HomeMy WebLinkAbout96-00718
f I
INHERITANCE TAX RETURN jk~~:.;n.~~.};~'D.D,;~,::~:.'T:::I;191CHICKHIRI
RESIDENT DECEDENT flU NUMBER -----1--
COMMONWEALTH 01 PENN'YlVANIA (TO BE FILED IN DUPLICATE ,'),.1 II f ') ) I
DEPARTMENT Of REVENUE f.O
OEPl 280601 WITH REGISTER OF WILLS)
HARRI58U~O, P...._!712fl,0601 .",..,......___n~~_... .....,,,. .,... ,...___ _ ___ cg.~!.~_T_~._~gp_E._.." .._..YEAR .... tlUMBE~
DECEDeNT'S NAME (l....r.l, fill!.!. AND MIDDLE INiTiAl! -.--,-------.---.-.....- DECfDEN!'5 COMPlETE ,.I-00RE!.!.
Strick1pr, Elhpl B. 206 Messiah Vi11agp
~ sOc~A~'~C~.~'~~~i~'6~'~~'-1D~i:~'~,~~-~-T'i'r5iOi"fil...-- r.,,,,~e~:~~~~~:~~:g, PA 17055
~ i'" .."<WiiTui~oo.,-,;;;.;;iI=-;;;O;;;6"i-,~,."--fsOCl,,i."CUR,-ii,~::" ~ 1'MOUNT RECElvEO I'" 'NSlRUCTIONSI
~ T[l Orlgmal Return n 2. Supplemental Rewrn r~ 3 Remainder Rerum
x:$ VJ (for dale5 01 death prior to 12- 13.82)
frl f ~ [] A. llmiled E$tote [J 40 Future Interes! Compromise 0 5 Federal Estate To}:; ReflJrn Required
5 ~ 9 (for dOle~ of death after 12.12.82)
t CIO 0 6 Decedent Died Testate C 7 Docedent Maintained 0 LIving Trus/ _ 8 TOlal Number of Safe DepoSit Boxes
.. I IAoach copy af Will} (Anach copy af Tru.'1
ALL CORRESPONDENCil AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO,' H j;:')'.f.~,,) vfJ :'
NAME ~ I~PteTE ,'MolllNO ADORESS
Larine E. Strick1p., ! 202 Harrisburg Pike
Im,,"oN'NUM""- i Di11sburg, PA 17019
I {717.J 417-'1071 I
If line 19 i. greater tnan lintt 18, enter Ihe difference on line 20, This is the OVERPAYMENT.
aD
121 If Line 18 is great'!!r than Une 19, {Inter tne diffflrencfI on Line 21 This is the TAX DUE,
A, Erller the interest on the balance due on Line 21 A.
B. Erlllr Ine totell 01 line 21 and 21A orl Line 218, This illhe BALANCE: DUE.
L Mak. Ch,c~ Payable to: Reglater of Wlll., Av,nt
.P~~-'lI!:~!tB! $URETP.AN$WER'ALL'QUESTlONS Qri~EVERSE SIDE AND To~ii:HECK M.lTJI~tS~_
~~der penalli" 01 perjury, ! declare tnot I have exomined thil r",turn, induding accompany'ing 1ch{ldule5 and 1latements, and to the best of my knowledge ond b,eliel,
II II true, corr0ct and complete. I dedare tnol all real ISlalt hos bun reporled ot true mmket valve Dedarolion of praparer other tnon the pononal repre1entallve is
~cn.d on allirlformollon of~, i<h..pl,', .;.;;,r ~Ol any knowl.dge.
510NATU, 0' P!R&ON RP~ON5!,*,f.1{)1t fill ~---;~___..a___~_ DATE
~-<-"'" l. ,.),/'.", "C/ . .' )'7019 '! 'I (,:(.
_ r.ClrLD.e....E.~Strickler 20}, HarLlsburq I'lke, Dillsburg, P^ ' __<
SIGNATURE 0' 'lIfPAiUR otHU THAN ItfPU5fNT,l,IIVE AOOllfS5
IH:V.1500 EX+ 17.Q4!
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1. Real E,tote (Schedul~ A)
2. Stock$ end Bonds (Schedule B)
3. Closely Held Stock/Portnlmhlp Interesl (Sc.nedule C)
4. Mortgages and Noles Receivable [Schedule Ol
5. Ca~h, Bonk Deposih & Miscellaneous Personal Property
IS,h.dul. E)
6. Jointly OWMd Property (Schedule F)
7, Trans/er. [Sch.dule 0) {Sch.dul. l)
S. Total Gron Assets (tolol lines 1.7)
I 9. Funer("ll Expenses, Administrative COSh, Mlsc:slloneous
Exp.ns.. {Schedule HI
10, Debls, Mor/gage liabilities, Liens (Schedule I)
11, T 0101 Deductions Ito/allinG$ 9 & 10)
12. Nel Volue of Estate (linl'l 8 minus Une 11)
1 J. Cnaritable and Governmental Bequests (Schedvle J)
Net yalue Subjed to Tax (Line 12 minvs Line 13)
Spoulol Tronsfers (for dales of death after 6.30.94)
See Instructions for Applicable Percentage on Reverse
Side. (Indude values from Schedule K or Schedule M.l
Amount of line 14 taxable at 6% rOl&
(Includ. values from Schedule K or Schedule M,l
Amount of line 1 A taxablo Of 15% role
(Include values from Sched~jle K or Sch&dule M.l
Principal tal< due (Add tax from lines 15, 16 and 17,1
Credil' Spousal PO'forty Credit Prior PaymenlS
,,~ ---- +
14.
15,
16,
17,
z
to
S 19.
i: 19,
:II
'"
u
~ 20,
....
[ I I ____..Q_.O,Q.._....
121 _.. 0.00
131 __iL..Q..Q__
141 0.00
(S) 0.00
(6} 3.915.0.7
{7} 0.00
3,915.07
19 }
19) 'i 200.00
(101
0.00
Ill! 5,200.00
{121 ....:..L..284. 93
113} 0.00
{141 0.00
0.00
[151
X._1a
116}
x .06 = 0.00
X ,15 = 0.00
(19) 0.00
1191 0.00
120} 0.00
1171
Discounl
Intflrest
Check here if you ore requesting (J r~fund of your overpayment:.
(211
(2IA}
[21 B)
0.00
0.00
0.00
DATE
"V.1JIl tll:. (1,",
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pt. a.. Print 0' Typo
_I FILE NUMBER
;),1- 9~" ) If
COMMONWUlJH 0' PfNNSYtyANI...
INHERITANce TAX "arUNN
A!SICeNT oeceoeNT
ESTATE OF
Ethel B. Strickler
ITEM I
NUMBER
DESCRIPTION
AMOUNT
1.
I Fun.,al Exp.n....
I Cocklin Funeral HomE'
$5,200.00
A.
B.
I
I
I
I
: Admini.t,ativ. Coot..
1.
Pers.onal Repre!en!a!I"e Commllllonl
Social Security Number of .Personal Repre!en!a!I".,
Year Commluian! paid
2, AHornev Fee!
J, Fomily Exemption
Clalman!
Addreu or Clalman! ot decedent's dea!M
Street Addreu
RelatioMhlp
City State Zip Code
I
4, I
I Probate Fee!
C. I Mllcallan.aul Exp",n""l
1. I
2, I
I
I
3, I
I
I
4, I
5,
6.
7,
8.
TOTAL (Also ent.r on IIno 9, Recapltulatlanl :S 5,200.00
(If mo,. spac. II "..d.d, In...n additional sh..t. of sam. Ilz..)
u....I~()qu.(Htll l J
COMMONW,^"" 01 """"'''"'' SCHEDULE F
'"'~','\',~~'~\'o;~'r:I~~'" JOINTLY -OWNED PROPERTY
EST:;Eh:.l ~~- St ri~kle';- _~,=-=~___~,= ~~~~= n. __h='._''=-r'LE ~l~E~~~~JL!=~n
Joint '.nonl(.I,
----"
NAME
-~------- ----
A, Lorine E. Strickler
_,_,___ADDR~____
202 Harrisburg Pike
Dillsburg, PA 17019
_.
RELATIONSHIP TO DEC.~!>!I'!T
Son
8,
C,
Jolntly.own.d prop.rty'
-~. L~g~R DATE .
TOTAL VALUE DECO'S DOLLAR VAL
NUMBER JOINT MADE DESCRI PTION OP PROPERTY OP ASSET % INT, DECEDENT'S IN
TENANT JOINT
.---
1. A 7/24191 PNC Bank N/A $7,830.14 50% $3,915.0
Acct # 5140472803
.
.
,
.
,
TOTAL IAllo .nl.r on IIn. 6, R.c.pitolotlonl $ 3.1l.5 .
-
UE OF
TEREST
7
07
(II m.r. 'poco i, n..d.d inlOrt oddU,onol ,h.. " of ,om. ,i..)
COMMONWEAL TH Of PENNSVl~ANIA
OEPARTMEHi OF REVENUE
BUREAU OF INDIVIDUAL TAIlES
OEPT, :!8060 1
HARRl::';IURG, PA Ilia-ObOl
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 2 1 '/I; ~ I g
96129202
08-14-96
lIV'l'~1 n ,,, (/.,u I
EST, OF ETHEL B STRICKLER
S,S, NO, 181-10-1062
DATE OF DEATH 11-30-95
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[J SAVINGS
IX] CHECKING
D TRUST
CERTlF.
LORINE E STRICKLER
202 HARRISBURG PIKE
O!LLSBURG PA 17019
REMIT PAVMENT AND FORMS TO:
REGISTER OF ~ILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK hu provided the Departllllnt liIlth th'e In40':lI8tJon Ilshd"Dlllow. lolhlch hllll bun und In calculating the
potllntlal talC due. Their rllCOrCl!l Indicate that at thll death 04 tho :,ooye dlloedent, you IolQrll , joint ownllr/benIlHciar'J of thjs ~ccount.
II you '11111 this InlorllaUon Is Incorrect, pluse ootaln lolrltte" correction frolll thll financial Institution, 3ttacn 1 copy to this forTII
"~nr1 r",tllrn l~ tn the i'lhnvo addre... ThIll aocount Is talOlltll. In accordance with the Inne,.ltllnQIl Tax La"" of tha Co,""on"'Il/llth of PonnsvlYMlla.
Question, aay be an.","rld by cal1Jno (717) 787.83~7,
COMPLETE PART 1 BELOW . . . SEE
Accoun't No.
5140472803
o.'t.
E~tabl!sh.d
REVERSE SIDE FOR
07-24-91
FI~ING AND PAYMENT INSTRUCTIONS
Accoun't Balance
Percent Taxabh
Amount SUbjec't to
Tax "lIh
Po't.nt!al Tax Du.
x
7,830,14
50,000
3,915,07
,06
234,90
To IMU'" proPliIr r:rllol t to your )ccount, t\040
12) cop lis 04 this notlcliI 'ust llccolllP<'Iny :Jour
paymlilr1t to thG~lghter of "Ills, H8~e cnllCf<.
payauLIl tOl ""'lgi5ar 04 Wills, Agent",
x
NOTE. If tax paYl'llents are 'IIede ~Ithjn throll
{3l llIanths of thQ ollcllaent'. dato 04 alilth,
YOY'IIfty dlduct II 5% discount 04 the tllX duo.
Any Inher I tane. tax t1UII ~ J 1\ ollco"e dll Inq\lon t
nine (';ll months aHer th. iJllte of (jut",
Tax
PART
'1i1
- FAILURE TO RESPOND WIL~
TAXPAYER RESPONSE
RESU~T IN AN OFFICIA: TAX ASSESSMENT BASED ON THIS NOTICE""]
CHECK
ONE
BLOCK
ONLY
A. Thll abcl/II lnforllation ,1nc:l t3X dY. is corre<:t.
-- 1. Vou I118Y cnoose to r"..it pay.llnt to !hll Register 04 Will!! iollth two coplu of this notlCI to obtain
i!l disc;oynt or al/oid tntlrut, or Y1H"ay chicK bo)( "Art and retyrn this notlcl to the HlIgistar of
Wills and an oHicllll Hun.ent iolill be ISRUld by the PA DI~ftrtl1ent IJf ~\lY.nu.,
IL Thll i1bOYII aS311t hall olle., or 01111 b8 rOJ'$orted and ta)( paid with thll Pennsylvania !nnerltanclI Tax rllturn
to be filed by thll decedllnt'i roprllSllntativfl,
C. Thll aboYI In40rlllllt Ion Is incorrect and/or dlbts and deductions iollra paid by YOy,
'-' You I1U\lt cO_Jllllt" PART ! 2 ana/or PARI ~ below.
PART
i21
If yo~ Jnd!ca'te a di1feren't tax ra'te, ple.s. s'ta't. your
relationship to decedent:
OFFIC!A~ USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
TAA ;\i;:T:.ii\N - CCiiiFUTAiION OF iAi: or; JOIrfi /-jRUSi ACCOUNTS PAD
lINE 1. o,tft Es'tabl!sh.d 1 1
2, Accoun't BalancI 2 2
3, Percent fixable 3 X 3
4, Anount Subject to Tax 4 4
5, Debts and Deductions 5 5
6, ^nount Taxable 6 6 --
], Tax Rah ] X 7
8, Tax DUI 8 I 8
PART DEBTS AND DEDLlCTIONS CL.AIMED
,31
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on line S of r.. Co.put.tion)
I
,
'<="
Under penal tie. of Plrjyry, I dlclare tn.t the facts I haye reported aboYI are true, carrec't and
co~pl.te to the b..t of ny knowledge and bal!ef,
HOME (
WORK (
TEL EPHONE
)
)
NUMBER
DATE
TAXPAYER SIGNATURE
GENERAL INFORMATION
1, FAILURE TO RESPOND HILL RESULT IN AN OHICIAL TAX ASSESSMENT ..lth applicable lnt.rut baud on InlQr~l!Itlon
tub.Jtttd by the flntrlcl.l It\ltltutlon.
Z. Inh.,ltane. tax blea... dlilnq\Jlnt ,.,1". rIIonlh. Ilfht,. th" dlc.d.nt's dllt. of duth,
l, " joint lIocount Is hxatd, .....n though the dle.d.nt', !'HI" Will <1ddlld III ,l "atter of conv.nlllnCII,
(I, Account. (Inoludlng thou hllet b.tw.." huuband <1nd wi,.) IolhJoh tnll decadent put In joint nUlt OIlthln tine yur prior to
auth Ir. r\lUy taJICabt. at tranlfers.
S. Account. established jointlY betw..n husband and wlf. lore than on. yenr prior to duath are not \oxllbll.
6. Ac;countl haLd by II dludent "In trUlt 'or" anothlr or other. are t/ll)lable fullv.
REPORTING INSTRUCTIONS . PART
1
TAXPAYER RESPONSE
I. SlOCK... If the InforutJon and co.putatlon in the notice /Ire corr.ct .lnd dflductlnns lr-A not bllng clalll8d, pla~e an "X"
In block "A" of Part 1 of the "TalCpIlV8r Ruponu" section. SIgn two caPlU tlrlCl 1ljbllllt th.. "11th vour cneck for the ..ount of
talC to tll, Raghtu of WIlh of th. county indlcatlld. Tht PA Ollpartl'uHlt of RevlInue witl ISlu~ an officiaL auelu.nt
(For. REV~lS4a E)O upon rlclipt of thl return Irolll the Register of Wills.
/,
BlOCI( ! . H the IIl1sot speclfilld on thi!l notice r'las bun UI' _ill bll rwpartDd
TalC Return fl10d by the dlctdlnt'~ rlPrnllQntlltlvta, pLaell 1" ~)(" In block "8"
copy and r.turn to the PA DllPartlulnt of Rnvllnul, Burellu of Ind\l.lidulll ral<llS,
I"vllop. provided. ."
.1lld tal< paid
of Part I of
lIep t ~80bO 1 ,
with the ~Ilnnsylvanill Inhttrltanco
the "Ta)(PlIyar Responoe" seotlon.
Harrlsburll, PA \71~B.'0601 In the
Sign ana
:-
3. BLOCK C - U tht notice in/arllletion Is IIl(';orrltct and/ol. deductions IIrlt being olaImlld, ctle~k bLock "C" and ~o.pleto Pl'lrtl Z IJnd 3
..".;;.;'.:Iln,; to U',: lr,:1ti...;~lci,J ::'.~J.I, :~a~l ~..'~ J:l;.:l~3 :nd ~>;::'::li~ ~r,:;;; ~i~:\ ~;..lJr ..r,:::: ;:,. U",. :l;';lo~n~ ::If t:lfl "="J:lbl:l to ~:-;: .'~;~;:::1"
of 1041111 of the county Indicated. The PA Dapartllant 01 Rel/unue will l$lua /In olllclal IIssass"umt (~ar" REV.1S48 EKl upon raaejpt
of the return fro~ thl RIGister 01 Wills.
TAX RETURN - PART
2
TAX COMPIITATION
LINE
1. gntar
NOTE:
thll date tha account originally Olas utttblished or titllld In the IlI11Mllr lIlCiAtln!l 'It oat. 01 dtl\th.
For a dacadent dvinG "Har lU12l8~: ",cc:ounts ..nlet, tha dacltllnt put In Joint namll9 ..IUlln onl (ll ,/IU.,. of death are
talC8bla fully olS trans1art, HOWaVltr, thtrlt Is .In lll<cJusion not to lIl<Clllld B,OOO pClr tr3hsferu rClGardlus af tha '1811.11 !l1
tha account ur the nYID.r of accounts ~.la.
If a dOyblo astlrlSk (1111) ''}PI'urs bofore :tour first na.a In the -"ddrGAS portion 01 thl, notlcl, thl '3,JDO elCchnlon
alr.ady hu bllln dtductltd fro. the aocount ba!lInce all raportlld bv tho flnllnc:lal Institution,
Enter the total blllnnclI of th. account lnoll/cllng lnt,rut accruld to th. data 01 duth,
Th" perce...t 01 the account that Is ta:.-abll1 for' each survlVllr Is doterllinlld as foLlowll:
A. fhe p.rcent talCable for joint Is.ets It.tabljshed liar a than ont year prior to tho daeedent's doath:
I.
DIVIDED BY TOTAL NU"BER OF
JOINT OWNERS
ElC18ple: "' jo Int alnt roghhrld
OllJIDED BY TOTAL HUMBER CF X 1DO PERCENT TAXABLE
SURVIVINC JOINT OWNERS
in tha na.o 01 thll aecadllnt and two other ~lIrsons.
1 DIVIDED BV 3 (JOINT OWNERSl OIvIDED BY Z (SURVIVORS) .. ,167 X 100
16,7% (TAXABLE FOR EACH SURlJIVORl
8. Th. percent talCabl. for Ilsats croatQd within one yQar of tht dacedent" death or 3cc~unt' owned by the decedent but hltld
in trust for anothar Indi...iduaJ(sJ {trust beneflciarlul:
1 DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARICS
100
~ERCENT TAXABLE
ElCl~lel Joint Iccount rllghtClrld In tho /'Ia.. 01 the decodent <'InCI two other j)orson, and astatlllsned ...Jthln anI year af dlath 0'1
thl d.ceuen t,
1 DIlJIDED BV 2 (SURVIVORS) . .50 )( 100 50% (TAXABLE FOR EACH SURVIVOR)
It. The 81lOunt 'ubject to talt (Une 4) II detllrlllinld by lIuItlphlng thl ilcl:ount balance Oin. Zl by the percent ta)Cabh (line ]).
S. Ent.r the total of the debt, and dlductians 11lted in Part 3.
6. The Ht'Unt tllCabll 01nl 6) 11 deter.ined by subtractjng the dltbts Ind dltductJonl (llnll Sl fro. the allount subjclIlt to talt ll1ne 101.
7. Entlr the appropriate talt rite (Une 7) II deter,in8d below,
A. For dates of dlath oocurrlng aHe,. 6/30/CJr., tho tAX ratu 10r tran,fer'! to spous.. ar. lIS folloWl1
1. Datu of death on or IH.,. 1I1/9r. and b,for. 1/1.'95 the rate Is 3%,
Z. Oat.. of d."th on or after 1/1/95 tranlf.,.s to !lOOl/US will be talCld at 0% tllx ratD.
Hot.: For aat.. of death prior to 7/1/94 tranlfar, to spOUlle. ara talCable at 6%.
B. Tran.flr, to Un..l due'nalntl InclUding fath.r, lIothlr, :lion, daughtllr, grandehIldren, son~Jn.law,
d8u;hter-ln-Ia", stepchlld and their luue are talCable at six plrcent (6%),
C. Tranlf,r. to 811 other. InClludlng brother, slstlr, \lnoh, 1J~lnt, napntw llnd niece ar. taxable at Ilfteln parmmt (15%).
O. If you change thlll tax ratl, phlln sPlcih YO~1r relationlhjp to the dDcodent In th. IIrQa j)rovided.
~
.,
t
a. The a.ount 01 taM dYI (lin. al II d.terlllned by lIuJtiplvjng the a.ount talCoblll {line oj by the talC ratl (11n. 71.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allow.bll dlbt. and deductions are dlt.rlllnea III follow,:
A, You iegllllh .,.e r..ponsibh for pay.ent, or the ",tut, SLJbj~ct to Jd,Jnlstrlltion by' parsonal rlpruentatlvl It InluHlcl'nt
to pay the deductJbIt it..s.
8. YOll actually paja the derus lifter dflllth of the d~.a.nt ana can lurnish proo1 of paYllent,
C. Debtl bling chi.ed IlIUSt be Ite.Jud fUlly in Put L If IIddltional space Is n..dld, un plltln paper 8 In" Ii 11", pro01:1f
~Iy"nt Illy 0. r.quuted by the p, Oeplt/'hent uf ~lIvenl.le.
TAXPAYER ASSrSTA~CE
IF YOU ~EED FURTHER I~FORMATIO~ OR ASSISTANCE, CONTACT ANV
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, TDDt (717) 772-2252 (HEARING IMPAIRED ONLY)
'/'1' 0
;,5' 'I,) - 7
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
8UREAU OF INDIVIDUAL TAXES
INItERtTANCf: 'lAX OIVISIOf'I
DU'I.2801101
IIARRtSBLJRG, P^ 1:'...d-OuOI
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-19-96
STRICKLER
11-30-95
21 96-0718
CUMBERLAND
101
LORINE E STRICKLER
202 HARRISBURG PIKE
DILLSBURG PA 17019
( '/
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'{~,Ihl f.l If' nl-Hl
ETHEL
8
I.~'_- A~~U~i.~~If~.~~:=::::l
[ ...uu..u_._ . .J
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG TMIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iIEV: E;iii- Eif"AFi>" fO;-:m--NCificr -oli- YNHEiiif ANCE - TAX - 'A-PPR'A is Ei'lENr; - ,m:liwANcE - ciii--" - - - -- -- - -, - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STRICKLER ETHEL 8 FILE NO. 21 96-0718 ACN 101 DATE 11-19-96
TAX RETURN WAS, (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. (Schedule Al
2. Stock:ll and Bonda (Schedlll. 8)
3. Clos.ly Held stock/Partnership Int.rest (Schedule C)
4. Mortgaa../Not.. Raceivable (Schedule DJ
5. C..h/Bank Deposits/Hisc. Parsonal Property (Schedule E)
6. Jointly Owned Property (Schedule f)
7. Transfars (Schedule G)
8. Total As..t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
q, Funer.l Exp.nsa./Ad~. COlts/Hi.c. Expensas (Schedule H)
10. Debh/Hodgage LbbUi'ths/thn, (Schedule 1)
11. Total Daduotion.
12, Nat Valua of Tmx Raturn
13. ChDrHab18/GoY.rn~.nhl a.que.ts ISchedule J)
14, N.t V.lue of E.t.t. ~ubj.ct to Tax
If an assessment was issued proviously, lines
reflect figures that include the total of abb
ASSESSMENT OF TAX:
15. A~ount of Lina 14 .t Spou..1 rat. (15)
1&. AMount of lin. 14 taxable at Line.l/Clall A rat. (16)
17, Anount of Line 14 t.xable at Coll.t.ral/CI... Brat. (17)
18, Principal Tax Due
NOTE:
TAX CREDITS:
---~, ---~------_.
PAYHENT RECEIPT
DATE NUMBER
DISCOUNT (+1
INTEREST (-I
) CHANGED
III
(21.
(3)__
(~I
(51
(6)
(7)
,00
,00
,00
,00
,00
3,915,OL
,00
(81
NOTE: To insure proper
credit to your .or-ount,
subnit the upp.r portion
of thiu furn with your
hx p.ynant,
3,915,07
~,2nn nn
1.284,93-
,00
1.284,93-
14. 15 and/or 16, 17 end 18 will
returns assessed to date.
,00
,00
,00
,00
i:~r~~E T ~~..I:-~~~~I,==~'~..~=...=~h:{ci. .-=1
[x:~:~~~~rt:_~E~E~'-j~ .'-=~'-~Jci=j
IF TOTAL DUE IS LESS THAN II, NO PAYHENT IS REQUIRED,
IF TOlAL DUE IS REfLECTED 'S A "CREDIT" (CR), YOU HAY 8E DUE
A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS, I
(91
(10)
5,200,00
,00
Ill)
(12)
1131
1l~1
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
,00x,00.
,00 X ,06.
,DO X,15.
1181
AHOUNT PAID
i. , ~)
RESERVATIOt<(1 EstateD \Jf Qooedenh dYing on or boforll DQcnmber 12, 1982 -- if ~n'l futurQ JntarASt In the oghhl lit transferred
In PossGssion or ,njuyment to Clatt 8 (Qo11aterftlJ bGnllflclarl~. of the decedent after the Ilxplrntlon of any 8state for
Ilfo or for years, tho COlll.onwe~lth hereby exprlluly rOUlr"'Qt the r Ight ~o apprliliu and aullSs trllnsfor Inhllr J hnoe TllXQlt
at the lawful Clan n (collat~ral) ratfl on any suc"'- futuro IntorOlL
PURPOSE OF
NOTICE:
To fulfJl! the rClquJr.,.onh of Section 2140 of tho Inhilrltanoe and Estate TOl( Act, Aot Z2 of 1991. 7Z P,S,
Seotlon Z140.
PAYHENTz
Detaoh the top portion of 'thh NoUc... find sublllit with your paYlllent to tho Reghter of Wl1lt prinhd 01\ thg reverslil side,
ul18k. chllck or money order pIIIyabh tnl REGISTER OF HILLS, AGENT
All paYlllllnh rlloeJvlld shllll first bll applJlld to tiny Inter8lt whloh may blil dUll wlth 8ny rOllaJndftr applied to the hll(.
R[FUNO (CRlz A rllfund of a tal( credlt, which was not requeotod on the Ta)( Return, lIIay bll rllqulil.ted by oOlllpletlng an "Application
for Refund of Pennsylvania Inhllrltance and Estste Taxfl (REV-l~13). Appll~ationl are nvellllble at the Office
of thll Registllr of Willi/ any of the 23 RevenUII Oistriot Office.. or by callIng the sPGcial 24-hour
answoring s.rvlce nu~bort for for~. ordorlngl In PennsylvanIa 1-800.362-2050, out,Jdl Penn.yJvania IIInd
within local H~rrJsburg arlla (717l 787-8094, TOO. (117) 77Z-2252 (Hlarlng I_paired Only).
OBJECTIONS: Any party In Intere.t not satt'fled with the appraisl.lnt, ~llowance or dllallowanclI of deductlon;/ or 8"el'~ent
M ta)( CincludIng dhcmmt (Ir lntllrutJ (It shown on thh NCltlc8 1lI111t object within ,ixty (6D) day, of rGr.eipt of
this NotJcQ by:
ADMIN
ISTRATIVE
CORRECTIONS:
.-wrlttOrl prot8ll to the PA neparhlllnl of Rllvemlllj 80aru of Appu1s, I)ept. 281021, H8rrlsbu;Q, PA 17128-1021, OR
--eler.tlon to havlI thll ~atter dllt.r.ln.d at audit of the atcount of thlil perlona) reprosentative, OR
~~8p~.al to the Orph8n.' Court.
Factusl error. dlsoovered on thl. assessount shOUld bll 8ddr....d In writIng tOI PA Ollpart~ent of R~v.r~e,
Burll8u o~ IndivIdual T8xllS, ATlN: Post ^ulIsslllent Rllvhtw Unit, Dllpt. 2806111, HarrisburG, PA .17128-0601
Phon.. (717) 1117-(,505. Su pega 5 of thlll bookl09t "Instructions for InheritanclI T8)( Return for 8 RGsldent
neclldent" (REIJ~IS01) for 8n l)(p18nl!ltlon of fldlllnhtr'8tlvolY correctl'lb1lll error..
DISCOUNT:
If "'1Y tax dUll Is pedd within throll (3) trllendrlr lIlonth. ofhir thlil dllCedllnt'. dll~th, 8 flvli percent (St:) dhoount of
th* ta)( paid I. allowed,
PENAl TY I
The 1St: tal( aMnuty non"pal'tJclplltlon plln"lty Is cOlllputIlId on tho total of the tax llnd In'terut a.....lld, Bnd not
paid before Jllnllary 18, 19Q6, the first dflY nHor thA and of the tal( 1Il11nosty periOd. 'Thh non"'pllrtlclplltlon
pllnalty Is appealablo In thCl SltMII IIIllnngr and In the tho ll~~U ti.. flU lod as YOU would appe81 the tal( and IntllrGllt
that has bllon olStund al l"dlClllhd on this notice.
INTERESTz
Int.rut Is charglld bogInnlng with first dllY of IlollnquellOY, or nInA (9) lIlonths llnd onll 0) day frolll thfl dRto Of
d.eth, to the date of paYlIent, Tlll(IiI' which beclI~e dgllnquent bofore JI!lnuary I, 19112 belar Intuelt at the r818 Of
sh (6%) percent pllr anmllll C81clllahd tlt Il dtJllv rbt. of ,(J00164. All t8l(U whloh bllClIlll1I delinquent Oil find aftllr
Janu8r~ 1, 1982 will bllar lntArO'lt &t It rl1tu which 1./111 vl'lry frolll calondtw ynr to eehndl'lr Yller with that rate
IInnounc.d by thll PA Departllllllnt of Revenull, The llppl Jcltbh lnhrut ratu for 1982 through 1996 arel
'!!!!!: tntGrost R8ht Dally Interll!t FRetor ~ InterBst..f!!.!.! Dally Intorollt FlIOtor
1962 20% .000!t4ft 1987 9% ,000247
1983 16% ,0004.'08 1968-1991 Ill. ,000.'001
1984 11% .000301 1992 9% .000247
1985 13% .000356 1993-1994 7% ,000192
1986 10% ,000274 1995.1996 9% ,000Z47
.-!ntliritlt Is calculat.d .. followSl
INTEREST' BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR
--Any NotIct Illutd 8fter the tell( b.collu delInqullnt 101111 r.flllct !'In intllrut c!'IJcu18tlon to flft..n (15) diYI
beyond th. d8h of th. aneuM.mt. If f1rlyment I. madlit llfhr the intor8lt oOllputatlon dfth shown on the
Nolle., additional Inhr..t lIuSt bo oalculated,