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Home My WebLink About03-0374PNCADv SORS Regi~t~:r -,;-'" \Uii~s '03 f~¥-1 AI050 April28,2003 Cumberiand Co., PA Mary Lewis Register of Wills & Orphans' Court Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 Re: ESTATE OF NORMA S. LETCHER Date of Death: February 1, 2003 S.S.N. 088-05-8681 Dear Ms. Lewis: Enclosed is our check in the amount of $10,687.50 representing PA Transfer Inheritance Tax less the 5% discount. This payment is as follows: PA Transfer Tax $11,250.00 Less: 5% 562.50 Net Tax $10,687.50 Please acknowledge receipt of the above by signing the enclosed copy of this letter and returning it to us for our files. Sincerely yours, JJD:kb Enclosure A member of The PNC Financial Services Group Two PNC Plaza 620 Liberty Avenue Pittsburgh Pennsylvania 15222 (~ PN CADV~SORS A member of The PN£ Financial Services Group Two PNC Plaza 620 Liberty Avenue Pittsburgh 15222 Pennsylvania Mary Lewis Register of Wills & Orphans' gourt Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 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 002519 ........ fold INVESTMENT MANAGEMENT & TRUST DIVISION, PNC BANK PO BOX 609 PITTSBURGH, PA 15230-9738 ESTATE INFORMATION: SSN: 088-05-8681 FILE NUMBER: 2103-0374 DECEDENT NAME: LETCHER NORMA S DATE OF PAYMENT: 05/01/2003 POSTMARK DATE: 04/29/2003 COUNTY: CUMBERLAND DATE OF DEATH: 02/01/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $10,687.50 REMARKS: TOTAL AMOUNT PAID: PNC BANK ADVISORS INVESTMENT MANAGEMENT & TRUST $10,687.50 SEAL CHECK# 0195907 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003203 PNC ADVISORS ATTN: JOHN J D'AMICO TAX DEPT PO BOX 6O9 PITTSBURGH, PA 15230-9738 ........ fold ESTATE INFORMATION: SSN: 088-05-8681 FILE NUMBER: 21 03-0374 DECEDENT NAME: LETCHER NORMA S DATE OF PAYMENT: 11/05/2003 POSTMARK DATE: 10/31/2003 COUNTY: CUMBERLAND DATE OF DEATH: 02/01/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,201.40 REMARKS' JOHN J D'AMICO CHECK# 0195958 SEAL TOTAL AMOUNT PAID: $1,201.40 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS 16-27-0:~7-3120459 REV-1500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA REV-1500 DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN HARRISBURG, PA 17128-0601 RESIDENT DECEDENT I DECEDENFS NAME (LAST, FIRST, AND MIDDLE INITIAL) FILE NUMBER OFFICIAL USE ONLY 21 -- 03 0374 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER ~' LETCHEH, NOP. MAS Z 088-05-8681 ua DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) t'~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ua 02/01/2003 I 12/30/1914 ~ REGISTER OF WILLS ua (IF APPLICABLE)SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~'~ SOCIAL SECURITY NUMBER ~"' IXI 1. Odginal Return [~] 2. SupplementalRetum I ,I 3. Remainder Retum (date of death priorto12_13_82) O Z O X J-~] 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) ~-]9. Litigation Proceeds Received ['~ 4a. Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required J-~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes ~ 10. Spousel Poverty Credit (date of death between 12-31-91 and 1-1-95) ~ 11. Election to tax under Sec. 9113(A) (Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS JOHN J. D~AMICO FIRM NAME (IfApplicable) TELEPHONE NUMBER (412) 762-8891 TWO PNC PLAZA, P2-PTPP-10-2 620 LIBEHTY AVE., PITTSBUROH, PA 15222-2705 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) F'---1 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. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 0.00 0.00 0.00 0.00 1,441.50 0.00 291,878.82 (8) OFFICIAL USE ONLY 293,320.32 10,099.16 6,523.34 (11) 16,622.50 276,697.82 0.00 (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 276,697.82 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 1 5. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (aX1.2) 0.00 x .00__ (15) 0.00 16. Amount of Line 14 taxable at lineal rete 276,697.82 x.045 (16) 12,451.40 17. Amount of Line 14 taxable at sibling rate 0.00 x.12 (17) 0.00 18. Amount of Line 14 taxable at collaterel rate. 0.00 x .15 (18) 0.00 19. Tax Due (19) 12,451.40 > · BE SURE TO ANSWER ALL ~EST'~hlS ON R~RSE SIDE AND RECHECK MATH < < 2W4645 1.000 D~'eden~'s Complete Address: S~E~ADD~SS MESSIAH VILLAGE 100 MT. ALLEN DRIVE ISTA~ I~P PA 17055 MECEANISBUI~G Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 10,687.50 562.50 (1) 12,451.40 Total Credits (A + B + C) (2) 11,250.00 0.00 1,201.40 0.00 0.00 Total Interest/Penalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 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. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1,201 o 40 , ~a,,k~e ~he~ ,p~,a~,,~b~e ,to OF WILLS, AGENT ,~ :~ PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the pmperbj 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 secudty 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 RET . uneer penalties or perjury, dec are that I have examined this return, including acco,,iwanying schedules and statements, and to the best of my know~edge and betief, it is true, correct and co~oleUteR.N Declaration of preparer other than the persenal representative is based en all information of which preparer has any knowledge. Sly .~JRE OF PERSON RESPONSIBLE FOR FILING R~:¥URN DATE ADORESS ~060 ktu~'z'EH HILL DKZVE LANSDALE, PA 19446-4827 · T~o P~P'laza~ P2-PTPP-'IO-2 For dates of eOe~l~--o~ ~t~g~r~l ! 199~-~nd be~a~e~ ~,7~j~ the tax rate imposed on the net value of transfers to or for the use of the sullying spouse is 3% [72 P.S. § 9916 (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)(I .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. 2w4646 1,000 REV-1508 EX + (1-9'7) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER LETCHER, NORMA S 21-03-0374 Includethe3mceedsoflitigationandtheda~theproceedswemreceivedbythee~ate. NIp~pe~jointly~wnedwiththeHghtofsu~ivomhipmu~ ~ disclosedonScheduleF. ITEM VALUE AT DATE NUMBER DESCRIPTION OFDEATH 1. 378.28 CAPITAL BLUE CROSS/BLUE SHIELD REIMBURSEMENT FOR OVERPAYMENT OF PREMIUM COMMONWEALTH OF PENNSYLVANIA REFUND OF OVERPAYMENT OF PA PERSONAL INCOME TAX ON BEHALF OF NORMA LETCHER FOR TAX YEAR ENDING 12/31/2002 IDS LIFE INSUI~ANCE COMPANY FINAL MONTHLY ANNUITY PAYMENT TOTAL (Also enter on line 5, R~'-~?itulation) 2W46AD 2.000 (If more space is needed, insert additional sheets of the same size) 200.00 863.22 $ 1,441.50 REV-1510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN R~SlDENT DECEDENT ESTATE OF FILE NUMBER LETCHER, NORMA S 21-03-0374 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENTAND THE DATE OF TRANSFER. ATTACH A COPY OF THE TAXABLE VALUE NUMBEI; DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (~F APPLICABLE) 1. PNC BANK, TRUS'~'~-. TRUST 291,878.82 100.00 0.00: 291,878.82 #16-27-027-3120459 TRUST UNDER REVOCABLE AGREEMENT OF NORMA S LETCHER (NOW DECEASED, NOW IRREVOCABLE) AS PER ATTACHED STATMENT TOTAL (Aisc enter on line 7, Recapitulation) $ 291,878.82 (If more space is needed, insert additional sheets of same size.) 2W46AF 2.000 Issues sorted by cusip number. PNC BANK ACCOUNT: 312045 ESTATE TAX SECURITIES VALUATION Name of Estate: NORMA S LETCHER PAGE NO. 1 DATE OF DEATH: Saturday, February 1 2003 ITEM CUSIP NO SHARES/ DESCRIPTION PRICE HIGH/ASK LOW/BID MEAN SECURITY ACCRUED COMMENTS ............. PAR VALUE DATE PRICE PRICE PRICE VALUE DIV/INT 1) 04314H204 1,600.8090 ARTISAN FDS INC 01/31 13.6900 13.69000 21,915.08 INTL FD MUT ~UND 2} 084045608 1,383.7810 EEEGER INVT PORTFOLIO TR 01/31 14.4200 14.42000 19,954.12 MID CAP VALUE NUT FUND 3) 091928622 12,562.0310 ELACKROCK FDS 01/31 10.8900 10.89000 136,000.52 PA TAXFREE INS MUT FUND 4) 128119302 631.8540 CALAMOS INV TR NEW 01/31 31.0400 31.04000 190612.75 GROWTH FD MUT FUND 5) 315805598 2,065.9330 FIDELITY ADVISOR SEE I 01/31 9.0400 9.04000 18,676.03 DIV GRW INSTL MUT FUND 6) 741479109 979.8870 PRICE T ROWE GROWTH STK FD INC 01/31 18.2800 18.28000 17,912.33 COM MUT FUND 7) 816221105 824.2770 SELECTED AMERN SHS INC 01/31 24.9100 24.91000 20,532.74 COM MUT FUND 8) 92343V104 800 VERIZON COMMUNICATIONS 01/31 38.6000 36.8400 37.72000 COM 02/03 38.9000 38.1800 38.54000 NYSE 38.13000 30,504.00 DIV $0.3850 EX 01/08/2003 EEC 01/10/2003 PAY 02/03/2003 308.08 4,636.5200 ELACKEOCK US TREASURy MM 01/31 1.0000 1.00000 4,636.52 PRINCIPAL CASH User/Man 1,026.7300 BLACKROCK US TREASURY MM 01/31 1.0000 1.00000 1,026.73 INCOME CASH User/Man 9) 992710525 10) 999271059 Grand Totals Total Principal plus Accrued interest and dividends 291,570.82 308.00 291,878.82 Thio report was prepared through APPRAISE Ver. 7.1.0, an EVALUATION SERVICES, INC. product. If there are any questions regarding this report, please contact EVALUATION SERVICES, INC. at (201) 784 8500. REV-1511 EX + (4-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER LETC]~'ER, NORMA S 21-03-0374, Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 6,919.00 5. 8. 7. M'YERS-HAR_NER FUNEI~L HOME PAYMENT FOR FUNERAL SERVICE [,ETCHER RENDERED FOR NORNA BARBAP~A GRULA REIM]~URSEMENT FOR BEREAVEMENT FUNERAL SERVICES LUNCHEON FOLLOWING 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 Fees 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 PNC BANK, N.A. FEE FOR SERVICES AS TRUSTEE-IN-POSSESSION ACTING IN THE NATURE OF AN EXECUTOR 250.16 0.00 0o00 0.00 0.00 0.00 0.00 2,930.00 10,099.16 TOTAL (Also enter on line 9, Recapitulation) $ 2W46AG 2.000 (If more space is needed, insert additional sheets of same size) REV-1512 EX + (1-97) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LETCHER, NORMA S FILE NUMBER 21-03-0374 SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS NUMBER Include un~imbum~ m~ical expenses. ITEM DESCRIPTION 1. PHARMERICA PAYMENT OF PHARMACY BILL ON BEHALF OF NOP. MA LETCHER ACCT. #5711-01-00136 2 MESSIAH VILLAGE PAYMENT OF FINAL BILL ON BEHALF OF NORMA LETCHBR, RESIDENT #000059022 3 INTERNISTS OF CENTRAL PA PAYMENT ON BEHALF OF NOP~MA LETCHER, PATIENT ACCT. #4992 4 UNITED STATES TREASURY PAYMENT ON BEHALF OF NORMA LETCHER FOR TAX PERIOD ENDING 12/31/2001 5 INTERNISTS OF CENTRAL PA PAYMENT ON BEHALF OF NORMA LETCHER, PATIENT ACCT. #4992 6 PNC BANK FEE FOR PREPARATION AND FILING OF INDIVIDUAL INCOME TAX RETURN FOR PERIOD ENDING 12/31/2002 7 INTERNISTS OF CENTRAL PA PAYMENT OF FINAL BILL ON BEHALF OF NOP~MA LETCHER, PATIENT ACCT. #4992 TOTAL (Also enter on line 10, R_~,:apitulation) $ AMOUNT 179.09 5,455.10 33.86 178.70 29.10 625.00 22.49 6,523.34 2W46AH 2.000 (If more space is needed, insert additional sheets of the same size} REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICl/~,RIES LETCHi NUMBER I1. H, NORMA S NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] GRULA, BARBARA 1060 HUNTER HILL DRIVE LANSDALE, PA 19446-4827 HEISLER, SUSAN L 16 HILLSTREAM ROAD NEWARK, DE 19711 FILE NUMBER 21-03-0374 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) DAUGHTER DAUGHTER AMOUNT OR SHARE OF ESTATE 138,348.91 138,348.91 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, A,~ APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 2W46AI 1.000 (If more space is needed, iF, seil additional sheets of the same size) BUREAU OF ZNDTVZDUAL TAXES TNHERTTANCE TAX DZVZSTON DEPT. 280601 HARRISBURG, PA 17128-0601 JOHN J DAMICO PNC BANK NA 620 LIBERTY AVE PGH CONHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOT/CE OF ZNHER/TANCE TAX APPRAISEHENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCT/ONS AND ASSESSHENT OF TAX REV-15~7 EX AFP (01-6S) ~..~ :~ATE ~¥i[15 ESTATE OF DATE OF DEATH FILE NUHBER '04 FEB 27 P"TY ACN PA 1522~umb£:riB;i~ ,~' ~0., PA 05-01-200q LETCHER 02-01-2005 21 05-057q CUHBERLAND 101 Amoun'~ Rem i'l:'l:md NORHA S HAKE CHECK PAYABLE AND REHTT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG TH/S LINE I~ RETATN LOWER PORTION FOR YOUR RECORDS 4 REV-1547 EX AFP (01-03) NOT/CE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCT/ONS AND ASSESSMENT OF TAX ESTATE OF LETCHER NORHA S F~LE NO. 21 05-037~ ACN 101 DATE 03-01-200~ TAX RETURN HAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par*nership Zn~eras~ (Schedule C) ($) ~. Mortgages/No,es Receivable (Schedule D) (~) 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) 6. Jointly O~ned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To'al Asse~s APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/Adm. Cos~s/Nisc. Expenses (Schedule H) (9) 10. Debts/Hortgege Liabilities/Liens (Schedule I) (10) 11. Tote1 Deductions 12. Ne~ Value of Tax Re~urn .oo .oo .oo .o0 lzqql.50 .00 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper pore/on of ~his form ~i~h your ~ax payment. 10,099.16 (11) ]6.622.50 (12) 276,697.82 ASSESSHENT OF TAX: 1.;. Amoun~ of Line 1~ e~ Spousal ra~e 16. Amoun~ of Line lq ~axeble e~ Lineal/CZass A ra~a 17. Amoun~ of LAne lq at Sibling rm~e 18. Amoun'lc of L/nm lq ~axable a~ Collateral/Class B rm~e 19. Prlncipal Tax Due TAX CREDITS: PAYMENT RECETpT DT$COUNT (+) DATE NUMBER TNTEREST/PEN PA/D (-) 0q-29-2005 CD002519 562.50 10-$1-2005 CD005205 .00 15. lq. NOTE: reflect figures that include the total of ALL returns assessed to date. (15) .00 x oo = .00 (16) 276,697.82 x (17) . O0 x 12 = . O0 (18) .00 x 15 = .00 (19)= 1Z,~51.qO AHOUNT pAID 10,687.50 1,201.q0 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDITIONAL INTEREST. Charitable/governmental Bequests; Non-elec~ed 9115 Trusts (Schedule J) (15) .00 He"l: Value of Es~:a~e SubSac~: ~co Tax (1~) 276,697.82 Zf an assessment ~as Assued prevAously, l~nes 1~, 15 and/or 16, 17, 18 and :19 ~All TOTAL TAX CREDIT I 12,q51.~0 BALANCE OF TAX DUEl .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CREDIT" (CR), YOU NAY DE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTZONS.)--~ 291~878.8Z (8) 295,520.52 RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNZN- ISTRATIYE CORRECT/ONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class S (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes et the lawful Class B (collateral) rate on any such future interest. To ~ulfi11 the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 914a). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which ams not requested on the Tax Return, say be requested by completing an "Application for Refund of Pennsylvania Inhecitance and Estate Tax" (REV-1515). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-$6Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-&OO-447-30ZO iTT 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 must object within sixty [60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZS-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. 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 (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day free the date of death, to the date of payment. Taxes which became delinquent before January 1, 198g bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest mt · rats which will vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: Interest Daily Xnterest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 2OX .000548 1987 9X .000247 1999 7X .000192 1983 16X .000438 1988-1991 IIX .000301 2000 8Z .000219 1984 Ill .000301 1992 9X .000247 2001 9~ .000247 1985 13Z .000556 1993-1994 7Z .O0019Z 200Z 6Z .000164 1986 lOX .000274 1995-1998 9Z .000247 2003 SZ .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 wi11 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.