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Home My WebLink About04-01-08 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 DONNELLY C W 1 AMHERST DRIVE CAMP HILL, PA 17011 _n_____ fold ESTATE INFORMATION: SSN: FILE NUMBER: 2108-0366 DECEDENT NAME: TILLER HELEN W DATE OF PAYMENT: 04/01/2008 POSTMARK DATE: 03/31/2008 COUNTY: CUMBERLAND DATE OF DEATH: 11/20/2007 NO. CD 009486 ACN ASSESSMENT CONTROL NUMBER AMOUNT 08111044 I $36.46 08111043 I $36.46 I I I I I I I TOTAL AMOUNT PAID: $72.92 REMARKS: CHECK#1649 INITIALS: CJ RECEIVED BY: SEAL REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS - COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 1712B-0601 r~~F~~HATION NOTICE .,," , '\jl.- ".' AND \\j~ C:T~.~~~YER RESPONSE FILE ACN DATE NO. 21-0~" ()~/'" 08111044 03-12-2008 REV-lS43 EX AFP (09-QO) I 2U08 APR - l PM l: 2it EST. OF HELEN W TILLER CLERKOF S.S. NO. QRPI-\PN'S CQUfflATE OF DEATH 11-20-2007 CUMBEPLtI!'~D Co.~P.JlNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [i] CHECKING o TRUST o CERTIF. C W DONNELLY 1 AMHERST DR CAMP HILL PA 17011 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BELCO COMMUNITY CU 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 ~f pc~n~~1~3~ia Q~~~~i~~~ m~y b~ =..~~~i~d by ~Q:I~ng ~717) 7g7~e~27. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 711190 Date 11-09-1992 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 4,860.97 X 16.667 810.18 X .045 36.46 TAXPAYER RESPONSE NOTE: If tax payments are made wi.thin three (3) months of the decedent's date of death, you may deduct a 5% discount of the ta" due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] 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. X PART [3J TAX If you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1- Date ~.:tiao:i..lsi1tHi 2. Account Balance 2 3. Percent 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 @] DATE PAID PAYEE X DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ that the facts and belief. correct and J i;1'i / cG OATE' - COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B060I HARRISBURG. PA I7I2B-060I NO. 21 -lft-{)'bfe& 08111043 03-12-2008 ~tF'C~~EORMATlNorr NOTICE I." TAXPAYER RESPONSE I ; ! ~ '_ FILE ACN DATE " ,. .-1, :' \_ ,."l_l I\".. REV-lS43 EX AFP (09-00) I TYPE OF ACCOUNT o SAVINGS [i] CHECKING o TRUST o CERTlF. 2008 APR -I PH I: 24 EST. OF HELEN W TILLER S.S. NO. DATE OF DEATH 11-20-2007 COUNTY CUMBERLAND CLERK OF ORPHAN'S COURT CUMBERLANO CO., PA REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ROBERTA S DONNELLY 1 AMHERST DR CAMP HILL PA 17011 BELCO COMMUNITY CU 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 P13nnsylvania. Questions may be answered bY calling (717) 787-83~7. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 711190 Date 11-09-1992 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 4,860.97 X 16.667 810.18 X .045 36.46 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 'he tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!1 [CHECK ] ONE BLOCK ONLY A. 00 The above information and tax due is correct. I. 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. 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. c=J The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. 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. !}ate Es'tablishcd 2. Account Balance 2 3. Percent 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 @] DATE PAID PAYEE X X DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID that the facts and belief. have reported above are true, correct HOME (117)1f.., I - IJ/(J WORK ( ) TELEPHONE NUMBER and O. Z~.Of\ DAT ---.J - , ,:. .. I . ,.' ., N ~ ~. J , ,-" '~J U..J .:.~:! , , ~;~- '-- ....,'>P" 't~~::) DC:':, I \ I LJ..J ~f~ 0:: .. ;. I " .. ,.- . .;. ,.- C) 1-- 1'- 'r-' ..... o .... I"- ., >;....:4: ~OD- c ....... -: ~~I O.ca. . c: ,.. 5;....c .4: ell U..-U .. - (I) UI :J (;) tt J: t,;:, t:: =so 1..1.-00 :J 000 0 ~<.(J:;?,; 0 (II') ~~~' 0 0 oct - 0 ,.... ~ ~ "<C O;c.. .... - .. (I) .... 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