HomeMy WebLinkAbout97-00847
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19 $'" {)1~114- r 11- EtUDiih flJ.,/iojAs
CIlHHIlHWt:Allll Ill' "'eNHIVlVAHIA * I
"""ARIHeHI Ill' ReVeHUe
AIIIII:AU nO' IRPIVIPUAI IUEI
PI "I , 110.01
IIARRlIIlIRa, IlA 11I21.0601
INPORMAT~ON NOTIOe
TAXPAYe~ ResPoNse
Fm NO, 21 - f1~,r.''11
ADN 91146572
DATI 10-31-91
TVPE OF ACCOUNT
EST, OF L LOVO E PRANtly ~ IAYINO'
S,S. NO, 196-01-1149 CHECKING
DATE OF DEATH OB- 06"97 . TRUll
COUNTY CUMaERLAND mm,
RIHIT PAVHENT AND ~DRH' TOI
RF.aISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
I(Y'\h1 u." ,"'"
SHIRLEY A EPPLEY
1B71 CRESCENT RD
FRANKLIN IN 46131
HARRlI IAVINO' BANK h.. proVI.'. Ih. P."",".n\ wtlh th. Inlor..\lon 11.,.. ".10. .hloh h.. "..n 0". In
uloYl.Ung '1\1 potlnUal taM d~'1 Th.lr r.oordl India",. that at thl duth of tho nbOlJI d,oltl,nt, you 14'1'1 . Jhlnt awner/bln,Uollrv of
'hit 1000un\1 If ,YOU f.~1 thh Inforutlon I, 1"001'1"0\, pi.,... Qbt.ln wrlUt" orrlotlun frQ" thl flmmolal tnlUtuUon, att"Qh .. OoPV
to thlt. tor. and rltl.lrn it to thl llbOlJ1 add"u, fhll nDQOllnt h trncnbh In aooordanGl wUh th, Inhlr 1 '''nol TalC Law' of ",. COII~onwutth
iJt r.nnl!r"'IMh, C~Qotton3 HJi b'''"lJii.,.td b, Ol\l~lnv (1}1) 101 O~~fl
OOHP~ITI PART 1 RI~OW " " . SII REVIRSI BIDI FOR PI~INO AND PAYMENT INBTRUOTIONS
Aooount No, 07-61-293332 Dlh 01-06-94
Ithblhhld
31,024.08
501000
15,512,04
115
2.326.81
~ TAXPAyeR R!SPoNSe
PAILUIlIlTO RI.POND WXLL RISULT ~NAN !1PPXC7.AL"A)( All9l89MIHT IlMllllnH TIot" N(lT~ell
to Inlurl prop.r Qrldlt to Vo",r ,uoount, two
(2) cap).. of thl. nQUoI Jllllt _coo,plny vo",r
paV.lnt to thl Rlghhr of WllU, Hlkl chick
payablt ,tn'J "Re,lIter of Willi, AOint",
M
HOTe. If taN p.v~.nt. trl .Idl withln thrie
(II .ontl\. of thl dlcld.nt', date af d..th,
you JlaY d'duot . IX dl.aount of thl t.~ dUI'
AtW tnhtr ItMOI tllC dUI will b'CQII' dtllnqu,"'
nlnl (9) Jlon'h, .ft,r thi dit. of de.th,
M
[ C~~~K ]
BLOCK
ONLY
~M'
Al 0 Thl 'bov. tnfOI'".t Ion II,d taN dUI It corrlat, .. "',
, 11 Vau Ill_V chao.. 'to,rillllt Plv..ntto th. R.ghhr of Willi with two oopl.. of thlt notl~. to obhln
. dltoount 01' avoid lntlrllt, or you lIIay Clh.ck bON "A" alid rl'hll'n this noUot,to thl MI,ht,r' of
Will. .nd In official ........n\ will b, '1IUAd hV thl ~A CIPlrt.lnt of Rlvlnull
I, 0 Thi .boy, ....t hai b..n or HUl b, repor\.d and talC Plid with t.hl Plnn.vlvlnh'lnhirJhnoe hM rlturn
to btflltd bv the dlcedlnt" rlprl'tntatlVl,
CI U2r!he above Infor.ltlon I~neorr.ot Ind/o~lbtl .nd d.~uatlonl wire paid bv you,
You IUlt oo.pt.,_ P.RT L!J and/or PART L!J bilow,
P~T If yO~ indiol .1 diff'rln I' rl I 1'1.1. I I your
~ rllltiQn.~ip to dlo.d.nt, .
TAX RITURN . OOMPUTATION OF TAX ON JOINT/TRUST AOCOUNTS
LINE 1, Dlh htlblhh.d I ",G. <1']
a, Aooount 8IlIn.1 a:3 I ~..z.. ~CPJ.
s, P.rclnt TI.lbll , ~ ti:/J
q, A~ount 8Ub~lot to TI. q I,r;;t;) 2.1/ "
&, Dlbh Ind D.du.Uon" ,. f ..
~: ~::U:~:~"'b11 : ~ I :~:t ~ :
POOT
bATE PAID
PAil
1
'2
!
4
5
,6
7
8
DIRTB A~D DIDUOTIONS CLAIMED
OFFICIAL USE ONLy 0 AAF
pA IlEPARTME.NTOF.RE...V....ENUli
...... '. " '--.',. "'.., ........
r~\ ('
f"....:;
.J:
~,.; f'
,
'.--'1
".'0'1
,
'PAVEE
DUSCRI PUON
AMOuNT PAID
,,1 ".,.".L.. .. TO, ..."....~, !
Undlr p,nllUu of plr~urYII dllllrl thltthl fach 1 hlVI rl"orhd IboVI Irl trOll oorr.ot Ind
.0~pllta to thl but of lilY kn.wlld,1 Ind blUlk HOME (~~ I? ) 9.1/- I) 9 '17
~~~~A.' d- W~:~EP~DNE N~MBER ~
GENERAL INFORMATION
1, F~I~URI TO RUPOND WX~~ RIIU~T IN ~N OFFICIAL T~" AlleslHINT wllh ...II..hl. In\o",1 h.". on 1,,'o,'..llon
..h.III.. hV Ih..lln.nol.1 In,tl",tl.n,
2. Inh.,lhna. tiN bloo... dellnqulnt "tni f1allth. "ft,r thl utalld,,,\'1 II"', of dutll.
'I ~ joint ftQoaunt It "ne,tll' Iv,n t11D\lOh the d'G,tI.ntl, MftlII' WlU "ddlll ftl n '11\\'1" of (IIlIlYlliI.not"
It. Aoooun'. :(ln~h.dl". thut held b.hfltli hu.band .nd wlft) whloh \ht dUldlnt lUll 1/1 Joint ".... wl\hln onl yur 1'l'lat to
d,.lh '1', fully 'INlbl, " tr.n.f.r..
II Aooounh ..,abU,h,d Jointly bltM"" h\l.b.nd Ilnd wi'. 1II0rt than onl yur prior to d..tllllt. flot "IIIUUJII.
6. Aooount, h.ld b~ ,'dtOld.nt "In truI' for" .nothlror u\I1,r. 1ft '11f.b'. fullY.
REPORTING INSTRUCTIONS . PART 1 - TAXPAVER RESPONSE
I, 'LOCK' ~ If tht '"far'ltton andop,pwt.tlon In th. no\101 ar. oorrlot _nd dtduotlonl II" Mat bl'nu ol,I.'d, pl.ot I" "k"
In blook "A" of Plrt 1 of thl "lI\IIpav.r "uponu't notto", IIgn 'MO copl.. and ,"II.H t~I' wl\h yaur ohuk fGr,.thl "ltount of
tile to th. RI,lIt,r ,of WIUt of thl county 'ndluted, TtI'P. OIPut.."' of R.y,nuI will 1111.1. an Clfflohl ........nt
1'01'" RtV-l1lt6 E)() upon rlotlp\ Df th. return 'rQ' thl Ruhtll' of WIlh.
t. flOCK a _ Ifth' a...t IPnlflitton thll nottel hll bun or w111 blr.port.d and hi( Pllld with 'hi Plnnlvlvllnll lnhlrl\anol ,. ,
Tale Rlturn fU.d bY thl dloedlnt'i r.pr..,ntitlvI, pl~ol In "M" 1n bloCk 11111 of Iiart 1 of thl "liMP.Vlr RIIPllnu" lIothlM, 11,n onl
OOPY Ind r.turn to thl PA nlp,rt..nt of RIlJiMU', 8ur.iu of lndlvldul1 TaKII, OlPttl0601, Ilurhbur., P4 17126-0601 In th.
InvI10pt pravldlU, ,
S. ILPCK, C'~ If thl ngHo,' 1nfor..Uon It Incortlct IInd/or dldyoUanl Irt b.lna ohllllld, ohuk black "C" and cOIPht. Parte 2 ftnd 1
..,not'ftlna t" tli. In.trutlttn"~ blll~w, .llIn two oopl.. Ine 'Ubfl\t U,.. with your okeok for thl 'lIount of't'M pavable ta thl Reeht"r
of Willi of the OCtuntv indlolhd, Thl PA alPlrt'lInt of AIIJ.nu. .,1&1 IIIUI IIn 0'110,1.1 ......IIi."t (~or. REV-UU E~l) upon rlollpt
01 Ih. rllurn fro. tho RIol'hr 01 Will', .
TAX RETURN - PART 2 - TAX COMPUTATION
LIH~
1, ~"t.r thl d.tl thl .ooountorlulnlllv W.I ."lb1llh.d or tltlad In thl ..nn.r .~l'tln~ i' d.tl of d'lth,
HOt~1 For'a diOld.nt dvlng aftl" 12112182. AoooynUwhlqtl th. dloldlnt put In Jl:llnt n.... Hlthtn on. 0) VIII' of d..th Irt .
tllClbb fulh at trin.hrl,. !Io"llJlr, there 11 an IKolUllon not '0 .)Co..d U,OOO per trat1,ftr.. relllrdl111 of thl v,lu..of
ttw, "000"1'1\ or thl nu.b,,, 1f aooounte hlld, "
!f . doubll ..t.rllk (MM) aPP,"rl hlfar, vour flt~t n"1 1n the addr... pnrtlon of thl. nottol, thl ..,000 IKolullon
alr.idy;hll b'lndldyot,d fro. thl Icoount bal.not al r.ported bv 'hi f1nanel.l In.tltutlon,
2. Inter tht totlll bll,no, of thl account' Inoludlng, In\lr..t u4;lrUtd tet thl deb of rlt.th,
I, Thl PlrOtnt of thl aooount thlt I. taKabll tor ,Ich .urvlvar II di'.r.lnld II fol10WII
., Thl porclnttllelbli fcr joint 1"ltl e.t'blllhld lor. than ant ViaI' prior to thl d.gldlnt'l d..thl
1 DIYIDtD IY TOT!L HUHI~R OF DIUIOEO IY TOIM HUHIER OF X 100 . PERC~HT TIXU~~
JOIHT OHNER' DURVIYIHO ,JOINT OHHERS
bllPll. A JoJnt, ....t rl,ht.red In thl n"" Of thl alold.nt Md two other plr'onl,
1 DIVIDED IY . (JOIHT OWHERI) DIYIOED IV 2 (SURVIYORS) . ,161 X 100 . 16.IX lUXIIL~ FOR EACH SURYIVOR)
a. Tht ".relnt t'~lblt for ....te or..tld within anI V'1f of thl dlC.atnt'l dnth or'loooun" ownld by thtfdl<l,dent ,bl,tt hlld
In trult for 'nothlr Indlyldl.l.H'\) (tru.t blnlfl<llarl"lI, '
1 DIYIDED IV TOtAL NUHIERDF.URYIYIHO JOINT
OWHER' DR TRU'T IEHEFICIIRIEI
X 100 . .ERCEHT TAXAILE
blt"plll ~olnt ICOount tlllllta"ed In thl n... 0' thldlaldllit and ,,",0 oth.;' plrlonl and .. tab 1 hhld within one Yllr 'of dllth bv
thl dleldlnt,
I DIYIDEO IV a (SURVIVORIl . ,io M 100 . lOX lUXIILE FOR EACII SURYIVORI
"'i Thl;a.oUf1. t tUbltat to tlM O'nl,'\) h dl.hr~ln'd bY' .ult1phlna thl ilIa~ount bahnol (\In. 2) by tha p.rot"t taleabl. (lInl III
M, "ntll' 'hi tota of thl dlbts end dlduotlo"t l"tld In Part S, .; . . '
~, Th. bU\.lnthHtl~h 01n1l6) 10 dotDt'Mll\ed bY:tubtraoUn; t1IQ dobh .csnd d,du,thT11' 01n' I) fl"OIIl tho nount ,ubjei":t to hI': nl", 4)
1, ~nhr thl IPproprll'l tlM r,ta(Un. 1)1,"d,tlrllln.d bIlow,
A'; For d.tll af dllth oaou~"Inll .ft,r 6110/94, .thl \lxd,.t.. for, tranlfArl to _pouII'.re II followt'
1, OI\I~ of dlath on'Ot ,ftir 7/1/94.ilid before 1/1/9. thl rat. II SX,
t. Dat.l.af dl,th on or aft_r 111/.. tranlf.r. '0 IpOUII. will b,tax,det O~ t.M rn't,
Hotl'. Ford.t'. of de.th prior to t'l"" trantflr. to IPOU'il aI" t'Mable ,t'~! ..
., Trln'f.rl tq,lS~e.a d..C.lidant.1 Inoludlna fath.r. lothlrl .on, diughtlrt gr.ndohlldr,n, tOn-ln-law,
'. dl",htlr-ln-lIWt It,pohUd and th,lr IllY. .t. taM.blt. IhI p.rc.nt (6J(), .. '
C. Tr.n,flr. to al oth'l'l Inc1udlna'brot.hl!lr, ,lIttrJ l,lncl",aunti n.. phlw and "I_clare tlllftbl1 Itt flftlln ~.r(lllit UIX),
D. lf~ou 'Chlligl tht Ull rata, ph.1I IpecHY your ,'eleUanlhip to tnl dloldent In the 1,.1. provld.d,
I, th. 'Iount of tlM d~' (11nl a) IlditarMln.d bv .ultlplvlnl thl ..ount tlMabie (11nl 6) bv the taM ratl (lln, 1),
CLAIMEb DKDUCTIONS . PART S
DKBTS AND DEDUCTIONS CLAIMED
Allow~" dlbt, and dlduotl~nw II"I d't.raln.d ",folloWII
", Vou 1...IIY or. .o,pon,lbl.lor p.~..n\. or Ih. 1.1.1' ,ool.o\ 10 ..0Inl.lr'llon bV 0 p.r.onol ...r."nt.ilv. I. In,uIII.I.nl
to pl~ th. deauetlbl1 Ita." . ; . .
Ii YOu lotuIllY p.ld thi dlbtl af\lr d."h of thi dloldlnt.and eln furnllh proofaf plv.lnt,
C; Dlbt,bilno ~l.I.ld Il.Ilt b' It,.I'ld fl.lllv In Pert s, If Iddltlonll Ipeci II nl.dld, UI. pllln paper .1/2" ,M \1", Proof of
plv.-"t liV bl rlql.ll.tld by th~.PA b,Plrt.,nt of Alv.nu..
,<t.,
. 'Xi "",...>i.>.............T~PAV~. R AssnTAllCl!
.........."............,.......,IP..VOU.~El!D. F.U~THl!R] OR ATION OR ASSUTANCE, CONTACT ANV
i Rl!BUTl!1 . OF WI . S " PA l! A TMl!HT OF Rl!Vl!NUI! DISTRICT OFPICI!
......... 0 .. ALTHB R A INDI IDUAL XES TAXPAYE IN UIR UNIT IN
HA~lttS~UR(l kT( 17~J8 .K~27, ~bD' (1I~)77t.2252 (~EAR~NO lHPAIRED ONLY)
COHMONWEAI.TIl or IIEHHIVLYANIA
DWAR'"""' Of MtYE"UE
IUMUU Of IMDIYIDUAl liMn
Pt:f". 160m
UAMAIUUMO, I'A 1'1/1.0'01
.
tNFORMAT~N NOTtel
TAXPAVB~ RBSPONS8
FILl
ACN
DATI
NO. 21 ,,,?~.P'I1
91146511
10-31-91
"1.lhlll'" lI.t\l
SHIRLEV A EPPLEV
1871 CRESCENT RD
FRANKLIN IN 46151
TVPE OF ACCOUNT
&8T, OF' LLOYD E BRANDT ~ I~VINOI
S,S. .NO. 195-01-1149 CIIBCKINO
DAT& OF D&ATH 08-06-91 TRUIT
COUNTY CUMBERLAND cuur,
RBHIT P~VHENT AND rORHI TOI
REGISTER OF WILLS .
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 11015
HARRII I~VINOI lANK hll proYld'd th' P,p"t..nt with Ih' Inlor.otlon lI,tod 1>.low whloh h.. blln ulld In ,
oalo",htlng the potlntle' tllC dut, Th.lr reoord, Indlcet. that lit the dllth of the above dloldlnt, yoU w.r. a JoInt own.r/b,n.fjCllir'f of
thll ,0001,mt, 1f !~Ou f.,t thle Infarlll_tlo" h l"oarrlGt, pllft" obtain wrlttln "orr.otlon frol thl flnanoi.1 In.\ltuUan, ,,\taoh II oop~
to thll farl Ind r.turn It to thl ,boy, addre.., Thlt"'C1C1ount 11 "'lUthi' In 10oc;trdal101 with Uti Inher I hna. Tilt Lllw. of thl Co..anw'llth
f)f "'n".vhl.nlt; O\lutlnM "IV bll "~~~I".,r1"v,..,,"ln:, ',!11) "'-1)27.
OOHPLITI PART ! BILCW " " " SII RIVERSI SXDI FOR FILXNG AND PAYMINT XN8TRUOTXONS
A...unt N., 01-61-244597 D.h 05-04-94
htab1l1h.d
6,004.06
50, 000
NOTEI If tal( pav..nt. ar. lII.d. within thr.1
3,002 I 03 (S) 'o"thl of thl dlo.dlnt', date of duth,
, 15 you 'IY d.C.uot I lle dhoount of the tilt dUll
A"~ Inherltano. hlC dut will bIOOIll, dlllnqlJtnt
Pot.ntial Tal( D\ll 450, 30 nlnl (9) .onthe Iftlr th. dati of d..thl
PAaT. TAXPAVBR RBSPONSB
W I FAXLURI TO ~18POND lULL RI8ULT tN AN OFPJCIA~ TAX ASlllllSHIHTIA8IlD ON 'tHUIl'lOnOa I
A, 0 lh. above Infor.IUon "Id hlCduI It oorrtllt. '
1. Yo", III'~ chao.. to rflllllt PIV.."t to thl Rlght.r of WlIlI with two ooP'" of th" notlOl to obtain
. dhoount or eyoJd Interllt, or vou .IV ah.ok bolC "A" end return thlt notlol to tht R.;ht" of
Willi Ind In offlol.I' ........nt will bt IlIuld bV the PA D.pert...nt of Revlnul,
A...unt 8I1.n..
P.r..nt Ta..bl.
A..unt Subj..t t.
Ta. Rat.
M
To In.url prop.r ar,dlt to your looount, two
(2) ooplt. of thl. notlol IU.t looolp.ny your
p'Ylllllnt to the Rlghttr of W1111. Hlkl oh.ok
plyabll tOI ~RIghttr of Will., Ag.nt't,
Ta.
M
[CHECK ]
ONE
BLOCK
ONLY
PART
l!J
TAX RITURN . OOMPUTATXON OF TAX ON ~OX T/TRU8T.ACCOUNT8
"' .
LINB 1, D.t. ht.b1hh.d 1 "' ~ .
2, ~c..unt 101.n.. 2 ·
I, P.r..nt T...blt I . Ii" ()
4. ~..unt Subj..t t. T.. 4 1- tJ tJ t.., I .'"
S. D.bl, .nd D.du.tl.n, I l?
6. A..unt Ta..bu 6 lPU., . tJ 'J
7. T.. R.t. 7 M
e, T.. Du. e
10 0 fhl ebolJ' III..t hu b'ln or will bl rlported Ind talC paid with thl Plnn.vlyanta Inherltanol TeIC ,,'urn
to bl fUld by thl dloldlnttl "pr"ln'tHvI,
C, ~hl Ibnl Inforlltlon IWnoorrlot and/ohJI.lbts and deduotlons Wltl palrt by you,
You IU.t Do"pllhPART l!J Indlor PART l!J b.low,
K r. " pl. I' I a . ~Qur
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
(!]
DATE PAID
PAD
1
2
3
4
5
6
/lU: H.. ~
DIBTS AND DIDUCTIONS CLAIHID
I.':;'
:' ~ r:
"\
--1
I.
DESCRIPTION
,.,1. II..., .. .!.. . .. ,.. .........., l
Und.r p.n.1tl.. .f p.rjur~1 Id.cllr. Ih.t tho fl.t, I hlv. r.p.rt.d .b.v. .r. tru.. ..rr..t .nd
...plth tD tho but .f .~ kn..1.dg. .nd blll.f. HOME (.11)) f},'? {., _ 'J q 17
1Q~. WORK ( ).. .
(;i~A~E ?t TELEPHONE NUMBER
PAYEE
AMOUNT PAID
~
GENERAL I~FORMATION
I. FAILURB TO RUPOND WUL RUUL T IN AN OFFICIAL TAM AilE liME NT .lth IPpll..blo Int"..t bond on Inlorllllon
IUb.lttld bV thl fln.nal61 Inltltutlon,
t, InhtrltlnCII taM bIClO'" dellnqu.nt nlnl lIon'hl a'tlr 'hi dIOlll,,,II, dati of "1.\11,
I, A Julnt loooyn' " '.Nabl"y,n thougll thl dlotd,nlll nft... wn. Added tU n ..U,,. of aOllv.nllne..
~I ACloountl Clnoh'dln, thOlt hlld ~..tw..n hu,blnd Ind wlfll whloh 'hi dlcld.nt Ilut In Joint n'".. wllhtlt on. VII,. prior to
dtl'" ere fully tlM,blt ft' tr,m'f,r.,
It Aooo"'"" ,Ulblhhld Jolnth b.'wII" hUI".ndlnd will liar. 'hM on. Vlllr prior to 1I...'h IIr, not '''kabll,
6, AoClOU"" h,ld IIII' . "Ind,nt Ill" tru.' 'orl1 Inathtr or othlrl art tlM.bl. fullY.
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
l. .lOCI( A . If tht 1"'o,...UO" Ind OOlput,tlan In thl notlGl IIrt oorrlot nnd d'duollonl at. not bllng cl_lllch plaol nn UMfl
In blook "A" of Plrt I of thl ItT.urplVlr ""ponlll" IUllon. Sign two copl.. IInd ,ublU th", with vnur el\,ok for thl alount of
'aM to' the RI,htlr of Willi of the Qountv itldlaatld. Th. PA OIPllrt...nt of R'v.n\I' NI11 IIIUI .n offlolal '..'.....nt
tFor. REY-lIft' EX' upon rlollpt of tht rlhnn frol 'hi R.gltter of Will"
I. aLOCK' - If tht I.,.t 'Plalflld on thlt notlo. hll blln or will b, rlParttd nnd taM plld with thl ".nnnlvanl. Inh.r"ancI
hM Rtturn fl1.d by tht d.Cldlntlt rtprlllntfltlv., placl .n "M" In blook "an of Plrt lof the flTtMPIVIr "..ponll" ..otlon, II,n ani
OOpy and rlturn to thl PA OIPlrta,nt of ",v"nu., nurelu of IndlYldul1 TIIMII, PIPt U06Ol, lllrrhburg, PA 17UI-0601 In thl
tnvllopt pravld'd,
I. 'LOCK el - 1f thl natJo. 'Infor.IUan It lnoorrlult IIndlar dlduotlon, Irt blln, olal...d, ahlok blaok "C" Ind oOlpllt. Parh t Ind I
acoordln. to the Inltruotionl bilow, Ilgn two oopl.. and lub.1t the. with your ch.ok for thl a.ount of \1M pIVlbl. tn th. IIIlhllr
of Willi 0' the oounty Indlut.d, lh. PA DIPlrt..nt of RlVlm~. wlll IlIu. an offlclll ........nt (,,"or. REV.UU EM) upon rlollpt
of thl return frol the RI.htlr flf Willi,
TAX RETURN - PART 2 . TAX COMPUTATION
LINE
1, Entlr
NOTE.
the dill tht looount arlglnllh Will utlblhh.d M tltI'd In tht IInner IMhung It dl'l of dlftth,
For I d.Qldln' dvln. lifter 12/1211121 Ac~oun\l "'flloh the d.aldlnt put In Jol'" n.... wltt'lll' <1"1 (1) y.ltr of duth Ir.
tlM.bll fulh II trenlf",. 1I0M'Ylr, thlr. If "" IlCCllullon not to IMOlld U.OOO "Ir trnl' , ',rll r,gardl... 0' thl yelul of
thl 1000u"t or ,thl nUllb" of looounts held,
1ft double ..terhk (MM) IPP"" blfore your nrtt onll' In thl addr,.. porHon of thlt notiol, thl U,OOO .lColullon
Ilr"dv hlu bltn dlduot.d frol the acoount balanol al rtport.d bv tht f Inlnolll In.tltutlon,
I, Enter th, total bll,nol of thl IjOOU"t Inoludln, Int.r..t aQQru.d to thl dlt. 0' d..th,
I. fhl p.runt of thl ,oooUht thlt I t.Mabl. 'or ..oh Jurvlvor I. d.tlrlllltn'~ .. 'oUelW"
A, ,Th. p.rctnt tlMlbll f~r Joint .".t. utlblhh,d 1II0rt thin on. YII" prior to the d,e.d.ntl, d..Uu
I DIYIDED IV' TOTAL NUHIER OF DIYIDED IV TOTAL HUHIER OF M 100 . PERtEHT TARAILE
JOINT DWNERI SURVIVING JOINT OWNERS
EMI,pll' A Joint .I..t r,.I.t.rl~ In thl n..e of the dlC'dent Ind two othlr p.r.on'l
I DIVIDED IV . (JOINT DWNERIl DIVIDED IV I (IURVIVDRI! . ,161 R 100 . 16,IX llARAlLE FOR EACtllURVIVDRl
I, Th. p.rolnt tllllbll for ....t. oreltld within on. Yllr of th, d,old,nt" duth or 'OOOllnt' ownld bv thl dlClldlnt but ".ld
In tru.t for Inother IndlvJdulUI) ltrult b.nlflclarl.."
I DIVIDED IV TOTAL NUHIER OF IURYIVIND JOINT
OWNERI DR TRUIT IENEFICIARIEI
R 100 . PERCENT URAILE
"
ENI'PII' Joint .ccount rl.I,t.r.d In the na'l of the d'Cld.nt _~d two othlr p,r.onl and I.tabll'hld within on. Vier 'ofd,.th bV
,thl d,o'dlnt,
I DIVIDED IV I IIURVIVDRIl . ,10 R 100 . iOX ITARAlLE FOR EACtllURVIVDRl
4. thl .,ount .Ub/,ot to tllC (lln. 4) I. d.tlr.tnld b~ .ultlplvlnl thl lacount bllano, (1In. I) bv the p.ro.nt tlMlbl1 (1lni I),
Ii Ent.r thl tot. of the dlbt, Ind d.duotlon. ll.tld In Plrt I,
... 'hi ".nt",t tAlIlbl. I1ln. 6) It dltll'ltn.d b'l ,ubtrlotlno the dthtt and dtduatlonl Oinl I) fro. the I.ount ,ubi.ct to tllC IlIn. 4),
7, Int.r thl IRprOprl,tl tllC rltl (11nl 7) II dltlr.ln.d bllow.
A. ~or d,t,1 of dtlth a~ourrlng .ft.r 6/10/94, the talC r.t.. for tranlf,rl to 'POU'I' ar. .1 follow.,
1. Olt', of d'lth on or ,'t.r 7/1/94 end b.for. 1/1/91 th,ret. I. J~,
e, Owtl' of d..th on or .fter 1/1/91 trenl"r' to IpOUII. wlJ1 be teMld It Ok t.~ reto.
Notl' for dltl' of dl.th prior to 11 I'~ tranlflt' to Ipau.e, .r. tIN.bl. .t 6k,
a, Tranlf." to Un..' dlloentllnt. Inoluding flther, .ather, .an, daughter, g,.andohlldrln, IOn"ln-l.w,
d.Ulhtlr.ln-I'''1 ,t'POhUd Ind th.lr .uu. era hMlbl1 at IIN PlrClant (6iO,
C, Tran.f.rl t~ el tlthl" lnoludln. brothlr, ,..tar, unCjlla, aunt, nlphlw and nllol .rl tlMlblt at flft.ln perunt (16:0,
D. If YOU Oh",,1 thl tIN tit., pl.... 'IPlolfV your rllatlan.hlp to thl dlo.d.n' In thl "" provld'd,
I, Thl llIOuntof t.M dul (Un.' I) .. d.ter.lnld bv lultlphlnl the ..aunt teN.bll eUn. 6) bV thl t&le rltl Illnl 7),
CLAIMED DEDUCTIONS . PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowlbil dtbts and dlductlonl II'. d.tlreln.d I' fol10wl'
Al You .t,a'lv II'I r.,poot1b.1 for p.ve.nt, or the Iltlt. .ubJ.o' to Idelnl.tretlo" by I p.t,onll r.pr.l.ntltlv. II Inluffial,nt
t. pov tho dodo.llb., tOOl,
8, YOu 10tuIllY Plld tht d.bt, Iftlr dlt'h 0' thl dlc.dlnt .nd can furnllh proof of plv..nt,
ell Dibt. titln, all .,d IUlt bt It'II'ld fUllY In Part I, If Iddltlonal 'pIal II n,.d'd, u,. pllln plplr . 1/2" IC 11", proo' of
plv"lnt ..v bl rl"ulltld b~ the PA DIPlrt..nt of RlY.nu~. '
T~tP.AV~R A~I~ANCE
R1P.,YOTU liED FU THEIl 1 FOR A'r~O 0 ASIU TANCE, CONTACT V
EG.$ I Oil W L 5, PA IlMltT Il. REV US OUT ICT Oil CII .
CALL. T I R A INDIV1:D A STAY UIRV NIT .IN
HARRlggUR~AT~l'1~ '~~.i~2'1' TAD ('1 ~~. '1h.Q~2 fftlll"YNo IH~R!D ONLY)'
c.tlHHONwrAI.IlI of l'1:NNI'HVAtHA
Ilfl'AlllHtNl or MEVr,HUE
eOAtAU 01 I.01YIIIUAI IAOts
Otl'l, 16060\
IIARAIUUAO, PA 11111'0601
~
INPORMATION NOTICE
ANP
TAXPAYB~ RESpoNSE
PILE
AeN
DATI
NO. 21 ,.91-.(/'17
9114~870
1 0-31 ~97
IIY.lhl't~ ut j,.,,1
Type Of ACCOUNT
EST, OF L L OYO e BRANPT ~ IAVINGI
S,S, NO, 198-07-1149 CHICK%HG
DATE OF DEATH OB-06-91 TRUBT
COUNTY CUMBeRLAND CIRTU.
ReHIT PAVHBHT AND PORH' TOI
ReGISTeR Of WILLS
CUMBERLAND CO COU.RT HOUSE
CARLISLE, PA 11015
SHIRLEY A EPPLEY
11111 CResCENT RD
fRANKLIN . IN 46131
HARRlI IAVIHG' IAHK II.. pr.YIO'O III' O,porl,,"1 .llh Ih, In,.".II.n 11'1.0 b.I.. .1I1.h h.. b..n u... In
..I.ul.llno Ih. pol.nll.' I.' du., Ih.lr "..ro. Indl..l. Ih.1 .1 Ih. d..lh .1 Ih. .b.Y. "...d.nl. Y.U .." · J.lnl ...orlb.n.II.I.,y .,
\hl. ....unl. II YoU ,.., Ihl. In,.r",II.. I. In.."..I, .1.... .hlol. .rlll.n ..r".II.n fr.. Ih. IIn.".I.II".lIlull.", .1I..h · 'oPY
I. Ihl' ,.,. .". ,,\Urn II I. I". .b.Y' .dO"", Ihl. ....ulll I' I.,.b'\. III ....rd."" .llh III. lnh.rll.n.. ,., I... .' Ih. c...."".llh
u, r'fIln",lValll_1 Qijnllu,," "'''' 1:1" <l1l1lt'flllIJ IIr ,""Hlllli tun TOt-aU?,
eOMPI.BTIl PART 1 all.OW II II II SII RIVllR8I 810B flOR Pll.INO AND PAYMBNT INSTRUOTlONS
Aocount Ho. 01-61-244562 O.t. 03-30-94
e.\lbll1h.d
Acoount I.hno. 7 . 004 , 73
P.rollnt T..lbl. M 80, 000
.A~ount lubj.ot to T.. 3,502.37
TaM Rat, 1)( I 1 B
pot.nUll TI. lIu. 825 . 36
, T V It --0':8
LPA1l.URI TO RI8POHDlof11.1. RIBUI.T IN AN OPpICIAI. TAl(. ABBallIU".H" .JA81l11 C1H1'HX$NIHXC,B
A. 0 Th' Iboy' Inforlll.Ul)h and.'taM due 'I oorrlot.
.1, y.u ..Y .h.... I. ".11 p.y..nl I. Ih. Aogl.lI, .f .111' .llh Iw. ..pl.. of Ihl. n.lleo I. nblaln
. dl.oount or ~Yoid lntqrllt, Dr you lIIay ohlok boM "A~ ana r.turn thll not1cI to thl ~,gll'lr af
Willi and an offlolll '~I"I'.lnt wlll bl llluld by thl PA PIPartMtnt of Rlv.nul,
.
To Ii'\lur.. prop,r aridlt tn your IIICOQliM:, two
(2) CQPhl of thll not\OllllUI\ 'ClClo..P~"W YDur
p"Y"ln\ to thl RI"h'lr af WUlI, 14111.1 ohlok
~'Vlbll '\01 "R,,,hhl' of ~Illt, A~lnt"1
H01~1 If tft~ pav..,,"tI ~r' nd. lfl\hln thrll
(S) 1lI0nthl of thl dIOI~lnt" dl'l nf de.th,
vou IIIlty dlduot II 6X d\lool,lnt of thl tlK dl,ll;
Anv lnh.rltanal tlM d~' wl11 bleo,' delln~Vlnt
nlne (9) Manthl aftlr thl dat,ofd,.thl
[ C~R~K ]
BLOCK
ON LV
a, 0 Tho .boy' ....1 ha' U... or .111 b. "p.rl.d a.d'" paid .Ilh Ih. po"n,Yly,nla Inhtrllln.. T.. "M.
to bt fll,d bV thl dlCed,nt" rlpr..,ntltlv'l
.C, ~h' .U.Y' Inlo"all.. 1,.,.~hC.r".1 ."dl.r...J\,bl, ohd d.du.Il.1Il .0," p,ld by you,
. "'ou !lUlt ODIPl.tt PART W Inn/or .' PART L!J b,lOW;
PART 1f~ou lndlo. . . dlff.r.n .. r'l'f.plo... I .t. ~our
00 rol.Uon.hlp to d.ced.ntl .. 1.1, 1_~ .- .-
TAl( RITURN . COMPuTATION OF TAl( ON.JOINT/TRUBT AoOOUNTS PAll
~lHB 1, O.t. ht.blhh.d 1 "1 ~ ...~.' q 'L 1
a. Ao.ount e.hnc. 2"7 /J .~ 11,1 ) 2
5. p.ro.nt ,T...bl. 5 M ~t/ ~
4, AMount Bubj.ot to T.. 4 , c: lI?. . '1 7 4
I. D.bt. .nd lI.du.tlcnl B (2 5
6, AMount T...bl. ,: " t; 1)? : 'J 7 6
1, T.. R.t. 1 K .J,1:Jt.z 7
I, T.. Ou. I ''2./ v, I '1 :, 8
plaTS AND IlIOUOTION$ OI.AIMIP
!lFF1CIAL USE. ONLV .tJAAF
PA ,DEPARTME.NT QF. ,RE.VaNUa
,....c'.
..... ~ "
, .'"
, L~
. '; j ~~'l
'.',
,,:-.1
P&jT
DATE
PAlO
PAYEE
DESCRI PTION
AMOUNT PAID
n .r on Inl of .. o~pu. on
f.ot. X h.V. r.port.d .boy. ",. tru.. oorr.ot .nd
1:l0ME ( .11 7 ) ~ '1 I - 'J '/ '17
WORK ( )
TELEPH~NE NUMBER
,-
GENERAL INFORMATION
1. 'Al~U"1 TO RBlPONO WILL R"U~T IN AN OF'ICIA~ TAM AIIUIHENT with .pplI,.~I. In'''''\ ~...d 'n Inf""lIon
lub,.ltttd bV thl fln,ocla' 'IntUtuUan.
" tnhtrlt,"CI 'llC blQQlIJtlI d.ilnqulnt nln. flont'" aftar till duoedln"1 dati Df duth,
). A Jot"t 1000U", ,It tIMablt 'VI" though the aIGldl"t'l /\l1ll.1 wtll mldlll at II IIII'hr of C10nVI"","a'r
ii, Alloounh OnOhidlng tho.. hlld bit...." tunblnd and wlf,1 Hhloh thl IIleld.", flut In Joint ""... within on. nar prior to
dlllh ar. fullV tanbl,.. \ta"I,.rl,
I, Aooounh ..tlblh".d Jointly blhltl" hll'ba"d and wi" 1II0r, th.n on. Vlar prior to d.,th art not hMabl..
6. AoeQUO" "lid bV . dlCldlnt n In truI' for" .nother or ot".r. .r. tillable fullv,
REPORTING INSTRUCTIONS - PART
1 - TAXPAYER RESPONSE
I, .LOCI( A ~ If the Infor..Uon and OUtPut,Uan In tht noUu ar. oorreot Iml dlductlon, IIr. not btl", oltl.'d, plto. an "M"
In blook "A" 0' P.rt 1 Of th. n'.ICPIVI" RIIPon,," ..otlon, llgn two cop I.. and .ubllt thl' with your ohlok 'or thl ,"ount of
ttlC to thl ",vl.t.r 0' Will. 0' the countv Indloatld, fhl PA O.part~lnt 0' R'V'PUt wl'l 1"uI.n 0"101.1 ........nt
IForl REY-lIft. EM) upon r,ollpt 0' th. rlturn fro. th. R.glttlr of Will.,
2. 'LOCM' - If the a..lt 'Plolfhd un thlt notlol hat bn" or wlli bl rtportld and talC paid with thl PlnnlV1Ylnl. Inhlrltanol
TalC Rlturn Hied bV thl d'cldlntl, r.prl..ntatly., pl.oI fln "Nil In blook "I" 0' Part 1 0' th. "hIlP.y.r R"pontt" ..ollon, 81un ani
oopv flRd r.turn to thl PA,DIP.rt..nt of Rlv.nu., lureau of Indlyldu.1 TaICIII P.pt 210601, Ilarrhburg, PA l11U-UOl In the
Inv.lop. provldld,
J, aLOCK C - If the noUn Infor"ltlon II lnoorrnt andlor d.duotlon. arl b.lng ol.huld, chlok bl001l. "e" and oo.pl.t. Par" e and S
cuordln. ta the lMtruttlon, t1tlllnw RIO" tWit nuplf," ",.,rt '1Ib..lt th... with vour oh.ot< for t..,. "!lount of talC paYflblo to thl Aull'-r
of will. of thl oountv 'ndlo.ted. the PA PIP.rtllnt 0' R,vlnuI will I..y, 'n offlol.1 ........nt (ror. REY-l6"" EMI upon reCllpt
of thl rlturn frol thl Alllltlr 0' Willi.
TAX RETURN - PART 2 - TAX COMPUTATION
~IHE
I. Enter thl dlt. thl looount orllln'llV Wftl "tablllhld or tltl'd In th. ...nner 'Il'htlng at'dl" of dllth,
NOTEt For I dlo.dlnt dvlnll after 2I12IUI Aoooun" I'fhloh thl d.eldlnt put In Joint na"1 within onl (1) vur of dllth Irl
hlClble fuU~ II tran"erl,; lIowlvlr, thlr. is In .1l01u.lon not to lIColld U,OOO ptr trln.f.rll rlgardl." of the y.lu, of
thl Iccount or thl nU.b,r 0' looountl hlld,
11 . dovbl. Isterisk (1Ut) app..r, b.for. vour flrlt n... In the addr... portion of 'hit hotlOl1 thl U,OOO IWclullon
Ilrl'dv hll bl.n deduotld fro. the .ocoun' ballnol .1 rlPortld bv th. flnlnolll lnltltution,
2. E~t.r 'hi totll b'l.no. of thl aoo~unt Includ'ng Int.r.lt locruld to thl dltl of dllth,
S. Th. p.rclnt of th. Icoount thlt II hMlh'.- for IIch lurylyor II d.ttrl'nld II foUowlI
A, thl p.ro.nt tI.lbl. 'or Joint ...."., IItlblhhld 1I0r' thin on. Vllr prior to thl dlcld.nt'. d..tht
I DIVIDED IV TDTA~ HUHIER OF DIVIDED IV TOTAL NUHIEA.D; M 100 - PERCEHT TAMAIIE
JOIHT DWHERI IUAVIVIWD JOIHT OWHERI
EIC..plll It ,Jol"t ",~It rlglltlr.d In thl na'l of the dlC.dlnt and tlul oth.r perlont,
I DIVIDED IV I IJOIHT OWHERIl DIVIDED IV 2 IIUAVIVOAIl - ,1" M 100 - 1b,7M IUHUlE FOR EACII IUAVIVDAI
I, Thl p.rclnt tllClbl. 'or "'Itl cr'tt.d wlth'n ana V'ftr of the d.ead.nt', dllth or acco~ntl ownld bv thl dloadlnt but h.ld
In t"Ult 'or .nothlr 'ndlvlduIUI. (trult blnlflohrl..)1
I DIVIDED IV TDIAl HUHIER OF IURVIVINO JDIHT M '100 - PEACEHT lAHAlIE
OWHEAI OR 'AUIT IEHEFICIARIEI
e."pllt Joint locount r.glltlrld In thl nt.. of thl dlc.dlnt and two othlr plrlon. Ind Ilt.bll'h.d within on. v"r of dl.th bv
" thl dlO:dlnt I
I DIVIDED IV 2 ( URVIVDRIl - .10 M 100 - 10M IUHUlE FDA EACU IURVIVORI
4.
I.
,.
7. .
The ..ount .ubl.ot to tow (l~nl 4) II d.tlralnld bv .ultlplvlnl th. locount blllnOI (11nl ,) bv th. Plrolnt tlwabl. (lina J),
Intlr thl tOtl 0' thl dlbtl .nd dlduotlon. llltld In Plrt .,
Th. .''':'\oII,t t61i,t..l. C1l1'" to) Li d'h'~jn'd bl Jubtrtl~Ur.liI ttlt (h.bh ."d "oi.,u,tJonJ ClIr;' ~) (rol, tI.. foJ:l:'..,.'t ,ubjlOt tc tau Ulna "J.
enter, thl approprll" tl. rat, Olnl ) II dlter.'nld bllow. ,
A, Fa" dltll of d..th oaourrlng IHlr ""19ft, thl hw rlt.. for tre,1I\'I'rl to IpauIII Irt II foUow'1I
1, D'tl' of d.lth on or Iftlr 7/1/94 Ind blforl l/1t91 thl rat. II IX,
t, Dltll of d'lth on 0,. .ftlr 1/1/91 trlnl'I,.1 to Ipau'll will bt tiMid It OX talC rlttl
Hot'l Fo,. d't,. of dllth prior to 7,t/9~ trlnlftr. to tPa41., Irl tlwlbl. It 6~,
I, Tranl"r, to lIn,.1 d"llndlntl Inoludlng flth.r, .othar, .on, d.ughttr, grandchlldrln, lon-In-l"',
dtulhtlr-ln.llwl Itlpoh ld Indth.lr 1"1,11 Irt tlIClbl1 .t I'r .p.rotnt (6X), '
C. Trln'f.r' to II othlrl 'ncludln" brother, Illtlr, unoll, aunt, nlph'w ,nd nl.o. Irl tllClbll lit '1ft"n Plrclnt (UX),
D. 11 you ahlno. thl t.1l' r.,t., pi.... IPulfv vaur rlhtlonlhlp to tht dlcld.nt In thl ,,.,, provldld,
I, fhl ..ount of t'M due Cllnl II II d.tlr"ln'd b~ aultlplvlng 'hi ..aunt "lCabl. (1In. 6) bv th. t.w rlt. (lln. 1),
CLAIMEO DEDUCTIONS - PART 3
OEBTS AND DEOUCTIONS e~AIMED'
AlloWlblt debtl and deduotlonl arl dettralnld II follow,l
A, You l".llv ,r, rllPan.lbll fnr PlVllnt, or thl'l.t.tl lubjlot to ad.lnlltritlon by ,p.rlon.l r.pre,.nt,tlv. II In.ufflallnt
to P'V \hl d'du,tl~11 It....
I, you 10tuaUv ..,Id thl dlbtl If tar duth of the dto.d.nt and OIn furnish proof 0' PIy..nt,
0. Dlbt. b,lng oal'.ld .u., bl 1",IIld ful1v In Plrt I. tf Iddltlonla IPIOI l. n'ldad, UI' pl,lh p.p.r . Ill" w 1&". Proof Of
Ply..nt .ay b. r.~..tld bv thl PA D.p.rt'lnt af R'vlnu.,
-
Iic YOU NEW FU~THaR TI'O\VJA\t~fO~A*C~ST~C~1 co~rtr:T~~Y .
. .' OR RCAltILSTrt\ OIlURWJiuSo'F PtNDI~rI~'t1A1EIf;A~ESl Ih\'lPA"v/R SlJlqUCIRr NI' IN
HARRISBURG AT (117) 787-8327, fD~' (7i1) 712-2212 (HEARiNG 1M A RED ONLY)
COHHOHWt:AlTIl Of' N:NHSVlVAHIA
OLI'AHtHtHf Of RtYCHUE
.u,,:AU or IHOIVIDUA~ lAME.
DfPT. moo'
ItAHIfIr.eURO, I'A l1lU-060\
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FX~E
ACN
DATI
NO. 21 - C; 1-f'l7
91146569
10-31-91
UY'\HIII iH 1""1
TVPE OF ACCOUNT
EST, Of' ~~OYD E nRANDT ~ S~VlNQI
S,S, NO, 196-01-1149 CIIBCKINO
DATE Of' DEATH O~- 06-91 TRUST
COUNTY . CUMnER~AND eaRTH.
ReMIT PAYMeNT AND rORHI TO.
REGISTER OF WI~~S
CUMnERtAND CO C.OURT HOUSE
CARLIS E. PA 11013
SHIR~EY A EPPLEY
18.11 CRESCENT RD
FRANK~IN IN 46131
HARRU SAVINoS 8~NK h.. pr.vl~l~ Ih. Do.orl,"nl .lth Ihl Inf.r..II.~ 1I,U~ hi'.. .h'.h h.. boon U..~ In
clIlouhUng thl pohnthl tax duI. Thllr rlQord' tndlQflh that Q' the d18th (:If thl auovl tlloadtnt, vou Wlrl a Jilin' ownlr/b,n.flolflry of
thl. looount. 1f y~u fill this tnfcmllaUon, I. InoQrrlot, pita.. obtatn wrltte" oorrtlo\loo frClfll 'hI financial In.tltuUon, .\t.Oh It collY
tll thh fori and rlturn 1\ ta th, above oddr..I, 1'hh aOQount I. trucable In aoaordlnOI with thl lnhtr1\ftnol TalC law. of thl COllllllllonwulth
ot "1"n1,:t,vllinlltl uuUtlQII. "av lJliI anlw.rlU bV olii In., I, llJ "'''~U':',
OQHP~ITEPART 1 DI~OW N N N '811I RaVIRIII SIDI POR PXLINO AND PAYHINT INS'tIlUOTXONS
Acocunt No, 07-61-244514 D.t. 02-12-94
eo hbl hh.d
AODount 8111"0. 31 ,021 ,28
P,ro.nt T...blo K 50 , 000
AMount lubj.ot to T.. 15. 51 0 . 64
r.. R.t. M . 16
pchnU.l Tt. Duo 2. 326 . 60
PffiT .... TAXPAYER RBSPONU
1 fiiAXLURI. TO. RIl8PtUiD. ",:m'. KlllfUl.l. IN. AN ,O,~tI~OIA~ TAl(ASnl;SNBNT JAUDON 'l'HX8 HOnOll
AI c=J Tht above Infor~atlun And taw nUQ 1. oorr.ct.
t. Vou ...~ choo.. to rllllltt paVllII.nt to'\h.'kul'hr of Wills with ,.,0 Gopl.. of thlt notlol to obt.l"
. dltCQuot or avoid lnter..t,.or Vall Mav C1heck bOM "A" Md rlturn thh noUol to thl Rlahtlr of
IH1h and aft off lola' ........"t HUl ~. h.Uldbv thl PA Olp.tt"ent ofRlly.nul,
To lo,url prop,r orldit to your ftooount,"two
(t.) copl" of tht. no\lol IIU.t aaoollllpanv voyr
PltYIlIDn' to thl Rlglitlr of Willi. Hake ohlak
pe,vabll tal IIR~"ht.,. of WllU. Ag.nt...,
HOTEl It tell PlY""" arl ..de wlthln tht"
(I) .onth, of th, daOia,ntis dati of d,.th,
you lIay d'duot . &~ dl.oount of the taw dUll
Anv lnhlrltanal \elM dul will btOOIllI.dtllnquln\
"In. (91 1I0nth, after thl ~ltt. of'd.ath,
[ C~n~K ]
BLOCK
ON~Y
81 [] Thl above a...t h.. b'ln erwll1 bl rlport,d and taM paid w(th thl p,"nlvlvanla InhlrltanclTaM return
to b. filed by thl dlOldlntl1 r.pr..ent.tlv..
C, Er!hl abovi ,1nforllll.\1an lJ..),noorrect ll.nd/O~'bh .nil 'dlduot Ion. w,4rl paid bV yOU,
Vou IUlt oallpllt, PART L!J andlor PART l!J bllowl
OFfICIAL USE ONLV OMP
PA DEPARTHENTOPREVENUE
PART
I!J
TAX RITURN . OOMPUTATION OF. TAX ON JOXNT~RUBT ACCOUNTS
LINe 1. Dot. hhblhhtd 1 ~ -/2.. ~t'f -
2. Aocount 801.nc. 2.:ll J.i _I. '?.
I. P.roont T..tblo I M . 112..
4. AlIIount lubj.ot to T.. 4 1'i''''J[)~/' y
S. Dtbtl .nd D.duotlonl S L?
~: ~::u::~:'.OblO ~ M '::'{hi:
PART
l!)
DATE PAID
PAn. _
1
2
3
4
S.~
6
1
8
paD'tB AND DEDUCTXDNB O~AXHID
t') (~:I
".~ [ .,
',.I.'i
,
,;;:J.},
L:I
1,'__.
'-"
-
PAVEE
DESCRIPTION
d ".,,,'" ""' · .. '" .".., ., ''" ,
AMOUNT PAID
!
Und.r ptn.ltlt. of porjur~, I d.ol.rt thtt tho f.ot. I
colltplttt to tho bt.t of lII~ knowl.dgt .nd b.ll.f,
-A~'IM~~~~A~l ~\
h.vt r.port.d .bOVt .ro trut. oorr.ct .nd
HOME \ J I? ) 'J.3 ... ,? 0/ r '7
WORK () JL~
TELEPHONE NUMBER ~
" .
.'
GENF.RAL INFORMATION
I, fAILURI TO RII'ONO WILL RklULT IN AN OffICIAL TAM AIIUIHSNT .lIh'appllolbll In\"..1 hl..d on Inlo",\lon
.ub.l\lld bv 1111 IInlnolll In.t1ldllon,
t, Inhtrlt.nol till blGO... dlllnqy,nt "'nt llIanthl ."Ir thl d.oldlntl. dlt, of duth.
I. A Joint IOClaU"t h t..able,IVI" though thl dIG.dl"tl, 0.... "" .dd,d ell " ...U" of convlnl.nol.
~I ADoountl tlncludlng thou hlld bl'lf..n hUlband IInd wlfl' whln" thl dlold.nt put In Joint nit.., within on. v",r prl:lr to
d"th ar. fully tlM'blt II trl",f,rl. .
I, Allllount. ..,.blhhld JalnUv bltwII" hUlband tnd wlfi 11I01" thin an. v..,. prior to d...th art not talC.bll,
6, AGOoun" held by . dlOldlnt "In \1'\11\ 'or" Inothu or other, II" h!Cable fUlly,
REPORTING INSTRUCTIONS - PART 1 -TAXPAYER RESPONSE
I. 1l.0CK A .. If thl IMar-nUo" 'nd OUfllputl'ltlon In thl notlol II" Clorrlot ,nu d.dllot1onl ar. not blllng 01,1..'d, phil In "K"
In blaak "A" of Plrt 1 of UII tlflllplnr A"pon'l" "Cltlon. Ilun two copl.. Dnd .ubllt th.. with your Qhlok for th" ..aun' 0'
till tea the R.glttlt 0' Will. 0' the Gountv IndlOI'ed, Thl PA DIPltt.,n' of Rlvlnu, wUI IIIUI ", offlcl.1 in....."t
"01'. RCY.lI'" EM) upon rlollpt 0' 'hi "Qt,,'1\ '1'011I th. RItJlII\" of Will.,
'1 ILOCK'. If thl ...., 'Plolft.d on thli notlOl hll' \lit" or will b, r,portld and tlllC plld with 'hi Plnnlvlvanll Tnhlrl'lnol
lite R,turn flhd bv thl dlold'n". ruprll.rUIUy., phOl II" "K" In bloo~ "a" of Part I of the "TaIlPIv.r RI,pon.." lIotlon, Ilgn a'll
oopv Ind return to the PA DIP,rt.lnt of R'Ylnu" auruu of lndlyldull "'1111, Plpt 280601, lI.rrlsburg, PA 17128'0601 In thl
Inv'laPI provlald,
I, ILOCI( C . If the noUn Inforlllltlo" It Inoorreot Ind/or dlduqtlon. art bllng 011 Iud; chuk block "el' IInd cOIllPhtl Pllrts 2 Ind S
lOoordlr\1 to tho lnctruoth"o' bololl, Clen tI/o ollplu Gnd .OIbIU tM., \~lth ~llur /Jhaolt '(Or tho JIllOUl1t 0' \/Ill p~Ylb1t t~ the RIl:'htc:'
of NUh of thl OQ~tv Indlottld, ,'h' PA D.p,rt..nt of Rlv.nul wlH "'.ue In off 101.1 ........nt (For. ftEY-U41 EIO upon rUllpt
of the r.turn frol thl R.gl.t.r of Will..
TAX RETURN . PART 2 - TAX COMPUTATION
lINe
I. Ent.r the dltl thl looount orltlnlllv WII IIt.bllthld or. tlthd In the .',,"11' "dlU"g It dlt. of dllth,
HOTlI For I d.o.dlnt dvlnl If Ir II la/te I Aocountt whloh thl d.cla.nt put In Jo nt "..... wlttll" on. (1) VIII' of d..th Ire
tlM.bl. ful1~ II tra"t'''', tlOWIVlt, ttl"t It .n 11Iclu.lon not to tMOlld U,OOO pit tren.hrll reuardl... of the vtlu, of
thl looount or thl nUlhlr of ,DClGU"t. hlld,
If . doubl. ..ttrhk (M") .pp.art b.fore your ftrtt n,.. In the .ddrl.. portlon of thh not h., th. U,OOO 'Molu,lon
,lr.adv hi' b.t" d.duot.d fro~ the aoooynt ballnul I' r,portld b~ 'h. 'In.nolll In.tltutlon,
.. ~ntlr thl tot'l bll.nol of thl .ooount Inoludlng Int.r.,t leoruld to th. dtt. of d.,th.
II Thl Plrolnt of thl loeount thlt I' t'.,bl' forl.ch .urvlvor I' d.tlr.lnld .. fallow'l
AI Thl PlrOlnt "I..bll 'or Joint ....,,, '''lbl1tttld lor. thl" onl V,II' prior to thl dlllld.nt.. dllthl
I DIYIDED IV ,rOlAl HUHIER OF DIYIDEO IV TOTAL HUHIER OF K 100 . PERCEHT TAKAllE
JOIHT OWHERI IURYIVIHO JOINT OWIlERa
bl.pll' A Joint ....t r'ClI.t.rld In thl nil.. of UIV dlOldlnt and two other p.runl,
I DIYiDED IV I. (JOIHT OWHERaI DIVIOED IV I (IURYIYORU . ,161 KIOO . 16.IX CTAKA6lE FOR tACt! IURY1VDRI
e, Thl plrOI"t tlMlbllfor "'Itl cre.tld within a'll V'lIr of thl d.cldlnt'. d'lth or locountl ownld bv thl dlctdlnt but hlld
In trult for .nother IndlvldullCll Ctru,t bln,flolerlll)1
I DIYIDED IV TOTAL HUHIER OF IURVIYIHO JOIHT
OWNERI OR TRUIT IEHEFICIARltl
EMI.pl.1 Joint looount r.gl.t.r.d In thl n... of thl dlc.d.nt .nd two oth.r plr.on. and ..t,blllh'd within on. ~'.r 0' death bv
the dlOldlnt. I '
I DIYIDED IV I (IURYIVDRII . .10 K 100 . lOX CTAKAllE FOR EACt! SURVIVOR)
K 100 . PERCEHT IIKAlLE
4, Thl ..ount lub/IOt to ta. Uln. It) II d.terllnld bv lult1plvlnu the 10 count ballnOI (llnl t.) bv the Pltolnt h.lbll (l1nl S),
I. Inllr Ihl loll 01 Ihl dlbll Ind dlduollon. 1IIIId In Plrl I,
6i TII. ......."',14 tll".bt., 011111 6) hi lh,tllrllllltd uv ~uuttlctlnll tnl' u,bll am' aeuyodo"1 (jln. I) irol thl ..oun' ,ubJIO' to t..IiI (IIn. 'f),
,. _"tit thl IPpropr'ltl tlM rltl (lln. 1) a. dl~lr.ln'd blloN.
A. ~or dlt'l of d,.th ooourrlng Iftlf 6/.0/9~, thl '1M r,tl' '01' tr.n.flr. to .pOU'I. II'I II folloWI'
I. nlll. 01 dlllh on or alllr 1/1/9~ Ind hllorl 1/1/91 Ihl roll I. IX,
I, Oltl' of delth on or Ifttr 1/1/9. trln.flf, to IPOU'" will bl t.Mld It OX taK ratl,
Hotll For dltl; of d.lth'prlof to 111/9~ tr'n,f.r. to IPOU... '1" tltelblt It 6X,
a" Tfln.flrl to 11""1 dllOlndlnt. naludlng flthlr, Mott'tlr, IOn, dlullhtlt, grandohll~rln, .an-ln-1IIw,
d~aht'f.ln.ll"~ ,t,pohlld and thllr IIIU' are tlxab). .t .IM Plrelnt (6%),
C, frin.f." to "I othlrl I~oludlng brot"'tr, "liter, utltl4, .unt, "tPhlw l'1d nllce It. tlMlbh 1ft' flHlln Plrclnt (,1&:0,
h, If you ohlng. t . \tte f.h, ph..1 ,p'o tv ~our rlhtlnn.hlp to thl dlcldlnt In tht .r.. ~rll.,lrtld,
a. th. ..ount of tlM dut Cl1n. a) I' d.ttr.ln.d bv llul,lplvlnl thl i.ount t'lIlb~1 (II'll 6) bv till' ',,, rl" Cllnl 7),
CLAIMED DEDUCTIONS - PA~T S
DEBTS AND DEDUCTIONS CLAIMED
A'low.bll d.bt. end d'duotlon. 'rl d.t.r,In.d .1 fallow'l
A. You 11,llh .re ",p,on"blt fo,.p.v..nt, Of thl ..tatl ,ubJlOt to ."Inlltt.tlon b~ . p,' ),,','1 rlpr.llntlllvl It In,ufflellnt
10 PIV Ihi .Iduollbll 1111',
a. You 10tUIUV plld thl dlbtl Ifter duth of the dlold.nt IInd oln furnllh proof of plw..nt,
C. Olbt. blln, olll..d .ult bl UII.lld fullv In Pert I. 1f .dd1tlonll,p'~1 11 ""aad, uu 111111"1 PiPit. 11." te 1\", Proa' of
p.W'I~t "v bl r.qul.tld b~ thl P' D'Plrt.lnt of RIy.nut.
TAXPAV~R ASSISTANCe . .
1 YOU NEED UTE I FOR TIO 0 S 1ST CE CONT OT Y
RlGISTHR 01 SIL~~, ~A ~EPA ~MIlN~ O~ ~1l\leNu1 DI'STRIC'I' optNh
OR CALL THE DUREAU OF INDIVIDUAL IAXESl TAXPAYER INQUIRV UNIT IN .
HARRISBURG AT (717) 787.8~27. TOOl (7 7) 712-2252 (HEARING IHPA RED ONLY)
h
COHHONWtAl III or I.CNN8VlVANU'
nr.PAHT"tHT Of REvumE
BURt AU 0" 'WDIYIOU'~ TUU
O~llt, ta0601
"'RRlGbURD, p, 1II11-0LOI
*
INFORMATION.NOTICE
AND
TAXPAVER RESPONSB
PILI
ACN
DATI
NO. 21 ,-91'~?''f/.7
91146569
10-31-97
U.,IUlum 1109"
SHtRLEY A EPPLEY
.la71 CRESCENT RD
FRANKLIN IN 46131
TYPE OF ACCOUNT
EST. OP LLOYD E BRANDT ~ IIIVINOI
S.S, NO, 198-07-1149 CH8CKINO
QATE OP PEATH Oa.06-97 TRUIT
COUNTY CUMBERLAND ceRm.
R8HIT p^VHeNT ^ND FDRHI TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS IAV%N08 lANK h.. pr.Yld,d Ih, P,.,rl"nl with \h, In'.r..llon 1I,\Od .".. .hl.h h.. ."n u"d In
aelout.Un; thl pot~nU.l Une dut, Th.lr racord. Indlaat, that at thl death of the aboYI c1ia'dlti\, YOY WJr' " Joint own'/"/b'r\.flalllr~ of
this looount, If You f.., thh lhforllllUcm It 1000orrlot, Pl.... obtain wrlthm oorreoUoh frail thl Unanolnl Inltl\utlon, .\taah ,. oOPV
to thh forll and r.turn it to the above addr.... thl.. aoaount I, \luclbh In aooord.npe with thl Inhlr!tllnol TaM lawI of thl 00.11I00....1\11
of f<wltlifVIVft1lht" Qy..thulW IIlwVbt ~11,w.HnJ LJ~ "dlllhll (Un 1&7-6317. '
CCH~LITI PART 1 IILOW M M M 'SII REVERSE SXDI FOR FXLXNO AND PAYHINT XNSTRUOTIONS
Aooount No, 07"61-244914 Olte 02-12"94 \. In'"" .rDpor ."dll I. v.ur ....un\' I..
S.t.blhh.d (21 oopl" of thle noUo. ''''It looo'plnV vour
pavllI,nt to thl Rlahhr of Willi, Hak. ch,Ok I
paY.bl' tOI IIRIght,r of WIlI'1 Ag.nt",
Aooount BolonD. 31,021 .28
P.rolnt TIWlbl. M 50 , 000
HOTEl If hI( plly",ntl art ..de within thr-..
A.Dunt 8ub~.at. to TIW 15, 51 0 . 64 (II ..Mh. .f Ih~ doc.d,n'" d.I, .f d..lh,
TaM Rat. )( I 1 B yay III'V d'du,ot a &~ dhoount of th., hI( dUI.
t .i. Any tnt\lrltanu taM dUI ~111 blOC"" dlUnqu.nt
. PO .ndol TIW PUI , ,2,326.60 r,ln, 191 .on\h' ."Ior \h' d.ll.f d..U,.
liAl\T . TAXPAVBR RESPONse, . .'
w r;AXLIII\'~C1I\B8POND WILL. RI8U~TXNAN.OFPIOXALTAX ASSBS8H.'Nr .MI'"Qtf'rHlIlNQ'r~llil
A, 0 Thl abovI Infor..tlon and 'tllC dUt h oorrlOt. '
. L Vou ~.y OhOO.. to ru..it plIVllllnt to thl RIghhr of WUlI with two cop I.. of thh notlol to obhln
. discount or .vold Intlr..t, or vou t1av qhwak bolC "A"'And rlt",rn thll noUct '0 thl R'Ghtlr of
Wtlll and an offlolal ......~.nt will bl hlv.d by th. itA Oapartllt.,,, of R.VlnUI.
II 0 Tht ,abov. ....t hat bltn 01' wlU b. rlPo'rtld ,nd tll( paid ,WUh th.' p,nn,'VllJlnla Inhtr-ltanClI TalC r.'urn
'0 bl Ulsd b~ thl dleld'nt'. I'lprl..ntatlvI.
C. [a1hl abov. Infor.atlbn lWncort'lot and/o~'bh and d.duoHon, w.r. ~ald by ~ou,
Yo", ""'It coaplltl PART Wand/or PART L!.J b,loW,
PART If ~C\l lndlal . I dlffor.n . r. lo..1 I I . ~our OFF.CIAL\II$E(lNW eJAAP'
[!] r.lIU.nlhlp ta dlOldlnt I RA DEPARTI'tE"FQ~.~EIi&:"UE
TAX I\ITURN . OOMPUTATION OF TAX ON JOINTI RUST ACCOuNTS PAD . ' .
LIN8 1. Dlte 8otlbUlh.d 1 -'" , 1 .
a. lIoc.unt hllnal a 2
I. Plrolnt T...bll I M ~ c2. 3 .
q. A.aunt lubj.ot ta T.w q I ~ r; J p. (, 'I tt
8. D.bh.nd DlduaUanl I ~ S
6. A~.unt. Tlw.bl. 6 ,J~- r:;:~ '1 6
7. T.w R.te 7 x _ _ _ __ 7
e. TI. Du. I '~ If 8
DEBTS A"~ ~IDUOTXON8 CLAIHID
[. C~~~K ]
BLOCK
ONLY
PART
I!I
DATE PAID
PAYEE
DESCRIPTION
~, ",;,. .. I... . .f ,......:,.....,
AMOUNT PA I D
I
.
Undlr PlnllU...,af p.r~ur~1 % dlallr. t".t th' f.oh I
Do.pl.t. t. th. bllt of ~~ knowl.d,. .nd blll.f.
T~~~tJ.~
hlYI rlPort.d IboY. .~. trll', oarr.at ond
liQML...h\I"J ) 1}:~1._1H"
WO R K () l..L...llLdJL
TELEPHONE NUMBER ~
-
OENERAL INFORMATION
1, fAILURE TO RUPOND WI~~ RUU~T IN AN O"ICIA~ TAM AIIUIHENT ol\h .ppll..bl. Inlo,.., bOlO. .n Ihf"~.II.n
IUblUt.d bv thl flnlnoll' I","\utlo".
!t InhtrltlnCII "lilt bloo'" d,llnqulnt nln. .onthl .'tlr 'hi dlctdtnt', dtltl of d,,,th,
I, A Joint loooun\ It t,l(lbll .".n thou8h Ih. dlaldlnt', n... Will "ad,d .. .. ..alter of (l0I1v.llllll0l,
4, AQoountl Clnoludlnll 'h(lll h.ld ...t....n h!,.llb,nd IIMU wl',1 ..t\loh 'hlllllo.dlnt put In Joint nil" within eml v..rprlar to
dllth Ir. hHh tlle'b" .1 'rlntf,rs,
I. Aooounh IItabll'hldJolntlv b.'....n hUlhlng .Ild wHt 10rl thin ant Yllr prior teiu..'" art not te""bll.
6. '0001,.1.,,, held b~ . dlGlutnt "In trult 'Dr" "nothlr or atht,., arl ',x,bl, fully.
REPORTINO INSTRUCTIONS - PART 1 . TAXPAVER RESPONSE
L noeK'. 11 tht lnfor..Uan and ao.putaH"" In thl naUal _",ClOt',.ct Ilnd dtduathm, IIrl not being Olll"d, PhOf an "1("
In blook "A" of Pert' of thl "TftNPUI" R"pontl" IIGoUon,Ilgn two oopl., and .ub.1t th,1 with your oh.ok for thl lIount of
tilt to the A"ht,r of Willi of the oountv Indto.lId, Thl PA OIP.rt..nt of Alv.nut will I..u, an 0"10111 .........nt
(For. REV.UU ~IO upcm rlollpt of thi r.tvrn fl'o. thl AI'''t'' of WUlI,
" BLOCK' - If the ....t 'PlGlflld on thh notto. hI' bun or will b, reported and tiN paid wJth the Plnn.vlvanl. Inherltenol '
TIIC R,turn fllld bv th' dlo_d."", r.pr..,ntltlv" pliO' an ")(" In blook "I" of Plrt 1 of thl "hN"lvlr A"pon'I" llOttO"1 II,n on.
OOPv Ind return to thl PA Plpartunt of RlVlnu., lur..u of IndlYldul1 hN", p"pt U0601, Illrrl.burll, PA 17"1-0601 In the
I"Vllap. proYld.d,
I, aLOCK C - If the notlcl Infar..tlan II Inoorrlc\ andlor d.duotlon, er. b.l"g IIl,I'ld, chICk blook "C" Ind cOIPlltl Plrh I ,nd I
loanrdh,,, tet thl In.tructlon. bilow, lip" tW9 oClpll1 IInd ,ubi" th.. with your eh.ck for thl ..ount 0' tlllC PIVlbl. to the R.ght"
of Wllh Of the ClfJuntv tndloltld, Th. PA DIPert.'nt of RIYlnu. will IlIu, I" offlolll\ '.......nt (For. Re.Y-l~4I t:~O ~pon flCltlpt
of th. rltur" frol thl Rellltlr of Will.,
TAX RETURN . PART 2 . TAX COMPUTATION
llN!
I. Ent.r
NOlEl
thl dltl thl 'OOOU"t C1rlgln.lIv Wit ..tabU.hld or UtI.I' In thl ',n".r 'MhU"g It d"" of d..th,
Par I d.oldtnt dvlnl .Uer U.'It/UI Account' which th. I1l1oldlnt put In JoJnt n.l.. within on. t11 Vllr of dllth .r.
tlMlbl. fuUv II tr'rufli"," Ilo~.v.t', thlrt it an 'Nolullon not to 'lColld U,OOO p.r tr.nl'lrll regardl,.. of thl v.lul 0'
thl IOClOunt or thl "ulber of 10000UI1t1 h.ld,
If " double ..t,rhk (1111) aPPlftl'" blfert vour IIrlt n'lII' In the addr... portion of thl' noUn, thl U,OOO IMolu.lon
~lr'ldv hi' bl.n dlduotld frol thl looount blllnol II rtported bv thl Itntnolll In.t1tutlon,
I, Intlr thltot.. b,a.nol of \tit IOOOU"t Inoludlng lnt.rlll locru.d to thi dl'l of d..th,
S. Thl p.rotnt of the looount thlt It hlllbl. for lIoh .ury VOl" It dlhr.lntd .. fol1owlI
.. Th. perolnt tllClblt for Joint ....tl IIt.blA.hld letre thin on, Vllr prior to thl d.ud.nt'ld..thl
I DIYIDEO IY TOTA\ NVHIER or OIYIOED IY TOUl NUNU~ OF X 100 . P/RCENT TAMAI\E
JOINT OWNE~I .. SURYIYIHO JDIN! OWNERS
IkIlPlll A Joint ....t,r.'ltter.d In thl "... of thl dlc.d.nt and two other Plr.on.,
I DIYIHO IV J (JOINT OWNERIl OIYIOED SY IIIU~YIYORI) . ,161 M 100 . 16.IX IlAUllF. FOR EACH SURYIYOR)
., Th. Plrunt tl.abll for '''Itl or..ted within ani VIII" of thl dle.dlnt'l d..th or Iccounh owned by thl dlcld'"t but h.ld
In tru.t 'or Mother IncUlJidu.ICI) (trult blnIHollrl',III
I DlYIOn IY TOTA\ NUHIF.R OF IURYIYINO JOINT X 100 . PERCENT TAiAllE
, OWNER' OR TRUST IEN!rICIA~IF.S
EklIPl.1 J91nt looount rlgllt.rld In th. n... of thl dlCldlnt Ind two ath.r Plr.on. and Ilt.blt.hld within on_ v..t of dllth b~
thl d.cld.n t, . ,
I DIYIOeD IY t (SURYIYORS) '.10 M 100 . lOX (TAMAILE FOR EAttl SURYIYOR)
,.. thl .bunt .ubllot to tlX Oln. It) II d.ttraln'd bVlultlphlng thl .oaount bll.nel 'Oln. 2) bv th. pirtlent tlM,bl. Clint ,,',
I, I",,, the tot. af thl d.bh and dtduotlon. Ilstld In Ptrt I, '
ill 'h. .._nlln' h"'l'\hl. ,11". ft' h rtllhr"lnllrl h~ luhf""t1t1ng the ri.l:'lh I'lnt4 rlfl,h,,,tl,,fU1 rll", ", fr"'. 191-. iIIl'\I'It,"f: "Ih,...t!t t" tft.. t'I". 41
7. ~"'Ir thl appropriate 'IX ~.t. Clln' 7) II d.t'rlln.d b.loM,
At Por dltll of dtlth aClDurrl"g tft,r 6/S0/'1t, thl '1M rat.. for t,.nlfert to IPOUIt. Ir. II followlI
I. D,t.. of d..th on or Ifttr 1I119~ and b.for. 1/1/9& thl rate haW,
II 01'" of d..th on or Ifter 1/\19' tr,n.f.rt to .po",,,. will bl tiMId It Ol( "11 rlt.,
Hotll For d't.. of dl.th prlpr t07/1/'Il tran,'.r, to ,pOUI., .rl tIM'bl. It 6>>,
I, Tran.f.r, to lln'll dIIClnd.nt. Inoludlng f.th.r, loth.r, lon, dllulhtlr, gra"dchlldrln, .on-In-IIM,
d.u,httr"ln-I'''t.tIPOhUd and thllt lllUI ,1'" t'Uj'b" It 'tM perotnt (610t
C, Ir,".f.I'" to 11 other. InclUding broth,r, Ilttlr, ynOlli lunt, nlph'.. and nl,ot Ir. tl.'bh It flft.tn Plro.nt (U)CJ.
II. f you ohlnoe thl tllC rltl, pl.... IP.olfv your rlletJon.hlp to th-. ctlaldlnt In thl Ir.. providld,
. ,
I. ThI ..ount of tlM dul (lln. .J It d.terlln'd bv ItUIU..hlng the a.ount tI.lbh Oln. 6J by thl tlM r.tl Olne 1).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AlloWlbal d'bt. in. d.duotlon. .r. d.ter.ln.d I' follow'l
A. You I.gllh '''1 r"flon.lbl~ for plV.lnt, .or thl Ittlts .ubJlot' to ldalnhtrp.,tlon bv I p.rtanll reprll.ntltlvl .. I'n.uf'flollnt
to PlY thl dldu~tlbll It....
I. You .otullh plld the debt..ft.r d..th of lhl d.oldint .Ind un furnlth prOOf of plv..nt.
C. Dlbts bll"l ohl..d IU.t b. It.....d fullv f1 PlrtSI If Iddltlonll .pao. II nttct.d, 1.1" Pllln piper. l/a" MUM, Proof of.
pUllnt lIy bl 'Iqulltld bv hi PA aIPlrt,.nt of fttYtnuI;
, ..' JfllV.~~l!ED FUI~THttrl TJ~'rt!tRV~~'J~SUoVAA\cse.~WCE' CONtACT~" Y. ......Y......:....
ReG..T OF IL s. PA"lfe IT II liP RIlVliXPAV bUT ICT fI II.. ... .....
HARRzgguRaLkTT( l'~R'~ ..H~2~~DIV~g A~7 ~~E'h!~~ll~ f~d~Y~~RfH ~UII~HONLV)
. '
NDv~mber 14, 1997
R~glat.~ of Wills
Cumba~l~nd County Court House
1 Court HouaeSquare
C>!\rl1sle Pi.'!. 17013-3387
Rei Est~te of Lloyd ro. Brandt
Deal: Sir 1
mno1oaed ~t'e oomp1eted copies of the Infol:mt\tiop Notioe ~nd
Taxpay~r Response forma for the above esti.'lte, Also enGlosed is a
.. C;QPY .?f receipt number M242379 to dor.:umel,t prapl\yment of the
inhe~iti.'lnaa taxes,
AeN Number Tax Due
97146569' $930.64
97146!;i70 210,14
97146571 180.12 r~"" ,. ,', -0
9"1146572 930.72 .1':'
Gt'oas Tax DUe 2251,62
S~ marly Payment Credit 112.58
.. Net Due Tax Due 2139.04
pl\id 10~23~97 2i39,66
Ovet'payment $ .62
The
the
not
,
reason for th~ overpayment is an error in the total
c;listdbution in ll\y original oalculdtion of the tax.
necessary to issue me a, refUnd.
amount of
It is
sinoere1y
~a~
Shil'ley A. mppley
1871 Crescent Rd.
(l'ranl<lih. In. 46131
PIIRPOIl OF
HOmE.
" j
To fulfill thl rlqulr...ntl Df 810tlon UItO of thl Int1lrltlnfll 'nd Elt'" lI)( AClt, Aot 1!1 o~ 199&, (72 P,8,
..ollon tim,
PAYHlN" Olhoh Ihl lIP porllon of 'ti,h Nolloo oncj ,,,"It wlln Vlur PIY.lnl 10 Inl .Iollllr of Millo prlnhd on Ihl
rever.. ,Id',
.- Hlkl ohlOk or .0n1Y order p.Ylbll 10' REO illER OF MILLI. AOEHI,
R.fUND (eA)1 A r.fund of . '1M ,orecHt, "hiGh Will nat r.quI.tld on the '1M return, "v bl nqu..t.d by DOlfll,Un, an "AppllOltlon
for Aefund of Plnnlvlvlnl. InhtrltlnCII Ind I!It.t. TI." (REY~lIU), Applloatlonl ar. IVll1tblt It thl OffiCii 0'
thl Algllt,r 0' Willi, env of thl I. R'Vlnul PII\rlot Of'lo.. ftr bv ollllng thl ,p,olt' lit-hour Inlwlrlnl ..rYlol
nYlb.r. for 'Dr.. ordtrlnlU In Plnnlvlv,,,I. 1-800-162-1010, ouhht. Penn,Ylvenl, and wUhln local
lIerrlobu,. ".. (1111 761.10'4. 10Pt (11/1 172-11&1 lIl..dn. IoPllrod Onh).
OIJECTlONII Anv partv In Int.r..t not ..U,Ued with thl ,ppr,"..,nt, ,110"anOl or dl"Uowlnn of dldua\lonl or UII....."t
of ttlC (Inoludlng dlsaount Dr' lntlrut) II shown un thh Hotla. ..~ obJlat w!thln .hctv (60) dlVI of rn'lpt of
Ihlo Nolloo bYI
".writt,n prat..t to thl PA DIP.rt..nt of RIVlnu., lalrrl of APPI,1I, DIP'. ta1011, Illrrhburg, PA 17118-1021, OR
....l.oUn. to hlv, thl ..tt.r dlt.rlln.d .t the lud!t of thl looount of ttl.,lrlonl' r.pr",nt.Uv., OR
"",,"1 to thl Orphan,' Cour t
AOHIII-
IIIRATlVE . .
CbRRECTioHI, ,.otu'l '1'1'01'1 di.aoVlrld on thl, ....II..~t I~ould b, .ddr.ll.d In writing tal PA O".rt..nt 'of R.v.nu.,
lurl,u of Indl\lJdu.1 T.MII, ATTNI POIt A....I..nt Rlvl.w Unit, PEPT. 280601, t1erf"hburg, PA 171U-0601
Phonl (117) '.,-6101. 'I' plUI I of thl bookllt "tn'truotlanl far tnh.rltlnc. T'M A.turn for I AI.,d.nt
O,cld.nt" (REY.IIOI) for In IMpa.n.tlon of ad,Inlltratlv.lv oorr.otablt '1'1'01"1
tf InV tlM due II p.id within thr.. (I) o.l,ndar .onthl Iftlr the dloldlnt'l d..th, a 'I~I plre.nt (I~)
dlloount.of tho tl. PIld II .llo.ld,
DIICOUNTl
PlHALTY,
INIEREII'
Thl lIX t.M .IIMIW non"PlrtlclPltlon P'''I&tV II oOlputld on thl to\ll of the t.IC end Int.r..t .......d, and not,
pold bOll'O J.nuory 11.1"6. Ihl flrlt dlV.lftl' Ihl Ind of thl I.. .onllty plrlo~, Thll non-plrll.lpltlon
...nlllY Is opPlol.bll In tho .....IMer oncj In thl thl IHI II.. period.. you would IPPIII thl to. oncj Intor..t
thlt h.. b,en ........ .. Indlalt,d on thl. "otlo..
Int.r"1 I. .hlrOld b.olnnlno with flrlt dlV 01 dllln,ulnoy, ot nln. (,) IOnth. .nd onl (I) d.y
frOf the da'e of d..th, to thl dati ef ~.v..ntt TIM" ..t11oh b.o... d.l1nqu.nt b.for' JlnUlrv 1, nil
b..r I"'.r..t It thl rlt. of .IM C6k) p.ro.nt p.r tnnUI olloul.t.d .t . dlllv rltl of .00016_1
All tiMi. whloh b.oll. dillnqu.nt on ar .ft.rJ.nu.rv 1, 19.e will b..r Intlr.lt It I rltl whloh wll. \I.rv fro.
o.l.ndar )lur to olhnd.r v..r..lth thlt rlt. '""ouncld bv the PA Dlpert...nt of R,v.nuII Th. Ippllo.bl.
Int.rl.t r.t'l for 19.2 through 1'9' .r'l
Yllr Inllt..t Rill DIUy tnt.r..t F.otor VIII' Inter..t R.te D.lly tnt.r..t Flotor
- -
1982 20X ,0001\1 1917 'X ,0002\1
1981 16X .000\11 19A1'1991 llX ,000101
191\ \IX ,100m 1991 IX .ooonl
1911 \IX ,000lh 1991-1994 /X ,000192
1916 lOX .0002/\ UU-I99ft OX ,0002\1
"Inl"..t I. o.loull'ld .. fo!'I....
INTEREIT . 8ALANCE OF TAX UNPAID X NUHIER OF DAVI DELINQUENT X DAILV INTERE8T FAOTOR
."Anv HoUn ".u,d Iftlr the tlM bIOc...dIUnqu.nt wll1 rlU.at .n Int.r..t a,louhtlon to flft,," ell) dlV.
b.~ond the d.tl .f the ......IInt. If PIVltnt I. I.d. Ift.r thl I~t'r'.t ooepu,.tlan dlt..hown 6n the
IIoUOI, oddltlonol Inter..1 ...01 bl ,",.lIl1led,
)(',
PU!lPOII O~
1101101' IQ fulfill Ihl ..qul..~~n~, .f IlOlIQn 1140 .f Ih. Inll..l\.n.. and hl.I' I.. A.I, ,Ao\.1I .f 1991, m P,I,
"Q\lQn .140).
PAY"'"I,
b.ll.h Ih. loP PQ.II.n Qf Ih!.HQII.. .1Id 'Ub~'1 willi Vqu. p.V..nl IQ Ih' R.ol.I" QfHIII~ p.lnl~d .n Ih.
r,v~r'l .Idl, '
_. HOI<. .h..k .. .""IV ord.. p.vllbl. I.' RIOIIIIA OP Hml, AOIHI.
REPUND (eRH . refund of. hl4 credit, which w.. not rlq\l"tld on th. taM rlturn, ..~b. r.quI,tld bY ao.pl,tlng an "Appllntton ! j
f~r Rlfun~ of Plnn,ylyanll Inh.rltano. Ilf'ld liIt,t. TaM" (REY.UU). AppllOftUQn, art a"allt\bll at thl OffiCi of
Ih. R'IIII" .f HI\I', ~nV .f Ihl n R.y.nuI 01'1.1.1 OHI... or bV ..lllno Iho "10101 14-h'u' on....lno ",YI..
nu.bo.1 f.. f...1 ...i.ln" In Ponn.vlYlnlo \-000-101-101., QUI.ld. P.nn..lyanlo In. wllhln 1...1
lI..rI.bU.o"" mil lol-un. 100. (1m 111-UII 1II.a.lno Iop.I..d Dnlv).
Any p.rty In lnt.r.., not ..tllfl.d wHh tll' apprah..lnt, .UoMlnol or dhilloMano. ,,' d.d~aUon. or iu.....nt
.f I.. Iln.ludlnl .l...unl or Inl.....I) .. Ih.wn .n IIII.HQlla. ~~v Qblool .lIhln .101. (60) dlVI .f ...~lpI .f
Ihll H.II.. bVI ..
.-wrlttln P~Qt..t to thl PA DIPart.,nt of Rlvlnul, 80ardu' ~pp.al., Dlpt, 2810et, ~'ttl.bur.; PA 17111-1011, OR
...,hotlnD to ,hay.' the ..".r dltlr.lnld It thl audit of the .~aoun\ of th, plreoni1 ,..pr..,ntlt1v., OR
....pp..l to, thl Orphlllns' 'Court
OIJllDTUHtIl
AD"IH-
UTRATlYll
OORRICTlOHII
lHIIAllIII
Flotual irrqrl,dtuoYlrld on 'hit .I......nt, Ihould b. .ddr....dln wrlUng un PA Olpar\iint ofRlv.nU'J
lu...u.f Indlyldu.II..... AllHI POll .",,,o.nl Rlyl~. llnll. DEPI, 160001, 1I1..lIbu". PA 11111'0601
Phon. (711) 187-68011 "I pal' I of th. bookllt "tn.'ruothml far Inhlrlt.-not TIM Alturn far '. 'A"ld.nt
Dla.d.nt"OUtlJ.UO\) for an 'Mpl,n.Uon of adlln"traUYI1v corrlat"blt .rrorl, .
If .nli hM due" paid wlthtn thrll (I) o.aendtr lonth. eftl" thi dtCli,d.nt'. d..\h, . ,iv. pero.nt (lln
dl"'\!l1f.' I~O h. pold II .Il...d.
.1
IhA II~ I~' .....IV n",,'po.II.lp~lIon pln"IV I. O"'f1u\.d .n \h. IQhl Qf Ihl I.. .~nd Inlol..1 '''A''ld. llId nOI
p~ld blfOro J"""lrV II, 1996. Ihl"rol dlV .fl.. \1\0 ond of Ih. I" o..,..IV porlOd. Thll n'n'p~.II.lpAII.n
ponol\v.l. 'PPAAI.bl. In Ih. .~o. .onno' And In Ih. Ih' ..~. II~. p..I~ .. V'u w.uld opp.~l Ih' II' And Inl....1
Ih.1 h.. bl.n OO"I'~ oi Inol.~lod .n Ihl. n.II..,
Inl....1 I. .hl.o.d b.olnnlno Wllh fl..1 d'V .f dllln,ulnoV, .. nino (,) ..nlh' an~ 0h0 (11 dov ,
frDI th' data ctf d"th, to the dati of PIIVltn\. '-M" whloh blaH. dlUnqUtnt' I,lfort 'Jenulr~ 1, 'IIn
b..1 lnl....\ 1\ Ih. rl\' Qf .1. (O~l p...onl por .nnuo .ol.ulolld 1\ ~ d~lIv rolo .f .Oa0166,
AI.l h." ""I'h b..... d.lIn"",",1 "" Q' '''or Janua'v. I. 1.961.111 b.o. Inll.OII II . rolo .hl.h .111 yo. V f..o
o..litldlr Yllr \Q olllnd,,. V"I" with \hllt ,.Itl a"nounold bV thl 'PA DIPlrt..nt. of AIV,"U" Tht .ppllo.bl1
Inl....1 ..1.. f', \.11 Ih.ouOh \"1 0'" '
nlCOUNII
PlHAI IV I
'Wr Int....1 ROl6 o.IIV lnll...I F"I.' V.... Inl....1 AAI. .Dlllv lnl....\ PHlor
-
1911 10~ ,000161 UII A~ ,000141
U" 10M ,000611 UII-Im m .000101
1916 Il~ .000501 I'" 'M.' ,OOOUI
1911 n~ ,000l.. 1991-1996 1~ . ,000191
1911 10~ ,000116 \991-\996 .~ .000141
.~Int.,...t;,h a.lout,tid II f.Il'WIl
INTBRBI' . 'ALANaB aF TAX UHPAla X HU"IBR DF DAYI DBLINQUBN' X DAILY INTERB.T FAC'DR
--Anv H.II.. 100IIOd,'II.. IhA II' b...... d.lInqu.nl .111 ..f1..1 on Inl...it '1IOullll"" 10 fllI..n (Ill d.VI
b6V",," 11\0 ..1,'oHI\O ......_I., If p.v.onl I. .... .11.. Ih. Inl....1 .......11\1"" d.l. """'" an lho
NOli", odd I 11"".1 Inl....1 11\I.1 bO ..loUI.I.., .
PURPO" OF
tlQllClI To fulfill. Ih. r.qulr.~.~1t of a.ollon 1140 of Ih. Inh.rlltnol Ind B."I. To. A.I. 401 1\ 01 199&. 111 P,I,
...1I0~ 914UI,
PAYHlNTI Ol\ooh tho \D. porllon .f :lhI. NoUOI .nd .uIl.1t with v.Ur p....nl I' Ih. Roel'l.r 01 WIllo .rlnlod .n Ih'
r"vlr.. tide. '
.. H.kO .hook .r I.n.. .rd.. ...obl. 101 RnUTBR OF WILL', AOiNT.
. RBIUHD' (CRII A rolund .f . I.. or.dll. ""I.h ... not roqU"l.d on "h' \0. r.lurn, IIV bl roqU"I.d bV ....IIHn,.n "A..II..Uon
for ,R'f~nd of p.nn.~lYanlft lnhtrU.nol .nd,htatt tlK" (REV-UUl, AppllOIt1onl el'l IveU.blt ,tthl Offlce of
thl Atght,r of MUll, '"va' ,hI U ",YlnUI bhtrlo\ Offle.. or ',,~ (l.11lnll 'thl IPlolt1 2~"hour ant",ulng .."vlo,
nUlblrt for for II ardtrlnl' In P.nn.~ly.nl. l..aOO.Su..to&O, ouUldlt p,nnlvlvlnt. end U1thln 10011 "
H.rrl.bUrI .r.. 17171 76,1-80.91. IDOl 11l71,nB'UIIIII"rln, IIP.lrod DnIV),'
Anv plrtv In Intlrll\ not ..tllflld with th..ppr.'....nt' tllaWlnel or dl..l1~w.no. of dtduo\lonl or ........nt
of ". (lnoludln, dl...unl .r In,....11 " .hown on thl. NotlOl .IV obj..1 wlthln .I.tv IUI d... of roo' In I .,
Ih.. N.Uoo bvt
"wrl\l.n .rol,,1 10 Ih. .A D....I..nl .1 R.yonu.. Boord ..f App..U, o.pt, 281011. lIotrl'bu'.' PA mil-IOU. OR
....lIOUnll to hi'" 'h' ..thr d,tl".t."d .t thl'ludlt of the It:loountof thl plrlonal rIPr..,nh\tv., OR
......p..l to thi Orphant. Court
OIJtlOTIONI.
'AIl\iIN'
UTRATlYC
CORRECTION..
INTERnT.
",~otu.l .rrat. dllooVlrld on thli ......lIIInt .hnu1d bl ~ddr.u.d 1n wrtUnu ,hi PA DIPart..nt elf Rlv,n,'"
lu...u.f Indlylclu.1 T...., 'IT~' Po.1 A~,,,.,.nl A..I.w UnU. OB.I,.180l01, H...hbUrl. PA 11128'0101
Phonl (7171 78j-6&U. ...- pia' & of thlbookht tttnltruoUanl for lnhlrlhncl"TlliM Return fOt . R..ldlnt
DIClldtnt" (REY.UOl) for In Iwpl.n.\lon Qf ad.lnhtl'.Ul!ll~ carr.ohb1. irrQrl1
If Oni I.. duo I. p.ld .llhln Ihr." (II ..I.nd.. ..nlh' "I.r Ih. d...d.nt'. ~..Ih, . II.. p.ro.nl IIMI
dl,lOount .f lho II' p.ld.l. .1l.iI.d,
Th..,IX 1",'IIn"tv non'n.rthlp.llon p.n,olIV II o....Utld On Ih. 1.1.1 .f tho t.. ond Inl"..1 .......d. Il/Id nol
p.ldb.,ore J.nu"v II. l"",th.'/lrol d'V .ft.r Ih' .nd .f Iho ". 'Il/I"" p..l.dl Thl. non'p..llol..llon
Pln.llv I. ..p..IObI. In Ih..... ,oon.r Ond In Ih. Ih. .... II.. ...Iod .. Vou ..U d .np..1 Ih. I."~ Inl.r"1
th.t hi. b.,n '1.'.,ld 'Ilndlo.t,d on thl.'natlo'j
'Inln.Uld. .h.r..d b..lnnlno with flrol dIV of d.llnqu.nOV. o. nln. (9) ..nth' ond .n' (I) dIV
f'.. Ih. d.I..f d..lh, 10 Ih. d.l. of..,..nt, T.... .hl~h b'O'" d.l\nqu.nt b./Or. JOnu..v 1,1.11
b..rlnl.r..1 .1 lho rOI..f .1. (IM)p.r.ont n.r onnuo ..lout.l.d .t . ..llv ..t. .f ,000111,
All I.... whl.h b.o... d.llnqu.nl on o. .fl.r Jonu..v I. I.BI .111 b... Inl.r..1 .t . ..to whloh .111 Y"V Iro.
~.l.nd'r v..r,to o.llndar v,lr with that I'ltl announold bv thi PA bIPlrt.."t of R.Y.n~'1 the applI08bI,
Int"o.1 ..1.. lor 19.1 Ih.ouQh 199'....,
OIlCOUNTI
.BNAL TY I
Yilt Inl..,,1 R." o.llv In\o...1 Footo. !!!r lnt"..t Rlt. blllv lntltlit Flatar
-
1911 lOX ,000101 1911 9X .000147
19U IIX .0004S1 191"1991 llX .000101
1m llX ,000101 "1911 9X ,000147
1m UX ,0001" 1""199, fX .000l1t
"61 lOX ,000lto 1991'191' .X ,000147
-'lnter..1 I. ..I.ul.l.d .. foll.w",
lNTERE.T . BALANOE OF TAK UNPAID K NUKBER OF DAve D~LINqUENT K DA1LV lHTERBBT FACTOR
'-AniW6llo' I..u.d .fl.r Ih. I" b...... d.llnqU.nl .111 r.fl.ol on Int.r"1 o.I.UI.llon 10 Ilfloon (II) d.v.
beVond Iho d.I.. .f lho ......oonl, If p.VOIPI I.,.... .fl" lho Into','1 .oopul.llon dlt. .hoWn on lho
H.\lOI, .ddl\lb!\ll Inl....t ....1 b. ..I.ul.lld,
PAY"INI I
u,taGh 'hi top portion 0' thll Hotlol and .~b.lt wtth your Plv..n' Nld, pavablo to thl n... and addr...
prlnttd on thl ray.r.. ,Idl.
q RIIIDI"I DECIDIHI ..kl .hook or ..nIV ordor pIVlbl1 101 RIO'IITBR OF WILLS. AOINT.
1/ HON'RIJlOINI DICIOIHI .Ikl .hook or .O""V ordor p.Vlblo 101 COHHONWIALTH OF PINN'V,LVANlA.
RI'UHD (CA)I A r,'und 0' . '1M orldlt, whloh WI' nat "qullt.d on th,'TIM Rlturn, I'V b. r,qu'lted bV aoapt,tlna In
"ApPUoIUon for R'fund ", Ptnnlvlv.nli Int'tlrltanQl and Estl" tlM" (REY"UU). Applloatlon. Ira Iv,lhbll .t
thl Of'101 0' thl ~..I.t.r 01 Willi, 'MV 0' thl 21 Ravlnu. 011trlot 0"10" or frol the D.p.rt"nt', I~.hour
anlWlrlna ..rvlat hu,blr. for for.. ord.rlnll In P.nn.vlvlntl 1-100-162-2010, out.ldt Plnn'vivan'.
Ind wllhln 10011 tlor,llb.,g or.. (7171 711-10'4, 100' (717) 172'1212 ltl..,lng IlpII"d onlv)'
REPLV TOI QUI.tlonl r'g,rdlng .rtorl oaMtalnld on thl. notl01 ahauld bl addr..I.d tal PA DIPlrt.lnt of AIVlnue, lur.lu
of IndlvJdul1 Ta~I', ATTNI POlt ~1""'lnt RIVllw Un't, Olpt, e10601, Hlrrl.burg, PA 111"-0601, phonl
(111) 717-1101.
DI.COUNTI .f .ny t.~ due II plld within thr'l (I) alt.nd.r .onth. .ft.r thl d.cldlnt', d.lth, . flv. parolnt elk) dlloQunt
of the tlM Plld I. IlloWld.
PENAL TV, Thl tau taM ,.n'lty non-PlrtlolPltlon pln,ltv I"oo~put.d,on the totll of thl tlM _nd Int,r'lt 1....I.d, .nd not
paid b.for. Januarv!', 1996, thl flr.t d.v ,fter thl Ind of thl tIN ..nllty plrl,od.
1<:
INTIRUTI
lnt.rl.t 1. ohar.ldblglnnln, with flr.t dlY of dlllnqu.noy, or nlnl (9) .onth. .nd ani (1) dlY fro. thl d.tl of
dl.th, to thl dlt. of PIy..nt. T'M" ~hJoh blo.., d.llnqu.nt blfor. Jlnu,ry I, 1ge' bl.r Int.r,.t It thl ratl of
.1M C6H) plrolnt plr annul oaloulat'd at I dilly rlt. of .OD01'~. All tiKI' whlah boo.,. dlllnquent on,lnd Ift.r
Janulry 1, 19" will bl.r lnt.r..t It I ratl which will vary frat att.ndlr y.arto callndlr y.,r with thlt r~t.
.nnounold by the PA Olpart,.nt of Alvlnul. Thl .ppllolb" Inter'lt ratl' far 19a., thro~'h 1'9. Ir"
1912
1981
1914
1911
1'1'
"'Int_rl.t
20M .000141
IIX ,000451
IIX ,000101
IIX .oooial
10M .000174
l,'olloul,tld 'I 'follOW' I
Vllr tntlrut Altl Dally tntlrl.t Flotor
-
1'1' ,~ ,000147
1'11-1991 IU .000101
1992 'X .000247
I99S-1994 1X .000192
1991.1991 'X .000241
VI'r tnt.rl.t Rlt. Dallv tnt.r'lt Flotor
-
INTEREST . BALANCB OP TAX UNPAID X NUNBBR Op DAYS DBLINQUENT X DAILY INTERB.T PACTOR
-.Any HOII," II.Uld 1111' Ihl II. bl".11 dllln,.lnl will '"fl"ol .n Inll,".1 .11..llllon t. 1111'" (II) dlvl
~,yO"d thl dlt. of the .......Int. If p.~..nt '1 .Id. Ift.r thl Inttr'lt 'oo.Putttlon dlt, ihoMn on thl
Hotlol, .ddltlonll Int.r..t .u.' bt olloulltld.
PAYHtlHII
g.I..h Ih. I.p porll.n .f Ihl' H.tl.. .nd ..~.It .llh V'., p.v..nl ..d. p.v.~" I. Ih' n..' .nd .dd""
prlntld on thl rIV.r.1 Ildll
._ If RUlg~HI g~C~g~HI ..~. .hlC. or .0n.V ord.' p'V.~I. 1., RKOISTER Of WILLS. AOENT,
__ If HOH-Rnlp~HI gleEbENI ..k. .h..k ., ..n.v .,d" p.v..I. 101 COHHONWEAPH Of PENNBVLVANIA,
RlfUHD ICRlI A ,.f.nd.f . I" ."dll, .hl.h ..' n.1 rlo."',d .n Ih. ra, R.t.,n, ..V ., "o...lOd bv ..,pl.llnA .n
"APpll..II.n f.' R.tund .f p.nn.vl..nl.,lnh.r1I.n.' .nd E.I.,' I.," IREY-UUI, IPpll..II.n.." ...11..1. ,I
Ih. Off I.. .f Ih.,R'OI.I., .f Will., .nv .f Ih. IS R...n.. 01.1,1., Offl... ., ".. Ih. D'P.",..I'. I.-h..'
'OI.",lnO,.".IOO .0""" for tor.. ord"lnA,1 In p.....I..nl. \.800-S61'1080, ..,.Id. p.M.vl..nl.
..d .lIhln 1.00111."I,'O'A ".'. 11111 767.8094. 100' (1171 77HUI 1II..,lnA l.p.lrld .nlvl,
REPLY 101 0...11... rlA"dlnA ",."...I.ln.d .n Ihl. n.II.. .h..ld ~. .dd"...d 1.1 pA b.p.'I...1 of R...no.. 80'''.
'.f lndl.I...1 .1..... AllNI POll A.......nl R..I.. D.II. D.pl, 18060\, II."I".'A. PA 1'11I8.'0101, ph..'
(111) 781-'808, '
PlICbDH1I ilf ..V IlK d.' I. p.ld .1Ihl. Ihrl' (II ..,..d.' ...Ih' 0"" tho d...d.nl'. d..th, . II.' p."..1 IIXI ol'....nl
of thl tlM pald II alloM,d,
PlHALIYI
,',
lh' \IX \I. .,...tv ...-potll.lp.II.. p...IIY I. ..,p.l.d .. Ih. 101.1 .f tho I.. ..d I.W..I .......d. .ndh.'
p.td b.f~)r.J,"ull'rv 18, 1996, thl flrlt dlllV afhrtht tnd of thl taM ail""tv plrlnd.
IH1ERUII
Inl.,..1 I. .h.'A.d '"AlnnlhA .llh fl,ll d.V .f d.llho..n.V, ., nln. (9) ..nlh. .nd onl'lll d.V f'O' Ih. d.I..f
d..lh, 10 Ih. d.I' of p.v..nl, T.... .hl.h. ~.o... d.ll.ou.nl ..for. J.n.orv I. 1981 ..., Inw..1 01 Ih. ,.1. Of
.1. (IX) p,,,"nl p" ..n.' ..I..III.d .1 . d.IIV "tl of ,000160. All \0... .hl.h ...... d.lInnu.nl .n ond .""
J.nu"V I. \911 .111 ~A.' Inl"..1 01 . rll. .hllh .111' .... fro. ..lInd., V'" t. o.l.nd., V'" .1Ih Ih.' rlt.
""n.un.~d hV Ih. PA D.p.,I.lnl .f R...no" Ih. .pplloo~l. Inl.,..1 ,.,.. fO' 1981 Ih".Ah \9'8 .,.,
1911
19U
'198'
I9U
1986
'.lnl"..1
lOX ,000&.6
I6X ,000r,a8
IIX ,000SOI
ISX ,000a&6
lOX ,000It.
I, olllcula,.d .1 fOllow.'
y,.r 1l'1hru' Rat_ Dwt1V l"hr..' rlotor
-
1981 9X 10002(11
19U-\991 BY. .000SOl
1991 'iJl'. ,000147
1995-1991 1Y, ,000191
1991-\998 9X ,000141
"'.ar lnhrlt' Rat.O.UY lnur..' Faator
- '
INTBRB8T . BALANCB' Of TAX UNPAIO X NUHBBR Of O^Y8 DBLINQUBNT X DULY INTBRllST' FADTDR
-'AhV H611.' I...,d .fl" Ih..I.. b.~o'" d.llnnu,nl .111 ,.fl.ol .n')nl.,..1 ..I.ol.ll~n 10 flfl.,n (1&1 d.V'
blVond Ihl dll. of Ihl ........nl, If p.v..nl Il ..d.,It" Ih. Inl"..1 ...pol.llon d.l. .ho.. on Ih'
HolI.', .ddllloh.1 In\,,"1 .u.t b. ..I.1l101.d. ' '
"
"
.'
PUIII'OII pp
HOTlCII T. fulllll lhe ,..,Ir_to ., ".lIan U~O ., lhe Inherllona. Ind hllll T.I ~.I. 1.1 II ., 1"'., (71 P.',
,".llon "~Olo
PAVHIlNT, DoIHh lho I... I>Grllan ., Ih.. HaIl.1 ond 1.....11 with .our PI,"lnl I. lho RII'lItor.' NIlII prlnlld an lhe
r.v.r.. ..",
-- Hokl ohIok .r oano. .rdor plvobll I., RIOI.TIR OP "l~~', AIIHT.
RlfUltO ICR), A rallln<l .'1 II' .radlt, IIhI.h ... nol r__.lld an the 1.1 ral"rn, H. be r..,,,11d b. .....1111"' on "!ppll.lllan
I.r R.11ln<I ., Pann..lyonll Inherll,",1 ond 1.111. T.." CREY'III.). Appll..llan. .rl IYlllobl1 II Ihl 0111.1 .,
lho RIII.llr ., Hili,. on. ., lho IS R..1nUI OI.lrl.1 Olll..,.r b. ..lllnl lho IPHI.I 1~.hDur In.wlrln. .lrYI.1
nuobIr. I.r I.r.. .rdorlnl' In Pann..IYonl. 1-100-11'-1010. Oul.ldo Pann,.lyonll and .llhln 1,,"1
lI.rrlllMlrs or" (1171 717-1094, TOOl (1171 771'1'" Ollorl... 1....lrld lInl.).
D....CTlIl!lI' An. p.rl. In Inlor..1 nol ..1..1l1d with lho ....ra"_t. 111......1 .r dl..II.wonal ., dlilll.llan. Or ",".._1
., III (In.l"dlnl dl,.aunl .r Inl.r.111 "' .haWn .n Ihl, HaII.1 ... oblHI wllhln .1.1. C601 dl" ., rH.lpl .,
Ihll Hall.. b.,
, --..ltlon prol.11 I. lho PA Ooporl.onl ., RIY_, I..rd ., .....1.. ....1. !lIOU. lIorrl,"'rl, PA 17111-1011, OR
--lltOll.. I. hlY. lho III lor dollr.lnod .1 lho'lUdll ., lho H.aunl ., tho p.r'anll rlPr..onl.IIYI, OR
.-.....1 I. lho orphon.' Dourl
IIIIIIH-
IITRATlI/I
CORRICTlIl!lI,
IHT'RlITI
'1011101 or..ro d....Yorld on .Ihll ......_I _id be odcIr...1d In ..111M lil' PA OlPorl_1 ., RIY......
I"rlou ., IndlYldual T..I., ATTN' p..1 A,..,,","I RIYI.. unll, DlPT. 110601, H.rrlllMlrl. PA 171"-0601
Ph'" (7171 717-6'01. ... Pili I ., lho boOMIII "In'lr..llan. I.r Inherll...1 T.. RII"rn I.r . RI.ldonl
D..odonl" (RlY-IIOII I.r on INPlanollon .f Idolnl,lr.II,"I. ..rr..llOll .r..r.. '
lIon. II' dUo I. p.ld wllhln IhrH Ii) ..Iondlr oonlh' .,llr tho dotodonl" dollh, I IIYI por.onl (.X)
dl..aunl ., lho I.. plld I. .11....,
Tho IIX 11M ..no.I. nan"p.rll.lplllon ponell. I. .'IOUI" on lho 1.111 .f tho II' and lnllr..1 1...,.Id, and nol
p.ld bol.r. Jonu.r. I'. I"', lho Ilr.1 d.. 111.r lho and .f'lho I.. .....IY Plrlld. Ihll nan-p.rll.lplll...
_11v I. """..lobi. In lho 0_ I.....r ond In lho I,he 0_ II.. porlld .. ,011 ....Id "Pili lho 11M and'lnlor..1
lhol h.1 boon .1.1...d .1 Indl'.11d an Ihl. n.II..,
IMtr..1 10 .hor,id bollnnl", with IIr.1 do. 01 doll~Y, .r 'nino (f) oonlh. and ... (II do.
/r.. lho dol. ., dollh, 10 lho 'd.11 ., Plvoonl. 1"'"' whlOh ~... dollnquonl bol.rl Jonuor. I, 1..,
bolr Inloro.1 .1 lho rill ., .1. (6X) poroonl Plr onnuo ..I.ulllld .1 . dillY rill ., .00011~.
All 't.... whl.h ~_ dllln'lUOnl on .r ./tor Janu.ry I, 191' wUlllllr Inllr..1 II . r.l. whl.h will yory fr..
.llondlr .o.r 10 .llondor .llr wllh lhol rltl onnounald b. lhO PA Dop.rl_1 .1 RIY,"",. Tho ..,11.obll
Inl.r.ol r.I.. I.r 1.11 Ihrough I"' .r.,
DllClJLIIfT,
PIlNAITY,
V..r Inlor,,1 R.lo 0.11. Inllro'l '..I.r !!!r lnt.r"t Rltl Dill. Inlor..1 'Ht.r
-
1911 lOX .000l~' 1917 n ,OOOI~7
1911 16N .000~U I9IN"1 IlN ,000101
'191~ IU .000101 1"' '" .00"~7
Ifll 11M .0001.. I"I'I'O~ 7X .000191
I'" 10M . ooOlT~ 1""'''1 '" .0001\7
--Intorlll I, DII.ulllld "' /.11...,
IH'ERII' . IALAHOI OF 'AK UHPAIO K HUnllR OP DAVI DELIHQUEH' K DAILV IH'ERII' PACTOR
-'An. Nail.. I"~, IIllr tho II' boo.... dollnquonl .111 rlll..1 on Inllrl.1 D'IDUI.I'~ I. 1IIIIIn (III dlY'
ill.""" lho dill pI tho ",o"""lnl. II pl,,""1 I. .... .,llr lhO Inl.r.'I .oopul.llon dll. 'hawn on lho
NaIIDI, oddlllon.1 Inl,r..1 IU,I bo .,IDUI.IId.
P'-
I,'!
,.1 ;i;
\(l
Co
", ::')
"rj
I,'
XI
1',)
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t-:i,
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I'URPOII 01'
HOTICI, T. fulfill Ih. "qulrll.nl. .f ...II.n 11.0 .f lho Itlh.rllon.. .nd BoI.I. To. A.I. A.I II .f \9,., (11 P,I,
I..llon 91.01,
PAY!4tHTl
P.t..h Ih. I.p plrll.n .f Ihl. H.Il.. .n. .ub.1I .lIh v.ur p.v..nl I. .Ih' R.gI.I.r .f HIU. prlnl.. .n Ih.
rIV,,... .Sd"
-, HIi<. .h..k .r ..n.V .rd.r p.v.bl. I., RIPUTllR PP HIUI. ,OINT,
Rll'OHO(CRI. , r.fun. .fl I.. .r'.II. .htoh ".. n.1 ".u..lld.n Ih.. I.. r.lurn. .'V b. r"","I.. bv .....IoIII'g .n ",ppU..II.n
f.rR.fund of P......vl,.nl. Inh.rll.n..."" E.I.I. T"- (RBY'IIIII, Appll..II.n. .r. .,.II.bl..1 lho Pff\.. .f'
Ihl RIgl.l.r .f Hill.. .nv .f Ih. II R.,.nu. Pl'lrl.1 Pffl....r bv ..lllng Ih. Ip..I.1 I.-h.ur .n...rlnl ..r,I..
nueb.r. f.r f.r.. ord.rlng, In p''''''VI,.nl. 1-100-161-1010, .UI.ld. P.nn.vl,,"I. .nd Hllhln 1...1
..rrloburg .rll' (111) 111-10'., TPDI (111) III-UIIINllrlng I.p.lf,.d Dnh),
OaJlCTIOHtI An>> plrt>> In Int.r..tnat ..tl.fl.~ with thl .ppr......ntl 1110WlnOl or dl.tl1aw.no. of ~.duotlon' or ........n'
.f I.. (In.lu.ln' .I...unl .r Inl.r"11 .. .hawn 111 Ihll H.II.. "Y abJ..1 Hllhln .I.IV (601 .'VI .f r...lpl .f
Ihlo 11<I11.. bV'
"".rlll.n pr.I..1 I. Ih' PA U.p.rlo.nl .f R.'on,,", ..,r. .f 'PPlllo, D.pl, 161011. H.rrloburl. p, lilli-IOU. DR
,-.I'.llng I. h.,. Ih. ..II.r ..I.r.ln.. .1 Ih' IUdII of Ih. ...QUhI of Ih. p.r..nol r.pr..onl.II,.. OR
--opp..l I. Ih. Drphonl' c.url
'DHIN'
IITRlTlvtl
CORRECTIONI, F..IU'I .rr.r. ~11..,.r'. an Ihl. ........nl ihQul. b. ...r....d In Hrlllno la, p,D.p.rl..nl.f R.,.nu..
lur.," .f Indl,ldu.1 T..i., 'TTH' p..1 6.....00n1 R.,I'HUnll. PIPT, .10101. H.rrl.burl. p, 111/1-0601
Phon' (711) 711'6101, I.. p.oi I .f Ih' b..kl.1 "In.lru.llon. far Inh.rll.no. T" R.lurn f.r . R..ldonl
PIClfd'nt" (M.V-UGH for an 'kplanlUon of Idllnlltr,UVlb oorrlotablt error..
If onv t.. duo I. p.ld Hllhln Ihr.. (I) ..l.""or """\h. .fl.r lho d.....nl'. d..lh, 0 fl,. p.roonl (I~)
dl..ounl .f lho Ii. ,"Id I. .11.H.., '
DIICOUHTI
IHTERlITI
Tho I'~ I.. .....Iv nan...rllolp.ll.n p.n.lIV I. ...pul.. on Ih. 1.1.1 .f lho I.. ond Inl.r..1 .......d. ond n.1
..Id blfor.'Jonu.ry II. 1'96, Ih. flr.1 d.v .fl.r \hi ond .f lho 10. ..ne.lv ..rlad, Thl. nan-..r,I.I..II.n
pon.IIV I. 00...11b1. In Ih. .....onn.r ond In lho lho .... II.. p.rl.d .. Y.U WOUld opp..1 Ih. I" ond Inl.r..1
Ih.1 h.. b'on .......d .. 1""lo.l.d on Ihl. n.II..,
IMor..I 10 oh,r..d b.,I""I", Hllh 11"1 d.V .f ..Unqull1lv. .r nino, 19I,..nlh. ond ono (I) dOV
f~o' Ihi d.to Of d.olh. I~ Ih. d.l. .f pOVlonl, T.... Mhl.h bo.... d.llnqu.nl b.f.r. J....rv I. 1'61
bllr Inll~..I..1 lho "I. .f .1. I6U por.onl por IMUO ..I.ulolod .t . d.llv r.1o .f ,9.00IA~,
AlII.... ,,"I.h bo.... d.llnqu.nl .n .r .f!.r JInu.rv I. 1'" .111 b..r Inl.r..1 .1 . r.l~ whl.h HIli ,.rv fr..
'~.I'nd.r v..r I. ..I.nd.r v..r HlIh Ih'l r.l. ......... bV lho .~ D...rl..nl 01 R.y..... Tho 1PP110.bl.
Inlir..1 r.I.. I.r 1'" thr.u," 19'1 .r.t
PlHA~TYl
...
'!!!! lntiru' R.'. D.llv Inl.r..1 ,,,I.r Y'" Intir..1 RII. D.Uv Inloroo\ P"I.,
-
I'n lOX ,000141 1m 9~ ,0001~1
III' \6~ .ooo~.. I'N-I"I m .000101
I'U m ;000101 199, u .000l~1
I'" IIX ;000116 1991'1994 7~ ,aGOI91
"16 10~ ,000t7~ 1991'1"1 ,~ ,00Dl~1
--lnl,,"1 II ..l.ul.locl .. foil.....
INT.R~T . IALAHca OF TAX VNPAID X NUHIBR OP DAVa DBLINQVEHT X DAILV INTBREST PADTOR
--Anv Holl.. I..... .fl.r Ih. I.. b.o.... dollnouonl wIll r.fl..1 on In,.r..1 ..I.ul.ll.. I. 1111'on (11) d.il
bovond lho .11' 01 lho ......."'1, If 'p.~.onl I' ..d. .".r lho Intir.II'.OPU\.llon. dll. Iho... OI\lho
Holl... odd I 11...1 Inlor..1 ""1 be ..IOUlllocl. '
PAVItlHTI
, ,
D.t..h Ih. t.p p.,tl.n .f thl. Hotl.. '.nd .ubllt .Ith v.u, p'V.ont ..d. ..v.bl. t. th. nlO' ond odd,...
prlnt.d on thl rlv.r.. .td"
"" If RIIIIIIHT D<<tlO~NT ."". .h... or ..n.v "do' ..vllbl. t" RIOIaTlR OP WILLI, AOINT.
"" If HCH'RIIID~NT IIIt1DINT ."". .hlO. or oonov ordor P'VIlbI. tOl COHHONWIALTH OP 'IHNIVLVANtA.
RefUND (CRII A ,.fund .1 . t.. .,.dlt, Mhl.h ... n.t ,.qu"11d .n tho T'. R.tu,n. "V be ,.qu..t.d bv ..opl,llng on
'"Appll..llon for R.fund .f Ponn~VIY,,"I. Inh..It..... ond ~.t.t. Il." (R~Y.llnl. Appll..ll.n. or. .y.llllbl. .t
tho Dffl.. .f tho R.glotor .f HIli., onv.f tho II R.y.nu. DIoI,I.t D/fl... 0, f'.. tho D.porl.ont.. 14.110\1,
in...,lng ,.,YI.. nu.b", f., f.,.. .,d.,ln., In P.nn,Vly.nl. 1-'DD-'61'~D'D, .ut.ld' P.nnovlyonl.
ond .Ithln 1'0.1 H."I.bu,O .,.. (1111 111'1094, TDDo (111) 11~'I~11 (H..,lng lop.I,.d .nlvl.
RIPIV TDI
DIICIlUHTI
PlHAITY I
';
INTlRlIII
Gu..'lone rl..rdS", .rror. oon'llnld on thl. notlol Ihould bl Iddr...ld tOIP. Dlp.rt.en' 0' R.yenue, lurllU
.1 Indlyhlll.1 T...., ATTHl P..t A.......nt ROYI.. unit. Ilof!t. 110601, Nor,lobu,.. PA 11111.0601, phono
(1m 111,UIa.
If'onv to. dUo 10 p.ld within th'.. III ..I.ndor IOnth. .ftor tho d...dont'.d..th, . fly. por.ont lIMI dl......t
.1 tho t.. p.ld I. .11..Id.
Th' IIX t.. .on,.tv n.n'p.,tl.lp.tl.n p.n.ltv I. ...put,d .n th. tot,l .f Ih. t.. ond Int"..t .......d\ ond not
p.ld b.f." J.nuorv ,II, 1996, tho lI"t d.v .ltor tn. .nd .f tn. t.. ._.tv porl.d.
Int...ot I. .h.,g.d'b,glnnln. with fl..t dov .f dlllnqUin.v, ., nIno (" eontho ond one (II dov f... tho d.t. .f
d..th, t. tho d.t. .1 PIY..nt. T.... Mhl.h b_ d.llnqu.nt bof." JonuorVl, 1911 bll' Intor..t ot tho rot. .f
01. (6XI p.,.ont p., onnuo o.l.ulot.d ot . d.llv ,.t. .f .00016'. All t.... Mhloh b..... d.llnquwnt on ond olt..
Jonu.,v I. I'll .111 b.o, Into,..t ot . ..tb Mhl.h will y.,v f... ..l.ndo, v.o. to .,Iond" v..,.lth thot ,ot.
innoun..d bV tho PA D.p.,t.ont .f R'y,nuo. Tho ,"pll.llbl. Int.,..t ,.t.o f.. I'll th'OUIh 1"1 ""
V.., Int.,..t R.t. D.llv Int.,..t f..t.,
Vllr Intor..t R.t. Dolly Into,..t f.otor
-
1911 'X .0001'1
1911-1991 IU .00~101
1"1 'X .0001'1
1991'1994 IX .000191
1991'1991 'X .000141
1911
191.
19"
1911
1916
""Intor..t
lOX .000'"
16X .000'"
IIX .000101
11M , .000116
lOX, .0001"
I. ..I.ul.l.d.. i'II~"
INTERS'T . 'ALANOS OP TAX UNpAID X NUHISR OP DAV' DSLINQUSNT X DAILV INTER"T PACTOR
--Any NOll" I..uld 'fto' tho I.. b...... doll_t .UI rofl..t on Intor..t ..loul.llon t. IIft...n,', dove
b.vond Ih. d.t. .f th. ........nt. If p'V...t I. .Id. .ft., tho Int.,..t .ooput.tlon d.t. .no." on tho
N.tl.o. Iddltl.n.1 Int.,.,1 ...t b. ..I.UI.tld.
I.t{.)(}g I ~
DVREAU OF INDIVIDUAL TAMES
lnmRIIA~cc UM DIY1~IO~
un'l, UOffOI
"'''RlnURG,'I'' 11118-0601
Cof r rt'
l.B"'rte~v dlP r:N()/I/IPlIf4t '1'I'I'/-,",%
..oerr, "'e>>~4)1 ,NfMll/'id lII'U., '11 (
QoMMONWIA~TH OF PENNSY~VANIA
DEPARTMENT OF REVENUE
^. rrn^ Iflljei~~: ~[I.mu~~ T aua~ I ~ ~r.,.DN~llaE
OF IliI~D81~M;1' \I~~~ D~ HTRSJJY:r~TSD~rTSTA DIl
DATI 02-16-90
E~TAtE OF BRANDT
DATI OFDIATH 00-06-97
FILl NUMBER '21 97-0B41
! I OOUNT\' CUMBERLAND
JERRV BRANDT sSN/DO 190-07-1149
AON 97146613
1\ 00. JoPFEE ST f Allounl iI,..I\I" ~]
ELWOOD CITY PA 16111 .. .
A M ~ U I~ i ,." H ~em,1 TtP- 0 MAKIl OHEOK PAYAB~E AND RI!MlT PAYMINT TO I
tt''''I~.q') h~r.S ~'D ~f\.o REGISTER OF .WILLS
F 14 'J.~ ,,(.. W,HICM ~U()UL:t> CUMBERLAND CO COURT UoUSE
~'m'L.Q. '9' '~l(lJr": t6/lv,,~IlSl'RLlSLE I PA 110\3,
l-/f+le.. 'Mlltl ,.1.1. ~(, , ~ C~f 1 (IF, ,
CUT ALONG THIS LINE. ~ RETAIN LOWER PORTION FOR YOUR REOORDS ~
RlrV:ta~.8wi1(*APPwwCO~:9,;.wW~W~M.~.~W...M."..."..._"."...".M~..........-......_..........M.~_._.~.M__.~......
NOTIOR OF INHERITANCE TAX APPRAISEMENT! A~~OWANCE OR DISA~~OWANOE OF
DEDUCTIONS, ANb ASSESSMENT OP TAX ON JcINT~Y HELD OR TRUST ASSETS
DATI 02"16-98
rv
*~
Ur'U'II, jIf IIHI.
UOYD
g
ESTATE OF BRANDT
1.1.0VD
E DATE OF DEATU 08-06~97
COUNTY CUMRERLAND
FILa NO, ~I 97-0847 S,S/D.C. NO, 195-07-1149
TAX RnJRN WAS, (Xl ACCEP1'ED AS FILED ( ) CIlANI3ED
~OINTOR TRUST ASBIlT INFORMATION
FINANCIAl. INSTITOTION, HMRIS SAVINGS QANK ACCOUNT NO,
AON 91146573
-
31-65-310590
TYPE OF' ACCOUNT I () SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABI.ISHEQ 01-06-95
Acccunt hhno8
Percent Taxebh X
A~CUht Subjeot tc Tax
'Debt. and ReductiOi'll
TaMeble An\~ui1t
Tex R~te X
Tax Due
50,041.78
0.500
~5.0~O,&9
,00
25,020.B9
,06
1,501.25
NOTEI TO INSURE pROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THU NOTICE
WITU YOUR TAX PAYMENT TO TUE
REGISTER OF WILLS AT THE
ABOVE ADDRESS, MAKE CHECK
OR MONEY ORDER PAVAbLE TO,
"REGISTER OF WILLS, AGENT,"
TAX .OUD:tTS I
PAYMENT
, DAT~
RECEII'T
NUMBER
O!"sCOUNT (+)
INTEREST/PEN PAID (~)
.----~-
, AMrUNT PAID
PAYMENT MUST bE ~lADifIIVOr:ii7-91i"i";--- .. TOT^~ TAX ORIlDIT
BALANCE OF TAX DUE
XNTIREST AND PIN.
---iOTA~ bUll
· 'l~. fAID ^~T~R ~"n K^TU1 SEE REVEnn raq CALCUL~TtDN DF ADD! D.HAr"'fllfmiff';-.
( Tgi~~ Dtl~ Is ~1~lE~IIIH~ ~~'ANP,CR~~~'H (I~R~~qy~OEgAV BE DUe A REFUND,
I RIVERse SlDE OF TlI S FDRH FDR INSTRUCTtDN5. I
----;00-
1',501,25"-
----:00'---
1.501.25
PAVHlHI,
POI..h Ih. I.Pp.'llon .f Ihl. N.Il.' ond .ub.l.1 wllh vour P.v..nl ..d' p.v.bl. I. Ih. n." .nd .dd'...
pr,,,t.~ ,on thl rlVlr.. lidl;
.. If RunJHT p,uPEHI .... .hO.. ., ..ntV .,d" p.v.bl' I.' R,OllTlR Of Wt~~', ~OINT,
._ If HOH-RUIIlI!NI PEC~PENI .... oh'.. ., ..n.v .,." p.v.bl. I.' COHHOH\lIA~lH OF PINN'VlV~Nt~,
REPIlHO (CRlI I ,dfund .f . hK .".1\, w~l.h .11 ".1 "qu..l.d .n Ih. I,K R.lu,n, tOV b. "qu..tod bV ...pl.lln, .n
"1..II..II.n for. R.fund .f. p.nn.vly.nl. Inh.tlton.. .nd utolO lI." (REV-ISU), APpll..II.n. 0" .y.ll.bl. .1
Ih. Of II.' of Ih, R.,I.I., .f'H1II.. .nv of Ih. II R.y.nu' Pl.I,lol Of II." ., I'.' Ih. p.p.,I..nl" I.-h.u'
.n..o,ln, "'Vl.' nu.b'" fo' f.'" .,d.,ln,' In P.nn.vly.nl. 1_600_161_1060. oul.ld. p.nn,vlyonl'
.nd .llhln 1.011 1I",I.bUr, .... (7111 111-609', IDO' (1111 In-un IH..rln, l.p.l"d onlvlo
REP~V IP' ou..llon. ,.,.'dln, .".,. .onloln.d .n Ihl. n.ll.o .~.uld b' .dd'....d 10' PA p.p.,I..nl 01 R.v.nu', 6U"'.
.f Indlyldu.II..... AllN' pool A.......nl.Uyl... Unll, o.pl. 160601, H",I.bU". PA 11116-0601. ph.n.
(1111 161-UOI,
OIlCDUNlI
If .nV I" d.' I. p.ld wllhln Ih'" ()l ..l.nd., .onlh' .fl., Ih. d.o.d.nl" d..lh, · fly. p.,..nl IIXl dl...unl
of Ih' I~K pOld I. .Il...d.
'h' IlX I" ..n..IV n.n.p.,ll.lp.llon p.n.IIV I' o..pul.. on Ih. \.\.1 of Ih' I" .nd lnl.,..1 .......d. .nd nol
p.ld b"." J.nu"V 16, 1996, Ih. llt.1 d.V .fl., Ih. .nd .f Ih. I.. ..n..ly p.,I.d,
PENAL IV ,
INTERnT I
Inl.,..1 I. .h.t,od b.,lnnl~' ..II~ flr.1 d.V .f d.llnqu.n.v. .,nln' 191 ..nlh' .nd .n< (II d.v f,..lh. d.l. .f
d..lh. I. Ih. d.to.f p.v..nl. '.......hl.h b..... d.IlM..nl b.l.,o J,"U"V I, 1911 b." lnto,..1 .t Ih. roto Of
ilK (6Xl p.t..nl p.r .nn.. ..I..l.l.d .t . d.llv ,.1. .f .00016', All t.... .~l.h b..... dollnq..nl .n .nd .ft.,
J.nuorV I, 19U .111 b..t ,lnt....t .1. ,.to .hl.h will y.'v f,.. ..l.ndor v... I. ..I.n"I' v'" ..lth Ih.1 rot,
~.un... ov tho PA D.p.,I..nl .f R.y.nu', Th,oppll..bl. lnt.,..1 ,.1.. f" 196t Ih'ou," 1991 0'"
196t
1961
196'
1911
ue6
utnt.,...,
lOX .0001.6
lOX .OOO.U
IIX .000lOI
IIX ,000116
lOX ,ooot"
llclloul.tld I. follOWI'
v." 1"'11"'" Mati D.IlV lntlr..' 'ftCltOr,
-
1961 OX ,000tOl
1'16.\9'1 lIX ,000l01
1991 9' ,000101
1991-199. IX .000191
1991.1996 .X .000101
v..r lnterl" M.,. DeilY In,.rll\ F~otor
-
tNTIREIT ~. '~L~NCE OF T~H UNPAIO H NUHIER OF D~Y. OELINQUENT H O~ILY INTEREST F~CTOR
"~nY Noll.' 1,,\l1d .It.. Ih. 11M b...... ddlnou.nl ..Ill ""." .n lnllt..1 oOl.ullllon Io'flft..n 1111 d.V'
b.vond Iho d'" .f Ih. ........nl, If P'V..nl I. ..d. .It" Ih' Inl....1 ...puIIII.n dll' .hO.., .n Ih'
HoUOli .ddl'tlan.' '"terlit ~,t bi Ililoulihdi
P\JRt'OI1lOl'
II\I1'CI'
PAVIlIHT,
To fulfl'~ thl r.qulr..tnt. 0' '.otlon 2140 of th~ Jnh.rlt.~o. end Etta', tlM Aot, Ao\ 21 of 199&. (1. PII.
".U.n .140),
Dolooh IhI lOP porllen .f Ihl. Noll.. end ....11 wllh ~.ur p.,..nl t. tho R..I.I.r .f WIll. prlnlld on IhI
r,vlr.. llde.
-- Ilok., ohloll or oono~ ordor p.~IlbI. t., REonlBR OP wnu. AO'Wl,
RIPUIIO (CHI. A r.fund .f . I.w .r.dll. whloh w.. nol r.quo.t.d .n tn. I.. r.lurn. ..~ b. r.que.t.d b~ ....I.llng on "Appllo.llen
f.r R.fund of Ponn.~lv.nl. Inh.rll.n.. ond B.I.t. 1"" (REY-I$I$), Appll..llon. .r. ...llobl. .1 In. Off I.. .f
lho R..I.I.r .f WIll.. on~ ., tho BI R...... Ol.trl.t Olfl... or b~ ..llln. tn. ....1.1 B4-nour on...rln. ..r.I..
nulbtr. far far.. order'",. tn Plnnlvlvenl1 l-100-16t-2010, out,ld,P,nnIVlvantl .nd within 1001.
, Herrlobor. or.. l7I11 117-80'4, 1001 17171 172'UU IIt..rlng I.p.lr.d Onl~l.
OIJlOTJOHI, Anv p.rt~ In Int.r'lt not I.tl'fl,d with thl 'PP~.ll...nt, ,11oWIOQI or dl..11oWlnOI of doduotlonl or.I......ot
.f I.. (InolUdlni dl...unl .r Inl.r..I) .. .hown.on Inl. N.II.. ..~ .bl..1 wllhln .I.t~ (601 d.~. .f r...lpl 01
Ihlo Holl.. b~'
--wrlllan prol..t 10 Ih. PA O.p.rl.anl .f R...nut. 8..rd ., App..I.. Dopt, BIIOBI. H.rrl.bor.. PA 17IB8-IOBI, OR
.-,llotlnt to havlthl .Itt.r dl'.r.lntd at thl audit of thl aooount 0' thl p.r.ona. r.prll.ntatlvl, OR
..8PPI11 to thl Orphan,' Court
AIIIlIN-
lITl1AT1Y1
_CTlOHt,
DllCllUItTl
PIllAL lY I
INTI"'ITI
Faotull .rror. dl'DOy,rld on thlt ..I.....nt lhould bl .ddr..I.d In writing tal PA D.part"nt of RIV.nue,
lur... 01 IndlvldUol T...... ATTN' Pool A.......nl Po.low Unll. IlI!PT, no,ol. lI.rrloborl, PA 11UI-0601,
~ 17I71 787-8101. I.. p'.. I 01 In. bookl.t "In.tr".llon. for Inhlrllon.. ro. Polurn lor. Ruldanl
Deqld,"tft (REY-11.l) for In 'MPlanltlon of Id.lnl.trltivllv oorrtot,bl, Irror.,
If InV tlM dul'il plld within thr.. (I) o,llndftr lonth. eft.r thl dlcld.nt', dt,th; a flv, plrolnt (1_)
dl.oounl .f tn~ I.. ..Id I. .llow.d,
ThI 1.~ tiN .-nt.t~ non-partlolpatlon p.nlltv 11 oOlPutld on the totel of thl t'M and tntlr..t ..'....d, and not
p.ld bolor. ~onu.r~ 18. III.. tn. Ilr.1 d'~ .,I.r IhI end .1 tn. t.~ .....I~ p.rlod, lnl. non-p.rll.lp.llon
....IIY I. opp..llbl. In tho .... .,"",r.nd In lho tni.... II.. ..rl.d .. ~.u w'Uld,..p..1 lho I.. ondlnl.r..t
thet h.. bMn ......ed II Indioatad on this noUc.. <
Int_r..1 I.on.rood b..lnnlng wllh flr.1 d.~ of d'~lnquono~. .rnlno (91 oonth. ond DOl (I) d.~
,froo IhI dol. .f d..ln. to IhI d.l. .f p.~..nl. 1.... whl.n b..... d.Unquonl bolor. Jono.,', I. 198B
bear Intara.t It thl rlt. of 11M (6~) p.rclnt p,r ann~ calculatld It I d.lly rlt. of .00016~.
All tIMI. whloh blo", d.linqu.nt on or attlr Jnnulrv 1, 19.2 Nlll b.lr Inttrtlt at a rltt whloh will v.r~ fr~
allendtr V'lr to ollendlr Vllr with thlt r.tl announcld by the PA blpert..nt of AaV'RUt, ThI tppllo.ull
Inl.r..1 r.I.. for 1981 Inr.ugh 1998 .r.,
U!J: Inl.r..1 R.I. b,llv Int.ra.t ~Iotor ~ Jnt.rllt Ratl , O.Uv Int.r..t FlGtor
198B 10H ,000848 1981 9H .00U47
1981 I.H ,OOOU8 1918-1991 IIH .000101
19'~ II~ .000101 19IE 9H ,OOU,1
1981 UH ,00011' 1'91-1994 1H .0001IE
1986 IOH .00OB74 1908-1998 .H ,OOOB47
--lnl"..1 II a,loul,t.d I' folioM"
IMTIRB8T . IALANC8 OF TA~ UNPAID ~ NUHI8R OF DAY8 D8LINQU8NT ~ DAILY INT8R88T FACTOR
.-AnV HOU.. l..uod ./tor .Iho t.. bo_. d.lInquonl will r.II..1 on Inl.r..1 o.loul.Uon to IlIt_ (Ul do~.
bo~ond IhI dol. of IhI ......_1, 1/ p.YHhI to .itd. .lIor IhI Inler..1 .......I.llon dol. "."n on IhI
Motlol, addltlona. Intar..~ lU.t be ollaullttd.
~-~-'
flUlIlOIIOI'
NOTlCII To 'uUlll thl rll1Ulr..'nh 0' Seotlon 2140 0' thl InhlrUlnol ,nd asht. hK Aot, Aot U 0' lli91, (72 PII.
I.. lion 9140),
PAVHlNTI Dtl..~ Ih. I.p portl.n .f Ihl. N.II.. lAd .Ub.11 .llh ~oUr p"'onl 10 Ih. R..I.I.r of Hili. prlnl.d onlh.
rly.r.. ,Idl,
.- Nok. .h.Ok .r .one. .rd.r p..obl. 10' RIOIS'IR UP HIIII. AOIN',
RIPUND (CRl. A rlfund of, 'IM orldlt, whioh W'I not r.que,t.d on thl tlK return, ..~ bI r.qullt.d b~ oOlpl.tlng en "Applloltlon
f.r R.fund .f P,""..lv.nl. Inherll.... ond 1.1.10 T,." (RIV-ISIS), Appll..tl.n. .r. .v.ll.bl. .1 lho Offl.. of
the RI.I.tar of Willi, Inv of tha II Rlv,nuI01.triot Offlol' or bv 01111n8 the ,plolal 14~hour anlwlrlna I.rvlo.
~r. for forll or~.rtnll In P.nnlvlvlnta 1~.OO~J6e..0'0, out.ld. Ptnn.~lv."la and within 100.1 '
""rrhburg .... (711) 111-1094, TOOl (111) nl-UII ut..r11ll1 I.p.lrod onl.).
O."CTlOKII An~ plrty In Inter..t not ..U'fI.d with the .pprel....nt' tUow.na. or dl..UoWlnol of dlduotlon, or .".....nt
.f I.. Iln'ludln. dl.oDUnt or Int.r..t) .. .ho.. on Ihl. Notl.. ... obj..t .llhln .I.t. (60) do.. .f r...lpt .f
thlo HoU.. bVl
--.rltt.. prot..1 to Ih. PA D.p.rt..nt of R.v.nu., lo.rd of App..I.. P.pt. 111011, H.rrl.bur,. PA 11111.1011. OR
..,ll~tlnl to h.ye thl ..ttlr det,r.ln'd at the ludlt of thl .ooount 0' the perlo"ll rIPr.llnt,tlvl, OR
~~IPPI.l to the Orphan.' Court
AIIIUN-
IITRATIVI ,
CORRICTIDN81 PlOt~l .rror. dlloaYlr.d on thl. .11...I.nt Ihauld b. .ddr..I.d In writing toi PA O'Plrtltntof A.y.nu.,
lurlOU oflnlllvldu.1 T...., ,ATTN' Pool A.......nl R.vl.. Unit, DIPT, 110601, it..rlobur., PA 11111-0601
Phono (111) 111.6101, I.. p'" I of lho bookl.1 "In.truollon. for Inhtrlt'n.. T.. R.lurn f.r . R..ldont
D..ldlnt~ (ReV-1IOI) far In 'KPI,".tl~ of adI1nl.tr.tlv.lv oorr.atabl. error..
If In~ tiN due II p.l~ wlthln'thr.. (I) oalendar .~nthl aft.r the d.o.dlnt', d..th, . fiv. p.to.nt (.~)
di.oaunt of thl t'N paid 1. allow.d,
DIICOUNTI
Pl!NAlTV,
The laX tlM IIn..ty non-pftrtlolpltlon penal tv I. ooaput.don thl tot.1 of the t.K Ind Inter'lt ....I..d, end not
pold b.for. J.....rv II. 1996. tho llrol do. olt.. tho .n11 .f tho t.. _..tv porlod. Thh non.p.rU.lPOtlon
ponolt~ I.opp..llbl. In tho .... ,,"".r .n11 In tho Ih. .... tl.. p.rlod .. ..u .ould opp..1 tho t.. .n11 Int.r..t
thlt MI bI.n .......dll indlotllt.d on thit noUo..
INTI1IIIII
Int.r..t I. .h.r..d boO I"" I.. .llh flr.t d.. .f d.llnquono., or nln. (9) .onlh. end Dno III d..
frDII thl dlt. of d.lth, to;'th. date ti' PIV.."t, T'KII which bloa" d.llnquent b.for. Jlnu,rv 1, 1912
bltr intare.t It tht rat. of .1M (6K) plro.nt plr en~ aI1ouI,t.d .t . dlllV rltl of .000164,
All tINI. Whloh blo... d.llnquent on orlft'r J.nulrv 1, 19a2 will b.ar Intar'lt It . rlt. whlah wll1'Ylrv frOl
oll.ndar v..r to a,llnder v..r with thlt rat. announo.d bV the PA b'Plrte.ht of ReY'nu.. the appllo.bi.
Int.r..t r.t.. for 1911 through 1991 .r.,
Vllr Intlr..t A.t. Otlhl' IM,r.1t Flotor 'V'.r Int....t R.t. Dll1v lnt.tett 'Iotor
- -
1911 19X . OOO&~I 1911 9X .000141
191& I6X .0004Jt 1911-1991 IIX .000SOI
191~ ilK ,000501 1991 9X .00014'
1911 IlK .0005&6 1991-1994 1X .000191
1911 lOX ,000114 1991-1991 oX .000141
..Jnt.r..t 11 allculatod I' fallow.,
INTBRB8T . 'ALANDB 0' TAX UNPAID X NUHIBR OF DAYBDBLIHQUBHT X DAILY INTBRBBT FAD10R
'.An. Hotl.. I..uod oft.r tho t.. b...... d.llnou.nt .111 r.fl..1 on Int.ro.1 ..I.ul.llon to Ilft.on (II) d...
b,YOnd tho d.l. of tho ........nt. If n....nl 10 ..d. olt.r I tho Int....t ._ut.Uon d.l. ._ on tho
MoUat, ttddlUonlt Inter..t ttu.t be alloUllttd.
IS: ,)clJ' ~ n
IURIAU O~ INDIVIDUAL TAMIS
INHfiRllAHCI lAM PIYlalOH
Pl!Pl, 110601
HARHIIIURO. PA 171"-0601
ODMMONWIALTH OP PINN8YLVANIA
DIPARTMINT OP RIVINUI
:l:NHIIR:l:TANCB TAX
8TATIMBNT OP ACCOUNT
CY
'*
UNUI II ." m.m
II"
DATI 03.08-1999
I8TATI OP BRANDT LLOYD Ii
DATI dllDIATH 08-06-1997
.1 I PILI NUMIlIR 21 97-0847
;, It. ' , OOUNTY CUMBERLAND
,I
AON 97146568
L A.ount Re.lthd ..I
MAKI OHIOK PAVAILI AND RIMIT PAYMINT TOI
<;)
MIRIAM M. BRANDT
256 N UNION ST
BOX 10 l;1
MIDDLETO~N PA(~70B7
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HDTII To lnlur. prop.r or.dlt to ~our eooount. tUb.it tho upper portion of this fora with ~our t.. p'~a.nt.
OUT ALONO THI8 \.INI .. RITAIN LOWER PORTION PORYOUR RICORD8 ~
'iW:l&'b'lf.l'll'.~~p..r~Y:n'j...miiMil"fNlliR!YANlii'"f~'ll'.Ii'A"fIHWf.'lilt'.1iIf66u'N'f..'iiiii.....................
18TATI OP BRANDT LLOYD E PILI NO,21 97-0847 AON 97146868 DATE 03-08-1999
THIG STATIHI"T IS PRDVIDID TO ADVISE Of THE CURRINT STATUS DP.THI STATIO ACN IN THE NAHIO ISTATI. SHOwN alLOW
IS A MUHHARV Of THI PRINCIPAL TAM DUI. APPLICATION Of ALL PAVHINTS, THe CURRINT BALANce. AND, If APPLICAILI.
A PROJBCTBD INTeRBST 'lOUR!.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT I 02-26-1999
PRINCIPAL TAX DUl! I ..--..-.....-----..------....................--.......--_..
....'..".n.."._'..,..."h..."'''.'."'',,.,'',.~...."n.''....'..~~u......u........
600,68
PAyMENTS (TAX CREDITS) I
PAVMENT RECEIPT
DATE NUMBER
llISCOUNT (+)
INTEREST/PEN PAID'(.)
AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-23-1999
AT THE RATES APPLICABLE AS OUTLINEb ON THE
REVERsE SIDE OF THIS FORM,.
TOTAL TAX ORIDXT
IALANCI Op TAX DUI
INTIRE8T AND PIN.
,DO
.
If PAID APTeR THIS DATE, see ReveRse
sloe fOR CALCULATION OP ADDITIONAL INTIRIIT,
( If TOTAL. DUI II LeiS THAN .1,
NO PAVHINT IS ReQUIRID.
IP rOTAL Due X8 REfLICTeD AS A "CREDIT" (CRI.
yOU HAV BE OUI A REFUND. SII ReVIRII SIDE DP THIS fORN fDR tN8TRUCTIONI. I
TOTAL DUE
600,611
44,9~
645.49,
PAVII!Nl,
IloII.h lho lop,porll.. ., Ihl. H.II'. IIIld .ub.1I wllh ~.ur ....,nl ..~. p'v.bl. 1.lh. n....nd .dd""
prlntld an the rlyerl' .'d..
.. 1./ RtIIID1HI Dt!CEDlNI ."". .h..k .r ..n.v order p.~.hh 101 REIl18TER OF 1I1~~81 AlleNT,
-. 1/ ~.RtI'IIII!Nl III!CIOENl ..k. .h..k or ..n.v or~er p.v.hl' 101 COHHONIIBA~ TH OF peNNsYLVANIA,
REfUND (CR)I A r.fund of . tlM Grldlt, "hl~h WI' not r.qu~.t.d onthl tlM M,turn, "V bl r.qut.t.db~ oo.pl,tlng an
"~pll..tl.. f.r R.fund ., p,"".vlv.nl. Inh.,lton.. ond E.t.t. I.." (REY-ISIII, APpll..tl.n. .r. ,v'lloIll. .t
tho 011,.. .f tho R.al.t., ., HilI., .~. " Ih' IS R.von.. OI.I,lct 0111... ., Ir.. I"o.o.p.rl..nt'. l~'''.vr
en'Wlrlng ..ryl~. nu.btrlfor for.. orderlngl In Plnnlvlvanl, l~aOO'a61.ep~O; out, Ide Pennlv1v,"1,
IIIld .lIhln 1...1 lIorrhh.'a or" 17l7l 717.au9~, 100. 17171 711-llll Woorlna I"".,,,d .nlv).
REPLV T01 etutlt'ion., r...rdlno error. oontaln.d on thh noUol Ihould bt .ddr....d tOI PA PIPlrt,.."t elf ReVlnut,lu",.u
of lndlvldull taMil, ATTHI PDlt h......nt Rlvl.w lJn1t, Dept; ea0601, Illrrhburlh PA 17121"0601, phof1'
17171 717-1&0&,
DI8COUHTI If IOV tiN dUI Ii Plld wHhln thr'. (3) oattndlr eonth. etHer thl dlOldlnt" death, I flvI Plro,nt HI:n dl100ut1t
of thl tlM ~aSd 1. allow.d,
PEltALTVI TM Uk taM un..tv non-partlolpaUon plnalty II oOIPuhd on thl 'totll 0' thl tlM and Sntlr..t .......d, IIltd'not
paid blforl J.nu..r~ la, If'96, th. fir.t dlVlnlr the Ind o( the tit( ,In..b perlod.
INtERet', In'.r..' 11 ohargld bl,InnSng with first dl~ of deUnqu.no~; 01" nln. (91 tlonth' and onl (1) d.~ frol thl dlt. of
dttth, to thl dlt. of Plv..nt. 'iM.' Whloh b.o... dll1nqu.nt blfor. Jlnulrw 1_ 1982 ~..r int.rl.t .t thl ratl of
.iM (6Xl Plro.nt ptr ennuI cll~ullt.d ata d.l1~ rat. of ,000164. All tlMII whS9h bloa.. dellnqulnt on and .ft.r
J~.rY 1; 1911M111 b,.t lntar..t.t . rat. whloh will y.r~ frol aalander VIer to aallndlr V'lr Mlth that tata
announoad bv the PA b'Plrt..nt of ReYlnUl, Thl IPpllolbla lntere.t rite' for 1.62 through 1999 .1"1'
V..r Jntlr..t Mat. P.IIY Inl.rl.t F..I., vI.r Inl.".t R". DallY lnt.rllt Faotor
- -
191. lOX . 0001~1 1911-1991 \IX .OOOS.I
I9n 16M .OOO~II 1991 9M .000l~7
191~ IIX .000101 1995-199~ 7X .000191
1911 UX .000116 1991-1991 9k .000147
1916 10M .00017~ 1999 7k ,000191
\917 9X .0001~7
..Sntlr..t 1. Oiloulated II follow'l NUNSeR OF DAYS OBLINQUBNT
INTBRBST . 8ALANOB OP TAX UNPAID X X OAI~Y INTBRBST PACTDR
--Any Hotl.. "'U'd .fl., Ih' t.. b...... ~.Iln~.nl wIll ,.,I..t.oo Inl.r..1 ..I.ul.ll.n t. fllt.on 1111 ~'VI
b'~ond the dat, of the .....I..nt. tf Ply..nt i, Ildt Iftlr the int.r.tt ao.putation det. thown on the
Hotioe, additional Jntititt .utt be o.loul.ted.
PAI'ItIlNTI
RIl'UNll (CR),
" ,
Rl!PLV TOI
bllCQUltTl
PINAL lVI'
IHTbRl!lTI
, '
DoI..h Ih. I"" porllon 01 Ihll HoII.. .nd .11I>o1\ NI\h .our p....nl ..d. po..bl. I. Ih. nIl' and .ddr...
prlhled on lho r.u.r.. 'Ido.
-- If ~~mbNT IlIICIPIlHl ,ok, .h..k .r ,on.. .rder p...bl. I., REGISTER OF HILLS, AQENT.
.- If .HDH-RI81IlllHT PIlCbllllNl ,.k. .h..k or ..n.. .rd.r p...bl. \., COHHONHEALTHOF FEIlNSYLVANIA.
A r.fund of . tiN Qr.dlt, whioh w..' not rlqu,.tld on th. T.~ A,'ur~, .'Y bt r.qultted bv Go.pl.tln, an
"
"Appll..II.n f.r R,fund DI p.nn..1von,. Inh.rlton.. ond b.I.I. T.,. (RIY-1111). AppIID.llon. .r. o..llobl".\
lho OfU.. .f, Ih. R'.lolOr .f "11l,".n. of lho II R.V'IIIl.DII\'IDI Of fl... D' frD' Ih. D.porl..nl'. I.-hour
,""IM.,.lnA ..rvhiJll.Nlbtr. for fori' ard,rlnOkIn PlnnlVlVlnhl 1"600"161"1080, outlldl P'Mlv1Y",11
.nd Hllhln 1...1 H.'rl...,. .,.. (111) 181-809.. TOOl (111) 111_1161 (H..,ln. l.p.lr.d .nl'l.
Qut.tlon, rlglrdlng .rrorl oon'.lntd on thit nottoo ,lhoUld b. .ddr....d tOI PA nep.rt.,nt of Rlv.nut; lur..u
oflndlvldull TIK", ATTNI POlt A.I.....nt R,vllw Unit, n,pt. 180601, Harrllbur" PA 1712.-0601, phon.
(1111 111-6106.
If any tlM dUt i.' paid within thr.. (3) calender lonth. .ft,r thl d,oldtnt'l d.ath, l;flvl p.rolnt (IX) ~l.oount
of the tlM plid 1. e110Wld.
1h~ 1BX tIMi~..t~ "on.plrtlo1p.tl~n plnaltv 1. Q~.put~d on thl tat.l of thl t.~ and tntl,...t .1..I..d, end nat
pltdblforl JlnUlrY ,18, 1996, thl flr.t da~ afttr thl tnd of tht tlM ..n..tv p.rlod.
Int.r..t It'onarg.d blglnnlng Mith firlt day of dellnqulnoy, or nlnl (~, 'o"th~ ~nd ani (1) day frOl :thl dlti of
d..th; to 'thl"d.tt OfpIYI.nt. TII(I. whioh Iilo... crlUttqu.nt blfor.JanUlrv 1,' 1912 b..r tntlrut It thl'r.te of
IlK (6X) p.rolnt plr ,"n~ OlloUl,ttd It e dall~ r.ta of .00016~. All tIK,,'whloh bIO..1 dll1nqu.nt on and Ifter
Jenulry t;l'" w111 b..r lntlr..t It . ratt,Whloh will vary frol all.ndar vt.r"ta aal.ndlr V"" with that rltl
announotd bv thtPA nlPlrtllnt of R.v.nUl. Thl ap~llc.bl. tnt.rllt r.te. for 19.. throuah 1.99 '1"1'
v.., Inl.r,.1 R.I. 0.11. Int.,..t P..to~
-"
V'lr Inter..t'Ratl 0.11. Inloro" P..I.r
-
19aa-1991 m .000101
1991 9~ .000147
1990-1994 1:': .000192
1996-1991 9~ .00la.1
1999 1X .000191
19B1 .O~ .000Bl1
1911 IBM .ooom
191., llX .000101
191& 11M .0001&6
1916 IO~ .050171
1917 OX .0001.1
..tntlr..t 1,'olloUl.t,d.. fOllOMit
IHTBRB8T . BALAHCB OF T~K UNPAID K HUHBBR 0' DAYS DBLIHQUBNT K DAILY INTBRBST PACTOR
~.Anv Hotlo. 1.,u.d .fter thl tex b'o~I' dll1nqu.nt w111 r,fllot .n Intlr..t o.loulatlon to fJftten (II) dlY'
btyond thl d.t_ of thl ......-.0\. If P.~..nt 1. ..d_ ift.rth, 1nttr..toolPutat10nd.te shOwn on the
NaUo.; IddlUDi1~l 1nt.r.tIt IN.t bt olloullt.d.,
rAVHENTI
battHlh the top ,portion of thll Hotlel' and lubllt with vour Plty..nt "lid. flhVlllbl. tu thl nltlt. ~d IIddr...
print.d on thl rlvtr.. ,Ide,
If RealDllNT U~~~U~NT ooko oheok or oon.. ordor povoblo to, REOnTeR OF WILLI, AOINT,
If HOH-hE81IllNT OE~~IlINT ..ko on.ok or oonov ordor povobl. to, CllHNONWIALTH Of PBNNIYLVANIA,
~'UND (CRli A r.fund-of . tlM orldit, whloh H.I not r.qu..tid on tho r.x Return, .'V bl rlqul.t,d bv oo.pl,tina an
"Appllootlon for Rof~d of Ponnovlvonlo lnh.rlt.no. ond EototoTo'~ (REY-ISIII, Appllootlono oro OYolloblo ot
the Oflloo of tho Roght.r of Wlllo. env af tho U Rovonuo Ohtrlot Offlao. ar fr.. \ho Ooport..nt'. 2.-"DUr
-neW.' tn. .Irvlol nUlbtr.-for fDr.~ orderingl In PennlYlYllnl, IM800.S6e.aOIO, o~t'ld. Plnn'vivanl.
endollhln 10.01 "orrhburg oreo (71?! 1$7-809.. TOOl 17lVl 712-EU! Woorlng lopolred onlYI,
RIlPLV TO' Qu..Uon' rta'~~l". .rror. aontalnld on thit "oUClI .hould b, .ddr....d tell PA DIPlrt.,"t of ReYlnu., 'ur..u
of Jndlvldull nut.., AttH. po.t A.......nt AIV11w Unit, nlpt, 280601, Ulrrhbura, I1A 171ia'l'0601, phon.
, !7171 787-UOR.
btlCQuHll If an~ tlW due S, plid Mith~n three (!) oalender .onth. aftlr thl dlcedlnt" dleth, a fSvI plralnt (a~) d11opuot
of the tax p'lld 1. 111oWld.
PENAm,1
Th' lBK tlW ..-'I,tV nonMpartlolpatSon Plnaltvl. oo~ut.d on thl tot.l ofi~hl tlX and Intere.t I......d, Ind not
pI1d,b,forl Januarv 18; 1996, thl f1r.t d.~ afttr thl end of thA tlX e.n,.tw plr1od.
IHURUTI
Int,rlltS, oh6rU,d b,~1nnlnu with f1r.t d'~,of del1nqutnov, or n1nl,(91 Month' nnd onA (l)'dav fro. thldlt, of
d..th, to the detl of Plv.'nt. -'ax,. whloh bloe.. d.llnqu.nt blfore Jlnulrv 1, 1982 bltr lnterelt It the rat, of
,IK (6Xl ,para.nt plr InnUI olloul.tld Ita dllh rat. of ,D00164, All taXI' ",hlcih'blo.., dellnqUlnt on I~ Iftlr
Jlnuarv 1, 1962 ~111 beer inter.tt It I rate whloh will y.r~ frPl oalendarva.t to o..tndlr y..rwlth thet tet.
ennouno.dbv the PA,Dtpart..nt of RtVlnu.. The ,ppllo"b1, Intere.t rate. for 1.82 through 1999 Ir.1
V,lf Intere.tRate DIIIV Intet..t ~aotor
-
v.,t tnterllt Ratl DallY Inter..t Faotor
-
198&-1991 IIX .000101
199! 9X ,000241
1995-199. 7X ,00019!
, U91-l990 9X .0001.7
1999 7X ,ODDl9!
1962 20X .0000.6
1985 16X ,000~16
198. IIX ,000501
1960 ISX .000506
196' lOX ,000tl.
1967 oX .000r.7
--tntet..t 11 oa1aUl.t,d .. fOllOWII
lNTBRBIT . BALANllB OF TAX UNPAID X HUHBBR OF OAYB OBLINQUBHT X DAlLY INTBRBBT FAOTIlR
--An~ Hotlol l..u.d .fter thl tl" b.oo... dollnqu,nt will rlfl.ot In lntert.t oaloulatlon tb flft.," (1.) da~.
bevOnd'thl dlttof thl ....i..'nt. tf p.~..nt il ..dl .'tlt the lnt.r..t ooaput.tlon dlt. Ihown on thi
HotlOI; ~ddltlon'l Int.r..t ~It be O,1oulated,
POV.HTI
Utl~ lho lap porllon of thl. Hotlo. ond,.ub..t wllh vour povoo.1 .Ido Plvlblo 10 Ih. n..o ond oddrol'
prlnlod ~ lho r..or.. oldo,
.. If Ra810EHT OaC~UEHT .oko ohlok or o~nov ardor plvobll la, RBGIITBR OF WILL8, AGENT,
._ 11 HOH-RE8ID1lHT DIlCEDIlHT .okl,ohlok or .0noY ardor plvoblo 'to, cOHHONWBALTHOIt rBNNIYLVANIA,
REfUHpCCAh A refund ~f, . hN or.d1t.,J'hSRh wal not ".qutlted 0," thi TIM R,turn, ..~ b, raqutltld b~ oOllPlIU,!SI In
"Applloollon for Rlf~ of Plnn.vl.onl. l.horllonol ond altoll T.." (REV-ISI8), opplla.tlon. Ir, a.olloall .1
lho Offl.lof lhoRagl.l.r af Hilla. onv of lho 28 Ra.onuo pl'lrlot Offloo. or Ir.. tho Pop.rl..nl'. 2.-hour
an.w.rSf11 ""ySOI 'nuabt,.. far far.. ordl'r"ln," In ~'M.~lY.ntil 1"100"562-2060, ouhide p,nnlylyMJa
end within laoal Horrhburg or.. (7171 787~8094, TOOl (7171 71!-22&E lil.orlng l.p.lr.d onlvl,
RRPIV TOI
UllClIUHTI
paNAL TV!
IHTI~8T I
QUI.Hons regarding, Irrorl,oortt"lntd Oil thh noUOt s"ould bll .ddr....d tOI PA D.~.,.t..nt of RI,vlnu.# ~ur.1U
of Individual 11M"; ATTH' POllt .........nt.R.vi.w Unit, Dlpt, '280601, Uarrhburlf PA 17120-0601, phon.
(7171 787-6808,
U anv t,,1t dUlf h paid within thrlu (5) oallnda,. .onth. _ft,,. thl dIO,dl"t', d"th, . fh. p.rolnt tax> dlloou"t
af lho t.. p.ld I. ollaw.d,
Th' 1&~ tDK ..nl.tw,non-ptrtlalp.tlon plnalty S. ooaputtd on 'hi tat~l of thl taw end '"t.r..t.......d, end not
plid blfor. JlnulrY'18, 1996, the flr.t dfty If tel" th. .nd of thl tlM '.nl'~Y p.riod.
Int.reit it ohlr"ld bl"Sn"ln. with Ur.t dlY of d.11nquenoy,or;"1n. (9,'. Month. Ind an. (U dlV frol the dlt. of
dtlth;to tht'~dfttl of Plv.,nt. Tawe. whioh bll;ll.. dlUr.qUlnt before Jlnul"Y 1, 19le bill" interllt It the retl I)f
,he .t~X) plrolnt plr annul oaUulat.d at . dalh rite of .000164, AU tlMU Whloh b,OiUll d_11nqulnt on Ind .Ulr
Januarv 1, 19a! will ~or Inlorl,! It 0 r.to Wllloh will ..rv fra. ollond~r VI.r 10 Oll.ndor Voor with Ihlt r.t.
ttnnoUhoed by _ thl PA b'Plrt..nt of Rlvlnul, Th. IfJfJllaab1t iMtrllt .ratll' far' 1911 through 19.99 11""
Vt.r Xntere.t Aat. Oal1y.!nttr'ltfaotor
-
VI.r tnter..t. A,tl OlllV lnt.tilt Faotor
1986.1991 IlU .000SOI
19U ~r. ,OOGE.?
199&-199. 7r. ,00019!
199&-1998 9:< ,0002.7
1999 7r. .00019!
1982 20r. ,'000848
1,61 16H ,000486
198. Ilr. ,00080\
,1m I8H ,000886
1986 lOr. ,000174'
1967 9r. ,000!.7
..1nttr.lt II o,lout,t.d" fallowll
INTIRBBT . 8ALAHCS OF. TAX UHPAID X NU"88R OF DAVS OILIHqUBHT X DAILV IHTIRBBT FACTOR
'-AnY H.llo. I"uld olt.r tho to. b..D... d.llnqu.nt will rafl.ot .n Int.r.ol .0loUlltlan to fllloln (181 diva
'b4vond thl dlt_ of thl ........nt. If fJly..nt Ii .,d, 'ftlr thl intlrl.t ootPut.tlon ditl ihownon the
Hotio., Iddltlonll Int.rl.t IUlt bl allaul_ttd.
CORROR.lOllIl or Pf-NNIYIYANlo
Df.IIA'"Hun Of' REV~Hut:
lUREoU Of INOIVlouoL IAKEI
OCPI, 110601
IIARRIlIURO, IIA 111/1-0601
"'- -,\_C_.L(I_ ('.IL
(1*
1\
I.. '( I
INFORMATXON NOTICI
AND
TAXPAVIR RI8FON81
PILI NO. 21- '1"1 .', q' I
AON 97146573
DATI 10-31-97
TYPE OF ACCOUNT
EST, OP L L OVD E BRANDT ~ IAVJNOI
8,S, NO, 196-07-1149 CHECKING
DATE OF DEATH 08-06-97 TRUIT
COUNTY CUMBERLAND cERTIF,
RBHIT PAYHBNT AND FORHI TOI
REOIST~R .gF WILLS
CUMBER AN CO COURT HOUSE
CARLU E, PA 17Q13
m.tUlllm"...,
JERRY BRANDT
11 OB JOFFEE ST
ELWDQD CITY
PA 16117
HA.RRJI IAVINOI BANK h.. provld.d Ih. O.portOlnl .lth 1110 In/Drootlon ll.t.d b.la. .hlDh h.. boon u..~ In
oahUhU"a the pot'nthl '.K dUl, Their r,Ogrd. Indioltl th.t at thl d..th of thl above dlcedlnt, VClIJ wnl . Jotnt oMn.rlbtn.UoSarv of
th" aaoount. If You fill th" '"'or..tlem II lnGorrlot, pi.... ob'"." ..rlttln oClrr.ot!an frail thl Unanolctl Inl\1\utlol'll Ithuh . ClOPV'
to 'hlf for. and r.turn It to the abov, addr'Ui Thll aooount It t_",bl, In lCoordanol with 'hi lnh.,.U"na. hw law,af the Ca..onH",1th
nf P."Myh,ll"h, g~",.t1MIlII"~ h. "Mt.lRr'l;rt hI' ,.,,\llnt' ('1\7~ '.7an21, ." _ . '
OOHPLITI PART ~ BILOW M M II III RIVIRII 8101 PORPILINlt AND PAVMINT INSTRUOTlON_
Aooount No, 31-69-310990 Dill 07-06-99
Blhblllh.d
Ao~ount BIllno. 90 , 041, 7 I
P.ro.nt T'MObh K 90 , 000
NOTE I If tiN' Ply.,ntl ar. MId. wlthln thr..
AMount 'ub~lot 10 T'M 25, 020, 89 (&1 o.nth. 0/ Iho d'n8d.nl'. dot. of. doolll,
TIM Rlto M , 15 vau .'V doduol 0 IX dlooaunt of tho to. duo,
AnvI lnhtrlhnq. '1111 due w111 b.oo". dtUnqulnt
PotonUll T'M Du. 3, 753, 13 nino 191 .Dnth' o/lor III' dol. DI d.oth,
PMT . .. '. ... .... . .' TAXPAVBR RBSPONSB . ..' . .,.....
L:!J l-"AILU~_,rOi~IMP9."~.t~~~~,)~nY~T!.~""~M",qp~~.9~.A~".rA~"A'.~~II'.".NT'A~.~..9Hi1H~'."NQr~Q-ITl
At 0 Thl,.bnyt Infor..Uon ,nd tiN' dUI It oorr.ot.
1. You al~ ohQollto r.I1tPlYJlnt tel th. Ruhtlr of HUh with two oopl.. of thh noUal to'obtaln
._dl.oount or,ftyold Intlr..t, or YoU ..V ohlck bOil HA" and r.turn thl. hotto. t~ thl R..t.t.raf
M11l1 Ind .n offlol.I........nt _HUI"b' IUU'd by the PA Dtpuh.nt of R.y~nu't
I, 0 Th. aboy, Ii,..t hu bun or wU'1 b. r.portld and tiN' p.ld wlth thl P,n",vlyanl. U1h.rl\anoi TaN' rltl,jrn
to bt'flled by thl d.atdlnV. rtprll.,H,.UYAI ;I'
e, IE Th.' abOY.' InforMlUon lJ-jnoorr'o\ Ind/o~'bh and dlduotloni wer. ~,Id by 'V'O~I
Vou Il,jlt ooaplltl PART 1.!J Ind/or PAIn L!J bilow, "
PI!JART ~:lY;~ l~~l~'t: :dl~f~~~n I pl.... · I · YOU~'::';i:::'iki)DlfelO~AM' k'4~~'9H~V~'Nk llM~:,!
· on. 10 I ,,",.,.,,.,.".""!,!,,, I'IPf\RT &:NT'OP'RI'IYI'I ~"vl""'1
~:N~ ~~~~~: B:I~b~~. ~~.~ATlON 0: T"X1~ lo.J,~~N:r:RUIT AOOOU, NTI li:~~~~!,!;:::"l:"':":":"i:::"i,,':,,',:":"':",,;,:,:!il,]I':
2, Aooount bllnol R ~f!."/.jl,?~. ',:,'!IL:""!I,:
~', ~:oruo'nnttluTb'~'.obtllto T." ~ W ,'\ "0 ~ '-, ~'Or '".'.',.,..i:,.,...,.'.':',..."..".!,....'....!:....:."!.."....J,':.........,..',.:..,:.',:....::. .: '" . . . ".::.'..!.' . ."':'... ,. '1
;, ~;bh Ind ~lduoUon." ; ~ ~_!!" !! ~,,'$.':"(""!'T,!,:,;!,,'~;t,'!~::il:1:;",
6, AMount TI..bl1 '_ iJ,ScillC'!i:Y ".'!6'!, i ".,,, ,
:: ~:: :~~'IIFf&l n.DI6(""~f: I~:U", 19 Is' () i', S~T' ~1",::,:i:L'i
DIBTI AND'DIDUOTIONI OLAIMID
To In'~r. prQ~.r or.dlt '0 YOl,jr IQOOl,jnt, twg
(2) oopl'l ofthl. notlol ~v.t 'DDO~P'"y vour
pav..nt to thl R.ullttr of Willi, Hak. Oh.ok
Plvlbll tql "R.ghter of WUI., ~8In1"1
[CHECK ]
ONE
5LOCK
ONLY
PooT
DATE PAID
l
PAV~E
DESCRIPTION
AMOUNT PAID
- "l""u "MI.' '0 _'.Hu' I
of Plr~urYI I d.oll~' Ihlt tho foot. % h.v. r.portld Ibovl Ir. tru.. oorr.ot Ind
IIf MY kn " .!.~gl Indb,U.I, HOME ( '71 d ) 'l~- /(r 9 ,') b go
WORK ( )
GENERAL INFORMATION
1. FAlLURa TO RUtoONO WILL RUU~ T IN AN OFfICIAL TAM A8U,8HBNT .II~ .pplloobl. Intm.t bmd on Info...1 Ion
'Ublllt.~ bY tho fln,nol.l Inltll~llon,
e. Inhlrltanol \1M b.a~." d'llnqulnt nlnt f10n~hI .fhr thl dlGldlnt" dlt, of dnth.
I. A Joint 10.I:IOunt II h>>l,blt IV'" thOUgh th. d,o,dlfH', ",I' ~.. Iddld at . ..U., of oOnVtntlnu,
", Aooaunh UnohtcUnl tho II hlld bttwtln hYlbl!lnd and wlf.. ,~I\tClh "1' dIC,d,nt put In Joint nalll wHhl" on. ,VI.r prior to
d..'h Jr. fully tlMlbl, II trln,'.r..
_I AGOGI,"" "tlbl hht" JolnUV bltw.." hi.llhlnd end wlf, "or. th,ltn on. yu, pdor to d..th !Jr. not tlMlbll,
,; ADClounh hlld bY . dIUd,"\ "In tru.' for" mothlr or IIthU' Ir. tllillbll fully,
REPORTING INSTRUOTIONS . PART 1 . TAXPAVER RESPONSE
" ILOCK.. If thft tnforl.Hon Ind OQlmut,Uon In thl noUn IIr, oorrea' tUld dtduo\lonl Ir. not bllng al.I.,d, pllal '" "M"'
In bhlOk "A" 0' Plr'. r ofthl "hMpIv',r Rupon.." .IOUOMI U,n two oopl" ftnd tub_U th.. with vaur chlok for thl "o~t of
t.. to tho R.gltl.r of .WlllI of Ih. ,DOOIY Indlo.tod, tho PA Uoporl..nt of RoYonu. .111 l..uo .n 011101.1 ........nl
(For. REY-II'I EKl upon r.oolot of tho r.turnfro.. tho R.gl.l.r of Will.,
/, 810CK 8 - If Ih. ....1 .p.ai'lIld on tnh nolln III' boon or will bl roportld 'nd I.. p.ld .Ilh Ih. P.nn'Vlv.nl. Inhorllono.
tlM A.hlrn fllld bv thl dlc,tdlnt'l rlpr",ntltlvl, phn ,n "K" In blook "I" of "Irt lof thl "h1'MPlnr A'IPOnti" lIotlonl tlan on.
oopv .nd r.turn ta thl PA'bIP.rhlnt 0' Mlvlnul, aurtlu of Indlvldull filM", DIPt Ba0601, Illrrhburll, PA 17UI"0601 'In thl
onvolop. pr.vld.d,
I, '~OCK C . If thl "OtlOI In'or..Uon II I"oorreot and/or dlduaUon. If" b,lng al,I!I'd, ohlOk block "e" IU\d oO.IHtt. Putt, and S
.ooordlnq to thl In.truotlon. bilow, .tan two OOplII Ind .ubalt thl. with vour uhlok for tht ..aunt of tlM p'Vlbl1 to thl Rlalltar
of HUh of thl oounh Indloatld. thl PA OlpartM"nt of Rlvlnu.'wlll lllu. In offlalal ........nt ('gra REV.Uft. E~() upon rla.lpt' I
af Ihl r.lurn fro. tho Rogllllr of Will..
TAX RETURN - PART 2 . TAX COMPUTATION
I Ill!
1, lInter th.d,t, thl toaaunt orlglnllhwlI ut,bllth.d or tlUld; In th, Mlnn.r 'Mhtln. It d.t. of dlllth,
HOTEl Par I d.old.nt dvlng .ft'r 1'11'1811 Aaoount. whloh thl dloldlnt put In JYi~' n.... within an. (1) v'tr of d..th ,r,
tlM.blt fulh II trln,'.r., 1I0WIVIr, there 11 In tl(alu,lonnot to nOlfd '~,OOO Ptr tr,n"lrll r'AlrcU... of thl VIlu, of
thl IQQount or thl nUlblr af tooountl h.l~,
If . dOUblt .,t.rl'k (NN) tppI'r. blfor. your ftt,t 1'..1 In thl addrl" portion of tht. notloe, thl ..,000 II(OlUllon
Ilr.tdv hil b.in dtduct.d,frol th. .aoount'bllanol I' rlPort.d bv thl fln.nolll In.tltutton.
I, enter thfl tot". balen,ot Qf 'hi B(lOOont InClh,dln, Int.rut tOClru.d to th. dlt. of duth,
I, Thl p.Nllnt 'Of thl looount thlt _ h tlllablt far IIch 'llrvlvor h ~,ttt.t".d II fotloWl1
A, ~h. paro.nt t'~lbl. for Joint a,..ts, ..t.blt_hld lor. thin o~. V'lr prtarto thl dlaedlnt'. dllth,
I UlYlU.D 8V TOIIL NUNa.R I)fI OIVIOEO av TOIM IMlIER OF K 100 . PERCENi TO~Ii(~
JOINT OWNER' 'aURV1YlNO JOINT OWNER'
EMaeplll A JQlnt ...,t,rl.I.t.rtd 1n the n... Qf th' d.old.nt Ind two other'p.rlonl,
I OIYIIlt!O 'V I CJlIIHT OWNER'1 OIVIO~O 8V I l'URY1VDRII . .101 K 100 . 10,IX (TAIIA8IE FOR EAc" 'URVIYORI
I, Thl Plrc,lnt tlMlbl. for ....t.or..t.d wlthln onl Vllr of th, d.a.d.nt'. d.,th or IOU~unt. own.d bv thl dleldlnt but h,ld,
" In Iru.t for Inolhor Indlvldu.llll llru.1 b.n.flDtorlo.),
I OIVIO~O 8V TOTAl NUH8ER OF IURVIVINO JOINT
OWW.RI DR TRUITa.NEFICIARIEI
K 100 . PERCENT TlK'IIE
EMlapl" Joint loaount rtgllUr,d In tht n... af thl dlaldlnt and two othlf Plrlem. Ind ..tlbJhh.d ",'Athln ant v"r of d.ath bv
the dloldlnt. . .
I OIYlllt!O 8V 2 CIURVIVORIl . ,10 K 100 . lOX lTAKUIE FOR EACH ,URVIYORl
.. The.....1 .lIbloO\ 10 II' Cllno ., to d.hr.lnod bv .ul\lplYln. thl. .000001 b.I.... liln. /) bv Ih. poro.nt II'"~I' (iln. Il.
I. .nt.r thl loll af IhI d.btl Indd.ouoIIDn. II.t.d In Plrt I.
,. T"'~""i'"t b,w"'h 11M 6. .. d."r,lntd bV tlJbtr.aUn" thl dab" lild dtduethml Ulnll) frel th. I.ount .ub,tlot to talC Uln. 4),
1, rntlr thl JPproprl.~. tlW rl\1 (lIne 1) I' d.tlr.th.d bilow,
Al For dltl';of d.ath ooourrln, If'!, 6/10/94, thl t'M rltl' for t'in,'.r. to ,pOUI.t ar. I' follow.'
I. 0.1.1 of d.olh on or .fl.r 7/ /9. .nd blfar. 1/1/91 tho r.l. I. SK.
I, U.I.l 01 d.Olh 0" or 111~r 111/91 Ir.n,'.ro la lFaUl.. .111 b. t...d It OK t.. r.t..
Hotll For dOlol 01 ol.th prior 10 111194 Ir.n"or. IO',Pou... .ro t..lblo .t OK, .
.. Trlnihr. tD 11n.il' dUI.lnd,n'. ittoludlnG fithir,. .oth,,\ '01'1, dlu"httr f arIMd.ohl1dr.n, '01'1. In. law,
dIUlht.to"In-1Iw,...t.pah ldlnd thll, l"u, art hoult ". .h~ PlrOlnt (6~), ..
C. Tran'f.,.. to.1 oth.rl Inohidlng bro hit, llittr, unol., lunt, niPhlw.nd nl,ol Ire tlMlbl' It flH"n pero.ot ClIUO.
0, If ~ou ,hongl Ihl ~.. rll., PI.III .p.olfY Your r.lltIDn.hlp to t~1 dlolU.nt In Ihl nr.. provld.d,
I. Th. 1....1 01 tl' dUltlln. II I.dll.rllnod bV oulllplvlng tho llDunt IO'.bll llln. 6) bV Iho t.w r.tl (1lno 71,
CLAIMED DEDUCTIONS . PART S
DEBTS AND OEDUCTIONS CLAIMED
'1Io.obl. dibl. ond d.dO.llon. Iro dltlr.lhld .. fOIIOW'1
A. You li'111v .r. r..pon.ibl. for pIVlint, or the ..tlt. iubJlat to ~Inlltrltlon b~ ,'p.r.on.l r.pr'l,ntltlvl I' In.ufflolent
10 p.v Ih6 d.dUollbl. 11101,
., Vou 10luolIY P.ld Iho d.bh I/I.r dlolh 01 Ih. dl..dont llId ..n furnlth prDaf 01 PIy.ont, . .
c, nabtl bilnl alal..d .ult ~. It'.'lld full~ In Pert S, If addltlonll '~'al 'I nald.d,u.. pllln PIP.r 1 lit" M 11ft. Proof of
p.~..nt "V bar,quI.ted bV thl PA O.p.rt'lnt af RiVIMU"
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HARRtg~uRa AT('1'Y~87.8a2~. TDDI (7Ih 7tll.a~2 (nEA~~NO fMPAt~IlDONLV)
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Octqper 22, 1997,
Regls~er ot Wl~~s
cumberl~nd County court House
1 court KouseSqu~r.
Carli.le Pat 17013~3397
Dear Sirl
Enclosed is check in the amount of $2,139.66 for the payment of
eet~~. taxes on the .eta~e of Lloyd m. Brandt, date ofde~th
August 6" 1997. I oaloulated the ta:lt aliI follows I
"
.
Amount of Distribution I
50% of Distributionl
6% Ta:lt'1
5% Early payment Creditl
Net T~)c1
$75,075.78
37,537.89
2,252,27
112.61
$:<\,139.66
please return a'reoeipt for my reoords, thanK you,
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Sincerely
, s~~m~
1871 creBoentRd,
Fr~nklin, In., 46131
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