HomeMy WebLinkAbout03-0273 PETITION
es,ate oS/eq,¢/,5-ZLz
also known as
No.
To:
FOR PROBATE and GRANT OF LETTERS
Deceased.
Social Security No. / '7
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut
in the last wilt of the above decedent, dated
and codicil(s) dated
Register of Wills for the
County of C O/v'/ i/'~. ~tOL/O,v't_~n the
Commonwealth of Pennsylvania
named
, 19__
(state relevanl circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~vt-y,'~) Z:~' q'(>L,':?'w't'~ County, Pennsylvania, with
h_,,~./7. _ last family or principal residence at l~J/2 z~- CJ~'/~"x,'~K'~, ~ f-
l
(list street, number and muncipality)
Decendent, then '7 ~ years of age, died (J~')-" 7 ,4~
at ./-~/ _5'?//C/, ~ "7' !4r55./'7> C'/7/71~ /f/LC
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
WHEREFORE, petitioner(s) respectfully r__~_~ues_.t(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters '_----~_~z~~~
ltestamentary; admi~stration c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PE~NNSyLVANIA
COUNTY OF _',,~-~'ilIltl'b~c~L¥'~O, f
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ~(~5~
before me this cx~."Y'7",O' day of
No. ~/- O~-
Estate Of /¢fi~v ~//~-///'~,///~,9 , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ,/9~W o~,:~' )~oaQ~, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated .'~-~ ,~vza~-.e. .~/. '2~,~~-~
described therein be admitted to probate and filed of record as the last will of
/'7')/¢/~f,, ~_//~,w /'>~//,R~/d ;
and Letters
are hereby granted to
FEES
Probate, Letters, Etc ..........
Short Certificates( ) ..........
enunciation ................
TOTAL
Filed .a~...-.~. ,-..~..~. ....................
R~egister of Wills
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WItNEss
(each) a subscribing witness to the
law, depose(s) and say(s) that
codicil
will presented' herewith, (each) being duly qualified according to
present and saw
the testat , sign the same and that signed as a witness at the
request of testat__ in h~ presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
19__
Register
(Name)
(Addres~i"%., ...x'
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that.
testat O'/~ of (one of the
that J
familiar with the signature of /tT/gk:)~,' ...:~'~'Z 'A_3V' ~ ,L/'/,~Zr-v'
~l~icil --
subscribing witnesses to) the will presented herewith and
codicil
believes the signature on the will is in the handwriting of
(Name) '~ '
Register
(Address)
(Name)
(Address)
to the best of ]iQ ~_i knowledge and belief.
Sworn to or affirmed and subscribed before ,~'
me this ,:~ ~'/'~ day of ~' ~~~/~
%'%REGISTER OF WILLS OF COUNTY
OATH OF SUB BING WITNESS
c~dicil
(each) a subscribing witness to th~/will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that / present and saw
the testat.
request of testat
other subscribing witfiess(es)).
Sworn to or affirmed
and
subscribed
before
me this ,: day of
, sign th4"same and that signed as a witness at the
.,ih h__ presence and (in the presence of each other) (in the presence of the
(Name)
.... '"'% (Address)
Register N
,%OVame)
(~l~ldress)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
~" c~rrl familiar with the signature of ~q ~LL~N ~L~E~-I~
codicil
of (one of the subscribing witnesses to) the ~ presented herewith and
testat
codicil
that ~ believe8 the signature on~s in the handwriting of
to the best of__ !3q X , . knowledge and belief.
Sworn to or affirmed and subscribed before
me this o.9~, ~',,'-' day of
/Agt.~ /,~_~.~, Register
(Name)
f A ddress)
(Name)
~ ~t4 ¢.~u6'ro~,,l ~qT 44 04
(Address)
LAST WILL AND TESTAMENT OF ~RY ELLEN MILLIKEN
I, MARY ELLEN MILLIKEN, of the Borough of Mechanicsburg,
County of Cumberland and State of Pennsylvania, being of sound
and disposing mind, memory and understanding, do make, publish
and declare this my Last Will and Testament, hereby revoking and
making void any and all prior Wills by me at any time heretofore
made.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can be conveniently
done.
I give, devise and bequeath all the rest, residue and
remainder of my estate, real, personal and mixed, whatsoever and
wheresoever the same may be situate, to my husband, JOHN B.
MILLIKEN, absolutely and unconditionally.
In the event that my husband, JOHN B. MILLIKEN, should
predecease me, or should he die at about the same time as I do,
such as in an accident common to both of us, then in either such
event, I give, devise and bequeath my entire estate, of whatsoever
nature and wheresoever the same may be situate, to my two
daughters, to wit, KATHY ANN MILLIKEN and ~REN ARLENE MILLIKEN,
-1-
share and share alike, per st~rpes.
LASTLY, I nominate, constitute and appoint my husband,
JOHN B. MILLIKEN, Executor of this my Last Will and Testament,
and in the event that my said husband should predecease me, or
should he be unable or unwi]!ing to serve in such capacity for
any reason, then in such event, I nominate, constitute and appoint
THE FIRST BANK AND TRUST COMPANY OF MECHANICSBURG, PA., Executor
of this my Last Will and Testament, in his place and stead.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
Ellen Milliken
(SEAL)
-2-
Signed, sealed, published and declared by the above named,
MARY ELLEN MILLIKEN, as and for her Last Will and Testament, in
the presence of us, who have subscribed our names hereto as
witnesses, at the request of said testatrix, in her presence and
in the presence of each other.
-3-
LAST WILL AND TESTAMENT
OF
MARY ~'~.~'~'f'~=~, MILLIi~EN
J. ROBERT STAUFFER
ATTOHNEY AT LAW
MARKET SQUARE BUILDING
MECHANICSBURG, PA. 17055
REV-1500 EX + {6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 171Z8-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
D DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
E Milliken Mary E.
CE DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-DO-YEAR)
D 10/07/2002 07/10/1924
E (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N
T Milliken, John B.
CAPB
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OFFICIAL USE ONLY
FILE NUMBER
21-03-0273
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
174-20-3094
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(date of death
3. Remainder Return priorto 12-13-8Z)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
1. OriginaIReturn 2. SupplementaIReturn
4. Limited Estate 4a. Future lnterest Compromise (date of death after 12-1Z-8Z)
6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0
(Attach copy of Will) (Attach copy of Trust)
["--'] 9. Litlgation Proceeds Received [--]10. Spousal Poverty Credit r--] 11. Election to tax under Sec. Ol13(A)
(date of death between 12-31-91 and 1-1-95) (Attach Sch O)
NAME
;James D. Bo~ar Esquire
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717,/737-8761
COMPLETE MAILING ADDRESS
One West Main Street
Shiremanstown, PA 17011
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
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
'None
OFFICIAL U~ ONLY
(8) 1,559.18
(11). O. O0
(12) 1,559.18
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)
1,559.18
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
1,559.18
X .0 0 (15)
X .0 45 (16)
X .12 (17)
X .15 (18)
(19)
0.00
0.00
0.00
0.00
0.00
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
312 Coover Street
CITY
Mechanicsbur~
ISTATE
ZIP
I 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) 0.00
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3) 0.00
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 re~luest a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (SA) 0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B} 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Total Credits ( A + B + C ) (2)
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ......................... ~ ~
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care? ...................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~] ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [---] ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
beneficiary designation? ................................ r-~ ~
which
contains
a
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative is based on ali information of which preparer has any knowledge.
iF PERSON RESPONSIBLEJ=OREILING RETURN John B Milliken DATE
~ ~ 312 Co;ver Street
'-' -- ~h-~ i~-s-I~.~--~ 7- ~-- i-~6 ~- .................... 6/23/03
SIGNATURE OF PRE.~ARER OTHER THAN REPRESENTATIVE James D Bogar Esquire
,,, :- ....................
For dates of deatil 0~ after ~J~ily' 1; 1994 and i3ef0~e ~Jar~uary' 1; 1'995; iile ia~ rate imposed. o~ ih; ~'et'value Of tr~n;fers to oi fei tile use of {he
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 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 the 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. 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 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) ;>000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESl DENT DECEDENT
ESTATE OF
Mary E. Milliken SS# 174-20-3094
SCHEDULE B
STOCKS & BONDS
10/07/2002
FILE NUMBER
21-03 -0273
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 74 shares AT&T Corporation 21.07 1,559.18
TOTAL (Also enter on line 2, Recapitulation) 1,559.18
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97)
REV-1513 EX * (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary E. Milliken SS~/ 174-20-3094
SCHEDULE J
BENEFICIARIES
10/07/2002
FILENUMBER
21-03-0273
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outfight spousal distributions, and
transfers under Sec. 9116(~(1.Z)]
John B. Milliken
312 Coover Street
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Spouse
AMOUNT OR SHARE
OF ESTATE
Rest, residue
and remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
LAST WELL AND TESTAMENT OF ~RY ELLEN MILLIKEN
!, ?.ARY ELLEN MilLiKEN, of the Borough of Mechanicsburg,
County of Cu~oerland and State of Pennsylvania, being of sound
and dispos~~ng mind, memory and understanding, do make, publish
and de~o'~.__. ~ this my _~.ast, W~._~ a~nd Testament, hereby revoking and
making void any and all prior Wills by me at any time heretofore
made.
I direct the payment of all my Just dabts and funeral
expenses as soon after my decease as the sa~e can. bs conveniently
do~eo
°
_r ~:iv~, devise and becue~h~ all the r:.s~,* residu~ and
?e?.~i~'~ Ol'~ ~C ..... ~[~dj
MiLLiKE.~, ~b~c!utely and ~,:onditlonaili.
in the event that mw husband, JOHN B. MILLIKEN, should
oredecease me, o? should he die ab about the same time as I do,
such as in an accident common to both of us, then in either such
event, I give, devise and bequeath my entire estate, of whatsoever
nature and wheresoevep ~he same may be situate, to my two (2)
daughters, %o wit, KATPTI ANN MiLLE&EN and KAREN ARLENE MILLIKEN,
share and share alike, per stirpes.
LASTLY, I nominate, constitute and appoint my husband,
JOHM B. MILLIi{EN, Executor of this my Last Will and Testament,
and in the event that my said h~o~.=nc s~oul~ predecease me, or
should he be unable cr unwilling to s~rve in such cap~city for
any reason, then in such event, I nominate, constitute and appoint
THE FIRST BANUf AND TRUST COMPACt OF MECHANICSBURG, PA., Executor
of this my Last Will and Testan~nt, in his place and stead.
iN WITNESS WP~--~R~EOF, I have hereunto set my hand and seal
this ~Y3~- day of /~C~-~9~T~' , A. O., 1985.
Mary Ellen
(S~%L)
-2-
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Mary E. Milliken
Date of Death: October 7, 2002
Will No. 21-03-0273 Admin. No.
To the Register:
I certify that notice of estate administration required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
March 31, 2003:
Name Address
John B. Milliken
312 Coover Street
Mechanicsburg, PA 17055
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except:
None
Date: 6/23/03
Capacity:
J a~es D. ~o.~r, Esquire
One West Mb~ Street
Shiremanstown, PA 17011
(717) 737-8761
Personal Representative
X Counsel for Personal
Representative
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Mary E. Milliken
Date of Death: October 7, 2002
Will No. 21-03-0273
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
State whether administration of the estate is complete:
Yes Xx No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No XX
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes XX No
d. Copies of receipts, releases, joinders and
approvals of. formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: 6/23/03
~i~n~tJre
James D.
Esquire
Name (Please tyre or print)
One West Main St.
Shiremanstown, PA 17011
Address
(717) 737-8761
Tel. No.
Capacity:
__Personal Representative
(MAH:rmf/AM3)
x
__Counsel for personal
representative
BUREAU OF INDIVIDUAL TAXES
TNHERZTANCE TAX DTVTSTON
DEPT. 2:80601
HARRISBURG, PA 17118-0601
JAHES D 80GAR ESQ
I W HAIN ST
SHIREHANSTONN
CONHON#EALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLOHANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-16~7 EX AFP (0'1-05)
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACH
08-11-2005
HZLLIKEN
10-07-Z001
21 05-0275
CUHBERLAND
101
Amount Remitted
NARY E
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGTSTER OF HILLS
CUHaERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LO#ER PORT/ON FOR YOUR RECORDS ~
REV-1547 EX AFP [01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR
DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLIKEN MARY E FILE NO. 21 05-0275 ACN 101 DATE 08-11-2005
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORI$INAL RETURN
1. Real Estate (Schedule A) (1),
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
~. Nortgages/Notas Receivable (Schedule D) (~)
5. Cash/Bank Deposits~Misc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Costs/H/sc. Expenses (Schedule H) (9)
10. Debts/Hortgag~ Lieb/lities/Liens (Schedule Z) (10)
11. TotaZ Deductions
12. Net Value of Tax Return
13.
1~.
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate Subject to Tax
O0
1~ 559 18
O0
O0
O0
O0
O0
(8)
.00
.00
NOTE: To insure proper
credtt to your account,
submit the upper portion
of this fora wlth your
tax payment.
NOTE:
1,559.18
(11) .off
(12) 1,559.18
(15) .00
(1~) 1,559.18
Z~ an assessment was lssued previously, lines 14, 15 and/or 16, 17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
will
ASSESSHENT OF TAX:
15. Amount of Line 1~ at Spousal rata
16. Amount of L/ne 1~ taxable at LLneal/Class A rata
17. Amount of Line 1~+ at Sibling rata
18. Amount of Line lq taxable at Collateral/Class B rata
19. Principal Tax Due
TAX CREDITS:
PAYtlENT RECEZPT DT~CUUNT (+J
DATE NUNBER :]:NTEREST/PEN PA]:D (-
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(16) 1,559.18 x O0 = .00
(16) .00 X 0(~5 = .00
(17) .00 x 12 = .00
(18) .00 x 15 = .00
(19)= . O0
ANOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
IF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECT[OHS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying an or before December 1g, 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 far
life ar for years, the CommonNealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of 2000. (TI P.S.
Section 91q0).
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 NILLS~ AGENT
A refund cf a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance end Estate Tax" (REV-1315). Applications are available et the Office
of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-50Z0 (TT only).
Any party in interest not satisfied with the appraisement, elloaance, or disallamance of deductions, or assessment
of tax (including discount or interest) as shomn 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. ZGIOZ1, Harrisburg, PA 171lB-lOll,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in mriting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for [nheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is alloead.
The 1SI tax amnesty non-participation penalty ]s computed on the tote1 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.
198Z ZOZ .000548
1983 16Z .000638
198~, llZ .000501
1985 157. . O 00356
1986 ZOZ .000Z74
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Interest is charged beginning aith first day of delinquency, or nine (9) months end one (1) day from the date of
death, to the date of payment. Taxes ahich became delinquent before January 1, 198Z bear interest at the rate cf
six (67.) percent per annum calculated at a daily rate of .000164. All taxes mhich became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary fram calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z005 are:
Interest Daily Interest Daily Interest Daily
Rate Factor Year Rate Factor Year Rate Factor
1987 9Z .000247 1999 7Z .O0019Z
1988-1991 117. .000501 ZOO0 BZ .000219
199Z 9Z .000Z47 ZOOl 9Z .000247
1993-1994 7Z .O00Igz ZOO2 62 .000164
1995-1998 9Z .000Z47 2003 5Z .000157
X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (1S) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.