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J l/ ' , i , If ( - 1/ / 'I , DATE , I i /I ( /z ;; I /, " /.:, I' , II I;, ( ,,/'" ESTATE OF ,', ,': Ii 1/ I z I /.: fYI, , , FILE NO, - , I , / /;'1,"/I~.., """" /", , .~. ; /1/ /1 (r ,J, /,,(j COUNTY OF For County Information purposes only I " If .;, ( /;;-7 COUNTY FILE NO: II - .. , ~ DATE OF DEATH - Approisod Voluo 01 Estato: (. / j' Real Estctlo Personal Property Jointly Hold PropollylTrans'ers $ ~ . 1/'" ( ?: Total Gross Estato $ :.> . '; ~ I ~ Total Approved Deductions 2. '1/ /1 CleDr Valuo of ESIDtO $ /'{I 7j Less: Approved Charitable Exemptions " Cluar Value of Estate Sub;ecllo Tall $ I( J, ? ~., Amount T..eble @ 6% Rate $ ./ ( / : taa: duo $ 117,.r:7 Amount Ta.able @ '5% Rat. tax due TOTAL PENNSYLVANIA INHERITANCE TAX DUE $ II 7 { 7" Loss Credils: DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT " -/ "~I ' 7'; $ .if" r + $ $ : $ ",,.. .,..,- t . = .' = BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $ 2,50 .,.:"S...4-4~ Interest will accruo at aho rate 01 si. (6) Inheritance tax from )..:. (" percent J'i pet - (.-:/ 't.', 71 annum on tho unpaid balance of 10 tho dato of paymont, por Ass.ssod by: Age"1 10f the Common~..I'h SEE REvrRSE SIDE rOR INstRucnONS REGISTER OF WILL'S COpy ~IDENT .DECEDENT DEBTS AND DEDUCTIONS CLAIMED NO : LiAI Itut rI,e ttrm. in tht .parr.1O pru,ldrd, ob..ne notations thtrton. and lnltruclionL DEBT OR CLAIM NATURE OF SAME OTHER DEBTS AND CLAI~ , Flduclary commtlllon . AMOUNT I / / / / / / / Funeral ~xptn.n paid Family nemption (will not tw allowed unit.. dfudfnt dif'd rnidinr with a lpoUH or chlldrtn.) Admini.tratlon EI~nlf' . Counsel ttn . (.) SH Noto below // / '" ~ '"" ""'" / / / // / '\... , ',,- "- , '"'' '" " " ""'. "- , ',- " "',,- ". '-'> " ". ''-, '. / /" ,,/' / Total ", "'. Subscribed and sworn to before me lbis "".."..'".., '..,.. ISI-l ~ ')t? ......,......~....,..... dayor ...... .....' .........,19.... ,~~ '~#7" 'Kilh1..ri), t1rtdberv. Nola,., I'lMc ' M., Commrulon [spilu Mlllh 1. Ita . __ ~NnIub..... PA Cumb,Nnd C...." Note: Theeslateagrees to advise lbe Register of Wills If the amounl actually paid In seWement of any ree, commis..lon or debt Is greater or' less than lbe estimated amounl claimed and allowed, "L-",k;?K-?,.i?'::.:))~?..,. (errt1l.ror-Admi"utro.or) 9?O,u:"..,/Ldd~.-"."", (Srr"r N7? .J.--;Yt',~/il?:!. .... ~,-:"...... .. ...... (C,rr ur Town and S'atr) -. """"~-=_.- -..--".- lIavlng been duly sworn according 10 law, I do hereby cert1ly thallhe above appraisement is made In conformlly wilb law on this I .. .. , . , .. , .. .. ' .. .. .. , .. , .. , .. .... day of .. .. , " ....' , , .. , , , .. ' .., 19...., Appraiser In lbe evonlthat any fulure lnlereslln lbis eslale is lransferred In possession or enJoyment 10 collateral heirs of the decedent aner the expiration of any eslale for life or for years, lbe Commonweallb hereby expressly reserves lbe right to appraise and a..ess Iransfer Inherllance Iaxes atlhe lawful collateral role on any such future Interest. - - -~~='~~-"--_._= REPORT OF TilE REGISTER 0.' WII.I.s I, the undel'llllJle(l duly elected Register 01 Wll1a In and for. , , , , , , , . . . , , County, Pennsylvania, do respectIully report lhat I have, allowed debta and deductlooa In lbe amounla claimed by deponenl, except as 10 lbose items where a greater or lesser amount is set forlh In the laat column to the right In said sehedule above, which greater or lesser amount represenla lbe sum allowed as a deduction, I Daled:..... .,..."..,..,.. ...... ,.,..,.,".""'.., ", " """." "". ii..i.i;; ~i Wln;.'."'.".,.".".,.. \ .'l; , , " . . . . . . ~ 0 .' . . ] . ..J r&l . ~ ::!l . < II) r&l 0 - . :l II) . .. - 0 OS :l 0 CO Po. . fa. . > Po. . 0 . Po. 0 . 0 ~ < . Po. . 0 . .. < .. r&l l:l . r: c . r: r&l Eo< .. Z 0 .. ~ Po. < cl ! == 0 ... Z Eo< f2 0 t: -- fa. ~ c 0 ~ ~ 0 :D l:ll ... ~ r&l ! l! ~ 0 c l:ll ~ . ... ~ j 0 . 3 c i. 6~ . " . :l 8 I . ~< . I ". . toe ~I ~ '" 0- ~ co ... ~ ~ ~ ... .... :: ~ :l ~ ~ :: .g .... d Cl . III III U \'-. ~ .... '" ::l '" 8 = ..: , N - ~ ~ .., """ l: l: t'<-l '5 Q I E E 'i .. ~ ,0 0;; ... " < ~ ,::/ ,::I "- 0 ~ ~ l! i i ~ - ... -a .; l! I ~ 'Q Q .... U ... ... !>: ~ 0 0 :.. IS, ... ~ ... ... 0 !l' ~ "I: "I: ~ . !i 1 w ;; :>ol fa ~ -ti .", ~ III '" ~ ~ ~ - i" 1 ~ ~ :l Q '" ~ ~ Ii a ~ .", '" e Cl N :'5 - 1l il 1 t l u 0 .::: N ~ 'i ii: "€ - 'Q ~ " I"l " 'i1 .. ;; ""- ~ ~ .e ~ "- III ~ Cl ::: ~ i! ::: "I: t'~ z ... :: ::: .. .~ :: - .::1 ~ ... III E Q t ~ .", ~ ... ~ "I: ;; tl. Ll. c ~ Q., .. Cl gj III ~ ......... ,\.. . . ... ~; '. . I, C :... c;: '. ~, - '- ~'" ", C- o. .....::.: 0'-: I =r::;( w"! t~-I QI- K>! U:tC; 0:'-1 ~ ';Jlr.J 0'- ~tD ..,<..:> :c W~ ~ <<::=:J a: :J<.> <.> Interest: If JnV t.x due is paid within three (3) months .fter the decedent's dllth. I discount of five percent (5%) 01 the tax paid is .Ilowed. o the discount period is cllculated in calend.r months. Example: date of death 1- 15-82. discount period expires 4-15-82. Except for tlX on I future interest. inheritance tlX becomes delinquent It the I. pintiD" of nine (9) months from the date of death. o Inherlt.nce ta. on I future interest becomes delinquent .t the expiralion of three months from: - the date of election to prepay or - the date of death of the life tenant or annuitant Interest is c.lculated on I dailv basis from - delinquent dale 10 cUte of payment on anv tax unpaid on delinquent date - date of last delinquent payment to date of payment on any unpaid balance. Interest is charged at the following rales: Delinquent Date Annual Interest Rate Daily Interest Factor Discount: 5127143 to and including 12131181 1/1182 to and including, 12131182 111/83 10 and including 12131/83 1/1/84 to and including 12131/84 6% 20% 16% 11% ,000164 ,000548 ,000438 ,000301 . Those estates thai become delinquent on or before December 31, 1981 will maintain a constant Interest rate. The rate in effect when the tax first becomes delinquent will remain constant until the delinquent tax balance is paid in full. . Those estates that become delinquent on or IHer January 1, 1982 will contain I variable interest rate. Thus, taxes thlt remain outstanding from calendar year to calendar year will be sUbjoct to the different rates In effect on each January 1. Interest Is calculated as follows: INTEREST . BALANCE OF UNPAID TAX X NUMBER OF DAYS X DAILY INTEREST FACTOR. II a tax balance remains outstanding for more than one calendar Ylar. a separate interest determination must be made for each year at the applicable rate. (Onlv one calculation is necessarv if the estate maint.ins the constant Interest rate.) AnV Notice Issued .lter the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date at the notice. II payment IS made aller the interest computation date shown on the Notice, additional interest must be calculated. To Remit Payment: Detach the top portion of this Notice And submit with your payment to the Register of Wills at the county shown on the Notice. . Address information is listed on page 13 of the booklet. -Inslructions for Inheritance Tax Return for a Resident Decedent- o Make check or monev order payable to: Register of Wills. Agent . ,. ... , ~ t.; C, I. ei! I..',: " , - " :'~~l 1~ .~.- ~~.... O. :,,'"-' I '.-_t 6e~ ~u: uJ41 - 0", C...' =; leu 0"" "'1: OCt cr.:;:, '-'w P5 ~(.,) ~o: u . .p.. , "