HomeMy WebLinkAbout01-0011
02 ;.-- ;t19 -;;-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
FILE
ACN
DATE
NO. 21 0 I - 0 II
00118734
11-28-2000
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REVISED NOTICE * * *
*
REV-1545 EX AFP C09-00)
*
EST. OF MARY J FISHBURN
S.S. NO. 160-16-1046
DATE OF DEATH 12-01-1999
COUNTY CUMBERLAND
TYPE OF ACCOUNl
[i] SAVINI
o CHECKl
o TRUST
o CERTIF
WENDY S KEIM
APT C311
1424 BRADLEY DR
CARLISLE
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
'ul\
(";! \
PA 17013'
PNC BANK has provided the DepartMent with the infor_tion listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this infor_tion is incorrect, please obtain written correction fro. the financial institution, attach a COpy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COM~nwealth
of PennsYlvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5130043431 Date 10-01-1978
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
2,860.90
50.000
1, 430.45
.15
214.57
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice .ust aCCOMpany your
paYMent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax paYMents are Made within three
(3) .onths of the decedent.s date of death,
yoU May deduct a 5% discount of the tax due.
Any inheritance tax due will beCOMe delinquent
nine (9) .onths after the date of death.
Tax
x
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[] The above infor.ation and tax due is correct.
1. You aay choose to reait payaent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you May check box "A" and return this notice to the Register of
Wills and an official assessaent will be issued by the PA Depart.ent of Revenue.
[] 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.
~ above inforaation is incorrect and/or debts and deductions were paid by you.
You ~ust cOMplete PART ~ and/or PART ~ below.
PART
[!]
TAX RETURN - COMPUTATION
lINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
If you indicate a different tax rate, please state your
relationship to decedent:
OF
I
2
3
4
S
6
7
8
TAX
PART
@]
DATE PAID
DEBTS AND DED IONS CLAIMED
-(JAC,e / /J/' ~
DESCRIPTION
r~Z"
72<;
j-O
$
TOTAL (Enter on Line S of Tax Co.putationl
T XPAVER
declare that the facts I have reported above are true, correct and
and belief. HOME (7/7) 21/~ 'I?/~~
WORK ( )
T LEPHONE NUMBER
J2k~Jx;
DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
;) 1- ( 9' If - Y
c7'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REVISED NOTICE * * *
FILE
ACN
DATE
NO. 21 -0'-111/
00118735
11-28-2000
*
REY-1543 EX AFP 109-001
*
EST. OF MARY J FISHBURN
S.S. NO. 160-16-1046
DATE OF DEATH 12-01-1999
COUNTY CUMBERLAND
TYPE OF ACCOUNl
o SAVINI
[i] CHECK]
o TRUST
o CERTIF
i:__
REHIT PAYHENT AND FORHS TO:
RESISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
WENDY S KEIM
APT D311
1424 BRADLEY DR
CARLISLE
PA 1701t";l'
PNC BANK has provided the Department.with the information 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 form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the ComMonwealth
of Penn~ylvenia. Questions may be answere~ by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5140074661 Date 09-01-1978
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
To insure proper credit to your account, two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
1,362.82
50.000
681.41
.15
102.21
TAXPAYER RESPONSE
NOTE: If tax payments are made within three
(3) Months of the decedent.s date of death,
you may deduct a 57. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
x
PART
[!)
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[] The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
[] 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.
~he above information is incorrect and/or debts and deductions were paid by you.
You MUst complete PART ~ and/or PART ~ below.
If you indicate a different tax rate, please state your
relationship to decedent:
PART
[3J
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
I
2
3
4
5
6
7
8
TAX
x
ON ""O,IN1/TRUST
flll/f7Y
(3/Rdl1~
, .;sa .
?> t:f I. '1./
~ 9ss-:3!
-0 -
~ IS-
ACCOUNTS
x
-17 -
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
'P-Pr&e:-3~2-
DESCRIPTION
I
AMOUNT PAID
S.
TOTAL (Enter on Line 5 of Tax COMPutation)
$
Under penalties of perjury, I declare that the facts I
comPle}e to the best 0 y~nowledge and belief.
j;a~ Lt
TAXPAYER SIS AT
have reported above are
HOME (7/7) ~
WORK ( )
ELEPHONE NUMBER
true, correct and
,- ~
... /h-/99-cR
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
SA
c
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEKENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-154a EX .FP <12-00)
WENDY S KEIM
APT C311
1424 BRADLEY DR
CARLISLE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
04-02-2001
FISHBURN
12-01-1999
21 01-0011
CUMBERLAND
160-16-1046
00118734
Amount Remitted
J
MARY
PA 17013
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 ~
Rtlfv=i5~8-Ex--AFP--[i1f:oo)------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON ~OINTLY HELD OR TRUST ASSETS
DATE 04-02-2001
ESTATE OF FISHBURN
MARY
J DATE OF DEATH 12-01-1999
COUNTY
CUMBERLAND
FILE NO.
21 01-0011
TAX RETURN WAS:
ACN 00118734
ATTACHED NOTICE
S.S/D.C. NO. 160-16-1046
() ACCEPTED AS FILED (X) CHANGED SEE
~OINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
5130043431
TYPE OF ACCOUNT: ()() SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 10-01-1978
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
2,860.90
0.500
1,430.45
1,430.45
.00
.15
.00
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
X
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
* 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"" ( CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
.00
.00
.00
.00
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~~
C/
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEKENTL ALLOKANCE OR DISALLOKANCE
OF DEDUCTION~, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-154S EX AFP (12-00)
/6-/cj9-~
04-02-2001
FISHBURN
12-01-1999
21 01-00ll
CUMBERLAND
160-16-1046
00118735
Amount Remitted
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
MARY
J
WENDY S KEIM
APT D3ll
1424 BRADLEY DR
CARLISLE
PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-Y=isiri-e:x--AFP--fi2-:6oi------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-02-2001
ESTATE OF FISHBURN
MARY
J DATE OF DEATH 12-01-1999
CUMBERLAND
COUNTY
FILE NO.
21 01-00ll
TAX RETURN WAS:
S.S/D.C. NO. 160-16-1046
( ) ACCEPTED AS FILED (X)
JOINT OR TRUST ASSET
ACN 00118735
CHANGED SEE ATTACHED NOTICE
INFORMATION
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
5140074661
TYPE OF ACCOUNT: () SAVINGS ()O CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 09-01-1978
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
1,362.82
0.500
681.41
1,895.39
.00
.15
.00
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
X
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
AMOUNT PAID
DISCOUNT (+)
INTEREST/PEN PAID (-)
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
.00
.00
.00
.00
REV-1.f70 EX (6-88) ·
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
Mary J Fishburn
Cathy Miller
FILE NUMBER
REVIEWED BY
ACN
2101-0011
00118734 & 001187~
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
A review of the expenses, which you submitted has resulted in the approval of $3325.84 i
deductions credited to these accounts.
The deduction for the Shippensburg Vet has been disallowed; this was not a debt of the
decedent outstanding at death.
ROW
Page 1
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