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Home My WebLink About03-16-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 01 1004 HARLE MARJORIE 47 FOREST DRIVE MECHANICSBURG, PA 17055 told ESTATE INFORMATION: ssN: 204-26-ss~ i FILE NUMBER: 2109-0252 DECEDENT NAME: MAXWELL HELEN DATE OF PAYMENT: 03/ 1 6/2009 POSTMARK DATE: 03/13/2009 COUNTY: CUMBERLAND DATE OF DEATH: 02/06/2009 REMARKS: CHECK#1735 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 09110112 ~ 599.99 TOTAL AMOUNT PAID: REV-1162 EX(11-96) 599.99 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 .^ HARRISBURG PA 17128-0601 r~r REV-1543 IX RFP (OB-087 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~~' -; r :__~~~~"'~- r~, AND ~. ~ ~ ~-- '~/Y7~PAYER RESPONSE FILE ND. 21-(~-UZSZ ACN 09110112 DATE 02-20-2009 Z~09 BAR ~ 6 ~h ~• EST. OF HELEN MAXWELL SSN 204-26-9911 CLERK; Ci DATE OF DEATH a2-o6-2009 QRPNP,~ ~ COI~RT OUNTY CUMBERLAND Cl~' er''r., `,~,. i EMIT PAYMENT AND FORMS T0: MARJORIE HARLE REGISTER OF WILLS 47 FOREST DR CUMBERLAND CO COURT HOUSE MECHANICSBURG PA 17055 CARLISLE, PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If you feel the 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. Please call C717) 757-8327 witi: questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 176833-00 Date 06-24-1998 Established Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due A CHECK ONE BLOCK ONLY $ 4,677.87 X 50.000 $ 2,338.94 X .045 $ 10 5.25 ""- To ensure proper credit to the account, two copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent d;~cene± on the tax due. Any Inheritance Tax due will become delinquent nine months after the date of death. IAArATCR RC.II"UR.It ~"I.'( ~~~~~ I L- //~~~{~~~-may The above information and tax due is correct. ~"~ `,'_ l^~ Remit payment to the Register of Wills with two copies of this notice to obtain 1 a discount or avoid interest, or 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 ar will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state 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 PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE IUTAL cEnter on Line 5 of Tax Computation) 8 . s ~Jj V s .a ta, ` ~ ti/ ~. s~ ~,, ~.* ~~ +~. ~~ l ^ T ~ i +~` V'L.,:i, '.'-J Lam' uE :? ;~ yn~ l~(l0~ S,N~; i - v ~~ ~ I Z =Z W~ ~ ~ ~~'~ 6~GZ ~~ ~ ~ ~ ~ ~ ~ _: ,-, ;, ..... ~. w ~.: r .~ ~:. +`... r` i