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Home My WebLink About04-0342 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: "~' WISE LEVERE C APT 217 121 1ST AVE RED LION, PA 17356 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) O03798 ........ fold ESTATE INFORMATION: SSN: 180~09-2931 FILE NUMBER: 2104-0342 DECEDENT NAME: WISE CHARLES E DATE OF-PAYMENT: 04/12/2004 POSTMARK DATE: 04/09/2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2003 REMARKS: .... SEAL ,~. ACN ASSESSMENT CONTROL NUMBER AMOUNT 04113936 I $4.08 TOTAL AMOUNT PAID: $4.08 CHECK# 4437 INITIALS. JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0O3807 WISE LEVERE C APT 217 121 1 ST AVE RED LION, PA 17356 ........ fold ESTATE INFORMATION: SSN: 180-09-2931 FILE NUMBER: 2104- 0342 DECEDENT NAME: WISE CHARLES E DATE OF PAYMENT: 04/13/2004 POSTMARK DATE: 04/1 2~2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04113935 $4.08 REMARKS: SEAL CHECK//2505 TOTAL AMOUNT PAID: $4.08 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 003808 WISE LEVERE C APT 217 121 1 ST AVE RED LION, PA 17356 ........ fold ESTATE INFORMATION: SSN: 180-09-2931 FILE NUMBER: 2104-0342 DECEDENT NAME: WISE CHARLES E DATE OF PAYMENT: 04/13/2004 POSTMARK DATE: 04/12/2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 104113938 $473.44 REMARKS: CHECK# 2506 SEAL TOTAL AMOUNT PAID: $473.44 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003809 ........ fold WISE LEVERE C APT 217 121 1 ST AVE RED LION, PA 17356 ESTATE INFORMATION: SSN: 180-09-2931 FILE NUMBER: 2104-0342 DECEDENT NAME: WISE CHARLES E DATE OF PAYMENT: 04/13/2004 POSTMARK DATE: 04/12/2004 COUNTY: CUMBERLAND DATE OF DEATH: 12/25/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04114730 $128.89 REMARKS: TOTAL AMOUNT PAID: (;128.89 SEAL CHECK# 2507 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~R~AU OF ~NDXvx~UAC ......--.-- TYPE OF AccoUNT ~EPT:_Z_.S.0.~0tpA t?tZ6-0601 .. ~,, ,P ~'-'~ ~ ~--~ SAVINGS HARR~a .... ~:~:'~;Or~:~ ~ :' .PT. OF CHARLES E wISE ~ CHECKING ~q:~! 1_80_09-Z9S1- ~ TRUST - S.S. NO. DATE OF DEATH 1Z-Z5-200~ ~ CERTIF. cUHBERLAHD '04 APR ~3 ~}~T~ R~H~T p~VH~NT ~.D roRHS TO: 6IsTER OF ~ILLS RE 0 cOURT HOUSE cUHBERLAND_~ ~? · ~ cARLISLE, PA 121 1ST AVE PA 17~56 RED LION ~n~ormat~on t~sted belo~ Nh[ch has b~en used ~n joint owner/bene{iciarY o~ instXt . ..... n~eaith haS provided ~e Department ~ith ~e · ution, attach a coPY o; the above decedent, you acre a HEHBERS 1ST FCU Their records indicate that at the death ton from the {inancial Tax Lams .... n iS ~flCO .... t. P___t iS taxa ..... ~E~ iNSTRUCTIONS . cat=uterine ~e po~ent[a[ tax due ....... tease obta~ ~,_ ~. accordanCe ~" .... is in*ora .... This ann .... FIb[NO AND PAY kccoun~ Ho. iZ575Z-fi6 Es~abZished payable to: -RegiSter of WilLs, Agent". 10,5Z0.96 kccoun~ Balance ~ [00, O0 HoTE: IT tax payments are m~e within three ~ (5) eonths o; the decedent's date eT death, X [0 ~Z0. ')6 _ you may deduct a SX discount of ~e tax due. Un~ sub~eC~ ~o TaX ~ nine (9) months ~T due ts correct. ~[[[s ~[th t,o copies o~ this net[ce to obtain k. ~ The above information and tax ~ -- e Register of ~ou t8~ choose ~o ~ou mav cheCk 1. avoid [nte~est~ or bY the PA Department o~ RevenUe- Tax return a d[scoun~ or C~EC~ H~[[s and an oT~c[al asseSsmen~ ~[~ be isled [nher[tance en or ~ be reported and tax pa~d ~[th the pennsylvania SLOCK s. ~ ~'~ ~ *iled b~ ~' deceu . and/or debts and deductions wore paid bY you. O~L~ n;oraat[o~ ts incorrect pART ~ beto~. C. ~ The above [ - "ART ~ and/or you must complete r e s~a~e your -f you in ''en~ ' ..... ---' TS p~T ' a~ionshtP ~o dece~ : .... ,nTHT/TRUST AcCOU~ ~ ~( AT[ON ~ ..... ""~ ......................... · ........................................ ~URN ' C TAX R .... ed LINE 1 Da~e EstabliSh Z ~ PART DESCR[PTION ~ pAYEE DATE pAID Under penalties of perjurY~ I declare ~ha~ ~he fac~s [ have e or~ed above are ~ru~ correc~ ~d ~he bes~ o~ m~ ~owledge and bezier- ) ~ORK ( 1. FAZLURE TO RESPOND NZLL RESULT ZN AN OFFZCZAL TAX ASSESSNENT mith aPPlicable ~nt~st based on submitted by the ~JnancJal institution. Z.ZnherJtance tax becomes delinquent nine aon~s a~ter ~e dacedent,s date of death. 5.4 Joint aCCount Js taxable even though the decedent,s name Nas added as a matter of Convenience. death a~e ~ully taxable as t~ansfers. S.AccoUnts established Jointly baleen hu~and and ~Jfe more than one Yea~ PrJo~ to death a~e not taxable. 6.ACCounts held by a decedent "Jrt trust for" another or o~ers are taxable REPORTZNG ZNSTRUCT~oNS _ PART 1. BLOCK A - [f the information and COlPutatJon - TAXPAYER RESPONSE ]n b]ock A o~ Part I o Jn ~e notice are correct and · glster oF HZl~s of *~- . Ctzon. ~= deductions are not being - Place an Z. BLOCK B If the asset Specified on ~is notice has been or ~11 be reported Tax RetUrn filed by ~e deced~n ~ ~ne return fro- -~- ~ '."" Uepartaent of ReVenue ~Jll issue an o~FJCJal .and return to the PA De-- ~ asses~ent s representative, Place ~ ~ . and tax Pa~d ~Jth =._e~ope Provided. ~=r;aent oF ReVenue, Bure- - an X In block -B- o~ o . the Pennsylvania ZnherJtance 5 .... CK C 'f th, notic, 'nfor,at,o~ ; . =u of Znd/vzdual Taxes, Depta;:O~ according 0 . T~xPaYer Response,. s . ~s Incorrect and/or ~eductJons are be'. · -r]sourg, PA 27~ZS_O60]e~ ~ S~gn one to the instructions be]o~. S~gn t~o copies and submit the= ,Jth YOUr check for the amount of tax Payable to the Register of H~j[s of ~e COunty indicated. The PA Department of Revenue ,j~] issue an offJCJa~ assessment (Fore REV-]S&8 EX) upon receipt of the return free the RegiSter of Hi]is' ]ng c]a~aed, check b~ock "C" and complete Parts LZNE ~. Enter the ~at, the ac=ount o~' ' TAX RETURN - PART NOTE.- ~or a decedent .;_ ~g~na~]y ,as , · ...... - TAX COHPUTAT~nu or the number of accounts heJd. '. ~ ;o exceed $5, OOO ~r~~h~n one (~) Year -~ ~ Zf a doubZe asterisk Z. a]ready has been deducted ;~:a~eb:~r. ~our first name, ..... ess of the -~- 3o;nt ass=*~ . r ~ach Surv~w. ; ~ to the date - 'scabl'~ed -ore ~,~'term,ned as of death. ] DZVZDEO BY TOTAL NUHBER OF DZVZOED BY TOT ,e Year Pr~or to the decedent,s death: JOZNT O~NERs AL NUNBEE OF X _ Example: R Joint asset registered ]n ~e SURV~VZNG JOZ"- - ~00 _ ] OZVZOED BY 5 ( ..... name of the d-c-- . ~; UHNERs PERCENT TAXABLE ~uzNr OHNERs) DZVZOEO BY Z r~ ...... = u~ent and t~o other Persons. B. ~he Percent taxabZe fo 'ou~vzvoRS) = .]67 X ~00 = ]6.7Z (TAXABLE FOR ]n trust ~or ano,~_ .r ~sfets Created ..-*-. "enetlclarJes): death or accounts ouned by ~e decedent but. Z DZVZDED BY TOTAL NUNBER OF SURvzVZNG JOZNT X ZOO OHNERs OR TRUST BENEFZCZARZES = PERCENT TAXABLE Example: Joint account regJstere 1 DZVZDED ~e decedent, d ~n the name of the decedent and t~o other Persons and established ~JthJn one Year o~ BY 2 CSURvZVORs) = SO X 100 = 50Z (TAXABLE FOR EACH ~- The amount sub~ect to tax (line &)'is deter S. Enter the to~l of the death by 6. The a~ount ta-=~ .... debts and de ,,-.= m/ned by muir' · r -Pr]ate tax rate r;;..'";['mu ay subtract/n. ;,-% l_.._= t4zne Z) by the Percent taxabZe (line ..... ~ as detere]ned ~elo~ oebts and deductions (~ine S) free the amount subject to tax ([ine ~). The [inca] Class o~irs inc]udes grandpare ,bather or not they have nt ,,u s~ep.desce~H=.~- ~*~. aescendents ~_.~---~ aaopted c i~ ~ mia zz~eal ' or adoption ..--''~' SlbZinas- ~. ~ -,ucner or nor +~ h~.dren and ste- .~..~escendents. "C ira. . . at ri R~..-- - ,,uzrs /nC]ud=o -,. - -,,u nave at I.._. y -----s, adoot=a ~- -.. ~nCZudes =~ ~.~Idren ~__ ~ _ DEBTS ANn n~ ...... e ......nether bu allo~able debts and deductions are determined as follows: ~ ucuucr[ONS CLAIMED A. You legally are re~onsible ~o ~..Pay the deductible ~.__ r PaYment~ or B. :uu actually paid +~ ~cems. ~e estate subl=.+ . . C. uebts being cZai~.~''e aebts after death ~z . ---- co administration PaYment mm- ~ --~ must be itc-i- . ." ~' ch; decade.+ - ~ by a Persona/ representative ..... uepartaent of e-~ Zf addJt]ona[ sp=~°~f of PaYment. insufficient · ,:~F fi~;~;~:~:;~:~:,;,;,;,:~:,:,~: .............. = unue. ~ zs needed, USe Plain Paper 8 Z/Z" x ll". Proof of COHNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 REV-15~S EX &FP (09-00} ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE ACN 0q115957 DATE Oq-O6-ZO0~ F~T. OF CHARLES E WISE S.S. NO. 180-09-Z951 DATE OF DEATH 12-25-2005 '04 APR 13 ~TY CUMBERLAND LEVERE C WISE APT Z17 121 1ST AVE RED LION PA 17556 TYPE OF ACCOUNT [] SAVZN;S [] CHECKING [] TRUST [] CERT'rF · REHZT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 HEHBERS 1ST FCU has provided tho Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at tho death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, pZease obtain written correction from the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of tho Commonwealth of Pennsylvania. Questions may be answered by calling (717) ?8?-8327. COMPLETE PART I BELOW ~ # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 12575Z-~6 Date 0~-0~-2005 Established Account Balance 10,520.96 Percent Taxable X 10 0.0 0 Amount Subject to Tax 10,520.96 Tax Rate X . Oq5 Potentia[ Tax Due To insure proper credit to your account~ two (Z) copies of this notice must accompany your payment to tho Register of Hills. Hake check payable to: "Register of Hills, Agent". NOTE: If tax payments are made within three (3) months of the decedant'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 tho date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX L/NE A. r--~The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills with two capias of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Hills and an official assessment will be issued by the PA Department of Revenue. B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by tho dacedent's representative. C. ~the above information is incorrect and/or debts and deductions wars paid by you. You must complete PART ~ and/or PART ~below. Zf you indicate a d~fferent tax rate, please state your relationship to decadent: RETURN -COMPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS ~. Date Established 2. Account Balance 2 $. Percent Taxable $ ~ q. Amount Subject to Tax q $. Debts and Deductions S - 6. Amount Taxable 6 7. Tax Ra~a 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE OESCRIPTTON TOTAL (Enter on Line $ of Tax Computation) AMOUNT PAID Under penalties of perjury, ! declare that the facts ]: have reported above are true, correct and complet~ the best o'f my knowledge and bel,a,. HOME ( TAXP~IYER- SIGNATURE TELEPHONE NUMBER ~)ATE GENERAL INFORHATION 1. FA[LURE TO RESPOND N/LL RESULT ZN AN OFF/C/AL TAX ASSESSMENT aith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's data of death. 3. A joint account is taxable avon though the decedent's name was added as a matter of convenience. 4. Accounts (including those held batsman husband and wife) which the decedent put in joint names within one year prior to death are fuLly taxable as transfers. S. Accounts established jointly between husband and wife more than one year prior to death ars not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue mill issue an official assessment (Form REV-IS4& EX) upon receipt of the return from the Register of Wills. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid aith the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept In0601, Harrisburg, PA 171Z8-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts Z end according to the instructions below. Sign two copies and submit them with your check for the amount ot= tax payable to the Register of Hills of the county indicated. The PA Department of Revenue ail1 issue an official assessment (Fore REV-154B EX) upon receipt of the return from the Register of Mills. TAX RETURN - PART 2 - TAX COHPUTATTON LINE 1. Enter the date the account originally mas established or titIed in the manner existing at date of death. NOTE: For a decadent dying after 1Z/II/BI: Accounts which the decedent put in joint names aithin one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (aa) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the dacsdent's death: I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X lO0 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.Tho percent taxable for assets created aithin one year of the decedent's death or accounts owned by the decedent buILheld in trust for another individual(s) (trust beneficiaries): Z DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in tho name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) = ,SO X 100 = 50Z (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 3. 6. Tho amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 7. Enter the appropriate tax rate (line 7) as determined below. De~e of Death Spouse Lineal Sibling Collateral 07/01/9q ~o 12/51/9q 01/01/95 ~:o 06/30/00 OX 6Z 157. 157. 07/01/00 '~o presen~ OX q.SX~ wThe tax rate imposed on the net va[ua of ti from a acease younger at death to or for the use of a natural parent, an adoptive parent, or a stepparsnt of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and [iaea! descendents. "Children" includes naturaL children whether or not they have bean adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" ara defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as folloas: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plaln paper 8 I/Z" x ll". Proof of payment may be requested by the PA Department of Revenue. Levere Wise 121 1st Ave. Apt. 217 Red Lion, PA 17356 COMNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. ZB0601 HARRISBURG, PA 171Z&-0601 REV-i$~iS EX AFP (gg-Og) ELEANOR V SHREVE 18 CONHAY DR MECHANICSBURG PA 17055 'O4 ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. 22 OUr ~:_~ ~ ACN 0q113935 DATE Oq-O6-ZOOq EST. OF CHARLES E HISE S.S. NO. 180-09-2951 DATE OF DEATH 12-25-2005 ~P~ 1 ~ C~N~ CUMBERLAND TYPE OF ACCOUNT []SAVINGS [~]CHECKINO []TRUST [--]CERT/F. REMIT PAYMENT AND FORMS TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 MEMBERS 1ST FCU hms provided the Department with thm information listed balow 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 faa1 this inforaation is incorrect, please obtain written correction free the financial institution, attach a copy to this form and return it to the above address. This account is taxabla in accordance Pith the Tnheritance Tax Laws cf the Coeeonesalth of Pennsylvania. Questions may be answered by calling (717) 787-83Z7. COMPLETE PART ! BELO# # # ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 125752-11 Da*a 06-19-1992 Established Accoun~ Balance 543.33 Percent: Taxable X 16.667 Aeoun~ Subjec~ ~o Tax 90 .S6 Tax Ra~e X . 045 Pod:end:ia1 Tax Due 4.08 To insure proper credit to your account, two (2) copies of this notice must accompany your payment to tha Register of Nills. Make check payable to: "Register of Wills, Agent". NOTE: If tax payments ara made within three (3) months of tha dacedant's date of death, you Pay deduct a 5Z discount of the tax due. Any inheritance tax due will becoae delinquent nine (9) months after tha date of death. PART TAXPAYER RESPONSE A. [] Tha above information and tax dua is correct. 1. You may choose to remit payment to the Register of Rills with tho copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to tbs Register of E ONE 3 Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK ~ B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the decedant's representative. C. [] Tha above information is incorrect and/or debts and deductions ware paid by you. PART TAX L/NE You must complete PART Band/or PART B below. If you indicate a d/fferen* *ax rD*e, please s~a~e your rela%ionship ~o decadan~: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Da%e Established 1. 2. Accoun~ Balance 2 3. Percen~ Taxable 3 ~ q. Aaoun~ Subjec~ ~o Tax q 5. Debts and Deductions E 6. Aaoun~ Taxable 6 7. Tax Ra~e 7 X 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Eh%er on Line 5 of Tax Computation) $ Under panal~es of perjury, ! declare ~he~ ~he fac~s ! have reported above are ~rue, correc~ and TELEPHONE NUMBER ~ATE GENERAL ZNFORHATION 1. FAZLURE TO RESPOND NZLL RESULT ZN AN OFFZCZAL TAX ASSESSNENT wlth eppliceble interest besod on information subeittad by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even though the dmcedent's naee was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death are fulLY taxable as transfers. 5. Accounts established jointly bmtmeon husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE BLOCK A - If tho inforeation and computation in the noticm are correct and deductions are not being claimed, place an in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and subeit them with your check for the amount of tax to the Registar of #ills of the county lndJcatad. The PA Department of Revenue will issue an official assessment (Form REV-1S48 EX) upon receipt of the return from tho Register of Hills. Z. BLOCK B - Zf the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decmdent's representative, piece an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes) Dept ZB060i, Harrisburg) PA 171zB-060l in the envelope provided. 3o BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts Z and according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-15~8 EX) upon receipt of the return from the Register of TAX RETURN - PART Z - TAX COHPUTATION LINE 1. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after IZ/1Z/BZ: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However) there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (xx) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by tho financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedant's death: I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUHBER OF X lO0 = PERCENT TAXABLE JOINT ORNERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of the decedent and (mo other persons. ! DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .L67 X 1eh = ~6.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ORNERS OR TRUST BENEFICIARIES Example: Joint account registered in tho name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BV Z (SURVIVORS) = .50 X 100 = SOX (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line q) is determined by multiplying the account balance (line Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxablm (line 6) is determined by subtracting the debts and deductions (line 5) from tho amount subject to tax (line q). 7. Enter the appropriate tax rate (Line 7) as determined below. Da~e of Death Spouse Lineal Sibling Collateral 07/01/9~ ~o 12/31/9q 3X 6X 15X 15X 01/01/96 ~o 06/30/00 OX 6Z 07/01/00 ~o presen~ OX NThe tax rate imposed on the net value of transfers free a deceased child twenty-one years age ar younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decadent) whether by blood or adoption. The "CoLlateral" class of heirs includes all other beneficiaries. (LATHED DEDUCTTONS - PART $ - DESTS AND DEDUCTIONS CLATHED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to adeinistration by a personal representative is insufficient to pay the deductible items. B. You actually paid tho debts after death of the decedent and can furnish preo~ of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use pIain paper 8 1/2" x 11". Proof of payment may be requested by the PA Department of Revenue. Eleanor V. ~reve ~8Co~O~ Mechanicsburg, PA 1711656135 P.O. Box or Street Address Apt. Numbe~ c~y COHNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF IHDZVZDUAL TAXES DEPT. Z80601 HARRISBURG, PA 17128-0601 REV-1S,~3 EX *FP C09-00) ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FZLE NO. 2! O~ ACN 0~113938 DATE 04-06-2004 TYPE OF ACCOUNT EST. OF CHARLES E WISE [] SAVTNGS S.S. NO. 180-09-2951 [] CHECKING DATE OF DEATH 12-25-2005 [] TRUST COUNTY CUMBERLAND [] CERTTF. REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 HEHBERS 1ST FCU has provided the Department mith the information listed beloa which has bean used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint oaner/beneficiary of this account. Zf you faa1 this information is incorrect, please obtain arittan correction from the financial institution, attach a copy to this ;ora and return it to the above address. This account is taxable in accordance aith the ~nharitance Tax Lams of the Commonwealth of Pennsylvania. Questions amy be ansaarad by calling (717) 787-8~Z7. COHPLETE PART 1 BELOW ~ # ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 12575Z-45 Da~e 04-04-Z005 Established Accoun~ Balance 10,5ZO. 96 Percen~ Taxable X 10 0.0 0 Amoun~ Subjec~ ~o Tax 10,5ZO. 96 Tax Ra~e X . 045 Po~en~ial Tax Due 475.44 To insure proper credit to your account, too (Z) copies of this notice must accompany your payment to the Register of #ills. Hake check payable to: "Register of Hills) Agent". ROTE: If tax payments ara made within three (~) months of the dacadant's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due Nil! become delinquent nine (9) months after the data of death. PART TAXPAYER RESPONSE A. [] The above inforeatien and tax due is correct. 1. You may choose to remit payment to the Register of Nills ~ith two capias of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of CHECK ~ Nills and an official assessment milt be issued by the PA Department of Revenue. ONE BLOCK s. [] The above asset has been or will be reported and tax paid aith the Pennsylvania inheritance Tax return ONLY to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions mere paid by you. You must complete PART [] and/or PART [] below. Tf you indicate a differen~ ~ax ra~e) please s~e~e your PART TAX LTNE relationship ~o decedent: RETURN - COMPUTATION OF 1. Da~e Established 2. Accoun~ Balance 2 3. Percen~ Taxable 3 ~. A.oun~ Subjac~ ~o Tax TAX ON JO/NT/TRUST ACCOUNTS $. Debts and Deductions 5 - 6. Aeoun~ Taxable 6 7. Tax Re~e 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION TOTAL (Enter on Line $ of Tax Computation) AMOUNT PAID Under penalties of perjury) I declare ~he~ ~he fec~s T have reported above ere ~ruez_cqrrec~ and knowledge belief. TAXPAYER SIGNATURE TELEPHONE NUHBER- ~ATE GENERAL INFORHATION 1. FAILURE TO RESPOND #ILL RESULT IN AN OFFZC/AL TAX ASSESSNENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the dacadent's date of death. 5. A joint account is taxable even though the decedent's name mas added as a matter of convenience. 4. Accounts (including those held between husband and mile) which the decedent put in joint names within one year prior to death ara fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another ar others ara taxable fully. REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions ara not being claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to the Register of Wills of the county indicated. The PA Department sf Revenue will issue an official assessment (Form REV-154B EX) upon receipt of the return from the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will bm reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the dacmdent's representative, place an "X" in black "B" of Part i of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept ZB06Ol, Harrisburg, PA 171Z8-0601 in the envelope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 5 according to the instructions below. Sign tmo copies and submit them with your check for the amount of tax payable to the Register of Nills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-IS4B EX) upon receipt of the return fram the Register of HilIs. TAX RETURN - PART Z - TAX COHPUTATION LINE 1. Enter the date the account originally was established ar titled in the manner existing mt date of death. ROTE: For a decedent dying after 1Z/1Z/BZ: Accounts which the decedent put in joint names within one (1) year of death are taxable fulIy as transfers. However, there is an exclusion not to exceed $~,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk [xx] appears before your first name in the address portion of this notice, the $5,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. 5. The percent of the account that is taxabIm for each survivor is determined as follows: A. The percent taxable for joint assets established more than Dna year prior to the dacedent's death: I DIVIDED BY TOTAL NURBER OF DIVIDED BY TOTAL NUNBER DF X lOO = PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 5 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the dacadent's death or accounts owned by the decadent but held in trust for anothmr individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE O#NERS DR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. I DIVIDED BY Z (SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 5. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. Dais of Death Spouse Lineal Sibling Collateral 07/01/9~ to 12/$1/9fi 01/01/95 to 06/$0/00 OZ 6Z 07/01/00 to present OX xThm tax rata imposed on the nat value of transfers from a deceased child twenty-one years of age or younger at death to ar for the usa of a natural parent, an adoptive parent, or a stepparent of the ch(Id is OZ. The linaa! class of hairs includes grandparents, parents, children, and lineal descendents. "Children" incIudas natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendants" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIHED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLA[HED Allo~able debts and deductions are determined as A. You legally are responsible for payment, or the estate subject to administration by a personal representative Js insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Pa~t 5. If add[tJanal space [s needed, use plain pape~ & 1/Z" x 11". Proof of payment may be requested by ~e PA Department of Revenue. P.O. Box or Street Address Apt. Number Cffy State Zip Code CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE BUREAU OF XNDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171Z8-0601 I ZNFORMATZON NOTZCE AND TAXPAYER RESPONSE REV-1643 EX AFP (09-06) ~,-:.~'' ' ; ~':~T. O~ CHARLES E NISE S.S, NO, 180-09-29S1 DATg O~ DBATH 12-25-2005 '~ APR 13 A~e?~ CUH~ERLAND ELEANOR V SHREVE 18 CONNAY DR MECHANICSBUR6 PA 17055 FX'E NO. 21 C -5H ACN 0~11~7~0 DATE 0~-07-200fi TYPE OF ACCOUNT D SAVINOS [~]CHECK/NG [~ITRUST ~C£RT~F. REH~T PAYHENT AND FORHS TO: REGISTER OF NILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 FULTON BANK has provided the Department ~ith the information listed beloa uhlch has been used in celcuIating the potentiaI tax due. Their records indicate that at the death o~ the above decedent, you were a joint owner/beneficiary of this account. Tf you feel this information is incorrect, please obtain ~ritten correction from the ~inancial institution~ attach a copy to this ~orm and return it to the above address. This account is taxable in accordance ~ith the [nheritance Tax La~s o~ the Commonwealth o~ Pennsylvania, Questions may be ansHered by calling (717) 787-8~Z7. COMPLETE PART 1 ]~ELON # x # SEE REVERSE STDE FOR FTL/NG AND PAYMENT ZNSTRUCTTONS Accoun~ No. 0008-05~8~ Dele 10-01-1967 Established Accoun* Balance 1,718.55 Percen~ Taxable X 5 0 . 0 0 0 Amoun~ Sub5ec~ ~o Tax 859.28 Tax Ra~e X .15 Potential Tax Due 128.89 To insure proper credit to your account~ tee (Z) copies of this notice must accompany your payment to the Register of Hills. Hake check payable to: "Register of Hills, Agent". NOTE: If tax payments are made Nith~n three [~) months of the decedent's date of death, you amy deduct a SZ discount o; the tax due. Any inheritance tax due Mill become delinquent nine (9) months a~ter the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY A. [-~ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills eith t~o 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 Nills and an official assessment ail1 be issued by the PA Department of Revenue. B. D Tha above asset has been or Nil1 be reported and tax paid aith the Pennsylvania inheritance Tax return to be filed by the decedent's representative. C. D The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ beloN. PART [f you indicate e differen~ ~ax ra~e, please s~e~a your relationship ~o decedent: TAX RETURN - COMPUTATZON OF TAX ON JOTNT/TRUST ACCOUNTS L[NE 1. Da~e Es~ebl/shed 1 2. Accoun~ Balance 2 3. Percen~ Taxable $ ~ ~. Amoun~ SubSec~ ~o Tex ~ S. Debts end Deductions S - 6. Aeoun~ Taxable 6 7. Tax Re~e 7 ~ 8. Tax Due 8 PART DATE PAID DE~TS AND DEDUCTZONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) $ Under penalties of perjury, I declare ~he~ ~ha fec~$ ! have reported above era ~rue~ corre~c~ and TAXPAYER SIGNATURE - TELEPHONE NUMBER' ~ATE GENERAL INFORMATION 1. FAILURE TO RESPOND MILL RESULT IN AN OFFICIAL TAX ASSESSMENT with appllcable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decadent's date of death. 5. A joint account is taxable even though the decadent's name was added as a matter of convenience. q. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death ara fully taxable as transfers. 5. Accounts established jointly between husband and wife aero than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORT[NG [NSTRUCT[ONS - PART i - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions ara not being claimed, place an in block "A" of Part 1 oF the "Taxpayer Response" section. Sign two copies and submit thee with your check far the amount of tax to the Register of Mills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-lSd8 EX) upon receipt of the return free the Register oF Mills. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA 171Z8-0601 in the envelope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts according to the instructions below. Sion two copies and submit thee with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Depart;ant of Revenue will issue an official assessment (Form REV-lSd8 EX) upon receipt of the return from the Register of Mills. TAX RETURN - PART 2 - TAX COHPUTAT[ON LINE 1. Enter the date the account originally was estabtished or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/II/BI: Accounts which the decedent put in ~oint names within one (1) year oF death are taxable fully as transfers. However, there is an exclusion not to exceed $5,000 per transferee regardless of the value of the account or the number of accounts held. If a doubIe asterisk (xx) appears before your first name in the address portion of this notice, the $5,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the totaI balance of the account including interest accrued to the date of death. 5. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets estabIished more than one year prior to the decedent's death: I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIVINg JOINT ONNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 5 (JOINT BNNERS) DIVIDED BY Z (SURVIVORS) = .I67 X lO0 = I6.7X (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust far another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X lO0 PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one year of dsath by the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .an X 100 = 50Z (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line ~) is datarmlnad by multiplying the account balance (line Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line q). 7. Enter the appropriate tax rate (line 7) as determined baloe. Date of Death Spouse Lineal Sibling I Collateral 07/01/9q to 12/$1/9q 01/01/95 to 06/30/00 OX 6X 07/01/00 to present OX q.SZ~ 12X wTha 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 OZ. The lineal cIass of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural chiIdren whether er not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, #bather by blood ar adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAZHED DEDUCTTONS - PART $ - DEIiTS AND DEDUCTIONS CLA[HED Allowable debts and deductions are determined as follows: A. You legally ere responsible for payment, or the estate subject to administration by a persona! representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 I/Z" x Il". Proof of payment may be requested by the PA Department of Revenue. 18 6o~way Dr Mechanicsburg, PA 170¢)5-6135 P.O. Box or ~l~t~ Apt. Number 3'7 CONNONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF /NDIV/DUAL TAXES DEPT. ZB0601 HARRISBURG, PA 171Z8-0601 REV-~,i' EX AFP F'rLE NO. Z1 f,~..~q -- ,~(-.~ ,_'_'~ ACN 0q113956 DATE 0q-06-200~ P..ST. OF CHARLES E WISE S.S. NO. 180-09-2951 LEVERE C WISE APT 217 121 1ST AVE RED LION PA 17:556 TYPE OF ACCOUNT ~]SAVINgS [~CHECKZNG ['--]TRUST [~CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 MEMBERS 1ST FCU has provided the Department with the information 11sted below which has been used in calculating the potential tax due. Their records indicate that at the death of tho above decedent, you wore a jolnt owner/beneficiary of this account. Zf you feel this information is incorrect, please obtain writtan correction from the financia! institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance with tho Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-6527. COMPLETE PART 1 BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account: No. 1Z57:SZ-11 Date 06-19-1992 Established Accoun~ Balance 5q3.3:5 Percen~ Taxable X 16. 667 Aeoun~ Sub~ec~ ~o Tax 90.56 Tax Ra'l:e X . Oq5 Po~en~iel Tax Due ~. 08 To insure proper credit to your account, tee (Z) copies of this notice must accompany your payment to tho Register of Mills. Make check payable t~: "Register of Niils, Agent". NOTE: If tax payments are made within three (5) months of the docedent'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. PART TAXPAYER RESPONSE A. ~ 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 -- CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of L ONE ~ Hills and an official assessment will be issued by the PA Department of Revenue. BLOCK ~ a. [] The above asset has been or will be reported and tax paid with tho Pennsylvania Inheritance Tax return ONLY to be filed by the decedent's representative. C. [] Tho above inforaation is incorrect and/or debts and deductions wore paid by you. You must complete PART [] and/or PART [] below. PART Tf you indicate a differen~ ~ax ra~e, please s~a~e your relationship to decedent: TAX RETURN - COMPUTAT:ZON OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Da~e Established I 2. Accoun~ Balance 2. $. Percent Taxable $ ~ q. Amoun~ SubSec~ *o Tax q S. Debts and Deductions ~ - 6. Aeoun~ Taxable 6 7. Tax Ra~e 7 X 8. Tax Due 8 PART DATE PAID DEDTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Coepu~ation) Under pene~ias of perjury, T declare ~hat ~he fac~s T have reported above are true, correct and TAXPAYER/SIGNATURE TELEPHONE NUMBER 'DATE ' BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DZVZSTON DEPT. 280601 HARRTSBURG, PA 171ZS-OGD1 LEVERE APT 217 121 1ST AVE RED LION C WISE '04 COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF /NHER/TANCE TAX APPRAISEHENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-$1-2004 ESTATE OF WISE DATE OF DEATH 1Z-25-ZO05 FILE NUMBER Z1 04-0542 COUNTY CUMBERLAND SSN/DC 180-09-2951 ACN 04115957 Amoun~ Remi~ed REV-I;48 EX AFP CHARLES MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-$1-2004 ESTATE OF WISE CHARLES E DATE OF DEATH 12-25-2005 COUNTY CUMBERLAND FILE NO. 21 04-0542 S.S/D.C. NO. 180-09-2951 ACN 04115957 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 125752-46 TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 04-04-2005 Account Balance Percent TaxabIe Amount Subject to Tax Debts and Deductions TaxabIe Amount Tax Rate Tax Due 10,520.96 NOTE: X 1.000 10,520.96 _ .00 10,520.96 X .45 475.44 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." TAX CREDZTS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-09-2004 CD005805 .00 475.44 TOTAL TAX CREDIT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 475.44 .00 .00 .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADH/N- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fuXfill the requirements of Section 21~0 of tho Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to tho Register of #ills printed on the reverse side. -- Make check er money order payable to: REGISTER OF NILLS, AGENT. A refund of a tax credit, ehich mas not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of tho Register of Hills, any of the 25 Revenue District Offices or by calling the special Z~-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers eith special hearing and or speaking needs: 1-800-qq7-3020 [TT only). Any party in interest not satisfied with the appraisement) allowance, or disallowance of deductions or assessment of tax (including discount or interest} as shown on this Notice amy object within sixty (60) days of receipt of this Notice by: --mritton protest to the PA Department of Revenue, Board of Appeals, Oept. 281021, Harrisburg) PA 17128-1021) OR --electing to have tho matter determined at tho audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue) Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit) DEPT. gao601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-lEO1) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedont's death, a five percent (5X) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the totat of the tax and interest assessed, and not paid before January 18) 1996) the first day after the end of tho tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death) to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q. A11 taxes which became delinquent on or after January 1, 198Z wi11 bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .0005q8 198'~%-1991 112 .000501 ZO0'--~ 92 .O00Zq7 1983 162 .000~58 1992 92 .O00Zq7 ZOOZ 62 .000219 198q 112 .000501 1995-199q 72 .O0019Z 2003 52 .000157 1985 152 .000556 1995-1998 92 .O00Zfi7 ZOOq ~2 .000110 1986 102 .O00Z7q 1999 72 .000192 1987 92 .0002~7 ZOO0 8Z .000219 --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELTNI~UENT X DATLY 'rNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15} days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES ZNHERITAHCE TAX DIVZSZON DEPT. Z80601 HARRZSBUR~-, PA 171Z8-0601 LEVERE C WISE(] APT Z17 121 1ST AVE t... RED LION ~A :PA. 17356 COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTZCE OF INHERITANCE TAX APPRAZSEHENT, ALLOHANCE OR DISALLO#ANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-$1-ZO0q ESTATE OF WISE DATE OF DEATH 12-25-2005 PILE NUHBER 210q-OSRZ COUNTY CUMBERLAND SSN/DC 180-09-2951 ACN 0~115956 Amount: Remitted REV-15~i8 EX AFP C01-03) CHARLES E HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-31-200~ ESTATE OF WISE CHARLES E DATE OF DEATH 12-25-2005 COUNTY CUHBERLAND FILE NO. 210q-O3q2 S.S/D.C. NO. 180-09-2931 ACN 0~113936 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORHATZON FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 125732-11 TYPE OF ACCOUNT: C ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-19-1992 Account Balance 5~3.33 Percent Taxable X 0.166 Amount Subject to Tax 90.56 Debts and Deductions - .00 Taxable Amount 90.56 Tax Rate X .Q5 Tax Due ~.08 TAX CREDZTS: 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." PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) Oq-O9-ZOOq CD003798 .00 q.08 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 TS LESS THAN $1, NO PAYHENT 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. ) q.08 .00 .00 .00 PURPOSE OF NOTICE: PAYNENT: REFUND (ER): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (71 P.S. Section 91~0). Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF RILLS, AGENT. A refund of a tax credit, which was not requested on tho tax return, may bo requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513)o Applications ara available at tho Office of the Register of NiIIs, any of the 23 Revenue District Offices or by calling the special Z4-hour answering service for fores ordering: 1-800-56Z-ZO50) services for taxpayers with special hearing and or speaking needs: 1-800-q~7-30ZO (TT only). Any party in interest not satisfied with the appraisement, allowance) or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1011, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. Z80601, Harrisburg, PA 171Z8-0601 Phone [717) 787-6505. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-150I) for an explanation of administrativeIy correctable errors. If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SX) discount of the tax paid is allowed. The 15X tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed es indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day fram the date of death, to the date of payment. Taxes ehich became delinquent before January 1, 198Z bear interest at tho rate of six (6Z) percent per annum calculated at a daily rate of .D00164. Ali taxes which became delinquent on or after January 1, 1982 wilZ bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZO0~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198"--~ 2OX .000548 198'~8-1991 llX .000301 ZOO~ 91 .000247 1983 161 .000~38 1992 91 .000147 ZOOZ 61 .000119 198q llZ .000301 1993-199~ 7Z .000191 2003 5Z .000137 1985 132 .000356 1995-1998 92 .000247 2004 42 .000110 1986 IOZ .000274 1999 7Z .000191 1987 9Z ,O00Z~7 ZOO0 8Z .000119 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DEL'rNQUENT X DA.fEY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is mede after the interest computation date shown on the Notice, additional interest oust be calculated. -- BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DTVTSTON DEPT. Z80601 HARRISBURG, PA 171Z8-060! ELEANOR V SHREVE 18 CONWAY DR HECHANICSBURG CONNONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLOHANCE OR DZSALLONANCE OF DEDUCTION~, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP (01-03) COUNTY x_SSN/DC ACN PA 170c55 DATE 11-08-ZOOfi ESTATE OF WISE CHARLES DATE OF DEATH 12-25-2003 FILE NUNBER 21 04-03fi2 CUHBERLAND 180-09-2931 04113935 Amoun~ Romi~ed I HAKE CHECK PAYABLE AND RENIT PAYNENT TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17013 E CUT ALONG THZS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *~ REV-1548 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-08-2004 ESTATE OF WISE CHARLES E DATE OF DEATH 12-25-2003 COUNTY CUHBERLAND FILE NO. Z1 04-0342 S.S/D.C. NO. 180-09-2931 ACN 04113935 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORNATION FINANCIAL INSTITUTION: HENBERS 1ST FCU ACCOUNT NO. 125732-11 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIHE CERTIFICATE DATE ESTABLISHED 06-19-1992 Account Balance Percent Taxable X 0.166 Amount Subject to Tax 90.56 Debts and Deductions .00 Taxable Amount 90.56 Tax Rate X .45 Tax Due 4.08 TAX CREDITS: 543.33 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYNENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYHENT RECEIPT DISCOUNT (+) ANOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 04-12-2004 CD003807 .00 4.08 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE ZF PAZD AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL ZNTEREST. ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORH FOR ZNSTRUCTZONS. 4.08 .00 .00 .00 PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Zi~O af the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TI P.S. Sect[on 91~0). Detach the top portion of this Not[ce and submit with your payment to the Register of Hills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, which ams not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Off[ce of the Register of Hills, any of the Z3 Revenue District Offices or by calling the special 2~-hour ensnaring service for fores ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and or speaking needs: 1-B00-~7-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Not[ce may object within sixty (60) days of receipt of this Not[ca by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ZB-1021, OR --electing to have tho matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ZB0601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedent's death~ a five percent (5Z) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty per[od. This non-participation penalty is appealable in the same manner and in the the same time per[od as you would appeal the tax and interest that has been assessed as indicated on this not[ca. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes Nh[ch became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on or after January 1, 198Z w[11 bear interest at a rate which w[11 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOfi are: Interest Daily Interest Da[ly Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198~'~ ZOZ .O00Sfi8 1988-1991 11Z .000301 2001 9Z .0002fi7 1983 16Z .000~38 1992 9Z .O00Z~7 ZOOZ 6Z .O00Z19 198~ llZ .000301 1993-199~ 7Z .O00XgZ 2003 5Z .000137 1985 13Z .000S56 1995-1998 9Z .O00Z~7 ZO0~ ~X .000110 1966 XOZ .O0027~ 1999 72 .00019Z 1987 9Z .O00Z~7 ZOO0 8Z .000Z19 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPA'rD X NUHBER OF DAYS DELTNQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Not[ce, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES TNHERTTAHC£ TAX DIVISTOH DEPTo ZSD601 HARRTSSURG, PA 171Z8-0601 ELEANOR V SHREVE 18 CONWAY DR MECHANICSBURG COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLONANCE OR DISALLONANCE OF DEDUCTION~, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP COl-OS) FILE NUMBER COUNTY ACN · DATE ll-08-ZOOq ESTATE OF WISE CHARLES DATE OF DEATH 12-25-2005 21 0q-05~2 CUMBERLAND 180-09-2951 0~113958 Amoun~ Rem~.'~'l:~d I HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 E CUT ALONG THIS LINE ~,- RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSENENT, ALLOWANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-08-200~ ESTATE OF WISE CHARLES E DATE OF DEATH 12-25-2003 COUNTY CUMBERLAND FILE NO. 21 0~-03q2 S.S/D.C. NO. 180-09-2931 ACN 0~113938 TAX RETURN WAS: IX) ACCEPTED AS FILED ( ) CHANGED JOZNT OR TRUST ASSET ZNFORNATZON FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 12573Z-~5 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED O~-O~-ZO03 Account Balance 10,520.96 Percent Taxable X 1.000 Amount Subject to Tax 10,5Z0.96 Debts and Deductions .00 Taxable Amount 10,520.96 Tax Rate X .q5 Tax Due ~73.~ 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 ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: ""REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID C- AMOUNT PAID Oq-12-ZOOq CD003808 .00 q73.qq IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT ZS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE q73.qq .00 .00 .00 PURPOSE OF NOTICE~ PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements oF Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of 2000. (72 P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. -- Make check or money order payable to: REGISTER OF NILLS, AGENT. A refund of a tax credit) which was not requested on the tax return, may be requested by completing an "AppIication for Refund of Pennsylvania Inheritance and Estate Tax" (REV-L313). Applications are available at the Office oF the Register of NilLs, any of the Z3 Revenue District Offices or by ceiling the special gq-hour answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and or speaking needs: 1-800-~q7-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown an this Notice amy object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of AppeaLs, Dept. ZSIOZI, Harrisburg, PA 17128-1021, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. gE0601, Harrisburg, PA 171gS-060I Phone [717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (RE¥-ISOL) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (aZ) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, L996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the date of death, to the date of payment. Taxes which became delinquent before January I, L982 bear interest at the rate of six (6g) percent par annum calculated at a daily rate of .OOOL6q. AIL taxes which became delinquent on or after January i, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOq are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .0005q8 198'~'8-199L 1LZ .OOO30l ZO0'~ 9Z .0002q7 1985 16Z .000q38 1992 9Z .O00Zq7 ZOOZ 6Z .000Z19 198q llZ .000301 1993-199q 72 .O0019Z 2005 5Z .000137 1985 132 .000356 1995-1998 92 .O00Zq7 ZOOq qZ .O00110 1986 lOX .O00Z7q 1999 7Z .00019Z 1987 92 .000247 ZOO0 8Z .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELTNI;IUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated. -- BUREAU OF INDIVIDUAL TAXES · INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 ELEANOR V SHREVE 18 CONWAY DR MECHANICSBURG COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-08-200q ESTATE OF WISE DATE OF DEATH 12-25-2005 FXLE NUMBER 21 0q-03~2 COUNTY CUMBERLAND SSN/DC 180-09-2931 ACM 0~11~730 Amoun'~ Remi'l:'l:ed REV-I~40 EX &FP (01-05) CHARLES E HAKE CHECK PAYABLE AND REMXT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-15&8 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-08-200~ ESTATE OF WISE CHARLES E DATE OF DEATH 12-25-2003 COUNTY CUMBERLAND FILE NO. 21 0q-03~2 S.S/D.C. NO. 180-09-2931 ACM 0~11~730 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATXON FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. 0008-05q83 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-01-1967 Account Balance Percent Taxable X 0.500 Amount Subject to Tax 859.28 Debts and Deductions .00 Taxable Amount 859.28 Tax Rate X .15 Tax Due 128.89 TAX CREDITS: 1,718.55 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.** PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) Oq-12-200q CD003809 .00 128.89 TOTAL TAX CREDIT BALANCE OF TAX DUE XNTEREST AND PEN. TOTAL DUE XF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. a IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REI~U/RED. ZF TOTAL DUE TS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND· SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 128.89 .00 .00 .00 PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADH/N- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (72 P.S. Section Detach the top portion of this Notice and submit aith your payment to the Register of Hills prlnted on the reverse side. -- Hake check or money order payable to: REGISTER DF HILLS, AGENT. A refund of a tax credit, ahich ams not requested on tho tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or by calling the special Z~-hour answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers aith special hearing and or speaking needs: 1-800-~7-50Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice say object within sixty (60) days of receipt of this Notice by: --aritten protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 17128-lOZ1, OR --electing to have the setter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Departeent of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, DEPT. 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allowed. The 15Z tax aenesty non-participation penalty is computed on the total of the tax and interest assessed, and nat paid before January 18, 1996, the first day after the end of the tax aenesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you #ould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (SZ) percent per annum calculated at a daily rate of .00016~. All taxes which be:ace delinquent on or after January 1, 198Z will bear interest at a rate which ail1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rata Factor Year Rate Factor Year Rate Factor 1982 20Z .O00SqB 196-~8-1991 llZ .000S01 ZO0'~ 9Z .000247 1985 16Z .000~8 199Z 9Z .O00Z~7 ZOOZ 6Z .O00Z19 19B~ 11X ,000~01 1995-199~ 7Z ,00019Z ZOO3 SZ .0001~7 1985 ISZ .000356 1995-1995 92 .O00Z~7 ZO0~ ~Z .000110 1966 lOZ .O00Z7~ 1999 72 .O0019Z 1987 92 .O00Z~7 ZOO0 8Z .O00Z19 --Interest is calculatad as follows: INTEREST = BALANCE OF TAX UNPAID X NU~IBER OF DAYS DELI'NQUENT X DAZEY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: JOHN F. LOVETT, SR. Date of Death: April 2, 2005 Estate No.: 2005-00342 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion ofthe administration ofthe above captioned Estate: 1. State whether administration of the Estate is complete: YES: x NO: 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. lfthe answer to No.1 is Yes, state the following: (a) Did the personal representative file a final Account with the Court? YES: NO: x (b) The separate Orphans' Court No. (if any) for the personal representative's account is: (c) Did the personal representative state an account informally to the parties in interest? YES: x NO: (d) Copies of receipts, releases, joinders and approvals of formal or inti al accounts may be filed with the Clerk ofthe Orphans' Court and y e attached to this report. Dated: Signature Francis . 109 Loc Street Harrisburg, PAl 71 0 1 (717) 232-1488 a (' .-' I! j r 7 ., .( ,'r ,<) ...I;,.J !.J ~ 1 '. \..;J II nil? r _U ,." Capacity: Personal Representative x Counsel for Personal Representative J