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Home My WebLink About02-0090'02 J~N 25 ~'~'!~ :38 G.I I',) 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 00O799 GIBSON QUILETT 19 DREXEL ROAD BUFFALO, NY 14214 ........ fold ESTATE INFORMATION: SSN: 184-16-5984 FILE NUMBER: 21 - 2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/25/2002 POSTMARK DATE: 01/23/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01143349 I $167.58 REMARKS. QUILETT GIBSON TOTAL AMOUNT PAID: $167.58 SEAL CHECK# 4656756 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS JaN 25 i;~I 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 000800 GIBSON QUILETT 19 DREXEL ROAD BUFFALO, NY 14214 ........ fold ESTATE INFORMATION: SSN: 184.-16-5984 FILE NUMBER: 21-2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/25/2002 POSTMARK DATE: 01/23/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01143347 $533.23 REMARKS: QUILETT GIBSON TOTAL AMOUNT PAID: $533.23 SEAL CHECK# 4656755 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS 'Q2 JAN 25 ,'i": ,~! :39 Ctt~nbe~ .-, 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 000801 GIBSON QUILETT 19 DREXEL ROAD BUFFALO, NY 14214 fold ESTATE INFORMATION: SSN.' 184-16-5984 FILE NUMBER: 21-2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/25/2002 POSTMARK DATE: 01/23/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01141882 $221.12 REMARKS' QUILETT, GIBSON TOTAL AMOUNT PAID: $221.12 SEAL CHECK# 4656758 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS '02 JAN 25 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 000802 GIBSON QUILETT 19 DREXEL ROAD BUFFALO, NY 14214 ........ fold ESTATE INFORMATION: SSN: 184-16-5984 FILE NUMBER: 21-2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/25/2002 POSTMARK DATE: 01/23/2002 COUNTY: CUM BERLAN D DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01143348 $623.68 REMARKS: QUILETT GIBSON TOTAL AMOUNT PAID: $623.68 SEAL CHECK# 4656757 INITIALS: AC RECEIVED BY: MARY C. LEWIS 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) 000806 GIBSON JANET 150-7TH STREET//104 BUFFALO, NY 14201 ........ fold ESTATE INFORMATION: SSN: 184-16-5984 FILE NUMBER: 21-2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/28/2002 POSTMARK DATE: 01/24/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01141881 $167.58 REMARKS- JANET GIBSON TOTAL AMOUNT PAID: $167.58 SEAL CHECK# 4621478 INITIALS: CW RECEIVED BY: MARY C. LEWIS 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 000807 GIBSON JANET 150-7TH STREET #104 BUFFALO, NY 14201 ........ fold ESTATE INFORMATION: SSN.. 184-16-5984 FILE NUMBER: 21-2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/28/2002 POSTMARK DATE: 01/24/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01141879 $533.23 REMARKS: JANET GIBSON TOTAL AMOUNT PAID: $533.23 CHECK# 4621476 SEAL INITIALS: CW RECEIVED BY: MARY C. LEWIS 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 000808 GIBSON JANET 150-7TH STREET//104 BUFFALO, NY 14201 ........ fold ESTATE INFORMATION: SSN: 184-16-5984 FILE NUMBER: 21-2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/28/2002 POSTMARK DATE: 01/24/2002 COUNTY: CUM BERLAN D DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01141880 $623.68 REMARKS' JANET GIBSON TOTAL AMOUNT PAID: $623.68 SEAL CHECK//4621475 INITIALS: CW RECEIVED BY: MARY C. LEWIS 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 OO08O9 GIBSON JANET 150-7TH STREET #104 BUFFALO, NY 14201 ........ fold ESTATE INFORMATION: SSN: 184-16-5984 FILE NUMBER: 21-2002- 0090 DECEDENT NAME: GIBSON THOMAS L DATE OF PAYMENT: 01/28/2002 POSTMARK DATE: 01/24/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/02/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01141883 $221.12 REMARKS: JANET GIBSON TOTAL AMOUNT PAID: $221.12 SEAL CHECK# 4621477 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS CONNONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 1712&-0601 RE¥-lF43 EX AFP (09-00) INFORMATION NOTICE AND TAXPAYER RESPONSE QUILETTE GIBSON 19 DREXEL RD BUFFALO NY lqZlq FI:LE NO. 21_c--?~_ ~2~ ACN 011~3347 DATE 09-25-2001 TYPE OF ACCOUNT EST. OF THOMAS L GIBSON [] SAVINGS S.S. NO. 18q-16-5984 [] CHECKTNG DATE OF DEATH 05-02-2001 [] TRUST COUNTY CUMBERLAND [] CERTTF. REHTT PAYMENT AND FORMS TO: REGISTER OF ~/ILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you mere a joint o-nar/beneficiary of this account. If you fee! this information is incorrect, please obtain erittan correction free the financial institution, attach a copy to this fora and return it to the above address. This uccouf~t is taxable in accordance .ith the Inheritance Tax La.s of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-83Z7. COMPLETE PART ! BELON ~ ~ # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Aocoun~ No. 5150361034 Da~e 02-~-2001 To insure proper credit to your account, two Established (z) copies of this notice must accompany your Accoun* Balance 2~, 699.2~ payment to the Register of Hills. Make check payable to: "Register of #ilZs, Agent". Percen~ Taxable X 50.0 0 0 Amoun~ Subjec~ ~o Tax 11,849.62 NOTE: Tf tax payments are made within three ($) months of the decedent's date of death, Tax Ra~e X .0~ you amy deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent Po~en~ial Tax Due 5~. ?~ nine (9) months after the date of death. PART TAXPAYER RESPONSE A. The above inforeation and tax due is correct. · ~'"' 1. You may choose to remit payment to the Register of Hills w/th two copies of this notice to obtain CHECK ONE BLOCK ONLY PART TAX LTNE a discount or avoid interest, or you amy check box "A" and return this notice to the Register of Hills and an official assessment .ill be issued by the PA Department of Revenue. B. [] The above asset has been or .ill be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions .ere paid by you. You must complete PART ~ and/or PART ~ belo.. If you indicate a different tax ra~e, please s~a~e your relationship ~o decedent: RETURN - COMPUTATION OF TAX ON dOZNT/TRUST ACCOUNTS 1. Da~e Es*ablished 2. Accoun~ Balance 2, 3. Percen~ Taxable 3 q. Amoun~ Subjeo~ ~o Tax ~. Debts and Deductions S - 6. Amount Taxable 6 7. Tax Ra*e 7. 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCT'rONS CLAIME~ PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line S of Tax Co.puPation) Under penalties of perjury, I declare ~ha~ ~he fac~s I have reported above are ~rue, correc~ and le*e ~o *he bes* of I~nowled~e and belief. HOME TELEPHONE NUHBER GENERAL INFORMATION 1. FAILURE TO RESPOND #~LL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted 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 decadant's name was added es a matter of convenience. 4. Accounts (including those hold between husband and #ifa) which the decedent put in joint names within one year prior to death are 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 or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 - 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 1 of the "Taxpayer Response" section. Sign two copies and submit thee with your check for the amount of tax to the Register of Rills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1S4B EX) upon receipt of the return from the Register of Rills. 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 I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Oept lB0601, Harrisburg, PA 171ZB-0681 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 and 5 according to the instructions bolo#. Sign two copies and sub~it thee 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 (Form REV-154D EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART Z - TAX COMPUTATION 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 lZ/lZ/SZ: 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 (wu) 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. 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 decadent's death: I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT OkgIERS Example: A joint asset registered in the name of the decedent and two other persons. ! DIVIDED BY 5 (JOINT O#NERS) 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 dacadant's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE O#NERS OR 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 = SOX (TAXABLE FOR EACH SURVIVOR) 4. 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. The 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 (llne 7) as determined below. Da~e of Death Spouse Lineal Sibling Collateral 07/01/9q ~:o 12/$1/9q eX 6X 15X l~X 01/01/95 ~o 06/50/00 OX 67. 07/01/00 ~o presen~ OX q.SZ~ 12X ..... ~ __1 .... · +,~ne~e~ &rom a deceased chiId twenty-one years of age or younger at ~The tax rate imposed on th~ death to or for the use of a natural parent, an adoptive parent, or a stepparant of the child is The lineal class of heirs includes grandparents~ parents~ children, and lineal descendents. "Children" includes nature! 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 descendants, whether or not they have been adopted by othars~ adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the dacedent~ whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS PART $ - DE~TS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: 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 plain paper B l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. COHHONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171Z8-0601 REV-I~4$ EX AFP (09-00) QUILETTE GIBSON 19 DREXEL RD BUFFALO NY 1421q ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FZLE NO. 21--/~-~ ACN 01141882 BATE 09-17-2001 TYPE OF ACCOUNT EST. OF THOMAS L GIBSON [] SAVINGS S.S. NO. 18~-16-598R [] CHECKZN; DATE OF DEATH 05-02-2001 [] TRUST COUNTY CUMBERLAND [] CERTZF. REH'rT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PHC BANK has provided the Department aJth the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decadent, you ware a joint o~nar/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in aCCordance aith the Inheritance Tax LaMs of the Co~-on.ealth of Pennsylvania. Questions may be answered by calling (717) 787-83Z7. COMPLETE PART 1 BELOW # # N SEE REVERSE SlOE FOR FILING AND PAYMENT ZN$¥AUCTZONS Account No. 31300203719 Date 02-19-1998 Establ/shed Account Balance 29,481.80 Percent Taxable X 16.66 7 Amount Subject to Tax 4,913.73 Tax Rate X .045 Potent/aX Tax Due 221.12 To insure proper credit to your ac¢ount~ two (Z) copias 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 within three (3) months of the dacedent's date of death, you lay deduct a 5~ discount of the tax due. Any inheritance tax due will becole delinquent nine (9) ecnths after the date of death. PART TAXPAYER RESPONSE A. ~Tbe above information and tax due is correct. 1. You lay choose to remit payment to the Register of Hills with two copies Of this notice to obtain CHECK ONE BLOCK ONLY PART TAX LTNE a discount or avoid interest, or you may check box 'A" and return this notice to the Register of #i~ls and an official assessment will be issued by the PA Departlent of Revenue. B. ~The above asset has been or will be reported and tax paid ~]th the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions ware paid by you. You must complete PART ~and/or PART ® below. Zf you indicate a dJfferent tax rate, please state your relationship to decedent:,, RETURN - CONPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS 1. Da~e Established 2. Account Balance 2 3. Percent Taxable 3. ~ q. Amount Subject to Tax 4 ~. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE PAID BEBTS AND DEDUCTIONS CLAXN~n PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) Under penalties of perjury, T declare that the facts T have reported above are true, correct and coeple~t~-)to the ~bast of my knowledge anc~ belief. *~ HOME ~ ~,"~'--' WORK ( GENERAL INFORMATION 1. FAILURE TO RESPOND W/LL RESULT ZN AN OFFIC/AL TAX ASSESSNENT .ith applicable irrterest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent ninelonths after the decedent's date of death. 3. A joint account is taxable even though the decedent's nome mas added as a matter of convenience. 4. Accounts (including these held between husband and wife) which the decedent put in joint names mithin one year prior to death are fully taxable as transfers. 5. Accounts established jointly betmeen husband and eife more than one year prior to death are not taxable. 6. Accounts held by e decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS- PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct end deductions are not belng claimed, place a~ "X' in block "A" of Part I of the "Taxpayer Response" section. Sign tmo copies and submit them mith your check for the amount of tax to the Register of Nills of the county indicated. The PA Department of Revenue mill issue an official assessment (Fore REV-1548 EX) upon receipt of the return fram the Register of Nills. Z. BLOCK B - If the asset specified on this notice has been or mill 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 I of the "Taxpayer Response" section. Sign one copy end return to the PA Department of Revenue, Bureau of individual Taxes, Oept ZB0601, Harrisburg, PA 17IZB-0601 [n tho envelope provided. $. BLOCK C - If the notice inforletion is incorrect and/or deductions ere being cleiand, check block "C" and coaplete Parts Z and $ according to the instructions below. Sign t.o copies end sublit thee with your check for the elount of tax payable to the Register of #ills of the county indicated. The PA Depertaent of Revenue ail! issue en official assess, ant (Fore REV-154B EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART 2 - TAX COHPUTAT~ON LINE l. Enter the date the account originally ams established or titled in the manner existing et date of death. NOTE: For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (I) year of death are taxable fully as transfers. Hoaever, 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 (Mx) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted free the account balance as reported by the finencial institution. 2. Enter the total balance of the account including interest accrued to tho 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 tho decedant's death: ! DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X lO0 = PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of the decedent end taD other persons. 1 DIVIDED BY 3 (JOINT Ok~IERS) DXVXDED BY 2 (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent's death or accounts caned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent end t~o other persons and established ,ithin one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .30 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR3 The alount 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. The aiount taxable (line 6) is deterlined by subtracting the debts and deductions (line 5) fro~ the amount subject to tax (llne 7. Enter the appropriate tax rate (line 7) as ~eterlined below. Da~e of -ne=-~h Sr.e;,~. Lineal SiblXng Coils*staX 07/01/9q 4o 12/$1/9q SZ 6X 01/01/95 4o 06/30/00 OX 6X 07/01/00 ~o pr~ OX q.SX~ 12X XJX _~ ,~- --+ ,,~.~ ~; *rams;ers ~ro. a deceased child t~enty-one years o~ age or at younger ~The tax rate impose( loath to or for the use of 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 uhether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents end their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" ars defined as individuals .ho have at least one parent in coemon with the decedent, .hother by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries- CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTXONS CLAIMED Allocable debts and deductions are deterainod as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pey the deductible items. B. You actually peid the debts efter deeth of the decedent end c~n furnish proof of peyment. C. Debts being claimed must be itemized fully in Pert 3. If sdditionel spece is needed, use plein paper & l/Z" x 1I~. Proof of peyeent aey he requested by the PA Depertment of Revenue. CONNONNEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE DUREAU OF ZNDZVZDUAL TAXES DEPT. 28060l HARRISBURG, PA 17128-060! REV-154S EX AFP (D9-05) ZNFORMATZON NOTICE AND TAXPAYER RESPONSE FZLE NO. 21-~)~' ~O ACN DATE 09-25-2001 QUILETT GIBSON 19 DREXEL RD BUFFALO NY lq21q TYPE OF ACCOUNT EST. OF THOHAS L GIBSON [] SAVTNOS S.S. NO. 18~-16-598~ [] CHECKZNG DATE OF DEATH 05-02-2001 [] TRUST COUNTY CUMBERLAND [] CERTTF. REHZT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 PNC BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, You mare a joint owner/beneficiary of this account. Zf you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This accou, t Js taxable in accordance with the inheritance Tax Laws of the Com~onweaZth of Pennsylvania. Questions amy be answered by calling (717) 787-8527. COMPLETE PART I DELOW # # ~ SEE REVERSE SiDE FOR FiLiNG AND PAYHENT iNSTRUCTiONS PART Account No. 51fi018~588 Date 02-15-2001 Established Account Balance 27,719.22 Peroen~ Taxable X 50.000 Amount Subjac~ to Tax 15,859.61 Tax Rate X .0~5 Potential Tax Due 625.68 To insure proper credit to your account, tho (2) copies of this notice must accompany your payment to the Register of NiIIs. Make check payable to: "Register of Hills, Agent". NOTE: Zf tax payments are lade within three (5) months of the decedent's date o~ death, you may deduct a 52 discount of the tax due. Any inheritance tax due wil! become deiinquent nine (9) months after the date of death. TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LTNE A. ~ The above information and tax due is correct. l. You may choose to remit Payment to the Register of Mills with two copies of this notice to obtain a discount or avoid interest, or you amy check box "A" and return this notice to the Register o; Hills and an o;ficJal assessment will be issued by the PA Department o~ Revenue. B. ~The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be ~ilad by the dacedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. Zf you ~ndica~e a differen~ tax ra~e, p]ee~ s~a~e your relationship ~o decedent: RETURN - COHPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS [. Da~e Established 2. Accoun~ Balance 2 ~. Percent TaxabZe 3 ~. Amount Subject to Tax ~.. 5. Debts and Deductions S 6. Amount Taxable 6... 7. Tax Rate 7 8. Tax Due 8 PART DATE PAID DEDTS AND DEDUCTZONS CLAZNED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne S o~ Tax Computation) $ _~ Under penalties of perjury, Z decZare that the facts ! have reported above are true, correct and /~om~lete to the bes~ ~ my knowledge and belief. ' WORK (?/G) &~/ -G~S-4. -, _. / -~ ~PAYER SISN~TURE ~ I?-~ -~ TELEPHONE NUMBER DAT~ GENERAL INFORMATION 1. FAILURE TO RESPOND NILL RESULT IN AN OFFICIAL TAX ASSESSNENT with applicable interest based on information submitted 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 decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband end wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year pr[or to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART I - 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 Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-154& 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 mith 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, Oept Z88601, Harrisburg, PA 171Z&-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 and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION 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 1Z/II/aZ: 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 (~x) appears before your first name in the address port[on of this notice~ the $3,000 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 taxable for each survivor is determined as folLo~s: A. The percent taxable for joint assets established more than one year pr[or to the decedent's death: i DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUHBER OF X I08 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 OIVIOED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 188 = 16.7Z (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 OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent end two other persons and established within one year of death by the decedent. i DIVIDED BY Z (SURVIVORS) = .50 X 180 = 50Z (TAXABLE FOR EACH SURVIVOR) 4. 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. The amount taxable (line 6) is deters[ned by subtracting the debts and deductions (line 5) from the amount subject to tax (line -fate tax rate (line 7) as leterained below. 7. Enter the aPF Date of Death Spouse Lineal Sibling Collateral 07/01/9q '1:o 12/$1/9q SZ 6Z 15Z 01/01/95 ~o 06/$0/00 OX 6Z lex l~Z 07/01/00 ~o preson~ OX q.~Z~ 12Z younger at ~The tax rate iaposed on death to or for tho use of a naturaI parent, an adoptive parent, or a stepparent of the chiId is OZ. The IineaI cIass of heirs incIudes grandparents, parents, children, and lineal descendents. "ChiIdran" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal desce~ents" includes ali children of the natural parents and their descendents, whether or not they have been adopted by othars~ adapted descendants and their descendants and stap-descendants. "SibIings" are defined as ind[v[duaIs who have at least one parent in common with the dece~nt, whether by blood or adoption. The "Collateral" class of heirs includes ali other beneficiaries. M CLAIMED DEDUCTIONS - PART 5 DEBTS AND DEDUCTIONS CLAI ED Allowable debts and deductions are determined as follows: 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 plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. COHNONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z8060! HARRISBURG, PA L7128-0601 REV-IE4~: EX AFP ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. ACN 0114S3q9 DATE 09-Z5-2001 EST. OF THOMAS L GIBSON S.S. NO. 18q-16-598q DATE OF DEATH 05-02-2001 COUNTY CUMBERLAND QUILETTE GIBSON 19 DREXEL RD BUFFALO NY lq21~ TYPE OF ACCOUNT [] SAVINGS [] CHECKTNG []TRUST [] CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Deportment with the information Listod below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a ~oint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form ond return it to the above address. This eccount is toxoble in accordance Pith the Inheritonce Tox Lows of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8~Z7. COMPLETE PART 1 BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 31500203013 Date 10-23-1998 Established Account BaIanoe 22,3q3.1 q Percen~ Taxable X 16. 667 Amount Sub~ect to Tax 3,723.93 Tax Ra~e X . OqS Potential Tax Due 167.58 To insure proper credit to your account, tho (Z) copies of this not,ce must accompany your payment to the Register of Nills. Make check payable to: "Register of Wills, Agent". NOTE: If tax payments are made within three (~) months of the decedent's date of death, you may deduct a 5X discount of the tax duo. Any inheritance tax due ~ill become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LINE A. '~/IThe above information and tax due is correct. L. You may choose to remit payment to the Register of ~il[s with t~o copies of this notice to obtain a discount or avoid intorost, or you lay check box "A" and return this notice to tho Register of Nills and an offlcial assessmontwil! bo issued by the PA Department of Revenue. B. [] The above asset has been or #ill be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions aere paid by you. You must complete PART [~land/or PART ® helou. ~f you ~nd~cate a d~fferent tax rate, p~ease state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Es*abl/shed 2. Account Balance 2 $. Percan~ Taxable $ ~ q. Aeoun~ Sub~ec~ to Tax q 5. Debts end,Deductions 5 6. Amount Taxable 6 7. Tax Ra~e 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, I declare tha~ ~he facts I have reported above are true, correct and /L let~e to the best.~f ay knowledge and bel,ef. HOME (~/~ /./ ,~ woRK ~XPAYER S~GNATURE TELEPHONE NUMBER DATE GENERAL INFORNATION 1. FAILURE TO RESPOND NILL RESULT ZN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the decmdent's date of death. 5. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) mhich the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly betmmmn husband and aJfe more than one year prior to death are 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 ! of the "Taxpayer Response" section. Sign two copies and submit them aith 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-1548 EX) upon receipt of the return from the Register of Rills. 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 decedmnt'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 280601, Harrisburg, PA 17128-0601 in the envelope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of ~il/s of the county indicated. The PA Department of Revenue mill issue an official assessment (Fora REV-1548 EX) upon receipt of the return from the Register of #ills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter the date the account originally was establlshed or titled in the manner existing at date of death. NOTE: For a decedent dying after 12/12/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 (**) 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. 2. Enter the total 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 folZoas: A. The percent taxable for joint assets established 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 ORNERS SURVIVING JOINT ONNERS Example: A joint asset registered in the name of the decedent and two other persons. I DIVIDED BY 3 (JOINT ORNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 ,= 16.7Z (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): i DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OHM(RS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and establlshmd wlthJn one year of death by the decedent. I DIVIDED BY Z (SURVIVORS) = .BO X 100 = 50g (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (llne Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 5. 6. The amount taxable (llne 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. Da{e of Dea{h Spouse Lineal Sibling Collateral 07/01/94 to 01/01/95 to 06/30/00 Oi iX 15Z 152 07/01/00 ~o present OX 4.5Z~ XThe tax rate imposed on the net value of transfers from a deceased child taenty-one years of age or younger et 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 ~hether 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 eith the decedent, whether by blood or adoption. The "CoZIateral" cZass of heirs includes a11 other beneficiaries. CLAIMED DEDUCTIONS PART 5 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: 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 plain paper B L/Z" x ll". Proof of payment may be requested by the PA Department of Revenue. i~:~::~::::i~i:~ ~ ~ i i i i ilil ~i!iiiiiii~ii~i~ii!i~i!i?ii!~iiii~iiiiiiii~iii~?~ii~iiiiiii!~i?~iii~!~i~i~i iiiiiiii!ili~~ :~:: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: i?:~::::ii::ii i::i::!ii iiiii ::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: l~ilili~iiiii~i?:ii~i~::::ii~~i~i::::::i~::iiii~s~i~i~ ~i::i~i~ ~ ~si~i~ ~ :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: [~fi~i ~:::~ ~g~g~::~?:~i~:;~ ~ fi~:: ::~:~:: ~ ~fi~i~g~ig::~::~::~:::~::~:~::~i~Z~ ~ :: ::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::: CGt~ION#EALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF IND[VZDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-IS,~5 EX AFP / '7- $'7- '-/ INFORMATION NOTICE AND TAXPAYER RESPONSE FZLE NO. Zl -0~~ ~0 ACN 01141879 DATE 09-17-2001 EST. OF THONAS L GIBSON S.S. NO. 184-16-5984 DATE OF DEATH 05-02-2001 COUN~ CUMBERLAND JANET GIBSON 240 WALNUT BOTTOM RD CARLISLE PA 17015 TYPE OF ACCOUNT [] SAVINGS [] CHECK/NG [] TRUST [] CERTZF. REMTT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 PNC BANK has provided the Department uith the information listed belo~ ~hich has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you mere a joint o.ner/beneficiery of this account. ~f you ~ee! this inforaatJon is incorrect, please obtain written correction froe the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance .ith the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling ¢717) 787-8327. CONPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT 1NSTRUCTZONS A~-coun~ No. 5130361034 Da~e 02-13-2001 To insure proper credit to your account, two Established cZ) copies of this notice eust accoepany your Accoun~ Balance 23,699 ~3 payment to the Register of Hills. Hake check · payable to: "Register of N~lls, Agent". Percen~ Taxable X ~0. 000 A.oun~ Subjec~ ~o Tax 11,8~. ~ ~TE: I~ tax ~y.ents are made .Jthin three (S) months o~ the decedent's date o~ death, Tax Ra~e X .0~ you ~ay ded~t a 5~ discount o~ ~e ~x due. Potential Tax Due 5~. 2~ Any ]n~r]tance tax d~ .ill bache delinq~nt nJ~ (9) monks a~ter the date o~ dea~. PAST TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LINE A. ~he above inforaatiun and tax due is correct. ~ 1o You aay choose to remit payment to the Register of #ills with two cop/as o~ 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 essesseent .ill be issued by the PA Department of Revenue. B. [] The above asset has been or will be reported and tax paid ~ith the Pennsylvania Inheritance Tax return to be filed by the decadent's representative. C. [] The above information is incorrect and/or debts and deductions ,ere Paid by you. You must complete PART ~and/or PART ~below. If YOU indicate a differen~ ~ax ra~e, please s~a~e your relationship ~o decedent: RETURN - COHPUTATZON OF TAX ON JOiNT/TRUST ACCOUNTS 1. Da~e Established 1 2. Accoun~ Balance 2 $. Percen~ Taxable $, ~ ~. Amoun~ Sub~ec~ ~o Tax ~ $. Debts and Deduc~/ons 5 - 6. Aaoun~ Taxable 6 7. Tax Ra~e 7 X 8. Tax Due 8.. PART DATE PAID DEBTS AND DEDUCTIONS CLAZNEn PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne S of Tax Computation) Under penalties of perjury, T declare ~ha~ ~he fec~s T have reported, above are ~rue, cqrrec~ le*e *o th~j~ bes"l: o'f ay knot,~,l~ml~dge amd bel'ief. HOME WORK XPAYER SIGNATURE TELEPHONE NUMBER' ' ' DATE GENERAL INFORMATION 1. FA/LURE TO RESPOND #ILL RESULT ZN AN OFF/C/AL TAX ASSESSHENT aith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dec~iont's date of death. $. i joint a¢coont is tax~bls ayah though the decadent's nasa ems added as a matter of convenience. 4. Accounts (includin~ those held bataaan husbond and wife) whi©h the decedent put in joint neeas within one year prior to death are fully taxable as transfers. 5. Accounts established jointly [~t~an husband and wi~ acre than one year prior to death are ~ot taxable. 6. Accounts held by a decadent "in trust for" another or others are taxable ~ully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice ara correct and deductions are not being claimed, place a~ in block "A" of Part I of the "Taxpayer Response" section. Sign t~o copies and submit thee with your check for the amount of tax to the Register of Rills of the county indicated. The PA Department of Revennee will issue an official assessment (Fora REV-IS48 EX) upon receipt of the return from the Register of Rills. 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 dacadant'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, Oept Z80601, Harrisburg, PA 171Za-060I in the envelope provided. $. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and co.Plate Parts Z and according to the instructions baldy. Sign two copies and submit thee with your check for the amount of tax payable to the Register of Rills of the county indicated- The PA Department of Revenue will issue an official assessment (Fora REV-la48 EX) upon receipt of the return from the Register of Rills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter the date the account originally was established or titled in the lanner existing at date of death. NOTE: For a decedent dying after lZ/1Z/&Z: Accounts which the decedent put in joint names within one (1) year of death ara taxable fully as transfers. However, there is an exclusion not to exceed $$,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (a~) appears before your first na~e in the address portion of this notice, the S5,000 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. $. 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 dacadant's death: ! DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT O#NERS SURVIVING JOINT ONNERS Example: A jolnt asset registered in the neee of the decedent and two other persons. ! DIVIDED BY 3 (JOINT ORNERS) 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 decedant's.daath or accounts owned by the decadent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE ORNERS OR 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 decadent. I DIVIDED BY Z (SURVIVORS) = .50 X 100 50X (TAXABLE FOR EACH SURVIVOR) 4. 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. The aaoont 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 belo~. Da*e of _n~__~h Spouse Lineal Sibling Collateral 07/01/9q '~o 12/S1/9q 01/01/95 to 06/30/00 OX 6Z 07/01/00 to present OZ 4.EZ~ 12Z ~Tha tax rate imposed on th~ ne younger at death to or for the use of a natural parent, an adoptive parent, or a stepparant of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children ~hether 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, ~hathar or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" ars defined as individuals who have at least one parent i~ common with the decedent, whether by blond or adoption. The "Collateral" class of heirs includes all other beneficiaries. ' CLAIMED DEDUCTIONS - PART ~ - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: 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 ~urnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x 11". Proof of payment aay be requested by the PA Department of Revenue. c~ JAN 28 CON~ONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRZSBURG, PA 17128-0601 JANET GIBSON 240 gALNUT BOTTOM RD CARLISLE PA 17015 TYPE OF ACCOUNT EST. OF THOMAS L GIBSON L'--]SAVZNOS S.S. NO. 184-16-598~ J~CHECKZNG DATE OF DEATH 05-02-2001 [=]TRUST COUNTY CUMBERLAND E~CERTZF' REHZT PAYHENT AND FORHS TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015, PNC BANK has provided the Department ,/th tha information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, You this account. If you feel this information is incorrect, please obtain mrittun correction free the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance mlth the Inheritance Tax Lws of the Colonmeelth of Pen~sylvania. Guestions may be ansmered by calling (717) COMPLETE PART I BELOg # # N SEE REVERSE SZDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 51~0] 8~588 Date 02-15-2001 Established To insure proper credit to your account, t~o (Z) copies of this notice oust accompany your Account Balance 27,719.22 payment to the Register of Hills. Hake check Percent Taxable X 50. 000 payable to: "Register of Hills, Agent". Amount Subject to Tax 15,859.61 NOTE: If tax PaYments ara made mithin three ($) months of the dacadent's date of death, Tax Rate X .0~5 you may deduct a 5Z discount of the tax due. Potential Tax Due 625.68 Any inheritance tax due miJlbeccae delinquent PART nine (9) months after the date of death. CHECK ~ a discount or avoid interest, or YOU may check box "A" and return this notice to the Register Of ONE Hills 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 mith tho Pennsylvania Inheritance Tax return ONLY to be filed by the decedant's representative. C. []The above information is incorrect You must complete PART [] a~d/or and/or debts and deductions PART [] balo~, were paid by you. PART If you indicate a different tax rate, please state your [ ] relationship to decedent:_ TAX RETURN - COHPUTATION OF TAX ON JOZNT/TRUST ACCOUNTS LINE 1. Date Established 2. Account Balance 2. 5. Percent Taxable $, ~. Amount SubSect to Tax S. Debts end Deductions 5 6. Amount Taxable 6' 7. Tax Rate 7 X 8. Tax Due 8._ PART [~ DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TO nter on Line S of Tax Computeti $ Under Penalties of perjury, Z declare that the facts TE .AT- TEE GENERAL ~NFORMATION 1. FA/LURE TO RESPOND MILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 5. A joint account is taxable even though the decadent's na~a was added as a matter of convenience. 4. Accounts (including th~se 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 between husband and wife more than one year prior to death ara not taxable. 6. Accounts held by a decadent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART 1 - 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 Re~ister of Mills of the countY indicated. The PA Department of Revenue will issue an official assessment (Form REV-154B EX) upon receipt of the return from 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 flied 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 260601, Harrisburg, PA 17128-0601 in the envelope provided. $. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts g and according to the instructions below. Sign two copies and sub~it them with your check ~or the amount of tax payable to the Register of Mills of the county indicated- The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART 2 TAX COMPUTATION LINE 1. Enter the date the account originally was established or tltlad in the manner existing at date of death. NOTE: For a decedent dying after lZ/lZ/BZ: Accounts which the decedent put in joint names within one (1) year of death ara taxable fully as transfers. However, there is an exclusion not to exceed $5,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk (wa) appears before your first nome in the address portion of this notice, the $$,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. $. The percent of the account that is taxable for each survivor is determined as follo~s: A. The percent taxable for joint assets established more than one year prior to the dacedant's death: 1 DIVIDED BY TOTAL HUMBER OF DIVIDED DY TOTAL NUHBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIV/NG JOIHT O~NERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 5 (JOINT OttNERS) DIVIDED BY Z (SURVIVORS) = .I67 X lO0 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the dacedant's death or accounts o,ned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other parsons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = 5OZ (TAXABLE FOR EACH SURVIVOR) 4. The aacunt 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 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). Jatermined below. )priate tax rata L,z.. ,, a~ Da~e of Death Spouse Li~=i S/bl/ng Collateral ~7/01/94 ~o 12/$1/94 SX 6% 01/01/95 ~o 06/50/00 0% 6X 07/01/00 ~o pre~n~ OX ~.BX~ + ~.~,,~ ~ tr~s~ers ~ro. a deceased child t~nty-one years o~ ~ or~ ~ounger at 7. Enter the appro; ~The tax rate imposed of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children death to or for the use of natural parent, an adoptive parent, or a stapparent of includes all children of the The lineal class whether.or not they have been adopted by others, adopted children and step children. "Lineal descendents" natural parents and their descendants, ~hethar or not they have been adopted by others, adopted descendents and their descendants and step-descendants- "SibLings" ara defined as individuals who have at toast cna parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 5 DE]iTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payacnt, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claiacd must be itemized fully in Part 3. If additlonal space is needed, use plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. ;-?ecorc~e:d :~e.rjister '02 JAN 28 ,. ... COHHON#EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28060! HARRZSBURG, PA l?lga-0601 JANET GIBSON 2qO WALNUT BOTTOM RD CARLISLE PA 17013 ~ 'rNFORMAT'rON NO.1-.rcE / FZLE NO. ~'1' '~.:L- ~ RE¥-1~$ EX AFP (09-08) DATE 09-17-2001 TYPE OF ACCOUNT EST. OF THOMAS L GZBSON []SAVZNGS S.S. NO. 184-16-598q [] CHECKZNG DATE OF D£AT~ 05-02-200! [] TRUST COUNTY CUMBERLAND [] CERTZF. RENZT PAYMENT AND FORMS TO: REGZSTER OF WILLS CUMBERLAND CO COURT HOUSE CARLZSLE, PA 17013 PNC BANK has provided the DePartment with the information listed below #hich has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you .ere a joint owner/beneficiary of this account. If YOU fee! this information is incorrect, please obtain written correction fro~ the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax La~s of tho Commonwealth of Pennsylvania. Guestions amy be ens~ered by calling (717) 787-B317. COMPLETE PART ! BELO# # # # SEE REVERSE SZDE FOR FZLZNg AND PAYMENT ZNSTRUCTZONS Account No. 31500203013 Da'l:e 10-23-1998 Established To insure proper credit to your account, two (Z) copies o~ this notice must accompany your Accoun~ Balance ~ · 343. !4 payment to the Register of Nills. Hake check Percen~ TaxabZe X 16. 667 pay~le to: ~egister of Hills, Amo~ Sub~ec~ ~o Tax ~, 7~. 9~ NOTE: [~ tax Pay~nts are made -ithJn three ($) months of the d~edent's date o~ death, Tax Ra{e X .0~ you may d~ct a 51 disc~t of the tax Poteniial Tax Due 167 ~8 Any l~erit~ce tax due ~ill b~ole deli~ent PART ' nine (9) eon~s after the date of dea~. A. ~e ~ove in~oreati~ and tax due is correct. ~ ~ 1. You may c~ose to remit Payment to t~ Register of ~ills ~ith t.o copies of this notice to obtain CHECK a discount or avoid interest, or You may c~ck ~x "A~ and return this ~tice to the R~ister ONE .iizs a~ an official assessment ~111 be issued by the PA Department o~ Revenue. BLOCK ONLY B. ~ The above asset has been or ~ill be reported and tax paid ,]th ~e ~vania Inherita~e~x return to be {iled by the decedent's representative. ~ ~ ~ --, ~ C. ~ The above information is incorrect and/or debts and deductions f~', . ~::'~. PA~T ~f you ~nd~ca~e a d~fferen~ ~ax ra~e, PZease s~a~e your reZat~onsh~p ~o decedent: TAX RETURN - COHPUTATZO~4 OF TAX ON JO;NT/TRUST ACCOUNTS LZNE 1. Da*e Es~abli~d 1 2. Accoun* Balan~ S. Percen* Tax~le ~ X ~. A.oun~ Subjec* ~o Tax S. Deb*s and ~uc~i~s ~ _ 6. Amen* Taxable 6 7. Tax Ra~e 7 X 8. T~ Due 8 PART ~ DEBTS AND DEDUCTZONS CLAZHED DATE PAZD PAYEE ~ DESCR~PTZON ~ ANOUNT PAZD Under permlties of perjury, I declare ~.ha~ th $ dge and belief · fac~s z have reported above are ~-,.-~ TEL GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with eppllcable interest based on information submitted 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 decedent's name was added as a matter of convenience. 4. Accounts (including those held bet.sen husband amd wife) which the decedent put in joint names within one year prior to death are',fullY taxable as tramsfers. · · and wife more then one year prior to death are not taxable. 5. Accounts. established 3ozntlY between husband 6. Accounts.held by e decedent "in trust for" another or others ere taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. DLOCK A - If the information and co~putation in the notice are correct and dedUctions are not being claimed, place an "X" in block "A" of Part ! of the "Taxpayer Response" section. Sign two copies and su~it the~ wlth your check for the amount of tax to the Register of #ills of the county indicated- The PA Department of RevenUe will issue am official assessment (Form REV-l~8 EX) upon receipt of the return fro~ the Register of Rills. Z. DLOCK B - If the asset specified on this notice has beam 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 ! of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Dureau of Individual Taxes, Dept za0601, Harrisburg, PA 17lID-0601 in the Parts Z and 3 envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete according to the instructions below. Sign two copies end submit them with your check for the amount of tax payable to the Register of Rills of the county indicated. The PA Department of Revenue will issue an official assessment (Fore REV-15~B EX) upon receipt of the return free the Register of Rills. TAX RETURN - PART Z - TAX COMPUTATION at date of death. LINE 1. Enter the date the account originally was established or titled in the manner existing HOTE: For a decedent dying after II/II/az: 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 (Nm) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted froe the account balance es reported by the finamcial institution. Z. 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 pr[or to the decedent's death: I DIVIDED BY TOTAL NUMBER OF DIVIDED DY TOTAL NUHBER OF X ZOO = PERCENT TAXABLE JOINT oWHERS SURVIVING JOINT O#NERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED DY 5 (JOINT O~NERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) but held D. The percent taxable for assets created within one year of the deoedent's death or accounts owned by the decedent in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL MURDER OF SURVIVING JOINT X 100 PERCENT TAXADLE ORNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons end established within one year of death by the decedent. Z DIVIDED DY Z (SURVIVORS) = .50 X LO0 = 5OX (TAXADLE FOR EACH SURVIVOR) The amount subject to tax (Iine 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 5. 6.The 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) es determined below. ------------ L'zneal Sibling Collar_era1 ~ Spouse ~n t) ne lid twenty-oneY--~-~ death to or for the use of a ~atural parent, an adoptive parent, or e stepparent of the child is OZ. The lineal class ~of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or net 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-descendents- "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- CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible ]teas. D. You actually pald the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 5. If additional space is needed, use plain paper 8 l/Z" x 11". Proof of payment may be reqUested by the PA Department of Revenue. COMNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUF~iAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171Z8-0601 REV-164S EX AFP (Dg-Gfl) ZNFORHAT2ON NOTICE AND TAXPAYER RESPONSE PILE NO. ACN ,011q1885 DATE 09-17-2001 EST. OF THOMAS L GIBSON S.S. NO. 184-16-598q DATE OF DEATH 05-02-2001 COUNTY CUMBERLAND JANET GIBSON 2qO WALNUT BOTTOM RD CARLISLE PA 17015 TYPE OF ACCOUNT I-]SAVINGS [] CHECKING I~ TRUST [] CERT]:F. REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 PHC BANK has provided the Department with the information listed belo~uhichhas been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint o~ner/beneficiary of this account. If you feel this information is incorrect, please obtain uritten 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 T~her[tance Tax law of the Comron~eelth of Pennsylvania. ~uastions may be answered by calling (717) 787-8527. COMPLETE PART I BELOW # # # SEE REVERSE SIDE FOR PILING AND PAYMENT INSTRUCTIONS Account No. $1500203719 Bate 02-19-1998 Established Account Balance 29,481.80 Percen~ Taxable X 16. 667 Amount Subject to Tax 4,915.75 T~x Rate X .045 Potential Tax Due 221.12 To insure proper credit to your account, two (Z) copies of this notice must accompany your paylent to the RegiSter of Mills. Hake check payable to: "Register of #ills, Agent". NOTE: If tax payments are made within three ($) months of the decedent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due wi1! become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. ~_The above information and tax due is correct. · You amy choose to remit payment to the Register of ~ills with tmo copies of this notice to obtain a discount or avoid interest, or you lay check box "A" and return this notice to the Register of CHECK -~ Mills and an official assessment alii be issued by the PA Department of Revenue· ONE BLOCK s. [] The above asset has been or #ill be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the dacedent's representative. C. [] The above information is incorrect and/or debts and deductions ~ere paid by you. You lust complete PART [] and/or PART [] bolou. PART If you indicate a different ~ax rate, please sta~e your relationship to decedent: TAX RETURN - COHP'JTAT!ON OF TAX ON JO:NT/T~JST ACCOUNT~ LINE [. Bate Established 1 2. Account Balance 2 3. Percent Taxable $ ~ ~. Amount Subjeo~ to Tex ~ 5. Debts end Deductions 5 - 6. Amount Taxable 6 7. Tax Ra~e 7 ~ 8. Tax ~u~ 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION TOTAL (Enter on Line 5 of Tax Computation) AMOUNT PAID Under penalties of perjury, I declare the~ the facts I have reported above are ~rue, ,co;r_ec~ and ~~y knowl.dg, end b. li.f. HOME (~/~) _~'~-.~ ~ ' WORK ) ~AXPAYER SIGNATURE TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOI~ #ILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine monlths after the decedent's data of death. 5. A joint account is taxable even though the decedent's name was added es a latter of convenience. 4. Accounts (incLuding those held between husband and #]fe) which the decedent put in joint names within one year prior to death ere 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 e decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information end computation in the notice are correct and deductions are not being claimed, place an in block "A- of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the omount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official essesoment (Fora REV-154B EX) upon receipt of the return from the Register of #ills. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Peonsylvania 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 end return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA 171ZB-0601 in the envelops provided. BLOCK C - If the notice information Ls incorrect and/or deductions are being claimed, check block "C' and complete Parts 2 and $ according to the instructions below. Sign tee copies and submit thee with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-15~8 EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION · a 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 class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural ChiLdren whetheror 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" 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. CLAIMED DEDUCTIONS - PART ~ - DEBTS AND DEDUCTIONS CLAIMED Allowable debts end deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible itas. S. You actually paid the debts after death of the decadent end can furnish proof of payment. C. Debts being claimed must be itemized fully in Part $. If additional space Ls needed, use plain paper 8 L/Z" x Il". Proof of payment lay be requested by the PA Department of Revenue. Da~e of Death Spouse Linea! Sibling Collateral 07/01/9~ '~o 12/31/9q SZ 6Y. 01/01/95 '¢o 06/30/00 OZ 67. 07/0]./00 '~o preson~ OZ 4.SZ~ 12Z LINE 1. Enter the date the account originally was established or titled in the manner existing et date of death. NOTE: For a decedent dying after 12/IZ/8Z: Accounts which the decedent put in joint names within one (l) year of death are taxable fully as transfers. Ho,ever, 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 double asterisk (--) appears before your first nome in the address portion of this notice, the $$,0g0 exclusion already has been deducted from the account balance as reported by the fJnancJal institution. 2. 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 decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY 2 (SURVIVORS) = .167 X lO0 = 16.7Z (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 NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in the na~e of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 X 100 5OZ (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 totaI of the debts and deductions Listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (Iine 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. S~ NV? ZO. BUREAU OF TNDTV/DUAL '£AXES TNHERXTANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 QUILETTE GIBSON 19 DREXEL RD BUFFALO COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF XNHER/TANCE TAX APPRAXSEHENT, ALLOHANCE OR DZSALLOHANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS '02 IlAR 18 P2:2(] F'rLE NUHBER COUNTY SSN/DC ACN REV-l~ll8 EX AFP COl-02) DATE 05-18-2002 ESTATE OF GIBSON THOMAS DATE OF DEATH 05-02-2001 21 02-0090 CUMBERLAND 184-16-5984 01143547 Amoun~ Remi~ed HAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND C0 COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE REV-IS&8 EX AFP (01-02) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 05-18-2002 ESTATE OF GIBSON THOMAS L DATE OF DEATH 05-02-2001 COUNTY CUHBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 184-16-5984 ACN 01143547 TAX RETURN WAS: (X) ACCEPTED AS FILED ¢ ) CHANGED dOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5130361034 TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 02-13-2001 Account Balance Percen~ TaxabZe Amoun* Subjec~ ~o Tax Debts and Deductions Taxable Amoun* Tax Ra*e Tax Due TAX CREDITS: 23,699.23 X 0.500 11,849.62 - .00 11,849.62 X .45 533.23 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 (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 01-23-2002 CDO00800 .00 535.23 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 533.23 .00 .00 .00 ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL ZH~KEST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CDRRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~ulfill the requirements of Section 21¢0 of the Inheritance and Estate Tax Act, Act Z~ of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit Nith your payment to the Register of Nllls printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. A refund cf a tax credit, which was not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices or by calling the special lC-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers ~ith special hearing and or speaking needs: 1-800-447-3020 (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 aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 251021, Harrisburg, PA 17128-1021, OR --electing to have the 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 ba addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (52) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the tatar of the tax and interest assessed, and not paid before January 18, 1996, 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 end interest that has bean 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 (62) percent per annum calculated at a daily rata of .00016~. All taxes Nhich became delinquaflt off or after January 1, 1982 will bear interest at a rate which wlll vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest R~te Daily Interest Factor Yaa.~_r Interest Rata Daily Interest Factor 1982 202 .000548 1992 92 .0002¢7 1983 162 .000¢38 1993-1994 72 .O00XgZ 1984 112 .000501 1995-1998 9Z .000247 1985 132 .000356 1999 72 .000192 1986 102 .00027¢ 2000 82 .000219 1987 92 .0002¢7 2001 92 .000247 1988-1991 112 .000501 2002 62 .000164 --Interest is calculated as follows: 'rNTEREST = BALANCE OF TAX UNPA'rD X NUIJBER OF DAYS DELTNQUENT X DATLY TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of tho assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8060! HARRISBURG, PA 171Z8-0601 JANET GIBSON 240 WALNUT BOTTOH RD CARLISLE COMMON#EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRATSENENT. ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON Jo'rNTLY HELD OR TRUST ASSETS ~_, ~ DATE 05-18-2002 ...... ~ ESTATE OF GIBSON DATE OF DEATH 05-02-2001 FILE NUMBER 21 02-0090 '02 I'1~R ]8 ~2 .*~UNTY CUMBERLAND SSN/DC 184-16 - 5984 ACN 01141879 Amoun~ Rem/~ed REV-1611, EX AFP COI-OZ) THOMAS L HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE REV-X548 EX AFP (01-02) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON dOINTLY HELD OR TRUST ASSETS DATE 05-18-2002 ESTATE OF GIBSON THOHAS L DATE OF DEATH 05-02-2001 COUNTY CUHBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 184-16-5984 ACN 01141879 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED dOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5130361034 TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TINE CERTIFICATE DATE ESTABLISHED 02-15-200! Account Balance Percent Taxable Amount Subject to Tax Debts and DeductAons Taxable Amount Tax Rate Tax Due TAX CREDITS: 25,699.25 X 0.500 11,849.62 - .00 11,849.62 X .45 533.23 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 DATE RECEIPT NUNBER 01-24-2002 DISCOUNT (+) INTEREST/PEN PAID (-) CD000807 .00 AMOUNT PAID 533.23 TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE ZF PAZD AFTER THZS DATE, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ~ ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REI~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" [ CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS. ) 533.23 .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 Z3 of 2000. (72 P.S. Sect/on 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of e tax credit, ehich ams not requested on the 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 Z4-hour answering service for fores ordering: 1-SO0-36Z-ZOSO; services for taxpayers eith special hearing and or speaking needs: 1-800-4q7-30ZO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloeance of deductions or assessment of tax (including discount or interest) as shomn on this Notice nay object within sixty [60) days of receipt of this Notice by: --er[[ten protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17lIS-lOll, DR --electing to have the matter determined at the audit of the account of the persunal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Oepertment of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. IS0601, Harrisburg, PA 1712B-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" [REV-iSOl) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent discount of the tax paid is alloeed. The 1SI 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 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, 198Z bear interest at the rate of six (SI) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 198Z will bear interest at a rate which will vary frae calendar year to calender year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200Z ere: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor XgBZ 20Z .OOOSq8 199Z 9Z .000247 1983 16Z .000438 1993-1994 7Z .00019Z 1984 llZ .000301 1995-1998 9Z .000247 1985 13Z .000356 1999 7Z .00019Z 1986 lOX .OOOZ74 2000 8Z .000219 1987 9Z .O00Zq7 ZOO1 9Z .OOOZ47 1988-1991 XZZ .oeo301 2002 6Z .000164 --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPATD X NUMBER OF DAYS DELINQUENT 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 be calculated. BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DIVZS/ON DEPT. 280601 HARRISBURG, PA 17128-0601 QUILETTE GIBSON 19 DREXEL RD BUFFALO COMMON#EALTH OFPENNSyLVANZA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS 'O2 C*;ttmL:,~ FILE NUMBER COUNTY IAR 18 P 2:20 SSN/DC ACN DATE 03-18-2002 ESTATE OF GIBSON DATE OF DEATH 05-02-2001 21 02-0090 CUMBERLAND 18q-16-598q 011q1882 Aeount Remitted REV-I~I EX &FP (01-0~) THOMAS HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~.~ REV-1548 EX AFP (01-02) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-18-2002 ESTATE OF GIBSON THOHAS L DATE OF DEATH 05-02-2001 COUNTY CUMBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 18q-16-598q ACN 011q1882 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 31300203719 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 02-19-1998 Account Balance 29,q81.80 Percent TaxabZe X 0.166 Amount Subject to Tax q,913.73 Debts and Deduct/ons .00 Taxable Amount q,913.73 Tax Rate X .q5 Tax Due 221.12 NOTE: TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PATD (-) AMOUNT PAID 01-23-2002 CD000801 . O0 221.12 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: ffREGISTER OF WZLLS, AGENT.ff IF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE KS LESS THAN $1, NO PAYMENT KS REgU/RED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 221.12 .00 .00 .00 PURPOSE OF NOTICE: PAYNENT: REFUND CCR): OBJECTIONS: ADNXN- ISTRATIVE CORRECTXONS: DISCOUNT: PENALTY: INTEREST: To fulfill tho requirements of Section 2140 of the Inheritance end Estate Tax Act, Act Z~ of lOgO. (72 P.S. Section 9140). Detach the top portion of this Notice and submit Hith your payment to the Register of gills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. A refund of · tax credit) Hhich Has not requested on the tax return, lay be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ore available at the Office of the Register of #ills) any of the 23 Revenue District Offices or by calling the special Z4-hour answering service for forms ordering: 1-800-362-2050; services ~or taxpayers eith special hearing and or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied Hith the appraisement, alloHance, or disalloHanca of deductions or assessment of tax (including discount or interest) as shoHn on this Notice may object Hithin sixty (60) days of receipt of this Notice by: --Hritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZSIOZ1, Harrisburg, PA 171lB-lOll, 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 Hriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment RevieH Unit, DEPT. lB0601, Harrisburg, PA 171Z8-0601 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 Hithin three (3) calendar months after the decadent's death, a five percent discount of the tax paid is alloHad. The 1iX tax amnesty 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 amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you Hould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning Hith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes Hhich became delinquent before January l, 19BI bear interest at the rate of six (6Z) percent per annum calculated et a daily rate of .000164. All taxes Hhich became delinquent on or after January l, 198Z Hill bear interest at a rate Hhich Hill vary free calendar year to calendar year Hith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOZ are: Year Interest Rate Daily Interest Factor Yea.__~ Interest Rate Daily Interest Factor 1982 20Z .000548 199Z 9Z .000247 1983 16X .000438 1993-1994 7Z .OOOlgZ 1984 llZ .000301 1995-1998 9Z .000Z47 1985 13Z .000356 1999 7X .O0019Z 1986 IOZ .000Z74 ZOO0 8Z .O00Z19 1987 9Z .000247 2001 9Z .000247 1988-1991 Ill .000301 200Z 6Z .000164 --Interest is calculated as folio.s: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent Hill reflect an interest calculation to fifteen [15) days beyond the date of the assessment. Zf payment is made after the interest computation date shoHn on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERTTANCE TAX IHVISZON DEPT. ZBO601 HARRTSBURG, PA 17128-0601 JANET GIBSON Zq0 WALNUT BOTTOM RD CARLISLE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSERENT, ALLO#ANCE OR DISALLOHANCE OF DEDUCTZONS~ AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS ~DATE 05-18-2002 ESTATE OF GIBSON DATE OF DEATH 05-02-2001 FILE NUMBER Z1 02-0090 COUNTY CUMBERLAND ;2~N/DC 18q-16-598q ACN 011~1880 Amoun~ Reai~ed THOMAS MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LINE REV-1548 EX AFP (01-OZ) RETAIN LOWER PORTION FOR YOUR RECORDS NOTZCE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTZONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 0~-18-2002 ESTATE OF GIBSON THOMAS L DATE OF DEATH 05-02-2001 COUNTY CUMBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 18q-16-598q ACN 011q1880 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 51qO18q588 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE OATE ESTABLISHED 02-15-Z00! Account Balance Percent Taxable Amoun~ Sub~ec~ to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDZTS: 27,719.22 X 0.500 13,859.61 - .00 13,859.61 X .q5 6Z$.68 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 DATE 01-Zq-2002 RECEIPT NUMBER CDO00SOS AMOUNT PAID DISCOUNT (+) INTEREST/PEN PAID (-) .00 IF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. ZF TOTAL DUE ZS LESS THAN $1~ NO PAYMENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THZS FORM FOR ZNSTRUCTZONS. ) 625.68 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 625.68 .00 .00 .00 PURPOSE OF NOT[CE: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~ulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice end submit mith your payment to the Register cf gills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, mhich was not requested on the tax return, may be requested by completing an "Application for Refund cf Pennsylvania Inheritance and Estate Tax' (RE¥-1313). Applications are available at the Office of tho Register of Hills, any of the 23 Revenue District Offices or by calling the specie1 Iq-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers aith special hearing end or speaking needs: 1-800-q47-sozo (TT only). Any party in interest not satisfied Nith the appraisement, allouance, 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 17128-1021, 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. 280601, 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 ~ithin three (3) calendar months after the dacedent's death, a five percent (52) discount of the tax paid is allowed. The 1SI 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 and of the 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 an 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 rata of six (62) percent per annum calculated at a daily rate cf .000164. All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary free calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Yea__r Interest Rate Daily Interest Factor X982 202 .000548 1992 92 .000247 1983 16X .000438 1993-199~ 72 .000192 198~ 112 .000501 1995-1998 92 .000247 1985 13Z .000356 1999 7X .OOO192 1986 102 .00027~ 2000 82 .OOOZl9 1987 92 .0002~7 2001 92 .000247 1988-1991 112 .000301 2002 62 .000164 --Interest is calculated as fallows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. If payment is made after the interest computation date shown on the Notice, edditionaX interest must be ceXculatad. BUREAU OF TNDTVZDUAL TAXES XNHERZTANCE TAX DTV[SXON DEPT. Z80601 HARR/SBURG, PA 171Z8-0601 JANET GIBSON Z40 NALNUT BOTTOH RD CARLISLE CONHONgEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DISALLO#ANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS 'OZ REV-16,18 EX AFP DATE 03-18-2002 ESTATE OF GIBSON THOMAS DATE OF DEATH 05-02-2001 FILE NUMBER 21 02-0090 COUNTY CUMBERLAND M~R 18 PZ :ZO SSN/DC 184-16-5984 ACN 01141885 _: ] Amount Remitted I MAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE REV-1548 EX AFP (01-02) RETAIN LOgER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOgANCE OR DZSALLOgANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOINTLY HELD OR TRUST ASSETS DATE 03-18-2002 ESTATE OF GIBSON THOMAS L DATE OF DEATH 05-02-2001 COUNTY CUMBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 184-16-5984 ACN 01141885 TAX RETURN gAS: (X) ACCEPTED AS FILED ( ) CHANGED dOZNT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PHC BANK ACCOUNT NO. 31300203719 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TINE CERTIFICATE DATE ESTABLISHED 02-19-1998 Account Balance 29,481.80 Percent Taxable X 0.166 Amount Subject to Tax 4,913.73 Debts and Deductions .00 Taxable Amount 4,913.73 Tax Rate Tax Due 221.12 NOTE: TAX CREDITS: PAYMENT RECEIPT DISCOUNT ¢+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 01-24-2002 CD000809 .00 ZZ1.12 TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE gITH YOUR TAX PAYMENT TO THE REGISTER OF gILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: **REGISTER OF gILLS, AGENT." TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 221.12 .00 .00 .00 PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~ulfi11 the requirements of Section ZI¢O of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, .hich Has not requested on the tax return, amy ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Hills, any of the ZS Revenue District Offices or by calling tho special Z4-haur answering service for fores ordering: 1-BOO-36Z-Z050; services for taxpayers ~ith special hearing and or speaking needs: 1-800-447-3gZ0 (TT only). Any party in interest not satisfied aith the appraisement, milo.anco, or disallo.anca of deductions or assessment of tax (including discount er interest) as sho.n on this Notice amy object .ithin sixty (60) days of receipt of this Notice by: --.rattan protest to the PA Department of Revenue, Board of Appeals, Dept. ZalOZ1, 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 ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Raviea Unit, DEPT. zao60l, Harrisburg, PA 171ZB-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions ~or Inheritance Tax Return for e Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid aithJn three (33 calendar months after the dacedent's death, e five percent discount of the tax paid is milo.ed. The lSZ 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 period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you .ould appeal the tax and interest that has been assessed as indicated on this notice. interest is charged beginning .ith first day of delinquency, or nine (9) months and one (1) day from the dote of death, to the date of payment. Taxes .hich became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .0g0164. All taxes .hich became delinquent on or after January 1, 198Z .i11 bear interest at a rate ~hich .i11 vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 19BZ through ZOOZ ara: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZOZ .000548 199Z 9Z .OgOg47 1983 16Z .000438 1993-1994 7Z .OOO19Z 1964 llZ .000301 1995-1998 9Z .000247 1985 13Z .000356 1999 7X .00019Z 1986 IOZ .000Z74 ZOOO 8Z .OOOZ19 1987 9Z .000Z47 ZOOZ 9Z .000247 1988-1991 11X .000301 2002 6Z .000164 --Interest is calculetad as follo.s: XNTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELXNQUENT X DAILY XNTEREST FACTOR --Any Notice issued after the tax becomes delinquent .ill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Xf payment is made after the interest computation date sho.n on the Notice, additional interest must be calculated. A OF /VZDUAL TAXES INH£RITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA I?ZZ&-OG01 JANET GIBSON ZqO WALNUT BOTTOM RD CARLISLE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF /NHERZTANCE TAX APPRAZSERENT, ALLOMANCE OR DZSALLORANCE OF DEDUCTIONS, AND ASSBSSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS F~:~;:: ' ~' ~; DATE O$-18-ZOOZ ~.:., ~, ESTATE OF GIBSON DATE OF DEATH 05-02-2001 FILE NUMBER 21 02-0090 COUNTY CUMBERLAND *02 M~ 1~ 72 :~SN/DC 18q-16-~98~ ACN 011~1881 Amount Remitted REV-15~8 EX AFP (01-0~) THOMAS MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LZNE REV-1548 EX AFP (01-02) RETAIN LOWER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-18-2002 ESTATE OF GIBSON THOMAS L DATE OF DEATH 05-02-2001 COUNTY CUNBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 18q-16-598q ACN 011q1881 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. ~1500205015 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 10-25-1998 Account Balance Percen~ Taxable Amount SubSect to Tax Debts and Deductgons Taxable Amount Tax Rate Tax Due TAX CREDZTS: 2Z,3q$.lq X 0.166 3,723.93 - .00 3,723.93 x .~5 167.58 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+) DATE NUMBER INTEREST/PEN PAID (-) 01-Zq-ZOOZ CD000806 .00 AMOUNT PAID 167.58 ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL ZNTEREST. ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 167.58 .00 .00 .00 PURPOSE OF NOTICE: To fulfill the requirements oF Section 21~0 of the Inheritance and Estate Tax Act) Act Z$ of 2000. (72 P.S. Section 9140). PAYHENT: Detach the top portion of this Notice 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. REFUND (CRY: OBJECT/OHS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: A refund of a tax credit, ahich was not requested on the tax return, say ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Wills) any of the 25 Revenue District Offices or by calling the special 24-hour answering service for forms ordering: 1-800-361-2050) services for taxpayers with special hearing and or speaking needs: 1-800-447-3010 (TT only). Any party in interest not satisfied with the appraisement) alloeanca, or disalloeanca 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: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 181011, 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. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-650S. Sam 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 decedant's death, a five percent (SI) discount of the tax paid is allowed. The 15X tax a~nesty 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 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 aith first day of delinquency, or nine (9) months and Dna (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 .000164. A11 taxes ahich became delinquent on or after January 1, 1982 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 1982 through 2002 ara: Year Interest Rate Daily Interest Factor Year Interest Rate Dail~ Interest Factor 1982 202 .000548 1991 9Z .000247 1983 16Z .000438 1993-1994 71 .000191 1984 111 .000501 1995-1998 92 .000247 1985 131 .000356 1999 71 .000192 1986 IOZ .000274 ZOO0 BZ .000219 1987 92 .000247 2001 92 .000247 1988-1991 111 .000501 2002 6Z .000164 --Interest is calculated as folloes: ZNTEREST = BALANCE OF TAX UNPAZD X NUMBER OF DAYS DELZNQUENT X DAZLY 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 made after the interest computation date sheen on the Notica, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTON DEPT. 280601 HARRISBURG, PA 171ZB-OG01 QUILETT GIBSON 19 DREXEL RD BUFFALO COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS R~4' i ~ ESTATE OF - DATE OF DEATH FILE NUHBER COUNTY '02 NAR 18 P 2:20 SSN/DC ACN REV-ISq8 EX AFP (DI-O~) 03-18-2002 GIBSON THOHAS L 05-02-2001 Z1 02-0090 CUHBERLAND 18q-16-598~ 011~33~8 HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~,~ REV-1548 EX AFP (01-02) RETAIN LO#ER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE O$-18-ZOOZ ESTATE OF GIBSON THOMAS L DATE OF DEATH 05-02-2001 COUNTY CUHBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 181-16-598q ACN 01113518 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORNATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 51~018~588 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIHE CERTIFICATE DATE ESTABLISHED 02-15-2001 Account Balance 27,719.22 Percent Taxable X 0.500 Amount Subject ~o Tax 15,859.61 Debts and Deductions .00 Taxable Amount 13,859.61 Tax Ra~e X .q5 Tax Due 623.68 TAX CREDZTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE NITH YOUR TAX PAYMENT TO THE REGISTER OF MILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF MILLS, AGENT." PAYMENT DATE 01-Z3-ZOOZ RECEIPT NUMBER CD000802 DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 625.68 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 625.68 .00 .00 .00 PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (TI P.S. Section 9140). PAYHENT: Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance end Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z5 Revenue District Officas or by calling the special [4-hour answering service for fores ordering: 1-800-36Z-Z050; services for taxpayers eith special hearing and or speaking needs: 1-800-q47-50ZO (TT OBJECT[OHS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as sheen on this Notice nay object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171Z8-1021, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: iNTEREST: 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. [BO601, Harrisburg, PA I71Z8-0601 Phone (717) 787-6505. Sss page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three [3) calendar months after the decedant's death, a five percent (BX) 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 period. This non-participation penalty is appealable in the same manner and in the tho same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. interest is charged beginning eith 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 (ii) percent par annum calculated at a daily rate of .000164. AIl taxes which became delinquent on or after January 1, 198Z will bear interest at a rata which will vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200Z are: Year Inter,st Rate Daily Interest Factor Yaa.~r 198Z 20Z .000548 199Z 1985 162 .O004~B 199~-1994 1984 IIZ .000501 1995-1998 1985 15Z .000556 1999 1986 IOZ .000Z7¢ ZOO0 1987 9X .000247 2001 1988-1991 11X .000501 2002 --Interest is calculated es follows: Interest Rate Daily Interest Factor 9Z .000247 7Z .00019Z 9Z .000Z47 7Z .00019Z 8Z .000219 9Z .000Z47 6Z .000164 XNTEREST = BALANCE OF TAX UNPA/D X NUHBER OF DAYS DELXNQUENT X DA/L¥ XNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. Xf payment is made after the interest computation date shown on the Notice, additionaX interest must be calculated. BUREAU OF INDIVIDUAL TAXES TNHER/TANCE TAX DZYZSZON DEPT. Z80601 HARRTSBURG, PA 17128-0601 QUILETTE GIBSON 19 DREXEL RD BUFFALO CONHONgEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERZTANCE TAX APPRAZSEHENT. ALLOHANCE OR DZSALLOHANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS !*~ .~i ESTATE OF GIBSON DATE OF DEATH 05-0Z-2001 FILE NUMBER Z1 02-0090 COUNTY CUMBERLAND '02 HAR 18 ?2:20 SSN/DC 181-16-598t ACN Ollq$$q9 Amount Remitted RE¥-I;,I$ EX AFP (Ol-Ol) THOMAS 1 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA z7015 CUT ALONG THIS LINE REV-1548 EX AFP (01-02) RETAIN LOgER PORTION FOR YOUR RECORDS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOgANCE OR DZSALLOgANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-18-2002 ESTATE OF GIBSON THOMAS L DATE OF DEATH 05-02-2001 COUNTY CUMBERLAND FILE NO. 21 02-0090 S.S/D.C. NO. 18q-16-598q ACN OllqSSq9 TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. $1500205015 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 10-25-1998 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate TaxDue TAX CREDITS: Z2,3q3.1q X 0.166 3,723.93 - .00 3,723.93 X .q5 167.58 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE gITH YOUR TAX PAYMENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID ¢-) 01-25-2002 CD000799 .00 AMOUNT PAID 167.58 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT'(CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 167.58 .00 .00 .00 PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 11~0 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit #lth your payment to the Register of Rills printed on the reverse side. -- Make check or money order payable to: REGISTER OF RILLS, AGENT. A refund of m tax credit, mhich was not requested on the tax return, may bm requested by completing an "Application for Refund of Pennsylvania inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Hills, any of tho 23 Revenue District Offices or by calling the special 24-hour enamoring service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and or speaking needs: 1-800-4qT-30ZO (TT only). Any party in interest not satisfied .ith tho appraisement, allomance, or disalloeance 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: --arittan protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, 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, ATTM: Post Assessment Review Unit) DEPT. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. Sea page 5 of tho booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-150I) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent 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 pa[d before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in tho 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, 198Z bear interest et tho rate of six (SI) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 196Z 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 1982 through 200Z ara: Year Interest Rate Daily Interest Factor Year Interest Rata Daily Intrrast Factor 1982 201 .000548 1992 9X .000Z47 1985 162 .00045B 1993-1994 7Z .000192 198~ 111 .000301 1995-1998 91 .0002~7 1985 X3Z .000356 1999 7Z .000192 1986 102 .00027~ ZOO0 BZ .000219 1987 91 .000247 2001 91 .000247 1988-1991 111 .000301 ZOO2 6Z .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT 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 be calculated.