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COMMONWEALTH OF PENNSVLVANIA. DEPARtMENt Of HEALTH' VITAL RECORDS
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O"ICI 0' CHII' COliNIEL
DEPT, 281081
HARRISBURG, PA 17128.1081
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
PHONE,717.787.1362
FAX: 717'772'145G
Donald K. Zagurskie, Esq.
Johnston and Zagurskie
117 Main street
P.O. Box 0
Mifflin, PA 17058
Re: Estate of Robert A. Barron, II, deceased
Court of Common Pleas of Cumberland County
No. 1997-00173
Dear Mr. Zagurskie:
.The Department of Revenue recel ved a copy of the PeU tion
for Approval of Compromise Settlement Concerning an Estate, filed
on behalf of the above-referenced Estate in regard to a wrongful
death and survival action,
According to the Petition, the eight year old decedent
drowned after attempting to flee a vehicle submerged in water.
Decedent is survived only by his father, as his mother died in
the same accident. Your letter asserts that the primary claim is
for loss of income over the child's work life expectancy.
As you should be aware, pursuant to the Supreme Court of
Pennsylvania, damages recoverable under a survival action include
those for future earnings, Kiser v. Schulte, 538 Pa. 219, 648
A.2d 1 (1994). This is supported by the Commonwealth Court.
Roberts v. Dungan, 574 A.2d 1193 (Cmwlth. ct. 1990). As your
letter claims that the primary claim in this action is for lost
earnings, a large portion of the settlement proceeds of this
action therefore must be allocated to the survival action.
Please be advised that, based upon these facts, and for
inheritance tax purposes only, this Department objects to the
proposed allocation of the gross proceeds of this action,
$135,000 to the wrongful death claim and $15,000 to the survival
claim. Instead, as the primary claim is for loss of income, the
Department would not object to an allocation of the proce~ds,
$50,000 to the wrongful death claim and $100,000 to the survival
claim. Proceeds of a survival action are an asset included in
the decedent's estate and are subject to the imposition of
Pennsylvania inheritance tax. 42 Pa,C.S.A. ~8302, 72 P.S.
~t;9l06, 9107.
Donald K. Zaqursk~e, ts~'
December 10, 199
page TWO
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6, At the aforesaid time and place, thc aforesaid vehicle came to rest upon thaI certain
bridge at the location described above and as l\ result of Kimberly S, Barron's negligence in
driving her vehicle on the bridge covered with high waters, both occupants were deceased,
7, The Register of Wills ofCull\berland County, Pennsylvania, issued Letter of
Administration to Robert A, Barron, II, on or about February :\ I, 1997, (See letters attached
hereto as Exhibit "A")
8, The administrator, Robert A. Barron, II, filed suit in Juniata County, the place of the
aforesaid accident, against the Commonwealth of Pennsylvania, Department of Transportation
and Charles S, Imes, Administrator of the Estate of Kimberly S, Barron, bearing the Court of'
Common Pleas of the 41 st Judicial District of Pennsylvania, Juniata County Branch, Civil Action
Number 17 of 1998.
9, The owner of the 1988 Grand Am, William E, Hackenberger, was insured through
Anthem Insurance Companies, now Shelby with an available policy limits in the sum of Fifty
Thousand Dollars ($50,000.00),
10, The driver of the aforesaid vehicle, the deceased, Kimberly S. Barron, has no other
insurance coverage available at the time of the aforesaid accident.
11. The Administrator of the Estate ofKlmberly S, Barron has executed an Affidavit
verifYing that no other insurance policy exists under which liability coverage would have been
extended to Kimberly S, Barron as a result of the aforesaid, (Said Affidavit is attached hereto as
Exhibit "B"),
12, Mr. Hackenberger's insured has offered the sum of Fifty Thollsand Dollars
($50,000,00) in full settlement of liability claims on behalf of their insured, and represents that this
is the available policy limlts which were confirmed,
I J, Al the time of the af(lresaid accident, Robert A. 13armn, I, lhc AdministratOl' of the
Estate of Robert A. Barron, II. had primary physical and legal cu&tody Mhis deceased child,
Robert A. Barmn, II,
14, At the aforesaid time, Robert A, Barron, I, has Underinsured/Uninsured Motorist
Benefits available through his insurance policy with Erie Insurance Company,
15, The Petitioner's lJnderinsured Motor Insurance Carrier, Erie Insurance Company, has
offered the One Hundred Thousand Dollars ($100,000,00) Policy Limits to settle the Under
Insured Policy Claim.
16, The Defendant, Commonwealth of Pennsylvania, Department of Transportation, in
Juniata County, Civil Action Number 17, 1998, has refused to render any type of settlement offer
and has taken the position that there is no liability on behalf of the Commonwealth arising from
the afpresaid incident. Petitioner, is of the opinion that the cost and potential liability of
Defendant, Commonwealth of Pennsylvania, Department of Transportation, is so limited that the
cost of suit is prohibitive verse the potential outcome gained therefrom on behalf of the Estate of
Robert A. Barron, II,
17, Based on the aforesaid, Petitioner is of the opinion and belief that this compromise
should be in full satisfaction ofal! claims arising out of the aforesaid incident, including releasing
Defendant, Commonwealth of Pennsylvania, Department of Transportation from any liability
therefrom,
18, Robert A. Barron, I, Administrator of the Estate of Robert A. Barron, 11, retained
the law firm of Johnston and Zagurskie, on a contingency fee basis to represent the interest of the
Estate, This Agreement provides for a thit1y-three and a third percent (33 1/3%) contingency fee,
However, the law firtll of .Johnston and Zagurskiehas agreed to reduce its fee to thirty pcrcent
(30%) of the Under Insured Bencfits and thit1y pcrccnt (]O%),
19, Pctitioner has requested from thc Pennsylvania Depat1ment of Revenue an Agreement
concerning distribution ofthc wrongful death and survival action and has received approval to
distribute $52,~OO,OO towards the survival action and Ninty-Seven Thousand Five Hundred
Dollars toward the wrongful death action, (See letter from the Department of Revenue, attached
hereto as Exhibit HE",
20, The Petitioner requests that the settlement be approved and he be allowed to settle
and sign any releases necessary,
21, Petitioner believes and therefore avers that the amount of the compromised settlement
is appropriate and fair.
22, The Petitioner's Counsel certifies to the COUt1 that all interested parties have received
copies of the Petition and proposed Order included herewith,
23, Petitioner requests the Court to approve the settlement.
24, Petitioner, Robert A. Barron, II, has joined this Petition to veritY his approval,
understanding, agrecment, and consent to this Petition,
WHEREFORE, Petitioner respectfully request the Court to enter an Order as follows:
I, The Court approves the settlement to the Estate of Robert A. Barron, II, in the
amount of Fifty Thousand Dollars ($50,000,00) from the Anthem Insurance Company on behalf
oftheir insured, the Estate of Kimberly S, Barron;
,____-"'.1_\",__""-",- .
2, The CoUlt approves the selllement of Underinsured Motorist .Benefits to the Estate of
Robert A. Burron, II, from Erie Insurance Company in the sum of One Hundred Thousand
Dollars ($100,000,00)
). The Court approves apportionment of the total selllement in the amount of One
Hundred Fifty Thousand Dollars ($150,000,00) as follows'
(a) Fifty-Two Thousand Five Hundred Dollars ($52,500,00)" Survival;
(b) Ninty-Seven Thousand Dollars Fivc Hundred Dollars ($97,500,OO)"Wrongful Death,
4, The Administrator of the Estate, Robert A, Barron, I, and the parent and natural
guardian of the deceased, Robert A, Barron, JI, may sign and execute any releases on behalf of
the estate in order \() sellle the above-referenced claims;
5. Shelby Insurance Company and/or Anthem, its heirs, successors, assigns, etc" are
hereby discharged from any claims arising our of the above-captioned action;
6. Erie Insurance Company, and/or its heirs, successors, assigns, etc" are hereby
dischargrd from any claims arising our of the above.captioned action;
7, Approval of the Release as attached hereto as Exhibit "C" is approved: The
administrator may sign this Release on behalf of the Estate,
8, Approval of the Release attached hereto and marked as Exhibit "0" is approved, The
administrator may sign this Release on behalf of the Estate
9. The Defendants, Commonwealth of Pennsylvania, Department of Transportation,
Estate of Kimberly S. Barron, deceased, Charles S, lines, administrator, are discharged from any
and all further claims arising out of the above-captioned action,
H.KLKA..~l<.;
KNOW ALl, TIIESE MEN THAT ROBERT A. BARRON, I, AS ADMINISTRATOR OF
THE ESTATE OF ROBERT A, BARRON, II, DECEASED (IIERElNAFTER REFERRED TO AS
TilE "RelellsOl'(s)"), 1i.\I' nnd in solc l,onsidcrntion of FIFTY TIIOUSAND ($511,OOll) DOLLARS,
the receipt IInd sufficicncy ol\vhich ure hcrcby ucknoll'lcdgcd, do/docs hcreby rcmise, release, and
dischurge COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF
TRANSPORTATION, ESTATE OF KIMBERLY S, BARRON, DECEASED, AND CHARLES
S, IMES, ADMINISTATOR OF TIlE ESTATE OF KIMBERLY S, BARRON ( IIERElNAFTER
REFERRED TO AS TIlE "Releasee(s)"), together with all other persons or entities, both known and
unknown, who arc or subscquently may be determined to be liablc 1'01' the claims rcfcrred to below,
their heirs, exccutors, administralors, insurcrs, employees, successors, and assigns or and from all,
and allmanncr of, actions nnd causcs of al'lion, sui Is, debts, liens, dues, accounts, bonds, eovenanls,
contracts, agrcements, judgments, elnims, and dcmands whatsoever in law or equity presently
existing or subsequl:t1tly discovered by ROBERT A. BARRON, I, ADMINISTRATOR OF
TilE ESTATE OF ROBERT A, BARRON, II, resulting 11'0111 an incident lhat OCCUlTed On January
19, 1996, which against thc said Releasccs I/we ever had, now have, or which my/our heirs,
executors, adminisll'l1tors, successors, or assigns or any onc of lhem hereafter shall, or may have for
or by reason of lIny cause, mutter, or thing whatsoevcr.
I/we understand snid Rclcnsees, by rcnson of' agreeing to this compromise payment, neither
admit Iinbility hut all exprcssly deny linhility of' any sl;ti, and said Relensces hnve made no
agreement 01' promise to do or omit to do nny act 01' thing not herein set forth, and Ilwe further
understand lhut this Relellsc is Illude liS n compromise to uvoid expense to termillute all controversy
EXHIBIT lie-I"
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{IIYy~;\ ('II~~;;;;~I~~----~-"'''- .----'--~~"_.~~~~
Tax Payments and Credits:
ITa, Due (Page tllne 1 B)
2 Credlts/Peyments
A Spouaal Poverty Credit
B, Prior Paymant.
C. Discount
(1)
$1.607,76
3. IntarBBVPenelty if appllceble
D. Interest
E Penalty
Total Credits ( A + B + C ) (2)
TotallntereSVPenalty (0 + E) (3)
4 Ifline 2 is greater Ihen line 1 + line 3, enter the difference. This Is the OVERPAYMENT,
Check bo, on Page 1 L1n. 19 to request a refund (4)
5 if IIn. 1 + line 31s lIfe.ter Iha~ line 2, enter Ihe difference This Is Ihe TAX DUE, (5)
A, Enter the interest on the te, due (SA)
B. Enler the tolal of line 5 + 5A This is the BALANCE DUE, (58)
Make Check Parable to: REGISTER OF WILL; AGENT
Pl.EASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
~, Old decedent make a transfer end' Yes No
a retern the use or income of the property transferred; , ,0 [RJ
b, retain the right to designate who shalt use the property trensferred or its income: 0 [RJ
c retain a reversionary interest: or ,. ..."Cl IXI
d, receive the promise for life of either payments, benefits or cdre? , , ,0 !RI
2 If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adoquata consideration? If death occurred
aftar December 12,1982, did decedent transfer property within one year of death without
receiving adequate consideration? , ".0 00
3 Did decedent own an "in trust for" or payable upon de.th bank eccount or secullly r"X"
at his or her death? 0 LC>J
4 Old decedent own an individual retirement account, annUity, or other non.probate property? ,0 [RJ
-
IF THE ANSWER TO IINY OF THE ABOVE QUEST tONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
72 P S, ~91 16 (a) (1.1) (i) provided for the reduction of the tox rate imposed on the net value of transfers to or for the use of the
surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January I 1995
72 P S ~91 '16 (a) (1 1) (il) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the survIving
spouse from 3% to 0% for dates of death on or after ,Ienuery 1, 1995. The statute does not exemill a transfer to a surviVing spouse
from tax, and toe statutory reqUllements for disclosure of assets and filing a tax return are still applicable even If the surviVing spouse
IS the only beneficiary
FOR DATES OF DEATH ON OR AFTER JANUARY 1,1995. Please answer the follOWing question by placing an "x" in the
appropriate space,
Old the decedent create a truat or similar arrangement which Is soley for the surviving spouse's benefit for his or her entire
lifetime? Yes 0 No [RJ
If you answered yes to the ebove question, tile ta, on tile trust or similar arrangement is postponed until the deeth of tile second
spouse, at which time It Will be fully taxable at the rate(s) applicable to the remainder beneflciary(les). Enter the value of the trust on
Schedule J, Part II, in order to remove it from the calculation of the tax due in this estate You may wish to file Schedule 0 in order to
make the election evailable under Section 91 I 3 If the election is made, the trust or similar arrangement is taxed In the estate of the
first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse IS taxed at the zero ta, rate,
and the remainder is taxed af the rate(s) applicable to the remeinder beneficiary(ies) If you choose to make the election, you must
att~ch Schedule 0 1.0 e tlmely.filed tax return, along with Schedule(s) K and/or M In order to show the apportionment of the trust or
similar arrangement between the survIving spouse and the remainder benaficiary(!es)
"'''''''''''''.
1,I)MI,lIlnWfM 111(11 f'lt,III',YiVAtIlA
IilHf W1AlW( 1^~: JlI1illlfl
HI.'iIIlIIH III Cl PI III
......_l _-...._~ __._.
mArE OF --'-
...emwl Robort.,L II
SCHEDULE C.1
CLOSH Y .HELD CORPORATE
STOCK INFORMATION REPORT
== .........:..
FILE NUMBER
2L 97
N&me of COI)lorollon
Address
City
2 F edeml Employer ID Number
3 Type of Business
St9te
Zip Code _
Stote of Incorporotion
Dole of Incorporation
Total Number of Shareholders
Business Reporting Yeer
ProducVSelVice
4
TYPE
Voting I Non.Voting
PAR VALUE
NUMBER OF SHARES
OWNED BY THE DECEDENT
TOTAL NUMBER OF
SHARES OUTSTANDING
STOCK
Common
Preferred
Provide ell rights and les~ictions pertaining to each class of stock
0173
VALUE OF THE ~
$ DECEDENT'S STOCK_
$
5. Was the decadent employed by the Corporation? 0 Yos DNa
If yes, Position Annusl Salary $ Time Devoted to Business --..--
--
6, Was the Corporetion Indebted to the decadent? 0 Yes o No
If yes, provide amount of indebtedness $
Was there life Insurence payable to the corporation upon the death 01 the decedent? 0 Yes 0 No
If yes, Cash Surrender Value $ Net proceeds payable $
Ol'mer of the policy
6 Old the decedent sell or transfer stock of this company I'o1thin one year prior to death or I'o1thin two years if the dete of death was prlqr to 12.31.82?
o Yas 0 No If yes, 0 Transfer 0 Sale Number of Shares
Trensferee or Purchaser
Attach a separate sheet for additional ~snsfers andlor sales.
9, Was there a \>fitten shareholder's agreament In effect at thA time ollhe decedenrs death?
If yes, provide a copy of the agreement
Consideration $
DYes 0 No
10. Was the decedenrs stock sold?
DYes 0 Nn
If yes, provide a copy 01 the agreement of sale, etc.
11, Was the corporation dissolved or liquidated efter the decedent'. desth? 0 Yas 0 No
If yes, provide a breakdown of dis~lbulions received by the estate, Including dates and amounts received.
12 Old the corporetion have en interest In other corporetions or partnerships? 0 Ye~ 0 No
If yes, report the necesssry information on a seporate sheet, including e Schedule C.l or C.2 for each Intarest
THE: FOLLOWING INFORMATION MUST BE SUBMllTEO WITH THIS SCHEDULE
Date
A Detailed calculations used in the valu.tlon of Ihe deceden!'s stock.
B, Complete caples of finsnClal statements or Federal Corporate Income Tai relurns (Form 1120) for the year of deeth and 4 preceding years,
C If the corporation owned real estato, submit a list shol'o1ng the complete address/os and estimated fall market veluels. If real estata appraisals have been
secured, attech cOP"s
D. list .'f principal stockholders etthe date of defllh, number 01 shares held alld thelllelallonshlp to the decedent
E list of officers. their salaries, bonuses and any other benefits received Iiom the cOl)loration
F Statement of dividends paid each year List those declared and unpaid
G Any other informalion relating to !he valuation 01 the decedent's stock
''',..",.,''''.
r.OMMotIWI AI fit or flUItl~,YI \MII/'I
IrjtllflIIAlICIIM;RIHiWl
HrSIUltl1 {)f,CUlUII
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
..flar.clln Robert A II
If.n ....t woo m.d./olnt within on. y'" of tho dIC.d.nl'. d.l. .f d"th, It mUll hi report.d on S,h.dul. o.
SURVIVING JOINT TENAtH(Sj NAW'
ADDRESS
A
B
c
JOINTL Y.OWNED PROPERTY:
FILE NUMBER
21 97
0173
RELATIONSHIP 10 Df:Cf,Olfjl
lETIER DATE DESCRIPTION OF PROPERTY II Of om OF DEA Tt!
ITEM FOR JOINT MADE l!\Cude nat1'\(j tlf flnmal insti1U\lon 8f1d bank axounl numbel' or 1imil!r Iden~1)1n1J number, Mach DATE OF DEAHl DECO'S VAlUE OT
NUMBER TENANT JOINT deed fOf jojl\t~.hekl f8aleFtllle VAlUE Of ASSET INTEREST OECEDE:NT'S ImEREST
1 A ,
,
,
TOTAL (Also enter on line 6, Recapitulation) I
(If more space Is needed, Insert additional shoets of the same siza)
'" -+, ." .......
'''"..".,''''.
1:()MMoI/WIAIIIIOf Plllljl;YI V^'II^
IIlHIIlI1MlCl IM:UI1\lfHl
rll~K)! Il1 OICWnl1
~EST"TE OF ---=
..Barron BQ.llert A II
SCHEDULE G
INTER.vIVOS TRANSFERS &
MISC. NON,PROBATE PROPERTY
FILE NUMBER
21 97
0173
Ihl~ schw1llle rlllml hp complel(td and filed If lhe ftflSWor 10 any of quolltlons I through 4 of11tw revarso Sldo 01 tho RLV.1500 covtH SHEET IS yes
.
DESCRIPTION OF PROPERTY %OF
III'M Jj~UIOO Ill' HAW Of ItE TIlNI$FEMf 11t"II!LA1~'OOl!ceOfHT .tHllltom Of 'llNI'UIR DATE OF DEATH DECO'S EXCLUSION T AXABI E VAl LIE
!~UMBIi R m~.MI.'OPYOf'~oeI!OfOllUUTI.U VAl.UE Of ASSf. T IIHEREST (Filf'tICI.'Ui
1
.
,
- --
TOTAL (Also enter on line 7, Recapitulation) I
'''"u,..,,'''.
cot,lMOljWfAUH ()f Pl'IU!SYI VAtjl'\,
1tII!l-HIIA/j(:l-lAX filllJllN
RISI[)Un tltGIDnn
EST.~TE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
M ~nh.rt .A.. II '1 Q7 n1'7'-
RELATIONSHIP TO DEOEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) REOEIVING PROPERTY Do Not L11l Trull"(I) OF ESlATE
.-
f. TAXABLE DISTRIBUTIONS (Include oulrlghtllpOuall dl9lrlbutlonl)
1. Robcn A, Bllrron Fllthcr 100%
IOf) Woodlllnd Avcnuc
Ncll' Cnmbcr/llnd. P A J7l17l1
ENTER DOLLAR AMOUNTS FOR OISTRIBUTlONS SHOWN ABOVE ON LINES 16 THROUGH 17, AS APPROPRIATE, ON REV 1500 OOVER SHEET
II, NON. TAXABLE DISTRIBUTIONS:
A SPOUSAL DISTRIBUTIONS UNDER SEOTlON 9113 FOR WHICH AN ELEOTION TO TAX IS NOT BEING MADE
1,
B, CHARITABLE ANO GOVERNMENTAL DISTRIBUTIONS
1,
TOTAL OF PART II - ENTER TOTAL NON. TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEE S
(If more space Is needed, Insert additional sheets of the same sLIe)
""""''''''.
Cot,II;\{1I;WfAllI10r f1ftlrJSYl VMHA
IlHIUmAllctlflXfH'lllfHl
III SI(l! IjJ Il[ClllrW
ESTATE OF
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
Check Box 4 on Rev.1500 Cover Sheet
FILE NUMBER
Barron Robert A II 21 97 0173
This schedule is to be used for all single life, )olnl or successive life eslate and lerm certain oalculallons, For dates of death
prior 105-1-69, actuarial factors for single life calculallons can be obtained from the Department of Revenue, Speoially Tax Unit,
Actuarial factors can be found In IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5. H9,
Indicate the type of instrument which created the future Interest below and allach a copy to the tax relurn,
o Will 0 Intervlvos Deed of TrUBt 0 Oth,,'
LIFE ESTATE INTEREST CALCULATION
- NEAREST AGE AT
DATE OF 31RTH DATE OF OEATH
NAME(S) OF
LIFE TENANT(S)
TERM OF YEARS LIFE ESTATE IS
PAYABLE
DUfoDrDTennDfYoars _
o Life or OTenn 01 Years _
OLlfaorDTennofYears _
OLlfe or OTonn of Years __
1, Value of fund from which life estate Is payable
2, Actuarial factor per appropriate table
Interest table rate. 031/2% 06% 0 10% 0 Variable Rate
3, Value of life estate (Line 1 multiplied by Line 2)
ANNUITY INTEREST CALCULATION
NEAREST AGE AT
DATE OF DEATH
. $
%
$
NAME(S) OF
ANNUITANTjS
DATE OF BIRTH
TERM OF YEARS
ANNUITY IS PAYABLE
OUle or o TenTl of Years __
DUloor OTennofYears_
Ollie or o Term of Years _
DUfe or OTerm of Years _
1, Value of fund from which annuity Is payable $
2, Check appropriate block below and enter corresponding (number)
Frequency of payout- 0 WBekly (52) 0 Si-weekly (26) 0 Monlhly (12)
o Quarterly (4) 0 Semi-annually (2) 0 Annually (1) 0 Other ( )
3, Amount of payout per period $
4, Aggregate annual payment, Line 2 mulllplied by Line 3
5, Annuity Factor (see instructions)
Interest table rate 031/2% D 6% 010% 0 Variable Rate %
6, Adjustment Factor (see Instructions)
7, Value of annuity .If using 3 1/2%, 6%, 10%, or if variable rate and period payout Is at end of period,
calculallon Is : Line 4 x Line 5 x Line 8 $
If using variable rate and period payout Is at beginning of period, calculation is :
(Line 4 x Line 5 x Line 8) + Line 3 $
NOTE: The values of the funds which create the above future interesls must be Teported as pari of Ihe estale assets on
Schedules A through G of this tax return, The resulting life or annuity interest(s) should be reported atlhe appropriate lax rate on
Lines 13,15,16 and 17,
(If more space is needed. Insert addltlonel sheets ollha same size)
foil V,H!44 I X . (I !\~I
'*
tOMMoNWEALTH OF PENNSYLVANIA
INt1fMlT ANeE TAX ReTURN
RfSlOEt-ll DECf.DENT
INHERITANCE TAX
SCHEDULE "L"
REMAINDER PREPAYMENT OR INVASION
OF TRUST PRINCIPAL
FILE NUMBER 21 97 01 Zl.-
I.
~,tat. of
Barron Robert A II
(leut N~ (Fint Nam_) IMlddl. Initial)
Thl'lChedu!e il appropriate only far o.tale, of dooodenla dying an or bofare Der.ember 12, 19S2,
lhillChedul. la to be u,ed for all remainder roturnl whftn an eloction to prepay has been filed under tho prOVllloDl
of Section 714 of tho Inherita,!ce and Eatate la. Act of 196 I or to roport ~allon of tnllt principal.
II, Remaind.r Pr.payment:
A. Eloctlon to prepay filed with the Reglater of Willi on
(attach copy of electlonl (Date)
8, Name(l) of Life Tonant(., Oato of Birth Age on date Term of years income
or Annultant(11 of election or annuity I, payable
C, Allets: Complete Schodule L.l
1. Real Eltate $
2. Stockl nnd Bondi $
^ Clolely Hold Stock/Partnership $
0,
4, Mortgagel and Notos $
5 Calh/MilC, Personal Property $
6, Total from Schedulo L.l $
0, C..dlt,: Complete Schedulo L-2
1. Unpaid L1abilitlos $
2. Unpaid Boqueotl $
3, Valuo of Unlncludable Anolo $
4, Total from Schedule L.2
$
$
III,
E, Total valuo of trult aSlotl (Line C.6 minus Line 0.4)
F, Remainder factor (see Table I or Table II In Inatructlon Booklet)
G, Ta.able Remainder value (L1no E . Line F)
Also enter on LIne 7, Recapitulation)
lnva.lan of Corpus:
A, Invalion of corpul
$
(Month, Day, Yoar)
8. Name(s) of Life Tenant(l)
or Annultant(l)
Ooto of Birth
Age on date
corpus consumed
Term of years income
or annuity il payable
C, Carpul caDlumed
O. Remainder factor (soo Tablo I or Table II In Instruction baaklot)
E, Ta.able value of carpul canlumed (Line C . Line 01
(Also enter on Line 7, Recapitulation)
$
$
$
~_ h. ,.n _"'.
II:IV.16H I!X t (:!-8~) INHERITANCE TAX
SCHEDULE l- 1
COMMONWEALTH OF PENNSYLV,tNIA REMAINDER PREPAYMENT ELECTION
INHERITANCE TAl( RETURN 21970173
RESIDENT DECEDENT -ASSETS- FILe NUMBER
I. hlale of Barron Robert A. II IMlddl.' InlllolL -
- {lent Name) (Flnl Nom_)
" !tem No. De.cription Value
-
A Real Eltet. (plea,e deocribel
Total value of real e.tat. $
tlnclude an Section II Line C.1 on Schedule LI -
S, Slack. and Sands (plea.e II.!)
,
Total value of Ilock. and bond. $
(include on Section II. Line C.2 on Schedule L)
I . C, Clo.ely Hold Stack/Partnership (attach Schedule C., and/or C.2)
(plea.elllt)
Total value of Clo,ely Held/Partnership - $
linclude on Section II. L1n.!!.f:! on Schedule Ll
0, Mortgageo ond Notel Iplea,e lI.tl
Total value of Mortgagel and Note. S
IInclude on Seellon II, Line C-4 an Schedule L)
e, Ca.h and Mllcellaneou. Personal Property (plea Ie Ii.t)
-
Total value of Cash/M!.., Pers, Property S
(include on Seelion II, Lin. C.5 on Schedule LI -
III. TOTAL (Alia ente.. on Section II, Line C.6 on Schedule L) $
(If more space il needed, attach additional 8'/, x ",heetl,1
Il:EV 11'1.c\ tx f (:l ^4l INHERITANCE TAX
.. SCHEDULE l-2
COMMONWtAL TH OF PfNNSYl VANIA REMAINDER PREPAYMENT ELECTION
INHERITANCE TAX RETURN -CREDiTS- FilE NUMBER .2.1970173
RESIOENT DECfDE~1T
I. e.tate af Barron A II
-. - (Mlddl.ll1ltial)
- (lall Nam.) (FirltNam.1
II, ItemNa. Oescrlpllon Amount
A Unpaid Liabllllles Claimed aroalnsl Original Estate, and payable from assets
reparted on Schedule L.l (p ease lilt)
Total unpaid IIablllllel $
ilnclude on Section II, Line 0.1 on Schedule LI
a, Unpaid aequests payable from assela reported on Schedule L.l (please IIsll
.
.
Total unpaid bequeoll S
ilnclude on Section II. Line 0.2 on Schedule Ll
C. Value of a..et. roporied on Schedule [.1 (other than unpaid bolue.tl II.ted un er
"a" above) thaI are not Included for tax purposes or thaI do not orm a port
of the trust.
Computation al follows:
.
Total unlncludable aosela S
iJndude on Section II. Line 0.3 on Schedule Ll
III. TOTAL {Allo enter on Section II, line 0.4 on Schedule LI $
(If more Ipace i. needed, attoch addllional 8'/, x 11 Iheets,1
COMMONWE"l TH or PfNNSYlVAI-lIA
INHERlTANC~ TAX DIVlstON
ESlAlE Of
.. earron....fu!llQI1 A II
lhi~ ~dwdld(o
SCHEDULE N 1
SPOUSAL POVERTY CREDIT
AVAILABLE rOR DECEDENTS DYING "HER 12131/911
--j filE NUMBER
_ --1zL-..-R
'nlJst br' (ornplotf'd on,l filnd i/ yO\! chocked thfJ !Ipo\}s(J1 pOVfJrly uudi! lJOX Of1 the cover shao!
0173
'fY """I' "I *
), 'I nxoblo ^!Ispb totol he,m li[1(> g (rovor- ~lll~Ot) .
I.
$~2YJ(lOO
'), InS\!lonco Procoods on U/o 01 [)oc~d{lnl
2,
~1, Rolinmwnt f3cmolits ,
J,
4,
Joird t\ssflll:; wilh Spouse
4,
5. PA LoHery Winnings ..,.."
5,
6d, Olhflr Nordaxoble Assels: U~l (Allachschedule 11 necessary) ..
6a,
6b,
6
6
6,
SUBTOTAL (Lines 60, b, c, d) .....,....""",........,,,,,,,,,,,,,,.....,,......,,,,..,,,,,,,,,,
6,
7,
T 0101 Grllss Assets (Add lines 1 thr(6)
7
$52.500,00
B, Total Actual Liabilitie!; ""."...""""",.., """".,.."""".."",.",."".",.,.. 8,
9. Net Volue Qf Eslale (Sublrod line B/rorn line 7) """""",,,,,,....,..,,,..,,,....,,,,,,,,..,,,,..,,,,,,,,,,,,,,,,.... 9,
II line 9 is greater than $200,000. SlOP, Th8 estate is not eflgiblcto claim the credit. II not, continue to Partll,
$52.51l1l.1l1l
InCQmfl:
I, TAX YEAR: 19 2 TAX YEAR: 19 3, TAl( YEAR: 19
I, 20 3(1,
lb 2b 3b
I, 2, 3,
Id 2d. 3d
\, 2,. 3e.
If, 21. 31.
0, Spouse.
b. Docodenl,
c. .Join!,
d. Tax txHmpt 11KClme
0, Othor Income no!
lisled above,
I. Tolol ""","",,",
4. Avorngo JOin! txempHon InC6me Colculatlon
40, Add Jr:oinl rxamplion Income /rorn qbove:
(III
+ (211
+ (31)
=
1+ 'JI
__----L:.-::J.-__
~b. AV8togfo> Joinl Lxarnptionlncorne ,
p
- . ,I ~
, ,.
. ,
1. ImE.tl amount 01 tnxoblfl trnnsfHrs k, spouse or ~ lOOJ)()O, whiche\'er is l~lSS ._
I
? Multiply by c:-pdit porcl'ntoql' (.'iL'fJ il)~h\J{'tion5) .
3. This is the ornOlJll! of thf' RfJ~idl1nj :lpou5ol PO\'flrty Cradil, Include this figure
In Ill!' cnlculoli\'lr1 0/ tolol fH-,rlit:, on lino 1 A 01 the CDvm shm'!L ,
4. ~ or Nonrt'!;idenls, (mlsr tho ratil" of the decedent's gross E'Slato in f1A !o lhf' value of tho
dm:fld(ml's gross oslolo , "".." .. " .. ".."
S. Multiply lil)o 3 by linn t\ nnd nntm tho te,lol here, This i.~ tlm rmlOunl 01 tha Nonresident Spou~ol
Pow.t!y (rodd, IrdlJde Ihis/ioure in the cokulalion 01 10101 crmJils on lino 18 of lhe cover sheu!.
?
J.
4
5.
0
0
.
0
.
<h
0 ..
'0 Q)
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M
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0
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JOHNSTON AND ZAGURSKIE
ATfORNEYS AT LAW
117 MAIN STREET
P.O, BOX 0
MIFFLIN, PA 170.58
Mh'I\Q{'1 IID6{'." JoIU\I.IOI\
DIlIIRld I<. ZR~lIrskl,'
KC'lUwth A. MUHlIt\f1h
Aro. Cod,. 717
Tolophlll," 436.Ro44
, .I'.x 4:16.2722
March 10, 2000
Register of Wills
Cumberland County Courthouse
Hanover and High Street
Carlislf', PA 17013
RE: Estate of Robert A. Barron, II
File No, 1997.00173
Deal' ClerIc
Enclosed herewith please find for filing an Inheritance Tax Retul'l1relative to the
above-captioned mattel'. Also enclosed pl~ase find our TrustCheck in the amount of
$1,607,76 representing the tax due.
YOUI' required fee is enclosed.
" ;:2'""Y Y"""
?ii?id~s
Attorney
M}:bbh
f?~ 8 (~f
g"
"
J i-- .X ~.o
Q; ~ (" Ci'
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W ,01- ,
~} .'
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: , :.;:?tll
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Enc: Stipulation
Envelope
6',' ! (:\:;J - / .(
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
c
BUREAU OF INDIVlnuAL TAKES
INHERITANCE TAK DIVISION
DEP'r. 1.8C1601
KlRfUSaURO, ,...- 17128-"'1
NOTICE OF I1lHERITANCE lAK
AFFRAISEHEN1, ALLOWANCE OR DISALL~ANCE
OF DEnucTIDWS AHV ASSESSHENT OF TAK
05"'30-2000
BARRON
01"19-1996
21 97-0173
CUMBERLAND
101
E:~ A~t~~tod ".1
HAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiiv=i!jijj-ix--AFP-nZ-:99T"HOi'"icinofi-YNHEifiTANCi-'fAitii"PpiiiiisEiiEilT-,nAiXowAiici.iiR~----~__---_m.-
DISALLOWANCE OF DEDUCTIONS AND ,ASSEIISHENT OF TAX
ROBERT A FILE NO. 21 97-0173 ACN 101 DATE 05-30-2000
TAK RETURN WAS, I 1 ACCEPTED AS FILED I X) CIIANGED SEE ATTACHED NonCE
DATE
ESTATE OF
DATE OF ilEATH
FILE NUMBER
, :! ,COUNTY
ACN
/I,."
I:
'CIO
nN\1
MICHAEL JOHNSTON
117 MAIN ST
PO BOX 0
MIFFLIN
Cl(
PA l7l1!ij I Ii
ESTATE OF BARRON
RESERVATION CONCERNING FUTURE INTEREST ~ SEE REVERSE
APPRAISED VAI.UE OF RETURN BASED ONI ORIGINAL RETURN
1. R..1 E.t.t, (S~l. A)
2. Stock. ond Bond. ISohedul. B)
3. Clo~ly "*ld Stock/P.rt~r.hlp Int.rest (Sohedule Cl
4. tto,.t"....a/Hot.. R.oetvabla (SohaduJ.. DJ
S. Cash/Bank Dapostt./Hi.c. P.rsonal Property (Scn.dul. E)
6. Jointly Owned Property (Sch.du~. f)
7. Tr.o.f.~. (Sc~l. G)
I. 10tal AGs.h:
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funeral [xpen.../A~. Co.t~/"l.c. E~panse. (Schedule H)
10. Oebts/Kor-tgage LlabU!i;l../Uens (Schedul. 1)
11, Tol.l Dacluctlona
12. Net Value of TaK R.turn
13. Char1t.ol.lGov.rllllHMlt.l hquast$; Non~el.ot.d 9113 Trust.
14. Net V.lua of Est.t. Subject to T.~
If an asses..ent was issued previously, lines
reflact figures that include the total of Abb
ASSESSMENT OF TAXI
16. AMOUnt of Li~ 14 .t Spous.l rat. (IS)
16, Aaount of Lina 14 t..abl. at Lina.l/Cl... A r.t. (16)
17. ~t of Line 14 taxable .t Coll.t.ral/CI..s Brat. (17)
II. Principal Ta~ ~
NOTEI
TAX CREDITS I
FAYHENT
DATE
01-25-2000
03-10-2000
RECEIPT
NUltBER
WRITEOFF
AA407700
DISCOUNT l+)
INTEREST/PEN PAID 1-)
.00
.00
(1)
(21
(3)
(4)
(5)
161
(7)
_.J!.l
.00
,00
.00
52.500,00
.00
.00
la)
(9)
(10)
25,704.06
ISohad\ll. JI
.00
Ill)
(12)
115)
114)
'*
In-I'" II U, CII-"I
ROBERT
A
NOTE I To in.ure proper
credit to your account,
.ubtsit tha uppar portion
of this for. with your
taM P.Ylt<<tt.
52.500.00
?e;. 7n4 .D.6...
26,795.94
.00
26.795.94.
14, 15 and~or 16, 17 and 18 will
returns assessed to date.
.00 K .00.
26.795.94 K' 06.
.00 K .15.
Ila)
AHOUNT PAID
440.35
1,607.76
-
BALANCE OF UNPAID INTEREST/PENALTY AS OF 03-11-2000 TOTAL TAX CREDIT
BALANCE OF TAX DUE
--.---
INTEREST AND PEN.
TOTAL DUE
.00
1,607.76
.00
1,607.76
1,607.76
.00
15,85
--.----
15.85
. IF PAID AFTEH DATE INDICATEO. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL OUE IS LESS THAN fl. NO FAYHENT IS REQUIRED.
IF TOTAL DUE IS flEFLECTED AS A "CREDIT" ICR), YOU HAY BE OUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR IHSTRUCTIONS.)
r -, .... .....
..
RESERVAnOth htah. of deoIldInb ctvi"l on or before OeoIIIMr 12, 1M! u if MY hltur. int.r..t I.n U. ..tet. 11 tr....h\"r..
in po.....ion or tlnjo)llMlnt to Chili B (OG1l,ter.1) benlfloi.rl.. of the cMoeMnt ,ft.t the ')(pit.tlon of em' ..t.t. for
11... or for y..r., the ~I.th hereby .xpr...ly r...rv.. the right to IPPr.l.. end ....., trlnlf.r l~rJtlnOl T.x..
.t the llWful CI... B (on11,t.re1) t.t. on any ~ tutur. Int.r..t.
Pt.IlPOSE OF
NDTJCEI
To fulfill ttM rMtUlr.-.ntl of s.oUon 2140 of tn. IMtrltMCe tnd Elt.t. ".)( Act, Aot 21 of 1996. (12 P.S.
SftotltJf'l 9140),
PAVKE14T 1
Det'ltOh tha top portion of thh ~Iotlc. .00 .oe-It ..lth your PIYM!lt to ttNl Allht.t of NUll prlnttd on tlw r.v.r.. .Ide.
nHak. chectl. or l/Ol"tIIy ord.r plyllb.. tOI REGISTER OF MILLS, AGENT
AEFQrW (CRh A r.fund of I t.x or..lt, Mhlch v.. not t.qu..t~ on tht T.lC A.turn, ..y bII reque.tect by COIIPl.tlnt en "Applioltlon
for R.fu'ld of Ptnnlylvenll InhetlttInC. tlnd E.t.t. Tax" (REY-UJ.!). AppUe.tlon. are evlUllbl. .t \hi OfflO4l
of tM ntlghter of NlIl', any of the 23 R.vent... Dhtrlot Offlu.., or by Cllllng tt. apeel.1 24-hoot
lIn....rlno ..r\llo. nultter. for forI. ordlrlnl11 In Penn.ylv."hl 1-800-3(,2-2a5/), outthM PMn.yIVWlla tnd vlthin
loc.l Harrisburg .r... (717) 787-8094. Ser\llcu for taxpay.r. ..Uh IfHlUlll he.rlng .1d IPMklng nMd.1
1-100-447-11020 (YT onlY).
OBJEt'TlONSI Any p.th In int.rttlt not sati.fled with th. IIpprah...nt, .UotIlanoll or dl..Uownoe of dIlduatlon., Ot .........,t
of talC (Including di.count or intera.t) I' ~ on this Hotlo. .u.t obj.ut within .ixt~ (60) ~Y. of rtcelpt of
thll MoUo. by:
--written proto.t to the PA Deplrt..nt of Rel,lenuca, Piolllrd of ~llIh. Dept. 2610tl, Harrllburg, PA
--.IICUon to have till ..tter datar.11lId at IlUdlt of the account of the petllONI ,.~r....,tlUv.,
~-lIpp..1 to the Orph."Il' COUtt.
1712e810?'1,
OR
OR
ADf1IH
ISTRATI\'E
COMECTIDHS I
factual .rtor. di.covered on this a......-nt .hould be addr..sed In writing tOI PA o.p.rtaent ef R.venue,
aur..u of Individual T.x.s, ATTNI po.t A.......nt A.view Unit. Dept. 280601, ~Irrl.burt, PA 1712880601
Phone (717) 7a7~6S0S. S.e P'118 5 of till bookl.t "In.ttuctlon. for InhltJt~e T.x Return fot . R..ldlnt
Dool6lnt.. (REY.lSOII for., ilMplane.tJon of "Inlltratlv'h oorr.ot.bl. artor..
r'ISCOl.JriITI
If ~y t.x duI ), paid within thtee (3) o.i~ndar .unthl aft.r the decadent', dlath, ~ fiv. percant (S~) dl.count of
thl talC paid II allowed.
PENALTY I
'fhl 15X tax ~.ty non-partlclpltUoo pwl.ltll h CC*POtld on tht total of thl tex end int.r..t .....Nd, .m not
paid btIfor. J.....ry HI, 1996, the fJl'lt day .fter the end of thfl hM "I"flb P4trlod. Thh non-plrtlclp.tlon
pelllll b hi app..lllbl. in th. .... .llIMfIr IltRd in the the .... Un per Icd I' yoo would eppeal the hx and Jnt.r..t
that ~. belR .....'~d aB ir~lC1ated on thl. notlo..
l'NU:REST I
Intlr..t 11 chIlrlPd baglnnlng with firlt day of dellInquanc:ol, or nlrw. (11) ItOnth. and OM (1) dill' frOll tM date o~
..th, to the dIIt. of p'v.ant. Taxa. whlcl\ &Ne... dalinqutmt befor. JilnuIty I. 1982 Mar Int.ra.t .t tn. rat. of
Ib (6in percant ptlr IInttl.W Clllleu1atld at . dally rat. 0" .00016'1. All tax.. which blo... dll1nquant on .-lei Ift.r
Jenuary I. 19&1 ~lll blar JntBt.st .~ a rat. which wJll vary froe c.landat yaIr to caJlhdlr yair ~Ith t~t rat.
.mounc~ by thl flA D8partaant of R.\lllIf'II.M, Tm. -wUtlftbla lntlt..t rater. for 1962 thrOO\,Jt1 2000 arel
'i!!!: Int.t.lt Rat! Dally Inter..t faotor :!!!r Intllr..t Rate Dally Int.ralt Factor
1982 20i: .000548 1988~1991 1Ii: .000501
1983 16i: .000..!& ,.., 9> .000t..7
'914 11i: .0'003(11 19CJ~H99'l n .000192
19.& 13i: .000]!i06 1995.1998 9r. .000?'..1'
".. 10i: .00027(, 1999 7Y. .000192
19.' 9~ .0001..7 lUO " .000ll9
--Int.re.t II o,.lculatad ., follnwtll
INTEREST . 8ALANCE OF TAX UNP.\ID X NUN8ER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice I,~ ~ft'r the t.x bIo~. dlllnquent will r.f1.ct In Int.ra.t oaloulatlon t~ flft"" (15) dly.
ba~ond tht datI of the .....IMMf\t. If p.~t II .... aftar thl Inter..t coeput.tlon dlta IhoWfI on tbt
Motla., additional Intara.t lIU.t t.. o.lcul.tlld.
JOHNSTON AND ZAGURSKIE
A1TORNEYS AT LAW
117 MAIN STREET
P.O. BOX 0
MIFFLIN, PA 17058
Mi<'h.l'I "D,"'" /oh"'lo11
nOli HId K Zfl~ll"kl,'
!(PIIIlf'lh A. MllllllllHh
Arpa end" 717
'('(!/"pho,\<' 4:16.H044
I'RX 4:H,.2722
June 9, 2000
Register of Wills
Cumberland County Courthouse
Hanover & High Streets
Carlisle, PA 17013
RE: Estate of Robert A Barron, II
Estate No, 21-97-0173
Dear ClerIc
Enclosed herewith please find our check in the amount of $15,85 for interest due on
the Inheritance Tax Return flied in this matter,
If you have any questions, do not hesitate to contact me.
no g _,::0
~ {I.! }./gl
,-j ,,< ",' .
nal;rr. f1~' ',I
Zagurskie u 1:.
Attorney ......'
......
N.
DKZ:bbh '.~l;!
fx_l {" ,
"[i ,'-~' ~-'J
;l~ ;:;1 I....,
Ene: check
/~,-I{;J-I,;f
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
C/
*
BURUU Of INDIVIDUAL TAKES
lHUERJTAHCf lAK DIVISIOM
DrPT. 280601
IIARRISIURO, 1'10 171211-0601
tEY.UI1U at,. cu.u)
"
I
07-03-2000
BARRON
01-19-1996
21 97-0173
CUMBERLAND
101
'00 JilL ill I'!:i
DATE
ESTAH OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
ROBERT
A
MICHAEL JOHNSTON
117 MAIN ST
PO BOX 0
MIFFLIN
Cj~.,i I
PA 1 fOsllii;
E ~~ount R..l:.i~- I
MAKE CHECK PAYABLE AND REMIT PAYMENT
TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE I To In.u~. proper oredit tD your acoount, subMit the upper portion ofthll for. with your t.K P.~t.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ......
REV :i6iri -i:iCAFP -I' i'F99r-----...- "iNHERiTANCE - Tilif- S;:jiTEiiE"NY-OF" At-coUNT- ..-li.---mm_-- --- - - - - --
ESTATE OF BARRON ROBERT A FILE NO. 21 97-0173 ACN 101 DATE 07-03-2000
THIS STATEHENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. S~ BELOW
IS A SlIHHARY OF THE PRINCIPAL TAK DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT bALANCE, AND, If APPLICABI.E,
!:.. PROJECTED INTEREST fIGURE.
!
,II
;1
II
I
I
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 05-22-2000
PRINCIPAL TAX DUE,_,
1,607.76
PAYMENTS (TAX CREDITS),
-,
,
I
I
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01"25-2000 WRITEOFF .00 440.35
03-10-2000 AA407700 .00 1,607.76
06-09-2000 M425674 15.85- 15.85
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
1,607,76
,00
,00
TOTAL DUE
,00
. If PAID AFTER THIS DATE, SEE REVERSE
SIDE fOR CALCULATION Of ADDITIONAL INTEREST.
I If TOTAl. DUE IS LESS T~N '1,
NO PAYMENT IS REQUIRED.
If TOTAl. DUE IS REflECTED AS A "CREDIT" (CRI,
YOU HAY BE DUE A REfUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
~__ "0' ........ .. .,..
PAYMENT I
o.tMlt\ tht top portion of thh Kotici and sub.1t with your p......nt _Itde payabl' to the nuo and "dre..
prll"1ttd on tM rever.e .lde.
If RESIDENT DECEDENT .... cheok or .ooey c,rdlr payabl. tOI REGISTER OF WILLS, AGENT.
If HOH~RESIDENT DECE1JENT .ake chock or .one:.> order poyable tOI CottHGttWEAL TH OF PENNSVLVANIA.
REfUMD (CR)1 A nfUnd of III tax credit, which was not rDq\$sted on the Tax Return, .ay be requuted by cotlPletlOf' en
"Appllcratlon for Refund of Penn.ylvanle InherUltnCe and E.tate hK" (REV-Ul:!l. ApplloaUon. are .val18ble at
the Office of tht $Ieglster of Nllls, any of the 23 RevenUl District Offices or frOfl the Depart.ent" 24-hour
Df'Ill",erlng ..rvloe ~r' for for.s ordering! In Penn.ylvanJa 1~aOO~362-2050, outll1de I'ennsylvenle and
within 100al Harrl.bUrg area (717) 787-8094, Service. for taKpaYlrs with Ipeclal hear In; and .~aklng
need.! 1~800-~47~30Z0 (Tl only).
REPlV TOI
Qu..tlons regarding orror. contained on thi& notice .hould be oddrened tOI PA Oepart..nt ot Revenuo, Bur.au
of Individual TaKe., A1TNl Po.t A,......nt R.vi.w Unit, Dopt. 280601, Harrisburg, PA 17128-0601, phon.
(717) 787-6505.
DIstOUHTI
If MlY teK due 11 paid ..lthln three (:5) cahmdar .onths afttlr the decedent'e death, a fi\le percent (5:0 dhcount
of tilt! tax paid it allowed.
PENAllVI
The 15); tllx --...ty non~partiolpatlon penalty is cOBPUted on the total of the tax and lntnrut 1lI.....d, end not
paid before .lanuery 18, 1996, the firflt day after tM and of the tax a.nefl.ty p.riod.
IHTEREST:
lntere.t is oharg.d b.ginning with fir.t day of delinquencY, or nine (9) .onths and one (1) day frail the date of
deeth, to tho date of PlIy..nL TaKe. which bee... d.Unqullnt be foro January 1, 1962 b.lIr int.re.t at the rate of
IIIx (6;(> peroent per snnUII calculated at II dally rate of ,000164, All t8Ke' lilhich b.c... do1Jnquent on and lifter
January 1, 198Z ",Ul b.ar intere.t at a rl:lt. which will vary froll calendar year to cal.ndar y.lr with that rllte
announoed by tho PA Ofpart..nt cf Revenue. The appl.lcable inte"..t rates for 1982 through 2000 arel
Vear Interellt qat. DaUy Interest Factor Veor Int.r.st Rat. Oa11:.> Int.r..t Factor
1982 20% .000548 19&8~1991 11:< .000301
1985 16~ .000458 1992 9% .000241
1984 11;( .000301 1995-19"4 n .000192
1985 15j( .000556 1995~1998 'X .000247
1986 10;: .000274 1991J n: .000192
1981 'X .000247 2000 aX .000219
~~Jnt.rest 1. calculat.d as folloWl1
INTEREST' BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~~Any Notloe iuued aft.r the t8)( b.eo.e. dol.lnquent wU 1 refleot ftn Inter.st oalculatlon to fiU.an (lfi) dflYI
beyond the dat. of the ..ntllll..nl. If pay..nt it; .ade after the intere.t coaputatlon date shoWn on t_he
Notice. IKktltlonal Int.r.st BU.t be (:llllculated.