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Home My WebLink About12-05-08COMMONWEALTH OF PENNSVIVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA%ES DEPT HARRISBURG, PA iJ12R-0601 RECEIVED FROM: EDENBO LEON 205 WOODLAWN LANE CARLISLE, PA 17013 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 N0. CD 010600 ACN ASSESSMENT AMOUNT CONTROL NUMBER ,old ESTATE INFORMATION: ssN: FILE NUMBER: 2108-1209 DECEDENT NAME: EDENBO JEAN DATE OF PAYMENT: 12/05/2008 POSTMARK DATE: 12/05/2008 COUNTY: CUMBERLAND DATE OF DEATH: 10/17/2008 08152542 ~ 555.71 08152543 ~ 595.12 TOTAL AMOUNT PAID: REMARKS: LEION EDENBO SEAL CHECK#752 INITIALS: WZ RECEIVED BY: S 150.83 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE /~ ^~ BUREAU OF INDIVIDUAL TAXES AND FILE NO. 21 -VO- (d~ PD Box zegsol TAXPAYER RESPONSE ACN 081525v42O HARRISBURG PA 17128-0601 DATE L1-07-2008 REV-1543 E% KP (OB-O B) TYPE OF ACCOUNT EST. OF JEAN EDENBO ® SAVINGS SSN ~ CHECKING DATE OF DEATH 10-17-2008 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS TD: LEON EDENBO REGISTER OF WILLS Iv 205 WOODLAWN ~ LAN ~ CUMBERLAND CO COURT HOU~ ° m CARLISLE PA 17015 CARLISLE, PA 17013 =~' o ' C O T'! ni ~ ~ r-q t G)< .,'cnT ~ 17 r `~~-;c: ~y ,_, c MEMBERS 1ST FCU provided the Department with the information below, which has been Ttal cu+y~1nB tMYI potential tax due. Records indicate that at The tle ath of the above-nametl decedent, you were a joint owner/b iarv of TTis accoNnE If you feel the information is incorrect, please obtain wrikken mrreciion from The financial institution, a copy ti~this Fa~RyG antl return it to the above atltlress. This account is taxable in accortlance wikh the Inheritance Tax laws of a Commonweal4fi of I " _ Pennsvly ania. Please call (717) 787-8327 with questions. 'T ~ COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS~'~ Account No. 251347-0 0 Date 09-21-2004 Ta ensure proper credit to the account, two Established copies of this notice must accompany pavm ant to The Register of Wills M k h k Account Balance $ 2 476 11 a e c ec " , . payable to Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax Payments are matle within three Ampunt Subject to Tax S` 1,238.06 ' months of the decedenk s tlate of death, Tax Rate X . 0 45 tletluct a 5 percent discount pn the tax due. Potential Tax Due g 55.71 Anv Inheritance Tax due will becgne delinquent i n ne months after the tlate of death. PART TAXPAYER RESPONSE ~ 4 3 A m. ~ m B 6B~$~aA~j$y~ E B B B~~q(~ p ~@ ~ '¢ V ~ ~ A. s B . w `S R~68 B . ...e e A ~ B Aa S e.A'.. ~eQ 8..e.: Ax .%A. P}B~ ,,~~ A. h)~ The above information and tax tlue is correct. uu Remit payment to She Register of Wills with two copies of This notice to obtain CH EC K a disc ount or avpitl inkerest, or check box "A" and return this notice to the Register of Wills antl an official assessment will be issuetl by the PA Departmenk of Revenue. ONE BLOCK B. ~ The above assek has been ar will be reported antl tax paid with the Pennsylvania Inheritance Tax return ONL Y to be file d by the estate rep rasentative. C. ~ The above inFOrma eon is incorrect and/or debts antl deductions were paid. Con pl ate PART ~ and/or PART ~ below. p pR7 If indicating a different tax rate, please state ~~gBeno;~~g~~g{¢ ~`~`~ ~~`. '_~" relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 +S ~ ~ °. X ~ 3. Percent Taxable 3 $ ~~a a e ~ 2'r Aav 4. Amount Subject to Tax 4 ~ 5. Debts end Deductions 5 a~° ~ ~ap a~® , ~ ® ~ 6. Amount Taxable 6 $ a a Be BAB ~¢ 7. Tax Rate 7 X i B~~ x~ ~A ! A 8. Tax Due e ~ A@~ 8 ~,~'ax ~A `a~B ~ ~~AB^. PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOONT PAID Under penalties of perjury. I declare that the Facts I have reported a~-b3o ve are trueJ,/~c or racy and complete to the best of my knowledge apn d~beli ef. HOME ( / 7~ ) ~_/ `9 ~~~~ ~ p ~ :i('/. y WORK ( ) ~~ •S_p 1M~X IXPAYER SIGNATURE TELEPHONE NUMBER DATE U V PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND Po Box zagsel TAXPAYER RESPONSE HARRISBURG PA 1]128-0601 REV-1543 E% ,sr (OB-O B) FILE N0. 21 ~~ ~ I~" , ACN 88152543 DATE 11-07-2088 LEON EDENBO 285 WOODLAWN A'4E'NQE La~'~ CARLISLE PA 17015 EST. OF JEAN EDENBO SSN DATE OF DEATH 10-17-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17813 C~ MEMBERS 1ST FCU provi tled khe Depa rtmenk with the information below, which has been ( potenkial tax due. Reco rtls intli cafe that at Me tleath of the above-named decetlenk, you we ra a joint owner/be If you feel the information is incorrect, please obtain written correction fron the financial institution, at and return it to the above adtl ress. This account is taxable in accordance with khe lnhe ritance Tax laws of t Pennsvlvania. Please call O1]] ]8]-8327 with queskions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSI Account No. 251347-11 Account Balance Percent Taxable Amount Subject to Tax Tax Rata Pptential Tax Due Date 89-21-2804 Established $ 4,227.34 X 50.800 S 2,113.67 2 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. r~ a O -: r'~ ~a2)culat~ the ~0'~ -~~ ~911f kha3ac count; ~~-~ sopY to hiis foriyd_ (.r( ms`s 1...' IONS IV To ensure proper credit to the account, two copies of this notice must accon pane pavnent to the Register of Wills. Rake check payable to "Register of Wills, Aeank". NUTE: If tax pavm ents era matle within three Wont hs of the tlecedent's tlate of death, tletlu ct a 5 percent discount on the tax tlue. Anv Inheritance Tax tlue will becane tlelinquant nine months of ker the date of tleath. A. I.II The above information antl fax tlue is correct. LI Renit paynent to the Register of Wills with two copies of this nokico to obtain CHECK a discount ar avaitl i nterest, er check box "A" antl return this notice to the Register of Wills antl an official assessment will be issued by the PA Department of Revenue. ONE BLOCK B. ~ The above asset has been or will be reported antl tax paid with khe Pennsvlvania Inheritance Tax return ONL Y to be filed by the estate representative. C. ~ Tha above inf orma eon is incorrect antl/or debts antl tleductions were paitl. C Deplete PART 2~ and/or PART 3^ below. PART If intlicating a different tax rate, please state ~~~P~~~i~~~al` r~ l ei{ E g relationship t0 de oetlent: ~~~1 d ~~ y TAX RETURN - COMPUTATION OF TAX ON JDINT/TRUST ACCOUNTS ~~ ~'soe~~~~~a¢ e 't~ ~~rpl~a ~i5(~(~~e «~ LINE 1. Date Established 1 e}'e~p~~(@~e~re ~~ +P~~J ;~~~{~iiF,r~~~,re~~"~ ~Y~~t~; ed $ e ~~~'a `° ¢ ~ ~ B~U~4 ~ ` ~ 2. Account Balance 2 ~ r e r td ~ ~ ~~ 3. Pe rc ant Taxable 3 X ea ~~~a.¢~a ~~~Be Oo~d ~ a~ rh"e(.a'~~e~'~~,a~~~ ~a~'e $ ~ ~ e^~e" ~ ~~ ~ e f e ~ 4. Amount Subject Yo Tax 4 ~~ a °~ ~ ~® ' Fe~~'~ ~e t ~ME ¢'~ 5. Debts and Deductions 5 - ~~fR ~~~~~~~~le 8 ~ a ie `®t ~' ~ ~@~~ir8:~ea~~nf( 9€r 4 ~ ~~ '~~~'' B U B B 6. Amount Taxable 6 $ 64 P ~ee~^d"a" ~ee~~~~~°,T'r ~, ~ ~ ~ ~ ~~,al,~~~,~_,~d~ +~i^~~d4 ~~~® J ~~'~e® tlT e~ 7. Tax Rate 7 X e ~ e° ¢ee eSla .,~ T ~a e~~a ¢ e~ 34e a s sa +$,e ae "eaTaeT~s }8 av] s ''i a,~ sa"~~b4e3tr a~ ~d~a e a ~f. ®.~ a I e 8. Tax ^ue 8 $ ed "°~®~ e' aP ~e e T ® , i~ ~~a ¢ a -e ge¢~~, a p~ .. .. a .: ... ® -. .... ,. PART DEBTS AND DEDUCTIONS CLAIMED DATE P AID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above era kru e , eor rect and complete to the best of my kn ow l~ d ge antl belies. ~ / H ME (~ ~ 7 ~ ~ 2 x 7f ~ ~ ~ O ) ` 0 . - ~ TAXPAYER SIGNAT RE TELEPHONE NUMBER DATE v V I