Loading...
HomeMy WebLinkAbout01-26-07 REV-1500 EX (6-00) .. OFFICIAL USE ONLY COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2 1 0600671 I- Z W C w U w C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Margaret J Weaver DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 05/05/2006 07/07/1929 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Joseph M Weaver ~ 1. Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received COUNIY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 207-22-2193 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I- Z W C Z o ll.. lJ) W c:: c:: o U D 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13-82) D 4a. Future Interest Compromise (dete of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy of Trust) ~ 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A)(AttachSchOJ REGISTER OF WILLS SOCIAL SECURITY NUMBER 192-14'-5857 W l- x: SlJ) U c::x: wll..U :tOO Uc::..J ll..lll ll.. < NAME Susan E Stott FIRM NAME (If Applicable) Stott & Stott TELEPHONE NUMBER 717-243-8077 COMPLETE MAILING ADDRESS 157 S Hanover St Carlisle, PA 17013 1. Real Estate (Schedule A) (1) OFFICIAL Us'~NL Y C".-.") 2. Stocks and Bonds (Schedule B) (2) r".) 0"' 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (4) (5) -Cj ---"'" 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) z o t= :3 :J l- ii: ~ w 0::: 6. Jointly Owned Property (Schedule F) (6) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 177,354.87 25,179.46 .r:'" .J::;- 8. Total Gross Assets (total Lines 1-7) (8) 8,543.00 2,165.91 202,534.33 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11) 10,708.91 191,825.42 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) (12) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 191,825.42 z o i= <C I- ~ a.. ::E o U >< <C I- 20. ~ 15. Amount of Line 14 taxable at the spousal tax 165,335.50 ~(15) rate, or transfers under Sec. 9116 (a)(1.2) x .0 16. Amount of Line 14 taxable at lineal rate 26,489.92 x .0 ~(16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x.15 (18) 19. Tax Due (19) .00 1,192.05 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 1,192.05 > > B~ SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 5W4632 1.000 q." " , " o d t' C I t Add ece en s omp e e ress: STREET ADDRESS 5 Channel Dr CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 1,192.05 1,500.00 59.60 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A +8 + C) (2) 1,559.60 Total Interest/Penalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 367.55 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) .00 A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58).00 Make Check Payable to: REGISTER OF WILLS, AGENT - ~...~- -. l1li1 -... PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. . . . . . . . . . . . . . . b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or .. . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ~ D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes No o o o o D D D D D ~ DATE ?! 7 I --,;7. I> -() DATE 01/24/2007 157 S. Hanover St. Carlisle, PA 17013 - 1 11 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.s.g 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P .S. 9 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9 9116(1.2) [72 P.S. 9 9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. 9 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 5W4633 1.000 REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret J Weaver SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21-060671 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT{S) NAME A. Nancy A Clark ADDRESS RELATIONSHIP TO DECEDENT Daughter 26 Edgewood Way Newar;c:.,DE 19702 B. Patricia J Lichty 3604 Loch'nor Parkway Durham, NC 27705 Daughter c. Joseph M Weaver 5 Channel Dr Carlisle, PA 17013 804 Lisburn Rd Carlisle, PA 17013 Spouse O. Kenneth M Weaver Son JOINTL V-OWNED PROPERTY: lETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF NUMBER OR SIMILAR IDENTIFYING NUMBER. ATIACH DEED FOR NUMBER TENANT JOINT JOINTLY -l-EUD REAL ESTATE VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. 01/16/02 Sovereign Bank CD 12,338.96 50 6,169.48 Account # 1695331254 2. B. 01/16/02 Sovereign Bank CD 12,338.96 50 6,169.48 Account # 1695331288 3. B & 07/22/98 Sovereign Bank CD 6,489.04 33.334 2,163.06 C Account # 1695213205 4. B & 01/16/96 Sovereign Bank CD 10,799.06 33.334 3,599.76 C Account # 1675207672 5. C & 07/10/86 Sovereign Bank Checking 2,900.75 33.334 966.94 D Account # 1691017493 6. C 1986 M&T Bank Checking 1,206.94 50 603.47 Account # 2674037102 7. C 02/13/86 Citizens Bank Checking 3,418.20 50 1,709.10 Account # 6247706109 8. C 05/18/04 Wachovia Bank CD 18,175.39 50 9,087.70 Account # 247412062027490 9. C Unknown 505 Shrs Comcast Stock 15,447.95 50 7,723.98 10. C Unknown 702 Shrs AT&T 18,259.02 50 9,129.51 11. C Unknown 1408 Shrs Bellsouth 198,795.52 50 99,397.76 12. C Unknown 18 Shrs PP&L 540.54 50 270.27 13. C Unknown 682 Shrs Votophone 1,623.16 50 811.58 14 C Unknown 97 Shrs Avaya 1,245.48 50 622.74 15. C Unknown 552 Shrs Quest 3,731.52 50 1,865.76 16. C Unknown 1112 Shrs Verizon 36,462.4B 50 18,231. 24 17. C Unknown 1168 Shrs Lucent Technologie~ 17,006.08 50 8,503.04 18. C 1986 1000 Trails Time Share 660.00 50 330.00 Clearfield, PA TOTAL (Also enter on line 6, Recaoitulation) $ 177,354.87 5W46AE 1.000 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret J Weaver SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21-060671 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM IN:LLCE TI-E No\ME OF TI-E TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE NUMBEF ~DATEOFTR!>NSFER ATTACHACCPY OF THE OEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE 1. Citizens Bank CD 30,472.91 50.00 3,000 12,236.46 Account # 6247706109 Transfer to Nancy J Clark Decedent's Daughter 2. Wachovia IRA 12,943.00 100 12,943.00 Account # 257410060357423 Beneficiary Joseph M Weaver Decedent's Spouse TOTAL (Also enter on line 7, Recapitulation) $ 25,179.46 (If more space is needed, insert additional sheets of the same size) 5W46AF 1.000 REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret J Weaver SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-060671 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 1. FUNERAL EXPENSES: James R Gingrich Memorials - Inscription Myers Funeral Home Inc 125.00 7,876.00 2. B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Joseph M Weaver Social Security Number(s) I EIN Number of Personal Representative(s) Street Address 5 Channel Dr City Carlisle Year(s) Commission Paid: 0 State PA Zip 17013 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 42.00 5. Accountant's Fees 500.00 6. Tax Return Preparer's Fees 7. 5W46AG 1.000 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 8,543.00 ~EV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Margaret J Weaver SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-060671 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. DESCRIPTION Central PA Pulmonary Associates Holy Spirit Hospital Harrisburg Gastroenterology LTD Family Home Medical Heritage Cardiology Assoc Internists of Central PA Bronstein Jeffries, PA Hershey Kidney Specialists VALUE AT DATE OF DEATH 293.43 981. 5 68.22 9.66 133.23 340.37 27.50 312.00 5W46AH 1.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,165.91 LAST WILL AND TESTAMENT OF MARGARET J. WEAVER I, MARGARET J. WEAVER, of Carlisle, Cumberland County, Pennsylvania, make, publish and declare this as and for my Last. Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my husband, JOSEPH M. WEAVER, provided he survives me by sixty (60) days. SECOND: Should my husband, JOSEPH M. WEAVER, prede- cease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remain- der of my estate of whatever nature and wherever situate, includ- lng any property over which I hold power of appointment and together with any insurance policies thereon, as follows: (A) I give and bequeath my membership in the Treasure Lake Property Owners Association, Inc. timeshare, at Treasure " Lake, DuBois, Pennsylvania, being Account No. 851, to my son, KENNETH M. WEAVER, provided, however, that should he predecease -"- me, I direct that this bequest be and become a part of my residuary estate to be distributed as set forth hereinbelow. (B) I give and bequeath my membership in the Travel ....~.- ~ Resorts of America timeshare, at Pinehurst, North Carolina, being :~' Account No. 141624 -I, to my daughter, PATRICIA J. LICHTY, pro- ,"" :'~ vided, however, that should she predecease me, I direct that this "'. ~, bequest be and become a part of my residuary estate to be dis- \ tributed as set forth hereinbelow. " (C) I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, as follows: (i) Ten (10%) percent thereof to Hickory town United Methodist Church, of 1677 Trindle Road, Carlisle, Pennsyl- vania, to be used for general church purposes as that organiza- tion deems appropriate. (ii) Ten (10%) percent thereof to the Slate Hill Mennonite Church, of 13~2 Slate Hill Road, Camp Hill, Pennsylvania, to be used for general church purposes as that organization deems appropriate. (iii) Eighty (80%) percent thereof, In equal shares, to my children, KENNETH M. WEAVER, PATRICIA J. LICHTY and NANCY A. CLARK. Should my son, KENNETH M. WEAVER, predecease me, I direct that his share under this, my Last Will and Testament, pass to his wife, DEBBIE L. WEAVER. Should either or both of my daughters, PATRICIA J. LICHTY and NANCY A. CLARK, predecease me, I direct that their share or shares pass to their lssue per stirpes by representation. THIRD: " ~'\'. ~ law and by other provisions of this Will, I give the fiduciaries ~ acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual In addition to all powers granted to them by ~ distribution of all property: ~, (A) To sell at public or private sale, or to lease, '-,.; - ~~for any period of time, any real or personal property and to give t~ options for sales, exchanges or leases, for such prices and upon ; such terms (including credit, with or without security) or - '\ ~ 'conditions as are deemed proper. This includes the power to give "" (' r\" '~ legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. 2 (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion/ improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate.. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in a~l forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries/ as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited tOt personal income, gift and estate or inheritance tax laws. (8) To make distributions to my herein named benefici- aries In cash or in kind or partly in each. (H) To borrow money from themselves or others in order r~ to pay debts, taxes, or estate or trust administration expenses, ~ ~ investment purposes. to protect or improve any property held under my will, and for (I) To select a mode of payment under any qualified .~ retirement plan (pension plan, profit sharing plant employee \' stock ownership plant or any other type of qualified plan) to the ,~~\ '"extent the plan or the law permits them to do so, and to exercise J.. ~ any other rights which they may have under the plan, in whatever -~ manner they consider advisable. I:' FOURTH: I direct that all inheritance, estate, 7'-" ~.. ("\. \" transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with 3 respect to property passing under this Will, shall be paid out of the principal of my residuary estate. FIFTH: All interests hereunder, whether principal or lncome, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any be~eficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. SIXTH: I nominate and appoint my husband, JOSEPH M. WEAVER, Executor of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said JOSEPH M. WEAVER, I nominate and appoint KENNETH M. WEAVER, PATRICIA J. LICHTY and NANCY A. CLARK, Co-Executors of this, my Last Will and Testament. I direct that my Executor or Co-Executors, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ,f,"- day of 2002. ," /--.'e~/'~ ./ I : ~I/!. r).' i~;> /;;'7"' ,l Ie '-:"'.?-1 ~? MARGARET J. ' WEAVER ( SEAL) 4 " . Signed, sealed, published and declared by the above- named Testatrix as and for her Last Will and Testament in our presence, who, at her reques&, in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address I /1 :' //.,. r) ,//)(!;~ ~~t1.iIL(/' ~ /( ~!-.. (/ , (J" \ . Address Ot..J 1., g-I-~--tk1.Y 1/ 5 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAG OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 06133022 07-07-2006 REV-1543 EX AFP 109-00l EST. OF MARGARET J WEAVER 5.5. NO. 207-22-2193 DATE OF DEATH 05-05-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [X] CERTIF. NANCY A CLARK 5 CHANNEl DR CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Departlllent with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1695331254 Date 01-16-2002 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 12,338.96 50.000 6,169.48 .15 925.42 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below~ If you indicate a different tax rate, please state your relationship to decedent: PART [3J TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART [!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE CDMMD~EALTH OF PENNSYLVANIA DEPARTMENT DF.REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 06133016 07-07-2006 REV-154S EX AFP ID9-DDJ I EST. OF MARGARET J WEAVER S.S. NO. 207-22-2193 DATE OF DEATH 05-05-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [X] CERTIF. PATRICIA J LICHTY 5 CHANNEL DR CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, yoU were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions .ay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1675207672 Date 01-16-1996 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 10,799.06 16.667 1,799.88 .15 269.98 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. [J The above information and tax due is correct. 1. You may choose to re.it payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU .ay check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. [J The above information is incorrect and/or debts and deductions were paid by you. You .ust complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION OF LINE 1. ~ate Established 1 2, Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART !!l DATE PAID DEBTS AND DEDUCTIONS CLAIMED TAX ON JOINT/TRUST ACCOUNTS x x PAYEE DESCRIPTION AMOUNT PAID I $ TOTAL CEnter on Line 5 of Tax Computation} Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE .' COMMOk~EALTH OF PENNSYLVANIA OEPARTMENT OF .REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '*' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 06133021 DATE 07-07-2006 REY-154! EX AFP [09-001 EST. OF MARGARET J WEAVER S.S. NO. 207-22-2193 DATE OF DEATH 05-05-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [XJ CERTIF. PATRICIA J LICHTY 5 CHANNEL DR CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form.and return it to the above eddress. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1695331288 Date 01-16-2002 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 12,338.96 50.000 6,169.48 .15 925.42 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are mada within three (3) months of the decedent's date of daath, yOU may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. [J The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ~ The above asset has been or will be reported and tax paid with the PennsYlvania Inheritance Tax return to be filad by the decedent.s reprasentative. [J The above information is incorrect and/or debts and deductions were paid by You. You must complete PART ~ and/or PART ~ below. PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED ~INE i. Date Estabi1shed I 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5, Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 OF TAX ON JOINT/TRUST ACCOUNTS PAYEE DESCRIPTION AMOUNT PAID : I TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE COMMONWEALTH OF PENNSYLVANIA DEPAR~MENT OF .REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '*' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 06133020 07-07-2006 REV-154S EX AFP (09-00) I EST. OF MARGARET J WEAVER S.S. NO. 207-22-2193 DATE OF DEATH 05-05-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST !iI CERTIF. JOSEPH M WEAVER 5 CHANNEL DR CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of PennsYlvania. Questions may be answered by cal.ling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1695213205 Date 07-22-1998 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 6,489.04 16.667 1,081.53 .00 .00 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Tax x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax dUB. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART m A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above information and tax due is correct. 1. You may choose to reMit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid Interest, or yoU may check box "An and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ~ The above asset has been or will be reported and tax paid with the PennsYlvania Inheritance Tax return to be filed by the decedent's representative. [] The above inforMation is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED LINE 1, Date Established i 2. Account Balance 2 3. Percent Taxable 3 X 4, Amount Subject to Tax 4 5. Debts and Deductions 5 6, Amount Taxable 6 7, Tax Rate 7 X 8. Tax Due 8 OF TAX ON JOINT/TRUST ACCOUNTS PAYEE DESCRIPTION AMOUNT PAID I TOTAL CEnter on Line 5 of Tax Computation) I $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief, HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE COMMONWEALTH OF PENNSYLVANIA DEPART~ENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '*' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 06133017 07-07-2006 REV-15~5 EX AFP (09-00> EST. OF MARGARET J WEAVER S.S. NO. 207-22-2193 DATE OF DEATH 05-05-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [X] CHECKING o TRUST o CERTIF. JOSEPH M WEAVER 5 CHANNEL DR CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, yoU were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form.and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1691017493 Date 07-10-1986 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 2,900.75 16.667 483.47 .00 .00 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent.s date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART ill A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART @] TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Estaolished 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Anount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) I $ Under penalties of perjury,I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAVER SIGNATURE .' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '*' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 06133018 07-07-2006 REV-15~S EX AFP (09-00) I EST. OF MARGARET J WEAVER S.S. NO. 207-22-2193 DATE OF DEATH 05-05-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS liJ CHECKING o TRUST o CERTIF. KENNETH M WEAVER 5 CHANNel DR CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, yoU were a joint owner/beneficiary of this account. If yOU feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by ~alling (717) 787-8327. COMPLETE PART 1 BELOW · . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1691017493 Date 07-10-1986 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 2,900.75 16.667 483.47 .15 72.52 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Tax x NOTE: If tax paYments are made within three (3) months of the decedent.s date of death, YOU may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART ill A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above information and tax due is correct. 1. You lIIay choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or YOU may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent.s representative. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART ~ TAX RETURN - COMPUTATION If yoU indicate a different tax rate, please state your relationship to decedent: PART I!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED LINE 1. Dillr~e Estabiished :i. 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 OF TAX ON JOINT/TRUST ACCOUNTS PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knOWledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE COMMONWEAL TH 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 WEAVER JOSEPH M 5 CHANNEL DRIVE CARLISLE, PA 17013 -------- fold ESTATE INFORMATION: SSN: 207-22-2193 FILE,NUMBER: 2106-0671 DECEDENT NAME: WEA VER MARGARET JANE DA TE OF PAYMENT: 08/01/2006 POSTMARK DATE: 08/01/2006 COUNTY: CUMBERLAND DATE OF DEATH: 05/05/2006 NO. CD 007036 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,500.00 I I I I I I I I TOTAL AMOUNT PAID: REMARI<S: WEAVER JOSEPH M CHECK# 0098 SEAL INITIALS: AJW RECEIVED BY: TAXPA YER $1,500.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS