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Home My WebLink About05-27-08 COMMONWEALTH OF PENNSYLVANIA 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 COYLE JACQUELINE K 1213 MALLARD ROAD CAMP HILL, PA 17011 -------- fold ESTATE INFORMATION: FILE NUMBER: 2108-0459 DECEDENT NAME: LITTLE BETTE D DATE OF PAYMENT: OS/27/2008 POSTMARK DATE: OS/27/2008 COUNTY: CUMBERLAND DATE OF DEATH: 04/03/2008 NO. CD 009786 ACN ASSESSMENT CONTROL NUMBER AMOUNT 08122466 I $226.59 08122465 I $37.58 I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 234 SEAL INITIALS: CJ RECEIVED BY: REGISTER OF WILLS $264.17 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 -- _"ii.' c: Ikk..:;~ 'EX~P co.-m INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-0~... oysq 08122466 05-23-2008 JACQUELI~K COYLE 1213 MALLARD RD CAMP HILL ZOOBHAY27 PH 1:28 EST. OF BETTE D LITTLE S.S. NO. DATE OF DEATH 04-03-2008 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS !iI CHECKING o TRUST o CERTIF. CLEFil( OF ORPHAf\!'S COURT Cr 'f)'":'-'-: DA v,. !', PA 17011-1222 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU 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 PennSYlvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW * · · SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0168142609-S4 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART [!] Date Established 01-25-1983 To insure proper credit to Your account, two (Z) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x 10,070.61 50.000 5,035.31 .045 226.59 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 [CHECK ] ONE BLOCK ONLY 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 '~" 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 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 I 2 3 X 4 5 6 7 X 8 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 f!1 DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCR I PTI ON AMOUNT PAID T AY SIGNATURE facts I have reported abOve are true, correct (7~) 7&3-9Y7~ WORK (7/ ) ~/ 3 -35"0{0 TELEPHONE NUMBER 5~/oc? DATE HOME and -- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG, PA 17128-0601 1_- -JIM___ "~.- rL\..):.~!. I INFORMATION NOTICE AND TAXPAYER RESPONSE 21 -o~ ~DVSq 08122465 05-23-2008 REV-15tt3 EX AFP (09-00> FILE ACN DATE NO. 2008 MA Y 27 PH ,: 28 CLERK OF GRDl{\\II,,, "QURT If i l;!\~.) tj~ I ClH . \!- '-':~'. p.~ EST. OF BETTE D LITTLE 5.5. NO. DATE OF DEATH 04-03-2008 COUNTY CUMBERLAND TYPE OF ACCOUNT fi] SAVINGS o CHECKING o TRUST o CERTIF. JACQUELINEK COYLE 1213 MALLARD RD CAMP HILL PA 17011-1222 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU 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 Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0168122609 Date 01-25-1983 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 1,670.12 X 50.000 835.06 X .045 37.58 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 [!J [CHECK] ONE BLOCK ONLY A. r1I 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. B. 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. 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 RETURN - COMPUTATION If YOU indicate a different tax rate, please state your relationship to decedent: OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 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 Under penalties of perjury, I declare that the facts complete to the best of my knowledge and belief. have reported above are true, correct and HOME ( I WORK ('7/ TELEPHONE r . '\ '\ \. \t .~ \ I 11 q ~ IIUSA fI"~!A? / T,1 . ..i :~, \, \ '; '\\' .', ~, ) \~ /JIll,} \\\(\~ H 1-'- 1'- l/ 'F. c{ "'i" a. ~ 0 t~ .~ ~: .... j:( 1 .; ..., 'r fO h V; >- .... tt < ,..., 'lr. "*' ~ <( .q-' X h B~;:2 >-.0:::: _ 0" U'-<t:: u.$o.. .5 C; ~ :~~= ,:: ;.;= C"M ..... , u _ Q. , ~N l== -._~ U :.fi,_..', 2008MAY27 Pt'j 1:28 ,.- - C' F""'/ nr L.....Hi\ ur ORPH"" ",-, r,n, fry'" f !/I.>,,:) ',~;,..J~)r'i I cur\t~'.:".:'- Dt~. ~ "- p " (I.~ J'n 1':'! (t) I.,:, ',' ~ '",:' ",,1 !:::: f'.' .....: