HomeMy WebLinkAbout01-02-07 (2)
---I
15056051047
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFRCIAL USE ONLY
County Code Year
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Date of Birth
Decedent's Last Name Suffix
Decedent's First Name
MI
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
.. 1. Original Return
<=>
<=> 4a. Future Interest Compromise (date of
death after 12-12-82)
<=> 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
<=> 10. Spousal Poverty Credit (date of death <=> 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT _ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Number
<=>
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
<=>
2. Supplemental Return
<=>
<=>
4. Limited Estate
-
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
~
8. Total Number of Safe Deposit Boxes
Second line of address
.~-' <~)
.en
iil
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of rny knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
.-- ~ -(
PLEASE USE ORIGINAL FORM ONL
Side 1
L
15056051047
15056051047
--1
cc
~
15056052048
REV-1500 EX
Decedent's Social Security Number
9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . .
9.
1. Real estate (Schedule A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3.
4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5.
6. Jointly Owned Property (Schedule F) c::> Separate Billing Requested . . . . . .' 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c::> Separate Billing Requested.. 7.
8. Total Gross Assets (total Lines 1-7)
................................ .
8.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10.
11. Total Deductions (total Lines 9 & 10).... . .' .. .,. ..... .. ..' .......... ... 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13)
................. .
. . . . . . 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spoLlsal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .0_
16. AmoLlnt of Line 14 ta}a~e
at lineal rate X.O ~
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
18.
15.
16.
17.
19. TAX DUE. . . . . . . . . . . . . . . . . . . .
................................ .
. . . . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
<=>
Side 2
L
15056052048
15056052048
.-J
REV-15Q() EX Page 3
File Number :Z-/-c!& ~~9'y~
Decedent's Complete Address:
DECEDENT'S NAME
SmEEkD~%f/'P-- Y-~/7fUsr-7-------- - -._- - --- ---.
-~-l9C-4:~C::: /4;ec- ~A:LZ~----~-~---------~----- -------------------
_._~----_._-_._-~~~._----,_.---_._---~_.,._-----_._._--_.----.--.------~_. --~---~--~'-..,.-'-'------'
CITY
i STATE
I
I
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
__n___.__. I
Total Credits (A + B + C )
(2)
(3)
(4)
(5) .317-7/
(5A)
(5B) :?/1--1/
3. InteresVPenalty if applicable
D. Interest
E. Penalty
--~------ ----..----------- Total Interest/Penalty ( 0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
i ZIP
t?/.3
J/ 'J-.-'/ /
,
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or.......................................................................................................................... 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
3. ~:~h~~~:~~~~:~na~~~,~~:~u~~~~~~:ra~~~:~;~ .~~~~ .~~~;~. ~~~~ .~~;~.~.~.; .;;.~~;~.;i;~. ~;. .~;~. ~~. .~~; .~.~~;~.;:::::::::::::: ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ 0
No
ill
~
~
o
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent (72 P.S. S9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. S9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an
adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. s9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. s9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-l508 EX -(1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
~/-C7~ -O'~.y&
ESTATE OF
.r .i.:-~i';?-- ~ C #-,/( /~ I
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. ~5~P - /f/c:;,-{~, e-?'t" 7-C' ':Z-7-' ~ 7?
l-t) S'-6' I ;V:6..!.L/1~ Sh4h-:s' ~d73
.j{) S-&J.( ?rf,.c-Z-~A./6' ~hf~? /7 (;, 3 I
/C) 5'--<'>7 ~1o/t~Y #/lt1k'-r Ii ::I~2 Z-
d) -5-~~o ?~~/;/7c:-/hf5hfk:} ;z.o) / &, q-
e-) S'-:f/' b-7<71/7c,4fr.--'=;fr/f#3 /......
/ (} I -z..5'-:7
/4~77-'10.: #-f7f-z:~ ~-(;c-N' tf
l) (l5~-:-~/ ~J';t~? p4c1: /o/fo&
z..) dp/1',R{, C9 /;:::: r /1- It~""- -y'- /~.?~
~6/l~*&~~7fl;<'fflF!f
/?c-57 tb/V'5~F ( ~ 'J
TOTAL (Also enter on line 5, Recapitulation) $ J3;91'c;
(If more space is needed, insert additional sheets of the same size)
PSEIJa
October 24, 2006
Account # 8002029679
JANEEN CHRIST
324 4TH STREET APT A
NEWCUMBERLAND,PA 17070
Dear MS CHRIST:
The following is the status of JESSIE I CHRIST's account with PSECU as of the date of death.
Joint Owner's Names
Date of Death
Date of Birth
JANEEN CHRIST EMILY AUSTIN
08/04/2006
12/18/1922
Share
SOl
S 04
S 07
S 50
S 51
Description,.
Regular Shares
Checking Shares
Money Market
Certificate Shares
Certificate Shares
Open date
11/28/2005
11/28/2005
12/02/2005
01113/2006
01/1312006
Balance
$ 402.87 i-
$ 1631.10 i-
$ 1,521.03 +-
$20,160.29 i-
$10,223.47 +
Accrued Dividend
$ 0.08 -
$ 0.02 :::
$ 0.74 -
$ 7.77 .-
$ 31.69 -
7;-&L
,yn. f'f
I,G3/ /J-
/I'~'~ 1?
:J..d/ I &~, ,9(;;,
/~I J.jf:/'
> The dividend earned fromJan the date of death was $ 1,103.85. The decedent had no loans
with us. We do not have safe eposlt xes or our me rs. If you have any questions, please call 234-8484 in
Harrisburg or our toll-free number, (800) 237-7328. At the menu prompt, enter 6 and then extension 2227.
Sincerely,
)fw 0JcJ:;lu\
-Sue Walter
Member Service Representative
Finance Support Unit
.
Pennsylvania State Employees Credit Union
Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 . 717.234.8484 . 800.237.7328
Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013 . 717.777.2100 (TDD) .800.472.1967 (TDD)
COMMDNWEAL~H OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
06149552
09-26-2006
REV-1545 EX AFP 109-00l
JANEEN CHRIST
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST ~~$,f5 [X] SAVINGS
S.S. NO. 333-20-5167 Set 0 CHECKING
DATE OF DEATH 08-04-2006 0 TRUST
COUNTY CUMBERLAND 0 CERTIF.
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU has provided the Department with the inforBation 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 Pennsylvania. Questions may be answered by ceIling (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679
Date
Established
11-28-2005
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
402.95
50.000
201.48
.045
9.07
TAXPAYER RESPONSE
NOTE: If tax payments are Bade within three
(3) months of the decedent's date of death,
you Bay deduct a 5X discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[] The above inforBation and tax due is correct.
1. You Bay choose to reBit paYBent 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 cOBplete PART ~ and/or PART ~ below.
x
If you indicate 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. 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
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of
ete to the be~t.of
- /
,. ""
perjury, I declare that the facts I have reported above are true, correct and
knowledge and belief.
HOME
WORK
(
(
COMMONWEALfH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACN 06149553
DATE 09-26-2006
REY-1545 EX AFP (09-00l
EMILY AUSTIN
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
TYPE _9J ACCOUNT
EST. OF JESSIE I CHRIST !:fZ:5'j() !Xl SAVINGS
S.S. NO. 333-20-5167 5&/ 0 CHECKING
DATE OF DEATH 08-04-2006 0 TRUST
COUNTY CUMBERLAND 0 CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU 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 PennsYlvania. Questions may be answered by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
x
402.95
50.000
201.48
.045
9.07
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: nRegister 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
[!I
[CHECK ]
ONE
BLOCK
ONLY
A. 0 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 nAn and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
8. ~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. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
x
If you indicate 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. Amount Subject to Tax
S. 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
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
perjury, I declare that the facts I have reported above are true, correct and
knowledge and belief.
HOME
WORK
( )
~-:7/~_?n ?,?'~/9'&;
,~~6Ai?
CDMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B060l
HARRISBURG, PA l7l2B-060l
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
06149550
09-26-2006
REV-15~3 EX AFP (D9-DD)
JANEEN CHRIST
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST 0 SAVINGS
S.S. NO. 333-20-5167 9~ IXJCHECKING
DATE OF DEATH 08-04-2006 0 TRUST
COUNTY CUMBERLAND 0 CERTIf.
REHIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU has provided the Department with the info~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 form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of PennsYlvania. Questions ~y be answered by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679
Date
Established
11-28-2005
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
Tax Rate
Potential Tax Due
x
1,631.12
50.000
815.56
.045
36.70
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.
x
PART
(!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
c=J The above information and tax due is correct.
I. 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.
c=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
l!J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate 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. 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
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL lEnter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the
c~lete to the. bestof,y knowledge and belief.
W/A'/#AA dt:/;N
facts I have reported above are true, correct and
HOME
WORK
( ) ~
(;7/;1'.).. ~~?"-- /j730
.~~M
COMMONWEAlTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
06149551
09-26-2006
REY-15~5 EX AFP 'D9-DDl
EST. OF JESSIE I CHRIST
S.S. NO. 333-20-5167
DATE OF DEATH 08-04-2006
COUNTY CUMBERLAND
s~1/
ACCOUNT
o SAVINGS
[X] CHECKING
o TRUST
o CERTIF .
TYPE OF
EMILY AUSTIN
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU 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 Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
x
1.631.12
50.000
815.56
.045
36.70
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice .ust acco.pany 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.
kJ(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.
x
If you indicate 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. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
x
PART
[!I
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
of perjury, I declare that the facts I have reported above are true, correct and
now ledge and belief.
HOME ( )
WORK (?'/?'?'& /~
. --. - -- ... -- . '
/~~4
,. .... ....-
CDMMONWEAL~H OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
XNFORMATXON NOTXCE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACN 06149547
DATE 09-26-2006
REV-1545 EX AFP [09- DO)
EST, OF JESSIE I CHRIST
5.5. NO. 333-20-5167
DATE OF DEATH 08-04-2006
COUNTY CUMBERLAND
~F
ACCOUNT
[iJ SAVINGS
o CHECKING
o TRUST
D CERTIF ,
JANEEN CHRIST
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PSECU 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 Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679
Date
Established
11-28-2005
To insure proper credit to your account, two
(ll copies of this notice .ust acco.pany your
payment to the Register of Wills. Make check
payable to: ftRegister of Wills, Agentft.
x
1.521.77
50,000
760.89
.045
34.24
TAXPAYER RESPONSE
NOTE: If tax payments are made within three
(3) months 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) months after the date of death.
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
c=J 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 ftAft 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
~o be filed by the decedent's representative.
c=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
x
If you indicate 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. 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
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury. I declare that the facts I have reported above are true. correct and
c~",let~ to the b~... o~ Y AnOWle..dge and belief, HOME ( ) ~
h~~ ~~l2f5L.. WORK ('?/'T)Z7..y-/9k' /~-~ .
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT DF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACN 06149548
DATE 09-26-2006
REV-1545 EX AFP <09-001
EMILY AUSTIN
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
~YlE OF ACCOUNT
EST. OF JESSIE I CHRIST f1;'tf. [i] SAVINGS
S. S. NO. 333-20-5167 '1'111 0 CHECKING
DATE OF DEATH 08-04-2006 0 TRUST
COUNTY CUMBERLAND 0 CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU 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 PennSYlvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
x
1,521.77
50.000
760.89
.045
34.24
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
Tax
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 5X discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) Months after the date of death.
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 ebove 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
[!J
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3 X
4. Amount Subject to Tax 4
5. Debts and Deductions S
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties
;;;:~ the best
perjury, I declare that the facts I have reported above are true, correct and
nowledge and belief.
HOME
WORK
(
(
COHHONWEALtH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1712B-060l
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
06149545
09-26-2006
REV-15~S EX AFP '09-001
JANEEN CHRIST
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST 0 SAVINGS
S.S. NO. 333-20-5167 o CHECKING
DATE OF DEATH 08-04-2006 0 TRUST
COUNTY CUMBERLAND,5"-j1; 00 CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU 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 Pennsylvania. Questions may be answered by calling (717) 7B7-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
x
20,168.06
50.000
10,084.03
.045
453.78
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
Tax
NOTE: If tax payments are made within three
(3) months 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) months after the date of death.
PART
ill
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
c=J 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
~o be filed by the decedent's representative.
c=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
x
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION OF
lINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
S. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT/TRUST ACCOUNTS
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on line S of Tax Computation)
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
co"te t~ the ~ies;, Of... ~y ~n~edge and belief. HOME ( ). ~ _ / "
Lk/~v)a.. /kA/;'L~/ WORK (~/?').?''7~- ,/?:~O /0 J/~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT DF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ZB0601
HARRISBURG, PA 171Z8-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
* REVISED NOTICE * * *
FILE NO. 21
ACN 06149545
DATE 10-05-2006
*
REY-1543 EX AFP 109-00)
** JANEEN CHRIST
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST 0 SAVINGS
S.S. NO. 333-20-5167 o CHECKING
DATE OF DEATH 08-04-2006 /" 0 TRUST
COUNTY CUMBERLAND 5~jO [X] CERTIF.
1:>,,~Ift~~~ REHIT PAYHENT AND FORHS TO:
__ REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
~ CARLISLE, PA 17013
PSECU has p~ovided the Depa~tment with the info~mation listed below which has been used in
calculating the potential tax due. Thei~ ~eco~ds indicate that at the death of the above decedent, you we~e a joint owne~/beneficia~y of
this account. If YOU feel this info~.ation is inco~~ect, 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 Pennsylvania. Questions may be answered by callir~ (717) 787-83Z7.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
x
14,168.06
50.000
7,084.03
.045
318.78
TAXPAYER RESPONSE
To insure p~oper credit to your account, two
(Z) copies of this notice must accompany you~
payment to the Registe~ of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
Tax
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 51. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
ill
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[J The above information and tax due is co~rect.
1. You may choose to ~emit payment to the Registe~ of Wills with two copies of this notice to obtain
a discount or avoid inte~est, 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 o~ will be ~epo~ted and tax paid with the Pennsylvania Inheritance Tax retu~n
to be filed by the decedent's rep~esentative.
[J The above information is inco~~ect and/or debts and deductions were paid by you.
You must complete PART ~ and/o~ PART ~ below.
x
If you indicate a different tax rate, please state your
relationship to decedent:
PART
@]
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1.
2.
3.
4.
5.
6.
7.
8.
Date Established
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Amount Taxable
Tax Rate
Tax Due
1
2
3
4
5
(,
7
8
x
PART
l!l
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief. HOME ( )
WORK ( )
---
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21
ACN 06149546
DATE 09-26-2006
REY-1545 EX AFP 109-00)
EMILY AUSTIN
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST 0 SAVINGS
S. S. NO. 333-20-5167 0 CHECKING
DATE OF DEATH 08-04-2006 0 TRUST
,/
COUNTY CUMBERLAND .5' -fO [X] CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU 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 Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679
Date
Established
11-28-2005
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
20,168.06
50.000
10,084.03
.045
453.78
TAXPAYER RESPONSE
NDTE: If tax payments are made within three
(3) months 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) months after the date of death.
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
PART
ill
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
~o 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.
x
If you indicate 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. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
OF
1
2
3
4
S
6
7
8
x
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCR I PTI ON
AMOUNT PAID
I
$
TOTAL (Enter on Line S of Tax Computation)
perjury, I declare that the facts I have reported above are true, correct and
knowledge and belief.
HOME
WORK
(
(
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
* REVISED NOTICE * * *
FILE NO. 21
ACN 06149546
DATE 10-05-2006
*
REY-15~5 EK AFP 109-001
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST 0 SAVINGS
S.S. NO. 333-20-5167 0 CHECKING
DATE OF DEATH 08-04-2006 ~ 0 TRUST
COUNTY CUMBERLAND 5>)it/ !XI CERTIF.
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
**
EMILY AUSTIN
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
.",11#
~ "t1'~
PSECU 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 Pennsylvania. QUQstions may ba answered by c~lli~~ (717l 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
14,168.05
50.000
7,084.03
.045
318.78
TAXPAYER RESPONSE
x
Tax
x
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
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".
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 5X discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
[] 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.
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.
[] 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 tax rate, please state your
relationship to decedent:
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
DEBTS AND DEDUCTIONS CLAIMED
PART
[!]
DATE PAID
AMOUNT PAID
PAYEE
DESCRIPTION
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
COllplete to the best of my knowledge and belief. HOME ( )
WORK ( )
COMMONWEALTH 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
06149543
09-26-2006
REY-1545 EX AfP 109-00'
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST o SAVINGS
S.S. NO. 333-20-5167 o CHECKING
DATE OF DEATH 08-04-2006 ,-. o TRUST
COUNTY CUMBERLAND S.-pl !Xl CERTIF.
** JANEEN CHRIST
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU 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/benaficiary 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 Inharitance Tax Laws of the Commonwealth
of PennsYlvania. Questions may be answerad by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
,-::'/' , /
/(:h 1-?~ -It?
'X
X
4,226.86
50.000
2,113.43
.045
95.10
TAXPAYER RESPONSE
To insure propar cradit to your account, two
(2) copias of this notica must accompany your
paymant to tha Ragistar of Wills. Maka chack
payable to: "Registar of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
Tax
NDTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 5% discount of tha tax due.
Any inheritance tax due will become delinquent
nine (9) months after the data of death.
PART
II]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[J 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 Revanue.'
~The above asset has been or will be reported and tax paid with the PennSYlvania Inheritance Tax
~ be filed by the decedent's representative.
[J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
return
X
If you indicate 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. 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
)(
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the
~~lete to ther~o~;.y knowledge and belief.
f..,h/.,a~_~hA /...,_~'/;2
facts I have reported above are true, correct and
HOME
WORK
( )
(~"7 ) 7'7~ /~Z>
~J
.{'~ Itt
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21
06149544
09-26-2006
REV-1S~5 EX AFP <09-00)
** EMILY AUSTIN
APT A
324 4TH ST
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
EST. OF JESSIE I CHRIST 0 SAVINGS
S.S. NO. 333-20-5167 0 CHECKING
DATE OF DEATH 08-04-2006 /' 0 TRUST
COUNTY CUMBERLAND ..5'-,> I IX] CERTIF.
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU 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 Pennsylvania. Questions may be answered by calling (71/) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8002029679 Date 11-28-2005
Established
/0 ~5g~/t
x
4,226.86
50.000
2,113.43
.045
95.10
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) copies of this notice must accollpany 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
Tax
NOTE: If tax payments are made within three
(3) months 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) 1I0nths after the date of death.
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. 0 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.
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
~o be filed by the decedent.s representative.
c. D The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
x
If you indicate 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. Amount Subject to Tax
S. 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
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties
complete to }he best
,
declare that the facts I have reported above are true, correct and
and belief.
HOME
WORK
(
(
REV-1510 EX + (1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
i .- i ,~
__J~'5$M~....L-. c: ;tf /5/
FILE NUMBER
2-/-06 -O~J'I?
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV -1500 COVER SHEET is yes_
/
'-
DESCRIPTION OF PROPERTY %OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE Of TRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE
ATTACH A COPY OFTHE DEED FOR REAl ESTATE_ VALUE OF ASSET INTEREST IF APPliCABLE)
NUMBER
1- j7,w.&?< /c/1/tf n."/L/D~ -~ A~At6', 73 "Z1''f't:';: V"
~- cl) 6f~ti;fh /7/,t{ b crfllf~. /7tP~ /C/C? :3(('9(;:0 C" ---
~ _700
{lJ - ~) +5~,~t: c;;4t tf:&tfLb/Yft /~i-d 0 ([)
( /~ 3i~ /7-; 0G-'t9
'/ -- ~.) /I-~f~.:;t? rC/f/V' #J,/ /, ~CI I
/ CJr Ct9<D /c~O /0cY6CO
"I) ~;111 i!-L<<Jc,dif~
-- /O-(!7 /
.:J I{~ .2 tJOO
~~~;'l'-1'.c- /G I
e) 7// ~/Lld/;;zIcJ r /hf( . 71 ,5'1.90 /(;?-CJ t:-?~
< /<.) ~- ;vjO;Vt&-(A'1< ~~ ~:/
/f~(/~~N'~ (O/f.?#~~
..-.-? . J/1-~-?(//f, ~~r:l5r (Mt )
(& r
~;4t(/y'AtI51//v (6~ ))Ift/ .
04; /1/7-IU~({;,
TOTAL (Also enter on line 7, Recapitulation) $ ~,r; OOD
..
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99) _
,.&
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
___(,e--:sJ:;/Y r ?"k,R/sT
Debts of decedent must be reported on Schedule I.
FILE NUMBER
2-/-cY&> ~cJ'C/ jL~
ITEM
NUMBER DESCRIPTION AMOUNT
A. ~RAL EXPENSES:
1. ./"0/?~5'r#'.A/~/(/1-L. /&ttrA'--r; #dv! IS ~kijJ fl /1 "Z-f-"J--
C ?"p-n4h'c::AI') . . .
t-- ~ fif~VMflflSr /r~Mr;drVla~ I:y /c;70
3, /"'#.65~J;i?$C-"'fIM<",A/ v.--5r:<<. . 1m
;, !3;J,<!IA-,L ~V/Ck"'?-13rCtlfr?tX-~m&;&-?Va~/>r
(/9/f; / .WV~~/~ ~) &-itd")
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State _Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as ciaimant's, attach explanation)
Claimant
Street Address
City State _Zip
Relationship of Claimant to Decedent
4. Probate Fees; /?:-~(>6?t tPrtZ~~ - 4<~~~ U/tI)) C!cJl##,y- 11'3
5. Accountant's Fees I ~(!)I7A! I~' &t<'c;"I'4 '2-( 3 .-.; 7
6. Tax Return Preparer's Fees (f;1- /0 II! UJo6) /':l?'-
#~ct'c;/JL- .- ~/113 72.>T .--
7. ~("
c:g', P=-~z.tj I/</x - #?J /' Cf F !t?C54.:~ )(~f5~-S z.-k:J
1- ;t-C;:uJt,'r/ ;7t.,I1/'T - tt%J P I~;be:: Kcr-/~'-X f~;;v'~~-:T:;- ~/
TOTAL (Also enter on line 9, Recapitulation) $ ~-:-zqq
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00*,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
NUMBER
I
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
~1tc~-;:-A/ ;"-1. cf.lrlflS'/
3~f' f& slAIn:?
~=-t() citAAc1<.4:W~/fl1 //o'/c
FILE NUMBER
2-/ - t.Jl~ .- Cl
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
IJ-/4t1
t
AMOUNT OR SHARE
OF ESTATE
/VC!'%
~--;>/d':/~--
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TEST AMENT
OF
JESSIE 1. CHRIST
I, JESSIE 1. CHRIST, now domiciled in Cumberland County, Pennsylvania, declare this to
be my Last Will. I revoke all other Wills and Codicils that I may have previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
including any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement from any
person. This provision is not a waiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of any property over which I have the power
of appointment.
AUSTIN, successor Executrix of my Last Will and Testament. I direct that my Executrix or
successor Executrix be permitted to serve without bond. In addition to those powers granted by law, I
grant them power to distribute in cash or in kind, in like or in unlike shares, and to file any qualified
disclaimer I could have filed ifliving. My Executrix or successor Executrix shall receive reasonable
compensation for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Executrix or successor Executrix
in her absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate
or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such return
prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
_3_
I, JESSIE I. CHRIST, Testatrix, who signed the foregoing instrument, having been duly
qualified according to law, acknowledge that I signed and executed this instrument as my Will, and
that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
JESSIE I. CHRIST, the Testatrix,
on t2 ,2005.
r-- ~f.E..Y 5-; -;.? L C /1 Yf / .:> r
J~SIE I. CHRIST
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Marielle F. Hazen. Notary Public
Susquehanna Twp_, Dauphin County
My Commission Expires Sept. 23, 2006
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
by ~-rfSBlC(l f1 Hot (cLrol
and t'rn OJ. .. <;n., I~ ,
witnesses, on /I - c.M.
,2005.
/i-::R QJJilAC'o. < ~, <t'~Q (Lru)
~71L#
1 n ss
u1jll;Aiir~
o ry Pu 1
5
COMMr'NWEAlXH OF PENNSYLVANIA
Notarial Seal
Marielle F. Hazen. Notary Public
Susquehanna Twp.. Dauphin County
My Commission Expires Sept. 23, 2006