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Home My WebLink About02-0619 1/}-?0~ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '*' NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOMANCE OR DISALLOMANCE OF DEDUCTION~, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REY-15~B EX IF!' <01-02) VICTOR H RUDY APT 905 200 N DUKE ST YORK DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 09-16-2002 DUNHAM 01-04-2002 21 02-0619 CUMBERLAND 185-36-1369 02112685 Allount Rellitted BARBARA A PA17403-1463 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 ... Rifv=is4-i-EX--AFii-fol-=ozl------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-16-2002 ESTATE OF DUNHAM BARBARA A DATE OF DEATH 01-04-2002 COUNTY CUMBERLAND FILE NO. 21 02-0619 TAX RETURN WAS, S.S/D.C. NO. 185-36-1369 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 02112685 FINANCIAL INSTITUTION, ALLFIRST BANK ACCOUNT NO. 80000001648697 TYPE OF ACCOUNT, () SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE DATE ESTABLISHED 04-15-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 23,493.62 0.500 11,746.81 .00 11,746.81 .15 1,762.02 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." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-08-2002 CDOO1392 .00 1,762.02 TOTAL TAX CREDIT 1,762.02 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act~ Act 23 of 2000. (72 P.S. Section 91(0). Detach the top portion reverse side. -- Make check or money of this Notice and sub.It with your payment to the Register of Wills printed on the order payable to: REGISTER OF WllLS~ AGENT. A refund of a tax credi t~ whIch was not requested on the tax return~ lIay be requested by cOlIPleting an "Application for RefUnd of Pennsyl~ia Inheritance and Estate Tax" (REV-1313). ApPlIcations are available at the Office of the Register of Wills~ any of the 23 Revenue District Offices or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpaYers with special hearing and or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfIed with the appraise.ent~ alloNance~ or disallowance of deductions or aSSBs~ant of tax (inclUding discount or interest) as shown on thIs Notice may object within sixty (60) days of receipt of this Notice by: --wrltbln protest to the PA Deparblent of Revenue~ Board of Appeals.. Dept. 281021.. Harrisburg~ PA 17128-1021~ OR --electing to have the .atter determined at the audit of the account of the personal representative~ OR --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.. ATTH: Post Assess.ent Review Unit~ DEPT. 28060l~ Harrisburg~ PA 17128-0601 Phone (717) 787-6505. See 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 .onths after the decedent.s death~ a five percent (5X) discount of the ta~ paid is allowed. The 152 tax amnesty non~participation penalty Is co.puted on the total of the tax and interest assessed~ and not paid before January 18~ 1996.. the first day after the end of tha tax a.nasty period. ThIs non-participation penalty is appealable in the same .anner and In the the salle tl.e 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 nina (9) months and one (1) day from the date of death~ to the date of pay.ent. Ta~es which became delinquent before January l~ 1982 beer interest at the rate of sIx (6%) percent per annu. calculated at a daily rate of .000164. All taxes which became delinquent on or aftar January 1~ 1982 will bear interest at a rate which will vary fro. calendar year to calendar year with that rate announced by the PA Depart.ent of Revenue. The applicable interest rates for 1982 through 200Z are: Vasr Interest Rata Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z 20% .000548 1992 .. .000247 1983 16X .000438 1993-1994 7% .00019Z 1984 11% .000301 1995-1998 .. .000247 1985 137- .000356 1999 7. .000192 1986 lOX .000274 2000 .. .000Z19 1987 .. .000247 200l .. .000247 1988-1991 11% .000301 2002 6. .000164 --Interest is calCulated .. follows: INTEREST = BALANCE OF TAX UNPAID X NURBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax beco.es delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assess.ent. If pay.ent is made after the interest co.putation data shown on the Notice~ additional interest must be calculated. / '7 - ?.y -.:2---- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVIDUAL TAXES " . INHERITANCE TAX DIVISION V DEPT. Z150601 HARRIS8URG~ PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISERENT. ALLORANCE OR DISALLOWANCE OF DEDUCTION~, AND ASSESSRENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX'FP I 0l-D2l VICTOR H RUDY APT 905 200 N DUKE ST YORK 0, DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY 'SSN/DC ACN 09-16-2002 DUNHAM 01-04-2002 21 02-0619 CUMBERLAND 185-36-1369 02112683 BARBARA A ji' Allount Rellitted PA 17403r~~463 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 ..... REii:is4-i-Eif-AFP--fol-:ozl------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-16-2002 ESTATE OF DUNHAM BARBARA A DATE OF DEATH 01-04-2002 COUNTY CUMBERLAND FILE NO, 21 02-0619 TAX RETURN WAS: S,S/D,C. NO. 185-36-1369 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 02112683 FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 0700107360 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE 10-01-1990 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X 11,771. 41 0.500 5,885.71 .00 5,885.71 .15 882.86 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." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-08-2002 CDOO1392 ,00 882.86 TOTAL TAX CREDIT 882.86 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS THAN $1, NO PAYRENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU RAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion reverse sida. -- Make check or money of this Notice and submit with your paymant to the Register of Wills printed on tha order payable to: REGISTER OF WIllS, AGENT. A refund of a tax credit, which was not requestad on the tax return, .ay be requested by cOllPleting an "Application for Refund of Pennsylvania Inheritance and Estata Tax" (REV-1313). Applications ani available at the Office of the Register of Wills, any of the 23 Revenue District Offices or by calling the spacial 24-hour answering service for forlls ordering: 1-800-362-2050; services for taxpayers with special hearing and or speaking neads: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice lIay objact within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --electing to have the lIatter detarllined at the audit of the account of the personal representative, OR --appeal to the Orphans' Court Factual errors discovered on this assesSllant should be addressed in writing to: PA Departllent of Revanua, Buraau of Individual Taxes, ATTN: Post Assess.ent Raview Unit, DEPT. 280601, HarriSburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inharitance Tax Return for a Resident Decedent.. (REV-1501) for an explanation of administratively correctabla errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (51.) discount of the tax paid is allowed. The 151. 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 end of the tax ~nesty periOd. This non-participation penalty is appealable in the selle lIanner and in the the salle time period as you would appaal the tax and interast that has baen assassad as indicated on this notice. Interest is charged beginning with first day of delinquency, or nina (9) months and ona (1) day frail the date of death, to the date of pay.ent. Taxas which became delinquent befora January 1, 1982 bear interest at the rate of six (61.) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Departllent of Revenue. The applicable interest rates for 1982 through 2002 are: Vear Interest Rata Daily Interast Factor Yaar Interast Rate Daily Interast Factor 1982 201. .000548 1992 OX .000l47 1983 161. .000438 1993-1994 7% .000192 1984 111. .0003Dl 1995-1998 9X .000247 1985 131. .000356 1999 7% .000192 1986 lOX .000l74 2000 8' .000219 1987 ., .000247 lODl ., .000247 1988-1991 llX .000301 ze02 ., .000164 --InterBst is calculated .. follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becoMBs delinquent will reflect an intarest calculation to fiftaan (15) days beyond the data of the assess.ent. If payment is made after the interest cOIIPutation date shown on the Notice, additional interest must be calculatad. /?- ?Y-.;L BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8060l HARRISBURG, PA 171Z8~0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEKENT, ALLOHANCE OR DISALLOHANCE OF DEOUCTION~<.AND ASSESSKENT OF TAX ON JOINTLY KELO OR TRUST ASSETS REV~ls~e EX AFP 101-0ll VICTOR H RUDY APT 905 200 N DUKE ST YORK 'U/ " I' 0, DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 09-16-2002 DUNHAM 01-04-2002 21 02-0619 CUMBERLAND 185-36-1369 02112684 Allount Rellitted BARBARA A , ~1\17403-1463 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-v=is4-i-Eif-AFii-foi-=o21------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD DR TRUST ASSETS DATE 09-16-2002 ESTATE OF DUNHAM BARBARA A DATE OF DEATH 01-04-2002 COUNTY CUMBERLAND FILE NO. 21 02-0619 TAX RETURN WAS: S.S/D.C. NO. 185-36-1369 (X) ACCEPTED AS FILED () CHANGED JOINT DR TRUST ASSET INFORMATION ACN 02112684 FINANCIAL INSTITUTION: ALLFIRST BANK ACCOUNT NO. 8740436571 TYPE OF ACCOUNT: () SAVINGS (JO CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-15-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 6,546.44 0.500 3,273.22 .00 3,273.22 .15 490.98 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. If TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-08-2002 CDOO1392 .00 490.98 TOTAL TAX CREDIT 490.98 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 $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. I PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill ths requirements of Section 2140 of ths InheritBncs and Estate Tax Act~ Act 23 of 2000. (7Z P.S. Section 9140]. Detach the top portion reverse side. -- Make check or .oney of this Notice and submit with Your payment to the Register of Wills printed on the order payable tal REGISTER OF WILLS~ AGENT. A refund of a tax credit~ which was not rsquestsd on the tax return~ .ay be requested by completing an ftApplication for Rsfund of Pennsylvania Inheritance end Estate Taxft (REV-1313). Applications are availsble at the Office of the Registsr of Wills~ any of the Z3 Revsnue District Offices or by calling the special Z4-hour answering ssrvice for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with ths appraise.ent~ allowancs~ or disallowance of deduction$ or asses5msnt of tax (including discount or interest] as shown on this Notice .ay object within sixty (60) days of recsipt of this Notice by: --written protest to ths PA Depart.snt of Revenus~ Board of Appeab~ Dept. Z81021~ Harrisburg~ PA 171Z8-1021~ OR --electing to havs the .atter deterMined at ths audit of ths account of the personal representativliI, OR --appsal to the Orphans' Court Factual errors discovered on this assessment should be addresssd in writing to: PA Depart.snt of Revenue~ Bureau of Individual Ta~es, ATTH: Post ASSBs~ent Revisw Unit, DEPT. Z80601~ Harrisburg~ PA 171Z8~0601 Phone (717) 787-6505. See page 5 of the booklst ftlnstructions for Inheritance Tax Rsturn for a Resident Decedent" (REV-150l) for an sxplanation of administratively correctable srrors. If any tax due is paid within thrs8 (3) calendar months aftsr ths decedsnt.s dsath~ a fivs percsnt (5Z) discount of the tax paid is allowed. Ths 15X tax amnesty non-participation penalty is co~utsd on the total of the tax and intersst ass&ss8d~ and not paid bsfore January 18~ 1996~ the first day after the end of the tax amnssty periOd. This non-participation penalty is appealable in the same danner and in the the sa.e ti.s period as YOU would appsal ths tax and inte~8st that has been assesssd as indicated on this notice. Interest is charged beginning with first day af delinquency~ or n1ne (9) months and one (1) day f~om the date of dBath~ to ths date of pay.ent. Taxes which beca.e delinquent befors January l~ 198Z bear interest at the rate of six (61.:) percent per ennOll calculated at a daily rate of .000164. All taxes which became delinquent on or aftsr January l~ 198Z will bear intsrest at a rate which will vary frod calendar year to calsndar year with that rate announced by the PA Depart-snt of Revenue. The applicable interest rates for 1982 through 200Z ara: Ysar Interest Rate .DaIly Interest Factor Year Intlllrest Rate Deily Intersst Factor 198Z 207- .000548 1992 9% .000247 1983 161.: .000438 1993-1994 7i.: .000192 1984 117- .000301 1995-1998 9% .000247 1985 137. .000356 '990 7% .ODOI9Z 1986 107. .00OZ7Ci ZOOO 8% .000219 1987 OX .000247 ZOO I OX .000Z47 1988-1991 117. .000301 200Z 67. .00Dl6Ci --Interest is celculated .. follows: INlERESl = BALANCE OF lAX UNPAID X NUNBER OF DAYS DELINQUENl X DAILY INlERESl FAClDR --Any Notics issusd 8fta~ the tax bscomes delinquent will reflect an interest calculation to fiftesn (15) days bayond the data of the assessmsnt. If payment is made after the interest computation dats shown on the Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DE~~MENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE / 7~ 7Y' Z-- FILE NO. 21 -() t,-(., ICj ACN 02112683 DATE 03-20-2002 REV-1545UAFPC09-00> EST. OF 8ARBARA A DUNHAM 5.5. NO. 185-36-1369 DATE OF DEATH 01-04-2002 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS iii CHECKING D TRUST D CERTIF. VICTOR H RUDY APT 905 200 N DUKE ST YORK PA 17403-1463 REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST BANK has provided the Departllent wIth the infor1l8tion 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 inforllation is incorrect~ please obtain written correction froll the financial institution~ attach a COpy to this for. and return it to the above address. This account is taxabla in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Questions lIay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW Account No. 0700107360 . . . SEE Date Established REVERSE SIDE FOR 10-01-1990 FILING AND PAYMENT INSTRUCTIONS Account Balance Percent Taxable Aaount Subject to Tax Tax Rate Potential Tax Due x 11,771. 41 50.000 5,885.71 .15 882.86 To insure proper credit to your account~ two (2) copies of this notice IIUst accollpany your paYllant to the Register of Wills. Maka check payable to: "Register of Wills~ Agent". x NOTE: If tax pay.ants are .ade within three (3) Months of the decedent's date of death~ you lIay deduct a 5% discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) 1I0nths after the date of death. PART TAXPAYER RESPONSE [!]li~l!i~I~~.I~j!.!~~ilijl~~~!!!!!"~ijlli~II!I!.!illi.~1~.11~!~.!!!!~'.IIR!i!!..iilligljiii.~~!i!i.~. [CHECK ] ONE BLOCK ONLY A. 0 The above inforllation and tax due is correct. 1. You May choose to I"'ellit paYllent to the Register of Wills with two copies of this notica 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 asseSSMent will be issued by the PA Department of Revenue. 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 reprssentative. C. 0 The above information is incorrect and/or debts and deductions were paid by you. You MUst cOllplsts PART ~ and/or PART ~ below. PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate I please state your relationship to decedent: PART ~ TAX RETURN - CO~~UTAT!ON LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. A.ount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due O~ TAX ON JO!~T/TRUST ACCOU~TS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) perjury I I declare that the facts I y knowledge and belief. I $ have reported above .re true, correct ?sf/ itJ ~/O and HOME (717 WORK ( ELEPHONE ) ) MBER DATE y GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based an infer.aUen sub.itted by the financial institution. Z. Inheritance tax baco.Bs delinquent nine .onths after the decedant.s date of dasth. 3. A joint account is taxable Bven though the decedent.s name was added as a matter of convenience. 4. Accounts (inclUding thasa held between husband and wifs) which the decedent put in joint names within one year prior to death are fully taxable 85 transfers. 5. Accounts established jointly between husband and wife .ore than one year prior to dasth are not taxabls. 6. Accounts held by 8 decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the infar.atian and computation in the notice are correct and deductions are not being clal..d~ place an "X" in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and subllit them with your check for the allount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Farm REV-1548 EX) upon receipt of the return from the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inhsritance Tax Return filsd by ths decedent's representliltivs~ placs an "X" in block "BOO of Part I of the '"Taxpayer Rssponse" section. Sign one copy and return to the PA Department of Revenus~ Bursau of Individual Taxes~ Dept Z80601~ Harrisburg~ PA 17128-0601 in the envelope providsd. 3. BLOCK C - If the notice inforllation is incorrsct and/or deductions are being claimed~ chsck block "Cn and complete Parts 2 and 3 according to the instructions below. Sign two copies and submit them with your chsck for the aMount of tax payable to ths Register of Wills of the county indicated. Ths PA Department of Revenue will issus an official assessment (Form REV-1548 EX) upon receipt of the return from thE Reglstsr of Wills. TAX RETURN PART 2 - TAX COMPUTATION lINE 1. Enter NOTE: the date the account originallY was established or titlsd in the .anner existing at date of death. For iii decedent dying after lZ/IZ/8Z: Accounts which ths decedent put in joint names within one (1) year of death are taxable fully as transfers. However~ thers is an exclusion not to exceed $3~000 psr transferee regardless of the value of the account or the nullber of accounts held. If a doubls asterisk (..) appears befors your first na.e in the address portion of this notice~ the $3~000 exclusion alrsedy has been deducted fro. ths eccount balance as reported by ths financial institution. Z. Enter the total balance of the account inclUding interest accrued to the dete of death. 3. Tha percent of the account that is taxable for each survivor is detar.ined as follows: A. The percent taxeble for joint assets establishsd more than one year prior to the decedent.s death: 1 DIVIDED BV TOTAL NUMBER OF JO INT OWNERS Exallple: A joint asset registered DIVIDED BV TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the nalle of the decedent and two other persons. 1 DIVIDED BV 3 (JOINT OWNERS) DIVIDED BV Z (SURVIVORS) = .167 X 100 16.7% (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the dscedent's death or accounts ownsd by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BV TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered the decedent. 1 DIVIDED BV 2 (SURVIVORS) . .50 in the name of the decedent and two other persons and established within one yeer of death by X 100 sox (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tBx (line 4) is determined by lIultiplying the account balance (lins 2) by the percent taxable (line 3). 5. Entsr the total of the debts and deductions listed in Part 3. 6. Tha allount taxable (lina 6) is datlilrmined by subtracting the debts and deductions (line 5) fro. the allount subject to tax Uine 4), 7. Enter the appropriata tex rate (line 7) as determined below. Date of De.th Spouse Lineal Sibling Collateral 07/01/9~ to 12/31/9~ 37. 67. 157. 157. 01/01/95 to 06/30/00 07. 67. 157. 157. 07/01/00 to present 07. q..5Z- 127. 157. _. nB tax rate l.posea on 'tne not value of tran sfers from a deceased chIld twenty-ana years of age or y ounger at daeth to or for the use of a natural parent~ an adoptive parent~ or a stepparent of the child is OX. Th. lineal class of hairs includes grandparents, parents, children~ and lineal descendents. "Children" includes natural children whether or not they have been adopted by others~ adopted chlldr8n and step children. '"lineal descendents" includes all children of the natural parents and thelr descendents, whethar or not they have been adopted by oth.rs~ adopted descendents end their descendants and step-descendents. "Siblings" are defined as individuals who have at least one parent in co..on with the decedent~ whether by blood or adoption. The "Collateral" class of h.irs includes all othar benBficiaries. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. Vou legally are responsible far pay.ent~ or ths estate subject to administration by a personal rBpres.ntative is insufficient to pay the deductible itns. B. Vou actually paid thB debts after death of the d.ced8f1t and can furnish proof of paYllent. C. Debts being clailled must be itlilMized fully in Part 3. If additional spaCR is needed~ use plain paper 8 l/Z'" x II". Proof of payment .ay be raquested by the PA Departmant of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG# PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE /7- ?~-;Z FILE NO. 21 - 0 2.- (" I Cf ACN 02112684 DATE 03-20-2002 REV-1545EXAfP<D9-00l EST. OF BARBARA A DUNHAM 5.5. NO. 185-36-1369 DATE OF DEATH 01-04-2002 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS iii CHECKING D TRUST D CERTIF. VICTOR H RUDY APT 905 200 N DUKE ST YORK PA 17403-1463 REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALL FIRST BANK has provided the Deparbent with the infor.ation 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 information is incorrect# please obtain written correction from the financial institution# attach a copy to this fo~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth oy ~ennsYlvania. Questions ~y be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW Account No. 8740436571 J( J( J( SEE oat. Established REVERSE SIDE FOR 04-15-1997 FILING AND PAYMENT INSTRUCTIONS Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due x 6,546.44 50.000 3,273.22 .15 490.98 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 payments are made within three (3) months of the decedent.s date of death# yoU ny deduct a 5iC discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE [!]~j!~~i~~.I!!I.!i!!~_!!!!I~~~!I!!!"~!I!j!~lli!I'!I!!.~1~.!i!ilrn~IJI!I."~!I!..I!i!il'!j!!!m~~!j!I.~~~!!I~ A. D The above information and tax due is correct. 1. You may choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest# or YOU .ay check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY B. c=J 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. D The above information is incorrect and/or debts and deductions were paid by you. You .ust completH PART 0 and/or PART ~ below. PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate} pl..se 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 OF 1 2 3 4 5 6 7 8 x TAl(,;J)N JOINT/TRUST l\CCOUNTS x PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Co.putation) I $ Under penalties of perjury, I declare that the facts I complete to the best of .y knowledge .nd belief. TAXP~f{;;~NA1dRE ./J,AJ1 have reported above are true, correct and HOME ql 7 ) tEt;tj 6 {""/O WORK ( ) TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on infor-otion sub.ltted by the financial institution. Z. Inheritance taK b.C~8S dalinquent nine .onths after the decedent's date of death. 3. A joint account Is taxable even though the decedent's naee was added 8S a .atter of conveniancB. 4. Accounts (including those held betwBen husband and wife) which the decadent put in joint na.es within onB year prior to death are fully taxable as transfsrs. 5. Accounts established jointly between husband and wife 80re than onB yesr prior to death are not taxable. 6. Accounts hald by 8 decadent "in trust for" another or others are taxabla fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the infor.atlon and co.putation in the notice are correct and deductions Bre not being clBi.ed~ place an "X" in black "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and sub.it the. with your check for the amount of tax to the Registsr of Wills of the county indicated. The PA Department of Revenue will issus an official assessment (Far. REV-1548 EX) upon receipt of the return fr~ the Rsgistar of Wills. Z. BLOCK B - If the l!lsset specified an this notice has been or will be rsported l!lnd tax paid with the Pennsylvania Inheritance Tax Return fUsd by the decedent"s representative~ place an "X" in black "B" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Depart_ent of Revenue~ Bureau of Individual Taxes~ Dept Z80601~ Harrisburg~ PA 171Z8-0601 in the envelope provided. 3. BLOCK C - If the notice info~ation is incorrect and/or deductions are being claimed~ check block "C" and complets Parts Z and 3 according to the instructions below. Sign two copies and sub.it them with your check for the a.ount of tax payable to the Register of wills of the county indicated. The PA Depart.ent of Ravenue will issue an official assessment (For. REV-1548 EX) upon receipt of the return frOB the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was establishad or titled in the manner existing at date of death. Far a decedent dying after IZ/IZ/8Z: Accounts which the decedent put in joint names within one (I) year of death are taxable fully as transfers. However~ there is an exclusion not to exceed $3~OOD per transferee regardless of the value of the account or the nu.ber of accounts held. If a double asterisk (__) appears before your first na.e in the address portion of this notice~ the $3~000 exclusion already has been dsducted fro. the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is deter.ined as follows: A. The percent taxable for joint assets established mare than ana ysar prior to the decedent's death: I DIVIDED BY TOTAL NUMBER Of JOINT OWNERS Example: A joint asset registsred DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the na.e of the dscedent and two other persons. I DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) . .167 X 100 16.7~ (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but hald in trust far anothar individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE EXaMple: Joint account registered in the nama of the decedant and two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 50~ (TAXABLE FOR EACH SURVIVOR) 4. The a.ount subject to tax (line 4) is dater.ined by mUltiplYing the account balance (line Z) by the percent taxable (lina 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The a.ount taxable (line 6) is detarllined by subtracting tha debts and deductions (line 5) fro. the amount subject to tax (line 4). 1. Enter the eppropriate tax rate (line 1) as deter.ined below. death to or for the use of a natural parent~ an adoptive parent~ or a stepparent of the child is ox. The lineal class of heirs includes grandparents~ parents~ children~ and lineal descendents. "Children" includes natural children whether or not they have been adopted by others~ adapted child ran and step children. "Lineal descendents" includes all children of the natural parents and their descendents~ whether or not they have been adapted by others~ adapted descendants and thair descandants and step-descendants. "Siblings" are definad as individuals who have at least ana parent in co..on with the dacedent~ whather by blood or adoption. The "Collateral" class of heirs includas all ather beneficiaries. Dat_ of Death Spouse L.iolfiiiill Sibling Collateral 07l01/9~ to 12/31/9~ 3Y. 6Y. 15Y. 15Y. 01/01/95 to 06/30/00 OY. 6Y. 15Y. 15Y. 07101100 to p....sent OY. 4.57.- 127. 15Y. _The 1:ax rili aposed on the not value o~ transfers ~ro. a deceased Ch1ld 'tWenty-one years of age D' Y oungar at CLAIMED DEDUCTIONS PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are deter_ined as follows: A. You legally are responsibla far pay~ent~ or the astate subject to administration by a personal representativa is insufficient to pay tha deductible ite.s. B. You actually paid the debts after death of the decadent and can furnish proof of pay.ent. C. Debts being clBi~ed lIust be ite.ized fully in Part 3. If additional space is needed, use plain papar 8 1/2" x 11". Proof of payment .ay be requested by the PA Depart.ent of Ravenua. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE / 7- 7'1-.:L NO. 21 -oJ- (,. 'Cj 02112685 03-20-2002 REV-1545Ell MP [09-001 EST. OF BARBARA A DUNHAM S.S. NO. 185-36-1369 DATE OF DEATH 01-04-2002 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST IX] CERTIF. VICTOR H RUDY APT 90S 200 N DUKE ST YORK PA 17403-1463 REKIT PAYKENT AND FORKS TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 ALLFIRST BANK has provided the Depart.ent with the infor.ation listed below which has been used in calculating the potantial tax due. Their records indicate that at the death of tha above decedent, you wers a joint owner/beneficiary of this account. If YOU feel this infor.ation is incorrect, please obtain written correction from the financial institution, attach a COpy to this for. and return it to the above address. This account is taxable in accordanca with tha Inheritance Tax Laws of the Co__onwealth of Pennsylvania. Quast ions .ay ba answared by calling (717) 7&7-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR Account No. 80000001648697 D.t. 04-15-1997 Established FILING AND PAYMENT INSTRUCTIONS Account Balance 23,,493.62 P.rc.nt T.x....l. X 50.000 Allount Subject to Tax 11,,746.81 T.x Rat. X .15 Potential Tax Due 1,,762.02 PART TAXPAYER RESPONSE [!]rW,l!;!.i."j!il"!;:~.__!:~,::~"1ffi~.i:;iiii.!,:!!gf,~'I';.i,IJJI,:~:_",:,,::::;:,::;,::,::;:,:,i::.mi~~mii;I::,i;::~~l~i.!~.!!~il I:...,~;m.....'i~,.,.~.,.,.. .~...,.,..,~~...~~.~.,.,....!rn~W!11!!!..:~i, ,..~........i~........,.,~~L.,...,...., .,.p..... ..~,~.i~!~i~~~,.jiWi....,. ....... ........'...... ,...,.,.,......)i~.,... ~~~. ....ii.. ..............,.~...... ;m1i!~.......,......,.J!., A. k7r Tha abova infor.ation and tax due is correct. ~ 1. You _ay choose to re.it pay.ant to the Register of Wills with two capies of this notice to obtain a discount or avoid interest, or you May check box "An and return this notica to the Registel'" of Wills and an official assessaant will be issued by the PA DepartMent of Revenua. To insure proper credit to your accountt two (Z) copies of this notice Must accompany your pay.ent to the Register of Wills. Maka check payable to: nRegistar of Wills, Agent". NOTE: If tax paYMents ara made within three (3) Months of the dacadent's date of death, you Nay deduct a 5~ discount of tha tax due. Any inheritance tax due will baco_e dalinquBnt nina (9) Months after the date of death. [CHECK ] ONE BLOCK ONLY B. 0 The above Bssat has bean or will ba reported and tax paid with tha Pennsylvania Inheritance Tax raturn to be filad by tha decadent's reprasentativa. C. 0 The above inforllation is incorrect and/or debts and deductions wara paid by you. You MUst co~leta PART ~ and/or PART ~ below. TAX ON J~INT/TRUST AC~OUNTS If you indlcat. 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. Allount Subject to Tax 5. Debts and Daductions 6. Allount Taxable 7. Tax Rate 8. Tax Due OF 1 2 3 4 S 6 7 8 X X PART @] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ of perjury" I declare that the facts I IIY knowledge and belief. have reported above are true" correct and HOME (1n) lrs'f h.<;IO WORK ( ) TELEP NE NU ER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with applicable interest based on inforllstion submitted by the financial institution. Z. Inheritance tax beco_s chll1nquent nine lIonths after the dsced8nt's date of dS8th. 3. A joint account Is taxable Bven though the decedent's halle was added as ill .attar of convsnienc8. 4. Accounts (including thosB held between husband and wife) which the decedent put in joint hallSS within one YlIlIar prior to death are fully taxable as transfers. S. Accounts Bstablishad jointly between husband and wife .ore than one year prior to death are not taxable. 6. Accounts held by ill decedent "in trust for" another or others are taxable fUlly. REPORTING INSTRUCTIONS - PART 1 TAXPAYER RESPONSE 1. BLOCK A - If the inforllation l!Ind computation in the notice aNi! correct and deductions are not being clabsd.. place an "X" in black "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and sub.it the. with your check for the a.ount of tax to the RasJstsr of WUb of the county indicated. The PA Department of Revenue will issue an official assesSllent (For. REV-1548 EX) upon receipt of the return fro. the Register of Wills. 2. BLOCK B - If the asset specified an this notice has bQen or will be rQPorted and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent.s representative.. place an "X" in block lOB" of Part I of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue~ Bureau of Individual Taxes~ Dept Z80601~ Harrisburg~ PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is inCOrrect and/or deductions are being clai.ed~ check black "C" and complete Parts 2 and 3 according to the instructions below. Sign two copies and Submit them with your check for the a.ount of tax payeble to the Register of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (Form REV-1S48 EX) upon receipt of the return fro~ the Register nf Wills. TAX RETURN - PART z - TAX COMPUTATION LINE 1. Enter NOTE: tha data the account originallY was established or titlad in the .anner existing at data 0# death. For a dacedent dying efter 12/IZl82: Accounts which the decedant put in joint na.es within one (1) yesr of death are taxable fully as tr~nsfers. However~ there is an exclusion not to axceed $3~000 per transferee ragardlass of tha value of the account or the number of accounts held. If a double asterisk (**) appears before your first na~e in the address portion of this notice~ the $3~00Q exclusion already has been deducted from the account balanca as reported by the financial institution. z. Enter the total balance of the account inclUding interest accrued to tha date of death. 3. The percent of the account that is taxable for each survivor is deter~ined as follows: A. Tha percent taxable for joint assets establishad ~ore than one year prior to the decedant.s daath: I DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Exallple: A joint asset registered DIVIDED BY TDTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JDINT OWNERS in the nama of the decedent and two other persons. I DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) - .167 X 100 16.7~ (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedant.s daath or accounts owned by thB decedant but hald in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Exa.ple: Joint account ragistered in the na.e of the decedent and two other persons and Bstablished within one year of death by the decadent. 1 DIVIDED BY Z CSUR~IVDRS) ~ .SO X 100 502 (TAXABLE FOR EACH SURVIVOR) 4. The a.ount subjact to tax (lina 4) is deter.ined by .ultiplying tha account balanca (line Z) by the percent taxable (line 31. 5. Enter the total of the debts and deductions listed in Pad 3. 6. The a~ount taxable (lIne 6) is detarmined by SUbtracting the debts and daductions (lina 5) from the a_aunt subject to tax (lina 4). 7. Enter the appropriate tax rate (line 7) as deter.ined balow. Oat. of Death Spouse Lineal Sibling Collateral 07/01/94 to 12/31/94 3r. 6r. lSr. lSr. 01/01195 to 06/30/00 Or. 6% 15r. lSr. 07/01/00 to present or. 4.5%- 12r. 15r. *Thllii tax rata illposed on the not value of transfers frOll a deceassd mUd twenty-one yelllrs of age or y ounger at death to or far the usa of a natural parent~ an adoptive parent~ Or a stepparent of the child is O~. Tn. lineal class of heirs includes g~andparents~ par.nts~ children~ and lineal descendents. "Children" includes natural childran whether or not they have been adopted by others~ adopted childrllln and step children. "lineal descendents" includes all children of the natural parents and their descendents~ whether or not thay hava been adopted by others~ adopted dascandents and their descendants and stap-descendants. "Siblings" are defined as individuals who hava at least one parent in co..on with the decedent~ whether by blood or adoption. The "Collateral" class of heirs includas all other beneficiaries. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS ~LAIMEO Allowable debts and deductions are detarminad as follows: A. You legally ara responsible for pay.ant~ or the estate subject to administration by a pursonal repraSllntative is insufficiant to pay the deductibla items. B. You actually paid the dsbts after death of the dacedent and can furnish proof of pay.ent. C. De.bts being claimed .ust be ite.ized fUlly in Part 3. If adcUtJonal space is needed.. use plain paper 8 1/Z" x 11", Proof of p~yment may be requested by the PA Depart.ant of Revenue, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RUDY VICTOR H 200 NORTH DUKE STREET APT 905 YORK, PA 17403-1463 ._U~__. fold ESTATE INFORMATION: SSN: 185-36-1369 FILE NUMBER: 2102-0619 DECEDENT NAME: DUNHAM BARBARA A DATE OF PAYMENT: 07/09/2002 POSTMARK DATE: 07/08/2002 COUNTY: CUMBERLAND DATE OF DEATH: 01/04/2002 NO. CD 001392 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02112683 I $882.86 02112684 I $490.98 02112685 I $1,762.02 I I I I I I TOTAL AMOUNT PAID: REMARKS: VICTOR H RUDY CHECK# 792 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $3,135.86 MARY C. lEWIS REGISTER OF WillS