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Home My WebLink About03-25-08 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96J DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYL VANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CO 009452 YEAKLEY MELISSA 118 YELLOW BREECHES DRIVE CAMP HILL, PA 1 7011 ACN ASSESSMENT AMOUNT CONTROL NUMBER nnnn fold ---------- -------- 08107790 I $124.75 ESTATE INFORMATION: SSN: I FILE NUMBER: 2108-0333 I DECEDENT NAME: YEAKLEY KATHLEEN A I DATE OF PAYMENT: 03/25/2008 I POSTMARK DATE: 03/22/2008 I COUNTY: CUMBERLAND I I DATE OF DEATH: 12/25/2007 I I I I TOTAL AMOUNT PAID: $124.75 REMARKS: CHECK# 143 INITIALS: CJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS . MELISSA A. YEAKLEY 143 ROBERT G. YEAKLEY /I 717-731-8925 U J 118 YELLOW BREECHES DR 60-8111/2313 CAMP HILL, PA 17011 -----3 I ~ () 5______DiITE b:H~~~I-J?<(ii~t<;'fC:dWILl,:i____~_i=. ------__J $ i) 't, 75 ,j I?/I CL. ~1L.--"",r<;'I'/(Li:V""'\'1:j"C\K_ ,i~l\uJ:;_~_ -__:__ __ _ _ _ ___~L\!~ Ii] PSECU " ",""",w'" '" '" "'''' . ~.- '\ lc - L f~J~~~ ~~jlt~ ~~~-Ifi'-~ O~5 5 1 ~ r; ~ r; ~~ ~Mle;}-- ~ J - ----- . 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 08107790 03-04-2008 REY-1543 EX AFP (09-00) EST. OF KATHLEEN A YEAKLEY S.S. NO. DATE OF DEATH 12-25-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS D CHECKING D TRUST D CERTIF. MELISSA YEAKLEY 118 YELLOW BREECHES DR CAMP HILL PA 17011 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST 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 PennsylvC'tn; ~_ QIJPo;;ti ons m~\' be Answered hv r:alling (717) 787-8327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 185260-00 Date 06-26-1999 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 5,544.33 X 50.000 2,772. 17 X .045 124.75 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. PART [!] [CHECK ] ONE BLOCK ONLY A. ~The above information and tax due is correct. AI. You may choose to remit payment to the Register of Wills with two copies of this notice to clbtain a discount or avoid interest, or you may check box "A" and return this notice to the RegistE!r 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 information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. 6. Amount Taxable 7. Tax Rate 8. Tax Due 6 7 X 8 PART ~ TAX If you indicate a different tax rate. please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. ~dle (s~o~lished 2. Account Balance 3. Percent Taxable 2 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 PART ~ DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ facts have reported above are true, correct and 7:'\ -<?(lJL) (/17 ) WORK ( ) TELEPHONE NUMBER HOME -:~ ~ r- -~~~,-j(;-~ 'l~. ~!~~~ "~ ~,,_.~ ~",j ;"i~" f: ~ ..... ~ :~ ~::lI\> ~ ~ ~' :~~ ~ ~ii t~ "~ ~a f'<, 'f<-:.f :~..,.! ~t>..'. '."'~" t CL l:.} ';'..J', ~;.,J 0:: ~- "'.....~ ~r/ ....--.i ",J' ...,:!: CD " '{ j /'~ ~. 1.-1'-, i-'-:'~ ~: l:t Ct ~ ^' .... ,;~: :""$ :!: i~'~ ~ -f2. ~ ,-+- s.. '~JI) ~ \0 (.) -- J 0 0 ..:- \ -;? 0'- ,70 ~ ~'vCv c;: J G ~ -:;J :;!., ~ .9 :C ~ c ;...- .. ,,~ <.; "':;; ;s. :3 0 :.\~L. cJ '-J "'1 '.. m i) .,..1 'r" ,') .,..1 () ='.. .,../ ,.; Cl "'- ....0_ ......c:o ~~!::; Cl.l~-< :li!l!lo.. g!~...... .....9'= 't:'Q)::I: Cl.l >- 0.. .l:loo E ~=8 .(,