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HomeMy WebLinkAbout02-0044COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 000754 QUERRY KENNETH M 421 WEST MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 204-26-8649 FILE NUMBER: 21 - 2002- 0044 DECEDENT NAME: QUERRY ALAN S DATE OF PAYMENT: 01 / 15/2002 POSTMARK DATE: 01/1 4/2002 COUNTY: CUM BERLAN D DATE oF DEATH: 1 O/18/2001 ACN AssESSMENT CONTROL --NUMBER AMOUNT 01155526 $12.60 REMARKS: KENNETH M QUERRY TOTAL AMOUNT PAID: $12.60 SEAL CHECK# 833 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMN'IONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128~0601 RECEIVED FROM: pENNsYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0O0755 QUERRY KENNETH M 421 WEST MAIN STREET MECHANICSBURG, PA 17'055 ........ fold ESTATE INFORMATION: SSN: 204-26-8649 FILE NUMBER: 21-2002- 0044 DECEDENT NAME: QUERRY ALAN S DATE OF PAYMENT: 01 / 15/2002 POSTMARK DATE: 01/1 1/2002 COUNTY: CUM BERLAN D DATE OF DEATH: 1 O/18/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01155527 $3.83 I TOTAL AMOUNT PAID: $3.83 REMARKS' KENNETH M QUERRY SEAL CHECK# 834 INITIALS:. CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS ~O~ONWEALTH OF PENNSYLVANIA DEP~.RTHENT OF REVENUE' BUREau OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-15iiS EX AFP (09-00) I ZNFORHATZON NOTICE AND TAXPAYER RESPONSE ACN 01155527 DATE 11-21-2001 Recorded--Off.ic~ et Register oi Wills '02 J&N15 ~2:18 KENNETH M QUE~R~r~CI~-~,%-:~?.'~ L]OL~;'~ HECHANZCSSURG L,~FO~~¢ ....... "' TYPE OF ACCOUNT EST. OF ALAN S QUERRY [] SAVINGS S.S. NO. 20q-Z6-86q9 [] CHECKING DATE OF DEATH 10-18-2001 [] TRUST COUNTY CUMBERLAND ..... []CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS. CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 MEMBERS 1ST FED CREDIT UNION has provided the Department with the information listed below mhich has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain mritten correction from the financial institution, attach a copy to this form and return it to the above address.. This account is taxable in accordance with the Inheritance Tax La.s of the Commanaealth c.= Pcnnsylvanim. Questions may-be a~s~o'rad ,by cml!lng (717) 787-8327 .... COMPLETE PART 1 BELOW # x x SEE REV:ERSE SIDE FOR. FILING AND. PAYMENTZNSTRUCTIONS Aooount No. 15q$OZ-11 Date 09-25-1995 Established Account Balance 1,189.$5 Percent Taxable X 50.000 Amount SubjeCt to Tax 59q.67 Tax Rate X .12 *Potential Tax Due 71.56 To insure proper credit to your account,' two (Z) copies of this notice must accompany your payment to the Register of Wills. Hake check payable to: "Register of Wills, Agent". NOTE: If tax payments are made mithin 'three (3) months of the decadent's date of death, you may deduct a SZ discount of the tax due. Any inheritance tax due mill become delinquent nine (9) months aftar_thq date of death. · PART TAXPAYER RESPONSE ...... ' ..... A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills .ith two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of ONE q Wills and an official assessment .ill be issued by the PA Department of Revenue. BLOCK d s. [] Tho above asset has been or mill bo reported and tax paid mith the Pennsylvania Inheritance Tax return ONLY to be filed by the decedent's representative. C. ~Tha above information is incorrect and/or debts and deductions aero paid by you. [] [] bela.. · 'You must complete PART and/or PART PART Zf you indicate a dJfferent tax rate, please state your TAX RETURN - COMPUTATION' OF TAX ON JOINT/TRUST ACCOUNTS LINE Z. Date-~-abl~shed .... 1 · 2. Account Balance 2. 3. Percent Taxable 3 ~ q. Aaount Subject to Tax ~ S. Debts and Deductions ~ 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE "eA~:~) PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION ? AMOUNT-.: pAID TOTAL (Enter on Line E of Tax Computation) Under Penalttes of perjury, Z declare that the facts Z have reported above are true, correct and compl~e'f. HOME C-'t \'1, ) ~ (,:,(p-- ~ k ~ 0 TAXPAYER SIGNATUR~ ~ TELEPHONE NUMBER DATE ~' '- ' GENERAL INFORMATION 1, FAILURE TO RESPOND #ILL RESULT ZN AN OFFICIAL TAX ASSESSHENT,m[th applicable interest based on information' submitted by the financial institution. Z. /nherJtance ta~ becomes del[nquentnine months after the decedent's date of death. 5. A joint account is taxable even though the decedmnt's name Nas added as a matter of convenience. .~. 4. Accounts (including those held bataeen husband and m~fe) Nh[ch the decedent put in joint names a[thin e yea~ prior to death are fully taxable as transfers ~: -_ '. : ,,'"...,' , .., .,~: ,! i ; . 5. Accounts established jointly bet.eon husband and .ifa more 'than one year prior to death· are ~ot taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. ~,' ~ *' ' -,' ........REPORTING INSTRUCTIONS - PART... I- - TAXPAYER"RESPONSE BLOCK A - If the informal(on'and computation in the notice are correct and deductions are not belngi~ai~ed~ ~laca an "X~ in block "A" of Part I of the "Taxpayer Response" sect[on. Sign t.o cop[es and submit thee .(th your ~heck. for the amount of tax to the Register of·Hilts of the county [nd[catad. The PA Department of Revenue ,ill issue an.offiCial assessment (Farm REV-15fi8 EX) upon receipt of the return from the Register of Hills. BLOCK D - If the asset specified on this notice has been or .ill be reported and tax paid ,[th the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Oept 280601, Harrisburg, PA 17128-0601 in the envelope provided. BLOCK C - if the'net[ce information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts according to the instructions bela.. Sign t.o cop[es and 'submit thee mith your check for the amount of, tax payable to theRegister of Hills of the county indicated. The PA Department of Revenue .ill issue an 'aff[cial'assessment (Form REV-1548 EX) upon receipt ' of the return' from the Register of Hills. ' ' :' TAX RETURN - pART' Z - TAX COMPUTATION LINE '' 1. Enter the date the account originally ems established or titled [n the manner existing at date of death. NOTE: For a decedent dying after 12/12/82: Accounts .hich the decedent put [n joint names m[th[n one (1) year of death are taxable fully as transfers. Ho.ever, there is an exclusion not to exceed $5,000 per transferee regardless of the value of ' the account or the number of accounts held. ~ . Zfa double asterisk (ex) appears before your first name in the address port~on of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. $. The percent of the account that is taxable for each survivor is determined as follo.s: A. The percent taxable for joint assets established more than one year prior to the decedent's death: . ~ DIVIDED ~Y* 'TOTAL NUHBER O~ DIVIDED BY . TOTAL NUNDER OF X ~00' = PERCENT TAXABLE ....... JDINT OHNERS . SURVIVING JOINT OHNERS ,..: Example: '.A joint asset registered in the name of the decedent and t.e other persons. .' "* "* : . , :* ! DIVIDED BY $ (JOINT OHNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 16.71 (TAXABLE FOR EACH SURVIVOR) B. '.The'percent taxable'for assets created m[thin one year of the decedent's death or accounts o.ned by'.the decedent but ~eld · c .... in trust for another individual(s) (trust beneficiaries):' :. -, 1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X' 100 = PERCENT TAXABLE , : OHNERS OR. TRUST BENEFICIARIES ,. ~. Example: Joint account registered in the name of the decedent and t.o other persons and established a[th[n one year of death by the decedent. I DIVIDED BY Z (SURVIVORS) = .SO X lO0 = 501 (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by muItiplyin9 the account balance (line 2) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part $. · 6. The amount taxab[e (line 6) is determined by subtracting the deb~s and deductions (line S) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined belom. Da~e of Dea{h Spouse .... 07/01/9~ {o 12/$1/9~ SX 6Z.. 01/01/95 ~o 06/30/00 OX' 61 151 07/01/00 ~o presen~ ,OX ~.51 eThe tax rate imposed on the net value of transfers from a deceased chlld twenty-one years of age or younger, at death to or for the use efa natural parent, an adopt[va parent, or a stepparent of the.child is OX. The lineal class of hairs includes grandparents, parents, childrel~, and lineal descendents. "Children" includes natural children .he[her or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children 'of the natural parents and their descendents~ .he[her or net they have been adopted by others, adopted descendents end their descendants and step-descendants. "Siblings" are defined as individuals ,ho have at least one parent in common ,ith the decedent, .hathar by blood or adopt[on. The "Collateral" class of heirs includes all other~ beneficiaries. CLATHED DEDUCTTONS - PART. $ - 'DE~TS AND DEDUCTTONS CLAIHED' A11oaable debts and deductions are determined as follo,s: A. :You iogally are responsible for. payment,, or tl~e. estate subject .to administration` by a personal represeqtativa ,is insufficient to pay the deductible items. B. Yed actually paid the debts after death of the decedent and can furnish proof of payment. . C. · Debts being claimed must be itemized fully in Part ~. If additi.onal space is needed~ use plain paper B 1/Z" x.11".. Proof of payment may be requested by the PA Department of Revenue. January 12,2002 Summary of decedent Alan S. Ouerry Checking Account Activityat Members 1st FCU, Mechanicsburg, PA - Date of death: October 18, 2001 Balance reported by Members .1st., Account Number 154302 $1,189.33 Less Checks Outstanding & Debt. Payments: # 983 York County Office of Aging $60.00 #984 Meadowbrook Mobile Home Park $270.00 #987 M & M Computers $109.18 #988 Cremation Society of PA $16.00 #989 HealthSouth $358.00 #990 PP&L Corp $52.63 #831 Verizon (Final) .'·* $35:64 #832 Dept of Vetrans Affairs $66.00 #833 Register of Wills, Agent (Savings) $12.60 #834 Register of Wills, Agent (Checking) $3.82 #835 PP&LCorp (Final) $26.51 TOTAL Debts & Deductions ..... .$1,010.38 Recomputation of Tax ...... ' ~" Line 1 Date Established: . .. _...,- Line 2 Account Balance Line 3 Percent Taxable Line 4 Amount Subject to Tax Line 5 Debts & Deductions Line 5 Amount Taxable '(50% of Line 2 minus Ln Line 6 Tax Rate Line 7 Tax Due Less 5% for filing within 3 months TOTAL TAX.DUE: ' ~ .9-25-1.995 $1,189.33~ · · 50% 594.665 $1,010.38 $89.47 4.5% $4.03 $0.20 $3.83 NOTE: As the decedent's brother and co-owner of this account I have paid final bills and maintained an accounting for distribution in equal shares of whatever funds may remain to my nephews, sons of the deceased, who are residents of Lake Havasu City, Arizona '- " '. '02 JAN 15 PI2:17 C~erk-O?;':/'.. Court (,llmD.~lJ&,';;". ,,., .. PA IZNFORHATZON NOTICE AND TAXPAYER RESPONSE ACN 011555Z6 DATE 11-21-2001 ~.' :;/'i"EST OF ALAN S OUERRY ~ DATE OF DEATH 10-18-2001 ~5 p]i~OUNTy ?/ ' with the in{ormation listed below which has been used in ith~e death ef the above decedent, you ware a joint o~ner/bene~iciarY o~ ~n ~ritten correction ~rom the ~inancial insti~tion, at.ch a copy .,-axable tn accordance ~th the Inher]=ance ~ax La~s o~ the Commonwealth ~,SIDE FOR FILING AND PAYHENT 'INSTRUCTIONS 125-1995 }0. 000 TYPE OF ACCOUNT []SAVINGS []CHECKXNG [~TRUST CUMBERLAND []CERTZF. REMXT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA .17015 To insure proper credit to your account, tao (Z) copies of this notice must accompany your payment to the Register of Hills. Make check payable to: "Register of Hills, Agent". NOTE: If tax payments are made within three ($) months of the dmcadent's date of death, you may deduct a SZ discount of the tax due. Anyinheritance tax due ~i11 become delinquent nine (9) months a;tar the data of death. Ii~ RESPONSE i~/correct. ,ltd the Register of Hills ~ith two copies of this notice to obtain · { you may check box "A~ and return this notice to the Register of , will be issued by the PA Department of Revenue. !¥ reported and tax paid with the Pennsylvania Inheritance Tax return .~/sentative.. · and/or debts and deductions were paid by you. ',fPART [] below. ~'~s~a~e your 3. Percen~ Taxable q. Aeoun~ Sub~ec~ ~o Tax 5. Debts and Deductions 6. Amoun~ Taxable 6 7. Tax Ra~o 7 8. Ta~ Due. 8 . PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION . AMOUNT 'PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties o'f perjury, T declare ~h~ ~he facts I have reported above ara ~rue, correct and co.~b~d bel'ef.. HOME ¢~1~,~ )-~d>(~--'~'LL-O !~:z~! . WORK ( ) t ~ TAXPAYER S~GN~RE ~ TELEPHONE NUHBER GENERAL INFORHATION 1. FAILURE TO RESPOND NILL RESULT IN AN OFFICIAL TAX ASSESSNENT with applicable interest based an information submitted by the financial institution. . .. . ~,. _ Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even though the decedent's name was added as a matter Of convenience. .. . -_' . ..~ . 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior, to death are fully taxable as transfers. - ~,. :! ' S. Accounts established jointly between husbahd and wild mbre than one year prior tm death are not'taxableL ,.'.fi', 6. Accounts held by a decedent "in trust for" another or others are taxable ~ully. ........... REPORTING INSTRUCTIONS:'::~AR~.? [.,,~- IA"XPAYER RESPONSE "' ........ ~ ........................ ~ ...... ... ...... :- _. :- '"~ 1. BLOCK ~ ' If the information and computation in the notice are correct and deductions are not being claimed, place an "X~. . in block "A" of Part I of the "Taxpayer Response" section. Sign t~o copies and submit them ~ith your check for the amount of tax to the Register of Wills of tho county indicated. The PA Department of'R~'.~will:J'ssue an o~ficial assessment (Form REV-ISq8 EX) upon receipt of the return fro= the Register of Wills. Z. BLOCK B - If the asset specified on this notice has been or ~ill be reported and tax paid aith the Pennsylvania Inheritance Tax Return filed'by the decedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue~ Bureau of Individual Taxas~ Bept Z80601, Harrisburg, PA 171Z8-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Pa~ts Z and according to the instructions below. Sign t~o copies and submit them ~ith your check for the amount of tax payable to the Register of Wills of tho county indicated. The P~ Department of Revenue'~i11 issue an official' assessment (Form EEV-15q~ EX) upon ~eceipt of the return from the Register of Rills. TAX RETURN - PART 2 TAX CONPUTATION' LINE 1. Enter the date the account originally ams established or titled 'in the manner existing at date of death. NOTE: For a decedent dying after 12/lZ/82: Accounts ~hich the decedent put in joint names within one (l) year of death are taxable fully as transfers. However, there is an exclusion not to exceed S5,000 per transferee regardZess of the value of the account or the number of accounts held. If a double asterisk (xx) appears before your first name in the. address portion of this notice, the $5,000'exclusion already has been deducted fro= the account balance as reported by the financialJnst~tution. Enter the total balance of the account including interest accrued to the date of death.' The percent of the account that is taxable for each survivor is determined as folloas: A. The percent taxable for joint assets'established more than one year prier to the dgcedent's death: 1 DIVIDED B~- TOTAL NUH~ER OF' DIVIDED BY TOTAL NUNBER OF' · ",X~-l~'0 PERCENT TAXABL~ ..JOINT ONNERS SURVIVING JOINT ONNERS Example:, A joint asset.registered in the name of the decedent and.two,other'pers~s'. ""~' . ' . ....... I DIVIDED BY 5 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.?Z (TAXABLE FOR EACH SURVIVOR) S.The percent-taxable, for a~etsLcreated 'within one year of the decedent's death o~ accounts O~ned' by 'the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUHBER O~ SURVIVING JOINT X 100 = ~ERCENT TiXABLE ._.- OWNERS OR TRUST BENEFICIARIES .... . Example: Joint account registered in the name of the decedent and tw~ other persons and established within one year of death by the decedent. ] DIVIDED BY Z (SURVIVORS) = .SO X 100 = SOl (TAXABLE FOR EACH SURVIVOR) ~. The amount subject to tax (line fi) is determined by multiplying the account balance [line Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 3. . 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 7. Enter the appropriate tax rate (line 7) as determined below. 07/01/9fi to 12/$1/91 3Z 6Z'' 15Z' 01/01/96 to 06/30/00 OX 6Z ** 15~** 15Z .. 07/01/00 to presen~ ~OX q.SZ~ 12X =The tax rate imposed on the net value of transfers from a deceased child t~enty-one years of age or younger death to or for the use .of a natural parant~ an adoptive parent, or a stappar&nt of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "ChiLdren~ includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, mhather or not they have been adopted by others, adopted ~escandents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in. common aJth the decedent, ~hethar by blood or 'adoption. The "Collateral" class of heirs includes all other beneficiaries. CLATMED DEDUCTTONS',- PART $ - DEBTS AND DEDUCTTONS CLATMED Allowable debts and deductions ara determined as follows: A. You' legally are.responsible, for.payment, or the estate subject to,a.dmJnist.ratimn by a personal representative is insufficient: to pay the deductible items. B. You actually paid the debts after death of the decedent and'can ~urnish proof of payment. - . C. Debts being claimed must be itemized fully in Part 3. If additional space ig needed, use' plain paper 8 l/Z" x ll". Proof of payment may be requested by the PA Oepartmen( of Revenue. ~ ' 2O02 ,,anu_., _, ..,~,~.;~?!~,? ~. ,,~ . Summary of decedent Alan S,.Querry Savings AcCOunt ActiVitY. at :.' Members 1st: FCU,'MeCh~iniCSburg'~' pA* "*' ACCount ~ NUmber *1*54302 ' -"- Date of death: October.t·8~,-.2001;~.*: -'.*~ ;'., -- .::,-,; ,.,-.-.-,~ ;:,,., .,:,-, ,.-:.~,, -,-. ~, ,,,,,; **-:,;~.--,. L; "'. **' ;'.~* ~*, ::; :.. '* .*r * ,i':" *,:';: ';."*..?*-; Balance reported by Members 1st_ $589.42 Check~:Outstandina& ,Debt'paVments: ... . Less TOTAL Debts & Deductions $0.00 Recomputation of Tax: Line 1 Date Established: 9-25-1995 Line 2 Account Balance ............. ' $589.42 .... : .... 'Line 3 Percent Taxable 50% Line 4 Amount Subject to Tax 294;71 Line 5 Debts & Deductions $0.00 Line 5 Amount Taxable (50% of Line 2 minus Ln $294.71 Line 6 'Tax Rate 4.5% Line 7 Tax Due $13.26 Less 5% for filing within 3 months . $0.66 ..·. .' · TOTAL TAX DUE: :~- .... .' :'. ........ .' .';-$1'2~60 ,, "' NOTE: '-~:':'."::'";' ".". .... '"-"::~"-::,"' ."';.:' '," :: '~ .... - ~:~."~.,:"",~': ~ ','~ ?.:'"? ~':.'.,' ,; '.,:,.,:.' ~' ,,~: :' ',~:~: · .As the'decedent's, brother and co-owne~::of-this account..I.:have paid fir~al..bills and. ~., accoun~in,*,,,u for distribution ,.i',~',-.,~-,,-,,Am"'gi ........ shares:"of' whatever" ' '" ...... funds" .... *-may"' :'""' maintained an remain to my nephews, sons· of the decoasod, Wh° 'are ~;e$idents6f. Lake Hagasti City, Arizona *.%1 L~'~ .r9 r,:t l ,H OF PENNSYLVANIA iNT OF REVENUE F INHERITANCE TAX tLLONANCE OR DISALLONANCE lAND ASSESSHENT OF TAX ON ELD OR TRUST ASSETS /~(~ DATE 04-'29-2002 ~IilS ESTATE OF QUERRY DATE OF DEATH 10-18-2001 FILE NUMBER 21 02-0044 COUNTY CUHBERLAND P3:2~SSN/DC 204-26-8649 ACH 01155526 o., PA ,/WER PORTION FOR YOUR RECORDS Amount Remitted REV-15~I8 EX AFP C01-02) ALAN HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 S ~SENENT, ALLONANCE OR DISALLONANCE OF IX ON JOINTLY HELD OR TRUST ASSETS ~ATE 04-29-2002 DATE OF DEATH 10-18-200'1 COUNTY CUMBERLAND NO 204-26 8649 ~TED AS FILED ( ) CHANGED NT OR TRUST ASSET INFORMATION A ED CREDIT UNION ACCOUNT NO. 154302-00 ~Co~n.,... ~ tCHECKING ( ) TR~ST ( ) TIME CERTIFICATE DATE ESTABLISHED ACN 01155526 Account Balance 589.42 Percent Taxable X 0.500 Amount Subject to Tax 294.7! Debts and Deductions 415.71 Taxable Amount .00 Tax Rate X 12 Tax Due ' .00 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER CD000754 NOTE: DISCOUNT (+) INTEREST/PEN PAID ¢-) .00 TO INSURE PROPER CREDIT TO YOUR ACCOUNT~ SUBHIT THE UPPER PORTION OF THIS NOTICE NITH YOUR TAX PAYHENT TO THE REGISTER OF MILLS AT THE ABOVE ADDRESS.. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF MILLS, AGENT." AMOUNT PAID 12.60 TOTAL TAX CREDZT-~ BALANCE OF TAX DUEI INTEREST AND PEN./ TOTAL DUE / 'IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADD! ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT TS REQUIRED. TF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR) YOU HAY BE DUE[ONAL INTEREST. ~ SEE OF FOR INS' ) A 12.60 Z2.60CRJ PURPOSE OF NOT[CE: To ~ulfill the requirements bf Section ZlqO of the Inheritance and Estate Tax Act, Act ZS of ZOO0. (7Z P.S. Section 91qO). PAYNENT: 'Detach the top. portion of this Notice and submit ~ith your payment to the Register of Wills printed on the reverse side. Make check or money order payable to: REGISTER OF WILLS, AGENT.; *'.. . REFUND (CR):*A refund of a tax credit, ~hich #as not requested on the tax raturn~may ba requested by completing an -Application forRefund of Pennsylvania Inheritance and Estate Tax" CREV'1515)-* AppliCations ara available* at the office of the Register of.Wills, any of.the 25 Revenue District Offices ar by ~alling the special gq-hour ansmering service for fores ordering: 1-BOO-36Z-ZO5§; services for' taxpayers mith speci~l hearing and or speaking needs: [-800-~qT-50ZO (TT onlY). OBJECT[OHS: Any party in interest not satisfied ~ith the appraisement, allowance, or disallowance of deductions or assessment of tax [including discount or interest) ms shown on this Notice may object within sixty (60) days of ~ecaipt of PA 171ZB-lOZ1, OR this Notice by: OR --written protest to the PA Department o~ Revanue~ Board of Appeals, Dept. Z&IOZ1, Harrisburg, ~. --electing to have the matter determined at the audit of the account of .the personal representative, --appeal to the Orphans' Court ADMIN- .~ * '' ~' writing to: PA Department of Revenue, [STRAT[VE ' CORRECT[ONS: Factual errors ~iscovmrad on this assessment should be addressed in Bureau of Individual Taxes, ATTN: Post Assessment Reviaa Unit, DEPT. ZB0601~ Harrisburg, PA 171ZB-0601 Phone (717) 767=650S. Sea page 5 oft ha booklet"[nstructions for Inheritance Tax Return ~or a Resident' Decedent" (REV-IS01) for an explanation of administratively correctable errors. ' DIScoUNT: If any tax due is paid within three C5) calendar months after the decedent's death~ a five percent discount of t~m tax. paid is allowed. PENALTY: The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996~ the first day after the end of the tax amnesty period. This non-participation . penalty is appealable in the same manner and in the the-same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day 'from the date of daath~ to the date of payment. Taxes which became delinquent before January l~ 198Z bear interest at the rate of six [6g} percent per annum Calculated at a daily rate of .00016q. All taxes Hhich became delinquent on or after January 1, 196Z will bear interest at a rate ~hich mill vary from calendar year to calendar year ~ith that rate announced by tho PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ ara: __ Year Interest Rate Daily Interest Factor Yeast .In~terest Rate 198Z ZOZ -O00Sq8 199Z 9X .O00Zq7 1985 16Z .O00qSB 1995-199q 7Z .O0019Z 198q llX .000501 1995-1998 9Z .O00Zq7 1985 152 .000356 1999 7Z .00019Z 1986 lOX .000Z7q ZOO0 aZ .000Z19 1987 9Z .O00Zq7 ZOO1 9Z .O00Zq7 1986-1991 '11Z .000501 ZOOZ .... 6Z ;00016q --Interest is calculated as folloms: Daily Interest Factor INTEREST = BALANCE OF 'TAX UNPAID' X NUltBER OF DAYS DEL:[NI;~UENT X DATL¥ INTEREST FACTOR -~AnY Notice issued after the tax becomes delinquent #ill reflect an interest calculation to fifteen (1S) days beyond the date of the assessment.' If payment is made after the interest computation date sho~n on the · Notice, additional interest must be calculated- BUREAU OF INDIVIDUAL TAXES /NH£RITANCE TAX DTVIS/ON DEPT. 280601 HARRTSBURG,, PA 17128-0601 KENNETH M QUERRY ~21 W MAIN ST HECHANICSBURG COHMONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1Sq8 EX AFP COl-D2) Recorced 05c~ of FILE NUMBER COUNTY '02 APR 29 P 3:20 SSN/DC ACN PA 17(0_,,5~k..~7;,...,i. :,,?-, ~ (~o~' DATE 0~-29-2002 ESTATE OF QUERRY DATE OF DEATH 10-18-2001 21.02-00~ CUMBERLAND 20~-26-86~9 01155527 Amoun~ Remi~ed ALAN I HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HouSE CARLISLE, PA 17015 S CUT ALONG THIS LINE ~ RETAIN LOHER PORTION FOR YOUR RECORDS *~ REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR DZSALLOHANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOINTLY HELD OR TRUST ASSETS DATE 0~-29-2002 ESTATE OF QUERRY ALAN S DATE OF DEATH 10-18-2001 COUNTY CUMBERLAND FILE NO. 21 02-00~ S.S/D.C. NO. 20~-26-86~9 ACN 01155527 TAX RETURN HAS: (X) ACCEPTED AS FILED C ) CHANGED dOZNT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FED CREDIT UNION ACCOUNT NO. 15q302-1i TYPE OF ACCOUNT: C ) SAVINGS C~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 09-25-1995 Account Balance 1,189.33 Percent Taxable X 0.500 Amount Subject to Tax 59~.67 Debts and Deductions - 59~.67 Taxable Amount .00 Tax Rate X .12 Tax Due .00 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS NOTICE HITH YOUR TAX PAYMENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE.TO: "REGISTER OF HILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 01-11-2002 CD000755 .00 3.83 TOTAL TAX CREDIT BALANCE OF TAX DUE J INTEREST AND PEN. TOTAL DUE ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" ( CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) 3.83 3.83CR .00 3.83CR PURPOSE OF NOTICE: To folfill the requirements Section 9140). of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ZSTRATZVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Detac~ the tOP portion of this Notice and submit with your payment to the Register o~,. Nills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit) which was not requested on the tax return) may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills) any of th~ Z5 Revenue District Offices or by calling the special Z4-hour answering service for forms ordering: 1-800-56Z-ZO50~ services for taxpayers with special hearing and or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement) allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1) Harrisburg, PA.ZZZZB-ZOZ1, OR --electing to have the matter determined at the audit of tho account of the personal representati~e)~ DR --appeal to the Orphans' Court· Factual errors discodered on this assessment should be addreEsed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit) DEPT. 280601, Harrisbbrg~ PA 17128-0601 Phone (717) 787-6505. See page S of the boaktet "Instructions forInheritance Tax Return fora Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the dacedent's death~ a five percent (SI) discount of the tax paid is alloaed. .~ The 1SI tax amnesty non-participation penalty is computed on tho total of the tax and interest assessed, and not' paid before January 18, 1996, the first day after tho end of tho tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax end interest that has been assessed as indicated on this notice. Interest is charged beginning ~ith first day of delinquency) or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1) 198Z bear interest at the rate of six (6Z) percent per annum calculated et a daily rate of .000164. AIl taxes which became delinquent on or after January 1, 198Z alii bear interest at a rate which will vary from calendar year to calendar year ~ith that rate announced by the PA Department of Revenue. The applicable interest rates for 19AZ through 200Z are: Year Interest Rate 1982 20Z .000548 * 1985 Z6Z .000438 198~ 11X .000301 1985 15Z .000356 1986 ZOZ .000274 1987 92 .000Z47 1988-1991 117. .000301 --Inter'~st is calculated as follows: INTEREST ~- BALANCE OF TAX UNPAID Daily Interest Factor Year ' Interest Rate Daily IntereSt Factor 1992 92 ~000247 * 1995-1994 72 .O0019Z 1995-1998 9Z .000247 1999 72 .O0019Z ZOO0 8Z .OOOZ19 ZOO1 92 .000247 ZOOZ - - 6Z .000164 X NUNBER OF DAYS DELTN{}UENT X DAILY INTEREST FACTOR L-Any Notice issued after the t~x becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the-date of-the assessment. If payment ~s made after tho interest computation date shown on the Notice, additional interest must be calculated.*'