HomeMy WebLinkAbout96-00927
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CfJ~~ INHERITANCE TAX RETURN
'!:~~ RESIDENT DECEDENT
COMMONWlAlllI Of "NNmyAt". (TO BE FILED IN DUPLICATE
OEPAIITMENt Of REVENU[
"..",fJ:U~On\lOO6OI WITH REGISTER OF WILLS) COUNIY CODE ~ I YEAR
OICM:';k:AM~;" "'~~':;~"L1 "~~" -IOI"~N~~OM~ ~:.:~;<. "?~
'O(OA\ '''0'''' "OMBO' IOA;I~'1 ~ :'1"'110 I"A':;,' :~'I' S I "'5 \..,~~ \,,,... '\ c: Pr \'72- 'tl
\ 90 - J.p_ - ct I (g ID · c"""'. c..,- b.....'''^'''c)C _ .
blJ 1 Original Relurn ! 2 Supplcmcnlol Roturn [ ; 3. Remainder Relurn
(101 dolo. 01 doalh prior 10 12.13.821
r] 4. limited hfOIC ! .to. Futuro Interost Compromise I 15. Foderal htole To,,"
(for dolOS of deolh aher 12.' 2.02) Relurn Required
rJ 6. Decedent Died Testate ) 7. Decedent Maintained 0 living Tru" _ B. TOlol Number 01 Sofe Deposit Boxes
(Altach copy 01 Will) IAltach copy of T rU'I)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAME COMPIfH MAlllf~G ADDII[~~
. ~'o=-T l-. O'~("~~~I._~~~'.
lU(PHONE NUMBER -'V
(117 ) .2 1f.1: c.,'i73
R(V.1S00 U. 11'1-881
FILE NUMBER
+ (18)
19. If line 18 is greoler than line 17, enlN Ihe dilfNcncc on line 19, this is the OVERPAYMENT. (lQ)
al]
20. If line 17 is greoter thon line 18. cnler the d,lfcrcnw on line 20 Thu is !he TAX DUE. {iOI
A. Enlcr tho interest on the balanc(! due on line 20A (20AI
B. Enler tho 10101 of line 20 ond 20A On line 20B Thi, i, tho BALANCE DUE. (20B)
~a~e Check Payable to: Reglst.r o. Wills, Agont
_ ..__.. ..t:.'.l.~!!.1IE_!0 A_NSWER AL~-_C?UESTic5NSON'REVERSE~IDEAN~!() -RECHEC~ .MAT~~"'=-=-==--
Under penahic\ of perjury. I declare lhall hove e.l.omined Ihi\ f(~lurn. including mcompunying \(hl'dule\ and \lU!f'mf'nh, nnd 10 !ht. bf'\1 01 my ~no\lVlt'dg-f'-~lntl b;.li('f
it i\ true. carred and complele I declare lhol 011 rf'oll'\IO'" hO\ bern Irpolled olllue mor~t'l ~nlur Dl'dClfation of flll'pOler o!h.~r Ihon Ih.. pl'nonul ft'IHI'H.n'oh~(O.\
ba\ed on 011 information 01 which proparer ha\ any lnowledge
SIGNA"'UII(Of P[RSONAhpQNSI8l(fOIl"flllt"G RIIURN AODIlI~'" OAT{
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I. Rool E..ole (Schodulo A) ( I)
2. Slock> and Band. (Schodulo B) I 2)
3. Clo.oly Hold S'ack/Parlno"hip Inloro.. ISchodulo C) I 31
4. Morlgage' and Noto\ Receivable (Schedule 0) ( 4)
5. Co,h, Bonk Oopo,ih & MiICellaneou, Perianal Properly{ 5)
(Schodulo E)
6. Joinlly Owned Proporly ISchodulo fl I 6)
7. Tra..le" (Schodulo G) (Schodule L) ( 7)
9. Total Gran Auel' (Iolollin., 1~7)
9. Funeral Expo",e" Admini,tralive Cosh, Mi\Cclloncou, ( 9)
Expen... ISchodulo H)
10. Dob". MOllgage LiobHiI;o,. Lion. (Schodulo II (101
11. Total Deductions (tolollinc, 9 & 101
12. Net Valuo of E,'ato (line 8 minus line 11)
13. Charitoble and Governmental Beque," ISchedule J)
~ Net V_~u~__S~~~!~~~~!oxlli~~_~_~_~i~u_~"I_i_~.~".1_3)
15. Amount of line 14 toxable 01 6% ralo (15)
(Includo value, from Schedule K or Schedule M.)
16. Amount of line 14 toxoblo 01 15% role (16)
(Include value, from Schedule K or Schedule M.)
17. Principal lox due (Add lax from line 15 and from line 16)
19. Credit, Prior Poymenh Di\counl Inlere"
(171
-0-
1'"13>
573<[
( 8)
,<133
1111
(12)
(131
(14)
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513'0
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X .15 =
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Check here If you are reque.tlng a re'und o' your overpayment.
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COMMONWfAlfH O' 'lNN\YWANIA
INHU".NCI 'AX _ITUIH
I'SIDINT DICIDINT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plea.e Print or Type
FILE NUMBER
...,,'SOt... II'"
ESTATE OF
(All p,oporlV jointlyaown.d with Ih. .1111'" of SUr.livonhlp mUll b. dllCloud on Sc.h.dulo "
ITEM I'
NUMBER.
DESCRIPTION
VALUE AT
DATE OF DEATH
?\\)C.
Aa.:t: -.,+0. 50- 0000 - S 30b
<oS8. ~S-
2.
\otC;~
C"'4:.\lt'il\~~
115.00
"
,
TOTAL (AlIa enler on line 5, Rocaailulatianl ! S
143.3.~
{A"ocft additional BYw" x 11. ,hulI.f mor. ,aoc, ,. "..dld.1
COMMONWEALTH OF PENNSYLVANIA
DEPART~ENT OF REVENUE
BUREAU Of IHOIVIOUAL TAXES
.....RIYAHCf TAX DIVISION
DEPT. 110601
HARA15atJtg, PA 17UI-0601
NOTICE Of INHERITANCE TAX
APPRAIStHENT, ALLOWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSHENT Of TAX
ROBERT L OBRIEN
17 W SOUTH ST
CARll SLE
ESQ
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17013
01-2B-97
Ml LlER
06-21-96
21 96-0927
CUMBERLAND
101
AMount R..ltt.d
*
.".1"'11'" 111-"1
HENRV
W
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 ~
ii"i.;:i54'nTAi:F-fi'F;&-niij'ficE--CF--iij";i~i'iiT;.7ic~-'f.;;n.-:=~it;.-iSEiiE;i~.-;-':;i.LOiiAiiCE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER HENRY W FILE NO. 21 96-0927 ACN 101 DATE 01-28-97
If an assessment was issued previouslY, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. AMount of line 14 at Spousal rat. C1S1
16. ~t of Line 14 taxable at lin..I/Cl... A rat. (16)
17. koount of Line 14 t..oblo ot CollotoroI/Clo.. B roto C171
18. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
TAX RETURN WAS: I X I ACCEPTEO AS fILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Rool Eatoto ISchodulo A I III
2. Stocko ond Bond. ISchodulo BI 121
3. Clos.ly Held stock/Partnership lnt.r..t (Schedule C) (3)
4. Kortgag../Not.. Receivable (Schedula OJ (4)
S. Ca.h/Bank Deposita/Hilc. Parsonal Property (Schedule El IS)
6. Jointly Owned Property (Schedula F) (6)
7. Transfars (Schedule G) (7)
8. Tot.l A'let,
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expense,/Ad.. COlts/Hisc. Expense, CSchedule H) (9)
10. Dobt./Hortoooo Llabllltlo./Llon. ISchodulo I) liD)
11. Totol Doductlon.
12. Net V.lue of T.x Return
13. Chorltoblo/Goyornoontol Boquo.t. CSchodulo JI
14. Net V.lue of Estate Subject to Tax
NOTE:
RECEIPT
HUHBER
DISCOUHT 1+1
INTEREST I-I
I I CHANGED
.00
.00
.00
.00
1.433.00
.00
.00
(8)
5,738.00
.00
1111
1121
1131
1141
.00 X .00=
.00 X .06=
.00 X .15=
1181
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
sub.it the upper portion
of this for_ Mith your
tax pay"ent.
1,433.00
~. BR no
4.305.00-
.00
4,305.00-
.00
.00
.00
.00
.00
.00
.00
.00
o If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
I If TOTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED.
If TOTAL OUE IS REfLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REfOND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS.)
RESERVATIONI E.t.t.. of decedent. dying on or before Oece.ber 12, 1912 -- If any futur. Int.r..t In the ..t.t. I. tran.f.rrld
!~ ~=;c:;:!~~ ~r ~~J~~t t; Cl::: a (:=llct:r~l) ~-~=flcla~l~. 0' t~: ~~::~~t "t.~ t~1 ,.~Ir'tl~ -f .~y .,~... f~p
Ilf. or for y..r., thl C~elth h.r.by .xpr...lY r...rv.. thl right to epprel.. and ...... tran.f.r InhlrltBnC' Tax..
.t the leMful Cle.. I (coll,t.r,l) ret. on eny .uch future Int.r..t.
P\IlPOSE ...
NOTlCEI
To ful,111 the requlr..-nt. of Section 21~0 of the Inhtrltenc. end E.t.t. Tax Act, Act Z2 of 1991. 72 P.S.
s.ctlon 2140.
PAYHDfTr
Detach the top portion of thlt Notice and .ubllt with your pay""t to thl Register of wllh prInted on thl r.vsr.. tide.
--ftek. check or IIOMIY ord.r peyebl. tal REGISTER OF HILLS, AGENT
All p.~t. r.c.lvld .hall flr.t b. BPPll1d to any Int.r..t which ..y b. duB with any r..alnd.r appllld to thl tax.
REF1.IfD (eRh A r.f\nS 0' . tax credit, whIch w.. not r.qu..tld on the Tax A.turn, ..y be requt.hd by cOIIPI.tlng en "'Appl1C11Uon
for A.fw'Id 0' PWlnIYI".,I. Inhtritence and E.tet. TIUIl'" (REV-13U). Appl1c.Uon..n .".Ilabl. .t tM OffIce
0' the Aegllt.r of Willi, any 0' the 2S AI"enut DI.trlct Dfflc.., or by c.lllng the specl.1 Z4-hour
.....rlna urvlce r.abtr. for for.. orderinal In P.m,yI".,I. 1-800-S62-2050, outside Ptnn..,lv.,,, and
within loc.1 Hlrrl.burg .r.. (111) 181-8094, TDD' (717) 77Z-Z252 (H..rlna IIP.lred Only).
DBJECTIONS: Any party In Int.r..t not .atl.fl.d with thl .pprel,..-nt, .llowanc. or dl..llowence of deduction., or ......eent
of t.x (Including dl.count or Int.r..t) .. .hown on thl. Notlc. .u.t obJ.ct within .Ixty (60) d.." of rec.lpt of
this Notle. by:
--wrltt.. prot..t to thl PA Dep.rt.....t of A.venut, aoerd of app..h, Dlpt. 281OZ1, Herrltburg, PA 17121-IGZl, OR
--election to hlv. thl ..thr detsrllned .t MKlIt 0' the account of thl psraonel r.r....,t.tlv., OR
ulppMl to the Orphan.' Court.
AOftIN
ISTAATIYE
CORRECTIDHS:
Fectuel errorl dlscov.rld on this .........,t should be edd,...ed In wrIting to: PA o.p.rt.."t of A.venut,
lurlsu of Indlvldull Tax.., ATTHr Po.t A......ent A.vlew unit, Dlpt. Z80601, Hlrr..burg, PA 111Z8-0601
~ (717) 7.7-6505. See Pili 5 of the bookl.t -In.tructlon. for Inherltanc. Tllx A.turn for. Ra.ldent
Decedent'" CREV-1501) for an IXPlanetlon of adllnl.tr.tlvalv correctabl. .rror..
DISCOUHTr
If an., t.x due I. p.ld within thr.. (3) cel.r~.r .onth. eft.r tha d.cedant'. d.eth, . flv. p.rcant C5X) dl.count of
th- t__ ~.I~ 1. ~11~~.
PDlAL TVI
ThrI 15% tax ..,..ty non-plrtlelPltton pwael ty It c~ted on the tot.l of the tax Md Inbn.t .....IId, and not
p.ld before January 18, 1996, the first d.y aft., the end of the tax lIInII,ty period. This n",-p.rUclpaUon
pen.lty It IIPPI.Iabl. In thl .... .lIIYMIr and In the thl .... tl.. p., lod .. .,ou would IIppe.1 the tax and Int.,..t
thlt he. bien ......ed .. Indlc.t.d on thl. notlc..
INttRESTa
Inter.st It chergld begInning with first d.y of delinquency, or nine (9) tonth. and OM 0) day frCMI the dIIt. of
_\h, to the dIIt. of P'YMnt. Tax.. which bIcaH dellnquant before January 1, 1982 bear Int.,..t .t the rat. of
.he (6X) perc...t ptIr .,..".. c.lculated at a dally ret. of .000164. All taxa. which bee... delinquent on and aftar
~ry 1, 1982 will bI.r Int.r..t at a rat. whIch will vlry frCMI calend.r yaar to c.lendar y.ar with that rat.
announced by the PA Depart-.nt of AavtnUl. The epplleabl. Intara.t rat.. for 1982 through 1997 .r'l
!!!! Int.,..t Aah Dally Int.ra.t r.ctar ~ Inttrllt A.t. 0111'1 Inhrllt FltCtor
1982 ZIX .000548 1987 'X .000247
1985 16% .000418 19&1-1991 IlX .000301
1.14 IIX .000301 I99Z 'X .000247
1985 13X .000356 1993-194M Tl .000192
1.86 I'X .000274 1995-1997 'X .000l47
nlnt.,..t I. calculated a. followlI
IKTEREST = BALANCE OF TAX UNPAID X HUKBER OF DAYS DELIHQUENT X DAILY IKTEREST FACTOR
--Any Notlc. I..ued .ft.r the tax btc~. delinquent will r.flect an Int.r..t c.lcul.tlon to flft"" (15) d.y'
beyond thl dlt. of the ......Mnt. If p..,.."t Is uda .ft., thli Int.r..t COllPUt.Uon dati shown on thl
Notlca, addltlonll Int.r..t lU,t be c.lcullttd.
lTV.1S('Q I~. 111.111
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COMMONWUUH C' "NN\yt.....NI..
OIPU'MINr 'J' U"'!NUI
JI" aObOl
H.t,UISlU'O ,,, I1lU.OhOl
I/lLI HUM'"
I
I
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
o
o N
I
: CO_UNIY ~O.O.f_
"I.. M l
YEAR
NUMBfll
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1 C10 - ~ ~ - ~ ! ~ ~
-=-1 Iii SI
~1
Z Suoplemenlol ~"rurn
~32. Ca!::'J\\1.:. ~
. '"5"'I'\"""~\,,,...,\ 7'>"
! r.J..~h c"\.I",,,", ~~ \a. """c9..
'_ J. Remolnoer ~'lur"
(for aoles 01 death prior 10 12.1 J.821
~ 5 Fealtol EUo,e To.
RelUr" ReqUired
_ 9. TOlol Number of Safe O.OOSII 90".'
oAff"}j,ilifH
n 2- 'tl
lDl~'I'\<o
O'UjlnOI Return
_J
limIted EUoltl
_'so FUlu,e InI",,,u CJmo,oml'.
[for dales 01 ~tlOII'\ oiter 12.12.821
- 0 Decedenl D..,o .. ""ot~ 7 Oeceoenl ,""olnrOlned 0 li..,lng Tru'l
(Altacn (00'" Q; ....till IAllOCn COOY t)I Truu,
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAMt .:OM"lfft: ,..U,'~jNG ..I)OlUH
. ~'osu-7
i TEUP"QNE ~UMeEiI
,
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nC\~
n W. S",,-H,
Ca....\\~k) 'YA
So...
1717
21f'i- r.,773
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I. Real Euare IScneoule .:..) I 11
.. Stocks ana aonol ISc~ecule 31 f :1
J. C;OIOIY Held StoC~IP::r'!"tersnlo InfereSf (Schedule Cl (31_
... MOrl90981 ana NO'~I 1ecel..,ooie {SChedule DI \ J}
5 Cosn, aani!: Deooll" 3. ,'O\isceltanltous Perlonal Prooerry( S)
(Scheauie cl
o. JOintly Owned Prooor<>v i5cneauie ;:) { 01
7 Transter, {Scheaule vi IScneaule II ( ;OJ
a. Total Gross Anon IIQrai lines 1.7)
Q. Funeral EJtoenses. Ac:mlniuratt..,e C"us. Miscellaneous ( QI
, c,ltoen"s IScneaule r11
,
i 10. Dei:m, Mortgage liaciiiries, tiens (Scnedule I) (101
! 11. Total Deductions (fOfQllinos ~!. 101
i 12. Ne, Value 0; E~farlt diM a minUs line t 1)
: 13. Charlloole ano Go..,ernmenral Beaue"s {Scheoule JI
,
: 101. Ne, Value Subiect!o 7'01. lIine 12 "'lnUS line 1JI
,15. Amount 0; line l.t Ic:c.aole 01 0% rOle (1.51
(Incluee "'olues from 3cneaule K or Scnedule M.I
v\."T~
1'133.
57 3"[
I 81
1'-133
S737J
( 't,30S)
{III
{I 21
(lJI
11"1
X .06 =
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'10, Amounr 0; line lJ felloole 01 '5~/l) 'Ofe
{Incluae voiues trom 3c~eouje K or Scn~ciule M,J
,1; P'lnCloallO. aue IAae lOll. from line 15 ana Itom line 10,)
(171
-0-
(161
X .15 =
18. Creaill
PrIor Poy,."enlS
Oi"ounl
Inlereu
{181
10 11 linp. 18 I~ greolt'r '''on ine ';" ~nf"r .",,, QIHere"ce on jine'O ~h,\ 1\ lhe OVERPAYMENT. llOI
at 1-:T"'!'1 "'I ,. . ..I"~';'.'!I JIIIi.;,~Il ~tll';'.'.'I~'I":":"'~'L"..d ;.:..r.:..J... ;..JI
:0 If line Ii'" 9,eole, '~on linlt i8. l!n'er Tn" aiH,,'enc~ on line :0. ;hi, i, Hut TAX DUE. (201
A. :nl"r 'Me InI",,," ~n In" borance aue on line :OA 120AI
a. Erll~r 'hit 10101 0; 'in" ::0 ana :ZOA on line :OB, ihi\ IS lhe BALANCE DUE. (20B\
Make Check Pavable 10: R.gister of Wills, Agent
.. ..BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH..
-0-
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UnOll' oenolhes 01 Oltflurv. j altClor. '!'l01 . ~a"'p. ~.o"",'""a 'Mt' ''''u,n. "CIUdlng C'lcco",oon't'"IJ \cn"oult" a"o UOlemenl\, Jno 10 t\'te ceS! 01 my -nowieoqe ana belIef
" " lrUlt, calteCI ana COmalltle : oecrore '''01 all '''01 ~uO'" 'lcu bet'M leoorteo ot lrue ~ane' ~Olue OIlClo,ot.an 0' oreoorer orh~r 'I'\on 'he Of'lanol 'eore1lnlotl..,e 'I
balltd on oil inlormotlon ot ""nlcn orOlOOle' 'los ,:In.., ."owlI!aqe
~IGNArUAE..;J~ ~fQSCN ~BPON~lau 'uil .'l "U ~HUIl:~4 ..lJOlltSS. OAr(
""AN 01 P.f~t&. A ."f
..loDCIlESs.
11 \.0. ~\.r\"- ~ ~hs ~ 9A
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COMMOHWUlIH O' 'HmUl\lA"'IA
INHUITA"'CI r... "W''''
USIDfNIO'CtO'NI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI.a.. Print or Type
. fiLE NUMBER
ISTAn Of
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
I.
Fun.ral Exp.n....
-;:;~'"'-\~'\'i!.<;"" ~"...r-a.\. \-;t>.....e.
o P"""'- "':-... ~~
'i, "CO ~-o
......,,;:: 00
~.~
z.
B. Administrative Cos'"
I. Personal Representative Commissions
Social SecurilY Number or Personal Representalive:
Year Commissions paid 04
ISO
2. Allorn.y F.., C'~- B-~'" <; "" \-. ~ <l..r
J. Family e..mplion
Claimonl R.lation,hip
Addreu of Claimanl 01 dec.denl" dea.h
Slr.et Addre..
Cily 510" Zip Code
4. Probate Fe., 30 .1lO
C. Mlscellan.ous Exp.nses: -
5,.......:i.\.:... Q...\ \'S (. ~
1.
2. .0...- Co, cr /Q. sea
~. e.MC:- ~o."2. '-
Lt. e,.:.\::..... ... ~~ ~....." 2s8.9""
S 77-+-L- Col. ~"[
la. U,^,~al \~\ '1. I o.j
TOTAL (AI,a enler on line Q. RecaoiluJolion) IS 5 ,'73~.03
(If mar. space is ne.ded, insert additional sh.ets of same size)
(). / '10 . j
. '
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*
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
U'UllAHCt: TlJI DIVISION
OCPl. ZIOU!
twnl1SIURO, PA 111l..D601
NOTICE OF INIIERITANCE TAX
APPRAISENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
tn.I"'"I" III.'"
ROBERT L OBRIEN
17 W SOUTH ST
CARLISLE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-28-97
MILLER
06-21-96
21 96-0927
CUMBERLAND
101
IlENRY
W
ESQ
PA 17013
r
Anount R.~ltt.d
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 ~
iiE'v:is'4TEx-"FP-ii'2:96Y-Nci'ficEuoi'uiNHEifii'ANcE-i:i\iC"A'PPRA'isEHENT-;-"Li."OWANCE-oli-_m_--m__m-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER HENRY W FILE NO. 21 96-0927 ACN 101 DATE 01-28-97
TAlC RET\JRN WAS: (X) ACCEPTED /oS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l eat.t. (Schedule A) III
2. Stock. _ Bond. (Schedule B) (2)
3. Clos.ly Hald stock/Partnership lnt.r..t (Schedul. C) 131
4. Hortgaga./Not.. Receivable (Schedule OJ (4)
S. Cash/Bank Depo.it./Hi.c. Par.onal Property (Schedule EJ 15J
6. Jointly Owned Property (Schedula Fl 161
1. r"anafa,.. (Schedule Gl (7)
8. Total AI..t.
I CIIANGEO
.00
.00
.00
.00
1.433.00
.00
.00
ISI
HOTE: To in.ura prope,.
credit to your account,
sub.it the upp.r portion
of this fora with your
ta)( pay..ant.
1.433.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.,..l h:p.ns../AdII. Costs/Hhc. Exp.ns.. ISch.dul. H) (,)
10. Oebt./Nortg.ge Llabllltl../Llen. (Schedule I) (10)
11. Tot.1 Deduction.
12. Net V.lue of Tax R.tur-n
13. Ch.,.ltabl./Gov.,.naent.l Beque.t. (Schedul. J)
14. H.t Valu. of Est.t. Subj.ct to T.x
5,738.00
.00
(111
(12)
(13)
1141
;.738 00
4,305.00-
.00
4,305.00-
I~ an assessment was issued previously, lines
reflect ~igures that include the total of ALL
ASSESSMENT OF TAX:
15. A~t of Line 14 at Spou..l ,..t. 115'
16. ~t of Lin. 14 t.xab1. .t Lin..l/Cl... A ,..t. (16)
17. ~t of Line 14 t.xabl. .t Collat.,..l/Cla.. 8 ,..t. (17)
18. p,.lnclpal Tax Due
TAX CREDITS:
PAYNENT
DATE
14, 15 and/or 16, 17 and 18 will
returns assessed to date.
NOTE:
.00 X .00=
.00 X .06=
.00 X .15=
(18)
.00
.00
.00
.00
RECEIPT
NUNBER
DISCOUNT It I
INTEREST C- I
ANOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
C IF TOTAL DUE IS LESS THAN '1, NO PAYNE NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF TillS FORN FOR INSTRUCTIONS. I
R,
{,..
,I
'(JI JI.II 24 F 1 :1) 7
CIL'
Cur,,,
.,
j't...
RESERVATIONI E,.,t.. of ~edent. dyIng on Dr before Dec.-ber 12, I"Z .- It any future I"t.r..t In the I.tet. I. tran.f.rred
In pa.....lon or anJoYHnt to CIe.. a (collalulU b....flcl.rl.. of thl dK~t aftar thtl explretlon of any utata 'or
II" or far y..r., thtl C~.lth hereby I.pr..,ly rlllrVl, the right to appral.. and ...... trans,.r Inheritance 'IX"
at the lew'ul CII.. . (colll'arall rat. on any .uch future Int.r..t.
PURPOSE OF
NOTICE I
Ta fulfill the r~lr..-nt. 0' Section Zl~O 0' the Inherltancl end E,t,t, rax Act, Act II of 1991. 12 P.S.
SKUon 211tD.
PAYtfl(1'r
D,tach the top portIon of thl. Notle. and subalt with your ply-.nt to the Rlgllt.r of WIll, prInted on thl raver.. .Id,.
--"eka check or lIOnav order paYl!Ibl. tal REGISTER OF MILLS, AGENT
All pa,..ot. recalved ,hall flr.t ba applied to any Int.r..t which ..y bl due with any r...lnd.r nppll~ to the tex.
REFUm (CAli A r.fund of a tax crlldlt, lilhlch wa. not rllqlLM.ted an the Tax Raturn. .ey be reque.ted by cQIIPletlna IW't "application
for Rafund of P~.ylvlW'tl. Inheritance and E.tata Tax" (REV~I)I)l. Appllc.tlon. .ra avallabla at the Offlca
of the Ragl.tar of Will., any of the 2) Rev~ DI.trlct Offlca.. or by call1na the .paclal Z~~hour
answarlna .arvlca nuabar. for for.. orderlna: In penn.ylvanla 1~8DD~16Z~ZD5D, out.lda Penn.ylvanla and
Mlthln loc.1 H.rrl.burg araa C7171 7a7~aD9., TOOl (711) 17Z.ZZSZ CH.arlng I~alr.d Onlyl.
OIJECT IONS I Any party In Int.r..t not .atl,'lad Mlth the .ppr.I...ant. allowanc. or dl..llowanc. 0' deduction.. or .......~t
a' t.x (Including dl.count or lnter..tl .. .hown on thl. Hotic. au.t Object within .Ixty (6DJ d.y. 0' recaipt 0'
this Motlc. bYI
..Mrltten prote.t to the PA Dap.rtaent 0' R.vanua, Board 0' Appaal., Dept. Z81DZ1, H.rrl.bura, PA 17IZI.IDZI, OR
ualectlon to hev. the ..thr datar.lhltd .t audit of the ecc~t 0' the p.rson.l rapra.antatlva, OR
u~.1 to the Or~.. Coyrt.
AOKIN
ISTRAUVE
CORRECTIONSI
Fectuel arror. dl.covared on thl. .......ant .hould be addra..ed In writing tal PA Dap.rt..nt 0' Ravanua,
Bureau 0' IncUvldual T...., AfTNI Poll a.....unt RavlaM Unit, Dept. l8D6DI, H."lsburg, PA ll1ZI.06Dl
Phone (7171 787.6505. Sea page 5 0' the booklat "In.tructlon. for Inherltanc. Tax Raturn for a Ra.ldent
Decadent.. IREV.15Dl) 'or Bn .xPlanatlon 0' ..Inlstratlv.ty cornctabl. a"o".
DISCDlIClI
I' any tax due I. paid Mlthln thraa ()l c.landar .anth. .'tar the decadant.. death, . flv. parcant (SXJ dl.count 0'
the tax p.ld I. allowed.
PEMlL TVI
The tS;C: tax --.a.ty nan.p.rtlclpaUon ~lty II c~ted on tha total of the tax and Intanlt .....Md, and not
paid be'ora Janu.ry 11, 1996, the 'Ir.t day a'tar the end 0' the t.x aane.ty parlod. Thl. non.partlclp.tlon
pen.lty II appealabl. In the ... aarvter and In tha the .... tI.. period In you would app..1 the tax and Int.r..t
that h.. been ......ad .. Indicated an thl. notlca.
INTERESTI
Intlra.t II charged beglMlna with 'I"t d.y 0' d.lInquency, or nine (91 enth. and one (1) d.y 'ro. tha data of
dMth, to the data 0' p.~t. Taxu lilhlch bee... dallnquent be'or. JlW'Ulry I, 191!1Z bu,. Int.,.a.t at the r.ta 0'
six C6:t:J parcent par annua c.lculated at . dally rat. 0' .000164. All tan. Wllch bee... d.lInquent on and .ftar
January 1, 1981 will be.r Intara.t at a ret. which Mill vary 'roe calend.r ye.r to celendar y.er Mlth th.t reta
announced by the PA Dapart.-nt of Revenue. The appllcabl. Int.re.t r.ta. fDr 1981 through 1997 .ra:
'!!!! Intarnt R.t. Dally Intarut FftCtDr !!!! In"r..t Rate D.lly In"r..t FftCtor
191Z ZOX ,000548 1917 'X .DDDlO
all .oX .0DU18 1961.1991 lIX . DDDSDl
19.. lIX .000301 I99Z 'X .DODZ'"
1985 UX .00DlS6 1993.1"" r< .00019Z
.... IIX .000Z7,. 1995.1997 'X ,OOOlO
ulntar..t I. calculatact .. follQtljIl
INTEREST . BALANCE OF TAX UNPAID X HUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTDR
uAny Notlc. Inu.d .ftar the tax beeOM' dallnquent will raflect an Int.r..t calcul.tlon to flftean CIS) d.y.
beyond the d.ta 0' the ......eant. I' p.y-.nt I. .eOa eft.r the Int.r..t coaputatlon d.t. .hown on the
Notice. additional Int.rut .u.t be c.lcul.ted.