HomeMy WebLinkAbout02-0659
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of .4-~?././/' ,dy/
also known as
No.
To:
;.J-o~- <"SCf
Register of Wills for the
County of &~6~~J.I/'> in the
Commonwealth of Pennsylvania
Deceased.
Social Security No..2P'/ -0/ - xf5 o;Z.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, apply
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in //~~.s::~NI> C!)Uj1ty, Pennsy]l{ania, Wi~
h 1'" JZ. last family or principal residence at __~ ~~Ao.:'" ~jVE: UiU/5/J. 17,c>/3
(list street, number and municipality)
Decep,dent,then 51 yearsofage,died ';t-$-gf ,1: 0/
at (ftJ2LH;U //C>5f'r74A
,
Decendent at death owned property with estimated values as foIllows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
3 Bt::O c.e>
$
$
$
$
/JC'O
Petitione=-- after a proper search h~ ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name
'7
~ /Yd$Z
;Y/~5./?
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
} 55
The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to ~r affirmed and subscribed f~ W
before me thiS 22nd day of ~
"~ ~OO~' .
:fWt,?1>>' -- '''d< I'<<~ , .
/ Reg/ste
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No. 21-2002-659
Estate of
Annabelle Hoyt
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW July 22nd 19'" 20~~n consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that Annabelle Hoyt
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to William H. Hoyt and Judith Ann Cashnan
in the estate of Annabelle Hoyt
Mary
FEES
Letters of Administration
Short Certificates(2) . . . . . . . . . .
Renunciation ................
JCP
$
$
$
$ 5.00
TOTAL _ $ 36.00
.. July. 22nd,2.002.. IKf)(lOOooL-
25.00
6.00
ATTOR,~EY (S,uP'.5'1; I;I?,. No.)..
'i. 1/: L ':; L"-. ,if (!).
ADDRESS
Filed
PHONE
MAILED Lt:1"1'~ 'ID WILLI1\M H. IDYl' 00 7/22/02
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
. /7"-..i../ a If,,, /ItJ
7- ;J5=- CJ I
;I~y/~
Date of Death:
Will No.
Admin. No.
.;(6'C'.< - d,(J~5'9
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orph!!!,s' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 7 -- J.7 - CJ 1. :
Name Address
cJ/?/ ~v7
/0 ;!u.u}fr;c;rt:vH' ~r
Ke-d A /!/,f/ .1}; /73~c:?
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
~J;~b
,
Date:
1/- (l1"~cJj
!1Jd d Cc~
Signature
Name JUJ/l-j;J Ca,7~/JJa.//
Address ?,.7tl 9 .Y~ ~ t: r-~ 84:J
/lJC;e/1J. M /7(lJ~7
Telephone (717) 7' t- f . 6 .!I .3 :J~
Capacity: ~ Personal Representative
_Counsel for personal representative
V'
Name of Decedent:
=;ATION OF N~CE ~DER RULE 5.6(a)
-~ ~ Yo?'
7/h.5' /01
<
Date of Death:
Will No.
Admin. No. 2a52 -(p~~c::(7
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the 'hans~rt Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on -:;;: /" S7.:2 :
/
Name
Address
Jv.or71( 417 ~,4-;L/
~;;07
(' D. /"
...Jt9J-1ivt ~I!L [j!JC:t.[
~,wjlj/rC:;>?d2~ If:
/ 70.<()'
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
~~
/;/1,0'2-
Date:
Signature
Name
Telephoneyr7 ~ 2///f'-;Z'(;uZ-
Capacity: ~nal Representative
_Counsel for personal representative
.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: -4&/f-RE.//. E:.- ~ ~V7
Date of Death: 7 - .7.<::' -01
Will No.: ;</-{);J- (PS9 Admin. No.:
CY/
/
.
. .
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration ofthe above-captioned estate:
1. State ~her administration ofthe estate is complete:
Yes Q1 No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal ~entative file a final account with the Court?
Yes _ No ULI
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal reor&entative state an account informally to the parties
in interest? Yes 0' No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: S/;~
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/~Ji//as lit ~JkM)}J~7d)t
Address / --; ,
717, 29'ij. ZL. L)U
Te one No.
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Capacity: Personal Representative
o Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
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Date:
6/10/2003
HOYT WILLIAM H
12 HUNTERS RUN CT
RED LION, PA 17356
RE: Estate of HOYT ANNABELLE
File Number: 2002-00659
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on:
7/25/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
Ji 1.),) c, U L /,oj {. h
~w-a f .V.iMr 'blp"~f':u
DONNA M. OTTO j}c~ <-}~/"
DEPUTY REGISTER OF WILLS . I 0
cc: File
Counsel
Judge
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REV.jSIJO EX (6.001
'* COMMONWEALTH OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
DEPT. 280601
_ HARRISBURG, PA 17128-0601
REV-1500
f/
OFFICIAL USE ONLY
INHERITANCE TAX RETURN FILE NUMBER
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RESIDENT DECEDENT caUNTYCOaE YEAR
--h5:9--
NUMBER
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DECE3ENT'S NAME (LAS~ND MIDDLE INITIAL)
4/AV,//3 >,.n F-
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
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(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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~1.0riginaIReturn
o 4. Limited Estate
o 6. Decedent Died Testate (Attadl ooPY of Will)
o 9. Litigation Proceeds Received
D 2. Supplemental Return
D 48. Future Interest Compromise (date of ooalh slier 12-12-82)
o 7. Decedent Maintained a Living Trust (Allach copy 01 Trust)
o 10. Spousal Poverty Cfl'luil (dalr. of (jaalh belYfflen 12-31-91 anrll-1-~5)
i SOCIAL SECURITY NUMBER
120'1- DJ - LBC~
I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
: REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dale ofdealhprior to 12-13-S2)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Eleclion to tax under Sec. 9113(A) (AlIadl Sd! 0)
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TELEPHONE NUMBER
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5, Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Intet-Vivos Transfers & Miscellaneous Non.Probate Property
(Schedule Gor L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expelses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
!Ilit!!~I~I'
l!!jir,!il:'.
COMPLETE MAILING ADDRESS
I:L #ON/~ l? i./N C:;i_H(;r
R~ bau P/ /735(.
(9) ~rp
(10) _---.B~CQ___
St::x::l::; _ CO
( J..)/s's _ L3)
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(2)
(3) C"..e/"C
(4) A~A/""tr.
(5) ~f!3 '-I J..j ~ 7'
(6) --I~~
(7) ~~~
(8)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to lax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal lax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable allineal rate
Q.___ x .0 __ (15)
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, .0
17. Amount of Line 14 taxable at sibling rale
D '.12 (17)
_.___D__~_, .15 (18)
18. Amount Of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
OFFICIAL USE ONLY
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(11)
(12)
(13)
(14)
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(16)
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(19)
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Decedent's Complete Address:
STREET ADDRESS , .r. C '
-----L rJO "-J'lR. f:0ij C>A/7'
~-8j)
CITY
STATE
-M
ZIP 170)3
f:
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
o
Total Credits (A + 8 + C ) (2)
()
3. Interest/Penalty if applicable
D.lnterest
E, Penalty
TotallnteresUPenally ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
8, Enter the total of Une 5 + SA, This is the 8ALANCE DUE,
(SA)
(58)
o
r)
o
n
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5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
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
a. retain the use or income of the property transferred;...................,............................... .......................... D
b. retain the right to designate who shall use the property transferred or its income;... ....................... D
c. retain a reversionary interest; or...................................... ......................................................................... D
d. receive the promise for life of either payments, benefits or care? ...... ....................... .... .......................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .................................. ............................... ................... D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........... .................... ..................................... ...................................... ..... D ISd
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
No
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Under penalties of perjury, I dl1c1are that I have examined this return, incJuding accompanying schedules and statements, and to the best of my knowledge and belief, rt is true, correct
and complete.
Declaralion of preparerother than the personal represenlalive is based on alJ information which preparer has any knowledge.
DATE
----IL Izc. /03
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DATE
ADDRESS. ~
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SIGNATURE OF PREPARER THER THAN REPRESENTATIVE
ADDRESS
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 3%
[72 PS, !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 0% [72 P.S. 99116 (a) (1.1) (ii)].
The statute does not exp.mot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return 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 0% 172 P,S, !9116(a)(12)],
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% {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.
REV-I503EX+(1-971
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
CHELX /NC-- ~cc-=v,<.)"r
. /
VALUE AT DATE
OF DEATH
4' 38'1i/. 3'7
TOTAL (Also enler on line 5, Recapitulalion) $
(If more space is needed, insert additional sheets of the same size)
-
COMMONWEALTH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
Harrisburg District Office; Lobby, Strawberry Square, Harrisburg, PA 17128-0101
Phone: (717) 783-1405 FAX: (717) 783-4447 Web: www.revenue.state.pa.us
JULY 30. 2003
EST A 'IE OF: ANNABELLE HOYT
DATE OF DEATH: 07-25-2001
FILE NUMBER: 2102-0659/2003-28
(Please remit top portion with your payment)
WILLIAM H. HOYT
12 HUNTERS RUN CT
RED LION, P A 17356
Dear WILLIAM H. HOYT:
A review of our records has disclosed that you are responsible for the settlement of the above estate, or
that you represent the responsible party.
This is to advise you that the above estate is in a delinquent status. According to our records, as of this
date, the estate still is not settled.
The Inheritance and Estate Tax Act, mandates the filing of a tax remrn and payment of all outstanding
liabilities by a personal representative of the estate or a transferee within nine months of the decedent's
death. The Department's records show that this estate remains open because:
AN INHERITANCE TAX RETURN HAS NOT BEEN FILED.
If the return has been filed it is important that you contac' us immediately. If this estate was opened
for the purpose of a lawsuit, please contact this office m writing with the term and docket number of the
lawsuit so that we may postpone any further action.
Weare extending a thirty day courtesy period from the date of this letter to permit you to file the
return. If you fail to do so, the Department of Revenue will make a formal demand on you or your client
and, if necessary, institute legal action.
MAKE CHECKS PAYABLE TO:
REGISTER OF WILLS, AGENT
Sinserely,
\ ") . "';:
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. -""\,f ..1:-:------- !' ,,' r' \ '-
~U\XJJ!h )~ 1JJ'tJ'J( 1.-1 ("milL
Rebecca Barriclc, District Administrator
Harrisbtirg District 0 ffice
Any questions regarding this estate, please
CONTACT: TOM HOOPER
(717) 783-1405
lA
.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
09-3-03
NOTICE OF JUDGMENTITRANSCRIPT
CIVIL CASE
PLAINTIFF: NAME and ADDRESS
'cLAREMONT NURSING & REHABILITATION"
1 0 0 0 CLAREMONT ROAD
CARLISLE, PA 17013
L ~
Mag. Dis!. No.
OJ Name: Hon
Address
SUSAN K. DAY
229 MILL STREET, BOX 167
MT. HOLLY SPRINGS, PA
VS.
T,lepho", (717) 486 -7672
17065
DEFENDANT' NAME and ADDRESS
'HOYT, WILLIAM
12 HUNTERS RUN COURT
RED LION, PA 17356
L
Docket No.: cv- 0000259 - 02
Date Filed: 9/18/02
.,
3$-fIl
17/7-
'7t/-/B~
WILLIAM HOYT
12 HUNTERS RUN COURT
RED LION, PA 17356
D'2G ~f-IV~
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THIS IS TO NOTIFY YOU THAT:
Judgment:
FOR PT,ATNTTFF
[iJ
[iJ
Judgment was entered for:
(Name)
f'T.nRRMfl'PJ"'r l\TT1R~TNr.:. s;. 'RRHlt.'RTT.TTll.
Judgment was entered against: (Name)
HOY'!' WTT,T,TAM
in the amount of $
R 100; 00 on:
(Date of Judgment)
1 ?/1 q /o?
D Defendants are jointly and severally liable.
D Damages will be assessed on:
D This case dismissed without prejudice.
(Date & Time)
Amount of Judgment Subject to
Attachment/Act 5 of 1996 $
Amount of Judgment $ 8.000.00
Judgment Costs $ 105.00
Interest on Judgment $ .00
Attorney Fees $ .00
Total $ 8.105.00
Post Judgment Credits $
Post Judgment Costs $
------------
------------
Certified Judgment Total $
D
D
D
I D'"
Time:
Levy is stayed for
days or D generaliy stayed.
Objection to levy has been filed and hearing will be held:
~ "eo,
ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE
OF APPEAL WITH THE PROTHONOTARY/CLERK OF THE COURT OF COMMON PLEAS, CIVILDIVISION. YOU
MUST INCLUDE A COPY OF THIS E OF JUDGMENT ANSC T FORM WITH YOUR\NOTjCE Of APPEAL.
;.
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1.(- I 'i'i L.
Date
':";-
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, District Justice
I certify that this is atrue
Date
proceedings containing the judgment.
, District Justice
My commission expires first Monday of January,
2004
SEAL
AOPC 315-99
IiJ allflrst
ANNABELLE HOYT
C/O WILLIAM HOYT
12 HUNTER'S RUN RUN CT
RED LION PA 17356
1".111,,,1,.11,,1,1..11..1.,1.1
Page 1 of 3
Relationship With Interest
Annabelle Hoyt
Activity Summary
June 22, 2002 thru July 23, 2002
Acct No 00444-8207-8
o autirsl.cam 0 24-hour
Customer Service
1-800-533-4630
Number of checks safekept
Annual percentage yield earned
Avg. daily ledger balance
Avg. daily collected balance
Interest earned this statement
Interest paid this statement
Interest paid this year
Days covered by this statement
Deposits and additions
Date Description
o
O.25Y.
$3,B43.55
$3,843.53
.84
.84
$5.63
32
$3,843.53
.B4
$3,B44.37
Balance on 06/21
Deposits and additions
Balance on 07123
Amount
07/23 INTEREST PAID
.84
.84
End of Day Ledger Balance
Account balances are updated in the section below on days when transactions posted
to this account.
Date
Balance
06/21
07/23
$3,843.53
3,844.37
006309
0013.98317473296 050
BUREAU OF TNDZVZDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 17128-0601
COHNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSENENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX
NTLLTAH H HOYT
ZZ HUNTERS RUN CT
RED LTO. PA
'04 ,q?R-5 P3:05
DATE 04-05-200~
ESTATE OF HOYT
DATE OF DEATH 07-25-2001
FILE NUNBER Z1 02-0659
COUNTY CUHBERLAND
ACN 101
t ,, Amount Remitted
ANNABELLE
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF NZLLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17015
T -~-u~..uno ~mu A~$E$$NENT OF TAX
ANNABELLE
FILE NO. 21 02-0659
ACN 101 DATE 0~-05-200~
TAX RETURN NAS: (X) ACCEPTED AS FZLED
RESERVATION CONCERNZNG FUTURE ZNTEREST- SEE REVERSE
( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schadula A} (1) .00
2. Stocks and Bonds (Schadula B) (2) .00
$. Closely Held Stock/Partnership Zntarast (Schadula C) ($) .00
~. Nortgagas/Notes RacaivabZa (SchaduZa D) (~) .00
5. Cash/Bank Daposits/Hisc. Personal Property (Schedule E) (5)
6. Jointly Ownad Property (Schedule F} (6) .00
7. Transfers (Schedule G)
8. Total Assats (7) .00
(8)
APPROVED DEDUCTIONS AND EXENPTZONS:
9. Funaral Expansas/Adm. Costs/Nisc. Expenses (Schadula H) (9) .00
10. Debts/Hortgaga Liabilities/Liens (Schedula l) (I0) 8;000.00
11. Total Deductions '
12. Nat Value of Tax Return (11)
NOTE: To insure proper
credit to your account,
submit ~he upper portion
of th~s form gith your
tax payment.
$,8~.$7
ZF PAZD AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDZTZONAL ZNTEREST.
ANOUNT PAID
1.;. A,ount of Line 1~ at Spousal rate
16. Amount of L/ne 1~ taxabla at Linaal/Class A rata
17. Amount of Lina 1~ at Sibling rata
18. A~ount of Line 1~ taxabla at Collataral/Class B rata
19. Principa! Tax Dua
TAX CREDXTS:
PAYHENT R~-C[TPT D/SCOUNT
DATE NUHBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT1 . O0
BALANCE OF TAX DUE . O0
ZNYE;REST AND PEN. . O0
¥OYAL DUE . O0
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)
(1,;) .00 X O0 = .00
(16) .00 X 0~5= .00
(17) . O0 X 12 = . O0
(18)_ .00 x 15 = .00
(19)-- . O0
(z2) ~,155.65'
15. CharAtabla/Govarneantal Bequests; Non-aXactad 911~ Trusts (Schedule J) (13) .00
ltl. Nat Va/ue of Estate Subject *o Tax
(1~) ~,155.65-
NOTE: Z~ an assessment was issued previously, lines 1~, 15 and/er 16, 17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
RESERVATION: Estates of decedents dying on or before December IZ, 19aZ -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coamon#aalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laefu[ Class B (collateral) rate an any such futura interest.
Act ZS of ZOO0. (72 P.S.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance end Estate Tax Act,
Section 9140).
PAYNENT: Detach the top portion of this Notice and submit eith your payment to the Register of N/lis printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILES, AGENT
REFUND [CR): 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-leiS). Applications ara available at the Off[ce
of the Rag[star of Nills, any of the Z5 Revenue District Offices, ar by calling the special Z4-hour
answering service for forms ordering: I-BOO-SBZ-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-BOO-4~7-SOZO (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisament~ allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must abject within sixty (60) days of receipt of
this Notice by: OR
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZelOZ1, Harrisburg, PA 171ze-lOZ1,
--election to have the matter determined et audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADHIN- of Revenue,
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in #riling to: PA Department
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZB0601) Harrisburg, PA 171Z8-0601
Phone [717) 787-6505. Sea page 5 of the booklet ..Instructions far Inheritance Tax Return for a Resident
Decedent" [REV-1501) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (SZ) discount of
the 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 tiaa 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 (l) day from the date of
death, to the date of payment. Taxes which became delinquent before January l~ 19az bear interest at the rate of
six (eX) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rata which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ zox .ooo5~ ~-199l ~ :O0OSO~ ~ ~ '"~
1983 162 .000~38 1992 9Z .000Z47 ZOOZ 62 .00016~
1984 itl .oo030t i993-I99~ 7x .OOOlgZ zoos sx .oooi37
1985 132 .000356 1995-1998 9Z .O00Z~7 2004 42 .000110
1986 10X .00027~ 1999 7Z .O0019Z
1987 lOX .000Z74 ZOO0 7Z .O00XgZ
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) 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-