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BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OFREVENUE
INNERITANCE TAX DIVISION APPRAISEMENT, ALLOMANCE OR DISALLOWANCE
PO BOX 2806u1 OF DEOUCTIONS. AND ASSESSMENT OF TAX ON REV-1548 EX AFP c12-12)
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
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i� V�,� . . . . .
. DATE OB-19-2013
�+��-���� � � - � � � � � � � ESTATE OF CALEYSEIG SHERRIE
DATE OP DEATH 11-11-2012
� '� ��., �^i _ =�'-� FILE NUMBER 21 13-0016
� COUNTY CUMBERLAND
SSN/DC
BEVERLEY LL;�;`�';� !.',- ACN 13136011
645 SILV��f;��il�6[(��;��'; APPEAL BY DATE:10-18-2013
M E C HAN,T G�S B,URG L 4`x,_�E/1�.��.,70 6 q-2873 (See reverse side under Objeclions)
GtlMfitK A�ount Re�itted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
RE6ISTER OF WILLS
1 COURTHOUSE SqUARE
CARLISLE PA 17013
CUT ALON6 THIS LINE '� RETAIN LOWER PORTION FOR YOUR RECORDS F`
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REV-1548 EX AFP (12-12)
NOTICE OF INHERITANCE 7AX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX DN JOINTLY NELD OR TRUST ASSE7S
DATE: OS-19-2013
ESTATE OF:CALEYSEIG SHERRIE DATE OF DEATH:11-11-2012 COUNTY:CIIMBERLAND
FILE NO. : 21 13-0016 S.S/D.C. NO. : 191-56-6550 ACN: 13136011
TAX RETURN WAS: (X) ACCEPTED AS FILED ( J CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT NO. : 0351060677
TYPE OF ACCOUNT: OSAVINGS ( JO CHECKING C )TRUST OTIME CERTIFICATE
DATE ESTABLISHEU 11-30-1983
Account Balance 13,611.68 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax _ 6,805.84 UPPER PORTION OF THIS NOTICE
Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE
Taxable AmounY 6,805.84 REGISTER OF WILLS AT THE
Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 306.26 OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) qpOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-22-2013 CD017926 .00 306.26
TOTAL TAX PAYMENT 306.26
BALANCE OF TAX DUE . 00
INTEREST AND PEN. . 00
TOTAL DUE .00
� IF PAID AFTER THIS DATE. SEE REVERSE FOR CALLULATION OF ADDITIONAL INTEREST. • ` ` ^ ,
IF TOTAL DUE IS REFLECTED AS A "CREDIT^ CCR), YOU MAY DE DUE A REFUND. \h�/
SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS. \�;l
PURPOSE OF
NOTICE: To fulfill tha raquira�anks of Seetion 2140 of the Inheritance entl Esteta Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
PAVMENT: OaSaeh 4ha tao oortion of th4s noYiea antl sub�it with vour oav�ent io tha Rapister of Wills nrinted on the
reversa sitle. Make check or �onaY ortler paYabla to: Rapister of Wills. Apent.
Feiluro to oav the tax, inGrast antl nonaltv dua �av rasulY in the filinp of a lien in the aooronriate
countv or the issuanca of an Orohan's Ceurt eStation.
REFUNU (CR)� A rafund of a tax cndi4, rhie� ras not roauwted on tM tax raturn, �sy ba nou�cbd bv co�olatinp en
"AOOlicatSon for R�fund of P}nnsvlvania lnh�Htanea antl EaLta Tv�^ (REY4313). �DOlic�Yionz en availaEle tro�
tM D�O�n4��nt•t.IMb siY� �t�r�ww.hr�nuwsLta. .us, aM RaYisi�r of Wills o��IMr�au� Oistri<t 01f�i¢� or fro� ths
Dwertont's 26-hour msw�rin0 sn�ie�a 1"tEE ]62•2050: slr�ids far tn[pm��rs rit� soieiel �earinp entl/or
svoekinp na�ds� 1-800-447-3020 (TT onlY).
OBJECTIONSi Am earty.in interost not saiisfied with tha annrais�en4, allowanea or tlisallwanea of daEUetions or assass�ent of tarz
(ineludinp�0lseount or intsr�sU az zhown on thia netle����v obiwt wikA3n 60 Eevs of tha tlab af roeeiot of t�is noiica
ev:
A) Protast to 4ha PA O�oxtunt of Rwanua, loartl of Mpuls bY filinp a orotest onlina et
.v4w.b0�N7p£ • b iL. .YS o0 Of bYfDl`Y Yh� LO-tlW ww+i P1HOtl 1XP3Ni.
In ortl�r for�pi a tietnn3< Prot�st to b� rallA. Yau awY�eve�iva a confin�tion nwb�r anA oroeassatl date
fro� the lo�rd of �oouls W�b sSU. You �sy elso s�nE a rrltt�n protut to PA Decsrtont of Revanua.
YoarO of Aooa�ls. PO iox 263021, Narrisburp. P� 1712l-I�1. P�tStions qy not O���fuatl; or
!) Eleef to �ava th� �etbr A�tar�inad �t kha autlit af th��D��sonQ �aDr�s�ntsC3v� aceount; or
pq�IN• C) Aoo�al to ths Orphans' Lourt.
ISTRATIVE
LORRECTIONS: Factual errors diseovaretl on this assass�an! shoulC ba atltlressed in writinp tos PA Oapart�ani of Ravanue,
Bureau of Individusl Taxes, ATTN� Post Rsseszsent Review Unil, PO Box 280601, Harrisburp. PA 17128-0601
or eall (717) 787-6585. Sae Pspe 4 of "Instruckiona for IriMHbnn Tvc Return for a Rasident Deeatlant" (REV4501)
for an �zolanstion of atl�inistr�livalv eorraetabla arrors.
DISCOUNT� If anv tax dua is oeitl vithin three ealantlar nonths afYar tfie tlaeaAant's tleath, a five oarcant tliseount of tt+e taz eaitl
is allowetl.
PENALTV� The 15 oarcant tax a�nesty non-oarticination penalty is co�ouYeG on the toiel of tha tax snd interesi assessatl and not
psid bafore Jan: 18, 1996, tha first tlev aftar kha antl of tha tax annasty peHOE. This non-carticipation
o�naltv is aYVaslebL in iM sa�a �annar and in iM tM aM� ti�a oariod �s You woultl acVeel tha tax sntl interas4
that has b�m assassad es intlieaietl on this notiee.
INTEREST: Intarast is chsryed bapinninp wit� firsk tley of dalinnuanev or nina �onths and ona dav
fron khe tlete of daaih to tM tlaN of nav�ent. Texes vhich becwe d�linauant bafore Jan. 1, 1982,
baar interost at tha reL of six naroan4 par annu� ulculatltl at a Eaily reL of 0.000164.
All kv[es which beea�a tlalinnuent on or eftar Jan. 1, 1982 will bear ini�r�st at a rata whic� varias fron
vear Yo vear with !ha rata announcetl by the PA Uaoart�ant of Revenu�. Rates for 1982 throuah 2006 can ba
found in the PannsYlvanie Resitlent Instruction Booklat (REV-1501), ihe PonnsYlvenia Non-ResitlenY Inskruction
Booklat (REV-17i6) or on tha Dauart�eni of Rovanue Wab sita ww.l`1V111YY.SYmkY.Di.US.
Tha a0olieable inkerest rates for 2007 throuph 2013 are:
Interesf OeilY Intarest Dailv Intarest Oaily
Y�ar Rate Factor Y�sr Rate Faeior Y�ar Rata Faetor
2007 BY. .000219 2008 7X .000192 2009 5Y. .000137
2010 4X .000130 2011-2013 3Y. .00OU82
Interes4 is taleulatad as follovsv
INTEREST = BALANCE OF TAX LNPRID X NUMBER OF p11YS UELINGUENT X MILY INTEREST FACTOR
Arir notice issuetl after the Lax beco�es tlelinauent will refleet an inierosk calculetion to 15 tlavs
beyontl the de4a ot tha assess�ent. IF oaY�ent is �ade efter the intarast eo�DUtation tlafe shwn on the
nokiee, aEtliYional inYerest sus! ba calculatetl.