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HomeMy WebLinkAbout02-08-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: RICKERT ROBERT 2 JR 16511 WALNUT RAIL ROAD CHESTERFIELD, MO 63005 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: sSN: 2o~-is-4613 FILE NUMBER: 2110-0121 DECEDENT NAME: RICKERT E B DATE OF PAYMENT: 02/08/2010 POSTMARK DATE: 02/05/2010 couNTY: CUMBERLAND DATE OF DEATH: 08/04/2009 AMOUNT 09154841 ~ 5157.69 09154839 ~ 5101.09 09154833 ~ 599.38 09154835 ~ 5217.50 09154827 ~ 5186.08 09154829 ~ 517.84 09154831 ~ 576.29 09154837 ~ 5167.48 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 7791 INITIALS: CJ RECEIVED BY: 51,023.35 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX(11-961 NO. CD 012331 TAXPAYER " :. `O r r 0 0 `Y, O ._. ?4 *~q r 'y:' ~ ~i ru ~, r ~' ..; r ~.~ ~ W -~] k~ .~ ~F .t e ~~~ ~~ ~' 3 ',l ~~ ~ y ;:,~ jJi n~,d~ m ,~~-, ~ ~ ~>9~ r C7 ~ . o~m °~~~ ~Wx V~H r ~- °; ~~, a ~:~ h i ., ,•~ ~;. ;`,`.; jrv -~ ly ~' A N , m ~ i o a at~ ~~A' ~ ~; ~ ~,, 4' -. N ~i v ~ ~~ ~~~ ~~~ Y g~ w 9 _ _-A:---_Rr PENNSYLVANIA INHERITANCE TAX ' INFORMATION NOTICE AND FILE N0. 21 -~~" ~~~~ BUREAU OF INDIVIDUAL TAXES ('~ ""~ PO BDX 280601 j ~.~ i ~~ 1 AXPAYER RESPONSE ACN 09154841 HARRISBURG PA 17128-0601 ~ r-~•, ~ t+,`;1 ~ ~ DATE 08-28-2009 Y ~'i.~v xtv- ZQ~~ FE8 -$ ~M 2• t~5 Q Gl_ER~K Cr !'}T of IY ~N}'93 ~1 Li t1 W't.l~l Cl~' r~-~~~,~.~1D C`~., ra. t ,,J~.i ROBERT W RICKERT JR 16511 WALNUT RAIL RD CHESTERFIELD MO 63005 EST. OF E B RICKERT SSN 201-18-4613 DATE OF DEATH 08-04-2009 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 point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this farm and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsvlvania. Please call :717) 787-8327 with questions. rn~DiGrG PAQT 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0201184613-C65 Date 11-28-2007 To ensure proper credit to the account, two Established copies of this notice must accomparo payment to the Register of Wills. Make check Account Balance $ 21 , 025 • 17 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 3,504.27 months of the decedent's date of death, 045 deduct a 5 percent discount on the tax due. Tax Rate X • Anv Inheritance Tax due will become delinquent Potential Tax Due $ 157.69 nine months after the date of death. TAXPAYER RESPONSE PART 0 A The above information and tax due is correct. . Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assessment will be issued by the PA Department of Revenue. ONE C BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsv lvania Inheritance Tax return 0 N L Y 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. If indicating a different tax rate, Please state '~.~ PART relationship to decedent: ~ D ~,, ".~ ,,, 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 $ 5 6 '~ 7 X 8 $ PART ... ~~ n~~rn DAVFG DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID YuinY. •cn wr Under penalties f p®`jury, I declare that the facts I have reported a'b"ove are true, correc~nd c th be t ~f my knowledge and belief. HOME ~~Q) ~.3~, ~ .. ~ WORK C ) ~ IIe PENNSYLVANIA INHERITANCE TAX _INFORMATION NOTICE t~' ~' ~~^'~`(~ (~y~. AND FILE N0. 21 ~('"17~02~ BUREAU OF INDIVIDUAL TAXES ' ~'-' ~-' t-,'~ + '~>~. Vi 1 PD Box 2aB6g1 '"" "~ ' ~'+£+,A~(pAYER RESPONSE ACN 09154839 HARRISBURG PA 17128-0601 ~ .~ ! ~ , ~I _:,,,~ DATE 08-28-2009 REV-1543 IX AFP (OB-08) -$ P~ 2= (~~ TYPE OF ACCOUNT EST. OF E B RICKERT ^ SAVINGS CLE~1\ ~~ $$N 201-18-4613 ^ CHECKING d~~i~a~`v'~ v`~~~~t DATE OF DEATH 08-04-2009 ^ TRUST ffly.~~f t "~r'~~`'C~.j~.~!~ ~~~?„ DA COUNTY CUMBERLAND Q CERTIF. REMIT PAYMENT AND FORMS T0: ROBERT W RICKERT JR REGISTER OF WILLS 16511 WALNUT RAIL RD CUMBERLAND CO COURT HOUSE CHESTERFIELD MO 63005 CARLISLE, PA 17013 PSECU 0rovided the Department with the information below, which has been used in calculating the votential tax due. Records indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If you feel the infonation is incorrect, please obtain written correction from the financial institution, attach a copy to this fon 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 INSTRUCTIONS Account No. 0201184613-C64 Date 01-28-2008 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 13,479.06 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 2,246.55 months of the decedent's date of death, Tax Rate X .045 deduct a 5 vercent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 101 .09 nine months after the date of death. PART TAXPAYER RESPONSE ~c ~n _ A. (The above information and tax due is correct. ~L~.. Remit pavmant to the Resister of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE BLOCK B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y 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 different tax rate, please state 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 5 6 $ 7 X 8 $ ~ ,~~ ~~ +•~.w ~` ....~. 3 ~» Ct w PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury I declare that the facts I have reported above are true, correct and complet o es y n ledge and belief. HOME C ) WORK C ) ______..__ ~-~..-~....~ TCI [:DLi rI AIC Al11MACQ P TG TOTAL CEnLer on Line ~ or lax (.ompuiazioni v PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE t ~ ~r ; J j BUREAU OF INDIVIDUAL TAXES ~ ~"~, r;~. !''~ AND FILE ND. 21 -"/ ~D/ 2i Po Box zao6ol ~. ~z35~ ; ~ TAXPAYER RESPONSE ACN 09154833 HARRISBURG PA 17128-0601 ^. i j ~,;~ , `~~.~• DATE 08-28-2009 REV-1543 IX AFP coe-oeo ~~~~ ~~~ _a ~~ ~: ~~j TYPE OF ACCOUNT EST. OF E B RICKERT ^ SAVING C~~~~~Q~ SSN 201-18-4613 ^CHECK d~i~~rv~~v CwURj DATE OF DEATH 08-04-2009 ^ TRUST V~~~:~;~tt~ :~;~(~ ~.~ ~~, COUNTY CUMBERLAND ~ CERTI REMIT PAYMENT AND FORMS T0: ROBERT W RICKERT JR REGISTER OF WILLS 16511 WALNUT RAIL RD CUMBERLAND CO COURT HOUSE CHESTERFIELD MO 63005 CARLISLE, PA 17013 PSECU provided the Department with the information below, which has been used in calculating the potential tax dua. Records indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this fon 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 0717) 787-8327 with questions. S ING F. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0201184613-052 Date 11-07-2007 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 13,250.21 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are ^ade within three Amount Subject to TaX $ 2, 208.41 months of the decedent's date of death, Tax Rate ~( .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential TeX Due $ 99 • 38 nine months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y 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 a different tax rate, please state g ~ ~ ~~ ~ +kg „~ .. ~ relationship to decedent: ~~ ~~ ~«~ _ ,,,~, .C}F F r TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~ f .EAU 54 ~.; ~a ~ R O,S LINE 1. Date Established 1 `~. ' 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 ~ ,~iyi 4 ~ ~. ,~. 5. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 X ..,*s. , ,', ~ >h 8. Tax Due 8 ~ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties rjury, I declare that the facts I have reported above are true, correct and comple to est f nowledge and belief. HOME C ) WORK C ) ~.vr..v~n n ,+u~rnnr TCI CDLJ rIWC IJIIY4CD TAT TOTAL (Enter on Line 5 of Tax Computation) 6 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE j BUREAU DF INDIVIDUAL TAXES ,n r ~ j~4 ~• r AND FILE ND. 21 ~IO~Q~c2/ Po BDX 280601 ,_ •~' ~ j'~`~~/~YER RESPONSE ACN 09154835 W-RRISBURG PA 17128-0601 '-t4 ~ c .z..,,~"} `-.'~ ~'`•-"' DATE 08-28-2009 REV-1543 IX AFP TYPE OF ACCOUNT 20th FEB -S PM ~~ 46 EST. OF E B RICKERT ^ SAVINGS S$N 201-18-4613 ^ CHECKING ~~-~~~~~ DATE OF DEATH 08-04-2009 ^ TRUST ~P~'~j~~J$~~}~}RT COUNTY CUMBERLAND X^ CERTIF. Cju~Y~C.'-~~.~~';~ ~''~" ~~REMIT PAYMENT AND FORMS T0: ROBERT W RICKERT JR 16511 WALNUT RAIL RD CHESTERFIELD MO 63005 REGISTER OF WILLS 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, you were a Saint a+ner/beneficiary of this account. 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 Tax laws of the Commonwealth of Pennrilvahia. Please call 0717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0201184613-057 Date 07-27-2007 To ensure proper credit to the account, two Established copies of this notice must accompargi payment to the Register of Wills. Make check Account Balance $ 28, 998 • 82 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 4,833.23 months of the decedent's date of death, X , OCIj deduct a 5 percent discount on the tax due. Tax Rate Anv Inheritance Tax due will become delinquent Potential Tax Due $ 217 • 50 nine months after the date of death. PART TAXPAYER RESPONSE ^ ~~c' s: ' CHECK ONE [ BLOCK ONLY above information and tax due is correct. Resit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. ^ The above asset has been or will be reported and tax paid with the Pennrilvania 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 3LJ below. PART If indicating a different tax rate, please state -~~~ `": relationship to decedent: TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS _ .v .> wFi 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 - 6. Amount Taxable 6 ~ 7. Tax Rate 7 X ~ 8. Tax Due $ $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ nerF Porn PAYEE DESCRIPTION AMOUNT PAID Under penalti of pe ury, declare that the facts I have reported above are true, correct and complete to he be f owledge and belief. HOME C ) WORK ( ) (~ ____ ___.._ ....~ TCI FP41f1NG NIIMAFR AT IYIAL Tenzer vn ~anv ~ ~~~r..~----••~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE A ND FILE //~~ N0. 21 ~~'Vf2'~ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 ~` .,~,, ., ~"'`';~` ~- ~~,~ RESPONSE ACN 09154827 HARRISBURG PA 17128-0601 . ` ~'~ ~`' ~ " t ~ DATE 08-28-2009 REV-1543 EX AFP C00-00) ~ i i„t r i. t.. _. i"•-~!+.r `~ TYPE OF ACCOUNT ~~~~ ~~~ -$ ~~ 2~ E~. OF E B RICKERT ® SAVINGS SSN 201-18-4613 ^ cNECKING ~~ DATE OF DEATH 08-04-2009 ~~ Ci~ ~ ^ TRUST ( t ~}{ ~ ` \Jr1PNf'~v`S LQV~1~ COUNTY CUMBERLAND ^ CERTIF. ~~~,t{~j~-~~iR3y'!k~ ~,!~~,,r , P~EMIT PAYMENT AND FORMS T0: ROBERT W RICKERT JR REGISTER OF WILLS 16511 WALNUT RAIL RD CUMBERLAND CO COURT HOUSE CHESTERFIELD MO 63005 CARLISLE, PA 17013 PSECU provided the Department with the infermation 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 ioint owner/beneficiary of this account. 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 Tax laws of the Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0201184613-S1 Date 02-15-1977 To ensure proper credit to the account, two Established copies of this notice ^ust accompany payment to the Register of Wills. Make check Account Balance $ 24 810 • 38 , payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 4, 135.15 months of the decedent's date of death, Tax Rate ~( .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due ~` 186.08 nine months after the date of death. PART TAXPAYER RESPONSE 0 c r t~rer~~~rn ~c ~er~ r ~ ~, CHECK C ONE BLOCK ONLY The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. ^ The above asset has been or will be revorted and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C. ^ The above inforna ion is incorrect and/or debts and deductions were paid. Complete PART ~Z and/or PART ~ below. PART If indicating a different tax rate, please state f ^ 2 relationship to decedent: ~{ , ° ° ESA ~ b ~~ ~~ ~ TAX RE TURN - COMPUTATION OF °9~@~„ ~ ~i ? a ,~{ TAX ON JOINT/TRUST ACCOUNTS „„~, ~ ~ LINE 1. Date Established 1 ~~~~~ ~''~~"~~t~'tr ~tti'9~ ;{~ ~°';' ~~vs 2. Account Balance 2 $ ~'~'~ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - '~' 6. Amount Taxable 6 $ "''J'' 7. Tax Rate 7 X ~' '~ 8. Tax Due 8 $ ; PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE P AID PAYEE DESCRIPTION AMOUNT PAID Under penalties of per . I eclare that the facts I have reported above are true, correct and complete lo~TiA'-ba,~t o my edge and belief. HnMF C 1 WORK C ) Tri cuunuE: uii TOTAL CEnter on Line 5 of Tax Computation) 8 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES '~ ri ~'-t~ ~~ `' AND FILE N0. 21 -~(~' ~~~' PO BOX 280601 ` ~ r~ ` `~~~~(~p ~ HARRISBURG PA 17128-0601 ~ fit. YER RESPONSE ACN 09154829 ~~ `~ L~ ~-`'~ ~'~-' DATE 08-28-2009 REV-1543 IX I1FP (OB-OB) ~~~~ ~~$ _8 ~y~ 2; ~6 TYPE OF ACCOUNT EST. OF E B RICKERT ^ SAVINGS CLFRK ~~ SSN 201-18-4613 ® CHECKING ~R~~'~ C4URT DATE OF DEATH 08-04-2009 ^ TRUST ~~ ~p ~ r+ COUNTY CUMBERLAND ^ CERTIF. ~~~'~ ,3 ,~ ~~` t,~~.' `~ REMIT PAYMENT AND FORMS T0: ROBERT W RICKERT JR REGISTER OF WILLS 16511 WALNUT RAIL RD CUMBERLAND CO COURT HOUSE CHESTERFIELD MO 63005 CARLISLE, PA 17013 PSECU provided the Depart^ent 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 point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this fon 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 C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0201184613-S4 Date 02-15-1977 To ensure proper credit to the account, two Established copies of this notice must accompamr payment to the Register of Wills. Make check Account Balance $ 2, 378.76 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject t0 TaX $ 396.47 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 17.84 nine months after the date of death. PART TAXPAYER RESPONSE 0 ~..~, .~ „ ~: „ FF A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ONE B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y 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 ~- ~-.a,%µ' z° `' relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS „~~' LINE 1. Date Established 1 .°"~ ' ';4`.' 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 8 - PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under pens perjury, declare that the facts I have reported above are true, correct and complete o the bes of k wledge and belief. HOME C ) WORK C ) ~ \6 r....,...~., .. r.. .r,,,,~ rr: rounur unuaro n Tr TOTAL (Enter on Line 5 of Tax Computation) # BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REV-1543 IX AFP (00-00) PENNSYLVANIA INHERITANCE T INFORMATION NOTICE i~ R RESPONSE FILE N0. 21'-~~'D,~~ ACN 09154831 DATE 08-28-2009 2p10 FE8 -8 PM 2~ 46 EST. OF E B RICKERT ~,~E~t'~ ~~ SSN 201-18-4613 Q~pH~~ CQURT DATE OF DEATH 08-04-2009 ~y ( d ~k~ ~OUNTY CUMBERLAND /y ~~d~r~s k•1VCJ ~~•• ~ EMIT PAYMENT AND FORMS T0: ROBERT W RICKERT JR l~Ud~ REGISTER OF WILLS 16511 WALNUT RAIL RD CUMBERLAND CO COURT HOUSE CHESTERFIELD MO 63005 CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. PSECU vrovided the Devartsent with the inforsation below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-nased decedent, you ware a ioint owner/beneficiary of this account. If you feel the inforsation is incorrect, please obtain written correction fros the financial institution, attach a copy to this tors and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cossonwealth of Pennsylvania. Please call 0717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Aecount No. 0201184613-051 Date 11-28-2003 To ensure proper credit to the account, two Established copies of this notice sust accospany paysent to the Register of Wills. Make check Account Balanee $ 10, 171 • 34 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax paysents are sade within three Amount Subject t0 Tax $ 1,695.26 sonths of the decedent's date of death, Tax Rate ~( , 0!}rj deduct a 5 percent discount on the tax due. Any Inheritance Tax due will becose delinquent Potential Tax Due $ 76 • 29 nine sonths after the date of death. PART TAXPAYER RESPONSE 0 ` ~ A. ~/ The above inforsation and tax due is correct. ~ Resit paysent to the Register of Wills with two copies of this notice to obtain Tr \ a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assesssent will be issued by the PA Departsent of Revenue. ONE C BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above inforsa ion is incorrect and/or debts and deductions were paid. Cosplete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION LINE 1. Date Established 2. Aecount Balanee 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 $ 5 6 $ 7 X 8 $ PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Ls ne s or iax (,ompucacaon, r Under penalties o rju y, I declare that the facts I have reported above are true, correct and complete the est o knowledge and belief. HOME C ) WORK ( ) __________ ___..__..__ Tom) E:cunuc WIIM AL:D e PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE n~,Cti~.~ ^~r,, FILE N0. 21~~b~~~o2~ BUREAU OF INDIVIDUAL TAXES ~ '~-"' / ! ~ ACN 09154837 PD BOX 288681 T/P.~t~R~`~SE HARRISBURG PA 17128-0 601 ~-~~~' L~`~ ',~, `, rak ! ) DATE 08-28-2009 REV-1543 EX IIFP (OB-097 'OiQ FEB -8 PM 2~ 46 EST. OF E B RICKERT 201-18-4613 ~~P~~N- DEATH 08-04-2009 p~ CUMBERLAND R~M~Y` PAh(i~ENT AND FORMS T0: ROBERT W RICKERT JR REGISTER OF WILLS 16511 WALNUT RAIL RD CUMBERLAND CO COURT HOUSE CHESTERFIELD MO 63005 CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. PSECU provided the Departrent with the inforration below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-oared decedent, you were a ioint owner/beneficiary of this account. If you feel the inforration is incorrect, please obtain written correction fror the financial institution, attach a copy to this forr and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Corronwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0201184613-C59 Date 07-25-2008 To ensure proper credit to the account, two Established copies of this notice rust accorvary payrent to the Register of Wills. Make check Account Balance $ 22, 330 .41 payable to "Register of Wi11s, Agent". Percent Taxable X 16.667 NOTE: If tax payrents are rade within three Amount Subieet to Tax $ 3,721.81 ronths of the decedent's date of death, . 0 4 5 deduct a 5 percent discount on the tax due. Tax Rate X Any Inheritance Tax due will becore delinquent Potential Tax Due $ 167.48 nine ronths after the date of death. PART TAXPAYER RESPONSE O ~~ ~ ~ . ~. The above inforration and tax due is correct. p. f i this notice to obtain ~ es o Rerit payrent to the Register of Wills with two cop ck box "A" and return h this notice to the Register of e a discount or avoid interest, or c t will be issued by the PA Departrent of Revenue. CHECK Wills and an official assessren C ONE B L 0 C K B ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y . to be filed by the estate representative. C. ~ The above inforra ion is incorrect and/or debts and deductions were paid. Corpleta PART ~2 and/or PART ~ below. If indicating a different tax rate, please state '{} PART relationship to decedent: ~~~~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Sub3ect 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 $ 5 6 7 X 8 ~ PART a DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) 0 Under pen ties of rj y, I declare that the facts I have reported above are true, correct and comple to the st o Y knowledge and belief. HOME C ~ WORK C ~ __ TFiEPHONE NUMBER A E N M M M M . rvt 'r ;;'~ ~`«:. ~.. ».., w r--. _~. ,'~.. - . -. ~ ,; ,~ ` j `; ,.~.,. .~` _ ~,._ - ,.. -,~:, ,,.,~ :. '"