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Home My WebLink About04-11-08 BUREAU IDF INDIVIDUAL Cl~kE-spr;':n rr;:ICE INHERITANCE TAX DIVISION '. - .." .,,---, -.-.. '. 'j! :-, PO BOX 2B0601 . ,,'.._.: HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX AFP (03-05) Z008 M'R II Pl'l I: 02 ROBERT 230 FAITH CARLISLE AI ""P'K Cr t 1 !~. ~"; ,! f- r~};';' ':'. ('(\1 !PT rl~'u,.J..,. ,I '-..; , " )1 " ,! vr\i \i ,: ~'j '~',,- ...J tl~ALLAWA'f, ..c, P.A. CIR DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 05143502 HEATHER M Amount Remitted PA 17013 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 (03-05) ~~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ DATE 04-08-2008 ESTATE OF FAUST HEATHER M DATE OF DEATH 04-18-2005 COUNTY CUMBERLAND FILE NO. 21 05-0561 S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 05143502 ADJUSTMENT BASED ON: FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 187476-00 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-13-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1.000 .00 .00 .00 .15 .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 ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .nn l " 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), I I YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 28,0601 HARRISBURG PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *' REV-1604 EX AFP (03-05) ROBERT A SALLAWAY 230 FAITH CIR CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 05143503 HEATHER M Amount Remitted 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 (03-05) ~~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ DATE 04-08-2008 ESTATE OF FAUST HEATHER M DATE OF DEATH 04-18-2005 COUNTY CUMBERLAND FILE NO. 21 05- 0561 ADJUSTMENT BASED ON: S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 05143503 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 187476-11 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-13-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1.000 .00 .00 .00 .15 .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 ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX I:REDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .nn * 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) BUREAU IJF INDIVIDUAL TAXES INHERITANCE TAX OIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS '* REV-160~ EX AFP (03-05) ROBERT A SALLAWAY 230 FAITH CIRCLE CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 06000360 HEATHER M Amount Remitted 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 (03-05) ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE 04-08-2008 ESTATE OF FAUST HEATHER M DATE OF DEATH 04-18-2005 COUNTY CUMBERLAND FILE NO. 21 05-0561 ADJUSTMENT BASED ON: S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06000360 FINANCIAL INSTITUTION: 230 FAITH CIRCLE ACCOUNT NO. 29-14-0868-146 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-20-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1. 000 .00 .00 .00 .15 .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 ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .nn " IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. n , ( 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.) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS '* REV-1604 EX AFP (03-05) ROBERT A SALLAWAY 230 FAITH CIRCLE CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 06000361 HEATHER M Amount Remitted 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 (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 04-08-2008 ESTATE OF FAUST HEATHER M DATE OF DEATH 04-18-2005 COUNTY CUMBERLAND FILE NIO. 21 05-0561 ADJUSTMENT BASED ON: S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06000361 FINANCIAL INSTITUTION: BAYLINER BOAT ACCOUNT NO. 3014CN TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-20-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1. 000 .00 .00 .00 .15 .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 ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE 1I11 * 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.) COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME REV-1470 EX (6-88) REVIEWED BY ITEM SCHEDULE NO. INHERITANCE TAX EXPLANATION OF CHANGES Heather M. Faust FILE NUMBER Eunice Baker ACN 2105-0561 05143502,05143503, 06000360,06000361 EXPLANATION OF CHANGES The above accounts have been adjusted to zero. The accounts were reported on the probate return. ROW Paqe 1 COMMONWEALTH OF PENNSYLVANIA p'~PARTMENT OF REVENUE 11~~ ; INHERITANCE TAX '.) RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS 2GUtl M'R \! Pi; \: 02 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 28iD601 HARRISBURG PA 17128- 0601 ROBERT 230 FAITH CARLISLE rl CD\< Or- ~ll-,-:' II,.....," ;:i~l lOT O~p. "'.,1.]' . I!...\ I'L1;~._J,C'i::"'~ \.1\1', 'PI!, A SALLAWAV CIRCLE PA 17013 CUT ALONG THIS LINE *' REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 06000362 HEATHER M Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ------------------------------..-.--------------------------------------------------------------------------------------------------.-------.-------------------.- REV-1604 EX AFP (03-05J -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 04-08-2008 ESTATE OF FAUST HEATHER CUMBERLAND M DATE OF DEATH 04-18-2005 FILE NO. 21 05-0561 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: CHEVY COLORADO ACN 06000362 ACCOUNT NO. YNX-6723 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-20-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1. 000 .00 .00 .00 .15 .00 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE RESISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE nn * 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.) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX AFP (03-05) ROBERT A SALLAWAY 230 FAITH CIRCLE CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 06000363 HEATHER M Amount Remitted 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 (03-05) ~~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ DATE 04-08-2008 ESTATE OF FAUST HEATHER M DATE OF DEATH 04-18-2005 COUNTY CUMBERLAND FILE NO. 21 05- 0561 ADJUSTMENT BASED ON: S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06000363 FINANCIAL INSTITUTION: PONTIAC FIREBIRD ACCOUNT NO. 703K TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 01-30-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxabl<e Amount Tax Rate X Tax Dwe .00 1.000 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE RESISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE nn * 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.) 0- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 22i0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX AFP C03-05} ROBERT A SALLAWAY 230 FAITH CIRCLE CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 06000364 HEATHER M Amount Remitted 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 (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 04-08-2008 ESTATE OF FAUST HEATHER M DATE OF DEATH 04-18-2005 COUNTY CUMBERLAND FILE NO. 21 05-0561 ADJUSTMENT BASED ON: S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06000364 FINANCIAL INSTITUTION: GRAND AM ACCOUNT NO. 2001 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 01-30-2001 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1. 000 .00 .00 .00 .15 .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 ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .nn * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ C IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ( 1_; BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX OIVISION PO BOX 28i0601 HARRISBUfi~G PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX AFP (03-05) ROBERT A SALLAWAY 230 FAITH CIRCLE CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-08-2008 FAUST 04-18-2005 21 05-0561 CUMBERLAND 204-48-6873 06000365 HEATHER M Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONS THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ----------..----------------......-------------.------------..----------------------..---------------------.------------------------------------------------------. REV-1604 EX AFP (03-05) ~~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ DATE 04-08-2008 ESTATE OF FAUST HEATHER M DATE OF DEATH 04-18-2005 COUNTY CUMBERLAND FILE NO. 21 05-0561 S.S/D.C. NO. 204-48-6873 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06000365 ADJUSTMENT BASED ON: FINANCIAL INSTITUTION: BOAT TRAILER ACCOUNT NO. 0000 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-01-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 1.000 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE RESISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "RESISTER OF WILLS, ASENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .nn * 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.) e /) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 Hf\RRISBURG, PA 17128-0601 DECEDENT'S NAME REV-1470 EX (6-88) REVIEWED BY ITEM SCHEDULE NO. INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER Heather M. Faust 2105-0561 06000362,06000363, 06000364,06000365 ACN Eunice Baker EXPLANATION OF CHANGES The above accounts have been adjusted to zero. The accounts were reported on the probate return. ROW Paqe 1