Loading...
HomeMy WebLinkAbout04-0971COMMONWEALTH OF PENNSYLVANJA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES OEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD OO4552 CRISCUOLO SHARON A 5750 ASPEN LN ENOLA, PA 17025 ...... fold ESTATE INFORMATION: SSN: 146-20-7472 FILE NUMBER: 2104-0971 DECEDENT NAME: KOHKE HENRY F DATE OF PAYMENT: 10/27/2004 POSTMARK DATE: 10/19/2004 COUNTY: CUMBERLAND DATE OF DEATH: 02/23/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 104117848 J $3,876.23 04121623 I $578.79 04121624 I $145.99 TOTAL AMOUNT PAID: $4,601.01 REMARKS: SEAL CHECK# 1395 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS SHARON A CRISCULO 5750 ASPEN LN ENOLA PA 17025 '04 00~ 27 INFORMATION NOTICE AND TAXPAYER RESPONSE I FILE NO. Z10L'/ 97/ ACN Oq1Z1625 DATE 06-0q-200~ TYPE OF ACCOUNT 'E$~. 0¥ HENRY KOHKE F-]SAVZNGS S~S, NO. 1~6-20-7~72 [--[CHECKZNG DATE OF DEATH OZ-Z3-ZO0~ F~TRUST REH~T PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA Z7015 COMPLETE PART I BELOW # . # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. SZZOOIOq~EZ Percent TexlbZe X 50. 000 PART TAXPAYER RESPONSE You must complete PART [] mnd/ar PART [] below. ] relationsh/p ~o decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 2. Account Balance 2 3. Percent Taxable 3 ~ q. A.ount Subject to Tm=< ~ $. Debts end Ih~duc~ions ~ PART DATE PAID PAYEE AND DEDUCTIONS CLAZHKn DESCRIPTION AMOUNT PAID TOTAL (Enter on L/nm 5 of Tax Computation} $ · to th ~d balLef. (~ m~ ~r~, correc~ mpd HORK ( ) TAXPAYER ~ATURE TELEPHONE NUNBE~ ~ GENERAL INFORNATION ~. 1, FA/LURE TO RESPOND NILL RESULT ZN AN OFFZCIAL TAX ASSESSHEHT ~ith applicable interest based on information REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE TAX RETURN - PART 2 - TAX COMPUTATION Da~e of Death Spouse Lineal { Sibling I Collateral CLAIMED DEDUCTTONS - PART $ DEBTS AND DEDUCTTONS CLAIMED ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE '04 27 SHARON A CRTSCUOLO 5750 ASPEN LN ~:~ ENOLA PA 17025 ACN Oq1178q8 DATE 05-18-200q TYPE OF ACCOUNT EST:! 0F HENRY F KOHKE F~SAV~NaS S:S. HO. 1q6-Z0-7fi7Z []CHECKZNO DATE OF DEATH 02-25-200~ [~ITRUST RENZT PAYMENT AND FORHS TO: RESISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 FULTON BANK has provided the DIpartlent with the information listed below which has been used in COMPLETE PART ! SELON il II # SEE REVERSE SIDE FOR FILZNO AND PAYMENT ZNSTRUCTIONS Accoun* No. 3622-65569 Om*e 10-2S-2005 To insure proper credit to your account, Percent Taxable X ~00.00 PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY []The above Jnforaation and tax due ]s correct. PART Tf you indtca~:e a differen* ~:mx re~e, please s~;a*e your ] relationship ~o decedent: TAX RETURN - CONPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS LTNE 1. Da*a Es-~ablishad 2. Accoun~ Balance $. Pmrcan* Tixable q. Aleoun~ ~bjec~ ~o Tax 6. Am~n~ Tax~le 7. Tax Rm~e 8. Tax D~ PAYEE DEBTS AND OEDUCTZONS CLAIMF11 DESCRIPTION PART DATE PA~D AMOUNT PAID TOTAL (Eh*er on Line $ of Tix Computation) $ ~l~leUnder penal*Jes of perjury, T declare *he~ *he fac*s 'r have repor~e~bova ere *rue, cpr~ect ~~ /~'/~t /~ ~'~--_~ WORK ¢ ) TAXPAYER ~S~gNATURE TELEPHONE NUMBER GENERAL ZNFORMATZON 1. FAZLURE TO RESPOND MZLL RESULT ZN AN OFFICZAL TAX ASSESSMENT .~th applicable ~nterast based on information REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE TAX RETURN - PART 2 - TAX COMPUTATION Ol/al/9S to 06/$0/00 aX 6Z 1Sg ZSZ / 07/0~/00 to prosont I OX q.SZa ~2X CLAIMED DEDUCTIONS - PART $ DEBTS AND DEDUCTIONS CLAIMED ZNFORNATZON NOTICE AND TAXPAYER RESPONSE COUNTY '04 O[J 27 P2:13 SHARON A CRISCULO 5750 ASPEN LN ENOLA PA :17025 ('~: ~! r FZLE NO. 2I ~)~ ACN 04121624 DATE 06-04-2004 TYPE OF ACCOUNT ~ST. OF HENRY KOHKE [--]SAVINGS S.S.:NO. 146-Z0-747Z []CHECKING DATE OF DEATH 02-23-Z004 E~TRUST CUNBERLAND []CERTXF, REHZT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701S COMPLETE PART I BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYNENT TNSTRUCTZONS Account No. ZX001q09196 Date 12-17-2003 EstabLished Accotmt Balance ~,Z44.2~ Percent TaxabLe X 100. O0 Al~ount Subject to Tax $,~44.Z3 Tex Rate X .045 PotentA~l Tax Due 145.99 PART TAXPAYER RESPONSE ] ~=.,::.~ .................... !Hi,.,,..:~ ,..:~ ......................... ,,.;,.,.,.,.,.,.. ,.,.=...: ............................ .................... ~,.:r...,.;,~.;. ............... ..:,,, .......................... ,......, [ONE] Rills and an official assessment will be Issued by the pa flapartmant o, Revenue. You must complete PART [] and/or PART [] below. PART Xf you indicate · different tax rate, pXeese stmte your ] reLetionshAp to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Estmb/~shed 2. Accost Balmnce 2 3. Percent Taxable 3 q. Amount Subject to Tax 4 5. Debts and Deductions 6, Amoun~ Tax.la 6 7, Tax RI~I 7 8. Tax ~m 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on LAne $ of Tax Computation) Undlr plnalties of perjury, X declmr! thmt t~ lice; X hive reported above are true, correct and //~~/~~c~P~lPte ~o the~ of my knowXed~m end beXief, WoRKHOME (( ~/TA~PAYER SI~3NATURE TELEPHONE NUMBER Dm~m OT Dem~h Spouse Lineal Sibling I Collm~eral 07/01/94 ~o 12/31/9~ 3Z 6Z 15~ 16~ 07/01/00 ~o presen~ O~ 4,5X~ 12~ 15Z CLAZMED DEDUCTIONS - PART $ DEBTS AND DEDUCTZONS CLAIHED GENERAL INFORHATZON REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE TAX RETURN - PART 2 - TAX COHPUTATION BUREAU OF ZND'rVZDUAL TAXES INHERITANCE TAX DTyTS/ON PO BOX Z80601 HARRTSBURG, PA 171Z8-0601 SHARON A CRTSCU L'~j4 5750 ASPEN LN ENOLA ~A .17025 CONNON#EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF /NHERZTANCE TAX APPRAISEHENT. ALLORANCE OR DISALLOHANCE OF DEDUCTZON~, AND ASSESSHENT OF TAX ON JOZNTL¥ HELD OR TRUST ASSETS DATE 11-29-2004 ESTATE OF KOHKE DATE OF DEATH 02-25-2004 PILE NUMBER 21 04-0971 COUNTY CUMBERLAND SSN/DC 146-20-7472 ACN 04121624 Amoun~ Remi~d REV-i$li8 EX AFP COg-O~i) HENRY HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LO#ER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-29-2004 ESTATE OF KOHKE HENRY DATE OF DEATH 02-25-2004 COUNTY CUMBERLAND FILE NO. 21 04-0971 S.S/D.C. NO. 146-20-7472 ACN TAX RETURN NAS: CX) ACCEPTED AS FILED ( ) CHANGED 04121624 JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 21001409196 TYPE OF ACCOUNT: ( ) SAVINGS C ) CHECKING ( ) TRUST ( ~ TIME CERTIFICATE DATE ESTABLISHED 12-17-2003 Account Balance Percent Taxable X 1.000 Amount Subject to Tax 3,244.23 Debts and Deductions .00 Taxable Amount 3,244.23 Tax Rate X .45 Tax Due 145.99 TAX CREDZTS= 3,244.23 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE NITH YOUR TAX PAYMENT TO THE REGISTER OF RILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 1Z-07-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE TF pATD AFTER THZS DATE., SEE REVERSE FOR CALCULATTON OF ADDTTIONAL TNTEREST. ~ TF TOTAL DUE ZS LESS THAN $1, NO PAYMENT TS REI~UTRED. TF TOTAL DUE TS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THTS FORM FOR INSTRUCTIONS. ) .00 145.99 .22 146.21 PURPOSE OF NOT[CE= To fulfill the requirements of Section Zi40 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (TZ P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. -- Make check or money order payable to: REGISTER OF NILLS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-131$). Applications ara available online at www.revanue.stata.pa.us~ any Register of Nills or Revenue District Office, or from the Department's Z4-hour answering service for forms orders: 1-aoo-36Z-ZOSO; services far taxpayers with special hearing and/or speaking needs: 1-800-447-30Zg (TT only). OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Any party in interest not satisfied aith the appraismant, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object eithin 60 days of the date of receipt of this notice by filing Dna of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at www.boardofappeals.state.pa.us on or before the expiration of tho sixty-day appeal period. In order for an electronic protest to ba valid, you must receive a confirmation number and processed date from the Board of Appeals aabsite. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box 281021, Harrisburg, PA 171ZD-1OZ1. Petitions say not be foxed. B) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box Z80601, Harrisburgj PA 17128-0601 Phone [717) 787-6505. Sea 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 (3) calendar months after the dacadent's death, a five percent discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and 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, or nine (9) months and Dna (1) 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 (6g) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 198Z aill bear interest at a rate which ell1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198'--'~ ZOZ .000548 1988-1991 XXZ .OO0301 gooI 9Z .000Z47 1983 16Z .000438 199Z 9Z .000Z47 ZOOZ 6Z .00016~ 198~ 11Z .O0030X 1993-1994 7Z .00019Z 2003 SZ .000137 1985 13X .000356 1995-1998 9Z .O00Z~7 ZOO~ 4Z .OOOllO 1986 IOZ .OOOZ74 1999 7Z .00019Z 1987 9Z .000Z47 ZOO0 DZ .000Z19 --Interest is calculated as follows: ZNTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELTNQUENT X DAZEY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. BUREAU OF ZND/VZDUAL TAXES /NHERTTANCE TAX DIVISION PO BOX 280601 HARRTSBURG,, PA 17128-0601 SHARON A CRISCULO 5750 ASPEN LN ENOLA COHNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT, ALLONANCE OR DISALLOHANCE OF DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS PA 17025 REV-lSd8 EX AFP DATE 11-29-200q ESTATE OF KOHKE HENRY DATE OF DEATH 02-25-Z00q FILE NUHBER 21 0~-0971 COUNTY CUNBERLAND ~-~.?*-~SSN/DC 1~6-20-7~72 ACN 0~121625 Amoun~ Remi~ed HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *"~ m m m m m m mm mmm m mm mmm m mmmmmmmmNmmmmmmm m mm mmm m mmmmmmmmmm mmm m mmmmmmmmmmmmmmmm mmm m mmmmmmmmmmmmm m mm mm m mm m mmmmmmmmmm m m m m m REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 11-29-200q ESTATE OF KOHKE HENRY DATE OF DEATH 02-Z$-200~ COUNTY CUNBERLAND FILE NO. 21 0q-0971 S.S/D.C. NO. lq6-20-7~72 ACN OqlZ16Z$ TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORHATZON FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. ~120010fifi52 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TINE CERTIFICATE DATE ESTABLISHED 10-09-1997 Account Balance Percent Taxable X 0.500 Amount Subject to Tax 12,862.10 Debts and Deductions - .00 Taxable Amount 12,862.10 Tax Rate X .~5 Tax Due 578.79 TAX CREDTTS: 25,72q.Z0 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBNIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYHENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUNBER INTEREST/PEN PAID ¢-) INTEREST IS CHARGED THROUGH 12-07-200q AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORH TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS. ) .00 578.79 .89 579.68 PURPOSE OF NOTZCE: PAYMENT: REFUND (CR}: OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 21q0 of the [nheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 91~0). Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side. -- Make check ar 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 far Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available online at ama.revenue.state.ua.us, any Register of Hills or Revenue District Office) or from the Department's g4-hour answering service for fores orders: 1-800-36Z-ZOBO; servlces for taxpayers with special hearing and/or speaking needs: 1-8gO-~47-~OZO (TT only}o Any party in interest not satisfied with the appraismant, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object ~ithin 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at w~w.boardofappaals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from the Board of Appeals webslta. You may also send a ~ritten protest to PA Department of Revenue, Board of Appeals P.O. Box Z810Z1, Harrisburg, PA 171Za-lOZ1. Petitions may not be foxed. 8) Election to have the matter determined at the audit of the account of the personal representative. C) 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, P.O. Box Z80601, Harrisburg, PA 171g8-0601 Phone (717} 787-6505. See page 5 of the booklet "Instructions for /nharitance Tax Return for a Resident Decedent" (REV-1501) for an axplanation of administratively correctable errors. If any tax due is paid ~ithin three (3) calendar months after the dacedent's death, a five percent (SZ) 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 and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you ~ould appeal the tax and interest that has been assessed as indicated on this notlce. interest is charged beginning with first day of delinquency, or nine (9} months and one (1) day from tho date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 198Z ~ill bear interest at a rate ~hich ~ill vary from calendar year to calendar year ~ith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are: interest Dally Interest Daily interest Daily Year Rate Factor Year Rate Factor Year__ Rate Factor 1982 lOX .000548 198'--~-1991 11Z .000301 ZOO1 91 .OOOZ~7 1983 162 .000458 1991 9Z .000247 ZOOZ 62 ,000164 1984 112 .000~01 199~-199q 72 .000192 2003 51 .000157 1985 132 .000356 1995-1998 92 .0002~7 200~ 42 .000110 1986 log .OOOZ7~ 1999 72 .000192 1987 91 .000247 ZOOO 82 .OOOZ19 --Tnterest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELINQUENT X DALLY INTEREST 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, additiona! interest must be calculated. BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DZV']rSI'ON PO BOX 280601 HARRISBURG, PA 171ZS-O6D! COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT RE¥-1607 EX AFP SHARON 57~1 ASPEN LN ENI:~.A A CRISCULO PA 17025 DATE 1Z-06-Z004 ESTATE OF KOHKE DATE OF DEATH 02-25-2004 FILE NUMBER 21 04-0971 COUNTY CUMBERLAND ACM I Amoun~ HENRY HAKE CHECK PAYABLE AND REMIT PAYMENT TO: : T~insure p;-~ler credi~ ~o your account, submi'c ~he upper portion of ~his form wi~:h your ~ax payment. C~ CUT ALONGC~HZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS 'ql REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 ESTATE OF KOHKE HENRY FILE NO.21 04-0971 ACM 04121624 DATE 12-06-2004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM IN THE NAHED ESTATE. SHONN BELON IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 11-Z9-Z004 PR/NC/PAL TAX DUE: ................................................................................ PAYMENTS (TAX CREDITS): 145.99 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-19-2004 CDOO455Z .00 145.99 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT 145.99 ~ALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. BUREAU OF TNDIVZDUAL TAXES INHERITANCE TAX DZVISION PO BOX 280601 HARRISBURG, PA 171Z8-0601 COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT o~ DATE 12-06-2004 L~- _= ~ ESTATE OF KOHKE c.c~ ~-'~ :~ __ ~ ~ATE OF ~EATH 02-2~-200~ ~ ~ ~ FZLE NUMBER Z1 04-0971 ~ O COUNTY CUH~ERLAND ~SH~N ~ISCUL0 ACN 0~1216Z~ ~EN~ ~ PA ~70Z5 HENRY HAKE CHECK PAYABLE AND REN'rT PAYNENT TO: REGISTER OF NILLS CUNBERLAND C0 COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~ ESTATE OF KOHKE HENRY FZLE NO.21 04-0971 ACN 0412162:3 DATE 12-06-Z004 THZS STATENENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NANED ESTATE. SHONN BELON TS A SUNNARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYNENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE, A PROJECTED TNTEREST FTOURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 11-29-Z004 PRINCIPAL TAX DUE: ........................................................................................... PAYHENTS (TAX CREDITS): 578.79 PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 10-19-2004 CD004552 .00 578.79 ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN 91, NO PAYHENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), TOTAL TAX CREDZT 578.79 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISldH- PO BOX Z80601 HARRISBURG PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLOHANCE OR DISALLOHANCE OF DEDUCTION~, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REY-1S48 EX AFP (12-0~l :J DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-21-2005 KOHKE 02-23-2004 21 04-0971 CUMBERLAND 146-20-7472 04117848 Allount Rellitted HENRY SHARON A CRISCUOLO 5750 ASPEN LN ENOLA PA 17025 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... RE-Y=isira-Ex--AFii-Coi-=03i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-21-2005 ESTATE OF KoHKE HENRY DATE OF DEATH 02-23-2004 COUNTY CUMBERLAND FILE NO. 21 04-0971 TAX RETURN WAS: S.S/D.C. NO. 146-20-7472 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04117848 FINANCIAL INSTITUTION: FULTON BANK ACCOUNT NO. 3622-65569 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE 10-23-2003 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X 96,867.55 1.000 96,867.55 10,729.00 86,138.55 .45 3,876.23 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 DR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-19-2004 CD004552 .00 3,876.23 TOTAL TAX CREDIT 3,876.23 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 I . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TDTAL DUE IS LESS THAN $1, ND PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) ~~x..