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Home My WebLink About01-23-07 (2) COMMONWEALTH OF PEI,NSYlVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MADDEN TIM P 6118 BLUESTONE AVE HARRISBURG, PA 17112 n___u_ fold ESTATE INFORMATION: SSN: 164-30-2957 FILE NUMBER: 2107-0005 DECEDENT NAME: MADDEN PHILLIP P DA TE OF PAYMENT: 01/23/2007 POSTMARK DATE: 01/22/2007 COUNTY: CUMBERLAND DATE OF DEATH: 11/02/2006 NO. CD 007733 ACN ASSESSMENT CONTROL NUMBER AMOUNT 06161731 I $153.02 I I I I I I I I TOTAL AMOUNT PAID: $153.02 REMARKS: CHECK# 2266 INITIALS: CJ RECEIVED BY: SEAL REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS 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 06161731 DATE 12-15-2006 REV-15~S EX AFP (D9-DDJ '?A EST. OF PHILLIP P MADDEN S.S. NO. 164-30-2957 DATE OF DEATH 11-02-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS o CHECKING IX] TRUST o CERTIF . ')rf!l I.HI 23 j...~U' ...;;''''..1 Dl., 'j. 2' rn ,-' o C,\_tt;lr<. " ~. TIM MADDEN C/O 733 OLD SLVR SPG RD MECHANICSBURG PA 17055 REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 FULTON BANK has provided the Department with the information listed below which has been used in calculating the potential taK 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 taKable in accordance with the Inheritance TaK Laws of the Commonwealth of Pennsylvania. Qu....tionS' m"y I>e an,me,."d by calling (717) 7678327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1818-38424 Date 05-29-1984 Established x 10,201.15 33.333 3,400.35 .15 510.05 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of WillS, Agent... Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If taK payments are made within three (3) months of the decedent.s date of death, you may deduct a 5% discount of the taK due. Any inheritance taK due will become delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY A. [] The above information and taK 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 bOK "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 taK paid with the Pennsylvania Inheritance TaK 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. If you indicate a different tax r~e, please state your relationship to decedent: ~<) 0 PART ~ TAX RETURN - COMPUTATION OF TAX ~~ ~O~~T!~RUST ACCOUNTS LINE 1. Date Established 1 S@ -{ !J. ql{'-f 2. Account Balance 2 I 0 ~ 0 I . 15' 3. Percent Taxable 3 X 1 ~ I -::)33 4. Amount Subject to Tax 4 <.-=1. 4-0 0 0 I .3~ 5. Debts and Deductions 5 ~ 6. Amount Taxable 6 \. q.:j-OO .3.5 7. Tax Rate 7 X ~ 046 8. Tax Due 8 /53Go;;;"" DEBTS AND DEDUCTIONS CLAIMED PART @] DATE PAID 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 ( [( ) 54<5-4 f d- { ,~~ WORK ( ) TA~PAYER SIGNATURE TELEPHONE NUMBER r-- M ....I ,...." N M <J: ~ a.. 0.. C) f', c( ~. :J co f/) Z Jool <( " cr: " ( N :r N (- -'. ~ ~ - "7 I~r::: IC~<t. 1i;o c-~ ~ .'0 t ~ ~ Y:3-:L J - - - - - - - - - - - - ~ 1<) cf) :$ Q o I c.j .-' ~J 4. 4--gt- () d J -'-. \..: ~ -- c.! <:::J '-~ tjJ '-'r~ _ E I~.~. .-.5 --S ('j ?c) U N j;,t: ) .,':.( J r-- = c:::::. C'.J - - - - - - - t'l ~ 1\) 1\) , 1\) t4 o l" t4