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Home My WebLink About02-15-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: HOPPLE ODA 108 SUNSET DRIVE NEW CUMBERLAND, PA -------- fold REMARKS: CHECK# 3552 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT 17070-3059 ACN ASSESSMENT CONTROL NUMBER TOTAL AMOUNT PAID: INITIALS: CJ REV-1162 EX111-961 NO. CD 015607 AMOUNT $1,024.65 SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PD BDX 2aB6B1 pennsylvania HARRISBURG PA 17128-0601 DEPARTMENT OF REVENUE REV-1543 E% AFP (05-11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 - I ~-r;'y.~~F~ AND ACN 12104028 TAXPAYER RESPONSE DATE 01-17-2012 TYPE OF ACCOUNT pv7 e.JJ Q ~ ~-- ~ EST. OF BARBARA R KOLLER X SAVINGS ~ CHECKING w~ =~ , ~ -,._ '~ ~~ ~ti- SSN 204-30-5198 011 TRUST ~.s'. ~= `-`-~~~' CL C.~C_~~ DATE OF DEATH 12-24-2 CERTIF. -- - Xu7~; COUNTY CUMBERLAND ~ w~--- T' REMIT PAYMENT AND FORMS T0: . LY1 C.3 `~- REGISTER OF WILLS max. ~ ~,, -; ~'~HOPPLE 0$ky rS ,. 1 COURTHOUSE SQUARE ~~ ~~ 1Q~; SUNS~D~,R N~¢: CUMBERLAAND PA 17070-3059 ~ .... CARLISLE PA 17013 FU LT ON BANK N A provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If yoD oUSe'h in PART 2 f the deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must 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,cscalcorrec7~ DQe27eWObhain~w}~~en correction from the financial institution, attach a copy to this form and return .t to the above address. ",~ COMPLETE PART ^1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 9932-31610 Date 11-29-1984 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 $ 3,632.76 payable to "Register of Wills, Asent". ~( 5 ~ ' ~ ~ ~ NOTE: If tax payments are made within three Percent Taxable Amount Subject to Tax $` 1 ~ 816 .38 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 $],, 7 4 nine months after the date of death. Potential Tax Due TAXPAYER RESPONSE PART FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT 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 C H E C K 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, ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. ONLY ~ AAF PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION 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 ~ [X. n.. $ Y PAD OFFICIAL USE PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 - DEBTS AND DEDUCTIONS CLAIMED PART PAYEE DESCRIPTION DATE PAID , ~, . AMOUNT PAID s TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I reported above aje t~ y ~ ~ ? ~~~ nd HOME C 7 complete to the best of my knowledge and belief. , ~ WORK ( ~ ~~ TELEPHONE NUMBER DAT __ _..~.. '.rn~1A T11 i BUREAU OF INDIVIDUAL TAXES PO BOX 28060... f~iRISBURG P~1712B-0601 ~ V {l1 ~, Pennsylvania DEPARTMENT OF REVENUE REV-1543 E% RFP (05-11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE NO. 21 ,P~.'C,~~~``~ AND ACN 12104029 TAXPAYER RESPONSE DATE o1-17-2012 ~_- _~ C; ~1 ~~ y~. ~ max. P~~ .e..l e:L Cti'_i ~ '- t-._ ~ OD~4` } C HOPPLE 108 SUNSET DR NEW CUMBERLAND PA 17070-3059 EST. OF BARBARA R KOLLER SSN 204-30-5198 DATE OF DEATH 12-24-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. FU LTON BANK N A provided the department with the information below, which was used in calculating the inheritance tax due. deceasedndandtanyaamounte ther thanezeroeisareflectedtbelowwonetheDP tentialbeTax) Dueylineh)note~no tax mayo be due h 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. 400-1859570 Date 05-31-1984 To ensure proper credit to the account, two copies of this notice must accompany Established payment to the Register of Wills. Make check ~. 32, 099.66 payable to "Register of Wills, Agent". Account Balance Percent Taxable X 50'000 NOTE: If tax payments are made within three Amount Subject to Tax $ 16,049.83 months of the decedent's date of death, X . 0 4 5 deduct a 5 percent discount on the tax due. Tax Rate Any inheritance tax due will become delinquent Potential Tax Due $ 722 • 24 nine months after the date of death. PART TAXPAYER RESPONSE 0 FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT H E C K A. n The above information and tax due is correct. L(;I 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. C ONE BLOCK 0 N L Y B. ~ The above asset has been or will be filed by the estate representative. reported and tax paid with the Pennsylvania inheritance tax return 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 OF 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 a- Tax Due PART DATE PAID PAYEE i~>2-~~`I ~~"' ~'~~ "~~~ PAD UF'F 1l.lAL UJt uiv~ 1 U rj'+r PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID s TOTAL CEnter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge and belief . HOME C'7 / 7 ) f fi `f ~ ~`'~ `7j WORK C ) ^ a r ~~ ~~ ~ ~-~`~ ~ ~' TELEPHONE NUMBER ~ AT T ..,.,...ro crr_ueTI1R TAX ON JOINT/TRUST ACCOUNTS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 - 1,~;: -~ <-~` BUREAU OF INDIVIDUAL TAXES Pennsylvania AND ACN 12104030 PO BOX 2BD601 HARRISBURG PA 17128-0601 DEPARTMENT OF REVENUE TAXPAYER RESPONSE DATE 01-17-2012 REV-1543 EX RFP (05-11) TYPE OF ACCOUNT EST. OF BARBARA R KOLLER ~ SAVINGS S$N 204-30-5198 ~ CHECKING DATE OF DEATH 12-24-2011 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. t.L_ ~ v1 L~ REMIT PAYMENT AND FDRMS T0: ~~ ~_ =_ODA'~' F~PPLE REGISTER OF WILLS ~-`.' 108~iUNS TI_r` 1 COURTHOUSE SQUARE -- `NEW~EUMB~~~4Hb PA 17070-3059 CARLISLE PA 17013 ~ «) ;;`~ `~L-~y~~ .__ FTI['TD N BAN~''}lA 0 ~ provided the department with the information below, which was used in calculating the inheritance tax due. Records indicl~ that at the~'t~ath of the above-named decedent. You were a joint owner/beneficiary of this account. If you are the spouse of the deceased and `eny amount 3t'her than zero is reflected below on the Potential Tax Due line. note no tax may be due, but you must 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. 40 0-1859588 Date 09-24-1985 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 15, 0~~ DO payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 7,5UO.UU months of the decedent's date of death, deduct a 5 percent discount on the tax due. Tax Rate X ' 045 Any inheritance tax due will become delinquent Potential Tax Due $ 337.50 nine months after the date of death. PART TAXPAYER RESPONSE D FAILURE TD RESPDND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT The A 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 ONE B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return 0 N L Y filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Com plete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Perr_ent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 s X 4 5 6 '~ ~ X 8 PAD OFFICIAL USE ONLY U AAF PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED _ _ __ ... _.. owvrc DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true; correct and complete to the best of my knowledge and belief. HOME C ~// .7 ~ / ~ ~ ` "~` ~ WORK C ) ,'Z.~d v ~ ~~~' ,V ~ ~~~~~~ TELEPHONE NUMBER DAT