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HomeMy WebLinkAbout95-00582 "' -.,i;->' " ~-, Rl!....-1543 EX AFP (8-941 *' COHHONWEALTIt OF PENNSYLYANIA ()[PARTHENT OF REVENUE IUREAU OF INDIYIDUAL TAXES DEPT. ZI0601 ItARRISIURG, PA 1712I~D601 / S-. 9,r:.. / INFORMATION NOTICE AND TAXPAYER RESPONSE '" FILE ACN DATE NO. 21- qJ: ..)-8'.:1..... 95131581 07-10-95 PEGGY STANK 30 CORNELL DR CAMP HILL TYPE OF ACCOUNT ~ SAVINCS CHECKINC TRUST CERTIFICATE RENIT PAYNENT AND FORNS TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ESTATE OF MARGARET ANTHONY 5.S. NO. 166-20-6094 DATE OF DEATH 04-10-95 COUNTY CUMBERLAND PA 17011 FNB BANK NA h.. prawided the Dep.rt.."t with the in'ar..Uon lht.d beia.. which h.. be.,.. u.ed in ulculaUna tha potantlal tax ~. Their r.cord. Indicat. that .t the d.ath a' the above dscedent, you ..er. I Joint ownlr/bene,iclary a' this .ccount. l' you ,..i this in'or.ation is incorrsct, pl.... Dbt.in written correction 'roe the 'Inancisl in.tltution, attach. copy to this for. and raturn It to the ~vs .ddr.... Thl. .ccount is t.xabl. In accard~' with ths Inh.ritanc. Tax L.... 0' the Co.-onwe.lth of Penn.ylvanl.. Quo~tl~s ..y b: an~..r_~ ~, ~f\JI", (717) ~e7- ,.~~. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account He. 500-0001461 Ooto 08-11-7B Eat.bli.h.d Aceo...,t B.lllnC_ P.,.c..,t T.xabl_ A.ount Subject to T.K R.t. Pot.nti.1 T.x Du. To in lure proper credit to your account, two (l) copis. 0' thi. notic. .u.t acccap."y your ply,,,,t to the Rsghter 0' wills. "aka check pSYabia tOI MRsgl,tar 0' Wills, Agent", PART ill I 15,033.43 16.667 2.505.62 .06 150.34 TAXPAYER RESPONSE . FAILU!lITO/ "1S"ONDjlf~LL RE8UL'1? IN,/tN, OFfXCXIlL., TAX. ASSESSHEHrBASIII.' OH.THXS NOTICI. x HOTEl If t.x plyaant. .r. aede within thrae (]) aonth. 0' the decedent', dlta of deeth, you uy deduct I SX dhcount of thl tlX due. Anv Inheritance t.M due wll1 bac:OIle dlllnquent nine I" ..",th. Itter thl d... 0' dnth. Tox x [CHECK ] ONE BLOCK ONLY A. 0 Tha abova in'or.IUon and ta. ~ II carrsct. 1. You a.y choo.a to r..lt p.~t to the Regi.tar a' Will. with two copi.. 0' thl. notica to obtlln I dl.count or Ivoid intsre.t, or yOU uy ch.ck box "A" and return this notic. to thl Regi.t.r o. Wills and an o'flcial .......ant will b_ il.ued bV the PA D~art-.nt 0' R_vanu.. I. 0 The Iabov. ....t h.. bHn or wUI b. r.ported and tax plld ..Uh thl PannlYlvania Inh_rUane. Tax return to b. ,11.d by the decsdent'. r~rs''"totiv.. C. r"g'Tha abov_ Infor..Uon i~ncorr.ct and/o~ebh and deduction. were plld bv you. ~You ...t co-..l_te PART l!J and/or PART L!..J belo... If you indicat. . diff.~.nt t.M ,..t., pl.... .tat. you,. ~.lation.hip to d.c.d.nt. PART I!I TAX RETURN - COMPUTATION OF LINE 1. D_\u E~t.tli~h.d 1 2. Account B.lanc. 2 5. P.~c.nt TaKabl. 5 4. A.aunt Subj.ct to T.x 4 5, Debt. end Deduction. 5 6. Aooount Tox-blo 6 7. Tax Rat. 7 x 8. T.x Du. 8 ..: OFF.ICIAL:USE ONLY, OAAFJ 'PA pEPARTHEN.l\~F REVENUE.: .,.\ ", '..,'.','.'..,..'....-..', .'. .'.'-'.......... '..,'...., .,'.'--.-, .', .....', '\;~~;;,~:;;,;~:': :':':';-"-:':": .j,:;" ',; PART [!] DATE DEBTS AND PAD 1 . . 2 3 .,4: ., 'S. .,. ."'.".'" ,..,.,...,.' ".;:::,::;t",:\.':;i;::::{:~;:':;~:;::h~,'!:!:'::;':;:~::;;: .'...'.-....7.'-.' "'-:""";':";..:? ....../ ..:, DEDUCTIONS CLAIMED ';';'::.' ....,';',".":-'J TAX ON JOINT/TRUST ACCOUNTS o:?//, / ~:? /.1"" 0..7.3 'fa /~. h6J ?' :? c-7>s-.- b~:3J' .3 /n/!) .,- t!P . I) I-. n .'::.;;:;:: ,-.....;".:',:,-!',. '''';r:;; .: ,j I K .,;::::';;;'." ,:.,-1'" ...:..,:.'.-,'. . :~.:' ," r 'N.. .:;:.:j .J PAID PAYEE DESCRIPTI AMOUNT PAID II I " rOTAL (En .,. on Line 5 of rax Cc.put. Ion) I d.ol.~. th.t the fecta I doo and IMU.,. . HOME WORK 9S- GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFfICIAL TAX ASSESSHEHT with ~lIcllbl. Intarut b..ed an In'or..tlon Mbltltted by the ,lnancl.l In.tltutlon. Z. JnharltllhC. tax becDM' delinquent nine MM'lth. ,ftar t'" d.cadent'. d.t. of d..th. S. A Joint acCOl.l'\t II taxabl. IY'" though the declldant'. n... .... IMid.d .. . uttar 0' conyenienc.. 4. Account. (Including tha.. held bet"'"" hulband and "U.) which the d.c.dent put In Joint n.... within OM y..r prior to M&.:l .t. fully tax_I. II tr....'.r.. S. Account. ..tablll~ Jolntlv between husband and wif. aor. t~ on. ya.r prior to d..th .ra not taxabl.. ,. Account. held by . dIe.dent "In tru.t for" another or other. ar. taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. Iloat A . If the In'or..Uon and cMPUtatlon In tha notic. .r. corr.ct and dMuctlon. .r. not b.lng clalaed, plac. 11M ""X'" In block MA" 0' Patt I a' the MTaxp.yar A..pon.'" .ectlon. Sian two cop... and .~tt t~ with your check 'or the .-aunt 0' tax to the Aegl,tar 0' Will, of the county Indlc.t.d. The PA DIPlrtaant 0' R.venue will l..u. an o"lclal ......eent (Fora REV.lS41 EX) upon rec.lpt 0' the return 'rDa the R.gI.t.r 0' Will.. !. IlOCK. ~ If the ....t IpecllflMl on this notice h.. b.." or ..UI b. report... and t.x p.ld with the penn.ylvanl. Inherltanca T.. R.turn 'lied bv the decadent" repr..ent.tlv., placa an "X" In block "I" of Part 1 a' the "Taxp.ylr A.,pon.a" .aotlan. Sign one oopy and r.turn to tha PA Qepartaent 0' R.v~, Bur.eu 0' Indlvl~l Tax.., Dept zaa601, Harrl.burg, PA 171Z.~a6al In the anv.l~ provided. S. IlOCK C . l' the notlc. In'ora.tlon 1. Incorrect andlor d.ductlons .ta b.lng cl.lald, check block "e" and c~l.ta P.tt. Z end ] Hoarding to the l".LI wcUon. b.l~. ~l;n two copl.. and ,ub.tt th_ ...Utl YOU" ctwck 'or the '.ol.WIt 0' t.x p.yabl. to the Raglster 0' Will. 0' the county Indlc.ted. The PA Osp.rtaant 0' R.v~ will 1.lus ... 0"101.1 .....I.."t (for. REY~lS4' EXI upon r.c.lpt 0' the r.turn 'roe tha RIgl.t.r a' Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Ent.r the d.t. tn. .ccount originally ~.. ..tabllshad or titled In tna .enne~ .xl.tlng .t data a' d..th. HOTEl For. decadent dying .ft.~ It/IlliZI Account' which the dlcadent put In Joint n.... within one (I) y..r of d..th .r. t.xabla 'ully .. t~IM.f.r.. Howav.r, th.r. I' an .xclu.lon not to .xcaad 1],000 par trIM.f.ra. rlg.rdl... 0' tha v.lue 0' the KCount a~ the nuaHr a' ItCCOU'1ta held. l' a doubl. ..tarllk (.M) eppa.r. b.'or. your 'Ir.t n... In the Iddr.'1 portion a' thl. notlc., the IS,OOO .xclu.lon .lr.ady he. bun d.ducted 'r08 the account b.l.nc:. .. ~aportad by UM financl.l In.tltutlon. Z. Enta~ the tot.l b.lanc. 0' the .ccount Including Int.r..t accrued to the d.t. of d..th. ]. The p.rcent 0' the KCount that 1. t.xabl. 'or .ach .urvlvor I. dat.~alnad .. fallow.. A. The pe~cent t...ol. for Joint ....ta .stabllshed .o~. thin one y..r p~lor to the decadent'. de.th. I DIVIDED IY TOTAL H\IfIER or JOINT OWNERS ~xaapl'l A joint ..Iat ~.gl.tar.d DIVI0U IY TOTAL tutlER DF )C 100 . PERtENT TAXABLE SURVIVING JOINT OWNERS In the n... 0' the decadent and tva othe~ p.r.on.. I DIVIDED IY S (JOINT OWNERS) DIVIDED IV Z (SURVIVORS) . .167 )C lOD . 16.7% nAUllE FOR EACH SURVIVOR) B. Th. p.~cent t..... 'o~ ....ta cr.ated ~lthln one y..r a' the decadwlt.. de.th or acCDUlta o..nad by the decadwlt bUt held In tru.t for anothe~ IncUvldualh' (trult bwMIt1cl.~I..h 1 DIVIDED BY TOTAL NlMIER OF SURVIYING JOINT OWNERS OR TRUST IEHEFICIARlES X 100 . PERCENT TAXAllE EXNPI.. Joint account registered In the n_ a' the dltCadlMt and tva oth.r p.r.onl IIl1d ..tablhhed within one Yair 0' de.th by the decadent. 1 DIVIDED IY Z (SURVIVORS' . .50 X 100 . SOX UAXABlE FDA EACtl SURVIVOR) 4. ThI aaount .ubJact to taM (line 4) 1. dat.raln.d by ~ltlplyl", tna ICcount b.l~. (line Z) by the p.rcent t.xabl. (line J,. 5. Ent.~ the total 0' the debt. and dedUction. ll.t.d In Part S. 6. The HOUflt texabl. Ulne 6) h d.tar.lnld by .ubtraaUng the debh and deduction. Ulna 5) fr'* the MOUr'It .wJact to hM Cline 4). 7. Entar the approprl.ta tax ~.t. (line 7) .. d.t.ralnad below. A. Fo~ dlta. of da.th occurring .,t.r 6/]0/94, the tax rat.. far trIM.f.r. to .pou,.. .r. al followll 1. nlta' 0' de.th on o~ .,t.r 7/1/94 and b.'or. 1/1/9' the rat. 1. 3X. l. Data. a' d..th on Dr .,tar 1/1/9. .nd be'ora 1/1/97 the ~.ta i. ZX. ]. Oat., a' de.th on or .,tar 1/1/97 and be'ora 1/1/9. the ~at. I. IX. 4. Dat.. 0' d..th on or .,t.~ 1/1/9. tran,'ar. to .pau... ~III be ..'IP~ 'ro. tax. Hota. Fo~ d.t.. 0' death p~lor to 7/1/94 tran.,.r. to .pau... .r. taxabla .t 6X. I, Tran,'.n to llnnl da.cllndanh inolucUna ,.the~, aother, son, d.,ght.r, grWMlChUdren, son-ln~l..., daught.r-ln-l..., 't-PChlld and their I.sua ar. taxabl. .t .1M pa~c'"t (6%). C. T~,"".r' to .11 other' Including broth.~, .I.t.r, unci., aunt, nephew and nlec. .r. taxSibI. .t 'lftaan percent (15X). D. If you changa the t.M rat., pl.... &paCify you~ nl.t1onlhlp to tM decadent In the ar.. provided. I. The..aunt D' taM dull Cllna I' .. dah...lnad by .ultlphlng the .-aunt t.xabl. Cllna 6) by the tax rat. Ulna 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. dabh and dMIuoUon. .r. d41taralnad .. 'ollowlI A. You lag811y .ra r.lpon.lbl. 'or p.yaant, or the ..t.t. subject to adalnl.t~.tlon by . per.onal rapr.aant.tlv. 1. insu"lolant to p,y the deducUbl. It.... I. You actuelh p.ld the debt. .fh~ death af the daclldent and can furnish praa' a' p..,..,t. C. Debte being ol.lMd .ust be It..laed 'ully In P.~t S. If .dct!tlDMl spac. h needed, un pl.ln p~~ . Ill" x 11". P~aa' af p.\'DIf\t uy be rl8qU8.ted by the PA DepartMnt 0' R.vanua. . '.TAXPAYERASSISTANCE . ... . . ... . IFVOU. NEED FURTHER. INFORMATION. OR, ASSISTANCE ,CONTACTANVc.c; ....._.,_,. '.' :'.'''''',',. '. RE91STEROF WILLS" PA DEPARTHEHT>OF REVENUE DISTRICT,OFFICE:.x:--,:<...,..., ><<ORCALL THE BUREAU OF INDIVIDUAL TAXES TAXPAYER. INQUIRY, UNITIN//.' . . Ji(\RRISBURG AT (717)787-8327 ;TDDIC71n772-225Z (HEARINO.IMPAIRED ONLY) ;.~' .: '.~.. , .',;.'. .'-,.;.,; .' .',; :. .,; ~::;,' -:. . . ..-: '~'. NEILL FUNERAL HOME, INC. 3501 Derry St. 3401 Markel St, Harrisburg, PA 17111 Camp HIli, PA 17011 (717) 564.2633 (717) 737.6726 Scoll D. Sowers, F.D., Supervisor James P. Fickes, F,D., Supervisor CONTRACT N! STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED CASE II Chargee are only lor thollltemsthat you salected or that are raqulred. II we are required by law or by a camatary or cramatory to use any Itam, we will explain the realOn In writing balow. Arrsngementsfor: mAIo'1,":r'" f A,v1 "",If 0.47& , SERVICES, FACILITIES, AUTOMOBILE, OTHER EQUIPMENT AND SERVICES: itemized Genaral Price List: Balle Proleaslonal Servlcea 01 Funeral Director and Staff: Date of Arrangsment: Po 1',:0; I. Date of Death: ., I":' L MERCHANDISE: Casket: r>'tfutl.) r. (', A,L II ,19 9'- ,19 '1 (' N $ ~ 2 9 'r. <YO ,$ Outer Burial Containers: LIN..ft /sv, <1'0 Care 01 the Deceased: Embalming $ Washing and DIsinfection of Unembalmed Remalns Dressing, Casketlng and Cosmetology Post Autopsy CarelPost Organ Donation Restoration Charge Relrlgeratlon Care and Custody While Shellerlng Remalns Other Care of the Deceased Cremation Um: Cremation Contalner: Clothing as Selected: Grave Marker: Acknowledgement Cards as Selected Memorial Register Memorial FolderslPrayer Cards Combination Shipping UnlVAlr Tray II,), V L' ;-:<: In) .1<".trn Total Services and Care of the Deceased $ Total Supervision of Servk:es and Use 01 Facilities $ TnlAI fQf MA~~Anrfloe Selected CASH ADVANCE!!:) Sales Tex: Cemetery:NU/l') ...(t'I.~"1 ",';'l ,ll'I" r,-" .. , 'Death Certlflcates (No. ~ @ $~) . ~ .....;;J.ieeanl(ClriPaiWnnJRllrlal PAnnlt- Medical examiner's Charge Honorarium: f ,,', .~, ,I r ~.Jd"o MuslclansIVocallst: Air or Othar Transport: Out of Town Funeral Homes: $ .~(il.r (it) SupervisIon 01 ServlceB..8nd Use 01 Faellltlaa: (, Visitation Funeral Service ' Memorial Service Graveslde Special Hm, Charge ..-,. $ $ ~IC; ~, ITO ~~. &>(): ( . .. IS(;. c~ Auto., Othar Equip., Other Services i and Chargaa: I Transfer of Rsmalns to Funeral Home $ I :'1:. Hearse/Coach and Drlvsr }J 0 Umouslne/Other Passenger Vehicle and Driver I SefetylLead Vehicle and Driver Flower Ven and Driver I Utility Vehicle and Driver I, Cemetery tent and grave equipment Additional Transportation Charges: I " I , I , Newspaper Notices: TelsphonefTelegrephlFex: Motor Escort: ':"',., II ~ It f1... ~ I I"~. .'.'J ,. . . .^;,.:; - .......,. - - 7.S" I;IJ.()"J) I.t,. (lll Total Cash Advances "7 .~l.. $~' U'O . 0tI We charge you lor our services In obtalnlng: Personellzed Servlca Program Package (a complete descr/pt/on 01 the package that you so/ectad Is In the General Price Ust provlcJedyou): $ ~:! IV. ~u SUMMARY: Basic Professional Services Care ollhe Deceased Supervision of Services and Use of Facilities Auto" Other Equip. and Services and/or Personalized Service Program Packege Other Services: Merchandise Selected Cash Advancas Total Charges Credits to Account: p.~~~Rts: '" I t!J e. $ Total Auto, Other Equipment and Services $ and/or 3710.00 Other Sarvlces: Immediate Burlel $ Direct Cremallon \lVIthout a Service $ Forwarding RemalnstoAnotherFuneral Home $ Receiving Remains frem Another Funeral Home $ $ 301S. o. '180 Do $ '7 "Z.oS", OlS )...:. 3&.4$", iN ,oa r+ PA7/1,.. Balance due alter credlta /c!rst0~ D Dauphin Deposit Ba.ll~ DATE PAGE PEGGY L STANK OR HARGARET E ANTHONY OR THOMAS H ANTHONY 30 CORNELL DR CAHP HILL PA 17011 2 T ASK FOR OUR SPECIAL HOHE EQUITY RATES CALL 1 800 637 9151 FOR 24 HOUR APPROVAL , :- 10.46928-1 SUMMARY FOR ACCOUNT " PEGGY L STANK , OR HARGARET E ANTHOHY PREVIOUS BALANCE 03-20-95 7 DEPOSITS AND CREDITS , 2 CHECKS AND DEBITS CURRENT BALANCE STATEHENT END DATE PRIHE OF LIFE 3,248.73 6,163.89 3,676.70 5,735.92 04-19-95 sac SEC NUHBER INTEREST RATE AS OF 04-19-95 CHECK SAFEKEEPING. ,. 1995 INTEREST PAID YTD'J~.V\ ANNUAL PERCENTAGE YIELD EARNED ~.- '\ P 0 S TE ~~ .; AHOUN CHECK . DATE 3,605.00 I ' CHECKS , CHECK. DATE AHOUNT HECK . DATE , 187 03-30 71. 70 I 188 04-14 i. DENOTES GAP IN CHECK SEQUENce NUH TOTAL NUHBER OF CHECKS 2 HIS C ELL A N E 0 U 5 DEB ITS AHOU/IT DESCRIPTION 14.33 + CD INTEREST DEPOSIT 8000180839 623.00 + US TREASURY 303 SOC SEC 7.61 + INTEREST PAYHENT D E P 0 SIT S DATE 04-10 AND TOTAL CHECKS PAID C RED ITS DATE 03-21 04-03 04-19 POSTED DATE 04-18 DATE 03-24 04-07 AHOUNT 278.79 5,012.63 AHOUNT 174.94 DATE 03-21 03-24 03-30 BALANCE 3,263.06 3,541.85 3,470.15 o A I L Y B A L DATE 04-03 04-07 04-10 A N C E S BALANCE 4,093.15 9, 105. 78 9,280.72 U H H A R Y DATE 04-14 04-18 04-19 04-19-95 1 239 10469281 CY 14 15 166-20-2415 1. 7507. 18.16 1.7637. AHOUNT 3,676.70 /'t.~1J 7,/.,1 -jJ:Pf AHOUNT 52.59 BALANCE 5,675.72 5,728.31 5,735.92 r'7 3' S- c.. + s4ILM~ 'I ~I a~~ !it! f, z. d' _ /p ~ I ~ or//; ~~ :: -z-,,1- ~~/j -?tJf{~/ ~ In 0... ct ."0" c, qUHdonl ccncornlng Elootrcnlo Trlnl'... cr your ATM ..Ill, pl.... c&II717.255,2079 cr l'80~&ll'2079. Fcr h..ring Impol'od I.Me. 0411 1.800.521 ,20G8. 9~? + D Dauphin DeposU Bqnls DATE PAGE 06-20-95 1 271 10469281 '-- PEGGY L STANK OR HARGARET E ANTHONY OR THOHAS H ANTHONY 30 CDRNELL DR CAHP HILL PA 17011 1 T CY 14 15 LOOK FOR YOUR PRIHE OF LIFE COUPOH BOOK WHICH ARRIVES EARLY AUGUST. HORE COUHTIES,COUPOHS AHD COHVEHIEHCEf CD SUIIIIARY FOR ACCOUNT 1lH69?R-1 PEGGY L STAHK OR HARGARET E AHTHONY PREVIOUS BALANCE 05-J8-95 J DEPOSITS AHD CREDITS J CHECKS AHD DEBITS CURRENT BALAHCE STATEHENT EHD OATE PRIHE OF LIFE 5,6+2.69 +.09 3,600.00 2,0+6.78 06-20-95 SOC SEC NUHBER INTEREST RATE AS OF 06-20-95 CHECK SAFEKEEPING J995 INTEREST PAID YTD ANNUAL PERCENTAGE YIELD EARNED J66-20-2+J5 1.7501- 30.14 1.7611. C H E C K S P 0 S TED AHOUNT CHECK 1/ DATE AHOUNT CHECK 1/ DATE AHOUNT Nct NUHBERS TOTAL NUHBER OF CHECKS 1 TOTAL CHECKS PAID 3,600.00 HISCELLANEOUS DEBITS AND CREDITS DATE AHOUNT DESCRIPTION 06-20 +.09 + INTEREST PAYHENT DAILY BALANCE SUHHARY DATE BALANCE DATE BALANCE DATE BALAHCE 05-24 2,0+2.69 06-20 2,046.78 In co.. ol.rrc.. cr qu...on. concerning Electronlo Tr.n.I... cr your'" TM cord, pi.... coli 717.261102079 cr 1.8OO.2116-2079, Fcr h..rlng l"1'a1rod IINlce colI1,eOD.621.2088. REV-1543 EX AFP (8-941*, eD~AlTH OF PENNSYlYANIA DEPARTHEHT OF REYtNUE IUREI.U OF INDIVIDUAL TAXf.'\! DEPT. 210601 HARRISIURG, PA 171ZI.0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21' '1:5 53,), 95131582 07-10-95 (j I' 0- ESTATE OF MARGARET ANTHONY 5.5. NO, 166-20-6094 DATE OF DEATH 04-10-95 COUNTY CUMBERLAND TYPE OF ACCClUNT ~ SAVINGS CHECKING TRUST CERTIFICATE RENIT PAYNENT AND fORNS TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 THOMAS H ANTHONY 9 BRETTAGNE ARBORDEAU DEVON PA 19333 FHB DANK NA h.. prawld.d tha Depart.ent with the In'or..Uan U.t.d b.low which h.. IMen u.ed In calCUlating tM potential tAA due. Their r.cord. Indlclt. th.t .t the d.ath Q' the abov. d.c~."t, you wer. . Joint awner/banl,lcl.ry of thai account. I' YOU '..1 thl, Infor..tlon 1. Incorrect, pl.... obt.ln written corr.ctlon 'ra. the 'lnane..l In.tltutlon, att.ch . copy to thl. 'or. and r.turn It to the above addr.... This account I, t.x~J. In accardanc. with the Inh.rlttne. Tax L.... of the eoaaonw..lth a' P.nnlylvanl.. ou..tlonl ..y be '"....r.d by c.lllng (717) 717-1527. COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTXONS Account No. 500-0001461 Dot. 08-11-78 Eat.b1iahed Account 801onoo 15,033.43 Porcant To.ob10 X 16.667 Aocunt Subjoct to To. 2,505.62 To. Roto X .06 potontlol To. Duo 150.34 PART TAXPAYER RESPONSE ill I ,FAXLURI,TO< flISI'O~.;lfXLL RESULt/1M AN '. OF.fXC~AL.'. TAX.' ASSESSIIEH.t'BASIDOII ,THXS.. NOTX.CI.i I A. 0 Th. above Infor..Uon and t.. due I_ corr.ct. I. You .ay choo.a to r..lt p.yaent to the R.gl.t.r of Will. with two c~~J.', 0' thl. notlc. to obtain . dhcount or avoid Int.r..t, or you ..y chick box MA" and r.turn thl. notlc. ,ht. the RlGh~ 0' Will. end an officl.l ........"t will b. Inuld bv the PA O..,.rt.."t a' Rev.,...: -;;; To In.ur. proper cr"adlt to your accOUlJL-.!!!!. (Z) copl.. a' thl. notlc. lU.t acco.pany your pI,..", to the KIgu,er 0' Will.. "aka check payable tOI ~.gJ.t.r ~r-wttl', Agent". HOTEl If taM payaant. .r. aad. within thr.. 11J ~th. 0' the dec.dent'. data 0' d.ath, you an deduct. S'C dhclK.W1t 0' the tax du.. Any Inherltanc. t.x due ..111 bacHe d.lInquent nine (9) aonth. .,t.r the data 0' death. [CHECK ] ONE BLOCK ONLY I. D Th. above ....t h.. b.", or ..Ul b. rllpOrtMt Met tex p.ld with the Pennnlvllfd. IntMrltllnC' Tax r.turn to b. fUad by the d.c!tdent', rapr..anhUvI. ' .;1 c. Ie TM above Infur.atlon l~ncornct andJo~.btl and d.ductlon. ..In paid by you. .~. You BU.t capl.ts PART l!J and/or PART ~ balow. './1 If you lndicat. . diff.rent t.M rat., pl.... .t.t. you" ".l.tlonship to d.c.d.ntl .......,;.i ..~~.....~~~~g~~r~~~~o~~~~~fPe~~FI ':::;::/';:::M'r;~t.,:::) :'.::;::\:...r< :(.: ,',. : :~. ., ..; :::;:::<::j .':",'.' '.';'.".,','. .,.l PART [!l TAX RETURN . COHPUTATION OF TAX ON LINE 1. Dat. E.tabliahad 1 2. Account D.lanc. 2 3. P."c.nt Taxabl. 3 4. A.ount Subj.ct to T.x 4 5. Dobt. and Deduction. 5 C 6. Aaount T.xabl. 6 7. T.K R.t. 7 X 8. T.x Due 8 ~o.s." .~,r.{)O. '-0-_ , ' :z.. PAD,.. , 1'_-'- 2 ,3; :',", :;:.4::' ."::,'~.",:.,".".' :::,:':"" ":"i';';':','..:, " " ; ::'~::::.~:: :::.;., '.' .'::'1" .,.. ...5 . "" "6' :-:::~~<;~::~::::!::~:,~:.::!:::~::: :.:,',:..~.., ~:': ;':; .. ."',,"e^,... ... 8'.. .. ,'" ..... CLAIMED .",-",,-,,'.'.'. ."'."'.':.::::'" '.;j .:'j ,.,,:! .; , n(~ -0- .: rART [!] DATE DEBTS AND DEDUCTIONS PAID PAYEE /JEAfl. CI'1/f.. DESCRIPTION ::o,VIf...l1,A- C ~a5.' . .2.0 ~- oS r A.. t.e'o.._ _ f;..elt. II I tV Ii 1'1,'" . DF'.3. 0 AMOUNT PAID o TOTAL (En ar on Line 5 of T.N Co.put. ion) . .!1 I, L Under p.naltl.. of p.rju"y, I d.cl.". that the CCMPl.t. to the b..t of my nowl.dg. and b.ll.f. ft': f.ct. I h.v. ".po"~d above .~e t~, co~~.ct HOME (.(01 t'l1-/.32-'7 WORK (G /0 1 C '('7 Coli'? () LEPHONE NUMBER and GENERAL INFORMATION l. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHEHT with IfItlIllcabl. Int.r..t bII.ed an In'or..tlon .Ubaltted by the 'In~I.I Inltltutlon. l. Inherltanc. tax bec~. d.llnquent nine ~th. a't.r the d.cedent'. d.t. of d..th. S. A Joint IlCCQWtt .. t.x"., .y," though the decedent'. n... ".. Hded a. . ..tt.r 0' convanlencl. 4. Accaunh (includlna tho.. held b.t...." hulband and wU.) whIch the dacadent put In Joint nanl ..lthln OM wur prior to Math ara '"l1y tu.a,la a. tun.tar.. 5. Account. ..tablhhed Jolnth bet...... hulbMd and wit. eors than one v..r prla,. to ct..t" .r. not t,x"h. 6. Account. held by . dec~t "In tru.t for" another or other. Ir. taxabla 'ully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE I. IlDCJC A .. If the In'or..Uan and cOllpUtaUan In the notic. Ir. carr.ct end d~tlon. .r. not belna ClIIMd, plac. an 'T" In block "A~ a' Part 1 0' the "Taxp.y.r' R..pon.e" .actlon. Sian two copl.. and lubalt thee with your check for the -.aunt 0' tax to the RIgl.t.r 0' Will. 0' the county Indicated. Th. PA Dap.rt-.nt 0' R.v~ will 1.1u. an offlol.l ......sent (fora REV~l54. EX) upon rae.lpt 0' the r.turn 'rOB the R.gl.t,,. 0' Will.. I. ILDCK I .. I' the ....t .p*cI,lad on thl. notlc. has been or .,111 be reported and t.x paId with the Penn'vlvanla Inherltanc. Tax A,turn 'lied by the deudent', rap,...."t.Uv., plllea an 'T" In block M." a' p.rt 1 0' the "TaxPlv.r RllponllM .acUon. Ilgn one cop, and r.turn to ~ PA Dap.rtaent 0' R.venue, Bur.au 0' Individual T.x.., Dept 21D6Dl, H.rrlsburg, PA 17121-06'1 In the env.lope provided. 1. BLOCK C .. I' the notlc. In'ar..tlon I, Incorr.ct and/or deduction. .ra b.lng Clalaed, check block Me" and cDapl.t. P.rt. l and 1 according to the In.tructlonl balD... Sian two caplu and lubalt the, ..lth your chick 'or the -.ount 0' t'M payable to thtt R....ter of NUll af thlI county IndJIl.tad, T'IM Pi Ikpllrt..." 0' ~.venu. ..Ul luul Coo, offlclDI '''.'l;1acnt (For. RtV~1S41 [X) upon rec:"lPt a' the return frOll the Rqht.r a' Wll... TAX RETURN - PART 2 - TAX COMPUTATION LItE I. Entar the date the eccount arlglnelly w.. ..tlbl1~ or titled In the .ann.r ..I.tlng .t d.t. 0' d.ath. HOTE. for. d.cadent dying aft.r 12l1Zl.21 Account. which the d.c.d~t put In Joint n.... ..lthln one (I) y..r 0' d..th er. taxabla 'uliy .. tran.f.r.. t~v.r, there I. an Ixclu.lon not to a.C.ed .1,DDO p.r tran".ra. reg.rdl... 0' the v.lue 0' the ecCDUr'lt or the ~r 0' KComt. held. If . doubla ..t.rlak (M.) appear. before your fir.t n... In ~ addr... portion 0' thl. notice. the 11,000 axclu.lon alrlady hll b..... d.ducted 'roe the Iccount b.1MCI II reported by the financial In.U tutton. Z. Entar tha tat.. tNllencl 0' the HCount InclUdlna Int.rllt Kllrued to the dtita 0' dI.th, 1. TM percent 0' tn. account that h t..llbl. 'or a~ .urvlvor .. deit.r_ined II 'ol1owlI A. The ptlrcent taxabla 'or Joint ...... ..tablhhad -.ore than ~ year prior to the dec.dent", d..th. 1 DIVIDED IV TOTAL I<<J(IER OF JOINT OWNERS Exaepilr A Joint ....t regl,t.rld DIVIDED IV TOTAL HUtCIER OF X lUD . PERCEHT TAXABLE SURYIVIHC JOINT OWNERS In the n... a' the dacecs.nt and two ath.r par.an.. I DIVIDED IV 1 (JOINT OWNERS) DIVIDED BY l (SURVIVORS) . .167 X IDD . 16.7X (TAXABLE fOR EACH SURVIVOR) I. The parcant taxabla 'or ....h cr..ted within one y..r of the dlcadant'. d.ath or accounts owned by the decMtant but held In tru.t 'or another Indlvldual(.) (tru.t bena,lclarl..)1 1 DIVIDED BY TOTAL JUtIER OF S\RVIVIHG JOINT OWNERS DR TRUST BENEFICIARIES Ex....lll Joint account r.ghhred In the n... a' the c>>cedent n two other p.r.on. and ..tabllthad within OM y..r 0' d..th by \hi; dec:Mtant. 1 DIVIDED IV l (sutVIYDR,S) . .50 X laD . sax (JAXUlE FDA EACH SURVIVOR) X IDD . PERtEHT TAXAllE 4. The MOUnt subJact to taM (11M 4) I. dater.lnad by aulUplYlng the ItCcount b.lanc. Ulna 2) bV the percent taJeabl. Ulna 1). 5. [nt.r the tat.l of the debts and daducttonl lilted In Put 3. 6. The MOUnt t.xabl. (Une 6J II detar.lned by IUbtrlHltlng the dabh and deducUon. (U". 5) froe the -..,t IUbJact to t.. (Une 4). 7. Enter t~ approprlat. ta. r.t. (line 7) .. d.t.r.lnad below. A. For dat.. 0' daeth occurring a'tar 6/30/94, tha h. rat.. 'or tr",,'.r. to .pou... Ir. I' follow.. I. D.ta. a' de.th on or .ft.r 7/1/94 and ba'or. 1/1/96 the rat. I. lX. l. D.t.. 0' d..th on or a't.r 1/1/96 and ba'ora 1/1/97 the rat. 1. lX. 3. D.ta, 0' d..th on or .,ter 1/1/97.and be'ore 1/1/91 the rat. I, IX. 4. D.te. a' death on or .tt.r Jl1I,8 tran"lr, to 'POU'" will be ...apt frOll tax. Not.. Far cbIt.. of dNth prior to 111194 tr",,'.re to spou... ar. taxabl. at 6%. 8. T""".r. to llna.l de,cendMt. Includlna '.ther, _ther, IOn, dauahhr, grandchlldran, .on..ln..l.... ct.uahhr"ln"I..., .tapchUd and their h..... .r. taxabla .t II. percent (6X). C. Tran".r. to all other. InclUding brother, .l.t.r, unci., .unt, nePhew and niseI .ra t.~abl. .t fi,tean percant (ISX). D. If YOU changa the tax rat., pl.... ,paalty your r.lIt1onlhlp to tha dacedlnt In the ar.. provldad. e. The IIICM.rlt a' to dull Ulna I) II det.ralnact by ..IUpblng the -.aunt t.xabl. UIM 6) by the to r.ta Ulna 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. ~h and ~Uon' er. .atar.lned .. 'OUOWII A. You legally ar. r.apon.lbll 'or PI~t, or ~ ..t.t. subJect to ldalnl.tr.tlon by . per.onal rapr.'ant.tlv. 1. Insu"lolant to p.y the daduotlbl. It.... I. You eatualb paid the debts .ftar death 0' the decedent and can 'umllh proo' of paY1tlht. C. Debt. bal", al.lled ...t be It..l,ad 'ully In Part 1. If ~ltlonel .pec. 1. needed. u,. pl.ln paper' 1/2" Mil". Proa' 0' p......,t "y ba requa.tad by the PA Depert_ant 0' R.venue. ,.".",.,.,.... .""'" .... ...TAXPAYER . ASSISTANCE .. ..IFYOU, NEeD FURTHER INFORMATION ORASSISTANCE,CONTACTiANY .>RE9ISTEROF WILLS. PA> DEPARTMENT OF REVENUE DISTRICT OFFICE.".. :ORCALLTH~BUREAUOFINDIVIDUAl TAXES,. TAXPAYER INQUIRY UNIT'IN. .... ... HARRISBURG AT '(717) 787-B327 , .TDD' (717)772-2252 (HEARINGIHPAIRED.ONLY.). :.... NEILL FUNERAL HOME, INC. 3501 Derry SI, 3401 Markel SI, Harrisburg, PA 17111 Camp Hili, PA 17011 (717) 564.2633 (717) 737.6726 Scott D. Sowers, F,D" Supervisor James P. Fickes, F,D" Supervisor CONTRACT N! STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED CASE /I Chargea are only for thon Itema that you aeleeted or that are required. II we ere required by law or by a cemetery or crematory to un any Item, we will explain the reaaon In wrlllng below. Arrangemenlstor: rnAP~.l~"'" f AN1 ",,'J { .. , , " < .' 0'.476 , SERVICES, FACILITIES, AUTOMOBilE, OTHER EQUIPMENT AND SERVICES: Itemized Generel Price L1at: Bulc PlOfeaalonal Servlcea of Funerel Director and Staff: Care of tho Deeeaaed: Embalming Washing and Disinfection or Unambalmed Remains Dressing, CaskeUng and Cosmetology Post Autopsy CarelPost Organ Donstlon A~oraUon Chouge . Retrigeratlon Care and CUstody While Shellering Rsmalns Other Care of the Decaased ( Dsle ot Arrangsmsnl: A r " I L Date of Death: 11(',~ l MERCHANDISE: Casket: ()~ Fot< ,) C, ('/ 11.( II ,19 9, ,19 'I (', I~ $ ~29~."D .$ Outer Burial Containers: I.. IV."'! ISv.u'o $ Cremation Um: Cremation Container: Clothing as Selected: Grave Marker: Acknowledgement Cards as Selected Memorial Register Memorial Folders/Prayer Cards Combination Shipping UnlVAlr Tray Iv. n,l ;: <: aU J~.l1t) , Total Services and Care of the Deceased $ Supervlalon of ServlcelL8nd Use of FacIII"es: I. Visitation , Funeral Service ' Memorial Service Graveslde Special Hrs. Charge ..-.' $ Tnt.' Inr M.r;c~e Selected CASH ADVANCE!!: ~ "Sales Tax: Cemetery:lJo,tf J ..,hrofl' ,,-'~ in'." (',.-.... , Death Certificates (No. ~ @ $~) ,: <,';,.<l.earmllOIspaaJUoo/BwlaLearmlt, Medical examiner's Charge Honorarium: f".,," "I r ~..Jd... MualclanaNocallsl: AIr or Other Transport: Out of Town Funeral Homes: $ .":'(jl:'- (;1,)' $ qrjt;'. ':0 :""'. V() ISO. ,,, Total Supervision of ServiCes and Use of Facilities Auto., Othar Equip., Othar Servlcea and Chargea: Transfer 01 Remains to Funeral Home .:'1:. Hearse/Coach and Driver JJ 0 Umouslne/Other Passenger Vehicle and Driver SatetylLead Vehicle and Driver Flower Van and Driver Utility Vehicle and Driver Cemetery tent and gmve eqUipment Additional Transportation Charges: $ $ Newspaper Notices: TelephonerrelegraphlFax: Motor Escort: '..F\.",,), ~ .~ II t... ~ I " r" ~ . .....,,--"'. I' ,..I.T , .-. - -Z..f"o . '~.' , I \'I~. v-fJ ","(. "i.. '.j , $--.1): "= ~.01I Total Cash Advances We charge you lor our services In Obtaining: .. and/or SUMMARY: Basic Prolesslonal Services Care 01 the Deceased Supervision 01 Services and Use of Facilities Auto" Other'Equlp, and Services and/or Personalized Service Program Package Other Services: Merchandise Selected Cash Advances Tolal Charges Credits to Accounl: paxments: ,) (\!~o. ~ /80 $ Total Auto, Other Equipment and Services $ Personalized Service Program Package (a comp/ete description of the package that you selectad Is In the General Price Ust provldedyou): $::\:lllJ,~O 3710.0<:> Other Services: Immedlale Burial $ Direct Cremation Without a Service $ Forwarding Remains to Another Funeral Home $ RaceMng Remalnslrom Another Funeral Home $ $ 30lS, o. Q80 00 $ '7-z.oS",OI) PO f}- .>..: 3 Co OS', _ PA7I1fD.4 Balsnce due after credlta idrst.0f; :.. v $ .: ..IIIF ,,4 3(,.00.00 Page 1 012 D Dauphin Deposit BQ!!!s DATE PAGE 06-20-95 1 271 10469281 . PEGGY L STANK OR MARGARET E ANTHONY OR THOMAS H ANTHONY 3D CORNELL DR CAMP HILL PA 17011 1 T CY 14 15 ., LOOK FOR YOUR PRIHE OF LIFE COUPON BOOK WHICH ARRIVES EARLY AUGUST. HORE COUNTIES,COUPONS AND CONVENIENCE' I 1'. SUMMARY FOR ACCOUNT 1H6928-1 PEGGY L STANK OR HARGARET E ANTHONY PREVIOUS BALANCE 05-18-95 1 DEPOSITS AND CREDITS 1 CHECKS AND DEBITS CURRENT BALANCE STATEHENT END DATE PRIHE OF LIFE 5,6+2.69 +.09 3,600.00 2,0+6. 78 06-20-95 sac SEC NUHBER INTEREST RATE AS OF 06-20-95 CHECK SAFEKEEPING 1995 INTEREST PAID YTD ANNUAL PERCENTAGE YIELD EARNED 166-20-2415 1.750% ,. 30.1+ 1.761% C H E C K S P 0 S TED AHOUNT CHECK . DATE AHOUNT CHECK 1/ DATE AHOUNT 3 600 I ENCE NUHBERS TOTAL NUHBER OF CHECKS 1 TOTAL CHECKS PAID 3,600.00 HIS C ELL A N E 0 U S 0 E BIT SAN 0 C REO ITS DATE AHOUNT DESCRIPTION 06-20 +.09 + INTEREST PAYHENT o A I L Y B A LAN C E SUN H A R Y DATE BALANCE DATE BALANCE DATE BALANCE 05-2+ 2,0+2.69 06-20 2,0+6.78 In "N of.no.. or qUMlon. oonoomlng EI_n1o Tron.'... or your A TM GIrd, pi.... ooJl 717.255-2079 or 1.500.2tll102079, For hurlng l"l'oIrod IONtOO ..111.500,521.2088, D Dauphin Deposit BOllls DATE PAGE PEGGY L STANK OR MARGARET E ANTHONY OR THOMAS H ANTHONY 30 CORNELL DR CAMP HILL PA 17011 2 T ASK FOR OUR SPECIAL HOHE EQUITY RATES CALL 1 800 637 9J51 FOR 24 HOUR APPROVAL (8 SUMMARY FOR ACCOUNT 1~1 PEGGY L STANK OR HARGARET E ANTHONY PREVIOUS 8ALANCE 03-20-95 7 DEPOSITS AND CREDITS 2 CHECKS AND DEBITS CURRENT BALANCE STATEHENT END DATE PRIHE OF LIFE \ \. \ SOC SEC NUHBER - INTEREST RATE AS OF 04-J9-95 ~~~~KI~1~~~~~P~~~DYTD \)'.\1\;.,. ANNUAL PERCENTAGE YIELD.EARNED 3,248.73 6,163.89 3,676.70 5,735.92 04-19-95 , ,\;,-,. C H E C K S CHECK . DATE AHOUNT HECK . DATE 187 03-30 71.70 I ' 188 04-14 .. DENOTES GAP IN CHECK SEQUENCE NUH I TOTAL NUHBER OF CHECKS 2 I HIS C ELL A N E 0 U S 0 E BIT S DATE AHOUNT DESCRIPTION 03-2J 14.33 + CD INTEREST DEPOSIT 8000J80839 04-03 623.00 + US TREASURY 303 SOC SEC 04-J9 7.61 + INTEREST PAYHENT o E P 0 5 ITS DATE 04-JO AND TOTAL CHECKS PAID CREDITS , I , , i I i I I P 0 S TED ANOUNT 174.94 DATE 04- J8 DATE 03-24 04-07 AHOUNT 278.79 5,OJ2.63 DATE 03-21 03-24 03-30 8ALANCE 3,263.06 3,541.85 3,470.15 B A LAN C E S DATE BALANCE 04-03 4,093.15 04-07 9,105.78 04-10 9,280.72 ,I H H A R Y DATE 04-14 04-J8 04-J9 DAILY 04-19-95 1 239 10469281 CY 14 15 166-20-2415 1.7501. 18.16 1.7631. AHOUNT 3,676.70 '.~,~-, '1'1. B$ 7,1.,1 -jJ:?f AHOUNT 52.59 BALANCE 5,675.72 5,728.31 5,735.92 rj3'r- c..L <"~M~ , / ~I a ~ IJ,Lo<-' r .;) !lCi {, z. d' _ ~ 'i I t:;" ()I/t ,,_ ~ ' '1-(,,1- ~j -s;-tJ" -4i In.... of orro.. cr qu"~onl ocnoomlng ElloIrcrno Tronll... c, your ATM ..rd. pl.... coil 717,265-2079 cr \o80~i5ll'2079, For hoarlng ImpAired ..l\'Iea 04111.800,821.2088. 9~? + -1 \ I ~ ... 1!' .. . I " ., ,'.It ;~il'- of :1' , .~.~ ~4 ,~ &ll' .. I. ...' , .... , " q 1 ,., \'~ 19' I " ..s , ., , , . I I ,) ,- ~ " .J/{ 1 il' -.c-. ~ ~ ~ \ -- l\1S It ~ Ill} \ ~ I Il! l).....,O I~SOfY) ! I:) I1/.. rolJ ! ~~ t"1) ,-.... ~ 1-,"- :<. \t! <l:~< ~ i~~ \- - V)~~ ..t:l:{~ \ t ~~ I ~ (t- u,\ ! \- ~ Q. -~ --...-.... 1 I i i I i \ i - I - ~ - - - , \:) I I " I - \ - - i =: i - , I { I I - I ~ \ -= , . . 0, .' . " " ., .... , ~ .''0'- . .,': I I I I '0 \ v ,,' . . <i.' ... . .N l"," .. \ 'L . .. ~<. 0\, , l' " ,..;,~ .". .~ -t. c . 0 ,.'. \ ' .r~,','/ ~" tk 'f .J . . f l",' , '. , .t. " > l : "001' . " '0. .. ~ ~ ~ '.,l ._r'.. \ .' ",1. -~.. . ."i_'" /\. ' " ...., I . 't. . ~" , ," . '., .... ,.., , ' / , I " ! " -, if< f 1": . L:--. ~.... p.' ., . t ,,.... 'I '.- .. ,;.~.~-_.,.,-... -- - .... ,- . 'u"_-.' "-~. ~-~ r.~r - - - -+.---' -r"""'--- ~- ~~ r... - ....~ . " /,) 'IY-I NO, 21- qS' ad.. 95131719 07-10-95 REV-1543 EX AFP (8-941 *' e~AlTH OF PENNSYLVANIA LC"PlRTHEHT OF REVENUE IUREAU OF INDIVIDUAL TAXES DEPT. ll06DI .~AISIURO, PA 17121.0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE TYPE OF ACCOUNT ~ SAVINGS CHECKING TRUST CERTIFICATE RENIT PAVNENT AND FORNS TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ESTATE OF MARGARET E ANTHONY 5.S. NO. 166-20-6094 DATE OF DEATH 04-10-95 COUNTY CUMBERLAND PEGGY L STANK 30 CORNELL DR CAMP HILL PA 17011 DAUPHIN DEPOSIT BK I T h.. pravldad ttM D~art..", with the In,or.aUon lhhd b.low which hat b.en uud In calculating the patentlal tax due. Their racord. Indlcat. th.t at the daath of the above d.c.d.nt, yOU ...ra . Joint owner/b.n.flclary 0' thl. account. I' you '..1 thl. In'or..tlon 1. Incorract, pl.... obtain written corr.ctlon 'roe the financial In.tltutlon, attach a copy to thl. 'or. and r.turn It to tn. abova addr.... Thl. account 1. taxabla In accordanc. with tha tnh.rlt~. Ta. l.... 0' tha eo..onw..llh 0' penn.ylvanla. Qu..tlon. ..y b. enlw.red by c.lllng (717) 717~11Z7. COMPLETE PART 1 DtLO~ ~ u ~ OtE REVERSe SIDE FOn FILING Ar.J P^YMtNT IN~TnUCTION~ Account No. 0010469281 Doh 03-25-94 E.tablbh.d Account D.lanc. P."e..,t TaMabl. AlItOunt Subject to Tax R.t. Pot.ntial T.M Du. To In.ure prop.r credit to your account, two (2) copla. of thl. not Ie. lU.t acc~,"Y your pay.ant to the Reglltar a' Will.. "ak' check payable tal ""R.ght.r Q' Willi, Agent". PART ill 9,2B5.36 16.667 1,547.59 .06 92.B6 TAXPAYER RESPONSE FAXLURe, '.rfORISPONDi\fXLL!tISUL 1':'. lIrA" ,OFJ:XCIAL'T AX ,. IlSSESSHI!JtT' BII.~III 01l'111XS tlOTIC1, x NOTE I I' tax paya.nte ar. aed. within thr.. (1) aontha 0' the d.cadent', data 0' d..th, you uy deduct . s:c dhcount 0' the tax du.. Any IntMrttMCa tax due will b.co" delinquent nine (,) aontha a,t.r the data of d.ath. To' K [CHECK ] ONE BLOCK ONLY A. 0 Tha abova Infor.aUon and tax m.. .. cornct. I. You .ay choo.' to ,..It payaant to the RIglltar 0' wlllt ..Ith two cop I.. 0' thl. notlca to obtain . dl.count or avoid Intara.t, or you .ay ch.ck box "AM and raturn this notlc. to the R.gl.t.r 0' Willa and 8M o"lclal ........nt will b. 1.lued by the PA D~art.."t 0' Ravenue. I, 0 Th. above lIIut hII. been or .,111 ba reported and tax paid with the PlIIV1aylvenla Inht1rlbnca Ta. return to b. 'llad by the decadent'. repr..entatlva. c. Q'1 The abova Infar.athMl IJ-.!.ncorract and/DJ:..:.!\'bt. and d.dUction. ...r. p.ld by YC'\J. ~Vou ....t caplata PART l!J and/or PART l!..J bala... If you indicat. . dlff.,..nt t.x r.t., pl.... .t.ta your r.lation.hlp to dec.dentl PART ~ TAX RETURN - COHPUTATION tINE 1. D.t~ F..tRhli.h.d 2. Account Balanc. S. P.rcent Tax.bl. 4. A.aunt Subj.ct to T.x 5. Debt. 8ftd Deduction. 6. Aaount Taxable 7. T.x Rate 8. Tax Ou_ . .. ..":,i{ii:OF1FICIACi: USE O~L y, CJ AAF, , .'..",'.PA"DEPARTHENT'OF' REVENUE .,:.1 PA~~! .... ......... ... . .,..,..... ........ ......... . .. .i :2' .-.:,.:,:::': "1 '3: .,..... :.',.,'...... .., "....i,., :;::-:<<:::;:::,::,:::., "i!:;> ., ".,." ,. .5" .'.. ..,..,..'. . ,. ... .. .-:-.'::6::':' ::::::':; ':::!#::::~;':::::::::::':::: ~:::::i.:::':::::,:-:" ,., :.<:.:':': ':':',-; .,: . . "..',:' :.::-:~ :: 7~~'! :~:;;::::!; ,;:,.: :':' ':::';::~,::'~" . "" :.>'::::'}8"::::-:".'."'.";".' ., DEDUCTIONS CLAIMED OF TAX !Iii J9IN,\,nRUST ACCOUNTS l__J.;L/..L Lf~~., _,___ 2 9,2 r .J:........fo 3 K' Ie;,. Y7 4 /5'1'7. ~.,'7 5 17'::-.""- ~ X . "}, In 8 ,;"..-,. .':;.,,::::". r> PART ~ DATE PAID 3- DEBTS AND PAYEE DESCRIPTION II " AMOUNT PAID CJ , TOTAL (En .r on Line 5 of T.x oaputation) . I d.cl.r. th.t the fact. I g. and b.U.f. h.v. r.port.d above a,.. HOME (71'7 1 7. WORK ( 1 ',,: ",.1 1 GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHEHT with -..lIcabl. Inhr..t bued on Infur..tlon Iubtlltt.d by the financial In.Ututlon. l. Inherltanc. tax bacu... d.llnquent nine aonth. a,tar the d.cedent'. d.t, 0' d..th. 1. A Joint accDU1t h taxabla .van thouDh the d.cecs.nt'. n... VII lidded II . ..tt.r 0' CDnv.,..lanc.. 4. Account. (Including tho.. held b.t".en hu.band and w1'a. whleh the dec.dent put In Joint naa.. within one v..r prior to de.th .ra 'ully taxabl. .. tran,'.r.. S. Account. ..tlblllhed Jalntlv bet"..,.. hu.band and ..I', acr. than one y..r prior to d..th ar. not t.xabla. 6. Account. held by a decadent "In tru,t 'or" anoth.r or other. .ra taxable 'ully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. IlDCIC A ~ If the In'or.aUon and co.put.t1on In the notic. ar. corr.ct and d.wcUon. .r. not belna c1alud, plac. an M)(" In block "A" 0' P.rt 1 0' the "Taxpa,.r Rllpon.." .ectlon. Sian two cap... Bnd .ubelt thUI ..lth your chad!. for the uount a' tlM to the R.gl.t.r 0' Will. of the county Indlc.tad. The PA Dep.rt.ant of R.vanue will I'IUI an a"lcl.. ........nt (For. REY~ls4. EX) upon rac.lpt 0' the r.turn 'rDl the R.gl.t.r 0' Will.. l. IlOCK. ~ l' the ....t .pacl'lsd on thl. notlc. he. been or viii be report.d and t.x paid with the P.nn.ylvanl. Inherltanca T.x R.turn 'lied by the d.cadent", rapr.,ant.tlv., plac. an MX" In block -I- of Part I a' the MTaxpay.r Rllpon.." ..ctlon. Sian one copy and r.turn to the PA Departaent 0' R.venue, Bur.au of Indlvldu.l Tax.., D.pt Z.D6DI, H.rrl.burg, PA 17121.0601 In the ~.lope provided. 1. IlOCK C - I' the notlc. In'or..tlon I. Incorrect and/or deduction. ar. b.lng cl.l..d, check black "e" and coapl.ta P.rt. Z and J accordlna to the In.tructlon. balow. Sian two capl.. and .ubllt th.. with vour ch.ck 'or the aaount a' taM payable to tha R.gl.tar 0' Will. a' the county Indlc.ted. The PA Dap.rtaent a' R.v~. will I..u. an o"lcla. "I...aent (Fora REY.ls41 EXJ upon rec.lpt a' the r.turn 'ra. tl.- RIglahll u, Willa. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Ent.r the d.ta the .ccount arlgln.lly .... ..t~ll.hed or titled In the a~r .xlstlng .t date 0' d.ath. HOTEl For. d.cedent dying .,tar IZ/llllll Account. which the d,cadent put In Joint n.... within Dna (I) y..r a' d..th .r. t.xabl. fully.. tran.f.rs. How.v.r, th.r. Is an ..clu.lon not to .xc..d '5,000 par tran,'ar.. r.gardl... 0' the valua 0' the eccount or the nuMMir D' accounts held. I' a double .st.rl.k (~.) app.ars b.'or. your 'Ir.t n... In the .ddr.l, portion a' thl. notlc., the 'l,DOD .xclu.lon alr.ady ha. b.an deductad 'rea the .ccount balanca a. reported by the 'Inanclel In.tltutlon. Z. Ent.r the tot.l b.lanc. 0' the account Including Intar..t .cc~ to the date 0' d..th. J. The parcent 0' the account that 1. taxabla for .ach .urvlvor 1. d.t.ralned al 'ollawII A. Th. percent t.xabla 'or Joint ....t. ..tabll.had acr. than an. y..r prior to the d.cadent'. deathl 1 DIVIDED IV TOTAL HUKlER OF JOINT OWNERS Exaapl., A Joint .I..t r.gl.t.red DIVIDED IY TOTAL HUHIEA OF )C 100 . PERCENT TAXABLE SURYIVINO JOINT OWNERS In tha n... 0' the decedent and two athtir perlan.. 1 DIVIDED IV 1 (JOINT OWNERS) DIVIDED IY 2 (SURVIVORS) . .167 )C lDD . 16.7% (TAXAllE fDA EACH SURVIVOR) I. The percent taxable 'or ....t. cr.ated within ana yaar of the decad.,..t'. d.ath or accounts DWnIId by the d.cadent but held In truat for another IncUvldualh) Ctru.t banat1cl.rlal)1 I DIVIDED IV TOTAL IUtBEA OF SURVIVING JOINT OWNERS OR TRUST IEHEFICIARIES Ex....l.. Joint aecount r.ghtared In the n_ 0' the decedent and two other p.rlon. and ..tltblllhtid within one y..r of d..th bw the dae.dent. I DIVIDED IV l (SURYIVDA;S) . .SD X IDD . SOl( nAMABLE FOR EACtl SURVIVOR) X loa . PERCENT TAXAIlE 4. The aaount lubJact to tax (line 4) II d.t'r.l~ by .ultlplylng the account balanc. (lln. Z) by the percent t.xabl. Cline 5). S. Ent.r the total 0' the debts and deduction. l1.ted In Part 1. 6. The.-aunt taxable (llna 6) Is dat.r.lned by .ubtraatlna the dabts and deduGtlan. (line S) 'rea the aaount IUbJect to taM Cline 4). 7. Ent.r the epproprlat. t.x r.t. (lln. 7) a. d.t.ralnad b.low. A. Far dat.s 0' da.th occurring .,t.r 6/30/94, the taM rata. 'or tran.,.r. to IpOUI.. ar. a. follow" 1. Oatas 0' d.ath on or .,tor 7/)/94 and ba'ora 1/1/96 the r.t. I. lX. l. O.t.. 0' d..th on or .,t.r 1/1/96 and ba'ora 1/1/97 thti r.t. 1. lX. 1. Data. 0' de.th on or .,t.r 1/1/97 'and ba'ora 1/1/98 thti rata 1. IX. 4. Oat.. 0' daath on or .,t.r ./1/98 tran,'arl to 'POUI" will b. ,x'MPt fro. tax. Hot., Far d.ta. 0' de.th prior to 7/1/94 tran,'.r. to .pau... ar. taxabl. at 6X. I. Tran,'.ra to 11neal d..cendants InclucUng 'ather, _thar, .on, dMlght.r, grandchildren, aon-ln-l..., dauaht.r-ln~l..., .tepchlld and thalr l.sua ara taxable at .lx percent (6iel. C. Tran,'.ra to .11 other. Includlna brother, .lst.r, unci., aunt, neph... and nl.ca ar. t.Mabl. at ,I,t,," percent C15%). D. If yOU changl the t.. nt., pl.... .pealfW your r.l.Uonshlp to the decadent In the ara. prawlded. e. Tha ~t 0' talC due (11". .) .. datar.lned bw .uIUplylna the MOC.I'\t taxllbl. Ulna 6J by the tu r.ta Ulna 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabla debh and dIduoUons .r. dat.r.lnect .. 'allowlI A. You laoally ar. ra.pon.lbl. 'or pavaent, or the ..tata .ubJ~t to adalnl.tratlon by a per.onal repra.enLatlve 1. Insu"lclant to p.y the d~tlbla It.... I. You actually p.ld the; debts .tt.r de.th 0' the decadent and can 'urnlsh proo' 0' p....-nt. C, Debt. balna cl.l-.d BU.t be It..laad 'ully In P.rt 1. I' addltlon.l ,p~. I. ~, u.. plain paper. 112M x 11". PrOD' 0' pavaent .ay ba request.d by the PA Depart..,t 0' Rsvanue. ..,',':,:..., ',,:,.:w.. " ".. ,.. .,.. ... .... .."..... .... . . TAXPAYER ASSISTANCE " ., . . .. . IF YOU: NEED, FURTHER INFORMATION. DR ASSISTANCE, CONTACT ANY'., .. ".'i;,REGISTEROFWILLS.,PA DEPARTMENT OF REVENU~ DISTRICT OFFICE " .:'<,...OR CALVTHE IUREAUOFINDIVIDUAl TAXES, TAXPAYER INQUIRY UNIT IN. ."..:,'. HARRISIURG:AT (717) ,787-8327..TDDI. (717) 772-2252 (HEARINGIHPAIREDONLV) . . '- PRIVATE DATI DESCRIPTION OR CODE '2 ACCOUNT ......OUNT I"LANtl CR 2/28/9; Balance Forward -0- I ~I J'/9r ...".elf A..... - 13''''''0 S1<I."CQ IJN,r "1 0... r.l lo~,oo U.. .u~P co .up' of) .,J,7/f~ A""'&' .(..,~... 4""''''0 ~It(,~o tlN;r /l DAVI t!!J 1001,00 .0( /lOr ,,,, R~'~ - ",;~JfS' If"""&' C"44U Aft ~"./6 UD I~ IJHI". 'N JI"~ '1 041.r Q '11."" I.II~ OC> ,j/i:J. c>o y},,,Joe- 141/44" ""... S,,', ST."" l),tfuN ... /414#"", ,.01,911 olt /?/l 5' J3"'~ sl u,,~ 19C' ,.".c." a.........., 6.,,1'. .11..1''' lJ. '1"- 3"7,- I.... U"~A. 1'40J S'f,901 'IS y/'7/.s 1441CN z,co..rr".!IIJVCu ~. 04 ", '0 ,J!;,o s.... ~ 11 / -~ fI t//;t 7" "~/~' I PAY LAST ODD FELLOWS HOME OF PENNA, AMOUNT IN 999 WEaT HARRISBURG PIKE THIS COLUMN MIDDLETOWN. PA, 17D!!7 PHONE 17171 944.33!!1 I < .'"'.' ,-"~,-,~"~,,,,,,"/T.~,,,.w~."'''-', ~', PAIVATI DATE DESCRIPTION on CODe D. ACCOUNT {. ""OUNT ....lANel 4/17/95 Balance Forward 3510 2 fh/9S" It! . ~" oJ. t!V. SsIO 1$.;1 -0 - I . 4., .....-co. __....... i t;lsl,~ u"... PAO, fl.".:.. t>l /0 7~ /D 7t "Ish~ /1I>.,c. r",It:~"'T'~.NC(. I'"u ..... f- Do " 71 ./:) ..... VJ IJ~ AV ( /'-' - PAY LAST, ODD FELLOWS HOME OF PENNA, AMOUNT IN . 999 WEST HARRISBURG PIKE THIS COLUMN MIDDLETOWN, PA, 170117 PHONE (717) 944.33111 ! -, D Dauphin Deposit Bemis DATE PAGE 05-18-95 1 251 10469281 PEGGY L STANK OR MARGARET E ANTHONY OR THOMAS H ANTHONY 30 CORNELL DR CAMP HILL PA 17011 5 T CY 14 15 ASK FOR OUR SPECIAL HOHE EQUITY RATES CALL 1 800 637 9151 FOR 2+ HOUR APPROVAL ..... ---- -.......- SUMMARY FOR ACCOUNT 111-4692801 PEGGY L STANK OR HARGARET E ANTHONY PREVIOUS BALANCE 0+-J9-95 4 DEPOSITS AND CREDITS 5 CHECKS AND DEBITS CURRENT BALANCE . STATEHEHT END DATE t.,." PRINE OF LIFE ,..... 5,735.92 3,470.33 3,563,56 5,642.69 05-18-95 SOC SEC NUHBER IHTEREST RATE AS OF 05-18-95 .CHECK-SAFEKEEPING 1995 INTEREST PAID 'YTD ,,- ANNUAL PERCENTAGE YIELD EARNED 166-20-2415 1. 750r. 26.05 1.7657. .', CHECKS POSTED ~i~'I DA~~. 'i~UJP' CHECK II DATE "A. H AHOUNT --- 0.5-~~3'5!..-,-_ l 192 05-18 ---'op' 1.69 ' R us- . 193 05-J7 19.20 DENOTES GAP N CHECK SEQUENC NUHBERS I~ TOTAL NUHBER OF CHECKS 5 HISCELLANEOUS DEBITS DESCRIPTION CREDIT HEHO INTEREST PAI'NENT DEPOSITS POSTED DATE AHOUHT 05-04 32.00 BALANCE SUHHARI' BALANCE DATE 5,687.84 05-18 5,636.49 '''-;' ">. CHECK /I DATE 194 - 05-17 "'G.h.. AHOUNT 15.37 AND TOTAL CHECKS PAID C RED ITS 3,563.56 DATE AHOUNT 05-04 3,168.00 f 05-18 7.89 f DATE AHOUNT 04-21 262.44 DATE BALANCE 04-21 5,998.36 05-03 2,487.84 DATE AHOUHT o A I L I' DATE 05-04 05-17 BALANCE 5,642.69 In co.. oIonoro Dr quo.IDna conDOmlng ElectronlD Tr.na'oro c, you, A TM cord, pl.... coli 717.255-2079 c, t .eoO.21l5-2D7U, Fc, hurlng Imp.'rld IINtco call t .500,621.20Ba, . " ,-I ~' I I Ii ,J../15,-!;"J!':;{ REVo15~~ RV ARa '.0941* eoKHOHVEAllh I' 'in ~A DEP'-Rltu:NT Of ... ' /. IN IURUU OF INDIVIth. d. OE:PT. ZlD6Dl . UARAUIURG, PA 17UI.UDl INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO, 21 ACN 95131720 DATE 07-10-95 TYPE OF ACCOUNT ESTATE OF MARGARET E ANTHONY ~ SAVINGS S. S. NO. 166-20-6094 CHECKINO DATE OF DEATH 04-10-95 TRUST COUNTY CUMBERLAND CERTIFICATE &JA 0"/1. v RENlT PAYHENT AND FORHS TO. THOMAS H ANTHONY, 111 Brett-.l'In"- jH~. REGISTER OF WILLS 'JO 6BRflE:LL DR . CUMBERLAND CO COURT HOUSE DAMP IIlLL PA 17911 ,,/133-3 CARLISLE, PA 17013 D~vcrJ.PI1 ' DAUPHIN DEPOSIT BK . T h.. provided the Dapart.ant with the In'or..tlon listed b.low which h.. been ulad In calcUlating the potentl.l t.x dUe. TIl.lr record. IncUcat. that at the d.ath of tha abova dacedMt, you ...ra . Joint own.r/b.,...Uclary 0' thh .ccount. I' yOU ,..1 thl_ In'or.etlon 1. Incorrect, pl"la obtain wrltt.n corractlan 'roe thl 'InMc181 Institution, att.ch . copy to thl. 'ora and r.turn It tu the ~v. .ddr.... Thl. account 1_ t8.abl. In accardanc. with the Inherltanc. Tax l.w. 0' the e~..lth 0' p.nnsylvanla. aua.tlons .ay b. anlwer.d by c.lllng (717) 787.&127. COHPLETE PART 1 BELOW . . . SEE REVERSE SXDE FOR FILING AHb PAYMENT INSTRUCTIONS Account No. 0010469281 Data 03-25-94 Eotoblhhed Aecount B.lance P.rcent T.>cabl. Aoount Subjoct to Tax Te)( R.t. Pot.nti.l Tax Du. To In.ur. prop.r cr~1t to )lour acClK.W'lt, two (2) copl.. 0' this notlc. aust accoaplnY )lour pa)'Ml"lt to the Aagllt.r of WUI.. Haka check payable tOI ~.Dl.t.r 0' Willa, AgentM. PART ill 9,285.36 16.667 HOTE. l' tax payaanta ar. aada within thr.. 1,547.59 el) Mnth. 0' the d.cadent'. date Q' duth, . D6 you .... deduct . 5X dhclM'lt 0' the t.x dul. Any InherltBnCa tax dI.M will beeR' d.Unquent 92.86 nln. (,) MH'lth. .ft.r the d.t. 0' daath. TAXPAYER RESPONSE ~_H J . I"AILURl!.:rO '. RIS.l'OHDllXLLRESUL lIH.AN~FfXCXIlL,J'AXiASSISSHI!HT.. AAS~:.ON~HXS, x x ., 0 Th. above Infan.Uon and taM due .. corr.ct. . I. You ..y choo'. to ,..It p.yunt to the Raghter Q' NUh with two copl.. of this) noUu to obtain . dl.count or .vold Intlrilt, or YOU ..y ch.ck box MAM and r.turn thl. notlc. to the Real.t.r a' Willi and en o,flcl.l a......ent will b. l..u.d bV the PA n.p.rtaant 0' R'V~ B. c:J The above ....t ha. bean or will b. r.ported and ta. p.ld with the Pann.ylvanl. Inherltanca T.. r.turn to b. ,U.d bv the d.cltdont'. npr......t.Uv.. ) C. J?ITha above In'or..Uon l~ncorr'Clt and/o~.bh and dedUcUon. w.ra pald bV you. .. " Vou MI.t cO"Pht. PART l!.J and/or PART l!.J bIIlo... ' ; If you Indicat. a diff.r.nt taM r.t., pl.... .t.t. you" ".l.tion.hlp to d.e.d.nt. [CHECK ] ONE BLOCK ONLY PART ~ DATE 2. DEBTS AND DEDUCTIONS "...; :.,.".;'::,.,.t., OFFICIAL., USE .,O,.ly.'..,C]:AAF:1 f~~r~::~;!~i!~~~':f~~~;;;:1 ','.' 4." ,', ".':;:i}::.:': ~:, :~:i;;i;.~' .:..:'::.:,',...... ;;::-:.:' ,'.... ,'..., :~ +::i!:,~','*,.,:,;.,:,',.;: ...',P ." :::, ......,..:- '.'1 : " 7'" ;.-;',':,;.i~;i: ::!:~:!'j<::;::;:;:i::!:~::~;::i:;ii::::~::!:i::i:!:\:(,!::,-:;;:-:" .:. '.', ;~:::-. .,' ~ . ~ Ei ": j :'::..>:~' ;,:,:!::,j:,~::::';i::~::':;~':';' :':.'.:> .'.-:;: ;.::,::,..:., '~,: :::;:.:';.~.:, . "ill CLAIMED PART ~ TAX RETURN - COMPUTATION OF TAX/N/JOINU"(RUST ACl:OUfHS LINe 1. 0.1. ealodolhh.,1 1 /..'.L J _ q~ 2. Account Bohne. 2 'q, .:l. !<"" -~ (" :5. P.rc.nt T.xabl. :5 x It:.. l~ G '7 4. Aoount Subjoct to Ta" 4 t s:. !to '7 . b-'/ 5. D.bt. and O.duet!on. 5 (- 1/ 7~t;"~-. ~ C 6. Aao\.nt Taxabl. 6 - 0 ,-- 7. Tax Rota 7 l( · 0" a. Tax Due a - 0 - DESCRIPTION 0'- IP 11-'- jJ.51 Nc.. ,., IlloJ'j, . 1 e r.: A-I'10 up.r "'= ()H AMOUNT PAID -.s PAID PAYEE - avO p.~J.~w:, ODI.I/A'r()u.~ eM A. ;>A- I- - 0 TOTAL (En ." on LIn. 5 of Tax Co~ut.tlon) . p.~ju"y, I decl.". that the fact. I .y knowl. a and baU.f. h.v. r.port.d abova ar. t"ue, corrfot and HOME ('/0) (,11'1-/.3 'z." . WORK ({.ltJ 1 CIf'7-(.Y70 o'i'/o'l/'iS' TJ;I PHnNF NUMBER !fATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with tappllcabla Int.rllt bUM on In'or..t'lon .ubaltted by the 'lnancl.l In.Ututlon. 2. lnherlt~. t.. bacoae. delinquent nine aanth. .,t.r the decedent'. data 0' d..th. 1. A Joint account 1. t.xabl. Ivan though the d.c~t.. n... w.. add.d .. a a.tt.r 0' cony,"I~.. 4. Account. ClnclUdlna thos. held b.tw,en hu'b~ and wlf.) which the d.c.dent put In Joint ~. within an. yaar prior to d..th ar. fully t.xabl. as tran.f.r.. S. Account. ..t~ll.hed JointlY b.tw.an hU.b~ and wi'. ear. than one va.r prior to d..th .r. not taxabl.. 6. Account. held by a dacedent "In tru.t forM ~ther or oth.r. ara ta.abl. fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE I. ILOCK A ~ If the In'oraatlon and coeput.tlon In the notlc. .ra correct and deductions ara not b.lng cl.laed, plac. In MX" In block MA" 0' Part I 0' the "Taxpay.r R..pon.." ..ctlon. Ilgn two copla. and .ub.lt the_ wIth vour check for the .-aunt 0' t.. to the R.gl.tar of Will. 0' the county Indlcat.d. The PA Dapartaant 0' Ravenue will I,aua an o"lcl.l .....~t (Far. REV-IS.' EX' upon racalpt 0' the raturn 'roe the Ragl.t.r 0' Will.. l. ILOCK. ~ If the ....t ,paciflad on thl. notlca h.. been or wUl ba report.d and tax p.ld with tha PeMnlwWll. lnhlrlhanca Tax Raturn ,ll.d bV the decadent'. r~r.''"tatlw., pllC' an MX" In block MIM of P.rt I a' the MTaxpay.r R..pon.," s.ctlon. Sian ana copy and r.turn to the PA D~'rt-.nt of R.y~, lur..u of Individual Tax.., D.pt ZID6DI, Harrllburg, PA 171ZI-D6Dl In the lttValop. provided. 3. BLOCK C ~ l' the notlc. In'or..tlon I. lneorr.ct and/or d.ductlan. era baing c!all.d, ChIck black "eM and coaplat. P.rt. Z and 1 according to the In.tru,tlon. b.l"". Sian two c~l.s and s~lt thee with your check for the .-ount 0' t.x payabl. to the R.gl_tar of WUII 0' the county lr"'lcated. Th. PA Dapart..,..t vI RnM1U' ..111 Inua en offlcJ.1 .........,t (ror. REY-lS41 EJU upon recalpt 0' the r.turn 'roe the R.gl.tar 0' Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE I., Ent.r the data the account orlgln.lly w.. .stabllahed or titled In the aanner axl.tlng .t d.t. 0' da.th. NOTE I For a d~.dent dying att.r IZllll1Z1 Accounh which the d.cedent put In Joint n.... within one (ll y..r a' d..th er. t.xabl. fully as tran,'.r.. Howev.r, th.ra 1. en .xclu.lon not to .xc-.d '5,000 p.r tr~"'r.. reg.rdl... 0' the v.lue of the account or the ,...r 0' accounh held. If . doubla ..hrhk (1111) app..r. b,'ar. your fir" n... In the addra.. portion a' this noUca, the n,DOO uclu.lon .1raadY hi. b.en d~ted froe tha .ccount b.lanc. I' raportad bV tha ,lnancl.l In.tltutlon. l. Ent.r the total balanc. a' the account Including Int.r..t accrued to the d.ta a' d..th. 1, The p.rcant 0' the account that 1. taxabl. 'or each .urvlvor I. d.taralnad .. 'allON" A. The p.rcent taxable 'or Joint ....ts ..tablt.had aara than on. y..r prior to the d.cadent'. d.athl 1 DIVIDED BY TOTAL ~IlA OF JOINT OWNERS Ellaaplal A Joint .s..t r.gl.t.rld DIVIDED IV TOTAL NUttIER OF X laO . PERctNT TAXAllE SURVIYING JOINT OWNERS In the n... a' the decadtlnt end two other p.non.. 1 DIVIDED IV 1 (JOINT OWNERS) DIVIDED IY l lSURYIYDRS). . .167 X lDD . 16.7J CTAXAIlE FOR EACH SURVIVOR) I. The p.rcent taxabla 'or ....ts cr..tad w1thln anti y.ar 0' the decedent'. de.th or acClUlt. owned by the cMcltdent but held In tru.t 'or anothlir Indlvldua1(.) (tru.t b.,...Ucl.rlash 1 DIYIDED IV TOTAL ~IER OF SURYIYING JOINT OWNERS OR TRUST IEHEFJCJARIES [1l..1al Joint account rlghtared In the n... 0' the decadent and two ather p.non. end ..tabUIIhad within one yaar a' d.ath by tM decedent. 1 DIVIDED IV 2 (SURVIYORS) ..50 )C U10 . 5Di( (TAXABLE FOR EACIt SURVIYOR) X 100 . PERCENT TAXAllE 4. ThI.-aunt subJect to tlW (line 4) 1. det.raload by aultlplylng the account b.lanc. (line 2) by the psrcent t,xabl. (line 5). S. Entar the tot.1 a' the debt. and ~tlane Il.ted In p.rt J. 6. The 'IOU'1t tlllabl. Ulna 6) .. d.t.r.lnad by .ubtractlng the debt. and deducUon. nine 5) 'rOIl the e.owlt .ubJect to tax 01". 4). 7. Entar the approprlata t.x rat. (lln. 7) .. datar.ln.d below. A. Far dat.. 0' death occurring a,t.r 6/5D/94, the t.x rat.. 'or tren.,.r. to spous.s ara I' 'allow., 1. O.t.. 0' death on or .,t.r 7/1/94 and b.'or. 1/1/96 the rat. 1. l~. 2. o.t.s 0' d..th on or ,'tar 1/1/96 end ba'or. 1/1/97 the rat. 1. Z~. 1. O.taa 0' death on or a,t.r 1/1/97 end b.'or. 1/1/9. the rat. 1. l~. 4. Olta. 0' d.ath on or .,t.r 1/1/9. tran.far. to IpouS.. will be Illaapt 'roe t... Nota. For d.t.. a' death prior ta 7/1/94 trln.,.r. to .paul" .r. tax~l. .t 6~. .. Tran.',rs to lineal de.c-ndants Including 'ather, aothlr, .on, dIluoht.r. granckhlldrWl, .on~ln.l..., d8Ughtlr.ln~I.., .tepchlld and thalr l.tua ara taxabl. at .lx percent (6~J. C. Tran,'.r. to .11 other. Including brother, sl.t.r, unci., aunt, n.Phew and nlec. .ra t.xabla .t ,l,t..n ~rcent (15%), D. If YOU ct.nge the tax rat., pl.... lpaclfy your rel.tlon..,lp to the dacadent In the .r.. prOvided. e. The -.aunt 0' t.. ~ nine I) h dahralnad by aultlphlne the .-aunt t.x_l. Ul.... 6) by the to rat. (U". 1). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED AU.,.,.bI. debts and deduction. ara dat.r.lnad II fallow.. A. You legally .r. r.apon.lbl. 'or p'vaant, or the ..t.t. IUbJ~t ta ~Jnl.tr.tlan by . personal repr.aant.tlv. 1. Insuf'lclent to p,y the deductibl. It.... .. You M1tually paid the debt. .ttar d..th a' the dKedent WId cen 'urnhh proo' 0' p....ent. C. Debt. baing cl.laed .u.t b. It..lzed 'ully In P.rt 1. l' eddltlonal .plC. I. needed, u,. pl. In p~.r e Ill" x II". Prao' D' pa..-nt ..y tHI reque.ted by the PA DapertHnt a' R.v.,... .... TAXPAYER ASSISTANCE 'i.".' ...IF YOU NEED FURTHER INFORMATION DR ASSISTANCE, CONTACT ANY .....,'....'..,...'.... REGISTER OF WILLS. PA DEPARTMEHToF REVENUE DISTRICT OFFICE .,"", OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN ,.,..,..'.. HARRISBURG AT..(717) 787-8327 . TDD' (717) 772-2252 (HEARINOIMPAIRED ONLY) - PRIVATI DATI DeSCRIPTION OR CODE , C. ACCOUNT IU"t4CI "YOUNT 2/28/9 Balance Forward -0- H""" Il........ a." A,o Sl<u.a.ao .. J, 11ft 1/",.1' ~ DA"S 10 .00 .... A'''''&' .It..~. ..,II4.D ~1t'U4D tlN;r ., '"1 H' ;t 011" ~ /. ,00 oW J1'.'1. CltAAU Ii.c ~'N6 /,co "i. f~ i<JN'LII IN II...., '1 "..s Ii) 'It.oo /tfiN4H 1.4.., SM" 61."" "," ~ D."'&s' .... /JH4IH. Ii 9' "".,,, a.....'" 6",1, ....." UN"A. 0 n. >>.J>r CD a.,,~ J'U.OO ~~U4 jjI~'~c .ca. D4 o ,Jf:/D ~.... " ODD FELLOWS HOME OF PENN.... 999 WUT HARRIBBURG PIKE MIDDLETOWN, P..., 170117 PHONE (717) 944.331l1 PAY LAST AMOUNT IN THIS COLUMN \ .' 1 PRIVATE DATI DESCRIPTION OR CODe ~ ACCOUNT "MOUNT IALANCI c. 4/17/95 Balance Forward 3510 2 tit /9 S- i>'7A.I. d, t'k, 111, 3$/0 ! 5:;). _0 - r . ..,,,,eIL .....co. trjsJ,~ u",... PliO) 9,~;;I" I>l 10 7f 10 7t I ,..h19. IJI.,.,L r.,Ju"'n4l~1tl "'.M - (, Do " 78 /:J -... /) I r /7~_L; / 1./ '-' PAY LAST ODD FELLOWS HOME OF PENNA. AMOUNT IN 999 WEST HARRISSURG PIKE THIS COLUMN MIDDLETOWN. PA, '70!l7 PHONE (717) 944.33!l1 ! - - - 0 " ......... " ~ ~ - - ~ "- - .". -::, I ct , ~ l ~ I ~i~ ,. ~ <'l) j't) 0-. -l- I.\!..... Ji:.~ 1 ~ ~i I w \ ~ ~~.... I ~ ~~ I ~ \)- ll} ! ;:!:. 'i: Q I, 1'- -" .. \ _-I ..__".. .............. , , ; ca. , , " . " \ << ,:.,...;. .' . . '. '".' , 'I I I ...1 " . ' , , ". '~ I 'I '.~;;' , \. . .. .<. 'j.' . '." I'. " I .-( '" ..\, '.', :. '. , f'.' " ,r " I, -.1 '. ... ,I. ' : ,~ ~" " ;) ... '..~. , , . '.,' ~ I ;~ ":s r t~ \ , ".'1 'I" ,i '.\., . , .' , .....-.. T ~.. . . '.. " . ,', .. t '; J t" ,... 'f ., I;. ,~' ... " ' , , .! " r.' , . " . . I " , , \' .., ~, . ~ t . . .t . -.. ..~ '.' .. -----,- t .. __ _~. A.IO ~-~.~-- .~~ . f- ~~.. "-. _ .. _--. ~.__.t _ ...'. .....;A. li.- - ,. - 1 . " j 15,. Y'?- / ~ RE~-1548 EX AFP (12-94* eOHHOHWEALTH OF PENNSYLVANIA DEPAATHENT Of' REVENUE IUREAU OF INDIVIDUAL TAXES DEPT. Z8D601 HARAISIURG, PA 171".0611 NOTICE or INHERITANCE TAK APPRAISEKENT, ALLONANCE OR DISALLONANCE or DEDUCTION. t, AND ASSEBSNENT or TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-25-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 COUNTY CUMBERLAND FILE NO. ,;). 1- 95 -,5"YrR S.S/D.C. NO. 166-20-6094 ACN 95131581 PEGGY STANK 30 CORNELL DR CAMP HILL PA 17011 REMIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 A.ount R..lthd CUT ALONG THIS LIHE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rifv:i54-i-EiC-AFP--fi2~94"j----------------------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAXSEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-25-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 COUNTY CUMBERLAND FILE NO. S.S/D.C, NO. 166-20-6094 TAX RETURN WAS. (XI ACCEPTED AS FILED (I CHANGED JOINT OR TRUST ASSET INFORMATION ACN 95131581 FINANCIAL INSTITUTION. FNB BANK NA ACCOUNT NO. 500-0001461 TYPE OF ACCOUNT I (I SAVINGS ( I CHECKING ( I TRUST (Xl TIME CERTIFICATE DATE ESTABLISHED 08-11-78 Account Ba1snce Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 15,033,43 0.166 2,505,62 3,605.00 .00 ,06 ,00 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." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+ I INTEREST (-I AMOUNT PAID TOTAL TAX CREDIT 8ALANCE OF TAX DUE INTEREST TOTAL DUE o Ir PAID AFTER THIS DATE, SEE REVERSE rOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS THAN '1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRl1 YOU NAY SE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRN FOR INSTRUCTION., I .00 .00 .00 .00 ClC. :1J ~ f,::' '0 \.Ii =!JW t:i ....1 -", ti -" U i,r; .,'; r,,'j -.. ,.l-' .' ~ PUIlPOII ... HaTlCE. T. 'ul'lll the raqulr--.nt. a' Sectton 214D 0' the Inheritance and E.t.t. Tax Act, Act II a' 1991. (72 P.S. IHUon '140). PAYlCHTI Detach thll top portion 0' this Notlc. and sut.1t ..lth Your p.YIMlnt to the R....t.,. 0' NUb printed on the rav..... ,Ida. .... Hek. check or ..... order P.yabl. tOI REGISTER OF NILLS, ACEHT. AU pevaanh rae.IVad lhall 'Ir.t b. applied to MV Intar..t Which "V b. dlM, with any re..lnder applied to tM tax. ItU\IW (eR) I A r.'und a' . t.x cr.dit, whiCh .... not raql.~..tad on the tax r.turn, "V be r.quastad bv coapl.Ung an "Appllc.Uon 'or A.,und of P~'vlv,"l. Inherltenca and E,tlt. Tax" (REV~1111). application. .r. .v.llabl. .t the D,,!co 0' the Raght.r of Willi, any 0' the Z3 RawWtUa DhtrJct OfficII or by u111ng the .pecl.l l4"hou,. ..,....rlnD ..rvlce nuaber. 'or 'or.. ordering, In PennIY!v..,.. 1~IDa.16l-lasD, outs Ida Penn.Ylvanl. and within loc.l f~rrlabur. .t.. (7171 717-8D94, TDD' (717) 17Z~lZ5l (Haatlng I~.lr.d Only), OI,lfCtJOHI. Any p.rty In Intar..t not ..U.fled with the epprahMant, aUovenca or dl..uovanc. 0' daducUon. or ..........t 0' tax (lnclucUng dhcDUrlt Dr Int.,...t) as shown on thh NoUn "Y obJeat Nlthln s!Jety (60) dly. of rae.lpt 0' thh NoUn byt ....r1ttan prot..t to the PA Depart...,t 0' Revenue, lo.rd 0' Appel", Dept, 211021, Harrisburg, PA 1712I"ID21. OR .....lectlng to have the .att.,. at.r.lned at the MJd!t a' the account 0' the per.onal repr.s."t.u.v., OR --.....1 to tM Drpe.,s' Court A,,"IN- liT_AllYl COIIR!CTJDNlI F.~t~l arror. dl.cav.rld on thl. ..s.....nt .hould b. addr."ed In ..rltlng tal PA D.plrtaent a' R.venue, lurlau 0' Indlvldu.l T.x.., ATTHI Po.t A.s....ent R.vlaw unit, DEPT. Z10601, Harrl.burg, PA 17121~0601 Phone (717) 717-65D5, Sa. P-a. 1 of the booklat Mln.tructJonl for I~rltanc. TIK R.turn for. R..ldant Decadent" (R[VwI501) 'or an Ixplanatlon D' ~1"lstr.tlv.l~ carr~tabl. arror.. DIICOUHT. If M~ tax due .. p.ld within thr.. (5) nIMCt.,. ~th. att.r the decHant'. da.th, . '1". percent (n) dhcount 0' the t.x paid" .llow.d. IHTER!IT I Int.ra.t 1. charged b.~lnnlna with flr.t da~ a' d.llnquency, or nln. (9) ~th. and ona (I) d.y 'rCNI the dat. 0' dMth, to the ct.t. 0' p.yaent. Tax.. which bee... dallnquent be'orl January I, 19lZ bear Int.r..t .t the rlt. a' .1K (6Xl p.rcent par annua c.lculated at . dally rat. of .OODI64. All tax.. which bee... delinquent on or a,t.r J~ry 1, I"l will b..,. Intar.st .t . r.t. which ..111 w.ry 'roa calendar Y.lr to calender y..r ..lth that rat. announced by the PA o.p.rtaent a' R.venue. The IPPIJcabl. Jnt.r..t nt.. 'or 191Z through 1995 .rl' lilt Inter..t Rlt. D.lly 'nt.r..t Faetor bar Int.r..t Allt, D..lv Inter..t Factor 1912 1911 1914 .,15 1'16 -"Int.r..t ZOX 16X IIX lSX lax 1. celcul.tad a. .DO0541 .00D4]1 . DODSDl .DDD556 .DD0274 fOllow.. 1987 1911-1991 1991 1991-1994 I... .X IIX OX 1lt 'X .DDOZU ,OD0301 .DDDl47 .ODDI9Z .OD0247 INTEREST. BALANCE OF TAX UHPAID X NVIIBER OF DAYS OELINQUEIfT X DAILY INTEREST FACTOR --Any Notlc. l.sued .,tar the tax beco... d.llnquent will r,'lact an Int.ra.t c.lcul.tlon to ,l't-.n (15) d.y. beyond the data 0' the ........"t. If p')'IIant .. .... att.,. the Intanlt co.put.Uon data ahcMIn on the Notlc., ~ltlanal Int.r..t aust be c.lcul.tad. j- ~r---'-"'''''''''''1ntf'''''A;1i'-4F.''lb.~i''''t~~' "\:--'-"----"---.-'-_.._..- "' j 15 - 'Ii-; V' REV-1548 EX AFP (12-94* c~AlTH OF PEHHSVlYAHIA DEPARTHE"T OF REYENUE 8lJ1EAU Of' INDIVIDUAL TAXES DEPT. za06D1 HARRISBURG, PA 17Il'~D6DI NOTICE OF INHERITANCE TAX APPRAISENENT. ALLOMANCE OR DISALLOMANCE OF OEOUCTION~, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-25-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 COUNTY CUMBERLAND FILENO. ;;Jj-q5-S~ S.S/D.C. NO. 166-20-6094 ACN 95131719 PEGGY L STANK 30 CORNELL DR CAMP HILL PA 17011 REHIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Aaount R...itt.d CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .... Ri!v=isiii-Ejf-AFi>-fi1i=941----.----------------.-------..-----------------.-----------------------------.....- NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX OH JOINTLY HELD OR TRUST ASSETS DATE 09-25-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 166-20-6094 TAX RETURN WAS, (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 95131719 FINANCIAL INSTITUTION, DAUPHIN DEPOSIT BK S TR CO ACCOUNT NO. 00104692B1 TVPE OF ACCOUNT, (I SAVINGS (lO CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 03-~5-94 Account Balanca Percent Taxeb1e X Amount Subjact to Tax Debts and Deductions Taxab1a Amount Tax Rate X Tax Due 9,285.36 0.166 1,547.59 1,755,00 .00 .06 .00 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 TOI "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+1 INTEREST (-I AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE , IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, · I IF TOTAL DUE IS LESS THAN II, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CH), YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I ,00 .00 ,00 .00 ("')0 c: ,-::: " lei 1]1 :0 ~'(j (~, '-. C:' t,;.-.I -I r~ w ~J l.~' I.c. :::.;-; t..] - PURPOS< OF NOTICE. To 'ulflll the raqulraaants of Section 2140 Q' the Inharltenc. end E.tat. T.x Act, Act lZ of 1991. (7l P.I. Section 2140). PAVHEHTI Detach the top portion 0' thh Notlc. end ~lt with ~our p.pent to the Aqht.r of WHII printed on thtl rav.r.. side. ... HIk. chack 0,. IIOMY ord.,. pnabl. tal REGISTER OF WILLS, ACEHT. AU p.Y8Iht. rKalvlld shill tlr.t be appU.d to ....y Int.....t which ..y M M, with an>>, r...lndl,. 1IPP1lad to tM th, REFUND lCR) I A n'und 0' . tax crlldlt, which w.. not raqua.tad on the tax return, .ay be r.....tld by caapl.Una an "Application 'or R.,und Q' P.nn.ylvanl. Inherltanc. end Estat. Tax" (REV~1113). Applications .r. .v.llebla It the D'flc. 0' the Reglst.r a' WillI, any of the 23 R.v~ Dl.trlct Df'1c.. or by call1na the .paclal Z4~hour ."....rlna ..rvlca nuaberl for 'or.s ord.rlnal In Pennsylvania 1.aDD-16Z.lD50, out. Ida PennsYlvania and within local Harrlabu!D ar.. (717) 11'-ID'4, TUDI (717) 77l~ZZSZ (Hearing l.palrlld Only). Any p.rty In Int.rast not s.tl.,lad with the IPPral..aent, allowanc. or dl.allowanca 0' deduction. or ........nt of tax (Including dl.count or Int.r.st) I' shown on this Notlc. ..y obJ.ct within .Ixty (60) daVI 0' rec.lpt 0' thh Notic. by' .~wrlttan prat..t to the PA Depart.ant 0' Aav.nua, laIrd 0' App.al., Dept. ,alOll, Harrl.burg, PA 171Za-lDZI, OR u.htct!na to have ttM ..tt.r d.t.r.1Md at the audit 0' the account of the person.l rapr...nt.U...., OR .......ppe.. to the Orphans' Court OIJECTlOHSI ADMIN" ISTRATlVE CORRECTIONS. F.ctual arrar. dlscov.red on thl, .....s.ent ~ld ba add,...s.d In wrltlna tOI PA D.partaant 0' R.venu., luraeu 0' Individual Tax.., ATTNI po.t A.....aant R.vl.w unit, DEPT. 2ID6DI, Harrl.burg, PA 1712a~06DI Phone (717) 717~6SDS. S.. p.ge 1 0' tha bookl.t "In.tructlon. 'or Inh.rlt8nCa TRM R.turn 'Dr. R..ldent Dac~t" (REV-ISD1) 'or an .xplan.tlon 0' ~lnl.tr.tlv.1Y corr.ctabl. arrDr.. DISCOUNTI I' any taM dUe 1. p.ld within thr.e (1) c.landar aonth. .,t.r the d.c.d.nt.. d.ath, . 'Iv. p.rcant CS~) dl.count of the teM p.ld 1. allowad. INTERESTs Int.r..t 1. charged beginning with flr.t day of d.llnquency, cr nln. (9) aonth. end on. (1) d.y 'rOll tt. date 0' d..th, to tn. d.ta 0' p.y.ant. Tu.. .....Ich b.c... d.linquent ba'ora J......ry 1, 19112 be.r 1nt.r..t .t the rat. 0' .1M (6~) p.rcent per annul calculated at a dally r.t. 0' .00DI64. All tu.. which bac... dallnquent on or .,t.r Januarv I, 19az will b..r Int.r..t .t . rat. .....lch will v.ry fro. calandar y..r to c.landar y..r with th.t rata lWMJUr\Ced by ttt. PA Dap.rt.."t 0' R.vlM'lUI. The applicabla lnt.r..t rat.. 'or 19a1 thrOUGh 1995 .r.s 'lUr Int.r.at Rat. Dallv Int.r..t Factor xur Int.,..st Rat. D.llv Intar..t Factor 1982 ..~ .0DD54. 1917 9~ ,DD0247 1983 lOX .DDDUa 19"-1991 II~ .DODSOI 1984 II~ .DoolOl 1992 9X .DD02o\7 1985 U~ ,ODDSS6 199]"1994 n ,OD0I92 1916 I'~ .DDD2n 199. 9~ ,DDDlU --lntar..t h c.lcul.ted .. 'allowss INTEIIElIT . BALANCE OF TAlC UNPAID X HUNBER OF DAYS DELINQUENT X DAILY INTEIIElIT FACTOR --Any Hot1c. l..uad .,t.r tt. taM baco.t. d.llnquent will r.'l.ot In Int.r..t c.lcul.tlon to ,l't.an (15) day. bayond the data of the ..........t. If p.y.....t h uda aft.r the Jnt.r..t caput.tJon dat. .hown on tM Notic., additional Intar..t ault be calcul.ted. . I , , . ._.~.~- .,.~.,....._-_._-..----.,. '( .; v /5- </Y-I C'./ REV-1548 EX AFP (12-94* COKHONWEAlTH OF PENNSYLVANIA DEPAAUtENT OF REVENUE IUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171ZI.06DI NDTICE OF INHERITANCE TAX APPRAISENENT. ALLOWANCE OR DISALLOWANCE OF DEOUCTION"\ AND ASSESSNENT OF TAX ON JOINTLY IELD OR TRUST ASSETS DATE 10-02-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 COUNTY CUMBERLAND FILE NO. ';1./- 'l.5-,~riC? S.S/D.C, NO. 166-20-6094 ACN 95131720 THOMAS H ANTHONY 19 BRETTAGNE ARBORDEAU DEVON PA 19333 REMIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 A.aunt R..i tt.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rifv=isiia-EiC-AFi>-Ciif=94i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-02-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 r.OUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 166-20-6094 TAX RETURN WAS. (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORHATION ACN 95131720 FINANCIAL INSTITUTION I DAUPHIN DEPOSIT BK & TR CO ACCOUNT NO. 00104692B1 TYPE OF ACCOUNT. ( ) SAVINGS (lO CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 03-25-94 Account Balance Par cent Taxable X Amount Subject to Tax Dabts and Daductions Taxable Amount Tax Rate X Tax Due 9.285,36 0.166 1.547,59 1,755.00 ,00 .06 .00 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." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-I AMOUNT PAID . TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE IF PAID AFTER THIS DATE,..SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, . IF TOTAL DUE IS LESS THAN 'I, NO PAYMENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREon" ( CRJ, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. J .00 .00 .00 .00 on \0 c: ii,' :':1 UI I.') C'"1 -< I "'" op I ,1 );> - -J . :rJ .1:1(') H' PURPOSE Of HOTlCEI To fulfill the raqulr~t. of S.ctlon 214D 0' the Inherltanc. IY1d E.tat. 'IX Act, Act II Q' 1991. (7l P.S, Sactlon l140J. PAVl'tENTI Detach the top portion a' thl, Notice and .ub.lt with your pay.~t to the R.gl.t.r of Will. prlntad on the r.v.r.. .lde, ..._ "aka check or lIOMy order p.yabl. tor REelSTER OF WILLS, ACENT. AU Plvs-ntl rec.lvacl .hall Ur.t b. appllad to MY Int.r..t which ..y bl du., with ."y r...1r1d.r appllad to the tu. REfUND (eA) I " r.fund of . taM cracllt, which .... not nqullltad on the talC r.turn, ..y be r.qutllt.d by cOIIPlIUna an "Appllc.tion for R.fund of Penn,ylvanl. Inherltanc. and E.t.t. TllC" (REV-I1I1J. Appllc.tlon. ar. Iv.llabl. .t the D,flc. of the RIghtar of WIU., MY 0' the Z] R.wenu. Ohtrlct attic" or by ceiling the ,p.elal 24~hour lIn.w.ring ....vlcs nuabar. for 'or.. ordarlnal In P.nnsYlvanla 1"'DD~162-2DSD, out.lda Pannsylvanla and ..I thin local Harrlabura ar.. (717) 717-ID94, TDD' (717) 77Z~2Z5Z (He.rlng tapalred Only). OIJECTIOHSI Any party In Int.r.st not .atls,l.d with the appr.l....nt, .llowanca or dl.allawanc. 0' d~ctlons or ......sent 0' taM (lnclucllna discount or Intarllt) I' .hown an thi. fr'otlce .'Y object w1thln ,blY (6D) day. 0' r.c.lpt 0' thh NoUce byl uwrltt., prot..t to the PA Olpart..nt of A.v.nue, loud 0' Appaa", a.pt. 211021, Hurhburg, PA 11121-1021, OR ,,".l.cUnt to h'v. thl ..tt.r d.tar.ln.d at the audit of the ICClX.W'lt 0' the par.an.l repr...nt.Uv., OR ".appe.l to the OrphlW'l" Court ADHIN- ISTAAT1Vf: CORRECTIONS. Factual .nora dhcoy.r.d on thh ........nt .hoUld b. IKkIr....d In wdUng tOI PA D.partlent a' A.v.nue, lur..u 0' Individual Tax.., ATTNI po.t A....s..nt R.vl... Unit, DEPT, 28D601, H.rrl.burg, PA 171l8~0'01 PhOM (7U) 787"6505. s.. paga S 0' the bOoklat Mln.trucUons 'or Inherltanc. TeM A.turn 'or . R..ld~t D.cedent" (REY"UDU 'or an 'l(planaUon 0' adlllnhtnUv.ly correctable errors. DISCOUNT I If MY taM due h p.ld w1thln thr.. (]) c.lendar .onths att.r the d.c.dent". d.ath, a tiva p.rcent (5:0 dlscOl.nt 0' the hI( paid h .llow.d. INTERnTl Int.r..t II charged beginning ..lth tint dey 0' deUnquency, 0" nine (,) aonth. end one (1) d.y frOl the d.t. D' de.th, to the d.t. 0' payeant. t.x.. which bee... delinquent ba'or. J~arY I, 1912 be.r Interut .t the rat. 0' .IM (6;() p.rc~t p.r .,..,.. calcul.ted at . dilly rat. 0' .DDDI64. AU t.x.. which bec... d.Unquent on or .tt.r Janu.ry I, 19U ..Ill bea,. Int.r..t .t a r.ta which will v.ry frOl calandllr y..r to caltnda,. Y.'" ..lth th.t rata announced by the PA D~art""t 0' R.venue. The .,.pUcable Int.r.at r.t.. 'or 1'12 through 1995 .r.1 . 'WI: Inter..t A.te O.l1v Int.nlt r.ctor 'WI: Int.r.st A.t. D.I1'1 Inter..t F.cta,. 191Z ZOX .DDD~. 1'17 OX .DDDZU l'U lOX .ODDUI l'II~I"1 IlX .DDUDl 1984 IlX ,DDnDl .". .X ,000247 l'as \SX .000n6 I"S~l994 7X .0oal'Z I'" lOX .000Z74 1995 .X .aaOlU ~.lnt.r..t II calcul.t.d .. follaw.. INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR "Any NoUce luued Ift.r the tax beco'" delinquent ..Ill r.flect an Int.rut calculaUon to ,1ft.." US) day. b.yond the data 0' the ......alnt, If plyaant I. .Ida .ft.r the Int.r..t coeput.tlon date .hown on the Motlce, additional Int.rut ....t be calcul.ted. /y '/$-1 REV-1548 EX AFP (12-94* COH"OHWUlTH Of' PEflltSYlVAHIA DEPAATttl:HT Of' REVEHlI: IURfAU Of" INDIVIDUAL TAXES DEPT. lIun HARRISBURG, PA 17121.a'01 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOMANCE OR DISALLDMANCE OF DEDUCTION.... AND ASSEBSHEIfT OF TAK ON JOINTLY "ELD OR TRUST ASSETS DATE 10-30-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 COUNTY CUMBERLAND FILE NO. v</-95 - ,5"t?R S.S/D.C. NO. 166-20-6094 ACN 95131582 THOMAS H ANTHONY JR 9 BRETTAGNE ARBORDEAU DEVOH PA 19333 REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Aatount R..itt.d CUT ALOHG THIS LINE ~ RETAIN LOWER PORnOH FOR YOUR RECORDS ..... R-lfv:isiii-iif-AFp.-li;r:94i------------------------------------------------------------------------------------ NOTICE OF INHERXTAHCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX OH JOINTLY HELD OR TRUST ASSETS DATE 10-30-95 ESTATE OF ANTHONY MARGARET DATE OF DEATH 04-10-95 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 166-20-6094 TAX RETURN WAS. (XI ACCEPTED AS FILED (I CHANGED JOINT OR TRUST ASSET INFORHATION ACN 95131582 FINANCIAL INSTITUTION. FNB BANK NA ACCOUNT NO. 500-0001461 TYPE OF ACCOUNT. (I SAVINGS ( I CHECKING ( ) TRUST (10 TIME CERTIFICATE DATE ESTABLISHED OB-11-78 Account Balance Percent Taxable ~ Amount Subject to Tax Debt. and D.duction. Taxable Amount Tax Rate ~ Tax Due 15,033.43 0.166 2,505.62 3,600,00 .00 .06 .00 NOTEI 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." TAX CREDITS: PAYMENT DATE DISCOUNT (+) INTEREST (-I RECEIPT NUMBER AMOUNT PAID o TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · IF TOTAL DUE IS LESS TNAN '1, NO PAYNENT IS REQUIRED. IF TOTAL DUE 15 REFLECTED AS A "CREDIT" I CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I .00 .00 .00 .00 0(") !~ ;:-. '0 ti, "" \.'~I -, l... - ~ . '.f) .,u , .' I......! -:r ~r: P\IIPClSE <If HDTlC!1 To fulfill the ,.-.ul,...,,, of IeGUon 2140 of the Irharltanc. Dnd Est.t. Tax Act, ItGt zr 0' 1"1. (72 P.S. IeGtlon 2140). PAYIIDO'I Oabch the top portion of this Hot1~ and .w.!t ..Ith vour p.....,. to the A..ht.r of Will. printed on the ,..VIIr.. .Ide. .... HIk. cMck or .one>> or.r p.plall tOI REOIITD1 OF' WILLI, AGOCT. AU pev-tt. ,...1'1*1 ..11 tint t. ~l1ed to .", Intar." ....,lch RY be w., Mlth MY r_lndar ..l1tld to the tax. RE1UND CCRh A raf\l'td 0' . tax credit, which .... not ,......tad on the tax ,.aturn, .., be raqu..tMt by cOllPhtlna M "Appl1C11Uon 'or Aafund ., ~IYIVWI1. InharltMCa MIl !steta Tax" (REV-nUJ. AppUc.Uon. .r. avallab1. at U. OttlCII 0' the R....t.r ., Wllh, MV of the U A...,.".,. Dhtrlot offte...,. by CIIIUng the specl.1 U~hou,. M....rll'll ..,...,tell nuaber. 'or fOrtll order-lngl In p."n.ylVMI. l-IOD-S62-USO, cutllda ~.,IVM1. WId ..lthln loc.. Harrlllbura .r.. (717) 7I7-IDM, fDUI (717) nz-un C....rlng I~lr" OnlY). OIJECTIDHSI Any p.rty In lnt....st not ..thf!ad with the appr.l......t, .ll~ or dl..l1~ of deduction. or .........,t 0' taw: (including dlllCOU1t or Inter..U .. shown on ttll. NoUce MY obJlClt within .bcly (601 day, of racalpt of this Notlce byl --.,rlll.., prot..t to the PI o.part...,t 0' Rav......, ao.rd D' Appall", Dept. 211011, HerrllbUrg, PA 17111-la21, OR --alItCU", to hw. thai ..tt.r dat....lned at the -..lit of the eocount of the paraonal rapr..entatlv., OR ..-.....1 to u. Orphana' Court AmtIH- lITAATlV! CDRMCTIDNSI 'aotu.l arrar. dhcov.red on thie ........"t IIhould be ~r..Md In writing tOI PA u.partHttt 0' A.venue, lur.", 0' Indlwldual Tu.., ATT'" Poat A.H.......t A.vl... Unit, ODIT. 210611, Hlrrhburl, PA 17U'-06DI Phone (717) 717-6IDI. s.. page S 0' the booklat Mln.truotlon. 'or Inherit~. Tax A.turn 'or . R..ident Decedent" (REV-II01) for an .xpl~tlon 0' adalnl.tr.tlv.IW corrao tabla .rror.. DIICDUfTI If '"" ta due .. paid within thr.. (1) cal__r .onth. .tt.r the daocedent'a death, . ,lva percent (5);) dhcount 0' the tax paid .. .UIM*f. IHTDtUTI Int.r.at h cn.rgad beglmlng with tirat day 0' delinquency, or nine (,) .onth. and one (1) ct.y 'rOIl tM data 0' ....th, to the data 0' p......t. Tax.. Which ~ dall,....,t be'or. .Janu.rv I, 1t1Z ~r intar..t .t the r.t. 0' .1M (6%) percent per annua calcul.ted .t . da11v rata of .00Dl64. AU tua. Wi1ch bee_ delinquent on or .ftar January 1, 1912 ..111 Mar Int.r..t .t a rata which w111 wry 'rOIl calendar y.ar to calendar year with t~t rat. ennow'ICtId by the PA Dapart..,t of A.venue. TN -..lIcabl. Int.r..t rat.. for 19'2 through 1"5 .r.. ~ Intl,...t R.t. Oellv Int.,...t F~to,. ~ Int.,...t R.t. O.lh, Int.r..t FltCtor nn 2.~ .DDDS4' 1917 OX . UU47 ItlS lOX ,DDDU' 1'''~I''1 II~ ,UnDl I'" II~ .DUnl 1"2 'X .DGUU 1915 ISZ .D'nltal 1991-1994 n .0UI9l I'" ..X ,'00274 I"' .X .UU47 --Int.r..t J. calcul.ted .. 'ollow.1 IIlTEIlElIT . IAUXCE OF TAll UIlPAID X NUKlER OF DAYB DELINQUEKT X DAILY IIlTEIlElIT FACTOR --Any Notic. luuad .tt.r the tax bee... dallncNant ..lU nflaot an Int.r..t calculaUon to '1ft... nl) My. beyond the ut. a' the .........,t. If p......t .. ..... .tt.r the Inhr..t coaput.Uon dIIt. Ihow1 on the NoUe., additional Int.r..t -.J.t be calcul.ted.