HomeMy WebLinkAbout01-0162
\ I
~\?V
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
1/ G~ d 09- :P
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
s: rI.
(:-
FILE NO. 21 .- ~)/ / h ~
ACN 00130933
DATE 08-15-2000
~
REY-154S EX AFP (07-00)
EST. OF MARJORIE M MYERS
S.S. NO. 177-24-6176
DATE OF DEATH 05-12-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
00 CHECKING
D TRUST
o CERTIF.
CYNTHIA HOLSTE
133 S 18TH ST
CAMP HILL PA 17011
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS BANK has provided the Department with the information 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 information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may bA an$~ered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 04-00012742 Date 04-10-1996
Established
Tax
1,526.35
16.667
254.40
.15
38.16
TAXPAYER RESPONSE
...:iLjiiiiREM1TIimiINm:AH::i:HFI "j;iii:iTAliiiij..
..................._..._._.....uu......_....._._._._._._......._..._._._._._._._............... ._......................._.....
.........-...-.......................................................-.................-...-.-. ...............-...................
.-.-...........-..................................................................................... .-................-.............
. . . ". ....
To insure proper credit to your account, two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
x
NOTE: If tax payments are made within three
(3) months of the decedent"s date of death,
you may deduct a 5Z discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
[I] iiiWFAiILURliWTOWiile.
...'''..,....,....:';:;iii_SEDW:iON::imtHI$iii:~ICI:::!ii
.......................................-.........................-...........-...............-.-.................-.-.....-.............
.........-.-.................-.-.........-...-.............-.....-.................-.....................-...-.....-..................
.....-...-....... .-...............................-.---.---..-.-.....----..-.-.-.........-.....
" "
[CHECK]
ONE
BLOCK
ONLY
A. The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. [] 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. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
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
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL CEnter on Line 5 of Tax Computation)
of perjury, I declare that the facts I
of my knowledge and belief.
. /1 f
;i-J/ /; Y'
t. <L. _ C
I
$
and
() . ~~, 0 /
DATE
...
~
,
~'1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
/ L;-' J09,-~
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO.
ACN
DATE
,-,,./
'>J(
21 ._{J/ .-/&;l.
00130931
08-15-2000
REV-154$ EX AFP (07-00>
EST. OF MARJORIE M MYERS
S.S. NO. 177-24-6176
DATE OF DEATH 05-12-2000
'COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
fX] CHECKING
o TRUST
o CERTIF.
CYNTHIA HOLSTE
133 S 18TH ST
CAMP HILL PA 17011
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS BANK has provided the Departllent with the information 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 information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Psnnsylvania. Ouestio"s may be ans~qred hy calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 04- 03- 007004 Date 09 -14 -1995
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
86,809.83
16.667
14,468.59
.15
2,170.29
TAXPAYER RESPONSE
'''''';~F: :i:"
............... .......-.
To insure proper credit to your account, two
(2) copies of this notice lIust accompany your
paYllent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Tax
x
NOTE: If tax payments are lIade within three
(3) months of the decedent's date of death,
you lIay deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
IT]
i1FAiILUlIWiintiiiii""
.-.-.-.........-.-.-.-.........-...-.-.-.....................
.......-.-...........-...-.............-...
.............-.-.-............-.-.-.......
he above information and tax due is correct.
You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or YOU may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
[CHECK l
ONE
BLOCK
ONL Y -
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 information is incorrect and/or debts and deductions were paid by you.
You must complete 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
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
declare that the facts I
and belief.
I
$
and
"'I (""y /
0< -/f' 0
DATE
E
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
l lo - ;) oct - '3
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
* * REVISED NOTICE * * *
REY-1S45 EX AFP (09-00)
FILE NO. 21 - 0\ - I\D~
ACN 00130932
DATE 11-09-2000
EST. OF MARJORIE M MYERS
S.S. NO. 177-24-6176
DATE OF DEATH 05-12-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[X] CHECKING
o TRUST
o CERTIF.
SANDRA J WINTERS
332 CHARLES ROAD
MECHANICSBURG PA 170SU
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS BANK has provided the Departllent 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 calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 04-03- 007004 Date 09-14-1995
Established
x
86,809.83
16.667
14,468.59
.15
2,170.29
TAXPAYER RESPONSE
''''''')~ilili~lliii~!m!ITI~~~!~~~Wi:Jft~~:i:i:Il.~~illiM~~'l'i:.W:~~~$:,W"~i.~~lill!
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 Rate
Potential Tax Due
x
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent's date of death,
you .ay deduct a 5% discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
Tax
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
The 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 "An and return this notice to the Register of
Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue.
[] 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.
[] The above infor~tion is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below.
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX
LINE
RETuRN - COMPUTATION OF
1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT;TRUST ACCOUNTS
......-.-.......-...........................................
.P........."""",,,,,,,,,,,,,,,,,'. "::'::::::;;:;:;~:i::iiilij;m;!i;i:i;;,m;iii!mm;j:
..._......... ....;;:;:;..~:~I;;~;;;:::;;;~i~;!;~i;~!;:r~;~~U;~;;;~;~;;;~i:~;;Ei~~;;;~;;;~;;~i;;;:;;~:;;;i~;~~~;;~~~;;;~;~;;~;~~~~~~~;~;~;~!;;~!~~;~;;;
;::;.:,:: ':.:;.;8..:: \.;: :' 'j i:: '.' . :,);:;\:1,';:;:;,,:,': : .-::. : .::.::.:.:: :::.::.:;,..::::::::: ':::::'P:':"Ti:;';:;;:
x
x
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the facts I
lete to the best of my knowledge and belief.
~)/~~~ .
ATURE
have reported above are true, correct
HOME ('7/7) 1/37-0d't/?
WORK ( )
TELEPHONE NUMBER
and
''ii~/t>/
ATt
<0
i.
x
<(
~
w
~
<(<(
-~
zen
<(w
>0
...Jz
>-<(
en
zW
zU
wZ
0.<(
t:
a:
w
:I:
~
<(
z
<(
~ C/)
>- w
~w~ 0
z::::J1- gs
wZ-, cD
~~~ N
O~Q ;::::
:CLL~ <(
':Joe 0...
<(I-~ 0
wZu..oa::
s~oc.o::::J
zl-::l::i5co
Oa::<N~
~~~b::~
OW::lW<(
()OmOI
x
w
C\J
'f.
:>
w
a:
en
m
v"r)
t'''-".
r-
""d"
<{
<(
o
z
\-
Z
:::::>
o
~
<(
~
c..
-
w
U
w
a:
...J
<C
-
U
-
u.
u.
o
\-
Z
wc)a:
z~a:w
o(/)\-a)
<((/)z~
wO:::::>
~oz
<(
~
o
a:
LL
C
W
>
jjj
U
w
a: L
: ")
-;;.'
j r:~~
'-)
! 'j
'-'
,-
i_) ~~:
~
~<
::~
w
a:
w
:r:
o
o
LL
z
o
f=
<(
2
a:
o
LL
Z
Ul
f-
<(
f-
(f)-1
ffi Ul u:
:r:
o
E2
~
~
(f)
a::
~
~.; :;
T:
W,'-
~~::,
~.-
a::' .
<(
:'E
I-
(f)
o
0...
o
~
Q..
\-
Z
:::::>
o
~
<(
.....J
<(
I-
o
I-
i: ,-'
Z
::J
o
()
:C"':
I-
<( '.
W
Oi'-
LL
o
W
I-
<(
o
>-.
a)
o
w
>
W
o
w
a:
(f) I
g
;:;>
LL
o
a:
w
f-
(f)
~
W
[(
(/)
::.:::
cr:
<(
~
w
cr:
.....J
<(
W
(/)
><
<
I-
LU
I-
<<
_I-
zen
<tLU
>0
..JZ
><
enLU
Zo
ffiz
Q.c(
C
a:
LU
::t:
Z
<:(
z
<:(
~ (/)
>- UJ
~w~ 0
z::J1- ~
WZ.... cb
o..UJc:( C\J
LL~::l ;:::
OXe
ILL::= <:(
~OC 0..
<:(f-~ <5
WZu..OIT:
S~O<O::J
Zf-::l~ro
Oa:c:(C\J~
~~~t:~
OW::lW<:(
UOmOI
-"~'. ,.......' """I. .""T"l'I'
(0
q>
x
w
C\J
<0
:>
W
0:
ex)
m
<.1)
r--
t--
lid"
<(
<(
o
Z
I-
Z
:J
o
:2:
<(
I-
a.
-
w
(.)
w
a:
-I
<3:
-
(.)
-
LL
LL
o
I-
z...J([
UJo
z:2:([~
oUJI-:2:
<(f.Bz:J
UJoz
UJO
<(
~
o
cr
u.
o
UJ
>
jjj
()
~ L
.....~~
"
I
I
;,':'
<";::
,,",'"
w
a:
w
:r
o
~
~
z
o
i=
e:(
~
a:
o
LL
Z
W
l-
e:(
I-
w CJ)
a: W
w
:r:
g
~
(1:
f=' '''::,
Cf) .,-'
<:(
::::!- '.
..-. ..- ..:
Z f-
W Z ,_.
o WI!
~.~ ~.
W <(
o '" 0..
~ 7 ~
W W
:2: f-
<:( <(
Z 0
W
f-
<:(
o
::.::: .,
IT: . ..
<:(
:2:
f-
(f)
o
CL
\
,
,?
o
<C
a...
I-
Z
:J
o
:2:
<(
...J
<(
I-
o
I-
C.f)
.-1
_.J
S
LL
o
a:.
UJ
l-
V)
:~~
.jJ
"r
>-
f-
Z
:J
o
U
c.
'I,
I r:.r
f-..
<:( '.
~ tfl ~
LL ([
o <(
W ~
f- UJ
;3 ([
...J
<(
UJ
UJ
i.O
If
f ::
x
L!J
(\J
co
,~ >-
l' L!J
CC
.........
(j')
01
,........
l'-
~
<C
<1;'
0
Z
><
ct l-
t-
W Q.
I- -
ct~ UJ
zen 0
ctW UJ
'::>0 a:
....IZ
>-ct -I
enW <t
Zu
~Z -
(J
a.ct -
l- LL
a: u.
W 0
.J:
~
LU
cc
LU
:r
Cl
~
I--
2
~
o
~
c;( ~d
I--
2-1cr:
UJo
Z~a:UJ
r, CJ) I-- CO
~ CJ) Z ~ '_
UJO::J
~OZ
<{
r
~
v
"
-,
i='
(f)
cr:
~
c.,
:
2: ~,:~
0 <( "-j
i= 2 '-
~~
<( I--
~ Z I--
a:: W Z W--,
0 o iI; wu ~:.<
l.L -.. W-, ~:'
~ cr U' ; >- ,~ 0
W W...;;.) <( :x: "
a:J '~ 0 .. Q : cr::
l.U ::? u. u. <(
f- :) : 0 0 ~
~ Z W W I--
W ::? I-- (/)
LU (fJ -J <( <( 0
cc l.U iL Z 0 Q
w
:r
Cl
2
1"0..
<(
z
<(
> en
-J
>- W
(f) >< 0
ZWc:r
Z:::JI- CD
0
wZ-l r:h
QWc:r C\J ,.j
u..>:::> r::. i;i -. -,
OLUe ...,-
cr:_ 0
Iu..~ <(
f-oe a. a:
;il--~ cj I.L
LUZu..ocr 0 ,
$~OCD:::J w
zl--:::>55OJ > .;.,
Ui - (1"
ocr:<(C\J~ .J..
~<(wr-:cr: U
::?a.a::a.cr: W L
OLU:::>W<( a:
UOQ)OI
o
<(
0-
I--
Z
::>
o
~
<{
-1
~
o
I--
r"::
I-- ~,
<( "
W
0,,"':
U.
o
UJ
f-
<(
o
...../)
-.J
....J
~
#
LL
o
a:
w
!-
U)
C)
"JJ
c:
CJ)
~
a::
<{
~
lJ.J
a:
....J
<(
lJ.J
CJ)
J/(,.- ---~-)
f (.;..?
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
/~ {I
'7 f\
-",
VI
J
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (12-00)
CYNTHIA HOLSTE
133 S 18TH ST
CAMP HILL PA 1701l
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
04-23-2001
MYERS
05-12-2000
21 01-0162
CUMBERLAND
177-24-6176
00130931
MARJORIE
M
Amount Remi H:ed
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE,,:i5lr8-Ex--AFP--(12-~OOl------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-23-2001
ESTATE OF MYERS
MARJORIE M DATE OF DEATH 05-12-2000
COUNTY
CUMBERLAND
FILE NO. 21 01-0162
TAX RETURN WAS:
S.S/D.C. NO. 177-24-6176
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
00130931
FINANCIAL INSTITUTION: HARRIS SAVINGS BANK
ACCOUNT NO.
04-03-007004
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE
09-14-1995
X
86,809.83
0.166
14,468.59
.00
14,468.59
.15
2,170.29
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."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-08-2001 AA477997 .00 2,170.29
TOTAL TAX CREDIT 2,170.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
/ ' ,j,,-- --)
(" '.,/ / J( 1_ '....,
..{. ,,~I '-,....
BUREAU OF INDIVIDUAL TAXES
INHCRITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(7 (,
o
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
,-
./
REV-1548 EX Arp <12-00)
SANDRA J WINTERS
332 CHARLES ROAD
MECHANICSBURG PA 17050
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
04-23-2001
MYERS
05-12-2000
21 01-0162
CUMBERLAND
177-24-6176
00130932
MARJORIE
M
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-V=15~8-EX--AFP--f12-:oo1------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-23-2001
ESTATE OF MYERS
MARJORIE M DATE OF DEATH 05-12-2000
COUNTY
CUMBERLAND
FILE NO. 21 01-0162
TAX RETURN WAS:
S.S/D.C. NO. 177-24-6176
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
00130932
FINANCIAL INSTITUTION: HARRIS SAVINGS BANK
ACCOUNT NO.
04-03-007004
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS (x> CHECKING ( ) TRUST ( ) TIME CERTIFICATE
09-14-1995
x
86,809.83
0.166
14,468.59
.00
14,468.59
.15
2,170.29
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."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-09-2001 AA477999 .00 2,170.29
TOTAL TAX CREDIT 2,170.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS lESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REfUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
-- )/i
>'l/
:---
---"
}
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHtR1TANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT} ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS} AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-154S EX AFP <12-00>
CYNTHIA HOLSTE
133 S 18TH ST
CAMP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
04-23-2001
MYERS
05-12-2000
21 01-0162
CUMBERLAND
177-24-6176
00130933
MARJORIE
M
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS --
R-E-v=is4-a-EX--AFP--C12-:oo1------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-23-2001
ESTATE OF MYERS
MARJORIE M DATE OF DEATH 05-12-2000
COUNTY
CUMBERLAND
FILE NO. 21 01-0162
TAX RETURN WAS:
S.S/D.C. NO. 177-24-6176
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
00130933
FINANCIAL INSTITUTION: HARRIS SAVINGS BANK
ACCOUNT NO.
04-00012742
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS (X> CHECKING ( ) TRUST ( ) TIME CERTIFICATE
04-10-1996
X
1}526.35
0.166
254.40
.00
254.40
.15
38.16
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."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-08-2001 AA477998 .00 38.16
TOTAL TAX CREDIT 38.16
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
;/;->> 9 - 3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
v
REY-1548 EX AFP (12-00)
SANDRA J WINTERS
133 S 18TH ST
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
07-16-2001
MYERS
05-12-2000
21 01-0162
CUMBERLAND
177-24-6176
00130934
MARJORIE
M
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE,,=i5~8-Ex--A~p--(i1f:oO)------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 07-16-2001
ESTATE OF MYERS
MARJORIE M DATE OF DEATH 05-12-2000
COUNTY
CUMBERLAND
FILE NO. 21 01-0162
TAX RETURN WAS:
S.S/D.C. NO. 177-24-6176
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
00130934
FINANCIAL INSTITUTION: HARRIS SAVINGS BANK
ACCOUNT NO.
04-00012742
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS (x> CHECKING ( ) TRUST ( ) TIME CERTIFICATE
04-10-1996
X
1,526.35
0.166
254.40
.00
254.40
.15
38 . 16
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."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 07-24-2001 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 38.16
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1.53
TOTAL DUE 39.69
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l