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Home My WebLink About03-30-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: REV-1162 EXI11-961 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMAS LINDA M 8 BOURBON RED DRIVE MECHANICSBURG, PA 17050 -------- fold ESTATE INFORMATION: SSN: 200-05-2802 FILE NUMBER: 2109-0296 DECEDENT NAME: TITUS BEULAH D DATE OF PAYMENT: 03/30/2009 POSTMARK DATE: 03/27/2009 couNTY: CUMBERLAND DATE OF DEATH: 1 1 / 1 7/2008 ACN ASSESSMENT CONTROL NUMBER N0. CD 01 1055 AMOUNT 09118345 ~ 58.57 TOTAL AMOUNT PAID: REMARKS: 58.57 CHECK# 463 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE 'TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES --,('•,- j"~• ~ AND PD Box zaB6o1 ~ ' ~' '- -~ TAXPAYER RESPONSE FUIRRISBURG PA 17126-0601 _ - ;~. .~.._.ua tti~~leee Lwa!ne 4' ... . FILE N0. 21~~~/-pag(p ACN 09118345 DATE 03-26-2009 ~~C° ~~,~ 30 Phi IZ~ 4~ r, ~]7 ~ i~ ~f ~~~~ !, ~i'l~ vJ LINDA M THOMAS 8 BOURBON RED DR MECHANICSBURG PA 17050 EST. OF BEULAH D TITUS SSN 200-05-2802 DATE OF DEATH 11-17-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PSECU 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 joint 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 C7177 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 8404902473-$4 Date 08-27-2003 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 1 , 142.22 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax pavnents are Wade within three Amount Subject to Tax $ 190 • 37 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 8 • 57 nine months after the date of death. PART TAXPAYER RESPONSE E i. A. The above information and tax due is correct. ~ Remit payment to the Register of Wills with two co pies of this notice to obtain a discount or avoid interest, or 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. C 0 N E ~ BLOCK B. ~ The above asset has been or will be revorted and tax p aid with the Pennsylvania Inheritance Tax return 0 N L Y 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 ~ u relationship to decedent: , •~ ~ PA DEE'~ ~ TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD ~~~"~ LINE 1. Date Established 1 ~ i~''~;" 2. Account Balance 2 $ 2 '""~'' ' 3. Percent Taxable 3 X ;9 ~ y ,. 4. Amount Subject to Tax 4 e , i. 5. Debts and Deductions 5 ~ ~ ~• 6. Amount Taxable 6 $ 4 ~ s --~ 7. Tax Rate 7 X 7 8. Tax Due 8 $ ~ 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE P AID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, ~orrecCt7 and comryT~~e to the b~ o ~ my knowledge and belief . HOME C /~~7) ~9 ~~` ~' S~7 '~~I.~~i`~~ WORK c 1i `7) f~U~~~ (~ TSB U~L~ TELEPHONE NUMBER D TE TOTAL CEnter on Line 5 of Tax Computation) S nt R% ~`" , {~ w~ i.~ 9~.. ~%: '~~+ cxl ~~ ~ [Sw~ ~~ j ~~ ~f; ;,,, ~ ~ ~ *3,. t'q. ~~' ;"` ~~,, _ . ~, __CJ~n$I {~1 _ lei it;;~ ,f ~ ~H'~d~O .~ ~ :zi ~~ a ~ ~nw E~ox ,.~., ~~o ~ v- ~ d ~.~n-~.. ~~'~~ tT~ f~, 4'` ~ ;~~ f'~~ .,.:, i;~~ n~t