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Home My WebLink About12-10-07 COMMONWEALTH OF PENNSYIN ANIA OEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1712B-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 009058 BROWN GALEN 6 PAMELA DRIVE MECHANICSBURG, PA 17050 ACN ASSESSMENT CONTROL NUMBER AMOUNT ____nn fold 07129180 $34.4 7 ESTATE INFORMATION: SSN: 575-14-8703 FILE NUMBER: 2107-1117 DECEDENT NAME: GELNETT ALICE K DATE OF PAYMENT: 12/10/2007 POSTMARK DATE: 12/08/2007 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2007 TOTAL AMOUNT PAID: $34.47 REMARKS: CHECK# 3090 SEAL INITIALS: CJ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 *.r ,r \S~,;;.\.'.-, ,: \Ii'\.' I I u--I....,-lM..Il-s43.d""AFP C09-DO) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21--07-11/7 07149180 11-23-2007 GALEN BROWN 6 PAMELA DR MECHANICSBURG 2001 DEe I 0 PH I: 4 1 EST. OF ALICE K GEL NETT S.S. NO. 575-14-8703 DATE OF DEATH 10-15-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [Xl SAVINGS o CHECKING o TRUST o CERTIF. CLERK OF ORPHAN'S COURT I!"'\rr.:',' 1'\ ('tI RI^ Cllt.--.,." h::',,-'..i\./.. f"'I _ \...... \ f - ~.",-,' . ,-" REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PA 17050 MEMBERS 1 ST FCU has provided the Departllent with the infol'llation 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 froll 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 COllmonwealth 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. 151139-05 Date 07-15-2000 Established To insure proper credit to your account, two (2) copies of this notice IIUSt 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 4,595.68 X 16.667 765.96 X .045 34.47 NOTE: If tax payments are made within three (3) 1I0nths 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. PART !!l [CHECK ] ONE BLOCK ONLY The above information and tax due is correct. 1. You aay choose to remit pay.ent 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 infor.ation is incorrect and/or debts and deductions were paid by you. You .ust complete PART ~ and/or PART ~ below. PART (!J TAX RETURN - COMPUTATION If YOU indicate a different tax rate, please state your relationship to decedent: L!NE l. Date Establ1shed 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 X 4 5 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED [!J DATE PAID 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, HOME (.q.t r ) ~/9--~sg WORK ( ) TELEPHONE NUMBER correct and 1;;"/0=1-/0 =f- DJ\TE c. P. SIMPSON-BROWN GALEN C. BROWN 6 PAMELA DR. MECHANICS BURG, PA 17050-1771 "AYTa f} 'J'dJiLbO JJJlIk t2"!f'-C THE OR~ I -rJud'f1Ju.~ LdYL 4'fi~ l\lSkEMBERS 1st FEDERAL CREDIT U/'olQN -k MeChani.CSburs, PA 17055 ~ www.mem~I5lst.org 1~';~B';;'~t:~~ 2lBH9095b~ ~~- ~~- ~ {~ C;,,::,c> 60-8224/2313 218 190956 3090 DATE kLL;z.HJ -r- , ~ $:3 'f; #l ~6) ~~~~:~~~cs COMMONWEALTH OF PENNSYLVA:JIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 009059 BROWN GALEN 6 PAMELA DRIVE MECHANICSBURG, PA 17050 u_u___ fold ACN ASSESSMENT CONTROL NUMBER AMOUNT 07149179 $34.47 ESTATE INFORMATION: SSN: 575-14-8703 FILE NUMBER: 2107-1117 DECEDENT NAME: GELNETT ALICE K DATE OF PAYMENT: 12/10/2007 POSTMARK DATE: 12/08/2007 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2007 TOTAL AMOUNT PAID: $34.47 REMARKS: CHECK# 3092 SEAL INITIALS: CJ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 *'"' .-...... t'......, ,., " " , ;1, ~ \....;. '.....' , L~' i :C!rI~FtJRMATION NOTICE " , 'vL ',J, AND ~~. '}IT~?CPAYER RESPONSE FILE ACN DATE NO. 21vo1~1I17 07149179 11-23-2007 REV-J543 EX AFP (09-00> 2007 DEe I 0 PH I: 47 EST. OF ALICE K GEL NETT CLERK OF S . S. NO. 575 - 14 - 8703 ORPHN~'S COURT DATE OF DEATH 10- 15 - 2007 CUM2~rT CO. PA COUNTY CUMBERLAND TYPE OF ACCOUNT IXI SAVINGS o CHECKING o TRUST o CERTIF. CAROLYN SIMPSONBROWN 6 PAMELA DR MECHANICSBURG PA 17050 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST 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../beneficia..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.... 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) 787-8327. COMPLETE PART 1 BELOW · . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 151139-05 Date 07-15-2000 Established To insu..e P..ope.. c..edit to you.. account. two (2) copies of this notice IIUSt 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 4,595.68 X 16.667 765.96 X .045 34.47 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 becolle delinquent nine (9) months afte.. the date of death. PART [!J The above info"lIation 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. [CHECK ] ONE BLOCK ONLY B. c=J 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. c=J 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. PART [!J TAX RETURN - COMPUTATION If YOU indicate a diffe..ent tax ..ate, please state YOU" I'elationship to decedent: DEBTS AND DEDUCTIONS CLAIMED LINt:: L Date Established 2. Account Balance 2 3. Pe..cent 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 f!] DATE PAID PAYEE I OF TAX ON JOINT/TRUST ACCOUNTS X x DESCR I PTI ON AMOUNT PAID TOTAL CEnte.. on Line 5 of Tax Computation) * Unde.. penalties of pe..ju..y, I decla..e that the facts I to the best of my knOWledge and belief. - -~-'''(J/y,,-- SIGNATURE have ..epo..ted above a..e t..ue, HOME ( .:::f 11 ) {, ?- 3:,sg WORK ( ) TELEPHONE NUMBER co....ect and ('IDbCJ C P SIMPSON-BROWN GALEN C. BROWN 6 PAMELA DR'URG PA 17050-1771 MEOiANICSB , ~ If!.F'- f; iu l{W, ~' , 'I-M +J:'(7) -~,~ { ~1S~EMBE~J~ON ~E~~~b~ PA 17055 membcrsllt.org ~ --:'t -O~ MEMO f .: 2 :1 . :1 B 2 2 ~ ..: 3092 60-8224/2313 218 90958 DATE ~" "1-; )dz;?- $31:rf!r- ~ SOCl.lrilyF...tu,,"s !n"lvdo<l. !lec~ UULL.I\l'\.3 ~.on 2 ~B ~ ~gOg 5[(ft~u-~___~ ! ,=-, ;; )\ .l \\ \....~ ~ j i ! J ! f f ((//(//1.', ". \\1,\ .\ 1:, ~s. t 'l"'l ~,,... f". 1',,1 'l"'l <t ,~,.~ 0.. C;.. 0 f''''~ tt: ..r...;. :J 1/ !0 iZl N iJ) i t-l .~,- c:: :;..~! ('4i ii,';,. - ~'J .( t'-C~ r b u,., Gcn l1.J _.1 () FE C.) 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