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Home My WebLink About01-0595 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 *' /6-.;2 39../ INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. ACN DATE 21-0/- 6-90- 01129193 06-13-2001 REY-l54S EX AFP ID9-DDl EST. OF MABEL KNOUSE S.S. NO. 205-16-4190 DATE OF DEATH 03-31-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [X] CHECKING o TRUST o CERTIF. BRENDA CHAPMAN 2009 LINCOLN ST CAMP HILL PA 17011 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAYPOINT BANK 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 accord~nce wit~ th~ Inheritanc9 T~~ Laws of the C~~nW8alth 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. 90052598 Date 03-08-1982 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 1,279.28 50.000 639.64 .15 95.95 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 5X discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) ~nths after the date of death. Tax PART m A. [ CHECK ] ONE BLOCK B. ONLY c. ~ The above infor.ation and tax due is correct. ~l. You .ay choose to re.it pay~nt 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~nt of Revenue. 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=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 [!] 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 S. 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 (Enter on Line 5 of Tax Computation) I $ Under penalties of perjury, I declare that the facts I complete to the best of my knowledge and belief. A.Ir' -'~ A /'I ~ t.1-L/ ~~A~ ~~W'r~GN~':URE Y-' . ~n ./ have reported above are true, correct HOME (1/1) 7iR/ - cZ 763 WORK ( ) TElEPHONE NUMBER and ~-IR-o/ DATE - - - - - - :- - ::- - - f ::- - :: ::- - ::- - - - - ::- - - :- - - - - - ::- ::- - - - :rOzml ~m:rC: :U"m:Uo :U:-f:U~m ~~~c:l C:CS;zo:U :uoC')"~ C)oo4mzm l ~9~ 004 ><So "" 00" 004 -c: it\) S ~ :u re,...~ ol:~ m o z z 004 c: rBm 9 111 .. (] 25 tl ;;! so~ ("1 '0 \O~ 8 ~t:(] _.:= :r ==ntIJ v 0 '0 "t:I S" 3 >~~ "-l o - - N "6' n i I ~l 'n~) '~') - - - - --.-.-._._--"~.--~...-.---.._-~ .- 'T1 .... ~ ~ ~ ..- "- ...... ~ J::Ot~M~)~Ttt-,Of PENt$Yt.VANlA oep~"(JF,,RE\J!NUE ,,".U,~.,~AL TAXES osn-,280801 '... · .. ." HAAf)\S8URG; PA 17128-0601 c~,.-NIW\ t.. "" ,t..'1~8._r.T .~ '. HIL.L., ..PWI' 1?'011 ~_.'--" ----.- No.AA 496163REV-1162EX(11.96) PENNSVL VANIA INHERIT ANCE AND EST ATE TAX OFF'C'AL RECE'PT ACN ASSESSMENT CONTROL NUMBER 101 saN 805-16-4190 (FIRST) " (MI) .,' AMOUNT $95. 9~5 FOLD HERE " . I, t.' TOTAL AMOUNT pAID '~ "'~ . '. ~'... ij,. ';. ~ ~ ~ .; ~- ..~5. 95 .. .. " RECEIVED BY ':~~'1~ ~~~~SrERLE !ii',",!!,,! REGISTER OF WILLS "'" ",' "{',"j!i<d.,",,,--~. ---- ---~. - . ._- -- --- ------ --~--~-.~ 10--;).31" - / BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT <)~* REY-1U7 EX AFP (12-10) BRENDA CHAPMAN 2009 LINCOLN ST CAMP HILL PA 11011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-04-2001 KNOUSE 03-31-2001 21 01-0595 CUMBERLAND 01129193 MABEL AlIOunt Re.i tted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... REY=i6cf'f-Ex-AFP-fi'2=ooY------...--iNiriiiTANci:--YA3r-STAfEMENY-OF'-AccoDiif--.-..--------------------- ESTATE OF KNOUSE MABEL FILE NO. 21 01-0595 ACN 01129193 DATE 09-04-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE. OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-03-2001 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 95.95 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-19-2001 AA496763 4.80 95.95 TOTAL TAX CREDIT 100.75 BALANCE OF TAX DUE 4.80CR INTEREST AND PEN. .00 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 4.80CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT.. (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J