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Home My WebLink About04-0206COMHONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF ZND/VIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-~ilS EX AFP INFORMATION NOTICE AND TAXPAYER RESPONSE FZLE NO. ACH 0q001908 DATE 02-26-200q GEORGE M SAVIDGE 101N :56TH ST CAMP HILL PA 17011 ~, !;~ST. OF RACHEL R SAVIDGE S.S. NO. lq8-0:5-586:5 DATE OF DEATH 06-0~-200:5 Ag-o~I~s?y CUNBERLAND TYPE OF ACCOUNT [~]SAVZNGS ~]CHECKIN~ ~ITRUST [~CERTIF. REHZT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701~ HEHBERS F]:RST FCU has pravidad the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at tho death of tho above decedent, you mare a joint oanar/benaficiary of this account. If you feel this information is incorrect, please obtain arittan correction from tho financial institution, attach a copy to this farm and return Jt to the above address. Thls account ~s taxable in accordance ~ith the /nheritance Tax La~s of the Common~ealth of Pennsylvania. Questions may be answered bY calling [717) 787-6~Z7. COHPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FZLZNG AND PAYHENT /NSTRUCT/ONS Accoun~ No. 17811:505 De~:e 10-21-2002 Established Accoun'l: Balance :51,6 79.76 Percent: Taxable X 50.000 Amoun'l: Subjec'~ ~o Tax 15,8:59,88 Tax Re~e X .15 PoSen,/al Tax Due 2,375.98 To insure proper credit to your account~ two (Z) copies of this notice must accompany your payment to the Register of Nills. Make check payable to: "Register of Nills, Agent". NOTE.: If tax payments ara made within three (5) months of the decadent's date of daath~ you may deduct a 5Z discount of tho tax due. Any inheritance tax due wiI1 become delinquent nine ¢9) months after the date of death. PART TAXPAYER RESPONSE A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with twa copies of this notice to obtain -- CHECK a discount or avoid interest, or you may check box "A" and return th[s notice to the Register of L ONE ~ Mills and an official assessment ~ill ba issued by the PA Department of Revenue. BLOCK] a. [] The above asset has been or ~ill ba reported and tax paid with the Pennsylvania inheritance Tax return ONLY to be filed by the dacadant's representative. C. [] The above information is incorrect and/or debts and deductions mere paid by you. You lust complete PART [] and/or PART [] baloa. PART If you ind~ca*e a differen* ~ax ra~e, please s~a*e your ~[[~[~~~~~ TAX RETURN - COHPUTAT/ON OF TAX ON JOINT/TRUST ACCOUNTS ~~~~~ LINE 1. Da~e Established 1, 2. Accoun~ Balance 2 3. Percen~ Taxable $ ~ ~. Amoun~ SubSec~ ~o Tax ~ 5. Debts and Deductions 5 6. Amoun~ Taxable 6 7. Tax Ra~e 7 ~ 8. Tax Due 8 PART DATE PAID DEIITS AND DEDUCTTONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne $ of Tax Computation) Under penalties of perjury, I declare ~he~ ~he fac~cs T have reported above ere ~:rue, correct: and complete ~o ~he bes~: of my knowledge and belief. HOME ( WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE COMMONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. HARRISBURG, PA 171Z&-0601 I ZNFORMATTON NOTICE AND TAXPAYER RESPONSE REV-1;¢iS EX AFP (gg-O0) FILE NO. 21-~~''~ ACN 04001906 DATE 0Z-26-2004 Rg[i!~::~,-: ,-~- ¥'~iI!s EST. OF RACHEL R SAVIDGE S.S. NO. 148-03-5863 DATE OF DEATH 06-04-2003 'C~, ~'~-2 ~9:58 COUNTY CUMBERLAND GEORGE M SAVIDGE 101N 36TH ST ~.. ~ CAMP HILL TYPE OF ACCOUNT [] SAVINGS [] CHECKING [] TRUST ] CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS FIRST FCU has provldad the Deportment with the infaraation 11sled below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this ~orm and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth =~ Ponnsy!v=ni=. O~cgt[ons may be answered by c=l!ing (7!7) 787-85~7. COMPLETE PART 1 BELON # # ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 17811311 Oe~e 10-21-2002 Es~abl 1shed Accoun~c Balance 13,805.20 Percent Taxable X 5 0 . 0 0 0 Amount: Sub~ec~: ~o Tax 6,902.60 Tax Ra~a X .15 Po*and:ia1 Tax Due 1,035.39 To insure proper credit to your account, two (g) copies of this notice must accompany your payment to the Register of Mills. Make check payable to: "Register of Hills, Agent". NOTE: If tax payments are made within three (3) months of the decadsnt's date af death, you may deduct a 5Z discount of tho tax due. Any inheritance tax duo will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills with too copies of this notice to obtain -- CHECK a discount or avoid interest, or you may check box "A" and return this notice to tho Register of L ONE -~ Hllls and an official assessment will bo issued by the PA Department of Revenue. BLOCK s. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to bo filed by the decedent's representative. C. [] The above information is incorrect and/er debts and deductions were paid by you. You must complete PART [] and/or PART [] below. PART If you indicate a different tax rata, please s~:ate your ~!i!!!i~!~!!~!!!!!!!~!!!~!~!!!~!~!~!!!i~i!a~~[iiii~iiiii~iiiiiiiii~ii~!!! TAX RETURN - COMPUTATION OF TAX ON dOINT/TRUST ACCOUNTS ~!!~i~i~!!~!~!~!~!~!~!~!~!~!~!!!!!!!!!!!!!!![!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! LINE 1. Da~a Established 1 2. Accoun~ BaZanca 2. 3. Parcan~ Taxable 3 ~ q. Aaoun~ SubSac~ ~o Tax q S. Debts and Deductions $ - 6. Amoun~ Taxable 6 7. Tax Re~a 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne .; of Tax Coepu~a~Aon) $ Under penalties of parSury, Z declare ~ha~ ~ha fac~s I have reported above ara true, correc~ and coaple~:e 4:0 ~:he bas~: of my knowledge and belief. HOME ( ) ~ORK ( ) TAXPAYER STGNATURE TELEPHONE NUMBER DATE CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171ZB-0601 J ZNFORHATZON NOTTCE AND TAXPAYER RESPONSE RE¥-1~4S EX &FP (09-00) '04 R-2 FZLE NO. Zl--~z/L,~~ ACN 0q001905 DATE 02-26-200q EST. OF RACHEL R SAVIDGE S.S. NO. 1~8-05-5865 n:flq TE OF DEATH 06-0 -Z005 COUNTY CUMBERLAND TYPE OF ACCOUNT [] SAVINGS [] CHECKING [] TRUST [] CERTTF. REHIT PAYHENT AND FORMS TO: REGISTER OF WILLS GEORGE SAVIDGE ~i~',: -. '-~.': 3q52 BEDFORD DR ~' ' ~-;-:, CAMP HILL PA 17011CUI~-L=i:~':~ ..... ~' ': CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 MEMBERS FIRST FCU has provlded the Department with the information listed below whlch has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint Donor/beneficiary af this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance Hith the Inheritance Tax Laws of the Comaon~ealth of Pennsylvania. Oue~tions may be anchored by cai ] Jng f717) 787-8~27. COMPLETE PART I BELOW ~ # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun* No. 17811511 Oa~a 10-21-2002 Es~abllshad Accoun~ Balance 15,805.20 Percent: Taxable X 5 0.0 0 0 Amoun~ Subjac~ ~o Tax 6,902.60 Tax Ra*a X .1Z Po~an~ial Tax Due 8Z8.51 To insure proper credit to your account, tho (Z) copies of this notice must accompany your payment to the Register of Wills. Hake check payable to: "Register of Hills, Agent". NOTE: If tax payments are made aithin three (3) months of the decsdent's date of death, you may deduct a 5Z discount o~ the tax due. Any inheritance tax due ail1 become delinquent nine (9) months after the date of death. CHECK ONE BLOCK ONLY A. ~-~ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills Hith two copies of this notice to obtain a discount or avoid interest, or you amy check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue· B. ~ The above asset has been or mill be reported and tax paid aith the PennsyZvania Inheritance Tax return to be filed by the decedent's representative. C. D The above information is incorrect and/or debts and deductions mere paid by you. You must complete PART F~ and/or PART ~ beloH. PART If you indicate a d$ffaran~ ~ax ra~e, please s~a~a your relationship ~o decadence: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LZNE 1. Da~a Established I 2. Accoun{ Balance Z 3. Parcan~ Taxable 3 ~ q. Amoun~ Subjac{ to Tax q 5. Dab~s and Deductions S - 6. Amoun~ Taxable 6 7. Tax Ra~a 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTZONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on LAne $ of Tax Compumat:ion) $ Under penalties of perjury, I declare ~ha* ~:he fac~s I have rapor*ed above are ~rua, corrac~ and coepla~:a ~o ~:ha bes~: of my knowledge and belief. HOME ( ) WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1712B-0601 REV-IS~5 EX AFP (09-00) ZNFORMATZON NOTICE AND TAXPAYER RESPONSE FILE NO. ~1--~/-~ ~ ACH 0q001907 DATE 02-26-200q GEORGE SAVIDGE Sq3Z BEDFORD DR CAMP HILL PA 17011 ~.S~3, OF RACHEL R SAVIDGE S.S. NO. lq8-05-5865 DATE Q.F DEATH 06-0q-2003 C~7 CUHBERLANO TYPE OF ACCOUNT []SAV/NGS [~CHEC~INO D TRUST ~-]CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS FTRST FCU has provided the Department with the information 11sted below whlch has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. Tf you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8527. COMPLETE PART 1 BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 17811305 Date 10-Z1-2002 Es~cablished Accoun~ Balance 31,679.76 Percen~ Taxable X 5 0.0 0 0 Amoun~ Subjec~ ~o Tax 15,839.88 Tax Ra{e X .12 Po~en~ial Tax Due 1,900.79 To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Mills. Hake check payable to: "Register of Hills, Agent". NOTE: If tax payments are made within three (5) months of the decedent's date of doeth, you may deduct a 5Z discount of the tax due. Any inheritance tax due will became delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. 1. You may choose to remit payment to the Register of MiLls with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of CHECK -q Hills and an official assessment will be issued by the PA Department of Revenue. ONE BLOCK B. [] The above asset has been or will be reported and tax pald with the Pennsylvania Inheritance Tax return ONLY to be filed by the decedent's representative. ~ The above information is incorrect and/or debts and deductions ware paid by C. you. You must complete PART ZI~ and/or PART 5[~ below. TAX RETURN LINE 1. Da~a Established 1 2. Accoun~ Balance 2 3. Percen~ Taxable q. Amoun~ Subjec~ ~o Tax 5. Debts and Deductions 6. Aeoun~ Taxable 7. Tax Ra~e 7 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/nm $ of Tax Compu~:a~ion) Under penalties of perjur:y, ! declare ~he~ ~he facts I have reported above ara ~rua, correc~ and complete ~o the bes~ of my knowledge end belief. HOME ( WORK ( TAXPAYER SIGNATURE TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003623 SAVIDGE GEORGE M 101 NORTH 36TH ST CAMP HILL, PA 17011 ESTATE INFORMATION: SSN.' 148-03-5863 FILE NUMBER: 2104-0206 DECEDENT NAME: SAVIDGE RACHEL R DATE OF PAYMENT: 03/02/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/04/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04001905 $828.31 04001907 $ 1,900.79 REMARKS: THOMAS SAVIDGE TOTAL AMOUNT PAID: $2,729.10 SEAL CHECK# 216 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA " DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28O601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96 CD 003622 SAVIDGE GEORGE M 101 NORTH 36TH ST CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 148-03-5863 FILE NUMBER: 2104-0206 DECEDENT NAME: SAVIDGE RACHEL R DATE OF PAYMENT: 03/02/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 06/04/2003 REMARKS: ACN ASSESSMENT CONTROL NUMBER AMOUNT 04001908 $2,375.98 04001906 $1,035.39 TOTAL AMOUNT PAID' $3,411.37 GEORGE M SAVIDGE SEAL CHECK# 215 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '*' BUREAU OF INOIVIOUA~-::Wlj$GED INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 171Z8-0601 r"'r ljr NOTICE OF INHERITANCE TAX :' ': : ,^PPRAISEHENT. ALLOHANCE OR OISALLOHANCE . <OF DEDUCTION~J AND ASSESSKENT OF TAX ON JOINTLY NELO OR TRUST ASSETS REY-1548EXAFPIl2-D4l LOD5 ..L~J! 2t~ fJ1 8: 20 GEORGE CiJ;AviDGE 3432 BEDFORD DR CAMP HILL PA 17011 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 01-25-2005 SAVIDGE 06-04-2003 21 04-0206 CUMBERLAND 148-03-5863 04001907 RACHEL R Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUM8ERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... Rifv=isiri-Ex--AFP--roi-:oij------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 01-25-2005 ESTATE OF SAVIDGE RACHEL R DATE OF DEATH 06-04-2003 COUNTY CUMBERLAND FILE NO. 21 04-0206 TAX RETURN WAS: S.S/D.C. NO. 148-03-5863 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04001907 FINANCIAL INSTITUTION: MEMBERS FIRST FCU ACCOUNT NO. 17811305 TYPE OF ACCOUNT: (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-21-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X 31, 679.76 0.500 15,839.88 .00 15,839.88 .12 1,900.79 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-02-2004 CD003623 .00 1,900.79 TOTAL TAX CREDIT 1,900.79 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I "V--s."-. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' r,-(\.........,r',.-:-, ('''-'-'/"'0'- n,r BUREAU OF INDIVIDUAL TAXEjb)~;!~I_.t'_: ',);-'--;',~.[: 'urNOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION ~PR.J:SEI'lENT 1. ALLONANCE OR DISALLONANCE PO BOX 'BOO" OI'DeoUCTION~, AND ASSESSRENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS REV-1548EX AF' U2-D4) ?n'o" I~'J ')1 ....U.' j ... i~,,'j L". "" 8' 00 hi!". '" DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 01-25-2005 SAVIDGE 06-04-2003 21 04-0206 CUMBERLAND 148-03-5863 04001905 Allount Re..itted RACHEL R CLEf:!( ORFi!,"i' GEORGE SAUIDGE 3432 BEDFORD DR CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE __ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-v=is4-i-Eif-AFP--roi-=oil------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 01-25-2005 ESTATE OF SAVIDGE RACHEL R DATE OF DEATH 06-04-2003 COUNTY CUMBERLAND FILE NO. 21 04-0206 TAX RETURN WAS: S.S/D.C. NO. 148-03-5863 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04001905 FINANCIAL INSTITUTION: MEMBERS FIRST FCU ACCOUNT NO. 17811311 TYPE OF ACCOUNT: () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-21-2002 x 13,805.20 0.500 6,902.60 .00 6,902.60 .12 828.31 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-02-2004 CD003623 .00 828.31 TOTAL TAX CREDIT 828.31 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYRENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YDU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I <,L ~-, BUREAU OF INDIVIDUAL ,11~~r INHERITANCE TAX DIVISION PO BOX Z8D60l HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (}?CE C::= NOTICE OF INHERITANCE TAX ",APPRAISEIlENT. ALLOWANCE OR DISALLOHANCE , "OF DEDUCTION~, AND ASSESSIlENT OF TAX ON JOINTLY HELD OR TRUST ASSETS * REV-1548 EX ~FP <l2-04l ?ODC 11"?[ LU'J'] Vi-d'j Co. '~ {'" q.. '/0 :';i U L. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 01-25-2005 SAVIDGE 06-04-2003 21 04-0206 CUMBERLAND 148-03-5863 04001908 Allount Re..itted RACHEL R CLE~;!< (Jor-I.:";","'\ ,...:Ii-I-,,",o.I:' GEORGE MC~AVfDGE' 101 N 36TH ST CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ___ RETAIN LOWER PORTION FOR YOUR RECORDS ... Rifv=isiri-Ex--AFP--roi-=oij------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 01-25-2005 ESTATE OF SAVIDGE RACHEL R DATE OF DEATH 06-04-2003 COUNTY CUMBERLAND FILE NO. 21 04-0206 TAX RETURN WAS: S.S/D.C. NO. 148-03-5863 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04001908 FINANCIAL INSTITUTION: MEMBERS FIRST FCU ACCOUNT NO. 17811305 TYPE OF ACCOUNT: DATE ESTABLISHED (Xl SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE 10-21-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 31,679.76 0.500 15,839.88 .00 15,839.88 .15 2,375.98 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-02-2004 CD003622 .00 2,375.98 TOTAL TAX CREDIT 2,375.98 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS OATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIP' ( CRl" YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) ,-"- <;>...~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~~':~~~AN~~ :A~D~~v~~~:NL fiAffiCDF:~: :).:;-:'rCt'~.'bRAIS~~~A~~ ~rL~C:~~~T~:cgI~t~LOIfANCE PO BOX Z80601', ' 'Of DEDUCTION::;" AND ASSESS"ENT OF TAX ON HARRISBURG PA 17128-0601 -- JOINTLY HELD OR TRUST ASSETS * REY-lS48 EX lFP <12-04) 20D" J.\\I ,.,. '. . J i.;i~ Ll.t '" ('). "'0 HII C). t... DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 01-25-2005 SAVIDGE 06-04-2003 21 04-0206 CUMBERLAND 148-03-5863 04001906 Allount Rellitted RACHEL R CLERi<, ORF:..:.." GEORGE M)~AVIDGl: 101 N 36TH ST CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... RE-V:iS4-i-Ex--AFP--lol-:03i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 01-25-2005 ESTATE OF SAVIDGE RACHEL R DATE OF DEATH 06-04-2003 COUNTY CUMBERLAND FILE NO. 21 04-0206 TAX RETURN WAS: S.S/D.C. NO. 148-03-5863 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04001906 FINANCIAL INSTITUTION: MEMBERS FIRST FCU ACCOUNT NO. 17811311 TYPE OF ACCOUNT: () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-21-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 13,805.20 0.500 6,902.60 .00 6,902.60 .15 1,035.39 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK DR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-02-2004 CD003622 .00 1,035.39 TOTAL TAX CREDIT 1,035.39 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATIDN OF ADDITIDNAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J ~c",'L