HomeMy WebLinkAbout03-1004 PETITION FOR GRANT OF LETTERS
Estate of Nestor, Loretta D. No. ~.?--~)~'
also known as
Petitioner(s), who is/are 18 years of age or older, apply)les) for:
, Deceased
Social Security No. 208033811
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix
['~ Decedent, dated and codicil(s) dated
named in the Last Will of the
State relevant c rcur~$~.ances, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: per,~er~te lite, durante absentia; durante minodtate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence
Jacqueline A. Kirby
dau,qhter
214 Lamp Post Lane
Camp Hill, PA 17011
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at 355 S. Sportin~ Hill Rd. #30, Mechanicsbur,q, PA Hampden Township, (list street, number and municipality)
Decedent, then 89 years of age, died Nov. 19 ,2003 , at Holy Spirit Hospital, Camp Hill, PA
Decedent at death owned property with estimated values as follows: (Location)
(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 ........................................................................................ $
Total
Real Estate situated as follows: none
2751000.00
275,000.00
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
I Typed or printed name and residence
Signature
Jacqueline A. Kirby
214 Lamp Post Lane
Camp Hill, PA 17011
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and 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 representative(s) of the
Decedent, Petitioner(s) will well and truly administer the estate accordin(>,to law:
Sworn to and affirmed and subscribed '-~ :"~('[~ ' ~ [' c ~_
Ja(~elir~ A. Kirby
before me this A ~ , day of
DECREE OF REGISTER
Estate of Nestor. Loretta [),
also known as
Deceased
Social Security No: 208033811 Date of Death: 11/19/2003
AND NOW,~'~-~,~ ~,.- ~ ,,~..~_ , in consideration of the Petition on the
reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary ~ of Administration
((c.ta., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate)
are hereby granted to
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the Last Will of Decedent.
FEES
Letters .................................... $
Short Certificates(s) ............... $
Renunciation .......................... $
Extra Pages ( ) ...............$
I.T.R ....................................... $
JCP Fee ................................. $
Inventory ................................ $
Other ...................................... $
TOTAL ............................. $
eg'ste - of Wills
Signature
Attorney: James H. Turner
I.D. No: 2928
Address: 4415 N. Front St.
Harrisbur~ PA 17110
Telephone: 717-232-4551
DATE FILED: 12/03/2003
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9650923
No.
Local Registrar
NOV 2 '1 2OO3
Date
Rev 2/87
"- Loretta D. Nestor
COMMONWEALTH OF: PENNSYLVANIA ,, DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
~,. Cumberland
~CEOEm'S usu^t occu~e,o.
,,.. Teacher
355 S. Sporting Hill Road
Mechanicsburg, Pa 17050
I ! I, Jan 18,14 / Clairton,Pa
I c~I l'- 17, Ik.
L ' BORO' I%~P O~ 0~ATH ri_J:A~&/TY "*M~
[ KI~ ~ BUSINES~IN~STRy ] ~OECE~NT EVERIN
I I Ub.~ES? I ~S~N~C~ I Ne~ W~ [ ..~V~S~
I"~- Jeffe~on Hills ,, '--- '-~
I. I,,. ~ I1,.w~a~ ~,,.
ACTU~ 178. ~,. Pa
.~s,~ . - H~
,,. Matthew Doyle
~. Jacqueline A. Kirby
~ ~.o c._,.~i ..--.,-,,.o [~V2.'.%~,.~f
~ E~ ~y~ { ~ ~ ~ AS A C~E~E ~:
,,. Mary Dailey
INFO~T'S ~ ~X~aSS ~. C~a,,. ~. Z~ Cm~J
2~,. 214 Lamp Post Lane Camp H'i ] 1, Pa 17011
I,,~. Rost Harrisburg Crematoryl,,d' Harrisburg, Pa
l~/v4/, "'1
IN,JURy AT WORK?
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No.:
Loretta D. Nestor
November 19, 2003
2003-01004
TO THE REGISTER:
I certify that notice of beneficial interest 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 December 16, 2003:
Nllme
Jacqueline A. Kirby
Date: 12/16/03
Address
214 Lamp Post Lane
Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a).
'James H. Turner, Esquire
Turner and O'Connell
4415 North Front Street
Harrisburg, PA 17110
(717) 232-4551
Counsel for personal representative
REV 1 SOO EX ~ (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA17128~601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL SOCIAL SECURITY NUMBER
I"-
Z Nestor, LorettaD. 2 0 8- 0 3 - 3 8 1 1
LEI
t'~ DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
LU REGISTER OF WILLS
~ 11/19/2003 01/18/1914
~'J (If APPLICABLE) SURVIVING SPOUSE'S NAME {LAST. FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z
J'~l. Odginal Return
r-'~ 4. Limited Estate
[~]6. Decedent Died Testate (^t~ch copy of ~)
r-~9. Litigation Proceeds Received
--']2. Supplemental Retum
~'-~ 4a. Future Interest Compromise (d~ ofde~ after 12-12-82)
[~7. Decedent Maintained a Living Trust (AttaCh copy of Trust)
] 10. Spousal Pover[y Credit (date of death bet~en 12-31-91 and 1-1-95)
NAME
James H. Turner
FIRM NAME {If Applicable}
Turner & O'Connell
TELEPHONE NUMBER
717-232-4551
COMPLETE MAILING ADDRESS
4415 N Front Street
Harrisbur,q
r~3. RemainderReturn (dateofdeathpmrto12-13-821
]5. Federal Estate Tax Return Required
__ 8. Total Number of Safe Depceit Boxes
]11. Election to tax under Sec. 9113(A) (^~ach Sch O)
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 {5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaoeous Non-Probate Prope~ (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 ~) (10)
11. Total Deductions (total Lines 9 & 10)
12 Net Vatae 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)
PA 17110
r
16,336.71!
265 81 ~ , :: ,~-~
21254.19 ~ z, .-
1,643.71
1,428.00
(11)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
OFficiAL us~ ONLY
283~875.71
3~071.71
280~804.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfem under Sec 9116 (a)(1
16. Amount of Line 14 taxable at tlneal rate
17. Amount of Line 14 taxable at sibtlng rate
18 Amount of Line 14 taxable at collateral rate
19. Tax Due
280~804.00 x .045
X .12
X .15
(14)
280~804.00
(15)
(16)
(17)
(18)
(19)
12~636.18
12,636.18
Decedent's Complete Address:
355 S. Sporting Hill Road, Apt. 30'STREETADDRESS
CITY
Mechanicsburg
I STATE PA I ZIP 17050-7702
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Povedy Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Total Credits ( A + B + C ) (2)
(1) 12~636.18
Total Interest/Penalty ( D + E ) (3)
(4) 0.00
(5) 1 2,636.1 8
(5A)
(SB) 12,636.18
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transfe~ed; ........................................................................... [] []
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 f 2, 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 preperty which
contains a beneficiary designation? ....................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE O AND FILE IT AS PART OF THE RETURN.
Under penaltles of perlury, 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 prerParer other than the personal representdive is based on all informalion of which preparer has any knodedge.
SIGNATUI:~E'OI~ PE,~RSON RESPONSIBLE FOP~.~ILINO~ RETURN
ADDRESS 1~14 ¢_.~mp Post Lane
"'Camp Hill
DATE f
PA 17011-1463
SIGNAT~
ADDRE~'~'-- '~['415 N'. Front ~treet
Harrisbu r.cj
DATE /
PA 17110
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a)(1.1) (i)].
For dates of death on or after 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.
REV-1503 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
Nestor. Loretta D.
All properly jointly-owned with right of suwivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 14,568.14
Marathon Oil Stocks
499.251 shares at $29.18 per share.
United States Steel Corporation
78.117 shares at $22.64 per share
1,768.57
TOTAL (Also enter on line 2, Recapitulation) $ 16,336.71
(If more space is needed, insert additional sheets of the same size)
REy-1508 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Nestor. Loretta D.
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property Jointly-oumed with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Van Kampen Mutual Fund
Penn Imit 87
20 Units at $197.05 per unit.
Van Kampen Mutual Fund
Penn Imit 103
12 Units at $219.16 per unit.
UBS Financial Services, Inc.
Resource Management Account #VP 32877 01
3,941.00
2,629.92
258,713.89
TOTAL (Also enter on line 5, Recapitulatior $ 265~284.81
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Nestor. Lorett~ ~r
If an asset was made joint within one year of the decedent'e date of death, it must be reported on Schedule B.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Jacqueline A. Kirby Daughter
B
C
214 Lamp Post Lane
Camp Hill, PA 17011
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
"lUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTERE~
1. A. Citizens Bank Checking Account 4,508.38 50. 2,254.1(.
Account # 610058-638-3
TOTAL (Also enter on line 6, Recapitulation) $
2~254.1.c
(If more space is needed, inser~ additional sheets of the same size)
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Nestor, Loretta D.
Debts of decedent must be reported on Schedule [.
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
Coakley's Restaruant & Pub
Myers-Hamer (obituary)
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s}
Social Secud~ Number(s)/EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees Turner & O'Connell
Family Exemption: (if decedent's address is not the same as claimant's, attach explanation)
Claimant
Zip
Street Address
City State Zip
Relationship of Claimant to Decedent
Pmhata Fees Cumberland County Register of Wills
Accountant's Fees
Tax Return Preparei's Fees
Publishing of Estate
TOTAL (Also enter on line 9, Recapitulation) $
277.19
99.41
795.00
295.00
177.11
1,643.71
(If more space is needed, insed additional sheets of the same size)
RE¥-1512 EX + (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES~ & LIENS
ESTATE OF FILE NUMBER
Nes~Qr. Loretta D.
Include unrelmbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Steve Dukes
income Tax Preparation Services
Internal Revenue Services
2003 Federal Income Tax Return
Commonwealth of Pennsylvania
2003 Commonwealth Income Tax Return
65.00
1,152.00
211.00
TOTAL (Also enter on line 10, Recapitulation) $ 1 ~428,00
(If more space is needed, inse~t additional sheets of the same size)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Nestor. [ )retta D. RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116(a) (1.2)]
Jacqueline A. Kirby
214 Lamp Post Lane
CampHill, PA 17011
Daughter
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE,
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 ][! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
100%
)N REV-1500 COVER SHEET
Recorded-.Off~c~ of
TURNER AND O'CONNELL
Attorneys at Law
4415 North Front Street
Harrisburg, PA 17110
Cumberland County
Register of Wills
1 Courthouse Square
Carlisle, PA 17013
IN THE MATTER OF
THE ESTATE OF
LORETTA D. NESTOR
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 2003-1004
STATUS REPORT UNDER RULE 6.12
Register of Wills of Cumberland County
Name of Decedent:
Social Security Number:
Name of Personal Representative:
Capacity:
Loretta D. Nestor
208 03 3811
Jacqueline A. Kirby
Administratrix
The administration of the estate is complete.
An account was stated to the parties in interest and the parties released the personal
representative.
I certify under penalty of perjury that the foregoing information is correct to the best of
my knowledge, information and belief.
Date: October 20, 2004
James H. Turner, Esquire
TURNER AND O'CONNELL
4415 North Front Street
Harrisburg, PA 17110
(717) 232-4551
Attorney for Estate
i'
BUREAU OF INDIVIDUAL TAXES
THHERZTANCE TAX DI'VTSION
DEPT. 280601
HARRISBURG, PA 171Z8-0601
COHMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-I~7 EX AFP C01-05)
JAMES H TURNER
TURNER & OCONNELL
qql5 N FRONT ST
DATE 10-11-200q
ESTATE OF NESTOR
DATE OF DEATH 11-19-2005
FILE NUHBER 21 05-100q
COUNTY CUMBERLAND
ACN 101
Amoun~ Remit "ced
LORETTA D
HAKE CHECK PAYABLE AND REHIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA I70I$
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS 4
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF NESTOR LORETTA D FILE NO. 21 05-100~ ACN 101 DATE 10-11-200~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
I Real Estate (Schedule A)
2 Stocks end Bonds (Schedule B)
$ Closely Held Stock/Partnership Interes~ (Schedule C)
Mortgegas/No*as Receivable (Schedule D)
Cash/Bank Deposits/Nisc. Personal Property (Schedule E)
6 Jointly Owned Property (Schedule F)
7 Transfers (Schedule G)
8 To~el Assets
APPROVED DEDUCTIONS AND EXENPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H)
10. Debts/Hortgege Liabilities/Liens (Schedule I)
11. Tote1 Deductions
12. Net Value of Tax Ra~urn
(1)
(2)
($).
(5)
(6)
(7)
.00
167556 71
O0
O0
265728~.81
2125~.19
O0
(8)
(9)
1,6~5.71
(lO)
1,~28.00
(11)
(12)
15.
1~.
NOTE:
ASSESSMENT OF TAX:
15. Amount of Line 1~ e~ Spousal rata
16. Amount of Line 1~ taxable at Lineal~Class A rata
17. Amount of Line lq a~ Sibling rate
18. Amount of Line lq taxable at Collateral/Class B rate
19. Princi)al Tax Due
TAX CREDITS
PAYMENT RECEIPT DISCOUNT (+)
DATE NUNBER INTEREST/PEN PAID (-)
08-08-ZOOq CDOOqZSZ .00
Charitable~Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15)
Nat Value of Estate Subject to Tax
If an assessment ,as lssued previously, lines 14, 15 and/or 16, 17,
reflect figures that lnclude the total of ALL returns assessed to date.
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
285,875.71
280,80q.00
.00
Z80,80q. O0
18 and 19 will
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(15) .00 x O0 = .00
(16) z80,806~.00 x Oq5= 12,656.18
(17) .00 X 12 = .00
(la) .00 x 15 = .00
(19)= 12,656.18
AMOUNT PAID
12,656.18
TOTAL TAX CREDIT { 12,656.18
BALANCE OF TAX DUEl .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADH/N-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the CoamonwaaZth 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 ZZO.O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S.
Section 91O.0).
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 payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which was not requested on the Tax Return, amy be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-362-Z050~ services for taxpayers with special hearing and ! or
speaking needs: 1-800-O.O.7-30Z0 (TT only).
Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 2BIOZ1, Harrisburg, PA 171Z&-10Z1, OR
--election to have the matter determined at audit cf 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. 180601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. See page 5 of the booklet "'Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid aithin three (3) calendar months after the decadent's death, a five percent (SX) discount of
the tax paid is allowed.
The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one [1) day from the data of
death, to the date of payment. Taxes which became delinquent before January 1, 1962 bear interest at the rate of
six (SI) percent per annum calculated at a daily rate of .00016O.. A11 taxes which became delinquent on and after
January 1, 19BI will bear interest et a rate which will vary from calendar year to calendar year with that rate
announced by the PA Oepartment of Revenue. The applicable interest rates for 19AZ through ZOOO. are:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ZOZ .000546 ~T~'8-1991 111 .000501 ~ 9z .000247
1983 161 .000o.58 1992 97. .0001~7 2001 6X .00016~
198~ 111 .000501 1995-199~ 77. . ooolgz 2005 52 .00013?
1965 151 .000556 1995-1998 9Z .0002~7 200~ ~Z .000110
1986 102 .00027~ 1999 7Z .000192
1987 lOZ .00027o. ZOO0 7Z .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY ZNTEREST FACTOR
--Any Notice issued after the tax becomes deIinquent w111 refXect 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.