HomeMy WebLinkAbout07-30-15 IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT
CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: ESTATE OF ORPHANS' COURT DIVISION
BETTIE J. LAUGHMAN, �
DECEASED
DOCKET NO. 21-14-0295
REGISTER'S CERTIFICATION OF TAX RECORD
FOR SMALL ESTATE
I, Lisa M. Grayson, Esq., do hereby certify the following information in regard to the Estate of
Bettie J. Laughman, date of death March 15, 2014:
REVENUE BALANCE
FILING DATE AMOUNT PAID NOTICE RECEIVED DEBT/ICREDIT
Inh. Tax Return 5/13/14 $311.16 Z/9/15 �
REV 1548-ACN 14124153 4/13/15 $2468.26
REV 1604 Correction 7/20/15 0
REV 1548-ACN 14124154 4/13/15 $2468.26
REV 1604 Correction 7/20/15 �
See attached copies of Department of Revenue documents for more detail. This certification is
made in accordance with the provisions of Local Rule, 6.11-2 (j)(4�.
In witness whereof I have hereunto set my hand and seal of
� u� office, at Carlisle, Pennsylvania this 30th of July, 2015.
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REV-1500 �"°�""`°
PA DapaNnent of Revenue oFFICIRL usF oNlv
eureauonndroiauairaxes INHERITANCETAXRETURN Counrycooe vear pikHumoer
ao eox zaosoi 2 1 1 4 0 2 9 5
Hamsbura Pn mae-osm RESIDENT DECEDENT
ENTER OECEDENT INFORMATION BELOW
Socia15acunyNumber pateofDeal� �mn00m'Y Oateof8irth hMn00vvn
■ � � ■ ■ ■ � � ■ � 3 1 5 2 0 1 4 0 9 2 0 1 9 2 5
�ereCenfsLastName . Sulfix �ecetlenCSFirslName . MI
L a u g h m a n B e t t i e J
(If Applicable)Enter Surviving Spouse's Iniortnatlon Below
SpouSe's Last Name Suffie SpouS¢§Firsl Name MI
Spouse's Social Sewrify Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
Q 1.Original Retum � Z Supplemanfal Relum � S.RemainEer ReWm(Da�e otOealh
Priorto 11-73-ffi)
j � 4. Limited Estate � da.Future Inleres�Compmmise(date of � 5. Federa�Es[ata Tax Return Rep�iretl
�� Eeath aXar 1242-82)
� 6.Oe<etlentDietlTeslate � ].OeceEentMainteinetlalivingTmst _ B.TotalNumperofSa�e�epositBoxeS
(A�taChGOPYOfWm) (AVac�COPYOfTmst)
� 4 �itigationProceeCSReraivetl � 10.SpousalFoveMCredit(Datao(Oeath � 11,ElectiontoTanontlerSec.9H9(AJ
BeMeen 12-31-91 anE 14�95) (Altacn Sclietlule O)
CORRESPONOENT-TNIS SECTION MUST BE COMPLEfEO.ALL COflAESPONDENCE 4N�LONFIDENTW�TAX INFORMATION SNOULD BE OIRECTED T0:
Name paytima Telephone NumEer
S t e p h e n J � H o g g , E s q • 7 1 7 2 4 5 2 6 9 8
REGISTER OF WILLS USE ONLY
Firsl Line of Atltlress �, �� =� ;�
O
1 9 S . H a n o v e r S t r e e t �4i y3y' �
Secon4Uneo/AtlCress � ��� � �j -
' �zy — r'ri n`5
S t e . 1 0 1 "'�'� W '- 1�
o,-. ,�
�, CityorPosfOKce Slate ZIPCotle ('�AT�,FaEo� =• ��
C a r 1 i s 1 e P A 1 7 0 1 3 _ . v� N �-n
C `3' OJ ���
N
Ccmesponpxnes e�mcil atltirusa:
Untle�peqellles M perjury,I Eeclaie Na�I Oave eumineC I�is reW(n,intlutlin9 ecwmpanyl�g 9Uetlulei anU slBlemenlz,enE ro NB CeAol my MOwI¢a5¢an0 0¢Ilel,
II i5 WC,CIXRYI aM fqTq'ele.DPCIil8�GI101 p2{VfG!O�II@'111n Ne�¢19��N Rpre5Bn1d6Ve IS Cd52U on dII MIC(T8E0�ol wM1�O�BCerel�as any k 'MI¢Ea¢.
S�NATVREDFPESONRE ON518LEFORGILINGRENPN � pq�� '
� � � � Y
nooaes
25 Beidler ' e Shi ensbur PA 1725?
SIGNATUftEOFPR T ESENTNTNE OATE
h00RE55
19 S• Hanover St , te• 101 Carlisle PA L7013
PLEASE USE ORIGINAL FORM ONLY
Side 7
L 1505610140 150561�140 � I
t?'l
J 150561024❑
REVq500 E%(Fp
�eceEenfs Social SecurTy Number
o«ea=�ra�ame Bettie J • Lau hman ■ � � � � � � � �
RECAPITULATION
1. Real Es[ate(SchetlWeA) . . . ... �
. ... ... . .......... . .... ...... . .. ..
2. Srocks entl BonEs(Schetlule 8) ..:.......... .. � ,,_.. p. � ,
3. Closely Heltl Corpontion, Patlnershi0 or Sole-Propnelorohip(ScM1eCule C) ..... J. ,
,4. Mortgages an0 Notes Recaivable(Schedule O) ...... ..... , ,., q_
5. Cas�,Bank Deposits antl Miscellaneous Persanal Propetly(Schetlule E).. . .... 5, L 4 6 � 2 , 9 2
6. Jointy qvnetl Property(SCM1etlule f) � Separeta Blllin9 Repuestetl .... . . 6. � , � �
]. In[ervVivos Translers&Miscellaneous N Probale Property
n.
(Scnetlule G) SeOarate Billing 0.equestetl ... .... ].
8. Total Gross Assets(lotal Lines i Nmugp]) ... ... _ .. ... ._. , ... 8. 1 4 6 0 2 . 9 2
9. Funaral Expenses antl Atlminislrelive Cosis(Schetlule H) . ..... ..... .. ..... 9- $ 9 4 1 . 6 3
t0. oebts of oe�dent,Monqage Liabiut�s.ana Llens(Scheauie p . _ .. . . .... .. to. 1 3 6 2 . 3 4
11. TolalDetluctions(rotalLines9andlp) . ._ . _. _ .. . . ..... .. ...__. . , 11, 7 3 0 3 . 9 7
12. Net Value of Estate(Line 8 minus Line 11) . . ..... . ... . . ..... ..... .... . 12. 7 2 9 8 . 9 5
13. CharitableandGovemmental8eques[s/Sac9113T�us[sforwhipi
an eleqion lo tax�as na[Deen made($qi¢yule J) . .... . .......... . . . 13.
id. Ne[Value 5ubjec[fo Tax(Line 12 miws Line 13) . . 14. 7 2 9 8 . 9 5
. .. . ........ ... . ...
TAX CA�CULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amaun[ofLinetAlaxable
at ihe spousal lax rate,ot
, iransfersunde�Sec. 9116
(a)(11)%.0 _ 0 . ❑ 0 15. Q . � 0
� 16. Amoun�oflinel6[axable
a�iineaiarox.o<5 7 2 9 8 . 9 5 �s. 3 2 8. 4 5
i]. AmounlofLinel4taxaEle
atsiblingrateX,12 0 . � 0 1]. Q � � �
18. Amoun[o/Lina14[arapie
etcollateralreteX.15 0 . 0 0 �g, ❑ . 0 0
19. TAXDUE .. ..... . . ..... . . ..... .. . ... 19. 3 2 8 . 4 $
, ... .. . . .... .... ... ...... ...
20. FILL IN THE OVAL IF YOU ARE REpUESTING A REFIIN�OF AN OVERPAYMENT �
Side 2
�L 150561024� 150561�240 J
REV-0500 EX�FI) pagC 3 �
Flle Num�pr
DecedenPs Complete Address: 2t ia o295
�ECEDENPSNAME
Beflie J. Lauqhman
SiREEiAD�RE55
CIiY
STATE ZIP ..
Tax Payments and Credits:
1� Tax�ue�PageP,line79) ('I) 32845
2. Cretlils/Gaymenis
A.Pno�Paymenls
B.Discowt ��P9
3. Interesl Tolal Credifs(A+5� (p� ��29
4. II Line 2 is greater ihan Line 1.line 3,enter Ihe tliHerence.This is ihe OVERPAYMENi. (3)
RIIlnovalonPageP,LinetOtorequestarefund. (4) 000
5. If Une i+Line 3 is greater Ihan line 1,mler�he diflerence,This is Ne TAI(OUE.
(`') 311 16
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Diddeced¢n�makeaVansterand: Yes No
a. relainUeuseaincomeNlhepmpetlyM1anslerred ................................._........._..................___ ❑ ❑
b. retainNenghtmaesignatewhoshallusethepmpenyVanslerreeorilsincnme ............................... ❑ ❑
c. retainareversionaryinterasl .......................
_......................................_..._...............................
d, receivethepromiseforlifeofeilherpyy�¢nis,beneftsor�are9 ............. . � O
. ............... .. ..
....................
, IlCealhaart�a(IerDecember12,1982,tliddeceCeMVanSterpmpertywithinoneyearotGeaN
wilhout receiving atlequale consideratim7 .....,..
................ . .
.... ... ...................................._.........._.... ❑
3. DidGeceeenlwman'inWslloforpayableupon-0ealhbankaccanlorsecutltyalhisaherdeaih? _....... ❑ �
4. Didtlecetlenlownanindividualretiremenlaccouni,annuirywothernon{�robalepmpe�y,vfiic�
con�ainsabeneficia7tlesignalion?............._................................................................................... ❑ ❑
IF THE ANSWER TO ANY OF THE ABOVE pUE5TI0N51S YES,Y0U MUST COMPLE7E SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on m aNer July i,7994,antl 6etore Jan. 1,1995,me lax rate imposed on the net value o(Uansfers�o or for ihe use of ihe surviving spouse is
is 3 percent p2 P.S.§97 i6(a)(1.1)lip.
For dates of tleath on or aRer Jan. 1,9995,tl�e tax rate imposed on Ihe net value of transfers lo or for ihe use of�he surviving spousa is 0 Oercent
[/2 P.S.§9116(a)(1.1)(ii�}7he staWte does not exempt a transfer to a surviving spouse fmm tax,and Me slalutory requirements for tlisclosure of asse�s and
fling a lax retum are still appliwble even i(ihe surviwng spouse is the onfy benefciary.
For tla�es oF death on o�after July 1,2000:
• The tat rate imposed on ihe nel value of transfers from a deceased child 21 years of age or younger at death to or for the use of a naNral parent, an
atloptive parenl or a stepparent of the child is 0 percenf�72 P,S.§9116(a)(12)J. '
• Thetaxrateimposetlonthenetvalueoftransfersloorfameuseo(NedecedenPslinealbeneficianesis4.5percen�,exceptasnatedinpzv.s.§9iis�a��i��.
• The tax rate imposed on Me net value of Vansfers to or for the uu of the tlecedenYs siblings is 12 perceN p2 P.S.§9116(aJ(7.3�].A sibling is defned,
under Section 9702,as an indiNdual who has at least one parent in common with ihe decedent,whether by blootl or adopUon.
.MMONW[q�7ry pt vENN5YLV9xIP
DFPAPTMw�0:aNLWe PEV-1162 EXII L9E)
BUFF4V OF iNDI ViDUPL'q%ES
OEGi.$D0601
XnqPI56VFL.GP lat]BL801
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTA7E TAX
OFFICIAL RECEIPT
NO. CD 019152
LAUGHMAN GARY
25 BEIDLER DRIVE
SHIPPENSBURG, PA 17257
ACN
. ASSESSMENT AMOUNT
CONTROL
___ a . NUMBER
---- ---
101 � S311 .16
ESTATEINFORMATION: SSN: � I
FILE NUMBER: 2174-02g5 I
oeceDeN7 NqMe: LAUGHMAN BETTIE J I
DATEOFPAYMENT: 05/13/2014 � I
POSTMARK DATE: 05/13/2�14 I
COUN7v: CUMBERLAND I
DATEOFDEATH: 03/75/20�¢ I
�
TOTAL AMOUNT PqID: S31 7 .16
REMARKS: RECEIPT TO ATTY .
CHECKJ1005
INITIALS: DMB
sea� RECENED BY: LISA M. GRAYSON, ESQ.
� REGISTER OF WILLS
FEGISTER OF WILLS
, . HOTICE OF INHERITANCE TAX � pennsylvania
euncnu oF ixpiv[nun� r4xes APPRA�SEMENT, ALLONANCE OR OISALLOWpNCE
OP pEDUCiIaNS ANO ASSESSMENT OF TA% � o[raainervioraEv[Nue
p��tjiQnry�EL%�011lis . .
Bsd aaf➢L:. l.:T�E GY xEv.�sar n uv u -�a,
x�avxs.wy, _i�iza-�soy , � c
REGI.,�. . � :J�..�
�m n OATE 02-09-2015
�O�S �EB Q 'rll � Jb ESTATE OF LAUGHMAN BETTIE J
�ATE OF DEATH 03-15-2014
Q�L.... �t FILE NIIMBER 21 14-0295
ORRJftP�G�� � � - �T STEPHEN J �OONTY CUM6ERLANO
CU�I°��,�5".HANOVER ST A�N 101
. APPEAL pATE: 04-10-2p15
CARLISLE PA I]013-3327 (SeereversesiCeunQer05jec6nnrJ
Amount Resitketl��
MAKE CHECK PAYABLE ANO REMIT PAYNENT T0:
REGISTEH OF WILLS
l COVRTHOOSE SpUARE
. [ARLISLE PA 17013
CUT ALON6 THIS LINE __ y RETAIN LOWER PORTION FOR YOUR RECOROS H
__"_'_'__"__""__"""_ _"_"__'_""""______""___'__"_'__"____"__"_'"_""
REV-1547 EX AFP (11-14J NOTICE OF INHERITANCE TpX APPRAISEMENT, qLLOWANCE OR
DISALLOWANCE OF DEUUCTIOHS pND pSSESSMENT OF TAX
ESTATE OF: LAIIGHMAN BETTIE JFILE N0. :21 14-0295 ACN� 101 �ATE 02 09 2p15
TGX RETUFN Wpi: OO qttEPTED AS iILEO O CXpXGEO
APPRAISED YALUE OF RETURN BASEU ON: �RIGINAL RETURN
1. Real Es<ate (Sc�eUule pJ CU �00 NOTE: To e e proee�
3. Stocks anE BonEa (Sc��Cule B] �2� .00 �eEt[ to y unt.
3. CloselY No1J Sfock/Pa�tners�ip Interest (Scp�Uula C) <;) ,00 sutml[ [�e u ?Cportlon
� ha�� ef tp15 £o�m�wlf� your
8�9es/Notes Race1ve03e (Sc�eEule D> (4) •�0 taz paymen[.
5. [ae�/Bank �eeozfts/Mtsc. p¢reonal Prope�ty (SCM1eOula E) 15) 14.602.92
6. Join[ly Ovnatl P�opertv (SCM1eGule F) �6� .00
]. iransfars (Scha4ulp G] ��� .00
G. TO<al A55e[5 8 �` 60J
APPROVED OEOIICTIONS AND E%EMPTIONS:
9. Fune�al Expensez/AGa. Cos[s/M1sc. Expansai (Sc�aEula H) �g� 5 941 6
lp. OeEts/Xo�<pa9¢ LtaG]lities/L1ens (SCM1aGule I> �yp� 62 4
1L Tab1 �atlucflans
a u �.303.97
iz. xet value o} *ax a.turn �yz� ],298.95
IS. C�a�1[eble/Govern�en[al B�pms[sp Nao-elect�d 91l} Trvsts (SCM1¢Evle J) �1}> _ 00
la. N.c vciw of Esbt. sueJ•co eo iax ���� ].298.95
NOTE: It an assessmenS vas iss�etl previeuslv, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect flp�res khat Snclutl¢ tha to�al af all refurns assessetl to tlate.
ASSESSMENT OF TAX: �
�s. .mo��o er �a�e i� ,< :,o�.,i �,e. us� .00 x oo - .00
]6. Amoun[ o£ Linp l4 [aiaOle at llnaal �ate (�6) ���4R 96 x 045 = 328.45
]]. �naunt of Line 14 pt siOltny rete U)) �� X 12 .QO
IB. Gpaunt Of Linp 14 taiaEle a< C011ate��] �at� f1B) .p0 % ]$ - .Q�
19. Grinclpal Tax Due �19). 328.45
TAX CREDITS:
P>YXENi RECE3PT pISCOUNi (N
➢qiE NUMBEN 1XTEFEST/PEN PRID (-) �`�OUNT VA1D
05-13-2014 C0019152 16.38 311. 16
02-02-2015 SBAOJl15T ,pp 91
TOTAL TAX PAYMENT 328.45
BALRNCE OF TAX OUE .OD
� INTEREST �ND PEN. .00
TOTAL OIIE .00
� IF pAIO AFiER ORTE INOICqTEO. SEE PEVEFSE {G TOTAL �VE IS REFLECiEO NS A [qEOIT ¢R)� YOII MAY BE OUE
FON [ALCULRTION OF ADOITIONPL INiEREST. p qEFUNO. SEE REVERSE SIDE FOR INSTROCTIONS. \��
V
'`i� pennsylvania
BORENU OF INDIVIOIIAL TAXES NOiI[E OF INHER[TpNCE TqX �W pEVAPiMENTOFflEVENUE
INNERIiaxLE iAY oIVISIOn APPflA�p3y5EMENi, qLLOMPNCE ON �ISALLOWANCE
P1WiRI5tVRG6PR �„:a-o6a,RECORDED OFFIZ`E�V�CTIONS� pN0 4SSESSMEHT OF TAX OH PEY-15G8 EX PFP Ill-14]
JaIHTLV MELU OR TqIIST ASSET$
REGISTER OF GILLS onre o�-is-zais
ESTATE OF LAUGHMAN BETTIE J
?O15 PPR 13 P,ii 11 58 OATE OF pEATH 03-15-2014
FILE NUMBER 21 14-0295
C�EGn Of �OUNTY CUMBERLANO
SSN/OL
i� CHARLES R LO�QI�n�aj' CGURT ' ACN G
96] BIG SPR�FtlfM�@I��F��� 1'� i,l� APPEAL BY OAiE:06-12-2015
SHIPPENSBURG PA 1]25]-9`/53 . (SeereversesideunderObjectionsf
Amount Remittetl ��
MAKE CHECK PAVABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQIIARE
CARLISLE PA ll013
CUT AlON6 TXIS LINE � RETAIN LOWER PORTION FOR YOUR RECORDS �
"""__'________""__'"__"""__"_"""___'____'_____'""____'_____""_""_'_"______'__"_____""____
REV-3548 EX AFP (il-14J
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR OISALLOWANCE OF
OE�UCTIONS, ANO ASSESSMENT OF TA% ON JOINTLY XELO OR TRUST ASSETS
OAiE� 04 13 2015
ESTATE OF: LAUGHMAN BETTIE J OATE OF OEATH:03-IS-2a14 COUNTY:CIIMBERLAN�
FILE NO. : Z1 14-0295 S.S/D.C. NO. : - ACN: 14124153
TAX RETUBN WAS: (XJ ACCEPTED AS FILED O CNAN6E0
JOINT OR TRUST ASSET INFORMqTION
FINANCIAL INSTITUTION: ACNB eANK qCCOUNT NO. : 189154
TYPE OF ACCOUNT: OSAVINGS (>J CHECKING ( JTRUST OTIME CERTiFICATE
�ATE ESTAB�ISHEU OB-20-2013
Account Balance 32,5]0.87 NOTE: TO ENSIIRE PR�PER CREDI7 TO
PercanY Taxable X 0.500 YOUR ACCOUNT, SUBMiT THE
/maunt Su�jecY to Tax 16,285.44 IIPPER PORTION OF THIS NOTICE
Oebts antl OeE�cYions ' .00 W(TH YOUR TA% PAYMENT TO TNE
Taxable Amount 16,285.44 REGISTER OF WILLS Ai THE
Tax RaYe z 15 ABOVE ADORESS. MqKE CHECK
Taz �ue 2,442.82 OR MONEV OROER PAVABLE To:
TAX CREOITS:
'BEGISTEN OF WILLS, AGENT."
PAYMENT RECEtPT OISCDUNT (�)
DATE NpMBEF IXTENEST/PEX PqID (-J oMDONT PL[�
ZNTEREST IS CHARGE➢ TNROIIGH 04-21-2015 TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUT�INED ON THE BALANGE OF TAX ➢OE 2,442.B2
REVERSE SIOE OF THIS FORM INiEREST AND PEN. 25.4G
. TOT4L DUE 2.466.26
� IF VqIO ARER TNIS OqTE� SEE NEVERSE FOR CFLCULRTIOX OF AOOITIONAL SNTEREST. +
IF TOTqL pUE IS NEFLECTEO NS p ^CREOIT" ([R). YOU MqY BE Dl1E q qEPOND. \
SEE REVEHSE SIDE OF THIS FOHM FOP INSTRUCTIONS. \\�l
`V
INHERITANCE TA%
� kECORO AOJUSTMENT � pennsylvania
I 1 - ' " - — ��-- —..,_._. .. JOINTLY NELO OR TRUST ASSET$ : oEPAPTMENTOFPEVENUE
BUREiV OF INOIVS➢UAL T4%ES
IXXERITqNLE 1qX OIVSSIOH � � ' PEVJ604 E% PfP (11-IG1
� �nv'�seue'i`ie i��e-�'oQaFDED OF�FICE OP . ,
' REGISTER OF WILLS
i DATE 0]-09-2015
?Ols JUL 2� �� S�Z �IO OATETOFOUE�TN 03UI5n2014 BETTIE J
� . FILE NUMBER 21 14-0295
. CLERK OF . counrr CUMBERLANO
CHARL�$RP�tfju�i���7 SSN/DC 198-22-7833
(1 p8 A�N 14124153
� . SHIP�ENSBURG��+��PI.��Y7T57-9753 am�vnc aemixtee
MAKE CNECK PAYABLE AND REMIT PRYMENT T0:
' REGISTER OF WILLS
1 COIIRTHOIISE SpUARE
CARLISLE PA 1]013
CUT ALONG THIS LINE H RETAIN LOWER PORTION FOR YOUR pECORDS H
I "_""�."_""_'�"�'_'__"____..��""_'�_�_.._�""'__"'�""�'.."_'__..�"..' �
. . '"""__�""
E -1604 EX AFP Cll-14J '� .
E• INHERIIANCE TA% RECORO AOJUSTMENT.JOINTLV HELD OR TRUST ASSETS i .
� . . . ' _ � . . �� DATE: 0]•09-2015 .
ESTAiE OF: LAUGHMAH � ' BETTIE �J UATE -OF DEATH:� 03-1$-2U14 ' COUNTY: � CUMBERLAND
FILE NO. : 21 14-0295 S.S/O.C. N0. :�196-22�-7H33 A�N: 1L124153 '
ADJUSTMENT BASED ON: ApMINISTRaTIVE [oRRECTION � � '
JOINT OR TkUST ASSET INFORMATION
FINANCIAL INSTITUTION: ACNB.. BANK . ACCOUNL.NO. :_189154
TYPE OF.ACCOUNT: ( ]. SAVINGS . ( b:CHECKING� ( J TftUST �( ). TIME CERTIFICATE
DATE ESTAB�ISHED OB-20-2013� � � ' � � � . - � . � �
AccounY Balance •00 � NOTE: TA' ENSURE 'PROPER �CREDIT i0 VOUR
PercenY Taxable % 0.500 pCCOUNT. SUBMIT THE UPPER PORTION
Amo�nt S�bject fo Tax .DO OF THIS NOTICE WITH YOUR TA% �
Oebis antl OeE�ckiens .00 ppyryENT TO THE RE6ISTEft OF WILLS
Taxable Amount .00 AT TNE ADDkESS SHOWN ABOVE.
Tax Rake X .15 HpKE CNECK OF MOHEY ORUER PAVABLE
Tax Oue � �DO T0: "RE6ISTER OF WILLS, qGENT.^
TAX CREDITS: �
P<VMENT RECE[PT ➢ISCOUNi U)
� U4TE XVMBER [NTEPEST/PEN Fp[D (O l�MOONT PA[0
I
, TOTAL TA% PAVMENT .00
9ALANCE DF TA% pUE .00
i INTEREST AND PEN. ,00
TOTAL DUE
� [F Pqlp AFTER iM(5 �GTE� SEE ftEVEMSE FON CqLNLATION OF pppITIONNL INiEREST. If TOT�L GUE IS PEfIEREo �S •
^CREOrt^ (CR)� YOU MpV BE �UE G qEFVHO. SEE qEVERSE SIDF OF TX6 GpRM FOp INSTqU[TIONS.
V \ .
�or,�E oF �„xER��p��E rqx 7 i� pennsylvania
BUREAO OF INOIVIOUAL ipXES I�I OEPAPTMENTOFfVEVENUE
INHERIiaxCE iPrt oryISIOx I�PPRIISENEXT� pLLOYAN[E OR OISPLLOWNLE
PO Bax 2E06o1 ��G6&DED OFFICE OF OF DE�UCTIOXS, qN0 LSSESSNENT DF TG% ON REvaSae [x �Fa (li�la)
x[RRISBVPG P� JOINTLY XELO OR TFUST ASSETS
REGISTER Or 'i/�L�$ OAiE 04-13-2015
ESTATE OF LAUGHMAN BETTIE J
?O15 PPR 13 P,i 11 58 ➢ATE OF OEATN 03-15-2014
FILE NUMBER 21 14-0295
CLERK CF COUNTY COMBERLAND
SSN/pC
i� JOSEPH QaP��iA�tl611�MA1f(�T p�N 14124154
lN,FI'yry{y��k��'„�D (` p( APPEAL BY DATE:Ob-12-2015
�A2�ISCE �D PAn17tl1`S-1139 (S¢ereversesiQeunderObjeclionsf
Amounf kemikketl �--I
J
MAKE [HECK PAVA6LE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COIIRTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG TNiS LINE '� RETRIN LOWER PORTION FOR YOfIR RECOROS �
"_____"__"______"___"______"____'_'_____________'__"_______"______""________""_'____'___'
REV-1548 EX pFP (I3-14)
NOTICE OF INHERITANCE 7AX APPRAISEMENT� pLLOWANCE OR OISALLOWANCE OF
UEOIICTIONS, pND ASSESSMENi OF TAX ON JOINTLY HELD OR T2U57 ASSETS
OATE• 04 13 2015
ESTATE OF: LAUGHMAN BETTIE J OATE OF OEATH:03-15-2014 COUNTV:CIIMBEftLANO
FILE NO. : 21 14-0295 S.S/D.C. NO. : - ACN• 14124154
TAX RETURN WAS: (%J ACCEPTEO AS FILEO O CHANGED
JOINT OR TRIIST ASSET INFORMATION
FINANCIAL INSTITUTION: ACNB BANK ACCOUNT NO. : 189154
TYPE OF pCCOUNT: ( ]SAVINGS ( X1 CHECKIN6 ( JTRUST OTIME CERTIFICATE
DATE ESTAHLISNED OB-20-2013
Acrount Balance 32.570 87 NOTE: TO ENSUftE PROPER CREOIi TO
Percent Taxable X 0.500 YOl1R ACCOUNT, SUBMIT THE
Ameunt Subjack to Ta: 16.285.44 UPPER PORTION OF THIS NDTI[E
Oebks anC Oetluctions .00 WTTH V011q TA% PAYMENT TO THE
Taxeble Amounk 16.285.44 REGISTER OF WIL�S AT THE
Tax Rate Y IS ABOVE AODRESS. MAKE CHECK
TaX Oue 2.442.82 OR MONEY ORDER PAVABLE T0:
TAX CREOITS:
"REGISTER OF WILLS, AGENT."
P�VMENT RELEIGT OISCOUXT (U
OPTE NUNBEN INTEREST/GEN PRIO f-) <MOIINT PAID
INTEREST IS CHARGE� THROUGH 04-21-2015 TOTAL TAX PAYMENT .00
AT THE NATES APPLICABLE AS OIITLINED ON THE � BpLANCE OF TAX DOE 2,442.82
REVERSE SIOE OF THIS FORM INTEREST ANO PEN. 25.44
TOTAL OIIE 2,468.26
+ IF PASD AFTER iN[S OATE� SEE REVEFSE FOR C0.LCULATION OF AODITIONRL INTEREST, i
IF TOTPL DIIE IS REFLECTEO q5 A ^CqEOIT^ (CR)� YOU XAY BE OVE A REFUNO. \
SEE 0.EVERSE SIOE DF THIS FORN FOR INSTRUCTIOXS. ,\^
���
��
INNERITANCE TA%
RECORD ADJUSTMENT ���� pennsylvania
� � �,- .JOINTLY HELU OR TRUST ASSETS y ��
BIIqEF4 OF INpIVI00Rl Tp%ES r�'�r oEvnarm[rur or aev[Hue
�xxexnnxee ru` orves�oRECORDED OFFICE OF'
Po eox veoso� x�vasea ex esv u�-�e�
x+xxiseuas re v�ve-oso�REGISTER Oh WIL�$
,O�r �1I �ATE 0]-09-2015
J LL ZO p� 12 �O DAiETOFODEATH 03U15M2014 BETTIE �
CLEFiY Gh FILE NUMBER 21 14-0295
pDun� COONTY CUMBERLANO
JOSEPH �ICp�ryry�pNQ��)�� SSN/OC 198-22-7833
3146 NEW�M��1�LA,'�D ��_ ACN 14124154
CARLISLE PA 17013-1]39 nnount zamitt.e
MAI(E CHECK PAYqBLE AHO REMIT PAYryENT TD:
REGISTER OF WILLS
1 COURTHOUSE SCUARE
CARLISLE PA 17013
CUT ALONG THIS LINE H RETqIN LOWER PORTION FOR YOUR RECORDS f�
.. _'__""_�_"�`_.___�_..___""_""�'�"_��_�_"_'_""_"`"___
REV-1604 EX AFP Q3-14) '—�-------"--"—'"
ek INHERITANCE TA% RECORO AOJOSTMENT JOINTLY HELD ON TRUST ASSETS a�
DATE: �]-09-2015
ESTATE OF: LAUGHMAN BETTIE J DATE OF OEATH: 03-15-2014 COUNiY: CUMBERLANO
FILE NO. : 2I 14-0295 S.5/O.C. N0. : 198-22-7833 ACN: 14124154
ADJUSTMENT BASED ON: ADMINISTRATIVE coRREcrION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ACNB BANK ACCOUNT N0. : 169154
TYPE OF ACCOONT: ( ] SAVINGS ( X1 [HE[KING O TRUST O TIME CENTIFICqTE
OATE ESTA6LISHED 08-20-2013
Acco�nt Balance .00 NOTE: TO ENSIIRE PROPER CRE�IT TO VOUR
Per<ent Taxable % 0.500 AC[OUNT, SUBMIT THE UPPER PORTION
� Fmount Subject Yo Taz .00 OF THIS NOTICE WITH YpUR TAX
Oebts and Oetivctions - .00 PAyMENT TO TNE REGISiER OF WILLS
Taxable Amount .00 p7 THE AOpRESS SHOWN ABOVE.
TaX Rate % .15 MAKE CHECK OR MONEY OROER PqYABLE
Tax Due �00 T0: "pE6ISTER OF WILLS, AGENT.'•
TAX CREDITS:
PRYMEHT RE[EIPT OISCOONT U)
OATE NOMBEq INTEPEST/PEN PRIO (-) PMOIINT pplD
TOTAL iA% PAYMENT ,pp
BALANCE OF TA% pUE ,00
INTEREST ANO PEN. ,00
TOTRL OIIE
a IF VqID PREq THIS ONTE, SEE qEVERSE FOR CpLCOLqTION OF AOOITIONRL INTEREST. IF LOiAt OVE IS qERECiEO <5 a
^CNE�R^ (CR). YOU M1V BE DUE L PEFUNO. SEE qEVERSE SIOE OF TXIS PoNM FOR INSTHURIOHS.
�\
�,a,.,o,
enns lvania - 2"'-°295
p y INHERITANCE TAX � 198-22-7833
.. . ' �EPpp���b�FD��EO���FICE F EXPLANATION � 03/15/2014
auaeaua�E�¢�q�Fp�gNIIL S OFCHANGES
DECEDENT'S NAM
Bettie J Laughman 2114-0295
REVIEWEDBY - �;; � �
o�Ppi�l�+agSiS�'�' "°"
�aizaisa
seHeou�e �No� MBERLA�JD Cn., Fq �
EXPLANATION OF CHANGES
A review has been conducted on this account. The Department has determined that this
joint bank account was properly reported on the probate return. Therefore, tNis
assessment has been corrected.
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