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Home My WebLink About04-03-07 COIlMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVOlU,'"~"lAX(S[: DEPT. 280601'" """ HARRISBURG, PA 1(12IHI601;: *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-07-0~:l.l/ 07111278 03-16-2007 REV-lSttl EX AFP C09.ao) Z001 !"PR -3 AH II: 46 C' r""ntl '"V- ! L.,(;r\r\~-:~!! _ ORPr-!i\ v_'uR \ ('I " ]1' J\....i. EST. OF JOHN R ROBERTS S.S. NO. 184-03-2419 DATE OF DEATH 01-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT Ii] SAVINGS o CHECKING o TRUST o CERTIF. JUNE ROBERTS 23 CAMBRIDGE CT CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Depart.ent with the infornUon listed below which has been used in calculating the potantial tax dua. Their racords indicate that at the death of the abova decedent, you w.re a joint owner/beneficiary of this account. If YOU feel this info~ation is incorrect, please obtain written correction fr~ the financial institution, attach a cOPY to this fo~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Co..onwealth of PennSYlvania. Questions.ey be answered .bY calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 36012-04 Date 02-01-2001 Established To insure proper credit to your account, two (2) copies of this notice .ust acco.panY your pay.ent to the Register of Wills. Make check payable to. "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 3,945.82 X 16.667 657.65 X .00 .00 TAXPAYER RESPONSE NOTE. If tax pay.ents are .ade within three (3) .onths of the decedent's date of death, you .ay deduct a 5X discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. PART [!] e above infor.ation and tax due is correct. 1. You.ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or YOU .ay check box "A" and return this notice to the Register of Wills and an official assesseent will be issued by the PA Depart.ent of Revenue. [CHECK ] ONE BLOCK ONLY B. r=J The above asset has been or will be reported and tax paid with the PennSYlvania Inheritance Tax return to be filed bY the decedent's representative. C. r=J The above infor.ation is incorrect and/or debts and deductions were paid bY you. You .ust co.plete PART ~ and/or PART ~ below. If YCLIlI indicate a different tax rate, please state YOUr relationship to decedent: PART l!J TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART I!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) . Under penalties of perjury, I declare that the to the best~. my ~elief. SIGNATURE facts I have reported HOME { I WORK { TELEPHONE above are true, correct and > ~.s-r_/ " a >- NUMBE DATE /' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 !::' =(vy: r( " HARRISBURG, PA 171211-11'6'01" , cW INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-07-3:lt.! 07111276 03-16-2007 "REV.154J EX AFP C09.00) EST. OF JOHN R ROBERTS 5.5. NO. 184-03-2419 DATE OF DEATH 01-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT Ii] SAVINGS o CHECKING o TRUST o CERTIF. 2001 tlPR -3 Mill!: 46 C! ER(Z ORP'H7\f~"C; 0111 !RT . t' 1;,"\[', '....1. \.j\....I..,; " CU.'" "I '"'-' JUNE ROBERTS 23 CAMBRIDGE CT CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Depart.ent with the infor..tion listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU were a joint owner/beneficiary of this account. If YOU feel this info~ation is incorrect, please obtain written correction fr~ the financial institution, attach a cOPY to this fo~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the CO..onwealth of PennSYlvania. Questions.~ be answered by calling (717) 7B7-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 36012-00 12-21-1983 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART ill Date Established To insure proper credit to your account, two (2) copies of this notice .ust acc~pany your pay.ent to the Register of Wills. Make check payable to. "Register of Wills, Agent". x 370.06 16.667 61 .68 .00 .00 TAXPAYER RESPONSE NOTE. If tax pay.ents are .ade within three (3) .onths of the decedent's date of death, yoU .ay deduct a SX discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. x 1!ll!1f':'f'%-ilif.=;;'~"'C;:""'F'F"~'];"'":;H;:';;"~"""'C'" ~ii'*"CF'dlE!f",:;"=w,=,,,,1j;.m:"''!l''~:!l!::jf~;;'1''J;~'' '";;''''"'''':;:;;))!li;:fr:;~'=!1lF.:~''~'''''''':F.rlh''''''i!'i:"''''''''Jr''I''''l'i';;'C'''"''''";j!j!l!;HII!lmF""~'""";'}t:l!!r-"jEf.:m='-"'_"1 ~::B;.'l,/ ,~, '1:':1', -~::: -:f,"'f;.f~:r*. ,~. s. .::::.:" ~:i;: t"'13p;;E: ~::;::"~t:~-!jf:B:'i:,:J..,,)l!l!" E '" : :b":~ :~,::=<;~:".:' ::",. f.TJ :~' ~ ',:f!: ,';;'.}'. -; '~_~l~ lijfrti::.i[;f..h~ :P)~Ti;i_" r~-..-.rJS.;nHF:;;:;::~-~-t~-E!:-::r>t,-.:-..:n:.n,"~:w:.El..:.1t-:~:"t;1-:1-t_}<~__ :1-t>r1t:t:'t.*7.amt~:p:H:-:r_-...m:i:~4-:r:iEEthrm*;AAgh:.ti::ili.. -:H:{:~:1-:r:a:-:.t':;::,1>~lt-;f:ili m:~.f!m:wj{ili.51EF::{-;r:..~-_*;lliMt1fu..'x-~*1-1t.~.;Hrnlt*!-,,":r~.r~'m:-.r:n:1Hf-qm::;tiP4!-..... [CHECK ] ONE BLOCK ONLY A. ~e above infor.ation and tax due is correct. 1. You.ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or YOU .ay check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. B. c:J The above asset has been or will be reported and tax paid with the PennSYlvania Inheritance Tax return to be filed by the decedent's representative. C. c:J The above infor.ation is incorrect and/or debts and deductions Were paid by you. You aust co.Plate PART 0 end/or PART 0 below. PART ~ TAX RETURN - COMPUTATION If YOU indicate a different tax rate, please state your relationship to decedent: OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED [!] LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due DATE PAID PAYEE DESCRIPTION AMOUNT PAID . TOTAL (Enter on Line 5 of Tax Computation) TAXPAYE facts I have repor~ed above are HOME ( WORK .c TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 :~T('r1:""<I' HARRISBURG, PA 17128-06111 '.'..1'. . .::..." r7'/r*, ' , , 1-,' ".,", \.... ..,. ~,' .. INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-07-0324 07111213 03-16-2007 'I" ." jlf:~Hm EX AFP 10', DOl ZD07 APR -3 M111: 46 EST. OF JOHN R ROBERTS 5.5. NO. 184-03-2419 DATE OF DEATH 01-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT iii SAVINGS o CHECKING o TRUST o CERTIF. ClEr.." r.c . . .tiY\ Ui ORPHAN'S COURT. ("lif..".... \J i' JUNE ROBERTS 23 CAMBRIDGE CT CARLISLE PA 17013 REMIT PAYMENT AND FDRMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Departaent with the info~ation lishd below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU were a joint owner/beneficiary of this account. If yOU feel this info~ation is incorrect, please obtain written correction froa the financial institution, attach a COpy to this fo~ and return it to the above ~ddress. This account is taxable in accordance with the Inheritance Tax Laws of the Coaaonwealth of PennaYlvania. Que.tions aay be anSWe~ed by calling (717) 787-8327. COMPLETE PART 1 BELOW · . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 36012-05 Date 10-17-1997 Establ1shed To insure proper cradit to your account, two (2) copies of this notice aust acc~pany your PBYaent to the Register of Wills. Make check PBYable to. "Register of Wills, Agent", Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 19,099.28 X 16.667 3,183.28 X .00 .00 TAXPAYER RESPONSE NOTE. If tax PBYaents ara aade within three (3) aonths of the decedent's date of daath, YOU aBY deduct a 5% discount of the tax due. Any inheritance tax due will becoae delinquent nine (9) aonths after the date of death. PART [!J he above inforaation and tax due is correct. 1. You aay choose to reait payaent to the Register of Wills with two copias of this notice to obtain a discount or avoid interest, or YOU aay check box "A" and return this notice to the Register of Wills and an official assessaent will be issued by the PA Departaent of Revenue. [CHECK ] ONE BLOCK ONLY B. c:J The above assat has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. c:J The above inforaation is incorrect and/or debts and deductions were paid by you. You aust coaplete PART ~ and/or PART ~ below. If yoU indicate a different tax rate, please state YOUr relationship to decedent: PART [!] TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due TAX ON JOINT/TRUST ACCOUNTS OF 1 2 3 4 5 6 7 8 X x PART [!] DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) . Under penalties complete to the best tZ, TAX SIGNATURE declare that the facts I and belief. have reported above are true, correct and HOME (1/'7) 4<;-&>- /sJ~ WORK (_) TELEPHONE NUMBER DATE ~ COMMONWEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 r"~~(, HARRISBURG, PA 17128-06'01--.." ,,''''r-~ '~I~~ INFORMATION NOTICE AND TAXPAYER RESPONSE NO. 21-D7-03..2 t{ 07111292 03-16-2007 ':.o-tSQ EX MP (09-00) FILE ACN DATE CI fie:;; ('F - . ,f, " ORPHM,"C; /"''-''1 Rr t"'l1f, I; ;1" "_' \.~".::...~< ! vi! rM rr, EST. OF JOHN R ROBERTS 5.5. NO. 184-03-2419 DATE OF DEATH 01-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST /Xl CERTIF. 20U7 APR -3 Af111: 46 ** JUNE ROBERTS 23 CAMBRIDGE CT CARLISLE PA 17013 REMIT PAYMENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HEHBERS 1ST FCU has provided the Depart.ent with the inforaation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, yoU Were a jOint owner/beneficiary of this account. If YOU feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the CO..onwealth of PennsYlvania. Questions.~ be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW · . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 36012-46 04-06-2006 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART I!l Date Established To insure proper credit to Your account, two (2) copies of this notice .ust accoapany Your pay.ent to the Register of Wills. Make check payable to. "Register of Wills, Agent". x 2,200.45 50.000 1,100.23 .00 .00 TAXPAYER RESPONSE NOTE. If tax pay.ents are .ade within three (3) .onths of the decedent's date of death, YOU .~ deduct a 5% discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. x [CHECK ] ONE BLOCK ONLY he above infor.ation and tax due is correct. 1. You.ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or YOU .ay check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. B. c:J The above asset has been or will be reported and tax paid with the PennSYlvania Inheritance Tax return to be filed by the decedent's representative. C. c:J Tha above infor.ation is incorrect andlor debts and deductions Were paid by you. You .ust co.plete PART [3] andlor PART m below. If yoU indicate a different tax rate, please state your relationship to decedent: PART I!J TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART ~ DATE PAID PAYEE x OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) I . TA perjury, I declare that the facts I ledge and belief. DATE true, correct and -/~~ S HOME ( WORK ( TElEPHONE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280'01 HARRISBURG, PA 17128-0'01 Jr..... ....L.t. ,.~ INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-07 -~ 'f 07111282 03-16-2007 REV"SS43- EX, AFP (0'.00) 2D07 APR - 3 fU'l 1/: 46 EST. OF JOHN R ROBERTS S.S. NO. 184-03-2419 DATE OF DEATH 01-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST !XJ CERTIF. 0'"'1 Er.!/ , """f' '- ~I . \ ORP' Jf', \T, o I ,r-. .:'~ ~~ ('/ p".' V'-' , C:C;:.1RT JUNE ROBERTS 23 CAMBRIDGE CT CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Depart.ent with the infor.ation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you Were a joint owner/beneficiary of this account. If YOU feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the CO..onwealth of PennSYlvania. Questions.ay be answered by ca11ing (717) 787-8327. COMPLETE PART 1 BELOW · . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 36012-47 Date 04-06-2006 Established Account Balance Pe..cent Taxable Amount SUbject to Tax Tax Rate Potential Tax Due x 3,120.26 50.000 1,560.13 .00 .00 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice .ust acco.pany your paY.ent to the Register of Wills. Make check payable to. "Register of Wills, Agent". x NOTE. If tax pay.ents are .ade within three (3) .onths of the decedent's date of death, YOU .ay deduct a SX discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. PART [!] A. ~e above infor.ation and tax due is correct. 1. You.ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU .ay check box "A" and return this notice to tha Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. [CHECK ] ONE BLOCK ONLY B. c:J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. c:J The above infor.ation is incorrect and/or debts and deductions were paid by you. You .ust co.plete PART ~ and/or PART [!] below. If YOU indicate a diffe..ent tax ..ate, please state you.. ..elationship to decedent: PART I!J TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Pe..cent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART [!I DATE PAID DEBTS AND DEDUCTIONS CLAIMED OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID Unde.. penalties complete to the best el. T PAYER SIGNATURE TOTAL (Ente.. on Line 5 of Tax Computation) . pe..ju..y, I declare that the facts I my knowledge and belief. have ..epo..ted above a..e t..ue, co....ect ~d HOME ( '7) ~..s-g-- /~ ~ WORK (- ) TELEPHONE NUMBER DATE COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE IUREAU OF INDIVIDUAL TAXES DEPT. 210601 HARRISIURG. PA 17128-0601 "'..'.- "j ;, ;'-......", :"',- i I, I, - " ,-, 'j - IHFORMATION NOTICE AND :TAXPAYER RESPONSE FILE ACN DATE NO. 21-07-0.3:2'/ 07111280 03-16-2007 REV"1543 0: 1m ca9.. DOl 2007APR-3 Ml!1:46 CLEm( OF ORP-Ht,r\i'(~ ("',"',1 'RT r I , " .. '"J '-.....;'\.j\j I! ClJ[\ ,~-: '~- EST. OF JOHN R ROBERTS 5.5. NO. 184-03-2419 DATE OF DEATH 01-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS IiJ CHECKING o TRUST o CERTIF. JUNE ROBERTS 23 CAMBRIDGE CT CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Depart.ent with the inforaaUon listed below which has bun used in calculating the potential tax due. Their racords indicate that at the death of the above decedent. YOU were a joint owner/beneficiary of this account. If yOU feel this infor.ation is incorrect. please obtain written correction fro. the financial institution. attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Coa.onwealth of PennSYlvania. Questions.ay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW · . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 36012-11 Date 09-14-1992 Established Account Balance Percent Taxable Amount SUbject to Tax Rate Potential Tax Due x 12,354.27 16.667 2,059.09 .00 .00 TAXPAYER RESPONSE To insure proper credit to Your account. two (2) copies of this notice .ust accoapany your pay.ent to the Register of Wills. Make check payable to. "Register of Wills. Agent". Tax x NOTE. If tax pay.ents are .ade within three (3) .onths of the decedent's date of deeth. YOU .ay deduct a 5X discount of the t.x due. Any inheritance t.x due will beco.e delinquent nine (9) .onths after the date of death. PART !IJ A. ~ above infor.ation and tax due is correct. I. You.ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest. or YOU .ay check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. [CHECK ] ONE BLOCK ONLY If YOU indicate a different tax rate. please state YOur relationship to decedent: I. c:J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. c:J The above infor.ation is incorrect and/or debts and deductions were paid by You. You .ust co.plete PART ~ and/or PART ~ below. PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID Under penalties of complete to the best of a I TOTAL (Enter on Line 5 of Tax Computation) . perjury. I declare that the ~d belief. facts I have reported above are true. correct and ~-;?-/9-~ HOME ( WORK ( TEl EPHONE ) } NUMBER DATE