HomeMy WebLinkAbout03-0265COHHONHEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z~0601
HARRISBURG, PA' 171Z8-0601
REV-~I3 EX AFP (09-00)
ELIZABETH~-NIAN
q06 PAWNEE DR
MECHANICSBURG
PA 17~055
ZNFORHATZON NOTZCE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACN 05108779
DATE 03-12-2005
TYPE OF ACCOUNT
EST. OF ELIZA M YEARICK D SAVINOS
S.S. NO. 190-16-1262 []CHECKING
DATE OF DEATH 11-18-2002 ['~TRUST
COUNTY CUMBERLAND [--1CERTIF.
RENIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HEHBERS 1ST FCU has provided the Department eith the information listed baloN ahich has been used in
calculating the potential tax due. Their records indicate that at tho death of the above decedent, you were a joint owner/beneficiary of
this account. Tf you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this for~ and return ~t to the above address. This account ~s taxable ~n accordance ~ the Inheritance Tax La~s of the Commonwealth
of Penn~ylu~nj.a. Questions m~y b~ answered by c~]).tn~ (717) 787-8327.
COHPLETE PART I BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Account No. Z103q6-11 Date 10-17-2001
Established
Account BaZance 9qO.Zq
Percent Taxable X 50.000
Amount Sub:ject to Tax ~70.12
Tax Rate X .0~5
Potential Tax Due Zl.16
To insure proper credit to your account, two
(Z) copies of this notice must accowpany your
payment to the Register of Hills. Hake check
payable to: "Register of Hills, Agent".
NOTE: If tax payments ara made within three
(3) months of the decadent's date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
A. ~ The above information and tax due is correct.
~ 1. You may choose to remit payment to the Register of Hills aith two copies of this notice to obtain
CHECK a discount or avoid interest, or you amy check box "A" and return this notice to the Register of
ONE ~ Hills and an official assessment will be issued by the PA Department of Revenue.
BLOCK J B. [] The above asset has been or ~ill be reported and tax paid aith the Pennsylvania Inheritance Tax return
ONLY to be filed by the dacedent's representative.
C. [] The above information is incorrect and/or debts and deductions mare paid by you.
You must complete PART [] and/or PART [] below,
PART Tf you indicate a different tax rate, please state your
[] relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established I
2. Account Balance
3. Percent Taxable
q. Amount Sub:ject to Tax
$. Debts end Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalties of per:jury, ! declare that the facts I have reported above are true, correct and
complete to the best of ~LV knowledge and belief. HOME (~/'~) ~_p/-/-/-'7._.~c~
TAX.ER SZGHATURE TELEPHONE NUHBER 'DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND NILL 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.
3. A joint account is taxable even though the decedant's name was added as a matter of convenience.
4. Accounts (including those held between husband and ails) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts estabIished 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 are taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-154B 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 eith the Pennsylvania Inheritance
Tax Return filed by the dacedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign cna
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 180601, Harrisburg, PA 17118-0601 in the
envelope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions arm being claimed, check block "C" and complete Parts Z end
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-154B EX) upon receipt
of the return from the Register of Hills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 12/12/82: 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 $3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (Ex) appears before your first name in the address portion of this notice, the $3,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Enter the totaL balance of the account including interest accrued to the date of death.
The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT OHNERS
Example: A joint asset registered in the name of the decedent and two other persons.
I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7X (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable far assets created within one year of the decadent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
DNNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
I DIVIDED BY Z (SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line 2) by the percent taxable (line
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line
7. Enter the appropriate tax rate (line 7) as determined below.
Da~:e of Dee~:h Spouse I Lineal [ Sibling Colla~ereZ
07/01/9fi '~o 12/$1/9~ SX 6X 157. 1.67.
01/01/9.6 ~.o 06/50/00 OX 6X 1.67. 1.67.
07/01/00 ~o pres~n~ OX
wThe tax rate imposed on the net value of transfers from a deceas t-one years younger at
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child ls OZ.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
natural parents 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.
CLAIMED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are determined as follows:
A. You legally are responsible far 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 ~urnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 1/Z" x 11". Proof of
payment may be requested by the PA Department of Revenue.
COMNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURg, P~ 171Z8-0601
REV-1GCS EX AFP C09-00)
L,
~ ELIZABE ~q' WIAN
q06 PAWNEE DR
MECHANICSBURG ? PA 1705S
ZNFORMATZON NOTZCE
AND
TAXPAYER RESPONSE
FZLE NO. 21 --g~7-~~)~-)/~
ACN 05108778
DATE 05-12-2005
TYPE OF ACCOUNT
EST. OF ELIZA M YEARTCK [] SAVINGS
S.S. NO. 190-16-1262 [] CHECKINg
DATE OF DEATH 11-18-2002 [] TRUST
COUNTY CUMBERLAND [] CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provldad the Department aith the information listed beloe ahich has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you Here a joint oHnar/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction free the financial institution, attach a copy
to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Comacneealth
of Pennsylvania. Questions may be answered by calling [717} 787-8SZ7.
COMPLETE PART I BELOW ~ # ~ SEE REVERSE S/DE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. Z103q6-05 Date 11-Z0-2001
EstablAshed
Account Balance 36,789.97
Percent Taxable X 100. 00
Amount Subject to Tax 36,789.97
Tax Rate X . Oq5
Potential Tax Due 1 · 655.55
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of #ills. Make check
payable to: "Register of #ills, Agent".
NOTE: If tax payments era made within three
(3) months of the decedent's date of death,
you may deduct e SZ discount of the tax due.
Any inheritance tax due mill become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
CHECK
ONE
BLOCK
ONLY
PART
TAX
LTNE
A. E] The above information and tax due is correct.
1. You amy choose to re. it payment to the Register of Hills with two copies of this notice to obtain
a discount or avoid interest, or you amy check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Oeparteant 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. ~Tha above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART []below.
If you indicate a different tax rate, please state your
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1. Date Established
2. Account Balance
S. Percent Taxable
q. Amount Subject
S. Debts end Deductions
6. A,ou,t Texebl,
7. Tax Rata
8. Tax Du.
PART DEBTS AND DEDUCTZONS CLAIMED
DATE PATD PAYEE DESCRIPTION
1- o31 I
I '
TOTAL (Enter on L/ne 5 of Tax
AMOUNT PAID
Under penalties of perjury, I declare that the facts Z have reported above ere true, correct end
_~)c/~mp).*~ ~o ,~)he b~ ay know/edge and belief.
TAX~YER SIGNATURE TELEPHONE NUMBER '~ATE
GENERAL INFORHATION
1. FAILURE TO RESPOND #/LL RESULT ZN AN OFFICIAL TAX ASSESSHENT with applicable interest based an information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the dacedent's date of death.
3. A joint account is taxable even though the decedent's na.e aaa added as a .attar of convenience.
4. Accounts (including those held between husband and mile) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife 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 - If the information and co.putation in the notice are correct and deductions ara not being claimed, place an "X"
in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit thee with your check for the amount of
tax to the Register of #ills of the county indicated. The PA Depart.ant of Revenue will issue an official assessment
(Fora REV-la48 EX) upon receipt of the return from the Register of Hills.
2. BLOCK B - If the asset specified on this notice has been or ail1 be reported and tax paid aith the Pennsylvania Inheritance
Tax Return filed by the decadent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C - If the notice infor.ation is incorrect and/or deductions are being claimed, check block "C" and complete Parts Z and
according to the instructions beloe. Sign tee copies and sub.it them eith your check for the amount of tax payable to the Register
of Hills of the countY indicated. The PA Department of Revenue mill issue an official assessment (Fora REV-1Sfi8 EX) upon receipt
of the return fro. the Register of Wills.
TAX RETURN - PART 2 - TAX COHPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 12/12/82: 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 $3,000 per transferee regardless of the value of
the account or the nv.bmr of accounts hold.
If a double asterisk (xx) appears before your first name in the address portion of this notice, the $3,000 exclusion
already has been deducted from the account balance as reported by the financia! institution.
Enter the total balance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT ONNERS SURVIVTNG JOINT OWNERS
Example: A joint asset registered in the name of the decedent and tee other persons.
I DIVIDED BY 3 [JOINT ONNERS) DIVIDED BY Z [SURVIVORS) = .167 X 100 = 16.7Z [TAXABLE FOR EACH SURVIVOR)
D.The percent taxable for assets created within one year of the decedent's death or accounts caned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
! DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE
DHNERS OR TRUST BENEFICIARTES
Example: Joint account registered in the name of the decedent and tee other persons and established within one year of death by
the decedent.
1 DIVIDED BY Z (SURVIVORS) = .50 X lgO = 5OZ (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line 2) by the percent taxable (line
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax [line
7. Enter the appropriate tax rate (line 7) as determined beloe.
Date of Death Spouse J Lineal Sibling Collateral
07/01/9~ to 12/$1/9q
01/01/96 to 06/50/00 OX 6X
07/01/00 to present OX ~.SX~ 12X
[ha tax rote imposed on the net value of fro. a younger at
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the chiId is oZ.
The lineal cZ.ss of heirs incZudes grandparents, parents, children, and Zineal descendents. "Children" includes natural children
ahethar or nat they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of tho
natural parents and their descendents, ehether or net they have been adopted by others, adopted descendents and their descendants
and step-descendants. "SibIings" ara defined as individuals mhd have at least one parent in common with the decedent, whether by bided
or adoption. The "CclIatera[" class of heirs includes ail other beneficiaries.
CLAIHED DEDUCTIONS - PART :5 - DEI~TS AND DEDUCTIONS CLAIFIED
Allocable debts and deductions are determined as follows:
A. You legally are responsible for payment, or the estate subject to ad.inistration by a personal representative is insufficient
to pay the deductibIa items.
D. 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, usa plain paper B z/z" x 11". Proof of
payment way be requested by the PA Department of Revenue.
COHNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.,IS0601 ,
HARRISBURG, PA 171Z8-060!
REV-16~13 EX AFP CDg-O0)
ZNFORHATZON NOTZCE
AND
TAXPAYER RESPONSE
FZLE NO.
ACN 03108775
DATE 03-12-2003
ELIZABETH J~NIAN
q06 PAWNEE DR
MECHANICSBURG PA 1,7055
TYPE OF ACCOUNT
EST. OF ELIZA M YEARICK [] SAVINGS
S.S. NO. 190-16-1262 [] CHECKING
DATE OF DEATH 11-18-200:;' [] TRUST
COUNTY CUMBERLAND [] CERTIF.
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HEHBERS /ST 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 eera a ~oint Donor/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financia! institution, attach a copy
to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. guestions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW N # N SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 2103q6-00 Date 10-17-2001
Establ/shed
Account Balance 2,2q5.q7
Percent Taxable X 50.000
Amount Sub,oct to Tax 1,122.7q
Tax Rate X .Oq5
Potential Tax Due 50.52
To lnsure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Hills. Make check
payable to: "Register of Hills, Agent".
NOTE: If tax payments ara made within three
(3) months of the decedent's date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
TAX
LTNE
PART TAXPAYER RESPONSE
A. ~The above information and tax due is correct.
~-1. You may choose to remit payment to the Register of Nills aith two copies of this notice to obtain
CHECK a discount or avoid interest, or you may check box
~ Mills and an official assessment will bm issued by the PA Department of Revenue.
ONE
BLOCKJ B. [] The above asset has been or ail1 be reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY to be fi~ed by the dacedant's representative.
C. O 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 different tax rate, please state your
relationship to decedent:
RETURN - COMPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS
1. Date Established
2. Account Balance 2
3. Percent Taxable 3 ~
fi. Amount Sub~ect to Tax q
5. Debts and Deductions E
6. Amount Taxable 6.
7. Tax Rate 7 ~
8. Tax Duo G
PART
DATE PAID
DEDTS AND DEDUCTTONS CLAIMED
PAYEE
DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalties of perjury, ! declare that the facts I have reported above are true, correct and
complete to the bast of ~l~dge and belief. HOME ('~/'7) 7~/-/--/-7~,~'
TAXP~ER SIGNATURE ' TELEPHONE NUHBER DATE
GENERAL INFORHATION
1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFIC/AL TAX ASSESSNENT aith appllcable interest based on information
submitted by the financial inst[tution.
2. Inheritance tax becomes delinquent nine months after the dacedent's date of death.
5. A joint account is taxable even though the decedent's name Nas added as a matter of convenience.
4. Accounts (including those held batNeen husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and Nifo 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 1 - TAXPAYER RESPONSE
1. BLOCK A - ]f the information and computation in the not[ca are correct and deductions are not being claimed, place an "X"
in block "A" of Part I of the "Taxpayer Response" section. Sign tNo cop[es and submit them Nith your check for the amount of
tax to the Rag[star 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 Rag[star of Nills.
Z. BLOCK B - If the asset specified on this not[ce has been or Nil1 be reported and tax paid Nith the Pennsylvania Inheritance
Tax Return filed by the dacedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept IR0601) Harrisburg, PA 171ZB-0601 in the
envelope provided.
3. BLOCK C - [f the notice information is incorrect and/or deductions are being claimed, check block "C' and complete Parts Z and
according to the instructions beloN. Sign two cop[es and submit them with your check for the amount of tax payable to the Rag[star
of Nills of the county indicated. The PA Department of Revenue wiIl issue an official assessment (Form REV-1548 EX) upon receipt
of the return from the Register of #ills.
TAX RETURN - PART 2 - TAX CONPUTATION
LINE
1. Enter the date the account originally Nas established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 1Z/II/BI: Accounts Nh[ch the decedent put in joint names within one (l) year of death are
taxable fully as transfers. HoNever, there is an exclusion not to exceed $3,000 par transferee regardless of the value of
the account or the number of accounts held.
If a doubIa asterisk (xx) appears before your first name in the address portion of this notice, the $5,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Z. Enter the total balance of the account including interest accrued to the date of death.
5. The percent of the account that is taxable for each survivor is determined as folloNs:
A. The percent taxabIa for joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
JOINT ONNERS SURVIVING JOINT ONNERS
Example: A joint asset registered in the name of the decedent and tad other persons.
1 D[VTOED BY $ (JOINT O#NERS) DIVTDED BY Z (SURVIVORS) = .167 X 100 = 16.7X (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created within one year of the decedent's death or accounts oNned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE
ONNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and tNo other persons and established Nithin one year of death by
the decedent.
1 DTVIDED BY Z (SURVIVORS) = .SO X lO0 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable [line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line
7. Enter the appropriate tax rate (line 7) as determined beloN.
Dais of Death Spouse Lineal I Sibling Collateral
07/01/9q to 12/$1/9q SZ 6Z
01/01/95 ~o 06/50/00 OX 6Z 15X 15X
07/01/00 ~o presen~ OX
XTha tax rate imposed on th; net value of transfers from a decea Younger at
death to or for the use of a natural parent, an adoptive parent, or a stapparent of the child is OZ.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
Nhether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendents, Nhether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals mhd 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 $ - DEIiTS AND DEDUCTIONS CLAIMED
AlieNable debts and deductions are determined as folloNs=
A. You legally ara 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 & l/Z" x Il". Proof of
payment may be requested by the PA Department of Revenue.
Elizal~h L Wan
g96 Pawnee Dr.
Mechanics~, PA 17050-2546
Co Co.er
/ 7o/._,a
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 002342
DUPLICATE
WlAN ELIZABETH L
406 PAWNEE DRIVE
MECHANICSBURG, PA 17055
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
........ fold
03108779 $21.16
03108778 $1,487.64
03108775 $50.52
ESTATE INFORMATION: SSN: 190-16-1262
FILE NUMBER: 2103-0265
DECEDENT NAME: YEARICK ELIZA M
DATE OF PAYMENT: 03/26/2003
POSTMARK DATE: 03/25/2003
COUNTY: CUM BERLAN D
DATE OF DEATH: 11 / 18/2002
TOTAL AMOUNT PAID:
$1,559.32
REMARKS: ELIZABETH L WIAN
SEAL
CHECK# 169
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280661
HARRISBURG, PA 17128-6661
ELIZABETH H WIAN
406 PAWNEE DR
MECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF XNHERITANCE TAX
APPRAXSEHENT. ALLONANCE OR DXSALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOXNTL¥ HELD OR TRUST ASSETS
Recorc~,~,~:
..... DATE 05-19-2005
~ "~; ~,,e.-?~~ ' '?: L'Ii!S ESTATE OF YEARICK
DATE OF DEATH 11-18-2002
FILE NUMBER 21 05-0265
'03 HAY 16 Al0:4~COUNTY CUMBERLAND
SSN/DC 190- 16- 1262
ACM 03108779
~-~' : Amount Remitted
REV-iS46 EX AFP
ELIZA M
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-15~8 EX AFP C01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-19-2003
ESTATE OF YEARICK ELIZA H DATE OF DEATH 11-18-2002 COUNTY CUMBERLAND
FILE NO. 21 03-0265 S.S/D.C. NO. 190-16-1262 ACM 03108779
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 210346-11
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 10-17-2001
Account Balance 940.24
Percent Taxable X 0.500
Amount Subject to Tax 470.12
Debts and Deductions .00
Taxable Amount ~70.12
Tax Rate X .~5
Tax Due 21.16
TAX CREDITS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
03-25-2003 CD0023~2 .00 21.16
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
21.16
.00
.00
.00
[F PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR)~ YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~
PURPOSE OF
NOTICE=
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S.
Section 9140).
PAYMENT:
Detach the top portion of this Notice and submit with your payment to the Register of Mills printed on the
reverse side.
-- Make check or money order payabZe to: REGISTER OF MILLS, AGENT.
REFUND CCR)=
OBJECTIONS=
ADMIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT=
PENALTY=
INTEREST=
A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of
the Register of Mills, any of the 25 Revenue District Offices or by calling the special 24-hour answering service
for forms ordering: 1-800-3&2-2050; services for taxpayers with special hearing and or speaking needs=
1-800-447-3020 CTT only).
Any party in interest not satisfied with the' appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty (&O) days of receipt of
this Notice by=
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue,
Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" CREV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent CSX)
discount of the tax paid is allowed.
The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 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 (lI day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982
bear interest at the rate of six (&X) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA
Department of Revenue.
The applicable
interest rates for 1982 through 2003 are=
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20X .000548 1987 9X .000247 1999 7~ .000192
1983 16~ .000438 1988-1991 11~ .000301 2000 8~ .000219
1984 11~ .000301 1992 9X .000247 2001 9X .000247
1985 13X .00035& 1993-1994 7X .000192 2002 6X .0001&4
1986 lOX .000274 1995-1998 9X .000247 2003 5~ .000137
--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. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
ELIZABE L WIAN
406 PAWNEE DR
MECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTXC~: OF XNHERXTANEE TAX
APPRAXSEHENT. ALLO#ANCE OR DISALLOHANCE
OF DEDUCTXONS, AND ASSESSHENT OF TAX ON
JOXNTL¥ HELD OR TRUST ASSETS
Recoraed-<)fl ::,;~ of
FILE NUMBER
COUNTY
'03 ['1AY 16 AIO :AS SSN/DC
ACN
Cumbe ~r~c ~
DATE 05-19-2005
ESTATE OF YEARICK
DATE OF DEATH 11-18-2002
21 03-0265
CUMBERLAND
190-16-1262
03108778
Amount Remitted
ELIZA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
M
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~
REV-1548 EX AFP ¢01-03)
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-I9-2005
ESTATE OF YEARICK
ELIZA M DATE OF DEATH 11-18-2002 COUNTY CUMBERLAND
FILE NO. 21 03-0265 S.S/D.C. NO. 190-1&-1262 ACN 05108778
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 210546-05
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 11-20-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deduct/ohs
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
36,789.97
X 1.000
56,789.97
- 3,731.35
55,058.62
X
1,487.64
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
05-25-2005 CD002342 .00 1,487.64
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF 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 NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.
1,487.64
.00
.00
.00
PURPOSE OF
NOTICE=
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S.
Section 9140).
PAYMENT=
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF HILLS, AGENT.
REFUND
08JECTIONS=
ADMIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT=
PENALTY
INTEREST=
A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS151. Applications are available at the Office of
the Register of Nills, any of the 25 Revenue District Offices or by calling the special 24-hour answering service
for forms ordering: ]-800-~62-2050; services for taxpayers with special hearing and or speaking needs:
1-800-447-5020 (TT only}.
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as 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. 281021, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue,
Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501I for an expianation of administratively correctable errors.
If any tax due is paid within three ($) caIendar months after the decedent's death, a five percent (5%)
discount of the tax paid is allowed.
The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before Januar~ 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 would appeal the tax and interest
that has been assessed as indicated on this not/ce.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (11 day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982
bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after Januar~ 1, 1982 will bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20% .000548 1987 9% .000247 1999 7% .000192
1983 16% .000438 1988-1991 11% .000501 2000 8% .000219
1984 11% .000501 1992 9% .0002~7 2001 9% .000247
1985 13% .000356 1993-1994 7% .000192 2002 6% .000164
1986 10% .000274 1995-1998 9% .000247 2003 5% .000157
--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 (151 days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0&01
ELIZABETH L WIAN
406 PAWNEE DR
MECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF XNHERXTANCE TAX
APPRAI*SEMENT. ALLONANCE OR DTSALLONANCE
OF DEDUCTXONI~, AND ASSESSIIENT OF TAX ON
JOXNTLY HELD OR TRUST ASSES
R~oF<'t~ ~: ~:~ C,f DATE 05- 19- 200~
R~[_/~:'"~- ~, ~/~s ESTATE OF YEARICK
DATE OF DEATH 11-18-2002
FILE NUMBER
COUNTY
'03 ~Y 16 AlO:4~s./oc
ACN
PA 170~rL- :~;d~7
21 05-0265
CUMBERLAND
190-16-1262
05108775
Amount Remitted
ELIZA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
M
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1548 EX RFP
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-19-2005
ESTATE OF YEARICK
ELIZA M DATE OF DEATH 11-18-2002 COUNTY CUMBERLAND
FILE NO. 21 05-0265 S.S/D.C. NO. 190-16-1262 ACN 05108775
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 210546-00
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 10-17-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
2,245.47
X 0.500
1,122.74
- .00
1,122.74
X .45
50.52
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 C-) AMOUNT PAID
05-25-2005 CD002542 .00 50.52
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
C IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT** C CA}, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
50.52
.00
.00
.00
PURPOSE OF
NOTICE=
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. C72 P.S.
Section 9140).
PAYMENT~
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the
reverse side.
-- Hake check or money order payable to= REGISTER OF WILLS, AGENT.
REFUND CCR)=
OBJECTIONS=
ADMIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT=
PENALTY~
INTEREST=
A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of
the Register of Wilis, any of the 23 Revenue District Offices or by cailing the special 2fi-hour answering service
for forms ordering= 1-800-362-2050; services for taxpayers with special hearing and or speaking needs=
1-800-447-$020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty C&O) days of receipt of
this Notlce by=
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-&505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three C3) calendar months after the decedent's death, a five percent
discount of the tax paid is allowed.
The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before JanuamJ 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 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 C9) months and one C1) day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982
bear interest at the rate of six (&X) percent per annum calculated at a daily rate of
All taxes which became delinquent on or after January 1, 1982 mil! bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2003 are=
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year
1982 20X .000548 1987 9X .000247 1999
1983 I&X .000438 1988-1991 IIX .000301 2000
1984 11X .00030] 1992 9X .000247 2001
1985 13X .000356 1993-1994 7X .000192 2002
1986 ]OX .000274 1995-1998 9X .000247 2003
--Interest is calculated as follows=
XNTEREST = BALANCE OF
Interest Daily
Rate Factor
.000192
.000219
.0002~7
.000137
--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 sho~n on the
Notice, additional interest must be calculated.
TAX UNPAXD X NUNBER OF DAYS DELINQUENT X DAXLY XNTEREST FACTOR