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BUREAU OF INDIVIDUAL T,�.g �y�� � �,t' "" ! � �NOTICE OF INHERITANCE TAX �EPARTMENT OFREVENUE
INNERITANCE TAX UIVISION ` kPPRYtIS�EMENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280603 OF DEDUCTIONS. AND ASSESSMENT OF TAX ON REV-1548 IX AFP C12-12)
HARRISBURG PA 1�128-0601 1;u.`� J�uI. � F7m � �[�TLY HELO OR TRIIST ASSETS
l U
DATE 07-01-2013
GL[=i�I�� GI ESTATE OF EADS JR JACK C
DATE OF DEATN 07-16-2012
Q;�Z'�f�t�FfS� i;�,Ui�r�� FILE NUMBER 21 12-0822
CU�It�L'RLP�Pi�i���:O.. i�A COUNTY CUMBERLAND
SSN/DC 191-40-8541
DOROTHY BOLTON ACN 12143002
70 OLD FEDEIRAL RD APPEAL BY DATE:OS-30-2013
CAMP HILI PA 17011-2047 (SeereversesideunderObjections)
A�ount Reeittsd
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SpUARE
CARLISLE PA 17013
CUT ALON6 THIS LIINE � RffTAIN LOWER PORTION FOR YOUR RECORDS F
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REV-1548 EX AFP C}2-12)
NOTICE OF IMHERITANCE TAX', APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUC7IONS. I,AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
� DATE: 07-01-2013
ESTATE OF:EADS JR JACK ��� C DATE OF DEATH:07-16-2012 COUNTY:CUMBERLAND
FILE NO. : 21 12- 822 S.SAD.C. NO. : 191-40-8541 ACN: 12143002
TAX RETU N WAS: CX) ACCEPTED AS FILED O CHANGED
� JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS #ST FCU ACCOUNT NO. : 343748-11
TYPE OF ACCOUNT: OSAVINGS K �0 CHECKING OTRUST OTIME CERTIFICATE
�ATE ESTABLISHED 11-25-2008
Account Balance 67,416.69 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X � 0.166 YOUR ACCOUNT, SUBMIT THE
Amount Subject to�. Tax 11 ,236.34 UPPER PORTION OF THIS NOTICE
Debts and Ueductibns ' � .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount j 11 ,236.34 REGISTER OF WILLS AT THE
Tax Rate r � .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 505.64 OR MONEY ORDER PAYABLE T0:
' "REGISTER OP WILLS, AGENT."
TAX CREDITS: �
PAYMENT 'RECEIPT DISCOUNT C+) qMOUNT PAID
OATE �. NUMBER '� INTEREST/PEN PAID (-)
INTEREST IS CHARC�ED THROUGH 07}09-2013 TOTAL TAX PAYMENT .00
AT THE RATES APPI}ICABLE AS OUT4INED ON THE BALANCE OF TAX DUE 505.64
REVERSE SIDE OF 1�HIS FORM '�. INTERES7 AND PEN. 3.48
�� TOTAL DUE 509. 12
� IF PAID AFTER THIS DATE, SEE REVER$E FOR CALCOLATION OF ADDITIONAL INTEREST. � �\
IF TOTAL DUE IS R�FLECTED AS A ^CRqi IT^ (CR). YOU MAV BE DUE A REFUND.
SEE REVERSE SIDE �F THIS FORM FOR INSTRUCTIONS.
PURPOSE OF
NOTICE� To fulfill kha reauire�ents of Sectian 2140 ot tha Inheritance antl Estata Taz Aet. Act 2S of 2000. (72 P.S.
Sectian 9140L �
PAYMENT: Detech the too nortion of this notice antl sub�it vith vour oavw�nt to the Rapistar of Wills orintatl on tha
reverse sitle. Make c�eck ar �onev ordar vayabla to: Rapistar of Wflls, Aeant.
Failura to oav t�e tas, intorast antl oanal4v dua eay result in the fil3ne of a lien in the aoorooriete
countv or tha issuance of an Orohan's Couri citation.
REFUND CCR): R rafuntl of a kax cratlit, whie� was not repuastaC on t�a 4ax relurn. �ay Ea reau�ztad by co�vlatinp an
"AOClieation fer Rafund ef Pannsvlvania lnhari4ance entl Estafa Tex•' (REV•1313). Avnlicationa arc available fro�
ths Danarhwtb�WaO aib e4 wr.��wnuastsU.oa.us. e�q. Rapistar of Mills or Rw�nua District Offie� or fro� tha
Daoart��nf's 24-hour anawarin0���rv ee� 1•! •3624 60; sarvieas for tuoavers with zoaeial hearinp antl/or
so�akinp roads� 1-800-447-3020 (TT onlv).
OBJECTIONS: Ary party in interast not saiisHetl vith tM aonraisan4, allwance or tlisalloranca of Eetluctions or essess�ent ot t�
(SncluEinO tliscount or intarast) as shwn on this notiea �ay obj�ct rithin 60 tlys of the �st� af raeai0t of this notice
bv�
•) Pratast to the PA Devart�ant of Rcvenw, Boartl ofi Apo�sls bY filinB e vrotest online a4
www.boertlef pl strt�. e.us an or b�fe�� Sh� 60-dm. apwel Deried n[piras.
In orE�r fer �n � �c ibnic V�o4�at ta ba relitl, rw�aust rw�iva a confirution nwb�r and orocassetl tlata
fro� tha 6oarA of Avo��ls W�b site. You �ey elsa santl a rritf�n proi�st to P� Oaoart��n4 of R>vanue.
Board of Rooaala. Po !mc 2H1021, Harrisburp, PA 17128-1B21. Patitions �p not ba fazad; ar
B) Elect to hava thc �aiter dateninctl at tha eudiY of the narsonal raoresantative aceount; or
qp�IN- L) Appeal to the Orohsns' Court.
ISTFATIVE
CORRECTIONS� Factual errors tliscovereA on this assesseenk shoultl be addrassetl in vritinp to: PR Deoart�ent of Ravenue.
Buraau of Individual Taxes, ATTN: Post Rasess�ent Raviw Unii. PO Box 280601, Narrisbura. PA 17128-0601
or call (717) 787•6505. Sae Papa 4 of "Instruckions for Inheritanea Ta Raturn for a Rosident Decetlant" (REV-1501)
for an exolanetion of sMiniatrativelv correctable errors.
UISCOUNT: If any kuc tlue is oaitl wiiAin three calentlar �onths aftar the tlacaEant's dea4h, a five oercent discount of the t� paitl
is allowetl.
PEW1LTYi Tha 15 vercent tax anasty non-verticination oanalty is co�nutetl on tha ioial af the tax and interest assessad and not
oaid before Jan. 18. 1996, iho first tlav aftar tha a�W of t�a tax anesiy veriod. T�is non-oarticivation
oenalty is anoaalebla 3n !he sa�e �anner antl in Lho the ss�e ti�a pariod as veu roultl aoaaal t�e kax anE interesk
that has baen assessatl as indicatetl on this notice.
INTEREST: Interest is char9ed bapinninp rith first tlav of tlalinauencv or nina �anths end one tlev
tro� tha date of tleath to tha tlata of pay�ent. Taxez rh3e� beca�e tlalinauani before Jan. 1. 1982.
bcar interest at the rata of six oarcen4 vor annu� <aleulat�d at a tlailv raia of 0.000164.
All taxes whieh beca�e tlalinvuent on or efter Jan. 1, 1982 will bear intenst ai a rete vhic� varies fro�
vear to vaar rith th� ratx announead M ths PA Danart�ant of R�vanue. Ratas for 19l2 throuph 2006 can be
fountl in t�e Pennsvlvania Resitlent Instruelion Booklet (REV-1501), ihe Pennsvlvania Non-Resitlant Insiruction
Booklei CREV-1736) or on tha Daparbent of Ravenue Web sita rw.rrvmw.ststa.oa.us.
The aoolicabla interest rak�s for 2007 throu0h 203i ara:
Iniaresi Uailv Intarest Uailv Intarast �ailv
V�ar Rate Feekor Y�ar R��a Fector Y�ar Rata Factor
2007 8X .000219 2008 7f: .000192 2009 5X .000137
2010 4X .000110 2011-2013 3X .000082
InYerest is caleule4ad ss follows:
INTEREST = BALANCE OF TAX U�ASD % NUMBER OF MYS DELINYUENT X MILY INTEREST FACTOq
Rny notice issuad afYer the tv[ Decwes delin0uent will refleck an intarast calculafion to 15 tlavs
beyond the date of t�e assass�en4. If paY�ant is �ade afte� iha interesk co�putation tlate shwn on 4he
noYice, addi4ionel interesk �ust ba calculeteC.