HomeMy WebLinkAbout11-12-09COMMONWEALTH OF PENNSYLVANIA
DEP~^-Tt.'~NT OF REVENUE
UREAU OF INDIVIDUAL TAXES
DEPT. 280605
HARRISBURG, PA 1 J 128-0605
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
N0. CD 010754
TOLAND LYNN M
1003 EAST COOVER ST
MECHANICSBURG, PA 17055
-- - gold
ESTATE INFORMATION: SsN: 022-2a-8798
FILE NUMBER: 2108-1168
DECEDENT NAME: GORDON CATHERINE H
DATE OF PAYMENT: 01/12/2009
POSTMARK DATE: 01/10/2009
COUNTY: CUMBERLAND
DATE OF DEATH: 10/23/2008
REV-1162 EX111-961
AMOUNT
08164136 ~ 5227.03
TOTAL AMOUNT PAID: 5227.03
REMARKS: LYNN TOLAND
CHECK#2217
INITIALS: WZ
seal RECEIVED BY: GLENDA EARNER STRASBAUG
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 200601
HARRISBURG PA L]120-0601
acv-isas cx. u?.eua: ma:
YtrvrvJTLVArv1H irvnGrta]Anl.¢
INFORMATION NOTICE
AND
" ``frAXPAYER RESPONSE
2~~9 JA ~i ~ 2 s'H 12~ C' 1
CL-"tK OF _
LYNN M TOLAND C~~~.._. ,?~~~.~~ ~~
1003 E COOVE ST
MECHANICSBURG PA 17055
FILE N0. 21 08-1168
ACN 08164136
DATE 12-26-2008
EST. OF CATHERINE H GORDON
SSN 022-24-8798
DATE OF DEATH 10-23-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SUSQUEHANNA BANK vrovided the Oevartme nt with the information below, which has been usetl in calculating the
vptential fax tlue. Re rortls intlicate that at the tleath of khe above-named tlecedent, you were a faint owner/beneficiary of this account.
If you feel the information is incorrect, al ease obtain written correction from the financial institution, attach a copy to this form
and return it tD the above adtlress. This account is taxable in accordance with the Inher if once Tax laws of the Comm pnwealth of
Penn svlvania. Please call i7i]) 767-032] with Hues ti ons.
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT TNCroiirrinuc
Account No. 4600414709 Date 08-29 -2000
To ensure prover cretlit to the account, two
Established copies of this notice must accompany
Accpunt Balance $ 10,620. 89 Davment tp the Register of Wills. Make check
Percent Taxabl¢
X payable to "Register of Wills. Agent".
50. 000
Amount Subject to Tax $` 5,31D. 45 NOTE: If tax payments are made within three
Tax Rate months of the tle cedent's tlate of death.
X . 0 45 tleduct a 5 percent tliscount on the fax tlue.
Potential Tax Oue y` 23 B 9 7 Anv Inheritance Tax due will become tlelin muent
nine months after the tlate of death.
PART .~.--. -..__ _
r CHECK
I ONE
L BLOCK
ONLY
A. ^ the above information and tax tlue is correct.
Remit payment fo the Register of Wills with two copies of this notice to obtain
a tliscount pr avoitl interest, or check box "A" and return this notice to the Register of
Wills antl an official assessment will be issuetl by the PA pepa rtment of Revenue.
The above asset has been or will be re portetl antl fax paid with the Pennsylvania Inheritance Tax return
to be filed by the esf ate represent alive.
L. ~ The above inf orma fan is iota rrect and/or tlebfs and deductions were paid.
Complete PART 2~ and/or PART 3^ below.
PART If indicating a dif to rent tax rate, please
relationship to decetlen t:
TAX RETURN - COMPUTATION OF
LINE 1. Date Es to blisned 1
TAX ON JOINT/TRUST ACCOUNTS
2. Account Balance 2 $
3. Percent Taxable 3 X
4. Amount Subject tp Taz 4
5. Debts and Deductions 5
6. Amount Taxable 6 .~
7. Tax Rate 7 X
e. Tax Due a $
PART DEBTS ANDDEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
er on lin¢ 5 of Tax
Un tler penalties of perjury, I declare that the facts I have reported above are true
comp to to the best of my knowledge and belief.
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