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Home My WebLink AboutOC1971-0329 - ESTATE OF THOMPSONFonn RCC-2 . ' ~ COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE ...... ~t9h .. ).QJ ..... +.9.7.! .................................. . DEPARTlUENT OF REVENUE BUREAJ7 OF COUNTY COLLECTIONS HARRISBURG, PENNA. 17 1 2 7 COUNTY ...... Yf~.~-~.:if.J:~.~.?..~ .......................................... . FILE NO .... ?.?:?.~:?..~.?. .................................................... .. Whereas, ......................................... ~f3.~.~~ .... W.~ ..... ~.hg~p~-~~ ............................................. late of ..................... ~~-~~!Y.~~ .................................................. . in the County of .............................. Washington ..................................................................... Commonwealth of Pennsylvania, having died on the .......................................... .l.9t..h ....................................... day of .................. ~~Y..~P.E3,~ ................................ 19 .. 7.9.. .. , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ................................ FRIDJC:ES .... L.E.O ............................................................... , an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Unit Appraisement Description of Asset Values Made for Inheritance Tax Purpoaes $ Jt. S;tvi ngos' A ;{ #29270 held in the ~~JESTERN PENNSYLVANIA NATIONAL BANK. MONONGAHELA OFFICE, MONONGAHELA, PENNSYLVANIA. In the names of JENNIE If. THOMPSON OR RUTH T. LONG. Opened 11-13-59. Balance as of date of death. $1,590.92 1,590 92 total 1,590 92 Jt. Sa.vinas Account. held in the WESTERN PENNSYLVANIA NATIONAL BANK, FINLEYVILLE OFFICE FINLEYVILLE PENNSYLVANIA. In the names of JENNIE W. THOMPSON OR MARGARET T. ALEXANDER. Opened, October 17, 1959. Balance as of date of death, $1,831.96 1,831 96 + "+"' 1 1 ~~, q(., -., Having been duly sworn according to law, I do h~reby certify that the above appraisement is made in con- formity with law on thiB .............. ~Q~ ..... day of ............ ·········~·········cp_·········· ..... ~-· ............................................ ~.~ ....... ~ ............ Ap raiser ···································••::eJrz~;~~)· ........................................................... Penna . ............................... , (Poat ee) WASHINGTON County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of JENNIE W. THOMPSON ........................ ······································································ Deceased. Late of ....... FINLEYV.lL.L.E. ............................................................. . Date of Death, .................... 11~~9~.70 ................................ .. Appraisemel!t Docket Vol., Page, 63-71-329 Filed in Register's Office, ....... l.':l~~~~ .... .?.9. .... J9..7:J..:. Amount of tax due $ I ·······························•····································• DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appraisement, Appeal j1'om Appraisement, Entered and charged, ... , RC C·43 (4·69) COMMONWEALT~ OF PENNSYLVANIA DEPARTMENT t1F REVENUE HARRISBURG Januaey 26t 1971 NOTE: TO BE SUBMITTED IN TRIPLICATE Pennsylvania Department of Revenue Bureau of County Collections 26 S. 4th Street Harrisburg, Pennsylvania Dear Sir: ' ' Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: NAME OF REPORTING FINANCIAL INSTITUTION Western Penna. tlot'l Bonk ADDRESS Founb & ~1at.n st. t J.tonccgebela• Pa• 1So63 ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT Savtaee Aeeetmt ,!129219 NAMES ON ACCOUNT \.;: OR INVESTMENT Jennie w, Tb.oanson or Ruth T; Long DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR JcnniG t~, tb011pson ADDRESS AND COUNTY ____________________ _ DATEOFDEATH_~U~·~1~~~7~0-------------------+'--~----- SURVIVING DEPOSITOR, . . ~ BENEFICIARY OR INVESTOR _Ru_th._1_::•:........;.:.1tcclg:..:..:: .. ___.::..;____,..,~,...::::::::;,.--.----- Y.NtJ c/a:j!!q!H'¥lti :'f.-Alguf1dert WtndilOOd Lrine• R») t F5 i1lt)'""JlUo1 Pa. ADDRESS RELATIONSHIP TO DECEDENT __ ? __ l~~~~.::=:~~¢C~~~:::;c:k:::z·~-_:::::-==~----+--/ DATE DEPOSIT OR INVESTMENT cf"'' WAS ESTABLISHED _.,Lll.L!I•!.!.l~J'·=;:;l~~;~t9---:------------ BALANCE, INCLUDING INTEREST t f . DUE, AT DATE OF DEATH $1,$90.92 ~~ 715: Jj{, )~ &-!.:.. TITLE Assistant ~~eger J RCC-!34 ( 1-69) COI.fMONWEAL TH OF PENN~YLVANIA DEPARTMENT OF REVENUE .t' BUREAU O'F ~uN)'\'-~OLLECTIOl'IS INHERiiANCE iAX QIVISICN-.. OFFICIAl NOTICE OF INHERITANCE TAX APPRAISEMENT AND ASSf:SSMSNT OF .ASSETS NOT SUBJECT TO ADMINISTRATION TO~-RUTH T. WNG c/O .l1iRGARET T •.. ALEXANDfR ·-~>JINDlvOOD rum~ .a,n,. 1 FJNLEYVII.T.E, PENNSYLVANIA 15332 Date: ...... ........_....._.!.F~.e~br!:..!uar~J...Y....:2::..5ua:...;l:.9LJ7L:!l:....._ __ _ C. t ~~-...... v~~~iS~JU~-~NG~T~O~N~~----~---. CiUI1 y --~-· CcwiHy File No . ..3 i" -/s-..s--;{., Bureau File No. c{J-;/~ J~9 We hav~ r~ceived noticethdt,l~~~~·~·~-~~-~--~-~~~-~-~-~~~~~~~~~~~~ on . . .. November J 9 .19'. .•. .20, you c€i'lf1'e iM6 ownership of certain property through,JlLII.)g.w~-..w1.AAI'IlftUUWIII:iiWLp.,AJIIIIU411ilra.AJ W.'<l~~~~. transfer from JENNIE \·l. THONPSON, Deceased. Under the· Inheritance and Es-fafe fax Laws of the Commonwealth of Pennsylvania such transfers ore taxable and the liability for the poyme:nJ of the inheritance-tax du~ is imposed upon you, as transferee. The prdperty on which fax is hereby assessed cons-ists csf: Jt. Savings Account # 29270 held in the .... tu!STERN PENNSYLVANIA, NATIONAL. BANK1 )·10NW~GAlllii.I\ OFF~CE,. 11()NO~GAHELA, Pi;;NNSYINANIA. In the ... names.of JtNNIE vJ._ T.HOHP$0rJ. O~t.. HU'.qt T. :LONG.__ OJ?e._n~c1 1+~:1.)~59 •.. J3a.la.nce as of date of death, $1,590-92 appraised by the Commonwe-alth, as csf the date of death, cit $ ____ ..... 1;590 .•. 9~ ..... 50 . % af this amount is taxable af the rate of 6. % DATE OF ASSESSMENT TAXABLE AMOUNT LES:S: ALLOWED DEBTS NET TAXABLE AMOUNT AMOUNt OF TAX D'UE 0 H yo·u po:y th~ above omoun~t· within thre-e (3) mcsnfhs of the d'ote of death df the decedent, or c:1n o·r before· . . . . T9. . . yc:1u ma'y dedu<::f d disc:ount df 5% of the· amount of tax due, or 0 This-tax became delinquen·t, fifteen· (15') manths- a.ft~r the date of: death· cmd, in od:di+ion to the tax., statutory inlere·st o:t the rate Cif 6'% of the tax per onn·um is also due as of *~----=---~~~~= l9_._ .. in· the amount' of *If the· fax is not paid by the above: dot~ «;rdditiei'nal interes;t is due at the rote df 6% per an'n'urtr until p·o·id lOT AL AMOUNt Due· $· QRfGINAL_ASSESSMENT AMENDED ASSESSMENT $ .......... 795.46 ----------------- ----------..--....... __ -- . 47.73 . --$==::::::::==::::::::::::========= (Agent for the Cornmonwea I th) INSTRUCT'IONS: TO' T'AXPAYERS Make checks or money orders pa.yable to: ---· . ··~· --· ·- Td in·sure prope·r credit to your account' this Officia·l Notice must a·ccompony yo-ur p·oymenf. Mai I or bring it fo: ' . ~i;.. •~l -··~ .._ ..... ~ ...... ~ •... "COU'RT HOUSE WASMiNGTON. PEN\~A. 15301 If you have already paid this tax to an executor, administrator, attorney or other personal representative of the decedent for forwarding to the Commonwealth, list below the date. paid, name and adpress of.the person to who~ you made payment, their official title and the amount. ~ ·-' .--'• 0:: .'f· ·' Date Paid Name and Address of Payee Official Title ... ---).m6&nt Paid . Under certain circumstances, if, after the date of death of the decedent, you personally paid funeral expenses or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended by you may qualify as deductions against the gross value of the property in the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you itemize the payments below, execute the affidavit, and return this notice. The Register of Wills will exam.ine the debts claimed and all~w those which he determines to be proper. The tax will then be recomputed and you will receive an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -You were personally legally responsible for these debts, and 2-You actually paid these debts out of the account or property described above and can furnish proof of such payment, if required, and 3-These same debts are not also claimed, for tax purposes, by an executor, administrator or other personal representative of the d~cedent handling the administration of the general estate of the decedent or any other transferee. · SCHEDULE OF DEBTS Date Paid Name of Payee -Description of Obligation Amou.nt Paid .. .. TOTAL $ (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) SS: COUNTY Of _______ _ I, hereby certify that the foregoing is a just and true statement of funeral expenses and other debts of the decedent, , for which I was legally responsible and which I did pay out of the property he.rein taxed. I further certify, that to the best of my knowledge and belief, these same debts will not be claimed by any other person, for inheritance tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS ___ DAY OF _____________ 19 __ . Signature of Taxpayer REPORT OF REGISTER OF WILLS I, the undersigned, duly elected Register of Wills in and for the above county, do respectfully report that I have allowed deductions listed above in the total amount of$---------·· Date of Approval: ___ ........_ __________ _ Register of Wills ~~ ~~ ~ ~ t~~---~"r:,t;;_· ."'1!.-~ ~:·?--.;'~~-~~·-·-.·. y: ~·--'---·~_·:_ .. _---r __ ,_..,.~.-.o:-,_: ... , • ·\· ~ r -·If you hove already paid this tox to an executor, odmin-.traf~r;<'oii;,rney or other personal reprh. "'"!"• ;.;;:,.- I ~ .. I decedent for forwarding to the Commonwealth, list below the date paid, nome and address of the peth ... _ ~ you made payment, their official title and the amount. Date Pqjd Name and Address of Payee Official Title Amount Paid ... Under certain circumstances, if, after the date of death of the decedent, you personally paid funeral expenses / or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended by you may qualify as deductions against the gross value of the property in .the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you itemize the payments below, execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and allow those which he determines to be proper. The tax will then be recomputed and you will receive an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 • Yop were personaffy legally responsible for these debts, and 2-You actualfy paid these delfts out of the account csr property described above and con furnish proof of such payment, if required, and 3-These same debts are not also claimed, for tax purposes, by an executor, administrator or other personal representative of the d~cedent handling the administration of the general estate of the _ decedent or any other transferee. · Amount Paid r See I'' t ·-· TOTAL (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) J SS: COUNJ,V OF. W~l{ 1 yli're 1,-IJ;TH rioN (( _ hereby certify that the foregoing is 9 just and tr~e statement o( funerok npenses and otfH•! d•b#-$ .. , d~* ....... -"~ ~:!IHK._""r_ "G:!.C!11'A«.~---, for which I wa t.Qolly responsible ond whi_ch I duf pay out ot the property herein taxed. I further certify, that to the best of .. knowl.dge and belief, these same debts will not be claimed by any other person, for inheritance .. .......... ....,,~"'"'LD BEFORE ME THIS 'Yf~· DAY OF -~~__,..----.J.-_191.L. . . WASH. co., PA. f REPORT OF REGISTER OF W'ILLS. lEX PIRES ~y IN JAN, 11178 Si gnatureofi"OOier. I, tb. undersigned, duly elected Register of Wills in a!"ld for the above county, do respectfully report that I hov• 6Jfowed deductions listed above in the total amount of$--------· Datt~;'Approval: ___________ _ Register of Wills ,_ RCC-43 (5-65) COMMONWEAi. TH. OF PENNSYLVANIA DEPARTMENT OF REVENUE HARRISBURG NOTE: TO BE SUBMITTED IN TRIPLICATE Pennsylvania Department of Revenue Bureau of County Collections 26 S. 4th Street Harrisburg, Pennsylvania Dear Sir: Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: NAME OF REPORTING FINANCIAL INSTITUTION l~eotm-n Po.mta;rlvania ha:tional ~ ADDRESS 35()'J Eilt.tmt&ion twooue ACCOUNT NO. OF JOINT I (, TRUST OR INVESTMENT DEPOSIT_,:;_nv_1__;ng;,;_G_II_6l_;_9_'4 --'---------- NAMES ON ACCOUNT . · OR INVESTMENT Jennie tv •. Th.ompoon or ~lrgarat T .• Ale.xander DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR ___ .J_e.nni.;_.· _;_e_W_..;;,_;_th=o=m=!)s:..:o=n-----.------- DATE OF DEATH november l9, l97Q SURVIVING DEPOSITOR, · BENEFICIARY OR INVESTOR __ :_.Jar_n_i·_u:·_et_·· _r_~ _J~_~_· :_· _de_r_{t_lu_usn_·. _t_er_} ___ __ ADDRESS R D IJ 11 FJ.nleyville, P~ •. 1.)332 RELATIONSHIP TO DECEDENT __ Da:_· uah.::._t._e_r ___________ _ DATE DEPOSIT OR INVESTMEtlTt. . l? lt:aSo WAS ESTABLISHED ___ o _,_._ . ...:..,_._7_:'------------ BALANCE, INCLUDING INTEREST . -6' DUE, AT DATE OF DEATH $ __ ...:;;.#~::...:;~.~:::!= ............. ;..:..96..;_ _ __p~=--___::."/..£._/ ..:::..,f.~JJ../~. f"~~:::..._ I Signature TITLE ) RCC-134 ( 1-69) COMMONWEALTH OF PE~SYLVA)liiA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INI-'~RITANCE TAX DIVISION OFFICIAL I'JOTICE OF INHERITANCE TAX APPRJ(ISEM~T, AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION TO: MARGARET T. ALEXANDER R.B. # 1 FINI.EYVILLE, PENNSYLVANIA 15332 ............ ~ Date: ---!14Maa-FrCGJha--.2"'3h,r--.&.l~9+7•1~~.:.;.;.._ County __ -IWu.::t:~o.~S:ub"-i.un~ge;.t""o~o.~.nLL..,_ ____ _ County File No. _________ _ Bureau File No. t't...Y-7/ ~S~f We have received notice that, ~~k.\o.t:X.'A~XLXXX.XXX.v_v • .Y..Xla'XXX~XXX on Noyember 19 .19~, you came into ownership ~r~ertain property th;oughJCitt~xknx ~~~~~.transfer from, JENNIE w. THOMPSON, deceased. . Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you, as transferee. The property on which tax is hereby assessed consists of: .It. Savings Account, bel d in the WESTERN PENNSYI.VANIA NATIONAL BANK, FINLEYVILLE OFFICE, FINLEYVILLE, PENNSYLVANIA. In the names of JENNIE \v. THOMPSON or NARGARET T. ALEXKNDER. Opened, October 17, 1959. Balance as if date of death, $ 1,831.96. appraised by the Commonwealth, as of the date of death, at $ 1, 8 31.96 50 %of this amount is taxable at the rate of 6 % DATE OF ASSESSMENT TAXABLE AMOUNT LESS: ALLOWED DEBTS NET TAXABLE AMOUNT AMOUNT OF TAX DUE 0 If you pay the above amount within three (3) months of the date of death of the decedent, or on or before 19 you may deduct a discount of 5% of the amount of tax due, or 0 This tax became delinquent, fifteen (15) months after the date of death and, in addition to the tax, statutory interest at the rate of 6% ofthe tax per annum is also due as of*------ 19 __ .in the amount of *If the tax is not paid by the above date additional interest is due at the rate of 6% per annum until paid /TOTAL AMOUNT DUE \---·/ // ORIGINAL ASSESSMENT $ -....::9ul..;J..S....:. 9:JJ:8~-- 54.96 $ 54.96 AMENDED ASSESSMENT $---------------- ' ----------- $ ================ APPRAISED BY~~·_..,__, oc?:z-:-ASSESSED BY: ______________ _ ,· (Inheritance Tax Appraiser) (Agent for the Commonwealth) INSTRUCTIONS TO TAXPAYERS Make checks or money orders payable to: To insure proper credit to your account this Official Notice must accompany your payment. Mail or bring it to: I I .J _ J, decedent for forwarding to the Commonwealth, list below the date paid, name and addr..ess of Jhe person to If you have already paid this tax to an executor administrator attorney ot other personal representative of the whom you made payment, their official title and the amount .. . ,_, .. ..,..._, __ ,_ "': .. Date Paid Name and Address of Pa~ee Official Title Amount Paid . ·-.. Under certain circumstances, if, after the date of death of the decedent, you personally paid funeral expens es ed any elow, ow or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expend by you may qualify as deductions against the gross val.ue of the property in the computation of tax due. If such expenditures meet all of the three following tests, it is recommended that you itemize the payments b execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and all those which he determines to be proper. The tax will then be recomputed and you will receive an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -You were personally legally responsible for these debts, and 2-You actually paid these debts out of the account or property described above and can furnish proof of such payment, if required, and 3-These same debts are not also claimed, for tax purposes, by an executor, administrator or other personal representative of the decedent handling the administration of the general estate of the decedent or any other transferee. SCHEDULE OF DEBTS Date Paid Name of Payee Description of Obligation Amount Paid TOTAL $ (attach separate sheet if required} COMMONWEALTH OF PENNSYLVANIA) SS: COUNTY OF: ) I, hereby certify that the foregoing is a just and true statement funeral expenses and other debts of the decedent, , for which was legally responsible and which I did pay-out of the property herein taxed. I further certify, that to the best of my knowledge and belief, these same debts will not be claimed by any other person, for inheritanc tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF 19_ Signature of Taxpayer REPORT OF REGISTER OF WILLS of I e I, the undersigned, duly elected Register of Wills in and for the above county, do respectfully report that I have allowed deductions listed above in the total amount of$ .. Date of Approval: Register of Wills . ,. c ' If you have already paid this tax to an executor, adminisfro'lo'f, attorney or other personal representot~vt' of'1ht: . decedent for forwarding to the Commonwealth, list below the date paid, nome and address of the person to .~om::t you made payment, their official title and the amount. 1.:.- Name and Address of Paree Official Title Amount Paid Under certain circumstances, if, after the dote of death of the decedent, you personally paid funeral expenses or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended by you may qualify as deductions against the gross value of the property in the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you itemize the payments below, execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and allow those which he determines to be proper. The tax will then be recomputed and you will receive an amended assessment of tax. · THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -You were perso~ally legally responsible for these debts, and 2-You actually paid these debts out of the account or property described above and can furnish proof of such payment, if required, and 3-These same debts ore not also claimed, for tax purposes, by on executor, administrator or other personal representative of the decedent handling the administration of the general estate of the decedent or any other transferee. SCHEDULE OF DEBTS Dote Paid Name of Payee Description of Obligation Amount Paid J ')../ :1.. 3/70 'at: »1 .f/JH.V ~ ~IL/2. ~ d}.-Lf ""d /) A·1f' ~.~ JY J~'fS",oo _i.=i?E~ _-j/~-fi£ _,-1 /. 'jLjt'J ., ' .. ., • ;! TOTAL $ ~_13 l ~ I o (attach separate sheet if required). COMMONWEALTH OF PENNSYLVANIA) I SS: COUNTY OF: Wll~o.J('rc,J . I, 11ittftffi£.T T,. ALeXfir./peiS hereby ,s.ptify that t~e1 foregoing is a ju~t .and true statement of. funeral expenses and othe.r debts of the decedent, JE.,!,Yt £ H.t. TrlolffP~o,J , for which I was legally responsible and which I did pay out of the property herein taxed. I further certify, that to the best of 11\1 knowledge and belief, these same debts will not be claimed by any, other person, for inheritance ta ..,qr.$M$. ··r·~· .~.._ .... ,-EFORE ME THIS YtJ1f!' DAY OF WASH. CO., PA • EPORT OF REGISTER OF WILLS ... -...... .. .-,,. ~l!ffSSION EXPIRES · ' . . f'tn'T. MONDAY IN JAN. llil711 : I, the undersigned, duly electea Register of Wills in and for the above county, do respectfully report that I hcive allowed deductions listed above in the total amount of $ --------• · Dote of Approval:-------------s ~. ~------~--~--~-------------------~--------------------------------------------------~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT DATE ESTATE OF 08-05-96 THOMPSON DATE OF DEATH 11-19-70 FILE NUMBER 63 71-0329 COUNTY ACN WASHINGTON 101 Amount Remitted REV-1607 EX AFP (OS-96> JENNIE MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS WASHINGTON CO COURT HOUSE WASHINGTON, PA 15301 w NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE DP-RETAIN LOWER PORTION FOR YOUR RECORDS ""'11113 ----------------------------------------------------------------------------------------------------------------REV-1607 EX AFP (03·96) ••~ INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF THOMPSON JENNIE W FILE NO. 63 71-0329 ACN 101 DATE 08-05-96 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-08-82 PRINCIPAL TAX DUE: 29.78 PAYMENTS <TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST (-) 08-03-96 WRITEOFF 43.62-73.40 ' / / TOTAL TAX CREDIT 29.78 THE DEPARTMENT HAS WRITTEN OFF THE BALANCE DUE AS UNCOLLECTABLE BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00