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HomeMy WebLinkAbout06-10-11 (2)•',* ~~-- ROTZ 5~~0~~ IF~R CERTIFIED PUBLIC ACCOUNTANTS Lynn C. Rotz, CPA Todd F. Stonesifer, CPA L. David Law, CPA Wanda K. Dietrich, CPA Register of Wills Jodi Frank Zeis, CPA Norman L. Myers II, CPA, CCIFPl COUrthOUSe Square Jessica L. Tice, CPA Carlisle, PA 17013 William E. Sanders, CPA Jennifer S. Gable, MBA, CPA Michael C. Buhrman, CPA A Pro/essiona! Corporation io- I~fa Robert D. Walker, Jr., CPA To Whom it May Concern: ' Michael L. Rider, CPA Randall E. Zook, CPA Rebecca J. Reese, CPA We disagree with the attached notices related to the Estate f Ol' J 1134 Kennebec Drive Chambersburg, PA 17201 (717)264-5961 Fax (717) 264-7377 190 Arsenal Road York, PA 17404 (717) 854-3700 Fax (717) 854-3701 643A E. Baltimore Street Greencastle, PA 17225 (717)597-8724 (717) 328-4122 Fax (717)597-4043 104 Locust Street East Berlin, PA 17316 (717)801-0568 Fax (717)259-0090 o rve .Evert (SSN 204-03- 0024). The Citizens Bank of Pennsylvania trust accounts 6140697115, 6140697123, 6140697085, 6140697077, 6140697093, and 6140697107 on the attached notices totaling $10,140.60 were reported on Schedule G of REV-1500 in the total amount of $10,142.64 and were properly taxed. In addition, we have attached a check in the amount of $225.07 related to Citizens Bank of Pennsylvania account 6140865352. This account was erroneously omitted from the originally filing of REV-1500. Since ly Michael Buhrman Certified Fublic Accountant h.i ~~, ~~ ~~~ ~~ ~~~ ~ ` ~- ,_~ >-~ ~~ PENNSYLVANIA INHERITANCE TAX ~ ~.,~' INFORMATION NOTICE ` BUREAU QF INDIVIDUAL TAXES AND FILE N0. 21 10-0142 Po Box zaosal TAXPAYER RESPONSE ACN HARRISBURG PA 17128-0601 11119956 eEV-I56] E%~FP (//-/p) DATE 03-25-2011 TYPE OF ACCOUNT EST. OF OLIVE EBERT ^ s,AYINGs SSN 204-03-0024 ~ CHECKING DATE OF DEATH 02-03-2010 ~ TRUST COUNTY CUMBERLAND © CERTIF. REMIT PAYMENT AND FORMS T0: SHARON E TAYLOR REGISTER OF WILLS 6 HOUSTON DR 1 COURTHOUSE SQUARE MECHANICSBURG PA 17050 CARLISLE PA 17013 CITIZENS BANK OF PENNSYLVANIA provided the Department with the information below, which has boon used in calculatinm the potential tax due. Records indicate that at the death of the above-named decedent. you were a joint owner/benefielary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above atldress. This account is taxable in accordance with the Inheritance Tex laws of the Comwom,ealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS account No. 6140865352 Date 04-07-1992 T Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Dua CHECK ONE BLOCK ] ONLY Established $ 10,009.17 X 50.000 $ 5,004.59 X .15 $ 750.69 O ensure proper CEedli LO LAB aCCOUntr two copies of this notice must aeeomparar payment to the Rspister of Wills. Make check payable to "Rapistar of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's tlate of death, deduct e 5 Darcent discount on the tax due. Any Inheritance Tax due will become delinquent nine months after the date of death. A. ^ The above information and tax due is correct. Remit payment to the Rapistar of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Raeister of Wills and an offfcial assessment will be issued by the PA Departaent of Revenue. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C. ~ Tha above infor ion is incorrect and/or debts and deductions were paid. Complete PART 2B and/or PART 3~ below. PART If indicating a different tyA rat/,, please state relationship to decadent:~~h}g,~ TAX RETURN - COMPUTATION OF TAX ON JOINT/BUST ACCOUNTS LINE 1. Date Established 1 ~~ ~ ~) ~- 2. Account Balance 2 $ 3. Portent Taxable 3 X J 4. Amount Subject to Taz 4 ¢ QQf.~_. ' ~- 5. Debts and Deductions ~ 5 - 6. Amount Taxable 6 s J , 7. Tax Rate 7 X e 8. Tax Due g $ 27 _ , 07 PART 0 DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEntar on Line 5 of Tax Computation) ~ Under penalties of perjury, I doclare that the facts I have reported a/b~,ove are true, correct and ~~~e~~ /t~,tD~6ist of y knowl~edg~ and b~oLlief. HOME C `1~) Q~Q- ~~~q J (o /,~/C~t.lR7I JX ~n "tI ~~ WORK ( ) DATE PENNSYLVANIA INHERITANCE TAX •'`' INFORMATION NOTICE ! BUREAU OF INDIYIDWIL TAXES AND F I L E N0. 21 10 - D 142 NARRISBURG6PA 17128-osol TAXPAYE R RESPONSE ACN 11119953 eEV-1543 EX 3FP (33-oe, DATE 0 3 - 25 - 2011 KELSEY M DODY 6 HDUSTON DR MECHANICSBURG PA 17050 EST. OF OLIVE EBERT 5SN 204-03-0024 DATE OF DEATH 02-03-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING ® TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA provided the Department with the infonation below, which has been used in calculating the Dotantial tax due. Records indicate that at the death of the above-named decedent. you were a joint owner/beneficiary of this account If you feel the information is incorrect, please obtain written correction frog the financial institution. attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of Lhe Commonwealth of Pennsylvania. Please call C717) J67-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6140697115 Date 04-07-1995 To ensure proper credit to the account, two Establishetl copies of this notice oust accompany Account Balance g 1,014.06 payment to the Register of Wills. Make chock payable to "Register of Wills, Agent". Percent Taxable X 100.00 Amount Subject to TeX NOTE: If tax payments are made within three 1 ~ 014. 06 months of the decedent's data of death, Tex Rate ~( ~ 1(j deduct a 5 Darcent discount on the tax due. Potential TaX Due ~ 152.11 Arty Inheritance Tax due will become delinquent nine months attar the data of death. PART TAXPAYER RESPONSE 0 A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Remistar of 0 NE Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK ~ B. ® The above asset has bean or will 6e reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above info a ion is ineorr ct and/or debts and deductions were paid. Complete PART ~ and/or PART 3~ below. PART If indicating a different tax rata, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 $ 3. Portent Taxable ; X 4. Amount Subject to Tax 4 ~ 5. Debts and Deductions 5 - 6. Amount Taxable 6 ~ 7. Taz Rate 7 X 8. Tax Due B PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) i Under penaltios of perjury, I declare that tho facts I have reportetl a/b/~~oTve areOtrue, correct and ~~- c`omplet o t~of m knowledge and bolief. HOME C '//7 ) 7/Q- ~ .~9 '•~'~~wyM'I/~ ~ ~ K~o'7 // WORK ( ) DATE PENNSYLVANIA INHERITANCE TAX . ~~ INFORMATION NOTICE 4 BUREAU OF INDIVID1a1L TAXES AND FILE N0. 21 10-0142 PO BOX 260601 TAXPAYER RESPONSE ACN HARRISBURG PA 17128-0601 11119954 esv-isas ex ov ne-ou DATE 03-25-2011 ADAM P HERROLD 6 HOUSTON DR MECHANICSBURG PA 17050 CITIZENS BANK OF PENNSYLVANIA Drovided the Departwent with the infonation below, which has been used in calculating th• potential tax due. Records indicate that at the death of the above-Hawed decedent, you were a joint caner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty antl return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvanf a. Please call 7717) 787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6140697123 Hate 04-07-1995 To ensure proper credit to the account, two Established copies of this notice wust accowpafry Account Balance $ 1,014.06 Daywent to the Reaistar of Wills. Make check payable to "Reaistar of Wills, Apent". Percent Taxable X 100.00 Amount Sub3ett to Tax $ 1 ~ 014.06 NOTE: If tax pavwents are wade within three months of the decedent's date of death, Tax Rate ~( ~ lj deduct a 5 percent discount on the tax due. Potential Tax Due $ 1 52.1 1 Any Inheritance Tax due will becowe delinquent nine wonths after the date of death. PART TAXPAYER RESPONSE 1 A. ~ Tha above intonation and tax due is correct. Rewit priwent to the Reaistar of Wills with two copies of this notice to obtain C CHECK ~ a discount or avoid interest, or chock box "A" and return this notice to the Reaistar of ONE ~vI Nills end an official assesswent will be fssuatl by the PA DaDartwent of Revenue. BLOCK B. uci The above asset has bean or will be reported and tax ON L Y "l to be filed paid with the Pennsylvania Inheritance Tax return by the estate representative. C. ~ Tha above inforwa ion is incorrect and/or debts antl deductions were paid. Complete PART ~2 and/or PART ~ below. PART If indicating a ditferent tax rate, please state a relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due g $ EST. OF OLIVE EBERT SSN 204-03-0024 DATE OF DEATH 02-03-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE S4UARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING ® TRUST CERTIF. PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) i Under penalties of par3ury, I declare that the facts T have reported above aro tnrue,~/eorraLc[k an~~11p c~o to the best of}~mY knowled9 and belief. r 7 ~ 7 - lS+fl / I ~ ~~' 'Y' ~ ~- !p `~I' ~ ~ WORK C ~T~7; DATE PENNSYLVANIA INHERITANCE TAX F E','` INFORMATION NOTICE ;~ suREwu DF INDIVIDUAL TAxES AND FILE N0. 21 10-0142 , PD Box zaBSOI TAXPAYER RESPONSE ACN WIRRISBURG PA 17128-0601 11119951 REV-1563 E%~FP (pp-Ip) DATE 03-25-2011 JODY L DODY 6 HOUSTON DR MECHANICSBURG PA 17050 CITIZENS BANK OF PENNSYLVANIA providetl the Department with the information below, which has boon used in calculating the potential tax due. Records indicate that at the tleath of the above-named decedent, you were a ioint owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in eeeordance with the Inheritance Tax laws of the Commonwealth of Pennrilvania. Plesse call 1717) 787-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6140697085 Date 04-07-1995 To ensure proper credit to the account, two Established covies of this notice must sccompann Account Ba18nCe S 2, U26. 12 Dayment to the Resister of Wills. Make check Percent Taxable payable to "Rapistar of Wills, Asent•'. X 100.00 Amount Subject to Tax ~` 2,02$.12 ND7E: If tax payments era made within three months of the decedent's data of death, TaX Rate X .1 5 deduct a 5 pa rcent discount on the tax due. Potential Tax Duo $ 3 0 4.22 Any Inheritance Tax due will become delinquent nine months after the date of death. POT TAXPAYER RESPONSE t A. 0 The above info nation end tax due is correct. Remit paymont to the Resister of Wills with two eoDies of this notice to obtain CHECK a discount or avoid interact, or chock box "A" and return this notice to the Resister of 0 N E Wills and an official assessment will be issued by the PA Departwent of Ravanue. BLOCK ~ B. ® The above asset has been or Mill be reported and tax Daid with the Pennsylvania Inheritance lax return ON L Y to be filed by the estate reDresentatiye. C. ~ The above informs Son is ineorre t and/or debts antl deductions ware paid. Complete PART ~2 and/or PART 3~ below. PART If indicating a different tax rata, please state relationship to decetlent: EST. OF OLIVE EBERT SSN 204-03-0024 DATE OF DEATH 02-03-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE DF ACCOUNT SAVINGS CHECKING ® TRUST CERTIF. TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Establishetl 1 2. Account Balanco 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Taz 4 ~ 5. Debts and Deductions 5 - 6. Amount Taxable 6 ~ 7. Tax Rate 7 X 8. Tax Due g $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Taz Computation) e Under penalties of perjury, I declare that the facts I have reported above era tru/e, correct and eompl he b st of m~ knowletlye~~~~and belief. HOME ( ~~~) 9`Q~ ~ ~~ ~ ~ ./ J9~~ ~~r1.r>~. 1'.e/ J '0 L ' 7- ~I WORK C ) I - --'-"- TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX ,.,;' INFORMATION NOTICE .f BuRE11U OF INDIVIDUAL TAxES AND FILE NO. 21 10-0142 . PO BOX 280601 NARRISBURG PA 171ze-osol TAXPAYER RESPONSE ACN 11119950 REY-1563 EI •FP <.e-RRI DATE 03-25-2011 JULI A HERROLD 6 HOUSTON DR MECHANICSSURG PA 17050 EST. OF OLIVE EBERT SSN 204-03-0024 DATE OF DEATH 02-03-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING ® TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA provided the Departaent with the infonation below, which has boon used in calculating the Dotential tax due. Records indicate that at the death of the above-naaed decedent. you were a joint owner/beneficiary of this account. If you feel the inf oraation is incorrect, Dlease obtain written correction frog the financial institution, attseh a copy to this fora end return it to the above address. This account is tsxable in accordance with the Inheritance lax laws of the Coaaonwealth of Pennsylvania. Pleas• call (717) 787-8327 with questions. COMPLETE PART 1 BELOW r SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6140697077 Date 04-07-1995 r Account Balance Percont Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART CHECK ONE BLOCK ONLY PART TAX Established $ 2,028.12 X 100.00 S 2,028.12 X .15 8 304.22 o ensure proper credit to the account, two copies of this notice aunt accoap ally payaent to the Register of Wills. Make chock Dayable to "Register of Wills, Agent". NOTE, If tax peyaents are aade within three aonths of the decedent's tlet• of death. deduct a 5 pa reent discount on the tax tlue. Ara, Inheritance Tax due will becoae delinquent nine aonths after the tlate of death. A. ~ Tha above inforaat ion and tax due is correct. Resit Dayeent to the Register of Wills with two copies of this notice to obtain a discount or avoid iota rant, or check box "A" and return this notice to the Resister of Wills and an official assessaent will be issued by the PA DaDartaent of Revenue. }~ Tha above asset has bean or will be reported end tax paid with the Pennsylvania Inheritance Tax return "~-a to bo filed by the estate reprosentetiva. C. ~ Tha above inforaa ion is incorrect and/or debts and deductions were paid. Coaplet• PART ~2 and/or PART 3~ below. If indicating a different taz rate, please state relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rato B. Tax Due PART DATE PAID PAYEE 1 2 ~ 3 X 4 5 - 6 $ 7 X 8 b` DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Taz Computation) Undor penalties of pe r~ury, I decla ra that the facts I have reported above aro true, correct and complete ~o t~ best of my knowledge and belief./ HOME ( ~~7 ) q~ Q- ~$~q G 7 /~ WORK ( ) TAXPAVFR crrueTior DA~_ PENNSYLVANIA INHERITANCE TAX .~' INFORMATION NOTICE :•; luREAU DF INDIVIDUAL TAXES AND FILE N0. 21 10-0142 • PO BOX 280601 TAXPAYER RESPONSE ACH WIRRISBURG PA 17128-0601 11119952 xevasas [i AFp ue-~u DATE 03-25-2011 HEATHER M DAGLE 6 HOUSTON DR MECHANICSBURG PA 17050 CITIZENS BANK OF PENNSYLVANIA Drovided the Department with the infonation bolow, which has been used in ealeulatine the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/banalieiary of this account. If You feel the information is incorrect, Dleese obtain written correction frow the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commora:ealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6140697093 Data 04-07-1995 To ensure proper credit to the account. two Established copies of this notice must accompany Account Balance $ 2, 028.12 payment to the Repistar of Wills. Make check payable to "Repistar of Wills. Apant". Percent Taxable X 100.00 Amount Subject to Tax $ 2,02B.12 NOTE: If tax payments are made within three months of the decedent's date of death. TaX Rate X ~ 1 rj detluct a 5 percent discount on the tax due. Potential Tax Due $ 3 0 4.22 Any Inheritance Tax tlua will become delinquent nine months after the dat• of death. P~r TAXPAYER RESPONSE 1 A. ~ Tha above information and tax due is correct. Remit payment to the Repistar of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Repistar of ONE Nills and an official assessment will be issued by the PA Department of Revenue. BLOCK ~ B. ~ Tha above asset has bean or will b• reported and tax paid with the Pennsylvania Inheritance Tax return ON L Y to be filed by the estate representative. C. ~ The above informs ion is incorr ct and/or debts and deductions were paid. Complete PART ~2 and/or PART 3~ below. PART If indicating a tlifferent tax rata, please state Z^ relationship to decodent: EST. OF OLIVE EBERT SSN 204-03-0024 DATE OF DEATH 02-03-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CNECKIN6 ® TRUST CERTIF. TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Data Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Taz Due B $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Lino 5 of Tax Computation) ~ Under penalties of perjury, I declare that the facts I havo reported ab/o~v~,/,are tru correct }yid o mp late 1`o ~ya~best f my knowledge and belief. HOME C / ~ J j q~ ~'" ~~~'T / - ' ~~/ WORK TAXPAYER SIGNAT E TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE T ~ ,~~,' INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND • HARRISBURG6PA 17128-0681 TAXPAYER RE S P O N S E REV-1563 E% AFP (R3-Fa) FILE N0. 21 10-0142 ACN 11119955 DATE 03-25-2011 EST. OF OLIVE EBERT SSN 204-03-0024 DATE OF DEATH 02-03-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAYINGS CHECKING ® TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA provided the Oepartwent with the info nation below, which has been used in ealculatins the potential tnc due. Records indicate that at the death of the above-named decedent. you ware a joint owner/beneficiary of this account. If you foal the information is incorrect, please obtain written correction frog the financial institution. attsch a copy to this fora and return it to the above address. This account is taxable Sn accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questfons. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6140697107 Date 04-07-1995 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due DAVID C DAGLE 6 HOUSTON DR MECHANICSBURG PA 17050 Established $ 2,028.12 X 100.00 $ 2,028.12 X .15 S 304.22 To ensure proper credit to the account, two copies of this notice oust accompany payment to the Resister of Wills. Make cheek payable to "Resister of Wills. Agent". NOTE: If tax payments era matla within three months of the decetlent's date of death. deduct e 5 Dercent discount on the tax due. Any Inheritance Tax due will become delinquent nine months after the date of death. A. ~ The above information end tax due is correct. Remit paymont to the Raaistar of Wills with two copies of this notice to obtain CH E C K a discount or avoid iota rest, or chock box "A" and return Will d this notice to the Resister f C ~ 0 NE s an an official assessment will ba issued by the PA o Department of Revenue. BLOCK ONLY rt~s1 B. ~ Th• '/i' above asset has been or will b• reported and tax paid with the Pennsylva i I to be filed by the estate raprasentative. n a nheritance Tax return C. ~ The above informs eon is incorr et and/or debts and detluetions Complete PART ~2 and/or PAR7 3~ below. were paid. PART TAX If SndieatinB a different tax rate, please state relationship to decedent: RETURN COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Data Established 2. Account Balanco 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART 0 DATE PAID PAYEE 1 2 $ 3 X 4 5 - 6 S 7 X 8 ~ DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL CEnter on Lino 5 of Tax Computation) _ Under penalties of perjury, I declare that the facts I have reported above are }{,f~~ qq,,,, a°Syt~' eomplet te~tige be of my knoWledye and belief. ~~!/~ //YI/ °O~F p~d / ,,~i 1 HOME t ( 7/ I d D r l /iP1Li~!/l/ X /e ,."! ~~ WORK C ) DATE c •' - Cd 55610105 REV-150D EX Decedent's Social Security Number Decedent's Name: OLIVE J. EBERT 204-03-0024 RECAPITULATION 1. Real Estate (Schedule A) ............................................. 1. 165,000.00 2. Stocks and Bonds (Schedule B) ...................................... . 2. 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C) ..... 3. 4 . Mortgages end Notes Receivable (Schedule D) ......................... .. 4. 5 . Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5.. 12,050.43 6. Jantly Owned Property (Schedule F) q Separate Billing Requested ..... .. 6. 22 859.27 7. Inter-Vivos Transfers & Miscollaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7. 10,142.64 8. Total Gross Assets (total Lines /through 7) ........................... .. 8. 210,052.34 9. Funeral Expenses and Administrative Costs (Schedule H) .. . . . . ........... .. 9. 17,020.80 10. Debts oI Decedent, Mortgage Liabilities, and liens (Schedule I) ............ .. 10. _ 633.43 11. Total Deductions (total Lines 9 and 10) ................................ . 11. ~ 17,654.23 12. Net Value of Estate (Line 8 mfnus line 11) ............... .............. . 12.: 192 398 11 13. Charitable and Governmental BequestslSec 9113 Trusts for which ""' , . an election to tax has not been made (Schedule J) ....................... . 13. 942.87 . 14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... . 14.. 191,455.24 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or Vans(ers under Sec. 9116 ~' (a)(1.2) X .0_ 15. 16. Amount of line 14 taxable at lineal rate X .0 45 191,455.24 16, 8,615.49 17. Amount of Line 14 taxable at sibling rate X .12 17 18. Amount of Line 14 taxable - at collateral rate X .15 18 19. TAX DUE ............................................ ....... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT '/o t7~ P~c1G¢sS. ,'~r AAgI Sys OT ~On~P• ~ y Side 2 1505610105 1505610105 8,615.49 Qlp _J ~ .,,-. « ~E~~-1510 EX+q08-04) • ~ x~ pennsytvania ~• OEOAgTMENT pF RRVENUE INMERITAnCE TAX RETURN RESioEnr oECEOenT C V~ `I SCHEDULE 6 INTER-VIVOS TRANSFERS AND MISC. NON-PROBATE PROPERTY ESTATE OF OLIVE J. EBER7 FILE NUMBER This schedule must be completed and filed IF the answer to any of questions 1 through 4 on page three of the REV-1500 is yes, ITEM DESCRIPTION OF PROPERTY (UMBER wtubE Tf1E qM[ a TqE TilEpi REUlT00lEHV m oxmeNr AND n+E °ire a ATfJQ1 A car a THE aEO WR REK fsrare. DATE ~ DEATH ~ % OF DEC05 I EXCLUSION ! • CERTIFICATE OF DEPOSIT -CITIZENS BANK; IN TRUST FOR JULI ANN VALUE OP accFr 1 ..:,,~~~.. HERROLD (GRANDCHILD) 2 CERTIFICATE OF DEPOSIT -CITIZENS BANK; !N TRUST FOR JODY LEE DODY (GRANDCHILD) 3. CERTIFICATE OF DEPOSIT -CITIZENS BANK; IN TRUST FOR HEATHER MARIE DAGLE (GRANDCHILD) 4 CERTIFICATE OF DEPOSIT -CITIZENS BANK; IN TRUST FOR DAVID CHRISTOPHER DAGLE (GRANDCHILD) g CERTIFICATE OF DEPOSIT - CITIZENS BANK; IN TRUST FOR KELSEY MARIE DODY (GRANDCHILD) 6• CERTIFICATE OF DEPOSIT -CITIZENS BANK; IN TRUST FOR ADAM PATRICK HERROLD (GRANDCHILD) ~(dC2SS. '~O~ 1 ~~~ ~QI S S 2,028.53 100 2,028.53 100 2,028.53 100 2,028.53 100 1,014.26 100 1,014.26 100 Not; TOTAL (Also enter on Line 7 Baran;t,,:~.:.._, u more space is needed, use addRional sheets of paper of the same size. / ~ raxABCE vALUE 2.028.53 2,028.53 2,028.53 2,028.53 1,014.26 1,014.26 10,142.64