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Home My WebLink About04-0723COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1712B-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004230 SAVIDGE GEORGE M 101 N 36TH ST CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 187-16-2828 FILE NUMBER: 2104- 0723 DECEDENT NAME: SAVIDGE GEORGE DATE OF PAYMENT: 08/03/2004 POSTMARK DATE: 08/02/2004 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04123700 $1,421.44 TOTAL AMOUNT PAID: $1,421.44 REMARKS: SEAL CHECK# 1485 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COF~4ONWEALTH OF PENNSYLVANIA DEPARTV~NT OF REVENUE BUREAU OF INDIVIDUAL TAXES .~ ZNFORMATZON NOTZCE AND TAXPAYER RESPONSE Re.o, oe ....... o[ I '~$?~ii',~ ~EORGE SAVT~E S.S. NO. 187-16-2828 DATE OF DEAT~ 02-27-200q '04 AUG-9o ' ..06 CUN)ERLAND MARGARET M SAVZDGE 3q32 BEDFORD DR CAMP HILL PA 17011 J FZLE NO. 21~J'~. "7~Z..~,~ ACN 0q123701 DATE 06-17-200q TYPE OF ACCOUNT []SAVINGS r~CHECKZNg []TRUST E~CERTZF. REMIT PAYMENT AND FORMS TO: REGISTER OF H~LLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701~ COMPLETE PART I BELO# ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 175q30-05 De~e 06-21-2003 ToJnsur. propercr.dJttoyoura¢¢ount, Pmrcen~ T~able X 50.000 FART TAXPAYER-RESPONSE ] .;'"'""~.':*i~ !~"'"'"'~ ~ ;~ ~ ~'v*' ."'.''~ "'.':~', ...... : .... .~.~ .... , ............ Y~ must complete PART [] and/or PART [] TAX RETURN - COMPUTATION OF TAX ON dOINT/TRUST ACCOUNTS PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne 5 of Tax Computation) Under permit/es of perjury, 1' declare ~ha~ ~he fac~s Z have reported above are ~rue, correc~ and TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND #ILL RESULT IN AN OFFiCiAL TAX ASSESSMENT wlth applicable interest based on tnforeatlon REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE TAX RETURN - PART 2 - TAX COMPUTATION CLATMED DEDUCTIONS - PART $ DERTS AND DEDUCTTONS CLATMED DCEO PI~ROTN~EENATL ToHpORFEvP[HUHtHI~ ESY L VAN [ A ~ I'NFORMATZO..OTZCE DUREAU DF XND'V'DUAL TAXES I ... I ,,E NO. 21 DEPT. 280601 ~ ------ ACN HARRISBURG, PA tT1Za-DEO! TAXPAYER RESPONSE 0~'125700 uv-z.s =x AP, .-. DATE 06-17-2004 GEORGE N SAVIDGE 101 N $6TH ST CANP HILL PA 17011 O¢~-'~T~!;OF GEORGE SAVTDGE S.S. NO. 187-16-2828 DATE OF DEAT~ 02-27-200~ AUG -3c~6 CUHBERLAND Cumb TYPE OF ACCOUNT ~]SAVZNGS [~CHECKING F-~TRUST REHXT PAYHENT AND FORHS TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE~ PA 17015 COMPLETE PART i BELOW # # # SEE REVERSE STDE FOR FILZNG AND PAYMENT INSTRUCTZONS Account No. 175450-05 Dato 06-21-2005 Establ/shad Account Balance 6~, 17~*. 90 P~rcent Taxable X 50. 000 /mount Subject to Tax 31,587.~,5 Tax Rate X . Po~tal Tax ~m 1,~21.~ PART TAXPAYER RESPONSE ] !i~!i'":"B' P!! ............. ! ~!~'"'=~! ',i ................................... ~', :, '"" i"" i'"i i i i ..................... i'""ii i ' '" ' H" ':'~i:*;'' ........... :'"' "~ ....... ~'"ui ...................... ~ .......................... ; '":'":' '" * ':;i;i:~';';'~iiii ........ ~:' i!i!i ................... ONE You must complete PART [] and/or PART [] bmlou, PART Zf you ind/ce~e a different tax rata, please s~ate your TAX RETURN - COMPUTATION OF PART DATE PATD TAX ON JOZNT/TRUST ACCOUNTS DEBTS AND DEDUCTZONS CLAZMED PAYEE DESCRTPTTON ANOUNT PATD TOTAL (Enter on Ltna $ of Tax Computer/on) $ Under penaZtles of per.tury, Z declare that the fac~s T have reported above arb true, correc~ and · c7/7 TELEPHONE NUMBER DATE GENERAL ~NFORHAT~ON 1. FA/LURE TO RESPOND NILL RESULT ZN AN OFFICEAL TAX ASSESSNENT .tth applicable interest basad on information REPORTING TNSTRUCTTONS - PART I - TAXPAYER RESPONSE TAX RETURN - PART 2 - TAX CONPUTATION Dete of Death 07/01/9q to 12/51/9~ 01/01/9S to 06/50/00 07/01/00 to proson~ CLATNED DEDUCTTONS - PART $ - DEBTS AND DEDUCTTONS CLATNED COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96} NO. CD 004231 SAVIDGE GEORGE M 101 N 36TH ST CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 187-16-2828 FILE NUMBER: 2104-0723 DECEDENT NAME: SAVIDGE GEORGE DATE OF PAYMENT: 08/03/2004 POSTMARK DATE: 08/02/2004 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04123702 $30.96 TOTAL AMOUNT PAID: $30.96 REMARKS: SEAL CHECK# 146 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS INFORMATION NOTICE AND TAXPAYER RESPONSE Re,,~, ,' ,~,~ GEORGE SAVZ~GE S.S. NO. ~87-~6-28Z8 DA~ OF D~A~ OZ-ZT-200~ '~ ~U~-~0~5 CUMBERLAND GEORGE M SAVIDGE lOl N $6TH ST CAMP HILL PA 17011 ACN 04125702 DATE 06-17-2004 TYPE OF ACCOUNT ~SAVXNG$ [~]CHECK~NG E~TRUST []CERT~F. R~H~T PAYHENT AND FORHS TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 HEHBERS 1ST FCU has provided the Department with the in~rmatlon listed below which has bean used in COMPLETE PART I BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No, 175450-11 Date 06-Z1-2005 Established Account Balance 1,376.19 Percent Taxable X 50,000 Amount Subjeot to Tax 688.10 Tax Rate X ,045 Potential Tax Duo 30.96 PART TAXPAYER RESPONSE A, ~e above information and tax due is correct. CHECK ~ MiLls and an Official asses~ent will be issued by the PA Department of Revenue. ONE SLOCK B. ~ The above asset has bean or w[11 be reported and tax paid ~Jth ~e Pennsylvania [nher[tance Tax return ONLY to be fried by the decedent's representative. You must coap[ata PART ~ and/or PART ~ be[oN. ] relationship to decedent: TAX RETURN - COMPUTATION OF L~NE 1. Date Estebllshed 1, 2. Account BeLance 2 3. Percent Taxable 3 4. Amount Sub,oct to Tax q, 5. Debts ~nd Deductions 6. Amount Taxable 6 7. Tax Ra~m 7 8. Tax Due 8, PART [] DAlE PAID TAX ON JOINT/TRUST ACCOUNTS DEBTS AND DEDUCTZONS CLAIMED PAYEE DESCRIPTION AMOUNT PATD TOTAL (Enter on Line S of Tax Computation) UAd~r penalt/os o~ porSury, T declare that the facts T hove reported above are true, correct and TA~AYER S~NAT~ ~ TELEPHONE NUH~ER DATE 6ENERAL ~NFORHATZON 1. FAZLURE TO RESPOND HELL RESULT ZN AN OFFECZAL TAX ASSESSHENT with applicable interest bas~don lnformatJan REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE TAX RETURN - PART Z - TAX COHPUTATTON CLATMED DEDUCTTONS - PART $ DEBTS AND DEDUCT:EONS CLATMED COHR~NREALTH OF PENNSYLVAN/A DEPARTHENT OF REVENUE BUREAU DF INDIVIDUAL TAXES ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE '04 U{3 -3 P 2 *05c°mmr RARGARE N SAV'rDGE 3432 BEDFORD DR CARP HTLL PA.,.,,,.~.Cumbe¢iaad Co., PA I FILE NO. 2! ACM 0qlZ$70$ DATE 06-17-200q TYPE OF ACCOUNT EST. OF GEORGE SAVIDGE []SAVINGS S.S. NO. 187-16-Z8Z8 ~]CHECKZNG DATE OF DEATH 02-27-Z001 [--~TEUST CUMBERLAND ['--]CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 MEMBERS 1ST FCU has provided the Department with the information listmd below which has been used in CONPLETE PART 1 BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYNENT INSTRUCTIONS Account No. 175150-11 DU'Ee 06-21-2005 Es'tabltshod Accoun'E Balance 1,376 · 19 Porcon't Taxable X 50. 000 Aeoun't Sub~ac'E 'to Tax 688.10 Tax Re.tm X . O0 Po'Eon'Eta1 Tax Duo . O0 PART TAXPAYER RESPONSE l/~ lh.e above information and tax due is correct. CHECK ~ Rills and an official assessment ~ili be issded b~ the PA Department of Revenue. ONE You must co.lets PART [] and/or PART 5L~J belo~. PART Zf you indica'Ea a difforon'E 'Eax ra'Ee; please S'Ea'Ee your TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Da.to Es'Eablished 2. Acooun'E Bmlm~co 2 3. Porcon.t Tuxablo 3 q. Amoun.t Subjoc'E 5. Dobbs and ~ductions 6. Am~n~ Tax.la 6 7. Tax Ra~e 7 8. Tax ~o 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAZNED PAYEE DESCRIPTION AMOUNT PAID TOTAL (En.ter on Line E of Tax Compu'Ea'Eion) WOeK c TAXPAYER SI~ATURE ~ TELEPHONE NUMBER 6ENERAL [NFORNAT[ON 1. FAZLURE TO RESPOND WZLL RESULT ZN AN OFFZC/AL TAX ASSESSHENT with applicable interest based on Information REPORTTNG INSTRUCTTONS - PART I - TAXPAYER RESPONSE TAX RETURN - PART Z - TAX COHPUTATION CLATNED DEDUCT*rONS - PART $ DEBTS AND DEDUCTIONS ~::iii::::::::::::::::::::::::::::::::::i?::f:::?:::i?:':ilil;iii;i::ifil COH~ON#EALTH OF PENNSYLVANIA DEPART#ENT UF REVENUE BUREAU OF INRIVIDUAL TAXES ZNFORHATZON NOTICE AND TAXPAYER RESPONSE ACN 0~ZZ$70~ DATE 06-17-Z00~ GEORGE M SAVZDGE ZO! N $6TH ST CAMP HILL PA 17011 ~ ;~! : ~S~! OF GEORGE aAVZDGE S~!S~. NO. 187-15-ZSZ8 DATE OF DEAT~ OZ-Z7-ZO0¢ '04 §EP 14 TYPE OF ACCOUNT []SAVINGS []CHECKING []TRUST CUMBERLAND J~]CERTZF. REHZT PAYHENT AND FORHS TO: REGISTER OF NILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 COHPLETE PART i BELON # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 18561¢-05 Date 0¢-23-1999 Established Account Balance 23,098.81 Percent Tlxlbll X 16.667 Amount Subject to Tax 3,8¢9.88 Tax Rate X Potm~t~l Tax Due 173.2¢ PART TAXPAYER RESPONSE I A. ~ Th~ abov~ infuriation end tax du~ Js correct, ONE You lust ¢olplltm PART [] and/or PART [] below. PART Zf yOU indicate a d~fferent tax rtta~ please state your TAX RETURN - COMPUTATION OF LINE 1. Date Established 1 2, Account Balance 2 3. Percent TIxable 3 · . Amount Subject to Tax ~ 5. Debts end Deductions ~ 6. Amount Taxable 6 7. Tax Rata 7 8. Tax Du~ ~ PART DATE PAID TAX ON JOINT/TRUST ACCOUNTS DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PA'rD TOTAL (Entir on Line E of Tax Computmt/on) $ Under perteltia$ of perjury, ! declire; that the facts [ hive reported ibo¥* are true, correct and TAXPAYER ~GNATU~ TELEPHONE NUMBER COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004379 SAVIDGE GEORGE M 101 N 36TH ST CAMP HILL, PA 17011 fold ESTATE INFORMATION: SSN: 187-16-2828 FILE NUMBER: 2104-0723 DECEDENT NAME: SAVIDGE GEORGE DATE OF PAYMENT: 09/14/2004 POSTMARK DATE: 09/13/2004 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04123704 $173.24 TOTAL AMOUNT PAID: 73.24 REMARKS: CHECK//7474 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 171Z8-060! COMMONHEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS, AND ASSESSHENT OF TAX ON JOZNTLY HELD OR TRUST ASSETS REV-I~ii8 EX AFP (01-0S) GEORGE M SA~DG~EP 15 ~8:23 101N $6TH ST CAHP HILL t~2~i~PA 17011 DATE 09-14-Z00~ ESTATE OF SAVIDGE GEORGE DATE OF DEATH 02-27-200~ FILE NUMBER Z1 0~-0723 COUNTY CUHBERLAND SSN/DC 187 - 16 - 28Z8 ACN 0~123700 Amoun'l: R,,,m 'i'l:'~md HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOHER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR DISALLO#ANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-1~-200~ ESTATE OF SAVIDGE GEORGE DATE OF DEATH 02-27-200~ COUNTY CUMBERLAND FILE NO. 21 0~-0723 S.S/D.C. NO. 187-16-2828 ACN 0~123700 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET ZNFORHATZON FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 175q30-05 TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-21-2003 Account Balance 63,17q.90 Percent Taxable X 0.500 Amount Subject to Tax 31,587.q5 Debts and Deductions - .00 Taxable Amount 31,587.q5 Tax Rate X .q5 Tax Due 1,~21.~ TAX CRED'rTS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE HITH YOUR TAX PAYMENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 08-02-Z00~ CDOO~Z30 .00 1,~21.q~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirsments of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Rills printed on the reverse side. -- Rake check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, which mas not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications are available at the Office of the Register of Rills, any of the Z$ Revenue District Offices or by calling the special Z4-heur ansaering service for fores ordering: 1-800-381-1050; services for taxpayers with special hearing and or speaking needs: 1-800-447-30Z0 iTT 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 aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, 5aard 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, Sureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 180601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decodent's death, a five percent (51) discount of the tax paid is allowed. 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 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 aith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes mhich became delinquent before January 1, 1982 bear interest at the rate of six (82) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 1982 wiZl 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 1982 through ZO0~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198~ ZOZ .000548 198----'6-1991 11Z .OOO~01 ZO0"~ 91 .000247 1985 16Z .0004~8 199Z 9Z .000Z47 200Z 6Z .000Z19 1984 11Z .000301 1995-199~ 71 .00019Z 2003 52 .0001~7 1985 Z~Z .000~56 1995-1998 92 .000247 2004 41 .000110 1966 IOZ .000274 1999 7Z .00019Z 1987 92 .000247 ZOO0 8Z .000Z19 --Interest is calculated as folloes: TNTEREST = BALANCE OF TAX UNPAZD X NUliBER OF DAYS DBLZNgIUENT 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 ba calculated. BUREAU OF TNDIV/DUAL TAXES TNHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 17128-0601 COHNONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT. ALLOHANCE OR DISALLONANCE OF DEDUCTION~) AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-16q8 EX AFP (01-05) MARGARET H SAVIDGE'04 SFP 15 ~8:23 SqSZ BEDFORD DR CAHP HILL P~.:g~7011 DATE 09-1q-200~ ESTATE OF SAVIDGE GEORGE DATE OF DEATH 02-27-Z00~ FILE NUNBER 21 COUNTY CUHBERLAND SSN/DC 187-16-2828 ACN 0~125701 Amoun~ Remitted HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-1q-200~ ESTATE OF SAVIDGE GEORGE DATE OF DEATH OZ-Z7-ZOOq COUNTY CUHBERLAND FILE NO. 21 0~-0725 S.S/D.C. NO. 187-16-2828 ACN 0~125701 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORNATZON FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO. 175q$0-05 TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-21-2005 Account Balance Percent Taxable X 0.500 Amount Subject to Tax 31,587.~5 Debts and Deduct/ohs - .00 Taxable Amount 51)587.~5 Tax Rate X .00 Tax Due .00 TAX CREDZTS: 65,17q.90 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."' PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDTTZONAL INTEREST. ZF TOTAL DUE TS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" ( CR)~ YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. .00 .00 .00 .00 PURPOSE OF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIOMS: D/SCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 21~0 of the Inheritance and Estate Tax Act, Act 25 of lOgO. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of Hills 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-1313). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices or by calling the special 2~-hour answering service for fores ordering: 1-800-36Z-20S0; services for taxpayers with special hearing and or speaking needs: 1-800-qq7-3020 (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 an 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. Z810Z1, Harrisburg, PA 171ZB-IOZZ, 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 Assassaant Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Znstructions 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 decedent's death, a five percent (52) discount of the tax paid is allowed. 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. 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 (l) 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 per annum calculated at a daily rate of .00016q. Al1 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 ZO0~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .OOOSq8 198-~8-1991 llX .000301 ZO0'~ 9Z .ooozq7 1983 16Z .000q38 1992 9Z .O00Zq7 ZOOZ 62 .000219 19Bq 112 .000301 1993-199q 7Z .000192 2003 5Z .000137 1985 132 .000356 1995-1998 92 .O00Zq7 200fi qZ .000110 1986 102 ,OOOZ7~ 1999 7Z .000192 1987 92 .0002~7 ZOO0 82 .000219 --[nterest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DATLY TNTEREST 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 ZNDTVZDUAL TAXES TNHERTTANCE TAX DZVTSTON DEPT. 280601 HARRISBURG, PA 17128-0601 HARGARE H SAVIDGE 3q32 BEDFORD DR CAHP HILL CONNONHEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTXCE OF INHERITANCE TAX APPRAXSEHENT. ALLOHANCE OR DISALLONANCE OF DEDUCTZON~, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-15~8 EX ~FP 'O4 DATE 09-1q-200~ ESTATE OF SAVIDGE GEORGE ~DATE OF DEATH OZ-ZT-ZO0~ FILE NUNBER 21 0~-0725 COUNTY CUHBERLAND /\ i~DC 0112570~ 187-16-2828 [ Anoun* Rem/~ed I HAKE CHECK PAYABLE AND REHXT PAYHEHT TO: REGXSTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOHER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAXSEHENT, ALLOHANCE OR DXSALLOHANCE OF DEDUCTXONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-1q-200~ ESTATE OF SAVIDGE GEORGE DATE OF DEATH 02-27-200~ COUNTY CUHBERLAND FILE NO. 21 0~-072~ S.S/D.C. NO. 187-16-2828 ACN 0~123705 TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET XNFORNATXON FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO. 175q$0-11 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIHE CERTIFICATE DATE ESTABLISHED 06-21-2005 Account Balance Percent Taxable ~ 0.500 Amount Subject to Tax 688.10 Debts and Deductions - .00 Taxable Amoun~ 688.10 Tax Ra~e ~ .00 Tax Due .00 TAX CREDZTS: 1,$76.19 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE HITH YOUR TAX PAYNENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATTON OF ADDTTZONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE TS REFLECTED AS A "CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. .00 .00 .00 .00 PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill tho requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of a tax credit, which ams 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 Hills, any of the Z3 Revenue District Offices er by calling the special Iq-hour ansaaring service for forms ordering: 1-800-36Z-ZO50; services for taxpayers with special hearing and or speaking needs: 1-800-q47-30ZO (TT only). Any party in interest not satisfied aith the appraisement, alloaance, or disallaaance of deductions or assessment of tax (including discount ar interest) as sheen on this Notice may object aithin sixty (60) days of receipt of this Notice by: --aritton protest to the PA Department of Revenue, Board of Appeals, Dept. Z81DZ1, Harrisburg, PA 171ZS-lOZ1, OR --electing to have the ;attar 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. ZS0601, Harrisburg, PA 171Z8-0601 Phone (717) 767-6508. See 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 aithin three (33 calendar months after the decadent's death, a five percent (SX) 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 same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) 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 (6g) 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 ail1 vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200q are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198'~'~ ZOZ '.000548 1988-1991 llZ .000301 2009 92 .000Z47 1983 16Z .000438 1992 9Z .000247 ZOOZ 6Z .O00Z19 1984 llZ .OOO30l 1993-1994 72 .O0019Z ZOO3 5X .000137 1985 13Z .000356 1995-1998 9Z .O00Zq7 ZOO4 4Z .000110 1986 lOZ .000Z74 1999 7Z .00019Z 1987 9Z .000Z47 ZOOO aX .000219 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DEL/NQUENT 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. Tf payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DZV/STON DEPT. 280601 HARRTSBURP., PA 171Z8-060! GEORGE M SAVIDGE 101N $6TH ST CAHP HILL CONHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOTNTL¥ HELD OR TRUST ASSETS '04 .S£? 15 ,~ 8:23 DATE 09-14-2004 ESTATE OF SAVIDGE DATE OF DEATH 02-Z7-ZO04 FILE NUMBER 21 04-07Z$ COUNTY CUHBERLAND SSN/DC 187-16-2828 ACN 04123702 Amoun~ Remi~ed REV-I~4, EX AFP GEORGE MAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-14-2004 ESTATE OF SAVIDGE GEORGE DATE OF DEATH 02-27-2004 COUNTY CUMBERLAND FILE NO. 21 04-07Z3 S.S/D.C. NO. 187-16-2828 ACN 04123702 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO. 175430-11 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-21-2003 Accoun~ Balance 1,376.19 Percent Taxable X 0.500 Amoun~ Subjec~ ~o Tax 688.10 Debts and Deductions .00 Taxable Amount 688.10 Tax Ra~e ~ .45 Tax Due 30.96 TAX CREDZTS: 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 RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 08-0Z-2004 CD004231 .00 30.96 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE TF PATD AFTER THTS DATE, SEE REVERSE FOR CALCULATTON OF ADDZTTONAL TNTEREST. ~ ( TF TOTAL DUE TS LESS THAN $1, NO PAYHENT TS REQUTRED. TF TOTAL DUE TS REFLECTED AS A "CREDTT" { CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR TNSTRUCTTONS. } 30.96 .O0 .00 .00 PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 91~0). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. -- Make check er money order payable to: REGISTER OF HILLS, AGENT. 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 are available at the Office of the Register of Nills, any of the Z3 Revenue District Offices or by calling the special Iq-hour answering service for forms ordering: 1-BO0-36Z-Z050~ services for taxpayers aith special hearing and or speaking needs: l-DOO-q47-30ZO (TT only). OBJECTIONS: 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, Oept. Z81OZ1, Harrisburg, PA 171ZB-IOZ1, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: 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. IS0601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1SO1) 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 alloaed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 1D, 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, 198Z bear interest at the rate of six (6g) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January l, 198Z will bear interest at a rata 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 ZOOq are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198'--'~ lOX .0005q8 198'~&-1991 112 .O0030X ZO0'-'~ 92 .O00Zq7 1963 162 .000q38 1992 9X .000Z47 ZOO2 62 .000219 19Bq iIX ,000501 X993-199~ 72 .000192 ZOO3 5X .000137 1985 I~X .000~56 1995-1998 92 .O00Zq7 ZO0¢ 4X .000110 1986 IOZ .O00Z7q 1999 72 .00019Z 1987 92 .0002~7 ZOO0 82 .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELTNQUENT X DATLY 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 THDZVZDUAL TAXES TtIHERZTANCE TAX DTVTSTON PO BOX 280601 HARRISBURG, PA 17128-0601 GEORGE H SAVIDGE 101 N $GTH ST C~ HILL = CUT ALO~THIS L PA 17011 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOT/CE OF INHERZTANCE TAX APPRAISERENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-20-2004 ESTATE OF SAVIDGE DATE OF DEATH 02-27-2004 FILE NUNBER COUNTY SSN/DC ACN 21 04-0725 CUHBERLAND 187-16-2828 04125704 Amoun~ Rem J.)dced REV-I~8 EX AFP (09-Ogl) GEORGE HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 RETAIN LONER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-20-2004 ESTATE OF SAVIDGE GEORGE DATE OF DEATH 0Z-27-2004 COUNTY CUHBERLAND FILE NO. 21 04-0725 S.S/DoC. NO. 187-16-2828 ACN 04125704 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORNATION FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO. 185614-05 TYPE OF ACCOUNT: (~ SAVINGS ¢ ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-25-1999 Accoun~ Balance 25,098.81 Percen* Taxable X 0.166 Amoun~ Subjec~ ~o Tax 5,849.88 Debts and Deductions - .00 Taxable Amoun~ 5,849.88 Tax Ra~e X .45 Tax Due 175.24 TAX CREDTTS: PAYHENT DATE RECEIPT NUMBER CD004579 DISCOUNT (+) INTEREST/PEN PAID (-) .00 TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT 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." AHOUNT PAID NOTE: 175.24 TOTAL TAX CREDIT 175.24 BALANCE OF TAX DUEI .00 INTEREST AND PEN.I .00 TOTAL DUE I .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~F TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" { CR), YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG 1 PA 17128-0601 *- IMFqRHATION NOTICE ~,,-~ AMD TAXP~YER RESPONSE FILE ACN DATE NO. 21 OY-/~~ 04123705 .) 06-17-2004 REY-ln3EX AFP [09-00) !'). 0'1. ;L.-' 't EST. OF GEORGE SAVIDGE S.S. NO. 187-16-2828 ~DATE OF DEATH 02-27-2004 -COUNTY CUMBERLAND TYPE OF ACCOUNT IX] SAVINGS D CHECKING D TRUST D CERTIF. ROBERT L SAVIDGE 3511 MARGO RD CAMP HILL PA 17011 REHIT PAYHENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Dgpartllent with the infor.ation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedentl YOU were a joint owner/beneficiary of this account. If you feel this infor.ation is incorrectl please obtain written corrgction from thg financial institution 1 attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Questions .ay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW Account No. 183614-05 . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date Established 04-23-1999 To insure proper credit to your account 1 two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of WHlsl Agent". PART [!] 23,098.81 16.667 3,849.88 .045 173.24 TAXPAYER RESPONSE !!!!!II~~~.i!I!~I!III.~.IIII!~!~~~!III!I.~~!i!i!~1ilil.!I!!!~~~I~~~!I!!I~.III!~alll_!!!!.!li!!!!.!I!!~~~~!!l!.~~~!l!li; Account Balance Percent Taxable A.ount Subject to Tax Rate Potential Tax Due x x NOTE: If tax payments are made within three (3) months of the decedent's date of deathl you may deduct a 5% discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY A. The above infor.ation and tax due is correct. 1. You may choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interestl or you .ay check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. D The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. D The above infor.ation is incorrect and/or debts and deductions were paid by you. You .ust complete PART 0 and/or PART ~ below. PART ~ TAX RETURN - COMPUTATION OF LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. A.ount Taxable 6 7. Tax Rate 7 8. Tax Due 8 TAX ON JOINT/TRUST ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: x x PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID Under penalties complete to the b t 1(..4J TAXPAYER S G I TDTAL (Enter on Line 5 of Tax Computation) I $ ry, I declare that the facts I have reported above ar. tru.1 correct and adga and baliaf. HOME (")1 ) I 7.9 'C) WORK (/0) 'n7' d-6:,<; TELEPHONE NUM GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interBSt based on infor.ation submitted by the financial institution. Z. Inheritance tax becomes delinquent nine .onths after the decedent's date of death. 3. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (inCluding those held batwBBn husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife .ore 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 INSTRUCTIONS - PART 1 TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed~ place an "X" in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit the. with your check for the amount of tax to the Register of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (For. REV-1548 EX) upon receipt of the return fro. the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritence Tax Return filed by the decedent'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~ Dept 280601~ Harrisburg~ PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice infonlation is incorrect and/or deductions are being clai.ed~ check block "C" and complete Parts 2 and 3 according to the instructions below. Sign two copies and submit the. with your check for the a.ount of tax payable to the Register of Wiils of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return fro. the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint na.es 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 the nu.ber of accounts held. If a double asterisk (..) appears before your first na.e 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. 2. 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 .ore than one year prior to the decedent"s death: 1 DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Exa.ple: A joint asset registered DIVIDED BY TOTAL NUM8ER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVDRS) = .167 X 100 16.77. (TAXABLE FOR EACH SURVIVOR) 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): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 in the na.e of the decedent and two other persons and established within one year of death by X 100 507. (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is deter.ined by .ultiplying the account balance (line 2) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is deter.ined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. P ounger at death to or for the use of a natural parent~ an adoptive parent~ or a stepparent of the child is 07.. The lineal class of heirs includes grl!lndpl!lrents~ parents~ children~ and lineal descendents. "Children" includes natural children whether 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 hava been adopted by othars~ adopted descendants and their descendants and step-descendants. "Siblings. are defined as individuals who have at least one parent in com~on with the decadent~ whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. Oat. of Death Spouse lineal Sibling Collateral 07/01194 to 12/31/94 3X 6X 15X 15X 01/01/95 to 06/30/00 OX 6X 15X 15X 07/01100 to present OX 4..5%- 12X 15X -The tax rate ]11 osed on the not value of transfers fro~ a deceased child twenty-one years of age or y CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED 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 ite.s. B. You actually paid the debts after death of the decedent and can furnish proof of pay.ant. C. Debts being claimed lIuSt be itemized fully in Part 3. If additional space is neaded~ use plain paper 8 1/2" x 11". Proof of pay.ent .ay be requested by the PA Department of R.vanue. COMrvONWEAlTH OF PENNSYlVANIA DEPARTMENT OF REVENUE 6UREAU OF INDIVIDUAL TAXES DEPT,280601 HARRISBURG. PA 17128-060, REV-l162 EX\1 '-96) RECEIVED FROM: PENNSYL VANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SAVIDGE GEORGE M 101 N 36TH ST CAMP Hill, PA 17011 -------- told ESTATE INFORMATION: SSN: 187-16-2828 FILE NUMBER: 2104-0723 DECEDENT NAME: SA VIDGE GEORGE DATE OF PAYMENT: 02/04/2005 POSTMARK DATE: 02/04/2005 COUNTY: CUMBERLAND DATE OF DEATH: 02/27/2004 NO. CD 004916 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04123705 I $173.24 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 2384 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $173.24 GLENDA FARNER STRASBAUGH REGISTER OF WillS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVI~~"~~~Si INHERITANCE TAX DIVISI.6'H"~ ;:-- - PO BOX 280601 :;:',: HARRISBURG PA 17128-060'1-,' NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOMANCE OR DISALLOMANCE OF DEDUCTION5. AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1541 EX AFP 112-04) 18 ! i: 44 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-21-2005 SAVIDGE 02-27-2004 21 04-0723 CUMBERLAND 187-16-2828 04123705 Amount Relli Ued GEORGE OF ORPHh,NS COUBT ROBERT CUt~D~~~,~W?E:):)., 3511 MARGO RD CAMP HILL PA 17011 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 ~ RE-Y=is4-i-EX--AFP--foi-:03i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 03-21-2005 ESTATE OF SAVIDGE GEORGE DATE OF DEATH 02-27-2004 COUNTY CUMBERLAND FILE NO. 21 04-0723 TAX RETURN WAS: S.S/D.C. NO. 187-16-2828 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04123705 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 183614-05 TYPE OF ACCOUNT: ()() SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-23-1999 X 23.098.81 0.166 3.849.88 .00 3.849.88 .45 173.24 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." Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-04-2005 CD004916 .00 173.24 BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-05-2005 TOTAL TAX CREDIT 173.24 BALANCE OF TAX DUE .00 INTEREST AND PEN. 1.48 TOTAL DUE 1.48 . IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR). YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) -~"--