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Home My WebLink About05-18-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BORDNER MARY A 3124 HARVARDSTON LOOP HOLIDAY, FL 34691-1028 REV-1162 EX(11-96) N0. CD 011261 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- told ESTATE INFORMATION: ssN: i s$-4s-3448 FILE NUMBER: 2109-0462 DECEDENT NAME: ANDERSON HILDA M DATE OF PAYMENT: 05/18/2009 POSTMARK DATE: 05/14/2009 couNTY: CUMBERLAND DATE OF DEATH: 01 / 1 5/2009 REMARKS: SEAL CHECK# 3437092656 091 19563 ~ S 18.85 TOTAL AMOUNT PAID: INITIALS: CJ RECEIVED BY: S 18.85 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE T,AX ~(2~'/ SOVEREIGN BANK 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 ioint 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS INFORMATION NOTICE: AND FILE N0. 21''~"~/ ~ BUREAU OF INDIVIDUAL TAXES p PD Box 2BO6B1 TAXPAYER RESPONSE ACN 09119563 HARRISBURG PA 17128-0601 * * ;*C;REVISED NOTICE ~ * * DATE 04-20-2009 REV-1543 EX AFP CQa-98 T' '- • '~ ---' TYPE OF ACCOUNT ~~~ ~~`~ '' ~ `~ /'~! EST. OF HILDA M ANDERSON ^ SAVINGS SSN 168-48-3448 ® CHECKING •"'t Cr- DATE OF DEATH 01-15-2009 ^ TRUST s`; --~_ ~:I~~j COl! ~- COUNTY CUMBERLAND ^ CERTIF. n, ~- ~ zi ~~P,~r~, ;~ .,- _. •. ,., -- REMIT PAYMENT AND FORMS T0: MARY A BORDNER REGISTER OF WILLS 3124 HARVARDSTON LOOP CUMBERLAND CO COURT HOUSE HOLIDAY FL 34691-1028 CARLISLE, PA 17013 Account No. 1681708221 Date 04-28-1999 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 $ 2,513.05 payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $ 418. $5 N07E: If tax payments are made within three 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 $ 18.85 nine months after the date of death. P~T TAXPAYER RESPONSE ~ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K 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 estate representative. C. ^ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to d'cedent: 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 OF ,TAX ON JOINT/TRUST ACCOUNTS 1 - - - 2 3 X 4 5 6 7 X 8 PAD OFFICIAL U5E ONLY ^ AAF PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I complete to the b st of m knowl ed e a d b li f have reported above are true, correc and ~ 4~ i ~ y,, g n e e . HOME ( 3~1 ) ~~~~ 1r`~~~ t ~'~~~ L'~ I~ti1 ~ti~~~ ~ ~'~~V CN-k~.-~ WORK C;3~j~ ) ~ "'~;~~5~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S PENNSYLVANIA INHERITANCE TAX Il2(~U INFORMATION NOTICE •AND FILE N0. 21-i~~"~~~~ BUREAU OF INDIVIDUAL TAXES - Po sox zso6ol TAXPAYER RESPONSE ACN 09119564 HARRISBURG PA lnza-ocol ~ - -*~- * "* 'REVISED NOTICE * * * DATE 04-20-2009 REV-1543 EX AFP (OB-OBJ ~~,~~ ~~.g•~ ~ G~ rr`~ ~: O ~ TYPE OF ACCOUNT EST. OF HILDA M ANDERSON ^ SAVINGS ~i -''',! ~',~ $$N 168-48-3448 ® CHECKING '~,~~: -';'~1+~'~ DATE OF DEATH O1 •• 15-2009 ^ TRUST ~J sly ' ~ _~ ~ ~ i ''1 ~;I.COUNTY CUMBERLAND ^ CERTIF. ni - , REMIT PAYMENT AND FORMS T0: ANDREW G ANDERSON REGISTER OF WILLS 3124 HARVARDSTON LOOP CUMBERLAND CO COURT HOUSE HOLIDAY FL 34691 CARLISLE, PA 17013 SOVEREIGN BANK 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 Yaws of the Commonwealth of Penn syivania. Please call c71%) i87-e327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1681708221 Date 04-28-1999 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 ,~` 2, 513. U5 payable to "Register of Wills> Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 418 • 85 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 18 • 85 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ^ The above information and tax due is correct. Remit Dayment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of C H E C K Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return D 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 ~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFICIAL US E ONLY U AAF relationship to decedent: PA DEPARTMENT OF RE1iENllE TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 I 2. Account Balance Z `~ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 ~ 6 6. Amount Taxable 6 ` X 7 7. Tax Rate 7 8. Tax Due 8 '~ $ PART DEBTS AND DEDUCTIONS CLAIMED 0 neTF Pain PAYEE DESCRIPTION AMOUNT PAID Under penalties af_„.perjury, I declare that the facts I have reported above are true, .co~rr/ect a d comet to the est of knowledge and belief. HOME c~1 7 ~ ~ LIS / S~/ _ ,~~ WORK ( r"f T AYER SIG A RE TELEPHONE NUMBER DATE IUTAL ltnLer on Lyle n ur ian mN.. ~o~~..~~. ~~ _ ., .- ~~_,,,~ L - -'~tf ~ C~ ,,. - .- :~ PA r~ u. ' ~' ~ ~ n ~. ~ ~ ~>: ~; ±.~: ~5 ~: ~ Y; ,~y ~ P -. ~ ~_. :~r ~. ~..~ ~:.; u <a ;~ ~` M rn t~ ~~ ~ J l~ .J v ~ ~ ~ r .~ `-'- ~ r ~. .~ '~~ ~ J ` ~ J ~ `~ J ~J (~, ;..~ ~~,~, F'~! S ~.~ ..1.. ~'{ .,.:, r•f