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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I,.........
,fILE NUMBER
21
iJ;UNlvUIIIL
..:.....:1
I{I!' flr-'f'i ICAlliL') ~>I,lliVIVII'IU sP(JlI~a:~j I'IAM!: ( [.,\,1I, !'lr~~i1 MIl! Mllll':!I!-lIIIAI I
: Nolll1lghnlll, I~oy (i.
1181 I Or;{Jilllll Roturn 0 2 811pplollll1llhll RultHII
'I' 0 4 1I11lihltl Elildlu 0 411, futou!! Inl.'I",;\ C'H"fll\lIOl'~O (iI,IW {If (lilaH,
.Illw 1:' 1,'1\.')
iD (j Dooo(ltllll Diml Tot>h.lltl (Allil!:11 CUPl 0 7 Dtl{)udllllt M,lillllllllmJ il U"inU Tnml (Alli\l;ll
I "rWIII) ':OPI(lIIF,,~11
i 0 9 LitiuulionP!OCtllldl> RecoivlJd 0 10, SpUIHHl1 POVllfly CltJdil (d,l(H (I' dt'~lh tlulWIlElI\ 0 \ 1.f:lllUti'-'ll 10 lu~ ulldtlll,tHl, 9113U\) (Allil',:
i, --,,' . . n_'_'_"".'''' ....__d._,___'_2.}_!:II\,lIlil_l,l-ll:>) . ,",",,, "'",__,T"'"__,___n",_,u".,,,,,,_,-,---,-.--,---,:,,",:--::
. THIS UCTICltI MUST" QQMPUlTBD. ALL COA/lISPONDINCB AND DONPIDBNTIAL TAX INPOA~TION, IttOU~ClB DlfUlD11lOTllI
t'^~I~Olli\lll\'u u u. . 'U "., ,.. ... ,..,... ','.' , ".. 'lcii;"PL';ILM;;';ii"t;:OOR;;;;;;~...-
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I " Ilul'<I\,'y,I'A 17(1,)1
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!7171:i)).X\ I>;
1 Real Esl.le (Schedule A)
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llll'All fMUIr O~ IH;V~t.IJf
IJer'[ I~L,~111
"^,I'4;~H\f'll'j 1''' Illlij-~~'lI
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UL\;I liHII', ~II\MlII A~;L fllbl Mill MIP:llL Iril!lfll)
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12/27/1 i)\)(1
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2 Stocks and Bonds (Sched~de B)
3, Closely Held CorpofaUon, Partnership or Sole. Proprietorship
4, Mortgages & Noles Receivable (Schedllle D)
5. Gasll, Banx Deposits & Mlscellaneolls Personal Property
(Schedule E)
6 .Ioinlly Owned P,operty (SchedUle PI
o Separ~le Billing Req"esled
7 Inler.Vivos Transfers & MisceUaneolls Non.Probate Property
(Schedule G or L)
6 Total Gross Assels (lol~1 Line. 1-71
9 FllI\eral Expenses & AdminIstrative Cosls (SQhedllle H)
10 Debls or Decedenl, Mortg~ge L1abilllies, & Liens (Soll'dulel)
11. Telal Oeductlons (tolal Lines 9 & ~O)
12, Net Value or Elitate (Line 8 mimls Unell)
(JIIICIAlll:il ; Ihl Y
97
829
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it_',1<
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THIS RliTUflN Musr at:: t'ILliU It! 11dfJI,IO/\1(!'NIII! Hill
REGIS1ER OF WILLS
SUCIAL fit.;CUH1IY NU,\III!;1f\
2.n-./h~'!(15 '\
o J 'r~elllilll\dlllllllllJfI){(jllnu'd~ flcJHfl<Jl".j:'~;'i
o
5 ruduful E:litulo Tu< RolurlllhJquitlld
0, Tolul NWllUQI of SoIftll)tlIIJ:.lt i lwwti
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C - Of'FluiALlJ'Sf UHl.Y
(I)
.(J.'
(2)
P)
(4)
(5)
(6)
(7)
.(1.
.(J.
.11.
.(J.
NOlie
NlIllU
(6) .0-,
(9)
(10)
(J(JII
(J,IJII,
(11)
11,00
(12)
. . ()...
13, Chantable and Governmental Beqllests/Sec 9113 TrLlSIS for wlllell an eleotlon to tax has not been
1ll0,Ie (Schedule J)
14 Nel Value Subjecl to Tax (Linel21lllmls Line 13)
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES
(13)
_-...:--1:1...---'-_...._._
(14) -0-
(Hi) - 0-
(16) _ 0...
(171 .. ().
----.-,-"-'._-,.....,--
(18) .. ()_
--......-..-,.,-..,-
20 0
C.U CK HI m If YOU Af-U RFQll( ~ riNG A Hf f UNn Of AN OV( HPAYMf NT
(19) .. IJ.
... .__.....~.; iiiialiiiulro ~il~~"A~L QUllrlOilsON "livii".~..IOiA~D-~~<;~~.MATIi'.~...
."":0>:"'''"""-,..-,,,
Copyright 2000 form sohware only The Lackrler Group, lne,
,,;.:.
15_ Amollnt of Une 14 taxable at the spOllsal tax rate, 11(1(1 x .00
or I,ansfers unde' Sec. 9116(a)(12)
. (1111) ,0(,
Q 16 Amount of Line 14 taxable at lineal rate ,
~
5
. 17. Amuurll 01 Line 14 ta)(able at sihling rate 0.00 , .12
~
1I
~ 18. Amolmt (.)f Une 14 ta)(able at collateral late 11.00 x .15
,.
19. Tax Due
Form REV.16rw EX (Rev 1<101
..
Decedent's COl11plete Address:
'rln II 1I>1l10:"
('1'1'\
('1I1111'11i11
i STA'IT I'll
;,,,,,':-=]
_1'l.1O (il\!l'll SIIL'l'l
Tax Payments and Credits:
I rill( DUB (Page I Una 19)
2 Cmdlts/Paymallls
A Spoll'~1 Poverly Crodil
B P,lo, P~Yll1enl'
C, Dlscollnt
(I)
"'0-.
3 Inl')leoIIPen~IIY II ~pplloable
D Inlereol
E Penolly
Tolol C,e,dils (A + B + 0)
(2)
n,uo
O,{)(l
Totallnlere~IIPen.lly (Dr E)
4 II Line 21s g'e~ler \lmn Line 1 + Line 3, e"le, IlIe dlll",onoe Tlllo is Ilia OVERPAVMENT
Check ~oi< on P~ge 1 LIII. 20 to reque.t a refund
5 II Line 1 + L1n. 310 g,ealo, \I,an Line 2, enle, III. dilloronce nus is IlIe TAX DUE
A, Enter the Interest on tllo lax dll6.
B, Enler Ihololal 01 Lino 5 + SA Tlli' 15111. BALANCE DUE
(31 (I\lU
(4)
(5) (100
(5A)
(5B) 0,00
Make Clleck Payable to REGISTER OF WILLS. AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BV PLACING AN "X" IN THE APPROPRIATE BLOCKS
Old decedent make a lransfer and Yeli No
a. retain the use or incon'8 of the property lranhhHrecl, ~ I.
b. retain the right 10 designate who shalllls8 HIe properly transforred or Its Income;
c retalll a reverslonalY Interest: or
d receIVe tile promise for life of either payments, lJaneflts or care'l
2 If death oeCllned after December 12, 1982, (lid (Ieeee/ent transfer properly within ono year of death witho~l! IU.
receivIng adeqllate conslderalion? [J ~
3 Old decedent own an "in Inlst for" or payable llpon deatl1 bank aGCOlmt or seCUrity alllis or tler death? [J ~
4 Old decedent own an Indlvldllal Relirernent AecOlll1t, annuity, or oIlier nor-probate proporty whloh 1~;1
contains a beneliclary deslgnatlOn?, [] ~
IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHeDULE G AND FILE IT AS I'ART Of' lHE RETURN,
Under I)~l\al!le5 of P1l111Hy, i declare IIlat I ha~ll o<.inl,I)ll(llIll~ rohHI1. IIwlu(!'llfl Jrnlllll',I"'f"'~ !'oOle'hl:e~ .111:1 ~tdlllllllllll", "11(1 hllht! hllst (lImy ~l'l.Iwllldllll dill! bU!rllf, ,t l!o IllItI 'd,~;:1 ~lId l'OIL)I,I!
D€!clarlltlOl\ullllUPdffJl ohllll tllUlltlillpOISOlII<11 rl.lp(llsclltul''1I! ISlid"l,doll illl,nlt\lllIdl'I'I'lllwlu:h fJll)r~(lll lidS 'l'lj!knOl'lltl<!lJl'
Slm~"TlJHF 01 i'IJ<SON fU~Sf!!.~N~)I!lLL Hili tlit"j(l m, rUlnl fIlii Jf~l:;;:, I ;A)L
,1iW(lrL'L'1l SII'L'L'l
(''''IIi' 1Ii11, /'1\ 171111
~1(jNATlm[ OF PUjf,ON IU:SflONStllLC nm l'ILlNG flllul<N
!\! I! )I~f; :;'-;
(IA!!'
~;f(lNA'flJflr 01 PllU'ArlUI
Hf'flllUil:~iI i\ IIV[
M)r)fiEf;~;
[)All
I' (), ""\14/
1Ie'"'",,\',I'A 1711,1.1
For dates of cleath on or after Jllly 1, 1994 and before JafHlary 1, 1 ~J95, the tax rale imposed on the net value of trans'ars to or ror th(l uge [)f(rw
surviving opollse ie 3% 172 PS ~9116 lai II I I (ill
For dates of death on or after January 1, '1995, tile tal( rate Imposed all tile net value of transfers 10 or for HIe Lise of the Slllif'iving SpOU~tl ii, O'UI
172 P,S, ~9116 (a) (1.1) (li)I, The slaMa Qq!it::; (wtQxf;tmpl a trM5fer 10 a SLlfVlif'lflg spollse from tax, anclttle statutory nl<luiretnenls for dlsc!o,iUltJ
of assets and filing a "'I< return IIro still arplicablt'l even if the bWVlvil1g spouse is ttlEl only beneflcialY
For dates of death on or aller July 1, 2000
ThQ tal< ratE' unposed on lhe nel val~le or transfers from a deceased ClltJd IW6nty,ono yaals or C1ge 01 younger at (lealtllo Of for llle ll:iO 01 a fldtwal
parent, all adoptive parent, Of a stepparent of 'Ile cl1i1d is 0% [i'J P S ~fJ116 (a) (12))
The lal< rate imposed on tile net vallIe of transfers 10 01 fur thtl W,e of tIle cJecedcnt's lineal banal!clarl6S is 4.5%, except as noted In 72 P ,;i, !j8116
1.2)172 P,S ~9116 (al (Iii
The lax rate imposee! on tile net value of transfers 10 or for the lIse of Ihe decedent's siblfngs is 12% [72 PS fi9116 (a) {1 3)1 A sfbllng Is clt'fl'lod,
under Section 9102, as an Imllvldual who has at least one parellllfl common WIth tile cJecedent. wlwlller by bloocJ or lIdopllon
,:'>:)1 y
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
)I~,~
v~
BUREAU Of INDIVIDUAL TAMES
INHERJTANC[ YAK DIVISION
DEPT. 2ao601
HA~lS.'JRG, PA 1711&~a601
NonCE Of INHERI1'ANCE TAM
APPRAISEMENT, ALLOWANtE DR DISALLOWANCE
Df DEDUCTIONS AND ASSESSMENT Of TAM
UV.IUl 1M." fl'.If'
04-09-2001
NOTTINGHAM
12-27-1996
21 97-0829
CUMBERLAND
101
[C': AMount .::~ H~~-=J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOl
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ...
iliV: i5"4j"!j["AFi; -[ i 'FoCiY -Ncii:rcE" "DF'-"i:"NHEifi;: ANcPr'Ain-pjiR'A IS Eiiiiir;-ALLiiwANCE"OR -- - -- "m__ - - -.."
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
BARBARA A FILE NO. 21 97-0829 ACN 101
SCOTT ABLY
'SCOTT ABLY ATTY AT LAW
PO BOX 341
HERSHEY
DATI
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
BARBARA
A
PA 17~33
ESTATE OF NOTTINGHAM
DATE 04-09-2001
TAM RETURN WAS I (X) ACCEPTED AS fiLED
RESERVATION CONCERNING FUTURE IN1'EREST " SEE REVERSE
APPRAISI!D VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Rool E.toto (Sohodulo Al
2. stocks and Bond. (Schedul. 8)
3. Clo..1y Held stock/Partner.hip Int.,...st (Schedule C)
it. KodSl.pI/Not.. Recal v.bl. (Schedule D)
5. C..h/Bank Deposits/Hi.c. Paraonal Property (Schedule E)
6. Jointly OWnod Proporty (Sohodulo FI
7. Tran.fa,.a (Scn.dul. 0)
a, Totol A..ot.
) CHANGED
UI
(2)
(31
(4)
IS)
(6)
(7)
.00
.00
.00
.00
_.00
.00
.00
(8)
NOTE: To in.ure prope,..
credit to your acaount,
lubMlt the upp.r portion
uf this forM "tth your
tax paYM.nt.
.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral E)(,.n.e./AdM. Camta/HJ.c. Expens.. (Schedul. H) (9)
10. DObt./Nort,o,o Llobllltlo./Llon. (Sohodulo II (10) .00
11. Totol Iltoduotlon. Ul)
12. Not Voluo of Tox Roturn 112)
15. Charitabl./Govern..ntal aequ..t'J Non~elect.d 91],5 "rust. (Schedule J) (13)
14. Net Voluo of htoto SUbJoot to Tox 114)
NOTE: If.n ........nt w.. i..u.d pr.viou.ly, lin.. 14, 15 .nd/or 16, 17, 18 .nd
r.fl.ct figur.. th.t includ. the tot.l of 61b r.turn. ......ed to d.t..
ASSESSMI!NT OF TAX:
15, Aoount of Llno 14 ot Spou.ol roto
16. A~unt of Line l~ taxable at Line.1/Cla.. A rat.
17. Aoount of Llno 14 ot Slblln, roto
18, ~ount of Line 14 taxable at Collet.ral/CI... Brat.
19. Principal Tax Du.
.00
no
.00
.00
.00
19 will
US)
1161
(171_
Ua)
.00
.00
.00
.00
x 00 =
M 06 =
K 00 =
M 15 =
1191=
.00
.00
.00
.00
.00
IlECElPT
NUNBER
'0 +)
I rUEST/PEN PAID (-I
AMOUNT PAID
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION DF ADDITIONAL INTEREST.
--.~--- . ~
TOTAL TAX CREDIT
BALANCElOF TAX'DUI! :.~~
INTEREST AND PI!N. .00
-~-._--
TOTAL DUI! ,00
If TOTAL DUE IS LESS THAN 01. NO PAYMENT IS RE~IRED,
IF TOTAL DUE IS REfLECTED AS A "CREDn" (CR). YOU NAY BE DUE
A REFUND. .SEE REVERSE SIDE Of THIS FORN FOR INSTRUCTIONS. I
RESERVATION,
PURPOSE OF
NOTICEl
PAYMENT I
REfUND (CR)1
OIJECTlONS I
ADttIN-
ISlRAlIVE
CORRECTIONSl
DISCOUNT I
PENALTY I
INURESl'l
Eet_t.. of decldent. dYing on or before Pec..ber 12, 1982 -. if any future Inter..t In tht I.t,t_ I, transfarred
In po.....lon or enJoy.."t to C.... a (aollatlral1 beneflclarl.. of thl dlcldent .ft,r tho Iwplratlon of eny ..tet. for
llf, or for y..r., the C~onw..lth ~r.by .~pr..>>lY rl'lrw.. the rlant to,appral.. nnd .,.... trantfer InheritlOcI Tlw"
at tht lawful cta.. . (oollater.,1) rata on any ~uch future Intar.st.
To fulfill the rlqulrlMnh of S6otion 2140 of the Inheritanoe and Elt.t, Tax Act. Act 23 of 2000. (n P.S.
Sllct Ion 9140 I.
Detaoh the top portion of this HoUoll nnd sublllt with your pay.rmt to thll RIlIister of Willi printed on the rl"er.. .Jete.
--Milk. chlok or .oney order payable tal REGISTER OF MILLS, AGENT
A reh,"d of a tax credit, which was not requosted on the TIlx Return, 8av be t'equ.sh1l1 by OOlllPleUnl1 an "AppUcaUun
for Refund of PeM.yll1lmla Inheritano. and Estate Tax" (REy-nUL Appliontions tire IIIvaU"ble at the Offle,
of ttt. Reglst.r "f WHh, eny of the l3 R.venue Dhtrlct Offlco~. or by calling the speoJal 24-hour
8n.warJn" ..rvlel8 for foru ordering: 1-300<~b2.20Sn, urvlceli for taxpayerli with special h.aring and I or
.peaklng n..dul 1-800-447-3020 (TT only).
Any party In lnt.r..t not .atisU.d with the apprais...nt, allowan08, or dlnllowanc. of d.ductlons, or e.......nt
of tax lincludJnu dhcount 01' Int.r.st) as .hown on thJs Notic. lIust obj.ct within sixty (60) days of raoelpt of
this Noti(llJ bYI
--writt.n protelit to the PI. V.partunt of Revenue, Board of Appeals, D.pt, 281021, Iiarrbburg, PI.
".lectlon to have the .atter d.ter.Jned at audit of the aooount (If the per.onllll r.pr.sentative,
nllPP.al to the Orph."s' Court,
OR
171la-lOll,
OR
F.ctual .1'1'01'. di.cov.r.d on thl. a*......nt~hauld bt addres.ed In writing tOI PI. Depart.ant of R'vonu..
lureau of Individual 'axu, ATTNI Po.t AU8111.8nt Review Unit, V.pt. zaOftOl, Harrisburg, PI. 171l8-0601
Phon. (717) 781,,6505, Seo page S of the booklot "Instruotions for Inherltl'lnce Tax R.turn for I'll Re.ldent
Den~dent" (REV-ISOI) for an .xpi.natl~n of ad.lni.tratlvlllv corr.ct~ble .rrors.
If any tax due I. paid wJthln thre. (1) cal.ndar .onths after the d.eadent', death. a flye p.rc.nt (S%) dl.count of
the '-lit p.ld It al1<>>fad.
th. 15% t.~ .-na.ty non~p.rtlclpatlon panalty Js c~puted on the total of the tax nnd Int.r..t .......d, Bnd not
p.id befor. JanuarY 1&, 19~6, the flr~t dav after the end of the talit ..na.ty p.rlod. Thl. nonRpartlclpatlon
pen.lty is app..labl. In the .... .ann.r and in the the .... ti.e p.r lad as ynu would app..1 the tax .nd Int.r.st
th.t ha. been .......d us Indlcat,d on thl, notice.
Inter..t Is charged beginning with first day of d.Unquen<lY, aI' nine (9) eonths and one (}) day fro. the d.t. of
death, to the,d.te of pay.ent. Tax.. which beca.e delinq~.nt before Jl'llnuarv I. 1982 b.ar Int.r..t at the r.ta of
.lx (6X) p.rc.nt p.r annUlI calculated at a daJly rate of ,000164. All taxe. which bec..e deHnquent on and .ft.r
.Ianuery I. 1982 will bear Int.rest at III rate whloh will vary fro. oal.octar year to oal.ndar year with that r.te
announc.d by the PI. D.pert.ent of R.v.nue, The applicable Int.rest rltos for 1982 through 2001 .ral
V..r Intlr..t Rat. Dally Int.re.t Factor Year Int.r..t Rat. Dally Internt faotor
1982 20% .000548 1992 91. .000241
1983 16% .000438 199~-1994 n: ,nOOin
1984 111. .OOUOI 1995-199a 91. ,000241
IilS 131: ,OOOJ!ib 1999 n: .000192
1916 101: .000214 2000 af. .000219
19ft1 9% .000l47 2001 'If. .000241
IneR1991 11% .000301
--Int.r..t I. calcul.t.d as followSI
INTEREST' BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X OAILY INTEREST FACTOR
~~Any,Notlc' I..u.d after the ta~ b8cOll.' delinquent Nlll r.fiect In lnt.r.st calculation to flft..n (IS) d.ys
bayond the det. of tM ....n..nt. If paye.nt Is ead. aft.r the Int.r..t coeputaUon date .hown on the,
Notlc., "dIUon.l Inter..t .lllt be C1alculated.
. Completo Ite01~ 1,2. and 3, Also oompleto
Item 4 ,If Restricted Delivery la desired.
. Print your name and addres!:l on the reverse
90 that we can ~eturn the card to you.
. Att~ch thl~ oard to tho baal( of the mailnlooo,
or on the front I' space permits,
1, Article Addressed to:
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