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Home My WebLink About10-01-10BUREAU OF INDIVIDUAL TAXES `~ j `'"""' -`~' ,'',~~T,~~CE,~4.F INHERITANCE TAX INHERITANCE TAX DIVISION ~APp.tfATS~~fEN(T,~„~LLOWANCE OR DISALLOWANCE PO BOX 280601 ~ _~~01! .DEDUCT~ANSc~ AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 ~ ~~OINTLY' HELD OR TRUST ASSETS ~. ~ ~ ~C. f ' ~ ~l ~ ~~~ ~i J ANDREW H VANSCYOC~',i 1` "~'=~~"` ~ ~~.'~' ~~. ~_~~, 11609 GALT AVE SILVER SPRING MD 20902 pennsylvania ~ ~~ DEPARTMENT OF REVENUE r REV-1548 EX AFP (12-09) DATE 10-04-2010 ESTATE OF VANSCYOC JR JOHN M DATE OF DEATH 01-07-2010 FILE NUMBER 21 10-0044 COUNTY CUMBERLAND SSN/DC 211-36-9776 ACN 10136791 APPEAL BY DATE:12-03-2010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~"~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C12-09)--------------------------------------------------•------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF~ DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-04-2010 ESTATE OF:VANSCYOC JR JOHN M DATE OF DEATH:O1-07-2010 FILE NO.: 21 10-0044 S.S/D.C. NO.: 211-36-9776 COUNTY:CUMBERLAND ~-CN: 10136791 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PSECU ACCOUNT NO.: 0211369776IRA51 TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING C )TRUST C ~ TIME CERTIFICATE DATE ESTABLISHED 01-01-1999 Account Balance 795.10 NOTE: TO ENSURE PRCIPER CREDIT TO Percent Taxable X 0.166 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 132.52 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX; PAYMENT TO THE Taxable Amount 132.52 REGISTER OF wIILLS AT THE Tax Rate x .045 ABOVE ADDRESS. MAKE CHECK Tax Due 5.96 OR MONEY ORDER PAYABLE TO• TAX CREDITS: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID ilvltKtJl 1J l.F1AKl~tL IHKUUC-;H lU-1Z-2010 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 5.96 INTEREST AND PEN. .00 TOTAL DUE 5.96 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. _~ -~~F~ ~~ ~' ;~RTLbE~,,,,~F INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES ,. .. INHERITANCE TAX DIVISION ~, ,°,A•P:RRAZ$EMFy~T,i~ALLOWANCE OR DISALLOWANCE PO BOX 280601 ~i_~.,~bF~ _D~D1JCTibN+S, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS Pennsylvania ~ • DEPARTMENT OF REVENUE r: REV ••1548 EX AFP (12-09) ~~~~ +~~~' -' PE'~ ~~: ~a,.'~} DATE 10-04-2010 ANDREW H VANSCYOC V~ ~ • ` ~' -'~- • " 11b09 GALT AVE SILVER SPRING MD 20902 ESTATE OF VANSCYOC JR JOHN DATE OF DEATH 01-07-2010 FILE NUMBER 21 10-0044 COUNTY CUMBERLAND SSN/DC 211-36-9776 ACN 10136793 APPEAL BY DATE:12-03-;?010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 M CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS F- REV-1548 EX AFP C12-09~---------------------------------------------------~----------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF' DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-04-2010 ESTATE OF:VANSCYOC JR JOHN M DATE OF DEATH:O1-07-2010 COUMTY:CUMBERLAND FILE NO.: 21 10-0044 S.S/D.C. NO.: 211-36-9776 A,CN: 10136793 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PSECU ACCOUNT NO.: 0211369776IRA54 TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING C )TRUST CX)TIME CERTIFICATE DATE ESTABLISHED 04-03-1999 Account Balance 1,224.89 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.166 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 204.15 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX: PAYMENT TO THE Taxable Amount 204.15 REGISTER OF WILLS AT THE Tax Rate x .045 ABOVE ADDRESS. MAKE CHECK Tax Due 9.19 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 1NIEREST IS CHARGED THROUGH 10-12-2010 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 9.19 INTEREST AND PEN. .O1 TOTAL DUE 9.20 ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. _ ~ ~~1- BUREAU OF INDIVIDUAL TAXES .- ..NAT-~~CE OF INHERITANCE TAX INHERITANCE TAX DIVISION ~'~ '~} }; •~A~PRA~S~'M1', ALLOWANCE OR DISALLOWANCE PO BOX 280601 aF"-•~3ED;LI~TYONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 ~, ~,• ,,,_> > ~ ~,.' :I~i3•IIJTLY HELD OR TRUST ASSETS .. •~ r ~ f r^ ~. L. t ;. ~ , r,~ ~ : n-r ANDREW H VANSCY~~~r ` ~ ~~ '," ~~,~ y~r~ ~+~ 11609 GALT AVE `"'"~`~ "~ ~- SILVER SPRING MD 20902 pennsyLvania ~ ::F DEPARTMENT OF REVENUE REV-1548 EX AFP (12-09) r DATE 10-04-2010 ESTATE OF VANSCYOC JR JOHN M DATE OF DEATH 01-07-2010 FILE NUMBER 21 10-0044 COUNTY CUMBERLAND SSN/DC 211-36-9776 ACN 10136795 APPEAL BY DATE:12-03-2010 (See reverse side under Objecti~~ns) Amount Remitted MAKE CHECK PAYABLE AND REMIIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS F' REV-1548 EX AFP C12-09~-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-04-2010 ESTATE OF:VANSCYOC JR JOHN M DATE OF DEATH:O1-07-2010 COUNTY:CUMBERLAND FILE NO.: 21 10-0044 S.S/D.C. NO.: 211-36-9776 ACN: 10136795 TAX RETURN WAS: CX) ACCEPTED AS FILED C ~ CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PSECU ACCOUNT NO.: 0211369776IRA63 TYPE OF ACCOUNT: C 3SAVINGS C ~ CHECKING C TRUST CX)TIME CERTIFICATE DATE ESTABLISHED 02-08-1989 Account Balance 2,018.86 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.16b YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 336.48 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 336.48 REGISTER OF WILLS AT THE Tax Rate x .045 ABOVE ADDRESS. MAKE CHECK Tax Due 15.14 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID INTEREST IS CHARGED THROUGH 10-12-2010 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 15.14 INTEREST AND PEN. .O1 TOTAL DUE 15.15 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ANDREW H VANSCYOC 11609 GALT AVE _~_,_,,,.,,~ .,,.-;-, ~-N-O~',~~E;Q~ INHERITANCE TAX ~-'~' I ~. A'~'~R'RAIS.~F1'~~4T~, ALLOWANCE OR DISALLOWANCE 0~ D~~U~T~ONS;~'AND ASSESSMENT OF TAX ON -' ' --~ ~J@'~INTL`Y` HELD OR TRUST ASSETS ~~~.~~`~ ~"~1'~i ,nT (~nn ~-, ,..~~ ~, r ~ ; n f s E ~ ti ... t `- ~ ~ -, n ,; ~ i SILVER SPRING MD 20902 Pennsylvania ~ DEPiaRTMENT OF REVENUE REV-1548 IX AFP (12-09) r DATE 10-04-2010 ESTATE OF VANSCYOC JR JOHN M DATE OF DEATH 01-07-2010 FILE NUMBER 21 10-0044 COUNTY CUMBERLAND SSN/DC 211-36-9776 ACN 10136797 APPEAL BY DATE:12-03-2010 (See reverse side under Objectir~ns) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C12-09)-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-04-2010 ESTATE OF:VANSCYOC JR JOHN M DATE OF DEATH:O1-07-2010 COUNTY:CUMBERLAND FILE NO.: 21 10-0044 S.S/D.C. NO.: 211-36-9776 ACN: 10136797 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PSECU ACCOUNT NO.: 0211369776IRA64 TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING C )TRUST ( ~ TIME CERTIFICATE DATE ESTABLISHED 07-01-1997 Account Balance 1,699.30 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.166 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 283.22 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 283.22 REGISTER OF WILLS AT THE Tax Rate x .045 ABOVE ADDRESS. MAKE CHECK Tax Due 12.74 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 1NItKt51 15 CHARGED THROUGH 10-12-2010 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 12.74 INTEREST AND PEN. .O1 TOTAL DUE 12.75 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ~., n;..~~-~v~( ,~•, N•pT-I,D~' Q`F- INHERITANCE TAX '.'AFrPE~AI'SEMENfi~r• A•~LOWANCE OR DISALLOWANCE ,' Q~F"' I1~~GUC'7`ION'•S `'AND ASSESSMENT OF TAX ON `-' ~~ ~ `-~JUSNTLY° `HELD OR TRUST ASSETS ~~ C~CT -1 P~~ ~~~ ~~ ANDREW H VANSCYOC 11609 GALT AVE ~ i `f E 'w U ~ ,'',' SILVER SPRING MD 20902 pennsyLvania ~ , c. DEP,4RTMENT OF REVENUE REV-•1548 EX AFP (12-09) DATE 10-04-2010 ESTATE OF VANSCYOC JR JOHN M DATE OF DEATH 01-07-2010 FILE NUMBER 21 10-0044 COUNTY CUMBERLAND SSN/DC 211-36-9776 ACN 10136799 APPEAL BY DATE:12-03-;?010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C12-09)---------------------------------------------------~----------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF' DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-04-2010 ESTATE OF:VANSCYOC JR JOHN M DATE OF DEATH:O1-07-2010 FILE NO.: 21 10-0044 S.S/D.C. NO.: 211-36-9776 COUNTY:CUMBERLAND A,CN : 10136799 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED FINANCIAL INSTITUTION: PSECU JOINT OR TRUST ASSET INFORMATION ACCOUNT NO.: 0211369776IRA79 C ) CHECKING C )TRUST CX3TIME CERTIFICATE TYPE OF ACCOUNT: ( )SAVINGS DATE ESTABLISHED 02-08-1989 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 1,009.94 NOTE: X 0.166 168.33 - .00 168.33 x .045 __ 7.57 TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID 1nitKtS~ t5 cHAKGtU THROUGH 10-12-2010 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 7.57 INTEREST AND PEN. .00 TOTAL DUE 7.57 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~~~ ~~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-06D1 ANDREW H VANSCYOC 11609 GALT AVE pennsylvania ~ .,-tir.",iN{~'T~EE": F""IjjR :ERITANCE TAX DEPARTMENT OF REVENUE `A~'PRA~SEM!*NT, ~1L'~OXANCE OR DISALLOWANCE OFD'~7~~FU1G1`..~ffNS,~~`~~4!N°D~,ASSESSMENT OF TAX ON REV-1548 EX AFP c12-D9) "° `"~ JbI`N~C1' FI~L)j OR TRUST ASSETS ~~ ~ ~~. _ ~ ~ ~~; ~ IRATE °~ 10 - 04 - 2010 STATE OF VANSCYOC JR JOHN M DATE OF DEATH 01-07-2010 ~~~-„~, i~'f . FILE NUMBER 21 10-0044 r ~,, ,,,,.,,~ , ~. n7~{, F COUNTY CUMBERLAND , ~ ~ ~~t i 4 ~ ~< ~ "~~- ~~ SSN/DC 211 - 36 - 9776 `~,,; - - ~~ . 10136809 SILVER SPRING MD 20902 APPEAL BY DATE:12-03-2010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C12-09~--------------------------------------------------•------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF= DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-04-2010 ESTATE OF:VANSCYOC JR JOHN M DATE OF DEATH:O1-07-2010 FILE NO.: 21 10-0044 S.S/D.C. NO.: 211-36-9776 ACN: 10136809 TAX RETURN WAS: CX~ ACCEPTED AS FILED C ) CHANGED FINANCIAL INSTITUTION: PSECU JOINT OR TRUST ASSET INFORMATION ACCOUNT NO.: TYPE OF ACCOUNT: CX}SAVINGS C ) CHECKING C TRUST C )TIME CERTIFICATE DATE ESTABLISHED 08-20-1987 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 2,500.84 NOTE: X 0.500 1,250.42 - .00 1,250.42 x .045 56.27 TO ENSURE PRCIPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAB: PAYMENT TO THE REGISTER OF ~fILLS AT THE ABOVE ADDRESS;. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID 1nitKtsi is I;HAKGtU IHKUUGH 10-12-2010 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 56.27 INTEREST AND PEN. .03 TOTAL DUE 5b.30 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRM FOR INSTRUCTIONS. 0164580185-S1 COUNTY:CUMBERLAND ~~~1 BUREAU OF INDIVIDUAL TAXES -- r~-~ ; . ~" N,6~f~~~E~~~':t~F INHERITANCE TAX INHERITANCE TAX DIVISION ,. r1lPPl2A~SE~I~KIT,~'ALLOWANCE OR DISALLOWANCE PO BOX 280601 _ ~OF .D~DUC7~;'fJN~; AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 +C l ~' 1 -°' DIN?C~' HELD OR TRUST ASSETS CLF~r~ ~'r .,~+ ?~~' ANDREW H VANSCYOC n~~~ ~i~~= '~ ~ . _ ~''~ 11609 GALT AVE SILVER SPRING MD 20902 +.,:; .. Pennsylvania ~ ~'T DEPARTMENT OF REVENUE REV ••1548 IX AFP t12-09) r DATE 10-04-2010 ESTATE OF VANSCYOC JR JOHN M DATE OF DEATH 01-07-2010 FILE NUMBER 21 10-0044 COUNTY CUMBERLAND SSN/DC 211-3b-9776 ACN 10136810 APPEAL BY DATE:12-03-;?010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE "'~ RETAIN LOWER PORTION FOR YOUR RECORDS ~"'~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF' DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 10-04-2010 ESTATE OF:VANSCYOC JR JOHN M DATE OF DEATH:O1-07-2010 FILE NO.: 21 10-0044 S.S/D.C. NO.: 211-36-9776 ACN: 10136810 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED FINANCIAL INSTITUTION: PSECU TYPE OF ACCOUNT: ( ~ SAVINGS DATE ESTABLISHED 08-20-1987 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAY f DGnTTC . JOINT OR TRUST ASSET INFORMATION ACCOUNT NO.: 0164580185-S7 ( ~ CHECKING C TRUST C TIME CERTIFICATE 8,008.86 NOTE: X 0.500 4,004.43 - .00 4,004.43 X .045 180.20 TO ENSURE 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 T0: "REGISTER OF TWILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID INTEREST IS CHARGED THROUGH 10-12-2010 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 180.20 INTEREST AND PEN. .10 TOTAL DUE 180.30 ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. COUNTY:CUMBERLAND ~~