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CDMMOMMEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*PliED ~;~~ET{NOiEsN:O:~CEE
1EV-154S EX A,/,.~.l
FILE NO. 21 6lo ~\ I
ACN 06133016
DATE 07-07-2006
TYPE OF ACCOUNT
D SAVINGS
D CHECKING
D TRUST
[i] CERTIf .
2007 FEB r 4 At1' IE~ OF MARGARET J WEAVER
S.S. NO. 207-22-2193
CLEni\ Or: DATE OF DEATH 05-05-2006
ORPHAN-i'l:' 00' l.!R,cOUNTY CUMBERLAND
I, ')\.;\ ii,
C1U~ 'r..CI:1
I P..': ,:" J .,
P;'!
RE"IT PA~ENT AND fO~ TO:
REGIS~ER OF WILLS
CUMBE~LAND CO COURT HOUSE
CARLISLE, PA 17013
PATRICIA J L.ICHTY
5 CHANNEL DR
CARLISLE PA 17013
SOVEREIBN BANK hilS provided the 08pert.nt with the infaMllltion listlHl below which hilS bun uslHl in
celculllting the pobntilll t:lIx due. Their records indicllte thllt lit the dellth of the llbave dtlc:lHI8nt, YOU were II joint owMr/beMficillry of
this IICCount. If YOU fIHIl this infar.lltion is incorrect, plell" obtain writt.... correction frOll the financilll institution, IIt'blch II copy
to this faMl III1d return it to the 8bove &ddMlss. This IIccount is taxllble in IIccordlmce with the Inheritllnce To LIIWS of the CO.IIDnwe.lth
of Pennsylveni.. Question...y be enswered by clllling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIbE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1675207672 Date 01-16-1996
Estllbllshed
Account BelMCe
Percent Texeble
AIIowIt Subject to Tex
Tex Rete
Potent leI Tex Due
x
10,799.06
16.667
1,799.88
.15
269.98
TAXPAYER RESPONSE
To insure prlJPtlr credi t to your IICcount, two
(2) copies of this notice BUst IICCDllpIlnY your
peYll8nt to the RlISJister of II111s. Meke chllCk
peyllble to: "Register of Wills, Ag....t...
x
NOTE: If telC PIIYll8l1ts lire .&de within thr..
(3) IIDnth. of the decedent"s dete of death,
you 8IIY deduct II 5% discount of the tex due.
Any inheritence tex due will beco.e delinqUllnt
niM (9) .onths lifter the date of dellth.
PART
[!]
~l[:;E:::.::~:ti.~~.~~t::..-:~~~.._~- . :~:J:~-~~;~~~1.~~2:"~':'~~~:~E~~t[:~:~""="~~;D~J'I~:'~~'JCjH::llF:r~.;I!1f~::~~}"r~~!~~:-~~;~~:JIJ'MH'r!v~'J!;::~'~01J1
.._."'..,_.."'_"'_."',.,.., "''''.,"'.."". ,.. __"'.' "'"' "''"'. ,"'"'... ",__iJ-_".~__.",~ ,"'C_~___."'i.. ~.:l'__.__'~"","',o,__ :., ___ ili""",.lc,__"nr.n""'_""I' ..L"''{~"._..lL' _4.-""""" c._ i.i..,,!,,, _. ._~.!lic?-='~=
----------,..-------..--.,- ----...-......------ ~-- ...- .....--.. --...--....- ...__.......__~;.n.;_... _:.n-:r_;.n..r_..,...._.._~.. .............. ............ ............. ..1'+......__ ..w..r_"l.r....:..r..__~.._..__ .. ...i.i-ULtl"1-l_~_:tiH._~ ;.I_ ~::::t1.W...... ,,;..<,,;,if.iit'j:t<'..t:im
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The IIbov. info.--tion III1d tex due is correct.
I. You.BY chao.. to rMit pllYHnt to the Register of Wills with two copies of this notic. to obtein
II discount or IIvoid interest, or you .IIY ch8Ck box "Aft and return this notice to the Register of
Nills IInd en officilll IIssesS88nt will be issued by the PA Depllrteent of Revenue.
B. IX! The 8bov. IIsset hll. b..n or will be reported and tex pllid with the Pennsylvanill Inheritance Tllx return
to be filed by the decedent"s repreHntlltive.
C. 0 The llbove infar_tion is incorrect and/or debts end dlHluctions were pllid by you.
You BUst coeplet. PART 0 end/or PART ~ below.
PART
[!J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
If you Indlcete e different tex rete, pleese stete your
reletlonshlp to decedent:
LJ:HE lo. u.i. cst.oiisned 1
2. Account hlMCe 2
3. Percent Texllble 3 X
4. AIIowIt Subject to Tex 4
s. Debts end Deductions S -
6. AIIount Tex_l. 6
7. Tex Ret. 7 X
8. Tex Due 8
PAYEE
DESCRIPTION
AMOUNT PAID
I I
TOTAL (Enter on Line S of Tex Co~tetlon) .
perjury, I declere thet the fects I heye reported above ere true, correct and
~ knowledge end bell.f.
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