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HomeMy WebLinkAbout03-0239COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 180601 HARRISBURg, PA 17128-0601 REV-lS4$ EX AFP cng-o0) ZNFORMATZON NOTZCE AND TAXPAYER RESPONSE ACN 05108780 DATE 05-12-Z005 CHERYL C LOWERY 1248 YORK RD MECHANICSBURG PA 17055 EST. OF WILLIAM B LOWERY S.S. NO. 210-60-2551 DATE OF DEATH 11-11-2002 · .~COUNT¥ CUMBERLAND TYPE OF ACCOUNT [] SAVINGS [] CHECKTNG [] TRUST [] CERTIF. REHTT PAYHENT AND FORHS TO: REGTSTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 HEHBERS 1ST FCU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you ears a joint owner/beneficiary of this account. Zf you faaZ this information is incorrect, pZaasa obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may ba answered by calling (717) 767-85ZT. COMPLETE PART [ BELOW x x # SEE REVERSE SZDE FOR FZLZNG AND PAYMENT ZNSTRUCTZONS Account No. 172784-11 Data 12-26-1997 Established Account Balance 1,479.49 Percent Taxable X 16. 667 Aaoun'~ Subject '1:o Tax 146.59 Tax Rate X .045 Potential Tax Due 11 . 10 To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Nills. Hake check payable to: "Register of Wills, Agent". NOTE: Zf tax payments ara made within three ($) months of the decadent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax dug will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LTNE A. []The above information and tax due is correct. 1. You may choose to remit payment to the Register of Nills eith two capias of this notice to obtain a discount or avoid interest, or you may check box 'A" and return this notice to the Register of Hills and an official assessment will be issued by the PA Department of Revenue. B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. D The above information is incorrect and/or debts and deductions ware paid by you. You must complete PART []and/or PART [ below. If yOU indicate a dlffarant tax rata, please s~ate your rala~ionshlp ~o decadent: RETURN - COMPUTATZON OF TAX ON dOZNT/TRUST ACCOUNTS 1. Data Established I 2. Account Balance 2 $. Percent Taxable $ ~ q. Amount Subject ~o Tax q 5. Debts and Deductions $ - 6. Amount Taxable 6 7. Tax Rata 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L~na 5 of Tax Computation) $ Under panalt/es of perSury, T declare that the facts I have reported above ara true, corrac~ and c~_~lnple~:e to *ha bast of ay knowledge and belief. HONE C~ilq TAXPAYEE S~GNATURE ' TELEPHONE NUHBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT ~N AN OFFiCiAL TAX ASSESSNENT .ith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dacedent's date of death. 3. A joint account ls taxable even though tho decedant's name ems added as a matter of convenience. 4. Accounts (including those held bet, eon husband and wife) which the decedent put in joint names wlthln one year prior to death ara fully taxable as transfers. 5. Accounts established jointly between husband and eifa more 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 I - TAXPAYER RESPONSE 1. BLOCK A - Tf the information and computation in the notice ara correct and deductions are not being claimed, place an in block "A" of Part I of the "Taxpayer Response"' section. Sign tee copies and submit them with your check for the smount of tax to tho Register of Nills of the county indicated. The PA napartmant of Revenue will issue an official assessment (Form REV-1S4B EX] upon receipt of the return from the Register of Hills. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the dacadent's representative, place an "X" in block "B" of Part 1 of tho "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes) Dapt ZBDB01) Harrisburg, PA 171ZB-0601 in the envelope provided. 3. BLOCK C - If tho notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Mills of the county indicated. The PA Department of Revenue mill issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART Z - TAX COMPUTAT]:ON LTNE 1. Enter the date tho account originally ems established or titled in the manner existing at date of death. MOTE: For a decedent dying after 1Z/II/BI: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However) there is an exclusion not to exceed $5,000 par transferee regardless of tho value of the account or tho number of accounts held. Ifa double asterisk (mx) appears before your first name in tho address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter tho total balance of the account including interest accrued to the date of death. 3, Tho percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established mare than one year prior to the dacedant's death: I DIVIDED BY TOTAL NUMBER OF D/VIDEO BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT O#NERS SURVIVING JOINT ONNERS Example: A joint asset registered in the name of the decedent and two other persons. I DTVTDED BY 3 (JOINT OHNERS) DIVIDED BY Z (SURVTVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decedant's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVTDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of tho decedent and two other persons and established within one year of death by tho decedent. I DIVIDED BY Z (SURVIVORS) = .SO X 100 = 50Z (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (Iine 4) is determined by multiplying the account balance (line Z) by tho 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 5) free the amount subject to tax (1ina 4). 7. Enter the appropriate tax rate (line 7) as determined beloe. De~e of Death Spouse Lineal Sibling Collateral 07/01/9q ~o 12/31/9q 3X 6X 01/01/95 ~o 06/30/00 OX 6X 07/01/00 ~o presen~ OX q.EX~ xThe tax rate imposed on thc nat value of ,sfars from a vounger at death to or for the use of e natural parent, an adoptive parent, or a stepparent of the child is OX. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes nature1 children xhether 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 not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent) whether by blood or adoption. The "Collateral" class of hairs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay tho deductible items. B. You actuaLly paid tho debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. Tf additional space is needed, use plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. CONNONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF iNDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171Z8-0601 REV-I~I~5 EX AFP i -i3 ZNFORHATTON NOTICE AND TAXPAYER RESPONSE ACN 05108776 DATE 05-1Z-ZOOS CHERYL C LOWERY 1Zq8 YORK RD MECHANICSBURG PA 17055 TYPE OF ACCOUNT ;.ST. OF WILLIAM B LOWERY [] SAVINGS S.S. NO. 210-60-2551 []CHECKING DEATH 11-11-2002 [] TRUST DATE OF COUNTY CUMBERLAND [] CERTIF. REHZT PAYMENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NENBERS 1ST FCU has provided the Department aith the information listed bale# which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you ware a joint ownar/benaficiaryof this account. If you faa1 this information is incorrect, please obtain written correction from the financial institution, attach a copy to this ~ora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions lay be ensnared by calling (717) 787-8527. COMPLETE PART ! BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 17278q-00 Data 12-26-1997 Established Account Balance 1,855.56 Percent Taxable X 16.667 Amount SubSact to Tax 505.95 Tax Rate X .0~5 Potential Tax Due 15.77 To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Nills. Hake check payable to: "Register of Wills, Agent". NOTE: If tax payments are made within three (3) months of tho decedsnt's data of death, you may deduct a SZ discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LINE 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 a discount or avoid interest, or you may check box "A" and return this notice to the Register of Hills and an official assessment will be issued by the PA Department of Revenue. B. [] The above asset has been ar will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedant's representative. C. []The above information is incorrect and/or debts and deductions ware paid by you. You must complete PART []and/or PART []below. Zf you indicate a different tax rate) please state your reZationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Established 1, 2. Account Balance 2 $. Percent Taxable $ X q. Amount SubSect to Tax q. 5. Debts and Deductions 5 6. Amount Taxable 6, 7. Tax Rate 7 X 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID i ¥OYAL (Enter on Line $ of Tax Computation) $ Under penalties of perSury) T declare that the facts I have reported above ara true) correct and (,~/C?_/mP//~- to the best of my knowledge and belief. HOME ( ~,-~ ) ~:~ ~ -_~ urI £ TAXPAYER 'SIGNATURE TELEPHONE NUHBER " DATE - GENERAL ~NFORHAT~ON 1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFICIAL TAX ASSESSMENT 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 decadant's name was added as a matter of convenience. 4. Accounts (including those held bataaen husband and wife) ahich the decedent put in joint names within one year prior to death are fully taxable as transfers. 5o Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions ara not being claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them aith your check for the amount of tax to the Register of Nills 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 Rills. Z. BLOCK B - Tf the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedant'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 Z80601, Harrisburg, PA 171Z8-0601 in the envelope provided. $. BLOCK C - If the notice information ]s incorrect and/or deductions are being claimed, check block "C" and complete Parts Z and 5 according to the instructions belom. Sign tmo copies and submit them with your check for the amount ef tax payable to the Register of #ills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt of the return from the Register of Mills. TAX RETURN - PART Z - TAX COMPUTATION LINE l. Enter the date the account originally was established or titIed in the manner existing at date of death. NOTE: For a decedent dying after II/II/BI: Accounts which the decedent put in joint names within one (l) year of death are taxable fully as transfers. Hamaver, there is an exclusion not to exceed $$,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 a[raady has been deducted from the account balance as reported by the financial institution. Z. Enter the total be[anco of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedant's death: i DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT ORNERS SURVIVTNO JOINT OliNERS Example: A joint asset registered in the name of the decedent and two other persons. I DIVIDED BY 3 (JOINT ORNERS) DIVIDED BY g (SURVIVORS) = .167 X 100 = 16.7Z (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 O[VIDEO BY TOTAL NUMBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE OMNERS OR TRUST BENEFICIARIES ExampIe: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = SOZ (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3). 5. Enter the tote! of the debts and deductions listed in Part 3. 6. The amount taxable (Zina 6) is determined by subtracting the debts and deductions (Zinc 5) free the amount subject to tax (Zinc 4). 7. Enter the appropriate tax rate (line 7) as determined belom. Da~e of Death Spouse Lineal Sibling Collateral 07/01/9q ~o 12/$1/94 SZ 6X 15Z lEX 01/01/95 ~o 06/30/00 OX 6Z 07/01/00 ~o presen~ OX 4.SX~ 12X lex xThe tax rate imposed on th~ nat value of transfers from a :~ younger at death to or for the usa of a natural parent, an adoptive parent, or a stepparent of the child is OX. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children ehether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all 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 least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLATMED DEDUCTTONS - PART $ OEBTS AND DEDUCTIONS CLATMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x 11". Proof of payment may 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 002313 LOWERY CHERYL C 1248 YORK ROAD MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 210-60-2331 FILE NUMBER: 21 03-0239 DECEDENT NAME: LOWERY WILLIAM B JR DATE OF PAYMENT: 03/1 9/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03108776 $13.77 REMARKS: CHERYL C LOWERY TOTAL AMOUNT PAID: $13.77 SEAL CHECK# 2306 INITIALS: SK RECEIVED BY' DONNA M. OTTO DEPUTY 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) 002314 LOWERY CHERYL C 1248 YORK ROAD MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 210-60-2331 FILE NUMBER: 2103- 0239 DECEDENT NAME: LOWERY WILLIAM B JR DATE OF PAYMENT: 03/19/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03108780 $11.10 REMARKS' CHERYL C LOWERY TOTAL AMOUNT PAID: $11.10 SEAL CHECK# 2307 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS /~-/~- ~ BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVZS/ON DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 CHERYL 1Iq8 YORK RD HECHANICSBURG COMHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERXTANCE TAX APPRAISENBNT, ALLONANCE OR DISALLONANCB OF DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS Recoroed-Office of C LOWERS50.3 APR 28 P3:02 CAnnberiand Co., PA DATE Oq-Z8-ZO03 ESTATE OF LOWERY JR DATE OF DEATH 11-11-2002 FILE NUHBER 21 05-0239 COUNTY CUMBERLAND SSN/DC 210-60-2331 ACN 03108776 Amoun~ RemZ~ed REV-1Sq8 EX AFP WILLIAM HAKE CHECK PAYABLE AND REMIT PAYNENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS "~ REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAXSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE Oq-Z8-ZO03 ESTATE OF LOWERY JR WILLIAM B DATE OF DEATH 11-11-2002 COUNTY CUMBERLAND FILE NO. 21 03-0239 S.S/D.C. NO. 210-60-2331 ACN 03108776 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET XNFORNATZON FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 17278~-00 TYPE OF ACCOUNT: (~ SAVINGS ¢ ) CHECKING ( ) TRUST ¢ ) TIME CERTIFICATE DATE ESTABLISHED 12-Z6-1997 Account Balance 1,835.56 Percent Taxable X 0.166 Amount Subject to Tax 305.93 Debts and Deductions - .00 Taxable Amount 305.93 Tax Rate X .~5 Tax Due 13.77 TAX CREDZTS: 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 03-19-2003 CD002513 .00 13.77 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THTS DATE, SEE REVERSE FOR CALCULATION OF ADDTTIONAL INTEREST. TF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REI~UTRED. IF TOTAL DUE IS REFLECTED AS A 'CREDTT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTTONS. ) 13.77 .00 .00 .00 PURPOSE OF NOT[CE: PAYMENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: ZNTEREST: to fulfill the requirements of Section ZI40 of the Inheritance and Estate Tax Act) Act Z3 of ZOO0. (7Z P.S. Section 91q0). Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side. -- Make check or money order payable to: REGISTER OF NILLS, AGENT. A refund of a tax credit, mhich mas not requested on the tax return, Bay be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of NilIs, any of the 23 Revenue District Offices or by calling the special Iq-hour answering service for forms ordering: 1-BO0-36Z-ZOSO~ services for taxpayers aith special hearing and or speaking needs: 1-800-q~7-30ZO iTT only). Any party in interest not satisfied with the appraisement, alloaancm) or disallomance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals) Dept. Z810Z1, 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) Dureau of Individual Taxes, ATTN: Post Assessment Revlma Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions far Inheritance Tax Return for e Resident Decedent" (REV-IS01) 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 (SZ) discount of the tax paid is a11oaed, The lex tax amnestY nan-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 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 tho same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning eith 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, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q. All taxes ehich became delinquent on or after January 1) 1982 eill bear interest at a rata which will vary from calendar year to calendar year aith that rata announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOO3 are: Interest Daily Xnterest Daily Interest Daily Year Rate Factor Yea__r Rate Factor Year Rate Factor 1982 ZOZ .O00Sfi8 1987 9Z .0002~7 1999 7X .000192 1983 16Z .000q38 1988-1991 11Z .000301 ZOO0 8Z .000Z19 1984 11Z .000301 1992 9Z .O00Zq7 ZOO1 9Z .OOOZq7 1985 13Z .000356 1993-199q 7Z .O0019Z ZOOZ 6Z .00016q 2003 5Z .000137 1986 lOX .O00Z7~ 1995-1998 9Z .OOOZq7 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY 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. Tf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG,, PA 17128-0601 COHNONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DXSALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-X~¢8 EX AFP (OZ-O$) R~c,J ........ - ........ of CHERYL C LOI~-~Y APR 28 P3:02 1Iq8 YORK RD MECHAN I CS B U RGc;ierkPA ,.,1. ? 0,_5 ~. Cc, un C~and Co., PA FILE NUMBER COUNTY SSN/DC ACN DATE 0q-28-2003 ESTATE OF LOWERY JR WILLIAM DATE OF DEATH 11-11-2002 21 03-0239 CUMBERLAND 210-60-2331 03108780 Amoun~ Remi~ed I HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ REV-IS48 EX AFP (01-03) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 0q-28-2003 ESTATE OF LOWERY JR WILLIAM B DATE OF DEATH 11-11-2002 COUNTY CUMBERLAND FILE NO. 21 03-0239 S.S/D.C. NO. 210-60-2331 ACN 03108780 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: HEMBERS 1ST FCU ACCOUNT NO. 17278~-11 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-26-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and DeductAons Taxable Amount Tax Rate Tax Due 1,q79.~9 X 0.166 2~6.59 - .00 2~6.59 X .q5 11.10 NOTE: TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 03-19-2003 CDOOZ31q .00 11.10 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." TOTAL TAX CREDIT [ BALANCE OF TAX DUE XNTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( 'rF TOTAL DUE TS LESS THAN $1, NO PAYMENT IS REI~UXRED. XF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCT/ONS. 11.10 .00 .00 .00 PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~ulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, which was not requested on the tax return, say be requested by completing an "Application for Refund of Pennsylvania Inheritance end Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Hills, any of tho 25 Revenue District Offices or by calling the special Z4-hour answering service for forms ordering: 1-BO0-56Z-ZOSO; 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 disalloaance of deductions or assessment of tax [including discount or interest) as shown on this Notice amy object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBiOZ1, Harrisburg, PA 171ZB-lOZ1, 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 ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, OEPT. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. 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 ES) calendar months after the dscedent's death, a five percent (SX) discount of the tax paid is allowed. The 15g tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 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 (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January l, 19BI ail! bear interest at a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 196Z through 2005 are: Xntersst Daily Interest Daily Xntarest Daily Year Rate Factor Yea.~r Rate Factor Year Rate Factor 1982 ZOZ .000548 1987 9Z .000247 1999 7Z .O0019Z 1983 16Z .000438 1988-1991 llZ .000501 ZOO0 8Z .000Z19 1984 llZ .000501 199Z 9Z .000247 2001 9Z .000247 1985 15Z .000556 1995-1994 7Z .OO019Z ZOOZ 6Z .000164 1986 lOX .000274 199S-1998 92 .000247 2005 5Z .000157 --Interest is calculated as fallows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELTN~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additlonal interest must bo calculated. BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPTo 28060! HARRISBURG, PA l?lZ&-O6g1 ELIZABETH A LOWERY 850 TORWAY RD GARDNERS PA 1752~ CONHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRATSENENT. ALLOHANCE OR DISALLOWANCE OF DEDUCTION~, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-09-200~ ESTATE OF LOWERY JR DATE OF DEATH 11-11-2002 FILE NUMBER COUNTY SSN/DC ACN 21 05-0259 CUMBERLAND 210-60-2551 05108777 Amount RE¥-1~48 EX &FP (Ol-e$) WILLIAM HAKE CHECK PAYABLE AND REMIT PAYHENT 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 (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-09-200~ ESTATE OF LOWERY JR WILLIAM B DATE OF DEATH 11-11-2002 COUNTY CUMBERLAND FILE NO. 21 05-0259 S.S/D.C. NO. 210-60-2551 ACN 05108777 TAX RETURN WAS: IX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO. 17278~-00 TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-26-1997 Account Balance 1,855.56 Percent Taxable X 0.166 Amount Subject to Tax 505.95 Debts and Deductions - .00 Taxable Amount 505.95 Tax Rate X .00 Tax Due .00 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 IF PAID AFTER THIS DATE, SEE REVERSE 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. TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE .00 .00 .00 .O0 PURPOSE OF NOTICE~ PAYMENT: REFUND (ER): OBJECTIONS= ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (71 P.S. Section 9140). 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 NILES, 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-1515). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices or by calling the special 24-hour answering service for fores ordering: 1-600-$62-Z050; services for taxpayers with special hearing and or speaking needs: 1-800-447-3010 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloaance of deductions or assessment of tax (including discount or interest) as shown an this Notice may abject within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlOZ1, 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 ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, DEPT. 180601, Harrisburg, PA 17118-0601 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 aithin three (3) calendar months after the decedant'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, 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 mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ahich became delinquent before January 1, 1981 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. AIl taxes which became delinquent on or after January 1, 1981 ail! bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Yea__r Rate Factor 19BI ZOZ .00054B 1967 91 .000147 1999 71 .000191 1983 161 .000438 1988-1991 111 .000301 ZOOO &X .000119 1964 111 .000301 1991 91 .000247 Z001 91 .000147 1985 131 .000356 1993-1994 71 .000192 ZOOZ 62 .000164 1986 lOZ .000274 1995-1998 92 .000247 2003 52 .0001~7 --Interest is calculated as follows: ZNTEREST = BALANCE OF TAX UNPAZD X NUHBER OF DAYS DELZNQUENT X DAZEY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. Zf payment is made after the interest computation date shown on the Notice, additionaI interest must bm calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTVTS/OH DEPT. ZSO6D1 HARRTSBURG, PA 17128-0601 ELIZABETH A LOWERY 830 TORWAY RD GARDNERS PA 17524 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF /NHERZTANCE TAX APPRAISEHEHT, ALLOWANCE OR DXSALLOHANCE OF DEDUCTIONS, AND ASSESSHEHT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-09-2004 ESTATE OF LOWERY JR DATE OF DEATH 11-11-2002 FILE NUMBER ZI 03-0Z$9 COUNTY CUMBER LAND SSN/DC 210-60-2331 ACN 05108781 Amoun'l: REV-1548 EX AFP (D1-$$} WILLIAM B MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-09-2004 ESTATE OF LOWERY JR WILLIAM B DATE OF DEATH 11-11-2002 COUNTY CUMBERLAND FILE NO. 21 03-0259 S.S/D.C. NO. 210-60-2331 ACN 03108781 TAX RETURN WAS: IX) ACCEPTED AS FILED ( ) CHANGED dOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 172784-11 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 12-26-1997 Account Balance 1,479.49 Percent Taxable X 0.166 Amount Subject to Tax 246.59 Debts and Deductions .00 Taxable Amount 246.59 Tax Rate ~ .00 Tax Due .00 TAX CREDZTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS 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 FORH FOR INSTRUCTIONS. } TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 PURPOSE OF NOTICE: PAYHENT: REFUND (CR}: OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Ta fulfill the requirements of Section ZI~O of tho Inheritance and Estate Tax Act) Act Z5 of ZOO0. (TI P.S. Section 91~0}. Detach the top port[on of this Notice and submit aith your payment to tho Register of Hills printed on tho reverse side. -- Hake check ar money order payable to: REGISTER OF HILLS) AGENT. A refund of a tax credit, ahich ams not requested on the tax return, may bo requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office of the Register of Nills, any of the 25 Revenue District Offices or by calling the special Z~-hour answering service for forms ordering: 1-800-56Z-Z050; services for taxpayers with special hearing and or speaking needs: 1-800-~7-50Z0 (TT only). Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue) Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZS-10Z1, OR --electing to have tho matter determined at tho audit of the account of the personal representative) --appeal to tho 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. Z80601, Harrisburg, PA 171ZB-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions R3r Inheritance Tax Return for a Resident Decedent" (REV-iS01) for an explanation of administratively correctable errors. If any tax duo is paid within three (5) calendar months after the decedant's death, a five percent discount of the tax paid is a11oaed. The 15Z tax amnestY non-participation penalty is computed on the toter of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice, Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on or after January 1, 1982 wil1 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 rotes for 198Z through ZOOS are: Interest Daily Interest Daily Interest Daily Year Rate Factor Rate Factor Rate Factor 1982 ZOZ .0005~8 1987 9Z 1985 16Z .000~58 1988-1991 11Z 198~ 112 .000501 1992 92 1985 152 .000556 1995-199~ 7Z 1986 IOZ .O00ZT~ 1995-1998 92 .OOOZ~7 1999 7Z .00019Z .000501 ZOO0 82 .000219 .O00Z~7 2001 9Z .O00Zq7 .O0019Z ZOOZ 6Z .00016~ .O00Z~7 2005 5Z .000157 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAZEY INTEREST FACTOR --Any Notice issued after the tax becoles delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDU~:~~~~~'r-' INHERITANCE TAX DIVISION -- -",' >,' L, PO BOX 280601' " '; HARRISBURG PA 17128-0601 ' COMMONWEALTH OF PENNSYLVANIA DEPARTMf.~T OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT . REV-1593 EX AFP (03-05) ')r1nr fro, I <') p'~'~ I' cr.. d;J:Jv;Ui .jrJ . ,JD DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-03-2006 LOWERY JR 11-11-2002 21 03-0239 CUMBERLAND 101 WILLIAM B CLEr;l<' CR~I' """-.' J 1!~'" r':/~r< ~ . VICKY A~ !~I:Rlfo'MEfb 3401 NOR't'H"FRONT STREET PO BOX 5950 HARRISBURG PA 17110-0950 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- .-------------------------------------------------------------------------------------------------------------------------------------- REV-1593 EX AFP (03-05) ESTATE OF LOWERY JR .. INHERITANCE TAX RECORD ADJUSTMENT .. WILLIAM B FILE NO. 21 03-0239 ACN 101 DATE 01-03-2006 ADJUSTMENT BASED ON: VALUE OF ESTATE: ADMINISTRATIVE CORRECTION 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 .00 .00 .00 (8) .00 10. 11. 12. 13. 14. TAX: 15. Allount of line 14 at Spousal rate 16. Allount of line 14 taxable at lineal/Class A rate 17. Allount of line 14 at Sibling rate 18. Allount of line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) Debts/Mortgage liabilities/liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Governllental Bequestsj Non-elected Net Value of Estate Subject to Tax (9) (10) .00 .00 (11) (12) (13) (14) .00 .00 .00 .00 9113 Trusts (Schedule J) .oox 00 = .OOX 045= .OOX 12 = .OOX 15 = (19) .00 .00 .00 .00 .00 (15) (16) (17) (18) , ..., ..... "'..-.. .... l1'J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE 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.) REV-1470 EX (6-88) . . '" '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER WILLIAM B LOWERY REVIEWED BY ACN 2103-0239 101 Department of Revenue SCHEDULE ITEM NO. EXPLANATION OF CHANGES Efforts to obtain an Inheritance Tax return have been exhausted for the above referenced estate. Therefore, the filing requirements have been waived. The Department however, reserves the right to assess any assets that may be recovered at a future time. PaQe 1