The URL can be used to link to this page

Home My WebLink About08-02-12REGISTER OF WILLS CLERK OF ORPHANS' COURT DIVISION COURT ~F COMMON PLEAS OF YORK COUNTY YORK COUNTY JUDICIAL CENTER BRADLEY C. IACOBS Register of Wills Clerk of Orphans'Court JOHN C. HERROLD Solicitor ARA KIMBERLY McPHERSON Chief Deputy Register of Wills BECKY K. FOUST Chief Deputy Clerk of Orphans' Court Division July 31, 2012 Glenda Farner Strasbaugh Cumberland County Courthouse One Courthouse Square, Room 102 Carlisle, PA 17013 RE: Estate of James K.,Beaverson Date of Death: September 5, 2011 Your File No. 211-0635 Dear Glenda: ~_ ~~ ~ ~Y . C7 ~ ~~ r r' , 1 j r~-t a-n V3 ~' N ?J~ _ ~ ~ -fi ~, ~, ~ r - ~, v - ~ r' ~ >V ~ ~~~` ~~ Pursuant to the correspondence from the Department of Revenue dated 3uly 20, 2012 (courtesy copy enclosed), please find enclosed herewith the original paperwork that we have in our files for the above-referenced estates. Sincerely, ~~U ~ Bradley C. Jac s Register of Wills /ks Enclosures 45 NORTH GEORGE STREET YORK, PA. 17401-1240 REGISTER OF WILLS (717) 771-9607 • CLERK OF ORPHANS' COURT (717) 771-9288 FAX: (717) 771-4678 www.york-county.org ~ pennsylvania DEPARTMENT OFREV~NUE BUREAU OF INDIVIDUAL TAXES AEGORr'~C; ,~F~~ REC;fSi~ ~:` `E'll 2t~12 AUG -2 PH t2~ 25 ~.. L ~~ r'ie, ~S ~Y7URT Telephone Ct1MBERLAND (~.~ ~ 717 787-8327 July 20, 2012 MR. BRADLEY C. JACOBS REGISTER OF WILLS YORK COUNTY JUDICIAL CENTER 45 N GEORGE ST YORK, PA 17401 Dear Register of Wills: Re: Estate of JAMES K. BEAVERSON File Number: 2112-0635 County: CUMBERLAND Date of Death: 09/05/11 SS#: 201-16-3969 The subject decedent legally resided in CUMBERLAND County as of the date of death. Accordingly, you are autthorized to cancel file number 6711-1570. All matters concerning this estate should be maintai~hed under CUMBERLAND County File Number 2112-0635. All original Inheritance T21x documents for the subject decedent should be forwarded to the CUMBERLAND County Register of Wills; however, you may wish to retain a copy, including photocopies of all receipts for the collection of Inheritance Taxes in the subject estate which have been issued by your office. Please contact me at the telephone number above if you have any questions. rely, ~, aurel Fulmer, Supervisor Inheritance Tax Division Department of Revenue ~ PD Box 2806011 Harrisburg, PA 17128 1717.787.8327 I www.revenue.state.pa.us BUREAU DF NOTICE OF INHERITANCE TAX INHERITANCE },4 ~ APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PD BDX 280601 Y.V~ - OF DED.{UCTIONS, AND ASSESSMENT OF TAX DN HARRISBURG PA ~f~B'i ~`;.f h}~7ry~ r\~~~~I YO~Ly HELD OR TRUST ASSETS Pennsylvania ~ DEPARTMENT OF REVENUE REY-1548 EX AFP C12 -1 D) t~;~G~STEf~ ~C ~yj~ ~C DATE 11-14-2011 ~Q~~ AUG _z - Pri l2' ~~! ESTATE OF BEAVERSON JAMES K 'LU4i 4~C -b A iii ~0 DATE OF DEATH 09-D5-2011 FILE NUMBER 67 11-1570 ,;t_~~j' COUNTY YORK R0 ~`~ O~~yJUt1ICIP L ~~: ~~TtY~ SSN/DC 201-16-3969 ~ , _ ACN 11161695 95 ' 171 I YI~ZtCi, ~ft APPEAL BY DATEs01-13-2012 E T T E R S PA ~ 7 319 - 9135 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 45 NORTH GEORGE STREET YORK PA 17401-1240 CUT ALONG THIS LINE ~! RETAIN LOWER PORTION FOR YOUR RECORDS 4"~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-10~ NOTICE OF INHERITANC TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSE SMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 11-14-2011 ESTATE OF:BEAVERSON K DATE OF DEATH:09-05-2011 COUNTY:YORK FILE NO.: 67 11-157D _ IS.S/D.C. NO.: 201-16-3969 ACN: 11161695 TAX RETURN WAS: (~C3 ACCEPTED AS FILED C J CHANGED FINANCIAL INSTITUTION: MEMB TYPE OF ACCOUNT: CIOSAVIN DATE ESTABLISHED 01-28-1952 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: JOINT OR TRUST ASSET INFORMATION 1ST FCU ACCOUNT NO.: 1596-00 C ) CHECKING C )TRUST C )TIME CERTIFICATE .00 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT ~'~ NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .OD INTEREST AND PEN. .00 TOTAL DUE .00 • IF PAID AFTER THIS DATE, SEE RE~ERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS REFLECTED AS A 'CREDIT" CCR)> YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM F R INSTRUCTIONS. L BUREAU?L~iCFSRLVL~d,~kE~ INHERITAI~Q•Tp3MI~~iq~ ~~~(+ PO BOX 2 v G (,. , +~„5 ~ ~,,,y-~J HARRISBURG PA 17128-0601 201? AUG -Z PM 12~ 25 ~Il~faRNfM~.- ~A.B~VE 95 BASS LAKE RD ETTERS NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON ,'~TgIBT - LD OR TRUST ASSETS ~~_~~IVC1J ,~ Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 IX AFP Q2-10] '' r~`~'S l tR 0r" I~~LL~ATE 11-14-2011 'ESTATE OF BEAVERSON JAMES K LQ(( ~~~ _~ DATE OF DEATH 09-05-2011 A fly 4~ILE NUMBER 67 11-1570 COUNTY YORK J;Ji;IL'IAL ~~~TER ACN DC 11161697964 RS N Y~'~~`' ~~~ APPEAL BY DATE:O1-13-2012 PA 17319 - 9135 (See reverse side under Objections) Amount Rewitted ~i MAKE CHECK PAYABLE AND REMIT PAYMENT T0: ~~ REGISTER OF WILLS 45 NORTH GEORGE STREET ~i, YORK PA 17401-1240 CUT ALONG THIS LINE -"'> RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C12-10~ NOTICE OF INHERITANC TAX APPRAISEMENT. ALLDWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSE SMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 11-14-2011 ESTATE OF:BEAVERSON K DATE OF DEATH:09-05-2011 COUNTY:YORK FILE NO.: 67 11-1570 S.S/D.C. NO.: 201-16-3969 ACN: 11161697 TAX RETURN WAS: C~C) ACCEPTED AS FILED C ) CHANGED FINANCIAL INSTITUTION: ME M, TYPE OF ACCOUNT: ( )SAVI DATE ESTABLISHED 10-03-198 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: JOINT OR TRUST ASSET INFORMATION LST FCU ACCOUNT NO.: 1596-11 (X) CHECKING ( )TRUST C )TIME CERTIFICATE .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTIDN OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT I+) INTEREST/PEN PAID (-] AMOUNT PAID ^ TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AMD PEN. .00 TOTAL DUE .00 IF PAID AFTER TNIS DATE, SEE RE ERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS REFLECTED AS A 'CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF 7HIS FORM F R INSTRUCTIONS. Pennsylvania ~ TAXES ~~" NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE N APPRAISEMENT, ALLOWANCE OR DISALLOWANCE P'~r y{~~~ yQ~ OF DEDUCTIONS. AND ASSESSMENT OF TAX ON REY-1548 EX AFp t12-10) Rbs 17Y!$~Vi01 '. JOINTLY HELD OR TRUST ASSETS ~y~`r`~~IVEI~ ' 2012 AUG _2 Pl1I2' Z5 ,, r DATE 11-14-2011 "U~Sj`-~ ~` W~L~S ESTATE OF BEAVERSON JAMES K DATE OF DEATH 09-05-2011 Z UMBER 1-1570 Off DEC - b - A I1~ 4 0 ~.lt,-L~ s?''. '.. COUNTY YORK F SSN/DC 201-16-3969 YI BEAVERS N ACN 11161699 !(~~~Y IaL ~~~TER ASSN LAKE RD (~~~~~ P~ APPEAL BY DATE:O1-13-2012 ETTERS PA 1 7319-9135 (See reverse side underObjeCtions) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 45 NORTH GEORGE STREET YORK PA 17401-1240 CUT ALDN6 THIS LINE ~!' > RETAIN LOWER PORTION FOR YOUR RECORDS ~ -------------------------- REY-1548 EX AFP (12-10 ---------------------------------------------------------------- NOTICE OF INHERITANC TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSE SMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 11-14-201 ESTATE OF:BEAVERSON AMES K DATE OF DEATH:09-05-2011 COUNTY:YORK FILE NO.: 67 11-1570 S,S/D.C. NO.: 201-16-3969 ACN: 11161699 TAX RETURN WAS: C ) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMB RS 1ST FCU ACCOUNT NO.: 159b-05 TYPE OF ACCOUNT: CX)SAVIN S C ) CHECKING C )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 05-23-2005 Account Balance 779.38 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable 0.166 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 129.90 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 129.90 REGISTER OF WILLS AT THE Tax Rate .00 ABOVE ADDRESS. MAKE CHECK Tax Due ~ .00 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) gMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ^ IF PAID AFTER THIS DATE, SEE RE ERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A 'CREDIT" (LR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM F R INSTRUCTIONS. ~ [' '' ~ Pennsylvania ~ j (( yyi~pp ` C BURE~hl~7l~RO~ NOTICE OF INHERITANCE TAX DEPARTMENT O R Et V~'S~,i6b v: ', INHERIT F EVENUE APPRAISEMENT, ALLOWANCE OR DISALLOWANCE ~ PO BOX ~~iUf[.'. ~,'- ~~~ HARRISBURG PA 171 -d ~ '~ OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1545 IX AFP (12-I OT 8 60 1 JOINTLY HELD OR TRUST ASSETS 2 PM 12. a~17d~G 11 ~ 2~ ~ ~~~C~~VE[] DATE 11-14-2011 E ' Gjs ~E~ QF. ESTATE OF BEAVERSON JAMES K w~~L C DATE OF DEATH 09-05-2011 ~y~''f ` ' Q FILE NUMBER 67 11-1570 ~~ ~EC p ~'~ rv ~ ~i'w~,,vvuflT - COUNTY YORK b A "' ~~ SSN/DC 201-16-3969 ~EAYERSO ACN 11161701 D1CJA C 95 BASS LAKE RD Cc ~ TES APPEAL BY DATE:O1-13-2012 ETTERS PA 731Y9~~~5F,~y (See reverse side under Objections) Amount Remitted -~ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 45 NORTH GEORGE STREET YORK PA 17401-1240 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS <"' -------------------------- REV-1548 EX AFP C12-10) ---------------------------------------------------------------- NOTICE OF INHERITANC TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSE SMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 11-14- 011 ESTATE OF:BEAVERSON AMES K DATE OF DEATH:09-05-2011 COUNTY:YORK FILE NO.: 67 11-157D S.S/D.C. NO.: 2D1-16-3969 ACN: 11161701 TAX RETURN WAS: C ) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMB RS 1ST FCU ACCOUNT NO.: 3696b9-11 TYPE OF ACCOUNT: C )SAVIN S (X) CHECKING C )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 10-15-2009 Account Balance 580.61 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.166 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 96.77 UPPER PORTION OF THIS NOTICE Debts and Deductions - .D0 WITH YOUR TAX PAYMENT TO THE Taxable Amount 96.77 REGISTER OF WILLS AT THE Tax Rate .00 ABOVE ADDRESS. MAKE CHECK Tax Due .00 OR MONEY ORDER PAYABLE T0: ^REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT I+) INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .0D INTEREST AND PEN. .00 TOTAL DUE .00 ^ IF PAID AFTER THIS DATE, SEE RE ERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A CREDIT" CC R), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM F R INSTRUCTIONS. ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE '~~15~ ^UREAU OF INDIVIDUAL TAXES AND FILE N0. 67 PO aDX 28e601 nn ( '` ACN 11161695 HARRIS6URG PA 17128-0601 ~ ~ UED ~~rE~i.' AYE R RE S P O NS E DEiARTM NT OFa ~('rr'f`~ i* i , DATE 09-16-2011 REY-i5a E% %FP (0 U l "-' ~-,.± t aJ TYPE OF ACCOUNT 2~IZ AISG 'Z PM t2~ 2~ EST. OF JAMES K BEAVERSON ® SAVINGS SSN 201-16-3969 ^ CHECKING ~~ ~:,; '; DATE OF DEATH 09-05-2011 ^ TRUST ~~'S V~Rr . couNT~r YORK ^ CERTIF. Ytw1V ~~Ce~~ ~a ~ REMIT PAYMENT AND FORMS TD: ROSEMARY BEAVERSO WM~~- REGISTER OF WILLS 95 BASS LAKE RD 45 NORTH GEORGE STREET ETTERS PA 7319-9135 YORK PA 17401-1240 MEMBERS 1ST F CU rovitled the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the ab ve-named decedent, you werea joint owner/beneficiary of this account. If y0U are the SpOUSe Of the deceased artd any amount other than zer is reflected below on the Potential Tax Due line, note no tax may be due, but you must notify the department of your relation hip to the deceased by checking Box C in PART 1 below and Writing "spouse" in PART 2. If you believe the information 15 incorrect, please obtain written correction from the financial institution, attach a copy to this form and return tt 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. 1596-00 Date 01-28-1952 Established To ensure proDGr credit Yo the account, two copies of this notice ^ust accompany payment to the Register of Wills. Make check payable to "Register of Wills. Agent". Account Balance Percent Taxable Amount Subject to Tax Taz Rate Potential Tax Due 4,846.80 16.667 807.82 .0 .0 NOTE: If tax payments era made within three months of the decedent's date of death, deduct a 5 percent discount On the tax due. Arty inheritance tax due will become delinouent nine months after the date of tleath. t~ _i ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~~_~5~ BUREAU OF INDIVIDUAL TAXES r_ 1 FILE N0. 67 Po Box zao6ol Penn CCU ~-~~ ~ AND ACN 11161697 NARRISBURG PA 17126-0601 DECARTM NT OF RE 5~ «± ~'}~ w~~(~pAYER RESPONSE DATE 09-16-2011 REY-15aj EY AFP [IS-11) ZOIZ AUG _2 Pt1 (~~ 2V TYPE OF ACCOUNT EST. OF JAMES K BEAVERSON ~ SAVINGS SSN 201-16-3969 ® CHECKING vL.C-ft , ,. ~ DATE OF DEATH 09-05-2011 ~ TRUST II~r1m~pCp~~~~~ ~//~~y~'~Rfpp~~ COUNTY YORK ~ CERTIF. ~~LIfIMOC~LAIV~ IAJ., I71~ REMIT PAYMENT AND FORMS TD: ROSEMARY BEAYERSO REGISTER OF WILLS 95 BASS LAKE RD 45 NORTH GEORGE STREET ETTERS PA 7319-9135 YORK PA 17401-1240 MEMBERS 1ST FCU ~I rovided the department with the information below, which was used in calculatin the inheritance tax due. Records indicate that at the death of the ab ve-named decedent, you were a 3oint ownerlbenefi ci ary of this account. If yoU ere the SpOUSe of the deceased and any amount other than zer 15 reflected below on the Potential Tax Due line, note no tax may be due, but you must notify the department of your relation htp to the deceased Dy checking Box C 1n PART 1 below and writing "spouse" in PART 2. If you believe the information is incorrect, please obtain written correction from the'fi nancial institution, attach a copy to this form and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART I BELOW aa',SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1596-11 Date 10-03-1985 7o ensure prooar credit to th• account, two Established copies of this notice must accompany Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Dua av.vv, 1,085.03 .00 .00 NOTE, If tax paiyments are made within three months of the decetlent's date of death. deduct a 5 percent tliseount on the tax dua. Ajjy inheritance tax due will become tlelineuent nine months after the date of tleath. -YER RESPONSE A. (~lhe above i foraat ion and tax due is correct. [J ~ Reait D Ywent to the ReOistar of Wills with two copies of this notice to obtain C HECK a disco nt or avoid interest, or return this notice to the Register of Wills and C 0 N E ~ an offi ial assessment will be issued by the PA Department of Revenue. B L DCK B. ~ The above a set has been or will be reported and tax paid with the Pennsylvania inheritance tax return ON L Y filed by th estate representative. C. ~ the above i forma >,on is incorrre~ct endlor debts and deductions Mere paid. Complete PA T ~2 and/or PART 3LJ below. PART If indicating a different ax rate, Please state a '~ I ~ ' I ~ ~ ~~ ' ~,"' l ilh ~' i j dpi I II i ~~,l li l III ~~~ III I I' rl, relationship to decedent: p~il ~~III fll~l III ~~ ~ III ~ ~ ~ !! TAX RETURN - CALCULATION OF TAX ON JOINTlTRUST ACCOUNTS ~~" LINE 1. Date Established l~ 2. Account Balance 2 3. Percent Taxable 3~ 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 s 7. Tax Rate 7 8. Tax Dua 8 $ PART DEBTS AND DEDUCTIDNS CLAIMED u DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of pe99jur/y. I d eomplet•At~ the best A t mb know 6,510.06 payment to the Register of Willz. Make check payable to "Register of Wills. Agent"• TOTAL [Enter on Line 5 of Tax ComRUtationl e are. that the facts I reported above are true, correct and ge and belief. unur i ~ I V f 1 WORK ~ __ ~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL rAxes ~ INF~~Oyy~~RMATION NOTICE FILE N0. 67 t f _ PD aDx 290601 Penn L ~~ ~_)~~~ lJf AND ~~ HARRISBURG PA 17128-0601 pEPARTM NT OFpE ~ "rl" (? ACN 11161 ~~ ~~,~~ ,v;~':~X~PAYER RESPONSE DATE 09-16-2011 REY-ISf FY 11FP (15.11) 2Q11 AUG -2 p~ ~G: 26 TYPE OF ACCOUNT EST. OF JAMES K BEAVERSON ® SAVINGS SSN 201-16-3969 ^ CHECKING ~1~` `-'( DATE OF DEATH 09-05-2011 ^ TRUST (] I,~p~ ~~~~~ /~+/~~~ COUNTY YORK ^ CERTIF. •+'~~„AA-~ZIfYViJ 41J., ~ REMIT PAYMENT AND FORMS TD: ROSEMARY BEAVERSO REGISTER OF WILLS 95 BASS LAKE RD 45 NORTH GEORGE STREET ETTERS PA 7319-9135 YORK PA 17401-1240 MEMBERS 1ST FCU rovided the department with the information below, which was used in cai culating the inheritance tax due. Recortls indicate that at the death of the ab ve-named decedent, you were a joint owner/beneficiary of this account. If y0U are the spouse of the deceased and any amount other than zer is reflected Delow on the Potential Tax Due line, note no tax may be due, but you must notify the department of your relation hip to'the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe the information is incorrect,'pi ease obtain written correction from the financial ins ti tutien,attach a copy to this form and return it to the above address. Please tali 717.787-8327 with questions. COMPLETE PART 1 BELOW aEI,SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1596-05 Date 05-23-2005 ro ensure proper credit to the account, two Established copies of this notice wst accompany 1~ __ __ ~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL rAxES n~~ ~'( INFORMATION NOTICE FILE N0. 67 ~~-~$~'O PD eox tao6al penn LVa "~~Q ~~~~ AND AcN 11161701 HARRISaURG PA 17128-0601 y('T~"~ DEPARTM NT OPREVE 1~J~' 4< ~t'T YER RESPONSE DATE 09-16-2011 ~_ , REY-156 Ei ALP (05.11) ) A..' ROSEMARY BEAVERS 95 BASS LAKE RD ETTERS PA MEMBERS 1ST FCU Recortls indicate that at the death of the a deceased and any emount other than ze notify the department of your relatid If you believe the information is incorrect it to the above address. Please call 717-7 COMPLETE PART 1 BELOW account No. 369669-11 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due C~t1 AUK' -2 py,2~ 2~ EST. OF JAMES K BEAVERSDN .~.r--: "'i'' ~ SSN DATE OF 201-16-3969 DEATH 09-05-2011 C~~t A/~U~R r LLJ„ ~ COUNTY REMIT PAYM YO R K ENT AND FORMS T0: REGISTER OF WILLS 45 NORTH GEORGE STREET 7319-9135 YORK PA 17401-1240 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. rovi ded the department with the information below, which was used in calculating the inheritance tax due. ve-named decedent, you were a Joint owner/beneficiary of this account. If you ere the SpoUSe of the 1s reflected below on the Potential Tax Due line, note no tax may be due. but you must hip°tbathe deceased by checking Box C 1n PART 1 below and writing "spouse" 1n PART 2. please obtain written correction from the financial institution, attach a coDY to this form and return -8327 with questions. SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date 10-15-2009 To ensure proper credit to the account, two Established copies of this notice gust accompany 580.61 .. .~ .~ payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments aro made within throe months of the dacadent's date of loath, deduct a5 percent discount on the tax duo. Arov inheritance Lax duo will become delinquent nine months after the date of death. L PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID 'Enter on lino S of Tav rnm Under penalties of perjury, I comp t to//}~~~/y~best~of my'' kn ( / ~. re that the foots I reported above are true, correct and e and belief. ,,,,,,~ WORK C~IrZ1 ~~g ~~ ~~ /~ p.~A/ ~ ~' yr~ r o~ ~~ ~~°~ r ~ 4 O l~ ~ ~ r 4 N ~ N ,~ Noa 7 .,~.• 7• a N~(E // Y V ~ O ~ ~ V N T Q ~h i ~ ~ N ~ NoN~ U Q ~~a N ~ U m ~ G ~ '^ ~ O ..~ w ,.+w A J ~~~ ~n~ .» ,•~, ;''„„ P .r. r ~ :, i ..~- .~ ~~~ •~"~ t~~, ~~ ~1 K) ~~ i~ .,..~ t:! ,...4 N' `?: } A N ° ~U a v ~ m ~_ cV `~ c r ~ ~a J ° O `m d m ~ O VNN c'd o~ ~ ~~ m °a <` ~ y c7 r n~' ~ o a- ~yY Ya>°- 0 Y _!