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Home My WebLink About01-0497 /t'..<-dJd ,- / COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '~I c *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT~ ALLOMANCE OR DISALLOMANCE OF DEDUCTION~, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (12-00) JANET RADAY 140 SHATTO DR CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 09-03-2001 COBURN 02-06-2001 21 01-0497 CUMBERLAND 038-09-0924 01123455 HENRY Amount RBllitted 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 ~ REfv:i5~8-E)f-AFP--(i2-:oo1------------------------------------------------------------------------------------ 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 COBURN HENRY DATE OF DEATH 02-06-2001 COUNTY CUMBERLAND FILE NO. 21 01-0497 TAX RETURN WAS: S.S/D.C. NO. 038-09-0924 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01123455 FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 90972514 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS (X> CHECKING ( ) TRUST ( ) TIME CERTIFICATE 10-26-1999 x 1,191.45 0.500 595.73 279.69 316.04 .15 47.41 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 (-) 05-16-2001 AA496623 .00 50.51 TOTAL TAX CREDIT 50.51 BALANCE OF TAX DUE 3.10CR INTEREST AND PEN. .00 TOTAL DUE 3.10CR . 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 ..CREDIr. ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) /~,-cl3ot -I BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~~* NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOWANCE OR DISALLOWANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REY-1548 EX AFP Cl2-00) JANET RADAY 140 SHATTO DR CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SS,N/DC ACN 06-18-2001 COBURN 02-06-2001 21 01-0497 CUMBERLAND 038-09-0924 01123456 HENRY Allount Rellitted 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 ~ REfv:is~i-Ex--AFP--(i1f:ool------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-18-2001 ESTATE OF COBURN HENRY DATE OF DEATH 02-06-2001 COUNTY CUMBERLAND FILE NO. 21 01-0497 TAX RETURN WAS: S.S/D.C. NO. 038-09-0924 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01123456 FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 50265912 TYPE OF ACCOUNT: ()O SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-26-1999 X 466.71 0.500 233.36 .00 233.36 .15 35.00 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 (-) 05-16-2001 AA496621 .00 35.00 TOTAL TAX CREDIT 35.00 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 $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 *' 1~-;A3J-1 INFORMATION NOTICE AND TAXPAYER RESPONSE FI LE NO. 21 - 0 1- '19 ? ACN 01123455 DATE 05-09-2001 REY-1543 EX AFP <09-00) JANET 140 SHATTO CARLISLE RADC f( /I- J> " DR PA 17013 EST. OF HENRY COBURN S.S. NO. 038-09-0924 DATE OF DEATH 02-06-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS IX] CHECKING D TRUST D CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAYPOINT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by c~11in9 (717) 787-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 90972514 Date 10-26-1999 Established x 1,232.83 50.000 616.42 .15 92.46 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. , ~i:m._!m_m!_rt$!!!l!ltdIrtcl]!!:!i: .................................................................-.........-.....-...........................-.......... ................................................................................................-.-........................ ..........._._._._._._._._._._._........._..._._._._._._._._._._._...........................u............................. [] 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. [] 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. ~he above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. . x TAX ON JOINT/TRUST ACCOUNTS /6- 2 (p ,.- 1. 9 II Cf 7 . ,.(;; Q..r.) Pi-- ;[1 ~ I () j 50. CV II ' (P/~.":J.. ;l '1 q . ~ q )1,,(.U - fIv 33G...-l~ ~ ~ ,s- ~" ." J , .J (J " ,,'l , DEBTS AND If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX LINE RETURN - COMPUTATION 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 PART ~ DATE PAYEE DESCRIPTION TOTAL (Enter on Line 5 of Tax Computation) $ perjury, I declare that the facts I my knowledge and belief. have reported above are true, correct HOME (1/1) ~~/ -Stl7;}... WORK ("'/7) 7cfl. - 02~ 37 TELEPHONE NUMBER and 5-1{.. 01 DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 - It,-Pl~;;'" I INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ""'01-1197 ACN 01123456 DATE 05-09-2001 REY-l~45 EX AFP C09-DDJ JANET 140 SHATTO CARLISLE -,/ Ri1r1)1 RADI; DR EST. OF HENRY COBURN S.S. NO. 038-09-0924 DATE OF DEATH 02-06-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT [XJ SAVINGS D CHECKING D TRUST D CERTIF . PA 17013 RE"IT PAY"ENT AND FOR"S TO: REGISTER OF WILLS CUM&ERLAND CO COURT HOUSE CARLISLE, PA 17013 WAY POINT 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) 767-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 50265912 Date 10-26-1999 Established x 466.71 50.000 233.36 .15 35.00 TAXPAYER RESPONSE 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". 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 beco.e delinquent nine (9) .onths after the date of death. Tax PART [!] 00 The above infor.ation and tax due is correct. 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 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. 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 TAX ON JOINT/TRUST ACCOUNTS ..-.-.-...-......... ...... . . ~:: ::i:;:;:::;:;:::;: ::::; :;:;:;: ;:;:;:;:; :;:::::;:;::::: ::: :;:;:::::;:;:::;: ;~o.:,o.I4:;::: ::;::::: ::;:: :;:;:;:;:;::::: ;:;:;:;:;:::;:; :;:: :::::: :;:::;:::;:;:::;:;:;:;:. -. lil!lilil!I!I!lil!lllil:!i!!!!!i!i!i!:!l!l!l!l!i!l!i!l!l!i!l!i!i!i!!!j!l!~l:~~!l!i!;!;!;!;!;!;!:!i!i!:!i!i!i!i!i!l!i!i!l!l!i!l!;!l:;!l!l!l!i!i!l!i!i!i!i!i!l!::!: If you indicate a different tax rate, please state your relationship to decedent: OF 1 2 3 4 5 6 7 8 x x PART @] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax Computation) compl declare that the facts I and belief. have reported above are true, correct HOME (7/7) ~if/-szl7;l. WORK (117) I(A ~;lJ 37 TELEPHONE NUMBER and 5-1" ~- OJ DATE 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 496623 REV-1162 EX (11-96) RECEIVED FROM: I _, {~!\!ET F~':ID y } 1+ (; (.: H () T T C; D F~ I :-:.. j.'":j n '-- r ::':.:_ F, F' ~~l ~ ~'?,"'\ ~; ~:! . '....~.l\. ......f - FOLD HERE ESTATE INFORMATION: I FILE NUMBER C~ .. .:?(1~) . _.~i')~ c;.tr"'.':,' ~::i.'S!\j 030-- (~~ (;,~ ,,-, () <~; 2 l., NAME OF DECEDENT (LAST) (FIRST) (MI) C.DDuR1": ~'iF J'\}r~>\~- DATE OF PAYMENT c; ,. ,::: .t I ;:;: () (::1 ,"j . POSTMARK DATE c' 1 i. / ....... "- ii- ..) ".; . COUNTY r~. :....i ~~l:_:! t.. c~ ~~. A !~~ [\ DATE OF DEATH / I) ~~~ {::~ t :~l (:; 1 ..... ..; .j i--'\i\!r::. I i':'i '''< f.-I 1) .~ REMARKS ~P_~~: -f E. C~ ~.: # :~{ {,;; t~, SEAL REGISTER OF WILLS ACN ASSESSMENT CONTROL NUMBER AMOUNT (> t 12345~S ~50.51 FOLD HERE ~> ~S ;~) . ~~j. 1 TOTAL AMOUNT PAID t.'t': /1., ( ~.f ~_I' J/;I'; ..-.. / /', ''''~/ " RECEIVED BY ../ '/,.(t.1f.' ( ,/'<._.C.(A.A/_~t..//)(,- 71 () h' 'i C. L E>;:~l r:;~ ..f .I. /. ~ /,,; "Jr' -'! c'- F' n r ,. I ' ". J. ,,~5f ,(/,"',.).,.1.-/ , , ,,:' ',:1 J.:; t:..' ,~. t,j .:. ~- "-- :'~/'~l;~',~tJ.-r:::l- __-L-_~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT280601 HARRISBURG. PA 17128.0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No.AA 496621 REV-1162 EX (11-96) RECEIVED FROM: I ESTATE INFORMATION: I FILE NUMBER .." <.~~> 1 I )l. (/.7 ;:3~:;rJ (j:3~~ E~ ... Or.}.., J..':\ {./ ~~:~ .,::" .. -' NAME OF DECEDENT (LAST) (FIRST) (MI) '.. O[!UF~!"~ :~..~ f::- ft.l C~... \: DATE OF PAYMENT .....-" ::1 ... [!!)(1 ,. POSTMARK DATE ~.c) 1 6 / (,~ (} t) ~ COUNTY )--- i..Jfv: D F_ ~?L. t=) r._~ I) DATE OF DEATH .. ();';'l ./ L::~t () () !-. r-";, .. J f'::;HE ';" r.:?'4DY 1 i..; (~ ~:J r ~ {:l T T C~ I:~ F:: \/ r~~ C~~ t:~~ F~: ~_.. I ~::~ L [" r I (~ ~ ~? t.)~.~J - FOLD HERE REMARKS .: H.'~t:.: "Il ,) Y C' ~"~l'~~ f~, ~I- H '~,?(-,;"-./ SEAL ~ ACN ASSESSMENT CONTROL NUMBER AMOUNT ~).l 1 2 ::; i:"r :5 tJ ~E,~:~) to (}(I FOLD HERE - ~. ',:35 . (~}() TOTAL AMOUNT PAID ,...:.....,.. REGISTER OF WILLS i -1/" .'c.... .,,/ ,/..' I', /l.d-.,.,.?" J /' . ,,,,,' ,;/ .......... ./l ...1' /......;.t ;;f./..['...'.# l/ ..":>" ---- ---- ..... ....\ i.:) ..... (..' ;i".~ (.J t:." t.':' l") nr'n7.:l~ ., Ct'jUl ~ n~ ~ C'O!;jH~ ~~~UlS t:" ij \ ~ ...; t'1 6 ~ n l'!jC 0 ~,j1 1"\1C' Mn t1 O~E i-'Ui HH ....l 0 n \:. Ul c; ot:" ,...: C t.;:l f;:\ ~ ~ (....t ..... C r;;l M - - - - - - - - - - - - -::""' - - - - - - .'" ... I -' ,..~,~ ~;o'_:) r>..) (;:> \ c:) (:;:-1 ,.: o ;' ......-Jl t:' (:j:~ -It - f .:1 , ~ ~ "0 o ~ ... .. '" 1ft ..... It .......... ...... --