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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 260601
HARRISBURG PA 17128-0601
INHERITANCE TAX
RECORD ADJUSTMENT
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DEPARTMENT OF REVENUE
REY-1604 EX AFP (12-11)
DATE 06-07-2012
ESTATE OF HILL JEAN M
DATE OF DEATH 05-13-2010
FILE NUMBER 21 11-0370
COUNTY CUMBERLAND
SSN/DC 202-20-5965
ACN 11117541
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~--) RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1604 EX AFP C12-11)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE• 06-07-2012
ESTATE OF: HILL JEAN M DATE OF DEATH: 05-13-2010 COUNTY: CUMBERLAND
FILE NO.: 21 11-0370 S.S/D.C. N0.:202-20-5965
ACN: 11117541
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT NO.: 0771022336
TYPE OF ACCOUNT: ( ) SAVINGS CX) CHECKING C ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 10-09-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
7,679.26
X 0.500
3,839.63
2,804.48
1,035.15
X .15
155.27
NOTE: TO ENSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
T0: "REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
03-20-2011 CD014166 .00 155.27
02-21-2012 CD015b13 .45- 433.98
TOTAL TAX PAYMENT 588.80
BALANCE OF TAX DUE 433.53CR
INTEREST AND PEN. .00
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A
"CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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 WILLS, AGENT.
Failure to pay the tax, interest, and penalty due may result in the filing of a lien of record in the
appropriate county, or the issuance of an Orphan's Court citation.
REFUND CCR): 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 are available from
the Department's web site, www.revenue.state.pa.us, any Register of Wills or Revenue District Office, or from
the Department's 24-hour answering service: 1-800-362-2050; services for taxpayers with special hearing and/or
speaking needs: 1-800-447-3020 (TT only).
REPLY TD: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, PO Box 280601, Harrisburg, PA 17128-0601, or call
(717) 787-6505.
DISCOUNT: If any tax due is paid within three calendar months after the decedent's death, a five percent discount
of the tax paid is allowed.
PENALTY: The 15 percent tax amnesty non-participation penalty is computed on the total of the tax and interest assessed,
and not paid before Jan. 18, 1996, (the first day after the end of the tax amnesty period.)
INTEREST: Interest is charged beginning with first day of delinquency or nine months and one day from the date of
death to the date of payment. Taxes which became delinquent before Jan. 1, 1982 bear, interest at the rate of
six percent per annum calculated at a daily rate of 0.000164. All taxes which became delinquent on and after
Jan, 1, 1982 will bear interest at a rate which will vary from year to year with the rate announced by the
PA Department of Revenue. Rates for 1982 through 1999 can be found in the Pennsylvania Resident Instruction
Booklet, <REV-1501) the Pennsylvania Non-resident Instruction Booklet (REY-1736) or on the Pennsylvania
Deptartment of Revenue Web site www.revenue.state.pa.us. The applicable interest rates for 2000 through
2012 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
2000 8% .000219 2001 9% .000247 2002 6% .000164
2003 5% .000137 2004 4% .000110 2005 5% .000137
2006 7% .000192 2007 B% .000219 2008 7% .000192
2009 5% .000137 2010 4% .000110 2011 3% .000082
2012 3% .000082
Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
Any notice issued after the tax becomes delinquent will reflect an interest calculation to 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.
REV-1470 fJC (01-10)
~ Pennsylvania
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
INHERITANCE TAX
EXPLANATION
OF CHANGES
DECEDENTS NAME
Jean M. Hlll FILE NUMBER
2111-0370
REVIEWED BY ACN
James Russell 11117541
ITEM
SCHEDULE Np, EXPLANATION OF CHANGES
Deductions in the amount of $2,804.48 for nursing home bills and partial funeral expenses
have been credited to the following ACN(s):
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