HomeMy WebLinkAbout04-0247REV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. ;)80601
HARRISBURG, PA 171;)8-0601
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REV-1500
NHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21- 04- 0247
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
189-18-7037
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
DECEDENT'SNAME(LAST. FIRST.ANDMIDDLEINITIAL)
Kin~sborou~h Carroll E.
DATE OF DEATH (MM-DO-YEAR) I DATE OF BIRTH (MM-OD-YEAR)
01/30/2004 I 11/11/1921
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Kin~sborou~h, Pearl M.
1, Original Return 2. Supplemental Return 3. Remainder Return prior zo ].'-]~-~)
.] 4. Limited Estate . Future Interest Compromise (date of death after 1;)- 1;)-8;)) 5. Federal Estate Tax Return Required
~ 6. Decedent Died Testate Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach copy of Trust)
[] 9. Litigation Proceeds Received r'~ 10. spousa~ Poverty Credit ['-'-] 11. Election to tax under Sec. 9113(A)
(date of death between 1;)-31-91 and 1-1-95) (Attach Sch O)
NAME
James D. Bo,;ar Esquire
FI R M NAM E (If Applicable)
TELEPHONE NUMBER
717/737- 8761
COMPLETE MAILING ADDRESS
One West Main Street
Shiremanstown, PA 17011
1,78~50
N°ne
None
1,300.00
None
None
None
None
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole -Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
r~ Separate Billing Requested
(7)
(8) 3,083.50
(11~ 0.00
(12) 3,083.50
(13).
(14) 3,083.50
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax 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
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
3,083.50
X .0 0 (15) 0.00
X .0 45 (16) 0.00
X .12 (17) 0.00
X .15 (18). 0.00
(19) O. O0
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
608 Bay Street
CIIY
Mechanicsbur~
ISTATE
ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
Z. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) O. O0
Total Credits ( A + B + C ) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3) O. O0
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) O. O0
A. Enter the interest on the tax due. (SA) O. O0
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. ($B) O. O0
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ......................... ['~ []
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care? ...................
Z. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ [~ [-~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. ~ ~]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ ['--']
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, [ declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Bonnie C. Kingsborough DATE
d 606 Ba Street
· Mechanicsburg, PA 17055 .
EOF
'-' PREPARE'~REI~I'HANREPRESENTI~tlVE James D. Bogar Esquire
y ~~ One West Main Street
//,~~ - - -s-~i~¥~h-s-~ ~ ~ - ~ - - lV6ii- ....................
For dates of death~3n DJ after
surviving spouse is '3%[72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt 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% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aX1)].
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. 9116(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.
Copyright (c) Z000 form software only The Lackner Group, [nc. Form REV- 1,~00 I~X (Rev. 6-00)
ADDITIONAL Personal Representatives
Estate of Carroll E. Kingsborough SS# 189-18-7037 01/30/2004
Under penalties of perjury, the undersigned declare that they
have examined this return, including accompanying schedules and
statements, and to the best of their knowledge and belief, it is
true, correct and complete.
Signature ~.~<~ ~ ~!~_~/
Name
Address Line 1
Address Line 2
City, State, Zip
Linda K. Nailor
217 Wolf Bridge Road
Carlisle, PA 17013
Date
REV-1503 EX + (1-97)
COMMONWEALTH OFPENNSYLVANIA
INHERITANCETAXR£TURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Carroll E. Kin~sborou~h SS# 189-18-7037 01/30/2004 21-04-0247
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 41 Shares-Prudential Financial, Inc. Common 43.50 1,783,50
Stock
TOTAL (Also enter on line 2, Recapitulation) 1,783.50
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97)
EQ_U $ERVE'
'~OUI$1=~V~ TRUST GOM~ANY, N.A.
PO BOX 43033
PROVfDENCE, RI 02940-3033
Tel: 800-305-9404
Internet: HTTP://PRUDENTIAL.EQUIS ERVE.COM
BONNIE KINGSBOROUGH
608 BAY ST
MECHANICSBURG PA 17050
February 4, 2004
Account Name:
Account Number:
Issue Name:
Issue ID:
CARROLL E KINGSBOROUGH
2838231
PRUDENTIAL COMMON
230010
STATEMENT SHARES: 41.0000
Dear Ms Kingsbourough,
This is in response to your inquiry regarding the transfer of shares following the death of the registered
shareholder.
If there is no will or the will is not being probated, you may transfer the shares using a Surety Bond in Lieu of
Probate. Please send us the enclosed Surety Bond along with the additional requirements listed below:
The enclosed Surety Bond in Lieu of Probate, fully completed and signed by all the heirs. This bond is
provided, as a convenience, through a group purchasing program at a fee of 2% of the current market value
of the shares. This fee covers our administrative services and the surety bond premium.
· A check or money order made payable to EQUISERVE TRUST COMPANY, N.A. in the amount of $36.45.
Please note that the minimum fee is $20.00.
· If there was a will, please submit a copy of the will.
· A certified copy of the deceased owner's death certificate(s). A photocopy with a Medallion Signature
Guarantee is acceptable.
A notarized Affidavit of Residence (also known as an Affidavit of Domicile) which was included in your
original package of transfer instructions. The Affidavit of Residence can also be obtained from your local bank
or stockbroker or an establishment that sells business forms.
If the shares will be transferred to someone other than the heirs, we will also require a completed Transfer of
Ownership Form (enclosed) signed by the heirs listed on the Surety Bond. The signature(s) must have a
Medallion Signature Guarantee which insures that the person(s) signing the form is the authorized
representative of those shares. The Medallion Signature Guarantee must be provided by an Eligible
Guarantor Institution such as a Commercial Bank, Trust Company, Securities Broker/Dealer, Credit Union, or
a Savings Association participating in a Medallion program approved by The Securities Transfer Association,
Inc. A Medallion Signature Guarantee can be identified by the word "Medallion" followed by a serial number.
Unfortunately, no other form of signature verification can be accepted.
See reverse for additional information
REV- 1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Carroll E. Kingsborou~h
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
SS~/ 189-18-7037 01/30/2004 21-04-0247
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 1,300.00
1994 Buick Century 4 door, VIN 1G4AG55M5R6422652, sold at private
sale
TOTAL (Also enter on line 5, Recapitulation) $ i, 300.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
(TO BE PLACED ON CAR DEALERSHIP'S LETTERHEAD)
OWNER OF VEHICLE:
VEHICLE IDENTIFICATION NO.:
YEAR/MAKE/MODEL:
isert date of death):$
ABOVE INFORMATION PROVIDED BY:
(Title)
~;[~ ~/~(717) 834-31357
' ~' ~4'.d '~ ,~L~17) 439-8383
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Carroll E. Kin~;sborou~:h
NUMBER
I1.
SCHEDULE J
BENEFICIARIES
SS# 189-18-7037 01/30/2004
FILENUMBER
21-04-0247
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116~1.Z)]
Pearl M. Kingsborough
608 Bay Street
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Spouse
AMOUNT OR SHARE
OF ESTATE
Rest, residue
and remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV-1513 EX {Rev. 9-00)
We, Carroll ]~. arid Pear'S. 1',!. ](inf~:~bo~'ou~.]b, beir~g of sound
mind, memory, and understanding, do hereby m~Jke, publish and
declare this as and for our last will and testament, hereby re-
voki~g all other wills and codici].s he~.ctofore ~mde by us[
FI}{ST
We direct the paymeni; of our debts a~d exp~nses of
last illnesses and funerals from our estates a~s soon after our
deaths as conveniently may be dome.
SECOND
We give, devise, and bequeath all 1. an{jibl~ persona]
prope~-ty ow~ed by us at the time of our deaths, together with
all insarance policies tber'eon, unto one amc'thor, if one of us
sur'vJves the other by thirty (]0) days. In the even't one off us
doe~ not survive the other by thirty (30) days, we ~ive and
bequeath saJ~ tangible per-'serial p~roperty and all i~surar~ce
cie~; thor'eon in as nearly eq~a], shares as J.s practicable unto
such of our' children as survive as by thirty (30) day~.
THIRD
We give, devise and bequeath all the rest, residue and
re~aindem of our estates unto one another, if one of us sur-
vives the other by thirty (~0) days. in the event one of us
does not survive the other by thirty (]0) days, we give and
bequeath all the rest, residue and remainder unto s~.oh of our
chi].dren as shall survive us by thirty (30) days, share and share
alike. In the event that either' of us take under this will, we
give, devise and bequeath, upon the-de~th of said legatee, all
vive us, share and share alike.
FOUl{TI{
In the event that cuff home passes to our daughters under
this will, we request, although ~]o not direct, that the home be
kept jointly by them ~til one o~.' both are married and that they
the~, sc].l or rent said ~ome, ~-~ 'they desire, and on equal terms.
FIFTH
We direct that any and all Inheritance, Estate and
Transfer Taxes imposed upon our estates ~assing ~der this
will or otherwise, shall be paid out of the principal of our
residuary estates.
SIXTH
We nominate, constitute and appoint one another as
personal representative of this oux' last will and testament.
In the event of the renunciation, death, resignation or inabil-
ity to act for any reason whatsoever, or upon the subsequent
death of the one of us who act as personal representative, we
then nominate, constitute and appoint our daughters jointly,
or the survivor of them, as personal representatives of this
our last will and 'testament.
IN WITNESS WHEREOF, we have hereunto set our hands and
seals to this, our last will and testament this..~)~j~-- day of
Signed, sealed, public, bed and declared by the above
named Testator and Testatrix, as and for their last will and
testament, in the presence of us, who, at their request, in
their sight and presence, and in the sight and presence of each
other, have hereunto subscribed our names as witnesses.
-2-
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Carroll E. Kingsborough
Date of Death: January 30, 2004
Will No. 21-04-0247
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
State whether administration of the estate is complete:
Yes x No
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 representative file a final
account with the Court? Yes No XX
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes XX No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: 4/22/04 ~ ~~w_,
S~gnatur~/
~ James D. ~ogar, Esquire
· ~ ~ Name (Please type or print)
~ One West Main St.
~ Shiremanstown, PA 17011
Address
{717 ) 737-8761
Tel. No.
Capacity:
__Personal Representative
(MAH:rmf/AM3)
X
__Counsel for personal
representative
gERTIFICATION OF NOTICE UNDER RULE 5.6 (ak
Name of Decedent: Carroll E. Kingsborough
Date of Death: January 30, 2004
Will No. 21-04-0247
Admin. No.
To the Register:
I certify that notice of estate administration required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
April 16, 2004:
Name
Address
Pearl M. Kingsborough
608 Bay Street
Mechanicsburg, PA 17055
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except:
None
Date: April 22, 2004
Capacity:
(717) 737-8761
Personal Representative
X Counsel for Personal
Represen3¢~tive
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 171:28-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 004073
KINGSBOROUGH BONNIE C
609 BAY STREET
MECHANICSBURG, PA 17055
........ fold
ESTATE INFORMATION: SSN: 189-18-7037
FILE NUMBER: 21 04-0247
DECEDENT NAME: KINGSBOROUGH CARROLL E
DATE OF PAYMENT: 06/22/2004
POSTMARK DATE: 06/22/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 01/30/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $1,354.42
REMARKS:
TOTAL AMOUNT PAID:
BONNIE KINGSBOROUGH
$1,354.42
SEAL
INITIALS: MW
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG. PA 17178-0601
REV- 1500
NHERITANCE TAX RETURN
RESIDENT DECEDENT
T
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INiTtAL)
D I DECEDENT'SNAME(LAST'FIRST'ANDMIDDLEINITIAL)
E Kin~sborou~h Carroll E.
C DATEOFDEATH(MM-DO-YEAR) DATEOFBIRTH(MM-DD-YEAR}
E
D 01/30/2004 11/11/1921
E
N
OFFICIAL USE ONLY
FILE NUMBER
21- 04- 0247
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
189-18-7037
THIS RETURN MUST BE FILED IN DUPLICATEWlTH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
CAPB
H~RL
coAC
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Supplemental Return
Future Interest Compromise {date of death after 17-1Z-8z)
Decedent Maintained a Living Trust 0
{Attach copy of Will) (Attach copy of Trust)
[] 9. Litigation Proceeds Received ['--]10. Spousal Poverty Credit r~
(date of death between 12-31-91 and 1 - 1-95)
C
O
R
R
E
S
(date of death
3. Remainder Return prior to 12-13-82)
5, Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch O)
Kin~sboroush, Pearl
1. origina~ Return X 2.
4. Limited Estate .
6. Decedent Died Testate
THIS SECTION MUST BEi COMPt:ETEDi ALL CORRESPONDENCE & CONFIDEN~i~E T~ INFORMATION SHOULD BE DIRECTED TOi!~:
NAME
James D. Bogar Esquire
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717/737-8761
R 5,
E
C
A 6.
P
I
T
U 7.
L
A
T 8.
I
O 9.
N 10,
11.
13.
C
O
M
Real Estate (Schedule A) (1)
Stocks and Bonds (Schedule B) (2)
Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
Mortgages & Notes Receivable (Schedule D) (4)
Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
Jointly Owned Property (Schedule F) (6)
r~ Separate Billing Requested
Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
COMPLETE MAILING ADDRESS
One West Main Street
Shiremanstown, PA 17011
None
None
None
None
None
60,196.51
None
None
OFFICIAL USE ONLY
(8) 60,196.51
(11). 0.00
(12) 60,196.51
(13)
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule t) (10) None
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 8 minus Line 11 )
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(14) 60,196.51
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
30,098.25
30,098.26
X .0 0 (15) 0.00
X .0 45 (16) 1,354.42
X .12 (17) 0.00
X .15 (18) 0.00
(19) 1,354.42
P
T U
A T
X A
T
I
0
N
Copyright (c) 2000 form software only The Lackner Group. Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
608 Bay Street
CITY
Mechanicsbur~
STATE
?A
ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
Z. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits ( A + B + C ) (?)
1,354.42
3. Interest/Penalty if applicable D. Interest
E. Penalty
Total Interest/Penalty ( 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)
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. (SA)
B. Enter the total of Line $ + SA. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ......................... [] [~]
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care? ...................
Z. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ [~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [~] ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ [~ ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
0.00
0.00
1,354.42
0.00
1,354.42
Under penalties of perjury. [ declare that I have examined this return, [ncludlng accompanying schedules and statements, and to the best of my Knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative is based on ail information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Bonnie C. Kingsborough DATE
;~ - ~ / ' ~ 606 Bay Street
d ....................
~REOFPREPARER~THE~HANR~PRESENT~VE-- J~es D. Bogar Esquire DAT~
-- -- .................... ut[ [e
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after Janua~ 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. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statuto~ requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficial.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twen~-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% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(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.
Copyright ~) Z000 form sol,are only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
ADDITIONAL Personal Representatives
Estate of Carroll E. Kingsborough SS# 189-18-7037 01/30/2004
Under penalties of perjury, the undersigned declare that they
have examined this return, including accompanying schedules and
statements, and to the best of their knowledge and belief, it is
true, correct and complete.
Signature
Linda K. Nailor
217 Wolf Bridge Road
Name
Address Line 1
Address Line 2
City, State, Zip
Date
Carlisle, PA 17013
REV- 1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Carroll E. Kin~sborou~h
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
SS~/ 189-18-7037 01/30/2004 21-04-0247
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Pearl M. Kingsborough "Spouse
Bonnie C. Kingsborough
608 Bay Street
Mechanicsburg,
606 Bay Street
Mechanicsburg,
PA 17055
PA 17055
Daughter
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM =OR JOINT MADE Include name of flnancialinstitution and bank DATE OF DEATH DECD'S VALUE OF
account number or similar identi~ing number.
NUMBER TENANT JOINT ~tachdeed for jointly-held realestate. VALUE OF ASSET INTEREST DECEDENT'S INTERE5
1 A&B 12/26/90 PNC Bank, N.A. - Checking 18,066.59 33.33~ 6,022.20
Account No.5070094164, date!
of death balance
~18,065.43, accrued
interest $1.16
2 A&B 01/01/79 PNC Bank, N.A. Savings 89,574.22 33.33% 29,858.07
Account No. 5030002165,
date of death balance
$89,550.29, accrued
interest $23.93
3 A&B 01/02/91 PNC Bank, N.A. Savings 72,948.73 33.33% 24,316.24
Account No. 5030115282,
date of death balance
$72,929.24, accrued
interest $19.49
TOTAL(Alsoenteronline6, Recapitulation) $ 60,196.51
(If more space is needed insert additional sheets of the same size)
Copyright (c} 1996 form software only CPSystems, [nc. Form REV-1509 EX !Rev.
PN CBANK
~/une 2, 2004
Jam~ D. Bogar
One West Maiu Street
Shiremanstown, PA 17011
Estate of Carroll E. K.ingsborough, deceased
$SN: 18.9-18-7037
DOD: 1/30/2004
Dear Mr. Bogar:
Iu response to your request for Date of Death halonces for the customer noted above, our
records show the following:
Checking Account
Accouat #50?00941~
CARROLL E KINGSBOROUGH
PEARL KINOSBOROUGH
BONNIE C KINGSBOROUGH
DOD balance: $18,065.43 + $1.15 accrued interest
Established 12/26/1990
Savings Accounts
Accotmt #5030002165
CARROLL E K]NGSBOROUGH
PEA.RI. M KINGSBOROUGH
BONNIE C KING.~BOKOUGH
DOD balance: $89,55029 + 523.93 accrued interest
Established 01/01/1979
Account #5030115282
PEARL M KINGSBOROUGH
CARROLL E KINGS'BOKOUGH
BONNIE C KINGSBOROUGH
DOD balance: $72,929.24 + $19.49 accrued interest
Establi~ed 01/02/1991
Pa~e I of 2
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do not proce.~ any financial
transactions or provide statements. If you need assistance with any of these items,
please call 1-sgs-PNC-BANK (1-885-762-2265) or s~op by your local PNC Bank branch
O~'~C8.
Rachetle Wells
1-800-762-1775
PT-PFSC-04-F
500 flest Ave.
Pittsburgh PA 15219
Page 2 of 2
Member FDIC
TI'lTl:il P_ 13~
REV- 1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Carroll E. Kin~sborou~h
NUMBER
II.
SCHEDULE J
BENEFICIARIES
SS# 189-18-7037 01/30/2004
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
FILE NUMBER
21- 04- O247
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 91
Pearl M. Kingsborough
608 Bay Street
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Spouse
AMOUNT OR SHARE
OF ESTATE
Rest, residue
and remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE. ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
Copyright (c~ Z000 form software only The Lackner Group, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
aind, l::C~:OP~'~ and understandi2s, do h~re~yy m;~l:e, publi~: amd
declare thi~ as and for our last ,viii and testalliellt, hereby r~-
yoking all oLlmr wills and codici].s hera:torero made by us.
We direct the payment of mir debtc and ez~ns,.n~ cf
last illnesses and funeral~; from our estates as soon al'tar our
deaths as coni~eniently may be done.
SECOND
We give, devise, and bequeath a]~[ l. angiblt~
prope~:-ty owned by us at the ~imc of our deaths, together
a].l insurance policies thereon, unto one ano!;}l~I', ii one o.F
survives thc other b~,- thirty (30) days. In the event one of us
does not survive thc ot~er by thii'ty (30) days, we ~[~_v~ and
beoueath said tangible personal pruperty and all insurance
ties thereon in as nearly equal shares as is practicab!,.~ unto
such of our- children as survive us by t. nJ. rty (303
THIRD
We give, devise and bequea'th all the rest, rcsi~lue and
ren~ainder of our estates unto erie another, if one of us sur-
vives the other by thirty (30) days. in -the event one of us
does not survive the other by thirty (30) days, we give and
bequeath all the rest, residue and remainder unto such of our
children as shall survive us by thirty (30) days, share and share
alike. In the event that either of us take under this ~,,ill,
give, devise and bequeath, upon the-death of said legatee, all
vive us, share and shaz'e alike.
FOUiITH
In the event tn,~ our home passes %o our daughters under
this will, we request~ although do not direct, that the home be
kept jointly by them ~til one or both are married and 2hat they
t;]en sell or ren% said home, ~s they desiy~e, and on equal terms.
FIFTH
We direct that any and all Inheritance, Estate and
Transfer Taxes imposed upon our estates p, assing under this
will or otherwise, shall be paid cut of the principal of our
residuary estates.
'#e nominate, constitute and appoint one another as
personal reore'~;entative of this our last will and testament.
In the event of the renunciation, death, resignation or inabil-
ity to act for any reason whatsoever, or upon the subsequent
death o.C the one of us who act as personal representative, we
then nominate, ~onstitute and appoint our daughters jointly,
or the survivor of them, as personal representativcs of this
our last will and ~estament.
IN WITHESS WHEREOF, we have here~to set our hands and
seals to this, our last will and testament this .,~'~.~ day of
,
Si~ed, sealed, published ~d declared by the above
named Testator and Testatrix, as and for their last will and
testament, in the presence of us, who, at their request, in
their sight and presence, and in the sight and presence of each
other, have here~to subscribe~ our names as witnesses.
/Y .... 2" '' "'""'
-2-
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0&01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
JAMES D BOGAR ESQ
i N MAIN ST
SHIREMANSTONN
PA 17011
REV-lS47 ED( AFP (01-05)
DATE 06-21-2004
ESTATE OF KZNGSBOROUGH CARROLL E
DATE OF DEATH 01-$0-2004
FILE NUMBER 21 0~-02~7
COUNTY CUMBERLAND
ACN 101
Amount Remitted I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS --~
REV-15~7 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KINGSBOROUGH CARROLL E FILE NO. 21 0~-0247 ACN 101 DATE 06-21-2004
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) C2)
$. Closely Held Stock/Partnership Interest CSchedule C)
4. Mortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/M/sc. Expenses CSchedule H) C9)
lO. Debts/Mortgage Liabilities/Liens CSchedule I) CIO)
11. Total Deductions
12. Net Value of Tax Return
13.
Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J)
Net Value of Estate Subject to Tax
.00
lr785.50
· 00
· 00
lr$O0.O0
.00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form w/th your
tax Payment.
.00
¢8) 3,08:5.50
.go
O0
(11) .00
c12) ~5,08:5.50
el3) .00
el4) $,085.50
NOTE:
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
ASSESSMENT OF TAX:
15. Amount of L/ne 14 at Spousal rate
1G. Amount of Line 14 taxabZe at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate C17).
18. Amount of Line 14 taxable at Collateral/Class B rate C18)
19. Principal Tax Due
TAX CREDITS:
RECEIPT DISCOUNT
NUHBER INTEREST/PEN PAID
reflect figures that include the total of ,ALL returns assessed to date.
PAYMENT
DATE
3,083.50 X O0 = .00
· 00 x 045 = .00
· OO;'X 12c~ .00
· OD x 15~--~ .00
AMOUNT PAID
clB~
.00
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT J .00
BALANCE OF TAX DUEI .00
INTEREST AND PEN. I .00
TOTAL DUE J .00
c IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DU~.-~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION=
PURPOSE OF
NOTICE:
PAYMENT=
REFUND
OBJECTIONS=
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT=
PENALTY:
INTEREST=
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B Ccollateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B Ccollateral) rate on any such future interest.
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. C72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NXLLS, 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" CREV-1315). Applications are available at the Office
of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 CTT
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax Cincluding discount or interest) as shown on this Notice must object within sixty C60) 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
--election to have the matter determined at 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. 280601, Harrisburg~ PA 17128-0601
Phone C717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" CREV-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 ¢5X) discount of
the tax paid is allowed.
The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before Januar~ 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquencY, or nine C9) 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 ¢6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced bv 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,,
~ 20X .000548 ~'~T8-1991 llX .000301' 200~ 9X .000247
1983 16X .000438 1992 9X .000247 2002 6~ .000164
1984 11X .000501 1993-1994 7X .000192 2003 5X .000137
1985 13X .O0035& 1995-1998 9X .000247 2004 4~ .000110
1986 10~ .000274 1999 7X .000192
1987 lOX .000274 2000 7X .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAXD X NUMBER OF DAYS DELINQUENT X DALLY XNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) days
beyond the date of the assessment. If payment is made after the interest computation date shc~n on the
Notice, additional interest must be calculated.
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DZVTSTON
DEPT. 280601
HARR/SBURG, PA 171Z8-0601
JAMES D BOGAR ESQ
I W MAIN ST
SHIREMANSTOWN
PA 17011
COHMONWEALTH OF PENNSYLVANZA BEPARTMENT OF REVENUE
NOTICE OF TNHERZTANCE TAX
APPRATSEHENT, ALLO#ANCE OR DTSALLO#ANCE
OF DEDUCTTONS AND ASSESSHENT OF TAX
BATE
ESTATE OF
BATE OF BEATH
FILE NUMBER
COUNTY
ACH
Amoun~ Ram/'l:'l:ed
08-09-Z00~
KINGSBOROUGH
01-$0-200~
Z1 0~-02~7
CUMBERLAND
101
REV-15ci7 EX AFP (01-03)
CARROLL E
HAKE CHECK PAYABLE AND REMZT PAYMENT TO=
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LINE ~ RETAIN LOWER PORTZON FOR YOUR RECORBS ~
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLOWANCE OR DZSALLOWANCE OF BEBUCTZONS ANB ASSESSMENT OF TAX
ESTATE OF KINGSBOROUGH CARROLL E FZLE NO. 21 04-0247 ACN 101 BATE 08-09-2004
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATTON CONCERNING FUTURE ZNTEREST- SEE REVERSE
APPRAZSED VALUE OF RETURN BASEB ON: SUPPLEMENTAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~narsh/p /n~aras~ (Schedule C) ($)
q. Hor~gages/No~as Rece/vabla (Schedule D) (~)
$. Cash/Bank DeposL~s/Hisc. Personal Proper~y (Schedule E) (B)
6. Jo/n~ly Owned Proper~y (Schedule F} (6)
7. Transfers (Schedule G) (7)
8. To'al Asse~s
APPROVED BEBUCTZONS ANB EXEMPTIONS:
9. Funeral Expanses/Ada. Cos~s/N/sc. Expanses (Schedule H) (9)
10. Dab~s/Hor~gage L/ab/1/*/es/L/ans (Schedule Z) (10)
11. To~el Deductions
12. Na~ Value of Tax Ra~urn
15.
lq.
NO. 01
.00
.00
.00
.00
.00
60~196.51
.00
.00
Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Ne~ Value of Es~a~e Sub~ec~ ~o Tax
NOTE: To /nsura proper
cred/~ ~o your account,
subm/~ ~he upper por*/on
of ~h/s form w/*h your
~ax payment.
60,196.51
.0O
(11) .OO
(12) 60,196.51
(~3) .00
(1~) 65,280.01
NOTE:
Zf an assessment was issued prev/ously, 11nee 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amoun~ of L/ne 1~ a~ Spousal ra~e (15)
16. Aeoun~ of L/nm 1~ ~axable e~ Lineal/Class A ra~a (16)
17. Amoun~ of L/ne lq a~ Sibl/ng ra~e (17)
18. Amoun~ of L/ne lq ~axeble a~ Collateral/Class B ra~® (18)
19. Prin¢/pa! Tax Due
TAX CREBITS:
PAYMENT
DATE
06-22-2004
NUMBER
CD004075
DX$COUNT
INTEREST/PEN PAID (-)
· 00 1, $ 54 ~::42 ~ ~:.~4~,
TOTAL TAX CREBZT I 1,354.42
,
BALANCE OF TAX BUE .00
ZNTEREST ANB PEN. O0
TOTAL BUE 00
( TF TOTAL DUE IS LESS THAN ~1, NO PAYHENT 1S RE~UZRED.
ZF TOTAL DUE IS REFLECTED AS A "CRED/T" (CR)~ YOU HAY BE D
A REFUND. SEE REVERSE SZDE OF TH/S FORH FOR /NSTRUCTZONS.
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULAT/ON OF ADDITIONAL INTEREST.
RESERVATION:
Estates of decedents dying on or before December lZ, 1982 -- if any future interest in the estate is transferred
in possess]on or enjoyment to Class B (collateral) boner]:Jar]es of the decedent after the expiration of any estate for
1ifa or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laNfut Class B (collateral) rate on any such future ]nterest.
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Sect/on ZlqO of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (71 P.S.
Sect]on 91qO).
Detach the top portion of this Notice and suba]t with your payment to the Register of H]Ils pr]nted on tho reverse side.
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, which Has not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Hills, any of the 15 Revenue District Offices, or by calling the special Iq-hour
ansNor]ng service for forms ordering: 1-800-561-Z050; services for taxpayers Nith special hearing and / or
speaking needs: 1-800-~7-5010 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disalloNance of deductions, or assessment
of tax (including discount or interest) as shown on this Not]ce must object within 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
--election to have the matter determined at 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 Rev]em Unit, Dept. 180601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid Nithin three (~) calendar months after the dacedent's death, a five percent (51) discount of
the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, tho 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 not]ce.
Interest is charged bag]nn]ng N]th first day of del]nquancy, or nine (9) months and one (l) day free the date of
death, to the date of payment. Taxes Nh]ch became delinquent before January 1, 1982 bear interest at the rate of
six (61) percent par annum calculated at e daily rate of .00016q. All taxes which became delinquent on and 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 1981 through ZOOq are:
Interest Daily Interest Da]ly Interest Daily
Year Rate Factor Year Rate Factor Year Rata Factor
['~ 20X .0005~8 1988-1991 111 .000301 ZOO1 91 .O00Zq7
198S I6Z .000~38 1992 91 .0002~7 ZOOZ 61 .O0016q
198~ llZ .000301 199S-199~ 7Z .000192 2003 5Z .000137
1985 131 .000356 1995-1998 91 .0002~7 200~ qZ .000110
1986 101 .00027~ 1999 71 .O0019Z
1987 101 .00027~ ZOO0 7Z .000191
--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 (15) days
beyond the date of the assessment. If payment ]s made after the interest computation date sheen on the
Notice, additional interest must be calculated.