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HomeMy WebLinkAbout03-0549COHHONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28060! HARRISBURG, PA 17128-0601 RE¥-1~,~$ EX AFP ¢09-00) ZNFORMATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 03 51'J'C~ ACN 03123893 DATE 06-26-2003 DALE 5 WALNUT LN CANP HILL PIERCE '03 ,JUL -7 TYPE OF ACCOUNT ESt. OF VIOLA NACLAY []SAVINGS S~.S. NO. 186-09-3553 []CHECKING DATE OF DEATH 03-04-Z003 J---~TRUST ~TY CUNBERLAND [] CERTZF. REHZT PAYHENT AND FORHS TO: REGISTER OF WILLS CUNBERLAND CO COURT ~OUSE CARLISLE· PA 17013~ NAYPOTNT BANK has provided tha Department wlth the information listed below 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/banaflciary of this account. If you feel this information is incorrect, pleasa obtain written correction from the financial institution, attach a copy to this fore and return it to tha above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may ba answared by calling (717) 787-8527. CONPLETE PART 1 BELOW x # ~ SEE REVERSE SIDE FOR FILING AND PAYNENT INSTRUCTIONS Account No. 1058292214 Date 07-18-1996 To insure proper credit to your account, two Established (Z) copies of this notice must accompany your Account Balance 2 · 043.68 payment to tha Ragistar of Wills. Hake check payable to: "Register of Nills~ Agent". Percent Taxable X 5 0.0 0 0 Amount SubSact to Tax 1 · 021.84 NOTE: If tax payments ara made within three (S) months of the dmcadent's date of death, Tax Rate X .15 you may deduct a 52 discount of the tax dua. Any inharitanca tax dua will become delinquent PotentLaz Tax Due 155.28 nine (9) months after the date of ~e ". PART TAXPAYER RESPONSE : r....?..~ ~.,.....:~,~, ,.I. ~ ~.... ~,, ,~ ~,, .~ ~ . : ..... . ........ , ....., ......... : ,. ....... ~:-,.,.,,.,.,., ,.,: .,::.=.,.,.,.,.,., ,.: A. ~ The above informer/on and tax due is correct. 1. You may choose to remit payment to the Register of Hills NJth t~o copies o~ this notice to ob~Jn CHECK ONE BLOCK ONLY PART TAX LZNE a discount or avoid interest, or you may check box "A" and return this notice to the Register of Nills and an official assessment will be issued by the PA Department of Revenue. B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decadent's representative. C. []Tho above information is incorrect and/or debts and deductions ware paid by you. You must complete PART ~ and/or PART ~belaw. Zf you indicate a different tax rate· please state your relationship to decedent: RETURN - CONPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Data Established I 2. Account Balance 2 3. Percent Taxable $ ~ ~. Amount Sub3ect to Tax ~ $. Debts and Deductions S 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAZHrq PAYEE DESCRIPTION AHOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of perjury, Z declare that the facts ! have reported above are true, correct and complete to the bast of my knowledge and belief. . ./ .*~ HONE ('// ~) ~/~/* £' 6~: .... ~/'~/r~- ~ i'~::; .... ~ WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUNBER ~ GENERAL [NFORHATION 1. FAILURE TO RESPOND H/LL RESULT ZN AN OFFZC/AL TAX ASSESSHENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dacedsnt's date of death. 5. A joint account is taxable even though the decadent'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 aithin Dna year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and eifa more than Dna 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 I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the not[ce ara correct and deductions are not being claimed, pXace an "X" in block "A" of Part 1 of the '"Taxpayer Response" smction. Sign two copies and submit them with your check for the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue w[11 issue an official assessment (Form REV-1S4B EX) upon receipt of the return from the Register of Hills. Z. BLOCK B - If the asset specified on this notice has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedant's representative, place an "X" in block "5" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Oapt Z80601, Harrisburg, PA 171Z8-0601 in the envelope provided. 5. BLOCK C - If the notice information ls incorrect and/or deductions are being claimed, check block "C" and completa Parts Z and 5 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1SqB EX} upon receipt of the return from the Register of Mills. TAX RETURN - PART Z TAX COMPUTATION LINE 1. Enter the data the account originally was established or titted in the manner ax[sting at date of death. NOTE: For a decedent dying after 1Z/II/BI: Accounts which the decedent put in joint names aithin one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $5,000 par transferee regardless of the value of the account or the number of accounts held. if a double asterisk (aw) appears before your first name in the address portion of this notice, the $5,000 exclusion already has been deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 5. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than Dna year prior to the dacedent's death: I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUMBER OF X lO0 = PERCENT TAXABLE JOINT OHNERS SURVIVING JOINT ONNERS Example: A joint asset registered in the name of the decedent and two other persons. I DIVIDED BY 5 (JOINT ORNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.TZ (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OgNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent end two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .SO X lO0 = SOZ (TAXABLE FOR EACH SURVIVOR} The amount subject to tax (line q) is determined by multiplying the account balance (line Z) by the percent taxable (line 5). 5. Enter the total of the debts and deductions listed in Part 5. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5} from the amount sub[act to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. Dance o~E Death Spouse Lineal I Sibling Collateral 07/01/9q ~o 12/$1/9q 01/01/96 "co 06/50/00 OX 6% 07/01/00 ~o presen~ OX q.SX~ 12X ,lounger et eThe tax rate imposed on the n~ death to or far the use of a natural parent, an adoptive parent, or a stepparant of tho child [s OZ. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "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 descendants, whether or not they have been adopted by others, adopted descendents and their descendents and step-descendants. "Siblings" ara defined es individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of hairs includes al1 other beneficiaries. CLAIMED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions ara determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must ba itemized fully in Part $. If additional space is needed, usa plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. .~REV- 1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 186-09-3553 HARRISBURG, PA 17128-0601 E Maclay Viola P. C DATE Of DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-OD-YEAR) E D 03/04/2003 10/30/1910 E (IF APPLICABLE) SURVIVING SPOUSE' NAME (LAST, FIRST, AND MIDDLE INITIAL) N T HP,n EP~ CR~ KO~ c°.i R E C A P I T U L A T I O N O M T I O N  1. Original Return ~ 24i Supplemental Return 4, Limited Estate · Future Interest Compromise (date of death after 12-1Z-8Z) 6, Decedent Died Testate Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) ~ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death between 1Z-31-91 and 1-1-95) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (date of death 3. Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes F-~ 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME George A. Vau~hn III FIRM NAME (If Applicable) TELEPHONE NUMBER 717./975- 9102 9. 10. 11. 12. 13. 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole -Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11 ) 14. COMPLETE MAILING ADDRESS 3904 Trindle Road Camp Hill, PA 17011 None None None Ndn'e 2,676.90 1,021.84 None 5,300.00 None Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (14) OFFICIAL USE ONLY (8) 3,698.74 (11)~ 5,300.00 (lZ) (1,601.26) (1,601.26) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate (1,601.26) X .0 0 (15) X .0 45 (16) X .12 (17) X .15 (18) 0.00 0.00 0.00 0.00 19. Tax Due (19) 0.00 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 831 Hummel Avenue CITY STATE Lemoyne PA IZiP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (~) 17043 Total Credits ( A + 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D * E ) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to re~luest a refund (4) 5. 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. (SA) O. 00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) O. O0 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 properly 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 benefts or car ? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. j---] ~-] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation3 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, 153.28 0.00 correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Dale F. ?ierce DATE , _ 5 Walnut Lane ......................... SIGNAT,~E OF PREPARER OTHERT~ REPRESENTATIVE George A Vaughn II I DATE . ['1... ~...~ ~ 3904 Tri~dle Road .... ......................... For a~t~ of a~th o~ o; ~er ~y' 1, l'~4a~a ~efore J;."~'~, I'~SS; ~e'tax'~;~e' i~posea' ~ i~;' ~5';ai,';';f .................................................... surviving spouse IS 3% [72 P.S. 9116 (a) (1.1) (i)]. transfers to or for the use of the For dates of death on or after Janua~ 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 statuto~ requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficia~. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twen~-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 benef c aries is 4.5% except as noted in 72 P.S. 9116(1 [72 P.S. ~116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (c) 2000 form software only The Lackner Group, Inc. Form R~V-I~OO EX (Rev. 6-00) REV- 1508 EX + (1-97) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN RESIDENT DECEDENT PERSONAL PROPERTY ESTATE OF Viola P. Maclay SS~/ 186-09-3553 03/04/2003 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 3 4 DESCRIPTION Blue Cross/Blue Shield - Refund of premium Waypoint Bank; Checking Account No. 100494202 as of date of death Principal balar Waypoint Bank; Savings Account No. 5500032528 as of date of death Waypoint Bank; Savings Account No. 5500032528 to date of death - Principal balan( - Interest accrued TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) FILE NUMBER VALUE AT DATE Of DEATH 122.44 2,284.35 270.00 0.11 $ 2,676.90 Copyright (c) 1996 form software only CPSystems, inc. Form REV- 1508 EX (Rev. 1-97) REV- 1509 EX * (1-97) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PR OPER TY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Viola P. Maclay SS# 186-09-3553 03/04/2003 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER SURVIVINGJOINTTENANT(S) NAME ADDRESS RELATIONSHIPTO DECEDENT A. Dale Pierce 5 Walnut Lane Nephew Camp Hill, PA 17011 Bo 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 identifying number. DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT Attachdeed forjoint~y-held realestate, VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A 07/18/96 Waypoint Bank; Certificate 2,043.44 50.00% 1 021 72 of Deposit No. 1058292214 ' ' Principal balance as of date of death 2 A 07/18/96 Waypoint Bank; Certificate 0.24 50.00% 0.12 of Deposit No. 1058292214 - Interest accrued to date of death TOTAL (Also enter on line 6, Recapitulation) $ 1,021.84 {'If rnnr~ ~m=r.,= ie ~==,q~ ;-~ --~u:.:--_, , · .. rt additional sheets of the same s~ze) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) REV- 1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Viola P. Maclay SS# 186-09-3553 Debts of decedent must be reported on Schedule I. ITEM NUMBER 5. 6. 7. Copyright (c) 1996 form software only CPSystems, Inc. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 03/04/2003 DESCRIPTION FUNERAL EXPENSES: Musselman's Funeral Home, Inc. Funeral service expense State ~ Zip ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / FIN Number of Personal Representative(s) Street Address City Year(s) Commission Paid: Attorney's Fees George A. Vau§hn III Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 5,000.00 City Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs TOTAL (Also enter on line 9, Recapitulation) $ 5,300.00 Form REV-1511 EX (Rev. 1-97) (If more space is needed, insert additional sheets of the same size) State Zip FILE NUMBER AMOUNT 300.00 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 002774 PIERCE DALE DUPLICATE 5 WALNUT LN CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 186-09-3553 FILE NUMBER: 2103-0549 DECEDENT NAME: MACLAY VIOLA DATE OF PAYMENT: 07/07/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/04/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03123893 $153.28 REMARKS: TOTAL AMOUNT PAID' $153.28 SEAL CHECK# 552 INITIALS: JA 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. CD REV-1162 EX(11-96) 002774 PIERCE DALE 5 WALNUT LN CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 186-09-3553 FILE NUMBER: 2103-0549 DECEDENT NAME: MACLAY VIOLA DATE OF PAYMENT: 07/07/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/04/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03123893 $153.28 REMARKS' TOTAL AMOUNT PAID: $153.28 SEAL CHECK# 552 INITIALS' JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS / - BUREAU OF ZNDZVZDUAL TAXES INHERITANCE TAX DEPT. 280601 HARRISBURG,, PA 17128-0601 DALE 5 WALNUT LN CAHP HILL PIERCE PA 17011 COHHONWEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF INHERITANCE TAX APPRAISEMENT. ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-06-2003 ESTATE OF HACLAY DATE OF DEATH 03-0q-2003 FILE NUHBER 21 03-05q9 COUNTY CUHBERLAND '*S,~N.~DC 186-09-3553 ACN 03123893 Amoun'~ RemL'H:ed REV-i~i$ EX AFP CDI-OS) VIOLA HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE REV-IS48 EX AFP (01-03) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 10-06-..~2003 ESTATE OF HACLAY VIOLA DATE OF DEATH 03-0~-Z003 COUNTY CUHBERLAND FILE NO. Z1 03-05~9 S.S/D.C. NO. 186-09-3553 ACN 03123893 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOZNT OR TRUST ASSET ZNFORHATZON FINANCIAL INSTITUTION: WAYPOZNT BANK ACCOUNT NO. 105829211~ TYPE OF ACCOUNT: ¢ ) SAVINGS ¢ ) CHECKING ( ) TRUST C~ TIHE CERTIFICATE DATE ESTABLISHED 07-18-1996 Account Balance Z,0~3.68 Percent TaxabZe X 0.500 Amount Subject to Tax 1,021.8q Debts and Deductions - .00 TaxabZe Amount 1,021.8~ Tax Rate X .15 Tax Due 153.28 TAX CREDZTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT DATE 07-07-Z003 RECEIPT NUMBER CDO0277q DISCOUNT INTEREST/PEN PAID (-) .O0 AMOUNT PAID IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORM FOR ZNSTRUCTZONS. 153.28 TOTAL TAX CREDIT BALANCE OF TAX DUE ZNi~KEST AND PEN. TOTAL DUE 153.28 .00 .00 .00 PURPOSE OF NOTICE: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 9140). PAYHENT: Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reversm side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. 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-1313). Applications ara available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or by calling the special Iq-hour answering service for forms ordering: 1-800-562-Z050; services for taxpayers with special hearing and or speaking needs: 1-800-~7-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied aith the appraisement, a11oaance, or disalloaance of deductions or assessment of tax (including discount or interest] as shown on this Notice may object within sixty (60] days of receipt of this Notice by: OR --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Zl, Harrisburg, PA 171ZS-lOZ1, --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Raviaa Unit, DEPT. 280601, Harrisburg, PA 171Z8-0601 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 within three (3) calendar months after the decedant's death, a five percent discount of the tax paid is allowed. The 15Z tax amnesty nan-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 tiaa 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 from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6g) percent per annum calculated at a daily rate af .00016q. All taxes which became delinquent on or after January 1, 198Z wi1! bear interest at a rate ehich mill vary from caZmndar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO3 are: Interest Daily Interest Oaily Interest Daily Year Rate Factor Yaa._._r Rate Factor Yaa__r Rate Factor 198Z ZOZ .0005~8 1987 9Z .OOOZq7 1999 7Z .OOO19Z 1983 16Z .000~38 1988-1991 IXZ .000301 2000 8Z .000219 198~ IIX .000~01 199Z 9Z .O00Z~7 ZOO1 9Z .O00Z~7 1985 152 .000356 1993-199q 7Z .O0019Z ZOOZ 62 .00016q 1986 lOX .O00ZT~ 1995-1998 9Z .OOOZ~7 ZOO3 5Z .000137 --Interest is calculated as fallows: INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS D~--LZNI~UENT X DAI'LY XNTERE:ST 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 bo calculated. BUREAU OF ZNDZVZDUAL TAXES >TNHER]'TANCE TAX DI'VTS]'ON DEPT. 28B'601 HARRTSBURG, PA 17128-0601 DALE 5 gALNUT LN CAMP HILL PIERCE PA 17011 COMMON#EALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERZTANCE TAX RECORD ADdUSTMENT dOZNTLY HELD OR TRUST ASSETS DATE 10-16-2005 ESTATE OF MACLAY DATE OF DEATH 03-04-2003 FZLE NUMBER 21 03-05q9 COUNTY CUHBERLAND -SSN/DC 186-09-3553 ACN 03123893 Amoun'l: R,,,m i 'H:ed RE¥-I~Oq El( AFP (01-05) VIOLA MAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LZNE ~'~ RETAZN LOWER PORTION FOR YOUR RECORDS REV-1604 EX AFP (01-03) #~ ZNHERZTANCE TAX RECORD ADdUSTHENT dOXNTLY HELD OR TRUST ASSETS DATE 10-16-2003 ESTATE OF NACLAY VIOLA DATE OF DEATH 03-0q-2003 COUNTY CUMBERLAND FILE NO. 21 03-05~9 S.S/D.C. NO. 186-09-3553 ACN 03123893 ADJUSTMENT BASED ON: ADNINISTRATZVE CORRECTZON dOZNT OR TRUST ASSET ZNFORNATZON FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 1058292211 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 07-18-1996 Account Balance Percent Taxable ~, Amount Subject to Tax Debts and Deductions - Taxable Amount Tax Rate X Tax Due TAX CREDZTS: .00 0.500 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDZT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTZON OF THIS NOTZCE WZTH YOUR TAX PAYMENT TO THE REGZSTER OF WZLLS AT THE ADDRESS SHOWN ABOVE. HAKE CHECK OR HONEY ORDER PAYABLE TO: **REGZSTER OF WZLLS, AGENT.'* PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (- AMOUNT PAID TOTAL TAX CREDZT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAZD AFTER THIS DATE, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THZS FORM FOR ZNSTRUCTZONS.) -°°1 .00 .00 .00 ..4 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGISTER OF #iLLS, AGENT. 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" (RE¥-1315). Applications ara available at the Office of the Register of #ills, any of the 25 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-56Z-ZOSO) services far taxpayers with special hearing and / ar speaking needs: 1-BgO-447-50ZO (TT only). REPLY TO: guastions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZB060[, Harrisburg) PA 17lZ&-O60[) Phone (7173 787-6505. DISCOUNT: if any tax due is paid within three (5) calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allowed. PENALTY: The leg tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, lggB, the first day after the end of the tax amnesty period. INTEREST: lntmrast is charged beginning ~ith first day of delinquency or nine (9) months and one El) day from the date of death to the date of payment. Taxes which became delinquent before January [, 19BI bear interest at the rate of six (BI) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January l, lgBZ ~11! bear interest at a rate ~hich ~ill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO5 are: Interest Daily Interest Daily Interest Daily Rate Factor Yea.___r Rate Factor Yea___r Rate Factor 1982 20X .00054B 1987 9X .000247 1999 7X .O0019Z 1955 16Z .00045B 198&-199l XlZ .000501 2000 SZ .O00Zl9 1984 lXX .000501 1992 9X .000247 ZOOZ 9X .OOOZ47 1985 152 .000556 1993-1994 72 .00019Z ZOOZ 62 .000164 1986 lOX .000274 1995-1996 92 ,000247 2005 52 .000157 --Interest is calculatad as folloas: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST 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 sheen on the Notice, additional interest must be calculated. REV-1470 EX (6-88)  INHERITANCE TAX COMMONWEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OF CHANGES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME VIOLA MACLAY !FILE NUMBER REVIEWED BY 21 03-0549 Phyllis Hoch ACN 03123893 ITEM SCHEDULE NO, EXPLANATION OF CHANGES ADJUSTED ABOVE ACN TO ZERO, REPORTED ON PROBATE RETURN. ROW Pa.qe 1 BUREAU OF ZNDZVZDUAL TAXES TNHERZTANCE TAX DZVZSTON DEPT. 18060! HARRISBURG, PA 17128-0601 GEORGE A VAUGHN III $904 TRINDLE RD CAHP HILL CONNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-16,1? El( AFP (01-0S) DATE 10-11-2005 ESTATE OF NACLAY DATE OF DEATH 03-04-Z005 : ? ~.~ ~ FILE NUHBER 21 05-0549 ~ ' ~ COUNTY CUHBERLAND ACN 101 PA 170~1'~ I VIOLA HAKE CHECK PAYABLE AND RENIT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-154? EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HACLAY VIOLA FILE NO. 21 05-0549 ACN 101 DATE 10-21-200:5 TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERS=. APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. RaaZ Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnarship Zntarast (Schedule C) ($) 4. Hortgagas/No~as Racaivabla (Schedule D) (4) E. Cash/Bank Daposits/Nisc. Personal Property (Schedule E) ($) 6. Jointly Owned Property (Schadula F) (6) 7. Transfers (Schedule G) (7) 8. Total Assa~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. FunaraZ Expansas/Adm. Costs/Nisc. Expanses (Schedule H) (9) 10. Debts/Hor~gaga Liabilities/Liens (Schadu/a Z) (10) 11. Total Deductions 2~676.90 1~021.84 .00 .00 NOTE: To insure proper .00 credit to your account, .00 subait the uppar portion .00 of ~his form with your tax payment. (8) 5,:500.00 12. 15. 14. NOTE: ASSESSHENT OF TAX: 15. Amount of Line 14 at Spousal rata 16. Amount of Line 14 taxable at Lineal/Class A ra~a 17. Amount of L/ne 14 at Sibling rata 18. Amount of L/ne 14 taxable at Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYMFNT R~CL~TPT DATE NUHBER .O0 (11) Net Value of Tax Return (12) Charitabla/Governmantal Bequests; Non-alactad 9115 Trusts (Schedule J) (1:3) Net Value of Estate Subject to Tax (lq) If an assessment was lssued previously, 11nas 14, 15 and/or 16, 17, reflect f/gures that include the total of ALL returns assessed to date. 07-07-200:5 I CD002774 :5,698.74 DISCOUNT (+J INTEREST/PEN PAID (-) .00 6.~oo.00 1,601.26- ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR ZNSTRUCTZONS.) (19); .00 TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 15:5.28 15:5.28 15:5. Z8CR ZF PAID AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. AHOUNT PAZD .00 1,601.26- 18 and 19 wi11 (1~) .00 x O0 = .00 (16) .00 x 045= .00 (17) .00 x 12 = .00 (18) .00 x 15 = .00 RESERVATION: PURPOSE OF NDTICE: PAYHENT: REFUND OBJECTIONS: ADNZN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 11, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class D (collateral) beneficiaries of the decadent after the expiration of any estate for life or for years, the CoaaonaeaZth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (coItataral) rate on any such futura interest. To fulfill the requirements of Section ZI~O of the Inheritance end Estate Tax Act, Act 15 of ZOO0. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit eith your payment to the Register of #ills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which ams not requested on the Tax Return, amy be requested bv completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office of the Register of Hills, any of the 15 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-q47-5010 (TT 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 abject within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 181011, Harrisburg, PA 17128-1021, 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 ba addressed in eriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Past Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. Sea 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 (5) calendar months after the dacedent's death, a five percent (SI) 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 tho end of the tax amnesty per[od. This non-participation penalty is appealable in the same manner end 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 from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (61) percent par annum calculated at a daily rate of .D0016~. All taxes which became delinquent on and after January 1, 1982 mill bear interest at a rate which mill vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2005 ara: Interest Daily Tntarest Daily Interest Daily Year Rate Factor Ysa__r Rate Factor Yea__r Rate Factor 1981 ZOZ .0005~8 1987 91 .0002~7 1999 71 .000192 1985 161 .000~38 1988-1991 11Z .000501 ZOO0 81 .000119 198~ 112 .000301 1991 9Z .0002~7 2001 9Z .0001~7 1985 137. .0003S6 1995-199~ 77. .000192 ZOOZ 61 .00016~ 1986 107. .000Z7~ 1995-1998 97. .0001~7 2005 57. .000157 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NURBER OF DAYS DELINQUENT X DAXLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date af the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. BUREAU OF TNDZVZDUAL TAXES TAX DTVISTON INH£RI'TANCE DEPT. 280601 HARR'rSBURG) PA 17128-0601 DALE 5 gALNUT LN CAHP HILL PIERCE PA 17011 COHHONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 10-1~-2003 HACLAY VIOLA 05-0q-2003 21 03-0549 CUHBERLAND 03123893 = Aeoun~ Remi~ed HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF NILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your accoun~, subei~ ~he upper portion of ~his form wi~h your ~ax payment. REV 1607 EX AFP (0! 03) "## TNHERZTANCE TAX STATEHENT OF A~:-~60~'~-'~'~ ESTATE OF HACLAY VIOLA FILE NO. 21 03-0549 ACN 03123893 DATE 10-14-2003 TH'rS STATENENT ]'S PROV'rDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN 'rN THE NAHED ESTATE. SHO#N BELON ZSA SUNNARY OF THE PRZNCZPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSNENT OR RECORD ADJUSTHENT: 10-06-2003 PRINCIPAL TAX DUE: PAYHENTS (TAX CREDITS): PAYHENT RECEIPT DATE NUHBER PAYNENT HUST BE NADE BY 12-05-2003~. AHOUNT PAID TOTAL TAX CREDIT r'-------~COUNT (+) - INTEREST/PEN PAID (-) 153.28 153.28 INTEREST AND PEN. TOTAL DUE .00 153.28 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR ZNSTRUCT/ONS. ) BALANCE OF TAX DUE .O0 PAYMENT: Detach the top portion of this Notice and submit with 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 #ILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH 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-ISIS). Applications ara available at the Office of the Register of Hills, any of the ZS Revenue District Offices or from the Department's g4-hour ensaerin9 service for forms ordering: 1-BOO-S6Z-ZOSO~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-SOZ0 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (S) calendar months after the dacadent's death, a five percent (5X) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 1996, tho first day after the end of tho tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from tho date of death, to the date of payment. Taxes which became delinquent before January l, 1982 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 l, 198Z 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 lgBZ through ZOOS ara: Interest Daily Interest Daily Interest Daily Rate Factor Year Rate Factor Year Rate Factor 19az ZOZ .00054& 1967 9Z .000Z47 1999 7Z .O0019Z 1983 16Z .00043B 1988-1991 XIZ .O00SO1 ZOOO 8Z .O0021g 1984 llZ .O00SO1 1992 92 .000247 2001 9Z .000247 1985 lSZ .000S56 199S-1994 7Z .O00lez ZOOZ 62 .000164 1986 lOX .00027q 1995-1998 92 .000Z47 ZOOS 5Z .O00XS7 --Interest is calculated as foXlows: XNTEREST = BALANCE OF TAX UNPATD X NUIIBER OF DAYS DELXNQUENT X DAXLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days beyond tho date of the assessment. If payment is made after the interest computation date shown on the Noticej additional interest must be calculated. BUREAU OF ZNDTVZDUAL TAXES ZNHERTTANCE TAX DZVTSTON DEPT. 280601 HARRTSBURG,, PA 171Z8-0601 GEORGE A VAUGHN III $904 TRINDLE RD CAMP HILL PA 1701~], COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT DATE ESTATE OF DATE OF DEATH ,.FILE NUMBER J'COUNTY ACN 10-20-2005 MACLAY 05-04-Z00:3 21 0:3-0549 CUMBERLAND 101 RE¥-1507 EX AFP (01-0S) VIOLA Amoun'l; Rem].~'l:ed 1 MAKE CMECK PAYABLE AND RENZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:3 NOTE: To insure proper crmdi~ ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. CUT ALONG THIS LINE I1~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) l~ INHERITANCE TAX STATEMENT OF ACCOUNT ~! ESTATE OF MACLAY VIOLA FILE NO. 21 0:3-0549 ACN 101 DATE 10-20-200:3 THIS STATEMENT ZS PROVTDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHONN BELO# ZSA SUNHARY OF THE PRINCIPAL TAX DUE, APPLZCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE, A PROdECTED Z~NTEREST F..~./gURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-14-2005 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): PAYMENT DATE 07-07-200:3 10-16-200:3 RECEIPT NUMBER CDOOZ774 REFUND r DISCOUNT (+) INTEREST/PEN PAID .00 .00 ZF PAID AFTER THIS DATE, SEE REVERSE SZDE FOR CALCULATION OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS. ) AMOUNT PAID 15:3.28 15:3.28- TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 .00 PAYNENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on tho reverse side. -- If RESIDENT DECEDENT make check ar money order payable to: REGISTER OF #ILLS, AGENT. -- If 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-1315). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's Z4-hour ansamring service for forms ordering: 1-800-$62-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-$020 (TT REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (52) discount of the tax paid is allowed. PENALTY: The 15X 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. 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 ahich became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .000164. All taxes mhich became delinquent on and after January i, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rote announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 arm: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor lgBz 202 .000548 1987 92 .000247 1999 72 .000192 1985 16Z .000438 1988-1991 112 .00050! ZOO0 82 .000219 1984 llZ .000501 1992 92 .000247 Z001 92 .000247 1985 152 .000556 1995-1994 72 .000192 Z002 62 .000164 1986 lOX .000274 1995-1998 92 .000247 2005 52 .000157 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill 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.