HomeMy WebLinkAbout03-15-07
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 6
File Number
o 4 8 2
Date of Birth
29344 1 5 5 0
012 020 0 6
07181957
Decedent's Last Name
Suffix
Decedent's First Name
GRANITO
CHARLES
MI
o
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
GRANITO
KATHRYN
MI
A
Spouse's Social Security Number
200462906
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
lXI 1. Original Return
o 4. Limited Estate
lXI
o
2. Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
o A V I 0 W REA G E R
717 763 138 3
233 1 MAR K E T S T R E E T
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Firm Name (If Applicable)
REA G ERA 0 L E R P C
First line of address
C..n
-0
Second line of address
City or Post Office
State
ZIP Code
~ -;
'--1
D~TE FILED
-
.,
C>
CAMPHILL
P A
17011
Correspondent's e-mail address:mzercher@reageradlerpc.com
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RE P NSIB FOR FILING RET DATE
- /~-
Carn Hill
PA 17011
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
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REV-1500 EX Page 3
Decedent's Complete Address:
File Number
0482
DECEDENTS NAME
Charles D. Granito
STREET ADDRESS
1020 North Waterford Way
CITY I STATE I ZIP
Mechanicsburg PA 17050-7632
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
Total Credits (A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( 0 + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
0.00
0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
A. Enter the interest on the tax due.
0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ...................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 00 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)).
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax retum are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 99116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Charles D. Granito
FILE NUMBER
0482
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
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REV-1505 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charles D. Granito
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
FILE NUMBER
0482
Zip Code
State of Incorporation
Date of Incorporation
Total Number of Shareholders
Business Reporting Year
1. Name of Corporation
Address
City
2. Federal Employer 1.0. Number
3. Type of Business
State
Product/Service
4.
Preferred
$
$
Common
Provide all rights and restrictions pertaining to each class of stock.
5. Was the decedent employed by the Corporation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes 0 No
If yes, Position Annual Salary $ Time Devoted to Business
6. Was the Corporation indebted to the decedent? ....................................... 0 Yes 0 No
If yes, provide amount of indebtedness $
7. Was there life insurance payable to the corporation upon the death of the decedent? ............... 0 Yes 0 No
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
8. Did the decedent sell or transfer stock in this company within one year prior to death or within two years
if the date of death was prior to 12-31-82?
DYes 0 No If yes, 0 Transfer 0 Sale Number of Shares
Transferee or Purchaser Consideration $ Date
Attach a separate sheet for additional transfers and/or sales.
9. Was there a written shareholder's agreement in effect at the time of the decedent's death? . . . . . . . . . . . . 0 Yes 0 No
If yes, provide a copy of the agreement.
10. Was the decedent's stock sold? ................................................. 0 Yes 0 No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedent's death? ....................... 0 Yes 0 No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships? . . . . . . . . . . . . . . . . . . . . .. 0 Yes 0 No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
THE FOllOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax retums (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have
been secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
(If more space is needed, insert additional sheets of the same size)
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REV-1507 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
Charles D. Granito
FILE NUMBER
0482
All property jointly-owned with the right of sUNivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
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REV-1509 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Charles D. Granito
FILE NUMBER
0482
If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
B
c
JOINTL Y.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY.HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A.
TOTAL (Also enter on line 6, Recapitulation) $
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(86-9) + X3 O~9~-^3~
REV-1511 EX + (12-99)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charles D. Granito
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
0482
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Chestnut Hill Cemetery 2,790.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attomey Fees Reager & Adler, PC 3,000.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Cumberland County Register of Wills 150.00
5. Accountanfs Fees
6. Tax Retum PrepareJ's Fees
7. Short Certificates 12.00
8. Advertisement - Cumberland Law Journal 75.00
9. Advertisement - The Sentinel 115.25
TOTAL (Also enter on line 9, Recapitulation) $ 6142.25
(If more space is needed, insert additional sheets of the same size)
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$ (uO!lelnl!deoa~ '0 ~ aU!1 uo JalUa 051V) 1V 101
H1 \f30 :10
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RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Kathryn A. Granito Spousal 61,461.57
1020 North Waterford Way
Mechanicsburg, PA 17050
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
..
,"'-"" "'. '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charles 0 Granito
SCHEDULE J
BENEFICIARIES
FILE NUMBER
0482
(If more space IS needed, Insert additional sheets of the same size)
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REV-1644 EX + (3-04) '* INHERITANCE TAX
SCHEDULE L
COMMONWEALTH OF PENNSYLVANIA REMAINDER PREPAYMENT
INHERITANCE TAX RETURN
RESIDENT DECEDENT OR INVASION OF TRUST PRINCIPAL FILE NUMBER 0482
I. ESTATE OF
Granito, Charles D.
(Last Name) (First Name) (Middle Initial)
This schedule is appropriate only for estates of decedents dying on or before December 12,1982.
This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of
Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust principal.
II. REMAINDER PREPAYMENT:
A. Election to prepay filed with the Register of Wills on
(Date)
B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income
or Annuitant(s) of election or annuity is payable
C. Assets: Complete Schedule L-1
1. Real Estate .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2. Stocks and Bonds . . . . . . . . . . . . . . . . . . . . . . . . . $
3. Closely Held Stock/Partnership. . . . . . . . . . . . . . . $
4. Mortgages and Notes. . . . . . . . . . . . . . . . . . . . . . . $
5. Cash/Misc. Personal Property . . . . . . . . . . . . . . . . $
6. Total from Schedule L-1 ................................................... .$
D. Credits: Complete Schedule L-2
1. Unpaid Liabilities. . . . . . . . . . . . . . . . . . . . . . . . . . $
2. Unpaid Bequests. . . . . . . . . . . . . . . . . . . . . . . . . . $
3. Value of Un includable Assets . . . . . . . . . . . . . . . . $
4. Total from Schedule L-2 ................................................... .$
E. Total Value of trust assets (Line C-6 minus Line 0-4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
F. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . .
G. Taxable Remainder value (Line E x Line F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
(Also enter on Line 7, Recapitulation)
III. INVASION OF CORPUS:
A. Invasion of corpus
(Month, Day, Year)
B. Name(s) of Life Tenant(s) Date of Birth Age on date Term of years income
or Annuitant(s) corpus or annuity is payable
consumed
C. Corpus consumed ........................................................... $
D. Remainder factor (see Table I or Table II in Instruction Booklet) . . . . . . . . . . . . . . . . . . . . . . . .
E. Taxable value of corpus consumed (Line C x Line D) ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
(Also enter on Line 7, Recapitulation)
('sJaa4s L L x ZitS 10UO!J!PPO 4:>0>>0 'papaau S! a:>ods aJOW }J)
$ (1 alnpa4:>S uo 9-::> aun'lI uo!pas uo JaJua oSIY) 1Vl0l -III
II alnpa4:>S uo go::> eun II Uo!pes uo epnpu!J
$ 4JedoJd 'SJed ':>S!W/4so::> }O enloA 10Jol
(JS!I asoald) 4JadoJd 10uoSJad snoauolle:>s!w pUO 4so::> '3
(1 elnpa4:>S uo Jr-::> aun'lI UO!paS uo apnpu!)
$ seJoN puo sa606Jjow }O enloA 10Jol
hS!1 asoald) saJoN puo se606Jjow '0
(1 alnpe4:>S uo E;-::> eun'lI UO!peS uo epnpu!)
$ d!4sJauJjod/PleH ^Iesol::> }O enloA 10Jol
hS!1 esoeld)
(l-::> JO/puo L -::> alnpa4:>S 4:>0>>0) d!4SJeuJjod/>POJS PlaH ^Iasol::> '::>
(1 alnpa4:>S uo l-::> eun'lI uo!pes uo epnpu!)
$ spuoq puo S>j:>oJs }O en(OA 10Jol
hS!l esoeld) SpUOS pUO S'l:>OJS 's
(1 elnpa4:>S uo L -::> aun'lI uo!pes uo apnpu!)
$ aJoJsa 10aJ }O anloA 10Jol
(aq!J:>sap esoald) aJoJs3 loall ''1
anlDA UO!ld!J)saa -oN wall -II
(ID!HUI eIPp!w) (eWDN ~SJ!:I) (eWDN ~SD1)
'0 sa(JeLl~ Ol!UeJE) JO alDlsal -I
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REV-1646 EX + (3-84)
'*
INHERITANCE TAX
SCHEDULE L-2
REMAINDER PREPAYMENT ELECTION
-CREDITS-
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I. Estate of
Granito Charles D.
(Last Name)
(First Name)
II. Item No. Description
A. Unpaid Liabilities Claimed against Original Estate, and payable from assets
reported on Schedule L- 1 (please list)
Total unpaid liabilities $
(include on Section II, Line 0-1 on Schedule L)
B. Unpaid Bequests payable from assets reported on Schedule L-l (please list)
Total unpaid bequests $
(include on Sedion II, Line 0-2 on Schedule L)
C. Value of assets reported on Schedule L-l (other than unpaid bequests listed under
"B" above) that are not included for tax purposes or that do not form a part
of the trust.
Computation as follows:
Total unincludable assets $
(include on Section II, Line 0-3 on Schedule Ll
III.
TOTAL (Also enter on Sedion II, Line 0-4 on Schedule L)
(If more space is needed, attach additional 81/2 x 11 sheets.)
0482
(Middle Initial)
Amount
$
(az!s awes a4llo slaa4s leuO!l!ppe l.Iasu! 'papaau s! aoeds aJOW ll)
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$...... (laa4S Ja^o~ JO g~ aU!1 uo UM04s leloHo lJed se apnl~u! oSle)
(%S~) aleJ leJalelloOle alqexel ~ aU!1Jo anle^ '9
$...... (laa4S Ja^o~ JO H aU!1 uo UM04S lelOl JO lJed se apnlOU! oSle)
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$............... . %00 '%€ 0 '%90 auo >lOa4~
aleJ xel ale!JdoJdde Ie asnods 01 6u!ssed ~ aU!1 JO anle^ '€
$...... (laa4S JaM~ JO €~ aU!1 uo UM04S leloHo lJed se apnlOU! oSle)
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:Jauo as!woJdwoO JO AJewwns "AI
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leMeJp4llM jO l461J pallW!1 0 leMeJP4llM jO l461J pallW!lun 0
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'~u!elJao 41!M pa4S!lqelsa aq louueo luaw,{o!ua pue uo!ssassod
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*
(00-6) + X3 LV9~.^3~
REV-1648 EX (11-e.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX DIVISION (AVAILABLE FOR DATES OF DEATH 01/01/92 to 12/31/94)
ESTATE OF FILE NUMBER
Charles D. Granito 0482
This schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet.
SCHEDULE N
SPOUSAL POVERTY CREDIT
PART I - CALCULATION OF GROSS ESTATE
1. Taxable Assets total from line 8 (cover sheet) ......................................................................................
2. Insurance Proceeds on Life of Decedent ..............................................................................................
3. Retirement Benefits ................. ...............................................................................................................
4. Joint Assets with Spouse ......................................................................................................................
5. PA Lottery Winnings ..............................................................................................................................
6a. Other Nontaxable Assets: List (Attach schedule if necessary) ..
6a.
6b.
6c.
6d.
6. SUBTOTAL (Lines 6a, b, c, d) .............................................................................................................. 6.
7. Total Gross Assets (Add lines 1 thru 6) ...............................................................................................
8. Total Actual Liabilities.................................................. ..........................................................................
9. Net Value of Estate (Subtract line 8 from line 7) ...................................................................................
If l' 9' t th $200 000 STOP Th t t' t l' 'b! t I' th d't If t t' t P rt II
1.
67603.82
2.
3.
4.
5.
7.
67 603.82
8.
9.
67,603.82
.
PART II - CALCULATION OF JOINT EXEMPTION INCOME - (Attach copies of Federal Individual Income
Tax Return for decedent and spouse.)
Income: 1. TAX YEAR: 19 2. TAX YEAR: 19 3. TAX YEAR: 19
a. Spouse ............................. 1a. 2a. 3a.
b. Decedent ......................... 1b. 2b. 3b.
c. Joint ................................. 1c. 2c. 3c.
d. Tax Exempt Income ......... 1d. 2d. 3d.
e. Other Income not
listed above ..................... 1e. 2e. 3e.
f. Total................................. If. 2f. 3f.
4. Average Joint Exemption Income Calculation
4a. Add Joint Exemption Income from above:
(1f)
+ (2f)
+ (3f)
4b. Average Joint Exemption Income ...............................................................................................................
If line 4(b) is greater then $40,000 - STOP. The estate is not eligible to claim the credit. If not. continue to Part III.
=
(+3)
PART III - CALCULATION OF SPOUSAL POVERTY CREDIT FOR RESIDENT AND NONRESIDENT ESTATES
1. Insert amount of taxable transfers to spouse or $100,000, whichever is less .....................................
2. Multiply by credit percentage (see instructions) ....................................................................................
3. This is the amount of the Resident Spousal Poverty Credit. Include this figure
in the calculation oftotal credits on line 18 of the cover sheet. .............................................................
4. For Nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the
decedent's gross estate ........................................................................................................................
5. Multiply line 3 by line 4 and enter the total here. This is the amount of the Nonresident Spousal
Poverty Credit. Include this figure in the calculation oftotal credits on line 18 of the cover sheet ..........
1.
2.
3.
4.
5.
(az!s awes alll!O slaalls leuo!llPpe \.lasu! 'papaau sl a::>eds aJOw !I)
$ lelo 1 8 lJed
enle^ UO!ldiJosea
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$ lelo 1 V lJed
enle^
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REV-1500 Discount, Interest and Penalty Worksheet
Discount Calculation
Total Amount Paid within three calendar months of the decedent's date of death:
Discount:
0.00
Interest Table
Year Days Delinquent Balance Due Interest
this time period this year this period
Before 1981
1982
1983
1984
1985
1986
1987
1988 through 1991
1992
1993 through 1994
1995 through 1998
1999
2000
2001
2002
2003
2004
2005
2006
TOTALS
Penalty Calculation
If the decedent's date of death was on or before March 31, 1993, insert the applicable amount:
Total Balance Due on January 17, 1996:
Penalty: