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Home My WebLink About02-0863 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 AEV-1162 EX(11-96J RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MARPOE BONNIE F 1044 ASHTON DRIVE SHIPPENSBURG, PA 17257 .-n----fold ESTATE INFORMATION: SSN: 204-03-' 095 FILE NUMBER: 2102-0863 DECEDENT NAME: MENTZER ANNA R DATE OF PAYMENT: 09/24/2002 POSTMARK DATE: 09/23/2002 COUNTY: CUMBERLAND DATE OF DEATH: 08/01/2002 NO. CD 001648 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02141583 I $39.65 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: BONNIE F MARPOE CHECK# 1006 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $39.65 MARY C. lEWIS REGISTER OF WillS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z8060l HARRISBURG, PA 17128-0601 *' I INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-a.:2-&'6.E 02141583 09-20-2002 REV-U4S UAFP n,-,n '02 2<1 ,l,'~ '1 TYPE OF ACCOUNT EST. OF ANNA R MENTZER 0 SAVINGS 5.5. NO. 204-03-1095 IXJCNECKING DATE OF DEATH 08-01-2002 0 TRUST . .-,COUNTY CUMBERLAND 0 CERTIF. ;.,--{ REMIT PAYMENT AND FORNS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BONNIE F MARPOE 1044 ASHTON DR SHIPPENSBURG PA 17251 Ct\ ORRSTOWN BANK has pravidlild tha IhIpart.nt with thB inforl!ation listed balow Mhich has bHn used in calculating tha potential tax due. ThBlr rBcords indicatB that at the death of the above deced..t~ YOU were a joint ownBr/beneficisry of this account. If you fe.l this infor~tion is incorr8Ct~ please obtain written correction fro. the financial institution~ attach a copy to this fOri! and return it to thB above addrBss. This account is taxable in accordl!lnc. with the InhBrltancB Tax Ll!IWs of th. COIIlIDnwealth of P......SYIYDnii!ll. Questions lIey bB en_red hy r.elllng (717) 787-8327. COMPLETE PART 1 BELOW Account No. 513385 Il Il Il SEE Date Established REVERSE SIDE FOR 10-01-1982 FILING AND PAYMENT INSTRUCTIONS Account Balance 556.49 Parcent Tex&bla X 50.000 AlIOUnt Subject to Tax 278.25 Tax Rata X .15 PotanUel Tax Qua 41.74 PART TAXPAYER RESPONSE [!] E~g_I:.)!I~!I_tRIl~l[8IiI~1:1;!lill.~.ll\1l.l~~~I.[...E.llIl'rr..::~:~..;:-']!]!!I.!.I,::,;;,.1P E-.-",,,,,,,,~m,,,,,,~,...~.......,.~,.,.......~,.,.~,,,.,.,,,.,.,,,.,.",.,.",.,.",...~.......__.~!~:~~:~:~L........,......._,.,.,......."""_",,,,,,~,,,,,,,",,,,"r,.~,.,.,.,.,.........~,,,~iffiEi~..~ ..... n._. ..n.. ......_ _nt. ,~. t."",,,, =.r,,=.m=.~ !i!;:,!i!_._._.~,~. .,.,.,.~,r,.~'i.~.r,3 To insure proper cr.di t to your account, tNO (2) copies of this notice IIUst eCC::DIIpany your pay.ant to the Rqisur of WUls. Make check payable to: "Register of WillS, Agent". NDTE: If tax paY.Wlts are aacle wi thin thrH (3) .onths of the decedBnt"s date of death~ you I18Y deduct 8 5% diSCount of the tax due. Any inhBrltance tax dull will b.cOlle d&1inquant niM (9) .onths aftBr the dl!lte of ...th. [CHECK ] ONE BLOCK ONLY A. DrJ The abovs informltion and tax due is correct. 1. Vou .ay choose to r..it paylllent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you .ay ChBCk box "An and rBtunn this notiCB to thB Register of Wills and an official aSSBssgent will bB issued by the PA Dapartaant of Revenue. B. D ThB abOVB SSSBt has bBsn or will bB rsportBd and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's represBntative. c. D ThB above inforllBtion is incorrect and/or debts and deductions were paid by you. You .ust cOllplet. PART 0 and/or PART [!] below. If you indicate. different tax rat., please stat. your relationship to decedent: PART [!] TAX RETURN - COMPUTATION OF TAX ON JOINT,TRUST ACCOUNTS LINE 1. o..te E.tllblishad 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 S. Debts and Deductions S 6. Amount Taxable 6 7. Tax Rat. 7 X 8. Tax Due 8 PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED . PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Ent.r on Line S of Tax Conputation) of perjury, I declare that the facts I have reported IIbov. of my knowledge end belIef. I , and \ /'7- fie) - Y' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '*' NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLOKANCE OR OISALLOKANCE OF DEDUCTION.., AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV.1548 EXAFP Ul-U21 BONNIE F MARPOE 1044 ASHTON DR SHIPPENSBURG '(}-. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 12-02-2002 MENTZER 08-01-2002 21 02-0863 CUMBERLAND 204-03-1095 02141583 ANNA R -' Allount Re..itted PA,17257 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=isiii-EiC-AFii-fol-=ozl------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-02-2002 ESTATE OF MENTZER ANNA R DATE OF DEATH 08-01-2002 COUNTY CUMBERLAND FILE NO. 21 02-0863 TAX RETURN WAS: S.S/D.C. NO. 204-03-1095 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 02141583 FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT NO. 513385 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE 10-01-1982 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X 556.49 0.500 278.25 .00 278.25 .15 41. 74 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 (-) 09-23-2002 CDOO1648 2.09 39.65 TOTAL TAX CREDIT 41.74 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER TMIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS TNAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDlr' ( CRJ, YOU MAY BE DUE A REFUND. C;I;C DlClIlCDiC:1C CTnc nc TUTO::::: enD" enD TYC:::TDIII'"TTnuc:: .. \ \ ~ ~ ~~ ~%. ~, ........ ~ -..~ ' ~~ ~~ '- ~ ~ ~ ~~---... ~ 'S\'''.Z .~~~ ~6~ ." -:. -:. -:. - . ~ ~ -:. -:. ~ -; :; ...::. =; ~ .::. \"1.) ,..\ :'"l I. Ot', \. ..... ,i.' ..... ", ,.. r" .....