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Home My WebLink About97-00114 '"2 <:;:. t, ..i - ! - d ~ <::S .... 0 ! . ~ 0 :z: u.a COHHOtM"AtTtf Of PENNSVLVANIA OEP"'THfNT or REVENUE IUItUU or IHOIVIDUAl TAMES PEPT. llO601 HARMISauRU, rA 1112'-0'01 * I:) I 'YI ') INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 . (i i 11'/ ACN 97103694 DATI! 01-23-97 _n.\t4'1I II' II."' 11<;1,,' Fi,' .., TVPE OF ACCOUNT [J SAVINGS [J CHECKING fX] TRUST [J tERTIF . VI lED ,_rj ii' EST, OF QUAV D HAMIL TON 5.5, NO, 177-24-6224 DATE OF DEATH 11-18-96 f'? :~,6CDUNTY CllMBERLAND DORIS " MURDORF 15 BIRCH ST 11ECHANICSBURG ellJli PA 170BJrll! ,. 111 1'1\ REHIT PAVHENT AND FORHS TOi REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK hu provld.d the D~.rt.."t with the Infor..Uon 1l1tad b.low which hit. b..n u..d In C:1l1clJ1I'dng the potttntl.l tall du.. Thailr record. IndJoate that It the death of the abovI d*eldlnt, you werlll a joint owtl,,'/blnlftdary I thh IlCCOUllt. If yCtU (lgI thh Infor..tlon II lnearrlot, pl.... obtain wrlttln correotlon frail the flmlnchl \n.tltu\lon, attach fl eopy to thh for. end r.turn It to the above addr.... Thl. "count I, ta)(lIbll In lIooordlnel with tl1. Inherltanc. hl< lows of thl Cflnonw..Uh of Plnn.ylyanla. YUII.i.),..t',. Iil"'y 1M en,Wtllt"l IlV CIlli!l!: \f!.'J tll:'':~'f. COMPLETE PART 1 BELOW . . Account No. 3U0005642(1 . SEE REVERSE SIDE FOR o.t. 09- 09-96 E.toblhhoci FILING AND PAVMENT I~~T~UCTIONS Account a.lane. Pera..,t Taxable A..unt Subj.ct to Tax R.t. Potenti.l Tax Due 20,172,65 100,00 20 :TI2."65- .15 3,025,90 TAXPAYER RESPONSE ftULl$.tQJIII.~J,!"l~I..~~~~TI"ANO'.'ICIAL TAX ASlll!SSMQIT. .ASI~. OM THIS N4)TIC1l To Inlur. 'lrOp.r- credit to your account, two (~) copi,. of this notlc. IIUlt ~ccn~any your pl'IYI.nt tc the RIghtClr of 11I1L.. .,81<. chIck payabl. tOI "Regilt.r of Will., Agent". M HOTE I If tal< paYHnh lire aade within thr.. 0) IIOflthl o( thfl decldent'. date of duth, YUU '.)' dldlHlt . 5% dhcOU'll of the hx due. Any l~rlt.nu tax dull will be<lu.. dellnqu<<lOt nlr111 (9) .onth. nftlr thl datIl o~ death. T.. M PART ill [CHECK ] ONE BLOCK ONLY A. Thai NavI InforMUon and till< due h cor'reet. 1. Vou..y choo'l to r..lt pllY.lnt to the RIgl.t.r of Willi with two copl.. of thl. notlc. to obtaIn .. dlwount 01' avoid Int.,..t, or you .IIY chIck bo)l. ..~" and r.turn thh not leI tn the RIghtar of Willi and an oHiollll IIUIU,."t 101111 b, IUWld by the PA nepllrt.."t of RIYItnUtI. B. c=J Thl above ....t ha. been or will b. r.ported ftnd tal< PIJd ~Ith the Penn.ylvenla Inhlrlt.nc. Tal< return to be (Iled by the dlcld<<lt'. r.-pr..."tatlvI. PART ~ T,AY tiNE C. 0 The !lbo.... tnfOrllllltlon II .Incorrect MId/or d.tlh and dedu<:tlon. ..ere Pllld by ~OU. You ltU,t cOIlplete PART 0 lWld/or P~T 0 b.low. ::l:r;O~:~::.:: :..:~~:~;~~t to. r.to, 01.... .tot. your I<i" ~~TII~N . ~ONpll"~T!O~ OF T~.Y ~~ ,1^!~T 'TOll!~ ,6:!,,"n1J~'!'9:e."~~':> :~, '1"""~'~ 1. o.to E.tobllah.d 1 . . 1 2. Acoount B.lanc. 2 :2:: 5, ParcMt Taxabl. 5 X 3 _t 4, AlICuot Sullj..,t to h. 4 4 _ 5, O...ta ond O.ductlon. S .l.'. 6. Aoount T.....l. , . , 7, h. R.t. 7 _.lL-. 1 a. T.. Ou. a e DEBTS AND DEDUCTIONS CLAIMED OFFICIAL llSE cmlV 0 AIIF! PA DEPARTHEN,'F ~E\lENUE " .w;;..;..:'.,...~~ - , -, : ~:! ".: ~ ~. .. .~ ~ ':; -..iIi, J: PART ~ DATE PAID ~ TOTAL (Entar on line 5 Under pan.lt!.. of p.~jury, J daclsra th.t tha 1act. I oOMPlat. to the b..t of .y knowledge and beliaf, 1- of Tax COMPutation) AMOUNT t-- . PAID PAVEE DESCR I PTI ON -- - ~~iYE~S~W~ have reported abov. ara tru., corre~t HOME (7/1.). 7t'fr) - ,StJ/.\/ . WORK ( ) TELEPHONE NUMBER llnd .;)-.s.J:J GENERAL INFORMATION 1. fAILURE TO ~ESPOHD WILL ~ESULT IN AN OFfiCIAL TA~ ASSESSMENT with ""pllu"l. In",..1 b.... on Inl.,..\lon 'ubIIltted by the fln8fKl1.1 In.t1tutlon. Z. Inherlhrlflotl tu bMDIHI. dtIl1nqu.nt nlllll .onth. .ft,r thfl dltfldlnt', d.t. of d..th. S. A joint aocount II t.~ltbl. ....." though the IJlc.dttnt'. nN' Will lidded II' . 'IItt" of ooo....nl..,o.. 4. AClClOIM'tt. (IMludlno tho~' held betWlHln hu.bWld Wld ~llf.J which the d~.d."t put 111 joint n..... within on. VI.r prlol' to d..th .r. full, hJCllbl. II t,..,f'fI, S. Ac;oounh .,hbl tlhed jalntlv botden hu.band lNld wHI .or. th... un. yn' pr lor let duth Ir. not '1/II1b11. Ii. Account. held by .. ~edttlt "In tru.t for" IWlOtl'\e.r or nthll" IIr. ts)(lIbl. fullv, REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BlOCI( A ~ If thtl Infor..Uon IW'I<d COIIputaUtJn In the notic. IIr. torr.at and deductlon. .rl rwt being chlHd, pi"' ., "X" in block ~'" ~f p.rt I of the "ra.ply,r MI,ponl." ..c\lon. Sign two CQpl.. and .~It t~ with your check for th_ ..ount of tax to the R-ehh,. of Willi of ''''. county Indicated. Th. P. O-,,"r-hlltnt of Rlvenua will 1..Ut1 ., offlclll ........"t (Ferl REV"lMI l::)O upon r.o.lp\ of tn. ,..turn f,.oll ttw Alllhtll,. of Willi, l. 11.0(;1< I . If th. nut .paa1flld on thh notlo. hili bllGn or will bll r.pert.d .nd tu p.ld wlth th. ponr..vlvanh Inh.rltancCt hx R.turn fU.d by thl dectd.."t'. r.pr...."h'Uvll, plaOI IIn "X" in block "!!" of Plrt 10' th. "laxplYlr RIIIPonlll" 1I0tion, Sign on. COPy IInd rdurn to thl PA D~.rt.."t of Rlvenu., Bl.ir..u of Indlvidulll hXIII, DI'pt ze0601, Harrlsburll, PA 11128-0601 In th. ."vdOPfl provided. 3, BLOCK C - If the notlcl Infor.aUon 111 incorrllot and/or dlduction. arl b.i"g olalled, ohlck bloClk "C" and cQllPl.h Parh , Ind :5 ::'QCCrd!l1; te ';h~ 1:"Jr~~'~c~1~:'H: b:1:~'. ~1~, ';'.... c~r'!~. .-,,1 ':',.'to._,.... ~~_'!I. ',dt.._ ~,...,.,.. ........~" ,,.,. ..... ~..~"..t ..., +." ~'..!.~I"..'. +" ....... "":,l:,."~ of Will.. of thl county Indicated, The PA Dlp.rt.."t of Rlvenue will II.UI an offlolll .......-nt (Fori REV-15~8 EX) upon r~.ipt of tha rlturn frOll thll R-eltt.r of Willi. TAX RETURN - PART 2 - TAX COMPUTATION lINE 1. Enter thll dat. the acoount originallY w.. ..t8bll.h.d or HUed in the IlWlnor nhting .t data of d..th, NOTE: For a deeflCMnt dying afhr 121121821 Acoounh ithich the d.c.dent put In joint n..... wlthln on. (1) Yllr M d..th are tll(M111 fully a. tr....f.rl, Howvflr, th.,.. I. an l'lColu.lon nct to IICCIId n,ooo p.,' tran,flr.. rlgardl..1 of the ",.IUII of thll lKloount or thl! ~r of account. hillel, If I double nt.rllt{ ("/Il) eflPeer. b.for. your fir.t n... In the addr..s portion of thll notlo., the n,ooo .xolusion Ilrlllety he. bMn cMtctuctld frOll the ecc:ount behnel u reportld by the UnllM'KllllI In.tltution, Z. Ent.r the tutll bllanc. of thll account Including lnt.r..t &ccrued to thl date of ~.th. S, The p.rc."t of tn. account thlt 11 taxabl. for lach '~lryIYor Is dlt.ralned u followll A. The percent t.'lClbll for joint ....t. ..teall.hId lOr. than ona Ylar prior tu th. decadent', d..thl 1 DIVIDED BV TOTAL ~IER Of JOINT OWNERS Exaapl.l . Joint I...t reaht."ed DIYIDfD BY TUTAl NUHBER OF M 100 .. PERCENT TAMABLE SURVIVING JOINT OWNERJ In thl na.. cf th. dec.dont If~ t~ otnar p.rson., 1 DIVIDED BV 3 (JOINT OWNf.RS) DIVI~D IV 2 (S'-IIRVIVDRS) . .161 M 100 . 16.7X <TAMABLE FOR EACH SURVIVOR) ~. The plrcent tl'ICable for ~'M.t. cr..tld within onl Ylar of the d.c.dent'. dlatn or account. owned by thl dlced."t but h.ld in trult for IInOther IndlvlduaH.) (tru.t bImlflcllrl..)1 I DIVIDED BV TOUl NUMBER OF SUR\HYIHG JOINT OWNERS DR TRUST BENEFICIARIES X 100 . PERCENT TAXABLE EIl..t'l Joint IICOount r.glthrlCl in the nau of the deolKJent and two oth.r p.,..on. and IItebilthed ..tthln OM Yllr of dftath by thll dM""'\' 1 DIYIDED BV 2 (StIRlJIYORS) . .50 X 100 . 50;( (TAMAllE FOR EACH SURVIVOR) 4. TnllIlOUnt .object to t'l( (11". ~) II dehr.itled by IIUIUplyina the account bllbncG (line 2) by thl! fMrclnt tl'IC1b1. (lIne ,~), 5. Entlt thll totel af the debh l'lnd deduCtlonl lltt.d In Pert s. 6, The ..ount \lxllbl. (11". 6) It cHttereined by .ubtrltCUng th. C1.bt. tM'ld C*lUClUon. (11M 5) frOll the MOUn\: .ubJtot to tIJ'IC U.lnl 'tJ. 7. Enter thl epprop,'I.t. tlX rat. (1101 1) a. d.t_relned belt>>l, A. For det.. of deeltl occurring .ftllr 6/]0I9~, the till< r.te. for tran.f.r. to .pou... Irll II fol104il'l 1. Dat.. of d..th on or after 7/1/94 11M blfor. 111/95 th. rst. 11 3%. l. Det.. of dn.th on or sft.r 1/1/95 tran,f'''1 to .pou... will bQ tax.d at 0% tllC rate. Natftl fOI' det.. of d..th prior to 111/94 tran.h,.. tn .pOU'" IIr. ta'IClble f.lt 6%. B. Tr."lflr. to I1tl1.1 n..~.,ldIInh Including fethlr. .other, r":"., aeugttt.r, grandchlldr,,", .on~ln~lltN, douIIhhr~ln~lltw, ..t~chll~ and their It.u. arM taxlbl. at .h percent (6%l. t, Trln,ftl,.. to ,II othtlr. Inclludlng brother, SllIt.r, lnOl., aunt, neph... and nl,ol er. \II)(.le.t flftllen p.ro.nt (15i() , D. If you chDnD' th. tax "Ilt., pl.... 'pIOlh your r.l.tlon.hlp to thll dlcedent In the area prnvlad, .. The ..ount of tall dI... (11M II) II det.relnltd by 1IU1tlplylng the Mount tI!lxlble (11M 6) by the t8'IC ,..t. (line n. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Al1owebl. debt. and d.ductlon. ar. d.t.r.lned .. folloWl1 A, Voo lellllly ar. ruponllbl. fo" p.y....,t. or the ..tate 'ubj.ct to adwlnlstreUon by I per.on.l rllPrllen~lt1v. It insufficient to pay the deduC'Ublfl HHIlI. 8. VCKl IHltu.Uy paid the dtbt. after death of th. dfludent and can furnhh proof of pay.ent, C. 3ebh being clelHd IN,t be HHhld fully In Pert S, If additlon.l .p.u h n..dlMt, u.. plein pap.r a 112" "U", Proot' of PIYllnt ..y be requa.tld by tha PA nlP'rteent of ~e",.nue. TAXPAVER ASSISTANCE .... II' YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACt ANY RE6ISTEIl OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE.. OR CALL THE BUIlEAUOF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (711) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY) CIJtfM(ltrAI(Al TH OF PUllNSVl VANIA DEP-.RHIJH OF R[YfNUr aURU,!J or INDIVHMJAl TAICES MPT, lllDIiDl UARRlSlU.lRO. Pl 1111I"D601 *' Il) .. INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATI NO.21 'I ( 97103695 01-23"97 I! ' I I(V.IUI U ~" /1,"1 '97 flU-5 ,I iEST, OF QUAY D HAMILTON 5,5, NO, 177-24-6224 DATE OF DEATH 11-18-96 I'? :t\auNTY CUMBERLAND TYPE OF ACCOUNT U ~AVINOS [] CHECK I NIl I~] TRUST [J mm, ['1(:( . I ~l { DORIS E MU~DORF 15 BIRCH ST MF.CKANICSBURG PA Clb' 17055 Cunl' I , .11 I'^ RE"IT ~AY"ENT AND FOA"S TOI RF.GISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 P-HC BANK lin pro\'d~ the OlpartHnt with the Infor...tlnn llllt~d b.low which h~. bIen used In cftlcuhting the pot.nthl t'll $.11. TMlr r.cord. IncHoate thftt lit tNi d..th of the &bol,ll deCl.dlnt. !J'ou were . Joint owner/ban.Ucillry 0+ thl. ftCcount. If YOU f.al thll Infur.llUon 111 Incorrlilt, pl.... obtain wrHt.n correction froll the financial Institution, IItta<:h II oopy to thll forll ltnd r.turn It to the abclI'" addr.... This IKIcount JI tlllCltbl. In ItClcordarnll with the lnh.rltltllC. Tell law. of the Co.-c.onw..lth of l'ann.ylvlInla. ou..tlOflI .II~ bI en....rH b~' c.111')Q (717) 7a7'~:!~:". COMPLETE PART 1 BELOW. . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Aoo.un! No, 5Q30078258 D.to 08- 05-88 eoh.blhMd T.x 18,292.42 50.000 9,146,21 .15 1,371,93 TAXPAYER RESPONSE ~X~K ,~~.~"XNA" OmCXALTAX A811f.S.~. ~$.ll',~ .!!'l~. fU)'l'IC"il To Insur. proper cr.dit to your ac(;ount, two (2) cophl. of thit notJCQ .Ullt IIcOO"Pany your plly..nt to the Rtgllhr of Willi. Hak. chtcjt.; payebl. tOI "Rellht.r of Will., o\lI*lt". Account Ballanefj Par-clint Tax_1. A.ounl Subj.ol 10 Tax R.t. Pot.nt 1.1 Tax Dull K HOTEl If hx plIY'fmh ar. ..w. within thr.. 0) .onth. of th41 decedent', dltt of d..th, YOU lay deduct II 5% dhcolMlt of tM hx ~. Any InMritenu t.lll( dull will bltCOM dIIl1nquent nJnt (9) tonth. IIft.r the riat. of dlath. K PART II] .. [ CHECK ] ONE BLOCK .. ONLY c. The abo..... Infor-nUon and tllX due h corr.ct. 1, You tQy choo.;. to r..U pay.ant to thVl Rllrlillttll" of Wllh with two eopl.. of thit notlc. to obhln . dltCOUilt or avoid lnt.rnt, rHO you U~ chlllck bmc "A" find return thh noUc. to tNi R_ulltlr of Will. and an offlclftl 1I11.....nt will be Issuad by tho PA Oepart.ant of R.v~,ue, c=J ThI abuva a",t h.. been or will be r.portad and t&ll paid with the P~.ylvlI~la I~rltanc' TalC r.turn to be filed by the dtctd-nt''J rtprlllentatlv.. c=J The abo~e infor..tion 1. !noQrr.ct and/or d.bt. and deductIon. were paid by y~. Vou UUllt cQIIIP1.t. PART ~ end/or PART [!] below. 11 you Indicat. a dlff.rent tax rat., pl.... .tat. your rdatlon.hip tD d.clKtentl____. c; T.!\~ O~ J~IH'!'...."!'~!.!~~ !~eco!.!f'!'!'s . g"FtC.AfU~EOtiLV 0 AAf: Po\.IlIEPARl'Ml::NT OF. REVENUE. . . .:.ii ~ART ~ r.".~ rf5.'!'!!p.~ - r.~~~!..!!...'!'!~~ 'f"o..... ,..... .::..-.; ...;' LINE 1, 001. EotlOblhh-.l 2. Account Balane. S. Parcant rax.ol. 4. ~.ount Subject to Tax 5, Oebt. _ O.duotlono 6. AlIOunt Taxlibl. 7. lex Rat. a. Tax Dua 1 2 3 K 1 2 :5 4 :s , "'::: , .. ~ - ~ tt__ S 6 7 8 ~.~I ~ ~ ~:; 1 , ":i '., :.'<,1 '~ K 7 PART [!J DATE PAID =-~ DEBTS AND DEDUCTIONS 8 CLAIMED PAYEE DESCRIPTION AMOUNT PAID -I TOTAL (Entar on lina 5 of Tax Co~ut.tlon) __I . --- ~~ Undar panaltl.. of parjury, I declara that the fMCt. I ao.,l.ta to the b..t of .Y kno"ladga ~d baliaf. 4~ hava reported above ara trua, correct and HOME (7/'1.) ,Z(;. to - ,n:.;/ f' WORK ( ) TELEPHON~ NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RUPOND WILL flE1iUL T IN AN OFFICIAL TAK ASSI!SSHENT with 1lflll1leMlle Int.rut b"H on In'ar.ttlon ,ubIIltted by tht flmanal,1 Inultl,.ltlon, 1.. Im-rItMClf' tall beoDlteP HlInqu.nt nlna looH" .fhr tM d.c.d~t'. dat_ 0' d.,th. !. . joint account I, tllltlbJ, IV'" though thl dlctNMnt' , n... .... Itdd,d on " ..ttll' of cunv."limCI, It. Aocount. llnoludlntl thC'l.. Mid b.tw.." hulbWld Md wlffjl whloh ,.,. dlCledMt put In Joint ".... within on. y..r prior to dlt,th at. 'ulIv tillable.. t'MI',r,. S. AClOOUr'il'l ..t_tlthed jointly lHIh...." tlu.bllnd Itnd wife lor. than OM V.llt pdor to dlllth era not t.~_h. 6. aOfl~t. hIlld by . (fecltd."t "In trult fa," ltnotMt or othlr. 't' '11(1Ibhl fully, REPORTING INSTRUCTIONS . PART 1 - TAXPAYER RESPONSE 1. IIlOCK A ' If tn. Infof".Uon and c~t"tlon In the notlCI Ira correot and d_X1tlont Ir. not being clalMd, plHe ., "x" In blDC'k "A" of Pett 1 0' ttM "r.Mpaytr Ruponu." .eotJon. 51"", two oopt.. Mld ,ubIllt thM with yoyr check for the .-ow'It of taM to the Reglttar of Wtll. of the ~ounty Indlc.tad. The PA o.p.rt.-nt of Aavanut wtll Illus an official .....-..nt (Fa". RfV~IS4e [10 IIp(Jf1 r.oelpt of thll rlturn fratl t~ A"hhr of WUII. Z. BLOC" B ~ If tt... ....t .peatfled un thh notlc. hat bun or will b. r.port.d and taM paid with tha Pannlylvltnl. Inh.rltlnol TaN Aaturn fllld by the deClad.nt'. rapra.antatlvl, plaG. an "M" In block ~ft" of Part 1 of tha "TIMpa~.r Aa.pon.a" leatlon. Sign one oapy and raturn to tha PA napartHnt of AlIvtlOUa, luralY (If Individual TaN", D.-pt 280601, Harrl.bur" PI. 17128-0601 In thl anv.l~ provided. :So BLOC" C - If tM notlCI Infor.atlon It Inoorr.ct andlar deduction. ar. belna ol.lnd, chIck block "C;OO ttnd C01IP1at. Partl 2 and 3 "'.....ralr... ~.:) .;,.. lr..st,.L;c1:!....-,.. !:.~l,)... =1,,~, tOlv ';':';":~;" ..i'~ .)~b..1t ~l".~... ..1t:. ""I'/; .:hllll;. ~..:" ~h.. ...:::.;;r,t ..~ t~;; PQYDbl.. t~ thQ i,~,l"t.:.' of Wt11. of t~ oounty Indlc.tH. Th. PA o.part.."t of R'"~I. wlll In\M ." offlolal ......eent (For. REV-15U EX) .,.on r.cllpt of the raturn frOll the Retltt.r of willi. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Ent.r tM d.ta the ltGcount orlot/lf'Uy w.. ..tllbllth..-t or tlUad In the .ltMar aMlttl"' lit d.ta of dtIath. NOTE I For 8 daoedent dvlne aftar lUIZ/'21 Account. which ttMl deCllldent put In joint n.... within OM (1) Y.llr of M.th .r. texllbla fully .a tran.fartl. HcMIaller, thllr. 11 an aNclu.lon not to a)(oaed 15,000 plr trenlf.r.. reprdlau of tM Vlllu. of tM ItCIcount or the nueber of MCOlM'ltt held. If . double a.terhk (11M) .....,. "fure you,. first n... In the add".. portion of thh l'IOtlee, the u,ooe axclullon alnlMtv h.. been dMlHltCld frOll t~ account balr.no. II raportad by thlll Unanclal InltttuUon. 2, Entar the totel b.l~e of the account Including lntera.t accr~ to the d.ta of de.th. 5. The parcent of the account th.t 11 taxable for a.ch .urvIllor 1. dltlr.Jnwd a. folloNl1 A. The ,.rcent taxabla for joint ....t. ..tablhhld NOr. than one y".r prior to the dMledln~" ~thl 1 DI~IIIED IV TOTAL HUMBER Of! JOHn OWHERS Ex..,lal A joint ....t r-at.tarad DIVIDED BV TOTAL NllHBER Of X 100 . PERCENT UXABL\; SURVIVING ,JOINT OWNERS In the n--. of tM decedent and two othar p.r.on.. 1 DIVIDED IV .s (JOINT OWNfRS) DIVIDED ftV 2 (SURVIVORS) . .167 X 100 " 16. n (TAXAILE FOR EACH SURVIVOR) I. The parcltnt h)tabla for ouats crfJ.tltd within or.. yallr of thl dac.ltdal\t.. d.eth or accounts o~ by the cklctd."t but h11ld In trult for IInGther IncllllldutllCo) (trult beneflctarln), 1 DIVIDED 8V TOTAL NUHaER OF SURVIVING JOINT OWHERS OR T~JST BENEFICIARIES It 100 . PERCENT TAXABLE EM..,le, joint ltCcount reghterad In the nHl of the lMclMJent and two other par.on. and ..tabl htMd within one yoar of cta.th by the d.-o~t. 1 DIVIDED IV Z (SURVIVORS) . .50 )( 100 . SOX (TAXABLE FOR EACH SURVIVOR) 4. The MOUnt lubjact to taN OIM 4) It d.tor,dned by IlUltlplylnt11 the account balanca (line 2) by the plreent tal(abl. Cline 5), S. Ent.,. the tot.1 of tha debh and dtMtuctlon. llltad In Part 1. 6. The MIOW'It taNllbla (ltne 6) h detar.lned by lubtracUng tha ~bh and d.duotlon. (11M !iJ frOll the allOUMt 'UbJ.ct to taM {lin. 'tJ. 7. Entar the apprOflrl.ta taN rllta (1Int1 7J at dataralnad bal()w. A. For datu of death occurring .fhr 6l3e/94~ the tit)( rat... for tran.farl to .pou.a. ara II followlI 1. Datil of da.th on or aftar 7/1/94 and bafora 1/1/95 tha ,.eta I. 3~. 2. Det.. of Math on or aha,. 1/1/95 tran.far. to 'POU'" will be talCad at Die talC rata. Hot81 For dlt.. ~f da.th prior to 1/1/94 tran.f.r. to SpOUII. ara taNabl1 at 6~. I. 'rran.f.rl to linaal delt:...ld8l"lh IncludIng fathar, aothar, Ion, daughter, grandchlldrWl, lon-ln*la.., OOughtar-In-I.w, 'tapchl1d and that,. l..~,. ara talCabl. lit .1M parcent (6;(), C. Tr.,.f.r. to all otMrl InclucUne broth4lr, .htar, .nela, MJI"It, neph4tw and nlee. ar. tlN_la .t flft..,.. percent US;O, D. If you ehtIngCI the tllC rata, pi..... 'PIl'Cllh your ralatlonlhlp to the dtludMt In the ar.. provldtld. .. The aaount of talC due Cllna 'U 11 rletar.tn.d by WYltlphl~ thl MKlUf'lt tlllCabla (11~ 6) bll the tal( rata (11'M! 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED AIIOlllbla ~t. and deductlonl ara d.t.r.lnad .. followll A. You ItlllUy .r. ruponl1bla fo,. payoant, or th41 ..tata tobject to adalnhtrlltJon by " parsonal r~re'Mtatllla if. InlUfftcllW'lt to pay tha dadfJCtlbla It.... I. You ItCItu.llY p.dd tlM! csabt. .ftar d.ath of the d.ud~t and een furnlllh proof of ~fly..nt. C. Debt. bllflno ol.l.ad ltIJ.t be ltaaizlKl fully In Pert 1. If additional .pac. it n..dad, u.a phln papar a 112" N 11". Proof of p.YllHNlt ..y b4l raqufl.ta,d by the PA n..,.r ta..nt of 'R'IIItnUI. , TAXPAYER ASSISTANCE IF YOU N!!IlDFURTHIlRINFORMATlONOR.ASSISTANCE, CONTACT ANY .. ""."..'" RE9UTER. OFWILLh PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CAllTH!! BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 7e7-B~27. TDDt (717) 772-2252 (HEARING IMPAIRED ONLY) C~UTH Of PfHNSVlv-.HU OEP"," -"' ,"If (M ~ Itt:V(>:HUl lUlU... .If <,\'flll,4YIDUAl TAlt[~ DEP'. ZIOMll IlAIUnUURQ, JI~ 111Za.OlloOl *' I'.J /1/ ( ') INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATI! NO.21 ! I' ( 971 03692 01-23-91 1/ i I UW.\UIII ,,, 1/,"1 '91 I [0 -5 (,I ! ".EST, OF QUAY D HAMIL TON 'i,s. NO, 111-24-6224 DATE OF DEATH 11-18-96 I' 2~~~TY CUMBERLAND TVPE OF ACCOUNT [J SAVINOS [J CHECK INO [Xl TRUST [J CERTIf, I1w" lie! DORIS E MURDORF 15 BIRCH ST MECHANICS BURG Clu" PA 11055 Curnb " ",t f'/\ REHIT PAYHENT AND FORHS TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 11013 PNC BAHt( hat pro",lded the Dlp.rt.ent with th_ tnfar...Uo" llthd below whlroh hlill b..n l.I.ed In olllculatlnq the pot.nUII! hue 0\/1, 'h.l,' rlcord. Indlcah thet at th_ d..th of the aboll. dlc.dent, you wert .. Joint (lifn.r/b.neUel.r... of thl. IICtr<:,unt. If you f..l thh info"..Uon h Incorrect, pl.... obtdln written corr.cUnn frol the flnancll'tl In.Ututlon, "ttaeh a copy to till. for. end r.turn It to the above Melt.... Thll I!'ccount 11 taMable In ltCCOrdlllnclII with thlll Inh.rltanr.1II Tall: law. of the CoaltOffiHlalth of Pllfm,ylvllOla, "','._ dur,,. ."!II 0. IIn_-=.,.,."... l'1 \:lId jng (i '.. j 101 t.Jd. COMPLETE PART 1 BELOW . ---- Acco,,,,t Ho. 31100065505 . . SEE REVERSE SIDE FOR Doto 11-12-96 E.tabU.h.d FIL,ING AND PAVMF....T INSTRUCTIONS Aceount B.lane. Percent T.x.,l. AlIlOUnt Subjoct to ro, Tax R.t. P~t..,t bl T.x Due K 40,038.95 50.000 20,019,48 ,15 3,002.92 To In.ur. proper crllldlt to your account, t.,o (2) copln of thl. notic. IIlIlt ltCCOlWlMW your pay..nt to the A.gl.tlllr of Will.. H"kG chlllak pByebl. tOt "R."ht.r of Willi, AIIMlt", K NOTE: If hiM Prly.."tt ar. aade within thr... (3) -.onth. of the dlllf8dent'. dllh of duth, you lIIay dedutlt a !:IX dhcOl.W1t of th. tll>l du.. Any Inn.rltancllll tall: Itu. will beeo.e d.linquent nln. (9J .onth. aft.r th. dat. of dIII.th. ~- TAXPAYER RESPONSE [] I ,'''~~'''''I TO "'.Jll:l!m~~~tll"9~rX" 4.. ~mCIALTAX A88U$MBHT IASlD ClH THIS HOTZC_1 A. 0 Thill ttbove Inforlll.Uon end tall: due Is corrlet. 1. You ..:'1 choo.. to r..lt paYHnt to th_ kellhter of WlItl with two copl.. 0' this l\otlCI to obtain . flhcount or ovoid lnt.rut, 01- ~ou UY 'Check bOI( "." anj r.turn this nQUee to thll RIIIlIhhr of WIlIt lS/'\d ftf1 official I"'......nt will bill Inued by th. PA Olpartlt.nt of Rlllvenue. [CHECK ] ONE BLOCK - ONLY' a. D Th4l MHJVI lII..t hili be..., or wll1 b. '-lIIportllld al'ld tal( p.id with thlll Penn.ylvenla Inharltenel Tal( rlllhHon to be filad by th. decedlllnt'. rlllpre.ontatlva. C. 0 The I!lbo\,llll InforuUon I. IIlcorreot WId/or dubh and d.tiuotlon. IHIre paid by you. You IlUst cQllPhtlll PART 0 and/or PART ~ below, PART [!] TAl( LIHE If you lnd1eat. a different tax r.t., pl.... .t.t. your rMl.tion.hip to dec~tl R"TII~~ - r.n"PIIUTTnN 1, Doto E.tobllohod 2. Account Balance S, P.raant TaxablM 4, AMOunt SubjiaCt to Tax S, D.bt. llI'ld DoducU..... ,. AllOunt Taxllbb 7, Tax Rat. a. T.. Duo , " , OFFICIAL USE ONLY 0 AAFj PA DEPARTMENT OF REI/ENU!! ", TAl( n~ .'"TNT tTRl,qT ar.r.nIlNT!l ~^n ". 'r."-""~ ,...~~,.,._, no: 1 2 ! K 4 S 6 7 K a PART I!J DATE PAID PAVEE =: 1- ) 0 , vD ~.', ,:ti-'- IS ) , <-j .:21.. ,'::J " DEBTS AND DEDUCTIONS 1 2- 3 '"..A~~ S , 1 8 CLAXMED ': ~Iol! 1;;('),ol?,()::J. 0'0 10.0,:>0",')/ ," .,;.';..,,: :::,1 w~~ DESCRIPTION AMOUNT PAID 1_ ~ . ]- TOTAL (Ental" on linll S of Tax ColtPuhUon) - --- - Under penaIU.. of p.rjuJ'y, I decl.,.. th.t tha fltClt. coftPlat. to the bait of MY knoMledg. and baliaf. ~~~tf/e;! I hay.. ,'.porhd abov.. "}'a tr'u., correct and HOliL__cZl-?-LlX ~-, r-o ;.1'__ .;(.:.:L:..] /' WORK ( ) L TELEPHONE NUMBER DATE " GENERAL INfORMATION . 1., FAILURE TO UlptOHD WIll RESUL.T IN AN OFFICIAl. TAM ASSf.SS"EHT with IIppllclbl. Int.rut bued on I,,'orutlon ,ubIIlttH bw tM f1nlinCll,l In.tUutlon. r. Inh.rlt."ol h. btGOH, HII~t nlM! IIOntlll ,fttlr tll. ".uriant', ri,t. of d..th. S. A joint .'MIoount I. talCMll, I."WI thDU9h thl dlnd.nt', n... wu ~d ... II ..tt.r of oonVlnl.nu, ". Accountl (IncllWlng tho.. Mid betWlIn htJlbllnd IInd wlf., which the ""edent put In joint n.... within OM Y"t pf'lor to death .t. fulh tnl&bll .. tr.,\I'.r,. It. Aooomt. eIIt_l\."... juinHv b..t...~ hUlb.td Ind wlf. Hr. than OMI y..,' prior to fl..th .t. IlQt "ubi., ~. Aoeount. hel~ by. ~edent "In trult for" ~t~r or other. .t. 'IMeble fully. REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. 11.0Cl A ~ If t"'- Infor..tlon W1d OQIIPUt,tlon In ttll notlcl .," corr.ct Ilnd cMduCItlona .r. oot bel", chlNd, piN. ." "X" In bl~lk "A" ('If Par't 1 of the "Ta'o(p'~.r "Uponl." notion. IIlln two oopl.. ond ,utNlit tMll with your oheck for tM .-ount of talC to t~ R.aht.r of Willi of the cwnt)' Inl1lc.tlKt. The PA l'Jep.rtMnt of R.venutl will luu. ltn offlolal .u.",.."t (for. REV.1S4' [10 upon reo.lpt of thl r.turn fr08 thl RIght.r of Willi. :1:::. BLOCk B . If the 1II,.t ....oIU.d on thh natlo. hu be.., or w1l1 b. r~rt.d and talC paid with the rlnnolvlltll, Inh8rlhno~ hlC R.turn flllld by the ~ttdent., l'apr...nhtJ"'l, plus In "M" In block "a" of P.rt 1 of thl "hIICElaV.r R..pon.... 'IOtlon. Sign on. -copv IIIld r.turn to the PA O.,..rt..nt of R.",InUa, &ur.au of Individual hlC", D.,.t Z80601, H.rrhbutg, PA 11128-0601 in the In"'llop.l provided. 3. BLOCK C . If the notlc. infor..tlon I. Incorrect andlor deduction. at. ~Inl olal.-d, c~k block "C" and cDMPllt. Part. Z tnd 5 tH;oorolrl6l to ~". IfI'hrW,iUtllJ "..h,.. J;., ....'" ".,...i... bI,'; ,,,...~. ,t,"'''' ...~U. ~;;.;i ..:-,..~Il Ie. th,- w';;';Olr.t cf ~:u: F:~'::~I: t:. ~rll n;;!:~:~ of Willi of thl county indioatld. Tht> PI. Dlp..,'t.."t of R.",.nu. will luu. an offloial ........nt (for. REV-1S41 EM) upon rlO.lpt of the r.turn frotl thG Regilt.r of Willi. TAX RETURN - PART 2 - TAX COMPUTATION lIHf 1. Ent.r thl dlt. thl lKlaount ad,lnllly wn ..tllblllhad or tltllMl In thl IltMlr Il(htln, at d.t. of duth. NOTE I for I ~lldInt dying aft.r IUll/aZI Account. which the decledent put In jolr.t n.... within one (1) )r..r of d..th .r. tIIxilt'.h fully ~. tren"ar.. llQtlHl"'Ir, there h an 1l(C1luslon oot to .l(c.ad t1,OOO pit tran.f.r.. regardl... of the "'lllue of thot IHlCotM'lt or thli nuIlbar of acuouna h.ld. If . doubl. ..t.rlsk .-'''''1) IIPpl.r. before your flr.t nIM In thl addr... portion (;f thh natloa, thl n,DDO .xolu.lon Ilralldv h.. bHn dlduatad frOll the acaomt b"IMlCl8 III rlported by the flnwKllat In.titutlon. Z. Ent.r thl tot.l b.lllnCl of thl account Incl~lna int.r..t acarued to tha dat~ of d.ath. 3. '(he plru..,t of the ItCcount thlt 11 tawabh far lach .urvJvor II detar.lnad .. follow., A. The percent t.lCabl. for joint ..~.t. .Itabll'hed ~r' then on. Ylar prior to the decldsnt'. deathl 1 DIVIDED IV TOTAL HUHaER Of JOINT OWNERS Ex...,I, , A joint ..lit r..lltarld OlvmfD BV TOTAL NUlIIlER OF >t 100 . PERCENT TA>tULE SURVIVING JCINT OWNERS In thl nIM of the (fe(:.dMt and tNCI other p.rton.. I DIVIDED BV 3 (JOINT OHRS) D11I[Df.O BV 2 (SUQYIVORS) . .167 )( 100 . 16.1;( nAMABLE FOR EACH SURVIVOfD I. Thfl paroW'lt tal(llbla for a...t. cra,tld wlthJn onl :f"" of the dacedant'. dnth ar ltCIaOta1t1 ownad bv thl HcNent but held In tru.t far W10thlr Indl",lduaU.) (trult ~fJclarl")1 1 DIYlDED BY TOTAl. NUMBER Of SURVIVI~ JOINT )( 100 . PERCENT TA>tAILE OWNERS OR TRUST IlfNE':ICIARIES ElCllIplll Joint IKlCCKrlt ,..,htlred In the naIII 0'11 thl decadent and two other person. and utlblhhld within one VI.r of death by the dec.oant. 1 DIVIDED tY Z (SURVIVORS) . .50 X 100 . SOiC (TAXABLE FOM EACli SURYIYOfU 4. The MOUnt al.otljMt to tax 01". 4) II dat.ralnttd b:f IlUltlphlng thl account balanc. UI". Zl by thl peroent tlMHlI Ulna 3), 1;.. r:ntlllr thtl tatal of thf, debt. and .1aduotlon. U.ted In Part ~. 6. Thl SIIO","t tll(abl. (11". 6) 11 dab.raln.d by .ubt,.aotlng thl dllbt. and deduction. (I1n. 5) fro. thl lIMIOunt .ubJ.ct to t.x Clln. 4), 7. Ent.,. the ItPPropr'l.t" tlX r.ta (ltM 7) II' d.terlllned bllow. A. for dIIt.. af death occurrln, IIfta,. 6/50/"", the tft)( r.t.. for tran.f.,.. to .pou", .r. a. fOUOMIl 1. Dat.. (If d..th on or .ft.r 711/94 and ,*for. 1I1/9S the rat. I. 5iC. l. Dlt.. of death on or aftlr 1/1/9S trln.f.r. to .pou*.. wl11 be talCld at 02 t.w r.ta! Not.l for datI. of o..th prior to 7/1/94 tran.flr. to .pOUI.' ftrl ta)(ablo 8t 62. I. Tr~,far. tn 11".al dl.cMdanta in<lludlFll filth.,., Rth.r, Ion, daughtar, grandchlldr,", .0u-ln~I..., dMJght.r~ln'IMl, .tapchUd and their lulHo ar.. tDubla It Ib p.rc."t (6;()' C. fran.f.r. ta 1111 othllr. includlnv brother, uhtor, Ufl<l1., aunt, nlphfilllnd nlM' a,.. ttllllba It flft.." perallnt US:O. D. If woo change the t.x rat., pl..... .pttOlh ym.r r.I.UOl'uhip to the cMclMMont Ih the IIrll provided. ft. ThI.-cont af talC w. (Una 8) II datar.llled by IlUltlplylng the allUUl1t taKabl1 (11M 6) b:f the tel( r.t. Ulna 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED All.owelll. debtl ttod doduCltlon. ar. dot.,.alnlKl al fol1l>>l11 A. You leplh .rot r..pon.ibl. for PlYHnt, ar the .atat. lubj~t to IdalnlltraUon by . personal 1'...,....,t.'::lv. II In.ufflalont to PIIIY thti dactuotlbl. ltN.. 8. Vou 8ctuall:f Pilei tn. d.bt. "ftlr d.~th of the decadent and aan furnl.h proof of ply.ant. C. o.tth blll'tSI rhlnd ltU.t bo It..lud fulh In Pllrt 3. 'If additional spec. ill n'.eNld, UIII ph In PlIPar a l/Z" J( 11". Proof af pay.."t ..y bt; r.qualtad b:f thl PA O.,..r't.."t of R.vlMlUl. .. ....... .. . . TAXPAYER ASSISTANCE. IPVOU NEED FURTHER INFORMATION OR A$SISTANCE, CONTACT ANV REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CAll THE aUREAU OF INllIVIDUAl, TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG A'f (711) 787-11327, TDDO (717) 772-22:52: (HEARING IMPAIREll ONLY) C(Ht(ltM':AV" flO' PUtlSn YAH I A p[PAN < In~t B '~l~Yf.NUt: IUJREAU Of INUWIDOAI. 'AKEI DfPT. lIa60 1 HAAAUIUAO, pl 11lZa.OfiOl * INFORMATION NOTICE FILE AND TAXPAVER RESPONSE lACN DAn: NO. 21qr7 -II fjL 97103690'1 01-23-97 U~.IHI U ." (/'Ml Fl:,'c.! I;, (II .11', EST, OF QUAV D HAMILTON 5,5. NO, 177-24-6224 DATE OF DEATH 11-18-96 COUNTY CUMBERLAND TVPE OF ACCOUNT [J SAVINGS o CHECKING [KJ TRUST [] CERTI~. '9""1 IUJ-5 DORIS E MURDORF 15 BIRCH S:t;lL;" MECHANICS6~tlrrlu F)2 :55 ;',)(1 PA F~~!5. I'A REHXT PAYHENT AND FDRHS TDI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK hilt pro...Jd~ the neplllrt..nt with ths InforMation listed htlow which h". b.&on u..d In Mlcuhtlng tn. pohnthl hI( du.. Th.lr r.cords Indlcnh thllt lit th. duth of th. IIbo.... decedent, YClU ltlr. II joint ownu/b.n.flclllry of this $ClCount. If YOU f..l this Jnfor..Uon h IniJorrtliot. pI.... obtain writton correction fro. the flnMolal 1"'t1tutlon, llttach II I:OJ'Y to thl. fore and rllturn It to the l'Ibo...C1 Itddrllll, Thl. ltCcount Is tllMflbl. In ftccordnnc~j with th.. Inhllrltt'lnc. Tax ll!lWs of the Coe"onwllalth of P.nnlyl...ltOlfI. Qu..t1tm. 8ay b. "n.w.red by ull1ng (/17) 781*0327. COMPLETE PART 1 BEL,OW . . . SEE Account No, H300065263 Dot. E,tabUshad REVERSE SIDE FOR 11"12-96 FILING AND PAVMENT INSTRllCTIONS Account Bebne. Perc.nt Ta)(.bl. Aoount Subjoct t. Tex Rat. POt-DUO!. Tox ou.. ")('- 7,531,00 50,000 3,765."5'0'-.-.- . --..--'.-:-.rS.... -, .., "'--~6.4 . 8 ~ TCl Inlurlll proper- credit to your llcoount, two (2) COpiRI of this notluM SUit acooMpany your pllYMllnt to the RIlI&d.tar of Willi. Make ch.ck payable tnl HRegister nf Will.. A~.ntH. K NOTE: If tax pt'lYMant~ fir. M&d~ within thr.. (3l Month' of thlll d.ced.nt.~ d,,1. of death, you MIlY deduct" S% dhcount of the ttll( du.. Any lnh.rltun~. tllN due will beco.. delinquent nJne (9) lIonthl aUel' the date of d~ath. Tax PART ,-. 1AXPAVER Rf:SPONSE [II [!AUURI 'to RIlSPOND IfXl.I,. "llli'll. T. lit Ail OFFICXAL TIIX ASIlE$$HIHT ~*!,iiil~~~T"'X$ ,~~ [CHECK ] ONE BLOCK ONLY ~. c=J Th. abo.... infDrMation and taN duI il corr~ct, 1. You .ay choo.. to f'Cl.tt paYHnt to the R.,dster of willi with two copl.1 of thll noth:. to obtain a discount Dr ll\'old interelt. or you Ball ch.ck bolo( "A" and r.turn tllh not1<:. to tha ReQhter of Will. bnd en offlclll1 a......llInt will b. I.sued by the PA Depart..nt af R.....~. B. c=l The aboY. a~..t he. ~en or will be r.ported and taN paid with the Pannsylvftnla Inheritance Ta)( r.turn to b. ill..J by the d~~ent.s r.prulIlntlttiv.. C. \:71" Th. nbo.... Infor..t1on Is jfl(:orr.c::t ltnd/or dltbtl and deduction. were paid by :iOU. '" Vou ltlI.t cQIIPhte PART 0 nnd/or PART 0 below. PART I!J DATE OF '!'."~ ~~~ ...f"!~!'!'/'!'!!l..lg,!, 1'.~~(uJ~'!'~ 1 2-.-7DO j;7J).]- 37-----"?:L>, (\ (! .--- 4 I () (\ (I (~ . f, I 5 ~t!Y' 6 lDOO~.~< I 7 K . I ~) 8 I y 2.L, , 2-1- DEBTS AND DEDUCTIONS . ... OFFICIAL USE ON LV 0 AAF; p~ DEPIIRlHENT OF REI/ENUl! .. . :ii """""~-_._~"~,-."""-,,,-"",:,,,-,,~., .,o:.,........-...,......r, If you indicate" diff.rent tax rete, pl.... stat. YOYr ..ell1t lonahlp to d.ced.nt: ~__._~..,_____.__ PART ~ T^X ~e!U~~ - CO~~~'!'^T!Q~ LINE 1. Doh Eahblhhod 2. Ace~t B.l~a 3. Percent Texabl. 4, AMount Subj.ct to Tax t, Dabt. ~d Deduotion. 6, A....."t Toxoblo 7. Tax Rat. 8. Tax Du. ~i,~ 1 2 3 /I .5 __ .6 1 ~ 8_ CLAIMED ~ "~~,:t'~~,: "':':.::::! ..' ':', - '<l~ - itJ :::<';:";';"';';""::;::) .4>,"7"'~'_"""" ;' .. .. PAID ~~ PAVEE DESCRIPTION AMOUNT PAID L TOT AL (Enhr .0 Lina S of Tax Conputatlon) ] . - Undar penaltJ.. of p.rjury, I d.ol.r. that the fach t coltPleta to th. b..t of .y knC'n.ladg. and bAII.f. ~r_r hava ..eported aboy. C~. tru., corract and HOME (1/'",7) llji!,- S'O(P __.!?.::5..:~ '7 WORK ( ) ,'7 TEl.EPHONE NUMBER DATE GENERAL INFORMATION i. FAILURE TO RF.S'OHO WILL RESULT IN AN OFFICIAL TAM ASSESSMENT with Ippl10labll Int.,...t ll..~ on in'orl.t1oo .ublllttltd tlv tnll flnMol.t In,tltutlon. l. lnh.dtMUI ttl': t)e,ClO.,.1 ~11"qu.nt "1M gnthl .fll,. thl decldent''! d.t, of d.,th. I, II joint IHHlboot i. lnlllbla ......n thou", thl dtl(lldltrlt', M'" w" lidded II " n~t.r of (lorwlnlanoe. 4. Acoount. IIM1Udln, ttM).. hlld botw..., hutb~ NMJ wlf.) whloh thl decldttnt put in joint n.... within on. v..,. prior to dntn II" futh t.-obl, II t,.....f.r.. Ii. Accolltt. 1II1tllblhhtHt jol"th Ht....n htllbllnd and wlf' IK)"I th,," nnca v..r pdor to d..th ar. Mt tlK.oll. 6. Accounh hlld bv a dttc~t "In trult for" ~th.r or otna" III" tlKIlbI, fulh. REPORTING INSTRUCTIONS . PART 1 - TAXPAVER RESPONSE 1. 8LOCK A ~ If the InforlllUon and c_ut.tlon In tnft naUo_ Ira correal Itnd d,duotlon. .r. not blllng clIl..d, plltCl M ")Co. In blook ",," of Part 1 ('If tM "TIMP.YlIr "..Pon.... .ecUon. 51..... two oopll' lIhd .ubIllt thell with your ohMk for the IIIOUnt of till to ttM RIghtlf' of willi of the counh/ lndh:atld. The PA O.partMnt ()f RaY~ will IltOll 'In oHlo.\.1 ,.....Mnt (Far. REV'lSite EXl UPOfl recllpt of the return fro. the RIghtlr of Willi. l. 8LOCK I - H the a...t ,ploCllflld on this notlcCl h.. blln \1r will bl rlportDd and till Plid with the P.nnlylvanJ. Inherltanol laM R.turn fll.d bv the dlald.nt'. f'e)'\r...nt.UvI, plac:a L'ln "X" In block "1\" of Plrt 1 (If the "TaMp.Vlr "..pon.... lIotll)n. Sign onl COPy .nd r.turn to the PA Dap.rtMnt of R.y~, burnu of Individual TaM", D~pt 280601, Hljrr-hburg, PA 17IUMD601 in the anvQI~ provided. 3. IlOCK C . If thl notice IMor-MeUon 11 IneorrlCt and/or deduClt1on. arl bllng ohi'ld, chick block "c" MId cOllPlat. Plrh Z nnet ~ :lCc:r:!I;., to: ~~.: Ir,,,trw.:.t1o,',,G b.~l.,oj. :nliir, t..u e.:.,.~u ;;;,.~ ':IJ~;dl \::10:::: wHt", .......; c~,....k r,)i t,.. 6..;u;,t..i ....;.: ,.4~~lot ~.. ~i... ~"IlIJ.'i.", of Wilt. of th.. COW'lty JncUcltld. The PA Daplrt..nt of RIVlnul will ".UI an offioll! UUIU.."t (Fori REV-lSq. EIO upon rlclh)t of ttM rlturn frOll HI' Rlnhtar of WUII. TAX RETURN - PART 2 - TAX COMPUTATION lINE 1. Ent.r the d.tl the aecount orlglnlU:i WII fIItablls.,.d or titlod In the .aMlr l>chtIng at d.tl of daath. NOTE I For a d.e.dont dying Ifter 12/IZ/8l: Acoount. whlch tho decadent put in joint n.... within onl (1) Yllr of dleth Ire tlMNl1 fullY II trlan.flrs. Howevlr, th.re Is en .Molu.Jon flot to IMCI.d n,ooo par trensfer.. rlglrdll.. of thl velul of the eaClount ar thll nuMHir af ,C(lount. hlld. If II doubll nt.rlak pUI) nppnra blfol'~ vour fir"t na"l tn the addrl" portIon of thh noUol, thl .s,l'i00 'Mo1\I.loo elre,ch' hll be." dlducltld frOll the a<llcount beJencI !II r.portlld by the financial lnIUtutlDl'l. Z. Enter the totll bllancQ of the 8CC?Unt Jncludlng lntlrl,t accru_d to the detl of dl,th. S. The plrcltnt of thl flClcount that 11 tlICabla for IMlh survivor Ii dltlr.lnld II folloWlll A. n,. percent tlll(lbll for joint Duete ..tabUshad ItOrl then onl y.er prJor to the claoed4lnt', death, I DIVIDEP IY TOTAl NUf1M:R OF JOINT OWNERS EM..I.'1 A Joint nut r.ghterld rlIVIDED BY TOTAl HOHBER Of )( 100 .. PERCENT TAXAIiLE ~IIRVIVIHO JOINT OWNERS In the! n... of thl doudlnt 'Iud two athlr perlon,. I DIVIDED BV 5 (JOINT OWNERS) DIVIDED BY 2 (SURYIYORS) .. ,167 )( 100 . 16.7:< (TAK....lE FOR EACH SURVIVOR) I. The porcant tllXlhll far "...h cr."tld within one Yler of the dac:edllnt'l dllth 01' f!ccountt ownld by the cHto.ctant but hlld III tru,t for another. Indlv!duel(.) (trult blnaficlerluh I DIVIDED BV TOTAL HUHIIER Of SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES )( 100 .. PERCENT TAXABLE EKIMIplol Joint eccount rlghtlrlKl In the n..1 o(l thl dlClldent and two other plrtons WId .,tabU.hed within ani Ylar of dlath by the! dKact.nt. 1 DIVIDHI IW ~ (SURYIVORS) .. .sn )( 100 .. 50:': (TAXABLE FOR EACH SURVIVOR) 4. The flItOunt 'Ubjoct to teM (11..... 4) II d.tlr_lnad by llU1tlpJylng thl account balenc. (lInl 2> b~ thl porc."t lIKabll Uine 3), 5. Enter thtl total af tha debts IW'Id d8dYctlon. lilted In Pert 3. 6. Thl auunt taKable Olnl 6) 11 dlter.lned bY sUbtrlctlng the debts and dldUCtlon. Ulnl 5) fro. the MOUnt .ubjlct to tex (line 4). 7. Enter thtl epproprJatl talC reta (Una 7) u detlra inld belaw. A. For At.. of dNlth occurrIng rlftlr 6/1O/9~, the! tax ret., for tran.flr, to ,pou", arl a, foUDMII 1. nat.. af death on or after 711194 and blforl 1/1/95 the rata 11 3.%. 2. Oat.. of d.a\h M Of' afhr 1/1/95 transflr. to 'POU'" NUl bl tUld ftt 0:': tlt;M rata. Hot'l for dat.. of d...th prior to 711194 trM'flr. to spous.. ara teMeble '1lt 6:':. I. Tran.flr. to lIn.11 dllcandanh includl"" fethlr, lothlr, .on, daughtlr, grandchlldrln, lon-In-Iaw, deughtlr-In-!aw, .tapc;hlld and thllr I..ua era tftxftbh It .1M parcant (6,:>. C. Tren,flra to eU ottwlr. In<lludlng brothlr, .lthr, unch, lunt, nlphlw and nllca arl tl'lxula at flft.." pllr'oent (15:0. D. If YOU e:h..",. the \eo< ratl/ pi.... IpICl!fy your rlletlonlhlll to the dIold.nt In the er.. provided. 8. The IltOunt of tu dul (Une 8) it detlr.ln.d by IlUltlplylng thl ..Clunt taKabll Cllnl 6) by thl tlM reta Cllna 1>. CLAIMED DEDUCTIONS' PART 3 DEBTS AND DEDUCTIONS CLAIMED AUOtrfetlll debt' and deductlonl arl dttter.tned II followlI A. You lagaUy an r..poneJbh for Pl'w.-nt, or the Utltl lut1ject to adtIlnlttr~t1on by a perlonll rapr..entet!vI It InMlffJolwlt to pay thl daduotJbl. Itlml. B. You actually paid tha dahtl aft.r ~.th of the d.eedent and can furnl.h proof of pey-.nt. C. !labt, baing olalHd IIU.t be ltl.iud fully In Pllrt 3. If additional ,,)ao. 11 n.lded, un plain paper e 1/2" )( U... Proof of plly.."t ..y bI r.~.tld by the PA n.part_Wlt of 'AIOJlnua, [ , TAXPAVER ASsISTANCE IF YOU NEED FURTHER INF'ORHATlON OR ASSISTANCE.CONTACTANV REGISTER llFWILl.s. PA DEPARTMENT OF REVENUE DISTRICTOFFICE OR CALL THE 8UREAU OF INDIVIDUAL TAXES. TAXPAVER INQUIRV UNIT IN HARRISBURG AT (7171 781-8327. TOOl (717) 772-USZ CHEARINlllMPAlRED ONLY) -- COMHOHWf.Al TH Of PEHHSYl VIVHA DEPAATHt:HT Of RfVfI<<Jf: 8lHtfAU Of INIJIVIOU"l rAl<rS Of:Pl. 180601 lI~lRlSBlHt(J, IIA Hlll'060t *' I !J INFORMATION NOTICE AND TAXPAVER RESPONSE './1 . ') FUE NO. 21 ((' 111'1 ACN 97103686 DATE 01-23-97 1[V.aH u~" cl-"1 H" Ii r,i.. ( "'.' EST, OF QUAV D HAMILTON S.S, NO, 177-24-6224 DATE OF DEATH 11-18-96 COUNTY CUMBERLAND TVPE OF ACCOUNT [] SAVINOS [J CHfCK TNO IX] TRUST [J CERTlf , '9'1 IlU -5 I'? :'i5 DDRIS ~ MURDDRF CI 15 BIRCH ST (J'i MECHANICSBURG CdMd~055, 1,11 lit PI, REHIT PAVHENT AND fO~HS TO, REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK hn provldld the nlpllrt.."t IoIlth tM Infor.atlon lilt.d bllow whJc" hll' bun u.ed In cIlcuhting the pot.nUul taw due. ThIllr record. IndlClltl that fit ttt. death of thli "bov. deeedlnt, you IIlrl II joint ownlr/b.nlflclar\l of thh &Ceolln\' If yOU fall thil Inforlllatlon II Incorrlct, plee., obhln wrlttfln correction fro. th. flnflnohl l"ltlt"tlo", tit tach n copy to thl. fora ltOd t'lIturn It to thlt ahoy. addr.... Thl. account II hwabll Irt oOODi'danol wHh the Inhlrltancl TIlw law. of th. COMOnwllllth 0' Pann.vlvltOh.. t1uuUun. Ilav be an,wlrld b}l olll1lng 171'1) '8/~a3U. COMPLETE PART 1 BELOW. . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31500056334 D.t. 12-08-95 E.t.blhhed x 50,(,31.62 50.000 25,215.61 .15 3,782.37 To In.url proper oredlt to your account, two (l.) co!'J.. of thll notlcl Il\lIt aocDllpllny your pay..nt to thl R~lIhr of WHlg. Hekl ch.ck 'layable tOI "Righter of Will.. Aga"t", Account e.lanc. P.rcent Taxabl. A~un~ Subj.ct to Tax R.t.. Potential Tax Due "ic NOTE: I f taw pllYllanh arl Iledl w lth In thr.1 (3) aonth. of thll dlclct.nt'. data of dll.th, you .ay dlcklot II 5% dhcount 0' thl hw dUI, Any inherltanc. taw 00.. will beCOH dellnqulnt nln. (~) aonth. after thl d~tl of dlath. T.. PAiiT- TAXPAVER RESPONSE [1J I JlAILUIlITOIlISPOHDWXl.l.. RE$ULTX~ AN OFFICIAL.TAX ASseSS"ENT lAUD ON THIS NOTIC!J A, ~. abovI Inforllatlon Itnd taw dUll 1. correot, 1. You ..y choo.~ to re.lt pav.lnt to thll RQgl~t.r of Will. with two copll' of lht. notlnll to obtain a dlloount or avoid Int.r..t, or you .~y chIck bow "A" and rlturn thl, notlcl to the Ragl,tlr of Will_ ond 9n o'flolal .......ont will bl I..ued by thl PA O.pltrt.lnt of Rlvenu.. [CHECK ] ONE BLOCK ONLY 8. 0 The aboVI nlllt ha. bean or wHl be raportt1t and ta~ paid wIth thl Plnn.ylvMia Inharl1;ltflOl Taw r.turn to bl fllld by thl dacedent'. rllpr...ntatlve. C. 0 The above Infor.atton I. Incorract and/or dllbt. 8nd dllduction. warl paJd by you. You ~.t CO.,,;"8t8 PART 0 and/or PART 0 bllow. PART [!] If YDU 1ndic,t~ A diff.r.~t t.x rat., pl~~.~our rel.tionlhip to decedent I ___ ....... .OFPICIAL USE .ONlV . 0 Mfi P/l DEPARTMENT. Ol'REVENUE ..... T^X ~!TU~~ - ~~MPU!~T!O~ LINE 1. D.t. e.tobll.h.d 2. Account Balance S. Percent Taxable 4. AMount Subject to Tax 6. Debt. .nd Daduction. 6. AltOtMlt Taxabl. 7. ra>< R,t. a. Tax Due ':'~ T.":X Q~-'(,!!MT/T~tl!,!, .~""'(,"'IJ~I,!,ct 1 2 3 X 4 S 6_ 7 X a non ,,"..e# ,,'_' ,',._.._..........~., ..,.___............--.-',.__ .-..,-: PART ~ DATE PAID --;t . 2 3 4 !l 6 _ 1 8 DEBTS AND DEDUCTIONS CLAIHEp ,~ - - "- -- ~ - PAVEE DESCRIPTION AMOUNT PAID r TOTAL (Enter on Line 5 of Tax Conputation) =1 I Undar panalt!a. of parjury, I dlclare that the flat. I cORPl.t. to tha ba.t of .y knowledge and beli.f. .f&~ tfiG$f~f1/ ~ h.vI reported above are true, correct and HOME?I:i?/;;." ) S\:) / .f-. :< ' 5~ /' WORK '( ) TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE fCt I'tES'ONO WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with apnllublt Intl,..t bIlled on 'n'or..Uon ,uiNlIU.ct by the Hn~l.1 In,t1tutlon, 2. lnh,rltlnol tlM bMO'" dtllnquwlt nIne aonth. ,fttr thtl dlcxMnt', date of d..th. 5, A Julnt IKlCount it tIMWJ1, .ven though thl QICledent'. n... lofl. .ddN IU . utter of ctlnvenlenc". It. ACClOunt. (lnoludl~ tho.. h.ld bltwefin '1Y.b~ Arid wlf,1 which thl lIMedl"t ,tOt In joint ".... with'" onI y..r prior to tI."th .r. lulh tIMHI, II trM"lrI, S. AOQO\M1t1 ..t..lhileo Jointly bIt...." hu.b~d And wife IItOf' th., on. y..r ,Idot to eMllth IIr. not tlMItbII. 6. Aooountt hlld by . d.c~t "In tru.t fnr" enoth.r or other. It. t'xabl~ fully. REPORTING INSTRUCTIONS . PART 1 TAXPAYER RESPONSE 1. BLOCK A . If thl Infor..tlon ~ o~t.tlon In tn. notlol Qr~ corr~t inti doductlons 'r~ not bllng olll.-d, pl~. In "X" In block "A" 0' Plrt 1 of the "llHJtIYlr Rup.on.." ..otlon. Sign two ooplas ltnd .utMlt th.. Mlth your check 'or thl! MOUnt of hk to tM Rqht.r of WHll of tho (Jl)Ur'lty Indlc.tln. Th. p~ D,plrt..nt of R.v.nutI will Inu. ." offlcl,1 IU'UMnt (for. REy-aU EX) upon r.cllpt of tho r.turn fro. the R.ght" of Wllh. t. ILOCI( I - If the ....t 1,.lolflod on thl. notlco ".. b..n or will b. repurted and t'l( Plld Mlttl the Penn.yllIlnl, Inhtirlttnol Tlk Rlturn fllld by thl decld'nt', rlprll.ntetlvl, plaoe an "X" In block "a" nf Plrt I of thl "T.kPI~lr RIIPon'l" ..otlon. Sign O~ oopy end rlturn to thl PA DlPlrt..nt of Rlv_nul, Bur.1Y of Indlvldu.1 TeMI', Dlpt Z80601, Hlrrl.burg, PA 1112a'06~1 In thl InV.lCJpfl prol/ldtKI. 5. ILOCK C ~ If thl notlol Infor..tlon I. Inoorr'ot and/or deduotlono Ir. beIng elal.od, ohook block "C" and OOIPlltl P.rt. 2 end 3 C:OQ'::.1.:,'.; ta U.,:, 1;.,~r;l~t1..r" 1.;;1".... :::... t.... "t;li..~ Q;.d luloll:t tt',t:o. .;!th ;e..; tj~::Qh f:.lr U,Q ....u~;'\t of t::H pn~'cbl:. t::. t!".=. n:,l;tt.~ of W.Illl of thl oounty Jl'ldleetld. Thl PA Dlpert..,..t of Alvlnu. will l..uI an offlolal ......nnt (for. REY~154a EIU upon rl,.Jpt of tn. r.turn froa the R,gl.t.r of WJll.. TAX RETURN . PART 2 - TAX COMPUTATIbN LInE 1. Enter the dIlt. the aocount orlllln'lh W8I ..tlblhhld or tltlld In the .enn4lr elChtlng It dlt. of dllth. HOTEl For ~ dlQldlnt dyIng after 12/12/821 Account. which the dec.dlnt put In joint n.... wIthin onl (1) ~Iar of d.ath are h)(lbl. fullY al trlWlshrl. How,Vlr, thllre il an 'lCciu.lon rtOt to '1((l.1KI n,ooo pit transflt.1 regardl... of th. vaiutl of theeccount or thl flUlIbtir of acaounts hald. If 1II doubll alt.rllk (lUl) appalltl blfore yuur- fIrst nO.1 In tha addralll portJCln of thll noticI, the 15,000 eMe1ullon Itread" has bpfl dltduoted frOll thl acoount balanoa II reported by the flnencbl institution. 2, tnt.r the total bllanca ef the account Jnciudlng Intara.t accruld to thl dato of ~.th. 5. The p.rc~t of the account that 1. talCabl. for tach survlver 1. dataralned II follo"'1 A. The parolnt taMobl. for jolnt ....t. .,tablllhld aora than ~ y.ar prior to thl decldent'l death, 1 DiVIDED IV TOTAL JrU4BEFl Of JOINT OWNERS EkMp1e1 A Jellnt a...t r.gllhrMl DIVIDED BV TOUL HOH8ER Of' X 100 . PERCENT TAXA8LE SURVIVING J01NT OWNER~ In the naea of thl d.e.dant and two othar persons. 1 DIVIDED IV 5 (JOINT OWNERS) DIVIDED BV 2 (SURVIVORS) . .167 X 1~0 . la.7~ (TAXAaLE FOR EACH SURVIVOR) I. The pltC~t ta)(abl~ for au.h c:rut.d within one y.ar of the dlcld."t'l dO.th or ICcounh oWMd by thl declldont but held In tru.t for amthlr JndlvJdu4tH.J (tru.t beneflcl.ri..)l 1 DIVIDED BV TOUL NUHBEM Of SIJRVIYING JOINT OWNERS OR TRUST 8F.NEfICIARIES X IOn . PERCENT TAXABLE F.lClllplal Joint account raglthrlKl In the nue of tn.. dacltCktnt lIndtwo othlr persons and IItlbllshld within OM yllr of dllth by t1Ml dIoldlrtt. 1 DIVIDED IV 2 (SURYl\1ORSl . .50 X 100 . 511i: (TAKABLE fOR EACH SURVIVOR) It. ThI.-cKI1t .ubj~t to telC (11M 4) I. dlter.ln.d by .u1tlplylng thl aocount bllMea <1ln. 2) by thl pare."t t.lClbl. (llne ,). S. Enter thl tot.1 of Uti debts and daducUon. lI.ted In Part 3. 6. lhl _coot teICIMJ1e (Una 6) It dfltareined by .ubtrllctlnll the debts and dldUOtlon. (Une 5) fro. the ..aunt subjlct to tax (I In' it). 1. Entlr thl opproprlata talC rate {Ulle 7J IU debr.lnad b,10w. A. for dat., of d.nth occurrIng ~ft'r 6/50/941 tha tBK rat.. for tranlfar. to spou..s ,ra al follow., L O.tu of dlath on or aft.r 7/1/94 and b.for. 1/1/9S thl rat. Is 3;(. 2. Dati. of d..th on or .ftar 1/1/95 trtnlfar. to .pou.e, will be taxld ut oi: t.x ratl. Hotll for d,ta' of d.,th prIor to 7/1/94 tr"n.f.r, to 'POu", are tOKabl. at 6i:. I. tranlf". to Iln.al ducandants Inoludlng hlthlr, 1I0thltr, S()7l, daughter, grandchlJdren, 'on~ln~llttf, dMl8ht,,~ln"law, ItlPChl1~ IIlnd theJr ItSutl are tIIlCabls at s1M percent (6:(). C. Tranlfars to III otMr. IncludIng brother, .1Ihr, uncia, auntl nlph... and nlec. Ira taKabl, at fHtNn parf)lIflt (15:0. D. If YOU ahllni' thl taw r.te, phes. sP8Cltfy your r.lIt1on.hlp to the dlOadant In the lrea provided. 8. ThI .eount of taM due (line 8l I. dlteralned by .ulUptylng tha aeount tuabll (11M Ii) by tha talC ratl Uln. 7), CLAIMED DEDUCTIONS. PART 3 DEBTS AND DEDUCTIONS CLAIMED Allow.bl. debtl and d.ductlonl are d~t.r.ln.d ". follow'l A. VOlA l.pllY aI'" r",pon,lbl. for P'YHnt, or the utah Subject to adIllnhtrlltion by II perlon.l rapr.'Mlt"U"1 II li'tlufflclent to p'y the ~tJbla Jt8" B. Vou IIctu.l1y p.ld thll dabts after daeth of tha dacadll,t snd can furnhh proof of paYl1lant. C. Dlbts b.I". olelUto ItUst nil Ua.lud fully In Pa,.t 3. If /'Hidltlonsl .peel h naeUd, UII ph In peper It Ill" I( 11". Proof of PIIl)'.."t .ey b, reque.ted by thl PA naparteent of R,,,,.l'lUa. TAXPAYER ASSISTANCE IF YOU NEED FURTMER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL TtlE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TOO' (717) 772-2252 (HEARING IMPAIRED ONLY) f.,. P.' , COHHONWEI~ I H OF Jff:NHSVl VANIA DEPARTHtH1 ~ REVENUE aURUU OF IHD1VlOOAl lAKES DEPT. ZlI1601 tlARRtsaURO, PA 1111'~O'Ol *' I" 1"( r I...J ,.J ( .) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE ( " I NO.21 ,I ' 971 03688 01-23-97 (J II IU-IIHUI" ct.." " , " EST, or QUAV D HAMIL TON S,S, NO, 177-24-6224 DATE OF DEATH 11-18-96 COUNTY CUMBERLAND lVPE OF ACCOUNT D SAVINGS D CHEC~ING IX] TRUST D CERTIF , HL'" n., 1'1 '91 I ~1I -~) I)? :<;6 DORIS E MURDORF 15 8IRCH ST MECHANICSBURG Clco PACUI~~!i ,1'1, REHIT PAVHENT AND FDRH5 TDI REGISTER OF WILLS CUMBERLAND CO COURl HOUSE CARLISLE, PA 17013 " IJA PNC BANK hu provldld the Dlp.l"b.,lt wUh th. Inforntlon lilted u.low whlt:h hili bun u..d In c"ltuhtlng thl pot,nUII tlx do,. Th,lr r.cordl lndlcdt. th,t at thl duth of the llbov. dlcedant, ytlU w.r. II Joint ownlr/blnlflc:lary 'Jf thil TACCOunt. If YBU f,.l thl, Infur.atlon I. Incarr.nt, pl.... ohtnln written corr.ollnn frol thl fln.no!~l lnltltutlon, attach. fOPV to thl, for. In<! r.turn it to UII tboYI l'ladr,u, Thh IIClomm'i h hI/able In ttoIJordanct with the Inheritance TIll< lawI of' the Co..onwlD.lth vf Pln".ylv."I.. Qutltionl ..y be an,wlred by 081llng (7)7) 167-63Z1. COMPLETE PART 1 BELO~ M M M SEE REVERSE SIDE FOR FILING AND PAYMENT IN9THUCTION9 Account No, 310000~6058 Dah 12-08-95 E.t.bl1ahed AccCMM"It 8alMefl Percent Taxabla AR,..,t Subj""t to T8IU( R.t. Potential Ta~ Due ~ 40,076,72 50,000 20,038,36 .15 3.005.75 TO Inlurl prnplr crldlt to your acoount. two (2) copl.. of thl. notlcl lMJ.t ,ccOIIPmny 'lour plll/Mlrlt to the Raghtlr of Willi. MaKI CMck p'~8bll tOI "Rlllhhr of Wl1h. A;ent" , ~ HOTE I If hue pllYlilnt. arl 111101 wlthlnthree (5) .onth. of thl de9101nt" datI of d.ath, yoU lIfty d.du~t .. S% dl.count of thl tal< due, Any lnhci1rltDnClA tal< dutI wIll b.OD.. dtllJn'1l1ltnt nln~ (9) .onth. .ftlr the dete of d..th. 1'.)( ~~ TAXPAYER RESPONSE ill rJ~~~!lII. TO. R.Sjl(lIJ".If....." IUltlllq..IH.IlIJOltFIW,L TAX ASsIl8~~EwrIAtIIDO" T"I8 IlO'rItlt I A, 0 The abovI Infor.eUo" .,..d tal< due I" corrllct. - 1, You ..y chao.. to rult JUII/.ent to thl Rellhtllr of Willi with two cople. of thh notlcl to obtain II discount or avald Inter..t. or you ~ay chICk bOl( "." an~ return thl. notlcl tQ the RIRllter of Willi and an ()fflcltl1 a.......nt wUI be lnuld by the PII O.pnrt..nt of hVlnue. [CHECK ] ONE BLOCK ONLY II, 0 Th. abav.. a.ut hu b.an or will be r.porteo and tlU( peJd with the Plnn.ylvnn!1l InnerHanel TalC rlturn to be flhd by ths decede,lOt'. rnpre..ntatlve. C. r\'l Th. above Jnfor..nUon I~\ncorrlct nnd/or debh l!lnd doductlon. werl paid by you. '11 You .u.t co..pleh PART ~ and/or PART [J below. PA~T ~ If you indicMte a different tax rat., pl.... .tate your relation.hip to u.eedentl ,!,,~~ ~E'!'LI!t~ - C~HPU,!,.A.,!,!C'~~ 1, Data E.hblhhad 2. Aecount e.l.noa 5. Percent T~~abl. 4. AMOunt Subject to T.~ 5, Dabt. and noductiono 6. AMount TMXabl. 7. Ta)( Rata 8, T.~ Due t'!=' '!'!'.~ !'~ .":'!~'!' 'Tp'IY~T !H~~!,"'I~T! 1 2____ .Iull S :i;,. KiT 5 v --- T:l5-:otj' -"--[::;iY' \ ~~_. 4__ __"". ,__L iL.. 5 - -f)' ----.-"..-.C':r-- 6___ ._;.2J"J.f_U,L~___ 7 .....lL-u.,I~-- __._ 8_ i]I'ii,:jS_ DEBTS AND DEDUCTIONS >OfFICfAl U~E ONLY OA~~! PAI)EPARTI'IENT... OF REVENUe......... >!,! :=-....r. -- LINE 1 2 3 /I 5_ .., ,'''''''' ,c,: '~~ ,:.)! ,...-.. '" '7...;.;...~_---. a , ---......! --- PART I!] DATE CLAIMED PAID --~ PAYEE DESCRIPTION AMOUNT PAID , -----' TOTAL (Enter an Lin. S of Tax - Conpuht 10n>> I . - -- Under pen.iti.. of parjury, I aeclare th.t the fact. I cOMPlete to the beat of MY knowledge .nd b.Uef. ~ER~I~~ " h.ve reported abov. .~tru., correct and !i!lJ1L.1.7/7) 7~ ~/J' c:2 ,~ '1)1 WORK ( ')' . TELEPHONE NUMBER DATE . - .-,-... .~AM ~ __ ,'r"'f II . . GENERAL INFORMATION 1. FAILURE TO Mf.S~OND WILL MESULT IN AN OFFICIAL TAX ASSESSHENT ,lth ...11,,,,,. 'n\.r.,\ ..... on Inf.r..llon liub.ltttd by t.... fl,,~I.1 In.tHutlon, 2. l~rItDnC. talC tHtclOHII delInquent nine ~tt1. ,Hlrtha dlude"t', dllta of "lith. J. A Jnlnt I'CIcount I, t'I(~I. I\/en though thl dK.o.nt'. nltMl w.. ad9d .. . ..tt.r of CDn\flnlMCl.. ft. Aocounh (IMludinGl thou "lid botlHlWl hulbltl"ld .nd wita) which thl Mc.Nnt put In joint n..... within ~ ~..r prior to deeth 'rlll fully tlllabll .. trlll'lf.rl, S. Aooountl ..tllbl1lNod jointly b.t....,.. hulbend and wH. Mr. than one y..r prior to dallth Ill" not hxlbl.. 6. AC4lOW\b hald by " ct.ce<Mnt "In trult for" IlI'lOth.r or other. .,.. tllCebh fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BlIXM.. M If the IlltarHtlon and oOllPUhUon In U,I naUo. flr. corrlct ancl d..duotJonl 111" not b,lne clllltttd, PhHI' ." "K" I" bloak "A" of Pert 1 of the "T8lCplylar Rupon..u IltCtlOf'l. $I.., two copl,. Bnd .~It th.. with y~r ehMk for the IIWOUnt of taM to thl! R.gllter of WUle of the t.ounty ind\cat..d. TM PA D.partHnt of N.vllnUe will i..ue un offlcilltl .1II....."t (Fora REV-1S048 EKI upon rHelpt nf th-'I rflturn froe the R-vlltar of Wills. 2. BLOCK' - If thtl ....t J.pMIHad on thll notlca hili b.." or will ba rapart.d and hlle paid with the Penn')llv~11'I Inn-rUanea hM Raturn filad by thl d.o.aant', re~ra"'lhtlve, p1llic. an "X" In block "." of Pllrt 1 of the "TaKplyer R..pon.... SlIOtlOO. 51., OM COPll and r.turn to tit. PA O.partont of R."It1U4l, Bur....., of Indlvlduft~ TalCa.. D~t 280601, tierrhhurCl. PA 1112a-n601 In thft 8nvalopl provided. J. BLOCK C - If thtl notle. Infor.atlon I.. In(;Orr.C1t and/or tt.duotlon. IIr. being CllaJ..d. chick block "C" end cOllPl.t. Plrtt 2 end J t.:.':'Oli'dlnio t~ tha lr,jtn.l':~:lOn:: t:;1..1oi. :lw.' t;.;o ,:\iph;;, .:l:-.~ ",..bodt tl",;,,, ~~th :J;):';,' eh~:;I, for tt,.. ~:.=ur,t oi hl: ?:l:;3::'1:: to. tha r,l,;gbt;.r of NUll of thtl eounty Indloatad. Thl PA OapartllQt1t of Ra\llnu. wll1 IlIu. Itn offlolal auaUMnt (For. REVM154a EXl upon r8CIllpt of thtl r.turn frOll tha Rqhtar of Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE L Ent.r tM dlit. the &cOOU'lt orllAnallll wa. o.tlblllMd .or tlt1ad In th. .ann.r 'Mhtlng It dlllta of alth. NOl'EI For II deoedant dlllne after lUll/aZ: Accounts whlc.h tha dentd4mt put In joint f\MIII' within OM (1) )I"" of esa.th are t~MDbla full)l al tren.fe,... How.ver, thlr. II en .Molu.Jon not to 'MCOad .S,OOO p.,. tran.f,r.. r...rdlals of the vnlua of tha acCCiM'lt or tha ~r of IKlcOU'Ih hald. If a doubh astarllk (....) 8PPIIar. wfer. your- flr.t n... In the Mtdrtlu portion of this notlc., the n,Ooo 'ltOhl.lon already h.' bHn daduot.. fro. th. 8Ct.:ount balWl<i. .. rapol"tad by the flnancJal In.tltutlon. 2. Enter the tut.l balanc. of the IICCount Includlna Int.rut IICCrlMO to the data of death. S. The parcent of the eceount that 11 tlxablll for tflKlh survl\lor h o.tarllIned III followlI A. TtMt percent tll)(lbll for jotnt 1II~.h utftblhhed DOr. thM 01\8 y..r prior t.o thtl dloIldW'lt.. denthl 1 DIVIDED BV TDYAl t<<.MBER {'If JOINT OWNERS EM_I. I A joJnt I..llt raghtsrad DIVIDED IIV TOTAL HIA1IER Of' X 100 . PERCENT TAXABLE SURVIVING JOINT OWNERS In th. n... of the daud."t and two other par.on.. 1 DIVIDED IV S (JOINT OWNeRS) DIVIDf:D BV ~ (SURVIVOA$) . .161 X 100 . 16.7:( (TAKABLE FOR EAell SURVIVOR) a. The par-oant t8lt.ol. for 1I..0t. erllat,d within on. yaar of the dee.dent'. d.ath or accounts ownId by the d6C~t but held In tru.t for anothar IncUvJduaH.) (tru.t bwMflcJ.rJuh 1 DIVIDED IV TOTAL tAAtBER OF SIJtVIYING JOINT OWNERS OR TRUST IENEFICURIE5 X 100 . PERC(NT TAKABLE Ex.,.l.l Jotnt IlCCount rqhtsr'd In the MIll of t~ dHerJant nod two othar par.on. and utlbll.tlacI within on. lIPr of da,th by tMdM.....t. 1 DlVIDED IV Z (SUNIVQRS) . .SO K 100 . SO:C (TAXABLE FOA EACH SURVIVOR) ~. The.-aunt .ubjact to tlM (lJ"a 4) J. datar.JnId by .ultlplylng the 1I0COunt ~I~. (line 2) by tha p.rc~t t'Mebl. (line S). S. Enta" tha tot.l of thl d.tl'" and dIIduotlon. IlItH In Part ~. 6, ThII MOUnt taxabta (Una 6) 11 dlltlralf14td by lootrltCtlna tntl deu and cNducuon. ~J.tl'e SI tr~ the MOUnt ,uoJjaot to tax ellM itl. 7. Entar the appropriatl tlM rate (llnl 1) !II datareined bel~. A. For data. of dnth cccurrlng Iftlr 61!O/~. thl tax rat.,. fnr tran.far, to .rou.a. Irs It folllMilll 1. DlIlt.. of duth on or aftar 111/94 and bafore 11l/95 th, retl 11 1:(. Z. Dat.. of delth on or _ft.r 111/95 tr."fer. to 'POO'" will ba tawed at 0;( t.x rlt.. Not'l For det.. of delth prJor to 1/1/94 tran.f,r. t~ .paus.. ~rl tlMehl. at 6~. I. ~ran,f'r' to llnaal dI.cand~t. Includlna f.thlr, lothar, .on, daughtar. Grandchildren, .on-In-lew, dau"ntltr~ln-lllW, .tapchlld and thair hlUll Ir. tlMabl. at .1M percMt (6:CL C. Trllrl.f.rl to all other. looludlno bl"oth.r. .I.tsr, unci., aunt, napn.w and nlacl arl taMabla It flft"" PIIroartt (15:0. D. If YOU chllnGe tha hlC ,.ate, pi.... .pae!f:>>, your rellltlnrllhlp to ~he ~.....t In tIM ar.. pl'ovldac1. .. TM MOUnt of taM due HlhII 8) It d.t".I".d by IIUlt1plylng tha 8ItOoot 'aK801. (111'1. 6l by th. taM rite (Une 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabla dabt. and d,ductJon. ara dat.r.l~d ~. follow'l A. Vou legally ~r. re~IJble for plyaent, or thll esteta .ubject to adaJnl.tretlon b:>>, I par.onal rtprl.entatl\l' I. Intufflolent to ply the deductible It.... a. You "tuaJh pnJd the debt. aftar dIIath of t~ dacl.dlMt end elM furnllh pro!')f M plyeant. C. o.bts b.ing chilled lU,t bel itulud fulh In Pllrt J. If additlonli ,pIICa h nHdId, u.e plain pllfIIIr II l/Z" IC 11". Proof of p~lIaant 'I~ ba r~.tad b~ tna PA o.part.-nt of R.Vaoull, ...................... ...... i. .\ TAXI'AVER ASSISTANCE .. '.. ... ...... 'i. .... ........ ....... III YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV...i i. RE6ISTER.OF WILLS. . PADEPARTMENT OF REVENUE DlSTRICTOFFICE"<. OR CAll THE lIUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN . .... i/ HARRISBURG AT (7171 787-8327. TDIl. (717) 772-2252 (HEARING IHPAIR~Il(J~WV _EOF NOTICE I PI\VI<<NTI REFUND (eR) I ~(j _, m. -,- .. 'rl .......J ::n :1" hi j.''-~ ffi - ",. :>J I" it, {', .u: .J.., ....~ " .~ N To fulf111 thfl r..lir...nt. of botlon 2l~O 0' thl Inheritlnet and Elt,tIt h)C Aot, Act 21 of I99S, (72 P,S, Slotion 9140), Deteon tM top portion of thll Notiol end lubllit ",Un your p.~..nt to tt,. RI,ht,r of wl1h prlntld on the rlVlr.. IldI. -- ~. check or IOn.v or~r plv.blt tOI REGISTER Of WILLS, AGENT. A r.fund of . tlK crldlt, whioh WI' not r.queltld on the tl. r.turn, ..v bu r.qu..tld by co~l.tJnp In "Applloltlon for R,fund of Plon,vlvlnia Inheritanol and E.tet. rlx" (REY-ISIS), Applioatlons ar. l"'al1Rbl, It thl Of,loI 0' thl RIgllt,r of WJ1l1, any of thl U HI....nuI Dhtriot Offlo.. or by olUlng thl ,plol,1 ZIt"MUt an.If.rlne "r'/lo. nuIlb.r. for for.. ordflrlngl In PIMlvlvanla 1-800-36Z-20S0, out.ld. P.nl1.yll1anl. Ina .,Hhln 100.1 H.rri.burg .r.. (111l 181-8094, TOOl (117) 772-2252 (H..rlng I.,alr.d Only). O.JECTlONSI Any p.rty In Interut not ..thUed .,lth tile "Ppral....nt, l11owano. or dl..UoltlltMl of d.duoHon. or ......ant of t.~ (Including dl.count or Int.re.t) a. .hown on thi, Nottee .a~ Object within .IMty (60) day, 0* r~o.lpt of thll Notloe bYI --",rltten prote.t to th. PA D.p.rt.ent of R.venu., loud 0' App..lI, Dept, 281021, H.rrhburg, PA 11121-1021, OR --el.ctlng to hevI the ..thr det.r.lned at tn. ludlt of the locount 0' tn. plr.onal rIPr...ntaUv., OR .-epPI.I to th~ Orph.n.' Court A!)MIN- ISTAATIIIE CORRECTIONS I DlSCOUHT I PfNAL TV I INTEREST I Featuel .rror. dl~tov.r.d on thl. 8.......nt .hould b. eddr.,.ed In writing tOI PA D,pert..nt of R.v.nue, lur.eu of Indlvldull Ta~.., AlTNI Po.t A.......ht R.vl.", Unit, DEPT. 280601, Herrl.burg, PA 17128-0601 Phone (117) 787.6505, $.. pIg. S of the bookl.t "In.truotIon. for Inh.rltence TaM Rlturn for. R..ldlnt Dec.dent" (REY.lSOl) for an .~pl.natlon of ad,lnlstratlv.ly corr,ot.bl. .rror.. If eny tlK Ck_ I. PIld within thr.. (]) ell.ndar MOnth. .,t.r th. d.o.dent'. de.th, . 'Iv. pere.nt (SX) dl.oount of the tax paid I. allowld. TM ISi< t.K MM.h non-p.rtlcdp.tlon pinel tv 11 COllPutlJd on th. tobl of the t.~ .nd Int.r..t .......d, and not Plld btIfore Jenuerv la, 1996, tha fir.t d.y .ft.r tn. .nd of the tu un"ty p.rlod. fhll non~p.rtlcipIUon pe"eJty i. app.elabl. In the .... ..nn.r and In the the .ew. tJ.. period a. ycu wouJd .PPIII the tlK end Intlr..t thet he. been .......d a. Indicated on thl. not lei. Inhr..t 11 charg.d bealnnlng ",lth fll'lt dey of d.llnqueney, or nine (9) .onth. and on. (}) day frol th. dati of doeth, to thl data of payaont. TIXI. which blel.. d.llnquent b,'or. January 1, 1982 b..r Intere.t et the rata of .hI (6%) pa"OInt plr annUlI caIcuht.d at I dalh rate of ,000164. All tax.. which b'(I~" d'llnqu.nt on or aft.r Jenuary 1, 1912 will be.r lnt.r..t It . rat. which will v.ry fr.. cellndor year to cII.ndar y.ar with thlt rata ennouno.a ~y the PA DlPlrt..nt of RlvtnUe, The appliCable Jnhr..t rlt.. for 1982 throUlIh 1991 er.1 V.lr Interut Rlt. ~Ih Int.r..t Fector V.er Inter..' Rata D.lly Inter..' Factor 1962 ZOX .000541 1987 OX .000247 1'83 16i( .000458 19U~1991 11% .000101 1914 lli< .000101 1992 'X ,00OZft7 1915 lli< .000156 19']-1994 ]X ,000192 1.86 1Oi< .000274 1995..1997 'X ,000241 nlnttr..t 11 c.lculrlt,d .0 follow'l INTEREST . BALANCE OF TAX UNPAID X NUNSER UF DAYS DELINQUENT X DAILY INTEREST FACTOR .~.nV Notice I..utd .,ter thl teK b.co... d.llnqu.nt will r.fl.ct ~ Int.r..t c.lcul.tJon to fl,te.n (IS) dav. b'vond thl det, of thl ........nt. If pay..nt I. .ede .ft.r thl Int.r..t cn~putltlon dati .hown on the NottcI, additional Jnterl.t au.t b. celcul~t.d. PIJRPOII!:llI' NOTICE, PAvttEHTt REfUMD (CfI) I To fulfill the f....dr..-nh of hoUon Z14D of the Int.rit... Ind E,t.t. TIM Act, Alt 21 0' 1."1. (12 P.'. IeoUon 114D1. DtteGtl the top pert Ion of thl. NoU. MIl NMiJt wIth YOUr p.vwnt to the Rlttl,ter of Willi prlntlld on the I"8Wr.. .lde. .... .... oMok or MMW .Ntt,. P')'IIblo t01 REGlIITD II" MILLS, AGENT. AU P41VIMf1t1 r..lyed _11 fir.t DfI ...1IM1 to Wly lnt.,...t tfhloh "\I bti M, with ~,I "..lnd.r ...Ued to tM tfbt. A nfund of . tu cr~1t, which .,... not ,...,.dfld on the to)! nturn, all be r..,..ted by cOIlpl.tI", ... "&PPllOlltlon for ftllflA. af ""'wlnnl. Inhsrlbncl Met bt.h Tax" (REV-UlS), Appllcltlons .r. ~.llllb.1e It tM Office of tM R....t.r of Willi, art:'f' af t~ 13 Rlvotf'ItH Diltrlot Offlc.. Dr by clnlne tM .-cll. Z4~hour .,....,..,... ..rvlo. rw.berl for for.. otdtlrlngl In J'lfIW1I'l.~lv.,h l-Ii)O"S6Z-ZD50. nuhlde PWV1.ylvllnl. WId within 1~1 NII,.,.ltlbur. Ir.. (117) 1I1~ao", lOO. (7171 'f7Z-ZZSr. ct....rlng IlIful1r~ Only), DlJECTIOHII Any t*rty In Intor..t not ..thfhtd with ttM IIPPr.l....,t. .1l~. or dllMlllowwtctl of rteducltlon. or ""'lIMInt of tax (Jncludlnw dlfCOU'1t or illter.lllt) .t. IflOWn on f.hh Hotioe ":fI ub.teoot NithJn .hety ('0) dIlw. of r.-Ipt of tit" Mot1oa b., I --writt., prot..t to the PA De,li1'tMnt of R.WInUa, Io8rd of ~ll, Dept. !l1O1l, "'rrllbur" PA 1711.~lOZl, 011I h.laoU", to haYe ttMl ..tt.r ater.lMd ..t ttMl .udlt "f' ttM llCloount of thti per.onel repr..Wlt.UVIJ OR h.....l t(l tM Drptw\..' rourt .....IN- IITRATlYE COllECTIONS I DJ SCOlIfT I PENAL TV I 1NTERE':1t1 FllClt~l .rrora dhooy.rN on thh .....uant Ihould be flddruHd In wr 1 tine tal PA ~rn.nt of RIlVInUII, aurl'" of Indlvlduel TaxI', AnNI Po.t AI"'lIMOt R....l... Unit, DEPT. Z10601, Hlltrhbura, PA 17128-0601 Phone (717) 7U-6S05. s.. Pitt 5 of the bolMc.let "InttruoUon. for Inhal"lhncl 'ex R.turn for. ".llNnt OeoIdent" (REV-ISOI) for In IXpI~tlon of .a.lnlltr.tlvelv corteetlble .rror.. If ":fI tv: dull h Plid wHhln thr.. U) eel"'r IIOnthl .ft.r thl decltdent'. dHth, a fI.... peto....t (S:Cl dl....,t of tt. tfI)l p11ld 11 IUOMM. The Ira taw ....ty non-partlclpaUon PflMlty II OotlPUt.- 0fI the totll of the tp .. lnter.ltt .....ted, end not paid "for. ..-."...r)' II, 1996, th4t flr..t ca." IH.r ttM ond of the tflx ""'lIty period. Thh non-p.,.tiCllp.tlon peNllty h 1IPPH11lb11 In thI .... MnMr end In thtl ttMI "... tI.. period "' you MOUld ~l tM tax IInd lnt.n.t thet MI been 'IH... .. IndlClltN on thh notlr.l. Int.r..t II charltl'd begl,..,!", with Ut.t .w of dell~~, or nlM (9) IMinth. end one (1) dIIw ff"Oll the dIIt. of dHth, to thI dIIt. of PIlY'Mt'tt. h... Nhloh bawM dlallnquent blfore -MnuIIr)' 1, lMZ hAr intlr..t .t the r.t. (If II. (6X~ perCl4llnt per antMl O1II(lul.tlMlllt a dalll~ rete of .000164. AU tax.. which beceM dellnqwnt 011 or tlft.r Jenuftry 1, 1912 ..Ul bMr loter..t .t . tat. Nhlch ..Ill WIn fr_ ClIllendlr ....r to eelender y..r wIth that tatl ~Id bW U-.. PA o.p.rt..-nt of A.v........ The 1IIPP1I0Ih1e Int.r.~t t.t.. for 1982 throuth 1991 'rml ~ Inter..t Ratti ~Intlr..t F~ V.er ~~ o.lb Inter..t Factor ..- 1911 tOX .000,," 1911 n .000241 I'" I'X ,000411 19M-1991 m .0ODSIl I... IU .0ODJOl \992 OX .nOOU7 19.. Ill< .0DOI56 1995-19M 7ll .UOOlft I... lOX .DD0214 1995-1"7 .X .000147 --Inter..t 11 eeloul.tN I. fnU"," IHTER1l8T . ..LAIlCE OF TAll MAID n HUIIIER Of' DAY. DELINqUENT X DAILY IIn'ER.UT FACTOR "-N'lv NDtlClII 1~1UId aft.r the tQIil becoMe .lh~t ..Ul refleot In Inter..t .lcullUon to f1ft..., (11) deVl lMlvond the date Df tM ...H.....,t. If fWlYMnt II ... after the Int.r..t ODIIPUtlUOf1 dlt. Ih1*n on tM Hotlel, additional Int.r..t lU.t be cIlculetld. '..~,', " ~Ol' NOTIa: I PAvte.MTI mum (CA)I TG fulfill the requlr..-nt. of StGtlon !l~O of the Jnn.rlt~. Ind E.t,t, Tax Aot, Aot rz of ."1. (71 p.r. IoGUon 1I401. DetHl' the top parUCll1 of tttl, Notte. Ihd ....tt ldttt your pQ'Mnt to ttMI R..,.tt,. of Willa printed on tM r.""rM ,... UM .... oheok or ItOt'MIW order pIYlblt tOI FH!:QXIlER OF Wlltll, MlEIf'T. All "YMntl rlMMllvect ..11 fl"t bel ...Ued to .,y Int.r.,t which _~ H due, with WlY ,._1,.,. .,.l1ad to the talC. A rlf\rld of . tax or.cUt, which w.. not r~.tlMf on the tax return, ..., b. rtqut.tlld by ~l.t1". WI "~1to.tlon for R.flRl of hnnllylVWlI, InMrlt~. Met E.t,te Tax'" (RE~~UU). Appllutlonl Ire avtlllal, It tM OfflCtl of ~ Regltt.,. of Will., any of the 23 Rlvenye Dl.trlct OffiCI' or by allIIn; the ~1.1 Z~uhour ln~rlnt ..rvlel "."...rt for far.. orMrlngl In PefY1lylVIIOI, 1.IOQ-SfIl-Z050, ouhllM P"""'Y!vIlnI, at1d within 10081 'Mrrhbut'. '1''' (717) 711-1094, TDOI (7111 nZ-ZZ!iZ (....rlna IlllPllred Only). OUCTIONSl My Plrty In Int.r..t not ..thflad with tt'l4l IIftPr.h.....t, .llc.t.l~. or dh.llowanc. of deduction. or ........"t of tM Unoludlnt dllWlount IJr Int.n.U .. Ihot/In on ttlll Nettle. ney objMlt .lthln 'IMb (60) cMY. of reo.lpt of thll NoUM bVl . ~~wrltten prot..t to tM PA OIflllrtMf1t af RevlW'IUC, IoGrd of Appelh, Dlpt. 2IlD21, Hcr,'llburl, PA 17121-1021, OR --&lectll'lfl'to have the ..ttar detl".lned .t 'thlt eodlt of the .ac04Jlt of the p.rJOO.l r~r.....t.t1v., OR --....81 to tt'I4l Orphwl.' Caurt ADt:If'l- IIWnYE CORRECT IONS I DISC:OlIlTI PENAL TVl INTalEST I FMtu.l .rr-Ort dbcoverMl on thh ........,..t Ihould tM .ddr....d In wrltlna tOI PA o.p.r~t of R.v......, IYtHU of Indlvldul.l Tax.., AnNl Po.t Au..sant Movl.., Unit. DEPT. 280601, ttlrrl.tturll, PA 17121-0601 PhoN (717) '.7~65flS. Sell p.,. 5 of thtI booklll1. "In.trucHon. for Inhttltlno. Tax R.turn for. R..ldent o.c.dInt" (REV-lSOl) far en 'l<Pllf\11tlon of IdIIlnhtr.tlv.h' corrilkltabl. .rrar.. If My t.M due II peAd within tht.. (l) CIll~r IIOf'lth. eft.t the tMc**'t', thIlth, . flv. percent (s;(l dhoount of tt'l4l t'lH peld II eUlMfMI. The 15le taM ~.ty non-p.rtlclIp.Uon f*MlI ty II CCJlpUtld on thI tabl of the tax Itf1d tnt.rut .....Md, Ind not plld blfor. .tanu."j' II, 1996, tlw Utlt uy .ft.r the tnd of U. tll.l( ....ty period. Thll non-~rUolp.tlon ~1 ty II .....bbl. In the ... IIlVW'ltIr end In thll the .... tI.. period I' you WOl,11d ....1 tM tll.l( ... Intlrut that hili b-.n IIl1uHd I. IncHc.teet OIl thl. notlu. Jr.ter..t Ia ohIItltld beginning Nlth Urtt .y of delJnquencw, or nl,. (9) .unu,. tnd ant (1) dlw fl'OIl the _t. of dMth, tu tn. ct.t. of p.vwnt. Texe. Iilhtcn be(l... dellnqutlf1t befo". JWlUllry 1, 191t. bur Int.rut .t the ret. of .he (6~) ptIrollflt per ~ c.lc:ul.tld .t . nUy rete of .000164. All tax.. Iilhlch ~ delllnquw'lt on or ..Her .J~ty I, 1911 Nlll bMr Interut .t . r.t. Iilhloh NIJ1 very fr. eGlt"r y.." to e.lenct.r w..r Nlth that r.t. ~4td by thtI PA OIpertMnt of R.vlnUQ. Tt'I4l tpplloabl. Int.r..t ret.. fot 198Z through 1991 .rel V.., Int.t..t Rat. o.lh Inter..t Feotor V.., Inter..t Ret. !Nlly Int.r..t Feetor I'll' 'OX .000!i4. 1917 o. .000241 19&' lOX .ooooa 1'''-1991 II< .00OSOI 19&4 11;( .000301 I.., 9. .000241 1915 n~ .000556 1995-1990\ r< .GOO192 1916 lOX .000l74 1995-1997 9. .000r41 ulnt.,..U 11 c.lCtJleted .. followlI INTEREST . .ALAHCE OF TAX UNPAID X NUHlER OF DAya DELINQUENT X DAILY INTEREST FAero. --Any Notice hlUlid Jlft.r the tlLlC MoOM' dell~HW'lt will ,..f1~t WI Int.,...t calculatlon to flftHn US) de.... bclyond the chit. of th8 all.n.."t. If p.pent It udII II!Ifter the Int.re.t COIIpUtltlon dIlt. IhoNn on the Notlc., ~ltiDn81 Inter..t au.t be ealcul.ted. PIIIPOIE OF NOTICE. PAYII!IIT. Rf7tHJ (tR), To fulfill tM ,...........,h of SectSon 2140 0' thtt InhtlrltlnOe end Elut. Tax Act, Aat 12 of 1991. (},2 P.I. Sootlon 21.0), o.tIIOft U. tap por-Uon of tflh MoUe:. WId ..It with ~CM.lr P8!1M1'lt tn the R....t..,. of WUb printed on t:M ,...,.rH 11_. -- HIk, chltc* or ....y onMr "._1~ tOI REGISTER OF NILlS, AGefT. AU p.'tMI1h reQ81vN .....11 flr.t be ...1.1. to InY tnt.red Mtllch -v be elM, with WI)' r...lnder lIPPllld to the t.x. A r.ftm of . t81( ClrecUt, IIhlOO wu not rltqUe.ted on the taM ,..turn, IiRIV tHI r~'llt1W:l by COIlPl.Unt M "Appl1oatlon for Reft.r1d of p...,llylvlJnla lnl",,.1t1lnCfl IInd Eot,t. Ttut" (REV-Ull}, ApplicaUon. er. 1lv.J1mble .t the DUlce 0' tha RHhbll' of Wllh, My of ttM 2~ RevMUQ Ollt,.."t OHio.. or by caUlng thct IJ*lhl 24-hour In'Nerlne ""vie. nuIltNr. '01' 'or.. or-rt.rlnCiI In P."".ylvanlll l-eOO-36l-Z0SCl, ootllde P."""yl,,-,le .w withl" loc.. "'rrltbllru er.. (711) 711-110", roDt (117) nZ"215l CHeletlllll Illftlllr..:J Only), OIJECTlONSI Any parb In Inhrut not AlbfllMl with the lIppr.l...."t, .ll~ or dlQl1owenct1 of aduct1on. or ........ot of UK (Jnaludf,. dJ~t or Int.r..U .. IhoNn Ofl thh NoUe. "Y ubjMlt within dxh (60) chin of r-.celpt of tilt. NoUOtI by, uNI"Utln prat..t tQ the PA U.lrt.unt of RIV~, Board of Appall, DIfIt. 211021, .ttrrllbur., PA 171tl~1D21, OR .~.l"tll'l8 to heve thl ..tbr dltlr.lnod .t the audit of the ItCCOmt of tM ptlrlOmlll rlflr"lntlt1V1, OR n-l'IPPNl to the Orphens' Court .,IlUN- ISTRATlYE COftiECT1OHS l DIscounl PENAL TV I INTEREIT I flMltuftl .rrol'_ dbcov.rtld on thb .....lIMnt 'Ihou1d btI BddruMd In NrUlnu to: PA lkIp.rt.."t of R.vtM'llJll, .UI""" of Individual Tax.., A11141 Past ......MI'lt R.vl.., lkllt, DEPT. 280601, Hanhburg, PA 11'12'1-0601 PhonI (717) 117-11505. s.. P'" 5 of th8 bookl.t -In.trl.Mlt1onl flJr InhtlrltMC. T.x R.turn for. R.tlctent Dlcedent- (REV-15011 for ~ Ixplanation of "'lnhtMlt1v.ty corl'tKIhlblo '1"1"01"1. If My tlbC ctu. AI p..!d wIthin thr.. (5) <l.l....r ItOnth. .'hr the dlIoedw1tt, datlth, , flv. percIMt (5;0 di~t of thI tu peld It .Uond. The lSX w --.tv non-ptIrUoJpetlon peMlty II ~tlld on tM tot.l of the tax II'id Jntltrut .....nd, ... not r'4ld befor. Jenuery II, 1996, tM flr-.t day _fter the ..MI of the taH __.~ Plrhlld. this notl-p.rtJnJpIUon p.'\Ilty I. lIPP"~~l. An thIi .... ......1. .'Id In the the .... tt.. p.lrlod .. YOU would -weal the tlllC Iitld 1nt.r..t thet hili bMn .11...'" .a IndlCltlld on thh notte.. Inter.at II chlrged blitlnn1ne Nith fI,..t dliy af 6I1Jnquency, or nine (9) IMlfltha 8nd OM (1) day fr_ thI deta Df ..th, to ttMI ca.t. of paYMnt. TlUClU whIch bIc8n dttllrMfUlOt blfurI .itnMry 1, 191! MIll" Inhrllat .t the rat. of ,1M C6X) pe"Cllnt pilI" Itnl'M. calcul.ted at a d8Uy rib of .000164. AU t8x.. whlu, ~ dal1nqlH1flt 00 or aU_I' J8nu0,.y I, 1912 will bMr Inhr..t at a I,.t. which NIll v,,,y frDII 081endlr y..r tl:l eIIl"'r y..r Nlth ttMit rata ~1Kt by thlt PA o.plrbMnt of RavlflUtl. 1lMI 1IPfI1Icllbla Int_rfllt rat.. for nit through 1997 .re: V... Int.r..t "-t.. DIlly Inter..t r*-tor V..r Inta,.a.t Rate DIl11y Inhr..t flKltor 1911 'OX .01l0S43 1911 'X .000l!47 1983 lOX .0000& 1968~1lJ91 llX .000301 1'" nx .000301 1... OX ,000247 19a5 In .oaosS6 1993~19" n .oa0192 1_ lOX .aDU74 1995~19'9" .X .00DZ47 -~Inter..t h Cllcul.tlld .. follow.I INTEREST . BALANCE OF TiX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notlctl IItN1d .ft-et tho tate baooM. dllInquent HIli rafl-.ot ., lntar..t calculation tl'l flft..... US) .VI ta.Yond the data of the .SHI..."t. If paY88nt .. Rdfl Iftlr thtl Inter..t c:~tatlon dfIt. Ihown on tM Notice. addltlOOllA Interl.t lUst bI calwllted. PUIlPOIl! OF NOTlCf:, PAVI1FJfTI RUlICDCCRh To fUlfill thI rtqUlreeentl of teotlon 2140 at the Inhtrltenoe ~ E,t,t_ Tax Act, Aot II of 1991. (7f P.I. "'Uon mOl, bltech thI top portion of thh NoUOI .... IlMIt wlttl your Plvwnt to the Regllt.r of WUlI printed on tn- r.vI...' 11d1, R. .... oMok or 110M)' order Plnbll tOI Rt!gIS11!R Of MILLS, AOEf(f. All pca,..,h nCllved ....U flrllt be 1IpP11ed to IIIn)' Int.r..t Which .v be due, wIth WI)' r...lncMr ""lied to the t.x. A r.fund of . tax credit, ....,lctl .,.1 not r~.ted on the to return, MV N rltqUeltad by COIIfIIIU" In "Appl1Qt1on 10" A,fund of PlWlf'llYlv.,t. InherJt~ Wld ht,t. Tax" (REV~lSlS)' Applletltlonl It'. DY1Ill8bll It tlw Offlol of .". ...hhr of NUh, ww of till Z5 Revenue DhtrtClt offt~. or by calling ttM ..,.e111 24-hour ."....rl". Hrylol ~r' for for.. orderlngl In P~.ylvanJ. 1-800-562-2050, out.lde PennlylYBnl1 and within local ",rrtabur. .r.. (717) 181-6094, TODI l117) 712-'/.251 m..rlf'lQ I.llrK! Onh), aaJECTIONSI Any p.rtv In Int.r..t not ..thfl~ with the eppr.h-.,t, .UotMI'IOe or di..l1owatlCI of dMuot1on. or .......wIt of taM Clndudlne dllMlount or' InhruU .. -.own on thh Hottol ..v obj~t within .bty (60) daVI of rHe1pt of th11 Notl~ tlYI ' --",titt.,.. protnt to tM PA Dep.rhw'lt of R.yWllM, aoard of Appeah, Dept. Ulon, ",'rhburl, PA 11128-1021. OR --.I&C1t1ng to MY. the ..tt.r dehr.lned ct tM III,XUt of tM eoCOIJ1t of thll per.MIII r....r...,t.Uv., DR --.....1 to thfI Orphwt.' Court A.DttI"~ IltltATIVE CORRECTIONS I DI ICOlJfT I PENALTY I IN'rERElT I FMltuu1 .rror. dheov.rltd on thh ....r..ant should bIi flddrrnlld In lilr1tlng tal PA o.q..rt.....t of R.venue, lur..u of IndJvldu81 Ta~I', AT1~1 Polt A......-nt Alyl.w unit, DEPT. Z80601, Marrllbur., PA 111Z6-0601 Phone (711) '''7-'505. s.. PIIgfI S of lM booltht "In.truotlons for Inhtlrltano. Ta~ R.turn for a R..ldent t\ecedent" (RI!V-15Dl) for WI expl_tlOfl of "lnhtr.tlv'h corr.ctebl. .rror.. If WlY tp: duI II paid within thr.. (5) c.lender MOth. aft.r tM decadent'. death, a flva ~r\lent (5'0 dlSCOlllt of the tllX paid h 11lotMd. The lSX t'l( ....ty flOf'I-p.rt.tclplltlon flenlllty is COIIlpOttld on the tob1 of the taM end Intar..t a'H.Md, Met not paid befora .-nu.rll II, 1996, the flr.t dfI~ Iftar thII and tlf ttM tax ..,..ty period. This non-partlCllptltlon pen81 tv I. .....llIbl. In tM AM ..-.ner and In tn. th4t .... UIM period In yOlJ WDUiC'i IIPPHI t:ha tax ... Int.r..t tJ\Ilt hlil bfIIn .....Ud .. IndlOlltacl on thh notl~.. Int.r'1t I. cher,.. b.glmlng lillth flr.t MV of dIIl1"...,..ev, or nlna (9) lanth. end DnII (I) day frOll the dltl of dNth, to the dlts of P'YMflt. Tpn which ...... dlIllnquw,t befar. .MnuIiry I, 1912 baar Int.rut at thIi tltl of lhe (6;() porcWlt per ~ c.lculattld lit II d11llv r.tl of .OnOlM. All talCe. which beceM dalll"lqUW1t 011 or after ~ry I, 1912 will baar Intarnt at a rata which ",111 YIIry frOll CII1andar v..r to oalannr _..r ",Ith th8t r.ta annolnCad bV the PA o.parn..nt of RlvlinUlt. Th. IIPPlloebla Int.rut rllt.. for 198: through 199' .r., V.., lnt'l'e.t RIte Dilly Inhr..t Fecltor Vear Inter..t RIlte Dilly Inter..t FlMltor 1.12 m .ooos~a 1911 'X .000U1 I"S 16X .OOOUI 19N~I991 IIX .ooonl 1.14 IlX .000li01 .992 OX .0002U 1915 ax .000156 1"~~1"" 71( .DGOI9! I... lOX .000U4 1995-1991 'X .000141 ~~Inter..t I. celculatad .. follovll INTERElT . 'ALANCE OF TAX UNPAID X HUKlER OF DAYS DELINQUENT X DAILY INTEREST FACTOR hAny NotlN hlUld aftllr the talC bK_I dall~t wilt rllfle<lt WI Inte"ut cllculatlon to flftHn (15) day. beyond the drltl of tM .....u..nt. If paYMnt II .... .fter the Int.r..t cNpUtatlon "'11 Ihot<<l on the Notln, IMXIltlOMI Int.r..t ...t tMl "Iout.tld. _llI' NOnCE I PAVttElffI AEflJID (CR) I To fulfill tt. ,.....lrlllenb of hotlon 2140 of tM IiYMritww. _lei E.t.t. TalC Act, Aat ZZ of .991. (72 P.I. hotJcw\ 2141). o.tMh the t. POI'Uon of thh Notic. ~ IniMIlt with vnor P.YHl'lt to the A.,hhr of Nlll1 printed on tN rlv.r_ .Ide. ~~ .... Clheok or IMWMlV 0"" pQllb1a to. ~GlSm OF WILLS, MEJrfY. All plnentl reoet..... IhaH flrlt be 1Ipp1,led to eny lnterlllt tthlch ..y tHt ctu., with MY 1"..lndt,. ..Bed to the taH. Ii ,.afurld of . tlb' C1redJt, which Wft. not r..-,ted OIl u.. tax raturn, ..y be r....tH b>> COllJlll1t!ng 1ft "Appll~tlon for Refw'ld of p-.,nlYlwnla Imer1tMClll .~ E.tlt, Tu" (lIfV~un), "'1J~Uon. Ire IVIUl'hh at the Office of ttMl R..htlr of W11l1, .,,, of tt.. 15 R'",efll,MI Dilt,.lClt OUle.. or by c..aUlne thtl Ipe(Ihll ~4-hour .,....rl"l Hrvl_ ~.r' 'or forMo orderl",1 In Penn,Ylvanla 1-'OO~S6Z~20S0, out,lde P~lsyly~l. Rnd within local Hlrrltbur,I,... (717) 7.'-1094, TOOl (717l 17Z-Zl5Z (Hearing I.,.lr~ Only), OIJECTXOKSI Any party In Int.red not ..thfled with the ~r.l.-,t, 111otfW'lCe1 or dl..Uowenoe 0' deduction. or ..........t 0' tex (1ncludtnl dhClOWlt or tnt.r..t) .. mown on thh Not1~ _Y obj.ct ..tthln .iKh (60) dey. of tM.lpt of tnh Hot1011 byl uNrJtt., prot:..t to thrI PAl o.p.rt.ent of R.v~, Pto8rd of AppMls, Dept. rllOn, HarrlNutl, PA 17UI-1021, OR --.IMtlr'll to Mv. the ..tht detar.IMd .t tlM iIlUdAt o' ttMa ItCCOU1t 0' tM "rSDnllI rapr..."t.Uve, OR -"epfMNll to thtI OtJ~t*'" COIJrt """IN- IlllIATl.... CORAECTJOHSl OISCOUNTl PENAL TV I ItfTPElTl FMlwll1 .rrot. dhODvllted on thh "......."t .t\oUld be MtdruMd In wrlt1". tot PA o.p.rt..."t of R.venue, I4JrNU of IndlvldlMl Tax.., AnNI Po.t .....lIMW'lt foI,l.fl... Unit, DEPT. 280601, ."rrbburg, PA 17UI-0601 PhofMI (717J 717-6505. SOlI P"- S o' ttMt bookht ''In.truotlOfl' for IfNrHence TII.lC Return for. R..INnt ~t.. (REV-IS01) for ~ .xplBn*tJon of ~lnl.tr~tlv.lv corrMlt~l. .rror.. , If MY tu 0.. 11 p.ht within \hr.. UU c.lendllr ItOI'lth. eft'r thl decedent'. dMth, . flv. percent (5:<) cU~t a' the t.M p.ld 11 "l1owed. The 10: w -...ty rkIn-p.,'Uolp.tlon penelty II c:~tlld o.n the tot~l of the t.)( and Int.r..t ......ed, WId not ptlld before .",......ry 11, I"" U. flr,.t di.lv IIft.r thti und of tt. tex .......tv parlod. Thll oon-p.rtlolp.Uon penelty .It .....ll1bl. In the ... ..,.,...r end In the tM .... tI.. Pflrlod .1 YOU would IIpPoI.I the tftX ... lnt.rest tn.t he. been .....ted .. Indl~ted on thll notlClI. Int.r..t .It chIrttd betln"lna with flr.t dl&v of dllI~'I, or nlM (9) ttOflthl Md OM (1) .'1 ft. the dIlt. of o..th, to the dIlt. o' p.~t. Tax.. which bee.-. dIIl1nquent before Jenutry 1, 1912 bMr Intlre.t at the rlt. o' .he ('X) percent per ~ celcul.tld .t . dltilv rete l)f .000164. All tak.. which bee... delinquent on or lifter January 1, 191Z wIll beGr Int.r..t .t . r.t. which will v.ry fro. cel"'r y..r to celendllr ynr liIlth that r.te IIrI'WoI.11C1ld by the PA Dep.rt-.nt of AevlNlOe. TlM eppllcMll. Int.r..t r.te. for 1911 through 1997 .rlll V'lr Int.r..t R,t. Ually Int.r..t F.utor "..r Inter..t fhIte DIlly lnt.r..t f'lIOtor nlz ZOX .ClOOS48 1947 OX .000247 1,.5 lOX .0000.8 19aa~I991 IU .000501 1,.4 IIX .DOeSOl 1'" OX .000l47 I"~ UX . DD0556 1"~-I99rtt n .00019Z 1916 lOX .001.1274 1995-1997 OX .000241 ~~Jnt.r..t 11 0II1oul.ted .. follow'l INTERElT ~ BALANCE OF TAK ~AID X HUKlER OF OAYB D~LI"qUEHT X DAILY INTERElT FACTOR uMY UOt1011 iuued .U.r the tax b.coM. dell~t wll1 reflect... Inter..t celoulltlon to flft.." (15) .!II blyond tNt dIIt, of the ...........t. If PIYMnt lit ..0. .Uer the lnt.r..t OOIlpUt.tlDn det. Ihown 011 t "lI Notice, eddltlOMll lnt.r..t Mollt be ClIlcullttd. ~OI' NOTICEl PAVItENT , REfUND (CR) I To fulfill thI r~tr...,tI of SeoUon 21110 of tha Im-ritanoe Met E"bt. TaM Aot, Aot U af 1"\. (72 P.'. IeGUon 1141). D1teoh tM t.,.. portion of thll Notto. tnd 1UblJ1t witt! yOUr PIYI*'t to the R-ultt.r of W11l1 prlntld on the r.w",' 11M. .~ ..... ClMck or ....y ONN" PtI~h tal REGUlTER Of WILLS, MDlT. .11 PII~t. ,..ollved ...11 flnt btI eppl1ed to BnY Int.r..t vl'tloh -v bI due, ..lth MY r_lnder ...111d tG tM tll)(, A rduM of . tlX oredlt, lllhlch WIll not r~wted on the tax r.turn, ..y be r......tMt bW cOllPl.t1". WI "'Applloatlon for R.fund of P.nnlylvlnl. Inherlt~. and E~t.t. TLM" (RE~-l!l!l. Appl1cltlont .r. ,wIlliG.e ~t thI Dfflol of the R,,'lt,r of Willi, ~y 0' ~ 21 Aftvenul DI.trlot Dfflc.. or by celli", the ~I.l l4-hour In~rl", ..rvloe ~r. for 'tor.. ardlwlng; In Per.n.~lv..,l. lM600.J6l-Z0S0, oubh" Pennlvlvlntl lWld within local Hftrrl.bur. .r.. (117l 767.8OM, TOOt (117) nt-USz (Hurlng II4II.red Onh), OaJECTlONII Any p.rb In Int.r..t not OIIthfllKl with the IIpfJr.h....,t, .1l0dnC' or dl..llo..1I'ICe of deduction. or .........,t of taM (Inoludlne dl~t or Int.r..t) .. shown on thl. Notle. ...,. obj~t Mlthln .IMty (60) ~.,.. of reo.lpt of thh Notice b'll ..wrltten prot,.t to ~ PA Deper~.t of R.v~, IoIrd of app..ll, o.,t. ZII021, "-rrl~r., PA 17121-1021, OR R-,lClCtlng to hawI tM .thr det,r,l,*, ,t the IUdIt of thI eccount of tM ,.rIDMI rapr..ent.tlv., OR u.....l to the 0"""1' Court ADMIN- ISTRATIVE CORRECTIONS' DISCOl.lfTI PENAI.TVI INTEREST I FNtull Ilrrof" dhcov.red on thh .1U.....,t Ihould t/4I addr..nd In writing tOI PA Deipert..,t of R(wenue, lur..u of rndlvl~l Ta~'I, ArrNt POlt A....~t R.vlew l~lt, PEPT. Z10601, HarrltbYr., PA 17121-0'01 Phone (717) 181.6505. See Pete S of thll boookl.t "InltruotlOfIl for InMrltlW'lC~ TIX "Iturn for I R..lct.nt Decedent" (REV-1501) for en IkPI~tlon of edIlnl.tr.tlv.l.,. cotrlCtwbll Irrot.. If WI.,. talC due II p.ld Nlthln tht.. (5) c.landlr ~ttl' .ftlt the dec.o.nt'. death, a flva Pftrolflt (SiX) dll00unt of thoa ta~ p~ld 1tI aUOHd. Th. ISX tu __lib' oon~per t1clp.tloo pttnIl tv It cDIIPUted on the tot.1 of tM t!IX and Int.r..t ......ad, Wtd not paid baforl ....lUIr'l II, 1996, the fltllt MY IIftar the end of the hl< _~.ty period. Thlt norl-Plrtlclp~tlon penIIltv It appNl_10 In thG .... NnMI" IIrld In ttn the ... tI.. pIIrlod .. .,.ou would .....1 the tax and Int.relt t:hIIt he. bean ......Id .. Indloated on thh notice. Int.r..t h oh.rllM Helnnl.... Nib, flr.t ell.,. of cbill~y, or nine (9) IIOtlth. and OM (1) dey frOll the dIIt. of dMth, to thl dati of P6YHf'lt. TIM" NhIct'1 bKIH dctllnqnnt blfor. .-nu.r'l 1, 1912 belr Int.r..t .t the r.t. of .I~ (6X) peroent plr ~ oaloul.ttd .t e datlY r.1. of .000164, All tu.. whloh bICMe .1lnquent on or .ftlr J.nulty 1, 1981. will ba.r Int.r..t .t . tlta IItllch will Wry frOll eal-*r '1Mr to Cftl"r '1Mr with t~t tit. wrI04JnO.d b.,. the PA o.ertMnt of Rlvenue. 1111 1IPP1IClbI. I"t.,...t ret.. for 19&;': through 1"7 .r.1 Y... Intlt..t bt. o.U.,. Int.r..t rector ~ Int.r..t Ret. 0.11.,. lrlt.,...t hotor 1912 ZDX .OOG~I 1917 'X .OOOl~7 1961 lOX .00001 19M.I991 1.t)C .00OSOl 1914 lIX ,000501 199t 'X ,OOaz~7 1..1 ax .ooos~ 19911.1"" n. .0001tz I'" lOX .00027' 1995-1997 .X .000247 ~-Int.r,.t I. o.loul.tld .1 follotllll INTER&8T . IALlHCB DF TAX UNPAID K HVKIER DF DAYS D~LINQUENT K DAILY IHTERElT FACTOR ~PAn'l Notlo. I.tutd .ft.r U.. tM beoCMII' del1nqu.nt will tlflMlt WI 1nt.,...t c.lcuhtlon to flft..., (15) dey. bayond tM det. of the .....nant. If Plpant II -.de .ftlt tn. Int.r..t co.-ut.UOf'l data IhoNn on the Notlc., addltlon.1 Int.r..t ~.t be c.lcul.t.d. ClHtOMWEAl.nl Of" PEHNlVI.VANU l'If,PARlHf.HT Oft REYfJU lUREAU Of IHbIVIOOAl TUU DEPT. t'O'Oi H"RfUI~, PA l1UI~0601 '* II 1n.IUIU"'17-"1 I/O) /','~; f/' - IS-' INFORMATION NOTICE AND TAXPAYER RESPONSE * REVISED NOTICE W * * FILE NO. 21 q f~ / I~' ACN 971 036117 DATE 02-05'97 - -,-- EST, OF QUAV 0 flAMI L TON S,S. NO, 177-24-6224 DA'rE OF DEATH 11-18-96 COUNTY CUMBERLAND TVPE OF ACCOUNT o SAVINQS IJ CHECKINQ [X]TRIIST o CUTlF. MARY E KELL 116 S CHESTNUT MECHANICS BURG ST PA 17055 *EHIT PAVHEHT AND FO~ TO, REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 PNC BANK ~a. provl~ thti o.,..rtHOt with tM Infor.etlon lhtad below whlth h"a bun used In calculating tttl patl8fltlal tlM dull. Thetr recorda IrKllclltll thllt at tM death of the abovI dacld.nt, YOU war. II joint owner/btiM,titJillry of thh ltCIoount. If you fool tht. Infor",tlon h Incarrlot, phuI obtfltn wrltt." correoUon frOll the flnltncll11 Jna~ltutlon, .ttlKlh It cOPy to thh far. Wld return it ta thtl abov.. lIIddru.. Thh ecoount h taMabl1 In aooordane. wJth thtl Inhllrltanctl hlO: Lew. of tha COIlHnweelth af Pe",uvlvanla. ~.tion. .ay ~ an'~red by ceiling (717) 787"8527. COMPLETE PART 1 BELOW II . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No, 31500056334 D.t. 12-08-95 E.t.blhh.d Account o.l""co 50,431.62 P.rc....t T..abh K 50.000- AllOunt Subj.ct to To, 25.215.81- T.. *.t. K .15 Pct....t1.l T.. Duo 3,782.37 PA*T TAXPAYER RESPONSE [!]li"'.~~~"IAii'~.~~~!m~~~.~,,~.~J!i,~~'~~:'C!~~*~~~~1!~~~,~~~~~~WtM~.~)l'f"iT!I~.,~t~~~:l A. 0 The above infor..Uoo and hI< due it corrllOt, 1. Vou III1Y choose to ,....It pl'lYllent tu tho RegIster of 10111111 with two QDPI.. of thh !lOtio. to obh!n 1'1 discount or aVDld Jn~.r.lt, or you ..y chick box "A" and rAturn thl. notloe to tht Rea,.tlr of Will. 1I~ an offl01al 6'....aent will b. I.,uad by the PA r-ep.rtwent of R.v~. Tn In,uf'a 'lroper oredJt to your aooount, tWD (2) oopl.. of thh notlcI Ilu.t llC'lcollpany your pl'ly..nt to the R.,htlllr of WUll. HiW>:lohfl<lk ~.YDbl. tOI "Ragl.ter af 101111., Agent". NOTEI If tft~ pay..,.,h arlll IIIl1d, within thr.. (5) Month_ of thl decedent', dete of de~th, ~ou .BY deduct n SX disoount of the tax du.. Any Inhlrltllne. hll( dUll will becOIljl dellnquant nine (9) IKtnth. aftar the dlltfl of d.ath. [CHECK ] ONE BLOCK ONL V - B. [J The Bbov. eUllt hu h.." or will ba reportad and talC paid with the PennsylvlIl'lla Inherlt.flu Ta:< r.turn t(l b. fH8<I bv the dlcedant's rllflr..8ntBUv.. C. c=J Tha abov. InforMation II Incorrwct and/o~.btl snd cl.duetlonl wer. puld bv YOU. VfJU Mllt co.plat.. PART 0 find/or P.lt.RT L!J below. If you Indlcet. a diff.rent ta)( rllt., pl.... .t.t. your r.lationlhip to dac.d_nt I _~_,_ _ PA*T ~ n.); LIHE l. 2. 3, 4. 5, 6. 7. ft, F:.I!TU;:~: ,~ CCMFUTATION or T,,",X eN JOINi/ln:J~T ACCOUNiu D.t. E.t.blhhed Account Balano. ".rgent Taxabl. A"",ont Subj.ct to T.x Debt. MOd Daductl~n. AltOunt Taxabl. TI)( Rat. Tax Du. 1 2. 3-11._ 4 ~ 6 7_ K ft "'" C:;i; i!:':"11 _,:",!:::,,: "i DEBTS AND DEDUCTIONS CLAIMED" "'" "'ill; "".,..1:1 ,-rWi':','", T """",.; - PA*T l~ DATE PAID .~t ..~ \ '-C) PAYEE DESCRIPTION AMOUNT PAID ~ . - f-= TOTAL tEnt.r on Line S of Tax Co~utation) Und.r pen.lti.. of perjury, I declare that the fact" I hlY' reported abOY' era true, correct and oO"",lot. to tho b..t of .. knowl.dg. ....d b.lief, HOME GENERAL INFORMATION 1, FAIlU~E TO ~ESI'OHD WILL ~ESUL T IN AN OFFICIAL rAM AS8tSSHtNT with _11...1. Inl....1 bond .., In,.,..II.. ilubIIltttel bw t~ flnlnClllIl Irl.tltllt\on. Z. lnherl'tMO. tu tMto.., ..1I"...,t MIMI ItOnth. "ft,,. the deCl~t'. dlt, uf death. ). A Joint Maount II tlM.,lt IV'" though thl d~.dttnt'. n.... "'" lIMidH III . ..tt.r gf ClOfW."IMlOI. it. AOClOWlt" (1l'lCIludtntl \hOlI ,..h1 blttWMn huth8nd .anc! wlf,) which the dec~lIjent put In Joint Mftl .,lthin OM 'I"" prior to dNth .r. fully 'II<IDI_ II tr~.f.r.. S. Aooou'lh "''''11__ jointly bet"'"" hur~ IIfld NU, IIOr. thwt OM ~..r prior to ..th .r. not tIIlM1,. .. ACloount. ~ld by . dec.o.nt "In tru.t 'or~ ~ther or other. .r. t.MIbI. fully, REPORTING INSTRUCTIONS - PART 1 . TAX PAVER RESPONSE 1. BlOt'K A ~ If tM t"'or_Uun and C10~t.tlon In tM MtlCI ar. oorrl()t and t1edUcUonl Ira not bfll". 01,11Ied, pllKll "" "X" I" block "A" of lI'rt 1 of the "TIlCpeVlr R..pont." ..otlon. Sign tlH:l oopl.. and .UhIllt ttte. with YIN,. aMok for the HCKI'\t of tl)! to the k..ht,r of Wll1. of thtl CCMJntv Indlcllt~. TM PA o.pertHnt of AIYInUe will ...- ... offloS.l ......lNttt (For. FtEY~lS4' EX) ~ r~.lpt of tlw r.turn 'rOIl tM Rqhter vf Willi. 1.. IlOCK 8 . If the ....t e".clflad on thh notlc. hae bUn or will bt rap.ortad r.nd taM paid wUk tM PIN"Y!YMi. InharltMee TII)( Rbturn fllad b" tM dec...,t', rlPreHnhtlv., pl.cut In "W" In block "I" of Part 1 of the "TIMPlye,. Reapon.." NOtion. Sign OM copy Mid return to ttM PA Deplrt..lt of R.y...., lurleu of IncUvldull TftM", [Jept 280601, Harrhburg, P. 1712a~0601 ln tM .nv.lope provl~. S. IlOUl: C ~ If thl natlCle Jnfor..Uon 11 lnoorrlCt and/or dIduoUon. ar. baing alet.ed, oheck blook "C" and oOllPlotl Perta Z IInd S llIC1cardl", to thll 1I\.trutltlon. billow. SIM! two copl.. IIInd .ubIllt tho with your oh.ck for the IIIIOUllt of tlUC pIli_Ie to the Rqlater of W11h of the cnunty IndlC\.t.d. The PA o.partunt of R.v~.. will I..ue an ufflol.l ........,t (For. REY~lS4' EX) upon r'ollpt of the return fra the "..ht.r of Will.. TAX RETURN - PART 2 TAX COMPUTATION LINE 1. f:nhr thcl date the aoeount orlalnalh' wu ..teblhh"d l3r tltlld In th" .ann.r .wlttln; at dati of d.ath. NOTE I for I daclCMnt dylnt afttr IUtZ/IZI AccolM"ttt which thtt dtcld.nt put In joint 1'.... within onl (1) ylftr of 9.th .r. tlxlllbl. fulb' u tran,fer.. Howtlv.r, Ultra I. ttn exolu.10n not to exo..d u,noe p.r tran.f.r.. rqerdl.1SI of t:htI value of the aocount or thl nu.mer of lKlcountl h.ld. If I doUble ..tarllk (Mil) epp.er. be for. your flr.t n... In the addr.., portion of this ~tiCI, the u,oaa 'Mclu.lon al....ty hu bean dedu.chd fr08 the lKlCmM"lt balanc. at r.porteu by the financial in.tItutlon. 1.. Entar the totll b.l8nCa of the account IncludIng Int.r..t ac~ru.d to the date of dlath. 3. The p.rcent of thui account that 11 taM8bla for each lurvivor 11 d.ttr.ln" lit folloWII A. Thl p.rcent tlMIStlI. for joint a...h ..tablhhed lIor. thMl one y..r prior to thl dltCldent'. d...th, 1 DIVIDED BY TOTAL ~BER Of JOINT OWNEPS En..l.l A joint Ullt r.glsterlld DlvIDED BV TOTAl. NUtlBER or lC 100 . PfR(ENT TA)(AllE SURVIVING JOINT OWNERS In thll nMM of thli deO"tnt and two other par,on.. I DIYIDED BV 3 (JOINT OWNERS) DIVInE:D BV 2 (SURYIVORS) . .167 X 100 . 16.1'1. (UXABlE FOR EACH SURYIVOR) B. TtMl parolW'\t tallable for until cr...tad within ona yur of th. doc.dlnt', d..th or aooounta own", by the dlcltCMnt but hIIld In tru.t for snotner InalvlduaU'J) (tru.t baneflciarl.')l I DIYIDED BV TOTAL N~8ER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 . PERCENT TAlCABlE EXHIPl" Joint account r.ghterld In the naM of thai dec.d.nt and t\lfO other Plrton. and l.tatlllshed within ona y'I" of d..th by tm. dloed.nt. I DIYIDED IV 2 (SURYIVORS) . .SO X 100 . SOX (TAlCA8lE FOR EACH SURVIYOR) 4. The.-ount .ubj~t to taM (line 4) Is d.t.r.lnad by aultlplylng tht account balance (lIne 2) by the percent taMabl. (line !). fl; En~lr the tohl of the dtltlh and dlductionfll I h\ld In Part 3. D. Th. ..oul'rt taxat\l. \11r__ b) U. d.uram.d b)' .obtrllctlrlQ tn. a.tIt. ISflCi dlduClt!ont lUna !JJ tro. tM .-ount tubjttCI\ tu I.IJC C..11'11 4). 7. Eilt.r thtl appropriate tax rats (Una 7l at dettralnod b.low. A. for dltl' of death oocurrlng flft" 6/l0/9ft, the tax rat.. for tran_fl,.. to .pous.. ar. .. followlI 1. Da~" of d.ath on or after 7/1/94 Md befor. I/l/CJ'i th. rllt. It 3X. 2. Dat.. of dI.th on t1r _ft.r l/1/9S tran.flr. to 'PIXI'.' 11111 bl taMed at 0:( tax retl. Note, for dat.. of death prior to 11'1/94 tran."", to .pou... Ilrt taxable at 6%. ft. TrlWl.far. to llna.1 deea!tndN1t. Including father, .oth.r, .on, d~lht.r. grandchlldr.n, .on~ln~l.,.., dlliUCilhtl,..ln.llW, .t.pehlld and th.lr h.u. I!Irt ta)(ftbl. at .1)( p.re.nt (6io. C. Tran.f.rs to all otherl Including broth.r, .htlr, unclt, Ilun~, nophaw and "lac. arl taMable at HUlin paroll'lt ClSX), D. If YOU ohWlII the ta)( r.t., pit... ,pl<llh your r.latllif1.hlp to the deeaant In the ar.. provldad. I. The ftlI()lJf1t of tl)( due (lIne II) h dttl,.Jnttd by ItUltlplylng tla aaount tl!lMabl. (11na 6) by thl tax rat. (lJM 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debt. ROd deduction. arM dlt.ralned a. folloW'1 A. You 1...11)0 ar. rupan.Jbl. for P'YlMl'lt, or UII D.tat. .ubjlttlt to fldllnhtrlltlon by a Plttonal rlJlPr..llntttlvl 11 i.nlYHlolant to pity the dt4uctlbl. It.... I. You actually paId the debts Iftlr deeth of the decadent and OWl hlrnlth proof of ply.-nt. C, Debts bllnt clnlHd IlUlt bl .\tubed fully In Part 3. If ItkUtlon.l .pac. Is nlldad, U'I plal" plplr a 1/2" )( 11". Proof of p.)'lIInt .IY be ,..qu.ut.d by the PA Depart..,..t of Rluanua. !i:kH::!:~::::::::,::i:: ' ' 'c.::.-, TAXPAVER ASnSTAHCE IF YOU NEED FURTH!!.r 1NFORMAnON OR ASSISTANCE, CONTACT ANY ...... . . REenTER Of' WILI.S, PA DEPARTMENT Of' REVENUE DUTRICT OFFXCE . .... . ... OR CALL THE BUREAU OF INDIVIDUAL TAXES TAXPAVER INQUIRY UNIT IN . ... .IlI\IlIU$IlURG AT (717) 787"8S:17. Tl'lllt,.1.1P) 772-2252 (HEAlllNO lHPA1REIl OIlLV) . . COHHONWEAlTH Of PfNHIVIVAHIA DEPARTMENT OF REyt~ IURfAU OF INDIVIDUAL TAMES DEPT. 210'11 twlRIIIURO, PA HUI"nut '*' INFORMATION NOTICE AND TAXPAYER RESPONSE . REVISED NOTICE ... AeN DATI! FILl! NO. 21 '7/ /1'/ 97103696 02-05-97 . II~'IUI" "', l/-lll EST, or QUAY D HAMILTON S,S. NO. 177-24-6224 DATE or DEATH 1.1-18-96 COUNTY CUMBERLAND TYPE OF ACCOUNT [] SAVINPS o CHECKINP !Xl TRUST [J CERTlF . MARY E KELL 116 S CHESTNUT MECHANICSBURG ST PA 17055 REHIT PAYNENT AND FORMS TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 PNC BANK ha. provided the Depart.."t with th. Infor.atlon IlItad balt>H wnlch hu b.." used In calcul.tlng thtl potl'nthtl tall duG. Th.ir racard. indlc.te that lilt the dtlllttl of the above deoedent, !IOU w.r. . joint olffler/ban.flc:hry of thh accOUflt. If you f..1 thh Infor.aUon II lrlCorr.<<t, pi.... obbln written correction fro. the flnaMial In.tltutlon, aHKh. COfIV to thll for. and t,.turn It to tilt! above .ddr.... Thit uccount 11 tftk'ablCl In Mcord.nc:. with the Xnhlrltanc. hI( lewa of th4t CollltOnw..lth of p."".ylvanla. Qua.tlonl "'1' ~ ~.w.r~ by o.lllng (111) 167.'527. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS -- Account No. 5030078258 D.t. 08-05-88 E.t.blhhed Account B.lance Pe~cent TaxAble A~unt Subj.ot to rllx Rat. Potent1.! T_x Du. K 18,292,42 50.000 9.146,21 .15 1,371.93 To Insure proper (lredit to your ltollcount, two (7.) copl.. of thh notloe IN.t .oco""any your pftYII.nt to the Reglttllr of Will., ..... check payable tal "R*glster of Wilh, Avant... K NOTF.: If tllk' plly.-nh lire .ado within three (!) .onth. of the decledent'. date of d.ath, you .ay dctdlK:t II S:C ditcount (If thl tax dUll. Any Inhorltance t.x due will becOl1e dlillnqu.flt nine (9) ItOIlth. afhr th41 date of death. T.. ~" TAXPAYER RESPONSE IIIIIlULUJll"""QJIll!SIlOHI)"X~~ ... R"IJ~ tJH ~I'l.' OFFI~XAL. 'fAX ASSI$$"~ .A$IIICiff"'HX$~X~'1 A. 0 TIn .bove Infor..tton and tllll due h correct. 1. You .IIY choo.e to r..it pllly.e"t to th~ R<lg)ftt.r of With with two cnpl.. of thlt not1r.:e to obt.ln . d).count or avoid IntRr..t, or you ~sy chock bOil "A" and return this notice to the Regl.t.r of Wllh IInd ar, offlllillll 8.......nt wlll bfl IlIued by the PA Deparhlent of R.venue. [-. C~~~K ] BLOCK ONLY a. 0 Th. above cuat hbt b..n or w1l1 be ropOI.tGd and tax pallJ with the Pennilylv&nt. Inh.r1tanc. Tall r.turn to be flhld by the dllCldlnt" r.pruGntat1v.. C. 0 Th. abo...e Infor.aUon I. incorrect andlor debh a"d deduction. were pUlld by you. Vou .u.t co.plet. PART [!J and/or PART 0 below. If you indlc.t. 8 dlff.r.nt t.x r.t., pl.... ,t.te your I r.l.t1onshlp to d.c.d.ntl_.; RETUF.N - CCNFUTATI..i; OF TAl( ON JOINT/TRUST ACCO,Jl;rs ' 1. D.t. E.t.ol1Ih.d 1 2. Account 8.lano. Z_ 5. P.rcent T.x~l. 3 X 4. A.ount Subj.ct to T.~ 4 S. Debt. and D.duction. 5 6. AMount T.xabl. 6 7. r.x R.t. 7 K 8. T.~ Du. a fAii 1 .~ 3 .;:.. 4 5 6:............~"'< ~.,..., ~~1 ~.~ 8._ -:.,':., Ofl:'"lCIAl USICONl\' 0 AAF. PA ,!RTHENTOF ~~"ue .. .,. .. .~ .:... i\~'fS:.o. ... .. .. ,:,"',-".'. "'. ....' .....',.'.0:. I':;:, ,',,",: .......,..... .;a. .",i. :1' ,.:: :'... ., . ....-.,;:~, :,:, , ':,~ ;:1 PART ~J TAX LINE ::"C:}<:j!::',,::, I tliit .. I: :'f';:'::NI Q ,II.""""': . :..~~ - ~ PART ~ DATE PAID =r DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID -i TOTAL (Enter on Lln.~T.x COMPut.tlon) -I. . Undllr PM.lH.. of perjury, I declare th.t U,. fact. t have r.porhd .boy. ar. true, correct IWld cOMPlete to the b..t of MY knowledge and b.l1.f. HOME_-1..__. \WRK ( TE L EPHllNE ) ) NUMBER DATE ~XPAYER SIGNATURE GENERAl. INFORMATION L FAILURE TO RESflOHD WILL Rf.SU~ T IN AN OFFICIAL TAM ASSESSHENT with t'tPpllubl. Int.r..t b..~ on l,n'or..Uon lJ~ltt'" by 1M fl"IIOOI,1 In.Ututlon. Z. InhlrltWMlI tll( ~l)"" o.ll~t nine lWnth' aft", th. dN,.,t', Ht, of death, J. . Job.t "cOU'lI h hlCflblfl evWl though the dec~t'. n... "'.. lKldtKl II .. .1I1it1,. of cOflvanl,no.. 4. Acoounh tlnolucUnt tho.. ~ld tHllwnn hu.blllnd IInd ..Ih) which 1M dHlden\ put In joint ".... within ont Y"" prior to death II" fulh IIMMla "' trlln.ftr.. Ii. Aoc-ounh ut"'J hhw jointlY HI.,...,.. hUlbahd Md wH. Mrl thM onu y..t prior to dHth .r. nnt tIM.I,. 6. Account. Mid by . deced6nt "In truII for" eno\h<<r or olhare II" tlMlbl1 fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE L BLOCK Ai M If t~ Infor..tlon ..",1 c~uht1on In 1M notlc. fir. corr~t and deduCltlon. er. not tMIlng ol,l"', pllt'lll In "X" In bl~ """ of Plitt 1 of 1M "TIMpIYlr "..pon.... .~t1on. st., two cop'" ... 1\AMl1t tMII .dlh your Wok for the ~t 0' hl< to the R..hhr of Will. of the county IndlcatlNl. The PA DltPlrtHnt of I1l\1enw wIll I..u. In offlct.l ....IIIHf1t (For. REV.1541 UO upon rlKlfllpt of the ,-.turn fro. the Rqht.r of Willi. 2. BLDC~. - If thl o...t .r.~lflld on thl. noticl h.. b..n or will be reported find taM paJd with the P,"".ylv~l. Inhlrlt~. hx R.turn flied by tn. tfIc~t'. repru."t.tlv., plICI IIn "X" In blOClk ..... of P"rt I of the "Taxpay.r R.~.." .actlon, Slun 001 copy WMf rlturn tI>> the PA o.p,rt.."t of RovlWMJl, IU"II'" of Individual Tax.., o.pt 2110601, Hlrrhbur., PA 17121"0601 In the anYII~. provJded. 5, BLOCK C - If the notIce Infor..tlon J. Incorrect and/or dIduotlon. ar. bllng clallld, ohlck block "C" and ~o.,l.t. Pert. Z end 5 ItCflflr'dlna to thfl lrH.trllctlun. hIIC". $1", tWl 1:01'11' and .uhttlt th.. with '\lour check for thll allOUl'tt of t." plvlbl. to the R."ht.r of W\II. of the county Indlc"t.d. T~ PA Oapert..nt of R.v~ will I..UG In offlcJ,1 ......-.nt (forM REV~IS4' EX) upon r.c.lpt of the r.turn frOll the HIght.r of Will.. TAX RETURN - PART 2 TAX COMPUTATION UHf I. Ent.r NOTE:: I the data the ICCCK.lItlt originallY ..at ..tabllshed or tltl.d In thl _anner el<htlng at d.t, of d..th. for II dlDldent dying Iftlr IUIUS;!1 Accounh Ifhlch thl dlacldaflt put In joint nHI' within onl (1) Ylllr of dl.Ut art t'Mabll fully e. trlWl.flr.. HolMy.r, there I. an eMolu.lon not to .,MClld 15,000 par tratllf.,... regardl... of till VIllA of ttw account or the nUllb.r of !Hl<lount. hlld. If a double ..tcri.k (~MI app.ar. before your flr.t na.. In th. dddrl.. portion of thl. notlca, the .],000 IMolu.lon Ilrlady hi' bien deductld fro. t~ account balance a. rlport.d by the flnanoial 1n.tltutlon. 2. Entar the t~t.1 blllencl of the account Including intar..t eccruad to thl date of daath. 5. The plrcent of tha account that I. taMable for aach lurvlvor I. d.t.rMlned a. follow.: A. The parclnt tal<abla for joint 1U..t. ..t8blhhltd lora than ono y.a,' prior to the d.oRant'. delthl 1 DIVIDED BY TOTAL NUM8ER OF .JOINT OWNERS Exaaplel A joInt ....t r.gl.t~r.d DIVIDED BV TOTAL NUHBER OF X 100 .. PERCENT TAXABLE SURVIVING JOINT OWNERS In the n.... of thl dao.dent and t\OlO other plrlOnl. 1 DIVIDED BV 3 (JOINT OWNERS) DIVIOED BV l (SURVIVORS) ~ .161 X 100 . 16.7% (TAXABLE FOR EACH SURVIVOR) a. Thr parcent ta~abla for al..t. cr.fttad Hlthln 0"' y.ar of the d.cedant's d.,th or account. owntd by the decedent buthlld In tru.t for another Indl\lIdua1(,) (trult benefIclarl")l 1 DIVIDED BV TOTAL NUHBER Of SURVIVING JOINT OWNERS OR TRllST BENEFICIARIES )( 100 . PERCEN'T TAXABLE EMllllplel .Joint account t'.ght.r.d In the n... of the dlr.ldlnt I!tnd two othar p.rlon' and ..tabll.had within on. y..r of daath by thl dlcad.nt. 1 OIt/IDEO BV 2 (SORt/IlJORS) . .50 )( 100 . Sil% (TAXABLE FDA EACH SURVIVOR) 4. The NCMM'lt .ubjlct to tal< (line 4) 11 dahr.lnect by luitiplylng till acoount bllallCe (l1nl 2) by the fMrcent tll<abll (11". ]). 5'. Enter the tohl of tha dabtl and d.duotIon. ll.hd in Pl!!Irt ]. 6. Tn. MtOUnt tllxabl. (I1na 6) 1. daterelnad by ~ubtrllCtIng thl debt. and deductJon. (l1ne SJ f'ro. thl -.aunt sWjHt to tu ~J.JOQ Itl. 7. Entlr tha approprl.t. tax rote (IIn. 1) ft. dlter.lnad b.low. A. for data, of dleth occurrlnQ aft.r 6/30/94, the taM reta. for trIO' far. to 'POU'I' .ra at follow'l 1. Dltl' of dleth nn or Ifter 1/1/94 and b~fore 1/1/95 the rate 1. 5~. l. Dati' of death on or aftar 1/1/95 tran.farl to .pOUII. will be tal<~ at O~ taK r.tl. Notel For dati' of deeth prior to 1/1/94 tranlf.r. t~ .pou.a. ara tlKable ~t 6~. II. Trenaflr. to lIne.1 dal(:and""t. lucludJng hth.I', IIOthar, Ion, daughter, grand()hUdren, lIotl.ln-law, ~hlr-ln.law, IIt-.pchlld and th.lr IlIlJfI "ra tlKDbla tit .he p.rc.nt (6%). C. Trensf.r. tu aU other. Includlng brother, .htur, unc:lll, aunt, n.phlW l!!Ind nlaoa are tal<abll at flftlen p.re."t (lS~J. D. If you ohanga the taM rat., pl.... lplclfy your rlillfttlon.hlp to tho dloldent in the .rl. provldad. a. Tha HOunt ot tIIM due (line 8) ill d.t.ralned by .u1tlptylng the uount tlll<abl. (lInl 6) by U,. ta)C rat. <lIn. 1). CLAIMED OEDUCTIONS - PART 3 OEBTS ANO DEDUCTIONS CI.AIMED Allowable debt. ftnd deductlun. ara d.tllr.lned a. follow.. A. You 1...lh are re.pon.lbla for pay..."t, or the "'tata .ubj.ct to edIIlnl.tratJon by a pBirlOMI rlprellentetlve Ie In.ufflol.nt to pay tho d~ductlbl. It..~. B. You aotually paid thl debt. aftar daath of thl decedent and cen furnl.h proof of ply..nt. C. Olbh being clal.ad lIIu.t bll it..lud fully In Part~. If addltion.t .pau 11 n..dld, u.. plain peper 8 112" )C 11". Proof of ply.."t .ay bl requ..ted by tht PA '''parteleot of Ravanu.. -- TAXl'AvellASSl$TillI(;E I fl. YOU NEED FURTHER..INFORMA TlOt( OR ASSISTANCE.. CONTIICT ANV REG~STE~ OF WILLS, PA DEPARTMENT OF REVENUE D~sTRICT OFFICe .....OR CAll THE BURIlAU OF INDIVIDUAl; TAXES .. TAXPAVER ~NQUIRV UNIT IN .. i~~RRIS.IJRlilAT (717) 187-8:$27.. !~P ,(1;7> 172-2252 (HEARING lUPAIRED ONLY) L I') /('. (/. ("" .'> ) COftMDHWfAl rn Of' PfNNlVlY.ulIA I)(PlRTHl:NT Of M~tu: IUREAU or IHDIVIDUAI TAKES DEPT, "1!J601 HARRISIUR9. ~A 1711.-0'01 '*' . '1V-114' iii lit U.NI INFORMATION NOTICE AND TAXPAYER RESPONSE . REVISED NOTICE . . . EST, OF QUAV D HAMILTON 5.S, NO, 177-24-6224 DATE OF DEATI! 11-18-96 COUNTY CUM9ERI.AND FILl! NO.21' '! I 11,/ ACN 97103691 DATI! 02-05-97 TVPE OF ACCOUNT o I4VIN8S o CHECKING 00 TMT o CUTIf . MAR V E KELL 116 S CHESTNUT MECHANICS8URG ST PA 17055 REHIT PAYHENT AND FORKS TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BAN< h.. provided tn. IMp.rtHnt with tn. Infor.flUDn \ilt.d ~low which hft. b..., u.ttd In C11l1ClUlIUng the potent'.1 ta)( dl,11. Thtlr r~ord. Indlo"t, thet It the d..th of the ftbov. dlcedent, 'lIOll wlr. 6 joint ownu/beoefi(,hllrY of thl. account. If yau f..l thll Infl'lrNUon 11 inClorr~t, '11.... obtain wrlttttn corrlHltlon frol the fln"lot.! Iflltltutlon, ettftCh . copy to thh f('lrll Bnd r.turn H to the Itbolifl adcIrl", This lacoont II taxltl). In Iccordll-,ol with the Inn.rltenu T.tx lftw. 0' tha Counnwea1tt1 ", PaM,ylvlIflla. Qutlltlona .ay bll .,....rtld by cll1lng (71i'l 787.6527. COMPLETE PART 1 BELOW . M . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Aooount No, 31300065263 o.t. 11-12-96 E8tablhhed Aooount Bolono. 20,017,02 P..o..,t To.obl. X 50 , 000 AllOUI'lt Subj.ot to To. 10,008,51 T.. R.t. X .15 Pot..,U.l T.. Dua 1,50 I. 28 PART TAXPAYER RESPONSE [!J r,AUlllllrO, "ISPO!f~I"%"'''''.'W.tXlfA''!lIl~~~~A~f~~ MSE~"~~r ~MI!JOIt.~HX.!lItr~CIJ To In.ura prop.r cr.dIt to your ltCcount, twt! un copln 0' thlll notlcl MI.t I'ICC08PllIn~ YOllr Plllym.nt to t~ R.gi.t.r of will.. Maka c~k p'lyttbl. tal "R.uht.r 0' Wllh, A(t8nt". Non: If t'l( P8YMnts I'Ir. lad. wlttlln thra. (3) MOnth. of the decedent', d.te of d.~th, YOU lIIt\y d.dllot a 5;( d!sc:ouo't of th. tal( due, Any Inheritance tal( dull will MCOlMl dellnqu-.nt nln. (9) lonth. aft.r the date of o..th. [CHECK ] ONE BLOCK ONLY . A. 0 The above Inforlatton and h)C due it correct. 1. Vou aay choose to r..It pn)'lNIlt to the Regiltlr of IHUI with two caplu of thh noUce to obtain a dhClOunt or "void Int"r.,It, 01' you lIay cheClk bOI( ..".. !Inti r.turn thh notice to t~ R.ght.r of Wills end nn off10lal a.......nt will b. luuad by the flA Departlllnt of R.v.nuII. B. 0 Th. above alset hat b..n or will be "eportad Md tal( paid with the Pennlylvanla Inherltano. Ta)C r..tuF'n to ba fJled by the d.cI~nt'l repr..entatJve. C. r=J The above Inforlation Is 1ncorroct and/o~.bt. and Uftdllotlonl were Pfti~ by you. Vou "Ult cQttplete PART CD and/or PART l~ bllow. PART ~ TAX Rl!TURN - COiiF.rrAiIO.. LINE 1, O.t. E.tobl1.h.d Z. Account 8.1ance 5. Pare.nt T.x~l. ". AltOunt Subjact to rax S. llabh _ IIaduc Hon. 6. A.ount T.xable 1, T.x Rlt. a. T.x Du. j;;;; ON JOiNT ,iilU3T ACCOUf;jS ~,.,..,.,',..'.".. .i,~~~l~~=~~~~~~ O~~~~~~ ...~I\.."....,......,...,...."."..,..." PAD . .... ',.... .'.' '1 . ..' . p ~'i1i~",:: :i ';.:"';~'" ;. ,; '.':::, ::' ",; ;':.' ':~',"::"."" ':;:~~i:;:.:.;!;::I:;,..:;.." ..';:."" ....,::.,..'! J' ." 5 .I.,'~.'. .lQ'" ''':' ',' :~.( ,.>i, ::61:::::;'.;:::.:';'<.;k,:i:~,:\i::,":;;li.',;' ....~~{:".::.::.-:,:; :':':::::;: ,':::':::',:""";,,.. ':;;;:;::;';"~:~ ',;, ::' "-,:' . ...~': -~ ,;:'~~::_~~~..,;;,:;:;,,; ,': '_ 8 . 1~'" 'I t~"~; , ~Q-' , DEBTS AND DEDUCTiONS CLAXMED If you indic.te a ~iffftrent t.x rat;, pl.... .tat. your rel,tion.hip to decedent: Or 1 2____ 3 X q S 6. 7----K 8 PARr [!] DATE PAID --=1-:= PAVEE OEseR I PTI ON J TOTAL lEnt.. on L1n. S o~ Tax Co~tatlon) AMOUNT PAID 1= --- . - Under penal tie. of ptIr jury, I dttclara th.t the fltCh I ".va reported above era tru., correct land a~l.t. to the be.t of My knowledga ~ bellaf. t!OME __ GENERAL INFORMATION 1. fAILURe TO IIIESlI'OND NUL RE$UlT IN AN OFfICIAL TA,. ASSESSMENT with IIPplloabll Int.,...t M'" on lnfor.lltlon IUbIIlttlld by -the f'lnMolel In,tltutlon. t. Intwl'ltenc.. tell lHKIo.' d.II~'t "Ine IIOnthl _ft.r the dM.dant', dIlt, of de,th. J. " Joint !tOG""'"t I. tflwMJII IV'" thoogtl thl dec.edttlt'lI nDee If" ltddtld .1 . ..tt.t of CO'Wflfl\encP.'. 4. Account. (InclUding thoH h41ld bIItWHn hUlb4lnd IIld wife) whloh it.. dM.."t put In joint MM' ..I thin 0fWI y..t prior to ....th lilt. 'ully tll>>ulbl, '1 tr.",f.rl. S. AclCl~tI ..tN,111htKI Jo~nth' hetWHO hY.bwld III'ld wif. 116" thftn one yeer prior to dllth ar. not tlMllbll, 6. AOI".ounh Mid by . deoedw.t "In try,t for" IInOUwr or athllr. ara taMIbI, fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE 1. IIIOCI( A . If thl! tnfor.tlon IInd OOIl,,,,;t,tloo in thll l'IOtlOI .r. ClorrltOt and dedl~tlo'" era not tMlno t1hINd, pi"' M "X" In block "'.'" af Part 1 of the "TIMpIVI" R..pon.... ..aUan. Sign two C1opl.. Itn(l .ubIl!t t"- with your oMok for t,. .-ount of taM to t~ RetAlt.r of Willi of t~ eount~ lndlcat~. Tht p. o.p.rt-.nt of R.~enuI wl~1 IIIYe an offlol.l .......-nt (Far. REV~IS411 fJ':) upon roulpt of the r.turn frlHl the Rqhtlr 01 Will.. 2. .LOCI( B - If the It...t IP',JHi~ 01\ thh notlc. h.. bun or Mill b. rllPOrted IWld tltM p.ld with ttMI Pem'1I1vanl. InMr1t~. hM R.turn fl1N by thl dl(ladent', rll1ra.ant8UvI, plaClI "" "X" In block ''I'' of P.rt 1 r,f the "Taxpay.r R..pon.... .ecUon. It", fIMI Dbpy ~ r.turn to t~ P. o.part~t of Rav~, Bureau of Indlvlduel TaM", n.pt 210601, ~rrl.burl, PA 11121-0601 In the enval~ provided. 3. BLOCK C - If the notlCI Infor..Uon 11 In-oorr.ot l'Wld/or dtduotlon. ar. being CllalNd, check blOC1k "C" end CDllPlata P.rt. 2 and 5 :lccardlr:;: tc the In::tructlcnr bdD\I. tt., hl:l c::Jpl.. u.d c~=t~ th:s -dth ....e'.::" ,h:-,k 1r:" th:: !lIlOl.1l'1t of tilt pllyecbla to th2 P:.~::drt... of Wllh of th4t oounty Jndle.tH. Th. PA Oepllrta."t 0' Rlvlnl.~ will luue an offlolal !I.....unt (for. REV-lS41 EX) upon racllpt of thtl r.turn 'rOIl th. Raghtlr of Willi. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter the data thl account orlglnBllY wa. e.tftblhtMd or titled In t,hl .armer ed.tlng lit d.t. of d..th. NOTE I for. deoMant dytl'l(l .ft.r 1211U8Z1 Accounts which the daeadent put In joJnt n.... within ona It) YI.r of dlath Ire hMab!. fuily at tran.fer.. HOWIVIr, there 1. an 'l<cly.Jon not to eMclted t3,OOO plr tran.feree rlg.rdlen of tM value of the account or the nUllOar of IIctOUl'lts hald. If II double lI.terhk (WIl) appallrt b,'ora your fint n""a In the .ddr... portl()R of thh notlcl, thl U,oon aMolullon .lr.ady hll' ba." daductlld fro. thll /tctoont b.IIlMe a. reported by the fln.ncl.l ltlltltutlon. 2. Enter the tot.l balance of t~ account including Int.r..t ftocruad to the date of de.th. 3. TM par cant of the account th.t h t.l<abl. for ..<:h .urylvor h detar.Jned u fnl10litll A. Th. ?IIroent tllxllUl. for joint ....t. ..tabll.hed .or. th~, one y.ar prior to the dec.dent'. deGthl 1 DIYIDED IV TOTAL NUttBER OF JOINt OWNERS EMMlPlel A joint auet r.ghterea DIIJIDED BV TOTAL HUMBER Of X laD . PERCENT TAXABLE SURVIVING JOINT OWNERS In the nMI of th. deo~t IIlnd two othar p.r.on.. 1 DIYIDED IV ! (JOINT OWNERS) DIVIDED BV Z (SURVIVORS) . .167 X 100 . t6.7~ (TAXABLE FOR EACH SURVIVOR) a. T~ percent taxabl1 for ..,et. cra.ted within one ~.ar of the dec.dent', de.th or .coount. owned by the dacedent but held In tru.t for Wloth.r IndlvJduaL<.) {trult ben.flejarJu)l 1 OIYJDED BV TOTAL HOMIER OF SURVIIJING JOINT OWNERS OR TRUST BENEFICIARIES K 100 . PERCENT TAXAatE r:X.~l'l Jotnt ~()ccunt r.gl.ter.d In the n... of the n.oadent ~ two ether per.on. and I.tabll.h.d within one ~..r of de.th by the d.cedent. 1 DIYIDED BV 2 (SURVIYORS) . .50 X 100 . SO% (TAXABLE FOR EACH SURVIYOR) 4. The MOUnt .ubjeat to taM 01ne 4) 11 deteraln.d by lIIul\1plylno tll. account blllanel Cline 2) by the p.,.cent t.xabla Olne :U. 5. F.nt.r the tot. I of th. debt. and deduction. liuted 1n Part 3. 6. The .-au1t hltllbl. (11M 6) h d.tar.JOIId by .ubtr80tln,~ tna debtt and a.duCltlcn. (llnlll 5) fro. tha lllOunt !Iubj~ot to taM (lln. It). 7. Enter tM lIpProprhte hl< rlltt (11nll 7) u dat.r.lned b.low. A. far dat.. of death occurring Bftar 6/30/94, the tal< rat.. fOI' tran.f.,.. to spou... arl u follow. I 1. Oat.. of dl.th an or .ft.r 7/1/94 and b.fare 1/1/95 th. r.ta 1. 3~. 2. D.t.. 01 death on or aftar 1/1/95 trltl1.,e,.. to .pou... wJU be taxM! It 0;( t&)l retl. Notl' For d.t.. of d.ath prior to 7/1/94 tran'fer. to spou... .r. t.Mabl. at 6X. ~. Tran.f.r. to 1lne.l d..cendants Including f.ther, ~tnar, .on, daught.r, grandchlldr.n, .on-ln~ltw, dIlught.r-ln-lMf, .tepchUd and tn.lr luu. ara tBMabl. lilt .IM p.rcent (6%), '=. Tran.fer' to all oth.r. Including brothur, .htar, unol., nUl'lt, n~hew and nl.c. IIr. tlxable at HUaon parcent 05XL D. If YOU che.nge the taM rst., pl.... 'fH'clfy your r.1ation.hlp to the dee.dlnt In the ara. pro~ldtd. 8. The MOunt of tax due (lIne 8) h datar.lnlld by IlUltiphlnll tha MlOUI'1t hxable (Una 6) by the taw rat. Oln. 7), CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable dabts and d.duction. are d.t.r.lned .. follow.: A. VMI 119lllh .rlll ra,ponllblll for pay..nt, or th. ..ht. ,ubjaot to ItdIIlnhtrBtlon by 1'1 p.rsonal repruent.tlYa Jt In.uHlclent to p,y the deduct Ibl. It.... B. VOI.l IItCtu.lly paid thtl debts Bfte,. death of the d.c.dlnt and eM furnhh proof of pay..."t. C. Debts being ol.IMd lIIU.t be It..had fully In Part 3. If eddJtlon.1 'pBce h ne.ded, uu phln pap.r 8 112" x 11". Proof of plly..nt ..y bl r~J8.t.d by the PA D,part.~t of R.y.nu.. - '~",,.,,," "'::,,',,' ,:" :t,:, ;,: ':,", TAXPAYER ASS1$TAIICE" ' ,,,',, ,:," : , ',:::: If! YOU NEED FURTHER INFORMATtON OR ASSISTANCE, CONTACT ANY" "',':, ";:::::,:,;:::::::::):::::!::Jtt!91 $T E R<OFWI LL $ t,' PADEPARTMEMT: ,OF ,-REVENUE, .,DI STRI CT .',' QfFICE:::,:::,:r;,;;,;:;)/;><<<<:r, .. .... .. ; H~RfUg=\I~~I.~T T~h W~~~ - g~2~ ~Dl~6g~~hI ~~E~tl!! ~~~~V~nEl=~~&RrM~~I~a~N ON~Vl ... .. """""'."'. .....,. ",.',",' ......'.,', . .....'... ".......,'....,'.'..,.,-...-...',..:-;.:,1;,;-'..,',,'...,... ',. ... '. '.. ... .... ......,...'.......' CotttOHWEAl TIt Of PEtfftVl YAHU DfPAAYHEHT Of' REY'ENUE IUM:AU 0,. INDIVIDUAL lAkEI DEPT. llO601 HARRIIIUtG, PA 111'.-0'01 . M 1...1..11111.11-"1 /.') /'J tq ~ ::,-' INFORMATION NOTICE AND TAXPAYER RESPONSE REVISED NOTICE M M M FILl ACN DATI! NO.21 (1'11/'1 97103689 02-05-97 TYPE OF ACCOUNT [] SAVINGS o CHECKINll IXJ TIIIIST [J CERm , II EST, OF QUAY D HAMilTON 5,5, NO. 177-24-6224 DATE OF DEATH 11-18-96 COUNTY CUMBERLAND MARY E KEll 116 S CHESTNUT MECHANICSBURO ST PA 11055 RE"IT PAYMENT AND FOR"' TO, REGISTER OF WillS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 PMC BAHK h'" JlrovlMd the DepartMnt with the II1'or..tlon Illt~ b.1C* which hila been u.~ In calculeUng thtl pot~tt.l taM du.. Their r.enrdl Indleet. that at the delth 0' t~ aboVI decaOtnt, you M*r. . joint ONntr/ben.flclary of this 8CCount. If you fHI thh In'or..t1on 11 Inoorrltlt, pi.... obhl1n wrltt., corr.otlon 'roe the flnltOClllIl InlltltuUon, attach a OOpy to this for. MCI r.turn H to the IIbov. IHNtr.... This IHlCDUnt is hMebh In accordance with the Inhtf'itWHlII fBx lMfI of tha COIfMnW.alth of Penn.ylvonh. ao..tlonl ..y be en.wer.d by ollllng (117) 761-8321. COMPLETE PART 1 BELOW II II II SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS . - Aooount No. 31000056058 Deb 12-08-95 E.t.blhhed Aooount Belence 10.083.89 Paro.nt Te.eble K 50,000 AMount Subject to TM' 5.041. 95 T.. Ret. K '.15 Potontld Te. Du. 756.29 PART TAXPAYER RESPONSE [1] E!AXLI$.l,',.(IR.S,.~"n.k Rell~T l~~l'<I~.'~~~~k,.Ax,~~~~"e!rl' ~SI!IO.. ....ft,~~ . ~!C~"l A. 0 Th. above Infor.ation Itfld tall' dUll ill torr.at. M 1. Vuu .8~ ohoo.. to ,...1t pay..nt to the Regllter of WIlli with two copl~. of thl. notIce to obtain II c1heOlJnt or avoid Int.r8llt, or YOU .ay oheck bo)! "A" and r'.turn thh notlo. to the Reghhr of Willi and an offlclol n...n..nt will be luued by the PI. Depart.Wlt of Rev.nut!. To Inlur. proper oreuit to you,- ltCeount, two U~) oopl.1 of th.11 notltl8 ltUlt acee..,an!!' yoor P"Ylltnt to the AltQhte,. of Will.. Hbk. ohlCk payllbh to: "RlIght.r of Nllh, ""'"tn. HOTEl If tax pay~t. ara .ad. within thr.~ (3) .Oflth. of thtl decedent's data of duth, you .BY deduct II 5;( discount of tll. tall du.. ~nY Inheritance taM duo will b.oaaa delinquent r.lnt (9) ItOOthl aft.r th41 dab of death. [CHECK ] ONE BLOCK ONLY If ~ou 1n~lc.t. _ different t.x rMt./ plee.. st.t. your f'ebtionah!p to dK.dent I _____ II. 0 The above a...t has been or wltl bl! reported 8nd till( paid with the P,"n.y~vanlll Iflhuit&l'l(l' TII)( r.turn to bll 111.cl by the dlKed.nt'. repr...nht1vlI. C. 0 Th. above Infor-lIatton II Incorrect tmd/or debts Bnd dllduct1on. w.r. p(I)tCbt YM.l. :TJ You .ult oOllpl.tt DART CD and/l;lr PART 0 b.lol~. !; (,: ::-::: I..... . "'"76FI1.CIA",",.,USE q~,"~Q Mf.; ::.'M.,~I\P~RTMQlI: ClF~~~~~UI1..: ..:, ;:~,;;:,:~.':;::. .:. .'~::,:: ::;::~ , ""-,,,~ :::':1;::: ,;,::,,!ii!::":;i!::{:i:'::;:;':':' ,jo.' '''''''~r ,'"',, "":";":-:':::1 ..: II.: ..:B'k. . :~ ..... .. ; ''" .. ",,:,:;',,::s," _''';' T!.X otJ JOINT,i~r.U~T AcCCUt:r:: PART ~ T~X RETURN - COMPUTATION or LINE 1. D.t. E.t~ll.h.. 2. Aocount Belllnc. 3. Percent T8xahle 4. AMount Subj~t to T8x 5, D.bt. an. Doductlon. 6. AMOunt Tax.ble 7. T.x R.t. $, Tax Du. 1 2 3 K 4 5 6 7 K B - , "-......\,~ PART I!l DATE DEBTS AND DEDUCTIONS ':',,::W:,r:': 1 e CLAIMED ,,'T"':"~ ~ I TOTAL CEnter on Line S of r.x Co......tationl AMOUNT :--~ . PAID PAID PAYEE DESCRIPTION .- Under pen.lti.. of perjury, I d.clere th.t the feet. I hev. reported above are tru., correct and o_lot. to tho but of e~ knowlod... and bo11of, ( aENERAL INFORMATION 1. fAILURE TO RU~OHD NUL RUUL T lit AN OfFlCIM. TAM AIIEUItf.NT .lth _11...1. In'"", M'od ... In..,..II... lubIIlttN by the fJrIIW'lClI,l In.tltutlun. 2. IntMl'lt.no. hiM _OMI' MII".,."t "1M Ntlth' .,tll' the ~t'lI dlt, of deeth. J. A '.lnt It(IO~t II tlMllblt IVIW1 thoutlh the rt<<:.-n'" n... .... IdHd II . ..tt.r Qf ClDnVWlIMCII, ~. AG(lount. ct'lClludJntI tho.. hf.ld betNMn hu.ea.nd Ind wlf., whldl thl Hcl"'" put In jolrrl MM' within OM vur prior t. dHth .r. tuBV' tl",lIbl1 .. trM.f.r.. I. AOOGu"t. ..t.U..., .'alnth bet...., hv.-ld WId wif. Hr. thin one y..r prior to dMth .r. not t.J\:lIbll, 6. Account. held by . deo~t "1n tru.t for" ~t~r Dr other. .r. t.IC..J~ fully. REPORTING INSTRUCTIONS . PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the In'or...Uon IInd COIIPUtotlon In the notlel In oorr"' wid deduction. .r. not belnM ol,IHd, plM' In "I(" In block "A" of P.rt 1 of th4t "YIIC"lIlv.r Rupon.... .ectinn. Sl~ two oopl.. Ind .ubIIlt th.. with your ~ for the ...un' of tlM to the Revl.t.r of Wlll. of the county lndloet.o, ThM PA o.p.rt-.nt of R.venue will I..ue ~ offlol.1 ......-ent (Fora REV-ISo\" DO upon rlKl.ipt of the r.turn 'rOIl the A..htlr of Willi. Z. BLOCK 8 ~ If the ....t .peolflH Gfl thh noUc. hili bMn or will Da reported end talC p.id with thl Pann.vlvenll Im.rttMOI TalC R.turn fHad bv the Hclechtnt'u rapr......taUv., plec. am "I("' In blOClk ...... of Pa,.t 1 of the "lllCpayar "..pon,." IAHItJOI'I, IIIIfl Dna copy and return to tlw PA Papatt."t cf A.y~, lur.., 0' Indhdduel TalC.', Dtlpt Z60601, Hlrrhbur" PA 11121-0'01 In the anvel~ provided. S, BLOCK C '. If tM notlc. Inforatton 10 lnootrlNt end/or deWGtlonl Irll belnt el_tlled, Cl~ bloat< "c-' Md o",lah P"rtJ 2 and 3 tl;lor.rdlng t:: thQ Instruction::! beltl\.<. t:gn tW<l ovpJa~ Dnd ''.lbdt thlll wlU, ~iU..r \ol""-k (u; 1IM1 ~.t vf tall. ~aJ.ull11 lu lIllI AlI1iIh...., of Willi of the o~ty IOOJe.tlKl. Tha PA DepartHnt of AavlIf'I'bIWUl I..\MI en offlel.1 ......Hf'lt (For. RfV~lS4' EIU upon r.clIJpt (If the r.tu,'n 'roe the A.,llIt.,. of Will.. TAX RETURN - PART 2 TAX COMPUTATION LINE I. Ent.r the deta the IKlcount orllJnall~ w.. ..tftblJ~ or tltlad In thl lannar aKlltine It datI of o.lth, NOTE I For I decadent dying Itft.r 12./12l1l1 Aceountl which the dlKlldlnt put In joint n.... within OM H) ~"r of duth are taKabl. fullV .. trWl.f.r.. ltowavllr, thera 11 an o1<clu.lIm not to .lCcHCf n,oao per tran.flr.. rqflrdl... of tM v.lue of the McOunt or tn. ~r of ttClCountl held, If a doubla ..terilk CMM) IIlPP..r. bafore your flr.t n.. In the ..dar... portion of thll natlca, the 15,000 l)Cclu.lon alr.ad~ hI' been deduotld fr~ the aocount balanc. ft' rl90rted bv the f1nenolll 1~,tJtutlon, Z. Enter tM totlll b.llaM' CJf tha acC(K.lflt lnolucUng Int.r..t acc:ruMI to the data of d..th. 3. The ~rcWlt 0' tM .ueount that 11 t.ICabl. for IltOh lurvlvor Js eMter.ln.d ft' follaNIt A. The peroWlt ta..eMlI. for joint ft...ts ..tablllhad IIOr. than on. y..r prior to the decadent', deathl 1 DIVIDED BV TOTAL NUMBER Of JOun OWNERS ExMpI'1 A Joint ....t raghterld DIVIDED BV TOTAl tutlER or )( 100 . PERCENT TAXAlLE SURVIVING JOINT OWNERS in the nlaM' of the dac.."t and two other pe"on., 1 DIVIDED BV 3 (JOINT OWNERS) DIVIDED IV 2 (SURVIVORS) . .167 I( 100 . 16.n (lAXAlI,E FOR EACH SURVIVOR) e. The paro.....t t8IC..I. for ....t. oraat.d within 001I VI.,. of the dtCecHlnt'l d..th or aocounh 0NMd by the daeedlnt but held In tru.t for enoth&r IndlvldulU,) (tru.t b....f1c:1.r!1I11 1 DIVIDED BV TOTAL NUMBER Of SURVIVING JOINT OWNERS 00 TRUST .ENEFtCURIES I( 100 . PERCENT TAKAILE E)C...III Joint account r.glstered In the nMe 0' thft dacadant and two oth",' partonl and ..tlblhn.d wHhln one v..r of dllth by the dKedent, 1 DIYIDEb BV 2 ($URVIVORfi) . .SO I( 100 . SOU (T'\)(AIlE FOR EACH $~VIYOR) 4, The aHUnt 'ubjlMlt to tllC. (111\1 If) 11 dlt.rlllOld by -.,Ulplylng tht> account balance (ll". 2) b~ th. p.ro-nt hlCllbll (11M 5), 5, Ent.r the totlll of the debts and deduc:tJonl lilted In Part !1. 6, Tn...-aunt hICabl. (lInn 6) h d.tlr.11lId by 61ubtract1nQ thee debt. and d.duction. Cline S) frOll the uount .ubject to talC (11M 4). 7, Ent.r the IiPJIroprJata talC rat. (lJn.. 7l al deter.lned blloll, A. For d.t.. of death occurdng .,t.r 6/30/94, thl tlll)c ret.. for tral"f.'" to .paull. ar. a. fol1ctw.1 1. o.tel of death on or after 7/1/94 and bafar. 1/1/llS ttla ut. II n. 2. Oat.. at d.lIlth on or Hfter 1/1/910 tron.flrll to 'IK'"III" will be t.IC~ at 0;': talC r.t.. Hot'l For d,t.. of d..th prior to 7/1/~ tranlf.r. to SpOUI.' are t.ICable .t 6~. I. Tran'f.'" to lIne.l delr;endenh lnclucUno father, IIOth.r, 100, daughter, grandchildren, 10n-ln~lllW, ct.ughtlr-ln~lltW, ItapchHd Wid th.lr l..uI ora hMfthl. nt IIIC p.rc~t (6;(). C. Tranlf.,.. to all oth.r. 1llcludln" brother, ..l.t.rj \1001., aunt, nlphlw and nllc, are t.IC_lI, It flft.en parcant (1S~). n. If YOU chMOll the talC ~"te, pll..a .ptIC)fy your relatlonlhip to the dlcedant In thl IIlr.. provided, .. TM MOunt of talC du. (lIna .) I. dlter.ln.d by _Jltlptylne thll ltMOunt tl)Cabl. (lIne 6) by tM talC ret. ClIna 7), CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED AHowllbl. dIlbtl and daduCltlonl arll dtIt.,.alnad .. 'OUOIUl A. You I.plty era rupone1bh 'or pay.ent, or tM ..tetl luttjKt to 8dllnhtratlon b)' I par.unal repr...enhtllol. II InauffleJ."t to pay the deductlbla It.... a. You ac:tul!lllY p.ld thl. debh Itfter delth of the dacedlrtt and Cln furnhh proo' of pay.."t. C. Debts belne cllJMd _lit be tt..hed fully In Pa,'t 5. If ilddltlonal IPec. 11 n..dad, u.a plain p.,..r a 1/2" )C 11". Proof of ply.."t NV be raqueltad bv tha pA Dap.rt..nt 0' RlloIlnua. '",'.' '-'.', ::'Y:j':::: :'::!:::.:'.:, :::i:::::':;' """,""""':"""'.. "'JTAl(PAYIiIl IISSISTAlfCILi ' .. '. ,Ji".i.,:"" ":/" " IF YOU NEED FURTHlnllNFORMATtON oR ASSISTANCE, . cotlTACTANY" ...\ ,<.. REGISTER OF WlLLhPA DEPARTHEt+T OF REVEt+Uli DI$TRXCTOFIIXCE ., . .~ARRl~:U~a"~TJ~~ l'~R~~~ .g~2~~Dl~il~~tjr~~E~t2! m~YffteI=~~~RrH~=nE~NONlVl . ;-""::;,,.:,,, ',,<',',',' ::::::::;.::! GENERAL INFORMATION 1. FAILURE TO REINNO NUL ftEIUl.T IN AN OfFICIAL TAX ASSESSf'ENT with .,.1lflllbl1 lnter..t b..eeI on Infor_UIn IIUbIIlttlld by the UnMCI.1 tn,t1tutlon, !, InMtltWWlI tllC becnMl; d.llntttMnt nlr" lIOnU" "n.,.. thtt dM...."t'. dill, of eket". I. .. JtIIlnt lMI<<:1ount It tlxllbll Iven thouth thl decI..,t', MM .... lidded II . _UI" of conVMtencl. .. Account. (lnCllucUnll thou tMhf lMItWQn t'll."bMd lINt wi'..., whloh the dec"nt l~t In Joln't 0lMte1 wUhln OM ....,. prior to dMtn .r. fulh hubi. II t""".r.. I. hOOW1tll ..tllbllllt~ Jntntlw lMltween huibwtd Wid wlf. IIClr. thM OM ....r prior to dHth Ir. not tile_II, .. Aocounh Mid by . deolMMnt "In tnl.t 'or" IInOthtlr or ottwlt. Ir. tlMllbl. fully, REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE I. BlOCI( A - If tM lnfar..tloo and CMPUtllUon in tM notlu .r. corr4IGt IIInd dHuctletnl .r. not bell'll olahttd, piMa *" "X" In blook to." of P.rt 1 of tho "Tlll<plJly.r R..pon.." ..otlon. Sian two ('opll. tnd .ubIllt thM with your chMtt for tt. ~t of tlUC to the A..ht,,. of 1411111 of the county Indlclltad. The P" o.PlttltWlt of RlVtlnUtI wHI 11... ... official ......ant (for. RfV.15.~ EK) upon r~elpt of the return fr~ the R~.I.ter of Will.. 2. BLOCK B - If lM ....t tpll(llfilftd on thh notice hu bMn or ..IH be r."ortltd and tax pIJd wUh the PW'lnlylv.,l. InharUW'IO. faM Return fllN by th. dRadwlt., r.,.,anntath,., plICa WI "Jr' In block ..... of Plrt 1 of the '"'Taxplyer RI."on.." MGUon, II., onI copy and return to the ..., Oflpl.'taent l1f RevlnUl, &lr'lU of IndJvhtual Ta)l", DlPt 210601, HerrllttYr" PA 1'1121"0601 In thli Invllopa provided, 3, BLOCK C n If U.. notlu Inforut1on II Incorroat Mld/or deduction. '1" bllng olIIMd, Clheok block "C" and aOlJPlatl P.rt. 2 and 1< occoidl!", tc tho: lnc~rUcHcnc: ~~1('''. ::1i;n t~n coploc ~'l:t c1,.'tmH th.. with ytl~r eh<lclt fol" th":l D.lt".mt of t~:: p:.~..'blu to the Rag1a'tl:lr of Will. of the county indicated, Tn. PA Deplrt-.nt of Revenu. ~ll1 I..u. In off1cJ.1 ......-.nt (forI REV-IS4' EX) upon reo.lpt gf the rltuf'n frOM the R..llter- of Wllh. TAX RETURN - PART 2 - TAX COMPUTATION tINE 1. Enter the det. thtl eccount orlglnelh WI. ..teblhked or titled In the lenner el(hUna It datI of dMth. HOTEl far a ~~lt dylnt eft.r 12/1~/'21 Account. whlah t~ decldent put In joint n.... within ~ (1) y.ar of death era tlllxllblll fully I' trltfl.farl. 1io1Hlver, tI'l." 11 an IXOlUllot1 not to llxoe.d 11,000 per tran,fer.. rtttardl.u ot the value of the; IICcount or the f'lUlIbIr- of ItCCOU1t. hald. If I do>lbl. athr1lk (M__) rapplllr, b41fora your first na.. il"l the IIddr... portion of thh notla., thCI U,OOO al(alu.lon already hI' been dlduot.d frna the aacount belanol al r.ported by the financlal In.tltution. 2. Ent.r the tobll balltnOll of thtt account inductIng In'l.rut accrued to ttw date of delth. 3. The perclnt of t"- DCClOunt that 11 ta'lo:ab1. for fllWh Illtviyor 11 datar.lnlld a. follow.. A. Tn. plreent tlxab1e for joint a..eh ..tablh~d ure that1 OM ~"r prior to th. deca~t'. deathl I DIVIDED BV TOTAL HUMBER Of JOIN'r OWNERS Ex.-pla, A joint ....t rlglltlr~ DIYIDED BV TOTAL NUHIER OF )( 100 . PERCENT TAKAlLE SURVIYINQ JOINT OWNERS In the :'\IJM of the de<l.dlnt end tltO other Plrton.. 1 DIVIDED BV 3 (JOINT OWNERS) DIVIDED BV 2 (SURVIVORS) M ,167 )( 100 . 16.7~ (TAKABLE FOR EACH SURYIYOR) .. The peroent ta1(eble for "...t. crlltld within CIM ')'11111" of the decltdant'l de.th or account. owned by the dMedant but held in tru.t for anotMr IndlvldueHI) (tru,t blnlflelerlel)l 1 nI'/IDEO BY TOTAl. NUMBER OF SlJNIVING JOINT OWNERS OR TRUST BENEFICIARIES )( 100 . PERCENT TAMABLE EI(..lal Joint OCCGUflt rlgllhred In the 1"1'" of the d~"nt and two other Plr.on. and ut.blhhltd within OM yellr of de.th by thai d.aoaden t . 1 DIVIDED BV 2 (SURVIVORS) . ,50 )( 100 .50~ (TAMAlllE FOR EACH SURVIVOR) 4. n..-oLWlt 'tJbj~t to till( Cllntl ~) 11 dlhr.IMd by IUlt1plYlna the DClCount balena. (line 2) by ttM pereWlt ta>>\:ebll Clina 3), 5'; Enhr the; totel of the debt. and deductlonl Iht~ In Pa..t 3. 6. The ltlIUunt tlkxable (1lfl8 6) it dltlrlklnlKf by .UbtrltCltinll the d.tth and d.duatlon. (Une ,5) frOll tM MOUnt itAlJlOt to t.x tUne ~J. 7. Enter the IPprOflrbtlt ta'lo: rlt. ClIt'Ie 7) II dltlr.lnad b4Ilow. A. For d.te. of death O(:(lurrlng lifter 6/30/94, thl tax rat.. for tranlflr. to IpOUII. arl a. fallow. I 1. Detl' of d81th on or after 7/1/94 end blfor. 1/1/9S the rate II 3~. Z. Dltl' nf de.th on or aft.r 1/1/95 tr,".flr' to .paule. will b. tll(ed It O~ tllX rllt.. Note' Fat' dltl' of de.th prlol' to 711/'4 tr'llfl.ftrt tCl SPOOl" are taxable It 6)<. ~. TrWl.f_1"I to 1101111 ducendnflt.lnoludlng fIIth"r, .othlillr, .on, daughtlr, grnndahl1dran, .on.ln.1IW, daughter-In-l..., tlt~hUd end thillI' IlIIue IIr. tlIxabl. It .11( P4treent (6~)' C. Trlm.f_r. to flU otMr' IMlludJnll brother, ,ht.r, unoll, aunt, illlPhlw end nloee .rl taMable at flft"" percent (lSXl. D. If you chllnp thti ta'lC rllte, pllalll ,pKih 1/0ur re1ntltln.hlp to the dec.~t In the erla provl6ld. ft. ihlltllOUnt of taM dufI (11ne 8) is dlt.r.ln-ad by 1IU1tlplylnll the o.ount t8ll(eblo Cllna 6) by the taM rab (11M 7), CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED AllOWKtla debte and ~ctlon. II,. dlitlrlllned III foll~'l A. V(M.I ll8l11y Ire re.ponslbl' for plynnt, or thtl ..tatl lubJ~t to .d111nhtr.Uon by . perlonal repruentlltlv" II Inaufflcient to PllY the d-OUotlble It.... II. Vou ectu.1ly PII!d the debh .fllr death of the dlKlltdlnt end CIIn fur'fllth prO(jf of P'YllMt. C. Debt. belnt clelMd lU.t be HHhlld fully In Plrt 3, If eddltJooal .pIC. hi MltdecI, 1.1.. plain p.-r a Ill" x 11", Proof of P')'lIIf"lt ..y bI requ..tld by the PA ~artlllflt of Rllvenue. -"q" !.i:><: !~~~it~::!:)::::::.:: ~ ..,. ,.llGt~uEllIU~:f :KRLT$~ER~:tNU;}^1~;~XAWjESJuA:)~'$TC~t~TACllr"f\"e'1i ....)!;q. ". ' ., '. OR CALL THE )UREAU OF INDIVIDU"L TAXES, TAXPAYER INQUIRY UNIT IN .' HAFllnSIIURG AT (717) 787-8:521. T~D' ,~'tl7) 772-2252 CHEARUIO IHPAIREIl (lNL"~ ;';-;';'::;;.,,:,:,. PIlRI'OSE Of' MOTlCEl PAVttENTI REFUND (CAll p~ ~ "1) 10 ~nii) " ~ ;13 ~ 0, .""';1 f'L) '" I.; ~~ (,' )J~ - N To fulfill thl rtqulrHfK\tt of SIOUon 2lltO of ~h. Inh.rltMc, ."d E,tet. Tile Act, Act 21 of 1"1. (7t: P.'. botton 9140), D.taoh tho top portion of thl. Notlol and .ubl!t with ynur p'~..nt to thl R..llt,r of Willi prlnt.d on thl r.....r... lido, -- M'kt check or 1OnI~ orderp'~lbl. tOI REOXSTf.R O~ WILLS, AOENT, " r.fund of . h~ oredH, which WI' not r.qu..tM on the hI( r.turn, lilY bt r.qu..t.d by cOllPltUna an "Appllo.tlon for R.fuM of PIM'vlvllnlft InherHenol and E.tat. TI"" (REYNl113>. Appltoations Ir. .".l1abh at the Offlo. 0' thti Rqltt.r of Willi, MY of the 23 ~lIy.nu. Dht'.!ot OHlou or by ollllng thl 'Plclt! 24.hour anlw.ring .."vlcl ~'r.for for.. order'nGI In Plnn,vlva"la 1~aOOM362-2050, out.lda Ptnntvlv."I. and wlthJn 10011 Herrl.burg er.. (717) 7a7.8094, TOPI (717) 77Z~ZZS~ (H..rlng I~.lr.d Only). OBJECTIONS, Anv perty In inter..t not .stl.fi.d Nith the .ppr.I....nt, ,110wlnC' or dl.alloNanc. of deduction. or ........nt of t.x (:ncludlng dl.oount or int.re.tl I' .hown on thl. Notlc. M'Y obj.ot within .Ix~v (&0) dlY. of r.o.lpt of thh Notlcl by' ~-wrltt.n prot~st to the PA D.part.ent of R_venue, loord of Appells, Dept. 2&10Z1, Herrllburg, PA 1712&-10Z1, OR -~el.ctlnll to have the 1Illltter deter.lned at the eudlt of the eceount I)f the per.onal r.preunteUve. OR "-appeel to the Orph.,,' Court "MIN~ tSYUTIVE CORRECTIONS, DISCOUNT I PENAL TV, INTERESTI Feetuel .rror. dlsoov.r.d on thl. .......ont .hould be addres..d In wrJtlng tOI PA Depert.ent of Aev.nu., Bureau of Indlvlduel Tlxa., ATTNI POlt .........nt R.vl.w Unit, DEPT. Z&0601, Herrl.burg, PA 17128-0601 Phone (717) 7a7*6&05. S.. P'O' S of th. booklet "In.truotlon. for Inh.rltanea tax Aeturn for. Ra.ldent o.cadant" (REY~IS01) (or In explanetlon of adBlni.tr.tJvelv oorrectable error.. If any t.x due is paid withIn thr.e (!) calendar lonth. Ift,r the d.cedlnt'. deeth, . flva p.rcent (fiX) dl.count of tht tlM peld I. .llowed, The 15X tex ~sty nonHPlrtlclpetlon panllty I. coeputad on the totel of the tlX end Intera.t .......d, and not Plld IMforl Jenu.ry 11, 1996, tht flnt d.y aftar the and of tha tlX une.tv plrlod. lhh non-partiCipation pan.lt~ la app..I.bIa In the ~~.. lann.r and In the the .... tl.. parlod e. you would appeal tha taM end Inter..t th.t he, bun aueuM a. Indlceted 01'1 thh notlc.. Intera.t I. uhergad ~elllnnlng with first dav of dellnquancv, or nine (9) lonth. .nd one (1) da~ frol th~ det~ of d.ath, to the data 01 pey~ent. Taxes whloh baca.. delJnqu.nt bafor. Januarv I, 1982 blar Int.r..t at thl rat. of .Ix (6%l p.rcent per annul calculat.d at . dilly rate of .OUOI64. All t.x.. whloh bac..e dallnquant on or aftar Januarv I, 1982 will bait Inter..t at a rat. which wlU varv fro. o.landar y..r to calender ~'Ir ~Ith thlt rete ennaunced by the PA O.rart..nt of Rav.nua. The Ippllcabla Intar..t ret.. for 1981 through 1991 .ra, V..r Intere.t R.t. Dally Interest factor Vear Intarut Rat. Dailv Intarllt F.ctor 1982 ... ,0005lt8 1987 OX .000llt7 1915 16X .00041' 1981-1991 11:,( .000501 191~ 11:,( .000501 1991 OX .0002tt7 1985 In .000356 1995~199" 7X .000192 19116 lOX .OUOH" 1995-1'97 OX .000Z"7 ~ ~ Intlr..t II oalcuhted .. follow. I INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Nutt~. I..ugd aftar the tax baeoae. delinquent will r.flact an Inter.~t ealoulation to flft.an (IS) day. b.yond the datil of the .........nt, If pay..nt I. Iltdll aft.r the In'"rut co.putatlon deh .hown on the Notlu, addltloll"l lot..rut IU.t be calculated, ~ () :'0 rrf \,d :0 <'f> '" -J , , Ie ;'8 - 01 :'9 hJ " :g~ .. ~ ~ N _EOF NOTICe: I To fulfill tha raqulr....,h 0' S.otlot\J140 of tht lnh.rl't."el IInd Ettlt, TIIM Act, Aot Z1 of 1995. (72 P.'. SIClHon 9140), PAY tENT I DatlMlh the top portion of thh Nottel II'ld flub.U ",lth your PIIY.lnt to the Righter of WIU, printed on the rl".r.. ,Ida. ~~ Hake chlok or ~onay order pmyabl, tOI REGISTER OF WILLS, AGENT. REFUNO CCR), A r.fund flf . tal( or.dH, Iofhlch "'ill not ,..qu..tad 0" the hI< r.tur'n, Ifty b, rflquested by (lollPllUng an "Application for n.fund of P,nnoylvanla InharltftncI Ill,d Estlth Tax" (REV-Ul3)' Appllclltlonl 15". IIvMllabh at the OffiCI of the Roghhr of WUh, Itny of the 25 RevenuI DI,trlct OffiCII or by calling tho opiela! 24-hour answlrlnll ..,.vlc. nUMber. for for.. ordedngl In Plln,."ylllanJa 1~80D-56,-Z050, ou,.ld. Penn.ylvftnlll and within ~oclll Harrisburg .r.. (717) 7ft7R8094, TOO" (717) nZ-l2!iZ OI..,'lng I,paired Oi1Iyl. OIJEClIONS, A"~ p.rh' In Interut not nthfhd wHh 'th. apprllheHnt, 1!I11owllrlce or dlll!111owancft of deductionl or .....IIIMnt of taM OhClucHng clhcount or Inter..t)u lhown on thh Nothll .ay object within Ihty (60) dl!lYII of rec'lpt of thh Notlc. bYI --,.rlttan protut to th. flA IkIpBrt/ll.nt of R8Ivenu", board of AjlfllUlh, Oept. l810Z~, Harrisburg, flA 17128-1021, OR --.I~t1ng to hll.... the ..U.,. d..br.iood lit the Iludit of th, Ilccount of the p"rllonal repru."tllthle} OR ~~~.l to th" Orphan,' Court AD'UH- ISlRAlIVE CORRECT IONS 1 Factual err~rl dilco...er.d on this B.I.al.ent ,hould be addre.ged In writing to: flA Depllrt..nt of R.venue, ItoI,.."" 0" Individual Tnx.., ATTNI POlt Anu..ent Review Unit, DEPT. l60601, Harrhburg, p" 17}j~6~060l Phon. (717) 787-6505. S.. pa"e S of the booklet "Inlltructlon. for IntlllritanC\l TaM Rlllturn for B R..ld."t Decedent" (REV-HiDl) for an ll)(phnatlon of adlillnhtratlvft1y cClrrllotoble errors. DISCOUNTl If ooy taM due is paid w!thln thrae (3) cal.ndar lonth. aftlr tlllI dleldent'. duth, .. flvlI perclnt (S~() dll~ount of the t~x paid il .11~~.d. PENAlTY, The 15X tax aane.t~ nonMpartloJpatJon penalty J. co~utld on tn. total of thm tax and Int.ra.t a.....ed, and not paid "foro .IGnUtJrw la, 1996, the flrllt day IIfhr the end of the tax allnuty Plrlod. Thh non-lllrUclpeUon penett~ I. app.>>labt. in thl s..e .~nlr ~nd in the the .a.1 tl.. periOd ft, you would appeal the tllM and I~tere.t that M.. b.." .......d tU Indicated on thh notic,. tNTER'ES'fl Inturlllt It ch.rgld baolnnlnll with firat da" of delinquency, or nlnl (9) llIonth. and ona (1) day frOM the data of death, to th~ date of pa~.ent. Te~&~ which bIVIM. dellnquont blfnr, January 1, 1982 lMar Int.rest at the rate of '~M (6%) percant plr IltIlnu. calculated at II dalh rBta of .000164. All taM.' whlClh bec... dfll1nouent on or aftar JltIlUary 1, 1981 will blar Inhrest at . rat. Which N111 v8ry fro nlland.r yur to calendlllr "ear wi th that "flte announcad by th. PA napart..nt of Rlvanu.. The appllCmbh Intere.t rat.. for 1982 thr~ 199/ arll Va.r Illt.r..t Rahl Ollllly Intarut Faotor Vier Intlrut Rata Dall)' l.ntarut Factor -- -- 1982 20;( ,0005,.1 Ull7 " .000247 19U 16;( .000411l 19.'-1991 11X .000101 1984 11% ,000501 1992 " .000247 1985 15% .ODn56 199!Sw1994 7~ .000192': 1986 1Ol( .aDflZ7,. 1"5~1"7 " .0002"7 --Inter..t II calculated eJ follD""1 INTEREST . BALANCE OF TAX UNPAIO X MUHBER or OAYS DELINQUENT X OAILY INTEREST FACTOR --Any Notice luu.d .fte.' the tax baeo... a.Unqu.nt will rllfleot In intere.t calculation to flfta.., nSl de,,1 beyond thl deta of the aU.fluent. If pllly.ant h r;,uJ. after th. Inhrut co.putlJtlon dlta .hown on tha Katie., ,ddltlonel Intere.t lUst b. cbloulfttad. .~~ 1.;1''',- \d "'-J :r;ff{ qi () ,-~ . b) \;'",\1'; ;~1( , ~ ....... "O!\ ~J :32 hJ ., .,;,;,;4 N i2~i _01' tllITlCi' To fYlfll1 the r.qulr...nti of &ectlon 21~O of thl Inherltanol end'"etl'e TIK Aot, Act 21 of 1"1. (1t P.I. 5tC1t1cm 9140). PAYMENT I Dltach tMtop portlon Qf thil NoHel and IIJbIU with your PlY""' to thl RI,hter of WIU, prln~DCI on tM rev.r.' ,io.. ~~ "lake chlok or ItOMIY \lIr"I' payable tOI REGISTER or: Wll.l'S, AGENT. OBJECT IONS I Anv pertv In Inter..t not 'lltl'fled with the appr.tIDRlnt, .11ow~c' or dllallOwaficl of deduction. or .....,aent of tlM (Inoludlng dlMCQuot or Inter..t) .. shown on thl. Notlcl .my objlct within ')Mty ('0) day~ of r~elpt of thh H\'tUCI. bv I ~~wrltttn prot..t to th~ PA DIPlrt..nt of n.y~nu'l laard of lpp..ll, Dept. 281021, Harrl,burl. pA 1711a~1021, OR -MllleUng to hl"'l the lIottar dltl,'.lned It the audit of th4l aeoount of thtt pefllonel r.prl..nhtllJfl, Ollt ~~IPfte.l to thtl OrphMIl' Court A r.fund of . tax credIt, whIch wa. not I..qu~.ted on thft tax r.turn, .ay b. r.quelted by o~letlng en HAppl1oation for Rafund of Penn.yll/enh Inh.ritanoa and E.tata Tax" (P.f,\I<15Ul. Appl1GaUonll arfl ....all.bl. at 1he OfHc. of tho R..hte,' uf WIll., llmy of thtl U Ra",8nll_ DhtrlGt OHio.. or by olllllng the .pecllll 24-ho\lr anlw.ring ..rvlol nua.ar. for far.. ordflringl In P.nnlYlvenla I-tlOO.56Z-20S0, outside PIl\MIlY''''N'lla Mld Nithln local Harrhburll ern (711) 787-80'14, TDOI (717) 772-2252 Oll'llllrlnll hlPolr~ Only). Rl!:FUHD (eft) I AlIt1IM- lS'I1lATlW CORRECTIONSl FaatulII errors dhcover.d on thh u.euMflt .hould be addr....d in wriUng to: PA OepertMnt of Ravanue, lur.au of Ind~vldu.l l~xal, ATTNI POlt ......-.ot Raview Unit, DEPT. 2806n1, Hartltburg, PA 171Z8-06D1 Phone (117) 787-6505. S.. paw. S of the bookl.t "In.tructlons for ll'lh.ritanctl TllIx Return for.. RelIant Decadent" (REY-IS01) for an explanation of ftd.inlstretl....lY oorrectabl. errort. DISCOUNT I If .nv tlX dua b paid within thr.' (1) oll.nlJar IIOnth. .ft.r tha dacadcmt'. da.th, III fiv. paroent (510 dl.count of tha tax p~ld I. .llow.d. Th. lSX tax ~.ty non~p.rtlalp.tlon p.n.tty I. coaput~ on tha totel of tha t.M and Int.rl.t ......ed, and not Plld "for' January 181 1996, tha fIr.t day .ftl" tM .nd of thlil tllol ..nuty p.rlod. lhl. non-pII'Uolp.t1Dn paMltY It WfIP.alltbl. in till.... .annar and In t~ tha ...a U.. pariod at you would ltPP'''~ the tax IIf1CI int.rett that hat bun ......ad .. lndioet.d on ttl1. noUc" PEMAl TV 7 I"TERESll Int.r..t 11 Clhtlrpd "glnnlllll wHh fir.t dl!lY (If dallnquMCoY, or nlnl (9) IIOnth. .nd ana (1) d'lI frOll tM dlIta of oath, to tht deh of pay"lnt. T'MU which blclllla d.lln.....nt baforl Jlnu.ry 1, 1982 bMr Interut It thl rlt. of .IM (6:() PllIrc.nt par l"nUII caloultltMl It .. d.lly rata of ,0aOl,... All tlllllll which btlc... d11Inqu~t orH1 or IIftlr JltnU8ry 1, lYI2 will blUM' interelt It .. r.ta which Nl11 vary fr. oll~r 1I,.r to oaland.r yaar with th~t r.ta BIW~ad by tn. PA Dapart..nt of Ra",enuI. T.,. applIoabla Int.ra.t rite. for 198' through 1997 arll ~ tntlr..t R.h DtllIly Intlr"~ Vaar Intera.t Rah DallY Jntar'llt flotor 1912 20X ,000S48 19" "' .0002't7 1'83 16~ .008't!lft 1988-1991 11:< .00OSOl 1'84 II~ .000501 1992' .~ .DD021\7 1985 UX ,000356 l'lIi5-19" 1X .060191 1'" lOX .000274 1995~1991 .~ .000247 nlntar...t It calcul,tad .. fol10w'l INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ~.AnY Motlc. I.,u,d .ft,r th' tax baco..' dallnquent wltl ,.lfllot &n lntera.t caloulatlon to flft.," (II) daYI beyond the data of th. ...n...nt. If p.~.Gnt 11 .~. after thlt 'ntarut cOIIP\Jhtlon dlte Ihnwn on the Notleal Iddltlonal Intara.t MUlt b. cBlculeted. gP, ~1 ~ t'f l ::3 :uffii (l) () o , ,:1 i;., j' ~ ...'" Ch Tjl ,,; ~ ::g f"L) '" .. ~ ii, Cl ...... N PURPOIE Ill' NOTICE~ To fulfHlthl rlqulr..ent. of lIoUon 21/t0 of t~ Inntrltlno. Ind ht". Tax Aot, Act 21 0' 1991. (12 P.', ,"Uon.IOIl. rAYHI!NTI Deteoh the t09 portlon of thil Notiu and tub_It ..Un your p.~..nt to thl A'8lthr of WUlI print" on the r...,.r.. aide. .... HIIk' aheok or IIOMY ord.r pIV.tlll tal REGISTER OF WILLS, AQEN1', RE~LJm (CR)I A refund of , tllC ClI'Hit, Nhlcn Iil" not rlq\M.tld on thl hM return, ..y bl rlqu..ted by nOIlPIIUne ... ",,,,UGatlon 'or RlI'und of PMI'llv!"'lnl, Inh.rltanOI anll E,t,t, Till" (REV~1:5Ul. App1!cDtlonl ,.r. Iv,11IbI, It the lJffloo of the Regllt.r of Willi. any ft' the 2J RayenuI DI.trlot Dfflo.. or bV 0111lnl thl IPlolat 2~.hour an.w.rl~ 'Irvlo. nuMHtl'l for 'orlll ortt.rlng: In Pann,vlvanla 1-800.562-2050, out. let. Ploolvlvllllt end within 100.1 Hlrrltbur. .r.. (717) 717~.094, TDOl (117) 772-225~ (H..rlng IMPalr.d Onl~). OIJECTIONSI An~ p.rt~ In Int.r..t not .ntl.flld with t~ .pprll....nt, allowancl or dl.allowanc. of ~tlon. or ......-.nt of till (Including dlscoUl\t or lnt.rut) u .hown on thll Notlc. ..~ objeat within .1lCt~ (60) dl~1 of rHelpt of thll NotlcI b~l uwrltt." protl.t to the PA D.parbll1t of R~lnuI, BClrd of APPIlIl., DIPt. 211021, Hlrrhbutg, PA 17121-1021, Oft ulleotlnt to haVI thl ..ttlr dltlr.ll'lId at th. ~it of thl account of thl plr'OMI rap,....,.tltl",., 01 ~-applll to the Orphan~' Court ADIlIM- ISTRATlYE CDAttf:CTIONS: Factus1 Irror. al.cOVlrld on thl. I.......nt .hould b. .ddr....d In writing tOI PA OePlrt.tnt of RIVlnua, al,lrlau of Indlvidull T.lC'" UTNI Po.t .......II..nt Alvl... Unit, Df,PT. 280'01, Hlrrhburg, PA 1712'-0601 Phone (717) 787-6505. S.. pag. 5 of thl book1_t "In.tructlon' for Inh.rltlnG. TIlC Maturn for I RI,ldlnt o.cedent" (REV-1SOI) for 1m .)(planatlon (If ad.lnl.tratlvll'l correctabl. _rtor.. DISCCK*T I If My talC duel II paid NUhln thr.. U) c.l.ndlr aontl" Iftlr the dlndlnt', d..th, . fI"'l plreent (5)0 dl.count of the talC Plld 1. a1lowad. PfMAtTVI The 15;( talC MInIlty non-participation panlllt~ Is COllPUtad C'n thl total of the talC lJtId Int.r..t .......d, Ind not plld blforl JllnUary II, 1996, the flr.t day /!1ft.,. the It"Id of th_ talC 81m.,ty period. Thh non-partlclpaUon IPlI\IIlty Is appealable In tha .... .annt,. 8n" In thl the .... U.. period .. you would appIIl the talC end Int.....t thllt hlr. bun a......d III Indlcat.d on thlt noUc.. INTEREST I Int.r..t II charo.d blglnnlng wHh flr.t day of dlllllnqu.ocy, or nln.. {9) lIQnth. Md on. (I) d.y f..~ thl dlt. of dlath, to the date Qf peY~lnt. TalCI, which booa.. ~llln~Ulnt blfore Januar~ I, 1982 blar lnterl.t It the rlt. of .llC (6%) p.rv.nt PQr annUM calcul.t~ at a nally rat. of .000164. All t.lC.. which ble... dlUnqulnt on or IIftlr Jllnuary I, nil will h.."r Inhrut at I rlt. whloh will "'...~ frM calandl~ 'II'" to c.l.ndar Ylar with that rat. announcGd by thl PA U.part.~t of R.v~. ThI .,,110101. Int.....t rat.. for 1982 through 1997 ar.1 VI.,. Intarut Rah ~ Int.r..t ractor Vlar Intl,ut Ret. Dilly Int.r'lt Factor --- 1912 lOX .000548 1987 'X .000247 1911 lOX .OODft!1 19.'-19\'11 11:< .000101 I'" 1IX .00nOI 199' 'X .0002'7 1915 11:< .000156 1995-1994 7X .00Dl1J2 I'" 10;': .000274 1995.1997 'X .000247 ulntlrut Is o.loulatld .. follows I INTEREST' I^L^NCE OF T^X UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTDR ..'"'1 Hotlel 1.lued .ftlr thl tlllC bleo... dlllnqylnt will r.~llct .n Interlll.t c.lculation to flft.." (1~) dlYI beyond the data of the a.'I'...nt. If ply..nt I. ..d. .ft.r the Int.r..t coaput.tlon alt. .hown on the NOtl(ll, additional Int.r..t IU.t bl CIlculate.