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Home My WebLink About11-22-06 (2) COIMllNlIEAL TH OF PEIIISVLVANIA IlEPARTIlEHT aF REVEIllE IlJREAU Of INDIVIIIlJAL T AllES IlEPT. 210601 . llARRJSIURG. PA 17128-0601 .* INFORMATION ~CE AND TAXPAYER RESPONSE FILE NO. 21 06-0261 ACN 06125433 DATE 06-02-2006 TYPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVAGE 0 SAVIN8S S. S. NO. 172-34-4165 0 CHECKI" DATE OF DEATH 03-10-2006 0 TRUST COUNTY CUMBERLAND IXI CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 IIY-1I4' EX .FP 11.....1 GERALDINE M DENISON 908 GREENBRIAR DR MECHANICSBUR6. PA 17055 AltERICHOICE FCU 1111. provided the aep...t.nt with the Info....Uon llste b.low .....Ich h.. b.." u..t In nlculaUIIII the pot.nUd tlIx dull. TMI.. .-.col"d. indlC1lt. thet .t the dHth of the abov. dlIceant. you ...... . joint _../bansflcl...y of thls .ccount. If YOU fssl this info....tlon Is Inco....sct. pl.... abtllln wdttan co.....ctlon fl"Oa the flnancl.l In.titution. attach. oopy to this fa... and r.tunt it to the above edr.... This account Is tIIlCabl. In accordanc. with the Inh.rltanca Tax L.... of the C_nw.alth of PennsYlvania. lluastlons _y be an_...d b!f 0.111l1li (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 27949 ht. 05-03-2001 Estllbllshad Account B.lllnO. Percent Taxabl. AIIo\nt Subject to Tax Tax R.t. Potenti.l T.x Due x 11,801. 22 50.000 5,900.61 .045 265.53 TAXPAYER RESPONSE To Insur. p..op... cl"8dlt to your account. two (2) copl.s of this notlc. ...st accOllpllny your payaant to the Aqlstar of lUll.. Mak. check payable to: "Aqlsur of Wills. Agant". x NOTE: If talC payaants .... II1Ida within thr.. (3) aonths of the dlIcadent's data of duth. you _y daduct a 5% discount of the tlIx due. Any InI1lId tanoe talC due will bac_ dellnquant nlns (9) aonths after the date of death. PART m ~::yw.--~: ;. ~~~q;~"-~-~.:"-i:~-~ ~ ~~._~-- (-_.< , ;:---~--it.f;:~ -:'M-r~~~~1:?-;~-0'"~fY'-'~=it:t:--:-0-:J-:tfr~r:-k;:p -~ .' -~~clM-~: _:r-"~.J::t:Jt2~ ;1- ~Y~:fr[-;P-:Z---:-- -i:_-~::.J ~~"_'=M-~~ - t ~f---- '(~'~+- ~M~1h';- :-1 ,--~t';~~.1>F<:--~"--o,,.-- -~w1fjt:r _4'iJl::ii:*:iif",:l1;:;fjjjj.i_~jj;~"i;jffi;*;g,.;J!:;lilHit~:!l:'l:~:j;:;F~.,;ll::'l::l.t-i~.;igf'!;_:J':1:3t1li.cjf;~ir:!ilk~:AAJi.aiAA::j;..*"W=_l!i!t'i-"':;t.;AA,.~:iW:iiHrulilfl!t.ffifull:tif~~~. A. 0 TI1II above Info....tlon and talC due Is corract. 1. You aay chaose to r_it payaant to the Aql.tBr of WUb with two copl.s of this noties to obtain a discount or avoid Intere.t. or YOU .ay chack bOlC "." and ...tum this notic. to the Aeglster of WUb and an official ass.sS1ltll1t will be Issued by the PA Dspartsant of Aevsnus. B. \XJ The abova esset has b_n or will be rsportad ..,d talC paid with the PamSl/lv..,la Inheritance TalC return to ba filed by ths dacadant's repre..ntatlve. C. 0 The above InforAtlon Is Incorract and/or debts and deductions ...re paid by you. You BUst colIPleta PART 0 andlor PART [!] below. PART If you Indlc.ta . dlff.rent t.x ret., pl.... st.t. your ~ rel.tionshlp to decadent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. ht. Estllbllshecl 1 2. AccOW\t B.lllnCa 2 3. P.rcent T.xllbl. ! X 4. Aeount SubJ.ct to T.x 4 S. Debts and Deductions 5- 6. AIIount T.xabl. 6 7. Tax R.te 7 X 8. Tax Due 8 [CHECK ] ONE BLOCK ONLY PART ~ DATE PAID PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Ent.r on Una 5 of T.x COIIPUt.tion) . Under penaltl.. of p.rjury, I decl.r. that the f.cts ~l.t. to the bast of .y knowledge and ball.f. I hav. r.ortad above .ra true, HOME ( ) WORK ( ) TELEPHONE NUMBER correct end TAXPAYER SIGNATURE DATE COMNlINMEAL 1M OF PElltSYL YANIA IIEPARTMEIlT OF REYEHUE IUREAU 1IF INDIYIDUAL TAXES IIEPT. 210601 HARRISBURG,.PA 171Z8-0601 '. INFORMATION NdltCE AND TAXPAYER RESPONSE FILE NO. 21 06-0261 ACN 06125432 DATE 06-02-2006 TYPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVAGE 0 SAVIH8S S. S. NO. 172-34-4165 0 CHECKI" DATE OF DEATH 03-10-2006 0 TRUST COUNTY CUMBERLAND Ii] CERTIF. REflIT PAYIIENT AND FORttS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 6'-945 EX III' 1"-1" GERALDINE M DENISON 908 GREENBRIAR DR MECHANICSBURG PA 17055 AltERICHOICE FCU h.. provided the Deperbent IIlth the Inforntlan Usted belDII IIhlch he. been used In celoul.t111l11 the potentl.l tell due. Their record. Indlcat. thet .t the dnth of the IIbova dao......t, you or. . jalnt Dlln8r/beneflc1.ry of thls eccount. If you fael this Info....tlon Is Incorrect, pl.... obteln IIrltten oarr.ctlon froe the fln...clal In.tltutlon, attech . CoPY to thb fore and r.turn It to the lIbov. IIdt:Ir.... Thlsaccount is texab18 In accardanc. IIlth the Inherlteno. Tex L.... af the Coe_..lth of PennsYlvenl.. lIu8.tlon. MY be lII'I_red by c.UII1lI (717) 7!17-8SZ7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS ACCOU"It No. 27949 o.te 06-01-2001 E.t_U.heeI x 111772.42 50.000 51886.21 .045 264.88 TAXPAYER RESPONSE To Insur. proper credit to your eccount, two (Z) copl.. of thl. notice su.t eccoepenll your paY881lt to the R...1ster af IUUs. Make check payable to: "R...lster of Wills, Agent". Account B.18l1Ce Percent TllXabl. AIIount Subjeet to Tex Tex Ret. Potentlel Tex Due x IIlTE: If tex pa_ts .r. 88da within thr_ (3) IIlII1th. of the declld8nt's dete of death, YOU ay deduct . 5% discount af the tex due. Any Inharl tence tell due will becD88 delinquent nlns (9) .unth. .fter the dete of death. PART ill illiilt~~; -"~-~-Hf-;-~ ~ - ;1r:--~'-'---::;.:-"~~---:--" ~~-~n.~_-_~ ?::-'P -'?-:S-l:t::fr "'f :---- ~'F:11 -~1t i-~- {:]:: -r"~ :.;:----~"' =- -: u-lf-~~ii~rii'_ ~~~if,.:t-k:F'Ff?,'1_ - [";k"~-~~:~~~":--~~--:.Ft-~:> ~-;~. -~-:J')i . f.;":-::----::s--;.l~..- .:-~-~--~ ;=~~~~ q,._:jjj!lF:P.!l:.J1liR~~_:r:f~:fu.!Wd~~;li;:3t:i';;'~:!'~~;;::lI:~!!r*~'ik~iiilli:f~-ij.:it*~.w:i!!l:~.'::J;::f:F:~~:AA:~'!Jll!:<fui.;j.~'Ijj::!':.ffill1:.~~:m:~:h:".'i!t~ A. 0 The above Inforaetlon and tell due Is correct. I. You _y choa.. to ~It p~t to the Register af Wills with two CoPies of thls notice to obteln a dl_unt Dr avoid Inter..t, Dr YOU _y check boll RAR ...d return this notice to the Register af Will. and en official assessaent will be I.sued by the PA Daparteent of Revenue. B. KI The above a.set has been Dr wlll be raported end telC p.ld with the PemSl/lvenla Inheritance Tax return ta be filed by the decedent'. rapresentatlve. c. 0 The IIbove Inforaetlon Is Incorrect andIo~ebts and deduction. were paid by lIOU. You au.t caaplete PART [!] end/ar PART ~ below. PART If you lndlc.t. . different tex retel pl_.. stete your ~ relet10nshlp to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. o.t. Est_Ushed 1 2. Account Balence 2 3. Percent Taxabla 3 X 4. AIIount Subject to Tex ... 5. Debts and Deductions 5- 6. A.ount Tex_l. 6 7. Tax R.t. 7 X 8. Tex Due 8 [CHECK ] ONE BLOCK ONLY PART I!J DATE PAID PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Enter on Line 5 of Tex C~t.tlon) . Under pemtlUe. of perjurYI I declar. thllt the feets I hIIve reported above ar. truel correct and coIIP1.t. to the best of IIY knowledge and beUef. HOME ( ) WORK ( ) TELEPHONE NUMBER DATE TAXPAYER SIGNATURE COIIIIMlIEAL TH OF PENNSYLVANIA IlEPARTIlEMT OF RE\/EIlllE IUIIEAU OF INDIVIDUAL TAXES IIEPT. ZlD601 I HAIlRISIIJRQ, PA 17121-D601 e.. INFORMATION NO~E AND TAXPAYER RESPONSE FILl NO. 21 06-0261 ACN 06125428 DATI 06-02-2006 TYPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVAeE 0 SAVINIS &.S. MO. 172-34-4165 IilCHECKIN8 DATE'. OF DEATH 03-10-2006 0 TRUST COUNTY CUMBERLAND 0 CERTIF. REMIT PAYIIEIIT AND FORtIS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 "'-114' D"" I""" . . CHARLES E DENISON 908 GREENBRIAR DR MECHANICS BURG PA 17055 AMERICHOICE FCU has pravl"" the u.p.rw.t IIlth the Infol'll.tlDn u.t.cl bdDII which has be.n und In cs1au1a1:lng the pDtsntlal ax due. T"-I,. nconts Indicate thet .t the de.th Df the ilbDva decedent, you liar. . joint _r/banaflciary Df this acCDllnt. If you feel this InfD,...tlDIl Is Incorrect, pi... Dbaln IIrltten CDrl'llCtlon fro. the fln_la1 In.tltutlon, dUch . copy to thl. tol'll and return it tD the sbov. scldr.... This soaount Is Uxsbh In SCDDrdenc. IIlth the Inlwrlt8nae Tax L.... Df the C_lth Df P.....ylvsnl.. QuII.UDIl. _y be ...._r.cI bl/. caUi... (717) 717-1327. COMPLITE PART 1 BELOW . . . SII REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 27949 DIIt. 11-10-1999 EsUbllllhed x 6,249.26 16.667 1,041.56 .045 46.87 TAXPAYER RESPONSE TD In_e proper or.cli t to your ecoount, two (2) cople. of this notice ..t _.....IY your payHIlt to the R..lster of 11111.. "sica chack flllYllbla tol "R..lsar of IIUh, ....t'". Account Bal.nc. Percent Tex_l. bIount Subject to Tax T.x Rat. Pot....ti.l T.x Due x NOTE: If tax ...~t. a,.. ... IIlthln th,... (3) ~th. of the dscsdant.. ate Df deeth, you RY deduct e 5% discount of the tax due. MY InlwrlUnca tax dull 11111 beco.e dslll1Cll*1t nlns (9) IKInth. after the ate of death. PART I!I ,;;tin::;.... .:...: ".:.;:*.;:..,~..~.:,;:"..;::.~":~.~~[:;.:'i:...:.:,..: ."~~.~:.., ''!J.x.;:;'-ot,,,,,,..,,.:.;::.,,,,,-i:;: '....~.;:'b-~:t:.f:'i:...". ':'::'i:' ,.:..::::::.~:...;:~.,..:.::~:::.:!t:n:";~"~'::;::~:-fC':: .;!~.:~i::~..c- '. . '.' :. :;:12 .,: '.' ~.~_~..,!::ot:::'<:n:j [CHECK ] ONE BLOCK ONLY ~. 0 TIw abova infDrsstiDll and tax dull Is CDrrsct. 1. You RY chCJD. to ,...It peyasnt to the Register of lflU. lIith two clIPle. Df this notice to Dbaln a dlsoount Dr .vold inta,...t, Dr yOU _II' chack box WA" and ratum thi. notice to the Registar Df 11111. and an offlci.1 .....ssent will ba l.sued by the p~ Dapertsant of Revenue. I. ~ The lIbava ....t h.. baen Dr IIUl ba rllportlMl and tax p.id ",ith the PannQlvSli. Inheritance Tax return )OJ to be filed by the dacsdant'. repre..ntative. c. 0 The lIbave infDr_tion 1s incorrllCt sndIo~t. end deductiDll. lIel'8 peid by you. You lIU.t CDIIP1ete PART [!] end/Dr PART ~ balD"'. PART If you lnc:llcat. . different t.x rat., pl..s. st.t. your (!] rel.tionshlp to daclldant: TAX RETURN - COMPUTATION OF TAX ON JOINT'TRUST ACCOUNTS LINE 1. Dltt. Esbbllshad 1 2. Account 8alMC. 2 3. P.rc.nt Taxabl. 3 X 4. Mount SUbject to T.x .. 5. Debts IInCI D.ductlons 5- {o. AlIOUnt Taxabl. 6 7. Tax Rat. 7 X 8. T.x Due 8 PART I!l DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Enter on Una S of Tax COIIput.tlon) . UncIar pen.lU.. of perjury, I daclara that the facts I have reported abov. .... true, correct IInCI .t. the t IIY knowl.. IInCI ball.f. HOME WORK ( 7/7 ) '"-90(/ ( ) ,If ,,_ DATE COIIIIIIIEAL TH OF PEIIlSYLVAHIA IEPARTMENT OF AEYENUE IIUREAU OF DIIIVIIlUAL TAXES IIEPT. 280601 'HARRISIURS, PA 17128-0601 e* INFORMATION Noel: AND TAXPAYER RESPONSE FILl NO. 21 06-0261 ACN 06125430 DATI 06-02-2006 TVPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVA9E 0 SAVD18S S.S. NO. 172-34-4165 IilCHECKIN8 DATE OF DEATH 03-10-2006 0 TRUST" COUNTY CUMBERLAND 0 CEITIF. REMIT PAYMENT AND FOIlItS TO: RE9ISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 "'-1141 II II' I.") .~ CHARLES E DENISON 908 9REENBRIAR DR MECHANICSBURG PA 17055 AltERICHOICE FCU 11.. provldMl the llIIp.rt.nt with the Info,...tlon u.ted Hlow. lIhlClh has .... uMd In oaloul.tlllll the potsntl.l tax due. Thslr rHord. Indlc.t. th.t .t the de.th of the above dacadant, l/OU ...,.. . joint _rlbaneflcl.f"l/ of this _lU'It. If l/DU feel this Info....tion Is Incorrect, pl.... obtain writtsn correction froa the fl_I.1 In.titutlon, .ttach . aopy to this fore and retum It to the above addre... This IIClCDlIl1t Is taxabl. In .ccordance with the Inherltsnoa Tax L.. of the C_lth of Penneylvanl.. Questlon..y H __red by 0.111111I (717) 717-1527. COMPLETI PART 1 BELOW . . . SIE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 27949 let. 11-10-1999 ht_U8hIKI 151,558.83 16.667 25,260.31 .045 1,136.71 TAXPAYER RESPONSE Account 881-. P.l'C8ftt T._I. MIow'tt Subject to T. TIIX Rat. Potential T. Du8 To Insure prop.r credit to l/our __t, two (Z) copl.. of this notice ..at __._1lI l/DUr PQRI'It to the Register of 11111.. Milk. Clheck p.l/Sbl. tal "Reglstar of 11111., Agent". x IllTE: If tax ~ts .re .... within three (3) IIDI'Ith. of the dIIClacIIInt'. data of ....th, l/DU _l/ decIuot . SX dleoDlll1t of the tax due. Ml/ lnharltsnoe tax due wUl Hc_ deUnquent nine (9) .onth. .ftar the data of ....th. x PART ill . - . _ i r I M__ r:: I __ - - r; .fIWr_- _ _ -_-: "':-..I:-..;::--t!i.- :-i:;::_-Y.:--.lJ.:';:;-:?'l..-~::-j:::;':---_-:7:{:J.'i:~::;:S-:- _-l-:":!":f:'t.-:--_- _-:&_-J.---_ _---_::1=_ ::;.::-::- _:,.:-M - "t. 1___';:-.1_ _.f_-H-. __H_ - f_4:_~~-_:-:::__L_::__-::-::::;:r_"__:-_ I _\-j - 11- 1_:- -__ --_-__::-_--_ - _-.:- - _-:! _ M_:' _~ ~ :__J."'J.:....;:=t [CHECK ] ONE BLOCK ONLY A. 0 The above Infor.tlon end tax due Is correat. I. YOU.1Il/ Clhoo.. to r_It pe_t to the Regist.r of lUll. with two oopl.. of this notice to obtain . dlROlll'lt or .vold Int.r.st, or yOU a8l/ check box "A" end retum this notloa to the Regbtar of lUll. and an offlclel .s.....ant will be beued by the PA lIep.rtaant of Rav..... I. ~ Th. abov. ....t has been or will H reportad and tax paid !11th the Pennsylvanl. Inh.rltsnCltl Tax r.tum to be filed by the dlIl1l1d.nt.s represent.tlv.. c. 0 The ebova Info....tlon Is Incorr.ct and/or debt. end deduction. w.re peld by you. You wet cOIIPI.t. PART [!] end/or PART [!] b.low. If you Indlcat. a dlff.rant tax rat., pl..s. stat. your relationShip to dec~t: PART [!) TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. let. E.t_Ushed 1 2. Account Balance 2 3. Percant T..,I. 3 X If. AIIow1t Subject to Tax It 5. Debt. and Deductions S- 6. AIIount T._I. 6 7. Tax Rate 7 X 8. Tax Du8 8 PART [!I DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Ent.r on Line S of Tax eo.putatlon) . Under penaltl.s of perjury, I declar. that the fact. I heve r.,orted Mova are true, correct and SlY knowl", and b.U.f. HOME (7/7) 7~-'OI'I WORK ( ) ~ ClIIIlNIlEAl TH OF PEIIlSVLYAIIIA IIEPAII11UT OF IlEWlIJIE UIEAU IF INDIYIDUAL TAXES IEPT. 281601 HARRISBURG, PA 17121-0601 .. INFORMATION NO~E AND TAXPAYER RESPONSE FILE NO. 21 06-0261 ACN 06125429 DATE 06-02-2006 TYPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVA9E D SAVINeS S.S. NO. 172-34-4165 iii CHECKI" .DATE OF DEATH 03-10-2006 D TRUST COUNTY CUMBERLAND D CEItTIF. lEY-InS II If' elt-..l ,.--0," . 9ERALDINE M DENISON 908 GREENBRIAR DR MECHANICS BURG PA 17055 REMIT PAYMENT AND FORIIS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AllERICHOICE FCU hII. provlcllld the IIIIp.r-UwIt IIlth the Infor-eetlan lI.ted belDII IIhlah hII. been used In .Ioul.tlllll the potantl.1 tell due. Their- r-ecor-d. Indlc.t. that .t the cIII.th of the IIbov. dRedent, YOU II'A . joint _r-/beneflol.r-y of this _ount. If YOU feel this Infor-eetlon Is lnoor-r-eot, pl.... obtdn lIr-ltten cor-r-eotlon fr-. the flnenel.1 In.tltutlon, .ttech . oopy to this for-e and retum It to the ebov. edcIr-e...ThI. acoount Is tIllCebl. In ecoor-dIIno. IIlth the Inhllr-ltenGe Tex Lew. of the C_..lth of Pennllll'lvenl.. Que,tlon. -If be en_Ad bv..eelllllll (717) 717-1327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 27949 o.t. 11-10-1999 E.t_ushed Account hl_. Percent T8Xllbl. Mount Subject to Tal< Tel< R.t. Pot.tial TIPe Due x 6,249.26 16.667 1,041.56 .045 46.87 TAXPAYER RESPONSE To Insur-. pr-oper- oAdlt to yOU!" _t, two (2) copl.. of thl. notlCII su.t ~y your peyant to the Regl.ter of 11111.. MIlk. check peyabl. tol "RtIIIlst.r of 11111., Agent". x illiTE: If tell pe_t. .A .... within thr.. (3) aonth. of the decedent'. clllte of daeth, yOU aey deduc:t. 5% dl_t of the tell due. Any Inhllr-l tenc. tell due will beaeae delinquent nine (9) eonth. .fter the clllte of cIII.th. PART [!] ll,_ _ _ ___ _ _ _ _ ~ _ _ _ _ _ _ ri:~~~ - - _;_ _~--"l.-__4:---i:_-__-_:~l-'_ t..4:'t.j::~_:~!~:- j:,,~,~,:~~~~~~:: .;:_::__.;:_:~:_~:~~l }'f ~t_-:{:.{::~?i:_~:.! :~:~j:.-:;:t~--~~::1~~ ~~:__: ~4 _-;:tH~:-_- _: __ :i;: _M-__- :~~1j _ _ _ _ --- _ _ ___ . __ -_: -?- "~~_ A. 0 The IIbove Inforeetlon end t1uc due Is oor-r-sot. 1. You.1IY chao.. to r-_It p._t to the Reglst.r- of Wills with two copl.. of this notice to obteln . discount or- .vold Int.r-ut, or yOu BY check boll "A" end Atum this notice to the Reglst.r of Will. end en offlcl.1 u.e._t will b. Issued by the PA Dep.r-bent of Revenue. I. III The lIbov. ....t he. b_n or- 11111 be repor-ted end tall paid IIlth the Plll1l\sYlvenl. Inh.r-ltance Tex retur-n to be filed by the deClldent.. repr-e.ntetlv.. C. 0 The lIbove Infor-eetlon I~noorreot end/or- debts end dlIductlons lIer. p.ld by you. You w.t COJIplete PART l!..J end/or- PART [!] bela. PART If you Indlc.t. a dl ff.......t tlPe Mlt., pl.... .tat. your ~ rel.t1on8hlp to decedant: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Dat. Est_Ushed 1 2. ACCOW\t aalanc. 2 3. P.rcent Taxabl. 3 X 4. AIIount SubJ.ct to TIPe 4 s. Dabts and Deduction. S- 6. AIIount TIPe_l. 6 7. Tal< R.t. 7 X 8. TIPe Due 8 [CHECK ] ONE BLOCK ONLY PART [!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Ent.r on Line 5 of TIPe COIIputation) . Under penalti.. of perjury, I declare that the fllCts I have report.d IIbov. aMi true, corMlct and l.t. to the b..t of IIY l;.. ...d bell.f. HOME (717) 7U-VO/l WORK ( ) ~ alllNEALTH 1If PEIlNSYLVANIA IIIJIM'IllENT 1If IlEYEIIJE IUREAU 1If INDIVIDUAL TAXES IIEPT. 210601 HARRISBURG, PA 17121-0601 -. INFORMATION N04llE AND TAXPAYER RESPONSE FILl NO. 21 06-0261 ACN 06125431 DATI 06-02-2006 TYPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVASE 0 SAVIN8S .",S.S. NO. 172-34-4165 liICHECKINCI DATE OF DEATH 03-10-2006 0 TRUST COUNTY CUMBERLAND 0 CERTIF. REMIT PAYMENT AND FORtIS TO: RESISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 IIP-I14' a II' In-Ill GERALDINE M DENISON 908 SREENIRIAR DR MECHANICSIURG PA 17055 . AllERICHOICE FCU has pravldH the u.p.rt.nt IIlth the Inforntlon 11stlSd 11II1011 IIhlah h.. bHn uslSd In OIlloul.tlng the poUntl.l tu M. ~Ir records Indlnts that .t the ...th of the sIIove dH~t, you lI.r. . joint _r/beneflcl.ry of this _~t. If yOU hel this Inforntlon 18 Incorrect, plAn lIbteln IIrltUn correotlon frR the fllWlClI.l Institution, .tteoh . oopy to this fore ~ return It to the 1Ibov. ~.s. Thb _aunt 18 tlIJaIbl. In _o~ IIlth the Inharlt_ Tn L.... of the C__lth of PwlnQlV111lI.. Que.tlons _y 11II __rlSd by o.l11ng (717) 717-1327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS ACClOU'lt No. 27949 o.t. 11-10-1999 E.t_ushed 151,558.83 16.667 25,260.31 .045 1,136.71 TAXPAYER RESPONSE ACClOU'lt "l~ Percent Taubl. MIowtt Subject to Tex Till( IlIIt. Potentl.l Tex Du. To Insur. prop.r credl t to your __t, two (2) oopl.. of this notlo. .u.t ecClOllPW1Y your pe_t to the R..bter of II1Us. MIlk. ahllCk p.yebl. to: ....I.ter of Will., Agent". x x IIJTE: If tu pepmts .re ... IIlthln thrM (3) ~th. of the decMlent's dete of deeth, yOU _y deduct . S% discount of the tu ~. Any 1nhIIrltenctl tu M 11111 bIIo_ ..Unquent nine (9) .onths .fter the dete of ...th. PART ill - ~ ~ 1 ~ . . ~=:G-' _" ~ ~~: - ~ _'k::-::'::_ ::-_k~_: _~__ _- k::~ ~ -:. ~'f::- _ _ k_ - :~:_- _~~ :~-:,-~:~_'::_.:-_-~:;-_~_: -= __ ::__>~:_:=----~~:~_)-.:1_=i:)=~_M_3:-_:t_:~_.:-_~:.. _ __>_' ::~~:::: _ ~__~'1 :__J!j!~ E~-2~-~~ _1._ ~ _ _ ~~: ~~_:~: M~;:),,_~~t1 A. 0 The sIIove Inforntlon ~ tu due is correct. 1. You esy chaon to r_1t p._t to the Regist.r of WUls IIlth two copl.. of thb notice to obteln . discount or .vold Intsrest, or yOU _y aheck box wAw end return this notice to th. R..bt.r of Will. end en offlcl.l ..n...ent 11111 11II islUlSd by the PA llepertHnt of R.venue. I. (Q( The sIIoVII ....t hes bHn or IIU1 11II reportlSd end tlIx peld IIlth the PennsYlvenl. Inh.rlt8nce Tn r.turn 'P to btI fUed by the decedent'. repr...ntetlv.. C. 0 The ebov. InforRtlon is Incorrect end/or debts end deduction. wer. peld by you. You lIU.t COlIIP1.te PART 0 endIor PART I!l b.1011. PART If you IndlCllt. e dlff.rent tex ret., pl.... st.t. your I!l rel.tlonshlp to cleCllclent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Dat. Est_llshed 1 2. Account 8.l~ 2 3. P.rcent Tex_l. 3 X 4. Mount Subj.ct to Tex 4 S. Debts end Deductions 5- 6. Mount T.xabl. 6 7. Tex R.t. 7 X 8. Tex Du. 8 [CHECK] ONE BLOCK ONLY PART [!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Ent.r on Une 5 of Tex COIIput.tion) . "'r penaltl.. of perjury, I decl.re that the fIlCh I hav. reported Mtov. .re true, correct end l.t. to the best of IIY ~ledge end bell.f. HOME ( 7/7) 71~- ~" WORK () II/ot/. DATE CUIIIlINIEAI TH IF ~LV"'IA IDAR11lEHT IF REWIIIE UlEAU IF DIlIVIIlUAL TAXES DEPT. 210601 , HARRISIlIRO, PA 171Zl-D601 ~ INFORMATION NO~ AND TAXPAYER RESPONSE FILE NO. 21 06-0261 ACN 06125433 DATE 06-02-2006 TYPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVAGE 0 SAVIN8S S.S. NO. .' 172-34-4165 0 CHECKI" DlD OF DEATH 03-11)-2006 0 TRUST COUNTY CUMBERLAND IX] CERTIF . RE"IT PAYHENT AND FOIHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 1EY-1I41 n tIP :."1 . . GERALDINE M DENISON 908 GREENBRIAR DR MECHANICS BURG PA 17055 AllERICHOICE FCU has provided the hpilrt.nt with the Info....tlan U.tlld belDll IIhlah hII. bHn uslld In ClIIloul.tlntl the pobntl.1 tex clue. Their reoord. IndIDt. thet .t the dAth of the IIbovII Malldent, you ...n a joint _r/benaflal.ry of this account. If YOU feel this Info....tlon Is Inoornot, pl.... obteln wrltbn corraotlon fr_ the fI_I.1 In.tltutlon, .tteah a copy to thl. fore .... nturn It to the above 1Iddn... this _t Is teobl. In _rdeno. with the Inh.rltenca Tex L.... of the C__lth of P....sylvenl.. lIua.tlon. _y be an_neI blI- ealUIllI (717) 787-1527. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 27949 ht. 05-03-2001 Estllbllshec:l x 111801.22 50.000 51900.61 .045 265.53 TAXPAYER RESPONSE To Insure proper cnell t to your account, two (2) copl.. of thls notlc. ...t eccoep8l1lf your pelfSant to the Raglst.r of lUll.. "-k. check PQSbls to: "Aaglst.r of lI11b, Agant". Account Balence Percent TlUIlbl. MIount SWJect to T.x Tax ht. PotenU.l T_ Due x NOTE: If tex ps_t. .1'lI Ada within thr.. (;5) IIDI1th. of the decedent'. cIIIte of cIIIeth, lfDU _y deduct. 5% dlscDlll1t of the tex due. Any Inharl tenc:. tex clue will baooM deUnquent nine (9) eonth. after the dete of de.th. PART [!) :~~! ili~ .i:~~j ~_ :-(~.._ ~ ~~-: t?'~_~~~_ ~_~~:::- l. ~ -~~_/ _ ::-:-~~- ~}:3 j~~-.;~ _ ~ ~ -- J -~~~-f;:::~ _ _::_~r.=_: _k_ M_ ~-~~ Jj: ::~:-:J_:;M-~-l:,~:- - _,_':{ :::-~:::t:Y:-~-::~~:.t:~l:~~ ~:-~~:_~ _-::::.--j: ~ ~--~~'::{-- ~-i::-_,:::;)~--!: ';'-~:'''~~-4fii A. 0 The IIbcv. Infc....tlcn .... tex dull Is ccrrect. I. You II1Ilf chao.. to r_lt p~t to the Aaglst.r of IIl1b with two copl.. of this notice to obteln . dl~t or avoid Int.ra.t, or lfDU _y chac:k box "A" end nturn this notice to the Register of 1I111s and an official .....ssent will be I.sued by tha PA Dap.rtsant of Revenue. I. IV The IIbova ....t hII. blltlll or will be reported and tex PlIld with the Pamsylvenl. Inhllrltence Tex r.turn !PI to be flied by the denclllnt'. rapranntetlva. C. 0 ThII IIbove Infa....tlcn Is Incorrect and/or debts end dllductlcns wan peld by you. You SlId coepl.te PART [!] and/or PART [!J belDII. PART If you IndlCllt. . diff.rent t.x ret., pl.... .t.t. your [!] ...l.Uonshlp to decedent: TAX RETURN .. COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. ht. EstllbUshed 1 2. Account B.l~. 2 3. P.rcent T__l. 3 X ... Mount Subject to T.x If S. Debts end Deductions 5- 6. Allount T__l. 6 7. Tax R.t. 7 X 8. Tax Due 8 [CHECK ] ONE BLOCK ONLY PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Ent.r on Line 5 of T_ COIIPUt.tlon) . Under peneltl.. of perjurYI I daol.r. that the .1 rl~t~ t~ t~ be.t of ji) knowl~ end beU.f. ~1ffN~ ~~,...~ fect. I hev. raported IIbov. .... truel correct end HOME ( 7/") ~~ ~" WORK ( ) TELEPHONE NUMBER " 1./o( DATE ClIIICINlEAL TH OF PINIlSYLVNlIA IlENRTflENT Of REVENUE IUREAU OF INDIVIDUAL TAXES IEPT. 210601 HARRISIUAC. PA 17121-1'01 e. INFORMATION NO~E · AND TAXPAYER RESPONSE . FILE NO. 21 06-0261 ACN 06125432 DATE 06-02-2006 TYPE OF ACCOUNT EST. OF MILDRED A ANDRUSCAVAGE 0 SAVIN8S S.S. NO. 172-34-4165 D CHECKI_ DATE OF DEATH 03-10-2006 0 TRUST COUHTY CUMBERLAND Ii] CERTIF. RIMIT PAYltENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013' .'-1141 EI U, 1......1 GERALDINE M DENISON 908 GREENBRIAR DR MECHANICSBURG PA 17055 AltERICItOICE FCU 111I. provided the o.p...t.nt ..Ith the Inforlllltlan U.ted b11law whloh has bIIM used In oaloul.tlng the paantl.1 to dIM. Th81.. .._rd. IndlOllt. thet .t the ..th of the aboV8 dea8dent. YOU ...... . joint _..lbIIneflcl.1"Y of this _oount. If YOlI feel this Info....tlon Is Inco...-.ct. pl.... abtaln ....It ten co..rwctlon froe the fl_l.l In.tltutlon. etteoh . copy to thl. fa... end ...turn It to the abov. ecId...... Thl. ~t Is taX8bl. In eccordsnc. ..Ith the Inhe..ltMM Tex L.. of the C_.lth of Penn.lIl"...I.. lIuestlon. _Y b. __...d II)' c.tUI'llI (717) 787-11527. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 27949 DIIt. 06-01-2001 Estllblbhed Account B.l.-,o. Pel'08l'lt Tullbl. Miount Subject to T.x Tex Rat. Potenti.l Tex Due x 11,772.42 50.000 5,886.21 .045 264.88 TAXPAYER RESPONSE To Insu... P""" ol"ecll t to YOU" _count. two (2) copl.. of this notl. ...t -llIIP8IlY lIDU" P8l/IIW1t to the R..lsta.. of 11111.. 1lIIk. check peyeble tol "R..lste.. of 11111.. Agent". x IllTEI If tax pqe.-.ts .... 8ecIe ..Ithln th.... (3) mnth. of the deoedwIt.. dllte of deeth, lIDU 8Q deduct . 5% dlsoClUl1t of the tax dIM. Any Inhel"itenos tax due ..Ill bII8eR delinquent nine (9) 8OI'Ith. .fta.. the ate of de.th. PART [!I I;; ~ ~ ~~ ~ ~ ~M ~ _~ ___~ _ _ _ _ _ r _ __~ __ __ ~'1," ~_ .:~:::j::-::t:fd:i ~M:j:-fk~:~~M ~::::~:1J"1:~~~:L1il}-~i..2_~~1:j:::it:M:~~ 1 _ ~~::.r~~:_t~::~~:r_: ~~:.t_~' ~~-:. M_: _: ;_,_:; ~T J; j -'" ~ ~ I . I ___ ' - ~ : _ _: __ 1 ~ ~ I;::~%~ A. 0 The ebov. Info....tlon end tax due Is co....ect. 1. You -1I choo.. to ...It p.l/8Snt to the R..lst... of 11111. ..Ith two oopl.. of this notlw to abteln · discount 0" .vold Int.....t. 0.. lIOU _1I check box "A" end ...turn this notice to the _1st... of 11111. end _ official .........t 11111 be Issued bll the PA D..,...teent of Rev__. I. IQ The above ....t 111I. been 0" 11111 bII ....,o..tad end tsx paid ..Ith the PennSl/lv_l. Inhe..It_. TIIlC r.tum ~ to be fUed by the decedent.. ....,.....nuUv.. c. 0 The ebov. Inforlllltlon Is Inco....ect endIo.. debts IIIld deduction. ...... p.ld by YOU. You suet co..,let. PART [!] endIo.. PART [!] billow. PART If you indicet. . dlff.rent tex r.t., pl.... st.t. your I!J r.lationship to dececlent: TAX RETURN - COMPUTATION OF TAX ON JOINT'TRUST ACCOUNTS LINE 1. o.t. E.tllbllsh11d I 2. Account 8.1ence 2 5. Percent Texabl. 3 X 4. Aeount Subj.ct to T.x 4 s. Dabts and D.ducUons S- 6. AIIount l.xabl. , 7. lex R.te 7 X 8. Tex Du. 8 [CHECK ] ONE BLOCK ONLY PARl [!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I I TOTAL (Ent.r on Line S of Tex CotIPUt.Uon) . Under penelU.. of perjury, I decl.... thet the fects I hey. reported IIboY. .... true, correct and l.t. to the b..t of IIY know~ecIge and bell.f. HOME (7/7) -?~~_~" WORK ( ) "/./,,, DATE