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Home My WebLink About95-00750 ~ i:~.l ~:;.;t.~~,:'- ,';'- " " ',' " " <,:-.," WiI.'!:, ~dP-,- ~t;-t~~S~!~ "t f~~'L' ;,- ~ - -.......- - ......-... --.' "- '. , . ~.I~IIIIIIIIIIII l'C:;'i: 1,1 ,.",., '" '''I t,.' 'I<, 'IIW ';1 h' 'lJ"'I'~ flll"11 I 1_.. j ~ r !~ (Ii r '\1';. !"/:' ~~l~W;1 c.;r,/. .' r , "'] ... t. lfil!l ~... > '. , :. "'.',01"; "l\ . r.. \ 11 ."',, . . -'i"'.f l' ' -4' -',; _ . .. . I , ~ ,o." ._ ., ',: .~ ..;' , " .1 .. , I " f' . I " ~. ... \, ' p,,' t. .' . .( 'I( . -_.,".,-, ..-.. ...,- .,--.....~._-".. ------ -'~ I r"-- -,-_.' ~~. ..-J _.JJ r ~ _ I ,~ . REY-1548 EX AFP (12-951* CDHKOHWEAltH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU Of INDIVIDUAL IAMEI DEPT. lauUI HARRISIURG, Pi 17111.0601 /(I(./,! .....'/ (,': 7,~,() '-I I c_ ,. NOTICE OF INNERITANCE TAX APPRAISENENT. ALLOXANCE OR OISALLOMANCE OF DEDUCTIONs t. AND ASSEssnENr OF TAX ON JOINTLY "ELD OR TRUST ASSETS DATE 06-05-96 COUNTY CUMBERLAND ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 FILE NO, S,S/D,C, NO, 170-36-2359 I J WINTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070 ACN 95130400 REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 Allount R.llltt.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... Rifv:is4-S.iif.AFji.iiz-:9Si.............-..------------..---....................-----.............-............ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD DR TRUST ASSETS DATE 06-05-96 ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 COUNTY CUMBERLAND ACN 95130400 FILE NO, S,S/D,C. NO. 170-36-2359 TAX RETURN WAS. (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION. HARRIS SAVINGS BANK ACCOUNT NO. 07-000081206 TYPE OF ACCOUNT. (Xl SAYINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-16-79 Account Balance Parcent Taxable X Amount Subject to Tax Dabts and Deductions Taxable Amount Tax Rate X Tax Due 7,042.50 0.166 1,173.77 ,00 1.173.77 .06 70.43 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) 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." AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE;. SEE REUERSE FOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS TH N II, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU NAY SE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I INTEREST IS CHARGED FROM 12-22-95 TO 06-13-96 AT THE RATES APPLICABLE AS OUTLINED ON THE REYERSE SIDE OF THIS FORM .00 70,43 3.04 73.47 I'URPClU OF HOTJCEI PAVHEHTI REFUND (CA)I DIJECTJDHS. ADHIN- ISTRATlVE COP.RECTJDHS. DISCOUNT. PEHALTY. JNTERESTI \D !i8.: o- R u t1l 0'1 C . ;\,)~i ;-\~ 0:: U d .' .' .... l{' , '.' " " ~ i 'il I'.' J ~) ( .. ""':;'11 ~.n Oil :doc ~ ~8 a: To fulfill tM requlr..."h of SHUon IIU of thl InMrltancl Md Elt.t. hll Act, Act II of 1"1. Ul P.I. IHUon 2141). Detach the top portion of thl, Hotlcl and tUb,lt with your pew-ant to thl AI,lt'.r of Will, printed on the rlv..... .Id., -. "1118 chedr. or IIOMY order Plvabl. tal REGISTER OF WILLS, ACENT. All ptr-ent. recllYld ahal! flr.t bt .,,11~ to any Int.r..t which "V bt due, with any .....lnder applied to the tl., A ...fund 0' . till cr.dlt, which w.. not r.qul.t.d on t~ till r.turn, "V bt r.quelted bv cu.pl.tlng an "Appllcltlon 'or A.fund of Penn'Vlvanl. Inh.rlt~. and Ett.t. 'I." (REY-ISIS). Appllcltlon. Ir. l"lllabl. _t the Df'lcI of the Reg.lt.,. of Willi, any 0' thl IS A.y~ District O"lc.. o~ b~ call1nl the .peclal r4-hou~ an.wa~lng ,.rvlc. ~r. for 'o~.. ordering 1 In P'nn.~lvanla I-JOO-S6r-2050, out.ld. Penn'~lvanla and within loc.1 H.~~I.burg .r.a (1111 711-1094, TOO' (711) 71r-2252 (He.~lnl I~alrad Onlw). Anw P.~ty In Int.r..t not ,.tl,'I.d with the .ppral...ent, .Ilowanc. o~ dl'lllowanc. 0' d'ductlon. or ......eent 0' taM (InclUding dltcfNlt or Int.r..t) ., .hown on thlt Notice ..y obJ.ct within ,bty (60) d.n 0' rec.lpt of thh NotlCI bYI .-w~ltten prot..t to the PA D.p.rtaent of R.venue, BOlrd of App.all, Dept. ZllOll, Har~l.burg, PA 11121-IOll, OR --.I.oUna to have the 'It..~ d.ter.lnad It the MMtIt 0' tha .ccount 0' the p.,.onal npru"'tatJvI, OR --appa.1 to the Orphan.' Court factu.l .rror, dllcov.r.d on thl. ........nt ~Id b. addr....d In writing tot PA D.p.rteent of R.venue, Buraau of Individual Tax.., ATTNI Po.t A......ant R.vl.w unit, DEPT. Za0601, H.rrl.burg, PA 17121-0601 Phone (711) '11-6505. S.. p.g. 3 0' the bookl.t "In.tructlon. fo~ Inh.rltanc. Tlx R.turn 'Dr a R..ldant Dac.dent" (REV-ISOI) 'or an Ixplan.tlon d' ldalnl.tr.tlv'IY co~~.ct.bl. .rror.. If any tlX due J. plld withIn thr.. (]) c.lond.~ Month. .,t.~ the d'c.dent'. d.ath, . 'Iv. p.rc.nt 15X) dl.count Dr thl tlX p.ld I. .llow.d. Th. 15X t.x .In..ty non-pe~tlclpatlon p.n.ltw I. coaput.d on th. tot.1 d. the tlM end Int.r..t .......d, and not p.ld b,'or. JInU.r~ la, 1996, the 'Ir.t d.~ .'t.~ the .nd 0' thl t.x len..ty p.rlod. Thl. non-p.~tlolp.tlon panllt~ I. app.llabl. In the .... Mann.r and In the the .... tla. p.rlod .. YOU would .pp..1 th. tax and Int.~I.t th.t h.. b.," ......ed I' Indlcat.d on thl, notlc.. Int.r..t I. chargld b.glnnlng wIth 'Ir.t d.~ o. d.llnquency, o~ nln. (9) .unth. and on. (I) daw fro. the data of d.ath, to the det. 0' P'~-.nt. Tlx.. which blc". dlllnqulnt bl'or. January I, 1912 bl.r Int.r..t .t the r.t. d' Ilx (6X) p.rc.nt p.r &nnuI cllculat.d at . d.lly rat. 0' .000164. All tIXI' which b.c... dlllnqu.nt on O~ e't.r Janulr~ I, 1911 will bllr Int.r..t .t . r.t. which will vary 'roe c.l.nd.r ~..r to cII.ndl~ Y'I~ with th.t rlt. announced b~ the PA D.p.rt'ant d' R.v~. Th. appllcabl. Int.~..t r.t.. fo~ 1912 through 1996 .r'l ~ Interut Rat. DailY Int.r..t F.ctor V.ar Int.ra.t Ret. DaJ1~ Int.~.1t Facto~ 1912 m .000541 1911 OX .000l47 1915 I6X .000431 1911-1991 1I~ .000301 .... m .000301 I99Z OX .OOOZU 1915 In .000U6 1995-1994 7~ .OD0l9! 1916 lOX .000214 1995"1996 OX .ODDZU ....Int.r..t I. c.lcul.ted .. followlI INTEREST . BALAnCE OF TAX unPAID X nUnBER OF DAYS DELInQUEHT X DAILY IHTEREST FACTOR --Any Hotlc. luuld after the tex blcOll., d.llnquent wUI r.fleot ... Intlre.t c.lcullUon to flftllft US, dIIn b.yond the d.t. 0' the ......-.nt. I' plYSant I. .ed. .,t.~ the Int.r..t coaputatlon dIIt. ,~ on thl Notlc., e4dltlon.1 Intlr..t ..u,t b. calculatad. .' RI!:V-1S48 I!:X AFP (12'95* COHHOHW(ALIH Of PENNSYLVANIA D[PARfHlNf Of REV[HU( IURUU Of INDIVIDUAl axu DEPI. II06DI IlARRIIlUAO, PA UUI'D601 M NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLOXANCE OR OISALLOMANCE OF OEDUCTION_., AND ASBESSHENT OF TAX ON JOINTLY nELD DR TRUST ASSETS -,'I 1/, "J t It . .ll' DATI!: 06-05-96 COUNTY ESTATE OF SIMS MARV DATE OF DEATIt 03-21-95 FILE NO, S,S/D,C. NO, 170-36-2359 ANITA S FISItER 753 COLLINA DR LEWISBERRV PA 17339 CUMBERLAND ACN 95130401 REMIT PAVMI!:NT TOI REGISTER OF WILLS CUMBERLAND CD COURT 1t0USE CARLISLE, PA 17013 Allount R...t tt.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... R-Eii:is4-i-iif.AFP--riif:9S)------------------------.-----.----------.-------------------------------....------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLV HELD DR TRUST ASSETS DATE 06-05-96 ESTATE OF SIMS MARV DATE OF DEATH 03-21-95 COUNTY CUMBERLAND ACN 95130401 FILE NO, S.S/D,C, NO, 170-36-2359 TAX RETURN WAS, (X) ACCEPTED AS F~LED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION, HARRIS SAVINGS BANK ACCOUNT NO. 07-000081206 TVPE OF ACCOUNT, (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-16-79 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER TillS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS THAN II, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIOHS. I Account BBIBnce Pe~cent TBxBble Amount Subject to Tax Debt. Bnd Deduction. TBxab1e Amount Tax Rate TBX Dua 7.042.50 0.166 1,173.77 ,00 1,173,77 .06 70.43 X x TAX CREDITS: PAVMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) INTEREST IS CHARGED FROM 12-22-95 TO 06-13-96 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE ~IDE OF THIS FORM . NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAVMENT TO THE REGISTER OF WILLS AT TItE ABOVE ADDRESS, MAKE CHECK OR MONEV ORDER PAVABLE TO, "REGISTER OF WILLS, AGENT." AMOUNT PAID .00 70,43 3.04 73.47 PURPOSE Of NOTlCEI PAvttENf. RUlJrID (tA) I . \D t:~ - ~ u lfJ ......'1.: 0, (' ~ -, ~.I o;;C '3 ,-" ;, :,1 h l{' " 0 ~ I .. " .0 ~~ (.) ~l) ~ W!l: a: To fulfill the requlrl-.nt. of Sactlon 2140 of thl Inharltance 8nd E".t, ,.. Act, Act ,t of 1'91. (12 P,I. IHtlon ZUDl. o.tKh the top portion of thh Notice Met ,ubalt with your p..,-ent to thll R"lstar of WUlI printed an the rav.r.. aide. _. ~. check or ~w order p.v~l. tOI AEGISTEA OF WILLI, AC[HT. All p.yaent. rac.lvld ahall flrat b, ~lJed to eny Intar..t which ..v b. due, with any r...lnder applied to the t... A refund of . t.. cradlt, which .... not r.~.ted on tha t.. raturn, "v bl r.~.t.d by 00__11,11\1I en "Application 'or R,fund 0' Penn.ylvanla Inhar1tlnCI Md [It_,. ,..- (REV.ISlS). 'ppllcatlonl ar. IVlllabla It thl O'flcl of the R.ghtlr of WUh, any 0' tM U RIVWMJI Obtrlct Offlc.. or by ce1l1ng tM .pecla. "-hour ..,....rlna urvlcl ~.r' for fora. orderlngl In Pann.ylv,"l. 1-100-162-2050, out.lda Pann.ylv..,l. and within local Harrl.burg .r.. (717) 717-10'., TOO' (717) 772-2252 ("..rlna lapalr.d Onlyl. OIJECTIONSI Anv plrtv In lnt.r..t not .Itlafl.d with tha appr.I...ant, .Ilow~' or dl'allow~. of daductlon. or ......eant of ta. (Includlna dl.~ount or Int.ra.tl .. .hown on thl. Hotlc. .av obJ.ct within 'I_ty (60) daya of rac.lpt 0' thla NoUca bYI --wrlttan prot..t to the PA Oapartaent of Ravenue, .oar~ of App.ala, Oapt. 211021, Harrl.burg, PA 17121-1021, OR n.llctlng to have the ..thr daUralnad .t the audit 0' thl aecount 0' tha p.nonal ,.pre.antaUv., OR --."..1 to thl Orphan.' Court ADttIH- IITRATlYE CORRECTIONS I OISCOUNTI PENAL TV I INTERESTt Factual .rrora dl.cov.r.d on thl. .......ant .hauld b. .ddr....d In writing tal PA Oap.rt.ant of R.venue, lur.eu 0' Individual T...., ATTHl po.t A.......nt R.vl.w Unit, DEPT. 210601, Harrl.burg, PA 1712a-0601 Phona (717) 717-6505. 5.. pig. 3 0' the bookl.t "In.tructlon. for Inh.rlt~. T.. R,turn for a R..ldant Dacad'nt" (REV-1501) 'or an a.planatlon of .dllnl.tr.tlv.ly corr.ctabl. .rrar.. If any taM due I. p.ld within thr.. C51 cal.nd.r lonth. .'t,r tha dac.d.nt'. da.th, . flv' p.rc.nt (5XI dlac~t a' thl t.. p.ld Is .Uawltd. Th. 15X t.. Ian..ty non-participation panalty ). caaputad on the tot.1 0' the t.. and Intar..t ......ltd, and not p.ld b,'ar. Janu.ry 18, 1"6, the flr.t d.y .ftar tha .nd of the t.. ...,a.ty p.rlad. Thl. non-p.rtlolp.tlon p.naltv I. app.alabla In tha .... .annar and In the tha .... tl.. p.rlod al you would appaal tha t.. end Intar..t th.t h.' ba~ .......d .. Indica tad on thl. notlc.. Int.ra.t I. chargad baalnnlng with flr.t d.V 0' d.llnquency, or nlna C.) .onth. and on. CI) dlY fro. thl d.ta of death, to the data of p.v.ant, T.... which bae..a dallnquant ba'ora January 1, l.a2 be.r Int.ra.t .t thl r.t. of .1_ (6X) p.reant p.r ~ calcul.t.d .t . d.lly rat. of .000164, All t.... which bac... d.llnquant on or ,'t.r Janu.rv I, l.a2 will baar Int.ra.t at a rata which will vary frol caland.r yaar to calendar y..r with th.t r.ta announead by the PA aapart...,t of R~v.nua. Tha .ppllcabl. Int.r..t r.ta. for l.a2 through 1"6 ar" Vear Int.rut R.t. U.lly Int.rnt ractor Vaar Intar..t Rat. O.llv Intar..t raetor 1912 ZOX .000548 1.87 'X .0002"" 1985 lOX .oooua 19aa-I991 IIX .00asol ..a. IIX .ooonl 1992 'X .0002"" 19a5 UX .UOSS6 1991-1"" 7X ,ODOl9Z 1986 I'X .00027" 1995-1996 OX . ODOZU --Inttrllt h c.lcul.tltd .. follows' INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hatlca I..uad .ftar the t.. baCDa.. dallnquant will raflact an Intara.t c.lculatlon to 'Ift.an (IS) day. b.yond the d.t. 0' t~ .......ant. I' p.y_ent I. ..da .ft.r the Int.r..t cDlPut.tlon dlt, .hown on the Notice, .ddltlon.1 Intar..t lIU.t b. c.lcull,.d. REY.X5"! EX AFP 02-95* CDfMOW(Al HI or PENNSYlVANIA DlPA'lIMlNl Of REYEHlI: IURUU OF INDIVIDUAL U>>lU DlPf. UD.U HARRnBURa, PI 1P1U-O'1I /" '\ )/ '/'I h (I NOTICE Of' INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR OISALLOHANCE OF DEDUCTION... AND ASSESSMENT Of' TAX ON JOINTLY nELO OR TRUST ASSETS DATI! 06-05-96 ESTATE OF SIMS MARY DATE OF DEATH 03.21-95 CUMBERLAND FILE NO. S,S/D.C. NO. 170-36-2359 I J WINTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070 COUNTY ACN 95130402 REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AMount R..ltt.d CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ..... Rifv:is4-8-ix..AFii.li2~95i----------.-.----'.-...._--.-..--......--......----...----.-----------.---.-----.--- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-05-96 ESTATE OF SIMS HARY DATE OF DEATH 03-21-95 COUNTY CUMBERLANO FILE NO. S,S/D.C, NO, 170-36-2359 TAX RETURN WAS. (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORHATION FINANCIAL INSTITUTION. HARRIS SAYINGS BANK ACN 95130402 ACCOUNT NO, 07-00000989 TYPE OF ACCOUNT. () SAYINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 02-08-82 Account Bahnca Pe~cent Taxable X Amount Subjact to Tax Debts and Deductions Taxable Amount Tex Rate X Tax Due 573.66 0,166 95,61 .00 95,61 ,06 5,74 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) INTEREST IS CHARGED FROM 12-22-95 TO 06-13-96 AT THE RATES APPLICABLE AS OUTLINED ON THE REYERSE SIDE OF THI~ FORM NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO TIlE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK DR HONEY ORDER PAYABLE TO. "REGISTER OF WILLS, AGENT." AHOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, . ( IF TOTAL DUE IS LESS THAN II, NO PAYHENT IS REQUIRED. IF TOrAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU HAY SE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS, I ,00 5.74 ,25 5.99 PURPOSE OF NOTlCEI PAYMENT I REFUND (CR) I \0 't::~ "- ~ l) .'{! '0.; 0'\ 0 :..:; <:>: l , 'I l{' , '. ~ y. , n ~J hl e.; ~ ~~ a: a: To fulfill t~ r.qulre...,t. of S.ctlon 2lU of the Inh.rlt."c. end E.t.te Tu Act, Act U 0' 1991. (72 P.S. Section 21411. Detach the top portion 0' this Hotlca and .ubtllt ..lth your pa1...,t to the Relllat.r 0' Willi prlnt.d on the I r.....r.. .Id.. -.. "ake ch.ck 0,. IlOn8Y ord.r p.YMl1. tOI REGISTER OF WILLS, "CENT. All p.y..,h rae.I....d .h.ll fI,..t be ~pll~ to INW Inter.at Which ..y ba du., ..lth MY r...lnd.r .ppll.d to the t.lC. A refund of a talC cr.dlt, which .... not request.d on the t.1C return, .a1 ba r.qu..t.d by cCNtp1.tlnll an "Appllc.tlon for R.fund of Penn.ylvanl. Inh.rltanc. end E.t.te T.lt" (REV-nU), Appllc.tlon. ar. .....Uabl. at the Office of the Re.htsr of WIUI, any of the IS R.v.,.,. DlItr1ct Office. or b1 c.lllng the .p.eI.1 Z4-hour .n....rlna ..rvlce ~.r. for fore. ord.rlnal In P"""1....."I. 1-1100-562"2050, outlld. P.M.yhenl. and ..lthln local Harrhbura .rea (117) 717-1194, TOO' t11l) nz..zuz CU..rlng I.palred OnlY). OBJECTIONSI Any p.rty In Int.r..t not .atl.fl.d with tha .ppr.I....nt, allowanc. or dl..llowanc. of d.ductlon. or .......ent of t.. (Including dl.count or Int.r..t) a. .hown on thl. Hotlc. .ey object within '1lCty (60) day. of r.c.lpt of thl. Hotlce bYI --written prote.t to the PA Oapart-.nt of R.venue, loard of App..I., D.pt. ZIlo21, H.rrl.bura, PA 17121-1021, DR --electlna to h.v. the ..tt.r d.t.r.ln.d .t the euellt of the .ccount of tha par.on.l rapre..nt.tlv., OR --appe.l to the Orphan." Court ADMIN- ISTRATIVE CDRRECTlOHSI OtsCDlWh PENALTY I INTEREST. F.ctual .rror. dl.co....r.d on thl. ........nt .hould b. .ddr....d In writing tal PA D.part..nt of R.v.nu., lur... of Individual hlC", ATTHI Po.t A......ant Review Unit, DEPT. ZI0601. n.rrllburg, PA 17121-0601 Phon. (117) 787-6505. s.. p.g. ] of the bookl.t "In.tructlon. for Inh.rlt.nce T.IC R.turn for. Ralld.nt O.c.dent" (REV-ISOI) far an .lCpl.n.tlon of .dalnl.trntlv.ly corr.ct.bl. .rror.. If .ny t.1C due h p.ld within thr.. (]) cal.nd.,. aanth. .ftsr the dacadant.. d..th, . IIv. p.rc.nt (5)() dhcount of the hlC paid It .llow.d. Th. 15~ taM a~..ty non.p.rtlclp.tlon p.n.lty I. co.put.d on the tot.1 of the tax and Int.r..t .......d, and not paid b.fora Janu.ry 18, 1996, the first da1 .ft.r the end of the talC .......ty p.rlod. Thl. non-p.rtlcJp.tlon pan.lty I. .pp.elabl. In tha .... aennar .nd In the the .... tla. p.rlod .. you would appa.1 the talC and Int.r..t that has b..n .......d .. lndlc.t.d on thl. notlc.. Int.ra.t h ch.rg.d b.alMJng with flr.t day of d.llnquency, 0" nJ,.. UJ .ontha and ona U) d.y fro. the data of d..th, to the d.ta of pay.ant. T.... whJch b.c... d.lInquent b.for. Janu.ry 1, 1'12 ba.r Int.r..t .t the r.t. of .b Ct.:CJ parc.nt p.r 'MU. c.lculated at a dally r.t. of .000164. All talC" WhJch b.c... dallnqu.nt on or after January I, 1982 will baar Inter..t et a r.t. which will vary fro. cal.nd.r y.ar to cal.ndar ya.r with th.t rat. announcad b1 the PA D.p.rt..nt of Ravanue. Th. .ppllcabl. Int.r.at rat.. for 198Z through 1996 .r" Vaar Intar..t R.t. DailY Int.r..t F.ctor V.ar Int.rut Rat. D.llY Inter..t Factor 1982 20X .000SIt8 1987 'X .00021t7 198] lOX .000438 1911-1991 llX .0003111 1'1" 11:( .000301 1992 'X .ooa21t7 1915 UX .000556 1993-1"4 'X .0011192 1916 lOX .00027" 1995-1996 'X .00021t7 --Int.r..t It calculat.d .. follow.. INTEREBT . BALANCE OF TAX UNPAID X IIUnBER OF DAYS DELINQUENT X DAILY INTEREBT FACTOR --Any Hotlc. luued .ft.r the t.1C b.co..a d.lInqu.nt will nfl.ct an Intsr..t c.lcul.tlon to flfta.., (5) d.y. b.yond the d.t. of the ........,.t. If p.v.ant II ..d. .ftar the Int.r..t COllput.tlon d.t. .hawn on the Notlc., addltlon.1 Int.r..t au.t b. c.lculated. REV-1548 EX AFP 112'95* COHttOHWULlU OF PENNSYlVANIA OCPARfHEHf OF R[V[NIJ[ IURfAU or INDIVIDUAL fAXES MP'. 110'01 ItARRISlURO, Pi Uatl'O,OI /} II 01,. '7__' " '. .)1." NOTICE or INHERITANCE TAX APPRAISE"ENT, ALLOMANCE OR OISALLONANCE or DEDUCTION".. AND ASSESS"ENT Dr TAX ON JOINTLY nELD DR TRUST ASSETS ESTATE OF SIMS MARV DATE OF OEAHI 03-21-95 CUMBERLAND FILE NO. S,S/O.C. NO, 110-36-2359 ANITA S FISHER 153 COLUNA DR LEWISBERRV PA 11339 DATE 06'05'96 COUNTY ACN 95130403 REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 A.ount R..ltt.d CUT ALONO TMIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE.V:is4-S.EX..AFii.fiif:9Sj..-.......--......---.....................-.-........--.-.........-................. NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD DR TRUST ASSETS DATE 06-05-96 ESTATE OF SIMS MARV DATE OF OEATH 03-21-95 COUNTY CUMBERLAND FINANCIAL INSTITUTION. HARRIS SAVINGS BANK ACN 95130403 FILE NO. S,S/D.C. NO. 110-36'2359 TAX RETURN WAS. (X) ACCEPTED AS FILED ( ) CHANGED JOINT DR TRUST ASSET INFORMATION ACCOUNT NO. 01-00000989 TVPE OF ACCOUNT. () SAVINGS (Xl CHECKING ( ) TRUST 1 ) TIME CERTIFICATE DATE ESTABLISHED 02-08-82 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID ArTER THIS DATE. SEE REUERSE FOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS TNAN 11. NO PAV"ENT ,IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FORN FO~ INSTRUCTIONS. I Account Balance Percent Taxabla X Amount Subject to Tax Debts and Deductions Taxabla Amount Tax Rate X Tax Due 513,66 0.166 95.61 ,00 95,61 .06 5,14 NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAVMENT TD THE REGISTER OF WILLS AT THE ABOVE ADDRESS, MAKE CHECK OR MOIlEV ORDER PAVABLE TO. "REGISTER OF WILLS, AGENT," AMOUNT PAID ,00 5.14 ,25 5.99 TAX CREDITS: PAVMENT DATE RECEIPT NUMBER DISCOUNT 1+) INTEREST (-) INTEREST IS CHARGED FROM 12-22-95 TO 06'13-96 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM . PlJ:IPOSE OF NOTICE. PAYttEHTI REFlHJ (CRl I OBJECTIONS I ADtUN- ISTAATlYE COARECTlONSI OISCOUNTI PENAL TV . INTEREST. . r- t~~ '0 ~ '0; ~1 0, " " o:C t , '. " ',,) , tp l.) ~n ~ ) ." .' tJ, " , ~ 1~ ' ~i ~ 8S a: a: To 'ulflll thl r.qulr..antl 0' s.cUon 2140 0' th. Inh.rUane. and Est.t. TllC Act, Act ZZ 0' 1991. (72 P.I. IHUon 11401. o.t.ch t~ top portion of thl. Natlc. and sUb.lt with your p.v-.nt to th. R.gI.t.r a' Will, prlnt.d on the r.".rs. .Id.. u HIlk. chick or IIOMY ord.r p.yabl. tOI AEGIITEA Of' WILLI, ACEHT. All p.w.."ts r.c.lv.d m.ll flrat b. appll.d to MW Int.rut which "W b. du., with MW ra..lnd., .ppU.d tD tha ta.. A ra'und 0' . ta. cr.dlt, which WI' not r.qu..t.d on the t.. r.turn, .aw b. r.qu..t.d bw cDapl.tlng M "Appllc.tlon 'or A.fund of Pannswl"anl. Inherltanc. ~d Est.t. T.." (REV-ISIS). Appllc.tlon. ar. .".llabl. .t th. 0"Ie. Df th. A.gl,t.r of Will., anw of th. IS A.v~. Ol.trlct o'flc., or bW calling the ,p.clal 14~hour M.w.rlng ..rvlc. ~'r' far 'Dr.. ord.rlngl In P.nn.ylvanl. 1-8DD-J6Z-ZDSD, aut.ld. pann.ylvant. and wtthln local H.-rt.burg ar.. (1111 181~80'., TDDI (111) 112-2251 (H..rlng lap.lr.d Only). Anw p.rtw In Intar..t not nthfl.d with th. apprah..ant, ,UOWMC' or dls.llowance of deduction. or ........"t of t.. CJncludlng dhcount or Int.r..t) .. .hDwn on thl. Notice "W abJlct wllhln .lxtv (6D) d.n of raealpt of thl. Notice bWI uwrlUan pro tilt tD th. PA O.p.rt.ant of R.v.nu., Board of App...., a.pt. lllOll, Harr..burg, PA l11ZI-lDll, OR u.l.ctlng to h...,. t~ ..U.r d.hraln.ct .t th. audit of tha .ccaunt of thl p.raon.1 raprallnt.tlvl, OR --app.al to th. Orphan.- Court Factual .rrars dl.cov.rad on thl. ........nt ,hould b. .ddr....d In writing tal PA O.part..nt of A.v.nus, aur.au of Indlvldu'l T...., ATINI Pa.t A.......nt Ra"l.v unit, DEPT. Z8060l, Harrl.burg, PA 11128-06Dl Phon. (111) 181-6505. S.. p.g. S a' tha bookl.t "In.tructlan. far Inh.rlt.nc. 'a. R.turn far a R..ld.nt O.e.d.nt" (REV-1501) 'or an I.plenatlan of .dalnl.tr.tlv.ly earr.ct.bla arror.. If any taM du. I. paid within thra. (3) e.l.nder _anth. aftar the d.eadant'. daath, a 'Iv. p.rc.nt (5~1 dJ.count a' the taM paid I. allawad. Tha 15~ t.lC .en..t~ nan-p.rtlclpatlan plnalty I. cD.putad an the total 0' tha ta. and Int.r..t .......d, and not paid b.for. Jenuarw 18, 1996, th. flr.t d.y aft.r tha and of the ta. ..na.ty p.rlad. Thl. non-partlclp.tlon penalty I. .pp..labl. In thl .... sann.r and In th. tha .... tl.. p.rlod a. ~ou would app.al tha t.. end Int.r..t th.t hu b.." .......ct II Indlcatad on this notlc.. Intarllt Is charg.d b.alnnlng with 'Ir.t daw 0' d.lInquencv, or nln. (9) eonth. and on. (1) d.w 'ro. thl d.t. D' d..th, to th. d.ta of paw..nt. T.... which b.c... dllJnqu.nt b.far. January 1, 1'8Z ba.r lnt.r..t at the r.t. a' .1. C6XJ p.rc.nt p.r annua calcul.tad .t . dellv r.t. of .000164. All ..... which b.ce.. d.lInquent an or .ft., Januarv 1, 1911 will baar In'arut at a rat. which will ...arw 'ra. c.landar ya.r to caland.r ya.r with th.t rat. .nnounc.d by thl PA D.p.rtaant 0' R.....nu.. Th. IPplJcabl1 Intar..t r.t.. 'Dr 1982 through 1996 .r'l V..r Int.rut R.t. Dallw lntar..t Factor V.ar tntar..t Rat. D.lb In'ara.t F.etDr nil 2U .000548 1981 9X .000247 19n 1'~ .DDOU4 1988-1991 IIX .DOOSOl Ita. IU .ooanl 1992 9X .0DDI41 1985 ..~ .00OS56 1995.199" 1~ .00DI9Z 1946 lOX .000214 1"5-1996 9~ .000Z47 ulnt.,lIt Is calculat.d .. 'ollowtl INTEREST . BALANCE OF TAX UNPAID X NunBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .-Any Notlc. I..ued ~'t.r th. t.M blca... d.llnquent will r.'lact an Int.r..t c.lcul.tlon to 'I,taan (15) d.y. b.wond thl d.t. 0' the .......ant. If pay..nt I. .ad. .'tar tha Intar..t ca.put.tlon data .hown on the Natlc., addltlon.1 Int.r..t lU.t b. calcul.t.d. ~REV-1604 EX AFP (12-..51 COHHQNWfALTH OF PEHHIVlVAHU DEPARTMENT Of REVENUE . BUREAU Of INDIVIDUAL "MES OEPT. 210601 UARRISBURG, Pi 17111-0601 / "II ;,-. I ~l ._") '. --- "'") . c.......' ~-' -- (& '-" INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE 06-26-96 ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 COUNTY CUMBERLAND FILE NO, ,;1./-95. /.'50 S.S/D,C, NO. 170-36-2359 ACN 95130(,00 REMIT PAYMENT TO: I J WI NTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070-0000 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AMount R...itt.d ~~_!_~~~_~~_!_~!~__~!~~_______~____~_~!~~_~_~~_~~~_~~~!_~~~_J:~~__~~~~__~~~_~~~~__._..~____________________ REV-1604 EX AFP (12-95) .. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS .. DATE 06-26-96 ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 COUNTY CUMBERLAND FILE NO. ADJUSTMENT BASED ON: S.S/D.C, NO, 170-36-2359 ADMINISTRATIVE CORRECTION JOINT DR TRUST ASSET INFORMATION ACN 95130400 FINANCIAL INSTITUTION: HARRIS SAVINGS BANK ACCOUNT NO. 07-000081206 TYPE OF ACCOUNT. (Xl SAVINGS () CHECKING ( ) TRUST () TIME CERTIFICATE DATE ESTABLISHED 04-16-79 Account Belance Percent Taxabl~ X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 7,042.50 0.166 I ,173,77 1,173.77 .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 ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) AMOUNT PAID TOTAL TAX CREDIT ,DO BALANCE OF TAX DUE ,DO INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FDR CALCULATION OF ADDITIOHAL INTEREST. ( IF TOTAL DUE IS LESS THAN n, ND PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIDNS,I . ,', '! "<t I-~ ~ ';0. . " CO , r:: , ~J ) cr 'J ~ ',i ..0 ~ ~E ~c3 '0 !!l 'J u ~~. " ',:h () fl.\ tUO: a: "'mENT I DetKh 'M top porUon of thh NoUee ... .ubIIlt with your ,lVIMlt ,ltd. p.vlbl. to tM "... Iftd Mdr... printed on the reverte .ldII. .. ...... check Dr ~y ord.,. p.rlble tOI REGISTER OF WILLS, AGENT. AU P.,...". recllvlMl IhriU be ...,.Uitd flr.' to M' Inte,...t which ..v bl w. with MY ,...lnder' .."Uld to UtI t... RUUKD eCAJI A refund .f . h. credit, which WI' not r.qw.tlMl on the hll R.turn, .., be requested bv cO.,.IUnll ." ~Appllc.tlon for R.fund of penn.vIY.,,'_ Jnherlt~. ~ E.t,t, ,..W (REV-ISIS). application. Ir. Iv_llabl. .t the Office of tM R....t.r of Willi, MY of the IS R.v~ DI.trlct OffiCI' or fro. the O.,.rt.-nt" 14.hour .".~rl", I.rvlee ~.r. for ,orl' orderlngl In penn.,lv",., 1-laO-'6,-roS" aut,lde P~'rlvlnl. Iftd within lOCI. Harrisburg .rl. UUJ 717"U94, TODI (717) 771-un (H.."lno I"llrlMl only). REPLY TOI Due.tlon. r...rdlng arror. cont.lned on thl. not lea .hould ba eddr....d tal PA a.p.rtlent of R.venue, Bur.eo of Individual Taxa., ATTNI Po.t A......ant R.vl.w unit, Dept. r10601, H.rrl'burg, PA 17IrO~06DI, Phone (717) 717"65OS. DIICOUHTI If ~, tex du. I. p.ld within thr.. (Sl cllend.r eonth' Ift.r t~ dec.dent'. d.ath, . five p.rc.nt (Sk) dl.count of ~ tex paid I. .Ilowed. p[HALTYI TM 151 tex ..-M.ty non.p.rUclp.Uan penaltv I. ca.putad on the total of t~ t.. MIl Int.r..t ......ed, end nat paid before J~r, 1', 1996, the flr.t day aftar the end a' tha t.x .-na,tv parlod. INTEREST I lntara.t la charged beginning with flrat day of d.llnquana, or nine (,) eonth. ~ ona (I) day fro' thl d.ta of delth to thl date of pa..-nt, "Ma. which bee... dallnquent bafor. Janu.rv 1, 1,.r b.a.. Int.ra.t .t the rat. of .1. ('k) parcent p'" annul calculltad at . dallv r.ta of .000164, All ta... ~Ich bac." dallnquent on and .ft.r Januarv 1, 1,.r will ba.r Intara,t at . rata which will varv frol caland.r v..r to calandar va.r with that rata announced bV the PA Dep.rt.ent 0' Rav.nua. The ~llcabla Intara.t rata. 'or I'" thr~ 1'" aral Yaar Intar..t Rata 01111, Intlr..t Factor Ya.r Intar..t Rata D.lly Intara.t FHtor I,ar ..X .000541 1917 'X .000247 191J lOX .000411 1'11~1991 IlX .ooosat 19" IlX .OIOS01 ,... OX .000247 "II 11X .OIOSH 1991"1," 7lf .00019Z 19" lOX .000274 1995.1"' OX .00OZ47 "Intar..t II calculatad .. fOU....1 INTEREST . BALAHCE OF TAX UllPAID X NVKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..An, t~Uca luUfHI aUa.. the talC beeo... dIlInquent .,111 rlfllct ~ Intarllt ulculatlon to flft.... (15) d.y. beyond thl dIta of thl .....lItIf'It. If p.....,t .. Ada .fta.. the Intarllt CDIIpUt.Uon data .hown on thl Notlc., addltlon.1 Intara.t .u.t be calculated. t.. 1-\ _...-..........~i_.._____4.____._~ ....._...... ,. REV.1604 EX AFP (12'9~) CDHHOHW[lLTH OF PENNSYLVANIA DfPARJPENT Of' AEY[NUE: BUREAU OF INDIVIDUAL TAIlEl O(PT. IIDUI HARAISBURG, Pi 17111aD'Ol ;.5- y/-/ :; INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD DR TRUST ASSETS (IV" OAT! 06-26-96 ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 COUNTY CUMBERLAND FILE NO, J./- q 5 . '15 () S.S/D.C. NO, 170-36-2359 ACN 95130401 REMIT PAYMENT TOt ANITA 5 FISHER 753 COLLINA DR LEWISBERRY PA 17339-0000 REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 AMount R...itt.d P.!l_L~~P_~~..:r-'!!L~!~!...m.~____!l_I!.!~~!L~P_'!.!~_!..~~.:r_~~~_!..~~.X~~!l..~~P_l?'!!.'!l______~__.______m______._ REV-1604 EX AFP (12-95) .. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS .. DATE 06-26-96 ESTATE OF SIMS MARY DATE OF. DEATH 03-21-95 COUNTY CUMBERLAND FILE NO. ADJUSTMENT BASED ON: S.S/D,C, NO, 170-36-2359 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 95130401 FINANCIAL INSTITUTION: IIARRIS SAVINGS BANK ACCOUNT NO. 07-000081206 TVPE OF ACCOUNT, (X) SAVINGS (I CHECKING ( ) TRUST () TIME CERTIFICATE DATE ESTABLISHED 04-16-79 Account Behnce Percent Texeb1e X Amount Subject to Tux Debt. und Deductions Taxub1e Amount Tux Rute X Tux Due 7,042,50 0,166 1.173.77 1,173,77 .00 .06 .00 NOTEt TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION UF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS I PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. 0 TOTAL DUE · IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIOHAL INTEREST, ( IF TOTAL DUE IS LESS THAN 11. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I "'" 1:,,( "- r. 0 <Il ) (I.. .,~ CO .~ , L-;:: ':- lJ c- ; . '1' ,) , ~ ' . ZJ ;;~ U';-.; ) ,{t 0 fIl q, ~ o.,E In.: c: u8 PA'ntEHTI a.tach the top portion of thll HaUc. end lua.!t with ~our PIVI..t lada pavabl, to tt. n... and .teIr... prlntad on the rav.r.. .Id.. u Meke check 0,. ""w ord.r p'VIlt... tal REGISTER OF WILLS, AGENT. All p.....,.... rHalved ah,U ba -"UM flrat to MV Inter..t Which "V be due with WlY ,....lnda" ItpplJad to the t... RUlJCD (CH) I A r.fund of I tax credit, Which "'.. not n~.t'd on the T.. Alturn, "V ba raqu"hd bv co~ht1nll WI "Application for R.fund of Penn.vlv.,..l, l~rJt~. ~ Eltat. Tlx. CREV-ISIS). Appllcatlona ara Ivallabl, at the OfficI of the R'II,t.r of Willi, WlV of the IS A.v.~ 01,'r10t D"lcI, or fr~ the DIp.rt....t". 24-hour en.w.rlna ..rvlel nu.ber. 'ar for.. ordarJnar In Pennsvlvanla l-aOD-S6Z-Z0SD, out'lda Pann'Vlvanla and within 10cIl Harrisburg .r.. (717) 7.7-1094, TDD' (717) 772-2252 (H..rlng 1~.lr~ only). REPLV Tal Due.tlon. r..ardlna arrar. cantalnad on thl. notlca .hould b. .ddr....d tor PA Dep.rt.ent 0' R.v.nue, lur.eu 0' Individual TaM.', ATTHI Pa.t ,......ant R.vl.w unit, D.pt. 2'0601, H.rrl.burg, Pi 17121-0601, ~ (17) 7.7-6515. DISCOUNTI I' any tax due I. paid withIn thr.. (5) cal~r .unth. a't.r the decedent'. death, . fly. percent (5~) dl.count a' the ta. paId I. aIIDN~. PENALTVI ~ 15~ tax -.ne.ty non-p.rtlclpatlon pen.lty I. coaputDd on the tat.l a' the t.. and Int.r..t .......d, and not p.ld ba'ara J~arY 18, 1996, the 'Ir.t d.y a,t.r the end of the t.. aane.ty p.rlad. INTERt!:1T1 Int.r..t I. ch.rged baglnnln, ~Ith 'Ir.t d.y 0' delinquency or nlna (9) .unth. ~ on. (1) d.y 'roa the data 0' death to the data of payaent. T.... Which bee..a dallnquent be far. Janu.ry I, 19.2 baar Int.re.t at the rata a' .IM (6k) pareant p.r ~ c.lculatad .t . d.lly rat. of .000164. All t.x.. which bec..a dallnquent on and "t.r Janu.ry 1, 19.2 wIll bear Int.re.t .t a rat. whIch will v.ry fraa c.landar y..r to c.l~ar y..r wIth th.t r.ta ennounc~ by tha PA Dep.rtaent of R.venu.. Th. appllcabl. Intar..t rat.. for 19.2 through 1996 .rar ~ Intera.t Rata DaUy Int.ra.t Factor V..r Int.r..t R.ta D.lly Int.ra.t Faa tor "u ZDX .oonn 19'7 'X .00OZ47 1"5 I6X .00008 19.'-1991 IU .000501 1'" IIX .000501 I"' 'X .00OZ47 1915 nx .00OS56 1995-1994 ]X .000192 1916 lOX .000274 1995-1996 9X .000247 --Intarllt I. calculat~ .. follow'l INTEREST . BALANCE OF TAX UHPAID X HUHBER OF DAYB DELIHQUENT X DAILY INTEREST FACTOR --Any Notlc. 1..UId aftar the t.x baco.e. delinquent wIll rafl.ct an Int.r..t c.lculatlon to flftaen (15) d.y. beyond the data 0' the ......-.nt. If p'vaent I. aade aft.r tha Int.r..t cu.putatlon data shown on the Notice, addl tlonal Int.rllt au.t be calcul.tH. '....,." / I I REY-1604 EX AFP (12-9~1 COKHQHW(AlTH Of PENNSYLVANIA DE:PARTHENY Of RfytNU( IUR(&U OF INDIVIDUAL "Mfl DOT. lIanl V HARRIIIURG, PA 17UI.06Gl ESTATE OF SIMS MARY /!; - (j '7- 13 INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS (!! t--. DATI! 06-26-96 DATE OF DEATH 03-21-95 COUNTY CUMBERLAND FILE NO.,:(/. l)6--?50 S,S/D,C, NO, 170-36-2359 ACN 95130402 REMIT PAYMENT TOI I J WINTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070-0000 REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 A.aunt R..ltt.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... ---------------------------------------------------------------------------------------------------------------- REY-1604 EX AFP (12-951 .. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS .. DATE 06-26-96 ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 COUNTY CUMBERLAND FILE NO. ADJUSTMENT 8ASED ONt S.S/D.C. NO, 170-36-2359 ADMINISTRATIYE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 95130402 Account BeIence Percent Texeble X Amount Subject to Tex Debts end Deductions Texeble Amount Tsx Rete X Tex Due FINANCIAL INSTITUTION I HARRIS SAYINGS BANK ACCOUNT NO. 07-00000989 TYPE OF ACCOUNT, () SAYINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 02-08-82 573.66 0,166 95,61 95,61 .00 .06 .00 NOTEt 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 ADDRESS SHOWN ABOYE. MAKE CHECK OR MONEY ORDER PAYABLE TOI "REOISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DI SCOUNT (+) INTEREST (-) AMOUNT PAID TOTAL TAX CREDIT ,00 BALANCE OF TAX DUE .00 INTEREST AND PEN. TOTAL DUE · If PAID AfTER THIS DATE, SEE REVERSE fOR CALCULATIOH OF AODITIDNAL INTEREST. I IF TOTAL DUE IS LESS THAH n, HO PAVHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAV BE DUE A REFUHD. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIDNS,) '. '<I \:'.~ ~ c:i .. r~ II :!1 co , ,-;ci;; -=: ~ . ::, ", , ) 'l' " " ,. ~ , ~:i :; .J .. " ''> It) ~ :. E IUa: ~8 a: PA\1t[HTI Detach U. top POrtion af thh NoUce Md .ubIIlt with your PI,..,..t ... plyabl, to the n... Md HeIr... pd"'''' an the rive,... .1.. .... "Ilk. check or 110MV' orar parable tOI REGISTER Of WILLS, AGENT. AU p'~h rec.J".d thli11 1M .PUld Un' to MV Intern' which .." be dlHI with env ,....Inder appllld to the taM. RU1JND (CHJ. A refund of . tax credit, which .... nat raque.t~ on thl 'IX Rlturn, .'V b. nquelhd by co-.alaUna WI "AppllnUon 'or R'fund 0' PMnlvlvWlla Inhl,,1tMCI and [It... T.... (REY-U1IJ. AIl911cIUon. Ira '''IUllbl. at the OffiCI of thl RI,ht.r of WUh, WlY of tM U R.v~ Olltrlet OffiCI' or 'rOIl thll a.,.a.-t...,t'l 24"hou,. ."....rlncl ..rvlce nullbtir. 'or for.. Ordlrh'IJ' In PWVl.vlvWlla 1.aOD-S6Z-IDSD, ouhlda P""'vlvlII'lla end within locI I Harrlaburg .r.. (717) 7'7.aa'4, TOOl (717) 77Z-2252 (H..rlng 1~.lr'd only). REPLV TDI Queltlon. rq1lrdlna .rror. cont.lned on thh noUn should b. ~dn..ad to. PA a.Plrt.."t of RlVemM, Bun.... of Indlvlduel Tlx." ATTHI POlt A.....aent R.vl.w UnIt, Dept. 2a0601, H.rrllburg, PA 1712'-0601, Phon. (117) 7""6505. DISCDlllT. If MY t.. duIi h p.id within thrH (J) c.hnd.,. Hnth. .,hr thli d.cedent'. dtUh, I flv. ~rcant (S~) dhcOWlt of thli t.. p.ld i. a11OMed. PEtUlTY. TM 15le talC ..,..ty non-p.rUcJp.Uon pen.lty h COllpUt.d on ttMI tohl of tM t.lC Met In..r..t ......H, IInd not p.ld b.fo,.. JMU,ry .1, 1996, tha Unt dlY .fh,. tha .nd of thl tlM a.,..ty parlod. INTEREST. Intlrut I. chlrged blol,..,lnGl wUh flnt d.y of delinquency or nlna (9' Mnthl Md O"Ia (1) d.~ fro. the data of death to the d.tl 0' ply.",t. TIXII which bee... dlllnquent bafor. Jww.rv 1, 1912 ba.,. lnt.rut It the rlt. of .llC (6X) ",.c."t pa,. annue u1cu11tld It . d.Uv ntl of .000164. AU tlMI. Mhlch bee... dlUnqu.,t on and .ft.,. Jenuary 1, 19U "Ul b..,. Int.,.ut at a nt. which "Ul v.,.v fro. cal.netar ya.,. to calanct.r va.,. wlth that r.t. MnOUnced by the PA Dep.rt.."t 0' R.venue. Th. appllcabl. Intarut nt.. fo,. 1912 through 199' .,... v..,. Int.r..t Rlt. allly Intara.t Factor v..,. Int.,...t R.t. aallv Inlar..t Facto,. - 1912 ZOX .000541 1917 9X .0DDI41 1913 lOX .OOOUI 19n-1991 1IX .00DSOl I... IU .000Sll 1"2 'X .000t41 1915 UX .0ou" 1995-1994 7X .0DDln 19.. lOX .OO0l74 1995"1996 .X .ODat4' ....In..r..t 1. c.lcul.tad '1 foUC*I' INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR uAny HoUc. h.lIed aftlr the taM blc", dlllnquent "Ul ,..fhct en Intar..t c.lculltlon to flfta.., US) din tNyond thl data of thl ........,..t. If plyqnt h ndI .ft.r thl Inl.,...t coaputaUan dltl lhown on the NoUn, -'cUtlanl. Inlarllt .,st ba cllculated. REV-1604 EX AFP (12-*51 COHHOHWEAlTlt OF PENNSYLYANIA DEtlARTHEHT OF REYENUE . l~iEAU OF INDIYIDUAl 'AkEI DEPT. Zl06G1 HARRISIURQ, Pi 17121-0601 IS s'Q-13 INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD OR TRUST ASSETS (f (, DATE 06-26-96 ./ ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 COUNTY CUMBERLAND FILE NO, :J/-q5 7'.iu S,S/D,C. NO. 170-36-2359 ACN 95130403 REMIT PAYMENT TOI ANITA S FISHER 753 COLLINA DR LEWISBERRY PA 17339-0000 REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 "..ount R.llltt.d ~y.!_~~~-~~_!_~~~--~~~~_______~____~~!~~_~_~p_~~~_~~~!_~~~_JF.~~__~~~~__~~p_~~~~______~____________________ REV-1604 EX AFP (12-951 .. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD DR TRUST ASSETS .. DATE 06-26-96 ESTATE OF SIMS MARY DATE OF DEATH 03-21-95 COUNTY CUMBERLAND FILE NO, ADJUSTMENT BASED ONI S.S/D.C. NO, 170-36-2359 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORHATION ACN 95130403 FINANCIAL INSTITUTIONt HARRIS SAVINGS BANK ACCOUNT NO. 07-00000989 TYPE OF ACCOUNT, () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 02-08-82 Account Balance Percent Texeble X Amount Subject tD Tex Debts end DeductiDns Texable Amount Tax Rate X Tex Due 573.66 0.166 95.61 95,61 ,00 .06 .00 NOTEt 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 ADDRESS SHOWN ABOVE. MAKE CHECK DR MONEY ORDER PAYABLE TOI "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST C-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. TOTAL DUE · IF PAID AFTER THIS DATE. SEE REVERSE FDR CALCULATION OF ADDITIOHAL INTEREST. ( IF TOTAL DUE IS LESS THAH el. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS,) ..V.I."......' . INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH 0/ PENNSYlVANIA . DEPA.tMENT 0/ .EVENUE _^ ,. . .1l.IAU OPlNDIVIDUAL TAXII' DEP1'.~I06D1 HAXXISlU.O. PA 17121.0601 ECEDENT" NAM! 5CHIDULI ITIM NO, IX PLANATION OF CHANGES ,.. '.~n.". ..,..p.....q_._. .". CfD . --C):';-:/-3VLlOI () C'h---Q_SL.JOlliJ-3 . J I' --.z;~~.-- -~.~;;t..--~.,,:t;~'~J -.---.~.Jb'~~.-'1<;c. jf.Li..c-t:t:.,^._~- . .-----.----....,.-.>-.---.,-. ......... ,~. ._"- . .. ....--~ ."--"'''.,,-, _... .....,.......... "......-.-. . . ...____ .,.."._ _, ... ~.,___._ >". ,_.._, -. -,"_'0 .... ___._ . ,.. , o,j~()-,vJ_ .-t -1ftJ.,.vUJ ~/J -Y/~ 0- ( l~)- <<.:/ -6: '~.-f', '710 v),-.. t?u.~ J!/)j~. -<.P~ ./1 _._~ ~v}1.~._..,t.-v'e-L ~')VI.- ~l..V~ - U\.-fA. _ \ ~tr h...~ ~~,~ I TAX EXAMINER, -077 f! I:t;;./~ - PAGE 1''t.l''OIlIt-'" . t;OMMONWEAlTH Of PENNSYLVANIA , DEPARTMENT Of REVENUE .. - .. IUAIAU O' INIIlVIDUAl TAXII DEPT, 280601 HARRI5IURO, 'A 17128.0601 DECEDENI'S NAME INHERITANCE TAX EXPLANATION OF CHANGES .i. filE NUMlEA \- tJ?) JoS/() /i , SCHIDULI ITIM NO, IXPLANATION 0' CHANGES J..Ic..'h . ...9 (~u.Y) .. ( I ,- .. .., ) (...1 (I ~ ("t.J ~." ..<......-.-. _. _.._~..-..... ..' - ..- U ,. , 'I l,t u ;). . 70 I.vIL..... .. _____~.~.~ ~.. H" <' _.. ....,.... ~ __"". ,. ., "~_ _..__ __. _ _ '+._ .___ .._.. ....... _ . .r' -~:-.t;.....L .._..(;l~-..-.......-...-.i:-~~__~ , ~. -~_.2i-~.._tL,-..t4--,.,".,;;t...___..0.. ,..th~..,. '.. , ~ /J ' !":/ t -~----- .-------.... "'.....~ . ~~.~'..>.---<._~--.~-_.~.~..--~-_._. ___"."_"","'_. . ',> __, .. A '.U ___+_ _ ...__ _ _ _._ __.._~. ..... "'__'._..."._,,_~__~__._,..__.___....._.,..~ _.._~__. ',;" -~~-.,.- ._~_.. ~-...-.__.._--~.--... ~-, L",~ .-" ~ --', '."_.,' _~___._._ . '~_"'_'"_'_'. .__.._ _.'. __ ~ ..~""_~ ~ _~_'u' ._._~___ _. _,,____.. . +" ~ _ _.K_,,_ "_'''_,,'_,.__~_'u_, __.... .~---~-~~ ~~ ...~.~._,--.---- .---~~-.-------"-_.". ..-... '". ~ ~.~ ...~._...*..~~.+-.-~____~__._....__..__"._M.. ,..... .... ~. ,~....,.~_.,._'--.-._~ ~__..~_."_____"._.__~.__.._._~ ~__ __. ,.. " _'n ,..----....._.-...., .____~ m ~." 2 _~'_.."__e_,...~_ ~_.._...._. ..... u,.. _~,~.",_... ,..... ..,.. ..... ~. __."" __"_.'__'~_'__'_"""".'_'______._~_ 2'~_"""'_--+~__~~_~~__~_'_ __.__ _ _ _~_. . .- ~---- ---. .~.. --_. .._.-~.-..""..,.-~.. '.' ..<-...-."-.-, . ~.~ ~ - ~',.~."-"--' ,.. .,..--..-.. -~--."_..-._--_..,...,.-_....__...~....-~.,. "-'~~-,..~.,----_..-.._--~----- . .". - ~ ...~ _.. .-.--.- ---..,-.., - -." ... -, ,.... "---'~""'-"_ -------__.~_ -. '..~_,..._..._ _, ,. _ ._h....~_._..~~____..__~__,..._.......,-.._.._._~-+~.__'"'. ___.___________., ...._. -~-- .-...~" ..-.--'"--~ .__._....-..,._._~__ ,....._.. e_..' .. ....," .___.____~_.._-..._._..__~ _.._.__,._.,. ._......,.______~________~__,,..._< .____._..____.______._ . - "--' --.--'----._'_" ......,~ _ . .."._~~ ____". .r"_,.., _., _....._..._~_._..~..___. .... ~._ . - . .... ...._.~ -_. ~~.._-...--_. -._..._~._. .^_._~ - -" "---.-.--. ----~-- .., .,.,... . --. -.. ....-~.._... ~ .._~~ ~---. .._..--_.,_..~..._---. --.-. -. ^".~.:.__...,--~'~>-:-'.-. -".".~_._-_.~._--_._~._~ '-.----" ",.. <" ... .-. -.-....""-...-'.<.._-...._-~...~ -...-e._..___.... TAX EXAMINER, 7-) /1 ? E ( " :r;; "~l"l ./ ~ 't PAGE \ , i , . /t . , " ... - , '" '. ~ . ! ~~ :L ~-: -~lLnfiH~~ bHH .-t,:i1 '15 "'~ 5\,>.-'. {' -. "'; ;':". T'7;..';' , {;~ II'! tj"tl ~'~l ceO: '. ~.....~T" co ,0:;;:.. ~+;;"" ~ ::1 19. .";, . REV-1543 EX AFP (8-941_ COHHOHWUl Tft OF PENNSYLVANIA DEPAAlHfNT Of REV[HU[ BUREAU OF INDlvlOUAl TAkEI DEPT. n06al HARAISIURG, PA 171'.-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 95130400 DATE 07-04-95 TVPE OF ACCOUNT ~ SAVINGS CHECKING TRUn CERTIFICATE REHIT PAYHENT AND FORHS TO, REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ESTATE OF MARV SIMS S.S, NO, 170-36-2359 DATE OF DEATII 03-21-95 COUNTY CUMBERLAND I J WINTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070 HARRIS SAVINGS BANK hu provided the Dep,,'..nt with the In'o",Uon Iht,d balow which h.. bien u.~ In calcul,Ung the pot~tl'l tax due. Thalr r.cordl Indica', that at the d..th of the above dlcadant, YOU ...r. I Joint owner/b~"lcl.ry of thl, ICCount. If you f.. I thl, Infor..tlon I, Incorrect, pl.... obt.ln written corr.ctlon Irol the fInancial In.tltutlan, attlch . copy to thl. for. and r.turn It to thl above .ddr.... Thl, account I, tlxabl. In accordance with the Jnh.,lttnel 'ax LeMI 0' thl Coa.onw..lth of PennsVlvanla. Ouestlon. .ow ba ""'...rod by nlllnll Cn71 117-15.'1, COMPLETE PART 1 BELOW M M M SEE REVERSE SIDE FOR FILING AND PAVMENT INSTRUCTIONS Aooount No. 07-000081206 D.ta 04-16-79 Eot.b1hh.d PART m 7.042,50 16.667 1,173,77 .06 70.43 TAXPAYER RESPONSE ,FAILURITQ.RESPOHDllILL RI8ULT.IH AN OFFICIAL TAX AS8E8SHI!NTIASIDON;THIS,NOTXCI Account Balanca P...c.nt Tax.ble Allount Subj.ct to T.x R.t. Potantl.1 Tex Du. x To Inlur. prop.r cr.dlt to your eccount, two Cl) caple, 0' thl. notlc. .ult eccoepeny your p.y.ent to thl A.gl.t., 0' Will.. Hek. check plyabl. tor "A'lIhtlr 0' Willi, Agent... , T.. K HOTEl.' t.x p.yaent. .r. .~. within thr.. Cl) BOnth. 0' t~ d.c.dent'. d.t. 0' d..th, YOU ..y d.duct . 5~ dl.count of the te. du.. Any Inh.rlt~. t.x due will b.cOl, d.llnquent nln. C,) BOnthl .'t.r the dlt. 0' d..th. [CHECK ] ONE Bl OCK ONLY A. 0 Th. Ibov. Infor..Uon and "x w. II corr.et. I. You ..y chao.. to r..lt Plyeent to the AIgl.t.r 0' Will. with two copll' 0' thl. notlcl to obtlln . dl.count or Ivold Int.r..t, or YOU I.y chick box ~A~ end r.turn thl. not Ie. to th. R.gl.tlr 0' Will. end an of'lcl.l ......sent will b. I"u'd by thl PA DIP.rt-.nt of Rlvsnul. I. c:J Th. .bovl ....t hI' been or will be r~rt.d tnd t.. Pltd with thl Penn'Ylvenll Inhlrltencl T.. r.turn to b. '111d by the d,cldent'. rlpr"lnt.tlv.. C. ~hl .bov. In'or..tlon I~ncorrlct and/o~.bt. and d.ductlon. w.r. p.ld by you. You .u.t cOIpI.tl PART l!J lndIar PAAT ~ b.low. If you Indlcat. . dlff....nt t.x ...t., pl.... .tat. you.. ...l.tlon.hlp to d.ced.nt, PART [!] TAX RETURN - COMPUTATION OF LINE 1, D.t. Elt.b11lhod 1 2. Account Salance 2 5. P...c.nt Texabl. 5 4. AMount ~ubj.ct to Tex 4 5. D.bt. and Deduction. 5 6. AMount T.xabl. 6 7. T.x R.t. 7 X a. T.x Du. a PART I!l DATE PAID L/ -,-1- '1J' DE8TS AND DEDUCTIONS ... it..o ;OFf11CIAL" USE ONL V'OMF} ..... .,')' PA' DEPARTHENT,'OF REVENUE';.:.! .PAD....'.. H;;... ., .. .1 p, .e'.... . 2 3.' .4: :S. 6 .' 7, 8 CLAIHED .....::';,,' x TAX ON JOINT/TRUST ACCOUNTS J..J-I{.-l'l '7, ()-f;3, ..ro It;.. t..r.'7 i 17 ~ 77 ...~ " .;19. 7:\- " dn o PAVEE I p,ql!r~~~'::Pr~':.,AI""AI I TOTAL DESCRIPTION ,'::U/yF""JL E"j'FN'" (En;.r on L1n. 5 of T.. Cooput.tlon' AMOUNT PAID I . .':1/~9. 71- Und... pen.lti.. of p...Ju..y, I decl.... that the feet. I cOMplete to the b..t of .Y knOWledge and b.li.f. TAXdv~ S-?~~~~~' have ..epo..tad above .... t..ue, co..r.ct HOME (::7,; '7 I ?..., - {J "'" ., WORK (_ _ I TELEPHO NUMBER and ~'- fV'9'- ~A1 GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with ..pllnal. Inhr..t ba'ed on Infnr..tlon IUbIIlttu b~ the flnMeI.. J"'tllutton. Z. InharltMCI t._ baco... delinquent nine lonth. a,t.r thl dlcedent', data of d..th. 3. A Joint account h t..abl, Iven though the dlcadent'. nu. .... added '1 . ..tt,t of convenl~.. 4. Account. .Includlng tho.. held batw.an hu,band ~ wl'l) ~Ich the Decedent put In Joint n.... within on. Y"t prior to d..th .t. 'ulh ,..tlbl, II It."."". 5. Account. ..t~ll.hed Jointly between hu.b~ and wi'. .or. th~ Dn4 y..t prior to d..th .t. not t'.~I.. 6. Account. held by . dlcadent "In trust 'or" enother Dr athar. .t. t..abl, fully, REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE 1. BLOCK'. If thl lnfor..tlon ~ co.put.tlon In thl notlcl .r. corraet ~ deduction. .t. not baing clal"d, pile' en "X- In block ",.. of P'tt I of thl "TuPlvu R..pon.... '.cUon. Sign twa copl.. and .ubalt th.. wlth your check 'or the .-ount 0' talC to the Rallhtar of Wllh of tha county Indlc.tld. The PA Dapart.."t of RevllnU. will Inue ." official ........"t (far. REV.IS~. EX' UPon r.cllpt of the r.turn froa the Ralll.t.r of Will.. 2. .LOCK. - If the a..at 'Plclfl.d on thl. notlc. he. b.." or will b. r~orted Ind talC paid with the Penn.ylvanl. r~rltencl T.IC R.turn fll.d by the d.ced."to. repr..antetlv., plac. en "X" In block ..... of Part I of the "Te.peyer RI.pon.." .actlon. Sian one copy and return to the PA Daparte."t of R.v~, Bureau of Individual TalC", D.pt 210601, Harrl.burg, PA 17121-0601 In the env.lope provIded. 5. .lOCK C - If the notice Infareatlan Ie Incarract endlar deduction. ar. b.lng clal.ed, check block "C" and co~lat. P.rt. 2 and 5 according to the In.trucUon. below. Sign two cop I.. Bnd .ubIIlt the. ..lth your check far the .aOWlt of talC p.yatll. to the R.ght.,. of Will. of the county Indlc.tad. Tha PA D.parta."t of Hav~. will I..UI ." afflcl,1 a..a..-.nt (For. RfV-15~. EX) upon r,cllpt of tha raturn frOll the Raghtar of Wllh. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. Entar the date the account originallY"" a.tBbI..had or tltlad In the Danna,. alCI.tlng at datI 0' d..th. HOTEl For. dacad."t dying .fter 12/12/.2r Account. which thl dacad.nt put In Joint n..a. within on. (II y..r 0' d.ath .r. t.lCabl. fullw .. tran.f.r.. f~avar, th.r. I. an alCclu.lon not to a.c..d '5,000 par tren.f.r.. rall.rdl,.. 0' the value of the Iccount or the nu-bar of 'CCDUn" h.ld. If . daubl. a.tarl.k (..1 appear. ba'or. your flr.t n... In the addr... portlan 0' thle notlc., tha '5,000 'lCclu.lon alra'dy ha. ba." d.ductad fro. thl account b.lanc. .. ,.opart.d by the ,Inancl.. In.tltutlan. 2. fntar the total balanca 0' the .ccount InclUding Intar..t ecc,.ued to the data of daath. 5. The p.rcent of thl account that I. taxabl. for .ach .urvlvor I. d.t.r.lnad I. follo"" A. The parc."t taxabl. far Joint '..It. ..tabll.h.d .or. than ana yaar prior to tha dacad."t". daathr I DIYIDED.V TOTAL HUHBER OF .JOINT DWNfRS E~8lpl.r A Joint ...at ragl.tar.d DIVIDED .V TOTAL HUHBfR OF X 100 . PERCENT TAXA.lE SURVIVING JOINT OWNERS In the n... of the d,ced."t and two other par.an.. I DIVIDED.Y S (.JOINT OWNERSI DIVIDED .Y Z (SURVIVORS' . .167 X 100 . 16.7% (TAXABLE FOR EACH S~VIVORI .. ThI parcent taxabl. 'or a..at. cr..t.d ..I thin ana w..r of tha dacad.nt'. da.th or .ccount. owned by thl decadent but h.ld In tru.t for another IndlvlduaU.) (tru.t b.naflcl.rl..1I 1 DIVIDED.V TOTAL HUMBER OF SURVIVING JOINT OWNERS OR TRUST .ENEFlCIARIES X 100 . PERCENT TAXABLE no ." Exaapl.r Joint account r.gl.tarad In the n... of tha d'cadant and two othar p.r.on. and ..t~ll~.d within GnI w'~r:~f d..th bw the dlcad."t. . 1, I DIVlDED.V 2 CSURVIVORSI . .SO X 100 . SOX (TAXABLE FOR EACH SURVIVOR) 4. Th. aaount 'UbJICt to tax (Jlne 41 II d.tar.lnad bW ItUltlphlnD the account b'lanc. ClIna 2J by thl percenttt-.xabla (Una 51. 5. Enter the tot.1 of the dab" end dlductlon. HU.d In P.rt 5. .'1 6. The aaount taxabl. Cllna 61 I. dataralned bW 'Ubtrectlna tha d~t. and d.ductlon. Cllna S, fro. thl .-aunt subject to tax (1In. 41. 7. [ntar the approprl.te tax rata (Jlna 7) .. dater.l"ed b.low. c;.. A. For deta. of daath occurring .,t.r 6/50/94, the t.1C r.te. for tren.f,r. to .pou... .r. .. fallow.r I. O.ta. 0' daath on or .ftar 7/1/9. and bafor. 1/1/96 tha rete I. lX. 2. O.ta. of da.th on or aft.r 1/1/96 and b.for. 1/1/97 the r.t. I. ZX. 5. O.t.. of d.ath on or aftar 1/1/97 and bafor. 1/1/98 tha rete II IX. .. Oat.. of d..th on or .ftar 1/1/91 tran.f.r, to .pou... will ba .x.apt fro. tax. Hot., For data. of death prior to 7/1/9. tren,'ar. to .pnu.a. .r. t,xabl. at 6X. B. Tran".ra to l1nell da,candant. InclUding f.ther, BOthlr, .on, daughtar, grandchildren, .on-In-I..., daughter-In-I..., .tepchlld and their I..UI .r. t,xable .t .Ix percent (6X). C. Tran.far. to all other I InclUding brathlr, 'I.t.r, unci., aunt, naphew and nlec. era t..abl. at flft.1O p.rclOt D. If wou chanoa the t.x r.t., plaa.. .pacl'y your r.l.tlonshlp to the decadent In thl are. provided. " ;,OJ u:' US%I. I. The MCQ'lt of tax due (Jlne II 11 dlhr'lned bw .uIUphlng the .ltOt.W'It t.xabl. (1ln. 6) by the tu rat. (lIne 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. dabt. and deduction. .re det.r.lned .. follow" A. You lagallw .ra r..panllbl. (or P.vaant, or the I.tat. 'UbJ.ct to ~Inl.tr.tlon bW a per~1 repr.sent.tlv. II Insufficient to pay the deductlbl' It.... e. You actu'lh P.ld the cWIh Iftar de.th of the decadent and can furnish proof of P'YNnt. C. Oabt. baing cl.l-.d au.t b. It..lzld fullw In P.rt 5. I' ~ltJonal .pac. I. na.ded, u.. pl.ln p.,.r . I/Z" x II". Proof of P'YHnt .ay be raqua.ted by the PA OapartHnt of Aavenue. TAXPAVER ASSISTANCE IFVOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACTANV 'REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNITItI HARRISBURG AT (717) 787-8327 .TDD' (717) 772-2252 (HEARING IMPAIRED ONLY) RtV-1543 EX AFP (B-941 * COHHOHWEAl HI Of PtHHSVl VANIA DEPARTMENT OF R[\,(HUf BUREAU OF INDIYIDUAL rUEI DEPr. lID6Dl HARRISBURG, Pi 11111-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 95130400 DATE 07-04-95 TYPE OF ACCOUNT ~ SAVINGS CHECkING TRUST CERTIFICATE RENIT PAYNENT AND FDRNS TO, REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 ESTATE OF MARY SIMS S,S. NO, 170-36-2359 DATE OF DEATH 03-21-95 COUNTY CUMBERLAND I J WINTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070 HARRIS SAVINGS BANK hu provldld thl Dlplrt..", with thtl In'or..tlon lIltld below which hI' bun und In nlcul.Ung the potlntl.l tlIC due. Thllt rlcord. Indlut. thlt It the duth of the abovI dIUd."t, YOU IlUI . Joint ownu/blnlUcb,v of thb ICCount. If you f..l thh Infor..tlon it Incorrect, pi.... obt.ln wrlttwt correction fro. the flnMel.1 Institution, attlch . copy to this for. ~ return It to thl abOVI addr.... Thl. ICCount I. I._abl. In ~cord~c. with thl Inheritance rIM l.... of thl Cu..on....lth of Penn.vlvanl.. Qu.,tlone .'V b. en'w.red bv cIlllng (717) "'p'SI'. COHPLETE PART 1 B!LOW ~ M M ~tE REVERse SIDE ran r-ILINO AND PAYMENT INSTRUCTIONS Account No. 07-000081206 D.ta 04-16-79 E.t.blhhad Account Salanca Pa,.c.nt Taxabl. Aaount Subjact to T.x Rat. Pot.ntlal Tax Du. 10 In.ur. propar cradlt to your account, two ill capl.. of this notlca lIU.t ItCcoltPeny your pay.ant to tha Regl.tar of Will., "aka chack payabla tal RR.gl.t.r of Will., AgentR. PART l!J 7.042.50 16.667 1.173,77 ,06 70.43 TAXPAYER RESPONSE ,FAILURI! TO RI!SPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON TNIS NOTICE x Ta. NOIEI If t.. pay.ant. ar. .ede within thr.. eS) aonth. of the dacad~t.. data of daath, YOU .ay deduct . 5X dl.count of the t.. due. Any Inherlt~a t.. due will baca.a dallnquent nlna (9) eonth. .ftar tha dat. of d..th, x [CHECK ] ONE BLOCK ONLY A. 0 Th. .bava Infar..Uon end tax due Is carr.ct. 1. You ..y chao.. to ra.lt pay..nt to tha Ragl.t.r of Will. with two copla. of thl. notlca to obtain . dl.count or avoid Intara.t, or you .ay check boM ~A~ and raturn thl. natlca to t~ R.gl.ter of Will. and an offlcl.1 a....seent will ba I..uad by tha PA Dapart..nt of Ravenue. 8. r:J Th. abova ....t h.. baan or will be r~rtad and ta~ p.ld with the Pann.ylvanl. Inherltanca la. raturn to b. fll.d by the dac.dant.. rapr.'.nt.tlv.. c. ~Th. abova Infar.atlon l~ncorrlCt Dnd/o~abt. and daductlan. w.r. P.ld by yOU. You lIU.t co.plat. PARI L!J and/or PART ~ b.law. If you lndlcata a diffarant tax rat., pl.... atata your ,..l.tlonahlp to dac.dant. PART ~ TAX RETURN - COMPUTATION LItlE 1. Da.-!. EatobU.~ad 2. Account Salane. 3. Pe,.c.nt Taxabl. 4. Amount Subjact to Tax 5. nebta and Daductlon. 6. A.ount Taxabl. 7. Tax Rat. 8. Tax Du. OFFICIAL USE ONLY 0 AAF PA DEPARTMENT OF REVENUE OF 1 2 3 4 5 6 7 X 8 TAX ON JOINT/TRUST ACCOUNTS L/-/,{, .- 79_____ /. " <,/:2, s-o 'It:,. 1.1!r, "/ /, / 7 ~. ., 7 ,~ / ::J Q, ? \ ~ o , n f., X PAD 1 2 3 4, 5 6 7 8 CLAIMED ("'~ DEBTS AND DEDUCTIONS PART ~ DATE PAID J.!.-loJ- r;;.C PAYEE I'~IJ~~:;~: "';~.: DESCRIPTION ~("ur.n"l' FI//II,:.,,J/ '='/,""1<1' < TOTAL lEnt.,. on LJn. 5 of rax Co.put.tion) AMOUNT PAID I I ~ ).1 "" II -,1 \.. Undar panalti.. of parjury, I daclar. that i~ cOMpl.t. to th. b..t of MY knowladga and ball.f. I- ~ O\{')- - ~ ,., -141,- TAXPAVE S flAtu ~ f.ct. I have ,.aportad above ara HOME (:7/"7) ., WORK (" , ) TELEPHONE NUMBER tru., corr.ct and ?c../. ,.., l~/-:? . 1-' \ I. -<;OJ' fiAl't ' . ; , i q ~.;4 "'-0, f!;.! 'j i i J J {;'j c:1 r. ~\ J I , , ."..--.--_......,... .., ._-.. .--- . , ')~o./_R5()M 1,~~ .J~.~) . Funeral of Mary Flory Sims JftJP70 ~ ~fY'" The Estate <It Ma1:Y Flory sims ..:ff')-t-- To c/o Mrs. Anita Fisher 753 Collins Drive Lewisberry, PA 17339 Dale March 21, 1995 No, (A) Services, lncludlna m.rcluncllla ...........,... ] $4,792.00 Profwlonal s.rYlce. PscWllu and Equlpment MOlar Equipment Cukll Jntennenc Receptacle !:l89,UO Total 'A' $5.781. UO (D) Cull Ad'llllcod. W. hi'" adnnOld tho foUowlnll\lndJ ror Death Notice, Indiana Gazette $ (6) Death Certificates @ $2/ea 'i'ant & Cemetery Equitmmt Transportation (181 miles @ $1.50/mile) Clergy Honorarium , \ , , I I ; , ; I , )'our comlnlence ._..............._.._.......................... 25.00 12.UO 70.00 ~71.50 100.00 478.50 (C) Addlllonslllems, ordored ....r ................ Total'B' $ Due Upon Receipt Total 'C' $ ~ Complele Total $6,259.50 Amounl Pald , ( ~:...>:-J.,1o~~~"".""_._.~__~___...~.."~~.........'-...I;~_.~~...,,,...._._.._--,..-,."'_~.~,+... .. ..Rolln"" _ H ~,.~_.---"._~..~.~_._,~.._. -'J.'1'--V- . "...4"....t'. " ~'.. ' ... . ,; ",' I .. . "' '.;~ .1 . . ' . , ,j I 1'" , " I' -. . ",.' f. ..... .f ".- "Ii- '.-... --........ , -.--.. r~' -.~. "_,_ _T----...Jj I ~ _ 1(. ~ -'II-'''--'~ .. --" ,..,-.--..--.--- \00 ..4 REV-1S43 EX AFP (8.94). COHHQHVEALtH OF PENNSYLVANIA DEPARrH[H, OF AE\I[NUE BUREAU OF lNDIVIDUAL TAXES OEPT. IID6GI HARAISBURG, PI 17UI.0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. Zl ACN 95130401 DATE 07-04-95 TYPE OF ACCOUNT ~ SAVINGS CNECKING TRUST tERTlFICATE REHIT PAYHENT AND FORHS TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ESTATE OF MARY SIMS 5.5, NO, 170-36-Z359 DATE OF DEATH 03-Z1-95 COUNTY CUMBERLAND ANITA S FISHER 753 COLLINA DR LEWISBERRY PA 17339 HARRIS SAVINGS BANK h.. provldltd the Depa,t..nt with the Infor..Uon lI.tad baluM which h.. b..., u.ad In ulcuhttng the patlntla. tax dul. Thalr racordl Indlcat, that at the d..th of the abovI dlcadent, VOU ...t. a Joint ownlr/beneflclarv of thl, ICCount. I' WOU ,... thl. Infor..tlon I, Incorr.ct, pl.... obtain wrltt.., corr.ctlon 'roe the flnlnCl,t In.tAtutton, attach. copy to thl. for. ~ r.turn It to thl ~ov. .ddr.... Thl. account I. t'.able In accordanc. with thl Inh.rltancl T.. LaMI of the C~....lth of renn.vlvanla. Du..llan. "V b, an.wlred bV c.lllng (111) "'.')2'. COMPLETE PAR I' 1 BilLOw.. .. .. Sill! R"VERU SIDI! Fall FILING AND PAYHEtlT IIl:lTRUCTIONS Account No, 07-000081Z06 D.t. 04-16-79 Ed.bUah.d Account a.lanc. Perc.nt T.x.bl. Amount Subj.ot to T.x Rate Pot.nti.l T.x Due fo In.ur. prop.r cr.dlt to your .ccount, two (2) copl.. 0' thl. notice .u.t eccoepeny your p.y.ent to the Ragl.t.r of Will.. "aka ch.ck paylbl. tOI ""AI.hter of WUb, Atent". PART III 7.04Z,50 16.667 1.173.77 .06 70.43 TAXPAYER RESPONSE FAILUR!T.O ..R!SP.O.ND WILL R!SUL T IN AN. OFFICIAL TAX ASSESSNENT BASED ON. THIS:. NOTIC! x T.. HOlE I If taM pav.ent. ar. .-de within thraa ()) .untha 0' tha dac.dant". d.t. of daath, YOU .ay deduct a SX dl.count of the taM dua. Any lnherltltnCe taM due wll1 b.co.. dlllnquant nine (9) .ontha .,t.r the d.t. 0' d.ath. x [CHECK ] ONE 8LOCK ONLY .. 0 lh. above Infor.atlon and taM due I, correct. 1. You ..y choo.. to r..lt p.y..nt to the Ra.I,t.r 0' Will. with two cop I.. of thl. not Ie. to obt.ln . dl.count or .vold Int.r..t, or you '.y cnack bOM "A" and raturn thl, notlc. to the R..l.tar 0' Will. and an official .......ent will ba I..uad by the PA Dapart.ant of R.venue. I. c:J Th. ahav. ....t h.. blan or will b. rapart.d and teM paid with the P.nn.ylvanle Inherltanc. TaM r.turn to ba 'Ilad by the d.c.dant', r.pre.antetlva, C. [(Thl ebave Infar..tlon l"--'-ncarrKt end/af.:.!tebt. and deduction. ware p.ld by you. You .u.t cCHlpllt. PART l!.J endlor PART l!.J below. If ~ou indicat. . differ.nt tax r.t., pl.... at.t. ~our r.lationship to d.c.d.nt, PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Dota ht.b.\hhod l--!l-_~.__. 2, Aooount O.lan.. 2 S 0 '1-.:1 .bl') 5. Percent Texable 5 W ~~ ~;7 4, AMount Subj..t to T.. 4 /, I 7 'J, '7:i- 5. O.bt. ond Doduotlonl 5 - J( I~ .:19.7. 6. A.ount Taxabl. 6 7, T.. R.t. 7 X ~'" a. Tax Due a PART I!l DATE . ....0FFICIAlUSE. ONLY'OA~Fi PA DEPARTHENT;OF, RE~ENUE.:.:i 'PAD',', ":::".,;,,",,.:..,,,:.<:-:.,,.,:.,.,., """''''''':','"',,..'. .' 1 2 '3 .4 5. :6 7 8 CLAIMED , "",;,'-:;.'.. DEBTS AND DEDUCTIONS PAID PA fEE d?eJ. 0"1 G DESCRIPTION ~ -.rIFS; AMOUNT PAID ClN "'Cln t:ra. ~ TOTAL (Ent.r on Lln. 5 of TaM Coapu ation) . p.rjury, I decl.re that the M~ and b.ll.f. fact. I h.v. r.port.d abov. er. tru., corr.o~ HOME (7/7) ?g?- ~9tP f&> WORK ( --r '-I,.-~.f'-~ TE '-1' --+, '0 :,:.:i CA1NO 03HIVdHI ONIHV3H) Z5ZZ-ZLL CLILl 1001 'LZtB-LBL CLILl lV OHnRSIHHVH NI .lINn AHIObNI H3AVdXVl 'S3XVl lVnOI^IONI .:10 nV3HnR 3111 llV::J HO 3::JlddO l::JIH1SI0 3nN3^3H dO lN3W1HVd30 Vd 'SllIM .:10 H31SI03H ANV 10V1NO::J '3::JNV1SISSV HO NOI1VHHO.:lNI H3H1Hn.:l 033N nOA dI 3::JNV1SISSV H3AVdXVl .~^.~ '0 lue.,,,ldeQ 'd .~, Aq p....nb." aq A'. lu..Ald '0 'OOJd '.11. .1/1 . J.o.d ulI,d .In 'pep..u II .~.d. ,IUOl1tPPI,1 'f '''Id ul Alt"' p.'"", .q ,.~ P"I"o &u"q .,qeo ') .,UMAld '0 ,OOJd lfl,um, UiII:I ~ ,ueplnp IlU '0 'U"P JIH' 'lqlP 141 Pled AlIlnlol no," " ...... Itqnonplp M41 Aid 01 \uelou,n,ul 'I 'A".,ueIUdU ,aUDu-.I . Aq uolll"I'IUIIlpI 01 lo.rqn. 1'1'" 141 ..10 flue.....d olD' .,q'IUOdU" loll A11,a,. noA "f 11"0'10' II peU,'JII'P loll lUOll0nplP ~ I,qlp ',q'"O,t, 03HIV1::J SNDI1::Jna30 aNV SlR30 t !HVd - SNDI!::Jn030 03WIV1::J 'U "'111 '.... "I Itn Aq I' lultl l,qtlU' luno.. 141 DUIA,dIHnIl Aq PIMlII"I"P " I' lUlU Inp nl '0 lunoM 14.1 " 'peplAOld ..... 141 VI luepl:llp 141 01 dl4IUO,,',IJ "no... Alloldl ....'d _1'1" ." 141 .&ue4:1 no"'1 '0 'CXSlJ IUnJld u.'UU .. 'lq.Il.' .... ':1'1" pull "~d.U '.urw "Ioun '.I"'" '.I.~\o..q IUlpnl0"1 '-!~'o 11' 01 ....'.U8.1J. 'J '(1.9) .u.u.d ICI' .. '.q8ICI' ..1. .nll' .I1~' puI PlIltOd.,. '...I."I.....ltOMP ''''I.uI.uo. 'UI.lPllltopue... '.I"l4D~P 'uo. '~14'~ '.1'4'" DulpnlOUI ..uepulo"P 1""11 a, '.I',''''''J. 'I '1.9 ,. 'Iq.IC" .... ...nod. a' '~"'UI~' ~/l/i a. .Iol~d q,..p 10 ..,Ip .IoJ 1.,0H '111' '0.1' .de.ll. .q III" ...nod. 0' ....'.UlJ. 16/1/1 ~"I' ~o UP 4"'P 10 ....0 '~ 'XI '1 ..... '4' 16/1/t .JOI.q puI i6/t/l ~"I' ~o UP It,l.p 10 ....0 'C '1.' '1 I"" .It, '6/1/1 .JOI.q puI 96/1/1 .I"" ~o UP q,..p '0 ""0 ., 'XC ., ..... ~, 96/1/1 'JO,.q puI ~6/1/i .I"" .10 uo q,"p '0 ""0 '1 IIf1'01IoI II .... ...nod. a. ....I.uw~. .10' ...... .., ~. '~610CI9 .I'''' IUIJ..nooo ql"P '0 ....p JOJ " '''Ol.q P.uI....I.P .. Ii ,uII) .,.~ II" "'IJdO..dd. '4' J"U] 'e~ ~II) IC., a' ,00f,", .~ '41 .0.11 C5 ,uII) .uoI,onpIP pue ..q.p .q. .UI,OIJ,qn. Aq p,ul.J','P '1 e9 'U'I) IIq8IC" .uno.. 141 'C ....d uI P""I .uol'onp.p pus .,q.p .It' '0 1"0' .It. J"U] 'CC lUlU "qllC":'UU.lld~, Aq n lUll) uuol.q .unooo. .It' OUIAldrUM Aq P.ul....'.p.I C~ ,uIU IC.' 0' .o.rqn. .uno.. .ltl '!' CHO^'^tinS HJ'l ~OJ ]'I'.'J.) 1.05 . DOl ''i. Aq q...p '0 J..A 'UD UI~'I" P~'IIqa... pus .uo....d ~.4.0 0"' puv ,u'P':I'P ~\ 'A '''U '4\ X 05' . CS~^'~S)' AI OlOl^IO , . .uap.:I.p 1\11 uI p....\...... .unOO:l. \Ulaf l'Id.'IC] ],g,x,J. JH]J~]d . DOl X Sll~'IJIJ1N]' J.Sn~1 HD S~lHftO INIDr OHI^IhHnS .:10 ~llMnH "101 A8 OlOI^IO , le"I~'I:lU'U'q ,.n..., ('lI.npfAIPUI J~'DUliI .10' ,.n.., uI PI~ \nq ,UIP'~.... Aq..P~ .,unooo, ~o q,"p '.'u,p'o,p '4' 'A ....A .uo ulql1" p.,....:I ','UII .10' 'Iqan, ,u.O.l.d .ltJ. 'I CtIOM^W1S 'triJt\tOJ l,IYllYlJ U'9J . 001 JC i91'. tstlOM^W1S) , AI OlOIMO CStllNftO INiOn t AI Q10IMO I ..UO....d .1'4\0 0"' pua .uepIO'P .It' '0 ...u .It\ ul S~lHftO tHIOr ONI^I^~S l,nnl IH1Jllld . 001 X JO ~lIM11H lYJOl AI Q]OIMO p....'.'a... ..... \ufaf, l'ld".] SUHI'IO tNIOr JO ttllHtlH "IOJ. AI Q10IMO 14"'P '"u'P'o,p ~, 0' Ja,Jd J..A .uo Ul4' '''0' p.4.I'q.... .,.... 'UIOf .101 'lq'IC" ,u,o"ld '4J. " 1'"01'01 ., plU'....'.p ., JOAIA..n. 40.. .101 'Iqall" II '14' ,unooo. '4' '0 ,u,o"'d '4t 'C 'q,.'p 10 .,Ip .~. a' p.n..oo. ......'u, .Ulpnlaul ,unooo. '4\ 10 ':lUI,'q "'0\ .~. JI'U] " 'uo.\n'I\,ul ,'lououII '4' Aq p.\Jod... I' ,oUIII.q .unO:l:l. '4' 'o~, PI'onp.p u..q "4 API''''I' UOI.n,oll. OOO'CI '4' '.ol'au '14' '0 uol,"Od "'JPP' '4' ul ..au ""1' ..naA ...o,.q .....dd. (**) ~"JI'" 'lqnoP . II 'P"4 ,\un030. 10 ...'q.nu .4' ..0 .unOOOI .4\ 10 ,nl.A ~, '0 "'IP...a... 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J ~'O,g .t 'P'PIAO..d .dOI'AU' '4' ul 1090.I'Iil 'd '."nq'IJ"ull "0901' ,d.O '..IC'I I.npIAIPUI '0 nelJnl '.nuoAIH 10 lu,.,..udIO 'd '4' al uJn,... pUI Ad03 'UO U.IS 'uol'o., .,.uod..tI ...A.d..!~ .4' 10 I ....d 10 ~I~ ~301q ul ~X. UII '31,d '.AI\a'u.....d... ",U.p.oap '4' Aq P'111 uJn"H 11'1 aoua'I.I'4UI 'IUlftIA,uu'd '4\ 4'1" Plld ICI' pu, p.,,,odaJ aq "I" ~o u..q "4 ':I"ou "4' UO P'IIIO.d. l.... '4' II - I ~JO'8 " ""I" 10 ~"'IB.tt 14\ .0'" UJn,... '4' '0 \dl.3aJ uodn ex] "SI.^lH .JoJ) ,~"", 1"0'1'0 uu .n." 'II" .nuIA.~ 10 ,u",J.dIO 'd '41 ,p",oIPur A,un03 '4' '0 "I'" 'A ""'IO.tI '4' 01 IC.\ 10 .unoaa '4\ ..01 ~o~o JnoA 4'1" "4' 'I.qn. pu8 "ldoO Oft. uBlS 'uol,o'l ~..uod"H J.A.dICel. '4' '0 I ''''d 'A ~,~ ~oo,q ul .X. UI '''Id 'Pelll,O Duraq .ou .... ,uol,onp.p pu8 ,0'~JOO .... .:lI\OU .4' ul UPI,.,nd'OO pull UOI\....o'u, .4' II . '.'0'1 'f 3SNDdS3~ ~3AVdXVl - t lHVd - SNDI1::JnH!SNI ONI!HDd3~ 'A"n, "q8ICI, .JI ....4'0 .10 J'4'ou, ~..o, ,.n.., ul~ \U.pI3.p a Aq PI.4 "unooo, " ..,qalll' .ou .... 4"'P 0\ ~olJd ....A lUG 084\ ...01 .,," puI puaq.nq ua.",.q A,\UIOr PI4'lfq.," .~un033' 'S ".1.,.",.., .a 'lqllC" Allnl .... q".p a' "OIJd J..A .UP UI4'1" '..IIU lUlor ul \nd \uap.3.p 14' 4314" ("1" pua pueq'n4 u..",.q Pla4 "04' aulpnlOUI) '\unG:l3' .~ '.3UlIUlAUOO '0 J'l\" . 'I p.ppe .." ..au '.'U'P'3'P '4' ~no4' ",AI .,qaICI, '1 'unG301 ,ulof , 'C '4"'P '0 _"p ..~uap'3'P '4' ""'11 '4'UO' .u,u \u.nbuI"P ".oolq Ill' aOUl'IJ'4UI " 'uonnll,.ur 1II0uouU '4' Aq n.UI,qn' uoU....o'ul uo p...q ....I.'ul 'lqlOlldda 14\1" 1N:lWSS3SSV XV1 'VI~I.:I.:IO NV NI J. ,ns:u! "1" aNOdS3H 01 :3Hn'IY::I 't NDI1VWHD.:INI lVH3N30 ~ . 'l '. .. '. REV-1S43 EX AFP (8-941*, CDNHOHW(AlHlor PENNSVlVANIA DlPARINENT Of RfVCNUE lURE AU or INDIVIDUAL TAMrS [)(Pl. 110601 tlAAAISlUAO, Pi 11111-0'01 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 95130401 DATE 07-04-95 TYPE OF ACCOUNT ~ SAVINGS CHECKING TRUST CERTIFICATE REHIT PAYHENT AND FDRHS TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ESTATE OF MARY SIMS S.S. NO. 170-36-2359 DATE OF DEATII 03-21-95 COUNTY CUMBERLAND ANITA S FISHER 753 COLlINA DR LEWISBERRY PA 17339 HARRIS SAVINGS BANK hu provldad the Dlp.rt..n' tilth thl Infor..tlon lI'ted b,IDM which hu bien u..d In ulcul.Unll thl potent Sa. '1M due. Thllt record. I"dleet. thlt It thl d..th of the _bavI dlcedent, you WIt. , Joint own.r/b.n.flclery of thl. lecount. I' you ,..1 thl. Infor..llon t. Incorrect, pl...1 obl,ln written corr.ctlon frol thl 'Inane I'. Institution, .ttech . copy to thl. for. and r.turn It to thl above .ddr.... Thl. ICCOunt I, ...able In accordance with thl Inheritance 'eM llW' 0' tha Co.aon....lth 01 Penn.~lyanl.. QuuUone ..'Ii' b_ _n....r.d b'li' celllnA (717) 787-UH. COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAVHENT INSTRUCTIONS Account No, 07-000081206 D.ta 04-16-79 E.bblhhed To In.ur. prop.r credit to ~our account, two (2) cop I.. of thl. not Ie. .u.t accoepan'li' ~our p.~e.nt to the Regl.ter of Will., "ake check p.~eble tal "R.glet.r of Will., Agent.., Account B.lanc. 7.042,50 Parc.nt Taxable X 16 . 667 bount Subj.ct to T.. 1 . 173. 77 Tax Ret. X .06 Pot.nU.l T.. Du. 70 . 43 PART TAXPAYER RESPONSE [!] I FAILURI! TO RI!SPOND ifILL RI!SUL T. IN AN OFFICIAL. TAX ASSESSHENT BASI!D OHTHXS NOTICe A, E:J Th. above Inlar..tlon and t.. due I. corr.ct, 1. You .av choo.e to r..1t p.ve..,t to the Register of WIl.. '11th two caple. 01 this notles to obtain a dl.count or avoid Inter..t, or vou .av check bow "A" and raturn thl. not lea to tha R.gl.tar of Will. .nd an olflclal .....~t will b. I..u.d by tha PA D.part.ent 0' Revanue. HOlE I l' t.. pav.ent. ar. .eda within thr~e en eonth. 01 the dacadent'. date 0' death, VOU .ev daduct e ~~ dl.count 0' tha t.. due. Anv Inherltanca t.. dua will bKo.a delinquent nlns (9. sooth. aftar tha date of daeth. [CHECK ] ONE BLOCK ONLV a. c:J Th. .bova ....t ha. bean or will ba r.portad and ta. paid with tha Pann.vlv.nla Inherltanca Ta. r.turn to be filed bv the deced.nt'. repr..antatlv.. C. ~Tha abova Inlor.atlon I~ncorract and/o~abt. and deduction. war. p.ld bv vou, You au.t co~hta PART l!.J and/or PART ~ b.low, If you Indlc.t. a different taM r.t., pl.... .tata your r.latlonlhlp to d.cedentl OFFICIAL USE . ONLY 0 AAF . PA DEPARTHENT OF REVENUE PART [!] TAX RETURN - COMPUTATION LI~E 1. D.ta E.t.bll.had 2. Account aal.nca 3, Percant T.Mable 4. A.ount Subjact to Tax 5. D.bt. and Daductlon. 6. A.ount T.x.bl. 7. Tax Rata 8. Tax Due TAX ON JOINT/~UST ACCOUNTS ~-/(J - 7 ~, (:) 11-2 . S -0 //J " fs,& 7 ~/Xi: gx, /'j 'C)b fJ K PAD 1 2 3 'I 5 6 7 8 CLAIHED OF 1 2 3 4 5 6 7 8 -.....-- x PART I!l DATE PAID PAYEE 1I--/lf'~1 ~1u7/:~;;~e DEBTS AND DEDUCTIONS DESCRIPTION I r-t./PB'<'#f.. C:t/'ffP<;e:-S TOTAL IEnter on Lin. 5 of rex Conput.tlonJ I , AMOUNT PAID d'/,;1p, 75 fect. I heve ~.port.d .bove ara trua, corr.ct and HOME (7/71 Y;3R-~7'1L>0 WORK ( ') g-.lcf'- 'IS" onATE , '~ -.. ~f' ,~ <::l'- - '~ '~-~~ 0 0 0 000 00 0 0 -~._" - Q .::> ;;> 000 lI'lO lI'l lI'l . , . . . . . , , , r'l '" .... lQ~g ....0 ClCl ....'" ~~~.~ '" ClCl ClCl ....0 .... lQ .... :n .... ,.".... .... . . iL . III i1> tl '" f II} II} II} II} .. i :< Gl m io tJi;! j ~ l lt2~ i>< '" ..... ~Jj i ~ >IN W .~ ~~~ m=r lI'l ...' ~~ ID ~ '" ~ III 'J'" ,~l.:xl ...r i jj~f f ~;:J ~ !l N II~ . ~ J '" i i ~~~j 1 ,~~ l~~ ! c ... .g alJ :2 ti i ;:; ~ 0 ~ ti8~~~1 1 0 6 :r jt~~ D ~ .; t2 8~~ II} d " :z: ... .l!u.~ .!l t i: . 'c. 1 II ... ~: " I il II f u .. . :i f " . , jf ~ - if '2 ~ iI I < ~ I 0 ':2 'E -a' :a f "l ~ ~ . ell A < ...... # '-' B ~ \~ REV-1543 EX AFP (8-94) * CO""OHWUlHI or PENNSYlVANIA DEPARlHEHt Of REV[HlJ( IUAUU Of INDIVIDUAL tAXES DEPf. rlOiOl HARRISBURG, PA 1111100'01 J.I- ..s- 750 INFORMATION NOTICE AND TAXPAVER RESPONSE FILE NO. 21 ACN 95130402 DATE 07-04-95 TVPE OF ACCOUNT ~ SAVINGS CNECKING TRUST CERTIfiCATE REHIT PAYHENT AND FORHS TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 /S'-.5V -/3 ESTATE OF MARV SIMS S.S, NO. 170-36-2359 DATE OF DEATH 03-21-95 COUNTY CUMBERLAND I J WINTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070 HARRIS SAVINGS BANK hu provld.d the D.p.rt'.nt with the Infor..Uon lht.d b.low which h.. b.M u..d In ulcul.tlnll the pat.ntl.l t.~ dU.. 'h.lt r.card. Indlc.t. thlt .t the d..th of the abav. d.cadent, VOU w.t. . Joint owner/ben.flcl.tv of thl, 'ecount. I' YOU f.. 1 thl. Inlor..tlon I. Incorr.ct, pl.... obl.ln wrltt.n corr.ctlon fro. the 'Inanele. In.tltutlon, attlch . copy to thl. for. ~ r.turn It to the above .ddr.... fhl. Iccount I. I.wable In Iccardene. with th. Inh.rltanc. ,.. law. 0' the C~.onv..lth 0' Pllnn'vlvenl.. au..tlon. ..v b. ltn,wllr.,t b~ rlllllno (717) 7a7'IU1. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No, 07-00000989 O.t. 02-08-82 E.t.blhhad Account Balanco 573,66 P.rclnt T..obl. X 16 , 667 Aoount Subj.ot to T.. 95. 61 T.. R.ta K ,06 Pot.nti.l T'M Du. 5.74 PART TAXPAVER RESPONSE CUI FAILURE TO,RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENTBASED ON THIS NOTICE A. 0 Th. .bov. Infor..tlon and t.1C du8 II corrllct. I. You ..v choo.. to r..lt p.y"ent to th. R.gl.t.r of Willi with two copl.. 0' thl, notlc. to obl.ln . dl.count or .vold Int.r..t, or you ..y ch.ck box "A" and r.turn thl. notlc. 10 lhe R.el.t.r 0' Will. and an offlcl"l ........nl will b. I..ued by the PA Dllp.rt.ant of R.venu.. To In.ur. prop.r cr.dlt 10 your .ccount, two ell cop I.. 0' this notle. .usl ecco....ny your Plly.ent to the R.gl.t.r 0' Will.. ""k. ch.ck pey.bl. tal "Rllgl.tllr of Will., Agllnt". HOTE, I' t.x p.y.ant. .r. ..dll vlthln thr.. e}) .onth. 0' th. dllc.dent'. dal. 0' daath, you ..y deduct. U discount 0' the t,,1C du.. Any Inherltancll t.. dUll will bllco.. dellnqullnt nlnll (9) ~thll .'t.r th. d.tll of d..th. TAX ON JOINT,TRUST ACCOUNTS ./- 0 '1'- 9.~ .',7 ~ ,:.~ It. '0(..,"7 q 5". -_0- .'JI.If..'1..fltL C) . r)J> o OFFICIAL USE ONLY 0 AAF PA DEPARTHENT OF REVENUE " [CHECK ] ONE BLOCK ONLY a. r:J The above ....t hell bllen or will b. ,.por(ed end telC peld with th. Pennlylv-nl. Inh.rltenc. T.1e r.turn to bll '1IIId by the dllclldent'. r.pr.,"nt.tlv.. C. ~h. .bov. Infor..tlon I~ncorrllct .nd/o~ebts .nd deductions wer. p.ld by you. You .ust cOlIPlllt. PART ~ andlor PART L!J b.low. If yau indlcat. a diff.rant t.x rata, pl.... .t.t. your r.l.tionlhip to dac.dantl PART ~ TAX RETURN . COMPUTATION Llh~ 1. oat. eltabll.had 2. Account O.lanc. 5. P.rcant Ta~abl. ~, Anount Subject to T.x 5. D.bt. and D.ducUonl 6. A.ount T'Mabl. 7. T.x Rat. a. Tax Dua OF I 2 3 X 4 5 6 7 X 8 PART ~ DATE DEBTS AND PAD 1 2 3 4 5 6 7 8 DEDUCTIONS CLAIMED PAID PAVEE DESCRIPTION ...';1(.' K , ;', -L.L~ , - = I .- 'JL. I _1.f7. ~ . tl v~ , l .::-' I '-: "- J l I:: P. (. t TOTAL CEntar on Lin. 5 of TaM COMPutation) L AMOUNT PAID ( , I/- " .75 ,I,;/~.!>;"- ~,- (?(,.L. 1<- -,' _ J. /0:. I Under pen.lti.. of p.rjury, I declar. thet the feet. I cOMpl.t. to tha b..t of ~y knowledge and bali.f. ;1() iF &- T AXP~~i' SIGNAt6~€ '-<<~ have report.d .bov. a~' true, correct HOME (7,,, l 7'V - U C;" '7 WORK ( l TELEPHONE NUMBER and "';)'k--C;;J~ ATE f: GENERAL INFORMATION 1, fAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAX ASSESSHENT with IlIIPllubl. Int.r..t b...d on Infor..tlon IlMltt... br thl flR8nCI.1 In.tltuUon. 2. InherltMCa h. becOMe d.llnquent nine _onth. afhr tM dend."t', ct.ta of d..th, S, A Joint HCOl..nt II t.....I. ......, though the decedent'. n... WI' lidded .. . ..tt.,. of con....,..IIInC.. 4, Accounh (InclucUng tho.. hlld b.t.,.." hu.band Md w1f,) IlIhlch the d.cedent put In Joint n.... within one r..r prior to ~.th .r. fullV t..lbl. ., tren.f.r.. I. Account. ..tlbll~ Jolntlr b.twe.., hu.bend Md wlf. eor. then one v..r prior to d..th .r. not t...bl.. ,. Accounh held by , decedent "In tru.t for" MOther or others .,. h.lbl. fulh. REPORTING INSTRUCTIONS . PART I - TAXPAYER RESPONSE I. 'LOCK A * If thl Infor.,tlon end CHP\lt.Uon In thl notice 'rs cornot end deduction. .r. not bllng chlMd, PIHI ." ..... In block "A" 0' Plrt I 0' thl "TI.p'rlr A..pon.." ..ctlon. Sign two cop I.. end .ubelt th.. with rour chick for the .-aunt 0' t.. to thl R.gl.tlr 0' Will. of the county Indlclt.d. ThI PA Dep.rt-.nt of R.venue will II~ en offici_I ......eent IFor. REV-IS41 EX) upon r,cllpt of the r.turn 'rol tM Regl.t.r of Will.. 2. ILOCK. * If thl ....t 'Plclfl~ on thl. notlc. h.. b.en or will b. report.d end t.. plld with the Penn...lv.,..l. tAherltMC' ,.. R.turn fllad by thl decadent'. repr..."t.tlv., pltcl .,.. "X" In block ..... of P.rt I of the "'..p.v.r R..pon.... ..ctlon. Sign one copy end r.turn to the PA DIp.rt,.,t of Rlvenue, 'ur.eu of Indlvl~1 T...., Dept 110601, H.rrl.burg, PA 11111-0601 In thl env.lop. provided. S. IlOCK C * If the notlc. Infor,.tlon I. Incorr.ct endlor deduction. .r. b.lng cl.I..d, ch.ck block "C" and coapl.t. P.rt. 2 and S Hoordlng to the In.truotlon. belO1f. Sign two copl.. IInd .ubIllt thell with vour ch.ck for the MOUnt of t'll p.,MI. to thl R.ght.,. of Willi of thl county Indlc.t.d. Th. PA D.p.rta.nt of R.vtnu. will I..ue .,.. officiAl ........nt Iror. RCV-1541 [XI upon rac.lpt of thl return froe the Regllt.r 0' willi. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. Ent.r thl d.te thl account originally wa. ..tahll.hId or tltlad In the '~r ..I.tlng .t date of d..th. HOTEl for a dec.dent drlng .ft.,. 12IIUI2. Account. which thl decedent f)\It In Joint n.... within one (I) ,.1,. of d..th .re ta.IbI. fully.. tran.f.r.. Howev.r, there I. an ..clu'lon not to '.Clad 'S,ODO p.,. tran.f.r.. r.a.rdl... of the value of thl HCount or thl nuablr of ICCount. held. If . doubl. ..t.rl.k (..) app.lr. b.fo,.. your flr.t n... In thl .ddr... portion of thl. not Ie., the 'S,DOO .~clu.lon alr.adY hi' b.., d.duct.d frol the .ccount b.lanc. I' r.ported bv the flnancl.l In.tltutlon. 2. Ent.r th. tot.1 bllanc. of the account Including Int.r..t accrued to the date of d..th. S. The p.,.cant of thl account th.t 1. ta.ahl. for .ach .urvlvor I. dat.ralned .. follow'l A. The p.rcant t..lbl. for Joint ....t. ..tlbll.hed ..r. th~ on. y..r prior to the dec.dlnt'. d..th. 1 DIVIDEa IV TOTAL NUtt'ER OF DIVlDEa IV TOTAL JUfIEA OF X 110 . PERttHl TAXAILE JOINT OWNERS SURVIVING .JOINT OWNERS E...,I.. A Joint ....t r.gl.t.rad In the n... 0' the dacl6ant and two other p.rlonl. I DIVIDED IV S I~)NT DWNERS':OIVIDED IY 2 (SURVIVORS) . .161 X 100 . 16.7X ITAXAILE FOR EACH SURVIVOR) . ) .r. . . . j~ I. ThI! perc."t t..IbI.1 for ....ts cn.tad within one Vllr 0' the dec.dent'. dllth or account. C*ned by the dacldant but held In tru.t for InGthlt Indlvldu.1C.) (t,.u.t banaflcl.rl")l I DIVIDED IY TOT.~,HUHaEA OF SURVIVING JOINT OWNE:IJ'S OR TRUST BENEFICIARIES Ex.-pl'l Joint -ii:' t r.gl.t.rad In thl! n... of thl d.cadent 8nd two oth.r p.r.on. 8nd ..tlbll.h.d within on. y..r of dlath by thl d.c t. I DIV~DED IV 2 ( IVDRS) .. .50 X 100 . SOX ITAXAILE fDA EACH SURVIVOR' X 100 . PERCENT TAXAILE The aaoun\;.~Jaat t~ltJ. (1In~. 4),:1. d.t.ralnld by eultJplYlng the ICCount b.lene. Cline 2) by the p.,.cent t..abl. (1In. S). Enter thlr!anl 0' tne"debts lion. Ihtad In P.rt S. The NCMlt h..bl. (lIna 6) I. .In.d by .ubtractlllQ the debt. and dlduotlonl Cline 5) frOll the IUtO\oW1t .ubJ.ct to t.. (line ..,. Ent.r thl apprOPrl.t. t.. r.t. Illn. 11 .. detlralned belbW. A. For dlt.. of d..th occurring .ft.r 6/50/94, the t.. r.t.. fo" tren.f.r. to .pou... .r. .. follow.. I. Dat.. of d..th on or .ft.r 1/1/94 end b,'or. 1/1/9' the rat. I. 5X. 2. a.t.. of d.lth on or .ftar 1/1/9' ~ b.for. 1/1/91 thl rat. I. tx. S. D.t'l of d..th on 0,. .ft.,. 1/1/91 end b.for. 1/1/9. the ,.at. I. IX. 4. D.t.. of d..th on or .ft.r 1/1/9. tran.f.r. to .pou... will b. ....,t fro. till. Hot.. For d.t.. of d.lth prior to 111/94 tran.f.,. to 'POU'" srI bwetbl. .t 6%. I. Tren.f.r. to Iln..1 d..candant. Including f.th.,., ..ther, .on, daught.r, grandchildren, .on*ln*l.w, d.uQht.,.*ln-Iaw, .t.pchlld and their 1.lua .r. t..lbl. .t .1. parcent C6X). C. Trantf.r. to .11 oth.r. InclUdlna broth.r, Illt.r, unci., aunt, n.ph.w and nllc, .r. t..ebl. .t flft.en parcant (15%). D. If you change the t.. rlt., pi.... .paclfY your r.l.tlonahlp to thl dlc.dant In thl .r.. provided. I. ThI.-aunt of t.. due (line .) I. dtt.ralned by IUltl~lylng the aaount t.xabl. Illns 6) by the t'll rat. (line 7). 4. 5. 6. 1. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowllbl. d.btt end deduCltlon. sr. detsrllned .. folllMf" A. Vou I".IIV .r. r.,pon.lbl. for p.~t, o~ thl ..tat. .ubJect to adllnlltr.tlon by . per.onal repr..ent.tiv. I. In.ufflolent to p.y tI'M daduotlbl. It.... a. You aot\MIl1y p.ld tI'M dab.. .ftar d.lth of thl d.cadent and e.,.. furnish proaf of p.'tUnt. C. Dabt. baing clll-.d au.t be It..lled fullv In P.rt S. I' addltlon'l .pac. I. n.aded, 1.1.. pl.ln PIPI~ I Ill" . II". Proof 0' p.....,..t Hr ba requattad bv thl PA Dep.rt.."t of Rtvenue. ::<:::::::::?:: '.'__ ,"'" '... :,', ,.,.::TAXPAVER::,AsSISTANCE: . ... IF. YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY .... REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE .. .. OR CALL. THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT. IN .IfARRISBURGAT (717'787-8327 .TDD' (7171 772-2252 CHEARINGIMPAIREIl ONLY) R!V-1543 EX AFP 18-94) *' COMMOHWEAlllt OF PENNSYLVANIA DEPAATKENI or REVEHU( BUREAU Of IHDIVIDUAl TAllES DEPT. UUIl 1..,",)SaURO, PA "UI-06al INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 95130402 DATE 07-04-95 TYPE OF ACCOUNT ~ SAVINGS CHECKING TRUST CERTIFICATE REHIT PAYHENT AND FORHS TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ESTATE OF MARY SIMS S,S, NO. 170-36-2359 DATE OF DEATII 03-21-95 COUNTY CUMBERLAND I J WINTERS 902 BRIDGE ST NEW CUMBERLAND PA 17070 HARRIS SAVINGS BANK hu provided thl Dlpa,t..", with lMi Infor..Uon 'htad balow which hu b..n und In calculating the pot~tl.l t.. dua. Thai, racord. Indlclt. that at tn. d..th of the abovI dlcldent, you w.t. I Joint Dwn.r/b~.flcl.ry of thl. account. If you ,..1 thl, Infor.atlon I. Incorr.ct, pi.... obtain wrltt~ corr.ctlon fro. the flnancla' In.tllutlon, .ttlch . copy to thl, for. and r.turn It to tha abovI .ddr.... thl. account I. t...bl. In accordance with tha Inheritance T.. L.... of tha Co..onw..lth of penn.vlvanl.. Oua'llan. .av be en.wered by cllllng (717) 7'7-a527. COHPLETE PART 1 8ELOW M . . GEE REVERSE SID~ FGR FILING AND PAYMENT INSTHUCTIONS Acoount No, 07-00000989 Oat. 02-08-82 Eltoblhhad Account Balancl 573.66 Pa,clnt Ta.obl. M 16.667 bount Subjact to Ta. 95 . 61 TaM R.t. K .06 Pot.nU.l TaM Dua 5,74 PART TAXPAYER RESPONSE IIlIFAUUIU!TORI!SPOND,WILL RI!SUL T. IN AN OFFICIAL TAX AS8ESSNENT BASIlD ON.THIS.NOTIC! I A. 0 Tha lIba\le Infor..t1on and t'M dua h cornet. 1. You e.v choo.e to relit peveant to the Regl.ter of Will. with two cop Ie. of thl, notlc. to obteln . dl.count or Ivold Inter..t, or you ..y chick bo. "A" .nd return thl. hat lei to the Regl.ter of Will. and an official .......ent will b. I..ued bv the PA D.part.ent of R'\lInUa, To In.ure proper credit to your .ccount, two U) copl.. of thle notice .u.t 'cco~any your p.ve'nt to the Regllt.r of Willi. "eke check pev.ble tOI "Regl.ter of WIlli, Agent". HOTEl .f tlM payeant. .r. .Id. within thr.. (5) .onth. of tha dac.dant'. d.ta of d..th, YOU e.v deduct . 5~ dllcCKM'lt 0' thtl tax due. Any Inherlt..,ca t.M du4I wUI buo.e delinquent nln' 19) eonth. .fter the d.ta of de.th. [CHECK ] ONE BLOCK ONLY a. c:J The .bo\l. ....t h.. bllO or will be reported and t'M plld with the P~nn.vlvenl. Inheritance T'M return to be flhd by the decadent'. rapre..nt8tIve. C. ffThe .bo\ll Infor..tIon l~ncorrlH:t Dnd/o~ebh and d.ductlonl wara paid by vou, You .u.t coaphte PART L.!..J and/or PAAT ~ below. If you lndlcat. a dlff.r.nt tax rat., pl.... .t.t. your r.latlonship to d.c.d.ntl PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE I, Dah Eohbl hh.d l____.;? -" 1? - ? .1.::..____ 2, Account ealanea 2 ..5' ~4 (~~ 3, Parcant T.xabl. 3)( 11'.., Lr" " it. Allount Subj.ct to Tax it 0 r-: t.... I 5, Dabh and DaduaUon. 5.. ,'l/,J.j ,'1_ 9"(.',_ 6, Allount TaMabl. 6 rJ 7, r.. R.h 7 X ,0" a. Tax Du. e () DEBTS AND DEDUCTIONS ., ..OFFICIAI.!;USEONLV;DMF1 ... ,...A DEPARTMENT OF REVENUE . PAD , '.1 2 3 4 5 6 7 8 CLAIMED ,--~ PART ~ DATE PAID PAYEE AMOUNT PAID '/7/ "- 1...7_'ll..'_ .:r:.'l.> ' ~'p/ ,L'C rJ:' :,tq7..!a'. ) I ':' ~ I N U_ .. ..'7...f'L_= TOTAL CEntar on Lin. 5 of TaM COMPutaUon) . .J.".'J" "IJ1. ~ _ p.rjury, I d.cl.r. that tha fact. I have r.port.d above are trua, correct and .Y knoMhdg. .nd ball.f. WHOOHRKE ((o~~;")) ~:~; t?Q/::-~ _. ,p" ".r"-9J- TELEPH N NUM E OAT~ k DESCRIPTION . .3/- .- ;U- I<!.e r, , '/ tYA/ 'r-: 1 r ) -, - ".~ ~t/ /. Under p.naltt.. of co.pl.t. to th. b..t of .~ Q ~,i;, TAXP Rv IG URE '. I' '\ ..- --... . -I" 'II 11111 " . J 1"\1 ..". ..-]- ',' ',' ',' ',' ',' '. ,." .,':.:' I' ,": ' ,) "'II::' ('I '::' ';:;' 0:'1 'r;' a 7 c. 0''', I." -.,1 ',' .",1'",1 ',.,1 I~.. r"T '" MARY SIMS I. JOANNE WINTERS ANITA S, FISHER 820 L1SDUnN nOAD API 603 ,'A-..I II '" _ """'>313 CAMP ItlLL, PA 17011 ///4.').<:/13/1'1-01':> 1~~'~',II~&ee'_ {d'td'1<-:K~___. ......", __., ..._J $ /~ ~ - $vd..<':<:,.J tY,(l_~_. ILl"'" "HARRIS SAVINlIS IIANK ~ "MMI"'W"(I, r, "1_' /} A~ . /. H. '?17::2(j'!':'/..2~?!/Y::?J_Sy f,f,//:t.ta. __~..L~t..J_ ':2B3?2:1871::I o7oooorf8<Jul 271,0 1"0000oO~2<J7," "-,....._,... MARY SIMS I. JOANNE WINTERS ANITA S, FISHER 820 LIS DunN nOAD API 603 CAMP HIll, PA 17011 ~k~j~_I'I.9~ "'\'1,,,1.. J la 't,.l. - ,.,..... ~ KCJa.', , I J $ /. S" l"k"/,-{:L~t.J,,,V~f1.____'L,._LU:'!""'_..... ___._..., I~' L.&.~~.lL.fL~.c%~__.n ---- IlJr.", DHARRlS;'.lO'} \ "':I"~ '" I 0 ~ ':;;:'1\;' ".,;~l:'.:'i D SAVINOS IIANK mIlK'H"""U, r' "ft' ~ 0 H...1lla- 't:.t-.&!KJ!. _ .alk~.:.JM.lu..l,) I: 2:1 ~:I 2:1871::1 070000 <J8 !:Jil' 271, ~ ,"000000 ~ ~ SO,,' 2741 fIO 1~31VZ313 ".........,,- MARY SIMS I. JOANNE WINTERS ANITA S. FISHER 820 L1SDUnN nOAD API 603 CAMP HIll, PA 1701 t .~~_llj.'Z.Q' r~'~,11'" ({;/:'Ch U:lt.e~c!::..Lt-)~~~",-,-I/~ ---.J $~.02S7.~ ~ ~();"~OII'IU99 111)1) II. 111,'7 tlI19 . . ~Jl..u'. ~./~ 0--" . '.5<)-- Nt .-- - ~"r~tMl"R K! HARRiS SAVINOS IIANK ,""",,,,,,,,,,,, r., "'.. /? _ . . .L2.. 0 1- H._~~-_....l~,*.!""'.L<../.A(I~.4..~_._'.;dIL9__ I: 2:1 ~ :I 72:1871::1 070000 <Ja <JU' 271, 2 ,"DODD b 25 <J SO." 2742 00-7238/2313 c._.......... MARY SIMS "lI7' '7,,';:;./7'/<<.' ;:'f~,: f1.Y 2743 I. JeANNE WINTERS " (:11; ;11; ;1I:f('1 'I ('I ":' ',:,' '::1 ''''I ":' ANITA S, FISHER . ' , , .', 'J.,"," ~;p:" ,!, "::' .1\7""~ll;'" ,;,1 820 lISDUnN nOAD API 603 -'1~.A. ",:. "i'I' '~, 'I b ,,;;. I;:, ',j '../ CAMP lUll, PA 17011 '--y~''''''''Vllj~ l'~~I''tJ.i'yljl tt/!1t,c.d:.o I $/..?.f.f,f. _~....(~tee..,c.." ""~ %'-t:) --- On 1'~1.'R DHARRIS D SAVINOS !lANK m~il":"11U1. r\ IIIftl, ___ /). P -t' \ 1;..j..!.-i<.J AL.e~___.u_. b-VJut(l,_CLJ!A,,,f1&.9__ 1:2:1~:l72:1871::I o7oooo<Ja<J. 271,:1 ~000000~57b~ ............- I i I (,)- 'j'i. p, I ,.-,. " \. I.-f---" /"- '1--95' f.c '. ~~, "Lli'~ "0 w~ 1",; ~...j,~~ 4 '. d:AM."")c.o :1-/ ~~~ ~7~rl"""" 5', S. ~ 170. 3(. -2 3 S'? ..J ~,4,-k-~ ~ C,+-J~~i.. 4~~~'Z" ~ "'~ 7,{3- 7/7:;V;~ --I.'_.,r.L.... JJ ",K'1u.. ~ ~ ~ -4 ~ ~ r~ . 4wr..-, ~. 11f'J. ~ ;JHLr'.- ~ W~ ~ J ~~'.l. ~ 77?"~~'C.~ ~)Jd.a.J. .P.{O ~~. ~ /<J~~~ ,..., M/~ ~~~~. ~~.c.<. (I~~..(... ~ (~5~) ~ 7/7- 93J-- Z,9C,k T~Ii~ ~ta:J~~ .r REV-1Q43 EX AFP 18-941. '-tMOft'\:ALTH or PENHSYlIJANIA DCPARlHEHT OF R[V(NIJ[ BUREAU OF INDIVIDUAL T'XES PEPf. 110601 HARRISBURG, PI. 1'1'1.0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 95130403 DATE 07-04-95 TVPE OF ACCOUNT ~ SAVINOS CHECKIHO TRUST CERTIfiCATE RE"IT PAV"ENT AND FOR"S TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ESTATE OF MARV SIMS S,S, NO, 170-36-2359 DATE OF DEATII 03-21-95 COUNTY CUMBERLAND ANITA S FISHER 753 CDLUNA DR LEWISBERRV PA 17339 HARRIS SAVINGS BANK h.. provided tha D.pa,'..n' with tM In'aratton lI.t.d blla.. which h.. been und In ulcul,Ung thl pot~tl'l '1M due. Tn.I, ,Icordl Indle.,. thlt _t thl a..th of the abOVI dlcldent, you we,. I Joint owner/blneflcl.tv of thl, account. I' you ,..1 thl. Inlor..tlon I, Incarr.ct, pl.... obtain ..rltten correction frol thl flnancla. Inltltutlon, attach. copy to thl. for. ~ r.turn It to thl aboVI .ddr.... Thl, account I. ,..~1. In accordance with the Inh.rlt~. I.. l..,. 0' thl Co..onwe.lth of Plnnl.lvenl.. au..Uun. ..y bl .n.",..red h) 1;.11'1'" t7U) 7A;-.a"7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No, 07-00000989 Dat. 02-08-82 Eatab1t.had Account Ba1anc. 573.66 P....nt T..abl. M 16.667 Aoount Subjact to Ta. 95,61 T.. Rat. K .06 Pot.ntlal Ta. Du. 5.74 PART TAXPAYER RESPONSE IIlI FAXLURI! TO RI!SPOHD lULL RE8UL T. IH AH OFFICIAL TAX ASSESSHEH1BASEDOH THIS HOnCa A. r=J Th. ~ov. In'or..tlon and t.. due I. corr.ct. 1. You "V ChoOI' to r..lt p.v'~\ to the R'al.t.r 0' will. with two copl.. 0' thl. notlc. to obt.ln . dl.eount or avoid Int.r..t, or you ..y chick box "AW and r.turn thl, notlcl to the Rlal.ter a' Wills and In a"lelel ......-.nt will be I.,ued by the PA Dlp.rt-.nt a' Revenue. To Insur. prop.,. cr.dlt to your .ccount, two U) copl.. 0' thh notlc. ...,.t acCHPIl'lY your p.Ylent to the Real.tlr a' Wills, Hlkl chick p.ylbl. tal "Rlalstlr 0' Will., Agent-. HorEI I' t.. p.Ylent. .r. Ilde within thr.. eS) .onth. 0' thl dlcldant'. d.tl a' dl.th, you ..y deduct. s:c dhcount 0' the tl. dul, Anv Inherltll'lc, tn w. will becOM dlllnquent nlnl t91 sonth. .,t.r the dltl a' d.lth. [CHECK ] ONE BLOCK ONLY .. D 1'he above ....t h.. ~." ar will b. r.part.d and till paid with the Penn.ylvll'lla Inhltlt.nc. TIll return to b. .11.d by thl dlcldent', r.pr.._nt_tlv.. C. ~he .bov. In'ar.atlon l~ncorrlCt .nd/a~.bh end dlductlon. WIre paid by you. You .u.t coapt,t, PART ~ andlar PART L!J b,l~w, If you indlcat. a diff.~ant tax rat., pl.... .tat. your r.lationlhlp to d.cad.ntl OFFICIAL ..USE O.NlV. OMF! PA DE~A~T~~N!,OF REVENUE i.' PART I3.l TAX RETURN - COMPUTATION OF TAX ON JDINT'TRUST ACCOUNTS LINE 1, Data Eotablhhao 1 ...:l.t:>Ji'~ R :2- 2, Account B.lane. 2 =-1:Z~' L "" 5, P.rcont Ta.abl. 5 X I ~. ~ (., 7 4. Allount SUbjact to Ta. 4 9,S,.~j 5, D.bt. and Doduotlon. 5.....:.-1f".1. ~ CJ.J!; ~,._ _ _ 6. AltOunt raxabl. 6' 0 7. rax Rat. 7--'1..-' ~ 8. T.x Dua a t"!:JJ PART I!l DATE DEBTS AN PAD 1 2 3 4 5 6 7 8' CLAIMED ,,:i ,::' I "~I; DEDUCTIONS AMOUNT PAID .,(PS' 4:g= . ..7 "> .:;2V&_7S' _... "1 '7 ':~ ~f1_- e ...:7 '\. 4-Z'f, ~.I&o..~ I have report.d .bow. .~. trua, eor~.ct and ' HOME (~~7 I ; ?~ ?- '1(,(, WORK ( ) - f,23"95 TELEPHD NUM E DATE PAVEE DESCRIPTION PAID ~ -tI'-.<A. . ~ ......, ........~ _ t' 4 TOTAL (Ent.~ on Lin. facta "'-"" of Tax Co~ut.tJon) i GENERAL INFORMATION 1. FAILURE TO AESPOtlD WILL HESUL T IN AN OfFICIAL TAX ASSESSHEHT ..Jth 11pf11lcatlla Inht... b...d Dn In'or..tlon .ub.ltt~ bw the fln~1.1 In.tltutlon. 2. Inheritance t.. beCoael delinquent nine ~th. .,t.t thl dlcadent', data of d..th, 5. , Jot"t account I, t..~l. Ivan though the dlcadentl, n... .... added .. . ..tt.r of convenience. 4. Accaunt. (Including that. held between hu.b~ ~ ..I'.. which thl dlcadent put In Joint n.... ..Ithln ~ y..t prior to death .t. fullV t'.abl, .. tt~.f.t.. 5. Account. ..tlbllshed Jolntlv b.t...en hu.b~ end ..1'. lor. th~ on. V..t prior to d..th .t. not tlxlbl.. 6. Account. held by . dlcadent Mln trult for" enoth.r or other. .t. tl.able fully. :- ... REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE I. .lOCl' - If the In'or..Uon IW'td COIIpUtlUon In ttM notice 't. correct end deduction. 't. not baing clal..d, PIIKI WI "}I" In block ..,. of Patt 1 0' the "TaxPlv.r R..pon..- ..etlon. Sian tva copl.. end .ubelt the. with vour check 'or the .-aunt of t.. to the RIgl.t.r a' Will. of thl county Indlc.ted. ThI PA D.p.rt.-nt af R.v.nue will I..ue an o'flol.1 ......sent (Fort REV-1541 EX) upon r.c.lpt 0' the r.turn 'ro. the R.gl.t.r 0' Will.. 2. ILOCK I - I' thl ....t .peol'led on thl. notlc. h.. b.en or will b. r.port.d end t.. p.ld with thl Penn.vlvanl. I~rltenc. T.. R.turn 'lIed by thl d.cedent', repr..tntltlv., plac. In -X- In block WI_ 0' P.rt 1 of thl "T..p.v.r R..pon.." ..etlon. Sign one copy and r.turn to the PA DIP.rt..nt 0' R.v~, lur.eu 0' Indlvldutl T...., Dlpt Za060., H.rrl.burg, PA 1712.-0601 In thl env.lop. provided. 5. 'LOCK C - I' thl not Ie. In'or..tlon I. Incorr.ct end/or d.ductlons art b.lng cl.l..d, chick block -C" end cu.pl.t. p.rt. I end S ICcordlng to the In.tructlon. b.low. Sian two copl.. and .ubelt th.. with your ch.ck 'or the IIOUnt 0' tt. p.v~l. to thl Rlal.t.r 0' will. of thl county Indlctt.d. Th. PA D.p.rtsent 0' R.v~ will I..ue In o"lel.1 ........"t IFar. REV-154a EX) upon rlc.lpt of the r.turn 'rOt thl Real.t.r 0' will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Ent.r thl d.t. thl tccount arlgln.llv WI. ..tabll.hld or titled In the aann.r ..I.tlng It d.t. of dlath. HOTEl for. dee~t dvlng .'t.r ll/lt/IZI Account. which thl decedent put In Joint n.... within ant (1) y..r 0' da.th .ra ta.lbla fu)ly a. tren.'.r.. Howav.r, thera I. In a.elu.lon not to a.ea~ 13,000 par trtn.fara. rag.rdl... of thl v.lue of the eccount or thl ~r 0' eccount. hald. I' . doubll I.t.rllk (..) .ppa.r. ba'orl your flr.t n... In the eddr... portion 0' thl. notle., thl 'S,OOO a.elu.lon .Ir.~v h.. been deductad frot the .ccount b.lenc. e. reported by thl 'Inencl.1 In.tltutlon. 2. Ent.r the tot. I balanc. of the .ccount Includlna Int.re.t accrued to the d.t. 0' d..th. S. ThI p.rcent 0' thl tccount thet I, t.xabl. for ..ch .urvlvor I, d.t.r.lnld .. 'ollow'l A. ThI p.rcent t.xabl. 'or Joint ....t. ..tabll.had lOr. than onl VI.r prior to the dlcadent.. d..th, 1 DIVIDED IV TOTAL fUllEA Of JOINT OWNERS EMatplel A Joint ....t r.al.t.rld DIVIDED 1'1 TOTAL frUCaEA Of X 100 . PERCENT TAXAILE SURVIVING JOINT OWNERS In the n... of thl dlctct."t and two othlr p."Of'l'. 1 DIVIDED IV 5 (JOINT OWNERS) DIVIDED IV Z CSURVIVORS) . .167 X 100 . 16.7~ (TAXAILE FOR EACH SURVIVOR) I. TM p.rcent "xllbla 'or ...... cr..t.d ..lthln on. Vllr of thai Mc.dant'. d..th or account. owned by the decedent but htI1d In tr~.:.'or tnOt~~ Indlv~du~~(.) (tru.t blna,lclarl")1 I DIVlDED-'''' TOT~i. 'NUttIER OF SURYIVINO JOINT )( 100 . PERCENT TAXABLE ' OWNOts OR TRUST BENEFICIARIES Ex-.I.I Joint eccount r.gl.ttr~ In thl n... 0' the dKedtnt and two othar p.rton. end ..tabl!thtd ..lthln on. Yllr 0' ~.th bv the dec...t. 1 DIVIDED IV 2 (SURvIVORS) . .50 X 100 . SOX (TAXAILE fOR EACH SURVIVOR) . ,- ,. ThI.-aunt .ubJ.ct to :t8M (lint ,) I. d.tar.lnad bv .ultlplvlng the .ccount balanca (lint Z) by the p.rc.nt t..abl. Clln. 5). 5. Ent.r the total 0' th_--.btl and deduction. II.t.d In P.rt 5. 6. ThtI.-aunt ta.~I. (1In. 6) I. d.tar.ln.d bV 'ubtractlng the dabt. and dtductlon. (1In. 5) 'roe the ttount .ubJ.ct to ta. (1In. 4). 1. Ent.r the ~roprl.tat.. rat. (lln. 1) a. dat.r.lned b.low. .~! ll~ tJ' 'J ;.- A. For d't.. 0' da.t~ occurrl~~ ~t.r 6/50/94, the t.x r.t.. 'or tren.f.r. to .pou... .r. a. folloN" 1. D.t.. 0' d..th on or .'hrl'"-TIII" end b,'ore 111/96 thl ra" It 5:C. Z. D.tl. 0' da.th on or .'t.r 1/1/96 end balora 1/1/91 the rat. I. Z:C. 5. Dat.. 0' death on or .ft.r 1/1/97 and ba'or. 1/1/9. the r.t. I. 1:C. ,. Oat.. of d..th on or .'t.r 1/1/9. tran.'ar. to .pou... will b. ax.~t 'rot ta.. Hot" for d.t.. 0' d..th prior to 1/1/94 tran.'.r. to 'POUI.. ar. taxable at 6:C. a. Tran.,.r. to Ilntal d..cendant. Including 'ath.r, toth.r, .on, daught.r, grandchildren, .on.ln-I.w, daughtar-in-I..., .t.pchlld end thllr I..ut .re ...IIbI. It .Ix parcent Cn). C. Tran,'.r. to .11 othar. inclUding brothlr, 'I.t.r, unci., aunt, neph.w and nl.c. '1', t..llbl. at 'i't.an p.rcent (15~). D. If YOU chang. the t.M rat., pl.... .pecl,y your r'lltlonlhlp to the dec.dent In the .r.. provided. I. The.-aunt 0' tax due (lin. 8) I. det.r.in.d by aultlplvlng thl .-aunt t.xabl. Illnt 6) bV thl t.. rat. (lIne 1). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED AUOtfabl. deb.. and deduction. .re deta,..ln~ .. 'ollOtfIl A. You l.gally .r. r..pon.lbl. 'or p.~t, or thl ..t.t. IUbJact to ~Inl.tratlon bV . per.onel rapr..antatlv. I. In,u"lclent to PIV thl deductlbl. It.... .. You ItCltual1y paid the dabts .Ulr death of tha dectdtnt and eM lurnlah proo' 01 pay.."t. C. Dabts belna cltl.ad au.t b. It..bed rulh In Part 5. If .dcUtlon.l .pec. It nHdtd, us. pl.ln PlPlr . I/Z" M 11". Proo' 0' paPlnt .av be reque.t.d by the PA Dtptrt.."t 0' R.vtnUl. <..,. ,. <<<<<<<<.<': '.i' ::' ,:'. T AXPAVER, AS 51 5 TANCE ' .....'::<,...:.':'><': . IF YOU NEED FURTHER I NFORHATI ON :.ORASSISTANCE, CONTACT ANY .,< REGISTER OF WILLS; PADEPARTMENTOF REVENUE DISTRICT OFFICE .. ..,.,............... .' '.':":".::',.,.,',"::.. OR CAlL'THE BUREAU OF INDIVIllUALTAXES, TAXPAYER INQUIRY UNIT IN" ,....< . . HARRISBURG AT (717)787-8327 ,TDD'(717) 772-2252, CHEARINOIHPAIRED ONLY) '-";,' *:;.,". , REV-1543 EX AFP (8-941_ ~EAlTH OF PENNSYLVANIA DEPAATHEHT OF REvtNUE: BUREAU OF INDIVIDUAL "XES D(PT. za0601 HARRnBURG, Pi HUI-06DI INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 95130403 DATE 07-04-95 TYPE OF ACCOUNT ~ SAVINOS CNECKINO TRUST CERTIfICATE RENIT PAYNENT AND FORNS TO. REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 ESTATE OF MARY SIMS S,S, NO, 170-36-2359 DATE OF DEATII 03-21-95 COUNTY CUMBERLAND ANITA S FISHER 753 COllINA DR LEWISBERRY PA 17339 HARRIS SAVINGS BANK hu provldld the D.,.rt.-nt with tM In'or..Uon lIUld batow which h.. b.." u..d In ulcuhtlnl thl pot~tJ.1 t.. dul, Thllt rlcordl Indlcat. that .t the d..th of thl aboVI dlcadent, yoU ...,. I Joint owner/b~flcl.ry of thl_ lecount. Jf YOU f.. 1 thl_ Infor..tlon 1. Incorr.ct, pl...1 obtain ~rltt." corrlctlon ftol thl 'In~cl.l In.lllutJon, .ttlch . cop~ to thl. for. and retu,n It to the abovI addr..s. Thl. account I, ,...bl, In accordanc. with thl Inh.rltanca r.. La... of the Coa.onwa,lth of Pann.wlvlnl.. QuI.,lona ..~ b. an.w.r~ hv cllllng (717) 7.7.131'. COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 07-00000989 o.t. 02-0B-02 Eat-bUahed Account Balann P.,..c."t Tax.bl. A.aunt Subj.ot to Tax Rat. Pot.nU.l Tax Dua To In.ur. prop.r cr.dlt to your account, two (I. copl.. of thl. notlc. ~.t accu.pany your p'ya~t to the R.gl.t.r of Wlll.. Haka ch.ck p.yabl. tOI "R'II.t.r of Wlll., Ag~t". PART III 573,66 16,667 95,61 .06 5,74 TAXPAYER RESPONSE F.AILURE.TO :. RESPOND,IIXLL ..' RESULT IN . AN. OFF.ICIAL : TAX . ASSI!8SNI!IIt BASlD. .ON' ,THI8.: NOnCI! .' x- T.. HOTEl If t.M p.y.~t. .r. '~a wlthln thr.. n. 'onth. of the d.ced..,t'. d... of d'.th, YOU ..y d.duct . 5% dl.count of the tax due. Any Inherltanc. t.x du4l will baco.. d.lInqu..,t nln. (,) ~th. aft.r the data of d..th. K [CHECK ] ONE BLOCK ONLY A. 0 Th' ebov. Infor'etlon end te. due Is corr'ct. I. You ..y choo.e to r..lt p.y...,t to the R.gl.t.r of Will. wlth two cop I.. of thl. notlc. to obt.ln a dl.count or .vold Int.r..t, or YOU "W check box "A" end raturn thl. notlca to the R'II.t.r of Will. and en official ......aant will b. I..u.d bw the PA Deperta..,t of R.v.nua. .. r=J Th. above ....t h.. b.an or will b. r.port.d end t'M paid with the Penn.wlvanl. Inh.rltanc. raM r.turn to b. flhd bw the d'c'd~t'. rapr..anht1v.. C. riThtI aboy. Infor..tlon I~ncorract and/o~.b" and deduction. wlra P.ld by you. You IN.t co-..I... PART l.!.J ....vor PART l!..J below. If you indicat. a diff.rent tax r.t., pl.... .tat. you,.. "'.lationship to dacadantl PART ~ TAX RETURN - COMPUTATION LINE 1. D.t. e.t.blhh.d 2. Account O.l.nc. 3. Percent Taxable 4. A.ount Subj.ot to Tax 5. Dabt. ."d Deduction. 6. Aaount Texabl. 7. Tax R.t. 8. rax Du. .......OFFICIAL:USEONLV.OMF PADEPARTHENrOFREVENUE '.::'> ".'; PAD' "'1' 2 .3 '4 5 6 7 8 CLAIMED O~N JOINT/TR~T ACCOUNTS 1 ... I>/?_ ;:1. 2 ,.,.?~. 1.>(., 5X /Cn.(~(,,? 4 1:1;' (,/ 5 - .,'!/. ~., ~.6' -'/' I . 6 ~ :X '~ -..-- PART [!] DATE PAID PAYEE DESCRIPTION l~}i~~~~~Z:.~~ ..,.. .."". .. ,o. , .. ,.. ,.......... DEBTS AND DEDUCTIONS hct. I AMOUNT PAID ~'/t}~1<;- . '7 [(:Ie. , .~ I 'f9=.Kt.- hav. report.d above are true, co,..r~t and HOME (~7 I 93Jl' .;l9(,r..- WORK ( I - g-;).9'-9b' --. DATE "- "-_.--. .--- -.-.- ..-... -'-'1' '" 11"11 , J". J tl 1 "",. '..-) , , ',- ',' ',- .' ',' -, .,' "~I:,:' It .-.j , ',:0 0:'11::; (', '::, ;:;' ':', ';:!' a 7.'.;,0""1 I.., '.. ',' ....11,..1 1...1.:.. r .T,,, I . I i ~ . MARY SIMS I, JOANNE WINTERS ANITA S, FISHER 820 L1SDUIlN 1l0AD API 603 ~" CAMP Itlll, PA 1101. '//ta,\.('A 3/1'1,9.:. - n:~~,~',t&ee'_{ltt.d~4<.____.__n --_____.1 $ /~~ -.ffi.()~'L.Uf'(LZ.. ILl,"" ,..,.~~~ /J _ rl T' Ii. 7/7~ ?6,~Y2~j:7_/~(Z.:Jy U4t~dr.._kL~l.J I: 2 :i ~:i? 2:i8 ?I::i 0 ?oooo (8 "III' 2? 1.0 ."000000 ~ i! "11," M"lftl'll) .co. " .......-.- " MARY SIMS I, JOANNE WINTERS ANITA S, FISHER 820 L1SDUIlN 1I0AD APT 603 CAMP IIILL, PA 110" ",\",,":jJ~'t,~, ,'I.u.!:J odItl. '", '" .1-' lJrilrr,l ~~"":""'c;;',--_l..t~, .. ffi,o.(,11 tl-'Y(_-f)Ko.o iii A lS~IJn~} \ 9':1'~ :\1. t. 0 7 !:.i~''''::':, ~r f~~;!ti:s MV NOS IIA it ....,..,..", "/;'''' , 0 '7 ' 1i._1J20/1.<l~1(ALJ ,ec /fJl~ 122J.1. a:,.&.:...T..<.Ju.-V 1:~2 :i8?1::i 0 ?0000"l8"1I1' 2?1. ~ ,"000000 ~ ~So," 2741 ~k.'~j~_I"_9~ $ S<J --_---..J //?c M.7234f23t3 --- I\Jt", .1_....,'... ~, I HARRJS SAVINGS IIANK .....,,',.".:' '"'' /? . " Ll. J l' (;.~~-~~,,~~ ' ~ 1:2:i~:i?2:i8?1::i o ?oooo "18 "ill' 211.2 ,,'oooof,i!S"iSo.,' MARY SIMS I. JOANNE WINTERS ANITA S, FISHER 820 L15BURN ROAD API 603 I'J.A......, I CAMP ItILL, PA 11011 '''7'''-~Jf._19!?.:tZ' P~l'k~,I}" PCi.....-r:iu:. mt"2C?-' -hl..-).,.,.;, I/.~ ---..J $~..,2S7.~ ();'~I)II~gg 'lnO It 1I1,~7 11119 ~L>~IJu-<<b~~~ ~a" 2742 lWH23&12313 MARY SIMS '7/-,. -7...;;: - /7 Y-r..' 7'(~.? 'dY. 274 3 I, JOANNE WINTERS / / , (:11:,:11:,:11:,:<':) :I. (:1 'j:' :Fi; '::1 ,) 1.." I::j ::IJ~B~n!~So~~RAPI 603 . ~:t>A :VJ..~il' J;. 1,-t:1 I::, ,~7f:~"lll~,' ::,; CAMP IIILL, PA 170'1 c..f-,,_,~.c"'VIl)g ti:lt::::}~t!I ttJ'&"d'".i.; __. ~ $/_'T.f,$. Y-<~t:ie.~(.) "?<-d!. '%'-<:'J,. _ I\~"'" ~I HARRIS ' S^VINllS IIANK t1"~)t"~"llllfl, r\ 171ft', /). P -r' \ "...,IAM.d kt.a.__.__ _____ 6.-VJut(l,4_,~~",-&,Li ': 2:i ~ :i? 2:i8 ?I::i 0 ?oooo "18 "ill' 2?1.:i ,"000000 ~ 5 71:.." Ihi-oJ- (~7.'l7, {,3 ...OtoIlIUCI''''