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JOHN W. Faulkner
208 Rld~evlew Rood
New Cumberland, PA 17070
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, REG I STIR OF WI LLS
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CARLISLE, PA 17013
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COI......Ul nt OF PDICIYl VANIA
IlOUfMl"" Dr' ftvou:
_""'" INIIIVlllU&l Tml
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~IIIUIO, PA 1'11'-""
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If-jb-/O
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
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I'ILINO.219"4/5
ACN 95159014
DATI 12-12-95
TYPE OF ACCOUNT
EST. OF PATRICIA J FAULKNER liJ IAVI_
S.S. NO. 208-28-5322 OtHECKINlI
DATE OF DEATH 10-03-95 0 TRUST
COUNTY CUMBERLAND 0 tERTI'.
RE"IT PA~EHT AHU 'ORftS Tal
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
COURTNEY CONRAD
208 RIDGEVIEW RD
NEW CUMBERLAND PA 17070
DAUPHIN DEPOSIT IAHK. h.. provIded the DepertHnt tilth the Infor_Uon IhtMl ~lDW which hili bewt uNcI In ulculaU". the
pat..,UI. tax dUe. ThIIlr rKOtdl IncUeat. thet at the dMth 0' the above dltc.o.nt, you wr. I Joint IMIMrlbeneftCllary of thll acCCU1t.
If you ,..1 \hit In'o,--Uon I. lrw:arrect, P..... obtain "dUen cornotlon frOll the flMM!_. In.tltutlon, ,UIlCh . con to thh fo,..
.., ratun, It tu tiMllIboVI .aD.,...,. nib ......_.L 1. ta.l:.ul. I.. CM.'-".d6..... ",Itt! U... Inh"l~tMCl<ll TM L.w. "r th6 C~lt.'\ '4' r.....)'l~lIIl'll..
Due.tlon. .-y be .......rlld by celllng (117) 717-13Z7.
COMPL!T! PART 1 B!LOW . . . S!E REVERSE SID! FOR FILING AND PAYMENT INSTRUCTIONS
Acc......t No. 4915746208 Doto 08-23-89
E.hb1hhed
Acc......t h1_0 371.25
P.rcont Tox"'lo X 50.000
~t SUbj...t to Tox 185.63
Tox Roto X .15
Pot....U.1 Tox Duo 27.84
PART TAXPAYER RESPONSE
[!]tf~IL~'/!:CJ),~I'CIftlr",IfILI.;~.~'1'i'i.~"..,.A"...,cnr,I:'~c:~I\Lji;"AXi~8~!HT',IAPP.,(ItI,..,nt~'i.~C:l.j.
To In.,,.. proper artlellt to your MCOWtt, No
(2) copl.. of tf'lll notlc..," 1': b. wry your
P8~t to the ...ht.,. of WUlI. ...... check
,.JWbJ. tal ~..I.t.,. of "Ill., Alent-.
NOTEI If tu: ~t. In ... wi thin thr..
(S) .onthl of the dKtldent', dill. of death,
you ..,. deduct . 5% dllCCUlt of the t.. w..
Any Int.r!tencl tax dlM .,111 becae del1~t
"I,. (9) IIOftthl .ft.,. the dIIt. of "th.
[CHECK ]
ONE
BLOCK
ONLV
A. IJII'TN Ilbove Info,...Uon Ind tu due is COf',._t.
\&J 1. You.-y choo.. to ,...it p.~t to the Aeglste,. of "UlI with No copt.. of this notice to obt.ln
. dhCOW'lt or avoId lnt.,...t, or you ..,. check box -,- ... return this notlc. to the A....t.r of
W11l1 Md WI officl,l .........,t .,Ul tM 1,1UIId by the PI. o.p.rt.-.t of R..,.,....
I. 0 TN IIbotre ....t h.. bMn or wUl tM reported and tax Plld ..Ith the Pemrylnnll IrnrltWlCe Tax return
to be '11M b the dec:..,..t'l nprIHnt,tlvl.
C. 0 The ~. I"forutlon l~ncorrect ..vo,. debtl Ind deduction. ...,.. Plld by you.
You .,.t c-..l... PARr l!J W'ldIor PUT I!l bel_.
If you Indlcat. . different tax rat., pl.... .tat. your
ro10Uonohlp to __t I
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DEBTS AND DEDUCTIDNS CLAIMED
PART
~
TAX RETURN - CO"PUTAlION OF TAX O~ ~OINT/1RUST ACCOUNTS
LINE 1. Doto E.tob110h0d 1
2. Account 8.1~. 2
S. Porcont Tox"'lo 3 X
4. ~t SUbj...t to Tox 4
5. Ilobb _ _Uon. 5-
6. ~t Tox"'lo 6
7. Tax R.t. 7 x
e. Tox Duo e
PART
~
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I I
TOTAL IEntor on Llno 5 of Tox t_bUon) I
Undor _HI.. of perjury, I _10... thot the f...b I how .--rtod _vo .ro t....., corr...t -
c0flp10to to the b.ot of oy know10dg0 - beUof. HOME (
WORK (
T"~~PJj.DNE
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1':~'~~tOft481' ,- 'C~MMONWEALTH OF PENNSYLVANIA
:.,,,.,,,,,' ....A',.,'< -,,', ,i DlPAllYMINTO. .IVINUI
~rd{~';<~}>:Ur_i'Yi" : O"ICIAL uClln . PINNIYLVANIA INHIItITANCI AND ISTATI TAX
ACN
-=" ASSESSMENT fl'I
II CONTROL ~
NUMBER
..
RECEIVED FROM,
AMOUNT
COURTNEY CONRAD
eOB RIDGEVIEW ROAD
9~H19014
.27.B4
NEW CUMBERLAND, PA 17070
-IOI:D Hilt fCXD HII'
EST....TE INFORMATION:
!I liE NUMIER
Y el-1996-001:5
r:I NAME OF DECEDENT ILAST)
~ FAULKNER PATRICIA
II D....TE OF P....YMENT
EI POSTMARK [),t, E
COUNTY
SSN 20B-2B-~32e
IFIRSTI (Mil
J
CUMBERLAND
D4TE OF DEATH
REMARKS
m TOTAL AMOUNT PAID .27. B4
(, '. SK
RECEIVED BY /1/(1)','1(. ;(-(~..) /'/.!,.,
I SlGNAtUIIE , /J'
MARY C. LE~IB ,.c/, 'I'I~ ~"!r/'
REGISTER OF WILLS
SEAL
JOHN W FAULKNER
C/O COURTNEY CONRAD
CHECK" :5701
REGISTER OF WILLS
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