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Home My WebLink About07-16-09 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 01 1496 MURRAY MARSHA SIMPSON 855 ORBS BRIDGE ROAD MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: ssN: isa-22-7695 FILE NUMBER: 2109-0656 DECEDENT NAME: SIMPSON JACQUELYN DATE OF PAYMENT: 07/ 1 6/2009 POSTMARK DATE: 07/15/2009 couNTY: CUMBERLAND DATE OF DEATH: 06/27/2009 REMARKS: CHECK#1119 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 09142496 ~ $3.79 09142494 ~ $3.79 REV-1162 EX111-961 TOTAL AMOUNT PAID: INITIALS: CJ RECEIVED BY: 57.58 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE NO. 21 -C'~-~(prjfp PO BOX 280601 ,i.{ `~ r-~ r,..«- HARRISBURG PA 17128-0601 _~ ~. ~.~ ~"A~CRy4YER RESPONSE ACN 09142496 "_ ,'.; DATE 06-12-2009 REV-1543 IX aFP (08-OBI ~' f .'~ti i L.i '/' ~ .... X009 JUL 16 A~ ~) ~ l~ST. OF JACQUELYN SIMPSON SSN 188-22-7695 C~E~i~ CF DATE OF DEATH o6-27-2009 ORFH~~';~ t~}URT COUNTY CUMBERLAND C~~~~~.`»~i ,~-` ~~ (J:~ ~A, REMIT PAYMENT AND FORMS T0: MARSHA MURRAY REGISTER OF WILLS 855 ORRS BRIDGE ROAD CUMBERLAND CD COURT HOUSE MECHANICSBURG PA 17050-2137 CARLISLEr 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 C7i7) 787-4327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1 72645-1 1 Date 12-15-1947 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 $ 504.77 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NDTE: If tax payments are made within three Amount Subject to Tax ~` 84.13 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 $ 3 • 79 nine months after the date of death. PART TAXPAYER RESPONSE IIIL(.D~Far'Ta R~^.P. ULT I €~fF ICIAL TIC ASSEeSSMENT A. F~'The above information and tax due is correct. ~L1 Remit payment 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 CHECK Wills and an official assessment will be issued by the PA Department of Revenue. C ONE 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 estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3L1 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 OF TAX ON JDINT/TRUST ACCOUNTS PAD 1 2 3 X 4 5 6 $ 7 X 8 OFFICIAL USE ~7NLY ~ AAF PA DEPARTMENT DP' REVENUE 1 2 3 4 5 6 7 - - 8 PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID 1 ~~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES ~'i"} n~ ~.-~ x _ AND FILE N0. 21-(~-d~PS~ PD aox 2ao6B1 ``-' ~-'..i..r ~ TAXPAYER RESPONSE ACN 09142494 HARRISBURG PA 17128-0601 \~;i ~~., ti °! DATE 06-12-2009 REV-1543 EX AFP (08-08) " Z0~9 JUL 16 AM ! f ~ 1 b GLER~t OF ORPHA,(i±'S COiIRT MARSHA MURRAY 855 ORRS BRIDGE ROAD MECHANICSBURG PA 17050-2137 EST. OF JACQUELYN SIMPSON SSN 188-22-7695 DATE OF DEATH 06-27-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE 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 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 Pe~~nsylvania. Please call (717) 787-8327 with vuestions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 172645-0 0 Date 12-15-1997 To ensure proper credit to the account, two Establ ished copies of this notice must accompany payment to the Register of Wills. Make check Account Balance 1 731 .81 ~ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax Davments are made within three Amount Subject to Tax $ 288.64 months of the decedent's date of death, Tax Rate )( . 0 4 5 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due 1 2.9 9 nine months after the date of death. P r TAXPAYER RESPONSE ~ ~ 'FAILt~i~iTO RESPOND WALL RESULT IN AN 0 ICIAL TAX A55E5SMENT A. WT The above information and tax due is correct. ~J Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid i nterest, 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. C ONE ~ 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 estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3LJ 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 OFFICIAL U5~E ONLY [~ PA DEPARTMENT OF REVENUE OF TAX ON JOINT/TRUST ACCOUNTS ,PAD 2 $ ~ 2 3 X 3 4 $ 4 5 5 6 $ 6 7 X 7 B '~ 8 DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and - y.ym lete to a be t of,~~m knowledge and belief. HOME C ~ WORK C ) AXPAYER SIGNATURE TELEPHONE NUMBER DATE