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Home My WebLink About09-30-08COMMONWEALTH OF PENNSYLVANIA DEPARTM~JJT OF REVENUE ~AU O~F INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 NO. CD 010345 MCBRIDE KEVIN 21 1 E WALNUT STREET SHIREMANSTOWN, PA 17011 fold ESTATE INFORMATION: FILE NUMBER: 2108-0976 DECEDENT NAME: MCBRIDE JOHN DATE OF PAYMENT: 09/30/2008 POSTMARK DATE: 09/29/2008 COUNTY: CUMBERLAND ~~ DATE OF DEATH: 08/06/2008 REMARKS: KEVIN MCBRIDE CHECK# 1060 ACN ASSESSMENT AMOUNT CONTROL NUMBER 08137387 ~ 5426.27 TOTAL AMOUNT PAID: 5426.27 INITIALS: WZ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA I N F O R MAT I O N N O T I C E F I L E DEPARTMENT OF REVENUE AN D BUREAU OF INDIVIDUAL TAXES AC N DEPT. 280601 I~'~aiX P/~1fE R R E S P O N S E HARRISBURG, PA 17128-0601 ., '~ '' -' DATE REV-1543 E% AFP CB9.00~~~ ~ ~ Zfi~'~~ C~y~ 'Q p;~ ~~~7 OF JOHN MCBRIDE S.S. N0. ~-~~ ~_-~, !".~ DATE OF DEATH 08-06-2008 O ~,~ ,~~OUNTY CUMBERLAND KEVIN MCBRIDE 211 E WALNUT ST SHIREMANSTOWN PA 17011 N 0. 21 - ol~.`U~ ' ~ ~~ 08137387 08-22-2008 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. i CU~YJ! ~, ~. +pa REMIT PAYMENT AND FORMS T0: 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 Pennsylvania. Questions may be answered by calling C717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 12311-05 Date 04-27-2001 7o insure proper credit to your account, two (2) copies of this notice must accompany your Established payment to the Register of Wills. Make check 19,942.67 Account Balance Percent Taxable X 50.000 Amount Subject to Tax 9,971.34 X .045 Tax Rate 448.71 Potential Tax Due PART TAXPAYER RESPONSE 't" ~ '_~Dt ~lL... ' !F.F I. payable to: "Register of Wills, Agent". NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5Y. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. A. I N The above information and tax due is correct. I[~ 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 CHECK 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 C ONE 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 2^ and/or PART 3^ below. PART If you indicate a different tax rate, please state your relationship to decedent: TAX RETURN - COMPUTATION 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 OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of perjury, I declare that the facts I have reported above are true ,G tort/rectP{a/nd compl e t of my knowledge and belief. HOME C7/ ~ ~C~ ~~~6 a ~{ "'~ t~! WORK C ~ g ~ ~ ~ ~~ TELEPHONE NUMBER AT 'J TA AVER SIGNATURE _ ~~, ~~ _. I '-~ ~~ n ~: f~ r1 f L';• r~ t1' + J {,~ t+'} ~1 7 3 ;_ ,1 `~~ `~-' y~~. '~~~..~ C r„....., ~ ` °a ~' f~ °~ ~?_J `~~~ ~^~-..~ c .. i '~'~.~ C~ V ` .~Y r ~-~^~-J 1, r~ ~~ .... V ~ t C3 a z ~ -y ~, A ~.~ ~- ~-~~- v e c C~ V r'.~ s~ti f''? ~~i ti .~, C.J ,~