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CO""ONWrAl1tl or P1NN<iVlVANIA
D[PAR1"[NI or p[V[Nul
ftURtAU or iNDIVIDUAl 'un
DlP1, .aObOI
llAPRI<iBURC, PA 1I11a-ObOI
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INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.2\
96\521,8\
\1-\3'96
Ill-;hll1 u' ,,-tU
TVPE OF I\CCOUNT
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EST. OF CRVIL R CI\SSNER
5.5, NO, \83-\2,\(,89
DATE OF DEI\TII 09-30-96
COUNTY CUMBERLAND
X, SAVINGS
CIlECKING
TRUSl
, CERIH,
HAREL BEASON
RR 4 CME
NEWVILLE PA 17241
REHIT PAYHENl AND fORH~ 10:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA \7013
ORRSTOWN BANK hn p,ov'd.d .h. D.p."..h' with ,h. 'hfo,.otlOh 1I.\Od b.low wh"h hn ...h und 'h ,o'culo"h' ,h.
pO..h.I.1 ..x du.. Ih." ..co,d. Ihdlc.'. ,h.' .. .h. d..,h of .h. .bov. d.,.d.h" ,DU w... 0 lolh' oWh."..h.",I.', D' ,h" hC'ouh'.
I' 'ou ...1 .h" Ih'O,.."Oh .. IhCO".C'. pl.... Ob,.'h w,I".h co".C"Oh "0. .h. f'hOhCI.1 Ih..I,U"Dh. o".'h 0 CDP' 10 'h" '0'.
ohd ,.'U'h I' '0 ,h. obov. odd'.", 'his oceOUh' I. .oxobl. Ih ",o,dohC. wl'h ,h. Ihh.,ItohC. to, 'ow. D' ,h. CO..OhW""" 0' P.hhsy'VOh'O,
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FILING AND PAYMENT INSTRUCTIONS
COMPLETE PART 1 BELOW
Account No. 000-016588
. .
. SEE REVERSE SIDE FOR
Ooto 10-22-84
Established
10 Insure prope" credit to your IIccount, two
(z) caples of this notice .ust IIcco.pllny your
Plly.ent to the Register of wills. "like check
PIlYllble tal "Peglste,. of wHls, Agent".
PART
[!]
2.263.72
50.000
1.131.86
.15
169.78
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON lllIS NOlICE
Account aalance
Percent T.~.ble
Aaount Subject to
T.~ Rate
potential Ta~ Due
NOTE: If tllK pay..nt' are .lIde wlthln three
(31 .onths of the decedlnt'. date of dlllth,
yOU .ay dlduct II SZ discount of thl tax due.
Any lnhe,.Itance tax dUI wlll becO.e delinquent
nine (91 1Il0nth' afte,. the date of dlath.
x
To'
K
[CHECK J
ONE
BLOCK
ON LV
A. ~ The above 'nforlllatlon IInd tax due 1. cor,.ect-
/,,"1, VOU .., choo'. '0,..1' p.,..h' '0 tho ..,1..., of ..". w"h 'WO CDP'.' of ,h" hO"C' '0 Ob.olh
o d..,OUh' 0' ovoid Ih'.'.'" 0' 'OU .0' ch.ck bo' -S- ohd ,.'u'h .h" ho.I,. '0 ,h. ..,1..., 01
wills and an offlcllll assess.ent will be issuld by 'he PA nepart.ent of R.v.nue.
., 0 1h. .bov. ..... hn b..h 0' will b. ,opo,tod ohd '0' ..,d with .h. P'hh,,'Veh'O Ihh.""hC. To' ,,'U'h
to be filed by the deced.nt', r.p,.esentatlve.
C. 0 'h. o.ov. 'hlo,.otloh .. 'h'O".C' .hd/o' d.." ohd d.duC"Dh. v... po.d b, ,Ou.
You IIIUSt cOIIIPlete PART 0 and/or PART r3l below.
If you indicate a different tax rate, please state your
relationship to decedent:
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
Till( ON .IOINT ,TRII<;T Ar.r.ntlNT~
1m
PART
~
Till( PFTtlRN - cnMPIITIITtON
lINE 1. Dot. Establlsh.d
2. Account aalance
3, Percent T.~able
4. A~ount Subject to Tax
5. Debts and Deductions
&. A~ount Taxable
7. T.~ Rate
8. Tax Due
nF
1
2
3
4
5
b
7
B
x
1
2
3
4
5
6
7
8
DEDUCTIONS CLAIMED
OP
K
DEBTS AND
PART
~
DATE
AMOUNT PAID
DESCRIPTION
I
I
i
I
.
PAID
PAVEE
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penal tie. of perjury, 1 declare that the facts 1
complete to the b st of my knowledge and belief.
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_I".,
A
aro
correct and
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- 19'- yk
DATE
HOME
WORK
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GE"ERAl I"FORMA1IO"
1. rAILURE 10 RESPOND Will RESULT IN AN OHIClAl TAX ASSlSSt1lHI ..ltlt 1I'1111(,llIh. Inh,.,' 1''''lIlt nn 111'0'''''110"
,ub_Iltad 11'1 tha flnltnchl t"ltlt"llull.
Z. Inh.rlt.ne. ,,,. blllO".' cl.llnllu.nl Ill". ..nnllll ,I't.t 0'. II_tllllll/lt', IlI'IllI III 11."th
3. A jalnt ,1C(Ollnl I. I"o"hl_ eVil" thllllQh ItI. 1111(111111"", """. ...., ,lilt hili ,'I ,I ""II.,r "I (1IIlVlIl.J""I.II.
40. Accounls Ilru:lwJillQ "'0'. "eld b.t....." hUlbll"" n!\ll ..If.' ..'lid' th.. 1'''111111111 1",1 In It)l II I """"Il' ..IUlln un_ yeln Ilrlor to
d."th ar. fullv 1"0/1111_ /" I'..".'.'"
!to Account. ..Illhll."ed lolntly h.t...." hUl''''''11 'Inll wlf. ...or. II,,,,, Clna 't.'" ,lflllf III II.IIlh ,".'''It I"oobl..
II, Account. hald by II dacadant "In tHat '0'" "noth., or nth.', "'II ""."11111 Illl i't'.
REPORTI"G I"STRUCTIO"S
PART
TAXPAVER RE~PO"SE
1. BLDClC A _ If tho In'onultlon tlnd co"putatlon In the notlt8 ,Ir. (orr.,t "rllJ 1I.IIuCllu"' Me not IlllH11I (1,IIIII.d. plAC. n" ")C"
In bloCk ",.. 0' PMt I of the ""II'P"".' RUllonu" ...ctlon. Siql1 two cOlli.. Ilnd ,Ull.jt thll" with 'lout ch.c~ for thll ".ount of
tall to the Aelllsht of willi of the county Indlc"ted, th. .IA nOPllrt..nt of Pn_nuII will luulI "" offlcllll "uu,..nl
(for" R[v.I~~a [lei upon r.c.lpt of tho r.turn frail Ih. Pug I".' of Willi,
2. BLOCK II . If tho IIlle' 'Pllel,lod on thl_ nottce h,,' boon or will bo '8porl.d "nd ,,,. pllld with tho Punnsylvnnltl InherltanCII
Tlllt R.turn fllod by tho dllcedon'o, r.pr...ntlllh.... pl.lell 11M oole" In hloclo "B" of PMt I of tho "'n.plI'Io' Pupa",." slIctlon. Sign one
COpy and rllturn to the PA Coplltt..nt of Rllvenue, Bure"u of Indlvtdulll I".es, Oept ~80bOI, tillrrhburo, PA 111za-0601 In the
en"elape provided.
3. BLOCK C . If the notice Infor,"tion Is Incorrect and/or deductions are being clai.ed, check block MCM nnd co_plete Pert. Z and 3
of will. of the county IndlCllted, the PA Depart..nt of Re"enue will Issue an official nssels.ent Iror" REV-l~4a [X) upon receipt
of the return fro. the Register of wills.
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TAX RETURN - PART
2
- TAX COMPUTATION
lINE
1. Enter
NOT(:
the date the occount originallY was estoblished or titled In the ~anner o.Jsting at dllte of death.
For II decedent dylno after lZ/IZ/aZ: Accounts which the decedent put In joint na.es within one II) year of death are
ta.able fully as transfers. However, there Is an e.cluslan not to e.ceed $S,OOO per transferee regardless of the value of
the account or the nu.ber of account. held.
If a double asterisk I..) appears be for. your first na.e In the address portion of this notice, the '3.000 exclusion
already has been deducted fro' the account balance as reported by the financial institution,
Z. Enter the total balance of the account Including Interest accrued to the date of death.
3. The percent of the account that Is taxable for each survivor is deter.lned a. follow.:
A. The percent taMable for joint a..et. established .ore than one year prior to the decedent's death:
DIVIDED BY TOtAL NUHSER OF
JOIHt OWNERS
Exaepl,,: A joint asset registered
DIVIDED BY TOTAL HUHBER OF X 100 .. PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the naee of the decedent and two other persons.
I DIVIDED BY 3 (JOINt OWNERS) DIVIDED BY Z (SURVIVORS) . .161 X 100
16.7% (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent's death or accounts awned by the decedent but held
In trust far another IndlvidualCs} Ctrust beneficiaries):
1 DIVIDED BV TOTAL HUNSER OF SURVIVIHG JOINT
OWHERS OR TRUST BENEFICIARIES
X 100
PERCEHT TAXABLE
EMaeple: Joint account registered In the na.e of the decedent and two other persons and established within one year of death by
the decedent.
1 DIVIDED BV Z (SURVIVORS) .. .50 X 100 50% (TAXABLE FOR EACH SURVIVOR)
4. The a.ount subject to tnx Illne 4) Is deter.lned by .ultlplylng the account balance Cline Z) by the percent ta.able (line )).
5. Enter the total of the debts and deductions listed In Part 3.
6. lne a.ount taxable ,Ilno b) Is deterelned by subtracting tne oebts ana aoouetlons Illne ~J ,roe tne a.ount suo)ect to t~A lilno ~J.
7. Enter the appropriate taM rato (1lno 1) as deter.lned below.
A. For dat.s of death occurring after 6/)0/94, the tnx rates for transfers to spouses are as follows:
1. Date. of death on or after 1/1194 and before 1/1/95 the rate Is 3%.
Z. Date. of death on or after 1/1/95 transfers to spouses will be ta.od at 07. tak rato.
Nato: For dates of death prior to 7/1/94 transfors to spouses are takablo at 6%.
B. Transfors to lineal descendants Including father, ~other. son, daughter, grandchildren, sonMln-law,
daughter-In-law, stopchlld and thoir Issuo are takable at slk percent 16%).
C. Transfers to all others Including brother, sister, uncle, aunt, nophew and niece aro takable at flfteon percent (15%).
D. If you change the taM rate, please specifY your relationship to the decedent In the area pravldod.
8. The a.ount of tax due (line 8) ls deter_lned by aultlplylng the a.ount takable (line 6) by tho tax rate Illne 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deter.lned as fallows:
A. You legally are responsible for pay.ent, or the estate subject to adainlstratlon by a personal ropresentatlve Is Insufficient
to pay the deductible U..s.
8. You actually paid the debts after death of the decedent and can furnish proof of pay.ent.
C. Debts being dal.ed IIIUst be It..ized fully In Part.5. If Ilddltional space Is n..ded, use plain paper 8 IIZ" M 11". Proof of
pay.ent aay b. requested by the PA Depart.ent of Revenue,
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. TAXPAYER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY)
CO~~ONWI AllIt 01 I'l NNi)'tl VANIA
U(lIANTI4INI 01 ill VI Nul
"UNI AU Of INDIVIDUAl a_I S
UlIII. ,'lObO I
tlANIU'i~UNG. IIA 111:1\-0"01
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INFORMATION NOTICE
AND
TAXPAYER RESPONSE
.;1j-t! &-- 1/ ff
FILE
ACN
DATE
NO.21
96152(.82
\1-13-96
It."hlllIU" t\l
TVPE OF ACCOUUT
I SAVINGS
CltECK ING
TRUST
CERTlF.
RU8V L LIUEAWEAVER
BOX 33
LOVERS Ltl
NEWBURG PA 17240
EST. OF CRVIL R CASSUER
5,5. NO. 183'12'\f.89
DATE OF DEATH 09-30-96
COUNTY CUMBERLAUO
REHIT PAVHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
ORRSTOWN BANK h.. p,.vl... ,h. D.p.,...n' .I,h ,h. Inf.,...lon II.'.. ..1.. .hl,h hR' ...n uu. In ,.I,ul.lln. Ih.
p...n.I.1 ... .u., Ih.l, ,.,.,.. In.I,.I. Ih.' .. Ih. ...,h of ,h. ...,. ..,...nl. ,ou ..,. . j.ln' ...."..n.fl,I." .f Ihl. .".unl.
If ,ou ,..I ,hl. Info,..lIon I. In,o""'. pl.... o...ln .,,".n ,.".,"on f'o. Ih. flnon<l.1 1"",u'lon. ."DOh . ,op, 10 ,hl. fo,.
.n. ,.Iu," It I. .h. ..0". ...,.... Ihl. .<<oun' I. .....1. In ."o...n<' .lth Ih. ,nh."\On<' To. I..' of .h. :o...n...lth of .,onn"lvonl..
\,Iu.,' l'Jn. ....Y oe en"were.' OY r"'111,"IQ I' I' I 'II' .O.!l/',
COMPLETE PART 1 BELOW
Account No. 000-015879
. SEE REVERSE SIDE FOR
Oah 12-30-82
Established
FILING AND PAYMENT INSTRUCTIONS
.'- -.. ~....,.-_...---_._'--'--
. .
10 l"t:ur~ Ilropar erg.iS" tc. 'Jour 1l(~Ount, t....
IZI caple, ot thh notice I'Iust aC('0.p3ny your
pay.ent to the Reglstal of Will", Ha"'. c.hvc.h
payable to: "ReQister c.f wills, Agent".
PART
[!j
1.129.88
50.000
564.94
.06
33.90
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT BASED ON THIS NOTICE
Account aalanca
Percent Taxable
AMount Subject to
Tax Rate
Potential Tax Due
x
NOlE: If ta~ payeents are ~ade within three
(1) eonths 01 the dncedent" date of death,
yOU .ay deduct a SZ dlscount of the taM due.
Any inherltanca taM due will beco.e dallnquent
nine (9) eonths after the date of doath.
Tax
x
r CHECK ]
ONE
L' BLOCK
ONLY
A, 0 Tho above Inforaatlon and taM due is correet.
1. You eay choose to realt payeent to the ROgister of wills with two copies of this notl~e to obtain
a discount or avoid intere,t, or you eay c~ec'" bnK "a" and return thls notic. to thO Regist.r of
wills and an official assess.ent will be Issued by tho PA Depart.ent 01 Revenu..
a. [:] Th. ...v. ..... h.. ...n 0' .111 .. ,.po".. .n. I., p.l. wllh .h. P.nn,,'v.nl. Inn.,ll.n,. T.' ,.'u,n
to be flied by the decedent's representative.
C. c=1 The above inforeatlon is Inc~rrect and/or debts and deductions were paid by you,
You .ust coeplete PART 0 and/or PART ~ below.
If yOU indicate a different tax rate, please state your
relationship to decedent:
~OFFICIAL USE ONLV 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TA'i OI:TIION .. r.nMPIITAT!nN
LINE 1. Data Estab1Is~.d
2, Account Balance
3. Percent Taxable
4, A~ount Subject to Tax
S, Debts and Deductions
&. Anount Taxable
7, Tex Rata
8. Tax Due
D'"
nCO Tav "'.. InT...T .ITOII~T AI"',..nIlNT~
1
2
3
4
5
&
7
B
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x
2
3
4
5
6
7
8
DEDUCTIONS CLAIMED
_.',
x
DEBTS AND
PART
~
DATE
DESCR I PTI ON
AMOUNT PAID
PAVEE
I
I
I
I
s
PAID
TOTAL (Enter on line 5 of Tax ConputationJ
and
perjury, I declare that the facts I
~y knowledge and belief.
HOME
WORK
DATE
GENERAL INFORMATION
1, FAILURE TO RESPOND WILL RESULT IN AN OFrICIAL TAX ASSESSHENT with ,11'1.lh.nhlu In"'r.,' hn\tuJ un Infur..,,'!nn
lub.ltled by 'h. "ntlntlnl 1".'11,,111111.
:. Inh.rltanc. 1,,_ liIlCo".' 1I.llnllu,,"t nln. I'Iont"I "ftllt '''. IIIIClIIJUI1I', lllltll "' ll."th.
), A joint "ccount I.. 1".,lbl_ IIVlln Ihoul,l" th. dlll:.llllnl', n...... .11" ,uldlltl III 41 ",.tlllt 01 (OI1\1."IIII1r....
.., Accounll llncludlng thou ".Id "lit....." hUlbltlld nnd wlf.1 whlth W. Iltle.lllm' 111.11 In Join' n......' within II". ~1I"r wlnt to
dllath Sf. fully In_nbl. "' 'fllntf.,.,
~, Accounts u'nblhh.d Jointly bllt....n hUlbllnd rlOd wlf. 1II0r. than 0"" Vllllr prior to IIlIlIth oItu not '"."blll,
b, "ccount' ".Id by II tllle.dllnt "In trul' fo," "noth.r or ot".,. I'Ir. '".nlllll fully.
REPORTING INSTRUCTIONS
PART
1
TAXPAYER RESPONSE
1. BLOCK'" If t"lI Inforlllatlon IInd co.putallon In the notice Me corrGct ,Ind deduction, MG nol tieing cl"l..ed. plnc. nn "It"
in block "A" of Pari I of Ihe "Tallpayer Ruponu" 'ectlon. Sign two copl.s nnd ,ub.1I the. wHh your check for the lI.ount of
tall to the R.gister of wills of the county Indlcltted. Ihe PA Depart..nt of Pevenue will luue .1n official oueu.ulnt
lfore REV-IS~a [It) upon receipt of the return fro. the Pegl,ter of wills.
Z. BLOCK B . If the aUllt specified on Ihh nollc. hilS bun or ...111 be ruport.d nnd tll. pltld with tho PennlYlvl'lnla In".r1lltne.
TI'Il( Return fllud by th. d.c.dent's repreunta\lvu, plltce fin ")C" In block "B" of Part I of the "Ta_pltyer 1I.,pon,." section. Sign on.
copy and return to the PA Depar\luant of Rovenue. Buruu of Indlvldultl TIIllIIS, Dept ~8QbOI. Illtrrlsburg, PA 111~8-QbOI In the
envelop. provided.
3. BLOCK C . If the no tic.. Infor.nUon is Incorr.ct lind/or deductions Itra blllng clalned, check blocl< "COO Md co.plat. Parts ~ Ilnd 3
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_ ....' .. ~ '''. _ _. _. . ,_ .' _"', .. ... "'_.1...
, ..~ ....-, . .. .... "., ...- .... .......
of Wills of the county Indicated. The PA Departeent of R.venue will I..ue an official a.s..s.ent IFor. REVMI5~B E)C) upon r.celpt
01 the return Iroe the R.lghter 01 wills,
TAX RETURN - PART
2
- TAX COMPUTATION
lIHE
I, Ent.r
NOIE:
the date the aceou~t originally was e.tabllshed or titled In the nanner ..Istln~ at date of d.ath,
For II decedent dying aft.r IZ/IZ/8Z: Account. ...hich tho d.cedent put In joint nlte.. within onll II) year 01 death are
ta.abl. fully a. tran.I.r., Iio....v.r, th.r. i. an ..clu.lon not to e.ceed '3,000 p.r tron.I.ree r.gardles. 01 tho value 01
the account or t~. nu.ber of account. held.
If a double a.torisk (..) app.ar. balore your Ilr.t nan. In tho address portion 01 this not lea, the '3,000 ..clu.ion
alr.ady has b.en deducted Iroe the account balanc. as reported by tho financial In.titutlon.
Z. Ent.r the total balanc. of tho account inclUding Int.ra.t accrued to tho date 01 death.
3. The p.rc.nt of the account that Is ta.able for each .urvlvor I. dat.relned as follOW':
A. Ihe perc.nt ta.abl. for joint as..t. establish.d .ore than on. yaar prior to the d.cedent'. death:
DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
Exaepl.: A joint assat rGglster.d
DIVIDED BY TOTAL NUMBER OF )( 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In tho na.. of the dec.dent and two other parsons,
1 DIVIDED BY 3 IJOINT OWNERS) DIVIDED BY Z (SURVIVORS) . .lft7 II 100 . 16.1i: (tAXABLE FOR EACH SUNVIVOIU
B. The perc.nt ta.able lor ass.ts created within one year of the decadant'. death or accounts owned by the decedent but h.ld
in trust lor anothar IndlvlduaUs) Ctrust benllflciariesl:
1 DIVIDED BY TOTAL NUHBER OF SURVIVING JOIHT
OWNERS OR TRUST BENEFICIARIES
)C 100 . PERCENT TA)CABLE
E.aapla: Joint account r.glstered In the na.a 01 tho decedent and two oth.r plrsons and .stabllshed within one year of d.ath by
the d.cadent.
I DIVIDED BY 2 (SURVIVORS) . .!to )C 100 50% ltAXAI\lE FOR EACH SURVIVOR)
4. The a.ount .ubJlct to ta. (lln. 41 Is deter.lned by .ultiplylng tho account balance llln. 2) by the perc.nt ta.abl. (lin. 3).
5. Ent.r the total of tha debts and deduction. li.ted In Part 3.
6. Tne a.ounl ta.aole (11ne tJl Is deur.lnea oy 'Ubtracllng lne tJeots /'Ilia a.auctlon. Itln. ~l tr~. tnc. llsount suolect 10 ta. 111n. ..J.
7. Enter the approprlat. tax rat. (1In. 7) aJ d.t.r.ined b.low.
A. For dat.. 01 d.ath occurring alt.r 6/30/94, the ta. rat.s for translers to spou.e. ar. as follow.:
1. Dat.s 01 death on or alt.r 7/1/94 and before 1/1/95 tho rat. is 3%.
Z. Oat., 01 d.ath on or aft.r 1/1/95 tran.f.r. to spouse. will be to.ed Itt 0% ta. r/'ll..
Note: For dat.. of death prior to 7/1/94 tran.f.rs to spouses ar. talll'lbl. at 6%.
B. Tran.I.r, to lln.al de.cendants Including father, "oth.r, son, daughter, grandchildren, son-In-law,
daught.r.ln"law, st.pchlld and th.)r Issue are ta.abl. at sill percent (6%).
C. Transfers to all others Including brother, si.ter, unci., aunt. nephew and nlec. ar. ta.able Itt filte.n p.rcent (15%).
D. II you chang. the ta. rate, please specify your relationship to the declldent in the area pro~lded.
8. Th. a.ount of tall due (line 8) is d.t.r.in.d by .ultlplying tho anount ta.abl. Clln. ft) by the la. rat. Illn. 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deduction. are d.tereln.d a. follow.:
A, You legally are responslbl. lor pay..nt, or the .state subj.ct to ad.lnlstratlon by a personal r.pr...ntatlve I. Insufficient
to pay tho d.ductlble Ite...
B. You actually paid tha debt. after death 01 tho decedent Ilnd can furnl,h proal 01 pay.ent.
C. Debts b.lng clal.ed .ust b. ite.lzed fully In Part 3. If additional space i. ne.ded, u.. plain paper a I/Z" . II". Proal af
pay.ent nay be requ..ted by tho PA Oepart.ent of lIev.nue.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORHATIDN OR ASSISTANCE, CONTACT ANY
REGISTER OF WIllS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE
C~ CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IHPAIRED ONLY)
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'96 ole 30 fIlO :33
Clen
Cumc,
. ,Ill
PA
PURPOSEDI'
NOTICE:
To fulfill the nqulraHntl of Section 21,.0 of tM Inheritance and Estat. fall Act, Act Z2 of 19'n. (72 P.S.
Section 21U),
PAYl€KTI
o.t~ the top portion of thl. Hotle. end l~lt with your pay.-nt to the Rall.tar of Will, printed on the
ravar.. IId11,
.. "aka cheek or .oney ardllr payable tOI RECISTER OF WILLS, ";ENT.
All p.~tI received ,hell first M applied to any Inter..t which ..y ba ctu., with any realnder applied to the tax.
REfUND (CR) I
A r.fund of a tax credit, which wa. not r~.ted on the tax r.turn, ..y ba r.~lted by ~l.tl"g an MAppl1catlon
'or R.fund of Penn,vlvant. Inn.rlt.nca .nd E.tata Tax" (REV-Ill]). applIcations ar. avallabl. at the OffIce of
the Reglltar of Willi, any of the ts Rav.nue District Dfflc.. or by call1na the special Z'-hour answerlna ..rvlce
~r. for for.. ordllrlngl In P~,Ylvenl. 1-80a-36Z-ZaSD, out,lda P~.ylvBnla end within 10e.1
H.rrlsburg ar.. (717) 717-1094, TOOl (717) 17Z-ZZ5Z (~.rlng JB9.lrad Only).
OlJECT10HS1 Any p.rty In Int.r..t not ..tl.flad wIth the eppr.I...ent, allowanc. or dl..llowenc. of deductIon. or .......ent
a' tax UnclucUng dheCM.W1t or Inhr..U .. shown on thil MotlCI ..Y object within l1.ty (60) daY' of rlealpt of
thla Notlc. byz
--written prot..t to the PA Dap,rt.ent of A.venue, Board 0' appeal', Dept. ZIIOZI, Harrl.burg, PA 17IZI-10Zl, OR
--.lectlng to have the ..Uar d.t.nIMd .t the eucUt of the account 0' the personal r.pr..entaUv., OR
--eppeal to tM Orphen,' Court
ADtO,I-
ISTltATIYE
CORRECTIONSz
Factual .rror, dl.cov.red on thl. .......ant ~Id be addr...ad In writing t01 PA O.part.-nt of Ravenue,
~.IU 0' Jndlvldual Tax.., AT1Hz POlt ,......-nt Ravlew UnIt, DEPT. Z10601, HarrIsburg, PA 171ZI-0601
Phone (717) 717-6505. S.. peg. 5 of the bookl.t RJn.tructlon. for Jnharltanc' Tax Aaturn for. R..ldant
DecadantR (REV-ISOl) for an axplanatlon of ~lnl.tr.tlvalY corrletabl. arror..
01SCCtlCT1
J' any tax due I. paid withIn thr.. (~) calendar aooth. aftar the d.cadant'. daath, . flva parcent (5%)
dl,cCM.W1t a' the tax paid I. 811DW1d.
PENALTYz
The 15% tax ..na.ty non-p.rtlclpatlon penalty I. co~tad on the total a' the tax and Intara.t ......ad, and not
paid bafar. January II, 1996, the flr.t day .ft.r the and of the tex ..na.ty p.rlod. Thl. non-p.rtlclp.tlon
penaltY II r:ppealabl. In the .... .annar and In the the ..... tI.. p.rlod .. you would appaal the tax and Inter..t
that ha. been ......ad .. Indlcatad on thl. '~tlc..
JHTERfST I
Jntera.t I. charged beginning with flr.t dey of delInquency, or nine (9) .onth. and one (I) day
froe the dIIte of death, to the data of peYMRt. Taxa. which bee.... delinquent b.for. JY1l.Iary \, 191Z
beer Intar..t et the rata of .Ix (6%) percent p.r ~ calculated at . dally r.ta of .000164.
AU t,.1I which Me.. dtillnclUMt on or aftlf Janu8ry 1, 191Z will baar Int.r..t at a rat. which will vary 'rOIl
calendar y.ar to c.lendar yaar wIth that rat. announced by the PA Departaent of Atvenut. Th. applleabl.
Inttra.t rat.. for 1912 through 1997 ar.e
1982
I9IS
19"
1915
I'"
--Jnbrllt
zoX
"X
IlX
UX
I'X
I. calculetad a.
.0aas.1
,OaOOI
.00OSOI
.DDOSS6
.DDDZn
fallowlt
V..r Jntar..t Aat. Dally Int.ra.t Factor
1917 'X .OOOZ,.?
1911.1991 IlX .DDOSDI
199Z 'X .DDDZft1
1995-1994 lX .ODDI9Z
1995-1997 'X .aaOZft1
V.ar Inttr..t Rat. Dally Intar..t Factor
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. I..ued .ftar the tax baea... dtllnquent will r.flact an Int.r..t calculation to flfte'" (15) day.
btyond the data of the ........,,~ If p.~ent Is .ede eft" the Int.r..t cOIPUtaUon date .hown on the
Notlc" additional lnt.r..t au.t be celculatad.
. ' i (~I -..,'
RECEIVED BY ,'" '.':"S1GN.'U~f" .' ~ I ',/, ~
MARV C. LEWIS /:' l'jAi.~t '
REGISTER OF WILLS ' ,
D NO. AA
184902 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF RlVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATETAX
'*'
...."..."1"'"
RECEIVED fROM:
i
ACN
ASSESSMENT r:t
CONTROL ~
NUMBER
AMOUNT
HAZEL BEASON
'1b1524l:11
$lbl.30
R D 4 CME 146
NEWVILLE, PA 17241
ESTATE INFORMATION,
~ FILE NUMBER
Ii 21-1996-0988
~ NAME OF DECEDENT (LAST)
~ CASSNER CRVIL R
II DATE OF PAYMENT
EJ POSTMARK E
COUNTY
SSN 183-12-1489
IFIRST) (Mil
CUMBERLAND
DATE OF DEATH
REMARKS
fa TOTAL AMOUNT PAID
$161.30
SK
HAZEL BEASON
SEAL
CHECKtI 3938
REGISTER OF WILLS
.
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BUREAU Of INDIVIDUAL TAMES
INHERITANCt ,.. DIVISION
DEPt. :10601
HlARISlUAG. Pi 11111-0ttOI
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
*
/'./
NOTICE OF INNERITANCE TAX
APPRAISE"ENT. ALLOMANCE OR DISALLOMANCE
OF DEDUCTION., AND ASSESS"ENT OF TAM ON
JOINTLY NELD OR TRUST ASSETS
I"-IUIU'''III.''I
HAHEL
RR 4 CHE
NEWVILLE
BEASON
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
SSN/DC
ACN
03-17-97
CASSNER
09-30-96
Zl 96-0988
CUMBERLAND
183-1Z-1489
9615Z481
A.ount R..ltt.d
CRYIL
R
PA 17Z41
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO CDURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-iv:isira-Eif-AFji-io:i:97i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-17-97
ESTATE OF CASSNER
CRVlL
R DATE OF DEATH 09-30-96
COUNTY
CUMBERLAND
FILE NO. Zl 96-0988
TAX RETURN WAS:
S.S/D.C. NO. 183-1Z-1489
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORHATION
ACN
9615Z481
FINANCIAL INSTITUTION: ORRSTOWN BANK
ACCOUNT NO.
000-016588
TVPE OF ACCOUNT: (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 10-ZZ-84
Account Balance
Percent Taxabla X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Dua
Z.263.7Z
0.500
1.131. 86
.00
1.131.86
.15
169.78
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO:
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAVMENT
DATE
11-19-96
RECEIPT
NUM8ER
AA184902
DISCOUNT (+)
INTEREST/PEN PAID (-)
8.49
AMOUNT PAID
161.30
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 'I. NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS RefLECTED AS A "CREDIT" I CRI. YOU HAY BE DUE A REfUND.
SEE REVERSE SIDE Of THIS fOR" FOR INSTRUCTIONS. I
169.79
.01CR
.00
.01CR
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PURPOSE Of
NOTICE:
To fulfill the r.qulr...nt. of Section Zl~O of the Inheritance end [stata Tax Act, Act II of 1995. (12 P.S.
Sactlon 9140l.
a.tach tM top portion of this Notic. and subalt with your plly..nt to the Raglst.r of lUll_ printed on the
ravar.. stde.
__ "... eMck or 110M)' order payable to: REGISTER OF WILLS, AtENT.
PAYMENT:
OBJECTIONS: Any party In Int.r..t not I.lltfled with the appr.i....nt, allowance Dr dl.allowance of deduction. or .I.....~t
of t.. (IncludIng discount Dr Int.rll.t) a. shown on thl. Notle. ..Y object within sixty (60) day. of racalpt of
this NoUu by:
--writtan prot..t to the Pi aepartaent of Ravanu., loard of ApPllals, Oapt. 281021, Harrisburg, PA 11128-1021, OR
"1I1KU", to hay. tM lIathr dlll.ulnad at the BUdlt of the account of the parlonal repr..."t.Uve, OR
e_eppe.l to the Orphan" Court
A nflM"d of . t'K credit, ..hIch .... not nquested on the t.. return, aay b. r.questad by co..-l.tln, an "Application
for RaflM"d of Penn,YlvanI. Inh.rltanca and E.t.t. T.... (AEY-IS1S'. Appllc.tIon. .r. avall.bla .t the OfficI of
tha A.,I.t.r of Will., any of the 2S R.v.nua Dl.trlct Offlc.. Dr by c.lllng tha .pacl.1 24-haUr an...arlng ..rvlc.
~.r. for for.' ordarlng: In Penn.ylvanI. 1-800-162-2050, out.Id. penn.ylvanla and ..I thin local
HarrI.burg ara. (7171 787-8094, TOO' (717. 772-2252 IHaarIng 1~.lr.d Only'.
REFUND (CR1:
"DKIN-
ISTAAT1YE
CORRECTIONS:
r.ctual .rror. dl.covar.d on thl. .......ant .hould ba .ddr....d In wrIting to: p" D.partaant of R.vanua,
Buraau of IndIvidual Ta_'" ATTN: po.t A.......nt A.vlew unIt, DEPT. 280601, Harrl.burg, PA 17126-0601
Phona (7171 787-6505. S.a paa. 5 of the booklat "In.tructlon. for Inhlrltanca Ta. Alturn for a AI.ldant
Decldent" IAEY-1501. for an ._plan.tlon of adalnl.tratlvllY corractabla arror..
If any t.. due I. paid wIthIn thr.a (11 cel.nder aanth' aftar the dac.dant'. daath, a flv' parc.nt (5Xl
discount of thai te. paid Is allow.d.
Tha 15X t.. a.na.ty nonMpart,clpatlon panalty I. co..-utad on tha total of tha ta. and Int.ra.t a..a..ad, and not
p.ld b.for. Januery 16, 1996, the flr.t day aft.r the end of thai t.. .an..ty p.riod. Thl. non-partlclp.tion
penalty Is appe.labl. In the .... aam... and In thai tha .... tI.. p.rlod a. you would appaal thl ta. and Int.....t
that has blan a.....ad as Indlcat.d on this notlc..
DISCOUNT:
PENALTY:
INTEREST J
lnt.r..t i. charg.d b.gInnlng with flr.t day of d.llnquency, or nln. 191 .onth. and on. (11 day
fro. the date of d.ath, to the date of pay.ent. Ta." ..hlch baca.. dellnquant bafora January 1, 1982
baar Inter..t at the ..at. of .1. (6Xl p.rcant p.r annul calculatad at a dally r.ta of .000164.
All t.... which baeaaw dalinqu.nt on or aftar January 1, 1982 will bo~" Intero.t at a ..at. which will v.ry fro.
e.l.ndar yaar to calondar yaar wIth that rat. announcod by tha PA DIPart.ont of Aav.nua, Th. applIcabl.
Intor..t rat.. for 1982 through 1997 ar'l
Yoar lntorest Aat. Dally Int.nst ractor Yaar lntar..t Rat. DallY lntan.t ractor
1982 ZOX .000546 1987 'X .000247
1965 16X .000438 1988-1991 IIX .000301
1984 IIX .000]01 1992 'X .OOOZ.'
1985 UX .000]56 1991-1994 1X .00019Z
19a6 lOX .000274 1995-1997 'X .000247
ulnt.r..t Is calculat.d as follolllll
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. I..u.d aft... the ta. blCo", d.llnquent wIll r.fI.ct an Int.r..t ealcul.tlon to 'Ift..n (151 day.
b.yond the date of the a..o....nt. If pay..nt I. .ad. .ftor the Int.r..t co.putetlon data .hown on the
NotIe., additIonal Int.r..t .u.t b. calculatad.