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Home My WebLink About05-14-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MITCHELL JOHN J.P. 839 RIDGEWOOD DRIVE MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: ssrv: 204-78-0883 FILE NUMBER: 2109-0294 DECEDENT NAME: MITCHELL GERTRUDE I DATE OF PAYMENT: 05/14/2009 POSTMARK DATE: 05/13/2008 COUNTY: CUMBERLAND DATE OF DEATH: 02/ 1 7/2009 REMARKS: CHECK# 3729 SEAL REV-1162 EX(11-96) NO. CD 01 1234 ACN ASSESSMENT AMOUNT CONTROL NUMBER 09503418 ~ 52,777.96 TOTAL AMOUNT PAID: 52,777.96 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REY-1543A AFP C7-00) INFORMATION NOTICE FILE N0. 21 09-0294 AND ACN 09503418 TAXPAYER RESPONSE * REVISED NOTICE * ~ * DATE 05-05-2009 JOHN J MITCHELL 839 RIDGEWOOD DRIVE MECHANICSBURG PA 17050 TYPE OF ACCOUNT EST. OF GERTRUDE I MITCHELL ^ SECURITY S.S. N0. 204-18-0883 X^ sEC ACCT DATE OF DEATH 02-17-2009 ^ sTOCK COUNTY CUMBERLAND ^ BoNDs REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 STIFEL NICOLAUS 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 beneficiary of this asset. If you feel this information is incorrect, please obtain written correction from the transfer agent, 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 (71'7) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5385-3049 To insure prover credit to your account, two C2) copies of this notice must accompany your DOD Valuation 370,387.00 payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Percent Taxable X 16.667 N07E: If tax payments are made within three Amount Sub]ect to TaX 61 , 732 • 40 (3) months of the decedent's date of death, Tax Rate X .045 you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 2, 777 • 96 nine (9) months after the date of death. P~T TAXPAYER RESPONSE 1 FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE A. The above information and tax due is correct. _ 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 b ox "A" and return this notice to the Register of C H E C K C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 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 ~ pFFICIAL USE ONLY ^ AAF relationship to deceden t: PA DEPARTMENT OF REVENUE TAX RE TURN - COMPUTATION OF TAX ON ABOVE ASSET(S) iPAD LINE 1. DOD Valuation 1 ~ I 2. Percent Taxable 2 X f 2 3. Amount Sub]ect to Tax 3 3 ~: 4. Debts and Deductions 4 - i 4 5. Amount Taxable 5 5 6. Tax Rate 6_ X 6 7. Tax Due 7 7 PART DEBTS AND DEDUCTIONS CLAIMED DATE P AID PAYEE DESCRIPTION AMOUNT PAID TA~'AYER SIGNATURE TELEPHONE NUMBER D Under penalties of perjury, I declare that the facts I have repot-t~ed"7above are true~j, correct and com ete o the best ,~o:f~my~k"no ledge and belief. HOME C /1 ( ) 73~-JI~L_ ~9~~ !~%~Lc.~~d(l/~ woRK c 71 ~7) ~~7 T~~fi~ C~~. f~ 4~ ~~. ~~.~ ;., ~~ ~ n _ . ~. ` .. ~i ~~ t L~ ~~~ R: 22 ~ ~l9 ~i V ~, '?`~ ~. r ~. ,~ ~, ~~ ~ ~ ~~ `~ ~ ~ ~~ ~~~ ~. ~ ~ V "`1 J \ „ ~~.~ '~ ~ry^7 Y `7`~ { ' v 4 V ~, lu ;fit }~~ '~ N't