mlflhew 8nd nloot! Me tllxRble lit fifteen porcflnt (lEiin.
D. If YOIl change the tax rilla, phMO spoclfy your rntatlonshJp to the d80edent In tho nr,," provided,
6. The a"'ount of tax dUQ (J Ino 81 III doterlllll1Cld by mwl tlplY!ng the flIIIolln~ tll)(lIble (line 61 by tho tl'lX rete (l1no 7l.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
AlloWflbl9 d9bh lInd deduotlons /lrO detornllned 8S folloWlll
A, Vou 1.901hl ar. rCIBponlllble for pAyment, 0/' tho ostnto sUbj8r.t to ndl1llnlstrntlon hy fl porsol1nl rCPr4lsanhtth.." It Insufficient
to pay the dedllotlhlo It8mll.
B. Vou fto\ul'll1y pl'lld the debts "ftor d(l8th of thn docoe/ent !'lnt! can fllrnlsh proof of PII'IIIICHlt,
C. Dobh being olalmed must he ltomlzod fllll~' In 118rt 3, If <'lddltlonnl spnco Is n"ndod, wle /llllln pnpor ft Ill" x 11". Proof of
t1aymont may hs rllquelltod by t111t PA nepnrtmClnt of Jlovmu/O,
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 INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327, TDDI (717) 772-2252 (HEARING IMPAIRED ONLVl
PURPOSE OF
NOTICE I
f1AVHEHTI
REFUND (CR):
t)
C
-ii,
Ta fuff111 the rllqulrliWlenh ofSeoUon 21(10 Of th. Inhllrltnnoe and E9hte lax'Act! Act 22 of 1991. <72 P,S,
!ieotlon 2140);
Dlteoh the top portIon of thIs Notloe end lub_it wlthyour paYMlnt to the RegIster of WIlt, prlnted on the
roversl side,
~~ Meke chlok or .oney order Pftyftblo tOI REGISTER OF WILLS, AGENT,
All PftYllenh reoeIved shall flrllt be appll~d to MY Interest whtoh 'lUIY bll dUll, wJth IIny reMsInder sppl1ed to the tftx.
A refUlld of II hl( or.dJ....! which w". not rGquClltnd on the tax return, may bEl request"d by (loJlpletJng 9n "AppUoetlon
for Rofund of PennflYlv~nlfl Inheritance find EstntQ Tax" (REV-Ul3)' ^ppllcat1onli <lrO llvnllftbh at the OffiCII of
the Reghter of Hills, any of the {.3 RllYllnUEI Illstrlot Offlo8t or by colting the speoial 24-hour ant;werlng urvloll
nu.bera for formG orderlngl In P8nn!~lvnnla 1-800-362'2050, outslde Pllnns~lv8nlll and within local
Harrisburg arn (717) "187-8094, TOOf (17) 772-l252 Oiollrlng ImpalrDd Only).
OBJFC'l'IONS: Any part'lf in Inhlrest not satlsjlhd with thn apprrtlsOlllunt, llllDwa/'lOo or dlsflllownnco of deductions or auelllllent
of tax (IncludIng dhcount or lntor~f1tl 81 shown on thls Not.lce fillY Objllct within sIxty (60) days of rooelpt oi
this NoticI bYI
.~wrltten protest to the PA Departlllent of Revllnuo, Boord of Appaa19, nlpl. 281021, tlarrlsburg, PA HI28-l0ll, OR
--1I1ectin; to have tho IIlnttor dQtor~lned nt the nudit of the account of the porsonlll rlpresentlltlv8, OR
~~apPu8l to the Orphans' CQurt
ADMIN-
ISTRATIVE
CORRECTIONS I
DISCOUNT:
PENAlTVl
INTERESTl
Faotual errors dhcovllred on thili aS5USlII8nt shoulLl be addressed in writing tOI PA Oeparhlent of Revenue,
Bureau of IndJ...ldual Tl!lxu, ATTNI Post ASlelSJIent Rnvlllw Unit, DEPT. 230601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. SII. page S of the booklot ~Inltructlont for Inheritance Tax Rllturn for II Resident
O.elldent" (REV~lSOl) for .!In C1xphllf'lation of adlllnlstratlvolY correotable errors,
Ii ony tax due Is peld within thrOB (31 celondar 1ll0nttl' ofter tho deelldent's death, fI I-lvo percent (S;O
dIscount of the tax paid 15 allowed,
The 15% hlx IIl11nest)" norrpertlc:lpatlon pOl'\fllty II cQIIPuted on the to\81 of tho tax 8nd IntGrlllt 81S8S lIOd , !lnd not
paid b.forll Janunry 18, 19961 the fIrst day nfter the end of the tax llllnesty periOd. This non-partlcIplltlon
penalty I. Hppe!lltnblo In tho sallie mnnner and in the the salll time pllrlod 88 YOU would Appeal thll tal< and Intlr..t
that hel bean allulled ft! Indloated on this not 1011,
Intllr~st I. charged begInning with first day of dellnq~encv, or nine (9) month. and one (1) day
fro. tho datil of cloath, to the date of PIIYlltlnt. Tax.. whlohboCflllle delinquent bllforll Januar)" 11 1982
bur Interest at the rllte of six (61:) percent per annulll calculated lit a d811~ ratu of .000164.
Atl tllxeu which buo"Me dollnquent on or after Januar)" I, 1982 will boar Interest at a ratQ which 101111 vftry fro.
oalendar year to catendllr )"ear wIth thnt rntll announoed by tho PA Department of ReVlnuu. Thll applioable
Interllst rates for 1982 through 1996 arel
Yoar lnhrut Rate 01111)' Interest FtlCtor Veal' Internt R!I\Q O!llly Interut Factor
--
1?82 lOX ,000548 1987 9% ,000247
1985 1Ii% .000<t38 1988-1991 11% .000301
1984 11% .000301 1992 9% .0002'47
1985 13% ,OOO3!it>> 1993-\994 7% ,000192
1986 10% ,000274 1995~1996 9% ,000241
--Intilrelt I. clllculftted .. folloWl1
INTEREBT = BALANCE OF TAX UNPAID X NUHBER OF DAYB DELINQUENT X DAILY INTEREBT FACTOR
-"Any Nc\l(llli ll1u~d lIftllr the tal( blloc... dellnqulmt wl.\l reflect 8n InturClct cl'lleulatlon to fifteen (151 dI'JY'
beyond the date o~ thll t'lllelllllenl. If pay.tlnt 11 Mild. IIftllr the Interut c;olllput"tlon dfth fihown on the
Notice, addltlonr.l Intor8ct must be crdoulatecl.