HomeMy WebLinkAbout96-01077
.
o
Z
'0
CD
..
o
1;;
~
CQMMOHW(Al HI or .-[HHSVl YANIA
O(PUt.-.Ht or R[Y[HU[
IURUU or INDIVIDUAL tAXlS
O(Pt. lAOiO I
KAAAISlURG, PA HUI-UOI
*
t !., \ ~ \ -~ L\
INFORMATION NOTICE
AND
TAXPAYER RESPDNSE
FILE
ACN
DATE
./
Y
NO. 21 _ "110' 10'1 '1
96159248
12-17-96
1I'.lhlII ,n lI.tU
EST. OF CARRiE I GRIFFITH
5.5. NO. 172-14-3470
DATE OF DEATH 06-15-95
CDUNTY CUMBERLAND
TVPE OF ACCOUNT
o SAVINGS
[X] CNECKING
o TRUST
o CERTlF.
NANCV E GROSZ
400 CHEROKEE DR
MECHANICSBORG PA 17055
RENIT PAYNENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CO CDORT HOUSE
CARLISLE. PA 17013
DAUPHIN DEPOSIT BANK & has provld.d the n.parh.nt with the Infarutlon listed b.low which ha. b..n u..d In calculatlng the
pot.ntlal taM du.. th.lr r.cordl Indlcat. that at the d.ath of the ftbov. d.c.d.nt, you w.r. ft Joint own.r/ben.flciary of thll account.
If you f.el this Infor..tlon II Incorr.ct, pl.... obtain written correction fro. the financial Institution, attach a copy to thl. for.
and r.turn It to the ..bo.... addr.... this acco.Jtlt Is tnabl. In ilccordanc. with the Inh...ritanc. ta. law. of 'he Co..anwealth of PennSY1...anla.
Questions .ay b. .n.w.red b1 call1no ell1) 161-B)Z/.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0038717611 Ooto 10-13-77
Elbblhhod
Account Balanca
Parcant Taxabla
AMount Subjact to
Tax Rata
Potantial Tax Dua
519.41
50.000
259.71
.15
38.96
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
to Insure proper credit to your .ccount, two
(2) caple. of this notice .ust acco.pany your
pay.ent to the Reol.ter of wills. M.k. check
paY.ble tal "Reolster of Wills, AO.nt".
x
x
NOtE: If ta. p.y.ents are .ad. within thr.e
e)) .onths of the decedento. date of d.ath,
you .ay d.duct a 5Z discount of the tax dU..
Any Inh.rlt.nc. t.x due will b.co.e delinquent
nln. (9) .onths .ft.r the data of de.th.
Tox
PART
ill
[CHECK ]
ONE
BLOCK
ONLY
A. c=J th. abov. Infor..tlon and t.. due Is corr.ct.
I. You .ay chao.. to re.lt pay..nt to the Reol.ter of Will. with two cop I.. of this not Ie. to obt.ln
a dl.count or avoid Int.r..t, or you ..y ch.ck bOM "A" and r.turn this notlc. to the Reol.ter of
Will_ and an offlci.l ........nt wlli be i..ued by the PA n.part.ent of Revenue.
B. c:J the abov. a..at ha. be.n or will b. report.d and ta. paid with the Penn.ylvanla InherltBnc. ta. return
to be filed by the decedento. repre..ntatlve.
C. ~ the above Infor..tlon i. Incorrect .nd/or debt. and deduction. w.r. paid by yOU.
You aust co.pl.t. PARt ~ and/or PART [!] b.low.
PART
~
If you Indicata a diffarant tax rat., pl.... ,t.t. your
relationship to decadent:
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
/')
AC-=~uiii'3 fAil
1
2_
3
4
5
6
7
8
DEDUCTIONS CLAIMED
LINE
1. Ooto E.toblllhod 1
2. Account Balanca 2
3. Parcant Taxable 3 X
4. AMount Subjact to Tax 4
5. Debt. and Deductions 5
6. Amount Taxabl. 6
7. Tax Rata 7 X
a. Tax Dua 8
un ~\i:i:ni' ,".i",;:;.
Il' . /1 - '7 '/
;<J/9.,W
~'fO
,.i,' ~;' %
rJ
iAX
ft~iUnn - C~HruiKii~n ur i"^
PART
[!J
DATE
DEBTS AND
PAID
PAVEE
DESCR I PTI ON
AMOUNT PAID
I
TOTAL (Entar on Llna 5 of Tax Conput.tion)
I
.
Under panaltia. of perjury, I declare that the
co.plata to tha b..t of MY knowladga and baliafo
Mfl~WdtGJft'D'''''''''
facts I have reported abova ara trua, corract and
HOME (? /7 ) '/b,/ -- ? "1,93
WORK (--"-)-- - -
TELEPHONE NUMBER
GENERAL INFORMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OffiCIAL TAX ASSESSHEHT with ftpplluble Inhrut b.ued on Infora.tlon
,w.ltted by the Un....el.1 Inltltutlon.
l. tm.rltMCII h. bllcOII., delinquent "1M lIonth. .It.r thl dleldent', dill_ of d..th.
S. A Joint account I. t..abl. liven thOuuh thl dlcedant', "ft,. Mil' added "' II ..t'.r of convenience.
4. Account. (Including tho" held batw..n hulbAnd And wll.1 which thl dlcldant put In joint n.... within on' y..r prior 10
Math .r. fully t,.abla .. I,.,,.'.r,.
S. Account. ..tabll.hed Jolntlv batw.,n hulband end wlf. lor. than one ya.r prior to d.ath .t. not I..abla.
6. Account. held by II dlcld'n' "In tru.t for" anathar or othar. .t. t...bl, fully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A ~ If thl I"'orlatlon end coeputatlon In thl notlc. at. cQrract and deduction. .r. not bal"9 chl.~, place an "X"
In block "A" of Part 1 of the "'a.pay.r R..pon.... .ectlon. Sign two copl.. and .ub.lt the. with your check for t~ a.ount 0'
ta. to the R.gl,t.r 0' Will' of t~ county Indicated. 'he PA Depart.ent of Revenu. will I,.u. an of'lcl.1 .......ent
(fora REV-I~48 EX) upon recalpt 0' tha raturn fro. tha Regl.t.r of will..
Z. .LDCK I . If tha a...t .peclfl.d on thl, notlc. ha, b..n or will b. r.port.d and ta. paid with tha P.nn.ylvanl. Inh.rltanca
T.. R.turn fll.d by t~ dac.d.nt', r.pr...ntatlv., plac. an "X" In block ..... of Part I of th. "'a.pay.r R..pon.... .actlon. Sign on.
COpy and return to tha PA D.p.rt.ant of Rev.nua, BureaU of Individual 'all", Dept 210601, Ilurhburg, PA 11128-0601 In tha
anvalopa provided.
S. IlOCK C . If the notlca Infor.atlon I. Incorract andlor daductlon. ara b.lng cl.l.ad, chack block "C" .nd co.plata Part. 2 and 1
eccordlM9 to tha In.tructlo~' balow. Sian two coola. and .ubalt tha. with your chAck for tha a.ount of tall pavabla to tha R.alstar
of Will, of tha county Indlcat.d. Tha PA Cepart.ant of Ravenua will I..u. an official ........nt (For. REV-I~~a EX) upon r.calpt
0' tha return 'roa th. R.gl.t.r of Will..
TAX RETORN - PART
- TAX COMPUTATION
2
LINE
I. Entar
NOTE:
tha dat. th. account origInallY wa. ..t.bll.had or tltl.d In tha .annar a.l.tlna at data of d.ath.
For. dac.dant dying a,tar 12/12/a2: Account. which tha d.c.d.nt put In joint n.... within ana III y.ar of d..th .ra
ta.abl. fully a. tran.fer.. How.v.r, th.re II .n .1Iclu.lon not to a.ce.d $1,000 p.r tran.f.ra. regardl..1 of tha valua of
tha account or tha nu.b.r of .ccount. hald.
If a doubl. ast.rl.k (..) app.ars b.fore your first na.. In the addra.s portion of this notlca, the $3,000 ..clu.lon
alra.dy h.. b..n deduct.d fro. the .ccount b.l.nca .. raport.d by the flnancl.l In.tltutlon.
2. Enter the tot.1 b.lance of the .ccount Including int.re.t accru.d to tha d.t. of daath.
1. The parcant of tha .ccount that I, t..abl. for ..ch .urvlvor I' dat.ralnad .s followSI
A. Tha parc.nt t...bl. for joint ....t. ..tablllhed .ora than on. yaar prior to the d.cad.nt'. daath:
DIVIDED .V TOUL HUHBER OF
JOINT OWNERS
E.a.pla: A joint ....t ragl.t.red
DIVIDED BV TOUL HUMBER or X 100 . PERCENT TAXABLE
SURVIVINC JOINT OWNERS
In tha na.a 0' tha dacadent and two oth.r par.ons.
I DIVIDED BY 1 CJOINT OWNERS) DIVIDED IV Z (SURVIVORS) . .167 X 100
16. n (TAXABLE fOR EACIl SURVIVOR)
I. Th. percant ta.abla for a,.at. cr.at.d within on. yaar of tha d.cad.ntt. d.ath or account. own.d by the dac.d.nt but hald
In tru.t for anothar Indlvlduales) (trust banaflcl.rl..):
I DIVIDED BV TOTAL HUHBEP OF SURVIVING JOINT
OWNERS OR 'RUST BENEFICIARIES
X 100 . PERCENT TAXABLE
E.a.plel Joint account ragllt.rad In the na.a 0' tha dac.dant and two oth.r p.r.on. .nd .,tabll.h.d within ana yaar of daath by
tha decadent.
1 DIVIOED.V 2 ISURVIVORS) . .~O X 100 ~D~ ITAXAILE fOR EICH SURVIVOR)
~. Tha aaount .ubjact to t.. (1In. ~) I. dat.r.lned by aultlplying tha .ccount balanca (1lna Z>> by the parcant t8~able Illne 3).
S. Entar the total of tha debt. and deductions II.t.d In Part 1.
o. lna aeaunt t.lIabla \Ilna oj I' oatar.lnaa by .uotractlng In. o.ot. ana O.auctlon. \11na ~, .roe lna a.aunt suoJec( 10 la~ \llna ~j.
1. Ent.r tha approprlata ta. rata (1lna 1) a. detar.ined b.low.
A. For datas 0' d.ath occurring .fter 6/30/94, the t.. rata. for tran.far, to spou.a, are .. follow.:
I. Oat.. of daath on or .fter 1/1/9~ and b.for. 1/1/9~ tha rata I. 1~.
2. Data. of daath on or .ft.r 1/1/95 tran.fer. to .pou,a. will ba t...d at O~ ta. rata.
Hotal For date. of death prior to 7/1/9~ tran.far. to spou... .ra ta.abl. .t 6~.
I. Tran.fart to lineal da.c.ndant. Including fathar, .oth.r, .on, daughtar, gr.ndchlldr.n, .on-In-Iawt
dauQhtar.ln.lew, .tapchlld .nd thalr I..u. ara ta.abl. at .i. percant 16~)..
C. Tran.far. to .11 other. Including brothar, .ister, unci., aunt, n.phaw and nl.ce ara ta.abla at 'Ift.an parcant (I~~).
D. If you changa tha t.. rata, pl.... .p.cify your r.latlon.hlp to the dec.dent in the araa provld.d.
I. Tha aaount of ta. dua (llna a) I. datar.ln.d by oultlplytng the aaount ta..bl. Cllna 6) by tha ta. rata Cllna 1).
CLAIMED DEDUCTIONS - PART
DEBTS AND DEDUCTIOHS CLAIMED
3
Allowabla debt. and daductlon. ara dataralned .. follow'l
A. Vou lagally ara ra.pon.lbla for pay.ant, or tha a.tata .ubjact to adalnl.tratlon by a par.onal repra.ent.tlva I. In.ufflclent
to pay the d.ductlbla It....
I. You .ctually paid tha debts a't.r death of t~ d.cadant and can furnl.h proof of pay.ant.
C. Dabt. baing claiead au.t ba Itaallad fully In Part 1. If additional .pac. II naadad, u.a plain paper a I/Z. II II". Proof 0'
payaant .ay be raqua.t.d by tha PI Depart..nt of Ravanue.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORHATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS, PA DEPARTMENT OF REVEHOE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-B327. TDDI (717) 772-2252 (HEARING IHPAIRED ONLY)
COPl'OMAl TII Of P(NHSYl\lANIA
OCPAJlTMENT or R[V[NU(
IUAlAU Of INDIVIDUAL TAX[S
Q(PT. ZI0601
HARJIISlURC, PA UUI"UOl
*
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
FILE NO. 21 - 'I 1.>- 10"\'
ACN 96159248
DATE 12-17-96
III-ad,.", .,.,,,
EST. OF CARRIE I GRIFFITH
5.5. NO. 172-14-3470
DATE OF DEATH 06-15-95
COONTY COMBER LAND
TYPE OF ACCOUNT
D SAVINGS
\xl CNECKING
D TRUST
D CERTlf.
NANCY E GROSZ
400 CHEROKEE DR
MECHANICSBORG PA 17055
REHIT PAYHEHT AND fORHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
DAUPHIN DEPOSIT aANK I h.. provld.d the a.part..nt with the Infor..tlon Ihtld b.low which has b..n und In ulculatlng the
pot.ntlal t.~ due. Their record. Indicate th.t at the d.ath of thl abovl dlcldlnt. you w.r. a joint o~n.r/bln.flclary of thl. account.
If you f..1 thl. Infor.atlon I. Incorrect. pl.... obtain wrltt.n cnrr.ctlon fro. thl financial Institution, attach a copy to thl. far.
and r.turn It to tha abava addra". Thl. nccount I, ta..bla In occardanc. with tha Inharltanc. Tn. law. of tha COllanwaalth of Pann,ylvanla.
Qua.tlon' aay ba an.wlr.d by COiling (7171 787'8527.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Accaunt No. 0038717611 o.t. 10-13-77
EstabUshed
Account aa1anca
Percent Taxable
Amount Subject to
Tax Rate
Potenti81 Tax Dua
To In.ura propar crldlt to your account, two
(ll copll' of thl, notlca IU.t accoapany your
pay..nt to the Rlglstlr of Will,. Hak. chack
payabla tal "Rlgl,t.r of will., Agant".
PART
[TI
519.41
50.000
259.71
.15
38.96
TAXPAVER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
x
NoTEI If ta. paYlants are .ada within thra.
(]) aanth. of tha daCldant's d.ta of da.th,
you .ay d.duct a S~ di.count of the ta. dUI.
Any Inh.rltanc. taw due will b.co.a d.llnquant
nln. (91 lonth' aftar thl date of death.
T..
x
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The abava Infaraatlan and taw due is corr.et.
1. You aay chaos' to r.alt pay.ant to the Rlgl.ter of Wills with two copla. of thl, notice to obtain
a dl.count or avoid Intlre,t, or you .ay check box "A" and r.turn thl, notlc. to the R.gI,t.r of
will. and an official a......ant will ba I,.uad by tha PA Dapart.ant of Ravenua.
B. c:J The abov. ....t h.. ba.n or will b. raported and tax paid with tha P.nn.ylvanla Inherltanca Ta. raturn
to b. fllad by the dacadant'. r.pr...ntatlvl.
t. ~ Th. above infor.atlon (. Incorrect .nd/or dabt. and daductlons wlrl paid by you.
Vou lU,t co.plat. PART [!] and/or PART ~ b.low.
PART
~
If you indicat. _ different tax rat., pleas. st.te your
relationship to decedant:
OFFICIAL USE ONLY D AAF
PA DEPARTMENT OF REVENUE
IKA un ~U'~"RU31 KCCuunl3
I(J'-~ -g'/
, .l) dJ
(;.1) ,10"
:;:z.1; 9. '))
r:f2.1'1 91.L"t1. .
,0
.r'1
x
rAil
1
2
3
4
5
6
1
8
CLAIMED
i"A it~TURi~ - CuHFUTATiun u;:
LINE 1. O.t. Est.bltsh.d 1
2. Account aalance 2
3, Percent Taxable 3
4. Amount Subject to Tax 4
5. Debt. and Deduction. 5
&. Anount Taxable &
7. Tax Rat. 7
8. Tax Due 8
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Lin. 5 of Tax Comput.tionJ
I
.
Under penalti.. of perjury, I declare that the
COMP1.t. to the be.t of .y knowledge and belief.
-t~rr6r f.,. ((/JY'~J,-
AY IGNATll .:/
fact. I have reported above er. trua, correct
HOME (7~~/7) /&'J-33~1
WORK ( _= ) ~-- --
TELEPH E NDMIi~1!
ond
. ."
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAM ASSESSHENT with "Ppllcabl. Inl,"" b...d on Infor..lIon
.utMltted b,;, the tlnMeI,1 Institution.
I. InhlrltMC:' In bleo... delinquent nine lonthl ,fI,,. thl dlced,n", dtt. af duth,
1. A Joint eccount II '....tJI. ."".n thouuh the dludlnl', n... "lit lidded .. "...Ihr of conlllnllnc..
4. Account. (lncludlno Iho'l hald b.t....n husband and ..If,1 which Ihe dlcld.nt pul In Joint "ft", wllhln on, Y.I' prior to
ct.,lh .t. fully t,.abl_ .1 tranlh,.,.
S. Account. ..tab! hhed Jalntlv b.t...." hulbWld Met ..If, lor. thlV'l one yu,. p,. lor to d..th II" not hubl,.
.. Account. held by . dlcadent ~In trult fa,." ~Ih.r or oth.r. .r. t..abl. fully,
REPORTING INSTROCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A & If the Infur..tlon end co~t.tIDn In Ih, notlcl are corrlct and deduction. IIr. not bllng Clll.'d, plecl an "X"
In block "A" of P.rt 1 of the "T..p.y.r R.lpon.." ..ctlon. Sign two cop I.. nnd lub.lt th.. with your check for the ..ount of
tax to tha Ragl.t.r of Will. 0' the county Indlcal.d. lh. PA Deparl..nl of Ravanua will I..ua an official .....'..nl
(far. R[V.lS~8 EX) upon rac.lpt of Ihe raturn fro. Iha Regl.tar of Will..
2, BLOCK B - If the a,.at .paclflad an thl. not lea h.. ba.n or will b. raportad and tax paid wilh tha Pannlylvanl. Inharltanca
Ta. R.turn fllad by the dacadant'. rapra,antatlva, placa an "X" In black "B" of Part I of tha "la.payar Ra.pon.a" .actlon. Sign an.
copy Bnd r.turn to the PA Dapart.ant of R.vanua, Bur.au of Individual la.al, Dapt Z80601, lIarrl.burg, PA 17128'0601 In the
env.lop. provided.
1. BLOCK C - If the notlc. Inforaatlon I. Incorract and/or daductlon. are baing clal.ad, ch.ck black "C" and co.pl.t. Part. Z and 1
according to tha In.tructlon. t.alow. Slo" two Callie. and lub.1t the. "llh vnur I;kec" 'nr tt1e a.ount of tax CUlvllbl_ tn tt1a Raohtar
of Will. of the county Indlcatai. Tha PA Dapartaant of Ravanua will I.'ua an official a..all.ent Ifora REV-IS48 EX) upon racalpt
of the r.turn froe the Ragl.tar uf Will..
TAX RETORN - PART
2
- TAX COMPUTATION
LINE
I. Enllr
NOTE I
the data tha account originallY wa. ..tabll,had or tltlad In Iha .annar e.l.tlng at data a' daath.
far a dacadant dying aft.r 12/1Z/82: Account. which the dacadant put In joint na... within on. II) yaar of daath ar.
ta.abl. fullv a. tran.f.r.. How.v.r, Ih.r. II an e.clullon not to ..c.ad 11,000 p.r tran,'er.. r.gardl... of the valu. of
the account Jr the nu.bar of account. h.ld.
If a doubl. a.t.rl.k (..) app.ar. b.for. your 'Ir.t na.. In the addr... portion of thl. notlc., Iha 11,000 ..cluslon
.Ir.ady has b..n d.ductad froa the account balanca a. raport.d by the 'Inanclal In.tltutlon.
2. Ent.r the tot.1 balanc. of the account IncludJng Intar.st accru.d to the data of d.ath.
3. Tha parcant of tha account that Js ta.abla for .ach survivor Is dataralnad a. fallows:
A. Th. parcant taxabla for joint .'Iats ..tabll.h.d .ara than an. yaar prior to the deced.nt'. daath:
DIVIDED BY TOTAL HlRtBER OF
JOINT OWNERS
E...pJa: A joint a...t r.gllt.r.d
DIVIDED BV TOTAL NlJMBER OF X 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In tha na.a of tha dac.dant and two othar p.rlon..
1 DIVIDED BV 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) . .161 X 100
16.7~ (TAXABLE fOR EACH SURVIVOR)
B. Tha p.rc.nt ta.abl. for a..at. craatad within ana yaar of the dacad.nt', daath or accountl ownad by the d.cad.nt but hald
In tru't for anoth.r Indlvldual(,) (tru.t b.naflclarl..):
I DIVIDED BV TOTAL NUHBER Of SURVIVINC JOINT
OWNERS OR IRUST BENEfiCIARIES
X 100 . PERCENT TAXABLE
E...pl.: Joint account ragl.t.r.d In the na.. of the dacadant and two othar par.onl and a.tabllshed within on. y.ar of d.ath by
the d.cadant.
1 DIVIDED BV Z CSURVIVORS) . .SO X 100 . SO~ ITAXABLE fOR EACH SURVIVOR)
~. Th..-aunt .ubj.ct to t.x (lln. 4) I, dat.raln.d by .ultlplYlng the account balanc. (1In. 2) by the p.rcant ta.abl. Clln. 1).
S. Entar the total of the dabt. and d.ductlon. 11.t.d In Part 3.
o. In. aaount t..eol. taln. OJ I. oal.r.ln.a Dy ,uDtractlng tn. daDt. ana oaouctlon' t11". ~J fro. In. a.aunt .uojact to taM l.in. ~j.
7. Ent.r tha approprlat. t.. r.t. (line 1) a. d.t.r.lnad b.low.
A. for dat., of d.ath occurring .ft.r 6/30/94, the ta. rftt.1 for tran,'ar. to IPOU'.' ar. a. 'ollowl:
I, Oat.. of d.ath on or .ft.r 7/1/94 and b.for. 1/1/95 the rat. I. 3X.
Z. Oat.. of d.ath on or aftar 1/1/95 tran".rl to 'POu"S will b. ta.ad at O~ ta. rata.
Hot.1 For dlt.. of d..th prior to 1/1/94 tran,far. to ,poula. ar. ta.abl. at 6~.
a, Tren.fars to IIna.1 d.scendant. InclUding father, _othar, .on, daughtar. grandchlldran, lon-In-Ilw,
daught.r-In-law, stapchlld and th.lr I.,u. ar. ta.abl. at sl. p.rcant (6~).
C. Transf.r. to .11 oth.r. Including broth.r, .I.t.r, uncle, aunt. n.phaw and nl.c. ar. t..abl. at 'Ift..n p.rcent (lS~).
D. If YOU chang. the taM rat., pl.... .p.clfy your ralatlonlhlp to the dec.d.nt In the ar.. provldad.
8. Th. ..aunt of ta. due (line 8) I. d.tar_lned by .ultlplylng tha a.aunt ta.abla (IJn. 6) by the taM rala (1In. 1).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. dabt. and d.ductlonl ara d.t.r.lnad a. follow.:
A. Vou lagally are ra,ponllbl. 'or pay_ant, or the ..t.t. subjact to ad.lnl.tratlon by a personal r.pra'.ntatlva I. Jnlufflclant
to pay the daductlbl. It....
B. Vou actuallY p.ld the dabt. .ft.r d.ath of the d.cadant and can furnl.h proof of pay_ant.
C. Debt, b.lng cl.l.ad au.t ba Ita.lz.d fully In Part 3. If additional ,pac. I. n.ad.d, u.a plain papar 8 l/Z" . II". Proof of
p.yaent .ay be r.qu..t.d by the PA Dapart..nt of Rav~.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICr
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-B327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
(I /:;-/../
BUREAU or INDIVIDUAL TAXES
INttlRnANC[ tA. DIVI'IOM
DCPI. IIDU'
tWt1tlSlLIIG, PI uUI.au,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
NOTICE or INHERITANCE TAX
APPRAIBE"tNT1 ALLOHANCE OR OIBALLOHAHCE
or DEDUCTIONS, AND ABBESB"ENT or TAX ON
JOINTLY UELO OR TRUST ABBETS
...."'111."'...'"
NANCY E GROSZ
400 CHEROKEE DR
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
11-17-91
GRIFF IT II
06-15-95
21 96-1077
CUMBERLAND
172-14-3410
96159248
Anount R...itt.d
CARRIE
I
MAKE CHECK PAYABLE AND REMIT PAYMENT TDI
REGISTER OF WILLS
CUMaERLAND CO COURT HOOSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-iy:isira-Eif-AFji-ioi-:97i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 11-17-97
ESTATE OF GRIFFITH
CARRIE
1 DATE OF DEATH 06-15-95
COUNTY
CUMBERLAND
S.S/D.C. NO. 172-14-3470
(X) ACCEPTED AS FILED ( ) CHANGED
JOINT DR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION, DAOPHIN DEPOSIT BANK & TR CO ACCOUNT NO.
ACN
96159248
FILE NO. 21 96-1077
TAX RETURN WAS.
003B717611
TYPE OF ACCOUNT, () SAVINGS ()() CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 10-13-77
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Texable Amount
Tax Rate X
Tax Due
519.41
0.500
259.71
.00
259.71
.15
38.96
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 TD,
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOONT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE. SEE REVERSE rOR CALCULATION or ADDITIONAL IHTEREST. ·
I IF TOTAL DUE IS LESS THAN .1, NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI. YOU NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I
.00
38.96
5.97
44.93
INTEREST IS CHARGED THROUGH 11-25-97
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
PURPOSE Of
NOTICE:
To fulfill the r.qulr...nts of Section Zl40 of the Inh.rltanc. and Estate Te. Act, Act Zl of 1995. (7Z P.S.
Section 9140).
PAY":NT,
D.tlch the top portion of thl. Notlcl and sub.lt with your pey..nt to the R.glst.r of Wills prlnt.d on the
r.v.r.. lid..
.. "Akl check Dr eonlY order plyabl. to: RECISTER OF WILLS, AtENT.
REFUND (CRJt
A refund of a tl. cr.dlt, whIch wa. not r.que.ted on the ta. r.turn, .ay b. r.qu.st.d by coaplatlng an "Appllcltlon
for R.fund of Pann.ylvanl. Inherltanc. and Estltl TI_" (REV.l11S). AppllCltlon. ar. aVlllable at thl Offlc. of
the RIgI.t.r of Willi, any of the ZS Rev.nu. Ol.trlct OfficI' or by calling the sp.clal Z4.hour answering .ervlcl
nuab.r. for foras :rdlrlng: In P.nn.ylvanll 1.aOO.S6Z.Z0S0, out.lde P.nnsylvanla and wIthin local
HarriSburg ar., (117) 717.1094, TDD' (711) 77Z.ZZSZ (H..rlng I.palr,d OnlyJ.
OBJECTIONS: Any party In Int.r.st not ..tl.fl.d with the apprals...nt, allowanc. or dls.llow.nc. of daductlon. Dr .s......nt
of t._ (Including dl.count Dr Int.r..t) .. .hown on thl. Notlc. .ay obJ.ct within II.ty (60J d.yl of r.c.lpt of
this Notice by;
..wrltt.n prot..t to the PA Oap.rt.ant of R.v.nu., Board of App..ls, Dapt. ZIIOZI, Harrisburg, PA 171ZI.l0ZI, OR
...lactlna to h.v. the ..ttar d.t.ralned It the audit of tM account of the par.on.l tlpruent.tlv., OR
..app.I. to the Orphan.' Court
AOftIN.
ISTRATlYE
CORRECTIONS:
Factual .rror. dl.covar.d on thl. a......ent .hould b. .ddr....d In writing to: PA D.part..nt of R.v.nue,
Bur.au of IndivIdual T...., ATTN: po.t A.....,.nt R.vl.w Unit, DEPT. Z10601, HarriSburg, PA 17128.0601
Phone (717) 787.6505. Se. page 5 of the bookl.t "Instruction. for Inherltanc. Ta. R.turn for. R..ldant
Decld.nt" (REV-ISOI) for an ..planatlon of adelnl.tratlv.ly correctabl. .rror..
DISCOUNT:
If any t.. due Is p.ld within thr.. (1) c.l.nd.r eonth. .ft.r the d.c.d.nt'. d.ath, a flv. p.rc.nt (SX)
dl.count of thl ta. p.ld I. allow.d.
PENAL TV:
TM 15X t.. .~.ty non.p.rtlclpatlon p.nalty I. coeput.d on the total of the ta. and Int.r..t ..s....d, and not
paid be for. January II, 1996, the flr,t day aft.r the .nd of the t.. aan..ty p.rlod. Thl' non.p.rtlclpltlon
penllty I. app.Illbl. In the .... .ann.r and In the the .... tl.. p.rlod a. you would app..l the t.. and Int.r..t
that ha. b.an a....,ad I. Indlcat.d on thl. notlc..
INTERESt!
Int.r..t I. charg.d b.glnnlng with first day of dellnqu.ncy, Dr nln. (9) lonth. end on. (1) day
fro. the date of daath, to the data of pay..nt. l.... which b.ca.e d.llnqu.nt before January 1, .9aZ
be.r Int.re.t .l the rete of .1. (6X) p.reant p.r ennu. celculat.d at a d.lly rete of .000164.
All t.... which bec... d.llnquent on or .ftar January 1, 198Z will b.ar Inter.st at . r.t. which will vary fro.
c.l.nd.r Y"~ to c'lend.r y.ar with that r.t. announc.d by the PA O.part.ant of R.venue. The appllcabl.
Int.ra.t r.t.s for 1912 through 1997 ar'l
V.ar Inler..t Ret. Oalh Inbrut F"Ictor Vear Int.rut Rat. OaUy tntarut F.ctor
1912 lOX .000541 1987 'X .D00247
1911 lOX .00008 19la.1991 llX .DODSOl
198. IIX .000101 199Z 'X .00OZ47
19as In .000156 1995.1994 7X ,OD019Z
1916 lOX .OOOZ,. 1995.1997 'X .00OZ47
--Inhrut I. calculat.d .. follow. I
INTEREST = BALANCE OF TAX UNPAID X NunBER OF DAYS DELINQUENT X DAILY IHTEllEST FACTOR
..Any Notle. I..ued .ft.r the te. b.co... delinquent will r.flect an Int.r..t calcul.tlon to flfte.n (151 day.
bayond the date of the ........nt. If peye.nt I. e.d. .ft.r the Int.r..t co~t.tlon data .hown on the
Notice, additional Intarllt ...t be calcul.ted.
, /s-/:.) 1.-- 'I
NANCY E GROSZ
400 CHEROKEE DR
MECHANICS BURG
COMMONWEALTH OF PENNSYLVANIA
OEPARTHENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
SSN/DC
ACN
Q
~J;d,
~
BUREAU OF INDIVIDUAL TAXES
.JNiI(AIfANC[ lAX DIVISION
DEP'. 1106001
IllARISlURG. PA 1111a,0.01
11',"""1" III.'"
05-20-98
GRIFFITIl
06-15-95
21 96-1077
CUMBERLAND
172-14-3470
96159248
Anount Ranitt.d
CARRIE
I
PA 17055-0000
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COORT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
~---------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (03-971
.. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ..
DATE 05-20-98
ESTATE OF GRIFFITH
CARRIE
I DATE OF DEATH 06-15-95
COONTY
CUMBERLAND
FILE NO. 21 96-1077
ADJUSTMENT BASED ON:
S.S/D.C. NO. 172-14-3470
PROTEST BOARD DECISION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: DAUPHIN DEPOSIT BANK & TR CO ACCOUNT NO. 0038717611
ACN
96159248
TYPE OF ACCOUNT, () SAVINGS (XI CHECKING ( I TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 10-13-77
Account Balance 519.41 NOTE: TO INSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 259.71 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions 2,OB7.00 PAYMENT TO THE REGISTER DF WILLS
Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .15 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due .00 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+1 AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (- )
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE
. IF PAID AFTER THIS DATE. SEE REVERSE FO~ CALCULATION OF AOOITIOHAL INTEREST.
( IF TOTAL DUE IS LESS THAH n. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
.
PAYHENT I
D,llch thl top portion of thl, Hotlel and lub_it with your pay..nt ..d, pay'bl' to thl n... and eddr...
prlntld on thl r.v.r.. ,ldl.
u Hakl chick or .onlY ord.r payable tal REGISTER OF WILLS, AGENT.
REFUND (CA)s A r.fund of . tlM crldlt, which WI' not r.quI.tld on thl fIX R.turn, ..y bl rlqul'lld by coaplatlng an
"Application for R.fund of Penn.ylvanla Inheritance and [,tet. 'ax. (REY-IlIS). Appl1cltlonl .r. IVIllable .t
thl OfficI of thl RlgSltar of Willi, any of thl 25 Rav.nul Olltrlct of,ICI' Dr frol thl DIP.rt,.nt', 2~.hour
anlw.rlng 'Irvlel nuab.r. for for.. ordering: In Plnnlvlvanla t-8DO-S6Z-Z0S0, autlldl Pennsylvania
and within local H.rrhburg ar.. (717J 187-a09it, TOOl t117l 17Z-ZZS2 Oturlng Ilpalred only).
REPlV TOt
Oul.tlonl rlgardlng .rror. contalnad on thl. not Ie. .hould b. addr....d to: PA O.part..nt of Rayenue, Bur.au
of Jndlvldual T...., ATTNt Po.t A.......nt R.vlaw Unit, O.pt. Z80601. H.rrl.burg, PA 17IZ8-0601, Phon.
(717) 787-6S0S.
DJSCOUNT:
Jf any taM due I. paid within thr.. el) calendar .onth. aftar the d.cadent.. da.th, a fly. p.rc.nt (S~) dllcount
of the taM paid I. allow.d.
PENAL TV:
The IS~ t.M a.n..ty non-participation panalty I. co.puted on the total of the taM and Int.r..t .11....d, end not
paid bafor. January 18, 1996, the flrlt day aftar the end of the taM aan.lty p.rlod.
JNTEREST:
Jnt.r..t I. charged bag Inning with flr.t day of d.llnquancy or nlna (9) .oothl and one (1) d.y fro. tha data of
d.ath to the data of pay..nt. T...I which beca.. d.llnqu.nt b.for. January 1, 198Z bear Int.r..t .t the rat. of
11M (6X) p.rcent p.r ~ calcul.t.d .t a dally rat. of .000164. All t.... which b.c..e d.llnqu.nt on and .,t.r
January 1, 198Z will b..r Int.ralt at a rat. which will yary fro. cal.nd.r y.ar to cal.nd.r y..r with that rat.
announcad by the PA D.p.rt.ant of Rav.nu.. The applicable Int.r..t rat.. for 198Z through 1998 ar.t
V.ar Jnt.r..t Rata Dally Jnt.rut factor
Vaar
Jnt.rut Rat.
DailY Jnt.r..t Factor
198Z zoX .000S48 1987 'X .000247
1981 16X .000458 1988.1991 11Z .000101
1984 IIX .000301 199Z .X .000247
1985 UZ .0003S6 1991-1994 7X .000192
1986 lOX .Oa0274 1995-1998 'X .000Z47
.-Jntar.lt la calculat.d a. followl:
INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X OAILY INTEREST FACTOR
_.Any Notlc. 1.lued .ftar the taM beco... d.llnqu.nt will r.,l.ct en Int.r..t calcul.tlon to flft.an (IS) daya
b.yond the d.te of the .......ant. Jf pay.ent I. ..d. aftar the Int.re.t cOIPutatlon data Ihown on tha
Hotlca, additional Intare.t IUlt b. calcul.t.d.
."-
-:"'----
,
,
IIV,U101......
~:~~:9l\
_..:/I.'~
'COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT Of REVENUE
IURlAU or INDIVIDUAL TAXIS
DEPT. 280601
HARRISlUR . A 171l8.0601
OECEDENT'S NAME
INHERITANCE TAX
EXPLANATION
OF CHANGES
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
llcduc:t 10nll ln tho AllIount of $ J () R'l. fY)
hIve
beeD c:redited to the followlng lieNs:
?J(/50 >%1
-
.,.
~,
TAX EXAMINER: . J
:L_jJ ,.Li 1
PAGE
"l
.
co t::cE
'0." ~
... i3
,g3 e (.l :
.8
'.,~
0'0 co ,'0
N ~
"0 ~.. ~ . '0
lUlU '-
-
01;; \~) <U
--.- '.0
8lif ~ 5B
c!a: