HomeMy WebLinkAbout03-0256REV- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
COUNTY CODE YEAR
NUMBER
D
E
C
E
D
E
N
T
cAPB ~
HpRL
EpIO
cRAC ~]
TK
KOEs
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
GATES GLADYS I.
DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-DO-YEAR)
12/25/2002 09/24/1919
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
186- 24- 8046
THIS RETURN MUST BE FILED IN DUPLICATEWITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1. Original Return U 2-- Supplemental Return
4. Limited Estate [~ 4;. Future lnterest Compromise (date of deathafter 12-12-82)
6. Decedent Died Testate Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
. 9. Litigation Proceeds Received L_] 10. Spousal Poverty Credit
(date of death between 12-31-91 and 1-1-95)
(date of death
3. Remainder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
[~] 11. Election to tax under Sec. 9113(A)
(Attach Sch O)
Co"
R
E
C
A
P
I
T
U
L
A
T
I
O
N
C
O
M
T
I
O
NAME
Edmund G. Myers
FIRM NAME (If Applicable)
Johnson, Duffie,
Stewart & Weidner
TELEPHONE NUMBER
717/761-4540
COMPLETE MAILING ADDRESS
P. O. Box 109
301 Market Street
Lemoyne, PA 17043-0109
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11 )
13.
14.
None
None
None
None
30.00
None
74,155.18
1,270.00
1,186.53
OFFICIAL USE ONLY
(8) 74,185.18
(11) 2,456.53
(12) 71,728.65
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) (14)
71,728.65
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
71,728.65
x .0 0 (15)
X .0 45 (16)
X .lZ (17)
X .15 (18)
(19)
0.00
3,227.79
0.00
0.00
3,227.79
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
3965 Mountain View Road
CITY
Mechanic sbur~
STATE
?A
ZIP
17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
161.39
Total Credits ( A + B + C ) (2)
3,227.79
3. Interest/Penalty if applicable D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retaintheuseorincomeofthepropertytransferred; .........................
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 ether payments, benef ts 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.
161.39
0.00
0.00
3,066.40
0.00
3,066.40
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 preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Sherry E. Ensminger DATE
.... 3965 Mountain View Road
-- .................... .
SiGN~,E OF PRIER OTH ER THAfi~E~SENTAT,VE %oh;sO;;xD~g~ie, Stewart & Weidner DA~-----
For dates of death on or after July 1, 1994 and before Janua~ 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 Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of th~ child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. ~6(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form R~V- 1~00 ~X (Rev. 6-00)
REV'- 1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GLADYS
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
I. GATES SS# 186-24-8046 12/25/2002
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F,
ITEM
NUMBER DESCRIPTION
1 ROBC Limited - Check returned
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
VALUE AT DATE
OF DEATH
30.00
Form REV-1508 EX (Rev. 1-97)
$ 30.00
REV'-1510 EX+ (1-97) SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
GLADYS I. GATES SS# 186-24-8046 12/25/2002
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDE THE NAME OF THE TRANSFERE~THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.
NUMBER ATTACH A COPYOF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
i Member's First Federal 57,062.44 3,000.0C 54,062.44
Credit Union Certificate of
Deposit Account 213177-41
Transferee: Sherry
Ensminger, Daughter.
Transfer dated: 1/17/2002
Accrued income on item 1 129.45 100.00% 129.45
through date of death
2 Member's First Federal 5,145.36 5,145.36
Credit Union Checking
Account No. 213177-11
Transferee: Sherry
Ensminger, Daughter
Transfer dated: 07/02/2002
Accrued income on item 2 3.77 3.77
through date of death
3 Member's First Federal 14,797.23 100.00% 14,797.23
Credit Union Regular
Savings Acocunt No.
213177-00
Transferee: Sherry
Ensminger, Daughter
Transfer Date: 01/17/2002
Accrued income on item 3 16.93 16.93
through date of death
TOTAL (Also enter on line 7, Recapitulation) $ 74,155.18
(If more space ~s needed, inse~ additional sheets of the same raze)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97)
RE~-1511 EX + (1-97)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GLADYS I. GATES SS# 186-24-8046 12/25/2002
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
FILE NUMBER
1
2
3
FUNERAL EXPENSES:
Enola First Church of God - Funeral Luncheon
George Jensen - Funeral Services
Gingrich Memorials
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Zip
Year(s) Commission Paid:
Attorney's Fees Johnson, Duffie, Stewart & Weidner
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
OtherAdministrativeCosts
Cumberland County
Inheritance Tax Return
Inventory
Register of Wills Filing Fees
$15.o0
10.00
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
100.00
50.00
95.00
1,000.00
25.00
$ 1,270.00
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV'-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GLADYS I. GATES SS#
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
186-24-8046 12/25/2002
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1
2
3
4
5
6
7
Alert Pharmacy
Bridges at Bent Creek, Mechanicsburg, PA - Transportation Fee
Elite Staffing Services - Private Duty Nurse
Elite Staffing Services
Pennsylvania Department
Income Taxes
ROBC Limited
West Shore EMS Transportation Costs
of Revenue - Payment of 2002 Individual
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
AMOUNT
231.55
38.38
435.50
284.00
104.00
30.00
63.10
$ 1,186.53
Form REV-1512 EX (Rev. 1-97)
TABLE OF EXHIBITS
For
THE ESTATE OF GLADYS I. GATES
Exhibit A Last Will and Testament of Gladys I. Gates dated June 14, 1979
EXHIBIT A
OF
GLADYS I. GATES
I, GLADYS I. GATES, of East Pennsboro Township, Cumberland County,
Pennsylvania, make, publish and declare this as and for my Last Will and
Testament, hereby revoking all other Wills and Codicils heretofore made by me.
FIRST: I direct the payment of all my just debts and the expenses
of my last illness and funeral from my estate, as soon after my death as
conveniently may be done.
S~.COND: I devise and bequeath all the rest, residue and remainder of
my estate of whatever nature and wherever situate unto my husband, SYLVAN A.
GATES, provided he survives me by sixty (§0) days.
THIRD: Should my husband, Sylvan A. Gates, predecease me or die on or
before the sixtieth (60th) day following my death, I devise and bequeath all the
rest, residue and remainder of my estate of whatever nature and wherever situate
unto my_children, GARY A. GATES, SHBRRY E. EN~INGBR, DAWNB D. ~cCARTNh~f,
GREGORY L. GATES and KEITH L. GATES, in equal shares.
FOJRTH: My tkecutor and personal representative shall have the
following powers in addition to those vested in them by law and by other
provisions of this Will, applicable to all property, exercisable without court
approval and effective until actual distribution of all property:
(A) To sell at private or public sale any real or personal property
for such prices as they deem proper.
(B) To compromise any claim or controversy.
FIFTH: I direct that any and all inheritance, estate and transfer
taxes imposed upon my estate passing under my Will or otherwise shall be paid
out of the principal of my residuary estate.
SIXTH: I nomi~ate and appoint my husband, SYLVAN A. GAT~.S, Executor
of this, my Last Will and Testament. In the event of the death, resignation or
inability to serve for any reason whatsoever of the said Sylvan A. Gates, I
ncmtinate and appoint .GARY A. GATES and SHERRY ~.. ENSMINGER, or the survivor
thereof, Co-Executors of this, my Last Will and Testament. I hereby relieve
my Executor £rau the necessity of posting security in connection with his duties
as such in any jurisdiction in which he may be called upon to act insofar as I
am able by law to do so.
IN WITNESS WH~RROF, I have hereunto set my hand and seal to this, my
Last Will and Testament, this /~/ day of ~..~2- , 1979.
Gl~s~I. Gales
Signed, sealed, published and declared by the above-named Testatrix
as and for her Last Will and Testament in our presence, who, at her request, in
her presence and in the presence of each other, have hereunto subscribed our
names as attesting witnesses.
Address
-2-
GLADYS I. GATBS
JAMES D, BOGAR
ATTORNEY AT LAW
23 WEST MAIN STREET
SHIREMAN-qTOWN. PENNSYLVANIA 17011
Register of Wills of
Estate of GLADYS I. GATES
also known as
INVENTORY
County, Pennsylvania
, Deceased
.o.
Date of Death 12/25/2002
Social Security No. 186 - 24 - 8046
Sherry E. Ensmin~er,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
'Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Edmund G. Myers
Attorney:
I.D. No.: 20558
Address:
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone: 717/761-4540
Personal Representative
Signatu re: ,_~~f./[ ~
Sherry ~ En~minger ' 0
Signature:
Address: 3965 Mountain View Road
Mechanicsburs, PA 17055
Telephone: 717 - ?3Z-':~--V--~ 77.F0
Dated:
Description
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Value
Total:
30.00
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-7 (199z)
Estate of:
Date of Death:
County:
GLADYS I. GATES
12/25/2oo2
Cumberland
INVENTORY
CASH:
ROBC Limited - Check returned
30.00
TOTAL RECEIPTS OF PRINCIPAL ...............
30.00
30.00
-1-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF IND~VlDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD
REV-1162 EX(11-96)
002336
MYERS EDMUND G ESQUIRE
JOHNSON DUFFLE STEWART WEIDNER
PO BOX 109 301 MARKET STREET
LEMOYNE, PA 17043-0109
fold
ESTATE INFORMATION: SSN: 186-24-8046
FILE NUMBER: 2103-0256
DECEDENT NAME: GATES GLADYS I
DATE OF PAYMENT: 03/25/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/25/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,066.40
TOTAL AMOUNT PAID:
$3,066.40
REMARKS: SHERRYE ENSMINGER
C/O EDMUND G MYERS ESQUIRE
SEAL
CHECK# 124
INITIALS: SK
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
TNHERZTAHCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
EDHUND G HYERS
JOHNSON ETAL
PO BOX 109
LEHOYNE
CONHONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRA/SEHENT, ALLO#ANCE OR D/SALLO#ANCE
OF DEDUCT/ONS AND ASSESSNENT OF TAX
REV-1547 EX AFP C01-0S)
Racr,r~, ~. ~ . C~ATE
R~i i~:=: .~J'.?3 ESTATE OF
DATE OF DEATH
FXLE NUNBER
'03 JUN-2 gll:l~l:J~'INTY
ACN
05-26-2003
GATES
12-25-2002
21 05-0256
CUHBERLAND
101
Aeouni: Ram'; tted
GLADYS I
HAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THXS LINE ~ RETA/N LONER PORT/ON FOR YOUR RECORDS -~
REV-1547 EX AFP (01-03) NOTXCE OF /NHERZTANCE TAX APPRAXSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCT:IONS AND ASSESSNENT OF TAX
ESTATE OF GATES GLADYS I FILE NO. 21 0:5-0256 ACN 101 DATE 05-26-200:5
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATXON CONCERNTNG FUTURE :iNTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Pertnersh/p /nterest (Schedule C) ($)
q. Nortgages/Notes Race/vable (Schedule D) (~)
5. Cash/Bank Depos/ts/N/sc. Personal Property (Schedule E) (5)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule ;) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Costs/N/sc. Expenses (Schedule H) (9)
10. Dabts/Nortgage L/ebil/t/es/L/ens (Schedule Z) (10)
11. Total Deduct/ohs
12. Net Value of Tax Return
30.00
.00 NOTE: To /nsure proper
.00 cred/t to your account,
.00 subm/t the upper port/on
.00 of th/s for. fi/th your
tax payment.
.00
7q/155.18
(8)
1,270.00
13.
NOTE:
1,186.5:5
(11)
(12)
Char/table/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13)
Net Value of Estate Subject to Tax (lq)
Zf an assessment .as issued previously, 11nas 14, 15 and/or 16, 17,
reflect flgures that include the total of ALL returns assessed to date.
7~,185.18
ASSESSHENT OF TAX:
15. Amount of L/nm 1~ at Spousal rate
16. Amount of L/nm 1~ taxable at L/neel/Class A rate
17. Amount of L/ne 1~ at S/bl/ng rate
18. Amount of L/nm 1~ taxable at Collateral/Class B rate
19. Principal Tax Dua
TAX CREDITS:
PAYMENT RECEIPT D~SCOUNT (+)
DATE NUHBER /NTEREST/PEN PA/D (-)
03-25-200:5 CDOOZ:5:56 161.:59
2.~56.53
71,728.65
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADD/T/ONAL /NTEREST.
.00
71,728.65
18 and 19 ~111
(1.;) .00 X O0 = .00
(16) 71,728.65 X 0~5= $,227.79
(17) . O0 x 12 = . O0
(is) .00 x 15 = .00
(19)= :5,227.79
AHOUNT PA/D
$,066.~.0
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
3,227.79
.00
.00
.00
( /F TOTAL DUE ZS LESS THAN $1, NO PAYHENT XS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or bmfore December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful CIass B (collateral) rate an any such future interest.
To ~ulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (72 P.S.
Section 91~0).
Detach the top portion of this Notice and submit uith your payment to the Reglster of Nills printed on the reverse side.
--Hake check or money order payable to: REGZSTER OF #ILLS, AGENT
A refund of a tax credit, which ems not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS15). Applications ara available at the Office
of the Register of Hills, any of the 25 Revenue District Offices, or by calling the special Zq-hour
answering service for forms ordering: 1-800-562-2050; services far taxpayers with special hearing and / or
speaking needs: 1-800-447-5020 (TT only).
Any party in interest not satisfied aith the appraisement, alloaance, or disallowance of deductions, or assessment
of tax (including discount or interest) as 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. 281011, 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 an this assessment should ba addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent (51) discount of
the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed on tho total 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 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 which became delinquent before January 1, 1981 bear interest at tho rate of
six (61) percent per annum calculated et a daily rate of .000164. AL1 taxes ehich became delinquent an and after
January 1, 19SI mill bear interest at a rate which mill vary from calendar year to calendar year eith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOS are:
Interest Daily Interest Daily interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1981 ZOZ .000548 1987 91 .000247 1999 7X .O00lgz
1985 161 .000438 1988-1991 IZZ .000501 ZOO0 8X .000219
1984 111 .000501 1991 91 .000247 2001 91 .D00247
1985 131 .000356 1993-1994 72 .O0019Z ZOOZ 62 .000164
1986 IOZ .000174 1995-1998 92 .000247 2003 51 .000137
--Interest is caIcuZated as follows:
TNTBREST = BALANCE OF TAX UNPAZD
X NUNBER OF DAYS DBLZNI~UENT X DAZLY ZNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (IS) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Not[ce, additional interest oust be calculated.