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Home My WebLink About04-04-07 COMMONWEALTH OF PENNSYLVANIA 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 LARSON BOBBETTE L 826 ACRI ROAD MECHANICSBURG, PA 17050 ~------- fold ESTATE INFORMATION: SSN: 191-18-3999 FILE NUMBER: 2107-0151 DECEDENT NAME: HAKE ELNORA E DATE OF PAYMENT: 04/04/2007 POSTMARK DATE: 04/04/2007 COUNTY: CUMBERLAND DATE OF DEATH: 02/03/2007 NO. CD 007972 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07113352 I $1,122.07 07113353 I $114.1 8 I I I I I I I TOTAL AMOUNT PAID: $1,236.25 REMARKS: CHECK# 5313 SEAL INITIALS: CJ RECEIVED BY: REGISTER OF WILLS GLENDA FARNERSTRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 oA.L..,.!~; ~:-I INFORMATION NOTICE ,- --- AND :TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0151 07113352 03-28-2007 REY-1SIiI EX AFP'Ca'~.01 TYPE OF ACCOUNT IiJ SAVINGS o CHECKING o TRUST o CERTIF. Z007 j~PR -4 M'IIIEs.'te OF ELNORA F HAKE S.S. NO. 191-18-3999 CLEF:K CF DATE OF DEATH 02- 03-2007 O'RC:H..jrJ<~ ('/":1 iRJ'lOUNTY CUMBERLAND i[ ,\. 'J ~",' ...../\..... U ;,.. CU".'~' --., REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BOBBETTE LARSON 826 ACRI RD MECHANICSBURG PA 17050 COMMERCE BANK has provided the Departaent with the infor..Uon 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 infor.ation is incorrect. please obtain written correction froa the financial institution. attach a cOPY to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the C~aonwealth of PennSYlvania. Q~..tions aay be er.swerad bv callin. (717) 717-B327. COMPLETE PART 1 BELOW Account No. 616119534 . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date 09-08-2005 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due x 49,869.82 50.000 24,934.91 .15 3,740.24 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice aust accoapany your payaent to tha Register of Wills. Make check payable to I "Register of Wills. Agent". Established x NOTE. If tax payaents are aade within three (3) aonths of the decedent's date of death, you aay deduct e 5X discount of the tax due. Any inheritance tax due will becoae delinquent nine (9) aonths after the date of death. PART [!] ~W~\.I'.r~~__!8_~_..._..._.._~;.r_______..______:.r_~..___:.r_:n__tB:.r_qj.r____..;:r__$.t_:rn::.._...__N::!j~_ir_..__....___....If'_~ tlt~ '..t..:.u r_1-:___::r-..:.rz;!_$:f,.:;::;:r_:.t;tiLt_..:.p:.r_;.;_~..;.;n:_:P:__;.:mHggmtilruy:~:';fi__;.;$_W,. titi::.r-jiili3m..1:F:'_:.r.t__@..'it:H::m:.*;H:.p..~ A. E:] The above inforaation and tax due is correct. 1. You aay choose to reait payaent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest. or YOU aay check box "A" and return this notice to the Register of Wills and an official assessaent will be issued by the PA Departaent of Revenue. [CHECK ] ONE BLOCK ONLY B. E:] 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 inforaation is incorrect and/or debts and deductions were paid by you. You aust coaplete PART ~ and/or PART ~ below. PART If you indicate a different [!] relationship to decedent: TAX RETURN - COMPUTATION OF ACCOUNTS LINE 1. Date Established 1 ~~q.cg~ 2. Account Balance 2 3. Percent Taxable 3 X ~\ . tlft'T\ 4. Amount SUbject to Tax 4 ~4 rdt ~c.{ .cr I 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X .~~ 8. Tax Due 8 \1 :l").o 1 PART ~ DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation> . perjury, I declare that the facts I my knowledge and belief. have reported abov~ p{e Ltrue, correct and HOME C1O..-1:J S ,~~ WORK C) ~_~~ TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 .'" , ' ,-: ,i . -- .... INFORMATION NOTICE AND :,)iT,'~,JUP.lER RESPONSE FILE ACN DATE NO. 21 07- 0151 07113353 03-28-2007 RiV.15~'~'fFPl f"~~) TYPE OF ACCOUNT D SAVINGS Ii] CHECKING D TRUST D CERTIF. Z007 APR - 4 (::LJJll< (~~ OF:PH'\:,!"::: C/J!,jRT CLJ\/ ~- At'lll: 2CEST. OF ELNORA F HAKE S.S. NO. 191-18-3999 DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND PA 17050 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BOBBETTE 826 ACRI RD MECHANICSBURG LARSON COMMERCE BANK has provided the Depart.ent "ith the infor.aUon listed belON "hich has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent. you "ere a joint ONner/beneficiary of this account. If you feel this infor.ation is incorrect, please obtain "ritten correction fro. the financial institution. attach a copy to this for. and return it to the above address. This account is taxable in accordance "ith the Inheritance Tax LeNS of the Co..onNealth of Pennsylvania. Questions.ey be answered bY ceIling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 513172536 Date 09-08-2005 Established To insure proper credit to your account, two (2) copies of this notice .ust acco.pany your pay.ent 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 5,074.68 X 50.000 2,537.34 X .15 380.60 TAXPAYER RESPONSE NOTE, If tax pay.ents are .ade "ithin three (3) .onths of the decedent's date of death. you .ay deduct a 5X discount of the tax due. Any inheritance tax due will beco.e delinquent nin.. (9) .onths after the date of death. PART [!] 1J~~:N-n-!!!lFll-~~';W=F';)':;"'::F"c:':-:'f-"~::jj!j'l'1':rDiw.i:r~tID~f:r-:o::r;S~"j::~"1l!!l:'-i:~~~t:t:~:~:if:g;~;l'ti~t:"'{':~f~"'~?;o"tn'f.'i"'i;s-~~-~"'l''l''~~''~F.''"~-E~O;::i;;'_"';~ 3O:~}~';!._"'~ofe_-.;:i!:C';:of~.;iit-c"":;'O;}~;:J-:1;;-:i:-~:i:-:;.::r:~" 'i-? """".,-..ron!"'rtm :H:'1:w:=~"'-"~-" :--iif;:.;: :.;:0,;:' ~o:.".:~:o.-"rt,H'""- ~:c.~:"'_" C:r: ""e""'''''''''=,;:'''_:::;: ,.,.:hi ~:-=:= .".,.:';;:-l;:~-": M"l,:lt'~'1:;t'H'1::.rM'1:tlttl_____"l;:'"_________::r_~H_'1.:,__~_~~~...~., :..t:l..!U:-t'..i:U'...t'.r..'J.,'J,W >t'..~...tr'~1-.~:.r_'"U:.t',tI.; :.r_..~., ~*It',.. :t::,~_r.."'.r4H.ji.,:U :t::.r~t:~ 'f...... >!:r..t~..+t,-..~.._ii :t,'1tl:: .,=0:::. 1.;..__'1.;.._'";: A. c:J The above inforllation and tax due is correct. 1. You.ay choose to r..it pay.ent to the Register of Wills "ith two copies of this notice to obtain a discount or avoid interest, or you .ey check box, "A" and return this notice to the Register of Wills and an official assess.ent "ill be issued by the PA Depart.ent of Revenue. [CHECK ] ONE BLOCK ONLY B. c:J The above asset has been or will be reported and tax paid "ith the Pennsylvania Inheritance Tax return --- ~ be filed by the decedent's representative. C. ~ The above infor.ation is incorrect and/or debts and deductions were paid by You. You .ust co.Plate PART 0 and/or PART 0 belON. PART If you indicate state YOUr [!] relationship to TAX RETURN - COMPUTATION OF TAX 0 ACCOUNTS LINE 1- Date Established 1 2. Account Balance 2 S-O'1LJ... (,-\ ~ 3. Percent Taxable 3 X ~{~cl 4. Amount SUbject to Tax 4 5. Debts and Deductions 5 6. A.ount Taxable 6 7. Tax Rate 7 X . 6 "-5 8. Tax Due 8 1\4., \1S PART I!I DATE PAID DEBTS PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) . perjury, I declare that the facts I my knowledge and belief. have repOrted above are true. cOrrect and (l(1 )1~~'f<l$.~ WORK ( ) TELEPHONE NUMBER HOME 3- ~~1 DATE -'""--"- -- :.......,-~...-..... I I , . d\ ;~ bF,(:I..;I<T': (", r-...~.>.I :.L}'._..;, 1..' ;. R ,,;. 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