HomeMy WebLinkAbout01-0211
COMMONWEALTH OF PENNSVLVANIA
Or:PARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO.
ACN
DATE
/~~;) (/)- /0
21'" 0 , .., Cl.JH
01100409
01-15-2001
REV-lS45 EX AFP (09-001 1
EST. OF HOMER D EBERSOLE
5.5. NO. 196-14-1119
DATE OF DEATH 09-30-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
[X] TRUST
o CERTIF .
MOLLIE KESSLER
968 SILVER LAKE RD
LEWISBERRY PA 17339
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS 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 froM 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 answe~ed by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 30-66-309926 Date 04-26-1997
Established
x
34,170.73
100.00
34,170.73
.15
5,125.61
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".
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
NOTE: If tax pay.ents are .ade within three
(3) months of the decedent.s date of death,
you .ay deduct a 5% discount of the tax due.
Any inheritance tax due will beCOMe 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 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 .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.
[] 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.ation is incorrect and/or debts and deductions were paid by you.
~vou .ust co.plete PART ~ and/or PART ~ below.
x
If you indicate a different~ ~~p1ease 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
TAX ON JOINT/TRUST ACCOUNTS
4- :;Llo -l&t 0'
'2>YJ 110.. 13
100 0]0
?'Yj 110.,3
()
;?>\..f 110.'13
1.'-
::!.~
II 5c~ I to '1
DEBTS AND DEDUCTIONS CLAIMED
x
PART
[!]
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
Under penalties of perjury, I declare that the
complete to the best of my knowledge and belief.
1'1~ ,ff1. I~
facts I have reported above are true, correct and
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
.'1-
~C/
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEKENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
/
l..
REY-1548 EX AFP elt-GU>
MOLLIE KE'SSLER"
968 SILVER LAKE RD
LEWISBERRY Ii PA 17339
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
- ACN
04-16-2001
EBERSOLE
09-30-2000
21 01-0211
CUMBERLAND
196-14-1119
01100409
Allount Rellitted
HOMER
D
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:IfV;i5~i-E:X:-AFil-(i1f:oO)------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-16-2001
ESTATE OF EBERSOLE
HOMER
DDATE OF DEATH 09-30-2000
COUNTY
CUMBERLAND
FILE NO. 21 01-0211
TAX RETURN WAS:
S.S/D.C. NO. 196-14-1119
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01100409
FINANCIAL INSTITUTION: HARRIS SAVINGS BANK
ACCOUNT NO.
30-66-309926
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS ( ) CHECKING (X> TRUST ( ) TIME CERTIFICATE
04-26-1997
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
34,170.73
1. 000
34,170.73
.00
34,170.73
.45
1,537.68
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."
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-22-2001 AA478059 .00 1,537.69
TOTAL TAX CREDIT 1,537.69
BALANCE OF TAX DUE .0ICR
INTEREST AND PEN. .00
TOTAL DUE .OICR
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
-- ~~..... nile T~ RFFLECTED AS A "CREDIr-"_.L~~!.!. Y<!U HAY BE DUE A REFUND.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
~ I ., - /6
/~_O"o(,
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
U
FILE NO. 21 - (') j- tJ;; II
01100411
01-15-2001
ACN
DATE
REY-154S EX AFP '09-001 I
EST. OF HOMER D EBERSOLE
S.S. NO. 196-14-1119
DATE OF DEATH 09-30-2000
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
[X] TRUST
o CERTIF .
CAROLYN HOOPER
4815 CAPE SAN BLAS RD
PORT SAINT JOE FL 32456
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HARRIS SAVINGS 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 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. 30-66-309927 Date 04-26-1997
Established
x
34,170.73
100.00
34,170.73
.15
5,125.61
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".
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 57. 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.
c=l The above infor~tion 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.
c=l 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=l The above infor~tion is incorrect and/or debts and deductions were paid by you.
You .ust co~lete PART 0 and/or PART 0 below. . "
x
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
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
Under penalties of
complete to ~~f
(J/1A~~ .
perjury, I declare that the facts I have reported above are true, correct and
my knowledge and belief,
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
c;1- ~
V~
NOTICE OF INHERITANCE TAX
APPRAISEKENT~ ALLONANCE OR DISALLONANCE
OF DEDUCTION~, AND ASSESStlENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
RE'/-1!i48 EX AFP (U-Ol>
CAROLYN HOOPER
4815 CAPE SAN BLAS RD
PORT SAINT JOE < fL 32456
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
09-03-2001
EBERSOLE
09-30-2000
21 01-0211
CUMBERLAND
196-14-1119
01100411
Allount R_itted
HOMER
D
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 ..
i-Efv=is~8-i3f-AFFi-(i1f=oOi)------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 09-03-2001
ESTATE OF EBERSOLE
HOMER
D DATE OF DEATH 09-30-2000
COUNTY
CUMBERLAND
FILE NO. 21 01-0211
TAX RETURN WAS:
S.S/D.C. NO. 196-14-1119
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01100411
FINANCIAL INSTITUTION: HARRIS SAVINGS BANK
ACCOUNT NO.
30-66-309927
TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING (x> TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 04-26-1997
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
34,170.73
1.000
34,170.73
.00
34,170.73
.15
5,125.61
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."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-21-2001 AA496765 .00 5,125.61
TOTAL TAX CREDIT 5,125.61
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.
-- ~^~AI nile To::. RFnECTED AS A "CREDIT.._!_~~).!. Y~U MAY BE DUE A REFUND.