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Home My WebLink About06-20-13 . - - ��i� BUREAU OF INDIVIAUAL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 Information Notice DEPARTMENT OF REVENUE HARRISBURG PA 17128-0601 REV-1543 EX DocE%EC �oe-iz� And Taxpayer Response FILE NO.2170 "'� ACN 13119754 � �— � �' D�3 / '_ t'�,�� F DATE 04-16-2013 ��as-►�F 3� aF ��.�s �� Type of Account %GI3 JUN 2� �� y O� Estate of Savings SSN Checking �L�� County CUMBERLAND�2 X Cert ficate, MICHAEL L SEAVERS � 6 KEYSTONE DR ORPHANS C��R MECHANICSBURG PA i��R�,p�D CO•, PA ORRSTOWN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.4000036601 Date Established 02-16-2010 REGISTER OF WILLS Account Balance $28,001.88 1 COURTHOUSE S�UARE CARLISLE PA 17013 Percent Taxable X 16.667 Amount Subject to Tax $4,667.07 Tax Rate X 0.150 NQTE*: If tax payments are made within three months of the Potential Tax Due $700.06 decedent's date of death,deduct a 5 percent discount on the t�jx With 5%Discount(Tax x 0.95) $(see NOTE*) due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or 1 am the parent of a decedent who v�as 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amoun� shown above as Potential Tax Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. � 4.5% I am a lineai beneficiary(parent il grandchild, ete.)of the deceased. (Select correct tax rate at right, and complete Part � �2% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tau form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. ��I� B��o oF INDIVIDUAL TAXES Pennsyivania lnheritance Tax � pennsylvania PO BOX 260601 Information Notice DEPARTMENT OF REVENUE HARRISBURG PA 17128-0601 REV-1543 EX DocEXEC<98-12) And Taxpayer Response FILE NO.2170 ACN 13119756 DATE 04-16-2013 REG15Y�k�r� 0� '�'dit,LS / Type of Account '�l3 JUN 20 P�i y ��tate of Savings SSN Checking ��E�� y� Date of Death 11-17-2012 Trust MICHAEL L SEAVERS � County CUMBERLAND X Certificat� 6 KEYSTONE DR 4�tPHANS COURT MECHANICSBURG PA i�oso-��RLANQ CO•. PQ► ORRSTOWN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.4000039247 Date Established 09-20-2010 REGlSTER OF WILLS Account Balance $10,017.88 1 COURTHOUSE SQUARE CARLISLE PA 17013 Percent Taxable X 16.667 Amount Subject to Tax $1,669.68 Tax Rate X 0.150 NOTE`: If tax payments are made within three months of the ii Potential Tax Due $250.45 decedent's date of death,deduct a 5 percent discount on the t��C With 5%Discount(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become delinquent nine morhths after the date of death. ' PART Step i : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or t am the parent of a decedent who�lufas 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard fhe amoun�t shown above as Potential Tax Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any ofher boxes. c �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(paren c ild grandchild, etc.)of the deceased. (Select correct tax rate at right,and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were pa+d. listed. Compleie Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritanc�i Tax inheritance tau form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. �� . _ ��i� BURFAU OF INDIYIDUAL TAXES Pennsylvania inheritance Tax � pennsylvania Po BOX 280601 Information Notice DEPARTMENT OF REVENUE HARRISBURG PA 17128-0601 pEV-1543 E%UocE%EG cna-iz� And Taxpayer Response FILE NO.2170 ACN 13119760 DATE 04-16-2013 ��°n'�� TYPe of Account Estate of Savings SSN Checking Date of Death 11-17-2012 Trust MICHAEL L SEAVERS County CUMBERLAND X Certificat� 6 KEYSTONE DR MECHANICSBURG PA 17050-1573 ^.:, n � � w �7 rn O rry W ..�� C �' p � = C'� ��" tJ� :�J f'�' � r~n N � �r � � � � � � � C3 � C'� O d � � `o'j O C ORRSTOWN BANK provided the department with the information below indicating�th�t the�ath�f�e above-named decedent you were a joint owner or beneficiary of the account id tified. �,,, o Remit Payment and Forms to: AccountNa 4000044555 Date Established 04-13-2009 REGISTER OF WILLS Account Balance $5,010.51 1 COURTHOUSE S(�UARE CARLISLE PA 17013 Percent Taxable X 16.667 Amount Subject to Tax $835.10 Tax Rate X 0.150 NOTE': !f tax payments are made within three months of the Potential Tax Due $125.27 decedent's date of death,deduct a 5 percent discount on the t�pC With 5%Discount(Tax x 0.95) $(see NOTE*) due. Any inheritance tax due will become delinquent nine mor�qhs after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who�lujas 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amour+E shown above as Potentia!Tax Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Sfep 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child, grandchild,etc.)of the deceased. ' (Select correct tax rate at ��' right, and complete Part � �2% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of fhis form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritanc�'Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. ,� ., _ _ _ _ ��i� BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 Information Notice DEPARTMENT OF REVENUE NARRISBURG PA 17128-0601 REV-1543 EX DocEXEC cea-iz> And T�payer Response FILE NO.2170 ACN 13119758 DATE 04-16-2013 ye, ��1 d .� R E G i S��:_�� G� '�`yi i f._!_5 �� Type of Account �� 20 t�(� � QZ Estate of�o o��'�:.�.'_�o Savings SSN Checking Date of Death 11-17-2012 Trust MICHAEL L SEAVERS CLERK Or CountyCUMBERLAND X Certificat� 6 KEYSTONE DR �RPN/.��js' CQURT MECHANICSBURG PA 1705 'Y573 � MBERLAND CO., PA ORRSTOWN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: ' Account Mo.4000042186 Date Established 07-08-2011 REGISTER OF WILLS Account Balance $20,510.11 1 COURTHOUSE SQUARE CARLISLE PA 17013 Percent Taxable X 16.667 Amount Subject to Tax $3,418.42 Tax Rate X 0.150 NOTE*: If tax payments are made within three months of the ;•! Potential Tax Due $512•76 decedenYs date of death,deduct a 5 percent discount on the�x With 5%Discount(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become detinquent nine mo hs after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. 1 am the spouse of the deceased or I am the parent of a decedent who Vn�as 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and d+sregard the amou'n� shown above as Potential Tax Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C The tax rate is incorrect. �4.5% I am a lineal beneficiary(parent, il grandchild,etc.)of the deceased. I ' �(Select correct tax rate at ' ; right,and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% Ail other relationships(including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of ihis form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritanci�Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed fo Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. i i: __ �R�� BUREAU OF INDIYIDl1AL TAXES Pennsylvania lnheritance Tax � pennsylvania Po BOX 280601 DEPARTMENT OF REVENUE HARRISBURG PA 17128-06 01 Information Notice And Taxpayer Response REV-154i EX OocEXEC �ae-�z� FILE NO.2170 ACN 13121127 �. ,�._ DATE 04-24-2013 �tEG(S�!"�;� Oi= �'o'��..LS Type of Account i�i3 JUN 20 �� y �� Estate of� � I� Savings SSN Checking C L E R tC Q i Date of Death 11-17-2012 Trust MICHAEL L SEAYERS Q�PNA�S� C�Uf�T CountyCUMBERLAND X Certifica�e LAND CO., PA � �� wr '�r� � oRRSrowN saNK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.4000044793 Date Established 09-05-2012 REGISTER OF WILLS Account Balance $ 17,510.11 1 COURTHOUSE SQUARE Percent Taxable X 50 CARUSLE PA 17013 Amount Subject to Tax $8,755.06 Tax Rate X 0.045 NOTE`: If tax payments are made within three months of the �" Potential Tax Due $393.98 decedent's date of death,deduct a 5 percent discount on the t�Dc With 5%Discount(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become delinquent nine mo,ti�s after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who wr�s 21 years old or younger at date of death. r"—"' Proceed to 5tep 2 on reverse. Do not check any other boxes and disregard the amount �,,,,,,„q,, . -•-v,.xu, shown above as Potential Tax Due. �ta��. g �The information�, The above information is correct, no deductions are being taken,and payment will be sent �,., correct ' with my response. t�� " '",`"`�` "" t" Proceed fo Step 2 on reverse. Do not check any other boxes. C The ta te s incorrect. � A�.51`/o I am a lineal beneficiary(parent, d randchild, etc.)of the deceased. �(Select c r ct tax rate at `' ��. � right, a o j piete Part � 7 2% I am a sibling of the deceased. 3 on re rs � 15% All other relationships (including none). ; p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complefe Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritancq Tax inheritance tax form Return filed by the estate representative. REV-i 500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. _ _ __ _ . i;,.,_ �___ _ � � �_ _ �_� � � � - �'�� -"` • "'�- � �� _ � � � � � � � � � � � ' � �.� � �, � � _ � � � �-�, i� �; _ c.� _-a � � �..� � rn � � � � � _ _ � �o c= _.. � . � " ,�! `"' -"-' rn � c-� __.� : � � � y� r- r� �r ; 1. � ,�.7� � �; � - ,>' '"� �� -• � C1'> � C-, c�y _� ('d � � � -;.. _;� ., = � ca c=� . . -� _. �-� r_•, � �� _-�-I � '`_ �-:..� `L7 � Ct) � Qp" C...� T> � � �--.._ � C ��? � ` r1 m � � o �i° � , o ,.� m � 1N �� _ �� _ +J = -_ O = GJ �� _ �� - �� 3 m � � x c C D • o� 3Z Z VI �.� _ ��• tD�� CtDO�D� �.: �.. o• Z• �Wp�p ,. � �w � � �