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HomeMy WebLinkAbout10-03-11BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~, Pennsylvania DEPARTMENT OF REVENUE REV-1543 EX RFP (05 -11) EST. OF MARY R DUNLEVEY SSN 166-14-9832 DATE OF DEATH 08-28-~11 COUNTY CUMBERLAND ~ REMIT PAYMENT AND FORMS TO:~~~-~ REGISTER OF WILLS . _ ~~^ ~ YPE OF ACCOUNT SAVINGS CHECKING w...rt ~f4UST ~~ t~._C~ R T I F . s' ~.{ ~ - DUNLEVEY ~ ** CHARLES 1 COURTHOUSE SQUARE stn T . 313 W GREEN ST CARLISLE PA 17013 ~`-'C'7t7 `' SHIREMANSTOWN PA 17011-6522 --~;~-ri _. ~:- _ : r~ • ~ .. `rJ- v -~a cnt.7 ~,: , MEMBERS 1ST F CU provided the department with the information below. which was used in calculating the inheritance tax due. note no tax may be due, but you must Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If y0U oUSe'h in PART 2 f t e deceased and any amount other than ZerOleaseeobtaCnew'bLenWO neChonpftomnthelfinanciGaleinstietution, attach a copy'to this form and return notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing sp If you believe the information is incorrect, p it tD the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date U2-22-2011 To ensure proper credit to the account, two Account No. 238630-47 copies of this notice must accompany Established payment to the Register of Wills. Make check 7 ~ U81 , 73 payable to "Register of Wills, Agent". Account Balance $ 100.00 Percent Taxable X NOTE: If tau payments are made within three 7 ~ 081 , 73 months of the decedent's date of death, Amount Subject to Tax , 045 deduct a 5 percent discount on the tax due. TaX Rate X Anv inheritance tau due will become delinquent 318,6$ nine months after the date of death. Potential Tax Due TAXPAYER RESPONSE pA^RT ~ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMEN The A above information and tax due is correct. Wills with two copies of this notice to obtain , ^ Remit payment to the Register of this notice to the Register of Wills and a discount or avoid interest, or return ued by the i PA Department of Revenue. CHECK ss an official assessment will be ONE orted and e b tax Daid with the Pennsylvania inheritance tax return C B L 0 C K B. ~ The p e r above asset has been or will e ti . v filed by the estate representa 0 N L Y C ~ r debts re 1 rm2 S e and deductions were paid. ~ below PART and/or PART te l Com e p r1 w w C PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate e r..., n~~o PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I reported above are true, correct and 7i 7 , ?G 3 - ~~~ ~ ~~1 HOME co lete to the best of my knowledge and belief . WORK C ~ l D' ~ ~ // ~~l/1!(,J TELEPHONE NUMBER DATE r.vnwvCD crr_NATl1R OF TAX ON JOINT/TRUST ACCOUNTS 1 2 $ 3 X 4 $ 5 6 '~ ~ X 8 $ PENNSYLVANIA INHERITANCE 7AX INFORMATION NOTICE FILE NO. 21~ ~ ~ - (~~1C11 AND ACN 11160946 TAXPAYER RESPONSE DATE 09-13-2011 PAD UYY1l.1HL Vow ~~~~ ~ I_I •~ PA DEPARTMENT OF REVENUE i 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED BUREAU DF INDIYIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~` Pennsylvania DEPARTMENT OF REVENUE REV-1543 EX RFP (OS -11> PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND * ~ ~A~E~~~~ ~~~~~5~ TYPE OF ACCOUNT EST. OF MARY R DUNLEVEY ^ SAVINGS SSN 166-14-9832 © CHECKING DATE OF DEATH 08-28-2011 ^ TRUST COUNTY CUMBERLAND ^ CERTIF. REMIT PAYMENT AND FORMS TO: n O ~L- ~•T T3 0 ~ ~~ CHARLES DUNLEVEY REGISTER OF WILLS ~~ ~=~ ,---~,=~_ 1 COURTHOUSE SQUARE "~~C'] ~'' 313 W GREEN ST CARLISLE PA 17013,.~.~'~~ ~ ~ ~' SHIREMANSTOWN PA 17011-6522 ~ ~ ~ "~' Cf7 "~ ,-~ C" -i=t - - Cwt %-r~l MID PENN BK provided the department with the information below, which was used in ca~la~ing the irrherita~c`~ta~~x due. deceased andtanyaamounte ther thanezeroeisareflectedtbelowwoo theDPotentialbeTax~Dueylineh~noteDno tax mayo be du but you mh~t he notify elheveethe tmfo matfoYourineorarectn ple se obtaen weCitteedCOr~ectionkfr~om Bhe CnanciaARTnstitut~onaadttach aic~opy'to0this~efor~m a dTr turn If you b it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 18014027 Date 03-29-2011 7o ensure proper credit to the account, two copies of this notice must accompany Established payment to the Register of Wills. Make check $ 39, 058.46 payable to "Register of Wills, Agent". Account Balance X 1 0 0 ' 0 0 NOTE: If tax Payments are made within three percent Taxable Amount Subject to Tax $ 39 ~ 058 • 46 months of the decedent's date of death, . 0 4 5 deduct a 5 percent discount on the tax due. Tax Rate X Any inheritance tax due will become delinquent Potential Tax Due $` 1 ~ 757 • 63 nine months after the date of death. PART TAXPAYER RESPONSE D FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT CHECK ONE [ BLOCK ONLY A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. g, The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return ~iled by the estate representative. C. ^ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE I. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate A Tax Due PART DATE PAID PAYEE PAD 1 2 4 5 6 7 8 TAX nn nn FILE N0. 21 - ~~ ~~`-lyi~ ACN 11163463 * DATE 09-27-2011 OFFICIAL U5t UnLT U Hrar PA DEPARTMENT OF REVENUE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID s TOTAL CEnter on Line 5 of Tax Computation) ? i Under penalties of perjury, I declare that the facts I repot HOME ov( ~~ ~ , e ~ `` J ~ ~~ mplete to the best of my knowledge and belief. (~ ~A~ WORK ( ) f6 `.3` ~ ~~~-~p~~ ~~"`"` ~'~'~`~ TELEPHONE NUMBER DATE ~.. .....vro cTCAIA TII F OF TAX ON JOINT/TRUST ACCOUNTS 1 2 $ 3 X 4 5 6 'fi 7 X 8 BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 Pennsylvania DEPARTMENT OF REVENUE REV-1543 EX RFP (05-11) TYPE OF ACCOUNT SAVINGS EST. OF MARY R DUNLEVEY SSN 166-14-9832 ~ CHECKING TRUST DATE OF DEATH 08-28-2011 _, COUNTY CUMBERLAND XQ CERTIF. REMIT PAYMENT AND FORMS T0: ~ -__ ~,._ ~~ ~ ~~ ;. REGISTER OF WILLS ~-; _ CHARLES DUNLEVEY 1 COURTHOUSE SQUARE ~TZ ~ --t 313 W GREEN ST .=-'`'~~ CARLISLE PA 17013 _~ ~~,..~ G~ SHIREMANSTOWN PA 17011-6522 ~~+~ MID PENN BK provided the department with the information below, which was used in calating the inheritanr~,~arx-r~ue. deceaseddandtanyaamounteother thanezeroeisareflectedtbelowwoo theDPotentialb Tax~Dueylineh~notecno tax may be due. but you 'must he notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe 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. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 309003025 Date 11-12-2010 To ensure proper credit to the account, two copies of this notice must accompany Established payment to the Register of Wills. Make check Account Balance $ 59,606.85 payable to "Register of Wills, Agent". 1 ~ ~ • ~ ~ NOTE: If tax payments are made within three Percent Taxable X Amount Subject to Tax $ 59,606.85 months of the decedent's date of death, . 0 4 5 deduct a 5 percent discount on the tax due. Tax Rate X Any inheritance tax due will become delinquent Potential Tax Due $ 2, 682 • 31 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPDND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT HECK C ONE B L 0 C K 0 N L Y A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with a discount or avoid interest, or return this an official assessment will be issued by the B. The above asset has been or will be reported and filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts Complete PART 2~ and/or PART ~ below. two copies of this notice to obtain notice to the Register of Wills and PA Department of Revenue. tax paid with the Pennsylvania inheritance tax return and deductions were Paid. ~-~ •r PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate u Tex Due PART DATE PAID PAYEE PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21~~~-~,G~C~~ AND ACN 11163464 TAXPAYER RESPONSE DATE 09-27-2011 PAD PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID s TOTAL (Enter on Line 5 of Tax Computation) ~~ Under penalties of perjury, I declare that the facts I repor HOME oY( 7r ', , e, co"' ect`~ d_~~ mplete to the best of my knowledge and belief. 7 3 /G ~„ _ , WORK ( ~ f/rte=C_f TELEPHONE NUMBER DATE reYaevFR SIGNAT RE OF TAX ON JOINT/TRUST ACCOUNTS 1 2 $ 3 X 4 $ 5 6 '~ 7 X s $ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~` Pennsylvania DEPARTMENT OF REVENUE REV-1543 EX AFP (05.11) PENNSYLVANIA INHERITANCE TAX \ ~ INFORMATION NOTICE FILE No. 21 '' ~ ~ ~ I AND ACN 11160815 TAXPAYER RESPONSE DATE o9-08-2011 TYPE OF ACCOUNT SAVINGS EST. OF MARY R DUNLEVEY ~ CHECKING SSN 166-14-9832 TRUST DATE OF DEATH 08-28-2011 ``~' X LIERTIF. COUNTY CUMBERLANDC~ ~ ~ ~ ~. REMIT PAYMENT AND FORMS T0: ~ ~.~~ _ REGISTER OF WILLSrT-~~C7 "°~ CHARLES DUNLEVEY 1 COURTHOUSE SQUARE ~ 313 W GREEN ST CARLISLE PA 17013 ~ ~ ~ ~^'' SHIREMANSTOWN PA 17011-6522 ..-~,%~ v ~ ~ ~ •~ ~/~ provided the depn~tmeou were ah~oint owner/beneficiaWy, of thisuacdCOUntcal ~ayou are th ~rspoUSetof the MEMBERS 1ST FCU Records indicate that at the death of the above-named decede Y notify the department of your relationshepsto the deceased by checking Box C in PART 1 below and writing spouse" in PART 2. deceased and any amount other than zero is eeobtaCnewrittenoWOrrrect onPftomnthelfinanciDaleinst tuti~oneattach a mopy,bo dhs foum andureturn If you believe the information is incorrect. p it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT YNSTRUCTYONS Date 04-15-2009 To ensure proper credit to the account, two Account No. 238630-41 copies of this notice must accompany Established payment to the Register of Wills. Make check 16 , 732 , 22 payable to "Register of Wills, Agent". Account Balance $ 50.000 Percent Taxable X NOTE: If tax Payments are made within three $ 8,366.11 months of the decedent's date of death, Amount Subject to Tax , 045 deduct a 5 percent discount on the tax due. Tax Rate X Anv inheritance tax due will become delinquent $ 376.47 nine months after the date of death. Potential Tax Due TAXPAYER RESPONSE PART ~ FAILURE TO RESPOND WILL RESULT IN AN ^FFICIAL TAX ASSESSMEN A, ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and CHECK an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ~( The above asset has been or will be reported and tau Paid with the Pennsylvania inheritance tax return C ONE 0 N L Y filed by the estate representative. C ~ CompleteePART rm2 land/or1PARTre~ belowr debts and deductions were paid. OFFICIAL USE ONLY ~ AAF PART If indicating a different tax rate, please state PA DEPARTMENT OF REVENUE relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD1 1 2 LINE 1. Date Established 2. Account Balance X rc 3 -' 3. Percent Taxable 3 4 4. Amount Subject to Tax 4 $ 5 5. Debts and Deductions 5 $ 6 6. Amount Taxable 6 7 7. Tax Rate ~ X g 8 g. Tax Due DEBTS AND DEDUCTIONS CLAIMED PART 0 DESCRIPTION AMOUNT PAID s TOTAL CEnter on Line 5 of Tax Computation) ~7 // v Under penalties of perjury, I declare that the facts I repor HOME ov( / ~ 7 ~ e7 ~ ~ `t~ y~(~ mplete to the best of my knowledge and belief. WOR K C ~ ~6 r~ ~ ~~ ~O ~ : ~. ~ ~n ~. A// __ __.._..~ .,,,unCO DATE BUREAU OF INDIVIDUAL TAXES PD BOX 280601 HARRISBURG PA 17128-0601 ~~. Pennsylvania DEPARTMENT OF REVENUE REV-1541 E% AFP (05-111 ES DUNLEVEY PENNSYLVANIA INHERITANCE TAX c~ INFORMATION NOTICE FILE N0. 21~-~I_C~ /~ AND ACN 11160816 TAXPAYER RESPONSE DATE 09-08-2011 TYPE OF ACCOUNT SAVINGS EST. OF MARY R DUNLEVEY ~ CHECKING SSN 166-14-9832 usT DATE OF DEATH 08-28"~~ RTIF. COUNTY CUMBERLAN~~ t~ __ REMIT PAYMENT AND FORMS T0:"~ ~ ~ "`'' REGISTER OF WILLS .~~-~'--~~ ~ ~-~ - CHARL 1 COURTHOUSE SQUARE E 313 W GREEN ST CARLISLE PA 17013 ~~~ ~.~ ~; ; , SHIREMANSTOWN PA 17011-6522 ~ ~ _ _^ ~; t.~:~ MEMBERS IST F CU provided the department with the information below, which was used in calculating the inheritance tax due. note no tax may be due, but you must Records indicate that at the death of the above-named decedent. you were aheckingwBoxbCnint PART 1 belowcandnwritingo'spouse'h in PART 2f t e notify thendeapartmentnof your relationship tofthetdeceased by the Potential Tax Due line, If you believe the information is incorrect, Dl ease obtain written correction from the financial institution, attach a copy to this form and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date 06-28-2010 To ensure proper credit to the account, two Account No. 238630-46 copies of this notice must accompany Established payment to the Register of Wills. Make check 17 ~ 318 , 21 payable to "Register of Wills, Agent". Account Balance $ 50.000 Percent Taxable X NOTE: If tax payments are made within three 8,659.11 months of the decedent's date of death, Amount Subject to Tax $ , 045 deduct a 5 Percent discount on the tax due. Tax Rate X Any inheritance tau due will become delinquent 389.66 nine months after the date of death. Potential Tax Due $ TAXPAYER RESPONSE PART FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSME p, ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and C H E C K an official assessment will be issued by the PA Department of Revenue. C B L 0 C K B. ~ The above asset has been or will be reported and tau paid with the Pennsylvania inheritance tax re urn ONE D N L Y filed by the estate representative. C, ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART ~2 and/or PART ~ below. fFICIAL USE ONLY ~ AAF PART If indicating a different tax rate, Please state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS 1 LINE 1. Date Established 2. Account Balance 2 3 X 3. Percent Taxable 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate ~ X 8 $ PA DEPARTMENT OF REVENUE PAD 1 3_.. - - 4 5 6 7 8 PART 0 DATE PAID DEBTS AND DEDUCTIONS GLAirttu TOTAL (Enter on Line 5 of Tax Computation) r~ Under penalties of perjury, I declare that the facts I repor HOME ovC 7~ ~ ) e ~~r~c~ _ ~_ «_ «tie h>st of my knowledge and belief. _ AMOUNT PAID __ DESCRIPTION BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 Pennsylvania DEPARTMENT OF REVENUE ocv-i u't EX AFP (05 -11) PENNSYLVANIA INHERITANCE TAX FILE N0. 21 ~1~-~''~~I INFORMATION NOTICE AND ACN 11160817 TAXPAYER RESPONSE DATE 09-08-2011 TYPE OF ACCOUNT SAVINGS EST. OF MARY R DUNLEVEY ~ CHECKING SSN 166 -14 - 9832 t ~ TRUST DATE OF DEATH 08-28- Oil _-T ~'S ~~CERTIF. COUNTY CUMBERLAI~~ REMIT PAYMENT AND FORMS Tf~j.-~ ~ 'a REGISTER OF WILLS i~~~ ~~~ _ CHARLES DUNLEVEY 1 COURTHOUSE SQUARE n. ~ ,L,,; 313 W GREEN ST PA 17011-6522 CARLISLE PA 17013 ~ v~~ SHIREMANSTOWN ,--,~~ ~' 'J ~ - ~, provided the department with the information below. which was note no taXUm y nbe due.~hbutayoU tmustue. Records indicate that at the death of the above-named decedent. You were a joint owner/beneficiary of this account. If you art the spOUSe o e MEMBERS 1ST FCU ouse" in PART 2. zero is reflected below on the PonenBoXlCTin PARTllnbelow and wri ai~o y to this form and return deceased and any amount other than notify the department of your relationship to the deceased by check 9 If you believe the information is incorrect. Dlease obtain written correct)on from the financial institution, attac P it to the above address. Please call 717-787-8327 with questions. nr~nm * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS •,.e ~rrnunt. two COMPLt ~ t rr.^' ~ ""-` 04- 18-2009 To ensure Proper ~~ ~~-- -- ---- Date copies of this notice must accompany payment to the Register of Wills. Make check Account No. 238630-48 Established $ 7 , 348.05 payable to "Register of Wills, Agent". NOTE: If tax payments are made within ree Account Balance X 50.000 Percent Taxable 3,674.03 months of the decedent's date of death, Amount Subject to Tax $` ~ 045 deduct a 5 percent discount on the tax due. X Anv inheritance tau due will become delinquent Tax Rate 165.33 nine months after the date of death. Potential Tax Due $ TAXPAYER RESPONSE PART FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT p, ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and CHECK an official assessment will be issued by the PA Department of Revenue. B L 0 C K ~ B.~The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax re urn ONE rr C O N L Y filed by the estate representative. C, ~ The above informs ion is incorre3t belowr debts and deductions were paid. Complete PART ~ and/or PART QFFICIAL USE ONLY ~ AAF dicating a different tax rate, Please state ~ PA TIFPARTMENT OF REVENUE PART If in relationship to decedent: ACCOUNTS PAD - CALCULATION OF TAX ON JOINT/TRUST i _ TAX RE TURN LINE 1. Date Established 1 2 _ 2, Account Balance 2 X _ - 3 3. Percent Taxable s 4 4. Amount Subject to Tax 4 5 5. Debts and Deductions 5 $ 6 -- 6. Amount Taxable 6 X 7 _ 7. Tax Rate ~ 8 - n..e B . r ucn o . . a,. . PART 0 DATE PAID DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I reported above a~% ~ ~e,,~ ;r ~t-a~d knowledge and belief. FiOME C , ~, .J _ a_ ~.. +tie hest of mY __.. ~ DEBTS AND DEDUCTluns ~~~+'-'~~-