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CUM"OHWI A111t lJf 1'1 HHSYI VANIA
Of IIAIII"I Nt Of III VI NUl
IIUIf! AU Of INDIVIOIJAl TUI S
1lI111. ,'80bOI
IlAHHI UUIIC, 1''' 1/1:8.01.01
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INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 -C"jlo. 786
961',7222
09-25-96
fir 1,"1111" ".,U
EST. OF MARY P SlABONIC
5.5. NO. 201-16-0715
DATE OF DEATH 08-25-96
COUNTY CUMBERLAND
TVPE OF ACCOUNT
IJ SAVINGS
[xi CItECKING
!] TRUST
LJ CERTlF .
CAROLYN S BIXLER
7 PINE RD
MT HOllY SPRINGS PA 17065,
REHIT PAYHENT AND FORHS TO,
REGISTER OF WillS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
DAUPHIN DEPOSIT OK & T hn provided thll Oepllrhlont with the Inlorrultlon Ihted billow which hlu bllen used In clllculntlno the
potentllll Ill_ dUll. Ihlllr records Indicate that ot the dlUlth of th8 AboVII ducedont. YOU Wllf. II joint owner/beneficiary of Ihll IIccount,
11 you f..1 this Infor.atlon Is Incorrect. ph.... oblllln wrlttlln caffllctlon fro. tho 'Inancilll Institution, lIttnct' II COpy ta this for.
and r.turn It to the IIbol/lI IIddrlll'l. 1"1s account Is lau,bla In II(COrannell with the (nheritl'mc. Tn_ law, of th. CO.llonwenlth of Penn~vlvllnln.
Que,tlonl .av b. anlwered by calling (717) 787-8321.
Od.
Eshblished
REVERSE SIDE FOR
07-30-85
FILING AND PAYMENT INSTRUCTIONS
COMPLETE PART 1 BELOW
Account No. 0023493194
. . . SEE
Account BoIonco 355.55
Pe,.cent Taxable )( 50,000
A.ount Subjoct to Tox 177 . 78
Tox Rob X .06
Pohntbl Tax DUB 10,67
PART TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
A. SJrThe above infor.atlon and ta. due is correct.
~ 1. You .av choo'. to r..it pav..nt to the Aeglster of Wills with two coplel of this notlc. to obtain
a dllcount or avoid Int.relt, or YOU .ay chock box "A" and return this notice to the Aoglster of
Willi nnd nn official nlleSlllent will be Illued bV the PA Depart.ent of Aevenue.
To Insure proper credit to you,. I'lccount, two
Il) copl.. of this nolice ..ust atcollpnny your
pay..nt to the Aeglst.r cf Wills. Hilke check
payable to: "Aelllster of "'1111, Ag.nt".
HOT[1 If tn. pay.entl are !lad a within three
131 Months of the decedent's date of death,
you lIay deduct a ~1. discount of the ta. du..
Any Inherltnnce ta. due will beco.. delinquent
nine (91 .onths nfter the dale of duth.
[CHECK ]
ONE
BLOCK
ONLY
B. c=J The nbove alset has been or will be reported nnd ta. paid with the Pennsylvania Inheritance 'a~ return
to be filed by the deced.nt.s ropresentatlve.
C. ~ The nbov. lnfor.atlon Is Incorr.ct nnd/or dobts nnd deductionl were paid by you.
You IIUlt cOllplllte PAAr ~ nnd/or PAAT ~ below.
If you indicate a diffe,.ent tax ,.ata, pl..S8 stata you,.
"Blationship to decedent:
OFFICIAL USE ONl V 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TA;;
LINE
nETU;.n . COX~UTAiION
I. Date Established
2, Account BalancB
3. Pa,.cant Taxable
4. Anount Subject to Tax
S. Debts and Deductions
6. Anount Taxabl.
7, Tax Rata
8. Tax Due
Oi- TAX c..;.. JCIi;.,iRU:ii ACCQtii;TS PALl
1 1
2 2
3 X 3
4 4
5 5
& 6
7 X 7
8 8
DEBTS AND DEDUCTIONS CLAIMED
PART
~
DATE
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
I
I
TOTAL tEnte,. on Line 5 of Tax Co~putationl
I
I
I
I
$
Unde,. penalties of pe~ju~y, 1 decla~e th.t the fects I have ~epo~ted above a,.e t,.ue, co,.rect and
conplete to the best of ~y knowledge and belief.
TAXPAVER SIGNATURE
GENERAL INFORMATtON
1. FAILURE TO RESPOND WIll RESULT IN AN OffICIAL TAX ASSESSt1[NT with All,.II..nbla Int.,nt Ilftud on Infor...'lon
lub_..,.d by the IlllI,nellll I",tltutlon.
t. Inheritance ,,,. b8co"., lIelhllNent nlna .lIn'hl "rt.r the deea"ent', dill. of ll."t".
S. A joint account h ,,,.alll. 81i1en '''nullh the deeailent', ,,,,.. "'fI' milled ftl A J111111.r II' CCllV8nlene..
... Accounts (IncludinG tho'. h.ld h.'....n hll,hAml /tud wlla' ..hh:h tll. tlecedent Ilul In Joint ",,-.. within on. Y.'" tlllar to
d..th ",. fullv '"."bl_ ft' t,nn,'.r..
~. Account. .,tabll,"ed Jointly bet",..n hUllllmd flnll ",If. 1II0r. Hum une .,.", I,rlor tn d...th ,Ir. not t"l"ble.
6. Accounts h.ld by " decaden' "In tru.t for" nnolhu or other. Me t".nlll_ 1111 Iy.
REPORTING INSTRUCTIONS
PART
1
TAXPAVER RESPONSE
I. BLOCK A . If the In'or..llon flnd eo.put.tlon In tn. notlc. Ilr. correct ,,,,d dllduetlonl are not baing elaieed. plllee fln ")c"
In block "A" of Pllrt I of the "'fl_pIIV.r pupon.." ,.etlon. Slun two eOI,ln nnd ,ubeU th.. with your ehoel< for thl ".ount of
tu to thl RIght.r of Wl1h of thl county IndICllt.d. Ih. PA D.pllrt..nt of R.v.nu. will Inuo Dn olllclal au.n..nt
(For. R[I".1~48 EM) upon r.nlpt of the return fro. the "ogl.ter of wllh.
Z. BLOCK B . If th. au.t Ipeelfi.d on thh noUn hft' bnn or will be r.portad and tl.. paid ,,1\h the Pann,Ylvanla Inh.,Uanu
'aM Return fll.d by th. dee.d.nt'l repr.l.ntatlve. pllleo nn "X" In block "BOO of Pllrt 1 of the "I,,_pav.r "e,ponla" ,oct Ion. Sign on.
COpy and return to tho PA Depart.ent of P.venu.. Bur.llu of Individual "'.... Dopt ZaObOl. Harrisburg. PA 11128.0bOI In the
.nvelopl provld.d.
J. BLOCK C . If the notlc~ Infor..tlon il incorrect lind/or deductionl IIr. being clal.ed. check block ..Coo IInd cooplete Part. 2 and 3
."....lIti;"\1 i.u ..... ;".t..,,,,i.i...... :....~o.. :::"r. :.:. ..:...1,. ...~;:I ;_:.=-~: ttle.lo ..!t~. "J::... et"..:..:: ,.;~ ~!'":. c~=;.;:,:t of t:;; F:'"J:~:L t: t~: ~::h:~c"
of Will. of the county Indlcatad. The PA OaPllrtoent of Revanu. will ISlue fin official alsassoant (ror. REV.I~48 Ex) upon receipt
of the r.turn fro. the P.gllter of will..
TAX RETURN - PART
2
- TAX COMPUTATION
LIHE
t. Ent.r the date the account originally wal astflblished or tltlad In tha .flnnor exi.tlng at date of de.th.
HorEl For a dec.d.nt dvlng aft.r 12/12:/82; Iccounts which the docedent put In joint nfl..s within on. (I) year of de.th ar.
taxabl. fully a. tranlfer.. tlow.v'" thera I. an e_clu.lon not to a_cnd 13.000 par transfer.e ragardl... of the value of
the account or the nu.ber of account. h.ld.
If a doubl. aster ilk (..) appear' b.for. your first na.e in the address portion of this notice. the S3.000 .xcluslon
already has b..n deducted fro. the account balance as r.ported by the financial In.tltutlon.
Z. Ent.r the total balance of the Dccount Including Inter.lt accru.d to the date of d.ath.
1. Th. p.rcent of the account that Is taxabla for each lurvlvor Is deterelnad flS follow.:
A. The p.rcant taxable for joint a.s.ts a.tabllshed .ore than one ye.r prior to the decadent'. death:
1 DIYIOED BY TOTAL NUMBER OF
JOINt OWNERS
Exa.ple: A joint a.set ragi.tered
DIVIDED BY TOUL HUMBER OF lC 100 . PERCEHT TAXABLE
SURYtVIHG JOINT OWNERS
In the nfl.. of the decedent find two other perlon..
B. Th. percent taxabl. for ass.ts created within one year of the decedent'. death or accounts owned by the decedent but held
In tru.t for anoth.r indlvldlJal(s) Itrust beneficiaries);
1 DIVIDED BV 1 (JOINT OWNERS) DIVIDED BV l (SURVIVORS) . .161 X 100
16.7l (TAXIBLE FOR EACH SURVIVOR)
I DIVIDED BY TOTAL HUHBER OF SURVIYIHG JOIHT
OWNERS OR TRUsr BEHEFICIARIES
X 100 . PERCENT TAXABLE
Exa.ple: Joint account registered In the na.e of th. deced.nt and two other p.rSons and establlsh.d within one year of d.ath by
the d.ced.nt.
1 DIVIDED BY Z (SURVIVORS) . .~O X tOO 50l (TIlCABLE FOR EACH SURVIVOR)
4. Th. aeount SUbject to taM ltine 4) I. d.tereined by eultlplylng the account balance Illne l) by the percent taxable (line 1).
S. Fnt_~ t~e total of the debt. and deductions listed In Part 1.
6. The aeount taxable (line 6) I. deter.ln.d by subtracting the debts and deductions Illn. 5) froo the aeount lubject to tax Cline ~J.
7. Enter the appropriate taM rate (line 71 a. det.relned below.
A. Far date. of death occurring after 6/30/94. the taM rates for transfer. to Ipoulas are a. follow.;
I. Date. of death on or after 1/1/94 and before 1/1/95 the rate Is 3l.
l. Date. of death on or aft.r 1/1/9~ tran.fers to IPousel will ba taxed at O~ tax rate.
Notel For dat.1 of d.ath prior to 111/94 transfer. to spouse. are taxable at bl.
B. Tran.fer. to lineal descendants Including father. .othu. son. daughter. grandchild,.en. son-in.law.
daught.,..in-law, .tepchlld and their Issue ar. "'xable at six percent C6~J.
C. Tran.fer. to all other. Including b,.other. sister. uncle. nunt. nephew and niece are tnxflble at flft.en percent (15l).
O. If you chang. the tax rate. pleasa specifY your relationShip to the decedent In the area provided.
8. The aeount of tax due Clln. 8) I. dat.r.ln.d by eultlplying the aeount taxable (line 6) by the tax rata (line 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debt. and deductions are deter.ined as follows:
A. You legally are r.spon.ible for payeent. or the estate SUbject to ad.lnistratlon by a personal representatlv. I. In.ufficl.nt
to pay the deductible It....
a. You actually paid the debt. after daath of the d.cadent and can furnllh proof of paveent.
C. nlbt. being clal.ed oUlt be lte.iled fully In Part 1. If additional spae. I. ne.ded. use pialn pflp.r e 1/2:" x 11". Proof of
pay.ent .ay b. reque.ted by the PI Depart.ent of "evenue.
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 INDIVIDUAL TAXES. TAXPAVER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY)
. ''''~'I_"''''''.'''' -
1'V.1W'I'''''''1
COMMONWEALTH OF PENNSYLVANIA
DI'AIl'IMINT 0' IlIVINUI
OFfiCIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.
DNo. AA '146798
AeN
ASSESSMENT r:t
CONTROL ~
NUMBER
RECEIVED FROM:
D
AMOUNT
""01 't Ic22
.1V.l'.
CAROLYN 5 BIXLER
441 PINE ROAD
MT HOLLY SPRINGS, PA t706~
ESTATE INFORMATION:
~ FILE NUM8ER
~ 21-1996-0786
eI NAME OF DECEDENT (lAST)
~ SLABONIC MARY P
II DATE Of PAYMENT
m POSTMARK DATE
COUNTY
SSN 201-16-071:)
(fiRST) (MI)
CUMBERLAND
DATE Of DEATH
m TOTAL AMOUNT PAID
"10.14
PB
REMARKS
CAROLYN S BIXLER
. ./
1'.'/ ..}'/(..
It.,"
,,' 1/ t
, ,
SEAL
CHECK" 5009
RECEIVED BY
REGISTER OF WillS
MARY c. LE IS
REGISTER OF WILLS
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COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
*'
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BUREAU OF INDIVIDUAL TAXES
INtIERITAH([ TAM DIVISION
OCPT. lIDbOl
llARAuaURC, PA .,1:.'0.01
NOTICE Dr INNERITANCE TAX
APPRAISEnENT. ALLOWANCE OR DISALLOWANCE
Dr DEDUCTIONS, AND ASSEssnENT Dr TAX ON
JOINTLY IIELD OR TRUST ASSETS
..,."41 111"111.'"
CAROLVN S BIXLER
7 PINE RD
HT HOLLY SPRINGS PA
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
SSN/DC
ACN
02-17-97
SLABONIC
08-25-96
21 96-0786
CUMBERLAND
201-16-0715
96147222
MARV
P
Allount R..it t.d
17065
HAKE CHECK PAYABLE AND REHIT PAYHENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE . RETAIN LOWER PORTION FOR YOUR RECORDS .....
R-iv:islra-Eif-AFFi-ii:f:9E;j-----------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLV HELD OR TRUST ASSETS
DATE 02-17-97
ESTATE OF SLABONIC
HARV
P DATE OF DEATH OB-25-96
COUNTY
CUHBERLAND
FILE NO. 21 96-0786
TAX RETURN WAS,
S.S/D.C. NO. 201-16-0715
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORHATION
ACN
96147222
FINANCIAL INSTITUTION. DAUPHIN DEPOSIT BK & TR CO
ACCOUNT NO.
0023493194
TYPE OF ACCOUNT,
DATE ESTABLISHED
( ) SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE
07-30-85
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rat.. X
Tax Due
355.55
0.500
177.78
.00
177.78
.06
10.67
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEV ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT
DATE
09-30-96
DISCOUNT (+)
INTEREST (-)
.53
AMOUNT PAID
10.14
RECEIPT
NUMBER
AA146798
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIOHAL INTEREST. ·
I IF TOTAL DUE IS LESS THAN f1, NO PAYNE NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU I1AY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
10.67
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.00
.00
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PURPOSE OF
NOTICE.
T. fulfill tho ,.qul,..ont. .f s.ctl.n 'I" .f tn. Inn.,ltonc. ond E.t.t. ,.. 'ct. 'ct " .1 1991. '7' P.S.
section nUl.
PAVItEHTt
O.t.ch tho t.p p.,.lon .f tnl. N.tlc. .nd .u..lt .Itn Y.u, ..y..nt t. tn. R..I.t., .f Will. p,lnt.d on tho
raver'. side.
.. Hek. ~ek or ~y order payBbla tOl REGISTER or WILLS, ACENT.
.11 P.....t. ,oc.lv.o ...11 11,.t .. oppll.d t. on. Int.,..t whlcn ... .. du.. .Itn on. ,...Ind" ...II.d t. tn. t...
REFUND (eA) I
. ,.fund .1 . ... c,.dlt. whlcn ... no' ,oque.t.d .n tn. t.. ,.tu,n. ... .. ,.qu..t.d .. c...I.tln. on -'..llc.tlon
I., R.,und .1 p.nn..lvonl. Inn.,ltene. ond E.t.t. ,..- 'REV-I'I'I. ..pll..tlon. .,. .v.lloOl' .. tn. Ofllc. .f
tho R..I.t., .1 will.. on. .1 tn. " R'v,nu. OI..,lc' Olllc...'.' c.llln. .n. .p.cl.1 ,'.nou' on...,ln. ..,vlc.
~.r' for for.' ordarlnor In p.nnlylvenla l_aOa.S6Z-ZDSO, outsida pennsylvania and within local
HarrisbUrg .t.. (7171 7al.aD9~, TOOl (717) 11Z-21St (H..rlng 1~.lr.d Only),
O.JECTIONS' An. ..,.. In Int.,... not ..tl.,I.d .I'n tn. ...,.I....n.. .11...... ., dl..II..onc. .1 d.ductlon. ., ........nt
.1 t.. 'Includln. dl.count ., Int.,..tl .. .noon on tnl. N.tlc. ... ..J.c. .Itnln .1.', "'1 d... .1 ,.c.lpt .1
this Notle. byl
-..,I.ton p,.t... .. tho .. O'P.,..on' .f R...nu.. ...'d .1 ..p..I.. O..t. "1"1. H."I.oo'., P' 1711'-1"1. OR
--oIocU.. t. n... tho ..ll.. d.t...lhOd .. tho oudlt .f tn. occount .f tho .."...1 ropro..nl.U... OR
__appeal to tM Orphans' Court
AllnN-
lSTRATlVE
CORRECTlONSl
Factuel .ttor. dl.cov.rad Oft thl_ .......ent should bl addr.s.ed In writing tot PA Oapart..nt of A_venue,
'u"ou .f Indl.ldu.1 ,..... .TTN. P..t ........n. R..I.. unit. OEP'. '....1, H."I.oo,..., 171'.....1
..... (717) 7.7.."" s.. p..' . .1 tn. ....1.. -In.t,uc.l.n. f.' Inhe,I''''' ,.. R.tu,n f.' . R..ld.nt
Decadent- (REV-lSDl) for an axplanatlon of adalnlstratlvalv correctable .rror..
DISCOUNT.
If on. t.. duo I. ..Id .Itnln tn," "I c.l.nd.' .ontn. .ft., tn. d.c.don". d..tn. . flv. ..,c.nt "Xl
dl.count of the taM paid 1. allowed.
PEMALTYl
Tn. ISX t.. ......v non...,tlcl...I.n ..n.lt. I. c...ut.d .n tho t.t.1 .1 tn. t.. ond Int.,... .......d. end not
p.1d ..1." Jsnu"y I'. 199'. th. fl,.' d.. .ft., tn. .nd .f tn. ... .on.." p.,I.d. 'nl. non.p.,.lclp.tlon
..nolt. 1. opp..loOl. In tho .... ....., ond In tn. tn. .... .1.. p.,I.d .. you would ep...t tn. t.. ond Int.,...
that hat been a,.B..ed at Indica tad ~" thl. notlc..
INTEREST I
Intara.t I' charged bag Inning ~llh flr.t day of delinquency, or nln. ('I ~th. and one el) day
fro. the data of d.ath, to the data of p.y.~t. rax.' which bae... delinquent bafore January I, 1'82
b.ar Inter..t at the rat. of .1_ (6~) plreant par annua calculatad at . dally rata of .000164.
.11 t.... whlcn ..c..' d.llnquon' .n ., .ft., Jsnu." 1. 19" .111 ..., Int.,... .t . ,.t. .nlcn .111 ..,. I'.'
calendar y..r to calandar y..r with that rat. announced by the Pi Dapartaent of Revenue. The appliCable
lntar..t rata. for 1'82 through 1997 aral
V..r Intarnt Rat. Dalh tntar..t fIlctol'" V..r In'a..a.t Rat. Dally tntaru' FIIctor
au zaX .000548 t'f87 9X .GOOl4?
1981 I'X .DDO,"lI 1986.1'9. IU .000lDl
191ft lIX .DOOlDl 19lfZ 9X .000241
1985 13X .DOnS6 1991.19'4 r. .000192
1986 10;( ,GOOll4 1995.1991 9X .000247
w-lntlre.t I. calculat.d al fallOWIl
INTEREST : BALANCE OF TAX UNPAIO X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hatlc. ISlued aftar the taM baca.e. delinquent will reflect an Interalt calculation ta flftaan (IS) day.
beyond the data of the alle.l.-nt. If payaent II aeds a'tar the Intaralt coaputatlon date .hoWn on the
Notice, additional Internt Wit ba calculated.
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