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HomeMy WebLinkAbout03-0836CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURg, PA 17128-0601 REV-16diS EX AFP (09-00) i--I-I "-'1o--/ ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE FZLE NO. Z! -03- ~,_~ ACN 0513627q DATE 10-10-2005 RAYMOND E KANE !06 S 36TH ST CAMP HILL PA 17011-q901 EST. OF THOMAS M KANE S.S. NO. 188-32-5123 DATE OF DEATH 05-13-2002 COUNTY CUHBERLAND TYPE OF ACCOUNT [] SAVINGS [] CHECKING []TRUST [] CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 #AYPOZNT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at tho death of the above decedent, you tare a joint oHner/benaficiary of this account. Zf you feel this information is incorrect, please obtain Hr]ttan correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance aith the Inheritance Tax Laos of the Comaonaealth of Pennsylvania. Questions may be ansHersd by calling (717) 787-8~Z7. COMPLETE PART I BELOW # # ~ SEE REVERSE SIDE FOR FILING AND PAYMENT ZN$¥RUCTZONS Account No. 310001317q Date 07-13-2000 Estebl/shed Account Balance 9,579.90 Percent Taxable X 5 0.0 0 0 Amount Subject to Tax q,789.95 Tax Rate X .15 Potential Tax Due 718. ~9 PART TAXPAYER To insure proper credit to your account~ tho (Z) copies of this notice must accompany your payment to the Register of Hills. Hake check payable to: "Register of Hills, Agent". NOTE: Z~ tax payments are made Hithin three (3) months of the dacadsnt's date of death, you may deduct a SZ discount of the tax due. Any inheritance tax due Hill become delinquent nine (93 months after the date of death. I:;;;, '~'~'!~:-'-:~'~'~-'-":-:,:,:,:-.-~.~ ~ ..................................................... RESPONSE A. ~ The above [n~oreatJon and tax due Js correct. ~. You amy choose to remit payment to the Register o~ HJ~s ~tth tad cop~es oF th~s not~ce to obtain a d~scount or avoid ~nterest, or you amy check box "A" and return this not,ce to the Register o; HJ~Zs and an o~tc~a~ assessment ~ be ~ssued by the PA Department o~ Revenue. B. ~ The above asset has been or ~ be reported and tax paid ~th the Pennsylvania inheritance Tax return to be ;~ed by ~e decedent's representative. C. ~ The above ~n;oreat~on ~s ~ncorrect and/or debts and deductions ~ere pa~d by ~ou. You lust coepZete PART ~ ~d/or PART ~ be~o~. Zf yOU ~nd~ca~e a d~fferen~ ~ax ra~e, p~ease s~a~e your relationship to decedent: RETURN - COHPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS i. Da~e Es~abZishod I CHECK ONE BLOCK ONLY PART TAX LINE 2. Account Balance 2 3. Percent Taxable 3 ~ q. Amount Subject to Tax q, E. Debts and Deductions S - 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8~ PART DATE PAID DEBTS AND DEDUCTIONS CLAZMEn PAYEE DESCRIPTION ~ AMOUNT PAID TOTAL (Enter on L/ne $ of Tax Computation) $ Under penalties of perjury) I declare that the facts Z have reported above ara true, correct and comp/eta to the best of By knowledge and,beZier. HOME (~7{~')r~'~ / ~-.~ 0~1~ WORK ( l TELEPHONE NUMSER ~~ GENERAL INFORMATION 1. FAXLURE TO RESPOND WXLL RESULT IN AN OFF/CZAL TAX ASSESSMENT .ith applicable interest based on information sublitted by the financial institution. Z. Inheritance tax becomes delinquent nine ionths after the decadent's date of death. 3. A joint account ls taxable even though the decadant's name Nas added as a matter of convenience. q. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death arm fully taxable as transfers. 5. Accounts established jointly betNaen husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART I TAXPAYER RESPONSE 1. BLOCK A - If the inforlation and colputation in the notice are correct and deductions ara not being claimed, place an in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and subait thai with your check for the aaount of tax to the Register of Hills of tho county indicated. The PA Departnent of Revenue will issue an official assessment (Fora REV-15qB EX) upon receipt of the return from the Register of Mills. BLOCK B - 1~ the asset specified on ~is notice has been or ~ill be reported and tax paid ~1~ the pennsylvania [nheritanca Tax Return ~iled by ~e decedent's representative, place an "X" in block "6" o~ Part I o~ the "Taxpayer Response" section. Sign one copy and return to the PA Department o~ Revenue~ Bureau o~ Individual Taxes, Dept ZB060I~ Harrisburg, PA [71Z8-0601 in the envelope provided. S. BLOCK C - If the notice in~raation is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and according to the instructions belo~. Sign t,o copies and ~bait thee ,ith your check ~or the amount o~ ~x payable to the Register o~ ~111s of ~0 catty indicated. The PA Department o~ Reve~e .111 issue an o~iciai assessment (Fore REV-IBfi5 EX) upon receipt o~ the return ~ro. the Register o~ Hills. TAX RETURN - PART 2 - TAX COHPUTAT[ON 1. Enter the data the account originally Has es~bllshad or titled in the manner existing at date o~ death. NOTE: For a decedent dying a~tar lZ/l~e2: Accounts ,hich the decedent put in joint names ,ithJn one ([) year o~ death are taxable ~ullY as transTers. Ho,ever, there is an exclusion not to exceed $5,000 per transferee regardless o~ the value the account or the number o~ accounts held. [~ a double asterisk [xx) appears before your ~irst name in the address portion o~ this notJce~ the $5,000 exclusion already has been deducted ~ron ~e account balance as reported by the ~inancial institution. Z. Enter ~e to~l balance o~ the account including interest accrued to the date o~ dea~. 5. The percent o~ the account that is taxable ~or each ~rvivor is deternined as ~ollo.s: A. The percent ~xable ~or joint assets established more than one year prior to the decadent's death: 1 DiViDED BY TOTAL N~BER OF DiViDED BY TOTAL NUHBER OF X' 100 = PERCENT TAXABLE JOINT O~RS SURV[VING JOINT OHNERS Ex~ple: A joint as~t registered in ~0 name o~ the decedent and t~ o~.r persons, I D[V[DED SY 5 (JO[NT OHNERS) DiViDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH S~V[VOR) B. The percent taxable ~r assets created aithin one year o~ the decedent's dea~ or accounts o,nod by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED SY TOTAL NUHBER OF SURVIVING JOINT X 100 PERCENT TAXABLE OHNERS OR TRUST 6ENEF[C[AR[ES Example: Joint account registered in ~e name o~ the decedent and t~o o~.r persons and establi~ed .ithJn one year o~ death by the decedent. 1 D[V[DED BY Z (SURV[VORS)= .50 X 100 ~ 50X (TAXABLE FOR EACH SURVIVOR) The amount subject to ~x (line ~) is detornined by multiplying the account balance (line Z) by the percent taxable (line 5. Enter the to~l o~ the debts and deductions listed in Part 5. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions llama 5) ~rom ~e amount subject to tax (line ~). 7. Enter ~e appropriate ~x mte (line 7) as deternined bela.. Dais of Death [ Spouse Lineal [ Sibling Collateral 07/01/9q 4:0 12/31/9q SX 6Z 1EX 15Z 01/01/95 4:0 06/30/00 OX 6X 07/01/00 ~o presen~ OX xThe tax rata ilposad on death to or for tho usa of a natural parent, an adoptive parent, or a stapparant of 'the child is OX. The lineal class of hairs includes grandparents, parents, children, end 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 descendants, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined ms individuals who have at least one parent in coaion with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS PART $ - DEBTS AND DEDUCTIONS CLAIMED AX1owable debts and deductions ara determined as fallows: A. You legally are responsible for paylent, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payient. C. Debts being claimed must be itemized fully in Part 5. If additional space is needed, usa plain paper 8 I/Z" x 11". Proof of paylent may bm requested by the PA Department of Revenue. ::::::::::::::::::::::::::::: .................. · ..................... ......... ..... COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003125 KANE RAYMOND E 106S36THST CAMP HILL, PA 17011-4901 ........ fold ESTATE INFORMATION: SSN: 188-32-5123 FILE NUMBER: 2103-0836 DECEDENT NAME: KANE THOMAS M DATE OF PAYMENT: 10/15/2003 POSTMARK DATE: 10/14/2003 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03136274 $718.49 REMARKS: RAYMOND E KANE TOTAL AMOUNT PAID' $718.49 SEAL CHECK# 2043 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS RAYMOND E KANE 106 S 36TH ST CAMP HILL PA 17011-4901 COHHON#EALTH OF PENNSYLVANIA DEPARTHENT DF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 17liB-0601 REV-I;~3 EX AFP ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. ACN 05156Z90 DATE 10-10-Z005 RAYMOND E KANE 106 S $6TH ST CAMP HILL PA 17011-~901 EST. OF THOMAS M KANE S.S. NO. 188-$2-5123 DATE OF DEATH 05-13-2002 COUNTY CUMBERLAND TYPE OF ACCOUNT [] SAVINGS [] CHECKING [] TRUST [] CERTZF. REH'rT PAYHENT AND FORHS TO: REGTSTER OF WILLS CUMBERLAND CO COURT HOUSE CARLTSLE, PA 17013 NAYPOZNT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth nf Pann;y~vania~ ~uastJons may bo ensuermd h~ calling (7171 7RT-B377. COMPLETE PART ! BELON # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 561260635 Date 01-30-1995 Established Account Balance 5,qZ2.16 Percen~ Taxable X 50.000 Amoun~ SubSect to Tax Z,711.08 Tax Rate X .15 Potential Tax Due q06.66 To insure proper credit to your account, two (Z) copies of this notice oust accompany your payment to the Register of #ills. Hake check payable to: "Register of #ills, Agent". NOTE: If tax payments are mede within three (3) months of the decadant's date of death, you amy deduct a SZ discount of the tax duo. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. ~ The above information end tax due is correct. 1. You may choose to remit payment to tho Register of Hills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of  ONE ~ gills and an official assessment ~ill be issued by the PA Department of Revenue. BLOCK J B. [] The above asset has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the dacedant's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART [] beloa. Zf you indicate a different tax re~e, please state your reZetionshtp to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PART TAX LINE 1. Date Establishmd 2. Account Balance 3. Percent Taxable ~. Amount Sub,eot to Tax E. Debts end Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRTPTTON AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, 'r declare that the facts 'r have reported above are true, correct and complete to the best of my kno. lmdg, and belief. NONE c7/7 / o~ TELEPNONE NUHBER DATE GENERAL ZNFORHATZON 1. FA/LURE TO RESPOND #ILL RESULT ZN AN OFF/CZAL TAX ASSESSHENT aith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dacadent's dote of death. 3. A joint accoun~ is taxable oven though the decedant's name .as added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. S. Accounts established jointly between husband and alfa aero than one year prior to death ara not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING TNSTRUCTTONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions ara not being claimed, place an "X" in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check for tho amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of tho return from the Register of Hills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid aith tho Pennsylvonia Inheritance Tax Return filed by the decadant'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 Z80601, Harrisburg, PA 17118-0601 in the envelope provided. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check black 'C" and complete Parts Z and according to the instructions beloe. Sign two copies end submit thee with your check for the amount of tax payable to the Register of Hills cf the county indicated. The PA Department of Revenue at11 issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART Z - TAX COHPUTATION LINE 1. Enter the date tho account originally ~as established or titled in the manner existing at date of death. NOTE: For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within Dna (1) year of death are toxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk (em) appears before your first name in the address portion of this notice, tho $3,000 exclusion already has bean deducted fram the account balance as reported by the financial institution. Enter the total balance of the account including interest accrued to the data of death. The percent of the account that is taxable for each survivor is determined as fallows: A. The percent taxable for joint assets estabIisbad cora than one year prior to the decadant's death: I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X ZOO = PERCENT TAXABLE JOINT O#NERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of the decedent and tee other persons. I DIVIDED BY 3 (JOINT O#NERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 = 16.71 (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decadant's death or accounts oenad by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and twa other persons and established eithin one year of death by the decedent. I DIVIDED BY Z (SURVIVORS) = .50 X 100 = 5OZ (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line Enter the total of the debts and deductions listed in Part 3. The amount taxabta (line 6) is determined by subtracting the debts and deductions (Line 5) from the amount subject to tax (1ina 4). Enter tho appropriate tax rate (line 7) as determined below. Data of Death Spouse L/nee1 Sibling Collateral 07/01/94 to 12/31/94 3X 6Z lSX 15X 01/01/95 to 06/30/00 OZ 61 15X 07/01/00 to present OZ S. 6. 7. xTha tax rate imposed on the net value of transfers from a deceased child taenty-one years of ago or younger et death to or for tho use of a natural parent, an adoptive parent, ar a stepparent of tho child is OZ. The linaa! class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children ohether or not they have been adopted by others, adopted children and stap children. "Linea! descendants" includes al! children of tho natural parents end their descendents, whether ar not they have been adopted by others, adopted descendents and their descendants end step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" ciasa of heirs includes all other beneficiaries. CLAIHED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIMED Ailowabia debts and deductions are determined as follows: A. You legally ara responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually pald the debts after death of the decedent and can ~urnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper D 1/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. RAYMOND E KANE 1 O6 S 36TH ST CAMP HILL PA 17011-4901 lTol~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003141 KANE RAYMOND E 106S36TH ST CAMP HILL, PA 17011-4901 ........ fold ESTATE INFORMATION: SSN: 188-32-5123 FILE NUMBER: 2103-0836 DECEDENT NAME: KANE THOMAS M DATE OF PAYMENT: 10/17/2003 POSTMARK DATE: 10/15/2003 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03136290 $406.66 REMARKS: RAYMOND E KANE TOTAL AMOUNT PAID: $406.66 SEAL CHECK# 2044 INITIALS: AC RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRTSBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS RAYMOND E KANE 106 S 56TH ST CAMP HILL PA 17011-q901 RE¥-IS~8 EX AFP (gl-OS) DATE 01-27-200q ESTATE OF KANE THOMAS DATE OF DEATH 05-15-2002 FILE NUMBER 21 05-0856 COUNTY CUHBERLAND SSN/DC 188-52-5123 ACN 03136290 Amoun~ Remi{~ed HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 M CUT ALONG THIS LINE I~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP [01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 01-27-200q ESTATE OF KANE THOMAS M DATE OF DEATH 05-15-2002 COUNTY CUMBERLAND FILE NO. 21 05-0856 S.S/D.C. NO. 188-52-5125 ACN 05156290 TAX RETURN WAS: (X) ACCEPTED AS FILED ¢ ) CHANGED dOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 561260655 TYPE OF ACCOUNT: ( ) SAVINGS ¢ ) CHECKING ¢ ) TRUST ¢ ~ TIHE CERTIFICATE DATE ESTABLISHED 01-50-1995 Account Balance Percent Taxable X 0.500 Amount Subject to Tax 2,711.08 Debts and Deductions - .00 Taxable Amount Z,711.08 Tax Rate X .15 Tax Due ~06.66 TAX CREDITS: 5,~22.16 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 (+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 10-15-2005 COOOSlql .00 q06.66 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-16-2005 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) q06.66 .00 15.59 13.59 PURPOSE OF HOTICE~ To fulfill the requirements of Section Zl~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 91~0). PAYMENT: REFUND (CR): OBJECTIONS: ADNIN- ZSTRATZVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. -- Make check or money order payable to: REGISTER OF NILLS, AGENT. A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-Ii13). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices or by calling the special Z~-hour ansaering service for forms ordering: 1-800-361-20S0; services for taxpayers eith special hearing and or speaking needs: l-BOO-qq7-$OZO (TT only). Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlOZ1, Harrisburg, P~ 171ZE-10Z1, OR --electing to have the matter determined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 180601, Harrisburg, PA 17118-0601 Phone (717) 787-650S. 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 within three ($) calendar months after the decedent's death, a five percent (SI) 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 tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent par annum calqulatad at a daily rate of .O0016q. All taxes which became delinquent on or after January l, 19BZ 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 200~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1981 ZOZ .OOOSq8 1987 9Z .O00Zq7 1999 7Z .000192 1983 161 .O00q38 1988-1991 111 .000301 ZOO0 8Z .000219 198q 111 .000301 1991 91 .O00Zq7 ZOO1 91 .0002~7 1985 l~Z .000356 1993-199~ 72 .000191 ZOOZ 6Z .00016~ 1986 102 .O00ZTq 1995-1998 9X .0002~7 2005 5X .000137 --Tntarest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after tho 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 INDIVIDUAL TAXES TNHERITANCE TAX DTVTSTON DEPT. 280601 HARRISBURg, PA 171Z8-0601 RAYMOND E KANE 106 S 36TH ST CAMP HILL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS PA 17011-q901 DATE 01-27-200q ESTATE OF KANE DATE OF DEATH 05-15-2002 FILE NUMBER 21 05-0856 COUNTY CUMBERLAND SSN/DC 188-$2-5125 ACN 0515627q Amoun~ Rem/t~®d REV-1S48 EX AFP COl-OS) THOMAS M I MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 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 ASSESSMENT OF TAX ON dOINTLY HELD OR TRUST ASSETS DATE 01-27-200q ESTATE OF KANE THOMAS M DATE OF DEATH 05-15-2002 COUNTY CUMBERLAND FILE NO. 21 05-0836 S.S/D.C. NO. 188-32-5123 ACN 0313627q TAX RETURN WAS: IX) ACCEPTED AS FILED ( ) CHANGED dOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 310001317q TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 07-15-2000 Account Balance 9,579.90 Percent Taxable X 0.500 Amount Subject to Tax q,789.95 Debts and Deductions - .00 Taxable Amount q,789.95 Tax Rate X .15 Tax Due 718.q9 TAX CRED'rTS: 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 (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID lO-lq-Z005 CD005125 .00 718.q9 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-15-2005 TOTAL TAX CREDIT r BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE TF pATD AFTER THIS DATE, SEE REVERSE FOR CALCULATTON OF ADDITIONAL TNTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT TS REQUIRED. IF TOTAL DUE KS REFLECTED AS A "CREDIT" ( CR], YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR INSTRUCTIONS. 718.q9 .00 25.92 25.92 PURPOSE OF NOTICE: PAYMENT: REFUND (CA}: OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section glqO of the Inheritance and Estate Tax Act, Act g$ of 2000. (7Z P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. -- Make check or money order payable to: REGISTER OF HILLS, AGENT. A refund of m tax credit, ehich Nas not requested on the tax return, may be requested by completing an "Application For Refund of Pennsylvania Inheritance and Estate Tax" (REV-131~). Applications are available at the Office of the Register of Mills, any of the Z3 Revenue District Offices or by calling the special Zq-hour answering service for fores ordering: 1-800-56Z-ZO50; services for taxpayers with special hearing and or speaking needs: 1-BOO-qqT-~OgO (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 17128-1021, 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 [ndividua! Taxes, ATTM: Post Assessment Review Unit, DEPT. ZB060I, Harrisburg, PA 171ZB-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (33 calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The lex tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and net paid before January 16, 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, ar nine (9) months and one (L) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on or after January l, 198Z will bear interest at a rate which will vary fram calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable lnterast rates for 1982 through ZOO3 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Yea.~r Rate Factor Year Rate Factor lYEZ ZOX .OOOSq8 1987 92 .000247 1999 7Z .OOOlYZ 1983 16~ .000q38 1988-1991 llX .000~01 ZOO0 8~ .000Z19 198~ llX .O0030X 1992 9~ .OOOZq7 ZOO1 9~ .OOOZq7 1985 13~ .000356 L993-199q 7X .000192 200Z 6X .00016q 1986 LOX .OOOZT~ 1995-1998 9~ .O00Zq7 2003 SX .000137 --Interest is calculated as folZows: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAXL¥ ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD OO3516 KANE RAYMOND E 106S36TH ST CAMP HILL, PA 17011-4901 ........ fold ESTATE INFORMATION: SSN: 188-32-5123 FILE NUMBER: 21 03-0836 DECEDENT NAME: KANE THOMAS M DATE OF PAYMENT: 02/02/2004 POSTMARK DATE: 01/31/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03136274 $23.92 TOTAL AMOUNT PAID: $23.92 REMARKS' SEAL CHECK# 2069 INITIALS' JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~UREAU OF INDIVIDUAL TAXES I'NHERTTANCE TAX DI'VTSTON DEPT. Z8060! HARRTSBURG:, PA 171Z8-0601 RAYHOND E KANE 106 S $6TH ST CAHP HILL COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS PA 17011-4901 DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY SSN/DC ACN REV-lS48 EX AFP (01-05) 01-Z7-2004 KANE THOHAS H 05-15-2002 21 05-0856 CUHBERLAND 188-52-5125 03136274 Amoun~ Rsml~ed HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LTMF k..._ Oe?A'W'k, ,maUD DnD??AU cno VrlLIR RECORDS PURPOSE OF NOTZCE: To fulfill the require;ants of Section Z140 of the [nharitance and Estate Tax Act, Act Z$ of ZOO0. (?Z P.S. Section COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 003517 KANE RAYMOND E 106S36TH ST CAMP HILL, PA 17011-4901 ........ fold ESTATE INFORMATION: SSN: 188-32-5123 FILE NUMBER: 2103-0836 DECEDENT NAME: KANE THOMAS M DATE OF PAYMENT: 02/02/2004 POSTMARK DATE: 01/31/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 03136290 $13.59 REMARKS: CHECK# 2068 SEAL TOTAL AMOUNT PAID: $13.59 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF ZNDTVTDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG; PA 17128-0601 RAYMOND E KANE 106 S $6TH ST CARP HILL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF XNHER/TANCE TAX APPRAXSEHENT, ALLORANCE OR DISALLOHANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE Ol-Z7-2OOq ESTATE OF KANE DATE OF DEATH 05-15-2002 FILE NUMBER 21 05-0856 COUNTY CUMBERLAND SSN/I~ 188-$2-5125 ACN 05156290 PA 170'11-q90! REV-161:i8 EX AFP C01-O3) THOMAS M Amoun'l: Remi'l:~edl_.~ ,. ~-:~-,~ I HAKE CHECK PAYABLE AND RENIT PAYNENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG TH~R LINE RETAIN LONER PORTION FOR YOUR RECORDS PURPOSE OF NOTICE:~ D&VMF~T. To ~ulfill the requireeents of Section Zl~O of the Inheritance and Estate Tax Act, Act ZS of ZOO0. (72 P.S. Section 91~0). nof~rh +h= fan oortion Of this Notice and subeit .Jth your paylent to tho R~o~f=r n; Uillr .~;.~.a .. ~k. BUREAU OF INDIVIDUAL TAXES /NHERXTAHCE TAX DT¥/SZON DEPT. 280601 HARRTSBURG, PA 17128-0601 KEVIN T KANE $51 CEDAR ST HT UNION COHHONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTZCE OF XNHERXTANCE TAX APPRAXSEHENT, ALLO#ANCE OR DXSALLONANCE OF DEDUCTXONS, AND ASSESSHENT OF TAX ON JOXNTL¥ HELD OR TRUST ASSETS REV-1;gi8 EX AFP (01-03) PA 17066 DATE 09-06-2004 ESTATE OF KANE THOHAS DATE OF DEATH 05-15-2002 F'rLE NUNBER 21 0:5-08.36 COUNTY CUI~E'~ L AND ssN,Dc ACN 03~6275 HAKE CHECK PAYABLEL::AND R~ZT PAYHENT TO: REGISTER OF N~LLS CUHBERLAHD CO,COURT ~USE CARLISLE, PA 17013 ~ CUT ALONG THIS LINE ~-* RETAIN LONER PORTION FOR YOUR RECORDS *'~ REV-X548 EX AFP (01-03) NOTXCE OF INHERITANCE TAX APPRAXSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-06-2004 ESTATE OF KANE THOHAS H DATE OF DEATH 05-1:5-2002 COUNTY CUHBERLAND FILE NO. 21 0:5-08:56 S.S/D.C. NO. 188-:52-512:5 ACN ~31:56275 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOXNT OR TRUST ASSET XNFORHATXON FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 1000020106 TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TINE CERTIFICATE DATE ESTABLISHED 07-05-1997 Account Balance Percent Taxable X 0.500 Amount Subject to Tax 488.68 Debts and DeductAons - .00 Taxable Amount 488.68 Tax Rate X .15 Tax Due 7:5.:50 TAX CREDITS: 977.:55 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBN[T THE UPPER PORTION OF THIS NOTICE W[TN YOUR TAX PAYHENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: '*RESISTER OF WILLS, AGENT.** PAYHENT RECEIPT DXSCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 09 14-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORH TOTAL TAX CRED'rT BALANCE OF TAX DUE 'rNTEREST AND PEN. TOTAL DUE 'rF pA*rD AFTER TH*rS DATE, SEE REVERSE FOR CALCULATION OF ADD*rT*rONAL *rNTEREST. TF TOTAL DUE TS LESS THAN $1, NO PAYNENT *rS REQU/RED. *rF TOTAL DUE TS REFLECTED AS A "CRED*rT" ( CR)., YOU HAY BE DUE A REFUND. SEE REVERSE S*rDE OF TH/S FORN FOR *rNSTRUCT/ONS. ) .00 7:5.:50 5.:50 78.60 PURPOSE OF NOTICE: PAYNENT: REFUND OBJECTIONS: ADH/N- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (72 P.S. Section 91qO). Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side. -- Hake check or money order payabIe to: REGISTER OF NILLS, AGENT. A refund of a tax credit, which Nas not requested on the tax return, may ba requested by completing an "Application for Refund af Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office of the Register of Nills, any of the 25 Revenue District Offices or by calling the special Z~-hour ansmering service for forms ordering: 1-800-56Z-Z050~ services for taxpayers with special hearing and or speaking needs: 1-800-~7-50Z0 (TT onZy). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, 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 bm addressed in ariting to~ PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Raviea Unit, DEPT. 280601, Harrisburg, PA 171ZB-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedant's death, a five percent (SI) 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, I996, the first day after the and of the tax amnesty per~od. 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 ahich became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daiIy rate of .00016~. A11 taxes ahich became delinquent on or after January 1, 1982 mill bear interest at a rate ahich wiII vary from calendar year to calendar year elth that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZO0~ are: Interest Daily Interest Daily Interest Dally Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .0005q8 198'~8-1991 llZ .000501 go0--~ 9Z .O00Zq7 1985 16Z .O00qBB 199Z 92 .O00Z~7 ZOOZ 62 .000219 198q llX .000501 1995-199~ 7Z .00019Z 2005 52 .000157 1985 15Z .000556 1995-1998 9Z .O00gq7 gOOq ~Z .000110 1986 102 .O00Z7q 1999 7Z .O00lgz 1987 9Z .OOOZ~7 ZOO0 BZ .OOOZ19 --Interest is calculated as folloas: ZNTEREST= BALANCE OF TAX UNPAZD X NUHBER OF DAYS DELINQUENT X DAZLY ZNTEREST FACTOR --Any Not/ce issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days beyond the date of the assessment. If payment is made after the [nterest computation date sheen on the Notice, additional interest must be calculated. BUREAU OF ZNDZVTDUAL TAXES TNHERTTANCE TAX DZVISTON DEPT. 280601 HARRISBURG,, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS RE¥-15~8 ~:X AFP DATE 09-06-200q ESTATE OF KANE THOMAS DATE OF DEATH 05-13-2002 FILE NUMBER 21 05-0836 COUNTY CUHBERLAND SSN/DC 188-32-5123 ACN 03156275 Amoun~ ReaLiZed MAKE CHECK PAYABLE AND REHIT FAYMENT TOt REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004444 KANE RAYMOND E 106S36THST CAMP HILL, PA 17011-4901 fold ESTATE INFORMATION: SSN: 188-32-5123 FILE NUMBER: 2103-0836 DECEDENT NAME: KANE THOMAS M DATE OF PAYMENT: 09/30/2004 POSTMARK DATE: 09/27/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/13/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 978.60 REMARKS: KANE KEVIN TOTAL AMOUNT PAID: 978.60 SEAL CHECK#416 INITIALS: CCP RECEIVED BY' GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXEii,,.. ~ J:NHERJ:TANCE TAX I_OITAIICE TAX DIVISION t"'4:COROED OtFICE ClfTATEMENT OF ACCOUNT PO 80X 280601 ....., "T-n (V- I A iii ' HARRISBURG PA 17128-0601 R','-r:I~,' :-1-' . }"- '."j, j S _.\~J \~ ' ;..... I 'J' i ,.~ ,_.... DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN *' REY-16D7 EX AFP (03-05) 2005 JUL 15 PH 12: 04 07-11-2005 KANE 05-13-2002 21 03-0836 CUMBERLAND 03136275 A.O\I'1t Re..itted THOMAS H KEVIN 351 CEDAR MT UNION CLERK OF T KA~'S COURT ST CUMBERLA\!D CO. PA PA 17066 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this forn with your tax p8y.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ................................................................................................................ REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF KANE THOMAS M FILE NO.21 03-0836 ACN 03136275 DATE 07-11-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NMED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-06-2004 PRINCIPAL TAX DUE: 73.30 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-27-2004 CD004444 5.30- 78.60 TOTAL TAX CREDIT 73.30 BALANCE OF TAX DUE .00 INTEREST AND PEN. .11 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .11 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, ND PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FORK FOR INSTRUCTIONS. I s~ <+- !':'t...,.....,ry..."rT\ (',cri('r r\r BUREAU OF INDIVlDUAC'r-A'Kts..'::j '<: '-,u' ,,'r INHERITANCE TAX DIVISION 1 -,~, PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE I:NHERI:TANCE TAX STATEMENT OF ACCOUNT *' REV-1607 EX AFP (03-05) ?rns "!" I? p",,', 1: 08 4'." "'wl.) l L Cpc.' ~ I ,I ('I! I' - KEVIN ""r ItlUIE 530B HARPERS CROSSING LANGHORNE PA 19047 E,,-" "-:iT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN OB-OB-2005 KANE 05-13-2002 21 03-0B36 CUMBERLAND 03136275 Miount R..d tted THOMAS M (\1 CDIf MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax payment. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT III ESTATE OF KANE THOMAS M FILE NO. 21 03-0836 ACN 03136275 DATE 08-08-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 09-06-2004 PRINCIPAL TAX DUE: 73.30 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-27-2004 CD004444 5.30- 7B.60 TOTAL TAX CREDIT 73.30 BALANCE OF TAX DUE .00 INTEREST AND PEN. .11 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .11 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDlr' ICR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRN FOR INSTRUCTIONS. ) ~-{.