HomeMy WebLinkAbout10-03-11],505610105
REV-1500Ext°z_",tFt' ~
enns lvania OFFICIAL USE ONLY
PA Department of Revenue P_ e , E Y y v„E County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN n ~ 1
PO BOX 280601 .~J t
Harrisburg, PA 1128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
204-26-7945 06/28/2011 01 /05/1934
Decedent's Last Name Suffix Decedent's First Name MI
FRANK GRACE M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (Date of Death
Prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Ta;< Return Required
death after 12-12-82)
~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (Date of Death O 11. Election to Tax under Sec. 9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule 0)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ELIZABETH FEATHER, ESQ. (717) 232-7661
First Line of Address
CALDWELL & KEARNS
Second Line of Address
3631 N FRONT ST
Gity or Post Offce
HARRISBURG
Correspondent's a-mail address: efeather@Cklegal.net
State ZIP Code
PA 17110
REGISTER OF 1r![ILLS USE ONI;Y,,_
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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 an complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SI URE R N RESPONSIBLE FILING RETURN DP~T
1210 4th.5t., Enola, PA 17025 1212 4th St., Enola, PA 17025 30 Cambridge Cir, Liverpool, PA 17045
SJfaNATURE OF ~RE~PPf~2 OTHFrR THAN REPRESENTATIVE DFITE _ ~
3631 N. Front St., Harrisburg, PA 17110
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105
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1 REV-150(1 EX (FI) Page 3
Decedent's Complete Address:
File Number
DECEDENT'S NAME
GRACE M. FRANK
STREET ADDRESS
1212 4TH STREET
CITY STATE ZIP
ENOLA PA 17025
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. CreditslPayments
A. Prior Payments _ __.. __._ _ 16,574.32
B. Discount 920.77
3. Interest
(1) 17,495.09
Total Credits (A + B) (2) 17,495.09
(3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
Make check payable to: REGISTER OF WILLS, AGENT.
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 transferred ................................................................................... ...... ^
b. retain the right to designate who shall use the property transferred or its income ...................................... ...... ^
c. retain a reversionary interest ....................................................................................................................... ...... ^
d. receive the promise for life of either payments, benefits or care? .............................................................. ...... ^
2. If death occurred after Dec. 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. Ditl 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 RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate Imposed on the net value of transfers to or far the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[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 21 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 percent [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 percent, except as noted in [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 percent [72 P.S. §9116(a)(1.3)]. Asibling 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-1$02 EX+ (01-10)
Pennsylvania SCHEDULE A
DEPARTMENT OE REVENUE
INHERITANCE TAX RETURN REAL ESTATE
RESIDENT DECEDENT
__---
ESTATE OF: FILE NUMBER:
GRACE M. FRANK 21-11-0800
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F,
If more space is needed, use additional sheets of paper of the same size.
REV-i~,o8 EX+ (u->o)
Pennsylvania
DEPART MF.NT OF REVENUE
INHERITANCE 'AX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS & MISC.
PERSONAL PROPERTY
ESTATE OF: FILE NIJMBER:
GRACE M. FRANK ;21-11-0800
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
If more space is needed, use additional sheets of paper of the same size.
REV-Iao9 EX+ (oI-Ia)
j i~ Pennsylvania
C.~7 DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
__
ESTATE OF: FILE NUMBER:
GRACE M. FRANK 21-11-0800
JOINTLY OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR ]O1NT
TENANT DnrE
MADE
]0[NT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET i of
DECEDENT'S
INTEREEST DATE of DEATH
VALUE OF
DECEDENT'S INTEREST
1 A
' ' 01125105 M&T Bank checking account #15004211803455 7,104.09 50% 3,552.05
2. A 01125/05 M&T Bank checking account #34041109 75,206.73 50°/r. 37,603.37
TOTAL (Also enter on Line 6, Recapitulation) I $ 41,155.42
If more space is needed, use additional sheets of paper of the same size.
If an asset became jointly owned within one year of the decedent's date of death, it must be reported on Schedule G,
pennsylvania SCHEDULE G
DEPARTMENT cF REVENUE INTER-VIVOS TRANSFERS AND
rNHERITANCETAXRETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GRACE M. FRANK 21-11-0800
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM
NUMBER DESCRIPTION OF PROPERTY
INCLUDE T!+E NAME OF THE TRANSFEREE, THEIR RELATIONSHIP To DECEDENT AND
THe DarF of raaNSFER. aTTaa+ a coPY of rHE DEED FoR REaL FsraTE
DATE OF DEATH
VALUE OF ASSET
% OF DECD'S
INTEREST
EXCLUSION
nF aP>LlcaaLE~
TAXABLE
VALUE
1 Sovereign Bank in trust for Richard M. Frank acccount # 0921710844
75,292.33 100 75,292.3?
John Hancock annuity based IRA with Richard Frank, Jeffrey Frank, Elaine
2 198,188.68 100 198,188.6E
Grove, C. Michael Frank, and Lee Frank as beneficiaries
John Hancock non-qualified mutual fund transfer on death to Richartl Frank
3 , 22,324.08 100 22,324.0E
Jeffrey Frank, Elaine Grove, C. Michael Frank, and Lee Frank
TOTAL (Also enter on Line 7, Recapitulation) $ ~ 295,805.09
If more space is needed, use additional sheets of paper of the same size.
•. i
Pennsylvania
DEPARTMENT OF RE VENUE
INHERITANCE TAX RETURN
RESIDENT DECECENT
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
GRACE M. FRANK 21-11-0800
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Musselman Funeral Home 10,404.97
B.
1
2, 500.00
2. Attorney Fees:
3,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
claimant Clarence Michael Frank
Street Address 1212 4th Street
c,ty Enola State PA ZIp 17025
4,
5.
6,
7.
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
City _
Year(s) Commission Paid:
Relationship of Claimant to Decedent SOn
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
State ZIP
348.50
TOTAL (Also enter on Line 9, Recapitulation) I $ 16,753.47
If more space is needed, use additional sheets of paper of the same size.
Pennsylvania SCHEDULE I
°FPAATMFN7 ~F AF~ENDE DEBTS OF DECEDENT,
INHERITANCE TAZ RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
GRACE M. FRANK 21-11-0800
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
(f more space is needed, insert additional sheets of the same size.
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I, GRACE MARIE FRANK, of Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament hereby revoking all prior Wills and Codicils.
TTT',~T /rT T a:_..~ A~1.. ,..41LL.. t 1.. .4 'll.,. ,] F,.r n.,.~.11-~n ~ 7
11 L1Y11. 1 Ull t.''l.L W1dL L11C Cli~lenseJ Vl ZL1J' 1aJ61111iC JJ ariU lUilct q~ tip. pain
from my estate as soon as practicable after my death.
ITEM II. I direct that my real estate be held for the use of my children
during their lifetimes. My children residing in my residence shall pay the real
estate taxes, insurance, utilities and the cost of repairs. My son, LEE
ALEXANDER FRANK, shall have a lifetime lease in the real estate for him to use
as his residence. At the time of the death of my son, LEE ALEXANDER FRANK,
if none of my other children choose to live in the property, the property may then
be sold with the proceeds distributed pursuant to the :residuary paragraph (Item
IV below). If the property has not been sold when only one of my children is still
living, the property shall become the sole and separate property of that; child.
PAGE I OF IV
ITEM III. I hereby reserve unto myself the right to make a list disposing
of items of personal property. If I make such a list, from time to time, it will be
signed and dated, will describe the items to be devised and the individual devisees
thereof. If no such written statement or list is found and properly identified by my
Executor within thirty (30) days after the issuance of Letters Testamentary or
Letters of Administration, it shall be presumed that there is no such statement or
list and any subsequently discovered statement or list shall be ignored. Any
reasonable distribution expenses incurred with respect to tangible personal
property, including but not limited to packing, shipping, storage and insurance
expenses, shall be paid by my Executor as an administrative expense of my estate.
These items are being distributed as a remembrance of my life.
'll'E1V1 1'V. 1 give, devise and bequeath aii of the rest, residue and
remainder of my estate of whatsoever kind and wheresoever situate, in equal
shares to my son, CLARENCE MICHAEL FRANK, per stirpes; my son, .IEFFREY
EUGENE FRANK, per stirpes; my daughter, ELAINE MARIE GROVE, per
stirpes; my son, RICHARD MARK FRANK, per stirpes; and my son, LEE
ALEXANDER FRANK, per stirpes.
ITEM V. I direct that the bequest to my son, LEE ALEXANDER FR.A1V-K,
shall be held in trust for him.
ITEM VI. In the event that a Trust is created by or as a result of any part
of this Will for my son, LEE ALEXANDER FRANK, the duties of the Trustee shall
be to administer the terms and conditions of the Trust as follows:
PAGE II OF IV
a. To pay the net income together with so much of the principal thereof
as Trustee shall consider advisable for the beneficiary's support and
care after taking into consideration all other readily available assets,
sources of income and other resources.
b. If the beneficiary shall die before receiving final distribution of his
entire share, the undistributed balance shall be distributed outright
to my residuary beneficiaries, per stirpes.
ITEM VII. I nominate and appoint my daughter, ELAINE MARIE GROVE,
my son, RICHARD MARK FRANK, and my son, CLARENCE MICHAEL FRANK
to serve as Co-Trustees for any Trust established in or created by this V~Till. If any
of one of them is unable or unwilling to serve the others may serve together or
serve alone.
ITEM VIII. I nominate and appoint my daughter, ELAINE MARIE GROVE,
my son, RICHARD MARKFRANK, and my son, CLARENCE MICHAEL FRANK,
Co-Executors of this my Last Will. If any of one of them is unable or uriw-illing to
serve the others may serve together or serve alone.
ITEM IX. I direct that my Co-Executors and Co-Trustees or their
successors shall not be required to give bond for the faithful performance of the
appointed duties in any jurisdiction.
ITEM X. I direct that all taxes due at my death or as a consequence of my
death shall be paid from my residuary estate.
PAGE III OF N
IN WITNESS WHEREOF, I have hereunto set my hand and seal this _,_, ~ day
of _ ~~~ ~J e .2011.
.;
GRACE MARIE FRA]~iK
~~ L
Signature
`J
Print or Type Name
Signature
-~. --
Print or Type Name
Cumberlanc County Boaro9 of Assessment Appeals
Old Courthouse, First Floor
One Courthouse Square
Carlisle, PA 17013
45000382-3A-34915
ln~l~ln~~l~nni~il~~~l~~i~linr~l~lnnn~ln~~~ri~~~~nil~
FRANK, CLARENCE 2
212 FOURTH STREET
WEST FAIRVIEW, PA
16670
T47 P1
17025-3101 Deadline for Scheduling ari Informal Review
Appointment: August :io, 2010
For details, please see the reverse side.
The Cumberland County Board of Assessment Appeals is providing you with notice of the value on this property,
determined as a result of the Cumberland County countywide reassessment completed this year. The countywide
reassessment values each property at current Fair Market Value, as of January 1, 2010, equalizing and establishing a
uniform tax base so that properties of like characteristics and the same actual Fair Market Value will bE; taxed the same.
FORMAL APPEAL DEADLINE:
August 1.0, 2010
MAILING DATE: July 1, 2010
Munic.: 45 - EAST PENNSBORO TWP/WF
School: 5 - EAST PENNSBORO SD
Location:
212 FOURTH STREET
LAND LESS THAN 1 ACRE
Taxable Property
Land Size: .19 acres
Property Type: A
Residential (Under 10 Acres)
Homestead Approved
Parcel Identifier:
45-17-1044-153.
2010 Base Year Assessed Value Old Assessed Value
Fair Market Value (2010 Market x 100%) (2004 Market)
Land 20, 800 20, 800 23, 330
Buildings 44, 200 44, 200 41, 410
TOTAL 65,000 65,000 64,740
2010 Clean and Green Values
Land NOT NOT NOT
Buildings APPLICABLE APPLICABLE APPLICABLE
TOTAL
Clean and Green values apply to qualified farm and forest land and become effective
only upon application and approval. Clean and Green applications must be received
by the Assessment Office no later than 4:30 p.m. on October 15, 2010. Those
previously approved for Clean and Green do not need to re-apply.
Below is your preliminary estimate of county taxes for 2011 (after reassessment), compared with your 2010 (current)
county taxes. A total estimated tax profile (county, municipal, school district) is available online. See our webpage,
www.ccpa.net. Click under "Reassessment" in lower right of home page.
Current 2010 County mills = 2.579
Adjusted 2010 County mills = 2.074
$ 167 2010 COUNTY Tax BEFORE Reassessment.
$ 135 2010 COUNTY Tax AFTER Reassessment.
(see reverse side)
BUREAU OF INDIVIDUAL TAXES
PD BDX 280601 Pennsylvania
HARRISBURG PA 17128-0601 DEPARTMENT OF REVENUE
REV-1543 E% AFP (05-11)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21
AND ACN 11149934
TAXPAYER RESPONSE DATE 07-26-2011
EST. OF GRACE M FRANK
SSN 204-26-7945
DATE OF DEATH o7-02-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
RICHARD M FRANK REGISTER OF WILLS
30 CAMBRIDGE CIRCLE 1 COURTHOUSE SQUARE
LIVERPOOL PA 17045 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
M & T BANK provided the department with the information below, which was used in calculat ng the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If y0U are the SpOUSe of the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return
-it to the above address. Flease call 117-7&7-8327 w~itYi questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 15004211803455 Date 01-25-2005 To ensure prover credit to the account, two
Established copies of this notice must accompany
Account Balance 7 104.09 payment to the Register o~F Wills. Make check
~ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $` 3,552.05 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any inheritance tax due w:i.ll become delinquent
Potential Tax Due $ 159.84 nine months after the date of death.
PART TAXPAYER RESPONSE
1^
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obta iin
C H E C K a discount or avoid interest, or return this notice to the Register of Wills and
0 N E an official assessment will be issued by the PA Department of Revenue.
BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
0 N L Y filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART 3~ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 I
2. Account Balance 2 $ Z
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 5
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ g
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above are true, correct .and
complete to the best of my knowledge and belief. HOME C ) _
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) ,
~.
BUREAU OF INDIVIDUAL TAXES
PD eox zaocol pennsylvanla
HARRISBURG PA 17128-0601 DEPARTMENT OF REYEN UE
REV-1543 EX AFP (05-11)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21
AND ACN 11149935
TAXPAYER RESPONSE DATE 07-26-2011
EST. OF GRACE M FRANK
SSN 204-26-7945
DATE OF DEATH 07-02-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
RICHARD M FRANK REGISTER OF WILLS
30 CAMBRIDGE CIRCLE 1 COURTHOUSE SQUARE
LIVERPOOL PA 17045 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
M & T BANK provided the department with the information below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If ycu art the SpoUSe Of the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy tc this form and return
it to the above address. Flease call 717-787-8327 with questions.
COMPLETE PART 1 BELDW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 34041109 Date 08-28-1964 To ensure proper credit tc the account, two
Established copies of this notice must accompany
Account Balance 75 206.73 payment to the Register of Wills. Make check
~ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax ~` 37,603.37 months of the decedent's dlate of death,
Tax Rate X . 045 deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $` 1 , 692.15 nine months after the date of death.
PART TAXPAYER RESPONSE
1^
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ^ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoid interest, or return this notice to the Register of Wills and
0 N E an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
0 N L Y filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART 3^ below.
PART If indicating a different tax rate, please state OFFICIAL USE 0 NL Y ~ A AF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 S
6. Amount Taxable 6 $ (, '
7. Tax Rate 7 X 7
8. Tax Due 8 $ $
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
TOTAL (Enter on Line 5 of Tax Computation) S
Under penalties of perjury, I declare that the facts I reported above are true, correct arnd
complete to the best of my knowledge and belief. HOME C ~
BUREAU OF INDIVIDUAL TAXES
PO BOX 260601
HARRISBURG PA 17128-0601
pennsylvania
DEPARTMENT OF REVENUE
REV-1543 E% AFP (05-11)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21
AND ACN 11152190
TAXPAYER RESPONSE DATE 08-08-2011
RICHARD M FRANK
30 CAMBRIDGE CIR
LIVERPOOL PA 17045
EST. OF GRACE M FRANK
SSN 204-26-7945
DATE OF DEATH 07-02-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
SOVEREIG N BANK provided the department with the information below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you are the SpoUSe of the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return
-it to the above address. Please call 71;-~G7-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0921710844 Date 05-03-1997 To ensure proper credit to the account, two
Established copies of this notice must. accompany
Account Balance 75 292.33 payment to the Register of Wills. Make check
~ payable to "Register of Wills, Agent".
Percent Taxable X 100.00
NOTE: If tax payments are made within three
Amount Subject to Tax $ 75x292.33 months of the decedent's slate of death.
Tax Rate ~( lrj deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due ~` 11 x 293.85 nine months after the date of death.
PART TAXPAYER RESPONSE
1^
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoid interest, or return this notice to the Register of Wills and
0 N E an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
0 N L Y filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART 3^ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF
relationship to decedent:
PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1 ~ _ ._
2. Account Balance 2 $ Z
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ G
5. Debts and Deductions 5 5
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ g
I,
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above are true, correct and
complete to the best of my knowledge and belief. HOME C
WORK C
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) S