Loading...
HomeMy WebLinkAbout02-0538[OMMONNEALTH OF PENNSYLVANIA gEpARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA%ES DEPT. 280601 HARRISBURG, PA vlza-o6g1 EY-156! ER RF9 [99-9n INFORMATION NOTICE AND TAXPAYER RESPONSE FILE pCN DATE N0. 21'~~--s3~ 02120049 04-30-2002 TYPE OF ACCDUNT EST. OF HENRY STARK ® SAVINGS S.S. N0. 195-07-1602 ^ CHECKING DATE OF DEATH 03-03-2002 ^ TRUSi °~~ ~~j, -,,, :=5 CODNTY CUMBERLAND ^ cERrIF. REMIT PAYMENT AND FORMS T0: KATHERINE S STARK REGISTER OF WI LLS APT 1 t, CUMBERLAND CO COURT HOUSE 1109 COLUMBUS AVE ((..~ CARLISLE, PA 17013 LEMOYNE PA 170~r~-1722 ALLFIRST FINANCIAL SERVICES has provided the Department with the information listed below which has boon used in ea leulatin9 the potential tax due. Their recortls indicate that at the tlaath of the above tleeetlent, you were a joint owner/beneficiary of this aeeeunt. If you feel this infernation is ineorrae t, please obtain written eerrec tion frow the financial institution, attach a copy tc this forty antl return it to the above atltlress. This account is taxable in accordance with the Inheritance Tax Laws of the Cowwonwealth of Pennsylvania. questions way be ensue ratl by callln9 (717) 787-8:27. COMPLETE PART 1 BELOW If * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 87005700434938 Date 02-02-1995 To insure proper credit to your account, tea Established (21 copies of this notice oust accompany your Account Balance 13,463.94 paywent to the Register of Wills. Make check payable ta: ^Register of Nills, Agent^. Percent Taxable x 8.333 Amount Subject to Tax 1 121 .95 NOTE: If tax paynen is are matla within three , (3) months eF the tlecetlent•s date of tlaath, Tax Rate X , 1 5 you way deduct a SR tlisccunt of the tax tlue. Potential Tax Due 168.29 AnY inheritance tax tlue will become tlelinquent nine (9] aonths after the date of tlaath. U F#Y€~11~ 'f~ ~PGN~t C~Yf.I. ~.'i` Xk~ #~i rC~AL 'tYLX , ~~~vSN`~ 5 Gtr "f!!Y~ t~!`M"Y~ Under penalties of periury, I declare that 4he facts I have reported above are truee,' correct and / complete to the bast o ny/knoNledge and belief. HOME C7~7 ) 3Q3,~6 7L ~/31/Q L ~ Q.~~.iir~csu_, ~~f ~~~ WORK C ) TAXPAYER SIGNAL R~-~ T LEPHON N R DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE I N FORMATION NOTICE FILE N0. 21-c~-.5-3~ BUREAU OF INBIVIBUAL TA%ES AND DEPT. 280681 TAXPAYER RES PONS E ACN 02120052 HARRISBURG, PA vlza-gaol DATE 04-30-2002 REY-154! EM RFV [n-On TYPE OF ACCOUNT EST. OF HENRY STARK ^ snvlNGs S.S. N0. 195-07-1602 ®cHECKING DATE OF DEATH 03-03-2002 ^ reusT ~~t ;U ti -.< `i COUNTY CUMBERLAND ^ CERTIF. REMIT PAYMENT AND FORMS T0: KATHERINE 5 STARK REGISTER OF WILLS APT 1 t, ,- CUMBERLAND CO COURT HOUSE 1109 COLUMBUS AVE CARLISLE, PA 17013 LEMOYNE PA l~f}~r3-1722 ALLFIRST FINANCIAL SERVICES has provided the Department with the information listed below which has been used in calculating the pc tential tax tlue. Their records indicate that at the death of the above tlecetlent, ycu were a joint owner/beneficiary of this aecoun t. If you feel this informs tion is iota rrect, please obtain written correction Oran the financial institution, attach a copy to this fo rn end return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Lonmonwea lth of Pennsylvania. Questions eav bm an sworod by calling (717) 787-8327. COMPLETE PART 1 BELOW ii i[ II SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0081301510 Date 08-2 8-1964 To insure prover credit to your account, two Established (2) copies of this notice oust aeeempany your Payment to the Register of Mills. Make check Account Balance 21,971 .31 payable to: ^Register of Wills, Agent^. Percent Taxable X 8 .333 Anount Subject to Tax 1 830 87 NOTE: If tax payments era made within three , . (3] months of the tlecetlent's tlata of tleath, Tax Rate X , 1 5 you mev tletluct a 5% discount of the taz duo. Potential Tax Due 274 63 AnY inheritance tax due will become delinquent . nine (9] won the after the tla to of tlea th. PART TAXPAYER RESPONSE LSa Y.Y~Eieit. M4t:!'.lblkl3lAfkXlt-.~iswY3 Ci~l~lEtl YY MAR .~Xk# !it`LY!lllt A:A AhA.tk ~ ~tbAl3tlw5tiil[tiewM. ~rw;+"u=a ~,wAi€ wniE:!• ablMUiKti A. ^ The above informs tian and tax tlue is correct. I. Vou nay choose tc remit payment to the Register of Nllls with two copies of this notice to obtain CHECK a diseeunt or avoid interest, or you way check box "A^ antl return this ne tica to the Register aF Wills and an official assessment will ba issued by the PA gepartmant of Revenue. ONE BLOCK g, ^ The above asset has bean ar will be reported and taz paid xith the Pennsylvania Inheritance Tax return ONLY to be filed by the decedent's representative. r--~ L. IN The "` above information is incorrect end/or debts antl datluc tions were paid by you. GGG--- lII YOU must eomple to PART 2^ antl/or PART 3^ below. PART If You indicate a different tax rat , please state your ~- ~1~"~*~~~~~. ~~ :D~~~ ~~~-,~ 2 ^ relationship }o decedent: FA DPA~k`~1EN`~ D~ ~~}~~NU TAX RETURN - COMPUTATION OF TAX ON JOINT~TRUST ACCOUNTS p'AlY -- LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X .,.. :: ~: '~ " ~' ~~ 4. Anount Subject to Tax 4 ~ ::~ 5. Debts and Deductions 5 - ~"~' 6. Anount Taxable b ~* -` 7. Tax Rate 7 ~ ~ ~ -_ ~~" .. ._:~...-k ::.: B. Tax Due 8 ~ ~ .... ,..,. -_ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID DATE Under penalties of perjury, I dealers that the facts I have reported above er1e true, correct andj J c plate to the best of`ny/knowledge and belief. HOME (717 ) 3'C1J~~•~y 1' /v ()1/Q~' ~~ `a"-~, . ~ . , ~ _ ,l/A~L ~t~: f WORK ( ) CBNMUNNEALTH OF PENNSYLVANIA eEPARTMENT gF REVENUE I N FORMATION NOTICE v~ -.59 8 FILE NO. 21 BUREAU OF IN81VI8UAL TA%E8 AND gEPT. zegbgl HARRI58URG, PA vlza-gaol TAXPAYER RESPONSE ACN 02120058 DATE 04-30-2002 REV-1569 EM IFP 109-00 TYPE OF ACCOUNT EST. OF HENRY STARK ^ saviecs S.S. N0. 195-07-1602 ^cHECKING DATE OF DEATH 03-03-2002 ^ TRUST •~L ,,, ,,, -,, ' CCOUNTY CUMBERLAND X^CERTIF. REMIT PAYMENT ANO FORMS T0: KATHERINE S STARK REGISTER OF WILLS APT 1 ~;_ CUMBERLAND CO CDURT HOUSE 1109 COLUMBUS AVE ((~ ~ CARLISLE, PA 17013 LEMOYNE PA 17D43 ~722 ALLFIRST FINANCIAL SERVICES has provided the gepartment with the infarnation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this ecccun t. If you feel this informs lion is incc rrect, please obtain written correction frog the financial institution, attach a copy to this fa rn and return it to the above adtlress. This account is taxable in accortlance with the IMeritance Tax Laws of the Commonwealth at Pennsylvania. Questions nay be en swerad by calling (717) 787-8327. COMPLETE PART I BELOW * ii ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 80000002183304 Data 06-16-1999 Established Account Balance 10,342.42 Percent Taxable X 8.333 Anount Subject to Tax 861.83 Tax Rate X .15 Potential Tax Due 129.27 To insure proper credit to your account, two (2] copies of this notice nu st aeepnpany your payaent to the Register of Wills. Make check payable to: ^Register of Nills, Agent^. NOTE: If tax paysents are node within three (3] sonths of the decedent's date of death, you aay deduct a 5% discount aF the tax tlue. Any inheritance tax tlue will become dellnquant nine (9] sonths after the tle to of death. r~' IAJCYAYEK KE~PUNSE ~ ~`ATL~ 7Q ~~19}+tMF~k ~f~~.l ~~.7 Y!! AN ~~~~~L 7~% ~S~S11~l1~" ~~~ 'I'ktYS ~1€11'YC A. ^ The above information antl tax due is correct. 1. You aay choose to remit payment to the Register o4 Wills with two copies of this notice to obtain CHECK a tliseount ar avoid interest, ar you aay check box ^A^ and return this notice to the Regi star of Nills and an official essesmant will be issued by the PA Oepar tment of Revenue. I ONE L B LOCK e. ^ Tha above asset has bean or will be repartetl antl tax paid with the Penn sylvenia Inheritance Tax return ONLY to be filed by the decedent's representative. ~/ L. ~I The above inforsa lion is incorrect and/ar debts antl deductions were paid by you. Ycu must coaple to PART ~ end/or PART ~ below. PART If you indicate a different tax'r,a~te, please state your relationship to decedent: ~f0~2 TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 K 4. Anount Subject to Tax 4 5. Debts and Deductions 5 b. Anount Taxable 6 7. Tax Rate 7 8. Tax Due 8 Under penalties of par jury, I declare that the facts I have reported above are true, correct andd//,, f ~/cynplate to the bask of ny knowledge and belief. HOME C 71~ ) ~Q~-Zb~~ .(~{)f/01i 7C" d ~i , ,- .. ,- . ~.~i~,c .~ ~ WORK ( ) ~~ PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID COMMONWEALTH OF PENNSYLVANIA BEPARTNENT OF REVENUE BUREAU OF INBIVIOU INFORMATION NOTICE FILE N0 21-~-53~' AL TA%ES AND . DEPT. 280681 HARRISBURG, PA 171za-gbol TAXPAYER RES PONS E ACN 02120061 DATE 04-30-2002 RfY-154! EX .1FV [09-00) TYPE OF ACCOUNT EST. OF HENRY STARK ^ snvieis S.S. N0. 195-07-1602 ^ cHECKIND DATE OF DEATH 03-03-2002 ^ TRUST •~~~ ~, ~ _,4, ~~ COUNTY CUMBERLAND © CERTIF. REMIT PAYMENT AND FORMS T0: KATHERINE S STARK REGISTER OF WILLS APT 1 CUMBERLAND CO COURT HOUSE 1109 COLUMBUS AVE r ~ ~- CARLISLE, PA 17013 LEMOYNE PA 17.0 4 3722 ALLFIRST FINANCIAL SERVICES has provided the gepartment xith the infatuation listed below which has been usetl in calculating the potential tax tlue. Their recortls indicate that at the death of the above tlecedent, ycu were a joint oxner/beneficiary of this aeeoun t. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form antl return it to Me above address. This account is taxable in accordance with the Inheritance Tax Laws of the [ommanuealth of Pennsylvania. guestions may be ensue red by calling (7i7: 787-8327. COMPLETE PART 1 BELOW I[ IF ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 80000002183798 Date 08-16-2000 To insure proper credit to your account, twc Established f2) copies of this notice musk accompany your Account Belanca 10,099.54 Pavmant to the Register of Nills. Make check payable tc: ^Register of Wills, Agent^. Percent Taxable X 8.333 84 1 .59 NOTE: If tax peynen is are natlm within three Anount Subject to Tax f31 months of the decedent's data of tlea th, Tax Rate X , 15 you may deduct a 5'/. tliseount of the tax due. 1 26 .24 Anv inhe ri tanea tax due will become delinquent Potential Tax DUB nine (97 months after the date of death. PART TAXPAYER RESPONSE 1^ ~`AYI1 7G;,1~~:ItxLL ~.T ~~ QI~FtrA1 7A~J4~~T ~AS# Gib Tl1~~ 'IFS; A. ~ The above information and tax due is em rrec t. 1. Vou may choose to ram it pavnent to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid intern st, or you may cheek box ^A^ and return this notice to the Register of ONE Wills antl an official assessment will be tssuetl by the PA gepartment of Revenue. [ B LOCK ONLY ] B. ~ The above asset has been or will be reported antl tax paid with the Pennsylvania Inheritance Tex return to be filed by the decedent's representative. .~~ C. j7Cj Tha ou above informs tian is incorrect and/or debts antl deductions ware paid by ypu. must coop is to PART Z^ and/or PART 3^ below. ppRT If you indicate a different1 ~taxL Qrate, please state your relationship to decedent: TJ'~"T /~ TAX RETURN - COMPUTATION OF TAX ON JOINTiTRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3_X 4. Anount Subject to Tax 4 5. Debts and Deductions 5 6. Anount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID DA~- Under penalties of perjury, I declare that the facts I have reported~fabov~ er2a true, correct and / / ,,~~ go~np~latm to the bestJofdny knoaladge and belief. HOME (~~ I ) 30 ]-~•tjy1- ~{;r ~~- /!~_~~~~,<c'__ iC! ~¢-t._s f~ WORK C ) CONMONNEALTH OF PENNSYLVANIA BEPARTMENT OF REVENUE BUREAU OF INOIVIBUAL TAXES DEPT. 288601 HARRISBURG, PA 17128-8681 INFORMATION NOTICE AND TAXPAYER RESPONSE REV-1515 EM RW (W-9n FILE NO. 21-0~-$3~ ACN 02120055 DATE 04-30-2D02 TYPE OF ACCOUNT EST. OF HENRY STARK ^ SAVINDS S.S. N0 . 195-07-1602 ^ CHECKIND DATE OF DEATH 03-03-2002 ^ 7RU57 •~~, ~ ~ _ ~ COUNTY - CUMBERLAND Q CERTIF. ~ , REMIT PAYMENT AND FORKS T0: KATHERINE S STARK REGISTER OF WILLS APT 1 ~. CUMBERLAND CO COURT HOUSE 1109 COLUMBUS AVE fi CARLISLE, PA 17013 LEMOYNE PA 17 0'1r~~1722 ALLFIRST FINANCIAL SERVICES has provided the Department with the inforwetimn listetl below which has been used in calculating the po ten tlal tax tlua. Their records indicate that at the daakh of the above tleeetlant, you were a joint owner/beneficiary of this account. If you foal this inforwa tion is incorrect, please obtain written eorrecticn fraw the financial institution, aktach a copy tm this form and return it tm the above address. This account is taxable in eccortlence with the Inheritance Tax Lexs of the Cowwonwealth of Pennsylvania. Questions may be enswe red by tailing 1717) 787-6327. COMPLETE PART 1 BELOW a * ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 800000021833D9 Data 06-17-1999 7o insure proper cretlit tm your account, two Established E2) copies of this notice wust accmwpanv your ACeOUnt Balance 6 2D4 73 Paywent to the Register of Wills. Make check , . payable to: ^Register of Kills, Agent^. Percent Taxable X 8.333 Anount Subject to Tax 517 04 NOTE: If tax paywents are wade within three . (3) won MS of the decedenYS tlate of tleath, Tax Rata X , 1 rj vau way deduct a 5% discount of the tax due. Potential Tax Due 77 56 Any inhe ritanca tax due will becowe tle lineuent nine (9) months after the tlate of death. PART TAXPAYER RESPONSE 1^ ' ~AxE ~ ~~Sr~1fYiL R~.T r![.## ~IG~AL TAX :#~~SIiT ~15t #~ T~lY& TIC A. ~ The above inforwa tian and tax due is correct. 1. You way choose ko rewit pavnent to the Register of Wills wikh two copies of this notice to obtain CHECK ONE a tliseount or evoitl interest, or you may check box ^A" and return this notice to the Register of Kills end an official assessment will be iswed by the PA Departwant of Revenue. BLOCK ONLY 8. ~ The above asset has been or will be reportetl antl tax paid with the Pennsylvania Inheritance Tax return tc ba filetl by the tlecedent's representative. C. ~he You above inforwa tion is incorrect antl/ar tleb is end tletluc ticns were paid by you. wust cowpleta PART ~ antl/or PART ~ below. PART If you indicate a different tax rate, please state your relationship to decedent: ~'-,~~,~ TAX RETURN - COMPUTATION OF TAX ON JOINT~TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent taxable 3 X 4. Anount Subject to Tax 4 5. Debts and Deductions 5 6. Anount Taxable 6 7. Tax Rate 7 B. Tax Due 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID DATE Under penalties of perjury, I declare that the facts I have reported above are tr~u1e, correct and complete to the best o,fi??ny knowledge and belief. HOME C7/1 > 3Q~ - [. ~1'`J~ ,r/J//~l, ~~l~'_4a<: ~, ~,A r ~ ? WORK ( ) LOMMONNEALTH OF PENNSYLVANIA BEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2806 D1 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE REY-1X{5 EX XFP (n-Yn FILE NO. 21 -~' as3c~ ACN 02120067 DATE 04-30-2002 `OZ U~r -, KATHERINE S STARK APT 1 1109 COLUMBUS AVE ;~t?, LEMOYNE PA 17D43-1722 TYPE OF ACCOUNT EST. OF HENRY STARK ^ snvlNCs S.S. N0. 195-07-1602 ^cHECKING DATE OF DEATH D3-03-2002 ^ TRUSr E9UNTY CUMBERLAND X^ CERTIF. REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST FINANCIAL SERVICES has provided the Department with the inforaation listed below which has been used in calculating the pa tential tax due. Their records indicate that at the tleath of the above dacetlent, ycu were a joint owner/beneficiary of this account. If you feel this inforaation is into meet, please obtain written correction from the financial institution, attach a copy to this fares antl return it to the above address. This acccunt is taxable in eccortlance with the Inheritance Tax Lews of the Commonwealth of Pennsylvania. questions aay be answered by calling [717] 787-8327. COMPLETE PART 1 BELOW ^ x x SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. SOD00002184226 Date 07-31-2001 Established Account Balance 41,033.06 Percent Taxable X 8.333 Anount Subject to Tax 3,419.28 Tax Rate X .15 Potential lax Due 512.89 TAVOAVC~ FflCnnui To insure proper cretlit to your account, two L2) copies of this notice must accompany your payment to the Register of Wills. Make chock payable ta: "Register of Rills, Agent". NOTE: If tax peymen is are matle within three L3] months of the decetlent's date of dee th, you way tletluet a 5% tliseount of the tax tlue. Any inheritance tax due will becone tlelinquent nine (91 months after the data of death. ~~~miXXXmT.~ 7Ek ~~SP~MI~C;#t~LL R~iL~ ~ I,~.,IR EIF"#`Yi~XAi ~~~: ~'nAL-ii!'~i2~ YAX~~"' Yk4' i~ ~{M'~~VL .. _.... .: ~.. .... ... .::i J. .. .....: _..:. A. ~ The above inforaation antl tax due is eorrec t. 1. Vou may choose to remit payment to the Register of Wills with two copies of this notice to obtain CHECK a tliseount or avoid interest, or you aay check box ^A^ and return this notice to the Register of ONE gills antl an official assessment will be issued by the PA Oepartwent of Revenue. BLOCK B. ~ The above asset has been or will be reported antl tax paid with the Pennsylvania Inheritance Tax return ONLY .rte/to be filetl by the tlecedent's representative. L. pQ Tha above inforaation is incorrect antl/pr debts antl deductions were paid by you. ~ ou oust coop la to PART 2^ antl/or PART 3^ below. PART It You indicate a dififierent tax rate, please state your relationship to decedent:~f~~~'t9- TAX RETURN - COMPUTATION OF TAX ON JOINTiTRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Anount Subject to Tax 4 5. Debts and Deductions 5 6. Anount Taxable 6 7. Tax Rats 7 B. Tax Dua B PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION eNtniiNr pern D~~ Under penalties of perjury, I declare that the facts I have reported above era true, correct and cpnplete to the best/of ny 1knoelstlge and belief. HOME C 7) ~ ) 3~3-1~yt S-'l7~/lam. ~// T =:~G+i. rri ~ 9Cl ~~C`-t~~.~ WORK ( ) COMMBNWEALTN GF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU BF INBIVIBUAL TAXES DEPT. 28 g681 HARRISBURG, PA 17128-8681 INFORMATION NOTICE AND TAXPAYER RESPONSE REY-]56! EX IFP (E9-001 FILE N0.21-U~~SS_3~ ACN 02120075 DATE 04-30-2002 KATHERINE S STARK APT 1 1109 COLUMBUS ~N~r LEMOYNE PA"17043-1722 ALLFIRST FINANCIAL SERVICE has provitletl the Bepertment with the Information listetl below which has been used in calculating the potential tax duo. Their records intlicate that at the tlaath of the above decetlen t, you were a joint owner/benef iclary of this account. If you feel this information is iota rreet, please obtain written eorrec lion from the financial institution, attach a copy to this fora antl return it to the above etltlre ss. This account is taxable in accortlence with the Inheritance Tax Laws of the Commonxealth of Pennsylvania. 4uestions may be answaretl by calling [717) 787-8327. COMPLETE PART 1 BELOW ^ ^ * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 87008141167049 Date 06-09-1998 7o insure proper credit to your account, two Established E2) copies of this ne ties oust accompany your Account Balance 10,021.17 Pevment to the Register of Nills. Make check payable tc: ^Register of Wills, Agent^. Percent Taxable X 8.333 835.0 6 NOTE: If taz paynants are matla within three Amount Subject to Tax (3] months of the tlacetlent's date of death, TaX Rata X ~ 1 5 You may tletluet a 5% tliseount of the tax tlue. 1 25.26 Any inheritance tax due will became tlelinquent Potential TaX Due nine (9) months after the date o4 tleath. P~T TAXPAYER RESPONSE 1 SAY 7~t ~S~-G1~t :ftLL Rt#.T ~i~ ~!~ D~~~AL 'S`AX ~lNT ~~ GR Tl~r~ !R1'I'Y A. ^ The above inforwe lion antl tez due is carrec t. 1. Vou may choose to remit payment to the Register of Wills with two copies of this notice to ob tale CHECK a discount or evoitl interest, ar you may check box "A^ and return this notice tc the Register of ONE Nills and an official assessment will be issued by the PA Bepartmenk of Revenue. BLOCK B. ^ The above asset has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the tleeedent•s representative. [. The above information is incorrect antl/ar tleb is and tletlucticns were paid by you. Vou must comp le to PART ~ antl/or PART ~ balox. PART if You intlicate a different tax rate, please state your ^y relationship to decedent: ~n„i-'T.~_~~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3_.X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 b. Amount Taxable 6 7. Tax Rate 7 8. Tax Due g PART DEBTS AND DEDUCTIONS CLAIMED _-_-- 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID D~~ TYPE OF ACCOUNT EST. OF HENRY STARK ^ snvlNCs S.S. N0. 195-07-1602 ^cNECKiNG DATE OF DEATH 03-03-2002 ^ TRUST COUNTY CUMBERLAND © CERTIF. REMIT PAYMENT AND FORMS T0: REGISTER DF WILLS CUMBERLAND CD CDURT HOUSE CARLISLE, PA 17013 Under penalties of perjury, I declare that the facts I have repor~lted above ors true, correct and cogplsta to the best opQf nyp knoErledga and belief. HOME ~ //7 ) 3o~-Z T~~`} ~L S/7l/gyp ~- ~./.2-~~u. w; cam: , ~O ~!"_~-fG 2 ~ > WORK C ) CDMMDNWEALTN OF PENNSYLVANIA DEPARTMENT DF REVENDE BUREAU DF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA vlze-Deol EY-154! EN IFE (n-un I N FORMATION NOTIC E AND TAXPAYER RES PONS E FILE N0. 21-~'-~-'~~ pCN 02120072 DATE D4-30-2002 TYPE OF ACCOUNT EST. OF HENRY STARK ^ saviecs S.S. N0. 195-07-1602 ^ CHECKING DATE OF DEATH 03-03-20D2 ^ TRUST ~O[ Juis -f,, ;COUNTY CUMBERLAND X^ CERTIF. REMIT PAYMENT AND FORMS T0: KATHERINE S STARK REGISTER OF WILLS APT 1 '•- CUMBERLAND CO COURT HOUSE 1109 COLUMBUS AVE i'.d:IY' CARLISLE, PA 17013 LEMOYNE PA 17043-1722 ALLFIRST FINANCIAL SERVICE has providetl the Department with the information listed below which has bean used in calculating the potential tax tlua. Their recartls indicate that at the death o4 the above tlecetlen t, you were a jc int owner/banal iciery of this account. If you feel this informs Lion is incorrect, please obtain written correction from the financial institution, attach a copy to this fo rn and return it to the above address. This account is taxable 3n accortlanea with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. questions nay be ensweretl by calling (717] 787-8327. COMPLETE PART 1 BELOW * ^ x SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 87008000173743 Data 11-16-1989 Established Account Balance 8, 019.04 Percent Taxable X 8.333 Amount Subject to lax 668.23 Tax Rata X .15 Potential Tax Due lOD.23 To Insure proper cretlit to your account, txo [2) copies of this notice must accompany your payment tc the Register of Nills. Make check payable to: ^Ragister of Nills, Agent^. NOTE: If tax payments are matle within three (3) months of the decetlent's tle to of tlea th, ycu may tletluct a 5% discount of the tax tlua. Anv inheritance tax tlua will become delinquent nine [9! months after the date of tleath. FAZE TEl ~ffiS~k.~tY~.L ~`1' Y!E X~SAi.. 7A~tAS~Sl~[~" Bpi F1li T~#~8 1~STrC A. ^ The above information entl tax tlua is correct. 1. You may choose to remit payment to the Ragister of Nills with tuo copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A^ and return this notice to the Register of ONE Nills entl an official assessment will be issuetl by the PA Department of Revenue. [ B LOCK ONLY ~ B. ^ The above asset has bean or will be reportetl and tax paid with the Pennsylvania Inheritance Tax return to be ftlatl by the tlecetlent•s representative. ~-,/ C. jJ9~Tha ou above informs tion is incorrect entl/or debts entl daduc Lions were paitl by Yau. must ecmplete PART 2^ entl/ar PART 3^ below. PART If You indicate a different tax rata, please state your relationship to decedent: 'driTi c TAX RETURN - COMPUTATION OF TAX ON JOINT~TRUST ACCOUNTS LINE 1. Data Established 1 2. Account Balance 2 3. Percent taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Dua 8 PART DEBTS AND DEDUCTIONS CLAIMED __-- 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Dl~ Under penalties of perjury, I declare that the facts I have reported above are true1, correct and complete to the bast of ny ~kno~aladgs and belief. HOME C ~) 7 ) ~ V Ij - Z U y Z {"j~/~~~ /d/---~J!~,r~~:~ ' ~Z~f i_~ WORK C ) ' /~ 6~- 6 BUREAU OF INDIVIDUAL INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17120-0601 COMMONWEALTH OF PENNSYLVANIA TAXES DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT ALLONANCE OR DISALLOMANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON JOINTLY NELO OR TRUST ASSETS l~'. ,~..,_ ,...... , KATHERINE S STARK APT 1 1109 COLUMBUS AVE LEMOYNE ,PA 17043-1722 DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 COUNTY CUMBERLAND SSN/DC 195-07-1602 ACN 02120049 Amount Ramittad MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120049 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT N0. 87005700434938 TYPE OF ACCOUNT: (X1 SAVINGS ( ) CHECKING C ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 02-02-1995 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 13,463.94 NOTE: X 0.083 1,121.95 .00 1,121.95- X .00 .00 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL OUE .00 , IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT IONAL INTEREST. A ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRT, YOU MAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I ~?- G ~- 6 BUREAU OF INDIVIDUAL TAXES INHERITANCE TA% UIV ISION SEPT. 280601 .HARRISBURG. PA 1T12N-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE SAX APPRAISEMENT ALLONANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 -,~ COUNTY CUMBERLAND KATHERINE S STARK ~ ~ ~~ SSN/DC 195-07-1602 APT 1 ACN 02120055 Amount Remitted 1109 COLUMBUS AVE _ LEMOYNE PA•'17043-1722 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120055 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT N0. 80000002183309 TYPE OF ACCOUNT: ( ) SAVINGS C ) CHECKING ( ) TRUST (X1 TIME CERTIFICATE DATE ESTABLISHED 06-17-1999 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due 6,204.73 X 0.083 517.04 517.04 X .00 .00 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT IONAL INTEREST. + ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REpUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION 'DEPT. 280601 HARRISBURG, PA 17128-0601 \~?-6~- G V COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE SAX APPRAISEMENT ALLORANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON JOINTLY NELD OR TRUST ASSETS lr ~_ _... KATHERINE S STARK APT 1 1109 COLUMBUS AVE '~ LEMOYNE PA''~17043-1722 DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 1; COUNTY CUMBERLAND SSN/DC 195-07-1602 ACN 02120052 Amount Remitketl MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-027 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120052 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT N0. 0081301510 TYPE OF ACCOUNT: ( J SAVINGS CX) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 08-28-1964 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 21,971.31 NOTE: X 0.083 1,830.87 .00 1,830.87 x .00 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTERES7 AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT IONAL INTEREST. aF C IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REpUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE OUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA n12a-oral NOTICE OF INHERITANCE TAX APPRAISENENT ALLORANCE OR DISALLORANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON \. /~ 6~-6 JOINTLY HELD OR TRUSS ASSETS xEVazae rx evv <m-an DATE o7-zz-zooz ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 COUNTY CUMBERLAND KATHERINE S STARK ~- ~-- -~ SSN/DC 195-07-1602 ACN 02120058 APT 1 1109 COLUMBUS AVE Amount Remlttetl LEMOYNE PA 1i~043-1722 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120058 TAX RETURN WAS: [X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT N0. 80000002183304 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 06-16-1999 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 10,342.42 X 0.083 861.83 .00 861.83 X .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PALD (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER THIS GATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ( IF TOTAL DUE IS LESS THAN 61, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR1, VOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J BUREAU OF. INDIVIDUAL TAXES INHERITANCE TAX DIVISION 'DEPT. 280601 HARRISBURG, PA 1]128-0601 ~/~-68- G COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT ALLONANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSNENT OF SAX ON JOINTLY HELD OR TRUST ASSETS KATHERINE S STARK ~~ APT 1 1109 COLUMBUS AVE '- L EMOYNE PA~'17043-1722 DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 COUNTY CUMBERLAND SSN/DC 195-07-1602 ACN 02120064 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CU7 ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120064 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT N0. 80000002183455 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (X1 TIME CERTIFICATE DATE ESTABLISHED 11-26-1999 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 10,059.80 X 0.083 838.28 838.28 X .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT IONAL INTEREST. ~ ( IF TOTAL ^UE IS LESS THAN 61, NO PAYMENT IS REpUIREO. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA BUREAU DF INDIVIDUAL TAxss DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION - DEPT. 280601 HARRISBURG. PA n)ze-osol NOTICE OF INHERITANCE TAX '~ APPRAISEMENT ALLONANCE OR DZSALLONANCE OF DEDUCTION, AND ASSESSMENT OF SAX ON JOINTLY HELD OR TRUST ASSETS xEVawe ex •rv ~a~-on DATE 07-22-2002 ESTATE OF STARK HENRY GATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 ~~j - .,~, COUNTY CUMBERLAND KATHERINE S STARK , ~~ SSN/DC 195-07-1602 ACN 02120061 APT 1 1109 COLUMBUS AVE Amount Remittee L EMOYNE ~~ PA 17043-1722 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE------- RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP CO1-02J NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE NO. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120061 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT N0. 80000002183798 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST Op TIME CERTIFICATE DATE ESTABLISHED 08-16-2000 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 10,099.54 X 0.083 841.59 .00 841.59 X .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAI^ (-) gMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST ~ ( IF TOTAL DUE IS LESS THAN E1, NO PAYMENT IS REpUIREO. . IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) . BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 H\ARRIS BURG, PA 11128-0601 V COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT ALLONANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSMENT OF SAX ON JOINTLY HELD OR TRUST ASSE'f5 DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 COUNTY CUMBERLAND `~- ~~~~ ~ SSN/DC 195-07-1602 KATHERINE S STARK ACN 02120067 APT 1 1109 COLUMBUS AV~.;, Amount Remitted LEMOYNE 7A~17043-1722 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS GATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120067 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 80000002184226 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST ( ~ TIME CERTIFICATE DATE ESTABLISHED 07-31-2001 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 41,033.06 X 0.083 3.419.28 3,419.28 X .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE A80VE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .OD TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION DF ADDIT IONAL INTEREST. ~ ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAV BE OUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 7 e BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX OIVIS ION DEPT. 280601 HARRISBURG. PA 1]128-0601 D COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT ALLONANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS KATHERINE S STARK APT 1 1109 COLUMBUS~AVE LEMOYNE ~ PA 17043-1722 DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 FILE NUMBER 21 02-0538 CDUNTV CUMBERLAND SSN/DC 195-07-1602 ACN 02120072 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE---_--- RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP CO1-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. N0. 195-07-1602 ACN 02120072 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE ACCOUNT N0. 87808080173743 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING C ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 11-16-1989 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Oue TAX CREDITS: 8,019.04 X 0.083 668.23 .08 668.23 X .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE ,Op INTEREST AND PEN. ,00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT IONAL INTEREST . ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REgUI RE D. . IF TOTAL OUE IS REFLE CTEO AS A "CREDIT" ( LR), YOU MAV BE DUE A REFUND SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) . ,BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 1]128-0601 \ 6 ~" ~ V ~~. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE SAX APPRAISEMENT ALLONANCE OR DISALLONANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON JOINTLY NELD OR tRUST ASSESS U' ,. J_ ,. KATHERINE S STARK ~-" APT 1 1109 COLUMBUS AVE _ LEMOYNE PA;~I.7043-1722 DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATN 03-03-2002 FILE NUMBER 21 02-0538 COUNTY CUMBERLAND SSN/DC 195-07-1602 ACN 02120075 Amount RamStted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CU7 ALONG THIS LINE------- RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMEN7, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-22-2002 ESTATE OF STARK HENRY DATE OF DEATH 03-03-2002 COUNTY CUMBERLAND FILE N0. 21 02-0538 S.S/D.C. NO. 195-07-1602 ACN 02120075 TAX RETURN WAS: IX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICE ACCOUNT N0. 87008141167049 TYPE DF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST OO TIME CERTIFICATE DATE ESTABLISHED 06-09-1998 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 10,021.17 X 0.083 835.06 - .00 835.06 X .00 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. ,Op TOTAL DUE ,00 IF ( IF PAID AFTER THIS DATE, SEE TOTAL DUE REVERSE FOR CALCULATION OF ADDIT IONAL INTEREST. ~ IS LESS THAN 81, ND PAYMENT IS REgUIRED IF TOTAL DUE IS REFLECTED AS . A "CREDIT" ( CR), YOU MAY BE DUE A REFUND SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) . COMMONNEALTM OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 288601 HARR I58URG, Pp 17128-8681 INFORMATION NOTICE AND TAXPAYER RESPONSE REV-1565 E% BFB cw-Bn FILE N0. 21-ca7~.S38 ACN 02120064 DATE 04-30-2002 KATHERINE S STARK ~ APT 1 1109 CDLUMBUS AVE , ~t;,+... LEMOYNE PA 17043-1722 TYPE OF ACCOUNT EST. OF HENRY STARK ^ savINCs S.S. N0. 195-07-1602 ^cHECKING DATE OF DEATH 03-03-2002 ^ reusT COUNTY CUMBERLAND Q CERTIF. REMIT PAYMENT AND FORMS TD: REGISTER DF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST FINANCIAL SERVICES has provitletl the Department with the information listetl below which has been usetl in caleula ting the potential tax due. Their recortls intlieate that at the tlaath of the above decetlen t, you ware a joint owner/beneficiary o4 this account. If you feel this information is incorrect, please obtain written corree tion from the financial institution, attach a copy to this fora entl return it to the above atltlress. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Oussticns msy bo arsworatl by calling (71T. 737-832'. COMPLETE PART 1 BELOW if if ^ SEE REVERSE SIDE FOR FILING AND PAYMENT iNSraucrleNc account No. 80000002183455 Date 11-26-1999 Established Account Balance 10,059.80 Portent Taxable X 8.333 Anount Subject to Tax 838 28 rax Rate x .15 Potential Tax Due 125.74 To insure proper cretlit tc your account, two (2) copies of this notice oust accompany your paywent to the Register o4 Nills. Make check payable to: ^Register of Nills, Agent^. NOTE: If tax peymen is are matla within throe (3] months of the decedent's date of tlaath, you may deduct a 5% tliscount of the tax due. Anv inheritance tax due will become delinquent nine (9] months after the date of death. TAXPAYER RESPONSE ~AX~.4l~ TQ ~ ~PrL~, REi~.i' I~t ~N 6TCxAL TAX +~S~~SM~T 'tail lRYI"XC~: , ,. _....: A. ^ The above information entl tax tlue is correct. 1. Vou nay choose to remit payment to the Register of Nills with two copies of this notice to obtain CHECK a tliscount or ova itl interest, or you may check box ^A^ entl return this notice to the Register of ONE Rills and an official assessment ulll be issued by the PA Department of Ravanue. BLOCK ~ g, ^ The above asset has been or will be reportetl and tax paitl with the Pennsylvan is Inheritance Tax return ONLY to be flied by the deeadent•s representative. C. The above informs lion is incorrect entl/or tlebts and detlue lions xere paitl by you. - ou must eomple to PART 2^ end/or PART 3^ below. PART If you indicate a different {ax rate lease state your relationship to decedent: .L.1 ~~~_ TAX RETURN - COMPUTATION OF TAX ON JOINT~TRUST ACCOUNTS LINE 1. Data Established 1 2. Account Balance 2 3. Percent Taxable 3_X 4. Anount Subject to Tax 4 5. Debts and Deductions 5 6. Anount Taxable 6 7. Tax Rate 7 x 8. Tax Due 8 (~ RT DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DFSf_R TP77eN x..,.~~.~r ...-.. DATE -- -• ~- pm.vaus or par)ury, I tlsclars that the facts I have report fed above era true, co~rprect and > eonplete to the best /of n/y knowled/ge and belief. HOME C /~ ~ ) (} ~ - ~ Y Z S/ 3 //J 1, ~,~_c~.~' ~ A XL ~~-~iL~C.J - WORK ( ) a IN RE: IN THE COURT OF COMMON PLEAS HENRY STARK ESTATE CUMBERLAND COUNTY, PENNSYLVANIA SSN: 195-07-1602 ORPHANS' COURT DIVISION DOD: 03-03-2002 _ NO. rJ3$ YEAR OF 2002 DISCLAIffiER I, DENNIS C. STARK, of 238 Walton Street, Lemoyne, Pennsylvania 17043, son of Henry Stark, deceased, and joint owner of the accounts and certificates described herein, do hereby, with the intention to be legally bound, disclaim, waive and give up all of my interest in the accounts and certificates described herein, and in connection therewith do aver and acknowledge the following: (1) I have consulted with an attorney prior to executing this Disclaimer. (2) I understand that as a result of this disclaimer and the disclaimer of my brother, Richard A. Stark, all ownership interests in the said accounts and certificates will pass to my mother, Katherine Stark. (3) I understand that this disclaimer is a complete and total disclaimer and renunciation of my right to receive any interest, joint or otherwise, in the accounts and certificates described herein. MEbIBERS 15T FEDERAL CREDIT UNION Account # AAVroxim8te DOD Value 10024-41 $ 6,510.83 10024-42 6,704.04 10024-43 7,047.03 10024-44 60,000.00 ALLFIRST CD's Account # Apnroxiatate DOD Value 87008141167049 $10,021.17 80000002183455 10,059.80 80000002183798 10,099.54 80000002183304 10,342.42 87008000173743 8,019.04 80000002183309 6,204.73 80000002184226 41,033.06 ALLFIRST SAVINGS & CHECKING Account # 87005700434938 0081301510 Approximate DOD Value $13,463.94 21,971.31 Dated: 2002 Sworn to and subscribed before me this ,~/si day of /'l1.~~ 2002. ~~~, ~. r~ ot~-rry Pu lic ~-~ „ e-~,,Q~ ~S C. STARK " Notarial Seal Jenny A. Tobias, Notary Public Hartisburg, Dauphin County My Commission Expires Feb.75, 2005 IN RE: IN THE COURT OF COMMON PLEAS HENRY STARK ESTATE CUMBERLAND COUNTY, PENNSYLVANIA SSN: 195-07-1602 ORPHANS' COURT DIVISION DOD: 03-03-2002 _ N0.00538 YEAR OF 2002 DISCLAIMER I, RICHARD A. STARK, of 503 Warren Street, Lemoyne, Pennsylvania 17043, son of Henry Stark, deceased, and joint owner of the accounts and certificates described herein, do hereby, with the intention to be legally bound, disclaim, waive and give up all of my interest in the accounts and certificates described herein, and in connection therewith do aver and acknowledge the following: (1) I have consulted with an attorney prior to executing this Disclaimer. (2) I understand that as a result of this disclaimer and the disclaimer of my brother, Dennis C. Stark, all ownership interests in the said accounts and certificates will pass to my mother, Katherine Stark. (3) I understand that this disclaimer is a complete and total disclaimer and renunciation of my right to receive any interest, joint or otherwise, in the accounts and certificates described herein. MEMBERS 1ST FEDERAL CREDIT IINION Account # Approximate DOD Value 10024-41 $ 6,510.83 10024-42 6,704.04 10024-43 7,047.03 10024-44 60,000.00 ALLFIRST CD's Account # Approximate DOD Value 87008141167049 $10,021.17 80000002183455 10,059.80 80000002183798 10,099.54 80000002183304 10,342.42 87008000173743 8,019.04 80000002183309 6,204.73 80000002184226 41,033.06 ALLFIRST SAVINGS & CHECKING Account # Approximate DOD Value 87005700434938 $13,463.94 0081301510 $21,971.31 Dated: J /~~ 2002 ~ [/~_ ' RICHARD A. STARK Sworn to and subscribed before me this ~/°y day of /'/'Ia~, 2002. ~~~ Q .~u~ Noty ry Public Notarial Seal Jenny A. Tobias, Notary Public Harnsburg, Dauphin County My Commission Expires Feb.15, 2005 COMMONWEALTH OF PENNSYLVANIA l ss: COUNTY OF CUMBERLAND 1 Robert S. Hippman being duly sworn according #o law, deposes and says that he *he Fx c„t~,- of the Estate of F1 ' h t, . e 1- late of -.East Pennsboro Township___ Cumberland County, Pa., deceased and that the within is an inventory made by Robert S. Hippman __ _ ., the said Rxec„tor of the entire estate of said decedent, consisting of all the personal proparty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death, -,/ and subscribed before me, o?C> ~. ZcG L Date of Death 1 Y .--~ s O n xseutor Adminis rotor Robert S. Hippman 14 Randi Road Enola, PA 17025 NOTARIAL SEAL public Roberta L. Radcliff, Notaery mr~erland WomdeYsburo tloraugh, Coum9 My ~m~seion Expires Jan. 20, 2005 rch Address 2002 Day Mon}h INSTRUCTIONS Yaar I. An inventory must be filed within three months after appointment of personal representetiva. 2. A supplement inventory musf be filed within thirty days of discovery of additional assets. 3. Addi+ional sheets may be attached as +o personalty or realty 4. See Article IV, Fiduciaries Aet of 1949. O Z ~ W Q Z F w K W Q a W H ~ a ro J LL y., J < O Q ~ Z ,j O Z .c w a v a a ro N .~ f- w E 0 {-I O P y C v a. m w w O J ti 0 m al 0 al 0 d 'o U v A d E U e w m ~ ~ '++ w O ~ .`~ ~ u b w ~ x b •r~ Y ~ G ~ 0 ro o LL m Q Inventory of the real and personal estate of FLi AR TH T STARK deceased Allfirst Bank Checking Acct 110056772459 Cert of Deposit 1180000002220195 Cert of Deposit 1/80000002220131 Cert of Deposit 1180000002220094 21036 72 10025 O1 43102 10 80148 97 54312 180