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Home My WebLink About05-23-08 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) ~II (~,'rk(.l J'~ U 1\ ~ MAKE CHECK PAYABLE AND REGISTER OF WILLS CUMBERLAND CO COURT CARLISLE, PA 17013 ANNA M d-1-08~ () ~D t::::3 ;;2 . ts --c '.:) :-51: . :::D ..?" Amount Remitted ", ::~~ ~ .~,J W C') .."'- .=-: () -0 REMIT~.r~NT::;'{) : ":.5 W ---I .. HOU~ 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358,~ CUMBERLAND 147-12-0582 07106872 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN JOELYN A CREWS 2736 N CONGRESS RD CAMDEN NJ 08104 w 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA M DATE OF DEATH 09-17-2006 COUNTY CUMBERLAND FILE NO. 70 0361358 S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 071 06872 ADJUSTMENT BASED ON: FINANCIAL INSTITUTION: BANK OF AMERICA ACCOUNT NO. 88708811643284 TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-17-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .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 00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $I, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), 0, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) -z> COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE r- INHERITANCE TAX . RECORD ADJUSTMENT Jri~~tLY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 Z008 MAY 23 PH 3: '3 JOY 2736 N CAMDEN ''"'I r',-"! t1F \ --. '->. \ ' I ...ILL., l~ ---" ORPU i: \I':~ ("11! IRT : . j"" "'_' \. .Il..),.j II A CRE~YJr'- -: .~..~.. p(\ CONGRESS RD NJ 08104 REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH ANNA 09-17-2006 '0 70 0361358 ;i..I' Of ,0,,3 CUMBERLAND 147-12-0582 07106873 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA CUMBERLAND M DATE OF DEATH 09-17-2006 FILE NO. 70 0361358 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: BANK OF AMERICA ACN 07106873 ACCOUNT NO. 88708811643284 TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-17-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .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, ASENT." 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. (jj ( 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 -.liN~ERITANCE TAX _, RECORD ADJUSTMENT -'Jq~N'[~ YHE'LD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 lOOO tlAY 23 PH 3: 13 CLERK OF ORP'L-' r.. t, :'C; ("r')! IRT \ I ,t"\i '.; '.~} \,~' ';.,~ '.../ Ct I'. fe, ,,- PA )\. . r I JOY A CREWS 2736 N CONGRESS RD CAMDEN NJ 08104 REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH ANNA 09-17-2006 ~,) 70 0361358 ~-DY-o~.;;v CUMBERLAND 147-12-0582 07106874 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA CUMBERLAND M DATE OF DEATH 09-17-2006 FILE NO. 70 0361358 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: BANK OF AMERICA ACN 07106874 ACCOUNT NO. 88701001030627 TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-01-2000 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 REGISTER 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 II, 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-b BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ;"1 C:1Nilik'ITANCE TAX ,,' ,RECORD, ADJUSTMENT l,ci,JD1Nll.,.Y 'HELD OR TRUST ASSETS REV-1604 EX AFP (03-05) JOELYN A CREWS 2736 N CONGRESS RD CAMDEN NJ 08104 2008 MAY 23 PM 3: \ 3DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN ClB~\( OF ORPHAN'S S',Q~RT, '''' ,DA CUt, : 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106875 ANNA 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA M DATE OF DEATH 09-17-2006 COUNTY CUMBERLAND FILE NO. 70 0361358 S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 07106875 ADJUSTMENT BASED ON: FINANCIAL INSTITUTION: BANK OF AMERICA ACCOUNT NO. 88700350018735 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 06-27-1994 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .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. C1J ( 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 .;.~,"~ ~'N'HERITANCE TAX , .'''RECORD ADJUSTMENT :Jg,INtLY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 .' i..., 2008 MA~ 23 PM 3: 13 CLr.::ov ry: c.l 11\ UI PI I \I.\'C' (,r11IRT OR \-il.--'J\.J \.':"_.It~, \ ~ c...... I' D\ C1J'!,-'- " r JOELYN A CREWS 2736 N CONGRESS RD CAMDEN NJ 08104 CUT ALONG THIS LINE REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106876 ANNA 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 (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 04-18-2008 ESTATE OF BUBNEKOVICH ANNA CUMBERLAND M DATE OF DEATH 09-17-2006 FILE NO. 70 0361358 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: BANK OF AMERICA ACN 07106876 ACCOUNT NO. 88708812074781 TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-06-2002 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 REGISTER 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. S5 ( IF TOTAL DUE IS LESS THAN $1, ND 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 HARRIS8URG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '}?~'e:RITANCE TAX . . _,! RE;CO~D ADJUSTMENT ~J&I'Nl'L Y'H'ELD OR TRUST ASSETS 200B MAY 23 PM 3: '3 Ci r.:C)I/ (',C JL..:......! ii,' ':::/; ..- ORPH[I,!\!'~~ y,')\J,R \ D JOY A CREWS CL)t!.-d .... ,A 2736 N CONGRESS RD CAMDEN NJ 08104 REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106877 ANNA M Amount Remi tted 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA M DATE OF DEATH 09-17-2006 CUMBERLAND FILE NO. 70 0361358 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: BANK OF AMERICA ACN 071 06877 ACCOUNT NO. 88708812074802 TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-06-2002 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 REGISTER 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.> ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE i' INHERITANCE TAX , ,-~tCORD ADJUSTMENT ,; JJpINTLY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 Z008 MAY 23 PH 3: 13 CLEr~1'( OF O~p1."" I ,,~ r,r\1 JRT K r-~,1-\l\i ,:),__,',.Jl I JOEL YN A CREWS C\H/:- - T DA 2736 N CONGRESS RD CAMDEN NJ 08104 REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106867 ANNA 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 e03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 04-18-2008 ESTATE OF BUBNEKOVICH ANNA CUMBERLAND M DATE OF DEATH 09-17-2006 FILE NO. 70 0361358 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: BANK OF AMERICA ACN 07106867 ACCOUNT NO. 88701001030626 TYPE OF ACCOUNT: e) SAVINGS e) CHECKING eX) TRUST e) TIME CERTIFICATE DATE ESTABLISHED 09-01-2000 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 REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT e+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID e-) 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.> C-p COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ;- INHERITANCE TAX RECORD ADJUSTMENT J(tIjJ;rL Y HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 1~fiB M~~ 23 PM 3: \ 4 JOELYN 2736 N CAMDEN ""-lC~i!'\" (\C \ . ,L. ~I vi --r ODPWL\i\\'S C'JUR\ A CREWS ,1,':'_,:1__"', -,- ?A CONGRESS ~U\ NJ 08104 REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106868 M ANNA 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA M DATE OF DEATH 09-17-2006 CUMBERLAND FILE NO. 70 0361358 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: BANK OF AMERICA ACN 07106868 ACCOUNT NO. 88708811643268A TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-17-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .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 REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "RESISTER 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), (J, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) I[) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT ~ot~TlY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 2008 MAY 23 PH 3: \ 4 JOY 2736 N CAMDEN CLERK 0;: Rpl 'f.' 1'0 ('('.\ IRT O . t-".,...,\\,' ,.....) .,..,.}\)"",; \ 1 , d. - . ". A CREWS Cl j\;'P'- . w' '.~p, ".. CONGRESS RD NJ 08104 REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106869 M ANNA 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA M DATE OF DEATH 09-17-2006 CUMBERLAND FILE NO. COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION 70 0361358 FINANCIAL INSTITUTION: BANK OF AMERICA ACN 071 06869 ACCOUNT NO. 88708811643268A TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-17-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .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 REGISTER 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. Co ( 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 '~OI~TLY HELD OR TRUST ASSETS 2008 KAY 23 PM 3: \ 4 CLEP,K OF l"' O~Pt\i\:\\::) COUHT Op JOEl YN A CREWS CU\:.' . ' . , 2736 N CONGRESS RD CAMDEN NJ 08104 REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106870 M ANNA 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 C03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 04-18-2008 ESTATE OF BUBNEKOVICH ANNA M DATE OF DEATH 09-17-2006 CUMBERLAND FILE NO. 70 0361358 ADJUSTMENT BASED ON: COUNTY S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: BANK OF AMERICA ACN 071 06870 ACCOUNT NO. 88708811643268B TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-17-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .15 .00 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 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." TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. C1J ( 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 2B0601 HARRISBURG PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX .1 RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX AFP (03-05) JOY 2736 N CAMDEN 1008 MAY 23 PM 3: \ 4 C\_E\;\'~ Or: ORPHf\l<") COURT ..' ,...- , r'l0, A CREWSU'/': . ,-r. CONGRESS RD NJ 08104 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-18-2008 BUBNEKOVICH 09-17-2006 70 0361358 CUMBERLAND 147-12-0582 07106871 ANNA 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 04-18-2008 ESTATE OF BUBNEKOVICH ANNA M DATE OF DEATH 09-17-2006 COUNTY CUMBERLAND FILE NO. 70 0361358 S.S/D.C. NO. 147-12-0582 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 071 06871 ADJUSTMENT BASED ON: FINANCIAL INSTITUTION: BANK OF AMERICA ACCOUNT NO. 88708811643268B TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-17-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .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 DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION DF 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.)