HomeMy WebLinkAbout03-0428CON#ONNEALTH OF PENNSYLVANIA
DEPA~RTNENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171ZB-060!
REV-1;bS EX AFP
ZNFORMATZON NOTICE
AND
TAXPAYER RESPONSE
FZLE NO. Z! 05 q~
ACN 051190q8
DATE 05-1q-2005
EVA N HOGAN
LOT 97
7075 CARLISLE PIKE
CARLISLE
Rec!:~:; fi:~ ! . OF KATHLEEN E LOUCKS
· NO. 199-07-7175
DATE OF DEATH 0:5-21-2005
'03 I'tAY 22 PI2C,'~TY CUMBERLAND
TYPE OF ACCOUNT
E~SAVZNGS
[]CHECKING
E~TRUST
E~CERTIF.
REHIT PAYHENT AND FORHS TO:
REGISTER OF HILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
ALLFIRST FTNANCIAL SERVICES has provided the Department alth the information listed bsloa which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. 1'f you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form ar,d return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may b~
CONPLETE PART 1 BELO# ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Aocoun'~ No. 0056575201 Da~e 12-28-1975
Established
Accoun~ Balance 11,782.55
PePcen* Taxable X 5 0.0 0 0
Amoun~ Sub~ec~ ~o Tax 5,891.17
Tax Ra~e X .15
Po~en~ial Tax Due 88~. 68
PART TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice must accompany your
payment to the Register of NiIIs. Hake check
payable to: "Register of Hills, Agent".
NOTE: If tax payments are 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 aJ!l become delinquent
nine [9) months after the date of death.
CHECK
ONE
BLOCK
ONLY
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
a discount or avoid interest, or you amy check box "A" and return this notice to the Register of
#il!s and an official assessment wi1! be issued by the PA Department of Revenue.
~. ~ The above asset has been or ail1 be reported and tax paid atth the Pennsylvania Inheritance Tax return
to bm fi!ed by the decedent's representative.
~Ths above information is incorrect and/or debts and deductions mare paid by you.
C.
You must complete PART ~and/or PART ~-~beloa.
2. Account B~lance 2,,
3. Percent Taxable 3 X
q. Aeoun~ SubSec~ ~o Tax q
S. Debts and Deductions E -
6. Amoun~ Taxable 6
7. Tax Ra~e 7 X
8. Tax Due 8
PART
TAX
LINE
If you indicate a differen~ ~ax ra~e, please s~a~e your
relationship ~o decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1. Da~e Es~abZished 1 , '~ - --~i - 1 o
///
PART
DATE PAID
,,,//
DEBTS AND DEDUCTIONS CLAZMEn
PAYEE DESCRIPTION
TOTAL (En~er on Line S of Tax
AMOUNT PAID
Under penalties of per3ury, T declare ~ha~ ~he facts I have reported above are ~rue, correc~ and
co_apieCe ~o ~he bes~ of ay knowledge and belief. HOME (
TAXPAYER SIGN~URE TELEPHONE NUMBER
GENERAL ZNFORHATION
1. FAILURE TO RESPOND #ILL RESULT IN AN OFFICIAL TAX ASSESSNENT with appllcable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decadant's data of death.
3. A joint account is taxable even though the decedent's name was added as a matter of convenience.
4, Accounts (including those held between 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 wife more than cna 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 - If the information and computation 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 tee copies and submit them aith your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue mill issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Rills.
Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedant's representative, place an "K" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Ospt ZOO601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and completa Parts Z and 3
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Nills of the county indicated. Tho PA Department of Revenue will issue an official assessment (Fora REV-ISq8 EX) upon receipt
of the return from the Register of Hills.
TAX RETURN - PART Z - 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 II/II/BI: Accounts which the decedent put in joint names within one (1) year of death are
taxable fully as transfers. However, there is an exclusion net to exceed $3,000 per transferee regardless of tho value of
the account or the number of accounts hold.
If a double asterisk (aa) 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.
Z. 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 follees:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
I DXVIDED BY TOTAL NUNBER OF DXVXDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT ONNERS SURVXVING JOINT ONNERS
Example: A joint asset registered in the name of the decedent and two other persons.
I DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent's death or accounts oaned by the decedent but held
in trust far another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE
DNNERS DR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established aithin one year of death by
the decedent.
! DIVIDED BY 2 [SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by tho percent taxable (line 3).
S. 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 t),
7. Enter the appropriate tax rate (line 73 as determined below.
De:ks of Des:kb Spouse Lineal Sibling Colla:kerel
07/01/94 :ko 12/$1/94
01/01/95 :ko 06/30/00 OX 6Z
07/01/00 ~o presen~ OX fi.EZ~ 12X 15Z
xTha tax rate imposed on the net younger at
death to or for the use of a natural parent, an adoptive parent, or a stapparent of the child is OX.
The lineal class of heirs includes grandparents, parents, children, and lineal dmscendents. "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, ahether 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.
CLAIHED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIHED
AlieNable debts and deductions ara determined as follows:
A. You legally ara responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
BJ 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 & i/Z" x 11". Proof of
payment amy ba requested by the PA Department of Revenue.
[
uiaremont Nursing &
375 Claremont Drive
Carlisle PA 17013
(7-27) 243-2031
12 PATIENT NAME
Loucks, Kathleen E
~4 BIRTHDATE hSSID(~ 16 MS~ 1 ~-~-i~.'
0219192 F 01180 'i '1
OESCRIPI3ON
R & B NURSING CARE - SEN
R & B.,NURSING CARE - SE~
PHARMACY
TOTAL CHARGES
~ PAY~
PRIVATE PAY
Loucks Ka%hleen E
63 TREATUENT AUTHORIZATION COOES
~7 PRIN, DIAG. CO.
PRINCIPAL. PROCEDURE
84 REMAPJCS
Reha~ 2 T3
~ / 4287
13 PATIENT ADDRESS
)HRJ22STATI23 MEDICALRECORDNO. I ~
L_
,I 44 HCPCS I RATES 45 SERV. DATE 48 SERV. UNITS 47 TOTAL CNARGES
175.0(~ 3
195 i0~ 25
1
2
525i00
41 78
5441 78
51 PROVIDER NO.
54 PRIOR PAYMENTS 55 EST. AMOUNT DUE 56
VN~JE ~~
:.
i
NON-COVERED CHARGES
CERT.- SSN- HIC.-lO NO.
61 GROUPNAME 62 INSURANCE GROUPNO.
KATHLEEN E. LOUCKS 12-75 /: .~: .;~. ~. :,
EVA M. HOGAN : - - ~ 7365
7073 CARUSLE PIKE NO. 97 ]).4TE . . 60-83/0313
/.ffARUSLE, PA 17013 4871
Bank
Harrisburg, PA 17101
iM
Claremont Nursing & Rehak 2 t3p^~ENTCONT~..O'
37- Cl. aremont Drive 4287
Carlisle PA 17013
12 PA~E~ ~E
LOUCkS ~ ~athlee~ E ~13PA~DRE~
I
~ R~. =. m~ OE~RI~ ~ ~ / ~S ~ SERV. DA~ $ SERV. U~TS 47 TOTg ~ARGES
~ ~25~ P~CY I 36181
~ ~0~1 TOTAL C~GES 15 2486~81
~ PAYER 51 P~DER ~. ~ m ~ ~ ~IOR PA~ ~ ~. ~U~ DUE
PRIVATE PAY CLAREMONT
~ I~RED'~ ~ME ~ P.R~ ~ CE~. - ~ - HIC.- ID ~. ~I G~P ~E ~ I~U~E G~UP
Loucks Ka%hleen E ~1 199~77175
mm ff~q~R~E ~elq,Y TO INI~ ILL ~N~ AM M~( & p,~qT i~
BUREAU OF TNDZVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRTSBURG, PA 171Z8-0601
EVA H HOGAN
LOT 97
7075 CARLISLE PIKE
CARLISLE
CONHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTZCE OF XNHERZTANCE TAX
APPRAZSENENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTIONS, AND ASSESSNENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
PA 17015-9761
REV-164B EX AFP [01-05}
DATE 10-06-2005
ESTATE OF LOUCKS KATHLEEN
DATE OF DEATH 05-21-2005
FILE NUHBER 21 05-0428
COUNTY CUHBERLAND
'i:Ii":~SN/DC 199-07-7175
ACN 05119048
Amoun~ Rmm/~d
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF gILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~
REV-X548 EX AFP (01-03)
RETAIN LONER PORTION FOR YOUR RECORDS
NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLOgANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE 10-06-2003
ESTATE OF LOUCKS
KATHLEEN E DATE OF DEATH 05-21-2005 COUNTY CUMBERLAND
FILE NO. 21 05-0428 S.S/D.C. NO. 199-07-7175 ACN 03119048
TAX RETURN gAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
dOXNT OR TRUST ASSET ZNFORHATZON
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 0056575201
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 12-28-1975
Account Balance 5,855.74
Percent Taxable X 0.500
Amount Subject to Tax 1,926.87
Debts and Deductions - .00
Taxable Amount 1,926.87
Tax Rate
Tax Due 86.71
NOTE:
TAX CREDZTS:
PAYHENT RECEIPT DISCOUNT C+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
NITH YOUR TAX PAYHENT TO THE
REGISTER OF gILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
**REGISTER OF gILLS, AGENT."
PAYHENT HUST BE HADE BY 12-22-2005~.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
TF PATD AFTER THTS DATE, SEE REVERSE FOR CALCULATZON OF ADDXTTONAL INTEREST.
IF TOTAL DUE TS LESS THAN $1, NO PAYHENT ZS REI~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF TH/S FORN FOR INSTRUCTIONS.
.00
86.71
.00
86.71
PURPOSE OF
NOTICE:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (71 P.S.
Section 9140).
PAYNENT=
Detach the top portion of this Notice and submit aith your payment to the Register of #ills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF HILLS, AGENT.
REFUND (CR): A refund of a tax credit, ahich ams not requested on the tax return, may ba requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of
the Register of Hills, any of the Z$ Revenue District Offices or by calling the special Z4-hour answering service
for forms ordering: 1-800-361-Z050; services for taxpayers Hith special hearing and or speaking needs:
1-800-447-3010 (TT only).
OBJECTIOHS: Any party in interest not satisfied uith the appraisement, alloeanca, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice amy object ~ithin sixty (60) days of race[pt of
this Notice by: OR
--mritten protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17118-1011,
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
ADNIN-
ZSTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Factual errors discovered on this assessment should be addressed in ~riting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Ravia~ Unit, DEPT. 180601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booktet "Instructions for Inheritance 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 dacedent'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 January 18, 1996, the first day after the end of the tax amnesty per[od. This non-participation
penalty is appealable in the same manner and in the the same time period as you weuld appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1981
bear interest at the rate of six (61) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after January 1, 1981 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 1981 through Z003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Yea~r Rate Factor
1981 201 .000548 1987 91 .000147 1999 71 .000191
1983 16X .000458 1988-1991 1IX .O003Ol ZOO0 8X ,000119
1984 1XZ .000301 X991 91 .000147 Z001 91 .000147
1985 131 .000356 1993-1994 7Z .000191 ZOOZ 61 .000164
1986 IOZ .000174 1995-1998 91 .0001~7 Z003 51 .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 (la) days
beyond the date of the assessment. If payment [s made after the interest computation date shown on the
Notice, additional interest must ba calcu[atad.
REV-1470 EX (6-88)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
REVIEWED BY
SCHEDULE N~
INHERITANCE TAX
EXPLANATION
OF CHANGES
Kathleen E Loucks ~
Teresa Seiders ---~
03119048
~ EXPLANATION OFCHANGES
Debts and deductions claimed for nursing care have been disallowed. They were
paid prior to the decedent's death, therefore not a debt of the decedent outstanding at
death. Check #7365, dated two days prior to date of death, has been deducted from the
accounts date of death balance as it was not a debit to the account upon reporting. The
adjustment reflects a total tax due of $86.71
ROW
Page I
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DI'VIS'roN
DEPT. Z80601
HARRTSBURG, PA 17128-0601
EVA H HOGAN
LOT 97
7075 CARLISLE PIKE ~.,~
CARLISLE PA 17015-~761
COHNON#EALTH OF PENNSYLVAN/A
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT) ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUI~ER
COUNTY
ACN
REV-1E~i8 EX AFP (01-DS)
10-06-2005
LOUCKS KATHLEEN E
05-Z1-2005
Z1 05-0428
CUHBERLAND
199-07-7175
05119048
Amoun~ Remi~ed
HAKE CHECK PAYABLE AND REHIT PAYflENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
7~7~ ~arll~lg F)lkg #~41
~rll~/d. PA 1701~
t?:o2..2'..:.3.3z:i h,,llh,,lthn,,,fh~lh,~/h,,lh,,hh,lhhh,hh,hf,,~
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 003130
HOGAN EVA M
LOT 97 7073 CARLISLE PIKE
CARLISLE, PA 17013-9761
........ fotd
ESTATE INFORMATION: SSN: 199-07-7175
FILE NUMBER: 21 03-0428
DECEDENT NAME: LOUCKS KATHLEEN E
DATE OF PAYMENT: 10/16/2003
POSTMARK DATE: 10/14/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 03/21/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
03119048 $86.71
TOTAL AMOUNT PAID:
$86.71
REMARKS: EVA M HOGAN
SEAL
CHECK# 5287
INITIALS: SK
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF TNDZVZDUAL TAXES
TNHERZTANCE TAX D/v'rsI*oN
DEPT. Z&0601
HARR'rsBuRG,, PA 171Z8-0601
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
REV-I&07 EX 4FP COl-OS)
DATE ~11-05-Z005
ESTATE OF LOUCKS
DATE OF DEATH 0:5-21-2005
F'rLE NUMBER 21
_ ~,c 'COUNTY CUMBERLAND
EVA M HOGAN ACN 0:51190q8
LOT 97
I Amount RemJ. tted ]
707~ CARLISLE PIKE
CARLISLE PA 1701~-9~6~
KATHLEEN E
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 1701:5
NOTE: To insure proper credit to your account, submit the upper portion of this form w/th your tax payment.
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS -~
b~-: [ g~- - i~' '~ P~' -[ §~=-i~- ..... -;~' 'g ~k-g~T-~ ~::~- -f R~' '~ ¥~'fg ~g-~f - ~3-~ -R~-~5 ~¥ - - ~-~; .....................
ESTATE OF LOUCKS KATHLEEN E F*rLE NO. 21 03-OqZ8 ACN 0:51190q8 DATE 11-03-200:5
THIS STATEMENT TS PROVIDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN 'rN THE NAMED ESTATE. SHOHN BELON
TS A SUMMARY OF THE PRZNC'rpAL TAX DUE., APPLZCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND., ZF APPLTCABLE,
A PROJECTED 'rNTEREST F*rgURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-06-200:5
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
86.71
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DZSCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-
lO-lq-ZOO:5 CD00:51:50 .00
ZF PAZD AFTER THZS DATE*, SEE REVERSE
SIDE FOR CALCULATION OF ADDZTZONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT'
AMOUNT PAID
86.71
TOTAL TAX CREDIT 86.71
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
PAYNENT:
Detach the top portion of this Notice and submit aith your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF HILLS) AGENT.
-- Zf NON-RESIDENT DECEDENT make check or money order payable to: CONNON#EALTH OF PENNSYLVANIA.
REFUND (CR): 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-IS13). Applications are available at
tho Office of the Register of Hills, any of the 25 Revenue District Offices or from the Department's Z4-hour
ansaering service for forms ordering: 1-BOO-56Z-Z050; services ~or taxpayers aith special hearing and / or
speaking needs: 1-BOO-447-50ZO (TT anly)o
REPLY TO:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Rev]em Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (5) calendar months after the decadent's death, a five percent (SI) discount
of the tax paid is aLloaad.
PENALTY:
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and intarast assessed, and not
paid before January 18, 1996, the first day aftmr the and of the tax amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January I, 198Z bear interest at the rate of
six (61) percent per annum calculated at e daily rate of .000164. Al1 taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z 20Z .000548 1987 9Z .000Z47 1999 7Z .00019Z
1985 16X .000438 1988-1991 llZ .000501 ZOO0 8X .000Z19
1984 11Z .000501 1992 92 .000247 ZOOZ 92 .000247
1985 15Z .000556 1995-1994 7Z .O0019Z ZOOZ 62 .000164
1986 lOZ .000Z74 1998-1998 92 .000247 ZOO5 5Z .000157
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELI'NQUENT X DALLY 'rNTEREST 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.