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HomeMy WebLinkAbout04-05-10 (2)PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE NO. 21 -~U'c3~{~ HARRI~SBURG6PA 171-a6.Q ~~~` ~' ~= , TAXPAYER RESPONSE ACN 10116356 - '~~~+ DATE D3-17-2010 i t 'REV'1546 tstivr coe-ae, 2010 APR -5 PM 1 ~ 5~ CLERK C`F ORPNA~1'S COUNT ('t l ,..~~~,~ ' h .,, p,:,. ~ ,~ i , P~. ZELDA ~GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 E5T. OF VIOLA M HARDING S5N 579-20-9770 DATE OF DEATH o3-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Department with the inforwation below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-named decadent, You ware a ioint 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 forty 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 C71T) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-00 Date 10-29-1986 To ensure proper credit to the account, two Established copies of this notice oust accompany Account Balance 3 447 94 payment to the Register of Wiils. Make check " " . ~ payable to Register of Wills, Agent . Percent Taxable X 8.333 NOTES If tax payments are made within three Amount Subject to Tax ~ 2$7.32 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 $ 12.93 nine months after the date of death. P T TAXPAYER RESPONSE a ~ ~ A. ~ The above inforwation and tax due is correct. Rewit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid i nterest, 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 Revenua. C BLOCK B. ~e above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return J 0 NL Y t 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 ~ h ~. z ~ relationship to decedent: z': ~ ~r ';~ ~ ~ ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS I}'~'~ ~°g~ ~' ~'r ~' LINE 1. Date Established 1 ~^ - ~ ~ ~'"~~ ~' f`~4~ ~}~w~q $ ~ »~ ~ ~~:, ~ 2. Account Balance 2 $ '~ x ~,~ X .. ~ ~ « , 3. Percent Taxable 3 ~ 'x rww~wwh YS~wrr :' x 7~ 4. Amount Subject to Tax 4 ~ ~ ~ e4 '~y1 ras ~,~ .~~` 5. Debts and Deductions 5 - ~ ` ` 6. Amount Taxable 6 ~ ,~~ ""'' ~ ~ 7. Tax Rate 7 X ef, 8. Tax Due 8 $ ~_ "~ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK C ) ~ji¢ . ~~c'j0 I ~/O TOTAL CEnter on Line 5 of Tax Computation) # Under penalties of perjury, I declare that the facts I have reported a//byyove are~,rtrue, correct and complete to the~best of mY knowledge and belief. HOME C I/ / J "/ ~~~ _~1 vZ~ BUREAU OF INDIVIDUAL TAXES PD SOX r2#86Q3;. r~,~-r~r ~ i~~- NAltftiseuR~_Rg_' 1.;izd~a~ot;~ _ , ,~ .. _ ~;;_:, ~ „ L~~~ ~~~ _~ ~~ ~ ~ ~~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE REV-1543 IX AFP C08-OB) CLEr~'.{ Ur ~~~N;r'~~~U ~rl~~~ t~ err ~ F~~~ DOR~IS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 FILE N0. 21 -(~~t3~-(.9 ACN 10116357 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FDRMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departeent with the inforeation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-eased decedent, you were a joint owner/beneficiary of this account. If you feel the inforeation is incorrect, please obtain written correction froe the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coeeonwealth of Pennsylvania. Please call (T17) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-00 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 10-29-1986 Established $ 3,447.94 X 8.333 $ 287.32 X .045 $ 12.93 To ensure proper credit to the account, two copies of this notice oust accoepany payeent to the Register of Wills. Make check payable to "Register of Wills, Agent•'. NOTE: If tax payeents are Bade within three eonths of the decedent's date of death, deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent nine eonths after the date of death. PART TAXPAYER RESPONSE ~. A. ~ The above inforeatien and tax due is correct. Resit payeent to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check bax "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Departeent of Revenue. C ONE BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O N L Y to be filed by the estate representative. C. ~ The above irtforea ion is incorrect and/or debts and deductions were paid. Coeplete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state 4 ~ a relationship to decedent: '~ ~ ` ~' ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PIi~ ~ ' ag '~€" '~ '••~ `~`"° r ~ LINE 1. Date Established 1 , ~ ~,~ ~~»~w' $ ,. ,.,. `' 's' '+kr~~ ~~~~` ~ ~°' ~ ;~~ 2. Account Balance 2 ' , " awyww .~rwww~w ~ 3. Percent Taxable 3 X w '.€ ~ _ 3~ .~ ,wkw..wr 4. Amount Subject to Tax 4 $ ca C{ ..«,Y.~.~F~~' ~>`,}d~~iq `~' ~ ''t ~~ 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 penalties of perjury, I declare that the facts I have reported above are true, correct and omplete t the best of my knowledge and belief. HOME C ) ~ - ~ !~ WORK C ) ~ J TA AVER SIGNATUR TELEPHONE NUMBER AT TDTAL CEnter on Line 5 of Tax Computation) BUREAU OF INDIVIDUAL TAXES _ PO 80X 280681 ``( '~'A`° '~i. HARRISBURG PA 171~~`g'd8~ ~• r''~ _._ ; - - t~1~ii r -- _, ,. f':Lt:i~ : L" ~ '~rREyn~ss ez~i~n coe-ae: 2010 APR -5 PN I ~ 5b C~E~K ~r OftPHAN'S~~ nk~~ p JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 "~U- `~~ -+ ACN 10116358 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 decadent, you were a ioint 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 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 INSTRUCTIONS Account No. 67691-00 Data 10-29-1986 To ensure proper credit to the account, two Established copies of this notice must accompargf payment to the Register of Wills. Make check Account Balance 3, 447.94 payable to "Resister of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are ^ade within three Amount Subject to Tax $ 287.32 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 $ 12.93 nine months after the date of death. PART TAXPAYER RESPONSE o ~. A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two co pies 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. 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due 3 X 4 5 - 6 7 X 8 ~ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are~t+ruce,' correct and complete to the be~ of my knowledge and belief. HOME CSZO) `~ ~ T ~ ~J~~ ~~ ~:~WZ4 WORK ( ) ~ . sV. SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) # BUREAU OF INDIVIDUAL T~~ ._ _ PO BOX 280601 ~~ ~ j~ • Ek-{ HARRISBURG PA 17128-g6A~, `' ~ ,~.:Iv 1 it ieEr<isa! or~r.coe-ee~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -l(S'c3N4 ACN 10116359 DATE 03-17-2010 ZOIQ APR -5 PM I : 5~ ORP~~AP1'~ OURT ZELDA GODFREY 227 MOUNTAIN ROAD ' NEWVILLE PA 17241 EST. OF VIOLA M HARDING S5N 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-mowed decedent, you were a point owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwoalth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-11 Date 03-29-2004 To ensure proper credit to the account, two Established copies of this notice roust accowpany payment to the Register of Wills. Make check Account Balance 15, 747.97 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paywents are •ade within three Amount Subject to Tax ~ 1 , 312.28 wonths of the decedent's date of death, Tax Rate ~( , 0 4 5 deduct a 5 percent discount on the tax due. Any Inheritance Tax duo will becowe delinquent Potential Tax Due $ 59.05 nine wonths after the date of death. RT P TAXPAYER RESPONSE A 1 ~ ,.. s A. ~ Tha above inforwation and tax due is correct. Rewit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid i nterest, or check box "A" and return this notice to the Register of CHECK Wills and an official assesswent will be issued by the PA Departwent of Revenue. ONE BLOCK C 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. ~ Tha above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART ~2 and/or PART 3~ 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 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury. I declare that the facts I have reported anbove are ~tlrue,//correct and complete to the best Hof my knowledge and belief. HOME ( / ~~ ) ! ~ (D "'rJ ~ o~--~ WORK C ) TOTAL CEnter on Line 5 of Tax Computation) C BUREAU DF INDIVIDUAL TAXES PO BOX 288601 HARRISBURG P/1" IFIr'~r'~IS~1 !~,~ Vin- .~~ - . ` , t`1' ~ - r,-REVq 1563 IX AFP (OB-09) ZOPO APR -5 PM i ~ 57 CLERi~ CAF ORP~tRhv ~ C;~U~T 107 NORMAN DRIVE BOHEMIA NY 11716 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 infonation 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. 67691^11 Date 03-29-2004 To ensure proper credit to the account, two Established copies of this notice must accorpany Account Balance 747 97 15 payment to the Register of Wills. Make check " " . , payable to Register of Wills, Agent . Percent Taxable X 8.333 NOTE: If tax payments are ^ada within three Amount Subject to Tax ~ 1 ~ 312.28 months of the decedent's data of death, Tax Rate ~( , Of~rj deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due ~ 59.05 nine months after the date of death. P T TAXPAYER RESPONSE ~ 1 A. ~ The above information and tax due 3s correct. Rewit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check bax "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. The above asset has bean 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 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 1 2 s X 4 5 6 7 X 8 PaRT DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are trcu~e, correct and complete to a best of my knowledge and belief. HOME C ') O c WORK ( ) 3 ~ ~ J -)(PAYER SIGNATUR TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 "~~~~~9 ACN 10116360 DATE 03-17-2010 TOTAL CEnter on Line 5 of Tax Computation) i BUREAU OF INDIVIDUAIt``:~AafP~.~:^,r+-.-_ ~., PO BOX 280b01 - _ _ _ ;, ~ HARRISBURG PA 17128-A'803~ ~- ~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -tt~'~'~~l ACN 10116361 DATE 03-17-2010 2~iQ APR -5 PN I= 5 C[~Er~K C~ t fORPH1'f~~,N'~ ~CU,~;' i !`ha JANICE DAVIS REGISTER OF WILLS 20551 N SANTA CRUZ DR 1 COURTHOUSE SQUARE MARICOPA AZ 85239 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwant with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a paint ot+ner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-11 Date 03-29-2004 To ensure proper credit to the account, two Established copies of this notice roust accawpa(nr payment to the Register of Wills. Make check Account Balance 15, 747.97 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paywents are wade within three Amount Subject to TaX $ 1,312.28 wonths of the decedent's data of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will becowe delinquent Potential Tax Due ~ 59.05 nine months after the date of death. PART TAXPAYER RESPONSE A. ~ The above inforwation and tax due is correct. Rewit 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 assesswent will be issued by the PA Departwant of Revenue. ONE ~.,/ BLOCK B. ~Q The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O N L Y o be filed by the estate representative. C. ~ The above infarwa ion is incorrnect and/or debts and deductions were paid. Cowplate PART 2~ and/or PART 3tJ below. PART If indicating a different tax rate, please state relationship to decedent` TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST 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 PART DEBTS AND DEDUCTIONS CLAIMED Under penalties of perjury, I declare that the facts I have reported'a~bojve are true, corr t d complete to the be(ns~t of my knowledge and belief. HOME tJLa) ~,~~" ~~I.~~a /l~}-~ WORK C ) s TAX YER SIGNATURE TELEPHONE NUMBER DATE EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: ACCOUNTS 1 2 $ 3 X 4 5 6 7 X 8 DATE PAID PAYEE DESCRIPTION AMOUNT PAID BUREAU OF INDIVIDUAL TAXES PO 80X 280681 °~~'~}"' "C`,;~ -" ^" -_'° (1[ HARRISBURG PA~'~1+7~I29*bi60$ I..' ~{•-- i~ ~ t~ ~~~- iV , @~/-J,543 EX AFP (OB-08) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -~Q ~~1 ACN 10116362 DATE 03-17-2010 2010 APR -5 P~ 1 ~ 59 C~ER~: C,= QRPNA,1~';~ ~~JRT CU~~~~E~~_ C~'::~, P,4 ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the infarwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-naead decedent, you were a paint owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this fors and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Gowwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-05 Date 03-29-2004 To ensure proper credit to the account, two Established copies of this notice wust accowparry payment to the Register of Wills. Make check Account Balance 17,270.70 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTES If tax paywents are wade within three Amount Subject to Tax $ 1, 439.17 wonths 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 becowe delinquent Potential Tax Due ~ 64 • 76 nine wonths after the date of death. PART TAXPAYER RESPONSE a A. ~ The above infarwation and tax due is correct. Rewit 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 assesswent will be issued by the PA Dapartwent of Revenue. ONE BLOCK B.~ The above asset has been or will be reported and tax paid with the Pennrilvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Corplete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state _ ~ ~; relationship to decedent: "; P'~'1'#~fx~a TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 ~, ~'~~.y „ P3( S 4, ~ ~Fi ..~ 2. Account Balance 2 $ 3. Percent Taxable 3 ~ 'A ' k~a E';, ~ r~, 4. Amount Subject to Tax 4 $ C; "~ ~"''~'" " '~~~~„ 5. Debts and Deductions 5~~~~:' ~~~sz` ~. ~y • ~ ~`31f ~ i i 6. Amount Taxable 6 $ ~ ~wwr,wurwrj'„ '.Pr~iw~wmw~w 7. Tax Rate 7 X "''~ ~~`'{ 8. Tax Due 8 $ „,, PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true,/ correct andL ~cjomplete t~the best of my knowledge and belief. HOME C °j/'7) ~~f0 ~- c~ ( ~Z~ o~ D~w 1 /T .)~ 1~~ n . WORK C ) ~1 ) ~/.~ ~I _~(r~ l r~,L~ b S TOTAL CEnter on Line 5 of Tax Computation) # PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUA4,JAX~S-~f~ ,,~: AND FILE NO. 21 '~U`~C{ Po Box zsgspr~,~,{'~- ~- TAXPAYER RESPONSE ACN 10116363 HARRISBUR6`',PA 1T128-Q6p1 ~- ~ ~~" 't'{i~.:.. DATE 03-17-2010 ` J - _ ~.i. ,. '1 :-•-. _: ~I ~'.~ REV-1545 IX KP (OB-OB) 20th APR -5 P~ ~ ~ 56 C,I.~T'~~ ~; ~~~~~ ~,, Gi~i~< ~ =`~~ - ~ ' `' DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-naead decedent, you were a ioint owner/baneficiarv of this account. If you feel the inforwation is incorrect, please obtain written correction fraw the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 witfi questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691'05 Date 03-24-2004 To ensure proper credit to the account, two Established copies of this notice roust accowpa(ry vaywent to the Repistar of Wills. hake check Account Balance 17,270.70 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paywents are wade within three Amount Subject to Tax g 1,439.17 months of the decedent's data of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will becowe delinquent Potential Tax DUe ~ 64.76 nine wonths after the date of death. PART TAXPAYER RESPONSE a ~. A. ~ Tho above inforwation and tax due is correct. Rewit paywent to the Repistar 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 assesswent will be issued by the PA Departwent of Revenue. C 0 N E ~ BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pannsvlvania Inheritance Tax return 0 N L Y to ba filed by the estate representative. C. and/or debts and deductions were paid. ect ~ Tha above inforwa ion is incorr r I Cowplete PART 2~ and/or PART 3L-1 below. PART If indicating a different tax rate, please state ~ 2 relationship to decedent: ~*,' rC.e ,nr2+asr~s~tt:; TAX RETURN - COMPUTATION LINE I. Date Established 2. Account 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 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) 6 Under penalties of perjury. I declare that the facts I have reported above are true, correct and complete to the best of my knoxledge and belief. HOME C ' ) ~ ~ O WORK C ) ~ -~- TAXPAYER SIGN URE TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE T INFORMATION NOTICE auREau~ 1~IDOae r~us~~~_ t'ts' AND PO BDX tao6e~- ~ ~ ~ y.C .. TAXPAYER RESPONSE HARRISBUR~PA ,, 171zai46D},'.;, :, i X17-,J ... ~ .~, ~ a Iffy-1543 IX AFP (OB-OB) 2010 APR -S PM I ~ ~ ~ CtE~~~ Cr ORFN~,1~?`S UUUFT C~~~~~ r ' ` i ~''l , ~~ JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 FILE N0. 21 -lU - c~~-1.~ ACN 10116364 DATE 03-17-2010 EST. OF VIOLA M HARDING S5N 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® savlNGs CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 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 PAYNENT INSTRUCTIONS Account No. 67691-05 Date 03-29-2004 To ensure proper credit to the account, two Established copies of this notice must accomparur payment to the Register of Wills. Make check Account Balance $ 17,270.70 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are made within three Amount Subject to Tax $ 1,439.17 months of the decedent's date of death, TaX Rete X .045 deduct a 5 portent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 64.76 nine months after the date of death. PART TAXPAYER RESPONSE 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. 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 NL Y o 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 5 ~ 2 relationship to decedent: ,,,,,,& ~ . .».4r~.~Y,»~.,*s». 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 DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported a~~bojjve~~ are['+t~rue, correct and co^mple`te to the bestf~of~ my kgowledge and belief. HOME C~L.i.~ ) ~O ~ -~`~~ ~//1~1i.A0 /Il L/.1,/M~ WORK C ) \~ ~l~`~ I TOTAL CEnter on Line 5 of Tax Computation) 8 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL fa~c~s ~.. AND FILE N0. 21 -t~~~~q PO BOX 260601 ~ ~; ? ~ TAXPAYER RESPONSE ACN 10116365 HARRISBURG PA 17126 0604.-, -~' ~ '' e'' ~ "' DATE 03-17-2010 ~'~ L ~-15dY IX IIkP (08-OB) EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. 2QiQ ~P~ -5 p~ E ~ S9 CLARK ,,~ ~~ ~jORPNAf1f'~ CURT L. r "' pry. ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 MEMBERS 1ST FCU 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 intonation 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67b91-52 Date 09-13-200b To ensure proper credit to the account, two Established copies of this notice rust accompany payment to the Register of Wills. Make check Account Balance 25 ~ 187.91 payable to "Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to NOTE: If tax payments are Wade within three Tax $ 2 098 91 ' . , months of the decedent s date of death, Tax Rate ~( , 0 4 5 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will bacons delinquent Potential Tax Due ~ 94.45 nine months after the date of death. P T TAXPAYER RESPONSE ~ 1 G;i 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, ar check box "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. ~he 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 inforna 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 ` s'~~'" a relationship to decedent: ~ ~~~ ~ ~ '=`' ` ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS rv y~ ~~~ 1'~«~ ta,d~~,~~~~ ~, ~~'~~~~i LINE 1. Date Established 1 4~'° r 2. Account Balance 2 ~ ~ ~ .. ' °' ~`~ ~~' t~i'~~~ ~~ 3. Percent Taxable 3 X e, ~~ a+ . ~~,~,' 4. Amount Subject to Tax 4 $ ~~ ','f, 3~', 3~x 5. Debts and Deductions 5 ~~~" ' m~~, 6. Amount Taxable 6 7. Tax Rat® 7 X ~- 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK C ) /tJ I% ~3~ ~ ~O 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 pf my knowledge and belief. unuc r~tr?i ~1'")~ ---L~~"7 l PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE NO. 21 `~~ ~~p PO BOX 280601 ,, r,~. ~ TAXPAYER RESPONSE ACN 10116366 HARRISBURG PA 17128-81011 _ Ii ;~ wsr-sos ex ~r cad-ae: DATE 03 -17 - 2010 2a~a aPR -5 P~9 3: 51 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH o3-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. CLERK ~~~ ORFH.=t~v`~ CC~UAT DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 MEMBERS 1ST FCU provided the Deoartmant with the inforwation below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/ben®ficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-52 Date 09-13-2006 To ensure proper credit to the account, two Established copies of this notice roust accompany Daywent to the Register of Wflls. Make check Account Balance 25, 187.91 payable to "Register of Wills. Agent". Percent Taxable X 8.333 NOTE: If tax payments are made within three Amount Subject to Tax ~` 2 ~ 098.91 months of the decedent's date of death, TeX Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due ~ 94.45 nine months after the date of death. PART TAXPAYER RESPONSE 0 A. ~ The above inforwation and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid i nterest, or check box "A" and return this notice to the Register of CHECK Wills and an official assessment will be issued by the PA DeDartwent of Revenue. ONE B L 0 C K B. The above asset has been or will be reported and tax Daid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Comvlete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state "' ,~ h.i & ~ f "~~ ~ ~ relationship to decedent: ~ ~ 6 ~~ : ~ 11~1~ ~~ ~~~` p ~~+ti~ ~~~~f'~ ai 1 TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~ LLNE 1. Date Established 1 ~'~«wwr, 2. Account Balance 2 $ ~ ~ 3. Percent Taxable 3 X ~w~«» ";~ ~`~~~~'~ ~~~~~~~' ~ a~ ~~~~~~ $ s „i;a a;~~ ~ i~'' 4. Amount Subject to Tax 4 »t» ~~ 5. Debts and Deductions 5 - ~ 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ ; PART DEBTS AND DEDUCTIONS CLAIMED Under penalties of perjury, I declare that the facts I have reported above are tr~jue correct a/nod omplete to the best of my knowledge and belief. HOME C ) D ~ ~ v WORK ( ) 30 ~ TAXPAYER SIGNATU TELEPHONE NUMBER D TE DATE PAID PAYEE DESCRIPTION AMOUNT PAID BUREAU OF INDI,1~~lr~q~F,~l ,.,,,_'..i ~fi_ PO BOX 280601 ' `~L HARRISBURG PA 1,71~~, ~4b,OL ~,~ ,,) ~, ~ ~ ~~ .~ r -'~"~ `- ~~ Y R@Y-1S63 IX KP (06-06) PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 `~U "`~~ 1 ACN 10116367 DATE 03-17-2010 2010 APR -5 PM ( ~ 55 CL~~,~ {Jt ~RPNi~'d V L~ C~_ llt~i- JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH o3-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST a CERTIF. MEMBERS 1ST FCU provided the Department with the information below, which has bean 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 infonation is incorrect, please obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coamonaealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67641-52 Date 09-13-2006 To ensure proper credit to the account, two Established copies of this notice oust accompany payaent to the Register of Wills. Make check AcCOUnt HalanCe 25 ~ 187.91 $ payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are made within three Amount Subject to Tax $ 2, 098.91 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 $ 94.45 nine months after the date of death. PART TAXPAYER RESPONSE 0 A. ~ The above information and tax due 3s correct. Remit payment to the Register of Wills with two co pies of this notice to obtain a discount or avoid interest, or chock 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. C ONE ~ ~ BLOCK B. , . ~ha above asset has been or will be reported and tax p aid with the Pennsylvania Inheritance Tax return O N L Y o be filed by the estate representative. C. ~ The above informa 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 ~ ~ ~~~ mh ^ 2 relationship to decedent: r' d ~ ... " ~~~ ~~ RE~~'. '° ~ ' ~ TAX RE TURN - COMPUTATION OF TAX ON JOINTtTRUST ACCOUNTS ~`' „~~ts~'~, `' ' '°~ ~ ~'. LINE 1. Date Established 1 ~ iW+W~Www"w~ 2. Account Balance 2 $ .:~~ ~~. ~ , ~ 3. Percent Taxable 3 X ,~ ~ ~ ' $ ~' ~' ' ~"~', ~ 4. Amount Subject to Tax 4 :4 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ .,; 7. Tax Rate 7 X ~~~ 8. Tax Due 8 $ `~'Y PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) i Under penalties of perjury, I declare that the facts I have reported above are true, ~orrect7a complete to the best Ivy y knowledge and belief. HOME C ~) ~~~~ ~~3 ~J`~ WORK ( ) ~ t TAXPAY R SIGNATURE TELEPHONE NUMBER DATE BUREAU OF INDIVID j rr~ PO BOX 280601 q~¢. ~ ~ H1IRRISBURG PA 171211:J16p.~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 ' IU ~ t~-~G ACN 10116368 DATE 03-17-2010 20111 APR -5 P~ i ~ 59 CLERK OF ORPN~~i' ~ ~~`~11R." Ci~P. f .._ ~, _, .. , ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SpUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU provided the Department with the inforwation below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, You were a point owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address- This account is taxable in accordance with the Inheritance lax laws of the Cowworoeealth of Pennsylvania. Please call (717) 787-8127 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILINS AND PAYMENT INSTRUCTIONS Account No. 67691-53 Date 09-13-2006 Ta ensure proper credit to the account, two Established copies of this notice roust accospany Account Balance 25, 170.14 paywent to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paywents are ^ade within three Amount Subject to Tex ~ 2, 097.43 wonths 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 TeX Due ~ 94.38 nine wonths after the date of death. PART TAXPAYER RESPONSE A. ~ The above inforwation and tax due is correct. Rewit paywent 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 tfie Register of Wills and an official assesswent will be issued by the PA Department of Revenue. ONE ~ ,.~ B L OC K B. ~jLJ_The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to ba filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART 2~ and/or PART 3~ below. PART If indicating a different tax rata, 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 l 2 $ 3 X 4 +~ 5 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID 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 . unMG rte/ 71 ~ ~~ ~ ~1.~ WORK ( ) TOTAL CEnter on Line 5 of Tax Computation) t BUREAU OF INI}11iiRUAI, jAXI<S ~„~ , ~r PO BOX 280601' ~~: ~ f,__~'1 jt- HARRISBURG PA LZ~$-441 ,` ,_ .~ ~ w1v~.'J _ 7 ~ 'v 1- e miV~S543 IX AFP (09-08! PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 ` ~U "~ ~~ ACN 10116369 DATE 03-17-2010 2010 APR -5 PM I ~ 57 CL~Ri{ r,F ORFN.~TJ'S C~U9T DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCDUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU provided the Dopartnant with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a ]oint owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction fraw the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowmonwaalth of Pennsylvania. Please call (717) TB7-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-53 Date 09-13-2006 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 ~ 25,170.14 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paywents are wade within three Amount Subject to Tax $ 2, 097.43 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 $ 94.38 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 co pies of this notice to obtain a discount or avoid intorest, or check box "A" and return this notice to the Register of CHECK Wills and an official assessment will ba issued by tho PA Department of Revenue. C ONE BLOCK B. Tho above asset has bean or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY a ba filed by the estate representative. C. ~ The above inforna ion is incorrect and/or debts and deductions were paid. Cowplete PART ~2 and/or PART 3~ below. PART If indicating a different tax rata, please state a 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 $ Under penalties of perjury, I declare that the facts I have reported above are true, co(r'rect and omplete to a best of my knowledge and belief. HOME C ) 'b WORK ( ) v TAXPAYER SIGNATU TELEPHONE NUMBER DATE PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU ~-` ~~1ti~YIlh~pL ~,TA ,~" ~~(~ AND F I LE N0. 21 -1~ '~-{~ PD Box zBA~ol t n TAXPAYER RESPONSE ACN 10116370 NARRISBUf~Q~PA, ~,1`~?18JI601y '.,.: ,i DATE 03-17-2010 REY-1541 IX /iiP COB-00) ~~~~ ~~~ _~ ~~~ ': ~~ TYPE OF ACCOUNT EST. OF VIOLA M HARDING ^ sAVINGs v~~~t/ 4vr $$N 579-20-9770 ^ CHECKING ~t~~N~,f,~C vCi't.,~~T DATE OF DEATH 03-05-2010 ^ TRUST ~ ~,;-r, ,~ =r7 ~~'1 q COUNTY CUMBERLAND ® CERTIF. REMIT PAYMENT AND FORMS T0: JANICE DAVIS REGISTER OF WILLS 20551 N SANTA CRUZ DR 1 COURTHOUSE SQUARE MARICOPA AZ 85239 CARLISLE PA 17013 MEMBERS 1ST FCU provided the Departsent with the inforsation below> which has been used in calculating the potential tax due. Records indicate that at the death of the above-nosed decedent, you were a joint owner/beneficiary of this account. If you feel the inforsation is incorrect, please obtain written correction free the financial institution, attach a copy to this fors 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 (717) 78i-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account Mo. 67691-53 Date 09-13-2006 To ensure proper credit to the account, two Established copies of this notice oust accospany paysent to the Register of Wills. Make check Account Balance $ 25 ~ 170.14 payable to "Resister of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paysents are lade within three Amount Subject to Tax ~` 2, 097.43 sonths 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 becose delinquent Potential Tax Due $ 94.38 nine months after the date of death. PART TAXPAYER RESPONSE ,. ,. A. ^ The above inforsation and tax due is correct. Resit paysent to the Register of Wills with two co pies 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 assesssent will be issued by the PA Departsent of Revenue. C ONE ~ ~,/1 BLOCK 8. f ~{ The above asset has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax return O N L Y o 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 3^ below. PART If indicating a different tax rate, please state relationship to decedent: ~ '' r 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 $ a X 4 ~ 5 6 7 X 8 $ Under penalties of perjury, I declare that the facts I have reported a~b+ove are~^truGe, correct and complete to the best f my knowledge and belief. HOME ~..7 ZD) J~ O ^ ~~~~ _ ~ WORK C ) ' 3O ' TAXPA SIGNATURE TELEPHONE NUMBER DATE PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID BUREAU OF IND~i~Ak ;TA3EES ~~ - `t HARRISBURG PA .1712&~Q401 ~,, i.. ..L ., - .. - - - REV-1563 EX AFP [U6-38) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE 2010 APR -~ P~ 1 ~ 58 CLEFK ~C ORPI=~~tN'~ ',.;OURT Ct~~~ And- ~. ~~~ ,,,-~ . Pry, ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 FILE N0. 21 ` ~~'~~ ACN 10116371 DATE 03-17-2010 E5T. OF VIOLA M HARDING SSN 579-20-9770 IIATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. MEMBERS 1ST FCU 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 joint 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 Pennrilvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-54 Date 09-13-2006 To ensure prover credit to the account, two Established copies of this notice must accompamr Dayment to the Register of Wills. Make check Account Balance 25 ~ 158.27 $ payable to "Register of Wills, Agent••. Percent Taxable X 8.333 NDTE: If tax payments are made within three Amount Subject to Tax $ 2 ~ 096.44 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 $ 94.34 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 co pies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of G H E C K Wills and an official assessment will ba issued by the PA Department of Revenue. ONE B L 0 C K B. The above asset has bean or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y JJJ to be filed by the estate representative. C. ~ The above informa 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 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK C ~~~/~ . ~ ~~©I~~bf~ Under penalties of perjury, I declare that the facts I have reported above are,~1tr.yu~e, correct and complete to tFle best of mV knowledge and belief. unur ~/~ ~ / !/ !~n - ~1.~ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 1712 U60~ r, Y., t'i m:v-}sw"o4 P roe-oe~ " " ~~ Z~10aPR-S f~ I~ ~7 CLF~~~ ~ O~~P~'~~i~f ~ U~u'~j DORISeU`., F ~BI~AGAI~1' PA. 107 NORMAN DRIVE BOHEMIA NY 11716 PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND TAXPAYER RESPONSE TAX FILE N0. 21 --~(1` ~~q ACN 10116372 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU 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 fora 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. 67691-54 Date 09-13-2006 To ensure vropar credit to the account, two Established copies of this notice must accompany Account Balance $ 25 158 27 payment to the Register of Wills. Make check , . payable to "Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to Tax $ 2 096 44 NOTE: If tax payments are ^ade within three , . months of the decedent's date of death, Tax Rate X .045 deduct a 5 portent discount on the tax due. Potential Tax Due ~ 94.34 Any Inheritance Tax due will become delinquent nine months after the date of death. P T TAXPAYER RESPONSE ~ 1 A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two co pies of this notice to obtain 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. B L 0 C K ONLY ~ B. The above asset has been to be filed by the estate or will be reported and tax paid with the Pennsylvania Inheritance Tax return representative. C. ~ The above informs ion is Complete PART 2~ and/or incorrect and/or debts and deductions were Daid. PART 3~ below. PART If indicating a different tax rate, please state relationship to decedent: ~ , ~ r ~~~f4 ~r~ R~X 3 x ~fR ~J ~~l~i ~~ q~l ~ ' ~ ~` " TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 5 ' SAD' rj'rH~,,~~~,,, h~s`b,~- ~~'~~~' LINE I. Date Established 1 "~~~ ~~`'' 2. Account Balance 2 ~ «.:_ ~ e 3. Percent Taxable 3 X ~~ ~~' ~ 4. Amount Subject to Tax 4 ~ ~ ~ 5. Debts and Deductions 5 - ,~ i. 6. Amount Taxable 6 $ ~ ':`` 7. Tax Rate 7 X 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, corCrect and) omplete to the best of my knowledge and belief. HOME C ) ~ O ~ ~C/ '"~-~' WORK C ) 3 3 0 J TAXPAYER SIGNATU TELEPHONE NUMBER DATE IPENNSYLYANIA INHERITANCE TAXI INFORMATION NOTICE ~'}~~ ; }.~.; AND FILE N0. 21 `~~-~~~ BUREAU OF INDI PD BOX 280601 -j, , _ TAXPAYER RESPONSE ACN 10116373 HARRISBURG PA 1'~~Q,§9~, ~ ... ~ . - DATE 03-17-2010 Za~o a~~ -~ ~~ ~ ~ ., ,: ~. JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. MEMBERS 1ST FCU provided the Departeent with the inforeation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-na^ed decedent, you were a ]oint owner/benaficiarv of this account. If you feel the inforoation is incorrect, please obtain written correction froe the financial institution. attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coweonxealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-54 Date 09-13-2006 To ensure proper credit to the account, two Established copies of this notice oust accoepam! pay^ent to the Resister of Wills. Make check Account Balance $ 25,158.27 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paysents are Wade within three Amount Subject to Tax $ 2, 096.44 sonths 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 $ 94.34 nine eonths after the date of death. PART TAXPAYER RESPONSE a £~ A. ~ The above inforeation and tax due is correct. Resit passant 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 assesseent will be issued by the PA Departeent of Revenue. C ONE B L 0 C K B. ,The above asset has bean ar 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 inforea ion is incorrect and/or debts and deductions xere paid. Coeplete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state a 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. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 ~ Under penalties of perjury, I declare that the facts I have reported ve are ~t+r~ue, correct a complete to the, best of my .knowledge and belief. Nf1MF C) ~(~~ ' ~~~ REV•L543 IX AFP (OB-Ue1 WORK C ) SIGNATURE TELEPHONE NU PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID BUREAU OF INDIIF;~UA~,~~$. ~ t--r;~.1 PO BOX 280601 {~ HARRISBURG PA 17128-,Q681 ~ '~ ,,~ ~ ! ~ ~, PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -~U-?jC~C.~ ACN 10116374 DATE 03-17-2010 za~a apR -~ Pn ~ ~ ~s CLARK 0- ORPHAI~~`.~ ~ ~:~tjRT ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU 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 inforoation is incorrect, please obtain written correction from the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-55 Date 09-13-2006 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 $ 25 ~ 217 • 54 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are made within three Amount Subject to Tax ~` 2,101 .38 months of the decedent's data 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 ~ 94.56 nine months after the date of death. PART TAXPAYER RESPONSE : h 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. C ONE BLOCK B. ~he above asset has been or will be reported and tax paid with the Pennsylvania Inheritance lax return 0 N L Y to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. ComDleta 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 i 2 3 X 4 $ 5 - 6 ~ 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of periury, I declare that the facts I have reported above are true, correct and complete to thq best of my knowledge and belief . Hf1MF C ~/r/) ~~~~ - _~ )~ d ~~.~-a~~ WORK C 1 /V ~;~ ~ 'S~ s:~ O TOTAL (Enter on Line 5 of Tax Computation) s BUREAU OF INDIVIDUAL 7AXE$„~.,.-r PO BOX 280601 ~;~ !, ~- _ HARRISBURG PA 17128-Q~~l: y- -_ l«'~ ~"''~ ~ r rj ~ ~ ~-15 3 ~~AFP (06-081 -- tf4 f. PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE TAXPAYER RESPONSE ACN DATE N0. 21 -~U-~~q 10116375 03-17-2010 2~1~ ~~~ -S P~ I= 57 EST. OF VIOLA M HARDING SSN 579-20-9770 CLEr,K (~;;~ DATE OF DEATH 03-05-2010 ORPHut ~ ~ ~O;,~RT COUNTY CUMBERLAND CUB i r ~'~ ' ~(~ REMIT PAYMENT AND FORMS T0: _ ` , PA. DORIS BRAGAN REGISTER OF WILLS 107 NORMAN DRIVE 1 COURTHOUSE SQUARE BOHEMIA NY 11716 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the infarwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you ware a ioint owner/beneficiary of this account If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-55 Date 09-13-2006 To ensure proper credit to the account, two Established copies of this notice roust accowpany Account Belance 25 217 54 pavwant to the Register of Wills. Make check ~ . payable to "Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to Tax ~` 2 101 38 NOTE: If tax paywents era wade within three , . wonths of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential TaX Due ~ 94.56 Any Inheritance Tax due will becowa delinquent nine wonths after the dat• of death. P T TAXPAYER RESPONSE ~ 1 .: A. ~ The above inforwation and tax due is correct. Rewit pavwant to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, ar check box "A" and return this notice to the Register of C 0 N E J Wills and an official assesswent will be issued by the PA Departwent of Revenue. BLOCK B. The above asset has been er will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to ba filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART 2~ and/or PART 3~ 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 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are pt,~rue, correct and omplete to the best of my knowledge and belief. HOME C ) ,,.) ~/ b v '~ WORK C ) ~ T AYER SIGNATURE TELEPHONE NUMBER D TE TDTAL (Enter on Line 5 of Tax Computation) $ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE PORBOXU 28060DIVIDUAL T,~F~S~_, ~f _,, AND F I LE NO. 21 - ~ (~ ~i-{ C~ FYIRRISBURG PA nlza b6o2 ' ~ TAXPAYER RESPONSE ACN 10116376 ' `'~``~ DATE 03-17-2010 ~~~'>>`~- `mSW ~54S L~7(MFP 10B-OB) 201a APR -5 PIS I ~ S5 ORPN~=,~ ~~'S ~~U~T JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU 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 joint 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 Pennrilvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-55 Date 09-13-2006 To ensure proper credit to the account, two Established copies of this notice must accompany 25 ~ 217.54 payment to the Register of Wills. Make check Account Balance payable to "Register of Wills, Agent". Percent Taxable X 8.333 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 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 DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and comp a to the best my knowledge and belief. HOME C ~ ~ '^~.~~ WORK C ) ~ 8 ~ TAXPAY SIGNATURE TELEPHONE NUMBER D TE IUTAL [inter on Line 5 of Tax Computation) $ BUREAU OF INDIYIDUAL Tl~S. PO BOX 288601 -~ ;~%~~~~~` j t HARRISBURG PA 17128?([60I - ~ ~ f':. ~.~;,~ !L~~` BR'!-isy0'oc: AFp we-oe: 2010 APR -5 P~1 t : 58 CLEPIC Cr QRPH~~~~ ,, ~ ~~JRT C~ij' e 1 r r ~ '~ ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SpUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU provided the Departwant with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a joint owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-56 Date 10-29-1986 To ensure proper credit to the account, two Established copies of this notice wust accowpamr paywent to the Register of Wills. Make check Account Balance ~ 20, 032.47 payable to "Register of wills, Agent". Percent Taxable X 8.333 NOTE: If tax paywents are wade within three Amount Subject to Tax ~ 1, 669.31 wonths 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 becowe delinquent Potential Tax Due ~ 75.12 nine wonths after the date of death. PART TAXPAYER RESPONSE F A. ~ The above inforwation and tax due is correct. Rewit paywent to the Register of Wills with two co pies 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 assesswent will be issued by the PA Dapartwent of Revenue. C 0 N E ~ BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return DNL Y to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete 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 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above arert~rue,//correct and complete to the best Hof my knowledge and belief . NOME C~ ~ ~ / ~ !a ~~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE * * * REVISED NOTICE FILE NO. 21 -~O-~L(c~ ACN 10116377 DATE 03-23-2010 WORK C )/V ~ly ~'~ Ls3CLL~1QfLS TOTAL CEnter on Line 5 of Tax Computation) $ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 -~!'/~f'rr.,r-~ . f HARRISBURG PA 17128 ~0$Ilk` I'_ . ~~_ ; ; , ~ ~ "f~"'(~-t~~~, i ~~ ~-~ REV:isc~,mt wFr.coe-oeo ZOiQ APR -5 P~ { ~ 59 GLER~4 P ORPHF~F ,, GO~JRT ZELDA GODFRE`~" ' ~A. 227 MOUNTAIN ROAD NEWVILLE PA 17241 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -~U-`3'x-1 ACN 10116377 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU 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 joint 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 I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-56 Date 10-29-1986 To ensure proper credit to the account, two Established copies of this notice must accompany 20' 000 • 00 payment to the Register of Wills. Make check Account Balance $ payable to "Register of Wills, Agent". Percent Taxable X 8.333 un~ BLOCK ON L Y B. ~/~The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return o 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 ~ ~ ~~~. '`_' ll l ~ LINE I. Date Established 1 z , ~ .:»t.~ ~t a ~fl IB~X~ ~~ ~~i ',...'''~'''t ~ ~ s, ~g~~~~ z'e~`as~, wr~w WMMMMM ~A u My 2. Account Balance 2 ~ ~ ~ ~ # a, ~ 4t~Pf" 't ~ ~~~~,, g`s~Pu si ~c ;~ P` 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 ~ ~ ~~. ''+ 5. Debts and Deductions 5 - v, ~~~~~°,' 6. Amount Taxable 6 $ ~~~ ~.~~' ~~a ~ 7. Tax Rate 7 X ~ y ~4 8. Tax Due B $ >'f PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are/~t7r~uej,>>~orrect and c ;mpnlete to the best of my knowledge and belief. HOME C ~~~) / / !P ~~~ i~~~ ~ , .G. WORK C ) ~ /1L e rDTAL (Enter on Line 5 of Tax Computation) i BUREAU OF INDIVID<~1,.4IAXES PO BOX 280601 `r`im - WIRRISBURG PA 171,@ OKOi - _ rf~ - ' 4~ ~ .~ 'm~/}15W E%AFP (OB-00) ZOIO APR -~ P~ I.57 CLCPrC r~. O.RPH4N`~ CCURT DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 .~U~~-(,q ACN 10116378 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU 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 joint 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. 67691-56 Date 10-29-1986 To ensure proper credit to the account, twa Established copies of this notice must accompany Account Balance ~ 20 0 0 0 0 0 Payment to the Register of Wills. Make check ~ . payable to "Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to Tax $ 1 666 60 NOTE: If tax payments are made within three . , months of the decedent's data of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due ~ 75.00 Any Inheritance Tax due will become delinquent nine months after the date of death. P T TAXPAYER RESPONSE ~ ~ .I A. ~ The above information and tax due is correct. Remit payment to the Resister of Wills with two co pies of this notice to obtain ~- C HECK ~ ~ ~~~ a discount or avoid interest, or check box "A" and Wills and an official assessment will be issued by return this notice to the Register of the PA Department of Revenue. L1nE 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 8 ~` PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and omplete to the best of my knowledge and belief. HO ME_ C ) j `~~y),P~C.L~/~-~" WORK ( ) ~ 2 , 1 ~ rDTAL CEnter on Line 5 of Tax Computation) S BUREAU OF INDIVIDUAL TAX~$,.,., ~,,-~; i PD BOX 280601 .'r~'•~I~` '"i`ii,; HARRISBURG PA 171289661 ~,: , ~.~ _~~~`'~~+ ~ `- REV-]543 IX AFP (OB-O8) 24!0 ~~'~ -S P~ I~ 57 GLEF~ ; G pRPNAN'c ~GURT;~ DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 FILE N0. 21 -~a~~v~-~,q ACN 10116378 DATE 03-23-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU 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-pawed 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 forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Comwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART I BELOW * SEE REYERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67641-56 Date 10-29-1986 To ensure proper credit to the account, two Established copies of this notice oust accompany payment to the Register of Wills. Make check Account Balance $ 20,032.47 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are made within three Amount Subject to Tax g 1,669.31 months of the decedent's date of death, Tax Rate X , 0!}5 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due ~ 75.12 nine months after the date of death. PART TAXPAYER RESPONSE a -~ A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two co pies of this notice to obtain a discount or avoid intorest, or check box "A" and return this notice to the Register of CHECK C 0 N E 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 Wills and an official assessment will be issued by the PA Department of Revenue. PART ~ below. PART If indicating a different tax rate, Please state a relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established I 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 penalties of perjury, I declare that the facts I have reported above are true correct/-an/dj omplete to the best of my knowledge and belief. HOME C' ~ ~~ ` ~' 6 v .~--~r WORK C ) TAXPAYER S ATUR TELEPHONE NUMBER D TE PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE * * * REVISED NOTICE TDTAL (Enter on Line 5 of Tax Computation) # PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21-~d-~Jyq Po Box zso~~, :--~. „ f,~ ~~ TAXPAYER RESPONSE ACN 10116379 HARRISBGRGPA ~17I2B~gsoi~,; ~- DATE 03-17-2010 `,ti~ J' `~ ~ c/ , ~ '^ REV-1543 IX AfP (OB-OB) 1010 APR -S PM 1 ~ 5~ Celli{ ~~ O~FH~~~'~ G~I.ERT JANICE ~DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU 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 ware a ioint owner/beneficiary of this account If you feel the information is incorrect, Dlease obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance 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. 67691-56 Date 10-29-1986 To ensure proper credit to the account, two Established copies of this notice oust accompany Account Balance 20 000 00 payment to the Register of Wills. Make check " ~ . payable to Register of Wills, Agent". Percent Taxable X 8.333 Amount Subjeet to Tax ~- 1 666 60 NDTE: If tax payments are made within three . , months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due s 7 5 . 0 0 Any Inheritance Tax duo will become delinquent nine months after the date of death. P T TAXPAYER RESPONSE a 1 `lRL" tll str r 4' ri -~ a ul ~ ` 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 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOC K ] B. 'y~ The above asset has been or will be reported and tax Daid 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 = .," a relationship to decedent: R p ~z ~'~ 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 Subjeet to Tax 4 ~ t="~ 5. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 ~ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported coyplete to the bes~f my knowledge and belief. HOME are~r4e~ ^rec~and ,) l/', 3 ~ WORK TOTAL CEnter on Line 5 of Tax Computation) 8 BUREAU OF IN T S(~'+'^_~~~ PO BOX 28060L~~~~ ~-,i. HARRISBURG PA ^1T~06g1 I ! ' C`' ~.J .. t ..., REV-1545 IX AiP COB-OB) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE * * * REVISED NOTICE FILE N0. 21-~u-~q ACN 10116379 DATE 03-23-2010 Z~l~ APP -5 P~ 1 ~ 5:~ t-ni nr /~pCJLA~r~ rC s.; ~ 1 y Vf1~[ Il~i~i ~ ~.,~itilT /~ _, JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departeent with the inforeation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-naeed decedent, you were a point owner/beneficiary of this account. If you feel the inforeation is incorrect, please obtain written correction frow the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coeeonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-56 Date 10-2 9-1986 To ensure proper credit to the account, two Established copies of this notice Bust accoepany payeent to the Register of Wills. Make check Account Balance $ 20, 032 .47 payable to "Register of Wills, Agent". Percent Taxable X 8 .333 NOTE: If tax payeents are •ade within three Amount Subject to Tax $ 1,669 .31 eonths of the decedent's date of death, Tax Rate ~( . 0 4 5 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will bacose delinquent Potential Tax Due $ 75 .12 nine eonths after the date of death. P r TAXPAYER RESPONSE ~ 1 5, A. ~ The above inforeation and tax due is correct. Resit payeent 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 C 0 N E ~ ~ Wills and an official assesswent will be issued by the PA Departeent of Revenue. 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 inforea ion is incorrect and/or debts and deductions were paid. Coepleta PART ~2 and/or PART 3~ 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 DN JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 $ 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, c act TOTAL CEnter on Line 5 of Tax Computation) S PO BOX 28060DIVIDUAL,TI~(~S r. » 1.~ HARRISBURG PA i'7r~B Q6D1 ~~~~" ~~. ~~ -~~ f "' ~ _ ~-1545 IX AFP COB-OB) PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21-~U-c3~r1 ACN 10116380 DATE 03-17-2010 201Q APR -5 P1~1 I= 59 CLER~~C ~F ORPN~~! S C~I.J~T Ci.l~r.~r ,,;, L PA. ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. MEMBERS 1ST FCU provided the Departwent with the information below, which has been used in calculating the Dotential tax due. Records indicate that at the death of the above-pawed decedent, yeu were a ]oint owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-57 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice oust accowpany paywent to the Register of Wills. Make check Account Balance $ 25 ~ 072.57 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are ^ade within three Amount Subject to Tax $ 2 ~ 089.30 months of the decedent's date of death, Tex Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due ~ 94.02 Any Inheritance Tax due will becoee delinquent nine months after the date of death. P~T TAXPAYER RESPONSE 1 'Lt7t F•a M3 :.~ A. ~ The above inforwation and tax due is correct. Remit paywent 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 C 0 N E J Wills and an official assessment will be issued by the PA Departwent of Revenue. BLOC K B. ~X~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O N L Y a be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were Daid. Cowplete PART ~2 and/or PART ~ below. PART If indicating a different tax rate, please state ) ~ '~~ f'• relationship to decedent: 1 > Ls' 6 F2• f ~ ¢a ~ ) t ~ 4 ~F ~ ~~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ' " ~'~' ~ ~" { ~~~~_ ~" ~ ~, ~r«,',. .~ LINE 1. Date Established 1 2. Account Balance 2 ~ ~ ~ »»~ 3. Percent Taxable 3 X ~ ~•~''~~'`~~' - ' `> ` 4. Amount Subject to Tax 4 $ ~ .t(.~~~~:s Ifi i I t f3 l~+ Cf '` ~~' `9~ ~ ,,,~. ~www~wiww ' 5. Debts and Deductions 5 - "~ * ~~~' j'~~ ti`. `" 6. Amount Taxable 6 ~ ~ ~ ,,, x y,"x„ _;+ ~~~^~u•>~kf~ ~~~' •~'• 7. Tax Rate 7 X ~ ~8 ;( ! s,~ q ~{ 8. Tax Due 8 $ ~ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~. WORK C ) NAfiUR TELEPHONE NU TOTAL (Enter on Line 5 of Tax Computation) ~ Under penalties of perjury, I declare that the facts I have reported a~b7ove are true, correct and _ complete to \t he best of my knowledge and belief. HfIMF I" / ~~l ~~~ -.~J~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE 2~~ BUREAU DF ~~IYIDUAL TAXES AND FILE N0. 21 -~~'c7~-~q PD Box zoo ^~ .`~~~ ^~r; ~ TAXPAYER RESPONSE ACN 10116381 HARRISBURG 'Ph i712&-0601.E a ~ f~ ~ r ' ~ DATE 03-17-2010 r~'u.,; i ~, ; _ , 'xsv-sty a wv coe-oe: EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. 2010 APR -5 P11 f ~ ~ 7 p CLE~r; C`~ CRPH R it ~ ~~r i ('~T ~''.e~ ~> v..J~..~(11 DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a point owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwanwealth of Pennsylvania. Please call (717) 787-6327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-57 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice oust accowparry Account Balance 25 ~ 072.57 paywent to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax paywents are wade within three Amount Subject to Tax ~ 2, 089.30 wonths of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. 9 4.0 2 Any Inheritance Tax due will becowe delinquent Potential Tax Due $ nine wonths after the data of death. PaT TAXPAYER RESPONSE 1 ~. A. ~ The above inforwation and tax due is correct. Rewit Daywent 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 0 N E ,~,/' Wills and an official assesswent will be issued by the PA Departwent of Revenue. B L 0 C K B. M The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y .Y~ to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART ~2 and/or PART 3~ below. PART If indicating a different tax rate, please state Ir ~ relationship to decadent: ~ ~s `` ~~ ~~~ ~` " sz€ , ~'~ ~ ~ ~~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS Q , mow` t ~~''~ ~ % ~~~• ~? ~"~°~~ "+e ' LINE 1. Date Established 1 ~~ ~, ~~ ~ 2. Account Balance 2 ~ ' ~ 3. Percent Taxable 3 X "~~. yfr.rr 4. Amount Subject to Tax 4 »~rwwiwww ' ' wfw~w:»~. 5. Debts and Deductions 5 ,~~'~ ~~~'~ ~~ ~~~~~ ~i ii ''u 6. Amount Taxable 6 ~ "!t 7. Tax Rate 7 X ~"~~.5t8• ~ ~s ~"~ 8. Tax Due 8 ~ ~` ~' ~~ 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, ~or~r'e~ct/a~nd complete to the best of my knowledge and belief. HOME C ) Z} tp C] ` WORK C ) ~j0 ~ c7 TAXPAYER SIGNATUR TELEPHONE NUMBER DA E TDTAL CEnter on Line 5 of Tax Computation) S BUREAU OF INDIVIDUpI.,-FAXrSr~ n--^'i PO BOX 280601 t~ ~ HARRISBURG PA 1~2E1g0@D} ,- .~ ~ IB:Y-1543 IX AFP (OB-00) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE TAXPAYER RESPONSE ACN DATE No. 21-10-~4q 10116382 03-17-2010 ~~1~J ~~~ -S Ph i~ ~b EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF .DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. ~r ORPN,,~b ~ GUU~ CUB;' = " ;, "~ P,". ,. ~~, JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 MEMBERS 1ST FCU 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 ]oint 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-57 Date 01-16-2009 To ensure Groper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 25, 072.57 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are Wade within three Amount Subject to Tax $ 2 ~ 089.30 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 $ 94.02 nine months after the date of death. P RT TAXPAYER RESPONSE A ~ 'fl' ~= r ter 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 i nterest, or check box "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. Tha above asset has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Com plete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state ~ relationship to decedent: 'r ~ ~' ~ 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 $ s' $ ~j~• ~~~~ .x. 5. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported eomalete to the bes ^ f my knowledge and belief. HOME WORK C are t ue, corr ct IUMBER TOTAL (Enter on Line 5 of Tax Computation) # BUREAU OF INDIVIDUAL TA7~S'?^~^r1•.y.... PO BOX 280601 , HARRISBURG PA 17128 060].,1;;'/ _ ~TM '`tei,-Saar ot~#'v'cb3-oe: ?OlQapp _5 p~ ~: 55 CCERt( r~~- ORPN~~~S, n~ T ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -~U "~y,~ ACN 10116383 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a point owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-58 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 01-16-2009 Established $ 25,072.57 X 8.333 $ 2,089.30 X .045 $ 94.02 PART 1 T To ensure proper credit to the account, two copies of this notice roust accowpaw paywent to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax paywents are wade within three wonths of the decedent's date of death, deduct a 5 percent discount on the tax due. Any Inheritance Tax due will becowe delinquent nine wonths after the dat• of death. A. ~ The above inforwation and tax due is correct. Rewit paywent 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 0 N E Wills and an official assesswent will be issued by the PA Departwent of Revenue. BLOCK ~ B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y ~o be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state a relationship to decedent: , TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 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 8 $ PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported a~b-7orve~7arel~trrufe,> correct and complete tom he best of Amy knowledge and belief. HOME C /~ /) / "/Co ~~~~~ WORK C ) ~~i~ ~ ~~ © Zj IUTAL canter on Line 5 of Tax Computation) $ BUREAU OF INDIVIDUAL .I~F$ ~ - _ PO BOX 280601 ~` f~ ;' HARRISBURG PA 17128-0~~1 - ,~ ,~; ! L'. •-''~J+i ; s ~-15~i3'DC-AFP (OB-OB) ZOIQ APR -5 Pry ~: 5$ GLQRFF~ ;~~'S, ~~,11~T F;~, DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -lU'3~Q ACN 10116384 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a joint owner/beneficiary of this account. If you feel the inforwation is incorrect, Dlease obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-58 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice roust accowpany Account Balance 25 072 57 paywent to the Register of Wills. Make check " , . payable to Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to Tax 2 089 30 NOTE: If tax paywents are wade within three . , wonths of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential TBX Due 9 4.0 2 Any Inheritance Tax due will becowe delinquent nine wonths after the date of death. P T TAXPAYER RESPONSE a 1 A. ~ The above inforwation and tax due is correct. Rewit pageant 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 assesswent will be issued bg the PA Departwent 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. ~ Tha above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete 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 JDINT/TRUST ACCOUNTS 1 2 +~ 3 X 4 $ 5 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID 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. un ur ~ , BUREAU OF INDIVIDUAL TAXES PO BOX 28060 -'r-~('~f hG ~~ N ~ " HARRISBURG P -1~1~&-.~D1 • - - ,, ,,, i - ~~!„~ .4'~meV, 1543 EX AFP [OB-00) lC1~APR-5 P~ i~ 56 CLEft~t 'v~~ O~FNp'~'' ~' JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE ,_._ X FILE N0. 21 _~(}'~-(C.~ ACN 10116385 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 fora 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. 67691-58 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 25 ~ 072.57 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 8.333 u TAX RETURN - COMPUTATION LINE 1. Data Established 2. Account Balance 3. Percent Taxable 4. Amount Subjeet 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 Under penalties of perjury, I declare that the facts I have reported above arectrue, corre~c+t- anCd comple o the best of~m knowledge and belief. HOME Cs'Zl~) J~~"~\ \~ TAXPAYER SIGNATUf rOTAL (Enter on Line 5 of Tax Computation) 6 BUREAU OF INDIVIDUAL TA~(I;Se~ ~i _r PO BOX 280601 .,. ~ ,- HARRISBURG PA 17128 0601'„-, + 2010 APR -S P~f ;' QO CLERK r~,~ o~PNa,r~~~ cr~uRr {( tP rr-~-. ~ ~ ~^,I~ny ZELDA GODFREY 227 MOUNTAIN ROAD NEWVILLE PA 17241 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -~~-~vy,q ACN 10116386 DATE 03-17-2010 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. MEMBERS 1ST FCU provided the Department with the information below, which has bean 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 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 INSTRUCTIONS Account No. 67691-59 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance g 25, 054.15 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to Tax 2, 087.76 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due 9 3 . 9 5 Anv Inheritance Tax due will become delinquent nine months after the date of death. P~T 1 TAXPAYER RESPONSE CX 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 HECK 0 N E 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 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 relationship to decedent: __ a.:. ,,,, 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 DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PATH Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to t best of my knowledge and belief. HOME C ~7) ~~~,p ^~l oZS z WORK ( ) w X7.4 ~/ ~.'. ~.. i ,~:..~ .encar on Llna s or iax computation) 4 BUREAU OF INDIVIBIlAb ~A~6f`S-.., ~ PO BDX 280601 ~ _ ~~ ~ ARRISBURG PA 17}~.8 ¢601. PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE N0. 21 - ~~-c3-i ~t TAXPAYER RESPONSE ACN 10116387 " ~~t"'`' '-'? "' anfW43`IX11FPC08-oe~ DATE 03-17-2010 20(Q ~P(~ -S Phi E ~ S8 C~E~,~ r~ C ~~! ~~ ° ti ~~U;;.E ~ (^, , ~'~ - - -, ~~~, DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. MEMBERS 1ST FCU 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 Soint 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 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 INSTRUCTIONS Account No. 67691-59 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice must accompany AcCOUnt Balance 25 054 15 payment to the Register of Wills. Make check " , . payable to Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to Tax $ 2 087 76 NOTE, If tax payments are ^ada within three ' , . eonths of the decedent s date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential TaX DUe ~ 93.95 Any Inheritance Tax due will become delinquent nine eonths after the date of death. P T TAXPAYER RESPONSE a ~ ~,. , . ~~ A. ~,7he above information and tax duo is correct. Remit payment to the Register of Wills with two cop ies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of 0 N E BLOCK B Th b 0 N L Y . ~ e a ove asset has bean 11X~~~ or will be reported and tax Daid with the Pennsylvania Inheritance Tax return to be tiled by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or Wills and an official assessment will be issued by the PA Department of Revenue. PART 3~ 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 +fi PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported a/bove are true, correct and omplete to the best of my knowledge and belief. HOME CIv ~ ) ~ ~ v WORK C ) c7 ) J TA AYER SIGNATUR TELEPHONE NUMBER D TE TOTAL CEnter on Line 5 of Tax Computation) 6 BUREAU OF INDIVIDUAL TAXES PO BDX 280601 --`~-'~~'~~ ;''.rte HARRISBURG PA 17128-06 B1- -,t ~- . _ :,. ;~- --- - Z~lO A,°R -5 Pfd 1.56 CtE~~ r 'r ORf M,~ly ~ ~'~l j~i~ !~ ~ JANICE DAVIS 20551 N SANTA CRUZ DR MARICOPA AZ 85239 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU provided the Departwent with the information below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a ]Dint owner/beneficiary of this account. If you feel the infarwatian is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty 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. 67691-59 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice gust accowpany Account Balance 25, 054.15 Daywent to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 8.333 2, 087.76 NOTE: If tax paywents are wade within three Amount Subject to TeX 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 becowe delinquent Potential TeX Due ~ 93.95 nine months after the date of death. P~T TAXPAYER RESPONSE 1 ~#. , A. ~ The above information and tax due is correct. Rewit paywent 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 C ONE J Wills and an official assessment will be issued by the PA Departwent of Revenue. BLOCK B. ~~Q The above asset has bean or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY 7ff'-'mot' to be filed by the estate representative. C. ~ Tha above inforwa 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 Deduetlons 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 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true corre t complete to the ben//st of my knowledge and belief. HOME C~~~) ~~~ ~~ ~~ ~~/1Gl~t'~ ~VLL!/7~- WORK ( ) '~~IL7 • 1 ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE TAXPAYER RESPONSE ACN DATE No . 21 -10 -~vtl9' 10116388 03-17-2010 A TOTAL CEnter on Line 5 of Tax Computation) 4 BUREAU OF INDIVIDUAL TAXES ~~`~~ ~[~ ~ PO BOX 280601 HARRISBURG PA 17128-0601 ''~ ' ) j,~4 q•~' irk ?,rti i C~ . 4: t ~ -. niV-154~D( AFd'C06-~0!) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE TAXPAYER RESPONSE ACN DATE 10116389 03-17-2010 xafa apR -s ~r~ 2. o0 CLERIC 0~ aRPN.~~v~s cou~r CU~;~^~ ~ ~ ~„ ,~~~ p~, EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: ZELDA GODFREY REGISTER OF WILLS 227 MOUNTAIN ROAD 1 COURTHOUSE SQUARE NEWVILLE PA 17241 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. MEMBERS 1ST FCU Provided the Department with the information below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a ]oint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of .the Comwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-60 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice roust accomparry payment to the Register of Wills. Nake check Account Balance $ 25, 054.15 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are wade within three Amount Subject to Tax $ 2, 087.76 wonths 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 $ 93.95 nine wonths after the date of death. PART TAXPAYER RESPONSE A. ~ Tho above information and tax due is correct. Rawit paywent 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. C ONE BLOCK B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return D N L Y to be filed by the estate representative. C. ~ The above inforna eon 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 a 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 PART a DEBTS AND DEDUCTIONS CLAIMED Under penalties of perjury, I declare that the facts I have reported above are true//, correct and v-complete to\t he best o~j/my knowledge and belief. HOME C ~ ) CO " S oZ. r- ~X.D~ ~ .~) /~X'l ~ /~h_l ~ WORK C ) /1~ ~~.aJO c~z'~ / b OF TAX ON JOINT/TRUST ACCOUNTS 1 2 $ 3 X 4 $ 5 6 $ 7 X 8 $ DATE PAID PAYEE DESCRIPTION AMOUNT PAID BUREAU OF INDIVlEI AL TAXES PD sox 280601 i`r ~`-~ -"',~~. ('"i~=~ HARRISBURG PA 171YB~b6g1 '- `~ ~ ~ .; _ d.-~ _ i ~~ -v. ,~ my-1543 IX IIFP (OB-067 E0~0 APR -5 P~ i ~ S8 C~Ff~'.C (!' O~PH =I1 '~:1 ~ 1'~~T a' V C~k~"~~ ' trill ry~ DORIS BRAGAN 107 NORMAN DRIVE BOHEMIA NY 11716 EST. OF VIOLA M HARDING SSN 579-20-9770 DATE OF DEATH 03-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 infonation is incorrect, please obtain written correction fros 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 Pennrilvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS. Account No. 67691-60 Date 01-16-2009 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 25 ~ 054.15 payable to "Register of Wills, Agent". Percent Taxable X 8.333 NDTE: If tax paywents are made within three Amount Subject to Tax ~ 2, 087.76 months of the decedent's date of death, Tax Rate ~( .045 deduct a 5 percent discount on the tax dua. Any Inheritance Tax due will become delinquent Potential Tax Due $ 93.95 nine months after the date of death. P RT TAXPAYER RESPONSE A A. ~ The above information and tax due is correct. Resit 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 C 0 N E J Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK B. AQ The above asset has been or will be reported and tax Daid with the Pennrilvania Inheritance Tax return O 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 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 L_ 2 3 X 4 5 - 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, cCo_rrect and complete to the best of my knowledge and belief. HOME C ) ~~ 'C ~ ~O v WORK ( ) ~ ~ TAXPAYER SIGNAT E TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 "~ ~-~~~ ACN 10116390 DATE 03-17-2010 TOTAL (Enter on Line 5 of Tax Computation) 6 r"' r ?' .~. n. ~. ' 2r ' ~ ~. BUREAU OF INDIVIDUAL TAX~3F`:-~ - ' 1~ PO BOX 280601 ~- HARRISBURG PA 17128-0601 Ex AFr cae-oe~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21~~V~c~~q ACN 10116391 DATE 03-17-2010 (;~~'~,~~` fv,~ EST. OF VIOLA M HARDING ~~f~f-~,f;` ~ SSN 579-20-9770 ~ ~ ~~ ~ ~-~ ~~ ~f=.T C~~`! J" < '~ t , ;J~ }' r P~ DATE OF DEATH 03 - 05 - 2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: JANICE DAVIS REGISTER OF WILLS 20551 N SANTA CRUZ DR 1 COURTHOUSE SgUARE MARICOPA AZ 85239 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Department with the information below, which has bean 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 fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 67691-60 Date 01-16-2009 To ensure proper credit to the account, two Established copies of this notice must accompamr Account Balance 25, 054.15 payment to the Register of Wills. Make check Dayable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax Dayments are Wade within three Amount Subject to Tax ~ 2, 087.76 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. 9 3.9 5 Any Inheritance Tax due will become delinquent Potential TeX Due nine months after the date of death. P~T TAXPAYER RESPONSE 1 A. ~ The above inforeation 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 C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O N L Y a 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: x __ 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 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 tru/e, eorr ct d com lets to the b~ of my knowledge and belief. HOME C SZ o) ~/~ ~ ~ ~~~ WORK C ) 3 •34 • Icy TAXP ER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) $