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HomeMy WebLinkAbout09-13-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: BENNETT BETTY E 7006 SUNDAYS LANE FREDRICK, MD 21702 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssly: ~ 72-~ s-~ 751 FILE NUMBER: 21 10-0872 DECEDENT NAME: LEE GUST ROBERT DATE OF PAYMENT: 09/ 13/2010 POSTMARK DATE: 09/ 13/2010 COUNTY: CUMBERLAND DATE OF DEATH: 08/05/2010 ACN ASSESSMENT CONTROL NUMBER REV-1162 EX(11-96) N0. CD 013341 AMOUNT 10145343 ~ $35.70 10145344 ~ $447.92 10145346 ~ $318.33 10145348 ~ $219.78 10145350 ~ $27.16 10145351 ~ $5.93 10145353 ~ $12.79 10145360 ~ $43.79 TOTAL AMOUNT PAID: REMARKS: $'1,111.40 CHECK# 3605 INITIALS: HMW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYL~"ANI/'A INHERITANCE TAX • r INFI,IF;MA1'ION NOTICE BUREAU OF INDIVIDUAL TAXES AND F I L E NO. 21 -~Q ~ ~'~?~ Po Box 2BO6o1 TA~;PAYE:R RESPONSE ACN 10145343 HARRISBURG PA 17128-0601 DATE 08-18-2010 REV-1543 EX AFP (OB-OB) TYPE OF ACCOUNT f:ST. OF GUST LEE ® SAVINGS SSN 172- 18- 1751 ~ CHECKING DATE OF DEATH 08-05-2010 ~ TRUST ~ COUNTY CUMBERLAND ~ CERTIF. (. ~. (;,~ ~,~-, '--- REMIT PAYMENT AND FORMS T0: f'; :: SETT ~.~,B~INETT REGISTER OF WILLS ~';-- a-:3006~UNDAI~~ANE 1 COURTHOUSE SQUARE {ti :, _ FREI~RICI~~~:;~`:, MD 21702 CARLISLE PA 17013 ~`a_ ...~ M ~ 0- L.: ~~'E'R~S 1ST~U ~~-~-^~~ ~, provided the Department with the information below, which has been used in calculating the potehtial tax Recor`rlS,~dicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you feel tl~'information~i3 incorrect, please obtain written correct;ion from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordaince with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call i7I'7) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE F=CIR F:[LING AND PAYMENT INSTRUCTIONS Account No . 50 195 - 0 0 Date 12 - 0 i~ - 1972 To ensure proper credit to the account, two Established copies of this notice must: accompany Account Balance $ 1 , 665.1 1 payment to the Register of Wills. Make check __ payable to 'Register of Wills, Agent". Percent Taxable X 50..000 Amount Subject to Tax ~''~ NOTE: If tax payments area made within three 1 `~,' $ 832 • 56 months of the decedent's date of death, Tax Rate r~, r~ ~ X . 045 deduct a 5 percent discount on the tax due. Potential Tax Due `' $ -' Any Inheritance Tax due will become delinquent 3 7 • 4 7 nine months after the date of death. PART TAXPAYER RESPONSE F~IL1~ItE T'p, RESPi~NtJ WII..L RESl~LT IN" AN 4FFICI~. TAX ASSESSl4ENT A. ~fhe above information and tax due is correct. IL~JI 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 ciheck boy: "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 debt:s and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state \ relationship to decedent: _ OFFICIAL USE ©~~Y ... '~~, AA~~~ PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ ~ 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ ~ 7. Tax Rate 7 X 7 8. Tax Due g $ $ rnrti DATE PAID UtlslS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMf111A1T DATTt Under penalties of perjury, I declare that the facts I have reported above are true, correct and tom lete to the b st ,qf my knowledge and belief. - _ x. HOME C~D ~ ) 3 Cam- ~ `~~ r _ ~ ~~~ WF6~RiE-- C~d ~ , t~,C p ~.- ~ C~ L~ r~ PAYER GNATURE TELEPHONE NUMBER DATE ~..~ \CIIICI V(1 amine ~ or lax computation) $ _ ~ • ~ ~, PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21•~,(~~G~~7~ PD Box 2BO6o1 TAXPAYER RESPONSE ACN 10145344 HARRISBURG PA 17128-0601 DATE 08-18-2010 REV-1543 EX AFP (OB-08) TYPE OF ACCOUNT EST. OF GUST LEE ^ SAVINGS SSN 172-18-1751 ^ CHECKING DATE OF DEATH 08-05-2010 ^ TRUST COUNTY CUMBERLAND ~~ _~ Q CERTIF. REMIT PAYMENT AND FDRMS T0: `~ ~ ~ _;; !7j ~1 BETTY BENNETT REGISTER OF WILLS f~i ~ ~ `~- ~ _~~ 7006 SUNDAYS LANE 1 COURTHOUSE SQUARE ' ~` ~"` '~ ~::~~'I. ~' FREDERICK MD 21702 CARLISLE PA 17013 ''`' ~ ""' Cry ~:;: W ~ _. -, • r-;~ ~ ... MEMBERS 1ST FCU provided the Department with the information below, which has been used in calcul~TYtng th'e'me ~~'; potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of ~s 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 Pernsylvania. Please call (7175 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 50195-40 Date 07-29-2002 To ensure proper credit to the account, two Established copies of this notice muse; accompany Account Balance $ 62, 865.40 Payment to the Register oi` Wills. Make check payable to 'Register of Wiills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $ NOTE: If tax payments are made within three 1 0 , 477 • 78 months of the decedent's elate of death, Tax Rate ~, /~' ~ X . 045 deduct a 5 percent discount on the tax due. ~'` Any Inheritance Tax due will become deainquent Potential Tax Due $ 471 .5U nine months after the dates of death. PART TAXPAYER RESPONSE FAIL T'O RESP~ iL~L RES~.T IN AN OFFICIAL TALC ASSESSMENT A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C 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 ~ and/or PART ~ below. PART If indicating a different tax rate, please state ,,,~,,,,~~~ ~3FF~C~~4L OSE 0#~,Y relationship to decedent: ~ ~ ^ lA. PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD _ LINE 1. Date Established 1 1 2. Account Balance 2 ~ 2 ,,,, 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 S 6. Amount Taxable (, $ 6 7. Tax Rate 7 X ~ 8. Tax Due g $ 8. PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION eMniiuT ~wrr, Under penalties of perjury, I declare that the facts I have reported abo~vle are true, correct and comp ete to the best of my knowledge and belief. HOME (~,3Grl ~ ~~'~ ~- ~~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE •+~ ~~~~~C, un Line 7 O7 IaX computation) $ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE REV-1543 EX AFP (08-08) FILE N0. 21 ,?D I U ~"j~ ACN 10145346 DATE 08-18-2010 TYPE OF ACCOUNT EST. OF GUST LEE ~ SAVINGS SSN 172- 18- 1751 ^ CHECKING DATE OF DEATH 08 - 05 - 2010 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS T0: TTY BENNETT REGISTER OF WILLS 06 SUND~fS LANE 1 COURTHOUSE SQUARE `~J G - F.BEDERI~ MD 21702 CARLISLE PA 17013 - O ,-., ~' i-S~ -_ -'..'~ " '~ 4~ ~~ ~- y -_ +~ ~ ~-.'' ~.._.i ,+--- -. M ~ ~ - ~4EMBE~2S 1ST FCU U ~..-Lar. provided the Department with the information below, which has been used in calculating the pgt'eat#'al t ue. Re indicate that at the death of the above-named decedent, you were a joint owner/benefir_iary of this account.. _. f`you_~feel informa s incorrect, please obtain written correction from the financial institution, attach a copy to this form a~d.re~turn it~-~o the above dress. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of P~nsyivania.~lease call C717) 787-8327 with questions. COMPL~'T~ PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRU(:TIONS Account No. 50195-41 Date 03-26-2004 To ensure proper credit to the account, two Established copies of this notice muss: accompany Account Balance $ 44, b7b . 0$ payment to the Register oi` Wills. Make check payable to Register of Wiills, Agent". Percent Taxable X 16.6b7 Amount Subject to Tax `s~ $ 7,446. lb NOTE: If tax payments are made within three r months of the decedent's elate of death, Tax Rate j~.~~,., '` X . 045 deduct a 5 percent discount on the tax due. ``)',` $ Any Inheritance Tax due will become deainquent Potential Tax Due 335.08 nine months after the dates of death. PART TAXPAYER RESPONSE a FAILURE TO RESPOND MILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C 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 informa ion is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFjCjAL USE C~fiiLY ~ A~qF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD \ LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ ~ 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ b 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION eMniiNT pern Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the bes,,~ of my knowl dge and belief. HOME ~CI/ ~ ~~~, ~-~ y~ TAXPAYE SIGNATURE TELEPHONE NUMBER DATE ~v~..~ ~cn~er on pine 5 or lax computation) $ PENNSYLVANIA INHERITANCE TAX " - INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 ~a~~ ~7~ Po BOX 280601 TAXPAYER RESPONSE ACN 10145348 HARRISBURG PA 17128-0601 DATE 08-18-2010 REV-1543 EX AFP (08-08) TYPE OF ACCOUNT EST. OF GUST LEE ~ SAVINGS SSN 172- 18- 1751 ~ CHECKING DATE OF DEATH 08-05-2010 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. ~-..- ~ REMIT PAYMENT AND FORMS T0: ~'~~ ~~' :'BETTY NNETT REGISTER OF WILLS %~`'' ~, - ~ 700@~j SUND~ANE 1 COURTHOUSE SQUARE =_4_ - ~ FRE~RICK ~~_, MD 21702 CARLISLE PA 17013 C3 ~~ ~-_, ~. -- ~; '-- .. - ~ ~ c r~ _. ..._ ..__.{ W ~,. 1{EMBHBlS 1S~CU ~~'`{-~ Q..~a provided the Department with the information below, which has been used in calculating the ~$o#en~ial ta~ue. Rec~ji~5lndicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account.. If you feel informaYY~is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return io the abov~.~ddress. 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. 50195-42 Date 12-31-2002 To ensure proper credit to the account, two Established copies of this notice muss; accompany Account Balance $ 30,845.66 Payment to the Register oi` Wills. Make check payable to Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject t0 Tax $ NOTE: If tax payments are made within three 5, 141 ' 05 months of the decedent's date of death, Tax Rate )( . 045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 231 .35 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 1^ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESS#ENT 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 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 OFFICIAL USE ONLY "^ ~,/.~~ relationship to decedent: \ PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ ~ 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION eMniiuT anrn Under penalties of perjury, I declare that the facts I have reported above/are true, correcclt and complete to the bes of my knowledge and belief. HOME C~~( ) ~?~,.~~" ~j 7~ f .. c,,P~ wets- ~~ ~ ~ D / ~ ~~ J'° - TAXPAYE SIGNATURE TELEPHONE NUMBER DATE • ~ • ~~ ~~ ~~• ~~~ ~~„r ~ or ~ ax computation) $ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE NO. 21 ~~1~ ~Za. Po Box 2BO6o1 TAXPAYER RESPONSE ACN 10145350 HARRISBURG PA 17128-0601 DATE 08-18-2010 REV-1543 EX AFP C08-08) TYPE OF ACCOUNT EST. OF GUST LEE 0 SAVINGS SSN 172 - 18 -1751 ~ CHECKING DATE OF DEATH 08 - 05 - 2010 ~ TRUST flp COUNTY CUMBERLAND ~ CERTIF. `""~ ~' REMIT PAYMENT AND FORMS T0: %'`-` _--~ BET ~-...~NNETT REGISTER OF WILLS - - 70 SUND~$_..,tANE 1 COURTHOUSE SQUARE _f FRERI(LK~~ ,, MD 21702 CARLISLE PA 17013 C, , _. -.... v J ~ C._ M~MB ER S 1S~j FCU 0 ~ provided the Department with the information below, which has been used in calculating the potential tue. Recordrs_7.~.indicate that at the death of the above-named decedent, you were a joint owner/benefic:iary of this account. If you feelctl~le informatibM 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 1717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 59195-00 Date 12-04-1985 To ensure proper credit to the account, two Established copies of this notice must: accompany Account Balance $ 1 ~ 270 . b8 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax $ 635.34 NOTE: If tax payments area made within three months of the decedent's elate of death, Tax Rate ,, ~' )( . 045 deduct a 5 percent discount on the tax due. F' Any Inheritance Tax due will become delinquent Potential Tax Due $ 28.59 nine months after the date of death. PART TAXPAYER RESPONSE 1^ FAI,L~URfE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT' A- ~ e~he above information and tax due is correct. uu 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 O N L Y to be filed by the estate representative. C. ~ The above intorma ion is incorrect and/or debts and deductions were paid. Complete PART ~2 and/or PART l___I below. p2 T If indicating a different tax rate, please state OFFICIAL USE ONLY ~~" ^ relationship to decedent: AAA PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 i' 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION eMniiu,- ewrn 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. H 0 M E ( ~ WORK t ~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE ~„ ~~~~«~ ~~~ amine ~ or i ax computation) $ PENNSYLVANIA INHERITANCE TAX • ~ INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND F I L E NO. 21 ~D1 d ~Z~ Po Box 280601 TAXPAYER RESPONSE ACN 10145351 HARRISBURG PA 17128-0601 DATE 08-18-2010 REV-1543 EX AFP (08-08) TYPE OF ACCOUNT EST. OF GUST LEE X^ SAVINGS SSN 172-18-1751 ^ CHECKING DATE OF DEATH 08-05-2010 ^ TRUST COUNTY CUMBERLAND ^ CERTIF. L,.. ~ REMIT PAYMENT AND FORMS T0: ~ ~ G -.... . , -~ 3 BET ~~NNETT REGISTER OF WILLS ~',-= ' = 700~SUND LANE 1 COURTHOUSE SQUARE ! ~- _"~ ~ FRE$~RIC~~_C~ --', MD 21702 CARLISLE PA 17013 ~_ ~ . ~ ~ u~ .t.-. - ' ~ ._..a -`, ~ U~~. t~_ ; M~MB~i~S 1S1"fCU ~- ~:?~ provided the Department with the information below, which has been used in calculating the potential tare. Reco~s~dicate that at the death of the above-named decedent, you were a joint owner/benefic:iary of this account. If you feel t+~e informatior~s 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 INSTRUC'.TIONS Account No. 156573-00 Date 02-06-1996 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $31 .54 payment to the Register of Wills. Make check ~` payable to "Register of Wills, Agent". Percent Taxable )( 16.667 NOTE: If tax payments are made within three Amount Subject to Tax ~ ~` 138.59 months of the decedent's date of death, Tax Rate ' X . 045 deduct a 5 percent discount on the tax due. r Any Inheritance Tax due will become delinquent Potential Tax Due ~' $` 6 • 24 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ONE B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O N L Y to be filed by the estate representative. C. ^ The above information is incorrect andlor debts and deductions were paid. Complete PART ^2 and/or PART 3^ below. PART If indicating a different tax rate, please state QfFICIAL USE ONLY ^ ~AA~ relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 +fi $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported ab/ove/ are/qtr/ue, correct a/nd omp ete to the b st of my knowledge and belief. HOME (~,JG~/ ) ~`(~~" Ct.~ %`~/ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 a~Ol~ ~~ Po Box 280601 TAXPAYER RESPONSE ACN 10145353 HARRISBURG PA 17128-0601 REV-1543 EX AFP (08-08) DATE 0 8- 1 8- 2 0 1 0 TYPE OF ACCOUNT EST. OF GUST LEE a SAVINGS SSN 172- 18- 1751 ~ CHECKING DATE OF DEATH 08-05-2010 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS T0: BETTY BENNETT REGISTER OF WILLS 7006 SUNDAYS LANE 1 COURTHOUSE SQUARE :~ FREDE~iCK MD 21702 CARLISLE PA 17013 {~~'c~ ~ ~ e~ .- C'? ~- MEM~ff~S-•.,hST F~ ~~.-jam-==-= provided the Department with the information below, which has been used in calculating the poted.~~iaL;.tax du,gs„. Rec ffcate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If y~:fee~ the 'nforma ~;i'ncorrect, please obtain written correction from the financial institution, attach a copy to this form and ~t;u,r~it t e ab~ d~.ess. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Penn~'Y3va. P se call 787-8327 with questions. r ,`•G`OM~LETLbPART 4~~LOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account N~? 34253-00 Date 08-05-1983 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 1 , 794.30 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $` 299.06 NOTE: If tax payments are made within three •~ months of the decedent's date of death, Tax Rate ~ )( .045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 13.46 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE FAILtiRE TO RESPfl~ID WILL RESULT IN AM OFFICIAL TAX ASSESSMENT' A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C 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 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: (3FFICiAL USE ONLY ~ AAF TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pAD PA DEPARTMENT OF REVENUE LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE nFCrRrnTrn~~ _ ___.__-_ Under penalties of perjury, I declare that the facts I have reported above are true, correct and ,compl,~te to the best of y knowledge nd belief. ` ~ J ~~HOME ~7l~ ~~ !~ ~'~~- ~- ~~.3 / 5~- TAXPAYER GNATURE TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE _„ .., _Y INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box 2BO6o1 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP C08-08) TAX FILE: N0. 21 a~~10~~p~ ACN 10145360 DATE 08-].8-2010 EST. OF GUST LEE SSN 172-18-1751 DATE OF DEATH 08-05-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. BETTY BENNETT 7006 SUNDAYS LANE 1 COURTHOUSE SQUARE CJ ~ __ FREDERICK MD 21702 CARLISLE PA 17013 ~ Ca ~+ ,.~' -:~. ~? C.~ ~- ~~~ ~ ~ "0 ,• f ~ l , T ~.., _ MEMBERS 1ST FCU f~~~°°~-~ C.•~~ ; provided the Department with the information below, which has been ~3 ~alcu~ng the ~"_.~~ potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/b ~'iary of s accbmt.~-: If you feel the information is incorrect, please obtain written correction from the financial institution, a€t~ack~7a copy tQ,~his fiorim ~-r=~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of t'R~ Commonwealt'Yi of ~~ Pennsylvania. Please call (717) 787-8327 with questions. 75 ~.~•`~ COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRU(:TIONS`'`~ Account No. 34251-00 Date 08-05-1983 To ensure proper credit to the account, two Established copies of this notice muss; accompany Account Balance $ 6 , 145.52 payment to the Register o1= Wills. Make check payable to "Register of Wills, Agent". Percent Taxable )( 16.667 Amount Subject to Tax ,~ $ 1, 024.27 NOTE: If tax payments area made within three Tax Rate ''~ months of the decedent's elate of death, t~ .., t +~ X . 0 4 5 deduct a 5 percent discount on the tax due. Potential Tax Due $ 46.09 Any Inheritance Tax due will become de:Linquent nine months after the date of death. PART TAXPAYER RESPONSE 0 FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A• (-'}T~"e 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 informs ion is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: OFFICIAL USE ONLY ~ AAF TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD PA DEPARTMENT OF REVENUE LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable (, $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ $ Under penalties complete to the ' of perjury, I declare that the facts I have best my knowledge and belief. reported above are true, / J ~ } co rect and ~ _..~> ~~ ~ ~ ~ HOME C C (~(p r y~ T _ AXPAYER SIGNA TURE TELEPHONE NUMBER DATE PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE nF4C'RTPTTf1Al ..._...._ _ _ __