HomeMy WebLinkAbout04-0107COMMONHEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
REV-lPi3 EX AFP (09-00)
ZNFORMATZON NOTZCE
AND
TAXPAYER RESPONSE
FZLE NO. 21 '0~°
ACN 0q100571
DATE 01-20-200q
CAROLYN A ~OLGAMUTH
C/O APT A5
611 MALLARD RD
CAMP HILL PA 17011
TYPE OF ACCOUNT
EST. OF CLAIR E NOLGAMUTH [] SAVINGS
S.S. NO. ZlO-$O-18g5 [] CHECKING
DATE OF DEATH os-gq-zoos [] TRUST
COUNTY CUMBERLAND [] CERTZF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF ~/ILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
FULTON BANK has provided the Department with the information listed below which 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 written 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 Laws of the Commonwealth
of Pennsylvania. Questions may be answered by caJtJng (717) 787-8327.
COMPLETE PART I BELOW ~ # # SEE REVERSE SZDE FOR FZLZNG AND PAYMENT ZNSTRUCTZONS
Account No. 0001-02052 Diite 11-27-1998
Estiiblishiid
Account Biilancii q27.q1
Percent Taxablii X 16.667
Aiiount Subjiict to Tax 71.2q
Tax Riite X .00
Potentia! Tiix Due .00
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of HiZls. Make check
payable to: "Register of Hills, Agent".
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after tho date of death.
PART TAXPAYER RESPONSE
CHECK
ONE
BLOCK
ONLY
PART
TAX
L/NE
A. I~/rTha above information and tax due is correct.
~ 1. You may choose to remit payment to the Register of Hills 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
Hills and an official assessment will be issued by the PA Department of Revenue.
L [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. D Tho above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART J~-lbelow.
If you indicate a different tax riite, pleasii sta~e your
riilationshlp ~o decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1. Date Establishiid
2. Account Balance 2
3. Percent Taxable 3 ~
q. Amount Sub5ec~ to Tax q
~. Diibts lind Deductions ~ -
6. Aiiount Taxable 6
7. Tiix Retie 7 ~
8. Tax Duii 8
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Entiir on Linii $ of Tiix Computation)
Under penalties of piir.~ur¥, Z diiclarii that the foots I helve reported IIbove arii truii, correc~ lind
ci}~?~~liitii to thii best of Ily knoleledgii end biilie,. HOME (7'/7) ,~., '~?~/"~
TAXPAYER ~IONATUEE ~ TELEPHONE NOH"E" DATE
GENERAL ZNFORHATION
1. FAILURE TO RESPOND NILL RESULT ZN AN OFFICIAL TAX ASSESSNENT eith applicable interest based an information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's dote of death.
$. A joint account is taxable even though the decadent's name ems added as a matter of convenience.
4. Accounts (including those hold beteeen husband and mile) ahich the decedent put in joint names eithin one year prior to
death are fully taxable as transfers.
S. Accounts established jointly between husband and aife Bore than one year prior to death ara not taxable.
6. Accounts held by a decedent "in trust for" another or others ara taxable ~ully.
REPORTING INSTRUCTIONS - PART ! TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice ara correct and deductions are not being claimed, place an
in block "A" of Part I of the "Taxpayer Response" section. Sign tad copies and submit thee aith your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue alii issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Hills.
Z. BLOCK S - If the asset specified on this notice has been or ail1 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 Taxes, Oept ZB0601, Harrisburg, PA 17128-0601 in the
envelope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Hills of the county indicated. The PA Department of Revenue mill issue an official assessment [Fore REV-iS48 EX) upon receipt
of the return free the Register of Hills.
TAX RETURN - PART 2 TAX COMPUTATION
LINE
1. Enter the data the account originally was established or titled in the manner existing at date of death.
NOTE: For a decadent dying after 1Z/1Z/8Z: Accounts ahich the decedent put in joint names within one (1) year of death ara
taxable fully as transfers. However, there is an exclusion not to exceed $$,00D per transferee regardless of the vaZua of
the account or the number of accounts held.
If a double asterisk (*m) appears before your first name in the address portion 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.
3. The percent of the account that is taxable for each survivor is determined as folloes:
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 ORNERS SURVIVING JOINT OHNERS
Example: A joint asset registered in the name of the decedent and tee other persons.
I DIVIDED BY $ (JOINT ONNERS) DIVINED BY 2 (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created within one year of the decedant's death or accounts oaned by the decedent but held
in trust for another individual(s) [trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
ONNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established eithin one year of death by
the decedent.
1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = 50Z [TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (line q) is determined by multiplying the account balance [line Z) by the percent taxable (1ina 3).
S. 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 4).
7. Enter the appropriate tax rate [line 7) es determined below.
De~e of Death Spouse Lineal Sibling Collateral
07/01/9q ~o 12/$1/9q
01/01/95 ~o 06/30/00 OX 6Z 15Z
07/01/00 to present OX q.EZ~ 12Z
xThe tax rate imposed on the net value of transfers free a d :~ younger at
death to or for the use of a natural 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
ehather or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of tho
natural 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 least one parent in cocoon with the decedent, ahethar by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED
Alloaable debts and deductions are determined as folloas:
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 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 plain paper 8 1/2" x 11". Proof of
payment may be requested by the PA Department of Revenue.
BUREAU OF ZNDZVTDUAL TAXES
TNHER/TAHCE TAX DXVISTON
DEPT. 280601
HARRISBURG, PA 171Z8-0601
CONNONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF XNHERXTANCE TAX
APPRA/SENENT. ALLONANCE OR DXSALLO#ANCE
OF DEDUCTION~, AND ASSESSNENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-I;q8 EX &FP (01-05)
CAROLYN
16 BUTLER RD
DOVER
A WOLGANUTm~0~ ~AR -5 P3:42
DATE 03-08-ZOOq
ESTATE OF WOLGAMUTH CLAIR
DATE OF DEATH 05-Zq-2003
FILE NUHBER ~/-4~)~-
COUNTY CUMBERLAND
SSN/DC Z10-$0-1825
ACN 0~100571
Amoun~ Remi~ed
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
E
CUT ALONG THIS LINE ~ RETAIN LOWER PORTXON FOR YOUR RECORDS ~
~¥:[~-~-~--~--~5~-5~T ...................................................................................
NOTICE OF INHERITANCE TAX APPRAXSENENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-08-200q
ESTATE OF WOLGAMUTH
CLAIR E DATE OF DEATH 03-gq-ZOOS COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 210-$0-1825 ACN 0q100571
TAX RETURN WAS: (X) ACCEPTED AS FILED ¢ ) CHANGED
dOZNT OR TRUST ASSET ZNFORMATXON
FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. 0001-02052
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 11-27-1998
Account Balance qZ7.q1
Percen~ Taxable X 0.166
Amoun~ Sub~ec~ ~o Tax 71.Iq
Debts and Deductlons - .00
Taxable Amount 71.2q
Tax Rate X .00
Tax Oue .00
TAX CRED'rTS:
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 RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE XS LESS THAN $1, NO PAYHENT IS RE~UXRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
PURPOSE OF
NOTICE:
To ~ulfiil tho requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S.
Section 9lqO).
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF HILLS, AGENT.
A refund of a tax credit, ahich was not requested on the tax return, Bay 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 Nills, any of the 23 Revenue District Offices or by calling the special Z4-hour answering service
for fores ordering: 1-800-36Z-ZOSO; services for taxpayers eJth special hearing and or speaking needs:
Z-800-q~7-30ZO (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions ar 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. ZalOZl, Harrisburg, PA 171Za-lOZ1, OR
--electing to have the matter determined at tho audit of the account of the personal representative, 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 Review Unit, DEPT. Ia0601, Harrisburg, PA 171za-060!
Phone (717) 787-6505. See page 5 of the book[et "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax duo 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 amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat
paid before January 18, 1996, the first day after tho and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiao period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning aith first day of delinquency, or nine (9) months and Dna (1) day
from the date of death, to the date of payment. Taxes which became delinquent before January l, 1982
bear interest at the rate of six (6g) percent per annum calculated at a daily rate of .00016q.
All taxes which became delinquent on or after January 1, 198Z 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 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .OOOSq8 1987 9X .OOOZq7 1999 7Z .00019Z
1983 16Z .000638 1988-1991 11Z .D00301 ZOO0 8Z .000Z19
1984 Ill .000301 199Z 9Z .O00Zq7 2001 9Z .O00Z~7
1985 13Z .000356 1993-199~ 7Z .00019Z ZOOZ 6Z .O0016q
1986 102 .OOOZ7q 1995-1998 92 .O00Zq7 2003 5Z .000137
--Interest is calculated as foIlows:
INTE:RE:ST = BALANCE: OF TAX UNPAID X NUNBE:R OF DAYS DBL'rN{IUE:NT X DAILY TNTERE:ST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen [153 days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must bo calculated.
COMNONMEALTH OF PENNSYLVANIA
DF~ARTNENT OF REVENUE
BUREAU OF ZNDZVZDUAL TAXES
DEPT. Z80601
HARRZSBURG, PA 17128-0601
RE¥-1545 EX AFP
ZNFORMATZON NOTZCE
AND
TAXPAYER RESPONSE
ACN 0~10555~
DATE 02-16-200q
Re<:/::':~ :EST. '~F CLAIR E WOLGAMUTH
- s~S:!::NO. 210-30-1825
DATE OF DEATH 05-2q-2005
COUNTY CUMBERLAND
17 P :02
MICHAEL G WOLGAMUTH
APT AS
611 MALLARD RD
CAMP HILL PA 17011
TYPE OF ACCOUNT
]SAVINGS
O CHECKING
[~TRUST
[]CERTZF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA I7015
FULTON BANK has provided the nepartaent aith the information Listed below which has been used in
calculating the potentiat tax due. Their records indicate that at the death~ of the above decedent, you mere a joint oaner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this fora and return ]t to the above address. This account is taxable in accordance aith the Inheritance Tax Laws of the Commonwealth
COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SZDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. qq15-q9887 Data 12-11-2000
Established
Account Balance ~, 155.67
Percent Taxable X 16. 667
Amount Sub~ect to Tax 692.65
Tax Rate X . Oq5
Potential Tax Oue ~1.17
To insure proper credit to your account, tee
(Z) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Nills, Agent'.
NOTE: If tax payments are made within three
(3) months of the dacedent's date of death,
you amy deduct a 5Z discount of the tax due.
Any inheritance tax due ailX become delinquent
nine (9) months after the data of death.
PART TAXPAYER RESPONSE
A. ~T?e above information and tax due is correct.
You may choose to remit payment to the Register of #ills with two copies of this notice to obtain
a discount or avoid interest, or you amy check box 'A" and return this notice to the Register of
CHECK ~ Mills and an official assessment ail1 bo issued by the PA Department of Revenue.
ONE
BLOCK s. [] The above asset has been or ail1 be reported and tax paid with the Pennsylvania [nheritanca Tax return
ONLY to be filed by the decadent's representative.
C. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART [] beloa.
PART If you indicate a different tax rate, please state your
relationship to decedent:
TAX RETURN -COMPUTATZON OF TAX ON dOINT/TRUST ACCOUNTS
LINE 1. Date Established I
Account Balance ~
Percent Taxable 3 ~
Amount Sub~ect to Tax q
Debts and Deductions $ -
Amount Taxable 6.
Tax Rate 7 ~
Tax Due ~
PART
DATE PAID
DEBTS AND DEDUCTIONS CLA/MED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalt/as of perjury, ! declare that the facts I have reported above ara true, correct and
TAXPAYER SIGNATURE TELEPHONE NUMBER }AT{
GENERAL INFORHATION
1. FA/LURE TO RESPOND MILL RESULT ~N AN OFFICIAL TAX ASSESSMENT wlth applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the dacedent's date of death.
3. A joint account is taxable even though the decedant's name was added as a matter of convenience.
~. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death arm fully taxable as transfers.
5. Accounts established jointly between husband and wife more then 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 being claimed, place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit thaa with your check for the amount
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-lSd& EX) upon receipt of the return from the Register of WiiIs.
Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid eith the Pennsylvania Inheritance
Tax Return filed by the dacadant's representative, place an "X" in block "B" of Part 1 of tho "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Oept Z8060I, 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 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 official assessment (Form REV-15q8 EX) upon receipt
of the return from the Register of Wills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date the account originally ems established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 12/II/BI: Accounts which the decedent put in joint names within one (1) year of death are
taxable fully as transfers. Hoeever, there is an exclusion not to exceed $3,000 par transferee regardless 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 $3,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Z. Enter the tote1 baIance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER DF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE
JOINT ONNERS SURVIVING JOINT ONNERS
ExsmpIa: A joint asset registered in the name of the decedent and two other persons.
i DIVIDED BY 3 (JOINT OWNERS) DIVINED BY 2 (SURVIVORS) = .I67 X IO0 = IB.TZ (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
! DIVIDED BY Z (SURVIVORS) = .50 X 100 SOZ (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line q) 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 (1ina 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line q).
7. Enter the appropriate tax rats (line 7) as determined baloa.
Da~e of Death I Spouse ) L[neal ] Sibling I Collateral
07/01/9q ~o 12/$1/9~ SX 6X 15X 15X
01/01/95 ~o 06/30/00 OX 6X
07/01/00 ~o presen~ OX q.SZ~ 12Z
wThe tax rate imposed on the net vaZua 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 OZ.
The Iineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
ehether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all chiIdren of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" ara defined as individuals who have at Ieast one parent in common with the decedent, whether by biDed
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLA[HED DEDUCTIONS - PART $ - DEBTS AND DEDUCT[OHS CLAIHED
AllmeabIa debts and deductions are determined as follows:
A. You IegaIIy are responsible for payment, 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 bm itemized fully in Part 5. If additional space is needed~ use plain paper 8 I/Z" x Il". Proof of
payment may be requested by ~e PA Department of Revenue.
Reg,.~...
" "COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUF,,,~AU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-11 62 EX(11-96)
CD 003685
WOLGAMUTH CAROLYN A
C/O APT A3
611 MALLARD RD
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 210-30-1825
FILE NUMBER: 2104-01 07
DECEDENT NAME: WOLGAMUTH CLAIR E
DATE OF PAYMENT: 03/17/2004
POSTMARK DATE: 03/1 6/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/24/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04105354 $31.17
:REMARKS:
........ SEAL
CHECK//1028
TOTAL AMOUNT PAID'
$31.17
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
CONNONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z60601
HARRISBURG, PA 171Z8-0601
REV-16~$ El( &FP C09-00)
ZNFORHATZON NOTZCE
AND
TAXPAYER RESPONSE
FILE MO. aZ
ACN 0q100570
BATE 01-ZO-ZOOq
MICHAEL $ WOLGAMUTH
APT A5
611 MALLARD RD
CAMP HILL PA 17011
Recr ?
'04 17
EST. OF' CLAIR E WOLGAMUT"
S~S. NO. 210-$0-1825
DATE OF DEATH 05-2~-Z005
pl~O..!~Y CUMBERLAND
TYPE OF ACCOUNT
[--]SAVIN~S
[]CHECK/NO
~]TRUST
[]CERTIF.
REHZT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FULTON BANK has provided the Department aith the information listed beloe Nhich 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 written correction from the financial institution, attach a copy
to this fora and return it to the above address. This account is taxable in accordance with the [nheritance Tax Laws of the Commonwealth
COMPLETE PART ~ BELOW a N N SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUOTIONS
Dais 11-Z7-1998
Established
Account Balance ~Z7. ~1
Percent Taxable X 16.6 67
Amount Sub:Ject to Tax 71.2~,
Tax Rata X · 045
Potential Tax Due 3.Z1
Account No. 0001-02032
To insure proper credit to your account, two
[2) 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
[33 months of the dacedent's date of death,
you amy deduct a 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
CHECK
ONE
BLOCK
ONLY
PART
TAX
LZNE
A. L)~Tha above information and tax due is correct·
· You may choose to remit payment to the Register of Nills aith 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
Hills and an official assessment will be issued by the PA Department of Revenue.
B. []The above asset has been or mill be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. []The above information is incorrect and/or debts and deductions were paid by you. You must complete PART []and/ar PART [] below.
If you indicate a different tax rate, please state your
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1. Date Established I
2. Account Balance
3. Percent Taxable
q. Amount Subject to Tax
E. Debts and Deductions
6. Amount Taxable
7. Tax Rata
8. Tax Due
PART
DATE PAID
BEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalties of perjury~ I declare that the facts T have reported above ara true, correct end
complete to the best of Ily kno.ladga end belief. HOME
TAXPAYER SIGNA~ TELEPHONE NUHBER ~ATE /
GENERAL INFORHATION
1. FAZLURE TO RESPOND NZLL RESULT ZN AN OFFZCZAL TAX ASSESSHENT aith applicable interest based on 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 decedant's name ~as added as a matter of convenience.
q. Accounts (including those held between husband and ~ife) ~hich the decedent put in joint names #ithin one year prior to
death are fully taxable as transfers.
5. Accounts established jointly betueen husband and ~ife 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 [NSTRUCT[ONS- PART I - TAXPAYER RESPONSE
1. BLOCK A - 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 thee ~ith your check for the amount
tax to the Register of Nills of the county indicated. The PA Department of Revenue ~i11 issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Rag[star of Hills.
Z. BLOCK B - If the asset specified on this notice has been or ~ill be reported and tax paid ~ith the Pennsylvania Inheritance
Tax Return ~led by the decedent's representat[ve~ place an "X" [n block "B" o~ Part I eT the "Taxpayer Response" sect[on. Sign one
copy and return to the PA Department of Ravenue~ Bureau of /ndJvJdual Taxes~ Dept Z80601~ HarrJsburg~ PA 171Z8-0601 Jn the
envelope prov[ded.
5. BLOCK C - I~ the not[ce [n~ormatJon is incorrect and/or deductions are being claJmed~ check block "C" and complete Parts Z and
according to the instructions below. Sign two copies and submit them with your check ;or the a;ount of ~x payable to the Rag/star
o~ Hills o~ the county indicated. The PA Department o; Revenue ~11 [ssue an of;(cia1 assessment (Fora REV-lSd8 EX} upon receipt
of the return ~rom the Register of Nills.
TAX RETURN - PART 2 - TAX CONPUTATION
LINE
1. Enter ~e date the account originally ~as es~blished or titled in the manner existing at date of death.
NOTE: For a decedent dying a~ter 12/1Z/82: Accounts ~hich the decedent put in joint names ~ithin one (1) year of death are
taxable ~ully as transfers. He.ever) there is an exclusion not to exceed $~000 per transferee regardless
the account or the number of accounts held.
[fa double asterisk (xx) appears before your first name in ~e address portion of ~is not[ce, the $5)000 exclusion
already has been deducted from ~e account balance as reported by the f~nancJa[ ~nstJtut[on.
Enter ~e to~[ ba[ance of the account Jnc[ud~ng ~nterest accrued to the date of death.
5. The percent of the account that Js taxable fur each survivor ~s determined as
A. The percent taxab[e for joint assets established more than one year pr~o~ to the decedent's death:
[ D[V~OED BY TOTAL NUHBER OF D[V[DEO BY TOTAL NUHBER OF X ~00 = PERCENT TAXABLE
JOINT ONNERS SURV[V[NG JOINT ONNERS
Example: A joint asset registered Jn the name of the decedent and t.o other parsons.
[ DZV[OED BY 5 (JO[NT ONNERS) D[VZDEO BY Z (SURVIVORS) = .~67 X ~00 [6.7X (TAXABLE FOR EACH SURVIVOR)
B.The percent taxab[e for assets created ~JthJn one year of the decedent's death or accounts o.ned by the decedent but held
Jn trust for another individual(s) (trust beneficiaries):
~ DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X [00 = PERCENT TAXABLE
ONNERS OR TRUST BENEFICIARIES
Example: Joint account registered Jn the name of the decedent and t.o other persons and established .~thJn one year of death by
the decedent.
[ DIVIDED BY Z (SURVIVORS) = .50 X [00 = SOX (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line ~) ~s determined by multiplying the account balance ([~ne Z) by the percent taxable
S. Enter the total of the debts and deductions [~sted in Part 5.
6. The amount taxable ([Jne 6) ~s determined by subtracting the debts and deductions (line 5) from the amount subject to ~x ([~ne ~).
7. Enter the appropriate tax rate ([~ne 7) as determined below.
Da~e of Death [ Spouse I Lineal Sibllng I Collateral
07/01/9~ ~o 12/$1/9~
01/01/95 ~o 06/50/00 OX 6X
07/01/00 ~o presen~ OX ~.SZ~ 12X 15X
aThe tax rata imposed on the net value of transfers from a Y younger at
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is OZ.
The lineal class cf heirs includes grandparents, parents, children, and lineal descendents. "Children" lncludes natural children
mhether 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, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals .ho have at least one parent in common .ith the decedent, whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLATNED DEDUCTTONS - PART ~ - DEBTS AND DEDUCTTONS CLATHED
Allowable debts and deductions are determined as follo.s=
A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible [tams.
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 plain paper B 1/2" x 11". Proof of'
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
PARTrv~NT OF REVENUE
';J ~EAU OF INDIVIDUAL TAXES
DEPT. 2806O1
HARgISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003684
WOLGAMUTH CAROLYN A
C/O APT A3
611 MALLARD RD
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 210-30-1825
FILE NUMBER: 2104-01 07
DECEDENT NAME: WOLGAMUTH CLAIR E
DATE OF PAYMENT: 03/1 7/2004
POSTMARK DATE: 03/1 6/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/24/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04100570 $3.21
~REMARKS.
SEAL
CHECK//1027
TOTAL AMOUNT PAID:
$3.21
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX D/VIS/ON
DEPT. 280601
HARRTSBURG, PA 17128-D601
MICHAEL G WOLGAMUTH
APT AS
611 MALLARD RD
CAMP HILL PA 17011
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE
NOT/CE OF INBERI'TANCE TAX
APPRATSENENT. ALLONANCE OR DTSALLO#ANCE
OF DEDUCTTON~., AND ASSESSHENT OF' TAX ON
JOTNTL¥ HELD OR TRUST ASSETS
~'~* c~/' ~'~/' DATE 0~-12-2004
ESTATE OF WOLGAMUTH
DATE OF DEATH 05-24-2005
FILE NUMBER
COUNTY CUMBERLAND
SSN/DC 210-30-1825
ACN
Amoun~ Reei~ed
REV-16,~8 EX AFP (01-03)
CLAIR E
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-12-2004
ESTATE OF WOLGAMUTH
CLAIR
E DATE OF DEATH 05-24-2005 COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 210-50-1825 ACN 0410555~
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. 4415-49887
TYPE OF ACCOUNT: ¢ ~ SAVINGS ( ) CHECKING ¢ ) TRUST ¢ ) TIME CERTIFICATE
DATE ESTABLISHED 12-11-2000
Account Balance 4,155.67
Percent Taxable X 0.166
Amount Subject to Tax 692.65
Debts and Deductions - .00
Taxable Amount 692.65
Tax Rate ~ .45
Tax Due 51.17
TAX CREDITS:
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:
ffREGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH O~-ZO-ZO04
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
ZF PAZD AFTER THTS DATE., SEE REVERSE FOR CALCULATZON OF ADDTTTONAL ZNTEREST. ~
ZF TOTAL DUE ZS LESS THAN $1., NO PAYNENT ZS RE{~UZRED.
I'F TOTAL DUE 'rs REFLECTED AS A "CREDZT" (CR), YOU NAY BE DUE A REFUND.
SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS. }
.00
51.17
51.58
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S.
Section 91403.
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF MILLS, 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" (RE¥-1313). Applications ara available at the Office of
the Register of Hills, any of the 23 Revenue District Offices or by calling the special 24-hour answering service
for forms ordering: 1-800-362-2050; services far taxpayers with special hearing and or speaking needs:
1-800-447-3020 (TT only).
Any party in interest not satisfied eith the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 17128-1011, 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 writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 180601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1SG1) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent
discount of the tax paid is alXowad.
The 15Z 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 and 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 is charged beginning with 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, 1982
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2004 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
2009 91 .000247
198~ 20Z .00054B 1988-1991 111 .000301
1983 16Z .000438 1991 91 .000247 ZOOZ 61 .000119
1984 111 .000301 1993-1994 72 .000192 2003 52 .000137
1985 13Z .000356 1995-1998 91 .000247 2004 4Z .000110
1986 IOZ .000274 1999 71 .000192
1987 9Z .000247 ZOO0 8Z .000119
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELTNI~UENT X DATLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will 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.
BUREAU OF INDIVIDUAL TAXES
THHERZTAHCE TAX DZVZSTON
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COHNONHEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF XNHERZTANCE TAX
APPRAZSEHENT. ALLOXANCE OR DZSALLONANCE
OF DEDUCTXONS, AND ASSESSHENT OF TAX ON
JOXNTL¥ HELD OR TRUST ASSETS
HICHAEL G NOLGAHUTH
APT AS
611HALLARD RD
CAHP HILL PA 17011
DATE 04-1Z-ZOOR
ESTATE OF NOLGAMUTH
DATE OF DEATH 0:5-Z4-ZO0$
FILE NUNBER
COUNTY CUHBERLAND
SSN/DC 210-$0-18Z5
ACN 04100570
Amoun~ Remi~c~ed
REV-15~i8 EX AFP (01-05)
CLAIR
HAKE CHECK PAYABLE AND REHIT PAYNENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (:01-03)
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOHANCE OR DZSALLO#ANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 0~.- 12-200~.
ESTATE OF NOLGAHUTH
CLAIR E DATE OF DEATH 0:5-24-200:5 COUNTY CUHBERLAND
FILE NO. S.S/D.C. NO. 210-:50-1825 ACN
TAX RETURN NAS: eX) ACCEPTED AS FILED ( ) CHANGED
0~100570
JOINT OR TRUST ASSET ZNFORHATZON
FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. O001-OZO:SZ
TYPE OF ACCOUNT: C ) SAVINGS (:~ CHECKING ( ) TRUST (: ) TIHE CERTIFICATE
DATE ESTABLISHED 11-27-1998
Account Balance
Percent Taxable X 0.166
Amount Subject to Tax 71.24
Debts and Deductions - .00
Taxable Amount 71.Z~
Tax Rate X .45
Tax Due ~.Z1
TAX CREDITS:
427.41 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
HITH YOUR TAX PAYHENT TO THE
REGISTER OF HILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF HILLS, ASENT.'
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
NTEREST IS CHARGED THROUGH 0~-20-2004
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORH
TOTAL TAX CREDIT
BALANCE OF TAX DUE[
INTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE TS LESS THAN $1, NO PAYNENT ZS REI~UZRED.
ZF TOTAL DUE TS REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
.00
:5.21
.04
:5.25
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 91~0).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF #ILLS, AGENT.
A refund of a tax credit, which was not requested on the tax return, may ba requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of
the Register of Nills, any of the 23 Revenue District Offices or by calling the special Zq-hour answering service
for forms ordering: 1-800-362-2050~ services for taxpayers with special hearing and or speaking needs:
1-80O-qqT-30Zo (TT only].
Any party in interest not satisfied with the appraisement, allowance, ar 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. 281021, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to tho Orphans' Court
Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ZBO601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) 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 allowed.
The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 16, 1996, the first day after the and 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 is charged beginning with 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 l, 1982
bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .00016q.
All taxes which became delinquent on or after January 1, 1982 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
intarest rates for 1982 through ZO0~ are:
Interast Daily Interast Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20Z .O00Sq8 198~-1991 11Z .OOO3Ol 2009 9Z .OOOZq7
1983 16Z .000~38 1992 92 .0002~7 2OOZ 6Z ,O00Z19
198q 112 .000301 1993-199~ 72 .000192 2003 52 .000137
1985 13Z .000356 1995-1998 92 .0002~7 ZO0~ ~X .000110
1986 102 .O00Z7q 1999 72 .000192
1987 92 .O00Zq7 ZOO0 8Z .000219
--Interest is calculated as follows:
/NI'ERES1. = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENt. X DAILY INTEREST FACt.OR
--Any Notice issued after the tax becomes delinquent will 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 ba calculated.
BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DIVTSZON
DEPT. 280601
HARRTSBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOT/CE OF INHERITANCE TAX
APPRAZSEHENT. ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTION~, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 05-29-2004
ESTATE OF WOLGAHUTH
DATE OF DEATH 05-24-2003
FILE NUMBER
COUNTY CUHBERLAND
SSN/DC 210-30-1825
ACN 04105355
:48
CAROLYN A WOLGAMUTH
C/O APT
611MALLAR~UI~I~,.~
CAMP HILL PA 17011:~
Amoun't Remi'tted
RE¥-1548 EX AFP COl-OS)
CLAIR E
HAKE CHECK PAYABLE AND REHIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-29-2004
ESTATE OF WOLGANUTH
CLAIR
E DATE OF DEATH 03-24-2005 COUNTY CUHBERLAND
FILE NO. S.S/D.C. NO. 210-30-1825 ACN 04105355
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
dOZNT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. 4415-49887
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 12-11-2000
Account Balance
Percent Taxable X 0.166
Amount Subject to Tax 692.63
Debts and Deductions .00
Taxable Amount 692.63
Tax Rate X .00
Tax Due .00
TAX CREDITS=
4,155.67 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. HAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REI~UTRED.
TF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR TNSTRUCTZONS. )
.00
.00
.00
.00
PURPOSE OF
NOTICE:
To ~ulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S.
Section 91qO).
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NILLS, AGENT.
A refund of a tax credit, mhich was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office of
the Register of Hills, any of the Z5 Revenue District Offices or by calling the special Zq-hour answering service
for forms ordering: 1-800-36Z-2050; services for taxpayers aith special hearing and or speaking needs:
1-SO0-qqT-5OZO (TT only).
Any party in interest not satisfied aith the appraisement, alloaancs, er 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. ZSlOZ1, Harrisburg, PA 17128-10Z1, OR
--electing to have the matter determined at the audit of the account of the personaI representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in ~riting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, DEPT. Z80601, Harrisburg, PA 17128-0601
Phone (717) 787-650S. 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 (5) calendar months after the decedmnt's death, a five percent (5Z)
discount of the tax paid is allowed.
The 15Z 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 Hould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with 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 deIinquent before January 1, 198Z
bear interest at the rate of six (6g) percent par annum calculated at a daily rate of .00016q.
All taxes #hich became delinquent on or after January 1, 198Z will bear interest at a rate ~hich ~ill vary from
calendar year to calendar year uith that rate announced by the PA
Department of Revenue.
The applicable
interest rates for 198Z through 200q are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
X98---'~ ZOX .0005q8 198'"~-1991 llX .000501 ZO0--'~ 9Z .O00Z~7
1983 16Z .000q58 199Z 9Z .0002fi7 2002 6Z .000219
198q llZ .000501 1995-1996 7Z .OO019Z ZOO5 5Z .000137
1985 152 .000356 1995-1998 92 .O00Zq7 ZOOq qZ .D00110
1986 IOZ .O00Z7q 1999 7Z .O00lgZ
1987 92 .000247 ZOO0 82 .O00ZI9
--Interest ts calculated as follces:
TNTERBST = BAEANCE OF TAX UNPAZD X NUtlBER OF DAYS DEEZN~UBNT X DAZEY ZNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will 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.
COMMONgEALTH OF PENNSYLVANIA
DEPARTgENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 171Z8-0601
REV-ISleS EX AFP
ZNFORNATZON NOTZCE
AND
TAXPAYER RESPONSE
FILE NO. 21- Z'"gz'f"'-/07
ACN 04105355
BATE 02-16-2004
CAROLYN A NOLGAMUTH
C/O APT AS
611 MALLARD RD
CAMP HILL PA 17011
TYPE OF ACCOUNT
EST. OF CLAIR E NOLGAMUTH [] SAVINGS
S.S. NO. 210-$0-1825 [] CHECKING
DATE OF DEATH 05-24-2003 [] TRUST
COUNTY CUMBERLAND [] CERTZF.
REHZT PAYHENT AND FORHS TO:
REGTSTER OF gILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FULTON BANK has provided the Department aith the information listed beloa which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you ears a joint oNner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance eith the Inheritance Tax Lees of the Comeonaealth
of Pennsylvania. Questions may be answered by ceiling (717) ?&7-83ET.
COMPLETE PART 1 mELON ~ # . SEE REVERSE SIDE FOR FILING ANB PAYMENT INSTRUCTIONS
Accoun~ No. 4415-~9887 Da~e 12-11-2000
Es*ablishad
Accoun~ Balance 4,155.67
Percen~ Taxable X 16.667
Amoun~ SubSac~ ~o Tax 69Z.63
Tax Ra~a X .00
Po~en~ial Tax Due .00
To insure proper credit to your account, tee
(2) copies of this notice must accompany your
payment to tho Register of gills. Make check
payable to: "Register of #ills, Agent".
MOTE: If tax payments are made aithin three
(3) months of the decedent's date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax due Nil1 become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
[
A.
~Tha above information and tax due is correct.
l. You may choose to remit payment to the Register of gills Hith too 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 ~ gills and an official assessment will be issued by the PA Department of Revenue.
BLOCK J B. [] The above asset has been or ail1 be reported and tax paid Nith the Pennsylvania Inheritance Tax return
ONLY to be filed by the decadent's representative.
C. [] The above information is incorrect and/or debts end deductions #era paid by you.
You must complete PART [] and/or PART [] beloa.
PART If you indicate a differen~ ~ax ra~e, please s~a~e your
[] relationship ~o decadent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Da~e Established I
2. Accoun~ Balance 2
3. Percen~ Taxable 3 X
q. Amoun~ SubSec~ ~o Tax ~
S. Deb~s and Deductions $ -
6. Amoun~ Taxable 6
7. Tax Ra~e 7 X
8. Tax Due 8
PART
DATE PAID
BEBTS AND DEDUCTZONS CLAIMED
PAYEE
DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Ce.puPation) $
Under penalties of perjury, I declare ~ha~ ~he fa¢~s I have reported above ara ~rua, corrac~ and
T~pc~4~,/~ePle~e ~o the bes~ of my knew lad ge and belief. HOME( )
AY~ SIGNATURE/ TELEPHONE NUHBER DATE
GENERAL INFORHATION
1. FAILURE TO RESPOND HILL RESULT IN AN OFFICIAL TAX ASSESSNENT aith applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
$. A joint account is taxable even though the decedent's name ams added as a matter of convenience.
4. Accounts (including those held betmeen husband and Hife) ahich the decedent put in joint names aithin one year prior to
death are fully taxable as transfers.
5. Accounts established jointly bataaan husband and Hire more than one year pr[or to death ara not taxable.
6. Accounts held by a decedent "in trust for" another or ethers are taxable fully.
REPORTING [NSTRUCTIONS PART I TAXPAYER RESPONSE
1. BLOCK A - Tf the information and computation in the not[ce are correct and deductions are not being claimed, place an
in block "A" ef Part I of the "Taxpayer Response" section. Sign tho copies and submit thee Hith your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue mill issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Wills.
Z. BLOCK B - Zf the asset specified on this notice has been or ail1 be reported and tax paid Hith the Pennsylvania [nheritance
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 Taxes, Oept 180601, Harrisburg, PA 1711B-0601 in the
envelope provided.
$. BLOCK C - Tf the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts Z and 3
according to the instructions baloH. Sign tho copies and submit thee Hith your check for the amount of tax payable to the Register
of Hills of the county indicated. The PA Department of Revenue Hill issue an official assessment (Form REV-154B EX) upon receipt
of the return from the Register of #ills.
TAX RETURN - PART Z - TAX COHPUTATION
LTNE
1. Enter the date the account originally Has established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 11/11/81: Accounts Hhich the decedent put in joint names aithin one (1) year of death are
taxable fuI1y as transfers. HoHevar, there is an exclusion not to exceed $3,000 per transferee regardless of the value of
the account or the number of accounts held.
[fa double asterisk (ex) appears before your first name in the address portion of this notice, the $3,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Enter the total balance of the account including interest accrued to the date of death.
The percent of the account that is taxable far each survivor is determined as folioas:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
i DTVZDED BY TOTAL NUNBER OF OZVZDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOZNT ONNERS SURVTVZNG JOZNT ONNERS
Example: A joint asset registered in the name of the decedent and tho other parsons.
I DTVTDED BY 3 (JOZNT OHNERS) DTVTDED BY 2 (SURVTVORS) = .167 X 100 = 16.71 (TAXABLE FOR EACH SURVTVOR)
B.The percent taxable for assets created aithin one year of the dacedant's death or accounts oHnad by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DTVZDED BY TOTAL NUNBER OF SURVTVTNC JOTNT X 100 = PERCENT TAXABLE
ONNERS OR TRUST BENEFZCIAR/ES
Example: Joint account registered in the name of the decedent and two other persons and established Hithin one year of death by
the decedent.
I DTVTDED BY 2: (SURVZVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVZVOR)
4. The amount subject to tax (1ina 4) is determined by multiplying the account balance (line Z) by the percent taxable (line
5. Eater 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 baloH.
De~e of Death Spouse I Lineal Sibling Collateral
07/01/9q ~o 12/$1/9q $Z 6X
01/01/95 ~o 06/50/00 OX 6X
07/01/00 ~o presen~ OX q.SX~
aThe tax rate imposed on tho net value of transfers free a dace .y-one years age younger at
death to or for the use of a natural parent, an adoptive parent, or a stepparant of the child is OZ.
The lineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
ahather or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendants, ahethar or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals Hho have at least one parent in common aith the decedent, ehether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLAIMED
AlloHable debts and deductions ara determined as folloes:
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 actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being cla~med must be itemized ~ully in Part ~. [f additional space ~s needed, use plain paper 8 1/2" x 11". P~oo~ o~
payment may be requested by the PA Department o~ Revenue.
BUREAU OF TNDTVTDUAL TAXES
INHER/TANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANXA
DEPARTMENT OF REVENUE
NOTXCE OF XNHERXTANCE TAX
APPRA/SEHENT. ALLO#ANCE OR DXSALLO#ANCE
OF DEDUCTXONS, AND ASSESSHENT OF TAX ON
JOXNTLY HELD OR TRUST ASSETS
26 :48
CAROLYN A WOLGAMUTH
C/O APT
611 HA L LAI~t~RI~'2, C ,
CAMP HILL PA 17011
REV-10~I8 EX AFP (01-05)
DATE 05-29-Z00q
ESTATE OF WOLGAHUTH CLAIR E
DATE OF DEATH 05-Zq-2005
FXLE NUHBER ~J-~-ID'-T
COUNTY CUHBERLAND
SSN/DC 210-$0-1825
ACN 0~105555
Amoun~ RemZ~ed I
HAKE CHECK PAYABLE AND REHXT PAYNENT TO:
REGISTER OF WILLS
CUMBERLAND C0 COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THXS LINE I~* RETAXN LOWER PORTION FOR YOUR RECORDS
REV-1548 EX AFP
NOTTCE OF XNHERXTANCE TAX APPRAXSENENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON dOXNTLY HELD OR TRUST ASSETS
DATE O$-Z9-ZO0~
ESTATE OF WOLGAHUTH
CLAIR E DATE OF DEATH 05-Iq-ZOO5 COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 210-50-1825 ACN 0q105355
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET XNFORHATZON
FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. qq15-q9887
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 1Z-lZ-Z000
Account BaZance
Percen~ Taxable X 0.166
Amoun~ Sub~ec~ ~o Tax 692.65
Debts and Deduc~/ons - .00
Taxable Amoun~ 692.65
Tax Ra~e X .00
Tax Due .00
TAX CREDITS:
q,155.67 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 RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
XNTEREST AND PEN.
TOTAL DUE
TF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
TF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REI~UZRED.
TF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THTS FORH FOR TNSTRUCTZONS. )
.00
.00
.00
.00
PAYMENT:
Detach the top portion of this Notice and submit eith your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #ILLS, AGENT.
-- If NON-RESIDENT OECEDENT make check or money order payable to: COMMON#EALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, ehich Nas not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at
tho Office of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's gq-hour
ansearing service for forms ordering: 1-eo0-36Z-ZOSO~ services for taxpayers with special hearing and / or
speaking needs: 1-BOO-qqT-3OZO (TT only).
REPLY TO:
guestions regarding errors contained an this notice should be addressed to: PR Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Raviee Unit, Dept. ge0601, Harrisburg, PA 171ZB-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid eithin three (3) calendar months after the dacedmnt's death, a five percent (SI) discount
of the tax paid is allowed.
PENALTY:
The 15Z 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.
INTEREST:
Interest is charged beginning with first day of dmlinquency, or nine (9) months and one (l) day from the date of
death, to the date of payment. Taxes which became delinquent before January I, 19Bg bear interest at the rate of
six (6Z) percent par annum calculated at a daiIy rate of .O0016q. All taxes ehich became delinquent on and after
January l, 19aZ will bear interest at a rate which mill vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicabIe interest rates for I98Z through ZOOq ara:
Interest Daily Interest Daily Interest
Year Rate Factor Year Rate Factor Year Rate
198Z ZOX .O00Sq8 1988-1991 llX .000301 ZOOl 9Z
1983 162 .000q38 199Z 92 .000Z47 2002 62
198q 112 .000301 1993-1994 72 .O0019Z ZOO3 52
1985 132 .000356 1995-1998 92 .O00Zq7 2004 q2
1986 10~ .O00Z7q 1999 72 .O0019Z
1987 9Z .000247 2000 82 .000219
Daily
Factor
.0002q7
.00016q
.000137
.000110
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUtlBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (la) days
beyond the date of the assessment. If payment is made after the interest computation date shoen on the
Notice, additional interest must be calculated.
BUREAU OF ZHDZVZDUAL TAXES
TNHER[TANCE TAX DTV/STON
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
REV-160? EX AFP
*O4
MICHAEL G WOLGAMUTH
APT A~
611 MALLARD RD
CAMP HILL PA 17011,AJF'
~, 24
DATE 05-17-200q
ESTATE OF WOLGAMUTH
DATE OF DEATH 05-2q-2005
FILE NUMBER 21 0q-0107
~.~ ~NTY CUMBERLAND
ACN 0q100570
I Amoun'l: Rem*~ ~:'l:ed
CLAIR E
MAKE CHECK PAYABLE AND REM'rT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account, submit: ~he upper por4:ion of ~chis fore wi~h your ~:ax payment.
CUT ALONG THZS LINE ~ RETAIN LOWER PORT/ON FOR YOUR RECORDS ~
REV-1607 EX AFP (01-03)
ESTATE OF WOLGAMUTH
a~ ZNHER/TANCE TAX STATEMENT OF ACCOUNT
CLAIR E FILE N0.21 0q-0107 ACN 0q100570
DATE 05-17-200q
THIS STATEMENT .rS PROV.rDED TO ADV.rSE OF THE CURRENT STATUS OF THE STATED ACN .tN THE NAMED ESTATE. SHOWN BELOW
.rS A SUMMARY OF THE PR.rNC.rPAL TAX DUE~ APPL.rCAT.rON OF ALL PAYMENTS~ THE CURRENT BALANCE~ AND, .rF APPL.rCABLE~
A PRO~ECYED INTEREST F.rGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: Oq-lZ-2OOq
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
$.21
PAYMENTS (TAX CREDITS):
PAYMENT
DATE
O~-16-ZOOq
RECEIPT
NUMBER
CDOO$68q
DISCOUNT C+)
INTEREST/PEN PAID (-)
.0O
.rF PA.rD AFTER TH.rS DATE~ SEE REVERSE
S.rDE FOR CALCULATION OF ADD.rTIONAL iNTEREST.
{ 'rF TOTAL DUE .rS LESS THAN $1~
NO PAYMENT .rS REnU.fRED.
.rF TOTAL DUE .rS REFLECTED AS k "CRED.rT" {CR)~
AMOUNT PAID
$ .Il
TOTAL TAX CREDIT 3.21
BALANCE OF TAX DUE .00
INTEREST AND PEN. .05
TOTAL DUE .05
YOU MAY BE DUE A REFUND. SEE REVERSE S.rDE OF TH'rS FORM FOR 'rrNSTRUCT.rONS. )
PAYMENT:
Detach the tap portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF HILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check ar money order payable to: COMMONNEALTH OF PENNSYLVANIA.
REFUND (CR):
REPLY TO:
DISCOUNT:
PENALTY:
A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available at
the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's Iq-hour
answering service for fores ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or
speaking needs: I-BO0-~q7-3OZO (TT only).
questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment RevieN Unit) Dept. Z&0601, Harrisburg, PA 171ZS-0601, phone
(717) 787-6505.
If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (SI) discount
of the tax paid is allowed.
The 15Z 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.
INTEREST:
[nterest is charged beginning with first day of delinquency, or nine (9) months and Dna (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 (6X) percent par annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which ~il1 vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOq ara:
Interest Daily Interest Deity Interest Daily
Year Rate Factor Year Rate Factor Year__ Rate Factor
198Z ZOX .OOOSq8 1988-1991 llZ ,00030! 200! 9Z .O00Zq7
1983 1SI .000q38 1992 9Z .O00Zq7 ZOOZ 6Z .O0016q
198~ IZZ .000301 1993-199q 7Z .O0019Z 200~ SZ .000137
1985 132 .000356 1995-1998 92 .0002q7 200q qZ .O001lO
1986 lOX .O00Z7q 1999 7Z .O0019Z
1987 9Z .O00Zq7 ZOO0 82 .O00Z19
--Interest is calculatad as follo~s:
TNTEREST = 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 (1S) days
beyond the date of the assessment. If payment is made after the interest computation date sho~n o~ the
Notice, additional interest must ba calculated.
CONNONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RE¥-1;~$ EX &FP (09-oD)
ZNFORHATZON NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21- L~-
ACH 0q105555
DATE 02-16-Z00q
CAROLYN A NOLGAMUTH
C/O APT A5
611 MALLARD RD
CAHP HILL PA 17011
TYPE OF ACCOUNT
EST. OF CLAIR E NOLGAHUTH [] SAVTNGS
S.S. NO. 210-50-1825 [] CHECKING
DATE OF DEATH 05-2q-Z005 [] TRUST
COUNTY CUMBERLAND [] CERTTF.
REHTT PAYMENT AND FORHS TO:
REGISTER OF HILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
FULTON BANK has provlded the Department with the information listed belle which 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 arJtten correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance aith the Inheritance Tax Lams of the Commoneealth
of Pennsylvania. guestiaus may be answered by caiZing (717) 757-8327.
COMPLETE PART !BELO# ~ ~ # SEE REVERSE SIDE FOR FILING AND PAYNENT INSTRUCTIONS
Account No. ~15-q9887 Bate 12-11-2000
Established
Account Balance q,155.67
Percent Taxable X 16.667
Amount Sub3act to Tax 692.65
Tax Rate X .00
Potential Tax Due .00
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 of Nills, Agent".
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 52 discount cf the tax due.
Any inheritance tax due will become delinquent
nine (9) months after tho date of death.
PART TAXPAYER RESPONSE
A. I--~Tha above information and tax due is correct.
~1. You amy choose to remit payment to the Register cf Hills aith 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
I- ONE ~1 Hills and an official assessment will be issued by the PA Department o~: Revenue.
BLOCK J a. [] The above asset has been or ail1 be reported and tax paid aith the Pennsylvania Inheritance Tax return
ONLY to be f~led by ~e decedent's representative.
C. ~ The above ~n~oraatlon ts ~ncorrect and/or debts and deduct[ons ~ere paid by you.
You must complete PART ~ and/or PART ~ bela~.
PART If you indicate a d[fferen* ~ax re*e, please s*a*e your ~~~~~H;~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~i~iiii~!iiii!~!~!!~H!!!!!!~!!!!!!~i!!!!!!!i!!!i!!} ! !~ ~
2. Account Balance
3. Percent Taxable 3
q. Amount Subject to Tax
$. Debts and Deductions
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalties of perjury, I declare that the facts T have reported above ara true, correct and
/cpmpletp to the best of ay knowledge and belief. HOME ( )
TAXPAYER SI6NATURE/ TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND HILL RESULT ZN AN OFFICIAL TAX ASSESSHENT aith applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedant's date of death,
3. 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 ~ife) ahich the decedent put in joint names ~ithin one year pr[or to
death are fully taxable as transfers.
S. Accounts established jointly between husband and wife more than Dna year prior to death ara not taxable.
6. Accounts held by a decedent "in trust far" another or others ara taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions ara not being claimed, place an
in block "A" of Part I of the "Taxpayer Response" section. Sign tho copies and submit them with your check for the amount
tax to the Register of Wills of the county indicated. The PA Department of Revenue ail1 issue an official assessment
(Form REV-1S48 EX) upon receipt of the return from the Register of Wills.
Z. BLOCK B - If the asset specified on this notice has been or ail1 ba reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decadent'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 Taxes, Dept ZOO601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts
according to the instructions below. Sign tee 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 ail1 issue an official assessment (Form REV-154& EX) upon receipt
of the return from the Rag/star of Wills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existlng at date of death.
NOTE: For a decedent dying after 1Z/IZ/BZ: Accounts which the decedent put in joint names ~ithin one (1) year of death are
taxable fully as transfers. Ho~avar, there is an exclusion not to exceed $5,000 par transferee regardless of the value
the account or the number of accounts held.
If a double asterisk (N~) 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.
Enter the total balance of the account including interest accrued to the date of death.
5. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
I DIVIDED BY TOTAL NUHBER DF DIVIDED BY TOTAL NUMBER OF X lO0 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other persons.
1 DIVIDED BY 5 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.77. (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created aithin one year of the dacedant's death or accounts oanad by the decedent but held
in trust for another individual(s) (trust beneficiaries).'
I DIVIDED BY TOTAL NUHBER OF SURVIVING JO[NT X 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established ~ithin one year of death by
the decedent.
1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = SOZ (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).
5. Enter the total of the debts and deductions listed in Part 5.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line S) from the amount subject to tax (line 4).
7. Enter the appropriate tax rate (line 7) es determined below.
De~e of Dea*h I Spouse I Lineal Sibling Co!la*ePa1
07/01/9fi ~o 12/$1/9fi
01/01/95 ~o 06/50/00 OX 6Z
07/01/00 ~o presen~ OX q.BXx 12Z
mThe 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 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
natural 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 mhd have at least one parent in common aith the decedent) ahather by blood
or adoption. The "Collateral" class of heirs includes a11 other beneficiaries.
CLAIMED DEDUCT[ONS- PART 5 - DEBTS AND DEDUCTIONS CLA[HED
A11o~abla debts and deductions are determined as
A. You Zegally are responsible for payment, 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 proo~ of payment.
C. Debts being cla~ed must be itemized fully
payment may be requested by the PA Depar~ent o; Revenue.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DZ¥/SZON
DEPT. 180601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
RE¥-1607 EX AFP C01-0S)
*O4
MICHAEL G WOLGAMUTH
APT AS
611 MALLARD RD
CAMP HILL PA
DATE 05-17-200~
ESTATE OF WOLGAHUTH
DATE OF DEATH 05-2~-2005
FILE NUMBER 21 0~-0107
:~UNTY CUMBERLAND
ACN 0~10555~
Aeoun*t Reei't'ted
CLAIR E
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account, sube/~ *~he upper portion of ~his fore frith your ~ax payeon~.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *~
REV-1607 EX AFP (01-03) ~ ZNHER*rTANCE TAX STATEMENT OF ACCOUNT ~
ESTATE OF WOLSAMUTH CLAIR E FILE NO. 21 0~-0107 ACN 0~10535~ DATE 05-17-100~
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHO#N BELOW
IS A SUHNARY OF THE PRINCIPAL TAX DUE,, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE., AND, IF APPLICABLE.,
A PROJECTED TNTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: O~-lZ-ZO0~
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
~1.17
PAYHENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
03-16-2001 CD003685 .00 31.17
IF PAID AFTER THIS DATE*, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
{ IF TOTAL DUE IS LESS THAN $1~
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)*,
TOTAL TAX CREDZT
31.17
BALANCE OF TAX DUE .00
INTEREST AND PEN. .19
TOTAL DUE .29
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
PURPOSE OF
NOTICE:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (TZ P.S.
Section 9140).
PAYMENT:
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NXLLS, AGENT.
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
A refund of a tax credit, ahich 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 NiIIs) any of the Z3 Revenue District Offices or by calling the special 24-hour answering service
for forms ordering: 1-800-362-2050; 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 er assessment
cf tax (including discount or interest) as shown on this Notice Bay object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZSlOZl, Harrisburg, PA i71ZS-IOZ1, 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 writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, DEPT. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-650S. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent
discount of the tax paid is allowed.
The iSZ 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 mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day
free the date of death, to the date of payment. Taxes ahich became de[inquent before January 1, 1982
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on ar after January 1, 1982 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 198Z through 2004 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198"'-~ goZ .000548 1988-1991 11Z .000301 ZOO1 9Z .000Z47
1985 16Z .000438 199Z 9Z .000247 2002 6Z .000219
1984 llZ .000301 1993-1994 72 .00019Z 2003 52 .000137
1985 152 .000356 1995-1998 9Z .000Z47 2004 42 .000110
1986 102 .000274 1999 7Z .O0019Z
1987 92 .000Z47 ZOO0 8Z .000219
--Interest is calculatad as folloes:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.