HomeMy WebLinkAbout97-00007
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COHHOUWFt,1 or PfNNSVI \I"MIA
OH'..,UMI'Hl or IU,\lfHUt
RURE"U Of INlIIVIDUAl TA)(fS
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11ARRISBURD, IIA 11Ila'DClOI
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m.l~'"Y,l~ AIr 11'''1
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 ;'
96160609
12-23-96
I
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"1
C/~r;
CUm'
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JI/N __?
- Ill! 8,
EST, OF MABEL L NORRIS
5.5, NO. 165-32-5656
DATE OF DEATH 10-25-96
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[] SA~INGS
[J CHECKING
[.1 TRUST
IXj CERTIF .
:97
"
"
MABEL M GROTZINGER
112D COCKLIN ST
MECHANICSBURG PA 17D55
,(" "/it
L't) ,
'/.1
REHIT PAYHENT AND FDRHS TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PNC BANK h.. prtwlded thl DIPart.lnt wHh th. InforMat!!)n lhted below whJch hili been u'e:j In cnlouIatlr" the
potential t~x due. Their record, Indicate that at thl deflth of the above decedent, YOll were a joint ownlr/blrllflolary of thj~ Rccount.
If you fl.l thh Infor..tJon I, Jnclorrlot, pllnl obtain written correction frail the flnanohl in,tih.tion, attaoh a copy tol:hll fore
<I...,;: r~t""r: It ".' ,~... l!.t:.~.,:.. ",;::'.-,,.,. 'fI'!\: t.~'l'_r.t l~ "'!\'T;.lg Ir. .!"-~r'::""',n. l:',tl\ th:> ;r,~.rlt":',:l~ ';.,,': (",..J oi l:'. C;'l:l::...~'..~lU, .' P.u,,',lyl"l';'lt
Que..tlonl .a~ be an'''"It'.d b~ toftillng (717) 7&7-li~V,
COMPLETE PART 1 BELOW M M M SEE REVERSE SIDE FClR FILING AND PAYMEllT INSTRUCTIONS
Aooount No. 31200037739 D.h 02-01"96
E.t.blhh.d
Aooount Bel.noo 2.281 .60
Poroent To..bb K I 00 . 00
A.OUllt Subjoot to Tox 2.281.60
Tox Roto K .06
Potor,tlel T.. Duo 136.90
PART TAXPAYER RESPONSE
m !pAlLoIll 'I'ORISPO~nlfmRESUL" IN AN OPfltCXAt.TAX ASSESSHl!HT DAsenOlfTHXS I/G'l'XCI!'l
4. ~The above infor.atlon nnd tax uue Is correct,
LV 1. You .rlV choo... to rnit Plw.ant to the Righter of Willi wlth two copl.. of thIs notica tCl obtl'lln
a dIscount or avoid Int.r..t, or ~ou efty check box "An and rAturn this notice to the ~.9J.tlr of
WIll, and an officIal ft...,...nt will b. JD5uad by the PA Oeparte.nt of Revenuu,
To Insur. pl'oper credit to your tlccount, two
(2) copl.. of this notloe .Ult aceo.pany ~our
pa~"nt to the R,'gIster of Wll1'J. l1ake chack
pllYflbh tOI "RAglshlf of WH1I, Agent",
HOTf: If tll~ pa~.lnt. ara .~d. wJthln thr.e
(3) Months of the dacedent', dllte of d..th,
you .BY dadllct III 5% dhoount of the tax dUll.
Any InherJtftnce tax due will beco._ delJnquunt
nln. (9) Month, aft.r the dati of death.
[CHECK ']
ONE
BLOCK
ONLY .
B, 0 The ftbOVII !lint hili b..n or will bit rlflor-ted and tal( paid with the PllnnlylvBnla InherltanCle Tax ratlwn
to b8 filed by the de~.d.nt', ropr.lentfttlYI,
C. 0 Th. aboy. In'forllstlon h Incorrect and/or debh and dadu<ltlon. were p81d bv YOU,
Vou .Ult oo.pletll PART 0 andlor PART [!j below,
-...
....n
.....,,"'..
1\"''''.'''
::::;~r~l.'7!C:: C;' i:.:-: ~~~ ._!':"~~:7 ''!':'!t~!;'!' .A..CCCU~!'!'e
L
......:"
~...
.,,....
OFF1C I ALU$EQNlNDAAF:]
PA IlEPARTHEN'r OF, REVENUE '
PART
[!]
If you indic.t. _ different tax r.te. pl.... stete your
r.l.tion.hip to d.ced.nt: ~__.
---~,-,'-,_..........._.._.
PART
[!l
DATE
DEBTS AND DEDUCTIONS
1
2
3
4
5
6
7
8 -
CLAIM~
~~.
~
LINE
1. Doto E.t.bl1.hod
2. Account Belence
3. Perc.nt Texeble
4. A~unt Subj.ct to Tex
S. Debt. end Dad,,'cUon.
6, A~ount Taxable
7, hx Rat.
a, rlx Due
1
2
3
4
5
6
7
8
K
--
--...
-
K
-
PAID
~~
PAYF.E
DESCRIPTION
AMOUNT PAID
P :
.
.'
E
TOTAL (Enbr
-=
on Line S uf Tax Conputetian)
Under pen.lti.. of parjurYI 1 decler. thet the fact. 1
/ CO~Pl.)t. to cth.,.:~.',t JOf" !~~/~nO~l""" ~ belief.
.,i{~~v~' ~?uRt.lYlr"'" ?\,.V'l
heYe reportedaboy. Ire 'ru., correct end
ti!l,!'l~ ( ,7/ ? ],.,~?-:i'JL~!:f.-___.._--
WORK ( )
TELEPHONE NUMBER
1. FAILURE TO RESPOND WILL RESULT IN ~N DFflCIAL TAX ASSESSHENT ,,,It, .","Ioobl. I"""" h...d on Infor..tlon
lub.lttl,d by thl flnnnllhll Inltltutlol1.
2, Inh.d..noo .OX b.o,." d.lInqu.n' nln' ,o,,'h' ,it.r ItIO d".d.n'" d,,' of d.,th,
,. ^ jo,nt "ODun' I. t",bl' ,,,n thOu,h 'h' "."",..,,'. "'00 "" III'd.d '" , ,,', ,,, "f 00""" I.noo,
4. A'DDunt. <1nolodl", 'hD" h.ld b""..n ,."h"''' ""d ,,11.1 "hloh Ih. ,'oo.d"" ,'10' In join' n.... ..IIhln ,00 yo.. pd.r t,
dlleth life fully tn~flbllll ft' trsnllferl,
,. A'.o'"'' ..t.bll,b.dj.lntl, '1O,.oon hU.bood ,,,d "If. ,.1" th." "". "or pdor " d..'h ". n" 'M.blo.
b, Acoounts hlld b'J fI tI.eedent "In trult for" nl10thvf or others !lfQ t!lll.!lble fully,
GENERAL INFORMATION
\. &LOCK A _ If tho I"fo",tlon nn" oo.puto"OO I" 'b' ",tic. ". ,or"O< ."d d,,'uctl'no ," no' b.lnO o"lood, pl'O' .n "X"
In bl'" "A" of p.., I of 'h. "T.,p."r '..pon.... ,,,tlon, Si,n t.o oopl.. ",d .ub.I' 'b" .IIh ,ou. ,h'.' for 'h. ...-, of
'" '0 'h. ...1.", of Will. ,f 'b' cou,," I""oo,.d, "10 PA O....to.n' of ..v.nv. .111 1."10 .n 01f1,1;1 ......."".
(forI RE\lr154tl [Xl ,jpon reoelpt of the nlturn fro. the RUQlltllf of Willi.
REPORTING INSTRUCTIONS - PART
1
TAXPAVER RESPONSE
2. BLOCK B _ If 'h' ....' .".olll.d on 'hi. notlo. hR' b..n o. .111 b. "p,d.d ,nd '" p.ld "IIh ,h. ".nn"lv.nl. In"'rI"OO'
,", ..,urn fIl.d by 'h' cloo.d."," rep...",..ti". ,,1.0. .n "X" 10 bloc' "B" 0' POI' 1 of .h. "T"p.'or ...ponoo" ooo,l<1n. Sign on.
oop' .nd ro'urn '0 "10 PA O.p",oon' of ,oy.nu" BVI"u of Indlvldu.1 T."', O'P' 280'0!' ,'.rrlobur" PA 17\28-060\ 10 ,h.
envolop. pI ~vld.d.
~, "oex c " II "c< "",100 In.",,"nn " 'n""." ,md'or d,duotl"" or. b.I"O ,I.,,,d. ,'rc' blo" "C" .'nd cueplo" p.r" , .nd 3
c'.-"""" ._ '",. ""., ",'",,,, "e,., , "..,..c _.,.., "," ",""leO'-,.' ,"', ,-- ,",co .'..,' ,:.. c","": d ,." .,."c.' " \:,,' ",,! ".
of Will. of 'h. """" Indloo"d. Th' PI O.p.,',oon' of 'oV.nu' .111 I..u, .n offl,l.l ........n' 'FOI. .EV-I". EXl upon ro..lp'
uf the roturn fro. th_ R.1I1Bt\~r of 141111.
TAX RETURN - PART
2
" TAX COMPUTATION
LINE
1. Entar
HoTEl
,he d.to .h. .oooun' orl,ln&ll' ... ..,.bll,nod or titl.d In .h. ..nnor o,l.tin, .. d.to 0' d..,h.
For. dOD.d.n' d,ln, .flor IUI2I'" Aoooun" .hloh 'he d.oed.n' pv' In joIn' II.... .Ithl" on. (\) ,..r of
to"bl. full, .. ....n"'"'' ","oyor, .h... I' .n "oIu.lon no' '0 ",co.d ",000 p" ....n...r.. "o.rdl...
the account or th~ nu.blr of ~ccounts hold.
dlleth area
of the v81\M of
If . d,ubl. .."d" ,"J .pp"" b.fore yo,,, fI'" n.oo In .h. .ddl'... pOltl,n ,f 'hi. notlDO, ,h' ",000 ",'u.loo
.\rood, h.. boo" d.duot.d fro' 'h' ,"count b.l.noo .. IOPortod b, 'h' fln.nol.1 l",tI'utlon,
2. Eotor tho .oto' b.l.nc. 01 'h. .ccou'" Includlno In'....' .cClu.d '0 'h' d." ,f d..'h,
3. Th. porcon' ,f 'h. .oo,un' 'h., I. ",.bl. for e.ch .u,'vlvor I. d.,...I".d .. fOll""
A. Th. p.reon. to"bl. fOl Join' ...... ..\Obll.'IOd .0.. th.n one "" prior ., 'h' d.o.d.n," doo,h'
OIVIDEO BV TUT~l HUM8ER OF
JOINT mINERS
Exa.plQ: A joInt nlsat rogls~.r.d
OlVtDED BY TOTAL HUMBER OF )( 100 " PERCEHl TAXABLE
SURVIVING JOINT OWNERS
In tho n~.. of the decectent and two other par.ons.
16.7% (TAXABLE FOR EACH SURVIVOR)
B. Th' p.roon' ,."bl. for ."... cl,..,.d "lthln ,n' ".. .f 'h' doo.d.",'. d,,'h or ,oooun'. ..n.d by 'h' d...d.n' bU' hold
In tru.t fClr anether IndlvidunHs) (tnllJt bemdld8r1U)1
1 OIVIDEO B'v ~ (,JOINT OWNE~S) D1'JlIlEO IW ? (SURVIVORS) "' ,167 )( 100
ElCl"lltPlel Jelnt ftCCount reQ1stertirl 1n
thtli dtliMdcant,
1 OIVIDEO RV Z (SURVIVORS) .. ,SO )(
'h' ",00 o. .h. doo.d.n' .nd '.0 o'h'" p."OIlO .nd ..tobll.h.d .Ithln 0"" ,..r 0' d..,h b,
)( 100 .. PERCEHT TAI<AftLE
1 DIVIDED sV TOHlL NUHBER OF SURVIVING JOllH
OWNERS OR TRUST BENEfICIARIES
.. Th. ..oun, .ubJOO' '0 ,., (lln. 41 I. d.,."lood b, ovltlpl,lnO the .ccoun' b.l.noo '1100 " b, 'h. por..n' ,.,.bl. '"n' 31.
5. Enter the tohl et tto" d~t' and d9dlictlon. li.ted In pflrt 3.
.. n" .ooun' .."bl. (lln. 6J I. d.,orolOOd b' ."b....ctlo, 'h' d.b" .nd d.ducllono "'110 " fro' 'h' .oo"n' .UbjOO' to '0< {lIn. '"
7. Enter the approprllttll tax rate (linG nos detllrlllned billoW.
100 sot. (TAXABLE FOR EACH SURVIVOR)
I, For d.'" o. d,o'h occurrln. ,ftor 6/"/94, tho '0< 1'.'" for ,,,n.f'" '0 .pou'" '"~ .. ,,110"'1
I. Datu of duth on or attar 1/1/')(' find bllfore 1/1/91; the ratll 1.1%.
2. n.... ., d..'h on o. ,ftor 1/11" ....n.f...' '0 .pou'" .111 ,,, .".d .. 0% '" ..to.
Hot.l For datil' ef duth prier to 111/94 tr'<'lnsfArs te spoUlllS rlre tll)(llblll at 6Z,
B. T"",fm '0 lIn..1 d..oondo,," Inoludlr,. f..hor, .o'hor, .on, d.UOhtor, ,r."dchlld"n, .000In'I..,
daughter-in-lftW, Ilhpchlld and thalr Issue l'lre t~lI(lIbl11 lit .1x pllrcllnt (6%1,
C, ".n...... '0.11 o'h'" lnoludln. bro'h", .l.t.r. IIno1', ,un', ooph'. ."d nl.co ". ,."bl.., flftoon p.reon, t15%1.
0, 11 ,010 ,hon,' ,h' .., 1'.'" p"OIO .p.clf' VO'" rel.lI",.hlp ., 'h' d,ood'''' In 'h' .". provld.d,
B. Th. ..oun' ,f '" duo (lln. .J I. d.....I".d b, ovltl"I,ln, 'h' ..0110' ..,.bl' llln. 61 b, 'h. ,., ro" (lln. 11.
Alla."able deht. llnd thlductlonll i!lr. datQr"lnlld fl. follow'l
A, Vou 1'0.11, ." ."pon.lbl' for p"o,"" or .h. ....,. .ubjOC' '0 .delnl..rollon b, . p.roon.' "pro.""'."" I. In.ufflolon'
to flay th. dMiu<ltlbla it.....
B. Vou .0'u.Il' p.ld 'h' d.b.. ,It" doo'h of 'h' d"ed.n' ,nd '00 furnl... proof of p"..n',
C. n.b" b.lno ,I,lood ."., b. 1I..I"d 'lOll' In p", ,. If .ddltl,n.1 .,"00 I. nood.d, u.. ploln p.por Bill" ,1\". p,oof"
pav..nt .8\1 b. r.q~lIlllt.d hy till PA Oepart...nt of Rev.nIlB.
,....- ---
TAXfAYER ASSI$TANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS. PA DEP~RTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRV urUT IN
HARRISBURG AT (~17) 787"8~27, TOO. (717) 772-2252 (HEARING XMPAIRED ONLY)
CLAIMED DEDUCTIONS - PART
3
DEBTS ANO DEDUCTIONS CLAIMED
GENERAL INfORMATION
1, FAILURE TO RESPOND WILL RESULT IN AN OFfICIAL TA)( ASSESSMENT witt, t\IIpllorlblll lnhr..t bllud rm Infor'utJen
'llb.1tt~ by the flnanohil Institution.
Z. InherJtance hl( beco... dellnqllent nine MUl1th. nfter the decedent', dah of dll"th.
5. A joint aaoount t. tallahl_ 8\18n though the ellle.dent'. fll'l.. was l'Idded ftI II utter of convenl..,ce.
4, Accounh (Inoludlng tho.. held betw..n hlllhaml !Ind wlh) which the dllcedent flut In joint flun within one year p,'lor to
doath are fully taKabl. III tran".rl.
5. Aooount. lIIhblhh.d jointlY hatw..n hu,band rind wife ."r. Ihnn on. yen,. prior to death ar. not taxable.
6. Aocount! hald hy I!I dlilaldent "11'1 trult for" ftnother or other. !'Irlil tl'lICabl. fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK" ~ If Ih. InforMatlon and coaputBtlon In thll notlcll I!lrQ correct I!lnd dllductlons lIrll not being olttlllllld, plao. an "X",
In block "A" of Part 1 of th~ "TI!l~paYer RtlpOnlll" sBctlon. Sign two cop Ie. nnd sub.Jt the. with your ch.ck far the a~unt of
tax to the R.ghtlr of W1l11 of thlt caunty Indluated. The PA Uepnrt.et1t of Revenue w111 I..Oft an offJohl tI...."'ent
(For. REV~1548 EX) upon r.o.Jpt of thl r.turn fro. thll RlIgJ.ter of Wills,
2. BLOCK B ~ If th\l aslllt IPlIcHlld on thl. notle. hllll been or wIll bll reportqd and taK paid with tho PlInn,Ylvl!lnla Inhllrltano.
TII)( R.turn flhd by thl d.cedlnt', representative. piac" an "X" In block "B" of Pl!lrt I of the "TI!lxpayer R..pon.... .10ti0t4. Sign anI
COpy and rlltum to thll PA Oepart.ent of RevlInull, Buruu of tndlvJdul!l1 T"~f!', Dapt 280601, HarriSburg, PA 1712:8~0601 In thl
IInveiop. provld.d.
!'. 8tOCK C ~ If V,e nnHr.Cl I.,fll"."tll'" It Incorred and/or deduction. "re hAlng clahed, check' blook "C" I'lfld cailplete Part. Z and 3
I!Il.lcor"ll1t .0 the il\ft,"'J(j'.IJI1~ O"lOW. .:.l\j.. ,"0 ....Ot,i.." tll,... 101...",.;. "li.l.l" wi.:. '/<J..;; ...,....." ,u, .;,. a.,,,..,,. ..,' .,,,. t"~lc.,,~. ... ,,,. :\.III:W'~
of WIll, of thl county lndlcatlld. Th. PA Depart..nt of Revanue will il.ue an official ".......nt (for. REV~1548 EX) upon r~.Jpt
of the return fro. thl Regtstor of WillI,
TAX RETURN - PART
2
- TAX COMPUTATION
UHE
1. Entn
HOTE:
the datI th~ account originallY we. 8itabll.had or titled In the .annar eKistlnu at datI cf death.
for a dlcedent dying I!Ifter 12112182:1 IIcccunt. which th" decadent put In joInt fla... within one (1) year of death are
te~able fully a. tran.fert, ~low.ver, thllre I. an e~~lu.lon not to axceed $3,000 per tran.feree reGardl,.. of the valul of
thl accou~t or the nuab.r of I!Iccounts h.ld,
If a double uhrhk (MM) app.arll before your flr.t na'l In the 8ddroll portion of thil notice, the $3..000 e~clulIon
already has b.., d.~uct~d fro. the account balanc. a. reported by thl financial InstItutIon.
Z. Entor tho total balanc. of the I!Iccount Including int.r..t aocrued to the date of death.
3, The parcent of th~ aocount that is ta~abla for each .urvlvor il deter.lnlld a. followSl
A. The parcent taxabla for joInt .ss.t. estabiish~d ~ra than anI year prior to the decedant'. de~thl
DIVIDED RY ToYAL HUMBER OF
JOINT OWHERS
E~a~lel A joint n...t rlgI.t~red
DIVIDED BY TOTAL HUMBER OF X 100 . PERCENT TAXARlE
SURVIVING JOINT OWNER~
In th. na.e of the dlcedlnt and two other per.ort..
1 DIVIDED BY ! (JOIHT OWNERS) DIVIDED BY 2: (SURVIVORS) . .167 X 100
16.7~ (TAXABLE fOR EACH SURVIVOR)
B. Th. plrc."t taxabie for al..t. cre.t.d within one ye.r of the dlcadent'. death or accounts owned by the d6leldent but held
In trult for another indlvldualCl) (tru.t beneHellari")1
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOIHT
OWNERS OR TRUST BEHEFJCI~RIES
X 100 . PERCEHT TAXABLE
Ex.-pll' Joint acoount rogi.tlred
the dlCled,nt.
I DIVIDED BY z (SURVIVORS) . ,SO
in the na.e of the decedent and two other per.on. and ..tabll.hed wIthin onl Ylar of death by
X 100
50% (TAXABLE fOR EACH SURVI~OR)
4. Thl ..ount ,ubject to tax (llnl ~) I. dltlr.lnld by .ultlplylng the aocount balancll (Line Z) by thl perclnt ta~abil (linl 3),
S. Enbr the total of thl d.abh and deduotlon. ihtcld .In Part 3.
6. The ..ount taKabh (1lnl 6) 1. deter.lned toy .ubtraotln" thl dlbt. !lnd dldl.k:ltlon. (llne 5) fro. the a.ount sUbjeot to tax (11M 4),
1. Ent.r thl appropr'lte ta~ rat. (llnu 1) a. d~t~rltn.d belo~,
A. For d.te. of d..th occurring aftar 6/30/94, the tax rate. for tran.flr. to .pou... arCl a. follow'l
1'. Data. of dl.th on or aft." 7/1/94 and blforl 1/1/95 the rl!ltl I. 3%.
Z. DatIl of d..th on or after 1/1/9~ trl!ln.fllr. to Ipou.e. will b. tax.d at 0% tax rat..
Notll For dat.. of death prlor to 7/1/94 tI'l!lnllflrl to IPOU'" arl taxabla at 6%.
II. Tran.flr. to 111'1181 d.scltntianh Including fathlr, .other, Ion, daughtlr, grandchildren, 'on~ln.l.w,
doughter~ln~ia~, .tlPchild and thlIr IlIue arl taKabi. at lhe plro,"t (6%).
C. Tran.fer. to all oth.r. Including brother, .1.t,r, uncle, aunt, nlphew and nleol arl taKable at flft.en perclnt (IS~).
D. If YOU change thl ta~ rat., plea,. IPaolfy your rllation'hlp to the dlcldlnt In th. araa provldld.
B. 'fhe aeount of tax dUI (lln. 8) I, detar.tnld hy .ultlplYlng thl "MOunt ta~abll (line 6) by the tax rate (lln. 7),
CLAIMED OEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable dabt. Imd deductions I!lre detlr.lnld n.. follo~'l
A. Vou lllllly lira r..ponslbll for pay.ant, or the ..tate lubjlCt to adMlni.tratIon by . plr.onll repre..ntativ. J. Inlufflciant
to PlY the dlductlble I talllll.
I, You aotually plllld thl dlbts aftlr dleth of the dllC...dont and can furnl'h proof of pay.."t.
C. II.btl being chllttCI IUlt bl lte.hed fully In Prlrt 3, If additional .pacCl III nnd.d, u.e pl"ln paplr a 1/2" K 11". Proof 0",
paV'lIf!t .ay be r.qu..tld by the PA Oepart..nt of Rlvenul.
TAXP~VER ASSlsTANCE
If' YOU NEED FURTHER INFORMATION OR AS:-1STANCE, CON1'ACT 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. TOot (717) 772-2252 (HEARING IMPAIRED ONLY)
CUHHONwrAl ~l. or IlfHNSVt VANIA
Ub "llll'1fHI or RLVIHUI':
IHIRfAU or INOIVlnU~l .lAMES
nfPT ?1I0M
tlARRIS"UR~, PA 17118-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21. (I 7' 'I
96160610
12"23-96
'H.I~"4'P,j1-'il
I-f.;;l! '
,"
TYPE OF ACCOUNT
[] SAVIMGS
o CHECKING
[J TRUST
00 CERTIF.
\.'ill[;
'97
JAil -3
EST. OF MABEL L NORRIS
S.S. NO, 165-32-5656
1111 :5,PATE OF DEATH 10-25-96
. 'cOUNTY CUMBERLAND
MM MABEL M GROTZINGER
1120 COCKLIN ST
MECHANICS BURG PA
CI/;'II
CUll/I),
17055
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REMIT PAYMENT AND FORHS TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK has provided the Dep3rtunt with the Inforllatlon lilted below which hu be.n u..d In cQlcl.dlttlnl,l the
potential tal< due, Their record. indIcate that at ttle death of the above deo"dent, YOU were a joint ownllr/ben.~lclftry of thh aocount,
If you f.el thl. InforMation I_ Incorrect, pIe... obtftln wrItten oorreotlon frail the flnanolal in,tltutlon} at~ach a ~Opy to thJ, for.
allt. rW~UI r, It 1\01 I."... It:''v'jl. U>:.:II.....1, T,~,:~ t:1,'l~'..:~.': b t[,':~..".. Ir ;,:,.1)rC1".~: \.~~~ t!",,: lr~:::' I~t...~t. ill"l l"...' -,~ th': C(lQ:\l.'lr,,~,..llh ~f P(\,m,ylvbnIa,
Uueltjonl .ay be ~t.wer.d bV cell!ng (711) 707-83/.7,
COMPLETE PART 1 BELOW . . . SEE
Account No. 31200060847 Doto
Eotobllohod
REVERSE SIDE FOR
10-07-96
FILING AND PAVMENT INSTRUCTIONS
Account Bolanco 3,538,25
Porcont Toxoblo X 100 .00
Allaunt Subjoct to Tox 3,538.25
Tax Rota K ---.06
PatonUol Tax Iluo 212.30
PART - TAXPAYER RESPONSE
[!] l"AILURI TO RESP~'1l) IIXLL . Rl!llU\. T, IH AN O'ltICIAL TAXA811I!llSMEMT BASID OM THIS NOTtCtj
To In.ure proplr oredlt to your acoount, two
(2) copi.. of thl. nolloe NU.t ~cco.panv your
Plly..nt to the Reghtfilr of ;/11111, I~akll oheok
PIIYllblll tOI nReghhr of Willi, Aaentn,
~aT[1 If till( paY.llnt. l'lr. ude within lhrn
(3) .'nth' of the decedent'. date of d.l'lth,
YOU "ay d.duct IS S% disoount of the tllll< du.,
Any Inheritllno. tax due wIll b'H.:O" delInqu.nt
nln. (9) 1Il0nthl aft.r the dllte of death.
[CHECK]
ONE
BLOCK
ONLY
A. h. nbove lnforll8Uon IInd tal< due it correct.
1. Vou Uy clloo.. to r..U puy..nt to the Ilagl.tor of WIlli with two capilli of thl. notJc. to obtllJn
a dl.count or avoid inter..t, or you .ay oh.ok bOl< nAn and return thJ. notloe to the Regl.ter of
willi and an offIcial a......ont will be Ilsued by the PA O.part..nt of Rev.nue,
8, 0 The above lII..t hat bun or \ollll be report.d and tal< paid with the Penn'Ylvanla inheritance TIl)( return
to he filed by the d.ced.nt'. repr...ntntIve.
C. 0 The nbovlI Inforntlon I. Incorr.ct find/or d.bt. nmt deductlon. werll pllid by YOU,
You .u.t cOltPht. PART 0 and/or PNH ~ below,
PART
[!J
If ~ou indic.t. . diff.r~t t.x r.t.~ pl.... .t.t. your
rel.tion.hip to dec.d.ntl
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LINE
1. D.to Eotoblllhod
2, Aooount Balance
3, Pel'ollnt raxeble
4. AMOunt Subject to r.x
5, Debt. and neductionl
6, AMount r.xabl.
7. Tax Rat.
e Tax Due
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DEBTS AND DEDUCTIONS CLAIMED
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PART
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DATE
PAID
PAYEE
DESCRIPTI ON
AMOUNT PAID
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TorAL (Entllr on Line S of tax Co"put.Uon)
1
.
of p.rjur~, I decl.re th.t the feet. I
)7' ~~ledge ~nd belie.,
}~ftr,/{ t (r,..: l.,.. i
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heye reported aboy. are true, correot and
tiOHLiL1.LL..::':;;'c{'-/ ~ 0 'f
WORK ( )
TELEPHONE NUMBER ~TE
GENERAL INFORMATION
1. FAILURE TP RESPOND WILL RESULT IN AN OfFICIAL lAX ASSESSHENT with .-mli It-abl. lntuut bllud on (nfurullon
lubeltted bv the 'lnftflolal lnlUtutlon.
2. fnh.rltatlC11 hI( bleo... dlllnqu.nt "In.. 1I0n\hl n'ht thl tllt.dlnt'. dati of dtath.
}. A joint tIIccount 11 hucabll IV.." though thl dlcedlnt'. nn.. 10111I added IU " n.,thr of <:('IIWlnIIl1101.
.... Accountl (Inoludlng tholl held batw..n hUlbllnd t\nd wife) which thl dlcedent put III joint rul.... wIthin on. vur prlur tn
dlllth It,. full v hlxllbl, as tran,f.r.,
S. Acoollnt. I.tllblhh,d jointly betwlen hu.band ftnd wife Iller. thlln Oil. Ylllt prior to dlllth at' not tlli(ftbl,.
6. Acc"..lnh h'ld by 8 dletdllnt "In trult for" IInoth't or other. lit. taKable fully,
REPORTING INSTRUCTIONS - PART 1
TAXPAVER RESPONSE
I. atocK A - If the Inforlllatlon and cOf'puhtlon In the notlr.:8 are correct IInd dRduotlont lire not hllng cll'llll.d, pirlee an "X",
In blook "..." of Pert 1 of thl "Taxpay.r Ruponfle" net Ion. SIAn hlD ooPt.1 and liub.lt th.. wtth your oheck fDr thll 8.0unt of
tll)( to the Regiltlr of Wl1h of the county Incllcnted, fhe II'" llitPllrt..nt of R.I/enue ulll luue an offlchl 1lI."'....nt
(For. REV~1548 EXl upon receiPt of the r.turn fro. the Regllter rf Willi,
2. BlOCK n - If the flint .peoIfied on this not1"e has been or will bit raporhd /lnd tllX pl'Iid with ttle Penn.ylvllnle Inhlrltlln<ll
TIlx Return 'lied by the decedent'. repruentatlve, plac. IIn ")(" In block "'&" of Part 1 of lhll "TbXptlyer Re.pon.." .ection. ShIn on.
DOPY and return to the r... Deparhlent of Rev.nue, BlIruu of Indll/ldulll Tllxel, Dept ?80601, Hflrrl.burg, P'" 1711.8.0601 tn thll
Qnvelopl provldld.
1. 8l0CI( C - If thl! notice infortatlon I. Incorreot andlor r1eduotlo.u 1I,'e belnq olnllllltd, check b'''l^''. "r." IInd cnllp1etn Pltrh Z Ilnd !o
of Wllh of the oounty Indlcat8d. The P'" Dopart.ent of Rel/enu. will luue IIn oHlohtl a..e....nt {For. REV-1543 E)()upon receipt
of the re'~urn frail the Re\:I.tlr of Willi.
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TAX RETURN - PART 2
TAX COMPUTATION
LINE
1. Enter the date the account orIgInally WIIS utabllshed or tltlld In the lIanner 8KI.tlng at data of death.
NOTE: For a decedent d..linClafter IU1U8?'1 "'ccounts which the deced."t put In Joint na... within one (I) Yllllr of death are
taKable fully lIS transf.rs. However, thlre I. IIn IlIxolu.lon not to exceed B,ODD p.r transteree regardIe.. of the value of
the aceount or the nullber of a<l<lountl held.
If a c1~ubll uterill( (MM) appellr. before your rtrlt nHI In the addreu portlon of this notJ<le. the $3,000 'MCllulJon
alr.ady ha. been deducted fro. the account balan<le a. reported by the fJnan<lJal In.tltutIon.
2. Ent.r thll tohl balanClI of the acoount inclUding Interelt aO<lrued to thl date of death.
3. The per<lent of thll account that II taxabl. for lIIIch survll/or is deterllJned III followl:
.... The peroent taxabll for joint ....t. I.tabllshed .~re than on. y.ar prior to the dec.dent', de.thl
1 ,HVIDED BV TOTAL NUMBER OF
JOINT OWNERS
flC..pl.1 A joint ....t r'ghtered
DIVIDED BV TOTAL NUMBER OF X 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the na.. of thl decedent and two oth.r per.onl.
1 DIVIDED BV 3 (JOINT OWNfI'S) DIVIDED BV 2 (SURVIVORS) . .167 )( 100 . 16.7% (TAXABlE FOR E...CH SURVIVOR)
B, The plrOIMt taMable for a..et. oreatld within onl ye.r of thl d~c,ulnt'. dl~th or acoount. owned by the d~.d.nt but held
In trUlt for aoother Irldlyjduall.) (trust blfleflclarl's)l
1 DIVIDED BV TOUL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICI...RIES
K 100 . PERCENT TAKABLE
El(a-rlll JoInt acoount regl'tered In the na.. of the dlcedent and two othlr person. and 'stabli'hed ~Ithin one year of d.ath by
thll decedent.
I DIVIDED BY 2 (SURVIVORS) . .50 X 100 . 50% CTA)(,t,BI.E FOR EACH SURVIVOR)
'to The uount IUbj'Dt to taM (Une 4) Is dlt.r.ined by lIult1plylng the IICCOunt balance (Une 2l by the peroent tallabll (l1ne 3>.
S. Enter the total of the clehtl and deduction. 1 hted In Pllrt 1.
6. Th. aMOunt taxabl, (1lne 6) III detnr.lnea hy suutraotlng U,. dluta IInd dsduotio.lI lJin" 5) fro. tLe a.ount SUDJ.Ct tCl tall tltne 4),
7. Enter the appropriate tel( rate (line 7l at d,ter.lned below,
.... For date. of death oc<:urrlnlJ after 6/10/94, the ta~ rlltes fnr tran.fe'" to IPOU,,, are a. follow. I
r. Oltll of death on or after 7/1/94 and before 111/95 the rate II 3%.
?. Oat.. of death on or after 1/1/95 transf.r, to 'po~,e. will be t.xed at 0% talC rate.
Notel For dat., of d.ath prior to 7/1/94 tran./er. tn .pou.e. ar. taxable at 6%.
B. Tran.fer. to lineal ullolKldentl IncludIng father, .other, lon, daughter, IiIrllndchl1dren, 10n~ln~lalol,
deuoht.r-ln~lltw, .t.,.chlld and their luu. are taxl'tble at .ix ptlrcent (6%l.
C. Trl!Huferll to all others Including broth.r, .lIh", uncle, flUnt, ne"he", and nleo. are taKable at flft.." percent (1S;:).
D. If YO\I ohangl thll tax rete, pIn.. Iplcih your relationlhip to the decedent In \he llrell provided.
e. The uount of tax dUI 01ne 8) II deterelned by lIultlptylnll the a.ount talCllbh (line 6l by the tax rate (lIn. 7),
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. debts and deductlC\nl are deter.lned at fcllow'l
A. Vo~ lega1Jy are rlflPonllble for "ay..."t, or thll ..tatll lubjeot to 8d1llnlltrfltlon by fl p.rson.1 reprllenhtlv. I. In.uffJoll1nt
to pay the deduotIble It..I.
B. Vou aotually paid the dlbt, IIft~r death af th~ decedent and can furnI.h proof o~ pllye.nt.
C. Debt, beJn" clehtod lItU,t b. it..llud fully In Parl 3. If IlddltJonel space I, naed.d, u.. plaJn paper 1I In" x U... Proof of
paY"nt eay be r,qulsted by the P'" Depart.ent of Rev.nue.
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TAXPAVEk 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 UN!T IN
HARRISBURG AT (717) 787-8327. TOOt (717) 772-2252 (HEARING IMPAIRED ONLY)
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAM ASSESSMENT with ftppllClftbl.... lnltrut blll.d on lnforutlon
IlIb_itted by thl financial In.tltut Ion.
2. Inh.rttlnClI till bllllOlMlI dltlnquamt nine I(mth, afhr the dlCldent', dllt. of dlath,
3. A joint account It t.~abl. '....n though th. dlcudent'. nft" WU added '" II Inlthr of o\)nlllnllnol,
4, AQcount. (IncludlnlJ tho.. hlld betw..n hUllbftnd atld wlhl which tho dlcldent put In joint nalu within on. year prIor to
d,.th fir, fully ta~Bbl. a. tranlf.rl.
!), Aocount~ ..tabU,hed jointlY betw..n husband and wife lor. than onl ynr prior to death fir. not taxabh.
6. AoooUr,tt h.ld by ft rlle_dlnl "In trult for" another or other"l are tlU(llble flllly.
REPORTING INSTRUCTIONS - PART
I
- TAXPAVER RESPONSE
L ftlOCK A - If the Inforeation and cOlpuhtlon In the notlclI arll corrllot and dllductlons Mil not bedng ohlllllld, plaoll an "X",
In blook "A" of Part 1 of the "Tal<paYlIr R..ponu" netlon, SllIn two oopln I'lnrl "ul:'"lt thllll with your check for the aaoount of
tal< to the Regllhr of Will, of the county Indlcllhd, The PA Ollpllrt.ent of nU/Mlue will IlIue an oHlclol IUllIu.umt
(Forll REV~lS4a EX) upon reoelpt of the return hall thll Regllter of Will,.
2. BLOCK B ~ If the ",..t Ipeclfled on thll nodce hili been or' will b. reportlld Md tl'll< paid with the Pennlylvanla Inherltanoe
Tal< Return filed by the dOlledent's reprolllntatlve, plecA M "X" In block "B" of Pert 1 of ttlll "Taxpayer R..pon.... 11Ictlon, Sign one
copv and return to th'll PA Departllant of Revenue. Burellu of Individual Taxu, Dept 280601, Hllrrl'burg, PA 11128-0601 In the
IIlwelope provided.
3. BlOCK (; . 1# the notloe In for 'lilt Ion Is Incorrect IIn'1/or deducdoni ure belt'!! olftlnd, check block "e" and oo",plete Part' 2 IInd 3
u.....",..n"lO \,.. \",.. ll,.i.....~t~....,~ l...l..." :1I., ..... I.i(i,.l;~ ...,.,.:/ ~.........I'.; ~"..... .d~:-, ~L". ,..;,~,', i..,' t:.~ ;:,;,1...;,., <l~ ';:<:: .~~~,:'~1,: ':: .,,",': R::,;:J::o-';:..
of Will. of the CiOunty Indloatud. Thll PA Dllpart..ent of Rllvenue will Iuull an oHlchl allUIIIlInt (For.. REV-1S48 EX) upon rllcelpt
of the return froll the ReQllter ~f Will,.
TAX RETURN - PART 2 - TAX COMPUTATION
LIHE
1. Enhr the datil the acoount or.llllnel1Y Will utabllshed or titled In the /lIl1nner existing et dete of dnth.
HOTE: for a decectant dying after lUlZ/82: Accounts which the dr,cldent put in joint na.u within one (1) year of dellth are
texeble fully al tranlfer~. How.ver, there I. an IIxclu.lon not to DXCII.d .3,000 pllr tran.feree regerdlll's of the value of
the eccount or the nuaber of accounts held.
If a double a.terltk (1Ul) ap"nrl before your first nail. In tho eddrul porUon uf thll notice, tho $3,000 IIxclu.lon
alrtady hal been deducted fro. thll account blllance as reported by the fInancial InltJtutIon.
2. Enter till totftl balance of the 8ccount IncludIng Interut accrued to the dlltl of deeth.
J. The percent of the account that 11 tIIxable for nch Jurvlv~r It dllt.,..inCld el follow'l
A. The percent taxzsblll for joInt auet. ..tablIthed eore than one year pdor to the decedent', death:
1 DIVIDED BV TOTAL NU"BER OF
JOINT OWNERS
[xa.,,1el A joint as.et regl.t.r.d
DIVIDED BV TOTAl NUMBER or x 100 . PERCEHT TAXABLE
SURVIVING JOIHT OWNERS
in the n8..e of the decedent and two other perlonl.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BV Z (SURVIVORS> ".167 X 100 .. 16.7% (TAXABLE fOR EACH SURVIVOR>
B. The pllrcent taxable for ~'Il.tl created within on. Ylar of the dlcedent', de8th or account, owned by thl decedent but held
In trult for another indlvldueHI) (trult benlfloiarlU)l
1 DIVIDED BV TOTAL NUMBER Of SURVIVING JOINT
OWNERS OR TRUST BEHEFICIARIES
X 100 " PERCEHT TAXABLE
Ex..pll: JoInt aooount regllt~red In the na.e of thll dle'dent and two other perlonl and e.tablilhed within one y.er of dlath by
the decBdent.
1 DIVIDED BV Z (SURVIVORS) ",50 X 100 .. SOX (TAXABLE FOR EACH SURVIVOR)
4. The MIOunt 'ubject to tax Cline 4) II deter.lned by lIlultlplying the account bal&nce (1\ne 2) by the perunt talCable (l1ne 3),
!), f'~t.!'" the tabl of \tll d.'ltlt end rllduot Ion. Ihtld 11' Part 3.
6. Thl tlIlOunt tuabll (llne 6) 11 d.tllrlllln&d by Iwtrect1llg th.. dllbtl and dectuctlon. (lln. 5) trot the HOunt lubJeot to talC llllltl 'tJ.
7. Enter the appropriate tal< rate (llno 1) al deter.lned below.
A. for c1at.. of cteeth occurring efter 6/30/94, the tal< rstll' for tren.flIr, to 'pou,el arl III fol10\ll'I
1'. Det.s of death or. or after 711/94 and b.for. 1/1/95 the rate 11 !t%.
2. Datlll of death on or after 1/1/95 tran.ferl to ~pou.el will be tal<ed a~ OX tax rate.
Hot~1 For date. of al,th prior to 7/1/94 tran.fllr. to IpOUI.. 8r. tnxablll at 6%.
B. Tranlfer, to 11nllll fjo'clndantl Inoluding ftlther, IIOther, son, daughtllr, grandchildren, .0nRln-law,
deughter-ln61aw, .tepcnUd and thlir luul ar. t!ll(able at Ilx percent (6%),
C. Tranlfer. to all othtrl inoludlng brother, Iltt,r, unolo, a~lnt, nephew Ilnd niece are taMabll at f1fte~ porcent (15%).
D. If you change the tax rate, pl.al~ specifY your relation.hlp to th_ d~.dan~ In th_ area provldll~,
8. Thl lItIOunt of tax due (1]ne 8) i~dt~~'\'~dbY .uHl"'~\H.i)t"lI a.ount tI!lxabh (llnll 6) by the tal< ret. (1ine n.
JIM,' 11"1::'>
CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED
All..ob'. _t. ond d.dud'.n. U.!i:dll~rol&.r oN\/folloi6.
ill. Vou lelath ere rupc.n.lbl. for Ila!flant, or tt\41 eltat. .ubjllct tn 8dIIlrdltretlon by II per,oMl reptuent.tlve is inluffloiltnt
to PlY th. deductiblft Itell,
You actuallY petd the debts ef\l;r, tllt"th of thl decedlnt and CIm furnllh proof of peYlent,
Debtt being clai.1d lutt bl It"~t.d hlJ.l!fln R."t)~. If ftdditlonal Ipec. 1. nleded, un plaIn paplr 5 1/2" M 11". Proof of
peYHnt "Y be r=utld b!f t~ PA 1)"P.",t..nt ~f I~~~tte,
TAXPAYER ASSISTANCE
IF YOU NEElJ 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. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
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PURPOSE Of
NOTICEI
I'A't'MEHTl
REfUND (CR) I
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To fulfill the rlqulrllllH1tt of SocItlon 2140 of the Inherihnoe and E,ht. Ttll< Aot, Act 22 of 1991. <72.f;,S.
Section 2140),
DetltCh thI top portion of th1l Notice and .oo.lt with your pavHnt to thtl RI"htn of Wlllt prJntlld on the
rlVlr.. .101.
~M Hate. cMok or ltOOey ordtr pavabll tCII REgISTER OF WILLS, AGENT.
All peY'Htlh reolt"'ltd 1h811 firlt be 8PPl1Mt to any lnter..t which IUIY be dlM, with any rMatnct.r applJ9d to the tiM,
A refund of . talC crRdIt, which WflI not reque.ted on the hlx return, lIfty be rlquutCtd by cDIIPhtlnll an "AppllolltJon
for Refund of Pennsylvania InherHance and Eltatl laIC" (REV-l.\l31. ApplioatIon. are IIvsllabh ftt thl Offlol of
thti Righter of Wllll, MY of the <':3 Revenue 01ltl"1ot Offlcu or by calling the speclal 24-l1oor lIll'l.werlnll .ervlo.
ntJllb4lrl for for.. ordlrlngl In P...."..,lvanla 1-800-362-2050, Duhln. P.nn.yl....ania and within loofll
Harrisburg ar.a (717) 787'8094, TOOt (717) 772-2252 (Hearing hlp.Ired Onh).
O!JECTIONSI Any Jlarh' In intere.t not .atllflctd with the appr.h.nnt, allowanc. or dh.lloWM<:8 of deduction. or ......Hnt
('Of taJe (1noll.lctlng dhcount or Int.rut) all .hown on thh NotIc. .all Object withIn .ixty (60) uay. of receipt of
tl\!I NoUe. by I
--writt.n prote.t to the PA OepartMnt of R.venue, Board of Appeah, O&f)t. 2810U, ~larrhburg, PA 17128-1021, OR
--.I.Clting to have the .att.r deter.ined at the audit of the aooount of the p.rsonal r.pruentat1v., OR
--app.al to the Orphans' Court
"'DMIN-
ISTRATIVE
CORRECTIONSl
DISCOUNT I
PEN...LTVl
INTEREST I
FlKltu.1 .rror. discov.red 00 thlt "......-.nt .hould b. .dcjr....d In wrIting tOl PA DepartHnt of R,vfInlHI,
!urGau of Individual TaxGI, ATTNI Po.t ..........,.,t RlvIew IJrlIt, DEPT. 280601, Harrisburg, PA 17128-0601
PhOO4l (717) 787"6505, S.. page S of the booklflt "Inatruction. for InherItano. Ta:< R.turn for a R..Id."t
Decedtlnt" (REY-IS0!) for an IlCPlanation of adIIlnJstrat1ve1Y correctable errort.
If any talC du. I. paId within thr.. (3) call1''1dar IIOnth. aft.r thl deClldel1t'. death, a five plrcent (S;O
dhcount of th41 tIS>c paid 11 allowed.
Thl 15;( hlC ~.ty non-participation penalty It c~utld on thl total of the telC and lnhrGlt u.....d, and not
paid ~for. January 18, 1996, the fir.t day aHur tM and of the tax ltWlG.ty ptIrIacI. Th1l non-partJolpatton
penalty 11 ....hbl. I" the .... ....,.r and In the the ... tiN period II YOU WOYld IIPPMI thfl tlUC and Int.re.t
that hu been tlll.Ued ft. Indlc.ted on thll notlc..
Interut 11 ehara-d tMtalmlng with flr.t dey of dellnquency, or nlM (9) .unth. BOd OM (I) day
fr~ tM date Df dII..ttl, to the d8te of pay.."t. TalCe. whloh becl.. d.llnqutflt ~for. JanulIry 1, 1982
be..r Int.r..t at ttM rat. of tile (6A:) percent p.r IIl'W'IUe calculated at a dally rflte of .0001~.
All talCu which beCaM dellnquent ('Ir(l or Gftar January 1, 1982 will bear Interut at II rat. whlClh 101111 vlry frOll
call8fldar y.ar to calendar VlfJr with tm.t rat. arnomclK.l by the PA DepartlMNlt of Rlvlll"lUl. The applJOIIbll
int.r..t rat.. for 1982 through 1997 <Jrel
V,llIr Int.rut R..,. Dtlily Interut FfJCltnr \'.ar Interut Rate DaBv Int.rut Factor
198Z 20lC .000Sl\8 1987 .i .00021\7
1983 16i .00003 1983-194)1 llA: .000301
,... UlC .00nD1 '991 'i .00021\1
"85 Ui .0003S6 1993wl994 r< .000192
"116 lOlC .000271\ 1995wl991 'i ,000l..,
--Interllt h DlllculatlMt .. followll
INTEREST = BALANCE OF T~ UNPAID K NUNBER OF DAYS DELINQUENT K DAILY INTEREST FACTOR
--Any Hotlcl luued lifter the tax bec:0MI1 delinquent will ref1l<lt an Inter..t calculation to flftHn (IS) day,
be)/ond tI'M dati of the ll........"t. If paYMflt II lade !!Ifter the Int.rllt cOllpUtatlon d8t. IhoNn on the
Notlc., Mldlt10nal Int.rllt ..,.t be cIlculated.
~M. ..__
..",-1
PURPOS~ OF
NOTICEl
PAYMENT I
REFUND (CR) I
'--,
o
(,'-'~
;J
ro
r-
r:l":
',~
"
IljiL
0::
r-.,
p,
::U :~
OU
To fUHtllth. ruqulr-..enh cH S.ctlon 2140 of tho lnhotltance and E.\llh Ta)! Aot, Aot "I of 1999, en-p,s,
Slot Ion 9\40),
Ootaoh the top portion of this Notloe nnd 6ubmlt with YOUr. payment to the Ihtglltllr of wlIt. printed 011 th.
rlverlll slullI.
-~ Hake oheck or MonlllY ord.r pay~hle tell REGISTER OF WILLS/ AGENT.
A r.fUnd of 8 teuc credlt, which wn not requutld on the tax return, 1lI11Y bll roquutod bv cOlllpletlnll an "Application
for Rlfund of Penn,yl118nlll Inherltllnoe and E.hlh, TlI~" (REI,I-13131. Appllofltlon. are available lit the Offlo. of
th8 Reghtlr of W1l1., l'lny of the 23 R8Ve!"1Ut District Offloe. or by Clttllflll the specle1 24-hour 8nvwlllring IArvAtHI
nUMber. for for~. orderlngl In Plnn.ylvania 1~800-36Z"lOSO, outline Plnnsylvanla end within looal
Harrhburg trea (717) 787~8094, TDn. (717J 77i':'2252 Oilutrlng [lIplllrllld Only).
OBJECT tONS I Any party In Intar..t not s~tlsfiod wIth the Itppral.e~Ant, 8llo~anQe or dl9~llowanoe of d~duotJon. or allellMent
of tIlK (Including dhcount or lnterllSt) nl Ihown on this Notloe IIIny objoct within IlKty (61)) dnYI of reclI!pt of
thl. NoUoe by!
-.~rlthn protut to thll PA Depftrtment of "evenuo. BOllrd of Allpenlll, Dlilpt. 281021. Hllrrlsburg, PA 17126-1021. OR
",elltctlnll to have the ~llItter duhrllln.d lit the audit of the llO(l~lunt of the personal ropruentntlvo, OR
Htlppeal to the Orohali" Court
ADMIN~
ISTRATlVE
CORRECTIONSl
DISCOUNTI
PENAlTVI
INTE.RESTl
fsctual error! dJscovored on thAi DIIII".lInt should bCl l'Jddreuld In wrltinlil tOI PA Departm.nt of Revenue/
Bureau of IndIvldual h)!u, ATTN! Post AII8UIIlent RAllIew Unit, DE:PT, l80601, H"rr!&burg, PA 1711a'0601
Phon. (17) 787~650S, Su pflue 5 of the booklet "Inltructionl'or InherltAncl hK Return for ft Resident
Oecedont" (REV~1sot) for nn expl/tnntlon of ndmlnlstrf\tJvu1y corrClctflblu Clrrorl,
If any hI( dUI II PAItI within thr". {:-;l cl'Illllndar Months nfhr the dIlCClChlt1t', daath. PI fl.... pero.nt (sy.]
dhoount ~f th. tel( paid 11 ellowed.
The 15;( h)! llllnBsty non~Pl!lrt,ioJpatlon pennlty I. COlllPUhld on thll totfll of tho hi)! "nd Interut IIssuudl find not
pl!I!d before Januftry 18, 1996. thll f.lr.t dtly tlfter the und of till tnx 1I1l1nlSty period, This non'pal.tJoipfttlon
pllnalh 11 epponhb18 In the '"111 ",amlllr And In the the SIlIMe tlllle plrIod III YOU would appeal the tal< and Inhrut
that ha. be." aUI.ued I!I' lndiceted on thh rlotiee.
Intore.t 11 oharg.d boglnnlng wIth first day of dA11nqullncYl or nine (ql month. and one (1) day
froll till dot. of duth, to the dllt~ of paYfllint. TllICII which bllcllllle dallllquent befarll January 1, 1982
bCllr Intflrut at the r!'lto of sil'< (6Y.) percent plllr annUli caloul!'ltod ata dtlliv rl!!lto of .000164.
All taK" whiCh bOC8l11lt del.lnquunt on or Mtur JllmJl\ry 1, 1982 will bellr Intorut at II rlllte whIch will Vl'lry frOM
llnl.ndar Yeal' to calundar year with thnt rn'41 Itnnollneed by thQ PA Ilepllrtmlnt of Re....nu.. The oppllcabh
Interut rat" for 1982 through 1991 flrOI
Vllar Interut Rate Dally Interll.t ""ctor
Yellr Jnt.r8lt Rl'Ite OallY Interut factor
1987 9% . 000~(,7
1986-1991 Il% ,000301
1992 9% ,000247
1993-199(. n .000192
1995.1997 9;( .000241
1982
1985
1984
1985
1986
uInhlrut
20%
16%
11%
13Y.
10%
I. onloulnted
.0005(.8
.0004~ft
.000301
.OOO~56
,000274
u folloWl1
INTEREST' BALANCE Of TAX UNPAID X NUHBER Of OA~S DELINQUENT X DAIL~ INTEREST fACTOR
""Any Notice I"wed IIftllr the tAX become. dllllnqllent wIll ref18ct fin Intll'81t cl'lloulatton to flft'oo CIS) day.
beyond thl d6t. of thl t1lflUtmllnt, If pAymlnt h mode aftor thl lntlllrut oo.putat!on r1l!lt. ''''o\<ln on the
Notice, /ttJoltlohtll lnterut mUlt b. u"lcul!1ted.
'":,..bel. --.. __ "~p - t
,; J
PURPOSE OF
NOTICE 1
To fulfill tho roq~dr...ents of SecUon ,140 of the Inh.r'1t&noa llnd Estatll Tax Act, Aot Z1 of 1995. (72 P.S.
SeoUon 9140),
PAVMENT I
Det&oh the top porUon of thlt Ho'tIce and 5ubMtt wHh your pay.ent to tho R.gllhr of W111s pr Inted on the
rovorsa lid..
~- Hake oheck or ~oney order payable tal REGISTER OF WILLS, ~GEHT.
REFUND (CR) I
A refund of a tax cradlt, which was not reque.tQd on the tax r.turn, lIay h. requ..ted by cCMpletlng an "App11cfttIon
fur Refund of PennsylvanIa Inheritance and Estete Tax" (REV~1513)' A",,!JCQUons are alltlll'\ble ftt the OHioe of
the Reghter of Wllh, "ny of the 23 Revenue OhtrlClt OHlcu or by clIlllng the speolol 24-hour nnswerlng 58,"v1ce
nUMbors for forlls orderlngl In PennSylV8nla 1~800-362-2050, outside rennsylvttnla and ;llth!n 10ca!
Harrhburg ar08 (711) 781r8094, TOOII (717) 772~2252 (Hearing Illlplllrad Only).
OBJF.CT!ONt: Any pnrtv In Interest not 5atlsf1.d wlth the appr~lseM.nt, nllowance or dls~llowance of deductlons or a..e.s.ent
of tIIx (includIng discount or InteruO III shown on this Notlclt UY objClet wHh!n sIxty (60) day I of receipt of
this HoUoe bYl
--wrItten protut to the PA Depal'tllent of RelienulI, Bonrd of Appeals, Oept. 281021, Harrisburg, PA 17128-102.\, OR
MKelectlng to have the aattor deterlllIned nt tho audit of the account of the personal repre,antetllie, OR
--appelll to Ute Orphans' Court
ADMIN-
ISTRATIVE
CORRECTIONS I
Factulll .rror. dlscoliefed on this IUliuliIIent should be llddrollltd 1n writing to: PA Departlllent of RCluenue,
&url8u of IndtvIdlJl!Il T.axtl, ATTNI Post A..USIIent Rtvltw UnIt, DEPT. 280601, H8"r1sb~frg, PA 17lZ8-0601
Phone (717) 787-6S05. Sell page 5 of the book lilt "InstructIons for Inh.rlhnoll Tax R.turn for I!I RllIldllnt
DeClldllnt" (REV~IS01) for an llxplanlltlon of adelnlstrfttlvely corrnctable errorl.
DISCOUNT:
If nny tax duCl II paid within threll (~) calendar .onths lifter the decodllnt', death, a fllie percent (H%)
dhcount of the hx flllld is !lllowed,
PENAl TV I
The 15% hw a.nesty nonMpartlclpatlon pennlty I' COMPlfhd on thll tCltal of t.hlt hi'\( and Inhlre.t a..uud, and riot
paid before January 18, 1996, thfl first day aftllr the and of tht tllX ".nuty perIod. This non-particIpation
penal ty 11 f1ppeoltlblll In tha salle .enna,. and In tho the IIine tlM. per lod al YOU would appanl the tax IlInd Inturut
t....at has been assessed 8S Indlcl'lton on thh notlca,
INTEREST I
Inhrast 1s char gad begInnIng with firlt day of dollnquenC',y, or nIno (9) 1Il0nths and on. (1) day
frOll the dah I1f dClllth, to the dot. of pftYllllillnt. Tl'lxas which htcalllQ delinquent before Janullry 1, 1982
bear lnttrut at the rat. o~ six (6%) percent IIU ftnnu" calculahd nt a dl'lily rnh of .000164.
All taxu which bClCI'IMIIiII delinquent on or afhr January 1, 19112 will bClnr Interut at a rsh whlch wIll liarv fro.
calendar ynr to ctll.ndl'!r yur wIth that rete ftnnounc8d by the PA Ol!parh8nt of RovltMut. The applIcable
Inter..t rat.. for 19112 through 1997 are:
19&2
19U
19114
19115
1986
~-Intorut
20%
16;(
11%
13%
lOX
Is ca}(:ullllted III
,00054e
.000458
,000301
,000356
,000274
follows I
Vear Interut Rate Dally Inbrut Far.tor
1967 9~ .000247
191111M1991 Ill: .000501
1992 9X .000247
1995MI994 7% .OOOI9l
1995-1997 9% .00024'1
Vear Interult Rl'ite Dally Intere.t fRctor
INTEREST = BALANCE OF TAK UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
uAny Hotlcl luued after tt... hl( beo-OUI d.lInquent 101111 rC/Hect an {nhlr.st calculation to flftCl~ (lS) dll)/~
beyond the date of the 1I.....III.nt. If pflYlll.nt Is led. after the Interut C:OSIPUhtlon dlh. shown on the
NlItloe, addItional Interut IN,,t b. cllculllted.
PURPOSE OF
NOTlCfl
To fulfUI th, r.quIr...ntl of Section 2140 of the Inheritanc. and E.tat. Tax Act, Act 21 of 1995. (12 P.S.
Slctlon 9140>,
PAVHENTl
D.hch the top portion of thh Notlc. and lub.1t with your paYMent to th. R,gllter of WHl. printed on the
rev.rll .Id..
.. Hake chick or .onl~ Qrder poyab1e tOI REGJSTER OF W:LLS, AGENT.
REFUND (CR) I
A rlfund of a 1ax oredlt, which W5t not rlquett.d on th, tax return, lIlay be r.qu..ted by cOllpletlng an "ApplJcatlon
for R.fund of r.nnlylvanh Inh.ritance and E.tate Tax" (REY-U13l. AppJlcatlonl ftl', avallabl. at the Offlc' of
the R~gl.t.r of Willi, any of the 21 R.v.nu. Ol.trlct OffiCI. or by calling the .paclal 24-hour anlw,rlng .ervlcl
nUllblrt for forll. orderlngl In Penn.yllillnln 1~800-36~-2050, outlld. Pennsll'lvanh antj within locftl
HarrIsburg tlrlll (717J -'87-8094, TOOl (717) 772-2252 (H.arlng IIlPalred Only),
O!lJECTIONSI Any patty In Interut not lathfled with the appr.IUllIllnt, allowrlnc, or dltallowaflC~ of dllductlont or UIUIllent
af tax llngludlng dllcount or Int.rllt) al shown on thll Notice IIlny abject within sixty (60) day I of rlcelpt of
thh Hotle. bYI
-~wrltt.n protllt to the PA Dlpart.lnt of Revlnu., !loard of Appeals, 'O.pt, 281021, Harrhburg, flA 11128-1021, OR
"llltctJnl1 ta havo th, .attlr d.ter.lnld at the audit of the account of the p.r.onal r.prl..ntatlvo, OR
uapp8Q1 to thlll Orphanl' Court
ADHIN-
ISTRATIVE
CORRECTIONS I
Fllctua1 Irrorl dlscov.rld on thlt ~11.....nt .hould b. addrllled In writing tOI PA OIPart.ent of R.venue,
!lurleu of IndivIdual TaXI', ATTNI Pelt ..I.....nt R.vl'M unit, DEPT. 280601, HarriSburg, PA 1112'-0601
Phon. (111) 181-6505, S.. png. 5 of th. booklet "tnttrucHon. for Intllrlhnc. Tax Rahlrn for ft Rllldant
D.eadent" (REY-150t) for an oxplanatlon of ad.lnl.tr~tlYoly corrlctable errors.
DISCOUNT:
If any tax due II paid wIthIn thr.e (31 callndar lIonths aftlr the decAdlnt'. death, a fllle peroent (5%)
dJloount of the tax paid 11 allowed,
PENALTY:
The 1~% tax a.nesty non-participatIon p.nalty Is co.'uted on the total gf the tax and Interltt all.l.ed, and not
Pllld befor. January la, '996, the flrlt day after tha end of thl tax ftltnelty p.ried. This non-pftrtlolpntJon
penalty 11 appelllab1e In the $n.. lIannlr and in the the sa.. tI.e periOd 81 you would appeal the tax and 1nt.rllt
that hat been .1..II.d II' Indicated on thl. notlc..
I1HERESTl
Intar'lt It charg.d b.glnnlng wIth flr.t day of delinqu'ncy, or nln. (9) .onthl and one (1) day
fro. the d.t. of d.ath, to tha d.te of pay.ent. Taxu ",hlc:h bacal. d.llnqu.rlt before January 1, 1982
blttr Inhrut at the rah of I!lC (6%) porcent per nnnu. cltlculated al It dnlly rllta of .000164.
All 'tftMII which bee a.. d.llnqullnt on or after January I, 1982101111 bur Int.relt at a rat. whIch ",111 vary fro.
olllandar y.ar to cal.mlar Ylar with that rllte announced by the PA D,part..nt of Relien"., The nppllcab1e
Interllt ratel for 1982 thrOUgh 1991 ar'l
Year Intlrllt Rat" Da!!y Inhrut Factor ~ Inhrut Rat. DailY Interut factor
1982 lOX ,000548 1981 9X .000241
1983 16:< ,000433 1988-1991 It:( .000501
1984 111: .000301 19'2 9X .000241
1915 UI: .0003&6 1993-1994 1X .000192
1986 10iC .000214 l....S.lm 9X .000247
-~Inter..t h calcuhted .. fallowtl
INTEREST. BALANCE OF TAX UNPAIO X NUNBER OF DAYS DELINqUENT X DAILY INTERES1' FACTOR
--Any Notlc. In,,*, .ft.r the tax bttco... dlllnquent "'Ill reflect Mi Int.rl.t allauletlon to flft,." (15) da~.
blyond thti d.te of the u......"t. If paY.lnt II .ad. after the Intlr..t cOllputat.!an dati IhO\lfn on the
Notice, IIddIt.!anal Interllt IN.t be calcullted.
":'.... _ ..~"L.;t
, ,
PURPOSE OF
NOTICEI
To fulfill the requlrelll8nts of Section 2140 of the Inherltanoe and E"tate T8K Aot, Act 21 of 1995, <12 P.S.
Section 9140).
PAYMENT I
Dettlch the top portion M thll Notloe and sublllttwlth your pal/lIltnt to the R~glstllr of WIlls printed on the
rovorse side.
__ Makll Ilheck or money order p8vab\1l tOt REOISTER OF wILLS, AGENT.
REFUND (CRll
A refund of n tax credit, which 1'10' not roquuted 01" thil tnx return, may be roqllestGd by co"pletlng an "ApplicatIon
for Refund!!' Pennsylllanla tnherltnnce lmd E.tate lex" (REV-I3l!)' Applications are available at the OHloe of
tho Reghtef of Willi, any of thCl 23 Aev"nue District OHlcn or by calling thQ speclnl 24-t1our nnswerlng sArlllcl
numbers for for"" nrderlngl In PonnsyllJllnla 1-800-362-2050, outside Ponnsylvnnla and ",!thin local
Harrhburg area (717) 787-809(1, roOl! (717) 17Z-22':12 (Hoarlng IlllJJltlred Only),
OBJECTIONS: Any party In Interut not satisfied with thD 8ppralslllllent, allowllnce or dlsnl10wance of deduction. or nU8UlIIent
of tax (Including discount or Interutl liS shown on thh Notice .ay obJict within ,!)(lY (60) day. of rllCelpt of
this Hotlc8 bYI
-~wrltten protut to the PA Oepartllet\t of RllYllnlJe, Board of Appellls, DepL 281021, Harrisburg, PA 17128-1021, OR
--electing to hell.. the matter determined tit tho audit of the nClcourlt of the florsonnl ropresontat!vlI, OR
--appanJ to tho Orphans' Court
ADHIH~
ISTRATlVE
CORRECTIOHS1
fllctual flrrors dlscollored on this Ilssusment should tUI nddrus..d In writing tOI PA Oop8rtmant of ~evenue,
Bureau of Individual Taxu, AlTNI post ASSClSsmllnt RIIVlflw Unit, Of-PT. 280601, ttarrlsburll, PA 17128-0601
Phone ('117) 787-6505, SQe page 5 of the booklet "Instructions for Inheritance Tax Return fo!" a Resident
Decedent" (RElJ"lS011 for an explanation of Ild.dnlstratlllelY c;orrec;table orrors.
DISCOUNTl
If any tax due Is paid within three (3) calendar months after the decedent's death, a fllle peroont (51.>
dl.count of the tex paId is allowed.
PENAL TVI
The IS% tax e~nuty non-p8rtlclpatlon penl1lty Is cOllpuhd on the total of nUl tax and Interest llt5Used, and not
paId before January 18, 1996, tho first dny lifter the end of the tax nmnosty por,\od. This non-pnrt!clpatlon
penalty Is appealtbU In the 58118 manrler end In the the sallie t1~e periOd III yOU would appeal thll tax and Inter'lt
that hftl been a.Sllled al Indlcetfld on this notloe.
INTEREST I
Interest It chllrlled begInning with first dllY of dClllnquet'lOy, or nine (9l lIlonth. nnd one (I) day
froll the datCI of death, to the dete of pflYllIent. TaxIS which bClcll~e d.llnquent before January 1, 198Z
bur Interflst at the rah of six (6%) percClnt per annUlll cnlculeted nt a dally rat. of ,000164,
All taxu IoIhlch blloalle d,tllnquent on or lifter January I, 1982 wlU bear Interut at a rntQ whIch will vary f,'o.
calendar yesr to oalend8r YOllr with thllt rllto Ilnnounced by the PA Dapllrtllent of RellllnUII. The applicable
Interest ratu for 1982 through 1997 are,
1982
1983
1984
1985
1986
~-Inter..t
20%
16%
11%
13%
10%
I. calculated III
,000S48
,000438
.000301
,000356
.000214
folJOWSI
Venr Interut Rflte DnllY Interest faG tor
--
1987 9% ,000247
1966'1991 11% .000301
1992 9% ,000241
1993.1994 7% .000192
1995-1997 9;: .000241
Vlill'lr
Inhrut Rate
Dally Intlilrut fector'
INTEREST' BALANCE or TAX UNPAID X NU"BER or DAYS DELINQUENT X DAILY INTEREST FACTOR
~.AnV Notice luued aUer the hx beco.e. delinquent 101111 reflect fIIn Int.rut calculation to flft.on (15) day I
beyond the date of the allenllllnt. If pay..nt 11 ud. nfter the Interut collpuhtlon d,ta shown on the
Notice, additional I"tar.st lIlust be cflllculated.
-,-- ... - ~-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
511
being duly. . oocordlng fo low, doposes and soys that he . .._ _____..___...
of the Estate of ._(\\.~':u..J::c.._~..t---:1 (~ci.._'__.':"'_..
late of ._, Cumberland County, Po" deceased and that the
within is on Inventory mad. by . __ __, the $Old ______._______
of the entire estate of soid deoedent, consisting of all the personal property and re.1 e.tate, e.cept real e.tate outside
the Commonwealth of Penn.ylvania, and that the figure. opposite each Item of the Inventory repre.ent it's fair value
as of the date of decedont'. death.
end subscribed before me,
"/.;t'il :t~{:(;(~t,? Ilk', )
/ - +, ~-- , . e~~cut~'; .;A,~tlnhtrl~or
/ / .' '-
._1 \].L_L.tfl'~_L.::_I.d.___ _. _______
NOW11^1. SEM.
,IGOY GOLOr\I~G, Nolary Publ~
....rllbu... Otuphkl Col1nly P^
Illy c.mmlssion ..xplr.. Nov 3, 1lle7
lv.\., 'L'\ 'VI
-"1______19_____
,
'--\ ' "
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Date of Death
25
Octobar
1996
Day
Mordh
Vur
INSTRUCTIONS
I. An inventory mu.t be filed wlthlnthr.e month. after appointment of personal representative.
2. A supplement Inventory must be filed within thirty days of discovery of addltlon.r issets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Flduciarie. Act of 1949.
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ti. I FOR DAlES OF DEATH AftER 12131191 CHECK HERE
<;\ iI INHERITANCE TAX RETURN IF A SPOUSAL
~~ .. RESIDENT DECEDENT :I~:~R~~~::DIT IS CLAIMED [ I
COMMONW,^'THOF '(NNSYlVANIA (TO BE FILED IN DUPLICATE '.. 7
DEPARTMENl' Of Rf:V~NUf .
'.-..- J:~~I?fJtl. ~~01J.:"'0601.._. .... WITH REGISTER OF. WILLS) .' COUNty COD~.~ L uYEAR'j) NUMBEIl
-- Ofc'WENT'S NAME l[mF"iErANDMi5D'ITIHmA1T....--.--~----'^".,-_..----' - ---.... - fJfi1r'f~tF0"OMPlnT7liJ[}RE'f~ "".._~~~_~_._
S~~st.*R~tfjutl~R~LL. ....]OAH (,'iifAi"!"AH Oi ""'" ~;~p L~~~~~n p~o~~O 11
..li.5..:::.32'=2-6.5.6..... ...._nla..2 5 .9~__3.;: 5.16 ''''''''f Cumber land .._....._.
"'~:"::~,,o".'"Nn':''''' N'.'''''' "'" '"'' "'''''''''"''''J ""'A' mo,"> ''''''''' . . . AMO,ii" ""liYfO'SHINS'RU(':".~.~_nm..__.._n.
[iJ 1, Original Return L. J 2, Supplemonl(/I Ralurn I 'J 3. Remainder Return
(fo, dot" of death prior to 12.13.821
LJ 4, lIml!ed Eslale L J 40, Fuluro InhHo~1 Compromise [] 5, Federal Estate Tax Relurn Required
(for dOIOS of dooth afler 12.12.82)
GfJ 6, Decedenl Died Te$lala [n_J 7. D€lcedenl Maintoinod Q living Tru~1
(Alloch copy of WillI IAttadi copy of Tru~t)
'__m.._ ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOUllllIE DIRECTED TO.
~~ t~AME ._~- ~'----~~-']OMPiTrEMAiITNOAODRrss
~li WillJaJ11m~L._Adle.I'.LEs.9..uire. .._~ 125 Locust street, P. O. Box 11933
81< '''''HONENU.''" Harrisburg PA 17108-1933
m~_._ _1- 7_!l.L ~~"~ 4 .;}~Jl..:9" "."=~ . - .~_~~ ~~-"~=="-_7~:'_"~=='_m
fH-Vl~OOtx"'l~.l}4J
21. If line 18 i~ grooler Ihun lino 19, f1ntor Ih6 diHorrmc6 on line 21 This i:. tho TAX DUE, (21)
A. Entar Ihe inlero~1 on lhfl bolonce dlJO on I.ir\o 21A (21A)
B, Enler the 10101 (If UnfJ 21 and 2 1 A Of1 lin6 21 B, This il thfJ BALANCE OUl), (215)
_ Make _Ch.e11( Pa';'(lbl~ tOl~$ghlet of Willi, Agent. _ _____ ___ n__ ____ .__m
---). .>- -B~ SURETO'ANSWER AiTQUESTIONS ON-REVliRSi-SII)E-AND TO RECHEtK MATH <(.. ---
U,;;r.7'p';;;-.;T,i;,ol';;;jury. ,'a;;I;,;-;ih~,i'I'h,;;o~;,"~,;~~;j'hi; "I"i~, i~il;,dio" ;,i'o;;;pooyillg;d,.d,;!;;'~od "Ol;;;;;;'l~-;;~;rio Ih. b;~",T';;YI;;';-';'i;ij9;-;;';d b,'iol,
ill~ Irue, (orr€lcl and complela, ! dflclor{) Ihot nil rool Intolo hos [wall tl\fl0rtod ot lrut! Ill(Hk<>!' vn!(lo De<lornlk!n of preparor other IhCln tlla pnrwnal rapraSlltllatlvtl 11
bClS,fld _onalll~formclll_on of .....hkh preparer hCl~ nny knowlodgfl
~c;N.'~A.. _-_~~E' oyt>>.li )!.~;.Rt~~-?7~i~.ll f~.'IIINC' In IllllH Mol,nl ~<,
;1(r::.41f:tfP(~(e,.,{"t{:~r,i~d"'\'I"\' ",[,~;t;,~ \
t{'liJ:ii/~,,- I( Li.(({(>l~- /. r
20, If line 1915 grealer Ihnn l.inft 18, enlor the difference on Unt) 20 Thh is Iho OVERPAYMENT.
a !X) li:rlr.l!llII".~I_''('IV..II''''I'l1fiJ:'1II'I~.'.l'i1I'n'':r.~D'j.J11....'...II~"iil'lil-
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1. Real EUolt\ (Schedule A)
'). Slock, and Bonds (Schedule BJ
3. Closely Held Slo<:k/Partnorshlp Interesl(Schedule q
4. Mortgages and Noles Rec&ivable (Schedule DJ
5. Cash, Bank Deposlls & MI$cellaneous P(4l'Sonol Property
(Schedule E)
6, Jointly Owned Property (Schedule Fl
7. Trund". (Sch.dul. G) (Schedule 1I
8, TOlal Gross Assets (Iota I Unes 1.7)
9, Funeral Expenses, Admlnislrative COSI$, MIscellaneous
~xpense$ ISchedule H)
10, Debls, Mortgage liabilities, liens (Schedule II
11. Tolal DedlJctlon~ (Iota I Unes 9 & 101
12. Net Vallie of Eslale (Une 8 minu$ Une 1"
13, Charitable and Governmenlal Bequesls I$chedule JI
14. Nel Value Sublect 10 Tax (line 12 minus line 13)
15. Spousal Transfer. lfor dales of dealh after 6.30.941
See I"'truelions for Ar,pllcoble Percentage on Revorse (15)
Side. (Include values rom Sctledula K or Schedule M,)
16. Amount of lInfl 14 laxable 01 6% role
(Include values from Schedule K or Schedule M,l
17. Amollot of Une 14 taxable al 15% role
/Include values from Schedule K or Schedule M,)
18, PdndpallaK dUEl (Add lox from llnAs 15, 16 and 17.)
19, Credi15 Spousal Poverty Credil Prior Paymants
+ 2,nS.33.t
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~ 8. T 0101 Number of Safe Oepo$ll Boxes
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( 6) _h~i,).5 3 '_~_~_
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(IOI_},99!. 77__~__
(8 )
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5271;47.
(Ill ___.:.L_____~
(121 _--..3}, 31 6.75 '___..
(131 ____.___
(14) 23,316.75
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1171
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SCHEDULE "E"
CASH, BANK DEPOSITS AND
MISCELIJANEOUS
PERSONAL PROPERTY
Estate of Mabel L. Norris
File Number
ITEM NUMBER
DESCRIPTION
VALUE AT DEATH
1. Refund, phone bill $2.72
2. Refund, prescriptions $75.26
3. Blue Shield $146.93
4. Blue Shield $235.10
5. Blue Shield $705.81
6. The Woods, refund overpayment $2,668.52
TOTAL CASH,
BANK
DEPOSITS,
MISC.
$3,834.34
SCHEDULE "F"
JOINTLY OWNED PROPERTY
Estate of Mabel L, Norris
File Number
Joint Tenant Name
Address
Relationship to
Decedent
Daughter
A,Mabel M.
Grotzinger
1120 Cocklin St.
Mechanicsburg, PA
17055
B.
C.
Item Number .Joint Descript 10 Total % Decedent
and Date Tenant n Property Value Interost of Interest
Made Joint Asset Ill/cedont
1. 10/5/91 A, Dauphin 2,381. 73 SO\ $1,190.87
Deposit I
Checking
10110534
2, 9/9/91 A, Dauphin 4,377,65 SO\ $2,188,83
Deposit ,
Savings,
5'700057077
3, More than A, PNC Bank, CD 36,226,76 50\ $1B,113,38
one year ago 210010141S~
4. More than A, PNC Bank, CD 6521.60 50\ $3,260,80
one ytlAr ago 31200060647
Total $24,753.88
Filing fees, inheritanCe tax return $25.00
.
-
-
-
-
--
TOTAL $2,277.70
EXPENSES
-
SCHEDUl,E I
DEBTS OF DECEDEN'I',
MORTGAGE LIABILJTIES AND LlEHS
Estate of Mabel L. Norris
ITEM NUM?jilR
File Number
--
AMOUNT
DESCRIPTION
Crowley Associates 581.83
Corning Lab 998.33
Rehab Physicians 101.44
West Shore Emergency 696.35
EKG Associates 159.59
Ritzman Assoc. )..78
pulmonary Care 139.56
Holy Spiri t Hospital 33.85
Holy Spirit X ray 281.04
$2,993.77
Total
/.')~~/,\;- ;;
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
UUREAU Of INDIVIDUAl. TAXES
INlltll:llMln IIIK 11lVISION
Illffl, ,'1I11hO\
llARfllSBUIl:G, PA IIIi'll 0601
NOTICE Of INflERlTAtICE TAX
APPRAISEMENT, Al.LOWANCE OR OISALl.OWANCE
Of OEOUCTlONS ANn ASSESSHUlT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
AON
05-04-98
NORRIS
10-25-96
21 97-0007
CUMBERLAND
101
! ...~.. .~...~~~"\:::R~E,i~j~.L-:---,~
.._..._J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifEV': iS47 " EY"j" F-P"1 0-9-: 97Y-NoTf CE- "OF -"f NHERIfi,iicE - TAY: APpilA-f SEMENT-;" j"L:COWANCE - OR -"---- -- ".-" -"" --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MADEL L FXL,E NO. 21 97-0007 ACN 101
---
APPROVED DEDUCTIONS ~ND EXEMPTIONS:
q, Funeral Expenses/Adm, costs/Mise, Exp8nse~ (Schedule HI
10. Debts/Mortgage Liabilities/Liens {Schedule Il
ll, Total Deductions
12, Net Value of lax Return
13. Charitable/GoVernmental Bequests; Non~81ect8d q113 Trusts (Sohedulo J)
14, N~t Value of Estate Suuject to Tax
WILLIAM L ADLER
125 LOCUST ST
PO BOX 11933
HARRISBURG
ESQ
PAl71 08
ESTATE OF
NORRIS
TAX RETURN WAS: (
I ACCEPTED AS filED
RESERVATION CONCERNING FUTURE INTER~- SEE REVERSE
APPRAISED VAI_UE OF RETURNBI\SED ON: ciRiG!NMRETURN
1, Rael Estate (Schedule Al
2. StocKS and Dond$ (Schedule B)
!, Closely Held Stock/Partnership Int~r8st (Schedule C)
4. Hortgages/Notas Receivable (Schndule OJ
S. Cash/Bank Deposits/~llsc.:, Personal Property (Schedule E)
b, ,Jointly Owned Proped~ (Schedulo F 1
7, Transfers (Schedule Gl
8. Total Assets
If an assessment was issued previoUSly, lines
reflect figures that include the total of AL~
ASSESSMENT OF TI\X:
15, Amount of Line 14
16. Amount of Lino 14
17, Amount of Line 14
18. Pr inc ipal Tax O~I"
NOTE:
at Spousal
taxable at
taxable fit
rahi
lineal/Class A rat.
Collateral/Class B rate
( X I CHANGED
Lll
(21
(3)_
(41
( 5)
161
171
,00
,00
,00
,00
3 ,834,34
3,37~
,00
18)
Cc""
.~.
" ',1':' .
1'i 11~; " '
r~)I'.".' ~
'.:'1" .. ..t1
~,l\ .1_ . .
(4)_
LlO I
2,277,70
2.993,77
Ll11
1121
Ll3)
Ll41
lH \\.1 H I~~ 1)1-111
MABEL
L
SEE
DATE
ATTACHED
05-0'\-98
NOTICE
-
NOTE I To !ns\,Jr8 p'"o~.r
eredi t to your account I
submit the upper portion
0'1 this form with your
tax payment,
7,214,04
5.711 47
1,942,57
,00
1, 942.57
14, 15 and/or 1&, 17 and 18 will
returns assessed to date.
,00
116,56
,00
116, S6
TAX CREDITS:
~"'::;:'=T='~::-l ~,,:i:;;: ~[i; ,- , ]----.;;~;;." --- --l
\.""" _" ~'",'-"Hi'"'" ",L'~'i --_.- - ---- -.T.-.orAL."";",,r.! -.~..' -.00 \
AT THE RATES APPLICABLE AS OUTLINED ON THE BA~~~NCE____OY~:!A~D~t::-'-~=:=:--=116:?.6=
REVERSE SIDE OF 1HIS FORM INTE~~~:LA~~/EN'I::-'-~::-'__J2;:G:j
(IS)
(16)_
(171
,OOX,OO=
1,942,57 X ,06=
,OOX.15=
1181
. IF PAID AfTER DATE INDICATED, SEE REVERSE
FOR CAL.CUL.ATlON OF ADDITIONAl. INTERES1,
IF TOTAL QUE IS LESS THAN I\, NO PAVMENT IS REQUIRED,
IF TOIAl. OUE IS REFLECTEO AS A "CREOIT" (CR), VDU MAV BE DUE
A REFUND. SEE REVERSE SIDE OF THIS fORM fOR INSTRUCTIONS, I
,
.
RESERVATlOlh E,tatClI 01 dteledlnts dYing art or beforl Dlolllbn \2, 1982 ~~ If any future Inttrllt In the utah Is t,..nlf.rrld
In PO....tlon or .njoY~liInt ,to Cia.. B (colht.rblJ blneflclar!.. of the qlOtdtnt after the Illplratlon of IlInv e.tat. for
life or for Ylar., the Co..onw,.lth hereby Ixprlllly r~l.r~.. the rJght to appral" and al.e.1 tra~lf.r Inh.rJtanol TaxI'
at the lawfui Clell 8 (oollat.ral) rftt. on any such future Intere.t,
PURPOSE OF
NOTICE:
PAVHENTI
REFUHD (CRll
To fulfill thl rlqulrnlntl of Slction 2140 of the InhlrltanQe and E,tate Tax Act, Ac1 Zl of 199~, (12 P,S,
$eetton 9140),
Oetach the top portIon of thl. Notice ~nd lub~lt with your p~y..nt to thl Regllter of Will. printed on the river.. lid.,
--Make check or lIloney order JHIYflblo tal REGrSTER OF HILLS, AGENT
A refund of a tax credit, which was not reqwuted on the TIIx Return, lIIlly bt rlqulutCld byco..phtlng an "Appllo.tlon
for Refund "f Pennsylvania Inherltencl and [It&te Tax" <REV-nBl, Appllctltlons are available at the Offlol
of the RClgistlr of Willi, 8ny of the 23 Revenue District Dlllels, or by oallln9 the splclal 24-hour
an,wlrlng 'Grllloe nu.bert lor forM' orderlngl In pann.YlllnnIa 1-800~362.20S0! outside Pennsylvania and
within local Harrisburg area (117) 187-8094, TOOl (717) 772~22S~ (HearIng Impaired Only).
OBJECTIONS I Any party In Internt not satisfied with the appraisement, "l1owanoe or dlae111owanoCl of deductions, or l'lSUllIlllent
of tax (iMludlng di!.~olJnt or Interest) liS shown on this Notice /IIUlt object within sixty (61)1 days of reotllpt of
this Notice bYl
ADHIN
ISTRATIVE
CORRECT IONS I
DISCOUNT I
PEHAL TV:
INTEREST I
"wrlthn protest to tho PA D.Pftrt"'~nt of RevenUliI, Board nl ApflClal., Oept. 281021, ~lllrrl9burg, flA 17128-1021, OR
~-e1eotlon to hall a the Matter deter~lned at lludlt of the Ilccount of the personal roprClsentatlve, OR
""appeal to the Orphan.' Court.
Factual errors discovered on this a's."~ent should be addressed In wrItJng tOI PA Department of Revenue,
Bur.eau of IndlviduftJ Ttlxe., A1THI Pcat hseuSlent Relllew Unit, Dept, 280601, Il<'lrrlsburg, Pit 17\2&-0601
Phone (717) 187-6S0S, Sea pnge S of the booklet "Instructlonll for Inherlhlncll TIll< RClturn for ft Ruldent
Geeedent" (REV'1501J for an explanation of adMinlstrfttlveh t\orrechlble orror.,
If any tax due Is paid within thr.e (3) calendar lllonth. ftfter the deoedent'. death, a fllle percent (5%) dltoount of
the tal< paid is !lUowed,
The 15% hx lllIlnuty non-participation p.nalty 11 cOMputed on the total of the hx and Interut fllSuled, and not
paId before Januftry 18, 1996. the flr.t day flHer the and of thO! tax "..natty perIod. Thlt non~particlpatlon
penalty II appealable In the laMe mnnnar ftnd In the the .a.a tllle poriod a. ynu would appeal thl tax and Int.r..t
that hSI been ItA'elled as Indicated on thIs notice.
Tntlrelt l~ charged b.gJnnlna with fIrst day of delInquency, or nine (9J IIcnth. and onl (11 day fro~ the date of
duth, to tha data cf pay"'lnt. faxII whIch becue delinquent before January 1, 1982 b.ar Intlrut at the rat. of
six (6%) perc.nt per annuli oalculated at ft dally rllte of .000164. All toXDl which bloallll deUnqulnt on and aU.,-
Janua,.y I, 1982 will bur Internt nt ,. rate which 101111 vary frcll callndar y..r to callndar yur with thet rat.
announcld by thl PA Oeparhllnt 0'1 Revenue. 'ftlG applIcable Intarut rat.. for 1982 through 1998 !Ira:
!!!! !.!l!!t!:.,t Rate Dally Intere.t fftctor ~ Inter..t Ratl Dl'llly Inter.st fltotor
1982 20% .000548 19&7 1)% ,000247
19U 16:( ,000418 1988"1991 11% ,000301
19114 11% ,000.501 1992 'X .000241
19115 13% 000556 199.5-1994 11. .000192
1986 10% ,000214 1995~19911 9% ,llUOZ47
~ ~ Intarut Js Claloullltad .. '011010111
INTER~ST . BALANCE OF TAX UNPAIP X NUNBER OF PAYS PELINQUENT X PAILY INTEREST FACTPR
'.Any Notice ItlUld aft.r tha tax baCOM.' dallnquant will refl.ct an Intere.t calculation to fifteen (1&) day.
beyond the date of th......nclftt. If paYMlnt II l~"de .ftlfr thCl Intlr.lt COlllputetlon date Ihown on the
Hotloa, additional Intar..t SlU.t be calculated,
9it
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:(, .p
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,
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0
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PAVMENT I
Det~" the top p~rtJon of th1l NoUtle ancl ,ubll!t wIth Your pay..nt lIade paYl'lbl. to thcl na.e and eddre..
prInted (In the reverie lidC.,
-- Make oheck or .onlY order paYable to: REGISTER OF WILLS, AGENT.
REFUND (CR): A refund of . taK credit, WhIch 101&1 not requelted on the Tax Return, aey be requested by co~l.tlnu an
"ApplIoatlon for Refund of P8nnlvl\lanla Inherltllnoe ftnd E.tate hx" (REY~1313). Application. are IYbilabl. at
the OffIce of th. Register of Wills, any of the ~3 Rev~nu. DistrIct Offlcel or frGl the Oepartllent'l 24-hour
an.werlng IRrvIce nUMber. for for.. ordering: In PennlvlvanJa 1-800~36Z~20SD, outllde PennlYlvanla
and with!u local Harrisburg aret! (717) 787-8094, TDOII (717) 77Z-2252 (Hillring lIlpalred only),
REPLY TOI
QUlltlonl regarding Clrrorl contaIned on thl. notice should b. addressed tal PA Oepart.ent of RevenuI, Bureau
Qf Individual TaXI" ATTNI POlt A.soII.ent R.vl.~ Unit, Dept, 280601, Harrl.burg, PA 17128.0601, Phone
(717) 787-6505.
DISCOUNTl
If any tax dVI I, paId wlthJn thr.e (3) calendar lIonthl after the decedent', death, a ~ive peroent (5%) dl.count
of the tax paId II nIiowld,
PENALTVl
The 15% tax aene.ty non~partlcJpatlon penalty II ooaputed on the totnl of the taM and Inter'lt allelled, and not
paJd btfore J~nuary 18, 1996, the first day after the end of the tax llMnl.ty perJod.
INTEREST I
Interest I, ohbrged beginnIng with flrlt day of delinqulncy or nine (7) a~th. and one (1) d$y fro. the dati of
death to the dati I'lf paY"nt. Taxu which bClCMle delinquent beforl January 1, 1982 bear lnterut at the rate of
sill' (61.) percent per annUlI oftlClulatad nt a dally rate of ,000164. AU taxu whIoh b.oa.. cklllnqu'nt on and after
January I. 1982 will bear IntRrut tit a rllte whlch will vorl' fro. oflhlndllr Year to calendar Year with that rllt.
announced by the PA DIPltrtHnt of Ravenue, The applicable lnterut rl!ltu for 1982 through 1998 ai'el
Vear Inter'lt Rat. Dally Interlst factor
Vear
tnter.st RlIhl
Dally tnt.rut fft(ltor
1982 ZO:( .000548 1987 9~ .000247
1':183 16% .000438 19'U~~1991 Il~ ,000301
1984 llX .000301 1992 9% .000247
1985 13% .OO03S6 1993~1994 7~ .000192
1986 10:( .000274 1995~1998 9% .000Z47
~~Int.rut h enloulltod .. follow'l
INTEREST ~ BALANCE OF TAX UNPAID X NU~BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~.Anv Hotle. luu.d Ilfhr t~ tal< blco", d.lInqlHN1t will rlflect an Inhrtut calolllaUon to HUH" 05) dl)ll
b'vand the dah of thtJ u......nt. If paYHnt h lIade after t.,. Interest cuputation data lhewn on the
Notloe, Ilddltlonal Inter'lIIt !lUst be olllcu1eteod,
PAVI1ENT I
Detach the top portion of thll Nutlot and lubftlt wIth Your p.v~.nt .ftda pay~ble to the na.. tnd addrl'l
prInted on the reverie sld~.
~~ Hake chock or Money order payable tOl REGISTER OF WILLS, AGENT,
REFUND (CRll A rafund of tl tax cradh, whloh ~al not requutad on the Tax Return, IIl!1Y ba requelted by COllpletlna an
"ApplIcatIon for Aefvnd of PennlYlvnnia InherJtance ftnd Estftte Tax" (REY-1313l, Appllcntlon. ar. available at
thQ Office of the Register of WIlli, any of the 23 RClvenue Dlstrtot Offices or fro. the Departllant', 24-hour
anlwer!ng servicI nUMbers for forlll orderlngl In Pennlylvania 1-800.362-2050, out,lde Ptnnlyll1anla
and'wlthln local HarrlsburQ ~roa (7l7l 787-8094, TOO. (717l 772.2,52 (HaarIng IlIpaJrad only).
REPLV TOI
Qunt!onv regarding errors contained 01\ this notice Ghnuld be addreued tOI PA Uepart..nt of Revenue, Durel!!lU
of IndIvidual Taxa" ATTNi Post A""SIlont R.vIew Unit, Oept, 280601, Harrhburg, PA 17128-0601, Phone
(717) "1117-6505.
DISCOUNT I
If any tax due II paId wIthin three (3) calandar ~onth. after the deoedent's death, a fllle perClnt (SXl dlloount
of t~e tax paId i. allowed,
PENAL TV I
The 1SX tax alnesty non-partJcJpation penalty I, COlputed on the total of th_ tax and IntArllt asseslld, and not
prdd before .ll!lnvary 18, 1996, tho fJrrtt-dl!ly ftfhr- tho and of the tl!ll< allnuty perIod.
INTEREST l
Irlterut it oharged bAgJnnlna with flr.t day of rJIl1nquencv or nIne (9) 1I0nth, and onoll (1) day fro. thl date of
death to th~ dftte of paY"nt. Taxes whIch be~ale delJrtqvollnt before Jnnuary 1, 19112 bear interelt at thl rete of
sJx (6%l percent per annoI oaloulated at a d~IIY rate of .000164, All tax. I whIch becQIl. delinquent on and after
Januar~ 1. 19H2 will bear Interest at a rftte whIoh wIll vRry fro. calendar year to oalendar year wIth that rete
announced by the PA O.art.ent of Revenuo. The appl1cl!lble lnterut rat.. for 1982 through 1998 at'el
Vlar IntRrut Ratl Dftlly Inhrut rl'lctor Vear Irlt_rut Rate Dally Interolt Fl!lotor
- -
1982 20% ,000548 1987 9;: .000247
1983 li11: ,OO04!8 19U-1991 11% ,000301
19114 11:< .0003U1 1992 9% ,000241
1911& 13X .000556 1993~1994 7X .000192
1986 10:': .000274 1995"1998 9% .000247
~.Inhr..t Is Qaloulahd .. folloWl1
INTEREST = BALANCE OF TAX UNPAIO X NUHBER OF OA~S OELINQUENT X DAILY INTEREST FACTOR \.
~~Any HotIc~ IllUftd ftfter the tl!lX btCOIIRI delJnquent will rlfllot an Interelt calculatJon to flfte.n (IS) dlYI
beyond the date 0' tt~ U"UII.nt. If paYlrMlt It .ed. after the Interut ~Ollpuht1Gn date .hown on till
NDtlce, additional Int.rut IH./Mt be caloulat.a.
I .,
Q ~~
'is:&! ~
~ () .
~';; ,-, d
,~~ :$~ '0
~i." ,'- ~ 'tJ
CJO C
'{) Q) ~ \1
~1!i "~
j~ ~ f
"
1 ~,
J.." -.
.
).")~ Isl -13
BUREAU Of INDIVIDUAL TAXES
II~IIHHT"HCI TAK 01Vl510N
DfPT, 260601
tlAIUnSBtJRG, II'" 17178-0601
COMMONWEAL TH OF PEllNSVLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD DR TRUST ASSETS
*'
MABEL M GROTZINGER
1120 COCKLIN ST
MECHANICSBURG PA 17055-0000
')
RH-LU. H UP 10/-"1
DATE 10-06-1999
ESTATE OF NOR lIS MABEL L
DATE OF DEATH 10-l5-1996
FILE NUMBER 21 97-0007
COUNTY CUMBERLAND
SSN/DC 165-32-5656
ACN 96160610
I=::=~:,,~~~~~~~~_.lt~!d -- ~J
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
--------------------------------------------.-----------------------------------....-----------------------------
REV-lb04 EX AFP (07-99)
.. INHERITANCE TAX RECORD ADJUSTME~IT JOINTLY HELD all TRUST ASSETS ..
DATE 10-06-1999
COUNTY
ESTATE OF NORRIS
MABEL
L DATE OF DEATH 10-25-1996
CUMBERLAND
ACN
96160610
FILE NO. 21 97-0007
ADJUSTMENT BASED ON:
5.S/D,C. NO. 165-32-5656
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
312000608ft7
TYPE OF ACCOUNT, ( ) SAVINGS () CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 10-07-)996
" ''''''-;:: ~" l
.--
B~~~~~/~~ _~:~D~_~E :~~ _ :__=~~~i_:~: 1:-
~NTEREST AND PEN~__ _ _ __ ,_00
TOTAL DUE _ ,D-O
. If PAID AfTER THIS DATE, SEE REVERSE fOR CALCULATION Of ADDITIONAL IHTEREST.
I If TOTAL DUE IS lESS THAN $1, NO PAYNE NT IS REQUIREO, If TOTAL DUE IS REflECTED AS A "CREDn" ICR),
YOU NAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
6,538.25
0.500
3,269.12
.00
3,269.12
.06
196.15
TAX CREDITS:
PAYMENT
DATE
01-02-1997
RECEIPT
NUMBER
AA185035
DISCOUNT (+)
INTEREST/PEN PAID
9.81
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT. SUBMIT THE UPPER PORTION
OF THI~ NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS. AGENT."
PAVMENT,
Detach thl top portJon of thl$ Notloe and lu~lt with your p~Y.Gnt Made payablo to the naMe and addrels
prInted on 'the reVerie side,
u Hake cheoj( or .one~ order payabJe tal REGISTER OF WILLS, AGENT.
REfUND (CRll A refund of a hill< credit, whioh was not fequosted on the Tax Rnturn, .ay bl! requested b~ cOMphUng fin
"Applloatlcm for Refund of Pennsylvania InherUanoe end Estate Tax" IREV-r,U31. Appl!oaUlms are IvaU,ble at
thG OffIce nf the Register of Wllh, any of the 23 RevenlM Dhtriot Offices or frOll the hpart.ent's 24~hour
llnlwerIng SlrvIoe nUllbers for forllls orderlngl In Pennsylll8nln 1-800-362~20S0, outsIde; Pennsy1!Janla
and wIthin local HarriSburg are8 (717) 787~8D94, TOOM 1-800-447-30Z0 (Servioe for taxpayers
wIth Ipecial hllaring and speakIng n~edl).
REPlV TOI
Questions regarding errors contained on thJs notloe should be addressed tal PA DepartMent of Revenue, Bureau
of IndIvldunl Taxasj ATTNI Post ASSUSIlllnt RaviClw Unit, OClpt. 280601, Harrisburg, PA 17128-0601, Phone
(717) 787-6~0!i,
DISCOUNT I
If Sny tax due Js paid within threll {3l calandar Months after th8 decedent's duth. 8 five perClllnt (fi%l discount
of thll tax paId l~ allowed.
PENAL TV I
The 15% tex alllnesty non-pelrt!clpftUon penlllty h cOlllput8d on tho total of the tax !'lnd Interest nll,QUed, and not
paid before January 18, 1996, thQ fIrst day aftllr the llnd of the tax allnClsty periOd.
INTEREST I
Interest hi charged beginning with first day cf dollnqullnClY or nine (9) lIonths and on9 (11 day fro. thll date of
death to the dftte of paYlll8nt, Taxes which becaMll delJnquGnl beforo J'lrluar~ I, 1982 benr Intereflt tit thll rflte of
11x (6%) percent per 8nnulll calculated at 0 dally ratCl of .000164. All taxes which beca.e dellnqullnt on and after
January 1, 1982 ..Ul bear lnterut ftt a rah Which will vaty fro. calendar year to cuIendar Ylillll' with that rate
announced by thCl PA nepart.ent cf Revenue. Thn appllcl'Iblg interest rates for 1982 through 1999 are:
V.ar
Interest Rate Dally Interest factor
YClor
Int8rest Rftt.
Dally InterQst factor
1982 20% ,000548 1988-1991 11% ,000301
1983 16% ,0004l8 1991 9% .000247
198<0 11% .000301 1993"199" n: ,000192
J985 13% .000356 1995-1998 9% .000247
1986 10% .000174 1999 n: .000192
1987 9% .0007.47
I-~T~f.~~il 'I.BbM~~t\.~r .nUJi.~~ID X NU"B~R Dr DAYS D~LINQUENT X DAILY INTEREST FACTDR
"-Any Hothl8 luued after the tn>o: h80111ll8l< rtellllquant will ntflect an Interelt clllculetlnn tll flftllen 1151 days
beyond th_ dftte of the l'lluu..nt, If Ilttv..nt Is 1lI11Oe after the tnterltst COllPUtlltloll dnte Ihollll on the
Notloe, ndditl,,""l jllt'lfltut .U'/it h51 r.ftlmd..ted.
PAVMENT I
"
\
Detloh tht tOP portion of this NotlQ8 and .ub~Jt wlth your Ply..nt .~de payable to tht na". and address
printed. on the reverse Bide,
-- l1eke ~heok or loney ol'der peyab1e tOl REGISTER OF WILLS, AGENT,
REFUND (CRll ^ rafund of 8 tal( credit, whIoh was not requuted on the Tax Return, 118Y b9 requnted by cQlpletlng an
"ApplIoatIon for Refund of Pennsylvanin Inherlt~loe and Estate Tax" (REY-13l3). ApplIoatlons are avallablCl at
the OffIce of the Resliter of W11111, any of tIle Z3 Revenue Dhtriot Offices or froll the Deparbtant', Z(I~hour
InRNerin; service nUlbers for fares ord~rlngl In PennsylvanIa 1-800-362~20S0, outside PennsYlvanlQ
and within locol Hsrrhburg arefl (717) 787.'8094, TODI! 1-800-447-3020 (Sorvice for texpsyerfl
with special hearIng and speaking needs).
REPlV TOl
DISCOUNT l
PENAL TV I
UHEREST 1
Questions regardIng errors contained on thIs notice should be addressed tOI PA Depa;'tllent of Revenue, Bureau
of Individual Taxes, ATTHI post Assess.ent Review UnIt, Dopt. 280601. Harrisburg, PA 17128~0601, PhonM
(717) 787-6505.
If any tax due Is paid withIn three (3) oalendar Months after thn decedent's dClath, a fIve peroent (5~) dlsoount
of the tax paid is allowed.
The ISY. tftX a.nesty non-partiolpation penal tv h c:ollPuted on the totul of tht! t8X and lnterust aueued, '"n,d not
ptlJd boforu January 18, 1996, the first day aftor the end of the tal< eenosty perJod.
Interest Is chargQd begInnIng with first day of dellnquenoy or nine (9) ~onths nnd ono (1) day froll tho date of
death to the dato of paVllent. Taxes whioh b~callo dollnquent before JAnuary 1, 1982 bear interest at the ratCl of
sIx (~%) percent par llnn~ calculntCld at fl dnlly rate of .000164. All taxos whloh becallo dollnquent on anrl aftar
January 1, 1982 will bear interest at 8 late whioh will vary frOM cBlendar year to cfllendar year with that rete
announoed by the PA DapartMont of Revenua. Tho applicable lntorest rRtes for 1982 through 1999 arel
Vear Interest Rate Daily Interest Faotor
Intersst Rah
Daily Interest Faotor
Vear
1982 20% .000548 19&8-19'i'1 11% .000301
1983 16% .0011438 1992 9% .000247
1984 11% .000301 1993-199(, 7% ,000192
19M 13Y. .000356 1995-1998 9% .000247
1936 10% .000274 1991J n .000192
1987 9% .00024'1'
~~l~l\.~rt =1.B~M~ffl.~r .Hlb P.~~PD X NUNBER or DAYS DELINqUENT X DAILY INTEREST rACTOR
~~Any NotiCQ IUlKIId Sftlll' thfl tnx haco."s dollnquont will rofleot fill lnt"rut c!llculfttlon tll flU.en CIS) days
beyond tho dLttn of thll 8uau.::mt. If 1,.,'1lllent Is .lIdo nHer tho Intflrest oOMPutatlon datG shown on thu
NoHo., additional Interest IlUllt hll anlf.illlntotl,
PAY"ENTI
Oetaoh the top portion of thl1 Nottoe enU .ub~It with your pay.ent lade p'~y.blo to th~ n..o and addrel'
prInted on thCl reverS8 11de.
If RESIDENT DECEDENT Illake cheok or Illoney order payable tOI REGISTER OF WILLS, AGENT.
If NON-RESIDENT DECEDENT Illako cheok or Ilonfty order payable to: COMMONWEALTH OF PENNSYLVANIA.
REFUND feR)1 A refund of n.tal( ol'lIdlt, whIch was not requllstCld on the Tax Retut'n, Illfty be requosted by oOIllPtetlnll an
"Appllofttlon for Refund of Pennsylvania InherHllnoe and E.tatll Tal(" (REV-1313I, Appl1oatlonll are available at
the OHIoe of the Reghter of Wills, nny of the ,3 ROllenue DIstriot OHJoos or' fro\ll tho Departllent's 24~hoUr
anlwulng urvl(lll nUMbers for for 115 orderJngl In Ponnsyllltmia 1-800-36,~?050, outfllde Pennsylvllnht
ftnd within 100al Harrisburg area (717) 787-8094, TDDII 1~800-447-3020 (ServlclI for taxpayere with
speoi81 hearing nnd speaking neCldD).
REPlV TDI
QuuUons regardIng errors contalnod on this notice ahould be addressed tOI PA Departllent of Revenue, BureaU
of Indillldua1 Tax8$, AHNI Post AlSess~ent Review Unit, Dep\. ?80601, HllrrJsburg, PA 11128-0601, phone
(717) 787-6505.
OISCDUNTI
If any tax due Is paId within three (3) calendnr .onths after the decedent's denth, a fJvo peroent (5%) dIloount
of the tax pald Is ~11owed.
PENALTY I
The 15% tax alllnest')' non-participatJon penalty is (lolllPuted on the total of the ta>: and JntClrellt auessed, and not
paId before January 16, 1996, the first day after the ond of tho tAX aMnesty porJod.
INTEREST I
Intclrest Js charged beginnIng with first dny of dClUnquency, or nine (9) Months and one (1) day frOM the dftte of
duth, to the elate of pt'lYMent, Taxes which bacftlle doUnquent before January 1, 1982 beer Interut at the rate of
.1>: (6%1 pAroent per nnnuII caloulated flt ft dally rate of .000164, All taxe. whlon becallo delinquent on and after
JanUary I, 1982101111 bear Jnterest at a rate whIch will vary frOM oalendar yClnr to oalendar year wHh thnt rfl1;Q
announoed by the PA Departlllent of Rellenue. The npplJcablo interest rates for 1982 thruugh 19~9 arel
Year Interest Rate Deily Interest Faotor YeQr Interu t Rllte Ilelly Interest Faotor
1962 20X .000548 1988.1'191 HY. ,000301
1983 16Y. .000438 1992 9% ,000247
1984 11Y. .000301 1993-1994 7% .000192
1985 15% .001)356 199f,-1998 9% .000247
1986 lOX .00027'1 1999 7% .000J92
1987 9% .OOO1!47
~-Int8r.st Is oaloulated us folloWSI
INTEREST . BALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY INTEREST FACTOR
-~Any HntlOfl illlued afhr the ta)( bOCONes delinquent will reflllct lIn internt. onlClulfltlon to fIfteen (IS) d.~.
beyond the date or till! alllClRsMcnt. If pftY.llnt Is lI11do nftor the Inter.st oOllputntioll elate Ih()Wn on the
Hntloe, additional Inhlrlutt lust bD calolllflted,
PAVH~Hll
Detl!lohth. top portion of this Nodotl and Il.lb.tt with yuur paYll8nt lladliJ payable to thlll nlllle and etddrels
printed on th. reverie .Jde.
If RESIDENT DECEDEMT lIake check or' lioneli' order PUlI.ble tOI REGISTER OF WILLS, AGENT.
If HOtlwRESIDENT DECEDEHluke oheck or lIonGY ord8f paYAble tal COHMONWEALTH OF PENNSVLVANIA.
REFUND CeR)l It refund of ft tft,\( ol'/ldH, which was not requ/ilIRted on the Tax Return, 1Il8Y be requestfld by oOIlPhUng an
"Application for Refund Of Pennsylvania Inharltanoe and Estate Tax" CREV-1313J. ApplIoations are available at
the Of floe of the Register of WillS, anY of thq 23 Rev.nu~ D'strJct OffleCls or frOM the Depart..nt', 24-hour
ansNerlng service nu.bers for forMS ord~rlngl In Pennsylv"nia lk8"0~362-Z0S0, outside Pannsylvanla
and within 10081 HarriSburg afeR (717) 787-8094, TUDII 1~800-447-~020 (Servloe for taxpayers with
.pooIel hearing and IPlnklng needs),
REPLY iOI
DISCOUNT:
PENALTVl
INTEREST I
Quutionll reODrdln9 errors oontained on this notloe fthould be addressed tOI PA Dilpartllent of Revenue', 8ur.llu
of IndIvidUal Tl/lXClII, ATTH: POlit Auosslltunt Review Unit, Dept. 2:80601, Harrhburg, PA 17126~0601, phone
(117l 7a7-6~OS.
.tf tIny tax due If,; paId withIn thrQe (31 oo1Gmdnr Ilonths eftor the deoedent's death, a five peroent (5%) dhoounl
of the tax paid is al1owod.
Th~ 15% tax G~nesty non-partlcIpatlon penalty is oomputed on tho total of the t~x and lnterClst a9sessed, and not
PMld before January 18, 1996, the first day sfter tho end of the tax a~nesty period.
Inter~st ls charged begInning wlth fIrst d"y of delinquenoy, or nIno f.9) Months Rnd one (1) day frOM the date of
death, to the date of paYMent. Taxes whioh beoBllo dollnquel1t before January 1, 1982 bear lnterest l!lt the rate of
six ,(6%l percent per annuli caloulated at 8 dailY rftte of .000164, All t8xe5 whIch beoa.D delinquent on .nd after
January 1, 1982 will bear lnterClst at II rate whIoh 101111 vary froll olllendar Yllllr to oalclndar year with that rete
announcod by the PA Depart.ent of Rellenue. The 8ppllcnblo Interest ratCls for 1962 through 1999 arel
Ve.r Interest Rato DailY Interest Fnotor Vllftr IntGtollt Rate OftUy Interest factor
1982 20;( .000548 1988-1991 111. .000301
198:5 16i: .00U438 1992 9" .000247
1964 ax .000301 1993~11)94 7% .000192
1965 13% .000356 I995~11)98 9% .000247
1986 10% .000274 1999 7r. .000192
1987 9% .000241
--Interest 10 caloul~ted 8t 10110ws:
INTEREST a BALANCE OF TAX UNPAID X NUNBSR or DAYS DELINqUENT X DAILY INTEREST FACTOR
--Any HoHoe IssuCld aHor the tal( botOlll8S d,ilJnquent NUl rafhlot an Int.rut tllllculetlon to fHte.n (lSl days
bllyond the date of the ftlle~Sllent_ If paysllnt is .ado aftor tho Int.r.st co.putatlon date shown on the
Hotlc., additlon"l Intorut .ust h41 caloulahd.
;5/ /s/ "j)
BUllE AU Of INDIVIDUAL TAKES
INflERITANCl TAX llIVISIOH
DEPT. Z8DbUl
HARRI~8URO, PA 17128-0601
~OMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
c/
*
~[V-I601 lX HI' (11."1
MABEL M GROTZINGER
1120 COCKLIN ST
MECHANICSBURG PA 17055
DATE 10-12-1999
ESTATE OF NORRIS MABEL L
DATE OF DEATH 10-25-1996
FILE NUMBER 21 97-0007
COUNTY CUMBERLAND
ACN 96160611
[ ~~~~~~nt R;.it:~_. -l
MAKE CHECK PAVABLE AND REMIT PAVMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTEI To insure proper oredit to your .coountJ subnit the upper portion of thi5 forn with your tax p8yn.nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV: i6iii -fiCA Fj>- - io 7=99r-- - --Ii iiit-- iNHER i T"ANi: E- - TAX-ST A"iEHE-N'T - '(iF' - ACCOLiiW- ii.1i - -- - - - -- - -- - -- - -.... - --
ESTATE OF NORRIS MABEL L FILE NO. 21 97-0007 ACN 96160611 DATE 10-12-1999
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARV OF THE PRINCIPAL TAK DUE, APPLICATION OF ALL PAVHENTS, THE CURRENT DALANCE, AND, IF APPLICADLE,
A PROJECTED INTEREST FIOURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 10-05-1999
PRINCIPAL TAX DUE, 1,086.63
PAVMENTS (TAX CREDITS),
PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-02-1997 AAI8503{, 54.33 1,782.87
01-02-1997 .AA185035 .00 15.34
10-06-1999 REFUND .00 765.91-
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
I,OS6.63
. IF PAID AfTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I If TOTAL DUE IS LESS THAN $1,
NO PAVHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CR I ,
YOU HAV BE DUE A REfUND. SEE REVERSE SIDE or THIS FORH FOR INSTRUCTIONS. I
TOTAL DUE
.00
.00
.00
PAYMENT I
Detach the top portIon ~f thl, Notice a~d IUbMit with your paYMent Maue Pftyable to the na~e and addrell
printed on the I',verl. sIde.
If RESIDENT DECEDENT Make cheok or MOnClY order p8yable tal REGISTER OF WILLS, AGENT.
If "ON~RESIDENT DECEDENT .ake ohock or Money order payablo tOl COMMONWEALTH OF PENNSYLVANIA.
REFUND (CRll A I'.fund of n tax crlJdlt, whiCh was not requosted on the TIlx Return, 1118~ bo requost.ed by (lo~pleting an
"Application fQr Refund Q'f P.nflllylllanht InherJtallcII nnd Estato Tax" (REV-BBI, App!ications ftre available at
the Office o~ the R&lliIlster of W1115, any of the 23 Revenuo Distriot OfflcQS or froll tho Deparhent's 24~hour
anlwClrJng lIarvl,.,e nUMbers for forlls ordering I In Pennsylvanill 1-800-362-2050, outaldo PonnsylvanJa
and withIn 10Clll H~rrlsburg araa (717) 787~8094, TOOl 1-800-447-3020 (S8r~lce for taxpnyers with
special hearing and speaking noeds).
REPLY TOl
Questions rellardlng errors contained on this nollcD IItlould bo addressed to: PA DepftrtMlnt of Revenue, RurClau
of IndIvJdulll Taxes, ATTNl Post ^ssQSSllIent Review Unit, Dept. 280601, liarrisburg, PA 17128~0601, phone
(717) 187-6505,
DISCOUNT I
If sny tax duo Is paId within th,'ea (3) cftlondar 1lI0ntllfl IIftor tho daoedentis elaath, fI flvll p8l'oent (5%) dhoount
of the tax PllJd hallowed,
PENAl TV I
The 15% tax alllnesty non-part!oJplltlon penalty is COMputed on tho totfll (,f the tax nnd Interest suessed, and not
paId before January 18, 1996, the first day ftftor the ond of th& tn~ !lMnesty perJod,
INTEREST:
InterClst Is charged heglnnlng with first day of dellnquency, or nIne 191 Months nnd one (l) day il"OM thll date of
death, tc the dote of pa~Ment. Taxes which blleftlle dollnquilnt befor"e Jl'lnuary 1, 1962 belli" Jnterut at the rate of
six (6%) percent per f1nnum oalculatlld at 8 daily rftta of ,000164. All taxes whIch beontlo delinquent on find efter
Jenuary 1, 1982 101111 beer Inhrest 8t a rate whJch wJll vary frail oalendar year to calendar Y8er with thnt rate
annDun~ed by the PA Departlllent of Revllnue. The npplleabla Interest I'fltes for 1982 through 1999 arlll
Veal Interest Rllto DnJly Intorost faotor Year Interost Rnte Daily Interost Faotor
1982 20% .000548 1988-1991 11% ,000301
1983 161: ,000438 1992 9% .000247
1984 11% .01l0~01 1993-199(1 7i: .0!t019Z
1985 13% ,000356 199!..1998 91: .000247
1986 101: .000274 1999 1% .000192
1987 9% .000241
--In1:erut Is calculatod us folloWll
INTEREST . BALANCE or TAX UNPAID X NUNBER or DAYS DELINQUENT X DAILY INTEREST rACTOR
-~AnY NoUce iUUl$ld ftft~r tho tal( beoo.es dellnq(lent 101111 refleot fin Int"rellt cflloulatlon to fJf'teen llSI daVI
bAyond the datCl of the allu.Ment. If pft:.rlllent is IIftd8 after the Interelt r.ollputatlon dlltu Ihown on thCl
NoUoe, ftddltlonnl IntorRlIt MUlt bo cnloulnted,