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Home My WebLink About03-0135CONNONgEALTH OF PENNSYLVANIA ~[PARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171Z8-0601 REV-1545 EX AFP (ng-oD) ZNFORNATZON NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 0:5102571 DATE 02-07-200:5 STANLEY A DUDEK JR :SZ PALHER DR CAMP HILL PA 17:011 TYPE OF ACCOUNT EST. OF STANLEY DUDEK E~SAVZNOS S.S. NO. 190-01-6q50 E~CHECKZN$ DATE OF DEATH 11-18-2002 E~TRUST COUNTY CUMBERLAND r~CERTZF. REHIT PAYHENT AND FORHS TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 PNC BANK has provided the Department Nith the information listed beige Nhich has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you Here a joint goner/beneficiary of this account. If you feel this information is incorrect, please obtain ~rittan correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance eith the Inheritance Tax Laos of the Commoneealth c.~ P~.n;ylvan[a. Qu=-s~,ions ==~ b= ans~cr~d by c=[[~n~ (717) COMPLETE PART 1 ~ELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT ~NSTRUCTZONS Account No. :51q00172:569 Date 11-1:5-1999 Established Account Balance 107,018.59 Percent Taxable X 50.0 0 0 Amount Subject to Tax 5:5,509.:50 Tax Rate X . Potent/al Tax Due Z, ~07.92 To insure proper credit to your account, too (Z) copies of this notice must accompany your payment to the Register of gills. Hake check payable to: "Register of gills, Agent". NOTE: If tax payments are made Nithin three (3) months of the decedant's date of death, you may deduct a 52 discount of the tax due. Any inheritance tax due NilZ become deZinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Nills with tee copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of J- ONE ~ #ills and an afficiel assessment will be issued by the PA nepartaent of Revenue. BLOCK J B. [] The above asset has bean or ail1 be reported and tax paid aith the Pannsylvania Inheritance Tax return ONLY to be filed by the decedant's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You .lust complete PART [] and/or PART [] belo~. PART Tf you /nd/cate a d/fferent tax rate, please state your relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Establ/shed 2. Account Balance ~ $. Percent Taxable $ X q. Amount SubSact to Tax q 5. Debts and Deductions $ - 6. Amount Taxable 6 7. Tax Rata 7 X 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne $ of Tax Computation) $ Under penalt/as of perjury, Z declare that the facts Z have reported above are true, correct and C~°"m--P~° t'~-'~t ~kn~edge and bel/ef' HORK HOME( ( ) ) TAXPAYER (~FI~NATURE TELEPHONE NUMBER DATE GENERAL INFORHATION 1. FAILURE TO RESPOND NZLL RESULT iN AN OFFiCiAL TAX ASSESSNENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes dmlinquent nine months after the decedent's date of death. 5. A joint account is taxable even though the dec.dent's name was added as a matter of convenience. ~. Accounts [including those held between husband and wife) which the decedent put in joint names within one year prior to death arm fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for tho amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-lSd8 EX) upon receipt of the return from the Register of Hills. Z. BLOCK B - If the asset specified on this notice has been or will bm reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the dec.dent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Oept lB0601) Harrisburg) PA ITIZS-060I in the envelope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and compIete Parts Z and according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Rills of the county indicated. The PA Department of Revenue will issue an official assessment [Form REV-15~8 EX) upon receipt of the return from the Register of Rills. TAX RETURN - PART Z - TAX COHPUTATION LINE l. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/IZ/BZ: Accounts which the decedent put in joint names within one (l) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $5,000 per transferee regardless of the value of the account or the number of accounts held. Tf a double asterisk (xN] appears before your first name in the address portion of this notice, the $5,000 exclusion already has been deducted free the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. 5. Tho percent of tho account that is taxable for each survivor is determined as follows= A. The percent taxable for joint assets established more than one year prior to the decodont's death: I DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUHBER OF X lO0 = PERCENT TAXABLE JOINT ORNERS SURVTVING JOINT ONNERS Example: A joint asset registered in the name of tho decedent and twa other persons. I DTVTDED BY 5 (JOINT ONNERS) DIVIDED DY Z (SURVIVORS) = .167 X lO0 = 16.?X [TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year cf tho decmdont's death or accounts owned by the decedent but held in trust for another individual(s) [trust beneficiaries): I DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by tho decedent. 1 DIVIDED BY Z [SURVIVORS) = .50 X lO0 = SOX [TAXABLE FOR EACH SURVIVOR) Tho amount subject to tax (line ~) is determined by muItiplying the account balance (line Z) by the percent taxabIo (line 5. Enter the total of the debts and deductions listed in Part 5. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 7. Enter the appropriate tax rate (line 7) as determined below. Dele of ~,,~h I Spa[ms. Lineal Si. bling I 07/01/9~ ~o 12/$1/9~ SX 6X 15X 01/01/95 ~o 06/50/00 OX 6X 07/01/00 *o presen~ OX ~.5Z~ xThm tax rate imposed on the net value of transfers from a decease twenty-one years egg or younger at death to or ~or the use of a natural parent, an adoptive parent, or a stepparent of the child is OX. The lineal class of heirs includes grandparents, parents~ children, and lineal descendents. "Children" includes natural children ~hether or not they have been adopted by others, adapted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, ~hether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIHED DEDUCTIONS - PART S DEBTS AND DEDUCTIONS CLATHED Allo~able debts and deductions are determined as follows: A. You legally ara responsible for payment~ or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can ~urnlsh proof of payment. C. Debts being claimed must be itemized fully Jn Part 5. If additional space is needed, use plain paper & i/Z" x 11". Proof of payment may ba requested by the PA Department of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) OO2167 DUDEK STANLEY A JR 32 PALMER DRIVE CAMP HILL, PA 17011 ESTATE INFORMATION: SSN: 190-01-6450 FILE NUMBER: 2103-01 35 DECEDENT NAME: DUDEK STANLEY A DATE OF PAYMENT: 02/13/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11 / 18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03102571 $ 6,087.00 REMARKS: STANLEY A DUDEK JR TOTAL AMOUNT PAID' $6,087.00 SEAL CHECK//112 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 STANLEY A DUDEK JR 52 PALHER DR CAMP HILL PA 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF XNHEETTANCE TAX APPRAISEHENT., ALLONANCE OR DISALLONANCE OF DEDUCTIONS., AND ASSESSHIDIT OF TAX ON JOXNTLY HELD OR TRUST ASSETS DATE 05-24-2005 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FILE NUMBER 21 05-0155 COUNTY CUMBERLAND ..... · SSN/DC 190-01-6450 ACN 05102571 Amount Remitted REV*IS48 IX AFP (01-05) STANLEY A MAKE CHECK PAYABLE AND REMIT PAYMENT TO= REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS *-~ REV-1548 EX AFP C01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-24-2005 ESTATE OF DUDEK STANLEY A DATE OF DEATH 11-18-2002 COUNTY CUMBERLAND FILE NO. 21 05-0155 S.S/D.C. NO. 190-01-6450 ACN 05102571 TAX RETURN NAS: (X} ACCEPTED AS FILED ( } CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 51400172569 TYPE OF ACCOUNT= ( ) SAVINGS ( ) CHECKING ( } TRUST (~ TIHE CERTIFICATE DATE ESTABLISHED 11-15-1999 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 107,o18.59 0.500 55,509.50 .00 55,509.50 .45 2,407.92 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT DATE 02-15-2005 RECEIPT NUMBER CD002167 DISCOUNT (+) INTEREST/PEN PAID C-) 120.40 AMOUNT PAID 6,087.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * C IF TOTAL DUE IS LESS THAN 41, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 6,207.40 5,799.48CR .00 5,799.48CR PURPOSE OF NOTICE: PAYMENT: REFUND (CR)= OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS= DZSCOUNT: PENALTY= INTEREST= To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit vith your payment to the Register of Nills printed on the -- Hake check or money order payable to= REGXSTER OF HILLS, AGENT. A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Hills, any of the 25 Revenue D/strict Offices or by calling the special 24-hour answering service for forms ordering= 1-800-562-2050; services for taxpayers with special hearing and or speaking needs: 1-800-447-$020 (TT Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by= --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue, Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone (717~ 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent discount of the tax paid is allowed. The 15X tax amnesty non-part/c/pat/on penalty is computed on the total of the tax and interest assessed, and not paid before Januarl/ 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6~) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 are= Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20~ .000548 1987 9X .000247 1999 7X .000192 1983 16X .000438 1988-1991 llX .000501 2000 8X .000219 1984 11~ .000501 1992 9X .000247 2001 9X .000247 1985 15~ .00055& 1995-1994 7X .000192 2002 &X .000164 1986 lOX .000274 1995-1998 9~ .000247 2003 5~ .000157 --Interest is calculated as follows= INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DBLXN~UENT X DATLY XNTEREST FACTOR --Any Notice issued after the tax becomes delinquent wiZ1 refZect an interest calculation to fifteen C15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. STANLEY A DUDEK JR 32 PALMER DR CAMP HILL PA 17011 July 14, 2003 Register of Wills Cumberland County Court House S. Hanover St. Carlisle PA 17013 Re: Stanley P. Dudek Sr., SSN 196-01-6450, File #2103-0135 Dear Sir or Madam: Enclosed you will find the Information Notice and Taxpayer Response Notices from the Commonwealth of PA for the various accounts that were jointly owned by myself and my father. My father had been a resident of Cumberland County for approximately 18 months prior to his passing. I previously made a payment on account of the Inheritance tax at your office on February 13, 2003 in the amount of $6,087.00 to obtain the discount of $120.40. I do not understand why these additional forms say Luzerne County. With this letter I am enclosing my check number 7983 in the amount of $ 578.67 which represents that balance of the PA Inheritance Tax due. Also please note that my father's correct social number is stated above. The notice that was received from the Commonwealth of PA has an incorrect social security number of 190-01-6450. Please inform the State of this error so that they may transfer the payment that was made in February 2003 to the correct social security number. Sincerely, Enclosures COHHONNEALTH OF PENNSYLVANIA DEPARTNENT DF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z&0601 HARRISBURG, PA 1711B-0601 RE¥-~li3 EX &FP (09-00) ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE STANLEY A DUDEK JR 52 PALHER DR CAMP HILL PA 17011-7925 EST. OF STANLEY P DUDEK S.S. NO. 196-01-6q50 DATE OF DEATH 11-18-2002 COUNTY LUZERNE FILE NO.*~'o~*~ -- ~ ~5 ACN 03125210 DATE 06-19-2003 TYPE OF ACCOUNT [] SAVINGS [] CHECKING [] TRUST [] CERTIF. REHIT PAYHENT AND FORHS TO: REGISTER OF HILLS LUZERNE CO COURT HOUSE WILKES-BARRE, PA 18711 VARTAN NATIONAL BANK has provided the Department m[th the information listed below Nh[ch has been used in calculating the potential tax due. The[r records [nd[cate that at the death of the above decadent, you Nors a joint omnsr/benaf[c[ary of this account. [f you faa1 this information is incorrect, please obtain written correct[on from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance mith the Inheritance Tax Lams of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART Z ~ELO# x x # SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS Accoun~ No. 109-163-6 Date 07-10-Z001 Established Accoun* Balance 39,557.1~ Parcan~ Taxable X 50.000 Amoun~ Sub~a¢~ ~o Tax 19,778.57 Tax Ra~a X .0~5 Po~an~ial Tax Due 890.0~ To insure propar credit to your account, two (Z) cop[es of this notice must accompany your payment to the Register of Rills. Hake check payable to: "Register of Hills, Agent". NOTE: ~f tax payments are made m[thin three (3) months of the decedsnt's date of death, you may deduct a 51 discount of the tax due. Any inheritance tax due mill become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. ~The above informer[an end tax due is correct. ~-1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of J- ONE ~ Hills and an official assssseent w[11 be issued by the PA Department of Revenue. ~LOCK ~L-J The above asset has been or will be reported and tax paid with the Pennsylvania [nher[tanca Tax return B. ONLY to be filed by the dscedant's representative. C, [] The above information is incorrect and/or debts and deductions were paid by you. YOU must compZete PART [] and/or PART [] below. PART If you ind/ca~a a d[ffaron~ ~ax ra4:a, please s~a~a your relationship ~o decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Da~a Established 2. Accoun~ Balance 2. 3. Parcan* Taxable 3 ~ q. Amoun~ SubSac~ ~o Tax ~ $. Debts and Deductions ~ 6. Amoun~ Taxable 6 7. Tax Ra~a 7 ~ 8. Tax Due 8 PART DATE PAID DEISTS AND DEDUCTIONS CLAINED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) Under panal~ias of perjury, Z declare ~ha~ ~he fac~s I have reported above ara ~rua, corrac~ and '~AXPAYER~NATURE -- TELEPHONE NUHBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. $. A joint account is taxable even though the dacedent's name was added as a matter of convenience. 4. Accounts (including these held bet#man husband and wife) ~hich the decedent put in joint names #ithin one year prior to death are fully taxable as transfers. 5. Accounts established jointly be[moan husband and wife more than one year prior to death are not taxabIe. 6. Accounts hold by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART I TAXPAYER RESPONSE 1. BLOCK A - If the information end cowputat]on in the notice are correct and deductions are not being c[aimed, place an in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit thee with your check ~or the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fore REV-lB48 EX) upon receipt of the return from the Rag[star of Hills. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedant's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue) Bureau of Individual Taxes, Oep[ 280601, Harrisburg, PA 171Z8-0601 in the envelope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts g and according to the instructions below. Sign tho copies and submit thee with your check for the amount of tax payable to the Register of Mills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-15q8 EX) upon receipt of the return free the Register of #ills. TAX RETURN - PART 2 - TAX COMPUTAT[ON LINE 1. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dy(nD after 1Z/II/BI: Accounts which the decedent put in joint names within one (1) year of death ara taxable fully as transfers. However, there is an exclusion not to exceed $5,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk (aw) appears before your first name in the address portion of this notice, the $3,0g0 exclusion already has been deducted from the account balance as reported by the fine,cia[ institution. Enter the tote[ balance of the account including interest accrued to the date of death. 5. Tho percent of the account that [s taxable for each survivor Js determined as follows: A. The percent taxab[e for joint assets established more than one year prior to the dacedant's death: i DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVTV[NG JDINT O#NERS Example: A joint asset registered in the name of the decedent and two other persons. I DIVIDED BY 5 (JOINT ONNERS) DIVTDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVTVOR} B.The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFIC[ARTES Example: Joint account registered in the name of the decedent and two other persans and established within one year of death by the decadent. I DIVIDED BY g (SURVTVORS) = .50 X 100 = SO[ (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line q) is determined by multlplying the account balance (line Z) by the percent taxable (line S. Enter the total of the debts and deductions listed in Part 5. 6. The amount taxable (llne 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 7. Enter the appropriate tax rate (line 7) as determined below. Da~e of Death Spouse L/naa1 Sibling Collateral 07/01/9q ~o 12/$1/9q 3X 6X 01/01/95 ~o 06/$0/00 OX 6X l~Z l~X 07/01/00 ~o presen~ OX xThe tax rate imposed on the nat value of transfers from a deceased child twenty-one years age or younger at death to or for the use of a natural parent, an adoptive parent) or a stepparent of the ch(Id is OZ. The [ineal class of heirs includes grandparents, parents, children, and [inca1 descendents. "Children" includes natural children #he[her or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others~ adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decadent, whether by blood or adoption. The "Collateral" class of he[rs includes all other beneficiaries. CLATMED DE])UCTTONS - PART 5 - DE]iTS AND ])E])UCTTONS CLATMEO A[lowabla debts end deductions ara determined as fo[lows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be item[zed fully in Part 5. [f additional space is needed, use plain paper & l/Z" x 11". Proof of payment amy be requested by the PA Department of Revenue. COMMONHEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE BUREAU OF ZND[VIDUAL TAXES DEPT. ZB0601 HARRZSBURG, PA 17128-0601 REV-I$115 EX AFP ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE FZLE NO./~ ~t--O~-- ~ ~- ACN 05125211 DATE 06-19-2005 STANLEY A DUDEK JR 52 PALMER DR CAMP HILL PA 17011-7925 TYPE OF ACCOUNT EST. OF STANLEY P DUDEK [] SAVTNGS S.S. NO. 196-01-6q50 [] CHECKTNG DATE OF DEATH 11-18-2002 [] TRUST COUNTY LUZERNE [] CERTTF. REMTT PAYMENT AND FORMS TO: REGISTER OF ~/ILLS LUZERNE CO COURT HOUSE NILKES-BARRE, PA 18711 VARTAN NATZONAL BANK has provlded the Department Nith the information listed beloN Nhlch has been used in calculating the potential tax duo. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you faa1 this information is incorrect, please obtain erittan 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. Questions may be answered by calling (717) 787-8527. COMPLETE PART I BELO# x x x SEE REVERSE SZDE FOR FZLZNG AND PAYMENT ZNSTRUCTZONS Account No. 501-033-1 Date 07-20-2001 Established Account Balance ?6,797.57 Percent Taxable X 50.000 Amount Subject to Tax 15,598.69 Tax Rate X . Potential Tax Due 602.9q To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Hills. Make check payable to: "Register of Hills, Agent". NOTE: If tax payments ara made within three (3) months of tho dacadant's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LTNE A. b(~Tha above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Hills and an official assessment will be issued by the PA Department of Revenue. B. N The above asset has been or will be reported and tax paid eith the Pennsylvania Inheritance Tax return to be filed by the dacedent's representative. C. D Tha above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART [] below. If yOU indicate a different tax rate, please state your relationship to decadent: RETURN - COMPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS 1. Data Established I 2. Account Balance 2. $. Percent Taxable $ ~ q. Amount Subject to Tax q S. Debts and Deductions ~ - 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8. PART DATE PAID DEBTS AND DEDUCTZONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computer/on) $ Under penalties of perSur¥, T declare that the facts I have reported above are true, correct and ete ~o th, Ilmat of /.¥ ~_~wledge and belief. TAXPAYER S~ATURE TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFICIAL TAX ASSESSHENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the dacedant's date of death. 5. A joint account is taxable even though the decedent's name wes added as a matter of convenience. q. Accounts (including those held betaeen husband end mife) ehich the decedent put in joint names aithin one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust far" another or others era taxable fully. REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an in block "A" of Fart I of the "Taxpayer Response" section. Sign tmo coples and submit them with your check for the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue ail1 issue an official assessment (Fora REV-15q8 EX) upon receipt of tho return from the Register of Hills. Z. BLOCK D - If the asset specified on this notice has been or Nil1 be reported and tax pald with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part i of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt 280601, Harrisburg, PA 17128-0601 in the envelope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Farts Z and according to the instructions belam. Sign too copies and submit thee with your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-15~8 EX) upon receipt of tho return fram the Register of Hills. TAX RETURN - PART Z - TAX COMPUTATION LINE l. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after II/II/BI: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transferee regardless of the value of the account ar the number of accounts held. If a double asterisk (mm) appears before your first name in the address portion of this notice, the $3,na0 exclusion already has been deducted from the account balance as reported by the financial institution. Enter the total balance of the account including interest accrued to the date of death. 5. The percent of the account that is taxable far each survivor is determined as follows: A. The percent taxable far joint assets established more than one year prier to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OHNERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of the decedent and two other persons. I DIVIDED BY 5 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X lO0 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created aithin one year of the decedent's death or accounts oened by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OHNERS DR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and too other persons and established within one year of death by tho decedent. 1 DIVIDED BY Z (SURVIVORS) = .SO X lOO = 507. (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line q) is determined by multiplying the account balance (line Z) by the percent taxable (line 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) ts determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line q). 7. Enter the appropriate tax rate (line 7) as determined below. Da{e of Dea{h Spouse L/naa1 I Sibling I Collateral 07/01/9q ~o 12/$1/9q SX 6X 01/01/95 ~o 06/30/00 OX 6X 07/01/00 ~o presen~ OX q.EZ~ 12X aThe tax rate imposed on the net value of transfers from a deceased child t~enty-ona years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and llneal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted chlldrsn and step children. "Lineal descendents" includes all children of the nature1 parents and their descendants, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common aith the decedent, whether by blood or adoption. The "Collateral" class of heirs [ncludes all other bene~[c[ar~es. CLAIMED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLA[MED Allo~able debts and deductions are determined as ;ollo~s: A. You IegaIIy are responsible for payment, or the estate subject to administration by a personal representative ts insufficient to pay the deductJble items. B. You at,ally paid ~e debts after death of the decedent and can furnish proof o~ payment. C. Debts being cla[eed must be itemized fully in Part 5. Zf additional space ts needed, use plain paper 8 l/Z" x 11". Proof of payment may be requested by ~e PA Department o~ Revenue. CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28060! HARRISBURG, PA 17128-0601 REV-1643 EX &FP (09-00) ZNFORMATZON NOTICE AND TAXPAYER RESPONSE FILE NO. ,kO/~- ~-~. ~ ACH 03123212 DATE 06-19-2003 STANLEY A DUDEK JR 32 PALHER DR CAMP HILL PA 17011-7925 TYPE OF ACCOUNT EST. OF STANLEY P DUDEK [] SAVINGS S.S. NO. 196-01-6q50 [] CHECKING DATE OF DEAT~ 11-18-Z002 [] TRUST COUNTY LUZERNE [] CERTIF. REMIT PAYHENT AND FORMS TO: REGISTER OF WILLS LUZERNE CO COURT HOUSE WILKES-BARRE, PA 18711 VARTAN NATIONAL BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you aero a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance Pith the Inheritance Tax Laos of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART i BELOW x x # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 301-078-3 Data 07-ZO-ZO01 EstabZished Account Balance 30,982.92 Percent Taxable X 5 0.0 0 0 Amount Subject to Tax 15, q91. ~6 Tax Rate X .045 Potent/al Tax Due 697.12 To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Hills. Make check payable to: "Register of Hills, Agent". NOTE: If tax payments are made within three (3) months of the decedsnt's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due #il! become delinquent nine [9) months after the date of death. PART TAXPAYER RESPONSE A. ~he above information and tax due is correct. 1. You may choose to remit payment to the Register of Mills with two copies of this notice to obtain CHECK , discount or avoid interest, or you may check box "A" and return this notice to the Register of ONE ~ Mills and an official assessment mill be issued by the PA Department of Revenue. BLOCKJ s. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the decedant's representative. C. [] The above information is incorrect and/or debts and deductions mare paid by you. You must complete PART [] and/or PART [] below. PART Zf you indicate a different tax ra~a, please state your [] relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LTNE 1. Date Established I 2. Account Balance 2. $. Percent Taxable 3 X q. Amount Subject to Tax q $. Debts and Deductions ~ 6. Amoun~ Taxable 6 7. Tax Rate 7 X 8. Tax Due ~ PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne 5 of Tax Computation) Under penaZties of perjury, Z declare that the facts ! have reported above ere true, correct and -~~ ~~. ~ WORK ( TAXPAYER ~NATURE TELEPHONE NUHBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFICIAL TAX ASSESSNENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. $. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death ara fully taxable as transfers. S. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING /NSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice ara correct and deductions ara not being claimed, place an in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check ~or the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt of the return free the Register of NilLs. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA 171ZB-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt of the return froe the Register of Hills. TAX RETURN - PART 2 - TAX COHPUTATION LTNE 1. Enter the date the account originally was established or titled in the manner existing at data of death. NOTE: For a decadent dying after 1Z/12/BZ: Accounts which the decedent put in joint names within one (1) year of death ara taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of tho value of the account or the number of accounts held. If a double asterisk (xw) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decadant's death: I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUHBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIVING JO1:NT OHNERS Example: A joint asset registered in the name of the decedent and two other persons. I DIVIDED BY 3 (JOINT OHNERS) DZVIDED BY Z (SURVIVORS) = .167 X 100 = 16.77. (TAXABLE FOR EACH SURVIVOR) B,The percent taxable for assets created within one year of the dacadent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DTVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OHNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. I DIVIDED BY Z (SURVTVORS) = .50 X 100 = 507. (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying ths account balance (line Z) by the percent taxable (llne 5. Enter the total of the debts and deductions listed in Pert 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line ~). 7. Enter the appropriate tax rate (line 7) as determined below. Da~e of Death Spouse Lineal Sibling Collateral 07/01/94 ~o 12/$1/94 01/01/95 ~o 06/30/00 OZ 6X 07/01/00 ~o presen~ OX 4.5X# 12Z xThe tax rate imposed en the net value of transfers from a deceased child twenty-one years of age ar younger at death to or for the use of e natural parent, an adoptive parent, or a stepparent of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children end step children. "Lineal descendents" includes ell children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents end their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent Jn common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLATHED DEDUCTTONS - PART 5 - DE~TS AND DEDUCTTONS CLATHED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. Tf additional space is needed, use plain paper 8 1/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. CONMON#EALTH OF PENNSYLVAN/A DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 17128-0601 1oo]REV-1S43 EX AFP ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE ACN 051050q2 BATE 02-27-2005 STANLEY A DUDEK JR C/O 52 PALMER DR CAMP HILL PA 17011 TYPE OF ACCOUNT EST. OF STANLEY P DUDEK [] SAVINGS S.S. NO. 196-01-6q50 [] CHECKING DATE OF DEATH 11-18-2002 [] TRUST COUNTY LUZERNE [] CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF HILLS LUZERNE CO COURT HOUSE HILKES-BARRE, PA 18711 FULTON BANK has provided the Department eith the information listed bela. ehich has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you .ere a joint Ocher/beneficiary of this account. [f you faa1 this information is incorrect, please obtain Hrittan correction from the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance .ith the /nharitance Tax La.s of the Coaeon.aalth of Pennsylvania. Questions may be ansHerad by calling (717) 787-8~Z7. COMPLETE PART I BELOH # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. SZ8-O17815q Da~a 05-19-Z00Z Established Account: BaZanca [ ~, ~Sq 5.9 q Percent: TaxabZa X 10 0.0 0 Amoun~ Subject: '1:o Tax l~,~q5.9q Tax Ra~e X . Oq5 Po~en~1aZ Tax Due 600.57 To insure proper credit to your account, tho (Z) copies of this notice must accompany your payment to the Register of Hills. Make check payable to: "Register of Hills, Agent~. NOTE: Zf tax payments ara made Hithin three (3) months of the dscedent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due .ill become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LZNE A. jX[The above information and tax due is correct. ~l. You may choose to remit payment to the Register of Hills ~ith t.o copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of ~il~s and an official assessment .ill be issued by the PA Department of Revenue. [~lTha abave asset has been or Hill be reported and tax paid .ith the Pennsylvania Znheritance Tax return B. ta ba filed by the decedent's repressntative. C. ~The above information is incorrect and/or debts and deductians Here pa~Ja~ you. You must coapleta PART r~ and/or PART ~ beloH. I I Zf you indicate a differan~ ~ax ra~e. please s~a~e your relationship ~o decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. De~a Established I 2. Accoun~ Balance ~ 3. Parcen~ Taxable 3 ~ q. Aaoun~ Subjac~ ~o Tax q ~. Dab~s and Deductions ~ 6. Aeoun~ TaxabZa 6, 7. Tax Ra~a 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLA?MED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line S of Tax Computation) Under penalties of parSury, Z declare tha~ ~:ha fac~s Z have raporj:ad~above ara ~rua, correct: and tco~lete ~o ~he beC. of my knowledge and belief. HOME (~%~) ~- ~%~ TAXPAYER SIGNATURE ~ TELEPHONE NUMBER DATE GENERAL ZNFORHATZON 1. FAILURE TO RESPOND #ILL RESULT ZN AN OFFICIAL TAX ASSESSHENT aith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent"s date of death. 3. A joint account Is taxable even though the dacadent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) eh]ch the decedent put in joint names within one year prior to death ara fully taxable as transfers. 5. Accounts established jointly betwean husband and wife acre than one year prior to death are not taxabla. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTTNG TNSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice ara correct and deductions ara not being claimed, place an in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-154D EX) upon receipt of the return from the Register of Wills. 2. BLOCK B - If the asset specified an this notice has been or will be reported and tax paid with tha Pennsylvania Inheritanca Tax Return filed by the decadent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 28060l, Harrisburg, PA ZTZZa-o60Z in the envelope providad. 3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and compZsta Parts Z and according to the instructions belom. Sign two copies and submit thee mith your check for the amount of tax payabZa to the Register of Hills of the countY indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon race[pt of the return from the Register of Hills. TAX RETURN - PART 2 - TAX COHPUTATZON LINE 1. Enter the date the account criginaZZy mas established or titZad in the manner existing at date of death. NOTE: For a decedent dying after ZZ/[Z/BZ: Accounts ahich the decedent put in joint names eithin one ([) year of death are taxable fully as transfers. However, there is an axcZusion not to exceed $5j000 per transferee regardless of the valua of the account or the number of accounts hold. If a double asterisk (ex) appears before your first name in the address portion of this notica, the $5,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. 5. The percent of the account that is taxabla for each survivor is determined as follows: A. The percent taxable for joint assets astablishad more than one year prior to the dscadant's death: 1 DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUHBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT OHNERS Example: A joint asset registered in tha name of tha decedent and two other persons. I D[VZDED BY 3 (JOINT OHNERS) DZV[DED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within cna year of the dacadant's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): Z DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X lO0 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and twa other persons and established aithin one year of death by the decedent. I BZVZDED BY 2 (SURVIVORS) = .50 X lO0 = 50Z (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (Zing 4) is determined by multiplying the account balance (Zing 2) by tha percent taxabZe (Zing 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 63 is determined by subtracting the debts and daductions (line 5) from the amount subject to tax (Zing 7. Enter the appropriate tax rate (lina 7) as determined below. Dote of Death Spouse 07/01/9q to 12/$1/9q IX 6X 01/01/95 to 06/30/00 OX 6X 07/01/00 to present OX eThe tax rate iaposed on the net valua of transfers from a deceased child tmenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent~ or a stspparent of the child is OZ. The ZJneaZ class of hairs includas grandparents, parants~ children, and lineal descendents. "Children" includes natural children ehethar or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, mhether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals mhd have at least one parent in cowmen with the decedent, whether by blood or adoption. The "CollateraZ" class of heirs includes all other beneficiaries. CLATMED OEDUCTTONS - PART $ DEBTS AND DEDUCTIONS CLATMED ALlowable debts and deductions ara determined as follows: A. You legally ara responsible for payment, or the estate subjact to administration by a personal representative is insufficient to pay the deductible [tens. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. Zf additional space is needed, use plain paper 8 1/2" x 11". Proof of payment ..By be requested by the PA Department of Revenue. CONNONREALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-16,~$ EX ~FP (09-00) ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE FILE NO./d~ ~Ob- ACN 0512q682 DATE 06-27-2005 EST. OF STANLEY DUDECK S.S. NO. 196-01-6q50 DATE OF DEATH 11-18-2002 COUNTY LUZERNE STANLEY DUDECK JR $2 PALMER DR CAMP HILL PA 17011 TYPE OF ACCOUNT [] SAVINOS [] CHECKING [] TRUST [] CERTIF. REMIT PAYHENT AND FORMS TO: REGISTER OF gILLS LUZERNE CO COURT HOUSE WILKES-BARRE, PA 18711 H & T BANK has provided the Department with the information listed bela. which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you mare a joint oenar/beneficiary of this account. If you foal this information is incorrect, please obtain Nrittan correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance aith tho Inheritance Tax Laus of the Coaaonaealth of Pennsylvania. Questions may be ansuared by calling (717) 787-8327. COMPLETE PART !BELON x # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. $1005905891262 Date 0~-07-1997 Established Account Balance 70,55q. 81 Percent Taxable X 5 0.0 0 0 Amount Subject to Tax 35,277. ql Tax Rate X . Oq5 Potential Tax Due 1,587.18 To insure proper credit to your account, tee (2) copies of this notice must accompany your payment to the Register of Rills. Hake check payable to: "Register of Nills, Agent". NOTE: If tax payments are made eithin three (3) months of the decedent's data of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due ~ill become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. ~Tha above information and tax due is correct. . You may choose to remit payment to the Register of Rills ~ith t~o copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of ONE ~ Hills and an official assessment mill be issued by the PA Department Of Revenue. BLOCK J S. [] The above asset has been or ~111 be reported and tax paid uith the Pennsylvania Inheritance Tax return ONLY to be filed by the decadant's representative. C. [] The above information is incorrect and/or debts and deductions t~are paid by you. You must complete PART [] and/or PART [] belcH. PART Tf yOU indicate a dlfferent tax rata~ please state your relationship to decadent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established I 2. Account Balance 2. $. Percent Taxable $ ~ q. Amount Subject to Tax q $. Debts end Deductions 5. - 6. Amount Taxable 6 7. Tax Rets 7 ~ B. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, ! declare that the facts I have reported abog~ are true, correct end ~-~ff _ ~-' complete ~o ~h~~ knowledge and belief. HOME (~'~)~ ~--~,~ TAXPAYER SIGNATURE TELEPHONE HUMMER DATE GENERAL INFORHATION 1, FA/LURE TO RESPOND N/LL RESULT ZN AN OFF/C/AL TAX ASSESSNENT mith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedant's date of death. 3. A joint account is taxable even though the decedent's name aaa added as a matter of convenience. q. Accounts (including those held between husband and wi~e) ehich the decedent put in joint names eithin one year prior to death are fully taxable as transfers. 5. Accounts established jointly bateeen husband and eifa more than one year pr[or to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - Tf the information and computation in the notice are correct and deductions are not being claimed, place an in block "A" of Part 1 of the "Taxpayer Response" section. Sign tee cop[as and submit them with your check for the amount of tax to the Register of mills of the county indicated. The PA Department of Revenue mill issue an official assessment (Form REV-15~B EX) upon receipt of the return from the Register of #ills. Z. BLOCK B - If the asset specified on this notice has been or mill be reported and tax paid eith the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an 'X" [n block "B" of Part L of the "Taxpayer Response" section. Sign one copy end return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA 171Z8-0601 in the envelope provided. $. BLOCK C - If the notice information is incorrect and/or deductions ere being claimed, check block 'C" and complete Parts Z and according to the instructions below. Sign two copies and submit thee with your check for the amount of tax payable to the Register of Mills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-15qB EX) upon receipt of tho return from the Register of mills. TAX RETURN - PART Z - TAX COHPUTATZON L 1. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after lZ/lZ/BZ: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or tho number of accounts held. [fa double asterisk (mx) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. $. The percent of the account that is taxable for each survivor is determined as follows: A. Tho percent taxable for joint assets established more than one year prior to the decedent's death: I DIVIDED BY TOTAL NUHDER OF DIVIDED BY TOTAL NUHBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIVING JOTNT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. I DTVTDED BY 5 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.TI (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decadant's death or accounts owned by the decedent but held in trust far another indlvidual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 PERCENT TAXABLE O#NERS OR TRUST BENEFXCXARTES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. ! DIVIDED BY Z (SURVIVORS) = .50 X lO0 = 50Z (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line q) is determined by multiplying the account balance (line Z) by the percent taxable (line S. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 7. Enter the appropriate tax rate [line 7) as determined beloa. I Da~e of Death Spouse Lineal I Sibl/ng I Collateral 07/01/9~ ~o 12/$1/9~ 01/01/9~ ~o 06/30/00 OX 6Z 07/01/00 ~o presen~ OZ mThe tax rate imposed on the nat value of transfers from a deceased child twenty-one years age or younger at death to or for the use of a natural parent, an adopt[va parent, or a stepparent of the child is OZ. Tho lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children ehathar or not they have been adopted by others~ adopted chitdren and step children. "Lineal descendents" includes ali children of the natural parents and their descendants, whether er not they have been adopted by others, adopted descendents and their descendants and step-descendants. "SibLings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "CoLlateral" class of heirs includes ali other beneficiaries. CLAZHED DEDUCTTONS - PART $ - DEBTS AND DEDUCTIONS CLAZHED Allocable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can ~urnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 1/Z' x 11". Proof of payment may be requested by the PA Depart. ant of Revenue. .,COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 0O2817 DUPLICATE DUDEK STANLEY A JR 32 PALMER DRIVE CAMP HILL, PA 17011 ACN ASSESSMENT CONTROL NUMBER AMOUNT ........ fold 03102571 $578.67 ESTATE INFORMATION: SSN: 196-01-64.50 FILE NUMBER: 2103-0135 DECEDENT NAME: DUDEK STANLEY A DATE OF PAYMENT: 07/17/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/18/2002 REMARKS: STANLEY A DUDEK JR. TOTAL AMOUNT PAID: $578.67 SEAL CHECK# 7983 INITIALS: DO RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA ~DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX O,F, FICIAL RECEIPT ~ NO. REV-1162 EX(11-96) CD 002817 DUDEK STANLEY A JR 32 PALMER DRIVE CAMP HILL, PA 17011 '03 Jill 25 ESTATE INFORMATION: SSN: 196-01-6450 FILE NUMBER: 2103-01 35 DECEDENT NAME: DUDEK STANLEY A DATE OF PAYMENT: 07/18/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03102571 9578.67 TOTAL AMOUNT PAID: 9578.67 REMARKS: STANLEYA DUDEKJR. SEAL CHECK# 7983 INITIALS: DO RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS TAXPAYER ~UL-17-200~ ~4:05 PHC ~HK 717 730 2254 P.01~0~ TO: DONNA OTtO FAX 240-7797 FROM: LINDA LUNDBERG PHONE 730-2265 FILE#21-03-135 STANLEY P. DUDEK SR. SSN 196-01-6450 PAYMENT OF PA INHERITANCE TAX ON JOINT ASSETS: NUMBER AMTSUBJECTTOTAX TAXDUE ACN03102571.~ $53,509.30 $2,407.92 - ACN03105042 $13,345.94 $600.57 ~ ACN03124682 $35277.41 $1,587.48 ACN03123211 $13,398.69 $602.94 ACN03123212 $15,491.46 $697.12 CAN03123210 $19,778.57 $890.04 TOTAL $6,786.07 LESS PAYMENT -6,087.00 LESS DISCOUNT APPLIED BALANCE DUE - 120.40 FAX 240-7797 PHONE 730-2265 TO: DONNA OTTO FROM: LIN'DA I,IYNDBERG FILE #21-03-135 STANLEY B. DUDEK SR. SSN 1911~-01-6450 PAYMENT OF PA INHERITANCE TAX ON JOINT ASSETS: AMOUNT PAID $6,2O7.40 $600.57 $1,587.48 $602.94 $697.12 $311.37 NUMBER AMT SUBJECT TAX DUE TO TAX ACN03102571 $53,509.30 $2,407.92 ACN03105042 $13,345.94 $600.57 ACN03124682 $35,277.41 $1,587.48 ACN03123211 $13,398.69 $602.94 ACN03123212 $15,491.46 $697.12 ACN 03123210 $19,778.57 $890.04 BALANCE OF TAX DUE -- $578.67, PAID JULY 17, 2003. DATE PAID 2/13m3 ~13~3 ~13~3 2/13m3 ~13~3 ~13~3 CREDIT REMAINING $3,799.48 $3,198.91 $1,611.43 $1,008.49 $311.37 $(578.67) STANLEY A DUDEK JR 32 PALMER DR CAMP HILL PA 17011 July 14, 2003 Register of Wills Cumberland County Court House S. Hanover St. Carlisle PA 17013 Re: Stanley P. Dudek Sr., SSN 196-01-6450, File #2103-0135 Dear Sir or Madam: Enclosed you will find the Information Notice and Taxpayer Response Notices from the Commonwealth of PA for the various accounts that were jointly owned by myself and my father. My father had been a resident of Cumberland County for approximately 18 months prior to his passing. I previously made a payment on account of the Inheritance tax at your office on February 13, 2003 in the amount of $6,087.00 to obtain the discount of $120.40. I do not understand why these additional forms say Luzerne County. With this letter I am enclosing my check number 7983 in the amount of $ 578.67 which represents that balance of the PA Inheritance Tax due. Also please note that my father's correct social number is stated above. The notice that was received from the Commonwealth of PA has an incorrect social security number of 190-01-6450. Please inform the State of this error so that they may transfer the payment that was made in February 2003 to the correct social security number. Enclosures COMMONWEALTH OF PENNSYLVANIA DEPA~iITMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DE'PT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002817 DUDEK STANLEY A JR 32 PALMER DRIVE CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 196-01-6450 FILE NUMBER: 2103-01 35 DECEDENT NAME: DUDEK STANLEY A DATE OF PAYMENT: 07/18/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 11 / 18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03102571 $578.67 TOTAL AMOUNT PAID: $578.67 REMARKS: STANLEYA DUDEK JR. SEAL CHECK# 7983 INITIALS: DO RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAX DTVTSTON DEPT. 280601 HARRTSBURG, PA 17128-06nl STANLEY A DUDEK JR $Z PALMER DR CAMP HILL PA 1'70'11 CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN REV-I$O? EX AFP (01-05) 07-28-2005 DUDEK STANLEY P 11-18-2002 21 05-0155 CUMBERLAND 05102571 Amoun~ Remi~ed I HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit: ~o your account, submi~ ~he upper por~:ion of ~:his fore wi~:h your ~:ax payeen~:. CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF DUDEK STANLEY P FILE NO. 21 05-0135 ACN 03102571 DATE 07-28-2003 THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAMED ESTATE. SHO#N BELO# ZSA SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-24-2003 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 2,407.92 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 120.40 02-13-2003 07-18-2003 CD002167 CD002817 .00 6,087.00 578.67 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT 6,786.07 4,378.15CR BALANCE OF TAX DUE INTEREST AND PEN. .00 TOTAL DUE 4,378.15CR YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORM FOR INSTRUCTIONS. ) PAYHENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed an the reverse side. -- Zf RESZDENT DECEDENT make check or money order payable to: REGZSTER OF #ZLLS, AGENT. -- Zf NON-RESIDENT DECEDENT make check or money order payable to: COHHON#EALTH OF PENNSYLVANZA. REFUND (CR): A refund of e tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Hills, any of the 25 Revenue District Offices or free the Department's 2~-hour ansaering service for forms ordering: 1-800-$62-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-3010 (TT REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent (51) discount of the tax paid is alloaed. PENALTY: The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. INTEREST: Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the data of death, to the date of payment. Taxes which became deIinquant before January 1, 1981 bear interest at the rata of six (6X) percent par annum calculated at a daily rata of .00016~. Al1 taxes ahich became delinquent on and after January 1, 1982 ail1 bear interest at a rate which ail1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .0005~8 1987 9Z .000Z47 1999 7Z .OOO19Z 1983 161 .000438 1988-1991 XXZ .000301 ZOO0 81 .000219 198~ 111 .000301 1991 91 .0001~7 Z001 9Z .OOOZ~7 1985 131 .000356 1993-199~ 71 .000191 ZOOZ 6X .00016~ 1986 IOZ .00027~ 1995-1998 91 .0002~7 2003 51 .000137 --Interest is calculated as folloas: I'NTEREST = BALANCE OF TAX UNPA/D X NUMBER OF DAYS DEL/Nt~UENT X DA/LY I'NTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES 'rNHERTTANCE TAX DZVTSTON DEPT. 180601 HARRTSBURG, PA 17118-0601 COMHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT STANLEY A DUDEK JR 32 PALHER DR CAMP HILL PA 170.11 REV-160? EX AFP (11-15) DATE 08-0~-2003 ESTATE OF DUDEK STANLEY P DATE OF DEATH 11-18-2002 FILE NUMBER 21 03-0135 ~' :.' ',.~ COUNTY CUMBERLAND ACN 03102571 Amoun'l: HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credit to your account, submit the upper port/on of this form with your tax payment. CUT ALONG THIS LINE ~m~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-Z607 EX AFP (01-03) ~- INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF DUDEK STANLEY P FILE NO. 21 03-0135 ACN 03102571 DATE 08-0~-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOIfN BELO# IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPL/CATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-2~-2003 PRINCIPAL TAX DUE: .......................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 2,~07.92 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AHOUNT PAID 02-13-2003 CD002167 lZO.~O 2,506.~5 XF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITXONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" TOTAL TAX CREDIT 2,626.85 BALANCE OF TAX DUE 218.93CR ZNTEREST AND PEN. .00 TOTAL DUE 218.93CR YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGTSTER OF NZLLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, ehich mas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office of the Register of Niils, any of the Z3 Revenue District Offices or fram the Department's Z~-hour ansaaring service for fores ordering: 1-600-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-BO0-qq7-3OZO (TT REPLY TO: guastions regarding errors contained on this notice should ba addressed to: PA Oepartaent of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid mithin throe (3) calendar months after the decedent's death, a five percent (DZ) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of slx (6Z) percent per annum calculated at a daily rate of .00016~. Ail taxes whlch became delinquent on and after January Zj 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Interest Daily Year Rate Factor The applicable interest rates for 1982 through 2005 are: Interest Daily Interest Year Rate Factor Year Rate Daily Factor 1982 ZOZ .0005~8 1987 9Z .O00Zq7 1999 7Z .O00Zgz 1983 16Z .000q38 1988-1991 llZ .000301 ZOO0 8Z .O00Z19 198~ llZ .000301 199Z 9Z .O00Zq7 ZOO1 9Z .O00Zq7 1985 13Z .000556 1993-199q 7Z .00019Z 200Z 62 .00016q --Interest is calculated as folloas: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAZLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15] days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF ZNDZVZDUAL TAXES TNHERZTANCE TAX D'rvI'STON DEPT. 280601 HARRXSBURG, PA 17128-0601 STANLEY A DUDEK JR C/O $Z PALMER DR CAMP HILL PA 17'011 CONNON#EALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAXSEHENT, ALLO#ANCE OR DXSALLOHANCE OF DEDUCT/ONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-11-2003 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FILE NUMBER 21 03-0135 ~.?'! ~2 --. ~- COUNTY CUMBERLAND "-~ SSN/DC 196-01-6q50 ACN 031050q2 Amoun~ Rem/~ed REV-Z~48 EX AFP (01-OS) STANLEY P NAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF ~ILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-154S EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-11-2005 ESTATE OF DUDEK STANLEY P DATE OF DEATH 11-18-2002 COUNTY CUMBERLAND FILE NO. 21 03-0135 S.S/D.C. NO. 196-01-6~50 ACN 051050~2 TAX RETURN WAS: eX) ACCEPTED AS FILED ( ) CHANGED dOXNT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. 328-017815~ TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 03-19-2002 Account Balance 13,3~5.9q Percent Taxable X 1.000 Amount Subject to Tax 13,3~5.9~ Debts and Deductions - .00 TaxabZe Amount 13,3qS.9q Tax Rate X .q5 Tax Due 600.57 TAX CREDITS: NOTE: TO INSURE 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 TO: **REGISTER OF WILLS, AGENT.ff PAYMENT RECEIPT i DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-13-2003 CD002167 30.03 570.5q TOTAL TAX CREDIT BALANCE OF TAX DUE] INTEREST AND PEN. TOTAL DUE XF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADD/TXONAL TNTEREST. a XF TOTAL DUE ZS LESS THAN $1, NO PAYMENT XS REQUIRED. XF TOTAL DUE 1S REFLECTED AS A **CREDIT*' ( CR], YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 600.57 .00 .00 .00 PURPOSE OF NOTICE: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 91q0). PAYNENT: Detach the top portion of this Notice and submit mith your payment to the Register of Nllls printed on the reverse side. -- Make check or money order payable to: REGISTER OF NILLS, AGENT. REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: A refund of a tax credit, ehich mas not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of NilIs, any of the Z3 Revenue Oistrict Offices or by calling the special gq-hour ansaering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and or speaking needs: 1-800-qq7-30gO (TT only). Any party in interest not satisfied eith the appraisement, alloeance, or disallomance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object aithin sixty (603 days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171Z8-1021, OR --electing to have tho matter determined et the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ge0601, Harrisburg, PA ITIZe-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions far Inheritance Tax Return for · Resident Decedent" (REV-1SOl) for an explanation of administratively correctable errors. If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is alloaed. The lSZ tax amnesty non-participation penalty is computed on tho total of the tax and interest assessed, and not paid before January 18, 1996, tho first day after the end of tho tax amnesty period. This non-participation penalty is appealable in the same manner and in the tho same time period as you mould appeal the tax and interest that has been assessed es indicated on this not[ca. Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 198Z ailI bear interest at a rate which will vary from calendar year to calendar year mith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rata Factor 198Z ZOZ .O00Sq8 1987 9Z .O00Zq7 1999 7Z .O00/gg 1983 16X .000q$8 1988-1991 llZ .000S01 ZOO0 8Z .OOOZI9 1984 llZ .000301 199Z 9Z .O00gq7 2001 9Z .OOOZq7 1985 13Z .000356 1993-199q 7Z ,000192 2002 6Z .00016q 1986 log .O00gTq 199S-1998 9Z .OOOZq7 ZOO3 5Z .000137 --Interest is calculated as folloms: INTEREST = BALANCE OF TAX UNPAID X NUNBBR OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after tho tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond tho date of the assessment. Tf payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 STANLEY $Z PALMER DR CAMP HILL A DUDEK JR PA ~:17011-7925 tit' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT. ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSIfENT OF TAX ON JOTNTL¥ HELD OR TRUST ASSETS DATE 08-11-2005 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FILE NUMBER 21 05-0135 COUNTY CUMBERLAND SSN/DC 196-01-6~,50 ACN 05125210 Amoun'l: Remi~'l:,.d REV-iG~8 EX ~,FP (01-03) STANLEY P MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~'~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-15q8 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 08-11-2003 ESTATE OF DUDEK STANLEY P DATE OF DEATH 11-18-2002 COUNTY CUMBERLAND FILE NO. 21 03-0135 S.S/D.C. NO. 196-01-6q50 ACN 03123210 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED dOZNT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: VARTAN NATIONAL BANK ACCOUNT NO. 109-163-6 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 07-20-2001 Account Balance 39,557.1q Percent Taxable X 0.500 Amount Subject to Tax 19,778.57 Debts and Deductions - .00 Taxable Amount 19,778.57 Tax Rate X .q5 Tax Due 890.0q TAX CREDITS: NOTE: TO INSURE 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. HAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT."* PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-13-2003 07-17-2003 CD002167 CD002817 lq.05 .00 266.86 578.67 INTEREST IS CHARGED THROUGH 08-19-Z003 TOTAL TAX CREDIT AT THE RATES APPLICABLE AS OUTLTNED ON THE BALANCE OF TAX DUE REVERSE SIDE OF THTS FORM INTEREST AND PEN. TOTAL DUE ~ XF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. ~ ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE;iUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) 859.58 30.q6 .00 30.q6 PURPOSE OF NOTICE: PAYMENT: REFUND [CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z1¢0 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (TI P.S. Section 91riO). Detach the top portlon of this Notice and submit aith your payment to the Register of Nllls printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13153. Applications arm available at the Office of the Register of Hills, any of the Z$ Revenue District Offices or by calling the special 2~-hour ansaering service for forms ordering: 1-800-:56Z-ZO50; services for taxpayers with special hearing and or speaking needs: 1-800-qqT-:50ZO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (incZuding discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --aritten protest to the PA Department of Revenue, Board of Appeals, Dept. ZSIOZ1, Harrisburg, PA 171Z8-1021, OR --aImcting to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. Z80601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sma page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the docodent's death, a five percent discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, end not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in tho the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day fram the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at tho rate of six (6Z) percent par annum calculated at a daily rate of .00016&. All taxes which became delinquent on or after January 1, 198Z will bear interest at a rate which w111 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: Interest Daily Year Rate Factor 198Z 20Z .OOOSq8 198:5 16Z .000A.38 198~ 117. .000:501 1985 15Z .000:556 1986 lOX .00027~. --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAXD Interest Daily Interest Dally Year Rate Factor Year Rate Factor 1987 9Z .0002~7 1999 ?Z .000192 1988-1991 llZ .000501 ZOO0 8Z .000219 1992 9Z .0002q7 2001 97. .0002q7 1995-199q 7Z .000192 2002 6X .O0016q 1995-1998 92 .0002~7 200~ 5Z .000137 X NUMBER OF DAYS DELINQUENT X DATL¥ INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond tho data of tho assessment. If payment is made after tho interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF TNDTVZDUAL TAXES TNHERTTANCE TAX DXVTSXON DEPT, Z80601 HARRXSBURG, PA 17118-0601 STANLEY A DUDEK JR $Z PALMER DR CAMP HILL CONNONWEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOTTCE OF 'rNHERTTANCE TAX APPRAXSEHENT, ALLO#ANCE OR DXSALLOHANCE OF DEDUCTTONS, AND ASSESSHENT OF TAX ON JOTNTLY HELD OR TRUST ASSETS ~-. DATE 08-11-2005 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FXLE NUNBER 21 05-0155 '0~ ,':~'~ 1 ~ '~ ~ ;~;] COUNTY CUHBERLAND SSN/DC 196-01-6q50 ACN 05125111 Amoun~ Remi~ed REV-1648 EX AFP CDT-OS) STANLEY I HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~'- RETAXN LOWER PORTXON FOR YOUR RECORDS REV-1548 EX AFP NOTICE OF INHERITANCE TAX APPRAXSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTXONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-11-2005 ESTATE OF DUDEK STANLEY P DATE OF DEATH 11-18-Z002 COUNTY CUNBERLAND FILE NO. 21 05-0155 S.S/D.C. NO. 196-01-6q50 ACN 05125211 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED dOXNT OR TRUST ASSET INFORNATXON FINANCIAL INSTITUTION: VARTAN NATIONAL BANK ACCOUNT NO. 501-055-1 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 07-Z0-2001 Account BaZance 26,797.57 Percent Taxable X 0.500 Amount Subject to Tax 15,$98.69 Debts and Deductions - .00 Taxable Amount 15,598.69 Tax Rate X .~5 Tax Due 602.9~ TAX CREDZTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOT[CE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "*REGISTER OF WILLS, ASENT.n PAYHENT DATE 02-15-2005 RECEIPT NUMBER CD002167 DISCOUNT (+) INTEREST/PEN PAID (-) 30.15 AMOUNT PAID 572.79 TOTAL TAX CREDIT BALANCE OF TAX DUEl 'rNTEREST AND PEN. TOTAL DUE · rF PA'rD AFTER THI'S DATE, SEE REVERSE FOR CALCULATTON OF ADD'rTTONAL ];NTEREST. ( TF TOTAL DUE TS LESS THAN $1, NO PAYMENT 1'S RE~tJI'RED. 'rF TOTAL DUE 1'S REFLECTED AS A "'CREDTT"' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE Si'DE OF THI'S FORM FOR TNSTRUCTTONS. ) 602.9q .00 .00 .O0 PURPOSE OF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S. Sectlon Detach the top portion of this Notice and submit with your payment to the Register of #i118 printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, which mas not requested on the tax return, may bm requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of #i118, any of the Z3 Revenue District Offices or by calling tho special Z4-hour answering service for forms ordering: 1-800-361-Z050; services for taxpayers with special hearing and or speaking needs: 1-800-4fi7-3010 (TT only). Any party in interest not satisfied mith the appraisement, alloeance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. g81021, Harrisburg, PA 17118-1021, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the sa~e time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 198Z bear interest at the rate of six (6Z) percent per annum calcuZated at a daiZy rate of .000164. A11 taxes which became delinquent on or after January 1, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Thm applicable interest rates for 198Z through ZOO3 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1981 201 .OOOS48 1987 9Z .000247 1999 71 .000191 1985 161 .000438 1988-1991 llZ .000~01 ZOO0 81 .000119 1984 111 .000301 1991 9Z .000247 2001 9Z .000247 1985 13X .000356 1993-199q 7Z .000192 20OZ 6Z .000164 1986 10Z .000274 1995-1998 91 .000147 ZOOS 51 .000137 --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNPA'rD X NUNBER OF DAYS DELXNQUENT X DATLY XNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, mdditional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 CONHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-10iiO EX &FP (01-03) STANLEY 32 PALMER DR CAHP HILL A DUDEK JR '03 G!] 12 PA 1R~21-7925 FILE NUMBER COUNTY SSN/DC ACN DATE 08-11-Z003 ESTATE OF DUDEK STANLEY DATE OF DEATH 11-18-2002 21 05-0155 CUHBERLAND 196-01-6q50 03123212 Amount: RemJ.'t~ed I HAKE CHECK PAYABLE AND RENXT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03} NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-11-2003 ESTATE OF DUDEK STANLEY P DATE OF DEATH 11-18-2002 COUNTY CUHBERLAND FILE NO. 21 03-0135 S.S/D.C. NO. 196-01-6~50 ACN 03123212 TAX RETURN WAS: eX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: VARTAN NATIONAL BANK ACCOUNT NO. 301-078-3 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIHE CERTIFICATE DATE ESTABLISHED 07-20-2001 Account Balance 50,982.92 Percent Taxable X 0.500 Amount Subject to Tax 15,q91.~6 Debts and Deductions - .00 Taxable Amount 15,q91.R6 Tax Rate X .~5 Tax Due 697.12 TAX CREDZTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE NITH YOUR TAX PAYMENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." PAYMENT DATE 02-13-2003 RECEIPT NUMBER CD002167 DISCOUNT (+) INTEREST/PEN PAID (-) $q.86 AMOUNT PAID 662.26 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE TS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ¢ CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR TNSTRUCTTONS. ) 697.12 .00 .00 .00 PURPOSE OF NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (71 P.S. Section 9140). PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, ehich ams not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office the Register of Hills, any of the 13 Revenue District Offices or by calling the special Z4-hour anseering service for forms ordering: 1-800-$62-Z050; services for taxpayers aith special hearing and or speaking needs: 1-800-447-3010 (TT Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest3 as sho~n on this Notice may object aithin sixty (60) days of receipt of this Notice by: --,rittan protest to the PA Departaant of Revenue, Board of Appeals, Dept. 181011, Harrisburg, PA 17118-1011, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in ~rJting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, DEPT. 180601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent [5Z) discount of the tax paid is allomed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period es you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning eith first day of delinquency, or nine (9) months and one (13 day from the date of death, to the date of payment. Taxes ~hich became delinquent before January 1, 1981 bear interest at the rate of six (6Z) percent par annum calculated at a daily rate of .000164. All taxes ahich became delinquent on or after January l, 1981 mill bear interest at · rate ~hich mill vary from calendar year to calendar year ~ith that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2003 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1981 ZOZ .D00548 1987 91 .000247 1999 7Z .000192 1983 16X .000438 1988-1991 llX .000301 ZOO0 8Z .000119 1984 11Z .000301 1991 9Z .000247 ZOO1 9Z .000247 1985 131 .000356 1993-1994 71 .000192 ZOOZ 61 .000164 1986 IOZ .000174 1995-1998 9Z .000147 2003 5X .000137 --Interest is calculated as fallows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINIIUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (lA) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. ~V BUREAU OF ZNDTVTDUAL TAXES TNHERZTANCE TAX DTVTSZON DEPT. IDa601 HARRISBURG, PA 171Z8-0601 STANLEY DUDECK JR SZ PALMER DR CAMP HILL PA 17011 COHHONgEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS RE¥-ISdi8 EX RFP , CDU. HTY '03 /:~g 12 -~M~,~C ACN DATE 08-11-2003 ESTATE OF DUDEK STANLEY DATE OF DEATH 11-18-2002 FILE NUHDER 21 03-0135 CUMBERLAND 196-02-6q50 0312q682 Amount Remitted I MAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~- RETAIN LOgER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOgANCE OR DZSALLOgANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOINTLY HELD OR TRUST ASSETS DATE 08-11-2003 ESTATE OF DUDEK STANLEY P DATE OF DEATH 11-18-2002 COUNTY CUMBERLAND FILE NO. 21 03-0135 S.S/D.C. NO. 196-01-6~50 ACN 0312~682 TAX RETURN gAS: (X) ACCEPTED AS FILED C ) CHANGED dOZNT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: N & T BANK ACCOUNT NO. 31003905891262 TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TINE CERTIFICATE DATE ESTABLISHED 0~-07-1997 Account Balance 70,55q.81 Percent Taxable X 0.500 Amount Subject to Tax 35,277.ql Debts and Deductions - .00 Taxable Amount 35,Z77.~1 Tax Rate X .~5 Tax Due 1,587.~8 TAX CREDITS= NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE NITH YOUR TAX PAYMENT TO THE REGISTER OF gILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF gILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-13-2003 CD002167 79.37 1,508.10 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) 1,587.q7 .01 .00 .01 PURPOSE OF NOTICE: To fulfill the requlreaents of Section 1140 cf the Inheritance and Estate Tax Act, Act Z$ cf ZOO0. (71 P.S. Section 9140). PAYNENT: REFUND OBJECTIONS= ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. -- Nake check or coney order payable to: REGISTER OF NILLS, AGENT. A refund of a tax credit, Nhich Nas not requested on the tax return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at tho Office of the Register of NilZs, any of U~ 23 Revenue District Offices or by calling the specie! 24-hour ansuering service for forms ordering: 1-800-362-Z050; services for taxpayers uith specie! hearing and or speaking needs: 1-B00-447-3010 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object Nithin sixty [60) days of receipt of this Notice by: --urittmn protest to the PA Department of Revenue, Board of Appeals, Dept. ZelOZ1) Harrisburg) PA 1712B-1011, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 1711B-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of adeinistratively correctable errors. If any tax due is paid aithin three (3) calendar months after the decedent's death, a five percent discount of the tax paid is allowed. The 1Si tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you Nould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning Nith first day of delinquency, or nine (9) months and one (1) day from the date of death, te the date of payment. Taxes ahich became delinquent before January 1, 1981 bear interest at the rate of six (61) percent per annue calculated at a daily rate of .000164. A11 taxes uhich becaee delinquent on or after January 1, 1981 will bear interest at a rate which will vary from calendar year to calender year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2003 are: Interest Daily Interest Daily interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 201 .000548 1987 91 .000147 1999 71 .000191 1983 161 .000436 1988-1991 llZ .000301 ZOO0 81 .000219 1984 111 .000301 1991 91 .000147 2001 91 .000247 1985 131 .000356 1993-199~ 71 .000192 ZOOZ 6~ .000164 1986 101 .000174 1995-1998 91 .0001~7 2003 SZ .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. If payment is made after the interest computation data shown on the Notice, additionaI interest must be calculated. BUREAU OF ZNDTVZDUAL TAXES TNHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG,, PA 17128-06D! COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT STANLEY A DUDEK JR 32 PALMER DR CAMP HILL PA 17811-7925 DATE 08-11-2003 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FILE NUMBER 21 03-0135 COUNTY CUMBERLAND ACN 03123211 Amount Remitted RE¥-16Cl7 EX AFP STANLEY P MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To /nsure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAZN LOWER PORTION FOR YOUR RECORDS *~ REV-1607 EX AFP (01-03) ### INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF DUDEK STANLEY P F'rLE NO. 21 03-0135 ACN 03123211 DATE 08-11-2003 THIS STATEMENT 'rs PROV/DED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHO#N BELOW 'rs A SUMMARY OF THE PR.rNC'rPAL TAX DUE, APPL'rCAT'rON OF ALL PAYMENTS, THE CURRENT BALANCE.. AND,, TF APPL'rCABLE, A PROJECTED INTEREST FTGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-11-2003 PRINCIPAL TAX DUE: ....................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 602.9q PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-13-2003 CD002167 30.15 572.79 IF PAID AFTER TH'rS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT 602.9q BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TM'rS FORM FOR 'rNSTRUCT'rONS. PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #ILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMON#EALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service far fores ordering: L-SOO-36Z-ZOSO; services for taxpayers with special hearing end / or speaking needs: 1-800-447-30ZO (TT only). REPLY TD: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZS060I, Harrisburg, PA 17IZS-060I, phone (717) 787-6S05. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SZ) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day free the date of death, to the date of payment. Taxes ahich became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z ail1 bear interest at a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20Z .000548 1987 9Z .O00Zq7 1999 7Z .OO019Z 1983 16Z .000~38 1988-1991 IXZ .000301 2000 az .000219 1984 11Z .000301 199Z 9Z .000Z47 ZOO1 9Z .000Z47 1985 132 .000356 1993-1994 72 .00019Z ZOO2 6Z .000164 1986 10Z .00027q 1995-1998 9Z .000247 2003 5Z .000137 --Xnterast is calculated as follows: TNTEREST = BALANCE OF TAX UNPATD X NUI(BER OF DAYS DEL'rNI~UENT X DAILY I'NTEREST FACTOR --Any Notice issued after the tax becomes delinquent wilI reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Xf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTyTSION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 STANLEY DUDECK JR 52 PALHER DR CAHP HILL PA 17011 COHHON~/EALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT DATE ESTATE OF BATE OF DEATH ACN REV-liS7 EX ~FP (nl-ES) 08-11-2005 DUDEK STANLEY P 11-18-2002 21 05-0155 CUHBERLAND 0512~682 Amount Rem/fred I HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To /nsur-m proper credit to your account, submit the upper port/on of th/s form w/th your tax payment. CUT ALONG THIS LINE ~ RETAIN LOgER PORTION FOR YOUR RECORDS REV-1607 EX AFP [01-03) .K. INHERITANCE TAX STATEHENT OF ACCOUNT ... ESTATE OF DUDEK STANLEY P FILE NO. 21 05-0155 ACN 0512~682 DATE 08-11-2005 THIS STATENENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NANED ESTATE. SHONN BELO# ZSA SUNNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE, AND., ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 08-11-2005 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................ PAYHENTS CTAX CREDITS): 1,587.18 PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 02-13-2005 CD002167 79.57 1,508.10 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' TOTAL TAX CREDIT 1,587.~7 BALANCE OF TAX DUE .01 INTEREST AND PEN. .00 TOTAL DUE .01 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGTSTER OF NZLLS, AGENT. -- If NON-RESIDENT DECEDENT aeka check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which Has not requested on the Tax Return, amy be requested by completing an "Application for Ra~und of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ars available at the Office of the Register of Hills, any of the Z3 Revenue District Dfficss ar from the Department's Zq-hour anseering service for fores ordering: 1-800-36Z-IDS0; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-30ZO (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZBO6Ol, Harrisburg, PA 171Z8-0601, phone (7173 787-6505. DISCDUNT: If any tax due is paid within three (3) calendar months after the decadant's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a dally rate of .00016~. Ali taxes which became delinquent on and after January 1, 1982 mill bear interest at a rate which will vary from calendar year to calendar year aith that rate announced by tho PA Department of Revenue. Interest Daily Year Rate Factor The applicable interest rates far 198Z through ZOO3 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor ZgBZ ZOZ .00054B 1987 9Z .0001~7 1999 7Z .000191 1983 16Z .000q38 1988-1991 111 .OD0301 ZOO0 8Z .000119 1984 llZ .000301 1991 9Z .O00Zq7 2001 91 .000147 1985 132 .000356 1993-1994 7Z .000191 ZOOZ 6Z .00016~ 1986 101 .000274 1995-1998 9Z .0002~7 2003 51 .000137 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAZLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent ail1 reflect an interest calculation to fifteen (15) days beyond tho date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated. BUREAU OF TNDZVZDUAL TAXES TNHERZTANCE TAX DTVTSTON DEPT. :~80601 HARRISBURG.. PA 171Z8-0601 STANLEY A DUDEK JR C/O SZ PALNER DR CAHP HILL PA 17011 CONHONgEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT DATE 08-11-2005 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 ~F~kE.~qNBER 21 03-0135 ~cOUNT~/ CUNBERLAND ACN 03105042 Amoun~ Remi~ed REV-I~O? EX AFl) STANLEY P HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF gILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account) submi~ ~he upper portion of ~his form Nigh your ~ax payment. CUT ALONG THIS LINE I1~ RETAIN LONER PORTION FOR YOUR RECORDS REV-1607 EX AFP [01-03]) ~N~ INHERITANCE TAX STATEHENT OF ACCOUNT ESTATE OF DUDEK STANLEY P FILE NO. 2! 03-0135 ACN 03105042 DATE 08-11-Z003 THIS STATEHENT ZS PROVIDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NANED ESTATE. SHONN BELOW ZSA SUNNARY OF THE PRZNCZPAL TAX DUE., APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE., AND., ZF APPLICABLE., A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSNENT OR RECORD ADJUSTHENT: 08-11-2003 PRINCIPAL TAX DUE: .......................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 600.57 PAYNENT RECEIPT DISCOUNT DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 02-13-Z003 CDOOZ167 30.03 570.54 ZF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN NO PAYHENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), TOTAL TAX CREDIT 600.57 BALANCE OF TAX DUE .00 INTEREST AND PEN. TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. PAYMENT: Detach the top portion of this Notice and submit ~ith your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or monsy order payable to: REGISTER OF NZLLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COHMON#EALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, ~hich ~as not requested on the Tax Return, may bo requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications arm available at the Office of the Register of Ni11s, any of the Z5 Revenue District Offices or frei the Department's Z4-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers eith special hearing and / or speaking needs: 1-BO0-4q7-5OZO (TT only). REPLY TO: Ousstions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revie~ Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid eithin three (5) caZendar months after the decedent's death, a five percent (SZ) discount of tho tax paid is allowed. PENALTY: The 1SZ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ~hich became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. Al! taxes mhich became delinquent on and after January 1, 198Z mill bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Interest Daily Year Rate Factor The applicable interest rates for 198Z through ZOO3 ara: Interest Daily Interest Year Rate Factor Year Rate Daily Factor 1982 ZOZ .0005q8 1987 9Z .000Z47 1999 7X .00019Z 1985 16Z .000438 1988-1991 I1Z .000301 2000 8Z .000Z19 1984 iix .000501 199Z 9Z .000247 ZOOX 9Z .000Z47 1985 13Z .000556 1995-1994 7g .OO019Z ZOOZ 6Z .000164 1986 lOX .000Z74 1995-1998 9Z .000247 ZOO5 5Z .000157 --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPAXD X NUI'IBER OF DAYS DELTNQUENT X DA'rLY 'rNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF TNDZVZDUAL TAXES TNHERZTANCE TAX D][v*rSTnN DEPT. 280601 HARRZSBURG, PA 17128-0601 STANLEY A DUDEK JR 32 PALMER DR CAMP HZLL PA 17011-7925 COMMON#EALTH OF PENNSYLVAN'rA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT 'O3 DATE ESTATE OF DATE OF DEATH FZLE NUI'tBER ACN REV-i&07 EX AFP COl-OS) 08-11-2003 DUDEK STANLEY P 11-18-2002 21 03-0135 CUMBERLAND 05125210 Amoun~ Remi~md I HAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLTSLE, PA 17013 NOTE: To insure proper cr-edi~ ~o your mccoun~:, submi~ *he upper- por~:ion of ~his form CUT ALONG THZS L'rNE ~'- RETAZN LO#ER PORTZON FOR YOUR RECORDS REV-1607 EX AFP (:01-03) ### ZNHERZTANCE TAX STATEMENT OF ACCOUNT ESTATE OF DUDEK STANLEY P FZLE NO. 21 05-0135 ACN 03125210 DATE 08-11-2003 THIS STATEHENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACH 'rN THE NAHED ESTATE. SHO#N BELO# TS A SUI'DIARY OF THE PRTNC:[PAL TAX DUE., APPLTCATI'ON OF ALL PAYHENTS., THE CURRENT BALANCE, AND., 'rF APPL*rCABLE, A PROJECTED 'rNTEREST F/GURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-11-2003 PRINCIPAL TAX DUE: .................................................................................................................................................................................................................... PAYHENTS (:TAX CREDITS): 890.0~ PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (:-) AMOUNT PAID 02-13-2003 07-17-2005 CDOOZ167 CD002817 14.05 .00 266.86 578.67 INTEREST IS CHARGED THROUGH 08-26-2003 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM.~ TOTAL TAX CREDZT ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS. 859.58 BALANCE OF TAX DUE 50.~6 INTEREST AND PEN. .05 TOTAL DUE 30.49 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed an tho reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #ILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CA): A refund of a tax credit, ahich was not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ara available at the Office of the Register of #tllsj any of the 25 Revenue District Offices or from the Department's Z4-hour ansaering service for forms ordering: I-BOO-56Z-ZOSO~ services for taxpayers with special hearing and / or speaking needs: 1-800-4qT-50ZO (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxesj ATTN: Post Assessment Review Unit, Dept. zeos01, Harrisburg~ PA 171ze-o&o1, phone (717) 787-6S03. DISCOUNT: If any tax due is paid within three (5) calendar months after the dacedent's death, a five percent (SI) discount of the tax paid is aZlowad. PENALTY: The 15Z tax amnesty non-participation penalty is computed on tho total of the tax and interest assessed, and not paid before January 18, 1996, the first day after tho end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ahich became deIinquent before January 1, 198Z bear interest at the rate of six (SI) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Tho applicable interest rates for 198Z through ZOO5 are: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor Year Rate Daily Factor 198Z ZOZ .000548 1987 9Z .OOOZq7 1999 7Z .00019Z 1985 16Z .000458 1988-1991 1II .OO05Ol ZOOO 8Z .OOOZ19 1984 11Z .000501 199Z 9Z .OOOZ~7 ZOO1 9Z .000Z47 1985 15Z .000556 1995-1994 7X .OOO19Z ZOOZ 6Z .000164 1986 lOX .000Z74 1995-1998 9Z .O00Zq7 ZOO5 5Z .000157 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI~UENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond tho date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF ZNDTVTDUAL TAXES *rNHERTTANCE TAX D*rv'rs'rON DEPT. 280601 H&RRTSBURG, PA 17128-0601 COHMON#EALTH OF PENNSYLVAN'rA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT STANLEY A DUDEK JR $Z PALHER DR CAHP HILL PA 17011-7925 DATE 08-11-2003 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FILE NUMBER 21 05-0155 ~OUN~] ] CUMBERLAND ACN 05125212 Amoun~ REV-I~07 EX AFP STANLEY P MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper cred/~ ~o your account`, submit: ~he upper portion of ~:h/s form wi~:h your ~:ax payment. CUT ALONG TH'rS LTNE I1~ RETATN LOWER PORTION FOR YOUR RECORDS *~ REV-1607 EX AFP (01-03) -## INHERITANCE TAX STATEHENT OF ACCOUNT ESTATE OF DUDEK STANLEY P FTLE NO. 21 05-0155 ACN 05125212 DATE 08-11-2005 TN'rs STATEMENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHO#N BELO# TS A SUMMARY OF THE PR'rNCTPAL TAX DUE., APPL'rCATTON OF ALL PAYMENTS, THE CURRENT BALANCE`, AND`, TF APPLTCABLE`, A PROJECTED TNTEREST FXgURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-11-2005 PRINCIPAL TAX DUE: ................................................................................................................................................................................................................ PAYMENTS (TAX CREDITS): PAYMENT DATE 02-15-2005 RECEIPT NUMBER CD002167 DISCOUNT ¢+) INTEREST/PEN PAID ¢-) 5q.86 ZF PAID AFTER THZS DATE`, SEE REVERSE SZDE FOR CALCULATION OF ADDZTZONAL ZNTEREST. ZF TOTAL DUE ZS LESS THAN $1`, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. 697.12 AMOUNT PAID 662.26 TOTAL TAX CREDIT 697.12 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 PAYMENT: Detach the top portion of this Notice and submit with your payment mode payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGTSTER OF NTLLS, AGENT. -- Tf NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANZA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications ara available at tho Office of the Register of Milts, any of the Z3 Revenue District Offices ar frae the Department's Zq-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers aith special hearing and / or speaking needs: 1-80O-4q7-3OZg (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280661, Harrisburg, PA 171gB-06Ol, phone [717) 787-6505. D[SCDUNT: [f any tax due is paid within three (3) calendar months after the decodent's death, e five percent (SZ) discount of the tax paid is aZtowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax alnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from tho date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes ahich became delinquent on and after January 1, 198Z wii! bear interest et a rate which aili vary from calendar year to calendar year with that rate announced by tho PA Department of Revenue. The applicable interest rates for 19BZ through 2003 arm: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor Year Rate Daily Factor 198Z 20Z .000548 1987 9Z .000Z47 1999 7Z .00019Z 1983 16Z .O00q38 1988-1991 llZ .000301 ZOOO BZ .O00219 1984 llZ .000301 199Z 9Z .000247 2001 9Z .000247 1985 13Z .000356 1993-1994 7Z .00019Z ZOOZ 6X .000164 1986 IOZ .000274 1995-1998 9Z .OOOZ47 2003 5X .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAI'D X NUNBER OF DAYS DELI'NQUENT X DAI'L¥ INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest lust be calculated. BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DZVZSTON DEPT. Z80601 HARRTSBURG, PA 17128-n601 STANLEY A DUDEK JR 52 PALMER DR CAMP HILL PA 17011 COMMONHEALTH OF PENNSYLVAN'rA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT DATE 08-25-2005 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FILE NUMBER 21 03-0135 ~UN.T? CUMBERLAND ACN 05102571 Amoun'l: Rem L 'l:*l:ed REV-1607 EX AFP [01-05) STANLEY MAKE CMECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To /nsure proper credi~ ~o your account:, submit: ~he upper pore/on of ~h/s form w/~h your ~ax payment. CUT ALONG THIS LTNE ~ RETAIN LOHER PORTION FOR YOUR RECORDS REV-1607 EX AFP (01-03) "## 'rNHER'rTANCE TAX STATEMENT OF ACCOUNT ESTATE OF DUDEK STANLEY P FILE NO. 21 03-0135 ACN 03102571 DATE 08-25-2003 THTS STATEMENT ZS PROVIDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELON ZSA SUMMARY OF THE PRINCTPAL TAX DUE., APPLICATION OF ALL PAYMENTS., THE CURRENT BALANCE:, AND., ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-Iq-ZOO3 PRINCIPAL TAX DUE: ......................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): Z,q07.gZ PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-13-Z003 07-17-2003 CD002167 CD002817 120.qO .00 2,Z87.5Z 199.99 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL /NTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A 'CREDIT' (CR), TOTAL TAX CREDIT BALANCE OF TAX DUE 2,607.91 199.99CR INTEREST AND PEN. .00 TOTAL DUE 199.99CR YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. PAYHENT: Detach the top portion of this Notice and submit eith your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REG/STER OF #ILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: CONNON#EALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, mhich ams not requested on the Tax Return, may be requested by completing an "Application for Refund of PennsyZvania Inheritance and Estate Tax" (RE¥-1313). Applications are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or free the Department's Z4-hour answering service for fores ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZS0601, Harrisburg, PA lT1ZS-060l, phone (717) 787-6505. DISCOUNT: If any tax due is paid eithin three (3) calendar months after the decedent's death, a five percent (SZ) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ehich became delinquent before January 1, 198Z bear interest at the rate of six (SZ) percent per annum calculated at a daily rate of .000164. All taxes ehich became delinquent on and after January 1, 198Z will bear interest at a rate ahich oil! vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. Interest Daily Veer Rate Factor m The applicable interest rates for 198Z through ZOO3 are: Interest Daily Interest Year Rate Factor Year Rata Daily Factor 1982 20Z .000548 1987 9Z .000247 1999 7Z .OOO19Z 1983 16Z .000438 1988-1991 IZZ .000301 ZOO0 8Z .000Z19 1984 11X .00030! 199Z 9Z .000247 ZOOX 9Z .000247 1985 13Z .000356 1993-1994 7Z .00019Z ZOOZ 6Z .D00164 1986 IOZ .000Z74 1995-1998 9Z .000Z47 2003 5Z .000137 --Interest is calculated as folloes: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY I'NTEREST FACTOR --Any Notice issued after the tax becomes delinquent sill reflec~ an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be caLcuLated. BUREAU OF INDIVIDUAL TAXES INHERTTANCE TAX DIVTSTON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COHHONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-Z60? EX AFP C01-g5) STANLEY A DUDEK JR 52 PALNER DR CAHP HILL PA 17011-7925 DATE 08-25-2005 ESTATE OF DUDEK DATE OF DEATH 11-18-ZOOZ FILE NUNeER 21 03-0135 ~J~UN~? -2 /~]~ C'~J~HBERLAND ACN 05125210 Amoun~ Remi~ed STANLEY P HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF HILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credJ~ ~o your account:, submi~ ~he upper portion of ~his fore wJ~h your ~:ex payment:. CUT ALONG THZS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS *-~ REV-1607 EX AFP (01-03) J~J~( INHERITANCE TAX STATENENT OF ACCOUNT x~ ESTATE OF DUDEK STANLEY P FILE NO. 21 05-0155 ACN 05125210 DATE 08-25-2005 TH/S STATENENT 'rs PROV'rDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACH TN THE NAHED ESTATE. SHO#N BELO# TS A SUNNARY OF THE PR/NC/PAL TAX DUE, APPL'rCATTON OF ALL PAYNENTS, THE CURRENT BALANCE, AND, 'rF APPL'rCABLE, A PROJECTED TNTEREST F'rOURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 08-11-2005 PRINCIPAL TAX DUE: .......................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 890.0~ PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 02-15-2005 07-17-Z005 CDOOZ167 CD002817 25.57 .00 ~85.79 578.68 ZF PA/D AFTER TH'rS DATE, SEE REVERSE S'rDE FOR CALCULATION OF ADDZT'rONAL 'rNTEREST. ( 'rF TOTAL DUE ZS LESS THAN $1, NO PAYNENT 1S REQU'rRED. 'rF TOTAL DUE 'rS REFLECTED AS A 'CRED'rT' TOTAL TAX CREDIT 890.0~ BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE S'rDE OF TH'rS FORH FOR 'rNSTRUCT'rONS. ) PAYMENT: Detach the top portion of this Notice and submit aith your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT. -- If NUN-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CA): A refund of a tax credit, which was not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office of the Register of Hills, any of the 25 Revenue District Offices or from the Oepartaent's 2q-hour answering service for forms ordering: 1-800-362-20S0; services for taxpayers with special hearing and / or speaking needs: 1-800-q¢7-3020 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171ZB-06OI, phone (7[7) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is aI1oaed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes #hich became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which wilZ vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO3 are: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor Year Rate Daily Factor 1982 ZOZ .0DOS¢8 1987 9Z .000Z¢7 1999 7Z .O0019Z 1983 16Z .O00qS8 1988-1991 ZIg .000301 ZOOO 8Z .O00Zl9 198¢ IIX .000501 199Z 9Z .0002¢7 2001 9Z .0002¢7 1985 15Z .000356 1993-199q 7Z .O0019Z 2002 6Z .00016~ 1966 log .000Z7¢ 1995-1998 9Z .OODZ¢7 ZOO3 5~ .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF TNDTVTDUAL TAXES I'NHERTTANCE TAX DI'VZS'rDN DEPT. 280601 HARRISBURG,, PA 1711&-0601 CONNONNEALTH OF PENNSYLVAN'rA DEPARTNENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT RE¥-1~07 EX AFP STANLEY A DUDEK JR $Z PALNER DR CAHP HILL PA 17.011 DATE 10-27-2005 ESTATE OF DUDEK DATE OF DEATH 11-18-2002 FILE NUHBER 21 05-0155 COUNTY CUHBERLAND ACN 05102571 Amoun'l: Rem i'l:'l:ed STANLEY P HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF NZLLS CUH~JERLAND CO COURT HOUSE CARLISLE, PA 1701:5 NOTE: To insure proper credit: ~:o your account; submi~ ~he upper por~Lon of ~his form wL~h your ~ax payment. CUT ALONG THIS LZNE ~ RETA'rN LONER PORT'rON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ##" ZNHER'rTANCE TAX STATENENT OF ACCOUNT ESTATE OF DUDEK STANLEY P FILE NO. 21 03-0155 ACN 03101571 DATE 10-27-2003 TNTS STATENENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NANED ESTATE. SHO#N BELON ZSA SUNHARY OF THE PRZNCZPAL TAX DUE; APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE., AND, ZF APPLICABLE; A PROJECTED ZNTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 03-24-2003 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 2,407.92 PAYNENT RECEIPT DISCOUNT (+) DATE NUNBER INTEREST/PEN PAID (-) AHOUNT PAID 120.40 02-13-2003 07-17-2005 10-09-2003 CD002167 CD002817 REFUND .00 .00 Z,287.52 199.99 199.99- ZF PAZD AFTER THZS DATE, SEE REVERSE SIDE FOR CALCULATZON OF ADDZTZONAL INTEREST. { ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" TOTAL TAX CREDZT BALANCE OF TAX DUE INTEREST AND PEN. 2,407.92 .00 .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORN FOR ZNSTRUCTZONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CA): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Rills, any of the Z3 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-$SZ-ZOSg~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-SOZ0 [TT only). REPLY TO: Questions regarding errors contained on this notice should ba addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, phone (7173 787-6505. DISCOUNT: If any tax due is pald within three (3) calendar months after the decedant's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: Tho lSZ tax amnesty nan-participation penalty is computed on the tote! of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and Dna (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of six (SI) percent par annum calculated at a daily rate of .000164. Ail taxes which became delinquent on and after January l, 198Z will bear interest at a rate which will vary from calendar year to calendar year mith that rate announced by the PA Department of Revenue. The applicable interest rates for lgBZ through ZOO3 are: Interest Dally Interest Daily Interest Year Rate Factor Year Rate Factor Year__ Rate Daily Factor 198Z ZOZ .000548 1987 9Z .000Z47 1999 7Z .00019Z 1983 16Z .000458 1988-1991 llZ .000~01 ZOO0 8Z .O00ZX9 1984 XXZ .000301 1992 9Z .000247 ZOOl 92 .000Z47 1985 13Z .000~56 1995-1994 7Z .O0019Z ZOOZ 6Z .000164 1986 lOX .000Z74 1995-1998 9Z .000247 ZOO3 5X .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.