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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG I PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
17' ":'1'(- II
NO. 21-0;1.-
02135948
08-22-2002
i'2z..
REY-15~5 EX AFP CD9-0OJ
IF
EST. OF THELMA D WAMPLER
S.S. NO. 230-38-8290
DATE OF DEATH 05-25-2002
. i iJ COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX] CERTIF .
JESSE HURLEY
1532 SHEEP FORD RD
MECHANICSBURG PA 11955
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU hills provided the Deplllrtllent with thlil information listed below which has been used in
calculating the potential tax dus. Their records indiClllte that at the death of the above decedlilntl YOU were a joint owner/beneficiary af
this account. If YOU feel this informllltion is incorrectl please obtain written correction from the financial institution I attach a copy
to this for.. and raturn it to tha above 8ddress. This account is taxsble in accordance with the Inheritance Tax Laws of the Commonwellllth
of Plilnns~l"'dniB. Qulilstiun:; .",y by I!ItlS""..ll;Io.l Ly (::CilHng ~717} 787~6~Z7.
nat.
Established
REVERSE SIDE FOR
04-04-2001
FILING AND PAYMENT INSTRUCTIONS
COMPLETE PART 1 BELOW
Account No. 203664-40
. . . SEE
x
10,721.78
8.333
893.45
.045
40.21
To insure proper credit to your accountl two
(2) copies of this notice .ust accollpany your
paYllent to the Registsr of Wills. Make check
payablB to: "Register of Willsl Agent...
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
NOTE: If tlllX payments ars ~ade within three
(3) months of the decedsnt's date of deathl
YOU .ey deduct e SZ discount of ths tax due.
Any inheritanca tax due will baco.e dslinquent
nine (9) months after the date of dsath.
PART TAXPAYER RESPONSE
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r.>.............,'.,..._........",.,.,..,..........,.,............,...,..............,.,....,.,.........."......_._.......,,,.,,.,,...,........,......"..........,,,..,'........,.,..,.,',.........,.,.
,.,.,,..........,.,.,...,.,....,.".,',','.........,.,,,.,..-...........,.,.,'...-.........,.',.,...........,.,.,',.-.......1'."'.,-,.........,.,.,', ,.......,.,.",-..-......., "",.-.
..............-...........................................-..................-.....................................,........-.........,...............,.,...........................,.,...-........,...
...........,...-.........,...........................,.............................................-......,...........
[CHECK ]
ONE
BLOCK
ONLY
A. ~e above infor.ation and tax due is correct.
1. You Nay choose to raNit payment to tha Registar of Wills with two copies of this notics to obtain
a discount or avoid intersstl or you may chsck box "A" and return this notice to tha Rsgister of
Wills and an official assessment ~ill ba issued by the PA Department of RevBnUe.
8. 0 The above asset has besn or will be rBportsd and tax paid with the Pennsylvania Inharitance Tax return
to be -filed by the dscedent.s TepMlsen'tat:ive.
c. 0 The above information is incorrect and/or debts and dsductions ~ers paid by you.
'tau must cOlllplste PART 0 and/or PART 0 bslow.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A.ount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rata
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
OF
1
2
3
4
5
6
7
8
x
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on LIne 5 of Tax Computation)
Under pensltias of perjury, I declare that the facts I
complete to the best of my knowledge and belief. )
~o:(~ rTes:J"l2tYoN'ry--;"s q/h~/;Ol"_
TAXPAYER S NA UR
have reported above are true, correct and
707- .:357"'-
HOME (/'77)
WORK ( )
TELEPHONE NUMBER
<7 - "/- 0.9-
DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INOIVIDUAl TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1 162 EX(1 1-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RUSSELL L WAMPLER
C/O JESSE HURLEY
1532 SHEEPFORD ROAD
MECHANICSBURG, PA 17055
nh_n_ fOld
ESTATE INFORMATION: SSN: 230-38-8290
FILE NUMBER: 2102-0822
DECEDENT NAME: WAMPLER THELMA 0
DATE OF PAYMENT: 09/11/2002
POSTMARK DATE: 09/05/2002
COUNTY: CUMBERLAND
DATE OF DEATH: OS/25/2002
NO. CD 001609
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02135948 I $40.21
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: RUSSELL L WAMPLER
CHECK# 2203
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$40.21
MARY C. LEWIS
REGISTER OF WILLS
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 OJ- '&'c2.d-.
02135949
08-22-2002
REY-15~5 EX iF" {Ot-DOl
TYPE OF
ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX] CERTIF.
TO:
'T),I
"..
, i
EST. OF THELMA D WAMPLER
S.S. NO. 230-38-8290
DATE OF DEATH 05-25-2002
-,\jOUNTY CUMBERLAND
REMIT PAYMENT AND
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
FORMS
JULIA A STOCKER
145 OAKEN LN
GRANTVILLE PA 17028,
HOUSE
MEMBERS 1ST FCU has provided the Departllent with the inforllation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU Were a joint owner/beneficiary of
this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the CO_lIonwealth
of Pennsylvania. QUestions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 203664-40
IE IE IE SEE
Date
Established
REVERSE SIDE FOR
04-04-2001
FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
10,721.78
8.333
893.45
.15
134.02
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice must acco.pany your
pay.ent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax paYllents are made within three
(3) .onths of the decedent's date of death,
YOU lIay deduct a 5Z discount of the tax due.
Any inheritance tax due will becolle dslinquent
nine (9) 1I0nths after the date of death.
PART
[!]
he above infor.ation and tax due is correct.
I. You .ay choose to re_it payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or YOU may check box "A" and return this notice to the Register of
Wills and an official assess.ent will be issued by the PA Depart_ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. 0 The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. 0 The above infor.ation is incorrect and/or debts and deductions were paid by you.
You must cOllplete PART 0 and/or PART ~ below.
If you indicate a different tax rate} please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
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
8. Tax Due
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury} I declare that the facts I have reported above are true} correct and
complete to the best of my knowledge and belief.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
DATE
TAXPAYER SIGNATURE
....
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(1,-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
JILlA A STOCKER
145 OAKEN LANE
GRANTVILLE, PA 17028
_nn_n fold
ESTATE INFORMATION: SSN: 230-38-8290
FILE NUMBER: 2102-0822
DECEDENT NAME: WAMPLER THELMA 0
DATE OF PAYMENT: 09/17/2002
POSTMARK DATE: 09/16/2002
COUNTY: CUMBERLAND
DATE OF DEATH: OS/25/2002
NO. CD 001626
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02135949 I $134.02
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JULIA A STOCKER
CHECK# 2227
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$134.02
MARY C. LEWIS
REGISTER OF WILLS
/~l`~~ ~~ COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 28601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEMENT ALLOWANCE OR DISALLOWANCE
OF DEDUCTION, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST A55ETS REV-1548 E% 1FP (81-82)
DATE 11-11-2002
ESTATE OF WAMPLER THELMA D
DATE OF DEATH 05-25-2002
FILE NUMBER 21 02-0822
_ COUNTY CUMBERLAND
SSN/DC 230-38-8290
JESSE HURLEY ACN 02135948
1532 SHEEPFORD RD Amount Remitted
MECHANICSBURG PA 17055
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1548 EX AFP (01-02)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 11-11-2002
ESTATE OF WAMPLER THELMA D DATE OF DEATH 05-25-2002 COUNTY CUMBERLAND
FILE N0. 21 02-0822 S.S/D.C. N0. 230-38-8290
ACN 02135948
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 203664-40
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST ( ~ TIME CERTIFICATE
DATE ESTABLISHED 04-04-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
10,721.78
X 0.083
893.45
.00
893.45
X .45
40.21
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
OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
09-05-2002 CD001609 .00 40.21
TOTAL TAX CREDIT 40.21
BALANCE OF TAX DUE .Or
INTEREST AND PEN. .~
TOTAL DUE
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU MAY BE DUE A REFUND.
--- .. ~..~....~ .. ~..~ ..~ r..rr rsu me tucr o~~rrrnuc ~
/-J-'??-//
'" BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 260601
HARRISBURG, PA 11128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
NOTICE OF INHERITANCE TAX
APPRAISEKENT ALLONAHCE OR DISALLONANCE
OF DEDUCTIDN~, AND ASSESSHENT OF TAX ON
JDINTL~ HELD DR TRUST ASSETS
REY-l!48EXAFP UI-Qt}
,
,
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
11-25-2002
WAMPLER
05-25-2002
21 02-0822
CUMBERLAND
230-38-8290
02135949
AMount Rellitted
THELMA
D
JULIA A STOCKER
145 OAKEN LN
GRANTVIL LE
PA 17,028
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-Y=isiii-Eif-AFP--foi-=02i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 11-25-2002
ESTATE OF WAMPLER
THELMA
D DATE OF DEATH 05-25-2002
COUNTY
CUMBERLAND
FILE NO. 21 02-0822
TAX RETURN WAS:
S.S/D.C. NO. 230-38-8290
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
02135949
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
203664-40
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
04-04-2001
X
10,721.78
0.083
893.45
.00
893.45
.15
134.02
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
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-16-2002 CDOO1626 .00 134.02
TOTAL TAX CREDIT 134.02
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. 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" [ CRI, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS. I