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Home My WebLink About01-0822 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 l'f ~ 6~\3 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 -t!J 1- S' .;).:J/ 01131720 07-06-2001 REY-154S EX AFP 109-001 EST. OF ERMA DEIBLER 5.5. NO. 167-40-4380 DATE OF DEATH 04-27-2001 u COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [XJ CHECKING o TRUST D CERTIF. MARGARET D CLECKNER 1119 COUNTRY CLUB RD .c" CAMP HILL PA 170.1 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MELLON 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 addres~. This8cco'Jnt i~ 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. 884-018-0890 Date 08-12-1994 Established x 1,286.26 50.000 643.13 .15 96.47 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice .ust acco~any your pay.ent to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Allount Subject to Tax Rate Potential Tax Due x NOTE: If tax pa~nts are .ade within three (3) months of the decedent's date of death, you may 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 ~y 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 asses~ent will be issued by the PA Depart~nt of Revenue. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return -- ~o be filed by the decedent's representative. ~ 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 If you indicate a different tax rljlte, please state your ~ relationship to decedent: ~":1~~'.f TAX RETURN - COMPUTATION OF TAX ON JQ~NT~TRUST ACCOUNTS LINE 1. Date Established 1 ill'! Lei I 2. Account Balance 2 ~ 99. d ~ 3 Percent Taxable 3 X ~ ~ 45'.' Allount Subject to Tax 54 ..3' ~ ~ ~/7. ~... ') Debts and Deductions ~O/.~V~ 6. Allount Taxable 6 /5- () D 7. Tax Rate 7 X 8. Tax Due 8 .5 A' ,A/ .3 PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID .;ZO , t? e:J ~,CJ 0 ~~ TURE have reported above HOME (~ ~ (7/7) TELEPHONE NUM are true, correct and ~'~ ~ /..2- 75/~ ER DATE Under penalties of perjury, I declare that the facts I cOllplete to the best of IIY knowledge and belief. @ Mellon Bank PERSONAL BANKING STATEMENT DIRECT INQUIRIES TO: MELLON BANK NA 1 COMMONWEALTH REGION UNION DEPOSIT 4271 UNION DEPOSIT RD HARRISBURG PA 17111-2802 717-558-2654 1...111...111......11...11...1111.....1.1..11....111.1...1..11 ERMA DEIBLER OR MARGARET D CLECKNER 1119 COUNTRY CLUB RD CAMP HILL PA 17011-1023 02440 0128 884-018-0890 PAGE 1 OF 3 STATEMENT FROM 07/20/01 THRU 08/17/01 WWW.MASTERCARD.COMIS YOUR BACK-TO-SCHOOL SHOPPING HEADQUARTERS. LOG ON TO FIND OUT ABOUT GREAT VALUES WHEN YOU USE YOUR MASTERMONEY OR MELLON CHECK CARD BETWEEN AUGUST 1 AND SEPTEMBER 30. 2001. OFFERS SUBJECT TO TERMS AND CONDITIONS. RELATIONSHIP SUMMARY DEPOSIT AC~QUHIS PERSONAL CHECKING TOTAL BALANCE 699.06 699.06 LOAN ACC~S OUTSTANDING PERSONAL CHECKING ACCOUNT 884-018-0890 DATE 08/16/01 SERVICE CHARGE REFUND CHECK I 6Z6 . lZ.OO Z95.00 00. · YOUR MONTHLY SERVICE CHARGE ISHOHN TO THE RIGHT) HAS BEEN HAlVED THIS MONTH. PLEASE USE THE ACC~ RECONCILEMENT FORM LOCATED ON THE LAST PAGE OF THIS STATEMENT TO BALANCE YOUR ACCOUNT. ~ Mellon Bank PERSONAL BANKING STATEMENT ERMA DEIBLER OR MARGARET D CLECKNER 02440 884-018-0890 PAGE 2 OF 3 PERSONAL CHECKING ACCOUNT 884-018-0890 (continued) ACCOUNT RULES AND REGULATIONS AMENDMENT: WE RESERVE THE RIGHT TO DECIDE WHETHER OR NOT AN ITEM IS PROPERLY PAYABLE BASED ON THE PREDETERMINED CRITERIA OF ANY FRAUD PREVENTION SYSTEM WHICH WE MAY USE. WE WILL NOT BE LIABLE IF WE DISHONOR AN ITEM ON THAT BASIS. IF YOU HAVE QUESTIONS ABOUT THE INFORMATION CONTAINED IN THIS STATEMENT, PLEASE CALL THE MELLONDIRECT 24 CENTER FOR CUSTOMER SERVICE. THE NUMBER TO CALL IS 1 800 222-9034. t ((((((( ~ "\ ~t ~ . ^ ~ . ~~ , I,' ft~ \~~'~ ~~J - ,- -- ,- ..,- - .,.... () f') f') ", '. 1") 'r-' () 1"" .~..! " : (j ,. /').,0-'*<3 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOHANCE OR DISALLOHANCE OF DEDUCTION~, AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-15~1 EX AFP (01-121 '02 MARGARET D CLECKNER 1119 COUNTRY CLUB RD CAMP HILL PA If'~1 Curi, !'i[\Y 31 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 06-04-2002 DEIBLER 04-27-2001 21 01-0822 CUMBERLAND 167-40-4380 01131720 Allount Rellitted ERMA '" 1 ""'3 / .:J 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 ~ Rifv:i5~8-Ex--AFP--(Oi-:02i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-04-2002 ESTATE OF DEIBLER ERMA DATE OF DEATH 04-27-2001 COUNTY CUMBERLAND FILE NO. 21 01-0822 TAX RETURN WAS: S.S/D.C. NO. 167-40-4380 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01131720 FINANCIAL INSTITUTION: MELLON BANK ACCOUNT NO. 884-018-0890 TYPE OF ACCOUNT: () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 08-12-1994 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X 1,286.26 0.500 643.13 .00 643.13 .15 96.47 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 DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 06-12-2002 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. .00 96.47 2.15 98.62 TOTAL DUE · IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) t < ... Z <III >::::1 ...IZ >-111 (I)> ZIII i5~ A. I&. 1&.0 Ot- ::I:Z t-III ...I:E <t- III~ 3: ZIII ~A :E o U tHs Zx ;1c OE-orn )C;jta.t; ccorn E-ornE-orn MZC 1lIC11l1 fi!Dll'-!li.i corn= E-ollllll~ lilurn IlIzrnDl :ll:CCo ~!iClCl ...:Iz...:I ta....:ICIlI OC ,,:II: III ''In >< UE-oiS...:I MZME-o E-oIllE-oZ OEUM ZIlI=O rnCl" Mill :lCl ll.ta. !;O Ul w )C C I- .. ~~ ~ =.... 'T ~:::: ~ >;:= .... .... g ~ lix c .... ~ .... 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COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 001282 CLECKNER MARGARET 0 1119 COUNTRY CLUB ROAD CAMP HILL, PA 17011 ACN ASSESSM ENT CONTROL NUMBER AMOUNT -------- fold 01131720 $96.4 7 ESTATE INFORMATION: SSN: 167-40-4380 FILE NUMBER: 2101-0822 DECEDENT NAME: DEIBLER ERMA DATE OF PAYMENT: 06/11/2002 POSTMARK DATE: 06/10/2002 COUNTY: CUMBERLAND DATE OF DEATH: 04/27/2001 TOTAL AMOUNT PAID: $96.47 REMARKS: MARGARET 0 CLECKNER CHECK# 2903 SEAL INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS /,,}-$"-3 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-1U7 EX AFP (01-02) MARGARET D CLEC~~~R JUL 15 1119 COUNTRY CLUB RD CAMP HILL ~.PA 17011 el1. '\ f3 : 15 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-08-2002 DEIBLER 04-27-2001 21 01-0822 CUMBERLAND 01131720 ERMA Allount RelliUed 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 forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=i6'ifj-E3f-AFP-foY=o2Y------...--iNi.fERITANc'E-fA3f-STA-fEM'Etif-oF"-AC-couiif--.-..---------------- ----- ESTATE OF DEIBLER ERMA FILE NO.21 01-0822 ACN 01131720 DATE 07-08-2002 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAY"ENTS. THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-04-2002 PR I NC I PAL TAX DUE: ........................................................................................................................................................................................................................... 96.47 PAYMENTS (TAX CREDITS): BAL PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-10-2002 CDOO1282 .00 96.47 ANCE OF UNPAID INTEREST/PENALTY AS OF 06-11-2002 TOTAL TAX CREDIT 96.47 BALANCE OF TAX DUE .00 INTEREST AND PEN. 2.12 . IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE 2.12 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ. YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. J /-'7-0--0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* . ~ BUREAU OF INDIVIDUAL TAXES " INHERITANCE TAX DIVISION DEPT. Z8060 1 HARRISBURG, PA 171Z8-0601 '0.:. MARGARET D CLECKNER 1119 COUNTRY CLUB RD CAMP HILL '" PA 17011-0000 f '~ , ~ ,t. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN REV-I'O~ EX AFP 112-001 ---'I L. 07-22-2002 DEIBLER 04-27-2001 21 01-0822 CUMBERLAND 167-40-4380 01131720 ERMA 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 ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-00) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 07-22-2002 ESTATE OF DEIBLER ERMA DATE OF DEATH 04-27-2001 COUNTY CUMBERLAND FILE NO. 21 01-0822 ADJUSTMENT BASED ON: S.S/D.C. NO. 167-40-4380 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 01131720 FINANCIAL INSTITUTION: MELLON BANK ACCOUNT NO. 884-018-0890 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 08-12-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions - Taxable Amount Tax Rate X Tax Due 1,286.26 0.500 643.13 .00 643.13 .45 28.94 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 ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE 06-10-2002 07-22-2002 RECEIPT NUMBER CD001282 REFUND DISCOUNT (+) INTEREST/PEN PAID (-) .64- .00 AMOUNT PAID 96.47 66.89- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $I, NO PAYI1ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" YOU I1AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORI1 FOR INSTRUCTIONS.) 28.94 .00 .00 nn (CR), REV.1470~(6-88)" · INHERITANCE TAX EXPLANATION . OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER REVIEWED BY ERMA DEIBLER SCOTT ELLISON ACN 2101-0822 01131720 ITEM SCHEDULE NO. EXPLANATION OF CHANGES THE TAX RATE HAS BEEN CORRECTED TO 4.5%. A REFUND WILL BE FORTHCOMING. ROW Paqe 1 \ /'J~--.E V BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-IU7 EX AFP (DI-D21 '(1~ DATE ESTATE OF DATE OF DEATH FILE NUMBER , :COUNTY ACN 08-05-2002 DEIBLER 04-27-2001 21 01-0822 CUMBERLAND 01131720 ERMA MARGARET D CLECKNER 1119 COUNTRY CLUB RD CAMP HILL PA 17Oll"" , ~ :.~ Allount Rellitted 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, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =i6'ifj-ix-AFP-(fff=o2Y------...-iNHERiYA'NcE--YA3f-STAfEME-riY-'ifF'-AC-couiif--...---------------- ----- ESTATE OF DEIBLER ERMA FILE NO.21 01-0822 ACN 01131720 DATE 08-05-2002 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A S~"ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-19-2002 PR I NC I PAL TAX DUE: "..."....................".............""""""""""..."........"........"".................".""."."."""".........".............."...."".....""."."."...."."....""................."" 28.94 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-10-2002 CDOO1282 .64- 96.47 07-22-2002 REFUND .00 66.89- TOTAL TAX CREDIT 28.94 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. J