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Home My WebLink About01-0276 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 ! (; '-)/7--/ INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE 5Lc- NO. 21 -0/-). " 01102960 01-31-2001 REY-IS4S EX AFP (09-00) \...! , EST. OF B C LANCASTER S.S. NO. 195-07-9126 DATE OF DEATH 10-27-2000 COUNTY CUMBERLAND TYPE OF ACCOUNT !XJ SAVINGS o CHECKING D TRUST o CERTIF. BARBARA K HEIGES 7 YORK CIR MECHANICSBURG PA ll055 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 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 calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 175856- 05 Date 05-11-1998 Established x 11424.89 50.000 712.45 .045 32.06 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 SZ discount of the tax due. Any inheritance tax due will become delinquent nine (9) .onths after the date of death. Tax PART [!] -- "":::::~:mriISm:lIlilICI~m:r ............-...........-.....-...........-............................... .......................-.............-.-...........-.-.-.....-.-.-.....-.-.-.-...-. .-.-.-.-.-.-.-.-.....-.............-.....................-.......................-. [CHECK ] ONE BLOCK ONLY A. 8' 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 assessment will be issued by the PA Department 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. 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 OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 If you indicate a different tax ratel please state your relationship to decedent: PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax Computation) of perjurYI I declare that the facts I have reported above are truel correct and of my knowledge and belief. HOME (7/7) 7C-tt; - S-~</q 3//2/~')/ WORK ( ) TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 *' / ~- ,,,,"'17-/ INFORMATION NOTICE AND TAXPAYER RESPONSE v-c:; ? FILE NO. 21 -'DI-;,' 01102959 01-31-2001 ACN DATE REV-1543 EX AFP (09-00) EST. OF B C LANCASTER S.S. NO. 195-07-9126 DATE OF DEATH 10-27-2000 _, COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [XJ CHECKING D TRUST o CERTIF. BARBARA K HEIGES 7 YORK CIR MECHANICSBURG PA 170~~ REMIT PAYMENT AND FORMS TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU 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 be answered by calling (717) 187-83Z1. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 175856-11 Date 05-11-1998 Established x 5,122.81 50.000 2,561.41 .045 115.26 TAXPAYER RESPONSE ...:'i"'H~\i[i1I. ............".................... ................................. ...................-............ 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 NOTE: If tax pay.ents 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. Tax PART [I] ili!!!~I~~.!!!!~:; [CHECK ] ONE BLOCK ONLY A. [fJ 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. [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 complete PART ~ and/or PART ~ 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 S. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due TAX ON JOINT/TRUST ACCOUNTS OF 1 2 3 4 S 6 7 8 x PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line S of Tax Computation) Under penalties of perjury, I declare that the facts I complete to the best of my knowledge and belief. have reported above are true, correct and HOME (1/ 7 ) /~& - ')-L/Vc;f J //oZ/Ci / WORK ( ) TELEPHONE NUMBER DATE 1~C>>7-i COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE <,( ~ )G~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEftENTL ALLOMANCE OR DISALLOMANCE OF DEDUCTION~, AND ASSESSftENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-15'iS EX AFP <12-00> BARBARA K HEIGES ' 7 YORK CIR MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 06-05-2001 LANCASTER 10-27-2000 21 01-0276 CUMBERLAND 195-07-9126 01102959 Amount Remitted B C 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 ~ RlEfv:i5~i-Ex--AFP--(i2-:oo1------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-05-2001 ESTATE OF LANCASTER B C DATE OF DEATH 10-27-2000 COUNTY CUMBERLAND FILE NO. 21 01-0276 TAX RETURN WAS: S.S/D.C. NO. 195-07-9126 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01102959 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 175856-11 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS (X'> CHECKING ( ) TRUST ( ) TIME CERTIFICATE 05-11-1998 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 5,122.81 0.500 2,561.41 .00 2,561.41 .45 115.26 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 (-) 03-12-2001 AA478147 .00 115.26 TOTAL TAX CREDIT 115.26 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 SlOE OF THIS FORM FOR INSTRUCTIONS. ) J~,~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 1&<-~/7'-/ NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLOMANCE OR DISALLOMANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS Sf v' *' REY-1548 EX AFP HZ-DOl BARBARA K HEIGES 7 YORK eIR MECHANICSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 06-05-2001 LANCASTER 10-27-2000 21 01-0276 CUMBERLAND 195-07-9126 01102960 B C Amount Remitted PA 17;0,55 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:is~i-Ex--AFP--(i2-:oo1------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-05-2001 ESTATE OF LANCASTER B C DATE OF DEATH 10-27-2000 COUNTY CUMBERLAND FILE NO. 21 01-0276 TAX RETURN WAS: S.S/D.C. NO. 195-07-9126 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01102960 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 175856-05 TYPE OF ACCOUNT: DATE ESTABLISHED (X> SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE 05-11-1998 x 1,424.89 0.500 712.45 .00 712.45 .45 32.06 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 (-) 03-12-2001 AA478148 .00 32.06 TOTAL TAX CREDIT 32.06 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" ( CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J ~ ~ ~...,... ,~" ,..,. ~--- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No.AA 478148 REV-1162 EX (11-96) RECEIVED FROM: I ACN ASSESSMENT CONTROL NUMBER AMOUNT p(~nD{:jp{:~ 1< HE I GES 011 Oc~960 ~?~]2 . ()&I 'for::f'~ C i F<C:LE ME[HANICS8URG~ PA 17055 FOLD HERE FOLD HERE ESTATE INFORMATION: I FILE NUMBER C " " i:~I)O i... Of:..'7 b 5 S ~.J 1 f,' 5"" () "'7-.- c;. J. c~ t:J NAME OF DECEDENT (LAST) ~,JINC~:r::. T E F: b '..' (FIRST) (MI) DATE OF PAYMENT :3 ...' ,/,~~()() 1 POSTMARK DATE ::..:; i (:: /:::-:00 J. COUNTY ~~ Jc:' . ()b l_~ II tV': F~ E F~ L A r\J [) TOTAL AMOUNT PAID ~ ~.) /2"')../ L?(}()~:# ~.J r: '72; . . hi.. 1/ RECEIV~~,~;" ~(~#LJ~ oz;t1<,~I/'.L.C- F:L G 1 c.::; 1 L n.11F h~ I l,,, L ~~~ ~/tw.(/J REGISTER OF WILLS ~ DATE OF DEATH REMARKS Bt-\r-<B(IF~'{:\ r: ;--IF J. GE~) L, '; L L.' H 1 1 ~+ SEAL "",, - --- -- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No.AA 4 7814 7 REV-1162 EX (11-96) RECEIVED FROM: I ACN ASSESSMENT CONTROL NUMBER AMOUNT F;A;<CJ~l'~A i< HE r GE'~3 <) 11 02";>::'(1' ~, 1 1 ~:~~ . i2tJ '7 '.{un~< C I f';CLE :.i[CfiAf\! I C~;ElUnG. F'P. 1705~") - FOLD HERE ESTATE INFORMATION: I FILE NUMBER <.;' 1 2 () () 1 -f)276 S;;:;/'I! 9 ~:; .....0 "";J -- '} , E'6 i NAME OF DECEDENT (LAST) (FIRST) (MI) L {4 ;\j C ;~~; T E r{ B C DATE OF PAYMENT ',-, I 1 ::1 i~ f) () 1 POSTMARK DATE -, i 1 i:l /2()O ,:3 " COUNTY f_~ ~_,! ~~ B f~~ F~~ t~" (~) f~j Ll DATE OF DEATH .l 1,._ / ~'? ':~7 / i.::(.t(>~) :.::!H:,"{ l3 (-i 1'\ (.1 r, ;~t::. 1 bL:..:::; FOLD HERE ~ $ '~ 1 ~:S . ~~:tJ TOTAL AMOUNT PAID C>H_ ~= V H 1 1 :;') SEAL ",/"') " .Iii" //1 RECEIVED BY /~/ /(1/ t.(/ ~"l(iq y c:. nEel ~J~< REMARKS REGISTER OF WILLS ----- ------- ---- ---------- ----" - COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 260601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) N0. CD 012708 BARBARA K HEIGES 7 YORK CIRCLE MECHANICSBURG, PA 17055 fold ESTATE INFORMATION: ssN: 195-o7-si2s FILE NUMBER: 2101-0276 DECEDENT NAME: LANCASTER B C DATE OF PAYMENT: 05/06/2010 POSTMARK DATE: 05/06/2010 couNTY: CUMBERLAND DATE OF DEATH: 10/27/2000 REMARKS: CHECK# 814 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 51,691.32 TOTAL AMOUNT PAID: INITIALS: SAP 51,691.32 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER C)F WILLS REGISTER OF WILLS 4 15056051047 REV-1500 EX (06-05) OFFICIAL U SE ONLY PA Department of Revenue = County Code Year File Number Bureau of Individual Taxes ,~; ~ Po Box 2sosol ~~ T ~ INHERITANCE TAX RETURN ~J ' ~ ' ~/ ~~ ~ PA 17128-0601 ~ rri r H b RESIDENT DECEDENT !J ~ L 7 % g. a s u ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Deat h Date of Birth l9s ~'7 q~~2~ ~r~~ 7~v~~e U~UO /~/i 3 Decedent's Last Name Suffix Decedent's Firs t Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required .,death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) Spouse's Social Security Number CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Firm Name (If Applicable) First line of address ?~/~' ~K Second line of address 1~'~L~ City or Post Office /~i~ ~ C /~ /~ /1~ / L~ S Ls' C>/ ~ is Correspondent's e-mail address State ~' R ZIP Code na REGISTER S USE Q~Y {~{~77 ~ ~ Q ~ ~ ~y ,~a^ ~o~ ~ ' DA~FILED ~ r; _' '.-) ~. ~ ~_.~ :, t /rIC~'G'~7.~`~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON REgS/PONSIB E FOR FILING RETURN DATEE ADDRESS ,~f l / '7 `~:=~~ ~L''CC'->", K~ ,/) `cal ~t1s'Z~'~<~Gws`~-7~i f~~/r'' ~~7CSG'' .~~5~ SIGNATU , OF PREPARER OTHER HAN REPRESENTATIVE , ~ DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY 15056051047 Side 1 15056051047 15056052048 REV-1500 EX Decedent's Name: Decedent's Social Security Number its"~~~~y,~~ RECAPITULATION 1. Real estate (Schedule A) . ......................................... ... 1. 2. Stocks and Bonds (Schedule B) .................................... ... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. • 4. Mortgages & Notes Receivable (Schedule D) .......................... ... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... ... 5. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested .... ... 6. ~ 1 5 ~ S , +w` 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. ~ '7 5 ~' S . ~ ~,.' 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............. .. 10. 11. Total Deductions (total Lines 9 & 10) ................................. .. 11. ~ 12. Net Value of Estate (Line 8 minus Line 11) ............................ .. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ...................... .. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... .. 14. p ~ ' ~, ~' G 5 G C TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 15. 16. Amount of Line 14 taxable at lineal rate X .0 /~`~- ~ ~ ~~ ~ ~ 2 16. / ~ 7 ~ . ~' 17. Amount of Line 14 taxable at sibling rate X .12 17. • 18. Amount of Line 14 taxable at collateral rate X .15 . 18. • 19. TAX DUE ....................................................... .. 19. ~ ~ ~1' ,~ ~ -1- 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056052048 15056052048 ~__ REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME STREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. InterestlPenalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference: This is the TAX DUE. (5) A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :................................................................................... ....... ^ b. retain the right to designate who shall use the property transferred or its income : ..................................... ....... ^ c. retain a reversionary interest; or ................................................................................................................... ....... ^ d. receive the promise for life of either payments, benefits or care? ............................................................... ....... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ....... ....... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ......................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)J. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. n H t~] ~~ ba w rr ~ (~D H H z R'~ O o d ~ a O 0 0 O H N d ~ a ~ ~ H m b n ~• n m 0 a ro rj r n rn ooooy~ Q~ J U7 Ut N ~ ~ ~ ~ w o o H o I-' ~ o ~~~~ N N N N 0 0 0 0 0 0 0 0 0 0 ~ ~ .s~ u, O O O O ~ rn rn ~ ~ ~A Ol 01 Ul Lb ~ to w w N r U] N W W J L7 Lit O O O O ~ V] L~! C m m ~ H ,P rn rn ui O ~o w w H H ~t w w ~ ~ 0 0 0 o r ~ H I ~ H H n ~ bG v C] try r d n H 0 H i ~----* i O~ N I i \iH I ro~o ~ ~ I w. 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O 't3 (D o\° - dz~ymr y ~ r A ~ O ~o ~~ LTJ 'Z O C C ~ '=J O H rn d i b C CrJ (p •v p ~ U7 f1 ~ H d d .• C ~~ b H ~ H b .. ~ ro ~ ~ r mr~y ~ ~ ~ oN ~r .. .. ~ ~ by CrJ H t=i ro 0 d ~] H H c H H ~c \ O ;U CrJ r Ci ~ -_ n '~ O ~ o ~ ~ ~' U1 H ~n z tit ~ ~ H C iJ z y N- tl n x r a u, b C ~ l~ r ~ ~ b ~ ¢ d ~ ~ ~ ~ ~ .. ~ ~ O H r H eh r O H H H (~] Ul H H O (D \\\\~ H N N O (p H W N ~7 Fj \\\\w o ~ ~o ~o r H N N O7 x lJl H H \ H O H\\H AI H N J Fj \ N \ H ~' O \ ~O H N H 1D 00 \ •• O~ O N l0 d J ~ "~1 d J OJ t=] xJ ow ~n l~ H C/~ U] H U] ~ Z H (~ ti `~ i G] ~n H LTJ G1 H o b ~ '~.' 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O ~ ",~ . ~ ~ ~ x ~ ~ ~ G p' ~ ~ ro O ~ ¢ i i i ~ O ~ ~ ro H °° o ~ ~ o z N ~ n y o fu ~ ~ cT K N ~ II H p L=J II ~ ¢ n II 0 II [ ~ II ~ II ~ ~ II u~ ~ n n ~ n i1, rt II ~ d n n u ~ II ~ ~ ai d o w . ~ N REV-1509 EX, (1-97) SCHEDULEF COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE: NUMBER If an asset was made joint within one year of the decedent's date of death, k must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT C. WNED PROPERTY JOINTLY -0 % OF DATE OF DEATH ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. VAI UE OFF ASSET IN ERDEST DECED NT S IONTEREST ~. A. ~j~a~~e fc~"f.~~,~~ C~ "wr C~,~~ / z` /~.1 c~ - C~ ~ r r ; s' 1 /'7C' ` TOTAL (Also ent er on line 6, Recapitulation) $ ,~j ~I S~PS . G c~ (If more space is needed, insert additional sheets of the same sizE:) - ~,N~~~ OF INHERITANCE TAX p£'1~S~/LV~n~+ BUREAU OF INDIVIDUAL TAXES ~~` ~ ~~_~, ~!, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE .~. INHERITANCE TAX DIVISION ~ ~~ ~~~fi.IDNS AND ASSESSMENT OF TAX REV-1547 EX AFP C12-09) HARRISBURG PA 17128-0601 ~~ ~~~„ "~ P~ ~~ _ $ DATE 06-21-2010 ESTATE OF LANCASTER B C ~~~~(~~ DATE OF DEATH 10-2?-2.000 ~~-S ~~~RT FILE NUMBER 21 01-0276 BARIARA K HEIGES G~~~~'i.~~~~, ~,'~.~.. ~~' COUNTY CUW^BERLAND ACN 101 7 YORK CIR APPEAL DATE: 08-20-2010 MECHANICSBURG PA 17055 (See reverse side under Ubfccteons) Auount R®uitted ~- MAKE CHECK PAYAHLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONC THIS LINE ~- RETAIN LOWER PORTION FOR YOUR RECORDS ~ - - - - - - - -- - - - - •• - - - - - - - - - - - - - -~ - ~- w - - - - - - - - - - - - - - - - - - - ~ - •• - - -,..- r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - REY-1547 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISAL1t1WANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: LANCASTER B (FILE N0.:21 01-0276 ACN: 101 DATE: 06-21-2010 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETUR=N 1. Real Estate (Schedule A) C1) •0 0 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) C2) .0 0 credit to your account, 3. Closely Heid Stock/Partnership Interest (Schedule C) C3) .0 O submit the upper portion of this form with your 4. Morteapes/Notes Receivable (Schedule D) C4) .0 0 tax payment. 5. Cash/Bank Deposits/Misc. Porsonal Property CSchedulo E) C5) •00 6. Jointly Owned Property tSchedula F) t6) ~_ 37, 585.00 7. Transfers (Schedule 6) C~) .0 0 8. Total Assets C8) 37,585.OA APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) tg) .a 0 10. Debts/Mortgage Liabilities/Lions (Schedule I) C10) .0 0 11. Total Deductions C11) .0 0 12. Net Value of Tax Return C12) 37,585•.00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0 14. Net Value of Estate Subject to Tax C14) 37,5~~_OQ NOTE: If an assessuent was issued previously, reflect figures that include the total ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rata 16. Amount of Line 14 taxable at Lineal/Class A rate I7. Amount of Line 14 at Sibling rate lines 14, 15 and/or 16, 17, 18 and 19 will of ALL returns assessed to date. 18. Amount of Line 14 taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: t15) .00 x 00 .00 t16) 37.5e5_ea x 045 = 1,691..32 u7) - as x 12 = . 00 ciB) . oo x 15 . o0 C19)= 1,691.32 PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 05-06-2010 CD012 08 .00 1,691.32 BALANCE DF UNPAID INTEREST/PENALTY AS OF 05-07-2010 TOTAL TAX PAYMENT 1,691.32 BALANCE OF TAX DUE .00 INTEREST AND PEN. 442.33 TOTAL DUE 442.33 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE .SIDE OF THIS FORM FOR INStRUCTIONS. `~ `. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 013390 BARBARA K HEIGES 7 YORK CIRCLE MECHANICSBURG, PA 17055 -------- cola ESTATE INFORMATION: ssN: ts5-o~-st2s FILE NUMBER: 2101-0276 DECEDENT NAME: LANCASTER B C DATE OF PAYMENT: 09/21/2010 POSTMARK DATE: 05/1 1 /2010 COUNTY: CUMBERLAND DATE OF DEATH: 10/27/2000 REMARKS: AMNESTY SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 5442.12 REV-1162 EX111-98) TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY 5442.12 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Pennsylvania DEPARTMENT OF REVENUE xsv-i~se nocExec cis-t~~ September 2, 2010 To the Register of Wills of the County of CUMBERLAND RE: INHERITANCE TAX CREDIT MEMO Estate of: File Number: Decedent's SS#: ACN Number: Payment Amount Postmark Date: BERTIE LANCASTER 2101-0276 195-07-9126 101 $ 442.12 05/11 /2010 ~~ /'4 t `.C~f~! r- 7 U~ :~rGli~rr~t ''~: S~~l~ ~ ~. 2010 SEP 2 I qM 10: 55 ~~ S OURT CUMBERC~,~p CC , PA ~ 33q~ An Amnesty payment on the above-referenced inheritance tax (tebiiily has been received and transferred to the inheritance tax fund. Please isaus an official inheritance tax receipt for the Tax Amnesty payment and postmark date above. Make the payment date on the receipt the date the receipt is prepared by your off>Qe. Also, type "AMNESTY" in the remarks area of the receipt. Mail the receipt to: Name: BARBARA HEIGES Street: 7 YORK CIRCLE City/State2lP: MECHANICSBURG PA 17055 The department's copy of the Official Receipt should be mailed using the postage paid Inheritance Tax bulk mail envelope (E-136) within five (5) business days after receiving this credit memo. Attach an "AMNESTY" cover sheet to the front of the receipt, or if multiple amnesty receipts are being submitted, attach the cover sheet to the top of the group. The amnesty cover sheet will help expedite the processing of the receipt when it arrives in the Inheritance Tax Division. Please keep the amnesty receipts sorted and bound separately from the other Inheritance Tax documents when placing them in the bulk envelope. On your next Register of Wills Monthly Report, REV-714, include the payment amount in the monthly inheritance tax collections reported on Line 5, and claim a credit on Line 7. Your monthly inheritance tax collections, less the credit for this payment, should equal the Total Amount Deposited on Line 12. Your efforts in expediting the issuance and mailing of the Department of Revenue's copy of the tax amnesty payment receipt is greatly appreciated. Thank you for your timely attention to this matter. If you have any questions, please call 717-787-7031. Individual Taxes ~ PO Box 280603 1 Harrisburg, PA 17128-0603 1717.787.7031 ~ www.revenue.state.pa.us BUREAU OF INDIVIDUAL TAXES - ~ ,I~~HERITANCE TAX INHERITANCE TAX DIVISION - ~ .,. S~'~'TEMENT OF ACCOUNT PO BOX 280601 - " HARRISBURG PA 17128-0601 ti . W ~; -, , ~,__. pennsylvania ~ ' ~ DEPARTMENT OF REVENUE REV-1607 EX AFP (12-09) ~` DATE 10-04-2010 ESTATE OF LANCASTER B C DATE OF DEATH 10-27-2000 FILE NUMBER 21 01-0276 COUNTY CUMBERLAND ACN 101 Amount Remitted _ ,_ lJ .. - , ~ r~- r .. ,. _. .- .... L '. i-~k BARBARA K HEIGE~S ~ ~ ' 7 YORK CIR MECHANICSBURG PA 17055 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure 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 ~ _ REV X1607 EX AFP~ C12 09~~~ ~ ~ *** INHERITANCE TAX STATEMENT~OF ACCOUNT ~~~** ~~~~~~~~~~ ~~~~~~~~~~ ESTATE OF:LANCASTER B C FILE NO.: 21 01-0276 ACN: 101 DATE: 10-04-2010 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. 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: 09-17-2010 PRINCIPAL TAX DUE: 1,691.32 PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+3 AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 05-06-2010 CD012708 .00 1,691.32 05-11-2010 CD013390 442.12- 442.12 10-01-2010 SBADJUST .00 .21 TOTAL TAX PAYMENT I 1:691.32 BALANCE OF TAX DUET .00 INTEREST AND PEN. ~ .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~