HomeMy WebLinkAbout97-00324
.'
.
1'0" OATffJ Of DE'ATH AFrEA '1:il/J1/81 cllfCl( 1lI!'U!
~CJ~:f~~~tl~~~_Plr ,lfiC-'AIM~P, L___::l._
FlU: NUMIIHI ~H:I': I';~l't'^'n; 1 N "'OH,
..::.21 - 9 1 3 ;t'l:iIlI':E'l'
f,lIlJNIU\lQ[ . ... YWl.mNf)Mlim
nitWrNF~ diMf'\JTF-AfltHl(S~'" --, -- - --------.-.-.--~
III ~IAY lilUVI': APT. ,:
DAII """'Hll ['AMI' 1111,1" I'A I"OJ 1
O? 0:, I :'GYU!\IY[l:U,MBr"I{I'ANI~_......m
",;;:~,'^,.."""'I"IY~'JMI'IIl'.I.A~~~I~~~;I,~~,~~;~ I~~~~::~_~~':::~"~__..___
(101 dill9~ 01 tJoRth priO! l(l 1'1.13-1I2l
[] n fedOlal tatalo hK nulUm ftoql.Jjted
01.( Jf' 7 - 30? If
IlIVI600[X' (1.941 INHERITANCE TAX RETURN
COMMO~W[ALTiI OII'[NNSYIVAN,A RESIDENT DECEDENT
DlI'AIHMfN' ollllVtNUr (TO BE FILED IN OUPl.ICA TE
DtPl ~DOOOl WI I
___jjABIlI~Jl\U10..rAllJZftQQQL__ WITH REGISTER OF LLS
-~------'---- D[tl~oHn' S NAMnrAsf.TfllfiT,'ANTl-Mf(jrftTINTifAU
~\[:i, l5~nt---J39.~,U~:.t ,_.H-,_.
SOCiAl Ul'CllllllY NUMllHl
094-12-110B
---.--- --r-;;-r----.-.--------.------.-
~ 1. Onglnal flatu,"
h
~~$
I
Ii
z
~
I
z
~
~
:e
8
S
[~] 40 ruturo InlmotH CompromlRo
llor dAtel of dallth IIllef 12, 1~,aZI
6 Decodont Diad Teltate [J 'I, Doc:edent MAintaIned a liVing Truel
(Attach copy of WI!Il (Attach copy 01 TllIall
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION sHODto BE DIRECTED'fO:
NAME ~'OMPIHE MAllI~O AOOIIESS
MICHAEl, J. ASKEN --- 5 CREEKSIDE LANE ~
TELEPHO~E NUMBER CAMP HII.L, PA 17011
17171761-46B3
1, Real Eatate- (Schedule Al - ( 11 ...
2. Stock, and Bond. (Schedule HI l 21
3. Closelv Held Stock/PlIltnor,hlp Interost (Schedule C) ( 31
4. MaHgaa.s and Noto, AocelVlIble (Schedulo U) ( 4)
5. Clllh, Bank Doposits & Mlscel1l1neoue Perianal Proporty ( 6)
___ '1,037 ___
It Une 19 Is oroater than Une 18, entor the dilleronco on Line 20, This is tho OVERPAYMENT,
A, 0 Chock hero If you .re roquo.tlng . r.tund at your overp.ymont.
I! Un€' 18 Is oroater than lIno 19, flntor tho difforenc(l on L1no 21 Thll Is tho TAX DUi:,
A Enlar the IntOlost on Iho balance duo all Lino 21 A
B, Entor Iho total of lIno 21 and 21A on Uno 21Et This i, tho BALANCE DUE,
Mak. Ch.ok P_Vlbl. to: Aeglst.r of WUls, A_oent
-. "[ flAil m IHA1H
. 0 I Il '"
(II ^1'1'IICMIIl t\llllVlVINO RI~)\lSI'H N^,yl1 II^\\I 1111") MI!l fvllll!lll H'/III^II
--[---T~---'----'-------
_.._J I SUllplornnl1lnl
D
[[)
4, lImllltd tslllte
(Schedule El
6. Jointly Owned Property lSchodule FI
7. T"nlllor, (Schedule Gl (Sche~ulo L)
8. Total GrolS Aaaetl (tolal linns 1.7)
9 ~uhorlll Expenae., Admlnlslrlltlve Coata. Mlscollaneous
Expenaes (Schedule tl)
10. Debts. Mortoage liablJltles, Liens (Schodule II
11 , Total Ooduc1lons (Iotal linos 9 & 101
12. Not Value of Estale (Un~ 8 mInus line 11)
13. Charitable and Govornmentlll Bequests (Schedule Jl
14, Net Value Subject 10 -roll (Un.fJ 12 minus lIno 13)
16. Spousal Tlanafe" (lor dales 01 death alter 6.30.94l
See Instructions lor Applicable Percentage on Revolse
Side, (Include values horn Schedule K or Schedule M,)
I 61
171
I 91
110 I
1161
16 Amount of Une 141suhle at 6% rate
llncludo valuoll from Schedulo K or Schedule M.I
17. Amount of Uno 14 taxable at 16% rIlle
{Include valufjll from Schedule K or Schedule M,I
16. ~(Inclpal tax dUI) (Add tax from Unea 16, 16 end 17.)
19. Credi~ Spousal Poverty Credit Prior Payments
1161
117 I
Discount
20.
21.
o
Total NUh100f ()f Sale DlIposlt 80xel
56,135
.~5,751
161
351,BB6
6,267
1111
1121
113)
1141
6,267
3451619
345,619
,.
345,619' ,oe-
20,737
II .15-
Inte;eat
116 I 20,737
119 I 1,037
120 I
1211 19,700
121A 1
1219 I 19,'700
~.._----
------
Aonmss 5 CH':I':KSIIlE l.J\NE
._.,.__._______________C,AHP -'~I j,LLJ'!\..J. 7 0 ~L_________
AOllmss KlmN AND CO~!PANY, 1'. C.
~33~..J'1.~I<!";:I~El:f<'~lc1~, CI\MPJllIoL, PA_ l'!O~~__
nAIl
J..:..?'C..?7 ___
IIEV.1000 EX '(1.011
SCHEDULE E
CASH. BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
~ ,-.-.-.- .-~~- ..
1 ..... ~.. .. ''''
FILE NUMBeR
l:OMMONWEALTII Of PENNSYLVANIA
INH'''fTANCI! TAX "nUAN
"UIDINT ISIC.DINT
mrnw-=-.- .-
HOSP. N, (\SK~N
~. nt' -own.d wUh~' 'UGh.! of 'uf~~l!!U!...!!!t~~...!!!.dwl~__
ITEM DESCRIPTION
NUM3ER
1 CAR
2 YORK FEDERAL r.D ACCOUNT II 600-0016556
3 YORK FEDERAL C'D ACCOUNT II 100-0210405
4 YORK FEDERAL CD ACCOUNT II 100-0212011
5 YORK FEDERAl, CD ACCOUNT II 100-0212012
6 YORK BANK ACCOUNT II 60000001'704291
7 YORK EDUCATIONAL FCU SAVINGS ACCOUNT II 26-013
6 FURNITURE
BEE ~.1! lNlrOr!....,'lIIf0"I'
VALUE AT
DATE OF DEATH
"
"
llW.41011OOO
TOTAL (Allo entor on line 6, f1ecapl1ulatlon) S
(Attach additional B 1/2" II 11" ,hoel_ II more .pace Is ngetJed,1
675
11,116
15,45r}
4,429
10,996
12,512
670
260
56,135
RLV-16D9 EX' 112-88) L
SCHEDULE F
COMMONWEALTH OF PENNSYI.VANIA JOINTL.Y.OWNED PROPERTY
INHERITANCE TAX RETURN .
RESIDENT DECEDENT
E8TATEOF - -----------~~=~-==~,.--
--
---.
ROSE N. ASKEN
!EE ESTATE INFOR. SHE~_
Jolnl ton.nl('):
NAME
A. MI CHAEL J. AS KEN
AOORE88
5 CREEKSIDE LANE
CAM~ HILL, PA 17011
RELATIONSHIP TO DECEDENT
--
SON. .
8.
C.
Jolntly-ownod propertY:
mR DATE
ITEM FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE OECD'S DOLLAR VALUE OF
NUMSER JOINT JOINT OF ASSET % INT. DECEDENT'S INTEREST
TENANT
1- MERRILL LYNCH ACCT.# 89840330 369,511 0.5000 184,756
2 YORK FEDERAL CD # 100-0212894 21,832 0.5000 10,916
3 YORK FEDERAL CD # 100-0212241 4,022 0.5000 2,011
4 YORK FEDERAL CD # 700-0003730 28,258 0.5000 14,129
5 YORK FEDERAL CD # 800-0023101 9,554 0.5000 4,777
6 HARRIS SAVINGS # 2060000307 2,054 0.5000 1,027
7 HARRIS CHECKING II 2000004166 2,977 0.5000 1,489
8 HARRIS LIQUID ASSETS MANAGER 86,243 0.5000 43,122
ACCOUNT # 2303004704
9 HARRIS CD ACCT. # 861193695 22,128 0.5000 11,064
10 HARRIS CD ACCT. # 2365296816 5,086 0.5000 2, ~4 3
11 ALLIANCE FUND # ALJOOO071827 25,756 0.5000 12,878
12 T. ROWE PRICE # 4009464663-4 6,080 0.5000 3,040
13 FRANKLIN ~ENNSYLVANIA TAX-FREE 7,997 0.5000 3,999
ACCOUNT #12910524387
TOTAL IAllo entor on llno 6, Recapitulation)
$
29.~), 7~)1
\
''1'
'\IYI611 ex '17-881
COMMONWEAlTH OF PENNSYLVANIA
INHEIIITANCE TAX RETURN
nE~IDrNT DECEDENT
E8TATffl --
ROSE N. ASKEN
ITEM
NUM8ER
A.
8.
1.
2.
3.
4.
C.
I.
2.
3.
4.
6.
8.
7.
8.
1.
Pun.,.l EK~n...:
REESE FUNERAL HOME
. Admlnl.lrIW. C.III:
SCHEDULE H 1
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISC~.L.LA~EOUS !,XPE!'J_S_E~_____ ~~!~nt.r Tvpo
__-~__:~____.~==:J:E EST: INFOR. flHr,E'l'
DESCRIPTION
AMOUNT
5t067
Porlonal Rep,",ntatiYe Comml.ilonl
Social SltOurltV Number of Perlonal Representallve:
Vear Comml"lonl paid
'''ttaml'( FItt'
Family 'Exemptl('tn
Claimant
R,IOII.~lhlp
Add'." of Clalmint It docedent'a death
Street Address
City
Probate', Feeo
Slate
ZlpCoq,
Mlao.ll.n.ou. EKJMn...:
ACCOUNTING FEES-Kj;;RN AND COM~ANYi ~.C.
400
,'"
TOTAL (Alto enter- on line 9. Recapllulationl
$
6 267
IIf mor. sp.o. Is nefld.d, Inlflrt addltlon.l.h..tl of urn. .lil..)
CotttONWfAL Hi Of' PENNSYLVANIA
nEPARTHEHT Of REVEHUf_
~LRE'~ Of INDIVIDUAL TAMES
OCPT. U1060l
HAARISIURCl, Pili 17121-0601
'*
INFORMATIO~ NOTICE
AND
TAXPAYER R~SPONSE
FILE NO. 21
ACN 97110956
DATE 03-18-97
.n-"~I u m (/.,u
EST. OF ROSE ASK EN
0.5. NO. 094-12-1188
DATE OF DEATH 01-13-97
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
IXJ CHECKING
o TRUST
o CERHF.
*_ MICHAEL J ASKEN
5 CREEKSIDE LN
CAMP HILL PA 17011
REHI1' ~AYHfNT AND FORHS TO I
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARHIS SAVINGS BANK hat provided the D.parte.nt with the Jnfor.atlon Iht.d balow which hu heen u..d In calculatl"9 the
pottlnUlIIl tax du.. Their rDO(lrd. IndJcah thlt at the d.nth of the Ibove cMc.dent, ~ou ware 1'1 Joint owner/han,flchry of thll 4<lCOllnt,
If YOU ftel tnil JnforenHon II Incorr.ct, plea.. obhln writt.n correotlon froa the flnlnctlll In.tltutlon, Ittach 1'1 copy to tnll forll
snd return it to thtl obova add"... Thil account lD taxable In accordance with the InherltMt'le faK law. cf the Co..onwealth of Penn.ylvwlla.
Qu~.,lu". tlllJ ...:.:. ltfluii,.v.' LJlI' o!u!lnw l,i,.' ;ui-Ij;;Zi,
COMPLETE PART 1 BELOW -
Aocount No. 23-03-004704
_ . SEE REVERSE SIDE FOR
Dot. 09-06-96
Eotobllahod
FILING AND PAYMENT INSTRUCTIONS
Aocount Bo1onoo 86,243.09
~orcont To.ob10 X 100 . 00
AllOunt Subjoot to 'r.. 86,243.09
To. Roto K .15
~otonU.l To. Duo 12,936.46
~~ TAXPAYER RESPONSE
m IflAh.lJrl,tef R'$PONXllf~W!lQUL" XHAlIC!M~~~"LTAX l\SSQ$1l1l1tT8ASllI ell'. TtlISHOTXCI! 1
A. 0 The IIbo"8 It.forll,,t1Cln and taK due I. oorrect.
1. You .ay choo.. to r..1t pay..nt to the Reghhr c.f WHlI 'With two copt.. of thl. notiee to obtrdn
a dhcount or al,lold Int.re.t, or ~ou .ay check bOl( "A" and return this notlca to the Reght.r of
Willa and an official u......nt will be luuad by the PI. Depart.ent of Rtvenue.
II. ~above auat hu b..n or wHI bt reportad and taK paid with thtl Pennllylvanlll Inherltanll. TalC return
to blll fUod by the d.cedant', repr...nt.th/ll.
To In.ur. proper cr.dlt to your a~oount, two
(2) copt.. of thll notlca lIU.t lKlC~any your
pay.-nt to the Rag),t.r of Willi, ~ak. check
plyabl. tOI "Regl.tar of Willi, Aoent".
HOTEl If t~H pay..ntl ~r. .ad. wIthin thr.e
(3) 80nth. of th_ deo.dent'. date of death,
YOU .ay deduct a S~ dJ.count of the talC du..
Any Inhorltanca talC du8 will beoa.. d4llnquent
nln. (9) Month. aft_,. tha date of death,
[CHECK ]
ONE
BLOCK
ONLY .
c. 0 Tha above Jnforlllltlon h Incorro~t and/or dGbh and deductlonll lofflIr. paSd by YOY.
You IIU.t cowpl.t. PART ~ andlor PART ~ bolow.
PART
[!]
Tille
LINE
If you indicate a dlf1~rDnt tax r.t., pl.... .t.t. your
rglaUonahip to d.oadent 1__
RET\!'!"! . C(l"''''JT~T~ll'''
1. Dot. Estob11shod
2. Aocount B.l~~
5. PAr-cent Taxabl..
4. AMount Subject to Tax
S. Dobts end Doclue t10ns
b. AMount Taxable
7. Tax Rat.
a. Tax Due
(OF Til:l( (I" .-'~!~T'T~I'ST ~.(,~(oIJHT"
1
2
3-L.
4
S
,
7 K
a
:>!:,{:+::':;::::
"~ArI"
'-"."-
. OF'1I1Cl/lL USE: ONLY 0 All'":
.PA IlE:PARTItIlNT OF." .RlfillENUI!. "Ii!
::,:'!:;;:.::::;:::-:;::;,', ,; :",..:,.,;;." . . ":", "":!
1~~'~""'""",,"~"':':" - ._,--,~~ ..,"..-....... "
;'1
PART
[!]
DATE
:...., 1.
".'::::)i!l;~1>'
:'} ((:~ ~ ~,~
II
. .5
,
.1
8
DEBTS AND DEDUCTIONS CLAIMED
~.-sv
"":::!
';::::::':
,,:,;:.::>::-:::.:<-:.;.::;' ;'::..:"~j
" "'" ' ,
.t)(..
-
.....
,I
,
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
r
TOTAL tEnt... on L~ne S of Tax Conput.tion)
i~
.
--
declare th.t the fact. I
a and belief.
halle ,'.ported above ara tru., carr.tlt
HOME (7r7) 7/,1-I1? e '!-
WORK (-;kT ~f2"Z'fI'
E L EPHO UMB
ond
Tl2-1/f1
TE
GEHERAL INFORMATION
1. FAILURE TO RESPOND WII.l RflSUlT IN AN OFFICIAL TAM ASSESSHEN'f with l\PpllDllbll Inbrut bl..d on In'nr...tltln
.ubIIlttttd b~ thG '10.....01.1 In.tltutlon.
2. Inherltanc. till blcOII" delinquent nln. llIon\ht "ft.r the dICldlnt'. dllt, of d,.th.
J. A jotnt IKlCOunt I. tlMabl, l\,Ion though thl dtlelld.,,". nHlI ",n addld IIIl 1'1 I.tt." 0' Qonvlnl,nol,
4. Accountt (Inoludlnl tho.. hlld betw.en hl.l.blnd and ",Ual Which thl dlCldlnt put In Joint nHIlI. within ~ Yllr prior to
death .r. fulh hl(Mh fll trantf.r..
S. Accounh ..hblhh~ J(dntlv beh,..n hv.bllnd Ilnll will liar. thIn on. YIII" prior to d..th Ir. not t.ucllbh.
,. Aooount. ~ld by . o.cedent "In troot for" mnothlr or athlr. .r. t'Nlbi_ fullv,
REPORTING INSTRUCTIONS - PART 1
- TAXPAVER RESPONSE
1. BLOCK A - If thl InforMIIUan IIOd OOlllPut,Uon In th_ notl01 are oorrlClt find dlduotlonl Ir. not hllnl olahltel, plln ." "~"
in block "A" of Part I of th. "TaMpIYlr R..pon,a" la~tlon, Sign two cop I., and ,ubllt th.. wIth your oheak for the .-ount of
tl>e to the Nqllt.r of WUh of the oounty Indlutad, Th. PA Dapart..nt of Ravanua will IlIue an offlolal ......unt
(Fnr. REV'.1S48 EX) upon r.o.lpt of the raturn fro. the Rlgltter of Willi,
2. IlOCk I - If thl ....t tPaolflld on thh noUca hu blln or will ba report.d and taM paJd with th~ PiIflnlylYlWlta Inhlrlteno.
TIK Raturn fllad by thl dlced.nt'. r.pr..entatIYI, plaol an "X" in block "I" of Part 1 of thl "TaMp'Ylr Re.pon.e" laotion, Sign one
cOPy Md rlturn to thl PA Depart...nt of RIVlInU4II, lur..u of Indlylltual hMI', OIpt 280601, Hnrrltburg, PA 11128-0601 In thl
~vllope proYIu.d.
J. BLOCK C ~ If the notlol Inforaltlon I. Incorrlot and/or o.duotlon. arl bllng olalaad, cheok blook "e" and o~l.t. Part. 2 and 5
lKI(1onllnw lu i.hv Irn..I..;:;\llol'. t....:...., ::ilw,', tlov ::;Ia:l r.,,:: J...:"...l~ ~:;'11. IIHh ~'t...;~ ch:~:~ ,-~ ~ht "!'~'.~~ to' till" r'''~'''''J" to t~ 't.tJ"'....
of WHh of thtt county Indloatlld. Tn. PA DepflrtMant of Rlvlf'IUI will lllue an official ......Mnt ("'orl REV-1541 EIO upon r.ceApt
Gf the r.turn frol tho Ra,i,t,r of ~III"
TAX RETURN - PART Z - TAX COMPUTATION
LINE
1. Entlr the ct.tl the account orJAinllh ~II ..tlblhhed or titled In the IIlW'llr IMhting at dlb of dllttl.
HOTEl ror a dlcadent dvlng after 12/12/821 Acoountl whloh thl dacedant put In jOint n.... within ani (I) yaar of death ara
tlxable fully e, tren"lr,. Howlver, thlra I, dn eKolullon not to eKoeld $3,000 p.r trenef'rl. rlgardla,. of the value of
the flOOl)Ul'l\ or thl nuear of ncnQunta Mid.
If e double ..hrltk (MM) apPIllrt blfor. your fIrst n8M In tha addra.. portion of thh notlCI, the $5,000 IKolualon
alr.ady hu bllll dtduotlld fro. thai aocount balanel .. r."or\ed by thl HnlMl.I In.UtutlM,
2, Ent.r the total balanoe of the account Including Int.rl,t acorued to tha natl of dl.th.
1, The p.roent of the account that I' taMable for .ach ,urvlvor II d.tlr~lned a' follow'l
A, The percent taMooI. for joint a".t, .,tabll,hId abre t~ on. yaar prior to tha decadent'. d..thl
I DIVIDED IV TOUl HUHBER OF
JOIHT OWNERS
Ex..I" "joInt UlOt ragllt"ad
DIVIDED IV TOTAL HUHIER OF K 100 . PERCENT TAKAILE
SUAVIVIHO JOINT OWNERS
In the fla.. of tho dlcadant and two other personl.
1 DIVIDED av ! (JOINT OWNERS) nIVIDED BV 2 (SURVIVORS) . .161 M 100 It 16.7:< (TAMAllE FOA EACH SUfNIVDA)
I. The percent tlMabla for 8111t' cr.atad wIthIn one y.ar of tha dacadant', dlath or a~count. owned by tht decadent but hald
In tN.t for' BOOth.r IncI!vldu,,1(o) (t,..Ult beneUclllrl..)t
I DIVIDED BV TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
K 100 . PERCENT TAM AilE
EM8IIpht Joint Ilocount rlgll\lIrad In the nil.. of tha dlcedent and two other person.. Itnd ..tabU.hld within ona y.ar of tltath by
the deell1Mt.
1 DIVIDED BV 2 (SURVIVORS) . .50 )( lOll . ~O;: lTA)(ABLE FDA EACH SURVIVOR)
4. The IIIOUf1t sUbject to tal( C\1nI4) Is deterlllln.d by IlUltlphJng the Ilcoount balanc. (111'1I ,2) by thl ptIroent taxtblt (lJnt 5L
5. Enter thl tot,,1 (If the debt. and dtducltlon. Ult.d In Plrt 5,
6. Tn. Maunt h)(lblt (Un. 6) II datt,.lned by lubtraetlng tha dlbh and dflduotlonl (lIne 5) fra the aItOUnt .UbjlOt to tel( (Una It),
1. Entlr tht tpproprJlta tl.)( rata (llna 7) at dattrainad below.
A. Fa, datal of ~th occurrlng lifter 6/10/94, thl tllM rat.. fp,.. trln,f.rl to 'POUII. arl .. fpllClwI'
I. Olt.. of dllth on or- lifter 711194 and belll"" 1/1/95 the rata Is 5t:.
Z. Oat., of dlath on or aftar 1/1/95 tranlf.,... to ,poU~" will be tll(eG lit 0;: tllM rltl.
Notal For dati. ~f death prior to 7/1/94 tranlflr' to ,pOu... IIrl tnM.bl. at 6;:,
I. Tren,fa,..' to liMat da,clndants Including fathlr, aother, .on, daught.r, grandchildren, aon-In-Iaw,
dlUlhtllr-in-lllN, ,tapchlld and their I..ue art taKable It ,1M paro..,t (6X),
C. Trenlflrs to III other. Irloludlng brothar, .lIhr, unci., aunt, nephew and nlaca ara tllMabla at flft"" percent (lS:O,
D. If you change thl tlM rat., pia.,. 'PlQlfy your relatlon'hlp to tha decldant In the .ra. provided,
A, Tn. HOOOt of till( due (line II) 11 dlttr.!nad by llu1tlphdnll th. &Ilount taMf'bh <1lne 6) by the hx rata Ulna 7),
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabll debtl end d.ductlonl 1"1 dahrlllnad ItS folloMIl
A. You l.pUV' Ire rllpon,lblo for Plty.."t, or thti 4Itlta .ubJltlt to Itdalnhtr.Uon by a par.onel rlprllontlUvl 11 intufflClI."t
to PI:ll thft dIdUOUbl1 It..t,
B. You .otuolly paid tha dabts aftar daath lIf the dleldent ftfld can furnish proof of paYHnt,
t, DlIbh baing cl..11tId lIll,t bll Utilized fully In Part 5. If Iddltlnnnl .plOl I. need.d, UI' pl.ln p..,..r 8 1/2" K 11". Proof of
payaant la~ be rlqUeltad by the PA Dopart..nt of Rlvenue.
" . ..[]""""',....,.
.<i .... ... . . TAXf>AVER ASsInANCE ". .....>i
.../>................ i.............. IFVOU. NEED FURTHER INFORHArlON OR ASSISTANCE, CONTACT ANV. ... ............................................
....REGXSTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICi.>< ............... ..
OR CAll THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN .......... .... ......
HARRisBURG AT (717) 787"6327. TOOt (7171 772-Z2fi2 (HEARING IMPAIREll ONLY) ......... ... ... .
. ~
.._..n.~ _ ._ "1".
COHHrJNWEAlllt OF PEHNSVllJAHU
DtPIIRTHEHT Of REVfHUE
BUREAU or IHDIVIOUAt TAMES
DEflT, l~O"'Ol
tlARRISBURG, PA 1'Iaa-OUl
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
EST. OF ROSE ,ASKEN
5.S. NO. 094-12-1188
"'DATE OF DEATII 01-13-97
COUNTY.. CUMBERLAND
FILE NO. 21
ACN 97110957
DATE 03-18-97
TYPE OF ACCOUNT
o SAVINGS
Iil CHECKING
o TRUST
o CERTIF ,
IIV.llU (lIU 1/."1
.. MICHAEL J ASKEN
5 CREEKSIDE LN
CAMP HILL PA 17011
REMIT PAYMENT AND FORMS TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS BAHt( hII. pro"l~ the ~.rtHnt with tht Jnfor..Uon 1 htlld b.lotl which h.. bMn uMd In c.lcul.tJ~ thl
po~.ntl.1 taK duI. Their rlCord. Indic.t. that .t t~ death of t~ eboVI ~~t, YOU war. I joint owner/~fJolMry of thl. ~count.
If yoU fill thil InforMUon II Jnoorrlot. ph... abt.ln wrJtten corrlaUon frOll thl flnlmClhl In.titutlon, IIlttKh . cop)' tc. thll fara
n rlturn it to th41 MOVI tddrlu. Thh ~count II tlMIIII.. In lCoOordlNlCl wJth thli InhlrltM<:1 TaM llltWI of the C~I1th of PWln.vlvenl..
'0u4ud,lulIlI .11I> lIw ..."tinK~ i..,. <lIllU1,/W (j'2'n 7u, 3~E7. ' . ,. ,
COMPLETE PART 1 BELOW .
Aooount No. 20-00004166
. . SEE REVERSE SIDE FOR
D.t. h3-05-96
E.tob1hhod
FILING AND PAYMENT INSTRUCTIONS
Aocount Bel.".. 2,976.57
P.roont Toxoblo K 100 . 00
AlIOunt Sub.l.ot to T.. 2,976.57
T.. R.t. K .15
Pot.nth1 Tox Duo 446.49
PART TAXPAYER RESPONSE
1!l1',~M~9~.'i,19:"'~~.~!m"'~~~"~'..Y~J"'l~,":,;~~i.,il!f~~~~~~:'iii;TM,ii~$.'EM",ir~i'~...~:i'i~!:~~~~~~~~Bl
A. [.1 The aboVI InforHUon W'd ta>c due .II corrltet.
1. Vou..y choa.. to reMit pav-.nt to the Rlgl.tlr of Will. with two copll' 0' thl. notle. to obtain
I dlKGU'lt or ."old lnt~rl.t, Of' yOll nv c:hKk boM "j," and rlturn ttlll not!" to tM Raghtlr of
~'l' Ilnd an offJolal ......HOt will bft h~ by ttw. PA DeparbtMt of RlvlN'IIJe.
ft. ~The. ~v. u..t t.1I bit." or will btc reported and bioi paid with ttt. penn'Vlv.d. IntMrltww:. Tit)( rlturn
to be flied bv the dee_dent'. rapr..antltt"..
To In.url pr~r crfdlt tQ your IICc~t, two
U) copt.. n(- thh notlCI ~J.t ItCCCMlPIlnY YDllr
PIYMllt to the A~htlr of Wllh. ~61 cheek
PlIyLlill. tOI ~efilhtlJr af W11I1, ~~t..,
HOTEl If taK p.~tB are .-de wlthJn thr8e
(3) IlOnth. of tha a.o~nt.. dltl 0' d..tll,
YOU HV deduct . 5): discount of the t.x dul,
Ariy Jnhlrltanc. tlM due "IU becOH dilllnqullOt
nAne (9) ~th. .ft.,. the d.tl of d.ath.
[CHECK ]
ONE
BLOCK
ONLY
c. 0 ThlIlIba\l1l Jnfortllltlon h~f'I(.orrltCt .nd/o~h end deductIon. wrl ptltd bv you.
You .."t cMflhtl PART l!:1 and/or PART ~ bllow.
PART If ~ou Jnd1c~d~;;;rt.~ r.t., p1r... .t.t. ypur
[!J r.hUon.hlp to docodont I -:> (HI OJ 'I ~
TAX RETUR~ . COMP~TATrO~ n~ TAY. ~~ J~!~T!TP.~!T ^C~~~~~!
LItlE 1. D.t. Eltob1hhod 1_
2. Account aalance 2
5. P.rcent Taxable 5 x
4. AlIOUl'lt Subj..t to Tox 4__
i. Doobh ..... DoducUon. S
6. AlIOUl'lt T..ob1o 6
7. T.. R.t. 7 K
I. Tax DUI "
. }'O
PART
[!]
DATE PAID
~
Ili!l!ii~;ii;~~!~i!i~
' e ~. ,.:,'" ::-:::;::!:: :::::::;::: :::i:::: ':::i ::;:):!::;::::~4:
DEBTS AND DEDUCTIONS CLAIMED
. 0(.
PAVEE
-
DESCR I PTI ON
AMOUNT PAID
t
TOTAL C[ntor on Line i of T.. CORPut.tlonl
:F
.
-
-
chr. thet thll f~t. t have r,par,ted abo". .r. true, correct Md
end b.lI.f. 1I0M~ 017> 7J.j..Yt ~ ~ __
- WORK l;tn> ,?fn.. -2-</11 .:tif)j~
fELEPH UMBE E
COI1OOHWEALTH OF PENH5VlYAHIA
DEPARTHENT OF :JEYENUE
BUREAU Of' IHDIYI[)lJAL TAMES
DEPT. ZII0601
HARPlS1URQ/ PA 11121'0601
'*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
EST. OF ROSE ASKEN
S.S. NO. 094-12-1188
DATE OF DEATH 01-13-97
COUNTY CUMBERLAND
FIL.E NO. 21
ACN 97110953
DATE 03-18- 97
TVPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUSI
[K] CERTlF.
UY.IH' ua"cr.m
MICHAEL J ASKEN
5 CREEKSIDE LN
CAMP HILL PA 17011
REHIT PAYHENT AND PORHS TDI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
HARRIS SAVINGS BANK ha. providld thl Dlpartltent with the Inforll8tton lilted below which ha. blln ll.ed In calcuhltlng the
pohnthl till due, Th.lr r.cord. Indicate that at thl dl.th of the above dlcldlnt, YOU WMI . joint ownlr/blneflchry of thh I!Iccount.
If you h.1 this Infor..Uan h Inccrr.ct, ph... obtain wrlttln corraoUon frolt tha flnanclll In.tltutlon, attaoh II copy to thh for..
and r.turn It to tha abav. addr...., lhh aocount 11 tll<lbh In a.,cordancl wJth the InherJtlK'1o, TIlC law. of the COllllOnw.alth of Pennlylvanla,
au_Ulan. illY b_ a'l'lHirad by ('811lnG (717) 787~tS?7,
COMPLETE PART 1 BELOW. . . SI!E REVERSE SIDE FOR FILING AND PAYMENT IN9TRUC'rIONS
Acoount No. 08-61-193695 Data 04-15-91
E.tablhhod
Aocount Sol....o 22,127.54
Porcent To.lIblo K 50 . 000
Aoount Subjoot to To. 11 . 063. 77
To. Roto X .15
Polontlol To. Dua 1 .659,57
PARI TAXPAYER RESPONSE
ill I FA;LURITORISPOH!lWILI'RIl8UL1<XM AH. OmC:IAL TIIXIISSl!S9HEHT SASlDON. THIS.HlmCa-1
.... 0 TI,. above Infarllation and tal< du. hi correot.
I, You .ay choa.. to "lilt paYMont to the Rloht.r of W1l1. with two cc\pl.. of thh notice to obtain
II dhtlouot or avoid Intar..t, or YOU lIay check bOlC "A" and "turn thh notlo. to t1~ Righter of
Will. and an offlc{~l ~g'."..nt will ba I..uad by the PA Depart..nt of R'~lnu.,
B, ~ov. a..et hftl baln or will ba reported and talC paid with the PennsVlvanla Inh.rjtan~' TIlC ~.turn
to he flhd by the d.e.dent's rapr...ntatlllll,
To Insur. prOJl.r oraellt to your account, two
(2) copll' of thh notioe OOlt ltOcoltPlW'lV your
pay..,.,t to thl Regllt.r of Willa. "aka oh4lck
Pllyeola tOI "Righter of Wl118, "'gant...
HOTEl If talC pay.antl IIrl ud. within thrflll
(3) aonthl of the dacadont'. data of death,
you 8ay ~.duot a S% dlloount of the ta~ dUll.
Any Inheritance tax dUll will heoo.. delinquent
nine (9) .(lnthl IIfhr the det. of death.
[CHECK ]
ONE
BLOCK
ONLY
C. [J Th. above InforMation l~ncorr.ot and/or dabt. and deduction. Wlr. paid by you.
Vou .u.t coaplata PART ~l and/or PART ~ balow,
If you indlc.t. a different tax rat., pl.... .t.t. your
relationShip to decldlnt I
.:,:,'
.. .."OFFICIAL.(JSIlONLY . QMF!
P41lEPAllTHENTOF IlIlI/ENUIl':,,1
, :'.,': ':' '.:'.,'.', .'....:,..,.,.:,.'..:,..".":. """""",.',:';i
----~ ':", ..,.
PART
~
TA~ ~P.,!,IIDl.! - ~(t"'!Ptl'!'!'.r!~~
LINE 1. Dote Eltablhhod
2. Account 8al~1
3. Plrclnt Taxabll
4, Allount Subjaei: to TI~
S, Dlbh and Dlduct ion.
6, AMount Taxabll
7, Tax Rltl
8, rax DUI
n-:: "''''.~ ~"I .J('l~~'!'lT!'!t.'ST .".r.C~U~'!'~'
I
2
3J
4
5
6
7 X
8
PAn
S""1'
... 1
..2.~
3
.11
.5
~
1
8
CLAIMED
.!
.",
:;,1
:-oz:
, I'~
i::i
..--..i
PART
~
DATE PAID
=-d
DEBTS AND DEDUCTIONS
PAVEE
DESCR I PTI ON
AMOUNT
3-
.
PAID
I
TOTAL (Entlr on Line S of Tlx CoftPutat1onJ
r-
~'.
Under panal ti.. of plrjury, I d.clare that the flch
CO"'lot~))2 b~~kno"IOdgO ond bollof.
TAXPAV~~
I hive r.portad abOVI Irl trua, correct and
IjOME (717) 71,Ict"L
_ WORK (-/11 > 711 l- Z.'M'___ '"~ h1 If"?
TELEPHORr NUM~R ~~~,
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT .lIh _11'''1. lnt.....t ..... on 1,,10,..\1..,
IUDllltt,d bv t'" flnanol,1 In.tltutlCln.
2. InhtirltlM'lfll tlM beaM" delinquent rdn. lM>>nttll ,ft,r U,. dlcctdl"t', d.t, of d..th.
5. A Jaint "count 11 t.)(llbh IVI" thfJugh thl d~(l.d.nt'" mtllll Wlli ad<;lld III . ,qtt.t of convent.nol.
.. A~oov"t. (Including tho.. held betw..n husband and wlf,l which thl decedent put In joint ".... within on. y..r prl~r to
~~th 't. fully talClbl_ ~. transf.r..
S. ikccounh ..tftbllaked jointlY blt-w.." hu.blMld end wife MOr. thM Of\ti v..r prior to d..th ar. not tl!Cabl..
.. Account. hlld by . d~.d~t "In tru.t for" anot~r or nther. ar. t'Mabl, fUlly,
REPORTING INSTRUCTIONS - PART
1
- TAXPAVER RESPONSE
1. BLOCI( Ai . If the Infor..Uon Ind co.-utlltlon III thl noUoe It. correot Itfld deduction. Ir. "Clt being ot,lud, pi", M "K'"
In block "A" of Pett 1 of thl "TI)(peyar RI.pBn.." ..ctlon. Sign two oople' and .ub.lt the. with ~our oh.ck for the .-aunt of
tex to t~ Regl.tlr of Will. of the county Indlcltld. Th. PA DIP.rt..nt of RIVlnUI will l..u. an official ......-.nt
(For. REV-154a Ele> upon recllpt of thl r.turn fr08 the R.,htlr of willi.
Z. BLOCK II. - If the ",ut IP.ciflad on thlt notlc. hu bun or will b. r.ported and tax flald with the P.nn,~lv.,lI. I~rltano.
Tax Return fllad by the dac8Otnt', r8pr.'ent~tlv., pl~. an "X~' In blook "8" of Part) of the "Taxpay.r R..pnn.t" ..etlon. Sian one
oopy ~ r.turn to thl PA Dtpart-.nt of Revenue, Bureau of Indlvldu.1 T.XI., Btpt 210601, HtrrltbUr., PA 11121~0601 In the
envllope prOVided.
3. BLOCK C w If the notlo. Infor..tlon I. Incorrlot .nd/or d~tlon. .r. betng olat..d, oh.ok block "C" and co~l.te Plrt. Z Ind S
accora1n, to tnt in.truotionl Da!OW. bien tWO oopi.. .nu ~~.1{ tn.. wit.. your oheck ior ~." ,.-ounl at tax p.y~l. '0 the ~W11...r
of NUh of the county iridlc,ted. The PA Oepart..nt of RevltlWt will luu. an of fie lei ........,t (Fort REY-1541 EX) upon reatlpt
of t.. r"turn frOll the RIII!IU'" of Nlll..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
I. Enter the at. thtt ItOcount ortglnalh w.. utablhhed or tlUId In the tann.r .xhtlng at chit. of death.
NOTE I For II dectdant dying .fhr 121121821 Account. which the dHtdtnt put In joint n.... ",!thin one (1) year of de.th ara
t.x~le fully.. tran.f.r.. Howevlr, thlr. ,. an .~clu.ion not to I~olld '3,000 plr tran.flr.. reg.rdla,. of tha Yllua of
thl Mloount or thl "".ar of tecountl hlld.
If . double ..tarl.k (ww) appelr. baforl your firlt n.-t In the addr... portion of this nQtlc., the 'S,OGO Ixclu.lon
alr.ady hili boGn dedooted frOll tha ICCount balanca 8' report.d h~ tha flnanci.1 In.tltutlon.
2. Entlr the total b.llnCl of thG account Inoludlng Int.rl.t accruad to tha date of death.
S. lht p.re.nt of th~ account that I. taKable fnr .ach .urvlvor I. datar.load a. follo""1
A. The PDrc.nt t.xabla for joint ....t. I.tablllhad .orl then 0"" Ylar prior to the dtoldtnt'. d.athl
1 DIYIDED BV TOTAL ......aER Of
.JOINT OWNERS
Ex.-plel A joint O'I~t ragl.t.red
DIVIDED BY TOTAL NUMBER OF X 100 ... PERCENT TAMABLE
SURVIVING JOINT OWNERS
In the n... of th, daoad.nt and two other par,oll"
I DIYIDED C, :5 (JOINT OWNERS) DIVIDED BV 2 (SURVIVORS) . .161 X 100 . 16.1X (TAXABLE FOR EACH SURVIVOR)
B. nn. p.rc.nt taxabl. for ....t~ cr..tld within one Y~dr of thl dacadent'. daath or aocount. DNnId by the deeedlnt but held
In trust for anoth.r Indl..,ldual(G) (trult b.naflchrJ..h
1 DIVIneD BY TOTAL NUMBER OF SUflVIVIHO JOINT
OWNERS OR TRUST BEHfFICIARIES
M 100 . PERCENT TAMABLE
Exa...l., Joint account r'Ahtorlld In the na.. of thlll d'/I:.dant and two other plrtonl end IIIttbllthed ",Uhln one y..r of dtlth by
the daotdWlt.
1 nIYIDf_D BV Z (SURYIVORSl . .50 K l~O . 50% (TAXA8LE FOR EACH SURVIVOR)
~. Thl..ounf;: .ubjact to tak <Una it) it dahraln.-d by .ultlp1ylng ttw account balance Ulna 2) by thl parctnt tllxMlla (l1ne S),
I; 1\"".... t.... +"...1 ,,' .,,_ .lotlt. II\tVI rt.lt(4ut1tll\~. 1 ht,,1.l In Pllrt 3.
6. The MOunt t'Kablt (lIne 6) III det.r"lned hy .ubtraotlng the debt. and dlductlon. (Jlnt Sl frot thl MOUnt 'Ubject ta tax Cll,. 4),
7. Entar the ."roprlate tax rete (lint 7) I' dlt.r.lnad below,
A. Far dat.. af Juth CMIcurrlng _ft.r 6/S0/94, th41 tlK rat.. for tran.fart to .poult. Irt II follow' I
1. Olte' of d..th on or aft.r 1/1/94 mod b~fnr' 1/1/95 the rltl II ]~,
2. tld... of dttth PI1 Dr oftl. 111/95 trar'llfar. to .paU'1II ",Ill tM taxld at Die tftx r.ta.
Hatel For dat.. of de.th flrlor to 7/1/94 tran.fer. to 'POUI" ar" taKable .t 6X.
I. Tran.f.r. to Ilntal cMI.cend."t. Inoludlnll f.thar. 'othtlr, .on, daughtllr, grandchlldr.", .on-ln.1"",
_tthtlr.ln-IIN. .tapohlld Ifld their luua are taK.bll at Ilx percent (6~)'
r,. Trllll.fer. to all otharl Including brother, .lItar, unOll, aunt, n.phe", and nlace Irt tlxable at flft.." parctnt USX).
D. If you chtngl. the tax rata. pI.... lpeclh your relationship to tn. daoedttnt In thl tre. provIUtd.
I. The MlC\unt of ta~ due Ulnl 8) II dat.r.Jn.d by .ultlplylnll the allou.,t ta)(llbl.. (line 6) by the tax rata Ulna 1).
f
r
.
J
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AllONable debt, and deductIonl er. dat.r.lnad a. folloWll
.. You lag.lly .rl r,IpOn.lbla for paYlant, or th. .8t.tl .ubjeot to adtlnlatrfttlon b~ I per.onal raprl~t,tlvl 1. In.ufflolant
to p.... tho deductlble it....
I, You aotuallY p~ld thl dabh after death of thft deud.nt and can furnish proof of pIYMant.
C. Debt. baing clel11d autt be It..lzed fully In p.rt 5. If eddltion.1 opac. I. natdad, u.a plein peper 1 1/2" MIl". Proof of
p.lYHnt HY bt requa.tad by thl PA Dlpart-.nt of Rlvanutl.
.,
\ ............ ... ..........................> > .TAXPAVER ASSISTANCE.....
IFVOUNEI!Il F'URTHI!R INFORHATlON OR. ASSISTANCE; CONTACTANV.
REanTliROFWIlLS. PA DEPARTMENT OF. REVENUE DlSTRICT .. OFFICE. .. ........i<...
... ..ORCALlTHEBURI!AU OF INllIVIDUALTAXES,TAlCPAVF.RINQUIRVUNIT IN<
>~~RRlSBURe.IlT .... p17 )..787.-.81527 .... IDIII! ... (IF) > n?~?~!ll', .... (H~IlRl~O l~rA~REll. o~~y)>.
,.,:,','':,'':-
-
CO""OHWEAl HI Of PEHHSVlIJAHI~
DEPARTMENT Of' REVENUE
BUREAU Of INDlvlDU.l TAMES
OEPT. Zlt0601
IlARRISaURO, ~IA 11128-0601
'*
INFORMATION NOTICE
AND
TAX PAVER RESPONSE
FILE NO. 21
ACN 97110954
DATE 03-18-97
UV.IHI If ,,, 0-"1
-----~
EST. OF ROSE ASKEN
5.5. NO. 094-12-1188
DATE OF DEATH 01-13-97
COUNTY CUMBERLAND
TVPE OF ACCOUNT
\XJ SAVINGS
o CHECKING
o TRUST
[J CERTIF .
MICHAEL J ASKEN
5 CREEKSIDE LN
CAMP HILL PA 17011
RE"IT PAY"ENT AND FORNS TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
HARRIS SAVINGS 8ANK h.. provided the Depart.ent with the infor.atlon listed bela... which has boen u.ad In calculating the
potentl.1 tax dua. Thalr r~ordi Jndlcot. that et tha d.ath of thl ahova da~adantl YOU warA a joint ownar/bfi'aflclar~ of thl. account.
If yoU faal thh Infor..tlon h Incorract, plaua ebbin written corractlon frea the financial in,tltutlon, attach a copy to thl. for.
and raturn It to tha ahova addr.... Thll aocount 11 tlll(able in accordanca with the Inharitanoll TaM law. of the Co..onwulth of Plnn.ylvanlll.
wa",\iot'l. ..)1' ot! ,;111.".11... ~Y ....lI..llly ~;':7j 1u1 :"..<:.,.
COMPLETE PART 1 BELOW . .
Account No. 20-60-000307
. SEE REVERSE SIDE FOR
Date 03-05-96
E.teblhh.d
FILING AND PAVMENT INSTRUCTIONS
Aooount ~oleno. 2.054.06
P.roent Toxobh X 100.00
A..unt Subj..t to Tox 2,054.06
T.x R.te K .15
P.tentlal Tox Duo 308.11
--.
PART TAXPAVER RESPONSE
illl..WtuI!ITO I!I!SPOHDIf~LL RUUI.TJHAI. OF.FIClXAI...'tAl{ ASSI$$HEIfl'. BASIDOH THIS HOTiCil
A. 0 The abova In-lora.tlon and taM due I, carraet,
1. You ."y choo.a to re..1t pay.ant to the Ragllt.,. ilf W!l11 with two copi.. of thll natic. to obtaln
a dl.caunt or avoid In\or..t, or YOU ..y c.hack bo)( "Aft and ratul'f'I thll notlc. to tha R.ght.r of
Will. and an official 1I1......nt will be I..uad by th. PA Oepart..nt of R.venu..
/.'
I. [3 The above lll'l..t hl'l' b..n or will b. r...ortad and tax paid with the PannsylvMl1I Inhoultanc. hI( return
to be filed by the decadent" repr...ntatlve.
To Insur.. prop.r Ilr.dJt to your account, two
(2) Clopl.. of thll notlc.. liJiJ.t acco.pal'\~ your
pay.ant to the Ragllt.r of Will.. Haka check
payable tol ftR.gl~t.r of Willi, Aoent".
HOTEl H tal( pay..ntl arc. iliad" within thr..
(~) Month, ef the deced.nt., dat. of d..th,
YOU May d.duct II SX dl.count of tho tax dUI.
Any Inheritance taM due wIll b.eo.. dol!nqUMlt
nina (9) lIonthl IIft.r tha data of daath.
[-_ CHECK J
ONE
BLOCK
ONLY -
c. 0 The above Infar.flUon II Incorract and/or debh ,,"d dllductlon. war. paid by you.
You .~ut coaphh PART CD and/or PART [!] balow.
11 ~ou indic.t. . different ta~ rat., pl..;. .t.t. your
relation.hip to docadentl
.4""OIJ"T,,!
.,' ..,. OFFICIAL USE ONlY 0 AAFi!
PA DEPARTMENT OF ,ReVENUE. .. .,
PART
~
TM!
LINE
R!TU~M ... C'('t!'lr."II"!"JI..T,."M
1. D.t. E.t.bll.h.d
2. Account Balanc.
5. Parcant Taxabla
4. A~unt Subjact to Tax
S. Debt. .-.,d Daduction.
6. A.cunt Taxable
7. Tax Rat.
a. Tax Dua
01' TA~ OM .'('nJT.'1'P"-'Q,!,
1___
2
3-1L
4
5,
6
7 X
8
;::'0.;::'1:::::''::::
r~ll
.1
...2
~:~",.,...,.:...,..:.:""-...-:"",,
,;:;
";'.i;j,*,
~
)1/
,,3~lltr1't'
1 I
DC.
~
5
6
1
8_
DEDUCTIONS CLAIMED
'i
.4.44
,4
"j
~
PART
~
DATE
DEBTS AND
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
t
t-
TOTAL I Enter'
-=~
on line S of rex Conput.tion) .
--
Under panaltia. of par jury, I declar. +'hat the fact, I
OOMPlot.~)~. b"W knuwl.dg. .nd b.U.f.
TAXPAYE~TURE -
have reported ~ov. are tru., correct ."~
HOME ...J..1!.V 7{,./ o.ffe-l, ~
WORK (~ ll) t~l-bM
TELEPHO E NUMB R
_.~n
OENERAL INFORMATION
1. fAILURE TO RESPOND WILL RESULT IN AN OfFICIAL 'fAM AS5ESSHENT with flPpllcebl1 Int.r..t lu,ud on In'orllltlon
tubttlttlKJ by th41 f1nancl.l hlltltut1on,
Z. Inharlt."cl tlM blon... d'llnqulnt nln. Month. "ft.r thl dlCldlnt'. dfttD 0' d..th.
S. A Joint ft<looont 111 hlMlbh l"ln though thl dtICldtnt', nHI ~".. added.. . ..U" of convlnl,nc..
... AcIc04M'1h (InolUdlng tho.. held bttW'''1 hUlband Md wlh) which the dleH,"t put In Joint n....wlthln onl v..r prior to
dII.th ar. fully '11(011 .. trllnt,.r..
S. AClCOlrltl ..tftblhh41d jointlY tHltw.en hUlbltfld and wlft lor. thlln on. y..r prior to d..th Ir. not tloblt.
fJ. Aocount hlld by a dModent "In trult for" lIlnother' Dr other' tlrt f'ICYt, hIlly,
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK II ~ If tM tnfar..Uon Ind oOlllflUt.Uon 1n tho notlcl It,. oorr.ot and deduotlon. IIr, not being Clltl..d, pllCl. ." ")("
In block "A" of P.rt 1 of the "T8Mply.r R..ponn" ..cUon. Sign two Clopl'l Itnd .ublU th.. with ,/our chllClk for U.. lItOunt of
hI( to thl Rlffhtlr of willi of thl countv Indlclt.d, Th. PA D'Plrt..nt of R8v.nu. will IlIu. an oHlcl.1 IUII,""t
(For. REY-1S41 f.)(l upon r,cllpt of thl r.t...rn fro. thl Righter of Willi,
Z. BLOCK B . If the 'II~~ .p~olflld on thl. notlo. hi' b.~ or will b. r.portld and tl~ paid with th. Penn.ylvlnll Inhlrlt.nol
TI~ R.turn flied by thu ~.o.nt'. r.,r..lnt_tlvl, pllc. ~ "M" In hlock "a" of Plrt 1 of thl "TalCpIYlr Re.pon.l" I~tlon, 61gn one
Cop!t .m rlturn to thl PA D."lrtHnt o~ R~yMUe, Burlau of Individual TaM", OIPt 210601, ttlrrhburll, PA 17121-0601 In the
~.lop. provided.
S. BLOCK C ~ If the notl~. Infor'ltlon I. Incorrect and/or deduction. ar. b.lng alll..d, c~k bl~k "C" Ind c~l.tl P.rt. ~ Ind S
"~~""rl,I,,C f;(I t,.., In!~r'.!'Jf;~.,.,. to"_',"", '.:'.1:... .','~ ':tlr"u .~... 'l"k~,I. .",~ l.I1t!1 ~'t.",. 01'.'='1 fr" t~. "Illtll'tol' ('f t:..\~ r"~""''1 .,. .... D.~l..t..,.
o~ Willi of thl Clount~ Indlclted. T~ PA Dlp.rt..nt of R.venu. will 1"uI an offlcl.l a.......nt (For.- REV~154a EM) upon rlG.Apt
of thl return froe the Rlffhter of Willi.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Ent.r the d&tl the IClcount originally we. ..tealllh.d or tltl*d In the .ann.r eMl.tlng It dlt. of de.th.
NOTE I For. dec~nt dwlng .ftlr 12/12/821 Acoountu which tha dlcldant put In Joint n.... within on. (1) YI.r of d.lth '1'1
t"lCMlI. fully at t",nlf.r.. HOWIV." th." 11 an 8I(clu.lon not to IlCO.ed 13,000 per trat\lferll "glrdll.. of thl lJltlu. of
the IHlClOunt arthl ~r of 8l'Jcaunh h.ld.
If . doubll ..t.r1~ (11M) app..r. btlfar. your fA"t nHe In the add".. portion of thh notJoI, tha U,GOO 'Molul1on
.lr.edw hI' bien UlduClted froa thl aecount blllnc. .. raportld by the flnenq1al In.tltutinn.
Z. Enter the totll b.I~. of the aClcount Including Intar..t aCloruad to tha dltl of death.
S. The p.rCl,"t of the account that 1. tD~.bl. for e'Clh lurvJvar I. d.t.rMlnld a. follow'l
A. The Plroent tl~lbll far joint "'Ats I.tablilhld ~rl thin one ye.r prior to the decldlnt', deathl
1 DIYIDED BV TOTAL NUMBER OF
JOINT OWNERS
bnpl.1 A Joint ....t rlght.rld
DIYIDED IV TOTAL NUtlBEA OF I( 100 .. PERCENT TAKABLE
SURYIYING JOINT OWNERS
In thl n... of the decedent and two othlr parlon..
1 DIYIDED IV 1 (JOINT OWNERSl DIYIDED BV Z (SURYIYORS) .. .167 IC 100 .. 16.7~ (TAXABLE FOR EACH SURYIVORl
I. ThI p.,.c~t taMebl. for ....ts cr..ted wJthJn on. y..ar IIf the dlcadlnt'l d.ath Dr acoount. owned bv thl d1e.dent but Mid
In tru.t for another Indlvldu4lH.l (trutt b.n.flolarl..)l
1 DIVIDED IV 'fOTliL HOI1IER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
M 100 .. PERCENT TAXABLE
EMDlpl.1 Joint .coount r.al.tered In thl na.. of t~ ~cldlnt and two othlr p.rlon. Ind ..tabll,hld w1thln on. Y"" of d1lth by
thQ dacldlnt.
1 DI~IDED IV 2 (SURVIYORS) .. .50 X IDD . 50~ (TAXABLE FDA EACH SURVIYon)
~. The -.aunt .uaJect to t.u Olnl 4) 11 d.t.,..lnld by .ultlply)ng th. .ccount balann (IIn. 2) by th. peroent telC.o1* Cl1nt 5).
5. Enter thl total 01 the tltlbh and dlduotlons I tltld In Par t 5.
6. The IIlKlunt ta~lIbl. Cllne 6) It a.twr.lned by lubtraotlng the aobh end deduotion. (lin. S) fro. the .ltCKM'lt lubjlCt to tlM (U.,. 4),
7. Ent., the IIPPrOflrlatl ta)( rilt. <lln. n IU d.t.r.ln.d b.low.
A. For data. of aelth occurring .ft.r 6/30/94, th. t.x r.t.. ior tr.n.f.r. to 'POUI.' ar. II folloWl1
1. Olt.. of de.th on or .ft.r 7/1/94 and b,for. 1/1/95 th. rat. 1. 3~,
2. Olt.. of d.-tll on or Ift.r 1/1/9!; tranlf." to 'p04..... will b. "'MId at OX taM r.t..
Not., FDr dat.. of d..th prior to 7/1/94 tranlf.r. to IPOUI" .rl taHabl. at 6~.
a. Tranlf.r. to Iln..1 u..c.nd.nt. Including f.th.r, loth.r, .un, daughter, Qrandohlldr.n, lon~ln~I8W,
dlUght.r-Il'l~I~, .tapc:hlld rind thllr luue arB ta~abl. at .IM plrcent ('Xl.
t. Tt'enlflrs to III oth.r. including broth", .!vhr, IIncl., aunt, nlphoM end nllC" Ire taMabl. at "1ft"" PIrOlnt (U:O.
O. If you ch.\g. thl t.lC r.tl, pl.... Ip~lfy your r.l~tlon8hlp to th. d.cld.nt tn th. ar.. provided.
I. Tha ..aunt of t.~ due (line 81 11 dator.lnud by .ultl~lylng the .Mount talCabl. (Iln. 6) by thl talC rlt. (lln. 7).
CLAIMEO OEDUCTIONS - PART 3
DEBTS AND OEOUCTIONS CLAIMED
Allowabla d4btl and daduotlonl arR d.t.r.ln.d a. follow'l
A. You 1'91111'1 ar. r..po,,,lbh for "ay..."t, or the utat. "ubJact to Id'lnhtratlon by I partonal rlpr..."taUYI II In.ufflcient
to PlY thl d.ductlbla It....
I. You aotuallY pa'd the dabh aHgr d..lh of th. dludlnt Ifld can furnlth proof of paya."t.
C. OUt. bllng olt.tMd .....t b. It.. Iud fully 1t'! Part 1. If additional .psee 11 n.ldld, U'I ph In it.." a 112" I( 11". Proof I)f
ply..nt .0 be rI~.t.d by th. PA O.partunt of R''''''nl.l',
TAXPAYER ASSISIANCE
IF YOU NEED FURTHER INFORMAY!ON OR ASSISTANCE, CONTACT ANY
.... REGISTER OF WlLLS. PA DEPARTMENT OF REVENUE DISTRICT DfF!CE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
tlARIUSIlURG AT(7171 787-8327. TDDl! (7171 772-USZ (HEARING IMPAIRED ONLY)
,"""'M.'~.4 _. "f-
GENERAL INFORMATION
1. FAILURE TO RES~ONO WILL RESULT IN AN OffICIAL TAM AUESSH~~T wi'" .ppll...l. Int.r.., .00'" on Inlor..lIon
lubIIlttMl by thft 'IMMel.1 In,Ututloo.
t. Im-rltllne. ttM btt1lo... delinquent nlna lonth. Mt.r thl dleldlnt', rlflt, of cl."th.
J. A Joint eecount I, t"Kable ."'." thou" thl dlclde"t" ".... WI' addld '" . ..t~.r of cony"nl,nol.
4. ",QClOunt. (inoludlna tho.. held btt",.." hu,lIlnd find wlf,1 whloh tho dlCldl"t put In joInt ".... ...lthln unl y..r prior to
Math .r. fully t,'(1Ib1, .. tran".rl,
&. Account. ..tebll.hed jolnt.ly b.twltn hulb~ and wlf. lIor. than 0"1 v.~r prior to d..th .r. not tlMabll,
6. Acoount. tMlld bv . daudll"t "In tnl.t feU''' Ill'lothtlr or nth.r. .,.. tullbl1 fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK A - If U.. Infor..tlDn Ilhd COllf)ut,t1on In thl notlcl .r. oorrect and d,ductlon' tirt not bllna Olll..dl PIMI In "X"
In bl~k "An of Plrt 1 o' the nTIMpayar Re.pon.." 'Iotlon. Sign two copJe' IInd .~~It the. wJth your check for the .-aunt of
hM to the Rqhhr of Willi tlf the county Indlc.ted. The PA nep.rt.ent of R.y,nue will lllu" .n offltlhl ........"t
(for. REY-1S41 fM) upon r.otipt of the r.turn frOM the Rlal.ter of Will.,
Z. Bl.OCK II - If the au.t .paoifJed on thll notlo. tll. b..n or will ~ reported antJ ta>e plld w1th the pem.ylvanle tnher1tllnCe
Ta~ R.turn flied by the ~~t'. rapr.lentatJv., pl~. In "k" In blook "8" of Part 1 of thl "Taxpayer RUlpon.." I.ction. Sign ant
cOPy 8nd r.turn to tn. PA Dep.rt..,,\" of Ravenue, BurallU of IndJyldual laM", Dlpt llO601, Herrhbura, PA 11lZI~0601 In the
envalope ~rovldtd,
J. II,OCM: C + If the notlc. Infor..Uon It IMorreot and/or deduction. Ira b.lng clah.ed, oheck blook "C" rmd oOllPl.te P.rh Z and 5
lMlClorolna to ;,tMl hlhl'uod..,.,,,, lJ......" , SlulI l.u ....,.1". "flO.j huU.-H li".... "I'.:, juu,' ..h....~ j..,' to'," .I......,,~ ...' ~..~: P8:Jabla toJ th~ r.:;!:.~:.:
of 111111 of the county Indluted. TM PA Depart.ent of RlvtHlu. w.ill luu. on offlol.l ......unt (For. REY~lS4e E)() upon r~.lpt
of the r.turn frOll the Rqhtlr of WOlD,
TAX RETURN - PART 2 - TAX COMPUTATION
liNE
1. Enter the dtlt. the 1C~l)Uf1t originallY ..al CIItab11lhed ai' titled In the IlMOar ed.tlng Itt data of death,
HOTEl For a dtH:lCIInt dying after lU1UIZI Aacountll which tt.. d.o.dent put In joint neIM" within on. (1) y..r of clalth ara
taxable fully., tran.fer.. How~v.r, thero II an .Kolu.lon not to aKo..d 'S,OOO p.r tran.f.rea ragardl... of the value of
thl ItCClOlmt or tha ~r (If aOClolZlt. held,
If a doubl. a,terlak (ww) 1P948r. before your flr.t ne.. In tha eddr... portion of thll notlo., the .5,000 'Mclu.lon
alr.ady h.1 been u.ducted froe the account balance a. rlpartad by the finanolal Inltitutlon,
t. Ent.r thl totel bllance of thl account InalUdtng Int.re.t aocruld to the dllte of d'ath.
S. Thtli percent of thl IIccount that 11 tnKabl. for nch .urvlvor 11 detar.lned II followll
A. n,. pare.nt hlMlDle for joint ....b utltblhhad I/Orll than 0fWI y.ar flrlur to the decldant', d..thl
1 DIYIDED IV TOlAl NUHIER OF
JOINT OWNERS
EKllltfJlel A joint auet rlghhrad
DIV10ED IV lOUl NUNIIER Of X 100 . PERCENT TAXAllE
StflVIVIHG JOINT OWNERS
In the ne.. of thl dac.~tnt ~nd two othar plrsonl.
1 DIVIOED IV 5 (JOINT OWNER:;) DIVIDED BV ? (S~VIYORS) . .167 )( 100 . 16.1i( (TAMABLE FOR EACH SlMYIVOR)
B. Tha percent t_KIMe far lI..ett crallt.d wIthJn ona Yallr of the deeadant'l! "'ath or aclC\CMJntl owned by the decedent but hIIld
In truDt for onother IndJ",ldual(ll) (trUlt bDnlf1chrl..)t
1 DIVIDED BV TOTAl HUHIEA Of SURYIVHfG JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 .. PF.RCENT T AXUlE
Ewaaplel joint account regl.t.rad In tha na.. of thl dlcadent and two othar parlonl and a.tlbll,had within on. y.ar of d.ath by
tM ckoacktnt,
1 DIVIDED BV Z (SURVIVORS) . .50 )( 100 . 50;': <TAXABLE FDA EACli SURVIVOR)
4. ThI MOUnt lubjNt to ta>e Cllna 4) II dat.r.inad by nU1U"lylng the aoaount balance (lIne 2) by thl paroent tax..l, Ulne 5),
Ij. Entu thl total of thl d9bh land dadu<ltlon. I htad In Part 1.
6. The NOunt tultbla Cllnl 6) 11 d.t.r_Anad by .ubtrllctlng tha d.bh and ded\lctlonl Ulna 5) frntl thllltOUnt .ubjltCt to taM (lIne ItJ,
7, Entar tn. appropri.tl tax rlt. (lin. 1) a. d.tQr.lnad b.low.
A. For date. 01 de.th occurrlna Bft.r 6/50/94, the tft~ r.t.. for tran.farl to SPOU"I are a. follow'l
1, Oat.. of d..th on or aftar 7/1/94 and b.fore Ill/I)!; the rate 11 H.
Z, O.t.. of d..th on or 8fhr 1/1/95 tr'lMllfflr. to ,po"... 101111 be taxed at 1)% ttK rat.,
Hotal For data. of dMth prior to 111/1)4 tranlf." to .pOU'" a"a tax.bl. at 6:<.
B. Tran.farll ~o lineal de'Clandantl Jnoluding lathar, .oth.r, .on, daughter, grandchildren, .on-In-l....,
dlUlht.r-ln-ltIW, .tttpehHd and their luue ar. tltMlfhla at .1x pere.nt (6':0,
C. Tran.fllr. to all ottltlr. hWludlnA brother, .h~ar. uncia, aunt, napha.. and nl.ae ara taxllble at fift.en percllnt USi(),
D. If 'jOU chlllnit thtl 't.JIC rata, ple.lIa .paotfy your rllhUonlhlp to thl d"edtnt 1n thl ar.. provJdad.
ft. Tn. HaUnt of hK due (lIn. 6) II deteralnad hy till Uphdng the IItOunt taKabl" (lIn. 6) bV the tax r.ta (11M 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowllbl. Mbt. and daductlon. ar. dater.lned ft. follolol"
.. VOlt legally arn reapofl.lbh for PI";Hnt, or t~ ..tste .ubjaot to adllllnhtratlon by a P4rtOOll rapr'I"'ltatlv. l. InaufUalent
to pav the deductlbl. Ite...
B. Vou actually Pflld thl dabt. aft.r da~th of the d.ced.nt and can furnl.h proof of pay..nt,
C, Debt. baing altllHd lIU.t b. U.lllzed fully In Part 5. If additional spece h n..dad, UII pl..!n p..r I 1/Z" x 11". Proof of
pay.ant a.y ba ra~la.t.d by the PA D.part..nt of Revanu.,
.. TAXPAYER ASSlSTANCE . .....i
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, COtlTACT ANY>'
REGISTER OF WILLS. PA DEPARTMF.N'r OF REVENUE DISTRICTOFFICIl;.,i
. OR CALL THE aUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN.".
HARRISaURG AT (717) 787-9327. TOOl <717> 772-22!iZ (HEARlNll IMPAlREDiONLV)
(/)
U)
<(
..J
0
:.- I-
fTI
fTI (/)
"'"
t:I a.::
r:.:J
0(] -
II'" U.
fTI
a.
'"
o
"""--'
~ r r l--~
a. ", (I) (.Or--:
....- ..t.~, ,1-- .~~
~,~~~~",t(,~. ("Y1Cl
~::t':tJ~'(,,-J - ~J!!II. P
n:.... "fiilI'7C)
vi ~ ~ .
:.1 W (
It
J
...
.
-
ta.
~t:
"t
" -
i!
~I
\ou
.
,~
c,
~
R(;~-, ,\ ,
n\~;_.. -:{c{, (;{
" of
JIlin
..I
~
:E
yl III"K' 1 .1/:. i
j..!
\,,1. '
Cur,
::;clur\.
i'l PA
(/).
::I
.....
:z:
....
~
I .
W.lm
~-
>- ;:)0
1-. 0....
$ (/).....
. 8~WJ~;f.
(/)0
;:)i=~
\;lex.....
~~6o:!
1515<'>5
UO.r-,
!,
.
...
..
I:) () ,7. ..,,~
IURf.AU OF INDIVIDUAL TA~ES
tNUERIlIINCI:: TAM Ot~ISION
DErT. ltl0601
llARRIGIURQ, PA nus-ottot
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
( '.
NOTICE OF INHERITANCE TA~
APPRAISEHENT, ALLOWANCE OR DISAl.LOWANCE
OF DEDUCTIONS ANO ASSESSHENT OF TA~
06-30-91
ASK EN
01-13-91
21 91-0324
CUMBERLANO
101
[~~~==~r~.Mlt~~]
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 11013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
REV: isi'-i - Eie - AFii - io'3:I'i'7Y -No;'-i cr-oF - INHEiiii'ANC E - T"A'x -iiP'PRAI SE;.tEN'r; ";. L Dj'WANCE -jiFi' -" - - - - - -.. -" - -" - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ROSE N FILE NO.21 91-0324 ACN 101
DATE
!STATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
APPROVED DEDUCTIONS AND EXEMPTIONS I
6,261.00
9. Fun.rel F.xpen...IA,dllt. COBt./Hho. E)(p.n... (Sohedule U) (9)
10. D.bh/Hodg.g. l.hbUIU../Lhna ISchodule II nDI .00
11. Totol D.woUona nll
1.2. Not V.lu. of r.. R.turn (12)
13. CharHabb/Guvarll...nt.l aequ..t. lSchedule J) U3)
14. N.t V.lu. of Eat.t. Subj.ot to TM' (14)
NOTEI If an assessment we. issued ~reviously. line. 14. 15 and/or 16. 17 and 18 will
reflect figure. that illclude the totol of ill return. a.....ed to date.
ASSESSMENT OF TAXI
is. Allount of l1ne 14 .t Spou..1 r'.t. (IS)_
16. A~t of line 14 taxable .t Lln..l/Cl~.. A rat. (16)
17. A.aunt of Lln. 14 taxabl. .t Collat.ral/Cll" 8 ret. (17)
11. Principel Tlx Du.
TAX CREDITS:
PAYHENT
DATE
04-04-91
MICHAEL J ASKEH
5 CREEKSIDE LN
CAMP HILL
PA 17011
ESTATE OF ASK EN
TAX RETURN WAS I (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Elt.t. (Sch.dyl. A)
2. Stock. an~ Bond. (Schedule B)
5. Clo..ly tl.ld St')Ck/P.rtn.rah1p Inter..t (Sonlldull C)
4. Hortgag../Not.. R.c.iv~bl. (Sohedul. DJ
5. C..h/B.nk Oepodh/HhCl. r.r.onal Prop.,-ty (SChldulll E)
6. Jointly Ownad ProPArty (Sch.dul. F)
7. Ti"'a"aflr. (Sch.dul. OJ
I. Total "...t.
RECEIPT
NUttIER
AA185362
DISCOUNT 1+)
INYEREST/fEN PAID (.)
1,036.84
. IF PAlO AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I CHANGED
Ul
(21
(3)
(4)
IS)
(6)
171
.00
.00
.00
.00
56.135.00
295,751. 00
.00
Ie)
*'
IIf.114f..." IIHH
ROSE
N
.00 x .00=
345,619.00 ~ .06.
.OO~.15.
uel
AHOUNT PAID
19,100.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
----_.
INTEREST AND PEN.
TOTAL DUE
DATE
06-30-91
NOTE I To in.ur. prop.r
cr.dit to your account,
'UbMit the Upper partiDo
of thi. farM with your
tlx pay...nt.
351,886.00
6.~67 DO
345,619.00
,00
345,619.00
.00
20,131.00
.00
20.131.00
20,136.84
.16
.00
.16
IF TOTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLF.CTED AS A "CREDIT" (CH), YOU HAY BE DUE
A REFUHD. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.'
In
!,'1
'C,
\'oJ
~
4
f-~ W t;
P'u8
AESEAVATIOHI E.t_t.. of dle.dlnt. d~lnQ on or blfore Dec.~r 12, 1"2 .- 1f any future lnt.ra.t in th...tl\a 1. trmna'lrrad
In po.....lon or Injoy""t to Cl... I (QollattlraU beneflel,d.. of tho dleadlnt aHet thl Illplriltlon of IIIfW .,httl 'or
11'. Dr for y.ar., the Co.-onw..lth h&raby ~xprel.ly r...rve' the right to appral.. .nd ~'I'" tran,fer lnh4rltencl T.M"
.t the lewful Cl... I (coll.taral) rat. on any .uch future Inter..t.
PIJIII'OSE Of
HOTJCEI
To 'ulfill thl r.qulr.lll~nt. of SIHlUon 2140 0' ttMI InharJtIl!ln<:1 and E.tah TIIl< Aot, AClt 21 of 1995. (72 P,S.
S.ction 9140l.
P'Y~HT 1
D.ttteh thAi tcp portion of thlll Notloe lInd tub,U with your JUIY.lnt to the RlIlilhtar (I' WUIl prlntad on 'the rIver.. .1N.
--H"" che<:k or IIOnlY order payablfl tal REGISTER OF HILLS, AGENT
REf"UNb teA),
A refund of . tI)C orfldH, which Willi nat roque.t.d on lh. Tal( RAt..rn, MlIY b. req.",e.ted by co-Iphtinrl "" "Application
fOl' Refund of \lonn.ylvanl. Inhlirltanc. and Estat. Ta,," (REV-UU), Application. are IIvallatJll It the OHloI
of thtl Rngl.hr of Willl1, r.',y uf the 23 W...,.nue Dhtrlct Offtu'II, or by olllllng the special 24-nour
8nl'worlng 1l0,...,lcI nUllb.r1f for for" orderlngl In Ponnlylvllrdll 1~800-362'lO!i0! ouhldo PennlYlvanla and
within loclll HlIrrhbur" ar8lll (117) 167~a09", TODlt (71'n 71?-?,25Z WOlldnll hpII,.ed Only),
OBJECTIONS I Any pa,.ty tn Intor..t not ..tllft" witn the app,.alull.nt, IIHowance or dhallowame of deductions, !'Ir lu.....nt
cf tax (lnoludln" dh<lount or' InhruU !II .hown on thh Notice IlUlt objeot ~dthin likty (611) dllY' of r&fleipt of
t,hh Notice b:tl
--written ,n'ote.t to the PA n.plIrt."nt of RIl..,,,nutl! ~ollrd of ",ppealt, !Jept. 281021, Harrhbur-lI! PA 1112a~10.n, OR
-~.hctlon tG Mve tha ..thr dlhndMld at lIUdit (11'1 the account of tne perianal r.pr...ntatlv.! OR
--""peel to the Orphen.' Court,
....IN
ISTnI<TIVE
tOP.RECTIONSI
Faotual .,.,.0,., dhcov.r.d tm thil 1I.......nt .hould b. addr....d 1n writIng tOI PA Oepart.lnt of Fllvlnue,
!U,...U of Inrllvidullll TalCe., AnNI po.t .....gunt Ravt.w Unit, Dlpt. 280601, tlarrhburg, PA 11lZb-060!
Ph~ (711) 187-6505. S.. plgo 5 of thl booklet "Inltruotlonl for Inheritance Tax Return for II R.vldtnt
Dec:adent.. (REV~lS01) for M el(p1enlltlon of ad.lnhtrllU..,.h CClrt'eohble Drror...
I
DISC~TI
If MY tOM dkt i. pftld wIthin thr.. (5) calendar 1I0nth. after the decedent" dlath, II flv. perctnt (~~l dl.oount of
th. tlX peld I. allowed.
!
I
r
.
)
PENALTY I
the 15;( tax MIne.tv oon-pllrtlolpetlon ~lt., is cOllVUhd on th. total of thll taJC and Interut a.....NI. end nat
pllld blfor. JlWlUlry 13, 1996, th_ fir.t day aft...r tha and of thtl hl( uolUb periOd. Tntl non-plrttolpllUnn
p~1 ty II lIIPPalllable In the I.. Innnar and In the the !lfttMI U.. period a. YUU would Ipp..1 the tOlC and Int.r..t
that h.e bMn a.....ed fl. Indle.teet on thll notlc..
Ifff~RESTI
Intera.t I. nh.rged be.innlng with first d..,. of dalln~y, or nine (9) eonthl end one (1) d~y frOl the dat. of
dHth, to thtl d,tll of paYDnt. TIM.e ,thlClh bacHa dltlln'lU'Gnt blVOI't January 1, 1982 b..,. inl-erut at the rate of
I!X (6~) p~ro.nt plr ann.. calculated _t II d.ll~ rate of .000164. All ta)(a. which beoallQ d511nquent on end aftar
JertUClry 1, 19&2 will b..r lnt.rllt at a rate ~lhlcn ifill very frol clllenda,. ynr to calandar Vllr with that rat.
announced by th_ PA DepartMent of Rev_n~. Th~ appllcablt Inter..t r_t~. for 1981 through 199' ar'l
'!!!! Int.rut Rat. DailY Int_,.o.t faoto! !!..I!!' Interut Ratll Da11y ~nhr..t Facto!'
1911.': 20~ .000546 1981 'X .000Z41
191J 1'~ ,000431 194a-1991 11}: .000301
19" lU ,000301 1992 'X .000241
1985 m .000556 1993 -1994 ]X ,000192
1986 lOX .OOOZ14 19'JS-1997 'X .000247
--Interllt II c.hll.llatld .. follow.1
INTERE&T . BALANCE OF 'fAX UNPAID X NUNDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~-Any Nottoe t'.u.d IIft.r the taM b.~O'I' d.llnquent will r.fleot an Jntwr..t calculation to f1ftaan (15) day.
beyond the dftte of th~ ....u...nt. If pay..nt i. .ada Ift.r tnl lntar.lt co~ut&tion data .hown on the
NoUc., addltlOMI 'nt~r..t IN.t w calcul.tltd.