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NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-09-2005
ESTATE OF MITCHELL
JACK
COUNTY
C DATE OF DEATH 05-20'2004
FILE NO.
,;( 1-05 - OLf4
TAX RETURN WAS:
S.S/D.C. NO. 194-09-2345
() ACCEPTED AS FILED (~:;:: ::)ff:.::, ~EE
JOINT OR TRUST ASSl!T"ItlFORtlAYt~,T
, '
ACN 04136240
ATTACHED NOTICE
FINANCIAL INSTITUTION, WAYPOINT BANK
"-);.. '
CUMBERLAND
" '7
j I
9: 09
ACCOUNT NO.
700034848
TYPE OF ACCOUNT: () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 12-01-1997
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
10,044.01
0.500
5,022.01
.00
5,022.01
.15
753.30
TAX CREDITS:
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 RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 05-17-2005 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 753.30
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 8.88
TOTAL DUE 762.18
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
REFUND (CR1:
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
A reiund of a tax c~edit, which was not ~equested on the Tax Return, .ay be ~equested by co~leting an
"Application for Refund of P.nnsylvania Inhe~itanc. and Estat. Tax" (REV-1313). Applications a~e available
online at www.rev.nue.stateoa.us. any Register of Wills or Revenue District Office, or fro. the Depart.ent's
Z4-hour answering se~vice for for.s orders: 1-800-36Z-Z050; services for taxpayers with special hea~ing and/or
speaking needs: 1~800-447-3020 (TT only).
Any party in interest not satisfied with the 8pprais.ent, allowance o~ disallowance of daductions or assessment of tax
(including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice
by filing one of the following:
A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at
www.boardofsPOBals.state.pa.us on or before the expiration of the sixty-day appeal periOd. In order for
an electronic protest to be valid, you Must receive a confirmation n~ber and processed data froN the
Board of Appeals website. You ~ay also send a written protest to PA Department of Revenue, Board of Appeals
P.O. Box Z810Z1, HarriSburg, PA 171Z8-10Z1. Petitions may not be faxed.
B) Election to have the matter determined at the audit of the account of the personal representative.
C) Appeal to the O~phans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of RevBnUB,
Bureau of Individual Taxes, ATTN: Post Assess.ent Review Unit, P.O. Box Z80601, HarriSburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of ths booklet "Instructions for Inhsritance Tax Retu~n for a Resident
DBcedent" (REV-I501) for an explanation af administratively correctable errors.
If any tax due is paid within th~e8 (3) calendar months after the decedent"s death, a five percent (S'l.l
discount of the tax paid is allowed.
The 15~ tax aanesty 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 time periOd as YOU would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, o~ nine (9) months and one (1) day
fro. the date of death, to the date of payment. Taxes which became delinquent before January I, 198Z
bear interest at the rate of six (6~) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after January 1, 198Z will bear interest at a rats which will vary
calendar year to calendar year with that rate announced by the PA Depart.ent of Revenue. The applicable
interest rates for 198Z through ZOOS are:
Interest Daily
Rate Factor
~ :iiiiS4i
16~ .000438
11% .000301
13% .000356
ID'l. .000Z74
9% .000Z47
Year
iffi
1983
1984
1985
198&
1987
Interest
Rste
--m-
..
7X
9%
7%
..
Year
00-1991
1992.
1993-1994
1995-1998
1999
ZOOD
-~Interest is calculated as follows:
fro.
Daily
Factor
:oDffii
.000Z47
.00019Z
.000Z47
.00019Z
.000Z19
Interest
Rate
--w-
6.
,.
4.
5%
Daily
Facto~
.'i'OiiZ47'
.000164
.000137
.000110
.000137
Year
20ii
Z002
Z003
2004
ZOOS
INTEREST = BALANCE OF TAX UNPAID X NUNSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued afte~ the tax beco.es delinquant will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If pay.ent is made after the interest computation date shown on the
Notice, additional interest .ust be calculated.
Ai"-~1r~~~~~~~~1J~'.........._-----
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-09-2005
ESTATE OF MITCHEll
JACK
COUNTY
CUMBERLAND
r... ,-.....-.
C DATE OF' J)EAT\in5-.20-2004
FILE NO. 021- 05 044<(
TAX RETURN WAS:
)' I i' Ail 9: 09
S.S/D.C. NO. 194-09-2345
() ACCEPTED ~~t~;F(X) CHANGED SEE
JOINT I9IJ'.lTRQS '.J TINFORMATION
ACN 04136239
ATTACHED NOTICE
FINANCIAL INSTITUTION, WAYPOINT BANK
.1"'._\
ACCOUNT NO.
755261224
TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST ()() TIME CERTIFICATE
DATE ESTABLISHED 02-15-1995
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
4,400.40
0.500
2,200.20
.00
2,200.20
.15
330.03
TAX CREDITS:
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
DR MONEY ORDER PAYABLE TO,
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 05-17-2005 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 330.03
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 3.89
TOTAL DUE 333.92
. IF PAID AFTER THIS DATE, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIDNS. )
REFUND (tRl:
OBJECTIONS:
ADHIN~
ISlRATIYE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
A refund of a tax credit~ which was not requested on the Tax Return~ /lay be requested by cOlllplBting an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REY-1313l. Applications are available
online at www.revenus.stats.Da.us~ any Register of Wills or Revenue District Office~ or frolll the Departlllsnt.s
Z4-hour answering service for for/ls orders: 1~800-36Z-Z050; services for taxpayers with special hearing and/or
speaking needs: 1-800-447-3020 (TT only).
Any party in intsrest not satisfied with the appraiseent, allowanCQ Dr disallowance of deductions or assess.ent of tax
(inCluding discount or Intlilrest) as shown on this Notice Illay object wi thin 60 days of thlil date of receipt of this notice.
by filing one of the fol1owing:
A) Protest to the PA Depart.ent of Revenue, Board of Appeals. You .ay object by filing a protest online at
www.boardofappeals.state.pa.us on or befors the expiration of the sixty-day appeal psriod. In order far
an electronic protest to be valid~ you Illust receive a confirlllation nueber and processsd date fro. ths
Board of Appeals website. You .ay also sand a written protest to PA Department of Rsvenue~ Board of Appeals
P.O. Box 2810Z1~ Harrisburg~ PA 17128-1021. Petitions mBy not be faxed.
B) Election to have the .atter detsrmined at the audit of the account of the personal rspresentative.
C) Appeal to the Orphans' Court.
Factual errors discovered on this assessment should bs addressed in writing to; PA Department of Revenue~
BUr8BU of Individual Taxes~ ATTN: Past Assessment Review Unit, P.o. Box 280601~ Harrisburg~ PA 17128-0601
Phone (717) 787-6505. Sae page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decsdent" (REV-ISOl) for an g~planation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dBcedant's death, a five percent (5X)
discount of the tax paid is aIlowsd.
The 15% tax a~esty non-participation penalty is co.puted on the total of ths tax and intersst asssssBd~ and not
paid before January 18~ 1996~ the first day after ths end of the tax a.nesty periOd. This non-participation
penalty is appealable in ths sa.e menner and in the the sa.e tims period as you would 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 (I) day
from the date of death~ to the date of pay.ent. Taxes which became delinquent before January 1. 1982
bear interest at the rate of six (liin percent per annu. calculated at a daily rate of .000164.
All taxes which became dulinquent on or aftsr January 1, 1982 will bear interest at a rats which will vary
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2005 arel
Interest Daily
Rats Factor
""'2'Or- :DiiO'5'4i
16X .000436
HX .000301
13X .000356
lOX .000274
9X .000247
frail
Year
00
1983
1984
1985
1986
1987
Interest
Rate
--m--
.X
]X
9%
]X
8X
Year
2iiOi
2002
2003
2004
Z005
Daily
Factor
:omor
.000Z47
.000192
.OGD247
.000192
.000219
Interest
Rete
~
6X
5X
4X
5X
Daily
Factor
. 'DOO"Z47
.000164
.000137
.000110
.000137
Year
rn8-1991
'99.
1993-1994
1995-1998
1999
ZOOO
--Intersst is calculatsd as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF OArS DELINQUENT X DAILr INTEREST FACTOR
--Any Notice issued after the tax becolles delinqusnt will reflect an interest calculation to fifteen (15) days
beYond the date of the assessment. If pay.ent is made after the interest computation date shown on the
Notics~ additional intersst .ust be calculated.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SLATICK PATRICIA J
32 HAZEL CIRCLE
MECHANICSBURG, PA 17050
____un lold
ESTATE INFORMATION: SSN: 194-09-2345
FILE NUMBER: 2105-0448
DECEDENT NAME: MITCHELL JACK C
DATE OF PAYMENT: 05/17/2005
POSTMARK DATE: 05/17/2005
COUNTY: CUMBERLAND
DATE OF DEATH: OS/20/2004
NO. CD 005333
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04136237 I $4,488.11
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$4,488.11
REMARKS:
CHECK# 1541
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS