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HomeMy WebLinkAbout03-17-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: REV-1162 EX(11-961 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 01 1006 WETZLER JAMES J 161 KLINE ROAD SHIPPENSBURG, PA 17257 -------- rom REMARKS: RECEIPT GIVEN TO DR JAMES WETZLER CHECK#1251 SEAL DUPLICATE ACN ASSESSMENT CONTROL NUMBER 08159022 08159023 08159024 08159025 08159026 08159027 08159028 AMOUNT I 519.83 I 519.83 I 521.56 I 521.56 I 522.47 I 522.47 I 515.43 TOTAL AMOUNT PAID: INITIALS: JN RECEIVED BY: REGISTER OF WILLS 5143.15 GLENDA EARNER STRASBAUGH REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES PD Box zaocol • AND FILE N0. 21 08-1083 HARRISBURG PA ln2a-0601 ~ ~~ TAXPAYER RESPONSE ACN 08159022 aev i¢~~~v.tae-~~ ~~ ;. -_.., DATE 12-02-2008 2~~Q F~,~,'? ~ ~ ~~~ ~~; ~7 TYPE OF ACCOUNT EST. OF MARY M WETZLER SSN ^ SAVINGS r ~ ,.~_ 024-18-9387 ® CHECKING ~'~- F ~'~~ DATE OF DEATH o9-07-2008 ~Hrl~~" ~ ~>'~.'~!~ i COUNTY ~`~~+ F ,,, CUMBERLAND ^ TRUST ~ ~ ~ ~ ~ CERTIF. JAMES •~~ REMIT PAYMENT AND FORMS T0: J WETZLER REGISTER OF WILLS 161 KLINE RD SHIPPENSBURG PA 17257-9649 CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, If you feel the information is incorrect, please obtain written correction from the financialainstitution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance TaxtlawseofbthefCommonwealthlofaccount. Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0024189387-S4 Date 10-15-1971 Established To ensure proper credit to the account, two Account Balance copies of this notice must accompany $ 2, 643.99 Payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 16.667 $ 4 4 0 . 6 7 NOTE: If tax payments are made within three Tax Rate X months of the decedent's date of death, Potential Tax Due • 045 deduct a 5 percent discount on the tax due. 1 9.8 3 Anv Inheritance Tax due will become delinquent PART nine months after the date of death. 0 TAXPAYER RESPONSE FAILURE TD RESPOND WILL RESULT IN AN OFFICIAL TAX ASSE55MENT A• ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK B 0 N L Y ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C• ~ The aboveinforma ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART 2f in.i; ....r:__ _ ^ 4 ..~~rerent tax rate, please state 2 relationship to decedent: TAX RETURN - COMPUTATION LINE I. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS z $ 3 X 4 5 6 7 X 8 $ DFFICIAL U5E DNLY ^ AAF PA DEPARTMENT DF REVENUE PAD 1 2 3 4 5 6 7 8 DATE PAID PAYEE DESCRIPTION TOTAL CEnter on Line 5 of Tax Computation) Under penalties of perjury, eclare that the facts I have reported above are true, correct and co ete to the best o owledge and belief. HOME ( 7~7 ) $'.?Z fI'f2 ~J AYER c _ uor WORK C ~ DEBTS AND DEDUCTIONS CLAIMED GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with apvlicable interest based on information submitted by the financial institution. 2. Inheritance Tau becomes delinquent nine months after the decedent's date of death. 3. A .joint account is t{hoseeheldnbetweenhhusbandeandswife) the decedent p fain jointcnameslwithin one Year prior to 4. Accounts (including death are fully taxable. 5. Accounts heldbbysaedecedenty"inttrusthfobananotherlor othershareofullvataxable.to death are not taxab e. 6. Account REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONS claimed, place an "X" 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being in Block A of Part 1 of thls,ofxtheecountYOindicated1OnThe PAnDepartmentsofnRevenue willmissue ancofficial assessment of tax to the register of wil (Form REV-1548 EX) upon receipt of the return from the register of wills. "Taxpayer Response" section. Sign one 2. BLOCK B - If the asset specified on this notice has been or wlin BlockpBrofdPart 1 ofPthe with the Pennsylvania Inheritance Tax Return filed by the estate's representative, place an "X" copy and return to the register of wills of the county indicated. check Block C and complete Parts 2 and 3 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, according to the instructions below The PAnDepartmentsofnRevenuetwillmissue anuofficialfassessmentu(Form REV-154BbEX)tuponereceipter of wills of the county indicated. of the return from the register of wills. _ TAX COMPUTATION TAX RETURN - PART 2 at date of death. are 1. Enter the date the account originally was established or titled in the manner existing LINE NOTE: For a Yaxablet wHowever after 12/12/82, accounts the decedent put in joint names within one year of dea there is an exclusion not to exceed S3,000 per transferee, regardless of the value of fully the account or the number of accounts held. the 53,000 exclusion wasadeductedafromlthe(accountebalanceoas reportedsbvnthe financialdinstitutionn of this notice, 2. Enter the total balance of the account including interest accrued to the date of death. 3, The percentage of the account that is taxable to each survivor is determined as follows: A. The percentage taxable of ioint assets established more than one Year pri°MULTIPLIED BY 1 0's dePERCENT TAXABLE 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY SURVIVINGBJOINT OWNERS JOINT OWNERS = 16.7 percent (TAXABLE TO EACH SURVIVOR) Example: A point asset registered in the name of the decedent and two other person 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 B. The percentage tauablindividual(s)cftrust beneficiaries)a of the decedent's death or accounts owned by the decedent but held in trust for another = PERCENT TAXABLE 1 DIVIDED BY OWNERSNORBTRUST BENEFICIARIESNT MULTIPLIED BY 100 Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 50 percent (TAXABLE FOR EACH SURVIVOR) 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 = the percent taxable (Line 3). 5. Entermthettotaleof thetdebts1and4deductionsmlistedvinuPartl3ing the account balance (Line 2) by 6, The amount taxable Cline 6) is determined by subtracting the debts and deductions (Line 5) from the amount subject to tax (Line 4). 7. Enter the appropriate tax rate (Line 7) as determined below. Sibling Collateral Spouse Lineal Date of Death 15 percent 15 percent 3 percent 6 percent 07/01/94 to 12/31/94 15 percent 15 percent ercent 6 percent 01/01/95 to 06/30/00 0 p * 12 percent 15 percent resent 0 percent 4.5 percent 07/01/00 to p ^The tax rate imposed on the net value of transfers from a deceased child 21 Years of age or Younger an adoptive parent or a stepparent of the child is 0 percent. children and other lineal descendents. "Children" includes natural chil ren death to or for the use of a natural parent, The lineal class of heirs includes grandparents, Parents, whether or not they have been adopted by others, adopted children and step children. Lineal descendents" includes all children o e sc whether or not they have been adopted by others; adopted descendents and their descendants; endents, at least one parent in common with the decedent, whether by blood natural parents and their de and step descendants. "Siblings" are defined as individuals who have DEDUCTIONS CLAIMED or adoption. The Collateral class of heirs includes aPARTer 3 neficiaDEBTS AND CLAIMED DEDUCTIONS Allowable debts and deductions are determined as follows: A. You are legally responsible for payment, or the estate subject to administration by a personal representative is insufficien to pay the deductible items. use 8 1/2" x 11" sheet of paper. Proof of C. Debtsc bein gv cl aimedh mustbbe itemizedefullyhinf Part 3ecelfn additionalf spaceh isrneeded,paymen . payment may be requested by the PA Department of Revenue. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFDRMATIDN OR ASSISTANCE, CDNTACT ANY REGISTER OF WILL , UE DISTRICT OFFICE OR THE BUREHEARINGNAND/DRASPEAiCING NEED5 PA DEPARTMENT OF REVEN 0717} 787-8327. SERVICES FDR TAXPAYERS WITH SPECI ONLY: I-8~0-447-320. PENNSYLVANIA INHERITANCE TAX _ INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES ~ ~~ Po Box zaocol _ .~-~ A N D HARRISBURG PA In za-ocol - ,, - TAXPAY E R R E S P O N S E REV-1543 E% AFP (OB-UB) ~r,~ Guy ~~A;; i 7 i'i`i ~~'~ ~7 lJU 4~' - i MILDRED E STOUFFER PO BOX 1587 CLEBURNE TX 76033-1587 FILE N0. 21 OS-1083 ACN 08159023 DATE 12-02-2008 EST. OF MARY M WETZLER SSN 024-18-9387 DATE OF DEATH 09-07-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF A SAVINGS ® CHECKING TRUST CERTIF. PSECU prove ed the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a If you feel the 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 account is taxable in accordance with the Inheritance TaxtlawseofbthefCommonwealthlofaccount. Penns•Lvar.iz. Plaasa cell (77~) 7g7_g;y~ wikh questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0024189387-S4 Date 10-15-1971 Established To ensure proper credit to the account, two Account Balance copies of this notice must accompany $ 2, 643.99 payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 16.667 $ 4 4 0 . 6 7 NOTE: If tax payments are made within three TaX Rate X months of the decedent's date of death, Potential Tax Due • 045 deduct a 5 percent discount on the tax due. 1 9.8 3 Anv Inheritance Tax due will become delinquent PART nine months after the date of death. 10 TAXPAYER RESPONSE FAILllRE TO RESPOND WILL RESULT IM AN OFFICIAL TAX A55E55MENT A• The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C C HECK a discount or avoid interest, or check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. D N Y B' ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C• ~ The above information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If inrl9,-~~~.._ _ - -----~.~y d uirrerent tax rate, please state 2 relationship to decedent: TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate B. Tax Due PART OF TAX ON JOINT/TRUST ACCOUNTS i 2 3 X ' 4 5 - 6 +C 7 X B S OFFICIAL U5E ONLY ~ AAF PA DEPARTMENT OF REVENUE PAD i 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. ~y C HOME C8/7 ) G ~S (~?/ TAX ER SI ATUR WORK (~/ 7 ) - 0 TELEPHONE NUMBER ADO _ - A E DATE PAID PAYEE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance Tax becomes delinquent nine months after the decedent's date of death. 3. A Joint account is t{hoseeheldnbetweenhhusbandeandswife) the decedent putain jointcnameslwithin one Year prior to 4. Accounts (including death are fully taxable. 5. Accounts heldbbYSaedecedenty"inttrusthforananotherlor othershare fullYataxable to death are not taxab e. 6. Accounts REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONS - If the information and computation in the notice are correct and deductions are not being claimed, place an "X" 1. BLOCK A in Block A of Part 1 °(wills„ofxtheecountYOindicatedionT he PAnDepartmentsofnRevenue willmissue ancofficial assessment o tax to the register of (Form REV-1548 EX) upon receipt of the return from the register of wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheri ance in Block B of Part 1 of the "Taxpayer Response" section. Sign one Tax Return filed by the estate's representative, place an "X" copy and return to the register of wills of the county indicated. claimed, check Block C and complete Parts 2 and 3 3. BLOCK C - If the notice information is incorrect and/or deductions are being according to the instructions bedlow. Sign two copies and submit them with Your check for the amount of tax payable to the regis er The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of wills of the county indicate of the return from the register of wills. _ TAX COMPUTATION TAX RETURN - PART 2 1. Enter the date the account originally was established or titled in the manner existing at date of dea LINE regardless of the value of NOTE: Fu11Y taxablet wHowever.athere 2is12an8 exclusion nath to ex eed S3 000 per transfereethin one Year of death are f the account or the number of accounts hel the 53,000 exclusion If a double asterisk (~~) appears before your first name in the address portion of this notice, was deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percentage of the account that is taxable to each survivor is determined as follows: A. The percentage taxable of joint assets established TOTAL NUMBER OF ear prioMULTIPLIED BY 100,s dePERCENT TAXABLE 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY SURVIVING JOINT OWNERS JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other person = 16.7 percent (TAXABLE TO EACH SURVIVOR) 1 DIVIDED BY 3 CJOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 B. The Dercentage tax ablindividual(s)c(trust beneficiaries)r of the decedent's death or accounts owned by the decedent but held in trust for another = PERCENT TAXABLE 1 DIVIDED BY OWNERSNORBTRUST BENEFICIARIESNT MULTIPLIED BY 100 Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. = 50 percent (TAXABLE FOR EACH SURVIVOR) 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 4. The amount subject to tax (Line 4) is determined by multiplying the account balance (Line 2) by the percent taxable CLine 3 . 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable CLine 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. Sibling Collateral Spouse Lineal Date of Death 15 percent 15 percent 3 percent 6 percent 07/01/94 to 12/31/94 6 percent 15 percent 15 percent 01/01/95 to 06/30/00 0 percent * 12 percent 15 percent O percent 4.5 percent 07/01/00 to present The tax rate imposed on the net value of transfers from a deceased child 21 years of age or Younger a e death to or for the use of a natarents a children nand tother lineal descendentsnt'Children hlincludespnatural children whether or not they have been adopted by others, adopted children and step children. Lineal descendents" includes all chil ren o The lineal class of heirs includes grandparents, p whether by blood whether or not they haho have atoleastbonetparentainpcommonswithethe decedents, descendants; natural parents and their descendents, and step-descendants. "Siblings" are defined as individuals w DEDUCTIONS CLAIMED or adoption. The Collateral class of heirs includes PARTer 3eneficiaDE$TS AND CLAIMED DEDUCTIONS Allowable debts and deductions are determined as follows: a personal representative is insufficient A. You are legally responsible for payment, or the estate subject to administration by a er. Proof of to pav the deductible items. use B 1/2" x 11" sheet of P P C. Debtscbeingyclaimedhmustbbe itemizedefullyhinfPart 3ecelfnadditionalfspacehisrneeded,paymen . payment may be requested by the PA Department of Revenue. TAXPAYER ASSISTANCE IF YQU NEED FURTHER INFORMATION OR ASSISTANCE, CO ALANE ANY REGISTER OF WILL , UE DISTRICT OFFICE OR THE BUREAUA~~NGNAND/ORASPEAKING NEEDS PA DEPARTMENT OF REVE C717) 787-8327. SERVICES FOR TAXPAYERS WITH SPECI ONLY: 1-800-447-302. PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AN D PO BOX 280601 ~,-, FILE N0. 21 08-1083 HARRISBURG PA 171za-ocol 'nAXPAY E R R E S P O N S E ' - ACN 08159024 REV-1543 EX IIFP (bs-~)l/ ,... ~ DATE 12-02-2008 -..': - .. t... Z0~9 ~~~ ~ 7 ~~ ~2. TYPE OF ACCOUNT T EST. OF MARY M WETZLER SSN ® SAVINGS 024-18-9387 ~ CHECKING G~~k`'~ n'-' DATE OF DEATH 09-07-2008 ~ ~' ' ~ TRUST ~r `r~ ti ~,~~ I~?j COUNTY CUMBERLAND CUB ~_ ~ CERTIF. r~;' p~ REMIT PAYMENT AND FORMS T0: JAMES J WETZLER 161 KLINE RD REGISTER OF WILLS SHIPPENSBURG PA 17257-9649 CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU potential tax due. Records indicate that Pat the de th of the abovetnamed de edent lyou weore~ a joint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a co and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. Pv to this form COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0024189387-S7 Date 10-15-1971 Established To ensure proper credit to the account, two copies of this. notice must accompany Account Balance $ 2, 874.29 payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 16.667 $ 4 7 9 . 0 6 NOTE: If tax payments are made within three TaX Rate X months of the decedent's date of death, Potential Tax Due .045 deduct a 5 percent discount on the tax due. 2 1 .5 6 Any Inheritance Tax due will become delinquent PART nine months after the date of death. 1~ TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A• ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C CHECK a discount or avoid interest, or check box "A" and return this notice to the Re 0 N E Wills and an official assessment will be issued by the PA Department of Revenue9ister of 0 N L YK B' ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C• ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indir~r;.... - ^ --- - --••=•=..c cax rate, please state 2 relationship to decedent: TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 +fi 5 - 6 7 X a $ OFFICIAL USE ONLY Q AAF PA DEPARTMENT OF REVENUE PAD 2 3 4 5 b 7 8 .0 DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) Unde penalties of ~ perjury, d are that the facts I have reported above are true, corre t and c lete to the be of y n ledge and belief. HOME (717 ~s3 z ~ ~zy AYER SIG TURE WORK ( ~ TELEPHONE NUMBER ^~ _P DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance Tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is t{hoseeheldnbetweenhhusbandeandswife) the decedent putain jointcnameslwithin one Year prior to 4. Accounts (including death are fully taxable. 5. Accounts heldbbysaedecedenty"inttrusthfor^nanotherlor othershare fullYataxable to death are not taxab e. 6. Accounts REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONS - If the information and computation in the notice are correct and deductions are not being claimed, Dlace an "X" 1. BLOCK A in Block A of Part 1 of Ills"ofxtheecountYOindicated1OnThe PAnDepartmentsofnRevenue willmissue ancofficial assessment o tax to the register of wi (Form REY-1548 EX) upon receipt of the return from the register of wills. ~,7axpayer Response" section. Sign one 2. BLOCK B - If the asset spstatees representative,hplaceean "XWlin BlockpBrofdPart laofpthe with the Pennsylvania Inheritance Tax Return filed by the e copy and return to the register of wills of the county indicated. 3. BLOCK C - If the notice informatio°W 15Signotwoccopiesoandesubmitnthemewithnvouracheck forcthelamountaof taxppaYablerto thenregister according to the instructions bel of wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receip of the return from the register of wills. _ TAX COMPUTATION TAX RETURN - PART 2 LINE NOTE: For a decedent who died after 12/12/82, accounts the decedent put in joint names within one near of death are 1. Enter the date the account originally wssansexclusion notttolexceedtS3,OOOnperetransferee,dre9aodlesstof the value of fully tau able. However, there i the account or the number of accounts held. the 53,000 exclusion wasadeductedafromlthe(accountebalanceoas reportedsbYnthe financialdinstitutionn of this notice, 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percentage of the account that is tau able to each survivor is determined as follows: A. The percentage taxable of joint assets established TOTAL NUMBER OF ear prioMULTIPLIED BY 100's dePERCENT TAXABLE 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY SURVIVING JOINT OWNERS JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other person = 16.7 percent (TAXABLE TO EACH SURVIVOR) 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 g, The percentage tax ablindividual(s)c(trust beneficiaries)e of the decedent's death or accounts owned by the decedent but held in trust for another PERCENT TAXABLE 1 DIVIDED BY OWNERSNORBTRUST BENEFICIARIESNT MULTIPLIED BY 100 Example: Joint account registered in the name of the decedent aEdFOR EACHeSURVIVOR) and established within one Year of death by the decedent. _ 5p percent (TAXABL 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 - 4. The amount subject {hetdebts1and4deductionsmlistedyinuPartl3ing the account balance (Line 2) by the Dercent taxable (Line 5. Enter the total of the debts and deductions (Line 5) from the amount subject to tax (Line 4). 6. The amount tau able (Line 6) is determined by subtracting 7. Enter the appropriate tax rate (Line 7) as determined below. Sibling Collateral Spouse Lineal Date of Death 15 percent 15 percent 3 percent 6 percent 07/01/94 to 12/31/94 6 percent 15 percent 15 percent 01/01/95 to 06/30/00 0 percent * 12 percent 15 percent p percent 4.5 percent 07/01/00 to present The tax rate imposed on the net value of transfers from a deceased child 21 Years of age or Younger a death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percen . children and other lineal descendents. "Children" includes natural children adopted children and step children. "Lineal descendents" includes all children of t e The lineal class of heirs includes grandpothers, parents, whether by blood natural Parents and their descendents, whether or not they have been adopted by others; adopted descendents and their descen an s; whether or not they have been adopted by 'Siblings" are defined as individuals who have at least one parent in common with the decedent, and step-descendants. ' or adoption. The Collateral class of heirs includes P1ARoTer 3eneficiaDEBT$ AND DEDUCTIONS CLAIMED CLAIMED DEDUCTIONS Allowable debts and deductions are determined as follows: a personal representative is insufficient p. You are legally responsible for payment, or the estate subject to administration by a er. Proof of to pay the deductible items. use 8 1/2" x 11" sheet of p P g. You actuallYClaimedhmustbbe itemizedefullYhinfPart 3ecelfnadditionalfspacehisrneeded,paymen . C. Debts being payment may be requested by the PA Department of evenue. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CO ALAHT ANY REGISTER OF WILL , E DISTRICT OFFTCE OR THE BUREA~ARINGNANDlORASPEAKING NEEDS PA DEPARTMENT OF REVS ~717~ Y87_g~27, SERVICES FOR TAXPAYERS WITH SPECI ONLY: I-800-447-302. PENNSYLVANIA INHERITANCE TI INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES Po sox zss6ol - --, AN D HARRISBURG PA I n zs-o6o1 ~'-_ - ~TAXPAY E R R E S P O N S E -,,, REV-1543 ~EI('A~P 2'Of!-'UD)" ~, .~ t ~ '..~.. FILE N0. 21 08-1083 ACN 08159025 DATE 12-02-~nnR MILDRED E STOUFFER PO BOX 1587 CLEBURNE TX 76033-1587 EST. OF MARY M WETZLER SSN 024-18-9387 DATE OF DEATH 09-07-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PSECU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a If you feel the 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 account is taxable in accordance with the Inheritance,TaxtlawseofbthefCommonwealthlofaccount. Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0024189387-S7 Date 10-15-1971 Established To ensure proper credit to the account, two Account Balance copies of this notice must accompany 2, $7Cf , 29 payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 16.667 $ 4 7 9 . 0 6 NOTE: If tax payments are made within three Tax Rate X months of the decedent's date of death, Potential Tax Due • 045 deduct a 5 percent discount on the tax due. 2 1 .5 6 Any Inheritance Tax due will become delinquent PART nine months after the date of death. 1Q TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT TN AN OFFICIAL TAX ASSESSMENT A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of 0 N E Nills and an official assessment will be issued by the PA Department of Revenue. 0 N Y 8' ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance lax return to be filed by the estate representative. C• ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3lJ below. PART If indicating ~ .,;s~,.___~ LJ relationship to decedent: ~dx rate, please state TA UX RETURN - COMPUTATION LI„~ 1. ..ate ~st~blished 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate B. Tax Due ,~~ OF TAX ON JOINT/TRUST ACCOUNTS IPAT1 i 2 3 X 4 +fi 5 - 6 +fi 7 X 8 $ .~ i 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE TOTAL (Enter on Line 5 of Tax Computation) Under penalties of ~ perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. '/ HOME ( / ~ (TS (~ /f~ TAX YER SIG ATURE WORK (~/~ I _ ~70~ ~ ~j TELEPHONE NUMBER DATE DATE PAID PAYEE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance Tax becomes delinquent nine months after the decedent's date of death. 3. A point account is taxable even when the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) the decedent ea~tP~i rototdeathsare not taxable prior to death are fully taxable. 5. Accounts established ~ointlY between husband and wife more than one Y 6. Accounts held by a decedent "in trust for" another or others are fully taxable. TAXPAYER RESPONSE REPORTING INSTRUCTIONS - PART 1 1. BLOCK A - If the information Tnd computation in the notice are correct and deductions are not being claimed, Place an "X " ax payer Response" section. Sign two copies and venue willmissue ancofficial assessment of in Block A of Part 1 of the tax to the register of wills of the county indicated. The PA Department of e (Form REV-1548 EX) upon receipt of the return from the register of wills. ..Taxpayer Response" section. Sign one 2. BLOCK B - If the asset sestatees representative,hplaceean rXwill be reported and tax paid with the Pennsylvania Inhere ante in Block B of Part 1 of the Tax Return filed by the copy and return to the register of wills of the county indicated. claimed, check Block C and complete Parts 2 and 3 3. BLOCK C - If the notice information is incorrect and/or deductions are being according to the instructions belowT Sign two copies and submit them with your check for the amount of tax payable to the regis er he PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of wills of the county indicated of the return from the register of wills. _ TAX COMPUTATION TAX RETURN - PART 2 at date of death. 1. Enter the date the account originally was established or titled in the manner existing LINE NOTE: For a decedent who died after 12/12/82, accounts the decedent put in point names within one Year of deat are 1 taxable. However. there is an exclusion not to exceed 53,000 per transferee, regardless of the value of ful v the account or the number of accounts hel . If a double afromlthelaccountebalanceoas reportedsbvnthe financialdinstitutionn of this notice, the 53,000 exclusion was deducted 2. Enter the total balance of the account including interest accrued to the date of death. 3. The Dercentage of the account that is taxable to each survivor is determined as follows: _ PERCENT TAXABLE A. The percentage taxable of joint assets established more than one year prioMULTIPLIED gy to 's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER O SURVIVING JOINT OWNERS JOINT OWNERS Example: A ioint asset registered in the name of the decedent and two other person . = 16.7 Percent (TAXABLE TO EACH SURVIVOR) 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 g, The percentage tax ablindividual(s)c(trust beneficiaries)r of the decedent's death or accounts owned by the decedent but held in trust for another = PERCENT TAXABLE 1 DIVIDED BY OWNERSNORBTRUST BENEFICIARIESNT MULTIPLIED BY 100 Example: Joint account registered in the name of the decedent aEdFOR EACHeSURVIVOR) and established within one Year of death by the decedent. _ 5g percent (TAXABL 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 - 4. The amount subject to tax (Line 4) is determined by multiplying the account balance (Line 2) by the percent taxable Cline 3 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 Cline 7) as determined below. Sibling Collateral Spouse Lineal Date of Death 15 percent 15 percent 3 percent 6 percent 07/01/94 to 12/31/94 15 percent 15 percent O percent 6 percent 01/01/95 to 06/30/00 * 12 percent 15 percent p percent 4.5 percent 07/01/00 to present ^The tax rate imposed on the net value of transfers from a deceased child 21 Years of age or Younger a death to or for the use of a natural Parent, an adoptive parent or a stepparent of the child is 0 percent. The lineal class of heirs incladesP grandparents, Parents, children and other lineal descendents. Children" includes natural chil ren do ted by others, adopted children and step childothersLladoptedsdescendentsnanddtheirldescendantsf the whether or not they have been whether or not they have been adopted by and step descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by bloo natural parents and their descendents, or adoption. The Collateral class of heirs includes P1ARoTer 3 neficiaDEBTS AND DEDUCTIONS CLAIMED CLAIMED DEDUCTIONS Allowable debts and deductions are determined as follows: a personal representative is insufficient A. You are legally responsible for payment, or the estate subject to administration by sheet of paper. Proof of to pay the deductible items. g. You actually Paid the debts after the death of the decedent and can furnish Proof of paymen . C. Debment may bearequested by themPAeDepartment ofrRevenuef additional space is needed, use 8 1/2" x 11" pay TAXPAYER ASSISTANCE IF YDU NEED FURTHER INFORMATION OR ASSISTANCE CONTACT ANY REGISTER OF WILL , E DISTRICT OFFICE OR THE BUREHEARINGNANDlDRASPEAICING NEEDS PA DEPARTMENT OF REVENU (717) 787-8327. SERVICES FDR TAXPAYERS WITH SPECIAL ONLY: 1-8~~-447-302. PENNSYLVANIA INHERITANCE T INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES Po BDx zaocol r;, ~ -., „ AND HARRISBURG PA 17126-ocol ~- ~ f~X~AYER RESPONSE ~~~ ~! f. REV-1543 EX AFp (p~-pg7~ FILE N0. 21 08-1083 ACN 08159026 DATE 12-02-~nnQ za~~ ~~~ ~ 7 ~~ i~: a ~ JAMES J WETZLER 161 KLINE RD SHIPP l~ CUB.' , - ~~'" ~ , ~~q ENSBURG PA 17257-9649 EST. OF MARY M WETZLER SSN 024-18-9387 DATE OF DEATH 09-07-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PSECU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, If you feel the information is incorrect, please obtain written correction from the financialainstitution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance,7axtlawseofbthefCommonwealthlofaccount. Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS account No. 9804921865-S7 Date 09-20-2001 Established To ensure proper credit to the account, two Account Balance copies of this notice must accompany $ 2, 996.43 payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 16.667 $ 4 9 9 . 4 1 NOTE: If tax payments are made within three TaX Rate X months of the decedent's date of death, Potential Tax DUe • 045 deduct a 5 percent discount on the tax due. $ 2 2 . 4 7 Any Inheritance Tax due will become delinquent PART nine months after the date of death. 1~ TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX AS5ES5MENT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. 0 N L Y B' ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C• ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LiWE I. Date 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 X 8. Tax Due $ $ PART 0 DATE PAID PAYEE Under penalties of .,e .., PAD 1 2 3 4 5 6 7 8 AIMED DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) !I declare that the facts I have reported above are true, correct and knowledge and belief. ___ ~,_ __ _ DEBTS AND DEDUCTIONS CL OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. 2. Inheritance Tax becomes delinquent nine months after the decedent's date of death. 3. A ]oint account is taxable even when the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) the decedent put in Joint names within one Year prior to death are fully taxable. 5. Accounts estabbisaedecedenty"inttrusthfobananotherlor othershare fullYataxable to death are not taxab e. 6. Accounts held Y REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONS 1. BLOCK A - If the information and a°e~uResponse" section1GeSign tworcopiesdanddsubmotsthem withbalcheckafordthe amount of" in Block A of Part 1 of the "Taxp v tax to the register of w~eceipt ofetheureturndfromethe registeDreofrwmlls.of Revenue will issue an official assessmen (Form REV-1548 EX) upon 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inhere ante 's representative, place an "X" in Block B of Part 1 of the "Taxpayer Response" section. Sign one Tax Return filed by the estate copy and return to the register of wills of the county indicated. - If the notice information issigcorrect and/or deductions are being claimed, check Block C and complete Parts 2 and 3. BLOCK C i n two copies and submit them with Your checalf assessmentu (Form REV -1548b EX)t upone receipter according to the instructions below. of wills of the county indicated. The PA Department of Revenue will issue an office of the return from the register of wills. _ TAX COMPUTATION TAX RETURN - PART 2 at date of death. are 1. Enter the date the account originally was established or titled in the manner existing LINE NOTE: For a decedent who died afterl2/12/82, accounts the decedent put in joint names within one year of dea there is an exclusion not to exceed 53,000 per transferee, regardless of the value of fully taxable. However, the 53,000 exclusion the account or the number of accounts held. wasadeductedafromlthe(accauntebalanceoas reportedsbynthe financialdinstitutionn of this notice, 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percentage of the account that is taxable to each survivor is determined as follows: _ PERCENT TAXABLE A. The percentage taxable of ioint assets established TOTAL NUMBER OF ear PrioMULTIPLIED gy to 's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY SURVIVING JOINT OWNERS JOINT OWNERS 16.7 percent (TAXABLE TO EACH SURVIVOR) Example: A 5oint asset registered in the name of the decedent and two other perso 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 g. The percentage taxable foVidualCs)c~trust benefic~aries)r of the decedent's death or accounts owned by the decedent but held in trust for another indi = PERCENT TAXABLE 1 DIVIDED BY ~1NERSNORBTRUST BENEFICIARIESNT MULTIPLIED BY 100 Example: Joint account registered in the name of the decedent andFOR EACHeSURVIVOR) and established within one year of death by the decedent. = 50 Percent (TAXABLE 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 4. The amount subject to et ax (Line 4) is determined by multiYheing the account balance (Line 2) by the percent taxable (Line debts and deductions listed in Part 3'debts and deductions (Line 5) from the amount subject to tax (Line 4). 5. Enter the total of th 6. The amount taxable (Line 6) is determined by subtracting 7. Enter the appropriate tax rate (Line 7) as determined below. Sibling Collateral Spouse Lineal Date of Death 15 percent 15 percent 3 percent 6 percent 07/01/94 to 12/31/94 15 percent 15 percent 0 percent 6 percent 01/01/95 to 06/30/00 * 12 percent 15 percent resent 0 percent 4.5 percent 07/01/00 to P xThe tax rate imposed on the net value of transfers from a deceased child 21 years of age or Younger a death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percen . children and other lineal descendents. "Children" includes natural children adopted children and step children. 'Lineal descendents" includes all children of e The lineal class of heirs includes grandPOthers, Parents, others; adopted descendents and their descendants; whether or not they have been adopted by whether or not they have been adopted by are defined as individuals who have at least one parent in common with the decedent, whether by o0 natural Darents and their descendents, and step descendants. "Siblings' or adoption. The co1CLAIMEDsDEDUCTIONSdes P1ARoTer 3eneficiaDEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You are legally responsible for payment, or the estate subject to administration by a personal representative is insufficien to pay the deductible items. B. You actually Paid the debts after the death of the decedent and can furnish proof of Pavmen . C. Debts being claimed must be themPAeDepartment ofrRevenuef additional space is needed, use 8 1/2" x 11" sheet of paper. Proo 0 payment may be requested Y TAXPAYER ASSISTANCE IF YOU NEED FURTHER INUORMATIDN OR ASSISTANCE, CDNLAHT ANY REGISTER OF WILL DISTRICT OFFICE OR THE BUREA~ARINGNAND/ORASPEAKING NEEDS PA DEPARTMENT OF REVEN (717) 787-8327. SERVICES FOR TAXPAYERS WITH SPECI ONLY: 1-800-447-~D20. ' BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND ` ~i ~ , ~;, _; ~ T~~N~R RESPONSE REY-1543 E% AFP (OB-BB)li .. tt T FILE N0. 21 08-1083 ACN 08159027 DATE 12-02-2008 ~~~9 ~~~' ~ ~~ (2. TYPE OF ACCOUNT O~ST. OF MARY M WETZLER ® savlNGs SSN 024-18-9387 ~ 1 ~~-K r, DATE OF DEATH 09-07-2008 ^ CHECKING GR^ ~ `J ~ r'n COUNTY ^ TRUST G`u ","- ~ Ur~l CUMBERLAND _. ' ;,i~' '''^ ^ CERTIF. (,'_,; ~Oli REMIT PAYMENT AND FORMS T0: MILDRED E STOUFFER PO BOX 1587 REGISTER OF WILLS CLEBURNE TX 76033-1587 CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, If you feel the information is incorrect, please obtain written correction from the financialainstitution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the InheritanceJTaxtlawseofbthefCommonwealthlofaccount. Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 9804921865-S7 Date 09-20-2001 Established To ensure proper credit to the account, two Account Balance copies of this notice must accompany $ 2, 996.43 Payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 16.667 $ 4 9 9 .4 1 NOTE: If tax payments are made within three Tax Rate X months of the decedent's date of death, Potential Tax Due • 045 deduct a 5 percent discount on the tax due. $ 2 2.4 7 Any Inheritance Tax due will become delinquent PART nine months after the date of death. 1^ TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A• The above information and tax due is correct. CHECK aediscounteor avoideinterest,~ or hle ks box h'A ~ and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK B 0 N L Y ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C• ^ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating ~ a; «___ 171 relationship to decedent: ~-~ ,ace' please state TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST A LINE 1. Datc Established I CCOUNTS I PAD 2. Account Balance 2 ~` 1 3. Percent Taxable 3 X 2 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 6. Amount Taxable 6 $ 5 7. Tax Rate ~ X 6 8. Tax Due $ $ 7 PAR 8 T DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjur ~ Y, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. ~2„s .o s . . -- - - - DEBTS AND DEDUCTIONS CLAIMED OFFICIAL U5E ONLY ^.AAF PA DEPARTMENT OF REVENUE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESUt TonIN AN OFFICIAL TAX ASSESSMENT wit thvvlicable interest based on information submitted by the financial institu 2. Inheritance Tax becomes delinquent nine months after the decedent's date of ea 3. A joint account is taxable even when the decedent's name was added as a matter of convenience. those held between husband and wife) the decedent put in joint names within one Year prior to 4. Accounts (including death are fully tau able. 5. Accounts established jointly between husband and wife more than one Year prior to death are not taxa e. decedent "in trust for" another or others are fully taxable. 6. Accounts held by a REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONS - If the information and computation in the notice are correct and deductuenwilleissuebannofficialdassessment „X, I, BLOCK A Response" section. Sign two copies and submit them with a check for the amount of in Block A of Part 1 of the "Taxpayer tax to the register of wills of the county indicated. The PA Department of even aid with the Pennsylvania Inheritance (Form REV-1548 EX) upon receipt of the return from the register of wills• .,T axPaYer Response" section. Sign one 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax p Tax Return filed by the estate's representative, place an "X" in Block B of Part 1 of the copy and return to the register of wills of the county indicated. check Block C and complete Parts 2 and 3 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, to the instructions below. SignOtPO copies and submit them with Your check for the amount of tax payable to the regas er according a artment of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of wills of the county indicated. The PA of the return from the register of wills. - PART 2 - TAX COMPUTATION TAX RETURN at date of death. LINE NOTE: For a deceblet wHowevetl~after 12/12/82, accounts the decedent put in joint names within one Year of death are 1. Enter the date the account orig1there issansexclusion notttolexceedt53,000nPeretransferee, regardless of the value of fully taxa the account or the number of accounts held. the 53,000 exclusion If a double asterisk (~~) appears before your first name in the address portion of this notice, was deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the ointuassetslestablishedemorecthandone Yeardpriorftoethe decedent's death: 3, The Percentage of the account that is taxable to each survivor is determined as follows: _ PERCENT TAXABLE p, The percentage taxable of ] TOTAL NUMBER OF MULTIPLIED BY 100 TOTAL NUMBER OF. DIVIDED BY 1 DIVIDED BY JOINT OWNERS SURVIVING JOINT OWNERS 16.7 percent (TAXABLE TO EACH SURVIVOR) Example: A joint asset registered in the name of the decedent and two other person . 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 g. The percentage tau able for assiCs)c~t~ust beneficiaries)r of the decedent's death or accounts owned by the decedent but held in trust for another individua MULTIPLIED BY 100 = PERCENT TAXABLE 1 DIVIDED BY OWNERSNORBTRUST BENEFICIARIESNT Example: Joint account registered in the name of the decedent and tR EACHeSURVIVOR) and established within one Year of death by the decedent. = 5g percent (TAXABLE FO 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 4. The amount subject to tax (Line 4) is determined by multiplying the account balance Cline 2) by the percent taxable (Line is and deductions listed in Part 3'debts and deductions (Line 5) from the amount subject to tax (Line 4). 5. Enter the total of the deb 7. Entermthe app opriateltax6rate CLinem7)easbdeterminedlbelowe Collateral Lineal Sibling Spouse Date of Death 15 percent 15 percent 3 percent 6 percent 07/01/94 to 12/31/94 15 percent 15 percent 0 percent 6 percent 01/01/95 to 06/30/00 * 12 percent 15 percent 0 percent 4.5 percent 07/01/00 to present The tax rate imposed on the net value of transfers from a deceased child 21 years of age or Younger a an adoptive parent or a stepparent of the child is 0 percent. children and other lineal descendents. "Children" includes natural chil ren death to or for the use of a natural parent, adopted children and step children. 'Lineal descendents" includes all children of e The lineal class of heirs includes grandpothers, parents, others; adopted descendents and their descendants; whether or not they have been adopted by whether or not then have been adopted by are defined as individuals who have at least one parent in common with the decedent, whether by o0 natural parents and their descendents, and step-descendants. "Siblings" or adoption. The Collateral class of heirs includes P1ARoTer 3eneficiaDE$TS AND DEDUCTIONS CLAIMED CLAIMED DEDUCTIONS Allowable debts and deductions are determined as follows: A. You are legally responsible for DaYment, or the estate subject to administration by a personal representative is insufficien to pay the deductible items. g. You actually Paid the debts after the death of the decedent and can furnish proof of paymen . claimed must be itemized fully in Part 3. If additional space is needed, use 8 1/2" x 11" sheet of paper. Proof o C. Debts being payment may be requested by the PA Department of even TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFDRMATIDN OR ASSISTANCE, CONTACT ANY REGISTER OF WIL DISTRICT OFFICE OR THE BUREH~ARINGNAND/ORASPEAKING NEEDS PA DEPARTMENT OF REVENUE 17) 787_8327, SERVICES FOR TAXPAYERS WITH SPECIA ONLY: 1-800-447-3~2~. PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 '' -' 1° ,+,,.r" AND HARRISBURG PA 171zB-o6B1 ~`~ ' -} T~~li{ryYER RESPONSE FILE N0. 21 08-1083 ~~r-~` ACN 08159028 REV-1543 EX pFP (Oef OB) A.-.-' + Y : ~',. -•~' DATE 12-02-2008 Z~~~ ~~~ f 7 f i'i i~~ Q7 TYPE OF ACCOUNT EST. OF MARY M WETZLER SSN 024-18-9387 ^ savINGs ~. ~~``~~~ r^ ® CHECKING ~~ , DATE OF DEATH 09-07-2008 OY~s~r .. ~`''~~ COUNTY ^ TRUST '~ " CUMBERLAND Cl„ :_ _ r., ~.` ^ CERTIF. JAMES REMIT PAYMENT AND FORMS T0: 161 KLINE RDWETZLER REGISTER OF WILLS SHIPPENSBURG PA 17257-9649 CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU potential tax due. Records indicate that at the death of the above-named decedent, provided the Department with the information below, which has been used in calculating the If you feel the information is incorrect, YOU were a point owner/beneficiary of this account. p ease obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT ruoTe,,..~__.._ A r_ennn* ~~_ Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART L_I CHECK ONE BLOCK ONLY ""w''`'~`+y13-54 Date Established 09-20-2001 $ 2,057.30 X 16.667 $ 342.89 X .045 $ 15.43 To ensure proper credit to the account, two copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent nine months after the date of death. FAILURE TD RESPOND WILL RESULT IN AN OFFICIAL TAX AS5E55MENT A• ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain Willscandtanrofficialnassessment willkbeoissu'edaby theuPA Department ofoRevenue. gister of B• ^ The above asset has been or will be reported and tax to be filed by the estate representative. paid with the Pennsylvania Inheritance Tax return C• ^ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a r1iFF.. ..__ 171 relationship to decedent: `~^ od`e' please state TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE i. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 )( 4. Amount Subject to Tax G $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate ~ X B. Tax Due B $ owo_ 0. DATE PAID PAYEE PAD 1 2 3 4 5 6 7 Q AIMED DESCRIPTION TOTAL (Enter on Line 5 of Tax Computation) DEBTS AND DEDUCTIDNS CL ieage antl belief. AMOUNT PAID --•--- awve are true, correct and HOME ( ~ Z ~~ W U K IC ( ~ -~-~ TELEPHONE NUMBER "'~=~ DATE OFFICIAL USE DNLY ^ qAF PA DEPARTMENT OF REVENUE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution 2. Inheritance Tax becomes delinquent nine months after the decedent's date of deat ear Prior to 3. A .joint account is taxable even when the decedent's name was added as a matter of convenience. those held between husband and wife) the decedent put in joint names within one Y 4. Accounts (including death are fully taxable. taxable. 5. Accounts establishedecedenty"inttrusthforananotherlor othershare fullyar prior to death are not taxa e• 6. Accounts held by a I - TAXPAYER RESPONSE REPORTING INSTRUCTIONS - PART claimed, place an "X" 1, BLOCK A - If the information and computation in the notice are correct and deductions are not being of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with a check for the amount of in Block A tax to the register of wills of ofetheureturndfromethe registeDreofrwills of Revenue will lwith the PennsYlvaniasInheritance (Form REV-1548 EX) upon receipt lace an "X" in Block B of Part 1 of the "Taxpayer Response" section. Sign one 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax Pal Tax Return filed by the estate's representative, P check Block C and complete Parts 2 and 3 copy and return to the register of wills of the county indicated. claimed, 3. BLOCK C - If the notice information is incorrect and/or deductions are being ding to the instructions below. Sign twor~mPies and submit them with your check for the amount of tax Payable to the regis er ent of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt actor of wills of the county indicated. The PA ePa of the return from the register of wills. - PART 2 - TAX COMPUTATION TAX RETURN at date of death. 1. Enter the date the account originally was established or titled in the manner exis in9 accounts the decedent put in er transfereethin one Year of death are LINE regardless of the value of there is an exclusion not to exceed $3,000 P NOTE: For a {axablet wHowevea~after 12/12/8 , fully the 53,000 exclusion the account or the number of accounts held. ortion of this notice, the financial institution. wasadeductedafromlthe(accountebalanceoas reportedsbyname in the ad ress 2. Enter the total balance of the account including interest accrued to the date of death. 3, The percentage of the account that is taxable to each survivor is determined as fol ow s: A• The percentage tau able of .]Dint assets established more than one Year priopULTIPLIED BY 10 s death: = PERCENT TAXABLE TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF 1 DIVIDED BY SURVIVING JOINT OWNERS JOINT OWNERS 16.7 Percent (TAXABLE TO EACH SURVIVOR) Example: A joint asset registered in the name of the decedent and 100 other Person 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BV 2 (SURVIVORS) _ .167 X e percentage taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held B. Th in trust for another individual(s) (trust beneficMULTIPLIEO BY 100 = PERCENT TAXABLE 1 DIVIDED BY ~1NERSNORBTRUST BENEFICIARIESNT e: Joint account registered in the name of the decedent and two other persons and established within one Year of death by Exampl the decedent. 100 = 50 percent (TAXABLE FOR EACH SURVIVOR 1 DIVIDED BY 2 CSURVIYORS) _ .50 X The amount subject to tax (Lined4) is determined by multiplying the account balance (Line 2) by the percent taxable (Line deductions listed in Part 3. s and deductions (Line 5) from the amount subject to tax (Line 4). 4• the deb 5• Enter the total of the debts an 6. The amount taxable (Line 6) is determined by subtracting Collateral 7, Enter the appropriate tax rate (Line 7) as determined below. Lineal Sibling SPOUSe 15 Percent Date of Death 15 percent 3 percent 6 percent 07/01/94 to 12/31/94 15 Percent 15 percent (, percent 01/01/95 to 06/30/00 0 percent * 12 percent 15 Percent p percent 4.5 percent ounger at 07/01/00 to present rate imposed on the net value of transfers from a deceased child 21 Years of age o xThe tax arent, an adoptive parent or a stepparent of the child is 0 percent. death to or for the use of a natural P al class of heirs includes grandparents, Parents, children and other lineal descendents. "Children" includes natural chil ren adopted children and step children. 'Lineal descendents" includes all children of t e The line others, others; adopted descendents and their descendants; whether or not they have been adopted by whether or not they have been adopted by are defined as individuals who have at least one parent in common with the decedent, whether by o0 natural Parents and their descendents, and step descendants. "Siblings" - PART 3 - DEBTS AND DEDUCTIONS CLAIMED or adoption. The Collateral clas DEDUCTIpN$des all other beneficiaries. CLAIMED Allowable debts and deductions are determined as follows: or the estate subject to administration by a personal representative is insufficient A. You are legally responsible for Payment, use B 1/2" x 11" sheet of paper. Proof of to pay the deductible items. g• You actually Paid the debts after the death of the decedent and can furnish proof of pay me claimed must be itemized fully in Part 3. If additional space is needed, C. Debts being the PA Department of Revenue. payment may be requested by TAXPAYER ASSISTANCE F YOU NEED FURTHER INFQRMASTRN OR ASSISTANCE, CONTACTAANY REGISTER OF WILL , ICT OFFICE OR THE BUREAU ~~NGNAND/ORASPEAKING NEEDS I PA DEPARTMENT OF REVENUE DI 0717) 787-8327. SERVICES FQR TAXPAYERS WITH SPECIAL ONLY: 1-800-447-3020•