HomeMy WebLinkAbout02-0204 OHHON#EALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 171Z8-0601
REV-15,~S EX AFP
ZNFORNATZON NOTICE
AND
TAXPAYER RESPONSE
CONNIE L~J4OZZNGO
178~JUNPER.L~D.
NEW~rqR~ CO P~17240
FZLE NO. 21' 02-
ACN 0Z105150
DATE
EST. OF PAULINE B SPECK
S.S. NO. 205-10-7154
DATE OF DEATH 1Z-05-Z001
COUNTY CUNBERLAND
REHTT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17015
TYPE OF ACCOUNT
[] CHECK/NG
[] TRUST
[] CERT/F
ALLFZRST FINANCIAL SE~/CE ::: has provlded the Department elth the information listed beloa ahich has been used in
calculating th~:pO~entiel tax due. The~~ records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. ~ ~b feeZ ~)s /nfo~m~on is incorrect, please obtain NrJtten correction from the financial institution, attach a copy
to this form a~turn Jtl~ the ~address. This account is taxable Jn accordance Ni~ the Inheritance Tax LaNe o; the Commonwealth
o~ Pennsylvan~ guestJo~ may be~red by cal[~ng (717) 787-85Z7.
COHPLETE PART I BEL~ x x SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Accoun~ No. 8000000ZZ~7~45 Da~a 10-01-1999
Es~abltshed
Accoun~ lialance ZZ, 198.56
Percen~ Taxable X 16. 667
Amoun~ SubSac~ ~o Tax ~, 699.83
Tax Ra~e X .15
Po~en~ial Tax Due 554.97
To insure proper credit to your account, tho
(Z) copies of this notice must accompany your
payment to the Reglstar of Nllls. Hake check
payable to: "Register of Hills, Agent".
NOTE: If tax payments are made within three
(3) months of the dacedant's data of death,
you may 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
A. J--] The above information and tax due is correct.
1. You may choose to remit payment to the Register of #ills with fao 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 ~ Nills and an official assessment .ill be issued by the PA Department of Revenue.
BLOCK ~ B. [] The above asset has been or will be reported and tax paid eith the Pennsylvania Znheritance Tax return
ONLY to be fJled by the decedent's representative.
C. ~ The above information [s ~ncDrrect ~d/or debts and deductions ~ere pa[d by
you.
You must complete PART ~ and/or PART ~ below.
If yOU indlca~e a dlfferen~ax ra~e, please s~a~e your
rela~ionshlp ~o decedent: ~ ~ ~
RETURN - COHPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS
PART
TAX
LINE
1. Da~e Es*ebltshed I I~ ~
2. Accoun~ Balance 2 ~.~ } C~ ~.~
$. Percen4: Taxable :5 }{ /./. ~ 7
~. Amoun~ SubSec~ ~o Tax ~ ~ ~, ~
· . Debts and Deductions 5 -
6. Amoun~ Taxable 6 '~ .~
7. Tax Ra~e 7 X ~ ,~
PART
DATE PAID
DEI~TS AND DEDUCTIONS CLAZHED
PAYEE DESCRIPTION AHOUNT PAID
TOTAL (Enter on Line 5 of Tax Compumat/on) $
Under penalties of perjury, T decZare ~ha~ ~ha facts I have reported above are ~rue) correct and
~P~~. and b.llef. HONE
WORK (
'DATE
T~XPAYER SIGNATURE ~ x TELEPHONE NUH)ER
GENERAL ZNFORHATZON
1. FAILURE TO RESPOND #ILL RESULT ZN AN OFFICIAL TAX ASSESSNENT with 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 was added ss a matter of convenience.
4. Accounts (including those hold between husband and ails) which the decedent put in joint names aithin one year prior to
death are fully taxable as transfers.
5. Accounts established jointly batsmen husband and eife more than one year prior to death are not taxable.
&. Accounts held by a decedent "in trust for" another or others are taxable RJlly.
REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE
1. BLOCK A - If the information and cosputation in the notice are correct and deductions ars not being claimed, place an
in block "A" of Part 1 of the "Taxpayer Response" section. Sign tad copies and submit them with your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Nills.
Z. DLOCK D - 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 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, Dept Z80601, Harrisburg, PA 171Z8-0601 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 Z and
according to the instructions below. Sign two copies and submit them with your check ~or the amount of tax payable to tho Ragistar
of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt
of the return fro. the Register of Hills.
TAX RETURN - PART Z - TAX COHPUTATI'ON
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 1Z/II/BI: Accounts ahich the decedent put in joint names within one (1) year of death are
taxable fully as transfers. Hoaaver, there is an exclusion not to exceed $3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a 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.
2. 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 folloas:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT OHNERS SURVIVING JOINT OHNERS
Example: A joint asset registered in the name of the decedent end two ether parsons.
I DIVIDED KY 3 (JOINT OHNERS) DIVIDED KY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created eithin one year of the decedent's death or accounts owned by the decedent but held
in trust far another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE
OHNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons end established within one year of death by
the decedent.
I DIVIDED KY Z (SURVIVORS) = .SO X 100 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line S) from the asount subject to tax (line
7. Enter the appropriate tax rate (line 7) as determined bales.
Date of Death I Spouse Lineal I Sibling Collateral
07/01/9~ ~o 12/$1/9~
01/01/95 ~o 06/30/00 OX 6X
07/01/00 ~o proson~ OX 4.$Xn 12Z
aThe tax rate imposed on th~ 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 e stepparent of the child is OZ.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children and step children.."Lineal descendents" includes all children of the
natural parents end their descendents, whether or net they have been adopted by others, adopted descendents and their descendants
end step-descendents. "Siblings" ere defined as individuals mhd have et least one parent in common with the decedent, whether by blood
or adoption. The 'Collateral" class of heirs includes ell other beneficiaries.
CLATNE]) DE])UCTTONS - PART 3 - ])EBTS AN]) ])E])UCTTONS CLAZHE])
Allocable debts end deductions are 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 claimed must be itemized fully in Part 5. If additional space is needed, usa plain paper 8 l/Z" x 11". Proof of
payment nay be requested by the PA Department of Revenue.
ORRONHEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ZB0601
HARRISBURG, PA 17128-0601
~oo)
REV-ZS4S EX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FZLE NO. 21-OZ' ~{~
ACN 02105149
DATE 01-50-2002
CONNIE: L~I~OZI NGO'
178 JUMPER R~D
NEWBURG
PA.17Z40
TYPE OF ACCOUNT
EST. OF PAULINE B SPECK O SAVINGS
S.S. NO. 205-10-7154 D CHECKINO
DATE OF DEATH 12-05-2001 D TRUST
COUNTY CUMBERLAND []CERTZF.
REHZT PAYHENT AND FORHS TO:
REGISTER OF NZLLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
ALLFZRST FZ~NC~AL SERa'ICE /~_~ has provided the Department .ith ~8 in~o~ation listed b.lo..hich has boon used in
calculating ~m potential tax ~e."~ records indicate that at ~e death of the a~ve decedent, you were a joint owner/beneficiary of
~is account. If yOU feel this information is incorrect, please ob~in written correct[on from the financial insti~tion, attach a copy
to this ~orm and return Jt to ~; above address. This account is ~xable Jn accordance ~[th the [nherJtance Tax La~s of the Co~mon~ealth
c~ P~nsylvania. Questions may bm ans.ered by calling (717) 787-8S17.
COHPLETE PART I ~ELON - - - SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Account No. 87008140988847 Dat. 11-10-1997
Established
Account Balance 10,276.56
Percent Taxable X 16.667
Amount Subject to Tax 1,712.76
Tax Rate X .15
Potential Tax Due 156.91
To insure proper credit to your account, tmo
CZ) copies of this notice must accompany your
payment to the Rogistar of Hills. Hake check
payable to: "Register of Hills, Agent".
ROTE: if tax payments ars made within three
(3) months of the decedent's date of death,
you may deduct a 51 discount of tho tax due.
Any inheritance tax duo will become delinquent
nine (9) months after tho date of death.
PART TAXPAYER RESPONSE
CHECK ]
ONE
BLOCK
ONLY
A. [-~The above information and tax duo is correct.
1. You may choose to remit payment to tho 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 bo issued by the PA Department of Revenue.
B. ~ The above asset has been or will bo reported and tax paid ~ith tho Pennsylvania [nheritanco Tax return
to be filed by tho decodont's representative.
C. ~7~The above information is incorrect and/or debts and deductions aero paid by
you.
You must complete PART ~-~-Iand/or PART
/
PART Zf you indicate a d~ffarant tax rate, please state your
[~] relat:ionship to decadent: ~]~'~ ~A~-Kt?~-
TAX RETURN - COHPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS
/ 7/~' 7~
· OqF
LINE 1. Data Established
2. Account Balance
$. Percent Taxable $ K
q. Amount Subject to Tax q
$. Debts and Deductions 5 -
6. Amount Taxable 6
7. Tax Rate 7 ~
8. Tax Due 8
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTTON AMOUNT PAID
PART
DATE PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
~XP~ER S~ATURE O 0 TELEPHONE NUM.ER
6ENERAL INFORHATZON
1. FAILURE TO RESPOND NZLL 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 dacadant's date of death.
3. A joint account is taxable even though the decedent's name ems added as a matter of convenience.
4. Accounts (including those held betaean husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife nora than one year prior to death ara not taxable.
6. Accounts held by a decedent "in trust far" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the inforeatlon and computation in tho notice ara correct and deductions are not being claimed, place an
in block "A" of Part I of the "Taxpayer Response" section. Sign two capias and submit them with your check for tho amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment
(Fore REV-Z54B EX) upon receipt of tho return from the Register of Hills.
Z. BLOCK B - [f tho asset specified on this notice has bean or will be reported and tax paid aith the Pennsylvania Inheritance
Tax Return filed by tho 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, Dapt ZB06Ol, Harrisburg) PA 1711B-0601 in tho
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 thaa with your check for tho amount of tax payable to the Register
of #ills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt
of the return from the Register of #ills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date tho account orJginalZy ams established or titled in tho manner existing at data of death.
NOTE: For a decedent dying after II/II/aZ: Accounts which the decedent put in joint names within one (1) year of death ara
taxable fully as transfers. However, there is an exclusion nat to exceed $3,000 per transferee regardless of tho value of
the account or the number of accounts held.
If a double asterisk (Ne) appears before your first name ]n tho address portion of this notice, the $3,000 exclusion
already has bean deducted from the account balance as reported by tho financial institution.
Enter the totaZ balance of the account including interest accrued to the date of death.
The percent of tho account that is taxable for each survivor is determined as follows:
A. Tho percent taxable for joint assets astablisbed more than ama year prior to tho decadent's death:
I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT ONNERS SURVIVING JOINT ONNERS
Example: A joint asset registered in the name cf the decedent and two other persons.
I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 16.7Z (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created within one year of tho decadent's death or accounts oaned by tho decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE
ONNERS 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 lO0 = ROI (TAXABLE FOR EACH SURVIVOR)
Tho amount subject to tax (Line 4) is determined by multiplying the account balance (line Z) by tho percent taxable (line 3).
5. Enter tho tote! of tho debts and deductions listed in Part 3.
6. The amount taxable (Iina 6) is determined by subtracting the debts and deductions (Iine 5) fram the amount subject to tax (line
7. Enter the appropriate tax rate (line 7) as deterainad below.
I Da~e of Death Spouse
07/01/9fi ~o 12/$1/9fi SX 6Z 15Z
01/01/95 ~o 06/$0/00 OX 61
07/01/00 ~o proson~ OZ
;The tax rate imposed on the nat 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 stepparant Df the child is
The linea! class of heirs inc]udas grandparents, parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children end 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" ara defined as individuals who have at Zeast one parent in common with tho decedent, whether by blood
or adoption. The "Collateral" class of hairs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART 5 - DEIITS AND DEDUCTIONS CLAIMED
Allowable debts and deductions ara determined as follows:
A. You legally ara responsible for payment, or the estate subject ta 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 ~urnlsh proof of payment.
C. Debts being claimed must ba itemized fully in Part $. If additional space is needed, usa plain paper 8 1/Z" x 11". Proof of
payment may ba requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD
REV-1162 EX(11-96)
000895
DAVIS HAMILTON C
P O BOX 040
SHIPPENSBURG, PA
17257-0040
f01d
ESTATE INFORMATION: SSN: 203-10-7154
FILE NUMBER: 2102-0204
DECEDENT NAME: SPECK PAULINE B
DATE OF PAYMENT: 02/26/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/03/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02103150 $166.49
TOTAL AMOUNT PAID:
$1 66.49
REMARKS: CONNIE LMOZINGO
SEAL
CHECK#104
INITIALS: JA
&
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD
REV-1162 EX(11-96)
000896
DAVIS HAMILTON C
P O BOX 040
SHIPPENSBURG, PA
17257-0040
........ fold
ESTATE INFORMATION: SSN: 203-10-7154
FILE NUMBER: 2102-0204
DECEDENT NAME: SPECK PAULINE B
DATE OF PAYMENT: 02/26/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/03/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02103149 $77.07
TOTAL AMOUNT PAID:
$77.07
REMARKS: CONNIE L MAZINGO
C/O HAMILTON DAVIS ESQUIRE
SEAL
CHECK# 105
INITIALS: JA
RECEIVED BY'
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
CONNIE
178 JUMPER RD
NEWBURG
'02 APR -5
L MOZINGO
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAXSENENT. ALLORANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 04-08-2002
: ~ ESTATE OF SPECK
DATE OF DEATH 12-05-2001
FILE NUMBER 21 02-0204
COUNTY CUMBERLAND
SSN/DC 205-10-7154
ACN 02105149
Amount Remitted
PAULINE B
I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THXS LINE ~ RETAXN LOWER PORTION FOR YOUR RECORDS ~
REV-lB48 EX RFP C01-02}
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-08-2002
ESTATE OF SPECK
PAULINE B DATE OF DEATH 12-05-2001 COUNTY CUMBERLAND
FILE NO. 21 02-0204 S.S/D.C. NO. 205-10-7154 ACN
TAX RETURN NAS: CX) ACCEPTED AS FILED C ) CHANGED
02105149
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE ACCOUNT NO. 87008140988847
TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING C ) TRUST C ~ TIME CERTIFICATE
DATE ESTABLISHED 11-10-1997
Account Balance 10,276.56
Percent Taxable X O.l&6
Amount Subject to Tax 1,712.76
Debts and Deductions .00
Taxable Amount 1,712.76
Tax Rate
Tax Due 77.07
TAX CREDTTS:
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 C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
02-26-2002 CDOOO89& 5.85 77.07
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT** C CA}, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. }
80.92
5.85CR
.00
5.85CR
PURPOSE OF
NOTICE=
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 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.
-- Hake check or money order payable to: REGISTER OF WILLS, AGEHT.
REFUND CCR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIOHS=
DISCOUNT=
PENALTY=
INTEREST=
A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office of
the Register of Wills, any of the 23 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=
1-800-447-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as sho~n 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. 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 the Orphans' Court
Factual errors d/scovered 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 (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 (5~)
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 da~ 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 (9) months and one (1) day
from the date of death, to the date of payment. Taxes which became delinquent before Januam~ 1, 1982
bear interest at the rate of six (6~) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after Januam~ 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 1982 through 2002 are:
Year Interest Rate Daily Interest Factor
1982 20Y, 000548
1983 16Y. 000438
1984 11Y. 000301
1985 13Y, 000356
1986 IOY. 000274
1987 9Y~ 000247
1988-1991 11Y. 000301
--Interest Js calculated as follows:
INTEREST = BALANCE OF TAX UNPATD
Year Interest Rate Daily Interest Factor
1992 9~ .000247
1993-1994 7~ .000192
1995-1998 9~ .000247
1999 7~ .000192
2000 8~ .000219
2001 9~ .000247
2002 6~ .000164
X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after tho 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, additionaZ interest must be calculated.
/
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
'O2
CONNIE L MOZINGO
178 JUMPER RD
NEWBURG PA
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOT/CE OF TNHER/TANCE TAX
APPRAXSEIIENT. ALLOHANCE OR DXSALLOHANCE
OF' DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOTHTL¥ HELD OR TRUST ASSETS
- DATE 04-08-2002
ESTATE OF SPECK
DATE OF DEATH 12-05-2001
FILE NUMBER
At K -5 /'~i .L;u COUNTY
SSN/DC
ACN
21 02-0204
CUMBERLAND
205-10-7154
02105150
Amount Remitted
REV-IS46 EX AFP (01-02)
PAULINE B
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE
RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1548 EX AFP COX-02)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-08-2002
ESTATE OF SPECK
PAULINE B DATE OF DEATH 12-05-2001 COUNTY CUMBERLAND
FILE NO. 21 02-0204 S.S/D.C. NO. 205-10-7154 ACN
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
02105150
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION= ALLFIRST FINANCIAL SERVICE ACCOUNT NO. 80000002257545
TYPE OF ACCOUNT= ( ) SAVINGS ( ) CHECKING ( ) TRUST ¢~ TIME CERTIFICATE
DATE ESTABLISHED 10-01-1999
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
22,198.56
0.I66
3,699.85
o00
5,699.83
166.49
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 C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
02-26-2002 CD000895 8.52 166.49
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A *'CREDIT" C CA}, YOU HAY RE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. }
174.81
8.52CR
.00
8.52CR
PURPOSE OF
NOTICE=
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
PAYMENT=
REFUND (CR)=
OBJECTIONS=
ADNIN-
IST~TIVE
CORRECTIONS=
DISCOUNT=
PENALTY=
INTEREST=
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 WILLS, AGENT.
A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Office of
the Register of Wills, any of the 25 Revenue D/strict Offices or by calling the special 24-hour answering service
for forms ordering= 1-800-562-2050; services for taxpayers with special hearing and or speaking needs=
1-800-447-5020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as sho~n 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, Depto 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 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, DEPTo 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (SI)
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 pariod. 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 (6X) 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 from
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2002 are:
Year Interest Rate Daily Interest Factor Year Interest Rate
1982 20Y. .000548 1992
1985 1R .000458 1995-1994
1984 llY. .000301 1995-1998
1985 15Y. .000556 1999 7Y.
1986 10Y. .000274 2000
1987 9~ · 000247 2001
1988-1991 llY. .000501 2002
--Interest is calculated as follows.'
INTEREST = BALANCE OF TAX UNPAID
Daily Interest Factor
.000247
.000192
.000247
.000192
.000219
.000247
.00016~
X NUNBER OF DAYS DELINQUENT X DAILY INTEREST 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 shown on the
Notice, additional interest must be calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-1U1 EX AFP 112-04)
CONNIE L MOZINGO
178 JUMPER RD
NE~RG PA 17240
("')
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-07-2005
SPECK
12-03-2001
21 02-0204
CUMBERLAND
02103149
PAULINE
B
Allount Rellitted
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
,:NO"Te: T~.::~nsure eE~!,r credit to your account. subllit the upper portion of this forll with your tax paYllent,
cui ALONG iJ}iIS L:@~ ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
illY :1'&.".,.ft".i'''..rB1.:cfJ'...........'"fARWlmer..,Ar.~nytAm.b'1!'.~~1:tmNY....................... ...
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
ESTATE OF SPECK PAULINE B FILE NO.21 02-0204 ACN 02103149 DATE 02-07-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-01-2002
PRINCIPAL TAX DUE:,
77 .07
PAYMENTS (TAX CREDITS):
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-26-2002 CDOO0896 3.85 77 .07
01-24-2005 REFUND .00 3.85-
TOTAL TAX CREDIT 77 .07
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
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).
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BDX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-1U1 EX AFP 112-04)
CONN~ L MOZINGO
178 OUMPER RD-
NEWBUQG PA 17240
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-07-2005
SPECK
12-03-2001
21 02-0204
CUMBERLAND
02103150
PAULINE
B
Allount Rellitted
._ ._.~ i
. r" gs ~,=~
NOTE: To~t~sure pro~~ credit to your account.
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
IllY:1".".,.lr.i'rr.rB1.:cfJ,............fARWlmer..,Ar.~tlYI!Am.b'1!'.~~1:o0FH....................... ...
ESTATE OF SPECK PAULINE B FILE NO.21 02-0204 ACN 02103150 DATE 02-07-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-01-2002
PRINCIPAL TAX DUE:,
166.49
PAYMENTS (TAX CREDITS):
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-26-2002 CDOO0895 8.32 166.49
01-24-2005 REFUND .00 8.32-
TOTAL TAX CREDIT 166.49
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
iii
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).
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )