Loading...
HomeMy WebLinkAbout12-16-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162EX111-961 NO. CD 013795 BAGGERS GREG C 349 EQUUS DRIVE CAMP HILL, PA 1701 1 fold ESTATE INFORMATION: ssrv: 1os-1s-7752 FILE NUMBER: 2110-1236 DECEDENT NAME: BAGGERS LOUIS C DATE OF PAYMENT: 1 2/ 1 6/201 0 POSTMARK DATE: 12/15/2010 couNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 9/2010 REMARKS: CHECK# 512 ACN ASSESSMENT AMOUNT CONTROL NUMBER 10168631 ~ 52.37 10168639 ~ 5262.67 10168640 ~ 5606.38 10168641 ~ 5275.02 10168642 ~ 5129.26 10168643 ~ 5338.53 10168644 ~ 5256.19 TOTAL AMOUNT PAID: INITIALS: CJ 51,870.42 SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ____~ ~_ - PENNSYLVANIA INHERITANCE TAX POR OX 28060DIVIDUAL TAXES f ~~~ ~ AN D HARRISBURG PA n1zB-oeol ~ r~ t `v~ ~XPAYER RESPONSE ~-" r REV-1543 E% ~ P B6- ~ ' ~.-1..~,% FILE N0. 21'1`12-~ ACN 10168631 DATE 12-03-2010 za~aQFC i6 ~Mii: s~ CLERIC pF oR~n+~s cou~r (~iBERi~'~(~ CC . PA GREG C BAGGERS 349 EQUUS DRIVE CAMP HILL PA 17011 EST .. OF LOUIS C BAGGERS SSN 109-18-7752 DATE OF DEATH 11-19-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE .SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this 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 (Tl?) ~8?.B32T xithgs~as-*fons. - ~~ - - -- COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3157 - 0 0 Date 11- 09 - 1954 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 $ 335.75 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject t0 TeX $ 55.96 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 ~ 2.52 ~ ,'3' nine months after the date of death. PART TAXPAYER RESPONSE A. ® The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain - CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. 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 +: y5, r ~,fi . `'~ _~° ~?~ ; 2 relationship to decedent: M. u.p A~ , ~ ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~ `~~~`` ' LINE 1 . Date Established _ _ _ _ _ _ ~ ~+~ •a ;.,,~~ v;,,, n ,~r .... ,.w~.iLZ........rrrrrr~ 2. A c c o u n t B a l a n c e 2 _ 4.. ~'..,~„,,, ;»; y k ;, ~ , ~ a ,; ; ~-„ 3. Percent Taxable 3 X ~ •, :r/^e s72P '~ m.. ~ • ri ,,,,,, , .+,,, . ,,,,~. , ~4'^* jt"FT r,..e~ tr3 %:~ r .. ~pp~ ~ w,.r.~..iir..~ 4. Amount Subject to Tax 4 $ ~M ~ ~ '`=~~~°" r°"`' ~ ' 5. Debts and Deductions 5 - ~~ '..Y ci ;ah . ~ - ~° * '>t ~ + `~ ~`~-' 't~ - 6. Amount Taxable 6 , q „ .~~, „ ~„~k ,y~~," „ 7. Tax Rate 7 X ,z 9 ,+~a:°F ~~~,,~"fp~,~„r ;~,. 8. Tax Due 8 $ -~~xakk ~:,~.<. t '~hv.:c~ iw;_6 ~ ~r,~,. PART DEBTS AND DEDUCTIONS CLAIMED DATE P AID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C Yt7 ) ~~~"yQ70 e ~~~~ WORK C 717 ) g77- 25a3 l'l~/yf2m,,,_, TAXPAYE NATURE TELEPHONE NUMBER DATE INFORMATION NOTICE TOTAL CEnter on Line 5 of Tax Computation) t PENNSYLVANIA INHERITANCE T. INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES '" AN D PO BOX 280601 • ~ ~ ., ~i TAXPAYER RESPONSE ~. HARRISBURG PA 17128-0601 ' , ~- ~ P•~C. Y~ l~ `' sJ ;kv~> Tfe•~ai+Y FILE N0. 21--~b--~Z~j(p ACN 10168639 DATE 12-03-2010 2010 0EC t 6 AM tl ~ 55 c~~~x o~ ORPH~1v'S COURT CUM~~FL.~~!~D C.., , PF, GREG C BAGGERS 349 EQUUS DRIVE CAMP HILL PA 17011 EST. OF LOUIS C BAGGERS SSN 109-18-7752 DATE OF DEATH 11-19-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a point owner/beneficiary of this account. If you feel the inforwation is incorrect, Dlease obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws. of the Cowwonwealth of Pennsylvania. Please eail 417-), 78?-8327-with questionr_ - - ~ "' --. ~. -. .. .._ ~. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3157-53 Date 07'24-2002 To ensure prover credit to the account, two Established copies of this notice ^ust aceorparvy paywent to the Register of Wills. Make check Account Balance ~` 12,288.74 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax paywents are wade within three Amount SubJeet to Tax $ 6, 144.37 wonths of the decedent's date of death, Tax Rate deduct a 5 percent discount on the tax due. X .045 -- 7 (j 1 Any Inheritance Tax due will becowe delinquent Potential Tax D ue ~` 276.50 a~p~-. nine wonths after the date of death. PART TAXPAYER RESPONSE A. ~ The above inforwation and tax due is correct. Rewit paywent to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assesswent will be issued by the PA Departwent 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 infor~wa ion is incorrect and/or debts and deductions were paid. Cowplete PART 1=1 and/or PART ~ below. PART If indicating a different tax rate, please state ;.; r ~ ~~ ~ ~ ~t~i ~~F . ~hY i3i (~ ~ ~' ~ relationship to decedent: , s z~ i ~ ~ ~ ~ ~' + ~~ ti i>. ~~. t ~ ~ ~ ~ ~ ~~ i i~i~i li~~l c ~ ~ TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS #- '+ ~r~~~ ~~ ~~ ~i ~ ~~ ~'~~ LINE 1. Date Established 1 _ ~;~a '`"~`~' ~ d~~'~ a".` z-; 2. Account Balance 2 ~ ~~ v J ~ ~~ '~~`~~ ~f,# 3. Percent Taxable 3 X .y } F ' f 7~ ~C `~, c K- T ~ t=~c sx~ r $ `T' ~''~~~ ~~' x ~~~ ~~~ ~ h ~ 4. Amount Subject to Tax 4 Cj ~ 5. Debts and Deductions 5 : ~ •~' ~ f~•~ ~~ .....t...W.. 6. Amount Taxable 6 ~ ~ '' ~ r'~ r ....$,,:~ ~,;,"„ ' X ~"'«~~""~ ~ `~~^~ '~ ~ ms's t''~ 7. Tax Rate 7 '-' . . . .w _ 8. Tax Due 8 `~ ~ ~~..~ y fit;' a ~ r ~',,, ~ek3~#`F-~L ~?~it tr,E w~ PART DEBTS AND DEDUCTIONS CLAIMED 0 , DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complQ~ete to th//e'1~ best of my knowledge and belief . HOME C `T ~ ~ ) '1 '7 ~" ~!'r7Td .~•IRQ.Q~1x~,1. 'W., WORK C Z 17 ) ~ 7 7 - 2 S-a 9 !2f t5l/tow TAXPAYER I ATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) # BUREAU OF INDIVIDUAL TAXES ~-. PO BOX 280601 ~„' HARRISBURG PA 17128-0601 ~ 4 '+~ REV-154i~ tC7`{oe~-Re> PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~i~"LE~,rC AND ~t,.~ { TAXPAYER RESPONSE ~ t'Y 1'..~.'J FILE N0. 21~~~-~oZ3~o ACN 10168640 DATE 12-03-2010 ZQIODEC 16 A!'t11~ 5~ CLER'-~ ~F ORPHAN S C~tJRT ~}~t~~R~A.N~ r~ , PA EST. OF LOUIS C'SAGGERS SSN 109-18-7752 DATE OF DEATH 11-19-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FDRMS T0: GREG C BAGGERS REGISTER OF WILLS 349 EQUUS DRIVE 1 COURTHOUSE SQUARE CAMP HILL PA 17011 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-naeed decedent, you were a joint owner/beneficiary of this account. If You feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. - - -- _ - COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3157-55 Date 08-26-2002 To ensure vroper credit to the account, two Established copies of this notice must accomvany Account Balance 2 7 payment to the Register of Wills. Make check 3 6 8 28 " $ . ~ payable to Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject t0 Tax $ 14 ~ 184.14 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due Any Inheritance Tax due will become delinquent $ 638.29 ~y(~.3~ nine months after the date of death. PART TAXPAYER RESPONSE 0 I~.1~~_ T'O.:QESP~r'~Ilf.t,,~~U~.~' ~H~ J-~>,O ~CIAi. 'fA~~~~x 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 C ONE ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION LINE i. Date EstabT33Raa'-'- ` 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART DATE PAID PAYEE `'s.~xi OF TAX ON JOINT/TRUST ACCOUNTS .P ~ ' w~'. ~;. ~.~... , ~ ~, s 5 5f X 4 7 r.1 c ? G ri ~v fr4,rl s ~ "~s*1~Na{'. i` DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) 6 Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best (off my knowledge and belief. HOME C 717 ) T74-~(O'f0 .rte ~ ~ - -'°s'~'99'~XS WO R K C 'T 17 ) $??-25'0 3 ! 14~ 2a~o TAXPAYER SIG ATURE TELEPHONE NUMBER DATE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 '~ HARRISBURG PA 17128-0601 _ .~~»L` rj~j,...~~ REV-1543 `j$~~AF~1. W 14os)Y PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE ,;cl~~~ l~'AXPAYER RESPONSE ACN ,`~~ 't ~' DATE Y -,t_•J No . 21 -tG- ~ a3c~ 10168641 12-03-2010 2010 DEC 16 AM I I = S5 c~~~~ o~ QR~jAPd'S COURT cu~~~~Lrs coo , QP. EST. OF LOUIS C BAGGERS SSN 109-18-7752 DATE OF DEATH 11-19-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: GREG C BAGGERS REGISTER OF WILLS 349 EQUUS DRIVE 1 COURTHOUSE SQUARE CAMP HILL PA 17011 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departetent with the infort,ation below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-vaned decedent, you were a Soint owner/beneficiary of this account. If you feel the infor~ation is incorrect, please obtain written correction frost the finpncial institution, attach a copy to this fon and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cott<torn+ealth of Pennsvlvania. Please call 0717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3157-57 Date 12-03-1999 To ensure proper credit to the account, two Established copies of this notice ^ust accompany Account Balance $ 12 866 43 payment to the Register of Wills. Make check " " , . payable to Register of Wills, Agent . Percent Taxable X 50.000 Amount Subject to Tax $ 6 433 22 NOTE: If tax payments are Dade 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 D ue ~` 289 49 a'~r •~~'' Any Inheritance Tax due will become delinquent . j nine sonths after the date of death. PART TAXPAYER RESPONSE #t~~~'O itL~~~.>r~.. `~~s~'#Y; 1i1L~. ~' Rr. ~F~~' A. ~ The above infonation and tax due is correct. Remit Dayment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Departeent of Revenue. B L 0 C K B. ~ The above asset has been oc will be reported and tax paid with the Pennrilvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were Daid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state , relationship to decedent: ~-,~ ~~;~ ~ ~, TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS °:Ri4#~x LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID .i4F4Y1.S~j-~~ s~.fifV~'3r ~. ., ~ .u `S~ 2~,f., !G 17.x+.+7 ~r i~,. per i-..+.~as ~~. °or k -•d::+€- ti~*. ~s'f,~ 4 ,z., .rim. ~,,,~ n CLAIMED TOTAL CEnter on Line 5 of Tax Computation) 6 Under penalties of perjury, L declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C 'ZtZ ) 77'/-yDTO ,~q,~,V WORK C Try ) 87?-2So3 t2 f4 ZQ~ TAXPAYER S NA RE TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AN D PD Box 2eocol "~~ •'~-GC+~`~{~~pAYER RESPONSE HARRISBURG PA 17128-0601 ;`t .,r ~ ~„tf ; <<., - ,.°~ ,..,,E ~ r, ~,_ REV-1543 EX ~~ ~ f Li! 5Y1_.i..',i FILE N0.21'IC'"IZ7j(~ ACN 10168642 DATE 12-03-2010 zosa aye s 6 aM s ~ = ss (~c~~~x of CUlv18TRG~`wC) ~n , PA. GREG C BAGGERS 349 EQUUS DRIVE CAMP HILL PA 17011 TYPE OF EST. OF LOUIS C BAGGERS SSN 109-18-7752 DATE OF DEATH 11-19-2010. COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 ACCOUNT SAVINGS CHECKING a 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 ioint owner/beneficiary of this account. If you feel the information is incorrect, Dlease obtain written correction from the financial institution, attach a copy to this 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) 7BI-B327 with ausst.ions. -' " " COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3157-68 Date 11-09-1954 To ensure proper credit to the account, two Established copies of this notice ^ust accompany Account Balance 0 4 7 . 2 9 payment to the Register of Wills. Make check $ 6, payable to "Register of Wills, Agent". Percent Taxable Amount Subject X 50.000 NOTES If tax Dayments are made within three to Tax $ 3, 023.65 months of the decedent's date of death, Tax Rate Potential TaX D )( .045 deduct a 5 percent discount on the tax due. 24 Any Inheritance Tax due will become delinquent ue $ 136.06 ' a, nine months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C HECK 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. C ONE ~ _ , BLOC K B. ~ The above asset has been or M111 be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION LINE 1. Date ~stabl.ished^~ 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Taz Due PART ^3 DATE PAID PAYEE OF TAX ON JOINT/TRUST ACCOUNTS P - -_ _~- __.... ~r , ,,E _ i ~ , ~ ~ ~. ~ ~` - .., ~o-~ ~ r $~ • 2 ~{i 4 $ 4 ', ~ ~ 6' f ~~ I I ~p. fE ~ tl +~+~ ~ ~~ X ~-a~, ii?~ ~ t vg's. -. ~E *R~ ° % :y~ "!*r. 7 •' ~ K `C ,~. 4' [y= DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) c Under penalties of perjury, I declare that the facts I have reported above a_re true, correct and complete to the best of my knowledge and belief. HOME C "il'7 ) 77q~-x{070 ~,~ ~ ~~~ WORK C 7i7 ) X77- 2yoE Nl~aota TAXPAVF s sNATURE TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIYIDUAL TAXES AND F I L E NO. 21 `~~ ~- ~ ~.~ PO BOX 280601 'T`; -~(-.L::~'`~-~~IXPAYER RESPONSE ACN 10168643 HARRISBURG PA 17128-0601 ~~(;,'~/ to E tV . _ ', ~ ~- ,±` i C! DATE 12-03-2010 REV-156 P9 ~f t F 1-.6-.'! ' ~a~oQEC t6 At~~~. ss c~CL~E*'RK ~~Fy}' T f/~~ QAI;"~Y~fj f`V'ttt-`~hq~~J~yy ~.rt~1+/V~~ In GREG C BAGGERS 349 EQUUS DRIVE CAMP HILL PA 17011 EST. OF LOUIS C BAGGERS SSN 109-18-7752 DATE OF DEATH 11-19-2010 COUNTY. CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ^ SAVINGS fLS JI CHECKING TRUST CERTIF. MEMBERS 1ST FC.U provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. - -' COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3157-73 Date 11-09-1954 To ensure proper credit to the account, two Establ ished copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 8 3 7 . 1 6 15, payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 7 ~ 918.58 months of the decedent's date of death. Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due ~ 356.34 Any Inheritance Tax due will become delinquent ~ •S3 nine months after tha date of death. PART TAXPAYER RESPONSE ^ ~~rr~:~r~'_ -rr~`~~xm %artt~ ~ ~4,a~x:~r~`= :-~~f~ts~`~`~-~r~;: M A. ~G The above information and tax due is correct. ~I 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 Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 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. If indicating a different tax rate, please state ~,,; ~ ",`` ~i i~ PART ~ x(t`; ',~.Sk ~ I i ~(t ~t~l ~ relationship to decedent: ';xL' ~ ~ ~ ~ ~~ eiV 2 ` ^ v f_~b ~ 4 Z LF 'v S ~` ~'' ~ TAX RETURN - COMPUTATION 0'F TAX ON JOINT/TRUST ACCOUNTS ~'-~~-~~' `' '~G'- _.._ -. . ~r LINE 1. Rafe EstatSl3sh-ed' 1 ~`'~~ ' w my,,,,. 2. Account Balance 2 +~ 3. Percent Taxable 3 X 3_ 4. Amount Subject to Tax 4 ~~~ 5. Debts and Deductions 5 - ~ ,~ d ~~"~` ~ ~ ~ti~ ~ ~ ~~ ~' - !!~~ r -9 ~ ,f,G~~~ (f~#~+ i~.rf ~t 6. Amount Taxable 6 IG` ~ ~~f~~ ` err,•~••~.- •-.• 7. Tax Rate 7 X ~ ~~` ~'"~~"X~'~t ~':,x ~} t~,+w `^v s~'::` 8. Tax Due 8 ~ :t~''t,'"~c ~ ,r,..£' ` ~~{ " %'I':,"'"'""°'C "' <,1 ;3' PART ~ DEBTS AND DEDUCTIONS CLAIMED . DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C Zl'I ) 77~,(- ~d~ ,,,e~lll~~jrQ'Lt~4 ~ ~Lisnes~.Z~u! WORK C Tl7 ) g7y' 2Sa3 ! zo-~azo-~a TAXPAYER GN TURE TELEPHONE NUMBER DA"TE TOTAL CEnter on Line 5 of Tax Computation) t PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIYIDUAL TAXES 'jr 11 ~~_r ~ AND FILE PO BOX 280601 _;~~~ ~~~l,~t^v~R RESPONSE ACN HARRISBURG PA 17128-0601 ~# / f`. E'~~ .)~- 1~' ; ~ DATE REV-1543 EX I1FP f0!-RB) 1. Wf i . 4_'j N0. 21 .~~(~-I'~~j(~ 10168644 12-03-2010 zo~o~~c 16 aM ~~_ c«~~ ~~ OR'V`S G~URT f~tli~tB~~i_,~,^JCl ~~ , PA,, ~~ST. OF LOUIS C BAGGERS ssrr log-18-7752 DATE OF DEATH 11-19-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: GREG C BAGGERS REGISTER OF WILLS 349 EQUUS DRIVE 1 COURTHOUSE SQUARE CAMP HILL PA 17011 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decadent, you were a joint owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvaoia. Please cal]_171.7) 787-8327 with q~~e stions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3157-74 Date 11-09-1954 To ensure proper credit to the account, two Established copies of this notice roust accowpany paywent to the Register of Wills. Make check Account Balance $ 11 , 985.12 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax paywents are ^ade within three Amount Subject to Tax $ 5, 992.56 wonths of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. 4 Any Inheritance Tax due will becowe delinquent Potential Tax Due $ 269.67 'a~jjp.~-I nine wonths after the date of death. PART TAXPAYER RESPONSE c ] j}y.~ ~~Ry~~j .may f T ~ ~}. jj~ ,.. ~L'~i ~.~5~ .T_'-^3"^ ~~ar""~ ~~~ ~~~u~ f•l1 ~ ~'.. ~~a1.~I1A~ {1~~11 F T}y~i rM1 A. ® The above inforwation and tax due is correct. Rewit paywent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assesswent will be issued by the PA Departwent of Revenue. C ONE BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION L3 NE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS `' ~'=` ~~•~"'' r ~, X , ~, r r , i.` ,.xf " ~"~` ~'~ 3 $ ~ .» fie ~~~~,~~~ ~t~', j',:, 4 ~ ., $ ~s ... ~ : ~ +: DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID Under penalties of. perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C "167 ) ~~~_SlOTO e' ,, WORK C 717 ) $41-25 C`3 l2 ~ 2a1G+ TAYPOVFR ST ATURE TELEPHONE NUMBER DATE PART 3^ DATE PAID PAYEE ha O-o oCW? tin ~ N *' Ea. ca ,~ ~ ~ N O g N LL ~. Q ~. ~ J~~!4{sH i ~.~ ~ M r~ c., ~ ~• ~ r ~- r~_ c ==' ~~ Q c~ ~- ~ CJ ~ ~ c~ -`_`_ ~~~ ~ ~~ ~. .' ~~ A b ~. ... ~~ _! ', S `` ~~M 'J ~„~+ -.,. .,.: ~, :.~ ~~.