HomeMy WebLinkAbout02-0047BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DTVZSZDN
DEPT. 280601
HARRISBURG, PA 171Z8-0601
ARLENE L HORLEY
379 YORK RD
CARLISLE
PA 17013
COMMONHEALTH OF PENNSYLVANIA
BEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISENENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
Recoraed-Offic:~z~E o I - 1 ~ - z o o z
Register of '~TATE OF HORLEY
W'DATE OF DEATH 01-Z3-ZO01
FILE NUMBER
COUNTY
'02 J~N 11 P~st~mc
ACN
Clerk ~ ......... ~., Court I
Cumber~ano Co., PA
REV-].S118 EX AFP (1~-00)
Z0~-01-31~0
01117232
Amoun~ Rem'i *t'l:ed
NORHAN
MAKE CHECK PAYABLE AND REHIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
REV'1548 EX AFP (lZ-O0)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR DZSALLOHANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 01-1~-2002
ESTATE OF HORLEY
NORHAN D DATE OF DEATH OI-Z3-ZO01 COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. Z0~-01-31~0 ACN 01117232
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MELLON BANK ACCOUNT NO.
181-981-1975
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 07-18-1985
Account Balance 1,896.97
Percent Taxable X 0.166
Amoun* Sub~ec~ ~o Tax 316.17
Debts and Deduc~1ons - .00
Taxable Amoun~ 316.17
Tax Ra~e X .00
Tax Due .00
TAX CREDITS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THISNOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF HILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1F PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATTON OF ADDTTTONAL INTEREST. a
( TF TOTAL DUE IS LESS THAN $1, NO PAYMENT TS REQUIRED.
IF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE STDE OF THIS FORM FOR INSTRUCTZONS. )
.00
.00
.00
.00
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTZONS:
DISCOUNT:
PENALTY: ·
INTEREST:
To fulfill the requirements of Section 21qO of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S.
Section
Detach the top portion of this Notice and submit eith your payment to the Register of gilZs printed on the
reverse slde.
-- Hake check ar money order payable to: . REGISTER OF NILLS, AGENT.
A refund of a tax credit, Nhich Nas not requested an the tax return, may bm requested by completing an "AppZication
for Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-1313). Applications are available at the Office of
the Register of Nii1s, any of the 23 Revenue D~trict Offices or by calling the special Z4-hour ansaaring service
for forms ordering: 1-B00-$62-Z050; services for taxpayers mithspacial hearing and or speaking needs:
1-800-4~7-$0Z0 (TT only).
Any party in interest not satisfied eith the appraisement, allomancm, or disallomance of deductions or assessment
of tax (including discount or interest) as shomn on this Notice may object mithin sixty (60) days of receipt of
this Notice by:
--mritten protes~ to the PA Department of Revenue, Board of Appeals,'Dept. 181011, Harrisburg, PA 17118-1011, OR
--electing to have the matter determined at the audit'of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in mriting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Raviem Unit, DEPT. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (52)
discount of the tax paid is alloeed.
The 152 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 mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning eith first day of delinquency, or nine (9) months and one (13 day
frae the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q.
ALl taxes mhich became delinquent on or after January 1, 1982 mill bear interest at a rate which will vary from
calendar year to calendar year mith that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2002 arm:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
1982 ZOZ .O00Sq8 199Z 91 .OOOZq7
1983 162 .000438 1993-1994 72 .OOO192
1984 111 .000301 1995-1998 92 .0002q7
1985 151 .000556 1999 7Z .00019Z
1986 101 .000Z74 ZOO0 82 .000119
1987 9Z .000Z47 2001 9Z .0002q7
1988-1991 11Z .000$Ol ZOOZ- 62 .000164
--Interest is calculated, as follows:
INTEREST = BALANCE OF TAX UNPAID X
NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delipquent mill reflect an interest calculation to fifteen (la) days
beyond the dat~ of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must ba calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 171Z8-0601
SUSAN M WEIBLEY
152 ELM ST
CARLISLE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
Recorc~ed. '"'~'
(./h ~"¢6 (~ATE 03-11-2002
Re!;,~Js:[or C,~ W~iiISESTATE OF WORLEY
DATE OF DEATH 01-25-2001
FILE NUMBER
'02 MAR -8 P 1 qO~NTY
$SN/DC
ACN
21 02-00q7
CUMBERLAND
20q-O1-$1qO
01117255
REV-15~8 EX AFP (01-02)
NORMAN D
PA 17013 .."
Cumberfa~'~d (.,,o~, PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-02)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE, OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-11-2002
ESTATE OF WORLEY
NORMAN D DATE OF*DEATH 01-25-2001 COUNTY CUMBERLAND
FILE NO. 21 02-00q7 S'S/D.C. NO. 20q-O1-51qO ACN 01117255
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
dOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MELLON BANK
ACCOUNT NO. 181-981-1975
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 07-18-1985
Account Balance
Percent Taxable X 0.166
Amount SubSect to Tax 516.17
Debts and Deductions - ,00
Taxable Amount 516.17
Tax Rate X .15
Tax Due q7.q5
TAX CREDITS:
1,896.97 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH O$-19-Z00Z
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. a
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REDUIRED.
IF TOTAL DUE tS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
.00
q7.q5
1.qZ
q8.85
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section Z140 o~ the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S.
Section 91~0).
Detach the top port~on of this No~lce and submit mith.y~ur payment to the Register of Hills 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-ISIS). Applications are available'at the Office of
the Register of N1118, any of the Z3 Revenue District Offices or by calling the special Iff-hour ansmering service
for forms ordering: 1-&OO-36Z-ZO50~ services for taxpayers with special hearing and or speaking needs:
1-800-fi~7-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallomance of deductions or assessment
of tax (including discount or interest) as sheen on this Notice may object within sixty (60) days of receipt of
this Notice by: ' - ·
--mritten protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021, OR
--electing to have the matter deteFained at the audit ~f the account of the pe~sonal represpntativa, OR
--appeal to the Orphans' Court ;
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, DEPT. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of tho booklet "Instructions far Inheritance Tax Return for a Resident'
Decedent" (REV-1501) for an explanation of administratively correctable errors. ·
If any tax due is paid mithin three (3) calendar months after the decedent's death, a five percent
discount of the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed o~ the total of the tax and interest assessed, and not
paid before ~anuary 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 uould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning uith first day ~f 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 at.a daily rate of .00016fi.
A11 taxes mhich became delinquent on or after January 1~ 1982 mil! bear interest at a rate which Nil1 vary fram
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 200Z are:
Year Interest Rate Daily Interest Factor Year
1982 EOT. .0005~8 1992 ' * 97.
1985 167. .000~38 1993-199~ 7Z
1984 11Z .000301 1995-1998 9Z
1985 137- .000356 1999 7Z
1986 IOZ .000274 ZOO0 8Z
1987 9Z .000Z47 2001 9Z
1988-1991 11Z *. 000301 ZOOZ -* 67-
--Interest-is calculated as follo~s':
XNTEREST = BALANCE OF TAX UNPAZD
Interest Rate Daily Interest Factor ~ '
.O00Z~7
.000192
.000247
.00019Z
.000219
.0002fi7
.000164
X NUHBER OF DAYS DELZNGUENT X DAZLY I'NTEREST FACTOR
--Any Notice issued after ~e tax becomes delinquent witt reflect an interest calculation to fifteen (15) days
· beyond the date of the assessment.- If payment is made after the interest, computation date shown on the
Notice, additional interest must be calculated.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM: ·
WEIBLEY SUSAN M
132 ELM STREET
CARLISLE, PA 17013
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RE(~EIPT
NO.
REV-1162 EX(11-96)
CD 001 659
........ fold
ESTATE INFORMATION: SSN: 204-01-3140
FILE NUMBER: 2102-0047
DECEDENT NAME: WORLEY NORMAN D
DATE OF PAYMENT: 09/26/2002
POSTMARK DATE: 09/1 8/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 01/23/2001
ACN
ASSESSMENT
CONTROL
NUMBER ·
AMOUNT
101 $50.53
REMARKS:
SUSAN M WEIBLEY
TOTAL AMOUNT PAID:
950.53
SEAL
CHECK# 3423
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
BUREAU OF TNDZVZDUAL TAXES
ZNHERTTANCE TAX D]'VTSZON
DEPT. 280601
HARRI*SBURG, PA ].71;?.8-060'1
STATEMENT
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
ZNHERZ'TANCE TAX
OF ACCOUNT
"03.' OCt -3 0:57
SUSAN M HEIBLEY
132 ELM ST
CARLISLE PA lt7'013' " · '
DATE 09-22-2003
ESTATE OF HORLEY
DATE OF DEATH 01-23-2001
FZLE NUMBER 21
COUNTY CUMBERLAND
ACN 01117233
Amoun*t RemiC'ted
REV-lSD7 EX RFP (01-05)
NORMAN D
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credi~ ~o your account, submi~ the upper por~&on of ~his form wi~h your ~ax payment.
CUT ALONG THXS LXNE ~ RETAZN LONER PORTION FOR YOUR RECORDS ~
REV-1607 EX AFP (01-03)
### /NHERITANCE TAX STATEMENT OF ACCOUNT ~
ESTATE OF HORLEY NORMAN D FTLE NO. 21 02-00q7 ACN 01117233 DATE 09~22-2003
THTS STATEMENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAMED ESTATE. SHOWN BELOW
TS A SUMMARY OF THE pRTNCTPAL TAX DUE, APpLTCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPL/CABLE,
A PROJECTED TNTEREST FTSURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-11-2002
PRINCIPAL TAX DUE: ..........................................................................................................................................................................................................
PAYMENTS
PAYMENT
DATE
09-18-2002
(TAX CREDITS):
RECEIPT
NUMBER
CD001659
DISCOUNT (+)
INTEREST/PEN PAID (-)
Z .8q-
ZF PAID. AFTER THZS DATE, SEE REVERSE
SIDE FOR CALCULAT/ON OF ADDITIONAL INTEREST.
( IF TOTAL DUE 10 LESS THAN $1,
NO PAYMENT IS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT' (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR INSTRUCTIONS. )
AMOUNT PAID
50.53
q7 .q3
TOTAL TAX CREDIT q7.69
BALANCE OF TAX DUE .26CR
INTEREST AND PEN. .00
TOTAL DUE .26CR
PAYNENT: Detach the top portio~ of this Notice a~d submit with your payment made payable to the name and address
printed on .the reverse side.
-- If RESIDENT DECEDENT cake check or coney order payable to: REGISTER OF NZLLS~ AGENT.
-- Xf NON:RESIDENT DECEDENT make check' or coney order payable to: CONHONHEALTH OF pENNSyLVANIA.
REFUND (CR): A refund of a tax credit, which wes 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 ~]11s, any of tho~Z3 Revenue District Offices or from.~he Department's Z~-hour
answering service fp~ forms ordering: [-800-36Z-Z~O; services for taxpayers with special hearing and / or
speaking needs:. 1-800-4~7-3~20.(TT only). ~ ....... ~., ~
REPLY TO:
DZSCOUNT:
PENALTY:
INTEREST:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Past Assesscent'Review Unit, Dept.: 280601, Harrisburg, PA-17128'0601','phone
(717) 787-6505.
[f any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount
of the tax paid is allowed. '
The 15Z tax a~nesty no~-parti&ipati~n' penalty i~ comPUted on ~the~total of the tax and interest a~sessed, and not
paid before January 18,' 1996, thh--firs't da~ after the end of the tax amnesty period.
Interest is charged beginning uith first day o; delinquency, or nine (9) months'and one (1) day from tho date of
death, to the date of payment. Taxes which became delinquent before January 1,:1982 bear interest at the rate of
six (61) percent par annum calculated at a daily rate cf .000164. All taxes which became delinquent on and'after
January 1, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2003 are:
Interest Daily
Year Rate Factor
Interest Daily , Interest Daily
Rate Factor Year~ Rate Factor
i
1987:
1988-1991
199~
1995~1998
1981 :ZOZ .000548 97. .000247 1999 71 .000192
1983 '16X . O00~38 llZ . 000301 2000 8Z . 000219
111 .000301 9Z .000247 ZOO1 9Z .000247
1985 137. . 000356 77. . 000191 ZOOZ 61 . 000164
- 1986 107. . 00017~ 97. . 000147 Z003 57. . 000137
--Interest' is calculated as follows: -
INTEREST = BALANCE OF TAX- UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes deli.nquent will reflect an interest calculation to fifteen (15). days
beyond the date of the assessment. Xf payment is made after the interest computation date shown on the'
Notice, additional interest must be calculated.
'-er of ~.
'01 APR ~-~
, PA
'~""ON"EALTH OF PENNSYLVANIA
· ~E,P~RTHENT OF REVENUE
.~J~tJ OF ZND[VZOUAL TAXES
DEP~ 280601
HARRISBURG, PA lT128~O&O1
REV-].~4$ EX &FP ¢09-00)
ZNFORHATZON NOTTCE FILE NO. 21
· AND ACN - 01117Z52
TAXPAYER RESPONSE- ',
' D'ATE 0q-09-200!
ARLENE L WORLEY
379 YORK RD
CARLISLE PA 17013
EST. OF NORMAN D'~ORLEY
S.S: NO. Z04-01-$140
DATE OF DEATH 01-25-2001
COUNTY CUMBERLAND
TYPE OF ACCOUNT
~ SAVINGS
[] CHECKING
~ TRUST
[] CERTIF.
RENZT PAYMENT AND FORHS TO':
REGISTER OF 9/ILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
HELLON BANK has provided the Department mith the inforaatlon listed belom Nhlch has been used in
calculating the potential tax due. Thei~ records indicate that at the death of the above decedent, you ~ere a joint o~ner/beneficiary of
this account. Tf you feet this information is incorrect, please obtain ~ritten correction from the fi~ial institution, attach a copy
to this fora end tatum it to the above address. This account, is taxable in accordance ~ith the Inheritance Tax Laos of the Coamoneealth
of Pe~yLvanie. gu~skio~;s, may ~,e ~n~era~ by
COHPLETE PART ! BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYHENT. INSTRUCTIONS
Accoun~ No. 181-981-1975
Accoun~ Balance
Percen~ :Taxable
Amoun~ SubSec~ ~o Tax
Tax Ra~e
Potential Tax Due
07-18-1985
Established
1,896.97
x 0
-' $16.17
x .15
~7.4~
insure
To proper~credit to your account, two
(Z) copies of .thl$.~otice must accompany you~
payment to the Register of #ills. Hake check
payable to: "Register of Hills, Agent'.
NOTE: if t~x payments are aade eithin three
($) months of the decedent's date of death·
you may deduc~'a ~Z discount of the tax due.
Any i~lharita~ce. ~a~ dt~Jll become delinquent
nine (9) aonths"~teF'the da~e of death. '"'
A. [] The above information and tax due is correct. "'
1. -You may choose to remit payment to the Register 'or,Rills mith two copies of' this notice to obtain
a discount or avoid interest, or you may check ~ox "A" and return thls~.nctice to/~he Register of
CHECK -~ gills and an official assessment ,ill be issued by the PA Department of. Revenue.
J
8LOCK B. [] The above asset has been or mill ha reported end tax paid 'aith the PamlsY~ania Tntmrltance Tax return
ONLY .... ,t,o. be filed by the decedent's representative..
C. [] The above information is incorrect and/Or debts and deductions ~ere paid,by you.'
You must' complete PART [] and/or PART []
PART Tf yOU indicate e diffe~en~ ~ax rate~ please s~ate your i ,
' rela{'ionship'~o:d&ceden~: ·
TAX RETUEN- COHPUTATZON. 'OF TAX. ON JO!'HT/TRUST ACCOUNTS
LTNE 1. Da~e Established. I
2o
3.
6.
7.
8.
A~oun~ Balancel
Percen~ Taxable
Amoun~ SubSec~ .~o Tax
Deb~:s and Deductions *
Amoun~ Taxable
Tax Ra*e "
Tax .Due ~,:
PART
DATE PAID
$ X
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
,; ,·TOTAL ::(En*er on LAne 5 ,of Tax Computation) ,.. , ,$:,
· ; Unde.r.?..enal~:zeS..of..per3u~y, T.~de.clare~:ha~..~he fac:ts ! have rpported above are ~:rue,.correct and
complete'.~o.'che be~'Of J,y kno~1-;dge and belie'f.: : " ~ *ur~c. "?r ' '~ ...... · L
': '~ '; ": '" ......' "- :: * ' ' : ' .: "' ":': :"' '"::~*'""~ ~''" "" '* :' ~'*~'WORK"" ( ' " ") *"'"' :"~'~':': .... -
TAXPAYER SIGNATURE 'TELEPHONE NUMBER D/~TE
" GENERA~ INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSmeNT mith applicable interest based on information
submitted by the flnanciaI institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
5. A joint account is taxable even though the decedent's.nama was added as a matter of convenience.
4. Accounts (incIuding those held between husband and mile) ahich the decedent put Jn joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly beteBen husband and #ifa aero than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the information and coaputatian in the notice ara correct and deductions are not being claimed, place an
in block "A" of Part 1 of the "Taxpayer Response' section. Sign two copies and subalt them mith your check for the' amount of
tax to the Register of Nills of the county indicated. The PA Department of Revenue ail1 issue an official assessment
(Fora REV-15~B EX) upon receipt of the return from the Register of mills.
Z. BLOCK B - If the asset sPecified on this n~tJce has been or mill be reported and tax paid with 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, Dept ZOO601, Harrisburg, PA 171Z&-0601 in the
envelope provided.
5. BLOCK C - If the notice inforaration is incorrect and/or deductions ere being claimed, check block "C" and complete Parts Z and
according to the instructions baled. Sign t~o copies and submit them with your check for the amount of tax payable to the Register
of Hills of the county indicated. The.PA .DepartJaent of Revenue will issue an official assessment (Fora REV-lSd8 EX) upon receipt
of the return from the Register of #ills.
TAX RETURN - PART 2 TAX COMPUTATION
LINE
l. Enter the date the account originally ams established or titled in the ~anner existing at date of death.
NOTE: For e decedent dying after 1Z/1Z/BZ: Accounts mhich the decedent put in joint names mithin one (1) year of death are
taxable ~ully as transfers. Homever, there is an exclusion not to exceed $5,000 per transferee regardless of the value o~
the account or the number of accoants held.
Ifa double asterisk (wx) appears before your first name in the address portion of this notice, the $5,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Z. Enter the total balance of the account ir~luding interest accrued to the date of death.
5. The percent of the.~count that is.taxable ~or each survivor is determined as folloas=
A. The percent taxable for joint assets established.more than one year prior to the decedent's death:
I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE
," JOINT ONNERS . . .. SURVIVING JOINT ONNERS
Example: A joint asset registered in the name of the decedent and two other persons.
1..D~VIDED BY ~ (JOINT O~HERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 16;7Z (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent's death or accounts oaned by the decedent but heId
in trust for another individual(s) (trust beneficiaries):
I DIVIDED.BY TOTAL NI~BER OF SURvIvING JOINT X 100 = PERCENT TAXABLE
OWNERS OR TRUST BEMEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
i DIVIDED BY Z (SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line ~).
5. Enter the total of tho 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 (lin~
7. Enter the oppropriate tax rata (llne 7) as determined below.
Date of Death Spouse Lineal Sibling Collateral
07/01/9fi !o 12/$1/9fi
01/01/95 to 06/30/00 OX 6Z lSZ
07/01/00 to present
~Iha 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 usa of a natural parent, ah adoptive parent~ or a stepparent of the child is OZ.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
,hether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
nature! parents and their descendents, mhother or not they have been adopted by others~ adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals abe have at Least ~one parent in common with the decedent, whether by blood
or adoption. The "Collateral" cIass of heirs includes ali other beneficiaries.
CLAIMED DEDUCTIONS - PART 3 - BESTS AN]) DEDUCTIONS CLAIMED
Allowable debts and deductions are determined as 'folloes:
A. You LegaIly are responsible for payaant~ or the estate subject to administration by a Personal representative is insufficient
to pay the deductible items.
B. You 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 3. If additional space is needed, use plaln paper 8 l/Z" x 11". Proof of
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
· DEPArATMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 1712&-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACH 01117232
DATE 0q-09-2001
ARLENE L WORLEY
379 YORK RD
CARLISLE PA 170~,3
TYPE OF ACCOUNT
EST. OF NORMAN D WORLEY [] SAVINGS
S.S. NO. 20qrO1-31qO [] CHECKINg
DATE OF DEATH 01-23-2001 [] TRUST
· COUNTY CUMBERLAND [] CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
~ CARLISLE, PA 17013
MELLON BANK has provlded the Department with the information listed below which has been Used in
calculating the potentiaZ 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 written correction from the financla! institution, attach a copy
to this form and return it to the above address. This account is taxab[e in accordance with the Inheritance Tax Laws of the Commonwealth
COMPLETE PART I ~ELOW N ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Accoun* No. 181-981-1975 Oa~e 07-18-1985
' Es{ablAshed
Accoun~ Balance 1,896 . 97
Percen~ .Taxable X "'~-"(3":'~b~?-
Amoun~ Subjec~ ~o Tax 316.17
Tax Ra~e X .15
Po*annie1 Tax Due ~7.
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Hills.. Hake check
payable to: "Register o~ Wills, Agent".
NOTE: If tax payments are made within three
($) months of the decedent's date of death,
you may deduct a SZ discount of the tax due..
Any inheritance tax due will become delinquent
nine (9) months after the 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 Wilts with two copies of this notice to obtain
a discount or avoid interest~ or you may check box "A" and return this notice to the Register of
CHECK ~ wills and an official assessment wi1! be issued by the PA Deportment of Revenue.
ONE
BLOCK B. [] The above asset has been or wi]I be reported and tax paid with the Peonsylvania Inheritance Tax return
ONLY to be fiZed by the decedent's representative.
C. [] The above information is~incorrect and/or__debts and deductions were paid by you.
You must complete PART 121 and/or PART I~1 below.
PART
TAX
LINE
If you indica*e a different tax ra~e, please state your
relationship ~o decedent:
RETU~N*~-COMPUTAT!ON OF TAX ~ON JOZNT/TRU~ .ACCOUNTS
1. Da~:e Es{abllshed I
2. Accoun~ Balance 2
5. Percent Taxable $ ~
q. Amoun~ SubSec~ ~o Tax ~
S. Debts and Deductions S
6. Aeoun~ Taxable 6
7. Tax Ra{e 7 X
8. Tax Due 8
PART
DATE PAID
DEBTS AND DEDUCTTONS CLA:ZMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalties of perjury, I'.declare *ha* ~he fac~s I have reported above are ~rue, correc~ and
comple~:e ~:o the bes~c of my knowledge and belief. HOME (
WORK ( )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with appIicabIe interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
2. A joint account is taxable even though the decedent's name ams 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.
5. Accounts established jointly betaeen husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are:taxable fully.
REPORTING INSTRUCTIONS - PART I TAXPAYER RESPONSE ·
1. BLOCK A - If the*information and computation in the notice are correct and deductions are not belng clalmed, ~lace an "X" .
in block "A".of Part I of the "Taxpayer Response" section. Sign two copies and submit them wlth your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an officiaI assessment
(Form REV-154B EX) upon receipt of the return from the Register of WiIls.
Z. BLOCK B - If the asset specified on this notice has been or ailI be reported and tax paid wlth 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 IndlvJdual Taxes, Dept Z&0601, Harrisburg, PA 17128-0601 in the
envelope p~ovided.
2. BLOCK C - If the notice information is.incorrec~ and/or deductions are being claimed, check block "C" and complete Parts Z and
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Wills of the county indicated. The PA Department of Revenue will issue an offlcial assessment (Form REV-1548 EX) upon receipt
of the'return from the Register of Wilts. _ ..... . ....
TAX RETURN PART Z TAX COMPUTATION
LINE
I. Enter the date the account priginaIIy was estabIished or titIed in the manner existing at da~e of death.
NOTE: For a decedent dying after lZ/lZ/&Z: Accounts which the decedent put in joint names within one (1) year of death are
taxable fuIIy as transfers. However, there is an exclusion not to exceed $5,000 per transferee regardless of the vaIue of
the account or the number of accounts held.
If a double asterisk (~) appears before your first name in the address portion of this notice, the $2,000 excluslon
already has been deducted from the account balance as reported by the financial institution.
2. Enter the total balance of the account includlng interest accrued to the date of death.
The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for jolnt assets establlshed more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING*JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other pecsons.
1 DIVIDED BY 5 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16~7Z (TAXABLE FOR EACH SURVIVOR)
B.- The percent taxable for assets created within one year of the' decedent's death oF accounts owned by the decedent but held
-in trust for another individual(s) (trust beneficiaries): · .
1 DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE :
OWNERS OR TRUST BENEFICIARIES
ExampIe: Joint account registered in the name of the decedent and two other persons and estabIished within one year of death by
the decedent.
1 DIVIDED BY Z (SURVIVORS) = .50 X 100 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (llne Z) by the percent taxable (line
5. Enter the total of the debts and deductions listed in Part 2.
6. The amount taxable (line 6) is determined bY subtracting the debts and deductions (llne 5) from the amount subject to tax (line
7. Enter the appropriate tax rate (line 7) as determined below.
Da~e of Death Spouse '~ Lih~al"' Sibling Collateral
07/01/9Q ~o 12/$1/9Q SZ 6% 15% 15%
01/01/95 ~o 06/50/00 OZ
07/01/00 ~o presen* 0%
~The tax rate imposed on the net value of transfers from a deceased child taenty-one years of age or younger at
death to or for the use of a nature! parent, an adoptive parent, or a stepparent 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
naturaI parents and their descendents, ahether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at [east one parent in common with the decedent, whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIHED DEDUCTIONS - PART· 5 - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts 'and deductions are determined as
A. .You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B.You actuaIly paid the debts after death of the decedent and can furnish proof of payment.
C.Debts being claimed must be itemized fuIIy in Part 2. If additional space is needed, use plain paper 8 1/Z". x 11". Proof of
· payment may be requested by the PA.Department of Revenue.