HomeMy WebLinkAbout01-0293
z
o
j:::
~i!'
I-'::::l
Q.
:E
o
(.)
REV-l500E<"'l..g7)~
. COMMONW~:YLVANIA
DEPARTMENT OF REVENUE
DEPT,280601
HARRISBURG PA 17128-0001
OECfDEtrr'S NAA1E(~T, FIRfT'ANDMI,DDlEI~ITIAlt~a,blllrtkbl(l~k,~,~,~,~
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
U~TOM.Y
~
z
w
c
w
(.)
w
c
TJ<.\NsotJ
SOCiAl SECURITY NUMBER
DATE Of BIRTH
o ~ I ~11
THIS RETURN MUST BE FItED IN DUPLICATE WITH THE
~ 0 \ - ) b . '<:f REGISTER OF WILLS
..:).,.'0 .(.. f
w
..,
~:!~
0"'8
w"
::t~....
0.."
..
0(
1: Original Retum 0 2. Supplemental Relum
o 4. LimitadEstale D4a.FuturelnterestCompromisel'..of,,",""'''.,,-82,
o 6. Decedent Died Testate (Attach copy of Will) 0 7. Decedent Maintained a Living Trust (AlIac:hcopyofTrust)
o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credtt I'" of""' _.m ".31.91 and1-1-95)
. TH~$ec;rIONlIN&TBE'l;QMl'tE'r!;!l;I!;!;!.i;~ ~; iqgIlF!m'l_:~TglIIF
NAME COMPlETEMAlUNGADDRESS
o 3. Remainder Return (da1eofdealh priorm 12.13-82)
o 5. Federal Estate Tax Retum Required
_ 8. Tolal Number of Safe Deposit Boxes
011. Election to tax under Soc. 9113(A) I_Son 0'
TIO"'i$~l!l1JI..ll.:!lMQTeo
!z
w
c
z
c
..
In
Il!
'"
o
o
lOb J()~~ Ru...o () v
N~ '^" c.",wae ~t.^AlO, ~, Ob'l
TELEPHONE NUMBER '1.
?I 7"'1'- V
1. Real Estate (Schedule A)
(1)
l
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation,Partnership or Soie-Proprietorship (3)
z
o
5
::J
~
ii:
<(
(.)
w
II::
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Join!y OWned Property (Schedule F)
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. T atat Gross Assets (total Lines 1-7)
(4)
(5)
(6)
(7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11)
(12)
(13)
, '1f d'3 ~. 'U...
,'d-.J S,/;~ ij.t,.l
, P 0
,!)..
12_ Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
15. Amount o! line 14 taxable
at the spousal tax rate ., I;
See instructions on reverse side for appli~b.lepercentage
16. ~t~~~f; line 14 taxab'e<}"'3 .S-f)\'
17. Amount of line 14 taxable
at 15% rate
(14)
&"t
'-.. X .06
X .15
(16)
(17)
(18)
18. Tax Due
19.
//)1>
5c{.':L
~
DATE
;;1-,5"-6)/
DATE
-.
J- I~H) \
~o
Decedent's Complete Address:
STREET ADDRESS
,
CITY
c..(S
ZIP 171> II
Tax Payments and Credits:
1. Tax Due (Page 1 Line 18)
2. Credits/Paymen\s ~
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
"
~
(1)
IH.I).I.n
3, InteresVPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C) (2)
A. u"
TotallnteresVPenalty (D + E) (3)
4, If line 2 is greater than line 1 + line 3, enter the difference, This is the OVERPAYMENT,
Check box on Page 1 Line 19 to requeat a refund (4)
5. If line 1 + line 3 is greater than line 2: enter the differenc~, ,T~is is the TAX DUE, (5) J l.:/ t I ?-1. fb
A. Enter the interest on the tax due. (SA)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
_ Make Check Payable to: REGISTER OF WILLS, AGENT L
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income olthe property transferred; .., ......................... .................... ..... B" 0
b. retain the right to designate who shall use the property transferred pr its income;. .............. 0 0
c. retain a reversionary interest; or......... ................. .............. ............................... .................. 0 0
d. receive the promise for iife of either payments, benefits or care?.... .................................. 0 0
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12', 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ................. ............... ...................... .....0 0
3. Did decedent own an "in trust for" or payable upon death bank account or security
at his or her death? ............~...... ....................... ................................ .............. ...........0 0
4. Did decedent own an individual retirement account, annuity, or other non-probate property? ... 0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
72 P.S. 9116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the
surviving 'spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995.
72 P.S. ~911/3 (a) (1.'1) (ii) provided for the reduction olthe rate imposed on the net value oltransfers to or forthe use of the surviving
spouse (rom 3% to 0% for dates of death on or after January 1, 1995. The statute does not exempt a transfer to a surviving spouse
from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse
is the only beneficiary.
~OR DATES OF DEATH ON OR AFTER JANUARY 1, 1995 - Please answer the following question by placing an "x" in the
appropriate space.
Did the decedent create a trust or similar arrangement which is solely for the surviving spouse's benefit for his or her entire
lifetime? Yes ~ No 0
If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second
spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(ies). Enter the value of the trust on
Schedule J, Part II, in order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule 0 in order to
make the election available under Section 9113. lithe election is made, the trust or similar ar;angement is taxed in the estate olthe
first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate,
and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(ies). If you choose to make the election, you must
attach Schedule 0 to a timely-filed tax reiun" along with Schedule(s) K and/or M in order to show the apportionment of the trust or
simi~ar arrangement between the surviving spouse and the remainder beneficiary(ies).
R~V.,1510 EX+ (2-871
ESTATE OF
..
SCHEDULE G
TRANSFERS
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
PLEASE PRINT OR TYPE
FILE NUMBER
__I<"Tt\~tV1=- P\, 1\"(l<'\Nb~,J
THIS SCHEDULE MU E COMPLETED AND FILED IFTHE ANSWER TO ANY OFTHE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES.
ITEM DESCRIPTION OF PROPERTY
NUMBER Include name of the transferee, their relationship to decedenf, date of fransfer.
EXCLUSION
TOTAL VALUE
OF ASSET
DECO.
%
INT.
DOLLAR VALUE
OF DECEDENT'S
INTEREST
, .
(.)E.ll I2..GG C ATK.I!'I501ll ~
-5 F\N () p.~ \Q.j M\ \.\..€ R... II fU.\≠:,
I tV \ R.~~Voc.A.e~&\\t\,L<;1 or
p(Cc:;Det.>T ~(JU'Ep tJc,t I. ICl'l'i"
1/ ,;).3 u.1'\.6e~/) 51. .. Hou.~e j. ~r -
, fAI~v\6~ ~ Po'j ~ Cv. @. ~ 73 .5M.
B. I ~1 "l'.~u;TD ~T. - fl....\' e.,-~~. -
.... ----r---'p V)~ Gi p.... 5;l..~1X).
rA\fl,lIn::w I"'" 0 r
5f;Co ~ Rwp.o 8001<''7 133q ~,e
a-nl. '+ /33'\ fA~6 ';}..<rd-S" - '16 ~i<. Cd'UJi'
/~~M>~fl.& 6Ff"~ / -r;, /f).,JYli
Co fNc. CltECI<-I.QG Aa..P.....~T If)
Pf/ilIJJ,T#$ - q-il-~11
o j/U.6"-V'f'lf! 346- '-"bY"-IOO;.t
D€:NJ \.\hHG~ ~~NO\..OS IIIIL,
--IIlo,.~?5 .[>1
~44,DD1.'Ut
~l\4, 0 l) (.~ ,
TOTAL (Also enter on line 7, Recapitulation) S ~w 4 DC\ . G.4
(If more spoce is needed, insert additional sheets of some size.)
." .
REV-1.511 EJ(+ (7_116\
ESTATE OF
-t~
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Please Print or Type
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ON
ITEM DESCRIPTION AMOUNT
NUMBER
A. Funeral Expenses: \t 773'(. DO
p,\\~"~ frA.Nef.9.I- I"t
L
2. ....u.N1 Ol..IV!S1 CCI'\"~~ /.oD.DO
?,. 13 t..OOJl'\;$ - F w-.vert-S ("D.IYO
'-I. f().() f~1- 1....,"'r>#- ~ \.. 1~,'t1
B.
4.
C.
L
2.
3.
4.
5.
6.
7.
8.
Administrative Costs:
1.
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
2. Attorney Fees
3. Family Exemption
Claimant
Relationship
Address of Claimant at decedent's death
Street Address
City
State
Zi p Code
Probate fees
Miscellaneous Expenses:
i\f. G \ ~ Tell {)f (,A) ,l..l-S
F/f..tc. RGT\A.f'-rJ
ID DO
TOTAL (Also enter an line 9, Recapitulation)
$ 1S)-b . q1
(If more space is needed, insert additional sheets of same size.)
'E\O-'\5I3EX-+\2.87\
'*
COMMONWEALTH OF P~NNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
ITEM
NUMBER
1.
~.
Kfl.T
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF BENEFICIARY
J.
A. Taxable Bequests:
6tbR<ec C..~ii<:.,~/.) RO*'l..l13Il'l..l~'i-J
J<',....~tI".T6'l..l\.S '1hS\.)....
SA.1I0~" t< I"\\L'-E.~ no. J.o\ ~ L.ANC .
ket.\\I\N~el4ll6,(k. . nO~D
<:.~~1."'5 Gf"DI.b~ ATI<.,II.sbU 101 c. f"itoN"T ~7'
t.t:W9l!>~'1 .. frtI. ,"~1'
J<p.,Tth P Anl.\NSbIV 20 5... S~(Ae hllrJ~k 1R.
.. .'J '101t K HAreN, f'"". I 7 ~ 1 C>
t<r;; IT Ii B ~TK'/VS()'V (?Dtl-{ 60,," so'j
1..,"eR-f'DfJ'-, f'~. /1 <><f-5
fteGINN-Q j!rr;Glto)W<v I Sf;' C<<OP,R I..F>/'Je
CARL,,,Le/ P,. J?C>I?;
5H)
II..
11.
5.
h
Df>.~t'Jf.
II..
:;6 f\.)
Ii \P
I(b
(J A.\.\.6 \;\TU.
60rJ
1)1.
II b
0<>0.)
ITEM
NUMBER
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF BENEFICIARY
1.
B. Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI,o enter on line 13, Recopitulotion) 5
(If more space is needed, insert additional sh.ets of same size)
ru
el: Z .::t
Z 0 Ii)
el: W ...0
> (/) z .,...,['
-'
>- w ~ I
(IJ >< 0 ::.: ill
ZUJel:
z:Jl- <0 I- ru x
UJz-, 0
Cl.UJcl: 00 <I .....1-
LL>::l N
OUJe r:::: :::i U x .
0:_
ILL~ el: 0 OZ
~oe Cl. ex: w row
el: I- a; - u.
UJZ ~<D C (!) W
~UJ~g~ w lY CU-1
Z::i:::lOIIl > 0 ..J
Oti:~~~ w w !- ......
::i:el: ~o: 0 (!J C:x
::i:Cl.D:Cl.0: W
OUJ::lUJel: ex: L
OOCllOI
w
a:
w
:c
9
0
"-
ii
r
I
I
I
I
)
j
I
I
I
I
I
I
I
I
I
I
I
I
I
1
I
I
,
I
I
X
<C
t-
W
t-
<c<C
_t-
zen
<cW
>0
..Jz
><C
en
zW
zO
wZ
D..<C
!:::
a:
w
J:
z
......
<.0
~
co
r-
-.::t
<(
<J;
o
z
I-
0..
-
W
o
w
a:
...J
<C
-
o
-
LL
LL
o
w
a:
w
:c
9
12
-0 ..0 u'
CD ill
. <I
I- [', r.,
z nJ ru
::) .... ~...
0 .
::2; cj' <t
<{ ..... ~.
if! {i't
.....
o
.....
o
<(
c..
I-
Z
=>
o
::2;
<{
...J
<{
I-
o
I-
I-
rl]...Jc:
o
z::2;c:w
O(/)1-1Il
<{(/)z::2;
Wo=>
~oz
<{
~
('J
.....
CD
..0
..Q
.....
I i='
- (IJ
0 0:
N u: ~
~a:
z
(J) w rz
In z ~
>-
0:: ~
r-- :r
(T) .-J-
Z 0-- I-<I ~
'0 ru ~~ .,... .... a ...
v
f= 0 d- o C> z 0
<( I Z 0 0 c.! 0
:2 ..... 1-0 ru OJ ..J flJ
a: 0 zl;") ..........,. "- cc "-
0 0 ~z di-.o UJ..... w IN
LL o:ru UJ~ ::i:.... ~('lJ m 1-.....
z ~::.:: >-, 0, L uJ'
UJI ~(T)
W 1Il... 01- ~nJ ::::l oln
I- ~n.: ~<t LL el: l:U LL
~ Z 0 ::i: 0
UJ UJ I- Z UJ
UJ ::i: I- 00 ::l I-
en -' el: el: 0 0 el:
W u: Z 0 Cl. 0 0
~,
~.~
J ~
~~ .s,
'~
~~~~
~..~.
<:~ cn
. , ..J
_J
~'~) ~1
-~..,.--
'-
t:", I
~..J
\~ -::< IX
'"..''''' . 1,1
~, l.U
" " 'l.. 1 r-
" ".,
, ..d
, >-.....
in Cl:: t!J
oct w
W ~ r.r
>
W
o
W
c:
:#
:x:
U
w
I
U
...J
(/) <{
:.::: W
c: (/)
<{
::2;
W
c:
..0
....
CD
t()
j()
.....
,
I
I
1
I
1
~1
~]
3:1
~I
a:f
~l
C/)j
@l
a:l
1
I
[
[
[
1
I
I
I
I
I
I
r
!
"
i'
f
r
1
1
\ /6 -d2/7-/y
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ROBERT E MYERS
100 YORK RD
NEW CUMBERLAND
; ,
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-21-2001
ATKINSON
05-12-2000
21 01-0293
CUMBERLAND
101
REV-1541 EX AFP <12-00)
KATHRYNE
M
PA 17010,
AlIOunt Rellitted
,0
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 ~
REV=is4-j-E3f-AFP--fi'2-:o0Y-NCfficE--OF-XNHEifiTAifcE-jAi-]rpPRXisEM€NT~--ALl-owAi'-cE-oR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ATKINSON KATHRYNE M FILE NO. 21 01-0293 ACN 101 DATE 05-21-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
Cl)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
.00
.00
244,001. 24
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
ClO)
8,536.97
.00
(11)
Cl2)
Cl3)
Cl4)
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ abh
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
NOTE: To insure proper
credit to your account,
submit the upper portion
of this forll with your
tax paYllent.
244,001. 24
8."36 97
235,464.27
.00
235,464.27
14, 15 and/or 1&, 17, 18 and 19 will
returns assessed to date.
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-21-2001 AA478161 .00 14,127.86
BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-22-2001 TOTAL TAX CREDIT 14,127.86
BALANCE OF TAX DUE .00
INTEREST AND PEN. 31.41
TOTAL DUE 31.41
.OOXOO=
235,464.27 X 06 =
.00 X 00 =
.00 X 15 =
Cl9)=
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
14,127.86
.00
.00
14,127.86
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
$
'<'
x
UJ
N
'"
:>
UJ
a:
<.0
0
r-
<.0
0>
~
<(
<(
0
z
><
<C l-
I-
W n.
I- -
<c<C W
-I- 0
zen
<cW W
>0 a:
...JZ
><C ...J
en
ZW <C
zO -
wZ 0
a.<C -
l- LL.
a: LL.
W 0
::I:
Z
.-<
.~
f-
Z
:::l
a
:2
<(
~,
(11
l.fi
..,-1
<:>
f-
ijJ...Ja:
a
z:2a:W
U(/)f-CO
<((/)z:2
Wa:::l
~UZ
<(
OJ
~ Z <1"
z 0 In
<( lJl ..0
> t/l Z .... ['-
-'
>- w ...... t
t/lw>< (; " Q)
~:J~ <D t- f'J :;.;::
0
wz-, 00 G: .... t-
a.W<(
u->:J N
oWe ..... ~ U >~ .
a:_
Iu-~ <( 0 f:: 2
~oe a. a: W OJ W
<(f-~ - u.. l!J W
wz ~~ 0
~w~g~ w 0:: :1J .J
z~~gm > 0 _J
Oa:<(N5!1 iij W !-
~<(w.-:a: 0 ,."J n: ......
a. a: a. a: w
OW:JW<( a: L
QOmOI
i---
I
I
w
a:
w
:c
'3
~
.....
.,~."~u
" .
/
.'
...lt~
~'r)
tI1
--
,
,
,
"
o
<i:
Jtf~ ~
f-
Z
:::l
a
:2
<(
...J
<(
f-
a
f-
t"A~.'
....
.w
~) 1-.
,,~
v,
>-:-: ;-~
c:c u. ....J
0,1 W
UJ :EX
~
LlJ
U
LlJ
a:
.',
~
cu
.....
0)
..0
,..
"<J
-<
I t="
..... UJ
<:> a:
GJ ~
E
Z
lJl W
UI Z ,
>-
0:-
- ::r
cr.t ~f-
Z 0' f-(!
OJ UJ. . Q
'0 <(:J;. .... .... -
i= c- 2- 0 0 2 ;.....'1 I
<( f Z 0 0 (! C> ,
::2: .... f-O [U il..l ...J !-'.l
a: c) z (;1 f- ',- "- cr -,
0 _. ~z m..... ~.J w IOJ
'.'
LL (i' ~~ :2"-' <( c. m f- ~...
Z a: ," >-..... 0.... I: U) "
wi W:O:. ;i..o
w m.... OL... ~.(j ,:) o iil
f- 3 i'tJ U-<r u- <( >-u u-
<( 0 0 :2 f- 0
f- z W W f- Z W
W :2 f- t/l ::::J f-
CI) -' <( <( 0 0 <(
w u:: z 0 a. Q 0
z
o
U)
.,::.
-<
~
1-.
<r
,
'-'
w
!!)
0::
o
W
i!)
(/)
~
a:
<(
:2
LlJ
a:
~
e;..
~,
nj
I
I
I
I
I
I
I
I
I
I
I
I
I
1
I
wi
::]1
-I
$1
[L,
01
a:1
~I
wI
m,
a:l
I
I
I
I
I
I
j
I
I
1
I
I
I
1
I
I
I
#:
.-
U
LJ
:r
u
...J
<(
LlJ
(/)
~ /b-~I 7-/~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
1-
<)C
/'
*
REV-I'D7 EX AFP lI2-DDl
ROBERT E MYERS
100 YORK RD
NEW CUMBERLAND
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
cOUNty
ACN
06-25-2001
ATKINSON
05-12-2000
21 01-0293
CUMBERLAND
101
KATHRYNE
M
PA 17070
AlIOUnt Re..itted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this fOri! with your tax paYll8nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV :i6'ifj-i3f-AFP-fi'2-:ooY------...--iNifERITANCE-TAx-si'iffEMENT-'ifF'-Accouirf--.-..---------------------
ESTATE OF ATKINSON KATHRYNE M FILE NO.21 01-0293 ACN 101 DATE 06-25-2001
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-14-2001
PRINCIPAL TAX DUE: .................................
14,127.86
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-21-2001 AA478161 .00 14,127.86
06-04-2001 AA496706 31. 41- 31.41
TOTAL TAX CREDIT 14,127.86
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l
r
I~
"0.' ~.."
~ ..
u.J
<.:> x
~ ~. -, ,...
v; I~I'-~~.._ c:::J~
t:~~\'~-:~ cnf~
V~r:~~(~N~ ....-;~;
, 0 Cf.:<r (V',
':) u: ~ ~~
""
~,r\ ~li
'.). 'I",
~r p,
-.:~'
.=r
IJ1
IT1
0-
r-'I
r-'I
IT1
ru
I'-
e
e
e
e
I'-
...ll
r-'I
e
e
e
I'-
~
(J C"'l
"1 ~
,~ '-. I"
.... , VI
~l>c;)~
~~
rX~
U 0
~~ ~'
~ ...\1
~~..J
l~'" ~
\..)~~
r
.~
l .....
~ ~
""..s Q/ ()
~ ::s 1\.1-
~ ~ UQ
J. ~ ~
~ ~ '
~ .
<t. ...... ~~
::t~()'
~ i- ~ .....
~ ~ ~ ~
~ ~ ~~'
~ ~i: ~
l i~ ~
\j~~'Z.
-
-
-
'"
t.n
-
o
0.(}
o
X
oG
~
....
I'"
....
~
-
-
-
.
-
-
-
-
-
-
-
"
I
I
:E I
I
0 0 I
D I
~ LIJ l- I
Z I
~ > l- I
Cl: Z I
.. :I: III I
... :E I.
... l- t
i!i <C > I -
.:. ~ < I -
A. I -
ill LIJ I.
I- CIl I -
:J ,j -
H 0 -:
:E :I:
'l:l III
r-l OM~ at Q: I-M -
OCl\Z ..... -
0 ..... Cl: r-l I
OZoC\l<C 'PI A CIl:JO I -
C\lOC\lO~ .. Z
at ~O"" I.
ICIlIICl: II:: < ~Ur-l (I) Ii -
r-lZC\lr-lLIJ I-l -
C\I I-l. r-l 0 llQ ..... III All
30 Q:I
I ~ I :E r-l C ~ ... U<C 0: :::
lnl-lnr-l:J 0 ;:, IIlI
0 u. Q., (.),
O<CoNU r-l .. < O~
W e >- 11I1 ~~ -
U < Z ~ Q:l =- '0
< ZX ::c -- A. OI::<CLIJ I --. CJ
H ee I- L1J~~ Q::
Z 31- <Q: ~ I-Cl:CIl ~I ~/
0 ::.= -
~III ...lll. 11I11I CIlLIJI-l 01 -
X...lO LLAIIlI (.) 1-ll:Q~ >-: "':
...~ ee o :E III (!):ECl:
I-CIlI- ::c I .
>-Z LL~ L1J:J< Q:I -
I-lZ (.) :::
(1)11I WQW IIIOZ>- Cl:UU 01
Z> UII::i5i I- I- III ILl
ZIII III <IIIIIIZ I -
ZOCll ::.= ,
IIIQ: ~ W I-I-I-"'~~ < Zr
A. I-lWCIl ~:J~~8< :E 0'
1.1. II::UCIl ...!
1.1.0 wze I-
::ce ~
0 Z3Q Q: 0
I- 1-l0Z 0
::CZ ...le A. i9
1-11I 1I....l <(
"':E oeCll Q: ,.,
Z
<I- W "0 III ,
IIIQ: UI-I-l 3: f]
3< I-lZI- 0 '-
ZA. I-WU ~
0:E:::l ...
011I ZWQ 0
:EA CIlW Z
:E I-lQ H r-
e
0 11::11. <, tf
(.) a.. 0 ....,
a.. 11I'
e 0 Q::
,... I
0 ,
,... I ~
r-l r
<C
Q.,
CIl
W
X
e
I-
CIl ~
01:: Z
LIJ <C
>~~
:ECl:ffi
LIJ~l:Q
Cl::E
I-O:J
OI::>U
LIJ
l:Q03
OOLIJ
OI::r-lZ
III
Z "
H
...
Cn,
HI
::c'
to
...
~i!i ::;
::l... c>
e~ .:,
>~ ~
I-l Cl r-
QX ...
Z..: ~
...
10. wo __
O~:g~
::l~:Siil
e... CIl
~ffi...:~
::li8i~
IIQ...ClX
~ n
~ ~
""}'-'^
." ( ~
~Oo"
~~
~ -\~
\j' ~ -
\J~ ~
9:.... \l
~~~
(j<t:i
, '
;. t