HomeMy WebLinkAbout97-00341
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF PINNmVAN'A (TO BE FILED IN DUPLlCA Tr: q 7 3 (/1
DEM.RTMENT m IlEVENlJ~ -1 7
HARRI5fJl'!d~nl,,060' WITH REGISTER OF WILLS) WUlm COD1 0/..' YEAR NUMBER
'O;C~~;S;AM' ~~~~~~NORM:O:" '~~i~'-~'~"~'---_."..- ...rr.;m,,',;,: ~ot"~t;~;~t~-~~===~==
I S5C~I;~~'~i4N~:~~; 1"~'40~~'~'/96 I"A~'~':;;';'; 4 7. I'''~:'(r) il~:~~l]~.~X~~_;~~P~._l"~O~.___
..... .....: . _'" :";:'illl~':""'" \""'" 'N'~'''" ,,,",,,,,,,,,,,, ;"", I""'^' ""'"'' IIUM'" ... _ AMOU"'_Rl"'''D~'~'N!1RU'_''~_":_.___.___.._
[]eX Original Return [ ] 2 Supplemanlol Return LJ 3, RemaJnd., Return
Ifor do'e. of deo,h prior 10 12,13,82)
[] 4. limited Eltelle LI 4n. future lnlerell Compromilfl [].5. Federal EliCIt. Tal( Return Required
Ilor dale' 01 dealh alier 12,12.02}
[] 6. Decedent Died Tentale [" I 7, Decedent Maintained 0 living Trull
IAHo,h copy of Will) IAHo,h copy olIMI)
ALi:cqRRS$POIiiDINCI ANDCONPlDINTIAL TAlC INPORMATlON SHOULD .1 .o'RIg~P TO, ".t(.dJfl'j!l;".'(~iV ~"
NA./,U - QOMPlflE MAIliNG AODItUS
~CJ:Larl.Ii)!?_1"_,__Q.r~l'!YYJ III, Bf'l.<]ulJ:'e._ 330 pi ne Street
m"HOII'NUM'" Williarnsport, PA 17701
__'_'_ ....L~,~71L_J2-0.:::.~1,!!.2.=_c=c- _ =_.~_.._- _ . _....
II) 0.00
12) .0:00---'--
i3) . .____~~J. (j'(f~:==:~~
141____ ..0.....9 Q. ______..,
( 51 ..15.,_Q1.5....5.3____.~
I 6) __.___.O'.JllL...____
171 __~_Q.. 0 L_..__
8,801.00
,
1l[l.....I~OO n: + lIQoil
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1. Real E,'a'e (Schedule A)
2, Slock! ond Bond. iSchedule B)
3. Clotely Held Stock/Partnership Inlerest 15chedule q
4. Mortgages and Noles Rltcelvable ISchedu:e OJ
5. COlh, Bank Dopa"lls & Miscellaneous Perlonal Properly
ISchedule E}
6, Join"y Owned Property ISchedule F)
7, lronll." iSchedule GIISchedul. lJ
8. lOlnl Gross Auets Itotalllnes 1.71
9, funeral EKpens4Is, Administrative Cosh, Ml"ellaneous
Expe"" ISchedule HI
10, Deb,., Mor'goge liobUllIe., lie" ISchedule II
11. Tolal Deductiorls jlofnllines 9 & \01
12, Net Volue 01 E.'ote Iline e mlnUl Line II)
13, Charitoble and Governmental 80quesl$ (Schodule Jl
14, Ne' Volue Subjec"o lox illne 12 minus line 13)
15, Spousal Trunsfers lfor datel of death after 6.30.94)
SilO Instructions for Ar,pllcable Percentage on Reverse
Side, (Include value, rom Schedule K or Schedule M,)
16, Amounl of LIne 14 taxable at 6% rale
llndude values from Schedule K or Schedule M.l
17. Amount of line 14 laxable at 15% rate
llnclude valuel from Schedule K or Schedule M,l
18, Prlncipol'ox dueiAdd 'ax from li,,,. IS, 16 and 17,}
19. Cradl" Spousal Poverty Credll Prior Payments
h__.~__.._________ + __ ..._________. +
POI DATI5 0' DIATH Ani I 12/31/91 CHICK HIRI
" A SPOUSAL .
POVIITY CAlDIT 15 CLAIMID [ I
PILI NUMBIA
._ 8. Tolal Number 01 Sale Deposil 80xel
18)
15 ,.075.53
z
..
!;i
I-
~
..
C>
L>
19)
1101
657.35
III} ___!!.,45B.35___.___.
(12) _ 5,6~7..:~8__.____
113} __~OO _..__
114} 5,_~p.18
1151 n__.___.._.~'_n__X'_..
1161__21~11.1~..c___,x ,06.
337.03
117} _,.___...._._.......___x ,15 =
1181
337.03
DISf;ount
Interesl
1191
(201
l:l
I-
20. If line lq Is greater than Una 18, enter the differenco on Llno 20, Thil II the OVERPAYMENT.
III]
337.03
(hcc~ ht'I(' If you fHt) f{!qUlJ!.tl"~J n f(lfuntl of yOUf 6\10fpuYUll,,'nL .
21. If lIlIe 18 h grealer than Line 19, enter the difforence on line 21. Thi' is the TAX DUE.
A. Enler Ihe Inlorest on th~ balance duo on linl;l 21 A.
B. Enler Ihe 10101 of Llue 21 ond 21A Ol1lino 218, Thil illhe BALANCF DUE,
~a~~ Check .~avabl. 10: ~.gl~l!r__of Wil~~! Ag.~t
1211
PIAl
(218)
337.03---
-)-)- liE SURE TO ANSWeR ALL QUESTIONS ON RiVERII SIDE AND TO ReCHECK MATH ,0(. "l( ~_
Uudflr penalties of periury, I declare Iho! I have examln&d Ihis relurn, induding accompanying schedules and sl<llemen", and to the best of my knowledge and belief,
it Is true, corree! and complflle, I dodarfl that all real ellcI18 hot been r(lported ollrue mmkel value. Declaration of preparer other Ihon Ihe perlonal rftprelonlollve is
based orl all Information of which preparer hm Clny knowledge.
~GNAlURf Of P~$ONR"f~PONsjillE~iOR'FiiiTi~Rrfl.iR~j-""-- ----~ilDR.ESS----- -- - -- -.--------..--------.... fMj~--".-_.-..~-.-...._-
~-.d- '~..i?Z..:.i.7.....'i![/.., . /;l......'..:'.._ 916 .CemetcrY_St . Wi IIi arnsport,. PA} 770} .'1. J.. ~_~Cl].....h-.-.
SIOtM1U. ."MER OHl~,T IMI REffi~f A ~_ A,O{)RES~ . -. ' . 0"'7 J /);.
_~_ '._.c:::ii')t,.L'.7- 330 PIne St. ,WI Iharnsport, PA 177()1~.-..t~_2.L___
Charles F. G eevy, III, Esq.
~,,t.~ SCHEDULE H
''.;'.!WJ;.\' FUNERAL EXPENSES,
COMMONWIMfH OIIlNNIYlVANIA ADMINISTRATIVE COSTS AND
UTATE OF 1~~I::b'i~~Wl!~U~~N ---- ____.MIs~E~LA_~:O~-~-~X~~~SE~.-_.L-.- 'ffflJ1:if~:O'. p,ln' or T~p.!......
RONALD R. CUPP, SR. ' .
'.__~'__"'____'._""'_'__4"_ _....__._R_____
DESCRIPTION
IIIV.ISII II(.,. '17'~'1
ITEM
NUMBER
A.
B.
4.
C.
1.
2,
3,
4.
5,
6.
7,
8,
.... '''..1
. AMOUNT
1,
__________........'.___4___.____.
Funeral Expen'."
Sptiler Funeral Home/Funeral Expenses
7,956.00
1.
Administrative COSlll
Per,onal Representative Con\mlulons
Social S.curlty Number of Personal Representative,
Year Commissions paid
2.
Attofney Fees Charles F. Greevy, III, Esqu~re
750.00
3,
Family Exemption
Claimant
.Addre" of Claimant 01 decedent', death
Str.et Address
City
Zip Code .
,;.'
R.16'lo~shll> '
Stale
Probate Fee,
Miscellaneous hpensesl
Cumberland County Register of Wills-File PA
Inheritance Tax Return
Cumberland County Register of Wills-File Petition
for Small Estate/Three certified copies Order
Miscellaneous notary fees, postage and overnight
mailing
15.00
50.00
30.00
TOTAL (AI,o enler on IIn. 9, Recapitulation)
S 8,801.00
----.-------.- -
(If moro spaco 15 needed, Insort additional S~1Oets cf some size.)
5. '111e Items of IlerllOnal pl'Operty owned hy the Decedent at the time of his death are as
follows:
c)
PNC Bank
- Checking Ac(\ount No, 5070062744
PNe Bank
. Savings Account No, 150258277
Fanners Trust
. Savings ACCOlUlt No, 11-303453
1984 Ford LTD Station Wagon
1985 Ford Tempo
1981 01ds Cutlass
$ 2.254,28
$1,37\,26
$10,149.99
$ 500.00
$ 300.00
$ '00.00
a)
b)
d)
e)
f)
TOTAL
$15,075.53
6, Neither the Petitioner, SCOTT L. CUPP, nor, his brother, RONALD R. CUPP, JR. were
a member of the Decedent's household at the time of his death.
7, TIle only parties entitled to distribution under the Intestate Laws of the Commonweahh
o Pennsylvania are the Decedent's children, SCOTT L. CUPP, an adult, sui juris, and RONALD R,
CUPP, JR., an adult, sui juris,
8. There are no persons entitled to distribution who are not sui juris,
9, Administrative expenses, preferred and other debts include:
a) Spitler FWleral Home $ 7,956.00
- Funeral Expenses
b) GM Card, Accowlt No, 54370001.0311.5491 $ 495.35
- Unpaid Balance Due
c) Montoursville Fire Department $ 162.00.
. Transport Charge
d) Charles F, Greevy, 111, Esquire $ 750.00
. Attorney Fees
e) Cumberland COllnty Register of Wills $ 15.00
. File Pennsylvania Inheritance Tax Return
f) Register of Wills, Agent $ 337.03
. Pennsylvania Inhelitance Tax
g) Cumberland COIUlty Register of Wills $ 50.00
- File Petition for Settlement of Small Estate
and tbree (3) certified copies of Order
"
,,,.,
MeV11,',OO ell. 1l,Q./o1
...
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I-:XIIIIII'I' "II"
o 40. Fulure InterlJlI Compromitll
(for datil' of death oft", : 2.12.82)
Deced.nl Died r"tole [I 7. Oeced.nl Maintained 0 liYlng TrYlt
I^"ach copy of Will) IAllach copy of Tru"l
ALL CORRESPONDENCE AND C~N'IDENlIAL TAX INFORMATION SHOULIUaDIRECTlD TO~",,':.,..,'li'ii.iIi'.J.li~*Hlf' ,.
NAME ~COMPLer! MAllINOAODIt!SS
~1es F. Greevy, III, Esquir~ 330 Pine Street
m""0NfNU.'" WilUamsport, PA 17701
71 320-7100 '
0.00
0.00
0.00
0.00
15.075.53
1. Real e"ale ISchedule AI
2, Slack. and Band. ISchedule B)
3, Cla.ely Held Slock/Portne"hlp InlerOl' ISchedule C)
4. Mortgagelt and Nal" Re<;.lyobl(l (S<;nedvle D)
S. Cath, Bank Oepollll & MllcellaneovI Pertonal Property
ISchedule el
6, Jain'ly Owned Properly ISchedule F)
7, Tran,'e"ISchedule GIISch.dul. L)
8, To'al Grall A..." 110101 Lln.. 1.7)
9. Funeral Expen"I, AdmlnltlrotlYI COlli, MllcellaneouI
exp.nll. ISchedul. HI
10, oeb,,_ Mortgage liablllll.., lion'ISch.dule II
11. Tolal o.ductlon, 110'01 lin.. 9 & 101
12, N., Value 01 e"al'llln. B minUl lint III
13. Charitable and Governmental 6squ'I'I (Schedule J)
14, N.I Value Sub ocllo Tax Ilin. 12 mln" line 13}
15, Spo"ol Tranof", Ifar dolOl of d.alh aher 6.30.94)
Se. Inllruc:flonl far Applicable Percentage on Reverse 11.~)
Side, IInclude valUll Iram Sch.dul. K or Sch.dule M,I
16. Amount or line 14 laxable at 6% rate
{Include value, from Schedule K or Schftdule M.l
17. Amount of Lint 14 taKable at 15% rote
(Include yalu.. from Schedule K or 5thedulo M.)
18, Principal lax duo IAdd 'ax Irom lIn.. 15, 16 and 17,)
19. Credill 5poulol Poverly Credit Prior Paymentt Discount
.---- ... +-.---- ..
20, If lint 19 il greater Ihan LIIle 18, .nter the differenc. on Une 20, Thil is the OVERPAYMENT.
mo
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llmltvd E6tal'
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COM/.ONW!AlllI 0, "NNlnYA"'A (TO BE FILED IN DUPLICATE
OfPA~TMENr Of Il;!VE~IUf
HA"'lfJt61~0'l'!l18 0601 WITH REGISTER OF WILLS) COUNTY COOE
~;p;: ~~N~f:~N~M:O~~:A~~"'~----'---- --- .---- -- -]Ol't~~ ~o]'rr;,:Z~~~~--
~Oa-..rfftuRn'1NUM1ii~~-----~" -J~ lii,{()nj!A~11-1 [OA1f Of 1111l1l1 Boi ling Spt:'ings, PA
173-34-6687 04/18/96 06/12/42 c"" Cumberland.'
.', "'"e"",.u..,.,..o "O;iil'~~"'i"~~'~'-.'''~~~~__IO(''''''u:~,,~~,r'_..'~.:.lM'OVHI ',cl,Vlo 1""Nl~6HII'
[)eX Original Relvrn [J 2. Supplemental Relurn [J 3. Remainder Return
liar dalOl 01 death prior 10 1~, 13,821
o .5. Federal e'ta" Tax Return Required
t1ffi
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lOR DATUOP DIATH AmA 12/31/91 CHICl<HIAI
II A SPOUSAL [-'1
POVIUT CUDIT IS CLAIMID _
IILINUM.iit- m d_'_ 'd_ ---.----------..
,_:~~~R
N~~J~..R
17007
_ 8. Tolal Numb.r of Safe O,po.1t BOil..
(I)
12)
131--
141
15 )
16)_---O...J)0
17) 0.00
15,075.53
19)
8,801.00
(8 )
1101
657.35
(II)
{I 2)
{I 31
{I 41
9,458.135
5,617.[18
O.!OO
5,617.18
)(._-
116)
5,617.18
337.03
.)( .06 .
1171
)( .15 .
(181
337.03
Inlerell
119)
1201
C::hl'Ck lUlU! II you (Ire rc.-,quct,III1O (I refund 01 you, ovcrpoYfTu1nt
337.03
121)
121A)
121B)
337.03
21. If Line 18 it greater Ihan Line 19, eLller thtl difference on Line 21. Thi1 is Ih" TAX DUE,
A. Enter Ine inlerest on Ihe balonclJ due on line 21 A,
B. Enler th.'otol 01 LIne 21 and 21A on Line 21B. Thil i, the BALANCE DUF..
Ma". Check Payo_bl. tOl Register of Willi, Ao~nt
~ ~ BE $URE TO ANSWEn ALL QUESTIONS ON REVERSE SIDE AND TO RECH~CK MATH "-<:'''~'~i,i .,',
Under penalties of perjury, I d"dare Ihat I have examined Inll return, including accornponyil"g scnedules and ,'otemenU, and to the b.1I of my knowledge and beli.f,
11 h true, correct and complete. I dedor" Ihal 011 real estol" has been reportfld 01 trufl morkflt "alull. Doc:loralion of preparer olher than the pertanal represenlatiYe Is
baled on allln/ormalion of which preparer hOI any krlowllldgtl.
S!ONATU~E Of P SON ~ESPONSI8lf. fQII.m~9'1TiiliiN---~"6Dil{~S----'"-"._---'--'_._._-'---------.---------- ~----
V. ~. i1 Z1l/;;l, 'l...~L.~.. ,'~_21LCeme.ter\1_St;_~\V~~_1~<l!'.l:lp~r::!:L.I'~.!.1701 0.1'------
$IOr V ..!'PAlER OT~lf~ rFiAN ~f [Sf A ADDRESS -r. , '"
--"-.' X-'z...:''-f,r[- n_n____._:l20_Pifl~_..f>.'::_'_~.1:~_]:~arn_S~~r_~_'__ PA__~70~__ ____._
Charles F. Greevy, III, Esq.
IN THe COURT OF COMMON PLEAS OF
CUMBEIUJ\ND
COUNTY, ORPHAN'S COURT DIVISION
NO,{~(-q7~ J<{/
INVENTORY
of on ,..1 ond po,.onol ..tal. of _ RONALD R. CUPP, SR.
Lal. of
7 Earl Streot, Roiling Springs
Cumberland
"~iIllICounly, P.nnoylvonlo
Oetoofd..th 04/18/96
Deo....d,
Morney
Charles F. Greevy, III, Rsquire
PERSONAL ESTATE SCHEDULE
1. Farmers First Bank/Savings Account No. 11-303453 $10,149.99
2. PNC Bank/Checking Account No. 5070062744 $ 2,254.28
3. PNC Bank/Savings Account No. 150258277 ;
plus accrued interest $ 1,371.26
4. 1984 Ford LTD Station Wagon $ 500.00
5. 1985 Ford 'Pempo Sedan $ 300.00
6. 1981 01ds Cutlass Sedan $ 500.00
TOTAL PERSONAL ESTATE $15,075.53
......
COMMONWEA~TH OF PENNSV~VANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAKES
\NHERIUNCE TAX DIVISION
OE'If, zaobCll
H.RRISIURC. p", 17128.0601
NOTICE DF INHERITANCE TAK
APPRAISEMENT, AlLDWANCE OR DISAllOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAK
DATE
ESl'ATE OF
l.1AT! OF DEATH
FILl NUHBER
COUNTY
ACN
07-21-97
CUPP
04-18-96
21 97-0341
CUMBERLAND
101
AMount Rift! H.d
t?, 73
HAKE CHECK PAVABLE AND REHIT PAYHKNT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ....
R 'Eli: Elt.-; -iif" ,\i:p" (03":97 niciffci - ii F" YNHiii"i i' ANC!" YA'ii - A"P'iinX {s Ei1iNT ~ - "AL UiWAiic i-erR' n"" -"" -" -"." - - -"
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
RllNAI.D R FILE NO. 21 97-0341 ACN 101
CHARL~S F GREEVV
330 PIt'lE ST
WILLIAMSPORT
PA 17701
ESrATE OF CUPP
TAK RETURN WAS I (X) ACCEPTED AS FILED
RESERVAfXONICOiiCERNING FUTURE INTEREgT " SEE REVERSE
APPRAISED VAl,UE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l E.hh (Soh_dull A)
2:. stock. and Bond. (Soh.uul. B)
3. Clo..ly Held Stook/P.rtnlrlhlp Int.r.at (Sohedull C)
4. Hartg'G,,/Not.. Rlclivable ISchedull D)
S. C..h/Bank n.po.lt./H1.c. Person.1 Prop.rty (Sch.dulM El
6. JointlY Own&d Pr~p.rty (Sch.dull F)
7. Tran8flrl (Sohedull Q)
IS. Tobl A....h
,
I"
I'
I
1
APPROVED DEDUCTIOHS AND EXEMPTIONS:
9. Funar-.l Expan.a./Adll. Co,t./Hit:c. Expan... (Schadule H)
10, Dabt./Hodgege l.tebilitia./Uans (Sohaduh Xl
11. Tobl Deductions
12, Nat V.lu. 01 Ta)( R.turn
13. Charit.ple/OoY.rn~antal Bequ..ts (Schedule J)
14, Net iJlIII1u. of Estat. Subject to TD)(
IT an a.II...IIm"nt wa.. i......"d pl."v;j,,,....l~. l.1n..
reflect figure II that include the tatal af ~
ASSESSI1ENT OF TAX:
15. Allount 01 Line 14 .t Spouse! rat. (15)
16. Anount 01 Lin. 1(; te)(able .t LineallClan A rat. (16'
11. Alnount of tIn. l(f tAxabla at ColhtDr.lIC1... 8 ,..t. el7)
la. Principal T&'I( D~l.
TAX CREDITS:
PAYMENT
DATE
04-10-97
I'lli,l!.:
RECEIPT'
NUMBER
AA185377
DISCOUNT I.)
INTEREST/PEN rAla (-)
.00
BALANCE OF UNPAID INTEREST/PENALTV AS OF 04-11-97
651.35
(11)
112)
(13)_
(1~)
14. 15 it,d";,, 16. 17 _ilel 18
returnll alleelllled ta date.
F
) CHANGED
(l)
(2)
(3)
I~)
IS)
161
(7)
,00
,00
,00
,00
lS,91S,S3
,00
,ll..
(8)
.
lU-Ulll'." Itl.tll
RONALD
R
(9)
(10)
8.801.00
DATE
07-2], -97
,OOK'OO,
S.617.18 x' 06,-
,DOx.1S.
(le)
AMOUNT PAID
337,03
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
HOTEl To in'ur_ ~rop.r
credit to your acoount,
sub.it the upper portion
of this forll with your
tax paYllent,
15.075,53
Q.4r:;A ~'i
5.617,18
.00
5.617,.18
,,~ .. ..
.......
.00
137.03
,00
33 7 .J!.L
337.03
.00
6.83
6.83
. IF PAlO AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADOITIONAL INTEREST,
( IF TOTAL OUE IS lESS THAN fl, NO PAYMENT IS REQUIRED.
If TOTAL OUE IS REFLECTED AS A "CREDIT" 'CR). YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
If-/IS ~ 7
BUREAU OF INDIVIDUAL TAKES
INHtRl1AHCE TAl( OIVIlIlON
OEPT, 110601
HARRIUURO, PA 17lld-Q601
COMHONWEA~TH OF PENNSVLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAK
APPRAISEMENT, ALLOWANCE OR DISAllOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAK
DATE
ESTATE OF
DA TE OF DEATH
FILE NUHBER
COUNT V
ACN
07-21-97
CUpp
04-10-96
21 97-0341
CUMBERLAND
101
CHARLES F GREEVV
330 PINE ST
WILLIAMSPDRT PA 17701
(.~./
-
14~'lhl Ii V~ 100.tll
RONALD
R
F~:Anount Ro~~d - l
MAKE CHECK PAVABLE AND REHIT PAVMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ....
R"fIi: i547" iif"AFi; - (O'j": 97 Y - NOY{ cr"o,; - Y NHEii! i' AN-CE" TAX - A PPRA"{ SEMEN T "; "A i:. l"oWANcE - if Ii --". n""""" - -" -"-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CUPP RONAI.D R FILE NO. 21 97-0~41 ACN 101 DATE 07-21-97
APPROVEl.1 DEDUCTIONS AND EXEHPTIONS:
0,SD1.00
9. Funanl EXPln.../Adlt. Cottl/Mho. Expense. (SClhedule H) (9)
10, Dobh/Mortsogo UobllltlOl/Uonl ISchodulo II nO) 657.35
11. Tohl Deductions Ul)
12. N.t V.lue of Tax Return (2)
15. Chlritable/Govl""..lnhl aeqUllt. (Sohedule J) US)
14. Net Value of Est.t. Subjeot to rlx (4)
NOTE: If an a..e.9ment was i.sued previou.ly. line. 14. 15 and/or 1'. 17 and 18 will
reflect figure. that inclu~e the total of ~ r.turn. a......d to dat..
ASSESSHENT OF TAX:
IS. A~ount of Line 14 .t Spou..l ret. (15)
16. AMount of line 14 taxable .t Un..l/Ch" A ret. (16)
17. AMount of Line 14 taxable .t Collateral/CI... Brit. (17)
18. Principel Tax Du.
TAX CREDITS:
PAYHENT
DATE
04-10-97"
TAK RETURN WAS, (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALU~ OF qETURN BASED ON: ORIGINAL RETURN
I. R.al Elhta (Schadule A l
2. Stocks and Bandl (Schedule B)
!. Clo..ly H.ld stock/Partn81'lhip Interest (Schedule C)
4. Hortpagal/No'.i Receivable (Schedule OJ
S. Calh/Bank Deposits/Hisc. P,rson.l Property (Schedu)e E)
6. Jointly Owned Property (Schedule f)
7. Transfer. (Schedule G)
8. Total As.et.
RECEIPT
NUMBER
AAI05377
DISCOUNT It) ~
_~NTEREST /PEN PAID (.) .
.00
BALANCE OF UNPAID INTEREST/PENALTV AS OF 04-11-97
) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
,OQ
~
,00
,00
15,075,53
.00
--o.ll
IB)
NOTE I To insure proper
credit to your account,
lub.it the upp.r portion
of this forM with your
hx pay.ant.
15,075,5~
Q.4I;A l.5
5,617,10
.00
5,617.10
.00
337.03
.00
337.03
337.03
---
,00
6,S3
6,03
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS lESS THAN tl, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFlECTED AS A "CREDH" ICR), YOU MAV BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FDRM FOR INSTRUCTIONS, I
.00 ~ ,00,
~,61 7. 10 K ,06,
.OO~,15,
(6)
AHOUNT PAlO
337,03
TOTAL TAX CREDIT
BA~ANCE OF TAX DUE
INTEREST AND PEN.
-~-_.
TOTAL DUE
~
r.
, ",0
I.'
r,"
~.
N
1I~
l'-~J
!:';l
,,-
(~,..
r'..;
(:7\
(J).{j
00
RESERVATION I E.~.t.. o'_dlcld,nt.-dvlnt on or bg'orl Oto.lber 12, 19S2 ~~ If any futurl Int.r..t In the ~.t.t. i. trln,flrred
in pOI...llon or ,njov..nt ~o Cl... . (oolletlrll) beneflciarl.. of t~ dlc.d.nt .ft~r the Ixptrltlon of InY ..t.t. for
11f. or 'or y..rt, thl CO"O"N"lth hlrebv Ixpr...lv r...rv,. thl, right tn .~pr.I.. end ...... tran'fer JnhlrttftnOI TIXI.
at the ilw'ul Cia" . (ooll,tlrai) rlt. on .ny .uoh future Inter..t.
PUItPOSE OF
NOTICE I
PAVMENT I
REFu..O (CR) I
OBJECTIONS I
ADHIN
!STRATIVE
CORRECTIONS I
DISCOUNT I
PEHALTV,
INTERESTl
To fulfill the requir...nt. of Slotlon 2140 of the Inh.rltlna. and [.t.te Tlx Aot, Act in of 1995. (72 P,S.
hotlon 'litO),
O.teoh the top portion of thl. Notlo. ana .ublllwlth your pay~.nt to thl R.gI.t.~ of Will. prlntta on thl rlver~1 wldl.
--Itllke CMck or Money order tHlIvabl. tOI REGISTER OF MILLS, ACENT
A refund Qf I tax orldlt, whloh WI' not requ.,tld on the Tax Rlturn, .ay b. requl.tld bv co~letlng an "Appll~.tlon
for Refund of P.nn.vlvanla InherU.nc, and E,tat. TalC" (REV-1313)' Application, ar. Ivalllbl. at the OffiCI
of th4 R.,I.t.r of Willi, anv of the 25 R.v.nu. DI.trlot OffI08., or bv cftllln; the .p.clal 24~hoUr
an.w.rlng ..rvlol nu.b.re for for.. ordarlngl In Plnn.vlvanl. 1-800-362~2050, outelda Pann.vlvanl. Ind
Mlthlf1 1eH1.l Hlrr!lburg ,r.. (717) 787-8094, rOD I (17) 712.2252 UI..rlng lIpllr'd Only).
An~ partv In Int.re.t not ..tl.fled with the appr.I....nt, allowano. or dlsallowlnol of d.duatlon., or ........nt
of talC (Including dl.count or lntar..t) .. .hown on thl" Notlol au.t objlct wlthln .llCty (60) dIva of r.cllpt of
thll NotlCI bYI
Hwrltten prot..t to the PA DIP.rt.ent of Ravenue, loaf'd of ApP'llh, Dept, 2811121, Harrllburg, PA 17128-1021, OR
-~.leotlon to have the .att.r deteralnld ~t .udit of the acoount of the plr~on.1 rapr...ntatlv., OR
-.appe.l to the Orphlln.' Court.
Feetual error. dhcov.,..d on thll a.......nt .~lould b. .ddr.sud 1,. wrlt1nll tOI PA Depart.."t of R.venu.,
lur..u of Individual Taw.., ATHII Po.t "'.o...,.nt R.vl.w Unit, nlpt. 280601, tierrhbu,.g, PA 17128~0601
PhOM (117) 787-6505. S.. page 5 of thl book lIt "In.truCltlon. for Inhlr1hnc. TalC R.turn for a Rasid.nt
Dlo.dent" IREY~IS01) for an 'lCpl.natlon of ad~lni'tratlv.ly aorrlat.bl. .rror..
If anv till dul II paid wJthln vlr.e (3) calendllr lonth. after the dlcedent', d..th, . five percent (SiC) dllcount of
the t.x paid t, Illowed.
Tn. 15l( tIll ..ne,ty non~partltdplltlon penlllh II coaputed on the total of the tllC end -Jnter..t .......d, Ind not
pald b.for. J&nlJllry 18, 1996, tha flr"t dllY .ftar the .nd of the hlC ''',"lItV p.rlod. Thll no~-Plrtlolp.Uon
penftlty i. .ppeal.bla In the .... Illnner and In the thl ,aae tl.. parlod a. you would appaal the talC and lnter..t
thet h.. beln ..,.,s.d ., Indlc.tld on this notlo.,
Int.r..t 1. cherg.d beginning with flr.t day of dalJnquencv, 0,. nln. (9) aonth. and one (1) dmv fro. the dati of
death, to the dllt. of pav..nt. rllC.. which bee... d.llnqu.nt b~for. January 1, 1982 be.r Int.r..t It thl r.t. of
,he (6;() percent p.r annUlI calcuh\ld .t a delly rata of .OOOI6~, All talC.. whloh beol" MUn..."t on and Ifter
Janu.rv I, 1982 will be.r Int.ra.t at a rata whlClh will vary fro. cIl.ndllr y.ar to cII.ndar y'llr with that r.t.
announCl.d by U,. PA Dapartaent of Revam:a. Th. appllcabl. Jnhrut rat... for 1982 through 1997 are I
'!!!! Inhrllt Rah Dally Int.rnt Fal:l!.2! :!.!!! Intlr..t Rat. UallY Intarut Flotor
1982 20;( .000546 1987 9% .0(\0247
1983 16% .000418 1988~1991 1lY. .000301
1984 11X .000301 1992 OX .000247
1985 13% .0003S6 1993-1994 71: ,00019Z
1986 lOX .000274 1995-1997 OX .000247
--Inter..t 11 c.loul.t.d .. follow. I
INTEREST . BALANCE OF TAX UNPAIO X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anv Hotlgl J..ued .ft.r the tllC b.co... dalinqu.nt w~11 r.fl.ct an lnt.r..t oaloul.tlo" tD flftlln (IS) dIY'
b.yond the data of the .u.....nt. If "'YllInt 11 .ad. aftar the Intar..t oOllputation data .hawn on the
Hotloa, additional interl,t aust b. caleul.t'G,
P4YHEKT,
Uttech the top portion of thl. Hotlot and iUbMlt with YQur p6vnent mod, payable to the nft.. .nd addr.'.
printed on the rlv.r.. Ilde.
H RESIDENT O~Ce:Of."'T .Ike ohlok or MonlY ord.r Plvable tOI REGISTER OF WILLS, AGENT,
If HOH-REfiIDEHT DECEDENTllIllke OhlCk or mon.y ord.r pltyabJ8 tOI COHHONWEAL TH OF PENNSVLVANIA,
REFUND (CRll A r.fund of a tax oredil, whloh wac not requI.ted ~n the TSK R.turn, ~.y b. requltted by cOMplltlno an
"ApplloaUon 'or R,fund of Plnnsvlvllnla Inhorltanol anD Elhh TalC" (REV-illS). ApplloaUon. IIf' avallllbl. at
the Office of the R~ollt.r of Will., any of the 21 ROVlnul 01strlot Offlo.. or from the Olpart.lnt', 24-hour
answlrlng 'Irvlcl nUMbers for fornll orderlngl In P.nn.ylv~nla 1~800.362~2050, out.ide Pennlyivnnia
and within local Harrlsbur; arCIII (717) 787-8D94, TOO_ (7\7) 772-2252 Utlarin; Impaired only),
REPLV TO, Qu..tionl regarding orrors contained on thll notloe should be addresled tOI PA Department of Revenue, Bureau
of Individual Tal<81, ATTN! Po.t AueulIlent Review Unit, Oept. 280601, Harrisburg, PA 1712B~0601r phone
<117> 787-6505.
DISCOUNT I
If any tal< due 18 paid within thre~ (1) calendar .onthl after the deoedent's death, a fIve peroent <5%) dlsoount
of the tal< paid II allowld.
PENAlT'!',
The 15% tal< unuty "Iol\~partloJpat1on pInal tv Is cOlIPuted on thl total of the talC and inter..t alluud, and not
paJd blfore January l~, 1996, the flr.t day after the end of the tal< a.ne,ty periOd.
INTEREST I
Interelt II oharOld beolnnlnowJth fJr.t day of dellnqulnoy, or nlnl (9) Ronthl and one (1) day fro. the date 0'
death, to the date of paynnt. TalC" whloh beoa.., delinquent before January 1, 1982 belr intere.t at the rat. of
.llC (6%) percent p.r annUR calculated at a dftlly rate of .000164. All tll<~' which beCIR. dellnqu.nt on Ind Ift.r
January I, 1982 will bur Interut at I rate which will vary frolll calOndllr y~.r to callndar Y"" wi'th that rllt.
announced by the PA DePllrtn~nt of Revenue. The applloabll Intere.t rate. for 1982 through 1997 Irel
Ve,r Inter..t Rat, DaJly Int.r'lt faotor
VII'"
Inhrut RllIta
Dally Inter..t Faotor
1982 20j( .000548 19&7 9j( .000247
1981 16Y. ,000438 1988-\991 11% ,000301
1984 11% .000301 1992 9% ,000247
1985 13% .000356 19lJ]~1994 7% .000192
1986 lOr. .000274 1995-1997 9Y. .000247
~.Inter.lt is oalou\eted .. folloWll
INTEREST = BALANCE OF TAK UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
uAny Notice luued afte,. the tal< beooJlu delInquent will reflect an 1nte,...t oalouhtlon to flft.en (IS) day.
b.yond the date of the allleu",ent. If paYlllent II ede ftfhl' the Interut OOMputatlon e1ete thown 0'1 tht
Notlca, additlonfll interest Jlust bel r.rl1cuIBted.