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Home My WebLink About04-27-07 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 HOCKENBERRY LORI 140 BRICK CHURCH ROAD NEWVILLE, PA 17241 -------- fold ESTATE INFORMATION: SSN: 162-22-1704 FILE NUMBER: 2107-0411 DECEDENT NAME: MCLAUGHLIN SHIRLEY DATE OF PAYMENT: 04/27/2007 POSTMARK DATE: 04/27/2007 COUNTY: CUMBERLAND DATE OF DEATH: 02/21/2007 NO. CD 008089 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07116387 I $13.52 07116389 I $92.31 I I I I I I I TOTAL AMOUNT PAID: $105.83 REMARKS: CHECK# 608 INITIALS: AJW 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 ACN DATE NO.21 07116387 04-11-2007 REV-1543 EX AFP (09-00) EST. OF SHIRLEY MCLAUGHLIN S.S. NO. 162-22-1704 DATE OF DEATH 02-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [i] CHECKING D TRUST D CERTIF. LORI HOCKEBERRY 140 BRICK CHURCH RD NEWVILLE PA 17241 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Departnnt with the infoNlation 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 Pennsylvenia. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW Account No. 180004-11 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART [!] It It It SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date 07-07-2003 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".. x 1,896.83 16.667 316.14 .045 14.23 TAXPAYER RESPONSE 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. x 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. [CHECK ] ONE BLOCK ONLY B. 0 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. 0 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 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 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. have reported above are true, correct and (717) 7 7(/J -59/1) () q.-~7-i"J7 Ti:1 i:PI..InNi: NIIMRi:~ nATI: HOME WORK COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU DF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07116389 04-11-2007 REV~1543 EX AFP C09-00> EST. OF SHIRLEY MCLAUGHLIN S.S. NO. 162-22-1704 DATE OF DEATH 02-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT Ii] SAVINGS o CHECKING o TRUST o CERTIF. LORI HOCKEBERRY 140 BRICK CHURCH RD NEWVILLE PA 17241 REMIT PAYMENT AND FORKS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1 ST FCU has provided the Depart.ent with the infoNlation 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 fro. the financial institution, attach a copy to this fo... and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth of Pennsylvania. Questions .ay be answered ~ calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 180004-00 Date 07-07-2003 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 PART l!] 12,955.12 X 16.667 2,159.23 X .045 97.17 TAXPAYER RESPONSE NOTE: If tax pay.ents are .ade within three (3) .onths of the decedent's date of death, you .ay deduct a 5% discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) months after the date of death. A. c=l The above infor.ation and tax due is correct. 1. You.ay choose to re.it pay.ent 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 assess.ent will be issued by the PA Depart.ent of Revenue. [CHECK ] ONE BLOCK ONLY B. c=l 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. c=l The above infor.ation is incorrect and/or debts and deductions were paid by you. You .ust complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART ~ TAX 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 DESCR I PH ON AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) . declare that the facts e and belief. HOME WORK have reported above are true, correct and ( III ) JIG, - c:; q 1(") ( ) ~-,;n-~7 nATF T~I ~pl-lnN~ NIIMRFR 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 07116388 04-11-2007 REV-1S43 EX AFP (09-00> EST. OF SHIRLEY MCLAUGHLIN S.S. NO. 162-22-1704 DATE OF DEATH 02-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT IiJ SAVINGS o CHECKING D TRUST o CERTlF. FRED G MCLAUGHLIN 531 HAMILTON ST CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1 ST 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) 7B7-B327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 180004-00 Date 07-07-2003 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 PART ill 12,955.12 X 16.667 2,159.23 X .00 .00 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. A. [] 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. [CHECK ] ONE BLOCK ONLY 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 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 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 I owledge and belief. have reported above are true, correct (717 ) ,:#'t>-~'l~ ( '7 f 7 ) jV'/~-~f?~ TI=I I=PHnNI= NUMBER -Y-:J-7 -CJ7 DATE and 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 07116386 04-11-2007 AEV-15li3 EX AFP (09-00) EST. OF SHIRLEY MCLAUGHLIN S.S. NO. 162-22-1704 DATE OF DEATH 02-21-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [i] CHECKING D TRUST D CERTIF. FRED G MCLAUGHLIN 531 HAMILTON ST CARLISLE PA 17013 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1 ST FCU 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../beneficial'Y of this account. If you feel this info..mation is inco....ect. please obtain w..itten co....ection f..om the financial institution. attach a copy to this fo..m and ..etu..n it to the above add..ess. This account is taxable in acco..dance with the Inhe..itance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answe..ed by calling (717) 7B7-B327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 180004 -11 Date 07-07-2003 Established To insu..e p..ope.. c..edit to you.. account. two (2) copies of this notice must accompany you.. payment to the Registe.. of Wills. Make check payable to: "Registe.. of Wills. Agent". Account Balance Pe..cent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 1,896.83 X 16.667 316.14 X .00 .00 TAXPAYER RESPONSE NOTE: If tax payments a..e made within th..ee (3) months of the decedent's date of death. you may deduct a 5% discount of the tax due. Any inhe..itance tax due will become delinquent nine (9) months afte.. the date of death. PART [!] [CHECK ] ONE BLOCK ONLY A. [] The above info..mation and tax due is co....ect. 1. You may choose to ..emit payment to the Registe.. of Wills with two copies of this notice to obtain a discount 0" avoid inte..est. 0.. you may check box "A" and ..etu..n this notice to the Registe.. of Wills and an official assessment will be issued by the PA Depa..tment of Revenue. B. [] The above asset has been 0.. will be ..epo..ted and tax paid with the Pennsylvania Inhe..itance Tax ..etu..n to be filed by the decedent's ..ep..esentative. C. [] The above info..mation is inco....ect and/o.. debts and deductions we..e 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 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 @J DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCR I PH ON AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) . that the facts I and belief. have reported above are true. correct HOME (7/7 ).P"I0 bl~ 7& WORK (? I ).JlL/ 3 :5 C"5C9 TELEPHONE NUMBER and ~ '1- j)-)-CJ /' DATE