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HomeMy WebLinkAbout96-00768 CO,",,",ONwrAllll or PI HNS'tl VANIA D[PAR,,,,[Nl Of Arvl NUl' BUR[AU Of INDIVItJUAl TAlliS DlP!, :80bO' HARR,saURO, PA 11\Z'-ObOl ~ INFORMATION NOTICE AND TAXPAVER RESPONSE FIl.E NO. 21' it, "/"'\ ACN 96136112 DATE 00-29-Q6 1111\.1...","\1 TYPE OF ACCOUNT o SAVltlGS o CHECK IIIG o TRUST [iiJ CERTlF, CST. OF BARBARA II IIARLACIIER 5.5, NO, 1Q4-26-6576 DATE OF DEATII 06'04-96 COUNTY CUMOERLAND EDITH V SQUIRES 4324 N 3RD ST HBG PA 1711 0 REHIT PAVHEIIT AIIO FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HARRIS SAVIIIGS BAtiK ha' .,o.ld.d ,h. D.......nt .lth tho lnfo,.oUon 1I.I.d b.lo. .hlch ha' b..n u..d In <olcul.U.' tho .0t.nU.1 to' dU.. Th.I' ,.co,d' lndl<ot. thot o. tho donth of Ih. obo'. ...c.d.nl, vou ..,. 0 joint o.n."b.o.tldo" of \tl. o"ount. If vou f..1 .hl. Info,..tlon I. Inco".ct, .1.... obt.ln .,It..n co".c'lon f'o. tho fln.nclol In..ltutlon. ....ch. co.. to 'hl, fo'. ."d ,.tu,n It tn tho .'0'. odd'.... lhl, ."ount I. ....bl. in n"o,dnnc. .lth tho Inh.oltonu t., to.. of tho Co..on...lth of ..onovl..nl.. Qua,tlan, May b~ an,wared by calling (7171 18/-0127. COMPl.ETE PART 1 BEl.OW M M M SEE REVERSE SIDE FOR FIl.ING AND PAYMENT INSTRUCTIONS Account 110. 05-39-105504 Date 06-10-07 Established to in,ura prapar cradlt ta yaur accaunt, two (21 caple, af this natlcR ~u,t acca"pany yaur plly".nt la Iha ~.ght.r of wllh. Ha.... chec'" payabla tal "Rught.r af \'HIl', Agent", PART m 17,759.33 50.000 0,079.67 .06 532,78 TAXPAVER RESPONSE FAIl.URE TO RESPOND WIl.l. RESUl.T ~N AN OFFICIAl. TAX ASSESSMENT BASED ON THIS NOTICE Account aalance Percent la_able A~ount subject to la)( Rata potantial la)( Oua HotE: If tall lIay.enl' are .ade wlthin three (11 "anlh' af Ihe decedent" dale af dealh, yau "ay deduCI a SZ dl,caunl af the tall due. Any lnheritance lall due will beca"e dellnquant n1na (q) "anth' aflar the date af dealh. x Ta. x [CHECK -J ONE BLOCK ONLY A. c:J 1ha nba~a infor.allan and lall due I' correcl. I. Vou .ov choo'. to ,..It .ov..nt to tho ...1.'" of Will' .Ith t.o <0.1.. of this notlc. to obt.ln . dl.coun. 0' ouold Int.,..t. 0' Vou 00' ch.c' bo' .,- ond ,.tu,n thl. notlc. to the ...I.t., of wUl' and an afflcl"l "'Uss"ent will be issued by Iha PA Daparl"ent af Rev,mue. PART o .. l:} th. .bo.. ..... h.. b,.n 0' .111 b. ,..o,'.d ond t.' .old .I.h tho ..nn.vl.onl. Inh.,I.onc. t., ,.'u,n 10 be fUed bY tha decedanl's ropraunlntlve. no c- . :IJ c. l:} th. ob". Info,..Uon I. Inco".c' ond'o' ..blS ond d.ductlon, ..,. .~; vou. ~ :D co 'ou "U,. co..,.t. .,., 0.nd'o, .,.T 0 b.lo.. U .,. g 8 I' . ," If you indicata a different tax rate, pl.asa stata your relationship to decedent: OFFICIAIc:1l5E O}!L.;, 0 AAF PA Q~PARTH~T OF REVENUE - -..I ~. ":' , ' 1 ,~ .; )..- :-u~: )'-;;l 11"'1.,..1.,.''''"'''''''' .. "'_.~. . ....-. ","'''''''11'''''' ........- .....- "'" ..",., ~~.:-. = ." ~ ~t.> ~ -.;; ...... ~ VI ~~: !...~ 1 2 3 4 5 6 7 ~ 8 DEDUCTIONS Cl.AIMED "':"...~ ~CT~r.~~ ,..,..U,.II.,."'."I"'I11o. ~~ -_tOO - .... ........ l- Date Established 1 2, Account Balance 2 3. Percent la_able 3 4, Afi'tount SUbject to Ta_ 4 S. Oebts and Deductions 5 b. Amount Taxable b 7, Ta, Rate 7 8. Ta)( Du. 8 DEBTS AND LItlE x x PART ~ DATE PAID AMOUNT PAID DESCRIPTION PAYEE TOTAL CEnter on Line 5 of Tax Co~put.t1on) , facts 1 tru., correct and j"t.C .j and baUef. HOME WORK T L R DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAM ASSESSHENT .,\10 "",11,""" '''..,.., "..." "" ''''0,..110'' sub"Uled by the IInllnch1 InlOtulton. Z. I"ho",.nc. ,.. b.Co'" ".II.....nl nln. .on'''' .ft.. 'h' ".,."".,' , ".,. o' "..Ih. S. , jolnl ."..nl I. I...b'. .,.n Iho.Oh 'h. "...".n'" ..... ... .""." .. . ....., ..I ,....."..",.. .. ,,,...to ll.cI."'''O 'ho'. h.ld b.""" h.'b'"'' .nd .11.1 .hl,h 'h. "...".., p.' I. jol.' n.... .IIhln on. ,,,, ." 10' '0 d..th ar. fully ,a..b'. ,.1 \'lInl,.r.. .. ,,,o..t. ..t.bll,h.d jol.II' b.....n h.,b.nd .nd .11. ..,. u..n on. .... .".' 10 "..'h ... nol ....bl., b, ,..o.nto h.ld b. . ".,.d.nt -In I,.,t I.'. .nolh.. 0' o'h." .,. ....bl. loll" REPORTING INSTRUCTIONS - PART 1 _ TAXPAVER RESPONSE I, BlOCK' _ II tho Inf.,..II.n .nd .....,.Il.n In 'h. n.ll.. ... ..".01 .n" "."..,lIon, ... no' b.lno cI.l..d, .1... .n "0- In b'o,' "'" 01 ..,t I of 'h. .,....... ....on.." ...,Ion. Slon t.o .0.1.. .nd ,.b.1t Ih.. .lth .0.' ,h." 10' 'h. ..o.nt .1 t.. '0 'h. ..01.'.' 01 Wllto of Ih. co.nIY Indl,.'.d. !h..' D..."..nt 01 ..,.no. .111 I.... .n olllcl.' ........nt (For. R[V.lS~a EX) upon r.c'lpt of the r.turn fr08 the Po;1s'.' of wllll. Z, BlDC' a . II 'h. ....t ...clfI.. on Ihls notl.. ..., b..n 0' .111 b. n.o".d on" ,.. ..Id .lth Ih. ..nn..loonl. Inh.",.n.. T.. ..'u,n fIl.d b. 'h. d.,.".n". ...,...ntoll", .1... .n "0" In b'o" "a- of ..., I of 'h. -!....." ....on..- ...lIon. SIOn on. .0., .nd ,.Mn '0 'h..' D..."..n' of ..,.n... 'u".u of Indl,ldu.1 10.... D..' "ObOl, 1I."I.bU'O, Pl 1"".ObOl In 'h. envelOP. pr~vld.d. s. aLDeK e . II tho notl.. Inlon.llon I' In.o,n.t .nd/o' d.d..Il.n. .,. b.lno cI.l..d. .h.c' b'o,' -C. .nd ,..pl.t. P.... Z .nd S "....,': " ," !",.,,,,,.., ,,"'. <':" ,,,: ,,,I,, '" :_,,:, ,",:' ,,!.. ",' ,':::' ." ".: :e'..,' " 'C' ",,":- ,- \r,' ",,:,,0' of Will. of tho ..""ty Indl..,.d, !h. Pl O..."..n' 01 ...onu. .111 I.... .n olllcl.' ........nt IFo'. .ev',," EOJ u..n ,...I.t of the r.turn fro" the Regllt.r of Will,. TAX RETURN - PART 2 _ TAX COMPUTATION LIHE 1. Entar HOTE; tho d.'. 'h. ."ount od,ln.lI. ... ..I.bll.h.d 0' tllI.d In 'h. ..nn.. .".lIno .t d.l. .f doath. fo' . d...d.n' d.lno .It., lUlU": ...o.n.. .hl.h 'h. d...d.n' put In j.ln' n.... .lthln on' II I "., .1 d..'h .,. ,...b'. full, .. .....1..,.. 110'''.'' 'h". I. .n "clu.lon not t. .....d 01,000 P" .....f.'" '.O.,dl." of 'h. ,..u. of the 8ccount or the nueber of account. held. II . d.ubl. ....".. ,.., ....." b.f.'. ..u, ""t n.'. In 'h. .d"'''' ..,tI.n .f 'hto notl.., 'h' 01,000 ,....u.lon ..n.d. h.. b..n d."u.'.d fco. tho ."..nt b.\o". .. ,.p.".d b. 'h. "....1.1 I..tltutlon. Z. Ent., tho ,.\0' b.l.n.. of 'h. ."ount Including In,.,..t .,,'u.. t. tho d.,. of d..'h. S. Th. p....n' of tho ."ount 'ho' .. ,...bl. f.' u,h .u..I,.' .. d.,.,.ln.d .. f.II.'" l. Th. ..,..nt ,...bl. fo' j.lnt ....t. ..t.b.l.h.d ..,. th.n .n. ..., p,lo' to 'h. d...d.n'" d..th: DIYIDED BY TOTal NUHI!.ER OF JOiNT OWNERS [)(II.plg: A J01nt augt nguterSld DIVIDED BY TOTAL NUHIER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS In thg na.e of th. dgced.nt and two other p.r~ans. 1 DIVIDED BY 1 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) . .167 )( 100 16.7X (TAXABLE FOR EACH SURVIVOR) .. Th. p....nt t...b'. fo' .00." ......d .Ithln on. ..., of 'h. d...d.nt'. dn'h 0' ....unto ..n.d b. tho d.'."on' but h..d In trust far another indivlduaU~) (trust bgngflc1arie,J: I 01'110[0 BY TOtAL NUHIER OF SURVIVING JOINT OWNERS OR TRUSt BENEFICIARIES )( lOa . PERCENT TAXABLE [xa.ple: Joint account regilterad In tha docadont. 1 DIVIDED BY Z (SURVIVORS) . .SO )( 'h. n... of 'h. "...d.nt .nd 'w. .'h.' ..,.on. .nd ..,.bll.h.d .I'hln on. ..., of d..'h by 100 !iOiC (TAXABLE FOR UCtt SURVIVOR) ., Th. ..o.nt .ubj." '0'.' <lln.'1 \. d.t.,.ln.d b. .ul'I.I.lnO tho ...ount b.l.n'. <lln. Zl b. 'h. ..,..n' t..obl. <.In. Sl. S. Entar tho total of th. dobtl and deductlan. lhtgd In Part 3. b. tho ..oun' ,...b1. ,"n. bl .. d.,.,oln.d b. ,ubt,..llno 'h. d.bn .nd d..u.llo" "an. .. f'.. 'h. ...un' ..bj." 'D ,.. < IIn. ... 7. Enter the approprlate tax rate (llno 7) a. detar.lngd bglow. l. fo' d.'OO of d..'h o..u" Ing .ft., b/So/'" 'h. ,.. ..,.. f.' '....I... '0 ,po.'" .,. ., fo\low", 1. Oat.. of d.ath on Dr aftgr 7/1/9~ and bgloro 1/1/9!i tho rate 11 SZ. Z. D.t.. 01 d..'h on ., .fto' 1/1/", .....1." to ..0.'" .1\1 b. ,...d ., OX ,.. ,.... Hot.: f.' d.t.. .f dnth .dD' '0 711/" .....f." '0 ..ou... .,. t...bl. .t b1.. a. T,.n.f." 'olin..' d....nd.nt. In.ludlng f.'h", .oth.', .on, d..gh'." g,.nd.hl'd,.n. .on-In-I.', dauvhhr.ln.law, .t.pchlld IInd tholr \ssuo aro tll_lIblo I'It she poregnt u,Zt. e. t,....... ,. .11 oth." Including b,o'h", .1.'." uncl., nun', n..h.' .nd nl.'. .,. to..bl. ., fl"nn .....nt tIS1.I. O. ".OU .hong. tho t.. ,.,., .to... ....If. .0.' ,...lIo",hl. '0 'h. d...d.n' In 'h. .,.. .,ould.d. a. Th. ..ount of t.. duo ,"n. " I. d...,.ln.d b. .ulli.l.lnO Ih. n.o.nt ...nbi. <lIn. b' b, 'h. 'ft' ,.,. IIln. 71. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED l, Vou 1...It. .n ,...on.lbl. fo' .....n'. 0' 'h. ..,.,. .ubj.., '0 nd.lnl.,..lIon b, o..".n.' ,..,...n'.tloo I. I",ufflcl.n' to pay tho doductlblg It..s. . a. Vou .c,..'I. ..Id 'h. ".b" .f'.' d..,h .1 Ih. d.,...n' nnd ..n I.,nl.h .,oof 01 ..,..n'. e. O.bto b.lno cI.I..d au" b. 1I..lzo. lult. In P.,t S. ".ddlllonn' ...,. I. n..d.d, u.. .'.In .n..' · 1/1- . \I", p,oof 01 pay.ont "BV bo requ.stod by thO PA OOPBr\ftOnt of Rovonug. Al1owl!lblo dobts> I'Ind deduct Ions ar. doter.lned a. lollo"s: TAXPAVER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF lIlDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT 1Il HARRISBURG AT (717) 787-8327, TDDI (717) 772-2252 (HEARING IMPAIRED ONLV) COt1"ONWIAlltl 01 IIINk~yt VAkil D[PAAIt1LHI 01 WIVI Hill !IUPUU Of IHOIVIIIUII IAI' ~ DlP'. ;80bOl IlARAISIUPG,IIA III:S.O"OI * NO. 21 . '((., '1"," 96136\13 08-29-96 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE tit ;h'lI ,..., '" TYPE OF ACCOUNT n SAVINGS l-= CHECK ING n TR'JST [Xi CERTlF . EST. OF BARBARA It ItARlACItER 5.5. NO, 194'26-6576 DATE OF DEATH 06-0(,-96 COUNTY CUMBERLAND EDITH V SQUIRES 4324 N 3RD 5T HBG PA 17110 REHIT PAYHENT AND FORHS TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HARRIS SAVINGS BANK hilS providllll Ule Owpnrt..ent with the Infor,,"tlon ll~ted billa.. which IIII~ 111181'1 uud in cslculatlnll the potential tlU due. 'heir rucord~ illdicate th.,t Itt the dllath of the "boVII dllc.dunt. "ou wer. II jotnt nwnllr/beneflclary of tnl~ account. If YOU f..l thl. Infor.lltlon t. Incorruct, pl.II~. obtllln writt.n corructlon Iro. thll ftnnncllll In~titution. nttllch II COpy to this for~ _rt r-_t\,,.n it 't) ttl. IIboV8 IIdd,.e... Jhl~ IIccount I" tllutble in nccord.'IOce with tho Inherttnllcu In. lnw~ of thu Co..onw."lth of "II"nsylvllnlo. Duntlonl ..y bll IIn....r.d by call1nll (1111 la/-e311. COMPLETE PART 1 BELOW · Account No. 05-31-139972 . . SEE REVERSE SIDE FOR 02-13-89 FILING AND PAYMENT INSTRUCTIONS Data Establish.d '0 insura proper cr-adlt to your account. t..o (Z) copieS of thi~ notice ~ust secOllpllny your pn".e"t to tha Rllgistar of wills. Hilke check payllbla to: "Relllstur of wills, Agant". PART [!] 21. 057.45 50,000 10,528,73 .06 631.72 TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE Account Bdanc. P.rcant Taxabl. Aaount Subjact to Tax Rata Potential Ta_ Due x NO'[: If ts. pay.unts are ~8da within thrlla (3) ~onths of the decedent's date of death, you allY dllduct ft ~% discount of the ta_ due. Any inheritanca taM due will baco.a dallnquunt nlna (91 .onths sfter tha datil of duath. Ta. x [CHECK l ONE BLOCK J ONLY A. ~.The abova Info,.~ation and taM dua is correct. . 1. You .Sy choose to rull pay.ent to the Register of wills ..ith two caples of this notica to obtain a discount or- Avoid Interult, or you aay check bOM "A" IInd ,.eturn this notice to tha Rllglstar of wills and sn ofllcll1! assess.ant will be issuud by thll PA Dopart.ant of Ravunue. B. c=J Tha abov8 sssat has belln or will be ruportad and ta_ paid with tho Pennsylvllnls Inhuritance Tnx retu,.n to ba fllod by the docedent's ropresuntatlve. ~ c. L-J The abov. infor~stlon is incorruct and/or debts nnd deductions wllre paid by yOU. You ~ust co.plato PART ~ snd/or ~AR' ~ balow. PART If you indicate a different ta_ ~ateJ pleasa stata you~ ~ ~elat1onship to decedent: '"A ..-_....., "..,...hf' :;:.:::-C7:.":'I:::: ^~ w. ":'A:: 0:: ~:::::":'.';~~:':' ....CC~~~:!!: OFFICIAL USE ONLY 0 AAF PA DEPARTMENT OF REVENUE ~~' 3::- '-' f~ \:.: ;..:.' non , nw ..,ia' ~.a. - - ..~ . ~: ~ 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED LINE 1. Date Established 2. Account Balance 3. Pe~cent la_able 4. Amount Subject to Tax S. Debts and Deductions &. Amount Taxable 7. Tax Rate 8. Tax Due 1 2 3 X 4 5 . 7 X 8 - ..... .'. - ...... .? . ~. ,~ ~':: ;' f. J' t.1 ~:- "" - ~ U1 (J)4 _ "" PART ~ DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Ent.~ on Line 5 of Tax Conputationl $ Und.r penalties of perju~y, 1 d.cla~a that th. facts 1 hava ~epO~ tad above ... t~ue, co~r.ct and co~plat. to the best of my knowledga and balief. HOME ( ) C I (,. ,.f lV, ..1_ <r"" _,_~ . ) I .r~4./ WORK ( ) X V NA U T l PHONE NUMBER DATE GENERAL INFORMATION 1, FAILURE TO RESPOND WILL RE5ULT IN AN OFFICIAL TAM A55E55HENT .lIh "".11"01. Inl.,..1 .....d .n Inl.'..II.n tubalttad by the finAncial In,tllullnn. Z. Inh.rltanc. tn baeo..' dallnl1ua"t "In. annthl after th. dacaden'.' dAta of d."th. S. A Join' account I. ,....b" &",a" thoullh the elacadant" "',.. WIt' IIthled In /I ."tt.r of [onva"I_"ea. 0, Ace.""" lIncludln. 'h.'. h.ld .......n hu,o.n.1 .nd .11.1 .hlch Ih. d.c.d.n' .u' In J.ln' n.... .lIhln .n. ".. .".' I. d..th .r. fully t".abla .. Irll"ll.r.. ~. Ace.""" ....bll'h.d J.lnll. b.....n hu.b.nd .nd .If. ..,. ,hon .n. .... ,,,,., .. d..lh". n.' ....bl., ft. Ar.t;ount, h,ld by III dacadant "In IfI..I' fo'" anothar or ulh.r. "f' lalllbl_ lulh'. REPORTING INSTRUCTIONS' PART 1 . TAXPAVER RESPONSE I. BLOC' A _ II .h. Inl.....I.n .nd c...ut.'I.n In ,h. n.tlc. .,. c.".ct .nd d.ductl.n, .,. n.t b.ln. cl.I..d. .I.c. .n -,. In bl.c' .A. 01 ..rt I 01 tho -to....., .....n.... ..cllon, ...n t.o co.l.. .nd ,ub.1I th'. .lIh .ou' ch.c' I., ,h. ..ount 0' t.. '0 tho ...1"" 0' Will. .1 .h. coun" Indlc.t.d. Ih..A O...,...nt 01 ....nu. .111 I.'u. .n ol'lcl.1 ..'.'...nt efor' ~EV.I~4a EXl upon r.calpt of tha r.turn Ir08 Iha Ragis,e, of Will.. .. BtOC, B . I' ,h. ....t ...cl'l.d on thl. not Ie. h.' b.,n 0' .111 b. ,..o,t.d .nd ... ..Id .llh Ih. ..nn..I..nl. Inh..lt.nc. I.' A.'u,n ,11.d b. tho d.c.d.n.'. ,..,.,.nt..I... .I.c, on -,. In bloc' .B- 01 ..,t I 01 tho -,......, A....n... ,.ctlon. 51.n on. co.. .nd ,.Iu,n to th..A O.......nt 0' A...nu., Bu'..u 01 Indl.ldu.1 I..... D..' 1""1, 1I."I.bu'., .A IIIIB-O"1 In tho anv.lopa provided. ,. BLOC' C . II tho no' Ie. Inl.,..tlon I. Inc.".ct .nd/.' d.duc.l.n. .,. b.ln. cl.I..d, ch.c' bl.c' "C. .nd co..I.t. ..,., · .nd , ,,,,,",,,, t. ". :"""_",...,, ~.,... ::,.. t.. ...".. ",'. ....:. .... .1..' ._"' ....... 'u' ,... ",.u',1 O. th. ..,dU'. ,. U.. ......., .f WI' I. 01 tho count. Indlc...d. Ih..A O....t..nt 0' A...nu. .111 I.,u. .n .,'lcl.1 .......'nt Iro.. A[u'I~'B [,I u..n ,.c.l.t of the r.turn fro. the hghter of will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE I the date the account originallY was ..tablished or titl.d In the .ann.r 'Mlsting at date of d.ath. r., . d.c.d.nt d.ln. .,t., 1./1./Bll Acc.unt. .hlch tho d.c.d.nt .ut In lolnt n.... .Ithln on. III ..., ., d..th .,. ....bl. lull. ., t,.n".'" II....", .h.'. I. .n ..clu,lon not t. ..c..d ".000 .., .,.n,I.,.. ,...'dl." ., tho ..Iu. 01 the account or the nu.b.r of accounts h.ld. ., . d.ubl. ..t.,I.. 1'" ....." b.I.'. .ou' 'l,.t n... In tho .dd'." ..,tl.n ., 'hl, n.tlc', tho ,',000 ..clu.l.n alr.ady has be.n d.ducted fro. the account, balanc. al report.d by the financial Institution. 2. Enter the total balanc' of the account inclUding Int.r.st accrued to the date of dlath. S. Th. p.rclnt of the account that Is taMabl' for each survivor Is d.tlr.in.d as follows: A. Th. Plrc.nt taMabl. for joint alsets .stablish.d .or. than on. y.ar prior to thl dlc.d.nt's d.ath: 1 DIVID[D BV TOTAL NUHBER OF JOINT OWNERS EMaIPl.: A joint asslt r.gist.red DIVIDED IV TOTAL NUHBEA OF )( 100 PERCENT TAXABLE SURVIVING JOiNT OWNERS in the na.. of the dlcldent and two oth.r plrsons. 1 DIVIDED BV S IJOINT OWNERS) DIVIDED BV 2 (SURVIVORS) . .161 X lOa 16.1~ ITAXABLE fOR EACH SURVIVOR) B. Ih. ..,c.nt t...bl. ,., ..,.t. c,..'.d .I.hln .n. ..., .f tho d.c.d.nt'. d..th ., .cc.unt. ..n.d b. tho d.c.d.nt but h.ld In trust for anoth.r indlwlduaHs) ltrust ben.fIclarles)I I DIVIDED BV TOTAL NUHBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X loa . PERCENT TAXABLE [Ma.pl.l Joint account regist.rld the dlcldlnt. I DIVIDED BV 2 (SURVIVORS) . .SO In thl na.. of the d'cI~.nt and two other plrsons and establlsh.d within on. year of dlath by x lOa sax <TAXABLE FOR EACH SURVIVOR) .. Ih. ...unt .ubl.ct t. t.. (1In." I. d.t.,.ln.d b. .ul.I.I.ln. tho .ccount b.l.nc. (1In. '1 b. tho ..,c.nt t...bl. Illn. ". S. Enter the tatal of the dlbts and deduct Ions I hted In PI"t \. .. Ih. ...unt t...bl. (1In. ., I. d.t.,.ln.d b. .ubt,.ctln. tho d.b" .nd d.ductl.n. (1In. ~I 1'0' tho ...un' ,ubJ.ct t. t.. Illn. ". 1. Entlr the approprlat. taM rat. (line 1) as det.r.lned b.low. A. for dat.. of d..th occurring aft.r 6/30/q4, thl taM rat.s for transf.r. to spous.s are os follows: I. Date. of de.th on or aft.r 1/I/q4 and h.for. I/I/QS the rat. I. 3X. Z. oat.. of dlath on or aftlr 1/1/QS tran.fers to spouse. will b. taJld at OX taM rat.. Hot.: For datil of death prior to 71l1Q4 transfers to spousn are taMabl. at 6:<. B. Transf.r. to llnlal d.scondant. Including father. "other, son, daught.r, grandChlldr.n, son-In-law. deulIht,,-in-lew, stepChild end th.ir Issue an ta.able at slM porunt (61.), C. I,.n."" to .11 oth." Includln. b.oth.', .I,t.'. unci.. nunt. n..h.. .nd nl.c. n,. t...bl. .t ,I,t..n ..,c.nt (I~XI. D. If you changl the taM rate, plee" sPlclfY your relationship to the decedent In the area provldld. B. Ih. ...unt 01 t.. duo (1In. BI I. d.t...ln.d b. .ul.I.I,ln. tho n..unt t...bl. Illn..' b, tho t.. ,.t. Illn. II. CLAIMED DEDUCTIONS . PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debt. and d.ductlon. ar. deteraln.d a. follows: A. ..u 1...11. .,. ,....n.lbl. ,., .....nt. ., tho .,t.'. ,ubl.ct t. .d.lnl,t,.tl.n b. . ..,..n.1 ,......nt.tl.. I. In.ul'lcl.nt to pay thl dlductlbll it.... B. Vou actually peid the dlbt. aft.r death of the doc.dont and can furnish proof of pay.ent. C. O.bt. b.ln. cl.I..d .u.t b. It..I,.d lull. In ..,. ,. " ,ddltl.n.1 ...c. I. h..d.d, u.. .,.In ...., Bill. . II.. .,0.'.' pay..nt .ay b. requetted by the PA D.part"ent of povenu" TAXPAVER ASSISTANCE IF VOU NEED FURTHER IllFORHATION OR ASSISTANCE, CONTACT ANV REGISTER OF WIllS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IHPAIRED ONLVl GENERAL INFORMATION 1. fAILURE TO RESPOND WILL RESULT IN AN OfFICIAL TAK ASSESSt1ENT with "IIJllltllhl. Inhr..' bll..d on Inlon'.llnn I...ballhd by the Ilmmel.1 In,tllullon. Z. Inherltanc. tu beea... d.llnqlJent nln. .onths 1I".r the ll.e..t.nl', dill. of dllllth. 1. A Joint /teeDu"1 I. 1.llIbl. .."e" thougtl the duellenl', nI'.. III" added '" .1 1II1111e' of convenlenc.. It. Acccunh IIr-eludlng tho.. h.ld bet...." "ulb.nd ""It wlf.l which thll deude"1 111.11 In Joint nil... within on. .,u' prior to d..lh .r. lult., t...bl. III Iran,l.r,. ~. Account, .,tabll,hed Jolntl" bill...." hUlband /lncl wlh liar. t"lI" on. "nr prior to dllllth "I'll not I.ubl.. 6. Account. h.ld by II dllcadllnt -In trult tor" IInoth.r or oth.,. ar. IIIJllbl. full.,. REPORTING INSTRUCTIONS PART 1 - TAXPAYER RESPONSE I. BLOCK A . If thll Inlor..tlon and co_putatlon In the notice nre correct "nd deduction, are not being clai.ed, place an "." In blo~k "A" of Part I of the "Ta.pay.r R.,pon'e" ,ection. Sign two cop I., and sub.lt th.. with your check for the ".ount of ta. to no Register of Will. of the county indicated. Th. PA nOPllrt..nt of Rev.nu. will lI,u. nn official auu,aent (For. REV-1541 EXI upon recalPt of the r.turn fr08 tne Regl,tor of Will,. 2. BLOCK B . If the a...t specified on this notlco ha' been or will b. r.portod and ta. paid with tho Pennsylvania Inheritance Ta. Return flted bv the decedont" representative, place an "M" In block "B" of Part 1 of the "Ta.payer Re,pon,." .ectlon. Sign one copy and retur:"l to the PA D.partunt of Re"enue, Bureau of Indhddual Taus, Dept 180601, Ilarrlsburg, PA 11118-0601 In the envelope pro"I~.d. 3, BLOCK C . If the notlc. Infor.atlon I, Incorrect andlor deduction. are being claleed, check block "C" "nd coaplete Part, 2 and 3 .:..::.:::..cl,"\; t~ ~;',.t :",J~. ....t:.:..,~ t.:..... ::If" ~.... ...:...1.. """ :..._;. .;"... "I '.:1 )'UIII ~I.a(.'" fl,' tn" "...un<< Ut ta. payaol' to tn. ".gl.c.r of Will. of the c~unty Indlcat.d. Tha PA Depart.ent of Revenue will i.sue an official as,e"..nt IFor. REV-15~1 EX) upon r.celpt of the r.turn froe the Regl,ter of will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enhr NOTE I the date tha account originally wa. established or titled In the .anner e.lstlng at data of death. for a dac.dent dying aftar 12/12/IZ: Accounts which the decedent put In joint na.es within ana (II y..r of daath are ta.abl. fully as trllnsf.rs. flowevor, there Is IIn e.c1uslon not to ..coed n,ooo per transf.rlle regardle.. of tha vlllue of the account or the nuebar of account' h.ld. If a doubl. astarlsk (..1 app.ars before your first na.. In the addr.ss portion of thl, not lea, the $3,000,e.cluslon alr.ady has b.en deducted fro. the account balanc. as r.ported bv the financial Institution. Z. Entar the total ball1nc. of the account Including Int.r.st accrued to tha data of daath. 3. The p.rcant of the IIccount that I, ta.able for aach survivor I. dlt.r.lnlld a, follow.: A. Th. p.rcent ta.abl. for Joint a.s.t. ..tllbllsh.d .ora than on. year prior to lhe decedant's dallth; DIYIDED BV TOTAL NUHBEA Of JOINT OWNERS Exa.ple: A joint als.t r.gl.tar'd DIVIDED BV . TOTAL NUHBEA OF . laD . PERCENl UMABlE SURVIVING JOINT OWNERS In tha na.. of tho docodllnt and two othor pllrlon.. I DIVIDED BY 3 IJOINT OWNERS) DIVIDED BY 2 (SURVIVORS) . .167 X 100 16.7~ (lAKABtE fOR EACH SURVIVOR I B. The parc'nt taxabla for aSI.t. craatlld within on. YOllr of tho decedent', dllath or account. owned by the dacadant but h.ld in trUlt for anothar Indlvldual!.1 (trult blln.ficlaria,l: I DIVIDED BY lOTAl NUHBER Of SURVIVING JOINT OWNERS OR TAUSl BENEfICIARIES . lOa PERCENT lAKABLE Ex..ple; Joint account r.gl.tarad the d.codent. I DIVIDED BY Z CSURVIVORS) . .SO In the na.e of the docodont "nd two othor por,ons "nd altablished within one yaar of de.th by )( 100 SO~ (TAKABLE fOR EACH SURVIVOR) 4. Tho 1I.0unt ,ubjact to ta. (1In. 4) Is detar.lnod by ~ultlplylng the account balanc. (1lna 2) by tho percant ta.able (1In. 31. S. Enter thlt total of the debts and doductlon. I htod I" Pl'lrt " 6. Th. a.ount t..abl. Iline 61 II dator.lnad by IUbtracting thl debt, "nd doductlons (Iina 51 fro. tho a.ount IUbject to tax Illno 4). 7. Entar the approprlata tax rllto 111n. 7) a. d.tlr.inod bolow. A. For datas of doath occurring aft.r 6/30/94, tho ta. ratlll for tran.ferl to 'POUSII' are a. follows: 1. Dat.. of death on or aftar 7/1/94 and bafora 1/1/95 the rate I. 3~. 2. Date. of daath on or aftllr 1/1/95 tran.fer. to SpOU'.1 will b. t...d at 0% tn. rata. Not.: for dat.. of death prior to 7/1/94 tran,fars to SPOUS'I .re t..able at 6%. B. Tranlfers to Iln.1I1 dasclndants Includln; fath.r. .other, son. daughter, grandchildren, son. In-law, daughter-In-law. ,tepchllJ and th.lr Islue are la.llble at six percont 16;:1'. C. Tranlfar, to all others Including brother, II.ter, uncle, ount, nophew ftnd nlaee ftra ta.abl. at flftllen porcent <<15%). D. If you chang. the tll. rat., pl.... spaclfy your relatlon'hlp to the decodont In the area provldOd. I. Tha aMount of tax due (1In. II il d.tor.lned by MUltiplying the a.ount ta.able (1lna 6) bv Iha ta. rate Illn. 1). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable dobis' and dllductlons are dater.lned ". follows: A. You legally are r.sponslbl. for pay.ant, or the ..t.t. subjlct to ad.lnistratton by a p.rson"l reprl'entative is Insufflclant to pay tha deductible it..s. . B. You actually paid the debts aftllr do"th of Iha decodont ~nd cnn furnish proof of pny~ant. C. D.bts b.ing clalRod nust be Ite.lled fully In Part J. If additlon,,1 spaca I. neodod. u'e pl.tn pApor 8 I/~" . II". Proof of pay.ont nay bl raquestlld by the PA DllpArtnent of Rlvonua. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TOO' (717) 772-2252 (HEARING IMPAIRED ONLY) CO""OHWI.AlTIl or PlfoIfoISVtVANIA DIPAAT"I HI Of AI VI NU[ aURLAU or INDiViDUAL TAIII S DIPT. leObOI IlAARuaURC, PA 11Ii'I'DtlDl *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21. '/~ h:/ 96136739 09-04-96 Ih.a.llIl" ".,,, TVPE OF ACCOUNT C SAVINGS fXJ CNECK ING [J TRUST o CERTlF . EST. OF BARBARA II IIARLACltER S,S, NO, 194-26-6576 DATE OF DEATH 06-04'96 COUNTY CUMBERLAND EDITH V SQUIRES PO BOX 233 LEMOVNE PA 17043 REHIT PAYHENT AND FDRHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 DAUPHIN DEP BANK & TRU has provided the aepart.ent wlth the Inforlflallon listed below which hn be.n us.d In celculatlng the potential tu due. Their records Indlcat. that /It the death of the above dllcedllnt, you WUII It Joint owner/bllneflchry of this account. If you feel this Infor.ation Is Incorr.ct, plllas. o~tain written corrllctlon fro. thll financial Institution, "ttach a copy to this forlll and r.turn It to the above addr.... Thl' account is taMable In accordanc. with the Inhllrltanc. TaM laws of the Co....onw./llth of P.nnsylvanla. Quntlons .ay b. an,wflr.d by calling (/111 ,'ij, dH/. Dab Eshbl1sh.d REVERSE SIDE FOR 02-19-70 FILING AND PAYMENT INSTRUCTIONS COMPLETE PART 1 BELOW Account No. 0081136226 II II II SEE x 13,802,82 50.000 6,901.41 ,06 414.08 To insure prop.r crlldit to your account, two (2) copllls of this notice nust accoepany your pay....nt to thll Rllglster of Wills. Hak. check pavable to: "Register of Wills, Agent". Account aalanc. Par-cant TalCabl. Aaount Subjact to TalC TalC Rate. Pot.ntial TalC Du. x NOTE: If taM pay.ent. are aade within thr.e e31 aonth. of the d.c.d.nt's date of death, you lfIay deduct a S~ discount of the taM due. Any inheritance teM due will beco.e dllllnquent nine ('1 aonths aft.r the date of death. PART ill TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE [CHECK ] ONE BLOCK ONLY A. t=] Th. above Infor.etlon end teM dUll Is correct. 1. You .av choos. to rll.it paye.nt to the Rllgister of wills with two cop ie' of this notice to obtain II discount or avoid interest, or you .ay check bOM "A" and return this notice to the Register of Will, and an official Bssesseent will be Issued by the PA DIIParteent of Rev.nue. B. c=J The above als.t has been or will be r.ported and taM paid with the P.nnsylvanla Inheritence TaM return to be filed by the dec.d.nt', representative. C. ~ The above Infor~atlon Is Incorr.ct and/or debt' and deductions wllre paid by you. You _ust coeplete PART ~ and/or PART ~ below. If you indicate a diffarant tax rat., ple.s. stat. your ralationship to decedent: OFFICIAL USE ONL V 0 AAF PA DEPARTMENT OF REVENUE PART ~ TAY LINE PFTII~" - r(""~IITATTnN 1. Date Established 2, Account B.lanc. 3. Parcant TalCable 4. Aaount Subjact to TalC 5. D.bts and Daductions &. Aaount Taxable 7. TalC Rate 8. TalC Dua nF TAY nN ..nTNT ITIJIIC:T Ar:r:nIlNTc: 1 2 3 X 4 5 & 7 X 8 P.^!l PART ~ DATE PAID PAYEE I -1~ ~ :u~ 2 \U 3 l~ 0 ,,' 0 'f.:. Q 4 \,' ~ ,~ 5 -, <0. U - r i."; 6 (} -.J 7 ~. ~ ,,:;: ':-:Cf: 8 ~ :; :.:. DEBTS DEDUCTIONS CLAIMED :;et 0 AND ~;: 0'\ DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Co~putationJ $ Undar penalties of perjury, I dacl.re that the facts I have reportad above are true. correct and .. co~ph~.. to th. ba~t of lilY knowledge and belief. "l' } HOME (,-f ?-, ) ~.- " ... ~~ (i~'~A(;iR 'sIG~AiuJ(/IIt-. I W~~~EP~ONE N~MBER DATE GENERAL INFORMATION 1. FAlLURE TO RESPOND WILL RESULT IN AN OffICIAL TA)c ASSESSHENT wit" "'If.lllc"bla In'.'''' hu.d on In'ot811110n lubeltled by Ihe fl".nebl In,lltutlon. I. Inheritance t.. baea... delinquent nln. 1I0nlh. lI'hr Ih. claude"I', tllIl. 01 lluth. J. A Joint account Is '...bl. IIva" though the datatle"I', ""... "'II' IIdllad In " lI..thr of tOnVII"lllnell, It. Account. ItnclUdlng tho.. "eld batw.." hu.bllnd and wlf,1 which thll duell."1 put In Joint tlf.... within on. y..r prior to d..th at. fully I...bl. II' Ite","'" !I. Account. ..t.bllth,d Jointly bat".." hUllumd nod wlf. 80r. Ihll" nna yur ,"lor to dalllh MI not I,.."bl.. b. Account. "eld by II dlCldlnt "In trult for" IIno'h,,. or oth.,. ",. h..hl. fullY. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK'. If thll Infor..tlon and co.putatlon In tha nollca ~ra corract ~nd daductton. ~ra nat batng clel.ad, plac. .n "X" In block "A" of Part I of Ih. "'..payar Aa.pon.a" .acllon. Stgn two copla. nnd .ub.11 Iha. wllh your chack for Iha .aounl of te. 10 Ih. Aagllter of Wills of Iha county Indicated. the PA D.pllrllll8nl 01 Ravanua will I..u. an official ...a...ant (For. AEV-15~a EX) upon racalpt of Iha ralurn Ir08 th. Pagl.l.r of will.. Z. ILoCK I - If tha ....1 .p.clllad on Ihl. nollc. ha. ba.n or will be raporlad nnd 1ft. p.ld wllh Ih. P.nnsylvanla Inherlt.nca fa. R.lurn fllad by Ih. dacAd.ntt. r.pra.anhtiv., plllca ..n "X" in block "I" 01 P..rt I of Ih. "'".plly.r Rupon.." IIIIcllon. Sign ana copy and ralurn 10 Iha PA Dapart.ant of Ravanu., Bura.u of Indlvidu.l ,...., Dapt 1110601, Harrhburg, PA 111Z1I-0601 In Ih. anvalop. provided. 5. BLOCK C - If Iha notlc. Inlor..tlon Is Incorrecl .nd/or d.ducllons .r. b.lng clal.ad, ch.ck block "C" .nd coapl.l. P.rl. Z and 5 .ccoraing to t:'\. i".tr....~lun. ur.iu... lI;,," ._u "oJlhn ....0 ~uclll~ .i... _i.;. yuur CIIIIC'" tur .fI. dadUI1\ 01' tlUt pttyaol' to tne I'lagl.tllr of Will, of the counly Indlc.l.d. Th. PA D.p.rl.ant of R.v.nu. will I.su. .n official a.......nl (For. REV-15~a EXl upon r.c.lpt of Ih. r.lurn fro. Iha A.gl.t.r of Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. [nt.r HOTEt Ih. dal. Ih. .ccounl origln.llY w.. a.l.bll.h.d or 1111.d In Ih. .ann.r ..I.llng at dal. of d.alh. For a d.cad.nl dying .ft.r lZ/IZ/IIZ: Accounl. which Ih. decedanl pul In joint n.... wilhln one (I) yaar of daalh are I..abla fully a. Iransfer.. How.var, Ihar. i. an ..ciu.lon not to a.c.ad $1,000 par trlln.farea reg.rdless of the valu. of the .ccount or Ihe nuabar of account. hald. If a doubla astari.k (1111) .ppe.r. be fare your fir.t naaa In the address portion of Ihi. notice, Iha $1,000 ..clu.lon alr.ady ha. baan daducted Ira. the account balanc. a. raport.d by tha financial In.lltutlon. 1. Ent.r the tolal b.l.nc. of tha .ccount Including Int.r..t accru.d to the date of d.ath. 5. 'h. p.rcant of Ih. .ccounl Ihal Is la.able for .ach .urvlvor I. datar.inad a. follow.: A. Tha p.rc.nt t..abl. for joint ....1. e.labllshad .or. Ihan on. y.ar prior to Ih. daced.nt', d.alh: DIVIDED IV TOTAL NUH!ER OF JOIN' OWNERS E...pl.: A joint ....t regl.t.red DIVIDED BV TOUL NUHBER OF X 100 PERCENT U)CAIIIE SURVIVING JOIN' OWNERS in the na.. 01 Ihe dec.danl .nd Iwo other persons. 1 DIVIDED BV ] (JOINT OWNERS) DIVIDED BV Z (SURVIVORS) - .161 X 100 16.1% (TAXAILE FOR EACH SURVIVOR) B. The parc.nl taxable for a.sels craatad within ana year of Ihe decedenl's death or accounl. owned by tha decedent but h.ld In tru'l for anolher Indlvldual(.) (tru.1 ben.flclarl..I: 1 DIVIDED IV TOTAL HUH!ER OF SUAVIVINC JOINT OWNEAS OR TRUST BENEFICIAAIES X 100 . PERCENT tAXABLE E.a.pl.: Joint account regl.larud Ih. d.c.dent. 1 DIVIDED IV 1 (SURVIVORS) - .50 In tha na.e of tha d.cedent and two olher parson. and establishad within one year of de.th by X 100 50~ (tAXABLE FOR EACH SURVIVOR I 4. th. aaount subjact to ta. (lln. 4l I. dat.r.lned by aultlplylng Ihe accaunt b.lanca (1In. Z) by Iha parcant ta.able (1In. 1). c ~"..t t... t....l tof th_ rt.hh "nd d.~'Jetlons lisl.rt In P.rt 1. 6. th. h.ount ta.abla (1In. 6) I. deter.ined by sUbtracllng tha dabts and deduction. Illne 5) fro. the a.aunt subjeel to 'a. (1In. ~). 7. Enler Ih. approprl.t. la. rat. (ll"a 7) a. deterainad b.low. A. Fat dat.. of death occurring after 6/]0/94, the t.. rate. for tran.f.rs to spou... are a. lollews: I. Oat.. of daath on or afta" 7/1/94 .nd b.for. 1/1/95 the ,.ale Is 1%. 1. Oat.. of d.ath on or after 1/1/95 Iranslar. to spou.e. will be ta.ed at 0% ta. rala. Notal For d.I.. of d.alh prior 10 111/9~ transf.rs to .pouse. are ta.able at 6~. B. Tran.f.r. to Iln.al d.scendant. Including f.th.r, aoth.r, son, daught.r, grandchlldr.n, .on-In-Iaw, daught.r-In-law, .t.pchlld and th.lr I..ue ar. ta.able at .1. parcent (6%). C. Tr.n.f.r. to .11 oth.r. Including brolh.r, .Ist.r, uncle, aunt, nephew And niece are t..able el Ilfteen perc.nt (15%). D. If you chang. the ta. rale, plea.a specify your relallonshlp 10 Iha deced.nl In the IIr.a provided. 8. th. a.ount ef ta. due (1In. 8l I. d.ter.ined by aUlllplylng Ih. a.ount ta.able (lln. 6) by the I.. ral. tlln. 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. d.bt. and d.ductlons ara dotar.lned es follow.: A. Vou legally .r. re.pon.lbl. for p.y..nt, or Ih. est.t. subj.ct 10 ad.lnl.lr.llon by a parsonal r.pre..ntatlv. I. Insufllcl.nl to pay Ihe d.ductlbl. It.... B. Vou .ctually paid th. d.bts after d.ath of Ih. d.c.d.nl and can furnl.h proof of pay..nt. C. D.bts b.lnG clal..d .u.t be it..I,ed lully In Part 1. If additlon.l spac. i. n.aded, u.. plain pap.r a Ill" . 11". Proof of pay..nt ..y b. requ.sl.d by the PA D.pert..nt of Rav.nu.. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TDD' (717) 772-2252 (HEARING IMPAIRED ONLY) COHHOHWUl TIl or PI NNSVl VANIA DlPAMIHlNI or NfVINUf. aUk[AU or INDIVIDUAL rul.s OlPI. ;'BObOI ItARRISBURC, II" Illa-ObOl * FILE ACN DATE NO.21 'I (,' '/1. ", 96136140 09-04-96 INFORMATION NOTICE AND TAXPAYER RESPONSE I".thllll""'" ACCOUtlT Ix] SAVINGS [] CItECKING o T1~UST o CERTlF . TYPE OF EST. or BARBARA It HARLACHER S,S, NO, 194-26-6516 OATE or OEATH 06 - 0', - 96 COUNTY CUMBERLANO EDITH V SQUIRES PO BOX 233 LEMOYNE PA 11043 REHIT PAYHENT AND FORHS TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 11013 DAUPHIN DEP BANK & TAU hili prollidld the Olpnrt.lnt with thl Infor."tlon listed below which hn bun used in calculating the pot.ntlal taM du.. Ih.lr r.cords Indicate that at thl death of the nbov. decedent, you w.re ft Joint ownlr/bln.flciarv of lhls account. H you f.el this Inforlllatlon is Incorrect, please obtain wdthn correcUon frolll lhe flnancl"l Institution, nttnch a copy to this for.. nnd return It to the nbo..,. addr.ss. This account Is taMnble In accordnnc. with the InheritnncI In. lnws of the COllllllonwlalth of Pennsvlvanla. QUI.tlons ..y be answer ad by calling 1/1/1 18/-a)l'. COMPLETE PART 1 BELOW Account No. 4908120614 . . . SEE REVERSE SIDE FOR 02-05-73 FILING AND PAYMENT INSTRUCTIONS Oat. EstabUsh.d 10 Insure prop.r credit to your account. two (2) caples of this notlc. IIIUSt nccoapany your pny..nt to the Register of Wills. Hnlt. checlt payable to: "Reglstlr of Wills. "Vlnt". Account Bdanca 11,811.41 Percent Taxabl. X 50.000 A~ount Subject to To. 5,905.71 Tax Rate X ,06 Pohnll.l Tax Du. 354.34 NOIE: If taM pay.ents are nadl within thra. 13) "onths of the decldlnt.s dati of death, you lIIay deduct a ~Z discount of thl taM dUI. Any Inh.ritanc. taM due will blco.. dlllnqulnt nine (9) "onths .fter the date of death. PART ill TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE [CHECK ] ONE BLOCK ONLY A. ~ the abov. lnfor~atlon and ta. due Is correct. 1. You ~ay chaos. to re.lt pay..nt to the Aeulster of wills with two cop Ie, of this notice to obtain a discount or avoid Interest, or you ~ay check bo~ "A- and return this notice to the Aegister of Wills and an official 8ssess..nt will be Issued by the PA Depart.ent of Aevenu.. PART ~ T~Y LINE B. r=J The ftbove asset has been or will be raported and tn. paid with the Pennsylvania Inheritance Tn. return to be fllad by the decedlnt's r.presentatlve. C. r=J The above 1nfor.ation Is Incorrect and/or debts and deduction, were paid by you. you ~ust co.pletl PART 0 and/or PART 0 below, If you indicat. a dlffe~ant tax rate, pl.ase stat. your relationship to decedent: n" TAY nN .InTNTITI>II"T Ar.r.nUNT!l OFFICIAL USE ONLY 0 AAF OF REVENUE :o~ ~.~ PART ~ DATE DEBTS AND DEDUCTIONS PA '8~RTHENT PA\ ~~.. .~ 2 g' 3 .. 4 ,:, 5 6 1 8 CLAIMED (J) .... - I>"TlII>N . r.nloll>lITIITTnll 1. Dat. Established 2. Account Balance 3. Percent Taxabl. 4. A~ount Subject to Tax S. Debts and Deductions 6. Anount Taxabl. 7. Tax Rat. 8. Tax Due 1 2 3 4 5 6 7 8 .... ~ -.."-_ ,-, .~' \.. x :::t ~.:. :. .-. s: 'i; ) --. ..... .. - e vl.. l>:l o 6. x PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax COMPutation) $ Unde~ penalties of p.~ju~y, 1 declare that the facts 1 IMPlete to the best of ny knowledge and beli.f. _I: I L' ell { "( L' J .-.;. ~ l ~_ I-t t '''--' TAXPAYER SIGNATURE i have ~eported above a~e HOME (-,,'" )').'H WORK ( ) TELEPHONE NUMBER true, correct 3('~f and DATE GENERAL INFORMATION 1. fAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAM ASSESSMENT with appllcabl. Int.,.., b.ud on Infor..tlon sub.lttld by thl flnancla. Institution. Z. InhlrltanCI tl. bleo... dlllnqu,nt nln. lonth, .ft., thl dlcldlnt', dlt, of d..th. J. A Joint account I, ,...bl, Ivan though thl dlc.dlnt', n... wa. ftddad '1 . ..It., of convlnlane.. ,. Account. I Including tho'l hlld batw.,n husband Ind wl'., which thl dlCldlnt put In Joint ".... within on. y.., prior to d..th .r. fully ".,bl. II trln,f.,.. 5. Iccount. ."abtl,hld Jointly batw..n hu'blnd Ind wi'. lor. thin on. y..r prior to d..th .r. not ,...bl., 6. Ac:ount. hlld by . dlcldlnt -In trult fo,. anoth., or oth.r. .r. ".abl, fully, REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BlOCX I - Jf thl Infor..'lon and co.pul.llon In Ih. nollc. ar. corr.cl and dlducllon, ar. nol being elat.ad, pl.ca an "X" In block "A" of P.rt I of Ih. "T'KP.yar A,.pon.l" '.ctlon. Sign two copl.. and .ub.11 Ih.. wllh your ch.ck for Ih. "ounl of la. to Ih. A.gl,t.r of Will. of Ih. counly Indlcal.d. Th. PA D.parl..nl 0' A.v.nu. will I.,u. an of'lcl.1 ........nt (For. AEY-IS~I EX) upon r.c.lpt 0' Ih. r.lurn 'roe Ihl R.gl.ler 0' Will.. 2. ILOCK I - J' the ....t 'p.clfled on Ihl, nolle. ha, b..n or will b. r.porl.d and la. paid wllh Ih. P.nn.ylvanla Inh.rtl.nce T.. Aeturn fll.d by Ih. d,c.d.nt'. r.pr...nl.tlv., plac. an "X" In block "I" 0' P.rt I 0' Ih. "T..pay.r RI.pon.." "cllon. Sign on. copy and r.turn to the PA Dlparl.ent 0' Rlvlnul, Bureau 0' Jndlvld~al TaKII, DIPt ZID601, Harrl.burg, PA 171ZI-0601 In Ihe .nv.lop. provided. 3. ILOCK e - I' Ihe nottcl In'or.atlon I. Incorrect and/or deduction. ar. b.lng clal.ed, check block "e" and coaplela P.rt. Z and 3 .","u,ulng tu 1.1. illhlullalon. ~.i.ow. !.Iwn two COp.i.1I ana 'UD.it tn.a _Itn your cnaCk ror tna aeount or .ax payaul. to .1" IiIlgluer 0' Will. 0' the county Indlcat.d. The PA D.part"nt 0' R.v.nue will I..u. an o'flclal a..e...ant (For. REY-1541 EX) upon receipt 0' the r.turn 'roa the R.gl.ter 0' Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. Ent.r the date the account orIginallY wa, e.tabll.h.d or tltl.d In the .ann.r ..I,tlng at data of d.ath. NOTE I For a dlc.dlnt dYing aft.r 12/12/IZI Account. which the dlc.d.nt put In joint n.... within one (I) y..r of d..th .r. t.x.bl. fully a. tran,'.r.. Howev.r, th.r. I. .n ..clu.lon not to 'Kc..d $1,000 per tr.n.f.re. r.gardl..s of the valu. of the account or the nueb.r of accounts h.ld. Jf a dOubl. asterisk C..) app.ars be fora your 'Irst n... In the addr.ss portion 0' thl. notlc., the $l,DOa axclu.lon alr.ady h.. been d.duct.d 'roe the account balance a. r.port.d by the ,In.ncJ.l In.tltutlon. Z. Ent.r the tot.1 balanc. of the .ccount Including Int.r..t .ccrued to tha d.t. of d..th. 5. The p.rcent of the ,ccount that I. taxabl. 'Dr .ach .urvlvor Is d.t.r.ln.d a. follow.: A. Th. p.rc.nt t.xabla 'or joint a...t. e.tabll.h.d aor. than ana yaar prior to the dac.d.nt's d.ath: I DIVJDED BY TOTAL HUHIEA OF JOINT OWNERS Ex.aplel A joInt ....t rlglstar.d DIVIDED BY TOUL HUHBER OF X lao . PERCENT TAMABLE SURVIYJNG JOINT OWNEAS In the na.a 0' tha d.c.d.nt and two othlr par.on.. B. Th. parcant t.x.bl. for ....t. cr.at.d within on. yaar 0' the dec.dant'. d..th or .ccount. owned by the daCldant but h.ld In trust 'or anoth.r Indlvldu.IC,) (tru.t b.n.flcl.rles)1 1 DJVIDED BY 1 (JOINT OWNERS) DIVIDED BY 2 (SURVJVORS) . .167 X 1ao . 16.7~ (TAXABLE FOR EACH SURVIVOR) I DIVIDED IY TOTAL HUHBER OF SURVIVING JOJNT OWNERS OR TRUST BENEFJCTARIES X 100 . PERCEHT TAXABLE Exa,pl.: Joint eccount r.glstlr.d In the ne.a a' the dlc.dent and two othlr plrsons and astabllshad within ana ya.r 0' daath by the d,cld.nt. I DIYJDED IV 2 (SURVIVORS) . .5a X lOa . 50~ (TAXABLE FOR EACH SURVIVOR) 4. Th. a.ount .ubJ.ct to t.x (11n. .) Is dat.r_Jn.d by .ultlplYlng the account balance (llna 2) by the parc.nt tax.bla (1lna 1). ~. Fnt.r th. totAl 01 t~. debt. and d-durtlan. II.tad In Part 5. 6. Tha aaount t.x.bl. Cline 6J I. d.t.r.lned by sUbtr.ctlng the dlbt. .nd d.ductlons (llna 5) 'ra. the ..ount subj.ct to tax Cllna ~). 7. Enter the approprlat. t.x rata Cltna 7) a. d.t.r.lnld b.low. A. ror dat.s of d.ath occurring .ftar 6/30/94, the tax rate. 'or tran.far, to SPOUSIS ar. .. 'allow.: I. Data. of d.ath on or a'tar 7/1/94 and b.fora 1/1/9S thl rate I. 5~. 2. D.t.s of d.ath on or a'tar 1/1/95 tran"lr. to .pous.. will b. t..ld at O~ tax rata. Nate: For d.t., 0' d.ath prior to 7/1/94 tr.n.,.r. to spou... ar. taxabl. at 6~. B. Trans'lr. to Iln.al d..candant. Including 'athlr, .oth.r, .on, d.ught.r, gr.ndchlldr.n, san-In-l.w, daughtar-In-I.w, .t.pchlld and thalr 1"uI ara t.xabll at .Ix parclnt (6~J. e. Tran.far. to all othars Including broth.r, sllt.r, uncia, aunt, neph.w and nl.c. ara taxabl. .t fl't..n p.rcant C15%J. O. If YOU chang. tha t.x r.t., pl.... sp.cl,y your rll.tlonshlp to the d.cad.nt In tha ar.a provld.d. B. Th. ..ount of t.x due C1Jn. 8) I. dlt.r_lnad by ,ultlplylng the ..ount t..abla (llnl 6) by tha t.. rata (lln. 1). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. dabt. and d.ductlon. .ra d.tlr_ln.d a. followSl A. You lag.lly ar. ra,pon.lbla 'Dr paya.nt, or the I.tate 'ubj.ct to .d.lnl.tr.tlon by I p.rsonal r'pr...ntatlv. I. In.u'flclant to pay the deductible It.... B. You actually paid the d.bts aft.r d.ath of the d.c.d.nt and can 'urnlsh proof 0' paY'.nt. e. D.bt. baing cl.I..d au.t b. It..Jz.d fully In Part 1. I' .ddltlonal .paca Is naed.d, u.. plain pap.r 1 1/2" xlI". Proo' of pay.ent .ay b. rlquast.d by the PA Depart..nt of Ravanua. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY) I ", , .I ' { .9.,M ~~. d.1-0~-7~f (O""OHWI"IIII UI I'INNSVIVANIA IlI,PAW''''' HI UI III VI NUl 'H"UlU UI IHlJlVWUAt 1"_1 S ~1'11l'. ~8D(,Ol tIANIUSI\UIlG, "1 111:"'01101 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 961',0930 09'10-96 Ii, 1~.1 II I" II 1\ I ----~----_._.__._--.-------_., ._~~-~,.--"~.~.,.._--- TYPE OF ACCOUNT I"] SAVINGS ixi CIIECKING , . l : TRUST i ,CERTlF. CST, or BARBARA H HARLACHER 5,5. NO, 194-26-6576 OATE or DEATH 06-0,,-96 COUNTY CUMBERLAND .. KURT A HARLACHER 51 N 31ST ST HBG PA 17109 REMIT PAVMENT AND FoRHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 DAUPHIN DEP BANK & TRU hilS provic1od tho Dnptlfl..nnt with Iho Inlornlttlon lhtml bAlow which has hun u\oll in cIllcullltlng the potontlnl tAll duo. Their rocordl Indlcnto lllat .11 tho tlllllth of tlut ,lhoVQ tlncullont. you woro it joint ownor/lleneflcl,'PI of Ihls /'lecount. If you f..l thls lnforftlltion 15 Incorrocl, Illonu olllnln wrlUon conoelle" Irolll tho flrlilnclill Institution. 'lttitch it COl'Y to this forn ..".. .....,,, 11 t.. tt,.. .-.:.0':".[, ud:1rr:::.::. !hl~ )t:,,:,,.1 It .......hl.. I.. ,.,rrn...h...... ""ltl1 Ih.. lnlmrlt;,"clI IIU Iilw, 01 tho (o""onwo/tlth 0' Panns'llvitnln. Qua.tlon. ./ty ba answared by calling 11111 181-8S11. FILING AND PAYMENT INSTRUCTIONS REVERSE SIDE FOR 11-17-95 10 Insuro prOllnr crfldll to your "ccounl. two Ii'J coplos of Il1ls notice nust nccolllp/tny your 'Jowl'llont to Ihe Roglslor of Wills. HIt~o chud Illlynbla to: "Raglster 0' Wills. Agont". COMPLETE PART 1 BELOW Account No. 004327371B . . . SEE Date E s tabU shed PART [!] 32.393.11 50.000 16,196.56 .06 971 .79 TAXPAYER RESPONSE FAILURE TO RESPOND WILL, RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE Account Oalanc. P81"'Cent Taxable A~ount Subject to Tax Rat. Potential Tax Due K NOI[: If IItlt paYlllenls Me Mda within thrna 11) "onths 0' lha dacedent'; dilte 0' daath. you .ay daduct 11 ~1. discount 0' tha tltX due. Any Inharlt"nca tit. dua 101111 beta.a dellnquont nino 191 1II0nths of tar the dltte of death. Ta. x [CHECK ] ONE BLOCK ONLY' A, ,Iho IIbove Inforlllatlan Itnd IIIlt due Is correct. 1. You .ay chao so to rll.lt pltYlllonl to tho Aogtster of Wills with two coplo. of Ihls nollco to obtain II discount or avoid inloro.t, or YOU IIlny chock bolt "A" .,nd roturn this notlco to tho Roghler of Willi nnd an offlclnl /tssos..ont will be iSluod by the PA Dopltrt.ont of PavonulI. B, r=J Iho nbovo /tlsot hns boon or 101111 be roporlad nnd In. pltld wilh tho PennlylvRnln Inherltnnce Inx return to be fllod by tho docedonl" roprosllntntivo. C. ~ Iho Abovo In'orllllttlon Is Incorroct nnd/or debts and daductlons wore paid by you. 'Iou .ust co.plolo PARI ~ nnd/or PARI [!] billow. PART ~ TAl. LINE If you indicate a diffel"'ent tax rate, please state your relationship to decadent: OFFICIAL USE ONLY 0 AAF PA DEPARTMENT OF REVENUE lAX UN JU1N I hRUST AC(;()UliT~ R~rURN - ~UM~UI~11UN 1. Date Established 2. Account Balance 3. Porcent Taxable 4, Anount Subject to Tax 5, Debts and Deductions &. A~ount Taxable 7. Tax Rate 8. Tax Due x rAil 1 2 3 4 5 6 7 8 CLAIMED . --J U~ 1 2 3 4 5 b 7 X 8 CJ(") -II PART [!] DATE DEBTS AND DEDUCTIONS ". '. PAYEE DESCRIPTION AMOUNT PAID tOO PAID I 'I' l TOTAL IEnter on Line 5 of Tax Conputationl l fach 1 ~c.. GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFfICIAL TA)c ASS[55HENl with IIl'pllcnhl. afl"H." 111""111011 inforllllltlol1 lubllltt.d by thll 'Immellll In'Illutlun. Z. Inh.rlt.nce h.M bllco... d.llnqullnl "lnll 'm""" .fl.r Ih. du..dent'. lilt'. II' 1I."lh. S. A Joint .ccount It I,,,"bl. IIVII" though Ih. tllI'"lhul'" "".. WII' ",hhul "I II ""tt.r of cnllv."llIncII. ft. Account. (Including tho,. ".Id h.tw..n hll_bllnd ""d wlf.. ..hll;h Ihe dMcII,hml II\lt In Joint ""... within line Ylltl' prior to d..th .r. rully 1,"1'1111. ". tnln,f.r.. !I. Accounts .,I"bll,hlld Jointly lI"tw..n hUltu,"d ,,"II wi" .,nll tlum one YII"t fir lor to llllnth lit. Jlot 11l~"bl.. 6. Accounts h.ld by . deellden' "In trull 'u," "nnth.r or oth.t. ",. ',unlit. fully. REPORTING INSTRUCTIONS - PART I TAXPAYER RESPONSE 1. BLOCK A . If thll Inlarlll.tlon ,md co.putatlon in Ih. notice nre corrDct llnd duductlnns nr. not belno dal"ed. plac. fIn "X" In bloc'" "A" of Part 1 of the "'".pny.r P..pon.... ucthm. Sign two caples and .uh.iI th.. wilh your chDclo for the n"ount of h. to the Reght.r of Willi of the county Indicated. 1h. IIA Dllpart.llnt of Pev.nu. will luu' an olflclal 1I1.......nt (For. R[V.I!t4B [XI upon nc.lpl of the r.turn fr08 IhD Rllohtllr of Willi. Z. BLOCX B _ If the ....t .p.cifl.d on this notlc. hn. be.n or will he r.port.d and ta. paid with the PDnnlylvanla Inherltanc. TaM Return fll.d by the dec.d.nt', r.pre.entntl",.. plnc. an "X" In bloc'" "B" of Part t of the "'a.paYllr R..pon.... .ectlon. Sign on. copy and r.turn to the PA Dep"rt"."t of Re",lInu.. Bureau of Individual Tn.... D.pt ZBObOI. Ilarrlsburg. IIA 111Z&-ObOI In the eny.lop. provid.d. 3. BLOCK C _ If the notlc. infor.atlon i. Incorr.ct "nd/or deduction. "re b.ing .cl"I..d. chDc'" bloc'" "C" nnd co.pl.t. Pnrt. Z "nd 3 DoCCC,.t::l'I; tc U:~ 1:-.~trl..;~tl.mJ 1..1..... ::I;r. t..... ......:"10 ....d jo..:.....;~ t;..... ..:u. ,...., ..It....t. fU' "'" ....UUIH uf tnll ,,,'yallh. \u In. ADgl.,er of Will. of the county Indic"t.d. 1h. PA Depart.ent of Rllv.nu. will i..ue an official "..e....nt eror. R[V-IS4& EX) upon rec.lpt of the r.turn fro. the Rogl.t.r of Will.. TAX RETURN - PART - TAX COMPUTATION 2 LINE I. Ent.r the date the account orlgln"IIY was ..tabll.h.d or tillod In thD .anner ..I.tlng lIt d"t. of do"th. NOTE: For a d.c.d.nt dying after IZ/IZ/BZ: Accountl which the d.cedent put in joint n"... within on. II) y.ar of doath are ta.abl. fully". tr"nsfer.. II0w.vDr. thore Is Dn lu(cluslon not to D.c.ed 13.000 p.r trnn.ferao regardl.n of the yalu. of the account or tha nu.b.r of "ccount. h.ld. If a doubl. a.t.rl.... C..) App.ar' b.for. your first na.. In the "ddr... portion of this notice. the IS. 000 ..clu.lon alr.ady has boen deducted fro. the account balDnc. a. report.d by the flnnnclal Institution. Z. Ent.r the totat balanc. of the account Including Int.r.st accru.d to the date of d.nth. 1. Th. p.rc.nt of the account that I. t..abl. for oach survivor I. d.t.rnined "s follows: A. Th. p.rc.nt taxablo for joint ....t. .stobli.hed nore than on. y.ar prior to the d.c.dent.. death: DIVIDED BV TOTAL HUMBER or JOINT OWN(RS E.,,_pl.: A joint "...t r.gi.lor.d DIVIDED BV TOTAL NUHB[R OF X 100 . P(RCENT TAUBlE SURVIVING JOINT OWNERS In the na.. of tho decodent and two other p.r.on.. I DIVIDED BV 3 (JOINT OWNERS) DIVIDED BV Z (SURVIVORS) . .167 )( 100 . 16.7:< (TAXABLE FOR UCll SURVIVOR) B. Th. p.rc.nt ta.able for a...t. cr."t.d within one y.ar of the d.c.dont.. death or account. ownod by the d.c.dent but hold In tru.t far another Indlviduale.) Ctru.t b.n.flciari..): I DIVIDED BV TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 . PERC[N' TAXABLE E.a.pt.: Joint account ragist.red in tho d.c.d.nt. I DIVIDED BV Z (SURVIVORS) . .50 X the na.. of the dec.dent "nd two oth.r p.r.on. and ..tabll.h.d within an. y.ar of doath by 100 SO~ lTAXABlE FOR [ACIl SURVIVOR 1 ~. Th. aeouot .ubject to ta. (Iln. ~) i. det.r.ln.d by .ultlplylng tho account balanco (1In. Z) by the p.rcent ta~ablo Illn. 3). S. [nt.r the total of the d.bt. and doductlon. II.t.d In Part 3. 6. 'h. a.ount ta.abl. tlln. bl i. dotor.inod by ,ubtractlng the dobt. and d.ductlon. Clln. 5) fro. the ".ount .ubJect to t". (line 4J. 7. Ent.r the approprl.t. tax rate Clln. 7) a. d.t.rolnod b.low. A. For dat.. of d.ath occurring aft.r 6/30/94. tho t". rat.. for tran.f.r. to IpOUSO' are ". follows: I. Oat.. of d."th on or aft.r 111/94 "nd b.foro 1/1/95 the rat. i. 3~. Z. Oat.. of death on or aft.r 1/1/9~ tranlf.r. to spoUle. will bo ta.od at O~ ta. rat.. Not.: For dat.. of d.ath prior to 7/1/94 tr"n.for' to spou.o. ara t,,~abl. at 6~. B. Tr.nsf.r. to lln."l d..c.ndant. inclUding f"thor, "oth.r. .on, d.ughter. gr"ndchlldron. Ion-In-law, daughter-In-law. .tepchlld and thoir 1.lu. aro ta."bl. at .1. porC.nt (6~). C. Tr.n.f.r. to .11 oth.r. Including brother, .I.t.r. unci.. "unt. noph.w .nd ni.ce are ta~ablo at flft..n porc.nt II~~). O. If you chang. the tax r.t., pl.... spocify your r.lallonship to the d.c.dent in the ar." provld.d. &. Th. a.ount of ta. due Cline &) I. dotoroln.d by eultlplvlng the a.ount t".abl. (1In. b) by the ta~ rat. Illn. 11. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED ~ CIJ Is t;.,fflcl.nt N Il.c,n Proof of Allownbl. debtt and d.duction. "r. d.t.r.ln.d as follow.: A. You l.gallY are r..pon.lbl. for pay..nt. or the ..tat. .ubJect to ad.lnl.tr"tlon by a p.rsonnl r.pr...ntatlv. to pay the d.ductlbl. It.... B. You actually p"id the dobt. aft.r d.ath of the d.c.d.nt "nd c"n furnish proof of p"y..nt. C. n.bts b.ing elal..d ou.t b. ite.lnd fully In Part 3. If "ddltionnl .pac. It n..d.d, un plnln p"p.r a I/~" . pay..nt .ay b. requ..t.d by the PA D.part..nt of R.v.nu.. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE. CONTACT ANY REGISTER OF WIllS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE ~ OR CAll THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN eo HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY) - - .. " ~ ....:s; r'~ I -~ - \.j \ r-( , ... -. .-..... w:2 ~ :::l~Z r>> ~t-Q ~ >-'cn " w<- _ ~:::l~ ...cC < o~~ ~ t-Ct- ZZw '" ~-u-~ ~O~~~ <:::l!:=~!!! ~<~ ~ ~~~fu~ <::!Zcx ~-- &-. ~i ~u '\.g- .~ ~~ ~\ \ '{ ! ,1; '- 'I !t \l ~.. \.~ ".~ \ i r'~ ~l ~ I = " , - - - - - - - - - - - - - - E -: - - - - -=- I I , '\ ,. <l ,~ .' . {, , . ( I . . ~. . ~ .r J (:' :r '" . !. . ~ ,.... .-. ;" \. .. . 'lito 'j " ';~ ..-:: , . J t<' . , ~. . --, ---- -,:, -~-. . --_.:-...~~ -.-- . - . ~ R, ~_ .. ~ W COMMONWEALTH OF PENNSYlVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE Dear Register of Wills: Enclosed you willlind: Dcheck(s) Ddocuments(s) which were received by the Deportment of RBvenue in error. These may be processed according to normal procedures. REMINDER: The POST MARK DATE on envelope attached to ony checks enclosed must oppeor an your Official Receipt. Thank you. DEltIll9-931 Sincerely, John Murphy, Chief Inheritance Tax Division (717) 787.6201 " t' t ,. :. -; "l l ". 'n ,) . , l ..' ~ " " ,." , ~ . " t,k- :,. , ___1 -,--- _ qr.._ -r-':. " . --- --,~_.~~-: -' -..-:"'~ .,' . , ~ , I .~ . . " GENERAL INFORMATION 1. FAILUAF. TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSE:,SHENT with fI,IPllubl. Int.,..t t",ud on Inlor...lIon lub.ltt.d by the linnnc:hl IntUtullon. l. Inherlbnee 'II. beeo... delinquent nine _Gntt,. aft.r the dec.d.nt', dllt. of f1uth. J. A joint .ccount h ta..bl. .ven thouQh the II.cedenl', nil.. ..... ..dd.,1 "' II ."thr of conll.nlenc.. 4. Account. (Including tho.. held betw..n hUlbllnd and wlf.. which the l.cedent put In Joint nil..' within on. yea' prior to d..th ar. fully ta..bl. 8' tranlf.r,. ~. Accuunt. .11.bllshed JointlY betw..n husbllnd and wi'. .or. than on. Y..' prior to II.IIth ",. not I"..ble. .. Accounts held by . dacadant "In trult for" anoth.r or oth.r. .,. t.."bl. fullv. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A . If the Inlor..tlnn and co.pulallon In Ih. nollc. ar. corr.cl and deduction. ar. not b.lno dal..d, plac. an "X" In block "A" 0' Part I 0' Ih. ..ta.pay.r A..pon.... ..cllon. Sign t~o copl.s and lubalt Ihaa ~Ith your ch.ck for Ih. a.ounl of ta. to the A.gllt.r 01 Willi of the counly Indlcat.d. The PA Deparl.enl of Aev.nue ~lll Ilsu. an olllclal nl......nt (For. AEY~IS4a EXI upon r.ulpl of the return fro. the Aeghhr 0' wills. Z. BLOCK a . If the ..,et .p.cllled on thl. notlc. has been or ~III b. reported and ta. paid with the P.nnsYlvanla Inh.rltanc. fa. R.turn 'lied by the dec.dent.s r.pr..entativ., plac. an "X" In block "a" of Part I of the ..ta.pay.r Aelpon.." .ectlon. Sign one COpy and raturn to tha PA C.parl.ent of Aevenue, Bur.au of Individual ta..., D.pt 18ObOI, tiarrllburg, PA 111ZS-0bOI In the .nvelop. provided. ]. BLOCk C . If thu notlc. Inlor..tlon II Incorrect and/or Jed~ctlon. ar. b.lng clai..d, chec~ block "C" and coaplate Partl Z an~ ] ...........:.... .... ::-._ ...~. 4...;..... ......... :;:... ..... ...",i... ...... .......i~ .;..... ...... ,..... ....... ,... .,,~ a.......II .., ...... ....,..u... ... .. ".."i..... of Willi of the county Indicated. th. PA D.part.ent 01 ~ev.nu. will I..ue an ofllclal "1..ls..nt (Fora AEV-IS4a EX) upon r.celpt of t~. return Ira. the Reoi.t.r of Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. Ent.r NOTE: tha det. the account originally ~as e.tabllshed or titled In tn. .anner e.l.tlng at date of de.th. For a d.c.d.nt dying alt.r IZ/IZ/aZI Account. which the decedent put In joint na... within on. II) y.ar 0' d..th ar. ta..bl. fully a. tren.f.". tlowev.r, there is an e.cluslon not to a.ceed $S,OOO p.r transfer.. re\lardl... of the value of the account or the nu.ber of accounts held. ,. S. If a doubl. .Iterlsk (..) appe.rs b.for. your flr.t na.. in the address portion of this notjs.""lhe alr.ady hal been deducted fr08 the account bal.nce as reported by the financial lnstitullo~)~ J C F' Entar the tot.1 balanc. of the account Including Intere.t accrued to the date 0' death. ~, ; th. percent of Ihe account that Is t..able for each survivor i. deter.in.d a. follows: A. Th. p.rc.nt t...bl. for Joint all.ts .stabllsh.d .or. than one year prJor to the d.cedent.s deethl U,OOo .6 --I e.clUtl~ :0{t! . -- ~ DIVIDED BY TotAL NUHBER Of JOINT OWNERS E...pl.1 A Joirlt ....t rellisterad DIVIDED BY tOTal HUMBER OF X laD . PERCENT UXABlE SURVIYINC JOINT OWNERS In the na.a of the decedent and two other persons. ,,1 --I D, I DIVIDED BY ] IJOINt OWNERSJ DIYIDED BY Z ISURVIVORS) . .161 X 100 1&.7Z UAlliBlE fOR E~Clt SUAYIVOAb th. perr.ent ta.able 'or a.,ets cr..t.d wilhin one y.ar of the doc.d.nt's doalh or account. own.d by the de~~t.nt in trust for anolh.r Indlvlduall') (trust b.neflclarluJ: +(J. I:;' >-- VJ but-h~~ I DIVIDED ay TGtAl HUMBER Of SU~VIVINC JOINT OWNERS OR tAUST aENEFICIARIES 100 . PERCENT TAKABLE x E.aoplel Joint account regist.red the doc.d.nt. I DIVIDED BY 2 (SURVIVORS) . .50 In the na.o of tho d.c.~ent and Iwo oth.r persons ftnd ..tabllshed within on. year of d.ath by X 100 50Z ITAXABlE foA EACH SURVIVOR) ~. The a.ount SUbject to IB~ Illne ~) is doler.ln.d by .ulliplYlng the account balance 1111'10 2) by Ih. perc.nt ta.abla (line ]). 5. Ent.r Ihe total of the d.bts and d.ductlons Iht.d In Part ]. 6. th. aa~ur.t ta.abl. Ulne 6) It. .let.r.lned by subtract I,.,) the d.Dts In.d do:tuctlons (1lnill 5) fno the uount s..bject to '11M (1ll'1e It). 1. Ent.r the approprlat. ta~ rat. (line 1) as d.t.rein.d below. A. For dat.. of d.ath occurring a't.r 6/]0/94, the taM rales for tran.fers to spouse, are ftS follows: I. Oat.s of death on or after 7/1/94 and b.'ore 1/1/95 Ih. ral. is SZ. 2. Date. of d..th on or a,t.r 1/1/95 trans'ers 10 Ipousas will be tft.ed at OZ tft. rat.. Note: For date. of dealh prior to 7/1/94 trftns'er, to spouses are la.able at &Z. a. trantf.rs to lln.al delcendants Including father, .oth.r, 'Ion, daughler, grandchildr.n, son-In-lnw, daughter-In-law, It.pchlld and their ISlu. ar. la.abl. al sl. p.rcent IbZI. C. Transfe" to all othe" Includlno brother, shter, unci., aunl, nephew and nl.c. are \a_abl. lit fllhon parc.nt (1SZJ. D. If you chang. the t.. rate, pleal. sp.ci'y your r.latlonshlp 10 the deced.nt In the ar.a provided. D. tha a.ount of taM due Illn. aJ Is d.ter.lned by nultlplylng Ihe aaount ta.able 1111'1. fI) by the la. ral. I line 71. \.."l -.J ~ CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED I'.) c..: Allowable dobts and deductions are d.t.r.lned as 'allows: .. You le\lally are r.,ponslble for pay.ent, or the .stat. subj.ct to ad.inlstralion by a p."onal representallv.:t.. inlufficlent to pay the deductible It.... You actually paid the d.bts after death of Ihe dec.d.nt and can furnish proof of ~ay.ent. D.bt. belno cl.I..d DUlt be It..lled fully In Part]. If addilional space II n.ed.d, u,e plain pap.r a I/Z~ ~.rl". Proof 0' pay.ent .ay b. request.d by Ih. PA Depart.ent 0' Aev.nu.. D. C. ..,. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327, TDD' (717) 772-2252 (HEARING IMPAIRED ONLY) GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSES'jHENT loll'" nllllllcllhl.. IntrHA,t 11,."...111I1 in'nfllu,t1l1ll lub.llhd 11'1 the finnncial Institution. .. Inh.rltance 11111 bneo"'.' dllllnqulInt nln. 1II0ntlll nftllr Iha decademt" cIltl. of cI.."I". J. A Joint account 11 t"."bh. A..,un thollQh Ih. Illlcltth",t', n".. 10M. Illldue III" lIIi,thlr of convenlllneA. 4. Accounts I including tho.'" hald between husbAnd "nd wlfel which I"A "..cllllt.ol II\lt In Joint 111111I8' within nlllt yltM wlor to dll..th IIr. fully '"xllbl. fit tra"lf.r.. !to Accounts ..tabll.hed jolntlv betw..n husband nnll wife lIIur. tllIIO on. yo,., prior to dUAlh ntQ nnl III.o:nbl.. b. Accounts "lIld by " declldont "In trust for" Imothur or oth..r. IIrO tl,.nbla fully, REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A . If the infer.atlon nnd CO.'lutftUOn In tho notico Me corroct nnd doduction" MO not being dnlflllld, pineo nn "X" In block "A" of Pnrt I of tho "Ia_pnyor Pupen,o" socllon. Sign two cop"'" mId ~utJ.it the. with your chod. for 'he ".ount of tnlt to the Reghter of ~i1ls of the county indlcatad. Ihe flA Dopnrtlllont of Pnvonuo will Inue nn offlclnl "UlIIu.ent (fer. RLV-I~4a [X) upon rocoipt of 'hlll ra'urn fro. 'ho Pllghtor of Wllh. Z. alDCK B _ 11 the nuot "poclUod on thl, notico hAS bOlln or will bu roportod nnd tall. pnld with 'he Pllnnnlvnnln Inhorltnnce Talt Peturn fUed by the docedant'" roprlll~ontallvo, plnca IIn "X" In block "a" of Part I of thlll "I".payar Ruponse" sllctlon. Sign onll copy and raturn to tho PA Dllpnrt.lIl1' of PlIvonulI, 8urnl1u of Individultl In.os, Dllpt ;'80601, Ill1rrhburg, PA 1I1za-0601 In thlll envelope provided. 5. BLOCK C _ If the notice Infor.atton is Incorrect nnd/or deductions nre being clni~ed, chock block "Coo nnd co.plete Pnrts 2 nnd 5 :;'';';.;lrd!:,it to. U',," ;",.itr..ct:;J(,.~ :........... :;;." ~.... ..op;... ..".. "vU"'~ ,..... willi YUur CII"l;'" ,ur tnu tUlOU"t 0' Hue pllYI'IDla to tnu "'oglster of Wills of the county indlcntad. Ihlll PA DlIIpllrt",ont of POVllnUlII will issuo nn officlnl nUlIIn.ont (rorlll R[V-I~4a [)O upon receipt 01 thlll return fro. the Register of wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. Enter NOTE: the date the IIccount originally was 1II1tl'lblishnd or tltlad In tho "nnnar o_lstlng nt datil Of~~. for a decedent dylno nfter IUIl/aZ: Accounts which the decadent put In joint MIIIOS within. _;;'11 yoft',.;of tallable fullY as transfers. tlowover, thore is ;an o_cluslon not to e.cood $3,000 pllr trnns H regllrdIilSs thO account or thO nu~bor of Accounls hold. ~I denthrll~ of I~' ~Iue of If a doublo allor1sk (1111) npponrs bufore your first nl'l.o In the addross portion of this notlClII, the $5~~~O o.cluslon alrendy has beon doducted fro. tho account bnlnnco as roportod by tho financial Institutlon.. ~- N -.J ,. " Enter tho total balanco of thu nccount InclUding Interest nccruod 10 thlll datil of death. The parcent of tho account Ihat Is ISlIablo for 8l1ch survivor Is dotor.inod liS follows: A. Tho parcant ta.abla for joint assots astabllshed nore Ihan one yoar prior to tho dacedent's du~th: DIVIDED BV TOTAL NUHBER OF JOINT OWNERS A joint assot roglstorad DIVIDED BY TOTAL NUHIICR OF SURVIVING JOINT OWNERS tho docadent IInd two othor x 100 . PERC[NT TAXABLE --;) W ~1 L' 1 DIVIDED BV 1 (JOINI OWNERS) DIVIDED BV 2 (SURVIVORS) . .167 X 100 .'~ W 16.7:1. (tAXABLE fOR [ACIt SURVIVORI parsons. pri J... ::-- Ella.pla: in the nll.o of B. Tho parcant taltabla for assets crentad within one yellr of tho dacedant's death or accounts owned by tho doclldent but hald in trust for anothar indlvldual(s) (trust buneflclarles): I DIVIDED ay TOIAl NUHBER Of SURVIVING JOINT OWNERS OR TRUST BENEfICIARIES )t 100 PERC[NT TAXABLE Elta.pla: Joint IIccount roglstored in tho na.o of tho ducadant IInd two othar persons and established within ono yoar of denth by tho docedon t. I DIVIDED BY Z (SURVIVORS) II .50 X 100 ~Ol (TAXABLE fOR EACH SURVIVOR) .. .. .. 7. Tho a.ount ,ubjact to tlllt (llno 4) Is deter.lned by .ultlplylng thlll account balanClll (1lna 2) by tho percent ta.able (line 5). Entor tho total of tho debt. and deduction. listed In Part 1. Tho a.ount taKabla (Iln. 6) I. deter.lnllld by subtracting tho dabts and deduction. (line 5) fro. tha a.ount .ubjlllct Enter the appropriate ta~ rat. (1lno 71 as det.r.ln.d bolow. 0In.41. A. For data. of death occurring after 6/50/94, tha talt ratos for transfars to spouse. aro as followl: 1. Date. of death on or nftar 7/1/94 nnd bafora 1/1/95 tho rata is 1l. 2. Datas of doath on or aftor 1/1/95 trnnsfar. to spousal will be ta.ad at Ol talt rate. Not.: For dat.. of d.ath prior to 7/1/94 translors to spou..s or. ta.abl. at 6l. B. Transf.rs to lineal desc.ndants Including fathar, "oth.r, son, dllught.r, grnndchildran, son-In-In.., daUghter.in-la.., stepChild and thalr Issue aro ta.llble at sill porcent (6ll. C. Transfor. to all oth.rs Including brother. sister, uncle, nunt, nllphew and niece lira tallablo nt fiftalln percant D. If you change tho talt rat., plen.a spaclfY your relationship to tho decadent In tha aroa provided. to tu \D -.J ~- ''0 L' ~~%l. a. Tho a.ount of tu duo Illno In h detor.inad by .ultlptylng the ".ount taublo Illne 6) by tho tall. rll'e Illno 7), ':.} .r.- o CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowablo debts and doductlons aro dator.ined ns follows: A. 'Iou legally are r.,ponslble for pay.ont, or the astato subjoct to ad.Jnlstrallon by n porsonnl represontntive i. insufflclant to pay tho dllductlblo lta.l. B. 'Iou actually paid Iha debt. nflar death of tho dacadont and cnn furnish proo' of pny.ent. C. Debls b.lng clel.ed .ust be Uo.lzad fully In Part 5. If additional sPlice 11 nuudod, usa plain pnper a Ill" 10; II". Proof of pny.ent lIlay be roquested by tho PA Oopart.ent of Rovanuo. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CAll THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY) - " // '=-" /~ ~:, ~ "~\: "\ :-: ... , ,:. "i; J ........~-, ,) '~ ~ 'J r- -. , ,\ ~ '~ ~ - 0 '.( .-' ~ . " U .. ~ t-. '3' " > ;: 1; ..;:. .. ':1 " ~ -' " -! '.c -~ '~ ~ . .:Ii 'u " - . ~ ... " .1 ~ - I: ~ C .. . Ru. ; of F' I ills '91 Jil:; 1../ P3 :3:' - - - - - CI:/~ ;, Cl'" , (:j" ,,,,,-,. . ~~ ... 8 , II) N ... '" ... w:3 ::l~z ~I-O >...'" w<- ao:::l2: 11..00 0>>< < 1-_< A. ZOI- 'wZw ~o~~~ ~::l!=II)::1 w<ao:Nji oWWl-ao: ao::J:A. ~~~~~ ". 1." r. .' [, . , r ~ . I r )- '" " " , , . \ ~ ;" t , ~ ,~ (~ . J \.: . __of -~ - -_-----........--"".JllIlI _ -- -'- -..,:. :- - . ,\ '0-', .,- ... MS MARY CLEWIS REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE CARLISLE PA 17013 . -, " '~'-'I..' .. ~ I , . '~ . . . . . . . . U;II. POUAGE : ., .\ " (')(') ~ ::0 C::'7 ~S is (1 ..',' .> ~ -"a . Sm " " .. ,:",,'Q. , c '" a~ ....J '^', ~. -::J ~g ~:J iii . 'llt-: ...~ sa. ):,.;-- " \,.oJ " ,I , .. , .:~ . r , \':' .' -_I -p--""""- . '. _~~ ~__d"'__~-:'~ _...rc~ 1-:. -'.-- .... C01lllllonlloalth of Deportment of Revenue nurcQu of Individual Dept. 2B0601 IbrrisburK. PA ~--'_.'_.._--'''';---,~''':';'' ~..... . ~", ., , i J" l' ). '"tc, , <- 'I . '. , . I ..,":" . t'JIo-' ! ,,~. " - -.-:"~" ---- -Q.- ~,:. . -..--,.----... --- --- --. ----.- - ....- _._- '~-' _..- ----~ - -..., .... -.-. ... ~--- --. -. - - -- - -- -~- _.. _. .--- ---- --- -- - -. _.~- - - lfV.I1UD(U'1 184966 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT O' REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX '* D ~o. AA RECEIVED FROM: 6 ACN ASSESSMENT 'l' CONTROL ... NUMBER AMOUNT EDITH V SQUIRES '>'1>131>112 _:;l;:li:!.'/t:l 4324 NORTH 3RD HARRISBURG, PA Sl'REET 17110 96136113 961::16114 '631.72 $.1,06::1.13::1 '>'1>1;;10/;;19 '''I''.IJt:l ,otO HUll .354 . 34 . ESTATE INFORMATION, ~ FILE NUMBER 5i 21-1996-0768 !:II NAME OF DECEDENT llAST) ~ HARLACHER BARBARA II DATE OF PAYMENT m POSTMARK E COUNTY 96136740 S5N IFIRST) H 19/+-26-6576 IMI) I,. i ,I CUMBERLAND DATE OF DEATH . i) 1 , . REMARKS EDITH V SQUIRES ra TOTAL AMOUNT PAID $2,996.75 CW SEAL CHECKtI 150 REGISTER OF WILLS RECEIVED BY >>>" , , " , < , . <-' SIGNATURE ." ",'-, .:-. MARY C. LEWIS ' .l.u" REGISTER OF WILLS ~ '.' '1 , ~ 'I. ":" /'/0 --.- --- '--- --...- -~.- -~-- " . . . ---. .- ..-.' ----,~ .......~ ~.nT ~1.:. ...~ -_. ~l'" 111....1 146786 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT O' REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX *' DNa' AA RECEIVED FROM: I ACN ASSESSMENT r:t CONTROL iii . NUMBER AMOUNT KURT A HARLACHER '/61"0'130 '$'171.79 5 NORTH 31ST STREET HARRISBURG, PA 17109 ESTATE INFORMATION: ~ fiLE NUMBER U 21-1996-0760 ~ NAME Of DECEDENT (lAST) ~ HARLACHER BARBARA II DATE Of PAYMENT m POSTMARK DATE COUNTY SSN (FIRST) H 19,,-26-6576 (Mil CUMBERLAND DATE OF DEATH m TOTAL AMOUNT PAID "971.79 REGISTER OF WillS . "SK (1 }1 ... "j RECEIVED BY h~/'I1 .. /' /)11" ~J) "/1..1 .. fl"Ul/ / . . I.,. MARY C. LE S ';. '" I, , ;1"/ f REGISTER OF WILLS 1'11.: ' , REMARKS KURT A HARLACHER SEAL CHECKtI 685 ...--..----.- --"--" i_;~ 1 ___1 --- ~....,... _ _ -- .---..." . -'-;"~.~_ F - .,:. f"'\ .. ,~ ,,' .. ci: co r~ co ~ LII ~1I PURPOS[ OF UJ u. r.....- - HOfICEr CCTo-'u1flllRh. ncal1rCi.ntl of Section 2140 of the lnh.rltanu and E_tate 'a. Act, Act 22 of 1991. cn P.S. Section ZlU). UU PAV~NTr D.tach tha top portion of thll Hotlc. and .ubalt with your pay..nt to the Rlgl,t.t of Will. printed on the r.v.,... _Id.. -. Hah check or ItOMY order PlYebla tal RECISTER Of lUllS, ACENT. All pay.ent. r.calved ,hall flr.t ba applied to any Int.r..t which '.y ba due, with any r...lnd.r applied to the t... REFUND (CAlr A r.fund of . ta. credit, which wa. not raqua.tad on the ta. r.turn, ..y ba requa.tad by coaplatlng an ~Appllc.tlon 'or Rafund of Penn,ylvanla Inheritance and E,tat. Ta." (REY-llllt. Applications .t. available at tha OffiCI of the Alal.t.t of Willi, any of the Zl R.v~' District Offlc.. or by calling the ,paclat Z4-hour an'wlrlng ..rvlcl ~r' for for.. ord.rlngl In P.nn.ylvanl. 1.8aa.,6Z-Za5a, out.lde Penn.ylvanla end wlthln local Harrl.burg Ir.. (717J 787.8a9~, TOO' (717) 77Z-ZZSZ (H.arlng I.palrad Only). OBJECTIONS: Any party In Int.r..t not .atl.flad with the appral...ant, allowanca or dl.allowanca of dlductlon. or ........nt of t.x (Including dl.count or Int.r..t) .. .hown on thl. Notlc. ..y obJ.ct within .I.ty (6a) day. of r.c.lpt of this Notice by: ..wrltten prot..t to tha PA C.part.ant of RIVenu., Bo.rd of App.al., Capt. Z8IaZI, Harrl.burg, PA 17IZ8-la21, OR ".lectlng to h.v. tha ..ttar d.t.r.lned .t the ItUdIt of the .ccount of the p.rson.1 repre.ent.tlv., OR .-app.al to tha Orphan.' Court ADttIN- ISlRATlVE CORRECTIONS: f.ctu.1 .rror. dl.cov.r.d an thl. .......ent .hould ba .ddr....d In wrltlng to: PA C.p.rt.ant of R.venue, Bur.au of Individual l...., ATTN: Po.t A......ent R.vl.w unit, DEPT. Z8a601, Harrl'burg, PA 171Z8-a6al Phone (717) 787-65aS. S.. p.g. S of tha bookl.t -In.tructlon. for Inharltanc. Ta. R.turn far. RI.ldent Decadent- (REV-15al) for an .xplan.tlon of adelnl.tratlv.ly corractabl. Irror.. DISCOUNT, If anv ta. due I. paid within thr.. tSJ calendar aonth. .ft.r the decad.nt'. d.ath, . flv. p.rc.nt (S~) dl.count of the ta. p.ld I. .Ilow.d. PENAL TV: The IS~ ta. aen..tv nan-partlclp.tlon p.n.lty I. coaputad an the tot.1 of the t.x and Int.r..t .......d, and not p.ld b.'or. January 18, 1996, the flr.t d.y aft.r the and of the t.x .-nl.ty period. Thl. non-partlclp.tlon penalty I. app.alabl. In the .... .ann.r and In the the .... tl.. p.rlod .. you would epplal the t.. and Int.r..t that ha. b.en ......ad a. Indlc.ted on thl. notlc.. INTEREST I Int.r..t I. ch.rged b.glnnlng with flr.t day of d.llnqu.ncv, or nln. (9J aonth. and on. CIJ day fro. the d.te of d.ath, to the data of paY.lnt. TaXI' which beca.. d.llnquent before Janu.ry 1, 1982 b..r lnt.r..t at the r.ta of .1. (6~) Plrc.nt p.r ~ calcul.ted at a dailY r.t. of .aaaI6~. All taxes which b.c... delinquent on or aft.r January 1, 198Z will b.ar Int.r..t .t . rate which will vary froe calendar year to c.lendar y.ar with that r.ta announced by the PA Cepart.ant of R.v.nu.. Th. appllcabl. Intar..t rata. for 1982 through 1997 ar.1 Va.r Int.r..t R.t. C.lly Intlr..t Factor V.ar Int.r..t R.ta Oally Int.r..t F.ctor 198Z Z'X .aaaS,.8 1987 'X .aaal47 1985 16;( .aoaos 1985-1991 llX .aoosol 198~ 11;( .00nDI 199Z 'X .DaDZft7 1985 UX .DanS6 1993-1994 1X .Oao19Z 1986 I'X .Da0274 1995-1997 .2 .DDaZft7 uJntar..t Is celculatad .. follow.: INTEREST = BALANCE OF TAX UNPAID X NUNSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .-Any Hotlc. I..ued aftar the tax b.co.., d.llnquant will r.fl.ct an lnt.r..t calculation to flft.an CIS) day. bayond th4t data of the .......ant. If pay.."t Is .acta .ftar the Inter..t coaputltlon d.t. .hown on the Notlc., additional Int.r..t au.t be calculated. ,'i-O'I' ), COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE l.--" *' BUREAU OF INDIVIDUAL TAXES INtIERITAHCE lAX DIVISION DEPf, ZIOftOl HARRISBURC. PA 11UI-060' NDTICE OF INHERITANCE TAX APPRAISE"ENT, ALLOHANCE OR DISALLOHANCE OF DEDUCTIONs, AND ASSESS"ENT OF TAX ON JOINTLY IIELD OR TRUST ASSETS ....lhlll ,,, III.nl EDITH 4324 N HBG V SQUIRES 3RD ST DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-03-97 HARLACHER 06-04-96 21 96-076B CUMBERLAND 194-26-6576 96136112 Allount R."ltt.d BARBARA H PA 17110 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ R-iv:isiia-Eif-AFji-Ci1f:96i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-03-97 ESTATE OF HARLACHER BARBARA H DATE OF DEATH 06-04-96 COUNTY CUMBERLAND FILE NO, 21 96-0768 TAX RETURN WAS, S.S/D.C. NO. 194-26-6576 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 96136112 FINANCIAL INSTITUTION, HARRIS SAVINGS BANK ACCOUNT NO. 05-39-105504 TYPE OF ACCOUNT. DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE 06-10-87 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 17,759.33 0,500 8.879,67 .00 8,879.67 .06 532.78 NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO. "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE 12-16-96 RECEIPT NUMBER AA184966 DISCOUNT (+) INTEREST (-) .00 AMOUNT PAID 532.78 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 "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I 532.78 .00 .00 .00 " . ' 00 Cf;7" ,.,. \ri -,( ::0 :;) :~: ;.u o I'UIIl'OStllF NOTlCEr .'. To fulfill t~ requlna""1 of S.ctlon Zl~D of thl IMlrlhnc:a end Eltat, hw: Act, Act ZZ~f~'99" Section 211'0). ~ ,* 1.':-.1 (7l- P.'. ~. '0 i). f") .;.~. PAYHENTa D,tlch the top portion of this NoUn end tub. It with you,. p.p.nt to thl AIghter of Willi prlntR on thl UVUI. tide. -- Maka check or ~'V order paYable tal REGISTER OF WILLS, ACENT. All pav-ent. r.calvad shall 'Ir.t ba applied to any Int.r..t ~hlch ..y ba due, with any r...lnd.r applied to thl tax. REFUND (CA)I A r.fund of . t.. credit, whIch ~.. nat r.qua.tad on the t.. return, ..y ba requa.tad by caapl,tlng an -Application for A.fund of Penn'Ylvanla Inheritance end E,tat, Ta.- (REV-Ill]). Appllcatlonl .r. avallabl, at the Of'lcI 0' the Rlalet.r of Willi, any of thl Z3 Aavenue DIstrict offlc.. or by callIng thl .paelal 24-hour en.w.rlng ..rvl,. nueber. for for.. ord.rlng: In Penn.ylvanla l-100-562-Z050, out.ld. Penn'Ylvanla and within local Harrl.burg ara. (717) 717-4094, fOOt (717) 772-Z2SZ (H.arlng I~alr.d Only). ~ i OIJECTIONS: Any p.rty In Int.re.t not ..tl.fl.d with thl appral...ent, .llowanc. or dl..llowance of d.ductlon. or ........nt of ta. (Including dl.,ount or Int.r..t) a. shown on thl. Hotl,. .Iy obJ.,t within .I.ty (60) day. of r.c.lpt of thle Natlc. by: --written prot..t to the PA D.part..nt of R'v,nu., Bo.rd of Appaal., C.pt. ZIIOZI, Harrl.burg, PA 17121-1021, OR --.I.ctlng to hlv, the .att.r d.t.r.lned at the audit of tha account of the p.r.onal r.pr..antatlva, OR --app.al to the Crphan.' Court , ,I '1 AotIIN- ISTRAflVE CORRECTIONS: Factual .rror. dl.cov.red on thl. .......ant .hould b. .ddr....d In writing tal PA C'Plrt..nt of R.vanua, Bur.au of Individual T...., ATTNI Po.t A.......nt Revlaw Unit, DEPT. 210601, Harrl.burg, PA 171ZI-0601 Phon. (717) 747-6505. 5.. page 5 of the bookl.t "In.truction. for Inh.rltanc. Tax R.turn 'or a R..ldant Dec.dent" (REV-ISOI) for an .xplan.tlon 0' adalnl.tretlv.IY corr.ctabl. .rror.. DISCOUNT s If any tax due I. paid within thr.a (5) ,alend.r .onth. .ft.r tha d.ead.nt'. d.ath, . flv. p.rcent (5X) dl.count of the ta. paid I. .llow.d. PENAL TV I Th. 15~ tax aana.ty non-participation pen.lty I. co~t.d on the tot.l of thl tax and Int.r..t .......d, end not paid b.fora January II, 1996, the flr.t day aftar the .nd of the tax aan..ty p.rlod. Thl. non-plrtlclpatlon penal tv I. appealable In thl .... .annar and In the the .... tl.. p.rlod a. you would appa.l the tlX and Int.r..t th.t ha. blan .......d I' Indlclted on thl. notlcl. INTERESTs Int.r..t I. ch.rgad b.glnnlng with flr.t dlY of dallnquency, or nln. (9) aonth. and one (1) day fro. the dati of death, to the dlt. of pa,..nt. Tax.. which bac... d.llnquent blfor. January I, 1912 b..r Int.r..t .t the rat. of .Ix (6X) perc.nt p.r ennua c.lculatad at . d.lly r.t. of .000164. All t.... whIch bee... d.llnquent on or aftar January 1, 191Z will b..r Int.r..t at a rat. whIch will v.ry fro. c.landar y.ar to c.landar y.ar with th.t rat. announcld by the PA DIP.rt..nt 0' R.venu.. The appllcabl. Int.r..t r.t.. for 191Z through 1997 ar'l V.ar Intlr..t Rata DillY Int.ra.t Factor Vllr Intlr..t R.t. CallY Int.r..t Factor 1912 ZOX .000541 1907 9X .000247 19n 16X .000451 1918-1991 It:( .000301 1914 llX .000101 199Z 9X .0002" 1985 UX .000156 199]-1994 7X .00019Z 1986 lOX .000274 1995-1997 9X .0002" --Int.r..t I. calculat.d .. followlI INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hotlc. I..ued .ft.r the tax blCoaal d.llnquent will r.fl.et an lnt.r..t calculation to flftaan (IS) day. b.yond the d.ta of thl ....,...nt. If pay.ant I. aad. .ft.r the Int.r..t co.putatlon data .hown on the Natlea, additional Int.r..t lU.t be calculat.d. ;5-/ ).'1,), COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE i*, c BUREAU Of INDIVIDUAL TAXES IHtIERlTAHC[ faX DiViSION D[P1. 2aOllOl HARRISBURG, PA l11:a-Ob01 NOTICE OF INNERITANCE TAX APPRAISEKENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTION" AND ASSESS KENT OF TAX ON JOINTLY IIELO OR TRUST ASSETS 1I,.lhlll U, Ill.... EDITH 4324 N HBG V SQUIRES 3RD ST DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-03-97 HARLACHER 06-04-96 21 96-0768 CUMBERLAND 194-26-6576 96136113 ""ount R...Ut.d BARBARA H PA 17110 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ R-EV:iSirS-Eif-AFfi-ii1f:96i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD DR TRUST ASSETS DATE 03-03-97 ESTATE OF HARLACHER BARBARA H DATE OF DEATH 06-04-96 COUNTY CUMBERLAND FILE NO. 21 96-0768 TAX RETURN WAS. S.S/D.C. NO. 194-26-6576 (X) ACCEPTED AS FILED ( ) CHANGED JOINT DR TRUST ASSET INFORMATION ACN 96136113 FINANCIAL INSTITUTION. HARRIS SAVINGS BANK ACCOUNT NO. 05-31-139972 TYPE OF ACCOUNT. DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE 02-13-89 Account Balanca Percant Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 21,057.45 0.500 10,528.73 .00 10,528.73 .06 631. 72 NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAVMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS, MAKE CHECK DR MoNEV ORDER PAVABLE TO, "REGISTER OF WILLS. AGENT." TAX CREDITS: PAVMENT DATE 12-16-96 RECEIPT NUMBER AA184966 DISCOUNT (+) INTEREST (-) .00 AMOUNT PAID 631,72 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AfTER TillS DATE, SEE REVERSE fOR CALCULATION OF ADDITIONAL INTEREST. · I IF TOTAL DUE IS LESS TIIAN '1, NO PAYKENT IS REQUIRED, IF TOTAL DUE IS RefLECTED AS A "CREDIT" ( CRI, YOU KAY BE DUE A RefUND, SEE REVERSE SIDE Of THIS fORK fOR INSTRUCTIONS. I 631.72 .00 .00 .00 00 c '- \.~j " (1' ......; :.:~ a .> ... \ J ~ J' -. '0 -, ?J ......l , " ,- -, PURPOSE OF NOTICE, To fulfIll the ~'qulr..ant. of Slctlon 21~D of the Inheritance and Elt.t. 'a. Act, Act 22 of 1991. (72 P.S. Sac:tJon ZUG). PAMHT, a.tach ttM top portion 0' thlt Hotlc. end lub.1t with your pay..nt to the Rlaht.,. of Wllh prInted on the r.....,... lid.. ... "aka chIck or ~y ord.,. payable tor REGISTER OF WilLS, AGENT. All p.y.en', rac.I...~ ~ll ,Jr.t ba ,ppll.d to any Int.r..t which '.y ba ~, with any ra..lnd.,. 'PPllad to the tax. REFUND C CR) I A r.fund of . ta. credit, which .... not ,..qu..t~ on the tax return, .ay ba raqua.tad by co~l.tJnD an "ApplIcatIon lor R.fund of Penn'vlvanl, Inheritance end Eatet. '.x" CREY.!]l]), 'ppllcatlon. ara available at the O"lce of the AI,lsta,. of WIlli, an) of the 25 Ravlnue Dlltrlct Offlc.. or by calling the .p.clal Z4-hour an.w.rlng ..rvlc. ~.r' fOr for.. ord.rlngs In P.nn.ylvanla 1-100-36Z-Z0S0, out.ld. P.nn'Ylvanla and within loc.l Harrl.burg ar.a (717) 717-1094, TOOl (717) 77Z-22SZ (Ha.rlng Iapalrad Only). OBJECTIONS I Any party In Int.r..t not I.tl.fl.d with the .ppr.I....nt, .llowanc. or dl..llowanca of d.ductlon. or ........nt of ta. (InclUding dl.count or Int.r..t) .. .hown on thl. Notlc. .ay obJ.ct within .Ixty (60) d.y. of r.c.lpt of thh Hatlc. bYI --written prot..t to the PA Dapart.ant of R.v.nue, lo.rd of Appe.l., D.pt. 2110Z1, H.rrl.burg, PA 171Z8-1021, OR --."ctlng to h.va the ..tt.r d.tar.lned .t the audit of the .ccount of the p.rson.l rapra.ant.tlve. OR --app..l to the Orphan.' Court ADMIN- ISTRATIVE CORRECTIONS I factual arror. dl'cov.r.d on thl. .......ant .hould b. .ddr....d In writing tal Pi D.p.rt..nt of R.v.nu., lur.au of Indlvldu.l T...., ATTNs Po.t A.......nt R.vl.w unit, DEPT. Z10601, H.rrl.burg, PA 171Z8-0601 Phone (717) 717-6505. 5.. p.g. S of the booklet -In.tructlon. for Inherltanc. Tax R.turn for. Ra.ldant Oec.dent- (REV-ISOl) for an .xplan.tlon of .dalnl.tr.tlv.ly corr.ctabl. .rror.. DISCOUNTI If any t.x due I. P.ld within thr.. (3) c.l.nd.r ~th. aft.r the dacad.nt.. de.th, a flv. p.rcent (S~) dl.count of the tax p.ld I. allow.d. PENALTYI Th. 15% t.x e~.ty non-p.rtlclpatlon p.n.lty I. coaput.d on the tot.l of the t.x and Int.r..t .......d, end not p.ld bafor. Janu.ry la, 1996, the flr.t d.y .ft.r the .nd of the tax a~..ty periOd. Thl. non-p.rtlclp.tlon pen.lty I. .ppaalabl. In the .... .annar and In the tha .... tl.. parlod .. you would .pp..l the t.. and Int.r..t th.t h.. baen ......ad .. IneUc.t.d on this notlc.. INTERESTI Inter..t I. ch.rg.d baglnnlng with flr.t d.y of delinquency, or nln. (9) .onth. and on. (1) day fro. the data of d.ath, to the d.ta of ply..nt. T.x.. which b.ca.. dellnqu.nt b.for. January I, 1912 baar Int.r..t at the r.t. of .Ix (6~) p.rc.nt p.r .nnu. calculat.d at a d.lly r.t. of .00016~. All t.M.. which b.ca.. d.llnquent on or a,t.r January 1, 191Z wIll b.ar Int.r..t .t a r.t. which will VAry fro. caland.r y..r to calandar y..r wIth that rata announc.d by the PA D.p.rt..nt 0' R.v.nu.. Th. appllcabl. Int.r..t r.te. 'or 191Z through 1997 .r.1 V..r Int.r..t Rat. D.11y Int.r..t factor 198Z 1913 191~ 1915 1916 --Int.r..t zax lOX lU UX lOX 11 c.lculat.d .000541 .000438 .000301 .000356 .oaoz" a. follow.s V..r Intar..t Rata Dallv Intar..t Factor 1917 'X .000247 1981-1991 11% .000301 199Z 9X .OaoZ47 1993-1994 7X .00019Z 1995-1997 9X .000ZO INTEREST ~ BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hatlc. I"u.d aft.r tha t.x b.co... d.llnquent will reflact an Int.r..t c.lcul.tlon to flft.an (15) day. b.yond the data of the ft.......nt. If pay.ant I. .ad. aft.r the lnt.r..t coaputatlon date .hown on the Notlc., addItional lnt.r..t ~.t be calculated. PURPOSE Of NOTlCEr PA'lH[HT. REFUND (CRlr ("')0 \('i :ry " ,. .I :",1 -' - " ) .i. , ..... '0 To 'ul,lll the r.qulr...nt. 0' S.ctlon ll~O 0' the Inh.rllanc. end E.tal. Ta. Act, Act 2l 0' 1991. (72 P.$. Sactlon 2140), Datach the top portion 0' thl. Nollca and .ubalt wllh your p.y..nl to Ih. R.gl.l.r 0' Will, prlnl.d on the ravar.. .Id.. -- Haka chack or .on.~ ordar p.yabl. 101 RECISTER DF WilLS, ACEHT. All p.~..nt. racal~ad .h.ll 'Ir.t ba appll.d to any Inl.r..t which ..~ ba du., with any r...lnd.r appll.d 10 the I... , ra'und 0' . t.. cradll, which wa. not raqua.lad on the tax r.lurn, .ay b. r.qu..I.d by co.platlng an ~Appllc.tlon 'or Aa'und 0' Pann.yl~anla Inh.rltanc. and E.tala Ta.~ (REV-l)I]). Applications ar. av.llabla .t Ih. O',lce 0' the Aegl.t.r 0' Will., any 0' tha 25 Revanua DI.trlct Of,lca. or by calling tha .p.clal Z4-hour an.w.rlng ..rvlca nuab.r. 'or 'or.. ord.rlng: In P.nn.ylvanla I-BOO-362-ZaSa, out.ld. P.nn'Ylvanl. and wllhln local Harrl.burg ar.. (717) 7B7-809~, 1001 C717) 77Z-llS2 CH.arlng lap.lr.d Onlyl. OBJECTIONS: Any part~ In Int.r..t not ..tl.,I.d with the .ppr.I....nt, allowanc. or dl.allowanca 0' dlductlon. or a.,.....nt of ta. (Including dl.count or Int.r..I) a. .hown on thl. Not Ie. .a~ obJ.ct within .I.ty C60) day. 0' r.calpt 0' thh Notice bYI --wrltl.n prola,t to tha PA D.part.ant of A.vanua, Bo.rd 0' App.al., Oapt. 281a21, HarriSburg, PA 17)2a-Ia2), OR --.I.ctlng to have Ih. .atllr d.l.r.ln.d at Iha audit 0' the account of tha p.r.onal r.pras.ntatlv., OR --app..l to the Orphan.' Court ADMIN- ISTAATlVE CORRECTIONS! OISCOUNTI PENALTY: INTEREST! F.ctu.l .rror. dl.cov.r.d on thl. ........nt should b. addr....d In writing to: PA Oep.rt..nt 0' RIV.nu., Bur.au of IndivIdual Ta..., ATTN: Po.t A.......nt Ravlaw Unit, DEPT. Z80601, ttarrhburg, PA 171za-a6al Phona (717) 787-6SaS. S.. pag. S of Ih. bookl.t ~In.tructlon. for Inh.rltanc. Ta. R.turn 'or a Aa.ldant D.c.d.nt~ (REV-)Sa)) 'or an a.planatlon of .dalnl.tratlv.ly corr.ct.ble .rror.. If any t.. due I. paid within thr.. ()) cal.ndar .onth. a'l.r the dac.d.ntt. daath, a 'Iv. p.rc.nt (S~) dl.count of Iha la. paid I. allow.d. Th. IS~ ta. aan..ty non-partlclp.tlon p.nalty I. co.pul.d on Ih. lotal of the la. and Inlar..t .......d, and not paid b.for. Janu.ry 18, 1996, the 'lr.t d.y a't.r the .nd 0' the ta. aan..ty p.rlod. Thl. non-Plrtlclpatlon penalty I. Ipp.alabl. In the .a.. .ann.r and In Ih. the .... II.a parlod a. you would apPIII Iha tax and Inl.ra.t th.t h.. b.en .......d .. Indlcat.d on this notlc.. Int.rast Is ch.rg.d b.glnnlng with flr.t day of d.llnqu.ncy, or nln. C9) aonlh. and on. (1) da~ 'fO. the d.t. of d.ath, to the d.t. 0' p.~..nt. T.... ~hlch b.c... d.llnqu.nt b.'ora Jenuary t, 1982 b..r Inl.r..t at tha rei. of sl. C6~) p.rc.nt par annua calcul.t.d at . dally r.t. 0' .aODI64. All tl... ~hlch b.ca.. d.llnqu.nt on or .ft.r January I. t982 will b..r Int.r..t .t . r.t. which ~III vlry 'ro. cat.ndar ~"r to cat.nd.r ~I.r wIth th.t ret. announcad by the PA Dapart..nt 0' Ravenu.. Th. appllcabl. Int.r..t rat.. 'or 198Z through 1.91 ar.r V.ar Inl.r..t Ral. Dally Int.r..t Factor V.ar Int.rut R.t. Oall~ Intarut hctor 1987 .~ .aOOlU t.88-199) tU: .Danal 1992 .~ .aaaZ47 )993-199~ 1~ .aaal9Z t99~-1991 .~ .aa0l47 t.82 t.83 19ar. 1985 1986 ulnt.r..t zn 16~ 11~ In In I. calcut.t.d .. .aaaS~8 .aOa~38 .aanal .aanS6 .aa0l74 follow.r INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notlc. I..u.d .ft.r the t.w b.coa.. d.llnqu.nt will r.,l.ct an Int.r.st calculation to fl,t..n (I~) dlys b.~ond the data of the ........nl. If p.y..nt I. ..d. .,t.r the Int.r..t co.put.tlon d.t. .hown on the Notlc., additional Int.r..t au.t b. calcul.t.d. (')(') c: " :1 f' vi <J :-:. ;::1 o 'J .... '. ",'- o 1:-: \Q PURPOSE Of' NOTICE, To fulfill the r.qulr...nt. of Slctlon 214D 0' the InherItance and E,t,t, TI. Act, Act 22 of 1991. (72 P.S. Section ZUO)' PAMNTI DelICh the top portion of thl. Notlel and .ub.lt with your paYlent to thl Algl.t.r of WIll. prlntad on the rav.r.. .Id., -. Make chIck or loney order psyab., tOt RECISTER OF WILLS, AGENT. All p.~t. rlc.lved .hlll flr.t be applIed to any Int,r..t which ..y b, dul, with any r...inder applied to the tax. REfUND leA J r A r.fund of . ... credIt, which wa. not r.qul.t.d on thl tax return, '.y ba raqua.tld by coaplattng en ~Appllc.tlon for R.fund of Pennsylvanl, Inh.rltencl 8nd Eat,t, T.x~ (REV..31]), Application. .r. IVIllable at thl OffiCI of the Regl.t.r of Willi, any of thl 23 Rlv.nue DIstrlct Offlc.. or by calling thl 'Plcla. 2'~hour an.werlng ..rvlc. nuaber. for for.. ord.rlngl In Penn,ylvanla 1.800-562-2050, out.lde Penn,ylvanl. and within loc.. H.rrl.burg .r.. (717) 787-80'4, TOO' (7.7) 772-2252 (H..rlng lap. Ired Only). OIJECTIONS. Any p.rty In Int.r..t not ..tl,'I.d with the .ppr.I".ent, '1lowance or dl..llowanc. of d.ductlon. or .......ant 0' t.x (Including dl.count or Int.r..t) a. .hown on thl. Notlc. '.y obj.ct wIthin .Ixty (60) d.y. of rec.lpt 0' thh Notlu byl --written prot..t to the PA D.p.rta.nt 0' R.v.nu., lo.rd 0' App.al., D.pt. 281021, H.rrl.burg, PA 17128-1021, OR ".Iectlng to h.v. the ..U.r d.t.raln.d at the audit of the .ccount 0' the per'onal repr..antlltln, OR --appe.1 to the Drph..,,- Court ADHIN- ISTRATlVE CORRECTIONS I Factual .rror, dl.cov.red on thl. ........nt should b. .ddr....d In writing tOt PA D.p.rt.ent of R.venue, Buraau 0' IndIvidual T.~.., ATTHI Po.t A......ant R.vl.w unit, DEPT. 2a0601, Harrl.burg, PA 17128-0601 Phon. (717) 717-6505. Sa. pag. 5 of the booklat "In.tructlon. 'or Inh.rltanca tax R.turn 'or a Ra.ldant Decadent" (REV-1501) 'or an axplanatlon 0' ad.lnl.tratlvaIY corractabla arror.. DISCOUNT' If any t.~ due I. P.ld wIthin thr.. (5) c...ndar .anth. a'tar thl d.cad.nt-. d..th, a 'Iv. p.rcent (5X) dl.count 0' the t.~ p.ld I. allow.d. PENALTYt Th. 15% t.. .~.ty non.p.rtlclp.tlon p.n.lty I. coaputld on the total 0' the t.~ and Int.r..t .......d, and not paId b,'or, Janu.ry 11, 1996, tha flr.t day ,'t.r the .nd 0' tha tax .an..ty p.rlod. Thl. non.partlclp.tlon pen.lty I. app..l.bl. In the .... .ann.r and In the the .... tl.. p.rlod .. YOU would appe.1 thl tax and Int.r..t that h.. b.an .......d .. Indica tad on thl. notlc.. INTEREST' Int.r..t I. charg.d b.glnnlng with flr.t day 0' d.llnquency, or nln. (,) lanth. and on. (I) d.y 'rol the d.t. 0' d..th, to the d.t. 0' p.y.ant. T.... whIch b.ca.. d.llnqu.nt b.for. January I, 1912 ba.r Int.r..t at the rat. 0' .Ix (6X) p.rcent per annua c.lculated .t . d.lly r.t. 0' .000164. All t.xe. ~Ich b.c... d.llnquent on or .ft.r January I, 1982 will b.ar Int.re.t .t . rat. whIch will vary fro. c.l.ndar y..r to c.l.nd.r ya.r with th.t rat. announc.d by the PI D.p.rtaant of R.v.nu.. Th. .ppllcabl. Int.r..t r.t.. 'or 1982 through 1997 .r'l Yaar Int.r..t R.t. D.lh Int.r..t F.ctor V..r Intlr..t R.t. Dally Int.r..t Factor 1912 lOX .0005". 1917 9X .000247 1985 16;( .000411 19U.I"JI1 IIX .000101 1914 IIX .000301 1992 9X .000247 un 13X .000356 1993-1994 7X ,000192 1986 lOX .000214 1995-1997 9X .000241 --Int.r..t I. c.lcul.tad .. 'ollowlI INTEREST D BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notlc. I..ued ,'t.r the ta. b.co... d.llnquent will r,'I.ct an Int.r..t calculation to 'I't.an CIS) d.y. b.yond the d.t. of the ........nt. I' p.y..nt I. ..d. a'tar the Intar..t coaputatlon d.t. .hown on the Notlc., additional Intar..t ault ba calcul.tad. .." -'-';-.- 'v'} ., PURPOSE Of NOTICE I PAVft[NT. REfUND (CA) I c]0 (": (" ': ~ '-I :J " ':J To fulfill the r.qulr...nt. of S.ctlon 21~0 of the Jnh.rltanc. .nd E.t.t. T.. Act, Act Z2 of 1991. (7Z P.S. S.ctlon ZIUJ. D.t.ch the tap portion of thl. Notlc. .nd .ub.lt with your pay..nt to the A.gl.tar of Will. prlntad on the r.y.r.. ald.. .. "aka ch.ck or .un.y ord.r p.y.bl. tal REGISTEA OF WILLS, AGENT. All p.y.ant. r.c.lv.d .h.ll flr.t b. .ppll.d to any Int.r..t which ..y b. dUI, with any ra.alnd.r appllad to the t... A r.fund 0' . ta. cr.dlt, which w.. not r.qu..t.d an the taM r.turn, .ay b. r.qu..t.d by co.pl.tlng .n -Application far R.,und of P.nn.ylvanla Inherltanc. .nd E.t.t. ta.- CREV-ISI!). Appllc.tlon. .r. .v.ll.bl. .t the Of'lc. of the Aagl.t.r of Will., any of thl 2S R.vanu. DI.trlct Offlca. or by calling the .pacl.1 2~-hour an.w.rlng .arvlc. ~b.r. for for.. ordarlngl In P.nn.ylv.nl. 1-800-S62-Z050, out.lda Pann.ylvanla and within local H.rrl.burg araa (717) 787-8094, TOO' (717) 772-2252 (H..rlng IIPalrad Only). OBJECTIONS' Any p.rty In Int.r..t not .atl.flad with tha .ppral.a.ant, allowanc. or dl..llowanc. of daductlon. or ........nt a' t.. (Including dl.count or Int.r..t) a. .hown on thl. Notlc. .ay object within ,I.ty (60) day. of racelpt 0' thl, NoUc. byl .-wrltten prote.t to the PA Dlpart.ent of A.v.nue, Board of App.al., Capt. 281021, Harrl.burg, PA 17128-1021, OR --.l.ctlng to have the ..tt.r d.t.r.ln.d .t the audit of the .ccount of the p.r.onal r.pr...ntatlv., OR --appaal to the Orphan.' Court ADtUN- ISTRATIVE CORAECTIONSI DISCOUNT I PENAl TVI INTEREST. Factual .rror. dl.cov.r.d on thl. ........nt .hoUld b. .ddr....d In writing tal PA C.p.rt..nt of A.v.nu., Bur..u of Indlvldu.1 T...., ATTNI po.t A.......nt R.vl.w unit, DEPT. 280601, Harrl.burg, PA 17128-0601 Phon. (717) 787-6505. S.. pag. 5 0' the bookl.t -In.tructlon. for Inh.rlt.nc. T.. R.turn for. Ae.ldant Decadent- CREY-1501) for an ..planatlon of .dalnl.tr.tlv.ly corr.ctabl. error.. If any t.. due I. p.ld within thr.. (]) calandar .onth. .'t.r the dac.d.nt'. d..th, . flv. p.rc.nt e5~) dl.count 0' the t.. p.ld I. .llowed. Tha 15% ta. a8ne.ty non-p.rtlclp.tlon p.nalty I. co~ut.d on tha total of the t.. and Int.ra.t ......ad, and not p.ld b.for. January 18, 1'96, the 'Ir.t day aft.r the and of the ta. ..n..ty period. Thl. non-participation p.n.lty I, .ppa.l.bl. In the .... .ann.r and In the the .... tl.. plrlod .. you would .pp..l the t.. and Int.re.t th.t ha. be.n .......d a. Indlc.t.d on thl. notlc.. Int.r..t I. ch.rged b.glnnlng with flr.t day of dellnqu.ncy, or nln. (9) .onths .nd on. CI) day fro. the data of de.th, to thl d.t. of p.y..nt. T.... which b.ca.. d.llnqu.nt be far. January 1, 1982 b..r Inter..t .t the rat. of .1. (6X) p.rc.nt per annul calculated at a dally r.ta of .000164. All t.... which b.c... d.llnqu.nt on or .ft.r January I, 1'82 will b.ar Int.r..t .t . rat. which will vary 'roe cal.ndar y..r to calandar y.ar with that rat. announced by the PA D.part..nt of R.v.nu.. Th. appllcabl. Int.r..t rat.. for 1982 through 1997 ar'l V.ar Int.r..t Rat. D.lly Int.r..t Factor V..r Int.r..t Rat. Dally Int.r..t Fector 1982 20X .000548 1987 .~ .000247 1985 16X .oooua 1918-1991 1I~ .000101 19a4 lliC .000101 1992 .~ .000247 1985 U:C .000356 1995-1994 7~ .000192 1986 10~ .000274 1995-1991 n .000247 --Int.r..t It calculat.d .. followtl INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR -.Any Notlc' I..u.d aft.r the ta. b.coe.. d.llnqu.nt will r.fl.ct an Int.r..t calculation to flft..n CIS} day. b.yond the det. 0' the ........nt. Jf pay..nt I. ..d. .ft.~ the Int.r..t co.putatlon data .hown on the Notlc., eddltlonlll Int.r..t lU.t b. calculat.d. is - 1),'(-0 BUREAU OF INDIVIDUAL TAXES INHERITANCE tAl DIVISION DtPl. UUIl HARAISIUAC, PA 171l"O'OI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (, *' HOTICE or IHHERITAHCE TAX APPRAISEftENT. ALLOXAHCE OR OISALLOMAHCE or OEOUCTIOH",.lHO ASSESSMENT OF TAX OH JOINTLY n.LO DR TRUST ASSETS "'.1"1 n u. IlI.Ht GARV 91 HUMMEL LEMOVNE S HARLACHER AVE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-10-97 HARLACHER 06-04-96 21 96-0768 CUMBERLAND 194-26-6576 96140929 BARBARA H A..ount R..Ubd PA 17043 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ R-iy:isira-Eif-AFii-ri-i:96i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLV HELD OR TRUST ASSETS DATE 03-10-97 ESTATE OF HARLACHER BARBARA H DATE OF DEATH 06-04-96 COUNTY CUMBERLAND FILE NO. 21 96-0768 TAX RETURN WAS. S.S/D.C. NO. 194-26-6576 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 96140929 FINANCIAL INSTITUTION. DAUPHIN DEP BANK & TRUST CO ACCOUNT NO. 0043273718 TVPE OF ACCOUNT. () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTA8LISHED 11-17-95 Account Balance Percent Taxable X Amount Subject to Tax Dabts and Deductions Taxable Amount Tax Rate X Tax Due 32,393.11 0.500 16,196.56 .00 16,196.56 .06 971 .79 NOTE. TO INSURE PROPER CREDIT TO YOUR 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 01-21-97 RECEIPT NUMBER AA185114 DISCOUNT (+) INTEREST (-) .00 AMOUNT PAID 971.79 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · I IF TOTAL DUE IS LESS THAN '1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YDU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I 971 .79 .00 .00 .00 I"..IlPQS[ OF NOTICE a "" l;f".l ,/\ L~\ ..;~ 0 - I::; . - PAVlEHTI To:fulflll u." requlr....,t. of Section 2l4G of tM Im-rltlne. end Est." Tu Act, Act 22 of 1991. (12 P.S. s.cUCIf" 21401 '1""- ~. ~.~ l C\.~ :i ~ the tOP' portlon(;.lJhh MaUe. end ....It ,dth your p.~t to the Reallt.r of WUh prlnt~ on the r...,.r.. dch. .... .... check or .aMY order p.yetll1 tal REctSTER ~ UtLLS, ~. AU ptI~t. r~lved th811 fint M eppl1M1 to .,y lnt.n.t .....lch .V be due, .lth any r_lndar epplled to the tP. A r.ftrd of . tu credlt, whlch .... not ra4Mlted on the tax r.turn, .V M ,.....ted by cOIIPhtlng en '"Application 'or A,fund of pennsylvanll Inn-rlt.nce and E,t.t_ Tax- (REV-ISIS). AppllC8tlonl .r. Iv.tlBble .t the OfficI of the AIII.t., of Will., any of the Z3 Alv.nue Olltrlel Offlc.' or by calling the speclel Z4.haUr anlVerS", ..rvlc. ~r. for fo~' orderlnGa In p.nnlYlvanle l-IOD-36Z-2D5D, out,lde P~.ylvanl. and within local Harrltburg .r.. (7.7) 7.7-8094, TDD' (717) 172-2252 (Hearing I~.lred Only). REf1JND (CR) I aUCTIONS I An)' party In Int.r..t not ..thfled ..Ith tM ~rel...."t, .11~ o~ dl..l1owlnC. of dedUCUon. o~ .........t of tax tlncludlng dhcOU"t or Int.~..U .. IhoWt on thh NoUe. ..v objlCt ..Ithln .bty (60) day. of ~1C.lpt of thh MaU~ bY1 -...~ltten prot.at to tM PA OIpIr~t of A.v........., Ia.rd of AppAll, Dept. 211021, HIlr~hburll, PA 17UI-lOU, OR ...IICUna to hItv. tM ..tt.~ dlt....lned at the aueU t of tM acCOU\t of tM pe~lOMl ~epr..ent.tlv., OR ..-...,..1 to tM Qrphen.. Court AlIIIIN' ISlllATlVE CORRECTIONS I Factual .rror. dSacav.red on this .........t shoUld be eddr...ed In ..rlUna tOI Pi OIp.rbMnt of A.v"", Bur..u of Individual T...., ATTNI po.t A......-nt A.vlew unit, DEPT. 280601, HIlr~llbura, PA 17128e0601 PhonI (717) 787e6505. SeI Pili 5 of the bookl.t -In.tructlons fo~ Inhlrltenc. T.. A.tum for. A..ldent OKedIf1t- (REV-nOI) far en .xpl_t1on of ..lnSatrlUv.lY corrltCtlbll .rror.. If ."y tax 0Je Sa p.ld ..Ithln thr.. (5) celendar MJnth. .ft.r the daadlnt", delth, . five perunt u:n dl.count of the tIX p.ld I. allowed. ThI ISX tax __Ity nanep.rtlclp.tlon penel ty Is ~ted on thI totll of tM tax IInd Int.r.at ......ed, IInd not peld before Jenu8ry .1, 1996, the first dIIY .fllr thI ... of the tax -'Illy period. This non.p.rtlclp.Uon ~lb 11 ...,..llbl. In the .... .8fVMr IInd In thl the .... tI.. period .. you NOUld eppeal the tax ... Intsr..t that he' ~ .....IICI I. IneUe.ted on this neUc.. DlSCQIMTI pOUL TV I INTtRf:STI Intu..t Sa m-rgICI bellmlng ..Ith flrat dIIy of dlllnq.JenCy, or nine (9) ~th. IInd one (I) dly frM the dIIt. of death, to tM dIIt. of paYMftt. TUII which ~ dellnquent Mfor. ~ry I, 1912 ~r Int.r..t .t tM r.t. of .lx (6X) percent per ennu- celcul.tld .t . dIIlly r.t. of .000164. AU tax.. which bIeaM cMillnquent on or .ft.r January 1, 1911 ..111 bear Int.r..t .t . r.lI whld1 ..Ill vary frOll celend1r y..r to cell1t'1d8r y..r ..Ith that r.t. 8MOU1C1d by the PA Dep.rbMnt of A.vltlUl. ThI eppllcllbl. lnt.r..t r.t.. for 191Z through 1997 .r.1 Y..r Int.r..t Rat. Deily Int.r..t Factor y..r Int.r..t Alt. Dally Int.r..t Factor 19U 196' 1964 1915 19116 -.Int.rllt ZO% 16% 1\% 1$% 10% 11 celcul.ted II .000541 .00001 .GOOSOl .000556 .000274 followl' .917 1961el991 I99Z 199"1994 1995"1997 9% 1\% 9% 7% 9% .000247 .000301 .00al'" .00019: .OOOZ'" INTEREST = BALANCE OF TAX UNPAID X HUKBER OF DAYB DELI"QUEKT X DAILY INTEREST FACTOR ."Any HoUc. ..sued eft.r U. tlUC bec~' d.Unquent ..UI refl.ct ." Intlr..t c.lcul.t1on to 'if teen (5) dIIYI beYond tM dIIt. of the ........,t. If PIYMftt Is ... .ft.r the Int.r..t ~t.t1on dait. shown on the Notice, Iddltlonel Intlr..t ...t blI celculetld. t:J _UtJ { BUREAU OF INDIVIDUAL TAKES IHttUIUHC[ tAl( DIVISION DlPf. :80.01 IlARAIUUAC. PA lIua-O.Ol COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE , , * NOTICt OF INHtRITANCt TAK APPRAIStHtNT, ALLDMANCt DR DISALLDMANCt or DtDUCTIDN., AND ASStsSHtNT or TAK ON JOINTLY IItLO OR TRUST ASStTS IU.U'tU &I' In.''l KURT 5 N 31ST HBG A HARLACHER ST DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-2B-97 ItARLACItER 06-04-96 21 96-0768 CUMBERLAND 194-26-6576 96133048 .lIount R...Ut.d ~ BARBARA It PA 17109 .J MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE' CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ R-iv:iSirS-Eif-AFii-ro;f:97i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-28-97 ESTATE OF HARLACHER BARBARA H DATE OF DEATH 06-04-96 COUNTY CUMBERLAND FILE NO. 21 96-0768 TAX RETURN WAS. S.S/D.C. NO. 194-26-6576 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 96133048 FINANCIAL INSTITUTION: HARRIS SAVINGS BANK ACCOUNT NO. 10-02-132084 TYPE OF ACCOUNT. (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 08-16-95 Account Balance Percant Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0,500 ,00 .00 .00 .15 ,00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS, MAKE CHECK OR MONEY ORDER PAYABLE TO. "REGISTER OF WILLS, AGENT." TAX CREDITS: PAVMENT DATE DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID RECEIPT NUMBER TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER TillS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . IF TOTAL DUE IS LESS TIIAII '1, 110 PAYHEIIT IS REQUIRED, IF TOTAL DUE IS REflECTED AS A "CREon" I CRI, YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I .00 .00 .00 ,00 . ... .. ~-H , . PURPOSE Of NOTlCEI '0 fulfill t~ r.qulr...nt. of S.ctlon 2140 of the Inherltanca and E,tata Ta. Act, Act 21 of 1995. III P.S. S.ctlon 9140J. PAM"T: a.tach the top portion of thl, Notlcl and .ub.lt with your pay.ent to the Rlgl.tar of Will, printed on the r.var.. ,Id.. ._ "aka chIck Dr .only order payable tol RECISTER Of WILLS. AC(NT. REfUND CtRJI A refund of . tax cr.dlt, which wa. not r.qu..ted on the t.. r.turn, .ay bl reque.ted by co~lltlng an "application for Rlfund of Penn.ylvanla Inh.rltanca and E.tata Ta." (REV-l]I]J. Application, ar. av.llabla at tha Office of the Ragl.t.r of Will" env of thl 23 R.vanue DI.trlct offlca. or by calling the ,plclal 24.hoUr an,werlng ,ervlce nuab.rs for forll ordering: In P.m.ylvanla 1-800-362-2050, out.ld. Penn.ylvanla and within local Harrl.burg ar.a (717) 787-8094. TOOl (717) 772-2252 CHaarlng lapalrld Only). OBJECTIONS I Any p.rty In Int.r..t not ,.tl.fl.d with the appral...ant, .llowanc. or dl..llowance of deduction. or .......ant of t.. (Including dl.count or Int.r..tJ a. .hown on thl. Notlcl a.y obj.ct within .I.ty C60J day. 0' rlcllpt 0' thla Not Ice bYI -.wrltten protl.t to the Pi Dep.rt...,t of R.vW\Ue, Bo.rd 0' App.als, Dept. 281021, Harrhburg, PA 11128.1021, OR --.l.ctlng to havl thl ..tter det.r.lned .t the audit of the ec:cotM"lt of the pe,rsOMI rapr..ant.tlv., OR nappeal to the Orphan,' Court ADttIN. JSTRA TlYE CORRECTlONSI Factual .rror. dl.cov.r.d on thl. ........nt .hould be .ddr....d In writing tOI PI n.p.rt,ant of R.venue, Bureau of Indlvldu'l T.x.., ATTNI Pa.t A.......nt Rlvl... unit, DEPT, 280601, H.rrl.burg, PI 17128.0601 Phon. (717) 787.6505. S.. page 5 of the booklet "Tn.tructlon' for Inh.rltanc. T.x R.turn for a R..ldant Oacadant" CREY.1S01J for an ..plan.tlon of ada!nl.tratlvaly corr.ctabl. arror.. OIStDllfTI If any ta. due I, paid within thr.. (3) calandar .unth. aftar tha dlcedant'. d.ath, a flv. p.rc.nt CS~) dl.count of the ta. paid I. allowed. PENAlTYI ,~ 15~ ta. ..n..ty non'partlclpatlon pln.lty I, cDlPUted on the tot.l of thl tax and Int.r..t a.....ad, and not p.ld ba'ora January 18, 1996, thl 'Ir.t day .ft.r the and of thl tax .an..ty parlod. Thl, non'partlclpatlon penaltY 11 nppe.labla In the .... .annar and In the the ..... tI.. par10d at you would app.al the tu and Int.,...t that ha. bean .......d .. Indlc.ted on thl. notle.. INTEREST I Int.rl.t I. charged bealnnlng with flr.t d.y of delinquency, or nine (9J aonth. and one Cl) day frOl the date of d.ath, to the data of pay..nt. Tax.. which b.caa. d.linquent b.for' January 1, 1982 bear Int.r..t at the r.t. of .1. (6~) p.rc.nt p.r annul calculatad at a daily rat. of .000164. All ta... which bee... d.llnquent on or .ft.r Januery 1, 198Z will b.ar Inter..t at . rat. which will vary fro. calandftr y.ar to cal.ndar y.ar with that rate announc.d by the PI D.partaent of R.v.nue. Th. appllcabl. Int.r..\ rat.. for 1982 through 1997 ar'l V..r lnter..t Rata Oalh Int.r..t ractar Vaar Int.r..t R.t. DailY Inter..t Factor 1982 zoX .OOD~U 1987 .X .0002U 198] 16:< .000U8 1988'1991 llX .000301 1964 llX .000301 199Z 'X .Oao2"7 1965 UX .Oao3S6 1993'1994 ]X .000192 196' lOX .00027" 1995.1997 .X .aoozu "Inter..t ls calcul.ted 00 follows: INTEREST = BALANCE OF TAX UNPAID X NunBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR "Any HotlcI ".ued afhr thl ta. bKOII' d.lInquent will r.fl.ct an Intar..t ulcul.tlon to flft"" U5J dau beYond tt. date of the ......""'t. If p.,..nt II aade aft.r thfl Int.r..t COllPUtatlon data shown on tt-.. Notice, ~Itlonal Internt lU.t be ulculated. 'C'! 'J .') / ...; . ..: - ". BUREAU OF INdiVIDUAL TAXES INtI.RltAHC[ lAX DIVISIDH orPI. lIa,u IlARAISlURG, PI. 11111.0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * NOTICE OF INIIERITANCE TAX APPRAISEnENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONs, AND ASSESSnENT OF TAX ON JOINTLY IIELD OR TRUST ASSETS ......dl.." 111.111 GARY S HARLACHER 91 HUMMEL AVE LEMOYNE PA 17043 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 10-13'97 HARLACHER 06-04-96 21 96-0768 CUMBERLAND 194-26-6576 96133047 Al'lount R...1tt.d BARBARA H MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ..... R-iv=is4-a-Eif-AFfi-[o;S=97i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-13-97 ESTATE OF HARLACHER BARBARA H DATE OF DEATH 06-04-96 COUNTY CUMBERLAND FILE NO. 21 96-0768 TAX RETURN WAS. S.S/D.C. NO. 194-26-6576 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 96133047 FINANCIAL INSTITUTION. HARRIS SAVINGS BANK ACCOUNT NO. 10-02-132084 TYPE OF ACCOUNT. (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 08-16-95 Account Ba1anca Par cant Taxabla X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rata X Tax Due 1,479.00 0.500 740,00 .00 740.00 .06 44.00 NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS, MAKE CHECK OR MONEY ORDER PAYABLE TO. "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE 01-21-97 RECEIPT NUMBER AA185114 DISCOUNT (+) INTEREST/PEN PAID (-) ,00 AMOUNT PAID 44.21 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. · I IF TDTAL DUE IS LESS THAN '1, NO PAynENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FDR INSTRUCTIONS. I 44.21 .21CR ,00 ' .21CR PURPOSE OF NOTICE I To fulfill the r.qulr...nt. of Section 21~D of thl Inheritance end E.tate Ta. Act, Act 21 of 1995. C12 P.S. Section 9140). ' PA\1tENTI Detach the top portion of thl. Notlca end .uo.lt with your pay.ent to the Ragllt.r of Will. printed on the r.v.r.. lid.. ..'"-ka ch.ck or eon.y order payabl. to: RECISTER OF WILLS, ACENT. REFUND C CRJ: A rafund of . taM cradlt, which wa. not requa.t.d on the t.. raturn, .ay b. raqu..t.d by coaplatlng an "Appllc.tlon for R.fund of P.nn,ylvanla Inharlt.nca and E.t.ta Tax~ CREYaI313J. Appllc.tlon. ar. av.llable at tha Office of the R.gI.t.r of Will., eny of the 23 R.venu. DI.trlct Offlca. or by calling the .paclal Z~ahour an.w.rlng .arvlc. nuaber. for for.. ord.rlngl In Penn'Ylvanla 1-800-36Z-Z05D, out.ld. P.nn.ylvanl. and within local H.rrlsburg .r.. (717) 717-8094, TOO' (111) 772a2Z52 CHearlng lap.lrad Only). OBJECTIONS: Any party In Inter..t not ..tl.flad with the appral...ant, allowanc. or dl.allowanca of daductlon. or ........nt of t.. (Including dl.count or Intar..t) .. shown on thl. Notice aay obJ.ct within .I.ty C6D) day. of recllpt of thll Not.lu by: --wrlttan prot..t to tha PA D.part.ant of R.venua, Board of App.el., D.pt. Z81DZ1, Harrl.burg, PA 17121-1021, OR ...lectlng to h.v. the .attar d.t.raln.d at the audit of the account of tha per.onal r.pr..entatlv., OR ueppaal to the Drphen.' Court ~IN. ISTRATlVE CORRECTIONS I Factual .rror. dl.cov.rad on thl. ........nt .hould b. addr...ed In writing tal PA D.part.ant of R.ve~, Buraau of Individual T...., ATTN: Po.t A.......nt R.vl.w unit, DEPT. 280601, H.rrl.burg, PA 17128-0601, Phone (717) 711-6505. Se. p.g. 5 of the bookl.t ~In.tructlon. for Inharltanca T.. Raturn for a R..ldant Dacadent~ (REV.1501) for an a.planetlon of edalnl.tratlv.lY correctabla error.. alSCDUfrfTI If any tax due I. p.ld within three (3) c.landar aonth. aft.r the dec.dent.. d..th, . flv. parcent (5%) dl.count of the tax paid I. .Ilowed. PENALTYI The 15~ tax .-na.ty non-participation pen.lty I. coeput.d on the total of the taM and Int.r..t ......ed, and not p.ld b.for. Janu.ry 18, 1996, the flr.t day .ft.r the and of the taM .-na.ty parlod. Thl. nan-p.rtlclpatlon ,*",1 ty 11 appe.labl. In the ... ...,.r and In the the ... UN par lod .. YOU would apptI.1 tha taM and Intar..t that h.. bean .......d .. Indica tad on thl. notlc.. INTEREST I Int.r..t I. charged b.glnnlng with flr.t d.y of delinquency, or nine (9) eonth. and one (I) day froe the data of d.ath, to the data of p.w-ant. Ta.a. which bee... d.llnquent before January 1, 1982 blar Intlr..t at the r.ta of .1. (6%) percent p.r annu. c.lcul.tad .t . dally r.ta of .000164. All t..a. which beca.. d_llnquent on or aft.r January I, 198Z will b.ar Int.r..t .t . rat. which will v.ry froe calendar y.ar to calendar y..r with that rat. announc.d by the PA a_part.ant of Rav.nue. The appllcabl. Int.r..t rat.. for 1982 through 1997 aral V..r Inter..t Rat. O.lly Int.r..t F.ctor V.ar Int.r..t R.ta O.lly lnt.r..t Factor 1982 zax .000S48 1987 'X .0002U 1983 16% .aoouI 1981.1991 11% .000301 1.14 11X .000301 1992 'X .000247 1985 15X .000356 1993-1994 7X .000192 1986 I'X .000274 1995-1997 OX .0002U .4olntar..t I. calcul.ted .. followlI INTEREST" BALANCE OF TAX UNPAID X !lUMBER OF DAYS DELINQUEIIT X DAILY INTEREST FACTOR ..Any Notice "1UaCI aft.r the taM becoaa. delinquent wll1 raflKt an Int.r..t calcul.tlon to flft"" (lSJ days beyond the data of the ........,t. If paplnt .. aads _ft.r the Int.r..t CCMIPUt.Uon date Ihown on the Notice, ~Itlonal Int.ra.t au.t be calcuhted. . _.-. ~~... -,- .- :-~- ... " , , I , ( I 1 , 1 I. " ., . " , ,. \. \ } I \ '''' , ,. ~"..... I ,..H... .. ~"'~'-- . f, ~ ,~ . 71' .~ t":,' , ;." ,,,:f ,{'I"l \, I , \ ( I '. , i , ( ( \ \ \ " ~-...... /.~~ " 10 1'_ ., u ',::.., "-. '.. '. ..:: ',l rt' . I - '.: ., 'J '- - ,- " ... '- - ,. ", , :~ ., -' ;.., '.:r ., " . ,- . {. " ....J ') , , Vl -:) -...) ~ -, ,_.... 1 .-P-- :J- -r '- .; ...) o o a u <1 a, -a () -...J <....l C I- Iu T './1 .::; 'u - - '- \A .... -c ;..;::- E \.- .- '...:J .:S '-.) ~ '..:J) .,j .' N' D r -_-I . -_."~-''''.----.~ ---. '. -' .,. '\ ":-: , \ ..: '~ , -'-',l- , [' . ~ r , . ., t ~ - l"" " ',. " , c, ,) , , '.~ ~ ., 'f . , " f.~ ':' . , . J " ". . , , -.~ "1,':. _ ....;r-~ r.. .......... \ \ w Ul ::> o j:; <Yo ::> o u III CIO ,..., C) III ... co .. .. oo .. . oJ D :~ to... 1:00 a:!E -- \ U) 5 u t; a:: II .... Ul>o_ ...JI-<o Ul...JZ,..., ~~::J_ tP'S ...J.... ..; 00,," u z t>:..;w >I.LJ..J...J ~~o:c.n <U1W~ :r:~=...J t.>:>:t>: Ulwb..: :>:t>:uu .::' I, I ~ 81 .. ~g~ ! IIlCII... N ~t~...;:: C111lo;...~... llo....~~ ....O..-lcv.c 0...... fl. c . ..ctiH~ . .;sB...~tt ill< 0 .5 Jj~l~ .~ I ::l.!!l IXl _ . , . . , 1 l '. , ' ~, -. / f . . . --.--. .___1 -........,....- -.-~..Jllf"'~ qr- .,.:.