The URL can be used to link to this page

Home My WebLink About01-1102 CDMMO~WEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 -C) 1- / / t:).:::v 01155531 11-21-2001 REY-150 EX AFP <09-0D) EST. OF CHARLES H ROBERTS S.S. NO. 430-32-2712 j DATE OF DEATH 10-10-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS !X] CHECKING o TRUST o CERTIF . ~S~~N8S A:K~ORMAN LP1 ~~~tAd HE:CIIANICSBblRG PA--17058 ?6~li.stif 60 0\ 1Lf-(p~4- REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST FINANCIAL SERVICES 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 Per.n!::Jlvar.ia. Quastians :lay be lms~arQd by calling (717) 781-'8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0072160004 Date 11-28-1973 Established x 3,144.89 16.667 524.16 .15 78.62 TAXPAYER RESPONSE 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". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 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 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. ~ The 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 relationship to decedent: state your 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 TAX ON JOINT/TRUST ACCOUNTS OF 1 2 3 4 5 6 7 8 x ()~4. {{ 0 x 1i::~ PART [!I DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ declare that the facts I belief. " have repor~,~bove are tru~ f?rrect and HOME (0~ )~1-7 ::)151-0 ,(\~ WORK () J~ I~ TELEPHONE NUMBER ATE r~-~ '01 0 I C -3 A'l :c, 2 ~"'~ I'~~ , fi ~~~ ~r~ i Hi ;c;rded', :, 'lister c CiEr, CCLi (~lunbi_ -"~)4i pj\ to:. ~?r~ ..,! 0 t-'. (rJ " 'I 1.1.. (,.I I'.) ~ (..1 - ~ I:>~ - ~~~ - - - -, --~ - U0? - - = - ( t - f - - C-- ~ ..----._~ ,,/'~. ',-'", /~. .~ :r\, 0,',,' ' , ( ',~) ( , <. ~:' I:) t',---.- _"'^ \,/ c; __":/ , -\,/ '>.. -, , .' ., ~~ -~ t','- '%,,"~,-,/ \.. , , " " I. I \ I: II i, . \ I I' 1 II J ' ", j I I ,,' f r I . I , iii/I!! I /'/1 I f I ; , I · / , !, f i ' I Iii, , ~ ~ 1 ~ : ~ ~. l' l!_ ,1m COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG, PA 17128.0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WORMAN SUSAN R 67 WHITE OAK BEND ROCHESTER, NY 14624 u_n___ fold ESTATE INFORMATION: SSN: 430-32-2712 FILE NUMBER: 21 - 200 1 - 1102 DECEDENT NAME: ROBERTS CHARLES H DATE OF PAYMENT: 12/03/2001 POSTMARK DATE: 12/01/2001 COUNTY: CUMBERLAND DATE OF DEATH: 10/10/2001 NO. CD 000589 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01155531 I $24.39 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: SUSAN R WORMAN CHECK# 2754 SEAL INITIALS: AC RECEIVED BY: $24.39 MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS \, //-~L/- /y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 SUSAN R WORMAN 67 WHITE OAK BEND C;~'n ROCHESTER NY 14624 CWnbL NOTICE OF INHERITANCE TAX APPRAISEMENTL ALLOKANCE OR DISALLOKANCE OF DEDUCTION~, AND ASSESSMENT OF TAX ON Flgf~rh~ HELD OR TRUST ASSETS ", I QAtE 01-21-2002 ESTATE OF ROBERTS DATE OF DEATH 10-10-2001 .02 JJl^J 18 FILE NUMBER 21 01-1102 P~~Y CUMBERLAND SSN~C 430-32-2712 ACN 01155531 REV-1548 EX AFP <l2-DDI CHARLES H .....f.. ........ MAKE CHECK PAYAB~E AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 ~~_~_~~p_t!l!_.!_~!~__I:.!~~_______~____~_~!~~_t-!_~p_~~~_!..~~!_7:.~~_!..~~_.!~~~__I!~~_~!~~____~___________________ _ __ REV-1S48 EX AFP (12-00) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR DISAL~OWANCE OF TRUSTTASSETS : DATE 01-21-2002 ESTATE OF ROBERTS CHARLES H DATE OF DEATH 10-10-2001 COUNTY CUMBERLAND FILE NO. 21 01-1102 TAX RETURN WAS: S.S/D.C. NO. 430-32-2712 (X) ACCEPTED AS FILED () CHANGED ACN 01155531 JOINT OR TRUST ASSET INFORMATION! FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 0072160004 TYPE OF ACCOUNT: () SAVINGS ()() CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 11-28-1973 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x 3,144.89 0.166 524.16 .00 524.16 .45 23.59 NOTE: TO JNSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WIT~ YOUR TAX PAYMENT TO THE REGJSTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR ~ONEY ORDER PAYABLE TO: "RE.ISTER OF WILLS, AGENT." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-01-2001 CDOO0589 1.18 24.39 TOTAL TAX CREDIT 25.57 BALANCE OF TAX DUE 1.98CR INTEREST AN~ PEN. .00 TOTAL DUE 1.98CR . 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" ( CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J