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HomeMy WebLinkAbout03-0106COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 17128-0601 REV-1G~iI1 EX AFP INFORMATION NOTZCE AND TAXPAYER RESPONSE FILE NO. ZI-~- ACH O21qg$Tq DATE 11-25-2002 BEVERLY A KEEFER 52 HIGHLAND AVE SHIPPENSBURG PA 15257 TYPE OF ACCOUNT EST. OF RAY E KEEFER []SAVINGS S.S. HO. 171-28-$956 []CHECKING DATE OF DEATH 05-$0-2002 []TRUST COUNTY CUMBERLAND []CERTZF. REMIT PAYMENT AND FORMS TO: REGISTER OF NILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 ALLFTRST FINANCIAL SER has provided the Department with the information listed helen which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you wore 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 tho Inheritance Tax Laws of the Commonwealth or Pannaylv=nia. n~ua=t"-on= aay be ans~arod by c=lling (717) 787-8227. COMPLETE PART ! BELON ~ ~ ~ SEE REVERSE SIDE FOR FZL:~NG AND PAYMENT INSTRUCTIONS Account No. 0025778609 Date 07-27-1993 Established Account Balance 3q9.79 Percent Taxable X 16.667 Amount Sub~ect to Tax 58.30 Tax Rate X .00 Potential Tax Due .00 To insure proper credit to your account, two (Z) copies of this notice oust accompany your payment to the Register of Hills. Make check payable to: "Register of Mills, Agent". NOTE: If tax payments are made ~ithin three (3) months of tho decadent's date of death, you may deduct a 5~ discount of tho tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAX LINE PART TAXPAYER RESPONSE A. ~ The 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 CHECK a discount or avoid interest, or you may check box ~ONE~ Hillsandanofficialassessaent~illbeissu.dbythePADepartlentofR.v.nu.. BLOCK s. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to bo 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 ~belo~. If you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Established 2. Account Balance 2 3. Percent Taxable 3 ~ q. Amount Sub~ect to Tax q 5. 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 Co~utation) Under penalties of perSury, T declare that the facts I have reported above are true, correct and - PAYER ~GNATURE ~ TELEPHONE NUMBER 'gATE GENERAL ZNFORHATION 1. FAILURE TO RESPOND #~LL RESULT ~N AN OFFICIAL TAX ASSESSNENT eith 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 Nas added as a matter of convenience. 4. Accounts (including those held beteaen husband and wife) Nhich the decedent put in joint names Nithin one year prior to death are fully taxable as transfers. S. Accounts established jointly betNean husband and Nifo more than one year prior to death ara not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable Tully. REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE 1. BLOCK A - [f the information and computation in the notice ara correct and deductions are not being claimed, place an "X" in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit thaa with your check for the amount of tax to the Register of Hills of tho county indicated. Tho PA Department of Revenue will issue an official assessment (Fora REV-1S4B EX) upon receipt of the return from the Register of Wills. Z. BLOCK B - If the asset specified on this notice has been or Nil1 be reported and tax paid Nith the Pennsylvania [nharitanca Tax Return filed by the decadant's representative, place an "X" in block "S" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt 280601, 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 Z and 5 according to the instructions below. Sign two copies and submit them Nith your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-lS48 EX) upon receipt o~ the return from the Register of Nills. TAX RETURN - PART Z - TAX COHPUTATION LTNE l. Enter the date the account originally Nas established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/12/BZ: Accounts Nhich the decedent put in joint names NJthin one (1) year of death are taxable fully as transfers. However, 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 (xx) 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. Tho percent of the account that is taxable for each survivor is determined as felloNs: A. The percent taxable for joint assets established more than one year prior to the dacadant's death: 1 DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT O#NERS Example: A joint asset registered in the name of the decedent end two other persons. I DIVIDED BY 3 (JOINT ONNERS) DTVIDED BY Z (SURVTVORS) = .Z67 X ZOO = 16.7X (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).' I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 160 = PERCENT TAXABLE OHNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and tee other persons and established eithin one year of death by the decedent. Z DIVIDED BY Z (SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR] 4. The amount subject to tax (line 4) is determined by multiplying tho account balance (1ina Z) by the percent taxable (1ina 3). 5. Enter the total of the debts and deductions listed in Part 5. 6. The amount taxable (1ina 63 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) as determined baloe. I Da~e of Death Spouse ; Lineal ; Sibling CoIia~eral I 07/01/9q. '~o 12/31/9~. 3Z 6X 15Z 1.qZ 01/01/9.~ ~o 06/30/00 07/01/00 ~o presen~ OX ;The tax rate imposed on th; ; younger at death to er for the usa of a nature! parent, an adoptive parent, or a stapparant of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children Nhether 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, Nhethar or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" ara defined as individuals Nho have at least one parent in common eith the decedent, Nhother by blood or adoption. The "Collateral" class of heirs includes al1 other beneficiaries. CLAIHED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIHED Allocable debts and deductions ara determined as folloNs: A. You legally ara responsible for payment, er 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. Oebts being claimed must be itemized fully in Part 3. if additional space is needed, usa plaln paper 8 1/2" x 1Z". Proof of payment may be requested by the PA Department of Revenue. CONHONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ZNDZVZDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-16q$ EX AFP C09-DO) RAY E KEEFER JR :52 HIGHLAND AVE SHZPPENSBURG PA 17257 ZNFORMATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 -<:::~- ACN 02149:575 DATE 11-25-2002 TYPE OF ACCOUNT EST. OF RAY E KEEFER [] SAV/NOS S.S. NO. 171-28-:59:56 [] CHECK/NO DATE OF DEATH 0:5-:50-2002 [] TRUST r ~ ,.C, OUNTY CUMBERLAND [] CERTTF. REHTT PAYHENT AND FORflS TO: REGISTER OF ~/ILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 ALLFZRST FZNANCZAL SER 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 decadent, you were a joint owner/beneficiary of this account. If you feel this information Js 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 Laos of the Commonwealth COMPLETE PART I BELO# ~ ~ # SEE REVERSE SXDE FOR FXLING AND PAYMENT XNSTRUCTIONS Account No. 0025778609 Da4:e 07-27-199:5 Es4:ablished Accoun4: Balance :549.79 Percen4: Taxable X 16.667 Amoun4: Subjac4: 4:o Tax 58 .:50 Tax Ra4:e X .045 Po4:en4:iel Tax Due 2.62 To insure proper credit to your account, two (Z) capias of this notice lUSt accompany your payment to the Register cf gills. Hake check payable to: "Register of gills, Agent". NOTE: If tax payments ara made aithin three (3) months of the decedant's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will bacoaa delinquent nine (9) months after the date of death. PART~ TAXPAYER RESPONSE ..................................... :,:,:,:,:,: ............................. :,:,:: ..................... !~;=::~,~,~,~,~m;;~;;~!;;~;m!~!;!~!m!;!;;;;;;~a;;;;;;;;~! ~i~i~!~i~i~i~i~i~i;~;;;~;;;;;;~i~i~i~i~i~i~!~ifi~i~i~i[i~i~i~i~i~i~i~i~i~L;i~ !~ :!;!:!:!:!:!~!~!~!';===ii A. [~j~ The above information and tax due is correct. 1. You way choose to remit payment to the Register of Hills with two copies Df this notice to obtain CHECK a discount or avoid interest, or you way check box "A" and return this notice to the Register of  ONE ~ Hills and an official assessment will be issued by the PA Department of Revenue. BLOCK J B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the dacadent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by ~tou. You must complete PART [] and/or PART [] below. PART Tf you indica4:e · differen4: 4:ex ra4:e] please s4:e4:e your [] rela4:ionship 4:0 deceden4:: TAX RETURN - CONPUTAT_~ON OF TAX ON dO_~NT/TRUST ACCOUNTS LINE 1. Da4:e Es4:ablished I 2. Accoun4: Balance 2 $. Percen4: Taxable $ X ~. Aaoun4: Subjec4:4:0 Tax ~ S. Deb4:s and Deduc4:ions $ - 6. Amoun4: Taxable 6 7. Tax Ra4:e 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAZMEn PAYEE DESCRIPTION AMOUNT PAID TOTAL (En4:er on Line $ of Tax Coepu4:e4:ion) Under penel4:ies of perjury, Z decZmr~j~[~m~4:he fac4:s T have repor4:ed above are 4:rue, correc4: ~nd ~ ATURE I ~ ~ TELEPHONE NUMBER ~ GENERAL INFORHATZON 1. FAILURE TO RESPOND NILL RESULT IN AN OFFICIAL TAX ASSESSHENT Nith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dacedent's date of death. $. A joint account is taxable even though the decedent's name Nas added as a matter of convenience. 4. Accounts (including those held betNesn husband and Nifs) Nhich the decedent put in joint names Nithin one year prior to death are fulIy taxabIe as transfers. S. Accounts established jointly betNaen husband and Nifo aero than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE I. BLOCK A - If the information and computation in the notice are correct end deductions are nat being claimed, piece an in bIock "A" of Part i of the "Taxpayer Response" section. Sign tNo copies and submit them with your check for the amount of tax to the Register of Niils of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1S48 EX) upon receipt of the return from the Register cf Nills. Z. BLOCK B - If the asset specified on this notice has been ar Nil1 bo reported and tax paid aith the Pennsylvania Inheritance Tax Return filed by tho 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 Individua! Taxes, Oept ZOO601, Harrisburg, PA 17lIB-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 3 according to the instructions beloN. Sign tNo copies and submit them Nith your check for the amount of tax payabIe to the Register of NiLls of the county indicated. The PA Department of Revenue Nil! issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART Z TAX COHPUTATION LINE 1. Enter the date the account originally Nas established or titled in the manner existing st data of death, NOTE= For a decedent dying after 1Z/1Z/8Z= Accounts Nhich the decedent put in joint names Nithin one (1) year of death ere taxable fully as transfers. HaNover; there is an exclusion nat to exceed $3,000 per transferee regardless of the value of the account or tho number of accounts held. If a double asterisk (aN) appears before your first name in the address portion of this notice, the S3,000 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. The percent of the account that is taxable for each survivor is determined as foIloNs: A. Tho percent taxable for joint assets established more than one year prior to the dacedent'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 of the decedent and tNo other persons. 1 DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 16.77. (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created Nithin one year of the decedent's death or accounts owned by the decedent but held in trust for another individuaI(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES ExampZa: Joint account registered in the name of tho decedent and two other persons and established Nithin one year of death by the decedent. I DIVIOEI1 BY Z (SURVIVORS) = .SO X 100 = 50X (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line 2) by tho percent taxable (line 3). S. Enter the total of the debts end deductions listed in Part ~. 6. The amount taxable (tine 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (tine 7. Enter the appropriate tax rate (line 7) as determined beloN. Date of Death ~ Spouse Lineal t Sibling Collateral 07/01/9~J to 12/51/94 01/01/96 to 06/30/00 OX 6Z 07/01/00 ~o preson~ OX xThe tax rate imposed on th( nat value ; younger at death to or for the usa of a natural parent, an adoptive arent, or a steppmrant of the child is OZ. The lineal class of heirs includes grandparents, parents, children; and lineal descendents. "Children" includes nature1 children Nhether 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; Nhether or not they have bean adopted by others, adopted descendents and their descendants end step-descendants. "Siblings" ara defined as individuals Nha have at least one parent in common Nith the decadent, Nhathar by blood or adoption. Tho "Collateral" class of hairs includes al1 other beneficiaries. CLAIHED DEDUCT[ONS- PART $ DEBTS AND DEDUCTIONS CLAIHED Allowable debts and deductions ara determined as follaNs: 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 tho debts after death of tho decedent and can ~urnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, usa plain paper S l/Z" x 11". Proof of payment Bay be 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. REV-1162 EX(11-96) CD 002134 KEEFER RAY E JR 32 HIGHLAND AVE SHIPPENSBU}~G, PA 17257 ........ fold ESTATE INFORMATION: SSN: 1 71-28-3936 FILE NUMBER: 2103-0106 DECEDENT NAME: KEEFER RAY E DATE OF PAYMENT: 02/05/2003 POSTMARK DATE: 02/04/2003 COUNTY: CUM BERLAN D DATE OF DEATH: 03/30/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2.62 REMARKS: RAY E KEEFER JR TOTAL AMOUNT PAID' $2.62 SEAL CHECK# 248 INITIALS: AC RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 RAY E KEEFER JR 52 HIGHLAND AVE SHIPPENSBURG PA 17257 COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTXCE OF INHERITANCE TAX APPRAXSEHENT. ALLOHANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 04-07-2005 ESTATE OF KEEFER DATE OF DEATH 05-50-2002 FXLE NUHBER 21 05-0106 COUNTY CUMBERLAND SSN/DC " 171:28-5956 ACN 02149575 RAY E Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THXS LXNE ~ RETAIN LOWER PORTXON FOR YOUR RECORDS REV-1548 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 04-07-2005 ESTATE OF KEEFER RAY E DATE OF DEATH 05-50-2002 COUNTY CUHBERLAND FILE NO. 21 05-0106 S.S/D.C. NO. 171-28-5956 ACH TAX RETURN NAS= (X) ACCEPTED AS FILED ( ) CHANGED 02149575 JOXNT OR TRUST ASSET XNFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SER ACCOUNT NO. 0025778609 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ¢ } TRUST ( ) TIHE CERTIFICATE DATE ESTABLISHED 07-27-1995 Account Balance 549.79 Percent Taxable X 0.166 Amount Subject to Tax 58.50 Debts and Deductions .00 Taxable Amount 58.50 Tax Rate Tax Due 2.62 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 (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-04-2005 CD002154 .00 2.62 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULAT]:ON OF ADDITIONAL INTEREST. ~ ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE S[DE OF THIS FORM FOR INSTRUCTIONS. ) 2.62 .00 .01 .01 PURPOSE OF NOTICE= PAYMENT= REFUND CCR)= OBJECTZONS= ADMIN- ISTRATIVE CORRECTIONS= DISCOUNT: PENALTY: INTEREST= To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. ¢72 P.S. Section 9140). Detach the top port/on of this Notice and submit with your payment to the Register of Mills 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" (REV-ISIS). Applications are available at the Office of the Register of Mills, any of the 25 Revenue District Offices or by calling the special 24-hour answering service for forms order/ne= 1-800-$&2-2050; services for taxpayers with special hearing and or speaking needs= 1-800-447-5020 (TT Any party in interest not satisfied with the appraisement, allowance, or disallowance of deduct/ons or assessment of tax Cincluding discount or interest) as sho~n on this Notice may object within sixty C&O) days of receipt of this Notice by= --written pretest 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 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-&505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" CREV-1S01) for an explanation of administratively correctable errors. If any tax due is paid w/thin three (5) calendar months after the decedent's death, a f/ye percent discount of the tax paid is allowed. The 15~ 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-part/c/patton 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 beg/nning with first day of delinquencY, or nine (9) months and one C1) 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 (&X) 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 /nterest rates for 1982 through 2005 are= Interest Da/ly Interest Da/ly Year Rate Factor Year Rate Factor Year 1982 20~ .000548 1987 9X .000247 1999 1983 l&~ .000458 1988-1991 11~ .000501 2000 1984 11~ .000301 1992 9~ .000247 2001 1985 15~ .000556 1995-1994 7~ .000192 2002 1986 10~ .000274 1995-1998 9~ .000247 2005 --Interest is calculated as follows= TNTEREST = BALANCE OF TAX UNPAXD Interest Daily Rate Factor .000192 .000219 .000247 .O00164 .000157 --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 Not/ce, addit/onal interest must be calculated. X NUNBBR OF DAYS DBLXNQUENT X DALLY INTEREST FACTOR BUREAU OF INDIVIDUAL TAXES ~ INHERITANCE TAX DEPT. 28060! HARRISBURG, PA BEVERLY A KEEFER 52 HIGHLAND AVE SHIPPENSBURG PA 17257 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTXCE OF XNHERXTANCE TAX APPRAXSEKENT. ALLOMANCE OR DXSALLOHANCE OF DEDUCTXONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 04-07-2005 ESTATE OF KEEFER RAY DATE OF DEATH 05-$0-2002 FX~E NUMBER 21 05-0106 COUNTY CUHBERLAND SSN/DC 171-28-5956 ACN 02149574 Amount Remitted 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 C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 04-07-2005 ESTATE OF KEEFER RAY E DATE OF DEATH 05-50-2002 COUNTY CUHBERLAND FILE NO. 21 05-0106 S.S/D.C. NO. 171-28-5956 ACH TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED 02149574 JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SER ACCOUNT NO. 0025778609 TYPE OF ACCOUNT= ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 07-27-1995 Account Balance 549.79 Percent Taxable X 0.166 Amount Subject to Tax 58.50 Debts and Deductions .00 Taxable Amount 58.50 Tax Rate ~ .00 Tax Due .00 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: "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 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE XS LESS THAN #[, 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. .00 .00 ,00 .00 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. -- Make check or money order payable to= REGISTER OF NILLS, AGENT. REFUND OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: 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" CREV-1313). Applications are available at the Office of the Register of Nills, any of the 25 Revenue District 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= 1-800-467-$020 (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 (&0) 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 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 17128-0&01 Phone C717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanat/on of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent 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 January 18, I996, the first day after the end of the tax amnesty period. This non-part/c/pat/on 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 C&X) percent per annum calculated at a daily rate of 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 2003 are: Interest Daily Year Rate Factor Year 1982 20X .000548 ]987 1983 I&X .000458 1988-1991 1984 11X .000301 1992 1985 1SX .000356 1993-1994 198& 10X .000274 1995-1998 --Interest is calculated as follows: INTEREST = BALANCE OF Interest Daily Interest Daily Rate Factor Year Rate Factor 9X .000247 1999 7X .000192 IIX .000301 2000 8X .000219 9X .000247 2001 9X .0002~7 7X .000192 2002 &X .0001&4 9X .000247 2003 5X .000157 TAX UNPATD X NUNBER OF DAYS DBLTNQUENT X DATLY TN/T, RE~T 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 sho~n on the Notice, additional interest must be calculated. q- ? BUREAU OF ZNDZVTDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. 2806D1 HARRTSBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT RE¥-I&07 EX AFP C01-03) RAY E KEEFER JR $Z HIGHLAND AVE SHIPPENSBURG PA 17257 DATE 04-07-200:5 ESTATE OF KEEFER DATE OF DEATH 0:5-:50-Z002 FILE NUMBER 21 0:5-0106 COUNTY CUMBERLAND ACN 02149:575 I lmoun~ Remi~ed RAY E MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 NOTE: To insure proper credit: ~o your account:, submi~ ~he upper por~:Lon of *hls form wi~h your ~ex payment. CUT ALONG THIS LINE ~ RETA'rN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) #~ INHERITANCE TAX STATEMENT OF ACCOUNT ~-~ ESTATE OF KEEFER RAY E FILE NO. 21 0:5-0106 ACN 02149:575 DATE 04-07-200:5 THZS STATEMENT ZS PROVTDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELON ZSA SUNHARY OF THE PRZNC'rPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-07-200:5 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): PAYHENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 02-04-200:5 CD0021:54 .00 2.62 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADD/TZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), AMOUNT PAID 2.62 TOTAL TAX CRED'rT 2.62 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .01 TOTAL DUE .01 YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORH FOR ZNSTRUCTTONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- [f RESIDENT DECEDENT make check or money order payable to: REGISTER OF NZLLS, AGENT. -- If NON-RES[DENT DECEDENT make check or money order payable to: COHMONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office of the Register of #ills, any of the Z3 Revenue District Offices or from the Department's Iq-hour answering service for fores ordering: 1-800-$62-20S01 services for taxpayers with special hearing and / or speaking needs: 1-800-q47-$020 CTT only). REPLY TO: Ouastians regarding errors contained on this notice shouId be addressed to: PA Oapartment of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ge0601, Harrisburgj PA 17128-060I, phone (717) 787-6SOS. DISCOUNT: If any tax due is paid within three (5) calendar months after the dacadent's death, a five percent (52) discount of the tax paid is allowed. PENALTY: The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January IB~ 1996, the first day after the and of the tax amnesty period. INTEREST: 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 (62) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1~ 19aZ will bear interest at a rate which will vary fram calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for I9B2 through 2003 ere: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 202 .000548 i987 92 .000247 2999 72 .000192 1983 162 .000438 1988-1991 ll2 .000301 ZOO0 82 .O00ZZ9 1984 112 .000301 1992 92 .000247 ZOOX 92 .000247 1985 132 .000356 1993-1994 72 .000192 ZOOZ 62 .000164 1986 102 .OOOZ7q 1995-1998 92 .0002q7 2003 52 .000137 --Interest is calculated as follows: INTEREST = BALANCE: OF TAX UNPAID X NUtIBER OF DAYS DEL~INQUENT X DAILY TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will re~lect an interest calculation to fifteen (1S) 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.