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~ INFORMATION NOTICE
auRH-u of INOIVwItw TAXES AND FILE NO. 21- ~~ - I ~~L
Po emc nobol ~ ~~ t-,~YER RESPONSE ACN 10162339
~ tNRRIS81R6 PA 17128-ObYl ~~
'` r" DATE 11-D2-~OiO
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DIANE KLACE
324 S DIAMOND ST
SNANOKIN PA 17872
EST. OF DEAN E KLIN6ER
SSN
DATE OF DEATR 09-14-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TCI:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
sAVZNSs
CHECKING
TRUST
CERTIF.
SUSQUElIAMNA =ANK prorfded tM Departaent with the inforeation below, rhid~ fies bean used in caleulatinp the
potential tact dw. Reeerds indicate that at tM death of tM abare-naasd decedent. you wra ; ioint ewnar/beneficiary of this secount.
If you feel tM i~eraation is incorrect. please obtain wMttan correction fraa tM fineneial institution. attach a copy to this fora
and return it to the sbers sddrsss. This accecmt fs taxsbla in accordance with the Inheritaneo Tact laws of tM Caeaonwealth of
Penn~rlrania. Plesse call CT171 7a7-8327 rith westiows.. _ --"- _- _' _.
- -
~. ~ COMPLETE PART 1 sELOM !~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 333178713 Data 03-24-2006 To ensue prover credit to the acownt, two
Established comes of This notice aunt seeoapacar
795.18 ~e1t to the Resister of Mills. Malta ehedc
Auount Salanes $ 1 9 , payable to 'Raoistsr of Mills. Aoent".
Psrasnt Taxabis X 100.00
NOTEc If talc paeraents ors wade within three
Aoount Subject to Tax ~ 19,795.18 aronths of the decedent`s date of death,
Tax Rste X .d~~ deatKt • 5 wruat diseoant on th. tax due.
Potential Tax Du. $ 2, 959.28 .~ Any IMeritanee Tax ace rail beta.. delinsuant
nim aMOnthc sftsr the dote of death.
PART TAXPAYER RESPONSE
_",.'DN~.'~'q PD~1;_lil~~~ESilL:T Ti~1~:IIAI;.fl-IC3~ii~'~1lic ASSES!!-ENfi-
0
A. ~ Tfis abore iaforaatien aced tax dw fs correct.
React paplaent to ~e Raaistar of Mills rfth two copies of this notip to obtain
CHECK • diseoont or amid interest. or cheek boot ^A" and return this notice to tM Resistor of
ONE ~ Miiis +~ an official assessaeot rill be issued 6or the PA Dapartaent of Rersrwe.
HLOCK 8. ~TM above asset has been or will be reported and tax paid rith the Pannsylvx~ia Itd~sritanea Tax return
ONLY to be filed 6e- the estate representative.
C. a The above tote on is incorr~ect s~/or debts and deductions were paid.
Cospleta PART- 2~atrVor PART I..J beibw.
p~T if indicatfnp a different tax rate, please stets _: : OF~~,IAL,I~ ~~ fl~-
relationship to decadent: _ PA DEPJIRTME1~i7jflF REVENUE -
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS =PAD - "
-I:~Nc i. Date Estsbi'ishao _~ _^ I - - :. ~ ~~-=~
~
2. Account Balance r
~
X _
=" 3
~ -
s~
3. Percent Taxable 3
4. Aeount Subject to Tax 4
8 '
-
4 ~ -..nwi 'S " - f ~_ _.
5. Debts and Deductions 5
~
_ ~ ::~.
- -
b. Aeount Taxable 6 ~ 6 _
- _
T X 7"
7. lax Rate
~ 8
8. Tax Due 8
PART DEBTS AND DEDUCTIONS C LAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
WORK c 7 t ~-~ ~
~~
Under penalties of penury, I daeiaro that the facts I have raportod above era true, correct and
eoaiplete ~ the,p4Pt_ of ny~wledge and belief . HOME ~ ) _
____ `~,ENNSTLVANiA iNNER1TANG€ TAX
INFORMATION NOTICE
EUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 ~ 1 ~ - ~ ~g ~
Po cox z6uol n. ,w~. ~,~- ~~iAYER RESPONSE ACN 10162338
NARRIS6URS PA 1712•-•661 - '~.~ ~ ' ' '..;"~i f . t,~" DATE 11- 02 - 2010
r.+t ,~'I14^
eEV-is.s a ~w ~I•. ~ _.
C;~ERK ~~
~~~~r~~~ ~ ~V~~
CU"~fi ~~~?~ "~ ~ ~,~., PA.
DEAN E KLIN6ER JR
561 OLD ORCHARD LN
CAMP HILL PA 17011
EST. OF DEAN E KLIN6ER
SSN
DATE OF DEATH 09-14-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17D13
TYPE OF ACCOUNT
SAVINGS
CHECKING
® TRUST
CERTIF.
SUSQUEHANNA BANK provided the Deaartasnt with tM inforoation below. which has boon used in ealeulatin9 the
potential tax due. Records indicate that at the death of the above-naaed Mcedent, you wore a ioint owner/bonefieiar~r of this account.
If you feel the fnfenation is ineorroct, please obtain written eorroction frog the financial institution, attach a copy to tfiis ion
and roturn it to th6 above addross. This account is taxable in accordance with the Inheritance Tax laws of tfa Coaaonwealth of
Pennsylvania. Please call C71T) 767-•327 with gwstions. _ _._._ - . _._ __-- _--
_. _.
COMPLETE PART I SELDW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTI S
Account No. 10005863104 Data 10-03-2008 To ensure proper credit to the account, two
Establlshed copies of this notice oust aeeoapany
payaent to tM Re6ister of Nills. Make check
Account Balance ~` 10 s 061.06 payable to ^Repister of wills. Avant^.
Percent Taxable X 100.00
NOTE: If tax payaents era aaM within three
Aeount Subject to Tax ~ 1D,D61.06 aonths of the Mcedent's date of Math.
TsX Rath X , 045 deduct a 5 percent discount on the tax due.
App, InMritanee Tax due will beeoae delinquent
Potential Tax Due ~ 452 •75 nine aonths after the date of Math.
PART TAXPAYER RESPONSE
...,. ~.
~ .f . 'mss
A. ~ The above inforration and tax due is cornet.
Resit payNnt to the Re63ster of wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or cMdc box ^A^ and roturn this notice to the Register of
Wills and an official assessaent will be issued by tM PA Departaent of Rerenw.
C ONE
B L OGK •. The Move asset has been or will be roportsd and tax paid with the Pennsylvania Inheritance Tax roturn
ONLY to be filed by tM estate roprassntatire.
C. ~ Tfie above inforaa son is incorrect and/or Mbts and Mductians wero paid.
Coewlete PART ~ and/or PART ~ below.
PART If fndicatin• a different tax rate, please state ~'''' "`
~~ ~~ +~~114F
relationship to decedent:
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~~ °`
y~,~::__
LINE -1.- Date Established -- - i-- -_-___. _ _
2. Account Balance 2 $ ~ ~~~~
3. Percent Taxable 3 X
r
4. Awount Subject to Tax 4 ~ `-' c: .
5. Debts and Deductions 5 - ~ `
~ i;;
6. Aoount Taxable 6 ` ~ ~`= -
7. Tax Rate 7 X ~ ~'
~~
~~~
~`
~ ~ ,~~~. .
~ :
~,
~~
.
~' ~$ _
8. Tax Due 8 _,
PART DEBTS AND DEDUCTIONS CLAIMED
0
narF PATn PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
cnaolete to t~i besyvT~aiy knowl~~^d belief. HdME C 7
WORK C 7/7 ~ 73/-
r~ 0
LAW OFFICES OF
GATES, HALBRUNER, HATCH & GUISE, P.C.
1013 MUMMA ROAD • SUITE 100 • LEMOYNE, PENNSYLVANIA 17043
(717) 731-9600 • FAX: (717) 731-9627
LOWELL R. GATES, LL. M. CORRESPONDENCE ADDRESS: BRANCH OFFICE:
3 WEST MONUMENT SOUARE, SUI7E 304
LL. M. in Taxation Lemoyne Office PA 17044
LEWISTOWN
Also Admitted to Massachusetts Bar WEB SITE: ,
(717) 248-6909
MARK E. HALBRUNER www.GatesLawFirm.com
CRAIG A. HATCH, CELA STACEY L. NACE
Certified as an Elder Law Attorney by Paralegal/Office Manager
the National Elder Law Foundation TRACT L. SEPKOVIC
CLIFTON R. GUISE Paralegal
Also Admitted to practice before the VALERIE LONG
U.S. Patent & Trademark Office Paralegal
JAIME D. BLACK TRACT L. SHERIDAN
Of Counsel Paralegal
2011
January 5 .,
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Cumberland County Courthouse ~
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Office of the Register of Wills -~ {? ~ ~?
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One Courthouse Square ~i
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Carlisle, PA 17013 '
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RE: Estate of Dean E. Klinger, Sr.
File No. 2110-1080
Dear Register of Wills:
Enclosed for filing, in duplicate, are two (2) Information Notice and Taxpayer Response
forms. Please time-stamp the third copy of each Notice and return them to our office in the
enclosed envelope.
Thank you for your assistance in this matter.
Sincerely,
Traci L. Sepkovic
Paralegal
Enclosures
cc: Terry L. Klinger, Administrator