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Home My WebLink About03-21-07 (3) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE FUREAU OF Ir~DIVIDUAL TAXES UEPT 280601 '-iA.RRISBURG, PA 17128-0601 REV-1162 EX(11-96) i\C:CEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LARSON BOBBETTE l 826 ACRI ROAD IvlECHANICSBURG, PA 17050 I I ESTATE INFORMATION: SSN: 191-18-3999 I I I I FILE NUMBER: 2107-0151 I : DECEDENT NAME: HAI<E ELNORA E : Df'.. Ti: OF PAYMENT: 03/21/2007 I POSTMARK DATE: 03/20/2007 I I I COUNTY: CUMBERLAND : UM TE OF DEATH: 02/03/2007 I NO. CD 007930 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,066.87 I I I I I I I I TOTAL AMOUNT PAID: $1,066.87 REMARI<S: CHECI(# 4442 SEAL INITIALS: CAJ RECEIVED BY: 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 ACN DATE NO.21 07-0151 07112295 03-20-2007 REV-1543 EX AFP (09.00) r"-"'l ,.'" f) " \ {JiJ I .i\l\ L f' " \ \. r) 0 Iii .,J TYPE OF ACCOUNT D SAVINGS D CHECKING D TRUST [Xl CERTIF. 0: CtJ EST. OF ELNORA E HAKE S.S. NO. 191-18-3999 DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND BOBBETTE LARSON 826 ACRI RD MECHANICSBURG PA 17050-2232 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CLEARVIEW FCU 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 IUSY be answered b~j calliny (717) 737~8527. Account No. 10278783 COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART [!] Date 07-08-1997 Established 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". 1,312.78 X 50.000 656.39 X .045 29.54 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. [CHECK ] ONE BLOCK ONLY The above information and tax due is correct. 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 ..ay 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 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. OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: LINE l. 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 PART [!] DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID $ and TOTAL (Enter on Line 5 of Tax Computation) perjury, I declare that the facts my knowledge and belief. have reported above are trq' cor~ct HOME (1~l )l~- ~~~ WORK ( ) TELEPHONE NUMBER ~ _~~~1 DATE (1) 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 07-0151 07112294 03-20-2007 REV-1543 EX AFP (09-00l ,~ EST. OF ELNORA E HAKE S.S. NO. 191-18-3999 DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS o CHECKING o TRUST o CERTIF. j;~rj i~/;J~ 2 I 1\I'-'~! 1: ~; 1 .'. )1 BOBBETTE LARSON 826 ACRI RD MECHANICSBURG PA 17050-2232 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CLEARV I EW FCU 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. 10278783 Date 07-08-1997 Established 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 48,545.80 X 50.000 24,272.90 X .045 1,092.28 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. PART [!] [CHECK ] ONE BLOCK ONLY A. ~ The above information and tax due is correct. ~. 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 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. LINE 1- Date Established 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART [!] DATE PAID PAYEE X PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: OF TAX ON JOINT/TRUST ACCOUNTS x DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TDTAL (Enter on Line 5 of Tax Computation) * perjury, I declare that the facts my knowledge and belief. have reported abo~re HOME (111) ~ WORK ( ) TELEPHONE NUMBER ;fue, correct and ~C1~1, ~ ')a -(j 1. DATE ct COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 1712B-0601 * INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0151 07112293 03-20-2007 REY-1S43 EX AFP (D9~OO) ... ~ / ,~) ,~} i \ .." "- I " r II. ," ,,1 ii- ',... (Y \j; EST. OF ELNORA E HAKE S.S. NO. 191-18-3999 DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [i] CHECKING D TRUST D CERTIF. BOBBETTE LARSON 826 ACRI RD MECHANICSBURG PA 17050-2232 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CLEARVIEW FCU 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. 10278783 Date Established 07-08-1997 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 43.15 50.000 21.58 .045 .97 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. x PART [!] A. ~The above information and tax due is correct. -~. 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 lIay 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. [CHECK ] ONE BLOCK ONLY B. [] The above asset has been Dr will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedentls representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART [!] TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 x If you indicate a different tax rate, please state your relationship to decedent: 6. Amount Taxable 7. Tax Rate 8. Tax Due 4 5 6 7 8 x PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ perjury, I declare that the facts my knowledge and belief. have reported above are true, correct and C-LLJ.i:Jlli0> ~ WORK C ) TELEPHONE NUMBER HOME 3.- Jd -o1LJ DATE -~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0151 07112292 03-20-2007 REV-1543 EX AFP (09-00) 1 ~ ,: ~~ 1 '.:. Ii , : I"~' , \\ l Ii....' · TYPE OF ACCOUNT IX] SAVINGS D CHECKING D TRUST D CERTIF. EST. OF ELNORA E HAKE S.S. NO. 191-18-3999 , DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND BOBBETTE LARSON 826 ACRI RD MECHANICSBURG PA 17050-2232 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CLEARVIEW FCU has provided the Departrlent 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 ans~ered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 10278783 Date Established 07-08-1997 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 PART l!I x 10.00 50.000 5.00 .045 .23 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. x [CHECK ] ONE BLOCK ONLY A. ~The above information and tax due is correct. ~. 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 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. OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: LINE l. 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 PART ~ DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID $ TOTAL (Enter on Line 5 of Tax Computation) perjury, I declare that the facts my knowledge and belief. and 1'\1 5-~ 1J10 DATE T have reported above are true, correct HOME C\ l1 ) I~ cf4d.. 0 WORK ( ) TELEPHONE NUMBER \ \ 1 { \ I , , , ~ i > 1 '0;, J "\ '. 't~ i J ~~: ., .,. ~,~ 'h' 1.- " " ~ " "" "', N ['-. N ~ ~ Q!' :J to V} ..... ct Q! II! :t -l (\L I ~ f"., 8: N ~. o(~ ~> ~ .~ i~ . 0\ T nrr,("'\,I"'"'r-.r-,"",- ,....-..- : ~ '1 .' 0 'j I Jd'l\ L I r'l r ~. ,1 . "; Hli I . oJ d\ I'f'\ i : ~ ~\ (-'Ie l, '. {:::r'y I:JT ";\."',,/j II ,