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Home My WebLink About08-16-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: FLUEVOG JEAN 125 PARKVIEW LANSING, KS 66043 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EXt11-96) N0. CD 013208 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ESTATE INFORMATION: SSN: 206-24-8892 FILE NUMBER: 2110-0837 DECEDENT NAME: FLUEVOG JANET DATE OF PAYMENT: 08/ 1 6/ 2010 POSTMARK DATE: 08/ 1 2/2010 COUNTY: CUMBERLAND DATE OF DEATH: 05/ 29/ 2010 101 ~ $499.60 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 8250 $499.60 INITIALS: DM RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ._ .. _ ,J, ,. ,. , 9 August 2010 ~'~~ 1 r ~ d ~~ ~~ pry Register of Wills r-- r CL.Er: 1 Courthouse Square C~F?' ' ~` `. j„ ~` r,,~, ~~T ~. Carlisle, PA 17013 ~~-' ~ ~ ~ '= = ~' ~ ~ ~~~ ~ {~~ ~, ,. , ;-., RE: Inheritance Tax Notices dated 17 June 2010 Enclosed are six Inheritance Tax Notices and the requested payment of taxes due in connection with the estate of Janet Fluevog who died on 29 May 2010. As these taxes are being paid within 3 months of my mother's death, I have deducted the allowable 5% discount and have- enclosed a total of $499.60 in payment of taxes due as follows: ANC Amount Due 10133432 $38.17 10133434 $150.63 10133424 $21.41 10133428 $307.89 10133426 $4.20 10133430 $3.59 $525.89 5% discount - $26.29 Total $499.60 If there are any issues associated with this filing, please contact me at 913-683-8389 or by e-mail at jean.fluevog@us.army.mil ~ ~ ;~ fr` ~.'.. .~ '' ~ ~ G. Jean Fluev~g 25 Parkview Co Lansing, KS 66043 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PO BOX 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REY-1543 EX AFP COB-08) FILE N0. 21 - ~L --`~~'j ACN 10133430 DATE 06-17-2010 JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 Cortimonwealth of Pennsylvania. Please call (7173 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCII'IONS Account No. 73374 - 11 Date 08 - 18 - 1987 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 478.44 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $ 79.74 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. Any Inheritance Tax due will become delinquent Potential Tax Due $ 3.59 nine months after the date of death. PART TAXPAYER RESPONSE 1 ~ ::........................::::.:::::.......:::::.... :A:I~.UR TO ~E.:::~.L U.T IN AN.....~FI::I:~. "~`:AX ASEMEN.~": ............::::.:..........::::.:..:. 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 H E C K 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 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 information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. A RT 2 f ' I in ' dica ' tin a d' iffe ren t 9 elationshi to d o x ra to le ase sta to P . :..... .::..::.:::...:.::..:..:..:::::: , .... TA X R E TU R `,'>~'`. - N C OMPU T ATIO N 0 F X 0 N JO INT/ TRU ST ACC OU NTS 1. Date Established 1 : ,:::::::::,.:,: : `i ,:;r.. ~~I f 2. Acc oun t B alanc e 2 $ ;r '[i'< i><`<':.<``'''s>'af''f'`' '`> ':~<'<!~al>~i~<>~>:`€~'~>::;a's's`>~':`i`<'`':s[>>[':<f>':' . Percent Taxable 3 ............ Amo unt Sub - ect to Ta 7 x 4 $ ::::.. ~ f~~~ ~ a~, 5. Deb is and Dedu cti ons 5 - ~><`'?>''>'z''~` <%'><?t`~~``?`<>~~`>a'~s ~'''z»>~~ `fir:>'z' '' s~.~,.rw w. wV. r ~ 6. Amo un t T axab le 6 ~ , ,..! * ,~ 7. Tax Rat e 7 X ili~ifi filf~~!!l ~~I}~wii .P dif111A~{ 1'{ -r„~.,~~ PART DEBTS AND DEDUCTIONS CLAIMED DATE P AID PAYEE DESCRIPTION nMniiNr peTn ~~~.,~ •~n~er on pine 5 or iax computation) $ Under pen 'es of 'ury, I declare that the facts I have reported above are true, correct and complet a of my knowledge and belief . HOME C ~j~/ ~ ) ~i ~y} ~`'~.~~'`%' ...,.' WORK C ~~~) ~~~ ~w ~,°..~ ~~~• c ~Z.1 TAXP YER G ATU, TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PO BOX 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-OB) FILE N0. 21 ~ ~(~ _~~~~ ACN 10133430 DATE 06-17-2010 JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 :717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS ;:.,.::.;::::.. :: ::.::.::.::.:::.....:::.:;:::::.;.....;... .;...:.....::::::.. s..: :::..:.::nom .:.::.:.d } nn....:. n::.... u 4ii:!.i:n(.: is ni;. ii y:4v.: ry~f:,.:':,:oib:::: ij~i.`i rr;> h ::: ~} ?' .: z>' .r.,,. ...:::::i?iii';.. n..::i:ii:. ...... :. .:...:. :•:T::.~}fjq[, F :::, r~.,.',..:. l~.:l:.:. .. ii~( C i:.i:<.i::..:::.:.ii:.i>:.i::<::::;:ii:.i.::::;::..ii:::,:.:.:.;::;i:::::::<i;i:,lr,: is /~:'l:: ~: Y~ U T .::..::. :.:................ . ............ . : :::: ..:.'; :::::. ~:::;o:i :.:. ::. .i • ..:.:.::l..i. : ::. ~::::.:::::.i ~:::.>.:. ~ :::.:...: ..:....... TA - X R ETU ...: y. ~::: iiy . .. ....:.......:......... ATIO N 0 F T AX ON JO IN T/T RUS T AC COU NTS II II ~µ ::. ~::::: Ii' Y li ;::;:;.i.>i:.t ci;:;:; ,`::..;.i %:Yi :i::%;::^::>:4:i:ij;#::: ~' I I III Ijjl I Illllil(I p~}~ Est ;,~.• ;~:<:,~: LI ate s<~%<`r NE 1. D ishe d 1 2. Acc oun $ <<>j t Ba lance f ~,.:.<, 2 ~~; ~~v.~ ~~~ ~, .:•,, <.•..f. 3. P X nt T axa ble 3 •,:f Krw~t++ww~f4rrri~iil4W~:~ii'i,:: , ~-+f ::, .:•~: 4. Amou nt $ Sub 'ect to 4 .: ,,; •.~:i t s j;;;,, 5. Deb and Dedu cti ons 5 ::< ~f ~: ~:::' ~yr~: $ 6. ount Ta xab le 6 .::.,::. a<~ s:> ~.~F ...::.: <.;:.i is ;:.:.:. r ~..: 7. T ax Ra e X °'~:..:. 7 ~`~< ............... ,.: :,..::, ::: :~€:, ><~ :::::::::::..v; +4:r 8. y(I :.~:. ~:::. ~:::: ii ~::.:: ynp.,~{::: l T ax D ue $ 8 'TY!":`:`%`;:~;';<. ~: '~`:'{'iii:?~~i l~~~;': ;{'i: '% 7~( :.f . :ri(~MYifihi4iiif~Yl~iii+i~+{ii~iiy~i . :,~.r; :s:::: PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT Pern Under n ties o come fr6"t~he~ Jd TA PAYER ~~SI NATUR rjury, I declare that the facts I have reported above are true, correct and of my knowledge and belief . HOME C ~7~~ ~ ~~~~,~fCi `~ WORK c ~'~ ~ ~ 7(~~~ v~r~'~; Cam,/~,~ TELEPHONE NUMBER DATE iuiw~ itnter on a ne 5 of Tax Computation) S „ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PD Box 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-n8) FILE N 0. 21 -- ~ (; ~° ''~ ~j'~ ACN 10133426 DATE 06-17-2010 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 MEMBERS 1ST FCU provided the Department with the information below, which has been used inn 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 Cornmonwealth of Pennsylvania. Please call (7I7) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 73373-11 Date 08-19-1987 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 560.54 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $ NOTE: If tax payments are made within three 93.43 months of the decedent's dalte of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Potential Tax Due Any Inheritance Tax due will become delinquent 4 • 2 0 nine months after the date of death. PART TAXPAYER RESPONSE 1 ~ ::::::::::.::::.::::.:::::.:.:.:::.:.::.:..:.::::.:.............................................. ;~k;LE "~`D ~~DNI~::.<:::;.~... ~EUL~`:::<»,I::N. AN ~3F.F'.I.~. ......:..........................:.:.............:...................::.:.::::.......................................:. ,..:................................::::::.....................................::N.E.N.T. ................. . ........................ ................................................. 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. 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 PA RT 2~ and/or PART ~ below. P ART If " in " dic ati n a d iffe re nt 9 lationsh t d d t x rat e lea se state P :::::... .... :::;.:: :.: ;:.:... : ::..:: ~~ `` »:. : AA 2 i o ece t. .:::< : ~.... .. .. TA X - RET UR N OF T AX N JO IN T/ 1' . TRUS T ACCO U NTS . f LIN E 1 ate stab fished R } I~ l ~~ :.: .:.:::.:..a,;,,. /.::..., :h..:~ :.~ .•:.v:.::::::.:::.~:::::.::.: ~>:;<.>:<::::: ::.:f,,. +..::. s<s:<> ;,'~F~ .~r . un t B ala n c e ~? ,,:+< .. :..rs' r.:i : <; .:.:.::.._~: "s.> ::..:,. ;~<> ++•,: 3. e rce nt Ta xab le 3 X >..: ::.,.,: :~:j» ::::::;..: {::<: ,'~:i>;r ~ " 4. A mou nt S ub t t 0 7 Tax 4 ~, - „~ .. . f 5. Deb is and De duc t ions 5 - .;:. 6. A mou nt Tax ab 1 e 6 •,«..> .~~~ :e./?:`• + • x Rat e 7 X ............... oa:. ~:. ~::::::: ....:. ~:. ~::::. ~: '#5;r 8rk.'~ .::Y:. ~~"::::.: r:.:...: + F~:%i~~ . /: ,:., .'G:i: `~f< :~: :.:rf . .: F:::::::::.. : r ::.....::: :..':.:::'f:n ..~%.` :::. •. •: r ~ rr ::.~.:.:~:G:r .. ."r ..:fir,r ' f'3if " ' " . T ax Due 8 I ..:.. I i IIY el li IIII I it fill II~Ili(III i Il~1 :.,.,:.r.::... . <~<««<:< ~. PART DEBTS AND DEDUCTIONS CLAIMED DATE P AID PAYEE DESCRIPTION eMniiNT aern Under Pena s of perj complete th~st~aF ~ ~ AXP YER SIG AT E I declare that the facts I have reported above are true, correct and knowledge and belief. HOME (~la~) ~'~%~~1~~"` ' WORK C l~~) TES ~~~~'~'"g TELEPHONE NUMBER / ~~ 2~ DATE ~~~.,~ •cn~er on amine 5 or iax computation) $ a. . PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PD Box 2so6o1 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP COB-OB) FILE N0. 21 ` (~ ` ~~'~ ACN 10133426 DATE 06-17-2010 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 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 zi 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 Under pens s o per complete the AXPAY SIGNAT RE ~'S/, I declare that the facts I have reported above are true, correct and my knowledge and belief . HOME ( ~~~) L~~~';;3~-~~~'_`,~ y _ ~''~' WORK ( yl"~ ) /~.S~a~ f''ti~~ ~~~ ,r TELEPHON NUMBER A E _ ,r/ iuiA~ ctnLer on Line 5 of Tax Computation) $ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PD Box 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-08) F I L E N 0. 21 -~ ~• ~~~'~ ACN 10133428 DATE 06-17-2010 JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 F CU 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 ai 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 C727) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Under penalt' of p rj r , declare that the facts I have reported above are true, correct and complete to e b t~of knowledge and belief . HOME C ll~ ~ ~c'~7}~~,i,,~~'r~ .~ ~-' WORK ( / ) ,7~~ ~~J~,'~~~ XPAYER SIGNA R TELEPHONE NUMBER ~ ~~ ,~~-~ DATE r";; ~'~ IUIHL ~tnter on Line 5 of Tax Computation) $ PENNSYLVANIA INHERITANCE TAX ' INFORMATION NOTICE ' BUREAU OF INDIVIDUAL TAXES A N D PD Box 2so6o1 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP C08-08) JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 FILE N0. 21 - Jc~ ~~ ~S~ ) ACN 10133428 DATE 06-17-2010 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 copv 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. Phase call C717) 787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 73374 - 00 Date 08 - 17 - 1 987 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 ~` 41 ~ 051.22 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax yr` 6 ~ 842 . O1 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 $ 307.89 nine months after the date of death. PART TAXPAYER RESPONSE 1 ^ ....... %,;~ ~ TOTAL CEnter on Line 5 of Tax Computation) S Under pe ties of "ury, I declare that the facts I have reported above are true, correct and complet to t of my knowledge and belief. ~'~" HOME C y/~ )l~`' ~~_~~'~~' TAXPA~'ER SIGNA URE TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PD sox zso6al TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-OB) FILE N0. 21 -- ~~ ~`~ ~-~ ACN 10133424 DATE 06-17-2010 JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 F CU 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 :717) 787-8327 with questi3ns. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Under penal complete tq TAXPAYER/ SIGNd'rU I declare that the facts I have reported above are true, correct and knowledge and belief . HOME C f~' !~ ) LP. ~'~~~~_ TELEPHONE NUMBER DATE ~i ~.., ~ ~ ~.,~ ~~nLer on pine 5 or i ax Computation) $ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box 2so6ol TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (08-OB) JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 FILE N0. 21 - ~ V ~ ~t~a~) ACN 10133424 DATE 06-17-2010 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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/benefic:iary 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 Coimmonwealth of Pennsylvania. Please call C717) 787-832T with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 73373-00 Date 08-17-1978 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 2, 854 . $5 payment to the Register of Wills. Make check " payable to Register of Willls, Agent". Percent Taxable X 16 .667 Amount Subject to Tax $ 475 .82 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 '~ 21 ' 41 Any Inheritance Tax due will become delinquent nine months after the date of death. PART 1 :::::.:.:.::.:.:.:..:::::.....::. :::..::.:. ;.:.:.:::.....::.:.: TAXPAYER .:.:::::::::::::.::::::.:.:.::::::::..:.................... RESPONSE .... Under penaltie~`,~f per complete to t be ~~l .,$ TAXPAYER GNAT E 3/declare that the facts I have reported above are t~~raue, correct and nowledge and belief . HOME ( f ~,~ ~~%~?~~~ WORK (~~ ' ) ~`~ ci' ,, ~~ TELEPHON NU BER DATE 1~~ \CIILCI V11 amine ~ or tax computation) $ ~ ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-OB) FILE N0. 21 - ~ U - ~~_~ ACN 10133432 DATE 06-17-2010 JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 zi 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 Pernsvlva~ia. Please call C717) 787-8321 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Under penal complete to AYE,R SIGN7~TU'RE r~, I declare that the facts I have reported above are true, correct and my knowledge and belief. '-^" HOME C ~ ~,~ ) ~''E``.',,?~~%~3c~`,';> TELEPHONE NUMBER DATE ~ / ~uit+~ ~tnter on ~lne 5 of Tax Computation) ~ ,L, ,, PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box zao6ol TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AfP (08-OS) FILE N0. 21-1~~~E?) ACN 10133432 DATE 06-17-2010 JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 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 Pernsylve~ia. ?lease call (717) 787-8327 with questiuns. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 73374-42 Date 08-17-1987 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $- 5 ~ 089 .86 payment to the Register of Wills. Make check payable to Register of Wills Agent" Percent Taxable X 16 .667 , . Amount Subject to Tax 8 4 8 • 3 3 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 $ 3 8 • 1 7 Any Inheritance Tax due will become delinquent nine months after the date of death. PART 1 TAXPAYER RESPONSE ',,-'~;% TOTAL CEnter on Line 5 of Tax Computation) S Under pena•l,~~g~'~ of perj complete ~p-'fthe b~sl~~ TAXPAYf'k SIGPATU I declare that the facts I have reported above are true, correc~tt and knowledge and belief . HOME ~~~) ll~ ~~~~i / TELEPHON NUMBER DATE PENNSYLVANIA INHERITANCE TAX . INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po sox z8o6oi TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-08) FILE N0. 21 -~(~~ - '`s~~ ACN 10133434 DATE 06-17-2010 JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 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 F CU 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 Cortimonwealth of Pennsylvania. Please call C717; 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS ~~~.,~ .~n~er vn uine 5 or iax l:omputation) S Under pena s of per' r ', I declare that the facts I have reported above are true, correct and complete th s y knowledge and belief. HOME C ~/~~~ !~~ ~~~~%,~~'~'~- ~ -'` WORK C l ~ S~GsF~.~_~ 1 ~ ~: TAXPA ER SIGNA URE TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX ., , . INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PD Box z8o6o1 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP COB-OB) EST. OF JANET FLUEVOG SSN 206-24-8892 DATE OF DEATH 05-29-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE 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/beneficiiary 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 gall t7I7) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Under pena 'es of perj y I declare that the facts I have reported above are true, correct and completel o th s knowledge and belief . HOME C ~/~) ~~~~~~~~~~ XP YER SIGNAT RE TELEPHONE NUMBER DATE JEAN FLUEVOG 125 PARKVIEW LANSING KS 66043 FILE N0. 21 - ~ (; .- `~~~ ACN 10133434 DATE 06-17-2010 IUTAL ctnter on Line 5 of Tax Computation) $