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REV"483 [8"78)
COt.'MONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPE RA nONS
INHERITANCE TAX SECTION
OFFICIAL NOTICE OF DETERMINATION
AND ASSESSMENT OF PENNSYLVANIA
ESTATE TAX
/OJ-/3r-1
'T
TO:
. -', ,- -..., ..-' ,--- ,.', -, - -.' ,,' -. , . .
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A. DETERMINATION:
1. Taxa!JJ,e estate based upon:", " ,',' " ' '
h.?>>nited States ,Estate' Tax' Retuin{Form 706)
~e communication' fromAhe Federa.I'C-overnment: .
confinning the acceptan.ce .of. orchange~ to the.
Federal Estate Tax Return
2. 'Amount of credit for State death taxes (as verified)"
3. Pennsylvania inheritance ~ax asses-sed
(excluding any di~count and/or interest)
4. Normel! inheritance'tax'paid to other.:States or
Territories of the United States (excluding
-'''<);::'any discount-'"cihd/or interest) .. .
5.,\'Total inheritance'tax ,credits (line item 3 plus line item 4)
6. ,,'iTotal liability for ,Penn'sylvania estote tax {line item 2
:=~f;"'-' minus line it~m,..5)-:':
. '
.' -,~,": ".;:.
'",c"", NOTE: Complete line items 7 and 8 ONL Y when determination
..' .. is bas'ed on, Federal Closing Letter,
7. ':"-~<_"mount of Pennsylv~~ia estate tax asses~ed:-on determination
""""d d "/A //\779'"
:;"~-";' ate ,:",,".' U - u- L6'::' '_:-
8. "'~'}-~"::Addition (reductio'n}"."to' Pennsylvania estate tax (line item 6
minus line item 7)
$
-'-'"
Determination prepored by:
Date:
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.'~ '
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B. ASSESSMENT". '" ",' "
1. Pennsylvania Est-a'te T-ax"r~fleCted"on:' .
line item A (6)
line item A (8)
2. Less credits:
DATE OF PAYMENT
$
.
AMOUNT PAID,
INTEREST
($,)
($ )
($ , )
" CREDIT
=
=
3. Balance of Pennsylvania estate tax due
$
Interest is due at the rate of six (6) percent per annum from
to the dote of payment.
Assessment prepared by:
AGENT FOR THE COMMONWEAL.TH
Date:
SEE REVERSE SIDE FOR INSTRUCTIONS
INSTRUCTIONS
To insure proper credit to your account, the name of the estate and file number should be
clearly printed on the check or money order.
This determination and assessment is made in accordance with Section 421 and Section 732
of the Inheritance and Estate Tax Act of 1961, 72 P.s. 2485-421, 732.
The estate tax imposed by Section 421 is due at the date of the decedent's death but shall
not become delinquent until the expiration of eight.n (18) months after decedent's death provided
that any estate tax occasioned by a final change in the Federol return or of the tax due thereon
shall not become delinquent until the expiration of one (1) month after the person liable ta pay
the tax receives final notice of the increase. Calculate interest fram the delinquent date shown
on the face of this form ta the date of payment using the following interest table:
---------------~------------------------------------------------------------------
1 month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 months .040 11 months .055
3 months .(115 6 months .030 9 months .045 12 months .(160
1 day .00017 11 days .00186 21 days .00352
2 days .. .00034 12 days .00203 22 days .00369
3 days .00051 13 days .00 22lI 23 days .00386
4 days .00068 14 days .00237 24 doys .00403
5 days .00085 15 days .00250 25 clays .00420
6 days .00101 16 days .00267 26 days .00437
7 days .00118 17 days .00284 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00152 19 days .00318 I!J doys .0048
10 days .00 16.9 20 days .00335 30 days .00500
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Any party in interest, including the COlllRonwealth and the p.sonal representative, not
satisfied with the assessment may object thereto within sixty (60) doys aft. receipt of this
notice as provided by Section 1001 of the Inheritance and Estate Tox Act of 1961 (72 P.s.
~ 2485-1001)
Make check or money order payable ta:
"R eg i ster of Willa, Atent It
l,Iail to the address listed below: