HomeMy WebLinkAbout03-0164PETITION FOR PROBATE and GRANT OF LETTERS
also known as
· D~ceased.
Social Security No. ~.t¢2~a '\C~ _C~.~_
To:
Register of Wills for the
County of
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut t~ {~
in the last will of the above decedent, da~ed
and codicil(s) dated ~ ~. Q \~i ~
in the
named
,19.__
at
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C'¢ ~-v~ ~)~.~r0~ ounty, Pennsylvania, with
last family or principal reside~ at
(list street, number and muncipality)
Decendent, then E O years of age, died ~ ~ ~
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal property in Pennsylvania $ ',~
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters.
theron.
request(s) the probate of the last will and codicil(s)
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF (x ~ .c~ ~._F\C~. ~ C~,.~ f
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will w~y admin~r t~ estate according to law.
Sworn to or affirmed and subscribed~~ ~-~ ~
before me this 24th day of [ ~'
~ FFRRIIARY 7003 ~. 19 ~ ~
~. ~. ~% O kegister ~
Estate Of RORERT W !RV!N , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW FEBRUARY 25; 2003 19 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 1 ?-1-lqqo
described therein be admitted to probate and filed of record as the last will of
ROBERT W IRVIN ;
and Letters TESTAMENTARY
are hereby granted to ROBERT C IRVIN
FEES
Probate, Letters, Etc .......... $ 1 fl. O0
Short Certificates( ) .......... $
>~i~i~neX tr.a .pag~.s .... $ ~. ac)
jcp $ !0.00
TOTAL ~ $ 37. O0
Filed ......2..- .2.5.-. ~ 00.3 ...................
mailed to exec 2-25-2003
ATTORNEY (Sup. Ct. I.D. No.)
ADDI~SS
PHONE
COMMONWEALTH OF PENNSYLVANIA )
) ss
COUNTY OF CUMBERLAND )
I, Robert W. Irvin
,TESTATOR, whose name is
signed to the attached or foregoing instrument, having been
duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my LAST WILL; that I
signed it willingly; and that I signed it as my free and
voluntary act for the purpose therein expressed.
Sworn or affirmed to and acknowledged before me,
by Robert W. Irvin , the TESTA'FOR, [his /~Lday
of December , 19 90
{ ~N ~, GL~R, ~ary ~HC chan icsburg, PA
I _ .~~,~y My Commission Expi es
thy c~ss~ Expires ~an. 3, t r :
The preceding instrument consisting of this and two (2)
other typewritten pages, identified by the signature of the
TESTATOR, was on the date thereof signed, published] and
declared by Robert W. Irvin , the WESTATOR therein named
as and for his LAST WILL AND TESTAMENT.
~,~ ~MES M. ~CH Residin~ at 352 S. Sporting Hill Road
_~ MeChanicsburg, -PA 17055
BARBARA A. GLESSNER
Residing at 352 S. S~octing Hill Road
Mechanicsburg, PA 17055
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND ) ss
)
We JAMES M. BACH and BARBARA A. GL[SSNER, the
witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw TESTATOR sign and execute the
instrument as his LAST WILL; that he signed willingly and that he
executed it as his free and voluntary act for the purpose therein
expressed; that each of us in the hearing and sight of the TESTATOR
signed the WILL as witnesses; and that to the best of ou~- know]edge
the TESTATOR was a~ t. be t~me 18 o~ more yea~:s o~[ age, of soun<~ mind
and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by
JAMES M. BACH and BARBARA A. GLESSNER, witnesses, this
/~Ft~day of December , 1990.
Mechanicsburg, PA
My Commission Expires:
I" NOTARIAL SEAL I
COt. EEN #. GLESSN{R, Notary Public I
Cumber1 and Coufl f.y {
ITEM 5. I hereby nominate and appoint ROBERT C. IRVIN, as
Executor of this my Last Will and should the Executor named fail to
qualify or cease to act as Executor, then I appoint BARBARA M. ADAMS,
as Executrix in his stead.
ITEM 6. I direct that my personal representatives, as well as
their successors, shall not be required to give bond for the faithful
performance of their duties in any jurisdiction.
ITEM 7. I direct that all estate, succession, legacy,
inheritance or other transfer taxes, however designated that shall
become payable by reason of my death in respect of all property
comprising my gross estate for tax purposes, whether or not such
property passesunder this Last Will, shall be paid by my Executor out
of my residuary estate.
ITEM 8. I grant to my personal representatives herein named,
in addition to, but not in limitation of those powers vested by law,
to be exercised without prior application to or approval of any
court, the power and authority to retain indefinitely any property,
to invest and reinvest any assets or the proceeds derived from the
sale of assets, although said investments may not be of the character
prescribed by law, to sell, convey, assign, transfer and encumber any
property, to pay, settle or compromise all claims, to make
distribution or divisions in cash or in kind, and in general to
exercise all powers in the management of any property hereunder which
any individual could exercise in the management of similar property
owned in his own right, and to execute and deliver any and all
instruments and to do all acts which may be deemed necessary and
proper.
ROBERT W. IRVIN
LAST WILL
AND
TESTAMENT
OF
ROBERT W. IRVIN
JAHES M. B~CH
ATTORNEY AND COUNSELOr AT LAW
352 SOUTH SPORTING HILL ROAD
MECHANICSBURG, PENNA. 17055
Tr~iJJ'HON~' (717) 737.2033
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 002250
IRVIN ROBERT C
15 FARMLAND ROAD
LEOLA, PA 17540
fold
ESTATE INFORMATION: SSN: 166-18-8801
FILE NUMBER: 2103-01 64
DECEDENT NAME: IRVlN ROBERT W
DATE OF PAYMENT: 03/04/2003
POSTMARK DATE: 03/03/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $54.59
REMARKS:
ROBERT C IRVIN
TOTAL AMOUNT PAID'
$54.59
SEAL
CHECK//5055
INITIALS' CW
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
~ COMMONWEALTH OF
~ PENNSYLVANIA
.e,,~~~ DEPARTMENT OF REVENUE
~('"~',~-~1,~,,~'~ '~ DEPT. 280601
'4~,~;~'~¢,'~ HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
USE ONLY
FILE NUMBER
COUNTY CODE YEAR NUMBER
Z
W
u.I
C)
u.I
141
H-
Z
UJ
Z
o
u~
UJ
o
DECEDENT'S NAME (LAS..~ FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (MM-DB-YEAR) DATE OF BIRTH (MM-DB-YEAR)
OB-O'--t - f?z..I
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1. Original Return
4, Limited Estate
E~6. Decedent Died Testate (Attach copy of Will)
F--"~ 9. Litigation Proceeds Received
[~2. Supplemental Return
[~4a. Future Interest Compromise (date of death after 12-12-82)
~'~7. Decedent Maintained a Living Trust (Attach copy of Trust)
] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
J-~3, Remainder Return (date of death prior to 12-13-82)
[~5. Federal Estate Tax Return Required
8, Total Number of Safe Deposit Boxes
E~11. Election to tax under Sec. 9113(A) (Attach Sch O)
FIRM NAME (IfApplicable)
TELEPHONE NU MBE~R
COMPLETE MAILING ADDRESS
14.
1. Real Estate (Schedule A) (1) (~7
2. Stocks and Bonds (Schedule B) (2) ~ ~ ? ~. ' ~ 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ~
4. Mortgages & Notes Receivable (Schedule D) (4) O
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) ('~
(Schedule E)
6. Jointly Owned Property(Schedule F) (6) ~
E~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9) ~'-I ~"'(~ ' 6 O0
10, Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10) (11)
12. Net Value of Estate (Line 8 minus Line 11) (12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(03?2,.00
15.
16.
17.
18.
19.
20.
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15)
Amount of Line 14 taxable at lineal rate \ ~- \ ~ ~ ~ ~ /
" x .0 (16)
Amount of Line 14 taxable at sibling rate
x ,12 (17)
Amount of Line 14 taxable at collateral rate
x .15 (18)
Tax Due (19)
's-ct
Decedent's Complete Address:
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A, Spousal Poverty Credit
B. Prior Payments
C. Discount
ZIP
(1)
Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits ( A + B + C ) (2)
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. (EA)
B. Enter the total of Line 5 + EA. This is the BALANCE DUE. (ER)
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? ...................................................................... []
2. 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, I 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 pr~arer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN/~'~RL=[O¥ PF__~SON RESPONS~E FOR FILING RETURN DATE
ADDRES~ ~ , ~ , ~ ~
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 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 RS. §9116 (a) (1.1)
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
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 paten'
or a stepparent of the child is 0% [72 RS. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 RS. §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 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as a~
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV,;1503 [tX + (1-97) ..,. ~ ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
ITEM
NUMBER
DESCRIPTION
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
& 37c . oo
REV-I~08 EX + (1-97) .~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Include the
ITEM
NUMBER
~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of su~ivorshi ~ must be disclosed on Schedule F.
DESCRIPTION
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUEAT DATE
OF DEATH
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
, .~ FILl NUMBER
~p..~ ~J 9.1~ '~.~-o~-o~(~/--
2 0o'5o o I(oc/
NUMBER
I
1.
II
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
~ ~. _/..--¢..u,~
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
637; .0o
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART I1 - 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)
E~-1511E~X + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A.
1.
FILE NUMBER
5,
6.
7.
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) ~,-~%~_
Social Secudty Number(s~ EIN Number of Personal R,_epresentative(s)
Street Address ~_ ~ ~::~/-~n~-[~¥ ~°b
City L~--'2~, (, ~, State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
State __ Zip
Accountant's Fees
Tax Retum Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
A, o 3(0 , co
tn...oo
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Date of Death:
Will No. ~B-' I (6q Admin. No.
To the Register:
I certify that notice of (beneficial interest) 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 -
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature ~ ~~'~
Name )/~~ ~, ~
Address
Telephone ~ 17 ~ ~,~6 0 ~
Capacity: __ Personal Representative
__Counsel for personal representative
~U
Name of Decedent:
Date of Death:
STATUS REPORT UNDER RULE 6.12
Will No.:
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:
1. State w~ether administration of the estate is
Yes fi~_] No ["-] complete:
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:
bo
Did [h~personal representative file a final account with the Court?
Yes)~ No['-]
The separate Orphans' Court No. (if any) for the personal representative's
account is:
Date:
Co
id the personal e~resentative state an account informally to the parties
ininterest? Yes~ No ['-]
/.\
c. Copies of r~ceil~ts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to th~ () L "~__
S~ature
Name
Address
Telephone No.
Capacity: ]~Personal Representative
[-] Counsel for personal representative
BUREAU OF INDIVIDUAL TAXES
TNHERZTANCE TAX DT¥ZSZON
DEPT. 180601
HARRTSBURG, PA 171Z8-0601
ROBERT C IRVIN
15 FARHLAND RD
LEOLA
PA 175~0
COHHONWEALTH OF PENNSYLVANTA
DEPARTHENT OF REVENUE
NOTTCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSHENT OF TAX
Recorded-
Re9;~'ter :?' V~i~tTATE OF
DATE OF DEATN
FILE NUHBER
'03 APR 28 PC~LI)~y
ACN
C,!erk-;;" ' :: -'-
Ctimbe;~a?
0~-Z1-2003
IRVIN
03-0~-2002
21 03-016~
CUHBERLAND
101
Amoun'~: RemL'l:ted
REV-I~q7 EX AFP ¢D1-05}
ROBERT W
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THZS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-15~7 EX AFP (01-03) NOTICE OF ZNHER/TANCE TAX APPRAZSEHENT~ ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF IRVIN ROBERT WFZLE NO. 21 03-016~ ACN 101 DATE 0~-21-2003
TAX RETURN #AS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~a (Schedule A) (1)
2. S~ocks and Bends (Schedule B) (2)
$. Closely Held S~ock/Par~narship ~n~eras~ (Schedule C) ($)
~. Hot,gages/No*es Receivable (Schedule D) (~)
5. Cash/Bank DaposL~s/HLsc. Personal Propar~y (Schedule E) ($)
6. Jointly O~ned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To~al Asse~s
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expensas/Adm. Cos~s/Hisc. Expenses (Schedule H) (9)
10. Deb~s/Nor~gage Liabilities/Liens (Schedule Z) (10)
11. To,al Deductions
12. Ne~ Value of Tax Ra~urn
15.
1~.
Chari~able/Govarnmen*al Bequests; Non-elected 911S Trus*s (Schedule J)
Na~ Value of Es~a~a Subjac~ ~o Tax
.00
6~372.00
.00
.00
.00
.00
.00
(8)
5,158.68
.00
NOTE: To insure proper
credi* *o your account,
subei~ ~ha upper por~Aon
of ~h/s form ~i~h your
~ax paymin~.
NOTE:
6,371.00
(12) 1,213.32
(15) . O0
(1~) 1,213.32
Z.F an assessment Nas issued previously, lines 1~, 15 and/or 16, 17,
reflect figures that lnclude the total of ALL returns assessed to date.
18 and 19 w111
5~.59
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL ZNTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN. I
TOTAL DUE I
5q.59
.00
.71
.71
( ~F TOTAL DUE ZS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. )
ASSESSHENT OF TAX:
15. Amoun~ of L~na 1~ a~ Spousal re~e
16. Amoun~ of L/ne 1~ ~axable a~ L/neal/Class A ra~e
17. Amoun~ of Line lq a~ Sibling ra~a
18. A.oun~ of Line 1~ ~axabla a~ Collateral/Class B ra~e
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEZPT DISCOUNT (+7
DATE NUHBER ~NTEREST/PEN PAZD (-)
03-03-2003 CDOOZ250 .00
AHOUNT PAID
(15) .00 x O0 = .00
(16) 1,215.32 x OR5 = 5R.59
(17) . O0 x 12 = . O0
(18) .00 x 15 = .00
(19)= 5q.59
RESERVATION:
Estates of decedents dying on or before December 1Z, 1981 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class S (collateral) rate on any such future interest.
PURPOSE OF
NOT/CE:
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (?Z P.S.
Section 91~0).
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
1STRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of Nilis printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS) AOBNT
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-1313). Applications ara avaiIabIe et the Office
of tho Register of Nills, any of the 13 Revenue District Offices, or by calling the special Z~-hour
answering service for forms ordering: l-BO0-361-Z050~ services for taxpayers with special hearing and / or
speaking needs: 1-800-~?-3010 (TT only).
Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) es shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlO21, Harrisburg, PA 17118-1011, 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 Raviaa Unit, Dept. 180601, Harrisburg, PA 17118-0601
Phone (717) 7&7-6505. Sea 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 decedant's death, a five percent (51) discount of
the tax paid is a11oNed.
The ZSZ 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 nan-participation
penalty is appealable in the same manner and in the the same tiaa period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning ~ith 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) 1981 bear interest at the rate of
six [61) percent par annum caZcuZated at a daiIy rate of .00016~. Ali taxes which became deIinquent on and after
January 1, 1981 Hill bear interest at a rate which ~il! vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z003 are:
Interest Daily ]nterest DaiIy Interest DaiIy
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .000548 1987 9Z .0002~7 1999 7X .000192
1983 161 .000~38 1988-1991 llZ .000501 ZOO0 82 .000119
198~ iix .000301 1992 92 .O00Z~7 ZOOl 9Z .O00Z~?
1985 13Z .000356 1993-199q ?Z .000192 ZOOZ 6Z .O0016q
1986 lOZ .OOOZT~ 1995-1998 9Z .O00Z~? 2003 51 .0001~7
--interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPA/D 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. 'rf payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.