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Home My WebLink About02-07-08 __ COMMONWEALTH OF PENNSYLVANIA k D TMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 009269 KLINE JAMES S 618 MARTIN DRIVE MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssN: i77-24-5674 FILE NUMBER: 2108-0135 DECEDENT NAME: KLINE CATHERINE F DATE OF PAYMENT: 02/07/2008 POSTMARK DATE: 01 /31 /2008 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /21 /2007 REMARKS: JAMES S KLINE SEAL CHECK# 2150 08500025 ~ 5202.32 TOTAL AMOUNT PAID: REV-1162 EX(11-96) 5202.32 INITIALS: WZ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS f COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 ' HARRISBURG PA 17128-0601 .REV~1S43R -AFP ()-03> INFORMATION NOTICE FILE N0. 21 - (~~- ~)~~~5 AND ACN 08500025 TAXPAYER RESPONSE * REVISED NOTICE * * * DATE 01-31-2008 -, ~ i" _ (~ U- ~ `~ _ ,~ 'I. JAMES S KLINE 618 MARTIN DRIVE MECHANICSBURG PA 17055 TYPE OF ACCOUNT EST. OF CATHERINE F KLINE ^ SECURITY S.S. N0. 177-24-5674 X^ sEC ACCT DATE OF DEATH 11-21-2007 ^ srocK COUNTY CUMBERLAND ^ soNDs REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 AMERICAN FUNDS 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 beneficiary of this asset. If you feel this information is incorrect, please obtain written correction from the transfer agent, 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 C717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 64665121 To insure prover credit to your account, two (2) copies of this notice must accompany your oavment to the Resister of Wills. Make check DOD Valuation 17,983.92 payable to: "Register of Wills, Agent". Percent Taxable X 25.000 NOTE: If tax payments are made within three Amount Subject to Tax 4,495.98 (3) months of the decedent's date of death, Tax Rate X .045 You may deduct a 5Y. discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 202 • 32 nine (9) months after the date of death. PART TAXPAYER RESPONSE 1^ ILA S A. The above information and tax due is correct. 1. You nay choose to resit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount ar avoid interest, or you may check box "A" and return this notice to the Register of ONE Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y 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. PART If you indicate a different tax rate, please state your relationship t o decedent: T4X RETURN - rOMP!iTATION OF TAX ON A.$OVF ASSET(S) LINE I. DOD Valuation 1 2. Percent Taxabl e 2 X { f ; I 3. Amount Subject to Tax 3 ~ I~`( ~ ~ ~ 4. Debts and Dedu ctions 4 € 5. Amount Taxable 5 6. Tax Rate 6 X 7. Tax Due 7 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID A TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I have reported above are true, co~rjrec/fit and co ete to the best af. y knowledge and belief. HOME C~%~ ) %~~ (J~/~ r.~/r' ~h~ __ WORK ( ) / .~/-~~ __ r ~,; ' ~;~ ~„ ~~ :~ C ~`' -~; ~~: ~; W W ~ r Q Z ~~ ('~ ~p W ~ !W O ~ W "` . . ~>>_ N ~; ~ > x T ~ ~:~: WZ~oQa ^-- ~LLUoQ a~~xN WWGCO~ W m am?a= x W W ~»