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fOR DAUI 0' DIATH AnlR 17/31/91 CHICK "IU
If A SPOUS./,
PClVlftTY CRlDIT IS CLA/MID I I
FlU HUM.1ft
I ,'1 I
COUNTY cQ[JI
iii('jllhj('; ({il.-ir'lni ,\[iiJjjtf~
INHERITANCE TAX RETURN
RESIDENT DECEDEN\'
(TO BE fiLED IN DUPLICATE
WITH REGISTER OF WILLS)
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1. Real eslate ISchedule Al
2, Slock. nnd ~ond, ISchedule BI
3. Clos.ly Held Slock/Partnenhip InltHell (Schedul. q
oil. Mortgages and Notes Receivable (Schedule PI
5. Coth, Bank Deposlll & Mlscellaneout Personal Property
IS,h,d,le EI
6. Jolnlly Owned Properly (Schedule F)
7. Transfers jSchedule G) (Schedule LJ
8. Tolol Gron Auet' (tala I LInGS 1.71
9. Funeral f,'o(,per.ult, Admlnlttratlve COlli, MllcellaneOUi
hpenS8t ISchedultt H)
1 D. Debit, Marlgoge liabilities, lIenl (Schodule II
11, 1'0101 Deduclions (Iolal linet 9 & 10)
12. Nel Value of Eltale (line 6 minus line 11)
13. Charitable and GovlHnmental 86quelll (Schodule J)
14. ~!!~~.!_~.~~.l!.:~_~_~!".. {~~~~~_~.-!.T1_~_~_~~.!_~,____~_..
51()
19C,'l
lEAR
NUM8ER
_n_.__.'_.,____
--~-_.__........-.;
COMMCmWfAlTli Of PENN5'l'lVANIA
OfllAA1MfNT OF REVfNUf
DEPT,260601
HARRISBUMO, I>A 17128,0601
o eO'N' 'rr^Mf--ilA~y~-,-ili'~,; -At-ih-MinllfnmliAfr---'-'
VINES. CIold C.
;07~i~Cii=~_:i~i I"^;:;~ ~'~~'91 I"^'; ~'~ ~'~'~ I n
I" ^,~:"::," '~''':'':'' va"" , '''"' ,,'" "'" ."" "","" "'"'''' 1"" '^, 'H ""',, HUM'"
[XI I. Original Relurn I I 2. SupplCtmunlul Roturn
[gj 4. lImlled e'late r I 4\1, future InlarCHI Cornp((101iul
(101' d(ltflt 0/ dfluth niter 12.12,A21
r:KI 6, Olcldlnl Dlod Te~It1le I I 7. Dflcedenl Muln/olnad tI lIvlnu Tru\'
, IAllo," ,opy 01 Willi (Alloch copy 0 Tr",')
"U' cO~Rii'PONO.NC. AND CON.iDINjjALTAx-iNjiOAMATlONSHOUL'D-i'-j)ijlicTiD'TQ'~-.--'----
NAM! ------. -- --'-~....._~.._---~.~ .__m '-"~'.-l(Qi.\PITffMm~m-~~ --
_.!:I.~n!..L(),:__.fle.l-",'r. Ill, EHCjltlre 101, 1I111tImorll Struet
tElE'HON'N'M'" Cottyaburf\, PA 17325
__LIll 33!~e2J;J4 . " .........
IS,
16,
17,
::a:
lil lB.
iC
,- 19.
::>
..
IE
!l
II 20,
to-
Spousal Transfers lfor dole, of death altar 6.30.941
See Instruction, fot Applicabll) Percenlago on Reverte
Side. Ilnclude valuel fronl Schedule K or Schedule M.l
Amounl of lino 14 ICI){Oble at 6% role
(Indude valu8slrom Schedull1 K or 5r;hedule M.I
Amounl of line 14 twwblEl at 15% rote
llnclude value! from Schodulfl K or Schtldulo M.I
PrinclpolloJl. due (Add tali: from linlH I." 16 and 17.)
Crodlts SPOUHll Poverly Credit Prior PClyme,lts
+
1000 W"Ht SOlllh Stroet
Cllr1I,II", I'A 17013
C"""'f C1I111b" I' 111\111
M\(-HJtll RfclIVE() I~Ef IN~tRuctIONSI
-- .-.--"-...---------------<--------
113
I 15
Rllmulnder Relurn
Ifor dOl" of d,.,h prior '0 12.IJ.B21
FoderfJl EI!cII. Tal( R"lurn R.quJr.d
_,u8. TUla! NlJmbtlr of Saf. Oeposlt Bolt"
-.............- -
111
121
131
( 41
I S I
161 . $...181..13
(71,_ ___ ~c ----., __ ___~____
/'1 nCC ~ 587 .13 ~~__._.
191 _It 78.f_JL~.,.~.,'~~.
1101 .
$ 782.73
(II) ._______~
(12) __~JlO
,rr~) -,--_..'_,_-'-_~,___.._.~~~_
M __ $, O.OQ
1151..-----~__r_--.~~, _,.,_
1161 __~__'__,_~_._~X ,06.
----+~,~~_.....-ri__'___.__~~
1171_.._______,..." ,__c..".__._ X ,15 -
,
---_...~."-~~..._---<,-_._--~ --
liB)
DI$count
Intefftlt
+
(191
120)
If line 19 I, greoter Inan lin& 18, enter Ihu dlfferenco on line 20, Thll ilthe OVERPAYMENT,
r~m
C fH~ l1erc if you Ole 't'lqutlUin9 a lU'ulld of you,' oVClpaymc t
21, If line 18 il gre~lttH Ihcln lina 19, MhH tho clHfo(oncf} on Una 21. This it Ihtl TAX DUE. (21)
A, Enter thf) Inlarel! on Ihu boltJllco dlln on Linu '1.1A (21AI
8, Enter the lolul 01 line '1.1 unci 21A on lino 211L Till, is tho BAI,ANCE DUE, (21 Bl ___ _________.
Mak. .(hack Payabll tOl R.gl.t.r 0' Willi, Agent ."H'.'.~C"'_,.__.._
~==:::~__,___~_~> .1I.(SURE_T()A~SWE,RA.tt QUE,STIONSONREVERSE SIOE.A!'lIl_T()R!~HECK MATH ~:;j(----~----
Under prmClllJel of perilJry, 1 daclmfJ thot I hovlt oKominod !hj~ ratum, indudinq (Jcwmponying '1chodultH nnd st(llomonls, and to !no basI of my knowledge tlnd belief,
il 11 truo, correct ClOd tOmplol6, 1 docloro Ihol (111 fOU! IJSloltJ nus blllll\ roportt,d ul Irun marko! vo\uu_ Dodarlllion of proparer other Ihon Ihe personol reprOlentClIIl/6 is
i4'ed 01'1 all Inforrno!lon of which propmeor hm (Illy kncwltl{t~J{]
- ~]r:-6r-i!Iii&HesR)~'~itr-OR fllir-lt,!u I\I~II IIllIlRI'>, l' () II 535 A It j ] ] I'A 17303 DAlE
. -------C"hL ------~-.-- . . OX ,rellC AV. - .e,
-.. __~,,--m , (Sea attached for additional persons)
SIGNA R, ~ I'R[PAR: o~~ Itl.\tj IHPRl'I/-J1AIIVI AfII)~I"'J 104 Ila,ltlnlo"e fiAii:
~ p , Street, Gettysburg, PA a!.Ji//17
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'. '[ SCHEDULE H
,,~~,f~ PUNERAL EXPENSES,
COMMONWEALlII Of ",NNSYLVAN'" I ADMINISTRATIVE COSTS AND
'I<II'''IANCf ,Ai ""U'N MISCELLANEOUS EXPENSES
E'STATE OF _"~'N' O"'D-''t;~=,_~",_~__,.__,~,.__ ---.,~.
VINES, Cloid C,
R!V I ~II 0 I !~n~1
ITF.M
NUMBER
DESCRIPTION
, _ Pl~~!._P,lnt_o' T,'!'p,,____
r~E N_UM8~.:__ __~_~-=~--
AMOUNT
A, Puntral bp.nl'"
1.
B, Admlnllt,allv. COlli I
4,
C,
1.
2.
3.
4.
5.
6.
1,
Personal Representallvo Commllllons
Social Security Number of Personal Representative.
Year Con,mllllons paid _.:..._.________
, --
2,
Attorney Fe..
Swope, Heiser & Mcquaide
Family Exemption
Claimant ,___________~_ Relatlon$hlp
Addre.. of Clolmonl 01 decedenl's dealh
Str.el Address
City _____.___________.___5Iale
Zip Code
$200,00
3,
Probale Fees
Mllcellaneoul Expense"
4/20/97
OS/27/97
06/12/97
1l/~4/97
$
Arendtsville Fire Company (hall rental)
Sarah Todd Memorial Home (balance due)
Dugan'B Funeral Home (flowers)
Codori Memorials (stone lettering)
Robert C. Vines (reimbursement of cash disbursement
- stamps, ,$25.001 snd funeral clothing for
decedent, $140.00)
. Cumberland County Register of Wills (filing tee)
50,00
168,53
74,20
115,00
165,00
10.00
TOTAL (Also entor on line 9, Recapitulation)
(If mo,e Ipac. II n..ded, Inlt,t addltlonallh..tl of lome .I~.)
$
782.73
GENERAL INFORMATION
1. FAILURE TO RESI'ONll MILL RESULT IN AN OFFICIAl TAX AS~ESSHENT ,It" _11...,. In'.ru' ..... .. lnfor."..
.~itted by the flnM'ICllll JnttltutlOfl,
Z. InhlrJt.wl1l tll.IC beclOHII d.lIn~nt nln. lIonth. aH.r ttal dMadenl', det. of death.
3. A joln't HtlOUht II tIlK..,l. .y~ though th. dtKledflnt'. nIMM W.. ltdcMd II . ..U.r of /JonvWlleno..
4. Ao41lQttl (Including tho.. hlld blh...n hu.bltfld and wlh) which tM deoedont put In Joint n.... \Illthln OM yur prior to
cMllth .r. fully ta",.~h .. tren,'.rll,
5. Accounh ..tMllt~ Jointly b.twllon hUlbllnd and ",If. .or. than on. .....r prior to d..th 8r. not tllMab1l.
6. lfloCOUTlt. held bv II deOlldllnt "In trult for" IInOtMr I)" other. .r. taKable fully.
REPORTING INSTRUCTIONS - PART 1
- TAXPAVER RESPONSE
I. !LOCK A - If the lllfotlllltlon and co.putet!on In th" notlc. at. correct and deduction. at. not blllng OIIlJlltd, plee. en "I("
In b),ock "A" of PllIrt 1 of thl "Ta)(payer R..~on.." 'lIotlon. Sign two copl.. "nd ,UOllllt th\lll ',11th your chllltk for tha ewount of
t.1( to tha Rllght.r af Willi of the county lndlcatad. Tha PA Dap"rt..nt of R.vanUG will III". an offlolal .......ent
(for. REVHlS48 EX) upon raoalpt of the return 'r~ the R.gl.tar of Will..
Z. 8LOCK a - If the ....t .paoifl.d on thll noUc. hat baan or will b. report.d lInd tI>e paid with the P.nnllylv....i. Inharltance
TalC R.tyrn filed by the decadentl. raprll4tntIUv., plao. en ")I" In bllMk "a" of Part 1 of the "Tlxpayer R..pon.... notion. SI., OM
(Iop~ and ratyrn to the PA DepartNnt of RaVanya, B\lreaU of Individual TI)(", Dept 210601, HlIrrhbUrg, PI. 11128-0601 In tha
anvelope provided.
.. fllnf"W r _ " Hie notte. In'Mlllett,," II Irwl"rr.nt Itnd/or Mdl.ltltinn. I'Ir. balna el.l..d. chIck blook "C" Md c~let. partl 2 WId S
according to the Inltruotlon. below. Sign two COflI.. end .ubIllt that! wtth YOtJr c~k for the HOUnt of talC p.Ylble to tht R..ilt.r
of Will. of the oounty Indloatlld. The PA Dlplrtaant of R.v~ will I..ua en offlol.l .....I.-nt (For. REV-lS41 EU) upon r~alpt
of the raturn frOll thll A.giltlr 0; "11111.
TAX RETURN - PART 2
- TAX COMPUTATION
LINE
1. Ental' the data the ftCoount originally Will utabll,had or tltIad in tha aeoner axltUng at data of dl.th.
NOTE I For I dlfOedant dying afhr lZ/li!lB21 Accountl whl(lh the deCldant put in johlt n..u wlttdn on. (I) y..r of duth ara
t'lClbil fully.. trln.f.r.. Howevar, thar. JI ftn .lCclullon not to IlCcead '1,000 par tr.nlf.r.e reg.rdl.I' cf the v.iya of
the account or tha nyabar of eccountl held.
If I double ..hrllk (11M) uppalr. bafora ~ourfl,..t n... in tha eddre.. portion of this notlc., the n,ooo .lCclYslon
elrafldY he. bMn dedUcted frOll thlll ac:count balano. II' r~rted by the flnenotel In.tltutlon.
2. Ent.r tlM tohl b.lenca of the lIocoont Ifl'lhldlng Jnter..t ttCcrlHld to the date of d..th.
5, The parcent of the Dccount that II tl!l<8bla for 8l1ch .urvlvor 1. dahrllllned a. follow'l
A. The parc~t t8~ablQ for Joint a".t, ..tabll.hed Mar. than onl yaar prior to the decedentl, deathl
I DIVIDED BY TOTAL NUHBER Of
JOINT OWNERS
EIC8l1plal A joint nuet ragilterod
DIVIDED BY TOTAL HUHBER OF X lOG . PERCEHT TAMABLE
SURVIVING JOINT OWNERS
In the naee of the dacedent and two other par.on..
1 DIVIDED BY 5 (JOINT OijNERS) DIVIDED BY 2 (SURVIVORS) . .161 )( 100 . 16,n (TAXAI!ILE FOR f:4CH SURVIVOR)
a. TM parcent talCabla for at..t. creatad within one ~..t of the d.cldlnt'. d..th or account. owned by th. deoadent but Mid
In trult for ~thlr Indlvldul1(.) <trult benaflcd6r1u)1
I DIVIDED BY TOTAL NUHBER OF SURVIVING JOIHT
OWNERS OR TRUST BE'IEFICIARIf.S
)( 100 . PERCENT UMABLE
EIC8IIlplal Joint &Ccount regl.tarad In the na.. of thl d.c.d.nt and two nth.r perlon. end I.tabli,hed within ani year of death by
tMi cMcadlnt.
I DIVIDED BY 2 (SUftVIYOItS) . .50 M 100 . 50% CTAMAlLE FOR EACH SURVIVOR)
4. The IIIOUr'lt ,lJlIj.ct to t81C (lIne 4) It dahr.ln.d hy ItUIUphlng the ltClCOWIt b.lenc. (llna l) by the parcent t.lClbl. (llna 3).
It. ton,.r tnll total at 1M debU ana t!4tOuotiOfl_ lhtaa In ~lIrt ~.
6, Thill ~t hlC.,l. (I1na 6) II det.relnad by .ubtreotlng the debts IInd MducUOfl. (line 5) frOll thlt UOU'\t aubjlOt to tlM: Ulna U.
7. Ental' thlllPProprlat. talC rllb (lln. 7) III deterMined b.low.
A. For dat.. of death occurring aft.r 6/51'1/94, the talC rat.. for tr..,.f.rl to lpou.a, are 811 fallow' I
1. Dat.. of death on or Ifter 7/1/94 and bafor. 1/1/9S tM rata It 5l(.
2. Oat.. of d..th on or after 1/1/95 trlln'"'' to .pou... 101111 be tIIxed It 0% tall rat..
Hotal For data, of cHiath pr~ot to 7/1/94 tranl'.'" to tpoo,.. ara tl>eebl.. at 6;(.
B. Trani"'" to Ilr.ael duelndantl Including fath.r, Hthat, .on, daught.r, grandchlldr.", lon.ln-IIW,
dMlihtar-Jn-lllw, .h,pchlld and thalr l..uII are talCabl. a1 ,Ill plrl"~t (6;().
C. TrlM,fera to all oth.r. IncllKtlng broth.,., ,hltar, uncla, aunt, n~ and nl.ce ara talCebll at flft,." "Iroent OS:O.
D. If YOU cl'\lnDllli the tll)( rllta, phu. .peolfy vour ralatlonthlp to thll dKadIIlnt In the arl. provided.
.. The IMIOl.Il'lt of hI( due <lln. BJ I_ detarained by ItUltlp)ylnQ tha 8ItOtW'lt taMabla (line 6) b,;, the tax rat. (llna 1).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabla deht. Md deductlonl are dehralnad .. .Iollow'l
A. YCM.I legalh .ra r..ponllbh for pay.."t, or the ..tet. .ubjaat to adalnlstr.tlon by . per.onal r.r..entIU"'. it Insufficient
to p.y thfl deductlhll ItNI,
B. You ICltUlllh p.ld the dlbts nfhr duth of thlll decedent and can furnish proof o' paYll8l'it.
C. Dabh beino chJHd eu,t bit ita.lud fyl1~ In Pat't S, If additional !I~aco it Maded, u.. pialn pap.r a 1/2" IC 11", Proaf of
PIV.-nt .~y be rIqUe. tad by the PA Oaplrtlllant of Ravenue.
c: IF YOU NEED FURTHER TtNVOA~E!TtJlNSIoSRTAA~Cs1:;ANCE, CO~;ACT ANV -J
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DIS1RICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAVER INQUIRV UNIT IN
HARRISBURG A~ (717) 187-8327, TDOt (717) 772-2252 (HEARING IMPAIRED ONLY)
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PIJRllOSt 1lI'
NOTICE 1
To fulfill tM reqUlrnent. of SIC lion 2140 of th_ Inhc1r-ltanol end E.tah TIIC Actl Act 21 of 1fl5. (12 P.'.
hCIUon 9lltO).
DetlCh ttMI top par-Hon of thlt MoUe. Mld ,ubIllt with ~04.lr- PIlYMnt to tM b,htlr of WILli pdntid on t~
rtvar.. tide.
~_ _. dMICk or- lIOMY order pl~abl" tOI REGISTER Df WILtS, AGENT.
PAVHEHTI
OIJECTlOMSI Any "Ir~ In 1nt.rut not ,~tld1.-d wtth thtl eppralt.ltM\t, 1l1lOWM\(;1 or dltal!owlIOC' tlf dtKtuotlDtlt or .....lHI1t
of tax (lndudlnn dlscovnt or lnt.I,..tl ftI ,hown on thh NoUe. .ay ohjlllct within .bty (60) d8~' of n.~_'pt of
thlt MoUe. bYl
~-Mrltt." problt to tilt! PA Dfb'/llrtlt8flt of R.vlffi\.~, lloltrd of Appull, O.,pt. 281021, HarrhbUro. PA l1U'~1021, OR
~-.leatlne to MYS thtl _ttlr dfttllnltwtd at the mtdlt of the MCOunt of t~ perlOMl rlPre..ntIUvS, OR
~~."..1 to th, or~l$' Court
A rIIfund of . talC credit, which wa. not r.qullted on t~ taM rllturn, MaY bti raquoltld by coaplltl"g en "~llclltlon
for Rlfmd of PIIlltllYlven1e Jnh4rltl'KlC4 and E,tate Taltfl (REV"UU). Appllcatlon* are avaUabh bt ttM Office of
tM ft..lIt.r of Will., any (If thli n RavlllUIiI Dhttld Offlc.. or by caUlng t"" If*lhl1 Z4~hoUr an....rlne ..rvIClI
nI,.,.rr for toru orMrtnQl In P""'II~lv\llnll 1-800-J6Z-~OSO, out.1de Pennlylvenla III'ld within locll
tMrrllbUrl en. (711) 7a7-8094, TOOt (7171 71l-ll52 (tMlrlMI IllPlll'aci OnlY).
REFUKD (CR) 1
AJJHJM-
lSTRATJYE
COAfI'ECTlOHSI
FlCltunl Irror. dhcovarWod on this ItUI1UlMOt ahotlld be llddrallad In wrltlnt tOI PA Ottpart..-.t of RIVlnlA,
luroltU of Jndlv1dulll Tox.., ATTIh po.t A.....lH'.lnt Review Unit, DEPT. 2.110601, Hertl.bur", PA 1712a~0601
~ 0'11) 181.6505. S-n p~ 5 of tht boOklet "Inltructlon. for Jnhlidtance Tex Raturn for a ifulc:kmt
o.ttdMtt.. (REV-1SOl> for an l>cp1W\1t1on of adltlnhtrlltlvlh' (lorrl<ltebh Irror..
If MlY tlt)( due; " paid w1thln thr.. (~l eallIDdar POOth. aftllr thli tHictWlIInt'l cMllth, I five perolnt (5;()
dhoount of the tll( paid 11 allowed.
The 15;( talC ",~.ty non-participation penaltY 18 eOlllPutad on thtl total of tha tlllt and Interalt a.......' Ind not
peld bafore JWlUsr~ la, 1996, tMi flr.t dey after the .rw.1 of t"- tax untlty p41dod. This non-plrtlclptlUon
ptnIlty 1. ~ll1bh In tM ..... unntr IIOd In the the 1M' U.. pclrlod fit YOl.1 would apptIlll the t~ and lnt.r..t
thllt he. bMn .",.u-.d .. lndlceted on thlt naHel.
DISCoutfTl
PENALTY I
INTEREST I
Jntsrut It chlrlld bq11V11r'l with 'lr.t day of dIlll~y, or "1M (9) lwnth. Wld OM (1) day
frOll tho dati of Hath, to the data of PI'IY'Mnt. Telt,.. lfhlch ba<:.a dll1nqtant tMtfors Joouary 1, 19lZ
tlPr lnt_r..t .t the reta of .lI< (6Xl percent per arvlUll calculatMt It \I dlIlly rllta o~ .000164.
All tax.. wh!eh tMtc_ dtllnqutllt on or e\'tar January 1, 19.111. will bier lot",..., at . rat. .thlet! will very frOll
ell-*r ya.r to ea11f\d1tr ~Nr with that rlh ew-.'KIlMCtd by the PA DepllrtMnt of Revllf'lUl. The IPflllclllhlt
Int.rut ,..t.. for 198Z throulitl 1991 IU'1
'!!!!; Inter-lit Ra'e Dally Int.r.lt f~tor Vellr Int.rut Rllt. ~~ere.t Facltor
- ---- --
I'll ZOj( .00O!t48 1911 OX .000247
1985 lOX .0004J8 1988-1991 11;( .000101
\984 l1X .000501 l"l .X .aOOl47
1965 11;( .OOO~~6 1991-199q 'X .0001YZ
10" lOX .000Z"14 1995-1991 OX .000247
~~lntlt..t 11 celculatld .. follow"l
INTEREST. BALANCE OF TAX UNPAID K NUKBER OF UAya DELINQUENT K DAILY IwnREST FACTOR
~~Ml~ Notice ItIUM .ftar the t_)( n.cat. del1nqutrtlt will r.HMlt I!IIf1 Intsrut calculation to flft.." (15) day.
beYond the d8t. of the .......-nt. If p.~t is .... aft.r thu tntar..t C"oepvhtlDf1 datil JhOWn on the
NoUn, MdIUonal 1Ilt'rflll~t -.tIt be celou1attd.
/'J" I r 1(' l'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
c,
*
I\I~UU Of INDIVIDUAL lAMES
lHIIUI 'ANet: lAM DIVISION
Oflll" , 1I0ftOI
Il.HRIliIUHO, PA HllI-OUI
NOTICE Of INIlERITANCE TAM
APPRAISEMENT. ALLOVANCE OR DISALl.DVANCE
OF DEDUCTIONS AND ASSESSNENT Of lAM
In I'" II '" cU'"
03-16--98
VINES
03-28-97
21 97-0510
CUMBERLAND
101
r----''A,'ou';tRo''tttoCj. =1
[_==-=-______...J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONO THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ..
REV: iii4-j- iif-AFjI""f (IF 9~Y-ii(iH CE - -ciF" YNHEii i f Aiic n'-AX - AP'PRA i mfiiir; -A L i"OWAN-cf iili" - - -"" - - - - - - - - - -"
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
CLOID C FILE NO. 21 9'/-0510 ACN 101
DATE
UTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
HENRY 0 HEISER III ESQ
104 BAL 1'lMDRE ST
GETTYSBURG
pA 17325
ESTATE OF VINES
TAM RETURN WAS, (X! ACCEPTED AS fiLED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..I Elt.t. (Schedule A)
2. stock. and Bond. (Schedul. B)
3. Clo..ly Hald stock/Partnership Int.r..t (Schedule C)
4, Hor~g.g../Not.. R.caivabl. CSchedul. OJ
S. C..h/Bank Depolita/Hile. Parlonal Property (Schedule E)
6, Jointly ewn.d Proporty (Schedulo F!
7. rranI1.r. (Sch.dull Q)
e, Tobl A...t.
CLOID
C
DATE
03-16-98
( ) CIlANGED
(1)
(2!
(5!
14!
IS!
(6!
(7)
,00
,00
.00
,00
.00
587 . 13
,00
lal
587,13
NOTE I To In.ure prop...
arldJ. t to 1I0ur account ~
.~J.t the uppar por~lon
of thla f~r.. with you..
ill< paYllent.
APPROVED DEDUCTXUNS AND EXEMPTIONS:
" Fun.ral Expen.../Adll. Co.ts/Hi.e, Expen... (Schedul. H)
10. D.bt./Hortgego liabiliti.s/li.n. (Schedul. X)
11. Tohl Deductiont
12. Net Value of hx R.turn
15. Charitable/Gov.rnItJllnt.l Bequ..hl Non-elected 9115 Tru.t. eSchedul. J)
14. N.t Valu. of Elltah, Subject to ra)(
If an assessment was issued previously, lines
reflect figures that include the total of 6bb
ASSESSMENT OF TAX:
15. Allount of lin. 14 .t Spou...l r.t. CUi)
16. Alloun't of line 14 ta)(able .t Un..lIel... A r"t. (6)
17. AMOunt of line 14 ta)(.bl. at Collat.ral/Cla.. Brat. (17)
la. Prinoipal Ta)( Due
TAX CREDITS:
PAYHENT
DATE
NOTE:
RECEIPT
NIIMBER
DISCDUHT (+1
INTF.REST/PEN PAID (-!
(9)
UDI
782,73
,00
llll
U21
llS!
114!
78" 73
195,60-
,00
195,60-
14, 15 and/or 16, 17 and 18 will
returns assessed to date.
,00 K ,00, ,00
,00 M ,06, ,00
.00 K ,15, ,00
(IB) ,00
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
,00
.00
.00
,00
. IF PAID ,AfTER DATE INDICATED, SEE REVERSE
FO~ CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS TIlAN 'I. NO PAVHENT IS REqUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" lCRI, YOU MAY BE OUE
A RefUND, SEE REVERSE SIDE Of TNIS FORH FOR IHSTRUCTl0H3.!
0\
,',I
~. ,-\
o.
.'"
-.'j
lI'
r,')
~ ....,
,j! r'i
0(;
RUERYATIOfrh E.tlt.. of dle.."t. dyJflI Qn or before heHber 1t, 1912 u If IN1V lutu,." tnter..t in tht IItllt. It t,ln.f.rrld
In pa.....ton or .nJoy.tnt to Ch.. D (C1011,t,r.O banefiohrt.. of the deCled,nt ,ft.r thl 'Kplr.Uon of InY ..tat. for
11f. or for v..r., the CNItOnwnlth her.bv 'Hpr'"h r...rv.. the right to .,,,11, Md ...... t'.....flr InheritInG' TlMI.
.t the h,,'ul Chu . (collat.reU nt. on Iny luch future Intar.tt.
PlJRPOSf OF
NOTICE I
PAVMENTI
REFUND (CA) I
DIJECTIDHSI
ADMIN
ISTRATIVE
CORRECTIONS I
DISCOUNT I
PENAL TV I
INTEREST I
To fulfill the r.quJruenh of 'Stctlon 2140 of the Inh.rlt.nell Ind ftt,t. hI( Act, Act Z1 of 199.", (72 ~,..
s.otlon 91~O I.
D.t.ch the top portion of thh Notlc. and lutHllt with your pay.."t to tNt Rqllt.r 0' Willi prlnttd on the r,vlr.. .Iet..
--Mek, ChIck nr 1IOM,'t ord.r P8vebl, tOI REOISTER OF MILI.S, AGENT
A r.fWld of .. hie oredlt, which w.. not r.qu..t.d (m the YIIIC R.turn, ..y be r.que.t.d by cOtlPleUng 110 "Applloatlon
for Refund of PWIn'\lhanlll Inh.rlhnc. and E.tat. Tax" (AEV-llUL AppllcaUon. .rll .....lIabl. .t thll Office
of tM R.ght.r of Will., any of thtlll A....1InUe DlttrlClt OHlcu, or by celllng the IP4HlI.I U-hour
..,....rlrrg ..r...lce noab,r. for for.. orrlllrlngl tn P.nn.yllJanlll 1-01100-"2-2050, ouhl. P.nn.yl...anla Met
within loul lia,.rltburg a,..a (17) 10117-'094, TOOl (11) 1"12-2252 lHurlna 11lp11,..d Only),
My pa,.ty In Inter...t not ..thfled with the IfIprah..."t, Illowenc. or dl..lIowence of dedocltlon., or ..........t
of hx Oncludlng dhcOUl'lt or Int.r..t) .n shawn on thh Hath. ltU.t obj'Kt within .lMty UO) d.y. of rllO.lpt of
thh NoUn bYl
--writt.n proh.t to the PA D.pl"..t.."t of A.....nu., Buard of Appflah, Dapt. 2'1021, "arr!tburg, PA 1712011-1021, OR
--.II1Cltlon to ha.... the ..U.,. d.teralMd at lIodtt of the account of the p.r.onal rltPr...nt.U...., Oft
--appaal to tha Orphans' Court.
Faotual .rror. dllcov.rld on thl. a.s..sa.nt should b. .ddr....d In wrltlnp tOI PA Dap.rt..nt of R....InUI,
Bur.au of IndllJldual T.IC.., ATTNl po.t AIA~..aant Aevllw Unit, Olpt. 2806Ul/ HarriSburg, PA 17121-0601
Phoi-,. (717) 717-6505. S.. page 5 of thtl bookht "In.tru(1t1ons for Inh.rt hnc. hiM R.turn for II Re.ldant
Decadent" (REV-ISOI) for an .xplanation of ftd.lnl.tr.tl~.ly corr.ct.ble .rror..
If any taM due ]a p.ld wIthln thr.. 11) c.land.r eonth. Plft.r tha decadent', death, . fl.... p.rcent (S~) dhcount of
the taM paid I. aUnwed.
The IS~ tlX ~.tv non-pllrtlclpwtlon pen.lty I. c~tad on the tot.l of the tllK end lntar..t ......ad, end not
paid bafor. January ua, 1"6, tht! ftrst dl"l)' .ftar the and of tha tOM ...-Ilty parlod. Thll non-p.rUclpaUon
panal t)/ 11 appaalabl. In the 1111.. IMWWIr 8l'\d In the the .aae t I.. p.r lod IU you would app..1 thlll hlC and lnter..t
that ha. b.an .......d a. indlclltad on thts notic..
Int.rut 11 chargad baglnnlng '11th flflt d.y of dellnquancy, or nine (9) Iltonth. 8f'Id ona (I) day fro. the data of
death, to the data of plly"nt. Ta)(U whIch lJ.c... d.lIn~t !Mifo,.. Janullry I, 1982 b..r Int.,...t at the r"h of
'~K (6X) parcant p.r annu. c.lcul.t.d at . d.lly rat. of .00016~, All taxI' which becaall d.llnquent on ~ aftar
JIIlnU.,.y I, 191Z wlll bur Int.r..t .t a rat. which wlll vary frol Cllhllldelr year to c.landar ynr with that rata
ftMOunClad by the PA Depllrh..nt of R.vanue. Th. appllcabla intarnt rltei for 191Z through 1996 IIr.l
'!!!! lnt.rut R!!lt.. Dfllh Intarnt Fl"ICtor :!!!.r Intar..t R.ta O.lly Intar..t FltCltor
l"AZ ZO;( .OOOS48 1987 .~ .OOOl47
1985 16;( .00043a 19aa~1'191 It;( .000301
1914 11;( ,000301 199Z .~ .00Ol47
1915 U;( .000356 1991-1994 7X ,000192
1'" lOX ,000214 1995pl99a .~ .000Z47
--Intaratt I. calClvlat.d a. follow'l
INTEREST . aALANCE OF TAX UNPAIO X NUNBER OF DAVS DELINQUENT X DAILV INTEREST FACTOR
uAnv NoUe. Is.ued aft." tha tlllM b.oOlMi. delinquent will refleot an Int.rnt calcuhtlon to flft.an (15) d.n
!Mivond the d.ta of the ........nt, If PlYlllf'lt It aade .Uer t.... Intar..t c"putatlon data .hoNn GO the
Hotlca, additional tnt.r.,t ~.t b. calculated.