HomeMy WebLinkAbout11-21-07
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
TOOLAND MARK J
160 RIDGE HILL ROAD
MECHANICSBURG, PA 17050
____un fold
ESTATE INFORMATION: SSN: 205-26-0252
FILE NUMBER: 2107-1070
DECEDENT NAME: TOOLAND MYRTLE C
DATE OF PAYMENT: 11/21/2007
POSTMARK DATE: 11/13/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 09/16/2007
NO. CD 009004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07146325 I $46.27
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$46.27
REMARKS: MARK J TOOLAND
CHECK# 1659
SEAL
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG. PA 17128-0601
'*
FILE
ACN
DATE
NO. 21 .-~ot/7 ./o'7iJ
07146325
11-01-2007
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV~15'i.5 EX AFP C09-ao,
TYPE OF ACCOUNT
EST. OF MYRTLE C TOOL AND 0 SAVINGS
5.5. NO. 205-26-0252 Iil CHECKING
DATE OF DEATH 09-16-2007 0 TRUST
COUNTY CUMBERLAND Q ~ 0 CERTIF.
".0 ~ :0
REMIT PAYME",T~D FORtt:eTO: rn
REGISTER OF wn..iJb c> :=3
CUMBERLAND CO c~ H~E /17
CARLISLE, PA l~ .~
L.;",-~,;:>;;: .. . <.J
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no 11 -0 '."
Oc :JIr ~i~
- ::0 :::""
~ -f ::- rr';
MEMBERS 1 ST FCU has provided the Department with the infoNlation listed below which has been used ~ I". ':-.:>
calculating the potential tax due. Their records indicate that at the death of the above decedent. you were a joint owner/~ficiary ~~
this account. If you feel this information is incorrect. please obtain written correction from the financial institution. attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of PenosYlvanii:l. Q...~s~ion.i ..ay be ailsw~n:f(f lIir calling (717) 787-8321 w
MARK J TOOLAND
160 RIDGE HILL RD
MECHANICSBURG PA 17050
COMPLETE PART 1 BELOW
Account No. 245002-11
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
[!]
* *
* SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Date 05-19-2004
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
6,169.88
16.667
1,028.33
.045
46.27
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
A. r=J 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
8. c=J 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)
. Lf-{n . 2.:7
facts I have reported above are true, correct and
fo17- 90 F L
Under penalties of perjury, I declare that the
complete to the best of my knowledge and belief.
--/If~ T M/~
HOME (7/7)
WORK ( )
T~I FPHONE NUMBER
//!I/!tJ7 .."
DATE \J
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
FILE
ACN
DATE
NO. 21- .;;pO'? -/6'70
07146325
11- 01-2007
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV-15ii$ EX AFP <09-0D)
EST. OF MYRTLE C TOOL AND
S.S. NO. 205-26-0252
DATE OF DEATH 09-16-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
IiJ CHECKING
D TRUST
D CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO ~OURT HOUSi
CARLISLE, PA ~!10",13 :s
~ ..._. ~ --..I
,CC.. ::0 .'1'.
,.,~l-o-"'-
C.cl ::r: (") c:;
,,,?:J>r-...... I
'_~Zm N ... -;
:';::u55? - S:;1
MEMBERS 1ST FCU has provided the Deparhent with the infor..ation listed below which has--"~~ed in. G
calculating the potential tax due. Theil" records indicate that at the death of the above decedent, you were a jOinto~r/be~ciar~~f<:)
this account. If you feel this infor..ation is incorrect, please obtain written correction from the financial instit~~ion, at~ a co~ :Ii
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax L~ of the-k9mmo~!i~
of Pennsylvania. Questions may be answered by calling l71fJ 787"8327. '.'c: ..' -f"?'t
MARK J TOOLAND
160 RIDGE HILL RD
MECHANICSBURG PA 17050
COMPLETE PART 1 BELOW
Account No. 245002-11
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
[!l
If If
If SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Date
Established
05-19-2004
To insure proper credit to your account, two
(2) copies of this notice must accompany YOUI'
pay..ent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
6,169.88
16.667
1,028.33
.045
46.27
TAXPAYER RESPONSE
NOTE, If tax payments are made within three
(3) ..onths of the decedent's date of death,
you ..ay deduct a 57. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) ..onths after the date of death.
x
A. c=l The above information and tax due is correct.
1. You ..ay 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. 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 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
I!]
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
410.27
.
facts I have reported above are true, correct and
(PC,l-Q6 i'L
Under penalties
complete to the best
-/II ~ J
of perjury, I declare that the
0~:i61n~e and belief.
///;//J 7
DATE
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