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HomeMy WebLinkAbout09-21-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: BYERS JOHN E 15 LYNN AVE NEWBURG, PA 17240 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: FILE NUMBER: 21 12-1043 DECEDENT NAME: BYERS EVELYN L DATE OF PAYMENT: 09/25/201 2 POSTMARK DATE: 09/20/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 07/27/2012 ACN ASSESSMENT CONTROL NUMBER AMOUNT 12144219 ~ $ 28.66 12144221 ~ $28.51 12144223 ~ 58.67 12144225 ~ 5234.36 12144227 ~ 56.69 12144229 ~ 528.51 12144231 531.15 12144233 ~ $204.35 12144235 ~ 51,192.48 TOTAL AMOUNT PAID: REMARKS: CHECK# 5392 SEAL INITIALS: HMW 51,763.38 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 016550 REGISTER OF WILLS ~- BUREAU OF INDIVIDUAL TAXES ~ r~l PD Box 280601 pennsylva~ HARRISBURG PA 17128-0601 DEPARTMENT OF REV , REV-1543 EX AFP (OS-11) PENNSYLVANIA INHERITANCE TAX -,~, _.(_., r,~~)~„, ORMATION .NOTICE FILE N0. 21 -~/~/Q~~ _._ __ ACN 12144219 --~' ;` '?'- ~1A~AYER RESPONSE DATE os-o8-2012 .... " ~ e SAP ' I ~~ I f ~ 4 ~ EST. OF EVELYN L BYERS SSN 202-20-4618 {,. ~ i. L. ~~~;~,~,~ ,W ; -~,;~~ ~. i DATE OF DEATH 0 7 - 2 7 - 2 012 ..,~.J'.~~#. COUNTY CUMBERLAND CU~~E~~ND ~~" PA REMIT PAYMENT AND FORMS T0: JOHN E BYERS REGISTER OF WILLS 15 LYNN AVE 1 COURTHOUSE SQUARE NEWBURG PA 17240-9229 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBER S 1S T F C U prov;ded 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 y OU are the SpoUSe of 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 de artment of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe ~he 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. 13170 - 00 Date 04 - 1 0 - 1972 To ensure proper credit to the account, two Estab llshe d copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 4, 023.90 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax ~` 670.66 months of the decedent's date of death, Tax Rate )( . 0 4 5 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due ~` 30.18 nine months after the date of death. PART TAXPAYER RESPONSE 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 C H E C K 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. 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 information is incorrect and/or debts and deductions were paid. Complete PART Z~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. P e r c e n t T a x a b l e 3 X , 3- .,...-.~-- -- -- ---.--- 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct an d ` ~ compl.~ a to the best of my knowledge and belief . HOME C ~/ % ' ) y~~ ~° ~ 3 ,~ G G't {~. ~ 11 7 7 _ -'"TAXPAYER SIGN RE TELEPHONE NUMBER DACE TOTAL CEnter on Line 5 of Tax Computation) S ~~, PENNSYLVANIA INHERITANCE TAX ~~ INFORMATION NOTICE FILE No. 21•~'~~• ~~~~~- BUREAU OF INDIVIDUAL TAXES t~~t~- tif~nr~,-:~ ,•~~-~,~,:~ Po Box 280601 pennsylvania ~r~~t_:~'~.~'~.~ t ~'= ~ D ACN 12144221 HARRISBURG PA 17128-0601 ~` ~~i~ Ty4~P ~ ~ RESPONSE DEPARTMENT OF REVENUE ` 1~ - i`~~',~,;~ -; ,, j f;~ DATE 08-08-2012 REV-1543 EX AFP (05-11) '~~~.1•~,~ TYPE OF ACCOUNT 'nk~~~~ ~~E- 2 ~ ~~ ~~1~~ OF EVELYN L BYERS 0 SAVINGS ~ CHECKING `~.~~ L `, ~ DATE OF DEATH 07-27-2012 ~ TRUST ~~ ~~-~~1~q~~~(~~;~j~,J~;~OUNTY CUMBERLAND ~ CERTIF. ~~~Lti1VlJ ~0,, I~IT PAYMENT AND FORMS T0: JOHN E BYERS REGISTER OF WILLS 15 LYNN AVE 1 COURTHOUSE SQUARE NEWBURG PA 17240-9229 CARLISLE PA 17013 MEMBER S 1S T F C U 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 y0U are the Spouse of 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 de artment of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe ~he 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' TNSTRUCIluNS Account No . 13170 - 04 Date 04 - 10 - 1972 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 4 000.71 payment to the Register of Wills. Make check ~` ~ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 666.80 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due ~` 30.01 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND. WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. n 'The above information and tax due is correct. Lf"J Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K 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. 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 information 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 OFFICIAL USE.. ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Tazable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and co et ' o the best of my knowled a and belief. C ~XPAYER SIGNATUR TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) 5 r~~ ~ PENNSYLVANIA INHERITANCE TAX F ~,~ _ INFORMATION NOTICE FILE N0. 21 `-/,~"~~j~~ BUREAU OF INDIVIDUAL TAXES r-°:.ti.- PD Box 2so6ol pen !}j~ .• ~'~~~ ~~ AND ACN 12144223 HARRISBURG PA lrizs-o6ol ~ " °[:~ ;,a;{~ 1 C TAXPAYER RESPONSE DEPARTME •fi VEMU~{ DATE 08 - 08.- 2012 ,. ., ~ ~..~.~J REV-1543 EX AFP (05-11) ~' ~ ~ SAP 2 i ~~ 1 I = 4 ~ ~~~~~~~fl ~~ ~~ A TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. JOHN E BYERS 15 LYNN AVE NEWBURG PA 17240-9229 EST. OF EVELYN L BYERS DATE OF DEATH 07-27-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 MEMBER S 1S T F C U 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 y OU are the Sp0U5e Of 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 "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. 13170-05 Date 08-05-1993 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 1 ~ 21 6.97 Payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable )( 16 . b67 NOTE: If tax payments are made within three Amount Subject to Tax $ 202.83 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 9.13 nine months after the date of death. PART TAXPAYER RESPONSE 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 C H E C K 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. ONE BLOC 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 information 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 OFFICIAL USE_ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 ~ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under pe alties of perjury, I declare that the facts I reported above are true, correct and co.mp~l~ to the best of my knowledge and belief. HOME C.%,~ C ~ ~~. ~ - ~ f ~l c- 'I"a XPAYER SIGNATUR r'` TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S ~~ ' PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE l~./ FILE N0. 21'- L BUREAU OF INDIVIDUAL TAXES ~ ~ 'r ~ (}-~;~ AND Po Box 280601 pennsylva- ~~-' 4..~` :: ~' +~.t~ ~ ACN 12144225 HARRISBURG PA 17128-0601 DEPARTMENT OF REV ~~~~~'-~_~ ?~':~ ~.TEk1p~CPAYER RESPONSE U~:~ _~ ,,:; ~_.;.~~ DATE 08-08-2012 REV-1543 EX AFP (05-11) :_y~~2 3LD ~ ~ ~,~, ~~ TYPE OF ACCOUNT C EST. OF EVELYN L BYERS ~ SAVINGS CHECKING `~-`'-~#~ DATE OF DEATH 07-27-2012 ~ TRUST Gr?PN~'~ ~' 'v{~~'~T COUNTY CUMBERLAND ~ CERTIF. C~,~~RER~.~`V~ `~'~~ ~~ REMIT PAYMENT AND FORMS T0: JOHN E BYERS REGISTER OF WILLS 15 LYNN AVE 1 COURTHOUSE SQUARE NEWBURG PA 17240-9229 CARLISLE PA 17013 MEMBERS 1ST F C U 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 you are the spouse Of 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 de artment of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe ~he 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. 13170-41 Date 04-08-2011 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 32, 890. $9 payment to the Register of Wills. Make check $ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 5, 481.92 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 246.69 nine months after the date of death. PART TAXPAYER RESPONSE a 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 CHECK 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. 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 information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state OFFICIAL .USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT. OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under pena ies of perjury, I declare that the facts I reported above are true, correct and ~ ,~ ,comte ~ the best of my knowledge and belief. HOME {~~~ ) ~ 3 `lG~ d / ~, ... --~ WORK { ~ _~ C' ~~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S BUREAU OF INDIVIDUAL TAXES r ,,JJ(1~ PO BOX 280601 P ~ ~' HARRISBURG PA 17128-0601 Pe~ M ~jFQF~~VEN'li~ REV-1543'EX AFP (05-11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21~~/~-/~~~~ ',~ z' ~~- A N D '~# `L'~ ~~ ACN 12144227 ~j= '~~? ; ~ TAXPAYER RESPONSE :,.__~~~ DATE 08-08-2012 ~~i~S~PcI ~~~1I:4$ ;~ ~~P~v ~ v`uLF~ r Ct1~FRl.~l~D ~0., PA JOHN E BYERS 15 LYNN AVE NEWBURG PA 17240-9229 DATE OF DEATH 07-27-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBER S 1S T F C U 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 you are the spouse of 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 "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 SIT1E FGR FILING AND PAYMENT INSTRUCTIONS Account No. 8472 - 0 0 Date 04 -14 - 1966 To ensure proper credit to the account, two Established copies. of this notice must accompany Account Balance 938.77 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable )( 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 156.46 months of the decedent's date of death, Tex Rate X 045. deduct a 5 percent discount on the tax due. Anv inheritance tax due will become delinquent Potential Tax Due $ 7.04 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT TN AN flFFICiAI_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 C H E C K 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. ONE BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return O N L Y filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART IJ below. PART If indicating a different tax rate, please state OFFICIAL USE ONLY - Q AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X ;~ ,~.M~._,._,. 4. Amount Subject to Tax 4 $ C} 5. Debts and Deductions 5 - rj 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penal ies of perjury, I declare that the facts I reported above are true, correct and(, ~~ co~mpr„y~te the best of my knowledge and belief. HOME C ~r ~ ) ~~' r.+~~ '~`" L%~ J ....-`TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) S r ; ~ f ~~ BUREAU OF INDIVIDUAL TAXES ~~~ PD BDx 280601 pennsylvar HARRISBURG PA 17128-0601 DEPARTMENT OF REVE U'E' REV-1543 EX AFP COS-11) PENNSYLVANIA INHERITANCE TAX /~ ~~~~~i ~~;,~p~MATION NOTICE FILE N0. 21 ~-~~ "~~~/' - ,,,~,~ ~+ AND ACN 12144229 4`'4 ' ~~' T'i4~'PAYER RESPONSE DATE 08-08-2012 2i ~i~~ 48 w i' ' i ~+,.~.., OF~P~~~~~~J~.vl u ~~L~~ ~ CU~,B~RI.~~wi~ ~0., PA JOHN E BYERS 15 LYNN AVE NEWBURG PA 17240-9224 EST. OF EVELYN L BYERS DATE OF DEATH 07-27-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBER S 1S T F CU 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 you are the Spouse of 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 "spouse" in PART 2. If you believe he 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 SIIIE FOR FILIiVG AND PAYMENT YNSTRUCTiONS Account No . 8472 - 04 Date 04 - 14 - 1966 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 $ 4 ~ 000.71 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 666.80 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $` 30. O1 nine months after the date of death. PART TAXPAYER RESPONSE ~ FAILURE TO RESPOND WILL RESULT IN AN fl FFICIAL 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 C H E C K a discount or avoid interest, or return this notice to the Register of Wills and 0 N E 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 return 0 N L Y filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFTCLAL .USE (INLY ~ AAF relationship to decedent: PA' DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 I 2. Account Balance 2 $ 2 ~. Perc2r.t Taxable ? X ~ ~.~ 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - ~j 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under pe alties of perjury, I declare that the facts I c e to the best of my knowledge and belief. reported above are HOME ( ~~ true, correct ,~ ~~ ~~ ~~ and "C~ y . TAXPAYER SIGNATUR TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) 5 -~~ PENNSYLVANIA INHERITANCE TAX ///'~f(~/(//I/`^J/ INFORMATION NOTICE FILE NO. 21 BUREAU OF INDIVIDUAL TAXES r~ r-., ~-~ ~-,,,y~~-yC Po Box zao6ol enns .- ~}; ~,-s~ ~ ~,~~. Q~ AND ACN 12144231 HARRISBURG PA I~IZB-o6ol p ~~~: .w ~~ -, - :~~: ~QAXPAYER RESPONSE DEPARTMENT OF _ a,, 3 ~;i ~~, - .,..~+1 DATE 08-08-2012 REV-1543 EX AFP D -I~5 t~ ~ ~ SAP 2 I A~ ! 1 ' 4 .~ i.. Ot~~`v~~ ;~t..~! i~ i CUMBFR~4~D C~., PA JOHN E BYERS 15 LYNN AVE NEWBURG PA 17240-9229 EST. OF EVELYN L BYERS DATE OF DEATH 07-27-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBER S 1S T F C U 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 y0U are the SpOUSe Of 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 "spouse" in PART 2. If you believe he 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. 8472- 11 Date 06 - O 1 - 1998 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 4 371 .34 Payment to the Register of Wills. Make check ~ payable to "Register of Wills, Agent". Percent Taxable X 16 . b67 NOTE: If tax payments are made within three Amount Subject to Tax ~` 728.57 months of the decedent's date of death, Tax Rate )( . 045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $` 32.79 nine months after the date of death. PART TAXPAYER RESPONSE 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 C H E C K 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. 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 information 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 OFFICIAL USE ONLY ~] AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 ~ 4 5. Debts and Deductions 5 S 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct a nd_ /~ y compl a to the .. best of my knowledge and belief . HOME C 7l ~ ) C _3 ~--' `' '~ 7 ./ ~ 4 ~ ~ E -•-' TAXPAYER SIGNA E TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S PENNSYLVANIA INHERITANCE TAX ~, BUREAU OF INDIVIDUAL TAXES ~ art ,~ ~~~ ~--, ~~~NFORMATION NOTICE FILE N0. 21"''p~'I ~,,~~ Po Box Zao6o1 pennsylv~~~ ~~_` i.,z `,'. v~ ~ AND ACN 12144233 HARRISBURG PA 17128- 0601 DEPARTMENT OF REV ~ i j i' ~r~~~PAY E R R E S P O N S E DATE o 8- 0 8- 2 012 REV-1543 EX AFP (OS-11) ;,~~~ ~~p ~ ~ ~~~' ~ Y `_ ~ TYPE OF ACCOUNT EST. OF EVELYN L BYERS ~ SAVINGS SSN CHECKING ```' ~' DATE OF DEATH 07-27-2012 ^ TRUST ~~~~-~V `~j ~''~`'~'~~n COUNTY CUMBERLAND ^ CERTIF. Vl~it~l©~RU~M~i~ ~~" PA REMIT PAYMENT AND FORMS T0: JOHN E BYERS REGISTER OF WILLS 15 LYNN AVE 1 COURTHOUSE SQUARE NEWBURG PA 17240-9229 CARLISLE PA 17013 MEMBER S 1S T F C U 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 you are the Spouse Of 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 "spouse" in PART 2. If you believe he 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. 8472- 05 Date 08 - 05- 1993 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 $` 28,679.97 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 4,780.09 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Anv inheritance tax due will become delinquent Potential Tax Due $ 215.10 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESUL7 IN AN t3FFICIAL 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 C H E C K a discount or avoid interest, or return this notice to the Register of Wills and 0 N E an official assessment will be issued by the PA Department of Revenue. B L ~ 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 information is incorrect and/or debts and deductions were paid. Complete PART Z^ and/or PART ~ below. PART If indicating a different tax rate, please state UFFICIAL ilSE ONLY ^ AAF relationship to decedent: PA DEPARTMENT flF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD.. LINE 1. Date Established 1 `1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and ~~ co t o the best of my knowledge and belief. ~.. HOME (7/ 7 ~ `~~-.J~.~--C ~~ iy ,X PAYER SIGNATUR TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) S ~, PENNSYLVANIA INHERITANCE TAX ,~~ ., ~ t.-~.,r FORMATION NOTICE .- BUREAU OF INDIVIDUAL TAXES ~~~ ~ ~._ ?`~I_4,f{,~~ . AND FILE N0. 21 j Or ~ ~~ Po Box Zso6o1 pennsyiV««yy (: -~ •,tt ~ ACN 12144235 HARRISBURG PA 17128-0601 DEPARTMENT OFRB 4y~kt~,t~.~ .~, Y~.~~XPAYER RESPONSE DATE 08-08-2012 REY-1543 EX AFP (05-11) p. r ~~~ ~~ ~~~ ~? ~ ~' ~ i ~~ TYPE OF ACCOUNT i- ^.: f i. EST. OF EVELYN L BYERS ~ SAVINGS Qf ~~a~..~~ ,V ~ , ~, , DATE OF DEATH 07 - 27 - 2012 ~ TRUST v V~..i~...l~ ~ ~~~~(~~ ~y~,~(~ r~r ~~ COUNTY CUMBERLAND ~ CERTIF. ti-rvVt l.~ REMIT PAYMENT AND FORMS T0: JOHN E BYERS REGISTER OF WILLS 15 LYNN AVE 1 COURTHOUSE SQUARE NEWBURG PA 17240-9229 CARLISLE PA 17013 MEMBER S 1S T F C U 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 y0U are the spOUSe Of 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 "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 BELUW * SEE REVERSE SIDE FOR FILING AND PAYMENT IN$TftUCTYONS Account No. 8472-40 Date 04-08-2011 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 167 , 362.1 0 Payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 27,894.24 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Anv inheritance tax due will become delinquent Potential Tax Due $ 1 , 255.24 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN UFFICiAL 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 C H E C K a discount or avoid interest, or return this notice to the Register of Wills and O N E an official assessment will be issued by the PA Department of Revenue. BLOC 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 information 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 OFFICIAL USE ONLY ~ AAF relationship to decedent: D PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. PcrcErt Taxable 3 X ~ ..~ 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - [j 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under pe lties of perjury, I declare that the facts I reported above are true, correct and c omp le to the best of my knowledge and belief. HOME C ~~ 7 ) y~ ~ ~ ~j h~~ , / ~ --~"TAXPAYER SI NATU TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S ~r/1AA~ t~h A!/~ w r r r y.. •- i"" `., F .. ,.. _ :I` ~ ~: a _. ..~ . 7 .. _.... 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